January 28, 2023

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3D imaging to boost diagnosis and treatment of kidney disease

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Medical researchers have successfully used 3D computer software to enhance traditional microscopic analysis.

This breakthrough can accelerate the diagnosis and target the kidney disease better for treatment.

As reported, this could provide clinicians with a highly detailed image of a patient’s kidney from biopsy, thereby bringing the kind of sophisticated structural analysis into the clinic.

The Problem

The build-up of glucose in the blood brought about by diabetes may cause about a quarter of patients with diabetes to develop kidney disease.

The kidneys will be damaged as they struggle to filter out waste from the blood and expel it as urine.

Clinicians are currently relying on monitoring for levels of albumin in the urine as a marker of diabetic kidney disease, carrying out tests every 6 to 12 months.

But not all people with diabetic kidney disease have elevated levels of albumin in their urine, which means that a diagnosis can be delayed or even missed.

The Solution

Sophisticated structural analysis is usually only available to medical researchers with access to an electron microscope and the specialised skills to use it.

The new technique works with similar accuracy to that of a Transmission Electron Microscope (TEM) that beams subatomic particles through a specimen in order to image it.

The computer 3D reconstruction technique is accurate, less operator-dependent and less time consuming than the current gold standard that is electron microscopy.

Benefits of 3D imaging

It is a promising method for both diagnostic and research purposes and has the potential to improve routine diagnosis of diabetic kidney disease and guide treatment.

The use of 3D structure studies has the potential to expedite the diagnosis albeit not cure the diabetic kidney disease yet.

Accelerating diagnosis could allow appropriate measures to be put in place, which can slow down the progression of the disease.

In traditional light microscopy, only a few slices of a biopsy are examined. Each of the slice or “section” is about one or two microns thick, allowing for only a 2D analysis.

A micron is one millionth of a metre.

On the other hand, using the latest 3D imaging software allows around 50 sections to be taken and reconstructed into a complete 3D image.

Moreover, this kind of 3D analysis can also potentially monitor the progress of kidney transplants.

This will thereby provide clinicians with an understanding as to why a patient may be having trouble accepting an organ.

Targeted treatments could then be applied to prevent the organ rejection.

In addition, the imaging technique could also boost kidney research since it makes detailed imaging more accessible to researchers.

The Future

The use of 3D technology is now on the cusp of becoming conventional in diagnosis and treatment across all fields of medicine.

The whole traditional 2D side of medicine will be phased out very soon because it will not be seen as practical anymore.

It can be likened to playing a computer game in 2D when you can be in 3D or even virtual reality.

HKSTP Partner Company Launches Non-Invasive Diabetes Pre-Screening Tool

Image Credits: HKSTP, Press Release
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A partner company of the Hong Kong Science and Technology Parks Corporation (HKSTP) unveiled “ARIA-diabetes risks”, a retinal imaging tool for non-invasive pre-screening of diabetes. This solution aims to tackle the problem of millions of undiagnosed diabetes patients worldwide.

The International Diabetes Federation reports that in 2021, nearly half of all adults with diabetes were unaware of their condition, amounting to 239.7 million individuals worldwide. In Hong Kong alone, at least 600,000 individuals have diabetes and more than 110 million in mainland China. This is a significant issue that has both local and global implications, as people with diabetes are at an increased risk for serious and potentially life-threatening complications such as heart disease, kidney disease, and vision loss.

The Automatic Retinal Image Analysis (ARIA) technology uses artificial intelligence and machine-learning techniques to detect various health issues. The solution provides a non-invasive pre-screening tool for diabetes that delivers results within minutes and has an accuracy rate of over 90%. It does not require a blood test and offers a faster and more accessible way for early diabetes diagnosis.

The partner company formed a joint venture called “Oneness Health” with an HKSTP incubatee to capitalise on the potential for remote healthcare offered by the ARIA-diabetes risks solution.

The joint venture combines the partner company’s retinal analysis technology with the incubatee’s network of Traditional Chinese Medicine (TCM) practitioners, as well as their software and hardware development capabilities. This creates a one-stop service platform under the name “Oneness Health” that provides high-risk patients seeking TCM treatment with added convenience and flexibility, with the goal of “disease prevention”.

The Oneness Health platform will offer features such as online appointments, mobile assessments, diagnosis, and personal health management in the first quarter of 2023.

In the near future, it will also provide prescriptions for traditional Chinese medicines that can be dispensed through auto-dispensing machines at over 100 convenient locations in 18 districts of Hong Kong or collected at various NGO centres. Additionally, door-to-door courier service will be available for single elderly individuals or needy families.

The CEO of HKSTP stated that the Park is dedicated to promoting innovation by providing a comprehensive support system for translational research, product development, and commercialization. The ARIA-diabetes risks solution from the two firms which is now being offered under the Oneness Health platform is a prime example of how innovative solutions can be developed in Hong Kong and at the Science Park.

The combination of breakthrough science, world-first technology, advanced software, and hardware to create an innovative primary healthcare delivery platform through Oneness Health, is a testament to the speed, talent, infrastructure, and innovation capability of Hong Kong’s I&T ecosystem.

In line with the HKSAR Government’s Primary Healthcare Blueprint announced in December 2022, the Oneness Health platform will contribute to the government’s goal of establishing a more community-based primary healthcare system. The platform will significantly improve healthcare convenience, expand treatment options, lower patient costs, and alleviate the burden on Hong Kong’s hospitals and clinics.

The Blueprint sets out a strategy road map towards establishing a primary healthcare system that can improve the overall health and quality of life for popular in a stable manner, under the challenges brought on by an ageing popular and increasing chronic disease prevalence.

Indonesia to Enhance Digital Public Mall Services

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The Ministry of Administrative Reform and Bureaucratic Reform (PANRB) join forces with a government IT firm to create a digital Public Service Mall (MPP). The initiative is a follow-up to President Joko Widodo’s directive to establish MPP Digital.

According to Minister PANRB Abdullah Azwar Anas, the IT government company is more advanced in digitalisation implementation. MPP Digital incorporates numerous services into the hand to make it easier for people to access high-quality government services.

“MPP Digital provides effective and efficient service delivery while enhancing information security for government digital services. The government IT company team will expedite the President’s vision for MPP Digital,” he explained.

MPP Digital is also expected to increase investment by allowing for faster and easier licencing, leading to job possibilities. In addition, the local administration will not need to construct a massive MPP building but will rely on digitalisation that everyone can access.

MPP Digital is expected to be ready by May 2023, following the President and Vice President’s directives. The creation of MPP Digital is also under the government’s present implementation of the Electronic Based Government System (SPBE).

At the same time, Ririek Adriansyah, the Main Director of the government IT company, declared his willingness to support the government’s initiative. He conveyed that the construction of MPP Digital was proceeding as planned because the digitalisation of services has enormous potential benefits for both the government and the general public.

Additionally, the government is working hard to progress SPBE, including introducing Digital Public Service Malls (MPP) as one of SPBE’s expressions. SPBE is also a component of President Joko Widodo’s Thematic Bureaucratic Reform, which is aimed at digitising government services.

The next Electronic-Based Government System (SPBE) aims to strengthen unity by offering a single access system for the country’s digital services, resulting in higher public service quality. Nowadays, the state’s digital public sector is still fragmented by agency, sector, and silo-based systems. As a result, citizens are frequently required to submit similar data and register several accounts to access various digital-based public sector services.

As a result, Anas will pursue a single sign-on account for users to access various government services. Users can utilise their accounts to access all public services e-services, such as population issues, business permissions, and other certifications. Digital MPP has done so following President Jokowi’s and Vice President Ma’ruf Amin’s objective to achieve bureaucratic reform with simple, powerful, and quick replies to the community.

 

More MPPs have been built and inaugurated by the government. In the future, all regions will have physical and digital MPPs, with all government services based on demographic numbers (Digital ID). MPP Digital, on the guidance of the President and Vice President, has become the PANRB ministry’s short-term focus.

As of December 2022, 103 MPPs (20% of the total of 514 regencies/cities in Indonesia) had been inaugurated in regencies and cities. Thus, fewer than 80%, or approximately 411 districts/cities, still need MPP. The Vice President aimed for roughly 150 new MPPs in 2023, with all towns and regencies having MPPs by the end of 2024.

The Ministry of PANRB has evaluated 10-15 MPPs (Public Service Malls) for inclusion in the future Digital MPP development process. These MPPs were chosen for their uniqueness, benefits, and good qualities. In general, the MPP Digital application development will be divided into four stages: requirements, design, testing, and upgrading.

Anas emphasised that government digitisation is a critical driver in enhancing the quality of public services, which would increase people’s well-being. Bureaucratic reform must increase investment and streamline business services, boosting the economic level of society. Improving the community’s financial level will undoubtedly influence the lowering poverty rate.

Indonesia to Develop Integrated Health Data System

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Budi Gunadi Sadikin, Minister of Health, announced the development of SATUSEHAT, an interoperable Indonesian health data system. Budi aimed to complete the digitalisation of health data by January 2024. In keeping with the spirit of an impactful bureaucracy, the Minister of Health is sure Indonesians would benefit from digitisation.

“The concept is interchangeable; (health facilities) can use the information anywhere: all hospitals, both public and private, pharmacies, clinics, health centres, and labs throughout Indonesia will use the same data format, and (the data) can be exchanged,” he said at the launch of the Digital Transformation Office (DTO) Space in Jakarta.

SATUSEHAT is a health platform that serves as a forum for various health apps from companies in the health business. As a result, all applications and health service facilities on the SATUSEHAT platform, including vertical hospitals, government hospitals, private hospitals, health centres, Posyandu, laboratories, clinics, and pharmacies, must adhere to the Ministry of Health’s criteria.

People no longer need to carry physical medical record files while moving hospitals because of this platform. All patient medical record resumes have been digitally captured on the SATUSEHAT platform, which can be viewed from anywhere and at any time using mobile phones.

“For certain users who haven’t been able to produce health applications, we can aid later. (And) We can eventually give standard and free applications for significant stakeholders such as Puskesmas (community health centres) and Posyandu (toddler integrated service post). This way, we can do data integration elegantly on the same platform,” Budi confirmed.

Furthermore, the Ministry of Health established DTO as a Ministry of Health work unit dedicated to implementing the Healthy Indonesia programme by developing effective data-driven policies and digital technology products. User-Based Technology Development, National Health Data Integration, Technology Capacity Building, and Data-Based Policy Making are the four principles of digital transformation being implemented.

Budi directed the DTO and the Data and Information Centre (Pusdatin) to take meaningful actions to expedite national health data digitisation. DTO must complete nationwide health interoperability that is transparent and accessible to all parties. The merger process started on July 6, 2022, and is expected to be finished by the end of 2023.

Another challenge is to combine clinical and genomic data to assess the health of the Indonesian population deployed with Artificial Intelligence to create more detailed and exact results. AI will subsequently support the Ministry of Health’s clinical and genomic data. The services are designed to help Indonesia advance health biotechnology.

During the inauguration ceremony, the Minister for Administrative Reform and Bureaucratic Reform (PANRB), Abdullah Azwar Anas, praised the Ministry of Health’s digital transformation in the healthcare system. He anticipated that the shift would affect at least five items. First and foremost, it increases the quality of healthcare services. Second, it improves access to healthcare services. Third, raise the added value of the health sector economy with a focus on domestic goods.

Fourth, speeding the achievement of the government’s main healthcare projects, such as lowering stunting prevalence. Fifth, strengthen health human resource expertise while guaranteeing equitable distribution across the country.

“For example, we may ensure that a health concern is treated by integrating data, then monitoring therapy until the assessment is entirely digitally driven. We can learn from the Covid-19 pandemic, in which health technology was extremely useful in combating the pandemic,” he went on to say.

Anas believes that the Ministry of Health’s SATUSEHAT will soon be merged with the National Electronic-Based Government System. He praised the tremendous efforts made by the Ministry of Health to implement digital transformation.

The Ministry of Health’s consolidation initiative can serve as a model for other Ministries/Institutions looking to increase work units’ roles in supervising the government’s digitalisation activities. Anas is optimistic that the integrated ecosystem of digital health data will be a huge step forward for the country’s health sector.

Expanding Internet Connectivity in the Philippines

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Senate President Pro Tempore Loren Legarda urged the government to prioritise cell sites in geographically isolated and disadvantageous regions (GIDA), indigenous villages, and other upland places. In addition, she advocated that the government’s digitalisation and internet connectivity initiative be implemented throughout Antique province in the future years.

In her hometown of Antique, 40% of the populace uses Globe and Smart connectivity. However, their tower locations are focused on urban regions. As a result, Legarda requested that WiFi hotspots be deployed throughout the province.

Legarda discussed her proposals with Department of Information and Communications Technology (DICT) Undersecretary Anna Mae Yu Lamentillo, Undersecretary Angelo Nuestro, and Assistant Secretary Philip Varilla at the Senate of the Philippines.

Around 18 Antique towns will undergo digital transformations to improve municipal services to be more accessible, faster, and more efficient. Legarda, the primary author of Republic Act No. 10844, the law that established the DICT, underlined the importance of ICT infrastructure, systems, and resources in ensuring universal access to excellent, cheap, dependable, and secure ICT services.

“We are doing this in Antique, and we will do it in other areas of the country. With our stronger cooperation with the DICT, we want every community, even our indigenous communities, to be digitally linked so that they are not left aside,” she added.

Meanwhile, Lamentillo said the DICT would pursue its mandate to build the digital infrastructure connecting communities, especially those in far-flung areas. The connectivity programme also provides citizens with better quality of life by delivering speedy and efficient government services to the people.

“We thank Senator Loren Legarda for her unwavering support to the DICT, from its inception and up to the present as we strive to ensure that every community in the country is digitally connected,” she declared.

Under President Ferdinand R. Marcos Jr., the Philippines has strengthened efforts to develop the country’s internet connection. He promised his administration would do all its power to offer free internet connection to rural communities. The government plans to roll out the “BroadBand ng Masa Programme” (BBMP) to all isolated islands, especially those without a mobile cellular connection.

BBMPs across the country give free internet access to students and teachers from geographically isolated and disadvantaged regions (GIDAs). As part of the programme, an additional 628 operational free WiFi sites were installed, increasing the total amount of such WiFi sites throughout the Philippines to 4,757. At least 2.1 million unique users, or around 100,000 families, can access the government’s free internet connections. Interconnectivity and government services will benefit from digital technologies.

DICT Secretary Ivan John Uy was optimistic about the programme’s ability to help develop a “direct relationship” between GIDAs and the government. Establishing the Free WiFi for All Programme is one of the government’s accomplishments in boosting connection. He committed to increasing efforts to extend internet connection to more remote places.

Indonesia is made a similar push to persuade local governments to accelerate the provision of digital infrastructure for telecommunications and internet needs in rural locations. To service the community in all villages/sub-districts in Indonesia’s most remote, outlying, and underserved (3T) sites that have yet to be served by a 4G signal network. The BTS was built with funds from the State Revenue and Expenditure Budget by the Ministry of Communication and Information.

The BTS will be a downstream facility allowing the public to benefit from upstream infrastructure such as a broadband fibre-optic cable network. Another method for providing internet connection to rural schools and health care facilities is the SATRIA-I Satellite and the Hot Backup Satellite.

Artificial Intelligence for Early Detection of Lung Cancer

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Sybill, an artificial intelligence tool, has been developed to estimate the risk of lung cancer. Lung cancer is the world’s deadliest cancer, accounting for 1.7 million fatalities in 2020, killing more people than the following three deadliest cancers combined. Consequently, it is critical to have an early detection solution to provide immediate treatment.

Cancer early identification AI tools can result in a better long-term outcome, according to MIT’s Abdul Latif Jameel Clinic for Machine Learning in Health, Mass General Cancer Centre (MGCC), and Chang Gung Memorial Hospital (CGMH). When it’s advanced, the five-year survival rate for the lung cancer patient is closer to 70%, compared to 10% when it’s early.

“It’s the worst cancer because it’s so common and so difficult to treat, especially once it’s advanced,” explained Florian Fintelmann, MGCC Thoracic Interventional Radiologist and Co-author of the current study.

Today’s images of the lung computed tomography (LDCT) procedure is presently the most common way people are checked for lung cancer to detect it early enough to be surgically removed. But Sybill takes the screening a step further in comparison to LDCT. It can forecast the likelihood of a patient acquiring lung cancer within six years by analysing LDCT imaging data without the intervention of a radiologist.

Co-author Peter Mikhael, an MIT PhD student in electrical engineering and computer science and an affiliate of Jameel Clinic and the MIT Computer Science and Artificial Intelligence Laboratory (CSAIL), associated the procedure with “trying to identify a needle in a haystack”. However, Sybill successfully detects early-stage cancer with satisfactory results, as shown in a new article published in the Journal of Clinical Oncology.

Fintelmann and his team labelled hundreds of CT scans with evident cancerous tumours that would be used to train Sybil before testing the model on CT scans with no discernible evidence of disease. The researchers took precautionary measures to ensure Sybil’s ability to identify cancer risk appropriately.

Sybil achieved C-indices of 0.75, 0.81, and 0.80 using a heterogeneous group of lung LDCT scans gathered from the National Lung Cancer Screening Trial (NLST), Mass General Hospital (MGH), and CGMH over six years. Models with a C-index score of more than 0.7 are regarded as good and models greater than 0.8 are considered strong, with 1.00 being the maximum attainable score. The ROC-AUCs for Sybil’s one-year prediction were considerably higher, ranging from 0.86 to 0.94.

Jeremy Wohlwend, an MIT electrical engineering and computer science PhD student and Jameel Clinic and CSAIL collaborator, was shocked by Sybil’s excellent score despite the absence of apparent disease. “We discovered that even while we [as humans] couldn’t see where the cancer was, the model could still predict which lung would eventually get cancer,” he described. “It was incredibly interesting that [Sybil] could identify which side was the more likely side.”

The 3D aspect of lung CT scans made Sybil challenging to create. Because early-stage lung cancer covers minuscule areas of the lung. It is just a fraction of the hundreds of thousands of pixels that make up each CT scan. The radiology data used to train Sybil was essentially free of any indicators of malignancy. Lung nodules are denser areas of lung tissue that, while they have the potential to be malignant, are most of the time not and can be caused by healed infections or airborne irritants.

In the United State, many patients diagnosed with lung cancer today have never smoked or are former smokers who quit more than 15 years ago – characteristics that preclude both groups from receiving lung cancer CT screening in the United States. However, cancer can affect a young, healthy, and athletic individual. As a result, prevention is vital to saving more lives.

Streamlining Indonesia’s Digital Transformation

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Abdullah Azwar Anas, Minister of State Apparatus and Bureaucratic Reform (PANRB) observed that the state digital public service sector is still fractured by agency, sector, and silo-based systems. As a result, citizens must frequently enter similar data and create several accounts to access various digital-based public sector services. Therefore, the next Electronic-Based Government System (SPBE) aims to improve unity by providing a single access system for the country’s digital services, resulting in better public service quality.

“The Presidential Decree on the Architecture of the National SPBE also aims to integrate separate digital services into an inclusive digital service through the National Government Administration Portal and the National Public Service Portal, aka digital Public Service Mall (MPP),” Anas explained in a meeting with representatives from various ministries/agencies at the Ministry of Home Affairs office in Jakarta.

The government is making significant efforts to advance SPBE, including introducing Digital Public Service Malls (MPP) as one of SPBE’s manifestations. SPBE is also a part of President Joko Widodo’s Thematic Bureaucratic Reform to digitise government services.

The Thematic Bureaucratic Reform focuses on five areas: poverty reduction, increased investment, digitisation of services, domestic spending, and inflation management. The thematic bureaucratic reform scheme has been implemented and will be applied inside the TNI (national army), Polri (federal police), and the Attorney General’s Office.

Furthermore, the government has physically constructed and inaugurated more MPPs. In the future, all regions will have MPPs that are not only physical but also digital, containing all government services based on population statistics (Digital ID). According to the advice of the President and Vice President, MPP Digital has become the ministry’s short-term focus.

As a result, the Ministry PANRB, in collaboration with the Ministries of Home Affairs, Communication and Informatics, BSSN, and Finance, is working to execute Thematic Bureaucratic Reforms. According to the President’s directives, the programme must impact society through the execution of SPBE.

The PANRB ministry would continue supervising SPBE implementation through the SPBE Coordinating Team. To design SPBE architecture, the team requires a plan and linked steps. The national SPBE architecture is supposed to maintain the integration of National Digital Services while handling the national programme theme.

The plan clarified each job description to eliminate overlapping work and maximise the coordinated approach. The structure will also serve as a guide to align digitisation initiatives to make them more effective and efficient. In addition, a timeframe for the implementation plan has been established to simultaneously carry out the National SPBE Architecture strategic effort.

Johnny G. Plate, Minister of Communication and Informatics, who also participated in the coordination meeting, explained that the Ministry of Communication and Information is currently building a National Data Centre (PDN), a government service liaison system, and an intra-government network to support SPBE. In addition, the Ministry of Communication and Informatics also develops and harmonises applications, creates SPBE super-apps, and employs big data analytics and artificial intelligence in collaboration with other ministries/institutions.

President Jokowi indicated that the bureaucracy movement must relate to the government’s main aims for the bureaucracy to impact society. With 4.2 million government employees in Indonesia, the government created a new performance measure for them. All the KPIs (key performance indicators) are aligned with the government’s main initiatives, which include investment, poverty, digitisation, inflation, and TKDN (domestic component level in government spending).

Assessment of bureaucratic reform (RB) of ministries/agencies and regional governments as of 2023 must be more directed towards fixing downstream community problems that are the government’s priority, namely poverty eradication, improved investment, digitising services, spending on domestic products, and inflation control.

HKSTP and Industry Partner to Boost Life Science Innovation

Image Credits: HKSTP, Press Release
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HKSTP has entered a strategic partnership with a Swiss multinational pharmaceutical company to position Hong Kong and the Greater Bay Area as a leader in life science innovation and set an example for the region. This is the first collaboration between HKSTP and the life sciences corporation that encompasses technology and data sharing.

The two are committed to promoting life science innovation and healthcare policy. They aim to provide a robust platform and support for start-ups in Hong Kong and mainland China by creating an ecosystem for healthcare start-ups. The goal is to make the Greater Bay Area a leader in life science and healthcare innovation and serve as a model for the rest of China in terms of technology application and registration. Additionally, they hope to establish the GBA as a hub for talent and corporates in the Asia Pacific region.

The principal areas of collaboration are:

  • Shaping Policy – A white paper to articulate policy recommendations, organising a public forum and a round-table for an in-depth discussion with government officials;
  • Co-incubation program – providing the start-ups with support and guidance on science, strategy and marketing, and creating a platform for the start-ups and potential partners to network and exchange; and,
  • Data collaboration – Fostering a conducive data-sharing environment in the STP Platform and among stakeholders; exploring synthetic data generation tools; promoting the “data collaboration” concept to the community.

The Secretary for Innovation, Technology and Industry was one of the witnesses to the Collaboration Agreement Signing Ceremony, he stated that the partnership aligns with the Hong Kong Innovation and Technology Development Blueprint recently released.

With the strong support from the Central Government and the government’s commitment to I&T development, as well as Hong Kong’s unique advantages, the partnership will greatly contribute to the development of a world-class biomedical ecosystem in Hong Kong.

The CEO of HKSTP stated that the partnering firm is a global pharmaceutical leader with strong connections to business leaders, scientists, marketers, and investors globally. It is believed that the partnership will foster the development of more health talents and significantly speed up growth in our medical research, drug development, and clinical trial processes.

The Head of the firm’s China-based innovation centre stated that the company is so glad to see this collaboration happen. It is hoped that the partnership can bridge HK and other cities in China for more opportunities to exchange, collaborate and empower start-ups; accelerate conversion and commercialisation; and to bringing hope to patients in China.

The APAC Sub Region 3 Head of the firm’s diagnostics arm noted that Hong Kong has a great foundation of scientific research. The firm looks forward to this collaboration in advancing high-quality research work, building a platform for innovation and benefiting the Asian population as well as the rest of the world.

The launch ceremony was attended by various dignitaries including the Under Secretary for Innovation, Technology and Industry; the Commissioner for Innovation and Technology, the Head of APAC Area at the firm, the Head of the firm’s accelerator (CICoR), the General Manager, Hong Kong and Macau and Mr Ronald Lo, General Manager, at the firm’s Hong Kong and Macau diagnostics arms.

Recent research has found that the global life science analytics market size was valued at US$ 8.3 billion in 2021, and is expected to grow at a compound annual growth rate (CAGR) of 7.7% from 2022 to 2030. This growth is driven by the increasing adoption of analytics by the life science industry, which uses descriptive and reporting analysis for building databases and prescriptive and predictive analysis for predicting future trends and results.

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