Understanding Medical Device Patenting and Clinical Trials for Product Leadership

Unmet clinical needs remain the primary driving force for innovations in medical devices. While appropriate mechanisms to protect these innovative outcomes are essential, the performance of clinical trials to ensure safety is also mandated before the invention is ready for public use. Literature explaining the relationship between patenting activities and clinical trials of medical devices is scarce. Linking patent ownership to clinical trials may imply product leadership and value chain control. In this paper, we use patent data from Indian Patent Office (IPO), PCT, and data from Clinical Trials Registry of India (CTRI) to identify whether patent assignees have any role in leading as primary sponsors of clinical trials. A total of 42 primary sponsors are identified from the CTRI database in India. Number of patents awarded to these primary sponsors in the particular medical device, total number of patents awarded to the primary sponsor in all technologies, total number of patents in the specific medical device technology provides an indication of leadership and control in the value chain.

An enzyme-linked immuno focus assay for rapid detection and enumeration, and a newborn mouse model for human non-polio enteroviruses associated with acute diarrhea

We have recently reported significant association of non-polio enteroviruses (NPEVs) with acute and persistent diarrhea (18-21% of total diarrheal cases), and non-diarrheal Increased Frequency of Bowel Movements (IFoBM-ND) (about 29% of the NPEV infections) in children and that the NPEV-associated diarrhea was as significant as rotavirus diarrhea. However, their diarrhea-causing potential is yet to be demonstrated in an animal model system. Since the determination of virus titers by the traditional plaque assay takes 4-7 days, there is a need for development of a rapid method for virus titer determination to facilitate active clinical research on enterovirus-associated diarrhea. The goal of this study is to develop a cell-based rapid detection and enumeration method and to demonstrate the diarrhea-inducing potential of purified and characterized non-polio enteroviruses, which were isolated from diarrheic children. Here we describe generation of monoclonal and polyclonal antibodies against purified strains belonging to different serotypes, and development of an enzyme-linked immuno focus assay (ELIFA) for detection and enumeration of live NPEV particles in clinical and purified virus samples, and a newborn mouse model for NPEV diarrhea. Plaque-purified NPVEs, belonging to different serotypes, isolated from children with diarrhea, were grown in cell culture and purified by isopycnic CsCl density gradient centrifugation. By ELIFA, NPEVs could be detected and enumerated within 12 h post-infection. Our results demonstrated that Coxsackievirus B1 (CVB1) and CVB5 strains, isolated from diarrheic children, induced severe diarrhea in orally-inoculated 9-12 day-old mouse pups, fulfilling Koch's postulates. The methods described here would facilitate studies on NPEV-associated gastrointestinal disease. (C) 2015 Elsevier B.V. All rights reserved.

First-in-Class Inhibitors of Sulfur Metabolism with Bactericidal Activity against Non-Replicating M-tuberculosis

Development of effective therapies to eradicate persistent, slowly replicating M. tuberculosis (Mtb) represents a significant challenge to controlling the global TB epidemic. To develop such therapies, it is imperative to translate information from metabolome and proteome adaptations of persistent Mtb into the drug discovery screening platforms. To this end, reductive sulfur metabolism is genetically and pharmacologically implicated in survival, pathogenesis, and redox homeostasis of persistent Mtb. Therefore, inhibitors of this pathway are expected to serve as powerful tools in its preclinical and clinical validation as a therapeutic target for eradicating persisters. Here, we establish a first functional HTS platform for identification of APS reductase (APSR) inhibitors, a critical enzyme in the assimilation of sulfate for the biosynthesis of cysteine and other essential sulfur-containing molecules. Our HTS campaign involving 38?350 compounds led to the discovery of three distinct structural classes of APSR inhibitors. A class of bioactive compounds with known pharmacology displayed potent bactericidal activity in wild-type Mtb as well as MDR and XDR clinical isolates. Top compounds showed markedly diminished potency in a conditional Delta APSR mutant, which could be restored by complementation with Mtb APSR. Furthermore, ITC studies on representative compounds provided evidence for direct engagement of the APSR target. Finally, potent APSR inhibitors significantly decreased the cellular levels of key reduced sulfur-containing metabolites and also induced an oxidative shift in mycothiol redox potential of live Mtb, thus providing functional validation of our screening data. In summary, we have identified first-in-class inhibitors of APSR that can serve as molecular probes in unraveling the links between Mtb persistence, antibiotic tolerance, and sulfate assimilation, in addition to their potential therapeutic value.

Mutations in the nucleotide binding and hydrolysis domains of Helicobacter pylori MutS2 lead to altered biochemical activities and inactivation of its in vivo function

Background: Helicobacter pylori MutS2 (HpMutS2), an inhibitor of recombination during transformation is a non-specific nuclease with two catalytic sites, both of which are essential for its anti-recombinase activity. Although HpMutS2 belongs to a highly conserved family of ABC transporter ATPases, the role of its ATP binding and hydrolysis activities remains elusive. Results: To explore the putative role of ATP binding and hydrolysis activities of HpMutS2 we specifically generated point mutations in the nucleotide-binding Walker-A (HpMutS2-G338R) and hydrolysis Walker-B (HpMutS2-E413A) domains of the protein. Compared to wild-type protein, HpMutS2-G338R exhibited similar to 2.5-fold lower affinity for both ATP and ADP while ATP hydrolysis was reduced by similar to 3-fold. Nucleotide binding efficiencies of HpMutS2-E413A were not significantly altered; however the ATP hydrolysis was reduced by similar to 10-fold. Although mutations in the Walker-A and Walker-B motifs of HpMutS2 only partially reduced its ability to bind and hydrolyze ATP, we demonstrate that these mutants not only exhibited alterations in the conformation, DNA binding and nuclease activities of the protein but failed to complement the hyper-recombinant phenotype displayed by mutS2-disrupted strain of H. pylori. In addition, we show that the nucleotide cofactor modulates the conformation, DNA binding and nuclease activities of HpMutS2. Conclusions: These data describe a strong crosstalk between the ATPase, DNA binding, and nuclease activities of HpMutS2. Furthermore these data show that both, ATP binding and hydrolysis activities of HpMutS2 are essential for the in vivo anti-recombinase function of the protein.

Human Papillomavirus (HPV) genotype 18 variants in patients with clinical manifestations of HPV related infections in Bilbao, Spain

Background:Human papillomavirus (HPV) variants differ in their biological and chemical properties, and therefore, may present differences in pathogenicity. Most authors classified variants based on the phylogenetic analysis of L1 region. Nevertheless, recombination in HPV samples is becoming a usual finding and thus, characterizing genetic variability in other regions should be essential. Objectives:We aimed to characterize the genetic variability of HPV 18 in 5 genomic regions: E6, E7, E4, L1 and the Upstream Regulatory Region (URR), working with both single infection and multiple HPV infection samples. Furthermore, we aimed to assess the prevalence of HPV 18 variants in our region and look for possible existence of recombination as well as analyze the relationship between these variants and the type of lesion. Methods: From 2007 to 2010, Clinical Microbiology and Infection Control Department analyzed 44 samples which were positive for HPV 18. Genetic variability was determined in PCR products and variants were assigned to European, Asian-amerindian or African lineage. Recombination and association of variants with different types of lesion was studied. Results: Genetic analysis of the regions revealed a total of 56 nucleotide variations. European, African and Asian-amerindian variants were found in 25/44 (56.8%), 10/44 (22.7%) and 5/44 (11.4%) samples, respectively. We detected the presence of recombinant variants in 2/44 (4.5%) cases. Samples taken from high-grade squamous intraepithelial lesions (H-SIL) only presented variants with specific-african substitutions. Conclusions: Multiple HPV infection, non-european HPV variants prevalence and existence of recombination are considered risk factors for HPV persistence and progression of intraepithelial abnormalities, and therefore, should be taken into consideration in order to help to design and optimize diagnostics protocols as well as improve epidemiologic studies. Our study is one of the few studies in Spain which analyses the genetic variability of HPV18 and we showed the importance of characterizing more than one genomic region in order to detect recombination and classify HPV variants properly

Clinical factors associated with a Candida albicans Germ Tube Antibody positive test in Intensive Care Unit patients

Background: Poor outcomes of invasive candidiasis (IC) are associated with the difficulty in establishing the microbiological diagnosis at an early stage. New scores and laboratory tests have been developed in order to make an early therapeutic intervention in an attempt to reduce the high mortality associated with invasive fungal infections. Candida albicans IFA IgG has been recently commercialized for germ tube antibody detection (CAGTA). This test provides a rapid and simple diagnosis of IC (84.4% sensitivity and 94.7% specificity). The aim of this study is to identify the patients who could be benefited by the use of CAGTA test in critical care setting. Methods: A prospective, cohort, observational multicentre study was carried out in six medical/surgical Intensive care units (ICU) of tertiary-care Spanish hospitals. Candida albicans Germ Tube Antibody test was performed twice a week if predetermined risk factors were present, and serologically demonstrated candidiasis was considered if the testing serum dilution was >= 1: 160 in at least one sample and no other microbiological evidence of invasive candidiasis was found. Results: Fifty-three critically ill non-neutropenic patients (37.7% post surgery) were included. Twenty-two patients (41.5%) had CAGTA-positive results, none of them with positive blood culture for Candida. Neither corrected colonization index nor antifungal treatment had influence on CAGTA results. This finding could corroborate that the CAGTA may be an important biomarker to distinguish between colonization and infection in these patients. The presence of acute renal failure at the beginning of the study was more frequent in CAGTA-negative patients. Previous surgery was statistically more frequent in CAGTA-positive patients. Conclusions: This study identified previous surgery as the principal clinical factor associated with CAGTA-positive results and emphasises the utility of this promising technique, which was not influenced by high Candida colonization or antifungal treatment. Our results suggest that detection of CAGTA may be important for the diagnosis of invasive candidiasis in surgical patients admitted in ICU.

Identification of non fishing income opportunities around Kainji Lake

The findings are presented of a study carried out in the Kainji Lake region of Nigeria in order to identify alternative income opportunities for the fisherfolk, so as to increase their acceptance of fishery management measures and also to reduce the harmful short-term economic effects that such management options can have. A description is given of the main non-fishing income earning activities in the Kainji Lake area and an assessment is made of the economic viability and expected acceptance of the identified income earning opportunities. (PDF contains 84 pages)

Directed evolution of terpene synthases for non-natural substrates

Terpenes represent about half of known natural products, with terpene synthases catalyzing reactions to increase the complexity of substrates and generate cyclizations of the linear diphosphate substrates, therefore forming rings and stereocenters. With their diverse functionality, terpene synthases may be highly evolvable, with the ability to accept a wide range of non-natural compounds and with high product selectivity. Our hypothesis is that directed evolution of terpene synthases can be used to increase selectivity of the synthase on a specific substrate. In the first part of the work presented herein, three natural terpene synthases, Cop2, BcBOT2, and SSCG_02150, were tested for activity against the natural substrate and a non-natural substrate, called Surrogate 1, and the relative activities on both the natural and non-natural substrates were compared. In the second part of this work, a terpene synthase variant of BcBOT2 that has been evolved for thermostability, was used for directed evolution for increased activity and selectivity on the non-natural substrate referred to as Surrogate 2. Mutations for this evolution were introduced using random mutagenesis, with error prone polymerase chain reactions, and using site-specific saturation mutagenesis, in which an NNK library is designed with a specific active site amino acid targeted for mutation. The mutant enzymes were then screened and selected for enhancement of the desired functionality. Two neutral mutants, 19B7 W367F and 19B7 W118Q, were found to maintain activity on Surrogate 2, as measured by the screen.

New neuroimaging methods for clinical neuroscience and neurological disorders

236 p.

Via L-arginina-óxido nítrico e insuficiência cardíaca: associação ao condicionamento físico

A insuficiência cardíaca (IC) é uma síndrome clínica de elevada incidência e com um prognóstico ruim a longo prazo. Ela é a via final comum da maioria das doenças que acometem o coração, sendo um dos mais importantes desafios clínicos na área da saúde. O óxido nítrico (NO) representa, por intermédio de sua influência sobre o endotélio e as plaquetas, um importante papel na regulação da homeostase vascular. Este gás de meia-vida curta é sintetizado a partir do aminoácido L-arginina, pela enzima NO sintase (NOS), levando à produção de guanosina monofosfato cíclica (GMPc). Estudos mostram que anormalidades na biodisponibilidade de NO em plaquetas podem contribuir para eventos trombóticos, não tendo sido ainda avaliada na IC. Na primeira parte do estudo, o objetivo foi investigar o efeito da IC na atividade e na expressão da NOS em plaquetas, no conteúdo intraplaquetário de GMPc, na agregação plaquetária, além dos parâmetros antropométricos e da composição corporal, das variáveis bioquímicas, dos aminoácidos plasmáticos, do estresse oxidativo (plasma e plaquetas) e da concentração sistêmica de marcadores inflamatórios em 15 pacientes com IC e 15 controles saudáveis. Na segunda parte do estudo, objetivou-se avaliar os efeitos do treinamento físico (TF) regular nessas mesmas variáveis (exceto a expressão da NOS) e nas variáveis hemodinâmicas e respiratórias. Para tal, foram avaliados 15 pacientes com IC que se mantiveram sedentários e 15 pacientes com IC que realizaram 30 minutos de atividade física aeróbia e treinamento contraresistência muscular localizada com pesos livres e máquinas, três vezes por semana, durante 24 semanas. Os resultados da primeira etapa do estudo demonstraram hiperagregabilidade plaquetária induzida tanto por colágeno como por ADP, com aumento do estresse oxidativo, da atividade basal da NOS e da concentração de GMPc, estando os níveis plasmáticos de L-arginina em pacientes com IC diminuído. A expressão da iNOS, estava aumentada em plaquetas de pacientes com IC em relação aos controles saudáveis.Também foi observado aumento da resposta inflamatória, com maiores níveis sistêmicos de proteína C reativa, fibrinogênio, interleucina-6 e fator de necrose tumoral α. Após o período de TF, houve aumento do VO2 máximo e a agregação plaquetária induzida tanto por colágeno quanto por ADP estava diminuída. Ocorreu um aumento dos níveis plasmáticos de L-arginina e, uma redução da atividade da NOS após o TF. Em relação ao estresse oxidativo, tanto a produção sistêmica, quanto a intraplaquetária de substâncias reativas ao ácido tiobarbitúrico (TBARs) e a carbonilação diminuíram na presença da atividade aumentada das enzimas superóxido dismutase (SOD) e da catalase após o TF. Houve uma diminuição da resposta inflamatória, uma diminuição do colesterol total, do LDL e dos triglicerídeos e um aumento do HDL, após oTF. Nossos resultados sugerem que o TF tem efeitos antioxidantes, anti-inflamatórios e antiagregantes, que parece ser independente da produção de NO, sendo uma importante ferramenta não farmacológica no tratamento da IC

Synthesis of marine ecosystem monitoring activities for the United States Virgin Islands: 1990-2009

The ecological integrity of coral reef ecosystems in the U.S. Caribbean is widely considered to have deteriorated in the last three decades due to a range of threats and stressors from both human and non-human processes Rothenberger 2008, Wilkinson 2008). In response to the threats to Caribbean coral reef ecosystems and other regions around the world, the United States Government authorized the Coral Reef Conservation Act of 2000 to: (1) preserve, sustain, and restore the condition of coral reef ecosystems; (2) promote the wise management and sustainable use of coral reef ecosystems to benefit local communities and the Nation; and (3) develop sound scientific information on the condition of coral reef ecosystems and the threats to such ecosystems. The Act also resulted in the formation of a National Coral Reef Action Strategy and a Coral Reef Conservation Program. The Action Strategy (Goal 2 of Action Theme 1) outlined the importance of monitoring and assessing coral reef health as a mechanism toward reducing many threats to these ecosystems. Monitoring was considered of high importance in addressing impacts from climate change; disease; overfishing; destructive fishing practices; habitat destruction; invasive species; coastal development; coastal pollution; sedimentation/runoff and overuse from tourism. The strategy states that successful coral reef ecosystem conservation requires adaptive management that responds quickly to changing environmental conditions. This, in turn, depends on monitoring programs that track trends in coral reef ecosystem health and reveal patterns in their condition before irreparable harm occurs. As such, monitoring plays a vital role in guiding and supporting the establishment of complex or potentially controversial management strategies such as no-take ecological reserves, fishing gear restrictions, or habitat restoration, by documenting the impacts of gaps in existing management schemes and illustrating the effectiveness of new measures over time. Long-term monitoring is also required to determine the effectiveness of various management strategies to conserve and enhance coral reef ecosystems.

Anti-HIV Activities of the Compounds Isolated from Polygonum cuspidatum and Polygonum multiflorum

The 70% EtOH extract of Polygonum cuspidatum showed inhibitory action against HIV-1-induced syncytium formation at non-cytotoxic concentrations in vitro with a 50% effective concentration (EC50) of 13.94 +/- 3.41 mu g/mL. Through bioactivity-guided fractionation, 20 phenolic compounds, including eight stilbenoids, were isolated from the roots of Polygonum cuspidatum, and their anti-HIV-1 activities were evaluated. Results showed that compounds 1, 13, 14, and 16 demonstrated fairly strong antiviral activity against HIV-1-induced cytopathic effects in C8166 lymphocytes at non-cytotoxic concentrations, with EC50 values of 4.37 +/- 1.96 mu g/mL, 19.97 +/- 5.09, 14.4 +/- 1.34 mu g/mL, and 11.29 +/- 6.26 mu g/mL and therapeutic index (TI) values of 8.12, > 10.02, > 13.89, and > 17.71, respectively. Other compounds showed either weak or no effects. Compound 6 also showed weak inhibition (153.42 +/- 19.25 mu g/mL); however, it possesses very good water solubility and showed almost no cytotoxicity (> 2000 mu g/mL), therefore achieving a fairly good TI (13.04). The activities of the two compounds (3 and 18) from Polygonum multiflorum were also assayed. The relationship between molecular structures and their bioactivities was also discussed.

Effects of human activities on migratory waterbirds at Lashihai Lake, China

Surveys on migratory waterbirds and their habitats at Lashihai Lake, China, were conducted from October 1999 to April 2000. Five fixed points, representing different degrees of habitat disturbance and quality, were selected around the lake. We used counts (n = 30) to compare diversity and abundance of waterbirds at each point and evaluate the effects of habitat disturbance. The distribution of waterbirds was affected by disturbance, with snore than one-third of the total species and nearly half of the total individuals occurring at the least disturbed point. Species richness was weakly and abundance was strongly correlated to habitat disturbance, but not to habitat quality. Habitat destruction and use of canoes were prominent at the lake. Naxi ethnic fishermen (n = 37) were interviewed. They caught 570 waterbirds between October 1999 and March 2000 in fishing nets. An estimation of the total number of waterbirds been trapped on the lake is 6164. Diving species were most susceptible. Conservation measures that should implement immediately include the cessation of habitat destruction, better plan for the development of tourism, a reduction in the number of canoes and zoning of the non-fishing area. (C) 2002 Elsevier Science Ltd. All rights reserved.

Evaluation of estrogenic activities and mechanism of action of perfluorinated chemicals determined by vitellogenin induction in primary cultured tilapia hepatocytes

Perfluorochemicals (PFCs) are emerging persistent organic pollutants (POPs) and are widely present in the environment, wildlife and humans. Recently, reports have suggested that PFCs may have endocrine-disrupting activities. In the present study, we have developed a non-competitive enzyme-linked immunosorbent assay (ELISA) method to investigate estrogenic activities of selected PFCs using vitellogenin (VTG) induction in primary cultured hepatocytes of freshwater male tilapia (Oreochromis niloticus). Cultured hepatocytes were exposed to various concentrations of perfluorooctanyl sulfonate (PFOS), pentadecafluorooctanoic acid (PFOA), 1H, 1H, 2H, 2H-nonafluoro-1-hexanol (4:2 FTOH), 1H, 1H, 2H, 2H-perfluorooctanol (6:2 FTOH) and 1H, 1H, 2H, 2H-perfluoro-1-decanol (8:2 FTOH) for 48h, while 17 beta-estradiol (E2) and 4-nonylphenol (4-NP) were used as positive controls. A dose-dependent induction of VTG was observed in E2-, 4-NP-, PFOS-, PFOA- and 6:2 FrOH-treated cells, whereas VTG levels remained unchanged in the 4:2 FTOH and 8:2 FTOH exposure groups at the concentrations tested. The estimated 48-h EC50 values for E2,4-NP, PFOS, PFOA and 6:2 FTOH were 4.7 x 10(-7), 7.1 x 10(-6), 1.5 x 10(-5), 2.9 x 10(-5) and 2.8 x 10(-5) M, respectively. In the time-course study, significant VTG induction took place at 24 h (E2), 6 It (4-NP), 48 It (PFOS), 48 It (PFOA), 72 It (4:2 FTOH), 12 h (6:2 FTOH), 72 h (8:2 FTOH), and increased further after 96 It of exposure. Co-exposure to binary mixtures of individual PFCs and E2 for 48 It significantly inhibited E2-induced hepatocellular VTG production in a dose-dependent manner except for 4:2 FTOH. The estimated 48-h IC50 (concentration of a compound that elicits 50% inhibition of maximally E2-induced VTG) values for PFOS, PFOA, 6:2 FTOH and 8:2 FTOH were 3.1 x 10(-7), 5.1 X 10(-7), 1.1 X 10(-6) and 7.5 x 10(-7) M, respectively. In order to further investigate the estrogenic mechanism of PFCs, the hepatocytes were co-exposed to binary mixtures of individual chemicals (E2,4-NP, PFOS, PFOA and 6:2 FTOH) and the known estrogen receptor inhibitor tamoxifen for 48 h; tamoxifen significantly inhibited the ability of these chemicals to stimulate vitellogenesis. The overall results demonstrated that PFOS, PFOA and FTOHs have estrogenic activities and that exposure to a combination of E2 and PFCs produced anti-estrogenic effects. The results of the estrogen receptor inhibition assay further suggested that the estrogenic effect of PFCs may be mediated by the estrogen receptor pathway in primary cultured tilapia hepatocytes. (c) 2007 Elsevier B.V. All rights reserved.

Facile, Efficient Copolymerization of Ethylene with Bicyclic, Non-Conjugated Dienes by Titanium Complexes Bearing Bis(beta-Enaminoketonato) Ligands

Copolymerizations of ethylene with 5-vinyl-2-norbornene or 5-ethylidene-2-norbornene under the action of various titanium complexes bearing bis(beta-enaminoketonato) chelate ligands of the type, [(RN)-N-1=C(R-2)CH=C(R-3)O](2)TiCl2 (1, R-1=Ph, R-2=CF3, R-3=Ph; 2, R-1=C6H4F-p, R-2=CF3, R-3=Ph; 3, R-1=Ph, R-2=CF3, R-3=t-Bu; 4, R-1=C6H4F-p, R-2=CF3, R-3=t-Bu; 5, R-1=Ph, R-2=CH3, R-3=CF3; 6, R-1=C6H4F-p, R-2=CH3 R-3=CF3), have been shown to occur with the regioselective insertion of the endocyclic double bond of the monomer into the copolymer chain, leaving the exocyclic vinyl double bond as a pendant unsaturation. The ligand modification strongly affects the copolymerization behaviour. High catalytic activities and efficient co-monomer incorporation can be easily obtained by optimizing the catalyst structures and polymerization conditions.