Todd Neale, Senior Staff Writer, MedPage Today
Published:
September 29, 2011

 

 

The listeriosis outbreak stemming from tainted cantaloupes has sickened at least 72 individuals, killing 13 of them, according to the CDC.

“This is the deadliest outbreak of a foodborne disease that we’ve identified in more than a decade,” said CDC director Thomas Frieden, MD, MPH, on a conference call with reporters Wednesday.

Overall, 18 states have been affected as of Monday, with four different strains of Listeria monocytogenes implicated. State and federal health officials are continuing to investigate other listeriosis cases across the country that might be related to the outbreak.

Most of the infected individuals are older than 60 or have conditions that weaken the immune system, the CDC said in its most recent update. All but one of the patients with information on hospitalization have required admission.

The 13 confirmed deaths have occurred in New Mexico (four), Colorado and Texas (two each), and Kansas, Maryland, Missouri, Nebraska, and Oklahoma (one each). That figure is more than triple the four deaths reported last week.  Three additional deaths could be related to the contaminated cantaloupe melons, the BBC reports.

Early on in the investigation, the Colorado Department of Public Health and Environment identified cantaloupes grown in the Rocky Ford region of the state as the likely source of the outbreak, which is unusual because Listeria has not previously been seen in cantaloupe.

Within days, the department pinpointed the exact source as whole cantaloupes grown at Jensen Farms’ production fields in Granada, Colo., which was later confirmed by the FDA.

The FDA said it is working with other agencies to determine how the contamination of the facility occurred, with consideration given to all environmental factors on the farm, including possible animal intrusions, water quality, and growing practices.

On Sept. 14, Jensen Farms recalled its Rocky Ford brand whole cantaloupes, reporting distribution to 17 states. In its update, the CDC said that the cantaloupes were shipped to at least 25 states, with the possibility of further distribution.

Even though the cantaloupes have been recalled, the CDC said that it expects to receive reports of more cases related to the outbreak through October because individuals can develop listeriosis up to two months after coming into contact with the bacteria.

The shelf life of cantaloupe is about two weeks, and all of the affected product was shipped from July 29 to Sept. 10.

The FDA said that it is collaborating with state health officials to check retail stores, wholesalers, and distributors to make sure they know about the recall and that they have taken steps to inform customers and remove affected product from shelves.

The agency said that consumers should throw away any of the recalled cantaloupes from Jensen Farms and should not try to wash the bacteria off of the fruit.

he CDC recommended that people at high risk for listeriosis — including older adults, immunocompromised individuals, and pregnant women — should not eat Rocky Ford cantaloupes from Jensen Farms, and that other individuals should not eat those cantaloupes if they want to reduce their risk of Listeria infection.

The agency noted that the bacteria can grow both at room temperature and in the refrigerator.

“For the public, it’s important to know that if you know the cantaloupe that you have is not [from] Jensen Farms, then it’s okay to eat,” Frieden said, “but if you’re in doubt, then throw it out.”

According to the CDC, there are about 800 reported cases of Listeria infection each year in the U.S., with three or four outbreaks. Typical sources include deli meats, hot dogs, and Mexican-style soft cheeses made with unpasteurized milk, although produce — including sprouts in 2009 and celery in 2010 — has been implicated as well.

Frieden said over the past decade there have been about 10 outbreaks of foodborne illness in which cantaloupes were the definite vehicle for infection, seven involving Salmonella and three involving norovirus.

He added that the number of multistate outbreaks of foodborne illness in general have increased substantially in recent years.

“This is a reflection at least of better quality monitoring and perhaps also of the increasing complexity and centralization of the food supply,” he said. “It’s not that food is getting riskier, but we’re getting better at identifying problems that have probably been there for a long, long time.”

FDA commissioner Margaret Hamburg, MD, added that “these kinds of outbreaks are a powerful reminder that, despite the fact that we have one of the safest food supplies in the world, it does remain vulnerable to contamination, and the American people remain vulnerable to foodborne illness.”

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Listeria monocytogenes with flagella

 

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New York Times:

LISTERIA Q & A

 

 

 

Q&A: Key Answers About Listeria in Fruit

 

On September 14, 2011, the FDA warned consumers not to eat cantaloupes shipped by Jensen Farms from Granada, Colorado due to a potential link to a multi-state outbreak of listeriosis. At that time Jensen Farms voluntarily recalled cantaloupes shipped from July 29 through September 10, and distributed to at least 17 states with possible further distribution. The CDC reported that at least 22 people in seven states had been infected as of September 14.[16] On September 26, the CDC reported that a total of 72 persons had been infected with the four outbreak-associated strains of Listeria monocytogenes which had been reported to the CDC from 18 states. All illnesses started on or after July 31, 2011 and by September 26, thirteen deaths had been reported: 2 in Colorado, 1 in Kansas, 1 in Maryland, 1 in Missouri, 1 in Nebraska, 4 in New Mexico, 1 in Oklahoma, and 2 in Texas.

Health officials say as many as 16 people have died from possible listeria illnesses traced to Colorado cantaloupes, the deadliest food outbreak in more than a decade. The Centers for Disease Control and Prevention said that 72 illnesses, including 13 deaths, are linked to the tainted fruit.

Some questions consumers may have about listeria in cantaloupes.

Q: What is listeria?

A: Listeria is a hardy bacteria found in soil and water that can be carried by animals. It is often found in processed meats because it can contaminate a processing facility and stay there for a long period of time. It is also common in unpasteurized cheeses and unpasteurized milk. It is less common in produce like cantaloupe, but there have been a couple of other listeria outbreaks in fruits and vegetables in recent years. When a person contracts the disease, it can cause fever, muscle aches, gastrointestinal symptoms and even death. One in five people who have listeria can die.

Q: Am I at risk?

A: Listeria generally only affects the elderly, people with compromised immune systems, pregnant women and newborns whose mothers were infected before birth. The median age of victims in this outbreak is 78 years old. Healthy, younger adults and most children can usually consume listeria with no ill effects or mild illness.

Q: So can I eat cantaloupe?

A: You should avoid cantaloupe from Jensen Farms, the Colorado grower that distributed the tainted fruit.

Q: How do I know if I have a cantaloupe from Jensen Farms?

A: The recalled cantaloupe may be labeled “Colorado Grown,” ”Distributed by Frontera Produce,” ”Jensenfarms.com” or “Sweet Rocky Fords.” It may also be labeled “USA.” Not all of the recalled cantaloupes are labeled with a sticker, the Food and Drug Administration said, so it may be hard to tell. Neither the government nor Jensen Farms has released a list of retailers who sold the fruit, so health officials advise consumers ask retailers about the origin of their cantaloupe.

Q: I think I may have had one of the contaminated cantaloupes in my home. But I’m not sure. What should I do?

A: The government’s motto is “when in doubt, throw it out.” And if you think you had tainted fruit in your home, clean and sanitize all surfaces it may have touched.

Q: I scrub all of my fruits and vegetables before I eat them. So I am okay, right?

A: Scrubbing is never a bad idea, but it may not rid produce of all contaminants, especially on cantaloupe which has a thick, rough skin with a lot of places for pathogens to hide. Health officials think people may have been sickened when people cut into their cantaloupes, bringing listeria on the outside of the fruit to the inside. If you think you may have a tainted cantaloupe in your house, the best recourse is to throw it out.

Q: It looks like the cantaloupes weren’t even shipped to my state. Should I still be concerned?

A: The FDA said Jensen Farms shipped to 25 states, but it may have been resold in other states. Illnesses have been discovered in several states where cantaloupes weren’t shipped, including in Maryland where a person died.

Q: Why have there been so many deaths?

A: Listeria is less well-known than other pathogens like salmonella and E. coli, which cause many more illnesses in tainted food every year. But listeria is more deadly. One in five people who contract it can die.

Q: When is this outbreak going to be over?

A: FDA and CDC officials said Wednesday that they expect the number of illnesses and even deaths to rise through October. Listeria has an incubation period of a month or more, so people who ate contaminated fruit last week may not see illnesses until next month.

 

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More about the bacterial genus, Listeria

 

 

Listeria monocytogenes grown on Biorad RAPID’L.Mono Agar

  • Listeria is a bacterial genus that contains six species. Named after the English pioneer of sterile surgery Joseph Lister, the genus received its current name in 1940. Listeria species are gram-positive bacilli. The major human pathogen in the Listeria genus is L. monocytogenes, which is usually the causative agent of the relatively rare bacterial disease, listeriosis. Listeria ivanovii is a pathogen of mammals, specifically ruminants, and has rarely caused listeriosis in humans.

Background

The first documented case of Listeria was in 1924. In the late 1920’s, two researchers independently identified Listeria monocyctogenes from animal outbreaks. They proposed the genus Listerella in honor of surgeon and early antiseptic advocate Joseph Lister; however, that name was already in use for a slime mold and a protozoan. Eventually, the genus Listeria was proposed and accepted.

The genus Listeria currently contains seven species: L. grayi, L. innocua, L. ivanovii, L. monocytogenes, L. murrayi, L. seeligeri, and L. welshimeri. Listeria dinitrificans, previously thought to be part of the Listeria genus, was reclassified into the new genus Jonesia.

Listeria can be found in soil, which can lead to vegetable contamination. Animals can also be carriers. Listeria has been found in uncooked meats, uncooked vegetables, fruit such as cantaloupes, unpasteurized milk, foods made from unpasteurized milk, and processed foods. Pasteurization and sufficient cooking kill listeria; however, contamination may occur after cooking and before packaging. For example, meat-processing plants producing ready-to-eat foods, such as hot dogs and deli meats, must follow extensive sanitation policies and procedures to prevent listeria contamination. Listeria monocytogenes is commonly found in soil, stream water, sewage, plants, and food. Listeria are responsible for listeriosis, a rare but potentially lethal food-borne infection. The case fatality rate for those with a severe form of infection may approach 25%. (Salmonella, in comparison, has a mortality rate estimated at less than 1%). Although listeria has low infectivity, it is hardy and can grow in temperatures from 4 C (39.2 °F) (the temperature of a refrigerator), to 37 C (98.6 °F), (the body’s internal temperature). Listeriosis is a serious illness, and the disease may manifest as meningitis, or affect newborns due to its ability to penetrate the endothelial layer of the placenta.

Pathogenesis

Listeria uses the cellular machinery to move around inside the host cell: It induces directed polymerization of actin by the ActA transmembrane protein, thus pushing the bacterial cell around.

Listeria monocytogenes, for example, encodes virulence genes that are thermoregulated. The expression of virulence factor is optimal at 37 degrees Celsius and is controlled by a transcriptional activator, PrfA, whose expression is thermoregulated by the PrfA thermoregulator UTR element. At low temperatures, the PrfA transcript is not translated due to structural elements near the ribosome binding site. As the bacteria infect the host, the temperature of the host melts the structure and allows translation initiation for the virulent genes.

Listeria monocytogenes is a Gram-positive, rod-shaped bacterium. It is the agent of listeriosis, a serious infection caused by eating food contaminated with the bacteria. The disease affects primarily pregnant women, newborns, and adults with weakened immune systems. Listeriosis is a serious disease for humans; the overt form of the disease has a mortality greater than 25 percent. The two main clinical manifestations are sepsis and meningitis. Meningitis is often complicated by encephalitis, a pathology that is unusual for bacterial infections.

Under the microscope, Listeria species appear as small, Gram-positive rods, which are sometimes arranged in short chains. In direct smears, they may be coccoid, so they can be mistaken for streptococci. Longer cells may resemble corynebacteria. Flagella are produced at room temperature, but not at 37 °C. Hemolytic activity on blood agar has been used as a marker to distinguish L. monocytogenes among other listeria species, but it is not an absolutely definitive criterion. Further biochemical characterization may be necessary to distinguish between the different listeria species.

As Gram-positive, nonsporeforming, catalase-positive rods, the genus listeria was classified in the family Corynebacteriaceae through the seventh edition of Bergey’s Manual. The 16S rRNA cataloging studies of Stackebrandt, et al. demonstrated that L. monocytogenes is a distinct taxon within the Lactobacillus-Bacillus branch of the bacterial phylogeny constructed by Woese. In 2001, the Family Listeriaceae was created within the expanding Order Bacillales, which also includes Staphylococcaceae, Bacillaceae and others. Within this phylogeny, there are six species of listeria. The only other genus in the family is Brochothrix.

Mechanism of infection

The majority of listeria bacteria are targeted by the immune system before they are able to cause infection. Those that escape the immune system’s initial response, however, spread through intracellular mechanisms and are, therefore, guarded against circulating immune factors (AMI).

To invade, listeria induces macrophage phagocytic uptake by displaying D-galactose in their teichoic acids that are then bound by the macrophage‘s polysaccharide receptors. Other important adhesins are the internalins. Once phagocytosed, the bacterium is encapsulated by the host cell’s acidic phagolysosome organelle. Listeria, however, escapes the phagolysosome by lysing the vacuole’s entire membrane with secreted hemolysin,now characterized as the exotoxin listeriolysin O. The bacteria then replicate inside the host cell’s cytoplasm.

Listeria must then navigate to the cell’s periphery to spread the infection to other cells. Outside the body, listeria has flagellar-driven motility, sometimes described as a “tumbling motility.” However, at 37 C, flagella cease to develop and the bacterium instead usurps the host cell’s cytoskeleton to move. Listeria, inventively, polymerizes an actin tail or “comet”,from actin monomers in the host’s cytoplasm with the promotion of virulence factor ActA. The comet forms in a polar manner and aids the bacteria’s migration to the host cell’s outer membrane. Gelsolin, an actin filament severing protein, localizes at the tail of listeria and accelerates the bacterium’s motility. Once at the cell surface, the actin-propelled listeria pushes against the cell’s membrane to form protrusions called filopodsor “rockets”. The protrusions are guided by the cell’s leading edge to contact adjacent cells, which then engulf the listeria rocket and the process is repeated, perpetuating the infection. Once phagocytosed, the listeria is never again extracellular: it is an intracytoplasmic parasite like Shigella flexneri and Rickettsia.

Epidemiology

The Center for Science in the Public Interest has published a list of foods that have sometimes caused outbreaks of listeria: hot dogs, deli meats, raw milk, cheeses (particularly soft-ripened cheeses like feta, Brie, Camembert, blue-veined, or Mexican-style “queso blanco”), raw and cooked poultry, raw meats, ice cream, raw vegetables, some fruit such as cantaloupe, raw and smoked fish, and the green lip mussel.

Prevention

Preventing listeria as a food illness requires effective sanitation of food contact surfaces. Alcohol is an effective topical sanitizer against listeria. Quaternary ammonium can be used in conjunction with alcohol as a food contact safe sanitizer with increased duration of the sanitizing action. Refrigerated foods in the home should be kept below 4 °C (39.2 °F) to discourage bacterial growth. Preventing listeriosis also can be done by carrying out an effective sanitation of food contact surfaces.

Modern relevance/future research

Listeria is an opportunistic pathogen: It is most prevalent in the elderly, pregnant mothers, and AIDS patients. With improved healthcare leading to a growing elderly population and extended life expectancies for AIDS patients, physicians are more likely to encounter this otherwise-rare infection (only 7 per 1,000,000 healthy people are infected with virulent listeria each year). Better understanding the cell biology of listeria infections, including relevant virulence factors, may help us better treat Listeriosis and other intracytoplasmic parasites. Researchers are now investigating the use of listeria as a cancer vaccine, taking advantage of its “ability to induce potent innate and adaptive immunity.”

  • Treatment

Antibiotics effective against listeria species include ampicillin, vancomycin (unclear effectiveness), ciprofloxacin, linezolid, azithromycin.

Mixtures of bacteriophages have also proven effective in the treatment of Listeria.

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Food Poison Alert

 

Food Poison Journal – Food poisoning outbreaks and litigation: surveillance and analysis

Presented By Marler Clark – The nation’s foremost law firm with a practice dedicated to representing victims of foodborne illness

Posted by Drew Falkenstein

 

 

 

Salmonella and cantaloupes

 

 

 

Salmonella and cantaloupe, and cantaloupe and other bugs like E. coli, have been bedfellows all too frequently. A 2005 article by Trevor Susslow, Linda Harris, and Tracy Parnell at UC Davis states that “[c]antaloupe has been associated with foodborne outbreaks involving Escherichia coli O157:H7 (DelRosario and Beuchat, 1995), Norovirus (Iversen et al.,1987), and numerous serovars of Salmonella, including Salmonella chester (CDC, 1991), Salmonella poona (CDC, 1991; FDA, 1991; California Department of Health Services, 2000, 2001, 2002), Salmonella oranienburg (Health Canada, 1998), and Salmonella saphra (Mohle-Boetani et al., 1999).

Common themes in these outbreaks were that the melons were cut and most had been subjected to temperature abuse. In some cases, melons were contaminated through inadvertent contact with raw meat (see Harris et al., 2003) or a human handler (Iversen et al., 1987), but in other cases, the contamination was thought to have been soil on the melon rind (Mohle-Boetani et al., 1999), packing house wash water, or shipping ice (Hedberg et al., 1994; Tauxe, 1997).

What are best consumer practices to reduce the risk of contaminating the meat of the melon by contact with surface bacteria?  Note that contamination of the meat can occur during cutting, so it is important to (1) simply avoid cantaloupe during an outbreak and (2) take measures to clean the entire melon before preparing it for consumption.  The same article by Parnell, Harris, and Susslow, says:

scrubbing with water resulted in reductions comparable to soaking in 200 ppm of total chlorine, while scrubbing in chlorine provided the greatest reduction.  However, in the absence of chlorine, Salmonella spread from inoculated to uninoculated surfaces. Washing cantaloupes in a common batch-water system is strongly discouraged for packinghouses, processors, foodservice, and home consumers.

In agreement with current recommendations, consumers and food service industries should scrub melons with a clean brush under running water. It is important that these instructions also include advice on cleaning and sanitizing brushes prior to and after preparation as using a contaminated scrub brush may negate the benefits achieved with washing. Brushes can be cleaned either by washing in the dishwasher with a hot cycle or by soaking in a 200 ppm total chlorine solution made with 45 ml household bleach (5% sodium hypochlorite)/l water

Amazon Chief Executive Jeff Bezos

 

 

 

FORBES.com, GoogleNews.com, by Brian Caulfield, September 29, 2011  —  Will Amazon‘s new tablet computer hurt the iPad? Maybe. Apple‘s 8th employee, Chris Espinosa, writing on his personal blog Wednesday, posed a much more interesting question: what does this mean for everybody else?

That’s because the real news Wednesday wasn’t Jeff Bezos‘ cheap tablet computer. It’s the next generation — or maybe last generation — browser, Silk, that will come with every Kindle Fire tablet.

Silk’s a next-generation browser because it relies on assistance from Amazon’s formidable cloud computing service, EC2, to crunch the web down to a manageable size and zap it content to tablet users.

It’s a last-generation piece of technology because it harkens back to the old client-server model of computing, with client software closely linked to code running on a powerful server that does all the heavy duty lifting.

And in exchange for all that lifting, Amazon is putting itself in between its users and the rest of the web. Are there privacy implications? Sure, but I doubt Amazon would do anything truly stupid with all the data it’s able to gather. So far the company is making right noises about usage data being “anonymous and stored in aggregate.

The competitive implications are more intriguing. How much data will Amazon be able to use about where its users — in aggregate, of course — shop? What they buy? What they spend?

It’s no surprise that the Kindle Fire puts Amazon’s movies, music, and electronic books in front of users. Apple does the same with the iPad. The real master stroke is how neatly Amazon has turned the World-Wide Web itself into just another app. Or as Chris Espinosa writes:

“Amazon now has what every storefront lusts for: the knowledge of what other stores your customers are shopping in and what prices they’re being offered there. What’s more, Amazon is getting this not by expensive, proactive scraping the Web, like Google has to do; they’re getting it passively by offering a simple caching service, and letting Fire users do the hard work of crawling the Web. In essence the Fire user base is Amazon’s Mechanical Turk, scraping the Web for free and providing Amazon with the most valuable cache of user behavior in existence.”

Fire isn’t just about beating competing retailers by offering a tablet computer they can’t get, at a price they can’t match. This might just be about using that tablet computer to get an edge when to comes to selling everything else, too.

 

Amazing Amazon

KINDLE FIRE OFFERS SILK BROWSER

 

 

Emmanuel Dunand/Agence France-Presse – Getty Images

The Kindle Fire has access to Amazon’s library of 18 million e-books, songs and movies and television shows, and can run Android applications that have been approved by Amazon.

 

 

FORBES.com, GoogleNews.com, September 28, 2011  —  A look at some of the major differences between Amazon’s just-announced tablet computer, the Kindle Fire, and Apple‘s popular iPad:

Price: The Kindle Fire, which connects to the Web over Wi-Fi networks, will cost $199 when it begins selling on Nov. 15. The iPad costs $499-$829, depending on storage capacity and its wireless capabilities.

Screen size: The Kindle Fire’s display measures 7 inches at the diagonal, while the iPad has a 9.7-inch display.

Software: The Kindle Fire runs Google Inc. ( GOOGnews people )’s Android software. The iPad uses Apple ( AAPLnews people )’s iOS software.

Storage: The Kindle Fire includes 8 gigabytes of internal storage, and free web-based storage for any digital content you get from Amazon, such as Kindle e-books, movies or music. The iPad includes between 16 gigabytes and 64 GB of storage space, depending on price.

Real-Time Quotes

09/28/2011 3:14PM ET

Thickness: The Kindle Fire is 0.45 inches thick; the iPad is 0.34 inches thick.

Weight: The Kindle Fire tips the scales at 14.6 ounces – slightly less than a pound – while the iPad weighs about 1.3 pounds.

Apps: Kindle Fire users will have built-in access to the Amazon Appstore, which includes thousands of free and paid games and apps. Apple currently offers more than 425,000 free and paid games and apps in its online App Store – more than 100,000 of which are tailored specifically for the iPad – including apps for Amazon.com ( AMZNnews people ) and the Kindle.

Camera: While the iPad has front and rear cameras for taking photos and video chatting, the Kindle Fire does not include a camera.

 

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Amazon Unveils Tablet That Undercuts iPad’s Price

 

Amazon CEO Jeff Bezos introduces the new Kindle Fire tablet in New York, on September 28, 2011. The Fire may pose the most serious threat to Apple’s iPad2.Emmanuel Dunand /AFP/Getty Images

 

 

The New York Times, September 28, 2011, by Jenna Wortham  —  Seeking to stake a claim in the tablet computer market alongside Apple and Samsung, Amazon.com on Wednesday revealed plans to begin selling a color touch-screen tablet.

 

 

 

The Kindle Fire has access to Amazon’s library of 18 million e-books, songs and movies and television shows, and can run Android applications that have been approved by Amazon.

 

Named the Kindle Fire, the device has a 7-inch touch screen, weighs 14.6 ounces and is outfitted with a dual-core processor. But the most important feature may be the price. At $199 the Fire is less than half the price of the Apple iPad, which starts at $499. It is the first tablet from a major company to seriously undercut the iPad in price.

Jeffrey P. Bezos, Amazon’s founder and chief executive, who showed off the Fire on stage at a news conference in Manhattan, said it was meant to build on the popularity of the company’s e-readers and appeal to a broader audience that also wants to browse the Web and stream music, movies and video. The device has access to Amazon’s library of 18 million e-books, songs and movies and television shows, and can run Android applications that have been approved by Amazon.

There is also a newsstand for users who want to subscribe to magazines, including Cosmopolitan, Vanity Fair, Wired and Glamour.

“We’re building premium products at non-premium prices,” said Mr. Bezos. “We are determined to do that.”

Mr. Bezos also introduced a speedy custom-built mobile browser, called Amazon Silk, which he said was “cloud-accelerated,” combining Amazon’s computing cloud with the Kindle Fire device. “It’s truly a technical achievement,” he said.

Amazon plans to begin taking preorders for the Fire on its Web site immediately, and they will start shipping Nov. 15. Mr. Bezos said the company was “making many millions of these.”

The Kindle Fire includes a free cloud-based storage system, meaning that no syncing with cables is necessary. Mr. Bezos seemed to take a swipe at Apple, saying, “That model that you are responsible for backing up your own content is a broken model.”

This first model of the Fire sends and receives data only over Wi-Fi, not cellular networks. Like the iPad’s screen, the screen on the Fire has so-called in-plane switching technology, meaning that unlike some LCD screens it can be viewed from a variety of angles, not just straight on. Mr. Bezos also introduced several new e-readers, including the Kindle Touch, a lightweight version of its current Kindle models, with the addition of infrared touch features to the black-and-white display. The Touch, which costs $99, has no buttons, and users navigate by tapping the sides of the screen. The device is available for preorder beginning Wednesday and will start shipping Nov. 21. Mr. Bezos showed off a version of the Kindle Touch with 3G wireless connectivity, for $149.

In addition, Mr. Bezos showed off a new, nontouch-screen Kindle that he said was 18 percent lighter than the Kindle 3, included a faster processor and would sell for $79. It will begin shipping immediately, he said.

“We have many customers who tell us they don’t want touch,“ Mr. Bezos said. “We’re going to sell many millions of these.”

The Kindle Fire has its work cut out for it. Apple has secured a strong lead in tablets, selling more than 29 million iPads in the product’s first 15 months on the market. Its competitors have been less successful. For example, Research in Motion, maker of the BlackBerry line of smartphones, said it shipped only 200,000 of its own rival to the iPad, the PlayBook, in three months.

Amazon will also be competing with the Nook, Barnes & Noble’s popular color e-reader. Many expect the Nook to get an upgrade later this year.

However, Amazon has an ace up its sleeve that other tablet makers do not, in that the Kindle Fire will offer Amazon’s full spread of digital content, said Michael Gartenberg, an analyst with Gartner who follows the consumer electronics industry.

“Amazon has already nailed the hardest part of the equation: the content,” he said.

Early sales estimates for the Kindle Fire reach as high as five million.

“The tablet market right now is easily defined as Apple and everyone else,” said Mr. Gartenberg. “There is certainly room for another player, and a well-executed device from Amazon could do well.”

 

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Now a Word from Master Inventor/Marketer, Jeffrey P. Bezos

 

 

Jeff Bezos unveils the Kindle Fire at a New York City press event, yesterday.

 

 

Amazon.com, September 28, 2011  —  There are two types of companies: those that work hard to charge customers more, and those that work hard to charge customers less. Both approaches can work. We are firmly in the second camp.

We are excited to announce four new products: the all-new Kindle for only $79, two new touch Kindles – Kindle Touch and Kindle Touch 3G – for $99 and $149, and a new class of Kindle – Kindle Fire – a beautiful full color Kindle for movies, TV shows, music, books, magazines, apps, games, web browsing and more, for only $199.

These are high-end products – the best Kindles we’ve ever made. Kindle and Kindle Touch have the most-advanced E Ink display technology available, and the 3G Kindle Touch adds free 3G wireless – no monthly fees and no annual contracts. Kindle Fire brings everything we’ve been working on at Amazon for 15 years together into a single, fully-integrated experience for customers – instant access to Amazon’s massive selection of digital content, a vibrant color IPS touchscreen with extra-wide viewing angle, a 14.6 ounce design that’s easy to hold with one hand, a state-of-the-art dual core processor, free storage in the Amazon Cloud, and an ultra-fast mobile browser – Amazon Silk – available exclusively on Kindle Fire.

We are building premium products and offering them at non-premium prices.

Thank you for being a customer,

Jeff Bezos
Founder & CEO

p.s. – Kindle Fire has a radical new web browser called Amazon Silk. When you use Silk – without thinking about it or doing anything explicit – you’re calling on the raw computational horsepower of Amazon EC2 to accelerate your web browsing. If you’re curious, watch this short video to learn more about how it works.

 

 

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Two incomparable geniuses duke it out…………..Bezos v Jobs

 

More On Kindle Fire v iPad

 

 

By Nilay Patel, September 28, 2011  —  It wasn’t overly explicit, but Jeff Bezos took a pretty big shot at Apple and the iPad this morning while introducing the new Kindle Fire: he flashed a photo of Apple’s white USB cable, called syncing and backup a “broken model,” and went on to emphasize the Fire’s Whispersync cloud storage capabilities. The line and photo drew a big laugh, but it also underlined a subtle message within Bezos’ whole presentation: the Kindle Fire is going to be the first hugely successful competitor to the iPad, and Amazon knows it. Hell, by the end of it all Bezos subtly hinted that Amazon would sell out of the “many millions” it was planning to make, and he’s almost certainly right. Amazon’s strategy of “premium products at non-premium prices” is a great one, and the Fire’s $199 price tag is extremely compelling, especially given the general quality of the hardware and the wealth of content available to Fire owners from Amazon’s various services.

But while the Fire and the iPad will almost certainly be the head-to-head comparison for most tablet buyers in the near future, I think Amazon made an even bigger decision about competing with the iPad that went unsaid during today’s presentation: the Fire is almost completely geared around content consumption, not creation. It’s remarkable, actually — we didn’t even see the Fire’s email app today. That’s in stark contrast to the iPad launch, during which we were treated to interminable demos of not only the email client, but also the iWork suite; Apple took great pains to emphasize the iPad’s productivity capabilities. In contrast, all of the Android apps Amazon demo-ed on the Fire today were… games.

 

 

Of course, it makes perfect sense for Amazon to focus on delivering media and entertainment to consumers — the company is first and foremost a store, after all, and it’s naturally playing to its strengths. But in many ways the company is neatly sidestepping one of the central questions about next-generation tablets like the iPad: are they actually credible laptop replacements, or are they just for fun? The answer to that question is pretty important when the price of entry is $499, but it’s almost irrelevant for the $199 Kindle Fire – Amazon is nearing impulse purchase territory, the same territory that sold hundreds of thousands of $99 TouchPads and sells $114 Kindles day in and day out. It’s easy to sell pure fun.

Who cares about productivity when there are 18 million songs, books, movies and TV shows to be had… and you can play Angry Birds?

And it’s not just that all of the Fire demos today were about watching video or playing games — it’s that the Fire’s custom variant of Android almost guarantees it’ll never be compatible with Honeycomb or Ice Cream Sandwich Android apps that are actually built for tablet use. One of the strongest early criticisms of the iPad was that it was merely a big iPod touch — criticism that quickly faded as developers took rapid advantage of the increased screen resolution and built an entirely new class of tablet applications. In contrast, the Kindle Fire is now and may always be little more than a big Android phone — but unlike, say, the Galaxy Tab 7, it’s a big Android phone intimately connected with the biggest and best content store in the history of the world. Who cares about productivity when there are 18 million songs, books, movies and TV shows to be had… and you can play Angry Birds? The Kindle Fire isn’t the first serious iPad competitor because it can outdo the iPad — it’ll compete with the iPad because it does far less.

 

 

A few months ago, Steve Jobs famously called traditional computers “trucks” in comparison to his small, sleek iPad. It was an amusing and prescient metaphor, and it’s one that works just as well to describe the Kindle Fire: the iPad might be a car, but Amazon went ahead and built a motorcycle.

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Kindle Fire will prime the pump for Amazon Video

 

 

 

gigaom.com, by Ryan Lawler, September 28, 2011  —  Amazon unveiled its Kindle Fire tablet, yesterday, Wednesday Sept 28, announcing what is expected to be the first widely adopted tablet based on Android. The Kindle Fire not only marks the first real competition to Apple’s iPad, but could also position Amazon’s Prime Instant Videos as a real threat to Netflix.

Priced at just $199, the new 7-inch Kindle Fire will likely sell millions of units as soon as they it’s available, which would be unprecedented demand for an Android-based tablet. But just as importantly, each new tablet comes with a 30-day free subscription to Amazon Prime, which means millions of new users will immediately have access to the company’s Prime Instant Videos service.

While it’s unclear how many of those users will choose to subscribe to the $79 a year Amazon Prime service after the free trial ends — or how many Kindle Fire customers are already subscribers — the packaging of a free video service on the tablet has the potential to be a game changer in the streaming video world. Until now, even those who subscribe to Amazon Prime might not be aware that in addition to free shipping they also get free access to more than 11,000 movies and TV titles. But making Amazon Prime Instant Videos available in the palm of their hands (and free! for a limited time) could convert a number of users over to the service, which is looking like the first real threat to Netflix.

That threat couldn’t come at a worse time for Netflix, which is still dealing with the hangover of a poorly communicated price change and the re-branding of its DVD business. Netflix’s DVD service is now called Qwikster, and its operations will be run separately — a change that has baffled investors and has many subscribers looking for alternatives. Amazon Prime Instant Videos could be one alternative they latch on to.

At $79 a year, Amazon’s subscription video service is priced slightly below the $7.99 a month Netflix subscribers pay — although for many consumers it’s easier to commit to a lower monthly subscription cost than one big yearly payment. And the service is available on more than 300 connected devices. That’s not as large as Netflix’s footprint, but it’s close enough that consumers will likely have access to both services on newer connected TVs or Blu-ray players.

So will the Kindle Fire become the gateway drug to wider Amazon Prime Instant Videos usage? At the very least, it’ll get the service in the hands of millions of new potential subscribers. With Netflix on the ropes, that could be all the new subscription video service needs.

This device is all about media consumption and it underlines Amazon’s core strategy: keep people connected to their storefront 24/7/365. It’s really a brilliant strategy and why Rim could never compete. It also highlights what has truly made the iPad so successful: iTunes. People may hate the software but, like Kindle, it’s a platform of media management, sharing, and distribution.

 

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Amazon Kindle Fire vs. iPad 2 vs. Nook Color: by the Numbers

 

 

 

By Chris Ziegler, September 28, 2011  —  Clearly, Amazon’s just-announced Kindle Fire isn’t designed to compete head-to-head with the iPad 2 on specs alone, but that doesn’t mean consumers won’t be cross-shopping the two this holiday season — and that means a comparison is in order. Of course, Barnes & Noble’s Nook Color is a more direct competitor, so we’re throwing that in as well. Amazon’s value proposition for the Fire comes from its vast, deep ecosystem and a highly-customized build of Android that CEO Jeff Bezos suggests will rock our world, so you don’t want to read too deeply into these numbers — particularly when the iPad starts at $300 more — but it’s something to keep in mind.

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Amazon Kindle Fire: Pictures, Video, and Hands-on

 

 

Posted by Joanna Stern on September 28, 2011

It’s been a morning of Amazon surprises, but amongst all the news of cheaper and Touch Kindles, there’s no doubt that the brand new Kindle Fire has us the most intrigued. Unfortunately, Amazon is being quite strict about actually letting us touch the 7-inch tablet and that glorious IPS display, but hit the break for some live shots, video, and our early thoughts from watching the demos.

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Laughing all the way to the bank………………again

 

 

By Ryan Lawler  —  The cable industry is pulling an about-face on the issue of a la carte programming, due to increasingly expensive content rights and a weakening economy making bundles of network programming less affordable for the average consumer. That’s the word from Reuters, which reports that cable executives are negotiating with content providers and seeking regulatory relief in an effort to create smaller and more affordable bundles of programming.

Cable companies have historically fought against the idea of a la carte, arguing that allowing customers to choose channels on an individual basis would tear apart the value of the bundle. Since typical cable viewers only watch a handful of networks each, such a choice would mean that many niche networks with lower ratings wouldn’t survive if viewers didn’t choose to pay for them.

But cable companies have become stuck between a rock and a hard place: On one hand, media companies are demanding ever-higher carriage fees for their programming; on the other, consumers are being squeezed by a weak economy that threatens to make cable service unaffordable.

Programming costs have risen six to 10 percent a year over the last decade, Reuters reports. In part, the increase comes from broadcast networks demanding retransmission fees for channels that cable companies used to provide free. It also comes from media companies negotiating larger bundles of networks together, each of which generally comes with a higher price.

Those price increases are generally passed on to subscribers, but given the general economic environment, consumers are less able to pay than ever. In a research report issued earlier this month, Bernstein Research Senior Analyst Craig Moffett wrote that a large number of consumers have little discretionary income to spend on luxuries like cable:

After the necessities of food, shelter, transportation and healthcare each month, the bottom 40% of U.S. households have already exhausted all of their disposable income. There is nothing left for clothing… for debt service… for cable… or for phone.

The solution for cable companies may be to find ways to lower the cost of cable. As a result, they will likely need to offer lower-priced bundles of content, or to make some networks — like ESPN — available on an a la carte basis. Under the current model, all cable subscribers pay for each network, even if they don’t watch that content.

 

 

By Janko Roettgers  —   The BBC launched a prototype for a new form of electronic programming guide (EPG) today that replaces the traditional grid with automatically updated wish lists. That will allow users to organize their favorite TV and radio shows in the same way a TiVo handles subscriptions to TV shows.

Users of The Programme List can search for TV shows by title, actors, guests and other keywords and then add their favorite shows to a list to track all future air dates.

The list also contains links to episodes available online, and shows can be tracked even when on hiatus. The whole thing utilizes a very simplified UI, looking more like the unfinished work of a startup than something that a seasoned broadcaster would launch. The BBC’s R&D department explained in a blog post that the site is part of an effort to explore “how people remember programmes and how best to help them do that.”

That’s a laudable effort, but there’s something else that’s remarkable about the site: The Programme List is specific to U.K. TV and radio programming, but it’s not limited to shows aired by the BBC. Instead, it also lists content from the ITV, Channel 4 and Five.

Does that list sound somewhat familiar? If so, that’s probably because those networks were also partnering with the BBC for its failed effort to create a British counterpart to Hulu.com. The three broadcasters joined forces in 2007 to work on what was then called Project Kangaroo. However, the project was held up by regulators, and eventually killed in early 2009.

A project like The Programme List is avoiding similar scrutiny with a much more decentralized approach: It replaces a central repository with simple lists of air times and links to online resources, thus avoiding all the regulatory and licensing nightmares. In a way, that’s again very much the TiVo approach to content aggregation: Instead of licensing it from broadcasters, it simply empowers the consumers to find and watch content with less hassle.

 

FORBES.com, GoogleNews.com, by Meghan Casserly, September 27, 2011  —  For a growing number of professional women, food issues take center stage mid-life.

When coworkers would pop into Alison’s office at lunchtime to ask if she wanted take-out, the petite advertising executive would look up from the piles of papers on her desk and say sure, and ask for a turkey on rye. But instead of being eaten, the sandwich would be slipped away in a desk drawer until quitting time, and eventually make its way into the hands of her husband. “It’s extra,” she’d tell him nonchalantly. As if no one suspected a thing.

In reality, Alisonwasn’t eating anything at all. The 49-year old married Chicagoan was in the thralls of an on-and-off lifelong battle with anorexia that she could trace back to middle school. And everyone around her knew she was self-destructing—everyone except herself.

Not Your Daughter’s Eating Disorder

Eating disorders including anorexia nervosa, bulimia nervosa and more recently orthorexia have long been associated with body-conscious teenage girls. In recent years, however, treatment centers have seen a significant uptick in the number of women seeking treatment later in life—from 30s to 60s. The Renfrew Center, the country’s first and largest residential treatment network has reported an increase of over 42% in the past five years.

Now three years out of treatment, Alison is among the growing cohort of middle-aged professional women who have struggled with the painful and life-threatening condition. Once a self-professed “huge perfectionist” over-achiever (“I was in the office until the lights were turned out”), Alison left her planned career path for the slower pace of non-profit work upon completing treatment in 2008, something experts say that’s not uncommon. For patients, treatment centers and psychiatrists are able to pinpoint significant stress triggers that serve as catalysts for the dangerous disease. Not surprisingly, career can be at the top of the list.

Holly Grishkat, Ph.D., is the director of The Renfrew Center in Radnor, Penn., where she specializes in mid-life eating disorders and has seen career anxiety as one of several stress triggers that plague older women. But like most issues for working women, it’s not just the job, but the “juggle” that causes untold amounts of stress.

 

The Quest For Control

 

 

“It can be a high pressure job situation with a divorce, an illness, a child leaving home,” says Grishkat, listing the litany of life change that strike mid-life. “It could be work and an aging parent. For this age group there’s a lot of anxiety to ‘keep it together.’ They’re grappling for something to hold onto. For many, the eating disorder is something they have complete control over in an otherwise out-of-control time.”

“To this day when I feel my stress levels go up, my first thought is how to restrict [my diet],” says Karen, a 40-year-old human resource professional in a Texas-based financial firm. Out of treatment just three months, Karen is struggling with her health in the wake of severe anorexia that left her with biting stomach ulcers and an inability to have children. In three months she has been admitted back into the hospital on six occasions for medical problems related to the disease. “I’m on the right path,” she says of her recovery, but the behavioral pattern is hard to fight. “The minute stress hits me my first focus is how can I restrict? How quickly can I binge and purge?”

Like Alison, Karen’s life was career focused. “I have always been the first to volunteer for extremely stressful projects,” she says, “even to the point of making up projects so that I could immerse myself in work.” Similarly, she had struggled with food as a teen but never been diagnosed with an eating disorder until her 40s; experts agree that it’s rare for these conditions to make their first appearance in middle age. “Maybe they had body image issues when they were young, but it’s exacerbated by a stress later in life says Melissa Pennington Ph.D., the medical director of eating disorders at Texas Presbyterian Hospital.

When Karen’s husband became ill in 2008, she says she began grasping at straws, and food was her first attempt at control. As her weight began to drop dramatically, she continued to restrict, even in front of coworkers. “If I’ve eaten 25 cashews a day” she remembers thinking, “I’ve eaten.” An obsession with drinking water (15 to 20 16-ounce bottles during a workday) landed her in the emergency room where she learned she had flushed her system of all nutrients.

She eventually lost close to 100 lbs and was so weakened by a bout with bacterial pneumonia that she lost consciousness and awoke days later, intubated and hospitalized, suffering from nutrition-related seizures. “A month later I was finally able to accept that I need help.” It wasn’t until several weeks into treatment that she had the realization that would save her life. “We did an exercise where you had to spend a whole day in your bathing suit,” she recalls. “You had to stand in a 360 degree mirror and then draw what you saw. I started to cry—what have I done to myself? What have I allowed to take control of me?” For the first time Karen accepted that in her quest for control—to control her diet—she had in fact relinquished control of her own life to a vicious disease that was hell-bent on killing her.

Admitting Defeat—And Asking for Help

Both Karen and Alison attest that asking for help was the most difficult thing they had ever done.  “Especially in the finance world, in an office full of Type-A men, I never wanted to come across as weak,” Alison says. Rehabilitation experts concede that for older patients, admitting defeat and asking for help can be a major roadblock—but it can ultimately be their saving grace.

Unlike young patients who are generally brought in by concerned parents, most adult patients come in of their own volition. Whether as the result of a health crisis or simply a conscious decision that they are risking their lives, there’s generally a motivation among the older set, says Dr. Ira Sacker, a leading authority in eating disorder treatment in the U.S. “There’s much less denial.”

“The most difficult thing for a woman my age to do is to ask for help,” says Alison, who admits that in addition to the control aspect of her eating disorder she also struggled with body image issues about aging. “Someone would tell me, ‘60 is the new 30.’ And what I would hear was ‘When you’re 60, you’d better look 30.’” In the advertising industry where she worked at the height of her disordered eating, the fast-pace of technology and turnaround of employees left her self-conscious of her capability and appearance compared with younger female colleagues. “It was a recipe for disaster for me,” she says of her decision to leave advertising for the non-profit world. “Much as it took everything in my soul to say I needed help, it was horrifically difficult to look at my career and say ‘I can’t do this anymore.’”

In the three months Alison spent in treatment at The Renfrew Center—crying through meals, spending three weeks in a wheelchair because she was too weak to walk–she says the biggest struggle was learning a new way to identify. “I realized the business cards, career, status—all those things are second to my life. I used to equate my job title with my value and my worth an in conjunction with my eating disorder it was killing me. Three years later when people ask me ‘What do you do?’ it takes everything I’ve got not to answer ‘I live my life.’” Alison’s new career revolves around mentoring and support for other women struggling with eating disorders and addiction—another affliction she has overcome.

Karen has years to go until she reaches Alison’s level of recovery. Just three months out of an inpatient program, she’s still weighing her employment options while battling through daily reminders of her lowest times—force ulcers recently ruptured, making her home look “like a crime scene” and the occasional fall has left her prone to concussions in her still-weakened state. But by sticking to her doctor-prescribed meal plan she sees light at the end of the tunnel for both herself, physically and mentally. “I’m not 20, I can’t just bounce back. But every day I’m stronger. I may weigh less than my German Shepherd,” she laughs, “But I’m getting there.”

Far From Any Lab, Paper Bits Find Illness

 

Todd Heisler/The New York Times

BIG DEAL A nonprofit company produces diagnostic tests the size of a stamp.

 


By Todd Heisler, Nancy Donaldson, Soo-Jeong Kang, Lisa Iaboni and Nick Harbaugh  —  Small Fixes: Paper Diagnostics: Donald G. McNeil Jr., a science reporter for The New York Times explains a liver damage test that fits on a postage stamp and could cost less than a penny.

 

 

 

The New York Times, by Donald G. McNeil Jr, September 27, 2011, BOSTON — While other scientists successfully shrank beakers, tubes and centrifuges into diagnostic laboratories that fit into aluminum boxes that cost $50,000, George Whitesides had smaller dreams.

 

Todd Heisler/The New York Times

 

 

 

The diagnostic tests designed in Dr. Whitesides’s Harvard University chemistry laboratory fit on a postage stamp and cost less than a penny.

His secret? Paper.

His colleagues miniaturized diagnostic tests so they could move into the field with tiny pumps and thread-thin tubes. Dr. Whitesides opted for a more novel approach, reasoning that a drop of blood or urine could wick its way through a square of filter paper without any help.

And if the paper could be etched with tiny channels so that the drop followed a path, and if that path were mined with dried proteins and chemically triggered dyes, the thumbnail-size square could be a mini-laboratory — one that could be run off by the thousands on a Xerox machine.

Diagnostics for All, the private company Dr. Whitesides founded four years ago here in Boston’s Brighton neighborhood to commercialize his inspirations, has already created such a test for liver damage.

It requires a single drop of blood, takes 15 minutes and can be read by an untrained eye: If a round spot the size of a sesame seed on the paper changes to pink from purple, the patient is probably in danger.

Using paper in diagnostic tests is not entirely new. It soaks up urine in home pregnancy kits and blood in home diabetes kits. But Dr. Whitesides has patented ways to control the flow through multiple layers for ever-more-complex diagnoses. His test has proved more than 90 percent accurate on blood samples previously screened by the laboratory of Beth Israel Deaconess Medical Center, a Harvard teaching hospital, said Una S. Ryan, chief executive of Diagnostics for All.

“They should be even more accurate on fresh blood,” added Dr. Ryan, a biologist. Field tests in India are set for later this year.

The initial target audience is AIDS patients with tuberculosis who must take powerful cocktails of seven or more drugs.

Some drugs damage the liver, and deaths from liver failure are 12 times as common among African AIDS patients as among American ones, Dr. Ryan said, because current liver tests are expensive and require tubes of blood.

The paper test was developed with a $10 million grant from the Bill and Melinda Gates Foundation.The foundation and the British government just donated $3 million toward creating three more paper tests to help small farmers. One is for aflatoxin, a poison produced by mold that grows on corn, peanuts and other crops. A large dose can lead to liver cancer, but even small amounts eaten regularly can leave children stunted. Farmers who can prove their crops are mold-free can protect their families and get higher prices. But current tests cost $6 each, far more than farmers can afford. A paper test that works on water washed over the grain could be made for as little as 50 cents, Dr. Ryan estimated. Volume production could drive the cost down to pennies.

The second test checks for milk spoilage caused by bacteria. Many small dairy farmers belong to cooperatives in which they pool their milk, and one sick cow can contaminate a whole batch.

The current test detects just the acidity caused by the bacteria, which is not very specific and can be defeated by adding a base like lime. A cheap enough test would help the cooperative find the offending farmer, and the farmer find the diseased cow.

The third proposed test detects hormones released into the urine when a cow is pregnant. Currently, farmers have to either watch their cows for behavior changes or perform physical exams that can be dangerous because they require reaching deep into the cow’s rectum to palpate the uterus.

“Raising cows is how farmers build wealth,” said Patrick Beattie, head of global health operations at Diagnostics for All. “They need better tests.”

The company’s office here is nothing fancy. The space is sublet from a nanotechnology company in an office park where pride of place belongs to an Acura dealership. Half the lab is piled with high-tech junk abandoned by a previous tenant.

And for all the elegance of the thinking that went into them, the tests themselves are produced in a remarkably low-tech, low-cost fashion. A sheet of filter paper, cut by hand, is fed into an $800 Xerox office printer that uses melted black wax instead of toner. Exactly 132 tests, resembling big shirt buttons, fit on an 8 ½-by-11-inch sheet.

The sheet is then placed for a few seconds into a heating box — one executive called it “our $5,000 Easy-Bake oven” — to melt the wax deeper into the paper, creating the channels.

(Originally, Dr. Whitesides used a plastic that hardened in ultraviolet light, but wax is cheaper and faster.)

Reagents are spotted on by hand with a pipette — a tedious job, but the $100,000 machine that can automate it is not in the budget, Dr. Ryan said. Then the paper “buttons” are cut out by a computer-driven scalpel.

Multiple layers are made this way, then glued into a sandwich and laminated.

Finally, each batch is sealed into a foil envelope to keep out moisture and sunlight.

In an interview in his office in Harvard’s main chemistry building, Dr. Whitesides described the origins of his idea.

He began working in microfluidics 20 years ago when the Pentagon was seeking a “lab on a chip” that soldiers could carry to detect bio-warfare threats like anthrax and rabbit fever.

Because cost was less of an issue for the military, expensive polymers could be used.

“But that was too expensive for the developing world,” he said, “so I was thinking, ‘What’s the minimum-cost way of making patterns, of putting things into test zones?’ And what came to mind was newspapers and comic books. And that led to these paper diagnostics.”

Dr. Whitesides sees many possible advances. The liver-function test uses chemistry. The next generation will use immunology — for example, one design has dried antibodies attached to bits of paint that drift over a surface to which other antibodies are fixed. The paint making it through gives the color reaction.

After that, he plans to build something like the battery-powered glucose meter used by diabetics, but on a disposable chip, employing flexible circuits printed with metal-infused ink and light-emitting diodes less than a millimeter across.

He also envisions a chip that will count how many cells in a drop of blood have malaria parasites inside.

Multiplying DNA, a key part of tests for viruses, is a bigger obstacle, since that usually requires repeated heating and cooling.

“I don’t see us doing sequencing,” he said. “That’s still going to be done in an aluminum box. But we’re still a long way from getting to the end of what’s inventable.”

For now, Dr. Whitesides is eager to see his inventions prove their usefulness in the real world.

“I’m going to breathe a sigh of relief when somebody says, ‘We’ve used up the first 10,000 in our clinic, and we think they’re absolutely terrific. Send us another 50,000.’ ”

Eventually, Dr. Ryan explained, the goal is for Diagnostics for All, which is nonprofit, to wean itself off grant money by licensing its chip technology to commercial companies.

For example, she said, marathon runners might be able to touch a chip to their sweaty foreheads to see if their electrolytes are still in balance before they drink more water. Or Americans with high cholesterol taking statins, which can also cause liver damage, might routinely monitor their liver enzymes with a finger prick.

Markets like those could give the company an income stream that would go a long way toward supporting its research in Africa, Dr. Ryan said.

“Although,” she added, “there will be huge pushback from the lab companies, because that’s their bread and butter.”

‘POSTAGE STAMP’ LIVER TEST

Dr. George Whitesides’s paper diagnostic test assesses the level of aspartate transaminase in the blood. The enzyme, better known as AST, is released when liver cells break down.

1. A drop of blood is touched to the back of the square of paper. It first seeps through a membrane with pores that block the large red and white blood cells, letting through only the clear plasma.

2. The next layer contains two dried chemicals, one of which is cysteine sulfinic acid, which is chemically similar to aspartate, the amino acid that AST normally binds to. (These chemicals are available from lab supply houses.)

3. If AST is present, it binds to the two chemicals, causing a reaction that ultimately releases sulfite ions, SO3.

4. The next layer contains a methyl dye that is normally blue but turns colorless when sulfites attach to it. It is printed over a pink background, so the spot looks purple. If the layer changes to light pink, the blood contains dangerous levels of AST.

 

 

 

The World Economic Forum

 

 

The World Economic Forum is an independent international organization committed to improving the state of the world by engaging business, political, academic and other leaders of society to shape global, regional and industry agendas.

The World Economic Forum encourages businesses, governments and civil society to commit together to improving the state of the world. Our Strategic and Industry Partners are instrumental in helping stakeholders meet key challenges such as building sustained economic growth, mitigating global risks, promoting health for all, improving social welfare and fostering environmental sustainability.

A key part of the Forum’s activities is the creation of distinctive communities of Member and Partner companies as well as leaders from civil society for more informal opportunities for interaction.

 

 

Strategic Partners

The Strategic Partners community comprises a select group of 100 leading global companies representing diverse regions and industries selected for their alignment with the Forum’s commitment to improving the state of the world. These Partners believe in the power of multistakeholder interaction to drive positive change and work closely with the Forum to help shape the industry, regional and global agendas.

 

 

Industry Partners

Industry Partners are select Member companies of the World Economic Forum that are actively involved in the Forum’s mission at the industry level. With privileged access to the Forum’s multistakeholder networks and experts, partnership brings visibility and insight to strategic decision-making on the most important industry and cross-industry related issues. This access and insight allows Industry Partners to help lead positive change across the issues and engage in action to support corporate global citizenship.

 

 

Foundation Members

The World Economic Forum’s 1,000 Foundation Member companies are at the heart of all the Forum’s activities and their support is essential in helping find truly sustainable and global solutions to improve the state of the world. The typical Member company is a global enterprise ranking among the top companies within their industry and/or country. Member companies play a leading role in shaping the future of their industry and/or region and, as such, are recognized among their peers and in the broader public as one of the world’s leading companies.

 

 

Global Shapers

The Global Shapers Community will provide youth with a global platform to shape the future – integrating the personal, community and global dimension. Through the unparalleled convening power of the World Economic Forum, the Global Shapers Community is diverse in demographics, geographical areas and sectors. However, it is united by a common desire to channel the members’ tremendous energy and enthusiasm into building a more peaceful and inclusive world.

 

 

Global Growth Companies

The World Economic Forum’s Community of Global Growth Companies (GGC) was formed in 2007 to engage dynamic high-growth companies with the potential to be tomorrow’s industry leaders and to become a driving force of economic and social change. As of August 2011, 315 companies from over 60 countries had been admitted to the GGC Community.

 

 

Risk Response Network

The Risk Response Network (RRN) was launched in 2011 to provide private and public sector leadership with an independent platform to better monitor, prepare for, respond to and mitigate global and systemic risks. A unique, exclusive and trusted community, the RRN is strategically positioned to respond to a continuously evolving risk landscape by leveraging the World Economic Forum’s knowledge base, experience-sharing and stakeholder approach.

 

 

Technology Pioneers            

The World Economic Forum’s Technology Pioneers programme recognizes companies, normally in a start-up phase, from around the world that are involved in the design, development and deployment of new technologies, and hold promise of significantly impacting the way business and society operate.Technology Pioneers must demonstrate visionary leadership and show signs of being long-standing market leaders – their technology must be proven. Each year, hundreds of innovative companies from around the world are reviewed, with approximately 30 selected as Technology Pioneers in the following three categories: Information Technologies and New Media, Energy and Environment, Life Sciences and Health.

 

 

Schwab Foundation for Social Entrepreneurship

Social entrepreneurs drive social innovation and transformation in fields such as education, health, environment and enterprise development. They pursue poverty alleviation goals with entrepreneurial zeal, business methods and the courage to innovate and overcome traditional practices.

 

 

The Forum of Young Global Leaders

The Forum of Young Global Leaders is a multistakeholder community of exceptional young leaders who share a commitment to shaping the global future. Each year, the World Economic Forum identifies 200-300 extraordinary individuals worldwide. Together, they form a powerful international community that can dramatically impact the global future.

 

 

Global Agenda Councils

The Network of Global Agenda Councils study the foremost topics in the global arena. The Network of Global Agenda Councils consists of select, invitation-only groups on the key topics in the global arena. Each Council, comprised of 15-20 Members, serves as an advisory board to the Forum and other interested parties, such as governments and international organizations.

 

 

Women Leaders and Gender Parity

Through the Women Leaders and Gender Parity Programme, the World Economic Forum is committed to promoting women’s leadership and closing global gender gaps. The programme strives to increase the participation of women in the Forum’s activities by ensuring their involvement as members in communities and inviting women leaders to be active contributors to the global dialogue.

 

 

Global University Leaders Forum

The Global University Leaders Forum (GULF) is a community of leading university presidents. The community fosters collaboration between top universities in areas of significance for global policy and helps shape the agenda of the World Economic Forum.

 

 

What is Global Competitiveness?

 

 

The World Economic Forum’s Center for Global Competitiveness and Performance through its Global Competitiveness Report and report series, aims to mirror the business operating environment and competitiveness of over 140 economies worldwide. The report series identify advantages as well as impediments to national growth thereby offering a unique benchmarking tool to the public and private sectors as well as academia and civil society. The Center works with a network of Partner Institutes as well as leading academics worldwide to ensure the latest thinking and research on global competitiveness are incorporated into its reports.

 

The Global Competitiveness Report 2011-2012, comes out amid multiple challenges to the global economy and a continuing shift in the balance of economic activity away from advanced economies and toward emerging markets. Policymakers are struggling to find ways to manage the present economic challenges while preparing their economies to perform well in an increasingly complex global landscape and the report offers a unique tool in addressing some key issues.

This year’s report findings show that Switzerland tops the overall rankings. Singapore overtakes Sweden for second position. Northern and Western European countries dominate the top 10 with Sweden (3rd), Finland (4th), Germany (6th), the Netherlands (7th), Denmark (8th) and the United Kingdom (10th). Japan remains the second-ranked Asian economy at 9th place, despite falling three places since last year.

 

The Global Competitiveness Report 2011-2012

 

 

Switzerland tops the overall rankings in The Global Competitiveness Report 2011-2012. Singapore overtakes Sweden for second position. Northern and Western European countries dominate the top 10 with Sweden (3rd), Finland (4th), Germany (6th), the Netherlands (7th), Denmark (8th) and the United Kingdom (10th). Japan remains the second-ranked Asian economy at 9th place, despite falling three places since last year.

The United States continues its decline for the third year in a row, falling one more place to fifth position. In addition to the macroeconomic vulnerabilities that continue to build, some aspects of the United States’ institutional environment continue to raise concern among business leaders, particularly related to low public trust in politicians and concerns about government inefficiency. On a more positive note, banks and financial institutions are rebounding for the first time since the financial crisis and are assessed as somewhat sounder and more efficient.

Germany maintains a strong position within the Eurozone, although it goes down one position to sixth place, while the Netherlands (7th) improves by one position in the rankings, France drops three places to 18th, and Greece continues its downward trend to 90th. Competitiveness-enhancing reforms will play a key role in revitalizing growth in the region and tackling its key challenges, fiscal consolidation and persistent unemployment.

The results show that while competitiveness in advanced economies has stagnated over the past seven years, in many emerging markets it has improved, placing their growth on a more stable footing and mirroring the shift in economic activity from advanced to emerging economies.

The People’s Republic of China (26th) continues to lead the way among large developing economies, improving by one more place and solidifying its position among the top 30. Among the four other BRICS economies, South Africa (50th) and Brazil (53rd) move upwards while India (56th) and Russia (66th) experience small declines. Several Asian economies perform strongly, with Japan (9th) and Hong Kong SAR (11th) also in the top 20.

 

The New Sustainability Champions

 

 

News Release

Meet the Technology Pioneers 2012: Innovating to Transform Society

  • World Economic Forum selects 25 Technology Pioneers, visionary companies in the fields of information technology and new media, energy/environment and life sciences/health
  • Technology Pioneers 2012 includes some of the world’s most innovative young companies whose cutting-edge technologies are transforming business and society
  • Read their profiles or download the report at http://www.weforum.org/techpioneers

 

Geneva, Switzerland, 1 September 2011 – The World Economic Forum today announced its new class of Technology Pioneers, comprised of 25 of the most innovative technology start-ups from around the world. These companies represent the latest generation of innovation and are poised to have a critical impact on how business and society work.

The Technology Pioneers 2012 will be recognized for their work at the Annual Meeting of the New Champions in Dalian, People’s Republic of China, from 14 to 16 September 2011.

The Technology Pioneers 2012 are drawn from the fields of information technology and new media, energy and environment, and life sciences and health where they are active in a variety of areas, illustrating the broad range of impact they have on the world. Among their many diverse activities are drip irrigation on small farms to high-precision greenhouse-gas measurement; providing financial services to underserved, rural populations; and developing photosynthetic biofuels or molecular diagnostics.

“One particular aspect to highlight this year is the large number of companies that are focusing on having a social impact, such as providing health or financial services to underserved populations, while revolutionizing the business paradigms in their industries,” said Olivier Schwab, Director, Head of Technology Pioneers, World Economic Forum. “This year’s companies showcase the diversity in which innovative technology can be deployed to benefit business and society.”

The selected companies are (in alphabetical order): 1366 Technologies, Altobridge, Appirio, Attero Recycling, Biocartis, CloudFlare, Diagnostics For All, DoubleVerify, Driptech, Dropbox, EcoMotors International, Electro Power Systems, Financial Inclusion Network and Operations, First Energy, Joule Unlimited, Kickstarter, Lending Club, Living PlanIT, Mocana, Palantir Technologies, Picarro, Protean Electric, Solazyme, Tabula Digita and Tethys BioScience.

For further information on the Technology Pioneers 2012, please visit http://www.weforum.org/techpioneers.

The identification of the Technology Pioneer companies is the result of a rigorous selection process for which the Forum received hundreds of applications from around the world and that were evaluated by over 50 global technology experts. The selection committee includes leading academics, journalists, technologists and venture capitalists.

Since 2000, the World Economic Forum has recognized the work of young companies who hold the promise of significantly transforming the way business and society operate. More than 400 innovative companies from five continents have been selected as Technology Pioneers. Among them, approximately 60% are still independent and 20% have been acquired by industry leaders. Previous Technology Pioneers include Monitise (2006), Mozilla Corporation (2007), Nanosolar (2007), Gridpoint (2008), Mint.com (2009), BloomEnergy (2010), Takadu (2011) and NetQin (2011).

Technology Pioneers are selected on a yearly basis. Candidate companies are nominated by Members, constituents and collaborators of the World Economic Forum, as well as by the larger public. A selection committee, comprised of top technology and innovation experts from around the world, reviews all candidate companies and makes a recommendation to the World Economic Forum, which then takes the final decision.

 

 

 

April 2010

Bloomberg TV, Innovators: Medicine. Diagnostics For All explains how we create our patterned-paper liver function tests and how they can be used to improve health in developing countries. Three companies are featured; DFA’s portion can be found here, or the entire episode can be watched here. (The segment on DFA begins at 0:07:08) Play »

 

 

March / April 2009

Technology Review, “TR10: Paper Diagnostics: George Whitesides explains how diagnostic paper chips could revolutionize health care in disparate places.” Play »

 

 

March / April 2009

Technology Review, “Making Paper Diagnostic Tests: The paper diagnostic chips are made in a few steps, shown here by graduate student Andres Martinez, a member of the Whitesides Research Group.” Play »

 

 

December 22, 2008

Charlie Rose, “An hour with Bill Gates” (roughly 26 minutes into the program) Play »

 

 

June 20, 2008

NYSE Euronext, “Diagnostics For All visits the NYSE to celebrate its unprecedented win of both the Harvard Business School and MIT Business Plan Competitions.” Play »

 

© 2011 Diagnostics For All

 

 

http://dfa.org/news/video.html

Just One Day of Exercise Protects the Heart

 

 

By Gabe Mirkin MD, September 26, 2011

“JUST ONE DAY OF EXERCISE CAN PROTECT THE HEART AGAINST…(A HEART ATTACK)…. and this protection is upheld with months of exercise, making exercise one of the few sustainable preconditioning stimuli” (Journal of Applied Physiology, September 2011). Wow.

HEART ATTACKS OCCUR WHEN A PLAQUE SUDDENLY BREAKS OFF FROM THE WALLS OF AN ARTERY SUPPLYING BLOOD TO THE HEART. The plaque travels down the ever-narrowing artery until it completely blocks the flow of blood to a part of the heart’s muscle. The heart’s muscle must receive oxygen from the bloodstream all the time. When a part of the heart muscle is suddenly deprived of oxygen, it dies and you suffer a heart attack. The dying heart muscle usually causes severe pain, in the chest, back or left arm. Heart attacks are not caused by progressive narrowing of an artery.

LACK OF OXYGEN IS THE ULTIMATE CAUSE OF HEART MUSCLE DAMAGE. Anything that increases the ability of the heart muscle to survive oxygen deprivation or increases oxygen supply to the heart muscle helps to prevent heart attacks.

Exercise helps to prevent heart attacks, and the more intensely you exercise, the greater the protection. Researchers in Norway treated recovering heart attack victims with the same intense training methods used by competitive athletes (American Heart Journal, June 2009). They supervised them as they ran on a treadmill very fast for a few seconds, rested and then repeated their intense intervals. For example, some of the patients ran fast for 30 seconds every five minutes. The interval-training heart attack victims were able to use more oxygen maximally (VO2max) and had their heart rates return toward normal faster than other heart attack victims who did slower continuous training. This advantage persisted for 30 months after the patients completed their 12-week rehabilitation program.

INTENSE TRAINING IS NOT ACCEPTED AS A TREATMENT FOR HEART ATTACK VICTIMS, particularly those who have chest pain with exercise or excessive shortness of breath. Intense exercise can precipitate heart attacks in people with blocked arteries. The exercise sessions are usually supervised by trained technicians using electrocardiograms, at least in the beginning.

INTENSE EXERCISE DOES NOT DAMAGE HEALTHY HEARTS. All known tests for heart function show no damage from intense exercise. Post-exercise electrocardiograms and echocardiograms are normal, as are blood levels of heart-specific enzymes, creatine kinase and creatine kinase MB, and myoglobin (Medicine and Science in Sports and Exercise, October 2003).

A WORD OF CAUTION: Before you start a program of cycling, running, tennis or anything else, realize that exercising intensely is far more likely to cause injuries and can cause heart attacks in people with blocked arteries leading to their hearts. You may want to check with your doctor before you start. Then get in shape gradually by exercising at an easy pace three to six days a week for at least six weeks.

 

Atherosclerosis

Danger level: High

What is it?

Atherosclerosis (the word comes from Greek, where “athero” means gruel or paste and “sclerosis” means hardness) is a process in which the arteries get clogged, putting you at risk for heart attacks, strokes and loss of blood circulation to your legs, intestines or kidneys.

Who gets it?

Anyone can get atherosclerosis. But there are risk factors which can put you at a greater risk of getting it. Some of them you can take care of, but some of them are inherent and can’t be changed:

  1. Cigarette smoking and exposure to tobacco smoke
  2. High blood pressure
  3. High blood cholesterol – Cholesterol has different forms. One of those is LDL cholesterol (also known as “bad cholesterol”). When it’s high you’re at a greater risk of developing atherosclerosis. The other is HDL cholesterol – this one is known as the “good cholesterol”. When this one is low you’re at risk of developing atherosclerosis.
  4. Diabetes
  5. Family history of having a heart disease in an early age – If you have a parent or sibling who had disease in the arteries of the heart (as opposed to other heart diseases) at an early age, you might be at a greater risk. What’s an early age? It’s usually before age 55 if it’s a man and 65 if it’s a woman.
  6. Age – If you’re a man over 45 or a woman over 55 you are at a greater risk.
  7. Obesity
  8. Physical inactivity – If you spend most of the time sitting and not doing any exercise you are at a greater risk.
  9. An improper diet – If what you eat contains a lot of saturated fats, cholesterol and trans fats (you can see that on the nutrition data labels on the foods you eat) you’re at a greater risk.

What causes it?

Our arteries contain a few layers, as can be seen in this picture:

 

 

The artery and its layers. Drawing by Stijn Ghesquiere

The outer layer is called the endothelium. Each of the risk factors listed above can cause damage to the endothelium. Once the endothelium is damaged, cholesterol invades the area and starts accumulating there. The white blood cells in our blood enter those areas to digest the bad cholesterol so that it won’t accumulate. Over time, those cells and the cholesterol together (along with other debris) accumulate as a mass, which is called a plaque. This created a bump in the wall of the artery.

This bump grows over time, reducing the flow of blood through the artery.

The following video shows this process in action –

 

How does it feel?

Atherosclerosis itself isn’t “felt”. Your arteries can get blocked to a certain degree and you will not feel the process. That is, until something happens.

That thing, as mentioned above, can be a stroke, something in other organs, or (the reason for this article) blockage of the arteries in your heart. This can lead to one of two things:

  1. Angina pectoris
  2. Myocardial infarction (“heart attack”)

In the upcoming parts we’ll discuss these two.

How is it discovered?

We will talk about how you can get diagnosed in the upcoming parts.

How is it treated?

Usually, until something develops as a result of the artery’s blockage, the condition isn’t treated. It can, however, be prevented, which is the most important thing you can do about it. Read ahead for that.


The bottom line – How do I avoid it?

There are 6 steps to lower your chance of developing atherosclerosis:

  1. Avoid smoking – We featured an article before about the benefits and ways you can stop smoking.
  2. Monitor your blood pressure – If you don’t know your blood pressure, visit your doctor to find out. If you do have a high blood pressure, they can recommend ways to lower it.
  3. Eat foods low in cholesterol and saturated fats – This article from the American Heart Association can help you choose the right foods.
  4. Be physically active – You can find more information on how to start here. Getting regular exercise can raise your “good cholesterol”.
  5. Maintain a healthy weight – The best way to start is by calculating your BMI. Your BMI (or Body Mass Index) can tell you if you’re in a healthy weight range or not. You can calculate yours here. A BMI of 18.5-25 is considered normal. If you’re between 25-30 you’re considered overweight. Above 30 is considered obese.
  6. Have regular medical exams

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