Cybersecurity and data protection in healthcare poses a distinct challenge. For instance, if a bank card is stolen, its owner can block it with a simple phone call and have a new one issued. But if information about laboratory tests or diseases is leaked, it is impossible to “cancel” it.  

Despite the great transformation that has happened over the decade in digital technologies, the healthcare sector’s ability to protect patient privacy is contentious. 

From the point of registering patients for treatment, clinical trials, research, and every other purpose, healthcare providers need to bear in mind that we are at war with cybercrime despite having to balance providing excellent quality, protecting patient privacy, and complying with HIPAA and GDPR. 

The healthcare sector has been on the target radar of nefarious hackers for a very long time. However, the fight between cyber criminals and the healthcare industry can be won by the latter, if they implement strong cybersecurity controls and adopt a cultural shift of adopting cybersecurity best practices. 

Here are some useful measures to incorporate and strengthen cybersecurity at healthcare organisations: 

Implement robust cybersecurity strategies 

Security Magazine reports that 18 per cent of organisations allocate one to two per cent of their IT budget to cybersecurity yet claiming to prioritise cybersecurity.  

This leaves open negligence to the provision of a layered cybersecurity approach that should cover the standard seven layers of cybersecurity, such as Mission-Critical Assets (this covers EMR), Data Security, Endpoint Security, Application Security, Network Security, Perimeter Security (firewalls that protect the business network against external forces), the Human Layer (a very weak and necessary layer that incorporates management controls and phishing simulations, for example). 

Develop incident response and disaster recovery plans 

According to the report, healthcare cybersecurity leaders should create a crisis response team that can manage cybersecurity in the event of a security incident. The team should include members of the technology, communications, legal, and business continuity departments. Conducting a tabletop exercise on a potential incident can help healthcare organisations identify gaps in their emergency response plan. 

Engage emerging technologies such as artificial intelligence 

Particularly for large providers, the volume of attempted attacks can be significant, that it would be impossible for a human or team of humans to efficiently sift through them to identify the most serious or pressing ones. This is one area where artificial intelligence can play an important role.  

As healthcare organisations continue to face increasing cybersecurity incidents, it is paramount that they pay close attention to these pressing issues and take swift action. Otherwise, they are not only putting themselves at risk, but also their patients.  

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Jennifer Orisakwe is a health researcher and data storyteller, who loves to explore the ways actions (and inactions) of healthcare stakeholders affect decision-making and outcomes. 

It is ironic that on one hand, the COVID-19 pandemic has diverted our attention towards healthcare, while on the other hand, people have delayed or missed out on much-needed care during these times. This can be attributed to various reasons such as concerns about coronavirus exposure, ignorance to routine diagnostic and screening check-ups and the deprioritization of existing conditions, including chronic diseases.

While public health awareness needs to be brought in the spotlight again, awareness alone is not enough when it comes to breaking stigma and taboo around more sensitive healthcare issues. Medical science continues to progress in leaps and bounds, however, the behaviours and attitudes that shape how people think about and champion their own health and wellbeing continues to be an ongoing challenge. One such topic is that of men’s health.

There are many issues that impact men’s health. From common ones such as diabetes and hypertension, to those specific to men such as fertility issues, prostatitis and cancers of the genitourinary system (GU), the list is endless.

“Prostate cancer is the second leading cause of cancer death among men globally, yet many men are reluctant to reach out for help,” says Dr. Waleed Hassen, Department Chair, Urology at the Surgical Subspecialties Institute of Cleveland Clinic Abu Dhabi.

Dr. Waleed Hassen

Even today, the misconception that issues around men’s health label men as less ‘masculine’ persists and this societal pressure forces men to portray a “tough” exterior all the time. When we equate vulnerability and emotion with weakness, we cannot be surprised if men suppress their feelings and medical problems, which can in turn lead to anger and depression.

Understanding the risk factors for prostate cancer

For those who struggle or have struggled with prostate cancer and for others who want to educate themselves, having an overview of what this issue is, what increases the risk factor and in what form help is available, can be a good start to raising awareness.

Prostate cancer is the most common solid tumour in men globally and is known to present no symptoms in the early stages. This is one of the many reasons why experts strongly advocate for preventive screenings and regular diagnosis. There are some triggers and red flags that men can watch out for, which should prompt them to book an appointment with a specialist. These could be things that can get easily ignored like frequent urination at night, painful and burning sensation during urination, blood in urine or semen or frequent pain or stiffness in the hips.

The risk factors for prostate cancer are quite broad. Age is the greatest risk factor, as prostate cancer is observed in men over 65 years of age. However, many other factors such as family history, diet and lifestyle choices make a tremendous impact on your risk assessment.

It is important to change your sedentary lifestyle patterns by getting regular exercise and maintaining an optimal weight, as this is the easiest way to keep health issues at bay. This is a serious matter as 70 per cent men in the UAE fall in the overweight category, which is quite concerning. Another factor that works against maintaining a healthy lifestyle is smoking, which is again an ordeal, as one in four men in the UAE are smokers. 

It is also important to be aware of diagnostic and treatment options that can become lifesavers. We are in the age of evolved technology, which effectively marries conventional methods such as ultrasound, biopsy, PET scan and laparoscopy with new age solutions such as minimally invasive, robotic radical prostatectomy, intensity-modulated radiotherapy and stereotactic body radiation therapy. These advanced methods of treatment present many benefits like smaller scars, shorter recovery time and reduced risk of infection.

“This all can seem quite overwhelming. However, if I were to consolidate my advice in three simple points it would be; don’t be afraid to ask questions- you don’t have to be embarrassed about asking for help; find a safe space to share- reach out to a doctor, friend or family member, who can maintain your privacy and direct you to an expert to seek the right help; and, to get your prostate-specific antigen (PSA) checked as early as 40 years if you have a family history of prostate cancer or 50 otherwise- catching a condition at an early stage always increases your chances of survival,” Dr. Hassen says.

“Time and again, I’ve witnessed the incredible transformation in patients who have the courage to take that first step and ask for help. Just the initial relief of talking about issues that one’s held on to for so long, is in itself a major step in the right direction.”, Dr. Hassen concludes.

And while we encourage men to take charge of their health, all of us have a role to play in it as well. It is important for us to direct them to programs like MENtion It, which are safe and inclusive spaces where men can get access to resources and specialists to get the necessary treatment and advice. Remember, silence and avoidance can make the difference between life and death.

Back to Clinical

Data is revolutionising the healthcare industry. It is no surprise that just as we generate enormous amounts of personal data as we use our devices and apps, we also produce healthcare data that can be gathered and analysed by our healthcare providers. 

Instead of targeted advertising, however, this healthcare data can be used to produce better health outcomes and transform both treatment and prevention. 

Related: Harnessing the power of telemedicine

Approximately 30 per cent of the world’s data is being generated by the healthcare industry; by 2025, the compound annual growth rate of data for healthcare is expecting reach 36 per cent, and healthcare providers need to utilise data effectively to stay competitive. 

We are what we wear 

But where does this data come from? For starters, it comes from the devices with which we surround ourselves. Since we have already become accustomed to our smartphones and wearable tech tracking and monitoring us, it makes sense that this can be utilised for health purposes. 

Related: How wearables can help support mental health and well-being

Today, many of us wear devices that measure our heart rate or blood pressure — important data that can influence our health. These devices can upload this information to the cloud or remote servers, making it easy to collate and analyse it. 

This is only the beginning. In the future, we may be using a plethora of wearable technology with stunning implications for healthcare, whether that is earbuds that measure our core temperature, socks that measure a baby’s heart rate, or underwear that can detect cancer — and send all that data to medicals database, enabling doctors to make instant assessments. 

The possibilities are endless, and many of these devices will soon be a key part of the consumer healthcare market. 

Implications of healthcare data 

The healthcare data gathered about us can be funnelled directly into our personal medical records, accessible to doctors and other practitioners for easy analysis. Smart artificial intelligence and machine learning tools will be able to make better, real-time judgements about our health, allowing doctors to diagnose us accurately and suggest better treatments and medications. 

One of the most widespread applications of data is electronic health records — constantly updated digital databases containing a patient’s medical history. These can be accessed and modified by doctors, giving them a holistic view of an individual’s health record based on real-time data. 

This will give doctors the ability to practice an extremely personalised form of healthcare, tailored and constructed around the needs of the individual. For instance, predictive analytics can identify risk factors for diabetes to determine which patients are most at risk, and therefore prescribe additional screenings or specific treatment. 

Data is a powerful tool. Predictive analytics and real-time data gathering can inform and streamline strategic planning, enhance patient engagement, manage risk, and improve any number of different processes. By cutting costs and improving healthcare outcomes, data will soon become an essential part of the healthcare provider’s toolset. 

<< Back to Technology 

Medlab Middle East, the MENA region’s largest medical laboratory exhibition and congress, has confirmed exhibitor space has sold out two months ahead of the show, which returns to the Dubai World Trade Centre from February 6 to 9, 2023.

The latest statistics from the Medlab Middle East organiser, Informa Markets, revealed that the number of exhibition halls has increased from four to six, with a total of 31,000 sqm of space. More than 350 new exhibitors have been confirmed, taking the total number to over 700, with 180 countries represented, denoting a 100 per cent increase on the 2022 edition of the show. International pavilions have also seen a rise from 11 to 14.

Related: UAE laboratories must adopt technology to drive automation and collaboration, says Medlab Middle East research

In line with the show’s theme, ‘paving the way for technological advancements and sustainability in laboratory medicine’, a range of exhibitors will showcase the latest product ranges in areas including disposables, imaging, IT systems, and medical equipment, amongst others, and has been a contributing factor in the spike in exhibitor numbers.

Tom Coleman, Group Exhibition Director, Informa Markets Healthcare

Related: Medlab Middle East to focus on reducing carbon footprint of resource-intensive medical laboratories

Tom Coleman, Group Exhibition Director, Informa Markets Healthcare, said: “It has been an incredible year of growth for the medical laboratory industry and Medlab Middle East. This year we will welcome 650 exhibitors from 180 countries, many of whom are making their debut at the event by highlighting the latest technological advances on the market.

“We are also welcoming back several of our Asian counterparts who have been unable to travel due to restrictions in their home countries as well as stalwarts of the event Abbott, Biomerieux, Beckman Coulter, Randox, illumina, bioMérieux, Randox and Mindray, amongst others.”

In addition to a full line-up of exhibitors on the show floor, Medlab Middle East has announced the launch of its Hosted Buyer programme, which will match exhibitors with senior decision-makers from the healthcare industry. The show floor will also include a series of seminars and workshops designed to allow visitors to learn first-hand about the latest medical laboratory innovations from exhibitors.

The newly launched Labpreneur competition has been created for all promising diagnostic company start-ups to pitch groundbreaking ideas designed to transform the laboratory market to a panel of experts who will announce the winner on the exhibition’s final day.

The Medlab Middle East Congress also returns this year, providing education and solutions to advance laboratory skills and improve laboratory functions to over 5,000 conference delegates. With 12 conferences, the Congress is the largest CME-accredited multi-track medical laboratory congress globally, featuring 130+ local and international speakers.

This year's conference programme includes eight core lab conference tracks, with a further four new additions addressing Point of Care Testing (POCT), Tech Advances and Clinical Impact, New trends in laboratory medicine, Quality Management in the Lab, and Sustainability in the Lab.

In another first for the event, Medlab Middle East will also showcase a new Entertainment zone – The Village, which will provide a more relaxed environment for networking, situated outside Za'abeel Hall 6.

For more information, visit https://www.medlabme.com/en/home.html or to register through the link here.

 

 

As the MENA region's most prominent medical laboratory exhibition and congress, Medlab Middle East plays a crucial role in developing the value of laboratory medicine in reshaping the future of diagnostics by providing a platform for laboratory industry leaders, including manufacturers, dealers, and distributors, in sharing best practice, showcase innovations, collaborate, and network.

Medlab Middle East stems from 15 years of growth alongside the MENA region's largest healthcare event, Arab Health. Now in its 22nd year, this annual medical laboratory meeting brings exhibitors and attendees from over 180 countries.

Medlab Middle East will take place from February 6 to 9, 2023 at the Dubai World Trade Centre, Dubai, UAE. A digital event will occur from January 9 to February 28, 2023.

As the popularity of cryotherapy has increased over the years, clinicians, practitioners, and athletes alike have pursued easy-to-use, rapid-to-deploy, and portable cryotherapy alternatives. But does this make the future of cryotherapy any brighter? 

An article published earlier this year in the European Journal of Applied Physiology, while giving an example of the growth of the procedures, points out that the development of cryopneumatic devices (e.g., Polar Care, Breg, Inc.; Game Ready, CoolSystems, Inc., etc.) became popular after receiving patents in the 1990s and early 2000s. It added: “Recent expert views suggest cryotherapies that aim to benefit or improve health, injury, or recovery should be implemented in an individualised and periodised manner that takes into account the athlete, training and competition schedule, session aims, proximity of future exercise, and environmental conditions.” 

Dr. Khalid Shukri, the Physician in Functional Medicine and Anti-Aging Medicine at Wellth in Jumeirah, also opined that the future of cryotherapy in wellness is promising.  

“It has a very bright future with steady progress for the last 10 years globally and the past five years in the UAE. The recent pandemic has made people concerned about their health and wellness much more than medical fitness. We have learned over the last few years that clients want to take care of themselves quickly with non-invasive treatment and that is even more prevalent now. Their first choice of treatment has shifted from invasive options like prescription medicine, surgery, and IV therapy to natural innovative wellness technologies like saunas, red light therapy, hyperbaric therapy, and cryotherapy,” he explained. 

Dr. Khalid Shukri, Physician Functional Medicine and Anti-Aging Medicine at Wellth in Jumeirah

Cryotherapy remains most effective in the field of wellness. “If we talk about wellness and holistic treatment, then it is an anti-ageing medicine that has various benefits like boosting energy, improving immunity, anti-ageing effect, pain relief, skin rejuvenation, mental clarity, reducing inflammation, and weight reduction. If we talk about this in the medical field, it has been used for some types of cancer and skin conditions,” said Dr. Shukri, adding, “The most exciting things about cryotherapy are yet to come.”  

In 2021, the global cryotherapy market was valued at US$292 million.  

“While that already may seem high, as we approach 2027, IMARC Group, a research and consulting group, expects this market will reach US$421.9 million which indicates that the expected compound annual growth rate (CAGR) will be 6.25 per cent between 2022 and 2027.”  

Key players in this cryotherapy market that are helping drive this growth besides the United States are China, Germany, Japan, South Korea, and the UAE. 

Researchers have been utilising 3D cell culture for a long time, with early adoption and current key roles in cancer and stem cell research. Indeed, traditional toxicology testing programs have existed for many years, and in vitro testing techniques have been developed over the past 20 years due to scientific research and animal welfare initiatives. 

Significant growth in the biopharmaceutical industry is driving unexpected innovation and demand for cell culture products for drug discovery and safety testing. Although 2D cell cultures have been used in labs since the 1950s, the market for 3D cultures, which more precisely simulate human tissue in vivo without using animal test subjects, has grown dramatically over the past ten years. 

Related: Advances in cellular therapy offer new horizons for Saudi cancer patients

The global 3D cell culture market in 2021 was USD$1.66 billion, and it will reach USD$6.46 billion by 2030, growing at a 16.3 per cent CAGR during 2021-2030. 

Rising R&D expenditures for many products, including antibodies and vaccines, soaring biopharmaceutical production, and an increase in cancer and liver-related problems will all contribute to the growth of this market. The market for 3D cell culture will continue to grow soon due to rising rates, improved consumer healthcare access in the US, and emerging markets like China and India. 

Next-Generational Outlook 

Related: CAR T-Cell Therapy operations launched in Saudi Arabia

3D cell culture has been used for decades, and it has evolved from being disorganised, labourious, and expensive to becoming more organised, thanks to a wide range of commercial tools. Already, the technology has enabled a ground-breaking understanding of tissue and cancer behaviour.

Positive signs for future adoption and growth rates, such as the emergence of common practices that map particular supplier technologies to particular applications, give hope for optimism about a coordinated market environment that is less competitive than the previous free-for-all applications. This includes the continued coexistence of 3D and 2D in most research application areas. This is partly due to the dynamics of change and researchers' opinions on the usefulness of contrasting 3D and 2D results for fundamental insights.  

Technology requirements will most likely be at the organotypic level of sophistication, which may conflict with demands for reproducibility, cost, and throughput.  

An expanding range of applications will contribute to the volume increases needed to support anticipated significant growth. 

Cancer 

3D systems have long been used in cancer research for safety, efficacy testing, and fundamental research. The efficacy role will probably continue to expand due to several unmet needs, and it may apply its experience to other therapeutic fields, particularly in applications involving precision medicine. 

Both low-throughput and high-throughput versions of 3D cancer co-culture models have been created, but only cancer cells combined with one other cell type (for example, fibroblasts) have been incorporated into models suitable for high-throughput screening of new compounds. Industry leaders anticipate the creation of 3D tumour panels for a variety of cancer indications in the future. 

Metastases 

Animals and 2D monolayers, in which cells only grow on a flat surface, are both insufficient models for studying metastases. Researchers only have a basic understanding of how they form. To spread throughout the body, tumour cells change the surface markers on their cells. They are attached to a specific region of the body by the molecules. The circulatory system allows cancer cells to spread freely throughout the body before expressing their original surface markers and settling elsewhere. Using 3D lung tissue, it is possible to examine metastases for the first time. 

Tumour recurrence 

Monitoring tumour recurrence is made possible by 3D cultures' ability to survive for longer periods. 

Patient-derived cells 

To date, personalised medicine based on patient-derived cells has mostly been limited to low-throughput preclinical testing. Oncotest and Champions Oncology, for example, have developed 3D assays based on indirect patient-derived samples, which have been expanded through the use of mouse xenograft models. Although 3D culture is expected to improve and play a larger role, developing standards to allow use in drug-screening programs remains a significant challenge. 

Liver 

Understanding liver function and dysfunction caused by toxins or drug-induced liver injury require 3D cell culture. The advantage of 3D over 2D in the liver is substantial, and adoption is expected to increase significantly over the next three to seven years. The unmet need left by 2D technology is met by 3D technology, and there is a growing likelihood that regulatory support will coalesce around a specific role for 3D in drug safety testing for liver toxicity and drug-induced liver injury (DILI). 

This adoption will occur in sub-segments like so-called slow-release (compound metabolism) indications. There must be a significant advancement in creating critical standards and best practices in many areas. 

Integration with -omics 

One intriguing possibility is that the liver's extreme complexity will drive increased integration of various -omics approaches and cell culture and analysis. This will necessitate continued innovation on the part of the 3D community. Proteomics lab directors have noted challenges with cell extraction from scaffold or gel, as it frequently only yields the denatured supernate for analysis. Additionally, many biochemical changes under investigation occur over extremely small time windows and are, therefore, simple to overlook. 

Existing related technology needs to be further integrated. A single chip can run thousands of experiments concurrently, maximizing the use of genomic analysis applications. However, attempts to adapt the chip format to protein arrays have largely failed to succeed in the market.  

The Luminex xMAP technology, which can measure up to 100 different analytes per well, has been widely adopted by customers who want multiplexing capability for proteins. In this area, MesoScale Discovery also has some intriguing technology. The interactome, or million protein-protein interactions, is also being studied under the new paradigm in addition to the structure and function of all the translated products (i.e., proteins) of the human genome's genes. 

Regenerative medicine and cell therapy 

In the beginning, 3D cell culture is anticipated to aid in testing stem cell-derived therapies in regenerative medicine. Although it is undefined, it is expected to proceed similarly to how biologics are tested during process development. The 3D field will be informed and prepared for the following therapeutic applications due to the experiences gained through these biologics research applications. Stem cell researchers have long used 3D cell culture, and it is anticipated that this trend will continue and eventually lead to therapeutic applications. 

Both allogenic and autologous models are used to produce stem cells for therapeutic purposes. One batch of cells treats numerous patients in an allogenic therapy. This strategy reflects the conventional pharmaceutical business model, which is typically simpler to implement, scale up, and automate and is probably less expensive.  

The inter-donor variability of source material poses a difficult challenge in autologous cell therapy. The future production platform will need a lot of process flexibility to account for the specific constraints of different cell populations. The inherent variability between different batches and technicians performing the same actions of a multistep process cannot be eliminated by even the best standard operating procedures (SOPs). These elements inevitably multiply across environmental parameters. 

Biologics development 

The drug product is the subject of characterisation and testing during drug development. The process is essentially the result of the creation of biologics. The process must be continuously assessed from initial clone selection through cell culture and media optimisation, scale-up, and manufacturing. Developers must consider the unique adherence traits of the cell type and the particular construction or clone they have chosen, in addition to the cell type itself. They must also take into account the surface of each culture technique used and the characteristics of the final product, making distinctions between techniques used for manufacturing and process development as well as between seed expansion and final bioreactor culture. 

The biological development of monoclonal antibodies has used 3D tumour microtissues to examine the kinetics of tissue penetration. This field is one of the important ones to watch as biologics for cancer is rapidly developing. 

Characterisation of new cell lines 

There is little doubt that prolonged passage of cells as monolayers can impair their capacity to react to outside stimuli. Cancer cell lines that have been put back into a 3D environment and partially restored their original cancer phenotype serve as a 3D illustration of this. New and existing cell lines will continue to be characterised in large part by 3D culture. 

Challenges ahead 

Critical obstacles for 3D cell cultures involve assay validation, correlation to previous 2D culture results, analytic methods like proteomics, and automation. This is in contrast to the optimism of these exciting possibilities. Basic issues include the inability to scale a single 3D format up or down and the poor reproducibility between batches of biomimetic scaffolds. 

Although conventional cell culture techniques are still widely used by researchers, microfluidic systems are proving useful tools.  

The lack of fundamental data to bridge the gap between 2D and 3D, compatible detection and readouts, and unmet needs in basic technology are seen as the main causes of this by innovators. 

Prevailing future trends 

The use of organoid models, artificial environments that grow small tissue samples using stem cells, is one of the most promising applications for 3D cell culture technology. Their use might result in significant purchases within the industry, but the real opportunity lies in the specialisation of many organoid models to a given task. For instance, the organ-on-a-chip paradigm involves growing organoids on electronic chips and enables researchers to monitor the electrical activity of cardiac cell cultures in real-time. 

Personalised medicine would become much more attainable if doctors could grow a wide range of cell types from harvested stem cells using organoid models. In addition to being able to grow transplantable cells and tissues, doctors can test a wide range of medications for side effects before prescribing them to patients. 

These potential shifts in the medical field portend a sharp upswing in the market for 3D cell culture. Although tools for pure research can be very profitable on their own, their applications in actual patient care have the potential to generate astronomical sales volumes. Testing any significant new drug option on cells first, before exposing the entire body, may become standard procedure if the impact on patient outcomes is significant enough.  

Amritesh Suman is a research analyst with Strategic Market Research. He writes on healthcare technology including POC diagnostics, digital therapeutics, mhealth and others. 

 

[References] 

https://www.strategicmarketresearch.com/market-report/3d-cell-culture-market 

https://www.corning.com/worldwide/en/products/life-sciences/resources/stories/the-cutting-edge/the-3d-cell-culture-market-is-set-for-rapid-sustained-growth.html 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749977/ 

https://www.frontiersin.org/articles/10.3389/fmolb.2020.00033/full 

 

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Over the past few weeks, the whole world has been watching in awe as one of the most exciting editions of the FIFA World Cup has unfolded. The Middle East region has come into the spotlight with Qatar being lauded for its hospitality as the host and with Morocco making history by becoming the first African and Arab country to reach the semi-finals, showing the passion this region has for the game of football.

However, as with any contact sports, several players have suffered injuries on the field, which could have a long-term effect, primarily due to the heading of the ball. For example, Chronic Traumatic Encephalopathy (CTE) is a specific form of dementia associated with repetitive head exposure related to contact sports. But it can only be diagnosed by examining the brain tissue after death. 

In an interview, Dr Michael Grey, Reader in Rehabilitation Neuroscience, Faculty of Medicine and Health Sciences, University of East Anglia (UEA), Norwich, UK, highlighted that a study carried out in Scotland, called the FIELD study, looked at the medical records of male Scottish footballers and compared those to active non-footballers. It looked at the cause of death, brain health, effects of dementia, and neurodegeneration, among other factors. Alarmingly, it found that former professional footballers were around five times as likely to be diagnosed with Alzheimer's disease, a form of dementia.

"To shed light on the correlation between headers and degenerative mental health conditions in footballers, we at UEA started the SCORES (Screening Cognitive Outcomes after Repetitive head impact Exposure in Sport) project. It has been designed to protect people before they get injured. The idea is to conduct cognitive and behavioural tests online and in people's homes, so they don't have to go into a laboratory," he explained.

SCORES monitors people's brains, cognitive health, and sleep patterns every three months through cognitive function tests and questionnaires about behaviour and sleep. It takes about 30 minutes to complete.

The brain function usually declines after the age of 40, said Dr Grey, but the decline shouldn't be rapid and lead to mild cognitive impairments and ultimately into dementia. The study asks the question - what is the rate of cognitive decline, when does the decline start, and if it is earlier in those who have repetitive head contact, such as in those who play football? The Professional Footballers' Association (PFA) in the UK has endorsed SCORES, and the study has the support of British ex-professional footballer and sports correspondent Mark Bright, amongst others.

Dr Michael Grey

Currently, there is no cure for dementia, but the study is trying to look at early signs and symptoms, such as mild cognitive impairments and identify them at an earlier stage through online brain assessments and MRI scans. These could include insidious symptoms such as memory problems or planning or spatial navigation issues and mood changes, including aggressiveness and depression. They are typically caught by people who live with them, not the individuals themselves. Through the study, researchers will be able to track and put numbers to cognitive performance and identify changes that family members might not even be able to see.

The study's early results have demonstrated that former professional male footballers have better or similar cognitive health compared with the average person from 40-50 but worse cognitive health over the age of 65.

We also spoke to UAE-based ex-Norwich City FC player Jay French, a UEA Alumni who is an ambassador for the SCORES project and CEO of Dubai-based private real estate development company Matthews Southwest, who shared that as an ex-professional footballer he has had over 20 stitches and concussions due to different head injuries.

Even though there are existing guidelines on avoiding the heading of the ball, it differs across sports and regions. For instance, there is a complete ban on heading the ball in the US, and penalties are associated with it. While in the UK, the guidelines are that players shouldn't be heading the ball during practice, but it's okay in match play, commented French.

"So, for example, there are some players and managers who just don't follow the guidelines, and there are no repercussions," he said. "We then have loads of people looking at that and saying, "well, if they're not going to follow it, then why do we need to?" Coaches also often teach youngsters heading because that gives them a competitive advantage. The guidance to stop this practice needs to come from the top. FIFA needs to be more involved in setting these guidelines and ensuring they are enforced."

Local awareness

French's company Matthew Southwest is a community-driven firm and is a sponsor for Dubai's Elite Sports Academy, a kids' sports academy, and are monitoring the SCORES study and its recommendations with regards to how their findings will impact kids' football training at the Academy.

It is well-known that sports and physical education are very good for the brain, and SCORES is not looking to create a fear of the game. Not participating in sports has an adverse effect on young people and can result in childhood obesity and diabetes, the numbers of which are already high in this region. The study's objective is to raise awareness about getting people off the pitch when they have a head injury, letting the brain recover, reducing the number of head contacts to make the game safer, and letting people get back to playing the sport they love.

He emphasised: "The brains of young children are still growing, and they don't have the same neuro protection an adult has, and they definitely shouldn't be heading balls. Through our partnership with Elite, we are keen to promote awareness among parents and provide them with the correct information. Because both parents and children are seeing these head injuries play out on the TV and in the World Cup and are going to wonder about the safety of the sport. We don't want to scare people but rather offer them better insight. In the future, we would like to work with the UAE Football Association to further shed light on this issue around a sport that people in this country are passionate about."

 Jay French with his family at the FIFA World Cup 2022 in Qatar 

Increasing representation

Today, women and girls all over the Middle East and the world are getting involved in football. However, all the existing analysis on the issue is around male professional footballers and women are not represented in the data.

Dr Grey concluded: "Women experience concussions and post-concussion symptoms to a greater extent than men. Also, reportedly, of all dementia cases, almost 65 per cent are women. Therefore, there is an increasing need to get women into sports-related studies and get more funding to support the research. SCORES isn't restricted to the UK; we aim to expand worldwide, specifically to the Middle East, and support the region's talents.

"Dementia affects the family, not just the individual. There are significant caring responsibilities associated with declining brain health. We cannot treat dementia, but we can slow it down if we catch it early enough."

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