Friday, September 29, 2017

A Startup Takes On Antibiotic Resistance

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September 29, 2017

Happy Friday, Dailies. It was not that long ago—at least when framed against the great history of this nation—that infections were the biggest killer of Americans. In 1907, the two leading causes of death in the U.S. were not heart disease and cancer as they are now, but rather tuberculosis and the brutal duo of pneumonia & influenza (which have long been grouped together as a category). No. 4 on the list was diarrhea and its related conditions.

What largely changed that—and vastly extended our lifespans in the process—was the advent of antibiotics, which came into widespread commercial use in the 1940s. "Antibiotics, as one scientific journal editorial sums up, "are arguably the most successful form of chemotherapy developed in the 20th century and perhaps over the entire history of medicine."

Most of us in the developed world simply can't imagine a life in which an endless array of infectious diseases runs unchecked, decimating life around them. We have taken this for granted because, well, we have taken antibiotics for granted.

The problem is, we have used this form of chemotherapy so much (and with so little restriction) that it has led to pathogens that no longer yield to it. The reasons for this are lengthy and complex, and I won't get into them here. But consider just one familiar aspect of the modern antibiotic-resistance cascade:

A person comes into a doctor's office or hospital with a potentially aggressive infection, but it's not clear right away what's causing it. So the doctor, often having little choice, prescribes a so-called "broad-spectrum" antibiotic that works against a range of microorganisms—from Gram-positive bacteria like "staph" (staphylococci) and "strep" (streptococci) infections to Gram-negative bacteria like E. coli.

In scenario 1, the drug works: End of story.

In scenario 2, the infection worsens over the next 48 hours. The patient is scared. But by then, the specific type and strain of bacteria causing all this nastiness has been identified by culture and the patient is given a specific and powerful antibiotic to halt the colonizing germs in their tracks. It does the job, thankfully. Hugs and kisses all around.

In scenario 3, the infection accelerates and the more specific, second- and third-line antibiotics have little effect because the underlying bacteria causing the infection, though now-identified, are resistant to multiple drugs. That's a not-so-happy an ending—and, unfortunately, it's getting more common than ever.

But here's the rub: It's not just scenario 3 that has become increasingly dangerous. There's actually a dark side to scenarios 1 and 2 as well. Here's why: While broad-spectrum antibiotics have prevented innumerable deaths in people with serious and aggressive infections, such as meningitis (where a delay in treatment could mean the patient dies), they've also led to widespread antibiotic resistance. (I've written about the problem here—and I'll come back to this topic in-depth in another column soon.)

For now, though, there's a bit of good news to share. A Boston-based startup called Day Zero Diagnostics has been developing a test that can identify a patient's specific infection-causing bacterial strain, along with the characteristics that might make it resistant to known antibiotics, within hours rather than the standard two days or so. DZD, which is cofounded by an infectious-disease doc at Mass General, Harvard, and MIT (and which raised $3 million in seed financing in August from angel investors Golden Seeds and VC firm Sands Capital Ventures), uses whole genome sequencing in combination with machine learning to rapidly identify the pathogen.

What that means, conceivably, is that doctors could skip—or, at least, significantly shorten the duration of—the broad-spectrum antibiotic and go right to the drug that has the best shot of working on that specific strain. That could not only help patients (by getting them on a more targeted therapy from the start), but also reduce the evolutionary selection pressures that lead to antibiotic resistance.

DZD isn't alone in this effort. Other companies are also working on shortening the ID-ID ("infectious disease identification") time—and heck yes, I'm trademarking that!

But DZD just got a big boost this week by winning a prestigious medical technology "Shark Tank" competition—which as Daily readers will recall is one of my happy obsessions (see stories here and here ). "It was a pretty thrilling finale to an eight-month competition," says Paul Grand, the CEO of MedTech Innovator, who awarded the $350,000 grand prize to DZD. Beating out three finalists and nearly 600 other startups in total, it was crowned champion in a live vote by the conference's nearly 1,500 attendees.

The sheer number of companies vying for a win, of course, suggests a different kind of evolutionary selection. But this one, I'm happy to say, we can live with.

Clifton Leaf, Editor in Chief, FORTUNE
@CliftonLeaf
clifton.leaf@fortune.com
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DIGITAL HEALTH

Cedars-Sinai hospital launches Apple Watch app. Cedars-Sinai, one of Los Angeles' premier hospitals, is introducing a new Apple Watch app meant to help patients locate doctors and nearby medical centers and clinics. That includes information on urgent care location and contact info for doctors that users may have checked out on the app. (9TO5Mac)

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INDICATIONS

Lilly's breast cancer drug gets a crucial FDA nod. The FDA has approved Eli Lilly's ademaciclib, which will be sold under the brand name Verzenio, to treat a common form of advanced breast cancer. This treatment will have to combat other popular new drugs in the space that include rivals from companies like Pfizer and Novartis. (Reuters)

Merck ditches the hep C field among growing competition and cures. A curious thing is happening in the hepatitis C treatment market: Drug makers are dropping out of it because: 1) new treatments have essentially cured the infections; and 2) a recent influx of competition in the space has driven down sales across the board. However, Merck's decision will likely be a boost to Gilead, which set off an explosion in the field with its groundbreaking therapies Sovaldi and Harvoni.

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THE BIG PICTURE

The Yemen cholera crisis is exploding. The cholera public health crisis in Yemen may affect one million people by 2018, according to a sobering new report from the International Committee of the Red Cross (ICRC). There have already been 750,000 suspected cases in 2017 and more than 2,100 deaths from cholera in the war-torn nation. (Al Jazeera)

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REQUIRED READING

Legal Pot Sales in Nevada Projected to Raise $120 Million in Tax Revenueby Chris Morris

Mastercard Users Can Now Browse and Buy High-End Home Decor in Virtual Realityby Kate Samuelson

Starbucks Is Doing Something Different for National Coffee Dayby Natasha Bach

Apple Mac Updates Are Quietly Failingby Robert Hackett

Produced by Sy Mukherjee
@the_sy_guy
sayak.mukherjee@fortune.com

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Five Breaking News Haikus

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September 29, 2017

Your week in review, in haiku.

 

1.

Puerto Rico is

an island. It's in the sea.

A very big sea

 

2.

Don't get comfortable

Bodak earned tha love: Fenty

basket, Swift flowers.

 

3.

Weiner heads to jail,

Kush’s bad at emails, pronouns.

Politics is hard.

 

4.

Idea: give the

taxpayers all of Price's

frequent flyer miles

 

5.

Time to look within:

Afflicted souls, close the gate.

Forgive, atone, joy.

 

Wishing you a good and sweet weekend.

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On Point

The complicated life of Dr. Seuss
Dr. Seuss is back in the news today after an award-winning librarian rejected a gift of Seuss books sent by First Lady Melania Trump, in part because Seuss filled his work with "racist propaganda" and "harmful stereotypes." She's not entirely wrong. Theodor Geisel drew deeply disturbing cartoons and advertisements in the 1920-1940s, and drew similarly racist cartoons of the Japanese during World War II. He seemed to have had a change of heart later in life, creating anti-racist cartoons, and expressing regret for his role in the propaganda work he did. But, it's complicated. Click through to see a collection of the images. Warning, they are upsetting.
Business Insider
CEOs weigh in on diversity
I was lucky enough to moderate a panel at Ad Week on Monday, which celebrated the work of the CEO Action for Diversity and Inclusion, the corporate alliance to foster inclusion that Fortune has covered since its inception . It was a candid conversation, starring Scott Kauffman (CEO, MDC Partners), Heather Brunner (CEO, WP Engine), Michael Roth (CEO, Interpublic Group), Clifford Hudson (CEO, Sonic), John Rogers (CEO and chief investment officer, Ariel Fund), Keith Cartwright (Saturday Morning co-founder). The advertising world has a significant role to play. "If there's anything we have the ability to do it is to change hearts and minds," said Cartwright. "If there's any good that's come of [the current administration], it's that it's a great awakening," he says. "There is no such thing as going backward. Sometimes it feels that way, but there's no such thing as going backward."
Ad Week
Jamil Smith: Football is us
A couple of years ago, Jamil Smith, then with the New Republic , declared that our national preoccupation with football said something important about us. "We need it partially because football serves as a kind of fun-house mirror for our national character," he says. He'd started his career as an associate producer at NFL Films, "the cinematic and mythmaking arm of professional football," and spent hours watching clips looking for the best collisions to turn into thrilling montages. Later in the piece, Smith goes into necessary detail on the lives of beloved players ruined by game-related brain disease. But Smith is at his best when he explores the military-as-performance essence of the game, the nostalgia for a simpler time it suggests but never delivers, and how hard football is for a fan to give up. It ends with a photo of Smith as a young footballer that will touch your heart. A must read.
New Republic
Beer stores in Whiteclay Nebraska to remain closed, says Nebraska Supreme Court
I've visited Whiteclay, Nebraska, a small strip of land that runs barely a few blocks, yet seems to exist only to sell millions of cans of beer into the neighboring dry Pine Ridge Reservation. It was a horrible place. Four beer stores will now remain permanently closed by order of the Nebraska Supreme Court and activists are declaring victory. "Wow. Outstanding. Outstanding. Wow. Tremendous," John Maisch, an Oklahoma attorney, told the Lincoln Journal Star. His 2014 documentary film about Whiteclay, Sober Indian, Dangerous Indian helped reignite the effort to halt beer sales.
Lincoln Journal Star
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The Woke Leader

When history majors hate
Clubs, helmets, shields, and torches are now part of the unsubtle signaling of modern-day white supremacists who are styling themselves, even naming themselves, after the Crusades, the medieval offshoot of the Catholic church which fought Muslims for Jerusalem. "There are people pretending to be Vikings but preaching white supremacy," explains David M. Perry, a columnist and former medieval history professor. Turns out, neo-Nazis are looking to the past to give their movements meaning, and the Crusades fills the bill as a lost, romantic cause. When one of the Charlottesville supremacists turned out to be a medieval history student, Perry wonders, "how many guys in my medieval history class have been like him? Did I refute him?"
WNYC
Learn more about the modern white supremacy movement
Check out the American Renaissance website, the home of one of the more serious "white movement" organizations. Jared Taylor, the ever-present host, is a grandfatherly Yale grad who shares calmly articulated views and wholeheartedly believes in the revolutionary nature of the alt-right. "[O]ur movement tends to be male-oriented, but every dissident or revolutionary movement tends to be for that matter," he says, citing Martin Luther and Lenin. "It's only later that the people who want to change society are joined by women." Recruiting women is the purpose of this 28-minute conversation is with Lana Lokteff, a lovely young millennial who is active in white supremacy circles. They begin with feminism - the domain of bougie-bored housewives, spinsters, minorities and ugly women. Although it's unlikely that you'll be persuaded by their arguments, it's worth understanding how seriously they're taking them - and how closely they track with "traditional" American values.
American Renaissance
Wisdom comes with age. Really
While there are certain stresses that come with aging - physical things like decreased health and mobility, this Q&A with Dilip Jeste, professor of psychiatry and neuroscience and director of the UCSD Center for Healthy Aging, explores the psycho-social elements of aging, which bring lots of benefits. "It includes things like well-being, happiness, quality of life, control of emotions, socialization," he says. That brings better decision-making, more resilience, and compassion. "Successful aging mainly refers to better well-being, greater happiness, and not just arriving at old age, but thriving and even flourishing."
Nautilus
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Quote

Finally getting out of the camps was a great day. It felt so good to get out of the gates, and just know that you were going home…finally. Home wasn't where I left it though. Getting back, I was just shocked to see what had happened, our home being bought by a different family, different decorations in the windows; it was our house, but it wasn't anymore. It hurt not being able to return home, but moving into a new home helped me I believe. I think it helped me to bury the past a little, to, you know, move on from what had happened.
—Aya Nakamura
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Term Sheet: Sep. 29, 2017

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September 29, 2017
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THE NIKE OF SLEEP: Casper struck a partnership with American Airlines to make flights slightly more comfortable. On Thursday, the mattress startup announced that it will design eight new bedding products, including a mattress pad for the seat, two kinds of pillows, a pillowcase, a duvet, a blanket, pajamas and slippers. The company declined to disclose the terms of the deal, but noted that this marks Casper's first foray outside of the bedroom.

I had a chance to speak with Casper CEO Philip Krim at the TAP Conference yesterday. Here are some highlights from our chat:

 
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Retail: Even though Casper launched as a company that removed the retailer from the equation, the startup is now starting to focus on the offline experience. It's launching 15 pop-up stores across the country in Q4 so that people can touch and feel their products before they buy. (In other words, it feels as though Casper is the bazillionth direct-to-consumer startup to get into retail.) "We've never been anti-retail — just anti-mattress retail," Krim said.

Marketing: Casper has spent a significant amount of capital on marketing initiatives, including napmobiles, a cruise around Manhattan, and a hotline that helped people fall asleep." Krim said the company's tried to take a more non-traditional approach to marketing. "The best thing we can do is have people see one of our ads and think, 'Oh, that's fun and tongue-in-cheek.'"

Acquisition: Earlier this year, Target offered to buy Casper for a billion dollars. After Casper turned it down, the retailer opted to invest $75 million instead. Krim said an acquisition didn't make sense this early on as the company still has time "to build an iconic brand."

Profitability: I asked Krim at what point profits will become the company's top priority. He said Casper is still relatively young, and he's confident it can get a lot bigger. "We're continuing to build awareness and build a paradigm for this 'sleep' category that hasn't existed before," he said. So in other words, don't hold your breath. ¯\_(ツ)_/¯

For more, read Erin's August feature on Krim and his massive ambitions to turn Casper into "the Nike of Sleep."

IKEA SHOPPING SPREE: Ikea just dove into the "gig economy" after acquiring on-demand services startup Taskrabbit. Although the terms of the deal have not been disclosed, Recode reports that TaskRabbit will operate as an independent subsidiary within Ikea. The startup had raised approximately $50 million in venture funding from investors including 500 Startups, Founders Fund, Floodgate, and Lightspeed Venture Partners. There are still a lot of questions swirling around the deal. My Fortune colleague Anne VanderMey outlines some of the possibilities:

"Did Ikea buy TaskRabbit because its furniture is too hard to put together, as Fast Company recently pondered? Or did it do it because millennials are too maladapted to do heavy assembly, and too cheap to call normal handymen for their floating bookcases? Or maybe it's because their store experiences are too time consuming and borderline traumatic."

If you're looking for a good weekend read, this reminds me of a brilliant feature that Fortune published in 2015. Appropriately titled, "How Ikea took over the world," it delves into how the Swedish home furnishings company used to be lousy at expansion before it built a truly global empire. My favorite quote is from Ikea's deputy manager of packaging:

There's an internal nickname for products that take too long to put together. "Sometimes," Dickner says, 'we call it a 'husband killer.'"

Let's see if TaskRabbit can help with that. Read the full feature here.

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THE LATEST FROM FORTUNE...

Uber's corporate customers will have to pay more (by Jen Wieczner)

GoPro launches a new camera (by Michal Lev-Ram)

Celebrities continue to endorse initial coin offerings (by Robert Hackett)

Elon Musk wants to colonize Mars in 2022 (by Feliz Solomon)

A top VW manager has been arrested over his role in the Diesel scandal (by Geoffrey Smith)

…AND ELSEWHERE

Anthony Levandowski founded a techno-futuristic church. South Korea bans ICOs. Walmart's Jet.com will launch its own line of groceries. Uber's next step in London. H&M hits the wall. Can tech startups do journalism?

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VENTURE DEALS

LetGo, a New York-based startup that has built a marketplace for people to buy and sell used goods, raised $100 million in funding at a valuation of over $1 billion, according to TechCrunch. Read more.

EchoNous, a Seattle-based parent company of Signostics, an ultrasound tool for bladder and kidney care, raised $35 million in funding from KKR.

Drive.ai, a Mountain View, Calif.-based developer of artificial intelligence software for autonomous vehicles, raised $15 million in funding from Grab.

Enevo, a Finland-based waste services provider, raised $12 million in funding. Lifeline Ventures led the round.

Anchor, a New York City-based podcast app, raised $10 million in Series A funding. GV led the round, and was joined by other investors including Accel, Betaworks, The Chernin Group, Eniac Ventures, Homebrew and Craig Kallman.

Varjo Technologies, a Finland-based virtual and augmented reality headset developer, raised $8.2 million in Series A funding. Investors include EQT Ventures, Lifeline Ventures, and The Venture Reality Fund.

Opkix, a Costa Mesa, Calif.-based consumer camera products and software developer, raised $5.4 million in Series A funding at a $90 million valuation. Investors include Bob McKnight, Kelly Slater, and Jennifer Prince.

Jobbatical, an Estonia-based job platform, raised $4 million in funding. Mistletoe Inc led the round, and was joined by investors including Union Square Ventures, AirTree Ventures and Tera Ventures.

AdAsia Holdings, a Singapore-based developer of artificial intelligence and marketing solutions, raised $2.5 million in Series A funding. Investors include Hisanori Watanabe and Gunosy.

DreamJay, a San Francisco and Poland-based maker of a medical app that helps prevent nightmares, raised $2.3 million in Series A funding. Joint Polish Investment Fund led the round, and was joined by investors including Nordic Makers.

Trellis, an Oakland, Calif.-based provider of cannabis inventory management software, raised $2 million in funding. Casa Verde Capital led the round, and was joined by investors including Gateway, Argonautic Ventures and One Gun.

GroupSolver, a San Diego, Calif.-based online consumer research company, raised $1 million in funding. Tech Coast Angels' San Diego network led the round.

Siigo, a Colombia-based provider of accounting and administrative software for small and medium sized companies, raised funding of an undisclosed amount from Accel-KKR.

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HEALTH AND LIFE SCIENCES DEALS

Peptilogics, a pre-clinical stage company utilizing an innovative peptide platform to treat multidrug-resistant bacterial infections, raised $5.5 million in Series A funding. Investors include Peter Thiel, Stefan Roever and BlueTree Ventures.

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PRIVATE EQUITY DEALS

Carlyle Group is looking to sell its 30% stake in Penti, a Turkey-based lingerie and swimwear retailer, according to Reuters. Read more.

Carlyle Group LP is in talks to sell a stake in TCW Group Inc, a Los Angeles-based investment manager, to bidders including Nippon Life Insurance Co. and Mitsubishi UFJ Financial Group Inc., according to The Wall Street Journal. Read more.

Lion Capital LLP is considering strategic options for Hema, an Amsterdam-based general merchandise retailer, according to Bloomberg. Read more.

Alpine Investors made an investment in Bill4Time, a Seattle and Pittsburgh-based provider of cloud-based time and billing software. Financial terms weren't disclosed.

Berkshire Partners acquired Accela, Inc, a Japan-based provider of civic engagement software solutions for state, county and municipal governments. Abry Partners will remain an investor in the company. Financial terms weren't disclosed.

Togetherwork, which is backed by Aquiline Capital Partners LLC, acquired Gingr, a Boulder, Colo.-based provider of pet services software. Financial terms weren't disclosed.

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OTHER DEALS

M Group Services acquired Magdalene Ltd, a U.K.-based telecommunications infrastructure services provider. Financial terms weren't disclosed.

Clarim Holdings invested in Copperfield Advisory, a New York City-based consulting firm providing professional support on marketing, communications, public affairs and strategy. Financial terms weren't disclosed.

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IPOs

Lyft, a San Francisco-based ride-sharing company, is close to hiring an IPO advisory firm, according to Reuters. Read more.

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EXITS

Naspers acquired another 13% stake in Delivery Hero (DB:DHER), a Berlin based food-delivery company, for €660 million ($775 million), from Rocket Internet. Naspers now owns 26.3% of the company.

Daimler acquired Flinc, a Germany-based peer-to-peer-style carpooling platform, according to TechCrunch. Financial terms weren't disclosed, but Flinc had raised funding of an undisclosed amount from investors including Deutsche Bahn, General Motors Ventures, and ISB Ventures. Read more.

IK Investment Partners agreed to sell Evac Group, a Finland-based provider of integrated waste, wastewater, and water management systems, to Bridgepoint, according to Reuters. Financial terms weren't disclosed. Read more.

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FIRMS + FUNDS

New Mountain Capital, LLC, a New York-based investment firm, raised $6.15 billion for its fifth private equity fund, New Mountain Partners V, L.P.

MidOcean Partners, a New York-based private equity firm, raised $680 million for its new fund, MidOcean Partners V, L.P.

Redpoint Ventures, a Menlo Park, Calif.-based private equity and venture capital firm, is seeking to raise $400 million for its third fund, according to an SEC filing.

Leerink Transformation Partners, a Boston-based private equity firm, raised $313 million for its debut fund, Leerink Transformation Fund I LP.

Defy Partners, a Woodside, Calif.-based investment firm, raised $151 million for its inaugural fund, according to an SEC filing.

Hustle Fund, a fund founded by two ex-500 Startups partners, is raising up to $50 million, according to an SEC filing. The fund will back pre-seed startups, according to Axios. Read more.

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PEOPLE

Leah Busque, founder of TaskRabbit, joined Fuel Capital as a general partner.

Ken Denman joined Sway Ventures as a venture partner. Previously, he was CEO of Emotient.

Raymond James named Geoffrey Richards as a managing director in its investment banking unit. Previously, Richards was at Canaccord Genuity.

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Polina Marinova produces Term Sheet, and Lucinda Shen compiles the IPO news. Send deal announcements to Polina here and IPO news to Lucinda here.

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