All in one: Conversation with Professor Dragan Primorac

I have that great honor to talk to Professor Dragan Primorac, our WSI’s esteemed guest. For the readers of WSI magazine, I use this opportunity to share a conversation with this prominent world scientist. Prof. Dragan Primorac is a pediatrician, forensic expert and geneticist. He is former Minister of Science, Education and Sports of The Republic of Croatia and he is the first recipient of the title “Global Penn State University Ambassador”. Currently he serves as the Chair of the International Affairs Committee of the American Academy of Forensic Sciences. Prof. Primorac is one of the pioneers in DNA identification of skeletal human remains from mass graves. He authored close to two hundred scientific papers and abstracts in clinical and molecular medicine, genetics, forensic science, population genetics, genetic legacy of Homo sapiens and education, science and technology policy. Currently, he has particular interest in metabolic bone and cartilage disorders, sports medicine as well as in personalized and regenerative medicine. Dr. Primorac was invited speaker at more than 100 conferences all around the world. His work was published in most cited journals including Science and Nature. Dr. Primorac is a pioneer in the application of DNA analysis for identification of war victims. His papers have been cited more than 3900 times (Google Scholar). He is currently honorary citizen of five cities in and outside of Croatia. Several renowned media outlets, both electronic and print, have reported on the results of his work, such as the New York Times, USA Today, Chicago Tribune, Hartford Courant, JAMA, Lancet, Science, NBC, Channel 8 (Connecticut TV Station), etc.

As adjunct professor, he serves at Eberly College of Science, The Pennsylvania State University and at Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, in the United States and as professor at Medical Schools in Split and Osijek as well as at Department of Biotechnology, University of Rijeka, in Croatia. In October of 2016. he was appointed as a visiting professor at the College of Medicine and Forensics, Xi’an Jiaotong University, People’s Republic of China. In addition, he is member of the International Consortium for Personalized Medicine Executive Committee (IC PerMEd) established by The European Commission while in November of 2015 he was elected to lead the State competitiveness cluster in personalized medicine. In addition, he co-founded The Department of Forensic Sciences at the University of Split, Croatia and in 2016. he was instrumental in establishing Regiomed Medical School in Bavaria, Germany.

In 2012, Dr. Primorac founded. Only five years later the European Business Award Committee announced that St. Catherine Hospital was chosen among the top 10 European institutions in “The Award for Customer Focus” category.

Earlier in his career he worked at The University of Connecticut, Health Center, Department of Pediatrics, Farmington, Connecticut; The University Hospital St. Christopher’s, Allegheny University, Philadelphia, Pennsylvania; The Armed Forces Institute of Pathology (AFIP), Rockville, Maryland; The Analytical Genetic Testing Center, Inc., Denver, Colorado; Roche Molecular Systems, Alameda, California and Connecticut State Police Forensic Science Laboratory, Meriden, Connecticut, all in the United States. Currently, he is a team leader of the Croatian partner in the international consortium within EU FP7 project entitled “Multi-dimensional OMICS approach to stratification of patients with low back pain”, worth 7.6 million euros. He is the co-founder and the President of The International Society of Applied Biological Sciences. In 2017. he was elected president of The Croatian Society for Human Genetics. Dr. Primorac received 21 domestic and international awards. In October of 2015 he has been awarded The State Science Award (the most prestigious national recognition by the Parliament of the Republic of Croatia) for his outstanding contribution to biomedical science. On February 12, 2015. Dr. Primorac received decoration “The Order of Croatian Star with the Effigy of Ruđer Bošković“, from the President of the Republic of Croatia for his extraordinary achievements in science. On June 2015, he was awarded with a special recognition for his outstanding service, dedication, professionalism and exceptional medical care and support to U.S. Embassy Sarajevo and Zagreb.

From 2003 to 2009 he served as Minister of Science, Education and Sports of The Republic of Croatia. According to the International Republican Institute survey of October 1, 2007, he was rated as the most successful minister in the Croatian Government with 31% approval rate. Dr. Primorac was junior Vice champion in Taekwondo of the former state (1984). In 2015. he was honored to be part of The Taekwondo Hall of Fame (United States) as “Pioneer Taekwondo Instructor”.

Prof. Primorac, your life and achievements have been an incredible and humbling journey in the past 25 years. What has kept you going?

I was fortunate to work with visionary people all my life. At the same time, I always followed the direction of my dreams and I never looked back in life with regrets. However, dreams don’t work unless you take action. Also, it is important to have enough courage and willingness to change things that others think is impossible to change. Personally, at beginning of my carrier I realized that my input will predict my output.

How is it possible to achieve so many recognitions in so many different areas?

It is not an easy task to give you a formula, but certainly you have to love what you are doing and you have to do it with passion. As I said earlier, I was fortunate to work with the best people from different areas and we always inspired each other.

What would be your most important advice for young people?

“Your future depends on what you do today” or “Believe in your dreams and then anything is possible”.

Scientist, physician, forensic expert, pediatrician, politician, sportsman, all in one person?

Well, science was always and it is still my greatest challenge. At the same time medicine is my love and passion and I am grateful for having a privilege to help others. Forensic means for me seeking the truth and justice. In opposite, politics is ugly but at the same time it could change the status quo, can serve common good and eventually can create better future than what we have found. Since childhood, I learn many important lessons from sport such as: teamwork, friendship, not to give up, to work hard, respect others, never underestimate others… Hence, if you combine all of these characteristics in one person it helps to look at life in a different perspective.

You are founder of the St. Catherine Hospital, the European center of excellence. How did you come to the idea of founding the hospital?

I was always intrigued by new technology and by the impact of innovations in the field of medicine. Since I entered medical school my dream was always to bring basic and clinical science together. I do not think that it will be possible to make significant progress in medicine otherwise. Albert Einstein said once “We cannot solve our problems with the same thinking we used when we created them”. We try to follow his advice and we are completely turning towards personalized medicine concept. At the same time St. Catherine’s Hospital main philosophy is to integrate innovations as new technologies to all our work according to the concept of personalized medicine.

In your hospital, some very famous athletes (Garry Kasparov (former World Chess Champion), Marin Čilić (Winner of 17 ATP singles titles, including the 2014 US Open), Aleksandr Viktorovich Khoroshilov (the first Russian male to win a World Cup race (Schladming, 2015), Gordan Giriček (NBA player: Memphis Grizzlies, Orlando Magic, Utah Jazz, Philadelphia 76ers, Phoenix Suns), Bojan Bogdanović (NBA player: Brooklyn Nets, Washington Wizards, Indiana Pacers), Mario Mandžukić (football player: Juventus and Croatian National Soccer Team), Luka Modrić (football player: Real Madrid and Croatian National Soccer Team), Ivan Rakitić (football player: Barcelona and Croatian National Soccer Team),) have been treated. How does it feel to know they chose your hospital?

Essentially, the concept behind the integral healthcare, (where expert teams from radiology, orthopedics, surgery, anesthesiology, gastroenterology, neurology and physical medicine take a multidisciplinary approach using the newest equipment and the latest treatment options, providing superior diagnostics in one place along with the best treatment options and individualized rehabilitation protocols) is what highlights and features the uniqueness of St. Catherine Specialty Hospital. Namely, every professional athlete’s goal is to come back as soon as possible into full sport activities after an injury. We are extremely proud to say that we can offer that kind of healthcare as a center of excellence for sports medicine, regarding both the expert staff and the equipment we contain. Our forward-thinking vision and ever evolving practices have ensured that we have treated more than 200 top athletes in the past few years.

You and colleagues from St. Catherine’s Hospital recently published an important article in the journal Genes describing the mechanism of how fat tissue containing mesenchymal stem cells influences cartilage regeneration. Could you elaborate a bit on this?

The results of our study indicate that the use of autologous and microfragmented adipose tissue containing mesenchymal stem cells (MSCs) in patients with knee Osteoarthritis (measured by dGEMRIC MRI) increased glycosaminoglycan (GAG) content in hyaline cartilage. We believe that once the active MSCs and pericytes obtain and sense the surroundings of the targeted knee joint, they start to secrete bioactive factors that are immunomodulatory, antiscarring, antiapoptotic, angiogenic, and trophic (regenerative), meaning that these cells make “therapeutic drugstores”.

St. Catherine’s Hospital is also center of excellence for treating very complex disease known as brittle-bone disease or Osteogenesis Imperfecta. Most of the patients coming from abroad because they have trust in your work. You must be proud of it.

You are right, a huge majority of our patients with Osteogenesis Imperfecta coming from abroad. The goal of treatment is to prevent deformities and fractures and allow the child to function as independently as possible. Currently, for the long-term fixation of long bone fractures in children, the state of art treatment that we apply in our hospital is use of telescopic Fassier Duval rods which allowing reinforcement throughout growth. However, one of the things that clearly separates St. Catherine’s Hospital from other hospitals is our team approach. Our unique combination of highly respected faculty members providing cutting-edge orthopedic, pediatric and physical medicine care, experienced nurses and nurse practitioners, provides patients with an exceptional level of care.

You are among physicians who are pioneering a new concept of personalized medicine. You are member of the Executive Committee of the International Consortium of Personalized Medicine supported by European Commission? How you would describe the concept of personalized medicine.

The International Consortium for Personalised Medicine (ICPerMed) brings together over 30 European and international partners representing ministries, funding agencies and the European Commission (EC) with a goal to coordinate and to foster research to develop and evaluate personalized medicine approaches. I strongly believe that the concept of personalized medicine will have significant impact on the future of the healthcare industry. FDA states, “personalized medicine is an innovative approach to disease prevention and treatment that takes into account differences in people’s genes, environments and lifestyles.” Actually, to be even more precise our goal is to use person’s molecular profile, medical imaging data as well as lifestyle data in order to tailor right therapeutic approach for the right person at the right time. However, the goal of personalized medicine is not only to treat a patient, its goal is also to determine predispositions to disease and to deliver prevention accordingly. Finally, I have to say that without a doubt: the future of medicine will rely on personalized treatments.

You are in charge of the International Society of Applied Biological Sciences ISABS. Recently, in partnership with Mayo Clinic in Dubrovnik you organized conference on personalized medicine that attracted more than 500 participants including 3 Nobel prize laureates. What were some of the highlights from the conference?

We all believe that the value of health care can be increased tremendously through an individualized (personalized) medicine concept. However, the integration of personalized medicine into healthcare system is beyond any doubt, a difficult task or job. Therefore, a comprehensive approach integrating the different phases of personalized medicine concept is needed. ISABS is having an important role in educating physicians, scientist and others about recent development in the field of personalized medicine. This year ISABS‘s conference attracted more than 60 invited speakers (including 3 Nobel prize laureates) as well as 500 participants from 45 countries. It is a great honor to have Mayo Clinic as our partner. Indeed, according to U.S. News & World Report, Mayo Clinic is the #1 hospital overall, as well as #1 in more specialties than any other hospital in the United States. I am particularly thankful to our colleagues from the Mayo Clinic since their involvement provided the critical link into the cutting-edge clinical applications of molecular medicine. This year conference topics included: biomarker discovery, epigenetics and epigenomics in health and disease, microbiome analysis in health and disease, clinomics, pharmacogenomics, etc. I have to underline: we strongly believe that the health care systems should utilize molecular information to improve outcomes, which will, indeed, make the health care system more efficient and effective.

It looks like that the industry understands the importance of personalized medicine concept so Philips was your strategical partner during ISABS conference.

Yes, we are grateful to have Philips as our strategical partner. With join forces Philips, St. Catherine’s Hospital, ISABS and others are trying to shape the future of medicine. Royal Philips is a leading global company in health technology focused on improving people’s health and enabling better outcomes with meaningful innovations and it is a privilege for us to be Philips’s partner.

It is known that a part of your achievements is happening because you are a dreamer. How to motivate people to have more dreams and to dare?

The best answer to this question was given by dear friend and Nobel Prize laureate Shimon Peres in his book “No room for small dreams”. The title of the book clearly shows the path. I would add, young people should dream big and when they get older they should be forever young in mind.

Former US President Clinton said once “Dragan is the future”. How you see the world’s future?

I am a great optimist, and I believe that all of us have a responsibility to shape the future to be even better and greater than we can even imagine. I do not have any doubts that we have greater opportunities ahead of us than ever before. A huge part of that are innovations and education.

Your continuous love is forensic science. Recently you published the book entitled Forensic DNA Applications and Interdisciplinary Perspective. Former editor of Journal of Forensic Sciences said that your book is the most comprehensive volume on forensic and ancestral DNA analysis yet published?

Professor Moses Schanfield and I put a significant effort to have all aspects of forensic genetics in one place: from crime scene analysis to ethics, law and policy. This particular volume is unique in the sense that the 51 authors who provided 23 chapters are experts in their specific areas.

Currently you serve as the Chair of the International Affairs Committee of the American Academy of Forensic Sciences.
The American Academy of Forensic Sciences with 6600 members is a multi-disciplinary professional organization that provides leadership to advance science and its application to the legal system. Representing all 50 United States, Canada, and 70 other countries worldwide, Academy members actively practice forensic science and, in many cases, teach and conduct research in the field as well. The objectives of the Academy are to promote professionalism, integrity, competency, education, foster research, improve practice, and encourage collaboration in the forensic sciences. It is a great honor and a privilege to serve Academy as the chair of International Affairs Committee and during my term I will do all I can to promote the basic value of Academy.

Last year Penn State University launched Global Ambassador Program appointing you as the first Global Ambassador. Nicholas Jones, Penn State’s executive vice president and provost formally announced your appointment. How did you feel receiving such a prestigious title?

I am grateful to President Eric Barron, for appointment to this distinguished role. This is a huge honor, and it makes me so proud to be a part of Penn State’s Global Network Strategy. Penn State University is fantastic institution and a currently I serve at Penn State University as an adjunct professor. With some colleagues from Penn State University like Professor Mitch Holland I collaborated for more than 20 years. On the other hand, on Global Ambassador Program, I collaborate closely with Prof. Michael Adewumi, Vice provost for Global Program. My goal is to bring Penn State University to every continent and country I have partners in.

For 6 years, you were minister of science, education and sports of the Republic of Croatia. According to the International Republican Institute survey of October 1, 2007, you were rated as the most successful minister in the Government. What makes some politicians more successful than others?

Unfortunately, the World is having so many politicians but only a few leaders. However, honesty, equality, kindness, compassion, treating people the way you wanted to be treated are values that every politician should share. The worst-case scenario for politicians is to lose touch with reality. At the same time, political correctness or political pragmatism confuses people. People would love to see those capable to make the World better place to live. The only people who can change the world are people who want to. And not everybody does.

The award for your efforts made in the Croatian educational system is the survey of the famous Newsweek (2010) which rated Croatia 22nd in education ahead of 12 countries from the G20 group. Could you please mention a few important projects you introduced?

In the period 203-2009 we were able to secure the greatest increase of the budget for science, education and sports in the history of modern Croatia (from €0.92 billion to €1.7 billion). My team and I launched a series of successful reforms in primary, secondary and tertiary education as well as in science, technology and sports that significantly improved the system. We successfully introduced two compulsory foreign language classes in all primary schools in the Republic of Croatia and national standard test equal to SAT for all student who are planning to continue their education in Universities. Furthermore, all school libraries and dormitories as well as all primary and secondary schools, have been supplied with computers and internet access while all scientific institutes and universities have been connected to the network at an access speed of 10 gigabytes. Within the National Programme of Measures for the Implementation of Compulsory Secondary Education, a series of incentives, such as free textbooks, free transport and housing in student dormitories have been offered to make secondary education accessible to everyone. In the period of 6 years we were able to build more than 350,000 square meters of new space for Croatian universities and the overall number of students was increased for about 40 000. Scientific collaboration have been signed with the most developed countries in the world (USA, Israel, Japan,..). At the same time with support from the Ministry, a total of 1,526 junior researches earned their PhDs.

In 2015, you were inducted into the Taekwondo Hall of Fame for your outstanding achievements and contribution to the taekwondo. You were also practicing soccer and athletics; do you still have time to do sports?

Indeed, every time when I have some free time. My love for sports will never end. I love sport and I want to promote it in whichever way I can. I am always telling young people that sport can prepare them for success. It doesn’t matter which part of the world I am, New York, Bangkok, London and so on: I will always bring my sneakers. (photos copyright by Archives, The Office of Prof. Dragan Primorac).