CORDIScovery Vodcast- Episode #5 - Taking heart from tech – a glimpse into the future of healthcare
This is an AI transcription.
00:00:00:00 - 00:00:50:22
Anthony Lockett
Hello and welcome to this special episode of the CORDIScovery Podcast. Today we're going to dive into some exciting innovations in health research that could transform the way we prevent, diagnose, and treat disease. We'll learn about efforts to make injections needle free. New diagnostic tools and therapies for heart conditions like arrhythmias and atrial fibrillation. How wearable technologies are being harnessed to detect life threatening conditions such as sepsis and the influence of urban environments on our health.
00:00:50:24 - 00:01:17:11
Anthony Lockett
I'm joined by representatives of five projects that have received funding from the EU Horizon Europe program. And these projects showcase how research can improve lives and reshape healthcare for the future. So a warm welcome to David Fernandez Rivas from the BuBble Gun project. Professor Stéphane Hatem, representing the project MAESTRIA, Doctor Bruno Miranda, from the eMotional Cities project.
00:01:17:13 - 00:01:54:03
Anthony Lockett
Doctor Andreu Climent, CEO of Corify Care, and Christoforos Panteli from the Project SepsISensoR. So, David, let me start with the BuBble Gun project. Your project aims to develop needle-free methods to inject liquids. What are the advantages in terms of patients wellbeing, security and waste reduction?
David Fernandez Rivas
Right. Well, the main aspect, the environmental aspect that you are just mentioning, we use too many needles and we are then on a quest to reduce the number of treatments that require a needle because we generate a lot of waste.
00:01:54:05 - 00:02:15:24
David Fernandez Rivas
The next, important, aspect of our technology is that it can be personalized because we inject tiny droplets in the very superficial layers of skin, and then we can do it in a very, specific way that you receive only the doses that you require.
Anthony Lockett
Okay. And how do patients feel about that?
David Fernandez Rivas
Well, we haven't done yet test with living subjects.
00:02:15:24 - 00:02:37:07
David Fernandez Rivas
We have done mostly laboratory tests. The hypothesis is that it's so superficial that you never touch the nervous system terminations that give the signal of pain. And it also happens so fast in such a small volume that you should not feel anything.
Anthony Lockett
Okay. And can you describe to us in relatively simple terms what is the science behind this innovation?
00:02:37:09 - 00:03:03:22
David Fernandez Rivas
The science begins by using very affordable lasers now, diode lasers, everybody now has it in their lamps at home. But a few years ago, it was still, you know, emerging technology. So, we use that as an energy source to set the liquid in motion by a phenomenon known as cavitation. So, we make simply bubbles. And that's why BuBble Gun and then the liquid travels at velocities high enough that it can make its way in between the space of the cells in your skin.
00:03:03:24 - 00:03:24:03
Anthony Lockett
And why is now the right time for this? Why hasn't this been possible before?
David Fernandez Rivas
It's a combination of different factors. The environmental element became clear during the pandemics. The amount of waste that is generated with each injection, because you have to imagine, is also the plastic, the metal, manufacturing, sterilizing it, bringing it to the place of application.
00:03:24:03 - 00:03:45:08
David Fernandez Rivas
And afterwards you cannot just simply throw it away. You need to process it properly. And, it's a combination also of the knowledge we have, at the University of Trent, in my experience in microfluidics and the emergence of new technology like diode lasers that make this whole combination of factors, into a portable device, which is now, what we are working for the next steps.
00:03:45:10 - 00:04:06:08
Anthony Lockett
Okay. Thanks very much, David. If I could turn to you, Stephan. Your project aims to develop new diagnostic tools and therapies for atrial fibrillation. How big a health problem is that in Europe today?
Stéphane Hatem
It's a very big health problem because, first, atrial fibrillation’s prevalence is increasing with the overall aging of the population, the lifestyles.
00:04:06:08 - 00:04:30:19
Stéphane Hatem
We anticipate an epidemic of atrial fibrillation. And it's at the same time the first cause of stroke, cardiac cause of stroke and heart failure. So, it's a major health problem. And today the difficulty is to better identify patients at risk. When you have a first episode of AF, who's going to have a second episode of AF? How much you are exposed to a risk of stroke?
00:04:30:21 - 00:04:59:01
Stéphane Hatem
And so, there's difficulty today to predict these two parameters. So, we have created a digital tool which is accessible for clinicians. And this digital tool is using your models that we have created using machine-learning approach. And this model is using clinical parameters that you can obtain during routine practice, CT scan, echo, electrocardiogram.
00:04:59:03 - 00:05:26:01
Stéphane Hatem
So, the clinician, by connecting to this server, get access to this model and can obtain for each patient the prediction risk, such as what we call now, the personalized medicine for a patient.
Anthony Lockett
And how widely used is this digital platform right now?
Stéphane Hatem
Well, we are in the phase where we need to validate this platform, to make it popular, to make it knowledgeable.
00:05:26:01 - 00:05:52:23
Stéphane Hatem
So, we have developed a cohort of patients with a number of investigators throughout Europe, and we are going to validate with them the use of this platform before extending the use to a larger audience.
Anthony Lockett
And how, how is the collaboration going with the different, stakeholders in the project? So you have the clinicians as you described, you have the patients, presumably you're working with industry as well.
00:05:53:03 - 00:06:17:16
Anthony Lockett
How does that work?
Stéphane Hatem
First, this consortium follows a previous European consortium from FP7. We are in fact a sort of European Community in this field of atrial fibrillation and atrial myopathy. So, we have built up this consortium, we’re used to working all together, and we have aggregated for MAESTRIA new partners from the industry, from patients.
00:06:17:16 - 00:06:39:15
Stéphane Hatem
But we have a source of matrice which is there, which is our history, because it makes things much more easy.
Anthony Lockett
Very interesting. Thank you very much. We'll come back to some of those points, I'm sure, in the discussion. But let me move, to the eMotional Cities project. So, Bruno, it aims to improve health through a better understanding of the interplay between people in urban spaces.
00:06:39:17 - 00:07:02:12
Anthony Lockett
That might sound a bit theoretical to some people. Can you explain in a bit more concrete terms what what that means?
Bruno Miranda
Yes. It's okay to think it's theoretical, but what this means is that we are bringing a new perspective into the field of urban planning and design by bringing methods and also new technologies, from the field of neuroscience.
00:07:02:14 - 00:07:36:00
Bruno Miranda
And the idea is that, when you think about the complexity of the city and how people experience it, you actually want to know, from the perspective of the individual, what is the impact of all these exposures that city might have? And so, we, of course, start with what we know about these two fields, but we are moving forward in a way that we integrate these two pieces of information because we believe it's the way forward to change human behavior.
00:07:36:03 - 00:08:16:18
Bruno Miranda
From the perspective of our environment influences the citizens, but also how citizens might change their behavior.
Anthony Lockett
And which cities are you working in for the research?
Bruno Miranda
So, we selected, four case study cities Lisbon, Copenhagen, London and Lansing, in Michigan state of the United States. Because we selected these cities on the basis of their different layouts on different properties from the demographics and urban design perspective, of course, as well, taking into account that there were partners working with us on the cities.
00:08:16:20 - 00:08:53:21
Anhtony Lockett
Okay. And how have you been organizing the field work there?
Bruno Miranda
So, we worked from the perspective of the local community and tried to adjust some relevant policy and local relevant questions and challenges. So, for example, when we run real life experiments by conducting some city works with wearable units, we selected these places on the basis of what a spatial analysis from Urban Analytics would tell us as informative, what type of hotspots are relevant.
00:08:53:23 - 00:09:20:08
Bruno Miranda
But we also try to sense what the local stakeholders actually were interested to know in terms of new evidence or new information that they could afford to have.
Anthony Lockett
Okay. And, how could city planners, for example, or local elected representatives, take into account some of the insights from your research in order to improve people's health in an urban environment?
00:09:20:10 - 00:10:03:01
Bruno Miranda
So, I think from various perspectives, we still have the perspective of a more micro level or geographic information system level. So, you could still use a lot of the data statistics that each country has from census and from surveys. But we could go deeper in terms of, the knowledge about how we could combine this information at the level of the neighborhood but going even further at the level of the street, so you could actually have very granular information about what's happening at the street level of your community.
00:10:03:03 - 00:10:33:15
Bruno Miranda
And so, this could have an impact and more importantly, it's human centered. So, you actually will provide information that is much more accurate than correlations that we might be using for some challenges.
Anthony Lockett
Thanks very much, Bruno. If I could turn to, you know, Andreu, SAVE-COR is an acronym, the title of your project, it actually stands for something quite complicated the stratification of atrial and ventricular arrhythmias based on electrocardiogram imaging.
00:10:33:17 - 00:10:52:16
Anthony Lockett
Can you explain a little bit what that means?
Andreu Climent
Sure. So first, thank you very much. And it is a great opportunity to have the chance to talk after Stephane because as he well mentioned cardiac arrhythmias is an epidemic. As he's pointing out, one of the main issues that we have in Europe is that almost 10 million patients are suffering from cardiac arrhythmia.
00:10:52:18 - 00:11:14:12
Andreu Climent
Every single day, we are performing around 1000 cardiac interventions to treat these kinds of arrhythmias. And it's great because we have at least these kinds of interventions, but the worst is that we only succeed in 50% of the patients. We put patients in the cath lab, in the surgery room, we introduce catheters into the heart and then we try to stop the arrhythmia by burning the region that has caused the arrhythmia.
00:11:14:14 - 00:11:34:12
Andreu Climent
But we fail. And why? We say because we do not have the technology within the heart, the technology to see where the arrhythmia was coming from. So, at the end, we are empirically burning the same gradient in every patient. I was an engineer. I was in the academy, working in hospitals trying to help the clinicians to see what was going on.
00:11:34:14 - 00:11:55:02
Andreu Climent
And we said, okay, what if we could map the heart globally, non-invasively, in a safe and efficient way? And that was the origin of Corify. This is a company that's a startup thanks to EIT Health, to the support of the European Union. And six years ago, we jumped from this is a prototype into a product. And right now, we already are in the market.
00:11:55:04 - 00:12:14:22
Andreu Climent
We already have CE Mark. We are in three half three countries around Europe. More than 1000 patients per year map with our technology and growing and growing. Because at the end, this is the thing we need to identify the arrhythmias, but we need to be sure that we can offer the best treatment to every single patient.
Anthony Lockett
And perhaps, I mean, a similar question to the to the one I asked a moment ago.
00:12:14:24 - 00:12:33:13
Anthony Lockett
You know, why does the technology now allow you to do that in a way that wasn't possible in the past?
Andreu Climent
It's a great technology. Great question. So, in fact, this technology we developed originally set in really basic research is scanning the thorax of the patient and reconstructing the electrical activity from a 3D reconstruction and generating digital twins.
00:12:33:15 - 00:12:56:03
Andreu Climent
Ten years ago, it took us something like one week from the recordings to get a digital twin. Right now, it's a matter of seconds for an individual digital twin. It's real time, bit to bit. And it is thanks, first, to better algorithms which are unique; artificial intelligence is helping a lot but also computing capacity.
00:12:56:03 - 00:13:16:21
Andreu Climent
So right now, we have some computer capacities within the hospital in real time that was something difficult to dream of just a few years ago.
Anthony Lockett
Yeah. And presumably this is less invasive for patients as well.
Andreu Climent
At the end, the technology right now we are using it within the hospital during the interventions because it's what we really want to be sure that it works, but it's fully noninvasive.
00:13:16:23 - 00:13:42:23
Andreu Climent
So, we already are developing a simplified version of the system to use it in any visit to the cardiologist or hopefully, one day sooner than later in the emergency rooms to detect infarct or in every check-up when you go to the cardiologist and instead of an EKG, that is 100 years old technology, making a real digital twin of yourself that can show to the clinician how is your heart and how to prevent any potential arrhythmia that you may have in the future.
00:13:43:03 - 00:14:06:09
Anthony Lockett
Okay, amazing. And last but not least, I turn to Christopher as, from the SepsISensoR project. You're working on a wearable to be used by vulnerable people to assess biomarkers that could indicate sepsis. First of all, how dangerous is the condition and how many people in Europe are concerned? Potentially.
Christoforos Panteli
Sure. So let me first make a correction.
00:14:06:11 - 00:14:28:03
Christoforos Panteli
It is not a wearable sensor. And the reason it isn't a wearable sensor is because the definition of a wearable sensor is something that we can wear when our everyday life like a smartwatch. But the vision we had for this kind of device for people in ICUs. And the reason for that is sepsis kills 11 million people every year.
00:14:28:05 - 00:14:50:08
Anthony Lockett
Is that a global figure?
Christoforos Panteli
Oh, yes. And if we do a calculation, it's about every 2.8 seconds someone dies from sepsis. And so, yeah, it's a big problem. And we're trying to solve it via exhaled breath. And the reason for that is when sepsis is being detected is after the clinical symptoms appear.
00:14:50:10 - 00:15:15:10
Christoforos Panteli
But that's already too late. And so, we thought could these signals, these biomarkers, appear in breath while the sepsis is being developed before the clinical symptoms. And the idea came from the fact that the bacteria are growing inside the body causing infection. Then infection spreads in the blood, in the organs. And obviously he's coming out of the breath.
00:15:15:12 - 00:15:35:18
Anthony Lockett
Okay. And you've clarified so quite rightly that it's not a wearable in the sense of, a smartwatch or something of that kind. But what can you describe what physically it looks like.
Christoforos Panteli
Exactly. So, in a situation where someone is sitting in the ICU, after surgery or any condition, the chances of developing sepsis are quite high.
00:15:35:20 - 00:15:57:21
Christoforos Panteli
So, we imagine a mask on the face, with the equipment on the side of the bed, monitoring their exhaled gases. But towards our goal, we haven't done any clinical trials yet. We’re in the in-vitro stage. So, this in-vitro on bacteria, then in vivo with mice and finally human trials.
00:15:57:23 - 00:16:23:15
Christoforos Panteli
But the in vitro tests were quite encouraging. We're able to detect the infection in bacterial cultures much faster. So we can detect infection between 2 to 8 hours, depending on the amount of infection, of bacteria, whereas the current protocol takes overnight.
00:16:23:17 - 00:16:43:13
Christoforos Panteli
So, it takes 24 hours for a microbiologist to see the bacterial culture grow and be able to tell whether it's an infection or not. Whereas with real time and gas sensors, we can detect it much faster.
Anthony Lockett
To what extent is artificial intelligence, big data, machine learning, and so on, enabling you to make progress in your different projects?
00:16:43:15 - 00:17:13:04
David Fernandez Rivas
Well, I think that's something that we all have is skin. And it's very personal. Depending on how old you are, your ethnicity, and weather conditions. So, in the follow up project that we are now executing, FlowBeams is a spin off company from part of the research that I did with my ERC Grant, there we have a work package where we are co-developing AI tools that can help us understand how skin reacts before, during, and after a needle free injection.
00:17:13:06 - 00:17:33:24
David Fernandez Rivas
And that is crucial because, well, when you are younger or are hydrated, your skin would react differently with the technology that we are developing. So, we need it to make sure that we can have that personalized treatment that we are claiming.
Anthony Lockett
Right. And Stéphane, for example, in your project, how significant is artificial intelligence there?
00:17:33:24 - 00:18:07:03
Stéphane Hatem
The biomedical research in different fields is facing a huge challenge, which is big data generated by omics, by clinical imaging. So, AI is becoming an essential tool for research to manipulate this data, to analyses this data, to cluster this data. And there is, I mean, all the projects that we are conducting now must have a data scientist or computer scientist on board to really bring together this expertise for new research
00:18:07:03 - 00:18:30:05
Stéphane Hatem
on biomedicine and the fields of atrial fibrillation, cardiac arrhythmia and diagnostic tools in this new dimension of biomedical research.
Anthony Lockett
And other particular safeguards you have to put in place because, I mean, obviously, this is quite sensitive personal and medical data that you're dealing.
Stéphane Hatem
Yeah. So, it's one difficulty of this type of research program.
00:18:30:07 - 00:18:54:21
Stéphane Hatem
So now we get in this data sharing space in Europe, the Gaia-X space, which facilitates a lot because it has delayed the beginning of the project to have to share data. So, it's a major question, a major issue in Europe which I think is partially resolved now.
Anthony Lockett
Yeah. Andreu, may I ask you, because I have the impression that you're quite far advanced in your project.
00:18:54:23 - 00:19:19:16
Anthony Lockett
What advice would you have for other colleagues around the table or others who might be listening to us? If they want to bring their research breakthroughs to the next step in commercialization and application security.
Andreu Climent
Thank you. It's true we already are 40 people or almost 40 people in the company, and we are already in several countries. And the truth is that I come from the Academy, from making papers and research and of course applying for grants.
00:19:19:18 - 00:19:43:15
Andreu Climent
But in the end what they clearly see is that if you are doing something that solves a need, solves the problem of someone, a clinician or a company, then there is a market for you. And you should understand the market as soon as you start having the ideas in the research; you need to understand who is going to benefit from your research, on who is going to pay for what you will produce in your research.
00:19:43:15 - 00:20:02:17
Stéphane Hatem
I think that it should be mandatory that as soon as we are doing this, we should be trained in understanding these kinds of questions.
Anthony Lockett
And Bruno, maybe I think many of us, live in cities ourselves. What can we do at a personal level to make sure that we have the best experience and look after our health when we're moving around in the urban environment?
00:20:02:22 - 00:20:30:23
Bruno Miranda
Well, from our perspective at the eMotional Cities, I believe, is to actually be more critical about the current evidence that we have. So, we have to push policymakers and politicians to go further in the data that we might provide. Because, at the moment, even if we face a climate change issue, we actually tackle it by statistical correlations, by doing inference on the data.
00:20:30:23 - 00:20:59:24
Bruno Miranda
But we do not actually have evidence from a human perspective. What's the actual impact of going on my street and walking on my street? So, I think that's the empowerment that the citizens will have to push for more evidence based, driven, policymaking, and decision making.
Anthony Lockett
And perhaps the last word from Christoforos, you described your project as being at the in vitro stage.
00:21:00:01 - 00:21:19:16
Anthony Lockett
What do you think it would take to bring it to the next level? And how do you see the project evolving over the coming years?
Christoforos Panteli
Yeah, that's a very good question. For the project to evolve better and then coming to life, we need few more experiments to collect a bit more data. Fortunately, or unfortunately, we haven't used AI yet.
00:21:19:18 - 00:21:47:17
Christoforos Panteli
We have a completely different algorithm called change point detection that so far is very robust and quick. And so, we want to make that algorithm handle more data and ensure that we can detect the infection, but also the bacterium that causes infection. That's the next stage for us. And after that, we're developing a prototype smart incubator that microbiologists and hospitals can use to speed up this detection of infection.
00:21:47:22 - 00:22:31:06
Anthony Lockett
Great. Well, thanks very much. Thank you all, guests, for joining us. And, to you for listening into this episode. You can follow us on Spotify and Apple Podcasts and check out the podcast homepage on the Cordis website. Subscribe to make sure the hottest research in EU funded science isn't passing you by, and you can find more information and project examples on the Cordis website, on the European Commission's research and innovation websites and in our online magazine, Horizon.
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