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Hims and Roman target erectile dysfunction, which can signal health issues

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startups young patients erectile dysfunctionErectile dysfunction can be the first sign of troubling health problems like heart disease.Shayanne Gal/Business Insider

  • New telemedicine companies like Hims and Roman have sprung up, offering online prescriptions for Viagra and other erectile dysfunction medications. 
  • That erectile dysfunction can be a sign of other, more worrying health problems, particularly in younger men, is well-established among physicians. 
  • One doctor worries about losing the “window of opportunity” to tackle health problems like heart conditions if men are getting care online rather than in a doctor’s office. 
  • Roman’s CEO, a Hims medical consultant and others say that online medical platforms can play an important role in getting men help. 

Most people associate erectile dysfunction with the silver-haired men in Viagra commercials.

Yet Zachariah Reitano was just 17 years old when he experienced it for the first time. Confused and frustrated, he knew something was wrong.

He was right. It’s well-established among doctors that erectile dysfunction can be the first sign of a more troubling health problem, especially in younger men.

Later diagnosed with a heart condition, Reitano compares erectile dysfunction to “the check engine light in your car going off.” 

“It’s a sign that something is wrong, but you don’t exactly know what,” he wrote in a blog post. Unfortunately, many men ignore that sign because of the embarrassment and stigma that surrounds the condition, he says, and doctors often don’t raise the subject during checkups. 

Reitano’s experience led him to start the men’s health company Roman, which prescribes and delivers medications like Viagra and its lower-cost generic, called sildenafil. Roman is one of a slew of new companies like Hims and others shaking up the traditional model of healthcare by offering this kind of online service targeted specifically at erectile dysfunction. 

These new companies paint erectile dysfunction as a problem among younger, not-yet-greying men, but one for which there is help. 

That raises two key questions. How can these online companies care for patients who could have serious underlying health conditions like Reitano? And are these companies over-hyping how common erectile dysfunction is in younger men?

Read more: Trendy startup Hims wants to shake up men’s health by prescribing generic Viagra online and is nearing a $1 billion valuation. But a move to relax guidelines has raised concerns among some of its doctor partners.

Roman and its telemedicine peers, though, say they can direct patients to get appropriate care, even if it’s not through their own companies. They also say they’re combating the stigma associated with impotence by talking about the condition openly and making care accessible in a discrete, affordable way. 

 

 

A ‘window of opportunity’

At its most basic, an erection happens because of blood flowing to the penis. Trouble getting an erection could mean that something is getting in the way.

Because that part of a man’s body contains very small blood vessels, erection problems could be the first sign of heart disease or other problems with blood circulation. Erectile dysfunction also has plenty of other potential causes, including common medications, psychological factors and health-related behaviors like drinking and not exercising. 

Not every young man with erectile dysfunction is going to have an underlying heart problem, urologist Dr. Hossein Sadeghi-Nejad told Business Insider, “but certainly some of them do.” Sadeghi-Nejad serves as president of the Sexual Medicine Society of North America, which promotes high standards in treating human sexual dysfunction, and co-authored the American Urological Association’s erectile dysfunction guidelines.

The AUA guidelines recommend a physical exam, which can’t be done online. 

“I think to lose that window of opportunity to address the bigger problem would be a pity,” Sadeghi-Nejad said. 

Without an in-person exam, some physical causes of erectile dysfunction could be missed, he said, giving as an example the handful of times in a year when he’s had patients who turn out to have a tumor in their testicles.  

Roman CEO Reitano knows from firsthand experience that a Viagra prescription won’t solve an underlying health problem. But Roman can help patients find out about the connection, including by strongly recommending that patients get in-person tests, and then walking them through the results and next steps for free, Reitano said. 

When Roman began working in erectile dysfunction, it found that many of its members smoked, a risk factor for erectile dysfunction. So the company next expanded into products that help them quit, Reitano said, and now sells the prescription smoking cessation aid bupropion as well as nicotine gum.

“I come to this as a patient,” he told Business Insider. “We treat our patient for life.”

If Roman’s physicians can’t treat a patient, they refer him to nearby health centers and physicians, something that it has done for thousands of patients, Reitano said. 

Read more: A startup aims to help the 18 million US men diagnosed with erectile dysfunction pay attention to their ‘check-engine light’

These online companies all patch patients through to doctors, but they have different approaches and styles. 

Rival Hims’ website reads at first like an e-commerce experience, greeting potential patients with the different categories of medical products they can shop—hair, sex, skin, or vitals—and then glossy product images. After a patient adds Viagra or another prescription product to his online cart, he gets directed to a medical consult. 

See also: We tried to buy generic Viagra online from Hims and failed — here’s how it went down

Online telemedicine services like Hims are a powerful opportunity to “find people who do have medical problems, and get them to doctors that can help them,” according to Dr. Peter Stahl, a Hims medical consultant and the director of male reproductive and sexual medicine at NewYork-Presbyterian Hospital/Columbia University Medical Center. As part of his role at Hims, Stahl came up with advice for Hims’ doctor partners that they can look at if they have questions.

According to those recommendations, one goal of care is to identify health conditions that can underlie erectile dysfunction, he said, which might include diabetes, testosterone deficiency, high cholesterol and vascular disease. Hims’ doctor partners “routinely” recommend patients see a specialist, rather than writing them a prescription, if they decide that is the best course of treatment, the company said in a statement. 

Lemonaid Health is another telemedicine company offering erectile dysfunction medications. The start-up says it is more of an online doctor’s office, and aims to care for the patient as a whole. A patient who clicks on Lemonaid’s various medicines and treatments gets directed to set up a doctor consultation, which might include answering online questions or a live video interaction. 

On a page about erectile dysfunction, the company points out that it can be the first sign of things like heart conditions, cardiovascular disease and diabetes, and says that it offers an optional lab test to look into those possibilities.

Lemonaid also offers a service to quit smoking with the smoking cessation aid Chantix or Zyban, and one to manage patients’ cholesterol, which might include a statin prescription. Both health problems are linked to erectile dysfunction. 

“When we do turn away patients, we think of other opportunities to help,” Dr. Davis Liu, chief clinical officer of Lemonaid, told Business Insider. The company also plans to launch services for depression and anxiety, high blood pressure and diabetes this year. 

40% under age 40

Viagra has been sold for about 20 years, and recently became available as an inexpensive generic drug. In its prime, the brand-name product — brought to market by Pfizer — brought in more than a billion dollars a year for the drug giant.

Back then, the type of older man frequently featured in Pfizer’s ads was a prime demographic, or roughly ages 40 and over, a 2006 article from the peer-reviewed medical journal PLOS Medicine found. 

But new online startups offering erectile dysfunction medications have men under age 40 in their sights, and cite a popular statistic: that erectile dysfunction affects up to 40% of men by that age. 

That statistic comes from one of the most important studies to measure the prevalence of erectile dysfunction, the “Massachusetts Male Aging Study,” which randomly selected men between ages 40 and 70 to participate.

As part of the study, researchers gave men a questionnaire to “characterize erectile potency.” They found that 52% of men reported some level of erectile dysfunction, ranging from minimal to moderate to complete impotence, and that age was strongly connected to the condition. Complete erectile dysfunction was more infrequent, according to the study, ranging from around 5% in the 40-year-old set to 15% by age 70. 

The study found that at age 40, about 40% of men had some level of erectile dysfunction, but didn’t look at younger men. 

Still, that figure isn’t a good estimate for the proportion of men who need erectile dysfunction drugs, urologist Sadeghi-Nejad told Business Insider. While up to 40% of men may have at some point experienced trouble getting or maintaining an erection by age 40, he draws a distinction between chronic erectile dysfunction and occasional experiences with it. 

In other words, not every guy who has experienced erectile dysfunction is bothered enough by it to see a doctor, or to take a medication for it. Online companies offering easier access to generic Viagra and other erectile dysfunction medications could change that, he noted. 

Erectile dysfunction research often excludes younger men, according to a 2017 study by Italian researchers. One exception was a large study published in 2004, which found that erectile dysfunction affected 8% of men in their 20s and 11% of men in their 30s. 

Hims and Lemonaid told Business Insider that the 40% figure is accurate, citing its use in peer-reviewed medical journals and the evidence-based medical resource UpToDate. Roman’s Reitano said in a statement that the “vast majority” of the start-up’s members are older than age 40, with an average age of 46. 

Hims has been dubbed the “millennial erectile dysfunction company” because its splashy advertising appears designed for men in their 20s and 30s, including through use of a color dubbed “millennial pink” and tongue-in-cheek eggplant emojis. The startup treats men starting at age 25 and going up to age 65. 

Hims consultant Stahl calls promoting awareness of erectile dysfunction in this population an important step forward.

Young men are a large part of his in-person practice at Columbia, he said. The condition is less common in men in their 30s and 40s than in older men, but those who do have it are “excellent candidates for treatment,” he said.

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Trudeau Government Should Turn to Sustainable Floor Heating In Its New Deal

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A consortium has been chosen by Public Services and Procurement Canada (PSPC) to manage the $1.1-billion overhaul of five heating and cooling plants in the National Capital Region. However, this decision has been met with a lot of disapproval by the country’s largest federal public service union.

Early June, the department announced that Innovate Energy has been awarded the 30-year contract “to design, retrofit, maintain and operate the plants,”winning the bid over a rival group that included SNC-Lavalin.

Minister of Environment, Catherine McKenna, said the federal government was “leading by example” in its bid to drastically reduce the amount of greenhouse gas emissions across the country. McKenna noted that by supporting this project, they’re utilizing heating and cooling infrastructure to promote a more environmentally friendly option.

“We’re very proud that our government is working with partners like Innovate Energy to modernize this critical infrastructure,” she said during the announcement at one of the facilities that will be upgraded, the Cliff Heating and Cooling Plant in downtown Ottawa.

The plants would be known as the district energy system and would heat 80 buildings in the area with steam. It is also expected to cool 67 of these buildings with chilled water through more than 14 kilometres of underground pipes.

Under the Energy Services Acquisition Program, PSPC will be tasked with modernizing the outdated technology in the plants to lower emissions and supportgrowth in the eco-friendly technology sector.

During the first stage of the overhaul, the system would be converted from steam to low temperature hot water and then switched from steam to electric chillers—with the estimated completion date being 2025. PSPC notes that the project will reduce current emissions by 63 per cent, the equivalent of removing 14,000 non-eco-friendly cars off the road.

Afterwards, the natural gas powering the plant will then be replaced by carbon-neutral fuel sources, which according to estimated will reduce emissions by a further 28 per cent. The renovation project is bound to save the government an estimated fee of more than $750 million in heating and cooling costs in the next 40 years.

Furthermore, the implementation of radiant floor heating in Ottawa by the federal government would be an additional step in driving its agenda for a more eco-friendly state.

According to the U.S. Department of Energy’s Energy Savers website, radiant floor heating has a lot of benefits and advantages over alternate heat systems and can cut heating costs by 25 to 50 per cent.

“It is more efficient than baseboard heating and usually more efficient than forced-air heating because no energy is lost through ducts,” the website states.

Radiant floor heating provides an equal amount of heat throughout a building, including areas that are difficult to heat, such as rooms with vaulted ceilings, garages or bathrooms. Consideringit warms people and objects directly—controlling the direct heat loss of the occupant—radiant floor heating provides comfort at lower thermostat settings.

“Radiators and other forms of ‘point’ heating circulate heat inefficiently and hence need to run for longer periods to obtain comfort levels,” reports the Residential Energy Services Network (RESNet).

Radiant heating is a clean and healthy option—a perfect choice for those with severe allergies—as it doesn’t rely on circulating air, meaning there are no potentially irritating particles blowing around the room. Additionally, it is more energy efficient, aesthetically pleasing with wall radiators or floor registers and virtually noiseless when in operation.

“They draw cold air across the floor and send warm air up to the ceiling, where it then falls, heating the room from the top down, creating drafts and circulating dust and allergens.”

It is important for the leadership in Ottawa to equally drive the adoption of radiant floor heating as doing this would lead to increased usage in residential buildings—and even government-owned buildings.

However, in October, the Public Service Alliance of Canada (PSAC), a representative body of employees of the plants,began a campaign target at the government against their decision to use a public-private partnership (P3) for the retrofitting project, citing concerns about costs and safety.

According to the union, outside employees won’t be bound to the same health and safety standards of government workers and that typically P3 projects cost a lot more than traditional public financing deals.

The union demands that the government scraps the proposed project and meet PSAC members and experts to brainstorm on a new way forward that would ensure federal employees continue to operate and maintain the plants.

However, parliamentary secretary to public services and procurement minister, Steve MacKinnon said that the union officials have consulted him but that after conducting an analysis, the P3 option was still the best for the job.

“We didn’t have (to) sacrifice on safety or health — we didn’t have to sacrifice on job security,” he said.

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Steps to becoming a Data Scientist

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Data science has become one of the most in-demand career paths in this century, according to Business Insider. With the amount of information being circulated online, it has created a huge demand for storing, interpreting and implementing big data for different purposes—hence the need for a data scientist.

Today, there too much information flying around for regular people to process efficiently and use. Therefore, it has become the responsibility of data scientists to collect, organize and analyze this data. Doing this helps various people, organizations, enterprise businesses and governments to manage, store and interpret this data for different purposes.

Though data scientists come from different educational backgrounds, a majority of them need to have a technical educational background. To pursue a career in data science, computer-related majors, graduations and post graduations in maths and statistics are quite useful.

Therefore, the steps to becoming a data scientist are quite straightforward.  After obtaining a bachelor’s degree in an IT related field—such as computer science, maths or physics—you can also further your education by obtaining a master’s degree in a data science or any other related field of study. With the necessary educational background, you can now search for a job and obtain the required experience in whichever filed you choose to invest your acquired skills.

Here are the necessary steps to be taken to become a data scientist.

Step 1: Obtain the necessary educational requirements

As earlier noted, different educational paths can still lead to a career in data science. However, it is impossible to begin a career in data science without obtaining a collegiate degree—as a four-year bachelor’s degree is really important. However, according to a report by Business Insider, over 73% of data scientist in existence today have a graduate degree and about 38% of them hold a Ph.D. Therefore, to rise above the crowd and get a high-end position in the field of data science, it is important to have a Master’s degree or a Ph.D.—and with various online data science masters program, obtaining one is quite easy.

Some institutions provide data science programs with courses that will equip students to analyze complex sets of data. These courses also involve a host of technical information about computers, statistics, data analysis techniques and many more. Completing these programs equips you with the necessary skills to function adequately as a data scientist.

Additionally, there are some technical—and computer-based degrees—that can aid you begin a career in data science. Some of them include studies in, Computer Science, Statistics, Social Science, Physics, Economics, Mathematics and Applied Math. These degrees will imbibe some important skills related to data science in you—namely, coding, experimenting, managing large amounts of data, solving quantitative problems and many others.

Step 2: Choose an area of specialization

There rarely exists an organization, agency or business today that doesn’t require the expertise of a data scientist. Hence, it is important that after acquiring the necessary education to start a career as a data scientist, you need to choose an area of specialization in the field you wish to work in.

Some of the specializations that exist in data science today include automotive, marketing, business, defence, sales, negotiation, insurance and many others.

Step 3: Kick start your career as a data scientist

After acquiring the necessary skills to become a data scientist, it is important to get a job in the filed and company of your choice where you can acquire some experience.

Many organizations offer valuable training to their data scientists and these pieces of training are typically centred around the specific internal systems and programs of an organization. Partaking in this training allows you learn some high-level analytical skills that were not taught during your various school programs—especially since data science is a constantly evolving field.

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Artificial intelligence pioneers win tech’s ‘Nobel Prize’

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Computers have become so smart during the past 20 years that people don’t think twice about chatting with digital assistants like Alexa and Siri or seeing their friends automatically tagged in Facebook pictures.

But making those quantum leaps from science fiction to reality required hard work from computer scientists like Yoshua Bengio, Geoffrey Hinton and Yann LeCun. The trio tapped into their own brainpower to make it possible for machines to learn like humans, a breakthrough now commonly known as “artificial intelligence,” or AI.

Their insights and persistence were rewarded Wednesday with the Turing Award, an honor that has become known as technology industry’s version of the Nobel Prize. It comes with a $1 million prize funded by Google, a company where AI has become part of its DNA.

The award marks the latest recognition of the instrumental role that artificial intelligence will likely play in redefining the relationship between humanity and technology in the decades ahead.

Artificial intelligence is now one of the fastest-growing areas in all of science and one of the most talked-about topics in society,” said Cherri Pancake, president of the Association for Computing Machinery, the group behind the Turing Award.

Although they have known each other for than 30 years, Bengio, Hinton and LeCun have mostly worked separately on technology known as neural networks. These are the electronic engines that power tasks such as facial and speech recognition, areas where computers have made enormous strides over the past decade. Such neural networks also are a critical component of robotic systems that are automating a wide range of other human activity, including driving.

Their belief in the power of neural networks was once mocked by their peers, Hinton said. No more. He now works at Google as a vice president and senior fellow while LeCun is chief AI scientist at Facebook. Bengio remains immersed in academia as a University of Montreal professor in addition to serving as scientific director at the Artificial Intelligence Institute in Quebec.

“For a long time, people thought what the three of us were doing was nonsense,” Hinton said in an interview with The Associated Press. “They thought we were very misguided and what we were doing was a very surprising thing for apparently intelligent people to waste their time on. My message to young researchers is, don’t be put off if everyone tells you what are doing is silly.” Now, some people are worried that the results of the researchers’ efforts might spiral out of control.

While the AI revolution is raising hopes that computers will make most people’s lives more convenient and enjoyable, it’s also stoking fears that humanity eventually will be living at the mercy of machines.

Bengio, Hinton and LeCun share some of those concerns especially the doomsday scenarios that envision AI technology developed into weapons systems that wipe out humanity.

But they are far more optimistic about the other prospects of AI empowering computers to deliver more accurate warnings about floods and earthquakes, for instance, or detecting health risks, such as cancer and heart attacks, far earlier than human doctors.

“One thing is very clear, the techniques that we developed can be used for an enormous amount of good affecting hundreds of millions of people,” Hinton said.

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