Old antibiotic compounds would be life-saving drugs

To combat  drug-resistant infections, scientists are scouring chemical compounds that were previously discarded to identify the ones that could be transformed into new antibiotics. In the mid-20th century, many different chemical compounds were examined to determine the ones that had antibacterial properties; however, only a small proportion of compounds was used for drug development.

In modern times, diseases have become highly resistant to existing drugs. At the University of Leeds, these old compounds are being re-examined by biologists and chemists by using advancements in science and technology. These compounds are being tested very precisely to determine if they could be developed into a drug in the near future.

Presently, more than 3,000 antibiotics have been discovered till date. Nevertheless, only a handful of compounds have been prescribed clinically till date. There may be several compounds with untapped potential.

Life-saving drugs may be produced by identifying compounds that have anti-bacterial properties; these compounds might have not been used in clinical practice earlier. With the mutation of bugs, scientists are clueless about tackling them with existing batches of antibiotics.

Potential new drug

According to latest research studies, a compound identified in 1940s was a realistic contender as a new antibiotic drug. Actinorhodins (ACT) constitute a family of compounds with some antibiotic properties; however, these compounds were not developed into life-saving drugs previously.

A promising new drug has been developed to combat bacterial infections.  Antibacterial activity was exhibited by two most important representatives of ESKAPE category of bacteria, which have the ability to ‘escape’ the action of existing drugs.

New drugs should be discovered and developed to tackle antibiotic resistance. Potentially useful drugs were identified from antibiotics, which were already to people.  The group of drugs belonging to ACT family showed weak antibiotic activity, so they could not be evaluated previously.

To discover new drugs, one needs to identify chemical compounds that were shelved out previously. New antibiotics have not been discovered in the past 25 years. Current strategy of considering chemical compounds that were shelved off previously is a nice way of combating the growing strain of drug-resistant bacteria.

 

Renewable power may soon be possible with new fuel cell

Compared to gas-powered engines, fuel cells are greener because electricity is produced in these cells without burning up hydrogen (or other fuel) that empowers them. But they cannot be manufactured on a commercial scale because they are very expensive.

Researchers have been successful today in creating a fuel cell, which operates at a midrange temperature. Thus, researchers have developed an inexpensive, powerful version of fuel cells, which boosts chances of developing abundant green energy.

Most fuel cells operate at temperatures, which are either too hot or too cool; therefore, they cannot be manufactured at a reasonable price. Polymer electrolyte membrane (PEM) cells are used to empower cars and buses, which are operated at about 100°C.

Solid oxide fuel cells (SOFCs) provide power backup generators for hospitals and other buildings, and they typically operate at 1000 °C. The essential chemical reactions continue at a sluggish rate when PEM cells are operated at a lower temperature.

Expensive metal catalysts, such as platinum, are required to speed up these chemical reactions. Moreover, SOFCs have feverish temperatures, implying that even if they don’t need pricy catalysts, they can be built from expensive metal alloys that withstand scorching operating temperatures.

In recent years, fuel cell researchers have implemented Goldilocks strategy . With this strategy, fuel cells can be operated at about 500 °C, which is a midrange temperature. Chemical reactions driving fuel cells can occur quickly at this temperature; moreover, fuel cells can be built from cheaper metals, such as stainless steel.

Scientists have tried to build cells with catalysts borrowed from SOFCs. Although the devices worked well, only 200 milliwatts of power per square centimeter (mW/cm2) was generated from the electrode surface area. This power was less than the performance of PEM fuel cells and SOFCs.

To develop fuel cells on a commercial scale, fuel cells must produce at least 500 mW/cm2; this requirement has been mandated by the U.S. Department of Energy (DOE). According to a paper presented last year in the journal Science, material scientists have produced a fuel cell with intermediate operating temperature.

This fuel cell can produce  power of 455 mW/cm2. Another research group had also successfully produced a fuel cell that operated at a temperature of 500 °C, which was reported last year in Nature. Both PEM fuel cells and SOFCs are like batteries, and they have two electrodes that are separated with an ion-conducting electrolyte.

At one electrode, fuel molecules are stripped off negatively charged electrons. These electrons pass through an external circuit and move to a second electrode. Meanwhile, protons are ripped off from fuel molecules, which move to the second electrode through the electrolyte. Here, they recombine with traveling electrons.

There is a weak connection between anode and electrolyte, which blocks protons from zipping through cathode. A thin but dense layer of catalyst was atop the bulk of anode catalyst, and protons would easily undergo a transition and move into the electrolyte.

Researchers investigated the composition of ceramic electrodes, making them more stable in presence of steam and carbon dioxide. According to a report submitted in the journal Nature Energy, the devices produced nearly 550 mW/cm2 at 500 °C. These cells were stable for several hours of operation , and these cells showed hardly any signs of degradation.

Few issues still need to be solved before introducing these devices into commercial market. Presently, cells are small in size. They have diameter of few centimeters. Researchers need to make cells of much larger diameter. Pulsed laser deposition technique was used to form a dense coating on the anode, but it is difficult to perform this technique on a large commercial scale.

All ceramic electrodes and electrolytes are extremely brittle in nature, so they are less durable for use in real-world conditions. If these limitations are overcome, then intermediate range fuel cells would function as renewable sources of energy.

These fuel cells would not only generate electricity but the generated electricity would be converted into hydrogen and other fuels for the purpose of storage. This energy would be later converted into electricity. Thus, the biggest challenge associated with renewable energy would be solved. These innovative fuel cells would store energy when the sun is not shining and when the wind is still.

 

International Conference on Public Health in East Asia

Harrisco announces first international conference on past, present, and future of public health in east Asia. The role of public health is now very significant today as most people die today due to chronic ailments and accidents. In the past, most people died due to infectious diseases and nutritional ailments.

Date: February 22, 2018

Venue:  Ramada Plaza, Jeju Hotel, Jeju Island, South Korea

Website: http://www.ivnforum.org/

Public health implies a concept that aims at maintaining the well-being of a society, given the sophisticated segregation and morphology.  The community is the smallest unit of public health, and the fundamental unit of a community are local residents.

The purpose of public health is as follows:

  • Prevention of disease
  • Life-span extension
  • Improvement in the efficiency of physical and mental health

In East Asia, pandemic such as Severe Acute Respiratory Syndrome (SARS) in 2003 and Middle-Eastern Respiratory Syndrome Coronovirus (MERS-CoV) in 2015 could not be solved by a single country; therefore, our conference emphasizes on solving such problems.

The topics of the conference are as follows:

A. Hygiene History
B. Hygiene, sanitation
C. Health administration
D. Community health
E. Health Communication
F. Environmental Health
G. Health Education
H. Occupational Health
I. Medical Service
J. National Health Insurance
K. Health Literacy

In this international conference, papers will be presented on these topics. After a fair review, the selected papers would be published in Iranian Journal of Public Health, which is indexed (SSCI) journal.

Speakers from Konkuk University and Korea University are going to present research papers on public health at this conference.  The first session consists of lectures on public health and medicines in rural China, Japan, and Korea. Second session analyzes the impact of health following untold disasters in factories and industries. Academic papers presented would analyze following topics: Sewol Ferry Disaster, Cigarette smoking, MERS-CoV outbreak, Social Anxiety disorder, aging, obese and elderly population.

Third session would include papers on following topics: educational policies of martial arts and health, cultural and social aspects of drinking, oral health knowledge, and mental illness. Fourth session would include papers on following topics: daily sports participation, plyometric training of women, physical activity restriction of cancer patients, and TAS inflammatory factors and exercise.

 

 

 

A new inclusive treatment guideline for stroke patients

American Heart Association/American Stroke Association has issued a new guideline for treating blood clots that cause strokes. As per this new treatment guideline, more patients would be eligible for receiving critical care and treatments.

The novel guideline was based on the most recent research study, and it was published in the journal Stroke. This novel guideline was presented at the International Stroke Conference 2018. This is an annual conference that invites globally renowned researchers and clinicians who are specialized in treating stroke.

According to this new recommendation, the window of time could be increased for selected patients provided blood clots can be mechanically removed from blood vessels that supply human brain. If blood clots block large blood vessels, then these clots can be removed mechanically.

According to this guideline, mechanical thrombectomy can be safely performed on large vessel strokes if patients receive treatment within 16 hours after a stroke. With advanced brain imaging, mechanical thrombectomy can be performed on some stroke patients even after 24 hours. The previous time-limit was six hours.

Mechanical thrombectomy is a procedure in which a physician places a device within a catheter, which is a thin tube threaded within an artery. The clot is then grabbed and removed with the device. The procedure is more effective as the risk of disability is limited. In particular, it is very useful to treat blockages in larger vessels, which lead to human brain.

The risk of disability from stroke would be minimized in most patients as the time-window is expanded for mechanical thrombectomy in appropriate patients Many people would benefit from this new treatment guideline, and the purview of acute stroke treatment has changed completely. Hospitals have now upgraded their rigorous standards for performing mechanical endovascular thrombectomy.

Alteplase is a clot-busting IV drug, which works as a tissue plasminogen activator (tPA). It is the only drug that is approved by FDA for treating clots caused by ischemic stroke. In previous studies, clot-busting treatment was not performed on patients with mild strokes, but the new treatment guideline suggests that these patients could be included in this new line of treatment.

According to this guideline, the risk and benefits depend on individual patients because if this new treatment modality is administered promptly and correctly, disability caused by the drug can be decreased. The number of people receiving intravenous treatment for clot busting increases consequently.

Whenever a patient shows signs of a stroke, the most important measure in saving the person’s life would be a treatment modality with immediate action. The risk of disability can be minimized in stroke patients if they receive treatment as soon as possible.

Stroke is one of the leading causes of death all over the world. Moreover, it is also a leading cause of disability in patients. Acute ischemic stroke is the most common type of stroke as per new guidelines.

Such kind of stroke is caused whenever a blood clot blocks the artery that supplies blood to the brain, reducing blood flow. In the USA, a person suffers from stroke every 40 seconds and more than 133,000 people in the USA die of stroke each year. Of all the cases of stroke, more than 87% patients suffer from ischemic stroke.

The guideline was published after performing a systematic review of more than 400 research studies, which were published in peer-reviewed journals. A group of highly specialized experts in stroke treatment formulated these guidelines after carefully examining these studies. These are the most comprehensive guidelines for ischemic stroke treatment since 2013.

 

 

 

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A month long standoff ends between Elsevier and South Korean universities

ScienceDirect is a database of more than 3500 academic journals and books, which is published by world’s no.1 academic publisher Elsevier. The publisher Elsevier is headquartered in Amsterdam, Netherlands. For more than a month, South Korean universities were opposing a steep price rise proposed by Elsevier.

Initially, Elsevier had proposed a price hike of 4.5%, which was severely opposed by a consortium of top South Korean universities. On January 12, 2018, a settlement was finally achieved between South Korean universities and Elsevier.

South Korean universities have agreed to a price rise of about 3.5–3.9%.  In the initial proposal, Elsevier was compelling South Korean universities to compulsorily prescribe to its lesser known journals, as part of their ScienceDirect package deal. In future, South Korean universities would negotiate further for more concessions.

According to Lee Chang Won, secretary general of the Korea University & College Library Association, Elsevier currently provides a flat rate system. Therefore, universities have to pay for digital content of all journals, including the ones that are read least by viewers.

Lee Chang Won led the consortium of South Korean universities along with Korean Council for University Education (KCUE). Previously, South Korean universities accepted whatever rate increase was imposed by Elsevier, but they can no longer do the same due to budget cuts in library expenditure.

The consortium of 300 university and college libraries was formed in May 2017 by negotiating with 42 providers of databases. This group sought concessions on open-access journals and other less-read journals, which were included in the ScienceDirect package of Elsevier.

When Elsevier authorities refused to oblige, the consortium boycotted Elsevier and refused to renew contracts. During the period of negotiations, Elsevier provided access to all its products. Following negotiations, individual universities will now have to renew their one-year license at 3.9%; moreover, their three-year contract would be increased by 3.5%, 3.6%, and 3.7% above the baseline. These terms and conditions have been agreed by the consortium of universities in South Korea.

For 2019 contracts, negotiations would continue about pricing and other details between the consortium of South Korean universities and Elsevier, the publisher. According to Sogang’s Kim, the consortium is keen on signing a multi-year contract with Elsevier, wherein the annual increase of fees would be in the range 3.5–3.9%. This annual rate of increase in subscription fees is well above the international level of 2%. ScienceDirect journals are expensive but indispensable for academicians, rights from professors to post-doc scholars.

The month-long standoff between South Korean universities and Elsevier is akin to similar dispute between the consortium of German universities and Elsevier in 2017. At that point of time, electronic journals of Elsevier were not accessible to more than 60 universities in Germany as Elsevier had temporarily suspended access; however, the publisher restored access few weeks later though negotiations are still going on between consortium of German universities and Elsevier. Meanwhile, more than 200 universities in Germany have ceased their contract with Elsevier.

 

 

New methods approved by FDA for treating digestive tract cancers

The drug Lutathera (lutetium Lu 177 dotatate) was approved by US FDA for treating gastroenteropancreatic neuroendocrine tumors (GEP-NETs), which is a new type of cancer that affects either the pancreas or gastrointestinal tract.

Lutathera (lutetium Lu 177 dotatate) is a radioactive drug or radiopharmaceutical that has been approved by FDA. This is an important breakthrough as it is the first radiopharmaceutical drug that is approved as treatment for GEP-NETs. In adult patients with somatostatin receptor-positive GEP-NETs, Lutathera drug was found to be quite effective in nature.

The treatment options for GEP-NETs were limited as it is a rare group of cancers and conventional therapy was not successful in preventing the cancer from proliferating. With US FDA approving the drug Lutathera, it is a ray of hope for patients with these rare forms of cancer. It also establishes that US FDA is now open to considering data from therapies, which are used in an expanded access program.

GEP-NETs may develop in pancreas and in different parts of gastrointestinal tract, such as stomach, intestines, colon, and rectum. Previous studies have reported that approximately one out of 27,000 people were diagnosed with GEP-NETs each year.

Lutathera is a radioactive drug, which works by binding with somatostatin receptor, which is a component of cell and is present in certain tumors. After binding with the receptor, the drug enters the cell and the resultant radiation damages tumor cells.

The drug Lutathera was approved by two research studies: a randomized clinical trial was conducted on 229 patients with a certain type of advanced GEP-NET, which showed positive response to the receptor somatostatin.

In this clinical trial, patients received a combination of Lutathera and octreotide drug or they received only the drug octreotide. In this research study, researchers measured the period of time for which tumors did not grow after the patients received treatment (progression-free survival).

Patients who were prescribed Lutathera and octreotide had longer progression-free survival period than patients who received only octreotide. Compared to patients who received only octreotide, the risk of tumor growth or patient death was lower for patients who received both Lutathera and octreotide .

The second research study was performed on 1,214 patients in Netherlands. These patients were diagnosed with somatostatin receptor-positive tumors, including GEP-NETS. They were administered Lutathera at a single site.

In 16 percent of a subset of 360 patients with GEP-NETs, the tumors shrunk either completely or partially. The US-FDA authorities evaluated the response of these drugs to GEP-NETs. Patients who were enrolled in this study initially received Lutathera as part of an expanded access program. For patients with serious or immediate life-threatening diseases or conditions, expanded access is the way to gain access to investigational drugs for treatment use.

The drug Lutathera has following side-effects: low levels of white blood cells (lymphopenia), high levels of enzymes in certain organs (increased GGT, AST and/or ALT), vomiting, nausea, high levels of blood sugar (hyperglycemia), and low levels of potassium in blood (hypokalemia).

The drug Lutathera has following serious side-effects: low levels of blood cells (myelosuppression), development of certain blood or bone marrow cancers (secondary myelodysplastic syndrome and leukemia), kidney damage (renal toxicity), liver damage (hepatotoxicity), abnormal levels of hormones in human body (neuroendocrine hormonal crises) and infertility.

The drug Lutathera can harm a developing fetus; therefore, women are advised of the potential risk to fetus before undergoing treatment. To administer the drug lutathera, patients are exposed to radiation.

Guidelines to include feedback of patients in clinical trials

 

The impact of treatment on participants and their quality of life must be assessed more comprehensively, so it is imperative to make changes in international guidelines. The safety of participating patients and integrity of data collected depends on the protocols used for describing a clinical trial: objectives, design, methodology, statistical consideration, and organization.

Current protocols do not emphasize much on patient-reported outcomes (PROs). Most researchers have recommended that feedback must be collected from patients on how clinical trial affects overall quality of life.

According to a noted medical researcher at the University of Birmingham, feedback received from patients participating in a clinical trial can hold valuable information for following purposes: pharmaceutical labeling claims, clinical guidelines, health policy, shared-decision making.

Most clinical trials currently do not include information on quality of life and symptom data. This data must be collected to provide patient-centered care and to develop specific protocol guidelines.

Recommended changes to current protocols of clinical trials were published in the Journal of American Medical Association. This information was a joint-collaboration across universities of Toronto, Sydney, and Birmingham. It is important to understand the impact clinical trials have on cancer patients.

With this information, patients can then decide which line of treatment is most suitable for them. The side-effects of cancer treatments are often long-lasting and most clinical trials do not include this line of information. A cancer patient receiving treatment may live for years but their quality of life is severely impacted with these side-effects.

Patient-related outcomes (PROs) are classified as primary or secondary in clinical trial protocols; these outcomes need to be included in the current checklist guidelines of clinical trial protocol.

The PRO specific issues are as follows: trial rationale, eligibility criteria, objective, intervention, assessment time-points, proxy completion, and strategies for minimizing missing data.

The guidance prescribed in PROs is not prescriptive, but it provides a pathway for implementing a careful planning of PRO components of trials. Thus, PRO trial design improves, and the rationale for assessing PRO is improved. Thus, high quality analysis is ensured and reported, thereby improving the evidence base of PRO on a global scale.

Clinicians can use PROs effectively to make right decisions, thereby improving the line of recovery and treatment. This is a more effective strategy for comprehensively reporting personal experiences of patients with serious illness.

More guidelines must be consistently presented to help both patients and clinicians and to improve the outcome of prognosis. By improving the reporting of PRO data, the outcomes of patients with chronic diseases can be improved tremendously.

 

 

 

First clinical trial on lung stem cell transplantation in China

In Tongji University in China, researchers have developed an innovative technology for regenerating human lungs. In a successful clinical trial, autologous lung stem cell transplantation was carried out to regenerate damaged lungs of patients.

This study was reported in open access journal Protein & Cell (This journal was published by Springer Nature.). Professor Zuo and his colleagues successfully published this paper in 2015. They identified p63+/Krt5+ adult stem cells in mouse lungs that could regenerate bronchioles, alveoli, and other pulmonary structures.

Following this successful breakthrough, these researchers from Tongji University are now working in conjunction with Kiangnan Stem Cell Institute to apply the same discovery to human cells, rather than mice.

Human lungs are completely different from that of mice, both in terms of anatomy and developmental processes. Therefore, chronic pulmonary disorders can be solved by directly investigating human lungs.

An SOX9+ marker was used to label the category of basal cells, which could be cloned into lung stem cells in human beings. Professor Ren Tao is a renowned physician who worked in Shanghai East Hospital.

To produce lung stem cells from tiny samples of basal cells, lung bronchoscopy was performed by a team of researchers headed by Professor Ren Tao.

Lung stem cells were produced from about 0.2% of cells from each brush. A scaled expansion was conducted in a well maintained fashion to ensure genetic stability and molecular phenotypes of these cells.

To determine the capacity of lung stem cells and to regenerate lung tissue in vivo, GFP-labeled human lung stem cells were transplanted into damaged lungs of immunodeficient mice.

Three weeks after transplantation, a “human-mouse chimeric organ” was formed by integrating human lung stem cells in a large area of mice lungs.

By performing histological analysis, the transplanted stem cells were regenerated into bronchial and alveolar structures in lungs of mice. Around the regenerated structures of human alveoli, host capillaries were observed to be rising.

In other words, functional respiratory units were generated and they were detected by gold nanoparticle tracking technique. After performing stem cell transplantation successfully, new human alveoli were formed in place of fibrotic area in injured lungs. Lung function in mice was significantly restored by performing arterial blood gas analysis.

The first clinical trial was performed successfully by a team of researchers from the following organizations: Southwest Hospital of China Army University and Regend Therapeutics.

An autologous transplantation of lung stem cells was carried out for the treatment of bronchiectasis. Bronchiectasis is defined as a permanent injury that is caused to the bronchial structure of lungs. Two patients were included in this study in March 2016 following strict supervision by ethical committees.

The generated lung stem cells were transplanted into patients’ lung by performing bronchoscopy. These patients were then monitored for one year continuously. Multiple respiratory symptoms, such as coughing and dyspnea, were mitigated in these patients, one year after transplantation.

The dilated structures showed almost complete recovery as per CT images. Three months after transplantation, patients showed an improved in lung function and they showed further signs of recovery till one year.