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1831 results in Biomedical engineering

Page 36 of 92

  • Japan

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp 28-31

  • Summary

    Background

    At nearly US$6 trillion, Japan has the third largest gross domestic product (GDP) in the world, after the US and China. Real GDP grew at about 1.9 percent in 2012, and it is projected to expand at roughly one percent per year through 2020. The Japanese economy was badly hit by the global recession in 2008–2009 and the massive tsunami in 2011, and it continues to suffer from persistent deflation. Japan's economy has been led by the advanced manufacturing sector, which generates strong export activity. However, the country is looking to bolster domestic demand in order to drive increased growth.

    The population of Japan, at more than 128 million people, is decreasing about 0.2 percent each year. Trends indicate that the country's total inhabitants will decline by almost 30 percent by 2060 due to a low birth-rate, limited immigration, and an aging population. Approximately 23 percent of the Japanese people were over 65 years of age in 2012; by 2060, more than 40 percent of the population will be senior citizens. As the population ages, cancer, heart disease, and pneumonia have become the country's leading causes of death.

    The Japanese universal healthcare system, known as kaihoken, has been lauded for increasing the quality of life of the Japanese people and is cited as a key reason the Japanese have the longest life expectancy in the world. However, increasing healthcare costs, in combination with the country's rapidly aging population and slow-growth economy, are creating the need for reforms and cost cutting. Japanese patients tend to visit physicians more frequently than their counterparts in the US (13.2 versus 3.9 appointments per person per year). And their hospitals stays are significantly longer (18.8 versus 5.5 days). Japan also has three times as many acute care hospital beds per 1,000 people (8.1 versus 2.7). Moreover, Japanese expenditures on medical devices are the highest in Asia at US$165 per capita, compared to just US$10 per capita in China.

  • Preface

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp ix-xiv

  • Summary

    There is no greater satisfaction than seeing a patient being helped by a technology that you've had a hand in creating. And thanks to continuing advances in science and technology, healthcare is more open for innovation than at any time in history.

    Despite this promise, however, medical technology innovators face significant hurdles – especially in the new era of cost containment. If not managed skillfully, patents, regulatory approval, reimbursement, market dynamics, business models, competition, financing, clinical trials, technical feasibility, and team dynamics (just to name a few of many potential challenges) can all prevent even the best idea from reaching patient care.

    So, where should you begin as an innovator? What process can you use to improve your chances of success? What lessons can you learn from the inventors, engineers, physicians, and entrepreneurs who have succeeded and failed in this endeavor before? This book delivers practical answers to these important questions.

    Who should read it and why?

    Biodesign: The Process of Innovating Medical Technologies provides a comprehensive roadmap for identifying, inventing, and implementing new medical devices, diagnostics, and other technologies intended to create value for healthcare stakeholders. It has been written to be approachable for engineering, medical, and business students at both the undergraduate and graduate level, yet comprehensive and sophisticated enough to satisfy the needs of experienced entrepreneurs and medtech executives. For instructors, it provides a proven approach for teaching medical technology innovation that begins pre-idea and extends through preparing for commercialization. It is ideally suited to support team-oriented, project-based learning experiences in academic and industry settings.

    The text describes the biodesign innovation process, which we initially developed to support the biodesign innovation and fellowship programs at Stanford University. Over 13+ years, the process has been built and refined based on:

  • • Presentations and mentoring by more than 200 industry leaders who have participated in our training programs

  • • Our experience advising more than 150 project teams that have applied the process to their work

  • • Feedback from those who have learned the process through our executive education courses, as well as input and suggestions from students, fellows, instructors at other universities, and industry representatives using the first edition of the book

  • • Extensive field-based research

    • Our confidence that the process is effective is based on the results of the students and fellows trained at Stanford and through our university-based partnerships in India and Singapore.

  • Global Perspectives

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp 7-9

  • Summary

    A world of opportunity …

    Although the United States and Europe remain global leaders in medical technology innovation, the story of the medtech sector has become much more diverse in recent years as healthcare has become a global priority. Inventors and companies in countries around the world are playing an increasingly important role in sourcing ideas, designing and developing them into viable products and services, and introducing them into patient care. In parallel, device sales in developing countries are expanding at a rapid pace. As the US and Europe both sustain growth rates in the low single digits, medtech revenues in countries such as India and China are forecast to increase at a compound annual growth rate of 14 percent and 26 percent, respectively.

    The global transformation of the medtech sector has been driven by multiple, interrelated factors. In developed markets, health systems are actively seeking to slow health spending associated with medical technologies as they become more cost conscious and attuned to the value these products deliver. Moreover, as the time, expense, and complexity of developing new solutions in environments like the US continues to increase, innovators are moving offshore and creating new innovation hubs in locations around the world.

    In developing markets, disease profiles are shifting from infectious to chronic conditions, which makes diagnostic and device solutions a more important part of efforts to meet the healthcare needs of patients. Governments and private healthcare providers alike are increasing health-related spending (see Figure G1). And innovators and companies in low-resource settings are becoming leaders in inventing more affordable solutions that enable care delivery in any setting and reduce (rather than increase) its cost.

    Medtech innovators can certainly find compelling opportunities in both environments.

    In developing markets, disease profiles are shifting from infectious to chronic conditions, which makes diagnostic and device solutions a more important part of efforts to meet the healthcare needs of patients.

  • Latin America

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp 32-38

  • Summary

    Background

    Latin America includes approximately 20 countries in North, South, and Central America and the Caribbean. In contrast to most of the United States and Canada, Latin languages – mainly Spanish and Portuguese – are primarily spoken in the region.

    While economic growth varies substantially across Latin America, the gross domestic product (GDP) growth in the region as a whole increased by an average of 5 percent from 2000 to 2008, and decreased to closer to 3 percent subsequently. Brazil and Mexico are the largest economies, accounting for roughly 65 percent of region's combined GDP. Globally, Brazil and Mexico have the 7th and 14th largest GDPs, respectively.

    Economic gains have stimulated increases in consumption, population, and longevity, as well as more demand for adequate healthcare by a growing middle class. This, in turn, has led to enhanced opportunities in the public and private healthcare markets and increased investment in healthcare access and infrastructure. Concurrently, Latin America has experienced a rise in the prevalence of chronic diseases across the region. Mortality due to cardiovascular diseases alone is predicted to increase by 145 percent between 1990 and 2020. Healthcare expenditure per capita in the region hovers around US$661, compared to approximately US$8,600 in the United States, suggesting future room for expansion.

    As a whole, Latin America has a medical technology industry valued at more than US$8 billion, which makes it one of the larger global markets. Moreover, medical device sales have been expanding at a rate of more than 10 percent per year in the region. Based on their size, Brazil and Mexico comprise the most important medical device markets in Latin America and, accordingly, will be covered in more detail below. However, Colombia has the fastest growing medtech market, with a projected 2013–2018 compound annual growth rate of 13.3 percent. This market is forecast to reach US$2.2 billion in 2018. Chile and Peru are among the region's top economic performers, but both of these countries represent small markets for medical devices. Argentina and Venezuela have demonstrated a higher demand for medical technologies, yet both countries are experiencing serious macroeconomic challenges that are hindering continued medtech expansion.

  • Europe

  • Paul G. Yock, Stanford University, California, Stefanos Zenios, Stanford University, California, Josh Makower, Stanford University, California, Todd J. Brinton, Stanford University, California, Uday N. Kumar, Stanford University, California, F. T. Jay Watkins, Lyn Denend, Stanford University, California, Thomas M. Krummel, Stanford University School of Medicine, California, Christine Q. Kurihara, Stanford University, California
  • Book:
    Biodesign
    Published online:
    11 May 2018
    Print publication:
    02 February 2015, pp 18-22

  • Summary

    Background

    Europe, in geographic terms, comprises 47 independent countries that jointly can be considered the largest economy on earth. The European Union (EU), as an economically and politically integrated group of member states, includes 28 countries, with 18 of these sharing the euro as their common currency. The EU member states have a total gross domestic product (GDP) of more than US$16 trillion, with a per capita GDP of roughly US$34,000. In terms of medical devices, the EU is often referred to as the “European market” because of its common device regulation under the CE mark. However, innovators should appreciate that the European market extends beyond the EU and includes such non-member states as Switzerland and Norway. Russia, which geographically belongs to both Europe and Asia, is also commonly considered part of the larger European medical device market, as most of its economy and population is located in the western portion of the country.

    Europe has a population of nearly 740 million people, approximately 7 percent of the global population (with the current 28 EU member states accounting for 69 percent of the total). Compared to other parts of the world, population growth in Europe is rather slow and the median age comparatively high. Nine of the top 10 countries with the highest median age, worldwide, are European countries, with only Japan having an older population.

    Spending on healthcare as a percentage of GDP ranges widely across European countries. France, Germany, the Netherlands, and Denmark commit more than 11 percent of GDP to health, while Romania and Cyprus spend less than 6 percent. In 2010, health expenditures as a percentage of GDP dropped in the EU for the first time since 1975. From an annual average growth rate of 4.6 percent between 2000 and 2009, growth in health spending per capita fell to –0.6 percent in 2010 and has been stagnant in many countries ever since. Among EU member states, those with higher average income levels per person generally spend more on health-related products and services. When considering absolute amounts of healthcare spending per capita, the variation in health-care spending is even more evident, ranging from about US$5,000 in France to merely US$500 in Romania.

  • 9 - The Stoichiometric Matrix

  • from II - Mathematical Properties of Reconstructed Networks
  • Bernhard Ø. Palsson, University of California, San Diego
  • Book:
    Systems Biology
    Published online:
    05 February 2015
    Print publication:
    26 January 2015, pp 151-171

  • Summary

    Mathematics is the door and key to the sciences

    – Roger Bacon

    The reactions that comprise a biological network can be represented by chemical equations. The stoichiometric matrix is formed from these chemical equations. It has several important attributes. In this chapter we focus on four principal views of the stoichiometric matrix and its content: (i) it is a data matrix, (ii) it is a connectivity matrix, (iii) it is a mathematical mapping operation, and (iv) it is a central part of in silico models used to compute steady and dynamic network states. These features are summarized in Figure 9.1.

    The Many Attributes of S

    The stoichiometric matrix is formed by the stoichiometric coefficients of the reactions that constitute a reaction network. It is organized such that every column corresponds to a reaction and every row corresponds to a compound. The entries in the matrix are stoichiometric coefficients that are integers. Each column that describes a reaction is constrained by the rules of chemistry, such as elemental balancing. Every row thus describes all the reactions in which the corresponding compound participates, and therefore how the reactions are interconnected. This deceptively simple matrix has many noteworthy attributes that are summarized in Table 9.1.

    Informatic attributes. The stoichiometric matrix is a data matrix. The data that go into building a genome-scale stoichiometric matrix come primarily from the annotated genomic sequence and detailed assessment of the literature (bibliomic data) that is available about the target organism. Often, inferences from phylogenetics are used as well. All this information is the basis for the reconstruction process described in Part I.

    Physical/chemical attributes. The stoichiometric coefficients represent counts of molecules that are involved in a chemical reaction. Chemical reactions come with conservation relationships of elements, charge, and other properties. These properties must be represented accurately. The cellular location of a reaction is included through the assignment of a metabolite to a cellular compartment.

    Genetic/genomic attributes. A genome-scale network reconstruction effectively represents a two-dimensional annotation of a genome [313].

Page 36 of 92