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Taking a Break

Airplane at gate

(A. Kotok)

12 April 2018. Science & Enterprise is taking a break for two weeks, to do personal travel and study tour. We will resume our regular posts on Monday, 30 April. Thanks for your continued readership, and we will see you then.

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Surprising Similarities Between Running A Vet’s Surgery and a Healthcare Clinic

– Contributed content –

Medical gear

(Rawpixel, Pixabay)

12 April 2018. At first glance, the idea of a healthcare clinic and a veterinary surgery being similar to one another seems absurd. As much as people love their pets, surely there is no true comparison between the two?

When viewed on the surface, then no, veterinary surgeries and healthcare clinics don’t have a lot in common. However, if you step back from the actual work that they are performing with patients, you can see that these two very different types of business likely have more in common than you’d think.

Both experience issues with payment

Both healthcare clinics and vet surgeries have to deal with collections at some point in their organizational cycle. Medical care — be it for an animal or a human — is expensive, and some people simply don’t have the means to pay. Both types of business will need to deal with debt recovery at some point, which can complicate the general operations of their day-to-day practice.

Specialist software makes management and compliance easier for both

Whether it’s healthcare clinic software that allows the business to ensure HIPAA compliance or specific software for veterinarians, the necessity for the right tools is clear. To ensure they can offer maximum protection to their patients, both of these businesses have to invest in specialist medicalized software that focuses on record-keeping and secure ease of access.

Both businesses rely on technological innovation

When it comes to choosing a healthcare clinic or a vet, patients (or the owners of patients!) are inclined to ensure they choose the best of the best. For both types of businesses, this tends to mean that they look for technological innovation— any equipment that can speed up diagnosis or offer a better prognosis is therefore an asset. This means that both vets and healthcare clinics often have to invest heavily in the latest technology, which helps to explain why the running costs for both businesses tend to be higher than average.

Missed appointments are a serious issue for both businesses

Most people know that missed appointments cost the healthcare service money, but the problem is just as profound for veterinary clinics. This issue of missed appointments is a huge problem for both types of business, further uniting them in operational terms. Increased public awareness of the true cost of missed appointments could benefit both these business types exponentially.

Clinical staff can be rated online

It may not be popular with doctors and vets, but their professions mean that their skills can be “ranked” online. While this kind of system is subject to a huge amount of debate, it does lead to more informed patients and owners, which is broadly accepted to be a good thing.

In conclusion

The types of work that vets and doctors do are a world apart from one another, but in terms of how their businesses operate, there are more than a few similarities. It just goes to show that healthcare is healthcare— the species of the patient, in terms of business operations, is not particularly important!

Puppy at vet

(12019, Pixabay)

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Platform to Integrate Robotics, Synthetic Biology, A.I.

Microbes

(Department of Defense)

12 April 2018. Two companies are developing a new model for a cloud-based platform that makes possible automated collaborative research with artificial intelligence in synthetic biology. The project is undertaken by Transcriptic, in Menlo Park, California and Ginkgo Bioworks in Boston, under a $9.5 million contract from Defense Advanced Research Projects Agency, or Darpa, an agency of the U.S. Department of Defense.

Transcriptic and Ginko Bioworks aim to to overcome current limitations of biological design and modeling that the companies say rely on trial-and-error experimentation and imprecise measurement making it difficult to explore complex cellular systems with reproducible results. This initiative expects to address these limitations, say the companies, with more intensive application of engineering principles enabling large-scale collaborative experiments using robotics by geographically dispersed teams.

In this project, Ginko Bioworks is contributing its synthetic biology facilities and expertise that now develop engineered yeast and other microorganisms for industrial processes and consumer products. The company’s labs, what it calls foundries, design customized biological forms to meet specified properties, using computational techniques, analytics, and robotics. Ginko Bioworks says its foundries generate terabytes of data from genomic sequences, transcriptions, metabolomics, and proteomics.

Transcriptic develops science lab automation systems that bring together lab instruments and processes with Internet-of-Things or IoT technologies. The company offers a robotic cloud-based laboratory platform that it says can accelerate scientific discovery. Transcriptic also integrates these systems and processes into a single user interface called Transcriptic Common Lab Environment that makes it possible to conduct lab experiments from a remote laptop.

The companies plan to merge these capabilities with design and analysis algorithms driven by machine learning, a type of artificial intelligence. In addition to analyzing large quantities of data, the project team expects to apply machine learning to accelerate discovery and biological design as well as produce an open data exchange in the cloud could that can benefit research and academic communities in fields other than synthetic biology.

Ginko Bioworks is already using Transcriptic’s technology in its labs. In a five-year deal announced in October 2017, Ginko Bioworks began installing robotics systems in its Boston labs with the aim of doubling their output and providing more flexibility to meet customer needs in a growing biotech industry. The deal represents Transcriptic’s first licensing activity that involved on-site collaboration with customers.

Darpa is supporting this collaboration under its Synergistic Discovery and Design Program to encourage more data-driven methods like those used in aeronautics, automobiles, and integrated circuits to boost robust designs in disciplines where full-scale models for those designs are lacking. The agency cites synthetic biology as one of those fields, with biological systems that have millions of protein-metabolite interactions, yet still too often rely on manually-intensive analysis of small data sets.

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Nasal Spray Vaccine Shown to Control Peanut Allergies

Peanuts in shell

(USDA.gov)

12 April 2018. A vaccine to protect against peanut allergies, given as a nanoscale droplets suspended in a nasal spray, is shown to prevent allergic reactions in tests with lab mice sensitized to peanuts. Results of the tests and a description of the vaccine developed at University of Michigan in Ann Arbor appear in yesterday’s issue of the Journal of Allergy & Clinical Immunology (paid subscription required).

According to Food Allergy Research and Education, an advocacy group that helped fund the study, allergies to peanuts and other foods are a result of the body’s immune system misinterpreting certain food ingredients as pathogens, and responding by the release of histamines, chemicals in the body causing the allergy symptoms. In most cases, the symptoms are mild, such as runny nose and itching, but people with peanut allergies face a real and elevated risk of anaphylaxis, a life-threatening condition constricting airways, swelling the throat, and causing a sharp drop in blood pressure. The group says says some 15 million people in the U.S. including nearly 6 million children, have a food allergy, with growing numbers of people reporting an allergy.

The Michigan team led by pharmacologist Jessica O’Konek and immunologist James Baker are seeking better tools for physicians and their patients deal with food allergies, such as peanuts. “Right now,” says O’Konek in a university statement, “the only FDA-approved way to address food allergy is to avoid the food or suppress allergic reactions after they have already started. Our goal is to use immunotherapy to change the immune system’s response by developing a therapeutic vaccine for food allergies.”

The researchers’ immunotherapy approach harnesses the immune system to prevent the reactions to peanuts caused by the immune system. In this case, the vaccine generates antibodies to block production of cytokines, proteins released by T-cells, white blood cells in the immune system that result in inflammation. At the same time, the vaccine must also activate other T-cells that help regulate immune responses.

The team knew from previous work that mucous membranes in the nose offer a rich target for generating these responses. To activate antibodies in the mucous membranes, the researchers formulated their vaccine into nanoscale droplets, suspended in an emulsion of purified soybean oil. The droplets, say the researchers measure 350 to 400 nanometers, where 1 nanometer equals 1 billionth of a meter. The soybean oil needed thorough purification to retain its physical properties, but also remove possible soy allergens.

The researchers tested the vaccine in lab mice chemically induced with peanut sensitivities. Over a 2 month period, the mice were each given 3 doses of the nasal spray vaccine, either as a nanoscale emulsion, or mixed with a saline solution for comparison, and then given peanuts as food. Mice given the nano-emulsion vaccine show decreases in the allergy-causing cytokines and other proteins before being given peanuts. After feeding on peanuts, the nano-emulsion vaccine recipients show measurable reductions in hypersensitivity and produce more protective interleukin-10 cytokines and T-cells that help regulate immune responses. Mice without the nano-emulsion, on the other hand, exhibit allergic responses, including itchiness and puffy eyes, and in some cases more severe reactions, such as shock.

The team now plans to delve more into the mechanisms for suppressing food allergies and extending the protection time for the vaccine. Baker, who is CEO and medical director of Food Allergy Research and Education, and O’Konek are listed as co-inventors on a patent application for the processes. Baker is also founder of the company NanoBio Corp. in Ann Arbor that licenses the technology.

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FDA Clears A.I. Software Detecting Diabetic Eye Disease

Fundus photograph

Fundus photograph of a healthy right eye (OptometrusPrime, wikimedia Commons)

11 April 2018. The Food and Drug Administration authorized a system for detecting diabetic retinopathy, a condition threatening the vision of people with diabetes, that uses artificial intelligence to analyze images of patients’ retinas. The system known as IDx-DR is a product of the company IDx LLC, in Coralville, Iowa, that developed the technology with University of Iowa.

High levels of blood sugar can cause serious complications in people with diabetes, including vision problems. Among these issues is damage to the fine blood vessels in the retina, located in the back of the eye that detects and converts light to signals sent through the optic nerve to the brain. Diabetic retinopathy is the name given to this condition that can range from mild leakage in the eye to swelling and distortion of the blood vessels, and proliferation of new blood vessels to compensate for the damage.

One consequence of this damage is swelling in the macula, the part of the retina that provides the sharpest vision, a disorder known as diabetic macular edema. Other outcomes include cataracts, glaucoma, or permanent vision loss if the retina detaches from the eye. Centers for Disease Control and Prevention says diabetes is the leading cause of new blindness among adults in the U.S. age 20 to 74. CDC estimates 4.1 million people have diabetic retinopathy, including 899,000 individuals with advanced stages of the condition threatening their vision.

The IDx-DR system analyzes images of patients’ retinas taken by a specialized fundus camera that provides high-resolution color medical images of the eyes. The images are stored on a local system and uploaded to a cloud-based server where IDx-DR software analyzes the images, and according to the company returns results in one minute or less. The analysis is based on algorithms the company says combine image analysis and deep learning that first assess image quality, then inspect for lesions and location of irregularities in the retina, resulting in an assessment of diabetic retinopathy. Assuming images of sufficient quality, IDx-DR either returns a positive result for moderate or more severe diabetic retinopathy, or a mild case of the condition, calling for a retest in one year.

FDA’s clearance is based in part on results from a clinical trial where retinal images from 900 individuals with diabetes were analyzed by IDx-DR software, compared to the original professional diagnosis. The results show the system could accurately detect more than mild cases of diabetic retinopathy 87 percent of the time, and identify cases where individuals had mild or no diabetic retinopathy 90 percent of the time. FDA’s authorization applies only to detection of more than mild cases diabetic retinopathy, and not to other eye disorders. The agency previously gave the system a Breakthrough Device designation, a new program that gives expedited reviews for devices that offer more effective diagnostics or treatments, with no cleared or approved alternatives.

IDx-DR is designed  for detection of diabetic retinopathy by primary care clinicians rather than specialists. The system is an invention of Michael Abramoff, a practicing ophthalmologist who developed the system with clinicians, researchers, and engineers at the nearby University of Iowa.

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Implanted Sensor Monitors Alcohol in Body

Alcohol monitoring chip

Alcohol monitoring chip (David Baillot, UC San Diego Jacobs School of Engineering)

11 April 2018. A university bioengineering lab developed a tiny implantable sensor that in lab tests tracked alcohol levels in bodily fluids, while requiring little power, making it capable of operating for extended periods. The development team from University of California in San Diego described the device in yesterday’s sessions of the IEEE Custom Integrated Circuits Conference in San Diego.

Researchers from the Biosensors and Bioelectronics Group at UC-San Diego, led by engineering professor Drew Hall, is seeking unobtrusive methods for easily monitoring alcohol levels in people needing help in dealing with alcohol abuse. Centers for Disease Control and Prevention says excessive alcohol use, either heavy or binge drinking, is associated with increased risk of liver disease and unintentional injuries, among other disorders. The National Survey on Drug Use and Health in 2015, cited by the IEEE paper’s authors, notes that 27 percent of adults in the U.S. engaged in binge drinking, while 7 percent reported heavy alcohol use. The survey also shows about 15 million adults suffer from alcohol use disorder.

Treating alcohol abuse often requires close monitoring of alcohol consumption to prevent relapse, but Hall and colleagues point out that most tools for this purpose have drawbacks. Breathalyzers are bulky and require individuals to initiate their use, while blood tests can be taken only by clinicians. Newer methods, such as tattoo-style electronics worn on the skin address some of those issues, but they can be removed or are designed to be used only one time.

“The ultimate goal of this work,” says Hall in a university statement, “is to develop a routine, unobtrusive alcohol and drug monitoring device for patients in substance abuse treatment programs.” The lab’s solution is a device they call the BioMote, a chip device measuring 1 cubic millimeter, and designed to be implanted under the skin. In that position, the chip interacts with interstitial fluids, which are a thin fluid layer surrounding cells, and make up about 40 percent of the water in the body. Alcohol levels in interstitial fluids correlate directly with alcohol in the blood.

The chip contains three gold and silver circuits, one with a coating of alcohol oxidase, an enzyme that reacts with alcohol resulting in a measurable electrical signal. The other two sensors measure pH levels and background noise. The team designed the chip as a potentiostat, a device with working and reference electrodes that measures current flow between those two electrodes. This design makes it possible to measure signals from the alcohol sensor, while canceling out pH and background signals that would otherwise corrupt the alcohol sensing signal.

A key objective of the BioMote is to use as little power as possible. The researchers were able to construct the device to use only 970 nanowatts, which the team says is about 1 millionth the power used in a typical smartphone voice call. The BioMote achieves this low power draw by off-loading the power source to a wearable device, such as a smartwatch or fitness band, paired with the sensor chip. BioMote draws power from the close proximity of the wearable system, which also receives data from the chip. The device uses a backscatter method, where the wearable system sends radio-frequency signals to the implanted chip, which are reflected back to the wearable system that interprets patterns in the reflected signals to calculate alcohol levels.

The researchers tested the BioMote’s concept in the lab using skin tissue from pigs. In the tests, the team sent varying levels of ethanol through the tissue samples, which the chip accurately detected and measured.  “We’ve shown that this chip can work for alcohol,” notes Hall, “but we envision creating others that can detect different substances of abuse and injecting a customized cocktail of them into a patient to provide long-term, personalized medical monitoring.”

The university filed a provisional patent — a document noting an intent to file a regular patent — on the technology, and the lab is working with start-up company CARI Therapeutics, incubating on the UC-San Diego campus, to commercialize the BioMote for alcohol and other substance abuses.

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Trial to Test Mobile App for Kidney Disease Screening

Dip.io test kit

Dip.io test kit (Healthy.io)

10 April 2018. A clinical trial will soon get under way that tests whether a smartphone app can easily and accurately screen for chronic kidney disease among people with high blood pressure. The trial is a joint project of the National Kidney Foundation, in Austin, Texas, with Israeli health technology company Healthy.io, and Geisinger, a Pennsylvania health care provider network.

Chronic kidney disease occurs when the kidneys become damaged and stop fully functioning. When this happens, waste products usually filtered out by the kidneys begin to build up in the blood, which can affect other parts of the body. National Kidney Foundation says some 30 million people in the U.S. have chronic kidney disease, with about 90 percent of those affected by the disease unaware of their condition. Without interventions, kidney functions can deteriorate until the kidneys fail, which requires either dialysis or a kidney transplant.

The two main causes of chronic kidney disease are diabetes and high blood pressure. The clinical trial is testing the concept of an easy-to-use method that allows people at risk of chronic kidney disease to test their urine at home for indicators of the disorder. That method uses a smartphone-based testing system developed by Healthy.io, a medical technology company in Tel Aviv, Israel. Like a urine test at a doctor’s office, the system called Dip.io, asks the user to collect a urine sample, but instead of leaving for a lab to analyze, the user performs the analysis.

The Dip.io system employs a dipstick with reagents printed on the stick that test for 10 factors, such as infections, pregnancy conditions, and chronic disease. The user then takes a picture of the stick with smartphone’s camera after dipping into the urine sample. The company says computer vision algorithms in the app calibrate and interpret the images, then send the results to a designated clinician. Healthy.io says the system already received CE regulatory approval in Europe, and is awaiting clearance from FDA to market the system in the U.S.

The company is also expanding the Dip.io system to include tests for albuminuria, a key indicator of chronic kidney disease. Albuminuria is elevated levels of the protein albumin in the blood, calculated as a ratio to creatinine, a metabolite and waste product in the blood.

The clinical trial is testing the feasibility of a home-based smartphone system to test for albuminuria, and follow-up with pharmacists. Some 1,000 Geisinger patients diagnosed with high blood pressure, a risk factor for chronic kidney disease, or CKD, will be asked to take part in the trial. Half of the participants will be randomly offered to use the Dip.io system for albuminuria screening at home, while the other 500 participants receive the usual care. For participants using the Dip.io kit, pharmacists will be enlisted to confirm the test results.

“Our hope,” says Kerry Willis, chief scientist at National Kidney Foundation in an organizational statement, “is that a home-based test makes it easier for patients at risk for CKD to comply with regular albuminuria screening, and that this will lead to earlier diagnosis and treatment of CKD, reducing cardiovascular risk, and preserving kidney function.”

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Advanced Wireless Research Platforms in Development

Wireless network graphic

(Gerd Altmann, Pixabay)

10 April 2018. Test networks for advanced research on wireless technology are being established in Utah and New York by an academic-industry consortium coordinated by National Science Foundation. Platforms for Advanced Wireless Research, or PAWR, is building centers in Salt Lake City and New York City to study technology advances beyond currently planned upgrades to 5G wireless networks, funded initially with $8 million from NSF.

The PAWR — pronounced “power” — initiative aims to develop advances in wireless technology in real-world urban settings. The platforms, says NSF, are being designed to enable academic labs and industry groups to experiment with new technologies on a larger scale than lab environments alone can provide. Among the applications expected to benefit from these test beds are vehicle-to-vehicle communications, telemedicine, immersive video, and virtual reality.

Early design work on PAWR was carried out by the Wireless Networks and Embedded Systems lab at Northeastern University in Boston and US Ignite, a not-for-profit group in Washington, D.C. promoting advanced research and development in wireless technologies, which will continue to oversee the project. Tommaso Melodia, an engineering professor at Northeastern, is the principal investigator on both of the new urban center research platforms. The agency says a PAWR Industry Consortium of equipment vendors, device manufacturers, and wireless carriers committed to provide $50 million in cash and in-kind contributions for the research platforms, to match the $50 million offered by NSF over the next 7 years.

The Utah platform is a joint project of University of Utah in Salt Lake City and Rice University in Houston testing wireless broadband and communications. That network is expected to cover a 5 square-mile area in downtown Salt Lake City and the university campus, driven by software that enables operators to dynamically modify its features without swapping out equipment. Network nodes will be installed throughout the test area, as well as on commuter buses and municipal vehicles, like street sweepers.

The software component of the Utah project is based on Rice University’s research in multi-input/multi-output programmable features anticipated in 5G networks and beyond. This test network is expected to manage communications with mobile nodes having predictable schedules, such as buses, and those with unpredictable movements, such as maintenance vehicles. The Utah team also anticipates connecting with already existing fiber networks, as well as various programmable devices provided by end-users.

The New York City project — an undertaking of Columbia University, New York University, and Rutgers University in New Jersey — plans to establish a research platform in a high-density urban environment, a 1 square-mile area of West Harlem. The New York team also expects to test software-programmable devices, and connect them to already existing networks and equipment. In addition, the researchers anticipate supporting edge-cloud computing that makes possible local and distributed processing of data from widespread devices, such as sensors on everyday appliances, rather than sending it all to a central location.

The PAWR project is a continuation of an initiative begun in 2016 by NSF to boost research and development in the U.S. on wireless technologies. The agency says it also supports basic research on the science underlying wireless technologies and efforts to apply the advances to needs of the larger society.

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Turning Your Product Idea Into A Reality: Tips For Success

– Contributed content –

Man with light bulb

(Pxhere.com)

10 April 2018. Every product on our store shelves started in one place: inside the inventor’s head. From computers to vacuum cleaners, somebody somewhere had a great idea and worked hard to see their product idea become a reality. Despite the challenges and setbacks, these inventors had the patience and diligence to see their ideas come to fruition. In most cases, fame and fortune were the rewards. But what about you? Do you have a great idea for a product? If so, you may be wondering how to get your idea out of your head and into reality. The following are the two areas you need to focus on.

Commit to research

Don’t spend your time and money creating something without doing some research first. Find out the answers to the following questions:

Are there products similar to your idea already on the market?  

If your idea isn’t completely original, it does need to have some significant differences to make it stand out from the competition. Go to your local store and head online to find out more. You should also hire a specialist attorney to ensure it doesn’t infringe on somebody else’s IP, as you don’t want to run into any costly legal battles if your idea is too similar to something already on the market.

Who is going to buy your product?

If your product doesn’t meet any practical needs, it is unlikely to sell. Therefore, you need to have an idea that is going to meet the needs of the consumer. Commit to market research to assess the viability of your idea, and then begin the production phase if there is a tangible consumer base.

Develop your product

For starters, you need to work out if you are going to manufacture your idea yourself, perhaps in your own warehouse space, or if you are going to sell your product idea to an outside company. Let’s consider both options.

Manufacturing and selling on your own

If you are going down this route, you will have tighter control over your idea. It doesn’t matter if you don’t have the technical know how to create your product, as you can bring in a third-party design engineering company to help you create the product based on your ideas. They know what components will make your product work, so it doesn’t matter if you don’t know one end of a Piezo transducer from another if your product needs to generate sound, and it’s okay if you don’t know anything about the durability of the types of product material available. The design engineers will get the work done from any blueprints you may have drawn up with them, and they will advise you on development time and costings. Once work has been completed, you will need to commit to product testing to ensure the safety and reliability of the product, and if successful, begin to market your invention yourself.

Licensing your invention to somebody else

By assigning the rights to your product to another company, you will cut out a lot of the hard work in getting your product to the shelves, as they will manufacture and market the product with their own resources. However, you may lose some control over your original idea, as you are effectively giving them the right to stamp their name on the product instead of yours. If you are going down this route, you do need to protect your idea with a non-disclosure agreement to make sure you get a share of any royalties once the product is finally put on sale. Then, having passed the hard work over to somebody else, you can sit at home and wait for the royalty cheques to arrive.

Final thoughts

Don’t let your good idea go to waste. Commit to further research if you have something to offer the world, and then get the ball rolling to get your invention onto the market and into the hands of the consumer. You may well be the next Steve Jobs!

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Kaiser Permanente to Spend $2M on Gun Injury Research

Handgun and bullets

(Brett Hondow, Pixabay)

9 April 2018. The health care provider Kaiser Permanente plans to spend $2 million on research into preventing injuries and death from firearms, as well as begin an internal task force on firearm injury prevention. The organization with 12 million members serving 8 states and the District of Columbia gave no timeline for this initiative nor specific projects or studies it plans to undertake.

Kaiser Permanente says it expects to address preventable gun-related deaths and injuries from suicide, homicide, or accident with the same kind of research tools it applies to other health problems. Bechara Choucair, chief community health officer for Kaiser Permanente, says in a statement, “we will study interventions to prevent gun injuries the same way we study cancer, heart disease and other leading causes of preventable death in America.” Choucair adds that Kaiser Permanente’s preventive and specialized care is “accomplished, in part, by using rigorous research, without bias, to determine which strategies are effective.”

The organization, based in Oakland, California notes that in 2016-2017, it’s clinicians treated some 11,000 victims of gunshot wounds. A study published in the journal Preventive Medicine in October 2015 shows more than 67,000 people in the U.S. are injured by firearms each year, leading to more than 32,000 deaths. More than 60 percent of these firearm deaths are suicides. With the exception of suicides, males, racial or ethnic minorities, and younger people are more likely to be injured or killed by firearms than other groups.

The paper’s authors from Centers for Disease Control and Prevention, say both fatal and non-fatal injuries declined from 1993 to 1999, and across all types of intent. Between 2000 and 2012, unintentional deaths from firearms declined, but gun-related suicides and non-fatal firearm assaults increased. In addition, the authors estimate medical costs of treating firearm injuries and lost productivity totaled more than $48 billion. The researchers conclude firearm injuries and death are “an important public health problem in the United States,” and noted that “a science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm violence.”

David Grossman, a pediatrician and researcher with the Kaiser Permanente Washington Health Research Institute, is the co-lead of Kaiser Permanente’s gun injury prevention task force. “Our mission,” says Grossman, “to improve the health of Kaiser Permanente members and the communities we serve, requires us to take preventive action.” The organization plans to disseminate its findings through peer-reviewed publications, as well as white papers and webinars.

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