Background: Chronic diseases (CDs) now account for 85% of all deaths in Chile, the most prominent being cardiovascular diseases (CVD, 27%), followed by cancer (26%) (WHO – Noncommunicable Diseases Country Profiles, 2018).
Advanced Center for Chronic Diseases (ACCDiS ): This is the first Chilean Center of Excellence to study CVD & cancer. ACCDiS is a bi-institutional center involving the University of Chile (UCH) & Pontifical Catholic University of Chile (PUC) that is financed by the Funds for Research Centers in Priority Areas (FONDAP) program of ANID (former CONICYT). ACCDiS goals are to observe and dissect the natural history of CVD and cancer in Chile. Our 6 Research Lines (RLs) and Principal Investigators (PIs) are:
- Metabolic signaling in heart failure (S Lavandero, UCH)
- Gender-related differences in heart (P Castro, PUC)
- Tumor cell biology and inflammation (A Quest, UCH)
- Epigenomic landscapes in gastric cancer (A Corvalán, PUC)
- Digestive cancer natural history (C Ferreccio, PUC)
- Nanomedicine and chemical science for diagnosis and therapy of cancer and cardiovascular diseases (M Kogan, UCH).
Organizational strategy. To promote synergy and collaborative activities, ACCDiS organized: to) Weekly Academic Council meetings; b) Scientific meetings with internal ACCDiS speakers or invited national/international speakers; c) ACCDiS annual retreat; d) Specific weekly meetings to promote interactions in the areas of Cardio & Cancer; e) Mentoring sessions for young investigators; f) MAUCO workshops, on site visits and coordination meetings; g) Weekly administrative meetings; h) Core Facility Coordination Meetings and i) Trimestral meeting with Lab. Coordinator RLs.
Integration strategy. To favor the integration of research efforts we adopted the following general strategies: to) To focus research on two main general topics of interest: heart failure and digestive cancers, including the areas: epidemiology of CDs, angiotensin-(1-9), exosomes and nanomedicine. b) PhD, MSc students and post-doctoral fellows were recruited to work on (transversal) problems of interest to two or more RLs. c) To create special funding to promote collaborations between different areas, with special focus on the transversal projects d) A population-based study (MAUCO). e) Core facilities providing support in the Basic, Preclinical and Clinical (BPC) Core Facility.
Results: After 6 years in operation, ACCDiS is recognized by Chilean society as a high-profile research center for the study of cancer & CVD, which has allowed participation in the formation of public health policies, generating transfer technology, participation as experts in issues of national interest and being an important player in the dissemination of science in the Chilean society. After 6 years in operation. ACCDiS personnel (246 persons approx.) work in the 6 RLs, MAUCO and/or the two core facilities and includes 6 PIs, as well as 21 Associate Investigators (AIs). ACCDiS organization includes an Administrative Office, an Academic Council, an Innovation Committee, an International Scientific Committee and a National Advisory Committee.
In Advanced Training of Human Resources: The center includes 34 post-docs, 91 PhD, 36 MSc and 37 undergraduate students. 38% of the post-docs, 15% of the PhD, 6% of the MSc students were co-mentored between ACCDiS members from different RLs. Of the students and post-doctoral fellows in training at ACCDiS, 20% are foreigners. ACCDiS PIs and AIs coordinated and taught in various PhD, MSc and undergraduate courses at both universities. MAUCO included academics and under-graduate students from local universities in the field activities.
In Research: The epidemiological Maule Cohort (MAUCO) project. By December 2019, we had enrolled 8,970 participants. To date, 5,748 participants completed the year 2 follow-up, which is ongoing. Main baseline findings will be published in the International Journal of Epidemiology in early 2020. b) Publications & Patents: During the informed period (July 2018-December 2019), the Center published 120 ISI and 6 non-ISI papers, whereby 20% were published in top 10 journals, 57% in Q1 journals, 16% were in collaboration between the RLs, 46% and 70% were the result of collaborations with international and national research centers or groups, respectively. The average ISI impact factor was 5.2. Also, the Center has 10 patents (5 patent applications were presented, another 5 in progress for application) and 5 licenses in the bioinformatics area. The cumulative indicators obtained and expected (shown in parenthesis) for the first 5 years (2013-2018) of the Center are: ISI papers: 309 (250); papers published in top ten journals: 62 (25); papers published in Q1 journals: 186 (not declared in the initial proposal) and an average ISI impact factor: 4.83 (5). During this year 6, the indicators obtained and expected of the Center were: ISI papers: 71 (65); papers published in top ten journals: 11 (12); papers published in Q1 journals: 37 (39); and average ISI impact factor: 5.4 (4.5). Almost all of our expected values have been exceeded.
In Outreach to Society: From May 2018 to November 2019, ACCDiS has followed the new Communications Plan proposed in our renewal proposal. ACCDiS was awarded funding from 2019-2022 by the Explora Regional Associative Program of ANID for the Northern Zone of the Metropolitan Region (RM) of Santiago. Our main aim is the dissemination of science and technology in this zone. This initiative has allowed us to carry out activities in 33% of the RM population, impacting 1,387 playschools and both elementary and middle schools (413,777 students). During the first year of execution (2019), the PAR EXPLORA project exceeded expectations, achieving 15 scientific initiatives aimed at students, teachers and the community in general, where more than 30,000 people participated. Our indicators in the last year-and-a-half are: 265 interviews: 213 website news articles, 16 newspaper articles, 1 article in magazines, 12 television interviews, 11 radio interviews and 12 appearances in social media. ACCDiS also organized and participated in 77 outreach activities with a total of 60,059 participants. With respect to the community, the MAUCO Project has maintained a high level of communication and outreach to scientists, as well as to the Molina community and the Ministry of Health.
In International Networking: We have active collaborations with outstanding international research centers in CVDs, cancer, epidemiology & nanobiomedicine. These were strengthened by 36 visits of Chilean and foreign investigators (45 visits of ACCDiS members to foreign institutions and 45 international researchers visited ACCDiS in Santiago). Moreover, 46% of our ISI papers were published in collaboration with our international collaborators.
In Contributions to Public Policies: MAUCO has been supported by the Ministry of Health, the Maule Health Service and the Molina municipality, which recognize the potential of the cohort to guide in health prevention and developing control strategies for CDs. We participated in the creation of a “Cancer Law” and in the development of the new Chilean guidelines for the management of heart failure. Our PIs and AIs are advisers to national and international organizations such as: IARC, American Association for Cancer Research (AACR), Pan American Health Organization, Ministry of Health, Ministry of Science, Technology, Knowledge and Innovation, Maule Regional Health Council and Antofagasta regional government. We have become a scientific partner of the Molina Hospital, the Municipality of Molina, Municipality of Independencia and their community organizations. We have been concerned about having a greater impact on the early prevention of CDs through education and intellectual development of school-age children, in addition to intervening with youth and adults. The new 2019 Explora Regional Associative Program for the Northern Zone of the Metropolitan Region of Santiago is allowing us to carry out activities with playschools and both elementary and middle schools.