Tag: 19/8/24

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Celebrating Aurélien Breton: A Champion of Patient Access to Innovation in South Africa

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In a world where healthcare challenges are evolving at an unprecedented pace, innovative leadership has become the cornerstone of transformative progress. 

Visionaries such as Aurélien Breton exemplify this dynamic approach, blending passion with strategic insight to drive meaningful change. By placing patient wellbeing at the heart of their mission, these leaders are not merely navigating the complexities of the healthcare landscape, but redefining it. 

Their commitment to advancing patient access and optimising care underscores a powerful message: that true leadership in healthcare is about more than just responding to current needs, but anticipating future demands and crafting solutions that elevate the quality of life for patients around the globe.

For nearly five years, Aurélien has been a driving force within the Innovative Pharmaceutical Association of South Africa (IPASA), serving as a cornerstone of the Executive Committee and leading the Patient Access to Innovation (PAI) Working Group. 

His journey with IPASA reflects a deep commitment to improving patient access to life-saving medicines, tackling the significant challenges within South Africa’s healthcare system, and advocating for those most in need.

“For me, being a part of IPASA means engaging in a collective effort that extends beyond personal or corporate interests to enhance the broader healthcare landscape in South Africa,” says Aurélien.

A native of France and current Managing Director of Southern and Eastern Africa at Servier, Aurélien’s passion for healthcare brought him to South Africa in 2019 driven by a desire to contribute to something greater than himself and to make a meaningful difference in the lives of all South African patients. 

“I am a firm believer that a true leader is someone who wakes up every morning driven by a deep sense of purpose. For me, that purpose is ensuring access to innovative medicines for those who need them most. Our work in providing medicines transcends mere numbers; it profoundly impacts the lives of patients and their families, enhancing their quality of life and serving a greater purpose beyond business,” he adds.

While Aurélien’s role has evolved since joining IPASA, his mission has remained constant – to address barriers to patient access and help patients benefit from innovative medicines. Under his leadership, the PAI Working Group has engaged key stakeholders, including government bodies, medical schemes, and patient advocacy groups, to improve access to innovative treatments. 

Aurélien admits that despite engaging with all relevant stakeholders, progress has been sluggish. He attributes this to the healthcare environment at large, where excessive processes and regulations dilute responsibilities and hinder effective action. 

“Constructing a path to improvement is challenging due to unresponsiveness and barriers, including a lack of urgency from some stakeholders and uncertainty surrounding the National Health Insurance (NHI) scheme. This has slowed efforts to enhance patient access to life-saving medicines. We must focus on refining the existing system rather than waiting for a complete overhaul.”

Despite these challenges, including others such as infrastructure, access to innovative medicines and their associated high costs, Aurélien and the team have made significant strides. Most notably, the Group has been instrumental in fostering strong engagement between medical schemes, the Council for Medical Schemes, patient advocacy groups, and others; while several prominent medical schemes, such as Discovery Health and Medscheme have entered into agreements that could improve access to innovative medicines in the future. 

Aurélien is quick to credit the collective efforts and dedication of the PAI Working Group for the progress achieved during his tenure, acknowledging their willingness to invest time and energy in something greater than themselves. He recognises the significant long-term commitment required, noting the burdensome and relentless nature of the work, which can lead to discouragement or frustration. Despite facing hurdles, the PAI Working Group has met these with resilience and determination to drive progress and effect meaningful change.

While Aurélien has helped achieve significant strides in improving patient access across the South African healthcare landscape, he is eager to broaden his impact by extending his expertise to other countries where he will continue his work in improving patient access.  

“While I am sad to be moving from South Africa, I believe I have helped set the foundation for change in the country. Even though the registration of innovative medicines has improved, access to these potentially life-saving medicines and increasing the public visibility of patient voices remains a challenge. I implore everyone involved to continue working tirelessly to break down these barriers, ensuring that all patients can benefit from the innovations that have the power to transform their lives. The work is far from over, and we must maintain our commitment to improving healthcare access and outcomes for all,” concludes Aurélien. 

Reflecting on Aurélien’s contributions, Bada Pharasi, CEO at IPASA, adds: “Aurélien’s commitment to improving patient access and healthcare innovation reflects a deep-seated passion for making a tangible difference. As he embarks on this new chapter, we, as IPASA, thank him for his commitment and drive to contribute positively to the healthcare landscape in South Africa. His influence will undoubtedly continue to inspire and impact many in the industry.”

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Online ‘FoMO’ can Cause Employees to Burn Out

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Photo by Vitaly Gariev on Unsplash

Fear of missing out (FoMO) is a key risk factor for employee mental health and, along with information overload, may increase burnout, according to new research.

Researchers from the University of Nottingham’s Schools of Psychology and Medicine analysed survey data from 142 employees to investigate the ‘dark side’ of digital working and found that employees who are worried about missing out on information and are overloaded by it are more likely to suffer stress and burnout. The results have been published today in SAGE Open.

The digital workplace is now recognised as a key strategic asset in organisations that enables worker productivity and flexibility in context of hybrid working. However, the potential downsides in terms of worker well-being also need to be considered, especially given the proliferation of digital communication channels and tools since Covid.

Elizabeth Marsh, PhD student from the School of Psychology

This new study connects to previous work which revealed that employees who are more mindful in the digital workplace are better protected against stress, anxiety and overload.

In this research FoMO is defined as anxiety about missing out on both important information and updates, as well as opportunities for relationships and interactions. FoMO has long been a term used in relation to social media, and now this new research shows it is an effect that is being felt in the workplace.

The participants in the study were surveyed about their experiences of the dark side effects of the digital workplace which were identified as; stress, overload, anxiety and fear of missing out and how these affected their wellbeing.

The results showed that among the dark side effects, those relating to information – both feeling overloaded by it and fearing missing out on it – proved particularly detrimental for well-being both directly and by elevating overall stress related to digital working.

Elizabeth adds: “The glut of information flowing through channels such as email, intranets or collaboration tools can lead workers to worry about missing out on it as well as succumbing to overload as they strive to keep up. To help people cope with information overwhelm, serious and sustained attention should be given to both optimising information management and supporting information literacy.”

The research makes some practical suggestions for employers which include investing in practices to optimise the amount and flow of information to employees. The findings could also be used by HR departments to consider policy and training options that would support the end-users of the digital workplace to better access, manage and consume information in a way that is conducive to well-being as well as productivity.

Consideration of the digital workplace in work and job design is essential to not only employee productivity but also well-being in modern organisations. Where this is lacking, elevated stress and burnout as well as poorer mental health may result. Our findings indicate the information ecosystem as an important area for attention both inside organisations and among the research community.

Professor Alexa Spence, School of Psychology

Source: University of Nottingham

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New Brain–computer Interface Allows Man with ALS to ‘Speak’ Again

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A new brain-computer interface (BCI) developed at UC Davis Health translates brain signals into speech with up to 97% accuracy – the most accurate system of its kind. The researchers implanted sensors in the brain of a man with severely impaired speech due to amyotrophic lateral sclerosis (ALS). The man was able to communicate his intended speech within minutes of activating the system.

A study about this work was published in the New England Journal of Medicine.

ALS, also known as Lou Gehrig’s disease, affects the nerve cells that control movement throughout the body. The disease leads to a gradual loss of the ability to stand, walk and use one’s hands. It can also cause a person to lose control of the muscles used to speak, leading to a loss of understandable speech.

The new technology is being developed to restore communication for people who can’t speak due to paralysis or neurological conditions like ALS. It can interpret brain signals when the user tries to speak and turns them into text that is ‘spoken’ aloud by the computer.

“Our BCI technology helped a man with paralysis to communicate with friends, families and caregivers,” said UC Davis neurosurgeon David Brandman. “Our paper demonstrates the most accurate speech neuroprosthesis (device) ever reported.”

Brandman is the co-principal investigator and co-senior author of this study. He is an assistant professor in the UC Davis Department of Neurological Surgery and co-director of the UC Davis Neuroprosthetics Lab.

The new BCI breaks the communication barrier

When someone tries to speak, the new BCI device transforms their brain activity into text on a computer screen. The computer can then read the text out loud.

To develop the system, the team enrolled Casey Harrell, a 45-year-old man with ALS, in the BrainGate clinical trial. At the time of his enrolment, Harrell had weakness in his arms and legs (tetraparesis). His speech was very hard to understand (dysarthria) and required others to help interpret for him.

In July 2023, Brandman implanted the investigational BCI device. He placed four microelectrode arrays into the left precentral gyrus, a brain region responsible for coordinating speech. The arrays are designed to record the brain activity from 256 cortical electrodes.

“We’re really detecting their attempt to move their muscles and talk,” explained neuroscientist Sergey Stavisky. Stavisky is an assistant professor in the Department of Neurological Surgery. He is the co-director of the UC Davis Neuroprosthetics Lab and co-principal investigator of the study. “We are recording from the part of the brain that’s trying to send these commands to the muscles. And we are basically listening into that, and we’re translating those patterns of brain activity into a phoneme – like a syllable or the unit of speech – and then the words they’re trying to say.”

Casey Harrell with his personal assistant Emma Alaimo and UC Davis neuroscientist Sergey Stavisky

Faster training, better results

Despite recent advances in BCI technology, efforts to enable communication have been slow and prone to errors. This is because the machine-learning programs that interpreted brain signals required a large amount of time and data to perform.

“Previous speech BCI systems had frequent word errors. This made it difficult for the user to be understood consistently and was a barrier to communication,” Brandman explained. “Our objective was to develop a system that empowered someone to be understood whenever they wanted to speak.”

Harrell used the system in both prompted and spontaneous conversational settings. In both cases, speech decoding happened in real time, with continuous system updates to keep it working accurately.

The decoded words were shown on a screen. Amazingly, they were read aloud in a voice that sounded like Harrell’s before he had ALS. The voice was composed using software trained with existing audio samples of his pre-ALS voice.

At the first speech data training session, the system took 30 minutes to achieve 99.6% word accuracy with a 50-word vocabulary.

“The first time we tried the system, he cried with joy as the words he was trying to say correctly appeared on-screen. We all did,” Stavisky said.

In the second session, the size of the potential vocabulary increased to 125 000 words. With just an additional 1.4 hours of training data, the BCI achieved a 90.2% word accuracy with this greatly expanded vocabulary. After continued data collection, the BCI has maintained 97.5% accuracy.

“At this point, we can decode what Casey is trying to say correctly about 97% of the time, which is better than many commercially available smartphone applications that try to interpret a person’s voice,” Brandman said. “This technology is transformative because it provides hope for people who want to speak but can’t. I hope that technology like this speech BCI will help future patients speak with their family and friends.”

The study reports on 84 data collection sessions over 32 weeks. In total, Harrell used the speech BCI in self-paced conversations for over 248 hours to communicate in person and over video chat.

“Not being able to communicate is so frustrating and demoralising. It is like you are trapped,” Harrell said. “Something like this technology will help people back into life and society.”

“It has been immensely rewarding to see Casey regain his ability to speak with his family and friends through this technology,” said the study’s lead author, Nicholas Card. Card is a postdoctoral scholar in the UC Davis Department of Neurological Surgery.

“Casey and our other BrainGate participants are truly extraordinary. They deserve tremendous credit for joining these early clinical trials. They do this not because they’re hoping to gain any personal benefit, but to help us develop a system that will restore communication and mobility for other people with paralysis,” said co-author and BrainGate trial sponsor-investigator Leigh Hochberg. Hochberg is a neurologist and neuroscientist at Massachusetts General Hospital, Brown University and the VA Providence Healthcare System.

Brandman is the site-responsible principal investigator of the BrainGate2 clinical trial. The trial is enrolling participants. To learn more about the study, visit braingate.org or contact braingate@ucdavis.edu.

Source: UC Davis Health

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Benefits of UV Exposure may Outweigh Risks in Low-sunlight Countries

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Photo by Julian Jagtenberg on Pexels

The health benefits of spending time in the sun could outweigh the risks for those living in areas with limited sunshine, a UK study suggests. In low-sunlight locations such as parts of the UK, exposure to higher levels of ultraviolet (UV) radiation was linked to a drop in deaths due to cardiovascular disease and cancer.

Adapting public health advice to reflect both the risks and benefits of UV exposure may help to reduce disease burden and improve life expectancy in low-sunlight countries, the research team says.

Experts caution that measures should still be taken to protect the skin when UV levels are high, to prevent sunburn and the development of skin cancer.

Volunteer data

University of Edinburgh scientists used genetic and health information from the UK BioBank – an anonymised database of health details from volunteers – to examine the UV exposure of 395 000 people across the UK. Participants were restricted to those of white European descent, due to the role skin pigmentation plays in the body’s response to UV exposure.

The team applied two measures to identify those exposed to higher levels of UV. They used the geographical location of participants to calculate their average annual exposure to solar energy and, separately, whether they used sunbeds.

The findings were adjusted for other factors that might influence health – including smoking, exercise, social deprivation and gender – to reduce the chance that these factors were responsible for any of the changes observed.

Health impact

Living in locations with higher UV levels, for example Cornwall, was associated with a lower risk of death from cardiovascular disease and cancer – 19% and 12%, respectively – than living in areas with lower UV levels, such as Edinburgh or Glasgow.

Sunbed use was linked to a 23% lower risk of death from cardiovascular disease and a 14% lower risk of death from cancer, compared to non-users. It is possible that people who use sunbeds may also seek out greater sun exposure and so this result may reflect broader sun seeking behaviour, the team says.

Those with a higher estimated UV exposure had a slightly increased risk of being diagnosed with melanoma, but their risk of dying from the condition was not raised.

As the study is based on UK data from a white European population, the findings are of most relevance to similar groups in low-sunlight countries. Further research into locations with higher UV exposure is needed to build a clearer picture of the potential benefits to health, experts say.

The study, funded by Health Data Research UK, is published in the journal Health and Place.

Our paper adds to a growing body of evidence suggesting that in lower light environments, relatively higher exposure to UV is good for your health. Though there may be an increased risk of skin cancer incidence with higher UV exposure, this risk appears to be outweighed by a larger reduction in the risk of death from cancer and cardiovascular related disease.

Professor Chris Dibben, University of Edinburgh’s School of GeoSciences

Dermatologists have traditionally only considered possible harm to the skin caused by sunlight, much of which dates from the experience of white-skinned individuals in sunny countries such as Australia. When the UV index is very high, protecting skin is important.

However, this research shows that in the UK, the balance of benefit and risk from sunlight exposure is probably very different from that in sunnier countries.

Professor Richard Weller, University of Edinburgh’s Centre for Inflammation Research

Source: The University of Edinburgh

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A New Way to Kill Cancer Cells via Ferroptosis

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Human colon cancer cells. Credit: National Cancer Institute

In a first, a team in Germany has produced a substance capable of sending cancer cells into ferroptosis, a form of cell death discovered only in recent years. This could pave the way for the development of new drugs.

Conventional cancer drugs work by triggering apoptosis, that is programmed cell death, in tumour cells. However, tumour cells have the ability to develop strategies to escape apoptosis, rendering the drugs ineffective. In the journal Angewandte Chemie, a research team from Ruhr University Bochum, Germany, describes a new mechanism of action that kills cancer cells through ferroptosis. Ferroptosis is another form of programmed cell death that wasn’t discovered until the 2010s. The Bochum group synthesised a metal complex, demonstrated its effectiveness in cell cultures and on microtumours and identified the chemical processes underlying the mechanism of action.

Two types of programmed cell death

In programmed cell death, certain signaling molecules initiate a kind of suicide program to cause cells to die in a controlled manner. This is an essential step to eliminate damaged cells or to control the number of cells in certain tissues, for example. Apoptosis has long been known as a mechanism for programmed cell death. Ferroptosis is another mechanism that has recently been discovered which, in contrast to other cell death mechanisms, is characterised by the accumulation of lipid peroxides. This process is typically catalysed by iron which is where the name ferroptosis derives from.

“Searching for an alternative to the mechanism of action of conventional chemotherapeutic agents, we specifically looked for a substance capable of triggering ferroptosis,” explains Johannes Karges. His group synthesized a cobalt-containing metal complex that accumulates in the mitochondria of cells and generates reactive oxygen species, more precisely hydroxide radicals. These radicals attack polyunsaturated fatty acids, resulting in the formation of large quantities of lipid peroxides, which in turn trigger ferroptosis. The team was thus the first to produce a cobalt complex designed to specifically trigger ferroptosis.

Effectiveness demonstrated on artificial microtumours

The researchers from Bochum used a variety of cancer cell lines to show that the cobalt complex induces ferroptosis in tumour cells. On top of that, the substance slowed down the growth of artificially produced microtumours .

“We are confident that the development of metal complexes that trigger ferroptosis is a promising new approach for cancer treatment,” as Johannes Karges sums up the research, adding: “However, there’s still a long way to go before our studies result in a drug.” The metal complex must first prove effective in animal studies and clinical trials. What’s more, the substance doesn’t currently selectively target tumour cells, but would also attack healthy cells. This means that researchers must first find a way to package the cobalt complex in such a way that it damages nothing but tumour cells.

Source: Ruhr-University Bochum

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Pesticide Use Within 500m of Pregnant Women Linked to Stillbirth Risk

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Photo by Arjun Mj on Unsplash

Living less than 500m from pesticide use prior to conception and during early pregnancy could increase the risk of stillbirths, according to new research published in the American Journal of Epidemiology.

Researchers from the University of Arizona found that during a 90-day pre-conception window and the first trimester of pregnancy, select pesticides, including organophosphates as a class, were associated with stillbirth.

“In this study, some specific ingredients stood out due to their significant associations with stillbirth risk,” said first author Melissa Furlong, PhD, who studies the chronic health effects of environmental contaminants as an assistant professor and environmental epidemiologist at the Zuckerman College of Public Health. “These findings underscore the importance of considering individual pesticides rather than just the overall pesticide class, as specific chemical compounds may pose unique risks. It also highlights the potential for pre-pregnancy exposures to affect reproductive outcomes.”

To conduct the study, researchers linked Arizona pesticide use records for 27 different pesticides with state birth certificate data that included 1 237 750 births and 2290 stillbirths from 2006 to 2020.

They found that living within 500m of specific pyrethroid, organophosphate or carbamate pesticide applications during a 90-day pre-conception window or the first trimester was associated with an increased risk of stillbirth. 

Specifically, the pesticides cyfluthrin, zeta-cypermethrin, organophosphates as a class, malathion, carbaryl and propamocarb hydrochloride were linked to increased stillborn births pre-conception. During the first trimester, fenpropathrin, permethrin, organophosphates as a class, acephate and formetanate hydrochloride were associated with stillbirths.

“Among organophosphates, acephate showed the strongest effect estimates on stillbirth, so that exposure to acephate in the first trimester was associated with a doubling of risk,” said co-author Paloma Beamer, PhD, a professor and interim associate dean at the Zuckerman College of Public Health.  “Within the pyrethroid class, cyfluthrin exposure during the 90 days prior to conception almost doubled the risk of stillbirth.”

Pesticides are chemical substances used to control pests in various settings. They are commonly categorized into different classes, such as organophosphates, pyrethroids and carbamates. The primary route of exposure for most people is through diet, but household use, agricultural drift and occupational exposure are also significant pathways.

Researchers say while some pesticides may not have been directly implicated in this study, they could still pose risks to maternal and foetal health.

Pregnant women may be particularly vulnerable to the adverse effects of pesticide exposure due to physiological changes during pregnancy, such as increased metabolic rate, altered hormone levels and changes in the immune system. The developing foetus may be more susceptible to the toxic effects of pesticides during this period of rapid growth and development.

“Further research is essential to fully understand the safety profiles of various pesticides and to understand the underlying mechanisms of pesticide-induced stillbirth,” Furlong said. “This study underscores the need to develop strategies for mitigating exposure to protect maternal and foetal health.”

Source: University of Arizona Health Sciences