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Anorue EC, Joshua PE. Evaluation of anti-sickling effects of two varieties of Cajanus cajan (L.) Huth on sickle cell beta thalassemia. JOURNAL OF ETHNOPHARMACOLOGY 2024; 331:118280. [PMID: 38714239 DOI: 10.1016/j.jep.2024.118280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/14/2024] [Accepted: 04/29/2024] [Indexed: 05/09/2024]
Abstract
ETHNO-PHARMACOLOGICAL RELEVANCE Globally, the prevalence of sickle cell disease is on the rise, with developing countries experiencing particularly alarming mortality rate compared to developed nations. The World Health Organization (WHO) and United Nations (UN) have acknowledged sickle cell disease as a significant global public health concern. Unfortunately, a cure for this condition is yet to be discovered, and existing allopathic treatments, while offering relief, come with serious side effects. In recent times, there has been a growing interest in exploring the potential of medicinal plants for treating sickle cell disease due to their content of secondary metabolites that may impact the disease's mechanisms. Cajanus cajan, a crucial grain legume in rain-fed agriculture in semi-arid tropics, has been traditionally used in folk medicine to manage various illnesses and is suggested to possess anti-sickling properties. AIM OF THE STUDY The present study investigated two varieties of C. cajan for their effectiveness in treating sickle cell beta thalassemia, a variant of sickle cell disease. MATERIALS AND METHODS The study was divided into four groups consisting of the untreated group (group 1), group treated with standard drug (group 2), group treated with white C. cajan (group 3) and group treated with brown C. cajan (group 4). The effects of the two variety of C. cajan were measured by polymerization test, reversibility test, osmotic fragility test, deoxygenation and beta globin synthesis test. RESULT The results revealed that both varieties of C. cajan demonstrated a reduction in polymerization rates, reversed sickled red blood cells, increased the oxygen affinity of Hb-S/β, elevated the Fe2+/Fe3+ ratio, and maintained the membrane stability of red blood cells. Notably, the white variety exhibited superior anti-sickling properties compared to the brown variety. CONCLUSION This suggests that this significant leguminous crop could be utilized for the treatment and management of sickling disorders, particularly in low-income countries where conventional treatments may be financially inaccessible to patients.
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Affiliation(s)
- Eleazar Chukwuemeka Anorue
- Department of Biochemistry, Faculty of Biological Sciences, University of Nigeria, 410001, Nsukka, Enugu State, Nigeria; Department of Chemistry, School of Sciences, Shalom Science and Technology Academy, Enugu State, Nigeria.
| | - Parker Elijah Joshua
- Department of Biochemistry, Faculty of Biological Sciences, University of Nigeria, 410001, Nsukka, Enugu State, Nigeria
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Mano RM, Kuona P, Misihairabgwi JM. Determination of birth prevalence of sickle cell disease using point of care test HemotypeSCâ„¢ at Rundu Hospital, Namibia. BMC Pediatr 2024; 24:323. [PMID: 38730340 PMCID: PMC11084002 DOI: 10.1186/s12887-024-04805-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Sickle cell disease (SCD), a noncommunicable disease, has the greatest burden in sub-Saharan Africa. The majority of children (50-90%) with SCD die before their 5th birthday, with approximately 150,000-300,000 annual SCD child deaths in Africa. In developed countries, newborn screening (NBS) has been shown to improve the survival of children with sickle cell disease, with under5 childhood mortality reduced tenfold due to interventions performed before the development of complications. Point -of-care tests have been developed for resource limited settings to expand NBS. The aim of this study was to determine the birth prevalence of sickle cell disease in Namibia using the HemoTypeSC™ point-of-care test. METHODS A cross-sectional descriptive study was carried out at Rundu Intermediate Hospital in the Kavango East Region. Two hundred and two (202) well newborns within 72 h of birth were recruited for the study from 22 February to the 23th March 2023. Descriptive statistics were used to compute the haemoglobin types of the study participants. RESULTS The majority of the participants (n = 105, 52%) were females, and (n = 97,48%) were males. The median age of the participants was 23 h (Q1, Q3; 11; 33),) with an age range of 2-98 h. Sickle cell trait was present in 9.4% of the screened newborns, no homozygous disease was detected, and 90.6% had Hb AA. CONCLUSIONS This study is the first to measure HbS gene carriage at birth using HemotypeSC point-of-care testing in Namibia. There was a moderate prevalence of sickle cell traits but no SCD. This baseline study may provide the foundation for larger epidemiological surveys to map HbS gene carriage in Namibia to provide evidence for policy makers to fashion appropriate SCD newborn screening services.
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Affiliation(s)
- Runyararo Mashingaidze Mano
- Department of Maternal & Child Health, Division of Paediatrics, School of Medicine, Faculty of Health Sciences and Veterinary Medicine, University of Namibia Hage Geingob Campus, Bach Street, Windhoek, Namibia.
| | - Patience Kuona
- Department of Child, Adolescent and Women's Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jane Masiiwa Misihairabgwi
- Department of Human, Biological and Translational Medical Sciences, School of Medicine, University of Namibia Faculty of Health Sciences & Veterinary Medicine, Windhoek, Namibia
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Alvarez OA, St Victor Dély N, Paul Hanna M, Saint Fleur R, Cetoute M, Metalonis S, Hustace T, Brown EC, Marcelin LH, Muscadin E, Eveillard R, Lerebours E. Implementation of hospital-based sickle cell newborn screening and follow-up programs in Haiti. Blood Adv 2024; 8:14-22. [PMID: 37820110 PMCID: PMC10784669 DOI: 10.1182/bloodadvances.2023010104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/13/2023] Open
Abstract
ABSTRACT One in 120 children are born with sickle cell disease (SCD) in Haiti. However, health care challenges include isolated newborn screening (NBS) activities and lack of transcranial Doppler (TCD) ultrasound to assess stroke risk. The implementation activities of the Comparative Study of Children in Haiti and Miami with Sickle Cell Disease involved both NBS and TCD ultrasound implementations at 4 Haitian clinical sites. We hypothesized that hospital-based newborn SCD screening and follow-up programs would be feasible at Haiti. A traditional NBS laboratory method with dried blood samples was performed at 3 Port-au-Prince sites, and the traditional method plus point-of-care (POC) testing was used at the 2 northern sites. The rate of clinical follow-up for newborns with SCD as the outcome for the NBS intervention was compared with that of the NBS method. The NBS programs identified SCD in 0.77% of 8224 newborns over a 24-month period. In the rural hospital assigned to the combination screening, 56% of newborns identified with POC testing returned for follow-up, compared with 0% when POC was not available (PÂ = .044). Newborns who tested positive for SCD and children aged <6 years with SCD at the clinical sites were eligible for study follow-up. Accrual was successful: 165 participants (mean age, 42Â months; 53% males; 93% hemoglobin SS) were recruited and received oral penicillin. TCD ultrasound screening was hampered by poor internet connections and trained staff leaving Haiti, with only 1 active site conducting screening. Despite challenges, the implementation of NBS and sickle cell programs in Haiti is feasible. We are in the process of understanding how to mitigate implementation limitations.
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Affiliation(s)
| | | | | | | | - Marie Cetoute
- Division of Pediatric Hematology, University of Miami, Miami, FL
| | - Sarah Metalonis
- Department of Public Health Sciences, University of Miami, Miami, FL
| | - Tally Hustace
- Division of Pediatric Hematology, University of Miami, Miami, FL
| | - Eric C. Brown
- Department of Public Health Sciences, University of Miami, Miami, FL
| | | | | | - Ronald Eveillard
- Hospital of the University of State of Haiti, Port-au-Prince, Haiti
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Sani A, Idrees Khan M, Shah S, Tian Y, Zha G, Fan L, Zhang Q, Cao C. Diagnosis and screening of abnormal hemoglobins. Clin Chim Acta 2024; 552:117685. [PMID: 38030031 DOI: 10.1016/j.cca.2023.117685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023]
Abstract
Hemoglobin (Hb) abnormalities, such as thalassemia and structural Hb variants, are among the most prevalent inherited diseases and are associated with significant mortality and morbidity worldwide. However, there were not comprehensive reviews focusing on different clinical analytical techniques, research methods and artificial intelligence (AI) used in clinical screening and research on hemoglobinopathies. Hence the review offers a comprehensive summary of recent advancements and breakthroughs in the detection of aberrant Hbs, research methods and AI uses as well as the present restrictions anddifficulties in hemoglobinopathies. Recent advances in cation exchange high performance liquid chromatography (HPLC), capillary zone electrophoresis (CZE), isoelectric focusing (IEF), flow cytometry, mass spectrometry (MS) and polymerase chain reaction (PCR) etc have allowed for the definitive detection by using advanced AIand portable point of care tests (POCT) integrating with smartphone microscopic classification, machine learning (ML) model, complete blood counts (CBC), imaging-based method, speedy immunoassay, and electrochemical-, microfluidic- and sensing-related platforms. In addition, to confirm and validate unidentified and novel Hbs, highly specialized genetic based techniques like PCR, reverse transcribed (RT)-PCR, DNA microarray, sequencing of genomic DNA, and sequencing of RT-PCR amplified globin cDNA of the gene of interest have been used. Hence, adequate utilization and improvement of available diagnostic and screening technologies are important for the control and management of hemoglobinopathies.
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Affiliation(s)
- Ali Sani
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Muhammad Idrees Khan
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Saud Shah
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Youli Tian
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China; School of Life Science and Biotechnology, State Key Laboratory of Microbial Metabolism, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Genhan Zha
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Liuyin Fan
- Student Innovation Center, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Qiang Zhang
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Chengxi Cao
- School of Sensing Science and Engineering, School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China; School of Life Science and Biotechnology, State Key Laboratory of Microbial Metabolism, Shanghai Jiao Tong University, Shanghai, 200240, China.
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Kshatri JS, Mansingh A, Kavitha AK, Bhattacharya H, Bhuyan D, Bhattacharya D, Rehman T, Swain A, Mishra D, Tripathy I, Mohapatra MR, Nayak M, Sahoo UK, Pati S. Odisha tribal family health survey: methods, tools, and protocols for a comprehensive health assessment survey. Front Public Health 2023; 11:1157241. [PMID: 37492137 PMCID: PMC10364047 DOI: 10.3389/fpubh.2023.1157241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/09/2023] [Indexed: 07/27/2023] Open
Abstract
Tribal or indigenous communities have unique health behaviors, challenges, and inequities that nationally representative surveys cannot document. Odisha has one of India's largest and most diverse tribal populations, constituting more than a fifth of the state. State and tribe-specific health data generation is recommended in India's national roadmap of tribal health. The Odisha tribal family health survey (OTFHS) aims to describe and compare the health status of tribal communities in the state of Odisha and to estimate the prevalence of key maternal-child health indicators and chronic diseases. This paper summarizes the methodology, protocols, and tools used in this survey. This is a population-based cross-sectional survey with a multistage random sampling design in 13 (tribal sub-plan areas) districts of Odisha, India. We will include participants of all age groups and gender who belong to tribal communities. The sample size was calculated for each tribe and aggregated to 40,921, which will be collected from 10,230 households spread over 341 clusters. The survey data will be collected electronically in modules consisting of Village, Household, and Individual level questionnaires. The age-group-specific questionnaires were adapted from other national family health surveys with added constructs related to specific health issues of tribal communities, including-critical indicators related to infectious and non-communicable diseases, multimorbidity, nutrition, healthcare-seeking behavior, self-rated health, psycho-social status, maternal and child health and geriatric health. A battery of laboratory investigations will be conducted at the household level and the central laboratory. The tests include liver function tests, kidney function tests, lipid profile, iron profile, and seroprevalence of scrub typhus and hepatitis infections. The datasets from household questionnaires, field measurements and tests and laboratory reports will be connected using a common unique ID in the database management system (DBMS) built for this survey. Robust quality control measures have been built into each step of the survey. The study examines the data focused on different aspects of family health, including reproductive health, adolescent and child health, gender issues in the family, ageing, mental health, and other social problems in a family. Multistage random sampling has been used in the study to enable comparison between tribes. The anthropometric measurements and biochemical tests would help to identify the indicators of chronic diseases among various age groups of the population.
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Affiliation(s)
- Jaya Singh Kshatri
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Asit Mansingh
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - A. K. Kavitha
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Haimanti Bhattacharya
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Dinesh Bhuyan
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Debdutta Bhattacharya
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Tanveer Rehman
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Aparajita Swain
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Debashis Mishra
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
| | - Indramani Tripathy
- Scheduled Castes and Scheduled Tribes Research and Training Institute, Government of Odisha, Bhubaneswar, India
| | - Manas R. Mohapatra
- Scheduled Castes and Scheduled Tribes Research and Training Institute, Government of Odisha, Bhubaneswar, India
| | - Moushumi Nayak
- Scheduled Castes and Scheduled Tribes Research and Training Institute, Government of Odisha, Bhubaneswar, India
| | - Uttam Kumar Sahoo
- Scheduled Castes and Scheduled Tribes Research and Training Institute, Government of Odisha, Bhubaneswar, India
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Centre (Department of Health Research, Ministry of Health and Family Welfare, Government of India), Bhubaneswar, India
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Tan AF, Thota P, Sakam SSB, Lew YL, Rajahram GS, William T, Barber BE, Kho S, Anstey NM, Bell D, Grigg MJ. Evaluation of a point-of-care haemozoin assay (Gazelle device) for rapid detection of Plasmodium knowlesi malaria. Sci Rep 2023; 13:4760. [PMID: 36959462 PMCID: PMC10036474 DOI: 10.1038/s41598-023-31839-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/17/2023] [Indexed: 03/25/2023] Open
Abstract
Plasmodium knowlesi is the major cause of zoonotic malaria in Southeast Asia. Rapid and accurate diagnosis enables effective clinical management. A novel malaria diagnostic tool, Gazelle (Hemex Health, USA) detects haemozoin, a by-product of haem metabolism found in all Plasmodium infections. A pilot phase refined the Gazelle haemozoin identification algorithm, with the algorithm then tested against reference PCR in a larger cohort of patients with P. knowlesi mono-infections and febrile malaria-negative controls. Limit-of-detection analysis was conducted on a subset of P. knowlesi samples serially diluted with non-infected whole blood. The pilot phase of 40 P. knowlesi samples demonstrated 92.5% test sensitivity. P. knowlesi-infected patients (n = 203) and febrile controls (n = 44) were subsequently enrolled. Sensitivity and specificity of the Gazelle against reference PCR were 94.6% (95% CI 90.5-97.3%) and 100% (95% CI 92.0-100%) respectively. Positive and negative predictive values were 100% and 98.8%, respectively. In those tested before antimalarial treatment (n = 143), test sensitivity was 96.5% (95% CI 92.0-98.9%). Sensitivity for samples with ≤ 200 parasites/µL (n = 26) was 84.6% (95% CI 65.1-95.6%), with the lowest parasitaemia detected at 18/µL. Limit-of-detection (n = 20) was 33 parasites/µL (95% CI 16-65%). The Gazelle device has the potential for rapid, sensitive detection of P. knowlesi infections in endemic areas.
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Affiliation(s)
- Angelica F Tan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia.
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.
| | | | - Sitti Saimah Binti Sakam
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
| | - Yao Long Lew
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
| | - Giri S Rajahram
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
- Hospital Queen Elizabeth II, Kota Kinabalu, Sabah, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Timothy William
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Bridget E Barber
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Steven Kho
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
| | - Nicholas M Anstey
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia
| | | | - Matthew J Grigg
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, PO Box 41096, Casuarina, NT, 0810, Australia.
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Sabah, Malaysia.
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Qua K, Swiatkowski SM, Gurkan UA, Pelfrey CM. A retrospective case study of successful translational research: Gazelle Hb variant point-of-care diagnostic device for sickle cell disease. J Clin Transl Sci 2021; 5:e207. [PMID: 35047218 PMCID: PMC8727719 DOI: 10.1017/cts.2021.871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/19/2021] [Accepted: 10/19/2021] [Indexed: 11/06/2022] Open
Abstract
Evaluation researchers at Clinical and Translational Science Award (CTSA) hubs are conducting retrospective case studies to evaluate the translational research process. The objective of this study was to deepen knowledge of the translational process and identify contributors to successful translation. We investigated the successful translation of the HemeChip, a low-cost point-of-care diagnostic device for sickle cell disease, using a protocol for retrospective translational science case studies of health interventions developed by evaluators at the National Health Institutes (NIH) and CTSA hubs. Development of the HemeChip began in 2013 and evidence of device use and impact on public health is growing. Data collection methods included five interviews and a review of press, publications, patents, and grants. Barriers to translation included proving novelty, manufacturing costs, fundraising, and academic-industry relations. Facilitators to translation were CTSA pilot program funding, university resources, entrepreneurship training, due diligence, and collaborations. The barriers to translation, how they were overcome, and the key facilitators identified in this case study pinpoint areas for consideration in future funding mechanisms and the infrastructure required to enable successful translation.
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Affiliation(s)
- Kelli Qua
- Clinical and Translational Science Collaborative, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Shannon M. Swiatkowski
- Clinical and Translational Science Collaborative, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Umut A. Gurkan
- Department of Mechanical and Aerospace Engineering, School of Engineering, Case Western Reserve University, Cleveland, OH, USA
- Department of Biomedical Engineering, Case School of Engineering, Case Wetern Reserve University, Cleveland, OH, USA
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH, USA
| | - Clara M. Pelfrey
- Clinical and Translational Science Collaborative, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
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