AMASSAn Infoholic Mouthpiece

Edition 4 May 2018

Table Of ContentsSpotlightQuantifying Health UsingUnprecedented Data AnalysisManagement CornerFrom the CEO Editor’s Corner

Analyst Zone

Expert Column

Quotes of the Month

Tech TalkX-Ray-Detectors: EffectiveVerifying Protection EquipmentEarly Diagnosis: The WayForward to Treat NeurologicalDiseasesTransforming OrthopedicTreatments with AdvancedDevicesSolving the Hearing LossMenace With Modern Devices

SpotlightQuantifying Health Using Unprecedented Data Analysis

Role of Sequencing Data in the Future of Genomic Medicine:Collaborating Genome Sequencing with Big Data: The data-driven genomics health assessment is structured to record and identify risk factors covering most critical diseases at an early stage. The genome sequencing is gathering large volumes of genetic data and this information gets accumulated in servers across the globe.

The key in utilizing this genetic data is to have the right kind of Big Data strategy. Its ability to merge data and visualization of analytical models will play an important role in fully exploiting the value of genomic medicine to help understand different life saving patterns in real-time.

www.infoholicresearch.com

The availability of large amount of biomedical data for analysis has put the healthcare industry into splits, as utilizing this data still remains a challenge, leading the way for a remarkable opportunity of translating the information into reliable insights.

Genomics uses data science to build personalized patient strategies by enhancing diagnostic or therapeutic decision-making. The power of genomics is the stepping stone to develop the much required innovative and impactful treatment for patients by using next-generation sequencing and high-class data analysis. There has been some collaborative success achieved in integrating genetic and phenotypic data to benefit patients by Geisinger Health System and Regeneron Genetics Center (RGC). The collaboration is leveraging information using close to two million genome sequences and close to 600,000 from own clinical trials to reach drug discovery and develop-ment, covering the full spectrum of therapeutic areas.

Companies like AstraZeneca along with its partner DNAnexus are utilizing their secure cloud platform to analyze large volume of raw sequencing data. This is paving the way for processing samples from millions of patients as well as sharing of data with collaborators across the world at regular intervals.

Image: Google.com

www.infoholicresearch.com

Robust High Performing Storage System: The data sequencing genome can produce around 25 times more than the genome itself. It is estimated that close to 2.5 billion human genomes will be sequenced by 2030, which will create a requirement of around 30 Exabyte’s of storage capacity.

Personalizing Medicine Care: Sequencing data insights are driving massive improvements in personalized medicine with personal genomics being extensively used to provide customized treatment by using patient’s genetic profile. Companies are using predictive methods using combination of genetic profiles and historical outcomes to select and provide the best suited course of treatment.

Critical treatments like cancer care makes use of scientific visualization of the patients’ DNA cancer cells to arrive at specific information, which is found to be more detailed in comparison to germline information collected from a patient’s inherited DNA.

The estimated genome data is expected to surpass the data generated by astronomy & physics and has given rise to the requirement of a hyper scale, high performance cloud computing model with enhanced data storage & processing capabilities. It will act as the key differentiator between companies to compete and realize their cost efficiencies.

Management Corner

Sreenivasan K RCEO, Infoholic Research

I welcome you all to the fourth edition of Infoholic’s monthly newsletter ‘Amass’ which intends to provide an update on the latest technology trends covering diverse industries. The newsletter addresses and highlights issues of major impact that correlates with different business environment. Today's business strategies are determined by digital and technological advancement. I hope you will have a good time reading our fourth edition of the Newsletter. We intend to offer more value to you over the upcoming editions.

One thing that seems to be inevitable in today's dynamic business environment is change. Pharma sector is no different in this regard with online shipping companies like Amazon expected to enter the business directly or showcasing a probability to provide back-end dispensing support. The industry will get a facelift with pickup, packing and shipping functions thereby becoming a reality. These services will change the whole industry spectrum leading to a more compre-hensive customer service and patient care system.

This progress by companies like Amazon is expected to create massive market disruption with all big companies adopting a consumer-centric approach. Many companies are expected to offer same-day door delivery in certain markets with other pharma companies will probably create innovative business models to stay prepared for the upcoming stiff competition.

From the CEO

Editor’s Corner

Image: Google.com

Pavan Mudholkar Editor, Infoholic Research

www.infoholicresearch.com

The rising growth in geriatric population along with advancement in orthopedic and cardiovascular procedures is driving the global X-Ray Detectors market. They are mainly deployed to measure flux, spatial distribution and spectrum using different variety of detectors like films, imaging detectors, flat panel detectors and image plates.

The increasing use of detectors in security and healthcare services in the US has pushed North America to yield high-est share among the X-Ray Detectors market.

The European market is driven by the growth in manufacturing sector, along with APAC market whose growth is mainly propelled by improvements in healthcare and infrastructure sectors.

The continuous improvements in technology, innovation, better image quality and price reductions have led the X-ray detectors market to reach a CAGR of more than 6% and the revenue is expected to cross US$2 billion for the forecast period 2017-2022.

The increasing cases of cerebral stroke and other disorders of severe nature like epilepsy, Parkinsonism and Alzheimer’s are pushing the demand for neurological disorders drugs and the market is driven by development in accurate algorithms and neuro-stimulation techniques for treatment. Some of the common symptoms include seizures, pain & intellectual disability and are mainly caused by genetic, lifestyle disorders and congenital abnormalities. Diagnosing neurological diseases is one of the major challenges for modern medicine. As per a WHO report, more than one billion people are affected from neurological disorders worldwide.

Advancement in Technology: Modern X-ray detectors like Digital X-ray systems use X-ray imaging technology with sensors instead of photographic films. It has the ability to digitally transfer image and can provide the images at higher resolution and low radiation exposure. It can provide the results in a very short span of time with better time efficiency and accuracy, making it apt for medical and other security sectors.

Chronic Diseases and Geriatric Growth: The increase in chronic diseases like cancer, arthritis, respiratory diseases and orthopedic problems has largely influenced the rapid surge of X-ray detector market. The demand for early diagnosis and the pressure to provide healthcare services to the entire population has pushed the industry to constantly invent new innovative devices that can fulfill the requirement of patients in a fruitful manner.

Rise in Government Initiatives: Governments, across the world, are consistently enhancing their investment in healthcare technology every day. Many international organizations are extending their helping hand, in terms of monetary and technical support. This has pushed Government-run healthcare institutes across the globe to upgrade their infrastructure to the highest levels, few of which include modern X-ray equipment and devices, further pushing the market to new heights.

Reliable Security Scanner: It is extensively used as a security device to detect prohibited items within briefcases, backpacks and other small packages. It can perform the function of superior imaging detector that ensures the rapid detection of all kinds of dangerous goods, weapons, drugs, explosives and other contraband products. The X-ray security baggage scanner meets different environmental requirements and can be set up at multiple security checkpoints including government buildings, companies and passenger terminals.

X-Ray Detectors: Effectively Verifying Protection Equipment

Major Factors Driving the X-Ray Detectors Market Include:

Early Diagnosis: The Way Forward to Treat Neurological Diseases

Tech Talk

Image: Google.com

www.infoholicresearch.com

It is estimated that more than 6 million people die on a yearly basis due to neurological disorders.

The market is expected to cross $100 billion by 2020, covering more than 90% of drugs related to sclerosis, Alzheimer and Parkinson diseases. Neuro-stimulation devices are forecasted to achieve high demand because of its prominence to treat locomotor and nervous disor-ders.

North America is expected to have the largest market because of the increase in neurological disease cases as well as rapid technological advancements, followed by Europe whose market is driven by rise in aging population and huge R&D investment. The Asia Pacific region is expected to grow at a fast pace driven by the rise in neurological disorders, rising awareness and better infra-structure facilities.

Arti�cial Intelligence to Diagnose Neurological Conditions: In the coming years, AI will play a critical role in identifying traumatic brain injuries using CT scans along with its ability to help store complex disease information. Further, this information will be used to build knowledge base system which will help to determine neurological disorders.

Future of Technology in Enhancing Neurological Disease Treatment:

Advanced Computing Algorithm: The computing algorithm makes use of multiple scan reports and data to precisely identify the condition of tissues during brain surgeries. This information is further used to restore neurological functions in patients.

Brain Biomarkers: Latest diagnostic equipment and devices allow doctors to identify psychiatric and neurodegenerative disorders in spinal fluid, blood. These biomarkers are helping to ensure better and early diagnostic approaches in the future which will help to provide better treatment.

Automated CAD System to Treat Neurological Conditions: Automated CAD system will help in detecting neurological abnormalities using big data. The advanced CAD algorithms will use pattern recogni-tion field techniques to help experts interpret medical big data to accurately diagnose neurological disorders and their conditions.

Smart Chip for Neural Implants: A smart chip has been developed to wirelessly transmit brain signals to different parts of the body. The data registered by these devices helps in curtailing diseases like Parkinson and provides support to paraplegic patients in moving their prosthetic limbs. The device analyzes the data before sending it back and transmits only that data which is required, drastically decreasing power consumption; making the product more viable.

Advanced equipment and innovative designs like titanium-based orthopedic devices and bio-absorbable implants are pushing the orthopedic device market to new heights. These devices are mainly used to restore deformed bones and to normalize postures.

Among the orthopedic devices market, the growing cases of spinal deformities like disc compression, artificial spinal disc and nucleus are driving the spinal device market to an estimated CAGR of around 9.0% during the forecast period 2017-2021,with the revenue expected to cross $15 billion by 2018.

Transforming Orthopedic Treatments with Advanced Devices

Image: Google.com

Image: Google.com

www.infoholicresearch.com

The joint reconstruction market expected to cross $20 billion by 2018 which is driven by the enhancement in medical technology and aging population.

North America is expected to have maximum share of the orthopedic devices market due to higher osteoarthritis cases and geriatric population, followed by Europe, which has improved their regulatory framework leading to an increase in healthcare expenditure.

The need for operational procedures and therapies that lead to reduced cost and time will be the road forward for orthopedic devices. Patients will look for devices that can provide customized and intelligent outcomes by creating a good blend of traditional and high-end techniques.

The APAC region is witnessing rapid economic growth, the key reason for the growth of the healthcare industry.

The future looks bright with customized implants, microprocessors-based smart implants and real-time tracking devices dominating the market. Customers are looking for preventive measures rather than curative actions which is pushing the focus on gene therapy and tissue engineering techniques.

Healing Process with Orthobiologics: Orthobiologics harness the regenerative potential of the cells in the human body. Orthobiologics, which are made with naturally found substances in the body are used to heal injured muscles, broken bones and ligament tears. Recent innovations show drug-eluting bone grafts can be used to heal problems related to orthopedic surgical infection.

Smart Implants the Way Forward: Sensor-enabled devices are enabling healthcare providers with unique and cost-effective products. Smart implants are providing real-time information using sensors to surgeons to get a know-how of the bone positioning. This helps in post-operative evaluation leading to enhanced patient care all along the treatment pathway; reducing problems like periprosthetic infection.

Robotic for Orthopedic Surgeries: Using robots for orthopedic surgeries provides better reproducible precision leading to faster recovery times. The future will witness more enterprises investing the technology as it provides better navigation enhancing the operative performance. It further helps in designing of customized joints using 3D scans.

Enhancing Surgical Procedures: Advanced surgical procedures like minimally invasive surgeries, tissue-guided surgeries, motion preservation techniques and cement-less joint replacements are enhancing the treatment pattern. The future will also see use of motion preservation techniques for total disc replacement, along with advanced stabilization devices that help in easy mobility.

Innovation is the Future for Orthopedic Device Industry:

One of the serious emerging health issues across the world has been hearing loss. Today's hearing aids have overcome stigma associated with the old and bulky hearing-aid devices with newly incorporated digital sound devices which are small and precise.

The devices can be adjusted easily according to the user's requirement to get the best sound experience with technological advances like directional microphones which help to enhance speech understanding by fading out unwanted surrounding noise.

The various initiations and awareness campaigns run by governments and NGOs along with good number of growth in hearing loss patients are the primary reasons driving the hearing aid devices market. The advancement in 3D technology has enhanced the hearing aid devices and it is pushing the expected revenue to reach more than US$9 billion by 2020 at a CAGR exceeding 6.0% during the forecast period 2017-2021.

Among the regional bifurcation, Europe is forecasted to occupy the highest market share, driven by factors like aging population and large patient pool suffering from hearing loss problems.

Solving the Hearing Loss Menace with Modern Devices

Image: Google.com

www.infoholicresearch.com

Different Hearing Aid Position Types:

Sleep Apnea Market: Booming Side of the Respiratory Care Devices Industry

Respiratory disease has been a major concern lately due to urbanization and increasing pollution. According to WHO, 235 million people are currently suffering with asthma and it is very common among children. In 2013, 401 thousand deaths were due to respiratory diseases in the European Union, which was equivalent to 8% of total death in the region.

It was seen that the proportion of death in developed countries like UK and Germany was high too. In countries like India, one in 10 deaths is due to a respiratory disease.

Sleep apnea is a condition in which a person stops breathing for few seconds during the night either due to airway blockage or no signal from the brain. In severe condition, a person stops breathing more than 10 times in an hour. According to the American Journal of Epidemiology, approximately 26% of adults aged 30–70 had sleep apnea disorder, among which 16% of them had mild sleep apnea and 10% had severe sleep apnea. Various other major respiratory diseases prevailing worldwide are Asthma, Chronic Obstructive Pulmonary Disease (COPD), Cystic Fibrosis, Pulmonary Fibrosis, Pneumonia, Acute Respiratory Distress Syndrome, and Tuberculosis.

Invisible in canal: It is custom-designed to fit deep in the ear canal with minimum visibility. The device is more suitable for first-time users with moderate hearing problem. It has enhanced features like Omni-directional microphone and very basic remote control and Bluetooth connectivity options.

Completely in canal: It is designed to substitute behind the ear styles and is suitable for users who are athletically active. It can be custom used with mild as well as severe hearing loss. It makes use of very small disposable batteries and has remote control and Bluetooth connectivity options as well.

Mini canal: The custom-built hearing aid device is slightly bigger than the completely ‘in canal’ design. It is equipped with directional microphones and is one of the best performing hearing aids suitable to handle both - moderate as well as high background noise situations. Most of the companies provide this design to customers, with remote control and Bluetooth connectivity options.

Receiver in the ear: It is suitable for mild and severe hearing loss and comes with a wide range of power options. In this device, the sound is transmitted to the ear using a coated wire to the receiver in the canal. It is equipped with directional microphones. Bluetooth connectivity and remote control options are available with most of the manufacturers.

Extended Wear:This pattern ofhearing aids canbe used round theclock for monthswithout taking it out whilesleeping, exercising or evenwhile taking bath. The deviceneeds to be installed by a specialistin your ear.

Analyst Speak

Image: Google.com

Image: Google.com

By: Victor Mukherjee, AM (Healthcare), Infoholic Research

www.infoholicresearch.com

Sleep apnea is a condition in which a person stops breathing for few seconds during the night either due to airway blockage or no signal from the brain. In severe condition, a person stops breathing more than 10 times in an hour. According to the American Journal of Epidemiology, approximately 26% of adults aged 30–70 had sleep apnea disorder, among which 16% of them had mild sleep apnea and 10% had severe sleep apnea. Various other major respiratory diseases prevailing worldwide are Asthma, Chronic Obstructive Pulmonary Disease (COPD), Cystic Fibrosis, Pulmonary Fibrosis, Pneumonia, Acute Respiratory Distress Syndrome, and Tuberculosis.

Evolution of Sleep Apnea:

Growth Factors

Latest Technological Advancements for Sleep Apnea DevicesThe University of Texas at Arlington has developed a collar like device, which is used for the diagnosis of sleep apnea. This device has an ultrasonic sensor, which sends ultrasonic waves to sense obstructions in the person’s airways throughout the sleeping time.

Nyxoah S.A., a company located in Belgium, has developed a neurotransmitter implant device, which holds the back of the tongue, thus widening the airway passage. On placement, it is expected to work for at least 12 years. This discovery presently holds a total of 11 patents.

ApniCure Inc., a US-based company, has developed an oral pressure therapy that can be used by adults for home care. It creates a negative pressure that holds the soft palate and tongue, avoiding the blocking of the airway. This device has a vacuum console, a mouthpiece, and a sleek tubing set.

ImThera Medical Inc. has developed Aura6000 Targeted Hypoglossal Neurostimulation (THN) Sleep Therapy System. It has both implanted and external elements, which makes it compatible for a different variety of people. In this technology, the hypoglossal nerves are activated to prevent OSA episodes. The device has a multi-contact electrode responsible for pulse generation with a single lead wire.

Sleep potrays a very important role in healing and repairing of our heart and blood vessels. However, inspite its importance, most people are not prioritizing sleep over other activities. Hence, numerous stakeholders have emerged with latest technologies to treat insomniacs. Sleep lab and home test devices, CPAP masks, premium mattresses and pillows, Rx and OTC sleep medications, apps, and sound machines are few of the examples. The solution providers are investing more than ever. Likewise, vendors such as Inspire Medical, are filing for initial public offering of stock focusing on sleep apnea market.

The Pure Sleep Company from the US has launched an anti-snoring device where a mandibular repositioning technique is used to clutch the lower mandible slightly frontward which creates a passage for breathing, thus eliminating vibrations and snoring.

Inspire Medical Systems has developed a pacemaker-like device which passes a mild pulse to the tongue and throat muscles to keep air flowing. Recently in January 2017, the device was implanted inside a 67-year-old person, making him the first person to receive this treatment

Obstructive sleep apnea was observed in ancient times over 2,000 years.19th century: The term “Pickwickian Syndrome” was adopted to describe apneic symptoms.1960s: Discovered that obesity was not essential for OSA.1970: The first sleep clinic was established at Stanford University, US.1975–1980: 319 Articles were published about research on sleep apnea.1978: J.E. Remmers et al. resolved that airway obstruction occurred during sleep apnea.

1979: Colin Sullivan designed a mask to fit a dog with snout to deliver air.

2000: The association between hypertension and OSA was published in four articles.2001: Studies showed that the presence of sleep apnea leads to increased prevalence of coronary heart diseases, heart failure, and stroke.

Twelve years later Young et al. published the first epidemiologic study of OSA prevalence and reported that 2% of middle-aged women and 4% of middle-aged men have sleep apnea.

Previously, the sleep apnea treatment used to be provided in hospitals with the help of big and stand-alone PAP devices. As the demand for home care treatment increased, manufacturers started focusing on compact and user-friendly devices. In January 2017, ResMed launched the world’s smallest CPAP device. The latest CPAP device from Inspire Medical does not require the use of masks, which is one of the problems in traditional CPAP device.

Hence, technological advancements in both, therapeutics and diagnostics devices, along with huge demand from the undiagnosed sleep apnea patients are boosting the growth of global sleep apnea devices market with a CAGR of 7.6% during the forecast period 2017-2023.

Sleep Apnea Devices Market Revenue Shareby Products

Chart 01

TherapeuticDevices: 89%

DiagnosticsDevices:11%

“

”- Rikitha Krishnamurthy, Research Analyst (Healthcare), Infoholic Research

Source: Infoholic Research

www.infoholicresearch.com

Since India has made forays into modern healthcare, the focus has been on cure solely via medicines, and that do not consider the support of other factors. Slowly, as we begin to learn more about medical science, modern medical treatments have begun to understand the importance of other factors such as food and patient’s comfort for quicker healing.

Internationally, more hospitals have adopted therapeutic diets to supplement healing. In India, though we have had this form of treatment historically, we are yet to rediscover it in its entirety.

Nutraceuticals have begun to catch on in India in a big way. The worldwide nutraceutical industry, esteemed at $182.6 billion out of 2015, is one of the quickest developing industries today and it is anticipated that it would expand at a CAGR of 7.3% from 2015 to 2021. India is one of the fast-developing markets in the Asia-Pacific region. According to a recent report, the nutraceuticals industry in India is worth approximately $2.2 billion and is anticipated to grow at 20% to touch $6.1 billion by 2019-2020.

The growth of this industry can be primarily attributed to the change of the Indian way of life. Faster pace, stressed lifestyles, unhealthy eating habits have taken a toll on well-being and health. Lifestyle diseases such as diabetes and hypertension have become extremely common. Naturally, the awareness towards well-being has been growing, and people have begun adopting nutraceuticals as a part of their everyday diet.

In times of distress, when hospitalized, they have had to rely on the bland diet provided by hospitals. Mostly, hospitals that have 80-100 beds and above have a practice of offering catering facilities for its patients. These hospitals have to cater to a wide variety of patients and end up serving the lowest common denominator - food that is safe for everyone. This often results in diets that feed you but do not necessarily help the specific condition or disease. The treatment for the disease is solely taken care by medicines and not food.

Hospitals in India are beginning to realize the importance of food in the overall healing process and attempting to serve personalized meals for patients. Diabetes, renal failure, pre-natal and post-natal treatments for women are some of the treatment areas where hospitals are exploring personalized diets.

This form of retail catering can aid hospitals that have in-house catering reduce their food bills by almost 80%. Hospitals that do not have a patient catering outfit can explore external retail catering outfits that can supply these specialized meals - either in the form of plated meals or ready-to-eat packaged diets, tailored for each condition. The challenge in this field lies in the suppliers of such therapeutic diets. It takes extensive knowledge of medicine as well as food to ensure the right pairing of ingredients for healing. The secondary challenge is meeting the required price point. Retail catering is cheaper than traditional hospital catering, but the years of investment in R&D does have a separate price component. And cost is one of the key components in this field. Personally-catered meals often add to the already hefty hospital bills, though they are cheaper in the long-run and hospitals can pass the cost benefits to the patient.

When it comes to nature of the food being served, cleanliness and sanitation kept up in the arrangement and serving premises assumes a key part in the support of well-being. Although foods are being checked with significant care amid preparation, there are odds of contamination with remote particles. For the most part, foods given to the patients are thought to be pricey and frequently not acknowledged by patients due to flat taste.

A few cases of regular therapeutic diets are gluten free diet, clear fluid diets, full fluid diets, no-concentrated sweet diet, diabetic (calorie controlled) diet, low-fat diet, high-fiber diet, no additional salts diet and a lot more. Diabetic diet is a standout amongst the most widely recognized therapeutic diets which include restricting high sugar foods to enable control blood sugar levels.

The idea of food synergy makes food more nutritious and delicious with therapeutic benefits. We can look forward to more such pairing of foods with research advancements in future.

Looking Beyond Traditional Foods at Hospitals

The Pure Sleep Company from the US has launched an anti-snoring device where a mandibular repositioning technique is used to clutch the lower mandible slightly frontward which creates a passage for breathing, thus eliminating vibrations and snoring.

Inspire Medical Systems has developed a pacemaker-like device which passes a mild pulse to the tongue and throat muscles to keep air flowing. Recently in January 2017, the device was implanted inside a 67-year-old person, making him the first person to receive this treatment

Expert Column

VijaysuryaCEO, NutriParadise Foods LLP

Image: nutriparadise.com

Quotes of the Month

“The lack of financial strength to avail healthcare

is a major challenge”- N. R. Narayana Murthy

“Organizing healthcare information is a daunting

task, but it is not an impossi-ble task. We've had people walk on the moon. This is a

lot more doable”- Bill Maris

The goal of real healthcare reform must be high-quality,

universal coverage in a cost-effective way”

- Bernie Sanders

Copyright @ 2018, Infoholic Research

You are receiving this email becauseyou are a user of infoholicresearch.com

Please share your candid feedback andadditional improvement areas of our

Newsletter at feedback@infoholicresearch.com