A Dutch startup BrightCape has developed a robot called SARA. SARA’s purpose is to support the nursing staff in taking care of the elderly. SARA can, for example, help the elderly doing their exercises, tell them stories or warn the nurses if something goes wrong.
While robots are not a new phenomenon in healthcare, SARA is to a large extent autonomous. With SARA Home, the nursing staff can add profiles of individual inhabitants of nursing homes. Currently, SARA is tested as a pilot in two Dutch nursing homes for the elderly. With the feedback they receive from both the nurses and clients SARA gets improved over time. As of right now, the main focus in on helping the elderly. But the aim is to make the robot also available for hospitals.
”Your sneak preview of the future” is the slogan of Innovation Origins, and that’s just what we will highlight with our Start-up of the Week column. Over the past few days, five start-ups of the day have been featured and on Saturday we will choose the week’s winner.
We shall consider various issues such as sustainability, developmental phase, practical application, simplicity, originality and to what extent they are in line with the Sustainable Development Goals of UNESCO. They will all pass by here and at the end of the week, the Start-Up of the Week will be announced.
EP Tender: a powerbank on wheels
It’s a strange sight, but the battery trailer from the French start-up EP Tender is definitely a very serious plan. You can regard the vehicle as a kind of extra battery for electric cars. This increases the range of the electric car by a maximum of 150 kilometers. Useful for holidays abroad where there are less charging stations than in The Netherlands. For the start-up it is to be hoped that battery nanotechnology is not set to overtake this wee trailer in the next decade.
Credimi – Fast financing for start-ups
Often an ambitious innovative business model needs money. Money that those involved don’t always have in their own pockets. Of course, you could go to a bank to finance your project, yet that frequently takes up an incredible amount of time. What makes Italian Credimi different from other lenders is that they are very fast. An applicant knows within 48 hours whether or not they will receive the loan. And this can be very welcome if you need to act quickly in a volatile market.
Skinive – Pocket-sized dermatologist
Almost everyone has discovered something on their skin that they were a little concerned about. A birthmark you didn’t know existed. Or a type of rash, an innocent spot. Or perhaps it would be a good idea to see your family doctor after all? By using the app from the Belarus start-up Skinive, you can find out directly by pointing your phone’s camera at your skin and taking a few pictures. The app then matches the images with data from a database that contains a multitude of nightmares for hypochondriacs.
The project initially began with the aim of discovering the first stages of skin cancer.However, the founders soon figured out that their smart app also worked for many other conditions. And because the app works on any smartphone, skin research is more accessible than ever. Skinive just offers advice on dermatological conditions, but unfortunately it doesn’t help against hypochondria.
Hydrogenious – All hail hydrogen
That hydrogen has the potential to be used as a fuel has been known for some time now. And how nice it would be if this would also be possible to roll it out en masse. Hydrogen is not a greenhouse gas. It produces about three times more energy than the same amount of petrol and there is more than enough of it on earth. So much for the advantages. Hydrogen is quite flammable at room temperature. Something that is obviously not very practical when you want to travel by car. In addition, the gas has the lowest density of the entire periodic table of elements, which makes it extremely difficult to work with. The gas evaporates just like that.
The German team behind Hydrogenious LOHC Technologies wants to address and overcome these two disadvantages with an innovative bit of chemistry. The ambitious start-up devised a process whereby hydrogen can be stored without any risk of explosion. And that’s not all. They have also discovered a way in which the gas can be transported to the end user with a tanker or a pipeline. How great would it be if we no longer needed to reduce the use of environmentally hazardous fuels, but simply had a clean alternative that we could burn which never runs out?
Fieldfactors – Avoid wet feet with green fields
Climate change is likely to have serious consequences for the Netherlands. Due to the fact that half of the country is actually below sea level, the risk of flooding is constantly looming over our tiny hinterland. And this is not the sole threat. Heavy rainfall will be more frequent as a result of a warmer kind of climate. Excess rainwater has to go somewhere if you don’t want the streets to be flooded. This is especially a problem in built-up areas. It can be very difficult to get rid of water when everything is packed in tight. However, the Dutch wouldn’t be Dutch if they didn’t have an innovative solution for this. One of these is Bluebloqs, a system from the start-up Fieldfactors, whereby 95% of rainwater can be stored underground in a basin.
This storage technology not only keeps our feet dry, it also looks pretty green. The system is visible at street level in the form of a plant bed. This naturally enhances the appeal of the street scenes. A win-win situation. An underground system is currently being installed in Rotterdam and is also dealing with a third sore point. Climate change does not limit itself to heavier rainfall, but also to longer periods of drought. Thanks to the compact storage basin, rainwater can be stored for months and reused at any time.
The biggest job these ex-students from Delft University have done so far was to install a storm water drain near the Kasteel football stadium, the home of Sparta. The football field is being watered in a sustainable manner through this basin. The square in front of the station has become a lot greener. And the local residents are no longer inconvenienced by flooding.
That the Dutch are internationally known as experts in the field of water management has once again been by Fieldfactors. The initiators show that innovation does not necessarily have to involve high-tech gadgets. One can also look towards nature too. In fact, everyone benefits from this system at a time when a well thought-out irrigation policy is more important than ever. This is enough reason for us to reward Fieldfactors this week with the title of Start-up of the Week!
The topic of a “culture of error” or a “culture that allows mistakes to be made” is fashionable and has recently been discussed in many companies and conferences. This discussion ranges from the enthusiasm and the desire for a quick introduction of so-called FuckUp Events in companies to the complete rejection of any tolerance for errors. The proponents want to celebrate mistakes as a learning opportunity while the critics describe mistakes as a cost factor that reduces profits and must therefore be bad per se. Both of these views fall short of the mark.
I have already written in previous articles why I love FuckUp Nights. This is because they enable us to learn: both the people concerned, who must have reported on such an experience and reflected on it, and the listeners, because they can learn through observation and the experiences of others. Talking about mistakes, errors or failed projects is an important part of a learning culture. Do they really need to be celebrated, as critics like to argue? No, they don’t. It is not at all about celebrating mistakes, as is sometimes done in Silicon Valley. What is the point of celebrating a failure and highlighting how grandiose it was? That would mean that we actually want to fail and make mistakes. I don’t think anyone likes to fail voluntarily. And certainly not healthy, happy, competent or successful people, as some authors like to express it.
It simply hurts
If failure is the ultimate non-achievement of personal goals, then it’s going to hurt because it is also about identity and downfall. This holds true whether it’s a project, an unachieved important goal, the end of a relationship or insolvency. Some go so far as to link the experience of failure to identity-creating motives and goals, in which case failure is simply painful. When we talk about a real culture of mistakes or learning, this has nothing to do with celebrating mistakes, but rather with the processing of emotional pain on a personal level. These negative emotions can also have a negative influence on the loyalty of an employee to their company.
For companies, the question arises as to how they can nevertheless benefit from the costs of an error or failure. The benefit of mistakes and failure lies in the learning effect. An error culture and a learning culture are mutually dependent, so to speak. Without mistakes there is no learning and there is no learning without mistakes. But learning is also an investment in the future in which the same mistake will hopefully not be made again. And then an open attitude towards mistakes and failures suddenly has a completely different meaning – namely investing in the experience and competence of employees.
Unwanted results are perfectly normal
Of course, not every mistake or failure is the same. If a mistake is predictable and avoidable, there is no reason other than negligence or stupidity for it to happen. The causes should have been known and thus avoided. If a mistake is neither predictable nor avoidable, that’s a different story. This is the case, for example, in complex and unsafe situations or when, as with innovations, new processes and products are involved. These must first be tested and checked in order to find out what the actual properties and results would be. This is different if a mistake is neither predictable nor avoidable, as is the case, for example, in complex and unsafe situations. Or when, as with innovations, new processes and products are involved. These must first be tested and checked in order to find out what the actual properties and results would be. Unexpected and undesired results are completely normal and cannot be avoided. And yet they are valuable for gaining knowledge about how it doesn’t work and new ideas about how it could work.
When I speak of a culture of error or improved learning, I speak of a culture in which exactly these unforeseeable and unavoidable errors may happen in order to learn from them. In principle, we have two learning strategies at our disposal: Imitation or exploration. Imitating others helps us to learn from their experiences and competences. This also means that we don’t try anything new, meaning that the results are predictable and avoidable. If we want to break new ground, explore and discover something new – exploration – then we have to be prepared to engage in something unpredictable and unavoidable.
If this unpredictable and inevitable is personally important and identity-building, then no matter how normal, natural or desirable the failure is – it will be painful.
Studies show that negative feelings in connection with failed projects increase the risk of decreasing commitment and loyalty of employees to the company. According to these studies, the processing of negative emotions and coping with failure is also influenced by the employees’ perception of how the company deals with failure and the amount of time given to employees to process it.
A credible error or learning culture is mandatory for all companies that are active in an environment in which errors cannot be avoided or foreseen. This is likely to apply to any company that operates in a so-called VUCA environment – in other words, almost all companies.
About this column:
In a weekly column, alternately written by Bert Overlack, Mary Fiers, Peter de Kock, Eveline van Zeeland, Lucien Engelen, Tessie Hartjes, Jan Wouters, Katleen Gabriels and Auke Hoekstra, Innovation Origins tries to find out what the future will look like. These columnists, occasionally supplemented with guest bloggers, are all working in their own way on solutions for the problems of our time. So tomorrow will be good. Here are all the previous columns.
Skinive is an AI-technology for Skin Health Self-Examination. Users upload photos of skin areas with suspicious spots, moles or rash into the app, Skinive algorithms examine the image and make an instant diagnosis. Skinive can detect signs of numerous skin diseases such as pre-cancerous moles and skin cancer, papillomavirus, rosacea and others.
Start-up Skinive began life as AI Skin Health Self-Examination service in 2018 in Belarus. Since then Skinive AI has been continuously learning from medical doctors’ input and countless images and descriptions of skin diseases. Recently the company from Belarus has become a finalist of Rockstart AI Accelerator program in the Netherlands.
Innovation Origins has spoken with Kirill Atstarov, the founder of Skinive, about highlights and challenges that the start-up has experienced and about its business journey from Belarus to the international market.
What motivated you to start Skinive? How did it happen?
Our motivation was to create our own health self-examination product. At first, we wanted to create AI technology for diagnostics of some common diseases and prediction modelling. However, this would involve the use of X-rays or ultrasound images. For that reason, the applications of our technology required pilot projects with medical institutions, which was difficult to arrange in Belarus. That is why we restricted our scope to a skin health examination. In this way, we could bring our technology directly to the end-user – thanks to the fact that nowadays almost everyone has a smartphone. We started with the diagnostics of skin cancer. But soon we realized that the market already had enough of AI skin examination apps serving the same purpose, so we broadened the range of skin diseases that could be detected by our algorithms.
What kind of problems do you solve?
Our main motivation is to create a product that would allow many people to be healthy. Now people can have a quick skin examination with our app, get a result and if a (potentially) dangerous skin condition is found, users need to visit a doctor. However, we plan that in the future it would be possible to confirm the diagnosis with a doctor in the app – in the form of a telemedicine service. Two opinions – from the AI and a dermatologist – are especially useful to have if people are dealing with skin allergy.
What is the biggest obstacle that you needed/will need to overcome?
Our main problem was that medical doctors in Belarus were initially sceptical about our technology. In the beginning, we faced a lot of criticism. Some medical specialists did not understand how AI-based diagnostics worked, some people even called our technology health fraud.
When I came to the Netherlands for the Rockstart program, I visited Nijmegen and met medical doctors who are specialized in diagnostics with the usage of neural networks and AI. That was a pleasant surprise!
What is the difference between Skinive and other skin self-examination apps?
Most of the existing skin examination apps focus on diagnostics of skin cancer. With our AI algorithms and we can detect and identify not only skin cancer but about thirty other skin conditions. Skin cancer is undoubtedly a dangerous disease, but it is not the most common skin problem. Most frequently people suffer from acne or viral infections, and we want to help those people.
Do you receive support from the government of Belarus?
The activity of Skinive and similar start-ups has attracted the attention of the Belarusian government. So, at the beginning of October there was a round table in Minks with the Minister of Health and the administration of Belarussian main technology hub – Hi-tech Park. They were discussing the new ways of cooperation between medical specialists and software companies like Skinive. As a result, they came up with a program that makes IT and healthcare cooperation more convenient both sides. It is an important step for the industry. Previously medical doctors could only work with IT-companies as private individuals in their free time – not as employees of a hospital.
Are there accomplishments that made you proud of your work?
The accomplishment we are most proud of is the first life that we have saved with our app! That happened during an international IT-conference EMERGE in Minsk. We were demonstrating what we do as a start-up to the visitors. We were letting them try out our application and examine moles, spots and rash they were concerned about. One of the visitors took the test and received a “potential threat” result for a mole on his face. We helped this person to arrange a visit to a dermatologist and oncologist in Minsk. They confirmed the diagnosis – the early stage of skin cancer – and directed him to the surgical removal of this life-threatening mole. After that case we received lots of attention in media, many people started using our service and the Belarusian Ministry of health offered us support. So that was a breakthrough for Skinive.
What can we expect from you in the near future?
We are going to become residents of the High-Tech Park in Minsk – the “Silicon Valley” of Belarus. Skinive has finished the Rockstart AI-track and with their help, we are setting up Skinive in the Netherlands. The company is going to start working in the European market. However, we are planning to leave RnD centre in Belarus.
s long as the software development concerned, we are planning to create an educational smartphone app for medical doctors and all the people who want to learn more about their skin.
What is the ultimate goal of Skinive?
We want to create a technology that enables people to diagnose different skin conditions in their early stages – a personal tool for skin health monitoring.
There are many employees with a colleague named Sara. But if SARA stands for Social & Autonomous Robotic Health Assistant, that’s probably not a colleague you are used to. SARA is the ‘robot care colleague’ that the Eindhoven-based company Bright Cape has developed. The project is part of a European EIT Digital Innovation Consortium and is intended to reduce the workload in healthcare and to guarantee the quality of care in general.
The SARA robots can interact with patients, like reading stories, showing videos, playing word games or reciting music. They can also offer basic fitness training. SARA already works in two Dutch healthcare institutions: Care group Elde Maasduinen and TanteLouise in Bergen op Zoom. The results so far are so encouraging that SARA is continuing as a start-up, says EIT Digital.
“The ageing of the population is presenting European society with challenges,” says Emmy Rintjema, SARA activity leader within Bright Cape. “The number of elderly people and the number of people with chronic diseases is increasing, while at the same time care institutions and hospitals are struggling with staff shortages and heavy workloads. In these situations, it is necessary not to work harder and harder, but to work smarter.”
This year’s SARA was developed as an EIT Digital innovation activity within a consortium of EIT Digital. Next to Bright Cape from the Netherlands, also Forum Virium Helsinki and GIM Robotics from Finland, and Curamatik en de Technische Universität Berlin from Germany are part of it. In 2020, SARA will continue as start-up SARA, a spin-off from Bright Cape that also leads the consortium. “We believe that robots can make a major contribution to healthcare. They can work together with healthcare professionals and thus reduce the workload,” says Rintjema.
That this actually has results, is demonstrated by a pilot project at the Elde Maasduinen Care Group and at a nursing home in Finland, which are involved in SARA development as test locations. “SARA is still in a prototype version that we are fine-tuning together with residential care centres. We mimic the work of a healthcare professional and test the functionalities.”
The results of the pilot are positive, says Rintjema. “Employees experience that SARA can indeed reduce their workload.” Healthcare professionals put SARA to work for residents so that they have their hands free to help other residents.
According to Rintjema, the most important lesson is that the system can be an addition to care for the elderly and especially for people with dementia. “Mental and physical stimulation has a positive effect on slowing down the disease process of dementia.”
The concept of robots in the healthcare sector is not new. Most of these robots are unable to function independently. According to the makers, the SARA robot can act largely autonomously. “Thanks to the SARA Home system, healthcare professionals can, for example, upload the input of a healthcare plan from the patient file to SARA. In this way, SARA knows that one patient prefers to hear stories and another patient needs musical stimulation. Healthcare professionals can add activities to this.”
According to Bright Cape, SARA can be set up differently for each residential care centre. “SARA can also ask a patient how things are going and give feedback to healthcare professionals. They can then act immediately if SARA receives a signal that someone is experiencing more pain than usual.”
SARA focuses primarily on the Dutch healthcare market. There are plans for English, German and Finnish SARA sisters. The focus of SARA is now mainly on care for the elderly. This could be extended to hospital care in the future. For the time being, the development focuses on perfecting SARA, says the project leader. “We want to improve the interaction and we want to investigate whether and how we can make SARA move independently.”
We all get the hiccups from time to time. Nevertheless, it is mainly babies who get the hiccups after they have drunk something. Parents try everything they can to stop the hiccups. If you enter the search term “hiccup babies” into Google, you’ll get almost 700,000 suggestions on what you can do about it. According to the latest insights, the best thing to do is to simply let the hiccups take their course. It would appear that this phenomenon has an important influence on the development of a newborn’s brain.
Hiccups are especially common in premature babies
A study at University College London (UCL) found that hiccups caused a surge of brain activity which help the baby learn to regulate its breathing. The scientists’ theory is supported by the fact that hiccups start in babies after just 9 weeks in the womb. This makes it one of the earliest patterns of activity in the unborn child. On top of that, premature babies are especially sensitive to hiccups, with a daily duration of about 15 minutes.
“The reasons behind our hiccups are not entirely clear. But it could be down to a a developmental reason as to why fetuses and newborns hiccup so often,” says Kimberley Whitehead, the main author of the study and a researcher at the Research Department of Neuroscience, Physiology and Pharmacology (NPP) at UCL.
During their study, the scientists recorded the brain activity of 13 newborns who had hiccups. Brain activity was recorded using EEG (electroencephalogram) electrodes on their scalps. Motion sensors on the babies’ bodies recorded when they swallowed. The premature babies were all born between the 30th and 42nd week of pregnancy. This may be a reflection of what usually happens in the last trimester of pregnancy.
Babies learn to control their breathing
The researchers found that the contractions of the diaphragm muscle caused by the hiccup caused a pronounced reaction in the cerebral cortex – as in two powerful brainwaves followed by a third. Since the third brain current is similar to that of a sound, the researchers believe that the brain of a newborn may be able to combine the “hiccup sound” of the hiccup with contraction of a muscle in the diaphragm. Researchers believe that this “postnatal processing of multisensory inputs” is important for the development of brain connections.
“The activity induced by a hiccup can help the baby’s brain to learn how to control its respiratory muscles. As a result, breathing can ultimately be controlled at random by moving the diaphragm up and down, says Dr. Lorenzo Fabrizi, the principal author of the study. “At birth, the circuits that process physical sensations are not yet fully developed. So building these kinds of networks is a crucial stage for the development of newborn babies.
The question remains as to why we still get the hiccups later on in life. For example, in stressful situations or while eating, or when drinking carbonated drinks. Scientists can only make assumptions about this. “Our results have raised the question as to whether hiccups in adults (which are actually just a nuisance) can indeed be caused by a spastic reflex left over from childhood when it used to have an important function.”
The research project was conducted at the Research Department of Neuroscience, Physiology and Pharmacology (NPP) at UCL and at the Elizabeth Garrett Anderson Maternity Department of University College London Hospitals NHS Foundation Trust (UCLH). It had been funded by the Medical Research Council with support from the National Institute for Health Research UCLH Biomedical Research Centre. The results have been published in the medical journal Science Direct.
Scientists have come one step closer to answering the question of what causes Alzheimer’s disease. Apparently, this involves changes in protein structures in the brain. Researchers at the University of Ulm have succeeded for the first time ever in isolating and studying these protein fibres (beta amyloid fibrils) from the brain tissue of Alzheimer’s patients. Nevertheless, much more research is required.
Nerve cells in the brain and the connections between these cells gradually die off in people suffering from Alzheimer’s disease. Worldwide, nearly 47 million people are affected by this most prevalent form of dementia. The cause of this disease is still a mystery to researchers. Until now, scientists have suspected that protein fibers (so-called neurofibrillary tangles) cause the disease, as the brain is incapable of breaking these down properly. These deposits are invariably found in the brains of Alzheimer’s patients.
The Alzheimer researchers see two proteins, namely tau and beta-amyloid, as being particularly pathogenic (as in organic pathogens). These proteins accumulate in fiber clumps in the brain that have formed from molecular chains known as fibrils. As yet, it has not been clarified as to why the body’s own proteins develop abnormally and subsequently lead to changes in the brain.
Major differences compared to artificial research material
The researchers found that the fibers differ significantly from the synthetically produced fibers used in the study. The individual peptides making up the fibrils differed from those that were artificially produced in a test tube.
Secondly, the structures twist in a completely different way than synthetic fibrils do. “This is a fundamentally different characteristic that we did not expect,” says Professor Marcus Fändrich, head of the Institute of Protein Biochemistry at the University of Ulm. During their study, the researchers examined tissue samples from three patients. They found the same structures in all three patients.
Scientists from Ulm, Tübingen, Halle an der Saale and San Diego did more than four years of intensive scientific research before they were able to arrive at this conclusion. The main challenge was removing the beta-amyloid fibrils from tissue samples and purifying them in several steps. What’s more, the fibrils under the cryo-electron microscope revealed many distinct subtypes, which made analysis even more difficult.
An ever-increasing proportion of bacteria are becoming resistant to antibiotics. Overuse or misuse of antibiotics causes bacteria to become immune to them. This is the reason why antibiotics no longer work effectively against infections in human beings. A faster method for identifying which bacteria a patient is suffering from will lower the risk of antimicrobial resistance. The iGEM student team at the Eindhoven University of Technology (TU/e), has designed a system that can do this. The team was ranked in the top three during the iGEM competition in Boston, America.
iGEM stands for international Genetically Engineered Machine, in a nutshell, everything that has to do with synthetic biology. This year, 377 teams from all over the world will take part in the competition. They have all been doing research on solutions to social problems from a biology angle. The Eindhoven team has focused on how we can lower the risk of antimicrobial resistance. A growing problem which currently there isn’t a solution for. “Developing a new antibiotic takes a lot of time, often decades. We don’t have that much time. That is why we have devised a detection system,” Yvonne van Mil explains.
“The competition is very broad, so it’s very difficult to compare projects with each other,” she says. That’s why there are different categories within the competition. The Eindhoven team participated in the diagnostics category. Within this category, iGEM was one of the top three in terms of components: best poster, best measurement, best base part, best composite part and best diagnostic project.
In addition to the different themes, there are also different levels. For example, there is a separate category for secondary school students. Then there are two categories for students from the university. These are divided by age, above and below 23 years. In the end, one team becomes the overall winner.
Unfortunately, the Eindhoven team missed out on this title. They did win a gold medal. “This is rewarded when a team fulfils all the requirements of the competition, varying from the registration of the team to the creation of a model of the project.”
With their system, the students want to focus on a faster diagnosis. It takes two to three days at the moment to diagnose what kind of an infection a patient has. “During this time, a patient is often given several antibiotics before it is actually determined which one will best help,” says Van Mil. “During those two or three days, someone could become resistant to those other antibiotics that they have been given which they never needed in the first place.” After several years, people run the risk that not a single antibiotic might work anymore.
That’s why the students have developed a detection system that can diagnose someone’s infection within a few hours. “This means that doctors are able to prescribe the proper antibiotics immediately,” says the student. The system works with bacteriophages. “These are a kind of a virus for bacteria which have a high specificity. These phages bind to a specific bacterium and inject their DNA into it. The phages rapidly multiply in the bacterium, which eventually destroys the bacterium,” Van Mil explains.
A specially engineered protein then binds to the phage DNA. This sends out a light signal which it uses to determines what type of bacteria a patient is carrying. “This is then measured in a sample taken from the patient, such as their urine,” she says. The system can test the sample for various bacteria in this way.
Determining the dose
At the same time, the students are also studying whether it is possible to use the same system to find out how widespread the infection is. This means that the dosage of the antibiotics can be adjusted accordingly. “Too much or not enough antibiotics do not always produce the intended results.”
Over the past six months, the students have focused primarily on producing the protein that is needed in this process. “The tests that we did have shown that it does work,” says Van Mil. “We have not designed a device for the system as yet. The university will continue studying this in the coming months.” Such a device has to be thoroughly tested before it can be approved for use in hospitals. “That’s going to take a few years.”
Would you like to know more about this technology? Check out iGEM’s extensive website here.
Improper use of antibiotics
The problem of antimicrobial resistance is less acute in the Netherlands than in countries such as Greece or America. “In the Netherlands, you have to see a doctor first before you get antibiotics to take home with you. In some other countries, you can just buy them at a chemist”, explains Van Mil. “People often use antibiotics when they don’t need them at all. This is how the bacteria become resistant much faster.”
University to take over the research
After the competition, the iGEM technology will be developed further at TU/e. “A professor has told us that he is interested in our technology,” says Van Mil. “One of our team members is probably going to take it on as a graduation project. We really like the fact that our idea has so much potential that the university wants to continue working on it.”
Polish start-up Genomtec is trying to introduce a compact and practical device to general practitioners (GPs). This will enable them to analyze samples on-the-spot. As well as help treat symptoms straightaway and stop a disease from spreading further.
The diagnosis requires no more than a reduced sample volume of biological material. Moreover, the examination does not need any samples to be prepared beforehand. Once the sample is placed on the test card, the device will automatically test the material and provide the results. These can then be sent directly to the patient’s medical records or to an email address.
This process is based on the amplification and detection of specific DNA and RNA fragments, i.e. standard procedure for molecular diagnostics. However, not just GPs will get to use it. Because research involving Genomtec’s technology is able to be carried out on both on humans and animals. Plus in the fields of agriculture, the food industry and environmental contamination control. This technology is easy to use so that family doctors, pediatricians, oncologists, veterinarians, scientists, and also regular consumers will be able to operate it. Nonetheless, the technology is still undergoing further development. Although it already has a number of implementation options in many areas of medicine,. These include liquid biopsy, immunological and biochemical tests.
Innovation Origins talked with Genomtec’s CEO and co-founder Miron Tokarski, here is what he had to say:
What can you tell me about your technology?
As you know, there are several competitors on the market. Though almost all currently use the old-fashioned qPCR technology. This is very energy-inefficient and also needs plenty of effective cooling in order to be able to provide the results as soon as possible. So, from day one, we decided that we need to move from the qPCR technology to a more novel technology. As in an isothermal technology. This has a lower energy consumption, which means that the device can be made smaller in structure.
Consequently, that was when we first realized that we needed to move from qPCR to isothermal technology. Then our co-founder Henryk sent us a very good idea for heating the system and measuring the temperature. This is important as these technologies require that all samples are all treated in a certain way. Subsequently, he found that it might be interesting to use optical heating. It means that we are using very powerful LEDs. These heat the test cards so that they are at the right temperature without the use of any other heating systems or sensors, or without any other active elements besides the test cards. The heating elements and the control temperature elements are built into the hardware of the control device. That way, we are able to heat the sample and measure the temperature at the same time. This ensures the temperature level will not experience any interference. This was quite interesting, because energy consumption is kept to a minimum so we can maintain the exact same temperature level more efficiently.
At that time, we also started work on acids which makes it possible to detect virilization patterns. We are still focusing on developing an acid which has a very low risk of detection and that can aid diagnosis as fast as possible. We are now able to get the results within seven minutes after the process has started.
And, who can use the Genomtec technology?
In general, this is intended for general practitioners (GPs). There is a high number of antibiotics being prescribed around the world. This is being done outside of hospitals and GPs sometimes don’t have enough experience or the necessary equipment. Therefore, this is a quite affordable device that we want GPs to have. They are then able to start with the correct treatment straight after the first visit. This means that the disease won’t advance any further and in many cases the patients will no longer need to go to hospital.
What has been the biggest obstacle during the creation of the start-up?
From my perspective this has to do with microbiology. The quality of the acid is very important because you need to have results that are constant. And also, we’ve stated that if you want to use equipment on site, you cannot use refrigerators to store the test cards. That means that you need to build equipment that is compatible for applications at room temperature. So, taking all those factors into account, building a state-of-the-art technology that will not affect the sample. However, it must be fast and specific enough at the same time. This has been our biggest challenge from the start. Back then, we thought this was our ultimate goal. But, of course, there were some tough moments when it came to developing this. Because at first, the acids were not acting in the way we wanted. It took over a year to finally develop the first acid that was extremely effective.
And the most rewarding moment?
This was right at the start when we eventually found a way to develop this acid. As we are taking a different approach from other people, this is particularly interesting. But, another very good time was at the beginning of this year when we received the Fast Track to Innovation grant. It is partially funded by the EU and the Polish government, it’s a grant of $2.5 million (€2.2 million). This is quite substantial for technological development. It was an endorsement that the experts saw potential for a real breakthrough solution.
What can we expect from Genomtec in the future?
Now we are moving into this production phase for the test cards. In the next few months we will finalize the so-called beta system, and of course then enter the clinical trial phase. Over 500 patient samples will be tested so that means we will be able to verify our parameters. This is what will happen over the next 12 months. And this falls in line with our idea of bringing the device onto the European market in 2021.
The worst thing a person with osteoarthritis can do to their joints is place too heavy a load on them. Excessive joint load often results in too much strain on the joints and weeks of pain. On the other hand, however, completely relieving those joints is not helpful either. That’s according to sports orthopedist Stefan Sell from the KIT Institute for Sport and Sports Sciences (IfSS) in Karlsruhe, Germany:
“When it comes to the prevention and treatment of osteoarthritis, weight and nutrition are just as important as the right amount of exercise.”
In other words, it’s best if the patient exercises intensively for a certain amount of time every day while at the same time avoiding too much strain. Like taking a brisk walk for several hours.
Training algorithms based on motion data
But how can you accurately assess all of this? Finding the right way to do this isn’t easy. Not too many people are able to interpret their body’s signals correctly without professional support. Perhaps a well-trained athlete might be able to do that.
All the more reason for a consortium of sports scientists, doctors, computer scientists and industrial partners to work on a cure for damaged knees. Together they have devised a prototype for a high-tech knee brace. It is equipped with sensors that use self-learning algorithms which are able to measure the load on the knee.
The consortium worked for a total of three years on the intelligent “Anthrokinemat” knee brace. This brace will help osteoarthritis patients in future to properly regulate their day to day physical activity. The model is equipped with numerous sensors that collect all relevant data concerning the load on the joint. Even before an osteoarthritis patient exceeds the maximum load level, they will receive alerts on their mobile phone. The aim is to make the patient aware that excessive strain can result in further damage.
Artificial neural networks calculate the joint load level
Professor Thorsten Stein, head of the BioMotion Center, states that the biggest challenge was to find a viable algorithm for quantifying the load on the knee.
“The sensors can only measure motion, not the load itself. However, in the case of osteoarthritis, joints should not be exposed to too much of a load. That’s why we need to be able to assess the forces in the knee as accurately as possible,”, Stein states.
Machine learning algorithms (as in artificial neural networks) are used to solve this problem. This involves training an algorithm with motion data. Over the course of the training process, the algorithm automatically learns to estimate the forces in the knee that are associated with motion.
“Osteoarthritis is a very common disease,” Stefan Sell explains.
According to official statistics, around 35 million people in Germany have radiographic signs of osteoarthritis. About ten million of these people are obviously ill. As joint wear and tear increases with age, one in four German citizens over the age of 50 and about 80% of over-75s will suffer from osteoarthritis. The spine is the most affected area, but osteoarthritis of the knee and hip joints is also widespread.
Joint project between Unis, BMWi and the company
In the past three years, sports scientists at the Karlsruhe Institute of Technology (KIT) have laid the foundations for the design of the smart brace. They have received funding for their work from the Federal Ministry of Economy and Energy (BMWi). The project partners are the University of Bremen, the manufacturer of amongst other things Bauerfeind orthopedic aids, and the sensor technology company ITP. A prototype is currently under development in another research project.
The Sell and Stein work groups have recently published some of these research results in the Sensors trade journal.
”Your sneak preview of the future” is the slogan of Innovation Origins, and that’s just what we will highlight with our Start-up of the Week column. Over the past few days, five start-ups of the day have been featured and on Saturday we will choose the week’s winner.
We shall consider various issues such as sustainability, developmental phase, practical application, simplicity, originality and to what extent they are in line with the Sustainable Development Goals of UNESCO. They will all pass by here and at the end of the week, the Start-Up of the Week will be announced. Moreover, our weekly winners may be awarded another prize. Because at the end of each calendar month, our readers, together with the editors of IO, will select the Start-up of the Month!
Magnotherm – Cool refrigeration magnets
We mainly know fridge magnets as a decorative item on the doors of our dull white goods. Although they often add a personal, feel-good touch and can be practical for shopping lists, they remain primarily a cosmetic feature of a refrigerator. Up until now that is. Did you know that magnets actually can play a prominent role in a refrigerator? And not just any role but the absolute leading role, in any case if it is up to Magnotherm. This German start-up addresses refrigeration in an entirely novel way.
And it is not just limited to refrigerators. Air conditioning and freezers can use this method to carry out their cooling function as well. This is a lot more environmentally sustainable than the gases that are still currently in use. Those gases are flammable and make a significant contribution to our ecological footprint. In fact, those greenhouse gases are more potent than carbondioxide.
How does it work? Think of it as a kind of microwave, except precisely the other way around. Bonus points by the way for the founding father who goes by the name of Max Fries! His name will no doubt delight English-speakers when they hear what kind of work he does.
DAC – Cooled air
Now that winter is approaching, cooling is apparently totally cool. Because this second start-up also has something to do with this branch of industry. Now, however, they are not magnetic coolants, but cool air cooled by … air. The Ukrainian team behind DAC was greeted with furrowed brows when they asserted that they could pull off this neat trick. It was said to be a Harry Potter magic spell that would only work in fiction. Yet nothing could be further from the truth. Collaboration was sought with the Czech Pavel Panasjuk and now they want their idea to become a reality. Because why would you use any polluting gases, when you can also use air to cool things?
The entire cooling process avoids the use of any greenhouse or toxic gas. The air is cooled by itself with a kind of kinetic reaction of the gases that can be found all around us. And this works better than you might think. These cool ‘wizards’ are able to lower the temperature of their immediate surroundings by 60 degrees within one minute. At the moment they are looking for investors who have no faith in hot air or castles of air, but who do have ears for a cool castle built on concrete ideas.
Neuron Soundwave – An ear for equipment
“Appreciate it, fix it!” – that’s the slogan of the most recent public campaign in the Netherlands. Why? People throw away far too much stuff that might just as well be repaired. Great excuse to buy a new one, right? Still, repairing something is not just easier on the wallet, but it’s a sustainable option as well. Equipment breaking down nonetheless never happens at a convenient time. Frequently you don’t find out that there’s something faulty until it stops working. If only there was one system that could tell you exactly when something is about to break down. After all, prevention is better than cure. Neuron Soundwave was created for this very reason. This Czech system ‘hears’ when a part of a nearby device is about to fail.
Mechanical parts that are almost worn out have a different sound signature than brand new parts. As a rule, a human ear cannot really distinguish that. But it is now child’s play thanks to the self-learning system from Neuron Soundwave. It’s very simple. You put the Neuron Soundwave receiver in a room, and it provides an ear that listens to the devices that surround it. When the receiver recognizes an anomaly, it alerts the user via an e-mail or a text message. A device rarely breaks down on its own accord, often it’s the result of an earlier process. This astute listener is connected to the futuristic Internet or Things so that no one else need be involved in the intercommunication. Moreover, it is capable of being self-taught as it shares the data with all the other Soundwaves. These are are all underpinned by an algorithm that is increasingly becoming capable of recognizing malfunctions of various equipment.
Eyesynth – I hear, I hear what you don’t see
Actually it’s quite strange that we know more about distant galaxies than about our own grey matter. Thankfully, in recent years innovation has made it possible for us to find out more and more about the workings of certain processes. These can be foreseen. An example of this is Eyesynth, which gives blind people the opportunity to see with 3d glasses by listening. Hearing the appearance of objects? No, this is not a hallucinogenic drug but rather futuristic technology. In the human brain, senses are constantly working together in order to perceive something. For the Spanish start-up Eyesynth, the principle that they focus on is called synesthesia. This means ‘crossed senses’ and causes sensory perceptions to flow through each other. This allows us, for example, to smell certain colors or visualize music. Okay, maybe it is a bit like hallucinogenic drugs …
Babies are 100% synesthete. As a person gets older, this trait disappears in most people. About 14 percent of the adults have a (light) form of synesthesia. These are often quite creative people. Eyesynth’s 3D glasses mimic this effect. Some very encouraging preliminary tests show that it seems to be a godsend for the blind and visually impaired. The data from their surroundings are converted into sound by this technology, creating a geometric ‘shape’ in the brain. The wearer then associates this sound with a specific object. Does it work? Absolutely! Even very small details can become visible. For example, even those who have never seen daylight are able to transform into veritable visual thinkers. Sounds a bit like a superpower, don’t you think?
Vitibot – the winegrower on wheels
The start-up VitiBot is perhaps the biggest nightmare for hedonistic travelers who want to do vacation work in a southern European vineyard. Whereas automation in agriculture has been rapidly spreading over the past few decades, winegrowers still rely on manual labor and fossil fuels to keep things ticking over. Surveying grapes, harvesting them and then stamping them into a pulp has been done by people for centuries and requires many helping hands. Where does this start-up happen to come from? No, for once we won’t pull the wool over your eyes. As it happens, Vinibot simply comes from France.
Vitibot designed a smart autonomous winegrower with the very congenial name of Bakus. It works completely autonomously, can be used 24 hours a day and is very energy efficient thanks to its electric motor. Bakus has already undergone a considerably lengthy developmental process and does exactly what a human winegrower with a lot of experience can do. Will there come a time when robots do all the dirty work on the vineyard while people just relax and enjoy the wine? This might just happen!
An entire fleet of these kinds of mechanical Ilya Gort’s will have to be built in the coming years. And the first signs of this perhaps happening are quite auspicious for these French guys. They have already secured their first substantial financial investment this year. In the coming period, a further investment of millions is called for from European funds and venture capitalists. The aim is to have the product on the market within two years and in this way help move wine production into the 21st century. No doubt the traditional images of harvesting, stamping and subsequent wine tasting will go down in history. But is that such a dreadful thing? The pleasure of wine is usually not really in the drawn-out production process, but rather in the final product. Speaking of finished products, Vitibot is almost ready for the market. Is this the new chapter for grape cultivation? Only the future can tell us that. In any case, they have our confidence with our Start-up of the Week incentive prize. Santé!
Technological advancements have created new opportunities for enhancing the quality of life for people with various disabilities. The Spanish start-up Eyesynth wants to improve day-to-day life for the blind.
The start-up has designed a pair of glasses which work as an audiovisual system for the visually impaired. The device is connected to a microcomputer and it records the surrounding environment in three dimensions. This is translated into intelligible audio that is then sent to the person wearing the glasses. Consequently, they work kind of like a pair of glasses that read the room, as it were.
The technology involved was developed and designed by the start-up itself. The glasses have three core features. They work in full 3D, which means that they allow the user to identify shapes and spaces. But also the ability to sense depth and locate objects accurately. Moreover, there are no words involved during this process – the sound is completely abstract. It is a new language that the brain is able to assimilate, and it is very easy to learn. Lastly, the sound is transmitted through the bones of the head. This frees up their ears for their regular range of hearing. This ensures that any subsequent listening fatigue is avoided.
Because the brain is capable of assimilating this information process fairly quickly, the blind person can soon wear the glasses and is able to focus on conversations or any other activities.
Innovation Origins talked with CEO Antonio Quesada, here is what he had to say:
What was the motivation behind Eyesynth?
The start-up stemmed from two distinct routes: one ideological, and the other came from a technical challenge. The ideological route is simple. How is it possible that despite the enormous range of technologies available today, there is still no technological standard beyond the guide dog and the cane? We are firm believers in the “humanist technology.” This refers to technology which concerns the day-to-day problems that people face. That makes us all want to go the extra mile. Regarding the technical challenge, there was one key question: How can we provide spatial information to a blind person in a way that is both easy to understand and instantaneous? We are passionate about challenges, and it was while seeking a solution to both these questions that we founded Eyesynth.
Can you tell me about the technology, how does it work?
The fundamental design premise was that we had to create a system which felt very natural in use. That’s why we had to rely on existing mechanisms that are available in nature. The technical principle which we base it on, is that of “synesthesia”, which means “crossed senses”. When we are born, absolutely everyone is 100% synesthetic. This means that we can smell sounds, taste colors, hear images and all kinds of mishmashes of senses. For practical reasons, the developing brain disconnects certain combinations and only keeps those that are most useful within our environment. The curious fact is that up to 14% of the population has some kind of light synesthesia. Often people who have it don’t realize it, as they assume it is a natural process. In my case, I am slightly synesthetic when it comes to music and images. For me, every sound has a concrete shape in my imagination. Ever since I was a child, I am able to remember complex sequences of music thanks to the shapes that they form in my mind. The “Eureka! moment” came when I asked myself the following question: what would happen if I were to reverse this process? I mean, if I extract real geometric data from the environment and turn it into sound – could a person instinctively interpret that? The immediate answer is yes. We did an initial version of the image-to-speech algorithm and tested it with a friend’s nine-year old son who was born blind. The results were amazing. Then we tested it amongst groups of blind people, and the results were equally as good. That’s when we knew we were onto something important.
So, the Eyesynth’s original motivation was to create smart glasses for this child. But we soon realized that there was clearly a social need for this type of technology. We went on to form our own company with the aim of reaching as many people as possible. We are responsible for the development of both the software and hardware for our technology.
What has been the importance of Eyesynth?
Our goal is to expand blind people’s mobility and independence. This project has provided us with the opportunity to meet a lot of wonderful people with exceptional qualities. We want our technology to serve as a stimulus for showing the value of these people to the rest of the world. In neighboring countries, being blind is not an impediment to leading a full life. Whereas in other countries, unfortunately, being blind automatically excludes you from society. In these cases, we are convinced that people are cast aside, even though they have wonderful qualities that could contribute a lot to their society. That’s why we want to be the instrument that helps people reach their potential.
How is a blind person’s quality of life enhanced with Eyesynth?
From the start, our main goal has been to focus on the issue of navigating and recognizing the environment. We have succeeded in designing a system that does not use words, but a sound signature similar to the sounds of ocean waves that “changes its shape” according to what the glasses’ cameras record. As no actual words are used, there is no language barrier. Which means it can be used in any country. The system offers analysis of an amplitude radius of 120° up to a distance of 6 meters, updating data 60 times per second. This means a lot of information is available in real time. It is very important to note that we cover areas that a cane or guide dog cannot cover. As in obstacles up in the air as opposed to those on the ground, e.g., awnings, traffic signs or tree branches.
Having developed the navigation system, we now plan to expand the system with software functions such as facial recognition, text recognition and a lot of other new features that we will roll out over time.
What makes EyeSynth different from other similar startups?
Our technology is radically different from other offers on the market. We don’t base our recognition system on spoken language but take advantage of the power of the user’s brain to interpret the environment. It’s a real-time system, so response is immediate. On the other hand, the acoustic system we use is cochlear. We transmit the sound through the skull directly to the cochlear nerve. With this, we avoid having to cover the ears with headphones or earbuds. Plus, we eliminate auditory stress during lengthy listening sessions.
What has been the biggest obstacle that EyeSynth has had to overcome?
The image-to-speech algorithm is tremendously complex, and a massive quantity of data is required in order to be able to process it. This invariably leads to a huge amount of energy and computational power being used. That’s why we had to develop our own hardware capable of doing these high speed calculations while using a low level of energy. The challenges regarding both the software and hardware have been very intense.
Did you ever consider giving up?
In very complex projects with small teams, the ups and downs are more noticeable than in large companies. We have had to devise many solutions – in the areas of mathematics, machine vision, computer architecture, or ergonomics. And of course, how to finance all of this. We have become accustomed to finding ourselves in front of seemingly insurmountable walls. But with time, focus and hard work, we have seen that these walls can be torn down. There have been really tough times. Yet the team’s perseverance and the passion we have put into our work have helped us get to where we are today.
What has been the most rewarding moment?
Working on a project like this provides us with plenty of wonderful rewarding moments. Each week, we have a day allocated to visitors who want to test our prototypes. It is amazing to welcome people from other continents who come over just to spend a couple of hours with us and test the technology. Their personal stories, their resilience, but above all, the moment when we see that our technology works for them, well that all feels incredibly amazing to us.
We are currently busy with the manufacturing process as well as arranging distribution channels. We can’t wait for our glasses to reach the streets. We are eager to hear from the blind community to tell us what new features they would like for their glasses. They will then be able to do this through our internet forums.
Eventually, we want to become the technological mobility standard for blind people. We want to create a solid community that shares their experiences and helps us craft technologies and products that really does make their lives easier.
Can you tell me a bit about the feedback you’ve gotten?
The response we have received so far from people who have tried our smart glasses has been fantastic. We are amazed at the human being’s ability to adapt to our technology. Users acquire a level of performance and accuracy that never ceases to amaze us. This is largely one of the reasons why we are moving forward in our mission to bring this technology to as many people as possible
Artificial intelligence is taking on more and more tasks in our modern world. For example, we use it every day when we use online search engines. Translation programs are unimaginable without AI, as are speech recognition, face recognition, computer games and, in the future, autonomous driving. In medicine, AI is also becoming more widespread and has already found its way into the operating theater. Just a few days ago, Innovation Origins wrote about operating with live 3D image navigation inside the body.
The Karlsruhe Institute of Technology (KIT) has now gone one step further and has even been awarded the NEO 2019 Innovation Prize (worth €20,000) by the Karlsruhe TechnologyRegion for their ‘HoloMed’ system. The new system assists surgeons in the operating room via Artificial Intelligence (AI) and Augmented Reality (AR). It does this by creating a model from computer tomographic images of the patient. These reveal the hidden structures deep inside the body.
GPS for the brain
HoloMed’s main focus is on cranial punctures. This is a procedure whereby accumulated fluid is removed from the brain in order to reduce pressure. Frequently used for e.g. brain hemorrhages, craniocerebral trauma and strokes. In order to determine the optimal point of insertion and alignment for the puncture, the surgeon must measure and glean data from “various anatomical landmarks” from computer tomography (CT) and/or magnetic resonance imaging (MRI) scans.
“The difficulty lies in the fact that determining the angle of insertion only allows for a very small margin of error and the doctor isn’t able to see the target straightaway,” notes Professor Björn Hein. He oversees the project together with Professor Franziska Mathis-Ullrich at KIT. Determining this exact point is complicated as these images are only two-dimensional and the human head is three-dimensional. That’s why only about 60 percent of all free-hand incisions are able to pinpoint the best position.
Surgeons use HoloMed augmented reality glasses to assist them in determining this optimal insertion point and angle for the puncture needle. An AI developed at the AI by science staff member Christian Kunz uses the data from the patient’s digital file and their latest CT and/or MRI scans for creating a model that accurately depicts the structures deep inside the body that cannot be seen externally. This information is superimposed onto the surgeon’s AR glasses and shows the surgeon precisely where and how to guide the needle, much like a navigation system.
Easy to use and cost-efficient
Professor Hein states that machine learning methods are used in the automated generation of this information. “First of all, a segmented 3D model of the head is generated, which is used to determine the target position. However, the doctor is always able to make their own adjustments if appropriate,” Hein adds. The aim of the system is to provide an “innovative, novel and cost-effective solution that has a direct influence on the quality of these procedures”.
After its puncture method is successfully rolled out, HoloMed will also be used for other operations in the future. Since the system is, firstly, easy to use, and secondly, cost-efficient, the inventors say it is ideal for lowering healthcare costs. Plus it would also benefit poorly financed hospitals in emerging countries.
Cover photo: Dr. Michal Hlavac from the University Clinic for Neurosurgery Ulm and Christian Kunz from the “Health Robotics and Automation” (HERA) KIT team evaluating the HoloMed system during the initial surgery simulation with a dummy. (Photo: KIT-HERA).
Multi-resistant germs evoke the specter of terror for people who have to go to the hospital. According to information from the German Federal Ministry of Health, 400,000 to 600,000 people in Germany contract infections every year that they have caught during in-patient treatment. As a result, between 10,000 and 15,000 people die in Germany and more than 30,000 throughout Europe.
The problem is that many bacterial pathogens are now immune to several classes of antibiotics. According to the World Health Organization (WHO), “Gram-negative bacteria with resistance to carbapenem and cephalosporin antibiotics” pose a growing threat because they can cause serious infections such as pneumonia or meningitis, wound infections or blood poisoning. The reserve antibiotic colistin is often no longer effective against these often life-threatening infections.
New mechanism of action
In the fight against these pathogens, researchers led by Anatol Luther of the pharmaceutical company Polyphor AG in Allschwil and Matthias Urfer of the University of Zurich have now developed a new class of antibiotics that can apparently also neutralize dangerous Gram-negative pathogens such as Escherichia coli, Klebsiella or Pseudomonas. The antibiotics interact with proteins of the outer membrane of Gram-negative bacteria,” said Urfer’s colleague John Robinson. “According to our results, they bind to fat-like membrane components, the so-called lipopolysaccharides, on the one hand, and to the BamA membrane protein on the other.
Just a few days ago, another scandal involving cruelty to animals in a Hamburg test laboratory hit the headlines. Not just animal welfare activists and animal lovers were shocked by images of dogs bleeding in cages and monkeys mounted on metal frames. Unfortunately the laboratory in Hamburg is by no means an isolated case. Tortuous animal experiments are still the order of the day in the cosmetics industry and in medicine in particular.
In order to gain approval, medicines and other active compounds are often first tested on animals. This is to check for any potential side effects and tolerance levels. In the past, these animal experiments have sometimes been replaced with synthesized cell cultures. These are only two-dimensional and differ considerably from human cell clusters and organs. Scientists led by Dr. Peggy Stock at the University of Leipzig have developed a system for 3D cell cultures which could replace a large amount of animal experiments. This research is being carried out in cooperation with industry partner KET Kunststoff-und Elasttechnik GmbH.
You can find more of our articles on the subject of animal testing here.
Silicone strands from a 3D printer
In 3D silicone plotting, silicone strands produced by a 3D printer form a grid with an organ-like structure. According to Stock, this has demonstrated that “the properties of 3D cell culture system are much easier to transfer to a human organism.” In the project ‘Conception of a 3D silicone structure for the culture of mammalian cells,’ the scientists are working with a type of silicone that is “very elastic and roughly corresponds to what is found in organs in the human body.”
After Stock and her colleagues had discovered a silicone that is well-suited to the replication of cell structures and 3D printing. They transplanted human stem cells from fat tissue into the silicone grid. These cells were then cultivated in an incubator. This was to find out whether the 3D cell cultures offered advantages over 2D cell cultures that were previously used. By arranging stem cells on the 3D grid, they could make these cells behave like cells in the human body.
Clear advantages over 2D cultures
Stock asserts that the cells ability to colonize a 3D grid and form three-dimensional cell structures has been proven. The cells’ innate properties, such as the ability to communicate with each other, are thereby effectively maintained. In addition, liver cells produced from stem cells in the 3D grid function significantly better than cells in the 2D culture.
The scientists state that the new silicone grid has provided the means for “accurately assessing the potential for new developments in medicine and pharmaceuticals.” In spite of this, animal experiments will still be necessary in the future. Albeit not to the same extent as they have been in the past. According to the project’s funding guidelines, plans are that the 3D grid will be used regularly within research by 2025.
A conversation with your running app: “Alexa, can you help me with my training?”
“Yes, I have just received information about your injury. Your heart rate monitor is on, your foot sensor is connected and you have slept well. It looks like you’re fit. You are ambitious and performance-oriented. You have to take your injury into account. I have put together your training. Are you ready to go?”
Is this real or fake? “This example is fake, but it is a reality as well,” says Professor Steven Vos, lecturer ‘Move to be’ at the Fontys University of Applied Sciences. Together with Colette Cuijpers, lecturer in Law and Digital Technology at the Juridische Hogeschool Avans – Fontys, he gave a public lecture on technology in sport: a curse or a blessing? “We don’t answer that question. For me, it’s both a curse and a blessing.”
Vos and Cuijpers discuss the different aspects of technology in sports. Cuijpers: “Sport is actually a separate world. There is layering in who determines the rules, the sports associations have quite a lot of autonomy. The anti-doping law says that there are forbidden methods and forbidden substances. But what really is allowed is determined by the sports associations.”
Using technology to get the best out of yourself is not new. “Tonny de Jong skated on the klapschaats for the first time in 1996″, says Vos, “Gunda Niemann was the fastest at the time and suddenly this girl skated four seconds faster on the five kilometres. World-shattering. Two years later, the whole skating world has this product.”
“The crazy thing is that about ten years later Speedo had developed a fantastic swimsuit”, Vos continues. “It was used for the first time in competition at the beginning of 2009. In one year, 103 world records were broken in swimming. Then came the World Cup in Rome. It had already been decided that the suit would not be used during the Olympic Games. During this World Cup, another 43 world records would be broken. What determines that the klapschaats can and the swimsuit can’t be used?”
Cuijpers: “It’s actually a game: how to get an advantage within the rules to achieve fair sport.” Cuijpers broadens this discussion to include society as a whole. “We are constantly thinking about how we can improve people. How can we restore functions that have broken down or deteriorated? Glasses or hearing aids are fine. But where is the limit if we are going to use technology to make better people? In sport, there are rules to maintain a certain degree of equality. But what would that look like on a more macro level? What does that mean in terms of equality throughout society? How do we qualify someone who, in part, is no longer made up of organic material but of bionic material? In fact, sport is the ultimate vestibule where you can see this happening. The klapschaats is allowed, the swimsuit is not. What will happen next?”
In the example with Alexa, an athlete receives an individual training program that takes into account parameters such as sleep and heart rate and injuries. Vos: “You give each athlete a personal coach, that’s not the most exciting thing. The exciting thing is that you combine medical data with non-medical data. One step further: with artificial intelligence, you can create a learning system that calculates your algorithm from all the data. I think we’re only just exploring the possibilities of artificial intelligence today.”
If this is a threat or a development that we must embrace, Vos wonders. Two years ago, Belgian football club Racing Genk decided to monitor its players 24 hours a day. This was done after disappointing results and decreasing ticket sales. Vos: “A whole debate in the media started immediately. Especially because you don’t know what happens with the data. Players feel threatened. In the battle for profit, every percent counts. The coach thinks: If we want to play better, we have to do everything we can. Does the employer have something more to say about your body if players receive an annual salary of three to five tons per year? Especially if you want to make that body stronger with a gadget?”
PSV Eindhoven thinks of something similar, Cuijpers says. “From a legal point of view, our students have reflected on whether PSV is allowed to optimise the sports performances of the players. The students asked whether there was a privacy-sensitive aspect to this. The answer was: ‘No, it’s all covered in their employment contract. Our players have given permission for this’. How would you feel if an employment contract was presented at work, in which the choice of whether or not to work there depends on the fact that you want to provide insight into your activities 24/7”?
More than half of the attendees raise their hands when Cuijpers asks who would find that going too far. A former lecturer at Fontys responds: “I think there’s still a difference between working at PSV and working for Fontys. At PSV, my physical condition determines how much I contribute. A day of bad sleep doesn’t mean that I teach badly that day.”
Cuijpers: “From a legal point of view, it is entirely up to the context and the data involved. You have to be able to prove that the collection of data is important for your goal as an employer. If it concerns medical data, permission is required. But how free is consent in an employment relationship? More so if consent to the processing of that data is a prerequisite for maintaining your employment contract in the first place?”
“I’m not saying that the law is good or bad. There is a discrepancy between what the law requires and the cases before us. There is a grey area there. Is it covered if the players have given their consent?”
Closer to home, the same situation applies, where permission is clear. “Who has a wearable, for example, a Fitbit?” Cuijpers asks the audience. Hands go up. “Are you aware of with whom you all share data? Who has checked the general terms and conditions to see who will retrieve your data? Are there any of you who have changed the settings?”
In this case, too, most people’s hands go in the air. “Very good. The new legislation obliges the providers of these types of products to offer you freedom of choice by which you decide which functionalities you turn off and that you share data with other commercial parties. Often you give them as bulk permission. It is useful to adjust your sharing options if you do not want all those subsidiary companies to have access to your data.”
Saving state interests versus saving people’s lives
Another story is Strava, an app that connects you to your watch or bike computer and keeps track of your distance, speed and location. You can upload it to a platform and share your cycling or walking performance with others. “Strava can do something that no one else can”, says Vos. “Soldiers on a secret mission run around the camp within the fence, with Strava. This data can be collected and at the beginning of last year, there was a photo showing American and Dutch bases. State secret, but thanks to Strava, visible to the world. A week later, the Dutch ministry of defence organised a workshop to make soldiers aware of the danger of sports apps. That’s all well and good, but why did they never think of it before?”
“Then, at the end of 2018. Steven de Jongh, once a talented sprinter cyclist and now sports director at Trek-Segafredo. He is on tour with his team and is going on a bike ride. There is no sign of life for six hours. His wife, in panic, throws it on Twitter. In Strava there appeared to be a functionality that Strava continues to log without you being active. That man is found again, laying half-unconscious alongside the road – his life could be saved. An app of up to four euros a month that saves a life versus the app that threatens the interests of the state.”
On a busy day, just do a brief breathing exercise to reduce or avoid stress. Industrial Design student at Eindhoven University of Technology (TU/e), Brigitte van der Lugt, has integrated technology into clothing in order to be able to do that. She is presenting her concept at the Drivers of Change exhibition during the Dutch Design Week (DDW).
The technology works on the principle of a magnetic field. Magnets are incorporated into the stitching on a garment. “Stitching is done with two threads. The inside thread is a conductor,” explains Van der Lugt. “An electromagnetic field is created when I let a small amount of current pass through the thread.” AC voltage attracts and repels the magnet. This is how the fabric vibrates. Van der Lugt: ” You can do your breathing exercises by using your hands to follow the pattern of the magnets’ vibrations.”
The tempo of the vibrations is linked to the breathing of a specific user. ” That way you can slow down your breathing, for instance, and then get back to work.” A user can turn the device on when they want to, or schedule a fixed time for the exercise. In the future, it may even be possible to connect the device to sensors that measure when a user’s breathing is too rapid. “Then the exercise could start when people need it most.”
The technology was developed by a professor at the university. It was up to Van der Lugt to come up with an application for it. She deliberately chose to use the technology in clothing. It is subtle and personal. “People around the user don’t immediately realize that someone is wearing this technology,” she explains. “I notice that a lot of people say they want to use this kind of help, but that they don’t want other people to be able to notice it straightaway.”
A variety of applications
In Van der Lugt’s view, the presentation of the concept during Drivers of Change is supposed to make people think about the applications for this technology. And that’s working. “Visitors immediately see a variety of possible uses for themselves.” Yoga practitioners, for example, see it as a good support system for their exercises. Athletes also see opportunities. “There are plenty of uses for it,” Van der Lugt says. “I mainly want to show how technology can take various forms and how it can be used in varying ways.” In the coming months, she wants to test the concept on a large scale in order to map out the various experiences. She wants to explore this further and develop it into a product that could enter the market.
There are several projects on healthcare at the Drivers of Change exhibition. From clothing – to an app that reduces stress – to an artificial uterus. For instance, researchers Suzanne Koch and Matilde Putti present a ‘living’ heart valve. The plastic heart valve takes over the function of the damaged heart valve, just like the existing mechanical variant. But the new plastic is also used to activate the body’s own cells. These cells break down the plastic and replace it with healthy cells. This way, the cardiac valve is able to simply grow along with the body and repair itself.
On top of that, installing the new heart valve is also very easy with this technology. “A special device ensures that open-heart surgeries are no longer necessary. The new heart valve is injected into a heart, as it were. This means that it is no longer necessary to stop the heart during surgery,” says Matilde Putti, a PhD student in the field of chemical technology.
One of the spin-offs of this research is the start-up Xeltis. Read more about that company here.
“We want to show people the advantages of this technology during the exhibition”, she continues. “When people receive a new heart valve now, they often have to take medication for the rest of their lives, such as blood thinners. Some people may even have to undergo more surgery if the mechanical heart valve fails to grow with the body.” Koch agrees: “I think it’s great that we can use this technology to ensure that people with heart problems are able to recover fully. Then they don’t have to remain a patient for the rest of their lives.”
Connecting technology and society
During the Dutch Design Week, student teams, spin-offs, PhD students and other TU/e researchers will present their technology at Strijp-T. Vice President of the University, Nicole Ummelen, opened the exhibition with the words: “It is important to make a connection between technology and social problems.” Students present their solutions to a social problem in their own way. From generating energy with iron powder to 3D printed food and from 5G networks to smart drones as assistants.
Philips in Best, the Netherlands, has completed a test of its new ‘Fiber Optic Real Shape’ (FORS) technology at the academic UMC hospital in Utrecht. So, there is no longer any reason to push a catheter through a vein or blood vessel needlessly (because otherwise it wasn’t possible to see how these wind their way through the body). There is also no need for more exposure to X-rays. Innovation Origins asked radiologist and Image Guided Therapy Chief Medical Officer at Philips, Dr. Atul Gupta, how the technology works. “This is a major breakthrough for medicine. Doctors are going to use this technology for all kinds of treatments.”
You are currently testing a new surgical technique using Philips’ ‘Fiber Optic Real Shape’ technology. Can you explain what that is?
You need X-rays for the conventional way of looking inside a body. In Fiber Optic Real Shape technology, we use a catheter the size of a piece of spaghetti which contains technology [sensors, ed.] that works on the basis of light. The information that this provides is sent straight to our image processing system which is connected to screens in the operating theater. We then see the location of the catheter in the body and the shape of that location [a vein or blood vessel, ed.] on the images, without the need for X-rays. The image that the catheter sends through is three-dimensional. This means that I am able to navigate through your body without the need for an X-ray machine. This offers a significant advantage, as it reduces the exposure of radiation to patients, doctors and nurses. It also gives me a much better picture of the internal body which my device is moving through. That works better than the two-dimensional X-rays that we have been using up until now. You can operate much more precisely with a three-dimensional image.”
As a doctor, will you be able to operate faster using this method than you can with X-ray images?
“We have conducted research into this at the UMC in Utrecht. But in previous demonstrations with catheters in veins during medical conferences, doctors who were using X-rays struggled during surgeries to get through veins that were twisted. That didn’t work out very well because they couldn’t see how the vein was shaped. They applied extra pressure to the catheter even though that didn’t help. When we got those three-dimensional images, we realized that there was no point. Because the vein was winding around, for example. Consequently, it would have been better to steer the catheter upwards rather than forwards. When we saw that, we were able to get through the vein with the catheter thread in under a second. So I definitely think that our technology will shorten operating times.”
How many hospitals are already using this system?
“It’s just a research product, so you can’t buy it yet. The UMC in Utrecht is the only location where this technology has been used for trials.”
Can you only use it to move through blood vessels?
“No. It can pass through blood vessels, but also through veins. But in the future its scope could be expanded. At the moment, we only use it to move a catheter through veins and blood vessels.”
When will the product be available on the market?
“We need to do more research in order to prove that it is safe and effective. Then we have to get approval from the medical equipment regulators like the FDA in the US. We have never set a date for when the product will eventually be offered for sale. But we intend to start clinical trials with it on patients soon. Usually, it doesn’t take long before approval can be granted.”
So far, have the results been as you expected? In other words, were there fewer patients harmed after an operation compared to the existing method used to date?
“The equipment can be used for all kinds of problems. But we have limited ourselves to the treatment of aneurysms in the stomach area. These types of veins twist and twirl quite a bit. We can now treat them by inserting a stent, a kind of tube to repair the aneurysm. This is a complex procedure. We are now looking at how the use of the catheter and the three-dimensional image on the screen enhances this procedure. Is there less need for X-rays? Can we operate faster? Will the operation be safer than blindly attempting to repair the vein over an extended period of time, which may cause complications because you can only use two-dimensional X-ray images? X-ray images do not allow you to look at the vein from all angles, you just have two-dimensional images. With three-dimensional images, you are able to view the veins from all angles. So then you see exactly where they go and where the problem is. You can compare the new method to a TomTom, or a three-dimensional GPS. But then for the inside of the body.”
So the new method works the way you expected to?
Is it an expensive system for hospitals to purchase?
“We don’t know yet. We are still going through the validation process. If we can demonstrate that this technology significantly shortens the operating procedures and that it works well, allowing you to treat more patients, it will be worth the expense. But at the moment it is too early to say anything about the costs. We don’t have that information as yet.”
Who invented it?
“We have discussed this technology with a lot of doctors. It is in fact a product that came into being through co-creation. We asked doctors what this procedure could be used for, such as heart surgery and surgery on veins in legs, veins that contain aneurysms. On the basis of this information, we started to test the treatment procedures for aneurysms. But as soon as doctors get a hold of this equipment for aneurysms, they automatically start thinking about all kinds of other applications. They soon think: hey, this is a great tool. That’s just how it always goes with tools. Why should I use a hammer just to hit a nail in the wall? Once they have a hold of it, they will use it for other procedures.”
Do you think this is a breakthrough development for medicine?
“I think so. For the first time ever, we can operate in an image-guided manner without the use of X-ray images. We are able to use 3-D images for the first time too. We are able to navigate our way through the body this way – another first! This is a major breakthrough for me. In addition, the X-ray images that we are currently using during operations have not been recorded live. With the new three-dimensional technology which uses this catheter, the images are live. You can decide to change your approach during the surgery if you see that what you were planning to do is not going to work.”
Bio-printing has brought new perspectives to cell research. So far, however, other 3D printing methods have fallen short of expectations. A special bio-ink has now been developed at TU Wien (Vienna) that solves the current problems.
The new bio-ink enables:
extremely fast and high-resolution 3D printing;
integration of living cells directly into microstructures during the printing process.
Bio-printing of microstructures provides cell research with models whereby it can be observed how diseases spread via cells and how their behaviour can be controlled. Nevertheless, the challenges for 3D printing are considerable. Not only do the structures have to be tiny, they also need to reflect the natural environments of cells. As it is the mechanical and chemical properties as well as the geometries of the cell environments that influence cell proliferation.
In concrete terms, this means that cell environments must be permeable for nutrients so that the cells can survive and multiply. It is also important whether the structures are rigid or flexible. And whether they are stable or if they degrade over time.
Problems related to bio-printing
Manufacture of microscopic 3D objects is nowadays relatively straightforward. Living cells are embedded in the structure as part of the 3D procedure using bioprinting technology – a special additive 3D printing process. The drawbacks of this technique have on occasion been a lack of precision. As well as a time frame that is very brief for processing living cells. The cells are damaged if the time frame is exceeded.
Precision vs. speed
The biggest technical challenge in bioprinting was at times the low resolution that conventional technologies offered. Lithography-based approaches such as two-photon polymerization (2PP) are able to overcome this limitation.
Researchers at the TU Vienna have many years of practical experience in the application of this method. This is based on a chemical reaction that only becomes active when a molecule of the material simultaneously absorbs two of the laser beam’s photons. This is the case if the laser beam has a particularly high intensity and causes a selective and very specific hardening of the substance. These properties are conducive to high precision manufacture of the finest of structures.
The disadvantages of the two-photon polymerization is the slow printing speed. This ranges at times from micrometers to a few millimeters per second.
According to Professor Aleksandr Ovsianikov, head of the 3D Printing and Biofabrication research group at the Institute of Materials Science and Technology at TU Wien, the slower print speed in bioprinting is the result of certain chemical substances. His team achieved a speed of one meter per second with cell-friendly materials. The process must be completed in a few hours in order for the cells to survive and continue to develop.
This represents a major breakthrough when it comes to embedding living cells for two-photon polymerization, Ovsianikov explains.
“The high level of speed achievable in laser scanning makes it possible to quickly generate structures for statistical analysis during cell culture experiments as well as for large-scale production”. Aleksandr Ovsianikov
Another advantage of this method is that the cell environments can be individually adapted. Depending on the structure, they can be made more rigid or softer. Even delicate, continuous transitions are possible. The laser intensity can also be used to adjust the degradation of the structure relative to time.
The bio-ink is based on a a gelatin norbornene hydrogel, whereby dithiothreitol was used as a thiol cross-linking agent together with a special biocompatible photoinitiator based on diazosulfonate (doi: 10.1039/C8PY00278A).
Compatible with stem cells
The discovery of the cell-friendly bio-ink is not only a technical breakthrough, but also a major contribution to cell research. The microstructures that result from this process provide unprecedented accuracy. New insights can be gained into the spread of diseases throughout the body.
“Furthermore, the material is also compatible with stem cells and has already been tested with obese human stem cells in a laboratory. As with the L929 cells used in the publication*, these cells can be embedded directly into the 3D matrix and printed in accordance with a suitable architecture. This leads to excellent cell viability.” Aleksandr Ovsianikov
Ever since she was very young, Jennifer Wichers had been in training every day to win an Olympic gold medal in judo. She recently had to let go of that dream. She is still busy with judo, albeit more as a metaphor for entrepreneurship. Her company stems from her graduation thesis which won her the 2016 Sport Innovation Prize at the Hanze University of Applied Sciences in Groningen in the Netherlands.
“My life was dominated by judo. I strove every day to improve as a judoka,” Wichers explains. “You are constantly analyzing yourself. What can I do better? Who do I need around me in order to make progress? – Physical therapists, mental coaches, technique trainers, strength trainers? It’s essentially a never-ending puzzle. Which is also quite nice.”
She came very close. At the age of fourteen she won gold at the Youth Olympic Games. This was the basis for her judo career. She competed for a long time on an international level after that. She won numerous European and international medals. But besides all of that, she also suffered a lot of injuries on both her shoulders, her ankle ligaments and an elbow. In 2016, a spiral fracture in her middle finger threw a spanner in the works for the 2020 Games.
She then spotted opportunities in the field of entrepreneurship during her search for a subject that she could connect judo to. Wichers explains that in the past articles had been published on judo economics. Based in part on using judo as a metaphor for how you can actually use the weight of a larger competitor against themselves. As an example, look at how a large organization is less likely to adapt to changes than a smaller one. “Yet there wasn’t really a connection with entrepreneurship at that time.” That’s where she found her new challenge: judo as a metaphor for entrepreneurship.
“I had to diversify into another branch of sport and that’s where I met quite a few challenges. From time to time my thesis supervisor threw me into the deep end. That was great, it cleared the way for me to delve more deeply in different ways.” Wichers managed to get through this and she succeeded in completing her research which she subsequently won a prize for. She also wrote a scientific article about her research which has since been published.
Workshops and corporate training
After graduating, Wichers started her own company – Judo Your Business. She gives workshops and corporate training. “In my courses, I teach you how to apply the practical language of judo and the philosophy behind it to your own work and your organization. This can vary per organization. Someone may have a question about cooperation, another about giving feedback to each other, and somebody else wants to know how you can do more within a team or on the job. As I adopt a different approach, which is theoretically substantiated, it can produce very surprising results.” The other approach I use starts out with the judo suit that you put on and ends up on the tatami (the judo mat). “I don’t know how you are with your colleagues, but in a lot of companies you just don’t get into each other’s comfort zone that easily. We do that here, but we build it up very slowly.”
“In judo, you have, amongst other things, leverage techniques that allow you to make certain moves much more efficiently. Which saves you a lot of effort. The participants can also transfer that to their companies. Because people are going to practice and apply that and see and feel the difference, I get reactions like: ‘Wow, I didn’t expect that.'”
Aniek Ouendag, coordinator of VentureLab North at the University of Groningen, took part in Wichers’ workshop with her team two months ago. Over the past five years, the team has grown from three to fifteen employees. “That is quite a transformation. We wanted something else than just talking to each other during a strategy day. That makes you feel a tad stupid.” Ouendag knows Wichers from the entrepreneurial environment in Groningen and suggested taking a ‘judo workshop’. “You really start thinking differently about your work. You also start talking to each other differently. Because if you’ve done judo with each other, you can talk about it with each other afterwards.”
From judo to management
What Ouendag likes is how Wichers has translated judo into business practice. “The most important thing I’ve learned from this is that by moving with each other, you can get things done. That you don’t always have to compete against someone. That in itself makes sense, but because you actually get to do this in a physical way, I now see it differently.”
Ouendag primarily applies judo techniques in her conversations with entrepreneurs. “Some are mainly specialists when it comes to their products and don’t yet see the point of having an in-depth knowledge of business management. I then tell them that, as experts, they could mislead someone who has no knowledge of their product. But an accountant might do that to them as well. That way I try to get them to understand that they have to deal with more aspects of business management than just product development.”
Wichers is part of a solid tradition. The Japanese Kanō Jigorō brought this new martial art judo to life at the end of the nineteenth century. Kano wanted to introduce more ethics into the sport. He thought winning a match was trivial. According to him, it was only of limited value if you couldn’t apply it in everyday life.