We used to hae Connaught Labs at Steeles Avenue and Dufferin St in North York. Then it disappeared. No more vaccine capacity of significance in Canada.

Then recently, I learned about Medicago and its greenhouses in Quebec City.

This business is one of the most interesting and innovative organizations that I have ever heard or read about and I have been around for a while.

Medicago uses plants as bioreactors. The plants produce virus like particles (VLP) which resemble Sars-COV-2. Spike proteins and all.

Check this out below. The virus and the virus like particle.

The virus like particles (VLPs) are injected into us humans which results in the development of antibodies to COVID 19.

Medicago has partnered with GlaxoSmithKline (GSK) to produce the final vaccine which is entering into phase 3 trials at this time.

I am a total supporter of Medicago and wish them well on the way to making 1,000,000,000 vaccines per year.  By the way, they also have a vaccine for Ebola.

High fives all around.

Raymond Rupert patient advocate and disruptor of healthcare for the common good.

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Uber complex implies high levels of uncertainty. Somewhat like a wicked problem. Not a complex problem.

The objective in using an expert panel is to go deeper in the analysis of the problem.

Hosting a diverse panel generates more options and more viewpoints.

We strive for diversity on the panel. Different disciplines. Different angles. Different styles.

With complexity, we don’t want to address the problem with a single lens.

We want to generate many diverse viewpoints. Then we want to seek consensus. Hard to get there but worth the effort.

Sometimes, we will do this blinded. The experts won’t know what each other thinks.

Sometimes, we will do this as an open discussion. Hard to reach consensus, if the opinions are ever shared.

For our current case involving the mental health and substance use disorder of a young adult with a history of self harm, we are going to start with a closed process. Like a delphi technique.

Then invite all the experts to an open discussion with each one knowing the opinion of the others first.

We hope that this process of using an expert panel delivers the best possible option for our client.

Experts should not be concerned that AI will replace them. Not yet.

Raymond Rupert patient advocate , former family doctor, founder of RCM Health Consultancy.

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His spinal fluid is abnormal and is sent to Mayo
Clinic Laboratories for an Autoimmune
Encephalopathy evaluation.

The evaluation detects an unclassified antibody, which is
reported back to the treating physician.

The patient is discovered to have a
squamous cell carcinoma of the sinus and
sees a dramatic improvement in symptoms
when treated with steroids. This antibody
was later classified as Glial Fibrillary Acidic
Protein (GFAP-IgG).

Case Two:

A 60-year-old smoker presents
to a community hospital with
subacute confusion and seizures.
The infectious disease evaluations
were negative, and the patient was
diagnosed with confusion from an
uncertain cause.

A new neurologist takes over the case and sends
an Autoimmune Encephalopathy
Evaluation on CSF to Mayo
Clinic Laboratories.

The patient is GABA-B receptor-antibodypositive, which is associated with small-cell lung cancer. The chest
CT shows a mass, and the biopsy
confirms small-cell lung cancer.
The patient improves with cancer
treatment and immunotherapy

Case Three:

A 74-year-old male presents with subacute confusion and abnormal movements. His spells are brief (2–10 seconds), affect the right side of his face and arm (occasional leg involvement), and occur up to 30x per hour. The episodes continued despite four anti-epileptic medications, and therefore, it was felt that they may be psychiatric.

An Autoimmune Epilepsy Evaluation was sent to Mayo Clinic Laboratories. The VGKC was 2.62 nmol/L (normal <=0.02), and LGI1 was positive by cell-binding assay.

The patient was diagnosed with autoimmune epilepsy associated with VGKC autoantibodies (LGI1 subtype). The episodes represented what we now term Facio-Brachial Dystontic Seizures. The confusion and seizures resolved with immunotherapy.

Raymond Rupert, patient advocate and healthcare consultant.

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