Alpha Omega, a revolutionary biomedical startup from Nazareth is valued at hundreds of millions of dollars and is writing a new and fascinating chapter in Israeli high tech history

When Reem and Imad Younis launched the technological system they developed, it filled the biomedical community with hope and excitement. The system’s great potential, which started a revolution in intracranial navigation during operations, immediately captivated many. Naturally, all the excitement and wonder raised several eyebrows: when a senior Israeli brain researcher sent an exclamatory email to his colleague overseas, sharing the news of the system, the colleague asked where the company’s offices are based, and thought the researcher was joking. 

The address was Maayan Mariam Square in Nazareth, a place that has long been considered a holy religious pilgrimage site for Christians, and differs drastically from the high tech hub in central Israel. The company’s idea was born in the home of young Arab engineer Imad Younis in 1993. Over the past few years, the company has become a leader in the field of surgical intracranial navigation, and has also created lab equipment for conducting brain research. The company owes its success to its founders Imad (60) and his spouse Reem (57) who opened Nazareth’s gates, turning the city into the capital of the Arab high tech industry in Israel, which today houses no less than 70 companies.

The couple founded the company in their youth (pictured). Photo: Courtesy of Younis family

Due to these impressive achievements, Reem and Imad were awarded the 2018 Industry Leaders Medal, at a special ceremony that took place at the Israeli President’s Residence in Jerusalem. But despite their breakthrough success, Alpha Omega remains private, and is owned by family, preserving its intimate character. Currently, it only employs 120 people – 48% of them women compared to the average of 33% in Israeli high tech. “We’re a small company that’s playing in the big leagues,” Imad said during an interview with Calcalist. “Our customers are Medtronic, Boston Scientific, or Abbott Laboratories, so people have high expectations from us. Surgeons who use our system don’t mind how many employees we have, or whether we’re from Nazareth or New York.”

And the number of surgeons using Alpha Omega’s smart system is growing. It already operates in over 200 different hospitals around the world, and has been used in a large number of life-changing brain surgeries. 

What exactly does your system do?

“In most cases, treating neurological and psychiatric diseases is based on trial and error: the doctor tries a certain medication and examines what effect it has on the patient,” Imad explained. “It’s really difficult, because you need to play around with the dosage, which sometimes causes side effects.” In order to overcome this challenge, researchers developed the Deep Brain Stimulation (DBS) process, a procedure that does not require medication in which a medical device – a neurostimulator complete with electrodes – is implanted in the brain and sends electrical impulses to specific areas of the brain. This stimulation could lessen worsening motor symptoms of neurological diseases like Parkinson’s disease or epilepsy.

Unlike a broken hand, however, which can be spotted from a mere X-ray, brain issues are far harder for doctors to diagnose, since they can’t see into the human brain. In order to do so, they must implant an electrode which can navigate the brain’s pathways, and that’s where Alpha Omega enters the picture. The company creates a separate electrode, which is inserted into the brain via a nail into the skull, and helps surgeons put together a “map” which helps point to the area that needs treatment. Alpha Omega’s technology is swift and precise, which is critical during such operations. “We simplify surgeries,” Imad specifies. “The surgeon can look at MRI images or CT scans, but deciphering neuron activity is tricky. The algorithm we developed analyzes neurotransmitters once the electrode penetrates the point of treatment, and our system builds a picture or an actual map. It enables the surgeon to find the best spot to implant the electrode.”

Once the system spots the problematic area, the surgeon can add additional electrodes (which are created by Medtronic, Boston Scientific, Abbott, and others) that remain inside the brain. A subcutaneous pacemaker, implanted later, activates the permanent electrode, which transmits nerve impulses instead of damaged nerve cells to treat the disease. “After implantation, our system gives neurologists and psychiatrists more options to treat patients: health professionals can try different medications or DBS – and send stronger or weaker pulses.”

The system starred in former Israeli government minister and Likud MK Michael (Miki) Eitan’s surgery, who was diagnosed with Parkinson’s. Since his diagnosis four years ago, the 77-year old politician had become a shadow of his former self – no longer lively, slow-paced, bent over, and shaky. But the surgery brought him back to life, and on a segment broadcast on Israeli television last month, he was shown skipping at home, playing ping pong on the beach, and speaking with the same fluency and alertness which characterized his political career.

“My father didn’t live to receive our treatment”

While the Younis couple is goal-oriented, they’re also a charismatic duo with a sparkle in their eyes. They’re also very loyal to their employees, with nearly a third of their senior management having accompanied Alpha Omega since its founding 28 years ago. They’re also very connected to their Christian Arab community, something that is hinted at from their company’s name. Alpha Omega denotes the first and last letter of the Greek alphabet, and together serve as a godlike symbol in Christianity, signifying the beginning and end of all. But when asked why they chose such a name, Reem provides a far more prosaic explanation. “When we started the company, we didn’t intend for it to be a startup, rather just another subcontractor in the high tech industry. We thought that companies would order our equipment or services, and we’d provide them everything from A to Z – from alpha to omega.”

When Reem is in the operating room next to a Parkinson’s patient, one can only imagine she must wonder what may have been had they developed their technology earlier. Her father, Wadia, developed Parkinson’s when she was a child, and was shuttled from place to place for treatment. In 1995, after three decades of coping with the disease, he passed away, which was “only two years after we founded the company,” she says sadly at the beginning of our conversation. “He didn’t last long enough to receive our treatment. That is the irony of life.”

However, her father did manage to raise a determined woman, who loves challenges, and who never desired to belong to the mainstream. At 18, Reem began pursuing a bachelor’s degree in industrial engineering at the Technion Institute of Technology, and there she met her husband, another Christian Arab, who was a senior college student and electrical engineering major. 

The couple founded Alpha Omega when they were already parents to Dima, their eldest daughter, who today at 30, serves as Product Specialist and manages the company’s international marketing. Their other children also work for the company, including son, Jude, 25, as Business Development Associate and their youngest daughter, Nada, 18. In parallel, they also founded Alpha-Cad Ltd., a company that provides software solutions for engineering, which was later sold. To make an initial investment, they sold their family car and four gold coins that Imad received from his father in case of a “rainy day.”

At the beginning of their journey, the Younises cooperated with two of the leading figures in the DBS arena – doctor and brain researcher Prof. Hagai Bergman from the Hebrew University of Jerusalem, and French-Algerian brain surgeon Prof. Alim Louis Benabid, who is a fellow at the French Academy of Sciences. 

“In Bergman’s post-doctorate which he wrote in the late 80s, he found that Parkinson’s disease could be treated in monkeys, if a small portion of their brain – termed the subthalamic nucleus – was lesioned,” Imad says. “In 1994, Benabid conducted the first such operation on a human to treat essential tremors (the most common symptom in neurological tremor disorders), but his team faced a problem: their intracranial navigation was based on CT, MRI scans, and the like, which weren’t precise enough. In 1997, we reached out to them and offered use of our navigation system which is based on neurotransmitters.” In 1999, they sold their first system in Europe, and a year later entered the U.S. market. In 2002, the Younis couple relocated to the United States for two years with their three children to open the company’s American branch. 

But the company’s real turning point came two years ago: in 2019, only a year after it received its first external investment of $7 million (from the Chinese Guangzhou Sino-Israel Biotech Investment Fund earmarked for expanding the company’s operations in China), the American medical equipment company Medtronic dropped a bomb. It announced that it would be marketing Alpha Omega’s systems worldwide, and in one swift move knocked out all of the company’s market competitors, including its own. “Medtronic recognized our system’s technological and clinical advantages, and decided to abandon their own system and instead sell ours,” Imad revealed. “We are continuing to conduct our own marketing and sales, but they opened the entire world to us. That allowed us to think like leaders.”

And that thought encouraged them to spread the news of DBS around the world. “This treatment is included and covered in the standard healthcare package in Israel, the U.S., and Europe, but it only reaches 10% of the potential population it could help,” Imad says.

Actor and environmental activist contributes undisclosed amount as part of Israeli company’s recent $105m funding round

Actor and environmental activist Leonardo DiCaprio recently invested an undisclosed amount in Israeli alternative meat startup Aleph Farms, a maker of cultivated meat that grows steaks from modified cattle cells, according to an announcement on Wednesday

The investment was made as part of Aleph Farms’ $105 million Series B funding round in July.

The movie star also backed Netherlands-based alt-meat startup Mosa Meat, according to the announcement. The Dutch company unveiled the first cultured hamburger in 2013 and recently announced an $85 million funding round.

Aleph Farms, meanwhile, rolled out the first cultivated steak in 2018 and a cultivated ribeye cut earlier this year.

DiCaprio will be joining both startups as an advisor, according to the statement. The actor has long championed environmentalism with his eco-focused Leonardo DiCaprio Foundation, giving out $100 million in grants for everything from lion recovery and mangrove restoration to the defense of indigenous rights and better access to affordable solar energy.

In 2019, he joined billionaire investors and philanthropists to create a new nonprofit, Earth Alliance, charged with tackling climate change and the loss of biodiversity.

“One of the most impactful ways to combat the climate crisis is to transform our food system,” DiCaprio said in the statement released on Wednesday. “Mosa Meat and Aleph Farms offer new ways to satisfy the world’s demand for beef, while solving some of the most pressing issues of current industrial beef production. I’m very pleased to join them as an advisor and investor, as they prepare to introduce cultivated beef to consumers.”

Aleph Farms thin-cut steak. (Courtesy)

Dr. Didier Toubia, co-founder and CEO of Aleph Farms said that “as a committed environmentalist, we welcome Leonardo DiCaprio to our advisory board and family of top-tier investors. Our team is committed to improving the sustainability of our global food systems and we’re thrilled to have Leo share in our vision.”

“With his passion for and dedication to climate action, we expect this collaboration will lead to great things together,” Toubia added in a video announcement.

“Food systems touch all people, and it will take all of us to make this change happen,” he said.

Toubia founded Aleph Farms in 2017 with Professor Shulamit Levenberg of the Biomedical Engineering Faculty at the Technion – Israel Institute of Technology, alongside Israeli food-tech incubator The Kitchen, a part of the Strauss Group.

To produce its meat, Aleph leverages the ability of animals to grow tissue muscle constantly and isolates the cells responsible. It then reproduces the optimal conditions for these cells to grow into tissue, basically growing meat outside the animal.

A rib-eye steak produced from meat cells cultivated in a laboratory by Israeli start-up Aleph Farms. (Courtesy: Aleph Farms/Technion Institute of Technology)

The tissue is grown in tanks that act as fermenters, similar to those in a brewery. There the cells are nurtured and shaped into a 3D structure that makes the meat.

Aleph Farms’ most recent investors include L Catterton, an American-French consumer-focused private equity firm with over $30 billion in equity capital, and DisruptAD, the venture capital arm of the Abu Dhabi holding company ADQ. The startup is also backed by a consortium of global food and meat companies, including Thai Union, BRF, and CJ CheilJedang.

The company has raised more than $110 million to date and has plans for a market launch in 2022. It signed an agreement earlier this year with Mitsubishi Corporation’s Food Industry Group to bring cultivated meat to the Japanese table.

Aleph Farms’ leadership team from left: Technion Professor Shulamit Levenberg, co-founder and chief scientific adviser; Didier Toubia, co-founder and CEO; Dr. Neta Lavon, chief technology officer and VP of Research and Development. (Rami Shalosh)

The Israeli firm has also set up similar partnerships with other multinationals: The Swiss industrial group Migros and the United States-based food corporation Cargill have also invested in the startup.

Aleph Farms is a leading player in a growing Israeli food tech sector. The global cultivated meat industry could reach $25 billion by 2030, according to analyst estimates.

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Leonardo DiCaprio is investing in Israel’s Aleph Farms

The actor is joining Aleph and Dutch foodtech company Mosa Meat as an investor and adviser in the growing global movement to support sustainable technologies and transform the way meat is produced

Israel’s Aleph Farms and Dutch company Mosa Meat, two foodtech companies in the emerging field of cultivated meat, announced on Wednesday an investment from environmental activist and Academy Award actor, Leonardo DiCaprio. Both companies have demonstrated their ability to grow beef directly from animal cells, with the unveiling of the first cultivated hamburger by Dutch Mosa Meat in 2013 and the first cultivated steak and ribeye by Aleph Farms in 2018 and 2021. 

“One of the most impactful ways to combat the climate crisis is to transform our food system. Mosa Meat and Aleph Farms offer new ways to satisfy the world’s demand for beef, while solving some of the most pressing issues of current industrial beef production. I’m very pleased to join them as an adviser and investor as they prepare to introduce cultivated beef to consumers,” DiCaprio said.

Hollywood actor Leonardo DiCaprio is investing in Aleph Farms. Photo: Shutterstock 

With global meat consumption projected to grow between 40%-70% by 2050, cultivated meat offers a solution to reduce negative impacts of industrial beef production, which uses precious sources such as land, water, and also causes harm to animals, while being a leading cause of carbon and nitrogen emissions. Cultivated meat will enable diners to enjoy the qualities of the meat they love, while eliminating the need for cutting out meat altogether. Analysts have projected the cultivated meat market could reach $25 billion by 2030, as part of the broader protein transformation. 

According to an independent Life Cycle Analysis study, cultivated beef production is projected to reduce climate impact by 92%, air pollution by 93%, and use 95% less land and 78% less water when compared to industrial beef production. 

“As a committed environmentalist, we welcome DiCaprio to our advisory board and family of top tier investors. Our team is committed to improving the sustainability of our global food systems and we’re thrilled to have Leo share in our vision,” Didier Toubia, co-founder and CEO of Aleph Farms said. 

Aleph Farms grows beef steaks, from non-genetically engineered cells isolated from a living cow, without harming animals and with a significantly reduced impact to the environment. The company is supported by The Kitchen Hub of the Strauss Group, and Professor Shulamit Levenberg from the Biomedical Engineering Faculty at the Technion – Israel Institute of Technology. Some of its investors include L. Catterton, DisruptAD (ADQ), BRF, Thai Union and Cargill.

Mosa Meat is a global food technology company pioneering a cleaner, kinder way of making real beef. Headquartered in Maastricht, the Netherlands, Mosa Meat is a privately-held company backed by Blue Horizon, M Ventures, Bell Food Group, Nutreco, Mitsubishi Corporation and others.

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DiCaprio invests in Israeli cultivated meat co Aleph Farms

The Rehovot-based company has cultivated the world’s first slaughter-free ribeye steak, using 3D bio-printing technology.

Israeli cultivated meat company Aleph Farms has announced that the actor Leonardo DiCaprio has invested in the company and will join its advisory board. DiCaprio is also investing in Dutch cultivated meat company Mosa Meat.

DiCaprio said, “One of the most impactful ways to combat the climate crisis is to transform our food system. Mosa Meat and Aleph Farms offer new ways to satisfy the world’s demand for beef, while solving some of the most pressing issues of current industrial beef production. I’m very pleased to join them as an advisor and investor, as they prepare to introduce cultivated beef to consumers.”

DiCaprio invested in Rehovot-based Aleph Farms as part of its $105 million financing round completed in July. The amount of the investment has not been disclosed.

Aleph Farms cofounder and CEO Didier Toubia said, “As a committed environmentalist, we welcome Leonardo DiCaprio to our advisory board and family of top tier investors. Our team is committed to improving the sustainability of our global food systems and we’re thrilled to have Leo share in our vision.”

Aleph Farms was founded by Israeli food company Strauss Group together with Prof. Shulamit Levenberg of the Faculty of Biomedical Engineering at the Technion – Israel Institute of Technology and Toubia and has cultivated the world’s first slaughter-free ribeye steak, using 3D bio-printing technology and natural building blocks of meat – real cow cells, without genetic engineering.

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Leonardo DiCaprio Invests In Israeli Cultivated Meat Startup Aleph Farms

Leonardo DiCaprio at the United Nations, 2012, in a photo taken by Christopher Camp via Flickr (CC by 2.0)

Academy Award-winning actor and environmental activist Leonardo DiCaprio recently invested an undisclosed amount in Israeli startup Aleph Farms, a cultured meat startup that has created slaughter-free steak and ribeye from cattle cells. His investment was part of the company’s $105 million Series B funding round in July, according to an announcement. released on Wednesday.

He also invested in Dutch alternative meat startup Mosa Meat, Aleph Farms and Mosa Meat said in the statement. The Netherlands-based company is known for unveiling the first cultured hamburger in 2013.

Aleph Farms is also known for unveiling the “world’s first” cultivated steak in 2018 and a cultivated ribeye steak earlier this year.

“One of the most impactful ways to combat the climate crisis is to transform our food system,” DiCaprio said in the announcement, “Mosa Meat and Aleph Farms offer new ways to satisfy the world’s demand for beef, while solving some of the most pressing issues of current industrial beef production. I’m very pleased to join them as an advisor and investor, as they prepare to introduce cultivated beef to consumers.”

DiCaprio has a long association with environmental activism and social responsibility, which started early on in his career. In 1998, at the age of just 24, the Oscar-winning actor established the Leonardo DiCaprio Foundation (LDF) with the purpose of raising awareness about environmental issues threatening the health of the planet and to date, has awarded more than $80 million in grants, funding over 200 projects in 50 countries.

In addition, the philanthropist also serves on the board of several environmental protection organizations including the World Wildlife Fund, the Natural Resources Defense Council, International Fund for Animal Welfare, Pristine Seas and Oceans 5. He is also an advisor on The Solutions Project, an organization dedicated to scaling up the adoption of clean, renewable energy.

He also has a history of investing in Israeli eco-friendly projects, including a green hotel at the Herzliya marina, as well as promoting the development of – at the time – in January 2017, the world’s tallest solar thermal tower created by Megalim at the Ashalim solar complex in the Negev.

Aleph Farms has consistently made the news over the last several years as it attempts to disrupt the traditional meat market with its cultured, slaughter-free meat. It grows beef steaks, from non-genetically engineered cells isolated from a living cow, without harming animals and with a significantly reduced impact to the environment.

The company was co-founded in 2017 by Didier Toubia, The Kitchen Hub of the Strauss Group, and Professor Shulamit Levenberg from the Biomedical Engineering Faculty at the Technion – Israel Institute of Technology.

In January, the company announced an agreement with Japanese multinational Mitsubishi Corporation’s Food Industry Group to bring cultivated meat to Japan, followed by a deal to operate in Brazil.

The Technion will partner with the Carasso family to renovate the FoodTech building and make it more advanced.

The Technion will be partnering with the Carasso Family and Carasso Motors in revamping the Faculty of Biotechnology and Food Engineering. The building that is currently known as the Food Industries Center will be renovated and turned into the Carasso FoodTech Innovation Center and will be dedicated to promoting cutting-edge food technologies, teaching, research and development (R&D).

The renovations will expand and upgrade the building, making it unique to Israel, and one of the most advanced of its kind in the world. It will include an R&D center for industrial production, a packaging laboratory, an industrial kitchen, and tasting and evaluation units. There will also be a visitors area for high-school students to be exposed to the world of FoodTech and startups.

“Eradicating world hunger and improving food security are among the main challenges facing humanity in the 21st century, as defined by the UN’s Sustainable Development Goals,” said Technion President Prof. Uri Sivan. “The Technion has the only faculty in Israel for research in food engineering, a faculty that leads the Israeli FoodTech industry.

“We are grateful to the Crasso Family for their generous contribution, which will establish the Carasso FoodTech Innovation Center, and will help us promote groundbreaking scientific research in the field, train the next generation of the Israeli FoodTech industry and maintain the faculty’s position at the global forefront of research and development.

“In 1924, our grandfather Moshe immigrated with his family to Israel from Thessaloniki, where he was one of the leaders of the Jewish community,” said Yoel Carasso, chairman of Carasso Motors. In Israel, he cofounded Discount Bank, Ophir Cinema and of course, Carasso Motors. For me and for my uncle Shlomo and my cousins – Ioni, Orli, Tzipa and Arik – this is coming full circle from a century ago.

Yoel Carasso, Chairman of Carasso Motors (Left) and Prof. Marcelle Machluf, Dean of the Faculty of Biotechnology and Food Engineering (credit: RAMI SHLUSH / TECHNION)

“We chose to support the Carasso FoodTech Innovation center since the Technion is synonymous with excellence. The Technion is an engine for combining basic and applied science in the Galilee and in Israel as a whole. We believe the Carasso FoodTech Innovation Center will contribute to the industry and to collaborative work in this field, and thus strengthen the Israeli economy and society. Our family has a history of supporting the Technion, and when the opportunity to establish this center sprang, we knew it was our calling to lead.

“The faculty is one of the only ones in the world that combines the disciplines of bioengineering, technology, food sciences and life sciences,” said Prof. Marcelle Machluf, the faculty’s dean. “Coping with the COVID-19 pandemic has only emphasized the importance of food and biotechnology in maintaining our existence and meeting future existential challenges. To address the many challenges in this field, including access to healthy, affordable food and innovative medical treatments, we need advanced infrastructure that will enable the integration of new engineering and scientific tools; these will enable us to develop the necessary technologies, as well as the infrastructure and equipment that will support the development and assimilation of knowledge required to tackle tomorrow’s food challenges.”

“Carasso Motors, with its various brands – Renault, Nissan, Infinity and Dacia – is committed to innovation and connection with our diverse customer base in Israel,” said Isaac Weitz, CEO of Carasso Motors. “Food technology is an evolving field that brings value in many ways to our stockholders. Food research tackled environmental and global warming challenges, providing food security and a balanced diet, accelerating paramedical developments that combine medicine and food, and of course, contributing to the development of innovative solutions that will put Israel at the forefront of science globally.

“At Carasso Motors, we jumped at the opportunity to make such a significant contribution to the establishment of this advanced research center, which will also improve and advance Israel’s education and society.”

Researchers at the Technion-Israel Institute of Technology have developed a new, low-cost, low-energy system for producing hydrogen from water.

Water electrolysis is an easy way of producing hydrogen gas. While hydrogen is considered a clean, renewable fuel, efficient electrolysis requires high electric potential, high pH and in most cases, catalysts based on ruthenium and other expensive metals.

As detailed in an article in The Journal of the American Chemical Society and reported on the university’s website, Technion researchers have developed a unique system for producing hydrogen from water using little energy and inexpensive materials. Led by Professor Galia Maayan, head of the Biomimetic Chemistry Laboratory at the Schulich Faculty of Chemistry, along with doctoral student Guilin Ruan, this is the fastest system of its kind reported to date that uses available copper catalysts.

Doctoral student Guilin Ruan (Technion Israel Institute of Technology via Twitter)

Maayan and Ruan designed and developed a system in which the catalyst is soluble in water. The system is based on three elements: copper ions; a peptide-like oligomer (small molecule) that binds the copper and maintains its stability; and a compound called borate whose function is to maintain the pH in a limited range.

The major innovation in this work is the researchers’ discovery that the borate compound helps stabilize the metallic center and helps catalyze it.

Maayan explained that the inspiration for the new system came from enzymes (biological catalysts) that use the protein’s peptide chain to stabilize the metallic center and by natural energetic processes such as photosynthesis, which are driven by units that use solar energy to transport electrons and protons.

The research was supported by the Israel Science Foundation (ISF) and the Nancy and Stephen Grand Technion Energy Program.

Israel’s leading tech institution, the Technion, has been rated the number one institute in leading European machine-learning research in a rating by CSRankings.

Israel’s leading tech institution, the Technion, has been rated the number one institute leading machine-learning research in Europe in a rating by CSRankings. The rating is based on data gathered between 2016 and 2021.

The Technion also placed 15th globally in artificial intelligence research and 11th in machine learning.

Some 46 people are researching AI at the Technion and over 100 are conducting research in the fields of industrial robotics, cybersecurity and smart vehicles. Some 42 of these researchers have done work that was published up to 30 times at computer science conferences, according to the rankings.

The Technion’s Machine Learning and Intelligent Systems research center has led groundbreaking research in AI both in Israel and worldwide, collaborating with other institutions involved in research in the field such as Carnegie Mellon University and American software company PTC, and connecting researchers with the industry.

The Computer Science Faculty building at Technion University in Haifa, Israel (credit: BENY SHLEVICH/WIKIMEDIA COMMONS)

“We are very proud of the recognition The Technion has received in its contribution to artificial intelligence – especially as it continues to make deep and personal connections with others in the field and a significant impact on what we can hope to expect from it in the future,” the Director of Technion UK, Alan Aziz, said.

The Technion – Israel Institute of Technology in Haifa has attained global prestige for work in numerous scientific fields, including life sciences, biotechnology, stem-cell research, sustainable energy, water management, materials engineering and aerospace and information technology. Over 13,000 students currently attend the university.

The risk of severe disease dropped by factor of almost 20 in people over 60—but some dispute the benefits of offering an additional dose

Older Israelis who have received a third dose of a COVID-19 vaccine are much less likely to test positive for SARS-CoV-2 or to develop severe COVID-19 than are those who have had only two jabs, according to a highly anticipated study published on 15 September.

The standard regimen for messenger RNA-based COVID-19 vaccines is two doses, but some governments, including Israel’s, have started administering third ‘booster’ shots. The latest study evaluated 1.1 million Israelis over the age of 60 who had received their first two doses at least five months earlier. Twelve or more days after receiving a third jab, participants were about 19.5 times less likely to have severe COVID-19 than were people in the same age group who had received only two jabs and were studied during a similar time period.

“It’s a very strong result,” says Susan Ellenberg, a biostatistician at the University of Pennsylvania in Philadelphia, who adds that the data might be the most robust she has seen in favour of boosters. But potential biases in the data leave some scientists unconvinced that boosters are necessary for all populations—and the data do not dispel concerns about vaccine equity when billions of people are still waiting for their first jab.

Israel, which got an early start on vaccinating its population, began offering third doses of the Pfizer–BioNTech vaccine in July, to people aged 60 and over. The latest analysis links the third jab not only with a significant reduction in severe COVID-19, but also with an 11.3-fold reduction in SARS-CoV-2 infections.

But Ellie Murray, an epidemiologist at Boston University in Massachusetts, cautions that observational studies such as this analysis can contain biases that are difficult to identify and account for. For example, people who sign up to get a booster might have a different risk of COVID-19, or behave differently, from people who do not get a third jab.

Ellenberg says that the authors try to address some of these potential biases. Even if not all biases have been eliminated, she says, the magnitude of the effect suggests that the booster offers some protection, at least in the short term. The authors of the study could not be reached before publication.

GLOBAL RAMIFICATIONS

The findings come as a slew of wealthier nations consider offering booster shots. An advisory committee of the US Food and Drug Administration (FDA) will discuss Pfizer’s application to supply boosters in the United States on 17 September. One of the authors of the Israeli study is slated to present data to the committee.

Murray argues that the potential biases in the data, and insufficient evidence for waning immunity after vaccination, mean that the latest findings don’t indicate a “strong need” for boosters. “From a public-health perspective, it’s way, way more impactful to get more people vaccinated than it is to boost the vaccine effectiveness by a few percentage points in those who have already gotten the vaccine,” she says.

Murray is not alone in finding the Israeli results insufficient to justify boosters. A review published on 13 September by a team that includes two high-ranking FDA scientists cites a preprint of the study and notes that the short-term protective effect documented in Israel “would not necessarily imply worthwhile long-term benefit”.

Dvir Aran, a biomedical data scientist at Technion—Israel Institute of Technology in Haifa, says that Israel has deployed boosters to stop transmission in younger people and to prevent severe disease and deaths in older people.

“Is it the best way? Whether a two-week lockdown would have given a similar result, I can’t answer that question,” he says. “But it’s an interesting approach, trying to stop an outbreak like this with vaccinations.”

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Study: COVID booster recipients 20 times more protected against serious illness

As US officials set to mull okaying Pfizer’s 3rd dose, data from a million Israelis shows it boosts protection from infection tenfold compared with eligible people who got 2 shots

A syringe is prepared with the Pfizer COVID-19 vaccine at a clinic at the Reading Area Community College in Reading, Pennsylvania, September 14, 2021. (AP/ Matt Rourke)

A new study conducted in Israel shows that individuals given a third COVID-19 vaccine dose are nearly twenty times more protected against serious illness and more than ten times more protected against infection, compared with those who received their second dose at least five months previously.

The research, published on Wednesday by The New England Journal of Medicine, showed that 12 days after receiving a booster shot of a Pfizer-BioNTech COVID-19 vaccine, the chance of infection was 11.3 times less than among those eligible for a third shot but didn’t get one.

And the chance of suffering serious illness as a result of COVID-19 among those who had received a booster shot was 19.5 times less, the research said.

The study was conducted by researchers from the Weizmann Institute of Science, the Ministry of Health, the Technion, the Hebrew University, Sheba Medical Center, and the KI Institute.

Even with a more conservative analysis, which attempted to control possible behavioral differences between the two groups, the infection rate was at least 5 times lower in the group that had received the booster shot, the Health Ministry said in a statement.

The research includes data from more than 1 million Israelis. Among those who hadn’t received a booster shot despite being eligible, there were 4,439 confirmed infections, including 294 serious patients. Among those who received the booster at least 12 days previously, there were 934 infections including 29 serious cases.

An Israeli woman receives a third dose of the COVID-19 vaccine at a Clalit clinic on September 1, 2021 in Jerusalem. (Olivier Fitoussi/Flash90)

The Israeli data could not say how long the boosted protection lasts.

But a separate study conducted at Sheba Medical Center in Ramat Gan, outside Tel Aviv, has stoked optimism as to the amount of time for which the booster shot retains its protection.

The study found that the antibody levels a week after the third COVID-19 vaccine dose was administered to its staff were ten times higher than their levels a week after the second dose was administered.

Israel — the first country to officially offer a third dose — began its COVID-19 booster campaign on August 1, initially rolling it out to those over the age of 60. It then gradually dropped the eligibility age, eventually expanding it to everyone aged 12 and up who received the second shot at least five months ago.

As of Thursday, nearly 3 million Israelis had received their third dose.

Meanwhile in the US, influential government advisers will debate Friday if there’s enough proof that a booster dose of Pfizer’s COVID-19 vaccine is safe and effective — the first step toward deciding which Americans need one and when.

The Food and Drug Administration on Wednesday posted much of the evidence its advisory panel will consider.

Pfizer’s argument is that while protection against severe disease is holding strong in the US, immunity against milder infection wanes somewhere around six to eight months after the second dose.

More important, Pfizer said, those antibodies appear strong enough to handle the extra-contagious Delta variant that is surging around the world.

A man receives his third dose of the COVID-19 vaccine at a temporary health care center in Jerusalem, on August 29, 2021. (Yonatan Sindel/Flash90)

To bolster its case, Pfizer pointed the FDA to the new data from Israel.

Pfizer said the data published on Thursday translates to “roughly 95% effectiveness” against Delta — comparable to the protection seen shortly after the vaccine’s rollout earlier in the year.

In Israel, the R-value — the reproduction rate of the virus measuring the average number of people each positive person infects — rose to 1.14 on Thursday, after it had hit a 4-month low of 0.81 just days earlier.

Any number over 1 indicates infections are rising, while a figure below that signals that an outbreak is abating.

There were 8,601 new COVID-19 cases diagnosed on Wednesday, according to the Health Ministry.

Of the 83,704 active cases, 654 are in serious condition. Since the start of the pandemic last year, 7,465 people have died of COVID-19 complications in Israel.

Prof. Moshe Shoham (courtesy)

Robots have captured the imaginations – and often raised the fears – of people for at least a century. These programmable machines perform boring, repetitive and dangerous tasks that people prefer not to or are unable to do because of size limitations or because they function in extreme environments such as in outer space or at the bottom of the sea.

The term comes from a Slavic root, robot-, with meanings connected to the word “labor” and was first used to denote a fictional humanoid in a Czech-language play R.U.R. (Rossumovi Univerzální Roboti – Rossum’s Universal Robots) written 101 years ago by Karel Čapek, (although it was apparently Karel’s brother Josef  who first gave the concept a name).

A robot may be guided by an externally controlled device or the control may be embedded inside its body. Robots can be constructed to look like humans or even dogs, but most robots are functional machines that perform tasks efficiently and thus designed without much attention to aesthetics.

They can be programmed to function autonomously or semi-autonomously and include humanoids such as Honda’s ASIMO (Advanced Step in Innovative Mobility) – the apex of 20 years of robotics research that can run, walk on uneven slopes and surfaces, climb stairs, turn smoothly, reach for and grasp objects and even understand and respond to simple voice commands. Robots are beginning to assist in hospitals, take hotel guests to their rooms, accept and deliver food orders and carry out numerous other tasks. But more common are industrial robots that build cars and perform other manufacturing work in factories, medical operating robots, high-flying drones that observe and even attack enemies, patient-assist robots and dog therapy robots that assist and reduce loneliness among the elderly and the disabled.

The 1966 American science fiction movie Fantastic Voyage about a submarine crew who are shrunk to microscopic size and float inside the body of an injured scientist to repair damage to his brain even presaged microscopic nano robots that today are hinting that they are no longer science fiction.

One of the world’s leaders in medical robots – the founder of numerous companies, the inventor with more than 100 individual patents publisher of more than 200 technical papers and three books and the teacher who has inspired many young people in Israel and around the world to enter the field – is Emeritus Prof. Moshe Shoham, who was born in Haifa. His official title is bearer of the Tamara and Harry Handelsman Academic Chair and director of the robotic laboratory in the department of mechanical engineering at the Technion – Israel Institute of Technology
in Haifa.

In 1978, Shoham earned his bachelor of science degree from the Technion in in the Faculty of Aeronautical Engineering, worked in Israel Aerospace Industries followed four years later by a master’s degree from its Faculty of Mechanical Engineering and a doctorate in 1986 from that same faculty. His main professional interests are robotic systems (kinematics and dynamics of robots), multi-fingered hands, sensor-based robots and medical robotics.

There were no approved medical robots in the world when he began. The pioneer in this area was a company named ISS, which developed a robot for replacing the hip joint, thereby opening the market, but eventually it failed to obtain approval from the US Food and Drug Administration (FDA). The company closed down in 2005, exactly when Shoham’s company, Mazor Robotics Ltd., got its marketing approval. In 2001, he founded Mazor, which was acquired in 2018 by the global medical electronics company Medtronic for $1.64 billion.

After working in the Israel Aerospace Industries, Shoham served as an assistant professor at Columbia University in New York and established the robotic laboratory at the department of mechanical engineering, a visiting professor at Stanford University in California. He is also a Fellow of the Institute of Electrical and Electronics Engineers (IEEE) Fellow of the American Society of Mechanical Engineers (ASME) and a International Member of the US National Academy of Engineering,

Among his numerous awards, are honorary membership – Israel Society for Medical and Biological Engineering, 2020; the Maurice E. Müller Award for Excellence in Computer Assisted Surgery, 2019; Innovation Award – Surgical Robot Challenge, Imperial College, London, 2016; Fellow –Institute of Electrical and Electronics Engineers (IEEE), 2015; International Member – US National Academy of Engineering, 2014; Thomas A. Edison Patent Award – American Society of Mechanical Engineers, 2013; Hershel Rich Innovation Award, 2011; Technology Award – the Society for Medical Innovation and Technology (SMIT), 2008; Fellow – The American Society of Mechanical Engineers (ASME), 2008; Outstanding Israeli project – ROBOCAST: ROBOt and sensors integration for Computer Assisted Surgery and Therapy, European Union 7th Framework Program for Research and Technological Development. Awarded by the European Commission to the State of Israel, 2007; Kaplan Prize for Creative Management of High Technology, 2002; and the Juludan Award for Outstanding Scientific Research Achievements, 1999. Shoham is particularly proud of the recent 2021 Yigal Allon Prize for Pioneering Excellence – given annually to individuals, entities or organizations whose activity serves as a model of pioneering excellence and a significant contribution to Israeli society – that he received recently.

The 2021 prize was awarded jointly to Shoham and Start-Up Nation Central for their work in promoting Israeli innovation in industry. “The entire state of Israel walks in your path,” Israel’s President Isaac Herzog said in congratulatory remarks.

Among the most memorable and thought-provoking award for Shoham was in 1999, when he received a research award for the development of a robot that performs knee replacement surgery with great precision.

“Next to me, Prof. Gershon Golomb from the Hebrew University of Jerusalem’s Faculty of Medicine also received the award. The winners’ families were invited to the award ceremony. At the entrance to the hall, I saw and was shocked that instead of coming to me, my mother fell into the arms of the mother of Prof. Golomb whom I did not know and burst into tears. When they stopped crying, my mother told me that Golomb’s mother shared with her a wooden bunk in the Auschwitz concentration camp during the Holocaust. They encouraged and strengthened each other during all that terrible time.”

This moving event “made me wonder: how many more people could have received the prize but did not because they were murdered in the Holocaust.” Among them were potential writers, poets, musicians, scientists, rabbis, actors, geniuses, shoemakers, carpenters, tanners. “How many worlds will no longer be created, and why?!”

Indeed, if the mothers of Prof. Shoham and Prof. Golomb had (God forbid) perished in the gas chambers of Auschwitz, their sons would never had been born and their great healing and lifesaving accomplishments would have been lost to the world.

Shoham’s father was born in Romania and escaped from Europe during the Nazi era, fortunately moving to Israel, where he settled in the youth village and agricultural settlement of Mikve Yisrael and helped establish a kibbutz called Tehiya. His mother was born in Czechoslovakia, and after being liberated from the concentration camp, moved to Palestine where she met her future husband at the kibbutz.

Moshe, who recalls that his family lived in modest circumstances, liked from boyhood to build and fix things. That hobby led to his outstanding mechanical engineering career.

Today, he and his wife  live in Hoshaya, a national-religious community settlement in the Lower Galilee. The village was established in three decades ago as a Nahal settlement, originally planned for soldiers from moshavim in the Galilee and later manned by soldier of the Religious Nahal Youth Aliyah, Three years later, it was transferred to civilians, and 15 families moved into caravans on the site, with some of the original Nahal soldiers remaining.

At Stanford, Shoham began to think about developing medical robots, which were then in their infancy. “I returned to Israel and called surgeons in all the hospitals. Even though medicine is very conservative, some of them were very supportive of the idea,” he recalled in an interview. “Some were opposed to the use of robots in surgery, and a few of them said it will not work and no robot would ever replace a human surgeon.” “we would like to apply robots at those tasks in which robots excel – accuracy and accessibility – but the decision making will always remain with the surgeon.”

Shoham established Mazor Robotic company, specializing in spinal surgery. Shoham founded a number of companies, each with a robotic surgery specialty. One company that is based on technology developed in his medical robotic laboratory donated by the late Betty and Dan Kahn, is Xact robotics, which has developed a robot for precise navigating  of flexible needle within the body. This technology is suitable for a variety of types of operations requiring penetration by a narrow instrument to a precise point deep within the body, such as biopsies, injections of drugs into internal organs, ablation (precise searing of tissue within the body) and drainage from within the body.

Another company he founded, Diagnostic Robotics, aims at dramatically reducing the time spent in emergency rooms. Shoham does not discuss what this robot can do, so it is possible that it can already perform several physical examinations even before the doctor.

ForSight Robotics is developing a surgical robotic platform for eye surgery to assist ophthalmologists. Microbot Medical (a company listed on Nasdaq as MBOT) that he co-founded has developed a system that includes miniature robots for internal cleaning of an implanted medical device, including devices implanted in the brain. His Microbot ViRob, an autonomous advancing micro robot – less than one millimeter in diameter, has the ability to crawl within cavities and lumens, allowing physicians to target a disease site with amazing precision.

So far, the device has completed animal trials; in the future, the product is likely to also prove suitable for cleaning blood vessels so as prevent heart attacks and strokes.

A company based on his doctoral student Hadas Ziso’s thesis is Tamar Robotics, which is developing a surgical robot for revolutionizing brain surgery, finally giving doctors a safer, minimally invasive tool to remove tumors and blood clots and treat other life-threatening brain conditions that now require major surgery.

“We hope we will be able to let the people suffering from these conditions get back to their lives,” Shoham says. “We believe that our robotic system is additional outstanding armament in the surgeon’s hand that can be used at those instances they perform better  than a surgeon’s free hand.” The neurosurgery robot has been tested so far on rodents, removing tumors from their brains, and removing blood hemorrhages from the brains of pigs. Shoham expects it will be permitted to be used in clinical trials in two years or so.

In many cases of robot-assisted minimally-invasive surgery, instead of directly moving the instruments, the surgeon uses telemanipulation one or several robot hands to administer the surgery. A telemanipulator is a remote manipulator that allows the surgeon to perform the normal movements associated with the surgery. The robotic arms carry out those movements using end-effectors and manipulators to perform the actual surgery.

One advantage of using the computerized method is that the surgeon does not have to be present, leading to the possibility for remote surgery.

In 1985 a robot, the Unimation Puma 200, was used to orient a needle for a brain biopsy while under computerized tomography guidance during a neurological procedure.

Another surgical system in which Shoham was not involved is the da Vinci Surgical System, made by the US company Intuitive Surgical. Approved by the by the FDA in 2000, it is designed to assist doctors in surgery using a minimally invasive approach and is controlled by a surgeon from a console. The system is used to remove prostate glands and increasingly for cardiac valve repair and hysterectomies. It was called “da Vinci” partly because  15th-century Italian genius Leonardo da Vinci’s “Study of Human Anatomy eventually led to the design of this first-known surgical robot.

“Da Vinci works as a telemanipulation, just following what surgeon does,” noted Shoham, “but we are involved in developing robots that are not telemanipulators but have higher sense of autonomy. not just following the surgeon’s hand motion,” said Shoham. “The robot will not be just a remote manipulator, but it will proceed to be fully autonomous. There are only two companies in world approved FDA to be autonomous, and this type is more of a challenge than semi-autonomous ones.”

He is very proud that many of his students have become chief executive officers or other senior developers in other companies involving medical robots. Israelis are world leaders in medical robots, thanks to the Technion professor.

As for the concern among some people that robots will put them out of a job, Shoham stresses that they will replace low-paying, tedious jobs but create many new positions.

Just as a few decades ago, they didn’t dream that everybody would carry a mobile phone around with them instead of being dependent on a land line.

On a larger scale, the initial steps for personal robots are already being sold in the form of Siri, a virtual assistant that is part of Apple Inc.’s  operating systems. The assistant uses voice queries, gesture-based control, focus-tracking and a natural-language user interface to answer questions, make recommendations and perform actions by delegating requests to a set of Internet services. The software adapts to users’ individual language usages, searches and preferences, with continuing use.

People will soon get used to the idea that everybody will have his or her own personal robot, Shoham concludes, and they will be better off. Unwilling to predict exactly where robotics will be in a decade or two, he ventured: “They definitely will be a substantial part of our lives. Combining robots with artificial intelligence and machine learning equips humanity with a strong new power. I hope it will be used wisely.”