Google to label healthcare facilities that provide abortions in search results

Google to label healthcare facilities that provide abortions in search results
Google to label healthcare facilities that provide abortions in search results

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Google will clearly label healthcare facilities that provide abortions in Search and Maps to reduce confusion among users looking for the procedure.

The change comes months after Congressional Democrats pushed the tech giant to better differentiate between abortion clinics and crisis pregnancy centers, which try to dissuade people from seeking abortions and may not offer accurate medical information

As part of the update, Google will label facilities that are verified to offer abortions with “provides abortions” in results, while other locations will say “might not provide abortions.” 

“When someone in the US searches for health care providers that provide abortions — for example, using the query ‘abortion clinics near me’ — the Local Search results box will display facilities that have been verified to provide abortions,” Mark Isakowitz, Google vice president of government affairs and public policy for the U.S. and Canada, wrote in a response letter to Sen. Mark Warner and Rep. Elissa Slotkin. 

“People will be able to broaden their search to show other relevant listings (including from organizations that do not provide abortions).”

WHY IT MATTERS

It’s not uncommon for patients looking for abortion services to find misleading information when searching online. According to a Bloomberg News investigation published earlier this month, people seeking abortion providers are “routinely” directed to crisis pregnancy centers on Google Maps. 

Research by the Center for Countering Digital Hate earlier this summer found one in 10 Google search results for abortions in states with trigger laws led to crisis pregnancy centers.

Google’s label update comes just days after review site Yelp announced it would flag crisis pregnancy center listings to distinguish them from clinics and healthcare facilities that offer abortions. 

In the wake of the Dobbs decision overturning Roe v. Wade, privacy experts have raised concerns about how personal data could be used to determine if a user sought an abortion in states where the procedure is now illegal.

In July, Google said it would automatically delete location history when users visit sensitive places like abortion clinics. Period tracking apps, which analyses have noted often share data with third parties, rushed to put out statements about privacy after the Supreme Court decision. Flo launched an “anonymous mode” it said would allow people to use the app without personal email, name and technical identifiers.

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New and Noteworthy: What I Read This Week—Edition 191

New and Noteworthy: What I Read This Week—Edition 191
New and Noteworthy: What I Read This Week—Edition 191

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Research of the Week

To avoid diabetes, South Asians should reduce carbohydrates and increase protein.

Uncomfortable knowledge” is important knowledge.

Is coagulation more important than LDL in heart disease?

Playing in microbial-rich soil produces an anti-inflammatory, more diverse microbiome and stronger immune system.

Trigger warnings don’t work.

New Primal Kitchen Podcasts

Primal Kitchen Podcast: The Link Between Dairy Intolerance and Dairy Genes with Alexandre Family Farm Founders Blake and Stephanie

Primal Health Coach Radio: Medicine the Way it Was Intended with Dr. Ken Zweig

Media, Schmedia

Shawn Baker brings the carnivore message to the UK.

Hopefully this forces a better re-usable propane canister system.

Interesting Blog Posts

Aspirin for COVID.

Some are starting to get it.

Social Notes

This is how you age.

What is best in life?

Everything Else

Fear of failure and performance on Master Chef.

The more kin-based the institutions, the less economic development a country has.

After losing their access to bison, the Plains tribes went from some of the tallest in the world to some of the shortest.

Medieval medicine.

Things I’m Up to and Interested In

Interesting paper: Looking beyond cholesterol.

Interesting result: Doppelgängers don’t just look alike. They also act alike.

Interesting article: They’re starting to get it.

Nice post: How non-nutritive sweeteners affect the gut and glucose tolerance.

Fascinating: Chess players play worse remote.

Question I’m Asking

What do you do to satisfy the “creative” side of you?

Recipe Corner

Time Capsule

One year ago (Aug 20 – Aug 26)

Comment of the Week

“Most of the studies on long COVID are looking at narrow slices of our body’s chemical interactions – and that’s far too limiting. I don’t have all the studies in front of me to reference, but there’s a lot of evidence (and many have accepted) that long COVID and mast cell activation syndrome (MCAS) are essentially the same thing. Dr. Tina Peers found that most of her long COVID patients reported symptoms of MCAS before they got COVID, suggesting that a genetic or underlying predisposition to long COVID lies in mast cell dysfunction. Anyone with long COVID also have asthma, hypothyroid, food sensitivities before you had COVID? When you shift your lens to the mast cells you have to acknowledge the complexity of the effect on the body – it’s not just about too much histamine, but a host of other chemicals. When our body is, or thinks it is, under attack, our mast cells activate, and in the process release histamine and, for the purposes of this discussion, cortisol. So, to “fight” the paper cut, infection, bee sting, or cat hair, our body goes into full fight mode – inflammation – and our cortisol levels rise. When things are functioning normally, histamine and cortisol levels drop in time, and we return to equilibrium. However, our bodies have been under attack by all sorts of toxins for decades, or maybe we have a genetic abnormality such as Mannose-binding lectin deficiency or Ehlers Danlos, so our bodies cannot find the equilibrium, and eventually we suffer from adrenal fatigue. I don’t have evidence of this, but I expect that the authors of this article are measuring this adrenal fatigue that is just a symptom of the underlying condition that presents a welcome mat for long COVID. And when COVID – a disease of the mast cells – finds that welcome mat, the sensitivities and inflammation that were already present now kick into high gear, and we’ve got long COVID. How do we treat it? As you would MCAS – with a strict low histamine diet, and analysis that identifies vitamin deficiencies (likely Bs and D, to start). Reduce emotional stress, avoid triggers like heat and exercise, pace yourself, sleep more, and accept that it’s going to take some time. Excellent source of info: https://www.youtube.com/c/RUNDMC1

-Interesting thoughts.

Classic-golden-hawaiian-mango-jalapeno-bbq-sauces

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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New Science May Show Why Sound Can Ease Pain

New Science May Show Why Sound Can Ease Pain
New Science May Show Why Sound Can Ease Pain

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Aug. 26, 2022 – Listen up, everybody: If you’ve ever thought your favorite song made your whole body feel better, new science suggests that wasn’t just your imagination.

In fact, it’s not only music that has an analgesic, or pain-reducing, effect. Many types of sounds or noises can help, researchers have found – if they’re played at the right volume, that is.

Doctors and researchers have long known about a connection between sound and the body. Music therapy has been used for decades to help manage pain after an operation, during labor and after childbirth, and during cancer treatment.

But why this happens isn’t well understood. Some theories suggest the analgesic effects of sound are psychological – that is, they calm, or distract, a person from the pain.

This new research suggests that something deeper is at work. And the paper, published in Science, may shed light on the inner workings of the brain, revealing the circuitry operating behind this pain relief.

Want to Hear More?

Yuanyuan (Kevin) Liu, PhD, is a sensory biology and pain researcher for the National Institute of Dental and Craniofacial Research and a co-author of the study.

“Relative sound intensity might play a role in helping reduce pain,” he says. “Low-intensity sound is able to inactivate the audio-somatosensory pathway and thus the activation of the somatosensory thalamus.” That means a noise played at low volume appears to blunt activity in parts of the brain responsible for signaling pain.

In the study, scientists injected mice with a solution that caused discomfort in their paw. They then put on a variety of sounds at different intensities, ranging from pleasant music to white noise, and watched for any changes in the rodents’ behavior.

What they saw, according to Liu, suggested that the sounds “reduced reflexive paw withdrawal and aversion to painful stimuli – indicators of analgesia for rodents.” In other words, the sounds appeared to help reduce pain in the mice.

The ideal volume for pain relief was just 5 decibels above room noise, the researchers found.

“The 5-decibel low-intensity sound is related to the background sound,” Liu explains. “It is not an absolute but rather a relative value.” So, you’d want to raise the volume just a bit louder than the background noise wherever you are.

And in what might be good news for sludge metal fans, the types of sound played made no difference. Even when noises were adjusted to be “unpleasant,” playing them at the right volume still provided a pain-relieving effect.

It doesn’t matter whether you’re into Mozart or Metallica, according to the findings, at least. Either can work – so long as the tunes are played at the right volume.

The Future of Sound and Pain Management

Liu cautions that when it comes to transcribing the symphony of how body and mind respond to sound, we’re only in the opening measures.

“There’s still a long way to translate these findings in mice to the human context,” he says.

We can’t say for sure that human brains work the same as mouse brains when exposed to sound. But the findings in mice can offer clues about how our brains might operate – and therefore provide us with one piece of the puzzle in understanding how sound influences the perception of pain.

“We hope our study opens up new directions for the field of sound-induced analgesia,” Liu says. But much more research needs to be done for that to happen.

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Like Humans, a Dog’s Odds for Dementia Rises With Age

Like Humans, a Dog’s Odds for Dementia Rises With Age
Like Humans, a Dog’s Odds for Dementia Rises With Age

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Many physical health issues can also cause CCD-like signs, Borns-Weil said. Pain, from conditions like arthritis, is a major one.

“If you think your dog has signs of cognitive dysfunction, take them to the vet and rule out physical causes,” said Borns-Weil, who was not involved in the study.

Although CCD has been on the radar for years, previous studies of it have been small, according to the researchers on the new work, led by Sarah Yarborough of the University of Washington.

For their study, the researchers used data on over 15,000 dogs nationwide who were enrolled in an ongoing research program called the Dog Aging Project. During the first year, owners completed two surveys: one on their dogs’ health and activity habits, and another with questions that screen for CCD.

The group overall was a young one, and just over 1% of dogs were deemed to have CCD. Among animals older than 10, each additional year of life was linked to an increase in the odds of CCD, according to findings published in the journal Scientific Reports.

Beyond age, dogs’ activity levels showed a strong link to CCD: Sedentary dogs were over six times more likely to have the condition than dogs of the same age and breed who were active.

That does not prove that exercise thwarts doggy dementia, both Peters and Borns-Weil said, since CCD itself may change activity levels.

“A dog with cognitive dysfunction may not want to go out for walks anymore because they’re confused,” Borns-Weil explained.

However, Peters noted, research in humans has tied physical activity to better brain function later in life. So the idea that exercise could benefit dogs’ brains is not far-fetched, she said.

Plus, Borns-Weil pointed out, going out to explore or play is a big part of dog’s mental stimulation. Again, in humans, staying mentally active with age has been tied to lower odds of cognitive decline — though, yet again, the cause-effect question remains.

Despite the unknowns, there is no downside to dogs having a healthy lifestyle that includes physical activity and mental stimulation, both experts said.

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Finding Meaning and Joy After Spinal Cord Injury

Finding Meaning and Joy After Spinal Cord Injury
Finding Meaning and Joy After Spinal Cord Injury

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Aug. 26, 2022 – Preethi Srinivasan was an 18-year-old with a bright future in sports and academics. A state-level medalist in swimming, she was also a proficient cricket player and dreamed of representing her native India in cricket.

Her academic achievements were equally stellar, and she was enrolled in a 5-year MBA course in Chennai, India. “My life was perfect, and the possibilities seemed infinite,” she says in an interview.

Srinivasan was on a college trip with friends at the ocean. She was standing in thigh-deep water when the sand under her feet gave way and she stumbled. As a seasoned swimmer, when she realized she was falling, she dived into the water.

“As soon as my face went underwater, I felt a shock-like sensation travel through my body and instantaneously, I could not move anything” Srinivasan recounts. “I tried to stand, but nothing happened.” From that moment, she was paralyzed below the neck.

“My life as I knew it was over, but a whole new life was beginning,” she says. “I just didn’t know yet what form that would take.”

The Serenity to Accept

Annually, there are an estimated 17,730 new spinal cord injuries in the U.S. and 250,000 to 500,000 worldwide. The U.S. Senate has designated September as National Spinal Cord Injury Awareness Month.

People who have a spinal cord injury confront not only practical, medical, and financial challenges, but also the feeling that their lives have been permanently upended, according to Rex Marco, MD, chief medical ambassador for the Christopher & Dana Reeve Foundation. This can lead to a sense of despair and loss of meaning.

Marco himself had a spinal cord injury that paralyzed him when he was in his 50s. He had been a nationally renowned spinal surgeon and musculoskeletal oncologist as well as an active snowboarder, mountain biker, and yoga practitioner.

All of that changed when the tire of his mountain bike stalled in a dip along a trail, catapulting him headfirst over the handlebars. He heard a crack but felt no pain. He knew that if the cracking sound came from his neck, he could be paralyzed.

“I had been doing breathing exercises to find calm for several years. In that moment, I used them to calm myself,” he says.

When a friend touched his leg and hand and he couldn’t feel the touch, he realized he had broken his neck.

As he lay there, he thought of the Serenity Prayer: “Grant me the serenity to accept the things I cannot change.” He asked for the serenity to accept whatever physical limits lay ahead.

“I knew there was less than 5% chance I’d ever walk again. I may never operate again, and I may never hold my unborn child.” Marco also knew he had to get to a hospital as soon as possible, so he helped coordinate his rescue and arrived at the hospital and then the operating room within less than 3 hours, which he describes as “miraculous.”

He considers himself fortunate that he never despaired because he had already been using practices that deepened his sense of meaning and he drew upon them after his accident.

“I knew it was important for me to do my best to live in the present moment and not dwell on the past or worry about the future; just try to smell and taste and listen and feel. I did that throughout the day and tried to be as present as possible.”

‘Why Not Me?’

After her accident, Srinivasan at first did fall into despair. “I didn’t cope well with what had happened and tried to escape this new reality any way that I could,” she says.

She felt an acute sense of loss. “For the first 18 years of my life, I had effortlessly excelled in every area, and the future seemed to be brimming with infinite potential,” she says. “Then, in just a split second, it was all over, and I found myself having to come to terms with life in a wheelchair.”

What was especially painful was how others treated her. “I had been looked up to all my life, seen as a role model and hero, and now suddenly people looked down on me as if I ceased to exist. I couldn’t bear it. I felt invisible and invalidated and tried to shut myself away for 2 years.”

She wondered what she could have done to deserve such a fate. “I was shattered. Who was I? I didn’t know, and I didn’t want to know. I just wanted to die.”

Her parents’ unconditional love and wisdom slowly brought her out and gave her a deeper understanding of life. Srinivasan’s father advised her not to ask, “Why me? Why did this happen to me?” Instead, he advised asking, “Why not me?”

He encouraged Srinivasan to use her injury as an opportunity. “Your body is going,” he told her. “Everyone’s body is going – if not today, then 10 years from today, and if not 10 years, then 50 years. Look within and find that within you which can never be taken away, which can never go.”

It was the beginning of a profound inner journey. Srinivasan began expressing herself through mouth paintings. “Slowly, I started feeling passionate about life again,” she says. “My parents gave me a beautiful spiritual lineage, and through grace, I started healing from within.”

‘There Is a Plan for Me’

Several weeks before the accident, Marco had started a practice of beginning the day with listing three things he’s grateful for, three things he’s excited about, a daily focus, a daily affirmation, and a daily exercise plan. He placed this practice into his new reality.

“I felt grateful for life, grateful for my breath, and grateful for my recovery program,” he says. “I felt excited to see my family, my friends, and my caregivers. My daily affirmation was, ‘I am enough,’ and my daily exercise plan was to get out of bed and into the chair.” At night, when he couldn’t sleep well, the nurses played a guided meditation for him.

“These practices gave me meaning and purpose, and I knew there was and there is a plan for me, although I wasn’t sure what the plan was,” he says.

Ultimately, Marco became involved with the Christopher & Dana Reeve Foundation. “Christopher Reeve was a childhood hero of mine, and I watched him play Superman,” Marco says. “I remember the day he got injured, and I remember his appearance at the Oscars when he was on a ventilator, which was so inspirational to me.”

Marco remembered that speech when he was in the intensive care unit. “I knew I wanted to do something that he did, which was try to find a cure and raise money for spinal cord injury research, which is part of my role in the foundation, as well as increasing mental health awareness, and introducing more people to mindfulness and mindfulness-based meditation.”

Founding Soulfree

When Srinivasan’s father was alive, he “took care of everything,” allowing her and her mother to be in a “bubble of safety, insulated and isolated.” But after his sudden death of cardiac arrest in 2007, there was no source of financial support. Some years later, her mother had cardiac bypass surgery.

“We began to wonder what would happen to me if my mother could no longer take care of me, and we began to look for long-term care facilities in India that were equipped to care for a person in my condition,” Srinivasan says.

She was “shocked” to find out that, throughout all of India, there wasn’t a single long-term care facility where a person with a spinal cord injury (SCI) could live with dignity. “So if the parents or family of a woman in my condition is unable to care for her, there’s nowhere to go,” she says.

She started to hear horrifying stories “Family members of women with SCI often think of a disabled daughter as shameful and refuse to feed or care for her. Two families even provided their daughters with poison and encouraged them to kill themselves.”

The lack of support for people with spinal cord injuries led Srinivasan to found Soulfree, an organization dedicated to creating long-term care centers around India that are equipped to care for those with severe disabilities permanently and ensure they will be trained for jobs and financial security, she says.

In addition to her work with Soulfree, Srinivasan is a motivational speaker, holds a master’s degree in psychology, and is and a senior research fellow pursuing her PhD at the Indian Institute of Technology in Madras.

“I know I’m being kept alive on this earth for some greater purpose,” she says. “I’m content in being fully alive in this moment and trying to spread love, light, and laughter in this world.”

Helpful Resources

Research shows that people who have supportive family, friends, and community and a spiritual connection have an easier time dealing with the challenges of finding new identity, meaning, and purpose after a spinal cord injury.

The Christopher & Dana Reeve Foundation’s National Paralysis Resource Center offers free resources about living with paralysis, including a blog in which people with spinal cord injuries describe how they found meaning after their accident. Getting psychotherapy or becoming involved with a support group (in-person or online) or peer counseling, such as through the Foundation’s Peer and Family Support Program, can also help.

More resources and suggestions can be found at:

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Healing Broken Bones Is More Complicated Than It Looks

Healing Broken Bones Is More Complicated Than It Looks
Healing Broken Bones Is More Complicated Than It Looks

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Aug. 26, 2022 – Healing a broken bone isn’t always a straightforward process of putting on a cast and waiting for the body to do its thing with time. The many materials that make up our bones have different densities and interact in several ways that affect whether a fracture heals correctly.

A fracture that doesn’t mend properly is called a nonunion, and in a long bone, such as a leg bone, it can be disabling. And doctors can’t always tell when a nonunion has occurred, much less how to predict how likely it is ahead of time. But research into bone imaging techniques is on the way to change that and give doctors a glimpse ahead to help them find problems earlier.

Mechanical engineering researchers at Lehigh University in Bethlehem, PA, are using bone imaging and virtual mechanical testing to develop a more accurate model of the healing process.

A virtual model can help doctors recognize when a bone strays from a healthy healing process so they can step in sooner. The key is to better understand the physical process in the healing zone where the fracture is actually being repaired.

Inside the Cast

The healing process starts when the body recognizes the fracture and sends out immune cells to cause inflammation. Swelling is the body’s warning signal to stop using the injured part.

Blood cells also collect around the injury, and this mass of cells – a hematoma, or a blood clot – fills the space in the break. Over the next week, a type of soft bone called callus gradually replaces the blood clot and holds the bone together, though not strongly enough to begin using the bone yet. After several weeks, the callus has time to harden, and then hard bone begins to replace the hard callus.

But it’s difficult to see how well these later stages are occurring on X-rays since hard callus and hard bone look so much alike. Engineers are working to understand the mechanical properties of bone and callus, such as mass and density, so they can better predict when hard bone has fully replaced the callus. Predicting it too soon could get in the way of the healing process if the person uses the bone normally before it’s fully healed.

Previous computer models couldn’t accurately tell hard callus from hard bone, largely because callus itself is made up of different types of tissue with different physical properties.

But this new research relies on testing the stress put on the bone during twisting. The researchers fed those testing results and corresponding CT images into a computer to model the healing process. Brighter areas on the image represent stiffer, harder bone, so their work helped investigators figure out the cutoff point when the material stops being callus and changes to bone. Knowing this cutoff point can help identify sooner when a nonunion is occurring, which in turn can help doctors to better understand how and why the healing process is failing so they can help.

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More Sick From E. Coli Outbreak Tied to Wendy’s Restaurant Lettuce

More Sick From E. Coli Outbreak Tied to Wendy’s Restaurant Lettuce
More Sick From E. Coli Outbreak Tied to Wendy’s Restaurant Lettuce

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By Ernie Mundell HealthDay Reporter
HealthDay Reporter

FRIDAY, Aug 26, 2022 (HealthDay News) – – A total of 84 people across four states have now been made ill by E. coli, in an outbreak possibly tied to contaminated lettuce used in sandwiches sold at Wendy’s restaurants.

“Since the last update on August 19, 2022, 47 more illnesses have been reported to CDC,” the U.S. Centers for Disease Control and Prevention said in an updated statement released Thursday. That includes 53 cases in Michigan, 23 cases in Ohio, 6 in Indiana and 2 in Pennsylvania.

Illnesses from infection with the gastrointestinal bacterium have often been severe.

“Thirty-eight people have been hospitalized, including 8 people in Michigan who have a type of kidney failure called hemolytic uremic syndrome,” the CDC said, although “no deaths have been reported.”

The exact source of the outbreak has not been officially confirmed, but the CDC said that in 84% of cases people reported eating at Wendy’s before they became ill.

“Of 17 people with detailed information about what they ate at Wendy’s, 15 (88%) reported eating romaine lettuce served on burgers and sandwiches,” the agency noted.

On Aug. 19, Wendy’s announced that it had removed romaine lettuce from its sandwiches in Michigan, Ohio and Pennsylvania.

“Wendy’s is taking the precautionary measure of removing the romaine lettuce being used in sandwiches from restaurants in that region,” the CDC said. “Investigators are working to confirm whether romaine lettuce is the source of this outbreak, and whether romaine lettuce used in Wendy’s sandwiches was served or sold at other businesses.”

Romaine lettuce sold in grocery stores does not appear to be affected, the CDC said, and people can still eat at Wendy’s and eat the romaine lettuce in the salads it sells. Wendy’s explained in a statement that the lettuce used in its salads is not the same as that used in its sandwiches.

“We are fully cooperating with public health authorities on their ongoing investigation of the regional E. coli outbreak reported in certain midwestern states,” the company said. “While the CDC has not yet confirmed a specific food as the source of that outbreak, we are taking the precaution of discarding and replacing the sandwich lettuce at some restaurants in that region.”

Most people with an E. coli infection “start feeling sick 3 to 4 days after eating or drinking something that contains the bacteria,” the CDC said. “However, illnesses can start anywhere from 1 to 10 days after exposure.” Illnesses typically last from 5 to 7 days.

What to Do:

  • Watch for symptoms of severe E. coli, which include diarrhea lasting more than three days or diarrhea accompanied by a fever higher than 102˚F, bloody diarrhea, vomiting and a lack of urination.
  • If you suffer from these symptoms, call your doctor immediately.
  • Keep track of what and where you ate in the week before you got sick and report it to your local or state health department.

More information

For more on the outbreak, head to the U.S. Centers for Disease Control and Prevention.

SOURCES: U.S. Centers for Disease Control and Prevention, news release, Aug. 25, 2022; Wendy’s, statement, Aug. 19, 2022

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Q&A: Using AI to expand access to breast cancer screening

Q&A: Using AI to expand access to breast cancer screening
Q&A: Using AI to expand access to breast cancer screening

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Though breast cancer treatment can be highly effective, women across the globe face drastically different outcomes depending on where they live. 

According to research compiled by the World Health Organization, survival for at least five years after diagnosis ranges from more than 90% in high-income countries to only 66% in India and 40% in South Africa.

Geetha Manjunath, founder and CEO of Bengaluru, India-based Niramai Health Analytix, set out to improve access to screening when a close family member died of breast cancer in her early 40s not long after receiving a diagnosis. The company recently participated in the M2D2 Impact accelerator at the University of Massachusetts Lowell and received FDA 510(k) clearance earlier this year.

Manjunath sat down with MobiHealthNews to discuss how Niramai’s artificial intelligence-enabled screening system works, the importance of explainability when using AI in healthcare and what’s next for the company.

MobiHealthNews: Can you tell me a little bit about how the Thermalytix system works for breast cancer screening?

Geetha Manjunath: I’ll set a little bit of context. If you look at the mortality rates across different countries, there is a huge variation in the number of people who survive breast cancer. In order to stop these deaths, we need regular screening, but that is not feasible today. One, because of the economic constraints. Such a huge initiative is usually restricted to women around 45 years and older, because there is a relationship with age. Also, mammography, which is the standard for breast cancer detection, does not work as well on younger women below 45 years old, because they have what is called dense breasts. In fact, in almost 50% of the ladies above 40 there is a density issue again.

In countries like India, China, the Philippines, the affordability of the machine itself is a big issue for the government as well as small diagnostic centers or private hospitals. So with all this, what Niramai has developed is an affordable, accessible method of detecting breast cancer in women of all age groups and all breast densities. In addition, the machine is actually very portable. You can do the test in the hospital. You can also take it out to do the test in remote areas, rural villages as well as corporate offices. We also have a home screening for breast cancer screening. 

The lady enters a small room, like a small booth. She goes in, she closes the door and then she removes her clothes in front of this device. Nobody is inside, it’s like a changing room. Nobody sees her or touches her during the test, which is unlike the experience of doing a mammogram, for example.

It uses an imaging technique called thermal imaging, which can be controversial. Traditionally, thermal imaging has been used for abnormality detection. However, it has never been accurate enough to be used or recommended in hospitals, because we are measuring, let’s say, 400,000 temperature points per person. It’s very hard for the human eye to differentiate between different shades of yellow, different shades of oranges, and so on. 

We have developed our artificial intelligence-enabled smart software, which analyzes this temperature distribution on the chest area, and converts that into a cancer report. That is completely done automatically with scoring indicating the level of abnormality. That is our main value proposition, AI algorithms to convert temperature distribution into a cancer report.

MHN: So the cancer report is not saying, you 100% have breast cancer. Is the idea that it highlights potential concerns and you get further tests?

Manjunath: Absolutely. It’s a screening test, which means that out of 100 women screened, we identify those nine or 10 women who need to go for a follow-up diagnostic workup – maybe another mammogram, or 3D mammogram, or more sophisticated breast MRI, or a breast ultrasound.

MHN: AI is becoming a lot more prevalent in healthcare, especially for imaging. How do you balance concerns about introducing bias or not understanding how the AI is making its recommendations?

Manjunath: AI is a machine, and a machine behaves the way you train it. So the training phase is very, very important. What kind of samples you use for training, making sure that the training set is addressing multiple abnormal aspects. For example, in breast cancer, we looked at pregnant women, we looked at people who are menstruating, we looked at people who had fibroadenomas. All of the different categories and subcategories of potential abnormalities have to be included. You definitely need to work with a medical expert to actually ensure that your training is unbiased. It’s really multidisciplinary, because the domain experts and the technology experts have to come together. 

And the explainability part is also hugely important. So for example, initially, we just said it would look at a patient and say, cancer or no cancer. But the doctor said, “What do I do with this? I can’t take any action with this. You just say cancer, but which breast and what happened?” So we now have a three page PDF report that is automatically generated, which gives scores for the left breast and the right breast. We do markings on the breast automatically, saying this is where you want to check again.

MHN: You recently received FDA 510(k) clearance here in the U.S. What are the next steps for the company?

Manjunath: We recently received the U.S. FDA clearance, we’re just finishing device registration, though we launched in a beta mode last month. So I’m already looking for partners. To start with, we will be working with thermographers, people who are already using thermal imaging. Our current clearance from FDA is to use this as an adjunct to mammogram, so we would love to work with these imaging centers to provide this facility as well. 

In parallel, we are working on the next device, which is a little more sophisticated than our current device, for clearance by the FDA. We need a multisite clinical study in the U.S., so we have identified hospitals in New Jersey and Arizona, and probably Florida as well.

Meanwhile, we have received a huge response from low and middle income countries because of the affordability and accessibility part of it. So, in countries like the Philippines, the UAE, India, Indonesia, we are working with distributors in the local domestic market to take the solution to the developing world. And also we are cleared for use in Europe.

So I’m very excited. I tried to solve a very, very local problem of trying to get Indian women detected with cancer. We’ve now screened 60,000 women in India alone, which is a considerable number, given it’s a new medical device. We have already launched in Kenya. So, I’m very excited to have an opportunity to make a difference in the lives of women, hopefully, around the world.

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Plume scoops up $24M for virtual transgender healthcare

Plume scoops up $24M for virtual transgender healthcare
Plume scoops up M for virtual transgender healthcare

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Plume, a startup focused on virtual care for transgender patients, raised $24 million in Series B funding.

The round was led by Transformation Capital, with participation from General Catalyst and Town Hall Ventures. The investment comes about a year and half after the company announced a $14 million Series A

WHAT IT DOES

Plume offers digital gender-affirming care, including prescriptions to hormone therapy like estrogen or testosterone, video consultations with providers, lab orders and analysis, support groups and medical letters of support for surgery or name and gender marker changes. In most states, the startup’s membership costs $99 a month.

Plume plans to use the capital from the Series B to expand nationwide, move into virtual primary care and add insurance coverage for the company’s services. 

“With today’s announcement, we are on track to reach our goal of increasing access to high-quality, gender-affirming care to patients across the U.S. in both urban areas and coverage deserts,” Dr. Jerrica Kirkley, Plume cofounder and chief medical officer, said in a statement.

“Knowing the hurdles trans Americans face when accessing care, I’m encouraged to reach this benchmark and I look forward to Plume’s growth in the future. I want to thank Transformation Capital, General Catalyst, and Town Hall Ventures for their partnership in transforming health care for every trans life.”

MARKET SNAPSHOT

Another digital health company working with LGBTQIA+ patients is Folx Health, which announced a $25 million Series A raise in February 2021. Folx recently launched an employer offering and added counseling, evaluation and referrals for Monkeypox treatment.

Last year, the recently merged virtual care companies Grand Rounds Health and Doctor On Demand acquired Included Health, a health concierge platform for the LGBTQIA+ community. The company later rebranded under the Included name

Like a number of other digital health and health tech companies pursuing layoffs this summer, Included recently reduced its workforce by less than 6% as part of a company restructuring.

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