The status and issues of the Institutional Animal Care and Use Committee of Seoul National University: from its establishment to the present day

The Institutional Animal Care and Use Committee (IACUC) of Seoul National University (SNU) plays a key role in monitoring and managing the humane use of animals in scientific research. Here, as one of the pioneers of the IACUC in Korea, we reported SNU-IACUC operations and activities including committee establishment and legal formulation, protocol review, and post-approval monitoring of protocols, which the IACUC has undertaken in the last decade. In addition, legal regulations and improvements were also discussed, and encompassed the limited number of committee members and the single IACUC policy in Korea. As of December, 2020, amendments are on the table at the National Assembly. We also emphasized the independent nature of the IACUC in protecting activities, including approval and monitoring animal experiments, and its public role in narrowing the knowledge gap between society and scientists. Thus, the aim of this report is to help society and scientists understand the operations of the SNU-IACUC and its role in animal welfare.     

Focus: Rare Disease: mEDUrare: Supporting Integrated Care for Rare Diseases by Better Connecting Health and Education Through Policy

Rare diseases affect an estimated 6-10% of the Australian population, a prevalence similar to that seen in other regions worldwide. These multi-system conditions are often severely debilitating and affect multiple domains of a person’s life. A salient necessity for effective care provision thus, is holistic care, achieved by appropriate and continual multi-disciplinary and cross-sectoral collaboration. Synonymous with this priority for collaborative care, is the need for increased partnerships between the health and education sectors. This partnership has the potential to benefit people with rare disease of all educational ages, but in particular, school-aged children and young adults. More than 70% of rare diseases affect children, and this population often experiences difficulties with overall well-being and functioning, including impaired school performance and confounding mental and social comorbidities. Ensuring adequate schooling needs and experiences along with provision of adequate medical care, is crucial in ensuring overall well-being for this population. For this, effective partnerships between the health and education sectors are paramount. This article highlights fundamental elements of health and education priorities, ingrained in current strategic documents, to build a policy foundation that informs and supports increased inter-sectoral partnerships between health and education services. Shared priorities identified in both sectors’ guidelines, co-developed with those with lived experience of rare diseases, build a strong policy base for future advocative initiatives to mold better integration between the sectors, a partnership which is vital to improving the overall quality of life, experiences and journeys of people living with rare disease.     

Natural products and their semi-synthetic derivatives against antimicrobial-resistant human pathogenic bacteria and fungi

Human infectious diseases caused by various microbial pathogens, in general, impact a large population of individuals every year. These microbial diseases that spread quickly remain to be a big issue in various health-related domains and to withstand the negative drug impacts, the antimicrobial-resistant pathogenic microbial organisms (pathogenic bacteria and pathogenic fungi) have developed a variety of resistance processes against many antimicrobial drug classes. During the COVID-19 outbreak, there seems to be an upsurge in drug and multidrug resistant-associated pathogenic microbial species. The preponderance of existing antimicrobials isn’t completely effective, which limits their application in clinical settings. Several naturally occurring chemicals produced from bacteria, plants, animals, marine species, and other sources are now being studied for antimicrobial characteristics. These natural antimicrobial compounds extracted from different sources have been demonstrated to be effective against a variety of diseases, although plants remain the most abundant source. These compounds have shown promise in reducing the microbial diseases linked to the development of drug tolerance and resistance. This paper offers a detailed review of some of the most vital and promising natural compounds and their derivatives against various human infectious microbial organisms. The inhibitory action of different natural antimicrobial compounds, and their possible mechanism of antimicrobial action against a range of pathogenic fungal and bacterial organisms, is provided. The review will be useful in refining current antimicrobial (antifungal and antibacterial) medicines as well as establishing new treatment strategies to tackle the rising number of human bacterial and fungal-associated infections.     

苯扎贝特降解菌的筛选及降解特性

【目的】药品苯扎贝特在水环境中频繁检测出,对环境的潜在危害不容忽视。我们筛选分离降解苯扎贝特的细菌,并研究其降解特性。【方法】根据分离菌株的细胞形态结构、生理生化特征及其16S rRNA基因序列分析鉴定降解菌,高效液相色谱法测定苯扎贝特,以判定该菌株的降解能力。【结果】分离菌株B-31属恶臭假单胞菌(Pseudomonas putida),降解机制是共代谢。降解最佳条件为30℃、pH7。此条件下,以1%甲醇为初级基质,30mg/L苯扎贝特的5日降解率为48%。当分别以5g/L葡萄糖、蛋白胨、酵母粉为初级基质时,可使降解率提高到61%,、72.6%、76.67%。【结论】这是国内首次报道恶臭假单胞菌可以通过共代谢降解苯扎贝特,该研究为利用细菌发酵消除水环境中苯扎贝特污染提供基础。     

Factores de riesgo asociados a desnutrición en personas mayores que viven en la comunidad: una revisión rápida

The aim of this review was to determine the most important risk factors (RF) in the development of malnutrition in people over 65 years living in the community. A rapid review has been conducted by applying the PRISMA methodology (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) and using the Medline database (PubMed). A search strategy was drawn up, up to 13 January 2020. A total of 24 articles published in the last 5 years were included in this review. Assuming the methodological limitations of the present review, it is possible to conclude that undernutrition is a multifactorial problem whose most significant RF are: age, economic status, alterations in the digestive system, comorbidity, polymedication, dependence on the performance of daily life activities, physical inactivity, food insecurity, depression, social isolation, and the field of self-perceptions. Early identification of geriatric patients exposed to these RF can allow a preventive approach in the development of malnutrition from primary care.     

Validez predictiva del cuestionario VIDA considerando pérdida funcional,institucionalización o muerte en pacientes pluripatológicos

IntroductionThe VIDA Spanish questionnaire assesses instrumental activities of daily living (IADL) in elderly people, and has shown to have adequate content, construct validity, and reliability.The objective was to analyse its predictive validity in patients with multiple morbidities aged ≥ 65 years without severe/total dependence in basic activities (BADL, Barthel index ≥ 60 points), by measuring any changes in this severe/total level of dependence, institutionalisation, or death at 8 and 18 months of follow-up.MethodsA prospective study of a diagnostic test was conducted on 197 patients (8 months) and 185 (18 months) included in the multiple morbidities program according to stratification by Adjusted Clinical Groups (ACG) or by fulfilling the Ollero criteria. Patients that were institutionalised, at the end of life, or on dialysis, or with a baseline Barthel index ≥ 60 points were excluded. The VIDA questionnaire was applied at baseline. The other baseline variables included age, gender, Charlson index, number of drugs, and Lawton-Brody index.The outcome event was changing the Barthel index to < 60, or institutionalisation, or death, in each follow-up period.ResultsThe median age was 81 years (IQR 74.5-85), and 45.2% were women.At 8 months, the best cut-off point for VIDA was ≤ 31 points (Sensitivity [S] 81.5%, [95% CI; 61.2-93.0]; Specificity (Sp) 58.2% [95% CI; 50.4-65.7], PPV 23.7%; NPV 95.2%), ≤ 30 in women, ≤ 34 in men. And at 18 months, ≤ 29 points (S 61.4 [95% CI; 47.6-73.7]; Sp 76.6 [95% CI; 68.1-83.4]; PPV 53.9; NPV 81.7).ConclusionsOverall cut-off points are provided as well as those for gender, predicting severe/total BADL decline, or institutionalization or death in patients with multiple morbidities. It seems to detect short-term events better and rules them out in the long term.     

Prevalencia y perfil de la persona frágil en la isla de La Palma

IntroductionPopulation ageing requires that health and social systems focus their attention on identifying frailty in the elderly. In the Canary Islands, there are no studies to determine the prevalence of frailty among its population. The objective of this study is to determine the prevalence and profile of frailty in the island of La Palma, Canary Islands, Spain.Material and methodA cross-sectional study was conducted to estimate the prevalence and the profile of frailty. The sample were residents over 70 years old, valued by the Fried criteria, and taking into account other related factors. The prevalence is offered with a confidence interval of 95% and is compared with that of other Spanish populations. To determine the profile, a simple comparison of variables was made, followed by using them in logistic regression models. All the tests were bilateral at a P≤0.05 level.ResultsThe prevalence of frailty in people over 70 years was estimated at 20% (17-23%). This prevalence shows differences with those of other Spanish populations. The factors that showed a relationship with frailty were, being female, widowed, living alone, low physical activity, cognitive impairment, depression, polymedication, and adverse clinical history. Multivariate analysis identifies factors associated with the frailty variables related to marital status, co-existence, polypharmacy, depressive states, and lack of physical exercise.ConclusionsThe elderly population of La Palma have greater frailty compared to that described in other regions of Spain, with their profile being that of a widowed person, with depression, polymedicated, living alone, and not exercising.     

Hospital amable para la persona mayor: el hospital del siglo XXI

The current health system must be revolutionized to meet the specific and real requirements of the largest population attended, older adults, and tailor the hospital to their needs, not the other way round. This is the goal of Hospital Universitario Infanta Leonor: senior-friendly hospital. The project was established as a business process management system integrated into the management's hospital map. Four subprocesses were defined, as were all activities and tasks to be performed. The subprocesses are health care (delirium and functional decline prevention and the identification of frail older patients), training, the environment and its structures, and patient and family involvement. The leadership corresponds to the geriatricians who coordinate a multidisciplinary team of the project's referents. Actions must be scientific, evidence-based, rigorous, and evaluable, and they should be audited. The final aim is to change established mentalities, routines, and habits to convert the hospital to a friendlier place for older adults.     

Test Alusti: nueva escala de valoración del rendimiento físico para la población geriátrica

Introduction

Physical and psychological functional conditions are key factors in the elderly population. Many evaluation tools are available, but they cannot be applied to the whole geriatric population. The use Alusti Test is presented. This test consists of 2 versions, which enable it to encompass this wide and complex population spectrum.

GLP-1 receptor agonists and reduction of cardiometabolic risk: Potential underlying mechanisms

Type 2 diabetes mellitus (T2DM) is a metabolic condition with an elevated impact on cardiovascular (CV) risk. The innovative therapeutic approaches for T2DM - incretin-based therapies (IBTs), including glucagon-like peptide 1 (GLP-1) receptor agonists, have become popular and more widely used in recent years. The available scientific data from clinical studies and clinical practice highlights their beyond glucose-lowering effects, which is achieved without any increase in hypoglycaemia. The former effects include reduction in body weight, lipids, blood pressure, inflammatory markers, oxidative stress, endothelial dysfunction, and subclinical atherosclerosis, thus reducing and potentially preventing CV events. In fact, the introduction of IBTs is one of the key moments in the history of diabetes research and treatment. Such therapeutic strategies allow customization of antidiabetic treatment to each patient's need and therefore obtain better metabolic control with reduced CV risk. The aim of the present paper is to provide a comprehensive overview of the effects of GLP-1RA on various cardiometabolic markers and overall CV risk, with particular attention on recent CV outcome studies and potential mechanisms. In particular, the effects of liraglutide on formation and progression of atherosclerotic plaque and mechanisms explaining its cardioprotective effects are highlighted.