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Main article: Health

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Facebook prototypes tool to show how many minutes you spend on it

18:08 | 22 June

Are you ready for some scary numbers? After months of Mark Zuckerberg talking about how “Protecting our community is more important than maximizing our profits”, Facebook is preparing to turn that commitment into a Time Well Spent product.

Buried in Facebook’s Android app is an unreleased “Your Time On Facebook” feature. It shows the tally of how much time you spent on the Facebook app on your phone on each of the last seven days, and your average time spent per day. It lets you set a daily reminder that alerts you when you’ve reached your self imposed limit, plus a shortcut to change your Facebook notification settings.

The feature could help Facebook users stay mindful of how long they’re staring at the social network. This self-policing could be important since both iOS and Android are launching their own screen time monitoring dashboards that reveal which apps are dominating your attention and can alert you or lock you out of apps when you hit your time limit. When Apple demoed the feature at WWDC, it used Facebook as an example of an app you might use too much.

Images of Facebook’s digital wellbeing tool come courtesy of our favorite tipster and app investigator Jane Manchun Wong. She previously helped TechCrunch scoop the development of features like Facebook Avatars, Twitter encrypted DMs, and Instagram Usage Insights — a Time Well Spent feature that looks very similar to this one on Facebook. Facebook confirmed the feature development, with a spokesperson telling us ““We’re always working on new ways to help make sure people’s time on Facebook is time well spent.”

Our report on Instagram Usage Insights led the sub-company’s CEO Kevin Systrom to confirm the upcoming feature, saying ““It’s true . . . We’re building tools that will help the IG community know more about the time they spend on Instagram – any time should be positive and intentional . . . Understanding how time online impacts people is important, and it’s the responsibility of all companies to be honest about this. We want to be part of the solution. I take that responsibility seriously.”

Facebook has already made changes to its News Feed algorithm designed to reduce the presence of low-quality but eye-catching viral videos. That led to Facebook’s first ever usage decline in North America in Q4 2017, with a loss of 700,000 daily active users in the region. Zuckerberg said on the earnings call that this change “reduced time spent on Facebook by roughly 50 million hours every day.”

Zuckerberg has been adamant that all time spent on Facebook isn’t bad. Instead as we argued in our piece “The Difference Between Good And Bad Facebooking”, its asocial, zombie-like passive browsing and video watching that’s harmful to people’s wellbeing, while active sharing, commenting, and chatting can make users feel more connected and supported.

But that distinction isn’t visible in this prototype of the “Your Time On Facebook Tool” which appears to treat all time spent the same. If Facebook was able to measure our active vs passive time on its app and impress the health difference, it could start to encourage us to either put down the app, or use it to communicate directly with friends when we find ourselves mindlessly scrolling the feed or enviously viewing people’s photos.

 


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Taste test: Burger robot startup Creator opens first restaurant

16:33 | 21 June

Creator’s transparent burger robot doesn’t grind your brisket and chuck steak into a gourmet patty until you order it. That’s just one way this startup, formerly known as Momentum Machines, wants to serve the world’s freshest cheesebuger for just $6. On June 27th, after 8 years in development, Creator opens its first robot restaurant. We got a sneak peek…err…taste.

When I ask how a startup launching one eatery at a time could become a $10 billion company, Creator co-founder and CEO Alex Vardakostas looks me dead in the eye and says “the market is much bigger than that.”

Here’s how Creator’s burger-cooking bot works at its 680 Folsom St location in San Francisco. Once you order your burger style through a human concierge on a tablet, a compressed air tube pushes a baked-that-day bun into an elevator on the right. It’s sawwed in half by a vibrating knife before being toasted and buttered as its lowered to conveyor belt. Sauces measured by the milliliter and spices by the gram are automatically squirted onto the bun. Whole pickles, tomatoes, onions, and blocks of nice cheese get slices shaved off just a second before they’re dropped on top.

Meanwhile, the robot grinds hormone-free, pasture-raised brisket and chuck steak to order. But rather than mash them all up, the strands of meat hang vertically and are lightly pressed together. They form a loose but auto-griddleable patty that’s then plopped onto the bun before the whole package slides out of the machine after a total time of about five minutes. The idea is that when you bite into the burger, your teeth align with the vertical strands so instead of requiring harsh chewing it almost melts in your mouth.

The startup’s initial burger options include the classic-style Creator vs. The World with a mole Thousand Island special sauce, the oyster aioli Tumami Burger designed by Chef Tu of Top Chef, The Smoky with charred onion jam, and the sunflower seed tahini Dad Burger from Chef Nick Balla of Bar Tartine.

The taste of each is pretty remarkable. The flavor pops out of all the fresh cut and ground ingredients that lack the preservatives of pre-sliced stuff. The patties hold together as you munch despite being exceedingly tender. And afterwards I felt less of the greasy, gut-bomb, food coma vibe that typically accompanies scarfing down a cheeseburger.

“This is the kind of burger you would get for $12 to $18 [at an upscale restaurant], and it’s $6” says Vardakostas. It might not be the best burger I’ve had in my life, but it’s certainly the best at that price. A lot of that comes from the savings on labor and kitchen space afforded by a robot cook. “We spend more on our ingredients than any other burger restaurant.”

The CEO wouldn’t reveal how much Creator has raised, but says it’s backed by Google’s GV, frequent food startup investor Khosla Ventures, and hardware-focused Root Ventures. However, SEC filings attained by TechCrunch show the startup raised at least $18.3 million in 2017, and sought $6 million more back in 2013.

It’s understandable why. “McDonalds is a $140 billion company. It’s bigger than GM and Tesla combined. McDonalds has 40,000 restaurants. Food is one to the top three biggest markets” Vardakostas rattles off. “But we have a lot of advantages. The average reastaurant is 50 percent bigger in terms of square footage.” Then he motions to his big robot that’s a lot smaller than the backside of most fast-food restauants, and with a smile says “That’s our kitchen. You roll it in and plug it in.”

From Flipping Patties To Studying Physics

Creator co-founder and CEO Alex Vardakostas

What you want in a founder is a superhero origin story. Some formative moment in their life that makes them hellbent on solving a problem. Vardakostas has a pretty convincing tale. “My parents have a burger joint” he reveals. “My job was to make several hundred of the same burger every day. You realize there’s so much opportunity not taken because you don’t have the right tools, and it’s hard work.”

Robots and engineering weren’t even on his radar growing up in the restaurant in southern California. Then, “when I was 15 my dad took me to a book store for the first time. I started reading about physics and realizing that this could be a possibility.” He went on to study physics at UC Santa Barbara, got to work in the garage, and finally drove up to Silicon Valley to machine the first robot prototype’s parts at the famous Silicon Valley TechShop.

That’s when he met his co-founder and COO Steve Frehn. “Steve told me he was from Stanford and I was super intimidated” Vardakostas recalls. But the two had a great working rapport, and a knack for recruiting budding mechanical engineers from the college. Momentum Machines started in 2009, was a full-time garage project by 2010, incorporated and joined Lemnos Labs in 2012, and the startup began to make serious progress by 2014.

In the meantime, other entrepreneurs have tried to find a business in food robots. There was the now-defunct Y Combinator startup Bistrobot that haphazardly spurted liquid peanut butter and Nutella on white bread and called it a sandwich. More recently, Miso Robotics’ burger-flipping arm named Flippy made headlines, even though all it does is flip and cook patties on a traditional griddle. “We have an arm that pulls out the burgers, but that’s probably 5 percent of the complexity” of the full Creator robot run by 350 sensors, 50 actuators, and 20 computers, Vardakostas scoffs.

Breaking Burger Behavior

The CEO’s past in the kitchen keeps Creator in touch with the human element. He tells me he thinks the idea of a staff-less restaurant where you order on a computer sounds “dystopian”. In fact, he wants to give his food service employees access to new careers. Vardakostas says with a sigh that “people look at restaurant work as a charity case, but man, we just need a chance.” Referring to the old Google policy of letting employees try out side projects, he explains how “Tech companies get 10 percent time but no one does that for restaurant workers.”

“Something we got really excited about in 2012 and we’re just starting to excute on is reinventing the job of working in a store like this, where the machine it taking care of the dirty and dangerous work” his co-founder Frehn explains. “We’re playing around with education programs for the staff. 5 percent of the time they’re paid just to read. We’re already doing that. There’s a book budget. We’re paying $16 an hour. As opportunities come up to fix the machine, there’s a path we’re going to offer people as repair or maintenance people to get paid even more.”

One tradition Creator couldn’t escape was french fries. Vardakostas says they’re basically the least healthy thing you can eat, noting they’re “worse than donuts because there’s more surface area exposed to the frier.” But chefs told him some people simply wouldn’t eat a burger without them. Creator’s compromise is that burgers are paired with hearty miniature farro or seasonal veggie salads by default, but you can still opt for a side of frites.

Creator’s fate won’t just be determined by the burger robot and the people that work alongside it. The startup will have to prove to fast food diners that it can be just as quick and cheap but a lot tastier, and that they’re welcome amongst the restaurant’s bougie Pottery Barn decor. At the same time, it must convince more affluent eaters that a cafeteria-style ordering counter and low price don’t mean low quality.

For now, Creator won’t be licensing out its bot or franchising its restaurant, though those could be lucrative. “I don’t want someone putting frozen beef in there or charging way more” says Vardakostas. Instead, the goal is to methodically expand, and maybe take advantage of its petite footprint to move into airport terminals or bus stations. “We want to get out of San Francisco” Frehn confidently concludes. “Our business model is pretty simple. We take a really good burger that people like and sell it for half the price.”

 


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‘Gaming disorder’ is officially recognized by the World Health Organization

01:26 | 19 June

Honestly, “gaming disorder” sounds like a phrase tossed around by irritated parents and significant others. After much back and forth, however, the term was just granted validity, as the World Health Organization opted to include it in the latest edition of its Internal Classification of Diseases.

The volume, out this week, diagnoses the newly minted disorder with three key telltale signs:

  1. Impaired control over gaming (e.g. onset, frequency, intensity, duration, termination, context)
  2. Increasing priority given to gaming to the extent that gaming takes precedence over other life interests and daily activities
  3. Continuation or escalation of gaming despite the occurrence of negative consequences

I can hear the collective sound of many of my friends gulping at the sound of eerily familiar symptoms. Of course, the disorder has been criticized from a number of corners, including health professionals who have written it off as being overly broad and subjective. And, of course, the potential impact greatly differs from person to person and game to game.

The effects as specified above share common ground with other similar addictive activities defined by the WHO, including gambling disorder:

“Disorders due to addictive behaviours are recognizable and clinically significant syndromes associated with distress or interference with personal functions that develop as a result of repetitive rewarding behaviours other than the use of dependence-producing substances,” writes the WHO. “Disorders due to addictive behaviors include gambling disorder and gaming disorder, which may involve both online and offline behaviour.”

In spite of what may appear to be universal symptoms, however, the organization is quick to note that the prevalence of gaming disorder, as defined by the WHO, is actually “very low.” WHO member Dr. Vladimir Poznyak tells CNN, “Millions of gamers around the world, even when it comes to the intense gaming, would never qualify as people suffering from gaming disorder.”

 


0

Bet money on yourself with Proveit, the 1-vs-1 trivia app

00:13 | 19 June

Pick a category, wager a few dollars, and double your money in 60 seconds if you’re smarter and faster than your opponent. Proveit offers a fresh take on trivia and game show apps by letting you win or lose cash on quick 10-question, multiple choice quizzes. Sick of waiting to battle a million people on HQ for a chance at a fraction of the jackpot? Play one-on-one anytime you want or enter into scheduled tournaments with $1,000 or more in prize money, while Proveit takes around 10 percent to 15 percent of the stakes.

“I’d play Jeopardy all the time with my family and wondered ‘why can’t I do this for money?'” says co-founder Prem Thomas.

Remarkably, it’s all legal. The Proveit team spent two years getting approved as ‘skill-based gaming’ that exempts it from some laws that have hindered fantasy sports betting apps. And for those at risk of addiction, Proveit offers players and their loved ones a way to cut them off.

The scrappy Florida-based startup has raised $2.3 million so far. With fun games and a snackable format, Proveit lets you enjoy the thrill of betting a moment’s notice. That could make it a favorite amongst players and investors in a world of mobile games without consequences.

“I could spend $50 for a three-hour experience in a movie theater, or I could spend $2 to enter a Proveit Movies tournament that gives me the opportunity to compete for several thousand dollars in prize money” says co-founder Nathan Lehoux. “That could pay for a lot of movies tickets!”

Proving It As Outsiders

St Petersburg, FL isn’t exactly known as an innovation hub. But outside Tampa Bay, far from the distractions, copycatting, and astronomical rent of Silicon Valley, the founders of Proveit built something different. “What if people could play trivia for money just like fantasy sports?” Thomas asked his friend Lehoux.

That’s the same pitch that got me interested when Lehoux tracked me down at TechCrunch’s SXSW party earlier this year. Lehoux is a jolly, outgoing fella who became interested in startups while managing some angel investments for a family office. Thomas had worked in banking and health before starting a yoga-inspired sandals brand. Neither had computer science backgrounds, and they’d raised just a $300,000 seed round from childhood friend Hilt Tatum who’d co-founded beleaguered real money gambling site Absolute Poker.

Yet when he Lehoux thrust the Proveit app into my hand, even on a clogged mobile network at SXSW, it ran smoothly and I immediately felt the adrenaline rush of matching wits for money. They’d initially outsourced development to an NYC firm that burned much of their initial $300,000 seed funding without delivering. Luckily, the Ukranian they’d hired to help review that shop’s code helped them spin up a whole team there that built an impressive v1 of Proveit.

Meanwhile, the founders worked with a gaming lawyer to secure approvals in 33 states. “This is a highly regulated and highly controversial space due to all the negative press that fantasy sports drummed up” says Lehoux. “We talked to 100 banks and processors before finding one who’d work with us.”

Proveit founders (from left): Nathan Lehoux, Prem Thomas

Proveit was finally legal for the 3/4s of the U.S. population, and had a regulatory moat to deter competitors. To raise launch capital, the duo tapped their Florida connections to find John Morgan, a high-profile lawyer and medical marijuana advocate who footed a $2 million angel round. A team of grad students in Tampa Bay was assembled to concoct the trivia questions, while a third-party AI company assists with weeding out fraud.

Proveit launched early this year, but beyond a SXSW promotion, it has stayed under the radar as it tinkers with tournaments and retention tactics. The app has now reached 80,000 registered users, 6,000 multi-deposit hardcore loyalists, and has paid out $750,000 total. But watching HQ trivia climb to over 1 million players per game has proven a bigger market for Proveit.

Quiz For Cash

“We’re actually fans of HQ. We play. We think they’ve revolutionized the game show” Lehoux tells me. “What we want to do is provide something very different. With HQ, you can’t pick your category. You can’t pick the time you want to play. We want to offer a much more customized experience.”

To play Proveit, you download its iOS-only app and fund your account with a buy-in of $20 to $100, earning more bonus cash with bigger packages (no minors allowed). Then you play a practice round to get the hang out of it — something HQ sorely lacks. Once you’re ready, you pick from a list of game categories, each with a fixed wager of about $1 to $5 to play (choose your own bet is in the works). You can test your knowledge of superheroes, the 90s, quotes, current events, rock’n’roll, Seinfeld, tech, and rotating selection of other topics.

In each Proveit game you get 10 questions, 1 at a time, with up to 15 seconds to answer each. Most games are head-to-head, with options to be matched with a stranger, or a friend via phone contacts. You score more for quick answers, discouraging cheating via Google, and get penalized for errors. At the end, your score is tallied up an compared against your opponent, with the winner keeping both player’s wagers minus Proveit’s cut. In a minute or so, you could lose $3 or win $5.28. Afterwards you can demand a rematch, go double-or-nothing, head back to the category list, or cash out if you have more than $20.

The speed element creates intense, white-knuckled urgency. You can get every question right and still lose if your opponent is faster. So instead of second-guessing until locking in your choice just before the buzzer like on HQ where one error knocks you out, you race to convert your instincts into answers on Proveit. The near instant gratification of a win or humiliation of a defeat both nudge you to play again rather than having to wait for tomorrow’s game.

Proveit will have to compete with free apps like Trivia Crack, prize games like studen loan repayer Giveling and virtual currency-based Fleetwit, and the juggernaut HQ.

“The large tournaments are the big draw”, though, Lehoux believes. Instead of playing one-on-one, you can register and ante up for a scheduled tournament where you compete in a single round against hundreds of players for a grand prize. Right now, the players with the top 20 percent of scores win at least their entry fee back or more, with a few geniuses collecting the cash of the rest of the losers.

Just like how DraftKings and FanDuel built their user base with big jackpot tournaments, Proveit hopes to do the same…then get people playing little one-on-one games in between as they wait for their coffee or commute home from work.

Gaming Or Gambling?

Thankfully, Proveit understands just how addictive it can be. The startup offers an “self-exclusion” option. “If you feel that you need to take greater control of your life as it relates to skill-gaming”, users can email it to say they shouldn’t play any more, and it will freeze or close their account. Family members and others can also request you be frozen if you share a bank account, they’re your dependent, they’re obligated for your debts, or you owe unpaid child support.

“We want Proveit to be a fun, intelligent entertainment option for our players. It’s impossible for us to know who might have an issue with real-money gaming” Lehoux tells me. “Every responsible real-money game provides this type of option for its users.

That isn’t necessarily enough to thwart addiction, because dopamine can turn people into dopes. Just because the outcome is determined by your answers rather than someone else’s touchdown pass doesn’t change that.

Skill-based betting from home could be much more ripe for abuse than having to drag yourself to a casino, while giving people an excuse that they’re not gambling on chance. Zynga’s titles like Farmville have been turning people into micro-transaction zombies for a decade, and you can’t even win money from them. Simultaneously, sharks could study up on a category and let Proveit’s random matching deliver them willing rookies to strip cash from all day. “This is actually one of the few forms of entertainment that rewards players financially for using their brain” Lehoux defends.

With so much content to consume and consequence-free games to play, there’s an edgy appeal to the danger of Proveit and apps like it. Its moral stance hinges on how much autonomy you think adults should be afforded. From Coca-Cola to Harley Davidson to Caesar’s Palace, society has allowed businesses to profit off questionably safe products that some enjoy.

For better and worse, Proveit is one of the most exciting mobile games I’ve ever played.

 


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First look at Instagram’s self-policing Time Well Spent tool

21:28 | 16 June

Are you Overgramming? Instagram is stepping up to help you manage overuse rather than leaving it to iOS and Android’s new screen time dashboards. Last month after TechCrunch first reported Instagram was prototyping a Usage Insights feature, the Facebook sub-company’s CEO Kevin System confirmed its forthcoming launch.

Tweeting our article, Systrom wrote “It’s true . . . We’re building tools that will help the IG community know more about the time they spend on Instagram – any time should be positive and intentional . . . Understanding how time online impacts people is important, and it’s the responsibility of all companies to be honest about this. We want to be part of the solution. I take that responsibility seriously.”

Now we have our first look at the tool via Jane Manchun Wong, who’s recently become one of TechCrunch’s favorite sources thanks to her skills at digging new features out of apps’ Android APK code. Though Usage Insights might change before an official launch, these screenshots give us an idea of what Instagram will include. We’ve reached out to Instagram for comment, and will update if we hear back.

This unlaunched version of Instagram’s Usage Insights tool offers users a daily tally of their minutes spent on the app. They’ll be able to set a time spent daily limit, and get a reminder once they exceed that. There’s also a shortcut to manage Instagram’s notifications so the app is less interruptive. Instagram has been spotted testing a new hamburger button that opens a slide-out navigation menu on the profile. That might be where the link for Usage Insights shows up, judging by this screenshot.

Instagram doesn’t appear to be going so far as to lock you out of the app after your limit, or fading it to grayscale which might annoy advertisers and businesses. But offering a handy way to monitor your usage that isn’t buried in your operating system’s settings could make users more mindful.

Instagram has an opportunity to be a role model here, especially if it gives its Usage Insights feature sharper teeth. For example,  rather than a single notification when you hit your daily limit, it could remind you every 15 minutes after, or create some persistent visual flag so you know you’ve broken your self-imposed rule.

Instagram has already started to push users towards healthier behavior with a “You’re all caught up” notice when you’ve seen everything in your feed and should stop scrolling.

I expect more apps to attempt to self-police with tools like these rather than leaving themselves at the mercy of iOS’s Screen Time and Android’s Digital Wellbeing features that offer more drastic ways to enforce your own good intentions.

Both let you see overall usage of your phone and stats about individual apps. iOS lets you easily dismiss alerts about hitting your daily limit in an app but delivers a weekly usage report (ironically via notification), while Android will gray out an app’s icon and force you to go to your settings to unlock an app once you exceed your limit.

For Android users especially, Instagram wants to avoid looking like such a time sink that you put one of those hard limits on your use. In that sense, self-policing shows both empathy for its users’ mental health, but is also a self-preservation strategy. With Instagram slated to launch a long-form video hub that could drive even longer session times this week, Usage Insights could be seen as either hypocritical or more necessary than ever.

New time management tools coming to iOS (left) and Android (right). Images via The VergeInstagram is one of the world’s most beloved apps, but also one of the most easily abused. From envy spiraling as you watch the highlights of your friends’ lives to body image issues propelled by its endless legions of models, there are plenty of ways to make yourself feel bad scrolling the Insta feed. And since there’s so little text, no links, and few calls for participation, it’s easy to zombie-browse in the passive way research shows is most dangerous.

We’re in a crisis of attention. Mobile app business models often rely on maximizing our time spent to maximize their ad or in-app purchase revenue. But carrying the bottomless temptation of the Internet in our pockets threatens to leave us distracted, less educated, and depressed. We’ve evolved to crave dopamine hits from blinking lights and novel information, but never had such an endless supply.

There’s value to connecting with friends by watching their days unfold through Instagram and other apps. But tech giants are thankfully starting to be held responsible for helping us balance that with living our own lives.

 


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YC alum Modern Health, a startup focused on emotional wellbeing, gets $2.26M seed funding

17:00 | 15 June

Modern Health founders Alyson Friedensohn and Erica Johnson

About one year ago, a note from a CEO thanking his employee for using sick days to take care of her mental health went viral. It was a reminder to Alyson Friedensohn of what she wants to accomplish with Modern Health, the emotional health benefits startup she founded last year with neuroscientist Erica Johnson.

“We want that to be normal. We want the email she sent to be normal, to be able to be that open,” Friedensohn tells TechCrunch.

Modern Health, a Y Combinator alum, announced today that it has raised $2.26 million in seed funding for hiring, accelerating the development of its healthcare platform and growing its network of therapists, coaches and other providers. Offered as a benefit by companies, Modern Health’s services are meant to improve employee well-being and retention rates. The round was led by Afore, with participation from Social Capital, Precursor Ventures, Merus Capital, Maschmeyer Group Ventures, Y Combinator and angel investors.

Friedensohn, Modern Health’s chief executive officer, says six employers currently offer its platform, which includes services like counseling and career and financial coaching. One thing the startup is especially proud of is the fact that Modern Health’s team is currently all female and Friedensohn wants to parlay their point of view into services that address issues affecting women. For example, the platform already works with providers who specialize in postpartum depression and infertility.

“People don’t talk about what working moms are dealing with and countless things like that,” says Friedensohn, who previously worked at health tech companies Keas and Collective Health. “People don’t want to talk about it because they are worried it will jeopardize their careers, but it makes a difference.”

Several other tech startups are working on mental health care platforms for employers to offer as a benefit, including Ginger.io, Lyra Health and Quartet, which have all have received significant amounts of funding from prominent investors. The space is especially important, given the alarming rise in the United States’ suicide rate and the fact that about 6.7% of all adults in the U.S. have experienced at least one major depressive episode.

One of Modern Health’s priorities is to reach employees before they hit a crisis point. Since many people are daunted by the idea of therapy, the platform connects them to coaches instead to focus on specific issues, like their careers, or overall emotional wellbeing. This helps referrals, Friedensohn notes, because it makes the service feel more approachable.

“They can say to friends, I have this awesome Modern Health coach, versus saying I have a therapist, so it’s way easier for people to engage,” she says.

Modern Health also makes its services more accessible by offering several ways to use the platform: texting, video calls or, for people who don’t want to talk to a therapist or coach yet, meditation apps and other digital tools created by the company. One of Modern Health’s newest customers, human resources startup Gusto, hit a 43% utilization rate of its services, including connecting employees to coaches and therapists, among registered users just four days after it began offering the platform. Friedensohn adds that it’s not uncommon for people to write essays on their sign-up forms when registering because it’s the first time they’ve been able to unload their problems.

“People like that it’s coaching,” she says. “What we found is that by focusing on that point, the biggest thing is lowering the barrier to entry, so that people who are depressed are also comfortable reaching out.”

 


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Audit of NHS Trust’s app project with DeepMind raises more questions than it answers

19:18 | 13 June

A third party audit of a controversial patient data-sharing arrangement between a London NHS Trust and Google DeepMind appears to have skirted over the core issues that generated the controversy in the first place.

The audit (full report here) — conducted by law firm Linklaters — of the Royal Free NHS Foundation Trust’s acute kidney injury detection app system, Streams, which was co-developed with Google-DeepMind (using an existing NHS algorithm for early detection of the condition), does not examine the problematic 2015 information-sharing agreement inked between the pair which allowed data to start flowing.

“This Report contains an assessment of the data protection and confidentiality issues associated with the data protection arrangements between the Royal Free and DeepMind . It is limited to the current use of Streams, and any further development, functional testing or clinical testing, that is either planned or in progress. It is not a historical review,” writes Linklaters, adding that: “It includes consideration as to whether the transparency, fair processing, proportionality and information sharing concerns outlined in the Undertakings are being met.”

Yet it was the original 2015 contract that triggered the controversy, after it was obtained and published by New Scientist, with the wide-ranging document raising questions over the broad scope of the data transfer; the legal bases for patients information to be shared; and leading to questions over whether regulatory processes intended to safeguard patients and patient data had been sidelined by the two main parties involved in the project.

In November 2016 the pair scrapped and replaced the initial five-year contract with a different one — which put in place additional information governance steps.

They also went on to roll out the Streams app for use on patients in multiple NHS hospitals — despite the UK’s data protection regulator, the ICO, having instigated an investigation into the original data-sharing arrangement.

And just over a year ago the ICO concluded that the Royal Free NHS Foundation Trust had failed to comply with Data Protection Law in its dealings with Google’s DeepMind.

The audit of the Streams project was a requirement of the ICO.

Though, notably, the regulator has not endorsed Linklaters report. On the contrary, it warns that it’s seeking legal advice and could take further action.

In a statement on its website, the ICO’s deputy commissioner for policy, Steve Wood, writes: “We cannot endorse a report from a third party audit but we have provided feedback to the Royal Free. We also reserve our position in relation to their position on medical confidentiality and the equitable duty of confidence. We are seeking legal advice on this issue and may require further action.”

In a section of the report listing exclusions, Linklaters confirms the audit does not consider: “The data protection and confidentiality issues associated with the processing of personal data about the clinicians at the Royal Free using the Streams App.”

So essentially the core controversy, related to the legal basis for the Royal Free to pass personally identifiable information on 1.6M patients to DeepMind when the app was being developed, and without people’s knowledge or consent, is going unaddressed here.

And Wood’s statement pointedly reiterates that the ICO’s investigation “found a number of shortcomings in the way patient records were shared for this trial”.

“[P]art of the undertaking committed Royal Free to commission a third party audit. They have now done this and shared the results with the ICO. What’s important now is that they use the findings to address the compliance issues addressed in the audit swiftly and robustly. We’ll be continuing to liaise with them in the coming months to ensure this is happening,” he adds.

“It’s important that other NHS Trusts considering using similar new technologies pay regard to the recommendations we gave to Royal Free, and ensure data protection risks are fully addressed using a Data Protection Impact Assessment before deployment.”

While the report is something of a frustration, given the glaring historical omissions, it does raise some points of interest — including suggesting that the Royal Free should probably scrap a Memorandum of Understanding it also inked with DeepMind, in which the pair set out their ambition to apply AI to NHS data.

This is recommended because the pair have apparently abandoned their AI research plans.

On this Linklaters writes: “DeepMind has informed us that they have abandoned their potential research project into the use of AI to develop better algorithms, and their processing is limited to execution of the NHS AKI algorithm… In addition, the majority of the provisions in the Memorandum of Understanding are non-binding. The limited provisions that are binding are superseded by the Services Agreement and the Information Processing Agreement discussed above, hence we think the Memorandum of Understanding has very limited relevance to Streams. We recommend that the Royal Free considers if the Memorandum of Understanding continues to be relevant to its relationship with DeepMind and, if it is not relevant, terminates that agreement.”

In another section, discussing the NHS algorithm that underpins the Streams app, the law firm also points out that DeepMind’s role in the project is little more than helping provide a glorified app wrapper (on the app design front the project also utilized UK app studio, ustwo, so DeepMind can’t claim app design credit either).

“Without intending any disrespect to DeepMind, we do not think the concepts underpinning Streams are particularly ground-breaking. It does not, by any measure, involve artificial intelligence or machine learning or other advanced technology. The benefits of the Streams App instead come from a very well-designed and user-friendly interface, backed up by solid infrastructure and data management that provides AKI alerts and contextual clinical information in a reliable, timely and secure manner,” Linklaters writes.

What DeepMind did bring to the project, and to its other NHS collaborations, is money and resources — providing its development resources free for the NHS at the point of use, and stating (when asked about its business model) that it would determine how much to charge the NHS for these app ‘innovations’ later.

Yet the commercial services the tech giant is providing to what are public sector organizations do not appear to have been put out to open tender.

Also notably excluded in the Linklaters’ audit: Any scrutiny of the project vis-a-vis competition law, public procurement law compliance with procurement rules, and any concerns relating to possible anticompetitive behavior.

The report does highlight one potentially problematic data retention issue for the current deployment of Streams, saying there is “currently no retention period for patient information on Streams” — meaning there is no process for deleting a patient’s medical history once it reaches a certain age.

“This means the information on Streams currently dates back eight years,” it notes, suggesting the Royal Free should probably set an upper age limit on the age of information contained in the system.

While Linklaters largely glosses over the chequered origins of the Streams project, the law firm does make a point of agreeing with the ICO that the original privacy impact assessment for the project “should have been completed in a more timely manner”.

It also describes it as “relatively thin given the scale of the project”.

Giving its response to the audit, health data privacy advocacy group MedConfidential — an early critic of the DeepMind data-sharing arrangement — is roundly unimpressed, writing: “The biggest question raised by the Information Commissioner and the National Data Guardian appears to be missing — instead, the report excludes a “historical review of issues arising prior to the date of our appointment”.

“The report claims the ‘vital interests’ (i.e. remaining alive) of patients is justification to protect against an “event [that] might only occur in the future or not occur at all”… The only ‘vital interest’ protected here is Google’s, and its desire to hoard medical records it was told were unlawfully collected. The vital interests of a hypothetical patient are not vital interests of an actual data subject (and the GDPR tests are demonstrably unmet).

“The ICO and NDG asked the Royal Free to justify the collection of 1.6 million patient records, and this legal opinion explicitly provides no answer to that question.”

 


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LOLA just raised $24M for a subscription service that ships tampons, pads and now condoms

23:01 | 12 June

LOLA, a subscription service delivering tampons and pads, and now other products, including condoms, lubricant, and feminine cleansing wipes, has closed on $24 million in Series B funding. While the startup touts its products’ “100% organic” nature, it’s also well-received because of the customization offered and its direct-to-consumer nature.

The new round of financing was led by private equity firm Alliance Consumer Growth (ACG), with support from existing investors Spark Capital, Lerer Hippeau and Brand Foundry Ventures.

To date, LOLA has raised $11.2 million, from investors including also BBG Ventures, 14W, the founders of Warby Parker and Harry’s, Sweetgreen, Bonobos, and Insomnia Cookies. Celebs like Serena Williams, Karlie Kloss, Lena Dunham, and Allison Williams have also invested.

Launched in 2015, LOLA’s founders Alex Friedman and Jordana Kier had the idea to challenge industry giants, like Tampax and Playtex, with a 100% organic product.

“We founded LOLA with a simple and seemingly obvious idea – as women, we shouldn’t have to compromise when it comes to our reproductive health,” explains Kier. “Like most women, we’d been using the same feminine care products since we were teenagers. But when we found out that brands – including the same ones we were loyal to all those years – aren’t required to disclose exactly what’s in their products, it made us wonder: what’s in our tampon?”

“If we care about everything else we put in our bodies, products for our reproductive health shouldn’t be any different,” she states.

LOLA’s tampons, pads and liners are made only with organic cotton, not synthetic fibers, like those used mainstream brands. Nor do they contain fragrances or dyes.

The nature of its products appeal to consumers – especially, young millennial women – who are more conscious of the chemicals in their products, as well as those who want to buy organic for the environmental benefits.

That said, there’s a bit of debate over how dangerous (or not) it is to use traditional feminine care products. Skeptics, including some doctors, insist there’s no threat from conventional products.

But even women not concerned with buying organic may find LOLA appealing because of its model.

Its subscription service lets you create a box with your own mix of tampon sizes (with or without applicators, which can be either cardboard or plastic). That’s something you can’t do when buying off the shelf.

Plus, LOLA’s boxes aren’t any more expensive than those bought in the store. Its 18-count box of applicator tampons is $10 per month; or it’s $9 each, if ordering two or three boxes per month. Non-applicator tampons are a dollar less.

In addition, LOLA sells other period-related products, including an essential oil blend for cramps, a multi-vitamin that protects against PMS, and a first period starter kit.

In May, the startup broadened its mission to become more of a female health company with the launch of SEX by LOLA. This product line includes condoms, personal lubricant, and all-natural feminine cleansing wipes for women. It’s the startup’s first product line outside of feminine care.

“Until now, there wasn’t really a place for women to turn to for honesty, reliability and information when it comes to their sex products,” says Kier of the new product lineup. “Historically, sexual wellness companies have been primarily marketed towards men and promote products that contain obscure ingredients and unnatural additives.”

SEX by LOLA products, on the other hand, don’t have “irritating” additives, the founder explains, but still deliver the sensation and reliability you’d expect, she says. 

These new products are also offered on subscription, starting at $10 per month for a 12-count box of condoms or 12-count box of cleansing wipes.

The company plans to use the Series B funds to finance product development, expand customer outreach – including through events, partnerships and offline – and expand its 19-person, currently New York-based team.

More importantly, perhaps, is throwing more fuel on the fire, as LOLA is no longer without competition.

There are a number of subscription startups for feminine products on the market today, including Le Parcel (which also ships chocolate); organic rival Cora, which focuses on discrete, portable tampons and carrying cases; Jessica Alba’s The Honest Company (which just got $200M) and sustainable competitors like Flex’s tampon alternative, as well as other reusable menstrual cups, like Diva Cup.

And, of course, you can subscribe and save on Amazon to almost anything, including tampons.

LOLA declines to share details related to the size and growth of its customer base or its revenue, so it’s difficult to rank LOLA in terms of its competition.

Where LOLA may have some leverage, however, is encouraging more open discussions about female reproductive health, and engaging its customers through social media. The startup touts 6 times the number of Instagram followers compared with mainstream brands, for example, and says 1 in 4 customers have directly engaged with its brand over a variety of communication channels, including calls, emails, DMs, texts, and letters.

ACG’s investment could help LOLA become more of a household name. The firm has previously backed brands like Harry’s, Pacifica, Shake Shack, Plum Organics, PDQ, barkTHINS, EVOL Foods, Suja Juice, Nudestix, and others.

“LOLA is at the epicenter of the shift towards transparency in the women’s health category, and we couldn’t be more impressed with the brand Alex and Jordana have built and the impactful conversation they’ve driven,” said Alliance Consumer Growth Managing Partner, Trevor Nelson, in a statement about its funding. “We’re thrilled to welcome LOLA into the ACG family and support their continued evolution and product innovation, enabling them to meet their consumers’ needs,” he added.

 


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Kry bags $66M to launch its video-call-a-doctor service in more European markets

16:36 | 12 June

Swedish telehealth startup Kry has closed a $66 million Series B funding round led by Index Ventures, with participation from existing investors Accel, Creandum, and Project A.

It raised a $22.8M Series A round just over a year ago, bringing its total raised since being founded back in 2014 to around $92M.

The new funding will be put towards market expansion, with the UK and French markets its initial targets. It also says it wants to deepen its penetration in existing markets: Sweden, Norway and Spain, and to expand its medical offering to be able to offer more services via the remote consultations.

A spokesperson for Kry also tells us it’s exploring different business models.

While the initial Kry offering requires patients to pay per video consultation this may not offer the best approach to scale the business in a market like the UK where healthcare is free at the point of use, as a result of the taxpayer funded National Health Service.

“Our goal is to offer our service to as many patients as possible. We are currently exploring different models to deliver our care and are in close discussions with different stakeholders, both public and private,” a spokesperson told us.

“Just as the business models will vary across Europe so will the price,” he added.

While consultations are conducted remotely, via the app’s video platform — with Kry’s pitch being tech-enabled convenience and increased accessibility to qualified healthcare professionals, i.e. thanks to the app-based delivery of the service — it specifies that doctors are always recruited locally in each market where it operates.

In terms of metrics, it says it’s had around 430,000 user registrations to date, and that some 400,000 “patients meetings” have been conducted so far (to be clear that’s not unique users, as it says some have been repeat consultations; and some of the 430k registrations are people who have not yet used the service).

Across its first three European markets it also says the service grew by 740% last year, and it claims it now accounts for more than 3% of all primary care doctor visits in Sweden — where it has more than 300 clinicians working in the service.

In March this year it also launched an online psychology service and says it’s now the largest provider of CBT-treatments in Sweden.

Commenting on the funding in a statement, Martin Mignot, partner at Index Ventures, said: “Kry offers a unique opportunity to deliver a much improved healthcare to patients across Europe and reduce the overall costs associated with primary care. Kry has already become a household name in Sweden where regulators have seen first-hand how it benefits patients and allowed Kry to become an integral part of the public healthcare system. We are excited to be working with Johannes and his team to bring Kry to the rest of Europe.”

As well as the app being the conduit for a video consultation between doctor and patient, patients must also describe in writing and input their symptoms into the app, uploading relevant pictures and responding to symptom-specific questions.

During the video call with a Kry doctor, patients may also receive prescriptions for medication, advice, referral to a specialist, or lab or home tests with a follow-up appointment — with prescribed medication and home tests able to be delivered to the patient’s home within two hours, according to the startup.

“We have users from all age groups. Our oldest patient just turned 100 years old. One big user group is families with young children but we see that usage is becoming more even over different age groups,” adds the spokesman.

There are now a number of other startups seeking to scale businesses in the video-call-a-doctor telehealth space — such as Push Doctor, in the UK, and Doctor On Demand in the US, to name two.

 


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With strategic investment, Insilico Medicine is using deep learning to defeat aging

23:22 | 11 June

Every once in a while, you meet an entrepreneur who is both fully present, but also has a head full of dreams. That was my experience meeting and hosting Alex Zhavoronkov, the founder and CEO of Insilico Medicine, a few weeks ago in Vienna at the Pioneers conference. There, he gave a presentation on how he is going to defeat aging using a set of deep learning AI tools, and also told me that I am going to live forever because I am young enough to benefit from the tech he is developing.

I am a huge skeptic to be frank (particularly anytime deep learning gets bandied about), but after chatting with him both before and after getting on stage, I can’t preclude the possibility that aging is something that might be within humanity’s (or at least Zhavoronkov’s) grasp to control.

That belief in the company’s mission is reflected in a set of twin announcements today. The company announced that it has received a strategic round of financing led by WuXi AppTec, a Chinese integrated R&D services platform, along with Peter Diamandis’ BOLD Capital and Pavilion Capital, a subsidiary of Singapore-based Temasek. In addition, the company announced a strategic partnership with WuXi, in which Insilico’s inventions will be tested by WuXi. The terms of the round were not disclosed, but Insilico has raised $14 million previously from investors according to Crunchbase.

Insilico Medicine founder and CEO Alex Zhavoronkov

In order to understand the company’s technology, we need to understand a bit more about how therapeutics are developed. In the classical model used by pharmaceutical companies, scientists in an R&D lab investigate naturally-occurring molecules while searching for potential therapeutic properties. When they find a molecule that could be a candidate, they begin a series of tests to determine the treatment efficacy of the molecules (and also to receive FDA approval).

Rather than going forward through the process, Insilico works backwards. The company starts with an end objective — say stopping aging — and then uses a toolbox of deep learning algorithms to devise ideal molecules de novo. Those molecules may not exist anywhere in the world, but can be “manufactured” in the lab.

The key underlying technique for the company is what are known as GANs, or generative adversarial networks with reinforcement learning. At a high-level, GANs include a neural net “generator” that creates new products (in this case, molecules), and a discriminator that classifies the new product. Those neural nets then adapt over time in order to compete against each other more effectively.

GANs have been used to create fake photos that look almost photorealistic, but that no camera has ever taken. Zhavoronkov suggested to me that clinical patient data may one day be manufactured — providing far more data while protecting patient privacy.

While Zhavoronkov has bold dreams about conquering aging, today the company is focused more broadly on creating an inventory of new molecules that could provide new therapeutics, albeit particularly focused on longevity (here is the company’s research paper on PubMed). Under the company’s new strategic partnership, WuXi will then take those new molecules and test them for efficacy in actual clinical settings.

As the company develops its technology, Zhavoronkov wants to offer a “longevity-as-a-service” engine that could power global longevity research using deep learning. That means providing a platform for researchers to find new molecules, identify which ones might be most promising as therapeutics, and then set them up for clinical trials to be used in actual clinical practice.

While Zhavoronkov is CEO, he is first a researcher. He has published extensively on his and his team’s discoveries while also leading a lab of 52 researchers. The hope is that the basic research that the team is producing can be commercially translated into industry, and ultimately, purchased by the largest pharmaceutical giants in the world.

It may be early days, but Zhavoronkov is deeply ambitious about Insilico’s potential to halt aging. Even if those dreams are difficult to accomplish, the technology built along the way could radically change our drug pipeline, and that will provide relief for all kinds of diseases.

 


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