Researchers are redesigning technology to detect low blood sugar in older adults with both diabetes and Alzheimer’s disease.
Scientists are developing user-friendly health information tools and technology to enhance accessibility to older adults with both diabetes and Alzheimer’s disease and their caregivers.
Without numerous finger sticks, these tools and technology will be designed to provide patients, caregivers, and clinicians with glucose metrics needed to diagnose hypoglycemia and identify treatment options.
Older adults with Alzheimer’s and Type 1 or Type 2 diabetes have a high risk of low blood sugar, known as hypoglycemia, which is often undetected. Hypoglycemia can cause dizziness, confusion, mood changes, hospitalisation, and even death. Diagnosis and treatment of hypoglycemia can prevent complications.
Regenstrief Institute Research Scientist April Savoy, PhD, a human factors engineer and health services researcher, said: “Alzheimer’s disease is a progressive disease, and hypoglycemic events can accelerate cognitive decline. That’s why we are focusing on detection of low blood sugar in these older adults with both Alzheimer’s and diabetes.”
Dementia hinders the ability of patients and caregivers to manage blood sugar levels, potentially resulting in hypoglycemic events and further cognitive loss.
Repeated finger sticks to test blood sugar levels, following a prescribed diet and exercising can be difficult for patients with Alzheimer’s. Use of traditional blood sugar monitors may be problematic for individuals with Alzheimer’s as well as caregivers.
The study, ‘Enhancing shared decision-making to prompt and guide individualized care for people with Alzheimer’s Disease and diabetes’ will enrol 75 pairs of older adults with both Alzheimer’s and diabetes, and their family caregivers. Twenty clinicians who see patients with both conditions will also participate.
Research into diabetes and dementia
Other studies have investigated how poor management of diabetes increases risk of dementia. But this new research, implementing a human factors engineering approach, targets older adults who have already been diagnosed with both Alzheimer’s and diabetes.
Dr Savoy and colleagues will investigate unique population dynamics, including how much data about glucose levels are needed, how to acquire them, and what works to enable shared decision-making for all involved, including patients, caregivers, and clinicians.
“We hope to increase awareness and empower patients and caregivers to make individualised, patient-focused decisions about effective treatment options,” said Dr Savoy.
“Our goal is to prevent hypoglycemia for the growing population of older adults with Alzheimer’s disease and diabetes.”
With the use of human-centred design, the authors indicate that they will be able to identify and inform continuous glucose monitoring designs for people with dementia and diabetes, broadening access to continuous glucose monitoring with what they believe is the attainable goal of increasing detection and treatment of the silent threat posed by low blood sugar.
The research is supported by a five-year grant from the National Institutes of Health’s National Institute on Aging.
Smart wristband developed to identify and manage atrial fibrillation
It’s one of the most common conditions affecting those over 65 and left untreated can lead to stroke, blood clots in the veins and, in the most extreme cases, heart failure.
Atrial fibrillation currently affects more than 40 million people worldwide and the incidence and prevalence of the medical condition have increased three-fold in the past 50 years as populations age and survival rates for chronic diseases increase.
Now thought of as a global epidemic, 16 million people in the United States alone are projected to have been diagnosed with the ailment by 2050. In Europe, the figure among the over 55s is expected to reach 14 million by 2060.
It is estimated that by 2050, AF will be diagnosed in at least 72 million individuals in Asia.
One of the most common symptoms of AF is a pounding, fluttering, or quivering heartbeat, more commonly known as heart palpitations. Other signs include dizziness, fatigue, a fast heart rate of more than 100 beats per minute, breathlessness, and chest pain – many of the classic stress or anxiety signs that characterise a panic attack.
It’s one of the reasons that millions of people are walking around unaware that they are suffering from atrial fibrillation. How many times have you heard someone attribute their racing heartbeat to a caffeine-induced surge brought about by having drunk one too many coffees?
Many more are asymptomatic, meaning they are producing and showing no symptoms at all.
Often the condition will only be picked up when a patient undergoes a health check for an unrelated matter.
However, early detection and treatment of AF are paramount if later complications are to be avoided.
Without treatment, people with AF are up to five times more likely to suffer strokes, leading to the risk of severe disability and even premature death.
But new patient-safe monitoring technology to check and manage individual factors provoking atrial fibrillation, has been invented by Lithuanian researchers that could hold the key to earlier diagnosis and outcomes for the potentially serious heart condition.
It involves patients wearing a so-called smart bracelet – already an accepted accessory for many – that uses an algorithm that can detect atrial fibrillation.
Traditional methods of diagnosing AF involve patients having to wear intrusive and uncomfortable sensors. But this new technology incorporates complementary sensors and a signal processing algorithm, with patients also being asked to input potential arrhythmia triggers on a mobile app.
The device is the result of a successful collaboration between the Kaunas University of Technology Biomedical Engineering Institute (KTU BMEI) and Vilnius University’s Santaros Clinics.
Researchers at KTU BMEI have been working in the field of atrial fibrillation monitoring technology development for more than a decade. It was several years ago that they developed the bracelet – the patent application for the device was submitted to the Lithuanian State Patent Bureau at the end of 2018 – which is aimed at older people, who can be especially self-conscious when using technologies and smart devices.
Professor Vaidotas Marozas, director of KTU BMEI, told Agetech World: “We are focusing on developing technologies which are needed for the public and contemporary medicine. For example, due to the prevalence of this condition (AF), every person older than 65 should be checked for atrial fibrillation.
“Non-invasive, compact wearable devices are an attractive solution for monitoring the health status of such high-risk groups.”
The disease usually starts with self-terminating so-called ‘paroxysmal episodes’ which, if recognised in time, can be treated by non-medication means.
These episodes may be different for each patient, however. For some, they may last for a short time and recur infrequently. For others, the episodes can be longer and more frequent.
But untreated AF will eventually develop into a persistent condition, which is more complicated to treat.
The KTU-developed smart bracelet – which Lithuanian company, Teltonika, has stepped in to produce – has been used together with other devices in the TriggersAF project supported by the European Regional Development Fund.
The aim of the project coordinated by the Kaunas University of Technology in partnership with Vilnius University, is to develop and test methods that allow patients to identify their individual arrhythmia triggers via a wrist-wearing device.
It is already known that for some patients, atrial fibrillation episodes can be provoked by certain modifiable factors, such as alcohol, increased physical activity, stress, and sleep disturbance.
Identifying and avoiding individual factors would help determine non-pharmaceutical intervention methods to arrhythmia management.
As the project addresses a clinical problem, it has been important to have on board experienced clinicians who deal with AF daily. One of them is Justinas Bacevičius, a cardiologist at VU Hospital Santaros Clinics.
He said: “Although we see a wide variety of atrial fibrillation patients in our hospital, two types can be distinguished. The first group includes older, overweight, diabetic, hypertensive patients or those having sleep apnoea.
“The second group is the complete opposite – often they are young, professional sportspersons, businesspeople or performers who are experiencing a lot of stress.”
Mr Bacevičius said the data from the patients suggests a link between the onset of arrhythmia and sleep disorders.
He added that interestingly, even in patients who are not diagnosed with sleep apnoea, a correlation between snoring during sleep and the onset of atrial fibrillation in the morning, or later in the day, had been identified.
But with no objective methods to identify individual factors influencing the arrythmia in patients, KTU BMEI researchers in collaboration with cardiologists from VU Hospital Santara Clinics and their long-term partner Leif Sörnmo from Lund University in Sweden, have proposed one.
It assumes that arrythmia parameters, such as the relative duration of an episode, increase after an arrythmia-provoking factor.
Vilma Pluščiauskaitė, a PhD student at KTU and a junior researcher on the project, explained: “The essence of our proposed approach is that the patient uses a wearable bio signal-recording device for a set monitoring period, e.g. two weeks, and enters potential triggers for atrial fibrillation into a mobile app.
“For the next two weeks, the patient avoids the identified potential triggers, and the relation is assessed by an equation proposed by KTU BMEI researcher Dr Andrius Petrėnas.
“If a correlation between the influencing factor and the occurrence of arrhythmia is detected, the patient is advised to avoid the specific identified factor.”
The project’s database is the first of its kind in the world. It includes the recorded patients’ physiological signals, such as electrocardiogram and photoplethysmogram (a simple and low-cost technique that sends light pulses through the skin into the blood vessels to detect blood volume changes), and potential arrythmia provoking factors entered in a person’s mobile app.
The database collected by the researchers has allowed them to test the developed method and identify arrythmia-provoking factors in individual patients.
Project leader, Professor Marozas, is understandably delighted with its success, which will allow further development of the smart bracelet technology.
He said: “The database generated by the project is a unique result. We have managed to interest an international consortium funded by the European Metrology Association in this data. This consortium has invited us to join their new project as a partner and we will continue our work.”
The lack of technology currently available to individually identify arrythmia-provoking factors is probably due to the fact that monitoring has traditionally been inconvenient. Patients usually have to have an electrocardiogram (ECG), which is an electrical recording of their heart rhythm.
If that doesn’t identify a problem, then further monitoring will be needed, involving having to wear a portable ECG recording device for 24 hours or more.
Patients may also be required to fill in numerous questionnaires to pinpoint trigger factors, which can be subject to recall bias, where they either forget about a potential arrhythmia provoking stimulus or are reluctant to acknowledge the presence of certain influences, such as alcohol intake.
Mr Pluščiauskaitė said: “Certain influencing factors for arrythmia, such as increased exercise, stress, or sleep disturbances, can be identified from physiological signals by the dedicated algorithms. However, other influencing factors, such as alcohol consumption, are difficult to identify in the signals, so it is best if the patient has the opportunity to indicate when he or she consumed alcohol.”
He added that it is hoped that in the future, identifying these arrythmia triggers will only require a smart bracelet incorporating complementary sensors and signal processing algorithm.
Revolutionary Scottish trial aims to improve outcomes for stroke survivors through exercise
A trailblazing rehabilitation hub using exercise and other therapies to help boost stroke survivors’ recovery has opened its doors at one of Scotland’s largest hospitals – with evidence already pointing towards its life-changing impact on patients.
The hub is part of a trial being conducted by the University of Strathclyde in partnership with NHS Lanarkshire, to meet the overwhelming demand for intensive stroke rehabilitation.
It’s already known that the sooner a patient can begin stroke rehabilitation, the more likely they are to regain lost abilities, such as speech and movement. It’s a common practice for therapy to start as soon as 24 to 48 hours after a stroke, while a patient is still in hospital.
New National Institute for Health and Care Excellence (NICE) guidelines in the UK suggest stroke patients receive three hours of rehabilitation a day, five days a week.
This is a significant increase from the previous NICE advice of 45 minutes per day.
However, due to the overwhelming demand for rehabilitation, the NHS has struggled to meet the minimum recommended level, with current data suggesting that on average patients receive just 14 minutes of physiotherapy, 13 minutes of occupational therapy, and seven minutes of speech therapy a day.
But the new technology-enriched stroke rehabilitation hub (TERHS) at the University Hospital in Wishaw, which lies 11 miles south east of Glasgow, allows patients to access therapy more quickly at the required frequency.
Just weeks after its launch, proof is already emerging that the hub, which has been designed to holistically address the physical and cognitive harm caused by a stroke, has the potential to positively transform the recovery process for survivors.
Now it’s hoped if further evaluation backs up the preliminary findings the concept could be rolled out not just across Scotland, but all four UK nations within the next two years, putting the NHS at the forefront of treating patients in the chronic stage of stroke recovery.
Dr Gillian Sweeney, an occupational therapist with NHS Lanarkshire and advanced practitioner for stroke survivors, who has led on the development of the trial and set up the hub, told Agetech World the model could receive a wider launch if health trusts are presented with concrete evidence of its physical and financial benefits.
Referring to the hospital trial currently underway and research being done by the University of Strathclyde’s Department of Biomechanical Engineering into the use of such hubs, Dr Sweeney said: “This is groundbreaking, a life-changing trial for those who have had a stroke. I’m a therapist myself and I’ve worked in the NHS for around 20 years, and what I would say is, we have never been able to deliver enough rehabilitation within the current model and resources, and things are getting more pressurised.
“I think every therapist that works in stroke would probably say ‘We know we are not delivering the level of intensity that we should be.’ We know from evidence that the greater the intensity the better the outcomes.
“But we have been on a hamster wheel for a number of years, and I think we are now at the point where this model, with modest investment – and I don’t want to say within current resources because we need the investment in the equipment and staff to run the groups – but with a realistic, modest investment, could actually achieve those levels of rehab activity that we never foresaw we could do without making a huge investment in staffing for one-to-one treatment.
“For me, the feedback from participants, both within the university and even in the early stages on the hospital ward, is that the difference that makes is massive.
“I think for me, as well, what it does, is that it brings back the person’s control of their own rehabilitation. They have the opportunity to attend this hub and with the minimum amount of support, they are back in control of their own rehab.
“They can choose how often they come for and how long they stay. That, in itself, has been huge.”
Even more remarkable is that participants from the community that have taken part in the university-based study – some of whom suffered a stroke up to a decade ago – have seen functional improvements.
“It wasn’t what we expected to see, but we did,” Dr Sweeney said.
“The study initially was just to look at, ‘is it safe, and do people like it?’ Ten years after a stroke there wasn’t a huge amount of expectation that things like arm function or walking speed would improve.
“But with the outcome measures we have taken, pretty much everybody has improved in one or more areas.
“If you look at that and think ‘we can make those improvements 10 years down the line,’ what could you do in the very early phases after a stroke when your brain is more likely to make the changes to see improvement?
“For me, it is groundbreaking. If you use this model and put some of this equipment in so people can do the things they need to, it is a total no-brainer.
“Yet it (the resource) is not there. There are reasons for it not being there, and part of that has to do with people within healthcare systems often working so hard and under such pressure they don’t get the space to think about new ways of working or to test them.
“There are traditional ways of working and it takes a long time within the NHS to adopt new ways and to embed that.”
The impact of stroke can be profound and the months immediately after suffering one are key to recovery.
Located within the University Hospital’s stroke unit, the TERHS hub has a virtual reality treadmill with a specialist harness, a balance trainer, and power-assisted equipment from UK-based wellness and wellbeing supplier Innerva, which supports users to exercise allowing them to work passively or actively, depending on where they are in their recovery stage.
The technology also incorporates ‘gamification’, such as virtual reality, puzzles and problem-solving activities, which helps to improve the engagement with and response to therapy.
In addition, the hub houses specialist cognitive and VR equipment, helping to enrich the environment and improve users engagement with and response to rehabilitation therapy.
The hub builds on the research being carried out by the University of Strathclyde which has seen a team led by Dr Andy Kerr and Professor Philip Rowe in the Department of Biomechanical Engineering, set up a gym-like space offering an eight-week programme to survivors under the supervision of Dr Sweeney and research physiotherapist, Mel Slachetka, in the Sir Jules Thorn Centre for Co-Creation of Rehabilitation Technology.
The hospital hub has attracted 15 patient recruits so far, all of whom have been “extremely positive” about the programme, Dr Sweeney said, with some managing three hours of rehabilitation a day.
“People are getting much more activity time than would have been the case. Patients like the Innerva equipment as all they have to do is press a button, and they feel they are in control.
“The setting seems to be popular, and what we are finding is that patients are coming up in a group. Having a stroke can be isolating, but the feedback we are getting is that users value the opportunity to meet people who are going through the same experience as them.
“We know that on stroke wards across the country there isn’t enough staff. Often what happens is that the nursing staff will help patients get out of bed and then they will sit in a chair for hours.
“But with the hub they are using their brain, they are being active, they are off the ward, and they are having the opportunity to socialise.”
The hub can support five patients at a time alongside two support staff.
Given the evidence already accrued through the University of Strathclyde’s rehabilitation programme in which every person using the Sir Jules Thorn Centre facility has seen an improvement, mostly in walking speed but also in some cases speech, it seems difficult to understand why the hub idea isn’t being rolled out as a priority.
Especially as Dr Sweeney admits her ambition is to see technology-driven rehabilitation hubs established in community settings across the UK to provide stroke survivors with easily accessible therapy for optimal recovery.
But whilst the idea may indeed, to quote Dr Sweeney, be a ‘no-brainer,’ even the most obvious concepts need to be proved on a number of levels.
With funding from the Engineering and Physical Science Research Council’s Impact Acceleration Account, a research assistant will assess the impact of the hub on inpatients in the early phase of their recovery with the aim of enabling them to achieve, or even exceed, the recommended levels of rehabilitation.
“We need to look at the costs and the harsh economics,” Dr Sweeney said. “From a research point of view, we must prove that. We are often not very good at proving that something is cost-effective.
“Rehabilitation in general has been run in the same way for a long time and it can be difficult to change traditional practices. And rehabilitation therapists as well as the public can be frightened of technology.
“There is often a feeling that if somebody who has had a stroke is elderly, they won’t be able to cope with technology. But one of our patients is 94, and we are finding that age isn’t as much of a barrier as people may think it is.
“But we need to prove all these things as well as the positive impact this approach can have on stroke survivors. At the minute we have tried it with people who are in the very early stages of stroke rehab, we have tried it in an acute inpatient ward, and we know it is safe and that it is acceptable.
“But we need to prove that people like the hub idea, that they get great intensity of rehabilitation, and that it improves people’s outcomes. Once we do that that will hopefully allow us to make a case that these facilities should be in place.
“Obviously, there are initial costs in terms of buying equipment, and there needs to be a discussion around how do we change the pathways and how do we change the ways the services work to allow this to become part of the normal treatment.
“But at the end of the day, what we want is to keep people out of hospital so they can go home and lead as normal a life as possible in the community.”
Innovative robotic cup could empower older adults to stay hydrated
A one-of-a-kind robotic cup designed to help people living with cerebral palsy stay hydrated could also be a game-changer for older adults suffering from mobility impairments.
The aptly named RoboCup enables people with limited upper body mobility to stay hydrated without relying on a caregiver for help.
The battery-powered device, which can be mounted on a user’s wheelchair and customised to suit their mobility needs, is activated either by a button or a proximity sensor that brings a straw directly to their mouth.
The user can then take a drink, and once they have finished the straw automatically withdraws.
The cup is the brainchild of engineering students Thomas Kutcher and Rafe Neathery, who came up with the innovative idea after Rice University’s Oshman Engineering Design Kitchen (OEDK) in Houston, Texas, in the United States, was approached by spastic quadriplegic cerebral palsy patient Gary Lynn for help creating an assistive drinking device.
The result is RoboCup, which Thomas and Rafe hope will offer users greater freedom as they won’t need to rely on a caregiver whenever they need a drink.
To this end, the undergraduates have generously made their design available for free to anyone with access to a 3D printer to assemble their own drinking device by downloading instructions from RoboCup’s OEDK website.
Having made it possible for those living with cerebral palsy to drink water autonomously, Thomas and Rafe are now looking at the cup’s wider application – and believe it could prove to be a life-changing piece of technology for those with age-related eating and drinking problems caused by muscle weakness, pain, disease, and neurological conditions that can seriously affect mobility.
Thomas told AgeTech World: “While our client who had the idea for this device has cerebral palsy, the potential use cases spread far and wide. Rafe and I wanted our design to be as generalisable as possible.
“The device is catered to anyone with impaired mobility in a wheelchair, to the extent that they can either push a button or hold their finger in front of a motion sensor, and sip water from a straw.
“Once the device is set up it is very intuitive. It just needs to be set up in a manner where the straw rotates directly to a comfortable location for the user, and the sensor should be placed in a position where the user is able to trigger it.
“Once that criteria is met it should be very easy for the user.”
Dehydration is dangerous for anyone of any age. But older people are at a greater risk than any other age group.
This is because as people age their bodies don’t demand the same levels of liquid as they did in their younger years. This in turn changes a person’s sense of thirst.
However, the body still needs fluids to function, whether that be helping lubricate joints, regulating body temperature, pumping blood to the muscles, or ensuring the kidneys and urinary tract continue to function properly.
According to the British Nutrition Foundation, dehydration is not only a common cause of hospital admissions in older people but is associated with increased mortality.
For example, a two-fold increase in the mortality of stroke patients has been reported.
Even mild dehydration can be dangerous, affecting tiredness levels and mental performance, potentially leading to low blood pressure, dizziness, weakness, and an increased risk of falls.
In older people, dehydration is often associated with dementia, poorly controlled diabetes, Alzheimer’s disease, and stroke.
Certain medications can also cause dehydration.
The obvious way to prevent a lack of fluids is to drink more. But this can be easier said than done if you have impaired physical or mental abilities that may confine you to a bed or a wheelchair.
There are several hydration aids on the market aimed at older adults and those with cognitive impairments such as dementia and Alzheimer’s, from water sweets to sports-type bottles and wearable devices that can monitor fluid intake.
But Thomas and Rafe believe RoboCup is in a class of its own.
Rafe said: “RoboCup is primarily focused on allowing those with limited mobility to find increased autonomy in their day-to-day lives. The primary alternative to something like RoboCup would be a water bottle with a long adjustable straw that can be positioned near the user’s mouth.
“However, the issue with these products is that they intrude on the user’s headspace, and they tend to leak water down their shirt. RoboCup gives people autonomy to have hydration when they want it, and to have control over their own personal space.”
Whilst currently designed for use with a wheelchair, Rafe and Thomas say the RoboCup could be adapted for use in other situations, such as a hospital or care home environment, where a patient is confined to bed.
Thomas and Rafe, who are both 21 and in their final year at Rice University studying bioengineering and mechanical engineering respectively, are currently busy with senior design projects in other fields.
But Thomas said: “As far as assistive devices go our focus is still on RoboCup. As there is such a wide range of potential users, we’re still looking for and exploring ideas to make RoboCup more customisable.
“The main ones are investigating different sensors and locations to fit an individual’s personal ability, adjusting the design to accommodate more viscous fluids, or making it simpler for people to adjust the timing of the motion.”
Making the device as accessible as possible has meant simplifying it. During its development, the duo removed some of the more complicated or expensive parts and found alternatives for custom pieces that required special equipment to be made.
Rafe explained: “It was challenging walking that thin line between simplifying the device and sacrificing functionality or robustness. We wanted to keep it working well while still making it simpler and cheaper.
“Balancing all these considerations was really tricky, but we did get to a point where it’s now a lot easier to 3D print and assemble the device using simple, readily accessible tools.”
The pair worked closely with Gary Lynn during the development stage to optimise the design, which went through several iterations. An initial prototype featured a camelback but was scrapped for the current mounted cup-and-straw version.
Both Gary and his mother Andrea Lynn have expressed their hope that the project will bring attention to the struggles of people living with disabilities who can often strain with something as seemingly easy as drinking water.
Gary has said of Thomas and Rafe’s design: “This cup will give independence to people with limited mobility in their arms. Getting to do this little task by themselves will enhance the confidence of the person using the device.”
To help spread the word about RoboCup, Rafe and Thomas entered the device in the World Cerebral Palsy Day Remarkable Designa-thon competition intended to promote “ideas for a new product or service that could change lives” for people in the cerebral palsy community.
Sadly, RoboCup didn’t win. The prize went to a woman with cerebral palsy who developed an idea for an app that knows who she is, and where she is, and contains a list of her contacts for emergencies, allowing those with speech challenges to effectively communicate their needs to anyone.
Rafe said: “I’m glad the money is going to someone with cerebral palsy who has an important need to be met.”
That hasn’t stopped Rafe and Thomas from getting the word out about RoboCup.
But why did they decide to make their invention freely available rather than taking the entrepreneurial route?
Thomas said their goal had always been to bring it to as many people as possible, especially as they had neither the time nor the investment to commercialise it.
“Helping other people make their own is best,” he commented. “We have open-sourced the part files and code online, and everything else is available to buy from other vendors. After everything is printed, all it takes is a screwdriver and less than an hour to assemble Robocup – the instructions are also online with a few dozen pictures.
“The idea behind all of this effort is to enable others to make Robocup themselves, regardless of access to tools or machinery.
“The low cost, small size, and wide capabilities of a desktop 3D printer are bringing it into more and more households, as well as schools, labs, and maker spaces. There are also several online services that can print and ship 3D-printed parts.”
He added: “We hope the manufacturing process doesn’t prove too burdensome, as Rafe and I worked hard to make it as simple as possible. We do believe that the fully idealised version of this device is purchasable off the shelf to make it as easy as possible for the consumer.”
With graduation looming, Thomas and Rafe admit they are keen to move on to future endeavours. Rafe is going to work for SpaceX post-graduation and Thomas is planning to pursue a PhD in Neural Engineering.
That doesn’t mean if the RoboCup takes off, it might not become a commercial enterprise.
Thomas said: “Like I said before, Rafe and I have wanted to get the word out about RoboCup and move on, as we are graduating. We were potentially hoping that another organisation could take the reins on the RoboCup, or our open-source website could become popular.
“We mostly just wanted to get our work out there through open sourcing, but Rafe and I have more things to discuss in terms of making sure the RoboCup is successful, reaching as many people as possible.
“I personally am somewhat interested in turning it into a commercial enterprise if there is a clear path there, but I need to do more research.”
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