Raymond McBride, Author At Healthy News

Why did a rural Nevada county turn down money to create a public health department?

ELKO, Nev. — When Elko County commissioners rejected a $500,000 grant from the Centers for Disease Control and Prevention that could have helped the county create a health department or health district, Kayla Hopkins pleaded with them to reconsider.

Hopkins, who has lived for nearly nine years in the sprawling rural county that forms the northeastern corner of Nevada, told the board how she struggled through postpartum depression and needed mental health resources.

“I was unable to get the help that I needed,” Hopkins said during a public meeting in late 2021, adding that she fell into what could be considered a mental breakdown. She said she was sent by air ambulance more than 300 miles away to Carson City, where she received care in a psychiatric facility for 10 days.

“I was away from my family,” Hopkins said. “I was away from my support system here, and I still struggle with mental health, and I still cannot get the help that I need because we just don’t have it here.”

Pleas from Hopkins and others weren’t enough to sway the elected commissioners. Neither were 11 letters from local health leaders urging the board to take the infusion of public health funding. Four of the county’s five commissioners, citing concerns about government overreach and their lack of trust in federal agencies, voted against pursuing the grant. Nearly a year later, as the pandemic grinds toward a third year and with the arrival of monkeypox, the county still is without a public health department to respond.

And the same mistrust of agencies administering grants for public health persists elsewhere.

Elko County, home to about 54,000 people, wasn’t alone in rejecting federal aid aimed at bolstering public health in the past year. Experts say they were surprised and concerned to see the rare local or state leader, swayed by political partisanship, dismiss funding opportunities for historically limited public health systems.

As many conservative leaders and their constituents railed against measures meant to combat Covid — things like masking policies and promoting vaccines — the pandemic revealed long-standing fissures in the country’s public health infrastructure, particularly in rural and underserved communities.

“Partisan politics has poisoned the well to a point that we’re willing to sacrifice the health of our citizens,” said Brian Castrucci, president and CEO of the de Beaumont Foundation, a national nonprofit that advocates for public health policy. “Is the political grandstanding worth it?”

Over the past two years, officials in Idaho, Iowa, and New Hampshire rejected Covid relief money, their decisions often accompanied by political pronouncements about federal government overreach. And officials representing local governments across the country, including Cochise and Pinal counties in Arizona, echoed those moves. A survey of local governments in 15 states conducted by the National League of Cities found more than 200 small governments declined pandemic relief funds, a small percentage of the money available to small governments.

Elko commissioners turned down a workforce grant funded by the CDC, money intended to “establish, expand, and sustain a public health workforce, including school nurses.” The funding would have flowed through the state to the county, allowing it to hire two employees dedicated to public health services for two years.

County workers in charge of researching the grant and pitching it to the board said the idea was to conduct a study in those two years that would help them determine how much it would cost to create a local health department or a health district, involving neighboring counties.

Elko County has not had a public health department since budget woes pushed officials to dissolve it more than 15 years ago.

Adriane Casalotti, chief of government and public affairs for the National Association of County and City Health Officials, said communities across the country have generally clamored for increased funding during the pandemic, which strained already underfunded and understaffed public health infrastructure.

“That being said,” Casalotti said, “in recent months, I’d say, we’ve heard of a handful of health departments that either would not apply for or couldn’t accept … specific grants,” involving Covid vaccines.

At an Elko County commission meeting in late 2021, then-transit management coordinator Abigail Wheeler pitched the grant to the board and a roomful of residents eager to air their grievances about the CDC and levy claims of federal government overreach, overspending, and corruption regarding the pandemic response.

Wheeler began by asking county commissioners to keep an open mind.

Why did a rural Nevada county turn down money to create a public health department? — Abigail Wheeler presented a grant from the Centers for Disease Control and Prevention to the Elko County, Nev., commission last year, telling it the funding could help the town create a health department or district and give Elko more local control over public health. The commission disagreed.Elko County via Kaiser Health News

“I am very aware that this is basically the worst timing that this grant could come forward because there’s a lot of distaste over public health because of what’s happened with Covid and our whole community, our whole country, and worldwide,” she said. “We have been beat to death, the fallout of the Covid pandemic.”

Wheeler, now the grants and contracts manager for the county, began by reminding the commissioners that creating a local health department or district was a goal that predated the pandemic and the polarization it triggered.

A 2019 meeting with the state Department of Health and Human Services underscored the need for more local public health infrastructure.

“They’re thinking about things like tuberculosis and measles and restaurant inspections,” Wheeler said. “They’re not thinking about Covid. And they’re saying to themselves, ‘We can’t get to you if you had a TB case. We’re 370 miles away from Elko County.’”

Elko is like a landlocked island, Wheeler said during an interview with KHN. Though smaller in population compared with Clark or Washoe counties in Nevada, Elko spans more than 17,000 square miles, making it the fourth-largest county by area in the contiguous U.S. and the second-largest in Nevada.

“We have to be our own cavalry,” Wheeler said.

Commissioners and community members who opposed the grant said Elko didn’t need more public health resources or a health district or department. They said they were concerned about giving up local autonomy and growing bureaucracy. They also expressed mistrust of the CDC.

“You’re 100{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} factual that the timing couldn’t be worse,” said Jon Karr, then the chairman of the commission, during the meeting. Although he said he did not buy into all the conspiracy theories about the CDC that others touted, he added that he did not think CDC officials should be trusted.

Commissioner Rex Steninger said he voted against the grant because he feared the commission would be “subservient” to the new entity. “Grants always have strings attached,” he wrote in an emailed response to questions from KHN. “We do not want the CDC tenacles [sic] reaching in to Elko County.”

Wheeler pointed to the fractured local public health system during the meeting, saying creating a health district or department could help reduce bureaucracy and give the county more control over decisions in state officials’ hands. She said it’s evident the county needs more resources, citing public health response duties she took on in her position as transit manager.

“We’re not public health experts, we’re just people who are willing to step up to the plate and take this on,” Wheeler said, referring to other county employees who helped with the public health response to Covid.

Wheeler was disappointed the county board turned down the grant opportunity, she told KHN in October. She said she would still like to see public health become a function of the county someday.

Since speaking at the meeting nearly a year ago, Hopkins said she found the mental health services she needed locally. But not everyone is as lucky as she is to find the help they need close to home, she said. The county’s decision to reject the CDC grant makes her sad, she said, but she accepts it was the commission’s decision to make.

Other local leaders saw the need for increased public health resources amid the pandemic. The Elko City Council wrote a letter of support for the CDC grant the day before the commission rejected it. “We know for sure it’s not something that the city wants to tackle by ourselves,” said Curtis Calder, city manager. “But if our regional partners want to do it as a partnership, we stand at the ready to assist where we can.”

Other rural Nevada counties have collaborated with the University of Nevada-Reno School of Medicine to create the Central Nevada Health District, serving four counties and a small city near Reno. “If we won’t step up and help ourselves and our constituents, we can’t complain when the State doesn’t provide what we need or expect,” wrote Dr. J.J. Goicoechea, a commissioner in neighboring Eureka County and the interim state veterinarian, in an emailed response to KHN.

Casalotti said there are advantages to having local health departments staffed and run by people who live in the community as opposed to a state government hundreds of miles away.

“One of the things that we’re hopeful that people can learn from the pandemic is that you don’t want to have to build the plane while flying it,” she said. “At some point, you need to take the leap because the next crisis is just around the corner.”

But polarization remains an obstacle, Castrucci said.

“This has become a holy war, this has become a war of right and wrong,” he said. “I don’t know how to get through that to a place where we are prioritizing the health of our nation.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Investigation raises concerns about poor FDA oversight of clinical trials

COVID-19 vaccines and drugs were developed at “warp speed” and now experts are concerned about the US Food and Drug Administration’s (FDA) inadequate surveillance of clinical trial sites, reports an investigation published by The BMJ today.

Regulatory documents show that only nine out of 153 Pfizer trial sites were subject to FDA inspection prior to licensing its COVID-19 mRNA vaccine. Similarly, 10 out of 99 Moderna trial sites and five of 73 remdesivir trial sites were inspected, writes investigative journalist Maryanne Demasi.

Notably, the FDA received a complaint from whistle-blower Brook Jackson, about misconduct at three clinical trial sites that were testing Pfizer’s COVID-19 vaccine, while she was employed as a regional director. Jackson observed a range of problems including falsified data, unblinded patients, and inadequately trained vaccinators who were slow to follow up on adverse events. “I thought that the FDA was going to swoop in and take care of everything,” said Jackson. The FDA did not, however, inspect the trial sites in question.

Experts have criticized the FDA’s oversight of clinical trials, describing it as “grossly inadequate.” They say the problem, which predated COVID-19, is not limited to a lack of inspections, but also includes failing to proactively notify the public or scientific journals when violations are identified, effectively keeping scientific misconduct from the medical establishment.

The FDA is “endangering public health” by not being candid about violations that are uncovered during clinical trial site inspections, says David Gortler, a pharmacist and pharmacologist who worked as an FDA medical reviewer between 2007 and 2011 and then as a senior advisor to the FDA commissioner in 2019-2021.

The FDA oversees clinical research of FDA-regulated drugs and devices in the US and abroad, if the product is intended for the US market. It conducts routine visits for trials, reviews records of those sites or the institutional review boards (IRBs) that oversee trials locally and follows up on complaints of violations. The FDA does not have a target for the proportion of trial sites it inspects.

Despite the estimated hundreds of thousands of clinical trial sites in operation across the US and abroad, the FDA told The BMJ that it only has 89 inspectors for its bioresearch monitoring program, which assures the quality and integrity of data submitted to the agency in support of new product approvals and marketing applications, but that it is recruiting more inspectors to reach its yearly average of 100.

“I don’t think that it is a sufficient number of staff to do that kind of level of oversight,” says Jill Fisher, professor of social medicine at the University of North Carolina. “The FDA must have enough of a presence to dissuade investigative sites from committing fraud,” she continues.

Between March and July 2020, at the peak of pandemic restrictions, the FDA paused its site inspections and only “mission critical” inspections were carried out. However, Gortler says this was the precise time that the FDA should have ramped up its oversight, not scaled back, especially since COVID-19 products were being developed at warp speed and intended for millions of people.

The FDA told The BMJ it takes oversight of clinical trials seriously and had adapted to travel restrictions, publishing draft guidance for remote regulatory assessments, which describes virtual inspections using live streaming and video conferencing and requests to view records remotely.

The FDA has a long history of failing to adequately oversee clinical trial sites, notes Demasi. For example, a 2007 report by the Department of Health and Human Services’ Office of the Inspector General found the FDA audited less than 1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of the nation’s clinical trial sites between 2000 and 2005 and was highly critical of the agency because it did not have a database of operational clinical trial sites.

In response, the FDA said it created a dedicated task force and “developed new regulations and guidance further to improve the conduct of clinical trials and enhance the protection of people participating in clinical trials,” but denied The BMJ an interview with a member of the task force.

Further, a 2020 investigation by the journal Science into the FDA’s enforcement of clinical research regulations between 2008 and 2019 concluded that the agency was often light handed, slow moving, and secretive. It said that the FDA rarely leveled sanctions and when it did formally warn researchers about breaking the law, it often neglected to ensure that the problems were remedied.

Although the FDA publishes its inspection reports, they are not proactively disclosed. Nor does it typically notify journals when a site participating in a published clinical trial receives a serious warning or alert the public about the research misconduct it finds.

Demasi points to reports of insufficient staff and low morale at the FDA. Fisher says the FDA “needs to be better funded and staffed to conduct inspections. At a minimum, the agency needs to inspect sites when complaints or concerns have been filed.”

Gortler doesn’t agree, however, that the FDA is under-resourced. With a total budget of $6.1bn in 2021, he suggests the agency needs to be leaner and more efficient, with employees interested in improving public health. “Half of its budget, about $3bn, is discretionary, which means it could have hired contractors, retirees, or repurpose existing workers. It chose not to. The FDA was just yawning its way through the pandemic. The entire agency is broken.”

More information:
Maryanne Demasi et al, Investigation: FDA oversight of clinical trials is “grossly inadequate,” say experts, The BMJ (2022). DOI: 10.1136/bmj.o2628

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New health care regulators ask OneCare executives for measurable results

OneCare, the nonprofit that distributes millions of public and private health care dollars to providers throughout Vermont, has asked state regulators to greenlight a $15 million operating budget — a slight decrease from this year — as part of an annual review process.

This is the first OneCare budget cycle for most members of the Green Mountain Care Board, the five-member body that regulates major players in Vermont’s health care sector, including hospitals. And the board’s new members seem keen to put OneCare executives in the hot seat.

During a five-hour marathon hearing last week, the board repeatedly pressed OneCare executives for quantitative results, whether that meant reducing Vermonters’ health care costs or improving their quality of care.

“Vermonters, either through taxpayer-funded health care groups, out-of-pocket expenses, copays or insurance, have borne the bulk of those staggering numbers,” said Owen Foster, the board’s new chair, at the start of the meeting. “And for that they deserve results.”

Owen Foster, chair of the Green Mountain Care Board, at the board’s office in Montpelier on Oct. 27. Photo by Riley Robinson/VTDigger

Thom Walsh, who was appointed to the board in December, asked OneCare CEO Vicki Loner to name the organization’s top three key performance indicators, or metrics of success. Loner declined to name any, saying, “They’re going to our board to be reviewed.”

OneCare is an accountable care organization, or ACO. It’s been described as a policy experiment because it’s intended to shift the state’s health care spending from a fee-for-service model to one in which providers get a flat fee per patient, with incentives to keep people well for the lowest cost. It funnels money from Medicare, Medicaid and private insurers to health care providers across the state, ranging from big hospitals to independent primary care doctors.

OneCare has a $15 million operating budget to manage these various contracts between payers and providers and to conduct data analysis of the health care system. Its operating costs are funded by Vermont hospitals, which pay millions in fees each year to be part of the ACO.

Tom Borys, OneCare’s vice president of finance, cited OneCare’s increased enrollment as one of his top indicators of success. He argued that increased participation in an ACO model is inherently good because it changes the incentive structure behind participants’ health care.

But Walsh quickly cut him off, seemingly unimpressed.

“What I’m struggling to find is an outcome that would be meaningful to Vermonters, and you may be able to say something like, ‘reduced (emergency department) visits,’” Walsh said. “Those are outcome measures that matter to patients, and I can’t find them.”

As part of this year’s budget process, OneCare submitted a study comparing it with a group of 20 similar ACOs nationwide. OneCare outperformed other ACOs on some cost metrics, including cost of inpatient and outpatient surgeries.

However, it found OneCare patients went to the emergency department at significantly greater rates, averaging 36{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} higher than patients in other ACOs. Vermonters in OneCare had 18{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} fewer visits to primary care providers and paid 30{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} more for prescription drugs.

In a June 2021 report, State Auditor Doug Hoffer recommended that the care board find a clear way to measure the ACO’s effectiveness, to determine whether OneCare saved Vermonters more money than it cost. The auditor said that assessment should be a prerequisite for any new all-payer agreement with the federal government, which is expected to be worked out in the next few years.

“On a high level … it’s important that any regulated entity, like OneCare going before the board, gets a good, careful review,” Mike Fisher, chief health care advocate at Vermont Legal Aid, said after the hearing. “And so I’m pleased to see the level of questioning from the board.”

OneCare executives pushed back on some of the board members’ demands for quantitative impact. They argued that changing the entire health care system takes a long time.

“How do you manage the one-year payer contract cycles and performance expectations with long-term outcomes that, our clinicians remind us all the time, it’s going to take years, decades, generations to address?” OneCare Chief Operating Officer Sara Barry said.

When governments or organizations invest in big, upstream factors that impact people’s health — things such housing, walkable communities and food security — those benefits don’t have an immediate, measurable impact on the health of a group, Loner said. OneCare executives also noted that about half of the ACO’s lifespan has been during the Covid-19 pandemic.

Walsh agreed with executives that systems change is a long game but countered that six years should be enough time to at least have some way of measuring results.

“If OneCare’s role was to support through data analytics, maybe trainings and other things over time, wouldn’t there be improvements that we could point to, right?” Walsh said. “If we look year over year, and it’s been going on for five or six years, wouldn’t there be improvements that we could point to, even if it’s just a little piece?”

About 296,000 Vermonters are “attributed” to OneCare — meaning they see a provider who participates in OneCare and is accountable to the ACO’s performance targets. These 296,000 patients are expected to generate $1.4 billion in health care spending in 2023, an expected $97 million increase from this year.

Overall, OneCare’s requested $15 million operating budget would reduce its expenses by about $248,000, or 1.6{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, from 2022. The ACO cut costs by reducing its in-person workspace and by combining some operations, such as data analytics, with UVM Health Network, executives told the care board.

OneCare’s budget request includes a roughly 3{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} cost-of-living increase for employees. If the budget were approved, Loner, the CEO, would make more than $490,000 next year.

Aside from the organization’s operating expenses, OneCare would also be responsible for another $29.9 million, which it would distribute to health care providers throughout the state.

That money includes bonus payments for providers who reach certain population health goals. It would also fund targeted investment and programs in specific areas, such as about $212,000 for the state’s five nonprofit Area Agencies on Aging.

In response to questioning by Foster, Loner said OneCare had conducted no cost-benefit analysis on how it should allocate money to particular programs or types of providers.

The proposed budget would raise hospital participation fees by 1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}, generating a total of $19.8 million. If approved, this budget also “escalates risk quite dramatically” for Vermont hospitals, Borys, OneCare’s vice president of finance, told the care board.

By participating in OneCare, hospitals join a risk pool. If hospitals meet certain cost targets and quality goals by the end of the year, hospitals can earn funds from the pool. If hospitals miss these targets, they could owe money — potentially millions. Theoretically, this payment model is meant to change financial incentives, to encourage coordinated care and reduce expensive or unnecessary services.

With the onset of the pandemic, OneCare had substantially reduced how much risk hospitals took on through their shared pool, from $42 million in the pre-pandemic portion of 2020, down to about $16 million for the past couple years. The proposed 2023 budget would raise the stakes for hospitals back to roughly pre-pandemic levels, at $36 million.

At last week’s meeting, Foster asked OneCare executives what the hospitals’ risk actually means: If a hospital fails to meet certain targets and owes money at the end of the year, who ultimately pays that penalty?

“Would any executives or individuals who are responsible for that loss have, actually, any skin in the game?” Foster said.

Hospital leaders are not individually responsible to OneCare’s goals, Borys said, but they are accountable to their boards.

“In the sense that if they had to make a large shared loss payment, the boards are going to consider that when evaluating management,” Borys said.

“So if the hospitals, ultimately as an organization, would foot the bill, is it fair to say that by and large, Vermonters are paying that?” Foster said. “Given that’s the source of the revenue streams?”

“I think through extension, there’s some truth to that,” Borys said. “But I will also add that the complexity of health care funding is huge. And if the general belief is that every dollar that funds health care comes from individual people, which is probably fair, then I’d say the answer is yes.”

3D Printing Medical Devices Market Size is projected to reach USD 9.79 Billion by 2031, growing at a CAGR of 16.1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f}: Straits Research

The global 3D printing medical devices market size was valued at USD 2.55 billion in 2022. It is projected to reach USD 9.79 billion by 2031, growing at a CAGR of 16.1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} during the forecast period (2023-2031). North America is the most significant shareholder in the global 3D printing medical devices market.

New York, United States, Nov. 17, 2022 (GLOBE NEWSWIRE) — The process of producing three-dimensional solid objects from digital files or designs is referred to as additive manufacturing or 3D printing. Hollowing out or cutting a piece of metal or plastic makes it possible to produce intricate functional shapes. In 3D printing, an object is made by adding materials in successive layers until the desired shape is achieved. Throughout the healthcare lifecycle, medical printing devices provide users with a wide range of advantages. With the potential to be used as a widespread care pathway for complex injuries, 3D printing helps to improve treatment outcomes, procedural efficiency, and reintervention costs. During the forecast period, 2023–2031, medical and surgical facilities are anticipated to lead the demand for 3D-printed medical devices. The demand for 3D printed devices is also being boosted by the quick uptake of technological innovations such as portable, multi-material, colored 3D printers, and others in the medical sector. Additionally, 3D printing technology is revolutionizing the medical industry by enabling doctors to create individualized and patient-specific implants through novel applications in surgical implants and prosthetics.

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The surge in 3D Printing Investment Drives the Market

The amount of public-private funding for various 3D printing initiatives has significantly increased in recent years. The market for 3D-printed medical devices is expected to grow as a result of these research and funding initiatives, which are expected to hasten the development of 3D printing technologies and products. In September 2020, the U.S. company nTopology raised $40 million in funding for the development of the nTop software platform for additive manufacturing methods. At the University of Huddersfield, a new generation of electron-beam additive manufacturing (EBAM) printer was developed with the help of USD 2.6 million in funding from Innovate U.K. in March 2019. (U.K.).

Digital Manufacturing Innovation gives Opportunity for Exponential Growth

With the aim of improving clinical workflow, there has been a significant advancement in the digitization of dental and medical procedures over time. Traditional dental and surgical procedures are being replaced by digital versions. Using computer-controlled processes, direct digital manufacturing is the process of making a physical object directly from a digital design. As 3D printing technology advances, direct digital manufacturing is becoming more and more popular in comparison to traditional manufacturing processes. Because it reduces the time between design and production, does away with the need for tooling, and increases output, it has a unique set of advantages.

Report Scope

Report Metric	Details
Market Size	USD 9.79 billion by 2031
CAGR	16.1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} (2023-2031)
Historical Data	2020-2021
Base Year	2022
Forecast Period	2023-2031
Forecast Units	Value (USD Billion)
Report Coverage	Revenue Forecast, Competitive Landscape, Growth Factors, and Trends
Segments Covered	Component, Technology, Application
Geographies Covered	North America, Europe, Asia-Pacific, LAME and Rest of the World
Key Companies Profiled/Vendors	3D Systems Corporations, Bio3D Technologies, Cyfuse Medical K.K., EnvisionTEC, Materialise NV, Organovo Holdings, Inc., Oxford Performance Materials, Inc., SLM Solutions Group AG, and Stratasys Ltd.
Key Market Opportunities	The Surge of Digital Manufacturing
Key Market Drivers	Rising Investment in 3D Printing Increasing Cases of Osteoarthritis

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Regional Analysis

North America is the most significant shareholder in the global 3D printing medical devices market and is expected to grow at a higher CAGR due to the region’s growing interest in 3D-printed medical devices and the rising demand for those devices. For instance, a U.S.-based service company called FORECAST 3D recently announced the purchase of 12 H.P. Jet Fusion 3D printers with the ability to provide full-run 3D manufacturing. In addition, the University of California (UCSF) and the Chinese 3D printer manufacturer INTAMSYS collaborated to launch the 3D printed orthopedics research initiative with technically advanced, reasonably priced orthopedic implants in June 2018.

Due to technological advancements, a strong and stable R&D environment, and innovation, Europe is expected to experience significant growth in the 3D printing medical devices market. Adidas and Carbon, a Silicon Valley 3D printing company, announced their collaboration in April 2017 to produce the “Futurecraft 4D” shoes, which feature 3D printed soles made using digital light synthesis technology. In July 2022, the 3D-printed bone graft manufactured by the medical device company Cerhum received approval for use in patients throughout Europe. MyBone is the first commercially available 3D-printed bone graft that has been authorized under the Medical Device Regulation 2017/745, according to reports. Additionally, it has obtained ISO 13485 certification. Thus, orthopedic and maxillofacial surgeons will now have access to the patient-specific bone graft across the continent.

During the anticipated period, the market for 3D-printed medical devices is likely to expand significantly in Asia Pacific. According to the E.U., as a result of government initiatives to promote the technological potential of orthopedics, the value chain for 3D-printed medical devices is gaining momentum. Additionally, nations like India and China are becoming more well-known due to factors like a rapidly aging population, a growing demand for cutting-edge healthcare, and others. In March 2022, Zoriox Innovation Labs will produce implants for facial reconstruction in India using 3D printing technology. In order to provide a 360-degree solution for facial reconstruction and related needs, a team of surgeons, dentists, mechanical engineers, biomedical engineers, software engineers, graphic designers, prosthetists, and anatomists collaborate at Zoriox Innovation Labs.

With several vendors expanding their operations and the implementation of favorable regulations in Latin America, the Middle East, and Africa, the LAMEA region is anticipated to experience moderate market growth. Using a 3D printed model of arteries to map out how to safely navigate the blood vessels, hospitals in Dubai have made it mandatory for doctors to use 3D printing to operate successfully on patients who have suffered a cerebral aneurysm in four veins.

Key Highlights

The global 3D printing medical devices market size was valued at USD 2.55 billion in 2022. It is projected to reach USD 9.79 billion by 2031, growing at a CAGR of 16.1{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} during the forecast period (2023-2031).
Based on components, the global 3D printing medical devices market is bifurcated into Printers, Materials, and Software & Services. The software and services segment is the highest contributor to the market.
Based on technology, the global 3D printing medical devices market is bifurcated into electron beam melting, laser beam melting, selective laser sintering, photopolymerization, direct metal laser sintering, and others. The laser beam melting segment is expected to grow at a higher CAGR during the forecast period
Based on application, the global 3D printing medical devices market is bifurcated into orthopedic & cranial implants, dental restorations, surgical instruments, tissue fabrication, and custom prosthetics.
North America is the most significant shareholder in the global 3D printing medical devices market and is expected to grow at a higher CAGR during the forecast period.

The global 3D Printing Medical Devices market’s major key players are

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Global 3D Printing Medical Devices Market: Segmentation

By Component

Printers
Materials
Software & Services

By Technology

By Application

By Regions

North America
Europe
Asia-Pacific
LAMEA

Market News

In May 2022, Organovo Holdings Inc announced its 3D tissue model for Crohn’s disease.
In October 2022, Cyfuse Medical K.K got approval for listing on Tokyo Stock Exchange.

News Media

3D Printing an Emerging Technology for Dentistry and Dental Surgery

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International Men’s Day 2022: Tips for men to reduce prostate cancer risk | Health

Prostate cancer occurs when the cells in the prostate gland which is found only in males start to grow out of control. Prostate gland is located just below the bladder and in front of the rectum and makes some of the fluid that is part of semen. Prostate cancer is the second most common cancer in men worldwide and unfortunately its incidence is increasing in India as it has moved from being the eighth most common cancer in males in 1990s to the third rank by 2015. It is the fifth leading cause of cancer-related deaths among men worldwide. (Also read: Prostate Cancer: Causes, symptoms, risk factors and treatment)

Can one prevent the prostate cancer? There are certain risk factors like age, race and genetics that cannot be modified while lifestyle factors can be modified to an extent.

“There is no proven strategy to prevent prostate cancer. Prostate cancer is primarily a disease of aging. As you get older, your chances of developing prostate cancer increase. Race and genetics also play a significant role. If your father, brother or multiple blood relatives had prostate cancer, you are more likely to get it, too. Worldwide African Americans have increased risk of having prostate cancer. These risk factors of age, race and genetics are non-modifiable risk factors. Preventing prostate cancer might be difficult if you have these risk factors, but screening early and often can help ensure that if you do get cancer, it’s diagnosed and treated as soon as possible,” says Dr Shrikanth Atluri, Consultant Uro-Oncologist and Robotic Surgeon within the division of Surgical Oncology (Cancer Surgery) at Sir HN Reliance Foundation Hospital, Mumbai.

LIFESTYLE FACTORS THAT INCREASE RISK OF PROSTATE CANCER

A wide variety of environmental or dietary factors may be associated with the risk of developing prostate cancer.

“Poor eating habits and diets that heavily rely on fats and animal proteins can cause DNA damage and lead to cancer. Even men who are already at greater risk due to age, race or genetics can reduce their chances of developing prostate cancer by adopting healthy diets and lifestyles. Improve your diet by reducing fat, charred meat, eating more fruits and vegetables, maintain healthy weight, regular exercise, stop smoking and drinking are the lifestyle changes to be adopted to which may help in reducing the risk of having a prostate cancer,” says Dr Atluri.

Dr. Preetam Kumar Jain – Senior Consultant Oncologist and Hematologist, Masina Hospital, says that although there is no definite method to reduce the risk of prostate cancer and certain risk factors are irreversible, there are studies that reversible risk factors when controlled can help in reducing the risk of prostate cancers. Dr Jain suggests some tips.

TIPS TO REDUCE RISK OF PROSTATE CANCER

– Healthy lifestyle: One should stay away from unhealthy food, eat nutritious food and sleep on time.

– Regular exercise: One should exercise 20 minutes a day and 5 days a week.

– Avoid Obesity: Staying physically active and eating healthy food can help. Weight problems should be addressed early.

– Maintain Body mass index

– Eating diets rich in antioxidants such as fruits and vegetables can help reduce risk of prostate cancer.

– Do not go overboard with dairy products and calcium content.

– Avoid diet containing red and processed meats.

– Some studies say that drugs that inhibit 5 alpha reductase inhibitors and aspirin may reduce the reduce the risk of prostate cancer and mortality. However, they are not FDA recommended as of now.

“It is also important to identify early symptoms of prostate related problem. Symptoms like frequent micturition, incomplete voiding of urine, nocturia, could be possible signs of prostate related problems. If you have a family history of prostate cancer, then the subsequent generation members are at a risk of prostate cancer, at least a decade earlier. Knowing this genetic susceptibility, you may have to remain alert as your age advances. New genetic studies are in the pipeline for better understanding of the prostate cancer. Mutation analysis like BRCA and HRR testing are now being recommended in patients with prostate cancer,” says Dr Jain.

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Does bread have cholesterol? White bread, rye and more

Bread does not generally contain cholesterol, but varieties that include animal products, such as milk and butter, do contain cholesterol. White bread and other types made from refined grains may raise a person’s cholesterol levels.

Bread is a staple food for many different cultures, and there are hundreds of unique types.

Some varieties of bread contain dietary cholesterol, while others may raise LDL, or “bad”, cholesterol levels in the blood. However, studies suggest dietary cholesterol has little effect on blood cholesterol levels.

This article further explains bread and cholesterol, the role of whole grains in managing cholesterol, and how people can follow a healthy diet to lower the risk of heart disease.

The cholesterol content of bread depends on certain factors.

There are two types of cholesterol: one in the blood and another in food, known as dietary cholesterol.

Most bread is made with flour, water, and yeast and contains no cholesterol. But some types are made using animal products with high levels of saturated fats, which often contain cholesterol.

Additionally, bread made from white or refined grains can raise LDL cholesterol levels. We explore this in further detail below.

Saturated and trans fats

Some varieties of bread contain animal products such as milk, butter, or eggs, which contain saturated fat.

According to the Centers for Disease Control and Prevention (CDC), foods higher in saturated fats usually contain lots of cholesterol.

However, dietary cholesterol has little effect on a person’s blood cholesterol. Saturated and trans fats in foods have a greater effect on increasing a person’s cholesterol levels.

Learn more about types of fat.

Below is a table of the approximate cholesterol and saturated fat content of various types of bread.

White bread

White bread contains refined bread flour — a process that removes the bran and germ to give the flour a finer texture.

However, the process also removes essential nutrients such as:

Therefore, manufacturers add in vitamins by “enriching” refined flour but do not replace the fiber.

This lack of fiber means that white bread is less likely to make a person feel full and more likely to overeat. Refined grains, also known as refined carbohydrates, are also digested more quickly by the body, which can raise blood sugar levels.

A person with high blood sugar levels is more likely to have higher LDL cholesterol levels and lower HDL, or good, cholesterol.

Learn more about the difference between LDL and HDL cholesterol.

Types of white bread include:

ciabatta
white pitta bread
white baguettes
focaccia
white sourdough
white wheat tortillas
flatbread
white sandwich loaf

Whole grain bread contains all the nutrients and fiber from grains, making it a good dietary fiber source.

The CDC states that fiber prevents the body from taking in some fat and cholesterol. This can lower triglyceride levels — another type of fat in the blood — and cholesterol levels and reduce the risk of heart disease.

A 2019 study also found that replacing white bread, which has a high glycemic index (GI) with wholemeal bread, which has a low GI, for breakfast slowed the body’s glycemic response. Research links higher blood sugar levels with high levels of LDL cholesterol.

Types of whole grain bread include those made with the following:

whole wheat
whole barley
brown rice
whole grain oats
rolled oats
sprouted grains
whole rye
multi whole grains

Learn more about what makes whole grains so healthy.

Here are some answers to common questions about bread and cholesterol.

Does rye bread have cholesterol?

Rye bread does not have dietary cholesterol, as it does not contain butter or other animal products.

Does gluten-free bread have cholesterol?

Gluten-free bread made with animal products, such as milk, butter, or eggs, may contain some cholesterol.

Learn more about the best gluten-free bread.

Bread is a staple of many people’s diets worldwide. While most types of bread do not contain dietary cholesterol, some may include animal products high in saturated fats. Foods that are high in saturated fats are usually high in dietary cholesterol.

However, studies have shown that dietary cholesterol has little effect on blood cholesterol levels. Saturated fat is more likely to increase LDL cholesterol levels in our blood, along with refined carbohydrates such as white bread.

People should try to increase their fiber intake, including eating more whole grain bread types, which can help to lower cholesterol levels. This can reduce a person’s risk of stroke and heart attack.