4Dx has appointed E&P (formerly Evans and Partners) and Bell Potter Securities as joint lead managers of its proposed IPO.
Advanced software reduces dose without sacrificing image quality.
Although the direct health risk of medical diagnostic scanning is not unequivocally clear, it is important for patients as well as health care professionals to mitigate the risks of radiation dose. While most of the concern regarding overexposure and cumulative dose has historically been focused on CT, which generally delivers much higher dose levels to patients than standard X-rays, the issue has raised awareness of a patient’s cumulative lifetime dose across all modalities that use ionizing radiation—CT, radiography, and angiography.
Most original equipment manufacturers have a strategy centered on improving the quality and safety of patient care through a commitment to lower radiation across a suite of medical imaging products. The challenge is doing so without sacrificing quality images or impacting care.
Less Dose, Same Quality
An example is Samsung’s GC85A premium fully digital X-ray system, which provides the same image quality with one-half the radiation. Deborah Chung, marketing manager of health care at Samsung Electronics America, says Samsung’s image postprocessing engine, S-Vue3.02, provides spatially adaptive multiscale processing and advanced denoising technology.
“The new system delivers the same image quality as the predicate device but with half the radiation exposure,” Chung says. “The key is Samsung’s cutting-edge denoising processing, adopted for the new engine, which reduces noise from the noisy low-dose data while preserving the details of the object being imaged.”
The dose reduction in digital chest radiography is based on limited phantom and clinical study results for Samsung’s GC85A and GM85 systems. Hetal Patel, MD, a radiologist at Alamance Hospital in Burlington, North Carolina, says the low-dose image quality on the GC85A equipment is excellent.
“The retro cardiac region is well visualized with excellent penetration, and the rest of the anatomical structures are clearly demarcated,” Patel says. “Also, bony structures were well delineated. Low-dose imaging has a similar or better image quality than regular-dose images.”
EOS Imaging develops and markets the EOS system, an X-ray-based modality for musculoskeletal imaging that captures simultaneous anteroposterior/lateral (AP/LAT) full-body images of patients in functional positions at significantly reduced radiation doses.
“The value of the EOS system is multiple: value in patient safety through a dose reduction that can be two-fold to 10-fold, compared with DR and CT; value in efficiency through a much faster exam—up to 75% savings in exam time; and value from a better-informed treatment thanks to our unique weight-bearing 3D data,” says Marie Meynadier, CEO of EOS imaging.
As a result, an EOS exam provides high-quality, full-body, low-dose AP/LAT radiographs, a 3D model of the skeleton, and a comprehensive report of automatically calculated clinical parameters in 2D and 3D in less exam time.
“Reducing health care-related radiation exposure is a metaphorical cornerstone in medical ethics and the standards exhibited in the Hippocratic Oath,” says Christopher J. Smith, CNMT, RT(N), administrative director of radiology and imaging at the Hospital for Special Surgery (HSS) in New York. “While incidental exposure from X-rays has minimal to no patient risk, there are patient populations, such as adolescent idiopathic scoliosis patients, that may receive serial X-rays for many years.”
Moreover, the aggregation of these exposures is yet to be fully evaluated and can be anxiety inducing. Smith utilizes the EOS imaging system, which he notes offers significant dose reduction for the imaging life of the patient.
“At HSS, we see dose reductions equal to approximately 50% of comparable digital X-rays,” Smith says. “EOS also offers a microdose feature that can further reduce patient exposure to near-background levels, which HSS will be exploring to offer for some patient cohorts.”
Two key factors that allow EOS to provide a reduced dose and clinical image quality are an innovative gas detector and a collimated X-ray beam to reduce scatter and unnecessary X-rays. The EOS detector has extremely high sensitivity and a very high gain, which is automatically adjusted for each exposure. This preserves contrast from the denser parts of the anatomy, such as bones, to the less dense parts, such as soft tissues and lungs.
“The outcome is an X-ray image with good resolution, sharpness, and 65,000 gray values,” Smith says. “This means that the X-ray images can be windowed similar to the way radiologists do for specific body parts in CT. Next, the X-ray beam is collimated just after the X-ray tube and passes through a shielded horizontal slot that is 500 microns high. The resultant fan-shaped X-ray beam limits the volume of the body exposed at each moment and, thus, drastically limits the total number of aberrant X-rays, the ‘scatter,’ exiting the patient and entering the gas detector, where it would degrade the image sharpness.”
Steven Eisner, senior product manager for Konica Minolta Healthcare Americas, Inc, says the company’s AeroDR family of digital flat panel detectors—AeroDR HD, AeroDR XE, and AeroDR LT—utilize a combination of high detective quantum efficiency, high spatial resolution, and REALISM image processing software to contribute to improved dose efficiency.
“REALISM is our next-generation advanced image processing software that provides superior visualization of structures within soft tissue and bone within the same image,” Eisner says. “It delivers a new level of clarity and detail in X-ray imaging that improves the sharpness of fine details, enhances visibility of hard-to-penetrate structures, and delivers excellent visibility of high-contrast images. This translates to the ability to generate more information with fewer exposures per exam as well as avoid the need to retake images due to poor image quality.”
At Cuero Regional Hospital in Cuero, Texas, Tyler Lemke, director of radiology, has been using REALISM and AeroDR.
“In the wrist, where there are many small bones, I immediately noticed the fine details and sharper images allowing me to see the fine details of each bone,” Lemke says. “The images were so crisp the bones just popped [off the image] and the edges and trabeculae of every bone were very clear.”
Lemke also tracks repeat exposures. He had previously noticed that technologists were performing repeat exposures because they were not optimizing exposure levels. In the first month after installing REALISM and AeroDR, Lemke worked with this staff to ensure a higher attention to detail with the new DR system; as a result, repeat exposures have dropped by 20%.
“Department managers are concerned with dose, and AeroRemote Insights provides the analytics, via interactive dashboards, they need to manage their AeroDR assets and deliver a better experience for patients,” Eisner says. “Over the last decade, with the increase in system connectivity and the more recent emergence of [the Internet of Things], we’ve tapped into our experience and expertise to be the first to deliver analytics in DR to our customers.”
A new preclinical scanner from 4Dx Limited, a Melbourne, Australia-based medical technology company, focuses on lung disease and reductions in radiation dose. Andreas Fouras, PhD, a mechanical engineer, is the inventor of the tech. He was working at a university doing wind tunnel imaging and developing algorithms to measure and quantify movement when he thought this capability could be used to measure motion in the lungs.
“The first layer is we measure in fine detail how the lungs move as the subject breathes, and then, once we have that information as to how the lung tissue is moving, it’s actually a relatively simple step to then calculate what the air flow is that creates that lung tissue motion,” he says. “So, we can create high-resolution maps of airflow, of ventilation in the lungs. We think of this as a brand-new modality, but we just use older X-ray equipment so we can do low-dose X-rays and apply the algorithm and generate this new, rich data.”
The whole procedure has a dose cost of about 0.2 milligrays—about two chest X-rays worth of dose—but it provides highly detailed data at no capital cost and no upfront cost to a site, a doctor, or a radiologist.
“We create a 3D image of this lung tissue motion,” Fouras says. “The old sort of CT way works by taking hundreds of images around the outside of a patient to reconstruct the 3D CT image. We’re actually able to do that with as few as three views. The closest sort of competing technology in this space would be a 40-slice CT, which is going to be substantially more dose than two chest films.”
Waseem Bhatti, MD, medical director of imaging at Summit Medical Group MD Anderson Cancer Center in Florham Park, New Jersey, says by utilizing a combination of clinical decision tools, hardware, and software technology innovations, along with purposeful scanning, the industry can optimize medical imaging for patients.
“Reducing dose for our patients begins before the scan. Software and the ‘cloud’ are increasingly playing a role in limiting the number of unnecessary scans and repeated scans within a short time interval,” Bhatti says. “From what we know about Moore’s law—the observation that the number of transistors in a computer chip double about every two years—we have seen dramatic improvements in CT scanners.”
In the early 2000s, most CT scanners used a single slice to scan. At Summit Medical Group MD Anderson Cancer Center, most of its current scanners use at least 160 slices.
“Customization of radiation dose using automated exposure control software on our CT scanners helps decrease unnecessary dose,” Bhatti says. “The patient’s size and shape is measured and calculated for the specified scan protocol, and the dose delivered through the 360 degrees of the scan may be modulated depending on soft tissue thickness at a given slice level.”
A large part of the dose depends on the clinical question posed by the referring physician. For example, a contrast-enhanced pancreatic protocol CT scan will require a higher dose than a noncontrast scan for detecting kidney stones.
“Unfortunately, the more we decrease the dose, the more noise or blurriness we encounter,” Bhatti says. “To deal with noise, postscan reconstruction software is used to produce diagnostic quality images by improving spatial resolution.”
The center’s Canon Aquilion CT scanners select the dose based on patient size, exposure settings, and type of scan being performed. Iterative reconstruction software on these scanners optimizes the images.
“When a patient undergoes a CT scan, they deserve to have the highest-quality scan using the lowest dose possible. The ALARA principle of responsible dose management guides our approach,” Bhatti says. “We also fully participate in the Image Gently campaign to reduce pediatric CT dose. Our equipment helps us adhere to these principles by giving us the tools necessary to limit dose while producing high-quality images.”
To view the original article, please click here
4Dx has developed an algorithm-based software that converts X-ray images into more detailed airflow studies.
4Dx is developing a software-as-a-service technology that enables four-dimensional lung imaging tests using the imaging equipment already in place at hospitals and other clinical settings. The company expects to have FDA clearance for the software sometime in 2019.
Here’s a story about how a technology developed to study air displacement from jet engines inspired one mechanical engineer to develop a unique solution for medical imaging.
“I used to work on as a mechanical engineer testing aircraft and other vehicles in wind tunnels,” Andreas Fouras told MD+DI. “We would place models in a wind tunnel, we would do this wind tunnel imaging with lasers and cameras and so on, and from that my team would write software that would perform the quantitative analysis of those images to do things like calculate where there was turbulence and how this aircraft or this vehicle was performing in the tunnel.”
Fouras invented new algorithms in that space that allowed that analysis to be done in 3D and 4D.
“And at the same time, I was rubbing shoulders with medical researchers who were talking to me about the difficulties they had in understanding or doing good quality functional imaging in the heart and lungs,” said Fouras. “I was able to put two and two together and extend and extrapolate the wind tunnel technology that I developed into this medical imaging technology. I had that idea in 2005 and worked on it effectively as a research project for eight years and then spun out the company in 2013.”
So that’s how Fouras became the founder, chairman, and CEO of 4Dx, a Melbourne, Australia-based company developing a software-as-a-service technology that enables four-dimensional lung imaging tests using the imaging equipment already in place at hospitals and other clinical settings.
“It’s a new measurement that has not been previously available,” Fouras said. “The modality is available in a virtual setting.”
So the way it would work is the patient would go to a hospital or clinic, the radiologist would use X-ray equipment already on site but would follow a slightly different protocol in terms of acquiring those X-rays, and load the images into the cloud. Then, 4Dx would run its software, perform the analysis, and send a scan back to the doctor and patient without there actually being a physical 4Dx scanner at the facility that the institution would have to buy and maintain.
“To a very high-resolution measure where the air is flowing in someone’s lung,” Fouras said. “We see everywhere in the lungs and also everywhere throughout the breaths, all phases of the breath … doctors love to have that visualization and patients love to have that visualization where they can see their lungs, and they can see where the air is flowing and where the air isn’t flowing as they breathe.”
But Fouras didn’t initially envision the technology being offered this way.
“I have to admit that we initially imagined building and selling scanners,” he told MD+DI. “We imagined the technology without really imagining the business side of it, which I think is not too unusual for a group of engineers to do that.”
Once the business focus kicked in, it became clear that the technology could be more efficiently developed and sold as a software-as-a-service model. The scan can be delivered on any piece of X-ray equipment and only delivers two chest X-rays’ worth of radiation to the patient, which is less than a CT scan.
Although 4Dx is an Australian company, it has a Los Angeles, CA-based office and the company is developing partnerships with major U.S. healthcare organizations like LA Children’s Hospital, Cedars-Sinai, University of California Los Angeles, and Cleveland Clinic. The company is currently leveraging those partnerships to develop clinical evidence to support an FDA submission, and if all goes as planned 4Dx will have its software cleared in the United States next year.
Future applications of the technology go beyond the lungs, including heart and cancer diagnostics.
To view the original article, please click here
Chronic obstructive pulmonary disease affects millions of people in the United States. The main method of diagnosis is the pulmonary function tests (PFTs), in which a patient breathes into a machine that measures pulmonary parameters. The disadvantage, however, is that pulmonary function tests take an “average” of a patient’s lung without being able to detect specific areas of lung function and compare them over time.
4Dx is hoping to improve that. Using principles of air flow dynamics and applying them to data from a simple X-ray, the company’s algorithms can calculate the amount of air that each area of the lung is receiving. This generates a moving, color-coded visual of a patient’s breathing lung.
The unique thing about this visual, says founder and CEO Andreas Fouras, is that it gives much more information than a traditional pulmonary function test. Physicians can easily see exactly which areas of the lungs are poorly ventilated, whether certain areas are over-compensating for poor function in other areas, and compare specific areas of lung function over time. Plus, says Fouras, the visual is an incredibly easy way for patients to understand their disease.
The technology works by using data from X-rays. The patient breathes 3-5 breaths in front of an X-ray machine, at various angles, and that data is run through an algorithm that converts the moving changes seen in the X-ray to air flow in the lungs. “We look at how the lung moves from each of the few angles,” explains Fouras, “and then we piece that together not to form a three-dimensional picture of the lung, but to form a three-dimensional picture of how the lung moves—or a 4D picture.” People think of X-rays as a method of directly identifying structures, says Fouras, but there’s actually a lot more information there.
The idea began when Fouras was pursuing his PhD at Monash University in Australia, where he helped develop imaging technology for analyzing air flow dynamics in wind tunnels. At the same time, he happened to talk with various physicians and got the idea to apply the same technology to lung imaging. Encouraged by the enthusiastic initial reactions of physicians, he began working towards developing a technology specifically for the lungs.
The research led to many grants and published research papers. “My academic career went ballistic,” he quips, as he went from new PhD to tenured professor in six years. But to successfully commercialize the technology, he had to go all in. He sold his house, moved his family to Los Angeles, and borrowed money to invest in his fledgling company. Since its official founding in 2012, 4Dx has grown to a team of thirty people.
The company is currently awaiting FDA approval, which will be decided sometime this year. In the meantime, the company is reaching out to hospitals and working with physicians to do investigational studies. “The vast majority of people we’ve spoken to have come on board,” says Fouras, a promising sign reminiscent of the enthusiasm his research generated when he was a student and professor in Australia.
The technology doesn’t have to be limited to the lungs, either. “Once you have a solid platform that has a good performance, the opportunity to spread it out across other applications is really significant,” says Fouras. “I don’t want it to be limited by my imagination.” The algorithms could be tailored for better visualizing the heart and other organs — the company even has a patent on using the technology for in vitrofertilization.
“But the thing that encourages me the most is the response I get when I talk to doctors,” says Fouras. “I see the look in their eyes, and they say something like ‘where have you been my whole career? I can’t wait to use this.’” And so above all of the excitement for the technology and its future, he says, “That’s really the most exciting thing for me.”
The original article “4Dx Uses Algorithms to Better Visualize Lung Function”, by CiCi Zhou is available at Medgaget.com.
Melbourne, Australia, 19 April 2017: 4Dx Group “4Dx”, Hydrix Pty Ltd “Hydrix”, and Monash University are collaborating “4Dx Pre-Clinical Scanner Project consortium” to rapidly manufacture two pre-clinical scanners for delivery to two major American medical research hospitals by the end of the year. A further three units will be supplied to other world leading hospitals by the end of the 2018.
This project will deliver technology that is a world first in innovative respiratory analysis and diagnostic systems. 4Dx provides a unique 4-Dimensional perspective and expert analysis of data to clinical practitioners. The technology results in lower costs, provides more information and faster validation of treatment with reduced radiation exposure, while also allowing for earlier detection of disease and intervention by doctors. The technology enables clinicians to capture images that effectively provide highly detailed footage of the motion and airflow within breathing lungs.
162 million respiratory diagnostic procedures are performed within the OECD each year, at a cost in excess of AU$25 billion per annum. A share of this market will create a new multi-billion-dollar industry in Victoria. This industry will see the creation of highly skilled jobs in design, engineering, software development, R&D and clinical trials in the Victorian economy.
4Dx technologies are globally unique and with strong interest from a number of major US hospitals 4Dx has the opportunity to secure a strong share of the US respiratory health clinical technology market. The technology opens up a new niche for the export of high value advanced technology manufactured in Victoria.
This innovative diagnostic was developed through research programs conducted at Monash University, with support and funding from a number of Australian and American government agencies and peak body groups.
Monash University Deputy Vice-Chancellor and Vice President (Enterprise) Mr Ken Sloan says, “the technology provides an enormous opportunity to impact global health and is a brilliant example of the leading role Monash University research teams are playing in world class innovation. By harnessing our leading research capability and driving government and commercial partnerships, Monash enterprise is tackling real world, high impact challenges, while also advancing economic growth.”
The approval process for clinical human use will be undertaken in conjunction with the utilisation of the pre-clinical scanning technology on small animals at US medical research hospitals. The partnership with major US hospitals to take up the clinical scanner technology will enable human clinical use in key facilities with a view to rapid global adoption of the technology.
4Dx CEO and founder Andreas Fouras says, “having these key US hospitals commit to a 4Dx scanner demonstrates their confidence in our technology and lays the foundations for the introduction of human research scanners in the near future.”
The Pre-Clinical Scanner Project is supported by the Victorian Government, with the project expected to create 56 new jobs and generate at least AU$6.7 million export revenue over the two year period. The consortium will directly co-invest $1.395 million in the project, with 4Dx committing to an additional $6.85 million investment into research and development operations in Victoria.
Hydrix Business Development Manager Paul Carboon says, “we are excited to support 4Dx in the design finalisation and assembly of the first batch of preclinical scanners. It is a great Victorian success story of technology that was created at Monash and is now being commercialised by 4Dx. This project leverages Hydrix’s significant experience in the development and commercialisation of x-ray based innovative products targeted at the Global Markets. It is fantastic to be able to secure the development and manufacturing of these products here in Victoria.”
4Dx CEO and founder Andreas Fouras also says, “4Dx envisages this project will provide a significant new advanced manufacturing, export and jobs opportunity for Victoria from what will be rapid global demand for disruptive 4Dx research and clinical technologies.”
Gaining Victorian Government funding support under the Future Industries Fund Sector Growth Program is vital to ensure the consortium is able to provide certainty to manufacture in Victoria and supply of the first two ventilator-scanner units to US research hospitals by the end of the year.
Minister for Industry and Employment, Wade Noonan says “through the Sector Growth Program, the Victorian Government is making it possible for innovative organisations such as 4DX Limited, Hydrix Pty Ltd and Monash University to undertake this ground breaking project which will improve the management of respiratory conditions.”
Melbourne, Australia, 20 February, 2017: Dr. Andreas Fouras, founder and CEO of medical technology company 4Dx Limited, will present preliminary clinical data at the prestigious World Lung Imaging Workshop on the 2nd of March at the University of Pennsylvania.
The software technology developed by 4Dx provides richer information, allowing for earlier detection of respiratory related disease. Dr. Fouras, who founded the company in 2012, says that “presenting the first 4Dx in human clinical data is a great milestone for the company and we are excited to share these results to many of the world’s leading lung imaging experts at such a prestigious event”.
4Dx technology enables clinicians to capture images that effectively visualise and quantify motion of airflow at high resolution within the breathing lungs. Currently more than 162 million respiratory diagnostic procedures are performed each year, at a cost of $25 billion per annum.
4Dx limited currently has a range of formal engagements with some of the leading institutions across the United States and is moving rapidly towards a commercial product in the United States by 2018.
Melbourne, Australia, November 23, 2016: 4Dx Limited is pleased to announce that, due to an overwhelming response, as of 5pm, Friday, 9th December, 2016, the company’s $4m Series A capital round will be officially closed.
It is anticipated that the round will close oversubscribed.
4Dx founder and Chairman, Andreas Fouras, said, “4Dx is extremely pleased with the response to our capital raise. The domestic investment community has demonstrated a deep understanding of our proposition, and the value inherent in it.”
“We believe this result indicates a very clear acceptance of the need for 21st century diagnostic technology in the medical marketplace. The enthusiastic reception 4Dx has received delivers 4Dx a broad base of investors and makes us highly optimistic about the prospects of a second round of capital raising in early 2017.”
4Dx has invented a four-dimensional, non-invasive, software-based imaging technology that maps regional lung motion and air flow as the lungs breathe.
The capital round places a valuation of $36m on 4Dx Limited.
Funds from the Series A investment round will be used to take the company’s first software product to market, including clinical studies to further validate the product, as well as the development and submission of its first application for U.S. Food and Drug Administration (FDA) clearance.
The respiratory diagnostic sector represents a global market of over US$25 billion per annum, and 4Dx has a clear plan to address this market, building the company one product at a time.
The 4Dx technology has been extensively patented, with core patents granted in key jurisdictions including the US and Australia. It has been proven through published preclinical studies over the past 10 years.
4Dx was featured in an article in Australias national daily newspaper, The Australian today. Andreas Fouras, Founder and CEO of 4Dx is interviewed and the article discusses the new software for imaging lung function devised by 4Dx.
A BREATH OF FRESH AIR FOR MEDICAL IMAGE TECHNOLOGY
A “dream job” studying airflow through jet engines has led to an innovative lung imaging system that Professor Andreas Fouras is convinced will disrupt a $25 billion a year global industry and dramatically change healthcare outcomes.
The Australian father of five, who has relocated his family to Los Angeles to progress his venture, says he has found his opportunity to make a difference. With his team at 4DX, he has devised a new way of imaging the lungs by showing in real-time motion how air flows through them, pinpointing the areas that aren’t working well and those that are.
Professor Fouras says given the best technology for imaging the lungs is 50 years old, his innovation, which relies on computer software and four-dimensional imaging technology, is the next generation of care.
“We take X-rays of your lungs and look at how all individual parts are moving in very subtle detail with very sophisticated mathematics, which allows us to see accurately in fine detail how the air is moving through every part of the lung,” the 42-year-old says. “It gives clear insight into the trouble areas.”
A patient gets an X-ray — the X-ray machine would be used slightly different to how it is used now — and it is sent to the 4DX analysis cloud, which picks up every deficit in lung function. A detailed report is then sent back to the doctor.
Fouras initially took his mortgage to the maximum to start his company, 4DX, and later sold his house to pour every last penny he had into his new dream job.
“We are definitely on to something. 4DX is going to change healthcare globally — I’m convinced of that,” he says. Fouras says he had worked his way up the ranks at Monash University to build what he thought at that time was his dream career as a researcher, working on “fantastic” technology.
“While I was excited intellectually by the research, I wasn’t excited by the outcomes of, say, reducing drag on an aircraft by 1 per cent,” he says. “I realised that the mathematical discoveries I’d made could be useful in helping make better-informed decisions in healthcare and impact on people’s life.
So I pivoted my career down that path, and while it’s fairly common overseas, I think I’m a little bit of a trailblazer in Australia in terms of an engineer working completely in healthcare research.
“Initially it was bittersweet leaving a dream career behind but as a researcher, inventor and now a CEO, there is that common thread of ‘I’m just looking to make the world a better place through good ideas’.”
Lung diagnostics mostly relies on historic procedures. The most commonly used procedure is the pulmonary function test, which was designed in the 1860s. Then there are chest X-rays, which were developed in the 1890s, and the CT from the 1970s. “They are the mainstay of lung diagnostics and the best-case scenario is you are relying on technology that is almost 50 years old,” Fouras says.
There are 72 million lung diagnostic procedures performed in the US each year and about five million to 10 million scans per year in Australia. “All of those people are getting sub-quality information,” Fouras says. “Diseases are getting picked up later than they should, bad treatments aren’t being stopped right away and millions of people are having horrible health outcomes, or worse, dying, as a result of that.”
4DX is in the process of getting regulatory approvals and expects US support early next year. Scans using the technology are already being done in clinical trials in several hospitals in the US and Australia.
Fouras says while 4DX would remain an Australian company, he has moved its corporate headquarters to the US, given that is where the key market is. The professor says the movement in Australia to support innovation appears to be in the right direction but he says there are some zeros missing from the scale at which that movement is being proposed.
“Over the last 10 years, if you aggregate it, there have been significant cuts to the innovation budget. Any small increases proposed by the current government don’t get us back to where we were five to 10 years ago.”
His company has raised $5m and Fouras expects to reach $7m by year-end. “We have done well out of the Australian market but it took about 10 times more effort and three times longer than what it would’ve taken overseas.”
4Dx is excited to announce that Paul Cooke will be taking on the role of General Manager of 4Dx’s specialist hardware subsidiary, Notting Hill Devices. As Paul moves into this role, he will be stepping aside from his role as Non-Executive Director, effective 1st September. During his tenure as Non-Executive Director, Paul played a key role in lifting 4Dx’s profile during our recent capital raising endeavours.