Wednesday, January 6, 2021

How artificial intelligence can assist primary care physicians in cancer diagnosis

In recent years, improvements in prevention, screening, diagnosis, and treatment have greatly lowered cancer incidence and mortality. Early diagnostics played an instrumental part in reducing mortality from cancer in the US by 29 percent from 1991 to 2017, annual statistics reported by the American Cancer Society show. However, a model created by the National Cancer Institute (NCI) projects nearly ten thousand more people will die of cancer over the next decade as a result of missed screenings, postponed diagnoses, and cutbacks in oncology care caused by the COVID-19 pandemic.


Identifying Cancer Cells in the Blood


Catching an early-stage cancer before it spreads based on a few drops of blood is considered the “holy grail” for cancer diagnostics but has been beset by many challenges. As cancer is more curable at early stages, its early detection is crucial. One of the most studied bio sources so far for early diagnosis is circulating tumor cells (CTCs), which are shed into the blood from metastatic sites and can therefore give a snapshot of the cancer progression at a given time. However, their extremely low numbers in the blood and molecular heterogeneity make it nearly impossible to use them as a diagnostic tool. Abnormal blood cells per contra, that are also indicative of different blood cancers, are more abundant in the blood stream and are routinely detected and enumerated by experienced technicians that inspect stained blood films using microscopes in hematology labs.


Current Challenges in Blood-Based Early Cancer Detection


While some cancers, such as prostate cancer, require specific antigen testing (PSA), or identification of immunoglobins for myeloma, blood cancers may be the first type of cancer that can be detected early based on basic blood testing that generally takes place in primary care. The most commonly performed blood test in the world, the complete blood count (CBC) that is mostly used to understand a patient’s overall health status, could become a much stronger indication of blood cancers if they incorporate the ability to flag and count abnormal cells, including nucleated red blood cells (nRBCs), Immature Granulocytes (IGs), and blast cells.

Today, this type of blood analysis is only partially available by using lab-based hematology analyzers, which are mostly large, expensive and located far from the frontlines of primary care. Furthermore, CBC testing is performed using analyzer technology that has not had a major upgrade since the 1960s and does not allow for precise identification and counting of abnormal cells. Standard hematology analyzers only measure 3 to 4 optical or electrical properties of each cell, which makes it very difficult to differentiate normal and abnormal cells that vary only in nuance. As such, abnormal cells cannot be differentiated from their normal counterparts and are often confounded with other types of cells, making the results unreliable. When the presence of abnormal cells is suspected a “flag” is raised by the analyzer and the sample is sent for manual inspection by microscope.


AI’s Role in Abnormal Cell Flagging and Enumeration


New point-of-care technologies that leverage machine vision and AI can now provide rapid analysis of blood cells, including comprehensive flagging and even counting of abnormal blood cells, to provide a better option for early diagnosis.

Making these diagnostics available through a point-of-care system means that physicians in primary care can have a significantly earlier indication of an issue through rapid blood testing in their office. This also means that patients do not have to go into specific labs to have routine blood testing that can be handled in the doctor’s office. Furthermore, a trend towards treating oncology patients at home, makes such POC diagnostic technologies highly valuable. Patients receiving chemotherapy must have their blood counts done regularly, being able to administer treatment at home demands portable and robust POC analyzers that can deal with abnormal cells that are frequent in such patients. Moreover, these patients are immunosuppressed and allowing them to be tested and treated at home eliminates the risk of infection in hospitals or other clinical environments.

Rapid and accessible abnormal cell enumeration can play a greater role in early cancer detection than the present cumbersome and time-consuming process. Making it available through a point-of-care diagnostic system that is easily managed and offers a fast turnaround time for lab-accurate results would both lower pressure on the healthcare system, as well as improve care options for patients. The ongoing COVID-19 pandemic has further underlined the need for such a solution to be implemented.

Developments that have gone through the clinical rigor of the peer-review and evaluation process will start making an impact in the “one-drop diagnostics” market. It will be to everybody’s benefit once the companies that have successfully showcased their technology in clinical trials are included in the mainstream healthcare system.


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Tuesday, January 5, 2021

4 Ways to Convert Your Instagram Followers into Clients

1. Promotions
2. Contests
3. Charity
4. Teasers

But how do you get more followers on Instagram?

Instagram has emerged as one of the most popular social media channels for individuals and businesses alike. If your practice has a presence on Instagram, it may be time to start converting your followers into clients. Here are four simple ways to do it.You can drive first time sales with your Instagram audience by enticing them with promotional offerings such as discounts, freebies, deals, BOGOs (Buy One Get One), and other similar promotional offers. You can create a sense of urgency by mentioning the date or time of offer expiry. You need to make sure that in your Instagram post you explain the steps a person needs to take in order to avail the promotional offer.A good way to turn your Instagram followers into clients is by encouraging them to try out your services and products. To do this, you can create online contests and ask users to participate by posting content with a specific hashtag or by following your account. You may offer a rebate or a free service as a prize to the winners.You can promote your favorite charities on Instagram and encourage your followers to support them. By getting involved in charitable work you can turn your Instagram followers into clients as they build an affinity for your brand. People expect and approve of businesses that give back to the community and society.Instagram is the perfect place to keep your audience excited by giving sneak peeks into any new procedures or products you may be about to introduce. However, you need to ensure not to spam your follower’s feeds.Growing a follower base on Instagram is a time-consuming process that requires dedication and patience. It needs tremendous effort and energy regardless of whether you are an established medical practitioner or a new entrant. You might wonder about quick ways to increase your follower count after you have used all the right hashtags and created good content.



However, it is important that you do not give in to temptation and indulge in dubious Instagram practices such as ‘buying’ follower lists from unscrupulous online sources. They might increase your numbers but will do nothing when it comes to future engagement.



You need a genuinely interested audience to promote your feeds. Fortunately, there are straightforward and less expensive ways to get followers on Instagram.



As a first step, make sure that your Instagram username is recognizable and searchable. This will make it easier for people to find you. Next, focus your attention towards your bio as it is one of the driving factors that will prompt the client to take an action.



Once you have optimized your Instagram profile as a physician, you can start posting. But before you start engaging with people, it is a good idea to have at least a few informative and useful posts online so that users who show up can receive some value right away. Additionally, remember that photo and video quality is more important on Instagram as compared to Twitter and Facebook, because your Instagram posts have to include a photo or video in order to post.



After a few postings, you might want to start following other accounts that relate to your medical practice. This works out in your favor as Instagram more or less works like a community. You can even gain influencers by interacting with content on other users’ accounts.



This is the most organic way to put your Instagram account in the spotlight, as the account holder will receive a notification when you interact or follow an account. This can lead to them following your account as well. Additionally, always remember to respond to comments and engage with user content. Using this goodwill, the next step is to encourage other users to share your own content.



Lastly, never forget to promote your account on other social media platforms and channels. You can add an Instagram button on your practice website or ask followers on other social media platforms to join you on Instagram. Asking and engaging with your target audience are the best ways to get more followers for your Instagram account.


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Sunday, January 3, 2021

WHO Report Highlights New COVID-19 Variants

As new variants of the coronavirus disease 2019 (COVID-19) begin to emerge across the globe, the World Health Organization (WHO) has released a report, replete with risk assessment and guidance, on the series of recently observed SARS-CoV-2 variants.


The global health institution highlighted a quartet of variants currently in circulation from various points in the last year.

D614G Substitution Variant – the Primary Virus


The currently most dominant form of the global virus is a SARS-CoV-2 variant with a D614G substitution in the gene encoding the spike protein, initially observed in late January or February 2020 before overwhelming the strain identified in China.

In June, it became the most dominant strain, having increased infectivity and transmission to previous strains. However, it does not cause greater illness nor worsen effectiveness of existing laboratory diagnostics, therapies, vaccines, or epidemiologic efforts.

The Danish “Cluster 5” Variant


A SARS-CoV-2 variant was identified in North Jutland, Denmark, in August and September. It was characterized by its link to infection among farmed mink before subsequently transmitting to humans. It possesses multiple mutations not previously observed, and experts have raised concern that it could result in reduced virus neutralization that would decrease the extent and duration of immune protection from infection recovery or vaccination.

The “Cluster 5” variant is currently being assessed for virus neutralization among humans infected with it, though Denmark has reported only 12 human cases in September, without indication of widespread transmission.

The Variant in the UK


Three weeks ago, the UK initially reported to WHO SARS-CoV-2 variant B117, which has since been observed to have 23 nucleotide substitutions without phylogenetic relation to the virus circulating at the time in the country.

The variant initially appeared in Southeast England, but has since replaced virus lineages in the area as well as in London.

Preliminary assessment indicates the variant has increased transmissibility, but no change in disease severity—as per hospitalization length and 28-day case fatality—nor reinfection risk.

Another of this variant’s mutations appears to have affected diagnostic PCR assays with an S gene target, however the impact is not anticipated to be significant.

As of this week, the variant has been reported in 31 other countries, territories, areas in 5 of the 6 WHO regions.

The South Africa 5O1Y.V2 Variant


A new variant was detected by South African authorities on December 18, spreading rapidly among 3 provinces with a N501Y mutation.

A month earlier, routine sequencing observed this variant had largely replaced other SARS-CoV-2 viruses in regions of Eastern Cape, Western Cape, and KwaZulu-Natal provinces. Despite this rapid displacement and an observed higher viral load that could indicate transmissibility, further research is needed.

Additionally, WHO indicated there is currently no evidence of this variant being associated with more severe disease or worse outcomes, though again, more research is needed. As of this week, is has been reported in 4 other countries.

Response to Variants


Aside from affected nation’s authorities currently undergoing epidemiological and virologic assessments on these variants, as well as the addition of the UK and South Africa variants’ genomic data to the Global Initiative on Sharing Avian Influenza Data (GISAID), WHO highlighted a series of actions initiated to respond to the new threats:
  • Intensified sampling in affected regions to interpret new variant circulation and spread.
  • Assessments by national scientific teams to observe the mutations’ effects on reinfection, vaccination, diagnostic testing, infection severity, and transmissibility.
  • The collaboration between WHO and research/government authorities to analyze epidemiologic, modelling, phylogenetic and laboratory findings as they become available.
  • Collaboration with WHO and national authorities to identify means of strengthening SARS-CoV-2 surveillance systems, as well as implementing or bolstering genetic sequencing capacity to evaluate variants.
  • Improved community engagement and communication to describe the public health implications of SARS-CoV-2 variants to the public, with emphasis on continued social distancing strategies while research continues.

Variant Risk Assessment


WHO stressed the commonality of viruses to change over time, often without direct benefit to its infectiousness or transmissibility, and sometimes limiting propagation. They also noted that virus mutation risk increases with the frequency of human and animal infections.

“Therefore, reducing transmission of SARS-CoV-2 by using established disease control methods as well as avoiding introductions to animal populations, are critical aspects to the global strategy to reduce the occurrence of mutations that have negative public health implications,” they wrote.

Though initial assessment implicates the UK and South African variants do not cause change in clinical presentation or severity, their potential for higher case incidence could lead to increased COVID-19 related hospitalizations, and therefore, deaths. As such, WHO warned more intensive public health response may be necessary to control variant transmission, pending research.

Guidance


Existing strategies of disease control—including epidemiological surveillance, strategic testing, contact tracing, and adjusted public health and social measures—are advised to continue during investigation of the variants.

WHO also advised countries increase routine systematic sequencing of SARS-CoV-2 viruses, when possible, to better monitor variant emergence.

“While mutations of SARS-CoV-2 are expected, it is important to continue to monitor the public health implications of new virus variants,” they wrote. “Any increased in transmissibility associated with SARS-CoV-2 variants could make control more difficult.”

What’s more, the authority advised national and regional health organizations work with travel, transport, and tourism sectors to assure travelers to and from countries affected by new variants are informed on variants and resourced to prevent spread.

“Countries should also ensure that measures affecting international traffic are risk-based, evidence-based, coherent, proportionate and time limited,” they wrote. “In all circumstances, essential travel by countries should always be prioritized and facilitated.”


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