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Telemedicine Kiosks Opening at Retail Pharmacies

Wall Street sign

(A. Kotok)

11 December 2017. Private kiosks providing individuals live video sessions with doctors to diagnose non-emergency medical issues are underway in New York. The service opened its first location at a Duane Reade retail pharmacy in Manhattan, connecting patients to the NewYork-Presbyterian health care network.

The kiosks are a result of a partnership between the retail drug chain Walgreens operating the Duane Reade stores, and NewYork-Presbyterian that plans to expand to more New York City locations in 2018. The service, called NYP OnDemand, is now available in one Duane Reade location, at 40 Wall Street, which charges $99.00 per visit.

The kiosks are located in a private room, with a video camera and monitor connecting to an emergency medicine physician for a private consultation. The physicians are board-certified and provided by Weill Cornell Medicine, a medical school and research center affiliated with NewYork-Presbyterian. Visit times are expected to take from 10 to 20 minutes, but can vary depending on the needs of the patient.

The one current NYP OnDemand kiosk is open from 8:00 am to 9:00 pm on weekdays and 9:00 am to 6:00 pm on weekends, with hours for children set for 6:00 to 9:00 pm on weekdays. Only walk-ins are accepted; no appointments are needed.

The service is designed for diagnosing non-emergency conditions, such as colds and flu, skin conditions, urinary tract infection, dizziness, fever, headache, and back pain, but also insomnia and mental health disorders, such as depression and anxiety. The kiosk also has a forehead thermometer, blood pressure cuff, pulse oximeter to measure oxygen levels in the blood, and a dermascope to provide high-resolution images of skin conditions.

Walgreens customers in New York will also be able to access NYP urgent care services for online video consultations through the Walgreens web site. Beginning in 2018, the kiosk service is expected to add consulting physicians from ColumbiaDoctors, part of Columbia University’s medical center, also affiliated with NewYork-Presbyterian.

“Patients can expect to receive focused, one-on-one care from leading physicians, where and when they need it,” says NewYork-Presbyterian CEO Steven Corwin in a company statement. “We believe telemedicine has a critical role to play in expanding access to high-quality care, and we are proud to be at the forefront of digital health care delivery.”

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CAR T-Cells Shown Effective in Long-Term Studies

Cancer in headline

(PDPics/Pixabay)

11 December 2017. Results from two clinical studies of engineered immune system cells show patients continue to respond their treatments after 6 months or more. Findings of tests of therapies by Novartis and Gilead Sciences are presented at the annual meeting of the American Society of Hematology, or ASH, now underway in Atlanta, Georgia.

Drug makers Novartis and Gilead Sciences are reporting on clinical trials of genetically engineered T-cells, white blood  cells from the patient’s immune system, modified to express chimeric antigen receptor proteins. The therapies reprogram the T-cells with genetic engineering to find and kill cancer cells like an antibody. These modified chimeric antigen receptor or CAR T-cells are infused back into the patient, seeking out and binding to a protein called CD19 found on the surface of B cells — another type of white blood cell — associated with several types of blood-related cancers.

Researchers from MD Anderson Cancer Center in Houston, offer results from an early and intermediate-stage clinical trial of axicabtagene ciloleucel, code-named KTE-C19, originally developed by Kite Pharma, but acquired by Gilead Sciences when it bought-out Kite in August 2017. This study is enrolling 142 individuals with aggressive and stubborn cases of non-Hodgkin lymphoma at 29 sites in the U.S., Israel, Canada, and the Netherlands.

MD Anderson oncologist Sattva Neelapu reports on 108 patients at 22 sites after a median period of 15 months following their treatments with KTE-C19. More than a year after their treatments, 42 percent remain in remission and 40 percent show no evidence of cancer. Neelapu says in an ASH statement, “Patients who are in remission at 6 months tend to stay in remission,” adding “With existing therapy, the median survival for people with this disease is only 6 months. Here, we see more than half of patients — 59 percent — are still alive over a year after treatment.”

As reported in Science & Enterprise, CAR T-cell treatments can cause serious adverse effects, leading to deaths in some clinical trials, including this study. Neelapu says 4 patients died within 2 months of treatment, while another 10 patients experienced serious adverse effects, such as infections, in the first 6 months. After 6 months, however, no deaths or new cases of cytokine release syndrome, the most common adverse effect, were reported.

A team from University of Pennsylvania medical school reports on a clinical trial of the Novartis drug tisagenlecleucel, marketed as Kymriah, approved by the Food and Drug Administration in August 2017 as a treatment for children and young adults with B-cell acute lymphoblastic leukemia. The intermediate-stage clinical trial is recruiting 130 participants with diffuse large B-cell lymphoma — the most common form of lymphoma — at 28 sites in the U.S., Canada, Japan, and Europe, where the disease is relapsing or not responding to other therapies.

Stephen Schuster, a professor of hematology and oncology at UPenn, offers interim results from 46 participants, where 30 percent achieved a complete response or remission to treatments, where all signs of the disease disappear, and another 7 percent showed a partial response. Among a larger group of 81 participants whose cancer disappeared after 3 months, the disease in these individuals did not relapse after another 3 months.

Most of the adverse effects are seen soon after the therapies, mainly cytokine release syndrome and neurological toxicity. No deaths are reported from these treatments. Schuster says about a quarter (26%) of the treatments are given in an outpatient setting, and in some cases, the patients T-cells are frozen until ready to administer. “These are very sick patients,” notes Schuster, “so this gives the treating physician some flexibility to schedule therapy when it’s best for each patient.”

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Hat tip: FirstWord Pharma

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Are These Overlooked Factors Affecting Your Company’s Reputation?

– Contributed content –

8 December 2017. You can spend many years making sure that your company has a positive reputation. You can do all the right things; deliver great customer service, have innovative ideas, position yourself at the forefront of your industry, and so on. Alas, sometimes it’s not what we do that has the biggest influence – it’s what we don’t do. Below, we take a look at some of the commonly overlooked issues that can cause your company problems, even if you’re not aware of them!

Can and string communication

(Gratisography, Pexels.com)

No conscience

It’s not the same world that we used to live in. Today, things are much more open, and as such companies face a level of scrutiny that simply wouldn’t have been possible in the past. Research shows that customers are asking more of the businesses they’re spending their money with. If a company has been shown to have bad practices, then your customers will turn away – and they’re unlikely to come back anytime soon. Check that you’re doing things ethically, such as by showing consideration for the environment, a fair policy when it comes to hiring, and the like.

Saying one thing, looking another

Your branding is everything when it comes to your business. Alas, many companies fall into the trap of presenting themselves as one thing, but then don’t back it up with their actions. You need to ensure that all aspects of your business operations are in line with the message you want to world to receive. Take your office. If it’s stuffy, boring, or unclean, then people will have a negative impression of your business – despite what your website says. Solicit commercial cleaning services, liven up the office atmosphere, and make sure your reception area presents the right image. With that done, you’ll be able to walk the walk, not just talk the talk.

Focusing only on the big stuff

It’s easy to get carried away with the aspects of your business that are the real money makers. However, if you’re forever focusing your attention on the big details, then what’s going on with the smaller details? You might create a situation whereby the top end of the pyramid is watertight, but where the foundations are shaky. In business, you should try to ensure that every detail is as strong as possible because you can’t predict what people will be looking at.

Off the clock gossip

We know that it’s hard to maintain a professional attitude at all times when you’re at work. It’s next to impossible to have the same attitude when you’re off the clock! However, when you’re a business owner, you always need to be in “networking mode.” If you’re acting unprofessionally, then it might just come back to haunt your business.

Too big to fail

Finally, remember that it’s important to stay humble. It’s easy to get carried away with success, but you never know what’s coming up ahead in the future. If you think you’re too big to fail, then you’ll be in for a nasty shock if profits begin to slump. Always acting like you need every customer will ensure you keep your standards high.

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Blood Glucose Monitor Built Into Smartphone Case

GPhone prototype

GPhone prototype (Jacobs School of Engineering, University of California in San Diego)

8 December 2017. Engineers at University of California in San Diego designed a case that fits over a smartphone with an integrated sensor, which in lab tests accurately measures blood glucose levels. A team led by engineering professors Patrick Mercier and Joseph Wang describe the device and its proof-of-concept tests in a recent issue of the journal Biosensors and Bioelectronics (paid subscription required).

The UC-San Diego team seeks to take advantage of the computing power widely available to people through their mobile devices, to make it easier for persons with diabetes to measure their blood sugar levels using a smartphone. Diabetes is a chronic disorder where the pancreas does not create enough insulin to process the sugar glucose that flows into the blood stream and cells for energy in the body. In type 2 diabetes, which accounts for some 90 percent of all diabetes cases, the pancreas produces some but not enough insulin, or the body cannot process insulin.

Individuals with diabetes need to closely monitor their blood glucose levels, with many glucose testing meters on the market. But a glucose meter is another separate device that people with diabetes need to remember to take with them during the day. Thus Mercier, Wang, and colleagues want to use the computing power in a smartphone to keep track blood glucose levels. “Integrating blood glucose sensing into a smartphone would eliminate the need for patients to carry a separate device,” says Mercier in a university statement. “An added benefit is the ability to autonomously store, process and send blood glucose readings from the phone to a care provider or cloud service.”

The researchers call their device the GPhone, with a 3-D printed case that fits over the phone. In one corner of the case is a sensor with a receptacle to capture a blood sample for analysis. Attached to the case is a stylus containing carbon pellets, dispensed one at a time that attach magnetically to the sensor. The pellets are made of carbon and the enzyme glucose oxidase that reacts in the presence of glucose to form glucolactone. When exposed to oxygen in the air, glucolactone converts oxygen to hydrogen peroxide, which sensors in glucose meters and the GPhone can measure. Thus, the higher the glucose concentration in blood, the more hydrogen peroxide produced.

The enzyme-loaded pellets are used only one time, then discarded. These single-use pellets overcome a problem with reusable sensors in some glucose-monitoring devices, where the enzyme degrades or leaks out, requiring that the sensor or the entire device be replaced. The authors report the GPhone’s pellets are stable for 8 months. Each test takes about 20 seconds. A companion app displays results of each test on the smartphone screen.

In the journal paper, the team evaluated the working features of the system, to prove its concept. The researchers used blood samples with known glucose concentrations that they matched against readings from the sensor, and they report the GPhone gives accurate readings each time.

The prototype developed for testing still needs refinements, say the authors. The GPhone requires about a dozen drops of blood to read glucose levels, and the team wants to reduce that quantity to a single drop like that used in most of today’s glucose monitors. The researchers also are working on a system fully integrated into a smartphone, and not requiring the added case. But the authors say the technology can be extended to other types of substance monitoring. “This system is versatile,” notes Wang, “and can be easily modified to detect other substances for use in health care, environmental and defense applications.”

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PTSD Drug Trial Begins, Gets Fast-Track Status

Brain circuits illustration

(HypnoArt, Pixabay)

7 December 2017. An experimental drug that aims to keep nerve cells flexible is beginning an early-stage clinical trial as a treatment for post-traumatic stress disorder, or PTSD. The drug code-named NYX-783 is made by biotechnology company Aptinyx Inc. in Evanston, Illinois, which also received a fast-track designation from the U.S. Food and Drug Administration.

Aptinyx develops treatments for neurological disorders that result from the lack of plasticity in synapses, the part of neurons, or nerve cells, that pass signals with neurotransmitter chemicals in the brain and nervous system. The company’s technology focuses on a particular set of pathways known as N-Methyl-D-aspartate, or NMDA, receptor molecules found in synapses. NMDA receptors help keep synapses flexible, which affects memory, learning, and development of the central nervous system. Aptinyx expects to use this platform to discover small-molecule, or low molecular weight drugs to treat PTSD and other disorders such as depression, neuropathic pain, migraine, and epilepsy.

The company says NYX-783 is designed to enhance the plasticity of synapses as a way to improve learning processes, considered a key factor in overcoming fear, and thus help relieve PTSD. People who experience or witness a terrifying event can experience nightmares or flashbacks for periods of time after the event, which can subside with counseling or help from family and friends.

For some people, however, the reminders continue and can develop into PTSD, marked by anxiety or depression, often with debilitating effects on their families, jobs, and personal relationships. Anxiety and Depression Association of America says some 7.7 million Americans age 18 and older have PTSD, including two-thirds of people experiencing mass violence, such as members of the military.

Aptinyx says in preclinical tests NYX-783 shows strong and long-lasting effects in enhancing plasticity of nerve cells, with favorable results in indicators of depression, learning, and fear extinction. The clinical trial is expected to test the safety and tolerability of NYX-783 among 64 healthy volunteers. The drug will be given as a daily capsule, with dosage levels evaluated against a placebo.

The company says FDA also assigned NYX-783 fast-track status, which qualifies Aptinyx for more frequent meetings and written communications with the agency as NYX-783 is reviewed. FDA designates drugs for fast-track reviews if they show superior effectiveness against serious disorders, or address emerging or anticipated public health needs. Aptinyx says preclinical data on NYX-783 reported at last month’s Society for Neuroscience meeting supported its request for fast-track status.

Aptinyx was formed in September 2015, when Naurex Inc., a spin-off enterprise from Northwestern University, was acquired by drug maker Allergan, which did not wish to continue Naurex’s work on drugs addressing NMDA receptors. Joseph Moskal, a biomedical engineering professor at Northwestern who founded Naurex, chose to stay with Aptinyx to continue development of NMDA receptor drugs. As reported by Science & Enterprise in May 2016, Aptinyx raised $65 million in its first venture funding round.

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Emergency Sealant Gel Developed for Eye Injuries

Eyes looking at laptop

(Tookapic, Pexels)

7 December 2017. A medical engineering team created a gel material that safely closes injured eye tissue until surgical treatments can be given. Researchers at University of Southern California in Los Angeles describe the material and tests with lab animals in yesterday’s issue of the journal Science Translational Medicine (paid subscription required).

The team led by ophthalmology professor John Whalen, with associates from USC’s medical and engineering schools, are seeking stop-gap methods for treating traumatic eye injuries, particularly on today’s battlefields where soldiers encounter improvised explosive devices. Even among civilians, open-globe injuries that disrupt the cornea or sclera in the eye, account for 10 percent of the annual 2.5 million eye injuries in the U.S., according to data cited by the authors. The U.S. Department of Defense and National Institutes of Health funded the project.

Current treatments for open-globe injuries use sutures and adhesives that require professional care and surgical equipment, which in most cases are not available to military field medics nor civilian emergency medical technicians. Whalen and colleagues devised a temporary fix for emergency staff to safely close injured eye tissue until patients reach facilities providing more permanent treatment.

The researchers’ solution adapts a polymer material called PNIPAM, short for poly(N-isopropylacrylamide), a so-called smart polymer that changes its state from liquid to semi-solid in response to changes in temperature. This state-changing capability is important for an emergency treatment that needs to be easily and safely removed when reaching expert medical care facilities. The team added other biocompatible plastics to PNIPAM to produce a hydrogel form of the material that could temporarily fill the shape of the injury and seal the wound, yet still be easily removed.

Lab tests confirmed the gel material’s physical properties, notably its ability to maintain a gel state at body temperatures until washed away with cold water, which converts the gel to liquid. In addition, the gel retains its elasticity, viscosity, and durability in these tests. Further tests of the gel in eyes taken from pig cadavers with injured tissue show the gel fills the wounds, and in simulations enables the treated eyes to retain enough intraocular pressure to keep the eyes functioning and prevent retinal detachment.

The team devised an injector device to dispense the gel, contained in a chamber surrounded by calcium ammonium nitrate crystals, like those used in disposable cold packs. Adding water activates the crystals, cooling the gel into a liquid for about 10 minutes that can be applied to the injured eye.

The researchers then tested the gel using the injector system on lab rabbits induced with eye injuries. The results show the gel works as designed with the test rabbits, with only some immediate inflammation that subsides within a few hours. Intraocular pressure also is restored among test animals, while pressure in the eyes of untreated animals remains below safe levels. After 30 days, the test rabbits show no signs of nerve toxicity, degraded retinal tissue, or chronic inflammation.

The university applied for a patent on the technology with Whalen and 5 of the co-authors listed as inventors, including Niki Bayat, the lead author. Bayat, an engineering doctoral candidate at USC, is a co-founder of AesculaTech, a start-up company developing a thermo-responsive gel to treat glaucoma. The gel, says the company, is applied to the tear duct, which then hardens and dispenses medication for the disorder.

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How to Design a Warehouse Perfect for Your Needs

– Contributed content –

Warehouse

(Flickr)

6 December 2017. If you’ve had an amazing idea for a product, you will need somewhere to manufacture and store it, ready for sale to your customers. For many businesses, buying a warehouse is a simple process, but for your more complex needs, you may need to look into how you can fully optimize a space to get the most from your square footage.

A warehouse isn’t just about storing products and parts, though, you also need to make sure that your warehouse staff will be safe in their working environment and that any risk of accident is minimized as far as possible. This will certainly influence the layout and design of your warehouse and thinking about this now will help you to save money and lives in the long term.

Make use of mezzanine levels

If you have a high ceiling, installing mezzanine levels is a really good idea. You will essentially increase your floor space without having to expand your footprint which is a much more efficient use of space and will likely end up being cheaper than bigger premises.

You can use a forklift truck to ensure the safe movement and storage of your stock and even have staff up there to guide things into place. A simple way to ensure their safety is to install pivoting mezzanine safety gates which will ensure that there is always a gate between your employee and a potential fall.

Consider layout and movement

Yes, it is obvious, but you do need to make sure that if you are using forklifts, they are able to move between the units in your warehouse and there is enough space for them to safely maneuver. The best way to do this is to create a floor plan that is roughly to scale to see what the best way of fitting everything in is.

Another thing to consider is how you want everyone to safely move around the warehouse. This could be another simple thing like marking colored lines on the floor to indicate where people can walk and where forklifts can drive. You should also mark out walkways around the warehouse to indicate where the safest places to stand are.

Use tech to optimize processes

There are all sorts of warehouse and logistics technologies you can use to optimize your processes while making the warehouse safer. However, the future is also looking bright for further developments in warehouse tech.

One of the most common causes of accidents in a warehouse are forklift trucks which can topple over, emit carbon monoxide and be mishandled. Every year 95,000 warehouse employees are injured and 100 employees are killed in forklift related incidents, giving a clear indication that there is room for technological intervention in this area.

There are already plenty of pick and place robots and human-friendly forklifts that are capable of doing these jobs effectively but due to the number of other modification required to let them do their job, they haven’t really caught on yet.

Watch this space, though, the future of industry is right around the corner.

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Tobacco Plants Studied as Drug Bio-Factories

Cara Mortimer and Peter Waterhouse

Cara Mortimer, left, and Peter Waterhouse (Queensland University of Technology)

6 December 2017. A university in Australia is joining a European research project to create new types of tobacco plants for producing pharmaceuticals. A team at Queensland University of Technology in Brisbane will take part in the Newcotiana project, an initiative of the European Union’s Horizon 2020 program, receiving the equivalent of $US 8 million in funding.

The tobacco plant is best known for products to smoke or chew, having little to do with health. But tobacco plants can also be exploited for generating therapeutic proteins, using the plants’ basic biological processes. An example is ZMapp, a drug derived from tobacco plants that was pressed into service as one of the few treatments for the Ebola virus, when outbreaks occurred in Africa in 2014.

The QUT team will study a native variety of tobacco in Australia, the Nicotiana benthamiana or pitjuri plant, it’s original name among Australia’s indigenous population, to help develop a set of advanced plant breeding tools. The university’s Centre for Tropical Crops and Biocommodities already cataloged many of the plant’s properties, which contributed to research worldwide on metabolic engineering, plant-microbe interactions, RNA interference, vaccine and drug production (including ZMapp), and functional genomics.

A biological tool set for N. benthamiana is expected to produce new varieties that can more efficiently generate proteins for drug treatments and vaccines using the plants as bio-factories. Cara Mortimer, an environmental scientist at QUT, is expected to apply the work of fellow QUT researcher Peter Waterhouse, who led the sequencing of the N. benthamiana genome.

Waterhouse’s work already sequenced about 85 percent of the plant’s genome, containing some 60,000 genes, about twice the number of ordinary plants. “Collaboration in the Newcotiana project will allow us to have 100% of the plant’s genome sequenced,” says Waterhouse in a university statement, adding, “If you have the whole genome sequenced, you know what you are dealing with, and you can achieve greater precision in the applications with that information.”

The goal of the biological tool set, notes Mortimer, is to create high-value, non-smoking tobacco varieties that act as factories producing drug molecules and proteins. “Traditional tobacco is in decline around the world,” says Mortimer, “and this presents social problems in many rural areas where communities and farmers’ livelihoods have been built around the crops.”

She adds that “This project looks to provide tobacco plants which are efficient bio-factories and which can be farmed, providing an alternative to farming of traditional tobacco.”

More from Science & Enterprise:

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Cell Programming Company Raises $49.5M in Early Funds

Obsidian rock

Obsidian rock (Kevin Walsh, Flickr)

6 December 2017. A start-up enterprise creating add-on treatments that program the effects of cell and gene therapies is raising $49.5 million in its first venture funding round. The two year-old Obsidian Therapeutics in Cambridge, Massachusetts licenses research from the chemical and systems biology lab of Thomas Wandless at Stanford University, the company’s scientific founder.

Obsidian Therapeutics aims to better control emerging treatments for cancer and other diseases that harness the immune system with genetically-altered cells, such as modified T-cells with chimeric antigen receptors, or CAR T-cells, to treat cancer. While CAR T-cells are shown to invoke the immune system to drive some forms of leukemia into remission for many patients, they also come with severe side effects and can be too dangerous for other individuals.

The Obsidian technology adapts a process developed by Wandless and colleagues known as destabilizing domains that its founders say can program the activity of CAR T-cell and similar treatments, and thus improve both their safety and efficacy. The destabilizing domains process adds a synthetic binding protein to the therapeutic protein that supports the therapy’s stability, in what the company calls a synthetic biological cassette. But the stability of the biological cassette can be adjusted with a companion small molecule compound, which makes it possible to control activity of the therapy, such as its dosing.

Obsidian’s first products are expected to help program cancer treatments, starting with cytokine, or short protein, cassettes for CAR T-cell therapies. These cytokine cassettes, says the company, will be designed to enhance the persistence and tumor-killing abilities of CAR T-cells, as well as improve their safety for patients. Future company products are expected to boost the safety and efficacy of gene therapies for cancer and other diseases.

“By equipping cells with new tumor-fighting powers,” says Obsidian CEO Michael Gilman in a company statement, “and by putting precise and dynamic dosing control in the hands of the treating physician, we believe we can improve safety, efficacy, and durability of CAR-T therapies. Moreover, we think Obsidian’s pharmacologic operating systems will enable us to build entirely new classes of living medicines.”

The company’s first funding round is raising $49.5 million led by GV, previously known as Google Ventures, the venture capital arm of Alphabet, Google’s parent company. Taking part in the financing is Atlas Venture — Obsidian’s seed capital source — as well as Takeda Ventures Inc., Vertex Ventures HC, Amgen Ventures, Alexandria Venture Investments, and ShangPharma Investment Group.

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Smart Things to Think About When Launching a Business

– Contributed content –

6 December 2017. Did you know that over 75% of startup businesses fail within the first 3 years? One-third of all of those fail within the first 6 months as well. If you want to make sure that you survive this crucial period then you need to make smart decisions very early on, while also ensuring that you are understanding of the various research you need to do.

Limited company or sole trader?

The option that you choose here will ultimately determine the tax that you pay and if something happens, it will also determine how much legal and financial responsibility you have. When you are a sole trader, you can take all of the tax profits that you make but if you experience a bad situation with your business then you are responsible for all of this.

The competition

There is a high chance that your competition was in your position once. For this reason, it is a good idea for you to find out how they did it, what mistakes they made along the way and even what their customers like about them. This is also a good way to find out if you are even ready to start a business.  You don’t want to try and repeat their success, but you do want to learn the various steps they took in order to ensure their own success. If there is one big player who is continually dominating the market then find out what they don’t do well, or what is bad about them. Find out who they don’t cater for, or if there is a gap in the market that they aren’t targeting. Then, try and fill this space.

Business meeting

(rawpixel/Pexels.com)

Your target audience

If you try and appeal to everyone then you won’t actually end up appealing to anyone. You need to focus on your target audience and you also need to heavily monitor your marketing efforts as well. Ensure that you send out questionnaires and that you are also active on social media. The only way for you to make a huge amount of sales with a product is to make sure that people actually want it, so try and involve your customers in your product development as you test and try out various models or style options. The same concept applies if you want to offer a service. Ultimately, it is a good idea for you to make your customers feel as though they are a part of your voice and the movement and progress you are trying to make.

Paying yourself

How will you take your wage home? You may have the best intentions when it comes to putting your profits back into your business but you do have to pay for your accommodation. Cut right back on any type of luxury products and live within your means. Your bank would rather see you doing this than you going back in 6 months to tell them that you have run out of money.

Calculator, pen, chart

(Pexels.com)

Business name

Your business name is quite possibly one of the most important decisions that you are going to make. Rebrands are expensive to say the least, and you will also have to set up a website domain that links to your business name as well. You need to communicate what your brand stands for, whether it is a geographical location or even the morals behind your business.

Staffing requirements

Think about it. Are you going to need staff from day 1? Or day 50? You need to have a plan when it comes to your staff and if you do have a lot then it helps to have a free employee scheduling software because this will help you to plan out the number of staff that you need and even the rota that you are going to have them on. Don’t just jump into this blind and know exactly what each person is going to do before you hire them. Ultimately, you need to ask yourself, what do they bring to your business? What can they offer you? Could you do that job without them? This will help you to make the best decision regarding your own hiring situation and it is a really good way for you to keep everything organized.

Find an accountant

An accountant is someone who does more than just count your money. They are a valuable and very trusted source of business advice. They usually have a ton of experience and they can also steer you away from making bad financial decisions. All you have to do is find a local accountant who has experience in your chosen business sector. Find someone who sees you as a success, not someone who sees you as a start-up.

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