Wednesday, April 26, 2017

Exciting New treatment for Prematurity from CHOP!


This extraordinary achievement should move the art of premature infant care into a new era.
DOI:10.1038/ncomms15112

Nature Communications
ARTICLE
Received 25 Apr 2016 | Accepted 2 Mar 2017 | Published 25 Apr 2017
An extra-uterine system to physiologically support
the extreme premature lamb
Emily A. Partridge1,*, Marcus G. Davey1,*, Matthew A. Hornick1, Patrick E. McGovern1, Ali Y. Mejaddam1,
Jesse D. Vrecenak1, Carmen Mesas-Burgos1, Aliza Olive1, Robert C. Caskey1, Theodore R. Weiland1,
Jiancheng Han1, Alexander J. Schupper1, James T. Connelly1, Kevin C. Dysart2, Jack Rychik3, Holly L. Hedrick1,
William H. Peranteau1 & Alan W. Flake1
In the

In the developed world, extreme prematurity is the leading cause of neonatal mortality and
morbidity due to a combination of organ immaturity and iatrogenic injury. Until now, efforts to
extend gestation using extracorporeal systems have achieved limited success. Here we report
the development of a system that incorporates a pumpless oxygenator circuit connected to
the fetus of a lamb via an umbilical cord interface that is maintained within a closed ‘amniotic
fluid’ circuit that closely reproduces the environment of the womb. We show that fetal lambs
that are developmentally equivalent to the extreme premature human infant can be
physiologically supported in this extra-uterine device for up to 4 weeks. Lambs on support
maintain stable haemodynamics, have normal blood gas and oxygenation parameters and
maintain patency of the fetal circulation. With appropriate nutritional support, lambs on
the system demonstrate normal somatic growth, lung maturation and brain growth and
myelination.
DOI: 10.1038/ncomms15112 OPEN

1

Thursday, April 6, 2017

The Key To Telemedicine(and everything else!)

The Future is Digital as we know- The Massive benefits are mixed with a notable Risk
India
By Raoul Pal
March 2017
Companies that create massively outsized technological breakthroughs tend to capture the investing population’s attention and thus their share prices trade at huge multiples, as future growth and future revenues are extrapolated into the future.
From time to time, entire countries re-model their economies and shift their growth trajectory. The most recent example was the liberalisation of China’s economy and massive spending on infrastructure, which together created an incredibly powerful force for growth over the last two decades.
But it is very rare indeed that a country develops an outsized technological infrastructure breakthrough that leaves the rest of the world far behind.
But exactly this has just happened in India... and no one noticed.
India has, without question, made the largest technological breakthrough of any nation in living memory.
Its technological advancement has even left Silicon Valley standing. India has built the world’s first national digital infrastructure, leaping at least two generations of financial technologies and has built something as important as the railroad was to the UK or the interstate highways were to the US.
India is now the most attractive major investment opportunity in the world.
It’s all about something called Aadhaar and a breathtakingly ambitious plan with flawless execution.
What just blows my mind is how few people have even noticed it. To be honest, writing the article last month was the first time I learned about any of the developments. I think this is the biggest emerging market macro story in the world.
Phase 1 – The Aadhaar Act
India, pre-2009, had a massive problem for a developing economy: nearly half of its people did not have any form of identification. If you were born outside of a hospital or without any government services, which is common in India, you don’t get a birth certificate. Without a birth certificate, you can’t get the basic infrastructure of modern life: a bank account, driving license, insurance or a loan. You operate outside the official sector and the opportunities available to others are not available to you. It almost guarantees a perpetuation of poverty and it also guarantees a low tax take for India, thus it holds Indian growth back too.
Normally, a country such as India would solve this problem by making a large push to register more births or send bureaucrats into villages to issues officialpapers (and sadly accept bribes in return). It would have been costly, inefficient and messy. It probably would have only partially worked.
But in 2009, India did something that no one else in the world at the time had done before; they launched a project called Aadhaar which was a technological solution to the problem, creating a biometric database based on a 12-digit digital identity, authenticated by finger prints and retina scans.
Aadhaar became the largest and most successful IT project ever undertaken in the world and, as of 2016, 1.1 billion people (95% of the population) now has a digital proof of identity. To understand the scale of what India has achieved with Aadhaar you have to understand that India accounts for 17.2% of the entire world’s population!
But this biometric database was just the first phase...
Phase 2 – Banking Adoption
Once huge swathes of the population began to register on the official system, the next phase was to get them into the banking system. The Government allowed the creation of eleven Payment Banks, which can hold money but don’t do any lending. To motivate people to open accounts, it offered free life insurance with them and linked bank accounts to social welfare benefits. Within three years more than 270 million bank accounts were opened and $10bn in deposits flooded in.
People who registered under the Aadhaar Act could open a bank account just with their Aadhaar number.
Phase 3 – Building Out a Mobile Infrastructure
The Aadhaar card holds another important benefit – people can use it to instantly open a mobile phone account. I covered this in detail last month but the key takeaway is that mobile phone penetration exploded after Aadhaar and went from 40% of the population to 79% within a few years...
The next phase in the mobile phone story will be the rapid rise in smart phones, which will revolutionise everything. Currently only 28% of the population has a smart phone but growth rates are close to 70% per year.
In July 2016, the Unique Identification Authority of India (UIDAI), which administers Aadhaar, called a meeting with executives from Google, Microsoft, Samsung and Indian smartphone maker Micromax amongst others, to talk about developing Aadhaar compliant devices.
Qualcomm is working closely with government authorities to get more Aadhaar-enabled devices onto the market and working with customers – including the biggest Android manufacturers – to integrate required features, such as secure
cameras and iris authentication partners.
Tim Cook, CEO of Apple, recently singled out India as a top priority for Apple.
Microsoft has also just launched a lite version of Skype designed to work on an unstable 2G connection and is integrated with the Aadhaar database, so video calling can be used for authenticated calls.
This rise in smart, Aadhaar compliant mobile phone penetration set the stage for the really clever stuff...
Phase 4 – UPI – A New Transaction System
But that is not all. In December 30th 2016, Indian launched BHIM (Bharat Interface for Money) which is a digital payments platform using UPI (Unified Payments Interface). This is another giant leap that allows non-UPI linked bank accounts into the payments system. Now payments can be made from UPI accounts to non-UPI accounts and can use QR codes for instant payments and also allows users to check bank balances.
While the world is digesting all of this, assuming that it is going to lead to an explosion in mobile phone eWallets (which is happening already), the next step is materializing. This is where the really big breakthrough lies...
Payments can now be made without using mobile phones, just using fingerprints and an Aadhaar number.
That is the biggest change to any financial system in history.
What is even more remarkable is that this system works on a 2G network so it reaches even the most remote parts of India!! It will revolutionise the agricultural economy, which employs 60% of the workforce and contributes 17% of GDP. Farmers will now have access to bank accounts and credit, along with crop insurance.
But again, that is not all... India has gone one step further...
Phase 5 – India Stack – A Digital Life
In 2016, India introduced another innovation called India Stack. This is a series of secured and connected systems that allows people to store and share personal data such as addresses, bank statements, medical records, employment records and tax filings and it enables the digital signing of documents. This is all accessed, and can be shared, via Aadhaar biometric authentication.
Essentially, it is a secure Dropbox for your entire official life and creates what is known as eKYC: Electronic Know Your Customer.    
Using India Stack APIs, all that is required is a fingerprint or retina scan to open a bank account, mobile phone account, brokerage account, buy a mutual fund or share medical records at any hospital or clinic in India. It also creates the
opportunity instant loans and brings insurance to the masses, particularly life insurance. All of this data can also in turn be stored on India Stack to give, for example, proof of utility bill payment or life insurance coverage.
What is India Stack exactly?
India Stack is the framework that will make the new digital economy work seamlessly.
It’s a set of APIs that allows governments, businesses, startups and developers to utilise a unique digital infrastructure to solve India’s hard problems towards presence-less, paperless and cashless service delivery.
Presence-less: Retina scan and finger prints will be used to participate in any service from anywhere in the country.
Cashless: A single interface to all the country’s bank accounts and wallets.
Paperless: Digital records are available in the cloud, eliminating the need for massive amount of paper collection and storage.
Consent layer: Give secured access on demand to documents.
India Stack provides the ability to operate in real time, transactions such as lending, bank or mobile account opening that usually can take few days to complete are now instant.
As you can see, Smart phones will act as key to access the kingdom.
This is fast, secure and reliable; this is the future...
This revolutionary digital infrastructure will soon be able to process billions more transactions than bitcoin ever has. It may well be a bitcoin killer or at best provide the framework for how blockchain technology could be applied in the real world. It is too early to tell whether other countries or the private sector adopts blockchain versions of this infrastructure or abandons it altogether and follows India’s centralised version.
India Stack is the largest open API in the world and will allow for massive fintech opportunities to be built around it. India is already the third largest fintech centre but it will jump into first place in a few years. India is already organizing hackathons to develop applications for the APIs.
It has left Silicon Valley in the dust.
Phase 6 – A Cash Ban
The final stroke of genius was the cash ban, which I have also discussed at length in the past. The cash ban is the final part of the story. It simply forces everyone into the new digital economy and has the hugely beneficial side-effect of reducing everyday corruption, recapitalising the banking sector and increasing government tax take, thus allowing India to rebuild its crumbling infrastructure..
India was a cash society but once the dust settles, cash will account for less than 40% of total transactions in the next five years. It may eliminate cash altogether in the next ten years.
The cash ban digitizes India. No other economy in the world is even close to this.
Phase 7 – The Investment Opportunity
Everyone thinks they know about the Indian economy – crappy infrastructure, corruption, bureaucracy and antiquated institutions but with a massively growing middle class. Well, that is the narrative and has been for the last 15 years.
But that phase is over and no one noticed. So few people in the investment community or even Silicon Valley are even vaguely aware of what has happened in India and that has created an enormous investment opportunity.
The future for India is massive technological advancement, a higher trend rate of GDP and more tax revenues. Tax revenues will fund infrastructure – ports, roads, rail and healthcare. Technology will increase agricultural productivity, online services and manufacturing productivity.
Telecom, banking, insurance and online retailing will boom, as will the tech sector.
Nothing in India will be the same again.
FDI is already exploding and will rise massively in the years ahead as technology giants and others pour into India to take advantage of the opportunity...