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At least 883 records · Page 49Linked to original sources

Quantifying the effects of exposure to indoor air pollution from biomass combustion on acute respiratory infections in developing countries.

Acute respiratory infections (ARI) are the leading cause of burden of disease worldwide and have been causally linked with exposure to pollutants from domestic biomass fuels in developing countries. We used longitudinal health data coupled with detailed monitoring and estimation of personal exposure from more than 2 years of field measurements in rural Kenya to estimate the exposure-response relationship for particulates < 10 microm diameter (PM(10)) generated from biomass combustion. Acute respiratory infections and acute lower respiratory infections are concave, increasing functions of average daily exposure to PM(10), with the rate of increase declining for exposures above approximately 1,000-2,000 microg/m(3). This first estimation of the exposure-response relationship for the high-exposure levels characteristic of developing countries has immediate and important consequences for international public health policies, energy and combustion research, and technology transfer efforts that affect more than 2 billion people worldwide.

Acute Disease↗

Sticking to the knitting: CIHR, innovation and Canadian biotech.

The novel proposal outlined by Glenn Brimacombe suggests that the federal government directly participate in funding incremental venture capital investment in Canadian biotechnology, with the goal of facilitating commercialization of Canadian biotechnology and health sciences intellectual property. In this way, they suggest, the economic development benefits of the Canadian current investment in health sciences will be increased. The proposal is based on two premises that need further evaluation: (1) the biotechnology sector in Canada presently underperforms in terms of value creation; (2) this underperformance is due to inadequate venture capital investment. It is the author's view that, although several measures do suggest relative system underperformance, this is likely due to structural differences rather than inadequate venture capital investment. The absence of large, integrated, global biopharmaceutical firms based in Canada, the large number of very small biotech firms and the absence of a clear federal policy mandate supporting technology transfer and underinvestment in public sector funded basic research may all be contributory factors. Given the Canadian biotech sector's current efficiency at creating value from limited public investment in basic science, increasing the core CIHR budget might be an even better investment opportunity for limited incremental funding.

Biotechnology↗

Genetic approaches for biologic therapy of cancer.

Recently, there has been an increase in the types of biological therapeutic approaches developed for the treatment of cancer. This rapid advance in the biological therapy of cancer is due in part to advances in the field of molecular and cell biology as well as in the development of gene transfer systems. In particular, a better understanding of the mechanism of antigen presentation and T lymphocyte activation has resulted in the development of new immunotherapeutic strategies targeting tumor-associated antigens (TAA). The discovery of dendritic cells (DC) as potent antigen presenting cells and the development of methods for their use in immunotherapeutic regimens has led to novel approaches for treating cancer. Furthermore, the identification of genes encoding TAA and their peptide products, which are recognized by T lymphocytes in the context of major histocompatibility complexes class I and class II molecules, has led to the development of DNA-based vaccines against defined tumor antigens. Cytokines have been shown to be important adjuvant tools for immunization protocols by directing a T helper response favorable for an adequate cytotoxic T lymphocyte-mediated immune response. Novel gene transfer technologies have made it possible to employ a wide range of gene delivery systems, either viral or nonviral based, in anticancer therapies. Current immunotherapeutic strategies, including the use of DC transduced with genes coding for tumor antigens and cytokines delivered by recombinant viral vectors, have shown promise in animal tumor models.

Journal Article↗

The supply and use of selected medical technologies.

Over the years, both government and the private sector have used a mix of regulatory controls and competitive market incentives to reduce the rate of spending and minimize excess capacity in health services. Despite these efforts, this study finds an oversupply of five medical technologies in Pennsylvania, which adds costs and raises concern over the quality of care provided by underused facilities. Moreover, as providers compete for network selection, many continue to expand their service capabilities. These findings emphasize the importance of ongoing assessment of the appropriate application, supply, and use of medical services.

Cardiac Catheterization↗

Managed care and technology diffusion: the case of MRI.

A growing body of evidence suggests that managed care can reduce overall health care costs but provides little insight into how this could happen. One possibility is that managed care influences the adoption of new medical technologies. In examining the relationship between health maintenance organization (HMO) activity and market-level availability and use of magnetic resonance imaging (MRI), we find that high HMO market share is associated with low levels of MRI availability and use. This suggests that managed care may be able to reduce health care costs by influencing the adoption and use of new medical equipment and technologies.

Diffusion of Innovation↗

The Ventilator-assisted Individuals Study.

A paucity of reliable data exists concerning ventilator-assisted individuals (VAIs) for program planning. The Chicago Lung Association, with funding from Blue Cross/Blue Shield of Illinois, conducted a community action project to determine the magnitude of the issues in Illinois. The purposes of the VAI Study were to ascertain needs and resources, generate recommendations, and recruit community involvement. The survey identified 453 VAIs: 145 in hospitals, 105 in extended-care facilities, and 203 at home. A majority (62 percent) of hospitals provided services to VAIs; many more would with proper reimbursement incentives. Only 60 percent of hospitals serving VAIs had active discharge teams; discharge was accomplished by a variety of mechanisms and personnel. Monthly hospital charges averaged $22,190 with a range from $10,020 to $66,750 depending on the location of the patient. Most reimbursement was public; private funding was fragmented. Major discharge barriers were inadequate payment for community-based services, limited community resources, constrained consumer's finances, and lack of access to information. Recommendations for future community action included establishing a technology transfer system, home care case management, an integrated management system, a documentation center, and trials and demonstrations prior to program and policy development.

Adult↗

Genetic improvement of poplar feedstock quality for ethanol production.

Opportunities for matching chemical and physical properties of woody feedstocks to ethanol production process requirements via genetic improvement have long been recognized. Exploitation is now feasible owing to advances in trait measurement, breeding, and gene transfer technologies. Poplar genetic parameters are favorable largely for reducing lignin and increasing cellulose contents and specific gravity. Transgenic poplars with decreased lignin and increased cellulose contents, but otherwise normal growth and development, have been produced via genetic transformation. The long-standing debate on feasibility has thus become one of when, not if, designer varieties will become available.

Biomass↗

Dental public health: the past, present, and future. American Association of Public Health Dentistry. American Board of Dental Public Health.

The continued recognition process of dental public health as a specialty of dentistry served as an opportunity for the specialty to rediscover and reevaluate itself. What it found was a discipline that has evolved for 38 years to address the issues of a dynamic society. Dr. Abraham Kobren, ADA past-president has stated that public health dentistry stands as the dental conscience of the nation. The changes in dental public health mirror both changes in society and the technical changes occurring in dentistry. Identifying diseases in children is giving way to identifying diseases in adults. Prevention for adults is taking on as much importance as is prevention in children. Access to dental care for the poor and homeless is as much a problem as is access to care for people with infectious diseases. Infection control, technology transfer, national oral health objectives, and a myriad of new financing mechanisms are some areas of change. What has remained constant is the specialty's goal to improve the oral health of the public, and its commitment to work through "organized community efforts" to achieve this goal.

Acquired Immunodeficiency Syndrome↗

Genetically modified dendritic cells--a new, promising cancer treatment strategy?

Dendritic cells (DCs), the most potent antigen-presenting cells (APCs), were discovered almost 30 years ago. Due to the priming of antigen-specific immune responses mediated by CD4+ and CD8+ lymphocytes, DCs are crucial for the induction of adaptive immunity against cancer. Therefore, vaccination of cancer patients with DCs presenting tumour-associated antigens (TAAs) have been believed to be a promising anticancer strategy. Multiple clinical trials have been carried out in order to evaluate the safety and efficacy of cancer vaccines based on antigen-pulsed DCs. However, pulsing of DCs with particular peptides has several disadvantages: i) short-time duration of antigen-major histocompatability complex (MHC) complexes, ii) a requirement for matching defined peptides with MHC complexes and iii) exclusive presentation of single antigen epitopes. Application of gene transfer technologies in the field of DC-based vaccines made possible the development of novel, anticancer immunisation strategies. In several animal models, DCs modified with genes encoding TAA or immunostimulatory proteins have been shown to be effective in the induction of antitumour immune responses. Based on these encouraging results, a first clinical trial of prostate cancer patients vaccinated with gene modified DCs has recently been initiated. In this article, methods used for genetic modification of DCs and anticancer vaccination strategies based on genetically modified DCs are reviewed.

Animals↗

The use of the evidence-based approach in a periodontal therapy contemporary science workshop.

BACKGROUND: When appropriately evaluated and carefully managed, the integration of emerging technology into practice can improve health and enhance the quality of life. Since the last American Academy of Periodontology Workshop in 1996, great technological advances in the areas of data access, retrieval, and management have been made. The World Wide Web has "exploded" with great possibilities for gathering data from many sources. Evaluation methods such as meta-analysis and modeling have likewise improved, permitting a more objective and useful assessment of the retrieved information. The purpose of this paper is to demonstrate how the evidence-based (EB) approach was used to plan and implement a consensus conference on periodontal therapy, the Workshop on Contemporary Science in Clinical Periodontics. RATIONALE: The methodologies and philosophies associated with the EB approach provided the ideal framework for assessing the applicability of the newest clinical research to patient therapy. METHODS: Evidence-based systematic reviews on 15 topics associated with contemporary clinical periodontal practice were conducted prior to the Workshop. High standards of scientific rigor and scholarly ideals were stressed throughout the process. At the highly structured conference the reviews served as the basis for development of consensus reports that include implications for practice and research. MATERIAL COVERED: 1. The rationale, design, and implementation of a conference on contemporary clinical periodontics using an evidence-based approach. 2. Data management, clinical versus statistical significance, and the challenges of technology transfer and dissemination. 3. The benefits and limitations of using the EB approach in a consensus conference. CONCLUSIONS: The consensus statements resulting from the conference should serve to augment clinical decision-making, research priorities, education, and reimbursement. The evidence-based approach removed much of the subjectivity traditionally associated with classical reviews of the literature and allowed participants to focus on substantive issues.

Consensus Statements as Topic↗

Integrated control of ectoparasites.

Integrated control of ectoparasites of veterinary importance is being implemented on a limited basis at present. However, several forces are accelerating a global shift to integrated pest management (IPM). These accelerating forces include the following: reduction in new chemical compounds registered for use on livestock and poultry universal development of resistance to pesticides heightened environmental sensitivities to exclusive dependence on pesticide-based control need for strategies which increase profits for the producer while decreasing costs to the consumer. Integrated pest control requires many technologies for incorporation into specific pest management systems. Individual components include new chemicals, formulations and delivery systems, biological control, mechanical control, immunological control, genetic control, and regulatory control. Computer simulation models based on a quantitative ecological database are invaluable in devising and monitoring IPM approaches to controlling ectoparasites which affect livestock and poultry. IPM strategies have been developed for pests of veterinary importance, but eventually these must be incorporated into total livestock production systems. For implementation, a number of major impediments to IPM must be overcome. These problems can best be solved through a vigorous technology transfer programme. In addition to face-to-face meetings between producers and extension agents, the implementation of IPM can be further encouraged at producer group meetings, through education of animal health professionals, by the publication of articles in producer magazines, and by radio and television broadcasts to the agricultural sector. Research focusing on the development of cost-effective and environmentally-compatible IPM systems is necessary for future progress.

Animals↗

A pilot outreach program for small quantity generators of hazardous waste.

The Massachusetts Department of Environmental Management initiated a pilot project to improve compliance with hazardous waste regulations and management of hazardous wastes with auto body shops around the state. The program consisted of mass mailings, a series of workshops throughout the state, a coordinated inspection program by the state regulatory agency, and technology transfer. At the start of the program in January 1986, approximately 650 of the estimated 2,350 auto body shops in the state had notified EPA of their waste generating activities; by January 1987, approximately 1,200 shops had done so. Suggestions for improving program efforts include tailoring the outreach effort to the industry, government-sponsored research and development directed at the needs of small firms, mandatory participation in hazardous waste transportation programs, and better coordination by EPA of its information collection and distribution program.

Automobiles↗

A prospective view on European pharmaceutical research and development. Policy options to reduce fragmentation and increase competitiveness.

This article analyses 3 areas of policy that could reduce the fragmentation and improve the competitiveness of the European pharmaceutical sector. It argues that a potential solution to the issue of fragmentation of pharmaceutical research, development and innovation may be the development of policies at the European level, in those areas that European institutions have a competence. These areas may not necessarily rely exclusively on solving the issue of pricing and reimbursing pharmaceuticals as European Union (EU) Member States invoke the subsidiarity principle to claim policy exclusivity in this area. By contrast, policy areas where European institutions have a competence may include: i) a more intensified collaboration in science and technology policy (supporting the science base, identifying education needs for the future, collaborating in the development of new technologies and fostering university-industry collaboration); ii) support of research and development (R&D) by means of directly channelling funds into basic pharmaceutical research, avoiding duplication of the research effort, developing a set of research priorities, tackling the issue of technology transfer, promoting university-industry and cross-border collaborations or providing incentives that would induce private R&D activities in areas with large socioeconomic impact; and iii) an improvement in the environment for the financing of innovation in the EU, by means of selective use of tax policy at the national level (and where applicable, at the EU level), institutional reform in order to widen the pool of available funds for private investment, and the introduction of schemes that would encourage individuals and institutions to hold equity in innovative companies. The article identifies specific research, regulatory, medical and financing needs that require policy intervention, evaluates the possible dynamic implications of such interventions and highlights the benefits that may accrue from their implementation.

Drug Approval↗

Lobaplatin: D 19466.

Lobaplatin [D 19466] is a platinum complex with DNA alkylating activity that was developed by ASTA Medica (Degussa) for the treatment of cancer. ASTA Medica discontinued development of lobaplatin, and subsequent development of the compound became the responsibility of Zentaris AG (AEterna Laboratories), which was formed in 2001 from the biopharmaceutical, inhalation technology and gene therapy activities of ASTA Medica. On 30 December 2002, Zentaris was acquired by AEterna Laboratories. Cisplatin, one of the original platinum compounds, has had a major impact on the treatment of solid tumours such as germ cell cancer, ovarian cancer, bladder cancer and bronchial carcinoma, but its clinical usefulness is limited by renal, neurological and gastrointestinal toxicity. This has led to the development of second- and third-generation platinum analogues, such as lobaplatin, with reduced toxicity and a better therapeutic index. In January 2003, Zentaris AG and Hainan Tianwang International Pharmaceutical signed a contract for the manufacture and marketing of lobaplatin in China. The technology transfer agreement provides for Zentaris to receive a one-time payment to the amount of 4.5 million Canadian dollars. In addition, the contract foresees for Tianwang to manufacture and deliver lobaplatin to Zentaris or its partners for marketing in all other countries worldwide. Lobaplatin has been approved in China for the treatment of chronic myelogenous leukaemia (CML) and inoperable, metastatic breast and small cell lung cancer. However, it has not yet been launched there. In June 2003, AEterna reported that it expects lobaplatin to be launched in China by the end of 2003 at the 10th Annual Meeting of the Biotechnology Industry Organization (BIO-2003). Lobaplatin has also completed phase II clinical trials in the US, Australia, EU, Brazil and South Africa for the treatment of various cancers, including breast, oesophageal, lung and ovarian cancers as well as CML.

Animals↗

Cardiac gene therapy: therapeutic potential and current progress.

Cardiovascular disease remains a major cause of morbidity and mortality in modern societies. While contemporary treatment modalities are making steady inroads to reduce this disease burden there remains a pressing need to vigorously explore novel therapeutic strategies. Rapid advances in our understanding of molecular pathology and the evolution of increasingly efficient gene transfer technology offer the imminent prospect of gene-based approaches to, at least, a subset of cardiovascular pathophysiologies. Initially envisaged as a treatment strategy for inherited monogenic disorders, it is now apparent that gene therapy has broader potential that encompasses acquired polygenic diseases, including many that affect the cardiovascular system. Extensive in vitro and animal studies are providing an increasingly sound scientific basis for cautious human evaluation. This review focuses on gene therapy of diseases primarily afflicting the heart, and provides an overview of gene and vector delivery systems with particular emphasis on systems suited to individual cardiac conditions. The pathophysiology underlying these conditions and molecular targets for therapeutic intervention are also reviewed.

Cardiovascular Diseases↗

Affordable antiretroviral drugs for the under-served markets: how to expand equitable access against the backdrop of challenging scenarios?

BACKGROUND: Threats by enforced Intellectual Property (IP) rights to equitable HIV treatment access by poor populations are impending. India and China's policy directions in the field will be crucial in ultimately affecting the affordability and accessibility of antiretroviral (ARV) therapy in the under-served markets. These directions, together with the exploitation level of IP-bound flexibilities and the evolutionary modelling in partnerships and trade agreements between research-based and generic pharmaceutical industry, will also affect the outcomes of self-sufficiency efforts now at their beginning in the developing world as far as domestic manufacturing of generic ARV drugs is concerned. AIMS: This paper explores key issues, implications and interaction dynamics across these challenging scenarios while attempting to provide equitable solution glimpses into the near future. RESULTS: Access-oriented long-term drug policy strategies entitled to pass muster of governments, research-based as well as generic industries in both developed and developing countries are needed if equitable access to affordable ARV treatments by poor people has to be achieved despite enforced IP rights. Predictable dynamics between western multinationals and transitional country generic corporations let regard IP-bound Voluntary License flexibilities as a fitting measure into just mentioned needs especially if substantial incentives to generic corporations are concurrently secured. Efforts to equitably expand ARV drug access through exploiting IP opportunities should encompass attainment of self-sufficiency in domestic drug manufacturing whenever basic requirements are in place in the developing world as a whole. A credible industrial potential would act, indeed, as a boosting factor for drawing branded drug producers into technology transfer agreements, the terms of which would let all contractors enjoy substantial advantages. These perspectives consistently bind up with the foreseeable long-term trade and drug policy directions of India and China according to frontier crossing implications of their key IP management trends as well as their multifaceted penetration strategies of both the wealthy and under-served markets worldwide. As coherent with these perspectives, more disbursement by wealthy country governments and donors to basic infrastructure development in sub-Saharan African nations with stable governments in place is urged both as a priority for improving Africa's economy and a prerequisite for allowing domestic industrial plants to take off. Aiming at the targets just underscored, WHO's brokering role in negotiated agreements between wealthy and developing country-based firms as well as its technical guidance in setting international standards have always to be sought if equitable and appropriate end results are to be attained. CONCLUSION: Overall insights in this paper would mean that, while research-based corporations are to be praised whenever waiving, on humanitarian purposes, part of their profits, the trade and profit rules cannot basically be given up if long-term sustainable results are the goal to look for. Only negotiated agreements securing all contracting parties lasting advantages may ensure shifting of such a goal from mere vision to a really sustainable attainment.

Anti-HIV Agents↗

Airway epithelium directed gene therapy for cystic fibrosis.

Gene therapy is a promising therapeutic modality for the treatment of cystic fibrosis (CF). Despite a better understanding of the molecular organization of the cystic fibrosis transmembrane conductance regulator (CFTR) gene and mutations resulting in pathophysiological and phenotypic alterations, several forms of treatments including gene therapy have failed to yield clinical success. Major limitations for the delivery of drugs and gene therapy vectors from reaching target cells in CF patients lie in physical and immunological barriers of airway epithelium. Over the last decade, non-viral and viral gene therapy approaches have been tested in preclinical studies and human clinical trials of CF. Outcomes of these studies have helped to identify hurdles that need to be overcome before such approaches can be routinely applied to patients. In addition to the physiological and immunological barriers of airway epithelium, vector transduction is also impaired by the absence or low-abundance of cellular receptors and co-receptors for viral binding and internalization. Thus, the initial enthusiasm for gene replacement therapy for CF following cloning of the CFTR gene dampened, as more limitations were recognized. Research directed towards improving the efficiency of gene transfer technology in CF, is focused on testing of compounds to enhance vector permeability and trafficking, identification and development of vectors which can transduce through alternate pathways, identification of airway epithelium-specific targeting ligands, and the identification of stem cells for combining cell therapy and gene therapy by ex vivo methods. Details provided in this article will give a comprehensive analysis of the prospects and limitations in CF gene therapy using viral and non-viral vectors.

Animals↗