Background: Older adults facing social or structural marginalization for reasons such as lower literacy, digital exclusion, financial constraints, restricted living environments, or complex health histories, face persistent barriers to much-needed health screening. Digital health tools, particularly those using audio computer-assisted self-interview (ACASI) technology, offer potential to overcome these barriers (audio-delivered and self-administrable), but their application to marginalized populations remains underexplored. Moreover, guidance is limited for developing such tools which require collaboration within cross-disciplinary teams. This paper presents development insights and user testing findings from the ASCAPE (Audio App-Delivered Screening for Cognition and Age-Related Health in Prisoners) project, which aimed to develop equitable digital frailty and cognition screening for older people in Australian prisons. Objective: This study aims to describe the collaborative development of the “ASCAPE-HS” prototype, a tablet-based ACASI-delivered Frailty Index and aging screener, and to synthesize key lessons from the project that can inform equitable digital health tool development in hard-to-reach older adults. Also, to present findings on the usability and acceptability of ASCAPE-HS in a diverse community sample. Methods: The ASCAPE-HS prototype was developed through an iterative process involving researchers, clinicians, software developers, and end users under a digital health equity framework. The prototype included a self-administered, audio-delivered Frailty Index, alongside other items relevant to aging. The design process prioritized accessibility, sociocultural relevance, and technical feasibility, with regular multidisciplinary consultation and iterative refinement. Exploratory user testing with 20 older adults (aged 47‐93 years, including n=5 who had not finished secondary schooling, n=3 people with previous imprisonment history, and n=9 with mild or moderate cognitive impairment) provided feedback on usability and acceptability. Results: A 50-item Frailty Index was developed, alongside an additional selection of holistic questions that could meaningfully capture age-related health, and transferred to an iOS app (Apple, Inc), with ACASI features. Key elements included lay wording, consistent interface, simple “tapping” response options with repeatable audio feedback, a tutorial, and artificial intelligence–generated audio guidance. Key development considerations were synthesized into a checklist for teams undertaking similar projects. Successful strategies for the collaborative design process included diverse teams abreast of emerging literature and policy with varying expectations for engagement during development, and dedicating time to flexible, iterative development processes. Acceptability (median scores ≥4 out of 5 across 6 constructs) and usability (mean System Usability Scale score 79.0, SD 8.8) were high. Conclusions: A collaborative approach can produce ACASI-based health screening tools that are well-received by older adults. We highlight the feasibility of integrating frailty and aging assessment into a usable and acceptable digital tool, and offer actionable principles for collaborative, evidence-based development of equitable health screening tools in diverse, hard-to-reach populations.
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Cellares and ProTgen Automate Manufacturing of Progenitor T-Cell Therapy for Blood Cancer
Cellares, an Integrated Development and Manufacturing Organization (IDMO) that combines automated manufacturing platforms with global Smart Factory infrastructure, and ProTgen, a therapeutic company pioneering targeted Notch activators to reactivate the thymus and reconstitute the adaptive immune system, have announced a partnership to automate manufacturing and quality control of ProT-096, ProTgen’s personalized progenitor T-cell therapy for patients with refractory leukemia and other hematologic malignancies. In this collaboration, Cellares will apply the company’s Cell Shuttle and Cell Q platforms to ProT-096 while providing regulatory support toward IND submission.
Fabian Gerlinghaus, co-founder and CEO of Cellares, says hematologic malignancies have waited too long for cell therapy to deliver on its promise, with manufacturing complexity being one of the main bottlenecks. ProT-096 represents “exactly the kind of innovative program” for which Cellares was founded.
“Early-stage developers should not have to choose between advancing their science and securing the manufacturing foundation they need to scale,” said Gerlinghaus. “By automating the manufacturing process and providing regulatory expertise toward IND submission, we can help ProTgen move faster and with greater confidence toward the clinic.”
Patients with refractory hematologic malignancies often face a compromised immune system following intensive treatment. While ProT-096 mandates precision manufacturing at scale, achieving the reproducibility, process consistency, and cost efficiency needed to support clinical development requires advanced manufacturing approaches.
Cell Shuttle’s automated, end-to-end manufacturing workflow reduces manual touchpoints, minimizes variability, and enables standardized execution across runs, equipment, and facilities. Combined with Cell Q, the workflow is designed to meet the demands of clinical- and commercial-scale production while maintaining quality standards for GMP manufacturing. The partnership also adds personalized progenitor T cells to Cellares’ platform capabilities across CAR T-cell therapies and HSC programs.
ProTgen’s proprietary targeted Notch activator platform programs cell fate both in vivo and ex vivo. The company’s initial focus is to reactivate the thymus and rebuild a diverse, functional immune repertoire for patients with compromised or aging immune systems.
Carter Cliff, CEO of ProTgen says ProT-096 represents a new approach to immune reconstitution, with the potential to address a significant unmet need for patients whose immune systems have been severely compromised by hematologic malignancy and prior treatment.
“This partnership allows us to pair our targeted Notch activator platform with an automated, scalable manufacturing foundation designed to support the path toward IND submission and, ultimately, clinical development,” he said.
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<![CDATA[New report reveals private practice delivers 113.6M mental health sessions, yet business training gaps and access mismatches persist.]]>
Adopting Creative Chemistry to Optimize Bioprocessing Workflow
Taking a creative approach to chemistry can help developers of antibody-drug conjugates (ADCs) improve the stability and purity of their products. That’s the view of Sunny Zhou, PhD, professor of chemistry and chemical biology at Northeastern University. Zhou will be speaking at the Bioprocessing Summit in Boston in August.
According to Zhou, the structure of ADCs can make them vulnerable to bioprocessing issues that don’t affect traditional antibodies. As one example, he says, the payloads of antibody drug conjugates often significantly absorb above 280 nm, making them markedly more sensitive to light.
“There’ll be photochemistry induced by the payload that can damage both the antibodies and payloads, such as crosslinking that likely leads to aggregation,” he says. “We’ve already published some work showing light-induced protein modifications, crosslinking, and aggregation.”
According to Zhou, some initiatives are already underway to address this issue. For example, by engaging in antibody production and downstream processing in dim or safe light (e.g., yellow or red light) instead of the more commonly used bright white light.
Another issue, he says, is that the linker connecting the antibody and drug payload is designed to be cleaved by enzymes in human patients. On the other hand, it also means that similar enzymes in host cell proteins (HCPs) may prematurely cleave the linker during production and storage, thereby decomposing the drug and contaminating the final product.
“Many host cell proteins contain such enzymes, but they don’t cleave antibodies. With these ADC linkers, however, enzymes that didn’t create problems before might do so now,” he says.
Zhou explains that premature cleavage of ADC linkers has been observed in an industrial setting. Fortunately, he says, his research team, in collaboration with companies like Takeda, is already creating universal platforms and workflows to identify and effectively remove these potential HCP contaminants, as well as working to better understand the stability of the linkers.
“These drugs circulate in the body for maybe two to three weeks, and stability issues can be amplified during circulation,” he says. “So, making the linker more stable [during manufacturing] may also help improve stability during circulation, further down the line.”
Zhou’s team is now hoping to look at other creative chemistries in bioprocessing. Among these is, for example, removing reagents, by-products, and impurities by filtration, which may be faster than relying on chromatography, he says.
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Yeast We Can Cut Costs By Optimizing Cell-Free Expression Systems
Choosing the right additives could help “cell-free” expression systems finally fulfill their potential and provide biopharma with a low-cost way of making protein drugs, according to a recent research report.
The new study looked at how cell-free systems, in which biochemical reactions occur independently of cells, could be fine-tuned to provide drug makers with alternatives for large-scale protein production.
And the potential of the approach is significant, says Karen Polizzi, PhD, a professor from the department of chemical engineering at Imperial College London, who adds, “Cell-free protein synthesis (CFPS) is a flexible manufacturing technology. It can be used for on-demand synthesis in low-resource environments or to make difficult-to-express products, especially medicines that are toxic to the cell. Cell-free reactions scale well across microliter to liter scale without needing adjustments.”
The Imperial team’s research focused on expression systems based on the yeast species Pichia pastoris, which, as Polizzi explains, “has machinery capable of post-translational modifications of proteins that can be necessary for function.”
As an expression host, P. pastoris combines elements of both prokaryotic and eukaryotic systems, such as a rapid growth rate and the ability to perform post-translational modifications (PTMs).
The problem is that current commercially available Pichia systems are only able to produce low amounts of protein. According to Polizzi and her co-authors, the productivity of P. pastoris-based cell-free systems usually ranges from 6 to 100 µg/mL, which is only approximately five percent of that achieved by comparable E. coli systems. In addition, the additives required by Pichia-based systems are more expensive than those required by equivalent platforms.
Additives to improve yields
To address this, Polizzi and co-authors systematically evaluated a variety of chemical additive combinations to identify the most effective stabilizers and crowding agents to be incorporated in the reaction.
The researchers also used a machine learning model to predict translation initiation rates and optimized the Kozak sequence—the protein translation initiation site in most eukaryotic mRNA transcripts—to enhance expression.
In addition, the Imperial team evaluated lower-cost glycolytic intermediates as substrates for ATP regeneration to reduce the cost of goods.
Polizzi says, “We focused on how to improve the yields and reduce the cost of production. We identified some additional additives that boost the yield without substantially increasing the cost. We also identified a different energy source that can be used.”
She adds, “This work underscores the importance of protein-stabilizing additives and the role of rationally designed DNA sequences with minimized mRNA structural complexity to enhance yield in CFPS. Our demonstration of glycolytic intermediates as a potential secondary energy system additionally provides the foundation for the development of a cost-effective P. pastoris CFPS.”
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Operator Protection as Core Design Principle for ADC Bioprocessing
Antibody-drug conjugates (ADCs) continue to gain momentum as one of biopharma’s most promising therapeutic classes, particularly in oncology. But while the science behind ADCs advances rapidly, manufacturing these highly potent therapies forces two requirements to coexist: strict aseptic processing and high-containment handling of highly potent active pharmaceutical ingredients (HPAPIs).
For Ashley Harp, a fellow in containment and bioconjugates at the consultancy CRB, operator protection is not simply an environmental health and safety issue—it is a core design principle for successful ADC bioprocessing.
“One of the primary concerns in ADC bioprocessing is protecting operators from exposure to highly potent compounds, which can exist in both solid and liquid form,” Harp says. “Those risks extend far beyond the core manufacturing team to include quality control, maintenance, and calibration staff—anyone who may interact with the process or equipment over its lifecycle.” That broader view is increasingly important as commercial bioprocessors scale ADC production.
Potential exposure points abound. “Across all stages of ADC bioprocessing, additional risks are associated with handling solid and liquid waste, collecting samples, changing or maintaining HVAC filters, and performing maintenance or calibration activities,” Harp says. These tasks often involve residual potent compounds that remain on equipment surfaces or within process systems, creating exposure risks long after active manufacturing ends.
Tackling those risks starts long before production begins. “Addressing operator protection risks starts with rigorous risk assessments and the implementation of recommendations based on those assessments,” Harp says.
She emphasizes the importance of involving experts in containment, industrial hygiene, and collaborative facility and equipment design early in project planning. Identifying hazards upfront makes it easier—and less costly—to build effective safeguards into the process rather than retrofitting them later.
Where higher-risk activities cannot be avoided, Harp recommends multiple layers of protection rather than relying on a single solution. Closed processing systems, equipment designed to contain materials at the source, and technologies that support safe cleaning and transfer all play a role. Examples include rigid and flexible containment approaches, containment valves, split valves, specialized piping systems, continuous liners, containment enclosures, spray balls, wash wands, and manual wiping protocols.
At the same time, smarter process design can reduce risk even further. “In parallel, thoughtful process development can reduce or even eliminate the need for direct personnel interaction with the manufacturing process,” Harp says. Technologies such as flow chemistry, process intensification, and robotics can significantly reduce manual handling and intervention, limiting the chances of exposure while also improving consistency.
For commercial bioprocessors, implementing these solutions requires organizational alignment. “Successfully implementing these solutions requires early and ongoing collaboration across disciplines,” Harp says. Environmental health and safety, industrial hygiene, maintenance, calibration, operations, engineering, and quality teams all need to be involved from the beginning to form truly cross-functional design teams.
Facilities must also remain flexible. ADC pipelines evolve quickly, and containment strategies need to evolve with them. Specialized expertise in integrating process equipment within high-containment environments is crucial, as are strong R&D capabilities—or partnerships that can provide them.
Although “high containment requirements inherently increase the operational cost and complexity of manufacturing ADCs compared to non-potent therapies,” Harp argues that strategic improvements can offset some of those costs over time. Process intensification, reduced manual handling, and stronger containment can improve raw-material efficiency and reduce waste generation. Implementing new systems might initially extend development timelines or delay time to market, but the long-term result can be safer, more sustainable operations for both people and products.
As ADC pipelines continue to expand, operator protection is shifting from a compliance checkpoint to a competitive necessity.
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Technique Yields Uniform, High-Quality, EVs at Scale
Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) play an outsized role in intracellular communications, influencing such functions as inflammation and tissue repair. With the possible applications of these small, membrane-bound particles growing, an efficient, cost-effective production method has been on drug manufacturers’ wish lists for some time.
A novel, streamlined chromatographic production and isolation method developed by scientists at Satorius BIA Separations in Slovenia may fulfill that wish, yielding uniform, high-quality EVs at scale. The method concentrates MSC-EVs directly from conditioned media. It also removes 97% of protein impurities and 95% of double-stranded DNA-related impurities, increasing their potential as therapeutics or drug delivery vessels.
Microcarrier + suspension
The method relies upon preferential exclusion chromatography, Katja Vrabec, head of product application area (EVs) at Sartorius, notes in a recent paper. In it, Vrabec and colleagues explain the method “uses monolithic hydroxyl columns to purify and concentrate the MSC-EVs,” and biochromatography analytics to track EV-specific surface antigens.
First, the team expanded the MSCs in growth media, and then produced the EVs in a lean media formulation to limit production of protein and particle contaminants. That part is standard.
Here’s what’s different: The scientists used a microcarrier-based system rather than flask-based 2D cultivation to scale the MSC cultures and increase the ratio of EVs to contaminants in conditioned media. They also used a suspension culture to enhance cell growth surface-to-volume ratios, and thereby increase EV yield. Then, they used a monolithic hydroxyl column to capture and purify the EVs directly from harvest.
Increasing cell density and the cell-to-impurity ratio lowers buffer consumption downstream and lays the groundwork for biomanufacturers to transition to a scalable bioreactor system.
Because the main impurities in EV harvests don’t interact with the chromatographic column in high-salt-binding conditions, the team recommends choosing a low-salt buffer for elution to reduce the need for buffer exchange before the polishing step. The optimal binding condition, they report, is “sodium citrate of 0.75M at pH 7.0.”
This research highlights the need to consider upstream and downstream processing as a cohesive system, to design a simple, scalable, holistic process, and to apply reliable analytics. This all is particularly challenging, the team admits, given “the heterogeneous nature of EVs and the presence of similarly-sized components in biological samples.”
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Regional Virtual Acute Care Helpline in Singapore at a National University Health System Virtual Care Centre: Retrospective Study
Background: Emergency department (ED) overcrowding and delayed access to care are ongoing challenges in Singapore. The COVID-19 pandemic further underscored the need for scalable virtual care models that go beyond traditional hospital settings, allowing patients to access acute specialist care quickly and efficiently. Objective: This study describes the design, implementation, and early outcomes of the National University Health System (NUHS) Virtual Care Centre (VCC), a clinician-led helpline aimed at reducing unnecessary ED visits and supporting community-based acute care. Methods: In 2020, the NUHS launched the VCC, a helpline at Alexandra Hospital, as a prehospital triage model. The helpline functions as a nurse-led telephone triage with real-time escalation to doctors for urgent medical issues. It ensures the continuity of care for patients recently discharged and diverts nonemergency cases from the ED. A retrospective analysis of call data from 2020 to 2024 was conducted to evaluate utilization patterns, clinical outcomes, and safety. Results: Over 4 years, the VCC managed 4857 calls, of which 59.3% (n=2879) were clinical in nature. Nearly two-thirds (1834/2879, 63.7%) were resolved remotely, preventing in-person ED visits. Only 13.8% (397/2879) required redirection to an ED, and 3.3% (95/2879) were directly admitted to an acute hospital or hospital at home service. Within 72 hours of call resolution, 69.1% (1990/2879) of the callers avoided an ED visit. Undertriage was 4.9% (110/2232) at 72 hours post call resolution, with no high dependency or intensive care unit admissions during this period. Mortality rates were low (1.0% at 14 days; 2.3% at 30 days). Conclusions: The NUHS VCC provides a feasible and safe model for virtual acute care triage within the public health care system. It effectively diverted lower-acuity cases from the ED and ensured continuity of care, offering a scalable approach aligned with national efforts to extend health care beyond hospital walls.
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Machine Learning for Comparative Antidepressant Selection in Major Depressive Disorder: Systematic Review
Background: Major depressive disorder (MDD) affects approximately 1 in 6 adults during their lifetime, yet antidepressant selection relies predominantly on trial-and-error, with response rates of only 42% to 53%. While machine learning (ML) models have shown promise in predicting treatment outcomes, most focus on single treatments rather than comparative selection across therapeutic alternatives, limiting their clinical utility for the medication choice decisions that clinicians face in practice. Objective: This systematic review evaluates ML approaches that examine 2 or more pharmacological interventions for predicting treatment outcomes in MDD, with a focus on their capacity to facilitate comparative treatment selection between medications or medication classes for individual patients. Methods: Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, Scopus, and Web of Science for studies published from 2015 to 2025. We included studies involving adults with MDD that used ML models to predict treatment outcomes across 2 or more pharmacological treatments and reported medication-specific prediction outcomes. Risk of bias was assessed using PROBAST-AI (Prediction Model Risk of Bias Assessment Tool for Artificial Intelligence). We conducted a narrative synthesis organized by modeling strategies, data integration approaches, validation methodologies, and performance patterns. Results: From 5370 initial records, 19 studies met the inclusion criteria, with dataset sample sizes ranging from 49 to 77,226 participants. Studies employed 3 distinct modeling strategies: drug-specific supervised models trained independently for each medication, subtype- or trajectory-based approaches using clustering methods to identify differential response patterns, and a unified differential prediction framework generating calibrated cross-treatment predictions. Performance varied substantially, with area under the curve values ranging from 0.59 to 0.95 and classification accuracies between 62% and 95.4%, though high performance was concentrated in studies with small samples, high-dimensional neurobiological features, and internal-only validation. Only 7 studies conducted external validation, which generally yielded more conservative performance estimates. Feature informativeness was more consistently associated with performance variation than algorithm complexity. Most studies did not formally distinguish between prognostic features predicting general outcomes and predictive features identifying differential medication responses, and none applied formal explainability techniques. Conclusions: ML for comparative antidepressant selection remains in an early stage of development. Only 1 study implemented a unified framework directly supporting patient-level treatment ranking. Key barriers to clinical translation include insufficient distinction between prognostic and predictive markers, limited cross-trial validation, near-absent calibration reporting, and absent explainability. Future research should prioritize unified comparative frameworks with calibrated predictions, rigorous external validation on diverse cohorts, explicit modeling of heterogeneous treatment effects, and integration of explainability into model development.
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“It Was Not a Cure”: Musunuru Cautions ASGCT on Baby KJ Promise
BOSTON – When Kiran Musunuru, MD, PhD, walked to the microphone to deliver remarks on behalf of the team that won the American Society of Gene and Cell Therapy (ASGCT) 2026 Catalyst Award, most of the thousands of attendees surely expected a feel-good speech.
After all, it was 12 months ago that Musunuru, addressing the same convention in New Orleans, shared the exciting news regarding the delivery of a bespoke base editor to an infant, Baby KJ, with a rare urea cycle disorder. Musunuru and his colleague, Rebecca Ahrens-Niklas, MD, PhD, were recently named to the TIME 100 Most Influential People of 2026. “A decade from now,” stated Nobel laureate Jennifer Doudna, PhD, “their names will be in medical textbooks, not only for Baby KJ, but for opening the door to personalized genetic medicine for thousands of children after him.”
Musunuru and Ahrens-Niklas, from the University of Pennsylvania and Children’s Hospital of Philadelphia (CHOP), respectively, were honored alongside Doudna’s colleague Fyodor Urnov, PhD (Innovative Genomics Institute) and Danaher Corporation, for building the remarkable academia-industry consortium that designed and delivered the gene editing therapy, resulting in Baby KJ’s discharge from CHOP and a wave of national television appearances.
Indeed, Musunuru opened his ASGCT remarks in upbeat mood. “The potential is there to [deliver personalized therapies] over and over again for hundreds of diseases centered in the liver.” But halfway through his speech, Musunuru’s tone changed. While most grateful for the recognition from ASGCT, he said it was important to always “be your own worst critic.”
“I’ll be brutally honest,” Musunuru said. Despite the unquestionable “enthusiasm and excitement” surrounding the Baby KJ story, “there are some profound limitations. It was not really science at all!” Musunuru continued. “It was not a clinical trial. It was not clinical research. It was not a cure.”
“The best we can say is we hope we’ve turned a devastating disease into a milder, manageable condition. But it’s too early to say that… This was a personalized N-of-1 therapy—we can’t say what this means for anyone.”
Drawing applause from the audience, Musunuru pushed on: “We mustn’t be snake oil salesmen or give false hope… We have a profound ethical responsibility not to mislead families over what is possible.”
“We don’t actually know anything,” Musunuru said. “We need to do clinical trials—scientifically and ethically.”
The path forward
Musunuru set the Baby KJ story in the broader context of his group’s work on phenylketonuria (PKU), one of the classic inborn errors of metabolism. A few years ago, Musunuru and Ahrens-Niklas set about designing gene editing therapies targeting the first and sixth most common PKU mutations using adenine base editors. (There are more than 1,000 known mutations that cause PKU.)
After testing in humanized mouse models, the researchers were delighted to see the phenylalanine levels rapidly drop to normal, sustained for the lifetime of the mice. Flush with funding from the Somatic Cell Genome Editing program at NIH, Musunuru and Ahrens-Niklas began talks with the U.S. Food and Drug Administration in February 2024 to settle the question: Do we need separate Investigational New Drug applications (INDs) for each PKU variant?
“It is basically the same drug, the same gene, the same disease, the same clinical endpoints. Can’t we cover both variants in a single IND and a single ‘umbrella’ clinical trial?” summarized Musunuru. The answer was “maybe”—the agency needed to consider the full implications of the proposal.
The Philadelphia team began to develop workflows for four more PKU mutations, leading them to propose an umbrella trial for a revised total of six variants. Following another meeting with FDA officials in early 2025, the response was extremely positive: a single IND application would be appropriate, with a single toxicology study conducted in a single species. The FDA also agreed to consider additional variants.
In parallel, Ahrens-Niklas and Musunuru were studying sick patients with urea cycle disorders. Although these are liver disorders, “the real harm happens in the brain,” Musunuru said, resulting from toxic levels of ammonia. Enter Baby KJ’s diagnosis with CPS1 deficiency, and the notion that there was chance to design a personalized therapy.
In the Fall of 2024, Musunuru and Ahrens-Niklas held a pre-IND meeting with FDA officials. The idea was to streamline applications for a group of urea cycle disorders caused by mutations in seven different genes.
The FDA judged that all seven therapies could be evaluated in a single Phase I/II trial, but separate INDs would be required for each gene. “We’d have to do it piece by piece,” Musunuru said. First, file a master protocol for urea cycle disorders; after that IND clears, then file additional gene-specific INDs and amend the original IND.
“This is how we can make the trial accessible to all UCD patients across the country,” he said.
Back to the future
Coming back to the present, Musunuru stated that although the primary IND had been filed, “this does not mean the trial is open or we can enroll patients.” Musunuru listed three major issues:
- The team has not yet manufactured any gene therapy product.
- As seven INDs are needed to fully open the clinical trial, it will be well into 2027 until all INDs are submitted.
- In February 2026, the FDA issued a draft Plausible Mechanism Framework. Musunuru’s team held another pre-IND meeting with the FDA to advocate for the use of prime editing for urea cycle disorders. After all, Musunuru reasoned, why should therapies be restricted to base editing approaches (G-to-A substitutions) but not patients who harbor a G-to-C mutation? The FDA indicated that a separate IND/BLA would be needed for each gene, and that process validation should be finalized before any dosing of Phase II subjects.
The path forward, Musunuru said, was to adopt an adaptive, real-time clinical trial design. That involves testing therapies, then advancing therapies from proof-of-concept to the validation phase. At that point, if all goes well, they can submit a BLA. Ahrens-Niklas and Musunuru laid out more details of their approach and dealings to date with the FDA in a commentary published late last year entitled: “How to create personalized gene editing platforms.”
With that, Musunuru hastily closed and exited stage left to give a keynote address at another conference across the road.
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