March-April 2017
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Serving the region for over 40 years January - February 2023
In the News
• Scientists uncover novel biomarker to detect Alzheimer’s in blood
• New surprisingly potent receptor ‘decoy’ drug deactivates Covid-19 virus and variants
• MBRU research team awarded grant to investigate subtypes of type 2 diabetes
• WHO and partners launch One Health Joint Plan of Action
Cardiology
Researchers discover new
immune target to treat CVD
Digital marker first to map CVD
characteristics on a spectrum
ARAB HEALTH 2023
Preview
Innovation
New cellular ‘glue’ developed
to regenerate tissues,
heal wounds, regrow nerves
Radiology
Scientists integrate
dark-field X-ray with CT
MIDDLE EAST HEALTHI 3
Serving the region for 40 years January - February 2023
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Prognosis
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Middle East Health is an official media partner to the Arab Health trade
show taking place at the Dubai World Trade Centre from 30 January
to 2 February 2023. This year’s show looks set to be a big one as Covid
restrictions are no longer in place. The organisers say they are expecting
more than 3000 exhibitors from more than 70 countries. MedLab,
which is now a separate event to be held from 6-9 February, sold out all
their available exhibition space two months ahead of the show – this,
even though the organisers expanded the available space. We trust they
will be productive events for everybody.
In this issue we look at two recent studies in cardiology. The first looks
at a protein called soluble urokinase plasminogen activator receptor, or
suPAR, which is shown to be a cause of atherosclerosis and could be a
potential target for future treatment for cardiovascular disease. In the
second study, researchers show how they have used machine learning to
develop a digital marker for coronary artery disease that is the first such
marker to map the characteristics of CAD on a spectrum.
We also look at several recent groundbreaking studies in our Laboratory
News section. One, in particular, has important implications for
Alzheimer’s disease and looks at the development of a novel biomarker
that can detect the disease in blood. Currently, diagnosing Alzheimer’s
disease requires neuroimaging.
In local news, researchers at Mohammed Bin Rashid University of
Medicine and Health Sciences in Dubai have recently been awarded
significant funding to investigate the subtypes of type 2 diabetes, which
has an exceptionally high prevalence in the UAE. The aim is that this
will help enable scientists to develop precision medicine for the disease.
Remember to keep an eye on our website – www.MiddleEastHealth.com
– where we regularly post interesting new developments in research as
well as healthcare news from the region.
We wish all our readers and advertisers a healthy, happy and
prosperous 2023.
4 IMIDDLE EAST HEALTH
contents
NEWS
6 Middle East Monitor
12 Worldwide Monitor
16 The Laboratory
Serving the region for 40 years January - February 2023
FOCUS
EXPERT VIEW
EXPOS & CONFERENCES
FINAL PAGES
www.MiddleEastHealth.com
22 Cardiology: Physician-scientists discover new immune
target to treat cardiovascular disease
24 Cardiology: New digital marker for coronary artery disease
is first to map characteristics of CAD on a spectrum
28 Cardiology: Gene therapy corrects mutation responsible
for dilated cardiomyopathy
44 Radiology: Researchers integrate dark field X-ray with
conventional CT technology
46 Radiology: PET technology more effective than
angiogram at determining need for coronary stents,
bypass surgery
48 Radiology: More frequent CT scans not associated with
improved outcomes after lung cancer surgery
52 Demand for mental health services grow across the Middle East
56 MedTech trends for 2023
82 Working to a healthier future
58 Arab Health preview
86 On the Pulse
94 Innovation in Healthcare
96 The Back Page
08
44
88
17
28
6 IMIDDLE EAST HEALTH
During the recent Healthcare Protective
Shield Wargaming Conference, the Department of Health – Abu Dhabi (DoH),
used simulated cyber incident response
scenarios to help prepare healthcare facilities in Abu Dhabi for cyber threats by
evaluating the effectiveness of their incident response and communication plans.
Hosted in Abu Dhabi as the first-ofits-kind in the region, the conference was
organised in collaboration with the Cyber
Security Council with the participation
of ten of the biggest healthcare groups of
Abu Dhabi, representing more than 370
entities. The Cyber wargaming conference
focused on assessing the sector’s preparedness to handle cyber challenges and pinpoint recommendations and best practices,
with the aim of ensuring the readiness of
the sector and continuity of care.
The event saw DoH showcasing its efforts
in the digitisation of healthcare services and
emphasised the importance of strong data
security to protect patient data and sensitive
information. Additionally, it covered a simulation of the Department’s Medical Operations Command’s (MOC) “Information SharGuy’s and St Thomas’ Private Healthcare
ing” and “Patient
Transfer Module”
in the Estijabah
Platform. The
module is used
to facilitate patient evacuation
from one healthcare facility to
another in order
to ensure an uninterrupted continuity of care
delivery to patients.
Dr Jamal Mohammed Al Kaabi, UnderSecretary of the Department of Health
– Abu Dhabi (DoH), said: “Under the
directives of our wise leadership, we are
continuously working on developing the
healthcare ecosystem in the emirate for it
to become one of the most innovative systems in the world through digital services.
Accordingly, we understand that advances
in technology entail that we provide the
highest levels of protection to patients’ privacy. This event creates an opportunity to
explore and discuss all possible solutions to
combat cyber incidents in accordance with
international standards and best practices.”
middle east monitor
Update from around the region
Department of Health –
Abu Dhabi boosts sector’s
preparedness for cyber attack
Dubai-based Emirates International
Accreditation Centre (EIAC) has received endorsement from the International Society for Quality in Health
Care External Evaluation Association
(ISQua EEA) for its Accreditation
Standard for Healthcare Providers.
The recognition was given after the
External Evaluation Award Committee (EEAC) of ISQua EEA conducted
a comprehensive independent assessment of the EIAC Accreditation Standard for Healthcare Providers.
EIAC is the world’s first organisation to
be accredited by the ISQua for a healthcare accreditation standard covering hospitals, clinics, day surgery centres, fertility centres, home health services, medical
tourism, and tele-health services.
The achievement further reinforces Dubai’s
status as a regional and global hub for healthcare and medical tourism and paves the way
for the development of a unified set of healthcare service standards in the UAE.
EIAC fulfilled 98.4 percent of criteria
in the evaluation conducted by the ISQua
EIAC receives international recognition for its healthcare accreditation standard
EEA. The evaluators noted EIAC’s extensive coverage of healthcare sectors and
institutions and the diversity of EIAC`s
quality parameters that cover not only patient rights but also health escorts, visitors,
and healthcare personnel.
Amina Ahmed Mohammed, Executive
Director of EIAC, said: “EIAC seeks to
contribute to the leadership’s vision to ensure the UAE and Dubai’s healthcare sector maintains the world’s highest standards.
By monitoring compliance with legislation, decisions and regulations, conducting
Mohammed Hamad Al-Kuwaiti, Head
of Cyber Security for the Government of
the UAE, noted that the Cyber Security
Council is building a safe and resilient infrastructure for cybersecurity in the UAE.
In addition, it is promoting a culture of
cybersecurity among institutions and individuals. He explained that the Cyber Security Council embodies the forward-looking
vision of the UAE leadership and the country’s proactive approach in dealing with the
various challenges posed by the fast-paced
development of digital technologies.
Globally, the healthcare sector is a frequent target for cyber-attacks due to the
sensitivity and value of patient information,
which is sold and used in identity theft.
site visits to audit and evaluate services, as
well as setting the right specifications, we
work to ensure healthcare services meet
the highest international standards. EIAC
also seeks to lead the development of these
standards to further enhance the UAE and
Dubai’s global pre-eminence in the field of
quality management and enable the public to obtain the best possible services in a
wide range of healthcare fields.”
The ISQua EEA recognition enables
EIAC to further raise the global profile of
its healthcare accreditation services. Currently, over 1,000 conformity assessment
bodies in more than 40 countries use EIAC’s accreditation services.
This international recognition is the
culmination of the extensive efforts of EIAC’s officials in cooperation with a group
of diverse Emirati medical professionals
and experts from various local and international healthcare organisations.
In addition to the latest endorsement
from ISQuaEEA, EIAC is recognised internationally by the International Laboratory Accreditation Cooperation (ILAC)
to provide accreditation for different types
of laboratories and inspection bodies.
The Jameel Clinic, the centre of artificial
intelligence (AI) in healthcare at the Massachusetts Institute of Technology (MIT),
co-founded by MIT and Community Jameel in 2018, in partnership with Wellcome, has launched the Jameel Clinic AI
Hospital Network, a new initiative which
aims to roll out clinical AI tools at 35 hospitals across eight countries, including Mexico, India and Taiwan. The network is supported by the Jameel Clinic and Wellcome.
In countries with low-resourced health
systems, hospitals and public health agencies are increasingly strained by emerging health challenges, including climate
change, sedentary lifestyles, as well as a
number of issues due to increased life expectancy, resulting in a rise in non-communicable, neurodegenerative, and infectious diseases. The past decade has seen
significant breakthroughs in clinical AI
technologies in all areas of clinical care,
including risk assessment and diagnostics,
treatment personalisation, and the prediction of outcomes. If adopted into everyday
clinical practice, these technologies have
great potential to save lives, improve quality of care, and control costs for clinical
care institutions.
Central to the missions of both the
Jameel Clinic and Wellcome is a commitment to ensuring new healthcare
technologies are developed and deployed
equitably, including in low- and middleincome countries. The broad deployment
and testing of AI technologies through the
Jameel Clinic AI Hospital Network will
offer hospitals free-of-charge access to a
repository of cutting-edge AI tools as they
mature sufficiently to become integrated
into the clinical pipeline.
The tools deployed will cover a range
of clinical applications, allowing hospitals
to select the ones relevant to their needs.
The network seeks to develop procedures
for the safe and effective deployment of AI
tools in specific clinical contexts, test AI
tools to ensure equitable health outcomes,
and refine tool development to optimise
their clinical utility.
In addition to the AI tools, which will
span multiple therapeutic areas, the network will also offer backline support to
the hospitals’ IT networks and access to
support, resources, and partners through
the Jameel Clinic. The Jameel Clinic will
further facilitate all stages of deployment,
from IT support to educating physicians
about clinical AI. This process will allow
the Jameel Clinic to collect critical feedback on adoption, ease of use, and usefulness of these algorithms in real-world contexts. The hospitals’ clinicians will utilise
the AI tools in compliance with patientrelated regulations and provide feedback
on the application of the AI tools and
their utilisation in real-life clinical settings, including statistics on usability, error
rate, and user comments.
Commenting on the newly launched
network, Professor Regina Barzilay, AI faculty lead at the MIT Jameel Clinic, said:
“With machine learning, we have the capacity to bring about truly transformative
change in healthcare and that can only
happen if we effectively deploy machine
learning models in real-world settings,
into hospitals and medical centres with
clinicians and patients. Building a robust
coalition of researchers, clinicians, hospitals, and public health actors is critical
to realizing the benefits of major advances
in machine learning in the detection and
treatment of diseases.”
Tariq Khokhar, head of data for science and health at Wellcome, said: “In
recent years, there’s been a proliferation
of AI tools in health – a trend that only
increased during the pandemic. But many
of them have not been rigorously tested in
diverse clinical settings with patients from
different backgrounds. This will be crucial
to making sure tools are effective and contribute to better health outcomes. We’re
delighted to support the Jameel Clinic AI
Hospital Network, to develop methods to
roll out clinical AI tools in safe and effective ways, ultimately improving people’s
health and saving lives.”
Jameel Clinic at MIT and Wellcome launch Jameel Clinic AI Hospital Network
Amina Ahmed Mohammed,
Executive Director of EIAC
MIDDLE EAST HEALTHI 7
8 IMIDDLE EAST HEALTH
A team of researchers at Mohammed
Bin Rashid University of Medicine and
Health Sciences (MBRU) and clinicians
from Dubai Diabetes Center, Dubai Hospital, and Kings College Hospital Dubai
have received almost AED 1 million
(US$272,000) from Sandooq Al Watan,
as a research grant to pursue precision
medicine research for type 2 diabetes.
Over the next three years, Dr Riad
Bayoumi, Professor of Basic Sciences at
MBRU, and his team of five researchers at
MBRU will work alongside the clinicians
to investigate and classify subtypes of type
2 diabetes. They hypothesize that if distinct subtypes of type 2 diabetes are identified, then clinicians can identify characteristics of the disease leading to treatment
strategies that are specific to an individual
patient.
Funding by Sandooq Al Watan, a private UAE philanthropic organization with
a significant endowment to invest and
support innovative researchers and organizations, will allow the team to research,
develop, and deploy precision medicine for
type 2 diabetes patients in the UAE. The
aim of precision medicine is to customize
the diagnosis, treatment, and aftercare of
an individual rather than deploying a one‐
drug‐fits‐all model. In similar studies, precision medicine has resulted in significant
improvements to the diagnosis and management of cancer patients.
“In the Middle East, 11% of adults suffer
from type 2 diabetes. in the UAE, almost
one in every five adults is affected,” commented Prof. Bayoumi. Over the past few
years, the SALAMA Hospital Information
System of the Dubai Academic Health
Corporation has registered data from
30,000 type 2 diabetic patients, Emiratis
and expatriates, in the UAE. Using this
database, researchers have applied an artificial intelligence system to identify patterns in certain pathophysiological traits
to create subtypes of the disease. The study
will attempt to identify these subtypes of
Type 2 diabetes using data-driven methods
and machine-learning algorithms in a cohort of patients with extensive clinical and
genomic variables.
“This will bring us closer to precision
medicine in diabetes, where a patient will
receive the right treatment that fits his
condition,” added Prof Bayoumi.
Yasser Al Garagawi, Director General
of Sandooq Al Watan, noted that “the
decision of the Board of Directors of Sandooq Al Watan chaired by His Excellency
Sheikh Nahyan bin Mubarak Al Nahyan
to provide this grant to MBRU stems from
Sandooq Al Watan’s appreciation for the
great efforts undertaken by the University
in the field of applied scientific research,
which strengthens the UAE’s position in
this field.”
“Sandooq Al Watan is keen to support the
UAE’s researchers in all fields to enhance
creativity and innovation. We wish the researchers the best in taking this potentially
life-changing research forward,” he said.
MBRU research team
awarded grant to
investigate subtypes of
type 2 diabetes
MBRU research team
Dr Riad Bayoumi, Professor of
Basic Sciences at MBRU
Mubadala Health has launched a pilot programme that supports parents across the
emirate of Abu Dhabi, in collaboration
with Abu Dhabi Early Childhood Authority (ECA), furthering its commitment to
safeguard and support the physical and
mental well-being of parents and children.
This pilot programme focuses on ‘Community Awareness and Child Development
Knowledge’ and is a key component of the
Abu Dhabi Integrated Early Childhood
Intervention System Framework.
The pilot programme aims to address the
needs and rights of all children in the emirate of Abu Dhabi, regardless of income level, geographical location, or gender; along
with boosting positive outcomes for children by educating parents on important developmental milestones and how they can
support their children in achieving the best
developmental outcomes during these milestones. The programme will leverage the
national vaccination schedule to increase
awareness and understanding about any
Mubadala Health and Abu Dhabi Early Childhood Authority establish
pilot programme to support parents and children
t
MIDDLE EAST HEALTHI 9
10 IMIDDLE EAST HEALTH
developmental delays and the importance
of early intervention, along with tracking
developmental progress for the appropriate age range and encouraging parents with
concerns about their child’s development to
seek guidance as early as possible.
The second phase of the programme will
see the launch of a ‘Child Healthline’ that
will be operated by Abu Dhabi Telemedicine Centre, a Mubadala Health Partner.
This helpline will provide immediate support to parents or caregivers who have concerns about their child’s development, by
providing them with the required healthcare services. Parents will also be provided
with the resources essential to foster their
child’s development and enhance awareness of their child’s changing developmental needs. These services range from tips on
how to play with children to guidance on
when and how to introduce solid foods to
infants. The dedicated children’s support
helpline will be resourced by trained and
qualified nurses who will provide support
and guidance to parents and assist in scheduling appointments if there are any concerns or problems that need to be resolved
quickly with medical interventions.
H.E. Sana Mohamed Suhail, Director-General of Abu Dhabi Early Childhood Authority (ECA), said: “Together with our partners
at Mubadala Health, we aim to raise parents’
awareness about the child’s key developmental milestones and the importance of early
intervention, as well as enabling them to detect any developmental disorders or delays,
and encouraging them to talk about their
concerns with healthcare professionals early
on; in order to ensure that the child receives
accurate and early diagnosis and access to appropriate intervention services.”
Suhail stressed that the lack of awareness
and understanding among parents regarding
their children’s development journey and
how to identify potential difficulties can be
a barrier to children’s timely access to early
intervention services. This programme will
contribute to improving the parents’ confidence and knowledge of the signs of proper
development of their children, and enable
them to access experts and formal sources
of information related to child growth and
development, in order to support the proper and healthy development of all children
during early childhood.
Commenting on the partnership, Hasan
Jasem Al Nowais, Chief Executive Officer of Mubadala Health, said: “Mubadala
Health is taking another significant step in
support of families across Abu Dhabi, by
launching pilot programmes that explore
ways to safeguard and support the emotional, psychological and physical wellbeing of parents and children. This is just
one of the many initiatives we are working
on in collaboration with Abu Dhabi Early
Childhood Authority to secure a bright
future for parents and children in the
emirate, by leveraging the expertise and
capabilities of our world-class network of
healthcare assets.”
The outcomes of the pilot programme
will bolster research and provide contemporary evidence on how to best support
parents as they navigate parenthood.
Agung Pandit Wiguna/Pexels
The UAE Ministry of Foreign Affairs and
International Cooperation (MoFAIC) has
signed a Memorandum of Understanding
(MoU) with International SOS to foster
cooperation and partnership in the field
of providing healthcare services to UAE
nationals abroad, in order to achieve MoFAIC’s strategic objectives to deliver proactive services for nationals abroad.
The MoU was signed on 28 December by Faisal Issa Lutfi, Assistant
Undersecretary for Consular Affairs,
representing MoFAIC, and Katherine
Brett, General Manager representing
International SOS, in presence of several
officials from both parties.
The MoU includes the provision of
medical advice, the implementation of
medical evacuations, and support in the
treatment of critical medical cases of nationals. This will contribute to expediting
the procedures for the transfer of patients
to the UAE to be completed within only 6
hours from the hospitalisation of national
patients abroad.
To ensure cooperation and strengthen
the partnerships with institutions in the
framework serving the nationals’ interest,
MoFAIC collaborated with health facilities in the UAE to provide healthcare
services for nationals who have been
medically evacuated.
MoFAIC worked with the Ministry
of Health and Prevention to activate
a unified mechanism to handle emergency medical cases of UAE nationals
abroad through coordination with the
UAE representative missions abroad.
• MoFAIC has launched an emergency line to respond to emergency reports
of UAE nationals abroad, by contacting
the following number: 0097180024.
UAE ministry signs MoU with International SOS to facilitate medical evacuations of nationals
MIDDLE EAST HEALTHI 11
Sharjah Ruler directs
establishment of
mental health facility
Sheikh Dr Sultan bin
Mohammed Al Qasimi, Ruler
of Sharjah and Member
of the UAE Supreme
Council, on 21 December
directed the establishment
of a facility dedicated to
the treatment of mental
illnesses. His Highness said
that the facility should
perform semi-custodial
work for mental patients.
He said it should provide
psychological and physical
monitoring of patients as
one of the centre’s primary
responsibilities.
Zimmer Biomet, a global medical technology company, has opened a new innovation
hub at Dubai Science Park to showcase its
advanced technologies, surgical robotics
and implants to healthcare customers.
“Our customers can now get close to our
solutions and better understand how Zimmer Biomet’s technology and data can improve healthcare efficiency and patient outcomes,” said Wilfred van Zuilen, President,
Zimmer Biomet EMEA.
In January 2022, Zimmer Biomet opened
a new office in Dubai to serve increasing demand from hospitals and clinics in the Middle
East, North Africa and Turkey (MENAT).
“Zimmer Biomet’s Dubai Innovation
Hub is the next step in our investment in
the region, and it demonstrates our commitment to helping customers maintain
momentum during a transformative period
in healthcare,” said Erik Antos, Vice President, Zimmer Biomet Emerging Markets.
“At the Dubai Innovation Hub, customers will learn more about the increasing
expectations of patients for personal and
connected digital experiences, and how
we deliver data-driven insights that help
increase efficiency, alleviate pain for patients, and improve the quality of life for
people around the world,” said Antos.
A central part of the company’s offering, ZBEdge, combines multiple Zimmer
Biomet technologies, implants and services to offer a unique medtech platform
in orthopaedics.
Farah Hamdan, General Manager, Zimmer Biomet MENAT, said: “ZBEdge, Zimmer Biomet’s suite of integrated digital
technologies, robotics, implants and consultancy services now have the power to
work together, gathering and sharing data
across the whole patient pathway.”
In the pursuit for optimized care, surgeons
and care teams can make decisions for individual patients with data-derived clinical insights and precise technologies, in the operating room and at every other phase of care.
ZBEdge can help to improve efficiency by
connecting technologies, streamlining communication and automating workflows. Care
teams benefit from real-time understanding of
their hospital’s performance and are in a better position to realize opportunities to unlock
efficiencies and optimize outcomes.
Zimmer Biomet opens innovation hub at Dubai Science Park
worldwide monitor
Update from around the globe
12 IMIDDLE EAST HEALTH
2022 was a busy and productive year for
WHO’s One Health Initiative. Key to its
efforts was the launch of the One Health
Joint Plan of Action with the other Quadripartite members, the Food and Agriculture Organization of the United Nations
(FAO), the United Nations Environment
Programme (UNEP), and the World Organisation for Animal Health (WOAH).
The plan integrates systems and capacity to collectively better prevent, predict,
detect, and respond to health threats. Ultimately, this coordination should improve
the health of humans, animals, plants, and
the environment, while contributing to
sustainable development.
The plan was launched on 18 October
2022, during a joint event at the World
One Health Joint Plan of Action launched
Health Summit in Berlin, hosted by the Federal Ministry for Economic Cooperation and
Development (BMZ), the Deutsche Gesellschaft für Internationale Zusammenarbeit
(GIZ), the Museum für Naturkunde and the
Foundation Healthy Planet-Healthy People.
It was then presented at the biennial
World One Health Congress, held in
Singapore in November. The focus of
that conference was on how One Health
could support the Covid-19 recovery by
integrating science, policy, and clinical practice. The pandemic has spurred
many governments to look for guidance,
and the One Health Joint Plan of Action
is providing them with a framework in
which to move forward.
Breaking the silos that exist between
sectors and disciplines will require innovative approaches and strengthening of
social, administrative, scientific, economic
and political will. Greater investment in
applied and multidisciplinary implementation research, including in social behaviour change across the spectrum from
building new knowledge to piloting and
scaling is needed to enable sustainable,
locally relevant scientific and evidencebased interventions that channel scientific
inquiry toward positive change.
The Quadripartite is currently developing an implementation framework to operationalize the One Health Joint Plan of
Action at all levels and to support countries to establish or further strengthen
their One Health systems and capacities. t
Member States of the World Health Organization on 8 December 2022 agreed to
develop the first draft of a legally binding
agreement designed to protect the world
from future pandemics. This “zero draft” of
the pandemic accord, rooted in the WHO
Constitution, will be discussed by Member
States in February 2023.
WHO Member States agree to develop zero draft of legally binding pandemic accord
One Health is an integrated, unifying approach to balance and optimize the health
of people, animals and ecosystems. It uses
the close, interdependent links among
these fields to create new surveillance and
disease control methods.
For example, the way land is used
can impact the number of malaria
cases. Weather patterns and humanbuilt water controls can affect diseases
like dengue. Trade in live, wild animals
can increase the likelihood of infectious diseases jumping over to people
– called disease spillover.
The COVID-19 pandemic put a spotlight on the need for a global framework
for improved surveillance and a more
holistic, integrated system. Gaps in One
Health knowledge, prevention and integrated approaches were seen as key
drivers of the pandemic. By addressing
the linkages between human, animal
and environmental health, One Health
is seen as a transformative approach to
improved global health.
Key facts
• The health of humans, animals,
and ecosystems are closely interlinked.
Changes in these relationships can increase the risk of new human and animal diseases developing and spreading.
• The close links between human,
animal and environmental health demand close collaboration, communication and coordination between the
relevant sectors.
• One Health is an approach to optimize the health of humans, animals and
ecosystems by integrating these fields,
rather than keeping them separate.
• Some 60% of emerging infectious
diseases that are reported globally come
from animals, both wild and domestic.
Over 30 new human pathogens have been
detected in the last 3 decades, 75% of
which have originated in animals.
• Human activities and stressed ecosystems have created new opportunities
for diseases to emerge and spread.
• These stressors include animal trade,
agriculture, livestock farming, urbanization,
extractive industries, climate change, habitat fragmentation and encroachment into
wild areas.
To implement One Health, major structural changes are required to integrate the
human, animal and environmental health
fields and support multi-sectoral communication, collaboration, coordination, and
capacity strengthening.
We now have an unprecedented opportunity to strengthen collaboration
and policies across these many areas
and reduce the risk of future pandemics and epidemics while also addressing
the ongoing burden of endemic and
non-communicable diseases
Surveillance that monitors risks and
helps identify patterns across these
many areas is needed. In addition, new
research should integrate the impact of
these different fields, particularly on the
drivers that lead to crises.
WHO is integrating One Health
across its units and offices, providing
strategic advice relating to policy, and
conducting training at the local, national and regional levels. The goal is
stronger programmes that are led and
owned by countries.
One Health Joint Plan of
Action https://bit.ly/3Z38fhw
One Health overview
MIDDLE EAST HEALTHI 13
The agreement by the Intergovernmental Negotiating Body (INB), comprised of
WHO’s 194 Member States, was a milestone in the global process to learn from the
COVID-19 pandemic and prevent a repeat
of the devastating impacts it has had on
individuals and communities worldwide.
The INB gathered at WHO headquarters
in Geneva from 5-7 December for its third
meeting since its establishment in December 2021, following a special session of the
World Health Assembly.
The Body agreed that the INB’s Bureau
will develop the zero draft of the pandemic
accord in order to start negotiations at the
fourth INB meeting, scheduled to start
on 27 February 2023. This draft will be
based on the conceptual zero draft and the
discussions during this week’s INB meeting. The INB Bureau is comprised of six
delegates, one from each of the six WHO
regions, including the co-chairs Roland
Driece of the Netherlands and Precious
Matsoso of South Africa.
“Countries have delivered a clear message that the world must be better prepared, coordinated and supported to protect all people, everywhere, from a repeat
of Covid-19,” said Driece. “The decision
to task us with the duty to develop a zero
draft of a pandemic accord represents a
major milestone on the path towards making the world safer.”
Matsoso said government representatives stressed that any future pandemic
accord would need to take into account
equity, strengthen preparedness, ensure
solidarity, promote a whole-of-society and
whole-of-government approach, and respect the sovereignty of countries.
“The impact of the COVID-19 pandemic on human lives, economies and societies at large must never be forgotten,” said
Matsoso. “The best chance we have, today,
as a global community, to prevent a repeat
of the past is to come together, in the spirit
of solidarity, in a commitment to equity,
and in the pursuit of health for all, and
develop a global accord that safeguards societies from future pandemic threats.”
14 IMIDDLE EAST HEALTH
New data released 8 December 2022 by the
World Health Organization (WHO) show
that countries around the world largely
held the line against further setbacks to
malaria prevention, testing and treatment
services in 2021.
According to the 2022 World malaria report <https://bit.ly/3GEpjmW>,, there were
an estimated 619,000 malaria deaths globally in 2021 compared to 625,000 in the
first year of the pandemic. In 2019, before
the pandemic struck, the number of deaths
stood at 568,000.
Malaria cases continued to rise between
2020 and 2021, but at a slower rate than
in the period 2019 to 2020. The global
tally of malaria cases reached 247 million
in 2021, compared to 245 million in 2020
and 232 million in 2019.
“Following a marked increase in malaria cases and deaths in the first year of
the Covid -19 pandemic, malaria-affected countries redoubled their efforts and
were able to mitigate the worst impacts
of Covid-related disruptions to malaria
services,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We
face many challenges, but there are many
reasons for hope. By strengthening the response, understanding and mitigating the
risks, building resilience and accelerating
research, there is every reason to dream of
a malaria-free future.”
Despite successes, there remain many
challenges, particularly in the African region, which shouldered about 95% of cases
and 96% of deaths globally in 2021.
Disruptions during the pandemic and
converging humanitarian crises, health
system challenges, restricted funding, rising biological threats and a decline in the
effectiveness of core disease-cutting tools
threaten the global response to malaria.
“Despite progress, the African region
continues to be hardest hit by this deadly
disease,” said Dr Matshidiso Moeti, WHO
Regional Director for Africa. “New tools
– and the funding to deploy these – are urgently needed to help us defeat malaria.”
At the same time, a decline in the effectiveness of core malaria control tools, most crucially Insecticide Treated Bednets, is impeding further progress against malaria. Other
risks are also rising, including parasite
mutations affecting the performance of
rapid diagnostic tests; growing parasite resistance to the drugs used to treat malaria;
and the invasion in Africa of an urbanadapted mosquito that is resistant to many
of the insecticides used today.
WHO recently launched a new global
framework < https://bit.ly/3Ijgpwd > to respond
to malaria in urban areas.
Despite continued impact of Covid-19, malaria cases and deaths remained stable in 2021
Marking this year’s International Day of
Persons with Disabilities (or People of
Determination) on 3 December, António
Guterres, the UN Secretary-General, called
for transformative, innovative solutions, in
a world confronted by crises which disproportionally affects people with disabilities.
In his message, Guterres noted that greater
public-private sector collaboration is needed
in order to develop strategies that benefit people of determination, noting that they should
also be involved in their development.
The UN chief pointed to the UN’s internal efforts to make the Organisation more
accessible to people of determination, describing the United Nations Disability Inclusion Strategy <https://www.un.org/en/content/
disabilitystrategy> as a road map to achieving
this aim.
“From headquarters to the field,” he
said, “we are working to assess, address and
promote digital accessibility and lead by
example on disability inclusion.”
Powerful tools for inclusion
Innovation and technology, he continued,
can be powerful tools for inclusion, enhancing
access to information, education, and lifelong
learning, opening new avenues for people of
determination to participate in the workforce
and society at large on an equal basis.
The United Nations estimates that 15
percent of all people – one in seven – has
a disability. Understanding is key to ensuring that the more than one billion people
with disabilities lead fulfilling lives where
they are fully integrated into a society that
respects their rights and benefits from their
contributions.
A newly released UN documentary illustrates this vision of integration, through the
eyes of two South Korean artists with disabilities, and reveals a new perspective on the true
meaning of inclusion, in today’s diverse world.
Breaking Barriers
“Breaking Barriers One Brushstroke at a
Time” <https://youtu.be/C3QfDr1VH6A>
takes viewers inside the homes and lives
of the artists, who communicate through
their paintings and, in the process, teach
audiences to listen with their eyes.
Far more than an exercise in social development, the works of these artists with
autism carry intrinsic artistic value, and
have been exhibited at the Seoul Arts
Centre, the largest and most prestigious
venue of its kind in the country.
Through interviews with the families
and intimate glimpses of the lives and
loves of two artists, Hansol Kim and Hyeshin Park, the documentary tells a specific story of struggle that also has universal themes: finding our voice in a world
that doesn’t listen, expressing truths that
rise above the noise, and coming of age by
accepting who we are and what we have
to contribute to society.
“Breaking Barriers” shows that inspiration is everywhere, disability is a matter
of perspective, and that all of us share a
common humanity that can be captured
and comprehended through art.
António Guterres, UN Secretary-General.
UN Chief says innovation key to fairer world
for people with disabilities
MIDDLE EAST HEALTHI 15
16 IMIDDLE EAST HEALTH
Medical research news from around the world
the laboratory
A group of neuroscientists led by a University
of Pittsburgh School of Medicine researcher
developed a test to detect a novel marker of
Alzheimer’s disease neurodegeneration in a
blood sample. A study on their results was
published 27 December 2022 in Brain [1].
The biomarker, called “brain-derived tau,”
or BD-tau, outperforms current blood diagnostic tests used to detect Alzheimer’s-related
neurodegeneration clinically. It is specific to
Alzheimer’s disease and correlates well with
Alzheimer’s neurodegeneration biomarkers in
the cerebrospinal fluid (CSF).
“At present, diagnosing Alzheimer’s disease requires neuroimaging,” said senior author Thomas Karikari, Ph.D., assistant professor of psychiatry at Pitt. “Those tests are
expensive and take a long time to schedule,
and a lot of patients, even in the U.S., don’t
have access to MRI and PET scanners. Accessibility is a major issue.”
Currently, to diagnose Alzheimer’s disease, clinicians use guidelines set in 2011 by
the U.S. National Institute on Aging and
the Alzheimer’s Association. The guidelines, called the AT(N) Framework, require
detection of three distinct components of
Alzheimer’s pathology – the presence of
amyloid plaques, tau tangles and neurodegeneration in the brain – either by imaging
or by analyzing CSF samples.
Unfortunately, both approaches suffer from
economical and practical limitations, dictating the need for development of convenient
and reliable AT(N) biomarkers in blood
samples, collection of which is minimally
invasive and requires fewer resources. The
development of simple tools detecting signs
of Alzheimer’s in the blood without compromising on quality is an important step toward
improved accessibility, said Karikari.
“The most important utility of blood
biomarkers is to make people’s lives better and to improve clinical confidence and
risk prediction in Alzheimer’s disease diagnosis,” Karikari said.
Current blood diagnostic methods can
accurately detect abnormalities in plasma
amyloid beta and the phosphorylated form
of tau, hitting two of the three necessary
checkmarks to confidently diagnose Alzheimer’s. But the biggest hurdle in applying the AT(N) Framework to blood samples
lies in the difficulty of detecting markers of
neurodegeneration that are specific to the
brain and aren’t influenced by potentially
misleading contaminants produced elsewhere in the body.
For example, blood levels of neurofilament light, a protein marker of nerve cell
damage, become elevated in Alzheimer’s
disease, Parkinson’s and other dementias,
rendering it less useful when trying to differentiate Alzheimer’s disease from other
neurodegenerative conditions. On the
other hand, detecting total tau in the blood
proved to be less informative than monitoring its levels in CSF.
By applying their knowledge of molecular
biology and biochemistry of tau proteins in
different tissues, such as the brain, Karikari
and his team, including scientists at the
University of Gothenburg, Sweden, developed a technique to selectively detect BDtau while avoiding free-floating “big tau”
proteins produced by cells outside the brain.
To do that, they designed a special antibody that selectively binds to BD-tau,
making it easily detectible in the blood.
They validated their assay across over 600
patient samples from five independent cohorts, including those from patients whose
Alzheimer’s disease diagnosis was confirmed
after their deaths, as well as from patients
with memory deficiencies indicative of early-stage Alzheimer’s.
The tests showed that levels of BD-tau
detected in blood samples of Alzheimer’s disease patients using the new assay
matched with levels of tau in the CSF and
reliably distinguished Alzheimer’s from
other neurodegenerative diseases. Levels
of BD-tau also correlated with the severity
of amyloid plaques and tau tangles in the
brain tissue confirmed via brain autopsy
analyses.
Scientists hope that monitoring blood levels of BD-tau could improve clinical trial design and facilitate screening and enrolment
of patients from populations that historically
haven’t been included in research cohorts.
“There is a huge need for diversity in
clinical research, not just by skin colour
but also by socioeconomic background,”
said Karikari. “To develop better drugs, trials need to enrol people from varied backgrounds and not just those who live close
to academic medical centres. A blood test
is cheaper, safer and easier to administer,
and it can improve clinical confidence
in diagnosing Alzheimer’s and selecting
participants for clinical trial and disease
monitoring.”
Karikari and his team are planning to
conduct large-scale clinical validation of
blood BD-tau in a wide range of research
groups, including those that recruit participants from diverse racial and ethnic
backgrounds, from memory clinics, and
from the community. Additionally, these
studies will include older adults with no
biological evidence of Alzheimer’s disease
as well as those at different stages of the
disease. These projects are crucial to ensure that the biomarker results are generalizable to people from all backgrounds,
and will pave the way to making BD-tau
commercially available for widespread
clinical and prognostic use.
Breakthrough: scientists uncover novel
biomarker to detect Alzheimer’s in blood
Thomas Karikari, Ph.D.
Thomas Karikari
Reference: 1. doi: https://doi.org/10.1093/brain/awac407
MIDDLE EAST HEALTHI 17
Researchers at UC San Francisco have engineered molecules that act like “cellular
glue”, allowing them to direct in precise
fashion how cells bond with each other.
The discovery represents a major step toward building tissues and organs, a longsought goal of regenerative medicine.
Adhesive molecules are found naturally
throughout the body, holding its tens of
trillions of cells together in highly organized patterns. They form structures, create
neuronal circuits and guide immune cells to
their targets. Adhesion also facilitates communication between cells to keep the body
functioning as a self-regulating whole.
In a new study [1], published in the 12
December 2022, issue of Nature, researchers engineered cells containing customized adhesion molecules that bound with
specific partner cells in predictable ways to
form complex multicellular ensembles.
“We were able to engineer cells in a manner that allows us to control which cells they
interact with, and also to control the nature of
that interaction,” said senior author Wendell
Lim, PhD, the Byers Distinguished Professor of Cellular and Molecular Pharmacology
and director of UCSF’s Cell Design Institute.
“This opens the door to building novel structures like tissues and organs.”
Regenerating connections between cells
Bodily tissues and organs begin to form in
utero and continue developing through
childhood. By adulthood, many of the molecular instructions that guide these generative processes have disappeared, and
some tissues, like nerves, cannot heal from
injury or disease.
Lim hopes to overcome this by engineering adult cells to make new connections. But doing this requires an ability to
precisely engineer how cells interact with
one another.
“The properties of a tissue, like your skin
for example, are determined in large part
by how the different cells are organized
within it,” said Adam Stevens, PhD, the
Hartz Fellow in the Cell Design Institute
and the first author of the paper. “We’re
devising ways to control this organization
of cells, which is central to being able to
synthesize tissues with the properties we
want them to have.”
Much of what makes a given tissue
distinct is how tightly its cells are
bonded together. In a solid organ, like a
lung or a liver, many of the cells will be
bonded quite tightly. But in the immune
system, weaker bonds enable the cells
to flow through blood vessels or crawl
between the tightly bound cells of skin
or organ tissues to reach a pathogen or
a wound.
To direct that quality of cell bonding,
researchers designed their adhesion molecules in two parts. One part of the molecule acts as a receptor on the outside of
the cell and determines which other cells
it will interact with. A second part, inside
the cell, tunes the strength of the bond
that forms. The two parts can be mixed
and matched in a modular fashion, creating an array of customized cells that bond
in different ways across the spectrum of
cell types.
The code underlying cellular assembly
Stevens said these discoveries also have
other applications. For example, researchers could design tissues to model disease
states, to make it easier to study them in
human tissue.
Cell adhesion was a key development
in the evolution of animals and other multicellular organisms, and custom adhesion
molecules may offer a deeper understanding of how the path from single to multicellular organisms began.
“It’s very exciting that we now understand much more about how evolution
may have started building bodies,” he said.
“Our work reveals a flexible molecular adhesion code that determines which cells
will interact, and in what way. Now that
we are starting to understand it, we can
harness this code to direct how cells assemble into tissues and organs. These tools
could be really transformative.”
Researchers develop cellular ‘glue’ to regenerate tissues, heal wounds, regrow nerves
Our work reveals a flexible
molecular adhesion code that
determines which cells will
interact, and in what way. Now
that we are starting to understand
it, we can harness this code to
direct how cells assemble into
tissues and organs. These tools
could be really transformative.
Reference: 1. doi: https://doi.org/10.1038/s41586-022-05622-z
Wendell Lim, PhD, director of UCSF’s Cell Design Institute, holds
a cellular model in his office at UCSF’s Mission Bay Campus.
Photo by Elena Zhukova
18 IMIDDLE EAST HEALTH
Scientists at Dana-Farber Cancer Institute have developed a drug that potently
neutralizes SARS-CoV-2, the Covid-19
coronavirus, and is equally effective
against the Omicron variant and every other tested variant. The drug is
designed in such a way that natural
selection to maintain infectiousness
of the virus should also maintain
the drug’s activity against future
variants.
The investigational drug, described in a report published 7 December 2022 in Science Advances [1], is
not an antibody, but a related molecule
known as an ACE2 receptor decoy. Unlike antibodies, the ACE2 decoy is far
more difficult for the SARS-CoV-2 virus
to evade because mutations in the virus
that would enable it to avoid the drug
would also reduce the virus’s ability to
infect cells. The scientists found a way to
make this type of drug neutralize coronaviruses more potently in animals infected
with Covid-19 and to make it safe to give
to patients.
This report comes at a time when antibody drugs used to treat Covid-19 have
lost their effectiveness because the viral
spike protein has mutated to escape being
targeted by the antibodies.
The researchers, led by first author
James Torchia, MD, PhD, and senior author Gordon Freeman, PhD, identified
features that make ACE2 decoys especially potent and long-lasting. For example, they found that when they included
a piece of the ACE2 protein called the
collectrin-like domain, it made the drug
stick more tightly to the virus and have
a longer life in the body. Their experiments showed that ACE2 decoys have
potent activity against the Covid-19 virus because they trigger an irreversible
change in the structure of the virus – they
“pop” the top off the viral spike protein
so it can’t bind to the cell-surface ACE2
receptor and infect cells.
The SARS-CoV-2 virus is covered with
projections called spike proteins that enable the virus to infect cells. The spike
protein binds to the ACE2 receptor on
the cell surface and then refolds, driving
the spike into the cell, enabling the
virus to enter. ACE2 decoys lure the
virus to bind to the decoy instead of
the cell, “popping” the spike and
inactivating the virus before it
can enter cells. This explains the
drug’s surprising potency: not only
does it function as a competitive
inhibitor, but it permanently inactivates the virus. Since binding to
ACE2 is required for infection, variants can change but they must continue
to bind to ACE2, making the drug persistently active against all variants.
The researchers say that, in addition
to treating antibody-resistant variants of
SARS-CoV-2, the drug described in this
study could be useful to treat new coronaviruses that might emerge in the future
to infect humans. This is because many
coronaviruses in nature poised to enter
the human population also utilize ACE2
to infect cells.
While the drug, called DF-COV-01, has
not yet been tested in humans, manufacturing development is nearly complete
and preclinical studies needed for regulatory approval are underway, with the goal
of advancing the drug to clinical trials.
Reference: 1. doi: https://doi.org/10.1126/sciadv.abq6527
New surprisingly potent receptor ‘decoy’ drug deactivates Covid-19 virus and variants
Researchers have long been working on
how to treat obesity, a serious condition
that can lead to hypertension, diabetes,
chronic inflammation, and cardiovascular
diseases. Studies have also revealed a strong
correlation of obesity and cancer – recent
data show that smoking, drinking alcohol,
and obesity are the biggest contributors to
cancer worldwide.
The development of fat cells, which are
produced from a tiny fibroblast-like progenitor, not only activates the fat cells’ specific
genes but also grows them by storing more
lipids (adipocytes and adipose tissue). In
fact, lipid storage is the defining function of
a fat cell. But the storage of too much lipid
can make fat cells unhealthy and lead to
obesity.
Challenges in targeting fat cells
The ability to target fat cells and safely
uncouple unhealthy fat formation from
healthy fat metabolism would be the answer
to many peoples’ prayers. A major challenge in obesity treatment is that fat tissue,
which is not continuous in the body but is
found piece by piece in “depots”, has been
difficult to target in a depot-specific manner, pinpointed at the exact location.
There are two main kinds of fat: visceral
fat, internal tissues that surround the stomach, liver, and intestines, and subcutaneous
fat, found under the skin anywhere in the
Researchers discover cationic charged P-G3 reduces fat at targeted locations
MIDDLE EAST HEALTHI 19
20 IMIDDLE EAST HEALTH
body. Visceral fat produces potbellies; subcutaneous fat can create chin jowls, arm fat,
etc. To date, there has been no way to specifically treat visceral adipose tissue. And
current treatments for subcutaneous fat like
liposuction are invasive and destructive.
Two studies show new way to treat obesity
Two new studies from researchers at Columbia Engineering and Columbia University Irving Medical Center (CUIMC)
may have the answer to targeting fat cells
depot-specifically and healthily. The papers
demonstrate a new method to treat obesity
by using cationic nanomaterials that can
target specific areas of fat and inhibit the
unhealthy storage of enlarged fat cells. The
materials remodel fat rather than destroying
it, as, for example, liposuction does. The
first paper [1], published 1 December 2022 by
Nature Nanotechnology, focuses on visceral
adiposity, or belly fat. The second paper[2],
published online 28 November 2022 by
Biomaterials, focuses on fat underneath the
skin as well as chronic inflammation associated with obesity.
The team of researchers, led by Li Qiang,
associate professor of pathology and cell biology at CUIMC, and Kam Leong, Samuel
Y. Sheng Professor of Biomedical Engineering and of systems biology at CUIMC, recognized that adipose tissue contains large
amounts of negatively charged extracellular matrix (ECM) to hold fat cells. They
thought that this negatively charged ECM
network might provide a highway system of
sorts for positively charged molecules. So
they took a positively charged nanomaterial, PAMAM generation 3 (P-G3), and injected it into obese mice. The P-G3 quickly
spread throughout the tissue and the team
was excited that their method to specifically target visceral fat worked.
Unexpected results
And then something intriguing happened:
P-G3 shut off the lipid storage programme in
fat cells and the mice lost weight. This was
totally unexpected, given the well-established
function of P-G3 in neutralizing negatively
charged pathogens, such as DNA/RNA cell
debris, to alleviate inflammation.
“Our approach is unique – it departs from
the pharmacological or surgical approaches,”
said Qiang, who specializes in obesity and adipocyte biology. “We used cationic charge to
rejuvenate healthy fat cells, a technique no
one has ever used to treat obesity. I think this
novel strategy will open the door to healthier
and safer reduction of fat.”
PAMAM generation 3
In these two studies, the researchers discovered that the cationic material, P-G3,
could do an intriguing thing to fat cells
– while it helped new fat cell formation,
it also uncoupled lipid storage from the
housekeeping functions of fat cells. And
because it inhibits the unhealthy lipid storage of enlarged fat cells, the mice had more
metabolically healthy, young, small fat cells
like those found in newborns and athletes.
The researchers found that this uncoupling
function of P-G3 also holds true in human fat biopsies, signifying the potential of
translation in humans.
“With P-G3, fat cells can still be fat cells,
but they can’t grow up,” said Leong, a pioneer
in using polycation to scavenge pathogens.
“Our studies highlight an unexpected strategy
to treat visceral adiposity and suggest a new
direction of exploring cationic nanomaterials
for treating metabolic diseases.”
New applications
Now that they can selectively target
visceral fat, Leong and Qiang envision
several applications. The Biomaterials
study demonstrates a simple approach
that could be used for aesthetic purposes;
like Botox, P-G3 can be locally injected
into a specific, subcutaneous fat depot.
The investigators, who have patents
pending, are now engineering P-G3 into
various derivatives to improve the efficacy, safety, and depot specificity. What
the researchers are particularly excited
about is developing P-G3 into a platform
that can deliver drugs and gene therapies
specifically to a given fat depot. This
may repurpose many drugs from systemic
safety concerns, such as Thiazolidinediones (TZDs), a potent but unsafe drug
that is a strong modulator of fat and used
to treat type 2 diabetes – but it has been
linked to heart failure and banned in
several countries.
“We’re very excited to discover that
cationic charge is the secret to targeting
adipose tissue,” Qiang said. “Now we can
shrink fat in a depot-specific manner – anywhere we want – and in a safe way without
destroying fat cells. This is a major advance
in treating obesity.”
References:
1. doi: https://doi.org/10.1038/s41565-022-01249-3
2. doi: https://doi.org/10.1016/j.biomaterials.2022.121850
Nicoletta Barolini/Columbia University
Illustration of depot-specific targeting of fat by cationic nanomaterials.
MIDDLE EAST HEALTHI 21
22 IMIDDLE EAST HEALTH
In a study led by Michigan Medicine, scientists have uncovered a protein produced
by the immune system that causes atherosclerosis, which offers the promise of new
treatments for cardiovascular disease.
Traditionally clinicians have treated cardiovascular disease by focusing on blood
pressure control, and reducing cholesterol
by using medications like statins. Despite
these measures, heart disease remains the
number one cause of death in many parts
of the world, with many patients having
heart attacks even after their risk factors
are controlled, said Salim Hayek, M.D.,
physician-scientist and medical director of
the University of Michigan Health Frankel Cardiovascular Clinics.
“Targeting the immune component
central to the development of atherosclerosis is the Holy Grail for the treatment
of heart disease,” Hayek, senior author of
the study, explained. “This is the first time
that a component of the immune system is
identified that meets all the requirements
for being a promising treatment target for
atherosclerosis.”
This protein, called soluble urokinase
plasminogen activator receptor, or suPAR,
is produced by the bone marrow. It acts as
a regulator, essentially a thermostat for the
activity of the immune system, or “immunostat”.
Past studies have shown suPAR to be
a marker of cardiovascular disease. But
Physician-scientists
discover new immune
target to treat
cardiovascular disease
Cardiology
this study, published 4 October 2022 in
the Journal of Clinical Investigation, [1] is
the first evidence showing that the protein actually causes atherosclerosis when
at high levels.
Three-pronged findings
First, the research team analysed the
Multi-Ethnic Study of Atherosclerosis,
which consists of over 5,000 people without known cardiovascular disease and
found that those who had higher suPAR
levels were much more prone to develop
atherosclerosis and experience cardiovascular events, regardless of their underlying
risk factors.
Then, the investigators did a genetic
study of 24,000 people to find whether
certain genetic variations affected levels of
suPAR in blood. They discovered a specific
variant in the gene PLAUR that codes for
suPAR, and people with that genetic variant tended to have higher suPAR levels.
Most importantly, that genetic variant was
linked to atherosclerosis in a Mendelian
randomization analysis of 500,000 participants in the UK Biobank, which was replicated in two other large data sets.
“We also found that participants lacking
a copy of the PLAUR gene have lower risk
of heart disease,” said first author and geneticist George Hindy, M.D., Ph.D., of Regeneron Genetics Center. “Altogether, the
genetic data is truly compelling for high
suPAR being a cause of atherosclerosis.”
Finally, in mouse models with high suPAR
levels, researchers saw a dramatic increase in
atherosclerotic plaques of mouse aortas compared to mice with normal suPAR levels.
“Even prior to developing atherosclerosis, the mouse aortas with high suPAR
levels contained more inflammatory white
blood cells, and the immune cells circulating in blood were in an activated state, or
‘attack-mode,’” said Daniel Tyrrell, Ph.D.,
co-first author and research fellow at the
U-M Health Frankel Cardiovascular CenSalim Hayek, M.D., physician-scientist and
medical director of the University of Michigan
Health Frankel Cardiovascular Clinics
ter. “High suPAR levels appear to activate
the immune cells and prime them to overreact to the high cholesterol environment,
causing these cells to enter the blood vessel
wall and accelerate the development of atherosclerosis.”
What is unique about this study, Hayek
says, is that it brings to light high-quality
clinical, genetic and experimental data –
all pointing to suPAR as a cause of atherosclerotic disease.
“Now, we’re looking into developing
treatments to reduce suPAR levels safely
as a strategy to prevent and treat heart disease, especially since traditional therapies
for atherosclerosis have no impact on suPAR,” he said.
suPAR links kidney and
cardiovascular disease
The study dovetails findings that suPAR
is known to be a pathogenic factor that
causes kidney disease. People often experience the two conditions together: twothirds of people with kidney disease are
affected by cardiovascular disease, and
over 40% of patients with cardiovascular
disease have signs of kidney disease.
“This paper places suPAR as the link
between kidney and cardiovascular disease;
a common factor causing both through
this inappropriate, persistent activation
of the immune system,” said co-author
Jochen Reiser, M.D., Ph.D., chair of the
Department of Medicine at Rush University
and an expert in the study of suPAR.
“This is pointed out in the Mendelian
randomization genetic analysis done by the
investigators, showing that high suPAR is
also linked to kidney disease.”
For both conditions, suPAR has long
been known as a biomarker for poor outcomes and disease progression. In a 2020
study, Hayek’s team found that suPAR
can worsen acute kidney injury [2] and
that blocking suPAR prevents it. A recent
study led by Hayek found that levels of
protein are high [3] in patients with heart
failure and predict death for patients.
Research into suPAR’s role in health
and disease has advanced rapidly in the
past 10 years. Hayek says suPAR has great
potential to be a successful treatment
target for cardiovascular and kidney
disease. His lab has already begun work
References:
1. doi: https://doi.org/10.1172/JCI158788
2. doi: https://doi.org/10.1056/NEJMoa1911481
3. doi: https://doi.org/10.1016/j.cardfail.2022.08.010
designing anti-suPAR therapies and
planning clinical trials.
“My hope is that we are able to provide
these treatments to our patients within
the next three to five years,” he said. “This
will be a game changer for the treatment
of atherosclerotic and kidney disease.”
MIDDLE EAST HEALTHI 23
Now, we’re looking
into developing
treatments to reduce
suPAR levels safely as
a strategy to prevent
and treat heart
disease, especially
since traditional
therapies for
atherosclerosis have
no impact on suPAR.
Coronary Artery Disease
24 IMIDDLE EAST HEALTH
Using machine learning and clinical data
from electronic health records, researchers at
the Icahn School of Medicine at Mount Sinai in New York constructed an in silico, or
computer-derived, marker for coronary artery
disease (CAD) to better measure clinically
important characterizations of the disease.
New digital marker
for coronary artery disease
is first to map characteristics
of CAD on a spectrum
The findings, published online on 20 December 2022 in The Lancet [1], may lead to
more targeted diagnosis and better disease
management of CAD, the most common type
of heart disease and a leading cause of death
worldwide. The study is the first known research to map characteristics of CAD on a
spectrum. Previous studies have focused only
on whether or not a patient has CAD.
CAD and other common conditions
exist on a spectrum of disease; each individual’s mix of risk factors and disease
processes determines where they fall on
the spectrum. However, most such studIndividuals with coronary artery disease exist on a spectrum of disease, such as the amount of plaque build-up in the arteries of the heart; however, the disease is conventionally classified as broad categories of case (yes disease) or control (no
disease), which may result in misdiagnosis. A digital marker for coronary artery disease derived from machine learning and
electronic health records can better quantify where an individual falls on the disease spectrum.
Icahn School of Medicine at Mount Sinai
Cardiology
MIDDLE EAST HEALTHI 25
At Royal Brompton & Harefield Hospitals (RB&HH), London, Mr Toufan Bahrami is at the forefront of pioneering new
totally endoscopic surgery for valve repair
and replacement. The procedure offers an
alternative to sternotomy, and allows for
a quicker patient recovery time with better aesthetic results.
Performed exclusively at RB&HH, the
endoscopic procedure is designed to treat
patients with mitral valve disease but is
also suitable for tricuspid and aortic valve
repair. Taking around four hours and performed under general anaesthetic, a 3cm
incision, without rib spreading, allows
enough room for endoscopic instruments
to rotate 360 degrees providing multiangled and precise views.
RB&HH at the forefront of
revolutionary 3D heart valve
endoscopic surgery
Cutting-edge 3D technology
A high-definition 3D camera is used to direct the procedure inside the heart and the
surgeon can then repair or replace the damaged valve. During the procedure, surgeons
wear 3D glasses and are guided by images
projected onto a 4k screen, which allows
other surgeons in the room to see the same
images. The projected images can also be
accessed remotely, allowing our specialists
to collaborate from anywhere in the world.
Mr Bahrami, consultant cardiac surgeon
at Royal Brompton Hospital, explains:
“This pioneering technology has revolutionised the way we work, as we’ve never
had such a view of the operating field. We
can now access views from deep inside the
chest, through high-quality 4K images – and
one big advantage of this, is that we can use
the 3D projections to teach our trainees.”
Gold-standard approach and results
Totally endoscopic surgery has similar results
to a sternotomy procedure but allows for a
much smaller incision with less bleeding,
greater precision, less pain, and less chance of
infection, resulting in a quicker recovery.
Due to its minimally invasive nature, patients are usually discharged after three days.
Within four weeks patients have reported
being active again with minimal scarring
and fewer complications when compared to
a standard procedure. “Without minimally
invasive and totally endoscopic options, we
would not be able to provide these gold-standard results,” comments Mr Bahrami.
• To find out more visit: www.rbhh-specialistcare.co.uk/totallyendoscopic
Royal Brompton & Harefield Hospitals
26 IMIDDLE EAST HEALTH
Reference: 1. doi: https://doi.org/10.1016/S0140-6736(22)02079-7
ies break this disease spectrum into rigid
classes of case (patient has disease) or control (patient does not have disease). This
may result in missed diagnoses, inappropriate management, and poorer clinical outcomes, say the investigators.
“The information gained from this noninvasive staging of disease could empower
clinicians by more accurately assessing
patient status and, therefore, inform the
development of more targeted treatment
plans,”said Ron Do, PhD, senior study
author and the Charles Bronfman Professor in Personalized Medicine at the Icahn
School of Medicine at Mount Sinai.
“Our model delineates coronary artery disease patient populations on a disease spectrum; this could provide more insights into
disease progression and how those affected
will respond to treatment. Having the ability to reveal distinct gradations of disease risk,
atherosclerosis, and survival, for example,
which may otherwise be missed with a conventional binary framework, is critical.”
Machine learning model
In the retrospective study, the researchers trained the machine learning model,
named in silico score for coronary artery
disease or ISCAD, to accurately measure
CAD on a spectrum using more than
80,000 electronic health records from
two large health system-based biobanks,
the BioMe Biobank at the Mount Sinai
Health System and the UK Biobank.
The model, which the researchers
termed a “digital marker”, incorporated
hundreds of different clinical features from
the electronic health record, including
vital signs, laboratory test results, medications, symptoms, and diagnoses, and compared it to both an existing clinical score
for CAD, which uses only a small number
of predetermined features, and a genetic
score for CAD.
The 95,935 participants included participants of African, Hispanic/Latino,
Asian, and European ethnicities, as well as
a large share of women. Most clinical and
machine learning studies on CAD have focused on white European ethnicity.
The investigators found that the probabilities from the model accurately tracked
Detection of left atrial mechanical
dysfunction by measurement of
left atrial reservoir strain improves
stroke prediction in persons without
a history of atrial fibrillation or stroke
A cohort study of more than 4,500 persons without a history of atrial fibrillation
(AF) or stroke has found that measuring left atrial mechanical function can
improve stroke prediction. The findings were published on 20 December 2022
in Annals of Internal Medicine.
AF is a serious public health problem because of its increasing prevalence in the aging
population and its association with risks of cardiac thromboembolism and stroke. An
intrinsically pro-thrombotic atrial myopathy, characterized by changes in left atrial mechanical function and size, may precede and promote development of AF. Evaluating left
atrial mechanics and size may have utility in enhancing prediction of cardiac embolism
and stroke earlier in a patient’s disease course before development of AF.
Researchers from multiple institutions including the Pennsylvania State University, University of California Los Angeles, and the University of Minnesota
evaluated data from 4,917 persons participating in the ARIC (Atherosclerosis
Risk in Communities) study. The authors found that left atrial mechanical dysfunction, detected by analysis of left atrial strain, was associated with ischemic
stroke independently of left atrial size and risk factors from the CHA2DS2-
VASc score. They also found that the addition of left atrial reservoir strain
to the CHA2DS2-VASc variables improved stroke prediction and yielded a
greater predicted net benefit, as shown by decision curve analysis. According to
the authors, the results of this study support the hypothesis that atrial myopathy,
characterized by left atrial mechanical dysfunction, is intrinsically prothrombotic, resulting in higher risk for cardiac embolism and ischemic stroke.
Reference: doi: https://doi.org/10.7326/M22-1638
the degree of narrowing of coronary arteries (coronary stenosis), mortality, and
complications such as heart attack.
“Machine learning models like this
could also benefit the healthcare industry
at large by designing clinical trials based
on appropriate patient stratification. It
may also lead to more efficient data-driven individualized therapeutic strategies,”
said lead author Iain S. Forrest, PhD, a
postdoctoral fellow in the lab of Dr Do
and an MD/PhD student in the Medical Scientist Training Program at Icahn
Mount Sinai. “Despite this progress, it
is important to remember that physician
and procedure-based diagnosis and management of coronary artery disease are
not replaced by artificial intelligence, but
rather potentially supported by ISCAD as
another powerful tool in the clinician’s
toolbox.”
Next, the investigators envision conducting a prospective large-scale study to
further validate the clinical utility and actionability of ISCAD, including in other
populations. They also plan to assess a more
portable version of the model that can be
used universally across health systems.
Cardiology
MIDDLE EAST HEALTHI 27
28 IMIDDLE EAST HEALTH
Cardiology
Gene therapy corrects mutation
responsible for dilated cardiomyopathy
destroying its ability to contract and causing it to become extremely enlarged and
fail over time. Treatment is limited to drugs,
which can improve contractile function but
don’t provide a permanent fix, or a heart
transplant, which frequently isn’t an option
due to a shortage of donor organs.
Seeking to attack the root cause of this
disease, Drs. Olson, Bassel-Duby, Nishiyama, and their colleagues looked to
CRISPR-Cas9, a popular tool for genetic
research recognized with the Nobel Prize
in Chemistry in 2020. Using this system,
researchers can potentially correct diseasecausing mutations in important genes.
Thus far, the Food and Drug Administration has approved a single clinical trial
that uses this technology to try to treat
sickle cell disease. However, Dr. Olson
said CRISPR-Cas9 has huge potential to
treat an untold number of other genetic
diseases. Dr. Olson and colleagues have
used CRISPR gene editing to develop a
technique to halt progression of Duchenne
muscular dystrophy in animal models.
To determine the feasibility of this approach for DCM, the research team used
a virus to deliver CRISPR-Cas9 components to cardiac muscle cells derived
from human cells carrying two different
types of DCM-causing mutations. ScienDrs Rhonda Bassel-Duby, Takahiko Nishiyama and Eric Olson (l-r) published a study on their use of the
CRISPR-Cas9 gene editing system to correct mutations responsible for dilated cardiomyopathy.
These representative hearts from 12-week-old mice show a
normal heart (left) and an enlarged heart that’s characteristic
of dilated cardiomyopathy.
Using the CRISPR-Cas9 gene editing system,
UT Southwestern researchers corrected mutations responsible for a common inherited
heart condition called dilated cardiomyopathy (DCM) in human cells and a mouse model of the disease. Their findings, published 23
November 2022 in Science Translational Medicine, [1] may one day provide hope to an estimated 1 in 250 people worldwide who suffer
from this condition.
“All of the disease characteristics we see
because of these mutations were reversed with CRISPR-Cas9 therapy. It’s
fair to say the success of this approach
completely exceeded our expectations,” said Eric Olson, Ph.D., Chair and Professor of Molecular Biology at UTSW, who
co-led the study with colleagues Rhonda Bassel-Duby, Ph.D., Professor of Molecular Biology, and Takahiko Nishiyama, M.D., Ph.D., a
postdoctoral fellow in the Olson lab.
DCM is caused by mutations in a gene
known as RNA binding motif protein 20
(RBM20), which affects the production of
hundreds of proteins in cardiac muscle cells
responsible for the heart’s pumping action.
This disease wreaks widespread havoc throughout
the heart, gradually
MIDDLE EAST HEALTHI 29
Reference:
1. doi: https://doi.org/10.1126/scitranslmed.ade1633
Researchers use seaweed
molecules to improve
outcomes for bypass surgery
Researchers are using a natural material derived from seaweed to promote vascular
cell growth, prevent blood clots and improve the performance of synthetic vascular grafts used in heart bypass surgery.
The new approach, developed and tested at the University of Waterloo, is especially
important in cases involving small artificial blood vessels - those less than six millimetres
in diameter - which are prone to clots that can develop into full blockages.
“There is a crucial need to develop synthetic vascular graft materials that will
increase the rate of long-term functions,” said Dr Evelyn Yim, a chemical engineering professor and University Research Chair who leads the project.
Researchers added a material called fucoidan, which is made from seaweed, to
modify synthetic blood vessels. Fucoidan has a structure similar to heparin, a drug
used as an anticoagulant.
When applied with a nanotechnology technique known as micropatterning, fucoidan
promotes the growth of vascular cells around the inner surface of the graft, significantly
reducing the chances of clots forming.
For patients, the potential benefits include fewer complications, better quality of life
and less risk of the recurrence of blockages requiring additional drug treatment or surgery.
“A functional, off-the-shelf, small-diameter vascular graft will help save lives,”
said Yim, director of the Regenerative Nanomedicine Lab at Waterloo. “What’s
important is that they will be much longer-lasting and allow blood to flow freely.”
Gold standard for grafts
Bypass surgery is performed to restore blood flow to areas of the heart when vessels become blocked. Vessels harvested from the patient are the gold standard for
grafts, but limited availability often requires the use of artificial vessels.
In addition to heart bypass surgery, grafts are used in medical procedures to treat vascular
diseases and restore blood flow to vital organs and tissues, including the brain and legs.
When synthetic graft material doesn’t allow vascular cells to grow on the inside of an
artery or vessel, there is a high chance of clots, which can develop into full blockages or
cause inflammation that restricts blood flow.
Yim has successfully tested the new technique using fucoidan and micropatterning on
small animals and plans to expand to large animal testing before advancing to clinical trials.
Several researchers from the Department of Chemical Engineering at Waterloo
and the Department of Biomedical Engineering at the Oregon Health and Science
University have collaborated on this project.
A paper on the work, Fucoidan and topography modification improved in situ
endothelialization on acellular synthetic vascular grafts, appears in the journal
Bioactive Materials [1]. Reference:
1. doi: https://doi.org/10.1016/j.bioactmat.2022.10.011
Photo of the synthetic grafts made by the researchers
tists used this gene-editing technology to
swap a single nucleotide, the basic unit of
DNA, to correct one type of mutation. In
another set of cells, researchers replaced a
piece of DNA from mutated RBM20 with
a healthy segment of this gene.
After CRISPR-Cas9 treatment, the mutant
cells gradually lost characteristics inherent
to DCM: The protein produced by RBM20
moved to its normal place in the nucleus, and
the cells began making healthy proteins.
When the researchers delivered the
CRISPR-Cas9 treatment to 1-week-old
mice carrying one of these mutations, the
animals never developed enlarged hearts
and had normal life spans. Untreated mice
had symptoms mirroring those of human
DCM patients.
The scientists said that several challenges
remain before this therapy can be used in
DCM patients. Work is needed to ensure
that the effects of CRISPR-Cas9 are permanent and precise, and that the smallest dose
possible is delivered. Also to be determined
is whether the treatment could be used in
patients whose disease is more advanced.
However, Dr. Olson said he’s optimistic
that this system could be used to treat a variety of other familial diseases.
“The pace of this field is really breathtaking,” he said. “I expect that if this moves forward into patients, we’re not talking within
decades – we’re talking within years.”
Dr. Olson holds the Pogue Distinguished
Chair in Research on Cardiac Birth Defects;
The Robert A. Welch Distinguished Chair
in Science; and the Annie and Willie Nelson
Professorship in Stem Cell Research. He is
also Director of the Hamon Center for Regenerative Science and Medicine.
The pace of this field
is really breathtaking. I
expect that if this moves
forward into patients,
we’re not talking within
decades – we’re talking
within years.
Our GPS team
helps manage
the complex
logistics involved
in planning for
care far from
home
30 IMIDDLE EAST HEALTH
When most people hear the term “GPS”
– they might think of a ‘global positioning
system’ that directs them to their desired
destination. It is fitting, then, that GPS
also stands for the Global Patient Services programme at NewYork-Presbyterian
(NYP), which assists patients and their
families throughout the Middle East and
around the world to make it their destination – for state-of-the-art medical care and
the best in patient experience.
NewYork-Presbyterian is the only academic medical centre in the United States
affiliated with two world-class medical
schools, Weill Cornell Medicine and Columbia University Vagelos College of Physicians and Surgeons.
Its longstanding reputation for clinical excellence has put the hospital at the forefront
in terms of medical education, groundbreaking research, and patient-centric treatment.
Global Services Program: 24/7 ‘concierge”
service’ – for when it matters most
Each year, more than 5,000 international patients travel to NewYork-Presbyterian with
assistance from its Global Services Program,
which gives them access to the hospital’s
world-renowned Columbia University and
Weill Cornell Medicine physicians.
NYP has a long history of caring for patients in the Middle East and North Africa,
and our regional ‘ambassadors’ collaborate
closely with local governments and private
institutions in those regions to provide access to our services and making the entire
process a smooth one for patients. Our GPS
team of multilingual professionals is dedicated to assisting families, 24 hours a day,
7 days a week, to help manage the complex
logistics involved in planning for care far
from home, including:
• scheduling physician visits and clinical appointments
NewYork-Presbyterian:
Providing a direct
connection to first-class
medical care
NewYork-Presbyterian
• escorting patients to appointments
• explaining and interpreting medical
information, instructions, and procedures
• facilitating communication between
physicians, administrators and patients
• organizing global air ambulance,
ground ambulance, or other emergency
transport services for critically ill patients
• helping to arrange for hotels or furnished apartments, including NYP’s onsite facilities
• assisting families in understanding
the cost of care
Innovative treatments in these
specialties and others:
• Cancer Care: NYP is home to two
major cancer centres – the National Cancer Institute-designated Herbert Irving
Comprehensive Cancer Center at Columbia, and the Weill Cornell Medicine
Meyer Cancer Center at NewYork-Presbyterian. Patients benefit from the latest
anti-cancer drugs, targeted therapies, advanced radiation therapies, and emerging
minimally-invasive surgical procedures.
• Cardiology: NYP is renowned for its
latest interventional therapies and pioneering cardiac surgery techniques, including heart transplants. NewYork-Presbyterian is one of the leading centres in the
United States for innovative treatment of
adult heart conditions and for paediatric
cardiology.
• Neurosciences: NYP continues to
make clinical advances for conditions such
as glioblastoma and complex epilepsy, as
well as offering new applications for highintensity-focused ultrasound for neurological conditions.
• Orthopaedics: NYP treats patients of
all ages, from newborns to older adults, for
virtually every type of orthopaedic injury,
disease, or disorder to relieve symptoms and
restore comfort, function, and mobility.
• Paediatrics: For more than a decade,
NewYork-Presbyterian has been at the forefront of more paediatric treatments than any
other New York City metropolitan area.
NewYork-Presbyterian/Weill Cornell Medical Center
NYP Global Patient Services Program
NewYork-Presbyterian’s Global Patient
Services Program starts you on your
journey to the very best medical care
that you or your loved one deserve.
For more information, contact:
• Issam Ramadan
Mob: +971 56 624 2588
Email: [email protected]
• NYP Main Office: +1 212 746 9100
Email: [email protected]
NewYork-Presbyterian/Columbia University Irving
Medical Center
MIDDLE EAST HEALTHI 31
Heidelberg University Hospital
Hospital overview
Heidelberg University Hospital with its
more than 50 specialized clinical departments is one of the leading medical centres
in Europe. Innovative and effective diagnosis and therapy for all complex diseases
is guaranteed by world-renowned professors and highly experienced doctors.
World renowned physicians, modern
buildings with state-of-the-art equipment,
as well as the proximity and interlinking
of the specialist departments directly benefit our patients. Thousands of patients
from all over Germany and over 100
countries worldwide travel to Heidelberg
for treatment. Outstanding physicians
and researchers, among them Nobel Prize
winners have been working in research facilities in Heidelberg.
Focus on cancer treatment
The National Center for Tumor Diseases
(NCT) in Heidelberg is a national pioneer in
the diagnosis and therapy of cancer. Patients
with cancer are treated jointly by qualified
experts from different disciplines. As a joint
institution of Heidelberg University Hospital
and the German Cancer Research Center, it
is ensured that new therapeutic approaches
are developed and quickly put into practice.
Surgical oncology as well as radio-oncology
are integral parts in cancer treatment as well.
Heidelberg physicians work with state-ofMedicine of the highest standard
– world-class medical care
the-art equipment (including robot-assisted
surgery) and are highly experienced. For
example, the European Pancreas Center at
Heidelberg University Hospital is one of the
world’s leading centres for pancreatic cancer.
The Heidelberg Ion Beam Therapy
Center (HIT) is the first radiation facility
in Europe that works with both protons
and carbon ions. Children and patients
with certain tumours can be treated effectively here. This form of radiation can
for the first time benefit a larger number
of patients with previously incurable tumours.
Outstanding areas of expertise
• Oncology (all disciplines): surgical oncology (including robot-assisted surgery
[DaVinci system]), chemotherapy, stem
cell transplantation, innovative radiation
therapy including latest technologies, such
as proton-/heavy ion, comprehensive care
in the National Center for Tumor Diseases, pain centre
Heidelberg University Hospital
The International Office Team will gladly support you with your treatment inquiry and further questions and highly experienced specialists will
review your case.
• Visit us on: www.heidelberg-university-hospital.com
• email: [email protected]
• Phone: +49 (0)6221 56 6243
32 IMIDDLE EAST HEALTH
• Heart and vascular medicine
• Neurology and Neurosurgery
• Metabolism and hormonal disorders
• Gynaecology and perinatal medicine
• Orthopaedics
• Paediatrics
Services for international patients
and Arab patients includes:
• Multilingual team of the International Office at Heidelberg University
Hospital
• Certified interpreters
• Support to foreign patients in obtaining a medical visa to travel to Germany.
• Service is provided by friendly, English-speaking nursing personal
• All doctors speak fluent English, and
medical reports are written in English, if
desired
• Special requests regarding meals are
taken into consideration
• There is a prayer room available in
the hospital for our Muslim patients
34 IMIDDLE EAST HEALTH
Health Industry Development Institute
(KHIDI), a government organization associated with Ministry of Health and Welfare
in Korea, will hold the “KOREA MEDTECH EXPERIENCE PAVILION” at Arab
Health from January 30 to February 2, 2023.
Visit the KOREA MED-TECH EXPERIENCE PAVILION to view and experience the excellent quality of Korean medical devices. You are invited to collaborate
with the Korean medical device compaVisit the Korean MedTech
Experience pavilion at
Arab Health 2023
Meet and collaborate with a range of excellent
and pioneering medical device companies
Korean Healthcare
nies who are seeking partners to grow their
businesses through one-to-one business
meetings during Arab Health 2023.
Nine companies will be showcasing their
medical products in the fields of surgery, diagnostics and medical imaging. Five of the
companies were selected by the Korean Government because of their pioneering medical
technology that will advance healthcare.
KHIDI is actively promoting and supporting the marketing of these innovative
medical device companies in an effort to
firmly establish the sector in Korea.
KHIDI looks forward to seeing you at pavilion H7.G50 during Arab Health 2023.
Korean pavilion H7.G50
Contact
Secretariat of KOREA MED-TECH
EXPERIENCE PAVILION of the KHIDI
Email: [email protected]
Website: www.khidi.or.kr/device
Deep Bio Inc. is an AI healthcare company with in-house expertise in deep learning and cancer pathology.
The company was founded in 2015
with the transformative mission: To advance patient outcomes by driving innovation in technology, while empowering
clinicians by providing the tools to make
critical decisions.
Deep Bio envisions a world where clinicians are empowered with technology designed to unlock personalized insights and
enhance healthcare delivery, so they can
focus more on what they do best: Caring
for their patients.
As a first step towards this goal, Deep
DEEP BIO to showcase
expertise in deep learning
and cancer pathology
Bio strives to radically improve efficiency
and accuracy of pathologic cancer diagnosis and prognosis by equipping pathologists with deep learning-based IVD
SaMDs (In Vitro Diagnostics Software
as a Medical Device), for optimal cancer
treatment decisions.
DeepDx Prostate
DeepDx Prostate detects and highlights areas
of interest on prostate needle biopsy whole
slide images (WSIs). It provides various automated metrics for more accurate and consistent results and facilitates faster pathology
workflow. In a clinical validation, its performance was demonstrated to provide specialist-level support to pathologists.
Key Features
• Coloured overlays for each Gleason
pattern at the gland-level: Pattern 3, Pattern 4, Pattern 5
• Tumour & Pattern Quantification:
The proportion of each Gleason pattern
out of the total tumour area and tumourto-tissue ratio quantified automatically
• Auto Length Measurement: Automatic measurements of total tissue and
total tumour lengths
• Use cases First Read Concurrent read
• Quality control and R&D
• Real world tested
• Deployed in US CLIA labs, successful analysis of 700K+ core biopsy images
between 2019 and 2021.
n To learn more, visit www.deepbio.co.kr.
email: [email protected]
DeepDx Prostate: Clinically-validated & CE marked AI software for prostate cancer
MIDDLE EAST HEALTHI 35
36 IMIDDLE EAST HEALTH
Neurosona, established in 2017, has a
research support agreement with the
Brigham and Women’s Hospital (BWH)
of Harvard Medical School and is leading
the world in research and development of
low-intensity focused ultrasound devices
for treatment of brain diseases.
Based on the differentiated brain stimulation technology, Neurosona is conducting clinical trials on brain diseases including major depressive disorder, Alzheimer’s
disease, neuropathic pain, disorders of
consciousness, sleep disorders, and stroke
recovery in specific areas of the entire
brain, including the deep brain.
Image-guided low-intensity focused
ultrasound technology
Neurosona’s low-Intensity focused ultrasound technology accurately transmits
low-intensity acoustic energy with low
heat generation from the brain cortex to
the deep brain for neuromodulation or
blood-brain barrier opening in specific
brain areas. Since it hardly generates any
heat, the technology is relatively safe and
it can accurately stimulate specific areas,
including the deep brain.
Ultrasound stimulator system
Neurosona has developed the low-Intensity focused ultrasound stimulator system
(NS-US series) for application of noninvasive interventions of brain diseases,
such as major depressive disorder and Alzheimer’s disease, by precisely stimulating
specific areas of the whole brain, including the brain cortex and deep brain with
the low-intensity focused ultrasound of
less than 250 kHz that has been proven
to be safe.
Neurosona’s focused ultrasound stimulation system enables good access to the deep
brain for treatment. In addition, since this
system offers ultrasound according to parameters optimized for target diseases, it
Neurosona specialises in development
of focused ultrasound devices for
treatment of brain diseases
can provide patient-customized precise
stimulation for local areas of the whole
brain. Based on these advantages, Neurosona continued to improve the ease of use
of this system for patients and doctors.
Neurosona’s low-intensity focused ultrasound stimulation system NS-US200
was designated as an innovative medical
device in August 2021 in recognition of
its innovative technology and clinical improvement potential by the Korean Ministry of Food and Drug Safety.
n For more information, visit: www.neurosona.com Email: [email protected]
Korean Healthcare
MIDDLE EAST HEALTHI 37
VUNO is a global leader in medical AI
with a proven track record developing and
commercializing medical AI deep learning
solutions. VUNO strives to realize the pos
-
sibilities of AI technology in medicine to
improve quality of life for mankind.
Their goal is to develop and commercial
-
ize AI solutions that leverage a wide range of
medical data including bio-signals, imaging,
and digital pathology to detect and prevent
disease early on.
Founded in 2014, VUNO was the first
company to successfully obtain Korea
FDA(MFDS) approval for medical AI soft
-
ware. Since then, VUNO has rapidly ex
-
panded its commercial presence and product
portfolio to encompass a diverse and compre
-
hensive line up of impactful and clinically rel
-
evant solutions.
With a proven R&D and commercial
track record, including a history of success
winning international technical challenges
coupled with global deployments in over
500 hospitals, VUNO is an undisputed
leader in the global medical AI arena.
n For more information,
visit: [email protected]
VUNO
specialises
in medical
AI deep
learning
solutions
38 IMIDDLE EAST HEALTH
Since its establishment in 2020, Surginus Co., Ltd.
has been developing and manufacturing products
with the value of improving quality and patient-centred technology.
For the first time in Korea, they have developed
a product (Foldable Skin Closure) that uses a new
type of suture method without using needles, threads
and staples.
In addition, in order to make products that can give
satisfaction to patients and medical staff, they are manufactured in a clean room (ISO 8, Class 10,000), and ‘ISO
13485:2016, FDA (Listing)’ has been acquired.
Surginus will continue to strive to increase its
value in the future.
Surginus
develops new
type of suture
method
Korean Healthcare
n For more information, visit: [email protected]
MIDDLE EAST HEALTHI 39
LAON MEDI Inc. provides medical solutions based on AI (Artificial Intelligence)
technology with a mission to create a happy world with technology.
Launched in 2018 by its parent company
LAON PEOPLE Inc. (KOSDAQ-listed), it
is a young company that was spun-off last
year and established as a separate corporation.
Based on their achievements in Machine Vision, they have developed their
own AI algorithms, and based on this, they
have expanded their scope to transportation, agriculture, military, and medical and
dental fields. AI is now a reality, not a field
LAON MEDI’s AI tech analyzes airflow
to detect of obstructive sleep apnoea
of study, and application in the medical industry is essential.
For more accurate diagnosis, LAON
MEDI is researching and developing
medical software that is convenient and
useful in real life.
Obstructive sleep apnoea
LAON MEDI’s software is an AI technology that analyzes airflow in the airway based
on the patient’s CT/CBCT imaging and
determines whether there is obstructive
sleep apnoea. This technology consists of
a medical image derivation model that extracts upper airway features from CT images, a flow factor derivation model that
predicts flow characteristics according to
airway features, and a sleep apnoea severity diagnosis model that determines the severity of obstructive sleep apnoea from the
patient’s ergonomic information.
Using this technology, it is possible to
identify the morphological factors of the
patient’s airway and quantitatively present the flow factors, air pressure in the
airway and the degree of airway closure
(strain rate). In addition, the derived factors help doctors make a final diagnosis
by analyzing the possibility of obstructive
sleep apnoea.
n For more information, visit: www.laon-medi.com Email: [email protected]
40 IMIDDLE EAST HEALTH
Founded in 2014, FCU Ultrasound specializes in developing and manufacturing handheld ultrasound devices and probes.
As a professional medical device manufacturer, FCU Ultrasound have
ISO13485, KGMP, MFDS, CE, and FDA certification products.
They have maintained a high growth rate every year. And, in 2021,
they recorded more than 70% growth year-on-year, and nearly 90% of
their sales were exports.
FCU Ultrasound manufacture OEM transducers (single crystal, composite, bulk PZT, low-cost PZT) for a variety of applications with technology that meets the price and performance based on customers’ needs.
They are gradually expanding from OEM supply to their own branded products. In particular, the handheld ultrasound is equipped with a
needle navigation solution for the first time in the world. Based on this,
they hope to target the world market in earnest to create new business
models with global companies in the digital healthcare field.
PC based needling training tool for ultrasound
guided procedures, eZSimulator
Various training
• For training of the probe-needle coordination in real application
scenarios
• The most intuitive tool to learn two hands eye coordination
Independent training
• Without the need of an ultrasound systems or special phantoms.
World’s first handheld navigation ultrasound, SC1
KEY POINTS
1. Best-in-class image quality
2. Needle guidance system
3. Easy to learn, easy to use
Needle Guidance System
By using magnetic sensors, SC1 recognizes and tracks a magnetized needle.
In-plane approach. Align confidently
• It is easy to perform the procedure while checking the alignment of
the probe icon and needle on the screen.
• Through the guideline, you can check where the needle is currently
located in the body.
Out-of-Plane approach. Just set the target, and inject
• While it is usually difficult to know the distance and depth from the
needle to the target, SC1 allows you to know these prior to insert and to
adjust the angle of the needle accordingly.
Procedure oriented ultrasound for safe procedures, for everyone.
FCU Ultrasound focuses on handheld
ultrasound devices and probes
Korean Healthcare
n For more information, email: [email protected]
Procedure oriented
ultrasound for safe
procedures, for everyone.
MIDDLE EAST HEALTHI 41
Established in 2004, Sunmedix Co., Ltd., specialises in manufacturing various kinds of medical devices, especially products related to
surgical procedures.
Their mission is: “For the wholesome daily lives of our neighbours.”
Through constant brainstorming, Sunmedix realizes and customizes products based on their buyer’s needs. They export their products
to more than 30 countries with ISO13485 and CE certifications.
Dcos DVT Prevention Pump System
Dcos is a portable and detachable pneumatic device with 3-chambers intended to prevent post-operative DVT (Deep Vein Thrombosis). It delivers a sequential pneumatic pulse through an air cuff
and stimulates blood circulation, and reduces pain and swelling.
Dcos is a lightweight device weighing approximately 326 grams,
which greatly enhances it convenience for the user.
The great advantage of Dcos is that it is not limited to use in the
operation room or recovery room. It is free of obstructions compared to the bed-mounted type.
Sunmedix is supplying the world’s first E.O. sterile cuffs,
which have has a great ripple effect in the market.
Gcos Bipolar Vessel Sealer
Gcos is a sterile single-use electrosurgical device used in coagulation (haemostasis) and incision of the blood vessels and
tissues, to be connected to a medical electrosurgical generator unit.
It reduces blood loss, procedure time and patient length of stay
compared to sutures and clips.
Features:
• Ergonomic handle
• Freely rotatable shaft
• Safety system for blade operation & auto-lock function
• Soft cutting & less tissue damage
• Compatible with different electrosurgical generators
• Minimally invasive procedure: minimizing tissue damage and
thermal injury
• Unique ergonomic design: eliminates deviation of the wrist, reduces carpal tunnel pressure and eradicates fatigue
• Efficient & precise surgery
Sunmedix’s portable
& detachable pneumatic
device helps prevent
post-operative DVT
MIDDLE EAST HEALTHI 41
42 IMIDDLE EAST HEALTH
meerecompany is a global company that
focuses on innovation and aims to maximize the happiness of its customers, employees and shareholders. Since 1984,
meerecompany has been responding to the
rapidly changing technological environment and conducting research to usher in
the innovations of the future.
Revo-i surgical robot
The Revo-i system is a safe and affordable surgical robot which utilizes the latest technologies with the aim of providing better care to
more patients anywhere around the world.
Features of the Revo-i system include:
informative imaging, intuitive control, advanced devices and virtual training.
Since 2007, meerecompany has conMeerecompany develops
surgical robots with
advanced technology
tinuously strived to reflect the voices and
opinions of medical professionals, while
also taking into consideration the difficulties of managing a hospital with dynamic
surgical environments.
meerecompany’s focus is to reduce this
burden by making an affordable surgical
robotic device and delivering a reliable
product with high-level service from their
professional care team.
meerecompany strives to offer an excellent programme that synergizes with hospitals, surgeons, patients and corporations.
Introducing Revo-i
Master Console
The Master Console is the Revo-i surgical
robotic system’s control centre. A surgeon
can issue commands to the master console
located outside of the sterilized area by
controlling the instrument with 3DHD vision during the surgery.
Operation Cart
The Operation Cart assists surgeons in
performing surgeries with the use of Revo-i
free-wrist instruments and a 3D endoscope
camera while minimizing tremors and micro-movements.
Vision Cart
The Vision Cart enables surgeons to clearly
visualize the overall process of the surgery.
The Revo-i image processing system delivers surgical images for surgeons and OR staff
to help them communicate better.
n For more information, email: [email protected]
Korean Healthcare
LIVSMED, established in June 2011, is a
medical device company specializing in laparoscopic devices. Their goal and vision is to
lead the global medical device industry with
their unique products beginning with ArtiSential, their multi-joint, multi-DOF laparoscopic instrument that allows 360-degree
movement in laparoscopy and overcomes
the various limitations of existing straighttype instruments and surgical robots.
Approved by the Korean FDA in 2018,
LIVSMED has received awards for its innovative technology and contribution to public
welfare, as well as being chosen as “Innovative Medical Device Company” by the Korean Ministry of Health and Welfare in 2020.
LIVSMED strives to contribute to life
extension and overall healthcare of all
mankind by creating innovative products while adhering to the highest ethics.
LIVSMED’s mission is to bring surgery
with precision to the hands of doctors, one
patient at a time.
ArtiSential: The innovative nextgeneration surgical instrument
ArtiSential is a disposable laparoscopic
medical instrument usable in all minimally
invasive surgeries including gastrointestinal, thoracic, hepato-pancreatic, colorectal surgeries and others.
ArtiSential is characterized by its total 360 degrees of freedom and intuitiveness, which distinguishes it from existing
straight-line instruments and their limited movement. ArtiSential’s multi-jointed
end-effector provides surgeons with precise
control which is essential for accessing narrow surgical sites and performing with dexterity in laparoscopy. In addition, ArtiSential’s end-tool moves in synchronization
with the user’s hand motions. Its intuitive
control provides much higher ease of use.
ArtiSential’s end-tool functions similarly
to that of a surgical robot, since the instrument moves in all directions smoothly with
the help of its multi-jointed technology.
ArtiSential is a hand-held device which
can be used in existing surgical environments without any additional devices.
LIVSMED’s laparoscopic medical
instruments enable precision surgery
This is advantageous in aspects of costeffectiveness and efficiency.
The company has a variety of end-tool
types (e.g. forceps/grasper, needle holder,
dissector, hook, spatula, clip applier, etc.),
selectable by surgical need or users’ comfort.
ArtiSential’s products come in various
lengths (25cm, 38cm, 45cm) and sizes
(5mm, 8mm). Some types have bipolar/
monopolar energy options.
n For more information, visit: www.livsmed.com Email: [email protected]
MIDDLE EAST HEALTHI 43
Radiology
44 IMIDDLE EAST HEALTH
For the first time, a team of researchers
at the Technical University of Munich
(TUM) has integrated the dark-field Xray method into a CT scanner suitable for
clinical use. Dark-field imaging provides
additional information to conventional Xray imaging. With the new prototype, it is
now possible to produce three-dimensional dark-field X-ray images.
Computed tomography (CT) is one of
the most important clinical methods for
precise and fast diagnostics. By combining
Researchers integrate
dark field X-ray with
conventional CT technology
multiple X-ray images three-dimensional
images of the patient are generated.
With dark-field imaging, additional information on fine tissue structures, in particular in the lung, is now accessible. Until
now, technical challenges have prevented
the integration of this new technology into
clinical CT scanners to examine patients.
A team of researchers working with
Franz Pfeiffer, Professor for Biomedical
Physics and Director of the Munich Institute of Biomedical Engineering at TUM,
has now developed a CT scanner that
combines both X-ray technologies [1].
“For the first time, we showed that
dark-field X-ray technology can also be
integrated into a clinical CT scanner.
Although this technology is in its early
stages, pre-clinical studies with mice have
demonstrated clear benefits from darkfield CT scans, especially for capturing images of lung tissue,” says Franz Pfeiffer, who
headed the study.
The new CT prototype has already been
Prof. Dr. Franz Pfeiffer with the dark-field CT scanner.
Radiology
used successfully with a thorax phantom,
a model of a human upper body, and is
large enough for the intended applications with real patients.
Conventional X-ray imaging
With conventional X-ray equipment, the
X-rays are attenuated by the intervening
tissue as they travel from the source to
the detector. This effect is used to produce
images based on the varying degrees of attenuation associated with different tissue
types and structures. That is why bones
and similar structures, which have a stronger attenuating effect, appear white in Xrays, while more transparent tissue types
such as the lung produce darker images.
Dark-field X-ray imaging
Dark-field imaging, by contrast, makes
use of the small-angle scattering of the
X-rays. When the X-rays interact with
materials of different densities such as the
interface between lung tissue and air, they
are scattered. The analysis of this scattering effect yields additional information
Reference: 1. doi: https://doi.org/10.1073/pnas.2118799119
on very fine tissue structures, which is
otherwise not accessible with conventional X-ray images
.
Grating technology
for dark-field imaging
To detect the scattering of the X-ray radiation, a set of three optical gratings is
required. They are placed between the Xray source and detector. When X-rays pass
through these gratings, a characteristic
pattern is produced at the detector. When
a sample or person is then positioned in
the beam path, this characteristic pattern
is changed. These deviations are then used
to analyze the structure of the sample or
the person’s tissue.
New hardware and
software for dark-field CT
The implementation of the dark-field
method in a human-size CT scanner poses
various technical challenges. Until now,
this has limited dark-field CT devices to a
scale much smaller than would be needed
for human patients. Apart from the size, the
Prof. Dr. Franz Pfeiffer (back, left), Professor for Biomedical Physics, and his team have developed a
prototype of a clinical CT scanner which combines dark-field and conventional X-ray technology (back
right: Dr. Thomas Koehler, front left: Clemens Schmid, front right: Manuel Viermetz).
fast rotation of the scan unit also creates
special difficulties for the technical design.
The scanning unit of CT scanners,
known as the gantry, rotates at very high
speeds. This causes vibrations that affect
the finely-tuned components in the interior of the device. Based on a detailed
analysis of these vibrations, the team was
able to use them to implement the required shift between the gratings needed
for dark-field imaging. To analyze the
scans, they developed new algorithms to
filter out the vibration effects based on
reference scans.
“With the dark-field CT prototype, we
can capture conventional and dark-field
X-ray images in a single scan. This yields
additional information that could be used
in the future not only to diagnose lung diseases, but also to differentiate between various types of kidney stones and tissue deposits,” says Manuel Viermetz, one of the two
first authors of the study. As the next step,
the researchers plan to further optimize the
dark-field CT prototype and prepare for the
first scans of human patients.
MIDDLE EAST HEALTHI 45
46 IMIDDLE EAST HEALTH
A new method for determining whether
patients with heart disease need coronary
stents or bypass surgery is more effective than the angiogram, which is currently used, according to research from
UTHealth Houston Heart & Vascular.
A team led by K. Lance Gould, MD, professor and the Martin Bucksbaum Distinguished
University Chair in Heart Disease with McGovern Medical School at UTHealth Houston, used positron emission tomography
(PET) imaging technology to map coronary
blood flow and its outcomes – namely, subendocardial ischemia – among patients with
heart disease. The study was published in
JACC: Cardiovascular Imaging [1].
Most forms of heart disease cause myocardial damage. Myocardial ischemia
occurs when blood flow to the heart is
reduced, preventing the heart muscle
from receiving enough oxygen. When
myocardial ischemia affects the deep, or
subendocardial, layer of the left ventricular muscle, it is known as subendocardial
ischemia.
Subendocardial ischemia is commonly
diagnosed in patients with cardiovascular
disease, but it is not quantified by current
imaging tools. Gould’s team developed
the PET technology, software, and clinical validation for defining the size and severity of this early stage of coronary artery
disease.
“The cumulative data reveals that all
randomized trials of coronary stents and
bypass surgery have failed to improve survival after revascularization due to profoundly flawed patient selection based on
the angiogram,” said Gould, who was first
author on the study. “Thus, the coronary
angiogram is not the gold standard for
determining stents or bypass surgery, but
PET technology more effective than
angiogram at determining need for
coronary stents, bypass surgery
rather, quantitative myocardial perfusion
by PET is the gold standard.”
Significantly, the paper confirmed the
team’s previous research by proving the
PET threshold of severity at which stents
and bypass surgery improve survival compared to medical treatment alone. The angiogram – an X-ray test that helps doctors
evaluate blockages in the arterial system –
shows how to do stents or bypass surgery,
Gould said, but not whether those procedures should be done at all.
Gould, who began working at UTHealth
Houston in 1979 as a professor and director of the division of cardiology, stepped
aside from administrative duties in 1987 to
focus clinically and scientifically on PET
imaging and quantitative coronary arteriography for identifying segmental and diffuse coronary artery disease, measuring its
severity and reversing it by vigorous risk
factor modification.
“Several equally paradigm-changing papers are underway for the coming year,”
Gould said. “For example, our preliminary
data show that virtual revascularization on
cardiac PET images predicts survival outcomes before actually doing stents or bypass surgery, as a guide to making decisions
for or against those procedures.”
Reference: 1. doi: https://doi.org/10.1016/j.jcmg.2022.05.016
Radiology
MIDDLE EAST HEALTHI 47
48 IMIDDLE EAST HEALTH
Regular postsurgical screening is critical for patients with lung cancer. In cases
involving early-stage non-small cell lung
cancer, up to half of patients will experience recurrence within the first two years
after surgery.
For these reasons, guidelines by the
U.S. National Comprehensive Cancer
Network and other cancer groups recommend computed tomography (CT) scans
every three to six months for patients
who have had malignant lung tumours
surgically removed. However, a new study
by researchers at Washington University
School of Medicine in St. Louis found no
improvements in survival or recurrence
rates among patients who followed the
protocol, compared with those who were
scanned every six months to one year.
“Our findings suggest that lung cancer
treatment guidelines should consider less
frequent surveillance imaging than current recommendations,” said the study’s
senior author, Varun Puri, MD, a thoracic
surgeon and professor of surgery. “Annual
surveillance would simplify guidelines and
may result in better, easier postoperative
care for early-stage patients.”
The study is published 28 November
2022 in the Journal of the National Cancer
Institute.
Non-small cell lung cancer accounts for
84% of all lung cancer cases, according
to the American Cancer Society, and the
overall five-year survival rate is 25%.
The researchers focused on the first two
years after surgery since that is when the
risk of lung cancer recurrence is highest.
More frequent CT scans
not associated with
improved outcomes after
lung cancer surgery
After two to three years, cancer organizations typically recommend annual scans
until the end of life.
“Scanning too frequently can be associated with unnecessary anxiety for
patients and increased healthcare costs,”
said Dr Puri, also a research member of
Siteman Cancer Center at Washington University School of Medicine and
Barnes-Jewish Hospital. “Patients who
receive scans to check for recurrent cancer are understandably anxious, especially
since it can take several days for results to
be received. This phenomenon is sometimes called ‘scanxiety.’ It is obviously
important to minimize scanxiety when it
can be done safely.”
For the study, the researchers analyzed de-identified medical records in a
database maintained by the U.S. Veterans Health Administration, the United
States’ largest integrated healthcare delivery system. The researchers examined
information involving 6,171 patients
with stage 1 non-small cell lung cancer who underwent surgery from Oct. 1,
2006, through Sept. 31, 2016. One patient group received scans every three to
six months, and the other group every six
to 12 months.
In all cases, more scans did not offer improved health, including among different
tumour sizes, tumour stages and types of
surgical procedures. Recurrence was observed in 22% of patients and did not differ
based on the frequency of scanning. Similarly, overall survival remained the same
between the two groups, with about 65%
of patients surviving at least five years.
The average age of the patients was
67.5. The patients were predominantly
male and white; however, statistical modelling controlled for different ages, genders
and races.
“We found that certain patients had received more frequent CT scans, including
patients who smoked and patients who
had certain types of operations,” said the
study’s first author, Brendan Heiden, MD,
a surgical resident and research fellow at
Washington University.
Heiden continued: “The VA treats a
unique patient population that consists
mostly of males with significant smoking
histories. Therefore, we believe that our
findings are most applicable to veterans
with lung cancer. However, prior studies
examining non-VA patient populations
have found similar results to ours, suggesting that the results may apply more
broadly to the general population. More
research is needed.”
Our findings
suggest that lung
cancer treatment
guidelines
should consider
less frequent
surveillance imaging
than current
recommendations.
Radiology
Reference: doi: http://doi.org/10.1093/jnci/djac208
50 IMIDDLE EAST HEALTH
30 years of UpToDate
Wolters Kluwer
Clinical decision support (CDS) is an essential tool [1] for empowering clinicians
with immediate, evidence-based knowledge, no matter how quickly the evidence
changes. Ubiquitous as CDS systems are today, it wasn’t all that long ago that providers
had to go out of their way to track down
answers to vital patient care questions.
A lot has changed in the world of patient care over the past 30 years. It’s hard to
imagine that 30 years ago when clinicians
had a question, they had no choice but to
stop what they were doing and run out to
the library to research the latest best practices. There was no guarantee the information was relevant to their specific needs,
and even if it was, the content was likely at
least a year old due to publishing timelines.
Building a better point-of-care
solution for clinicians
That was the inspiration behind the very
first clinical decision support tools like
UpToDate® [2]. Over the years, having
electronic access to clinical research has
been a game changer for healthcare professionals, helping them keep up with the
crushing number of new studies, best practices, and therapies. Thirty years later, UpToDate is the most widely used and universally respected resource for efficiently
accessing clinical evidence at the point of
care. The advantages of having UpToDate
right by their side whenever and wherever
clinicians and healthcare professionals
have questions has helped it grow to:
• 44,000+ institutional sites
• 190+ countries
• 2 million+ users
• 650 million+ topic views per year
About 1.6 million times every day, a clinician turns to UpToDate for support with their
decision-making – and about a third of the
time [3], it changes their practice. It could be in
a hospital ward; a doctor’s office; a lecture hall;
an emergency room; a laboratory; or wherever
else the point of care happens to be.
Today, clinicians around the world rely
on UpToDate to support their confidence
in clinical decision-making:
• “Having UpToDate in my pocket always gives me strength and confidence.”
– Dr. Turgut Kacan, Associate Professor, Oncologist, Bursa Yuksek Ihtisas MOH, Turkey
• “It’s like an attending physician.
When I have some clinical question, I always consult UpToDate.”
– Dr. Hiroshi Sudo, MD, FACP,
Department of Medicine, Ofuna Chuo
Hospital, Kamakura, Kanagawa, Japan
• “The clinical teams trust UpToDate.
It gives them the confidence to make care
decisions because they trust the information, because it’s evidence-based.”
– Dr. Jonathan James, Chief Strategy
Officer, Axis Medical Center,
Minneapolis, Minnesota, United States
• “UpToDate has the value of a stethoscope and fever thermometer for us physicians. The tool has replaced quite a lot of
textbooks and journals.”
– Dr. Michael Zeller, Senior Physician,
Pediatrics, Klinikum Dritter Orden,
Munich, Germany
Clinical decision support during COVID-19
But what happens when there is no clear, actionable, evidence-based knowledge to share?
In the months leading up to the pandemThe evolution of clinical decision support
and the future of evidence-based medicine
MIDDLE EAST HEALTHI 51
Wolters Kluwer
References
1. https://www.wolterskluwer.com/en/expert-insights/in-an-increasingly-complex-healthcare-system-information-is-the-best-medicine
2. https://www.wolterskluwer.com/en/solutions/uptodate
3. https://assets.contenthub.wolterskluwer.com/api/public/content/fcaf3046dec8457fa898900b4380bfd4?v=72635d88
4. https://www.wolterskluwer.com/en/solutions/uptodate/resources/covid-19
5. https://www.wolterskluwer.com/en/know/healthcare-challenges/reducing-clinical-variation
6. https://www.nejm.org/doi/full/10.1056/nejmsa022615
7. https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1248
Watch this video to hear
from Wolters Kluwer
leadership as they look
back on 30 years of how
UpToDate has become the
standard for evidence-based
clinical decisions.
>> https://bit.ly/3vojMdL
ic, CDS tools contained just a few topics on
the coronavirus. And in the early months,
there was little published literature to help
clinicians understand the signs, symptoms,
and consequences of being infected. Based
on input and guidance from global experts
in the field of infectious disease, the content
in UpToDate has expanded [4] to 90 topics
on the disease – and was refreshed more
than 2,000 times to synthesize new learnings as quickly as it was being published.
Focused on a future of
evidence-based medicine
While the delivery method and technology has evolved, the core principle of
thoughtfully answering questions with actionable information at the point of care
has never wavered.
At the heart of UpToDate is an unparalleled community of over 7,400 authors and
editors from around the world who share
a singular passion – writing and editing
trusted evidence-based content and guidance to produce harmonized content.
One of the challenges the healthcare
industry continues to grapple with is the
potential patient harms and organizational inefficiencies caused by variability
in care [5]. According to a New England
Journal of Medicine study [6], only about
55% of recommended care is actually given to patients. Data [7] published in 2018
found that only 8% of U.S. adults over
the age of 35 received all of appropriate,
high-priority, preventive clinical services
they required, while 5% received no such
services at all.
With each year, UpToDate seeks to
further reduce harmful variations in care
by connecting healthcare professionals
to the most recent standards of practice,
latest literature and recommendations on
treatment options and diagnostic tests,
and clinical pathways.
As we look to the next 30 years, we know
the speed at which new medical advances
become available will only continue to
accelerate. Distilling all that down into
a discrete recommendation for a specific
patient – while making the entire experience easy and transparent for clinicians –
will be one of the most important things
we can do to help ensure every decision at
the point of care results in the best possible
outcome for that patient.
Watch video:
30 years of UpToDate
52 IMIDDLE EAST HEALTH
Since Priory opened its inaugural Wellbeing Centre in Dubai in 2017, the worldrenowned mental healthcare provider has
gone from strength to strength across the
region. This has coincided with a period
in which the mental health landscape in
many Gulf countries has witnessed a transformation, according to the company’s
Chief Operating Officer, Will Goodwin.
During the last five years, Priory has
opened two more Wellbeing Centres – one
in Abu Dhabi and, more recently, one in
Riyadh, Saudi Arabia. This is in addition
to operating a school and training institute
for young people with autism. Such is the
increase in demand for mental health services that in the New Year, Priory will be
relocating its current Wellbeing Centre in
Dubai from Healthcare City to larger premises in City Walk. This new location will
enable an expansion of provision to include
adult and children’s services, alongside psycho-educational assessments for conditions
such as autism, with associated treatments
including speech and occupational therapy.
Goodwin is in no doubt that some of this
demand is an after-effect of the pandemic,
which has led to an increase in anxiety levels, particularly among women and younger
people. Priory, for example, experienced an
increase in volume of patients as a direct
consequence of this and it led to the launch
of its telehealth services, which supported
patients remotely during this time. This has
now become a useful, mainstay addition to
support its services for patients who may
want to use a digital medium and much of
the private mental health sector was quick
to incorporate telemedicine into practice.
This was not only to meet the increase in
demand, but also to facilitate the availabilDemand for mental health services
grow across the Middle East
Mental Health
ity and accessibility to the services.
However, Goodwin feels strongly that
the pandemic also exacerbated existing
mental health challenges, such as the growing influence and dependence on electronic devices and social media. Nevertheless,
such issues have also encouraged more people to become more aware of their mental
health needs generally. In a recent study,
more than 40% of those surveyed said they
are paying more attention to their mental
health following the pandemic.
Breaking the silence of mental stigma
“Mental wellbeing was already one of the
key components in the UAE GovernPriory Healthcare continues its expansion across the Middle East as
attitudes to mental healthcare witness an encouraging transformation,
according to Will Goodwin, the Chief Operating Officer at Priory.
Will Goodwin, Priory COO, Trevor Torrington, Priory CEO, and Patrick Moody,
Her Majesty’s Ambassador to the UAE
ment’s national agenda of the UAE Vision
2021 and the UAE National Happiness
Agenda,” says Goodwin.
“It was also already fostering and encouraging local and international enterprises to
establish innovative services in the mental
health sector. But during the pandemic the
Government really came into its own and
further raised the profile of mental health.
“Many forward-thinking and targeted
mental health support initiatives were introduced, such as a national campaign for
mental health support launched by the National Programme for Happiness and Wellbeing, the Employee Assistance programme
(Hayat) to assist federal government employees dealing with mental health challenges and ReacHer a WhatsApp mental
health support and consultation service for
Emirati women, to name a few.
“Such activities really helped seize the
opportunity to break through the silence of
mental health stigma and encourage people
to talk openly about their mental wellbeing
and ill health. Importantly, this improved
landscape for people to be able to seek help
earlier is incredibly beneficial in treating
conditions and gaining the best possible,
long-term outcomes,” says Goodwin.
He reports that many mental health clinicians are seeing increases in the number
and severity of cases in their clinics. This
may be an actual increase or that many previously undiagnosed individuals are now
coming forward and seeking support. For
example, depression and anxiety are more
common as a result of the recent pandemic. People became socially isolated, they
were ‘cut off’ from recreational and health
promoting activities, there were also more
financial and social stressors, to name few.
Either way, Goodwin is pleased that Priory
will be able to help support the increased volume of patients that are now reaching out for
help. He is keen to point out how this increase
in demand is now being complemented by the
expansion of mental health services in the private sector generally.
Access to support
Additionally, access to its support has been
made more readily accessible as a result of
the improved inclusion of mental health
by a number of health insurance providers.
This is aptly reflected by a new empanelment between the Priory Wellbeing Centre
in Abu Dhabi and one of the UAE’s leading insurance providers, Daman. As a result
of this improved health insurance coverage
for mental health, Goodwin expects more
people – both Emiratis and expatriates – to
feel encouraged to seek help.”
Goodwin believes the constantly evolving
and progressive mental healthcare landscape
in the UAE, in addition to its supportive visionary nature have been pivotal in its current
success and plans for future expansion.
“Our plans are to expand our services
in the UAE and KSA to support our integrated model for education and healthcare.
We have been able to transfer the quality
of our UK services into the Middle East
market successfully and our plans include
further developing our healthcare offer to
include inpatient services and, in education, the development of further provision
across the UAE and KSA geographies. We
feel extremely privileged to be a part of the
country’s efforts to provide a world class
mental health and educational service.”
MIDDLE EAST HEALTHI 53
Photo by Matthew Ball/Unsplash
54 IMIDDLE EAST HEALTH
Since its foundation in 1972, HUMAN has
been developing and marketing comprehensive solutions for in vitro diagnostics (IVD).
The portfolio ranges from classical clinical
chemistry to innovative molecular diagnostic
methods as well as special applications such as
assays for autoimmunity testing.
The German medium-sized company
has its headquarters in Wiesbaden (near
Frankfurt). In addition, HUMAN maintains regional sales offices in the United
Arab Emirates (Sharjah), Singapore, China, India, Panama and has local HUMAN
representatives in many other countries.
With its approximately 300 employees
from over 40 nations, its worldwide service and delivery capacities, and a broad
network of long-standing sales partners,
HUMAN supports medical laboratories in
more than 160 countries.
From a reagent specialist to a global player
“HUMAN has grown from a small reagent
manufacturer to a global player in in vitro
diagnostics,” says Dr Björn Breth, CEO of
HUMAN since 2019. “For 50 years now,
we have been helping to improve healthcare in many places around the world.
With our comprehensive portfolio, we
cover a wide range of regional needs, from
semi-automated devices to fully automated
solutions. Through our logistics and services, we are a recognized partner to numerous governmental and non-governmental
organizations (NGOs) in support of medical care, particularly in crisis areas.”
At the development and production
site in Magdeburg, scientists work with
modern technologies on further developments and innovations with a focus on
HUMAN Diagnostics celebrates its 50th anniversary
HUMAN Diagnostics
clinical chemistry, haematology, haemostasis, and immunoassays. These products
are “Made in Germany” and are in compliance with the highest European quality
standards.
Focus product lines
Clinical chemistry
HUMAN offers a broad range of routine and
special tests in a variety of package concepts
to serve the needs of modern state-of-the-art
laboratories. In the same way, all HUMAN
analyzers and systems emphasize functionality
and modern workflow requirements to meet
customer and market demand.
Haematology
HUMAN’s automated haematology products
are designed for small to large laboratories and
range from 30 to 80 samples throughput per
hour. HUMAN offers both 3-part and 5-part
differential systems with specially developed
and dedicated reagents suitable for human
and veterinary applications.
Haemostasis
HUMAN offers laboratories integrated
haemostasis test solutions with HEMOSTAT reagents and HumaClot analyzers.
Semi-automated, as well as fully automated
HumaClot analyzers support an accurate
and economical assessment of the coagulation status. The applications of the HEMOSTAT reagents are pre-programmed
and fully validated. The HUMAN coagulation portfolio includes a broad range of
commonly performed screening parameters, indicating medical disorders related
to coagulation and fibrinolysis.
CLIA | FIA Immunoassay systems
Chemiluminescence- and fluorescence-based
immunoassay systems are platforms that complement each other perfectly. HumaCLIA
150 is the ideal immunoassay system for testing in central and more remote laboratories.
HumaFIA on the other hand fits into small
to medium throughput laboratories and is intended to run low throughput parameters also
as a backup system for HumaCLIA 150.
For inquiries contact our regional sales
representatives:
HUMAN Diagnostics Middle East FZE
Office: Q3 - 198
P. O. Box 122348 Sharjah, U. A. E.
Phone: +971 6 5578650
E-mail: [email protected]
• From reagent specialist to global player with a broad network of long-standing
distribution partners in more than 160 countries
• Covering a comprehensive product portfolio with more than 400 in-vitro
diagnostic products in 12 segments
Interesting facts
about the 50-year
history of HUMAN,
its milestones and
product highlights
as well as voices and insights of our
cooperation partners can be found
on our anniversary page at
https://www.human.de/abouthuman/50-years-human/
Discover the comprehensive
product portfolio at
https://www.human.de/products/
56 IMIDDLE EAST HEALTH
Covid-19 forced the faster adoption of
innovation by healthcare systems, which
needed quick solutions to address increased hospital admissions and limited
staff and resources. Innovations which
would have otherwise taken a decade to
adopt were rolled out in months.
New medical technology (MedTech)
will play a vital role in years to come,
helping healthcare systems tackle issues
caused by Covid, such as the backlog of
patients awaiting surgery. There are some
clear trends likely to emerge in healthcare
during 2023 and these pose important
considerations for the MedTech industry.
Balancing telemedicine solutions
The pandemic triggered an increase in
telemedicine solutions, with consultations
largely moved to virtual platforms. This
helped healthcare professionals remain
safe but impacted healthcare delivery as
many conditions simply cannot be identified via video or phone calls. Healthcare
systems have realised that some patients
struggle to get appointments or become
frustrated with remote diagnostics.
2023 could mark the year that this trend
begins to reverse. Telemedicine and remote diagnostics will continue, but the future will focus on a hybrid model that balMedTech trends for 2023
MedTech
ances convenience with the patient need
for face-to-face meetings.
Hospital-to-home care
Remote monitoring devices and MedTech
that can be self-applied and managed at
home are likely to increase.
MedTech that allows patients to manage
their conditions remotely reduces the need
for frequent check-ups. The deployment of
clinical grade monitoring equipment has the
power to make care more efficient, providing
treatment to patients only when they need it.
Remote treatment will also increase, enabling hospital-to-home care to support overwhelmed front-line staff. Patients can address
issues in the home that previously would have
required a hospital visit. For patients experiencing delays in surgery, this can keep patients
comfortable while they await treatment.
New treatments
Healthcare services have traditionally been
slow to adopt new treatments. Medical innovation needs to demonstrate it delivers
better clinical outcomes to achieve adoption, but this requires time and funding.
With the development of the MedTech
industry, treatments can demonstrate real
patient benefits far quicker. MedTech solutions can speed up healing by double
or more and, in some cases, identify and
prevent conditions from developing altogether. The pandemic encouraged more
frictionless adoption of MedTech, which
will hopefully continue.
Driving sustainability
Healthcare will not be immune to the growing global climate crisis, and 2023 will see
an emphasis on sustainable solutions that
drive a more circular healthcare system.
MedTech companies are increasingly
challenged to demonstrate compliance
with high levels of sustainability as part
of them becoming a preferred supplier.
Clinicians will look to MedTech innovation which provide solutions that are
good for the planet – not just those that
do less harm.
Less supply chain vulnerability
The recent supply chain issues in China,
combined with the impact of the RussiaUkraine crisis, has demonstrated that an
uncertain world has global implications –
and the healthcare industry is no exception. Healthcare systems need to deliver
continuity of care in an unpredictable
world, particularly ensuring drugs and
MedTech solutions that help people heal
are always available.
Another key trend we can expect to see
in 2023 is that MedTech companies will be
required to prove that they can ensure continuity of supply in all circumstances.
By Bernard Ross
The author
Bernard Ross is CEO and founder of Sky Medical Technology (Sky).
Sky’s multi-award-winning device – the geko™ device – is a wristwatch-sized wearable applied to the knee delivering painless electrical
impulses to stimulate blood flow, without the patient having to move.
It has been globally adopted into healthcare systems to treat a range of
medical conditions such as the prevention of blood clots.
Ross is a serial entrepreneur with more than 20 years’ senior experience
at private and public board level across multiple industries.
58 IMIDDLE EAST HEALTH
Arab Health has underscored its commitment to showcasing the latest advances
in healthcare technology and innovation with the launch of the Intelligent
Health Pavilion and the return of the Future Health Summit, which will explore
healthcare in the Metaverse.
Taking place at the Dubai World Trade
Centre from 30 January to 2 February
2023, Arab Health will host the Intelligent Health Pavilion in partnership with
the Intelligent Health Association and
provide visitors with the opportunity to
experience the most innovative and sustainable healthcare technologies.
Located in Arab Health’s Healthcare
Transformation sector, the Intelligent
Health Pavilion will feature three demonstration rooms showcasing several new
technologies through live demonstrations, including a groundbreaking digital
Intensive Care Unit, an intelligent Operating Room, and a revolutionary Emergency Room.
The new feature will also have a seminar theatre and provide a platform for exhibitors to reveal the latest cutting-edge
healthcare technology.
Ross Williams, Exhibition Director for
Informa Markets, said: “The healthcare industry has witnessed incredible changes in
recent years, with technology and innovation
The Metaverse set to feature
prominently at Arab Health
the driving force behind how the industry is
elevating patient care. These latest advancements are expected to increase further by
utilising the Metaverse and looking at how we
interact with technology to utilise artificial
intelligence (AI), augmented reality (AR)
and virtual reality (VR) to improve patient
outcomes.”
Future Health Summit
Doubling down on innovation and technology, Arab Health will also host the second edition of the Future Health Summit
at the Museum of the Future. The exclusive, fully immersive event will look into
the future of health and healthcare possibilities in the Metaverse. World-renowned
industry leaders, visionaries, metaverse
experts, authors, and futurists on the topic
will offer their insights.
According to a report titled Healthcare
in the Metaverse from Market Research Future, the healthcare metaverse market is
predicted to grow at a CAGR of 48.3% until 2030, with the industry’s value expected
to top US$5.37 billion.
“The Future Health Summit is dedicated to trailblazers. From AI and robotics to
the role of the Metaverse, the healthcare
industry is continuously evolving. A result
of cutting-edge technology combined with
innovative leaders committed to improving patient outcomes,” said Williams.
“The Metaverse is expected to disrupt
healthcare and open new channels of treatment while lowering costs. The predicted
growth within this market is huge, and we’ve
only explored the tip of the iceberg. The Future
Health Summit will provide an invaluable look
at how everyone in the healthcare industry can
maximise what it offers,” he added.
Innov8 Talks
Arab Health 2023 will also see the return
of popular start-up competition, Innov8
Talks, which will feature 24 companies
showcasing unique and innovative solutions. At the same time, the Transformation Talks and Start-Up Zone will also
explore the latest tech advancements from
global innovators and disruptors.
The event will be supported by a host of
government entities, including the UAE
Ministry of Health and Prevention, the
Government of Dubai, the Dubai Health
Authority, the Department of Health, and
the Dubai Healthcare City Authority.
Internal Medicine Conference
The growing prevalence of diabetes in the
UAE and the broader Middle East and North
Africa (MENA) region will be addressed by
world-renowned industry experts at the Internal Medicine Conference, which takes place
Arab Health 2023
from 30- 31 January as part of the 2023 Arab
Health Congress. The conference will have
dedicated sessions designed to bring together
stakeholders who are at the forefront of diabetes care and research. Sessions will include the
evolution of diabetes management moderated
by Dr Hamed Farooqi, Director and Consultant Endocrinologist, Dubai Diabetes Center,
Dubai Health Authority. Panellists include
Dr Saf Naqvi, Imperial College London Diabetes Centre, Abu Dhabi; Dr Saria Gouher,
American Hospital Dubai; and Dr Hammad
Hussain, Cleveland Clinic Abu Dhabi. Topics to be addressed include the management
of diabetes, endocrinologists’ views on steroid
therapy and the severe complication of diabetes and diabetic ketoacidosis.
Exhibitors
The exhibition will feature over 3,000 exhibitor companies from 70 countries and include
nine product sectors, showcasing the latest
technology and innovations in disposables,
orthopaedics, healthcare and general services,
imaging, medical devices, IT, wellness and
prevention, and infrastructure and assets.
MIDDLE EAST HEALTHI 59
Due to exceptional demand, coupled
with the relaxing of Covid-19 travel
restrictions, exhibitor space at Medlab Middle East sold out two months
ahead of the show, which returns to the
Dubai World Trade Centre from 6-9
February. Medlab Middle East is the
MENA region’s largest medical laboratory exhibition and congress.
Medlab Middle East organiser, Informa Markets, noted that the number
of exhibition halls has increased from
four to six, compared to the 2022 event.
More than 350 new exhibitors have
been confirmed, taking the total number to over 700, with 180 countries represented. International pavilions have
also seen a rise from 11 to 14.
In line with the show’s theme: ‘Paving the way for technological advancements and sustainability in laboratory
medicine,’ a wide range of exhibitors
will be showcasing their latest products
in areas including disposables, imaging, IT systems, medical equipment,
amongst others.
Tom Coleman, Group Exhibition
Director, Informa Markets Healthcare,
said: “It has been an incredible year of
growth for the medical laboratory industry and Medlab Middle East. This
year we will welcome exhibitors from
180 countries, many of whom are making their debut at the event.
“We are also welcoming back several
of our Asian counterparts who have
been unable to travel due to restrictions in their home countries as well
as stalwarts of the event Abbott, Biomerieux, Beckman Coulter, Randox, illumina, bioMérieux, Randox and Mindray, amongst others.”
Hosted Buyer programme
In addition to a full line-up of exhibitors on the show floor, Medlab Middle
East has announced the launch of
its Hosted Buyer programme, which
will match exhibitors with senior
decision-makers from the healthcare industry. The show floor will
also include a series of seminars and
workshops designed to allow visitors
to learn first-hand about the latest
medical laboratory innovations from
exhibitors.
This year’s conference programme includes eight core lab conference tracks,
with a further four new additions addressing Point of Care Testing (POCT),
Tech Advances and Clinical Impact, New
trends in laboratory medicine, Quality
Management in the Lab, and Sustainability in the Lab.
The Village
In another first for the event, Medlab
Middle East will also showcase a new
Entertainment zone – The Village,
which will provide a more relaxed environment for networking, situated outside Za’abeel Hall 6.
MEDLAB sells out early
Middle East Health is a media
partner with the US and Canada
pavilions at Arab Health 2023.
Find out more about who is exhibiting at these pavilions and what
products they are showcasing.
Download the US and Canada
pavilions exhibitor news PDF by
scanning the QR code
or visiting this link:
https://bit.ly/3Ito5wb
United States and
Canada pavilions
60 IMIDDLE EAST HEALTH
At Siemens Healthineers, we are striving
to overcome the most threatening diseases, improving the quality of outcomes,
and enabling access to care by pioneering breakthroughs in healthcare. We are
excited to share with you our vision and
mission at Arab Health exhibition from 30
Jan to 2 Feb 2023 at Dubai World Trade
Center in Dubai and to showcase our diverse products and solutions.
Visitors to our booth can look forward
to experiencing our latest innovations
across our comprehensive portfolio – from
in-vitro and in-vivo diagnostics to imageguided therapy and innovative cancer care,
presenting our solutions with special focus on the most threatening NCDs (noncommunicable diseases), stroke, coronary
artery disease, and cancer. Visitors will be
able to discover how advanced diagnostics
and therapy workflows can combine to create comprehensive and personalized care
and we will show our perspective on how
to leverage digitalization and automation at
scale to create a smart imaging value chain.
Attendees will be provided with a hybrid
event approach on our almost 300 sqm large
booth S1.D10 located in Sheikh Saeed Hall
1 for face-to-face exchange and live experiences, as well as through online events and
insights in our virtual environment Shape23.
Medical Imaging innovations
Siemens Healthineers will be showcasing
a vast range of the latest innovations and
state-of-the-art technologies to valued customers and conference attendees. One of
the highlights will be the world’s first photon-counting CT, the NAEOTOM Alpha
with Quantum Technology, representing
nothing less than the total reinvention of
Pioneering breakthroughs in healthcare to
overcome the world’s most threatening diseases
Siemens Healthineers
computed tomography, offering high-resolution images at minimal dose with spectral
information in every scan and improved
contrast at lower noise. The MAGNETOM
Free.Max, with its 80 cm bore, sets a new
paradigm in patient comfort, breaking barriers in expanding access to care in MRI.
Visitors will receive a first-hand experience of the MOBILETT Impact, providing a high-quality, mobile, and digital
X-ray solution to the patient’s bedside at
an economical price, enabling a fast and
undisrupted workflow. At the same time,
the intuitive and supportive user interface
allows even inexperienced staff to achieve
high-quality results. The Symbia Pro.
specta with myExam Companion sets new
standards in SPECT/CT, bringing your nuclear medicine department into the future.
The system includes intelligent SPECT/
CT imaging and a fully integrated user interface to give you the power of more.
Also, among our highlights will be the
ACUSON Sequoia Ultrasound System
powered by BioAcoustic technology,
which helps to deliver effective clinical
insights by reducing the effects of ultrasound variability between users, patients,
and technology. The medical imaging solutions are being complemented by a tailored and interdisciplinary IT infrastructure for imaging and reporting solutions.
Syngo Carbon, for example, is designed
to improve patient care by leveraging data
management and Artificial Intelligence,
integrated into a user-friendly workspace.
Laboratory diagnostics &
point-of-care testing
On the show floor, visitors will also be
able to gather detailed insights from our
experts on the booth on Siemens Healthineers’ latest advancements and broad
spectrum of immunoassay, chemistry, hematology, molecular, and urinalysis testing solutions, in conjunction with automation, informatics, and services to serve
the needs of laboratories of any size – today and tomorrow. In our point-of-care
section, attendees will be informed about
solutions providing immediate, convenient, and easy-to-use diagnostic testing,
including the latest innovations in blood
gas testing and cardiac care.
Value Partnerships and
Innovation Think Tank
We will discuss Value Partnerships and the
benefits that such long-term, performanceoriented, collaborative engagements provide
to healthcare institutions, their staff, and patients. Exemplary global and local case studies
will be featured on our Exhibit Globe, where
visitors will be informed on how Siemens
Healthineers is bringing a combination of
clinical insights, medical innovation, strategic
vision, and implementation expertise to the
advancement of healthcare.
In an exclusive VIP lounge, customers
and interested attendees will have a closer
look at one of our 3D Innovation Think
Tank models, showcasing how Siemens
Healthineers enables the creation of knowledge economies through self-sustainable local innovation infrastructures promoting
expertise development, capacity building,
and entrepreneurship at hospitals, universities, and governmental institutions.
ARAB HEALTH stand: S1.D10
Sheikh Saeed Hall 1
62 IMIDDLE EAST HEALTH
The Stanford Medicine Online Second
Opinion Program provides access to expertise that can inform patients’ most important care decisions. The programme allows
them to connect with world-class doctors
without leaving home. Patients create an
account, and Stanford Medicine doctors
review their medical records, imaging, and
test results before sending personalized
treatment recommendations.
Stanford Medicine’s clinical networks,
Precision Health approach, and unique
position as an academic medical centre in
the heart of Silicon Valley enable personal
patient care by bridging
medicine and technology.
Wherever patients are in
the world, the Stanford
Medicine Online Second
Opinion Program puts
world-class care within
reach. Patients with a diagnosis gain access not only
to expert second opinions
from renowned Stanford
Medicine doctors but also
to peace of mind when they
need to make crucial decisions about care.
For second opinions on
adult cases, Stanford Medicine specialties include ear, nose, and throat; cancer;
cardiovascular health; neurology; neurosurgery; orthopaedics; ophthalmology;
transplant, and more. For second opinions
on paediatric cases, specialties include ear,
nose, and throat; cardiothoracic surgery;
orthopaedics; heart failure/heart transplantation; epilepsy, and more.
Stanford Medicine’s reputation
for excellence
In adult care, Stanford Health Care is
among the top 10 hospitals in the U.S.,
according to the U.S. News & World Report’s 2022-2023 Best Hospitals rankings.
Stanford Health Care’s strong showing
Stanford Medicine experts
offer second opinions online
Stanford Medicine
reflects its expertise in numerous specialties and complex procedures. It was recognized as No. 1 in the U.S. for ear, nose,
and throat, and it earned top-10 rankings
for cardiology and heart surgery as well as
obstetrics and gynaecology. The hospital
also ranked among the nation’s best for the
following specialties: cancer, diabetes and
endocrinology; gastroenterology and gastrointestinal surgery; geriatrics; neurology
and neurosurgery; orthopaedics; pulmonology and lung surgery; and urology.
In paediatric care, Lucile Packard Children’s Hospital Stanford, part of Stanford
Medicine Children’s Health, has been
named among the top 10 children’s hospitals in the U.S., according to the U.S. News
& World Report 2022–23 Best Children’s
Hospitals survey. For the seventh consecutive year, the hospital has achieved rankings
in all 10 paediatric specialties. The 2022
survey ranked four of the hospital’s specialties in the top 10, including two in the top
five nationwide. These include nephrology,
pulmonology and lung surgery, neonatology, and neurology and neurosurgery.
Supporting both paediatric and adult
care, Stanford Cancer Institute is designated a Comprehensive Cancer Center
by the National Cancer Institute, a part
of the National Institutes of Health and
the world’s leading cancer research organization. Stanford Cancer Institute
quickly translates discoveries into improved diagnostics and safer, more effective
therapeutics.
Serving international patients
and medical professionals
After receiving an online second opinion,
patients who desire further follow-up may
receive high-touch navigation support from
specialists in the International Medical
Services (IMS) department. It welcomes
patients from around the world by providing individualized, and
culturally competent services 24/7 year-round. The
seasoned team assists with
identifying and scheduling appointments with the
right physicians for each
patient; interpretation and
translation services for patients, family members,
and caregivers; handling
billing and insurance; and
helping plan their visits
among other services.
Stanford Medicine is
committed to advancing
human health globally by leading innovation in research, education, and clinical care.
Educational opportunities for international
physicians, including clinical observerships
and hospital campus visits and tours, can be
arranged by the IMS department as well.
• For more information about our online
second opinion programme for adults
(age 18 and older),
visit: stanfordhealthcare.org/2ndopinion
• For paediatric online second opinions
(under age 17),
visit: secondopinion.stanfordchildrens.org
• To learn more about the International
Medical Services department,
contact: [email protected]
RoboPharma
64 IMIDDLE EAST HEALTH
Pharmacies that are in high-expansion
mode today may be considering two likely
paths for optimum business growth and
customer satisfaction and compliance:
• Modernize and fully automate 100%
of the existing central filling process, or
• Expand into mail order/digital pharmacy
In either case, RoboPharma is your bestchoice partner. RoboPharma is the fastest
growing pharmacy automation provider in
the Middle East and Europe. Our unique designs deliver Speed, Efficiency, and Reliability
– whether your pharmacy needs to dispense
1,000 to 100,000+ prescriptions per shift.
Customized automation
Our designs are 100% customized so they are
adapted to your available space, workflow,
budget and business growth plans. This is an
essential part of the RoboPharma process and
it ensures your long-term success. With a deep
understanding of your challenges, medication
formulary, patient population, and local regulations, we set you up for success from your golive date and for years to follow. Even when
expansion is needed, RoboPharma technology is modular and grows with your volume
– without the need for knocking down walls
or building new!
High volume application specialist
Our “hub and spoke” approach is proven
to be the most efficient method to handle
a heavy flow of data and medication without missing a single step. Whether patient
RoboPharma revolutionizes
pharmacies’ high-volume central
filling and mail order solutions
orders are originated in their local pharmacy or online, the next steps are all orchestrated flawlessly by RoboPharma.
• Central Filling model: RoboPharma
designs your end-to-end system where patient orders are received from retail pharmacy branches, are completely processed
in your facility, then are shipped back to
the patient’s local pharmacy.
• Mail Order/Digital Pharmacy model:
RoboPharma designs your end-to-end system where orders are received from your
pharmacy’s website or app, are completely
processed in your facility, then are shipped
back to the patient’s home.
Sounds simple? Yes, we make it that
simple for you! Your project managers and
your pharmacy staff will find that RoboPharma’s ability to streamline an ultracomplex and interconnected environment
is our greatest skill.
Superior technology for bulk processing
RoboPharma’s design philosophy of “lessis-more” has been proven to reduce downtime, mechanical failures, and bottlenecks;
utilize less energy; lower operational costs;
and ultimately quicken your return on
investment. In every installation to date,
RoboPharma central filling and mail order
is proven to be superior in every way to
stand-alone classical pharmacy filling and
one-dimensional robotic picking.
Whether you are improving your existing flow or you are building new, RoboPharma is ready to partner with you to revolutionize your pharmacy’s business.
• For more information, visit: https://robopharma.com/solutions/central-fill/
Capsa’s Gulf Region Contact:
Tamer Bakkar
+971 555 570 664
ARAB HEALTH stand: SA.E60
Improving affordable access to modern medical care is one of the
world’s most pressing challenges and must be one of our biggest collective priorities. Some 8.4% of the global population lives in extreme poverty living on less than of US$ 2.15 a day according to
2022 World Bank estimates.
Abdul Latif Jameel Health is our response, with a focus on the
disparity in access between developed and developing nations, notably in the fast-growing economies of the ‘Global South’. Backed
by Abdul Latif Jameel, one of the region’s most respected diversified
family businesses and global investors, with over three quarters of
a century of commercial heritage and established networks across
30 countries, Abdul Latif Jameel Health is uniquely positioned as
a strong and trusted partner to address real-world healthcare needs
today, for a better tomorrow.
With a strong partnership ethos, Abdul Latif Jameel Health has confirmed its participation in Arab Health 2023, returning to the Dubai
World Trade Centre under the theme ‘Innovation and Sustainability in
Healthcare’. Easing of COVID-19 restrictions and a return to normality
will see the 48th Congress much larger – and busier – than the last two
years, with the UAE reaffirming its position as a global healthcare hub
with AED 2.8bn (US$ 763m) deals secured in 2022.
Abdul Latif Jameel Health will showcase a range of innovative, disruptive products from partners from as far afield as the USA and Japan,
including Butterfly, Melody, Holoeyes, and Cyberdyne, as it brings these
cutting edge technologies to the Middle East and Africa.
The Butterfly iQ+, the world’s first handheld, single probe, wholebody ultrasound solution, brings the power of ultrasound into assessment, diagnosis, and treatment processes.
Melody’s iCTG is a convenient, wearable, smart, and highly portable remote mobile foetal monitoring device to assist in problematic or high-risk pregnancies, enabling safer and more secure births
for both mother and infant.
Holoeyes’ extended reality surgical platform fuses technology, artificial
intelligence and medicine enabling physicians to share complex information intuitively and with greater understanding and transparency than
conventional 2D imaging techniques to plan intricate surgery and raise
educational understanding in training new medical professionals.
Cyberdyne will showcase its Hybrid Assistive Limb (HAL) exoskeleton technology pioneering rehabilitative therapy.
Access to affordable health
These partnerships underscore Abdul Latif Jameel Health’s commitAbdul Latif Jameel
Health brings health
tech innovators
from around the
world to Arab
Health 2023
Abdul Latif Jameel Health
ment to adding real, tangible, value; not only to all our business
partner relationships, but also to the communities across the
Global South. In a year that saw the 8 billionth human being
born, addressing the issue of access affordable health care makes
Abdul Latif Jameel Health’s vision is more relevant than ever.
Akram Bouchenaki, CEO, Abdul Latif Jameel Health, said:
“To achieve success as a solutions partner, we work together
with world class and leading partners pioneering new technologies, techniques, and medicines; focusing on driving inclusivity
– we continue in our vision to accelerate access to affordable
modern medical care for more people, in more places, and to
meet the unmet need across the Global South.”
• For more information, visit: aljhealth.com.
Connect with the Abdul Latif Jameel Health team
and their partners at Arab Health, January 30 to
February 2, 2023, at the Dubai World Trade Centre.
ARAB HEALTH stand: S1.J10
*Disclaimer: Within the Middle East and depending on the specific country, Butterfly iQ+TM is a Class IIa/
Class B/ClassII/Class II/IIa portable ultrasound system designed for diagnostic imaging by trained healthcare
professionals. Carefully read and understand all cautions, warnings and operational instructions prior to use.
The Cyberdyne Hybrid Assistive Limb or HAL
MIDDLE EAST HEALTHI 65
66 IMIDDLE EAST HEALTH
People all over the world passionately pursue their dreams only if their health is assured. In this era of personalised and precision medicine, Neusoft Medical Systems
provides intelligent technology that can be
applied to medical devices to enable medical professionals to make medical examinations easier and more efficient. This technology helps to satisfy customers’ diversified
needs and bring care to more patients.
Here we will introduce two AI technologies that can be applied to our CT scanners. Both are currently works in progress.
ClearInfinity reduces noise and
artifacts for better image clarity
ClearInfinity is a Deep Learning Reconstruction (DLR) technique that uses a network of multi-layer neurons preformed and
trained to become more accurate and more
efficient. It removes artifacts and provide
natural images with sharper edges and reduced noise. This provides gains in resolution and improvement in clinical performance foreshowing its utility for routine
clinical practice.
Using ClearInfinity for low dose
coronary CT angiography
The number of streaks is very important in
MPR planes for cardiac images, in particular in the axial plane. For FBP images, conEnabling precision medicine
with advanced technology
Neusoft Medical Systems
tours of hollow and solid organs all have
streaks of contours and too much noise,
therefore, spatial resolution in the axial
MPR plane is seriously reduced. However,
the ClearInfinity technology significantly
decreases streak artifacts and reduces noise
to deliver a natural and sharper low-dose
coronary CTA.
Virtual Reality and vessel analysis are promising tools for diagnosis in cardiology and,
combined with ClearInfinity, this promises to
provide significant improvements in accuracy
and efficiency, thereby decreasing variability
in image interpretation.
A-Eye – a smart system
for patient positioning
Neusoft Medical Systems has developed
the A-Eye smart patient positioning system in order to improve the current scanning operation process and reduce the
workload of doctors. Intelligent and accurate positioning can be realized by oneclick operation with new smart cameras.
Its main features are:
1. Automatic positioning
Doctors can select the scanning protocol
with one click in the operating room with
no need to position the patient in the
scanning room. The A-Eye intelligent
positioning system, with innovative AI
technology, can accurately identify the
feature points of the body, automatically
move the scanning table to the initial position of scanning and press the exposure
button to realize image positioning and
scanning, thus helping achieve the realization of automatic positioning and oneclick efficient workflow.
2. Standardized workflow
Compared to traditional positioning,
Neusoft’s automatic positioning is faster
and more efficient, which, to a large extent, reduces errors by manual operation.
Meanwhile, the camera, with automatic
calibration function, can calibrate the
camera parameters without manual adjustment, which ensures the accuracy of
each scan.
3. Non-contact workflow
The intelligent positioning system avoids
direct doctor-patient contact which is particularly useful during epidemics. In other
words, doctors can do remote patient positioning, real-time monitoring and scanning
of the patient.
Visit: www.neusoftmedical.com/en
ARAB HEALTH stand: S1.D30
MIDDLE EAST HEALTHI 67
Cedars-Sinai is truly honored to be named
the No. 2 hospital in the USA on U.S.
News & World Report’s Best Hospitals
Honor Roll. We’re also proud to be
ranked among the best in the USA in the
following 11 specialties: Gastroenterology
and GI Surgery; Cardiology & Heart
Surgery; Ear, Nose & Throat; Orthopedics;
Pulmonology and Lung Surgery; Urology;
Neurology and Neurosurgery; Geriatrics;
Cancer; Diabetes & Endocrinology; and
Obstetrics and Gynecology.
In addition, we’ve been named the No. 1
hospital in California and No.1 in five specialties in California–Cardiology and Heart
Surgery, Gastroenterology and GI Surgery,
Orthopedics, Pulmonology and Lung Surgery, and Urology. Our Neurology & Neurosurgery specialty has also been ranked No.
1 in the Los Angeles region.
The U.S News rankings are based on
patient outcomes, patient experience,
technology, reputation (according to surveyed physicians) and a variety of other
health-related measures. They reflect
the tireless commitment of all those who
work and practice at Cedars-Sinai to deliver the highest-quality patient care, especially during the challenging times of
the COVID-19 pandemic.
Located in West Los Angeles, California, in the beautiful neighborhood of BevCedars-Sinai
erly Hills, Cedars-Sinai is part of a diverse
and lively city, known for its art, culture,
music, sporting events, cultural landmarks
and warm weather.
Every year, thousands of patients from
around the globe receive treatment at
Cedars-Sinai. We offer new treatments,
surgeries and clinical trials that are only
available at a few hospitals in the U.S. We
treat each patient with an individualized
treatment plan. Patients at Cedars-Sinai
can expect the best available care, a personal approach, and the newest diagnostics and treatment options.
“Thanks to the dedication of our physicians, nurses, academic leaders and thousands of others on our staff, Cedars-Sinai
continues to provide innovative healthcare, enhanced by our commitment to pioneering research, teaching and education,”
said Thomas M. Priselac, president and
CEO of Cedars-Sinai Health System. “We
are proud of Cedars-Sinai’s contributions
to our diverse Los Angeles community as
well as nationally and globally.”
International patients
As part of this commitment to our global
community, Cedars-Sinai International has a
dedicated patient-services team that speaks
multiple languages and focuses specifically
on helping our international patients. We
• Follow us on at: Cedars-Sinai International
• Learn more about Cedars-Sinai at: cedars-sinai.org/international
Cedars-Sinai
proud to be
No. 2 hospital
in the USA
provide a range of concierge services to
meet the unique needs of patients traveling
from outside the U.S. to receive world-class
care and treatment at Cedars-Sinai.
Our global-services team leverages the
clinical and nonclinical excellence at
Cedars-Sinai to provide a full spectrum of
advisory and consulting services that help
our partners around the world achieve their
strategic goals and thrive in today’s everchanging healthcare environment.
“Today, we care for patients from over
100 countries. Our top areas are heart and
cancer, as well as neurological diseases, orthopaedics, gastrointestinal diseases, transplant surgery and women’s health,” said
Heitham Hassoun, MD, vice president and
medical director of Cedars-Sinai International. “Whether through receiving care at
our state-of-the-art facilities in Los Angeles or through remote second opinions and
teleconsultations, we want international
patients to benefit from our services wherever they live.”
Cedars-Sinai would like to thank our
staff for earning this global recognition.
They are true leaders within their fields,
and their innovation and compassion are
unparalleled. We’re so grateful to each and
every one of them for sharing their expertise and always keeping our patients’ wellbeing as their top priority.
68 IMIDDLE EAST HEALTH
The effectiveness of strength training depends on many small, key elements: the
correct load, the adequate number of repetitions, the recovery time, the speed of execution of the exercise, the posture, the range of
motion. Optimising every single detail and
preventing the most common errors is fundamental to making your training effective
and achieving better results in less time.
Biostrength, the new Technogym line
for strength training, adapts to you, thanks
to a patented technology that uses artificial intelligence and scientific research,
and ensures you get 30% better results
in the same amount of time compared to
classic training with equipment or free
weights. Biostrength allows you to train
with the right load, range of motion, correct posture, speed of execution and even
indicates the number of sets, repetitions
and optimal recovery times.
The patented Biodrive system, which
uses aerospace technology, offers you 6
types of resistance, which can improve the
effectiveness of your exercise depending
on the goal you want to achieve. You are
guided through every aspect of the workout to achieve maximum results in a safe
and effective way: Biodrive recognises
when you are too tired and the spotter
function automatically reduces the load
to allow you to complete the set, while,
to keep you motivated and encourage you
to improve, Biostrength gives you reward
badges as you achieve new goals.
A connected experience
Biostrength is a digital and connected experience with an unprecedented variety of training programs and content. With a simple login to the Technogym Ecosystem, Biostrength
equipment allows you to select the workout
experience that best suits the results you want
to achieve from goal-oriented programs, to
custom programs or free training.
Technogym Biostrength
The revolution in strength training
The first strength training solution that adapts to you and
guarantees 30% superior results in the same amount of time
Technogym
The 4 target programs include:
• HYPERTROPY: to develop muscle
mass. This program increases the load in
the eccentric phase of the movement,
while the muscle fibres lengthen, in a way
that is functional for developing mass.
• POWER: to train like an athlete.
The use of a resistance without inertia allows you to train explosive strength and to
express maximum force in complete safety.
• STRONG: to increase your strength. The
viscous resistance that makes the exercise more
intense as the speed of execution increases.
• TONE: get more muscle tone with
less effort. Elastic resistance and a gradual
increase in the workload allow you to improve muscle tone constantly throughout
the entire range of movement.
If you are a more advanced user and
would like to optimise every single exercise in your training program, the CUSTOM function will offer you various training techniques, such as drop sets, pyramids
and single set tone express.
If you already know what to do and want
to set up your own program, with the FREE
TRAINING mode you can train quickly
and easily, without logging in, simply by adjusting your session and selecting the workload and number of repetitions you want.
Biostrength represents a great opportunity for fitness clubs and personal trainers
to increase the value of their membership
by offering their clients innovative programs that guarantee the desired results.
Thanks to Mywellness, Technogym’s professional software platform, they can assign each user a tailor-made program optimised to individual goals; with a simple
log-in the user will be fully guided by Biostrength in the optimal execution of the
exercise.
n Technogym is available at the Technogym Experience Centre in Dubai.
With the emergency monitor and defibrillator DEFIGARD Touch 7
and the mechanical CPR device EASY PULSE, rescue teams are ideally
equipped for any situation.
The Helicopter Emergency Medical Services (HEMS) crew member
Samuel Ernst from the Swiss helicopter rescue service AAA Alpine Air
Ambulance confirms: “For us as HEMS, after dropping off or getting out
of the helicopter, it is crucial to reach the patient as quickly as possible
and to carry as little weight as possible. Both devices are extremely lightweight and user friendly, and with its harness system, the EASY PULSE
is attached to the patient easily and efficiently.”
Important advantages
EASY PULSE, the mechanical CPR device, is ideal for confined
spaces, for example in helicopters, aircraft, ambulances and on rescue sites such as in crashed cars or after earthquakes. It is possible to
operate the device on patients in a head-up position.
DEFIGARD Touch 7 is a compact and lightweight monitor/defibrillator, which is extremely intuitive to use and equipped with high-end data
transmission technology.
FRED easyport plus is a small and lightweight defibrillator, available as fully automated, semi-automatic or manual version. A 1-2-3
workflow, the large colour screen and the spoken instructions make
it very easy to use.
DEFIGARD HD-7 is SCHILLER’s latest hospital defibrillator
which minimizes the time to shock thanks to fast analysis and parallel charging. A shock can be delivered with paddles, defibrillation
pads or spoons. The device works with SCHILLERs unique data
management solution SEMA. Touchscreen, CPR feedback options
or cybersecurity are only some of the device’s convincing advantages.
Around the world with 1200 employees
SCHILLER was founded in 1974 by Alfred E. Schiller. Starting in
a four-room flat as a one-man business, the company has become a
Swiss HEMS
save lives with
SCHILLER
rescue devices
SCHILLER
successful group with more than 1200 employees, 30 subsidiaries
and a global sales network. Today, SCHILLER is a world-leading
manufacturer and supplier of devices for cardio-pulmonary diagnostics, rescue and patient monitoring as well as software solutions for the medical industry.
n For more information, visit: www.schiller.ch
For almost five decades, SCHILLER has been
committed to fighting sudden cardiac death.
In the rescue product range, SCHILLER has
specialized in lightweight and small devices
for professionals and lay rescuers.
SCHILLER rescue devices are powerful, intuitive, lightweight, and
ideal for confined spaces, for example in helicopters.
The SCHILLER rescue devices EASY PULSE and DEFIGARD
Touch 7 support rescue services in any situation.
Extremely small and powerful: The defibrillator FRED easyport plus,
available in fully automated, semi-automatic or manual version.
70 IMIDDLE EAST HEALTH
Email: [email protected]
ARAB HEALTH stand: S3.D10
For the first time, Cone Beam technology
is applied to all areas of the body, including
the spine, shoulder, and hip thanks to one
of NewTom’s latest high-tech devices.
NewTom 7G brings cutting-edge Cone
Beam Computed Tomography (CBCT)
into all-new application fields. Equipped
with an extremely high-performance Xray generator (up to 120 kV and 120 mA)
and independent selection of the focal
spot (0.3 or 0.6 millimetres), this device
lets users perform accurate bone tissue examinations at a resolution of up to 90 μm,
ensuring ultra-precise analysis of even very
small complex structures such as those of
the inner ear.
The ability to perform exams quickly in
“low dose” mode – with the acquisition of
the desired anatomical area in just seven
seconds – is particularly convenient.
NewTom 7G can be used to investigate
innumerable anatomical areas in a wide
range of clinical applications, both in 3D
with numerous fields-of-view (FOVs) and
in 2D (also sequentially). Users can acquire
ultra-high definition images to diagnose the
micro-structures of the ear or hairline fracNewTom 7G – the world’s first
multi-scan body Cone Beam CT
NewTom
tures in complex joints, for example.
NewTom 7G features automations that
streamline workflow and limit the distortion
inherent in manual procedures, thus ensuring
the best results in the shortest time.
One of the most recent additions is for
hip examinations. Developed to acquire
bilateral hip images, the NewTom 7G can
capture a 40 x 17cm FOV. The horizontally extended FOV allows comparative
assessment of hip bones via reconstruction
into a single volume.
Pioneering Cone Beam technologies in
the dental sector
A global benchmark in the field of diagnostic imaging technologies, NewTom was
the first company to introduce Cone Beam
technology into the dental sector and now
offers a vast array of clinical solutions for
medical, dental, and veterinary diagnostics.
This trusted brand delivers state-of-theart equipment and provides professional
support and service around the globe.
Since the brand was created 25 years
ago, NewTom has extended the boundaries
of medical imaging, introducing the most
advanced diagnostic devices capable of
micrometric, ultra-high-resolution detail
of bone structure, covering all anatomical
areas, from head and neck examinations
to ENT, MSK for orthopaedics, as well as
dental maxillofacial radiology.
In each area, NewTom has led the field,
innovating through technology and driving scientific trends. Patented algorithms,
advanced functions for both 2D and 3D
imaging, as well as a host of features devoted to reducing the effective dose,
thereby safeguarding the health of operators and patients alike, are just a part of
the innovations achieved through NewTom’s constant commitment to technological excellence.
• NewTom devices are supported by powerful DICOM 3.0 compatible NNT
software, which can interface with third-party systems and software to store and
exchange medical data.
• To learn more for yourself, visit www.newtom.it/en
MIDDLE EAST HEALTHI 71
72 IMIDDLE EAST HEALTH
CONSIS robotic dispensers offer a tailormade and highly efficient automation concept for your dispensary. With CONSIS you
will be able to automate more than 90% of
your daily dispensed products on a footprint
starting from only 0.8 sqm. The CONSIS
software interfaces with all major dispensary software. The design is available in a
range of colours to suit your pharmacy.
FAMA drawer system is a customized solution, so that all products in your dispensary are organized in a compact, efficient
and professional manner. FAMA neatly
stores all medication in your dispensary,
script ready, scripts on file and excess stock.
FAMA round shelves combine high
density storage with optimum product visibility and easy access. Due to a patented
magnetic mechanism, filling is done quickly. Trays do not have to be pulled out to
replenish stock ensuring a safe and convenient replenishing process.
FAMA shelves are a modular system
that can be configured to your individual
needs and requirements. Pull out trays
easily store up to 1500 packages using the
FIFO (First in – First out) principle. Support rails hold plastic bins for particular
patient medication.
The answer to pharmacy
automation: CONSIS solutions for
hospital outpatient pharmacies
Increasing healthcare expenditure is driving the demand for pharmacy automation
in the region in order to provide improved
service to a large patient base. Pharmacy
staff require modern technology tools to
perform their jobs efficiently without losing on patient safety or care quality.
Hospital Outpatient Pharmacies busy
with dispensing prescriptions find it challenging to focus on additional revenue
Change your workflow with smart
dispensary solutions from Willach
Pharmacy Solutions
Willach Pharmacy Solutions
streams and so Pharmacy Automation is
attractive in order to improve the speed,
space and accuracy of dispensing.
Medication dispensing and patient consultation take time and where efficiency
is critical to maximize the potential of
this revenue-generating department, rush
mode can mean finding yourself with costly, even dangerous, errors on your hands.
Pharmacy automation allows the pharmacy staff to improve customer service, reduce dispensing errors and workloads, and
add a higher level of security, tracking and
accountability.
The key benefits of Pharmacy automation:
• Speeding up the dispensing process
• Cutting down on dispensing errors
• Saving space on product storage, creating more room for retail space or consultation facilities.
Pharmacy automation advice
Willach Pharmacy Solutions can offer
pharmacy automation advice and support
within your own business.
All key benefits are covered by the
CONSIS robots – the fast and reliable
principle capable of providing automation
over a long period of time with its parallel
ejection from several storage channels.
Reference projects
Reference projects in MENA include:
• John Hopkins ARAMCO Hospitals
(Al Khobar and Al Hasa, in Saudi Arabia)
• Jaber Al Ahmad MoH Hospital in Kuwait
The solutions that use CONSIS robots
and FAMA storage and dispensing systems have a reliable dispensing volume of
at least 10,000 packages / day for many
years.
Willach Pharmacy Solutions has a network of reliable partners in the Middle
East to provide a wide range of solutions
for the dispensing and storage area in hospital and community pharmacies.
• For more information, visit: www.willach-pharmacy-solutions.com/ME/ ARAB HEALTH stand: Z3.B19
Diabetes.co.uk estimates that 415 million people in the world live with
diabetes, with this figure expected to rise to 642 million by 2040.
Not only can diabetes be a debilitating condition, but it is also
a significant indicator and risk factor in the development of Peripheral Arterial Disease. However, due to calcification of arteries that occurs as part of the disease process in diabetic patients,
particularly around the ankle, normal ABI measurements can be
misleading, making it difficult to diagnose Peripheral Arterial
Disease or assess lower limb wound aetiology.
Huntleigh have developed a comprehensive diabetic foot assessment kit that gives diabetic specialists everything they need
to make an assessment of arterial disease and peripheral diabetic
neuropathy. International guidelines such as the International
Working Group for the Diabetic Foot (IWGDF) indicate the use
of pulse waveform analysis and/or toe pressure assessment instead
of using potentially inaccurate ankle pressure readings. The kit
also allows clinicians to take pressure from the toe to determine
both the TBI (toe brachial index) and individual toe pressures.
It features a DMX digital Doppler with probe to provide an
aural and visual confirmation of blood flow. PPG (photoplethysmography) and waveforms can be read along with the compatible Dopplex Vascular Reporter package for waveform visualisation as well as for reviewing, archiving and printing.
Toe pressure is taken using the specially designed PPG probe
and adaptor, which links the toe cuff, the PPG sensor and sphyg.
This allows the Doppler to not only display a PPG waveform on
screen, but also a visual aid to guide clinicians on the optimal
deflation rate to ensure a more accurate reading. The Doppler
can also automatically identify systolic pressure,
Additionally to facilitate the assessment of peripheral diabetic
neuropathy, the kit also comes with a box of monofilaments, as well
as a Neuropen to deliver a more controlled level of pressure.
Huntleigh introduces
the complete diabetic
foot assessment kit
Huntleigh
MIDDLE EAST HEALTHI 73
ARAB HEALTH stand: H2.H30
74 IMIDDLE EAST HEALTH
Mobile workstations play an important
supporting role in the delivery of patient
care. Clinicians spend a large percentage
of time on patient documentation, medication administration and care coordination, all requiring the use of their workstation. The right mobile workstation
helps caregivers simplify workflow and
save critical steps by carrying what they
need most often to deliver patient care.
They enable clinicians to easily access
electronic medical records while remaining close to and interacting directly with
their patients.
The TrioTM Computing Workstation is
Capsa Healthcare’s latest advancement in
mobile workstations and a clinician’s most
reliable partner in patient care. Trio combines innovative advancements with flexibility to meet the needs of clinical users
today, and into the future.
Ease-of-use
Trio is personally adjustable for optimal user
comfort including height adjustments and
‘memory’ presets that are stored in a user’s profile and transfer to any cart the user logs into.
Trio features tools that streamline workflow, save time, and support an efficient
clinical process. An intuitive control cenCapsa Healthcare
ter with touchscreen shortcuts helps users
to easily control their cart.
Adaptable
Trio can be configured with storage and accessories to fit a wide range of care applications.
It’s easily adaptable to support simple documentation, medication administration, phlebotomy, telehealth, or registration workflows.
Trio supports a variety of storage options including standard bins or the new MaxBin™
system. Both are fully configurable and provide ample, secure storage capacity.
Reliable
A clinician’s focus is providing patient
care, not worrying whether a workstation
will run out of power during a shift. The
flexible, scalable GoLiFeTM Power System incorporates both internal and external battery options to meet varying runtime requirements. Trio provides a reliable
battery system with extended runtimes to
power clinicians through their day.
Remote fleet management
Trio features N-Sight Fleet Management
software, which makes it easy for IT to
proactively manage, maintain, and update
workstations remotely. N-Sight helps fa-
• For more information, visit:
https://www.capsahealthcare.com/product/trio-computing-workstations/
cilities improve asset utilization, maximize
fleet performance, and prevent issues before they impact clinical workflow.
Whether your facility is expanding its existing fleet or planning to replace older workstations, Capsa Healthcare is ready to help you
select a solution that enables your facility to
deliver the highest level of care.
Trio Computing Workstation
optimizes caregiver workflow
and enhances patient care
Capsa’s MEA region contact:
Fadi Saleh
Tel: +96 279 000 1133
ARAB HEALTH stand: SA.E60
The GOSH team has
the world’s most
extensive experience
of slide tracheoplasty,
managing close to
75% of all cases
of complex airway
repairs worldwide.
76 IMIDDLE EAST HEALTH
Recently recognised by Newsweek as one of
top three paediatric hospitals in the world,
Great Ormond Street Hospital (GOSH)
is a globally renowned children’s hospital,
championing innovation across more than
60 clinical specialties and 19 highly specialised national services.
The GOSH tracheal service comprises a
group of leading health professionals who
have been brought together to provide a
range of expertise. The tracheal team specialises in managing children with complex
congenital and/or acquired tracheal defects
including stenosis, malacia and other rare
congenital disorders of tracheobronchial
tree. The team consist of specialists including cardiothoracic surgeons, ENT surgeons,
interventional radiologists, pulmonologists,
intensive care specialists, speech and language therapists and physiotherapists.
Since it was formed in 2000, the tracheal service has become one of the largest
and most successful services in Europe and
a world leader in the field.
The surgical technique the team use
to treat tracheal stenosis is slide tracheoplasty. The GOSH team has the world’s
most extensive experience of this type of
surgery, managing close to 75% of all cases
of complex airway repairs worldwide each
year and this is reflected in the published
outcomes, with the lowest death rates for
this serious condition.
Between 1995 and the end of 2021,
a total of 210 slide tracheoplasty procedures were been performed at GOSH,
with an overall survival of 92% and the
most recent weighted survival (recent
experience in the last 5 years) of 96%.
There has been an increasing number of
slide tracheoplasties and a significant improvement in survival over time despite
increasing patient complexity.
Great Ormond Street Hospital:
Managing children with complex
congenital tracheal defects
Great Ormond Street Hospital
Other complex airway reconstructions
of increasing nature include reconstruction of trachea following injury (specifically related to button battery related injuries) and on those with failed repair of
trachea-oesophageal fistula. In both these
conditions, the technique used is one of
vascularised pericardial patch for tracheal
reconstruction. The GOSH surgical team
has revolutionised the use of this vascularised patch for trachea in many of the complex airway defects – with experience on
this being close to 75 children. The overall
success rate in this is 98% with stent needed in one-third of these children.
For those children with tracheomalacia
– both open and thoracoscopic aortopexy
and posterior tracheopexy is offered. External splints are often used as support to the
trachea in resistant situations and work is
in progress to get the most bio-effective
external splints for this.
Want to know more about Great Ormond Street Hospital (GOSH)
in London and our office in UAE?
We have been helping children overcome rare and complex conditions ever
since we opened our doors in 1852. Stronger than ever, our team is made up of
300 exceptional and dedicated consultants across more than 60 specialties. We
are a driving force in medical technology and research so we can provide much
needed treatment for children across the world.
Our International and Private Care service supports more than 5,000 children
from over 80 countries every year. We have a compassionate and multi-lingual
team to help our international patients and their families feel at home.
GOSH has a longstanding relationship with the Middle East providing high
quality and safe care for patients in a family-centred environment. A dedicated
Gulf office ensures that children and families being referred to the hospital receive the very best experience possible as well as providing a local point of contact. The unit is tailored to the referral and treatment of international patients
with a dedicated, multi-lingual team ensuring a smooth and efficient patient
experience.
• You can email us on: [email protected]
Call us: +971 4 362 4722
Or visit: www.gosh.ae
Malaysia’s medical devices industry comprise more than 250 manufacturers of
which 30 are multinationals that have
made Malaysia their manufacturing base.
In addition to producing rubber gloves, the
industry also produces higher value-added
and technologically advanced products
such as cardiac pacemakers, stents, orthopaedic implantable devices, ophthalmic
lenses including contact lenses, dental instruments and appliances, and electromedical, therapeutic and monitoring devices.
Malaysia’s exports of medical devices were
valued at US$10 billion in 2021.
Medical Devices from Malaysia
Malaysia has the largest medical devices
industry within the ASEAN region with
an estimated market size of US$1.8 billion
and is the preferred offshore manufacturing site for global medtech companies.
“Malaysia is the preferred outsourcing
destination and medical device manufacturing hub within the ASEAN thanks to
strong support from the government to
develop this industry. Malaysia’s position
is further reinforced with the existence of
world class supporting infrastructure such
as sterilisation services, precision engineering, contract moulding and assembly, machinery fabrication, universities,
research and training institutes as well as
testing and accreditation bodies” said Mr.
Megat Iskandar – Trade Commissioner of
Malaysia to the UAE.
Malaysia at the Arab Health
Malaysia considers the gulf region as a major market for pharmaceutical and medical
equipment due each government’s commitment to provide quality healthcare to its
growing population. Companies participating under the Malaysia pavilion this year are
mainly manufacturers of syringes, haemodialysis concentrates, irrigation solutions and
other hospital consumables, rubber products,
stem cells for hospital and research, laboratory equipment, facility and asset management services for hospital among others. This
is Malaysia’s 19th year participating in the
event, which shows our strong commitment
to this market, added Megat.
Bilateral trade between the UAE
and Malaysia
Despite the challenges and uncertainties
around the world, Malaysia is optimistic
for 2023 with the global economy opening
up after the pandemic. “Already we have
seen a 41.2% growth in our exports to the
UAE during the first 11 months of 2022
compared to the same period in 2021. Malaysia’s total trade with UAE during this
period registered at US$8.06 billion. We
foresee bilateral trade between Malaysia
and the UAE will further improve with
the easing of travel restrictions in both
countries” said Megat.
Malaysian Companies to make a
Strong Presence in Arab Health
Atrium Health’s Carolinas
Rehabilitation fortifies partnership
with Qatar Rehabilitation Institute
Atrium Health
78 IMIDDLE EAST HEALTH
the quality of their services; demonstrate
and value operational efficiency to payors;
and meet internationally recognized programme standards.
In 2010, CR started a unique informationsharing platform, EQUADRsm (Exchanged
Quality Data for Rehabilitation), which enables participants to share information, ideas
and best practices. EQUADRsm was the first
rehab specific quality AHRQ-listed (Agency
for Healthcare Quality & Research) patient
safety organization in the world.
Carolinas Rehabilitation is an integral
part of Atrium Health, a large healthcare
system with more than 70,000 clinical
and administrative employees servicing
patients at 40 hospitals and more than
1,400 care locations, with several nationally recognized facilities including
Carolinas Medical Center, Levine Children’s Hospital, Levine Cancer Institute
and Sanger Heart & Vascular Institute,
among others.
New $100M hospital to open
In January, CR will cut the ribbon on a new
US$100 million hospital occupying 160,000
square feet. The new facility will have 72
private rooms, offer extensive outpatient services and feature many new amenities.
Vishwa Raj MD, CR’s vice chair for Clinical Operations, says CR has always benefited
greatly by being part of a fully integrated
healthcare system. “We share a common goal
– for patients to receive the right care
at the right time. By working together,
we are effectively helping each other
improve in all aspects of care delivery.”
The future of rehabilitative care
Diane Lynn, head of Global Healthcare Services at Atrium Health,
agrees that the future of rehabilitative care
lies in integrated services. “Being part of a
larger system is a transformative way to do
business,” she says. “This was a big reason
QRI sought out a partnership with us, to
stay ahead of future trends.” CR is doing
everything possible to support QRI’s ambition to be a destination hospital for patients
throughout the Middle East. “For our part,
we’re thrilled to be in a position to help.”
CR has been ranked as a Top 20 Rehabilitation Hospital by U.S. News & World
Report for the last two years. Many of
Atrium Health’s other component hospitals and programmes routinely achieve
top national rankings from U.S. News &
World Report and other rating agencies.
“Our people enjoy being involved internationally,” Lynn says, “and the benefits of these arrangements flow in both
directions. We’ve learned a great deal by
working with QRI, and we look forward to
initiating other successful partnerships in
the future.”
Atrium Health’s Carolinas Rehabilitation
(CR), of Charlotte, North Carolina, ratified a new partnership with the Qatar Rehabilitation Institute (QRI) in Doha earlier
this year. QRI is the region’s largest tertiary
rehabilitation hospital and is part of the
Hamad Medical Corp. (HMC), the principal public healthcare provider in Qatar.
According to QRI’s chief medical director and Chairman of the Geriatric and
Long-Term Care Department at HMC, Hanadi Al-Hamad, MD, the institute had several compelling reasons for seeking a new
arrangement with a leading rehabilitation hospital in the U.S.
“First and foremost, we wanted to
enhance the quality of clinical care
for our patients,” Dr Al-Hamad says.
“We take pride in providing services
based on the most up-to-date rehabilitation research and practice in
an environment that encourages healing
– both mentally and physically. One of
the ways to ensure best practice is to work
more closely with clinicians who are highly regarded in all major areas of rehabilitative care. Specifically, we are collaborating
with the CR team to develop bespoke staff
training and work with us to develop new
services that meet the needs of our population groups.”
Accreditation
Dr Al-Hamad says there is also interest in
gaining accreditation through the Commission on Accreditation of Rehabilitation Facilities (CARF).
“We’ve started consulting with our
counterparts at CR to learn more about
CARF procedures and expectations to establish the right basis for us to apply for
this renowned accreditation,” Dr Al-Hamad says.
CARF is an international organization
that assists service providers to improve
Huntleigh recently introduced a single-use intraoperative
probe for the Dopplex Doppler range.
Intraoperative Doppler ultrasound assessment provides immediate evidence of success in vascular reconstructive procedures. By providing quality assurance of blood flow intraoperatively, time can be saved and costs of a potential re-operation
avoided.
As a leader in diagnostic devices Huntleigh prioritises safety
and accuracy above all else, and single-use probes offer the best
combination.
Quality control is vitally important in performing surgery,
if secondary intervention and re-operation are to be avoided.
The Dopplex single-use intraoperative probe can assist in the
performance of safe surgery.
Accuracy of pulse detection
As a leader in diagnostic devices, Huntleigh prioritises accuracy and reliability above all else.
While some practitioners opt for manual palpation to detect
a pulse, it is easy to demonstrate that a pulse does not necessarily indicate good blood flow, and in fact the pulse gained from
a blocked vessel can be stronger than the pulse of an open one.
Infection risk
Another alternative to single-use probes is a non-surgical
probe in a makeshift sterile field such as a glove. This costs
theatre time, and greatly increases the risk of infection. The
Dopplex probe is supplied with a 2.5-metre sterilised cable to
minimise the opportunity for non-sterile objects entering the
sterile field.
As part of the Dopplex range, the flow detected by the probe
is immediately visualised on the DMX Doppler unit.
Huntleigh
launches single-use
intraoperative probe
Huntleigh
MIDDLE EAST HEALTHI 79
80 IMIDDLE EAST HEALTH
Digital pathology helps pathologists view,
manage, share, and analyze tissue samples
by converting glass slides into digital
slides. Therefore, you need a high-speed,
high-resolution slide scanner and an accurate barcode, which provides patient
information – or, at least, the patient ID
– throughout the entire process (from receiving the original specimen to digitizing
the tissue section for diagnosis under a virtual microscope).
Prevent misidentification
Indeed, one of the main goals of digitizing
the entire process is to prevent misidentification, and to make connecting, reviewing, and managing patient data faster and
more reliable. In the past, most labeling was
accomplished by handwriting information
with a pencil or marking pen. However,
handwriting tends to be difficult to read,
may be inaccurate, and can rub off during
processing. Even if the sample is not to be
scanned and digitized, a barcode – which
can only be produced digitally – is a necessity for matching it to other samples and
data in the laboratory information system
(LIS). Fortunately, today’s printing inks
are chemical- and UV-resistant enough to
withstand common laboratory processes.
With the right solution, labs can print not
only 2D barcodes, but also text, graphics,
and logos to scan and apply directly to tissue cassettes and slides. Such an approach
completely eliminates both handwriting
and expensive, difficult-to-apply xyleneDTM Medical
resistant labels – two things that decrease
workflow efficiency and place patient safety
at risk.
There are two types of printing systems
most laboratories use nowadays: cassette
printers and slide printers. Cassette printers are available as standalone manual
printers or as complete automated systems.
The standalone options, such as the Signature Cassette Printer, are compact, robust,
and small enough to fit next to a grossing
station. They usually load one tissue cassette at a time through an operator. These
modern manual printers can produce several cassettes per minute. Fully automated
systems function at nearly the same speed,
but use separate hoppers instead of requiring manual input. Some models even come
with a robotic arm that picks each cassette
from the top of the desired stack and places
it into the printer. Exactly like that is the
SCP-R version of the Signature Cassette
Printer. It’s a completely automated system consisting of the Signature Cassette
Printer and a new upgraded robotic picking system called Autoloader EVO.
Slide printers
Slide printers, like the Signature Slide
Printer EVO, are designed for efficient,
hands-free operation. Because slides are
stored in easy-to-load cartridges that protect them from dust and other potential
contaminants, they increase workflow
safety and slide longevity. The devices can
also print in a variety of hues and shades,
reducing the need to purchase consumables in different colors. State-of-the-art
systems are advanced enough to offer ondemand or batch mode printing and are
also designed for very low noise emission.
Placing a cassette printer at a grossing
station or a slide printer at a microtome
station is an important step toward significantly increasing the lab’s efficiency while
reducing the risk of specimen misidentification. Even after several years, cassettes
and slides with properly printed labels can
be reliably identified. By printing on tissue
cassettes and slides, we digitize the entire
process chain, which not only facilitates
LIS integration but also (when using the
right printer) prepares the laboratory for a
future in which the entire pathology workflow is digital.
DTM Medical at Medlab 2023
DTM Medical will showcase the Signature
Series at Medlab 2023 at stand Z6.F33 in
Za’abeel Hall 6 and is well represented in
the Middle East through its network of
experienced local distribution partners in
the United Arab Emirates, Saudi Arabia,
Qatar, Oman, Kuwait and Bahrain.
DTM Medical
Mainzer Str. 131
65187 Wiesbaden, Germany
Phone: +49 611 92777-0
Email: [email protected]
Website: dtm-medical.eu
Think before you (don’t) print
Consider the importance of specimen
identification solutions in pathology digitization
Thanks to legislative reforms,
the UAE has been repeatedly
one of the first countries to
launch innovative therapies,
while always advancing the
healthcare system to expand
access to medicines for
patients who need them.
82 IMIDDLE EAST HEALTH
Diabetes is a global pandemic that is not
going away, with 16.3% of adults in UAE
aged between 20 and 79 years afflicted by
the disease – a number that is expected to
double by 2040.
Type 2 is the most common form of diabetes in the UAE, with weight, smoking,
sedentary lifestyle, and poor diets linked to
the illness.
If diabetes is not detected and well managed, it can lead to severe complications
and, ultimately, premature death. And yet
an estimated the 50 percent of people living with diabetes are undiagnosed. This
may be due to lack of awareness about
symptoms, or absence of regular health
screening, for example.
Being part of the pharmaceutical industry, at Lilly, our number one priority is to
work with different stakeholders to improve diabetes healthcare outcomes, with
patients at the centre of this process.
Building a healthcare ecosystem
The first task is to prevent diabetes. While
Type 1 diabetes and some of the risk factors
for Type 2 diabetes, such as family history,
can’t be avoided, there are many other risk
factors that we can control.
For example, in the UAE, we are fortunate to have a government that is redefining healthcare by moving from sick care
towards prevention.
Specifically for diabetes, this includes
several education programmes in schools
and workplaces, together with fitness and
awareness programmes, such as the ongoing Dubai Fitness Challenge, which encourage lasting healthy habits.
The UAE has also done some vital work
in advancing innovations and fostering an
environment that incentivizes advancements in treatments and care. This summer,
Dubai Health Authority launched an analytics-based, digital-led programme, Ejadah,
that will form the foundation for valuebased healthcare adoption. The platform is
Working to a healthier future
Diabetes
expected to lead to faster claim approvals,
minimise waste of healthcare expenditure,
and focus on preventive care, while allowing access to next-generation technology.
Technology is also playing a key role in
patient outcomes monitoring. However,
a pre-requisite to using technology is to
complete important work around data privacy. Such data plays a key role in understanding disease management, progression
to improve patient care.
Another form of providing local data is
Real-World Evidence (RWE). RWE are
studies that aim to provide insights on diseases, medicines, patient populations and
healthcare practices. This landscape continues to evolve rapidly in the UAE, and
Lilly has embarked on this journey to support providing local data across different
therapy areas, including diabetes.
Partners for success
Another advantage of this developing
health ecosystem is that it allows for rapid
introduction of innovative medicines and
treatments. Thanks to legislative reforms,
the UAE has been repeatedly one of the
first countries to launch innovative therapies, while always advancing the healthcare system to expand access to medicines
for patients who need them.
Most recently, the UAE was the first country to approve and launch our innovative
diabetes treatment, a new class of medication
in nearly a decade, just one month after it received FDA approval in the US. This is a true
testament to the country’s commitment to
advance access to innovative therapies, protect innovation, and reward it. This was also
an exceptional milestone for Lilly, as we were
the first company that made insulin commercially available 100 years ago. Discovering and
launching a new class of medicines in the occasion of our insulin centennial speaks to our
long-lasting commitment to help people living with diabetes.
I believe the role of pharmaceutical
companies does not stop there. Making
sure that patients can access innovative
treatments is at the centre of our work.
Lilly’s Sawiyan programme in the UAE
was introduced to support patients who
have affordability challenges to help them
access the medicines they need. This programme is supported by the UAE Ministry
of Health and Prevention.
Lilly is also working with the Emirates
Diabetes Society in the UAE and other
industry stakeholders to support efforts
on patient education, access to treatment,
and healthcare providers’ engagement and
awareness about innovations.
Finding a cure for diabetes is the ultimate
dream. But the reality today is that tangible
steps can help prevent diabetes through education and lifestyle changes, and improvements to the management of diabetes is
possible through early detection, innovative
treatments, and regular health screening.
Diabetes is a growing problem in the UAE – but the groundwork is being laid
for improved outcomes. Amr Saeed, Corporate Affairs Director for Eli Lilly Gulf,
Levant, and Pakistan, looks at some of the latest developments.
84 IMIDDLE EAST HEALTH
Uterine rupture remains one of the most
frightening complications in obstetric
care. The risk of its occurrence is likely
to increase for many women who undergo
caesarean sections.
It is important to consider because it
continues to be associated with maternal
and foetal mortality, especially in developing countries, and with major maternal
morbidity, particularly peripartum hysterectomies.
Maternal outcomes following uterine
rupture include hysterectomy, bladder injuries, transfusion, ICU admission, shock,
assisted ventilation, and an increase in
hospital length of stay.
Diagnosis of uterine rupture
The diagnosis of uterine rupture is principally based on clinical manifestations,
foetal heart abnormalities, or imaging examinations before or after delivery.
There should be a higher index of suspicion by the healthcare provider, in order
to identify the rupture as early as possible,
and provide immediate surgical treatment.
The main reason that a patient is predisposed to uterine rupture is weakness of
the muscle layer of the inferior segment of
the uterus after caesarean section, or after
scarring of any sort, in this area.
It is also associated with obstructed labour, prolonged labour, the use of induction agents, malpresentation, and grand
multiparity.
Deliver the baby as soon as possible
The key message is that the delivery of
the baby should be done as soon and as
safely possible if a uterine rupture is suspected.
If the rupture is suspected after delivery,
an immediate response for management
and treatment should start. Stabilising
the patient clinically with transfusions,
medications and proper intravenous access
Women’s Health
should be done concomitantly with preparation of the operating room theatre and a welltrained team.
A major decision facing the surgeon
will be whether to preserve the uterus
with a repair, or perform a hysterectomy.
Obviously, the patient’s desire for future
pregnancies is important, but this may be
superseded by the emergent need to perform
life-saving measures such as hysterectomy.
The traditional approach is to perform a laparotomy, and either repair the
uterine defect or remove the uterus. It is
very important once inside to control the
haemorrhage and identify damage to adjacent organs, most likely the bladder.
Minimally invasive techniques using
laparoscopy or keyhole surgery have been
described in the literature. These will allow a faster recovery with less pain, and a
decrease in postoperative wound complications.
da Vinci Xi HD 4 arm robotic system
Recently at Mediclinic City Hospital,
Dubai, Dr Labib Riachi, an expert in advanced robotic gynaecological surgery,
and his team performed a repair of a uterine rupture using the da Vinci Xi HD 4
Dr Labib Riachi is a
Consultant Obstetrician &
Gynaecologist. He specialises
in Minimally Invasive
Gynaecological Surgery,
Obstetrics and Gynaecology
and Urogynaecology
• View Dr Labib Riachi’s
Mediclinic profile here:
https://www.mediclinic.ae/en/city-hospital/
specialized-units/da-vinci-robotic-surgerysystem.doctor.html/8/labib-riachi.html
Mediclinic City Hospital uses
advanced da Vinci robot for
uterine rupture repair
arm robotic system which enabled them
to use the most advanced surgical techniques available worldwide. This allowed
an unparalleled level of high precision
in manipulating torn tissues, as well as a
three-dimensional view of the field, with
the freedom to rotate the instruments independently without any assistance. The
repair was done successfully in 30 minutes. Following surgery, the patient was
taken to a regular ward and recovered
with no complications.
The da Vinci Xi HD 4 arm
robotic surgical system
Dr Labib Riachi, Consultant
Obstetrician & Gynaecologist,
Mediclinic City Hospital, Dubai.
86 IMIDDLE EAST HEALTH
AIRS Medical showcases SWIFTMR Artificial
Intelligence solution for MR imaging
At the RSNA radiology event in Chicago
in November last year, South Korea-based
AIRS Medical, a leading medical AI solution
provider, showcased SWIFTMR, an FDA
510(k)-cleared AI Imaging solution that enhances MR images acquired under various
conditions, contributing to better image quality and patient experience. SwiftMR utilizes
conventional MR imaging techniques such
as parallel imaging and compressed sensing,
combined with its award-winning deep learning technology. SwiftMR thus enhances SNR
and sharpness of the images, allowing radiologists to read with confidence and ease.
Since its official commercial launch in Korea in the fourth quarter of 2021, SwiftMR
has been installed in more than 100 hospitals,
for an average of 30,000 monthly MRI exams.
After its successful launch and with proven
performance in Korea, the company is rapidly
expanding globally.
n For more information,
visit: airsmed.com
Annalise.ai has joined the Nuance Precision
Imaging Network (PIN), connecting Annalise.ai workflow orchestration and diagnostic
support solutions to over 12,000 healthcare
facilities worldwide. Annalise.ai is one of
the largest medical imaging AI companies in
the world, developing robust AI solutions intended to assist with the interpretation of radiological imaging studies. In 2022, Annalise.
ai’s chest X-ray products received U.S. FDA
clearance for use in triage and notification for
a subset of chest X-ray findings.
The collaboration between Annalise.ai and
Nuance Communications (a Microsoft company) also harnesses the power of AI from
Annalise.ai to enhance the Nuance Clinical
Analytics platform. This will complement
Natural Language Processing (NLP) within
Nuance’s Clinical Analytics platform to create an advanced AI analytics engine, allowing
radiologists to better evaluate the results from
AI, as well as mine their historical reports using the power of AI through mPower. The
combination of pixel-level insights and textbased insights helps providers extract deeper
meaning from their medical imaging data.
“We want to transform healthcare for patients around the world every single day and
have already impacted more than one million
lives globally through our Annalise.ai solutions,” said Lakshmi Gudapakkam, Annalise.
ai CEO. “We are extremely excited about
the enormous potential of this collaboration
to empower radiologists and other clinicians
through end-to-end workflow support.”
n For more information, visit: https://bit.ly/3YzsanT
Annalise AI collaborates with Nuance Communications
MIDDLE EAST HEALTHI 87
88 IMIDDLE EAST HEALTH
GE Healthcare has launched its SIGNA Experience, a platform of
four synergistic technologies that help users through the diagnostic journey. This integrated collection works together to ensure a
smooth MRI scanning experience for the physician, technologists
of all skill levels, and the patient.
• SIGNA One is the cornerstone of these solutions: A next generation, imaging software platform supporting an elegant, intuitive
user interface, designed to offer high quality magnetic resonance
(MR) imaging.
• AI/Deep-learning solutions: Pioneering, deep-learning AI
applications, such as AIR Recon DL for improved signal-to-noise
ratio (SNR), image sharpness and shorter scan time.
• Workflow solutions: Automated, intelligent workflow technologies, that include AIR x and AIRTouch, which guide technologists to help make an MRI scan set up better, faster, and easier.
• AIR Coils: Industry leading, transformative technology in coils,
which are flexible, lightweight, and comfortable, enabling total freedom in coil positioning and handling during an MRI scan.
With operational efficiency the fastest growing challenge for radiology departments, SIGNA One enables greater workflow productivity
by requiring only a fraction of the clicks needed to perform an exam
from setup to completed scan. The benefits of this user interface are
that it enables:
• Intuitive workflow for all experience levels and virtually
no learning curve. Technologists can keep track of progress at a
glance with useful visual reminders, showing them where they are
at any point within the scanning process.
• Efficiency with visually assisted highlighted fields to guide
technologists step-by-step, making the process flow easily; and
flexibility in design to accommodate for future expansion in AI
and workflows.
• Simplification with an easy-to-use express mode which only
requires a few clicks to complete an examination, helping to
streamline workflow and optimize throughput.
• Intelligent automation that highlights the most likely action
following a scan.
SIGNA One is currently commercially available on SIGNA
Prime. All other SIGNA Experience solutions are commercially
available.
n For more information, visit: www.gehealthcare.com
GE Healthcare
releases SIGNA
Experience
technologies for MRI
Siemens Healthineers has unveiled the Magnetom Viato.Mobile, its latest MRI scanner optimized for mobile use and featuring a patient bore of 70 cm. The Magnetom Viato.Mobile is currently under development and is not yet commercially available.
“With Magnetom Viato.Mobile, we plan to offer the most
powerful innovations at 1.5 Tesla for mobile use. Installed in
a trailer setup to provide greater flexibility in deploying MR
imaging, the scanner can easily be taken from one place to the
next or stay at the customer’s site for longer use. For example,
the solution can help with screening programmes in underserved regions – it’s not the patient coming to the scanner,
but the other way around,” explained Arthur Kaindl, head of
Magnetic Resonance Imaging at Siemens Healthineers.
Operation and service of Magnetom Viato.Mobile can be
done remotely via a fixed internet or, if needed, via a 4G connection. This means that the system can be used almost anywhere, while experts – when required – can provide support
from another location during two crucial steps: performing the
scan and maintaining the system. This means that fewer staff are
Siemens Healthineers
introduces new mobile MRI
Magnetom Viato.Mobile
needed on site, specialists can work from home and service technicians can take exactly the right spare part with them when they
deploy for maintenance.
• For more information, visit: www.siemens-healthineers.com
MIDDLE EAST HEALTHI 89
90 IMIDDLE EAST HEALTH
At the RSNA radiology event in Chicago in
November last year, radiology reporting specialist OpenRad launched its enterprise remote
reporting platform, Enterprise Edition, which
enables cloud-based reporting, collaborative
workflows across companies and advanced mobile fleet management in one offering.
At a time when increased workload and
radiologist shortages are putting a strain on
the healthcare system, OpenRad Enterprise
Edition allows imaging centres to fully leverage remote radiologists to speed up the
diagnostic process, increase efficiency, improve patient experience, and reduce costs.
The OpenRad SaaS based platform
provides a fully digital end-to-end teleradiology workflow – combining a domestic
cloud platform, OpenRad Cloud (by Biotronics3D), with a DICOM 3.0 routing,
translation, compression, and encryption
device, OpenRad Cube (by Visbion),
which includes the industry leading mobile fleet management solution.
OpenRad’s solutions have been implemented in more than 350 clinics and other
static imaging sites as well as in 350 mobile
trailers across 18 countries.
OpenRad Enterprise Edition also offers radiologists the option to view images
through their existing picture archiving
communications system (PACS) via a
single cloud. The solution can be easily
applied to fleets of mobile scanning trailers where imaging data is seamlessly and
securely fed into the PACS.
The solution is designed to help imaging
centres optimise the use of equipment and
reduce the impact of radiology staff shortages.
Radiologists, referrers, imaging providers
and patients are all able to access the webbased platform remotely via any device
connected to the internet. This collective
intelligence with AI integrations makes
it easier to address complex decisions and
drive innovation in disease prevention,
diagnosis, and monitoring. It also features
intelligent worklists, contract management, referrer and patient portals as well
as peer review capability.
The OpenRad Cloud offering has minimal on-premise and end user information
technology costs, since the zero-footprint
solution is fully web-based and utilises existing workstations and monitors.
Brian Plackis Cheng, CEO, OpenRad said: “At RSNA, we are delighted
to launch OpenRad Cloud and Cube for
the European market and OpenRad Cube
for the US market. Our comprehensive
SaaS-based platform, Enterprise Edition,
will increase collaboration, improve patient outcomes, and reduce costs. OpenRad Enterprise Edition will better connect
healthcare professionals, imaging centres,
referrers, and their patients, unlocking the
full potential of medical imaging. Together
with our customers and partners, we will
fully deliver the cloud promise and benefits
in teleradiology.”
• For more information, visit: www.openrad.com
OpenRad unveils enterprise remote
reporting platform for radiology
MIDDLE EAST HEALTHI 91
92 IMIDDLE EAST HEALTH
Philips has launched globally their next-generation compact portable
ultrasound solution, the Compact 5000 Series. This new ultrasound is
designed for portability and versatility without compromising image
quality or performance and aims to bring the diagnostic quality associated with premium cart-based ultrasound systems to more patients.
Replicating the intuitive user interface and workflow of Philips’
cart-based systems EPIQ Elite and Affiniti, and offering full compatibility with these systems’ transducers, the Compact 5000 Series
supports an easy learning curve for users. Designed for shared service
capabilities across specialties including cardiovascular, obstetrics and
gynaecology, point of care, and general imaging, the Compact 5000
Series system helps meet the needs of multiple clinical segments. The
Compact system can be configured with an optional battery allowing for 2.5 hours of scanning time and faster power-up capability to
quickly ready the system at the patient’s side. Additionally, the new
system features fewer hard keys on the console and a fully sealed control panel for easy disinfection and cleaning protocols.
“Improving patient outcomes and the patient experience means
providing clinicians with our best diagnostic tools available and
making advanced technology available wherever the patient is located,” said Jeff Cohen, general manager of Ultrasound at Philips.
“With the patient at the centre of everything we do, we
built the Ultrasound Compact System 5000 Series to perform as a highly versatile portable ultrasound system to be
used in multiple care settings for many different types of
exams without compromising image quality, diagnostic ability, or clinical workflow.”
This newest system also features ‘Philips Collaboration Live’
secure real-time telemedicine software, with the ability to call on
additional clinical expertise via secure voice, text, screen sharing, and video streaming from anywhere with a mobile or internet
connection. Collaboration Live even allows a remote user to control the unit’s settings to acquire diagnostic quality images, reducing the need for follow-up scans and patients having to travel to a
central hospital facility.
The Compact 5000 Series recently received U.S. FDA
510(k) clearance and is pending CE mark.
Philips launches new
compact ultrasound system
MIDDLE EAST HEALTHI 93
Busch developed a new concept: a central
vacuum supply for all particle counters using
two vacuum pumps, which operate according
to the MINK claw vacuum principle. These
are also equipped with an intelligent drive
with a frequency converter, which enables
the vacuum pumps to be regulated such that
they permanently operate at the required
performance, even if the process conditions
change. In May 2014, two MINK MV 0040
D claw vacuum pumps were installed in the
technical centre of the JCC and operated redundantly. This means that only one of the
two vacuum pumps is in operation, while the
other acts as a stand-by.
The two new vacuum pumps are programmed to maintain a precise standard flow
of 28.3 litres per minute at the particle counters. Both vacuum pumps are connected to
the building control system and constantly
monitored, with any malfunctions immediately displayed. The vacuum system is in use
Busch provides reliable vacuum
supply in clean rooms
Busch Vacuum Solutions
around the clock, with the control system designed by the technical centre of the university hospital in such a way that the vacuum
pumps operate alternately and therefore both
spend the same amount of time in operation.
In the event that one of the vacuum pumps
malfunctioned, the control system would immediately ensure that the other pump springs
into operation and the vacuum supply does
not fail. A continuous and reliable measurement of the particles in the air in clean rooms
at the Josè-Carreas-centre for somatic cell
therapy is imperative.
MINK vacuum system solution
and its benefits for the customer
MINK claw vacuum pumps operate dry,
meaning that they are free from operating
fluids in the compression chamber and operate contact-free. Unlike dry-running rotary vane pumps, there is no wear, thanks
to this method of contact-free operation. It
is another reason why this type of vacuum
pump permanently generates the required
pumping speed. The operation without
operating fluids and without wearing parts
makes the MINK claw vacuum pump virtually maintenance-free. This new vacuum
technology has been in operation at the José-Carreras Centre since May 2014, and so
far, there have been no “flow alarms” in the
clean room or any other malfunctions or
disruptions to the vacuum supply. Furthermore, in the last 3 years since implementation of the MINK claw vacuum pumps no
maintenance work has been required on the
vacuum pumps.
Contact:
Website: www.buschvacuum.com
Phone: +971 (0) 50 6312898
94 IMIDDLE EAST HEALTH
The Covid pandemic has revealed just
how delicate our public health is in terms
of overcoming infectious diseases and antimicrobial resistance. Over the last decade
small proteins known as anti-microbial
peptides (AMPs) have delivered promising results in helping anti-infectives
overcome increasing antibiotic resistance
problems but have proven difficult to commercially produce.
Now, a radical research project involving
experts from the University of Huddersfield
aims to develop a new method for the commercial production of AMPs which if successful will open up a whole new range of opportunities for the use of bio-active peptides.
The RADOV Project
Titled RADOV or ‘RADiation harvesting of bioactive peptides from egg prOteins and their integration in adVanced
functional products’, the four-year project
features an international consortium of
partners and has been awarded €2 million
from the European Union’s Euratom Research and Training Programme (EURATOM) Horizon Europe to carry out the
necessary research.
Heading the team from the University
is Professor Robert Edgecock from the
University’s School of Computing and
Engineering. He revealed why AMPs
have aroused great interest as potential
next-generation antibiotics and how because long-term chemotherapy in cancer
patients can lead to resistance to conventional cancer treatments and a susceptibility to pathogenic infection, due
to AMPs’ antibacterial and anticancer
properties, they could also become a new
treatment option for cancer patients.
A potential gamechanger in
beating antimicrobial resistance
Innovation in Healthcare
What are anti-microbial peptides?
“Antimicrobial peptides (AMPs) are small
proteins present in different lifeforms in
nature, or that result from enzymatic digestion of proteins, which provides these
lifeforms with a natural defence against
microbial infections,” he said.
“In addition to the more specific antibacterial and anti-viral actions, they have
shown immune-modulatory activities, antifungal actions, anti-inflammatory properties and even possess the ability to disintegrate cancerous cell membranes,” he added.
What makes AMPs viable and important alternative antimicrobial agents,
explained Prof. Edgecock, is the fact that
the development of resistance by the microbes against the AMPs is relatively slow
or delayed compared to that against conventional antibiotics.
“However, despite their promise,” he
said, “very few of the AMPs have been
commercialised so far, mainly due to technical difficulties in their manufacture.”
Synthesising AMPs
To begin with, the researchers will use beams
of electrons to synthesise the AMPs from egg
proteins, and the results acquired regarding
the peptide structure, irradiation conditions,
and related bioactivity properties will become a vital output of the project.
The researchers will then use electron
beam irradiation to further integrate the
AMPs into two new products, peptideladen antimicrobial/antioxidant hydrogel
wound dressings and peptide-grafted active plastic foils for food packaging. This
will effectively demonstrate the potential
of the technique and the benefit of the
antimicrobial properties of egg-derived
bioactive peptides manufactured by radiation-induced fragmentation.
Co-ordinating the project is Poland’s Institute of Nuclear Chemistry and Technology, who will be assisted by the University of
Huddersfield, Sweden’s KTH Royal Institute
of Technology, Italy’s University of Palermo,
the Italian National Research Council and
Portugal’s Association of Instituto Superior
Técnico for Research and Development.
Also playing a crucial role in the successful implementation of the project will
be three industrial partners: Kikgel Sp. z
o.o. and Dekofilm Polska Sp. z o.o. from
Poland and Italy’s E.P.S. S.p.A. Egg Powder Specialists.
A radical project involving a team of researchers
from the University of Huddersfield aims to
develop a new method for the commercial
production of anti-microbial peptide’s (AMPs) and
if successful could open up a whole new range of
opportunities for the use of bio-active peptides.
Beams of
electrons will
synthesise the
AMPs from
egg proteins
obtained
preferably from
an abundant
waste stream
of the egg
industry, such
as the eggshell
membrane.
The development of autism may now become
easier to understand, thanks to an explanatory
model presented in a thesis from University
of Gothenburg, Sweden. This model provides
new insights into how various risk factors give
rise to autism and why there is such great variability between individuals.
Autism, a neurodevelopmental condition,
affects how people perceive the world around
them and how they interact and communicate with others. Among individuals with
autism, there are major differences in terms
of personal traits and manifestations alike.
The disorder is therefore usually described as
a spectrum, with numerous subtle variations.
The new explanatory model is theoretical
but simultaneously practical in application,
since its various components are measurable through, for example, questionnaires,
genetic mapping, and psychological tests.
The model describes various contributing
factors and how they combine to prompt an
autism diagnosis and cause other neurodevelopmental conditions.
Three contributing factors
The model links three contributing factors. Together, these result in a pattern of
behaviour that meets the criteria for an
autism diagnosis:
1. Autistic personality – hereditary common genetic variants that give rise to an
autistic personality.
2. Cognitive compensation – intelligence and executive functions, such as the
capacity to learn, understand others, and
adapt to social interactions.
3. Exposure to risk factors – for example,
harmful genetic variants, infections, and other
random events during gestation and early childhood that adversely affect cognitive ability.
“The autistic personality is associated with
both strengths and difficulties in cognition
but does not, as such, mean that diagnostic
criteria are fulfilled. Still, exposure to risk
factors that inhibit people’s cognitive ability
may affect their capacity to tackle difficulties, which contributes to individuals being
diagnosed with autism,” says Darko Sarovic,
physician and postdoctoral researcher at SahlModel explains
how autism arises
grenska Academy, University of Gothenburg,
who wrote the thesis.
The model makes it clear that it is the
many different risk factors combined that
bring about the major differences among
individuals on the spectrum. The various
components of the model are supported by
results from previous research.
Adaptive ability
High executive functioning skills may enable people to compensate for their impairment in such a way as to mitigate the symptoms, which reduces their risk of meeting
the diagnostic criteria for autism. This may
explain why, at group level, researchers observe a lower degree of intelligence among
people diagnosed with autism, as well as
other neurodevelopmental conditions. It
also affords an understanding of why intellectual disability is more common among
these groups. Thus, the model indicates
that low cognitive ability is not part of the
autistic personality but, rather, a risk factor
that leads to diagnostic criteria being met.
“The autistic personality is associated
with various strengths. For example, parents of children with autism are overrepresented among engineers and mathematicians. The parents themselves have
probably been able to compensate for their
own autistic personality traits and thus not
met the criteria for an autism diagnosis.
The impact of the disorder has then become more noticeable in their children
owing, for instance, to an exposure to risk
factors and relatively low cognitive ability,” Sarovic says.
Difference between girls and boys
The diagnosis of autism is more common
among boys than girls, and girls often get
their diagnosis later in life. Some girls reach
adulthood before being diagnosed, after
many years of diffuse personal difficulties.
“Girls’ symptoms are often less evident to
other people. It’s well known that girls generally have more advanced social skills, which
probably means that they’re better at compensating for their own difficulties. Girls also tend
to have fewer autistic traits and be less susceptible to the effects of risk factors. Accordingly,
the model can help to answer questions about
the gender gap,” Sarovic says.
Research and diagnostics
The model also proposes ways of estimating and measuring the three factors (autistic
personality, cognitive compensation and exposure to risk factors). This makes it possible
to use the model in the planning of research
studies and interpretation of their results.
Diagnostics is another conceivable area
of use. In a pilot study in which 24 participants had been diagnosed with autism and
22 controls had not, measuring the three
factors of the model enabled more than 93
percent to be correctly assigned to the right
category. The model can also be used to explain the inception of other neurodevelopmental disorders, such as schizophrenia.
Darko Sarovic is now a postdoctoral research fellow at Harvard Medical School in
Boston, Massachusetts, while remaining affiliated to the Gillberg Neuropsychiatry Centre
at the University of Gothenburg, Sweden
A Multimodal Approach toward
the Biological Categorization of Autism
— Development of Theoretical Models,
Classification Methods, and Biomarkers.
https://hdl.handle.net/2077/73553
The three factors have different weights, and
jointly build up to the diagnosis of autism.
photo: Max Thorsson
Darko Sarovic, physician and postdoctoral
researcher at Sahlgrenska Academy,
University of Gothenburg.
MIDDLE EAST HEALTHI 95
96 IMIDDLE EAST HEALTH
To perform coordinated movements, we
rely on special sensory neurons in our
muscles and joints. Without them, the
brain wouldn’t know what the rest of our
body was doing. A team led by Dr Niccolò Zampieri, head of the Development
and Function of Neural Circuits Lab at
the Max Delbrück Center in Berlin, has
studied their molecular markers to better
understand how they work and describes
the results in Nature Communications [1].
Sight, hearing, smell, taste, touch:
We’re all familiar with the five senses that
allow us to experience our surroundings.
Equally important but much less well
known is the sixth sense: “Its job is to
collect information from the muscles and
joints about our movements, our posture
and our position in space, and then pass
that on to our central nervous system,”
says Dr Zampieri. “This sense, known as
proprioception, is what allows the central
nervous system to send the right signals
through motor neurons to muscles so that
we can perform a specific movement.”
This sixth sense – which, unlike the
other five, is entirely unconscious – is what
stops us from falling over in the dark, and
what allows us to raise a cup of coffee to our
mouth with our eyes shut in the morning.
But that’s not all: “People without proprioception can’t actually perform coordinated
movements,” says Dr Zampieri.
In the study, he and his team describe
the molecular markers of the cells involved in this sixth sense. The findings
should help researchers to better understand how proprioceptive sensory neurons (pSN) work.
The genes
of the
sixth sense
The Back Page
Precise connections are crucial
The pSN cell bodies are located in the
dorsal root ganglia of the spinal cord. They
are connected via long nerve fibres to the
muscle spindles and Golgi tendon organs
that constantly register stretch and tension
in every muscle of the body. The pSN send
this information to the central nervous
system, where it is used to control motor
neuron activity so that we can perform
movements.
“One prerequisite for this is that pSN
precisely connect to different muscles in
our bodies,” says Dr Stephan Dietrich, a
member of Zampieri’s lab. However, almost nothing was known about the molecular programs that enable these precise
connections and lend the muscle-specific
pSN their unique identity. “That’s why we
used our study to look for molecular markers that differentiate the pSN for the abdominal, back and limb muscles in mice,”
says Dr Dietrich, lead author of the study.
Guidance for nascent nerve fibres
Using single-cell sequencing, the team investigated which genes in the pSN of the
abdominal, back and leg muscles are read
and translated into RNA. “We did find
characteristic genes for the pSN connected
to each muscle group,” says Dr Dietrich.
“We also showed that these genes are already active at the embryonic stage and remain active for at least a while after birth.”
Dr Dietrich explains that this means
there are fixed genetic programs that decide whether a proprioceptor will innervate the abdominal, back or limb muscles.
Among their findings, the Berlin researchers identified several genes for ephrins and their receptors. “We know that
these proteins are involved in guiding
nascent nerve fibres to their target during
development of the nervous system,” says
Dr Dietrich. The team found that the connections between the proprioceptors and
the rear leg muscles were impaired in mice
that can’t produce ephrin-A5.
Better neuroprostheses
“The markers we identified should now
help us further investigate the development
and function of individual muscle-specific
sensory networks,” says Dr Dietrich. “With
optogenetics, for instance, we can use light
to turn proprioceptors on and off, either individually or in groups. This will allow us to
reveal their specific role in our sixth sense.”
This knowledge should eventually benefit
patients, such as those with spinal cord injuries. “Once we better understand the details of
proprioception, we’ll be able to optimize the
design of neuroprostheses, which take over
motor or sensory abilities that have been impaired by an injury,” says Dr Zampieri.
Scoliosis
He adds that researchers in Israel have recently discovered that properly functioning proprioception is also important for a
healthy skeleton. Scoliosis, for instance,
is a condition that sometimes develops
during growth in childhood and causes
the spine to become crooked and twisted.
“We suspect this is caused by dysfunctional proprioception, which alters the
muscle tension in the back and distorts
the spine,” says Dr Zampieri.
Reference: 1. doi: https://doi.org/10.1038/s41467-022-34589-8
Different populations of sensory neurons cell bodies in a dorsal root ganglion
(right) and their axons in the spinal cord (left): The cells in green detect
proprioceptive information while the cells in red thermal and tactile information.
Stephan Dietrich, Zampieri Lab, Max Delbrück Center