Nurse-1-1 lets you text a nurse for health info, learn if a doctor is needed

A new startup wants to help you figure out if your medical issue requires a visit to a doctor’s office, the ER, or can be handled over a telemedicine service, while also providing you with some basic information about the problem and its severity. Nurse-1-1, the latest company from former RunKeeper co-founder Michael Sheeley, is launching today to offer a quick, affordable way to get answers from physician assistants, nurse practitioners, and registered nurses via chat.

Sheeley, a serial entrepreneur, sold his shopping app Kickscout to Mobee in 2014, and later worked on a food ordering service before starting Nurse-1-1 around two years ago.

The idea for the startup emerged from an experience he had after the birth of his daughter.

“My daughter was born with a congenital heart defect,” Sheeley explains – a health crisis that involved her having open heart surgery, he tells us. “I was sitting next to her for a week while she was recovering in the hospital….and I was Google searching everything and anything I could to learn about her condition,” he says.

But the more he read, the more confused he became, as it can be hard to parse health information found online.

He ended up connecting with his wife’s friend, a nurse practitioner, over SMS text messaging, in order to ask some of the questions that he hadn’t asked the doctors at the hospital.

“I was having these conversations with my friend, Kim, and I didn’t have to worry about it being a treatment; I didn’t have to worry about it being a prescription; and I didn’t have to worry about interrupting her busy day,” Sheeley says.

That nurse practitioner, Kim Liner, now works at Nurse-1-1 along with Meri Clare, RN; an ER doctor from Boston Children’s Hospital, Igor Shumskiy, MD; and a former marketing exec for TripAdvisor, Steve McAveeney, among others. The team is currently based out of Harvard University’s Innovation Lab.

The team opted for texting instead of calls, after doing some customer research. They found that most people preferred to communicate asynchronously – like through text messages. When offered the choice between phone calls, video chat or texting via the Nurse-1-1 website, patients choose texting at a much higher rate.

The startup also found that, often, what people first want to know when they have a health concern is what level of care they should get.

Ahead of today’s launch, the texting service was tested with over 1,200 patients and received interest from 190 nurses, who have since joined its platform. It’s free to end users if the patient’s provider is signed up on Nurse-1-1. (None have yet – but discussions are underway, Sheeley says.) Otherwise it’s $12.50 per chat.

This is much less than video visits with doctors, which typically go for around $49 or have co-pays of around $30 per visit.

 

“The triage industry is a multi-billion dollar industry. When you call your doctor late at night and get that phone call back, it’s usually a third-party service calling you. They charge $15 per call to these clinics and it’s very low quality,” Sheeley explains. “Our business model is to charge clinics only $12.50 per call…if your provider is on the platform, that money is charged to them, not to [patients.],” he notes.

When your provider is not available, the money customers pay, minus a $2.50 processing fee, will go directly to nurses instead.

In the future, Nurse-1-1 may generate referrals to telemedicine providers, allowing it to earn referral fees, too.

Already, the company found that many of its customers are moms or moms-to-be, asking questions about pregnancy, kid’s ailments, colds, flus, and the like. They’re trying to figure out if they should visit an urgent care now, or see a doctor in the morning, for example.

The service works both via the web and through an iOS app. It’s HIPAA-compliant, and data is encrypted end-to-end.

Nurse-1-1 is immediately available across the U.S. because it’s not actually prescribing or diagnosing. The company hasn’t raised outside funding, but may look to do a seed round in the near future.

Weed in space is going to be a thing now

Scientists interested in cannabis as a subject for pharmaceutical studies may find an unlikely new home for their research into the plant, its byproducts and biochemistry aboard the International Space Station.

Yes, weed is going to space thanks to the work of a small Lexington, Ky.-based startup called Space Tango.

The company makes a “clean room” laboratory in a microwave-sized box. Because space is tight on the International Space Station, companies that want to conduct experiments in microgravity have to do more with less. And Space Tango gives them a small environment in which to perform tests and monitor the results.

Using Space Tango’s “CubeLab” modules, which slot into the larger TangoLab containers, companies like Anheuser-Busch can send barley up to the space station to observe how the crop could be cultivated in environments approaching zero gravity.

Now, Space Tango is taking its own steps to develop experiments on how the zero gravity environment could affect cannabis cultivation.

Alongside two Kentucky hemp and cannabis cultivation and retail companies, Atalo Holdings, which provides hemp genetics, and Anavii Market, an online retailer of hemp-derived cannabidiol (CBD) therapeutics, Space Tango has set up its own subsidiary to research how microgravity can be used to better cultivate particular strands of hemp for medical compounds.

“For all entrepreneurial companies in this new space area everyone is trying to hone in [sic] on what is the actual business,” said co-founder and chairman Kris Kimel of Space Tango, in an interview. “We’re trying to figure out here what’s the business now… For us, the model is looking at low earth orbit to actually develop and design applications for life on earth.”

Kimel said the company now has two micro-laboratories installed on the International Space Station and has payloads launching to the space station for corporate and university customers about six times a year.

In its early stages, the company is mainly operating on existing income. “We’re able to meet our operating expenses off of revenue,” says Kimel. “Which is great for a company that is not just three years old.”

As it looks to create these kinds of joint ventures with other companies, Kimel said that additional revenue could come from a profit-sharing agreement rather than just straight contracts for services. The new subsidiaries enhance what the company sees as its broader mission, Kimel said.

“Each time a new type of physics platform has been successfully harnessed such as electromagnetism, it has led to the exponential growth of new knowledge, benefits to humankind and capital formation,” said  Kimel, in a statement. “Using microgravity, we envision a future where many of the next breakthroughs in healthcare, plant biology and technology may well occur off the planet Earth.”

Industrialized hemp production and research and development into the crop was enabled four years ago with the passage of the 2014 U.S. Farm Bill. It was the first time in 70 years that new rules were enacted to promote research into applications for the hemp plant as fiber, food or medicine.

By taking the plants to space, Space Tango hopes to study whether the growth of certain strains can be better controlled in the absence of gravitational stresses on the plant’s development.

“When plants are ‘stressed,’ they pull from a genetic reservoir to produce compounds that allow them to adapt and survive,” said Dr. Joe Chappell, a member of the Space Tango Science Advisory Team who specializes in drug development and design. “Understanding how plants react in an environment where the traditional stress of gravity is removed can provide new insights into how adaptations come about and how researchers might take advantage of such changes for the discovery of new characteristics, traits, biomedical applications and efficacy.”

Founded by former NASA engineer Twyman Clements and Kimel, who was serving as the president of the nonprofit Kentucky Science and Technology Corp., Space Tango was spun up to be the for-profit arm that would commercialize experiments in space as a service for large businesses that wanted to take advantage of the unique properties of manufacturing in microgravity.

There have been few commercially viable products that have come from microgravity research or production, in part because it’s expensive to bring products from space to earth.

That’s why Space Tango has focused on drug discovery and pharmaceuticals and why the company is spinning up its independent subsidiary that will focus exclusively on cannabis. Pharmaceutical compounds are lightweight and can be profitable in production without enormous volumes.

“That’s why biomedicine is attractive,” Kimel said. “You’re dealing with products that are incredibly high value and incredibly low weight.”

Treatments that cause the immune system to attack cancer earn a Nobel

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Today, the Nobel Prize Committee has honored two researchers for their role in pioneering a new avenue for cancer treatment, one where the therapy targets the immune system, which then goes on to attack the cancer. The researchers, James Allison of the MD Anderson Cancer Center and Tasuku Honjo of Kyoto University, worked separately to identify and target proteins that help keep the immune system from attacking other cells in the body. When these proteins are inhibited, the immune system can target cancers, although at the risk of autoimmune disorders.

Immunity and cancer

Our thinking about the relationship between the immune system and cancer has undergone a number of revisions over the last century. The initial question—why doesn’t the immune system attack cancers?—was seemingly answered as people developed a better understanding of how it normally keeps from attacking healthy cells. Under this view, cancer cells looked too much like a normal cell to generate a response.

But this turned out to be not quite right. People taking immunosuppressive drugs over long periods tended to have increased incidence of cancer, suggesting that the immune system was attacking and eliminating cancers all the time. The question then became one of why the immune system wasn’t effective against some cancers.

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What is atrial fibrillation, and why is your watch telling you about it?

Image of a cardiac trace showing irregular activity.

What is atrial fibrillation, and why has Apple decided that it’s worth screening for it? The first question is much easier to answer, so let’s get that out of the way.

Your heart has four chambers, two atria and two ventricles. The atria are smaller chambers at the top of the heart, and their contraction fills the larger ventricles with blood. The ventricles then provide the powerful push that sends the blood either to the lungs to pick up oxygen or out to the body once it is oxygenated.

Got no rhythm

The proper coordination of the beating of all these parts requires a carefully synchronized spread of electrical signals through the four chambers. Given the complexity involved in getting this to work, it shouldn’t be surprising that it sometimes goes wrong. The fault for problems can be anything from a temporary physical change to a permanent problem with your heart’s development that started back when you were an embryo. The consequences can range from irrelevant to fatal.

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HP is ‘printing’ drugs for the CDC to speed up antibiotic testing

At least 2 million people in the U.S. become infected with so-called “super bugs” and at least 23,000 people die as a direct result of these infections each year, according to the Centers for Disease Control (CDC). Now, HP’s Biohacker technology is working with the CDC on a pilot program to “print” and test antibiotics in an effort to catch these antimicrobial resistant strains from spreading faster.

The HP D300e Digital Dispenser BioPrinter technology works by using the same set up as a regular ink printer, but instead dispenses any combination of drugs in volumes from picoliters to microliters to be used for research purposes.

Part of the reason these bugs spread so rapidly often comes down to mis-use of antibiotics, leading the bacteria to develop a resistance to the drugs available. The CDC hopes to give hospital providers access to the technology nationwide to cut down on the problem.

“Once a drug is approved for use, the countdown begins until resistance emerges,” Jean Patel, PhD, D (ABMM), Science Team Lead, Antibiotic Resistance Coordination and Strategy Unit at CDC said in a statement. “To save lives and protect people, it is vital to make technology accessible to hospital labs nationwide. We hope this pilot will help ensure our newest drugs last longer and put gold-standard lab results in healthcare providers’ hands faster.”

The 3D bioprinting sector has been experiencing rapid growth over the last few years and will continue on pace through the next decade, mainly due to R&D, according to market researchers. Innovation in the space includes printing of organs and human tissue and drug research and development.

Further, this potentially valuable antibiotic resistance research could help patient care teams stem a grim future where we experience a regression in health and life spans due to no longer having the ability to treat currently curable diseases.

The HP BioPrinter is currently used by labs and pharmaceutical companies such as Gilead, which tests for drugs used against the Ebola virus. It is also being used in various CRISPR applications. The CDC will use these printers in four regional areas spread throughout the U.S. within the Antibiotic Resistance (AR) Lab Network to develop antimicrobial susceptibility test methods for new drugs, according to HP.

The FDA OK’d an app as a form of birth control

Don’t want to get pregnant? There’s a Food and Drug Administration approved app for that. The FDA has just given the go ahead for Swedish app Natural Cycles to market itself as a form of birth control in the U.S.

Natural Cycles was already in use as a way to prevent pregnancy in certain European countries. However, this is the first time a so-called ‘digital contraceptive’ has been approved in America.

The app works using an algorithm based on data given by women using the app such as daily body temperature and monthly menstrual cycles. It then calculates the exact window of days each month a woman is most fertile and therefore likely to conceive. Women can then see which days the app recommends they should avoid having sex or use protection to avoid getting pregnant.

Tracking your cycle to determine a fertile window has long been used to either become pregnant or avoid conceiving. However, Natural Cycles put a scientific spin on the age-old method by evaluating over 15,000 women to determine its algorithm had an effectiveness rate with a margin of error of 1.8 percent for “perfect use” and a 6 percent failure rate for “typical use.”

What that means is almost two in every 100 women could likely conceive on a different date than the calculated fertile window. That’s not exactly fool-proof but it is higher than many other contraceptive methods. A condom, for instance, has an 18 percent margin of error rate, according to the Centers for Disease Control (CDC).

And though the app makers were able to convince the FDA of its effectiveness, at least one hospital in Stockholm has opened an investigation with Sweden’s Medical Products Agency (MPA) after it recorded 37 unwanted pregnancies among women who said they had been using the app as their contraception method.

“Consumers are increasingly using digital health technologies to inform their everyday health decisions, and this new app can provide an effective method of contraception if it’s used carefully and correctly,” assistant director for the health of women in the FDA’s Center for Devices and Radiological Health Terri Cornelison said in a statement.

However, she also acknowledged there was a margin of error in the app’s algorithm and other contraceptive methods. “Women should know that no form of contraception works perfectly, so an unplanned pregnancy could still result from correct usage of this device,” she said.

The 5,000% price hike that made Martin Shkreli infamous is no longer paying off

Martin Shkreli’s former pharmaceutical company lost more than $1 million in the first quarter of 2018 amid waning sales of the drug made famous by Shkreli’s more than 5,000-percent price increase. That’s according to financial documents recently reviewed by Stat.

Vyera Pharmaceuticals, formerly known as Turing Pharmaceuticals, had brazenly maintained Shkreli’s despised price hike of the drug Daraprim, which treats relatively rare parasitic infections that often strike babies and HIV/AIDS patients. As founder and CEO of Turing, Shkreli bought the rights to the cheap, off-patent drug and—without any generic competitors—abruptly raised its price from $13.50 a pill to $750 a pill in the fall of 2015.

The move was wildly unpopular (to say the least) and attracted intense public scrutiny to the country’s quickly escalating drug costs. But it was a lucrative decision for Turing and later Vyera—at least until recently.

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Using a virus to kill what antibiotics can’t

Due largely to overuse, we’re at risk of seeing many of our antibiotics lose effectiveness, leaving us without a defense against a number of potentially fatal infections. People are taking a variety of approaches to dealing with this, like looking for combinations of drugs that remain effective, developing entirely new drugs, and trying to reform how we dispense these critical drugs. (Although the latter may be an impossible dream.)

There’s another option that was under consideration even before antibiotic resistance had hit crisis levels: use something that makes killing bacteria part of its life cycle. Like other cells, bacteria often find themselves victims of viral infections, dying as new viruses burst out to infect their neighbors. If this happens out in regular ecosystems, people reasoned that maybe bacteria-killing viruses would also work in a pneumonic lung. But those maybes had always been accompanied by a long list of reasons why a virus wouldn’t work. Now, a group of researchers has tested it on mice with pneumonia, and none of those reasons seems to be an issue.

Meet the phages

Viruses that specialize in infecting bacteria are often called bacteriophages, or simply phages. We’ve known of some of them from shortly after we started studying bacteria, since their spontaneous infections would leave open holes of what would otherwise be an even lawn of bacteria. We’ve studied a number of them in detail, and some of the proteins they encode have become key tools in our genetic-engineering efforts. And they’re not simply oddities that strike when bacteria are forced to live in artificial lab conditions. Surveys of DNA obtained in environments from the deep ocean to the subways show that, wherever you find bacteria, you also find viruses that prey on them.

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