Leveraging implementation science in clinical trials of vaccines in the global south
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Optimising the mainstreaming of renal genomics: Complementing empirical and theoretical strategies for implementation
To identify and develop complementary implementation strategies that support nephrologists in mainstreaming renal genomic testing. Interviews were conducted with individuals nominated as ‘genomics champions’ and ‘embedded genomics experts’ as part of a mainstreaming project to identify initial barriers and investigate empirical strategies for delivering the project at initial stage. Data were mapped onto implementation science framework to identify complementary theoretical strategies. Interviews with 14 genomics champions and embedded genomics experts (genetic counsellors, nephrologists, renal nurses), identified 34 barriers to incorporating genomic testing into routine care, e.g., lack of long-term multidisciplinary team support and role clarity. In total, 25 empirical implementation strategies were identified such as creating new clinical teams. Using the Consolidated Framework for Implementation Research, 10 complementary theoretical implementation strategies were identified. Our study presents a novel approach complementing empirical strategies with theoretical strategies to support nephrologists in incorporating genomic testing into routine practice. Complementary strategies can potentially address barriers and inform future studies when mainstreaming renal genomics. This process underscored the need for integrating collaborative efforts among health professionals, patients, implementation scientists and the health system to overcome identified challenges to mainstream genomic testing. Future research should explore the applicability of these strategies to support mainstreaming genomic testing in different clinical settings.
Leveraging the collaborative power of AI and citizen science for sustainable development
Both artificial intelligence (AI) and citizen science hold immense potential for addressing major sustainability challenges from health to climate change. Alongside their individual benefits, when combined, they offer considerable synergies that can aid in both better monitoring of, and achieving, sustainable development. While AI has already been integrated into citizen science projects such as through automated classification and identification, the integration of citizen science approaches into AI is lacking. This integration has, however, the potential to address some of the major challenges associated with AI such as social bias, which could accelerate progress towards achieving sustainable development.
Trust in scientists and their role in society across 68 countries
Science is crucial for evidence-based decision-making. Public trust in scientists can help decision makers act on the basis of the best available evidence, especially during crises. However, in recent years the epistemic authority of science has been challenged, causing concerns about low public trust in scientists. We interrogated these concerns with a preregistered 68-country survey of 71,922 respondents and found that in most countries, most people trust scientists and agree that scientists should engage more in society and policymaking. We found variations between and within countries, which we explain with individual- and country-level variables, including political orientation. While there is no widespread lack of trust in scientists, we cannot discount the concern that lack of trust in scientists by even a small minority may affect considerations of scientific evidence in policymaking. These findings have implications for scientists and policymakers seeking to maintain and increase trust in scientists.
Bridging gene therapy and next-generation vaccine technologies
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Sequential STING and CD40 agonism drives massive expansion of tumor-specific T cells in liposomal peptide vaccines
The clinical use of cancer vaccines is hampered by the low magnitude of induced T-cell responses and the need for repetitive antigen stimulation. Here, we demonstrate that liposomal formulations with incorporated STING agonists are optimally suited to deliver peptide antigens to dendritic cells in vivo and to activate dendritic cells in secondary lymphoid organs. One week after liposomal priming, systemic administration of peptides and a costimulatory agonistic CD40 antibody enables ultrarapid expansion of T cells, resulting in massive expansion of tumor-specific T cells in the peripheral blood two weeks after priming. In the MC-38 colon cancer model, this synthetic prime-boost regimen induces rapid regression and cure of large established subcutaneous cancers via the use of a single tumor-specific neoantigen. These experiments demonstrate the feasibility of liposome-based heterologous vaccination regimens to increase the therapeutic efficacy of peptide vaccines in the context of immunogenic adjuvants and costimulatory booster immunizations. Our results provide a rationale for the further development of modern liposomal peptide vaccines for cancer therapy.
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