New Florence. New Renaissance.

Digital twin of the human body

Twin’s Whole Body Digital Twin builds a “digital twin” modeled after a patient’s individual metabolism. This digital replica is continuously updated based on data from wearables, blood tests and self-reported symptoms. AI is then used to analyze the twin and offer personalized guidance that could facilitate improvements.

Users can see how changes to nutrition, sleep, activity and breathing could potentially reverse or prevent chronic metabolic diseases. Because it enlists technology and monitors that are already approved, Twin has said that its system doesn’t need FDA approval.

Medical Media and Marketing

More possible applications of the concept in healthcare

 

AI and new drug innovation

It takes on average a decade to go from the initial discovery stage of a drug to approval and, with a high failure rate, the pharmaceutical industry estimates it costs $2.7bn to bring each one to market. Clinical trials make up the bulk of this time and cost, but discovery and pre-clinical tests can still take three or four years.

During the pandemic, AI was primarily used as a tool to save scientists’ time, accelerating this notoriously slow discovery process, while often using drugs and vaccines designed for similar viruses such as Mers as a starting point. But advocates of AI believe its wider use during the crisis is just the start of a revolution in drug discovery that will harness growth in biological and chemical data, computing power and smarter algorithms that could reduce soaring healthcare bills and create treatments for conditions where we have none.

They argue AI proved itself in the crisis. AbCellera sorted through 6mn cells in three days to find an antibody that could be mass produced — in this case by Eli Lilly — as a drug called bamlanivimab that has helped more than 1mn Covid patients. A supercomputer helped in Pfizer’s quest for an antiviral that could be taken orally.

Financial Times

Demis Hassabis co-founder of Isomorphic Labs which is part of Google presents on the future of AI

Biophilic Design for Hospitals

As a cancer patient himself, he understood that design could play a huge role in how patients experienced the often uncomfortable treatments. He started asking patients what they wanted in a new facility. “What I heard repeatedly is, ‘We don’t want sterile fluorescent lights. We don’t want to feel like we’re on a stage while we’re sitting on these high exam tables and freezing cold in gowns,'” he says. Patients wanted a softer experience, with more natural light, not the typical sterile white walls of a chilly hospital room.

“As we met with the architects, we went with a full natural material palette for everything, lots of varying textures and colors all relating to nature, what we felt was more soft and inviting,” Flora says. He wanted the project to “echo more the feeling you get when you walk into an Apple Store than the feeling you get when you walk into your gynecologist’s office.”

FastCompany

More on biophilic design for health settings

 

The future of mRNA

Messenger ribonucleic acid, or mRNA for short, is a single-stranded molecule that carries genetic code from DNA to a cell's protein-making machinery. Without mRNA, your genetic code wouldn't be used, proteins wouldn't be made, and your body wouldn't work. If DNA is the bank card, then mRNA is the card reader.

At the University of Rochester, Dragony Fu, associate professor, department of biology, received expedited funding for his laboratory from the National Science Foundation to research RNA proteins. If we are currently witnessing mRNA vaccine 1.0 for Covid-19, then 2.0 will address two further categories of disease, says Fu: "one is pathogens, like Sars, but you can apply this technology to other foreign invaders such as HIV. Already before Covid, companies were in development making mRNA vaccines against HIV." He also cites Zika, herpes and malarial parasites in the pathogens camp.

"The other category is autoimmune diseases," he says. "That is intriguing because it's verging beyond the very strict definition of a vaccine." Fu says the future could involve mRNA "treatments", for example to reduce inflammation. "In theory, that opens up so many possibilities," he says.

BBC

Colon Cancer cure next for mRNA?

 

Non-sleep Deep Rest

Sundar Pichai, CEO of Google, told the Wall Street Journal

“Meditation is something I see the value of, but I struggle to do that. Walking is very helpful to me. I find it much easier to think when I’m walking or pacing. Through the pandemic, sometimes it’s been helpful to take my dog out for a walk, and I can relax by listening to podcasts. I found these podcasts which are non-sleep deep rest, or NSDRs. So while I find it difficult to meditate, I can go to YouTube, find an NSDR video. They’re available in 10, 20 or 30 minutes, so I do that occasionally.”

So what exactly is NSDR? It includes specific techniques to reach self-directed states of calm through mental focus. NSDR protocols can improve learning, help you relax, reduce stress, and help you fall asleep more easily. The term NSDR was coined by Dr. Andrew Huberman at Stanford who also practices Yoga Nidra  

In this video the doctor discusses the science of sleep and relaxation

 

 

From telehealth to hybrid health

Smart companies are recognizing that telehealth is just one piece of a much larger whole. Carbon Health, an early virtual care provider, now has physical locations in 17 regions around the country and is getting into clinical trial research. Amazon Care, which launched its virtual care platform in 2019, has opened 17 in-person clinics for Amazon employees with Crossover Health. Companies such as Rezilient Health are also thinking about the ways in which spaces such as parking lots can be repurposed to house health clinics.

This movement is part of a coming wave of retail health clinics. This year, Walgreens agreed to invest $5.2 billion into VillageMD (see video below) to put 1,000 of its primary care offices next to Walgreens pharmacies. CVS is making similar investments. At its recent investor day, CVS Health CEO Karen S. Lynch said the company would be expanding services to include primary care, both in person and virtually. Even Dollar General is marketing itself as a health care destination.

Fast Company

 

Reshuffling the pharma supply chain

After witnessing generic drug quality issues during visits to Asian manufacturing facilities and wrestling with dwindling domestic production capacity and foreign pricing fluctuations, family-run Nexus Pharmaceuticals found a solution a half hour north of its Lincolnshire, Illinois, headquarters.

This summer, the company opened a generic specialty injectables manufacturing plant on 16 acres in Pleasant Prairie, Wisconsin, joining the same corporate park as the soon-to-open Haribo gummi bear manufacturing plant, its first in North America.

Founded in 2003, Nexus was 100% virtual, relying on contract manufacturers to produce the drugs they formulated for hospitals and distributors.

But as more pharmaceutical companies began moving manufacturing abroad to capitalize on cheap labor and fewer environmental regulations, Nexus took note of the poor quality and sharp price spikes of drugs made in China and India. Over the last decade, production of most generic injectables has moved to those countries.

"Since 2002, imports from India have increased 35-fold and imports from China 135-fold," Ahmed said.

CIDRAP

Slowing down the game

Players stand inside a giant tent, and footballs are fired at them under different light conditions and at different speeds to help sharpen their response times. The changing light levels manipulate how fast the ball appears to be moving, making it more difficult for the visual system and brain to process a ball’s movement, pushing the delay in processing from 200 milliseconds to 250. That adds a further two metres of “blindness” to any decision an athlete makes.

Initially, that means a lot of getting hit in the head and body by wayward balls you’re unable to react to. Hladký, in his first trials with OKKULO, ended up catching some shots from OKKULO’s ball cannon with his neck. But the body adapts and recognizes it needs to take decisive action earlier. “You're constantly recalibrating your brain to interact with your environment,” says Stockman. The process becomes rewired to the low light levels—which means when you’re back in normal light, time seems to slow down and your brain makes more measured decisions about where a ball’s likely to go. “We make them see six feet better off,” says Mel O’Connor, founder of OKKULO.

Wired UK

 

Patient-centered hospital design

The Hospital of the University of Pennsylvania is one of the most recent examples of this trend in patient-centered design; in October, they opened a new pavilion to house the emergency department and in-patient care for the cardiology, neurology, neurosurgery, oncology, and transplant departments. “One of the things we know is that sleep is really, really critical to healing,” says Reich, who was one of many hospital employees who worked with the architects to finalize the design. So the new more-than-500-room building uses an “onstage/offstage” design to minimize noise and disruption. Private patient rooms are “onstage,” lining the outside of the building. Supply and medication rooms and staff break rooms are “offstage,” clustered in the core. Separating the two reduces noise and gives staff more private space, too. Each nursing specialty is now housed on the same floor, making it easier for nurses to coordinate care instead of having to travel between floors to consult about a patient.

Wired

The Centro Hospitalario Serena del Mar in Cartagena, Columbia

 

The Big, untapped Data of Medical Records

Details on the medical care of hundreds of millions of patients are piling up in electronic health records in clinics and hospitals around the world, comprising a growing treasure trove of real-world data on the daily practice of medicine—patient diagnoses, treatments and outcomes. Hardly anyone has sought to tap the knowledge sequestered in those digital vaults that might benefit future patient care. Until now.

Aided by advances in artificial intelligence, search capabilities and other analytics, researchers are now probing the huge databases for rapid insights into the performance of the healthcare system.

For example, closely held Epic Systems Corp., maker of one of the most widely used electronic health record systems, searched a segment of its database in the spring of 2020 to find that routine breast, colon and cervical cancer screenings in the U.S. had each dropped by more than 85% during the first weeks of the Covid-19 pandemic. The report helped spur efforts to persuade people to make up for missed screenings.

WSJ (sub required)

Here is a cancer specific database from ASCO