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Start, fall down, get up, start over

This describes the lives of entrepreneurs facing continuous unforeseen events on the road to success

Klaus Vedfelt / Getty Images

After looking over the business plans of friends who wish to become entrepreneurs, electrical engineer and entrepreneur Rafael Holzhacker usually praises them, and then warns: “Be prepared, because nothing will go according to plan. What you wish to accomplish will probably cost twice as much and take three times as long.” Holzhacker—CEO of Timpel, a medical instruments manufacturer—knows what he is talking about. Although they are not often discussed, unforeseen challenges are a constant in the lives of innovators—such as staff anxiety, limited funds or resources, issues importing components, or extra work spent on adjusting applications for patents and permits.

Pesquisa FAPESP has shown several success stories from companies supported by the FAPESP Research for Innovation in Small Businesses (RISB, or PIPE in the Portuguese acronym) program. Among the most recent ones are the lung ventilator by Magnamed (see Pesquisa FAPESP issues no. 259 and no. 291) and the intracranial pressure monitor by brain4care (see Pesquisa FAPESP issues no. 223 and no. 280). Now, to illustrate the challenges posed by the process of developing each of the proposed innovations, Pesquisa FAPESP has highlighted 35 projects for medical devices supported by FAPESP through RISB or regular research grants, developed in the state of São Paulo and reported in the magazine since 1999, when the program was first launched. Sixteen coordinators (some of whom oversee more than one project) responded to our email. We were unable to reach the other coordinators; they either did not respond to messages or their contact details were out of date.

When they face major setbacks, small companies born from innovation often do not make it because, by that point, they usually have not yet managed to establish a solid structure. Larger organizations, on the other hand, can usually absorb the challenges of technological development without jeopardizing the whole company. The innovation paths that were able to be reconstructed here illustrate the challenges and setbacks in planning, team building, or commercial development that can shatter the dreams of researchers and keep them up at night. On the other hand, obstacles are an opportunity for innovators to show their ability to change initial plans, create strategies to win over their customers, and start over—often quite successfully.

A common mistake: focusing on product development and taking too long to find the right fit for the market

“Having an optimal prototype is only a small part of developing a product,” Holzhacker says. The next steps are to increase the scale of production, gain access to investors, get the necessary permits, win over customers, and finally sell the product. He compares it to playing a video game, where each level is more difficult and requires more skills than the previous one. Since 2015, the company has had three of its projects supported by RISB. Its most recent one, from last year, involves adapting its electrical impedance tomography machine to treat critically ill COVID-19 patients on artificial ventilation (see Pesquisa FAPESP issue nº 291).

Physicist Adilton Carneiro, coordinator of the group for innovation in medical instrumentation and ultrasound at the University of São Paulo (USP) in Ribeirão Preto and president of the Supera Park of Innovation and Technology until 2020, observed that companies whose staff is made up of a single type of professional—such as engineers—are automatically more fragile. “It is key that teams include business management and legal experts to minimize errors and accelerate new business development,” he suggests.

Biomedical engineer Aron Andrade, from the Dante Pazzanese Cardiology Institute, noted that delays are commonplace in the medical field, due to the ethical, scientific, and legal requirements for performing experiments. Since 2007, Andrade has been working on developing a Brazilian version of an implantable artificial heart. He has developed a prototype alongside colleagues from the Polytechnic School at USP; it had satisfactory results in 24 calves, whose heart is about the size of a human’s, and was approved for testing in humans. It was supposed to have been implanted in heart failure patients in 2011 (see Pesquisa FAPESP issue 185), but the process did not go as expected.

Léo Ramos Chaves Innovations in the medical field: mannequin for training…Léo Ramos Chaves

“The implantation candidates undergo a preliminary medical treatment. If their health improves, they are no longer candidates for implantation. If it gets worse, they are also no longer candidates, because they go on to other treatments,” shares Andrade. “We still haven’t figured out exactly when to perform the implantation on humans.” He says one option currently being explored is implanting small centrifugal pumps, which involve a simpler surgical procedure than that of implanting a whole artificial heart. The device, which can pump blood from the left ventricle of the heart to the aorta, has already been tested in three animals, with promising results, and could benefit patients with some types of heart conditions.

Change of plans
“I know that initial projections rarely play out, but they at least give us some direction,” acknowledges biologist Marcos Tadeu dos Santos, founder of Onkos, from Ribeirão Preto. Onkos has had its own facilities since 2018, after spending three years in its local technology park. In 2017, he licensed away the exclusive rights to his first product—a method for identifying the primary origin of metastatic tumors—to a large laboratory testing company but was disappointed that it did not help him achieve the necessary visibility to get new customers and promote new products. “For the company that licensed our test, it was just one amongst hundreds of others,” he says.

This motivated him to change his business strategy. In March 2018, as planned, Santos launched another test—this one for diagnosing thyroid nodules through microRNA analysis (see Pesquisa FAPESP issues 264 and nº 275). This time, however, his own team will perform the tests for the laboratories using mailed-in biopsy samples.

Miguel Boyayan …Clorovale dental drill…Miguel Boyayan

“I spend much of my days discussing the test results with doctors, so they can figure out when surgeries are really necessary and when they could be avoided,” he shares. “My challenge is now persuading health insurance companies to cover the cost of the test, which could help avoid much more expensive surgeries, with hormone replacement in later years.” The change also helped clarify his plans: “I prefer to have a few high-value products, for large markets, to be supplied by specialized staff.”

Also in Ribeirão Preto, physicist and physician Felipe Grillo, from Gphantom, was first disappointed then pleasantly surprised, which opened new doors for him. In 2017, at the beginning of the zika outbreak in Brazil, he sped up his work on a mannequin for medical professionals to practice amniocentesis. The test includes drawing amniotic fluid through a needle in the belly of pregnant women, revealing whether or not the fetus is infected with the zika virus, among other diseases that can be tracked. After the outbreak was over, many outpatient maternity clinics closed, and the mannequin has yet to be completed—in part due to how challenging it is to source its parts.

When selling his first simulator, which identifies breast tumors or cysts, Grillo noticed a high interest from customers in a recently developed product used to practice the application of anesthesia. This led him to conclude that “we must fulfill the needs of the market, not just sell what we want to sell.” Attending medical fairs allowed him to meet a representative from an exporting company, with whom he signed a contract in 2019—with legal assistance from Supera. He began selling his mannequins for medical training in France.

Eduardo Cesar …and photodynamic therapy device to treat cancer, developed by a group from USP in São CarlosEduardo Cesar

His simulator mannequins were used in the planning of a successful surgery to separate two conjoined twin sisters in 2019, at the USP hospital in Ribeirão Preto, which brought him both visibility and recognition (see Pesquisa FAPESP issues 247 and nº 276). Today, other companies have been ordering mannequin prototypes for specific uses in medical training.

In 2020, even before he had his own company, physicist Andrey Soares—who is currently a postdoctoral intern at Embrapa Instrumentação, in São Carlos, São Paulo—started getting orders for electronic device projects called biosensors, which detect the presence of microorganisms in industrial processes. His client’s interest stemmed from one of his earlier projects, which detected pancreatic tumors (see Pesquisa FAPESP issue nº 242). A result of his PhD at the São Carlos Institute of Physics (IFSC) at USP, this work did not advance according to plan. “The proof of concept went well enough, but we are having a hard time getting the project approved by ANVISA (Brazilian Health Regulatory Agency),” he says.

Physicist Osvaldo Novais de Oliveira Junior, from IFSC-USP, who advised Soares’ PhD, explains that, in order to request certification of a diagnosis from ANVISA, they would need several prototypes at hand. “We would also have to test how well the devices can be reproduced and how durable they are. That is extremely expensive,” he says. He states it would only make sense to move in this direction if there were interest from a company to produce the diagnostic tests.

Léo Ramos Chaves More innovations: electrode device for detecting antigens, by the group from USP in São Carlos…Léo Ramos Chaves

Materials engineer Valtencir Zucolotto, from IFSC-USP, faces a similar issue with his biosensor for detecting dengue and zika, which uses electrical signal variation (see Pesquisa FAPESP issue nº 258). “We are finalizing the prototypes; the next step is to present it to companies that show interest in continuing the work,” he says. His team makes biosensors for a multinational; they will likely be later produced on a larger scale. “When the company is involved from the beginning, the chances of selling are greater,” notes Zucolotto.

According to production engineer Eduardo Zancul, from the Polytechnic School at USP—a member of the Adjunct Panel for Innovation of FAPESP’s Scientific Board—entrepreneurs often focus on product development and take too long to figure out where it would fit in the market. “When they realize the market is not interested in what they have created, they have to change the direction of their work based on the real needs of customers.”

Those who start out based on real demand seem to have a higher chance of success. In one of the Research, Innovation, and Dissemination Centers (RIDC) established by FAPESP, the IFSC-USP optics group was frequently sought out by individuals who experienced limb pain and mobility issues. They all wanted to use a photodynamic therapy device, which combines laser and ultrasound technologies into one device and relieves arthritis pain. The team led by physicist Vanderlei Bagnato was motivated to perfect a device called Recupero, which was approved by ANVISA and is being produced and sold by MM Optics, also from São Carlos.

There is nothing wrong with starting with the basics, states Nakagawa

But there were surprises, of course. Several prototypes had to be assembled and tested on animal models and, later, on elderly women with osteoarthritis in the hands and knees. Occupational therapist Alessandra Rossi Paolillo, from the Federal University of São Carlos (UFSCar), monitored the tests closely and knew the importance of volunteer participation. On one occasion, one of the participants failed to show up for the assessments. Paolillo called the woman in question, who explained she was unable to get to the location on her own. “I immediately got in my car and drove to pick her up at her home,” shared the researcher.

They also face some resistance. “When I began developing research on photodynamic therapy with my group, in the 1990s, I was fiercely criticized by the Brazilian Society of Surgical Oncology,” Bagnato recalls. “A doctor once told me: ‘we can’t play Frankenstein.’ She was unaware that this type of treatment was already being used to treat esophageal cancer in the United States.” He is proud to be able to claim that the research developed in his laboratory has helped create about 40 products currently on the market (see Pesquisa FAPESP issues nº 74, nº 94, nº 139, nº 160, nº 299). “But I still tell this to my team every day: to be successful, one must know how to manage failure.”

Starting with the basics
“Innovative entrepreneurs must be flexible and offer what the market wants to buy,” reiterates business manager Marcelo Nakagawa, from the Insper Education and Research Institute, reinforcing the point made by Felipe Grillo from Gphantom. Nakagawa has authored the book Empreendedorismo: Elabore seu plano de negócio e faça a diferença (Entrepreneurship: How to develop a business plan and make a difference – SENAC, 2013) and is a board member for the RISB Entrepreneur – High-Tech Entrepreneurial Training Program.

Léo Ramos Chaves …lung ventilator by Magnamed…Léo Ramos Chaves

Established in 2016 by FAPESP and George Washington University, in the United States, RISB Entrepreneur has hosted 336 researchers with RISB-supported projects. The seven-week program—currently in its 16th class—includes interactions with potential customers, from which the participants must gauge the consistency of their business plans; they are also mentored by experienced entrepreneurs, who help them perfect their plans. “There is nothing wrong with starting with the basics,” states Nakagawa.

This approach was very helpful for Holzhacker of Timpel. Four years ago, he began selling a simple electrical impedance tomography device (see Pesquisa FAPESP issue nº 259). His goal was to gain customers and get some breathing room to mature more sophisticated versions of it. More refined devices, however, require more work and time before they become ready, mainly due to the lengthy process of obtaining approval from national and international regulatory agencies.

“We develop and manufacture the equipment according to international standards, but there is always room for interpretation and questioning,” he says. In late February, he participated in yet another video call with staff of the FDA (US Food and Drug Agency). “There were 11 physicians and risk experts asking tough questions and demanding further analysis to show the effectiveness of a new feature we want to get approved there.” Holzhacker currently exports nearly all of his production.

Timpel …and CT scanner by TimpelTimpel

Expanding to a global market is one of the challenges currently being faced by the three owners of Phelcom. The three physicists are former IFSC-USP students and have each branched out into different business areas: production, business, and research. Two years ago, with funding from FAPESP, Samsung, Hospital Israelita Albert Einstein, and the Brazilian Funding Authority for Studies and Projects (FINEP), they developed and launched the Eyer, a portable version of the retinograph, a device that records retinal images (see Pesquisa FAPESP issue nº 249).

“The challenges change over time,” reports Flavio Pascoal Vieira, operations director for the company. “Our initial challenge was of a technological nature: will the device work? Later, we faced a funding challenge: will we be able to afford all that we propose to do? Next, we had a market challenge: will customers buy our product? Finally, there was a manufacturing challenge: will we be able to produce the devices we have sold with high quality?” he sums up. There were also questions about human resources: how to put together and maintain a team that is motivated, productive, and innovative. More recently, they have focused their concern on operational security, that is, how to prepare for possible failures in the production process. As Nakagawa says: “The entrepreneur’s journey is a winding road.”

Those who changed direction…
Projects that have been abandoned could be useful in other applications

A piece of equipment called a susceptometer, created and produced in Brazil, is used to measure the iron levels in the livers of hospital patients by using the intensity of the magnetic field emitted by this chemical element. Its development began in 1998 and was proven to be technically viable. The prototype was used for 15 years at the Hospital das Clínicas at USP in Ribeirão Preto (see Pesquisa FAPESP issue nº 90) until it was deactivated in 2014.

 Eduardo Cesar Eyetec corneal topographer (detail): helpful for eye surgery Eduardo Cesar

One of the reasons was that the device did not prove to be economically viable, as the small number of patients that needed it did not justify its production costs. The other is that it proved to be expendable, since the same team that built it was able to program the hospital’s nuclear magnetic resonance machines to read liver iron content, with a similar level of accuracy.

“The susceptometer was useful as a steppingstone to develop MRI machines, to train entrepreneurs, and for other research,” says physicist Adilton Carneiro, from USP Ribeirão Preto, who developed the device during his PhD, which was advised by Oswaldo Baffa. Carneiro shares that these experiences led to two companies: Figlabs, bought out by the Gnatus group, and Gphantom, established through the Supera incubator.

Carneiro, in turn, is working on new technologies, this time combining magnetic techniques and ultrasound to identify tumors and amplify the effect of medication, as detailed in a paper published in January 2021 in the scientific journal IEEE Transaction on Biomedical Engineering. Testing on mice began last year.

 Eduardo Cesar Eyetec corneal topographer (overview): helpful for eye surgery Eduardo Cesar

Eye surveying equipment
In 2004, due to a heavy workload as a newly hired professor at the USP São Carlos School of Engineering, physicist Liliane Ventura decided to pause the development of the keratometer, a device that measures corneal curvature and could help testing for contact lenses (see Pesquisa FAPESP issue nº 107). Ventura explains, however, that the work was not lost, since portions of the software development for the device were useful for other products produced by Brazilian companies. One of her colleagues on the project, Jean-Jacques de Groote, was hired by Eyetec to develop software for a similar device, the corneal topographer (see Pesquisa FAPESP issue nº 114).

Eyetec recalls projects that were abandoned due to unsatisfactory results, such as the intra-surgical eye topographer. “The idea behind it was great, but the prototype was not very practical, and we did not feel it would be worth investing in because there was not a large market for it,” says Sílvio Antonio Tonissi Junior, director of the company. “The device worked well enough, but it took a long time to process the image and calculate the topographical map; physicians need these results almost in real time.” The size of the device was also an issue. It needed to be placed between the patient’s eye and the microscope, which sometimes hindered the surgeon’s movements. “Although it did not succeed, many parts of this project were used to help improve the corneal topographer, one of our top products to this day,” says Tonissi.

…and those who started over
Business initiatives that seem to be off track must be noticed and corrected in time

In 2003, Clorovale began selling—and soon exporting—synthetic diamond tips for dental ultrasound devices (see Pesquisa FAPESP issues 78 and nº 192). Physicist Vladimir Airoldi, one of the founders of the company established in 1997, shares that to continue growing and winning over new markets they needed external investors since financial reserves were scarce.

Negotiations with initial foreign interested parties who approached them did not evolve past a certain point. “They insisted we sell them the production technology, which they intended to give to their parent company abroad,” shares Airoldi. “The fact that FAPESP had coauthored the patent helped keep the deal from moving forward.”

The real problem occurred with another investor in 2011. “Due to our inexperience and lack of legal support,” he says, “we were unaware of the consequences of the contract we had signed.” As a result, the investors appointed their own managing director, who changed the focus of the business from medical to oil; their drills were then developed, tested, and approved for oil drilling. Five years later, although some prototypes had been sold, the plan was not successful.

In 2016, Airoldi and his partners dismissed their investors and directors, restructured the company, and brought the work back to the medical and dental fields. “We are putting the company back on track. We were able to double our revenue in 2017. In 2018, we doubled it again and, in 2019, we practically doubled it again,” he celebrates.

The most recent changes include a new commercial director, a newly established marketing department, an expanded product line, and the hiring of a law firm to help with contracts and managing the staff, which currently includes 35 employees. “We will consider external investments, but now we know where we are going and how to get there,” he concludes.

Eduardo Cesar Exa-m hemoglobinometer: used to diagnose and fight anemiaEduardo Cesar

Innovation in the fight against anemia
“A good prototype or good field tests are not enough to open doors,” states pediatrician Mario Bracco. From 2007 to 2009, he led a project—supported by FAPESP and the Ministry of Health—to evaluate the possibility of using a portable, automatic hemoglobin measuring device in the public health system. The device—called a hemoglobinometer—takes a single drop of blood and can give results in only a few minutes. It was developed by Exa-m, a company linked to the business incubator of the University of Mogi das Cruzes (see Pesquisa FAPESP issue 151).

In one of the tests, the research staff—including doctors, nurses, and nutritionists—detected anemia in 25% of the 667 public school children from Ilhabela, on the coast of São Paulo, and in another 219 children from Santa Luzia do Itanhy, in the state of Sergipe. The three-month treatment, which involved taking ferrous sulfate supplements, eliminated the issue in 76% of them, as described in a February 2011 article published in Jornal de Pediatria (Journal of pediatrics) and two months later in the BIS Boletim do Instituto de Saúde (Institute of health newsletter). In another test, the researchers were able to reduce cases of anemia from 54% to 28% in a population of 3,000 children, adolescents, and adults in riverside communities on the island of Marajó, in the state of Pará, and Macapá, in the state of Amapá.

The project coordinators received an award in 2012, where the then Minister of Health, Alexandre Padilha, was present. Nevertheless, talks with health care authorities about using the device as part of a public policy initiative have not progressed. “Anemia is a serious problem that impairs learning in children and productivity in adults,” argues Bracco. “For doctors, having the equipment on hand makes their work much easier, as it allows them to detect the problem during the appointment and begin treatment,” reinforces pharmacist and biochemist Jair Ribeiro Chagas, from the Federal University of São Paulo (UNIFESP). Chagas is one of the founders of Exa-m, alongside physicist Paulo Alberto Paes Gomes, currently at the Federal University of Bahia (UFBA), and veterinarian Maurício de Oliveira.

However, the company was only able to sell 50 pieces, failed to penetrate other markets, and finally shut down in 2017. “The investors we talked to did not understand the technical requirements of the health care sector and expected quick results,” explains Chagas. In 2020, he decided to start over, teaming up with three other experienced entrepreneurs to seek out investors and resume the hemoglobin measuring device project. “We want to rebuild the device to perhaps be the size of a cell phone,” says Chagas.

1. Electronic pulmonary ventilators on emergency transport (nº 09/52278-7); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Wataru Ueda (Magnamed); Investment R$135,576.27.
2. Neonatal electronic pulmonary ventilator with high frequency ventilation (nº 09/52357-4); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Toru Miyagi Kinjo (Magnamed); Investment R$71,643.27.
3. High-resolution signal acquisition and parallel processing for image reconstruction in electrical impedance tomography (nº 13/50775-9); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Agreement FINEP RISB/PAPPE Grant; Principal Investigator Rafael Holzhacker (Timpel); Investment R$245,475.
4. Development of a minimally invasive inductive sensor to monitor intracranial pressure (nº 14/50618-3); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Sérgio Mascarenhas Oliveira (Braincare); Investment R$913,895.75.
5. Braincare system for data acquisition, storage, and analysis for health care (nº 16/01990-2); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Deusdedit Lineu Spavieri Júnior (Braincare); Investment R$737,309.60.
6. Technical and commercial feasibility analysis of synthetic biological tissue simulators for training in ultrasound-guided medical procedures (nº 2014/50414-9); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Felipe Grillo (Gphantom); Investment R$100,875.
7. Synthetic biological tissue simulators for training in ultrasound-guided medical procedures: Amniocentesis (nº 17/50185-8); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Felipe Wilker Grillo (Gphantom); Investment R$330,513.11.
8. Implantable electromagnetic propulsion systems for uni- and bi-ventricular blood circulatory assist devices or artificial hearts (nº 06/58773-1); Grant Mechanism Thematic Project; Coordinator José Roberto Cardoso (USP); Investment R$1,185,540.09 and US$281,960.21.
9. Molecular classification of indeterminate thyroid nodules via microRNA profiling (nº 15/07590-3); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Marcos Tadeu dos Santos (Onkos); Investment R$108,781.17.
10. Nanostructured films of materials of biological interest (nº 2013/14262-7); Grant Mechanism Thematic Project; Principal Investigator Osvaldo Novais de Oliveira Junior (USP); Investment R$2,539,907.03.
11. Study of the interaction between nanostructured materials and biological systems: Applications in studies of nanotoxicity and diagnostic sensor development (nº 08/08639-2); Grant Mechanism Regular Research Grant; Principal Investigator Valtencir Zucolotto (IFSC-USP); Investment R$368,230.90.
12. CEPOF – Optics and Photonics Research Center (nº 13/07276-1); Grant Mechanism Research, Innovation, and Dissemination Centers (RIDC); Principal Investigator Vanderlei Salvador Bagnato (USP); Investment R$44,106,793.11
13. Portable smartphone-controlled retinal diagnosis device (nº 2016/00985-5); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator Flavio Pascoal Vieira (Phelcom); Investment R$225,351.29 and US$29,389.58.
14. Automatic corneal curvature ray measurement system for slit lamps – automatic keratometer for slit lamps (nº 00/13218-4); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Coordinator Liliane Ventura Schiabel – USP/Calmed; Investment R$215,878.
15. Development of a device for determining ocular aberrations using wavefront measurement (nº 00/06810-4); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Coordinator Jarbas Caiado de Castro Neto – Eyetec; Investment R$325,750 and US$12,250.
16. Development of Diamond-CVD Devices for Short-Term Applications (nº 97/07227-6); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Coordinator Kiyoe Umeda – Clorovale; Investment R$135,333.50 and US$76,485
17. New materials, studies, and innovative applications of CVD diamonds and Diamond-Like Carbon (DLC) (nº 2001/11619-4) (2002–2007); Grant Mechanism Thematic Project; Coordinator Vladimir Jesus Trava Airoldi – INPE/Clorovale; Investment R$576,456.12
18. New CVD diamond concepts for high-performance drilling and cutting tools (nº 2006/60821-4) (2007–2010); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Coordinator Leônidas Lopes de Melo – Clorovale; Investment R$550,661.41
19. DLC film applications for oil well drill pipes and antibacterial, anti-friction, space, and industrial surfaces (nº 2006/60822-0) (2007–2010); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Coordinator Alessandra Venâncio Diniz – Clorovale; Investment R$505,917.65
20. Ultrasound equipment with CVD diamond tips for bone surgery (nº 13/50791-4); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Principal Investigator João Henrique do Prado (Clorovale); Investment R$1,121,524.80.
21. Evaluation of the technology used in the HB-010 homoglobinometer and the possibility of being used in the Brazilian Public Health System (SUS), FAPESP-CNPQ-SUS agreement (nº 06/61907-0); Grant Mechanism SUS Research Program – Public Policy; Coordinator Mário Bracco (Cruz de Malta); Investment R$178,185.
22. Simplified fluorometer for measuring angiotensin-converting enzyme (ACE) activity in biological fluids (nº 04/14274-6); Grant Mechanism Research for Innovation in Small Businesses (RISB/PIPE) program; Coordinator Paulo Paes Gomes – Sépia; Investment R$326,778.35 (FAPESP)
23. Patent application assistance request for the HB-010 portable hemoglobinometer and associated method (nº 06/61239-7); Grant Mechanism Industrial Property Support Program; Coordinator Paulo Paes Gomes (Sépia); Investment R$6,000
24. Nanostructured films applied to microfluidic biosensors to detect bacterial mastitis (nº 18/18953-8); Grant Mechanism Postdoctoral Fellowship; Supervisor Luiz Henrique Capparelli Mattoso; Beneficiary Andrey Coatrini Soares; Investment R$305,246.34.

Scientific articles
HADADIAN, Y. et al. A novel theranostic platform: Integration of magnetomotive and thermal ultrasound imaging with magnetic hyperthermia. IEEE Transaction on Biomedical Engineering. Vol. 68, no. 1, pp. 68–77. Jan. 2021.
COSTA, Juliana T. et al. Prevalência de anemia em pré-escolares e resposta ao tratamento com suplementação de ferro. Jornal de Pediatria. Vol. 87, no. 1, pp. 76–9. Feb. 2011.
BRACCO, M. M. et al. Avaliação da tecnologia empregada no Hemoglobinômetro Hb-010 (Agabê®) e a possibilidade de aplicação no Sistema Único de Saúde. BIS – Boletim do Instituto de Saúde. Vol. 13, no. 1, pp. 46–52. Apr. 2011.