Tuesday, April 09, 2024

 

Norwegian Sets Long-Term Strategy Ordering Eight Ships from Fincantieri

cruise ship construction
Norwegian set its long-term strategy ordering eight additional ships for its three brands (Fincantieri)

PUBLISHED APR 9, 2024 8:16 AM BY THE MARITIME EXECUTIVE

 

 

Norwegian Cruise Line Holdings announced the largest cruise ship order in the history of the company mapping the long-term strategy for each of its three cruise brands with shipbuilder Fincantieri. The order comes as the cruise industry has successfully overcome the pandemic soaring to record booking levels and a newfound pricing power.

The new order calls for a total of eight cruise ships with 25,000 berths to be introduced in the decade between 2026 and 2036. It represents nearly 40 percent of the corporation’s current capacity of 66,5000 berths and when combined with four large cruise ships already under order and construction at Fincantieri due between 2025 and 2028 that combined will have 16,000 berths, it represents more than 60 percent of current capacity. The corporation is highlighting that the new ships will leverage its operating efficiency with larger passenger capacities.

"This strategic new-ship order across all three of our award-winning brands provides for the steady introduction of cutting-edge vessels into our fleet and solidifies our long-term growth,” said Harry Sommer, president and chief executive officer of Norwegian Cruise Line Holdings. “It also allows us to significantly leverage our operating scale, strengthen our commitment to innovation, and enhance our ability to offer our guests new products and experiences, all while providing opportunities to enhance the efficiency of our fleet.”

The deal includes four of the largest cruise ships yet built for the company, which will be approximately 200,000 gross tons each for the Norwegian Cruise Line brand. Fincantieri highlights it is a letter of intent subject to financing but it calls for each ship with a capacity of nearly 5,000 passengers due for delivery in 2030, 2032, 2034, and 2036. The move reverses NCL’s recent strategy of building the smaller Norwegian Prima (143,500 gross tons with 3,099 berths) and five sisters including larger Prima plus versions still under construction. The third ship, Norwegian Aqua (156,300 gross tons with 3,500 berths) enters service in 2025 and the last two vessels with be approximately 177,000 gross tons.

The order also replaces a space reservation for two cruise ships for Oceania Cruises with an order for two 86,000-gross-ton ships, each with a capacity of 1,450 passengers in 2027 and 2029. Oceania already has the Allura (67,000 gross tons and 1,200 passengers) under construction at Fincantieri for delivery in 2025. The order also includes two 77,000-gross-ton ships, each with a capacity of 850 passengers, due in 2026 and 2029 for Regent Seven Seas Cruises. This brand had taken delivery on its last new build in late 2023, a 55,500 gross ton cruise ship with accommodations for 746 passengers. This four-ship order has been financed and Fincantieri reports it is in effect with Norwegian calling the financing terms very attractive.

The orders come as the industry has just begun to resume its future construction plans after pausing all orders since late 2019, before the pandemic. Carnival Corporation has so far announced orders for two large cruise ships (182,000 gross tons) to be built in Germany for Carnival Cruise Line. Competitor Royal Caribbean International has two more of its largest cruise ships on order since before the pandemic, and MSC Cruises confirmed previous options for more of its 215,000 gross ton cruise ships. Norwegian said it believes competitors are in discussions with the four major yards and it wanted to secure slots before the others.

Despite the surge in orders, the overall expansion of the cruise industry remains constrained with the new ships expected to take at least two years to build. Analyst Patrick Scholes of Truist Securities commented to customers yesterday on Norwegian’s order, “Even with this sizable announcement, industry-wide new supply for 2026-2027 is very minimal compared to the 10-year pre-Covid average of approximately five percent per year,” describing the capacity growth.

Following another industry trend, Norwegian also reported it will add a pier at its private port in the Bahamas. The company plans to spend $150 million to add a two-ship dock at Great Stirrup Cay following Royal Caribbean Group and Disney Cruise Line which also have piers at their Bahamas port. It expands the use of the port reducing the impacts of bad weather which prevents the cruise ships from anchoring and landing passengers. Norwegian’s pier is due in late 2025 and the company says it would increase monetarization at the island by increasing passenger throughput by over 50 percent in its first year of operation. 

NCLH declined to comment if any of the ships would be replacements for some of its older tonnage. The ships reflect the industry’s continued move to larger cruise ships with increased capacity. The company said details regarding the ships’ amenities, staterooms, dining, recreational, efficiency, sustainability, and other features will be announced in the coming months.

 

B.C. Government Issues Cleanup Order for Controversial Scrapyard

DWR
Courtesy NGO Shipbreaking Platform

PUBLISHED APR 8, 2024 9:27 PM BY THE MARITIME EXECUTIVE

 


Authorities in British Columbia have imposed a pollution abatement order on a local ship recycling company, Deep Water Recovery (DWR), handing a win to local residents who opposed the firm's operations. DWR is now required to stop discharge of hazardous material and toxic effluent that pose health, safety and environmental risks.

In issuing the Pollution Abatement Order, B.C.’s Ministry of Environment and Climate Change Strategy said that repeated tests on samples collected from the site since 2022 have shown high concentrations of a retinue of pollutants. These include cadmium, copper, iron, zinc, and septic system discharge among many others. The agency concluded that it had reasonable grounds to conclude that "a substance is causing pollution on or about lands" occupied by DWR. 

The order follows extended protests by Union Bay residents under the banner of Concerned Citizens of Baynes Sound (CCOBS). The residents have been demanding the shutdown of the shipbreaking site, where DWR is dismantling former National Oceanic and Atmospheric Administration (NOAA) oceanographic research and survey vessels Miller Freeman and Surveyor. (NOAA has no ongoing connection with these retired vessels.) The community group - supported by NGO Shipbreaking Platform - argued that the operation risked releasing dangerous pollutants into the marine environment. 

The order demands that DWR must immediately cease releasing toxic wastes to the environment and bring on board an independent qualified professional to undertake a detailed review of the site and ongoing activities that could be contributing to the discharge of contaminants.

B.C’s Ministry of Environment warned that failure to comply with the order could see DWR face penalties of up to C$300,000 in fines, imprisonment for not more than six months, or both.

Established in B.C. in 2016, DWR is involved in the salvage, dismantling, and recycling of marine vessels, barges, and railroad assets such as locomotives. In 2019, the company purchased a multi-zoned property in Union Bay, including a 15-acre industrial marine site and a 27-acre water tenure specifically for vessel recycling.

 

Galveston LNG Bunker Terminal Moves Ahead

LNG bunker port
Illustration courtesy Galveston LNG Bunker Port

PUBLISHED APR 9, 2024 1:39 PM BY THE MARITIME EXECUTIVE


 

Galveston LNG Bunker Port has filed applications with the United States Army Corps of Engineers (USACE) to build its small-scale LNG terminal on Shoal Point in Texas City, Texas. If approved, the project would be the first purpose-built LNG bunker terminal in the area, and the port's second LNG fueling service.

The planned terminal includes two liquefaction trains capable of putting out 600,000 gallons of LNG per day, two 3-million-gallon storage tanks, a bunker vessel loading berth, and associated marine and loading facilities.

In addition to the USACE application, partners Seapath Group and Pilot LNG have also asked the Texas Railroad Commission (TRRC) and the United States Coast Guard (USCG) for permission to build. 

"This facility is a critical investment into the resilience of the United States' maritime infrastructure," said Joshua Lubarsky, President of JV partner Seapath Group.

LNG is one of the most popular options for dual-fuel vessel orders. According to data from DNV, there were about 470 LNG-powered vessels in operation globally as of the end of 2023, with over 500 more on order. A record 240 LNG-fueled ship orders were placed in 2021, 222 more in 2022 and another 130 in 2023. The LNG-powered fleet should exceed 1,000 vessels by 2027, DNV reports. 

The growth has been particularly pronounced in the container ship, car carrier, and cruise ship sectors, and Galveston is a major cruise port. 

The new terminal expands on previous efforts to establish Galveston as a hub for LNG fueling. In 2021, the Port of Galveston and Stabilis Solutions agreed to launch the use of LNG as a marine fuel at the port. Stabilis provides the fuel, and Seaside LNG provides the bunkering barge. Customers include Carnival Jubilee, which became the first ship on the Gulf Coast to receive ship-to-ship LNG bunkering in December 2023. 

"The Galveston Wharves views LNG fueling of marine vessels as an important step in our commitment to environmental stewardship," said Rodger Rees, Port Director and CEO, in 2021. "With the number of LNG-fueled vessels in the global fleet growing rapidly, having LNG fueling services in the port is an important step in our commercial growth."

 

Mental Health Issues in Seafarers

Seafarer on deck of anchor handling ship
iStock / Igor Kardasov

PUBLISHED APR 9, 2024 3:25 PM BY DR. ARTHUR L. DISKIN

 

 

Mental health issues in seafarers have always been a concern, but the impact of COVID-19 heightened these issues even more and brought the issue into the open. Crew members faced a multitude of additional stressors while at sea during COVID, including concerns about family at home (especially if they were from high COVID prevalence countries), prolonged length of contracts (up to 400,000 seafarers beyond 8 months at one point), multiple extended contracts, travel restrictions getting home, inability to be present to mourn deceased relatives, forbidden or greatly limited shore leave and financial stressors. These were added to the everyday stressors potentially experienced by all crew such as strained interpersonal relationships in closed quarters with long contracts, threats of violence, sleep disturbances, boredom, low job satisfaction. performance of same job for prolonged periods – especially if high risk positions, and lack of communication with friends and family back home.

Isolation is a key factor in driving mental health issues, as crew members often feel cut off from their support systems.  Certain crew may be hindered by cultural and language barriers in seeking help. Additionally, certain cultures have a very high threshold for help-seeking behaviors and this may serve as a barrier to early identification, thereby increasing suicide risk. Studies have shown up to 20% of crew have contemplated suicide.

The issues of high stress, isolation and cultural variations in response to mental health problems must be managed pro-actively at the ship and corporate levels with pro-active program development and interventions.  Officers may be as severely affected as crew, limiting their potential for assistance and necessitating shared onboard and shoreside solutions. 

In addition to suicide and the direct manifestations of mental health issues, crew may become more prone to mistakes and accidents putting the ship, themselves, and fellow crew at risk.

A very important consideration is that underlying mental health issues such as depression, anxiety, and substance abuse are exacerbated by the conditions at sea.   The motivation for going to see must be examined and considered.  If it is to escape issues at home, it is rarely, if ever, effective. Isolation from normal social support systems can unmask underlying mental illness.  It is not uncommon to see the first manifestations of schizophrenia in a newly hired crew member during the first few months of their first contract and first time away from home.  Understanding and managing culturally specific mental health issues is crucial in providing effective support to seafarers.

Mental health screening must be a part of all PEME and REME programs.

AP Companies offers comprehensive PEME services, and we strongly advocate for the inclusion of mental health assessments in the required PEME/REME package. Prioritizing mental health evaluations not only promotes the wellbeing of the crew onboard but also mitigates potential financial and security risks, ultimately leading to cost savings.

The impact of other medical conditions must be considered. The effect of medications used to treat underlying medical problems, the inability to access appropriate medical care and lack of access to chronic medications may all have mental health implications.

The experiencing and communication of psychological stress as somatic symptoms, known as somatization, is a common occurrence among crew members, often leading to physical symptoms that prompt them to seek medical care - psychiatric conditions generating physical symptoms. Complaints of chest pains, headaches, back pain, insomnia, weakness, and tremors are leading cause of returning home crew members seeking medical care and are often due to somatization resulting in complex case management challenges.  The somatic complaint must be fully evaluated medically before concluding it is secondary to psychological issues and then addressing those issues.

Utilization of medical resources is a secondary measure that can be employed and can produce a justifiable ROI for mental health services.

COVID-19 also introduced new emotional and behavioral concerns for seafarers, with feelings of isolation, loneliness, and stigma becoming more prevalent. Recovery from the virus may also leave individuals at a greater risk of depression, anxiety, PTSD, cognitive issues and substance abuse, along with other conditions collectively known as “Long COVID”. These post infectious complaints must be taken seriously.

To address these mental health challenges, assistance must be offered to seafarers both on board and through various support programs. Designated mental health liaisons, additional training for captains and crew members, and culturally sensitive support programs need to be implemented to provide the necessary help. Videos, telephonic or online direct interventions and required YouTube videos are all strategies that can be deployed. Organizations such as ISWAN (International Seafarers’ Welfare and Assistance Network) also offer specific training programs and resources directed towards increased social interaction, connectivity, and mental health assistance.  Mitigating mental health issues for all crew by increasing positive social interaction and connectivity amongst crew, enhancing the ability to communicate with friends and family at home and developing robust crew wellness programs addressing sleep hygiene, exercise, hydration, and diet, as well as assuring the availability of medications must be part of corporate strategies.

AP Companies' Telemedical services include the availability of psychologists and psychiatrists for both crew members and officers. This provision ensures that the crew has continual access to essential support in their native language while also enabling captains to receive guidance on identifying mental health issues within the crew and effectively managing them onboard.

Accessing mental health assistance through medical case management assistance companies such as AP Companies is a valuable and much needed resource.

In conclusion, the mental health issues faced by seafarers are complex and pervasive, requiring proactive intervention and support from ship and corporate leaders. By addressing stressors, isolation, underlying mental health issues, somatization, and emotional concerns related to COVID-19, the well-being of seafarers can be better safeguarded. It is crucial to prioritize mental health awareness and assistance to ensure the safety and mental well-being of seafarers during these challenging times.

Dr. Arthur L. Diskin is a graduate of the University of Miami School of Medicine with specialty training in Emergency Medicine and an interest in critical care. He is certified by the American Board of Emergency Medicine and is a Fellow of the American College of Emergency Physicians. He has held leadership roles such as the Past President of the Florida College of Emergency Physicians and is the former Chief of the Department of Emergency Medicine at Jackson Memorial Hospital in Miami, Florida, and Mount Sinai Medical Center in Miami Beach, Florida.

Dr.Diskin has also as an examiner for the American Board of Emergency Medicine as an examiner and is a past Chair of the Section on Cruise Ship and Maritime Medicine within the American College of Emergency Physicians.

His medical experience includes a notable tenure as the VP and Global Chief Medical Officer for Royal Caribbean Cruise Lines from 2008-16. In this position, Dr. Diskin played a pivotal role in recruiting and overseeing ship physicians and nurses, designing and operating the medical centers, developing infectious disease and disaster management policies, and ensuring the highest standards of medical care for guests and crew members.

Before this, he served as Medical Director for Carnival Cruise Lines from 1990-2008. During his time there, he honed his expertise in maritime health care, further solidifying his reputation in the field.

Dr. Diskin is also known for his consulting services in the maritime industry, offering case management, risk assessment, outbreak analysis, and more. He extends his knowledge to risk and claims management for both shoreside healthcare, particularly in the field of emergency medicine, and the maritime sector.

The opinions expressed herein are the author's and not necessarily those of The Maritime Executive.

 

Third Indian Shipyard Wins U.S. Navy Approval for Ship Repairs

Cochin Shipyard at peak activity (file image courtesy CSL)
Cochin Shipyard at peak activity (file image courtesy Cochin Shipyard)

PUBLISHED APR 9, 2024 5:18 PM BY THE MARITIME EXECUTIVE

 

 

Against a backdrop of deepening U.S.-India defense relations, a third Indian shipyard has struck a deal with the U.S. Navy for repair of its vessels. On April 6, the state-run Cochin Shipyard Limited (CSL) announced that it had signed a Master Shipyard Repair Agreement (MSRA) with the U.S. Navy, which qualifies the yard to repair vessels under the U.S. Navy’s Military Sealift Command.

“The MSRA is a non-financial agreement and is effective from April 5, 2024. CSL has been qualified for entering into the MSRA after a detailed evaluation process and capability assessment by the U.S Navy,” the shipyard said in a regulatory filing.  

Last year, two other Indian shipyards - L&T Kattupalli and Mazagon Dock Shipbuilders - signed a similar vessel repair agreement with the U.S. Navy. These agreements signal U.S. commitment to follow up on its pledge of using Indian repair facilities, reducing the maintenance turnaround time and costs for U.S. naval assets deployed in the Indo-Pacific region. The use of Indian yards also relieves pressure on the U.S. shipbuilding industrial base, which cannot keep up with the Navy’s needs.

Last year during Prime Minister Narendra Modi’s visit to Washington, the Indian government invited the U.S. to evaluate more yards for repair deals. In a joint statement after talks between President Joe Biden and Modi, the two leaders acknowledged India’s emergence as a hub for maintenance and repair.

“Partnerships with Indian shipyards will allow the U.S. Navy to expedite repairs for forward-deployed naval assets. As envisaged in the Defense Industrial Roadmap, both countries agree to work together for the creation of logistic, repair and maintenance infrastructure for aircrafts and vessels in India,” added the statement.  

Besides the U.S, the UK has bolstered its defense ties with India with two Royal Fleet auxiliary ships arriving last month at the L&T Kattupalli shipyard for maintenance. This is the first time the Royal Navy vessels sought maintenance in India, indicating progress in the UK-India 2030 Roadmap, which reflects the two nations’ commitment to a secure Indian Ocean.

 

RWE Wants to Expand Supply of Fiber Cables for Floating Offshore Wind

Braided covering machines on FibreMax's assembly line (FibreMax)
Braided covering machines on FibreMax's assembly line (FibreMax)

PUBLISHED APR 9, 2024 5:54 PM BY THE MARITIME EXECUTIVE

 

 

The German utility company RWE is working with Netherlands-based offshore mooring company FibreMax to develop synthetic mooring systems for floating wind production. The firms will work together on supply chain options and look for ways to reduce costs on ultra-deepwater and local floating offshore wind installations.

FibreMax believes that its products are the “strongest cables in the world.” According to the company, FibreMax mooring tendons offers much better strength, longer operational life and lower levels of maintenance compared to traditional steel moorings. The mooring system’s integrity is key to financial and operational viability of floating offshore wind.

“It is important to further develop and grow the supply chain for floating wind, in order to leverage its full potential. Working with forward-thinking and innovative companies like FibreMax helps unlock this potential,” said Chris Willow, Head of Floating Wind Development, RWE Offshore Wind.

Three years ago, FibreMax delivered prototypes of what it believes to be the strongest aramid cables in the world. The continuous-wound lines were tested to withstand a load of 1,700 tonnes. They were developed with offshore wind mooring and lifting applications in mind; at 85 percent lighter than an equivalent steel cable, fiber has advantages for tethered floating structures.

FibreFlex has a vision for a unique floating production factory for its cables, which could be towed to each installation site in order to enable localization (local labor employment) without building a shoreside facility. 

RWE wants to become a market leader in the emerging floating offshore wind market, which has substantially higher costs and new technical challenges when compared to bottom-fixed wind power. The company aims to have 1 GW of floating wind deployed or under construction by 2030 and at least 4 GW by 2035.

RWE has secured a commercial-scale floating offshore wind lease off the California coast, and is also preparing for floating wind auctions in France, Norway, Spain and the UK.

 

Three Castaways Rescued From Remote Pacific Island

Help sign
A Coast Guard HC-130J aircrew checks on three survivors on Pikelot Atoll, April 8 (USCG)

PUBLISHED APR 9, 2024 7:17 PM BY THE MARITIME EXECUTIVE

 

 

After being stranded on a remote atoll in Micronesia for more than a week, three fishermen are now safe, thanks to the joint efforts of the U.S. Coast Guard and the U.S. Navy.

On April 6, the Coast Guard's Guam station received a distress call from a relative of the missing men. The caller said that her three uncles had not returned from Pikelot Atoll, about 100 nautical miles northwest of Polowat Atoll in the Federated States of Micronesia. The three fishermen, all in their 40s, had reportedly set out from Polowat on March 31 in a 20-foot skiff.

At first the Coast Guard had some difficulty finding any search assets to visit Pikelot, which is about 350 nm south of Guam in the Caroline Islands. They kept trying, and they managed to get a U.S. Navy P-8 aircrew from Kadena Air Force Base in Japan, as well as the fast response cutter USCGC Oliver Henry, which was already in Micronesia. The initial search area covered over 78,000 square nautical miles.

Luckily, the U.S. Navy P-8 Poseidon aircraft identified the three mariners on April 7 on Pikelot Atoll. The men had helpfully spelled out "help" in palm fronds on the beach, aiding in the search. The P-8 aircrew dropped survival supplies for them, and a Coast Guard HC-130J out of Honolulu visited the next day to drop a radio and establish communication. The men said that they had food and water, but their boat was damaged, and they asked for help in getting home. 

USCGC Oliver Henry met up with the three mariners on Pikelot Atoll on the evening of April 9 and returned them the 100-nm distance to Polowat.

"This recent operation near Pikelot Atoll hits home the kind of difference we can make. It's about more than just performing a duty; it's about the real human connections we forge and the lives we touch. Every day, I'm reminded of the impact we have and the bonds we build," said Lt. Ray Cerrato, commanding officer of USCGC Oliver Henry. 

 

Haiti's Gangs Try Their Hand at Piracy, Hijacking a Ship Full of Food

AP
A boarding team from Haiti's National Police recovered the hijacked vessel (National Police)

PUBLISHED APR 9, 2024 4:29 PM BY THE MARITIME EXECUTIVE

 

 

Haiti's gang warlords have turned the country into a disaster zone, abusing the citizenry and shutting down commercial transport in and out of the country. As if their violent behavior ashore were not enough, two gangs recently decided to turn to piracy, hijacking a cargo ship full of food at one of the nation's largest terminals. 

Last Thursday, members of the 5 Seconds and Taliban gangs (no relation to the Afghan Taliban) captured the freighter Magalie at Port-Au-Prince's Varreux terminal district, according to local media. They made off with one-sixth of the cargo of rice, Haiti's primary staple food, and they took all of the crewmembers hostage, police said. Kidnapping is rampant in Haiti, and has long been a favored form of piracy worldwide. 

On Saturday, Haiti's National Police stormed the ship in a gunfight that lasted for five hours, the agency said. Two officers were injured in the altercation and an unspecified number of gangmembers were killed, and the vessel was safely recovered.  Haiti's National Port Authority assisted with transport for the boarding teams.

The fate of the crew is not known, according to Haiti Libre. A video provided by police showed the Magalie making way astern off the coast, apparently being towed on the hip by a large tug. 

Port-au-Prince's waterfront operations have come under attack by gangs multiple times, disrupting the flow of aid and supplies. Vandals damaged the Varreux Power Plant last month, and briefly occupied and looted the nation's largest container terminal, CPS. The terminal's waterside operations were closed for weeks (and may still be shut, according to the UN's Famine Early Warning System Network). 

NTU Singapore scientists grow ‘mini kidneys,’ revealing new insights into metabolic defects and potential therapy for polycystic kidney disease




NANYANG TECHNOLOGICAL UNIVERSITY
NTU Singapore scientists grow ‘mini kidneys,’ revealing new insights into metabolic defects and potential therapy for polycystic kidney disease 

IMAGE: 

MEMBERS OF THE LKCMEDICINE RESEARCH TEAM INCLUDE (STANDING, L-R):  RESEARCH ASSOCIATE LIU MENG, RESEARCH FELLOW DR ZHANG CHAO, (SEATED, L-R) ASSISTANT PROFESSOR FOO JIA NEE AND ASSISTANT PROFESSOR XIA YUN.

view more 

CREDIT: NTU SINGAPORE





Scientists at Nanyang Technological University, Singapore (NTU Singapore) have successfully grown ‘mini kidneys’ in the lab and grafted them into live mice, revealing new insights into the metabolic defects and a potential therapy for polycystic kidney disease.

‘Mini kidneys,’ or kidney organoids, are kidney-like structures grown in the lab using stem cells. In the study led by NTU’s Lee Kong Chian School of Medicine (LKCMedicine), researchers grew the organoids using skin cells derived from patients with polycystic kidney disease (PKD), a prevalent form of genetic condition that affects 1 in 1000 individuals across all ethnicities. [1]

People with PKD often progress to end-stage kidney disease between their 50s and 60s, with the standard treatment options available being dialysis or a kidney transplant. However, dialysis significantly compromises a patient’s quality of life, while a transplanted kidney can be challenging to acquire. One other option is the Food and Drug Administration (FDA) approved drug Tolvaptan, which is very costly and has severe side effects on the liver.

To address the need for more effective treatment for PKD patients, the NTU research team sought to better understand the disease by engrafting their newly developed mini kidneys into mice.

Previous studies were conducted on mini kidneys grown in a dish, which could only partly mimic the kidney structure and function. The NTU scientists engrafted the mini kidneys into live mice to comprehensively replicate the pathological features of kidney disease, including blood flow, fluid movement (tubular fluid) and cellular communication with other organs.

Lead investigator Assistant Professor Xia Yun at LKCMedicine said, “Engrafting the kidney organoid in mice provided us with a physiologically sophisticated approach to studying polycystic kidney disease as we were able to successfully emulate critical disease characteristics similar to those observed in human kidney patients.”

Critical disease characteristics included abnormalities like the spontaneous formation of cysts in the kidneys and the subsequent damage to its tiny tubes.

In their study, reported in the scientific journal Cell Stem Cell, the NTU research team said that they believed their engrafted mini kidneys were high quality because cysts sustained without extra stress stimulation or chemicals, even after they were removed from the live mice for further investigations in a dish. In contrast, previous kidney organoids grown in a dish cannot form cysts without stress stimulation.

Co-investigator Assistant Professor Foo Jia Nee at LKCMedicine said, “The similarity between the disease manifestation observed in our engrafted mini kidney model and the real-life experiences of polycystic kidney disease patients suggest that growing kidney organoids and engrafting them into live mice  could be beneficial in studying the disease and a useful tool to test new treatments.”
 

Metabolic defects in polycystic kidney disease

Scientists have long known that abnormalities in a structure on kidney cells, or the primary cilium, cause cysts to form in kidneys. However, tests to understand the regulatory mechanism and relationship between the primary cilium and cell metabolism (autophagy) in live mice with PKD, have not been possible until now.

By studying the development of PKD in live mice and testing cellular pathways, researchers found evidence that boosting autophagy could reduce the severity of cysts in the mini kidney.

After establishing that boosting autophagy could reduce cysts, the NTU scientists shortlisted 22 drugs known for their effects on cell metabolism and tested them in the lab. Results showed that minoxidil, a clinical drug widely used to cure hypertension and hair loss, effectively reduced cyst formation in the novel mouse model.

Asst Prof Xia Yun said, “Our study has demonstrated how cysts in polycystic diseased kidneys can be reduced by boosting autophagy, suggesting that this could be a promising treatment for PKD. Moreover, the proven clinical safety of minoxidil may allow it to be quickly re-purposed to treat PKD patients in clinic. However, more research will be needed to establish this potential.”

Commenting as an independent expert, Associate Professor Ng Kar Hui, Senior Consultant, Division of Paediatric Nephrology, Dialysis and Renal Transplantation, Department of Paediatrics, Khoo Teck Puat – National University Children's Medical Institute, National University Hospital, said, “Polycystic kidney disease is one of the biggest causes of chronic kidney diseases among adults. An effective treatment may potentially ameliorate the rising numbers of people with kidney failure in Singapore. The establishment of such models in live organisms brings us one step closer to finding more treatment options.

In future studies, the NTU team will test the efficacy of minoxidil and adapt the mini kidney models to investigate other burgeoning kidney diseases without a strong genetic underpinning, such as diabetic kidney disease.

 

***END***

Image of microscopic cystic kidney organoids derived from patient induced pluripotent stem cells.

Immunofluorescence image of a polycystic kidney disease organoid.

CREDIT

NTU Singapore

Notes to Editor:

[1] Harris, P.C., and Torres, V.E. (2009). Polycystic kidney disease. Annual  Review of Medicine. Volume 60, 321–337.

 

Researchers identify an economic solution to Canada's opioid crisis



Waterloo student uses mathematical modelling to bring awareness to opioid-related death reduction method




UNIVERSITY OF WATERLOO





Nasal-administered naloxone is more cost-effective and could help reduce the number of opioid-related fatalities compared to the current publicly funded intermuscular version, a new study has found. 

Since 2016, Canada's opioid crisis has worsened, with over 40,000 opioid-related deaths, or about 22 deaths per day. Most of these accidental deaths (88 per cent) occur in British Columbia, Alberta and Ontario. 

An effective way to help prevent opioid-related deaths is through community pharmacy-based naloxone programs. Currently, intramuscular naloxone is publicly funded across Canada, but it can be stress-inducing and difficult for bystanders to administer naloxone through a syringe. Intranasal naloxone, used as a simple nasal spray, is only publicly funded in Ontario, Quebec and the Northwest Territories.

The study by University of Waterloo researchers found a research gap in identifying the cost-effectiveness of implementing intranasal naloxone distribution across Canada through public funding. Mathematical modelling conducted by Waterloo researchers confirmed that intranasal naloxone is cost-effective when distributed to all Canadians and could help save additional lives. Based on the model, 151 deaths will be prevented per 10,000 people.

"Think of an EpiPen," said Ashley Cid, a PhD candidate in Waterloo's School of Pharmacy, which offers North America's most innovative pharmacy curriculum by integrating biomedical and pharmacy science with clinical, behavioural and social sciences that emphasizes patient-focused care.

"Similarly, naloxone is effective, safe, easy to use and is a medication meant to save someone's life regardless of whether you take opioid medication for a prescription or not. Providing publicly funded intranasal naloxone kits can effectively manage and reduce opioid-related fatalities due to increased distribution."

Cid adds that naloxone is a harm-reduction measure and does not increase the risk of opioid use. She believes policymakers should consider publicly funding intranasal naloxone across Canada and increasing distribution as it would help to mitigate the immediate public health opioid crisis and save more lives, especially in provinces like Alberta and British Columbia, where high rates of deaths are occurring.

"Providing intranasal naloxone through community pharmacies would have an immediate impact and be a great solution to increase access to publicly funded naloxone kits," Cid said. "I hope someday naloxone will be kept in first aid kits in your car, purse or home for emergencies."

The study, An economic evaluation of community pharmacy dispensed naloxone in Canada, was recently published in the Canadian Pharmacists Journal.