National Medical Research Council affirms the role of innovative research ensuring quality healthcare

National Medical Research Council affirms the role of innovative research ensuring quality healthcare

NMRC Awards Ceremony and TCR Symposium held concurrently to foster collaborations across biomedical research community

1. Ensuring quality healthcare through innovative research and supporting clinicians in pursuing research are the twin focal points of the annual National Medical Research Council (NMRC) Awards Ceremony, which will for the first time be held together with the Translational Clinical Research (TCR) Symposium.

2. The two events provide a strategic platform for networking among clinicians, researchers and industry partners. More than 300 participants will be attending this one and a half day event at the Resorts World Sentosa Convention Centre from 31 October to 1 November 2012.

3. Organised by the Ministry of Health’s NMRC, this year’s event is themed “Pursuing Healthcare Research Excellence and Innovations” to signal the importance on ensuring quality healthcare through concerted efforts to develop and support innovative research.

4. Whilst Singapore has been ranked as the healthiest country amongst 145 nations in a recent Bloomberg survey¹, Singapore also faces a rapidly ageing population where one in five will be aged 65 or older by 2030. Coupled with changing lifestyles, this is expected to result in an increase in chronic diseases, amongst other healthcare challenges. To address the challenges, the NMRC Human Capital Awards recipients, with their diverse research projects, seek to pursue healthcare research that would ultimately lead to improved patient outcomes and healthcare affordability for all Singaporeans.

5. The NMRC Human Capital Awards, comprising the Singapore Translational Research Investigator (STaR) award, Clinician Scientist Award (CSA) and Transition Award, aim to recognise clinician scientists from Singapore public healthcare and research institutions and support their research projects. This year, 25 clinician scientists from seven healthcare institutions received the awards along with grant funding for their research fields including cardiology, mental health, neurology and infectious diseases.

6. One STaR award winner, Prof Stuart Cook, Distinguished Clinician Scientist, National Heart Centre Singapore and Professor at Duke-NUS Graduate Medical School Singapore, will also share his experiences at the symposium on the ingredients for success as a clinician scientist.

7. Also joining the event as the plenary speaker is the Chief Editor of the renowned Nature Medicine Journal², Dr Juan Carlos Lopez Garcia, who will share his thoughts on “How the world views Singapore’s push in the biomedical sciences”. Dr Garcia will be presenting data on scientific publications to gauge how far Singapore’s efforts have gone towards achieving the nation’s goal, and discussing some indicators that might be worth taking into account to help Singapore take stock of its progress in this area.

8. Permanent Secretary for Health, Mrs Tan Ching Yee, and Chairman, A*STAR, Mr Lim Chuan Poh, graced the Awards. Mrs Tan said, “The annual Awards ceremony is a good way to recognise the good work of clinician scientists who are supported through various NMRC awards. It is particularly meaningful to invest in our new researchers, through the Transition Award, given out to the first batch of eight recipients. We look forward to these outstanding individuals progressing to become independent, full-fledged clinician scientists.”

9. Mr Lim said, “I am heartened to see the growing pool of clinician scientists and clinical investigators in Singapore. They form the core of the clinical research community to advance translational and clinical research and bolster the increasing partnerships between the basic research and clinical communities in Singapore.  Such integration of capabilities along the translational value chain is pivotal to translate research findings into medically meaningful applications and impactful industry collaborations.”

10. In addition to the Awards, the TCR Symposium will showcase the five TCR Flagship programmes which are led by leading clinician scientists: Associate Professor Chong Siow Ann from the Institute of Mental Health, Associate Professor Chong Yap Seng from the Yong Loo Lin School of Medicine (YLLSOM), Professor Donald Tan from the Singapore Eye Research Institute (SERI), Associate Professor Leo Yee Sin from the Communicable Disease Centre and Associate Professor Yeoh Khay Guan from YLLSOM. They will share their latest research findings in the areas of neuroscience, metabolic disease, eye, dengue and gastric cancer respectively and in particular, will focus on how their projects have been successful in pursuing academic excellence, forging stronger partnerships and contributing towards better healthcare outcomes.

11. The second day of the event features workshops to facilitate discussions on a variety of important topics for TCR, including clinical trials, health economics and the process of developing a research idea, drug or medical device into a product that can be used by patients.

12. A key highlight of the second day is an opportunity for the clinicians and industry partners to come together in a forum discussion, to share their thoughts on factors on improving clinician-industry partnership.

13. More information on the Awards, the full list of awardees and the Symposium programme can be found in the annexes.

¹The Bloomberg survey considered the health system and risk factors of various countries. Singapore was scored 92.5% for our health system, coming in behind Italy, Australia and Switzerland.

http://www.bloomberg.com/slideshow/2012-08-13/world-s-healthiest-countries.html#slide1

http://images.businessweek.com/bloomberg/pdfs/WORLDS_HEALTHIEST_COUNTRIES_v1.pdf

² Website: www.nature.com/nm

Ministry of Health

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List of annexes

Annex A: About the National Medical Research Council

Annex B: About the Agency for Science, Technology and Research (A*STAR)

Annex C: About the National Medical Research Council Awards

Annex D: List of Awardees

Annex E: Selected Projects/ Profiles

Annex F: Programme for NMRC Awards Ceremony and TCR Symposium 2012

Annex A: About the National Medical Research Council

The National Medical Research Council (NMRC), established under the Ministry of Health in 1994, provides competitive research funds to publicly funded healthcare institutions; awards competitive research funds for thematic programmes and developmental projects, provides support for critical infrastructure for clinical research, and is responsible for the development of clinician scientists through awards and fellowships.

In 2006, the Ministry of Health established a new mandate to support translational and clinical research (TCR). Taking on the expanded role, NMRC is now leading, promoting, coordinating and funding TCR efforts in Singapore, with special focus on areas which Singapore has strengths in. NMRC-funded research has led to inter-disciplinary partnerships and international collaborations. The Council also evaluates the outcomes of the research projects and facilitates the commercialisation of research findings.

Since its inception, it has built up the medical research capabilities in Singapore through the funding of more than 1,100 individual research projects and 13 national research programmes.

For more information about NMRC, please visit www.nmrc.gov.sg.

Annex B: About the Agency for Science, Technology and Research (A*STAR)

The Agency for Science, Technology and Research (A*STAR) is the lead agency for fostering world-class scientific research and talent for a vibrant knowledge-based and innovation-driven Singapore. A*STAR oversees 14 biomedical sciences, and physical sciences and engineering research institutes, and seven consortia & centres, which are located in Biopolis and Fusionopolis, as well as their immediate vicinity.

A*STAR supports Singapore's key economic clusters by providing intellectual, human and industrial capital to its partners in industry. It also supports extramural research in the universities, hospitals, research centres, and with other local and international partners.

For more information about A*STAR, please visit www.a-star.edu.sg.

Annex C: About the National Medical Research Council Awards

NMRC’s Human Capital and Talent Development Programmes

NMRC’s human capital and talent development programmes include the prestigious STaR Investigator award, the Clinician Scientist Awards (CSA) and various scholarships and fellowships. These programmes are part of the overall talent development programme started during Phase II of Singapore’s Biomedical Sciences (BMS) Initiative. Such programmes aim to provide the clinician scientists with a conducive environment for medically relevant research that will one day translate into better healthcare delivery for patients in Singapore and the region. For more information, please visit www.nmrc.gov.sg.

STaR Investigator Award

The STaR Investigator Award is a prestigious award to recognise and support investigators with outstanding qualifications in translational and clinical research.

Tenable in Singapore, STaR Investigators can start a new research programme which can potentially advance Singapore’s priorities in biomedical research and healthcare or contribute to the Translational and Clinical Research Flagship Programmes. STaR Investigators may also spend up to 20% of their time engaging in direct patient care in Singapore.

In keeping with the international status of the STaR Investigator Awards, recipients will also receive competitive research support and remuneration. A total of 12 STaR Investigator awards have been given to date.

Clinician Scientist Award (CSA)

The CSA awardees will spend at least 70% of their time doing research relevant to their areas of specialty and the remaining seeing patients. This enables them to stay in touch with medicine and at the same time, explore and expand new research grounds by bringing insights from their clinical work to the laboratories. The selection of CSA awardees is based on scientific merits of their research proposals and their track records.  There are two calls each year for the CSA.

The award has two categories: Senior Investigator (SI) and Investigator (Inv). The former targets outstanding senior clinician scientists who have demonstrated a sustained, high level or productivity and leadership in translational and clinical research.  They will be funded for a period of five years under the scheme. The Inv category caters to younger doctors who have a good track record of research work and demonstrated potential to become leaders in their field. They must already be capable of doing independent research. This group of clinician-scientists will be funded for three years.

The CSA is funded by the National Research Foundation and administered by the NMRC. A total of 38 CSAs have been given out to date.

Transition Award

The Transition Award programme is designed to assist young clinicians build up their capability and transition to an independent research position or other independent research funding, and with an enhanced probability of success in obtaining long-term research support.

The award also comes with salary support to ensure that awardees spend at least 70% of their time on clinical research. The primary long-term goal of the Transition Award programme is to increase the cohort of new and talented, NMRC-supported independent clinician scientists. 

The Transition Award provides up to three years of mentored research funding support for highly promising, Singaporean/Permanent Residents PhD-qualified clinicians and clinicians who have received Masters-level research qualifications (e.g. Masters in Clinical Investigation, Masters in Public Health, etc.), or completed research training.  It is funded and administered by the NMRC. The first call for the Transition Awards was opened in mid-2011.

Annex D: List of Awardees (FY11 and FY12)

Annex E: Selected Projects/Profiles

STaR Award - Stuart Cook (NHCS and Duke-NUS)

Professor Stuart Cook’s research uses state-of-the-art approaches to discover genes that cause heart and artery diseases, which are the commonest cause of death and disability worldwide. This is achieved by integrating advanced cardiac imaging with genomic data to derive unbiased and novel insights into human disease. This is possible thanks to the huge advances in human genetics in the post Human Genome Project era and, more recently, the availability of ultra high throughput sequencing technologies, such as those at Duke-NUS. Success in this area relies not just on technology but also on close attention to the human condition and a detailed understanding of patients. This is what defines the Clinician Scientist and enables them to work at the interface between science and medicine as they endeavor to translate basic discoveries into healthcare improvements.

The overall aim of Prof Cook’s research is to identify new ways of preventing, diagnosing, stratifying and treating patients with cardiovascular disease. In Singapore there are a number of areas where this research could have an impact on local healthcare. One of the new programs this team will be running at the National Heart Centre Singapore will investigate why some people’s hearts go into abnormal rhythms that can cause them to have strokes. The team hopes to find new ways to predict and prevent heart rhythm problems with the ultimate goal of preventing strokes. Prof Cook also has an interest in sudden cardiac death that can happen at any age and is devastating for the families of affected individuals. Working with industrial partners and using cutting-edge genetics and data analysis tools he hopes, in time, to develop research into clinical diagnostic tools to screen people in Singapore and prevent sudden cardiac death. A final area that is part of this research is healthy cardiovascular ageing, which is particularly important given the ageing populations around the world, and in Singapore. In all these areas it is critical to study the local population in health and disease. The team aims to recruit interested patients and volunteers into research studies to make these goals a reality.

Over the last five years, Prof Cook and his team have identified a number of new genes for heart disease and published their findings in premier scientific journals that include Nature and Nature Genetics. This year, the team published a paper in the New England Journal of Medicine with collaborators and close colleagues from Harvard University, USA. In this study, the team identified that mutations in Titin, the biggest human gene, cause heart muscle weakness. This is a major step forward in the understanding of heart muscle disease and tests have already been developed to screen for this gene in individuals with a family history of heart failure.

Professor Cook is a Distinguished Clinician Scientist, Senior Consultant in Clinical and Molecular Cardiology and Senior Research Advisor with the Department of Cardiology at the National Heart Centre Singapore. He also has a primary academic appointment as Professor at the Duke-NUS Graduate School Singapore, in their Cardiovascular and Metabolic Diseases Research Program, where he has established a laboratory.

STaR Award - Karl Tryggvason (Duke-NUS)

Professor Karl Tryggvason has been a Professor in the Department of Medical Biochemistry and Biophysics at Karolinska Institutet in Stockholm since 1994 where he has had a distinguished career. Understanding the role of basement membrane proteins in normal physiology and disease has been a major research interest. In particular, his laboratory has made major contributions in understanding the molecular features of the filtration barrier in the kidney. Through this work, he determined the causes of human kidney diseases such as congenital nephropathy of the Finnish type and Alport's syndrome. Moreover, his findings opened a new and burgeoning field of research around the role of the glomerular epithelial cell or podocyte in human glomerular diseases.

Professor Tryggvason’s work has also led to understanding the molecular basis of other non-renal basement membrane diseases such as junctional epidermolysis bullosa and congenital muscular dystrophy. More recently, his laboratory has developed methodologies for synthesizing laminins, a family of basement membrane proteins, and has shown that these proteins can be used to control stem cell growth and differentiation.

At Duke-NUS, Professor Tryggvason plans to build a program focused on understanding the causative mechanisms of diabetic nephropathy, the leading cause of end-stage kidney disease in Singapore.

Professor Tryggvason has published more than 380 research articles. He is a member of the Swedish Royal Academy of Sciences, Vice-Chairman of the Nobel Assembly at Karolinska Institutet, and he has received a number of international awards, mainly for his kidney research, including the American Society of Nephrology Homer Smith Award and Louis Jeantet and Anders Jahre awards. Professor Tryggvason is also the founder of four companies, including NephroGenex, Inc. (USA) that has developed a drug for diabetic kidney disease.

Clinician Scientist Award - Christopher Chen (NUHS)

Dr Chen’s research focus is on “Translational Research in Cognitive Impairment & Dementia" which includes Biomarker Discovery and clinical trials. Together with collaborators from Clinical Imaging Resarch Centre (CIRC), NUS and NTU, the team is utilising novel neuroimaging, neurochemical. lipodomic and proteonomic methods to add further insight into the pathogenesis of stroke and dementia and suggest potential targets and markers for therapeutic strategies.

The team also has considerable expertise in conducting regional neuroscience clinical trials and aims to initiate more innovative clinical trials using biomarker as well as clinical endpoints. Only by investing in, restructuring, and increasing the capacity of Singapore's neuroscience clinical trials program, can it enable us to more efficiently convert recent scientific discoveries into effective interventions and increase patient access to clinical trials.

Recent notable publications :

M Saini, MK Ikram, S Hilal, A Qiu, N Venkatasubramaniam, C Chen. Silent Stroke – Not Listened to rather than Silent. Stroke

M Cavalieri, R Schmidt, C Chen, et al. B vitamins and MRI-detected ischemic brain lesions in patients with recent transient ischemic attack or stroke: The VITATOPS MRI-Substudy Stroke (accepted)

YH Dong ,N Venketasubramanian,  BPH Chan, VK Sharma, MJ Slavin, SL Collinson,  P Sachdev, YH Chan, CL-H Chen  Brief screening tests during acute admission inpatients with mild stroke are predictive of vascular cognitive impairment 3-6 months after stroke. J Neurology Neurosurgery & Psychiatry 83 (2012) 580-5

Clinician Scientist Award - Cheng Ching-Yu (NUHS)

Singapore Age-related macular degeneration Genetic Architecture (SAGA) Study: from Population Genomics to Personalized Medicine

Age-related macular degeneration (AMD) is the leading causes of irreversible blindness in the elderly both in Western countries and in Asia. The etiology of AMD has not been fully understood, and effective therapeutic interventions remain limited. Recent genome-wide association studies have identified a few common genetic variants associated with the risk of AMD, but the studies were mostly conducted in Western populations. A key difference in the clinical presentation and treatment of AMD in Western populations and Asians, is a “subtype” of AMD called polypoidal choroidal vasculopathy (PCV), which is more common in Asians. Knowledge of the genetic architecture of Asian AMD, especially the PCV sub-type, is very limited, and is the focus of Dr Cheng’s research: the Singapore Age-related macular degeneration Genetic Architecture (SAGA) study.

The SAGA study is a prospective research to recruit 1,000 Singaporean patients with AMD or PCV. The study aims to: 1) to identify novel coding genetic variants associated with AMD/PCV using exome-wide genotyping and next-generation sequencing approaches; 2) to perform an integrated pathway-based analysis to unravel genetic mechanisms underlying AMD/PCV; and 3) to dissect genetic determinants of individuals’ response to AMD/PCV therapies.

This research has significant clinical and public health impact. It is one of the first studies to comprehensively investigate the genetic architecture of Asian AMD, including PCV. The novel genes and pathways, together with non-genetic risk factor information, would improve the ability to identify individuals at risk for the disease and thus initiate timely intervention to prevent its onset and slow its progression.

Currently, intravitreal anti-VEGF injection is the main therapy of choice for AMD, but it is not effective for every individual patient, and the requirement for monthly injection makes it very costly in clinical practice. If the genetic variants correlate well to treatment response, by a simple genetic testing, it will make it possible to identify those patients more likely to benefit from anti-VEGF injection. Treatment plans then can be customised to individual patients. This will enable more effective and efficient management for this highly prevalent blinding disease in Singapore and in the rest of the world.

Furthermore, each of the identified genetic loci and pathways can potentially provide insights about disease biology and merits detailed follow-up experiments. Currently, there is still no effective pharmacological treatment for PCV. Therfore, in the long term, in-depth experiementals will open new opportunities for developing effective drugs.

Transition Award - Jimmy Lee (IMH, Duke-NUS)*

Schizophrenia affects one in a hundred persons and is one of the leading causes of disability in Singapore and around the world. In clinical practice today, psychiatrists rely on reliable accounts and behavioural observations to make a diagnosis and monitor improvements following treatments. These observations and reports can be difficult to obtain, and result in delays in treatment. There is a need for more reliable and objective tools to assist psychiatrists in delivering and monitoring care. Dr Lee’s early work has demonstrated the potential of blood-based biomarkers in identifying individuals with schizophrenia. In this study, his team attempted to reproduce the same results from earlier studies in a larger sample. The team is also looking to evaluate the ability of these blood-based biomarkers in predicting clinical outcomes, especially with regard to selection of suitable therapeutic regimen.

If the objectives of the study are fulfilled, this study team would have identified a truly novel peripheral biomarker for psychosis. This will be a significant advancement in the management of psychosis as a biomarker will provide much needed objectivity when it comes to evaluating disease response and making an informed decision in developing treatment plans.

Transition Award - Ng Oon Tek (TTSH)*

There are three strains of HIV virus circulating in Singapore – subtype B, CRF01_AE and CRF51_01B. Dr Ng’s research proposal focuses on how different strains of HIV virus affect the immune system differently. The research is potentially important at both international and local levels. At an international level, most of the immense body of HIV research is conducted on the Western subtype B strain, and differences in biology and clinical behavior of non-B strains could render those results not immediately transferable to other regions. For example, a recent publication from Dr Ng’s group highlighted the finding that Singaporeans infected with the CRF01_AE strain present with more severe immune-compromise, and as a result did not respond as well to treatment, as subtype B infected counterparts.

At a local level, the impact of HIV strain on patient outcome is important as public health and treatment strategies may need to be adapted to account for the differences. Some preliminary evidence has demonstrated that despite more testing among individuals infected with CRF51_01B compared to other strains, individuals infected with CRF51_01B present with more severe immune-compromise. The research team is currently conducting epidemiological and laboratory research to determine if this is due to increased aggressiveness of CRF51_01B.

* Articles on Dr Lee and Dr Ng can be found in the July-August 2012 issue of the “Catalyst”, available at: http://www.research.nhg.com.sg/wps/wcm/connect/romp/nhgromp/resources/catalyst

Annex F: Programme for NMRC Awards Ceremony & TCR Symposium

DATE:                                    31 October & 1 November 2012

VENUE:                                                Resorts World Sentosa Convention Centre

THEME:                                Pursuing Healthcare Research Excellence and Innovations

Guests-Of-Honour:  Mrs Tan Ching Yee, Permanent Secretary (Health)

Mr Lim Chuan Poh, Chairman, Agency for Science, Technology & Research (A*STAR)

PLENARY SPEAKER:         Dr Juan Carlos López García, PhD, Chief Editor, Nature Medicine Journal

Day 1

TRANSLATIONAL & CLINICAL RESEARCH FLAGSHIP PROGRAMMES SHOWCASE

PARALLEL SESSIONS - Pursuing Partnerships

Features the Flagships’ successful collaborations with industrial partners/overseas academic

 PARELLEL SESSIONS - Pursuing Academic Excellence

Features the Flagships’ best research outcomes, e.g. generation of publications, IP/ patents and products

 PARELLEL SESSIONS - Pursuing Better Health Outcomes

Features the Flagships’ contributions towards achieving better healthcare outcomes

 Day 2

Track 1 - Intellectual Property & Commercialisation

Track 2 - Clinical Trials and Health Technology Assessment

 Forum on Industry-Clinician Researchers Partnership

Perspectives and Experiences from Industry and Public Institution Research Community