AI helps bring clarity to LASIK patients facing cataract surgery

 While millions of people have undergone LASIK eye surgery since it became commercially available in 1989, patients sometimes develop cataracts later in life and require new corrective lenses to be implanted in their eyes. With an increasing number of intraocular lens options becoming available, scientists have developed computational simulations to help patients and surgeons see the best options.

In a study in the Journal of Cataracts & Refractive Surgery, researchers from the University of Rochester created computational eye models that included the corneas of post-LASIK surgery patients and studied how standard intraocular lenses and lenses designed to increase depth of focus performed in operated eyes.

Susana Marcos, the David R. Williams Director of the Center for Visual Science and the Nicholas George Professor of Optics and of Ophthalmology at Rochester, says the computational models that use anatomical information of the patient's eye provide surgeons with important guidance on the expected optical quality post-operatively.

"Currently the only pre-operative data used to select the lens is essentially the length and curvature of the cornea," says Marcos, a coauthor of the study. "This new technology allows us to reconstruct the eye in three dimensions, providing us the entire topography of the cornea and crystalline lens, where the intraocular lens is implanted. When you have all this three-dimensional information, you're in a much better position to select the lens that will produce the best image at the retinal plane."

The future of optical coherence tomography

Marcos and her collaborators from the Center for Visual Science, as well as Rochester's Flaum Eye Institute and Goergen Institute for Data Science, are conducting a larger study to quantify in three dimensions the eye images using the optical coherence tomography quantification tools they've developed to find broader trends. They are using machine-learning algorithms to find relationships between pre- and post-operation data, providing parameters that can inform the best outcomes.

Additionally, they have developed technology that can help patients see for themselves what different lens options will look like.

"What we see is not strictly the image that is project on the retina," says Marcos. "There is all the visual processing and perception that comes in. When surgeons are planning the surgery, it is very difficult for them to convey to the patients how they are going to see. A computational, personalized eye model tells which lens is the best fit for the patient's eye anatomy, but patients want to see for themselves."

With an optical bench, the researchers use technology originally developed for astronomy, such as adaptive optics mirrors and spatial light modulators, to manipulate the optics of the eye as an intraocular lens would. The approach allows Marcos and her collaborators to perform fundamental experiments and collaborate with industry partners to test new products. Marcos also helped develop a commercial headset version of the instrumentation called SimVis Gekko that allows patients to see the world around them as if they had had the surgery.

In addition to studying techniques to help treat cataracts, the researchers are applying their methods to study other major eye conditions, including presbyopia and myopia.

More information: Carmen M Lago et al, Computational simulation of the optical performance of an extended depth of focus intraocular lens in post-LASIK eyes., Journal of Cataract and Refractive Surgery (2023). DOI: 10.1097/j.jcrs.0000000000001260

https://medicalxpress.com/news/2023-09-ai-clarity-lasik-patients-cataract.html

Cue Health Adopts Limited-Duration Shareholder Rights Plan

 Cue Health (Nasdaq: HLTH), a healthcare technology company, today announced that its Board of Directors has unanimously approved the adoption of a limited-duration shareholder rights plan (the "Rights Plan") to protect the long-term interests of all shareholders. The Board adopted the Rights Plan in response to a rapid accumulation of shares by a third party. The Rights Plan is effective immediately and has a one-year term, expiring on September 20, 2024.

"Cue is committed to engaging in constructive dialogue with our shareholders, and we value their perspectives," said Ayub Khattak, Chairman and Chief Executive Officer of Cue Health. "We are also focused on ensuring that all shareholders receive fair and equal treatment and are able to realize the full long-term value of their investment, which is what a Rights Plan is designed to do. As we look ahead, we are focused on executing our strategic plan, and we are confident that Cue is poised for significant sustainable growth with numerous near-term milestones."

The Rights Plan is designed to reduce the likelihood that any entity, person, or group can gain control of Cue through open market accumulation without paying all other shareholders an appropriate control premium and on terms that would not deliver sufficient value for all shareholders. It will also give the Board sufficient time to make informed judgments and take actions that it believes are in the best interests of all shareholders. The Rights Plan does not preclude the Board from considering an offer that recognizes the full value of Cue.

https://finance.yahoo.com/news/cue-health-adopts-limited-duration-202200478.html

China Relaxes Capital Controls in Top Cities to Woo Investors

• Shanghai’s rules on freer transfers took effect Sept. 1
• Beijing seeking public feedback on similar regulations

 

China is taking steps to loosen strict capital-control measures in its two most important cities amid efforts to win back foreign companies as overseas investment slumps and the economy slows.

In Shanghai’s pilot free-trade zone and Lingang area, foreign investors are now allowed to freely transfer their investment-related funds in or out of China without any delay should the money be “real and compliant,” authorities in the financial hub said in a set of rules that took effect on Sept. 1.

https://www.bloomberg.com/news/articles/2023-09-21/china-relaxes-capital-controls-in-top-cities-to-woo-investors

Chamath Palihapitiya discloses sale of 1.7M ProKidney shares

 

• ProKidney (NASDAQ:PROK) 10% owner Chamath Palihapitiya discloses the sale of 1.7M shares of the company at a transaction value of $9.29M.
• https://seekingalpha.com/news/4014414-chamath-palihapitiya-discloses-sale-of-17m-prokidney-shares

Pharma's reputation hits record low in US as Republicans shun industry: Gallup

 Americans' perception of the pharmaceutical industry is at its lowest point this century, especially among Republican voters, as the initial support for COVID-related efforts has turned into disillusionment.

That’s according to the latest Gallup industry reputation poll, which surveyed people across the U.S. throughout August on how they viewed the leading industries.

That survey found that just 18% of Americans have a positive view of pharma, while a record-high 60% view it negatively. About 21% of Americans have a neutral view of the industry. 

This represents a notable year-on-year decline, with positive views of the pharmaceutical industry dropping from 25% to the current 18%. Notably, Republicans have seen a 13-point decrease in their positive score, declining from 26% last year to just 13% in the latest survey.

The Gallup pollsters point to both Republicans and conservative figures being “critical of the pharmaceutical industry generally, and of COVID-19 vaccines and booster shots specifically,” as a motivating factor for this drop.

It's a significant turnaround from the early days of the pandemic in 2020 when Republicans' positive rating surged to 45%. This increase coincided with pharma's efforts, aligned with then President Donald Trump, to rapidly develop new vaccines against COVID and lift the country out of lockdowns.

Gallup notes that even before COVID, Republicans' positive view of the industry averaged 37% from 2001 to 2019, nearly three times the current level. In contrast, Democrats' view has remained relatively stable at 31%.

This has placed the pharmaceutical industry at the bottom of the reputation list, with 32% of respondents expressing a "very negative" sentiment toward pharma. This dissatisfaction score is the highest among the 25 industries assessed, surpassing even the federal government, which ranked second from the bottom by just one percentage point.

Unsurprisingly, the industries responsible for providing Americans with food, such as restaurants (which ranked first) and farming and agriculture (which ranked second), claimed the top positions. The computer industry secured the third spot on the podium this year

https://www.fiercepharma.com/marketing/pharmas-reputation-hits-record-low-us-republicans-shun-industry-their-droves-gallup

Puma: Orphan Status for Small Cell Lung Cancer Candidate

 Puma Biotechnology, Inc. (NASDAQ: PBYI), a biopharmaceutical company, announced that the U.S. Food and Drug Administration (FDA) has granted Orphan Drug Designation to alisertib, a selective, small-molecule, orally administered inhibitor of aurora kinase A, for the treatment of patients with small cell lung cancer (SCLC). SCLC is an aggressive form of lung cancer with a poor prognosis, and with limited treatment options for patients whose cancer has progressed on or after platinum-based chemotherapy.

https://finance.yahoo.com/news/puma-biotechnology-receives-fda-orphan-201000150.html

Appeals court takes up transgender health coverage case likely headed to Supreme Court

 A federal appeals court is considering cases out of North Carolina and West Virginia that could have significant implications on whether individual states are required to cover health care for transgender people with government-sponsored insurance.

The Richmond-based 4th U.S. Circuit Court of Appeals heard oral arguments in cases Thursday involving the coverage of gender-affirming care by North Carolina’s state employee health plan and the coverage of gender-affirming surgery by West Virginia Medicaid.

During the proceedings, at least two judges said it’s likely the case will eventually reach the U.S. Supreme Court. Both states appealed separate lower court rulings that found the denial of gender-affirming care to be discriminatory and unconstitutional. Two panels of three Fourth Circuit judges heard arguments in both cases earlier this year before deciding to intertwine the two cases and see them presented before the full court of 15.

Tara Borelli, senior attorney at Lambda Legal — the organization representing transgender people denied services in both states — said excluding the coverage is a clear example of discrimination outlawed by the 14th Amendment.

“The exclusion here is actually quite targeted, it’s quite specific,” Borelli said in court, arguing that a faithful interpretation of the U.S. Constitution and the equal protection clause ensures transgender people coverage.

“One of the most important things that a court can do is to uphold those values to protect minority rights who are not able to protect themselves against majoritarian processes,” she said.

Attorneys for the state of North Carolina said the state-sponsored plan is not required to cover gender-affirming hormone therapy or surgery because being transgender is not an illness. Attorney John Knepper claimed only a subset of transgender people suffer from gender dysphoria, a diagnosis of distress over gender identity that doesn’t match a person’s assigned sex.

Knepper said North Carolina’s insurance plan does not discriminate because it does not allow people to use state health insurance to “detransition,” either.

Before offering pharmaceutical or surgical intervention, medical guidelines call for thorough psychological assessments to confirm gender dysphoria before starting any treatment.

In updated treatment guidelines issued last year, the World Professional Association for Transgender Health said evidence of later regret is scant, but that patients should be told about the possibility during psychological counseling.

West Virginia attorneys said the U.S. Centers for Medicare & Medicaid Services has declined to issue a national coverage decision on covering gender-affirming surgery.

Caleb David, attorney for the state defendants, said West Virginia’s is not a case of discrimination, either, but of a state trying to best utilize limited resources. West Virginia has a $128 million deficit in Medicaid for the next year, projected to expand to $256 million in 2025.

“West Virginia is entitled to deference where they’re going to take their limited resources,” he said. “They believe that they need to provide more resources towards heart disease, diabetes, drug addiction, cancer, which are all rampant in the West Virginia population.”

Unlike North Carolina, the state has covered hormone therapy and other pharmaceutical treatments for transgender people since 2017. “That came from a place of caring and compassion,” he said.

There’s no indication of when the court will rule.

In June 2022, a North Carolina trial court demanded the state plan pay for “medically necessary services,” including hormone therapy and some surgeries, for transgender employees and their children. The judge had ruled in favor of the employees and their dependents, who said in a 2019 lawsuit that they were denied coverage for gender-affirming care under the plan.

The North Carolina state insurance plan provides medical coverage for more than 750,000 teachers, state employees, retirees, lawmakers and their dependents. While it provides counseling for gender dysphoria and other diagnosed mental health conditions, it does not cover treatment “in connection with sex changes or modifications and related care.”

In August 2022, a federal judge ruled that West Virginia’s Medicaid program must provide coverage for gender-affirming care for transgender residents.

U.S. District Judge Chuck Chambers in Huntington said the Medicaid exclusion discriminated on the basis of sex and transgender status and violated the equal protection clause of the 14th Amendment, the Affordable Care Act and the Medicaid Act.

Chambers certified the lawsuit as a class action, covering all transgender West Virginians who participate in Medicaid.

An original lawsuit filed in 2020 also named state employee health plans. A settlement with The Health Plan of West Virginia Inc. in 2022 led to the removal of the exclusion on gender-affirming care in that company’s Public Employees Insurance Agency plans.

After the proceedings Thursday, West Virginia Republican Attorney General Patrick Morrisey released a statement saying that, under Medicaid, states have wide discretion to determine what procedures their programs can cover.

“Taxpayers should not be required to pay for these surgeries under Medicaid — our state should have the ability to determine how to spend our resources to care for the vital medical needs of our citizens,” he said.

Borelli, on the other hand, said reversing the lower courts’ decisions would cause “true harm” to the lives and health of transgender people in both states.

“It is disappointing that state officials in North Carolina and West Virginia have chosen to double-down on the discriminatory denial of medically necessary, evidence-based care,” she said.

https://www.fox44news.com/news/ap-appeals-court-takes-up-transgender-health-coverage-case-likely-headed-to-supreme-court/