Friday, 16 March 2018

• Shares of Healthineers surged more than 6 percent during morning deals, with the listing likely to galvanize the mood among other pending German floatations.
• The initial public offering (IPO) of Healthineers marked one of Germany’s biggest listings in recent years and one of the largest European IPOs in 2018.
• "It is a great moment for us, we are happy about the confidence investors have put in us," Bernd Montag, CEO of Siemens Healthineers, told CNBC on Friday.

The medical equipment unit of German engineering firm Siemens began trading on the country’s stock exchange Friday.
Shares of Siemens Healthineers surged more than 6 percent during morning deals, with the listing likely to galvanize the mood among other pending German flotations.
"It is a great moment for us, we are happy about the confidence investors have put in us," Bernd Montag, CEO of Siemens Healthineers, told CNBC Friday.
The initial public offering (IPO) of Healthineers marked one of Germany’s biggest listings in recent years and one of the largest European IPOs in 2018.
Issued at 28 euros apiece, shares of the company opened at 29.10 euros on Friday. However, the IPO was delayed.
When asked whether the delay to Healthineers’ stock market debut had been a source of frustration, Montag replied: "No, we have been on the journey to this day for basically three years … We had very great moments and challenging moments on this journey so half an hour at the home stretch didn’t make a big difference and we are happy that we made it anyway."
The offer price was seen by some investors as a climb-down by Siemens in order to create heightened interest in the issue. Despite previous valuations of closer to 35 billion euros, Healthineers’ equity is valued at 28 billion euros.
Siemens is selling a 15 percent stake in the world’s biggest maker of medical imaging equipment. The move is designed to help the company raise its own funds for future takeovers and investments as well as bolstering its standalone value.
Several major banks acted as global coordinators to help the IPO take place Friday with Goldman Sachs, Deutsche Bank and J.P. Morgan all involved in the listing.
Several large German IPOs are pending, with DWS scheduled for next week. Meanwhile, SpringerNature, HSE24, Takko and Godewind are all expected to follow over the coming weeks. CNBC.com

The 42nd IHF World Hospital Congress, IHF’s cornerstone event, will bring together leaders of national and international hospital and healthcare organizations to share knowledge, expertise and experiences and discuss how healthcare needs to evolve to meet 21st century demands.

Globally health systems are in transition. How do you harness the benefits and overcome the obstacles at this critical point? The Congress will inspire delegates with the journey to date and the opportunities for the future to come.

There are over 40 keynote, plenary panel and concurrent sessions delegates can participate in which will cover value-based care, integrated care and digital transformation.

Value-based healthcare
Prof Elizabeth Teisberg, co-author of “Redefining Health Care: Creating Value-Based Competition on Results”, will open the Congress by sharing insights into the evolution that needs to take place in healthcare. A panel discussion will explore views from health leaders from Hong Kong, Singapore, UK and USA on what 21st century patients demand from healthcare. Concurrent sessions will tackle platforms for value, paying for value and achieving outcomes, the right combination to move from volume to value, among others.

Health system integration
Nigel Edwards, Chief Executive of the Nuffield Trust will share the UK experiences and Nagwa Metwally, Member of Supreme Council of the Egyptian Red Crescent, will talk about patient engagement in Egypt. A panel discussion will explore how we can rethink the role of the hospital in the medical neighborhood. Concurrent sessions will focus on collaboration, health workforce as driver of integrated care, models to support integrated care, partnering and leading in communities and improving health of indigenous peoples.

Impact of technology on healthcare delivery
Charles Alessi, Chief Clinical Officer of HIMSS will provide a big picture and Prof Jeffrey Braithwaite, Foundation Director of the Australian Institute of Health Innovation at Macquarie University will share future predictions for global care. Panelists from around the world will discuss the industry’s bright future. In the concurrent sessions, topics that will be covered include getting the most out of data and intelligence, innovation as a building block for quality and value, hospitals of the future and several innovative technological projects will be shared by speakers from all over the globe.

These are just some of the topics that will be tackled at the World Hospital Congress on 10-12 October in Brisbane, Australia. View the full program here.

The early bird registration ends on 30 June. For more information about the Congress and to register visit: www.hospitalcongress2018.com

In rare diseases, the computer-aided image analysis of patient portraits can facilitate and significantly improve diagnosis. This is demonstrated by an international team of scientists under the leadership of the University Hospital Bonn and the Charité – Universitätsmedizin Berlin on the basis of so-called GPI anchor deficiencies. Using data on genetic material, cell surface texture and typical facial features, researchers utilized artificial intelligence methods to simulate disease models. The results may also be ground-breaking for other diseases.
Mabry syndrome is a rare disease that causes mental retardation. It is triggered by a change in a single gene. “This disease belongs to a group that we describe as GPI anchor deficiencies and which includes more than 30 genes”, explains physician and physicist Prof. Dr. Peter Krawitz from the Institute for Genome Statistics and Bioinformatics of the University Hospital Bonn. GPI is the abbreviation for glycosylphosphatidylinositol. GPI anchors attach specific proteins to the cell membrane. If this does not work properly due to a gene mutation, signal transmission and further steps in the cell-cell communication are impaired.
The spectrum of the external appearance of GPI anchor deficiencies is very broad: The clinical impact of a mutation in a particular gene can range from mild to profound. This also applies to distinctive facial features. In Mabry syndrome for example, a narrow, sometimes tent-shaped upper lip, broad bridge of the nose and wide-set eyes with long palpebral fissures are among the classic features, but these may be more or less pronounced. This often complicates the diagnosis of this rare disease. The elevated alkaline phosphatase (AP) levels in the blood which are also considered characteristic for the syndrome cannot be detected in every patient. “The result is that many patients and their relatives often suffer many years of uncertainty until the correct diagnosis is made”, says Krawitz.
An international research team led by Dr. Alexej Knaus and Prof. Krawitz from the Institute for Genome Statistics and Bioinformatics of the University Hospital Bonn and Prof. Dr. Denise Horn from the Institute of Medical Genetics and Human Genetics of the Charité investigated how the diagnosis of GPI anchor deficiencies can be improved with the help of modern, particularly fast DNA sequencing methods, cell surface analysis and computer-aided image recognition (next-generation phenotyping).
The researchers applied artificial intelligence in image analysis
In the large-scale overview study, the scientists used photographs of the faces of a total of 91 patients. Cell surface changes characteristic for GPI anchor deficiencies were detected in some of the participants. Genetic analysis also revealed gene mutations that are typical for this rare group of diseases. “The artificial modelling of gene-typical faces that we achieved with these datasets clearly shows that the computer-aided evaluation of patients’ portraits can facilitate and improve the diagnosis of GPI anchor deficiencies, which is significant progress”, says lead author Dr. Knaus.
With the assistance of combined data from the laboratory and the computer, the authors hope to gain better understanding of the molecular processes involved in such diseases. For example, it was shown that increased blood alkaline phosphatase levels and conspicuous image analysis results provide a reliable indication of a new mutation in a GPI anchor deficiency. Because of the shared molecular causes shown during the research and the similarity of the patients that has now been quantified, Krawitz also advocates using the term “GPI anchor deficiency” for this group of diseases.
Bonn Universityhttps://tinyurl.com/ycq27csx

Continuous glucose monitors (CGM) can protect individuals who have had type 1 diabetes for years and are at risk of experiencing dangerously low blood sugar by increasing their awareness of the symptoms, according to a study.
Episodes of low blood sugar, known as hypoglycemia, are a major barrier to achieving glycemic control for people with diabetes.
The study’s publication comes as the Endocrine Society is developing a multi-year, multi-stakeholder initiative to improve understanding of hypoglycemia and reduce associated costs by implementing strategies to improve prevention and surveillance.
Severe hypoglycemia can cause seizures, loss of consciousness and death. Hypoglycemia linked to the use of insulin was responsible for an estimated $600 million (£510 million) in emergency room visits between 2007 and 2011.
“In individuals who have repeatedly experienced hypoglycemia, the body blunts awareness of symptoms warning of impending episodes,” said the study’s first author, Michael R. Rickels, M.D., M.S., of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pa. “Wearing a continuous glucose monitor that flags falling glucose levels and has built-in alarms raises recognition of the threat.”
Eleven individuals who had been diagnosed with type 1 diabetes for at least 10 years and had impaired awareness of hypoglycemia received CGMs to monitor their blood sugar levels during an 18-month period. The researchers found the participants became more aware of hypoglycemia events and were less likely to experience severe hypoglycemic episodes after they started using CGMs. However, the body’s defence mechanisms against developing low blood sugar remained impaired. The participants’ hemoglobin A1c levels, which track average blood glucose over time, did not change.
“While the body’s own defences against hypoglycemia did not improve, CGMs filled a valuable need in alerting individuals to oncoming episodes,” Rickels said. “In the absence of physiologic defences against the development of low blood glucose, near-constant use of continuous glucose monitoring may be required to minimize the burden of problematic hypoglycemia in patients with long-standing type 1 diabetes.”
The Endocrine Society and its 18 partners in the Hypoglycemia Quality Collaborative identified reducing and preventing the condition as a high priority.
The Society’s new hypoglycemia quality initiative aims to improve outcomes in individuals with type 2 diabetes. The project’s goals include decreasing the frequency and severity of hypoglycemia episodes, identifying patients who are at high risk in a timely manner, and supporting appropriate clinical interventions that can be administered in doctors’ offices and clinics, avoiding the need for hospitalization. The effort brings together stakeholders from industry, nonprofit organizations and patient groups.

Endocrine Societyhttps://tinyurl.com/yar6t4wb

By no means are only elderly people at risk from heart diseases. Physically active individuals can also be affected, for example if a seemingly harmless flu bug spreads to the heart muscle. Should this remain undetected and if, for example, a builder continues with his strenuous job or an athlete carries on training, this can lead to chronic inflammation and in the worst case even to sudden death.
Professor Eike Nagel and his 12 co-workers at the Institute for Experimental and Translational Cardio Vascular Imaging of Goethe University Frankfurt are developing better ways to predict and diagnose heart diseases. In recent years, the researchers have taken the lead in the development of a procedure that is still very new in heart scans. Nagel explains the advantages: “With the help of magnetic resonance imaging, we can look right inside the heart muscle.” Blood flow to the heart muscle is visualized and shows whether there are any constrictions of the arteries supplying the heart. Experts can also spot whether the heart muscle is scarred, inflamed or displays any other anomalies.
The comparatively fast method makes it possible to examine patients at an early stage and may prevent cardiac insufficiency or even a heart attack. “Diseases such as HIV, kidney damage, rheumatic diseases or tumours often affect the heart either directly or as a side effect of therapy,” says Nagel, describing groups potentially at risk. The cardiologist is convinced: “Nowadays we can treat or even cure so many diseases, but the heart suffers too and this should be carefully monitored as it mostly remains undetected.”
MRI is a non-invasive and gentle examination technique, which is less risky but just as efficient as an examination using a conventional heart catheter, where a thin tube is pushed in the direction of the heart through an artery. Nagel’s research group was recently able to demonstrate this in a large international multi-centre study that was met with international acclaim.
The Institute for Experimental and Translational Cardio Vascular Imaging also has state-of-the-art computer tomography equipment at its disposal that can produce three-dimensional images of the heart. These especially reveal calcium deposits and plaques in the artery walls which could rupture and trigger a sudden heart attack. “This allows us to determine the risk of a heart attack and the need for therapy fast and at an early stage, which can then be non-invasive,” says Nagel. Which technique is best for which patient is one of the research topics Nagel’s group is evaluating. In some patients, both may be needed and the Institute is optimally equipped to answer most aspects of heart disease thanks to its deep insight into the heart.
Nagel finds these rapid advances in imaging over the last decades fascinating: “Nowadays we can spot the slightest changes and literally get a clear picture of the heart’s condition.”
Goethe Universitäthttps://tinyurl.com/ycvjvutf