Ricoh Academy Revisited bijeenkomst bij DSM met het thema Chaning Business Models & Innovation. Een gevarieerd programma met mooie sprekers. Sustainability & Alliances als rode draad door het programma.
Ricoh Academy Revisited bijeenkomst bij DSM met het thema Chaning Business Models & Innovation. Een gevarieerd programma met mooie sprekers. Sustainability & Alliances als rode draad door het programma.
Similar to Siemens acquisition of Dade Behring (20)
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
3. Flow of Presentation
Background
Deal & Mechanism
Change of Guards!
The New Kid on the Block!
What’s in Dade Behring for Siemens?
Portfolio Evaluation
The New Game Plan & Impact: India
What is Dade Behring India?
Comments
4. Background
The Siemens – Dade deal is between world’s largest clinical
chemistry company and world’s only full-service diagnostics
company
Siemens has agreed to buy Dade Behring (DADE) for $7 billion, or
$77 a share; shares at this time were around US$ 54
Dade Behring has accepted the offer with board of directors’ votes &
the transaction is expected to be completed in next 3-6 months
With this acquisition; Siemens will own ∼ 20% market share of IVD
market
India IVD market is estimated at Rs. 10 Bn with ∼ 17% growth with
major shares; ∼ 77% from Chemistry & Immunochemistry
business
Siemens India has completed Bayer Diagnostics acquisition in 2006
Need to understand the new portfolio equation, synergies & India
angle to the situation
5. Deal & Mechanism
DPC
3.3 X Sales
11 X EBITDA
Bayer
2.8 X Sales
17 X EBITDA
Dade
3.5 X Sales
39 X EBITDA
GE-Abbott
3 X Sales
15 X EBITDA
The Dade deal is dubbed as ‘Horrendous’ by the analysts due to the 39X pay-out on
EBITDA. However, Siemens has increased profit projections from 11 – 13% to 13 – 15%
for the Healthcare business by 2010. Competing deal of GE – Abbott is already called
off.
6. Was this deal required for Siemens?
SIE:GR DAX:IND SMAWF:US SPX:IND NSIEM:IN SENSEX:IND
Across the geographies; Dade Behring purchase has not been liked by the investors as it is
expected to hit the bottom-lines
Dade deal is expected to be 38% more than the market value while exorbitant with 39 times
EBIDTA
DAX: Frankfurt; Siemens shares have dropped by 6% to € 99.70 from € 106.04; this
reduction has eroded company revenue by € 6 Bn
SENSEX: Mumbai; Siemens shares have dropped by 18% to Rs. 1207 from Rs. 1478
Broadly; the deal is expected to catapult Siemens in the top 2 slots but the pay-out will take
time & would compromise profitability for next two years
Source: Bloomberg, 1st Aug, 07
7. Was this deal required for Dade?
DADE:US SPX:IND DADE:US Last 3 Yrs
Dade Behring shares have been showing gradual increase over last 3 years
while it grew by 33% to US$ 74.6 from US$ 56 at NASDAQ
Dade had been struggling on the new innovation in the existing portfolio &
was operating in only one of the two high-growth segments of Dx business
Dade had been performing well on the revenue expectations; while the
shareholders have gained with the over-valuation of the stock
Source: Bloomberg, 1st Aug, 07
8. Change of Guards!
Pharmacy
Driven
In Vitro Diagnostics (IVD)
Engineering
Driven
The series of recent deals from Siemens in IVD market have changed the historical view point towards
Diagnostics industry which started as an off-shoot of Pharma companies. Now Engineering has taken a
lead over Chemistry & the now industry dynamics have completely changed.
10. What’s in Dade Behring for Siemens?
Dade: Geography Split Dade: Revenue Stream Dade: Portfolio Contribution
Post-inclusion of Dade,
APAC focus is expected
to increase with Siemens
Microbiology &
Hematology become
leadership areas
alongwith Immuno while
strengthening chemistry
Dade inclusion makes
Siemens an only & all-in-
one Dx service provider
Dade: Segment Market Shares
Source: Dade Behring
11. Synergistic & Comprehensive Portfolio… Finally
1↑ ! ∼ 1
ID Dx using DOA & Tx Drug
Fully-integrated
microtitre plates Monitoring
chemistry for
Available ex-US More Drugs
high volume
included
labs
1 1
Cardiac Dx ↑&!
Coag & PFT
POC & LTS
thru Global
Alliance with
Sysmex
Automation
1 1
Plasma Protein
Automated
Testing
Microbiology
Immediate
Testing
application in
covering latest
Nutri & Cardiac
pathogens
Long term use
in Proteomics
Denotes competitive positions; 1 – Leader, ↑ - Growing, ! – New, ∼ - Also available
12. India gets it’s share too!
14%
13% India IVD Market Share Scenario 2006 (Figs in %)
11%
9% Leap to
the # 3
8%
6% 6%
3%
Transasia Roche Siemens + Abbott Siemens Nicholas J&J Dade
Dade
Source: Industry Estimates
13. What is Dade Behring India?
Ranbaxy ties up with Dade acquires Dx assets Dade Behring India
Dade Behring for a JV from Ranbaxy fully functional
Annual sales Rs. 120 Mn.
1987 2000 2001 2002 2003 2004 2005 2006 2007
Ranbaxy started selling Ranbaxy sells the allied business
Dade products as a with remaining IVD products to
distributor in India ICICI Venture Funds
Dade present in India as a wholly owned subsidiary as Dade Behring India Pvt Ltd. Okhla,
Delhi with estimated annual turnover Rs. ∼ 312 Mn; 50 people, Country Manager – Dr. P.
Sivakumar
Virology business of Dade was with Merck which has been shifted back to Dade
Routine Chemistry [3% MS]
Automated & Medium range Immunochemistry [3% MS]
automated instruments with the Coagulation [20% MS] Non-isotopic systems
reagents Rs. 150 Mn Semi-auto/ manual instruments Rs. 110 Mn
(Dimension RXL/XL/ES) Rs. 65 Mn (BNPProSpec)
(Sysmex alliance)
Source: Industry Estimates