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Innovation, Health Are in Drivers’ Seats At UCSD Institute

For the past 10 years, the UC San Diego has been fielding a winning team. From engineers to community advocates to clinicians and even grant writers, it is a diverse team with an impressive mix of skill sets, and when they are on top of their game, they can be lifesavers.

The Altman Clinical and Translational Research Institute (ACTRI) has again garnered recognition and funding that will help to advance its goals.

ACTRI has received a five-year, $54.7 million Clinical and Translational Science Award (CTSA) from the National Center for Advancing Translational Science (NCATS), part of the National Institutes of Health. The new grant is the third such award since ACTRI opened in 2010, bringing total funding support to approximately $144 million.

According to the university, the ACTRI facilitates research by providing assistance with proposal development, study design, regulatory issues and submission, biostatistics and informatics, and offers ethics consultation, clinical trial coordination, genomics and many more services.

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Its members and affiliates, represent some of the top talent in town.

“The first CTSA laid the foundation for transforming our institution. It built the early infrastructure that would help change the way we thought about moving discoveries from the lab to the clinic,” said Gary S. Firestein, M.D., founding director of ACTRI and dean and associate vice chancellor of clinical and translational research at UC San Diego School of Medicine.

“The greatest impact was the creation of a dedicated research clinic to perform clinical trials that can test drugs and devices,” Firestein said. “A new phase I unit was developed as part of the clinic and enables first in human trials of novel treatments, often in collaboration with our local biotech partners.

“The second CTSA focused on making ACTRI the hub for clinical research and clinical trials at UC San Diego,” Firestein said. That resulted in 95% of the young faculty that we support having been able to launch funded research programs, according to Firestein. It also brought recognition from hundreds of high profile publications.

The latest CTSA, Firestein said, will refine the fundamental work of the past decade and provide new resources that will launch a new wave of discovery and transformation.

“The next five years will be about bringing together basic scientists, engineers and clinicians to create a pipeline of innovation,” Firestein said. “This effort builds on our Tricorder XPRIZE competition and will bring together multidisciplinary teams of clinicians and scientists.”

Game Center

The school said the new funding will also be used to continue a scholar program supporting young faculty members establishing careers, expand ACTRI’s “Game Center,” a program that uses virtual reality games to train investigators in team science and create new mentoring programs in grant-writing, the financial lifeblood of research.

Firestein explained the Game Center. “We wanted to find a new way to train people who are interested in translational research,” Firestein said. “The old classroom or webinar methods are not particularly exiting and people tend to forget as soon as they walk out the door. So, we are leveraging people’s fascination with games, also taking advantage of the fact that fun games get played over and over. The trick is to take a simulation, which rarely gets repeat play and “gamify” it by adding mystery challenges, scores, timers and fun.”

Grant Writing

Considering its importance in the process, one doesn’t hear much about grant writing.

“When we surveyed early stage investigators, it turns out that mentoring in grant writing is perhaps the greatest unmet need,” Firestein said. “We have established a ‘Mentoring Core’ that includes mentor training and (we’ve) worked with the School of Medicine on a grant writing training program to help people put together a compelling proposal.”

New efforts include the Dissemination & Implementation Science Center (DISC), which will help investigators move their ideas into the community and a new Team Science Core. Mobile apps will be developed to help integrate clinical trials and the electronic health records, improving safety for research participants the university said.

“The DISC develops ways to move discoveries and new treatments from academia into the community beginning with the earliest stages of project design,” Firestein said. “Examples of projects include ways to increase adoption of technology supported interventions, increasing quality improvement in primary care and implementation of evidence-based practices in childhood illnesses such as autism.”

According to the university, The Center for Life Course and Vulnerable Population Research will expand to engage communities and ensure vulnerable and underserved populations are part of the research and clinical enterprise. The Center for Clinical Research will provide dedicated project managers, ethics support and clinical research infrastructure. Two new centers will be launched: the Device Acceleration Center and Center for Excellence in Immunogenomics, both intended to bring scientists and clinicians together in teams to address unmet medical needs, specifically in the science and medicine of immunity.

The new centers get some guidance. “We are creating infrastructure that will bring teams together and support innovation,” Firestein said. “Devices and Immunogenomics have their own special requirements for team formation. We will provide resources to create collaborations, design studies, perform studies that move the projects forward and have developed a ‘Translational Science Certificate’ program to train entrepreneurial researchers.”

Parallel Universes

“Science and medicine often operate in parallel universes,” said Firestein. “We’ve taken steps to bring them together, but we want to go further in integrating research and clinical care. For example, combining data from clinical trials with health records would benefit researchers but even more so trial participants and patients. It would make clinical trials even safer.”

Inclusion on many levels seems to be an underlying theme.

Increasing Engagement

“Absolutely,” Firestein said. “We are focused on increasing engagement of a broad range of stakeholders in the community including our research partner institutions, community clinics, county health authorities, advocacy groups and underserved communities as far away as the Coachella Valley and Imperial County. We also include the community in governance, priority setting and selecting projects to fund.”

ACTRI is an essential partner in most clinical trials conducted at UC San Diego Health, providing support in the form of informatics tools, workspace and trained personnel, an infusion center, an investigational drug pharmacy, a Phase I drug testing unit and education and training programs. Nearly 1,000 clinical and translational research faculty and staff are housed in the 7-story, 359,000-square-foot Altman CTRI building, which opened in 2016, the university said.

There are approximately 2,400 ongoing clinical trials at UC San Diego Health, involving an estimated 7,000 participants in active treatment. Approximately 250 new trials begin each year, including most recently COVID-19-related trials investigating an antiviral drug, an arthritis drug and a medication for hypertension.

Firestein, an internationally recognized translational researcher, is co-leader of the NCATS’ Accrual to Clinical Trials platform, which links electronic medical records of more than 50 academic medical centers across the country and has been expanded to provide comprehensive medical data to COVID-19 researchers. The ACTRI has also created an institutional COVID-19 biobank to enable development of novel diagnostics and treatment for the virus and has collaborated with UC San Diego Health to screen all health care workers and assure a safe workplace, the university said.

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