WHILE working with staphylococcus variants a number of culture-plates were set aside on the laboratory bench and examined from time to time. In the examinations these plates were necessarily exposed to the air and they became contaminated with various micro-organisms. It was noticed that around a large colony of a contaminating mould the staphylococcus colonies became transparent and were obviously undergoing lysis (see Fig. 1).Subcultures of this mould were made and experiments conducted with a view to ascertaining something of the properties of the bacteriolytic substance which had evidently been formed in the mould culture and which had diffused into the surrounding medium. It was found that broth in which the mould had been grown at room temperature for one or two weeks had acquired marked inhibitory, bactericidal and bacteriolytic properties to many of the more common pathogenic bacteria. CHARACTERS OF THE MOULD.The colony appears as a white fluffy mass which rapidly increases in size and after a few days sporulates, the centre becoming dark green and later in old cultures darkens to almost black. In four or five days a bright yellow colour is produced which diffuses into the medium. In certain conditions a reddish colour can be observed in the growth.In broth the mould grows on the surface as a white fluffy growth changing in a few days to a dark green felted mass. The broth becomes bright yellow and this yellow pigment is not extracted by CHCL3. The reaction of the broth becomes markedly alkaline, the pH varying from 8-5 to 9. Acid is produced in three or four days in glucose and saccharose broth. There is no' acid production in 7 days in lactose, mannite or dulcite broth.Growth is slow at 370 C. and is most rapid about 200C. No growth is observed under anaerobic conditions.In its morphology this organism is a penicillium and in all its characters it most closely resembles P. rubrum. Biourge (1923) states that he has never found P. rubrum in nature and that it is an " animal de laboratoire." This penicillium is not uncommon in the air of the laboratory.

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The efficacy and safety of the new drug, BGP-15, were compared with placebo in insulin-resistant patients in a 28-day dose-ranging study. Forty-seven nondiabetic patients with impaired glucose tolerance were randomly assigned to 4 weeks of treatment with 200 or 400 mg of BGP-15 or placebo. Insulin resistance was determined by hyperinsulinemic euglycemic clamp technique and homeostasis model assessment method, and beta-cell function was measured by intravenous glucose tolerance test. Each BGP-15 dose significantly increased whole body insulin sensitivity (M-1, p=0.032), total body glucose utilization (M-2, p=0.035), muscle tissue glucose utilization (M-3, p=0.040), and fat-free body mass glucose utilization (M-4, p=0.038) compared to baseline and placebo. No adverse drug effects were observed during treatment. BGP-15 at 200 or 400 mg significantly improved insulin sensitivity in insulin-resistant, nondiabetic patients during treatment compared to placebo and was safe and well-tolerated. This was the first clinical study demonstrating the insulin-sensitizing effect of a molecule, which is considered as a co-inducer of heat shock proteins.

SINCE the war began, much attention has been directed t o the treatment of suppurating wounds, for in the earlier years-1914-15-16-practically all the gunshot wounds becanie infected, and even in 1918 nearly all the wounds which were left open for more than a week became grossly infected with pyogenic cocci and other organisms.Prior to the war, the surgeon gave most of his attention to aseptic methods, his great object being to exclude microbes from the wound. The question of how to deal with thc bacteria after they were in possession was a problem of much less interest to him. 1 can remember in tlie days when I was first admitted to the surgical wards as a dresser, there were always a certain number of septic wounds which we were instructed to dress with this or that antiseptic, which stood in jars around the fire, and which we were told 110ssessed great virtue as destroyers of microbes in the wound. These antiseptics were chiefly carbolic acid, mercury salts, and boric acid. The wounds were religiously dressed once or twice a day with these lotions, and although it was obvious that the antiseptic did not kill all the microbes in the wound, we were always told that it would kill many of them. and so the condition would be better than if no antiseptic were used. We werc not then in a position to criticize this view.At the beginning of the war in 1914, a11 the old antiseptics were used in military hospitals, in just such a manner a s when I started surgery. Carbolic acid, perchloride or biriiodidc of mercury, boric acid, and hydrogen peroxide were poured into septic wounds once or twice a day, either singly or in mixtures of two or more, according to the fancy of the rncdical ollicer. Very soon, however, campaigns were started in favour of particular antiseptics. I h r l y in 1925, tlic merits of pure carbolic acid and of 2 per cent iodine in spirit were tested. R certain number of cases were treated with these two chemicals a t the Front, and tlie patients were sent down to No. 13 General Hospital, where I had the opportunity of seeing tlic wounds and examining them bacteriologically. I n the carbolic series there was a higher pcrcentage of gas gangrene than in tlie general run of the wounded, while the iodine cases showed practically no diflerence from the cases treated in other ways. Soon after this, antiseptic pastes were advocated. The wound was plugged with the paste, but it soon appeared that in France, a t any rate, the chief result of this method of trcatment was to shut off all drainage, so that gas infections dcveloped in a large number of cases.These pastes, therefore, very soon disappeared from the antiscptic arnramcntariurn.The first real advance in the 'antiseptic' treatment of wounds was the introduction of tlic hypochlorite solutions. Lorrain Smith introduced eusol, which is a solution of Ilypochlorous acid, while Dakin, about tlie same time, produced a solution of sodium liypoclilorite, which has come to be recognized as Uakin's solution. Both of these solutions attained grcat favour in wound t...

Site-less CROs offer a working example of how remote technologies and in-home monitoring methods can address shortcomings of conventional drug development. This model maximizes time and cost, as well as potentially earlier identification of adverse events. Coordinated communication among investigators, sponsors, regulators, and patients will be needed to develop standardized strategies for incorporating site-less CROs into current and future study design.