IBMS_portofolio

1. Introduction to BMS portfolio
Author: Dorobantu Adina Georgiana
Section 1 Lecture Tasks
1. The Human Tissue Act
2. HCPC Standards of Proficiency for Biomedical Scientists
3. Pre-analytical Variables in the Emergency Department
4. Advantages and Disadvantages of Point of Care Testing
5. The SHOT Report
6. Pharmacology task – Drug Administration Routes
7. The Cholera Transmission Path Discovered by Dr. John Snow
8. The Caldicott Report
9. Huntington`s Disease: Woman who inherited gene sues NHS
10. Cellular pathology task

2. The Human Tissue Act
The Human Tissue Act approved in 2004 constitutes the regulations formulated in regards to the use of human
tissue, as well as the storage, removal and disposal of such materials, which were constructed around the baseline matter of
the crucial importance of consent.
In the light of this aspect, The Human Tissue Act 2004 underlines the relevance of consent being required, for any
human tissue involved conduct, which has been defined as “any material which has come from a human body and which
consists of or contains human cells” (Department of Health, 2011). An important influencing factor taken into consideration
in the appropriate consent regulations (Part 1, Sections 2 and 3) is represented by the age and relationship an individual must
have in relation to a supposed child or adult uncapable of making a valid and informed decision with respect to possible
activities that might involve the body of a deceased child or adult or any relevant material obtained from a living or deceased
child or adult.
Section 2 states that in the case of a living child, under the age of 18, the child is permitted to give his own consent,
however if the child is incapable of doing so, parents are required to offer consent. In addition to this, in the case where a
child has died, any witnessed decision made in writing by the child prior to his death, regarding the use of his body for
anatomical examination or public display, including organ donation, will apply, unless the child was unable to do so, therefore
consent must be gained from the responsible parents or, in their absence, from an individual of qualifying relationship, such
as next of kin. The same regulations are applied and respected in the case of an adult, as stated in Section 3, with the only
difference being that parental consent in the case of death is replaced by consent from a person nominated by the deceased
prior to his death. Moreover, Section 4 describes how any adult aged 18 or over can nominate one or more representatives
to give consent of use, storage, removal or disposal of the deceased body.
In addition to gaining appropriate consent from an adult under Section 3, Section 6 also adds that in the case of an
adult who is incapable to consent personally or prior to a supposed unfortunate event, the responsible representative is
expected to give consent considering the adult’s best interest relating to any use or research that might be undertaken. This
decision also takes into account the Mental Capacity Bill.
Section 7 brings to light situations, however rare, where information could be gained from the research of a certain
relevant material obtained from a living person who is either untraceable or incapable to consent or chose not to, that is
believed to have a significant impact on the overall public health. Therefore, in such cases, relevant materials could be used
in order to help in the understanding of certain diseases, along with treatments, that might benefit a larger proportion of the
population.
Section 43 allows the preservation of organs in the body of a deceased individual, by minimal and invasive methods,
in the interest of organ transplantation, until consent is gained.
Section 45 states that possession of any bodily material with the aim of DNA analysis, without consent from the
individual the material was obtained from, the parent, in the case of a child or any nominated representative is considered
an offence. This regulation is to be respected for all areas in the UK, with certain clear exceptions. For example, should the
material be analyzed for general interests, including criminal justice or medical treatment, this regulation would not apply.
Further exceptions of this regulation, would be if the material belongs to a person who died more than 100 years ago, as well
as embryos outside the body, or material obtained from an unidentified individual. Moreover, if consent was gained prior for
any other purpose, for example consent required for anatomical examination or public display, it would also be considered
as consent for DNA analysis.
Department of Health. (2011). Human Tissue Act 2004 - Explanatory Notes, Part 3, Section 45. Retrieved March 21, 2021, from
Legislation.gov.uk website: https://www.legislation.gov.uk/ukpga/2004/30/notes/division/5/3/1/3
(“Human Tissue Act 2004 | Human Tissue Authority,” 2020)
Human Tissue Act 2004 | Human Tissue Authority. (2020). Retrieved March 21, 2021, from Hta.gov.uk website:
https://www.hta.gov.uk/policies/human-tissue-act-2004

3. HCPC Standards of Proficiency for Biomedical Scientists
In the UK, registration with the Health and Care Professions Council (HCPC) is required in order to obtain
approval to work as a biomedical scientist (“Becoming HCPC registered,” 2020). The HCPC represents the
regulatory entity for healthand care professions, such as biomedical scientists, which aims to ensure patient safety
and protection by their evaluation of standards, which classifies an individual as capable of performing as a
biomedical scientist (“Becoming HCPC registered,” 2020).
The HCPC list of standards of proficiency presents 15 general standards, each of which have been allocated
additional specific regulations describing detailed principles that characterize a variety of biomedical science areas
of expertise.
First of all, biomedical scientists are expected to operate in a safely and effective manner in their field of
practice, which implies that they need to be organized individuals, that can appreciate how to manage their time
and resources efficiently. In addition to this, biomedical scientists need to respect certain limitations their
profession involves that are required by the HCPC. For example, ethical aspects of their profession, along with the
obligation of gaining informed consent while being aware of current regulations in the field they perform,
therefore being well informed and conscious of the legal aspects of their profession.
Another important standard is represented by the understanding, respecting and maintaining
confidentiality within its limits, which is important in situations when biomedical scientists need to be able to
discern the appropriate information that should be shared. In relation to this, effective and clear communication
as part of a team is also an essential requirement that ensures a good collaboration with other professionals or
service users, as it would be expected in order to accurately communicate the outcomes of biomedical
procedures.
Secondly, biomedical scientists are expected to demonstrate and perform in conformity with their
particular knowledge and skills specific to their profession, therefore upholding their capacity of presenting
qualitative results and endorsing the ability to collect proper records and assess their practice. For instance, in
order to analyze a sample, a biomedical scientist would use the knowledge of how to operate suitable systems for
specimen identification, while constantly keeping record of the steps followed until completion of the experiment,
taking into consideration all the possible errors that may occur, with the aim of producing sensitive, efficient and
accurate results.
An equally significant aspect of the systematic nature of competence a biomedical scientist is required to
demonstrate, is represented by the importance of understanding the broad diversity of cultures that is the
biomedical field and be able to practice and participate in a non-discriminatory environment.
In the light of all aspects, the HCPC standards of proficiency for biomedical scientists display a diverse
spectrum of regulations that mirrors a safe and effective practice, for all parts involved, as well as providing a
detailed understanding of the responsibilities, risks and methodology that need to be considered about this
profession.
Becoming HCPC registered. (2020). Retrieved March 21, 2021, from Institute of Biomedical Science website:
https://www.ibms.org/registration/becoming-hcpc-registered/
Biomedical scientists | The standards of proficiency for biomedical scientists. (2020). Retrieved March 21, 2021, from Hcpc-uk.org website:
https://www.hcpc-uk.org/standards/standards-of-proficiency/biomedical-scientists/

4. Pre-analytical Variables in the Emergency Department
Errors encountered in the pre-analytical phase of the testing process represent a crucial point of
improvement in overall laboratory services and especially in the Emergency Department (ED). Due to the
continuous high-pace and pressured environment the ED often confronts with, errors characterized by the
collection of sub-optimal quality specimens can generate consequences such as result inaccuracy, as well as a
delayed turnaround time (TAT) and unnecessary elevated costs for an eventual prolonged hospital stay. In
addition to this, the dynamic setting of the Emergency Department has also been shown to expose physicians to
potential specimens of infectious nature, along with a high risk of needlestick injury (NSI).
This field closely follows the pattern of five common, most encountered pre-analytical mistakes that
often require re-collection of samples or even rejection by the laboratory.
First of all, a common incident can be generated by the incorrect identification of the patient under
assessment and even by registration of incomplete identification details. As an example, sample tubes collected
from one patient could be easily mismatched with a test request form intended for another patient, due to a
misanalysis of the patient’s identity details. As a result of this example of misunderstanding, both patients
involved would be at a disadvantage or even at risk of receiving inappropriate test results that could eventually
follow unnecessary and unsuitable treatment.
Secondly, another serious pre-analytical error concerns the protocol of performing intravenous (IV) ‘line
draws’ for blood specimens. Samples as such are usually collected from peripherally inserted central catheters
or other central lines and should only be used for the purpose of blood collection when the line is newly placed,
therefore before fluid administration. However, this procedure needs to follow certain steps to provide a quality
specimen and at the same time, avoid hemolysis and infusion fluid contamination.
In the light of this aspect, hemolysis represents a common outcome of incorrectly performed blood
collection procedures that can either be easily detected or almost impossible to detect in the case of micro-
clots, therefore representing the fourth most noticed pre-analytical error in the ED. Hemolysis occurs as a
consequence of mechanical trauma suffered by erythrocytes, cause by osmotic shock or exposure to extreme
temperatures. If left undiscovered, it can easily influence the outcome of certain laboratory tests, for instance
producing an inaccurate result of normal potassium levels in a hypokalemic blood sample or platelet damage.
In the case of multiple blood samples being collected from the same patient, this procedure should
follow a certain order of draw formulated by the CLSI which aims to avoid carryover of additives between tubes.
Lastly, anticoagulant additives are added to specific blood collection tubes used for preventing clotting
of the sample. Incorrect or insufficient mixing of the sample tube has been shown to impact the efficacy of the
anticoagulant additive, results in clotting, which inevitably impacts accurate testing results.
In conclusion, it must be acknowledged that even though they are hard to be avoided under the ED
pressured environment, pre-analytical errors have been improved overtime through the use of automated
analytical technologies as well as through intensive education and training.
Pre-analytical Systems, Volume 17, No. 1, LabNotes. (2007). Retrieved March 24, 2021, from Bd.com website:
http://www.bd.com/vacutainer/labnotes/Volume17Number1

5. Advantages and Disadvantages of Point of Care Testing
Point of care testing (POCT), also known as near the site of the patient testing methods have been
developed with the aim to attend to easy self-directed care of the patient itself or assist nursing or
biomedical staff in easy interpretation of results and draw of subsequent decisions. However, as many
other automated devices used in the medicine field, point of care testing reveals both advantages and
disadvantages, which deserve important and consistent considerations in order to ensure an efficient and
safe standard of healthcare.
Among the advantages the POCT has demonstrated, it can be mentioned:
• short turnaround time (TAT) and therefore, hardly any time delays that would usually be expected
in a laboratory setting, along with transport requirement, which also represents additional costs
• fast availability of results, allowing for direct interpretation and decision of subsequent steps and
appropriate courses testing or treatment
• minimally invasive procedures, that represents a more comfortable and convenient approach from
both the patients and the practitioner’s point of view, due to the small amount of blood required
• easy at home use, suggesting fewer doctor visits, for example in the case of glucose monitor meters
for diabetic patients
• the portable characteristic of devices, assists in lack of space for performing procedures and testing
availability in different locations
On the other hand, disadvantages of POCT can include:
• interpretable sample quality, as at home use of point of care testing are usually performed by
unqualified individuals, in comparison to the sample collection and laboratory analysis by
qualified physicians
• possible safety concerns, as sample collection is required, implying potential risks of needle stick
injuries, infections and knowledge regarding appropriate clinical waste storage and disposal, in the
case of using POCT at home
• absence of result records over time in the home setting, which in a laboratory setting would usually
be registered and updated into the medical records of the patient
• additional training for staff uses in authorized settings, in order to ensure efficient monitorization
of results for accurate outcomes
Advantages of POCT - LabCE.com, Laboratory Continuing Education. (2021). Retrieved April 15, 2021, from Labce.com
website: https://www.labce.com/spg1033982_advantages_of_poct.aspx
Disadvantages of Point of Care Testing (POCT) -- Testing Process - LabCE.com, Laboratory Continuing Education. (2021).
Retrieved April 15, 2021, from Labce.com website:
https://www.labce.com/spg1039486_disadvantages_of_point_of_care_testing_poct____tes.aspx

6. The SHOT report
SHOT stands for the Serious Hazards of Transfusion report which represents the hemovigilance scheme
established in the UK in 1996, consisting of data presentation and evaluation of voluntary reports regarding
adverse reactions or near misses following transfusion, along with anonymous data collected with the aim of
assessing the risks and benefits and formulating recommendations in the interest of improving patient care.
To begin with, according to the most recent SHOT report from 2019, a list of steps should be followed
throughout the transfusion process, starting from the assessment of the patient, followed by careful analysis of
blood results and appropriate treatment options. Then, based on the conclusions the patient must be fully
informed of the situation and asked for consent when a decision has been made to proceed. Furthermore,
before continuing, other points should be considered, such as vitamin K levels, and any hesitation must be
confronted with other colleagues in order to reach a rational and trusty decision. Moreover, complete
documentation must be sustained and updated throughout the transfusion process and checklists must be
followed to evaluate the benefits, alternative treatments or eventual risks.
These steps represent the baseline of any transfusion procedure and the 2019 SHOT report displays the
most common mistakes expressed in numbers that took place over the year due to omission or possible
oversight of these crucial stages, which highlights the gravity of an incorrect decision.
In the light of this aspect, out of 17 transfusion related deaths that were registered in 2019, 5 such cases
could have been prevented. At the same time, over the last ten years, transfusion related deaths have been
found to predominantly arise from delays or transfusion associated circulatory overload (TACO), however in
comparison to the last four years, the SHOT report shows that in 2019 a slight decrease in delay-related
transfusion deaths can be observed.
In addition to this, there were four cases of ABO incompatible red cell transfusions, three of which could
have been detected at the time of administration, for which the SHOT report accentuates the focus on bedside
checks improvement.
As a result of these outcomes, the SHOT report also states that errors accounted for 84.1% of all cases,
10.3% have been found to be not preventable and lastly, but most importantly, 5.6% could have been ruled out.
Despite the fact that in the UK transfusion procedures have been identified as low harm risks regarding blood-
component related transfusions, the overall data suggests that improvement should be emphasized, for
example in situations where errors in patient identification were observed in 42.6%, 28.2% due to the sample
not being labelled at the bedside and 5.6% on account of the sample not being labelled by the person who
collected the blood.
Based on this evidence, as rigorous steps must be followed in the transfusion process, a set of
improvements must also be reinforced and reiterated in the interest of achieving a higher degree of accuracy
and assurance of patient care. As shown, education, training and efficient communication are key essential skills,
that if strengthened would definitely promote better treatment efficacy and patient outcomes.
2019 Annual SHOT Report - Individual Chapters - Serious Hazards of Transfusion. (2020, August 4). Retrieved March 24, 2021, from
Serious Hazards of Transfusion website: https://www.shotuk.org/shot-reports/report-summary-and-supplement-2019/2019-
annual-shot-report-individual-chapters/

7. Pharmacology Task – Drug Administration Routes
The choice of method of administration of medicines represents an important and sensitive skill in
clinical settings, that practitioners need to perform with careful considerations of established protocol and
possible influencing factors, in order to ensure the highest standard of care is provided and the best
possible outcome is achieved.
Out of the many administration route available, seven of them are:
1. Subcutaneous injection
Insulin is one drug only administered via subcutaneous injection, due to the fact that if
taken on the oral route, it would be inactivated by destruction of its structure by factors such as,
gastric acid and digestive tract movements.
2. Intravenous route
Duramorph is a narcotic morphine pain reliever used for treatment of severe pain, delivered
by intravenous injection, because of its rapid absorption into the blood of an exact dose, in a
controlled and quick manner.
3. Intramuscular route
Fluarix Quadrivalent is an Influenza Vaccine, otherwise known as a flu shot, used against
influenza A subtype and B type viruses, that cause disease in humans. This drug is administered
intramuscularly in the upper arm, in order to ensure steady and efficient absorption.
4. Intrathecal route
Prialt (ziconotide) is a non-narcotic pain reliever used as a treatment for severe chronic
pain in patients who have usually received conventional pain-alleviating medications with
unsuccessful results. It is suitable for intrathecal administration in order to deliver a rapid localized
effect in either the spinal cord and meninges or brain.
5. Transdermal routes
Catapres-TTS (clonidine) is a drug used for the constant control of hypertensive patients,
administered transdermal by the application of a patch on the skin, due to continuous and constant
delivery of the drug for a period varying from hours to days.
6. Rectal route
Hydrocortisone acetate rectal suppositories used in the treatment of post-irradiation
proctitis or hemorrhoids, administered rectally due to its easy and rapid absorption in the
bloodstream, through the blood supply of the rectum wall.
7. Vaginal route
Clindamycin vaginal is an antibiotic drug used in the treatment of bacterial vaginal
infections, which are administered vaginally in the form of ovules, due to its efficient absorption
through the vaginal wall.
CareFirst Specialty Pharmacy. (2019, February 21). Routes of Medication Administration. Retrieved April 15, 2021, from
Cfspharmacy.pharmacy website: https://www.cfspharmacy.pharmacy/blog/post/routes-of-medication-administration
Drugs A-Z List (2007, February 14). Retrieved April 15, 2021, from RxList website:
https://www.rxlist.com/drugs/alpha_c.htm

8. The cholera transmission path discovered by Dr. John Snow
Cholera is an acute water transmitted disease, first identified in 1831 and still representing a
global public health concern, usually encountered in underdeveloped countries, which manifests by
severe acute watery diarrhea and consequently, severe dehydration and mostly caused by low standard
sanitation and hygiene. In the light of this ongoing aspect, the World Health Organization (WHO) have
initiated in 2017 worldwide program regarding the eradication of cholera related deaths by 90% until
2030.
To begin with, the first appearance of Asiatic cholera originated in 1831 in Soho, however, at the
time, being an unidentifiable and a previously unknown disease, for the reasons of which it has greatly
impacted public health over a long period of time that has concluded in tens of thousands of deaths
spread all over England. Doctor John Snow, a respected anesthetist and epidemiologist, renowned for
his critical thinking and dedication, then and until present time, has showed a vital role in the
discovering of the transmission mechanism of cholera during that introduced the outbreak.
Thirty-five years before Koch officially acknowledged the discovery of the cholera disease, Dr.
John Snow has concluded, after carefully analyzing the little understood and continuously changing
variables of the confusion that was the cholera outbreak, that infections and death associated cases
seemed to be localized in areas where, in those times, the general population was obtaining their water
reserves from different wells in specific regions of the city.
Taking into account the current unsanitary living conditions of the people of Soho, but not only,
as the disease rapidly spread to other parts of the country, the problem-solving abilities Dr. John Snow
acquired over his scientific career, helped him to conclude that water collected and consumed from wells
around the region was the method of transmission of this ruthless disease. As a result, Dr. John Snow
considered the importance of making his concerns heard, therefore decided to act and raise his
suspicions to authorities, who agreed to remove the handle of the water pump. What followed came as a
confirmation for Dr. John Snow that his theory was true, as cholera cases surrounding that region slowly
dropped.
Since then, the cholera disease has been extinguished over the year, mostly due to development
of the majority of countries around the world, however it still persists to the present day in
underdeveloped countries, where, unlike the 1931 outbreak, is now a well-recognized condition, kept
under surveillance and assisted by oral vaccination programmes, as well as improvements in the safe
water supply and sanitation and availability of antibiotics and intravenous fluids for rapid treatment
whenever required.
Broad Street Pump Outbreak. (2021). Retrieved April 15, 2021, from Ucla.edu website:
http://www.ph.ucla.edu/epi/snow/broadstreetpump.html
World Health Organization: WHO. (2021, February 5). Cholera. Retrieved April 15, 2021, from Who.int website:
https://www.who.int/news-room/fact-sheets/detail/cholera
Dr. John Snow—Anaesthetist and Epidemiologist on JSTOR. (2021). Retrieved April 15, 2021, from Oclc.org website:
https://www-jstor-org.hallam.idm.oclc.org/stable/41976374?sid=primo&seq=2#metadata_info_tab_contents

9. The Caldicott Report
The Department of Health published in 1996, the collection of regulations formulated with
regards to ‘The Protection and Use of Patient Information’, developed by ------ Caldicott and her
associated committee, after which it is commonly known as the Caldicott report. The paper outlines the
legal and ethical requirements that professionals and involved medical staff are bound to respect in
clinical settings, in order to ensure that patient confidentiality is followed and proper consent is gained
for the necessity of personal medical information sharing between medical practitioners.
As a reflection of this summarized baseline principle, the Caldicott report states that upon
request of medical advice, a minimal amount of personal information should be needed for the
identification of an individual patient and its afferent medical records, which represents the main focus
of the new NHS number importance and applicability. This aspect is described throughout the paper,
which states that the NHS number, a random number generated for each individual patient, should be
used as a replacement of other identifiers in all applicable cases, due to its low risk of misinterpretation,
given by its unicity of design.
In addition to this, the nature of personal circumstances must be considered by the medical
practitioner and when necessary, additional identifiers such as date of birth, sex and address of the
patient may be used in association with the NHS number, which also prevents unauthorized access to
patient records.
In order to strengthen the safety aspect on clinical protocols, the Caldicott report also introduces
the concept of the Caldicott guardian, who is recommended to be a senior, trusted person within each
health care unit who has the responsibility of safeguarding patient information confidentiality.
Therefore, any change or action involving the transfer of personal information with regards to patients
should be carefully analyzed and approved for access by a designated guardian.
However, maintenance of patient-identifiable information should always be respected and even
more carefully evaluated when there might arise reasons to believe that medical records concerning one
patient may be of significant importance for a larger proportion of patients, found in the same
circumstances, therefore requiring the interprofessional sharing of information. This decision is to
always be made with the patient`s best interest in mind and always approved by an authorized guardian
according to ‘The Protection and Use of Patient Information’.
Crook, M. A. (2003). The Caldicott report and patient confidentiality. Journal of Clinical Pathology, 56(>6), 426–428.
https://doi.org/10.1136/jcp.56.6.426
Herefordshire and Worcestershire Health and Care NHS Trust. (2021, April 15). Caldicott Principles | Our quality and safety
standards. Retrieved April 15, 2021, from Herefordshire and Worcestershire Health and Care NHS Trust website:
https://www.hacw.nhs.uk/quality-and-safety/caldicott-principles-943/

10. Huntington`s disease: Woman who inherited gene sues NHS
In the year 2015, a woman whose identity has been anonymized for her and her daughter`s
protection, now being known as ABC, discovered by mistake that her father was diagnosed with
Huntington`s disease, a condition known to be caused by a faulty gene that has been proven to progress
throughout life and future generations to loss of brain cells, influence mood, thinking and movement
abilities and a risk of aggressive behavior development. The seriousness of her father`s disease, has
surfaced after he inexplicably killed ABC`s mother and was arrested according to the Mental Health
Act.
ABC, now in her 40s, has apparently been motivated by the concern for her daughter`s health,
now nine years of age, and future quality of life, and proceeded to sue three relevant NHS trusts that
have been involved in her father`s care for the lack of information she claims she should have received
regarding this matter and that she admits would have influenced her decision of keeping her pregnancy
at that point in time.
The chance of developing the disease on inherited consideration is of 50% and in order to be able
to test this risk, individuals must be at least 18 years old. Consequently, this chance of inherited
Huntington’s disease has also tested positive for ABC, therefore, considering the age ABC currently has,
it inevitably raises causes for concern, due to the fact that specific symptoms start to appear between 30
and 50 years old.
Moreover, ABC`s case was presented for the first time at the High Court in 2015, when it was
dismissed, followed by a reevaluation by the Court of Appeal in 2017, that decided to send the case to
trial once more. However, when presented with the chance to spare her sister from experiencing the
same situation and inform her on their father`s disease and the risk her sister faces with her pregnancy
ahead, ABC refused to rightfully inform her, which let judges to believe that although her situation was
unfortunate, ABC would not have proceeded to terminate her pregnancy upon finding this information.
Therefore, in 2020 ABC`s claim to her right to be informed of aspects targeting her own health, was
once again dismissed.
To sum it up, from a completely objective perspective, this case has presented a various array of
ethical, legal and trust challenges, since from being given his diagnostic, the father specifically
mentioned that he did not wish her daughter to be informed of his illness. From this perspective, the
events that followed can simply be justified as the compliance of the health care system to a patient`s
confidentiality, as it might have been just as right for the daughter to be informed on her health long-
term risks referring strictly to her person and independent of her father’s specifical case.
Fergus Walsh. (2019, November 18). Huntington’s disease: Woman who inherited gene sues NHS. Retrieved April 15, 2021,
from BBC News website: https://www.bbc.co.uk/news/health-50425039
BBC News. (2020, February 28). Huntington’s disease: Woman with gene fails in bid to sue NHS. Retrieved April 15, 2021,
from BBC News website: https://www.bbc.co.uk/news/uk-51680980

11. Cellular Pathology
The Periodic Acid-Schiff (PAS) stain
• PAS is used as a stain for glycoproteins, for example glycosaminoglycans,
by oxidizing molecules rich in carbohydrate content, which result in a deep
reddish-purple color accentuating these oxidized molecules, as seen in
Figure 1.
• It is also used as a stain for goblet cells and mucin
The Giemsa stain
• Commonly used in blood smears and bone marrow testing
• It gives three types of stains (Figure 2):
- pink stain, observed in red blood cells due to their lack of nuclei
- pale blue stain, seen in the cytoplasm of white blood cells
- dark blue/purple stain, showing the nuclei of white blood cells
The Van Gieson stain
• Used for the stain of connective tissues (Figure 3)
Figure 1. Periodic Acid-Schiff
(PAS) on goblet cell (purple
stain) in association with
Alcian blue stain on mucins
(blue stain)
Figure 2. Giemsa blood smear
stain
Figure 3. Van Gieson stain of mid-dermis
and upper layers showing elastic fibers
(Medknow Publications, 2016)

12. Alcian Blue stain
• Usually used in association with the Periodic Acid-Schiff (PAS) stain
• Used in the staining of glycosylated proteins, for instance, mucins, which can be seen in Figure 1 (blue stains)
Masson`s Trichrome stain
• Used for the selective stain of fibrin, collagen fibers, muscles, red blood cells and keratin in various tissues, for
example heart, muscle or skin tissues (Figure 4)
• The name `trichrome’ is attributed to the generation of three different stains:
- red stain of muscle cells, by the Biebrich Scarlet-acid fuschin stain
- blue stain of collagen fibers, by the Aniline blue stain
- black stain of the muscle cell`s nuclei
Perls Prussian blue stain
• Used for the analysis of intracellular pigments seen in tissues
• Occurs in reaction with ferric hydroxide contained in these molecules
• The ferric ion stains a blue colour
• The nuclei stain a red colour
• The background stains a pink colour
Mayank Jaiswal, mayank.jaiswal@proquest.com. (2021). ProQuest Ebook Central - Reader. Retrieved April 15, 2021, from
Proquest.com website: https://ebookcentral.proquest.com/lib/shu/reader.action?docID=822523
Masson’s Trichrome Staining | Staining | Microbe Notes (2020, October 28). Retrieved April 15, 2021, from Microbe Notes
website: https://microbenotes.com/massons-trichrome-staining/
Medknow Publications. (2016, March 4). Figure 6: Verhoeff–van Gieson stain showing loss of elastic fibers in... Retrieved
April 15, 2021, from ResearchGate website: https://www.researchgate.net/figure/Verhoeff-van-Gieson-stain-showing-
loss-of-elastic-fibers-in-upper-and-mid-dermis_fig6_296704128
Figure 4. Masson`s Trichrome stain on an
airway sample collected from rats
Microbe Notes, 2020)
Figure 5. The Perls Prussian blue stain

13. Section 2
Content List
1. Genetic Scissors: a tool for rewriting the code of life
2. Coronavirus vaccine development: from SARS and MERS to COVID-19
3. An obituary of Dr. Ding-Shinn Chen
4. The Rapid Development and Early Success of COVID-19 Vaccines Have Raised Hopes for
Accelerating the Cancer Treatment Mechanism
5. NIH scientists identify nutrient that helps prevent bacterial infection
6. Discriminative Accuracy of Plasma Phosphatau217 for Alzheimer Disease vs. Other
Neurodegenerative Disorders
7. Hepatitis C virus vaccine design: focus on the humoral immune response
8. Role of iron and iron-related proteins in mesenchymal stem cells: Cellular and clinical aspects
9. NIH awards grants to support bacteriophage therapy research
10. Vitamin D supplementation to prevents acute respiratory infections: a systematic review and
meta-analysis of aggregate data from randomized controlled trials

14. Genetic scissors: a tool for rewriting the code of life
In the year 2020, scientists Emmanuelle Charpentier and Jennifer Doudna were awarded the Nobel Prize
in Chemistry for the discovery of the CRISPR/Cas9 genetic scissors, considered to be a revolutionary breakthrough
in science and expected to be a building block for the development of future endless applications.
Emmanuelle Charpentier has been portrayed as a research and curiosity driven scientist, who has focused
throughout her career on the subject of pathogenic bacteria and the aggressive manifestation and treatment
dilemma that they entail. On the other hand, scientist Jennifer Doudna has expressed a fascinating interest in the
subject of RNA since the beginning of her scientific career and has gained two decades of experience in performing
research on this subject, while recently concentrating on RNA interference.
As a result, Emmanuelle Charpentier was the one to take the first step towards the CRISPR/Cas9 discovery,
by conducting research on the gene regulation mechanism of a seriously harmful bacteria, Streptococcus
pyogenes, otherwise known as `flesh eater’, that infects millions of people every year and manifests, among other
symptoms, by degenerating the soft tissues of human organisms.
Charpentier and Doudna decided to become partners after analysing previous research done on this
subject and realising that their particular, but vast knowledge might help to decipher the still unknown and hard
to understand aspects of it. At that time, available research on archaea and bacterial genome was showing the
presence of repetitive DNA sequences, called clustered regularly interspaced short palindromic repeats (CRISPR)
separated by different, unique and non-repetitive sequences, later demonstrated to be parts of the genetic code
of different viruses, that at one point infected the bacterium, which kept a memory of the virus, in the form of
CRISPR. Consequently, CRISPR was considered to be a type of ancient immune system involved in the protection
of archaea and bacteria against viruses, that was aided in its process by two important factors: Cas9, a protein
which helps in the cleaving of the virus DNA and tracrRNA, a molecule discovered by Emmanuelle Charpentier.
The theory proposed and demonstrated by the two scientists was that CRISPR DNA is transcribed into
CRISPR RNA that binds tracrRNA at specific places of the sequence, along with Cas9, forming a complex that is
able to cut the virus DNA at the place of binding. Furthermore, the genetic scissors complex formed by tracrRNA
and Cas9 protein allows the generation of immunity, so that if the bacterium is to be reinfected with the same
virus, these components will provide the protection needed to destroy the virus and fight the infection.
The application-oriented adaptation of this theory consisted of artificially creating a guide RNA molecule,
composed of CRISPR-RNA and tracrRNA that matched the virus DNA sequence where the cut was desired to be
made. Moreover, Cas9, the genetic scissor protein, would then bind the guide RNA and travel to the proposed
genome site.
The Nobel Prize in Chemistry 2020. (2020). Retrieved April 9, 2021, from NobelPrize.org website:
https://www.nobelprize.org/prizes/chemistry/2020/press-release/

15. Coronavirus vaccine development: from SARS and MERS to COVID-19
The last two decades have brought to light three significant and increasingly progressing respiratory tract
infection viruses, specifically coronaviruses, that have led to critical worldwide outbreaks affecting humans:
Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), Middle East Respiratory Syndrome Coronavirus
(MERS-CoV) and recently, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).
The critical and frequently lethal nature of these three predominant CoVs has been reflected over the
years through their level of spread across countries, number of cases and associated deaths. As an illustration, the
SARS-CoV outbreak (2002-2004) has exposed a 10% mortality rate over 29 countries, while the MERS-CoV one
(2012-ongoing), shows a 35% mortality rate spread across 27 countries.
In the light of this aspect, the development of an efficient vaccine against this virus is urgently needed,
especially considering the high risk of transmission through asymptomatic patients. However, the recent COVID-
19 disease caused by the SARS-CoV-2 virus, manifested by mild flu-like symptoms, with a possibility of
developing acute respiratory distress and in certain cases, death, benefits from previous development attempts for
other coronaviruses vaccines and generally, other diseases.
Previous research regarding the development of an efficient vaccine for the SARS-CoV and MERS-CoV
outbreaks, has proven unsuccessful in developing an efficient vaccine and gaining FDA approvement, however
the theoretical approaches followed in the clinical and preclinical trials, currently serve as a preliminary starting
point for the SARS-CoV-2 vaccine.
The fast-paced COVID-19 clinical trials have so far included a generous number of vaccine candidates
based on various approaches, such as viral vector vaccines, already studied and tested in SARS-CoV and MERS-
CoV and RNA vaccines, not previously studied, but considered to be an efficient choice due to its adaptability to
new pathogens and possible mutations of the virus. For example, the Moderna and BioNTech/Pfizer vaccines are
two developers that have created a two dose RNA vaccine, proven to produce neutralizing antibodies with an
efficacy of 94.5% and 95% respectively. Another popular choice is the AstraZeneca and Oxford University
vaccine, using a viral vector approach, with an efficacy of 70% on average.
Moreover, it has been brought to attention that scientists are searching for additional ways to combat the
spread of COVID-19 through licensed vaccines for other diseases, for instance the bacillus Calmette-Guerin
(BCG) tuberculosis vaccine, able to aid in the formation of innate immunity, which represents an important and
useful tool in reducing the mortality rates caused by SARS-CoV-2, alongside an expanding relevant point of
current interest for the biomedical science field.
Li, Y.-D., Chi, W.-Y., Su, J.-H., Ferrall, L., Hung, C.-F., & Wu, T.-C. (2020). Coronavirus vaccine development: from SARS
and MERS to COVID-19. Journal of Biomedical Science, 27(1). https://doi.org/10.1186/s12929-020-00695-2

16. An obituary of Dr. Ding-Shinn Chen
June 2020 has brought into the scientific and medical field the great loss of Professor Ding-Shinn Chen,
who died at age 77 from pancreatic cancer. Dr. Chen was a prestigious hepatologist, esteemed throughout the
world for the impact his research and projects have had on the improvement of general public health.
First of all, Dr. Chen was known as a dedicated lecturer and skilled educator, a good friend and colleague
and above all a hard-working scientist who has devoted the majority of his scientific career to research
surrounding the subject of viral hepatitis. Furthermore, Dr. Chen was an honorable member of the Journal of
Biomedical Science founding Editors to whom he dedicated his time, knowledge and administration skills.
Shortly after graduating from the National Taiwan University, College of Medicine in 1968, Dr. Chen
decided to follow a gastroenterology specialty under Professor Sung Juei-Low, considered to be the father of liver
disease, at NTUH in Taiwan. From this time forth, Dr. Chen concentrated his work around different investigative
methods and treatment approaches for the hepatitis B virus (HBV) surface antigen (HBsAg) identified in patients
suffering from liver disease.
Professor Sung along with his colleague Dr. Chen decided to test the effectiveness of the HBV vaccine
against the constantly increasing number of liver disease and viral hepatitis cases in Taiwan. As a result, after
careful considerations and government approval was obtained, a remarkable nationally widespread newborn
vaccination program was initiated in 1984. The success of their project was quantified in 1997, a decade after its
initiation, when a paper published in the New England Journal of Medicine stated that HBsAg infection and
carrier rates have descended from 15% to less than 1%.
In addition to this, another impressive result of their vaccination initiative was reflected in the
considerable decline in the prevalence of liver cancer cases detected in children, that many would acknowledge as
the first effective cancer vaccine to offer successful outcomes in humans.
Furthermore, the work of Dr. Chen also involved studies concerning potential hepatitis C treatments, for
which he and his team proposed the use of alpha-interferon combined with ribavirin, that at the time, represented
the most effective hepatitis C treatment.
For all his efforts and devotement, Dr. Chen has been recognized throughout his scientific career and
received a collection of awards, such as the EASL International Recognition Award (2009), the Blumberg Award
from the Hepatitis B Foundation USA (2018) and most importantly, the second rank Jin-Hsing Medal by the
Taiwan President (2018). Moreover, I believe that Dr. Chen`s drive to improve and develop healthcare has had a
significant impact on expanding knowledge associated with hepatitis B and C, that could be considered
breakthroughs on his time, but also objectives that continue to influence current approaches in this field.
An obituary of Dr. Ding-Shinn Chen. (2020). Journal of Biomedical Science, 27(1).
https://doi.org/10.1186/s12929-020-00675-6

17. The Rapid Development and Early Success of COVID-19 Vaccines Have Raised Hopes for
Accelerating the Cancer Treatment Mechanism
The medical and biomedical science field have experienced a great and difficult challenge in the
last year, due to the COVID-19 pandemic, for the purpose of which scientists were bound to develop
new, efficient and fast short and long-term treatments, in the form of vaccinations. Their considerable
efforts, involvement and introduction of novel and successful approaches regarding this matter have,
however, proven to be an inspirational resource for progress in determining possible cancer vaccines,
while also decreasing their long validation process.
Immunotherapy treatments, in the form of vaccines, have been used for a long time for the
protection against various infectious diseases by identifying viruses through specific pathways and
mechanisms and stimulating immune system cells to attack invading cells and prevent infection. Similarly,
cancer vaccines are adopting the same method in the attempt to create vaccines that are able to recognize
cancer cells by the means of specific proteins found on their surface.
Consequently, the development of effective cancer vaccines has been considered to have numerous
advantages, such as: prevention of cancer cells proliferation and recurrence of the disease, as well as
eradication of possible cancer cells that could have escaped previous treatments. In the light of this aspect,
researchers, in collaboration with production companies, are currently proceeding to test and further study
the effects and effectiveness of a broad selection of cancer vaccines founded on different approaches:
antigen vaccines, containing specific antigens or associated proteins found in cancer cells, whole-cell
vaccines, which contain the entire cancer cell, dendritic cell vaccines, which aid in the identification of
abnormalities present in body cells and DNA vaccines, containing fragment of DNA originating from
cancer cells.
Moreover, the urgent nature of the COVID-19 pandemic has inevitably required the adaptation of
international protocols for vaccine approval and mass production, which has generated the rise of certain
concerns. Firstly, the long-time process necessary for the development and approval of drugs and vaccines
is has been reduced during the COVID-19 pandemic from 5 to 10 years to a very short period, due to
recent technologies, such as AIs that allow shortening of the production route and authorization. Secondly,
the newly introduced SARS-CoV-2 vaccines use a technology based on messenger RNA (mRNA), which
presents many advantages, for instance, cow costs of fast production, suitable effectiveness and low
registered adverse reactions.
Furthermore, vaccine developing companies that have been prominent in the current global crisis,
such as BioNTech and Moderna who successfully developed 90% effective mRNA vaccines, have also
been involved in initiating vaccine clinical trials for different types of cancer, such as melanoma and breast
cancer.
Summing all these aspects, it is important to acknowledge the extensive studies made by scientist
and researchers, both in the medical and biomedical fields, have now made not only the rapid development
and production of effective COVID-19 vaccines possible, but also influenced further continuation of
future studies for the improvement of a vast array of other diseases, such as cancer, HIV and other serious
diseases.
Amanpour, S. (2021). The Rapid Development and Early Success of Covid 19 Vaccines Have Raised Hopes for Accelerating the
Cancer Treatment Mechanism. Archives of Razi Institute, 76(1), 1–6. https://doi.org/10.22092/ari.2021.353761.1612

18. NIH scientists identify nutrient that helps prevent bacterial infection
The National Institutes of Health recently announced an interesting discovery regarding the
identification of a novel nutrient, called taurine, demonstrated to aid in the body`s innate immune
mechanisms of fighting against bacterial infections, published in the ‘Cell’ journal.
Firstly, the novel taurine nutrient function has been observed at the gut level, where it has been
shown to aid gut cells in recalling previous infections with certain bacteria and generate immune
responses in following infection cases with the same bacterial factor, thus promoting the eradication of
such potential invaders.
It is already acknowledged that the rich gut microbiotic environment plays a vital role in the
protection against bacterial infections, however the mechanisms that take place in the accomplishment
of this process are currently unknown. Furthermore, their extensive research approaches surrounding
this aspect and conducted with the aim of elucidating and outlining these essential mechanisms, in the
interest of developing novel antibiotics or additional, more mild treatments, that would help to avoid the
current treatment routes, which use antibiotics that negatively influence the function of the microbiota
and therefore, determine bacteria in the gut to become drug resistant, as well as less effective and
reliable in future bacterial infections.
Moreover, taurine, also found in naturally occurring bile acids, has been proven to assist
digestion of oils and fats, alongside production of hydrogen sulfide, its byproduct. In the light of this
aspect, their research has shown that pathogens colonize the gut in the presence of low taurine levels,
but on the other hand, high taurine levels have been found to inhibit pathogen colonization, which
underlines the importance and high relevance of their discovery.
In addition to this, it has also been observed that even a mild bacterial infection is effective in
generating the gut recall mechanism in order to assist protection in future infections, with the same
effect taking place at the gallbladder and liver levels, where synthesis and storage of bile acids takes
place. Similarly, an experiment has been conducted on mice, which were administered water containing
the taurine nutrient, that revealed the effect of infection protection mechanism being initiated.
Conclusively, the study performed by the National Institute of Health researchers have revealed
new knowledge about the gut microbiota and its functions, which represents a relevant subject in
biomedical science as it opens a door for future development of more effective and less damaging
courses of treatment against bacterial infections.
NIH scientists identify nutrient that helps prevent bacterial infection. (2021, January 15). Retrieved April 15, 2021, from
National Institutes of Health (NIH) website: https://www.nih.gov/news-events/news-releases/nih-scientists-identify-
nutrient-helps-prevent-bacterial-infection

19. Discriminative Accuracy of Plasma Phosphotau217 for Alzheimer Disease vs Other
Neurodegenerative Disorders
Following a continuous estimated rise extended on the next decades in dementia cases caused by
Alzheimer disease (AD), the World Health Organization (WHO) has accentuated the importance of
diagnostic improvement as a starting point in proper management of disease and development of
treatment schemes. Current studies regarding diagnostic prospects have underlined the great impact of
biomarker-based diagnosis of Alzheimer Disease, which might represent an accurate and efficient point
of approach.
Recent advancements on this subjects, have brought to light the pathways of positron emission
tomography (PET) or analysis of cerebrospinal fluid (CSF), which have been proven to be reliable and
accurate methods for Alzheimer Disease diagnostic and have rapidly been embraced and incorporated
with the applicable protocols, However, a new discovery, the phosphorylated at threonine 217
biomarker, with an even higher accuracy rate, and its applications in differentiating Alzheimer Disease
dementia from other neurodegenerative diseases, which is still in testing phase, is a significant discovery
yet to be proven that would greatly benefit health care systems and rapid diagnostic of patients suffering
from this disease.
Researchers have successfully obtained consent and approval of ethical aspects from the relevant
authorities and the study was organized and conducted on three patient cohorts in Arizona, Sweden and
Colombia. Furthermore, results were generated from blood samples, specifically focusing on
measurement of plasma P-tau217 by the use of sensitive immunoassays analysis.
Following the study, the results have shown that compared to other previously used AD
biomarkers, the P-tau217 is considered to be highly discriminatively accurate in differentiating AD
patients from patients suffering from other neurodegenerative diseases, one reason being that P-tau 217
levels are believed to show variations earlier in the development of the disease, which allows for timely
detection, that was not observed in other cognitive impaired diseases.
Nevertheless, apart from the significant discovery of the AD diagnostic biomarker, the study has
also met different challenges, due to the low numbers and limited diversity of the cohorts involved,
which demands further, more complex trials in order to truly validate the results. Another important
aspect that has been observed in this research was represented by the very low concentrations of P-
tau217 collected from cohort volunteers, which represented a challenge in adjusting the detection limits
to sensitive levels in order to produce accurate and relevant results to be analyzed.
Further steps in the improvement of the study protocols, procedures, assays performed, as well as
a better and more diverse selection of volunteering participants are needed to generate more specific
outcomes. However, this discovery of the high potential of the P-tau217 biomarker represents a vital
step forward in the understanding and development of diagnostic and treatment of AD patients, a disease
that has been little understood for a long time.
Palmqvist, S., Janelidze, S., Quiroz, Y. T., Zetterberg, H., Lopera, F., Stomrud, E., … Dage, J. L. (2020).
Discriminative Accuracy of Plasma Phospho-tau217 for Alzheimer Disease vs Other Neurodegenerative
Disorders. JAMA, 324(8), 772. https://doi.org/10.1001/jama.2020.12134

20. Hepatitis C virus vaccine design: focus on the humoral immune response
Hepatitis C virus (HCV), a single-stranded RNA virus, has been long know to affect a significant
proportion of the worldwide population, being declared by the World Health Organization (WHO) to
infect over two million individuals yearly. After extended studies, scientists have come to the conclusion
that apart from the current treatment schemes that were steadily updated in the last decade, the most
promising solution would be the introduction of a vaccine that would, as a baseline, provide reduction of
viral antigens and prevention of chronic hepatitis C (CHC) and slowly lead to herd acquired immunity.
This effort comes as a reflection of the 2016 WHO goal to lower HCV infection rates by 90% by 2030.
HCV prevalent transmission routes include: share of supplies used by injecting drug users (IDU),
tattoos, blood transfusions, nosocomial transmission, as well as sexual transmission. The exposure to
this virus manifests following an incubation period, after which individuals either succeed in clearing
the virus, or, in most cases, the infection pursues a cascade effect of successive complications from the
initial infection, to fibrosis, liver cirrhosis, CHC, followed by development of end-stage liver disease
and possible hepatocellular carcinoma, which can eventually lead to death or urgent requirement for
transplantation. Furthermore, the risk of acute HCV infection, however rare, represents a high mortality
repercussion.
Moreover, current HCV treatment, the direct-acting antivirals (DAAs), designed to aid in the
inhibition of proteins demonstrated to have an important role in the viral replication process, has shown
high efficiency rates, however fairly hard to access and high priced in developing countries and
influenced by resistant variants in its effectiveness.
Alternative vaccine objectives are being considered, with the ultimate goal to generate either
humoral, cellular or both immune responses, with the humoral inducing immune response vaccine using
the E1E2 recombinant protein extracted from the 1a genotype of HCV being the most efficient
development until now. Additionally, HCV neutralizing antibodies present in this vaccine, target the E1
and E2 proteins identified in the genome of the virus and have been proven to completely cure acute
cases of infection and prevent reinfection in both animals and humans, with demonstrated long-lasting
effects.
Conclusively, the significant breakthroughs made by scientists in the development of a
successful, efficient and long-lasting prophylactic vaccine against HCV, along with the upgraded and
highly effective DAA treatment, accurately reflect the expanding understanding and influence of
technology on global health, by continuously proposing novel treatment approaches and possible future
eradication of prevalent serious diseases that affect large numbers of people every year.
Sepulveda-Crespo, D., Resino, S., & Martinez, I. (2020). Hepatitis C virus vaccine design: focus on the humoral immune
response. Journal of Biomedical Science, 27(1). https://doi.org/10.1186/s12929-020-00669-4

21. Role of iron and iron-related proteins in mesenchymal stem cells: Cellular and clinical aspects
Recent studies focused towards finding potential adjuvant treatments for excess iron diseases,
have shown a strongly corelated link between iron blood levels and mesenchymal stem cells (MSCs)
and presented the relevant pathways that may reveal disrupted performance in pathologies directly or
indirectly related to excess iron influencing proper functionality of MSCs.
To begin with, in order to discuss the iron conditioned MSCs mechanisms, an important aspect is
the understanding of the roles these two individual components have in a physiologically normal
scenario. Firstly, iron uptake leads to its absorbance into the circulation, where it later binds to proteins
and enzymes, aiding in accomplishing various roles, such as oxygen transport, by hemoglobin and
myoglobin. Furthermore, iron is normally exported from the cells through the assistance of ferroportin, a
transmembrane protein, while potential excess iron is stored in a storage protein, called ferritin.
The key purpose of MSCs is to regenerate and repair most types of tissues because of their
potential of self-renewal and differentiation into different cell types, in correspondence to the needs of
the body. Moreover, another important role of MSCs is to regulate the secretion of growth factors,
messenger RNAs and DNA, therefore playing a significant role in a broad selection of physiological
mechanisms, such as BM hematopoiesis, wound healing or bone turnover.
The close link between excess iron and MSCs can be observed at the bone marrow level, where
bone marrow mesenchymal stem cells (BM-MSCs) have an essential role in hematopoiesis regulation,
which is describe as an iron-dependent process. As a result, inappropriate iron levels will have a great
impact on bone marrow hematopoiesis, due to incapacitation of MSCs to perform their support function.
Consequently, abnormal functionality of MSCs can lead to hematological conditions, that are
already recognized as generated by overload of iron levels, such as myelodysplastic syndromes and
beta-thalassaemia. Moreover, disorders such as neurodegenerative, menopause, sickle cell anaemia or
chronic liver diseases have been shown to also be caused by iron overload, induced by mutations
relating to iron-regulatory genes.
Another relevant disease that is believed to be closely linked to elevated iron levels is diabetes,
about which scientists demonstrated that stress of physiological nature encountered in this illness is
likely to cause functional abnormalities in MSCs, that can therefore reveal reduced proliferation and
differentiation and elevated apoptosis. Likewise, patients suffering from transfusion-dependent
disorders, for example, beta-thalassaemia, are predisposed to experience iron-loading following their
treatment.
Taking into consideration the fact that experimental research demonstrated that MSCs preserve
their ability to renew, regenerate and differentiate at similar standards in vitro, compared to in vivo
studies, the potential development of cell-based therapies must be accentuated, as knowledge in this
subject can help identify future signaling pathways and molecular targets for improvement of treatment
schemes for various diseases.
Mehta, K. J. (2021). Role of iron and iron‐related proteins in mesenchymal stem cells: Cellular and clinical aspects. Journal
of Cellular Physiology. https://doi.org/10.1002/jcp.30383

22. NIH awards grants to support bacteriophage therapy research
In 2019, a summary report analyzing the evolution of pathogen infections that are resistant to antibiotics, revealed
the concern of rapidly occurring microbial infections and associated deaths, with over 2.8 million cases being reported yearly in
the US. As a result, the National Institute of Allergy and Infectious Diseases (NIAID) has decided to support the effort of
research towards elucidating this problem by awarding $2.5 million directed to studies developed by 12 institutes on
bacteriophage therapy.
Their goal is to develop new anti-bacterial treatment approaches that would minimize the risk of antimicrobial
resistant bacteria and increasing the efficiency of treatments, that would consequently have a great impact in reducing the
number of microbial infection deaths. Scientists have planned to approach this matter by using the already efficient roles of
bacteriophages, or shortly phages, which act like viruses that can target specific bad bacteria, without harming good ones or
surrounding human cells, thus trying to enhance this naturally occurring property and redirect it as a form of efficient and low
risk treatment.
The choice of using this method was dictated by the fact that, unlike antibiotics which directly kill bacteria, phages
work by rather infecting bacterial cells in order to invasively eliminate them and due to this treatment mechanisms based on this
approach, are expected to be highly efficient in patients that suffer from infections resistant to antibiotics. Furthermore, scientists
have also considered the concomitant use of both antibiotics and phages, a treatment pathway that would potentially assist in
prevention of drug resistant bacterial formation.
This research initiative represents a greatly relevant subject in the biomedical field, as the awarded grants have been
announced to support additional studies that aim to classify different types of bacteriophages and their functions, as well as their
potential roles in fighting against biofilms, known to be antibiotic-resistant at the present time, while continuously looking for
relevant methods of application in the combat battle against various diseases, such as tuberculosis.
NIH awards grants to support bacteriophage therapy research. (2021, March 11). Retrieved April 15, 2021, from National
Institutes of Health (NIH) website: https://www.nih.gov/news-events/news-releases/nih-awards-grants-support-
bacteriophage-therapy-research

23. Vitamin D supplementation to prevents acute respiratory infections: a systematic review and
meta-analysis of aggregate data from randomized controlled trials
Evidence showing the evidence of vitamin D advantages in the prevention approaches of acute
respiratory diseases has been once again coming to light during the present COVID-19 pandemic, with
one important highlight being that vitamin D is expected to take part in the innate immune system of
the human body against various respiratory viruses.
In this interest, the research was conducted on a total number of 1528 studies formed of
randomized participant who have been declared eligible to take part in this research project,
comprised of three major groups, one that received high doses of vitamin D, one that received low
doses of vitamin D and one placebo group. As a reflection of this study, participant groups outcomes
were analyzed under consideration of the treatment received, while also sex, age and origins
categories were taken into consideration in order to understand variants of expected outcomes on a
diverse population, in order to ensure a high reliability result.
The conclusions of this study, included the theory that effectiveness of vitamin D in prevention
of respiratory diseases aggravation is greatly dependent on the hosts metabolism and their natural
reaction to respiratory pathogens, however representing an important aspect to be taken into
consideration under current conditions, when the recent COVID-19 pandemic has brought forward the
infectious SARS-CoV-2 virus, which in the last year has manifested through the form of acute
respiratory disorders, which developed into even more serious diseases, therefore affecting a large
number of the worldwide population and raising numbers in associated death rates.
Jolliffe, D. A., Camargo, C. A., Sluyter, J. D., Aglipay, M., Aloia, J. F., Ganmaa, D., … Janssens, W. (2021). Vitamin D
supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from
randomised controlled trials. The Lancet Diabetes & Endocrinology. https://doi.org/10.1016/s2213-8587(21)00051-6