or Rhode Island Governor Vetoes Consumer Data Privacy Act By cohealthcom.org Published On :: Wed, 03 Jul 2024 14:32:46 +0000 On June 25th, Rhode Island Governor Daniel McKee transmitted without signature (effectively a pocket veto) the Rhode Island Data Transparency and Privacy Protection Act (SB 2500 / HB 7787). The act is based on the Washington Privacy Act model but diverges from the prevalent forms of that model in two ways. First, the act contains a unique […] Full Article Data Privacy Legislative consumer privacy data privacy legislation Rhode Island RI veto Washington Privacy Act
or California Adopts a Bundle of AI & Privacy Laws, Most Controversial Bills Vetoed (Updated) By cohealthcom.org Published On :: Mon, 30 Sep 2024 19:05:07 +0000 Sorry, but you do not have permission to view this content. Full Article Artificial Intelligence (AI) Data Privacy Legislative child data privacy CO Colorado consumer privacy data privacy legislation Jim Potter
or FTC Finalizes “Click-to-Cancel” Rule to Make It Easier for Consumers to End Recurring Subscriptions and Memberships By cohealthcom.org Published On :: Fri, 18 Oct 2024 20:56:52 +0000 Sorry, but you do not have permission to view this content. Full Article Regulatory/FDA Federal Trade Commission final rule FTC Good Rx HBRN Jim Potter PHI privacy
or Former CHC Board Chairs Sharon Callahan and Nick Colucci Named as 2025 MAHF Inductees By cohealthcom.org Published On :: Fri, 25 Oct 2024 20:39:55 +0000 Two former board chairs of the Coalition for Healthcare Communication (CHC) were named as the Medical Advertising Hall of Fame (MAHF) 2025 inductees – Sharon Callahan, former Chief Client Officer at Omnicom Health Group (OHG), and Nick Colucci, former Chairman and CEO of Publicis Health/COO of Publicis Groupe North America. The inductees will be honored […] Full Article CHC News chc MAHF Nick Colucci Sharon Callahan
or Don’t Confuse the Art and Science of Medicine: PCI vs CABG for Left Main Disease By www.cardiobrief.org Published On :: Thu, 20 Aug 2020 15:56:47 +0000 It is often said that medicine is both an art and a science. In an imperfect world this is both inevitable and desirable. But it is extremely important that the two should not be confused with each other. In particular, because the “science” side of the equation has achieved overwhelming prestige and authority, it is...Click here to continue reading... Full Article Interventional Cardiology & Surgery People Places & Events Policy & Ethics CABG guidelines left main disease LMCA PCI
or Regulatory update for post-registration of biological products in Brazil By www.gabionline.net Published On :: Tue, 29 Oct 2024 09:23:29 +0000 <p>On 3<sup> </sup>June 2024, Resolution RDC No. 876 was published in Brazil in the Official Journal of the Union (DOU)[1], modifying the current regulations regarding the post-registration of biological products (RDC 413/2020).</p> Full Article
or Medicines for Europe 23rd Regulatory Affairs Conference 2025 By www.gabionline.net Published On :: Tue, 05 Nov 2024 09:04:58 +0000 <p> <b>23rd Regulatory Affairs Conference 202</b><b>5</b><br /> <b>27</b><b>‒</b><b>28 February 2025</b><br /> Hilton Amsterdam Airport Schiphol<br />Amsterdam, The Netherlands</p> Full Article
or NPRA Malaysia trials new timelines for variation applications By www.gabionline.net Published On :: Tue, 05 Nov 2024 09:13:55 +0000 <p>In May 2024, Malaysia’s National Pharmaceutical Regulatory Agency (NPRA) announced that it will trial new timelines for variation applications of registered pharmaceutical products and natural health supplements (TMHS).</p> Full Article
or EC approval for three ustekinumab biosimilar: Eksunbi, Fymskina, Otulfi By www.gabionline.net Published On :: Tue, 05 Nov 2024 09:15:00 +0000 <p>The European Commission (EC) granted marketing authorization for<b> </b>three ustekinumab biosimilars<b>: </b>Samsung Bioepis’ Eksunbi on 12 September 2024; Formycon’s Fymskina, and Fresenius Kabi’s Otulfi on 25 September 2024.</p> Full Article
or Transforming healthcare: CinnaGen’s leadership in follow-on biologicals/ biosimilars development and market expansion By www.gabionline.net Published On :: Fri, 08 Nov 2024 13:18:16 +0000 <p> <b>Abstract</b><br />CinnaGen, the largest biopharmaceutical company in the MENA region, is a leader in developing follow-on biologicals/biosimilars. Dr Haleh Hamedifar, Chairperson of CinnaGen, spoke to GaBI<i> </i>(Generics and Biosimilars Initiative) about the company’s strategic focus, which includes expanding its product portfolio, entering highly regulated global markets, and advancing affordable treatments for conditions such as multiple sclerosis and immunological diseases—transforming healthcare in underserved regions.</p><p><b>Keywords</b>: Biosimilars, clinical development, commercialization, MENA</p> Full Article
or RPS and pharmacy students' association call for rethink over overseas exam decision By www.pharmaceutical-journal.com Published On :: Tue, 9 Feb 2021 16:42 GMT The Royal Pharmaceutical Society and the British Pharmaceutical Students’ Association have called for all overseas candidates to sit the March 2021 registration assessment in their home countries. Full Article
or Pharmacy negotiators in talks over plans to distribute COVID-19 treatments in primary care By www.pharmaceutical-journal.com Published On :: Wed, 10 Feb 2021 15:25 GMT The Pharmaceutical Services Negotiating Committee is in talks with the government over potential plans to distribute COVID-19 treatments in primary care. Full Article
or Regulator looking at 'flexibility' that would allow overseas candidates to sit registration assessment By www.pharmaceutical-journal.com Published On :: Thu, 11 Feb 2021 14:53 GMT The General Pharmaceutical Council has said it is “double, treble, quadruple-checking” for any “flexibility” that would allow all overseas candidates to sit the March 2021 registration assessment exam in their countries of residence. Full Article
or Risk of mortality drops in COVID-19 patients given anticoagulation within a day of hospital admission, research finds By www.pharmaceutical-journal.com Published On :: Fri, 12 Feb 2021 13:58 GMT Starting COVID-19 patients on prophylactic anticoagulation within 24 hours of being admitted to hospital has been linked to a reduced risk of mortality. Full Article
or Everything you should know about the coronavirus pandemic By www.pharmaceutical-journal.com Published On :: Mon, 15 Feb 2021 11:25 GMT The latest information about the novel coronavirus identified in Wuhan, China, and advice on how pharmacists can help concerned patients and the public. Full Article
or Semaglutide effective for weight loss in non-diabetic adults, research suggests By www.pharmaceutical-journal.com Published On :: Mon, 15 Feb 2021 12:04 GMT The type 2 diabetes mellitus drug semaglutide is effective for weight loss in non-diabetic overweight or obese adults, when taken alongside a reduced-calorie diet and exercise, researchers have found. Full Article
or Overseas candidates will be allowed to sit registration assessment remotely, regulator says By www.pharmaceutical-journal.com Published On :: Tue, 16 Feb 2021 12:05 GMT The General Pharmaceutical Council has said most candidates living in countries with a two-hour or more time difference from the UK will be able to apply to sit the registration assessment at home. Full Article
or NHS England lowers threshold for COVID-19 vaccination site applications By www.pharmaceutical-journal.com Published On :: Wed, 17 Feb 2021 12:13 GMT Community pharmacies able to administer up to 400 COVID-19 vaccines per week can now apply to become designated vaccination sites, NHS England has said. Full Article
or Pharmacy negotiators discuss patient registration with community pharmacies By www.pharmaceutical-journal.com Published On :: Thu, 18 Feb 2021 17:07 GMT Pharmacy negotiators have discussed proposals to take “a patient registration-based approach” to the community pharmacy contractual framework. Full Article
or Pharmacology: The Anchor for Nearly Every Diligence By lifescivc.com Published On :: Thu, 25 Apr 2024 11:00:33 +0000 By Haojing Rong and Aimee Raleigh, as part of the From The Trenches feature of LifeSciVC This blog post is the second in a series on key diligence concepts and questions. If you missed the intro blog post yesterday, click The post Pharmacology: The Anchor for Nearly Every Diligence appeared first on LifeSciVC. Full Article Biotech investment themes Drug discovery From The Trenches Science & Medicine Translational research Efficacy IVIVc PD pharmacology PK
or Mariana Oncology’s Radiopharm Platform Acquired By Novartis By lifescivc.com Published On :: Mon, 06 May 2024 10:42:46 +0000 Novartis recently announced the acquisition of Mariana Oncology, an emerging biotech focused on advancing a radioligand therapeutics platform, for up to $1.75 billion in upfronts and future milestones. The capstone of its three short years of operations, this acquisition represents The post Mariana Oncology’s Radiopharm Platform Acquired By Novartis appeared first on LifeSciVC. Full Article Exits IPOs M&As Leadership Portfolio news Talent #RLT Mariana Oncology Novartis radioligand therapy Radiopharm
or Boiling It Down: Conveying Complexity For Decision-makers By lifescivc.com Published On :: Wed, 22 May 2024 11:00:28 +0000 By Ankit Mahadevia, former CEO of Spero Therapeutics, as part of the From The Trenches feature of LifeSciVC Drug development is complex. So is running a business. Sometimes, the work of doing both can make your head spin. In my The post Boiling It Down: Conveying Complexity For Decision-makers appeared first on LifeSciVC. Full Article From The Trenches Leadership
or To B or Not to (Series) B By lifescivc.com Published On :: Tue, 18 Jun 2024 11:00:03 +0000 By Robert Clarke, CEO of Kinaset Therapeutics, as part of the From The Trenches feature of LifeSciVC Strategic considerations of when and how to consider raising additional capital to support clinical development in an improving but still volatile market. As The post To B or Not to (Series) B appeared first on LifeSciVC. Full Article Biotech financing From The Trenches Fundraising
or A Molecular Biologist’s Advice For Life By lifescivc.com Published On :: Mon, 01 Jul 2024 10:25:46 +0000 Having just turned 50, I’ve been reflecting on my first half-century of late… many fun and impactful moments, a few regrets, and a life I’ve tried to live to the fullest. One thread that has run throughout it has been The post A Molecular Biologist’s Advice For Life appeared first on LifeSciVC. Full Article Bioentrepreneurship Leadership Personal The Human Element
or Looking for Opportunities to Accelerate Clinical Research in Rare Diseases By lifescivc.com Published On :: Wed, 17 Jul 2024 11:00:40 +0000 By Mike Cloonan, Chief Executive Officer of Sionna Therapeutics, as part of the From The Trenches feature of LifeSciVC The drug development process in rare diseases is rife with challenges especially when companies target significant differentiation or first-in-class targets. Identifying The post Looking for Opportunities to Accelerate Clinical Research in Rare Diseases appeared first on LifeSciVC. Full Article Business Development From The Trenches Portfolio news Rare Diseases Science & Medicine CFTR Cystic Fibrosis NBD1 Sionna Therapeutics
or Keeping It Simple: What Really Matters For Emerging Enterprises By lifescivc.com Published On :: Wed, 04 Sep 2024 11:00:46 +0000 By Ankit Mahadevia, chairman of Spero Therapeutics, as part of the From The Trenches feature of LifeSciVC A common theme in startup literature is that by cutting a range of unnecessary tasks, a step-change in results will follow. I’ve found The post Keeping It Simple: What Really Matters For Emerging Enterprises appeared first on LifeSciVC. Full Article Bioentrepreneurship Biotech startup advice Corporate Culture From The Trenches
or Biotech Risk Cycles: Assets And Platforms By lifescivc.com Published On :: Mon, 28 Oct 2024 10:00:52 +0000 Today’s market likes products. Platforms aren’t in vogue anymore. Investors, especially in the public markets, only want late stage de-risked assets. Pharma only seems to be buying these kinds of asset. VCs need to focus on clinical stage companies. Or The post Biotech Risk Cycles: Assets And Platforms appeared first on LifeSciVC. Full Article Biotech financing Biotech investment themes Capital efficiency Capital markets Exits IPOs M&As
or Tell the UK’s research regulator to do more on clinical trial transparency By www.alltrials.net Published On :: Mon, 29 Jul 2019 13:41:09 +0000 The UK body that oversees health research is writing a new strategy on clinical trial transparency and it wants to hear opinions on it. The Health Research Authority (HRA) says its strategy aims to “make transparency easy, make compliance clear and make information public.” It has opened a public consultation on the strategy and some […] Full Article News
or UK universities and NHS trusts that flout the rules on clinical trials identified in report to Parliament By www.alltrials.net Published On :: Thu, 24 Oct 2019 00:19:34 +0000 An AllTrials report for the House of Commons Science and Technology Select Committee this week has found that 33 NHS trust sponsors and six UK universities are reporting none of their clinical trial results, while others have gone from 0% to 100% following an announcement from the Select Committee in January that universities and NHS […] Full Article News Uncategorized
or Half of US clinical trials are breaking the law on reporting results By www.alltrials.net Published On :: Fri, 17 Jan 2020 23:30:00 +0000 New research has shown that the majority of clinical trials which should be following the US law on reporting results aren’t. Less than half (41%) of clinical trial results were reported on time and 1 in 3 trials (36%) remain unreported. The research also found that clinical trials sponsored by companies are the most likely […] Full Article News
or Brazen Scofflaws? Are Pharma Companies Really Completely Ignoring FDAAA? By www.placebocontrol.com Published On :: Wed, 31 Jul 2013 16:54:00 +0000 Results reporting requirements are pretty clear. Maybe critics should re-check their methods? Ben Goldacre has rather famously described the clinical trial reporting requirements in the Food and Drug Administration Amendments Act of 2007 as a “fake fix” that was being thoroughly “ignored” by the pharmaceutical industry. Pharma: breaking the law in broad daylight? He makes this sweeping, unconditional proclamation about the industry and its regulators on the basis of a single study in the BMJ, blithely ignoring the fact that a) the authors of the study admitted that they could not adequately determine the number of studies that were meeting FDAAA requirements and b) a subsequent FDA review that identified only 15 trials potentially out of compliance, out of a pool of thousands. Despite the fact that the FDA, which has access to more data, says that only a tiny fraction of studies are potentially noncompliant, Goldacre's frequently repeated claims that the law is being ignored seems to have caught on in the general run of journalistic and academic discussions about FDAAA. And now there appears to be additional support for the idea that a large percentage of studies are noncompliant with FDAAA results reporting requirements, in the form of a new study in the Journal of Clinical Oncology: "Public Availability of Results of Trials Assessing Cancer Drugs in the United States" by Thi-Anh-Hoa Nguyen, et al.. In it, the authors report even lower levels of FDAAA compliance – a mere 20% of randomized clinical trials met requirements of posting results on clinicaltrials.gov within one year. Unsurprisingly, the JCO results were immediately picked up and circulated uncritically by the usual suspects. I have to admit not knowing much about pure academic and cooperative group trial operations, but I do know a lot about industry-run trials – simply put, I find the data as presented in the JCO study impossible to believe. Everyone I work with in pharma trials is painfully aware of the regulatory environment they work in. FDAAA compliance is a given, a no-brainer: large internal legal and compliance teams are everywhere, ensuring that the letter of the law is followed in clinical trial conduct. If anything, pharma sponsors are twitchily over-compliant with these kinds of regulations (for example, most still adhere to 100% verification of source documentation – sending monitors to physically examine every single record of every single enrolled patient - even after the FDA explicitly told them they didn't have to). I realize that’s anecdotal evidence, but when such behavior is so pervasive, it’s difficult to buy into data that says it’s not happening at all. The idea that all pharmaceutical companies are ignoring a highly visible law that’s been on the books for 6 years is extraordinary. Are they really so brazenly breaking the rules? And is FDA abetting them by disseminating incorrect information? Those are extraordinary claims, and would seem to require extraordinary evidence. The BMJ study had clear limitations that make its implications entirely unclear. Is the JCO article any better? Some Issues In fact, there appear to be at least two major issues that may have seriously compromised the JCO findings: 1. Studies that were certified as being eligible for delayed reporting requirements, but do not have their certification date listed. The study authors make what I believe to be a completely unwarranted assumption: In trials for approval of new drugs or approval for a new indication, a certification [permitting delayed results reporting] should be posted within 1 year and should be publicly available. It’s unclear to me why the authors think the certifications “should be” publicly available. In re-reading FDAAA section 801, I don’t see any reference to that being a requirement. I suppose I could have missed it, but the authors provide a citation to a page that clearly does not list any such requirement. But their methodology assumes that all trials that have a certification will have it posted: If no results were posted at ClinicalTrials.gov, we determined whether the responsible party submitted a certification. In this case, we recorded the date of submission of the certification to ClinicalTrials.gov. If a sponsor gets approval from FDA to delay reporting (as is routine for all drugs that are either not approved for any indication, or being studied for a new indication – i.e., the overwhelming majority of pharma drug trials), but doesn't post that approval on the registry, the JCO authors deem that trial “noncompliant”. This is not warranted: the company may have simply chosen not to post the certification despite being entirely FDAAA compliant. 2. Studies that were previously certified for delayed reporting and subsequently reported results It is hard to tell how the authors treated this rather-substantial category of trials. If a trial was certified for delayed results reporting, but then subsequently published results, the certification date becomes difficult to find. Indeed, it appears in the case where there were results, the authors simply looked at the time from study completion to results posting. In effect, this would re-classify almost every single one of these trials from compliant to non-compliant. Consider this example trial: Phase 3 trial completes January 2010 Certification of delayed results obtained December 2010 (compliant) FDA approval June 2013 Results posted July 2013 (compliant) In looking at the JCO paper's methods section, it really appears that this trial would be classified as reporting results 3.5 years after completion, and therefore be considered noncompliant with FDAAA. In fact, this trial is entirely kosher, and would be extremely typical for many phase 2 and 3 trials in industry. Time for Some Data Transparency The above two concerns may, in fact, be non-issues. They certainly appear to be implied in the JCO paper, but the wording isn't terribly detailed and could easily be giving me the wrong impression. However, if either or both of these issues are real, they may affect the vast majority of "noncompliant" trials in this study. Given the fact that most clinical trials are either looking at new drugs, or looking at new indications for new drugs, these two issues may entirely explain the gap between the JCO study and the unequivocal FDA statements that contradict it. I hope that, given the importance of transparency in research, the authors will be willing to post their data set publicly so that others can review their assumptions and independently verify their conclusions. It would be more than a bit ironic otherwise. [Image credit: Shamless lawlessness via Flikr user willytronics.] Thi-Anh-Hoa Nguyen, Agnes Dechartres, Soraya Belgherbi, and Philippe Ravaud (2013). Public Availability of Results of Trials Assessing Cancer Drugs in the United States JOURNAL OF CLINICAL ONCOLOGY DOI: 10.1200/JCO.2012.46.9577 Full Article Ben Goldacre clinicaltrials.gov FDA FDAAA JCO oncology trials pharma legislation Pharmalot transparency
or Questionable Enrollment Math(s) - the Authors Respond By www.placebocontrol.com Published On :: Fri, 20 Sep 2013 04:09:00 +0000 The authors of the study I blogged about on Monday were kind enough to post a lengthy comment, responding in part to some of the issues I raised. I thought their response was interesting, and so reprint it in its entirety below, interjecting my own reactions as well. There were a number of points you made in your blog and the title of questionable maths was what caught our eye and so we reply on facts and provide context. Firstly, this is a UK study where the vast majority of UK clinical trials take place in the NHS. It is about patient involvement in mental health studies - an area where recruitment is difficult because of stigma and discrimination. I agree, in hindsight, that I should have titled the piece “questionable maths” rather than my Americanized “questionable math”. Otherwise, I think this is fine, although I’m not sure that anything here differs from my post. 1. Tripling of studies - You dispute NIHR figures recorded on a national database and support your claim with a lone anecdote - hardly data that provides confidence. The reason we can improve recruitment is that NIHR has a Clinical Research Network which provides extra staff, within the NHS, to support high quality clinical studies and has improved recruitment success. To be clear, I did not “dispute” the figures so much as I expressed sincere doubt that those figures correspond with an actual increase in actual patients consenting to participate in actual UK studies. The anecdote explains why I am skeptical – it's a bit like I've been told there was a magnitude 8 earthquake in Chicago, but neither I nor any of my neighbors felt anything. There are many reasons why reported numbers can increase in the absence of an actual increase. It’s worth noting that my lack of confidence in the NIHR's claims appears to be shared by the 2 UK-based experts quoted by Applied Clinical Trials in the article I linked to. 2. Large database: We have the largest database of detailed study information and patient involvement data - I have trawled the world for a bigger one and NIMH say there certainly isn't one in the USA. This means few places where patient impact can actually be measured 3. Number of studies: The database has 374 studies which showed among other results that service user involvement increased over time probably following changes by funders e.g. NIHR requests information in the grant proposal on how service users have been and will be involved - one of the few national funders to take this issue seriously. As far as I can tell, neither of these points is in dispute. 4. Analysis of patient involvement involves the 124 studies that have completed. You cannot analyse recruitment success unless then. I agree you cannot analyze recruitment success in studies that have not yet completed. My objection is that in both the KCL press release and the NIHR-authored Guardian article, the only number mentioned in 374, and references to the recruitment success findings came immediately after references to that number. For example: Published in the British Journal of Psychiatry, the researchers analysed 374 studies registered with the Mental Health Research Network (MHRN). Studies which included collaboration with service users in designing or running the trial were 1.63 times more likely to recruit to target than studies which only consulted service users. Studies which involved more partnerships - a higher level of Patient and Public Involvement (PPI) - were 4.12 times more likely to recruit to target. The above quote clearly implies that the recruitment conclusions were based on an analysis of 374 studies – a sample 3 times larger than the sample actually used. I find this disheartening. The complexity measure was developed following a Delphi exercise with clinicians, clinical academics and study delivery staff to include variables likely to be barriers to recruitment. It predicts delivery difficulty (meeting recruitment & delivery staff time). But of course you know all that as it was in the paper. Yes, I did know this, and yes, I know it because it was in the paper. In fact, that’s all I know about this measure, which is what led me to characterize it as “arbitrary and undocumented”. To believe that all aspects of protocol complexity that might negatively affect enrollment have been adequately captured and weighted in a single 17-point scale requires a leap of faith that I am not, at the moment, able to make. The extraordinary claim that all complexity issues have been accounted for in this model requires extraordinary evidence, and “we conducted a Delphi exercise” does not suffice. 6. All studies funded by NIHR partners were included – we only excluded studies funded without peer review, not won competitively. For the involvement analysis we excluded industry studies because of not being able to contact end users and where inclusion compromised our analysis reliability due to small group sizes. It’s only that last bit I was concerned about. Specifically, the 11 studies that were excluded due to being in “clinical groups” that were too small, despite the fact that “clinical groups” appear to have been excluded as non-significant from the final model of recruitment success. (Also: am I being whooshed here? In a discussion of "questionable math" the authors' enumeration goes from 4 to 6. I’m going to take the miscounting here as a sly attempt to see if I’m paying attention...) I am sure you are aware of the high standing of the journal and its robust peer review. We understand that our results must withstand the scrutiny of other scientists but many of your comments were unwarranted. This is the first in the world to investigate patient involvement impact. No other databases apart from the one held by the NIHR Mental Health Research Network is available to test – we only wish they were. I hope we can agree that peer review – no matter how "high standing" the journal – is not a shield against concern and criticism. Despite the length of your response, I’m still at a loss as to which of my comments specifically were unwarranted. In fact, I feel that I noted very clearly that my concerns about the study’s limitations were minuscule compared to my concerns about the extremely inaccurate way that the study has been publicized by the authors, KCL, and the NIHR. Even if I conceded every possible criticism of the study itself, there remains the fact that in public statements, you Misstated an odds ratio of 4 as “4 times more likely to” Overstated the recruitment success findings as being based on a sample 3 times larger than it actually was Re-interpreted, without reservation, a statistical association as a causal relationship Misstated the difference between the patient involvement categories as being a matter of merely “involving just one or two patients in the study team” And you did these consistently and repeatedly – in Dr Wykes's blog post, in the KCL press release, and in the NIHR-written Guardian article. To use the analogy from my previous post: if a pharmaceutical company had committed these acts in public statements about a new drug, public criticism would have been loud and swift. Your comment on the media coverage of odds ratios is an issue that scientists need to overcome (there is even a section in Wikipedia). It's highly unfair to blame "media coverage" for the use of an odds ratio as if it were a relative risk ratio. In fact, the first instance of "4 times more likely" appears in Dr Wykes's own blog post. It's repeated in the KCL press release, so you yourselves appear to have been the source of the error. You point out the base rate issue but of course in a logistic regression you also take into account all the other variables that may impinge on the outcome prior to assessing the effects of our key variable patient involvement - as we did – and showed that the odds ratio is 4.12 - So no dispute about that. We have followed up our analysis to produce a statement that the public will understand. Using the following equations: Model predicted recruitment lowest level of involvement exp(2.489-.193*8.8-1.477)/(1+exp(2.489-.193*8.8-1.477))=0.33 Model predicted recruitment highest level of involvement exp(2.489-.193*8.8-1.477+1.415)/(1+exp(2.489-.193*8.8-1.477+1.415)=0.67 For a study of typical complexity without a follow up increasing involvement from the lowest to the highest levels increased recruitment from 33% to 66% i.e. a doubling. So then, you agree that your prior use of “4 times more likely” was not true? Would you be willing to concede that in more or less direct English? This is important and is the first time that impact has been shown for patient involvement on the study success. Luckily in the UK we have a network that now supports clinicians to be involved and a system for ensuring study feasibility. The addition of patient involvement is the additional bonus that allows recruitment to increase over time and so cutting down the time for treatments to get to patients. No, and no again. This study shows an association in a model. The gap between that and a causal relationship is far too vast to gloss over in this manner. In summary, I thank the authors for taking the time to response, but I feel they've overreacted to my concerns about the study, and seriously underreacted to my more important concerns about their public overhyping of the study. I believe this study provides useful, though limited, data about the potential relationship between patient engagement and enrollment success. On the other hand, I believe the public positioning of the study by its authors and their institutions has been exaggerated and distorted in clearly unacceptable ways. I would ask the authors to seriously consider issuing public corrections on the 4 points listed above. Full Article NIHR patient recruitment trial delays UK trials
or Can a Form Letter from FDA "Blow Your Mind"? By www.placebocontrol.com Published On :: Mon, 06 Jan 2014 22:14:00 +0000 Adam Feuerstein appears to be a generally astute observer of the biotech scene. As a finance writer, he's accosted daily with egregiously hyped claims from small drug companies and their investors, and I think he tends to do an excellent job of spotting cases where breathless excitement is unaccompanied by substantive information. However, Feuerstein's healthy skepticism seems to have abandoned him last year in the case of a biotech called Sarepta Therapeutics, who released some highly promising - but also incredibly limited - data on their treatment for Duchenne muscular dystrophy. After a disappointing interaction with the FDA, Sarepta's stock dropped, and Feuerstein appeared to realize that he'd lost some objectivity on the topic. However, with the new year comes new optimism, and Feuerstein seems to be back to squinting hard at tea leaves - this time in the case of a form letter from the FDA. He claims that the contents of the letter will "blow your mind". To him, the key passage is: We understand that you feel that eteplirsen is highly effective, and may be confused by what you have read or heard about FDA's actions on eteplirsen. Unfortunately, the information reported in the press or discussed in blogs does not necessarily reflect FDA's position. FDA has reached no conclusions about the possibility of using accelerated approval for any new drug for the treatment of Duchenne muscular dystrophy, and for eteplirsen in particular. Feuerstein appears to think that the fact that FDA "has reached no conclusions" may mean that it may be "changing its mind". To which he adds: "Wow!" Adam Feuerstein: This time, too much froth, not enough coffee? I'm not sure why he thinks that. As far as I can tell, the FDA will never reach a conclusion like this before its gone through the actual review process. After all, if FDA already knows the answer before the full review, what would the point of the review even be? It would seem a tremendous waste of agency resources. Not to mention how non-level the playing field would be if some companies were given early yes/no decisions while others had to go through a full review. It seems fair to ask: is this a substantive change by FDA review teams, or would it be their standard response to any speculation about whether and how they would approve or reject a new drug submission? Can Feuerstein point to other cases where FDA has given a definitive yes or no on an application before the application was ever filed? I suspect not, but am open to seeing examples. A more plausible theory for this letter is that the FDA is attempting a bit of damage control. It is not permitted to share anything specific it said or wrote to Sarepta about the drug, and has come under some serious criticism for “rejecting” Sarepta’s Accelerated Approval submission. The agency has been sensitive to the DMD community, even going so far as to have Janet Woodcock and Bob Temple meet with DMD parents and advocates last February. Sarepta has effectively positioned FDA as the reason for it’s delay in approval, but no letters have actually been published, so the conversation has been a bit one-sided. This letter appears to be an attempt at balancing perspectives a bit, although the FDA is still hamstrung by its restriction on relating any specific communications. Ultimately, this is a form letter that contains no new information: FDA has reached no conclusions because FDA is not permitted to reach conclusions until it has completed a fair and thorough review, which won't happen until the drug is actually submitted for approval. We talk about "transparency" in terms of releasing clinical trials data, but to me there is a great case to be made for increase regulatory transparency. The benefits to routine publication of most FDA correspondence and meeting results (including such things as Complete Response letters, explaining FDA's thinking when it rejects new applications) would actually go a long way towards improving public understanding of the drug review and approval process. Full Article accelerated approval Adam Feuerstein DMD FDA Sarepta Therapeutics transparency
or These Words Have (Temporarily) Relocated By www.placebocontrol.com Published On :: Tue, 18 Mar 2014 14:17:00 +0000 Near the end of last year, I had the bright idea of starting a second blog, Placebo Lead-In, to capture a lot of smaller items that I found interesting but wasn't going to work up into a full-blown, 1000 word post. According to Murphy’s Law, or the Law of Unintended Consequences, or the Law of Biting Off More Than You Can Chew, or some such similar iron rule of the universe, what happened next should have been predictable. First, my team at CAHG Trials launched a new blog, First Patient In. FPI is dedicated to an open discussion of patient recruitment ideas, and I’m extremely proud of what we've published so far. Next, I was invited to be a guest blogger for the upcoming Partnerships in Clinical Trials Conference. Suddenly, I've gone from 1 blog to 4. And while my writing output appears to have increased, it definitely hasn't quadrupled. So this blog has been quiet for a bit too long as a result. The good news is that the situation is temporary - Partnerships will actually happen at the end of this month. (If you’re going: drop me a line and let’s meet. If you’re not: you really should come and join us!) My contributions to FPI will settle into a monthly post, as I have a fascinating and clever team to handle most of the content. In case you've missed it, then, here is a brief summary of my posts elsewhere over the past 2 months. First Patient In How to Catalyze a Clinical Trial - My inaugural post introducing the blog and its purpose Video: Predicting Referral Conversion in Clinical Trial Advertising - A somewhat technical but very important topic, how to visualize and model the “real time” results of recruitment advertising at the sites. The Crystal Ball is on the Fritz - What to do with a broken enrollment feasibility process, and how asking will never be as good as measuring Partnerships in Clinical Trials The New Breed of Clinical Trial Matchmakers - A (hopefully pretty complete, thanks to knowledgeable commenters) listing of services looking to match interested patients to clinical trials Rethinking Patient Enrollment, in One Graphic - The perils of predictability in site-based enrollment Seize the Data! Will Big Data Save Us from Ourselves? - My take on what I consider to be the large and serious obstacles in the way of “Big Data” solutions for patient recruitment Please take a look, and I will see you back here soon. [Photo credit: detour sign via Flikr user crossley] Full Article Big Data metrics patient engagement patient recruitment site relationship management
or Waiver of Informed Consent - proposed changes in the 21st Century Cures Act By www.placebocontrol.com Published On :: Tue, 14 Jul 2015 20:21:00 +0000 Adam Feuerstein points out - and expresses considerable alarm over - an overlooked clause in the 21st Century Cures Act: Waive informed consent requirement for clinical trials?!?! Unbelievable but true if #Path2Cures becomes law. pic.twitter.com/dqmWPpxPdE — Adam Feuerstein (@adamfeuerstein) July 14, 2015 In another tweet, he suggests that the act will "decimate" informed consent in drug trials. Subsequent responses and retweets did nothing to clarify the situation, and if anything tended to spread, rather than address, Feuerstein's confusion. Below is a quick recap of the current regulatory context and a real-life example of where the new wording may be helpful. In short, though, I think it's safe to say: Waiving informed consent is not new; it's already permitted under current regs The standards for obtaining a waiver of consent are stringent They may, in fact, be too stringent in a small number of situations The act may, in fact, be helpful in those situations Feuerstein may, in fact, need to chill out a little bit (For the purposes of this discussion, I’m talking about drug trials, but I believe the device trial situation is parallel.) Section 505(i) - the section this act proposes to amend - instructs the Secretary of Health and Human Services to propagate rules regarding clinical research. Subsection 4 addresses informed consent: …the manufacturer, or the sponsor of the investigation, require[e] that experts using such drugs for investigational purposes certify to such manufacturer or sponsor that they will inform any human beings to whom such drugs, or any controls used in connection therewith, are being administered, or their representatives, that such drugs are being used for investigational purposes and will obtain the consent of such human beings or their representatives, except where it is not feasible or it is contrary to the best interests of such human beings. [emphasis mine] Note that this section already recognizes situations where informed consent may be waived for practical or ethical reasons. These rules were in fact promulgated under 45 CFR part 46, section 116. The relevant bit – as far as this conversation goes – regards circumstances under which informed consent might be fully or partially waived. Specifically, there are 4 criteria, all of which need to be met: (1) The research involves no more than minimal risk to the subjects; (2) The waiver or alteration will not adversely affect the rights and welfare of the subjects; (3) The research could not practicably be carried out without the waiver or alteration; and (4) Whenever appropriate, the subjects will be provided with additional pertinent information after participation. In practice, this is an especially difficult set of criteria to meet for most studies. Criterion (1) rules out most “conventional” clinical trials, because the hallmarks of those trials (use of an investigational medicine, randomization of treatment, blinding of treatment allocation) are all deemed to be more than “minimal risk”. That leaves observational studies – but even many of these cannot clear the bar of criterion (3). That word “practicably” is a doozy. Here’s an all-too-real example from recent personal experience. A drug manufacturer wants to understand physicians’ rationales for performing a certain procedure. It seems – but there is little hard data – that a lot of physicians do not strictly follow guidelines on when to perform the procedure. So we devise a study: whenever the procedure is performed, we ask the physician to complete a quick form categorizing why they made their decision. We also ask him or her to transcribe a few pieces of data from the patient chart. Even though the patients aren’t personally identifiable, the collection of medical data qualifies this as a clinical trial. It’s a minimal risk trial, definitely: the trial doesn’t dictate at all what the doctor should do, it just asks him or her to record what they did and why, and supply a bit of medical context for the decision. All told, we estimated 15 minutes of physician time to complete the form. The IRB monitoring the trial, however, denied our request for a waiver of informed consent, since it was “practicable” (not easy, but possible) to obtain informed consent from the patient. Informed consent – even with a slimmed-down form – was going to take a minimum of 30 minutes, so the length of the physician’s involvement tripled. In addition, many physicians opted out of the trial because they felt that the informed consent process added unnecessary anxiety and alarm for their patients, and provided no corresponding benefit. The end result was not surprising: the budget for the trial more than doubled, and enrollment was far below expectations. Which leads to two questions: 1. Did the informed consent appreciably help a single patient in the trial? Very arguably, no. Consenting to being “in” the trial made zero difference in the patients’ care, added time to their stay in the clinic, and possibly added to their anxiety. 2. Was less knowledge collected as a result? Absolutely, yes. The sponsor could have run two studies for the same cost. Instead, they ultimately reduced the power of the trial in order to cut losses. Bottom line, it appears that the modifications proposed in the 21st Century Cures Act really only targets trials like the one in the example. The language clearly retains criteria 1 and 2 of the current HHS regs, which are the most important from a patient safety perspective, but cuts down the “practicability” requirement, potentially permitting high quality studies to be run with less time and cost. Ultimately, it looks like a very small, but positive, change to the current rules. The rest of the act appears to be a mash-up of some very good and some very bad (or at least not fully thought out) ideas. However, this clause should not be cause for alarm. Full Article 21st Century Cures Act Adam Feuerstein informed consent
or The first paid research subject in written history? By www.placebocontrol.com Published On :: Mon, 21 Nov 2016 20:31:00 +0000 On this date 349 years ago, Samuel Pepys relates in his famous diary a remarkable story about an upcoming medical experiment. As far as I can tell, this is the first written description of a paid research subject. According to his account, the man (who he describes as “a little frantic”) was to be paid to undergo a blood transfusion from a sheep. It was hypothesized that the blood of this calm and docile animal would help to calm the man. Some interesting things to note about this experiment: Equipoise. There is explicit disagreement about what effect the experimental treatment will have: according to Pepys, "some think it may have a good effect upon him as a frantic man by cooling his blood, others that it will not have any effect at all". Results published. An account of the experiment was published just two weeks later in the journal Philosophical Transactions. Medical Privacy. In this subsequent write-up, the research subject is identified as Arthur Coga, a former Cambridge divinity student. According to at least one account, being publicly identified had a bad effect on Coga, as people who had heard of him allegedly succeeded in getting him to spend his stipend on drink (though no sources are provided to confirm this story). Patient Reported Outcome. Coga was apparently chosen because, although mentally ill, he was still considered educated enough to give an accurate description of the treatment effect. Depending on your perspective, this may also be a very early account of the placebo effect, or a classic case of ignoring the patient’s experience. Because even though his report was positive, the clinicians remained skeptical. From the journal article: The Man after this operation, as well as in it, found himself very well, and hath given in his own Narrative under his own hand, enlarging more upon the benefit, he thinks, he hath received by it, than we think fit to own as yet. …and in fact, a subsequent diary entry from Pepys mentions meeting Coga, with similarly mixed impressions: “he finds himself much better since, and as a new man, but he is cracked a little in his head”. The amount Coga was paid for his participation? Twenty shillings – at the time, that was exactly one Guinea. [Image credit: Wellcome Images] Full Article benefits of clinical trials ethics Guinea Pigs PRO sample size
or For good sleep and good health, regulate your exposure to light By www.npr.org Published On :: Sat, 09 Nov 2024 07:58:39 -0500 Your daily light exposure impacts your health. A new study finds that too much light at night and not enough natural light during the day can be harmful. This story first aired on Morning Edition on Nov. 4, 2024. Full Article
or Hospitals face months of IV fluid shortages after Helene damages N.C. factory By www.npr.org Published On :: Sun, 10 Nov 2024 08:34:20 -0500 Hospitals have been forced to innovate with new ways of hydrating patients and giving them medications, after a key factory that produces IV fluid bags flooded during Hurricane Helene. (This story first aired on Morning Edition on Nov. 7, 2024.) Full Article
or A human bird flu case is thought to be found in Canada for the first time By www.npr.org Published On :: Mon, 11 Nov 2024 03:18:54 -0500 A person has tested positive in British Columbia, Canadian health officials said, though the results must be sent to another lab for confirmation. Full Article
or What does a 2nd Trump term mean for the Affordable Care Act? By www.npr.org Published On :: Mon, 11 Nov 2024 04:47:01 -0500 President-elect Donald Trump tried unsuccessfully to get rid of the Affordable Care Act during his first term. What action will he take this time around? Full Article
or More young people are surviving cancer. Then they face a life altered by it By www.npr.org Published On :: Mon, 11 Nov 2024 05:00:00 -0500 More people are getting cancer in their 20s, 30s, and 40s, and surviving, thanks to rapid advancement in care. Many will have decades of life ahead of them, which means they face greater and more complex challenges in survivorship. Lourdes Monje is navigating these waters at age 29. Full Article
or Online yoga classes prove helpful for back pain in new study By www.npr.org Published On :: Tue, 12 Nov 2024 08:00:00 -0500 Participant reported relief from chronic low back pain and reduced need for pain-relief medications. Full Article
or Kumpulan Game Slot Gacor Dengan Persentase RTP Tertinggi Hari Ini By biosimilarnews.com Published On :: Tue, 12 Mar 2024 04:30:20 +0000 Dalam dunia perjudian online yang terus berkembang, pencarian para pemain untuk menemukan peluang terbaik dalam meraih kemenangan mengarah pada fenomena populer: kumpulan game slot gacor dengan persentase RTP tertinggi hari… The post Kumpulan Game Slot Gacor Dengan Persentase RTP Tertinggi Hari Ini appeared first on Biosimilarnews. Full Article News
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or Tiny Biosensor Unlocks the Secrets of Sweat By spectrum.ieee.org Published On :: Wed, 24 Apr 2024 15:00:04 +0000 Sweat: We all do it. It plays an essential role in controlling body temperature by cooling the skin through evaporation. But it can also carry salts and other molecules out of the body in the process. In medieval Europe, people would lick babies; if the skin was salty, they knew that serious illness was likely. (We now know that salty skin can be an indicator for cystic fibrosis.)Scientists continue to study how the materials in sweat can reveal details about an individual’s health, but often they must rely on gathering samples from subjects during strenuous exercise in order to get samples that are sufficiently large for analysis.Now researchers in China have developed a wearable sensor system that can collect and process small amounts of sweat while providing continuous detection. They have named the design a “skin-interfaced intelligent graphene nanoelectronic” patch, or SIGN for short. The researchers, who described their work in a paper published in Advanced Functional Materials, did not respond to IEEE Spectrum’s interview requests. The SIGN sensor patch relies on three separate components to accomplish its task. First, the sweat must be transported from the skin into microfluidic chambers. Next, a special membrane removes impurities from the fluid. Finally, this liquid is delivered to a bioreceptor that can be tuned to detect different metabolites.The transport system relies on a combination of hydrophilic (water-attracting) and hydrophobic (water-repelling) materials. This system can move aqueous solutions along microchannels, even against gravity. This makes it possible to transport small samples with precision, regardless of the device’s orientation.The fluid is transported to a Janus membrane, where impurities are blocked. This means that the sample that reaches the sensor is more likely to produce accurate results.Finally, the purified sweat arrives at a flexible biosensor. This graphene sensor is activated by enzymes designed to detect the desired biomarker. The result is a transistor that can accurately measure the amount of the biomarker in the sample. At its center, the system has a membrane that removes impurities from sweat and a biosensor that detects biomarkers.Harbin Institute of Technology/Shenyang Aerospace UniversityOne interesting feature of the SIGN patch is that it can provide continuous measurements. The researchers tested the device through multiple cycles of samples with known concentrations of a target biomarker, and it was about as accurate after five cycles as it was after just one. This result suggests that it could be worn over an extended period without having to be replaced.Continuous measurements can provide useful longitudinal data. However, Tess Skyrme, a senior technology analyst at the research firm IDTechEx, points out that continuous devices can have very different sampling rates. “Overall, the right balance of efficient, comfortable, and granular data collection is necessary to disrupt the market,” she says, noting that devices also need to optimize “battery life, calibration, and data accuracy.”The researchers have focused on lactate—a metabolite that can be used to assess a person’s levels of exercise and fatigue—as the initial biomarker to be detected. This function is of particular interest to athletes, but it can also be used to monitor the health status of workers in jobs that require strenuous physical activity, especially in hazardous or extreme working conditions.Not all experts are convinced that biomarkers in sweat can provide accurate health data. Jason Heikenfeld, director of the Novel Device Lab at the University of Cincinnati, has pivoted his research on wearable biosensing from sweat to the interstitial fluid between blood vessels and cells. “Sweat glucose and lactate are way inferior to measures that can be made in interstitial fluid with devices like glucose monitors,” he tells Spectrum.The researchers also developed a package to house the sensor. It’s designed to minimize power consumption, using a low-power microcontroller, and it includes a Bluetooth communications chip to transmit data wirelessly from the SIGN patch. The initial design provides for 2 hours of continuous use without charging, or up to 20 hours in standby mode. Full Article Health monitoring Microchannels Sweat Wearable sensor
or Sea Turtle Ears Inspire a New Heart Monitor Design By spectrum.ieee.org Published On :: Thu, 02 May 2024 14:14:33 +0000 This article is part of our exclusive IEEE Journal Watch series in partnership with IEEE Xplore.Sea turtles are remarkable creatures for a number of reasons, including the way they hear underwater—not through openings in the form of ears, but by detecting vibrations directly through the skin covering their auditory system. Inspired by this ability to detect sound through skin, researchers in China have created a heart-monitoring system, which initial tests in humans suggest may be a viable for monitoring heartbeats. A key way in which doctors monitor heart health involves “listening” to the heartbeat, either using a stethoscope or more sophisticated technology, like echocardiograms. However, these approaches require a visit to a specialist, and so researchers have been keen to develop alternative, lower cost solutions that people can use at home, which could also allow for more frequent testing and monitoring. Junbin Zang, a lecturer at the North University of China, and his colleagues specialize in creating heart-monitoring technologies. Their interest was piqued when they learned about the inner workings of the sea turtle’s auditory system, which is able to detect low-frequency signals, especially in the 300- to 400-hertz range.“Heart sounds are also low-frequency signals, so the low-frequency characteristics of the sea turtle’s ear have provided us with great inspiration,” explains Zang. At a glance, it looks like turtles don’t have ears. Their auditory system instead lies under a layer of skin and fat, through which it picks up vibrations. As with humans, a small bone in the ear vibrates as sounds hit it, and as it oscillates, those pulses are converted to electrical signals that are sent to the brain for processing and interpretation. iStock But sea turtles have a unique, slender T-shaped conduit that encapsulates their ear bones, restricting the movement of the similarly T-shaped ear bones to only vibrate in a perpendicular manner. This design provides their auditory system with high sensitivity to vibrations. Zang and his colleagues set out to create a heart monitoring system with similar features. They created a T-shaped heart-sound sensor that imitates the ear bones of sea turtles using a tiny MEMS cantilever beam sensor. As sound hits the sensor, the vibrations cause deformations in its beam, and the fluctuations in the voltage resistance are then translated into electrical signals. The researchers first tested the sensor’s ability to detect sound in lab tests, and then tested the sensor’s ability to monitor heartbeats in two human volunteers in their early 20s. The results, described in a study published 1 April in IEEE Sensors Journal, show that the sensor can effectively detect the two phases of a heartbeat.“The sensor exhibits excellent vibration characteristics,” Zang says, noting that it has a higher vibration sensitivity compared to other accelerometers on the market. However, the sensor currently picks up a significant amount of background noise, which Zang says his team plans to address in future work. Ultimately, they are interested in integrating this novel bioinspired sensor into devices they have previously created—including portable handheld and wearable versions, and a relatively larger version for use in hospitals—for the simultaneous detection of electrocardiogram and phonocardiogram signals. This article appears in the July 2024 print issue as “Sea Turtles Inspire Heart-Monitor Design.” Full Article Heart monitor Biosensors Journal watch
or Noise Cancellation for Your Brain By spectrum.ieee.org Published On :: Tue, 04 Jun 2024 13:06:40 +0000 Elemind, a 5-year-old startup based in Cambridge, Mass., today unveiled a US $349 wearable for neuromodulation, the company’s first product. According to cofounder and CEO Meredith Perry, the technology tracks the oscillation of brain waves using electroencephalography (EEG) sensors that detect the electrical activity of the brain and then influence those oscillations using bursts of sound delivered via bone conduction.Elemind’s first application for this wearable aims to suppress alpha waves to help induce sleep. There are other wearables on the market that monitor brain waves and, through biofeedback, encourage users to actively modify their alpha patterns. Elemind’s headband appears to be the first device to use sound to directly influence the brain waves of a passive user. In a clinical trial, says Perry [no relation to author], 76 percent of subjects fell asleep more quickly. Those who did see a difference averaged 48 percent less time to progress from awake to asleep. The results were similar to those of comparable trials of pharmaceutical sleep aids, Perry indicated.“For me,” Perry said, “it cuts through my rumination, quiets my thinking. It’s like noise cancellation for the brain.”I briefly tested Elemind’s headband in May. I found it comfortable, with a thick cushioned band that sits across the forehead connected to a stretchy elastic loop to keep it in place. In the band are multiple EEG electrodes, a processor, a three-axis accelerometer, a rechargeable lithium-polymer battery, and custom electronics that gather the brain’s electrical signals, estimate their phase, and generate pink noise through a bone-conduction speaker. The whole thing weighs about 60 grams—about as much as a small kiwi fruit.My test conditions were far from optimal for sleep: early afternoon, a fairly bright conference room, a beanbag chair as bed, and a vent blowing. And my test lasted just 4 minutes. I can say that I didn’t find the little bursts of pink noise (white noise without the higher frequencies) unpleasant. And since I often wear an eye mask, feeling fabric on my face wasn’t disturbing. It wasn’t the time or place to try for sound sleep, but I—and the others in the room—noted that after 2 minutes I was yawning like crazy.How Elemind tweaks brain wavesWhat was going on in my brain? Briefly, different brain states are associated with different frequencies of waves. Someone who is relaxed with eyes closed but not asleep produces alpha waves at around 10 hertz. As they drift off to sleep, the alpha waves are supplanted by theta waves, at around 5 Hz. Eventually, the delta waves of deep sleep show up at around 1 Hz.Ryan Neely, Elemind’s vice president of science and research, explains: “As soon as you put the headband on,” he says, “the EEG system starts running. It uses straightforward signal processing with bandpass filtering to isolate the activity in the 8- to 12-Hz frequency range—the alpha band.”“Then,” Neely continues, “our algorithm looks at the filtered signal to identify the phase of each oscillation and determines when to generate bursts of pink noise.” To help a user fall asleep more quickly [top], bursts of pink noise are timed to generate a brain response that is out of phase with alpha waves and so suppresses them. To enhance deep sleep [bottom], the pink noise is timed to generate a brain response that is in phase with delta waves.Source: ElemindThese auditory stimuli, he explains, create ripples in the waves coming from the brain. Elemind’s system tries to align these ripples with a particular phase in the wave. Because there is a gap between the stimulus and the evoked response, Elemind tested its system on 21 people and calculated the average delay, taking that into account when determining when to trigger a sound.To induce sleep, Elemind’s headband targets the trough in the alpha wave, the point at which the brain is most excitable, Neely says.“You can think of the alpha rhythm as a gate for communication between different areas of the brain,” he says. “By interfering with that communication, that coordination between different brain areas, you can disrupt patterns, like the ruminations that keep you awake.”With these alpha waves suppressed, Neely says, the slower oscillations, like the theta waves of light sleep, take over.Elemind doesn’t plan to stop there. The company plans to add an algorithm that addresses delta waves, the low-frequency 0.5- to 2-Hz waves characteristic of deep sleep. Here, Elemind’s technology will attempt to amplify this pattern with the intent of improving sleep quality.Is this safe? Yes, Neely says, because auditory stimulation is self-limiting. “Your brain waves have a natural space they can occupy,” he explains, “and this stimulation just moved it within that natural space, unlike deep-brain stimulation, which can move the brain activity outside natural parameters.”Going beyond sleep to sedation, memory, and mental healthApplications may eventually go beyond inducing and enhancing sleep. Researchers at the University of Washington and McGill University have completed a clinical study to determine if Elemind’s technology can be used to increase the pain threshold of subjects undergoing sedation. The results are being prepared for peer review.Elemind is also working with a team involving researchers at McGill and the Leuven Brain Institute to determine if the technology can enhance memory consolidation in deep sleep and perhaps have some usefulness for people with mild cognitive impairment and other memory disorders. Neely would love to see more applications investigated in the future.“Inverse alpha stimulation [enhancing instead of suppressing the signal] could increase arousal,” he says. “That’s something I’d love to look into. And looking into mental-health treatment would be interesting, because phase coupling between the different brain regions appears to be an important factor in depression and anxiety disorders.”Perry, who previously founded the wireless power startup UBeam, cofounded Elemind with four university professors with expertise in neuroscience, optogenetics, biomedical engineering, and artificial intelligence. The company has $12 million in funding to date and currently has 13 employees.Preorders at $349 start today for beta units, and Elemind expects to start general sales later this year. The company will offer customers an optional membership at $7 to $13 monthly that will allow cloud storage of sleep data and access to new apps as they are released. Full Article Alpha waves Elemind Neuromodulation Sleep Startup Wearable