Everyday characterizations of translational research: researchers\u2019 own use of terminology and models in medical research and practice

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Biomedical literature and policy are highly concerned with encouraging and improving the clinical application and clinical benefit of new scientific knowledge. Debates, theorizing, and policy initiatives aiming to close the “bench-to-bedside gap” have led to the development of “Translational Research” (TR), an emerging set of research-related discourses and practices within biomedicine. Studies in social science and the humanities have explored and challenged the assumptions underpinning specific TR models and policy initiatives, as well as the socio-material transformations involved. However, only few studies have explored TR as a productive ongoing process of meaning-making taking place as part of the everyday practices of the actual researchers located at the very nexus of science and clinic. This article therefore asks the question of how the discourse and promise of translation is embedded and performed within the practices and perspective of the specific actors involved. The findings are based on material from ethnographic fieldwork among translational researchers situated in a Danish hospital research setting. The analysis draws on the analytical notion of performativity in order to approach statements and models of TR in the light of their performative dimension. This analytical approach thus helps to highlight how the characterizations of TR also contain prescriptions for how the world must change for these characterizations to become true. The analysis provides insights into four different characterizations of TR and reflects on the associated practices where performative success is achieved in practice. With the presentation of these four characterizations, this paper illustrates different uses of the term TR among the actual actors engaged in research-clinic activities and contributes insight into the complex processes of conceptual and material reorganization that form part of the emergence of TR in biomedicine.

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The possibility for physicians to repair a failing heart with stem cells or applied tissue-engineered myocardial patches still represents a new frontier for the treatment of heart failure [8]. Unfortunately, as in the field of cardioprotection, most of the attempts to effectively translate the highly promising experimental results obtained in this field into the clinical setting highlighted mixed results with benefits ranging from absent to transient or, at most, marginal [9, 10]. A part of the delay in the therapeutic advancement in the field of stem cells and cardiac regeneration is caused by the fact that little is still known about the mechanisms to increase stem cell survival after in vivo transplantation and to efficiently induce its transdifferentiation into mature cardiomyocytes. These mechanisms need to be urgently elucidated in future investigations. In addition, the standardization of the procedures for isolation, purification, manipulation, and transplantation of human stem cells used for therapeutic purposes needs to be implemented, despite the fact that the standards of safety and quality for stem cell therapeutic uses are currently defined in the Good Manufacturing Practice (GMP) guidelines (see Eudralex EU guidelines for Good Manufacturing Practice for Medicinal Products for Human and Veterinary Use) [11, 12]. Nonetheless, full compliance with GMP is a mandatory aspect of stem cell-tissue engineering and manufacturing. The improvement of translational research, however, cannot represent alone the solution for developing new strategies for the cure of cardiovascular diseases. Together with translational research, it would be highly important to implement also clinical and outcome research. These scientific research branches aim to further expand the current knowledge of the prevalence, incidence, impact, and management of cardiovascular abnormal conditions in selected or real-world patients. This would help to identify shortfalls in practice and to develop strategies to improve care. In particular, outcome research is planned to continuously provide new insights into the therapeutic interventions working best for specific types of patients and under specific circumstances. Given these premises, this special issue aimed at integrating expertise from different disciplines toward the same objective: a deeper understanding of the mechanisms underlying cardiovascular diseases as well as the development of new therapeutic strategies to prevent or treat cardiovascular diseases. In our opinion the result was notable. Among the accepted manuscripts, some studies developed new methods enhancing the cardiovascular transdifferentiation of stem cells or standardized the procedures for the isolation of bone marrow-derived cellular subtypes for the treatment of refractory ischemia. Other manuscripts dealt with the molecular mechanisms underlying ischemia/reperfusion damage or heart failure with preserved ejection fraction. The biomarkers associated with resistant hypertension or aortic aneurism rupture were also studied. In addition, some epidemiologic studies provided new insights into the factors associated with coronary artery disease or with a worse cardiovascular outcome. Finally, the genetic basis of metabolically unhealthy obesity was also investigated. The editors really hope that the scientific contributions accepted for this special issue may contribute in some extent to the advance of the current knowledge of the pathophysiology, prognosis, and management of cardiovascular diseases. Giacomo Frati Umberto Benedetto Giuseppe Biondi-Zoccai Sebastiano Sciarretta

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