Annika Hässler is a specialist in general medicine and pain management, as well as a rheumatologist. In this interview, however, her role is as chairperson of Funktionsrätt Stockholms Län, a patient and disability association that brings together 44 associations in several different disease areas, such as cardiopulmonary diseases, diabetes, epilepsy, and mobility impairment. The association participates in MedTechLab's Patient Advisory.
Hi Annika, what have you been working on for the Swedish elections?
– We have a big launch of a new concept, Functional Impact Assessment, the complicated word we abbreviate FKB. It is based on the UN Convention on Disability and can be compared to the requirement for environmental impact assessments that exist today. We have published a handbook on FKB which can be downloaded from our website. We have also be working on health issues such as assistive devices, rehabilitation, and public transport issues.
What challenges do you see connected to new treatments in healthcare?
– Today there are definitely barriers to bringing in the new methods. This could be for several reasons, such as the difficulty of getting the clinical trials that are needed. A new treatment may be more expensive and stopped for this reason. Tradition has quite a big impact, a clinic does not always want to change approaches and treatments that they know work. Sometimes it is pure ignorance or a fundamental lack of interest in innovation.
How can that be changed?
– It’s not that easy. One way is continuous training of health care providers, something that is otherwise often saved. But this inevitably brings participants face to face with the latest developments, and that is very important. The fact that the method in question becomes public knowledge, for example through the media, can put pressure on patients and patient organisations to start these treatments. Well informed patients mean a lot.
How can more people be encouraged to take part in clinical trials?
– There is a need for more knowledge, for patients and relatives to understand what these involve. It’s also easy to overlook the importance of trust, that’s the most important thing of all. If the patient has confidence in the provider, they are more likely to participate. With the new Swedish law concerning good and equal care, it may be easier to recruit to clinical trials because the law is about expanding primary care. One challenge will be to get hospital doctors to want to move to primary care, which is already understaffed.
How do you see your involvement in MedTechLab’s Patient Advisory?
– The exchange of knowledge between patient associations and research needs to be reciprocal, we can contribute a lot through our experiences. So, I am looking forward to that in our participation with the Centre. Then I see the opportunity in creating joint seminars. I believe very much in meetings as a communication method to increase the level of knowledge, we need interaction, not exclusive printed material.
Read more about Funktionsrätt Stockholms Län on their website
Contributing to European level infrastructure. Fredrik Strand's research group has been granted SEK 3 million from EU as one of the participants in the EUCAIM (European CAncer IMaging) project. The aim of EUCAIM is to establish a European infrastructure for medical cancer imaging.
Hi Fredrik, what would such a European infrastructure entail and when could it become a reality?
– Developing accurate machine learning algorithms requires a lot of data, often more than what is available locally. In addition, as we move towards precision medicine, i.e. choosing treatment more individually based on the specific characteristics of the cancer tumour, the need increases even more. International cooperation is essential for this development.
What will you use the research funds for?
– The EU project is well aligned with our ongoing VAI-B project, which aims to create a national platform for the evaluation of AI algorithms in breast radiology. We hope to contribute with the knowledge we have accumulated in the past, but also with X-ray images and clinical data in a federated solution at European level.
Read more about the call here
The prize recognizes one or more researchers/research students who have distinguished themselves through outstanding utilization of research results that have led to innovation.
Staffan Holmin at the Department of Clinical Neuroscience at Karolinska Institutet, is awarded the Prize for Innovation and Utilization, 2022. Staffan Holmin is also a research leader at MedTechLabs in the programme Spectral CT-imaging and Endovascular Techniques.
Read more about the priz and the prize committee’s motivation here.
New Phd in Medical Science and focusing on non-invasive vagus nerve activation. Alessandro Gallina has the ultimate goal to bring discoveries on neural regulation of non-resolving inflammation to clinical trials.
1. What research are you doing at MedTechLabs?
I am currently working on several projects at the Stockholm Center for Bioelectronic Medicine at MedTechLabs. Primarily, study how the vagus nerve regulates inflammation and am involved in developing new technology for specific non-invasive activation of the vagus nerve.
2. What impact are you hoping your research will have?
Our program at MedTechLab brings together different laboratories, expertise, point of views, and approaches, to find novel ways to overcome methodological limitations and bridge the gap between scientific discoveries and clinical implementation.
My work has the ultimate goal to bring our discoveries on neural regulation of non-resolving inflammation – a condition that underlies many chronic inflammatory diseases, including debilitating cardiovascular and rheumatic diseases – to clinical trials. I hope that the outcome of my research will improve the quality of life for patients, and maybe even prolong life for patients suffering from debilitating excessive inflammation.
3. When might the results be of practical use to patients?
In our most recent paper from the Stockholm Center for Bioelectronic Medicine at MedTechLabs (Caravaca, Gallina et al., PNAS, 2022), we show how electrical activation of the vagus nerve in the neck promotes resolution of inflammation, which is an important part of healing from infection and tissue damage. These results improve our understanding of how inflammation resolves and heals.
Since electrical vagus nerve stimulators are already approved and used in clinical trial for treatment of inflammation, clinical studies that build on these findings can be planned in the near-term. Our technology for non-invasive vagus nerve stimulation is currently being developed for human use in a start-up company supported by KI Innovations. Accordingly, we expect this technology and these insights to be part of clinical trials in in the coming 2-3 years.
4. What is your background and motivation as a researcher?
On the 1st of April 2022 I defended my doctoral thesis: Understanding Inflammation Requires Neuroscience, and I am now a Doctor of Philosophy in Medical Sciences from the Karolinska Institutet. I have a Master Degree in Neurosciences and a Bachelor’s Degree in Biology. Between my MSc and the beginning of my PhD studies I have been employed as research assistant in the Department of Medical Biochemistry and Biophysics (Biomaterials division) at Karolinska Institute, where I had the opportunity to merge the knowledge acquired during my master studies with the foci and techniques of the hosting laboratory, the Ana Teixeira’s Lab. Aimed to deploy novel approaches in clinical research, I then joined the Peder Olofsson’s group, the Department of medicine (Cardiovascular Medicine division) at the Karolinska lnstitutet at Bioclinicum, to start my PhD studies.
I have always had a passion for solving a variety of problems via interdisciplinary approaches, which is reflected in both my academic choices as well as in my doctoral studies and publications. The Stockholm Center for Bioelectronic Medicine at MedTechLabs has allowed me to fully explore this passion, being able to establish several collaborations with experts in fields far from mine, and finally face many, often old, questions still in need of an answer.
Elisabet Schesny is deputy chair of the Swedish Breast Cancer Association (Bröstcancerförbundet), Sweden’s only interest organisation focused solely on breast cancer. The association represents its 11,000 members on the MedTechLabs Patient Advisory.
Hi Elisabeth, what will you be working on during this election year?
– We will be focusing on the demand for equitable care, an issue that is incredibly important to our association. This involves raising issues related to the introduction of methods for individualised screening based on the woman’s risk of developing breast cancer (today, everyone is given the same screening in the mammography programme), the right of all patients to rehabilitation and equitable access to new drugs across Sweden.
What challenges are you aware of regarding new treatments in healthcare?
– Naturally, it is frustrating that it takes so long for new drugs and technologies to reach the health service. It takes a long time for a drug to work its way through FDA approval, then the same process with the European Medicines Agency (EMA) and then finally receive approval here in Sweden. Then there is a problem in that Sweden has so many regional health authorities, each with its own budget, and new treatments and technologies are therefore not made available equitably. It shouldn’t matter where in the country one lives. For patients with a serious illness such as breast cancer, this is a matter of life and death.
How can we change that?
– We are promoting the cause of equitable care, as this is an extremely important issue for us. As things stand, regional health authorities prioritise differently and the time it takes for patients to gain access to new treatments can therefore vary. One possibility worth considering is to centralise implementation, but not operational healthcare. A survey conducted by the Swedish Breast Cancer Association showed that only four of ten people with the most common form of breast cancer received treatment conforming to current research and recommendations. We use this example in our advocacy and opinion building work to demonstrate that, in the field of breast cancer, treatment is not equitable.
How can we persuade more people to participate in clinical studies?
– In the present situation, where studies are often conducted in a large, regional hospital, it can prove difficult to recruit widely. One wonders whether clinical studies ought to be national and include multiple hospitals all over the country. Research nurses are based at major hospitals: how can we get more of them into smaller hospitals? Multidisciplinary conferences to discuss patient cases have a role to play in assessing appropriate clinical studies for each patient. Treating physicians are responsible for informing patients. Contact nurses should also be able to inform their patients. Both of these professions need to be well-informed about which clinical studies may be relevant to their patients and what the benefits are for patients who participate a given study. While there is often written information in waiting rooms about clinical studies that are recruiting patients, patients in the waiting room are focused on something else entirely while waiting for their appointment and may well be anxious about what the doctor is going to tell them. And then, information about individual clinical studies can be convoluted when it should be patient-friendly and easy to understand. There are any number of things that patient organisations can contribute to a clinical study, such as insights into anticipated concerns and discomfort regarding certain elements of the study, or helping to ensure that unreasonable demands are not made in terms of how many hospital visits the patient is expected to make to complete the various parts of the study. The participation of patient organisations is often limited to certain areas but, in some cases, it is a matter of more significant involvement in which the patient organisation becomes almost an equal partner. It is also reasonable to discuss the question of whether remuneration for patient organisations that contribute to research projects should be budgeted from day one.
How do you feel about your participation in the MedTechLabs Patient Advisory?
– It has become more common to try and include patient organisations in the research process, as MedTechLabs is doing, and we are delighted to contribute given our resources and opportunities to do so. Patients in general are not particularly well-informed about innovations in medical technology and the implications for them personally; how research is implemented and how high-tech equipment works. It can also be difficult to grasp what an interdisciplinary centre actually does and what it means to have industrial partners as a necessary component. So, I hope that by participating on the Patient Advisory we can exert influence so that our members and other target groups can learn more about what research can mean for breast cancer patients; for example, by encouraging MedTechLabs to inform about its operations in an easily understood manner.
Learn more about the Swedish Breast Cancer Association at brostcancerforbundet.se /
A radiology resident at Karolinska University Hospital with an interest in breast imaging research. Mattie Salim is a radiology resident at Karolinska University Hospital and Phd Student at Karolinska Institutet. She is also affiliated to MedTechLabs.
What research are you doing at MedTechLabs?
– My research is about how we can use AI CAD to improve breast cancer screening. Breast cancer is the most common cancer type among women in the world today. And even though the breast cancer mortality rate has decreased since breast cancer screening was implemented in Sweden in the 90’s there is still room for improvement. In our ongoing randomized clinical study ScreenTrustMRI, we explore different algorithms to select women for supplemental MRI screening to detect missed cancers.
What impact are you hoping your research will have?
– That earlier detection with the help of AI will minimise the number of missed cancers that otherwise would have been more advanced at the time of diagnosis. Advanced breast cancer come with a poorer prognosis, therefore early detection is of great importance to further reduce breast cancer mortality.
When might the results be of practical use to patients?
– Since its an ongoing clinical trial we won’t know the results until the study is complete, our aim is by the end of 2023. By then we are hoping to have examined 1 000 women with MRI screening. We wish for our results to lead to an improvement in today’s breast cancer screening programme. However, since MRI is very expensive, we depend on our results to know if the combination of AI and MRI is socioeconomically justifiable.
What is your background and motivation as a researcher?
– Early in my career as a physician i realized i wanted to be a researcher. I have been doing research at Karolinska Institute on the evaluation and implementation of AI CAD algorithms since 2019. Being part of Fredrik Strands research team has given me the opportunity to conduct important and exciting projects. My motivation is all breast cancer survivors and my focus is the more than 650 000 women who die of breast cancer each year in the world.
"He wants to create a Swedish MIT, a world-class research center for medical technology where the cross-fertilization of KI and KTH, doctors and engineers is part of the secret."The model we set up and believe in is that engineers and doctors work closely together. We demand that it be a research couple consisting of an engineer and a doctor who runs all projects," explains Niclas Roxhed, director of Medtechlabs."
Interview with researcher and innovator Niclas Roxhed. Niclas Roxhed wants to create a European Kendall Square in Hagastaden.
Niclas Roxhed took over as permanent director of MedTechLabs in November. As a researcher, he is renowned for both his inventiveness in the field of medical technology and his ability to translate new ideas into projects, business opportunities and patents. One of his most famous inventions is a pill that can be swallowed to inject drugs into the stomach lining. In this article, he discusses his research, entrepreneurship and how he sees Stockholm developing as a life science region.
What is it you do in your research?
“I lead the medical microsystems group at KTH. We work with things that are small enough to have in the body, such as microneedles that can penetrate the skin deep enough to deliver drugs but without being felt. Another area is minimally invasive brain therapy, where it is possible to insert minute implants containing drugs via the blood vessels. One idea we are working on is to insert implants into brain tumours and then activate them with a remote control, turning the drug delivery on and off as required.”
And you are a cofounder of the blood test company Capitainer?
“Quite so, Capitainer is a spinoff from my research at KTH. We develop technology that simplifies sampling of blood and other bodily fluids. The vision is to provide access to accurate measurements of biomarkers or drug levels on a much more frequent basis than is currently the case. Today, we might measure blood content on a few occasions, at the beginning of a treatment and so on. By simplifying tests, we can monitor the treatment and disease progression over time and achieve an entirely different level of insight and quality in the treatment.”
I believe that Capitainer has developed a kit for home testing that has been trialled during the pandemic?
“Our method ensures an accurate amount of blood on the sampling card and is so simply you can do it yourself at home. The correct amount of blood is crucial to measuring the right concentration of antibodies in the body. At the start of the pandemic we sent out our test kits to a random sample and had a good response rate. We repeated the process at the end of April and could see that 12% had been infected with COVID. At the time, there were no accurate figures available for the infection rate in Sweden. We conducted new tests in the summer to see what effect vaccination was having. I think our excellent response rate is down to the fact that we employ a copywriter when designing our mailshots.”
Why did you decide to go into research?
“I read electrical engineering at KTH and I guess I was thinking in terms of joining a company such as Ericsson. During my education, I began to wonder whether I should use my abilities to develop the next generation of mobile phone, or if there was something that felt more important. My conclusion was that I should set my sights on medical technology, where there were exciting challenges that involved people’s lives, which would motivate me more. Given that attitude, it was only natural to study for a doctorate, as a Degree of Master of Science in Engineering is not really sufficient if one wants to achieve great things.”
Could you tell us more about microsystems and medical technology?
“It might involve using light to create small microchips with a very high transistor density, or defining mechanical structures at nanometre level using etching or other techniques. We develop various types of sensors, as well as solutions for mechanically releasing drugs. For example, it’s possible to create a membrane to encase a drug capsule and then specifically affect it to control when it releases the drug. By using multiple membranes, one can release the right dose at the right time.”
You have also found time to conduct research at MIT. How did that come about?
“Professor Robert Langer works there and he is a doyen of drug delivery, as well as one of the founders of Moderna. He and physician and gastroenterologist Giovanni Traverso came up with the idea of delivering drugs from inside the intestine using needles. They started looking at microneedles that could be swallowed through the oesophagus and wanted a postdoc who was familiar with that field. Their announcement reached KTH, where we were among the first to work with microneedles, although in our case on the skin. This was in 2015, at which point I already had three doctoral students of my own. Still, as they were researchers who had long been an inspiration to me, I wrote that I would like to assist with the project. We found a solution whereby I combined a sabbatical year with a half-time salary from MIT as an expert. My family and I moved there for 18 months, until 2017. That work resulted in an article in Science with a famous illustration of our pill standing up in the correct position in the stomach ready to give the injection. We later developed a similar capsule for the intestine.”
What is your own view of innovation and research?
“For us, it’s deeply ingrained. We develop highly specific applications and we are used to working closely with companies. When that collaboration pays off, it can save lives all over the world, something that has happened at our division previously. We also generate a great many patents; if I’m not mistaken, I am one of the KTH researchers with the most patents? Still, I have a long way to go to catch Bob Langer, who is both the most cited engineer in world history and the holder of most medical-technology patents. So, in my world innovation and research are intimately linked. If it is to pay off for society and for those who invest in research, the results need to be applicable in practice and protected by patents. Bob Langer has started some 30 companies and his commitment allows him to attract both money and good people. The fact that we have a COVID vaccine today has a great deal to do with Bob being such an entrepreneur. Even before the vaccine, someone calculated that Langer had affected the lives of two billion people with his innovations. Now, there are even more.”
In terms of research, what do you think is the difference between the United States and Sweden?
“One thing that immediately struck me as odd was the unconditional way they approached things. As they have greater resources in the US, they can afford to allow a doctoral student to take a thousand measurements of a given thing without having any clear idea at the beginning of what it might lead to. Their approach seemed almost idiotic! Why invest resources in something when we have no idea how we might use it? I now realise that one of the keys to their success is that they find and discover things almost by chance. While they’re at it, they also generate more and richer data that contributes to research in the long term. That’s one big difference compared to how things work in Sweden.”
What would you like to see more of in medical technology research?
“We should bear in mind that Sweden has a history of doctors and engineers working together to develop new medical technology; that’s how the gamma knife and pacemaker came about. But we need even closer interdisciplinary collaboration in order to achieve even greater feats. The time I spent in the US was very inspirational. What they have there that we do not yet have at KTH is their own animal facilities where they conduct experiments. This drives research on faster to the next stage, makes it more relevant and creates a greater impact. Thanks to my research collaboration with physician and researcher Staffan Holmin I have started to use the animal facilities at Karolinska Institutet, KI. So, these days I commute back and forth between KTH and KI. I look forward to KTH, KI and Karolinska University Hospital growing closer, even physically. As we get to know the organisations at KI and the hospital, the doctors and other staff there, this will facilitate collaboration.”
Finally, what are your hopes for Stockholm as a life science region?
“I hope that we get our own Kendall Square, like they have at MIT, where spinoffs, researchers and the business community are close enough to share coffee breaks. When Bob Langer was a postdoc in the 1970s, the area around Kendall Square was a slum; now, it’s the world’s leading life science centre. I wasn’t convinced that colocation was such a big deal, but it really creates expectations and ideas among the people who work in the area; one becomes more aware of the companies based there and their development. The area around KI, in the newly built Hagastaden district between Stockholm and Solna, can change in the same way and become a place that makes you say ‘wow’ when you visit it.”
"Niklas Roxhed, director of Medtechlabs, compares the life science cluster in Hagastaden with American life science clusters. And it is precisely in such clusters that the conditions for new ideas are generated and breakthrough technologies are created, he says.
- What is happening here in Hagastaden, with Karolinska University Hospital as the church in the village, is exciting. The thoughts go to Kendall Square in Boston, which is a boiling cauldron where all the pharmaceutical companies are wedged between Harvard and MIT, he told Life Science Sweden earlier this week."
"Fredrik Strand, breast radiologist and researcher at Medtechlabs, is granted funding for research on breast cancer. Fredrik Strand, a specialist in X-ray at Karolinska University Hospital and a researcher at Medtechlabs, receives four million from Horizon Europe, which distributes a total of SEK 60 million in research support to participants in the Radioval project."