PR and Communication Management in Asia-Pacific: Trends, Growth and Gaps

With a number of Asia-Pacific countries among the fastest growing in the world, the requirements for public relations and communication management are also growing in terms of both demand and professionalism. It is essential that practitioners and academics keep pace with demand and achieve ‘international best practice’. In 2015/16, the largest ever survey of PR and communication management in Asia-Pacific was launched as a biannual study, with the second survey undertaken in 2017/18. The survey is modelled on similar studies that have been conducted in Europe since 2007, in Latin American since 2014, and North America from 2018, allowing international comparison. This analysis examines key findings of the latest Asia-Pacific survey and compares results with the 2015/16 Asia-Pacific study as well as with international data to identify trends, areas of growth in professional practice, and gaps and shortcomings to be addressed. The findings are informative for educators, professional associations, and practitioners in terms of the design of undergraduate and graduate courses and ongoing training and professional development

MEK inhibitors cobimetinib and trametinib, regressed a gemcitabine-resistant pancreatic-cancer patient-derived orthotopic xenograft (PDOX).

A pancreatic ductal adenocarcinoma (PDAC), obtained from a patient, was grown orthotopically in the pancreatic tail of nude mice to establish a patient-derived orthotopic (PDOX) model. Seven weeks after implantation, PDOX nude mice were divided into the following groups: untreated control (n = 7); gemcitabine (100 mg/kg, i.p., once a week for 2 weeks, n = 7); cobimetinib (5 mg/kg, p.o., 14 consecutive days, n = 7); trametinib (0.3 mg/kg, p.o., 14 consecutive days, n = 7); trabectedin (0.15 mg/kg, i.v., once a week for 2 weeks, n = 7); temozolomide (25 mg/kg, p.o., 14 consecutive days, n = 7); carfilzomib (2 mg/kg, i.v., twice a week for 2 weeks, n = 7); bortezomib (1 mg/kg, i.v., twice a week for 2 weeks, n = 7); MK-1775 (20 mg/kg, p.o., 14 consecutive days, n = 7); BEZ-235 (45 mg/kg, p.o., 14 consecutive days, n = 7); vorinostat (50 mg/kg, i.p., 14 consecutive days, n = 7). Only the MEK inhibitors, cobimetinib and trametinib, regressed tumor growth, and they were more significantly effective than other therapies (p < 0.0001, respectively), thereby demonstrating the precision of the PDOX models of PDAC and its potential for individualizing pancreatic-cancer therapy

Interaction of Chemotherapy and the immune response in experimental malaria infections

Plasmodium chabaudl malaria Infections in CBA mice showed a characteristic and consistent pattern. Primary parasitaemias reached a peak of 30-50% but resolved within 3 weeks. Small recrudescences occurred at 4 and at 8 weeks and parasites were demonstrable up to 9 weeks by subinoculation of blood and other tissues. Infections in T-lymphocyte deprived mice were not fatal but the mice remained parasitaemic for at least 120 days. By contrast, P. berghel killed both intact and deprived mice; the survival time of the T-cell deprived mice was significantly longer. Treatment of P. chabaudl infections with chloroquine, quinine or pyrimethamine was generally more effective in intact than in T-cell deprived mice. Chloroquine and quinine treatment of P. berghel infections, however, was more effective in the deprived mice. None of the recrudescences of either P. berghel or P. chabaudl infections following treatment showed evidence of increased resistance to the drugs. Mice treated with cortisone acetate died of P. chabaudi infections and were not as effectively treated with quinine or chloroquine as infected controls. Induced protein energy malnutrition prolonged P. chabaudi parasitaemias but these were as readily treated as infections in controls on balanced diet. Suppression of P. chabaudi infections by subcurative chemotherapy gave rise to a strong immunity. Curative treatment given early in infections resulted in only partial immunity to challenge whereas treatment late in the infection gave a high degree of resistance to infection. Generalized immunodepression during P. chabaudi infection was related to the degree of parasitaemia. There was some increase in the rate of catabolism of immunoglobulins as a result of the infection. P. chabaudi infections were significantly suppressed in mice which had mature Schistosoma mansoni infections but acute or chronic infections did not influence development of the schistosomiasis

Opiates and elderly: Use and side effects

The evaluation of pain and the subsequent issue of pain control is a clinical challenge that all healthcare providers face. Pain in the elderly population is especially difficult given the myriad of physiological, pharmacological, and psychological aspects of caring for the geriatric patient. Opiates are the mainstay of pain treatment throughout all age groups but special attention must be paid to the efficacy and side effects of these powerful drugs when prescribing to a population with impaired metabolism, excretion and physical reserve. In a random chart review of 300 US veterans, 44% of those receiving an analgesic also received opioids. The increasing use of opiates for pain management by healthcare practitioners requires that those prescribing opioids be aware of the special considerations for treating the elderly. This article will address the precautions one must take when using opiates in the geriatric population, as well as the side effects and ways to minimize them

Efficacy and effectiveness of dihydroartemisinin-piperaquine versus artesunate-mefloquine in falciparum malaria: an open-label randomised comparison.

BACKGROUND: Artemisinin-based combinations are judged the best treatments for multidrug-resistant Plasmodium falciparum malaria. Artesunate-mefloquine is widely recommended in southeast Asia, but its high cost and tolerability profile remain obstacles to widespread deployment. To assess whether dihydroartemisinin-piperaquine is a suitable alternative to artesunate-mefloquine, we compared the safety, tolerability, efficacy, and effectiveness of the two regimens for the treatment of uncomplicated falciparum in western Myanmar (Burma). METHODS: We did an open randomised comparison of 3-day regimens of artesunate-mefloquine (12/25 mg/kg) versus dihydroartemisinin-piperaquine (6.3/50 mg/kg) for the treatment of children aged 1 year or older and in adults with uncomplicated falciparum malaria in Rakhine State, western Myanmar. Within each group, patients were randomly assigned supervised or non-supervised treatment. The primary endpoint was the PCR-confirmed parasitological failure rate by day 42. Failure rates at day 42 were estimated by Kaplan-Meier survival analysis. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN27914471. FINDINGS: Of 652 patients enrolled, 327 were assigned dihydroartemisinin-piperaquine (156 supervised and 171 not supervised), and 325 artesunate-mefloquine (162 and 163, respectively). 16 patients were lost to follow-up, and one patient died 22 days after receiving dihydroartemisinin-piperaquine. Recrudescent parasitaemias were confirmed in only two patients; the day 42 failure rate was 0.6% (95% CI 0.2-2.5) for dihydroartemisinin-piperaquine and 0 (0-1.2) for artesunate-mefloquine. Whole-blood piperaquine concentrations at day 7 were similar for patients with observed and non-observed dihydroartemisinin-piperaquine treatment. Gametocytaemia developed more frequently in patients who had received dihydroartemisinin-piperaquine than in those on artesunate-mefloquine: day 7, 18 (10%) of 188 versus five (2%) of 218; relative risk 4.2 (1.6-11.0) p=0.011. INTERPRETATION: Dihydroartemisinin-piperaquine is a highly efficacious and inexpensive treatment of multidrug-resistant falciparum malaria and is well tolerated by all age groups. The effectiveness of the unsupervised treatment, as in the usual context of use, equalled its supervised efficacy, indicating good adherence without supervision. Dihydroartemisinin-piperaquine is a good alternative to artesunate-mefloquine

Fluorescent humanized anti-CEA antibody specifically labels metastatic pancreatic cancer in a patient-derived orthotopic xenograft (PDOX) mouse model.

Pancreatic cancer is a highly lethal disease in part due to incomplete tumor resection. Targeting by tumor-specific antibodies conjugated with a fluorescent label can result in selective labeling of cancer in vivo for surgical navigation. In the present study, we describe a patient-derived orthotopic xenograft model of pancreatic cancer that recapitulated the disease on a gross and microscopic level, along with physiologic clinical manifestations. We additionally show that the use of an anti-CEA antibody conjugated to the near-infrared (NIR) fluorescent dye, IRDye800CW, can selectively highlight the pancreatic cancer and its metastases in this model with a tumor-to-background ratio of 3.5 (SEM 0.9). The present results demonstrate the clinical potential of this labeling technique for fluorescence-guided surgery of pancreatic cancer

Beneficial effect of ustekinumab in familial pityriasis rubra pilaris with a new missense mutation in CARD14

Pityriasis rubra pilaris (PRP) represents a group of rare chronic inflammatory skin disorders in which ~1 in 20 affected individuals show autosomal dominant inheritance. In such cases, there may be gain-of-function mutations in CARD14, encoding caspase recruitment domain-containing protein 14 (CARD14) that activates the non-canonical nuclear factor-kappa B (NF-κB) pathway, thereby promoting cutaneous inflammation. Here, we report a mother and son with PRP due to a new missense mutation in CARD14 and describe the beneficial clinical effects of ustekinumab, a monoclonal antibody against interleukins-12 and -23, in both subjects. A 49 year-old female and her 20 year-old son had lifelong, generalised, patchy erythematous scale with a few islands of sparing, as well as minor nail ridging and mild palmoplantar keratoderma, features consistent with generalised PRP. Topical steroids, phototherapy and oral retinoids proved ineffective therapies. Following informed consent, Sanger sequencing of CARD14 in both individuals revealed a new heterozygous single nucleotide transversion in exon 16, c.356T>G, resulting in the missense mutation, p.Met119Arg. Ustekinumab, at a dose of 45mg every 12 weeks, brought about a significant physical and emotional improvement in both the mother and son within a few days of the initial dose, which was sustained on maintenance dosing. This report highlights the therapeutic potential of biologics that downregulate NF-kB signalling in familial PRP with mutations in CARD14. This article is protected by copyright. All rights reserved

Poverty among households living in slum area of Hlaing Tharyar Township, Yangon City, Myanmar

Background: Slums can be regarded as physical manifestations of urban poverty. Although the world has made dramatic improvement in reducing poverty since 1990, poverty still persists at an unacceptable level. Although current situations highlights the importance of slum areas to be given priority in poverty alleviation, there are limited data on poverty level among people living in urban slums of Myanmar.Methods: A cross-sectional study was conducted among households living in slum areas of Hlaing Tharyar Township, Yangon City, Myanmar during 2016. Multi-staged systematic random sampling and face-to-face interview were applied in selecting the samples and collecting the data, respectively. The new global poverty line (1.9 USD per person per day) was used as a threshold in determining the poverty. Chi-squared test and multivariate logistic regression analysis were utilized in data analysis.Results: Altogether 254 participants were recruited after getting informed consent. The occurrence of poverty among households was 54.3% (95% CI: 48.2%, 60.5%). Head counts of poverty among study population was 58.8%. The education status of household’s head, size of household and the presence of less than 15 years old children in the household were detected as significant determinants of being poor household.Conclusions: Poverty among households living in slum area of Hlaing Tharyar Township, Yangon City was high. Measures to alleviate poverty in urban slums should be intensified. Education level of household’s heads should be improved. Family planning or birth spacing programme should also be strengthened, especially in urban slums.

The Mucin Family of Proteins: Candidates as Potential Biomarkers for Colon Cancer

Mucins (MUC1-MUC24) are a family of glycoproteins involved in cell signaling and barrier protection. They have been implicated in the progression of numerous malignancies including gastric, pancreatic, ovarian, breast, and lung cancer. Mucins have also been extensively studied with respect to colorectal cancer. They have been found to have diverse expression profiles amongst the normal colon, benign hyperplastic polyps, pre-malignant polyps, and colon cancers. Those expressed in the normal colon include MUC2, MUC3, MUC4, MUC11, MUC12, MUC13, MUC15 (at low levels), and MUC21. Whereas MUC5, MUC6, MUC16, and MUC20 are absent from the normal colon and are expressed in colorectal cancers. MUC1, MUC2, MUC4, MUC5AC, and MUC6 are currently the most widely covered in the literature regarding their role in the progression from normal colonic tissue to cancer