Turning science into health solutions: KEMRI’s challenges as Kenya’s health product pathfinder

BACKGROUND: A traditional pathway for developing new health products begins with public research institutes generating new knowledge, and ends with the private sector translating this knowledge into new ventures. But while public research institutes are key drivers of basic research in sub-Saharan Africa, the private sector is inadequately prepared to commercialize ideas that emerge from these institutes, resulting in these institutes taking on the role of product development themselves to alleviate the local disease burden. In this article, the case study method is used to analyze the experience of one such public research institute: the Kenya Medical Research Institute (KEMRI). DISCUSSION: Our analysis indicates that KEMRI's product development efforts began modestly, and a manufacturing facility was constructed with a strategy for the facility's product output which was not very successful. The intended products, HIV and Hepatitis B diagnostic kits, had a short product life cycle, and an abrupt change in regulatory requirements left KEMRI with an inactive facility. These problems were the result of poor innovation management capacity, variability in domestic markets, lack of capital to scale up technologies, and an institutional culture that lacked innovation as a priority.However, KEMRI appears to have adapted by diversifying its product line to mitigate risk and ensure continued use of its manufacturing facility. It adopted an open innovation business model which linked it with investors, research partnerships, licensing opportunities, and revenue from contract manufacturing. Other activities that KEMRI has put in place over several years to enhance product development include the establishment of a marketing division, development of an institutional IP policy, and training of its scientists on innovation management. SUMMARY: KEMRI faced many challenges in its attempt at health product development, including shifting markets, lack of infrastructure, inadequate financing, and weak human capital with respect to innovation. However, it overcame them through diversification, partnerships and changes in culture. The findings could have implications for other research institutes in Sub-Saharan Africa seeking to develop health products. Such institutes must analyze potential demand and uptake, yet be prepared to face the unexpected and develop appropriate risk-mitigating strategies

Improved Energy Reconstruction with Generalized Particle Decays by Applying Multiple Constraints

Mass constrained fitting is a technique that improves jet energy resolution. The fit is performed by assigning a well-known mass to a decaying particle and minimizing a χ 2 consisting of the constituent particle’s measured parameters. This technique is utilized in an abstract frame work which applies multiple constraints to arbitrary multi- generational particle topologies. The software is constructed with the ability to both fit designated particles and automate the analysis of all particle parameters post-fit, including Monte Carlo information. The energy reconstruction is tested for single and multiple constraints in the decays of J/ψ → μ + μ − , π 0 → γγ, η → π + π − γ, and η → π + π − π 0

Gribov vs BRST

We investigate the way in which the Gribov problem is manifested in the BRST quantization of simple quantum mechanical models by comparing models with and without a Gribov problem. We show that the hermiticity and nilpotency of the BRST charge together with the Batalin-Vilkovisky theorem yield non-trivial supplementary conditions on gauge fixing fermions. If the gauge fixing fermion satisfies the supplementary conditions, the BRST physical states form a space isomorphic to the Dirac space, and the BRST formal path integral does not suffer from the Gribov problem. The conventional gauge fixing fermion, that gives rise to the Faddeev-Popov integral, fails to satisfy the supplementary conditions due to the Gribov problem. Alternatively, enforcing the conventional gauge fixing fermion, these supplementary conditions imply restrictions on the BRST physical states for which the Batalin-Vilkovisky theorem holds. We find that these BRST physical states are not isomorphic the Dirac states. This can be interpreted as a violation of the Batalin-Vilkovisky theorem on the space of Dirac states and implies a breakdown of unitarity and a general dependence of physical quantities on the gauge condition.Comment: 9 pages, Revtex, A better formulation of the conditions on the gauge fixing fermion is given, Several relevant references are added, To appear in Ann. Phys. (N.Y.

Corporate Social Responsibility: Considerations for Sport Management in the Age of Neoliberalism

International Journal of Exercise Science 10(6): 900-914, 2017. For financial reasons, in efforts to maintain legitimacy, and in response to social pressures, sport organizations increasingly engage with corporate social responsibility (CSR). However, with the rise of global neoliberalism, the logic of CSR can be problematic. In this essay, we provide a brief overview, critique, and reconstruction of CSR in the sport industry. Specifically, we call into question three popularized forms of CSR: (1) diversity, inclusion, and diversity management, (2) environmental responsibility, and (3) health and physical activity-based initiatives. In a neoliberal context, CSR in sport provides, at best, a limited response to social issues. At their worst, CSR initiatives may be socially irresponsible programs that further engender inequalities and inequities while a neoliberal logic serves to rationalize and augment sport organizations’ place(s) in society. We discuss these issues and challenge the field of sport management to further consider how we may demonstrate a more legitimate social concern in the 21st centur

Indian vaccine innovation: the case of Shantha Biotechnics

BACKGROUND: Although the World Health Organization had recommended that every child be vaccinated for Hepatitis B by the early 1980s, large multinational pharmaceutical companies held monopolies on the recombinant Hepatitis B vaccine. At a price as high as USD$23 a dose, most Indians families could not afford vaccination. Shantha Biotechnics, a pioneering Indian biotechnology company founded in 1993, saw an unmet need domestically, and developed novel processes for manufacturing Hepatitis B vaccine to reduce prices to less than$1/dose. Further expansion enabled low-cost mass vaccination globally through organizations such as UNICEF. In 2009, Shantha sold over 120 million doses of vaccines. The company was recently acquired by Sanofi-Aventis at a valuation of USD$784 million. METHODS: The case study and grounded research method was used to illustrate how the globalization of healthcare R&D is enabling private sector companies such as Shantha to address access to essential medicines. Sources including interviews, literature analysis, and on-site observations were combined to conduct a robust examination of Shantha's evolution as a major provider of vaccines for global health indications. RESULTS: Shantha's ability to become a significant global vaccine manufacturer and achieve international valuation and market success appears to have been made possible by focusing first on the local health needs of India. How Shantha achieved this balance can be understood in terms of a framework of four guiding principles. First, Shantha identified a therapeutic area (Hepatitis B) in which cost efficiencies could be achieved for reaching the poor. Second, Shantha persistently sought investments and partnerships from non-traditional and international sources including the Foreign Ministry of Oman and Pfizer. Third, Shantha focused on innovation and quality - investing in innovation from the outset yielded the crucial process innovation that allowed Shantha to make an affordable vaccine. Fourth, Shantha constructed its own cGMP facility, which established credibility for vaccine prequalification by the World Health Organization and generated interest from large pharmaceutical companies in its contract research services. These two sources of revenue allowed Shantha to continue to invest in health innovation relevant to the developing world. CONCLUSIONS: The Shantha case study underscores the important role the private sector can play in global health and access to medicines. Home-grown companies in the developing world are becoming a source of low-cost, locally relevant healthcare R&D for therapeutics such as vaccines. Such companies may be compelled by market forces to focus on products relevant to diseases endemic in their country. Sanofi-Aventis' acquisition of Shantha reveals that even large pharmaceutical companies based in the developed world have recognized the importance of meeting the health needs of the developing world. Collectively, these processes suggest an ability to tap into private sector investments for global health innovation, and illustrate the globalization of healthcare R&D to the developing world

QCD_4 From a Five-Dimensional Point of View

We propose a 5-dimensional definition for the physical 4D-Yang-Mills theory. The fifth dimension corresponds to the Monte-Carlo time of numerical simulations of QCD_4. The 5-dimensional theory is a well-defined topological quantum field theory that can be renormalized at any given finite order of perturbation theory. The relation to non-perturbative physics is obtained by expressing the theory on a lattice, a la Wilson. The new fields that must be introduced in the context of a topological Yang-Mills theory have a simple lattice expression. We present a 5-dimensional critical limit for physical correlation functions and for dynamical auto-correlations, which allows new Monte-Carlo algorithm based on the time-step in lattice units given by \e = g_0^{-13/11} in pure gluodynamics. The gauge-fixing in five dimensions is such that no Gribov ambiguity occurs. The weight is strictly positive, because all ghost fields have parabolic propagators and yield trivial determinants. We indicate how our 5-dimensional description of the Yang-Mills theory may be extended to fermions.Comment: 45 page

Long-term yogurt consumption and risk of incident hypertension in adults

The Nurses' Health Study and Health Professionals Follow-up Study cohorts are supported by grants UM1 CA186107, UM1 CA176726, and UM1 CA167552 from the National Institutes of Health. The current analyses were supported by small grants from the National Dairy Council, the General Mills Bell Institute for Health and Nutrition, and the Boston Nutrition and Obesity Research Center. The Boston Nutrition Obesity Research Center is administratively based at Boston Medical Center and is funded by the National Institutes of Health (NIH/NIDDK) grant P30DK046200. (UM1 CA186107 - National Institutes of Health; UM1 CA176726 - National Institutes of Health; UM1 CA167552 - National Institutes of Health; small grants from the National Dairy Council; General Mills Bell Institute for Health and Nutrition; Boston Nutrition and Obesity Research Center; P30DK046200 - National Institutes of Health (NIH/NIDDK))Accepted manuscrip

Correlation functions in ionic liquid at coexistence with ionic crystal. Results of the Brazovskii-type field theory

Correlation functions in the restricted primitive model are calculated within a field-theoretic approach in the one-loop self-consistent Hartree approximation. The correlation functions exhibit damped oscillatory behavior as found before in the Gaussian approximation [Ciach at. al., J. Chem. Phys. {\bf 118}, 3702 (2003)]. The fluctuation contribution leads to a renormalization of both the amplitude and the decay length of the correlation functions. The renormalized quantities show qualitatively different behavior than their mean-field (MF) counterparts. While the amplitude and the decay length both diverge in MF when the $\lambda$-line is approached, the renormalized quantities remain of order of unity in the same dimensionless units down to the coexistence with the ionic crystal. Along the line of the phase transition the decay length and the period of oscillations are independent of density, and their values in units of the diameter of the ions are $\alpha_0^{-1}\approx 1$ and $2\pi/\alpha_1\approx 2.8$ respectively.Comment: 21 pages including 9 figure

Improving health care quality and safety: the role of collective learning

Despite decades of effort to improve quality and safety in health care, this goal feels increasingly elusive. Successful examples of improvement are infrequently replicated. This scoping review synthesizes 76 empirical or conceptual studies (out of 1208 originally screened) addressing learning in quality or safety improvement, that were published in selected health care and management journals between January 2000 and December 2014 to deepen understanding of the role that collective learning plays in quality and safety improvement. We categorize learning activities using a theoretical model that shows how leadership and environmental factors support collective learning processes and practices, and in turn team and organizational improvement outcomes. By focusing on quality and safety improvement, our review elaborates the premise of learning theory that leadership, environment, and processes combine to create conditions that promote learning. Specifically, we found that learning for quality and safety improvement includes experimentation (including deliberate experimentation, improvisation, learning from failures, exploration, and exploitation), internal and external knowledge acquisition, performance monitoring and comparison, and training. Supportive learning environments are characterized by team characteristics like psychological safety, appreciation of differences, openness to new ideas social motivation, and team autonomy; team contextual factors including learning resources like time for reflection, access to knowledge, organizational capabilities; incentives; and organizational culture, strategy, and structure; and external environmental factors including institutional pressures, environmental dynamism and competitiveness and learning collaboratives. Lastly learning in the context of quality and safety improvement requires leadership that reinforces learning through actions and behaviors that affect people, such as coaching and trust building, and through influencing contextual factors, including providing resources, developing culture, and taking strategic actions that support improvement. Our review highlights the importance of leadership in both promoting a supportive learning environment and implementing learning processes