November 20, 2019

Exponential Medicine 2019 - Day 3 - Cool Stuff Summary

INTRO / SUMMARY

Day 3 - Wednesday November 6, 2019

Cool Stuff Summary: this collection of slides is certainly not a comprehensive summary of the conference, but some of the points I wanted to remember. Occasionally [My comments are inserted in brackets with bold italics]

The Day 3 live stream is  available on YouTube. I wasn’t able to attend this year’s Exponential Medicine in person.

Watch this article as a video

Exponential Medicine 2019 Summaries

Day One   |   Day Two  |   Day Three (this article)   |   Day Four

Trends out of Day 3

A year has led to much deeper understanding of the microbiome and actual correlation of the data with disease expression.

Modulating angiogenesis (blood vessel formation) was mentioned in a number of the presentations. Will this be a research fad? or does it hold the answer to treatment of a number of conditions? Time will tell.

The food as nutrition movement presented far more research based findings than I have seen before. I used to think this space was complete quackery, but it may turn into a scientifically interesting space to watch.

The benefits of exponential technologies to have a significant impact in terms of being able to scale healthcare delivery to low resource areas around the world is a significant step forward in the conversation of ‘medical-technology’. In prior years, the conversation was far more centred around the use of medical technology at high resources areas.

Fungi research continues to have powerful findings.

Session 16
Neuromedicine At The Frontier

“Our understanding of the brain and mind is accelerating. This session will explore the cutting edge, from consciousness, to preventing and treating neuro pathologies.”

16.1. Neuroscience

Divya Chander MD PhD, Chair for Neuroscience, Singularity University

Santiago Ramón y Cajal was frist person to take idea of brain mapping seriously. Drew photos of neutrons.

View fullsize
View fullsize

We continue to try to map the brain’s connections.

Screen Shot 2019-11-12 at 7.24.59 PM.png
View fullsize
Screen Shot 2019-11-12 at 7.25.13 PM.png
View fullsize
Screen Shot 2019-11-12 at 7.25.56 PM.png
View fullsize

One of the early targets of such research is the ability to be able to create a ‘bionic eye’ for those with vision loss.

View fullsize
View fullsize
View fullsize

There is also potential to synthesize speech from brain way activity for those who are unable to articulate their mouth.

View fullsize

Deeper human-machine interfaces has potential to dramatically transform the lives of those with paralysis and other physical disabilities.

Screen Shot 2019-11-12 at 7.30.44 PM.png
View fullsize
View fullsize



16.2. Alzheimers’s Prevention & Treatment

Rudolph Tanzi PhD, Professor of Neurology, Harvard Medical School. Co-Director Center for Brain Health at Massachusetts General Hospital.     @RudyTanzi

Contextual integration: some people ‘feel’ the ground shaking when they watch this video. Their body knows what it should expect based on the visual input

View fullsize

In Alzheimer's disease one theory is that there is loss of contextual integration. E.g. I smell rotten food, I shouldn’t eat that. Over time this is lost.

View fullsize

In order to halt Alzheimer’s we need to stop neuro-inflammation. Problem is drugs to effectively do this have failed.

View fullsize

Once one has full 'dementia’ they have had years of accumulation of plaques and tangles from neuroinflammation.

Our diagnosis of Alzheimer’s disease is coming too late. “We do not diagnose Alzheimer’s Disease until the brain has degenerated to the point of dysfunction.” “Imagine if we did the same with cancer, diabetes, and heart disease!”

View fullsize
View fullsize
Screen Shot 2019-11-17 at 6.56.13 PM.png
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-17 at 6.58.39 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-17 at 6.59.12 PM.png
View fullsize
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-17 at 7.00.11 PM.png
View fullsize

Research into use of eye tracking headsets as a surrogate marker of neuro-inflammation.

16.3  Brain, Oxygen, and Recovery

Shai Efrati MD, Director of The Sagol Center for Hyperbaric Medicine and Research. Tel Aviv University

Screen Shot 2019-11-17 at 7.05.55 PM.png
View fullsize

The wound on the foot, and the wound in the brain are similar. If we control inflammation on the foot, it can heal. In a similar way, if we could control the inflammation in the brain - perhaps it could heal too.

View fullsize
View fullsize
View fullsize
View fullsize

Oxygen is a limiting factor for brain activity.

  • The brian uses 20% of the oxygen in the body.
  • The brain always uses up 100% of the oxygen that is delivered to it.
  • Oxygen get redistributed through the brain to the activity of interest.

The hyperbaric chamber can be used to study people performing single and dual tasks. This study looked at healthy participants who were asked to perform a single or dual task at normobaric (regular oxygen) conditions, compared against hyperbaric (extra oxygen) conditions.  There was a improvement in task performance with the extra oxygen.

View fullsize

We know this limitation of brain activity, by our inability to do complex multi-tasking

Screen Shot 2019-11-17 at 7.13.41 PM.png
View fullsize

2. TRIGGER

  • What is the trigger for the body to sense hypoxia? It is the rapid decrease in oxygen change that is the trigger.
View fullsize

A hyperbaric environment enables oxygen to reach areas of the brain through oxygen tissue diffusions, that may be blocked by delivery from occluded vessels.

View fullsize

THESIS: it is possible to stimulate angiogenesis in the brain? To help heal the brain from stroke.

View fullsize
View fullsize
View fullsize

Which patients should receive this therapy? Can map this using MRI imaging. Is there a wound that may be amendable to therapy in the area of deficit.

“Our buisness is wound care”

View fullsize
View fullsize



16.4  Viome

Guru Banavar, CTO, Viome     @banavar

Viome: about 100,00 customers

THESIS: Gene expression, not genetics, is a major player in chronic disease.

View fullsize

E.g. when you have Chron’s disease there are periods where you are healthy and periods with illness. Is this a result of altering expression of your genes. Because your genetics aren’t changing between flares.

Screen Shot 2019-11-17 at 7.23.25 PM.png
View fullsize

Can we check the expression of your genes from your blood?

Screen Shot 2019-11-17 at 7.24.35 PM.png
View fullsize

What can we do today with this testing?

  • Can predict within 8 years your age.
  • Can we model how your body will respond to different foods.
  • Their model can predict glucose response to foods much better than the traditional method of ‘calorie counting’ that those with diabetes do,
  • Several very clear markers of irritable bowel syndrome.
View fullsize
View fullsize
Screen Shot 2019-11-17 at 7.26.17 PM.png
View fullsize
View fullsize
View fullsize
View fullsize

Can find a signature for oral cancer in the gut microbiome.

View fullsize
View fullsize

16.5  Mental Health

Kristian Ranta, CEO & Founder Meru Health     @ihqkristian

Showing superior long term outcomes. (Though not testing RCTs yet).

View fullsize
View fullsize
View fullsize



Session 17
The Future Of Clinical Care: AnyTime, AnyWare, AnyBody.

“Who does what, when and where? New tools for preparation and practice to upskilling and collaboration. The blending of in-person and virtual care, avatars, to AI enabled decision support is reshaping how and where healthcare happens.”

Jennifer Radin, Healthcare Chief Innovation Officer & Future of Work Leader, Deloitte Consulting

View fullsize
View fullsize
View fullsize

Shafi Ahmed MD, Professor of Surgery Barts Medical School.    @ShafiAhmed5

Screen Shot 2019-11-17 at 10.15.25 PM.png
View fullsize
View fullsize

The image below was hands free manipulation of 3D images on the television via used of Hololens. Quite smooth and accurate from what I could tell.

View fullsize
View fullsize
Screen Shot 2019-11-17 at 10.17.48 PM.png
View fullsize
View fullsize

Colon polyp identified via machine vision on colonoscopy. A few years ago this concept was just something for the future. This October 2019, Medtronic released a colonoscopy technology that places visual markers in real-time on pre-cancerous lesions.

http://newsroom.medtronic.com/news-releases/news-release-details/medtronic-launches-first-artificial-intelligence-system

Screen Shot 2019-11-17 at 10.20.07 PM.png
View fullsize

Use of AR to expand first responder’s capabilities

View fullsize

Danny Thomsett Digital Humans, CEO, UneeQ     @DannyTomsett

“Digital Humans” ability to scale to provide better experiences.

Unique human creation process based on the needed user.

Common issue that holds patients back from being honest in medical care is judgment. Therefore they are willing to share more with the digital human than with

View fullsize
Screen Shot 2019-11-18 at 7.35.23 AM.png
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize

Marie Johnson, Centre for Digital Business     @mariehjohnson

Important that design includes people with disability.

Screen Shot 2019-11-18 at 7.39.02 AM.png
View fullsize

In the UK, 60% of the population has grade 5 reading ability. Whereas most documentation in the UK is produced at a grade 10 level.

View fullsize

Digital cardiac coach

View fullsize
View fullsize
View fullsize

Look for common patterns of healthcare conversations, to build digital humans around this.

View fullsize

Clinton Phillips, Founder & CEO, Medici     @ClintGPhillips

10 million members to date

benefits of virtual

  • Less wait
  • Better digital intake
  • Language is no longer a basis
  • Better long term education via digital
  • Collaboration easier to bring in other specialise
  • Engagement in digital world can begin before the patient gets sick
  • Geography is not an issue in the digital world
  • Outcomes are better when patients have regular interactions with their doctors
  • Doctors
  • Satisfaction of patients on average for in clinic visits is rated 1 star, whereas for a virtual experience across multiple platforms it is 4.5 stars
View fullsize
View fullsize
Screen Shot 2019-11-18 at 7.44.38 AM.png
View fullsize

Julia Hu, CEO/Founder Lark Healthcare @JuliaHuCEO

The world’s largest AI healthcare provider, treating nearly 2 million patients with

Why did she start Lark? She had a misdiagnosed disease for 12 years. Wanted to understand better how to scale healthcare.

View fullsize
Screen Shot 2019-11-20 at 8.02.36 AM.png
View fullsize

THESIS: Care protocols via conversational chat. Coach you in the moment.

View fullsize
Screen Shot 2019-11-20 at 8.03.07 AM.png
View fullsize

Goal - short five minute conversations, in the moment, when people need help.

Will coach you based on what you are doing in the moment.

View fullsize
View fullsize
View fullsize

Their AI system, is the equivalent of 14,833 “nurses added” to healthcare.

View fullsize
View fullsize
View fullsize

Ardy Arianpour, CEO Seqster

The personalized health record.

View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 7.59.19 AM.png
View fullsize
View fullsize

Ted Goldstein PhD, C hief A.I. Officer, Anthem Inc.     @tedgoldstein

Kira Radinsky PhD, Co-founder, Diagnostic Robotics     @KiraRadinsky

THESIS: use of AI to triage medical issues that can be dealt with outside the emergency room

View fullsize
View fullsize
View fullsize
View fullsize

Creation of a knowledge graph from patient record and data.

Screen Shot 2019-11-18 at 8.06.29 AM.png
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize

The medical record is incomplete sometimes, because of the variation between what the patients report, and what is documented.

  • When patients report “constant pain” it is only documented as “constant pain” 20% of the time.
  • 21% of patients reported paid radiates to the left side. Doctors write this 5% of time
View fullsize

The top result isn’t always correct, but they frequently surface an answer to the top three

Screen Shot 2019-11-18 at 8.09.19 AM.png
View fullsize

Example 1 of system

Screen Shot 2019-11-18 at 8.09.53 AM.png
View fullsize
Screen Shot 2019-11-18 at 8.10.28 AM.png
View fullsize

Example 2 of system. This time the answer after investigation was the second proposed answer.

View fullsize
View fullsize

They are finding the system generally effective when applied to different data sets with different populations.

Screen Shot 2019-11-18 at 8.11.47 AM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 8.11.58 AM.png
View fullsize

Value of this system is its ability to deliver care at scale.

View fullsize
View fullsize

Rajeev Ronanki, SVP and Chief Digital Officer, Anthem     @RajeevRonanki

View fullsize
View fullsize
View fullsize
View fullsize



Session 18
Nutrition, Health And Food Of The Future

“Let Food be Thy Medicine” (Hippocrates). The science of nutrition is rapidly evolving, as are new forms of FoodTech. What are the implications for the environment, to prevention to treatment of disease.

William Li MD, Founder, Angiogenesis Foundation     @drwilliamli

View fullsize
Screen Shot 2019-11-18 at 12.05.02 PM.png
View fullsize
Screen Shot 2019-11-18 at 12.05.23 PM.png
View fullsize
View fullsize

Advancements in nutrition sciences:

View fullsize
View fullsize
View fullsize

Angiogenesis as a root of a number of conditions

View fullsize

The “biological potency” of a number of common medications and cancer drugs.

View fullsize

The same graph above, but with inclusion of dietary foods “food as medicine” compounds.

View fullsize

About a cup of soy.

View fullsize
View fullsize
Screen Shot 2019-11-18 at 12.21.12 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 12.23.23 PM.png
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 12.24.25 PM.png
View fullsize
View fullsize
View fullsize
View fullsize

Flavorome looks to connect the biologic effect of multiple foods together into common categories.

View fullsize
Screen Shot 2019-11-18 at 12.28.01 PM.png
View fullsize

Session 19
Planetary, Global & Public Health

From climate change to pandemic disease, novel approaches are needed to address these grand challenges and to apply technologies that democratize and improve healthcare at a global level.

Moira Gunn, Tech Nation    @biotechnation

Michelle A. Williams, SM, SD, Dean, Harvard T.H. Chan School of Public Health    @HarvardChanDean

  • Concept of “Planetary Health
Screen Shot 2019-11-18 at 12.35.51 PM.png
View fullsize
View fullsize

Paul Auerbach MD. Emeritus Professor. Stanford, Dept of Emergency Medicine. Founder, Wilderness Medical Society. Author of Enviromedics     @PaulAuerbachMD

  • Our first response systems can’t respond to multiple environmental disasters at the same time
View fullsize
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 12.43.54 PM.png
View fullsize

Stephen Hunt MD PhD, Professor, University of Pennsylvania     @md_rogue

View fullsize
View fullsize
View fullsize
View fullsize
View fullsize



Session 20
The Things That Kill Us: #ThisIsOurLane

Clinicians and patients are increasingly becoming activists at the social and policy level on matters of public health addressing a range of issues including gun violence, vaccination rates and clinician well-being and burnout. Hear from those on the frontlines of hashtags making a difference.

Megan Ranney, MD MPH, Brown University Associate Professor of Emergency Medicine, Health Services, Policy & Practice. Chief Research Officer of American Foundation for Firearm Injury Reduction in Medicine     @meganranney

This was a very good talk on the issue of firearm injuries. I think both non-gun owners, and gun-owners will find Dr Ranney’s approach here quite reasonable.

In short: the major focus of the talk is on the fas that 2/3 of gun-related deaths are suicide. Therefore, there are a number of ways that public health interventions (such as locking up firearms during periods of vulnerability) can help save lives.

Screen Shot 2019-11-18 at 12.58.44 PM.png
View fullsize
View fullsize

Although there are a lot of gun deaths in the USA. Most guns don’t cause deaths.

View fullsize

Firearm deaths have not decreased in the USA

Screen Shot 2019-11-18 at 1.00.25 PM.png
View fullsize

There is almost a direct correlation between improved outcomes, and research funding.

In terms of gun violence, this area is underfunded, and perhaps that is also why there are too many deaths in the area, and without decline in the last few decades.

Screen Shot 2019-11-18 at 1.00.35 PM.png
View fullsize

Those at risk of depression, suicide, inter partner and interpersonal violence are highest risk.

View fullsize

In periods of depression, locking up guns can help save lives.

View fullsize

Mapping of facilities where gun owners can store their guns so that they are out of the house.

Helps reduce deaths from impulsive behaviour during a depressive period.

Screen Shot 2019-11-18 at 1.02.12 PM.png

Kristina Saffran. Co-founder and CEO, Project HEAL

Eating disorder research:

View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.08.59 PM.png
View fullsize
View fullsize

Lori Boyle, BSN, MS, APRN. Nurses Who Vaccinate     @KristinaSaffran

View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.13.49 PM.png
View fullsize

Stephen Eisenberg, DO. Oncologist & Co-founder cCARE.com: CPR for the Doctors Heart     @drseisenberg

View fullsize
View fullsize
View fullsize
View fullsize

Don’t become an heartless robot going through the actions when providing healthcare.

View fullsize



Session 21
The Things That Save Us: Mushrooms, Mycology & Medicine

A keynote from the world’s leading mycologist and medical researcher on the role of fungi in environmental and human health.

Paul Stamets, Founder, Fungi Perfecti     @PaulStamets

The largest organisms in the world is fungi mycelium.

Screen Shot 2019-11-18 at 1.19.06 PM.png
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.19.40 PM.png
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.19.59 PM.png
View fullsize
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.21.05 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.21.18 PM.png
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.22.04 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.22.13 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.22.24 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.22.31 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.23.23 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.24.45 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.24.53 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.25.27 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.25.59 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.26.22 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.30.41 PM.png
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.32.17 PM.png
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.34.05 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.34.11 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.35.04 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.35.08 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.35.14 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.36.13 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.36.33 PM.png
View fullsize
View fullsize



Session 22
MEDy (M.edical E.ntrepreneurship & D.isruption)
Startup Awards

Selected winners share their innovative startups

View fullsize
Screen Shot 2019-11-18 at 1.42.48 PM.png
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.45.13 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.46.00 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.46.06 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.47.08 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.47.31 PM.png
View fullsize
Screen Shot 2019-11-18 at 1.48.52 PM.png
View fullsize
View fullsize
Screen Shot 2019-11-18 at 1.49.18 PM.png
View fullsize
View fullsize

Let me know if anything looks incorrect. I’ve tried to summarize the presentations accurately, but haven’t had chance to externally verify what presenters claimed to be true.

Exponential Medicine 2019 Summaries

Subscribe for updates

Get an email update weekly, monthly, or quarterly.
Subscribe