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Medical Batteries

Combat Alexander has been supplying medical batteries and medical battery packs for over 25 years. As a leader in our field, we have an excellent reputation within the medical sector for our product quality and customer service.

Combat Alexander has been providing an excellent service to the Medical Sector for over 25 years.  Supplying high quality medical betteries and medical battery packs to the industry with great pride.

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Medical Device and Diagnostics Industry
  • Operating Rooms Get a Dose of Augmented Reality

    Operating rooms are set to get a dose of augmented reality because of a new clearance from FDA. The agency recently signed off on an augmented surgical navigation system from Mariner Endosurgery.

    The Ontario-based company’s LaparoGuard is an augmented surgical navigation system that enables surgeons to annotate areas of 3D safety zones during minimally invasive procedures, to aid surgeons in guiding their tools and informing their surgical approach. Similar to the heads-up display of a fighter jet, LaparoGuard allows surgeons to annotate areas of risk, and then see 3D renderings of surgeon-defined safety zones as a heads-up, real-time image overlay.

    This information from LaparoGuard is integrated into the operating room’s conventional visualization equipment, and LaparoGuard’s functionality provides surgeons with additional spatial awareness information. In addition, LaparoGuard provides continuous tracking of multiple tools throughout a procedure for real-time location updates within the abdominal cavity.

    "LaparoGuard empowers surgeons to have the latest in advanced visualization, augmented reality and spatial awareness tools for minimally invasive procedures,” Mitch Wilson, President of Mariner Endosurgery, said in a release. “Our upcoming pipeline of surgical visualization and advanced laparoscopic instrumentation will further support LaparoGuard and our company thesis of putting the right innovation, at the right time, in surgeons' hands. I am proud of our team’s efforts, and we look forward to seeing LaparoGuard successfully deployed in operating rooms across the U.S.”

  • Fertility Tracker Guarantees Pregnancy Within One Year

    Until recently, detecting the time during a woman’s cycle when she is most likely to conceive has been imprecise. Methods included measuring basal temperature spikes, which only detect ovulation after the fact, or urine tests that indicate a surge in luteinizing hormone, which predict ovulation is imminent within 12-36 hours. Both require meticulous recording of data by the user.

    Ava Science offers a fertility tracker that requires much less effort on the part of the user. Ava, a device that is worn on the wrist like a bracelet while the woman is sleeping, measures key physiological parameters to detect signals that mean the user is entering the fertile window. The data is then synced with an app on the user’s smart phone.

    One of the factors Ava analyzes is resting pulse rate. According to a recent study using the device, researchers observed a significant increase in pulse rate during the fertile window compared with the menstrual phase (2.1 beat-per-minute, p < 0.01).

    The device also measures other variables such skin temperature, breathing rate, heart rate variability ratio, blood perfusion, movement (which determines between light and REM sleep), and amount of sleep. Ava must be worn a minimum of four hours per night, with at least three hours of sleep for the data to be meaningful.

    The tracker can detect an average of 5.3 fertile days per cycle at 89% accuracy, although the company says that algorithm performance may be improved with more regular cycles and diminished with less regular cycles.

    The new version of the device, 2.0 Ava, “features an improved sensor and strap, is more lightweight and comfortable, and has a battery that lasts twice as long as previous generations,” said Lea von Bidder, Ava cofounder, in an interview with MD+DI. Other improvements include a vibrating alarm and a Bluetooth connection to sync wirelessly with the app, which has a new dashboard feature. Upgraded packages are available as well. They include the device, paired with Webinars, e-books, and fertility coaching services.


    So confident is the company about the device’s ability to predict optimal fertility days that it guarantees pregnancy within one year or the purchase price is returned. “Ultimately the goal of adding all the updated bracelet and app features, as well as offering the new value-added services has been simple—to help Ava users get pregnant faster, setting them up for the best chance of success,” said von Bidder. She adds that the one-year pregnancy guarantee requires that users synced their devices an average of 80% of all their completed cycles during the 12-month period.

    “Launched in the United States in July 2016, the bracelet is sold in 34 countries and has helped more than 16,000 women (since April 2017) become pregnant,” said von Bidder. She said about 50 new pregnancies a day (in Q3 2018) are being reported among Ava users.

    [Images courtesy of AVA SCIENCE]

  • Abiomed’s New Collaboration Could Cause Shockwaves in Industry

    Abiomed and Shockwave Medical just got a little bit closer. Recently the two companies announced that Danvers, MA-based Abiomed and one of the MDDI 2017 company finalists would be investing about $15 million in Shockwave. In addition, the two firms would be working on a training and education program in the U.S. and Germany focused on the benefits of complementary use of their respective technologies.

    Fremont, CA-based Shockwave has developed an intravascular lithotripsy technology that employs sonic pressure waves to safely crack vascular calcium within the vessel wall, which enables arteries to expand under low pressure and become more compliant. The firm received a nod from FDA in 2016 to market its technology.

    Currently the Shockwave M5 catheter is being used in patients with heavily calcified Iliac arteries in order to facilitate the transfemoral delivery of sophisticated devices with catheters, including transcatheter heart valves and Abiomed’s Impella. IVL enables this patient group to benefit from these life-saving therapies when they would otherwise be ineligible for the procedure or would be at increased risk for procedural complications. In Europe, Shockwave also markets its coronary catheter – Shockwave C2 – which is used to treat severely calcified de novo coronary artery disease.

    “We are delighted to be able to offer patients our solution in combination with Abiomed’s Impella technology using a minimally invasive approach, which should meaningfully improve outcomes,” Doug Godshall, president and CEO of Shockwave Medical, said in a release. “With Abiomed’s best-in-class approach to training and education, Shockwave will be able to more efficiently increase awareness and introduce IVL to customers, which we believe will help them better treat their most challenging patients. We are encouraged to see the positive clinical response we have witnessed to date.”

    Abiomed picked up the Impella technology when it acquired Aachen, Germany-based Impella CardioSystems AG in 2005.

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  • Apple's Medical Hires: Big Deal or Much Ado About Nothing?

    Apple has been careful to keep its future healthcare plans under wraps, but whatever it is, expect that it will be big.

    “Apple has a huge opportunity in health … and I don’t want to talk about the future because I don’t want to give away what we’re doing, but this is an area of major interest to us,” CEO Tim Cook said during Apple’s earnings call in November, according to Seeking Alpha transcripts.

    The ECG app recently became available to Apple Watch Series 4 customers in the United States, and U.S. customers with an Apple Watch Series 1 or later are now able to check themselves for irregular heart rhythms.

    “These are unprecedented and potentially life-changing features showing how Apple Watch is not only an indispensable communication and fitness companion, but also an intelligent guardian for your health,” Cook said. “More broadly we see this as just one further example of the kind of contribution we can make in the health space, and we look forward to making more in the future.”

    But the million dollar question for medtech is what role will Apple play in the industry and how will it impact traditional medical device players?

    Earlier this week CNBC reported that Apple has been quietly adding dozens of medical doctors to its payroll. The company has not yet commented on the report, but it’s not necessarily a surprise, given what little we do know about the company’s interest in the medical space.

    Zimmer Biomet is working with Apple to study the mymobility app’s impact on patient outcomes and overall costs of hip and knee replacement surgeries.

    One analyst on Apple’s earnings call made another interesting point.

    When you combine the new Apple Watch health features with the company’s staunch advocacy for privacy, “Apple could become a really large disintermediating force in all the friction in the healthcare industry today in the way medical information is shared and distributed,” said Womsi Mohan at Bank of America.

    Apple isn’t the only consumer tech titan looking at opportunities in healthcare.

    Amazon has been teasing the industry all year with its foray into healthcare, most recently by teaming up with Arcadia to launch an exclusive brand of consumer-use medical devices for diabetes and hypertension management.
    Dubbed, the Choice Brand, Amazon’s medical device offerings will start with a range of blood glucose monitors and blood pressure monitors both with supporting mobile apps which offer measurement tracking, data mobility, and reminders.
    Arcadia, a consultancy firm, has extensive experience in brand development within the diabetes and cardiovascular markets and is widely known as the original architect of Walmart’s ReliOn brand as well as Abbott’s Freestyle line of diabetes devices.

    Earlier this year Amazon announced a new healthcare joint venture with Berkshire Hathaway and JPMorgan Chase & Co. A couple weeks later, the Wall Street Journal reported that Amazon wants to become a major medical supplier, although the company had not made any public announcements to support that report at the time.

    Meanwhile the company reportedly hired Taha Kass-Hout, MD, a former FDA chief health informatics officer, to serve in a business development role focusing on healthcare projects.

    Amazon’s healthcare entry is similar to Google’s move into the industry in 2014. The Mountain View, CA-based company eventually restructured and its life sciences division, now called Verily, continues to penetrate the market at a rapid rate through noteworthy collaborations.

  • Colorectal Cancer Screening Pill to Be in US Pilot Study

    Check-Cap is getting one step closer to having its capsule-based screening method for colorectal cancer on the U.S. market. The Isfiya, Israel-based company has received FDA conditional approval for an IDE to initiate a pilot study of the C-Scan capsule.

    FDA’s conditional approval of the IDE requires Check-Cap to provide additional information to the agency and the company may begin enrolling patients immediately upon approval by the study site's Institutional Review Board (IRB). The trial will consist of up to 45 patients and it will be a single-arm study. Patients who are enrolled will be those considered to be of average risk for polyps and colon cancer. The study will also evaluate C-Scan’s safety, usability, and subject compliance.

    Alex Ovadia, Check-Cap’s CEO said FDA’s conditional approval for an IDE is a significant milestone for the company.

    “Following this conditional approval, we are applying for approval from the IRB and making sure we can start or initiate the pilot at NYU, which is our selected site,” Ovadia, told MD+DI.

    Here’s how C-Scan works. After being swallowed in capsule form, the C-Scan system's ultra-low-dose X-ray technology is used to produce a 3-D map of a patient's colon. The system differs from capsule technology already on the market by eliminating the need for a bowel prep prior to ingestion and examining the colon in its natural state without distention.

    The system produces a 3-D contour map of the colon that can be viewed in different ways to look for polyps, including a "tube" view a flat "fillet" view, or even the outside of the surface of the colon wall. There's other data from the system that may help clinicians detect polyps too, including Compton backscatter, X-ray fluorescence, and pressure data. If polyps are seen, a colonoscopy would likely be prescribed.

    Early last year, Check-Cap began a clinical trial to obtain CE mark for C-Scan. The technology obtained regulatory approval in January of this year. The technology also has approval from the Israeli Ministry of Health. The company hasn’t launched C-Scan in these markets yet, but is working on the commercialization path, Ovadia said.

    “Moving forward, I hope this is going to become a larger and more compelling method that could support screening for many people,” he said.

  • Supplier Stories for the Week of December 9
  • Study Links Air Pollution with Rescue Inhaler Use

    A recent study concludes that there is a strong and significant association between daily exposure to fine particulate matter (PM2.5), which refers to tiny particles or droplets in the air that are two and a half microns or less in width, and the frequency of asthma rescue medication usage. Because the particulates are so small, they can get deep into the lungs and greatly affect respiratory conditions.

    “This study is unique in that it looked at how air pollution impacts someone’s day-to-day life, in terms of their symptoms,” said Meredith Barrett, vice president of research at Propeller Health, in an interview with MD+DI. She said past studies have had to rely on mortality or hospitalization data to understand how air pollution affects asthma, which represents more rare and severe exacerbation events. “By using this medication-use data, we’re able to look at the daily burden of disease,” she said.

    Data was gathered by fitting small sensors onto inhaled medication devices of some 2800 people across the United States. The sensors collected information on when and how frequently (by measuring the number of puffs) people were using their medicine. The sensors were paired with the patient’s smartphones, which provided a GPS location.

    This data was merged with environmental information such as temperature, humidity, and precipitation, as well as air pollution data, all of which were collected from government sources. “From that data, we’re able to understand the conditions in which symptoms may occur,” Barrett said.

    Propeller has developed models that will look at a person’s past record of medication use. As more and more data is collected on each individual, the models learn what their particular environmental sensitivities are.

    “For each Propeller user, we gather information about the environmental conditions in which they use their rescue inhaler. We can use that information to learn about whether environmental conditions on any given day in their location may lead to symptoms for them,” explained Barrett. “It’s helpful to get that information back to the patient, so they learn about their disease, so they can plan their day, whether or where they exercise, or be sure to carry their rescue medication, if it’s going to be a high-risk day.”

    The information helps inform clinical care as well, Barrett said. “Providers are getting information so that they can see when their patients are having rescue-medication-use spikes, and then are able to target their care. It helps them to focus in on the patient and give them the right care at the right time,” she said.

    A similar model has also been created for the entire country. “We’ve collected hundreds of millions of data points about where and when rescue medication use occurs. We use that data to develop models that estimate when environmental conditions may lead to symptoms for any location in the United States,” said Barrett. “We share that information widely--it’s freely available for people to better self-manage their health.”

    “We’re really trying to use the data we’re collecting to better understand respiratory disease in general. What are the conditions that may cause symptoms?” Barrett said. “What are the particular environmental sensitivities, and how do they differ across people? We are going to use this information to gain a better understanding of how the environment influences respiratory disease and try to inform public health.”

    In fact, the company has already made strides in the public health arena. Propeller recently collaborated with government and nonprofit partners in Air Louisville, a community program that used Propeller’s connected inhalers to capture data from asthma sufferers in Louisville, KY.

    As a result of the information gathered from the sensors, the city is increasing tree coverage in high-risk asthma areas, identifying alternate truck routes that would take traffic away from high-risk neighborhoods, and considering other changes to city-wide zoning policies to address the health impacts of highways and industrial emissions.

    “We’re really trying to connect the individual data to a policy level in terms of having impact,” Barrett concluded.

  • New Field Test Discerns Between Ebola and Lookalike Fevers

    At the close of the 2014-2016 West Africa Ebola crisis, the Paul G. Allen Foundation identified diagnostic gaps as one of the major deficiencies that had contributed to the outbreak’s spread.

    “The standard diagnostic tests that exist are very good, but they’re hard to do out in the field in the middle of an outbreak like we saw in West Africa,” said John Connor, a virologist at the Boston University National Emerging Infectious Diseases Laboratory (NEIDL). Instead, samples need to be sent to a facility capable of running the tests, which means it could be several days between taking a sample and getting a diagnosis.

    Connor, in collaboration with researchers from Columbia University, the National Institutes of Health Integrated Research Facility, clinical collaborators from Senegal and the Hemorrhagic Fever Lab in Guinea, as well as Becton, Dickinson and Company (BD), came together and proposed an idea for a new kind of diagnostic that would bridge critical gaps in the field.

    “We set out to create a rapid, point-of-care diagnostic that could look for malaria, Ebola and other pathogens that are often found in these regions,” said Connor, who is also an associate professor of microbiology at Boston University School of Medicine. The Allen Foundation, based in Seattle, WA, agreed to fund the project.

    While there are myriad ways to design rapid, portable diagnostics, the solution pursued by the team was based on a test that could be stored without refrigeration, which is typically hard to maintain along supply routes to rural outbreak areas. That’s why the researchers liked the idea of designing a portable material identification system built on magnetic beads and glass-encased gold nanoparticles.

    The system, surface-enhanced Raman scattering (SERS), is based upon the idea that light scatters off of different types of molecules in distinct ways. As such, specific molecules have distinct light-scattering signatures (or unique barcodes) that can be detected. Although the barcodes can be weak on their own, the addition of gold particles amplifies the detectable light signal making the barcode easier to detect.

    “Gold amplifies the barcode by about a million times,” Connor said.

    Working with BD, which was developing SERS for other applications, Connor and his collaborators helped design a system capable of differentiating between the different barcodes of the malarial parasite and Ebola virus, as well as Marburg and Lassa viruses, two other deadly hemorrhagic fevers found in the same regions of Africa where Ebola outbreaks are common.

    At the start of the test, a small sample of blood is mixed with magnetic beads coated in antibodies that attract each of the four infectious agents. If the blood contains malaria-causing parasites or Ebola, Marburg or Lassa viruses, the pathogens glom onto the magnetic beads. At the same time, similar antibodies on glass-encased gold nanoparticles also attach to the pathogens, creating a link between the magnetic and gold beads. Then, inside a small machine, the materials are concentrated into one spot by magnetic force and hit with a small laser beam.

    Analyzing the barcode of light that flashes back from a sample, the machine can rapidly provide a readout of the presence of malarial parasites or Ebola, Marburg or Lassa viruses. From sample-taking to final readout, the entire process can be completed in 30 minutes or less. The development of the system, and experimental data showing its efficacy in animal and human blood samples, was published Wednesday in Science Translational Medicine.

    Once the sample is added to the tube, there is no need to reopen the tube because all the reagents are already inside, noted Yanis Ben Amor, one of the study's authors. Amor is an associate research scientist and the executive director of the Center for Sustainable Development at Columbia University in New York. For the technicians carrying out the testing, “this was seen as a tremendous advantage in the context of highly infectious samples," he said.

    Designed to go anywhere, the system’s components can be battery operated and can fit inside a standard-sized backpack, the researchers said.

    “The implications for getting good diagnostics to remote places are huge,” Connor said.

    Connor said the value of the diagnostic is not just in identifying who has a contagious illness and who does not, but also in creating better relations with the communities at risk of becoming infected. If patients can rapidly be diagnosed and treated for illness, it can foster trust while immediately helping clinicians identify who should be quarantined and who should be sent home with antimalarial medicines.

    Connor said the system could be custom-tailored to detect and differentiate virtually any combination of pathogens, whether they be bacterial, viral, fungal or parasitic.

    “The reason I find this system so promising is that it can diagnose more than one thing simultaneously, which is important in the real-world context of infectious diseases,” Connor said. “The disease landscape is complicated and pathogens aren’t operating in isolation from one another.”

  • How One Engineer's Blood Disorder Enabled the Development of an Anemia Detection App

    Every month from the time he was six months old, Rob Mannino has had to go into a clinic to receive a blood transfusion. Mannino has an inherited blood disorder known as beta-thalassemia, which is caused by a mutation in the beta-globin gene.

    “My doctors would test my hemoglobin levels more if they could, but it’s a hassle for me to get to the hospital in between transfusions to receive this blood test. Instead, my doctors currently have to just estimate when I’m going to need a transfusion, based on my hemoglobin level trends," Mannino said.

    For his biomedical engineering PhD project at Georgia Tech, Mannino set out to develop an image-analysis algorithm capable of detecting anemia just by looking at pictures of a patient's fingernails.

    "Every single one of us at some point is at risk for anemia," said principal investigator Wilbur Lam. "Rob has essentially developed a way in which anybody now can answer the question 'am I anemic' and all they need is a smartphone."

    Lam is a clinical hematologist-bioengineer at the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, associate professor of pediatrics at Emory University School of Medicine and a faculty member in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech in Atlanta, GA.

    The researchers published their results Dec. 4, 2018, in Nature Communications.

    “All other point-of-care anemia detection tools require external equipment and represent trade-offs between invasiveness, cost, and accuracy,” Lam said. “This is a standalone app that can look at hemoglobin levels  without the need to draw blood.”

    The app should be used for screening, not a clinical diagnosis, the researchers caution. Mannino was a graduate research assistant in biomedical engineering who has since graduated.

    “This whole project couldn’t have been done by anyone but Rob,” Lam said. “He took pictures of himself before and after transfusions as his hemoglobin levels were changing, which enabled him to constantly refine and tweak his technology on himself in a very efficient manner. So essentially, he was his own perfect initial test subject with each iteration of the app.”

    The app could facilitate self-management by patients with chronic anemia, allowing them to monitor their disease and to identify the times when they need to adjust their therapies or receive transfusions, the researchers said. That may reduce side effects or complications of having transfusions too early or too late.

    The technology could be used by anyone at any time and could be especially appropriate for pregnant women, women with abnormal menstrual bleeding, or runners/athletes. Its simplicity means it could be useful in developing countries. Clinical diagnostic tools have strict accuracy requirements, but Mannino and Lam said that with additional research, they can eventually achieve the accuracy needed to replace blood-based anemia testing for clinical diagnosis. The current gold standard for anemia diagnosis is known as a complete blood count (CBC) test.

    The researchers studied fingernail photos and correlated the color of the fingernail beds with hemoglobin levels measured by CBC in 337 people: some healthy, and others with a variety of anemia diagnoses. The algorithm for converting fingernail color to blood hemoglobin level was developed with 237 of these subjects and then tested on 100.

    The researchers were able to show that a single smartphone image, without personalized calibration, can measure hemoglobin level with an accuracy of 2.4 grams/deciliter with a sensitivity of up to 97%. Personalized calibration, tested on four patients over the course of several weeks, can improve the accuracy to 0.92 grams/deciliter, a degree of accuracy on par with point-of-care blood-based hemoglobin tests. Normal values are 13.5-17.5 grams/deciliter for males and 12.0-15.5 grams/deciliter for females.

    In the app, the use of fingernail beds, which do not contain melanin, means the test can be valid for people with a variety of skin tones. The accuracy is consistent for dark or light skin tones, Mannino said. The app uses image metadata to correct for background brightness and can be adapted to phones from multiple manufacturers.

    Mannino and Lam are working with a variety of doctors at Children’s Healthcare of Atlanta and Emory – geriatric, internal medicine, neonatologists, transfusion medicine, global health – to obtain additional data and better calibrate their system.

    “This is just a snapshot of the accuracy right now,” Lam said. “The algorithm gets smarter with every patient enrolled.”

    The smartphone anemia app is projected to be available commercially for public download as early as Spring 2019. A patent application has been filed for the anemia app, and both Lam and Mannino have a financial interest in the success of the product.