Day: 05/05/2013

Turning Traditional Medicine Into Cancer Drugs.

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Quite a few substances used in traditional medicine in China or other countries have received Food and Drug Administration (FDA) approval as cancer drugs… and their numbers are growing.  Some examples are:

Arsenic trioxide, made from arsenic sulfide ore, has been used therapeutically for more than 2,400 years. Following promising reports from China, the agent was tested in clinical trials and received FDA approval in 2000 for patients with acute promyelocytic leukemia who have not responded to other therapies or whose disease has recurred.

Camptothecin, isolated from the bark and stem of a tree native to China, was long used as a cancer treatment in traditional Chinese medicine. When preliminary clinical trials of the compound showed encouraging results in patients with leukemia, chemists made synthetic versions that retain its anticancer properties while reducing its harsh side effects. Two of these synthesized versions, or analogues, have been approved for the treatment of chronic lymphocytic leukemia.

Podophyllotoxin, isolated from the Mayapple plant that grows in forests in the eastern United States, has a long history as a medicinal agent. A gel made from the compound is used to treat certain kinds of warts, and a synthetic version is used to treat lung cancer, testicular cancer,lymphoma, and certain forms of leukemiaand sarcomas.

Vinca alkaloids were derived from the Madagascar periwinkle plant and, according to folklore, were useful in treating diabetes. Scientific testing found they had no antidiabetic properties but could extend the lives of mice with certain forms of leukemia. Synthesized forms of the alkaloids include two of the most common chemotherapy agents in use today, vincristine and vinblastine. Cancers treated with vinca alkaloid-derived drugs include acute leukemia, neuroblastoma,  Wilms tumor, Hodgkin and non-Hodgkin lymphomas,breast cancer, melanoma, and uterine cancer.

Homoharringtonine, which comes from an evergreen shrub indigenous to China called Plum Yew or Cowtail Pine, was approved by the FDA last year for the treatment of adult patients with chronic myelogenous leukemia (CML) who aren’t helped by agents known as kinase inhibitors.

Indirubin, extracted from the indigo plant, is part of a traditional Chinese preparation used to treat CML. Laboratory and animal studies suggest it may be an effective treatment for patients, but clinical trials have not yet been conducted.

Natural compounds from Chinese medicine currently being studied as potential cancer drugs include astragulus (a large family of herbs and shrubs); scutellaria (flowering plants of the mint family, used in traditional Chinese medicine to strengthen the immune system); and indigofera (a large family of flowering plants, used to alleviate pain).

Some naturally-derived agents are used as stand-alone treatments; others are part of combined therapies. Because some natural therapies can decrease the effect of chemotherapy drugs, it’s important for patients to inform their physicians of any alternative treatments they are using.

Source:Dana Faber

Judith MacKay: self-made scourge of the tobacco industry.

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Judith MacKay learned early on in her career to wear insults as a badge of pride. “A gibbering satan”, prone to the use of “diatribes full of putrid corruption, lies, conspiracy, and total censorship” is just a taste of the many slurs that came MacKay’s way in the early 1990s. What MacKay had done to merit such attacks from US smokers’ rights groups was what she has been doing since the early 1980s: tirelessly and effectively advocating for better control of tobacco products around the world, but in Asia in particular.

As MacKay and her colleagues explain in their paper on Tobacco Control in The Lancet, as well as being one of the biggest markets for tobacco, Asia has also been at the forefront of efforts to control its use. MacKay has been a central figure in that cause. Born in Saltburn by the Sea on the UK’s northeast coast, MacKay moved to Hong Kong with her husband in 1967 after graduating in medicine from the University of Edinburgh at the age of just 22 years. And after a brief hiatus to do what she calls “a few traditional things like having babies”, and brushing up on her Cantonese, her increasing involvement with the feminist movement led MacKay to think more seriously about a long-term career.

She went back to medicine, and as a specialist in internal medicine at Hong Kong University’s hospital MacKay started to see more and more patients with tobacco-related diseases. It dawned on her that there was a pressing need “to go further up the river in public health terms”, and at the same time, she says, she was “very interested in health education, and was writing 1000 words a week for the South China Morning Post for a column on women’s health”. It was the “ballistic”, vitriolic response of the tobacco industry to a series of MacKay’s articles on women and tobacco that finally affirmed tobacco control in her mind as the cause to which she should devote her life’s work. “I left clinical medicine in 1984”, she says, “and I never looked back really”.

So how do you go about setting yourself up to influence government tobacco policy? It’s not something, as a rule, that tends to come up in medical curricula. “I was never trained on how to lobby a finance minister for a tax increase, or put out a press release, or front up to a very powerful industry”, says MacKay. But she was steadfast in the face of industry intimidation and, importantly, “she had the ear of governments because she has a persuasive style rather than confrontational approach—a skill much appreciated when dealing with conservative style Asian governments”, says Mary Assunta, Director of the International Tobacco Control Project run by Cancer Council Australia.

Working alone and often unpaid for 25 years, MacKay’s appointment in 2006 as Senior Advisor to both the World Lung Foundation component of the Bloomberg Initiative to Reduce Tobacco Use in low-income and middle-income countries and the Bill and Melinda Gates Foundation reflects the huge change in attitudes towards tobacco over the intervening years. “It’s institutionalised now”, she says: “it’s become mainstream public health in a way, whereas back in the 70s and 80s it was seen as very quirky. There was a caution and a real feeling that somehow I’d gone off the main tracks of medicine, but nowadays the understanding is much wider than it was before.” Through the WHO Framework Convention on Tobacco Control to new funding from Bloomberg and the Bill and Melinda Gates Foundation, there is a real momentum now behind tobacco control. “Almost every day I get something in the inbox about a new law that’s been created or expanded or implemented”, MacKay says. But there is also a real need to ensure that progress does not breed complacency.

The tobacco industry is no different than it has ever been, MacKay warns, although their tactics have evolved. “They’ve tried to attack the science, then moved on to attacking individuals like myself, and now they’ve moved to attacking governments”, she says. The Australian Government’s recent decision to introduce plain packaging for cigarettes attracted a lengthy challenge in the Australian High Court, along with an ongoing dispute in the World Trade Organisation. It’s a familiar story according to MacKay. “In the same week, the Minister of Health from Scotland and the Minister of Health from Iran said the same thing to me: ‘we’re bogged down with legal challenges’. It’s a delaying tactic, and they’ve delayed some legislation in India for example for almost a decade”, she notes. But apart from delaying the adoption of graphic warning labels on cigarette packaging in the USA, these challenges have been unsuccessful. “It’s a paper tiger”, she says.

The same can’t be said of MacKay herself, and she is in no doubt that over the next few years she can help persuade more governments to start setting targets and consider endgames, such as New Zealand’s recent announcement of a goal to reduce smoking prevalence to 5% by 2025. An endgame for MacKay, though, is something she’ll not be considering any time soon. “That’s the wonderful thing about public health, you can go on forever”, she says. “I really quite seriously think I’ll be campaigning on my 100th birthday.” And for the tobacco industry representatives who she assures me will be poring over this article, there can’t be much worse news than that.

Source: Lancet

 

 

IT’S TIME FOR ALLTRIALS REGISTERED AND REPORTED.

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The Cochrane Collaboration has become a lead partner in the AllTrials initiative (AllTrials.net), a campaign to ensure that all clinical trials are registered and the results reported, for all treatments in current use. Cochrane joins Sense About Science, Bad Science, the BMJ, the James Lind Initiative, and the Centre for Evidence Based Medicine in leading this international campaign, which has already signed up over 200 research bodies, regulators, and patient groups, and nearly 50,000 individuals. This, though, is just a beginning.

Everyone involved in medical research knows that we only see parts of the picture of how treatments work and in whom. There are ‘known unknowns’: studies not yet conducted and comparisons not yet made, for example. We can press for the funds and motivation to do them. There are ‘unknown unknowns’: limits to our current understanding that we can only guess at, such as the extent to which epigenetics might sweep away working assumptions about how we respond to drug treatments. But medical research is suffering from something far less explicable: ‘unknown knowns’. Trials are run and data are gathered, but what many of them found is kept a secret. Researchers, doctors, and patients cannot benefit from knowledge that they are unable to obtain.

Around half of all the clinical trials that have been conducted have not yet been published, and trials with positive results are twice as likely to be published as others.[1] The problem of failure to report the outcomes of trials exists for industry and non-industry trials, internationally, and at all stages of drug development. A cross-sectional analysis of trials registered and completed on the FDA-run registry ClinicalTrials.gov between 1999 and 2007 found that 56% of industry-sponsored trials and 40% of non-industry, non-government-sponsored trials had been published.[2]

Compared to all the other challenges of medicine, the missing information about clinical trials is a routine barrier to knowledge, and its solution is a simple matter of communication about what is known. It is strange that we have lived so long with a problem that can be fixed relatively easily. It is unfair to patients and trial participants, it is frustrating to researchers and medical practitioners, and it is completely unnecessary.

One of the reasons that the problem of missing trials has not been addressed is that discussions have taken place behind closed doors, amid promises that “it is being fixed”. Behind those closed doors, arguments to slow and complicate the path to improvement can thrive. These arguments have been redeployed against the AllTrials initiative. The problem is fixed. It shouldn’t be discussed in public because it undermines trust in medicine. Publishing research results causes scare stories. The regulator has what it needs, and we should be content with that. Patients are alarmed that their information might be shared. It wastes resources. The problem is being exaggerated. And so on.

These are not, though, the arguments of people with greater insight into the problems of clinical trial reporting. They are the arguments of people who don’t want change. The problem is not fixed. We have seen a slow improvement in registration compliance and reporting rates, but the medicines that are currently prescribed for patients already have marketing authorisation. This is why AllTrials is calling for retrospective publication of trials relating to treatments in current use. Talking only about the conduct of future trials is just kicking the ball further up the street, which is what has happened since Iain Chalmers first sounded the alert on the problem of non-reporting 20 years ago.[3] Registering protocols and reporting outcomes do not present insurmountable patient confidentiality issues. GlaxoSmithKline, the first pharmaceutical company to sign up to AllTrials, has agreed to publish the results of all trials going back to its formation as a company, which shows it can be done. Under the glare of the public spotlight now on this issue, the arguments against communicating trial results disappear into the shadows.

AllTrials is an opportunity for us to come together to ensure that this public spotlight continues to shine on the dark corners of missing trials until there is change. There are no new arguments here. Patients have expected and continue to expect their treatments to be based on the best available evidence.[4] Clinical trial participants expect to be contributing to knowledge about their disease and future treatments. Policy-makers expect to be able to make decisions about effective and efficient health care. We all expect researchers to know what is known and to be free to analyse it. All of this underlines the valuable and necessary role of The Cochrane Collaboration in this essential campaign. Please sign up and urge other individuals and organisations to do the same at AllTrials.net.

Source: http://www.thecochranelibrary.com

Oral Regimen Temporarily Suppresses Resistant Gut Bacteria.

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An oral regimen of colistin and neomycin suppresses extended-spectrum beta-lactamase in patients, but the effect of treatment disappeared within 7 days, according to a new study.

There have been attempts to eradicate these resistant bacteria, but most previous research has been uncontrolled or used case studies. “This is the first really methodologically sound and well-controlled study in this area. We tried to improve the evidence base,” Stephan Harbarth, MD, associate professor of infectious diseases and infection control at Geneva University Hospitals in Switzerland, told Medscape Medical News.

This regimen could be used to combat outbreaks and prepare patients for surgery, said Dr. Harbarth, who presented findings here at the 23rd European Congress of Clinical Microbiology and Infectious Diseases.

In the single-center, double-blind, placebo-controlled trial, adults with a rectal swab that tested positive for extended-spectrum beta-lactamase were randomized to 1 of 2 groups. A total 27 patients received colistin (50 mg 4 times daily) and neomycin (250 mg 4 times daily) for 10 days, plus nitrofurantoin (100 mg 3 times daily) for 5 days if they had a positive urine culture at baseline; and 27 patients received placebo.

The researchers conducted cultures (rectal, inguinal, urine) on day 6 of treatment, day 1 after the end of treatment, and day 7 after the end of treatment. The primary outcome was the detection of Enterobacteriaceae by rectal swab at 28 ± 7 days after the end of treatment. When primary outcome data were missing, they were imputed on the basis of the last observation.

There was no significant difference between the 2 groups at 28 ± 7 days after the end of treatment. However, there were differences during and soon after treatment.

Patients in the treatment group were more likely to experience liquid stool than those in the placebo group (25.9% vs 6.9%; P = .05). Inguinal Enterobacteriaceae colonization was present in 29 of 58 patients at baseline, whereas urinary colonization was present in 12 patients in the treatment group and 7 in the placebo group. There was no difference between the 2 groups for inguinal or urinary colonization at any point during the study.

In the treatment group, there was no significant change in minimum inhibitory concentration of colistin from baseline to 28 ± 7 days after the end of treatment.

Although the primary end point was not met and the regimen can’t be used for broad-scale control of infection, “it’s an infection-control measure that could be useful for suppression of this multiresistant carriage in the gut flora. In certain situations, like epidemics or prior to high-risk surgery, this could be a valuable intervention,” said Dr. Harbarth.

He pointed out that modifications to the regimen might be more successful. Different agents that are more active in the colon might improve outcome, probiotics could be used, and drug dosages could be refined. It could also be that one of the drugs used — neomycin — was underdosed in the study, Dr. Harbarth added.

“The results were interesting, but sadly disappointing,” session moderator Hilary Humphreys, MD, professor of clinical microbiology at the Royal College of Surgeons in Dublin, Ireland, told Medscape Medical News. This study confirms that “it’s very difficult with a temporary suppression regimen to see permanent eradication in the gastrointestinal tract, because there are huge numbers of bacteria and the physiology and the environment where those bacteria exist is very complex.”

Dr. Humphreys said he agrees that the regimen could be applied to outbreaks and during preparation for major surgery. “I think those are probably its major uses.”

Source: medscape.com

 

 

Thyroid Screening Neglected in Hypercholesterolemia.

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Just half of primary-care patients with hypercholesterolemia received recommended thyroid-function screening, a new retrospective study has found.

The findings were presented here at the American Association of Clinical Endocrinologists (AACE) 2013 Scientific & Clinical Congress by Devina Willard, MD, an internal-medicine resident at Boston Medical Center, Massachusetts.

Hypothyroidism is an important secondary cause of elevated total cholesterol and LDL cholesterol. In overt hypothyroidism cases, thyroid hormone replacement treatment often normalizes the cholesterol levels. For that reason, guidelines from the AACE, American Thyroid Association, and National Cholesterol Education Program (NCEP) recommend testing for hypothyroidism.

Dr. Willard‘s study was designed to determine the rate of adherence to the guidelines by primary-care physicians. “The 50% rate of screening is a bit surprising. Although guidelines from the NCEP and [American College of Physicians] ACP state that thyroid dysfunction is [included in the] differential [diagnosis] for new-onset dyslipidemia, the practice of screening in standard clinical practice seems to often be overlooked,” she told Medscape Medical News.

Important to Treat Underlying Cause of Hyperlipidemia

Dr. Willard and colleagues reviewed charts from patients aged 18 years and older with total-cholesterol levels of 200 mg/dL and/or LDL-cholesterol levels of 160 mg/dL or above, who were seen at Boston Medical Center’s internal-medicine and family-medicine clinics for routine care during 2003 – 2011. Patients who had previously taken lipid or thyroid medications were excluded.

Of the 8795 patients newly diagnosed with hypercholesterolemia, thyroid-stimulating hormone (TSH) levels had been checked within 6 months of the diagnosis for 49%. Peripheral thyroid-function tests were also done for 18.4% of the patients.

Of the total 4349 patients who had TSH levels screened, 151 had TSH levels greater than 5 mIU/L and 74 had TSH levels over 10 mIU/L. Of these 225 patients (with TSH levels >5), 50.7% received levothyroxine treatment, Dr. Willard reported.

Of those 114 patients treated with levothyroxine, 75.4% did not receive a lipid-lowering agent within 1 year, possibly because correction of their hypothyroidism resulted in improvement of their lipid panel and correction of the dyslipidemia, she said.

The clinical implications of the findings are identifying a treatable cause of dyslipidemia and saving on the potential costs of long-term management of cholesterol-lowering therapy in many individuals, as well as reducing risk for cardiovascular events, Dr. Willard told Medscape Medical News.

She added, “We agree with the guidelines… It is important to treat the underlying and potentially reversible cause of dyslipidemia. However, we would conclude that more research is needed to better assess the cost/benefit effectiveness of having these guidelines be universally adopted.”

Source: medscape.com

 

 

Prolonged, Disabling Fatigue in Teens Common, Undertreated.

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Extreme, persistent fatigue in US adolescents is common, highly disabling, and often coexists with mood disorders, new research shows.

A survey conducted by investigators from the National Institute of Mental Health showed that prolonged fatigue, defined as lasting 3 months or longer, was reported in 3% of teens aged 13 to 18 years, and more than half of these youth reported severe or very severe difficulties in school, family, or social situations.

Among teens with prolonged fatigue, 1.4% had prolonged fatigue alone, and 1.6% had prolonged fatigue with comorbid depression or anxiety.

“Many parents complain their adolescents are ‘lazy’ because they tend to sleep late on weekends and do not seem to have much energy. Our data suggest that fatigue may be an indicator of either physical or mental disorders that should be followed up by their physician,” Kathleen Merikangas, PhD, from the National Institute of Mental Health, told Medscape Medical News.

The study is published in the May issue of the American Journal of Psychiatry.

The investigators studied the prevalence and correlates of prolonged fatigue in a representative sample of 10,123 US adolescents aged 13 to 18 years. They defined prolonged fatigue as extreme fatigue with at least 1 associated symptom, including pain, dizziness, headache, sleep disturbance, inability to relax, and irritability, that does not resolve by rest or relaxation and lasts at least 3 months.

Dr. Merikangas said what she found most interesting was “the extent to which persistent fatigue alone, without comorbid anxiety or depression, was associated with disability in adolescents from the general population.”

Nearly 60% of the adolescents with prolonged fatigue only had severe or very severe disability, and their rates of poor physical and mental health were on par with those of adolescents with mood or anxiety disorders, the investigators say.

Adolescents with prolonged fatigue plus a mood or anxiety disorder had significantly greater disability, poorer mental health, and more health service use than those with either condition alone.

“Extreme fatigue that continues even after rest and interferes with adolescents’ ability to participate academically, socially, or at home is a pathological condition, yet it’s not being recognized and treated,” Dr. Merikangas commented in a statement. “Also, teens with a depressive or anxiety disorder plus persistent fatigue appear to be sicker than those without fatigue.”

“Fatigue should be routinely assessed by healthcare providers. Among youth with mood or anxiety disorders, fatigue may be an important indicator of negative health behaviors (eg, smoking, drug use) and disability,” she said.

In an accompanying editorial, Gijs Bleijenberg, PhD, and Hans Knoop, PhD, of Radboud University Nijmegan Medical Centre, the Netherlands, write that the prevalence of persistent fatigue without anxiety or depression was “surprisingly high.”

Perhaps of even greater concern was that 60% of this group had disabling fatigue, yet most did not seek medical help.

They note that is not unusual for adolescents to engage in extreme behavior and exhaust themselves. However, fatigue that does not resolve when teens modify their behavior has significant health implications for social, emotional, and intellectual development and warrants medical attention.

Source: medscape.com

 

C difficile: 10% of Patients Are Carriers at Hospitalization.

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One in 10 (9.7%) patients has asymptomatic Clostridium difficile(CD) colonization at the time of hospitalization, according to a new study. The 3 main risk factors for colonization are recent hospitalization (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.02 – 5.84), chronic dialysis (OR, 8.12; 95% CI, 1.80 – 36.65), and corticosteroid use (OR, 3.09; 95% CI, 1.24 – 7.73).

Surbhi Leekha, MBBS, MPH, from the Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, and colleagues present their analysis of adults admitted to a tertiary care hospital in an article published in the May issue of the American Journal of Infection Control. Approximately half of admissions were enrolled in the study, but only 22% of admitted patients provided stool samples (n = 320).

Colonization rates were determined by polymerase chain reaction analysis of formed stool. This approach circumvented the problems associated with anaerobic cultures.

The data are consistent with a previous large, multicenter study in Canada, which demonstrated that recent hospitalization is a risk factor for CD colonization. A previous study has also demonstrated that individuals receiving chronic dialysis are at risk for CD infection. This is the first study, however, to demonstrate that corticosteroid use is a risk factor for CD colonization.

The authors note that although CD epidemiology has changed during the past decades, the risk factors for infection appear to be unchanged.

“We propose that elucidation of risk factors for CD colonization could help identify asymptomatic individuals for targeted surveillance in selected hospital settings such as high endemicity despite the use of other control measures or epidemic situations. Potential infection prevention measures to prevent CD transmission from asymptomatically colonized patients include contact precautions, hand hygiene with soap and water, and environmental cleaning with a sporicidal agent. In our population, by targeting those with identified risk factors, we would need to screen approximately half of those patients with anticipated stays >24 hours, to identify three-fourths of those colonized with C difficile,” the authors write.

Source: medscape.com

 

 

Aspiration Pneumonia Risks Premature Death in Alzheimer’s.

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The risk of dying of aspiration pneumonia among people with Alzheimer’s disease and related dementias (ADRD) is higher for men than women and, in the United States, is higher for younger elderly compared with those 85 years or older, according to a survey of death certificates.

Presenting his analysis here at the Alzheimer’s Disease International (ADI) 28th International Conference, Tsung-Hsueh Lu, MD, PhD, from the Department of Public Health at National Cheng Kung University Hospital in Tainan, Taiwan, told delegates that death certificates list a disease or condition directly leading to death and then other antecedent conditions as contributing causes, but often those latter causes are lost in analyses.

For example, a death certificate may list sepsis as the direct cause, but if aspiration pneumonia and Alzheimer’s disease are listed as antecedent causes, only sepsis may be considered for purposes of vital statistics. So he and a colleague looked for occurrences of listings of aspiration pneumonia, which can be a preventable cause of premature death, with ADRD.

Between 2002 and 2009, 6% of death certificates in the United States and 3.6% of those in Taiwan that listed ADRD as a cause of death also listed aspiration pneumonia.

Men in the United States were at a 78% greater risk for aspiration pneumonia if they had ADRD than were women (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.776 – 1.80). Similarly, men in Taiwan were 71% more likely than women there to die with aspiration pneumonia with ADRD (OR, 1.71; 95% CI, 1.36 – 2.14).

Compared with people aged 65 to 74 years in the United States, residents with ADRD had a decreasing risk for aspiration pneumonia as they aged (at 75 to 84 years: OR, 0.92 [95% CI, 0.90 – 0.94]; at ≥85 years: OR, 0.84 [95% CI, 0.82 – 0.86]). An interesting finding that Dr. Lu could not explain was that Taiwan residents trended in the direction of a nonsignificant increased risk with age.

In both countries, the proportion of people dying with aspiration pneumonia and ADRD decreased during the study period, from 6.9% in 2002 to 2003 to 5.0% in 2008 to 2009 in the United States (OR, 0.72 [95% CI, 0.70 – 0.73] for later period vs earlier) and (nonsignificantly) from 3.9% to 3.5% in Taiwan for the same periods (OR, 0.86 [95% CI, 0.63 – 1.17]).

Dr. Lu cautioned that aspiration pneumonia may be underreported as a cause of death, so the true figures may be even higher than that found from death certificates. And in the United States, different states may have different systems for determining and reporting the causes of deaths.

Preventing Premature Death

Aspiration of food is a major cause of pneumonia, but the risk can be reduced. “Speech therapists should be consulted to evaluate the swallowing ability in such a patient, training of the swallowing, or preparing of food to prevent this premature death,” Dr. Lu advised.

Session moderator David Troxel, MPH, a long-term care consultant and writer in the field of dementia in Sacramento, California, commented to Medscape Medical News that swallowing issues and food aspiration are recognized as big problems among elderly patients with dementia.

“Where I’d say we aren’t doing a good job is I think that families don’t know to go to a speech pathologist. Doctors may not think about referring to a speech pathologist who can maybe help with that and assess [the patient],” he said. “Certainly in home settings I doubt families know much about how to prepare foods or go to different kinds of puréed foods.”

He said he believes families are not getting much support in this area, so problems persist. He suggests that professionals in the elder care field talk to physicians about recognizing problems contributing to aspiration, about referring to speech pathologists, and “to really do more education with the families about different dos and don’ts about food.”

Source: medscape.com

 

Supercomputers Can Save U.S. Manufacturing.

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The key to reviving manufacturing in the U.S. may lie in the nation’s supercomputers

The U.S. used to be a powerhouse in manufacturing. In the past quarter of a century we have relinquished this leadership position, in large part because we made a decision—consciously or unconsciously—that the service and financial sectors are sufficient to sustain our economy. But they are not. Service jobs pay little. The financial industry makes nothing of value and therefore cannot maintain, let alone raise, the nation’s standard of living.

The fate of manufacturing is in some ways linked to our prowess in the physical sciences. In the 1960s and 1970s high-performance computing (HPC) developed at the national labs made its way to the manufacturing sector, where it now powers much of the innovation behind our most successful commercial firms. Yet we are ceding leadership in the physical sciences, too. Canceling the Superconducting Super Collider in the 1990s ended U.S. dominance in particle physics. NASA’s decision to delay, and possibly eventually abandon, the Wide-Field Infrared Survey Telescope could do the same for cosmology.

Fortunately, the nation’s lead in high-performance computing still stands. HPC is the advanced computing physicists use to model the dynamics of black holes, meteorologists use to model weather and engineers use to simulate combustion. This expertise may also be our best chance to rescue U.S. manufacturing. If we can successfully deliver it to engineers at small firms, it might give the sector enough of a boost to compete with lower labor costs overseas.

We already know how useful HPC is for big firms. When Boeing made the 767 in the 1980s, it tested 77 wing prototypes in the wind tunnel. When it made the 787 in 2005, it tested only 11. In the future, Boeing plans to bring that number down to three. Instead of physical wind tunnels, it uses virtual ones—simulations run on supercomputers—saving much time and money and quickening the pace of new products development. HPC modeling and simulation has become an equally powerful tool in designing assembly lines and manufacturing processes in a broad range of fields—big manufacturers such as Caterpillar, General Electric, Goodyear and Procter & Gamble use it routinely. Small manufacturers could get similar benefits from these tools, if only they had access to them.

I first came to appreciate the potential of HPC to help small manufacturers in 2009 as part of the Obama transition team. Working with the Council on Competitiveness, we identified lack of software, cost of entry and shortages of expertise as the main obstacles to the use of HPC by small manufacturers and proposed a partnership among government, manufacturers and universities to help. The result is the National Digital Engineering and Manufacturing Consortium, or NDEMC, a pilot pro­gram created by the council and the federal government.

Recently NDEMC made HPC resources available to a handful of firms, including Jeco Plastic Products. This 25-employee firm in Plainfield, Ind., makes plastic pallets for packaging of auto parts. The plastic pallets are a less expensive alternative to steel pallets, which are heavier and prone to rusting. When Jeco makes a new product, its engineers build a prototype, test it in the lab to see how it bears up under the stress it is likely to encounter in the field and repeat the process until they arrive at the best design. Last December, however, Jeco engineers got a chance to tap expertise at Purdue University to develop simulations of a pallet designed for a German automotive company and ran them on hardware at the Ohio Supercomputing Center in Columbus. As a result, Jeco bypassed that trial-and-error process completely, arriving at a design in only a few hours of computer time.

Many other small firms could reap similar benefits. NDEMC’s goal is to find the best business models for getting HPC to these firms and eventually take the effort nationwide. Small manufacturers today are in some ways like farmers at the beginning of the 20th century, most of whom did not know what contour farming, crop rotation and fertilizers could do for productivity. When the U.S. agricultural extension service, in conjunction with land-grant universities, made the requisite expertise available, it triggered a revolution in agricultural productivity. A similar revolution could be in the cards for small manufacturers if we can get supercomputing technology into the hands of their engineers.

Source: Scientific American

 

Nanoscale Printing Has Big Implications for Science and Technology.

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IBM researchers arrange 60-nanometer gold particles to re-create a work of Renaissance art

By Larry Greenemeier

 

Researchers from IBM‘s Zurich Research Lab and Switzerland’s ETH Zurich science and technology university today announced the development of a dramatic new printing process that can manipulate nanosize particles to create larger images. The new technology promises to allow scientists, medical professionals and technologists to for the first time place particles smaller than 100 nanometers precisely where they are needed.

The process, which likely will not be commercially available for several years, is expected to have the most dramatic impact in the fields of biomedicine, electronics andinformation technology. It will help advance the development of nanoscale biosensors and ultratiny lenses that can bend light inside future optical chips as well as the fabrication of nanowires that could be used to build more advanced computer chips, researchers report in Nature Nanotechnology.

“This process is more reliable than any process before it at depositing particles,” says Heiko Wolf, a researcher in nanopatterning at IBM’s Zurich Research Lab who worked on this project with five other IBM and ETH Zurich colleagues.

The researchers are the first to print particles as tiny as 60 nanometers, more than 33,000 times smaller than a pinhead. In “dots per inch,” the measurement used to indicate the number of individual spots of ink printed on a certain area, the nanoprinting method yields a resolution of 100,000 dots of print, or dpi, compared with the 1,500 dpi of common offset printing.

The research utilizes the principles behind printing technology to more efficiently place nanoparticles onto a surface. Scientists demonstrated the efficiency and versatility of their method by using it to print a copy of 17th-century mystic philosopher Robert Fludd‘s image of the sun (the alchemist’s symbol for gold) using about 20,000 gold particles, each of them 60 nanometers in diameter. The printing method placed one particle per dot to create the tiniest piece of artwork ever printed from single pigment particles.

Still just a conceptual construct, the nanoprinting process could be applied to biomedicine to help screen for diseases by graphically illustrating the locations of, say,cancer cells or heart attack markers in a patient’s body.

In the information technology world, nanoprinting could be used to achieve the controlled placement of catalytic seed particles for growing semiconducting nanowires. Such nanowires are promising candidates for future transistors in microchips. “We were looking to find some technique to grow a nanowire,” Wolf says, “where you want one to grow.”

Researchers at the Georgia Institute of Technology are also experimenting with a form of nanoscale printing called nanolithography, which may lead to the production of nanopatterned structures, including nanocircuits, that may be useful in a variety of fields, including electronics, nanofluidics and medicine. Once perfected, nanolithography could be used to draw nanocircuits for the electronics industry, create nanochannels for nanofluidics devices or be adapted for drug delivery or biosensing technologies.

Source: Scientific American