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"This institute intends to spur a virtuous cycle of new research, product innovation, startups, private investment, and jobs," says Christy Wyskiel, senior adviser to the president for innovation and entrepreneurship at JHU

DECLARATIONS Authors contributions Performed literature search, review writing, data analysis, and interpretation: Ding M Made significant contributions to the conception, design, and revision of the manuscript: Luo Y Proposed the rationale and framework of review, provided guidance for manuscript design: Ji L Availability of data and materials Not applicable

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Increasing protocol complexity further contributes to delays, deviations, and slower study execution