How To Harness The Pain Blocking Effects of Exercise

Athletes have a very complicated relationship with pain. For endurance athletes in particular, pain is an absolutely non-negotiable element of their competitive experience. You fear it, but you also embrace it. And then you try to understand it.

But pain isn’t like heart rate or lactate levels—things you can measure and meaningfully compare from one session to the next. Every painful experience is different, and the factors that contribute to those differences seem to be endless. A recent study in the Journal of Sports Sciences, from researchers in Iraq, Australia, and Britain, adds a new one to the list: viewing images of athletes in pain right before a cycling test led to higher pain ratings and worse performance than viewing images of athletes enjoying themselves.

That finding is reminiscent of a result I wrote about last year, in which subjects who were told that exercise increases pain perception experienced greater pain, while those told that exercise decreases pain perception experienced less pain. In that case, the researchers were studying pain perception after exercise rather than during it, trying to understand a phenomenon called exercise-induced hypoalgesia (which just means that you experience less pain after exercise).

This phenomenon has been studied for more than 40 years: one of the first attempts to unravel it was published in 1979 under the title “The Painlessness of the Long Distance Runner,” in which an Australian researcher named Garry Egger did a series of 15 runs over six months after being injected with either an opioid blocker called naloxone or a placebo. Running did indeed increase his pain threshold, but naloxone didn’t seem to make any difference, suggesting that endorphins—the body’s own opioids—weren’t responsible for the effect. (Subsequent research has been plentiful but not very conclusive, and it’s currently thought that both opioid and other mechanisms are responsible.)

But the very nature of pain—the fact that seeing an image of pain or being told that something will be painful can alter the pain you feel—makes it extremely tricky to study. If you put someone through a painful experiment twice, their experience the first time will inevitably color their perceptions the second time.

As a result, according to the authors of another new study, the only results you can really trust are from randomized trials in which the effects of exercise on pain are compared to the results of the same sequence of tests with no exercise—a standard that excludes much of the existing research.

The new study, published in the Journal of Pain by Michael Wewege and Matthew Jones of the University of New South Wales, is a meta-analysis that sets out to determine whether exercise-induced hypoalgesia is a real thing, and if so, what sorts of exercise induce it, and in whom. While there have been several previous meta-analyses on this topic, this one was restricted to randomized controlled trials, which meant that just 13 studies from the initial pool of 350 were included.

The good news is that, in healthy subjects, aerobic exercise did indeed seem to cause a large increase in pain threshold. Here’s a forest plot, in which dots to the left of the line indicate that an individual study saw increased pain tolerance after aerobic exercise, while dots to the right indicate that pain tolerance worsened. 

The big diamond at the bottom is the overall combination of the data from those studies. It’s interesting to look at a few of the individual studies. The first dot at the top, for example, saw basically no change from a six-minute walk. The second and third dots, with the most positive results, involved 30 minutes of cycling and 40 minutes of treadmill running, respectively. The dosage probably matters, but there’s not enough data to draw definitive conclusions.

After that, things get a little tricker. Dynamic resistance exercise (standard weight-room stuff, for the most part) seems to have a small positive effect, but that’s based on just two studies. Isometric exercises (i.e. pushing or pulling without moving, or holding a static position), based on three studies, have no clear effect.

There are also three studies that look at subjects with chronic pain. This is where researchers are really hoping to see effects, because it’s very challenging to find ways of managing ongoing pain, especially now that the downsides of long-term opioid use are better understood. In this case, the subjects had knee osteoarthritis, plantar fasciitis, or tennis elbow, and neither dynamic nor isometric exercises seemed to help. There were no studies—or at least none that met the criteria for this analysis—that tried aerobic exercise for patients with chronic pain.

The main takeaway, for me, is how little we really know for sure about the relationship between exercise and pain perception. It seems likely that the feeling of dulled pain that follows a good run is real (and thus that you shouldn’t conclude that your minor injury has really been healed just because it feels okay when you finish).

Exactly why this happens, what’s required to trigger it, and who can benefit from it remains unclear. But if you’ve got a race or a big workout coming up, based on the study with pain imagery, I’d suggest not thinking about it too much. Hat tip to Chris Yates for additional research. For more Sweat Science, join me on Twitter and Facebook, sign up for the email newsletter, and check out my book Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance.

By: Alex Hutchinson

Source: How to Harness the Pain-Blocking Effects of Exercise | Outside Online

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Critics:

Exercise-associated muscle cramps (EAMC) are defined as cramping (painful muscle spasms) during or immediately following exercise. Muscle cramps during exercise are very common, even in elite athletes. EAMC are a common condition that occurs during or after exercise, often during endurance events such as a triathlon or marathon.

Although EAMC are extremely common among athletes, the cause is still not fully understood because muscle cramping can occur as a result of many underlying conditions. Elite athletes experience cramping due to paces at higher intensities.The cause of exercise-associated muscle cramps is hypothesized to be due to altered neuromuscular control, dehydration, or electrolyte depletion.

It is widely believed that excessive sweating due to strenuous exercise can lead to muscle cramps. Deficiency of sodium and other electrolytes may lead to contracted interstitial fluid compartments, which may exacerbate the muscle cramping. According to this theory, the increased blood plasma osmolality from sweating sodium losses causes a fluid shift from the interstitial space to the intervascular space, which causes the interstitial fluid compartment to deform and contributes to muscle hyperexcitability and risk of spontaneous muscle activity.

The second hypothesis is altered neuromuscular control. In this hypothesis, it is suggested that cramping is due to altered neuromuscular activity. The proposed underlying cause of the altered neuromuscular control is due to fatigue. There are several disturbances, at various levels of the central and peripheral nervous system, and the skeletal muscle that contribute to cramping.

These disturbances can be described by a series of several key events. First and foremost, repetitive muscle exercise can lead to the development of fatigue due to one or more of the following: inadequate conditioning, hot and or humid environments, increased intensity, increased duration, and decreased supply of energy. Muscle fatigue itself causes increased excitatory afferent activity within the muscle spindles and decreased inhibitory afferent activity within the Golgi tendon.

The coupling of these events leads to altered neuromuscular control from the spinal cord. A cascade of events follow the altered neuromuscular control; this includes increased alpha-motor neuron activity in the spinal cord, which overloads the lower motor neurons, and increased muscle cell membrane activity. Thus, the resultant of this cascade is a muscle cramp.

See also

This Remote Patient Monitoring Startup Just Landed A $70 Million Series C

Health Recovery Solutions in action

hen Covid-19 cases began to soar around Ann Arbor in April, the University of Michigan Hospital reached 100% capacity. Like most hospitals, University of Michigan Hospital was not ready for the pandemic surge, but they did have a leg up.

That same month they’d coincidentally implemented Health Recovery Solutions’ remote patient monitoring, a patented technology system that records patient vitals via Bluetooth and connects them with their clinicians through video or instant messaging. This enabled the resource-strapped hospital to care for over 400 patients remotely throughout 2020.

Today, HRS announced it closed a $70 million series C led by LLR Partners with participation from existing investor Edison Partners, bringing the Hoboken, New Jersey-based startup’s total funding to $86 million. The news comes on the heels of a year of massive growth, which saw their head count balloon 258% to 155 employees and revenue grow by 188% to $23.5 million.

“People are choosing the proven remote-monitoring solution right now,” says Jarrett Bauer, HRS’ Forbes 30 Under 30 cofounder and CEO. “That’s one of the reasons why we’re doing so well—people are looking for the company that’s best.”

Bauer, now 34, was inspired to start by HRS by his grandma. Battling a heart condition, Bauer’s grandma was admitted to the hospital three times, resulting in over $14,000 of medical bills. While pursuing his M.B.A. at Johns Hopkins in 2012, Bauer began constructing an at-home hospital alternative that would eventually become HRS. “We didn’t know where to start,” Bauer told Forbes in 2019 when the company raised its $10 million series B. “We just knew it was a problem, and the best companies solve problems.”

With Covid-19, telehealth doctor appointments have become just doctor appointments, increasing 154% from March to October of 2020, according to the Centers for Disease Control. Rather than cut into HRS’ margins, the telehealth boom has helped HRS soar. The healthcare company has deals with over 220 U.S. healthcare systems—74 of which signed on as clients of HRS during the pandemic—with over 20,000 nurses checking HRS logs every day.

“We consider Health Recovery Solutions the Cadillac model,” says Brandy Knudson, Michigan Medicine’s Telehealth Project Manager. “It fills a huge gap for us because we want to reduce readmissions and reduce unnecessary trips to the hospital.”

The company makes money by billing clinical institutions on subscription to integrate their solutions in treatment, coming at no additional cost to patients. HRS recognizes the varying levels of sickness and technological ability of patients, so the company’s products range from a pulse oximeter for the sickest, while near-recovered patients can manually enter symptoms on HRS’ smartphone app.

All of this patient data is stored in a cloud for clinicians, making it easier to recognize prognosis patterns and health trends. By implementing HRS, major healthcare systems like Penn Medicine have reduced 30-day readmission by over 50% for all heart failure patients, while FirstHealth of the Carolinas says the technology has saved patients more than $1.9 million since its implementation in 2016.

“Patients are looking to stay in their homes longer, get care in their homes longer, and there’s an increasing prevalence of chronic conditions,” says Sasank Aleti, a partner at Philadelphia-based private equity firm LLR Partners. “HRS met our criteria of taking costs out of the system, driving better outcomes and a better patient experience.”

For Bauer, the future of HRS lies in universalizing hospital-from-home treatment. With the $70 million round, the company plans to more than double head count in 2021 to 250 employees with the goal of being able to treat over a million patients by adding new healthcare providers and upping their disease module count (they currently treat 90 diseases). “Why aren’t we like Google? Why aren’t we like Apple?” asks Bauer. “We’re playing to win—to be that.”

I’m the Under 30 Editorial Community Lead at Forbes. Previously, I directed marketing at a mobile app startup. I’ve also worked at The New York Times and New York Observer. I attended the University of Pennsylvania where I studied English and creative writing. Follow me on Instagram and Twitter at @iamsternlicht.

Source: This Remote Patient Monitoring Startup Just Landed A $70 Million Series C

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The coronavirus pandemic has overwhelmed hospitals, physicians and the medical community. That’s pushed telemedicine into the hands of providers and patients as the first response for primary care. Telemedicine isn’t new to the medical community, however it hasn’t been embraced due to insurance coverage, mindset and stigma. Here’s how it works and what it means for the future of health care. » Subscribe to CNBC: https://cnb.cx/SubscribeCNBC » Subscribe to CNBC TV: https://cnb.cx/SubscribeCNBCtelevision » Subscribe to CNBC Classic: https://cnb.cx/SubscribeCNBCclassic
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What’s The Difference Between Covid-19 Coronavirus Vaccines

Coronavirus COVID-19 single dose small vials and multi dose in scientist hands concept. Research for new novel corona virus immunization drug.

The world can’t return to normal without safe and effective vaccines against the SARS-CoV-2 coronavirus along with a coordinated global vaccination programme.

Researchers have been racing to develop potential drugs that could help end the ongoing Covid-19 pandemic. There are currently around 200 vaccine candidates and about a quarter passed preclinical tests and are now undergoing clinical trials.

What’s the difference between the various candidate vaccines?

A pie chart of candidates can be cut several ways. One is to slice it into six uneven pieces according to the technology (or ‘platform’) that’s used to produce the drug. Those six technologies can be grouped into three broader categories: dead or disabled viruses, artificial vectors, and viral components.

Dead or disabled viruses

Traditional vaccines contain a dead or disabled virus, designed to be incapable of causing severe disease while also provoking an immune response that provides protection against the live virus.

1. Live-attenuated viruses

Attenuated means ‘weakened’. Weakening a live virus typically involves reducing its virulence — capacity to cause disease — or ability to replicate through genetic engineering. The virus still infects cells and causes mild symptoms.

For a live-attenuated virus, an obvious safety concern is that the virus might gain genetic changes that enable it to revert back to the more virulent strain. Another worry is that a mistake during manufacturing could produce a defective vaccine and cause a disease outbreak, which once happened with a polio vaccine. MORE FOR YOUJapan Has Opened Hayabusa2’s Capsule, Confirming It Contains Samples From Asteroid RyuguDonald Trump’s Presidency Will End On The Day Of A Comet, A Meteor Shower And A Total Eclipse Of The SunIn A New Epidemiological Study, Daily Doses Of Glucosamine/Chondroitin Are Linked To Lower All-Cause Mortality

But using a live-attenuated virus has one huge benefit: vaccination resembles natural infection, which usually leads to robust immune responses and a memory of the virus’ antigens that can last for many years.

Live-attenuated vaccines based on SARS-CoV-2 are still undergoing preclinical testing, developed by start-up Codagenix and the Serum Institute of India.

2. Inactivated viruses

Inactivated means ‘dead’ (‘inactivated’ is used because some scientists don’t consider viruses to be alive). The virus will be the one you want to create a vaccine against, such as SARS-CoV-2, which is usually killed with chemicals.

Two Chinese firms have developed vaccines that are being tested for safety and effectiveness in large-scale Phase III clinical trials: ‘CoronaVac’ (previously ‘PiCoVacc’) from Sinovac Biotech and ‘New Crown COVID-19’ from Sinopharm. Both drugs contain inactivated virus, didn’t cause serious adverse side-effects and prompted the immune system to produce antibodies against SARS-CoV-2.

Sinopharm’s experimental vaccine has reportedly been administered to hundreds of thousands of people in China, and both drugs are now being trialled in countries across Asia, South America and the Middle East.

COVID-19 vaccine landscape (left) and platforms for SARS-CoV-2 vaccine development (right)
The global COVID-19 vaccine landscape (left) and Vaccine platforms used for SARS-CoV-2 vaccine … [+] Springer

Artificial vectors

Another conventional approach in vaccine design is to artificially create a vehicle or ‘vector’ that can deliver specific parts of a virus to the adaptive immune system, which then learns to target those parts and provides protection.

That immunity is achieved by exposing your body to a molecule that prompts the system to generate antibodies, an antigen, which becomes the target of an immune response. SARS-CoV-2 vaccines aim to target the spike protein on the surface of coronavirus particles — the proteins that allows the virus to invade a cell.

3. Recombinant viruses

A recombinant virus is a vector that combines the target antigen from one virus with the ‘backbone’ from another — unrelated — virus. For SARS-CoV-2, the most common strategy is to put coronavirus spike proteins on an adenovirus backbone.

Recombinant viruses are a double-edged sword: they behave like live-attenuated viruses, so a recombinant vaccine comes with the potential benefits of provoking a robust response from the immune system but also potential costs from causing an artificial infection that might lead to severe symptoms.

A recombinant vaccine might not provoke an adequate immune response in people who have previously been exposed to adenoviruses that infect humans (some cause the common cold), which includes one candidate developed by CanSino Biologics in China and ‘Sputnik V’ from Russia’s Gamaleya National Research Centre — both of which are in Phase III clinical trials and are licensed for use in the military.

To maximize the chance of provoking immune responses, some vaccines are built upon viruses from other species, so humans will have no pre-existing immunity. The most high-profile candidate is ‘AZD1222’, better known as ‘ChAdOx1 nCoV-19’ or simply ‘the Oxford vaccine’ because it was designed by scientists at Oxford University, which will be manufactured by AstraZeneca. AZD1222 is based on a chimpanzee adenovirus and seems to be 70% effective at preventing Covid-19.

Some recombinant viruses can replicate in cells, others cannot — known as being ‘replication-competent’ or ‘replication-incompetent’. One vaccine candidate that contains a replicating virus, developed by pharmaceutical giant Merck, is based on Vesicular Stomatitis Virus (VSV), which infects guinea pigs and other pets.

4. Virus-like particles

A virus-like particle, or VLP, is a structure assembled from viral proteins. It resembles a virus but doesn’t contain the genetic material that would allow the VLP to replicate. For SARS-CoV-2, the VLP obviously includes the spike protein.

One coronavirus-like particle (Co-VLP) vaccine from Medicago has passed Phase I trials to test it’s safe and has entered Phase II to test that it’s effective.

While there are currently few VLPs being developed for Covid-19, the technology is well-established and has been used to produce commercial vaccines against human papillomavirus (HPV) and hepatitis B.

Viral components

All vaccines are ultimately designed to expose the immune system to parts of a virus, not the whole thing, so why not deliver just those parts? That’s the reasoning behind vaccines that only contain spike proteins or spike genes.

5. Proteins

Protein-based vaccines can consist of the full-length spike protein or the key part, the tip of the spike that binds the ACE2 receptor on the surface of a cell — ACE2 is the lock that a coronavirus picks in order to break into the cell.

Manufacturing vaccines containing the protein alone has a practical advantage: researchers don’t have to deal with live coronaviruses, which should be grown inside cells within a biosafety level-3 lab.

A vaccine against only part of the protein — a ‘subunit’ — will be more vulnerable to being rendered useless if random mutations alter the protein, known as ‘antigenic drift‘, but full-length proteins are harder to manufacture. The immune system can recognize either as an antigen.

One candidate vaccine based on protein subunits is ‘NVX-CoV2373’ from Novavax, where the spike subunits are arranged as a rosette structure. It’s similar to a vaccine that’s already been licensed for use, FluBlok, which contains rosettes of protein subunits from the influenza virus.

6. Nucleic acids

Nucleic-acid vaccines contain genetic material, either deoxyribonucleic acid or ribonucleic acid — DNA or RNA. In a coronavirus vaccine, the DNA or RNA carries genetic instructions for producing a spike protein, which is made within cells.

Those spike genes can be carried on rings of DNA called ‘plasmids’, which are easy to manufacture by growing them in bacteria. DNA provokes a relatively weak immune response, however, and can’t simply be injected inside the body — the vaccine must be administered using a special device to force DNA into cells. Four DNA-based candidates are in Phase I or II trials.

The two most famous nucleic-acid vaccines are the drugs being developed by pharmaceutical giant Pfizer, partnered with BioNTech, and Moderna. Pfizer’s ‘BNT162b2’ and Moderna’s ‘mRNA-1273’ both use ‘messenger RNA’ — mRNA — to carry the spike genes and are delivered into cells via a lipid nanoparticle (LNP). The two mRNA vaccines have completed Phase III trials and preliminary results suggests they’re over 90% effective at preventing Covid-19.

As the above examples show, not only there are many potential vaccines but also various approaches. And while some technologies have already provided promising results, it remains to be seen which will actually be able to defeat the virus.

Full coverage and live updates on the CoronavirusFollow me on Twitter or LinkedIn. Check out my website or some of my other work here

JV Chamary

JV Chamary

I’m a science communicator specialising in public engagement and outreach through entertainment, focusing on popular culture. I have a PhD in evolutionary biology and…

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TODAY

Dr. Ashish Jha, dean of Brown University’s School of Public Health, joins the 3rd hour of TODAY to break down the differences between Moderna’s and Pfizer’s coronavirus vaccine candidates. He also comments on speculation of another national shutdown and whether families should still get together over Thanksgiving. » Subscribe to TODAY: http://on.today.com/SubscribeToTODAY » Watch the latest from TODAY: http://bit.ly/LatestTODAY About: TODAY brings you the latest headlines and expert tips on money, health and parenting. We wake up every morning to give you and your family all you need to start your day. If it matters to you, it matters to us. We are in the people business. Subscribe to our channel for exclusive TODAY archival footage & our original web series. Connect with TODAY Online! Visit TODAY’s Website: http://on.today.com/ReadTODAY Find TODAY on Facebook: http://on.today.com/LikeTODAY Follow TODAY on Twitter: http://on.today.com/FollowTODAY Follow TODAY on Instagram: http://on.today.com/InstaTODAY Follow TODAY on Pinterest: http://on.today.com/PinTODAY#COVID19Vaccines#AshishJha#TodayShow

FDA Approves Remdesivir For Covid-19 Treatment

The Food and Drug Administration on Thursday approved remdesivir as a treatment for hospitalized coronavirus patients, Gilead Sciences said, making it the first FDA-approved drug for Covid-19.

Key Facts

The drug was previously granted an emergency use authorization in May, which allowed healthcare providers to administer the treatment even though it wasn’t formally approved by the FDA.

Remdesivir, which is sold under the brand name Veklury, “should only be administered in a hospital or in a healthcare setting capable of providing acute care comparable to inpatient hospital care,” Gilead said.

The drug is approved for adults and children 12 and older weighing at least 88 lbs. for coronavirus treatment requiring hospitalization.

Clinical trial data has been mixed: A randomized trial from the National Institute of Allergy and Infectious Diseases found remdesivir improved recovery time, but a study from the World Health Organization, which has not yet been peer reviewed, found last week the drug did not increase the chances of survival or result in faster recovery.

Gilead shares jumped 3.8% in after hours trading following the announcement. 

Crucial Quote

“It is incredible to be in the position today, less than one year since the earliest case reports of the disease now known as COVID-19, of having an FDA-approved treatment in the U.S. that is available for all appropriate patients in need,” said Gilead CEO Daniel O’Day in a statement.

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Key Background

President Donald Trump took remdesivir when being treated for the coronavirus earlier this month. Follow me on Twitter. Send me a secure tipRachel SandlerI’m a San Francisco-based reporter covering breaking news at Forbes. I’ve previously reported for USA Today, Business Insider, The San Francisco Business Times and San Jose Inside. I studied journalism at Syracuse University’s S.I. Newhouse School of Public Communications and was an editor at The Daily Orange, the university’s independent student newspaper. Follow me on Twitter @rachsandl or shoot me an email rsandler@forbes.com.

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Remdesivir is a prodrug of an adenosine triphosphate (ATP) analog, with potential antiviral activity against a variety of RNA viruses. Upon administration, remdesivir, being a prodrug, is metabolized into its active form GS-441524. As an ATP analog, GS-441524 competes with ATP for incorporation into RNA and inhibits the action of viral RNA-dependent RNA polymerase. This results in the termination of RNA transcription and decreases viral RNA production.

Remdesivir has an FDA Emergency Use Authorization for use in adults and children with suspected or confirmed COVID-19 in hospital with an SpO2 ≤94%.[L13239] This is not the same as an FDA approval.[L12609] The FDA Emergency Use Authorization suggests a loading dose of 200mg once daily in patients ≥ 40 kg or 5 mg/kg once daily in patients 3.5 kg to less than 40 kg, followed by a maintenance dose of 100mg once daily in patients ≥ 40 kg or 2.5 mg/kg once daily in patients 3.5 kg to less than 40 kg.[L13239] Patients not needing invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) should be treated for 5 days (including the loading dose on day 1), up to 10 days if they do not show improvement.[L13239] Patients requiring invasive mechanical ventilation or ECMO should be treated for 10 days.[L13239]

Clinical trials used a regimen of 200mg once daily on the first day, followed by 100mg once daily for another 9 days.[A191931,L12174,L12177] Early data suggests that some patients may benefit from only 5 days of treatment.[A198810] Remdesivir was originally investigated as a treatment for Ebola virus, but has potential to treat a variety of RNA viruses.[A191379] Its activity against the coronavirus (CoV) family of viruses, such as SARS-CoV and MERS-CoV, was described in 2017,[A191382] and it is also being investigated as a potential treatment for SARS-CoV-2 infections.[A191427,A193254]

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CNBC Television 1M subscribers The FDA has approved Gilead’s Remdesivir as a Covid-19 treatment. Previously, the drug was approved only for emergency authorization. Gilead stock was up 4 percent after the news. Meg Tirrell joins ‘Closing Bell’ to discuss. For access to live and exclusive video from CNBC subscribe to CNBC PRO: https://cnb.cx/2NGeIvi » Subscribe to CNBC TV: https://cnb.cx/SubscribeCNBCtelevision » Subscribe to CNBC: https://cnb.cx/SubscribeCNBC » Subscribe to CNBC Classic: https://cnb.cx/SubscribeCNBCclassic Turn to CNBC TV for the latest stock market news and analysis. From market futures to live price updates CNBC is the leader in business news worldwide. The News with Shepard Smith is CNBC’s daily news podcast providing deep, non-partisan coverage and perspective on the day’s most important stories. Available to listen by 8:30pm ET / 5:30pm PT daily beginning September 30: https://www.cnbc.com/2020/09/29/the-n… Connect with CNBC News Online Get the latest news: http://www.cnbc.com/ Follow CNBC on LinkedIn: https://cnb.cx/LinkedInCNBC Follow CNBC News on Facebook: https://cnb.cx/LikeCNBC Follow CNBC News on Twitter: https://cnb.cx/FollowCNBC Follow CNBC News on Instagram: https://cnb.cx/InstagramCNBChttps://www.cnbc.com/select/best-cred…#CNBC

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This Japan Startup Is Using Deep Learning To Detect Early-Stage Cancer In Blood Samples

Imagine going for a routine blood test during an annual health checkup and being able to select a screening option that could tell you whether you have early-stage cancer. A Japanese startup is using deep learning technology to realize this dramatic advance in the fight against cancer, one of the top causes of death around the world.

A technician prepares samples at PFDeNA’s lab in Tokyo
A technician prepares samples at PFDeNA’s lab in Tokyo, where researchers are developing a screening system for early detection of cancer from blood samples. Japan BrandVoice

Unique skillsets

PFDeNA Inc. was established in 2016 as a joint venture between DeNA, a Japanese internet giant, and Preferred Networks, Japan’s leading artificial intelligence startup, to solve complex problems. One such problem is cancer detection.

PFDeNA’s cancer research can be traced back to the vision of one of Japan’s pioneering entrepreneurs. In 1999, Namba Tomoko founded DeNA, a mobile and online services company that had extraordinary success in e-commerce and gaming. Namba stepped down from her role as CEO in 2011 to care for her cancer-stricken husband, but her commitment to fighting the disease inspired DeNA to launch a healthcare business with its own bioscience lab in 2014. Meanwhile, Preferred Networks had been conducting research on cancer screening with National Cancer Center Japan since 2015, but needed a partner with expertise in lab operations and business. The two companies decided to use PFDeNA as a platform for collaboration, which began in 2018.

DeNA founder Namba Tomoko
DeNA founder Namba Tomoko’s commitment to fighting cancer inspired DeNA’s healthcare business. Japan BrandVoice

Led by board members including DeNA President and CEO Moriyasu Isao and Preferred Networks CEO Nishikawa Toru, PFDeNA is harnessing the power of deep learning, an artificial intelligence technique modeled on the brain, as a way to detect cancer as early as possible. To do that, the venture is building computer tools as well as a state-of-the art lab that will be able to find almost undetectable signs of cancer in routine blood samples. This “liquid biopsy” approach contrasts greatly with current methods such as radiographic imagining and tissue biopsies.

“We want to transform healthcare from a sick-care model, in which patients are cared for when they become ill, to one based on preventive medicine,” says Yoneyama Hiroshi, executive officer at DeNA and vice president of PFDeNA. With a background in business development and healthcare, Yoneyama is keenly aware of the challenges faced by the medical care system in Japan.

“There’s a dire need for early-cancer detection, not only in Japan but overseas as well,” Yoneyama says. “There are hurdles in the liquid biopsy field but we believe we can overcome them based on the strengths of our two founding companies.”

Each partner brings a unique skillset to the challenge. Preferred Networks’ specialty is developing cutting-edge AI solutions. DeNA is able to quickly make decisions on large-scale investments based on its long experience in mobile services. It’s also a player in the healthcare business, and has accumulated significant experience in negotiating with medical centers as well as lab operations. In 2014, DeNA began a direct-to-consumer genetic testing service called MYCODE, which can detect predisposition to a variety of illnesses. About 90% of MYCODE users have made lifestyle modifications to protect their health.   

Looking for molecular changes

PFDeNA aims to screen for 14 types of cancer, including lung and pancreatic cancer, and estimates the domestic market for such services could be worth about 400 billion yen ($3.8 billion). The startup is working to develop a system that can rapidly detect telltale signs of the 14 cancers with just one blood test. These can include changes in the number of molecules that can indicate the likelihood or presence of cancer.

Prostate-specific antigen (PSA), for instance, is a protein produced by the prostate gland that is used to screen for prostate cancer. Genetic mutations can also suggest whether a patient may be more likely to develop certain kinds of cancer. PFDeNA is examining the expression patterns of extracellular ribonucleic acid (exRNA) including microRNA (miRNA) as a potential screening tool for multiple types of cancer. Many cancer researchers expect that certain changes in these miRNA biomarkers can indicate the presence of cancer in various organs.

PFDeNA Vice President Yoneyama Hiroshi
Healthcare must be transformed from a sick-care model to one based on preventive medicine, says PFDeNA Vice President Yoneyama Hiroshi. Japan BrandVoice

“In addition to massive computational resources, high-quality data is indispensable for the high-precision deep learning computations needed to create an accurate screening system,” says Abe Motoki, a bioinformatics engineer at Preferred Networks. Abe is in charge of developing a predictive model using deep learning. He also has access to Preferred Networks’ computational resources including the MN-3 supercomputer, recently ranked as the world’s most energy efficient on the Green500 list.

“With a disease like prostate cancer, we only need to look at the levels of just one biomarker, PSA,” Abe says. “But with we are trying to detect multiple types of cancer by analyzing over a thousand exRNA expression levels, which is way more than humans can possibly handle. That’s why we need technology like deep learning.”

A powerful collaboration

Japan provides an ideal location for medical startups such as PFDeNA, in part because of readily available medical checkups covered by employers and municipalities, as well as a wealth of high-quality medical data. At its lab in Tokyo, PFDeNA is analyzing thousands of blood samples provided, with patient consent, by medical institutions such as National Cancer Center Japan. The company is working with more than 10 medical centers as it works toward its goal of building a rapid-screening system that could be part of annual medical checkups in the future. These partnerships, along with collaborations with industry and academia, form a solid foundation that’s giving PFDeNA the best chance of succeeding in its quest.

Abe Motoki, a bioinformatics engineer at Preferred Networks
An accurate cancer-screening system requires high-quality data, says Abe Motoki, a bioinformatics engineer at Preferred Networks. Japan BrandVoice

The Japanese government has also pivoted to support such efforts. With their universal healthcare system, Japanese tend to focus on treating problems, paying less attention to prevention. This tendency, along with the aging population, has increased demand for medical care. While grappling with these issues, the Japanese government is trying to transform the national healthcare system into one that focuses more on prevention. The state is also backing R&D projects in the field of early disease prediction and intervention through programs such as the Cabinet Office’s Moonshot R&D program.

“The Japanese government is very keen to come up with measures for cancer detection and prevention, so we fit into the context of what it’s doing,” says Yoneyama. “We were able to receive cooperation from more than 10 medical institutions because they’re working on this issue, and it’s now a trend. So Japan, as a government and as a whole, is very much backing this movement and taking leadership in this area.”

While PFDeNA works toward publishing the results of its research in academic journals, it’s consulting with the Pharmaceuticals and Medical Devices Agency, the authority responsible for certifying drugs and medical devices in Japan, in order to streamline approval of its services when they’re ready for the market. 

PFDeNA’s lab
PFDeNA’s lab has already processed thousands of samples in its quest to build an early cancer detection service. Japan BrandVoice

“Japan is an aging society, and early cancer detection is one way in which the burden of healthcare costs can be reduced,” says Ishikura Kiyo, associate director of PFDeNA’s healthcare business. “Liquid biopsies are a hot international topic right now. This service would be the first of its kind in the world and it’s a complex challenge to overcome. It’s a long-term journey but we have already begun.”

Note: All Japanese names in this article are given in the traditional Japanese order, with surname first.

To learn more about PFDeNA, click here (Japanese).  

To learn more about DeNA, click here.

To learn more about Preferred Networks, click here.

Japan

Japan

Japan is changing. The country is at the forefront of demographic change that is expected to affect countries around the world. Japan regards this not as an onus but as a bonus for growth. To overcome this challenge, industry, academia and government have been moving forward to produce powerful and innovative solutions. The ongoing economic policy program known as Abenomics is helping give rise to new ecosystems for startups, in addition to open innovation and business partnerships. The Japan Voice series explores this new landscape of challenge and opportunity through interviews with Japanese and expatriate innovators who are powering a revitalized economy. For more information on the Japanese Government innovations and technologies, please visit https://www.japan.go.jp/technology/.

This Entrepreneur Wants to Bring Independence and Dignity to Mealtimes for Stroke and Paralysis Patients

In this ongoing series, we are sharing advice, tips and insights from real entrepreneurs who are out there doing business battle on a daily basis. (Answers have been edited and condensed for clarity.)

Who are you and what’s your business?

My name is Ilana Herman. I am the founder and owner of the Independent Feeding Tray Inc., located in the Bronx, NY. The name of my invention is INFT1. It is a unique Adaptive Innovative Technology that will provide adults and children who have the use of only one hand with the ability to feed themselves independently.

What inspired you to create this product?

I have been a speech pathologist (SLP) for the past 38 years, working in long-term and short-term rehabilitation facilities. I have been frustrated for my patients who have suffered a stroke, brain injury, Parkinson’s, tremors, orthopedic Injury and other neurological diseases who have use of only one hand to feed themselves. They are unable to scoop from a food cup on their meal tray with the use of only one hand.

Related: How a Personal Mess Became a Passionate Message for This Entrepreneur

INFT1 is designed to hold food cups (ice cream, yogurt, fruit, pudding, applesauce) securely. The food cup is placed into the molded cup that is molded to the food tray. The INFT1 will be used by patients in nursing homes, hospitals, rehab facilities, VA hospitals, home-bound patients and children with special needs.  

What has been the biggest lesson you’ve learned in producing and marketing this product?

The biggest lesson was to conduct the necessary research to identify companies with the specific capability to meet the specifications of 3-D prototypes, actual prototypes and the final injection molding of the triple mold. 

The INFT1 had to meet specific requirements for a food tray that would be offered to the healthcare market. I had to negotiate the budget and the arrangement with National Sanitation Foundation International to obtain the mark for both for the INFT1 tray and the plant. Without the NSFI mark, the INFT1 could not be marketed to the healthcare market. 

The raising of funding for the INFT1 has also been a challenging lesson. I have tried crowdfunding twice and have been successful to some degree. However, at the moment I have invested 100% of my own capital funds into the development of the INFT1.

Related: Covid Sucks. Here’s What This Entrepreneur Is Doing to Make Schools Safe.

What does the word “entrepreneur” mean to you?

The word entrepreneur means someone who has a new unique idea, who takes it from design to an actual product offered in the market. You have to be prepared to work hard for the success of the product, spend money in the early stages as well as communicate and identify the key staff within the market as well as publish marketing literature that describes the product.

What trait do you depend on most when making a decision and why is that useful for you?

I have thought a great deal about my design and the value of the INFT1 for my patients. I have seen the frustration of my patients on a daily basis attempting to eat independently. I know that the INFT1 will improve the lives of my patients and I know that the design and my product will be a success within the market.

Is there a particular quote or saying that you use as personal motivation? 

The quote that I offer when I describe the product is that it will provide “independence and dignity “ at mealtime. I am inspired to improve the quality of life of my patients and countless other adults and children to be as independent as possible at mealtime despite their physical limitations. 

By: Entrepreneur Staff

The Independent Feeding Tray is a unique Adaptive Innovation Technology invented and designed by Ilana Herman MA, CCC/SLP licensed Speech Pathologist.

Ilana is a licensed Speech Pathologist for the past 38 years. She is currently the Senior Speech Pathologist providing speech therapy to patients on a daily basis at one of the leading Rehab/Nursing Home facilities in NY. The main goal of Ilana’s unique invention of the Independent Feeding Tray is to provide patients who are in suffered a Stroke or other Neurological Disease to regain their Independence and Dignity at meal time.

In addition, Ilana has designed the Independent Feeding Tray for “children with special needs” at school and at home. The unique adaptive innovation technology will assist with teaching the children how to feed themselves independently now and in the future. Ilana is pleased to hear from other professional SLP’s , OT’s , PT’s and family members who have friends , family or patients who are either in short term/long term facilities or home bound.

We are now seeking business connections with Healthcare Distributors, Independent Healthcare Dealers, Independent Sales Reps as well as other healthcare professionals who seek to help their patients with their Independence and Dignity at meal time.

Contact Information:
Email : ilana@independentfeedingtray.com

The Covid Vaccine Will Require Billions of Tiny Glass Vials & This Italian Billionaire Family Is Making Them

At the height of Italy’s lockdown in April factories were shuttered across the country. But in Piombino Dese, a small town about20 miles outside of Venice, the hulking glass-cutting machines at the Stevanato Group kept whirring along, spitting out millions of ampoules and syringes. Hundreds of employees donned face masks to work around the clock in three daily shifts, seven days a week – making everything from insulin pen cartridges to miniature glass barrelsand — most pressingly — millions of tiny sterile vials, each one smaller than a single fluid ounce, that one day will house doses of a Covid-19 vaccine.

“Every Saturday and Sunday, even on Easter, I went to work alongside my employees to show that we were in the trenches as well,” says Franco Stevanato, the 46-year-old CEO of the group and grandson of its founder, Giovanni.

Vaccines, like most injectable drugs, need to be packaged in sterile glass. Glass is essentially impermeable to corrupting gases like oxygen while even high-grade plastic lets some air inside. Making these vials was a big business even before Covid-19 appeared in January. Last year, the global pharmaceutical industry purchased some 12 billion vials. The Stevanato Group, a 71-year-old family-owned firm, provided more than 2 billion of those (The company is also the world’s largest manufacturer of cartridges for insulin pens). A Covid-19 vaccine, which likely will have to be administered in two separate injections, will require billions of additional vials. Stevanato expects the pandemic to drive up demand for its glass vials by 20% over the next two years.

“We proactively started to supply our customers with everything they wanted [to fight] Covid-19,” says Franco. “There was no magic strategy. We tried to move quickly and took enormous risks by anticipating some investments, because it was the right time to do it.”

Other than making the actual glass, which they buy from big outfits like Corning and Schott, Stevanato does it all. They design the vials. They make the machines that craft and sterilize the containers. They work with medical regulators in 150 different markets around the world. And then many of their customers use Stevanato-made machines to package the drugs before shipping them to pharmacies and hospitals.

Those machines are a key differentiator. In 2007, when French pharma giant Sanofi needed a supply of sterile syringes that could quickly hit the market, Stevanato developed a ready-to-use syringe that didn’t require any additional sterilization. Stevanato built its own machines to wash and sterilize the syringes and patented the whole process, creating a product line that is now one of the company’s top earners.

“They really value quality and they really value customers and connecting the customer needs to their products,” says Ron Verkleeren, who manages the life sciences division at Corning and has worked with Stevanato since 2011. “That really sets them apart from the competition.”

It’s a solid, if unspectacular, business. In 2019, Stevanato netted $47 million on $675 million sales. Forbes estimates that Sergio Stevanato, the 77-year old company president and son of the founder, owns a 68% stake worth $1.8 billion. Sergio’s sons, Franco (the CEO) and Marco, the 47-year-old vice chairman, run the place now. Each own 16%, worth more than $400 million apiece.

Big changes are afoot. In June, the group raised $59 million in a private debt placement, the first time the company had ever sought outside funding. They plan to use the money to develop wearable medical devices and machines to automatically assemble them. And the family has plans to take the company public within the next three years.

“The banks we’re working with want us to go public earlier, but I want to do it when I feel sure, regardless of Covid-19,” says Franco.


Stevanato has been ramping up for a Covid-19 vaccine for months. The firm hired more than 580 new workers in the first six months of 2020. In late June, Stevanato signed a deal with Norway’s Coalition for Epidemic Preparedness and Innovations (CEPI), a Gates Foundation-backed group that is assisting with scalingnine different Covid-19 vaccine projects — including efforts by Boston-based biotech Moderna and Oxford University — to supply 100 million borosilicate glass vials for up to 2 billion doses of vaccine.

Borosilicate glass can withstand much higher temperatures than other types of glass and is more resistant to external chemicals, making it the glass of choice for sensitive medicines like vaccines. Stevanato is also supplying several other significant vaccine efforts it can’t currently disclose, along with 30 more in early stages of development. Altogether, that’s more than a fifthof the 176 vaccines in the works around the world.

“We talked with every glass producer and the Stevanato Group was the only group that still had uncommitted glass [vial production] capacity,” says Jim Robinson, deputy chair of CEPI’s scientific advisory committee. “They had the prize that everyone wanted.”

Vaccines face much tougher regulatory barriers than most other medicines and need to be stored in sterile glass vials and syringes, says Verkleeren of Corning. “A lot of drugs degrade in the presence of oxygen. It would take millions of years for one molecule of oxygen to permeate glass, and it would take minutes for it to go through plastic,” he says. “Quality and sterility are really, really important, because if it’s not sterile, or there’s a quality problem, and you’re injecting something into the body, it can be very, very serious.”


The Stevanato Group was founded on the outskirts of Venice, a city with a long tradition of glassblowing, in 1949 to make bottles for wine and perfume. The firm, originally called Soffieria Stella, grew as the postwar Italian economy boomed. By 1959, they needed more space so they relocated to Piombino Dese, an industrial town situated on the confluence of five rivers.

As food producers began to switch to plastic in the 1960s, Giovanni Stevanato took a risk and doubled down on glass, developing a machine capable of rapidly producing containers from glass tubing at scale. The 3BS machine, named after Stevanato and his three co-inventors — Bormioli, Bottaro and Bardelli — enabled the firm to double production and target a new market: the growing pharmaceutical industry. In the early 1970s, the family shut down Soffieria Stella entirely, cementing its pivot to medical glass packaging.

“The first decades were very difficult,” says Franco, particularly because the family shunned outside investment. But they made headway. “By making our own machines, we could produce 50% to 60% more than our competitors. Because my father reinvested all our profits into the company, we could advance our technology faster than the others. [They] would buy their technology in Germany, but we could double their production with the same number of employees.”

Franco and Marco entered the family business in 1998 in their mid-twenties, two years after the death of Giovanni. The first order of business: rebuffing a series of acquisition offers from larger competitors. The second order: Expanding the company abroad. In 2008, the family opened its first overseas plant — in Monterrey, Mexico — to target the North American market. Stevanato now has a network of 12 factories on four continents. In 2016 the group entered the U.S. for the first time, via its acquisition of German plastic packaging firm Balda for $112 million, which has two facilities in southern California.

One advantage of providing complex, specially designed packages is that they are patented and included in the regulatory approval process for new drugs, meaning that pharmaceutical firms must use the company’s packaging for the duration of the product’s lifespan. According to Aaron DeGagne, healthcare analyst at Morningstar, this effectively locks in business for decades, because drug producers often continue to use the same packaging—even after the medicine’s patent expires and it becomes a generic drug.

Spinning a sleek, Stevanato-made insulin pen between his fingers during an interview via video, Franco spells out a future in which his family firm expands into more complex products. “Now we have [insulin] pens, and tomorrow the devices will be more self-medicating, analyzing…and much more evolved,” he explains. For example, a cancer patient may be able to self-administer drug infusions at home. “This is the big challenge we want to dive into over the next 10 to 20 years.”

Giacomo Tognini

Giacomo Tognini

I cover billionaires and their wealth for Forbes. In the past, I’ve covered everything from oil & gas for Bloomberg News to the 2014 Indonesian presidential election for the Jakarta Globe. I’m a graduate of Columbia Journalism School and UC Berkeley, and my work has also appeared in the Houston Chronicle, the Calgary Herald, and more…

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Meet Violet, the Robot That Can Kill the COVID-19 Virus

In just a few months, the COVID-19 pandemic has crossed borders and oceans, killing thousands, sickening millions, and forcing millions more to reckon with the economic and personal chaos of closures and lockdowns.

Yet as the global infection count rises, the crisis has also given rise to acts of ingenuity. The pandemic has set off a global race for both an effective vaccine and for the accurate, rapid-response tests that will be necessary before workplaces can safely reopen. Vaccines and tests are essential, but they’re not the only front on which to combat the virus.

In the face of an urgent threat, scientists have pivoted from other projects and pooled their resources toward breakthroughs aimed at reducing infection and protecting lives. Chief among those are tools that make for cleaner, safer places for patients and those treating them, and that alleviate the crushing demands placed on healthcare workers during this crisis.

There’s no magic bullet to halt the advance of COVID-19, but many smaller acts of creativity and collaboration can save lives.

The Irish robot

Conor McGinn is a roboticist and professor at Trinity College Dublin. McGinn and his colleagues at Trinity’s Robotics and Innovation Lab focus on figuring out how robots can best assist aging individuals in care homes.

The signature product from the lab and its spinoff company, Akara Robotics, is Stevie, a 4-foot 7-inch tall social robot whose primary function is alleviating loneliness. In trials in the U.S., U.K., and elsewhere, the robot has been programmed to tell stories, call bingo numbers, lead sing-alongs, and other morale- and community-building exercises in a group care setting.

Its team of engineers have also worked closely with care home staff to understand what additional functions could be added to the robot to boost patient safety. In July 2019, well before the first reports of the coronavirus outbreak in Wuhan, China, the team began exploring whether Stevie might be able to ward off infections too.

The team has a longstanding partnership at Knollwood Military Retirement Community in Washington, D.C. A director there had pointed out that acquired infections are one of the greatest threats to health inside care homes. With that in mind, McGinn approached Michael Beckett, a postdoctoral research fellow in Trinity’s microbiology department, to discuss whether it would be possible to equip the robot with an ultraviolet light feature that would be powerful enough to kill harmful pathogens, yet safe to use alongside residents and staff.

Ultraviolet light at wavelengths between 200 and 280 nanometers, also known as UV-C light, “causes DNA either to change shape, or acts like molecular scissors,” says Beckett, . “It will cut that genetic material and cause little nicks in it.”

Complex organisms and even some bacteria can repair those small lacerations themselves. Viruses, which are molecularly much simpler than bacteria, don’t stand a chance.

UV-C light is a long-established disinfectant in health care settings. Over the last 10 years, hospitals around the world have adopted machines that sterilize rooms and equipment with powerful blasts of light. Because UV-C can also cause sunburn and the cell mutations that lead to skin cancer, most machines currently in use can only work safely and effectively in rooms empty of people, making them impractical for use in high-traffic areas like waiting rooms and other common spaces.

The Stevie robot already had sensors allowing it to navigate independently and stop when it detects the presence of a person. A directed light source that automatically shut down when it detected motion nearby could be a useful feature. Akara toyed with the idea of putting a disinfectant UV-C feature on Stevie, but eventually dropped it when they couldn’t find a satisfactory way to integrate it into the robot’s design.

Then on Feb. 29, Ireland’s Health Service Executive (HSE) confirmed the country’s first case of the novel coronavirus. Less than two weeks later, an elderly woman in a Dublin hospital became Ireland’s first COVID-19 casualty. The Akara team had data on how effective UV-C light was as a disinfectant, and knew how to make a relatively lightweight, nimble robot that could move effectively around humans in a busy healthcare settings. If there was ever a time worth revisiting the idea for an autonomous UV-C equipped robot, McGinn realized, this was it.

The team began drawing up plans for a new robot that would combine the navigational features they’d designed for Stevie with a UV-C light. The robot wouldn’t have any anthropomorphic features, but would be designed to work alongside humans. They would call this one Violet.

Robot time

A common saying in robotics is that robots are best suited for jobs too dirty, dull, or dangerous for humans. The coronavirus outbreak is a textbook example of the last. Violet is one of many robots deployed or soon to be deployed on the front lines of the global outbreak, navigating hospitals and assisting health workers and patients with a very low risk of spreading the infection.

In China, the November emergence of COVID-19 kicked off a rush to get robot technologies to the frontlines. In March, a hospital in the pandemic’s epicenter, Wuhan, opened a new wing for coronavirus patients staffed by robots that clean, deliver food to patients, and monitor vital signs.

“As epidemics escalate, the potential roles of robotics are becoming increasingly clear,” a group of 13 researchers wrote in an editorial last month in the journal Science Robotics. They singled out several key areas where robots could make a significant difference: among them, disinfection using UV light.

“Instead of manual disinfection, which requires workforce mobilization and increases exposure risk to cleaning personnel, autonomous or remote-controlled disinfection robots could lead to cost-effective, fast, and effective disinfection,” the researchers wrote. “New generations of robots, from macro- to microscale, could be developed to navigate high-risk areas and continually work to sterilize all high-touch surfaces.”

Akara isn’t the only company working on robot cleaners. A Danish company called UVD Robots has shipped hundreds of disinfectant robots to China and elsewhere around the world since the outbreak began. Other robotics companies in China and the U.S. are redesigning existing technologies to assist with the current outbreak.

“We’re trying to do something [to help], like everyone here in China,” Keyman Guan of Shenzhen-based YouiBot told the BBC. The company, which usually makes robots for warehouse stocking and other logistics, also now produces a disinfectant robot.

End game

Akara has focused on making Violet portable and compact enough to be able to operate in tight, crowded spaces that are otherwise hard to clean: bathrooms, waiting areas, the nooks and crannies of public transit. It also has a protective shield around the back of the light, and motion-detecting sensors so that people don’t have to vacate the area while it’s at work.

With support from Ireland’s HSE, the Violet team recently tested the robot at Midland Regional Hospital Tullamore, about 60 miles west of Dublin. They conducted tests in a room with a CT scanner, one that would be reserved for COVID-19 patients in need of chest scans if and when the hospital sees an influx of patients. It typically takes a radiographer 15 minutes to clean the room with disinfectant wipes and then another 30 to 60 minutes for the chemicals to dry and any airborne germs to dissipate, meaning that the room can only handle about one patient an hour. In tests, a Violet robot has been able to get the job done in 15 minutes, a fourfold increase in turnaround time.

Akara is looking to raise money now to build a more advanced prototype that can be tested in different settings. Under typical circumstances, the process of design, testing, and approving such a robot for hospital use could take months, if not years. This situation doesn’t have that kind of time. There’s no cutting corners when it comes to tools that could affect people’s health, but the urgency of the coronavirus crisis means that it’s better to move fast than not at all.

“Anyone who’s involved in emergency response will know this—if you need to be right before you move, you will never win. Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection,” epidemiologist Michael Ryan, executive director of the World Health Organization’s Health Emergencies Program, said in March of his previous experience managing outbreaks of Ebola. “Everyone is afraid of the consequence of error. But the greatest error is not to move. The greatest error is to be paralyzed by the fear of failure.”

There will—hopefully—be many lessons learned from the coronavirus crisis. One will be the necessity of innovation in peace times so that the right technology is ready to go when crisis strikes. If there is anything that science is certain of, it is that in an increasingly interconnected world, a global pandemic will strike again.

Weeks after the first U.S. case of Ebola was reported in 2014, the National Science Foundation and the White House’s Office of Science and Technology Policy launched a series of workshops to explore the potential of robots to assist with tasks like waste removal, decontamination, and human burial in situations that could get human workers sick. But funding and initiative to pursue these ideas slowed after Ebola’s containment, at least in the U.S. After Trump’s inauguration, the chief role at the Office of Science and Technology Policy sat vacant until the August 2019 confirmation of meteorologist Kelvin Droegemeier. The White House recently announced a partnership between major tech companies to pool supercomputing resources to fight the virus’s spread, but there has been no public discussion at the federal level of enlisting robots.

“Without sustained research efforts robots will, once again, not be ready for the next incident,” the researchers wrote in the Science Robotics editorial. “By fostering a fusion of engineering and infectious disease professionals with dedicated funding we can be ready when (not if) the next pandemic arrives.”

By Corinne Purtill April 24, 2020 9:53 AM EDT

Source: Meet Violet, the Robot That Can Kill the COVID-19 Virus

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Subscribe to our YouTube channel for free here: https://sc.mp/subscribe-youtube A UV light bacteria-killing robot is being used at a hospital in Wuhan, the epicentre of the Covid-19 outbreak. It has been placed inside a CT scanner to prevent cross-infection while patients are tested for the coronavirus. Follow us on: Website: https://scmp.com Facebook: https://facebook.com/scmp Twitter: https://twitter.com/scmpnews Instagram: https://instagram.com/scmpnews Linkedin: https://www.linkedin.com/company/sout…

Ford and GM launch battle to produce COVID-19 ventilators

Workers at GM and Ford are beginning to produce life-saving ventilators at Michigan plants that normally make cars and trucks.

While full production won’t begin until May, the many thousands of ventilators they make will be useful then and in later months should a COVID-19 resurgence occur in the fall or later in 2021 before a vaccine is ready and widely used.

The engineering feat of converting from making vehicles to ventilators is complex, not only because of the technology involved. Both cars and ventilators share electronics and metal and plastic parts that need to be assembled, but there are the added challenges of building thousands of medical devices rapidly with high accuracy and of keeping workers safe while they maintain personal distancing on an assembly line.

 “We’re used to building big automotive products but scaling to product a small ventilator requires different sourcing of components and capabilities,” Adrian Price, Ford’s director of global core engineering, said in an interview with CBS This Morning. 

“There’s quite a bit that goes into taking a design that is currently produced at the rate of two a day and scaling that to over 7,000 a week,” he added.

GM is bringing back hundreds of workers to produce ventilators next week and will be imposing safety guidelines that include distancing between workers, periodic taking of temperature and scrubbing down work areas between shifts, according to the CBS report.

The two companies together are enlisting up to 1,500 workers to make ventilators, while Ford wants to produce 50,000 by July 4 and GM wants to build 200,000 overall, according to The Washington Post.

Getting fully functioning machines ready for use that are tested and reliable will be part of the process.  Some ventilators are built to operate only for short periods of time, pumping air or oxygen into a patient’s lungs, while others must pump for days.  There can be an array of electronics for controlling alarms and fail safes, as well as redundancy.

Testing of the machines will typically take a few minutes, looking at plastic and metal parts but also assessing how well a machine responds when in use, even when a patient coughs into a tube that is connected to the device, according to engineers that spoke to FierceElectronics.

RELATED: COVID-19 ramp-up marshals engineering army

Price told the Post that Ford is looking at ways to scale up more quickly, adding that “time is of the essence.”

Ford is partnering with Airon, which normally makes up to three ventilator machines a day, while GM is working with Ventec Life Systems.

Price told the Post that Ford asked thousands of auto suppliers to retool their manufacturing to create ventilator components and found that all but one component could be purchased inside the U.S.  Ford is developing ventilators in its Rawsonville, Michigan, plant with tradesmen from Local 898 of the United Auto Workers Union, according to the Post.

By: Matt Hamblen |

Source: Ford and GM launch battle to produce COVID-19 ventilators

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Regulation & Reimbursement Strategies Should Not Get In the Way of ‘Smart’ Electronic Skin Patches

Recent IDTechEx research in their report: Electronic Skin Patches 2019-2029, has revealed significant opportunities in the development and use of electronic skin patches, with over $7.5bn in revenue made from the technology in 2018 and a growth forecast of over $20bn per year over the next decade.

However, it also shows that reimbursement and regulatory consideration aren’t necessarily keeping pace. James Hayward, Principal Analyst at IDTechEx, highlights the dangers of a closed market driven by regulation and reimbursement strategies which favour devices for simplicity and cost rather than effectiveness; deterring new entrants.

Electronic skin patches are wearable products attached to the skin of a user incorporating sensors, actuators, processors and communication technology, allowing the device to connect to the internet to become ‘smart’. Skin patches are one of the latest waves in health monitoring; their non-intrusive design meaning they are comfortable and discrete. Unsurprisingly, interest in electronic skin patches has soared, driven by significant hype and market growth around wearable devices starting in 2014.

A number of significant applications of electronic skin patches are now having a profound impact on health and quality of life. Some of the foremost use cases center around healthcare and medical applications, while the consumer health market is another early adopter. As such, several product areas, particularly in diabetes management and cardiovascular monitoring, have grown exponentially to create billions of dollars of new revenue each year for the companies at the forefront of this wave.

Cardiovascular monitoring faces reimbursement and competitive roadblocks

Alongside this growth has come the need for forward-thinking regulation and reimbursement, especially given the life-changing medical context of their applications. Following regulatory approval, the funding of medical devices can come from different sources, including government-led reimbursement schemes. These provide funding for medical devices defined within certain categories according to central definitions and understandings of the performance and cost of the device. While systems do vary by country, it is typical for central procedural terminology to be linked to reimbursement amounts for each device.

Take cardiovascular skin patches for example, which exist in a highly competitive landscape alongside consumer wearables such as watches and chest straps (which provide cardiac data but with limited medical usefulness due to a lack of medical approval) as well as cardiac implants which offer a more accurate but less safe approach.

Effectiveness must have a role to play in future developments 

Electronic skin patches for cardiovascular monitoring must strike a compromise between data quality and patient comfort. A patient can remain active while wearing the device, minimizing additional issues caused by remaining in a hospital bed for too long. However, they also typically produce simpler data sets than the full 12-lead standard monitor and offer less control over the quality of the data produced. These competitive landscapes drive positive product development but it is often the central regulatory and funding bodies that have the power to drive change.

Previously, these mobile cardiac telemetry products have benefited from a favorable reimbursement scenario in the US, defined under a Category 3 CPT code for “extended Holter monitoring”. This code entitles them to twice the amount of reimbursement as “event monitoring” and more than eight times the amount afforded to generic “Holter monitoring” (both Category 1 CPT codes). If the reimbursement situation were to change, the entire revenue structure for these devices will change with it. Should reimbursement strategies be allowed to shape developments rather than consumers and effectiveness?

Diabetes management reveals a confusing system

One of the biggest revenue generators in the electronic skin patches market has been continuous glucose monitoring (CGM) for diabetes management, which posted annual revenues of over $2.5bn in 2018. The US Food and Drug Administration (FDA) has given four companies approval to sell CGM products, three of the four companies offer a skin patch with a small needle to test glucose levels in interstitial fluid. Only one organisation offers a subcutaneous implant which is then read using a skin patch as a communication hub. In such a closed market, regulations and reimbursements are shaping its course.

The three large players offering a needle-based skin patch have benefited from multiple geographies now offering partial or full reimbursement for CGM products under national healthcare schemes. Yet each of the three products is treated under a single regulatory category and receive the same reimbursement per device, regardless of performance, longevity or functionality. This opens up the potential for a closed market which favours devices because of simplicity and cost rather than effectiveness.

The fourth player is a new market entrant with lower revenue but offers a much longer-lasting CGM solution with significant differentiation from its rivals, but because of limited regulation and reimbursement, however, it may struggle to break the market stranglehold from larger players with cheaper solutions.

New entrants need to be encouraged

This reimbursement and regulatory environment provide an even bigger barrier to entry for new and innovative electronic skin patches. If the product is to be offered as a medical device, it must go through regulatory approval processes, either showing equal performance to existing equivalents or going through a de novo process to prove its efficacy and safety.

These hurdles often result in new electronic skin patch devices being pushed towards the consumer health market, where regulatory roadblocks aren’t as stringent but offer less long-term returns than in direct healthcare. This is already proving to be the case with the promising area of temperature sensing for fever and fertility monitoring, as well as other patient monitoring devices.

Healthcare Sensors Cambridge Event

This is exactly why IDTechEx has been tracking the emergence of electronic skin patches and the reimbursement and regulatory landscape back to 2010, across 26 application areas and over 100 market players, in its report Electronic Skin Patches 2019-2029. The report forecasts the market through 2019-2029 and aims to help innovative healthcare organisations make more informed business decisions before deciding how to roll-out one of the hottest technologies in patient monitoring.

In addition to detailed reports on this topic, IDTechEx are hosting an event: Healthcare Sensor Innovations 2019, in Cambridge, UK which is a conference and table-top exhibition focusing on the latest developments in the use of wearables and sensors in continuous monitoring of individuals and point-of-care diagnostics.

Register here: www.IDTechEx.com/Cambridge


About the Author

James Hayward, Principal Analyst at IDTechEx. James is a Principal Analyst at IDTechEx. Joining in 2014, he initially developed IDTechEx’s wearable technology platform. He now oversees a team of analysts across varied topic areas, as well as oversight over the wearable technology research efforts.

Featured Image: Peshkova

Source: Regulation and reimbursement strategies should not get in the way of ‘smart’ electronic skin patches – TechNative

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Engineers at the University of California San Diego have developed a flexible wearable sensor that can accurately measure a person’s blood alcohol level from sweat and transmit the data wirelessly to a laptop, smartphone or other mobile device. The device can be worn on the skin and could be used by doctors and police officers for continuous, non-invasive and real-time monitoring of blood alcohol content. The device consists of a temporary tattoo—which sticks to the skin, induces sweat and electrochemically detects the alcohol level—and a portable flexible electronic circuit board, which is connected to the tattoo by a magnet and can communicate the information to a mobile device via Bluetooth. Lots of accidents on the road are caused by drunk driving. This technology provides an accurate, convenient and quick way to monitor alcohol consumption to help prevent people from driving while intoxicated. The device could be integrated with a car’s alcohol ignition interlocks, or friends could use it to check up on each other before handing over the car keys. Blood alcohol concentration is the most accurate indicator of a person’s alcohol level, but measuring it requires pricking a finger. Breathalyzers, which are the most commonly used devices to indirectly estimate blood alcohol concentration, are non-invasive, but they can give false readouts. For example, the alcohol level detected in a person’s breath right after taking a drink would typically appear higher than that person’s actual blood alcohol concentration. A person could also fool a breathalyzer into detecting a lower alcohol level by using mouthwash. Recent research has shown that blood alcohol concentration can also be estimated by measuring alcohol levels in what’s called insensible sweat—perspiration that happens before it’s perceived as moisture on the skin. But this measurement can be up to two hours behind the actual blood alcohol reading. On the other hand, the alcohol level in sensible sweat—the sweat that’s typically seen—is a better real-time indicator of the blood alcohol concentration, but so far the systems that can measure this are neither portable nor fit for wearing on the body. Now, UC San Diego researchers have developed an alcohol sensor that’s wearable, portable and could accurately monitor alcohol level in sweat within 15 minutes. News Source: http://jacobsschool.ucsd.edu/news/new…
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