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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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Best Stress Medication? This Doctor Says It’s RediCalm Doctor Formulated

The Biological Cause of Anxiety

Scientists have identified why it can be so difficult to escape the cycle of negative behavior.Your mood is strongly influenced by two key neurotransmitters, GABA and serotonin. When levels are low, anxious thoughts fill your mind and you don’t you feel like yourself.

But promoting healthy levels of GABA and serotonin helps restore your mind to a state of calm. More importantly, this feeling is maintained even when you are faced with a stressful situation.

Prescription medication is often considered the only treatment for anxiety. However, a new group of doctors are advocating for a more natural approach.

“Our Research Confirms a Natural Approach Is Best”

Dr. Hoffman reveals new clinical evidence supporting the use of natural remedies for anxiety relief.

Ronald Hoffman, MD, has been practicing for over 30 years in New York City and is an internationally recognized expert in integrative medicine. He and his team of researchers have been investigating the most effective alternative remedies to boost levels of GABA and serotonin naturally.

“After months of research and testing, we arrived at a formula of 5 natural ingredients that outperformed all others in terms of safety and effectiveness,” Dr. Hoffman states. “Following the results of the placebo-controlled clinical study, we decided to release the formula to the public.”

Ashwagandha

Passion Flower

L-Theanine

Lemon Balm

5-HTP:

The Clinical Study

  • More than 2 out of 3 participants experienced anxiety relief within just 30 minutes of taking RediCalm.
  • More than 95% of participants felt improvement in their overall anxiety level over the course of 30 days.
  • None of the participants reported any negative side effects.
  • Every participant said that they would recommend RediCalm to a friend or relative.

Each of the ingredients in the RediCalm formula has a long-standing history of safety and effectiveness.

RediCalm can be taken with most prescription and over-the-counter medications. When taken as directed, RediCalm is safe, poses no short-term or long-term health risks, and is not addictive or habit-forming.

As with any dietary supplement, it is recommended that you consult with your doctor or healthcare provider before taking RediCalm. Please visit our Safety Facts page for more information about contraindications and possible side effects.

* For more details, click here to view the complete results of the study.

Source: Clinically Proven Natural Stress Relief

Stress Changes The Brain, And This Could Be How It Happens

The results of a new brain imaging study may have just answered a big question about how stress changes the brain. Using a combination of genetic editing and brain scanning in mice, researchers found that stress triggers a chemical cascade that radically changes how brain networks communicate, and the results could sharpen our understanding of anxiety disorders in humans.

Breaking down the research

Stress serves an important purpose in preparing us to react to danger. Anything the brain perceives as threatening triggers multiple brain networks to synchronize and communicate, all in just a fraction of a second. With systems humming, we make immediate decisions to survive the threat.

But what facilitates all of those brain networks to connect and communicate? That’s been a difficult question to answer in the human brain, because doing so would require examining brain function during the split-second window of facing a threat.

Enter our friends the mice to help solve the problem. Researchers followed a trail of previous studies and zeroed in on the neurotransmitter noradrenaline (aka norepinephrine, a chemical that floods the brain during stress) as a likely facilitator of brain-network connectivity.

The twist was that they had genetically manipulated the rodents’ brains to allow for selectively controlling when noradrenaline was released (not possible in human brains). While controlling the chemical faucet, they also scanned the mouse brains using fMRI to see what would happen.

And what happened, it turns out, was pretty amazing. The release of noradrenaline “rewired” the mouse brains, allowing different brain networks to instantly cross-communicate. But the neurotransmitter wasn’t just facilitating communication, it was restructuring neural connections beyond anyone’s expectations.

“I couldn’t believe that we were seeing such strong effects,” said the study’s first author Valerio Zerbi, a brain imaging specialist from the University of Zurich.

The researchers found the strongest rewired effects in brain areas responsible for processing sensory stimuli (auditory and visual, for example), and in the amygdala, the epicenter of the brain’s threat response system.

What does this mean for us?

It’s the part about threat response that may hold the most promise for better understanding what stress does to our brains.

Allowing for the fact that this was research in mice, the particular dynamic studied here is probably quite similar between us and our rodent counterparts. If noradrenaline rewires the human brain as it appears to rewire the brains of mice, it’s possible the long-term effects of stress are more profound than we’ve realized.

Previous research has linked the flood of noradrenaline to changes in brain connectivity, but it seems likely we’ve underestimated the effects, especially in the small but powerful part of our brain sitting at the center of anxiety disorders: the amygdala.

At a minimum, this research opens new doors for better understanding how both acute and chronic stress effects the brain, and could enlighten new ways of deconstructing anxiety conditions, now the most prevalent mental health disorders worldwide. The study was published in the journal Neuron.

Follow me on Twitter. Check out my website or some of my other work here.

David DiSalvo is the author of the best-selling book “What Makes Your Brain Happy and Why You Should Do the Opposite”, which has been published in 15 languages, and the books “Brain Changer: How Harnessing Your Brain’s Power to Adapt Can Change Your Life” and “The Brain in Your Kitchen”. His work has appeared in Scientific American Mind, Forbes, Time, Psychology Today, The Wall Street Journal, Slate, Esquire, Mental Floss and other publications, and he’s the writer behind the widely read science and technology blogs “Neuropsyched” at Forbes and “Neuronarrative” at Psychology Today. He can be found on Twitter @neuronarrative and at his website, daviddisalvo.org. Contact him at: disalvowrites [at] gmail.com.

Source: Stress Changes The Brain, And This Could Be How It Happens

How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

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Photographer: Scott Eisen/Bloomberg

© 2016 Bloomberg Finance LP

The landscape of experimental Alzheimer’s disease (AD) drugs is strewn with failures, so much so that it has been referred to as “an unrelenting disaster zone”. Recognizing the greatly increasing number of patients with this disease, many biopharma companies have invested a lot of resources in attacking this problem, only to be turned away in late stage studies as happened to Merck with its BACE inhibitor, verubecestat, and Lilly with its beta-amyloid antibody, solanezumab.

Now add Biogen to the list of companies that have failed in this arena. Its drug, aducanumab, partnered with Eisai, was believed to be better in removing beta-amyloid from the brain than any agent previously tested. Many have hypothesized that beta-amyloid causes the formation of damaging clumps of debris in the brain leading to AD. Unfortunately, Biogen halted a major clinical trial with aducanumab due to a futility analysis showing that the drug doesn’t work.

This is a terrible result for Alzheimer’s patients who had hoped that this was the drug that would finally succeed in treating AD. But the demise of aducanumab is also disastrous for Biogen which had expended an enormous amount of resources into this program, likely at the expense of other opportunities. It was a risky bet and one for which Wall Street has delivered a punishing blow. Biogen’s stock dropped by nearly 30% shortly after announcing the disappointing aducanumab results.

How is Biogen going to respond? As John Carroll has reported, many industry analysts believe that there aren’t many gems in the Biogen pipeline that can make up for the loss of this potential blockbuster. In predicting Biogen’s next steps, perhaps there are some learnings from another such pipeline failure – that of Pfizer’s torcetrapib.

Torcetrapib was the first of a class of compounds known as CETP inhibitors, drugs that both raised HDL-cholesterol and lowered LDL-cholesterol. A CETP inhibitor had the potential to remodel a heart patient’s lipid profile thereby greatly reducing his risk of a heart attack or stroke. There was tremendous excitement generated in this potential breakthrough treatment, not just in Pfizer but also among cardiologists and heart patients. In fact, internal commercial analyses predicted annual sales in excess of $15 billion. However, as happened with aducanumab, on December 4th, 2006, Pfizer announced that torcetrapib failed its long-term clinical study. The drug was dead. The Wall Street reaction was swift, albeit not as dramatic as Biogen’s experience. Pfizer stock dropped 10% as a result of this news.

Internally, the Pfizer reaction was intense. Torcetrapib was supposed to be the blockbuster that would drive growth into the next decade. Its loss created an enormous hole. Pfizer CEO Jeff Kindler responded in a couple of ways. First, he decided to “right size” R&D in relation to lower expected future revenues. In effect, hundreds of millions of dollars needed to be cut from R&D. Pfizer’s R&D budget had already undergone major portfolio adjustments and reorganizations over the previous five years due to the acquisition of Warner-Lambert Parke-Davis in 2000 followed by the acquisition of Pharmacia in 2004. Meeting the new R&D budget targets weren’t going to be achieved by simple cuts; rather, major research sites had to be closed and jobs had to be eliminated. Gone were R&D sites around the world including those in France, Japan and, most significantly, the iconic laboratory in Ann Arbor, Michigan.

But budget cuts weren’t going to be enough for Pfizer to meet its desired goals. The company began assessing major M&A opportunities and in 2009 it acquired Wyeth for $68 billion leading to yet another round of reorganizations and portfolio reshuffling. The ripple effect of the torcetrapib demise was felt by the entire company and lasted for a number of years.

So, how will Biogen respond? Undoubtedly, there will be budget cuts. In addition, perhaps Biogen will look at its R&D portfolio and give a higher priority to those programs that have the potential to deliver revenues in the short term. There might also be a push to drop programs deemed to be very risky or where the proof-of-concept requires long, expensive clinical trials. Finally, it wouldn’t be surprising to see Biogen become aggressive in their M&A activities. But make no mistake. The death of an important drug like aducanumab will have both a short and a long term effect on Biogen as a company and especially on R&D.

I was the president of Pfizer Global Research and Development in 2007 where I managed more than 13,000 scientists and professionals in the United States, Europe, and Asi…

Source: How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

Open Innovation In Japan Breaks New Ground In The Operating Room

Yoshihiro Muragaki (left) and Jun Okamoto (right) of Tokyo Women's University's Institute of Advanced Biomedical Engineering and Science

Yoshihiro Muragaki (left) and Jun Okamoto (right) of Tokyo Women’s Medical University’s Institute of Advanced Biomedical Engineering and Science pose in a version of the Smart Cyber Operating Theater (SCOT).JAPAN BRANDVOICE

Imagine undergoing surgery on a robotic bed that can automatically help perform a magnetic resonance imaging (MRI) scan while an artificial intelligence (AI) system actively supports surgeons by suggesting various procedures. It sounds like a scenario from a Hollywood movie, but it’s reality in Japan.

Doctors at the Tokyo Women’s Medical University – Waseda University Joint Institution for Advanced Biomedical Sciences (TWIns) recently performed a groundbreaking brain surgery to treat essential tremor, a neurological disorder. It was the first clinical use of the latest version of the institution’s Smart Cyber Operating Theater (SCOT). Hyper SCOT, as it’s known, brings robotics and AI into the operating theater so that patients can have better post-surgical outcomes. It’s an impressive example of the many forms of open collaboration driving innovation in Japan.

A new frontier in surgery

Walking into the Hyper SCOT operating room at Tokyo Women’s Medical University, one gets the feeling of entering Sick Bay aboard the starship Enterprise from Star Trek. Silver doors slide open to reveal a sleek white room illuminated by variable-color lights. In the center are a pair of robots: an operating bed that swivels to position a patient under a large MRI scanner nearby, and a dual-armed industrial-style robot that can support a surgeon’s arms while operating. On the wall are high-resolution images of a patient’s brain. Surgeons can gesture to zoom in or change the images’ orientation, a feature inspired by the Tom Cruise film Minority Report.

As a next-generation operating room, SCOT can reduce risks and increase benefits for patients, says Muragaki.

As a next-generation operating room, SCOT can reduce risks and increase benefits for patients, says Muragaki.JAPAN BRANDVOICE

Hyper SCOT is designed to transform surgery from an analog process, where standalone equipment is not connected, into a digital process where data are shared. It can support surgical teams by providing them with a rich stream of data from networked medical tools as well as AI-powered advice on surgical options. SCOT also aims to improve precision by helping brain surgeons accurately navigate to a tumor site. Although MRI had only been available to surgeons before an operation, Hyper SCOT would enable them to get scans during the procedure, which could dramatically improve outcomes.

“If we have many kinds of information, we need some kind of strategy desk, like Mission Control at NASA,” says SCOT project leader Yoshihiro Muragaki, a professor in Tokyo Women’s Medical University’s Institute of Advanced Biomedical Engineering and Science. “Our moonshot is to make new eyes, brains and hands for surgeons. With SCOT, we can perform precision-guided therapy.”

Okamoto demonstrates a SCOT brain imagery gestural interface inspired by the film Minority Report at Tokyo Women's Medical University.

Okamoto demonstrates a SCOT brain imagery gestural interface inspired by the film Minority Report at Tokyo Women’s Medical University. JAPAN BRANDVOICE

A neurosurgeon himself, Muragaki conceived of the SCOT project and has spearheaded it since its inception in 2000. Back then it was known as the Intelligent Operating Theater, a version now known as Classic SCOT. Supported by a grant from the Japan Agency for Medical Research and Development (AMED), the system began as an initiative to enhance interoperability among devices used in the medical theater, but the development team later added features such as multiple surgery cameras that can send imagery to remote consultants, usually senior surgeons. These advisors have a bird’s-eye view of the action as well as near-real time data streams of patients’ vital statistics. Since 2000, the technology has been used in some 1,900 cases, mostly brain surgeries. MRI has been key in detecting residual tumor tissue that escaped surgeons’ notice during operations.

“Even under a microscope, it’s very difficult to detect where brain tumor tissue ends and healthy tissue begins,” says Muragaki. “That’s why we need MRI during surgery. It’s a very powerful tool for removing tumors. But that also means we can only use MRI-compatible devices in the operating room and we must choose them carefully.”

Fruits of teamwork

With over 100 researchers, SCOT is the result of a complex collaboration between academia and the private and public sectors. Aside from the two universities in TWIns, Muragaki and colleagues are working with Hiroshima University and Shinshu University, where versions of SCOT are being evaluated in clinical settings. High-tech companies are also helping to develop SCOT, including Hitachi, Canon Medical, and Air Water. Another participant is Denso. It developed a medical-equipment middleware called OpeLiNK that is based on factory automation technology as well as ORiN, a platform created with the support of the New Energy and Industrial Technology Development Organization (NEDO), a leading Japanese state-backed research center. Orchestrating all these players was essential in creating SCOT.

Another major benefit of SCOT is the ability to obtain scans using an MRI machine (right) during surgery.

Another major benefit of SCOT is the ability to obtain scans using an MRI machine (right) during surgery. JAPAN BRANDVOICE

“If one company tried to do this alone, it would want to use its own technology and keep rivals out,” says Muragaki. “That company wouldn’t succeed in integrating all the various technologies. That’s why public institutions are vital for this kind of open innovation project. They act like the frame in a traditional sensu Japanese folding fan, keeping everything together as the project unfolds.”

The collaborations that gave birth to SCOT were recently recognized when it picked up the Minister of Health, Labour and Welfare Award as part of the first Japan Open Innovation Prize. Sponsored by the Japanese government, the accolade was set up to promote initiatives that can serve as future role models for open innovation. In Japan, companies traditionally kept R&D in-house, even in recent years. But the public and private sectors have been pushing open innovation as a vehicle for enhancing competitiveness. Collaborations between government labs, corporations and universities are now flourishing. Major telecom carrier KDDI, for instance, launched the first of a series of Open Innovation Funds in 2012, aimed at investing in IT startups in Japan and overseas.

“There’s a growing recognition that if a company categorizes itself as a camera company, for instance, it is limiting itself,” Keiichiro Koumura, an official with major real estate company Mitsui Fudosan, recently told attendees at an open innovation seminar at Mitsui Fudosan’s Base Q in Tokyo. “Because as technology changes, cameras have become smartphones. One way to address this is open innovation.”

Keiichiro Koumura of Mitsui Fudosan (center left) and Hideaki Nagano of Samurai Incubate (center right) discuss open innovation during a seminar at Base Q in Tokyo.

Keiichiro Koumura of Mitsui Fudosan (center left) and Hideaki Nagano of Samurai Incubate (center right) discuss open innovation during a seminar at Base Q in Tokyo.japan brandvoice

Looking to the future

As for SCOT, Muragaki hopes to spread the technology to other hospital facilities such as intensive care units, and apply it to other forms of surgery such as vascular operations. He also hopes to take the technology overseas.

“Most doctors are resistant to change. Before they try SCOT, surgeons don’t regard it as something that’s necessary but once they give it a go, their view changes,” says Muragaki. “After brain surgeries, we want to try the technology on bone tumors, and keep going. If you could do all surgeries with SCOT, it would decrease risks and increase benefits. That’s something we can work toward.”

To find out more about SCOT, visit the university’s website here.

For more on the Japanese Government’s innovations and technologies, please click here.

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

Source: Open Innovation In Japan Breaks New Ground In The Operating Room

Blood Type: Microbiome and Diet — CFS Remission

One of my favorite sources for information on the microbiome is run by Dr. Peter J. D’Adamo. For many years he has advocated eating for your blood type. In this week’s issue of New Scientist. an article “Your gut bacteria may match your blood group – but we don’t know why“ The difference between many […]

via Blood Type: Microbiome and Diet — CFS Remission

HLA system in solid organ transplantation part 25 — MEDICINE FOR ALL

HLA mismatches and the production of alloantibodies HLA mismatches are not only the trigger for alloreactive T cells to destroy the transplant parenchyma, they also lead to the formation of alloreactive anti-HLA antibodies; and together they contribute to acute and chronic rejection, and the eventual immunologically-mediated transplant loss. But it is not the number […]

via HLA system in solid organ transplantation part 25 — MEDICINE FOR ALL

Human Leukocyte Antigen (HLA) part 102 — MEDICINE FOR ALL

The discovery that foetal cells are devoid of the highly polymorphic HLA class Ia molecules, except for a low expression of HLA-C, is believed to play a dominant role for the induction of tolerance to the semi-allogenic foetus. Interestingly, the foetal-derived tissue in placenta does express the loss polymorphic HLA class Ib molecules, HLA-E, […]

via Human Leukocyte Antigen (HLA) part 102 — MEDICINE FOR ALL

Why Doctors Hate Their Computers – Atul Gawande

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On a sunny afternoon in May, 2015, I joined a dozen other surgeons at a downtown Boston office building to begin sixteen hours of mandatory computer training. We sat in three rows, each of us parked behind a desktop computer. In one month, our daily routines would come to depend upon mastery of Epic, the new medical software system on the screens in front of us. The upgrade from our home-built software would cost the hospital system where we worked, Partners HealthCare, a staggering $1.6 billion, but it aimed to keep us technologically up to date……..

Read more: https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers

 

 

 

 

Your kindly Donations would be so effective in order to fulfill our future research and endeavors – Thank you

Welcome To Medicare’s Open Season Your Head Is About To Explode – Howard Gleckman

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It is Medicare open season. And, let’s face it, nobody has any idea what to do. The other night, I got a call from a friend who works in the long-term care advocacy world. She will soon turn 65 and is confronting the reality of enrolling in Medicare. She has been doing diligent research and creating detailed spreadsheets. And she is baffled. Some choice is good. So is competition. But needless complexity is something else entirely. And we know from behavioral science that, faced with too many choices, humans often make poor decisions or …do nothing………

Read more: https://www.forbes.com/sites/howardgleckman/2018/10/19/welcome-to-medicares-open-season-your-head-is-about-to-explode/#368279248edc

 

 

 

Your kindly Donations would be so effective in order to fulfill our future research and endeavors – Thank you

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