As stated in a well-known article, “Gender-specific medicine is the study of how diseases differ between men and women in terms of prevention, clinical signs, therapeutic approach, prognosis, psychological and social impact. It is a neglected dimension of medicine.” Medical research conducted over the past 40 years has focused almost exclusively on male patients.
How men and women are different?
Differences could lead to wrong diagnosis, symptoms underestimation, and even premature death. Differences appear in a variety of domains such as:
PKPD (pharmacokinetics & pharmacodynamics): efficacy and side effects profiles as well as drug-drug interactions.
cardiovascular diseases: risk factors for these diseases; clinical manifestations; influence of drugs (see below for more).
cancer: incidence; aggressiveness and prognosis.
liver diseases: epidemiology and progression.
…
The main goal
The main goal of gender medicine is focused on understanding the differences of patho-physiology, clinical signs, prevention and treatment of diseases equally represented in men and women.
Advocacy
Advocacy in this field is emerging with amazing women like Marianne Legato, Alyson McGregor and Noel Bairey Merz, whose conference and TED Talks below really show the decisive importance of this discipline.
Conclusion
Traditionally, research has been done almost entirely on men and those conclusions were then applied to both men and women. Even though the law requires that women be included in studies, the gender-different results are almost never analyzed. Instead, they are blended. This is detrimental to both men and women. Perhaps now is the time for everything in research and medicine to be reviewed in the light of potentially significant gender differences.
As promised, the summary of the 2nd day. I must admit, it is a bit long but all these topics were fascinating and the speakers really stood out from the “crowd” with excellent ideas. If you do not wish to read it all, just have a look at the headlines by scrolling down and skip to the topic that catches your eye.
With the current trends in demographic development,more than 2 million people in Switzerland will be over 65 in 2050. What does it mean? More surgery as ageing is very often the synonym of diseases.
Surgery is more and more helped by technological tools, especially for complex cases like facial surgery where augmented reality could be really useful. But, technology has to be human centered and it is the moto of Mimedis, a fab lab for surgeons. Together with small interdisciplinary teams, the company focuses on design and manufacture (3D printing) of patient specific bone implants.
The speaker is not only the founder of Mimedis but also the initiator of MedTech Innovation Partners (MTIP), which helps finance innovative medical technologies. MTIP has a clear focus on innovations within health technologies. It offers business building support as well as continuity of funding and its network to accelerate growth.
Nothing has changed fundamentally on how things are cut in surgery. But laser could be extremely helpful, leading to finer and more precise cuts. Plates will need to be smaller and even resorbable.
This technology also makes it be possible to perform functional cuts in order to avoid pain for the patient. It is a complete new thinking about how surgery is executed. No more straight cuts for an improved healing.
Together with enabling technologies, such as navigation and robots holding laser, surgery will be much more efficient with reduced doses of anesthesia and better recovery time.
The surgeon will not be replaced but empowered and the robot will be part of the surgery team.
AOT is dedicated to the development, manufacturing and sales of medical devices for osteotomy pursuing the vision of contact-free bone surgery using laser, robotics and navigation systems to re-invent bone surgery (osteotomy). 3 lasers are built into the system; one of them is a ruler and will measure across the cut. The main product, Carlo, is a robot, currently tested in animal experiments.
Innovation strategy coupled with human-centered design will deliver corporate value. Human-centered design is the primary goal of Erdmann Design.
For human-centered design to produce worthwile results, several and diverse stakeholders are requested to interact and think on how can you help with low tech simple solutions. Stand where problems occurred helps understand better the real context and will generate more relevant solutions.
It is not big data anymore but it is a tsunami of data. Not only text data but pictures, videos, sensor data… and 90% of the data was created in the last 2 years.
How can we use it? What’s in there?
Clinical data only represents 10% of data
Genomics factors reprsent 30%
Exogenous factors represent 60%. What do we mean when we say exogenous factors? It’s the information about lifestyle (diet, sport, smoking,…), behaviors, drug adherence. It is immensely useful when combined with all the other types of information.
Machine vs. Humans?
Humans are the best machine ever because of feelings such as compassion, intuition, design, value, judgement and common sense. No robot or machine is ever capable of such skills. However, machines have huge learning capabilities, especially deep learning (+ machine learning), discovery, large-scale math and fact checking. The last competency is crucial because, as of today, we do not know exactly what’s true on the internet.
The key: Human + Machine – rethink whats possible, what would you do, how could we use it…
Examples:
Memorial Sloan Kettering teams are partnering with IBM to train Watson to interpret cancer patients’ clinical information and identify individualized, evidence-based treatment options that leverage doctors’experience and research. Big data could stimulate the building of knowledge for diseases without current treatment option – what can we do, other medications, which data do we consider,…
Watson will help reduce the time of drug discovery by identifying markers quicker and accelerate the time to market for drug projects.
Cécile Monteil
The impact of technology on the patient-doctor relationship
Talking with patient was key before, science has now made huge progress. From “medicine is art” to “medicine is a science”. As a result, medicine today is taking the human touch away.
For a patient, talking and having explanations about the results of an exam is as important as undergoing an exam. Technology is here to increase the productivity of tasks but the relationship between the doctor and his patient has to stay and to be developed further. The human part of the process is already key in the healing process.
Technology can connect people. Today, technology allows patients to find information and to empower them. Participation in decision-making about treatment options and pathways is relevant for patients. Moreover, smartphone and connected objects can help track patient symptoms and treatment choices. It is used today for Type 1 Diabetes glucose monitoring.
With connected objects it is easier to monitor body parameters. Furthermore, doctors will be informed of those parameters and will be able to act upon.
The patient has to be at the center of care, beyond simply being part of the loop.
New types of expertise will show up, like medical data scientist, care coordinator, prevention doctor, education nurse,… and whole teams will collaborate in order to take care of the patient for better outcomes.
Yesterday, the patient-doctor relationship was compassionate, coordinated, comprehensive, continuous, accessible and family-centered. Today, the change is not only technological but also societal.
Patient-centered care is paradigm change, in which patients would like to be considered a they are and not as animals. A whole new ecosystem is emerging and developing itself.
Between a patient and his/her doctor, very often, there is a nurse. Thus, it is more a patient-nurse system or relationship.
But who is the expert?
It is crucial to visit the right expert that will be able to pose the right diagnostic. Provider empowerment (or nurse empowerment in this case) via technology will free time for the doctor while the nurse will do the consultation and collect the data to send them to the doctor. He will then be able to analyze them and act upon.
An interesting example comes from the dietitians of Canada, following obese patients and being their point of contact or new reference to talk to instead of the doctor.
Technology allows patients to stay connected with healthcare professionals following them. In addition, digital technology makes it possible for healthcare professional to be empowered.
Furthermore, caregivers and relatives can use digital technology as well. For example, Alertwatch is a tool giving relatives access to the localization of the loved one on a GPS map. Needless to say that caregivers will have more serenity, increased freedom themselves and improved information on the patient.
Remote support is complementary to human support without replacing it.
The speaker is the CEO of RetroBrain R&D and trying new approaches promoting people to live healthier. As we all know, it is difficult to incentivize now for long term benefits. The key to have a switch into the behaviors, it to change the way it is percieved: you change your behavior because it is cool and not for long term benefits.
Gamification and videogaming are fundamentally different from the actions you could perform right know. You do not even realize you are changing your own behavior.
How to motivate people? The game is challenging you again and again and when people succeed, they have a dopamine surge. These games influence will stimulate the brain and could delay dementia because of movements, social dimension and brain activity. The game can be personalized with car shapes and music appreciated by the patient.
Scott Smith
New emerging business models connected to the ageing society
The speaker is the founder of Changeist. For him, it is fundamental to look at the macro picture when it comes to ageing.
He took the interesting example of Paro, a companion cuddle robot. It is a seal puppet therapeutic robot. It has been tested is geriatric facilities to help patients cope with multiple diseases such as dementia.
The demographic time bomb challenge is fairly widespread.
Which solutions? Which possibilities?
Full automation, robots helping us, freeing time for more leisure
Designing our future
Human-machine combination – the pairing has to be culturally and socially acceptable
Senior Quantified-Self. These technologies will probably transform the way many families care for their loved ones. Estimated market size USD 14.6 bn in 2019.
California Life Company – Calico. It will help bring new technologies to the market and promote their adoption for a better management of ageing.
Intervention is easy to develop but the scale up is very difficult mainly for economic reasons.
Genotyping is the process of determining which genetic variants an individual possesses. Genotyping can be performed through a variety of different methods, depending on the variants of interest and resources available. For looking at many different variants at once, especially common variants, genotyping chips or arrays are an efficient and accurate option. These do, however, require prior knowledge of the variants you want to analyze.
Sequencing is a method used to determine the exact sequence of a certain length of DNA. You can sequence a short piece, the whole genome, or parts of the genome (such as the “exome,” which are the parts of the genome that contain genes). Depending on the location, a given stretch may include some DNA that varies between individuals, like SNPs, in addition to regions that are constant. Thus, sequencing can be used to genotype someone for known variants, as well as identify variants that may be unique to that person.
With genotyping, we look at SNP. We can then make some predictions with those data. For example: to see whether I will pass some of these genetic characteristics to my children. It is also widely used for ancestry analysis and microbiome exploration.
Why should this data be open?
Snpedia is sharing genomic data and helps determine whether you have higher risk. Connecting data to others can save lives. Big data is needed in this field.
Dna digest is promoting data sharing because of limited publicly available data despite huge sequenced DNA.
Malaria takes it toll on children as 86% of deaths are noted below age 5. Despite the 47% reduction in death since 2000 thank to an UN initiative focused on trying and improving public health in developing countries, the world still needs medicines to tackle the disease.
The traditional model of drug development in silos, obsessed by profitability and shareholders value is not working for developing countries. A reassessment on how we do drug discovery in this field is necessary.
A new model with a public health focus should be developed, like product development partnership. Interesting projcts are selected and funded. Advisors work in close collaboration with partners and open source science experienced.
How do they fund their late stage development candidate? They try to find a willing pharma partner or secure sufficient public funding.
Open Access initiative: empowering research.
20’000 drug discovery starting points have been published, MMV selected 400. They are all commercially available.
Another initiative has been launched in order to enrich the drug discovery database: the Malaria Box. Launched in 2011, it has already been supplied to 30 countries for a total of 218 boxes.
A new project: thePathogen Box, same initiative for neglected diseases to stimulate further research.
There is an ever increasing role of open source in new drug discovery models.
Gernot Abel
Going open innovation and citizen science in biotech
The speaker sees brand new opportunities for collaborative innovation.
How we manage, develop and initiate innovation will shift from traditional to open approaches.
When you create into a community you not only achieve, you exceed what you achieve.
Hackers want to change something and add a new innovation to existing products. The epicenter is both in US and Europe. Novozymes started recently to collaborate with hackers in an open mode. Biologigaragen is an open space for citizen science in biology. In addition, tools are getting cheaper, easier to use and more powerful.
Examples:
Open trons is a USD 3000 full lab available to everyone.
Transcriptic is a a fully automated cell and molecular biology laboratory in the cloud.
SYNENERGENE is a four-years mobilization and mutual learning action plan (MMLAP) supported by the European Commission under the 7th Framework Programme.
Joint value capture is fully present when engaging in open innovation.
For Novozyme, open innovation brings a lot:
Low cost analytical technologies
Evaluation on given technology and opportunities
Insight for business development projects
Spot the next big theme in biotech
Societal impact and mutual learning cycles
Last but not least – a fantastic lesson on how to engage in open innovation.
I had the fantastic opportunity to attend the annual Lift Basel Conference at the end of October. The topics covered as well as the speakers were amazing.
I must admit, it is always refreshing to have access to all those passionate people with jaw-dropping experiences, new companies, innovative business models, renewed thinking (totally out of the box! even without the box!!)…
I really appreciated it and I’m delighted to share the main points with you, one talk at a time with added references on the discussed topic. I hope you’ll enjoy the first day! The second one is coming soon.
Rob Carlson is interested in the future role of biology as a human technology. He has worked to develop new biological technologies in both academic and commercial environments, focusing on molecular measurement and microfluidic systems. He has also developed a number of new technical and economic metrics for measuring the progress of biological technologies.
Rob Carlson has been precisely predicting exponential drops in the costs of DNA sequencing and synthesis (reading and writing DNA), and resulting impacts on the global economy. The Economist magazine in 2006 identified this as the biotechnological equivalent of Moore’s Law, and named it the Carlson Curve after Rob.
It was extremely interesting to see him explaining that, in biology, every piece has its purpose and, then, it can be repurposed. Needless to say, synthetic biology has evolved fantastically over time, from a single gene in a single cell to cell-grown organs as shown in the Nature chart below.
Biotechnology will soon take over the other segments of the economy, like chemicals, energy generation,… Biochemicals are already competing today with oil chemicals. According to the last numbers recently published, biotechnology is the fastest growing field in the US economy. Economics are at the center as they are really driving the adoption of those technologies.
“The promise of synthetic biology lies in its engineering roots. Engineers are trained to define, modularize, stan-dardize, characterize, specify, optimize, and control physi-cal systems in order to deliver reliable, repeatable outcomes. When such approaches are applied to biological experimentation, the results can be marvelous. When measurement systems and data are standardized and qualified, then biological knowledge can be stacked upon other knowledge in an information supply chain distributed across hundreds of thousands of people. If we standardize and improve the quality of biological characterization, then the tools for efficiently designing and building ever more complex systems will soon follow.”
Neil Goldsmith
New food ingredients into custom-built organism
Nature has treasures but sometimes we need huge amounts of raw materials to extract flavors or fragrances in tiny quantities. For example, vanilla is regularly made from petrochemicals and rarely extracted from vanilla seed pods as demand is far larger than supply.
Evolva developed a revolutionary technology to brew flavors from yeast.
For example, to manufacture Stevia, a natural sweetner, Evolva takes the genes the plant uses to make that molecule and put those genes into the yeast so it can make the molecule. They then ferment the yeast by brewing, just like with beer. The yeast takes up the sugar, turns it into Stevia and pumps it out; the yeast is filtered off and Stevia is in the «broth» which can be purified out.
Synthetic biology is an iterative process. It is not smooth, you need to go back and forth at each step. However, it has and will lead transformational changes on today’s science.
According to Xavier Duportet, editing DNA has become as simple as editing a newspaper. It is now possible to modify the DNA with a repair template.
That’s exactly what he’s doing: using CRISPR/Cas for the microbiome engineering. As we all know, antibiotics are not an adequate solution as they kill all the bugs… Bad and good ones. Eligo Bioscience, founded in May 2014 by Xavier Duportet as well as scientists and professors from the Rockefeller University and the Massachusetts Institute of Technology (MIT), found a fantastic way to tackle this issue: hijack the CRISPR/Cas system of the bacteria. Below a video (in French) explaining the technology.
Their “synthetic biology platform, which combines CRISPR/Cas system with engineered phage capsids, develops “eligobiotics”: a new generation of highly precise antimicrobials. They can program the eligobiotics to eliminate bacteria based on the genetic sequences they carry in their genome. As opposed to traditional antibiotics, their sequence-specific antimicrobials can therefore discriminate between close bacterial strains and selectively eradicate harmful bacteria from the microbiome while sparing the beneficial ones.”
Eligo Bioscience is also working on other diseases such as inflamatory bowel disease, acne. The company owns an exclusive license for the use of CRISP in the antibacterials field.
Reto Schnyder expects major disruption in food, especially in the field of business models.
We spend a lot of money on food. The consumer behavior is really changing. More and more online grocery shopping is used, as demonstrated by huge growth rates as well as booming household penetration rates.
Companies are trying hard to stimulate purchases and expand their reach. AmazonDash on AmazonFresh is a wonderful example of what can be done.
Amazon is definitely good at understanding big data and will not put somthing stupid in your basket, it will always suggest you new products to try.
Several other examples help us to understand the changes taking place in the food industry such as HelloFresh, June Intelligent Oven,…
Cooking good food is easier and easier. And this is just the beginning.
Before the food industry structure was: brands – shop – cook. But now the ranking has changed: cook – shop – brands!
In the cosmetics and toiletries industry, the shaving blades domain has been completely shaken by outsiders, like Dollar Shave Club and Harry’s Blades. They put in place subscription services and Dollar Shave Club took over 10% market share in units in USA.
Lesson learned: easy to attack global power brands as they are not invincible.
Wisdom: how can we make our cash cow irrelevant? Disrupt the market before other companies do it.
How can drones can provide wings to farmers? The use of drones, coupled with analytical tools, could help farmers make better decisions.
Field analysis on foot is only giving a partial view of the crops. With a new software technology, Pix4D, it is possible to “automatically process terrestrial and aerial imagery acquired by light-weight drones or aircraft based purely on image content. This desktop software converts images into highly precise, timely and customizable results for a wide range of GIS and CAD applications.”
Experiments and tests are implemented in order to optimize yields. The systems are also helping to decide when and where to start the harvest.
Moreover, it is incredibly useful to detect diseases early by identifying spectral signatures. With the use big data and re-engineering, close monitoring is now feasible. Flight plan is defined in advance in order to optimize which data to record. Sensefly is targeting multiple industries like agriculture, mining, humanitarian, environmental protection. Vitiscan is fully dedicated to vineyards.
Those technologies and their applications will lead to more transparency on which species to seed, which and how much fertilizers allowing for better quality and quantity of crops as well as improved variety.
“Design Thinking is a human-centred approach to innovation that draws from the designer’s toolkit to integrate the needs of people, the possibilities of technology, and the requirements for business success.”
Tim Brown, president and CEO, IDEO
There is no need to say more than the definition given by Tim Brown. It is really self-explanatory.
When it comes to scientific method, the approach is different.
In this way of thinking, you try to understand first, then hypothetize and start data collection, once it’s done you can analyze data and select some criteria. Ultimately, you can ask for peer review and then publish your work.
Neither of these methods serve as a path for the solution to more societal problems. It is then fundamental to combine both of them with system thinking and action. Transdisciplinarity is another crucial component toward solutions.
The main message of the talk was: “Whatever you produce and send to the society has an impact on the society itself. It is crucial to develop self-awareness and impact analysis of actions on society.
In the TED talk below, he takes us through a fantastic journey about the future of medicine and how it could change soon.
Medicine started with simple principles, such as have disease, take pill and kill something. It worked and is still functioning as of today for specific diseases. However, the future is elsewhere.
The natural world gives us some clues about how one might think about illness. In fact, the natural world is organized hierarchically upwards, not downwards. It begins with a cell that give rise to self-regulating, semi-autonomous units called organs, and these organs coalesce to form humans, and these organisms ultimately live in environments.
Siddhartha Mukherjee takes the example of cancer. To tackle this disease, we started to kill cells with chemotherapeutic agents and targeted therapies, then we realized that it would be a nice idea to harvest the immune system in the war against cancer. This gave birth to immuno-oncology drugs bringing extraordinary outcomes to patients. The next step is to change the environment but it is much more challenging…
Stem cells are also part of the solution according to Siddhartha Mukherjee. However, it raises tons of questions… as what’s at stake is not killing something, but growing something. This means that we need to think upside-down and shift our views as well as our traditional thinking.
Could your medicine be a cell and not a pill?
How would we grow these cells?
What we would we do to stop the malignant growth of these cells? Could we implant suicide genes into these cells to stop them from growing?
Could your medicine be an organ that’s created outside the body and then implanted into the body? Could that stop some of the degeneration? What if the organ needed to have memory?
Could your medicine be an environment? In every culture, shamans have been using environments as medicines. Could we imagine that for our future?
It is very often said that the reason we haven’t had the transformative impact on the treatment of illness is because we don’t have powerful-enough drugs, and that’s partly true. But perhaps the real reason is that we don’t have powerful-enough ways of thinking about medicines.
“When everything is connected to everything else,for better or for worse, everything matters.” Bruce Mau
From natural ranking order to network relationships, data visualization has always been present even in the early ages of humanity. However, that wish to classify and find an order is actually not relevant anymore in today’s world. Linear relationships cannot show what networks can communicate and promote: those notions of decentralization, interconnectedness and interdependence.
It is fascinating to see that this web architecture is widespread to several fields like knowledge, history, social ties between people, online social collaboration, terrorism, life sciences, species, ecosystems…
“This metaphor of the network, is really already adopting various shapes and forms, and it’s almost becoming a growing visual taxonomy. It’s almost becoming the syntax of a new language. And this is one aspect that truly fascinates me. And these are actually 15 different typologies I’ve been collecting over time, and it really shows the immense visual diversity of this new metaphor,” highlighted Manuel Lima.
Having an understanding of complex systems, with the support of IT technology, is crucial today as any decision could have unexpected effets.
Accelerating the path to market for drugs is the dream of many scientists. Reality is closer than you think…
A Financial Times article (subscription required) highlights this breathtaking innovation that could revolutionize the life sciences world.
“These new organs on chips will enable scientists and researchers to mimic responses to drugs and treatments in human tissue without recourse to animal or human testing”.
It will enable researchers and pharmaceutical companies to spend less time and money in animal models as well as in human clinical trials. It will also accelerate the development and allow patients to be provided with the needed drugs sooner than ever before.
Human organ on a microchip has won the 2015 Design Museum’s Design of the Year contest. Thought and developed by a cross-disciplinary team of researchers led by D. Ingber and D. Dongeun Huh at Harvard University’s Wyss Institute, this chip is able to mimick several different types of organs. By using it, it will also be possible to see whether a patient would respond or not to treatments. Personalized medicine will be more precise and more targeted. Additionally, multiple chips can be connected to play the role of the human body.
Have a overview of the technology in their 2-minute video presentation:
Go deeper into this amazing technology and its potential application with the TEDx Boston talk by Geraldine Hamilton:
Needle phobia is quite common but may be soon part of history!
Approximately 20% of the population don’t like to be jabbed with a needle… Students from Rice University found a solution by inventing the Comfortably Numb, a new device that makes getting an injection practically painless.
Have a look at how it works with this video:
The cost could be an issue but with scale-up production it could go down significantly (USD 2 per piece today vs USD 0.35 for syringe with needle). The extra cost is worth it, especially for people afraid of needle like children for example.
Affordability is one of the key word coming back every time we speak about cancer drugs. This time, oncologists are joining the cancer price revolt. The Mayo Clinic published a 4-minute video really worth watching and an article detailing all the points where oncologists can act upon.
Cancer care is not only the issue for the patient but for all the stakeholders (doctors, healthcare providers, insurances, governments, relatives,…). We all need to team up to find solutions. Mayo Clinic is giving us a starting point.
A very interesting discovery made by Dr. Martin D. Burke, a professor of chemistry at the University of Illinois at Urbana–Champaign. Why is it a revolution?
The traditional way of synthesizing small molecules requires a step-by-step series of chemical reactions–a process that is time-consuming and which requires enormous expertise. The new printer simplifies the molecule-making process and makes it accessible to non-chemists.
It’s a concept called “herd immunity,” and it relies on a critical mass of people getting their shots to break the chain of infection. Health researcher Romina Libster shows how herd immunity contained a deadly outbreak of H1N1 in her hometown.
Today we have TOOLS (vaccines) that can protect the lives of the most vulnerable people. Why some people still refuse to use them?
Rob Knight is a pioneer in studying human microbes, the community of tiny single-cell organisms living inside our bodies that have a huge — and largely unexplored — role in our health. “The three pounds of microbes that you carry around with you might be more important than every single gene you carry around in your genome,” he says. Find out why. Human microbiota (Wikipedia entry)Rob Knight’s Lab
Lillian Pravda was born with a cataract and endured several surgeries. The more time she spent in the hospital, the more she learned not all children were as fortunate as she was to have access to care. At age 8, Lillian set out to help children in need of sight-saving eye surgeries and vision services, making sure they would get the care they need and deserve.
