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Thermofluidic heat exchangers for actuation of transcription in artificial tissues – Science Advances

September 30th, 2020 4:50 pm

INTRODUCTION

Cells transform noisy environmental signals into spatial and dynamic gene expression patterns that guide biological form and function. Information describing how these transcriptional networks are patterned is exploding because of revolutions in single-cell RNA sequencing and spatial transcriptomics. Recapitulating this spatiotemporal information transfer in three-dimensional (3D) tissue settings remains a pivotal yet elusive goal of diverse fields, such as tissue engineering (1), synthetic biology (2, 3), and developmental biology (4, 5).

To control gene expression, biologists have developed diverse technologies to rewire cells at the genetic level, such as gene knockout, inhibition, overexpression, and editing (68). To further enable spatial and dynamic control of gene expression, several of these tools have been adapted to be triggered by exogenous stimuli such as light (e.g., optogenetic transcriptional control) (9, 10). Light-based actuation of gene expression patterning has been especially useful in 2D culture or optically transparent settings. However, the inherently poor penetration of light in densely populated tissues (11), long exposure times needed to activate molecular switches, and corresponding challenges in patterning light delivery have limited widespread adoption of light-based patterning of gene expression in 3D settings (12).

We hypothesized that we could overcome these challenges by exploiting more penetrant forms of energy to drive gene patterning. In particular, mild heating is an attractive option for 3D patterning across length scales, as heat can be targeted locally and penetrate tissues at depth. Furthermore, heat can diffuse through tissues to establish thermal gradients in predictable and controllable patterns that are dictated by established rules of heat transfer (13). Last, advances in molecular engineering have led to proliferation of thermal molecular bioswitches to regulate gene expression (14, 15), with mammalian systems activating in the mild hyperthermia range (~38 to 45C).

Heat transfer has a long industrial history, as heat is often added, removed, or moved between processes using heat exchangers, which transfer heat between fluidic networks. Recently, heat exchanger fabrication has undergone a radical shift due to developments in advanced manufacturing (e.g., 3D printing). Predating its history in industry, biological organisms have also long used heat exchanger design principles for thermoregulation. We reasoned that instead of building heat exchangers from hard materials, developing methods to build heat exchangers in materials compatible with living cells could facilitate volumetric heat patterning in artificial tissues.

We introduce a thermofluidic method for mesoscale spatiotemporal control of gene expression in artificial tissues that exploits volumetric fluid-based heat transfer, which we call heat exchangers for actuation of transcription (HEAT; Fig. 1A). HEAT leverages our open-source projection stereolithography bioprinting technology (16) to fabricate topologically complex fluidic channels of user-defined geometries in hydrogels (Fig. 1B, top and middle). 3D printed hydrogels are laden with genetically engineered heat-inducible cells during the printing process (Fig. 1A). Encased channel networks are perfused with precisely heated fluid from a power-supplied heating element. During perfusion, tissue temperature is monitored in real-time using an infrared camera (Fig. 1A). We find that thermofluidic perfusion facilitates heat transfer from the channels into the bulk hydrogel and enables architectural heat patterning in hydrogels (Fig. 1B, bottom).

(A) Schematic of thermofluidic workflow. A biocompatible fluid flows around a power supplied heating element to preheat the fluid before entry in perfusable channel networks within hydrogel tissue constructs laden with heat-sensitive cells. During perfusive heating, hydrogel temperature is continuously monitored using an infrared camera. (B) Perfusable channel networks of varying spatial geometries can be bioprinted within biocompatible 3D hydrogels. Top: 3D rendering of network architectures. Middle: Hydrogel channels infused with tonic water fluoresce when imaged under ultraviolet backlight. Bottom: Infrared thermography of heat-perfused hydrogels demonstrates that during perfusion, heat traces the path of fluid flow and dissipates into the bulk hydrogel. Scale bars, 5 mm.

Most mammalian thermally inducible gene switches require exposure to mild hyperthermia (39 to 45C) for prolonged periods of ~15 to 60 min to activate transcription (15, 17). We therefore tested whether this approach could precisely regulate tissue temperature over prolonged periods of time by maintaining steady-state thermal profiles in perfused hydrogels. To do this, we first printed hydrogels that contained a single channel (Fig. 2A). We then perfused precisely heated fluid through this channel while tracking hydrogel temperature in real-time using infrared thermography (Fig. 2B). Upon initiating perfusion, we observed that hydrogel temperature underwent an initial ramp-up phase (~5 min) followed by a steady-state plateau in which temperature deviated by <0.4C/min at three separate regions measured across the hydrogel (Fig. 2B, right).

(A) Photograph of a single-channel bioprinted hydrogel used for initial thermal characterization. Scale bar, 5 mm. (B) Representative infrared images from controlled perfusion of heated fluid through the channel over time (left). Scale bars, 5 mm. (C) Representative finite-element modeling images depicting steady-state predictions on the surface of perfused hydrogels at varying flow rates and constant heater power (left; full dataset in fig. S1B). Computational modeling predicts that flow rate can achieve maximal hydrogel temperatures in the mild hyperthermia temperature range (right, gray shading denotes mild hyperthermia range). (D) Hydrogels were experimentally perfused at flow rates of 0.5 and 1.0 ml min1 and imaged using infrared thermography. Scale bars, 5 mm. (E) Hydrogel temperature plotted orthogonal (x) to the flow direction at inlet and outlet positions show agreement between thermal gradients in computational and experimental measurements (computational, dashed lines; experimental, solid lines). (F) Hydrogel temperature plotted parallel (y) to flow direction demonstrates a larger temperature drop from inlet to outlet (y) during flow at 0.5 ml min1 (T0.5) compared to flow at 1.0 ml min1 (T1.0) in computational and experimental models (computational, dashed lines; experimental, solid lines; n = 5, data are mean temperature standard error, **P < 0.01 by Students t test). Photo credit: Daniel Corbett, University of Washington.

During perfusion, heat is transferred from fluidic channels to the bulk through convection and conduction, resulting in thermal gradients throughout the bulk volume (18). The perfusate input temperature is known to govern the rate and magnitude of heat transfer, while fluid flow rate influences the thermal profile (18). To determine the relative effects of perfusate temperature and flow rate on hydrogel heating at biologically relevant temperatures, we sought to develop a finite element model of heated hydrogel perfusion for mild hyperthermia that incorporated thermal and flow parameters from our heating system. To derive these parameters, we first incrementally increased flow rate over a range of heating element powers and measured fluid temperature at the point of heater outflow (i.e., hydrogel inlet; fig. S1). We then implemented perfusate temperature values observed from each flow rate at 13.5-W heater power into a computational model of single-channel hydrogel heating (Fig. 2C and fig. S1B). Computational simulations predicted that hydrogel temperatures in the range for mild hyperthermia were achievable using flow rates from 0.4 to 1.6 ml min1, but not for slower or faster flow rates (Fig. 2C and fig. S1B). Within this window, we observed that flow rates of 0.5 and 1.0 ml min1 produced subtle differences in the shape of thermal profiles, despite roughly equivalent input temperatures (Fig. 2C and fig. S1B). Thus, these flow rates provided a set of conditions to further examine the effects of flow rate on heat transfer.

We therefore performed experimental validation studies of perfused single-channel hydrogels at 0.5 or 1.0 ml min1 and analyzed the steady-state thermal profiles from infrared images (Fig. 2D). Experimental temperature measurements (solid lines) and computational simulation predictions (dashed lines) showed agreement when measured both orthogonal (Fig. 2E) and parallel (Fig. 2F) to channel flow. Both physical measurements and simulations demonstrated thermal gradients in the hydrogel. Temperature along the channel was better maintained under flow at 1.0 ml min1 compared to flow at 0.5 ml min1 (**P < 0.01; Fig. 2, E and F), and flow at 0.5 ml min1 promoted more heat transfer at the channel inlet (fig. S2A). Addition of cells to single-channel hydrogels did not affect temperature profile after thermofluidic perfusion (fig. S2B) nor did differences in hydrogel weight percent in ranges commonly used for 3D printing of cellularized hydrogels [i.e., 10 to 20 weight % (wt %); fig. S2C] (16). Stiffer hydrogel formulations (i.e., 25 wt %) did exhibit different temperatures at the hydrogel edge, although these formulations are less commonly used for bioprinting due to their limited support of cell viability (16).

These findings led us to further computationally explore the potential spatial design space for a single-channel system. To do this, we assessed how varying channel length and ambient temperature affect the thermal profile in our model. Predictions showed that single channels up to 30 mm long achieved hyperthermic temperatures (40 to 45C) along their entire length, with outlet temperatures falling out of the hyperthermic range at greater lengths (fig. S3A). Spatial heat distribution was only marginally affected within the ambient temperature range used in our studies here (20 to 22C; fig. S3B), but more substantive increases in ambient temperature (e.g., to 30, 37C) produced wider spatial gradients in hyperthermic range (fig. S3B). Together, these studies showed that the rules of heat transfer could be leveraged to predict thermal spatial profiles in perfused hydrogels and that these profiles could be finely tuned by varying parameters such as flow rate, channel length, and input and ambient temperature.

We next aimed to genetically engineer heat-inducible cells that activate gene expression upon exposure to mild hyperthermia. To do this, we implemented a temperature-responsive gene switch-based on the human heat shock protein 6A (HSPA6) promoter, which exhibits a low level of basal activity and a high degree of up-regulation in response to mild heating (19). This promoter activates heat-regulated transcription through consensus pentanucleotide sequences (5-NGAAN-3) called heat shock elements, which are binding sites for heat shock transcription factors (19). We transduced human embryonic kidney (HEK) 293T cells with a lentiviral construct in which a 476base pair (bp) region of the HSPA6 promoter containing eight canonical heat shock elements was placed upstream of a firefly luciferase (fLuc) reporter gene (Fig. 3A). Initial characterization of temperature-sensitive promoter activity in engineered cells in 2D tissue culture demonstrated a temperature-dose dependent up-regulation of luciferase activity in the range of mild hyperthermia (fig. S4A). Statistically significant up-regulation was observed in heated cells compared to nonheated controls after hyperthermia for 30 min at 45C or 60 min from 43 to 45C, while peak bioluminescence occurred after 60 min at 44C (292 26-fold increase in bioluminescence relative to 37C controls). Bioluminescent signal was first detected 8 hours after heat shock, peaked at 16 hours (110 30-fold increase), and fell back to baseline by 2 days (fig. S4B). Administration of a second heat shock stimulus 3 days later reinduced bioluminescent signal (fig. S4C). Thus, gene activation with this promoter system is transient but can be reactivated with pulsing.

(A) HEK293T cells were engineered to express fLuc under the HSPA6 promoter. (B) Schematic of thermofluidic activation of encapsulated cells. (C) Single-channel tissue used for 3D heat activation (left). Scale bar, 3 mm. Transmittance image of cellularized hydrogel after printing (middle). Scale bar, 500 m. HEK293T cells in bioprinted tissues stained with calcein-AM (live, green) and ethidium homodimer (dead, red; right). Scale bars, 200 m. (D) Representative infrared images of thermofluidic perfusion in single-channel hydrogels. Scale bars, 2 mm. (E) Hydrogel temperatures are tuned by changing heater power at constant flow rate (n = 3, mean temperature standard error). (F) Representative bioluminescence images of hydrogels (top; scale bars, 2 mm) and intensity traces at three positions (A to C) across the width (x) of the hydrogel after 30 min of perfused heating. (G) Fold change in bioluminescence after 30 min of heating relative to 25C controls. (H) Representative bioluminescence images of hydrogels (top; scale bars, 2 mm) and intensity traces after 60 min of perfused heating (bottom; scale bars, 2 mm). (I) Fold change in bioluminescence after 60 min of heating demonstrates a temperature-dependent dosage response in gene expression [(G and I); n = 3, mean fold luminescence standard error; *P < 0.05 and **P < 0.01 by one-way ANOVA followed by Dunnetts multiple comparison test]. (J) Temperature-expression response curve (black) shows mean bioluminescent radiance across temperature; shaded regions (gray) indicate SD. n = 3. Photo credit: Daniel Corbett, University of Washington.

We observed that our highest heat exposure (45C for 60 min) led to a tradeoff between bioluminescence and cell integrity, as indicated by reduced cell metabolic activity and substrate detachment (fig. S5A). These findings suggested that fine control of heat would be needed for thermofluidics to be useful in cellularized applications. We therefore rigorously characterized the effect of heating on HEK293T cells embedded in the hydrogel formulation used for our thermofluidic studies. Similar to 2D studies, cell viability fell significantly only after exposure to our highest temperature, 45C (fig. S5B). Together, these studies demonstrate engineering of human cells with a heat-sensitive gene switch and identification of a tight window of thermal exposure parameters that both differentially up-regulate gene bioluminescence and maintain cell integrity.

We sought to determine whether thermofluidic heating could be used to induce gene expression in heat-inducible cells encased within 3D artificial tissues (Fig. 3B). To do this, we encapsulated heat-inducible cells in the bulk of bioprinted constructs that contained a single perfusable channel (Fig. 3, B and C). Since tissue constructs were printed from biocompatible materials without ultraviolet light cross-linking, most cells remained viable upon encapsulation, similar to our previous studies (16) (Fig. 3C). To determine whether our heat-inducible cells could be activated using thermofluidics, we perfused channels at 0.5 ml min1 using thermal exposure parameters identified in 2D culture (Fig. 3, D and E). Similar to 2D, we observed that thermal dose-dependent luciferase up-regulation (Fig. 3, F to J) was statistically significant after 30 min of heating to a target hydrogel temperature of 44C or after 60 min of heating to temperatures of 43 and 44C by whole-gel bioluminescent output (71 22-fold and 169 44-fold increase relative to controls, respectively; Fig. 3, H and I). To more finely characterize how bioluminescent intensity correlates with temperature, infrared and bioluminescence images were overlaid to map individual pixels and generate temperature-bioluminescence response curves. The shape of temperature-response curves appeared similar in shape across various target temperatures (Fig. 3J, all data overlaid; fig. S6, individual response curves). Similar to whole-gel analyses, greater target temperatures generated the most robust activation (Fig. 3J and fig. S6). In initial studies, we noted that leakage at the hydrogel inlet or outlet could activate cells. Subsequent improvements to fluidic connectivity with a custom-printed perfusion apparatus led to higher precision thermal patterning (fig. S7; see link to open source perfusion apparatus design in Methods). Last, multiperspective imaging and bioluminescence quantification of single-channel perfused hydrogels from both top-down and cross-sectional perspectives demonstrated that reporter gene activation had a 3D radial gradient topology around each channel (fig. S8). Together, these results illustrate that thermofluidics can be used to activate varying levels of gene expression in 3D artificial tissues.

Spatial patterns of gene expression within native tissues vary widely in magnitude, scale, and spatial complexity. While we achieved variation in magnitude in our signal-channel studies, the expression profile geometry across the hydrogel remained similar at various perfusion temperatures. This raised the question of how to design heat delivery schemes that enable more spatially complex expression patterns across the hydrogel. Our thermal characterization (Fig. 2) revealed flow rate as one parameter that we could use, but changing flow rate alone imparted only subtle differences to the spatial thermal profile (Fig. 2, D to F). To identify a more perturbative and user-defined means of affecting heat distribution across the hydrogel, we turned to industrial heat transfer applications, in which heat exchangers are optimized to transfer heat between fluids by controlling parameters such as channel placement and flow pattern.

We mimicked a double pipe heat exchanger design within cellularized hydrogels by printing two channels at varying distances from one another (Fig. 4A, narrow versus wide). We then perfused hydrogels under different conditions for flow direction (concurrent versus countercurrent) and fluid temperature [hot (44C) versus cold (25C)]. Similar to our single-channel characterization, double-channel tissues showed close matching between thermal and bioluminescence profiles (Fig. 4A). Concurrent flow in narrow spaced channels created elongated spatial plateaus of heat and bioluminescence between the channels. Conversely, widely spaced hot channels generated mirror-imaged thermal and bioluminescent profiles, with distinct spatial separation between channels. Countercurrent flow patterns generated parallelogrammic thermal and bioluminescent profiles in both channel spacings. Substituting a hot channel for a cold channel attenuated bioluminescence in a manner that depended on channel spacing (Fig. 4A). Computational models of a similar bifurcating channel geometry further demonstrated how simple changes to parameters such as channel spacing can alter spatial thermal profile (fig. S9).

(A) Heat exchanger inspired designs for various flow directions, fluid temperatures, and channel architectures (schematics; left and center). Representative thermal (middle) and bioluminescent (right) images demonstrate spatial tunability of thermal and gene expression patterning. Scale bars, 5 mm. (B) Photographic image of four-armed clock-inspired hydrogel used for dynamic activation (top; channel filled with red dye). Each inlet is assigned to a local region (A to D). Schematic shows the spatial and dynamic heating pattern for the 4-day study (bottom). (C) Representative infrared (top) and bioluminescence expression (bottom) images for dynamic hydrogel activation at each day during the time course. (D) Quantification of local bioluminescent signals from regions of interest corresponding to each day of heating. Across all 4 days, regions corresponding to perfused arms had higher bioluminescent signals than nonperfused arms (n = 5, data are mean luminescence standard error; *P < 0.05 and **P < 0.01 by one-way ANOVA followed by Tukeys post hoc test).

As biological gene expression patterns are transient and fluctuating, we next tested whether thermofluidics could dynamically localize regions of gene expression over time. To do this, we printed clock-inspired constructs, in which four separate inlets converged on a circular channel (Fig. 4B, top). We then perfused heated fluid through each inlet over four consecutive days (Fig. 4B, bottom) and imaged tissues for bioluminescence. Bioluminescent images demonstrated statistically significant luciferase up-regulation for regions surrounding heated inlets compared to nonheated inlet regions on all 4 days (Fig. 4, C and D.) Together, our results illustrate that by exploiting heat transfer design principles, thermofluidics enables user-defined spatial and dynamic patterning of mesoscale gene expression patterns in 3D artificial tissues.

To test whether gene patterning could be maintained after engraftment of artificial tissues in vivo, we stimulated tissues with HEAT and implanted these tissues into athymic mice. All tissues contained HEK293T cells expressing fLuc under the control of the heat-inducible HSPA6 promoter. All tissue constructs contained a single channel and were stimulated in one of three ways: (i) thermofluidic perfusion at 44C for 60 min, (ii) bulk heating in a cell culture incubator at 44C for 60 min, or (iii) bulk exposure in a cell culture incubator to 37C. Tissues were implanted into mice immediately after heating, and bioluminescence imaging was performed 24 hours later. We found that thermofluidic spatial control of gene expression was maintained after in vivo tissue engraftment (Fig. 5A and movie S1).

(A) Artificial tissues with embedded heat-inducible fLuc HEK293T cells received 44C thermofluidic heating (channel heat, n = 5), 44C global heating (bulk heat, n = 3), or remained at 37C (no heat, n = 3) for 1 hour before immediate implantation into athymic mice. (B) Bioluminescence from implanted hydrogels (dashed lines) showed region specific signal only in channel heated hydrogels. (C) Average line profiles (top) across the width (x) of the hydrogel for inlet, middle, and outlet positions show that only channel heated gels induced a spatially coordinated response that was statistically significant (bottom) between the center (position B) and edges of the hydrogel (position A and C; channel heat, n = 5; bulk heat, n = 3; no heat, n = 3; data are mean luminescence standard error; **P < 0.01, by one-way ANOVA.

We next sought to demonstrate the modularity of our system for spatially regulating expression of the Wnt/-catenin signaling pathway, which directs diverse aspects of embryonic development, tissue homeostasis, regeneration, and disease (20). We engineered heat-inducible constructs to drive expression of three genes in the Wnt/-catenin signaling pathway: (i) R-spondin-1 (RSPO1), a potent positive regulator of Wnt/-catenin signaling (21); (ii) -catenin, a critical transcriptional coregulator that translates to the nucleus upon canonical Wnt signaling (22); and (iii) Wnt-2, a ligand that binds to membrane-bound receptors to activate the Wnt/-catenin signaling pathway. The Wnt-2 gene was also tagged with V5 (23). We engineered lentiviral constructs in which RSPO1, -catenin, or Wnt2-V5 is driven by the heat-inducible HSPA6 promoter, and mCherry is driven by a constitutive promoter [spleen focus-forming virus (SFFV); Fig. 6A]. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) analysis of each engineered cell line for mCherry expression relative to GAPDH expression suggested lentiviral integration (fig. S10A). We then printed artificial tissues containing heat-inducible -catenin, RSPO1, or Wnt2 HEK293T cells and a single fluidic channel (Fig. 6B). Constructs were heated fluidically and then sliced into longitudinal zones (Fig. 6, A and B) to analyze expression of the Wnt family gene expression by RT-qPCR. Representative artificial tissues contained mCherry+ cells across the tissue (Fig. 6C). Immunostaining for the V5 tag fused to Wnt2 appeared higher near the heated channel compared to the gel periphery (Fig. 6C). RSPO1, -catenin, or Wnt2 expression was highest in the zone surrounding the heated channel (Fig. 6D). These results show that HEAT can be leveraged to activate expression of various family members of the Wnt/-catenin signaling pathway.

(A) Schematics of lentiviral constructs (left) and thermofluidic HEK293T tissue experiments (right). (B) Transmittance image of cellularized construct after printing (left; zones indicated by dashed lines). Infrared image of construct during heating (right). Scale bars, 1 mm. (C) mCherry+ HEK293T cells in printed tissues (left). Scale bars, 1 mm. Images of thermofluidically heated Wnt2 constructs after immunostaining for V5 tag (coexpressed with Wnt2; right; images taken near the tissues channel and periphery as indicated by insets). Scale bars, 200 m. (D) Wnt family genes were up-regulated in zone 3 of thermofluidically perfused gels compared to controls (n = 4, mean fold change standard error; *P < 0.05 and **P < 0.01 by two-way ANOVA followed by Tukeys multiple comparison test). (E) Differentiated HepaRG cells were engineered with a heat-inducible RSPO1 construct (schematic, top) and printed in single-channel hydrogels (photograph, left). Scale bars, 1 mm. After heating (infrared), HepaRGs remained viable in printed constructs (calcein). Scale bar, 200 m. (F) Thermofluidically heated RSPO-1 HepaRG hydrogels were dissected into zones 1 to 3 based on distance from the heat channel for RT-qPCR analysis at 1, 24, and 48 hours after heating. Expression fold change was normalized to no heat control samples. qPCR analysis of RSPO-1 across dissected zones (n = 5 to 10, data are mean fold change standard error; *P < 0.05 by one-way ANOVA followed by Tukeys multiple comparison test). (G) RT-qPCR analysis of pooled RNA across all zones at each time point for pericentral associated genes, glutamine synthetase, CYP1A2, CYP1A1, CYP2E1, and CYP3A4, and periportal/midzonal genes, Arg1 and E-cadherin (n = 15 to 30, data are mean fold change standard error, **P < 0.01 and *P < 0.05 by one-way ANOVA followed by Tukeys multiple comparison test). Photo credit: Daniel Corbett, University of Washington. n.s., not significant.

We reasoned that the ability to activate expression of Wnt/-catenin signaling pathway members could be useful for the emerging human organ-on-a-chip field by affecting functional cellular phenotypes in vitro. To test this, we turned to the liver, which performs hundreds of metabolic functions essential for life, including central roles in drug metabolism. To carry out these functions, hepatocytes divide the labor, with hepatocytes in different spatial locations performing different functions, a phenomenon called liver zonation. Recent studies have shown that liver zonation is regulated at the molecular level by Wnt/-catenin signaling (22), with higher Wnt activity associated with a pericentral vein phenotype and lower Wnt activity characteristic of a periportal phenotype. However, the extent to which different members of this pathway affect human zonated hepatic phenotypes remains unclear. A better understanding of this process would accelerate development of zonated human liver models for hepatotoxicity and drug metabolism studies.

We hypothesized that thermofluidic activation of RSPO1 in human hepatic cells would be sufficient to activate zonated hepatic gene expression profiles, as ectopic expression of RSPO1 in mouse liver has recently been shown to induce a pericentral zonation phenotype in vivo (24). To test this hypothesis, we transduced human HepaRG cells, an immortalized human hepatic cell line that retains characteristics of primary human hepatocytes, with our lentiviral construct in which HSPA6 drives RSPO1, and SFFV drives mCherry (Fig. 6E). Transduced human hepatic cells were then printed in artificial tissues with a single fluidic channel, to mimic central lobular placement of the central vein (Fig. 6E). Constructs were heated fluidically and then sliced into zones (Fig. 6A), and gene expression was measured by RT-qPCR (Fig. 6F). Fold up-regulation values were normalized to identically fabricated control artificial tissues maintained at 37C. We found that RSPO1 expression increased in a dose-dependent and spatially defined manner, with expression in zone 3 nearest the channel (central vein) 10-fold higher than in zone 1 by 1 hour after heating. RSPO1 expression was transient, falling with each day after heating, similar to our luciferase studies (Fig. 4C and fig. S5C). Thermofluidic activation of RSPO1 induced expression of key pericentral marker genes, including glutamine synthetase, an enzyme involved in nitrogen metabolism, and the cytochrome P450 (CYP) drug-metabolizing enzymes CYP1A2, CYP1A1, and CYP2E1 relative to control tissues that were not heated, although with varied timing and without spatial localization in this study (Fig. 6G and fig. S10). Expression of pericentral drug-metabolizing enzyme CYP3A4 was not induced with heating, consistent with other studies in which adding Wnt3a ligand to primary human hepatocyte cultures did not alter CYP3A4 expression (25). Periportal marker E-cadherin was not induced, but periportal/midzonal gene Arg1 increased at 48 hours, especially in the zone 2 midzonal region (fig. S10). Together, these studies contribute a fundamental understanding of how various liver zonation genes are induced by RSPO1 activation in human hepatic cells.

In this study, we demonstrate that thermal patterning via bioprinted fluidics can directly pattern gene expression in 3D artificial tissues. A key advantage of the HEAT method is that it leverages the recent explosion in accessible additive manufacturing tools (16, 26, 27) by using open-source bioprinting methods that are readily available to the broader community. Furthermore, the entire patterned network is stimulated nearly simultaneously (as opposed to sequentially by time-intensive rastering), and this parallel stimulation can be sustained for exposure times required to trigger gene expression. Together, the sheer rapidity and highly parallel nature of this process enable spatial and dynamic genetic patterning at length scales and depths not previously possible in 3D artificial tissues.

Most previous methods to elicit cellular signaling in artificial tissues have focused on tethering extracellular cues to hydrogels (28, 29). Innovations in stimuli-responsive or smart biomaterials enabled activation of these chemistries by exogenous physical stimuli, such as light, to control the spatial position and timing of extracellular cues (30, 31). Although useful, these material-focused methods are unlikely to provide complete control even in fully defined starting environments because cells rapidly remodel their microenvironments (32). Moreover, these technologies offer an imprecise means to control downstream transcription because many, often unknown, intermediary steps modify intracellular signal transduction before gene activation. Our thermofluidic approach provides a complementary new technology to these methods that target extracellular signals by facilitating spatiotemporal control at the intracellular genetic level.

While our studies here reveal the potential power of HEAT for gene patterning, the first-generation system presented here does have limitations in its ability to fully control heat transfer both spatially and temporally. In our studies here, we found that channels up to 30 mm long (but no longer) could achieve hyperthermic temperature ranges along the entire channel length. Furthermore, the effect of heat-mediated stimulation on gene expression was transient. These limits could be overcome through a variety of design modifications. For example, the hydrogel or perfusates thermal conductivity could be increased by materials engineering to extend patterning area or length, such as by cross-linking metal nanoparticles into the polymer backbone as has been done before for other applications (33). To achieve different activation temperatures or dynamics, further genetic engineering of the heat shock promoter or other heat-activatable gene switches could be used (14). Thus, we envision that our initial system here will establish an important foundation that leads to a new family of studies that will ultimately describe a far greater design space for thermofluidic patterning.

To fully realize the vision of precision-controlled 3D artificial tissues, a diverse toolkit of orthogonal physical delivery and molecular remote control agents will likely be needed (34, 35). Thermofluidics could be coupled with other tissue engineering strategies that program extracellular (3, 2931) or intracellular (10, 14) signal presentation, cell patterning (36), or tissue curvature (37). Thermofluidics could also be used orthogonally with other remote control agents, such as those leveraging small-molecule (12), ultrasound (38), radio wave (39), magnetic (40), or light-based activation (41). Coupled with rapid advances in gene editing (10), synthetic morphogenesis (2, 3), and stem cell technology (4, 5), thermofluidics could be useful for spatially and temporally activating genes across tissues to drive cell proliferation, fate, or assembly decisions. While we demonstrate utility for activating Wnt/-catenin signaling pathway genes here, this approach could be rapidly adapted to activate any gene of interest. In our studies, we demonstrate one application of this approach by driving human hepatic cells toward a more pericentral liver phenotype in 3D artificial tissues. In doing so, we gain fundamental insights into how activation of Wnt agonist RSPO1 regulates expression of various metabolic zonation genes. These findings have important implications for developing both organ-on-chip systems for pharmacology and hepatotoxicity, as well as artificial tissues for human therapy. By blurring the interface between the advanced fabrication and biological realms, thermofluidics creates a new avenue for bioactive tissues with applications in both basic and translational biomedicine.

Poly(ethylene glycol) diacrylate (PEGDA; 6000 Da) and lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP) were prepared as previously described (16, 42). Gelatin methacrylate (GelMA) was synthesized as previously described, with slight modifications (43). Methacrylic anhydride was added dropwise to gelatin dissolved in carbonate-bicarbonate buffer at 50C for 3 hours, followed by precipitation in ethanol. The precipitate was allowed to dry, dissolved in phosphate-buffered saline (PBS), frozen at 80C, and then lyophilized for up to 1 week. GelMA was stored at 20C until use. Tartrazine (Sigma-Aldrich T0388, St. Louis, MO, USA) was added to prepolymer solutions as a photoabsorber to increase print resolution as previously described (16). Prepolymer mixtures for all cellular studies contained 7.5 wt % 6 K PEGDA, 7.5 wt % GelMa with 17 mM LAP, and 1.591 mM tartrazine. For characterization of heat transfer with respect to gel density, the overall polymer weight percent was varied while holding the ratio of 6 K PEGDA to GelMA constant at 50:50 (for example, 20 wt % = 10 wt % 6 K PEGA + 10 wt % GelMa).

Hydrogels with perfusable channel networks were designed in an open-source 3D computer graphics software Blender 2.7 (Blender Foundation, Amsterdam, Netherlands) or in SolidWorks (Dassault Systemes SolidWorks Corp., Waltham, MA).

Our stereolithography apparatus for tissue engineering bioprinting system was used in this study (16). Briefly, the system contains three major components: (i) a Z-axis with stepper motor linear drive, (ii) an open-source RepRap Arduino Mega Board (UltiMachine, South Pittsburg, TN) microcontroller for Z-axis control of the build platform, and (iii) a projection system consisting of a DLP4500 Optical Engine with a 405-nm light-emitting diode output (Wintech, Carlsbad, CA) connected to a laptop for photomask projection and motor control. The projector is placed in front of the Z-axis, and a mirror is positioned at 45 to the projection light path to reflect projected images onto the build platform. A sequence of photomasks based on a 3D model is prepared using Creation Workshop software (www.envisionlabs.net/), which also controls the Z-axis movement of the build platform. Printing is achieved by curing sequential model layers of the photosensitive prepolymer. All printing was conducted in a sterile tissue culture hood. For visualization of channel networks, we perfused open channels with ultraviolet fluorescent tonic water or India ink dyes (P. Martins, Oceanside, CA).

To control temperature distribution in perfused hydrogels, an in-line fluid heater was developed to prewarm perfusate solutions before infusion in hydrogel channel networks. The fluid heater consists of four components: (i) an adjustable dc Power Supply (Yescom USA Inc., City of Industry, CA), (ii) a cylindrical cartridge heater (Uxcell, Hong Kong), (iii) perfusate tubing (peroxide-cured silicone tubing, Cole Parmer, Vernon Hills, IL), and (iv) a syringe pump (Harvard Apparatus, Holliston, MA). To construct the in-line fluid heater, perfusate tubing was connected to the syringe pump for flow rate control, while the cartridge heater was connected to the power supply for heating control. Perfusate tubing was then wounded around the cylindrical cartridge heater, allowing for heat transfer from the heater into the flowing perfusate. The temperature of the fluid was then controlled by changing the flow rate or heater power. In all studies, we used PBS (Thermo Fisher Scientific, Hampton, NH) for the perfusate solution.

To establish a fluidic connection between the heating system and hydrogel channel networks, we used custom-designed 3D printed perfusion chips printed on a MakerGear M2 3D printer (MakerGear, Beachwood, OH) in consumer-grade poly(lactic acid) plastic filament. Perfusion chips were fabricated with (i) an open cavity to insert 3D bioprinted hydrogels and (ii) attachment ports for fluid-dispensing nozzles. The outflow of the fluid heater was fitted with a male luer hose barb (Cole Parmer) connected to a flexible tip, polypropylene nozzle (Nordson EFD, East Providence, RI) and inserted into 3D printed attachment ports. Hydrogels were then inserted to perfusion chips, and proper fluidic connections were ensured before beginning perfusion. Model files for 3D printed perfusion holders are provided in the open repository data of our previously published work (16).

Fluid temperature and heat distribution were measured in perfused hydrogels by infrared thermography. Images were acquired by an uncooled microbolometer-type infrared camera (FLIR A655sc, Wilsonville, OR) that detects a 7.5- to 14.0-m spectral response with a thermal sensitivity of <0.05C and analyzed for temperature values using the FLIR ResearchIR software (Wilsonville, OR).

We built finite element models of perfused hydrogels in COMSOL 4.4 software (COMSOL AB, Burlington, MA). Simulations were run under transient conditions using the Conjugate heat transfer module and 3D printed hydrogel and housing geometries to predict the temperature distribution. The model was based on (i) forced convective heat transfer from the perfusion channel to the hydrogel volume and (ii) conductive heat transfer within the hydrogel volume.

Equation for (i): Heat transfer in a fluidCTt+CuT=pT(pAt+upA)+:S+(kT)+

Where is the fluid density, T is the temperature, C is the heat capacity at constant pressure, u is the velocity field, is the thermal expansion coefficient, pA is the absolute pressure, is the viscous stress tensor, S is the strain rate tensor, k is the fluid thermal conductivity, and Q is the heat content.

Equation for (ii)CpTt=(kT)+Q

Where is the hydrogel density, T is the temperature, k is the hydrogel thermal conductivity, and Q is the heat content.

Material properties of both the hydrogel and perfusate were modeled as water. Heat flux boundary conditions were included to model heat loss to the ambient environment, heat transfer coefficients of 5 and 30 W/(m2 * K) were applied to the sides and upper boundaries of the hydrogel, respectively, with an infinite temperature condition of 22.0C applied for all boundaries. Boundary temperature and fluid inflow conditions at the channel inlet were used to simulate the effect of changing perfusate temperature and flow rate, respectively. Model geometry was manipulated for studies on channel length and channel branching. Prescribed external temperature was varied for ambient temperature studies.

HEK293T cells were maintained in Dulbeccos modified Eagles medium (DMEM; Corning, NY, USA) supplemented with 10% (v/v) fetal bovine serum (FBS; Gibco) and 1% (v/v) penicillin-streptomycin (GE Healthcare Life Sciences, WA, USA). Differentiated HepaRG cells (Fisher Scientific) were maintained at confluence in six-well plates at a density of 2 106 cells per well in Williams E media (Lonza, MD, USA) supplemented with 5 HepaRG Thaw, Plate & General Purpose Medium Supplement (Fisher), and 1% (v/v) Glutamax (Fisher).

A vector containing a 476-bp version of the human HSPA6 promoter driving expression of fLuc reporter gene (gift of R. Schez Shouval from the Weizmann Institute of Science) was packaged into lentivirus using helper plasmids pMDLg/pRRE (Addgene no. 12251), pMD2.G (Addgene no. 12259), and pRSV-Rev (Addgene no. 12253) by cotransfection into HEK293T cells. Crude viral particles were harvested after 48 hours of transfection. For viral transduction, crude lentivirus was diluted 1:20 in DMEM containing polybrene (6 g/ml; Invitrogen), added to competent HEK293T cells in six-well tissue culture plates, and incubated overnight (Corning). The next day, virus-containing media was removed and replaced with fresh DMEM containing 10% FBS. After transduction, cells were heat-activated (see below) and flow-sorted to obtain a pure cell population.

To activate transgene expression under the HSPA6 promoter, engineered HEK293T cells were exposed to varying levels of hyperthermia in 2D and 3D. For 2D heat treatment studies, cells were seeded at 8 104 cells/cm2 in tissue culture plates 1 day before heat treatment. The next day, tissue culture plates were exposed to indicated heat treatments in thermostatically controlled cell culture incubators. Temperature was verified with a secondary method by a thermocouple placed inside the incubator. Upon completion of heat treatment, cells were returned to a 37C environment and sorted or analyzed at later time points. For the luminescent transient studies in fig. S4B, cells were lysed in TE buffer [100 mM tris and 4 mM EDTA (pH 7.5)] and stored at 4C until imaging. For the pulsed activation studies in fig. S4C, cells received two heat shocks as described previously at days 0 and 3. Luminescence was quantified across days 1 to 4 and normalized to cell counts from tissue culture plates that were processed in parallel according to each experimental temperature. For 3D heat shock studies, cells were encapsulated and printed in 3D perfusable hydrogels (see below) 1 day before heating. 3D hydrogels were then heat-perfused in a room temperature environment. Hydrogel temperature was monitored continuously with the infrared camera, and small adjustments to heater power were made as necessary to maintain a stable temperature profile. During perfused heating, outlet medium was continuously discarded. Upon completion of perfused heating, hydrogels were dismounted from the perfusion chips and returned to a cell culture incubator.

Cultured HEK293T cells were detached from tissue culture plates with 0.25% trypsin solution (Corning), counted, centrifuged at 1000 rpm for 5 min, and resuspended in liquid prepolymer (7.5 wt % 6 K PEGDA, 7.5 wt % GelMA, 17 mM LAP, and 1.591 mM tartrazine). For characterization of heat transfer with respect to cell density, cells were encapsulated in prepolymer mixtures at final densities from 0 to 24 106 cells ml1 before printing. For HEK293T expression studies, cells were encapsulated at a final density of 6 106 cells ml1. For HepaRG studies, cells were encapsulated at a final density of 2.5 106 cells ml1. Printing was performed as previously described under DLP light intensities ranging from 17 to 24.5 mW cm2, with bottom layer exposure times from 30 to 35 s and remaining layer exposure times from 12 to 17.5 s. Upon print completion, fabricated hydrogels were removed from the platform with a sterile razor blade and allowed to swell in cell culture media. Hydrogels were changed to fresh media 15 min after swelling and allowed to incubate overnight. Media was replaced the following morning. We tested the viability of both HEK293T and HepaRG cells following 3D printing by incubating cell-laden hydrogels with Live/Dead viability/cytotoxicity kit reagents (Life Technologies, Carlsbad, CA) according to manufacturers instructions. Fluorescence imaging was performed on a Nikon Eclipse Ti inverted epifluorescent microscope, and images were quantified using ImageJs built-in particle analyzer tool [National Institutes of Health, Bethesda, Maryland].

To visualize the magnitude and spatial localization of heat-induced luciferase expression, bioluminescence imaging was performed on heated cells and hydrogels using the in vivo imaging system (IVIS) Spectrum imaging system (PerkinElmer, Waltham, MA). Immediately before bioluminescence imaging, cell culture media was changed to media containing d-luciferin (0.15 mg/ml; PerkinElmer), and images were taken every 2 min until a bioluminescent maximum was reached. Images were analyzed using Living Image software (PerkinElmer). Luminescent imaging was performed from a top-down view (perspective orthogonal to hydrogel channel axis) for most studies. For cross-sectional images in fig. S8, hydrogels were manually sliced, incubated in luciferin containing media, and imaged under cross-section view (perspective parallel to hydrogel channel axis).

Data for the expression versus temperature plot was obtained by aligning thermal and bioluminescent images using MATLAB. To align the images, four reference points corresponding to the corners of the hydrogel were manually selected on both thermal and bioluminescence images. Then, an orthogonal transformation was performed on each image to align the corners of the hydrogel, after which the areas outside the selection were cropped. Pixel values from each image were then plotted against each other to produce the expression versus temperature plot.

Heat-inducible cells were generated as previously described and embedded into 3D-printed artificial tissues with single channels before being placed at 37C overnight. The next day, artificial tissues received either thermofluidic heat stimulation via flow of 44C biocompatible fluid at 1.0 ml min1 for 60 min (n = 5), global heat stimulus by being placed in a 44C tissue culture incubator for 60 min (n = 3), or were maintained in a 37C tissue culture incubator (n = 3). The artificial tissues were then immediately implanted subcutaneously on the ventral side of female NCr nude mice aged 8 to 12 weeks old (Taconic). Twenty-four hours after implantation, mice were anesthetized and injected with luciferin (15 mg/ml; PerkinElmer, Waltham, MA). Bioluminescence was then recorded via the IVIS Spectrum Imaging System (PerkinElmer). For 3D images, a custom 3D imaging unit developed by A. D. Klose and N. Paragas (44) (InVivo Analytics, New York, NY) was used. Briefly, anesthetized mice were placed into body-fitting animal shuttles and secured into the custom 3D imaging unit that uses a mirror gantry for multiview bioluminescent imaging. Collected images were then compiled and overlaid onto a standard mouse skeleton for perspective.

Line profiles in the x-direction across the inlet, middle, and outlet of 2D IVIS projection images from artificial gels were generated using Living Systems software (PerkinElmer, Waltham, MA). The three line profiles (inlet, middle, and outlet) from each artificial tissue were then averaged together with the average line profiles from the other artificial gels within each respective group (experimental group, n = 5; positive control group, n = 3; negative control group, n = 3). The average line profile of each group was then plotted, and average radiance values from positions 0.75 cm from the center of the channel (denoted positions A and C) were then statistically compared to the average radiance value at the center of the channel (position B) within each group by one-way analysis of variance (ANOVA).

Lentiviral constructs in which the HSPA6 promoter drives a Wnt family gene were subcloned using Gibson assembly by the UW BioFab facility. Human -catenin pcDNA3 was a gift from E. Fearon (Addgene plasmid no. 16828; http://n2t.net/addgene:16828; RRID: Addgene_16828) (45). Active Wnt2-V5 was a gift from X. He (Addgene plasmid no. 43809; http://n2t.net/addgene:43809; RRID:Addgene_43809) (46). RSPO1 was subcloned using a complementary DNA (cDNA) clone plasmid. (Sino Biological, Beijing, China). All plasmids contained a downstream cassette in which a constitutive promoter (SFFV) drives the reporter gene mCherry (gift from G. A. Kwong, Georgia Institute of Technology). Lentivirus was generated by cotransfection of HEK293Ts with HSPA6Wnt transfer plasmids with third-generation packaging plasmids (pMDLg/pRRE, pMD2.G, pRSV-REV) in DMEM supplemented with 0.3% Xtreme Gene Mix (Sigma-Aldrich). Crude virus was harvested starting the day after initial transfection for four consecutive days. For viral transduction, HEK293Ts at 70% confluency and HepaRGs at 100% confluency were treated with crude virus containing polybrene (8 g/ml; Sigma-Aldrich) for 24 hours. Five days following viral transduction, mCherry+ HEK293Ts were sorted from the bulk population by flow cytometry at the UW Flow analysis facility. HepaRGs were not sorted by flow cytometry. mCherry expression in positive HEK293T cell populations was performed using RT-qPCR.

To quantify Wnt regulator levels in HEAT-treated gels, HEK293Ts and HepaRGs for a given construct were encapsulated and heated in 3D hydrogels as previously described. No heat control samples remained at 37C in tissue culture incubators until RNA isolation. One to 48 hours following heat treatment, hydrogels were manually sliced into corresponding zones (1 to 3) and RNA was isolated using phenol-chloroform extraction (47). cDNA was synthesized using the Superscript III First-Strand Synthesis Kit (Thermo Fisher Scientific), and qPCR was performed using iTaq Universal SYBR Green Supermix (Biorad, Hercules, CA) on the 7900HT Real Time PCR System (Applied Biosystems, Waltham, MA). Primers for Wnt and housekeeping genes were designed and synthesized by Integrated DNA Technologies (Coraville, IA). Relative gene expression was normalized against the housekeeping gene 18S RNA calculated using the Ct method. Data are presented as the mean relative expression SEM. Data for HEK293T studies were normalized to relative expression of the Wnt target in 2D culture at 37C. Data for HEK293T mCherry expression were normalized to 18 s RNA and compared to GAPDH (also normalized to 18S RNA) expression levels. Data for HepaRG studies were normalized by relative expression of the Wnt target or pericentral/periportal gene marker to no heat control samples.

HSPA6Wnt2/V5 gels were fixed in 4% paraformaldehyde 24 hours postheating. For staining, samples are blocked overnight at room temperature in 1% bovine serum albumin, 1% normal donkey serum, 0.1 M tris, and 0.3% Triton X-100 with agitation. After blocking, samples are incubated in Anti-V5 tag antibody (Abcam, ab27671) diluted 1:100 in fresh blocking buffer and 5% dimethyl sulfoxide for 24 hours at 37C and agitation. Samples are washed and then incubated in secondary antibody diluted 1:500 in fresh blocking buffer and 5% dimethyl sulfoxide overnight at 37C and agitation. After incubation, samples are washed in PBS + 0.2% Triton X-100 + 0.5% 1-thioglycerol three times at room temperature and agitation, changing fresh buffer every 2 hours. To begin clearing, samples are incubated in clearing enhanced 3D (Ce3D) (48) solution at room temperature overnight with agitation protected from light. 4,6-Diamidino-2-phenylindole is diluted 1:500 in the Ce3D solution to counter stain for nuclei. To 3D image the cleared samples, the gels are placed on glass-bottom dishes and imaged overnight on an SP8 Resonant Scanning Confocal Microscope.

Data in graphs are expressed as the SE or SEM SD, as denoted in figure legends. Statistical significance was determined using two-tailed Students t test for two-way comparisons or one-way ANOVA or two-way ANOVA followed by Dunnetts, Sidaks, or Tukeys multiple comparison test.

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Thermofluidic heat exchangers for actuation of transcription in artificial tissues - Science Advances

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The Global CRISPR Technology Market Size Is Seeing Exponential Growth Due To The Application Of CRISPR Technology In Treating COVID-19 – GlobeNewswire

September 30th, 2020 4:50 pm

LONDON, Sept. 24, 2020 (GLOBE NEWSWIRE) -- (Companies Included: Crispr Therapeutics, Thermo Fisher Scientific, Intellia Therapeutics, Horizon Discovery, and Synthego Corporation)

In another instance, in early May, the US Food and Drug Administration (FDA) granted Sherlock Biosciences an emergency use authorization (EUA) for its COVID-19 diagnostic assay, beating out other companies and academic groups trying to use the powerful gene-editing technology to figure out who is infected with the novel coronavirus. Sherlocks test is the first FDA-authorized use of CRISPR technology for anything. Sherlocks test is a molecular diagnostic, intended to identify people who have acute SARS-CoV-2 infection. It capitalizes on a CRISPR-based technology developed in the lab of Feng Zhang, a scientist at Broad Institute of MIT and Harvard and a cofounder of Sherlock.

The Business Research Companys report titled CRISPR Technology Global Market Report 2020-30: Covid 19 Growth And Change covers the CRISPR market 2020, CRISPR technology market share by company, global CRISPR technology market analysis, global CRISPR technology market size, and CRISPR technology market forecasts. The report also covers the global CRISPR technology market and its segments. The CRISPR technology market share is segmented by product type into Cas9 and gRNA, design tool, plasmid and vector, and other delivery system products. The CRISPR technology market share is segmented by end-user into biopharmaceutical companies, agricultural biotechnology companies, academic research organizations, and contract research organizations (CROs). By application, it is segmented into biomedical, agriculture, diagnostics, and others.

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The global CRISPR technology market value is expected to grow from $685.5 million in 2019 to $1,654.2 million in 2023 at a compound annual growth rate (CAGR) of 24.6%. The application of CRISPR technology as a diagnostic tool is expected to boost CRISPR technology market growth during the period. The Sherlock CRISPR SARS-CoV-2 kit is the first diagnostic kit based on CRISPR technology for infectious diseases caused due to COVID-19. In May 2020, the US FDA (Food and Drug Administration) announced emergency use authorization of Sherlock BioSciences Inc.s Sherlock CRISPR SARS-CoV-2 kit, which is a CRISPR-based SHERLOCK (Specific High-sensitivity Enzymatic Reporter unLOCKing) diagnostic test.

This test helps in specifically targeting RNA or DNA sequences of the SARS-CoV-2 virus from specimens or samples such as nasal swabs from the upper respiratory tract, and fluid in the lungs from bronchoalveolar lavage specimens. This diagnostic kit has high specificity and sensitivity, and does not provide false negative or positive results. Widening the application of CRISPR technology for the diagnosis of infectious diseases will further increase the demand for CRISPR technology products and services and drive the CRISPR market 2020.

Several advancements in CRISPR technology are trending in the market. Advancements in technology will help in reducing errors, limiting unintended effects, improving the accuracy of the tool, widening its applications, developing gene therapies, and more. Scientists, researchers and companies are increasingly developing advanced CRISPR technologies for more precise editing and to get access to difficult to reach areas of human genome. For instance, in March 2020, scientists at University of Toronto developed CHyMErA, a CRISPR-based tool for more versatile genome editing. Similarly, in March 2020, researchers at New York genome center developed a new CRISPR screening technology to target RNA, including RNA of novel viruses like COVID.

In November 2019, researchers at ETH Zurich, Switzerland, swapped CAS9 enzyme for Cas 12a, that allowed the researchers to edit genes in 25 target sites. It is also estimated that hundreds of target sites can be modified using the above method. In October 2019, a team from MIT and Harvard developed new CRISPR genome editing approach called prime editing by combining CRISPR-Cas9 and reverse transcriptase into a single protein. The prime editing has the potential to directly edit human cells with high precision and efficiency.

The CRISPR technology market share consists of sales of CRISPR technology products and services, which is a gene-editing technology that allows researchers to alter DNA sequences and modify gene function. The revenue generated by the market includes the sales of products such as design tools, plasmid & vector, Cas9 & gRNA, and libraries & delivery system products and services that include design & vector construction, screening and cell line engineering. These products and services are used in genome editing/genetic engineering, genetically modifying organisms, agricultural biotechnology and others, which include gRNA database/gene library, CRISPR plasmid, and human stem cell & cell line engineering.

CRISPR Technology Global Market Report 2020-30: Covid 19 Growth And Change is one of a series of new reports from The Business Research Company that provide market overviews, analyze and forecast market size and growth for the whole market, CRISPR technology market segments and geographies, CRISPR technology market trends, CRISPR technology market drivers, CRISPR technology marketrestraints, CRISPR technology market leading competitors revenues, profiles and market shares in over 1,000 industry reports, covering over 2,500 market segments and 60 geographies. The report also gives in-depth analysis of the impact of COVID-19 on the market. The reports draw on 150,000 datasets, extensive secondary research, and exclusive insights from interviews with industry leaders. A highly experienced and expert team of analysts and modellers provides market analysis and forecasts. The reports identify top countries and segments for opportunities and strategies based on market trends and leading competitors approaches.

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The Global CRISPR Technology Market Size Is Seeing Exponential Growth Due To The Application Of CRISPR Technology In Treating COVID-19 - GlobeNewswire

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Novavax Initiates Phase 3 Efficacy Trial of COVID-19 Vaccine in the United KingdomClinical trial to enroll up to 10000 volunteers across the UK to…

September 30th, 2020 4:50 pm

GAITHERSBURG, Md., Sept. 24, 2020 (GLOBE NEWSWIRE) -- Novavax, Inc. (Nasdaq: NVAX), a late stage biotechnology company developing next-generation vaccines for serious infectious diseases, today announced that it has initiated its first Phase 3 study to evaluate the efficacy, safety and immunogenicity of NVX-CoV2373, Novavax COVID-19 vaccine candidate. The trial is being conducted in the United Kingdom (UK), in partnership with the UK Governments Vaccines Taskforce, and is expected to enroll and immunize up to 10,000 individuals between 18-84 (inclusive) years of age, with and without relevant comorbidities, over the next four to six weeks.

With a high level of SARS-CoV-2 transmission observed and expected to continue in the UK, we are optimistic that this pivotal Phase 3 clinical trial will enroll quickly and provide a near-term view of NVX-CoV2373s efficacy, said Gregory M. Glenn, M.D., President, Research and Development at Novavax. The data from this trial is expected to support regulatory submissions for licensure in the UK, EU and other countries. We are grateful for the support of the UK Government, including from its Department of Health and Social Care and National Institute for Health Research, to advance this important research.

NVX-CoV2373 is a stable, prefusion protein made using Novavax recombinant protein nanoparticle technology that includes Novavax proprietary MatrixM adjuvant. The vaccine has a favorable product profile that will allow handling in an unfrozen, liquid formulation that can be stored at 2C to 8C, allowing for distribution using standard vaccine channels.

Novavax has continued to scale-up its manufacturing capacity, currently at up to 2 billion annualized doses, once all capacity has been brought online by mid-2021.

About the Phase 3 Study

Consistent with its long-standing commitment to transparency and in order to enhance information-sharing during the worldwide pandemic, Novavax will be publishing its UK study protocol in the coming days.

The UK Phase 3 clinical trial is a randomized, placebo-controlled, observer-blinded study to evaluate the efficacy, safety and immunogenicity of NVX-CoV2373 with Matrix-M in up to 10,000 subjects aged 18 to 84 years. Half the participants will receive two intramuscular injections of vaccine comprising 5 g of protein antigen with 50 g MatrixM adjuvant, administered 21 days apart, while half of the trial participants will receive placebo.

The trial is designed to enroll at least 25 percent of participants over the age of 65 as well as to prioritize groups that are most affected by COVID-19, including racial and ethnic minorities. Additionally, up to 400 participants will also receive a licensed seasonal influenza vaccine as part of a co-administration sub-study.

The trial has two primary endpoints. The first primary endpoint is first occurrence of PCR-confirmed symptomatic COVID-19 with onset at least 7 days after the second study vaccination in volunteers who have not been previously infected with SARS-CoV-2. The second primary endpoint is first occurrence of PCR-confirmed symptomatic moderate or severe COVID-19 with onset at least 7 days after the second study vaccination in volunteers who have not been previously infected with SARS-CoV-2. The primary efficacy analysis will be an event-driven analysis based on the number of participants with symptomatic or moderate/severe COVID-19 disease. An interim analysis will be performed when 67% of the desired number of these cases has been reached.

For further information, including media-ready images, b-roll, downloadable resources and more, click here.

About NVX-CoV2373

NVXCoV2373 is a vaccine candidate engineered from the genetic sequence of SARSCoV2, the virus that causes COVID-19 disease. NVXCoV2373 was created using Novavax recombinant nanoparticle technology to generate antigen derived from the coronavirus spike (S) protein and contains Novavax patented saponin-based Matrix-M adjuvant to enhance the immune response and stimulate high levels of neutralizing antibodies. NVX-CoV2373 contains purified protein antigens and cannot replicate, nor can it cause COVID-19. In preclinical trials, NVXCoV2373 demonstrated indication of antibodies that block binding of spike protein to receptors targeted by the virus, a critical aspect for effective vaccine protection. In its the Phase 1 portion of its Phase 1/2 clinical trial, NVXCoV2373 was generally well-tolerated and elicited robust antibody responses numerically superior to that seen in human convalescent sera. NVX-CoV2373 is also being evaluated in two ongoing Phase 2 studies, which began in August; a Phase 2b trial in South Africa, and a Phase 1/2 continuation in the U.S. and Australia. Novavaxhas secured$2 billionin funding for its global coronavirus vaccine program, including up to$388 millionin funding from theCoalition for Epidemic Preparedness Innovations(CEPI).

About Matrix-M

Novavax patented saponin-based Matrix-M adjuvant has demonstrated a potent and well-tolerated effect by stimulating the entry of antigen-presenting cells into the injection site and enhancing antigen presentation in local lymph nodes, boosting immune response.

About Novavax

Novavax, Inc.(Nasdaq:NVAX) is a late-stage biotechnology company that promotes improved health globally through the discovery, development, and commercialization of innovative vaccines to prevent serious infectious diseases.Novavaxis undergoing clinical trials for NVX-CoV2373, its vaccine candidate against SARS-CoV-2, the virus that causes COVID-19. NanoFlu, its quadrivalent influenza nanoparticle vaccine, met all primary objectives in its pivotal Phase 3 clinical trial in older adults. Both vaccine candidates incorporate Novavax proprietary saponin-based Matrix-M adjuvant in order to enhance the immune response and stimulate high levels of neutralizing antibodies.Novavaxis a leading innovator of recombinant vaccines; its proprietary recombinant technology platform combines the power and speed of genetic engineering to efficiently produce highly immunogenic nanoparticles in order to address urgent global health needs.

For more information, visit http://www.novavax.com and connect with us on Twitter and LinkedIn.

Novavax Forward-Looking Statements

Statements herein relating to the future ofNovavaxand the ongoing development of its vaccine and adjuvant products are forward-looking statements.Novavaxcautions that these forward-looking statements are subject to numerous risks and uncertainties, which could cause actual results to differ materially from those expressed or implied by such statements. These risks and uncertainties include those identified under the heading Risk Factors in the Novavax Annual Report on Form 10-K for the year endedDecember 31, 2019, and Quarterly Report on Form 8-K for the period endedJune 30, 2020, as filed with theSecurities and Exchange Commission(SEC). We caution investors not to place considerable reliance on forward-looking statements contained in this press release. You are encouraged to read our filings with theSEC, available atsec.gov, for a discussion of these and other risks and uncertainties. The forward-looking statements in this press release speak only as of the date of this document, and we undertake no obligation to update or revise any of the statements. Our business is subject to substantial risks and uncertainties, including those referenced above. Investors, potential investors, and others should give careful consideration to these risks and uncertainties.

Contacts:

Novavax

InvestorsSilvia Taylor and Erika Trahanir@novavax.com240-268-2022

MediaBrandzone/KOGS CommunicationEdna Kaplankaplan@kogspr.com617-974-8659

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Novavax Initiates Phase 3 Efficacy Trial of COVID-19 Vaccine in the United KingdomClinical trial to enroll up to 10000 volunteers across the UK to...

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Orgenesis to acquire regenerative medicine company Koligo Therapeutics – Pharmaceutical Business Review

September 30th, 2020 4:49 pm

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Orgenesis to acquire regenerative medicine company Koligo Therapeutics - Pharmaceutical Business Review

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Heart attack patches may save lives in US and beyond – Galveston County Daily News

September 30th, 2020 4:49 pm

A promising therapy for heart attacks uses stem cells to repair the damaged areas of the heart. However, getting the transplanted cells to stay at the site is a challenge. Now scientists have created a new type of off-the-shelf cardiac patch that overcomes these limitations.

The leading cause of death in the United States is coronary heart disease, which kills about 360,000 per year. Heart attacks result from the loss of blood flow to part of the heart muscle. This can be caused by fat, cholesterol and other substances forming plaque in the coronary arteries that supply oxygenated blood to the heart.

When the plaque breaks, a clot forms around it, which can prevent blood flow to a part of the heart and kill cells. The degree of damage depends on the area of the heart supplied by the blocked artery.

Treatments for a heart attack include limiting the original damage and blocking the secondary damage, which reduces long-term consequences and saves lives. As the heart heals, the damaged area forms scar tissue, which cannot pump blood like normal heart tissue, and it can affect the performance of the rest of the heart.

Cell therapy for heart attacks involves using cardiac stromal cells to encourage the heart to heal with muscle cells rather than scar tissue. Cardiac stromal cells interact with muscle cells and release chemical signals to encourage muscle cell growth.

This approach has only moderate benefits, because cardiac stromal cells are fragile and must be carefully stored and transported. Making matters worse, some stem cells can grow out of control and become tumors. Using a patients own cells has some advantages, but its expensive and time consuming. Theres also the problem of preventing the beating heart from washing the cells away.

Several types of scaffolds have been developed to keep the cardiac stromal cells at the proper location. However, these scaffolds dont overcome the cost and difficulties of isolating and expanding the stem cells.

Now a group of scientists has created a new type of artificial cardiac patch. It consists of a scaffolding matrix made from pig cardiac tissue, from which all cells have been removed. They then created artificial cardiac stromal cells by putting the important healing components from cardiac stromal cells into biodegradable microparticles within that matrix. The synthetic cardiac stromal cells mimic the therapeutic features of live stem cells while overcoming their storage and survival problems, and the matrix preserves the structures and activity found in cardiac tissue.

The artificial cardiac patch was shown to hold the synthetic cardiac stromal cells in place on the heart. In heart attack experiments in both rodents and pigs, the patch resulted in a 50 percent improvement in heart function and a 30 percent reduction in scarring when compared to no treatment.

Medical Discovery News is hosted by professors Norbert Herzog at Quinnipiac University, and David Niesel of the University of Texas Medical Branch. Learn more at http://www.medicaldiscoverynews.com.

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Heart attack patches may save lives in US and beyond - Galveston County Daily News

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Orgenesis Announces Agreement to Acquire Koligo Therapeutics, a Leader in Personalized Cell Therapies – GlobeNewswire

September 30th, 2020 4:49 pm

Acquisition to support accelerated commercialization of Koligos KYSLECEL,a personalized islet cell therapy available in the U.S. for chronic and recurrent acute pancreatitis

Goal to rapidly advance KT-PC-301, an autologous cell therapy under investigationfor the treatment of COVID-19-related Acute Respiratory Disease Syndrome (ARDS)

Orgenesis to leverage Koligos 3D-V bioprinting technology across its POCare Platform

GERMANTOWN, Md., Sept. 29, 2020 (GLOBE NEWSWIRE) -- Orgenesis Inc. (NASDAQ: ORGS) (Orgenesis or the Company), a global biotech company working to unlock the full potential of cell and gene therapies, and Koligo Therapeutics, Inc. (Koligo), a regenerative medicine company, today announced that the two companies have entered into a definitive merger agreement, subject to final closing conditions, with expected completion before year-end (Transaction).

Koligo is a leader in developing personalized cell therapies utilizing the patients own (autologous) cells. Koligo has successfully launched its first commercial product, KYSLECEL, and plans to commence a phase 2 trial of KT-PC-301 for COVID-19-related ARDS. Koligos development stage technology utilizes 3D bioprinting and vascularization with autologous cells (3D-V technology) to create biodegradable and shelf-stable three-dimensional cell and tissue implants. The 3D-V technology is being developed for diabetes and pancreatitis, with longer term applications for neural, liver, and other cell/tissue transplants.

Following closing of the Transaction, Orgenesis plans to accelerate the commercial scaleup of KYSLECEL throughout the United States and, subject to regulatory and logistical considerations, in international markets as well. After closing of the Transaction, and subject to FDA review and clearance of the Companys Investigational New Drug application, Orgenesis expects to start patient recruitment for a phase 2 randomized clinical trial of KT-PC-301 in COVID-19 patients. Orgenesis also plans to leverage Koligos 3D-V bioprinting technology across its POCare platform.

Under the terms of the merger agreement, Orgenesis will acquire all of the outstanding stock of Koligo from its shareholders (the founders and staff of Koligo and a subsidiary of Bergen Special Opportunity Fund, LP, an institutional investor managed by Bergen Asset Management, LLC). The agreed consideration terms are an aggregate of $15 million in shares of Orgenesis common stock valued at $7.00 per share which shall be issued to Koligos accredited investors (with certain non-accredited investors to be paid solely in cash) and an assumption of $1.3 million in Koligos liabilities, estimated to be substantially all of Koligos liabilities. Additional details of the Transaction will be available in the Companys Form 8-K, which will be filed with the Securities and Exchange Commission, and will be available at http://www.sec.gov.

KYSLECELKoligos KYSLECEL is commercially available in the United States for chronic and recurrent acute pancreatitis in a surgical procedure commonly called Total Pancreatectomy with Islet Autologous-Transplant (TPIAT). TPIAT has been proven to provide significant pain relief, improved quality of life, and a reduction in the need for pain medication for patients suffering from chronic or recurrent acute pancreatitis. KYSLECEL infusion after a total pancreatectomy helps preserve insulin secretory capacity and reduce the risk of diabetic complications. KYSLECEL is made from a patients own pancreatic islets the cells that make insulin to regulate blood sugar.

Koligo has commenced its commercial pilot program for KYSLECEL at six U.S. hospitals, treating 40 patients to date. The KYSLECEL pilot program has generated approximately $2 million in sales revenue. KYSLECEL has also been shown to result in significant savings to payors over traditional chronic pancreatitis management. Following the closing of the Transaction, Orgenesis plans to make KYSLECEL available to an increasing number of hospitals throughout the United States through its POCare Network.

KT-PC-301Koligos lead clinical development program is for KT-PC-301, an autologous cell therapy under investigation for the treatment of COVID-19-related Acute Respiratory Disease Syndrome (ARDS). KT-PC-301 is comprised of autologous stromal and vascular fraction cells (SVF) derived from each patients adipose (fat) tissue. KT-PC-301 contains a population of mesenchymal stem cells, vascular endothelial cells, and immune cells which migrate to the patients lungs and other peripheral sites of inflammation. Nonclinical and clinical evidence demonstrate that KT-PC-301 may: (1) stabilize microcirculation to improve oxygenation; (2) maintain T and B lymphocytes to support antibody production; and (3) induce an anti-inflammatory effect.

Koligo has completed a pre-IND (Investigational New Drug) consultation with the U.S. Food and Drug Administration to start clinical trials of KT-PC-301 in COVID-19-related ARDS. Following the closing of the Transaction, and subject to FDA review and clearance of the Companys Investigational New Drug application, Orgenesis expects to start patient recruitment for a phase 2 randomized clinical trial of KT-PC-301 in COVID-19 patients. As currently planned, the phase 2 trial is expected to enroll 75 patients and evaluate the safety and efficacy of KT-PC-301. Mohamed Saad, MD, Chief of Division of Pulmonary, Critical Care, and Sleep Disorders Medicine at the University of Louisville, will be the lead clinical investigator on the trial.

3D-V Technology Koligos 3D-V bioprinting technology is designed to support development of a number of product candidates for the treatment of diabetes, cancer, neurodegenerative disease, and other serious diseases. The 3D-V technology platform is able to print three-dimensional cell and tissue constructs with a vascular network. Key benefits of the 3D-V approach include: faster revascularization/inosculation of cell/tissue transplant to improve engraftment; host tolerance of the graft while minimizing need for immune suppressive drugs; better site of transplant administration of such products; and scaffolding to keep cell/tissue in place in vivo. These solutions are ideally suited for islet transplant and other cell/tissue transplant applications.

Koligo ManagementFollowing the closing of the Transaction, Koligos management team will be joining Orgenesis to continue commercial and development activities. Koligos CEO, Matthew Lehman, is an accomplished executive in the biotech and regenerative medicine fields. Prior to co-founding Koligo, he was CEO of Prima Biomed Ltd (now Immutep Ltd, a Nasdaq (IMMP) and ASX (IMM) listed biotech company). Stuart Williams, PhD, Chief Technology Officer, is a bioengineer and thought leader in regenerative medicine, with over 300 publications and 20 issued patents in the field. Dr. Williams has co-founded three other biotech companies and is an experienced academic-industry collaborator. Michael Hughes, MD, Chief Medical Officer, is a transplant surgeon who started the islet transplant program at University of Louisville which was the genesis of Koligos KYSLECEL program. He has successfully treated nearly 50 chronic pancreatitis patients with islet autologous transplant after pancreatectomy. Balamurugan Appakalai, PhD, has more than 20 years of islet isolation experience, having processed more than 800 human pancreases. He is a leader in the field of islet transplant with 100+ publications.

Vered Caplan, Chief Executive Officer of Orgenesis, stated, We are pleased to announce this transformative acquisition, which we expect will add broad capabilities to our therapeutic and technology platform, and will further our leadership in the cell and gene therapy field. Based on several phase 1 studies, Koligos KT-PC-301, using a patients own cells, has demonstrated safety and tolerability, and has shown signs of efficacy to support continued development in COVID-19-related ARDS. If successful for the treatment of COVID-19-related ARDS, KT-PC-301 is likely to have applications in other acute and chronic respiratory indications, areas that represent significant unmet medical need. In addition, we see significant potential in KYSLECEL, a commercial stage asset for the treatment of chronic and acute recurrent pancreatitis, which we plan to introduce through our global network of hospitals. Finally, Koligos 3D-V bioprinting technology is highly complementary to our POCare Platform, as we implement new technologies to improve efficacy and lower the costs of cell and gene therapies. I would like to personally welcome Matthew and the rest of the Koligo team to the Orgenesis organization when the Transaction closes. We believe that their skills and experience will be an important addition as we execute on our strategy to unlock the power of cell and gene therapies and make them accessible to all.

Matthew Lehman, Chief Executive Officer of Koligo Therapeutics, stated, The merger with Orgenesis marks a major milestone for our company and builds on our recent progress, including the Pre-IND package submitted to the U.S. FDA for KT-PC-301 and our pilot commercial program for KYSLECEL. The Orgenesis team brings extensive clinical, regulatory, and manufacturing expertise well suited to supporting Koligos goals. Orgenesis intellectual property is highly complementary to Koligos technology and the combined companies will work to advance a robust commercial and development product portfolio. Orgenesis POCare technologies are also ideally suited for low-cost and efficient production of autologous cell therapies at the point of care, which we believe will considerably enhance the delivery of these therapies to patients. Additionally, we believe Orgenesis global network of leading hospitals and healthcare institutions will enable us to accelerate the commercial rollout of KYSLECEL. We are quite encouraged by the outlook for the business and look forward to leveraging Orgenesis POCare Platform in order to accelerate the timeline to bringing our innovative cell therapies to market. Through this merger, we believe we can maximize value for all shareholders and we are grateful to Orgenesis for this opportunity.

Pearl Cohen Zedek Latzer Baratz LLP and KPMG advised Orgenesis on the Transaction. Maxim Group LLC acted as a finder and Nelson Mullins Riley & Scarborough, LLP advised Koligo on the Transaction.

About Koligo Therapeutics Koligo Therapeutics, Inc. is a US regenerative medicine company. Koligos first commercial product is KYSLECEL (autologous pancreatic islets) for chronic and acute recurrent pancreatitis. Koligos 3D-V technology platform incorporates the use of advanced 3D bioprinting techniques and vascular endothelial cells to support development of transformational cell and tissue products for serious diseases. More information is available at http://www.koligo.net.

About OrgenesisOrgenesis is a global biotech company working to unlock the full potential of celland gene therapies (CGTs) in an affordable and accessible format at the point of care. The Orgenesis POCarePlatform is comprised of three enabling components: a pipeline of licensedPOCare Therapeuticsthat are processed and produced in closed, automatedPOCare Technologysystems across a collaborativePOCare Network. Orgenesisidentifies promising new therapies and leverages its POCare Platform to provide a rapid, globally harmonized pathway for these therapies to reach and treat large numbers of patients at lowered costs through efficient, scalable, and decentralized production. The Network brings together patients, doctors, industry partners, research institutes and hospitals worldwide to achieve harmonized, regulated clinical development and production of the therapies. Learn more about the work Orgenesis is doing atwww.orgenesis.com.

Notice Regarding Forward-Looking Statements The information in this release is as of September 29, 2020. Orgenesis assumes no obligation to update forward-looking statements contained in this release as a result of new information or future events or developments. This release contains forward looking statements about Orgenesis, Koligo, Koligos technology, and potential development and business opportunities of Koligo and Orgenesis following the closing of the Transaction, each of which involve substantial risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Risks and uncertainties include, among other things, uncertainties regarding the commercial success of the Companys products; the uncertainties inherent in research and development, including the ability to meet anticipated clinical endpoints, commencement and/or completion dates for our clinical trials, regulatory submission dates, regulatory approval dates and/or launch dates, as well as the possibility of unfavorable new clinical data and further analyses of existing clinical data; the risk that clinical trial data are subject to differing interpretations and assessments by regulatory authorities; whether regulatory authorities will be satisfied with the design of and results from our clinical studies; whether and when any such regulatory authorities may approved the Companys development products, and, if approved, whether such product candidates will be commercially successful; decisions by regulatory authorities impacting labeling, manufacturing processes, safety and/or other matters that could affect the availability or commercial potential of the Companys products; uncertainties regarding the impact of COVID-19 on the Companys business, operations and financial results and competitive developments.

A further description of risks and uncertainties can be found in the Companys Annual Report on Form 10-K for the fiscal year ended December 31, 2019 and in its subsequent reports on Form 10-Q, including in the sections thereof captioned Risk Factors and Forward-Looking Information, as well as in its subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commission and available at http://www.sec.gov.

Contact for Orgenesis:Crescendo Communications, LLCTel: 212-671-1021ORGS@crescendo-ir.com

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Orgenesis Announces Agreement to Acquire Koligo Therapeutics, a Leader in Personalized Cell Therapies - GlobeNewswire

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Bariatric surgery is booming, as obese patients worry about their Covid-19 risks – The Daily Briefing

September 30th, 2020 4:49 pm

Bariatric surgery, a significantly underutilized treatment for weight management, is beginning to see an uptick in usea trend spurred by a somewhat unlikely cause: the novel coronavirus epidemic.

The 3 most important considerations for patients deciding on bariatric surgery

According to the New York Times' "Well," bariatric surgery is an increasingly safe, effective, and simple procedure available to patients with a BMI of at least 40 who cannot lose weight via diet and exercise alone, as well as patients with BMIs between 30 to 35 who have obesity-related health issues.

Bariatric surgeriesincluding gastric bypasses, laparoscopic bands, and gastric sleeveswork by reducing the physical size of the stomach and curbing appetite by altering the hormonal signals between a patient's stomach and brain. Bariatric surgery, according to "Well," has become increasingly safe over the years, with the rates of complications and deaths related to such procedures plunging from a peak of 11.7% and 1%, respectively, in 1998 to 1.4% and 0.04% in 2016.

However, despite the safety and efficacy of the procedure, experts say it's significantly underutilized. "Only one-half of 1 percent of people eligible for bariatric surgery currently undergo it," Anne Ehlers, a bariatric surgeon at the University of Michigan, said.

According to a JAMA article, this under-use of bariatric surgery likely stems both from "the reluctance of the medical community and patients to accept surgery as a safe, effective, and durable treatment of obesity," and because patients worry that they "may be judged by others for taking the easy way out and not having the willpower to diet and exercise."

According to the Wall Street Journal, several studies have found a link between obesity and its related health issuessuch as diabetes and hypertensionand increased rates of serious Covid-19 infection. In fact, CDC this month confirmed that new research demonstrates that Covid-19 patients who are obese have a greater risk of severe outcomes.

Researchers think this increased risk for obese patients may stem in part because of how the coronavirus enters the body via an enzyme called the ACE2 receptor. This enzyme is located in cells that line the lungs and fat tissue, which means that patients with excess weight may be more likely to experience a high viral load. In addition, obesity is linked to hyperinflammation and shortness of breath, two conditions that make it more difficult for someone to combat viral infection.

As John Morton, head of the bariatric practice at Yale Medical Center, said, "The virus frankly has an easier job" replicating itself among patients who are obese, because "[i]t has more targets."

But ongoing research indicates that losing weightand losing weight via bariatric surgery in particularmay help lower this risk, the Journal reports. According to a clinical study from the Cleveland Clinic that's currently under peer review, patients with obesity who've had bariatric surgery were 25% less likely to require hospitalization after contracting Covid-19 when compared with obese patients who have not had the surgery. In addition, among those patients in the study who were hospitalized, none of those who've had bariatric surgery were admitted to the ICU or died from the pathogencompared with 13% and 2.5%, respectively, of hospitalized patients who have not had the surgery.

In light of this increased risk, some patients who are struggling with their weight are undergoing bariatric surgery as a proactive measure against severe infectiona trend that seems to have made bariatric surgery more popular than ever, the Journal reports.

In fact, while most scheduled procedures are now experiencing a rebound after several months' pause amid the epidemic, bariatric surgery is not only rebounding more quickly than other services, but it's surpassing even its 2019 levels. Specifically, according to research from health care data company Perception Health, claims for bariatric surgery fell to nearly zero in April, but then rebounded by June to a higher level than that same month in 2019.

Separately, Optum, which owns medical facilities and surgical centers across the country, reported a 26% annual increase in patients joining bariatric-surgery programs this summer. (The Daily Briefing is published by Advisory Board, a division of Optum.) Similarly, Cigna said that while prior authorizations for bariatric surgeries declined 38.8% annually between March and May of this year, they increased 9.3% annually in June, July, and August.

The leaders of various surgical practices at major hospitals have reported similar anecdotal evidence, according to the Journal. For instance, Morton said that after Yale reopened its five hospitals for scheduled surgeries in June, bariatric surgery volume increased 20% when compared to 2019 levelsand inquiries about the procedure are also on the rise. "The only two surgeries that have been Covid-proof have been cancer and bariatric," he said.

Similarly, Ali Aminian, director of the Cleveland Clinic's Bariatric and Metabolic Institute, said intake for severely obese patients seeking bariatric surgery increased 40% annually over the summer. "We've had patients who wanted to come and take care of their obesity, to be healthier, and when we ask them, why did you come now? It's because they've heard this message that it's a risk factor for Covid infection," Aminian said.

And speaking as a bariatric surgery patient, Eliza Henderson said the coronavirus spurred her to "take the plunge" and schedule herself for the procedure later this month. "I don't want my being obese to stack the odds against me with something like coronavirus," Henderson explained. "More than anything, I want to have a better chance to survive" (Whelan, Wall Street Journal, 9/28; Brody, "Well," New York Times, 9/28).

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Global Stem Cell Reconstructive Market- Industry Analysis and Forecast (2020-2027) – Unica News

September 30th, 2020 4:49 pm

Global Stem Cell Reconstructive Marketwas valued US$ XX Mn in 2019 and is expected to reach US$ XX Mn by 2027, at a CAGR of 24.5% during a forecast period.

Market Dynamics

The Research Report gives an in-depth account of the drivers and restraints in the stem cell reconstructive market. Stem cell reconstructive surgery includes the treatment of injured or dented part of body. Stem cells are undifferentiated biological cells, which divide to produce more stem cells. Growing reconstructive surgeries led by the rising number of limbs elimination and implants and accidents are boosting the growth in the stem cell reconstructive market. Additionally, rising number of aged population, number of patients suffering from chronic diseases, and unceasing development in the technology, these are factors which promoting the growth of the stem cell reconstructive market. Stem cell reconstructive is a procedure containing the use of a patients own adipose tissue to rise the fat volume in the area of reconstruction and therefore helping 3Dimentional reconstruction in patients who have experienced a trauma or in a post-surgical event such as a mastectomy or lumpectomy, brain surgery, or reconstructive surgery as a result of an accident or injury. Stem cell reconstructive surgeries are also used in plastic or cosmetic surgeries as well. Stem cell and regenerative therapies gives many opportunities for development in the practice of medicine and the possibility of an array of novel treatment options for patients experiencing a variety of symptoms and conditions. Stem cell therapy, also recognised as regenerative medicine, promotes the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives.

The common guarantee of all the undifferentiated embryonic stem cells (ESCs), foetal, amniotic, UCB, and adult stem cell types is their indefinite self-renewal capacity and high multilineage differentiation potential that confer them a primitive and dynamic role throughout the developmental process and the lifespan in adult mammal.However, the high expenditure of stem cell reconstructive surgeries and strict regulatory approvals are restraining the market growth.

The report study has analyzed revenue impact of covid-19 pandemic on the sales revenue of market leaders, market followers and disrupters in the report and same is reflected in our analysis.

Global Stem Cell Reconstructive Market Segment analysis

Based on Cell Type, the embryonic stem cells segment is expected to grow at a CAGR of XX% during the forecast period. Embryonic stem cells (ESCs), derived from the blastocyst stage of early mammalian embryos, are distinguished by their capability to distinguish into any embryonic cell type and by their ability to self-renew. Owing to their plasticity and potentially limitless capacity for self-renewal, embryonic stem cell therapies have been suggested for regenerative medicine and tissue replacement after injury or disease. Additionally, their potential in regenerative medicine, embryonic stem cells provide a possible another source of tissue/organs which serves as a possible solution to the donor shortage dilemma. Researchers have differentiated ESCs into dopamine-producing cells with the hope that these neurons could be used in the treatment of Parkinsons disease. Upsurge occurrence of cardiac and malignant diseases is promoting the segment growth. Rapid developments in this vertical contain protocols for directed differentiation, defined culture systems, demonstration of applications in drug screening, establishment of several disease models, and evaluation of therapeutic potential in treating incurable diseases.

Global Stem Cell Reconstructive Market Regional analysis

The North American region has dominated the market with US$ XX Mn. America accounts for the largest and fastest-growing market of stem cell reconstructive because of the huge patient population and well-built healthcare sector. Americas stem cell reconstructive market is segmented into two major regions such as North America and South America. More than 80% of the market is shared by North America due to the presence of the US and Canada.

Europe accounts for the second-largest market which is followed by the Asia Pacific. Germany and UK account for the major share in the European market due to government support for research and development, well-developed technology and high healthcare expenditure have fuelled the growth of the market. This growing occurrence of cancer and diabetes in America is the main boosting factor for the growth of this market.

The objective of the report is to present a comprehensive analysis of the Global Stem Cell Reconstructive Market including all the stakeholders of the industry. The past and current status of the industry with forecasted market size and trends are presented in the report with the analysis of complicated data in simple language. The report covers all the aspects of the industry with a dedicated study of key players that includes market leaders, followers and new entrants. PORTER, SVOR, PESTEL analysis with the potential impact of micro-economic factors of the market has been presented in the report. External as well as internal factors that are supposed to affect the business positively or negatively have been analysed, which will give a clear futuristic view of the industry to the decision-makers.

The report also helps in understanding Global Stem Cell Reconstructive Market dynamics, structure by analysing the market segments and projects the Global Stem Cell Reconstructive Market size. Clear representation of competitive analysis of key players by Application, price, financial position, Product portfolio, growth strategies, and regional presence in the Global Stem Cell Reconstructive Market make the report investors guide.Scope of the Global Stem Cell Reconstructive Market

Global Stem Cell Reconstructive Market, By Sources

Allogeneic Autologouso Bone Marrowo Adipose Tissueo Blood Syngeneic OtherGlobal Stem Cell Reconstructive Market, By Cell Type

Embryonic Stem Cell Adult Stem CellGlobal Stem Cell Reconstructive Market, By Application

Cancer Diabetes Traumatic Skin Defect Severe Burn OtherGlobal Stem Cell Reconstructive Market, By End-User

Hospitals Research Institute OthersGlobal Stem Cell Reconstructive Market, By Regions

North America Europe Asia-Pacific South America Middle East and Africa (MEA)Key Players operating the Global Stem Cell Reconstructive Market

Osiris Therapeutics NuVasives Cytori Therapeutics Takeda (TiGenix) Cynata Celyad Medi-post Anterogen Molmed Baxter Eleveflow Mesoblast Ltd. Micronit Microfluidics TAKARA BIO INC. Tigenix Capricor Therapeutics Astellas Pharma US, Inc. Pfizer Inc. STEMCELL Technologies Inc.

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Maximize Market Research provides B2B and B2C market research on 20,000 high growth emerging technologies & opportunities in Chemical, Healthcare, Pharmaceuticals, Electronics & Communications, Internet of Things, Food and Beverages, Aerospace and Defense and other manufacturing sectors.

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Regional Forecast of Opthalmic Therapeutics Market Emerging Technology (Analysis of COVID-19), Regional Imapact, Business and Industry Growth…

September 30th, 2020 4:48 pm

Global Opthalmic Therapeutics Market reports offers vital insights that facilitate the trade consultants, product managers, CEOs and business executives to draft their policies on varied parameters together with enlargement, acquisition and new product launch in addition as analyzing and understanding the market trends.

Each segment of the worldwide Opthalmic Therapeutics market is extensively evaluated within the analysis study. The segmental analysis offered within the report pinpoints key opportunities on the market within the international Opthalmic Therapeutics market through leading segments. The regional study of the worldwide Opthalmic Therapeutics market enclosed within the report helps readers to achieve a sound understanding of the event of various geographical markets in recent years and conjointly going forth. Weve provided a close study on the important dynamics of the worldwide Opthalmic Therapeutics market, that embrace the market influence and market impact factors, drivers, challenges, restraints, trends and prospects. The analysis study conjointly includes alternative styles of analysis like qualitative and quantitative.

Access Free Sample Copy of Opthalmic Therapeutics Market Report: https://calibreresearch.com/report/global-opthalmic-therapeutics-market-14754#request-sample

Global Opthalmic Therapeutics Market report offers a close Outlook and future prospects of the trade. The Opthalmic Therapeutics Market report includes varied topics like market size & share, Product sorts, applications, key market drivers & restraints, challenges, growth opportunities, key players, competitive landscape.

NOTE: Our reports include the analysis of the impact of COVID-19 on this industry. Our new sample is updated which correspond in new report showing impact of Covid-19 on Industry trends. Also we are offering 20% discount

The report forecast global Opthalmic Therapeutics market to grow to reach xxx Million USD in 2019 with a CAGR of xx% during the period 2020-2025 due to coronavirus situation. The report offers elaborated coverage of Opthalmic Therapeutics trade and main market trends with impact of coronavirus. The marketing research includes historical and forecast market information, demand, application details, worth trends and company shares of the leading Opthalmic Therapeutics by earth science. The report splits the market size, by volume and price, on the premise of application kind and earth science.

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Global Major Market Players indulged in this report are:

Pfizer

Novartis

GlaxoSmithKline

Alcon

Merck

F. Hoffmann-La Roche

Bayer

Actavis

Boehringer Ingelheim

R-Tech Ueno

Valeant Pharmaceuticals

Regeneron Pharmaceuticals

Acadia Pharmaceuticals

Allergan

Falcon Pharmaceuticals

Otsuka Pharmaceutical

Senju Pharmaceutical

OPKO Health

Lexicon Pharmaceuticals

The Opthalmic TherapeuticsThe Opthalmic Therapeutics Market report is segmented into following categories:

The Opthalmic Therapeutics market report is segmented into Type by following categories;Oral

Injection

External Application

The Opthalmic Therapeutics market report is segmented into Application by following categories;Hospitals

Clinics

Home Care Settings

Other

First, this report covers the current standing and also the future prospects of the worldwide Opthalmic Therapeutics marketplace for 2020-2026. And during this report, we have a tendency to analyze international market from five geographies: Asia-Pacific [China, geographical region, India, Japan, Korea, Western Asia], Europe [Germany, UK, France, Italy, Russia, Spain, Holland, Turkey, Switzerland], North America [United States, Canada, Mexico], Mideast & Africa [GCC, geographic area, South Africa], South America [Brazil, Argentina, Columbia, Chile, Peru]. At constant time, we have a tendency to classify Opthalmic Therapeutics in keeping with the sort, application by earth science. a lot of significantly, the report includes major countries market supported the sort and application. Finally, the report provides elaborated profile and information info analysis of leading Opthalmic Therapeutics company.

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Our exploration specialists acutely ascertain the numerous aspects of the worldwide Opthalmic Therapeutics market report. It conjointly provides associate degree in-depth valuation with reference to the longer term advancements wishing on the past information and present circumstance of Opthalmic Therapeutics market state of affairs. During this Opthalmic Therapeutics report, weve investigated the principals, players within the market, geologic regions, product kind and market end-client applications. The worldwide Opthalmic Therapeutics report contains of primary and secondary information that is exemplified within the style of pie outlines, Opthalmic Therapeutics tables, analytical figures and reference diagrams. The Opthalmic Therapeutics report is bestowed in associate degree economical means that involves basic non-standard speech, basic Opthalmic Therapeutics define, agreements and bound facts as per solace and comprehension.

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Regional Forecast of Opthalmic Therapeutics Market Emerging Technology (Analysis of COVID-19), Regional Imapact, Business and Industry Growth...

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Understanding COVID-19s impact on the Opthalmic Drugs Market Trends, Infers Fact.MR – The Cloud Tribune

September 30th, 2020 4:48 pm

Fact.MR has introduced a new research report on the Opthalmic Drugs market. This report intends to offer a complete analysis of all the important factors and trends contributing to the growth of this market. Thus, the study offered in this report provides an assessment of vital restraints, drivers, opportunities, and challenges faced by players in the market for Opthalmic Drugs. In addition to this, it depicts a clear picture of demand opportunities in different regions of the Opthalmic Drugs market Trends during the tenure of 2020 to 2025. The Opthalmic Drugs market is estimated to show an upward graph of revenues together with an exceptional CAGR of around 4.2% during the tenure of 2020 to 2025. Thus, the market is all set to reach a value of around US$ xx Mn/Bn by 2025 end.

The latest report on the Opthalmic Drugs market is the end product of extensive research carried out by analysts. The analysts have used a gamut of industry-wide top business intelligence tools to present figures, facts, and market data. This aside, they deliver reliable projections and estimations on the revenues in the Opthalmic Drugs market during the forecast period of 2020 to 2025. The report provides regional as well as global statistics on revenues, shares, and volume of the market.

Request for Sample Report @ https://www.factmr.com/connectus/sample?flag=S&rep_id=4799

The study performs segmentation of the global Opthalmic Drugs market based on various key factors such as product type, end-user industry/application, and important geographical regions. In addition to this, it provides a detailed list of the important players operating in the global Opthalmic Drugs market. Reliable statistics on volume, shares, and revenues of the key market players are precisely presented in the latest report. This aside, the report sheds light on the competitive landscape and various business strategies used by the key players in the global Opthalmic Drugs market.

The latest study on the Opthalmic Drugs market provides detailed information on recent technological developments and product developments in diverse regions of the globe. Apart from this, the report discusses various regulatory aspects in various geographical regions. It includes the study of new regulations together with the impact of these regulations on the growth of the global Opthalmic Drugs market.

COVID-19 pandemic has impacted adversely on the growth of almost all businesses in all worldwide locations. Policymakers, government bodies, and industry leaders are consistently focused on the development of various strategies to lessen the unpleasant effects of this pandemic. The latest study covers the analysis of the impact of the COVID-19 outbreak on the Opthalmic Drugs market. It carries out a detailed discussion on diverse issues faced by market entities during this crisis. In addition to this, the report delivers important information on various strategies used by industry leaders to deal with this global pandemic.

Key product type explained in the Opthalmic Drugs market report are:

The list of important players profiled in the Opthalmic Drugs market report includes:

Based on geographical regions, the Opthalmic Drugs market is segmented as follows:

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Reports published by Fact.MR is a result of the combination of our experts and digital technologies. We thrive to provide innovative business solutions to the clients as well as tailor the reports aligning with the clients requisites. Our analysts perform comprehensive research to offer ins and outs of the current market situation. Clients across various time zones tend to utilize our 24/7 service availability.

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Computer Glasses For Kids Don’t Need To Be Expensive | Moms.com – Moms

September 30th, 2020 4:48 pm

Computer glasses are marketed to kids who use screens & now that more kids are doing virtual schooling, do we need expensive blue light lenses?

There is no overlooking that since we have been home due to the coronavirus pandemic in March that kids' screen time has skyrocketed. And really, how could it not? Even if you were able to be super strict about limiting their time on devices throughout the summer, now that we are back to school and a lot of people virtual learning, kids are back behind the computer quite a bit. This has us thinking a lot about our children's eye and really how healthy it is to be having that much screen time.

Because of this, something called "computer glasses" orblue-light-blocking glasses are starting to gain some popularity. According to PopSugar, their claim is to help "to combat the apparent shorter, blue-light wavelengths that are emitted from digital screens."

But are they really necessary?

As parents, we worry so much about our kid's eyes being behind the computer all day during virtual learning. We know how we feel starring at the computer screens all day for work and want to make sure that they are protected from anything harmful.

Dr. Scott Edmonds, an optometrist,shared withPOPSUGAR that kids eyes are"still-developing eyes generally allow for more high-energy blue light to reach and potentially damage their retinas" and that excessive blue-light emissions "may produce oxidative and phytotoxic damage to cells in the cornea and retina of the eye."

Digging deeper though, a recent study done by theInternational Review of Ophthalmic Opticsshows that there is a lack of"strong evidence" whenever it comes to the connection between eye strain and blue light.

RELATED:Students' Reaction To Teacher Disappearing From Video Meeting Is Priceless

Here's the thing though: the purpose of blue light, especially in relation to screens, is to keep people alert. However, it doesn't always come from screens. Nope. It's actually everywhere and can be found influorescent lighting, LED, but mostly - it comes from the sun.

Yup. And theAmerican Academy of Ophthalmology (AAO) even says that we get10 times as much blue light from the sun than we do from a computer screen.

"There's no scientific evidence to suggest that blue light from our screens or devices are damaging our eyes or our children's eyes," Dr. Purnima Patel, the clinical spokesperson for the AAO, said in a statement. "That's why the American Academy of Opthalmology does not recommend blue-light-blocking computer glasses."

So back to our original point about these expensive glasses that moms are fretting over purchasing: don't waste your money.

READ MORE:Teacher Shares Hack That Uses CDs To Solve Virtual Learning Tech Trouble

Sources: PopSugar, International Review of Ophthalmic Optics

Why Is A Pap Smear Test Important To Have Every Year?

Allison Cooper is a full-time blogger at Project Motherhood and freelance writer. Her writing can be found at Reader's Digest, Classpass, Romper, Working Mother, Mommy Nearest Magazine and more. When not creating content, she's spending time with her family, running, or sipping on strong coffee!

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Computer Glasses For Kids Don't Need To Be Expensive | Moms.com - Moms

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Research lab opens in India focused on deep learning | Technology & AI – Healthcare Global – Healthcare News, Magazine and Website

September 30th, 2020 4:48 pm

Medical equipment manufacturer Wipro GE Healthcare has partnered with the Indian Institute of Science (IISc) to open a research lab.

The lab is located at the Department of Computational and Data Sciences (CDS) in Bangalore. It will specialise in healthcare diagnostics, deep learning technology, ML and AI systems. Work will also be done on digital interfaces to produce sophisticated diagnostic and medical image reconstruction techniques.

This research unit will involve around fifty students and three faculty members of IISc to begin with. They will work closely with clinicians as well as Wipro GE Healthcare to integrate computational models into clinical workflows, to help doctors improve patient outcomes.

The partners are aiming for this collaboration between the worlds of industry and academia to solve some of the toughest challenges healthcare faces, using artificial intelligence and machine learning. One of their work streams will be exploring deep learning models to analyse lung lesions caused by COVID-19 via ultrasound and CT images.

Additionally they will apply deep learning models to improve opthalmology imaging, and medical image reconstruction methods.

The IISc was established in 1909 through a partnership between founder of the Tata group Jamsetji Nusserwanji Tata, the Maharaja of Mysore, and the Government of India. Over the 111 years since its establishment, IISc has become a major institution for advanced scientific and technological research and education in India.

Wipro GE Healthcare is supporting the research lab with a grant as part of its CSR efforts. This funding will be used to equip the lab with the necessary hardware and software. This includes state-of-the-art deep learning servers and an advanced visualization platform.

Commenting on the collaboration, Dileep Mangsuli, Chief Technology Officer at GE Healthcare South Asia said: The world's healthcare is transforming through use of digital technologies which can enable precision health. This transformation can be accelerated by building a collaborative ecosystem of industry and academia partners.

"This Healthcare Innovation Lab at IISc will help bring to market unique digital solutions which will get integrated into our Edison platform and intelligent devices, helping clinicians solve some of the toughest healthcare challenges.

Prof. Phaneendra Yalavarthy, convener of the lab as well as the Chair of the Office of Development and Alumni Affairs at IISc, said: Private-Public partnership is in the DNA of IISc and this collaborative lab in the space of artificial intelligence in healthcare funded by Wipro GE Healthcare is timely, given the push for digital technologies.

"Translation of the research work carried out in the lab into the clinic will be the priority, and there is no better industry partner in India than Wipro GE Healthcare that can accelerate this. This is only the beginning of the collaboration and we are hoping to scale up the research activities in the near future.

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Ambulatory Healthcare IT Market By Business Growth, Trend, Segmentation, Top Key Players, Revenue and Industry Expansion Forecast Report|mSurg Corp,…

September 30th, 2020 4:48 pm

Latest launched research document on Ambulatory Healthcare IT Market (Covid-19 Version) study of 350 Pages provides detailed analysis with presentable graphs, charts and tables. The report also enlists several important factors share, size, growth, trends, global statistics, key manufacturers and 2027 forecast analysis. This report presents an in-depth assessment of the Ambulatory Healthcare IT including enabling technologies, Hey trends, market drivers, challenges, standardization, regulatory landscape, deployment models, operator case studies, opportunities, future roadmap, value chain, ecosystem player profiles and strategies. The Research Study also presents a complete assessment of the Market and highlights future trend, growth factors & drivers, leaders opinions, facts, and primary validated market data. This Ambulatory Healthcare IT market report provides detailed profiles of the key players to bring out a clear view of the competitive landscape of the Healthcare industry outlook.

Download Sample (350 Pages PDF) Report: To Know the Impact of COVID-19 on this[emailprotected]https://www.databridgemarketresearch.com/request-a-sample/?dbmr=global-ambulatory-healthcare-market&ab

Ambulatory Healthcare IT Market Scenario

According to Data Bridge Market Research the market for ambulatory healthcare IT is developing owing to certain parameters, such as administration commissions and maintenance for healthcare information and technology solutions, enhancing the application of big data mechanism, necessitate diminishing escalating healthcare expenses and tremendous profits on financing for healthcare IT solutions will help the market to grow. Some of the factors may hinder the business growth during the foreseen period such as information technology infrastructural restrictions in emerging nations and security concerns.

Market Drivers

Growing incidence of chronic diseases, is driving the market growth

Continuous technological advancement, is flourishing the market growth

Rising geriatric population, is helping the market to grow

Rising demand for minimally invasive surgeries, drives the market growth

Market Restraints

Inadequate communication, hinders the market growth

Prevalence of adverse drug activities, hampers the market growth

Delayed diagnostic, acts as a market restraints

The Ambulatory Healthcare IT Market Report provides in detail information about market analysis, market definition, market segmentation, key development areas, competitive analysis and research methodology. This Report Provides superior market perspective in terms of product trends, marketing strategy, future products, new geographical markets, future events, sales strategies, customer actions or behaviors. This market research study presents actionable market insights with which sustainable and money-spinning business strategies can be created. All this information, facts, and statistics lead to an actionable ideas, improved decision-making and better deciding business strategies. This Ambulatory Healthcare IT market research report is framed with the most excellent and sophisticated tools of collecting, recording, estimating and analysing market data.

TO UNDERSTAND HOW COVID-19 IMPACT IS COVERED IN THIS REPORT-REQUEST FREE COVID-19 SAMPLE @https://www.databridgemarketresearch.com/covid-19-impact/global-ambulatory-healthcare-market?ab

The Segments and Sub-Section of Ambulatory Healthcare IT Market are shown below:

By Type (Ambulatory Services, Primary Care Offices, Outpatient Departments, Emergency Departments, Surgical Specialty, Medical Specialty, Others)

By Modality (Hospital-affiliated, Freestanding), Surgery Type (Opthalmology, Orthopedics, Gastroenterology, Pain Management, Others)

By Application (Laceration Treatment, Bone Fracture Treatment, Emergency Care Service, Trauma Treatment)

Some of Key Competitors or Companies Included In the Study Are

AmSurg CorpSurgical Care AffiliatesSurgery PartnersHealthway Medical GroupSurgCenterTrillium Health PartnersMedical Facilities CorporationNueterra CapitalAspen HealthcareSuomen Terveystalo OyIntegraMed America, Inc.SHERIDAN HEALTHCARENueHealthAthenahealthGENERAL ELECTRICOptum, Inc.Apria Healthcare Group, Inc.DaVita Inc.LVL MedicalFresenius Kabi AGSonic HealthcareComplete Report is Available (Including Full TOC, List of Tables & Figures, Graphs, and Chart) @https://www.databridgemarketresearch.com/toc/?dbmr=global-ambulatory-healthcare-market&ab

This Ambulatory Healthcare IT Market Research document takes into consideration several industry verticals such as company profile, contact details of manufacturer, product specifications, geographical scope, production value, market structures, recent developments, revenue analysis, market shares and possible sales volume of the company. It consists of most-detailed market segmentation, systematic analysis of major market players, trends in consumer and supply chain dynamics, and insights about new geographical markets. The market insights and analysis provided in this market research document are based upon SWOT analysis on which businesses can trust confidently. This Ambulatory Healthcare IT report is produced by chewing over several fragments of the present and upcoming market scenario.

To comprehend Ambulatory Healthcare IT Market dynamics in the world mainly, the worldwide Ambulatory Healthcare IT market is analyzed across major global regions.

North America: United States, Canada, and Mexico.

South & Central America: Argentina, Chile, and Brazil.

Middle East & Africa: Saudi Arabia, UAE, Turkey, Egypt and South Africa.

Europe: UK, France, Italy, Germany, Spain, and Russia.

Asia-Pacific: India, China, Japan, South Korea, Indonesia, Singapore, and Australia.

This Ambulatory Healthcare IT Market Research/analysis Report Contains Answers to your following Questions

Which Manufacturing Technology is used for Ambulatory Healthcare IT?

What Developments Are Going On in That Technology?

Which Trends Are Causing These Developments?

Who Are the Global Key Players in This Ambulatory Healthcare IT Market?

What are Their Company Profile, Their Product Information, and Contact Information?

What Was Global Market Status of Ambulatory Healthcare IT Market?

What Was Capacity, Production Value, Cost and PROFIT of Ambulatory Healthcare IT Market?

What Is Current Market Status of Ambulatory Healthcare IT Industry?

Whats Market Competition in This Industry, Both Company, and Country Wise?

Whats Market Analysis of Ambulatory Healthcare IT Market by Taking Applications and Types in Consideration?

What Are Projections of Global Ambulatory Healthcare IT Industry Considering Capacity, Production and Production Value?

What Will Be the Estimation of Cost and Profit?

What Will Be Market Share, Supply and Consumption?

What about Import and Export?

What Is Ambulatory Healthcare IT Market Chain Analysis by Upstream Raw Materials and Downstream Industry?

What Is Economic Impact On Ambulatory Healthcare IT Industry?

What are Global Macroeconomic Environment Analysis Results?

What Are Global Macroeconomic Environment Development Trends?

What Are Market Dynamics of Ambulatory Healthcare IT Market?

What Are Challenges and Opportunities?

What Should Be Entry Strategies, Countermeasures to Economic Impact, and Marketing Channels for Ambulatory Healthcare IT Industry?

For More Information In the Analysis of Reports Please Visit:https://www.databridgemarketresearch.com/inquire-before-buying/?dbmr=global-ambulatory-healthcare-market&AB

Table of Content:

Market Overview: The report begins with this section where product overview and highlights of product and application segments of the global Ambulatory Healthcare IT Market are provided. Highlights of the segmentation study include price, revenue, sales, sales growth rate, and market share by product.

Competition by Company: Here, the competition in the Worldwide Ambulatory Healthcare IT Market is analyzed, By price, revenue, sales, and market share by company, market rate, competitive situations Landscape, and latest trends, merger, expansion, acquisition, and market shares of top companies.

Company Profiles and Sales Data:As the name suggests, this section gives the sales data of key players of the global Ambulatory Healthcare IT Market as well as some useful information on their business. It talks about the gross margin, price, revenue, products, and their specifications, type, applications, competitors, manufacturing base, and the main business of key players operating in the global Ambulatory Healthcare IT Market.

Market Status and Outlook by Region:In this section, the report discusses about gross margin, sales, revenue, production, market share, CAGR, and market size by region. Here, the global Ambulatory Healthcare IT Market is deeply analyzed on the basis of regions and countries such as North America, Europe, China, India, Japan, and the MEA.

Application or End User:This section of the research study shows how different end-user/application segments contribute to the global Ambulatory Healthcare IT Market.

Market Forecast:Here, the report offers a complete forecast of the global Ambulatory Healthcare IT Market by product, application, and region. It also offers global sales and revenue forecast for all years of the forecast period.

Research Findings and Conclusion:This is one of the last sections of the report where the findings of the analysts and the conclusion of the research study are provided.

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The orphan drug market is continuously growing over the years now at twice the growth rate of overall prescription drug market due to the arising interest from pharmaceutical companies for underlying benefits and involvement of many smaller biotechnology start-up companies who are primarily focused on rare diseases. However still there are lot of attention that needs to be given since the ratio of one having rare disease is 1 in 2000 leading to the lack of knowledge about disease mechanisms, along with FDA/Marketing approvals which take years.

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More Elmiron Lawsuits, including Canada Class Actions, and the Impact of Vision Loss – LawyersandSettlements.com

September 30th, 2020 4:48 pm

Santa Clara, CAMore Elmiron lawsuits are being filed in the U.S. and Canada has filed two class action lawsuits, all alleging the interstitial cystitis drug can cause permanent vision damage.

While plaintiffs complaints differ regarding how long Elmiron was used to treat interstitial cystitis, and a range of vision problems have been cited, all lawsuits, including the class action in British Columbia and the other in Quebec, are similar. All claim the manufacturers failed to disclose the serious link between Elmiron use and significant visual damage, including pigmentary maculopathy and Elmiron did not properly warn patients of the risks, according to the Quebec complaint.

In August 2020, two women in the U.S. filed lawsuits against Elmiron manufacturers Johnson & Johnson and its subsidiary Janssen, Bayer and Tevaaccusing them of failure to warn consumers of Elmirons risk, negligence, designing Elmiron in a way that makes the drug defective and hazardous to health, and fraudulent misrepresentation of the risks associated with Elmiron. One woman had taken Elmiron for about four years, the other woman ten years. These complaints (cases are Johns v. Alza Corp. et al., case number 3:20-cv-10341, and Levy v. Alza Corp., case number 3:20-cv-10342, both in the U.S. District Court for the District of New Jersey).

The British Columbia plaintiff, Arenlea Felker, filed the Elmiron side effects class action lawsuit against Janssen Inc. and Teva Branded Pharmaceutical Products R&D Inc. Felker, prescribed Elmiron to treat interstitial cystitis in 2005 and continued to take the medication daily, allegesthat the drug caused permanent vision-threatening eye disease called pigmentary maculopathy.

In a study published in Opthalmology back in November 2018, researchers concluded that maculopathy associated with chronic exposure to PPS is possibly avoidable". Another study published in January 2019 associated the Chronic use of pentosan polysulfate sodium with risk of vision-threatening disease, and a number of articles have been published with similar conclusions.

As well, studies have found that patients with interstitial cystitis who don't use Elmiron have no instances of pigmentary maculopathy. But many other issues are related to vision loss, from mental health issues to a higher risk of falling. One 2014 studypublished in JAMA Ophthalmologylinked poor vision to a reduced life expectancy. Additional issues can include cognitive decline, difficulty learning, and a feeling of being discriminated against.

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Women’s Health, Wealth And Longevity – A Retirement Triple-Threat – Employment and HR – UK – Mondaq News Alerts

September 29th, 2020 3:59 pm

28 September 2020

Gilson Gray

To print this article, all you need is to be registered or login on Mondaq.com.

Because women typically live longer than men and may have asmaller pension pot, they need to plan accordingly to make theirmoney last.

While longevity sounds like a blessing, we wouldn't want tobe unwell and struggling financially during our later-life years.But many women run the risk that this will be their future. Notbecause they've got the 'right genes' or live asuper-healthy lifestyle: it's simply because they were born awoman.

A 40-year-old woman has a one in four chance of living to age96, and a one in ten chance of living to 100.1 Betterhealthcare and positive lifestyle changes have helped to raise lifeexpectancies across the board, but women still are likely to livelonger than men. And with several studies finding that more menthan women have died from COVID-19, the life expectancy gap couldwiden further from here.

Women not only need their pensions to last longer, they alsogenerally have smaller pension pots to use during these extra yearsof life. We already know that women typically retire with one-fifthof the pension wealth of men.2 New analysis from theCentre for Economics and Business Research found that, when lifeexpectancy is taken into account, the gender pensions gap could beas much as 108,130 for single women, and 186,120 forwomen who are married or in a relationship.3

Because they tend to live longer, women are more likely to endup in single-person households later in life. This could addfurther to their financial pressures because it can be much moreexpensive to run a household of one, covering all bills alone.

Adding to this, the State Pension age is rising, which meansmany people who will rely on this government payment will have towork longer before they can claim it. Plus, there's noguarantee your health will support you working into your lateryears.

Some women may have taken their first job at 16. If you'replanning on working until your late 60s or early 70s, that's alot of years in the workforce - you might well be feeling burnt outor struggling with health issues. As early as your mid-40s or early50s, you could be suffering from symptoms of the menopause, such as'brain fog', which can make it tough for some women tocontinue working at the pace they once did.

You may want to drop to part-time hours or get a job with lessresponsibility to take some of the pressure off, even if it justfor a few years. But will you be able to afford it?

For women in same-sex relationships, they may think that theirjoint longevity will give them a long and happy retirementtogether. But in fact they could face a triple whammy ofchallenges: both partners might take a period of maternity leavethat could impact their earning power and pension contributions,both may need to work longer, and both may suffer from healthconditions over their long lives.

Luckily, there are things all women can do to increase yourchances of a financially secure life, however long you live. If youdo nothing else, have a think about what you want your future tolook like. Do an appraisal of all your long-term savings plans,rounding up any small savings pots you may have forgotten aboutover time. Sit down and have a chat with a financial adviser to seehow things are actually looking for your retirement years. Takinginto account the money you've already saved, and your capacityto save over the coming years, an adviser can model a likelyoutcome.

You may find that you can retire sooner than you think or canslow down your working pace as you near retirement if you come upwith a sensible plan now. Take charge today and speak to your St.James's Place Partner for help with your finances.

Footnotes

1. ONS life expectancy calculator, accessed 7 September2020

2. Securing the Financial Future of the Next Generation,Insuring Women's Futures and Chartered Insurance Institute,2018

3. Centre for Economics and Business Research, September2020

The content of this article is intended to provide a generalguide to the subject matter. Specialist advice should be soughtabout your specific circumstances.

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Among Us and Fall Guys Can Ensure Longevity With This Feature – Essentially Sports

September 29th, 2020 3:59 pm

Among Us and Fall Guys have been in a tussle to see who can capture more fans. As of now, Among Us seems to be the clear winner with the popularity of the game still rising. On the other hand, Fall Guys is seeing a steep, downward trend which is quite alarming for the game.

Regardless of its popularity, Among Us shouldnt be too quick to celebrate. The gaming industry is constantly innovating and really dynamic. Just like it rendered Fall Guys pretty irrelevant, there might soon come a game that would do the same to Among Us.

However, analyst Rod Breslau feels that there is one solution that would help both the games stay relevant for a long time. The idea would increase engagement among players.

Many games such as GTA 5 and Minecraft have involved the community in their development process. It is safe to say that a majority of them have seen rising engagement in players as well as a jump in sales. The freedom to include an element of ones creativity in the game always motivates fans. There is similar scope for both the games in question concerning their maps.

Popular streamer Shroud has already urged Fall Guys to add maps, especially if the game wants to stay in the race. It would make it so much easier for the developers to give that responsibility to the community.

This would allow the community to flaunt its creative side. Allowing players to make community maps will provide unlimited and constant new content for the game.

With limited maps and modes, the game becomes a bit repetitive after a while. This wont happen if they have unlimited access to new maps and tasks.

Not only is this Slashers opinion but that of many fans as well. They think that this something the developers should have included since the inception of the game.

While Among Us has other plans for the game to keep it interesting, Fall Guys needs to work on this stat!

It might not be that easy a task because it would require major changes in the game. Therefore, no matter how much criticism the game faces, it will still be a while until we are able to see those options come to the game. Till then, just like Among Us, Fall Guys too can work on other strategies to stay featured in the spotlight.

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Women’s Health Care Costs in Retirement Projected to be $200000 More than Men’s – Business Wire

September 29th, 2020 3:59 pm

DANVERS, Mass.--(BUSINESS WIRE)--Health care costs are a major expense during the Womens Longevity Gap, the period in which a woman will need to cover expenses single-handedly after the death of a male spouse or partner, according to recent data from HealthView Services, the nations leading provider of health care cost projection software. The company estimates that in retirement an average, healthy 43-year-old woman will face nearly $200,000 more in health insurance premiums than her husband.

The company, which provides software for personalized health care cost projections to financial professionals, urges women and couples to start planning early to address the longevity gap.

HealthView Services encourages thoughtful, personalized planning for the disparities of age, income, and life expectancy that commonly exist among male/female couples. Recommendations include:

Following these steps, women and their financial advisors can mitigate and potentially even eliminate the longevity gap and the other challenges that are common among female retirees, said Ron Mastrogiovanni, CEO of HealthView Services. Financial advisors with the right tools and data at their fingertips have the power to help their female clients close that longevity gap.

About HealthView ServicesFounded in 2008, HealthView Services is the nations leading provider of healthcare cost projection software, built on a dataset of 530 million health care claims. Its portfolio of retirement healthcare planning applications centered on personalized longevity estimates and individual health care cost projections is used by advisors, financial institutions, employers and consumers to create comprehensive, reliable health cost projections for 33 million users annually. Visit us to know more: http://www.hvsfinancial.com.

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Longevity gap: Poverty remains a scourge. India must focus on economy, public health – The Times of India Blog

September 29th, 2020 3:59 pm

At 69.4 years, Indias life expectancy has made almost a 20 year leap from 49.7 in 1970-75. While this is no mean feat, the sobering reality is that Japan was here in 1960 and China in 1990. The link between poverty and life expectancy is fairly obvious looking at the India story. People in Delhi, Kerala, Jammu & Kashmir, Himachal Pradesh, Punjab, Maharashtra and Tamil Nadu with lower incidence of extreme poverty live longer than the national average. Poorer states like Chhattisgarh, UP, MP, Assam, Rajasthan, Bihar and Jharkhand drag down life expectancy.

Worries that Indias current economic difficulties are turning the clock back in the fight against poverty make life expectancy a key indicator to track. Countries like Nepal and Bangladesh had lower life expectancy than India in the 1980s, but they have now pulled ahead. Apart from the incidence of poverty, access to public health services could be an equally important factor separating Indian states. This is borne out by infant mortality and maternal mortality rates largely correlating with life expectancy. Keralas IMR is 7 per 1,000 live births, Delhis 13 and TNs 15 against 48 in MP, 43 in UP and 41 in Assam.

The Covid pandemic may be a short term phenomenon. But its effect on lives and health services has multiple dimensions with generational implications. State outreach like immunisation and supplemental nutrition schemes took a backseat this year. Treatments became harder to access, evident in statistics of fewer surgeries, procedures and OPD visits for heart diseases, cancer, TB etc. The loss of incomes and livelihoods will force many to scrimp on meals and protein-rich foods. A vigorous public health response to neutralise these setbacks is needed.

Total fertility rates have fallen sharply below replacement levels in most Indian states, barring a few like UP and Bihar. Coupled with better institutional services and families investing in fewer children, this could help reduce malnutrition and IMR. While the Centre is betting big on health insurance for the poor, this cannot substitute adequate doctor availability and healthcare infrastructure in rural areas. The neglect of public healthcare by successive governments has been extremely expensive for the country. While this must be urgently remedied, only a growing economy will enable the government to make these interventions and citizens to live longer and healthier lives.

This piece appeared as an editorial opinion in the print edition of The Times of India.

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Top 5 Group Exercise Classes for Your Return to the Gym – Longevity LIVE

September 29th, 2020 3:59 pm

Its not hard to see why yoga has become so popular. In addition to helping with strength, balance, and body awareness, its meditative qualities can help center your life and reduce stress and anxiety. Taking a yoga class with a professional yoga instructor is an absolute must since some moves can be dangerous if not performed properly.

Taking yoga as a group class, additionally, will allow for the meditative qualities of yoga to be enhanced by group participation and will give you the motivation to participate more fully in the spiritual aspects of the practice. Being a group yoga classalso allows you to benefit from the shared, collective energy of the group, and youll be able to leverage that energy throughout your yogic flows. For those who struggle to stay consistent with their yoga effortsparticularly beginnersthese classes can be a great way to create accountability, learn from others, and make it more fun.

Taking a group dance class can be an incredibly fun social experience, especially if you go with your significant other. Dance has many of the same advantages of yoga, including strength, balance, and cardio training, but instead of meditation, it concentrates on interpersonal interaction.

The social aspects of group dance go back to ancient traditions. All over the world, dance would have incredible importance in the ritual life of the community. Many of these ancient rituals have been lost, but some of those social benefits can be tapped into. Be it through swing, salsa, and other group dance classes. In fact, the ability to build close connections with your fellow dancers is one of the biggest benefits.

Because dancing involves physical connection, it allows you to bridge the gap between human interaction and human touch. Group dance classes are also almost always more affordable than private lessons, and youll benefit from getting a firsthand look at how many different people have different styles and approacheseven for the same dance.

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Finding The Right Diet To Eat For You and Your Body – Longevity LIVE – Longevity LIVE

September 29th, 2020 3:59 pm

Its a diet thats really effective in weight loss and is a good diet for those that are currently severelyobese. Thererealso cases of the diet being really effective in dealing with type two diabetes, as many followersof this diet have been able to put the disease in remission, however, more evidence is needed on this front to determine its viability in combating diabetes.

The way the diet works is pretty simple. By drastically reducing carbohydrates and replacing themwith fat, yourbody is put in a metabolic state called ketosis.Being in this state makes your body really good at burning fat for energy, and this type of diet is also great at reducing blood sugar and insulin levels.

There are various forms of the Ketogenic diet. However, they all follow the main basic principle: fewer carbs and more fat. There is the Standard ketogenic diet, which can be broken down as 75% fat, 20% protein, and 5% carbs; High-protein ketogenic diet, which has a 15% increase in protein and a corresponding decrease in fat consumption; Cyclical ketogenic diet, which allows you to have two days a week of eating more carbs; and Targeted ketogenic diet, that allows you to add carbs around a workout.

When on a Ketogenic diet, there is only a certain amount of food you are permitted to eat. This includes meat, particularly red meat, and pork, as well as fatty varieties of fish like salmon, tuna, and mackerel. Eggs are good to have, as well as cheese like cheddar and mozzarella. Avocados are also very worthwhile food to eat on this diet, as there are lots of health benefits when it comes to consumingavocados.

It may sound strange, due to other diets encouragement of high fruit and vegetable consumption, but for the Keto diet, its critical that you avoid all fruit and root vegetables such as potatoes, carrots, and parsnips. Sugary food is also a no-go, as sugar is just a form of carbohydrates, which also means you should avoid wheat-based products like pasta. Its also important that you avoid alcohol, as due to its carb content you would turn the ketosis process off.

There are negatives tothis diet, however, and the main one is that for it to work, it needs to be followed strictly. If not, your body will fail to entera ketogenic state, meaning that youll actually store the fats youre eating, making you put on weight. It can also make you feel extremely tired and fatigued when you first start the diet, and could also see you get an increase of headaches and muscular pain.

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Finding The Right Diet To Eat For You and Your Body - Longevity LIVE - Longevity LIVE

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