Category Archives for "Blockchain"

Jun 11

AI helps detect wrist fractures, & more

By Kanwal Sood | Artificial Intelligence , Blockchain , Blog , Disruptive Innovation , Machine learning , Spine Cloud Platter , Value-Based Healthcare

In this week’s platter, we look at blockchain technology and cyber-hygiene; we consider how AI in medicine is getting closer to making rounds; we pay attention to the development of 3D-printed corneas and, finally, we look at smart medical packaging. Enjoy…

What the health sector needs to know about cryptocurrency technologies, blockchain, and cryptojacking attacks

While blockchain technology could forever alter the digital landscape of the health sector, this blog post calls out attention to digital threats, cryptojacking and the necessity for cyber-hygiene especially in the healthcare sector.

Scientists 3D print human cornea for first time, a technique which could save millions from blindness

UK Scientists from Newcastle University say they’ve created the world’s first 3D-printed human cornea. They combine unique printing techniques, cornea stem cells and a new bio ink to create corneas in just 10 minutes. While the printed corneas will have to undergo several years of testing before they become a viable transplant option, this development could eventually help millions of people around the world suffering from corneal blindness.

AI in Medicine Gets Closer to Making Regular Rounds

On May 24, FDA gave the green light to an AI algorithm that uses machine learning techniques to analyze wrist radiographs (X-ray images) to assist clinicians in locating areas of distal radius fracturing. On its own, it’s not ground-breaking news, but it is a sign artificial intelligence in medicine is getting closer to making regular rounds (also see “Computer learns to detect skin cancer more accurately than doctors”).

Further to that, if this radiology AI technology can be shown to enable clear, clinical efficiencies in radiology practices, it does hold a particular promise in the gradual migration towards a value-based payment paradigm.

What’s so smart about medical device packaging?

Cambridge Consultants, operating out of one of the UK’s leading medtech clusters, has been working on a new concept which would use audio messaging to communicate instructions – with the prompts being triggered by touch-sensitive paper technology. The concept, dubbed AudioPack, delivers instructions via an avatar named Ana, who guides the patient through step-by-step use of their medical device – particularly useful for devices like autoinjectors. There’s potential here for use amongst patients who have cognitive difficulties as a result of their condition; thereby reducing patient harm harm and drug misuse because of poorly understood instructions.
Added value is all well and good, but if it can’t be achieved cheaply, it adds cost that some won’t be able to afford

May 28

9 weird predictions about the future of healthcare & more

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Machine learning , Spine Cloud Platter , Sub Category 1.3 , Value-Based Healthcare

In this week’s platter, we look at an AI-enabled digital platform which uses patient reported outcomes data to support patients through the recovery process; we consider the factors which indicate that Amazon may indeed dominate the healthcare sector; we consider the aspects which need to be developed before the mass adoption of blockchain in healthcare; we look at how Hurricane Harvey could be seen as a blessing in disguise for a Houston hospital; and, finally, we look take a peek at how healthcare may look like 100 years from now. Enjoy!

A Finnish startup founded by uni students has raised €4 million to revolutionise treatment

Already deployed in over 30 hospitals across across 5 countries in Europe, this digital platform ultimately seeks to reshape the whole healthcare system from being doctor-centred to patient-centred, and from transaction-based to value-based. This is achieved by combining patient-reported outcomes data and AI-assisted patient monitoring software to automate follow-up and support patients through treatment and recovery. Its algorithms screen for symptoms, alert care teams and trigger personalised instructions for patients. Future developments could even help to detect and treat additional health problems early on.

Why Amazon’s Jeff Bezos Might Just Dominate Another Trillion-Dollar Industry

Amazon this year announced a partnership with JP Morgan Chase and Berkshire Hathaway to cut healthcare costs, characterizing the initiative as a Herculean effort that would require “talented experts, a beginner’s mind, and a long-term orientation.” Approaching things with a “beginner’s mind and long-term orientation” is how technology leaders create companies of sustainable value. So, how do company founders learn to lead like Bezos?

Blockchain in Health Care – from evolution to revolution

Health care is complex and data intensive. The industry has lots of players. Health care transactions are slow, cumbersome, and expensive. Constraints on access to critical data sets limit progress in research. Data privacy is a big deal. Data security can be a life-or-death matter. So what now…? Blockchain technology can address all of these.
Inasmuch as blockchain technology has major disruption potential, it will not disrupt health care overnight—or even over the next few years. This article presents the technology aspects that need to be developed before blockchain reaches tipping point in adoption and impact.

How Hurricane Harvey spurred a Houston hospital to rethink emergency care

An often-referenced adage states: “Never let a good crisis go to waste.” This article details some the major interventions by the emergency department of a Houston hospital which permitted a sustained 7.5% surge in volume without increasing cost. Definitely worth close examination and replication.


9 weird predictions about the future of healthcare

This article shares the weirdest ideas about how healthcare might look a hundred years from now. Or even further down the road. Let’s peek into a dystopic future of healthcare.

May 21

Spine & Health Info platter (14 May ’18)

By Kanwal Sood | Artificial Intelligence , Blockchain , Disruptive Innovation , Machine learning , Spine Cloud Platter , Wearable Tech

In this week’s platter, we explore the convergence of 3D printing and wearables; we take a critical look at how healthcare can prepare for artificial intelligence and machine learning; we look at how to spot disruption in healthcare delivery; and, finally, we consider the implications of blockchain in healthcare and pharma. Enjoy.

Flexible and Wearable Electronics by Hybrid 3D Printing

Researchers from Harvard and the Air Force Research Laboratory have collaborated and developed a new hybrid 3D printing technique that overcomes a key limitation of current active trackers – rigidness. The new technique combines stretchable conductive inks and electronic components into flexible, durable wearable devices that move with the body and offer increased programmability. This technology is a dream come true for any professionals interested in study of human movement and muscle function. Enjoy the video.

How Healthcare Can Prepare for Artificial Intelligence, Machine Learning

The healthcare industry represents a particularly significant opportunity for machine learning to prove its value. The sheer volume of available medical knowledge has long since outstripped even the most intelligent clinician, requiring supercomputers just to keep up with the latest best practices and big data breakthroughs in genomics, predictive analytics, population health management, and clinical decision support.
How are these tools already helping providers to produce better outcomes for patients, how will they evolve in the near future, and what steps should the industry take to integrate AI into the care process without fearing a disastrous big data backlash?

Catching disruption in the act: 3 problems innovation will solve in healthcare delivery

Today, the term Disruptive Innovation is widely used across industries, including healthcare, in which complex, fragmented and costly services fuel the quest for better alternatives. But how does one actually spot this? This article provides tips on how to spot disruption in healthcare delivery

What The Hell Is Blockchain And What Does It Mean For Healthcare And Pharma?

Blockchain already earned the buzzword of the year award, so it is high time to address the elephant in the room. Is it really there? If it is, will it really change everything? How will it impact healthcare?

Apr 16

‘Disruptive diagnostics’: How it’s changing healthcare.

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Spine Cloud Platter , Wearable Tech

In this week’s platter we pay attention to ‘disruptive diagnostics’; we look at an example of the novel use of technology to communicate with the deafblind; we consider 2 applications for cryptocurrency in healthcare; we look at what healthcare can learn from finance about data sharing; and, finally, we turn to insightful infographic on wearables. Enjoy!

What is ‘Disruptive Diagnostics’ and How is it Changing Health Care?

No keen observer of the healthcare sector can deny the massive innovation witnessed in various pockets of the health care value-chain in recent times – from the advent of all things digital to the shift in business models. Here we pay attention to innovation in disease diagnostics and we take a look at how far it has come in just a few years.


Good Vibes – New app helps deafblind people communicate

How can deaf-blind people communicate with each other or with their care givers? Enter Good Vibes – a free app that uses haptic feedback and does not have a visible user interface. Developers say this is the “first time in history” that an effective tool has been created for two-way communication between those who are visually and hearing impaired. It can be downloaded for free on Google Play.


Cryptocurrency’s digital health potential for data sharing, behavior incentives

Cryptocurrency has both advocates and critics in the financial sector. In digital health, the use of cryptocurrency is equally undefined, but it has a lot of potential. While the use of cryptocurrency in digital health is still in its infancy, some experts say this is only the beginning of a growing field. This article looks at 2 applications for cryptocurrency in healthcare – data for digital dollars and cryptocurrency as a behavorial incentive.


What can healthcare learn from finance about data sharing

Both financial data and health data require the highest levels of security and privacy. But the experience of that safe and secure data exchange, between healthcare and finance, is dramatically different. Banks, credit card companies and other financial institutions are able to navigate these barriers to talk to one another, making it easier for customers to coordinate payments and understand their overall financial wellbeing. So why can’t patients, doctors, payers and insurance providers do the same for health data? … It is time redesign the way that healthcare ecosystems communicate…


Infographic: Wearable Healthcare Technology

And finally, we pay attention to an infographic which provides examples of a wide range of healthcare wearables, the most popular types of healthcare apps and insight into healthcare wearable trends. Enjoy!

Image Credit: Vivian Abagiu/University of Texas at Austin

Mar 22

Full-body exoskeletons to minimise occupational injuries?

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Spine Cloud Platter , Videos , Wearable Tech

In this week’s platter, we get introduced to industrial exoskeletons; we look at UAE’s adoption of digital health solutions; we see the smartwatch come of age; and we pay attention to innovations in the pharma supply chain. Enjoy!

They say that prevention is better than cure – so let the robot lift…

Backaches as a result of poor lifting techniques may soon be a thing of the past.  Sacros Robotics, a global leader in the production of robots that combine human intelligence and dexterity with strength, is working with industry groups to identify key performance and safety requirements necessary to bring powered and quasi-passive, full-body industrial exoskeleton systems to the work force.  This will surely improve efficiency and reduce occupational injuries and especially the proverbial lower back pain (yay!!!).  See demonstration of this highly dexterous machine here and here.  Who wants to bet that we see surgical robots evolve to surgical exoskeletons…?


Saved by the watch

The Apple Watch smartwatch has been found to be pretty accurate when it comes to detecting abnormal heart rhythms. A continuing study (see journal article here) on the potentials of wearables has identified that the watchOS device has a 97 percent accuracy rate in determining abnormal heart conditions.  We can be sure that the phone will inform your cardiologist before you even know it. This development is enough to make my heart skip a beat…


UAE adopts virtualization of care through digital health solutions.

Residents in the UAE will soon be able to access real-time medical data, ascertaining the continuity of care when patients move from one hospital to another.

The project for unified medical records ‘Riayati’ will connect public and private sector healthcare providers across the country, in order to create a secure way to access and share the right health data with the right people in real time. That’s right – in real time… Complications arising due to unavailability of reliable medical information during emergencies will soon be a thing of the past.


Robotics, A.I. and Blockchain Redesign The Pharma Supply Chain

Exoskeletons will aid pharma factory workers. 3D printing will allow pharmacies to produce drugs on the spot. Blockchain technologies will help fight counterfeit drugs. These are just bits and pieces, but the entire process of the pharmaceutical supply chain will be affected by disruptive technologies. Let’s look at a comprehensive overview of how innovations will make the supply chain more efficient, faster and cheaper than ever before.

Image Credit: Utah Business

Feb 23

Spine & Health Info Platter (23 Feb ’18)

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Value-Based Healthcare

In this week’s platter, we consider some of the issues related to the migration towards value-based programmes; we look at an executive’s guide to AI; we learn about the FDA approval for AI-enabled stroke alert app; we learn about the deployment of DNA nanorobots in the fight against cancer; and, finally, a treatise of blockchain technology and what it means for healthcare and pharma. Enjoy…

Most healthcare execs say value-based programs led to positive financial results

HFMA and AAFP reports found that nearly three-quarters of executives surveyed said their organizations achieved positive financial results, including return on investment, from value-based payment programs. Despite the benefits associated with the fee-for-value payment models, the report found that barriers to value-based payments persist: such as lack of resources, inconsistencies among payers, lack of physician alignment and support, lack of staff time, lack of standardization of performance measures and uniform performance reports from payers.
The move into value-based payments is just beginning…


An executive’s guide to AI

With the accelerating artificial-intelligence race, executives have to make nimble, informed decisions about where and how to employ AI in their business. Management consultant McKinsey & Co. present AI essentials for executives in this interactive guide.


FDA OKs marketing of AI-enabled stroke alert for providers

We’ve seen the FDA approve prescription apps for substance abuse and digital pills that track when patients take it, and now we learn of the approval of clinical decision support software which analyzes brain scans and alerts clinicians if a patient is at risk of a stroke. During the FDA review, real world evidence was used to show that the app could alert a neurovascular specialist sooner than a clinician in cases where a large vessel blockage was seen. Incremental improvement, but improvement nonetheless…


Power Source Inspired by Electric Eels to Energize Medical Implants

Last week we learnt about the development of spine-like battery to power flexible electronics. Here we learn of a power source inspired by electric eels to energize medical implants. This is a significant development as the power source would overcome the limitations of batteries: it will remain inside the body (no need to remove/replace), no need for the introduction of toxic materials into the body, and – stating the obvious – completely alleviate the need to use batteries for implants.


Nanomachines Create Clots Inside Vessels Feeding Cancer Tumors

Researchers from Arizona State University and National Center for Nanoscience and Technology of the Chinese Academy of Sciences have developed a remarkable new way of killing tumors. They’ve developed robot-like nanoscale devices that cling to the walls of tumor vessels, release a clotting agent, and block the tumor from receiving nutrients. This article reports that the technology was applied to mice with a variety of tumors, including breast cancer, ovarian, melanoma, and lung cancer. It worked in all the tumor types, to different degrees, but quite well. Inasmuch as there is a lot of work still to be done even before clinical trials can begin, the expanding of the possibilities of this new technology is exciting…


What Is Blockchain And What Does It Mean For Healthcare And Pharma?

This article presents a treatise on blockchain technology; and argues the immense potential in both healthcare and pharma.

Feb 18

Spine & Health Info Platter (18 Feb ’18)

By Kanwal Sood | Big Data in Healthcare , Blockchain , Disruptive Innovation , Wearable Tech

In this week’s platter, we look at how the earth’s most customer-centric company (…Amazon) could disrupt healthcare; we learn how FitBit is enabling providers to better support patients beyond the walls of the clinical environment; we pay attention to an application of blockchain technology that promises to lower drug costs; we consider the importance of cybersecurity given the advent of EHRs; we look at how technology imitates nature; and finally, we pay attention to the application of machine vision for spinal navigation. Enjoy!


What could Amazon’s approach to healthcare look like?

It is clear from some of its recent moves that Amazon sees the 18% of U.S. GDP dedicated to health care as fertile ground for expansion. The challenge is formidable. As many critics have noted, employers have banded together before to address health care costs and failed to make much of a dent in health care spending. How will this effort be different? If Amazon succeeds in changing health care, how might it do so? This article presents four key strengths that Amazon will have to exploit to bank this opportunity.
Suffice to say that for existing health care companies, the operative words in their mandates have been “health care”; for Amazon, the operative words likely are “service that needs to be delivered to a customer.” Is this the disruption that the healthcare industry has been waiting for?


Fitbit digs into healthcare industry with acquisition of personal coaching platform Twine Health

On Tuesday, the wearables manufacturer announced plans to purchase Twine Health, a Boston-based company that combines artificial intelligence with personalized coaching to assist patients with diseases like diabetes and hypertension. This is in pursuit of helping healthcare providers to better support patients beyond the walls of the clinical environment, which can lead to better health outcomes and ultimately, lower medical costs.


Cambridge Consultants creates blockchain-based platform to help manage drug costs

Development firm Cambridge Consultants has designed an open market trading platform for drug price negotiation that’s based on a public blockchain. The company says it’s an effort to help fix the lack of transparency around how drug prices are set – that by creating a set of so-called smart contracts on the Ethereum blockchain, it will enable a trust-based mechanism for the trading of drug products as if they were commodities. By moving to an open market that creates price competition and improves access, one can expect that drug prices will taper and could eventually decline.


Tennessee Hospital’s EHR Hacked by Cryptocurrency Malware

Decatur County General Hospital, a 40-bed hospital located in Parsons, Tennessee, has informed its patients about a security incident in which is electronic medical record (EMR) system was hacked, impacting 24,000 patients’ records.
As per classic PR, the hospital alleges that, at this time, there is no evidence that patient information was actually acquired or viewed by an unauthorized individual and officials investigating the incident do not believe that patient health information was targeted. Nonetheless, this incident highlights the risk associated with digital EHRs on a network


Lithium-ion battery shaped like spine could power flexible electronics

Scientists are developing a lithium-ion battery shaped like the human spine to power wearable electronics in the future. Researchers from Columbia University in the US were inspired by the suppleness of the human spine, and used the spine model to design a battery with a similar structure as that of the spine. The battery allows remarkable flexibility, high energy density and stable voltage no matter how it is flexed or twisted, researchers said. The solution to some of our problems is found in paying attention to what has already been created…


Machine-Vision Image Guided Surgery: Cost-Effective & Radiation-Free (YouTube)

The 7D Surgical System is an impressive Machine-vision Image Guided Surgery (MvIGS) platform. The system delivers on the promise of image guided surgery (IGS) and allows surgeons to perform fast, cost-effective, radiation-free IGS. Unlike conventional IGS systems that rely on time-consuming intra-operative radiation emitting devices or laborious point matching techniques, MvIGS uses only visible light to easily register patients in less than 20 seconds. Have a look…

Feb 09

Spine & Health Info Platter (9 Feb ’18)

By Kanwal Sood | Big Data in Healthcare , Blockchain , Disruptive Innovation , Spine Cloud Platter

In this week’s platter, we look at curing disease through big data; then we pay attention to the early applications of virtual reality technology in healthcare; we look at how a simple tweet about your cough could help reduce the impact of a pandemic; we consider the rise of ‘digiceuticals’; and finally, and frankly ironically, we turn our attention to the lobby against digital addiction.            Sign up for our newsletter on the left. Enjoy!


Medichain – saving lives with blockchain

MediChain is a Medical Big-Data Platform that allows patients to control all their medical data with complete privacy and at no cost to themselves, the doctors, or hospitals using the system. The platform is unique in that it that stores the anonymised data in such a way that patients can opt to let researchers use it in developing cures for every possible disease or illness that occurs in the population. So your data can actually be used to save the life of others. This is a fine example of curing disease through big data.

Where is the business case for medical VR?

Proponents of virtual reality (VR) technology believe VR offers a valuable new addition to the clinical toolkit, with potential applications ranging from education and training to rehabilitation, pain reduction and even treating anxiety and depression. But is there evidence supporting the use of VR in the treatment of medical conditions? This article answers in the affirmative, and suggests that VR could even find application in cognitive behavioral therapies.


Fighting the flu with code

Early detection and prediction of disease outbreak is critical because it can provide more time to prepare a response and significantly reduce the impact caused by a pandemic. Multiple researchers are harvesting data from social media platforms to estimate current (real-time) influenza activity and determine hot spots of transmission.
This represents a big leap because such predictions provide actionable insights for public health that can be used for planning, resource allocation, treatments and prevention. So, the next time you tweet ‘Oh, I’m coughing,’ you may just be helping the authorities determine to where to focus their resources. Was that a cough I just heard…?


Don’t worry, be appy

LUANN STOTTLEMYER has had diabetes for 23 years, but it was only in 2016 that her doctor prescribed a treatment that changed her life. It has allowed her to bring her blood-sugar levels under control and lose weight. Yet this miracle of modern science is not a new pill. It was a smartphone app (a “digiceutical” for those who are into the lingo).


Social media pioneers will now fight what they helped build

With the advent of digital solutions/apps for just about anything, a lobby group has been formed to highlight the dangers of excessive smartphone use has on the mental health of the users. Ironically, the lobby group is spearheaded by the very same people who helped create these ubiquitous social media platforms. What was once a solution is now becoming a massive problem…

Jan 26

Spine & Health Info Platter 26 Jan ’18

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Internet of Things , Spine Care , Value-Based Healthcare , Wearable Tech

In this week’s platter, we look at a simple guide for organisations interested in utilizing blockchain technology; we look at the interesting intersection of medical training and urban design; and finally, we look at some trend predictions for 2018. Sign up for our newsletter on the left. Enjoy:


Blockchain Technology is Ready to Restructure the Healthcare Industry

As cryptocurrencies grow in popularity and value, there is an emerging consensus that the technology that powers them may bring long-awaited changes onto various industries. In this article, we take a look at 3 of the blockchain-based applications prepared to make a tangible impact on the healthcare industry.

Blockchain—A new model for Health Information Exchanges

This report presents a simple guide for organisations interested in utilizing block chain technology. While the report recognizes that blockchain technology is not the panacea for all system integration challenges, the benefits of the technology are numerous.


These Future Doctors Are Learning How to Influence Urban Design

The built environment itself can influence both physical and mental health. Researchers have even found that heart rates will go down when people simply walk past green space that have been added and blight cleaned up. The built environment is as much a public health concern as it is an infrastructure need.

Here we learn how JeffDESIGN, a hybrid university program that combines medical training with design classes, seeks to change the way doctors think and influence public health in cities by equipping them to influence the way cities are built or retrofit.


Value-Based Purchasing Tops List of Health Benefit Trends to Watch in 2018

The pursuit of value-based purchasing arrangements tops the list of employer health benefit trends to watch in 2018, according to the National Business Group on Health. The Washington-based employer health coalition released a list of nine employer health benefit trends to watch to this year. Not surprised to see “engagement platforms” listed as number 3 – sign-up and join our network!!!!


What To Expect From Digital Health In 2018?

2017 was a year full of marvelous advancements in healthcare. So what’s next? This article takes a sneek peek at the crystal ball (assuming one even exists) to look at what 2018 will mean for digital health

Jan 12

Spine & Health Info Platter (12 Jan ’18)

By Kanwal Sood | Artificial Intelligence , Big Data in Healthcare , Blockchain , Disruptive Innovation , Low Back Pain , Spine Care , Spine Cloud Platter , Value-Based Healthcare

In this week’s platter, we pay attention to the promises that mulberry silk has on spinal replacement therapy; what Starbucks could teach healthcare providers about “patient adherence”; the applications of blockchain technology in healthcare administration and pharmaceuticals; and, finally, we meet FLIPPY


Powered by silk: on spinal replacement therapy (The Hindu)

Using mulberry silk, researchers from IIT-Guwahati have fabricated a spinal biodisc construct that could mimic the human intervertebral disc in form and function (successfully tested in rats so far).  Because of its abilities to accurately mimic the human disc that acts as a soft cushion between two vertebra, the artificial biodisc has the potential to replace the metallic or ceramic or collagen-based discs that neurosurgeons use at the moment to surgically cure some of the lower back pains.

Just looking at the rise in the prevalence of surgical interventions for lower back pain, perhaps it is time that we harvest silkworms… 🙂


What could Starbucks possibly teach providers about “patient adherence”?

Patient non-adherence costs between $100 and $300 billion annually in the US alone, and is therefore an important public health consideration, affecting health outcomes and overall health care costs.   Healthcare delivery models has sold healthcare as “products” – whereas patients want “progress.”

In tune with Peter Drucker’s famous insight, “The customer rarely buys what the company thinks it is selling them.”  Starbucks has created and thrived in this space, and perhaps healthcare innovators can learn from that experience.


Change Healthcare’s enterprise blockchain tech now available for hospitals, practices, payers

The finance domain may have been the forerunners in adopting the blockchain revolution (cryptocurrencies etc.), but healthcare is finally catching up.  Change Healthcare has launched what it’s calling the first enterprise-scale blockchain network in healthcare.  This is a positive development worth watching closely; especially as innovators continue to explore new areas where blockchain technology can leveraged to help lower costs, improve quality and make healthcare more patient-centric.


What if blockchain could be used to save lives? (Coindesk)

In recent years, pharmaceutical companies have been put under more pressure to bring new, more personalized drugs to market faster and at more affordable prices and in a personalized fashion.  The 3 pharmaceutical heavyweights – Pfizer, Amgen and Sanofi – are now eyeing blockchain as a means of reducing the length and cost of clinical trials and improving the success rate of these trials.  Watch this space.


Meet FLIPPY the robotic kitchen assistant (Miso Robotics)

The development of very capable and autonomous AI systems could completely transform is already transforming multiple sectors and professions.  Meet “FLIPPY” the kitchen assistant and watch him/her in action.  Watch the video and let us know what you think the implications of this development could mean in your domain.