Nightingale Health Oyj

Good afternoon and welcome to half year result and webcast of Nightingale Health. My name is Teemu Suna. I'm CEO and founder of Nightingale Health. Today's agenda, I will first talk about Nightingale Health, about our business, our technology. Then we move to the business targets of the ongoing fiscal year. Then we go through the key achievement of the past half. Then we talk about significant events after the H1 period. Then we have a financial review with our CFO, Tuukka Paavola. And then in the end, we will have the Q&A. Please post your questions to the online tool. So let's go. So Nightingale Health, our mission is to build sustainable healthcare and reduce health inequalities. So why do we need a more sustainable healthcare system? Well, we can see this everywhere. Healthcare is overburdened with too many sick people. with chronic diseases and importantly, with diseases that could have been prevented. So let's look at this a bit in more detail. So when we think about the health care system, so health care system has two main parts, the primary care system and the secondary care system. Today, we will be focusing in the primary care system. So what is the purpose of the primary care system already today? So the core idea of the primary care system is to promote health and prevent diseases. So actually, many times we talk about prevention and preventative health. Prevention is actually being done all the time. It's the core part of the healthcare system today. But there is a problem, and the problem is that the tools that are being used for prevention in primary care system are not very efficient. They're not very efficient and they do not scale well. So this leads into a situation that prevention is not working the way it could. And when the prevention is not working, we have increasing number of sick people burdening the health system. When we put this into more tangible numbers, 90% of healthcare costs comes from chronic diseases. From chronic diseases that could have been prevented. And this is what we need to change. So what can we do? When we talk about healthcare and we talk about healthcare problems, we often overcomplicate things. The answer actually is very simple. Primary care needs better tools for prevention. So if we look at this in more detail, we have the current primary care system, as I described in the earlier slide. Prevention is done all the time. But the current tools do not scale well and require a lot of resources. So when we bring better tools for the health system, we enable many elemental things to do prevention. We can access a broader group of people. So then prevention is not anymore done a bit like randomly or done to a small group of people. We can actually scale this to entire populations. We can apply the known interventions, so the clinical guidelines, more broadly. And the idea with the clinical guidelines is that when you apply a clinical guideline, you prevent diseases. With better tools, we can apply the guidelines more comprehensively. And then finally, when we can detect the diseases better, we can also monitor and treat the diseases more systematically. We can actually build the whole health system in a more systematic way. And with better tools, we can reduce the number of sick people. We can achieve cost savings, and we can build sustainability and equality. This is what Nightingale is all about. We are a company that brings the tools for prevention available in primary care system all around the world. And the Nightingale Health Check is an efficient, effective tool that scales well and enables population-wide prevention. So let's have a more detailed look also about this. So how the Nightingale's health check, how that is positioned with the current risk assessment tools for prevention. So I will show you a comparison where we have different parameters. We compare the current tools that are being used every day all around the world to assess risks for chronic diseases. We compare those tools with Nightingale. So let's start from the current risk assessment tools and look at the risk detection capability. So these tools, they have good performance. I will give you an example. Let's take cardiovascular disease risk. I think this is something that almost everyone knows. Around the world, there are different protocols in the current healthcare system to evaluate the risk. Here in Finland, we have a tool called FinRisk. We go to other countries, we have ASCVD, we have SCORE, we have Framingham SCORE, we have multiple different tools. But all of these tools, elementally, they do the same thing. They evaluate the risk for cardiovascular disease in this case. The tools are different, but what is shared between these tools, they all need various inputs to evaluate the risk. And again, we all know this. If we go to see a doctor, they evaluate the risk for cardiovascular disease in this example. You go to see the doctor, they take lab tests, they may ask family history, they make patient surveys, they make different clinical examinations, they evaluate body mass index. So there are various things that are needed as an input to evaluate the risk. And the current health system always evaluates one disease risk at a time. So if you go to be assessed for cardiovascular disease, your risk for cardiovascular disease is being assessed. They do not assess your risk for kidney disease, as an example. And now let's keep in mind, I'm talking about primary care all the time. I'm talking about large scale healthcare. Of course, for the richest 1% in the world, you get any test you want. But as a summary, the current risk assessment tools, they are not very efficient. They are resource intensive because they require a lot of different inputs. They are time consuming for the healthcare professionals. So they don't scale well. There has been some initiatives in different countries that let's invite everyone in the country, the whole population to meet the GPs to do the risk evaluations. It's a good idea, but it doesn't work in practice. And here you can see why it's not working in practice. So we don't have enough healthcare professionals to do it, given the situation that they are overburdened already. And then we are running only one disease risk at a time. So which disease to assess? So there are like multiple problems. So now when we compare the current risk assessment tools with Nightingale, And what is the core of this company? We do the risk assessment better than the current tools. And when we do it better, we can actually enable preventative health for the whole, for the entire health system. So in more detail, we simplify the risk assessment in the entire health system. So when we look at the risk detection capability, the Nightingale test is equal or it has superior performance to the current tools. And I use again this cardiovascular disease example. We take FinnRisk here in Finland. So if you run the cardiovascular disease risk assessment with Nightingale or you run it with FinnRisk, you can use it exactly the same way. You can use it exactly the same way. This is just more simple. And why this is more simple, this doesn't require the complicated inputs or the resource intensive inputs. The only thing we need is a single blood sample, AIDS and sex. This is the core thing why this is so efficient, because you can do it with so little resources. And because it's blood, every country with advanced health system has very good capabilities to collect blood samples. This is something that actually scales. This is something that can be done for everyone. So even if you only compare the cardiovascular disease risk, you do it with a traditional way, you ask the family history or do the blood work, you do the clinical examinations. And you compare that with nightingale, you take a single blood sample, age and sex. The nightingale way is much, much better. And both sides provides equal performance. So why would you do the old way? But it doesn't end here. So because of the advancements of the Nightingale's technology, we do not only detect one disease risk at a time. We detect multiple. So my earlier example, so you get the cardiovascular disease risk assessment, but you get also the kidney disease risk assessment. You get also type 2 diabetes, you get a liver disease, you get lung diseases. We go into more detail to these different disease risks. But the point is that every single risk that we measure has equal or superior performance to the current clinical tool that is being used all the time, we just do it better. We do it better because it's more scalable, because it's less resource intensive and it scales. So this is the core, what this company does. We make the health, we make the primary care system better in risk assessment. And when we make it better, we also enable the benefits of preventative health everywhere. So you can scale this to the entire population. So what we should do with this technology and what we are already doing, we are replacing the current risk assessment tools with Nightingale's technology. And as said, we are already doing it and it's available today for healthcare use. This will change how we do primary care worldwide. How is it working? How it happens in practice? We need blood. The blood can be collected at lab or it can be self-collected. It doesn't matter. Self-collected samples, there are some interesting use cases where we can actually reach some parts of the population that are unreachable to the health system at the moment. Not everyone will do it, but the point is that we can reach some parts of the population that cannot be reached right now. It doesn't have to be everyone. Then when we get the blood, we provide the risk assessment for the most common chronic diseases. Here you see the list. Then a very common question is, so when you get the Nightingale health risk assessment, what do we do? What do you do after that? So measuring health is not valuable if it's not actionable. The answer is very simple. We do exactly the same thing that we are doing in healthcare system all the time today. Exactly the same thing, exactly the same interventions. Because the nightingale risk assessment is no different to the risk assessment that are being done today. It's just better because it's more efficient. Then in addition to the risk assessment, we also provide several clinical great blood values such as cholesterol, glucose, creatinine, et cetera. So clinicians can use those blood markers exactly the same way as they are using blood markers today. What we do, we accelerate how the current prevention is already working in primary care. We make it broadly available. We make it scalable. So, I mean, the Nightingale way is superior to the way how these risks are being assessed at the moment. So it's time to replace the current chronic disease risk assessments with Nightingale's technology. And I think this is something very exciting because it makes the health system better for everyone. OK, so the next question is, of course, so if it's so superior, how is it possible? So how have we built this technology? So let's walk through the key points about the technology and validation. Measuring blood samples is actually quite an old thing. So I think people have been measuring blood samples to be used in medicine for 100 years. Blood testing was created to detect diseases, to detect already manifested diseases. And to do that, you typically try to discover some single biomarkers that you can use to detect the disease, that the disease is there. And then you have treatment, et cetera. This is very solid and very valid approach still today to detect, to diagnose diseases. But when you want to detect the risk of developing a disease, it's a bit of a different thing. Because the disease is not yet there. You are just predicting the future risk. So you need different way of measuring blood. So the tools for prevention and what Nightingale has created, our proprietary biotechnology to measure the blood samples detects a holistic number of blood markers from every sample we measure. And it's important because we are looking at the future onset of the risk. That's why we need also a broader set of biomarkers. And then it's not only the biomarkers, because I mean, if you are just looking at the single biomarker, for example, you look LDL cholesterol for cardiovascular disease risk, Well, the LDL cholesterol alone is just one marker when what you are aiming to do is that you are looking at the overall risk for the cardiovascular disease. So what we have done is that in addition to that we are able to capture this broad biomarker set from every sample, the more important thing that we have done is actually how we have turned this multi-biomarker approach into detection for multiple diseases. So we detect the health outcomes. The biomarkers, the individual biomarkers is not the most exciting thing, it's to measure the outcomes. Because why are you looking at the biomarkers? You are looking those to do something about the outcomes. So we measure the actual outcomes. So that is the kind of the ultimate goal in preventative health, to understand the risk for the outcomes. So we have created this proprietary biotechnology to measure the blood in a new way. and we have created the capability to detect the health outcomes. So the next question is, how have we created the capability to detect the outcomes? So here I have an example how we have created the risk detection capability. And we are using as an example, UK Biobank. UK Biobank is the world's largest health data repository. And we've been working with different biobanks all around the world. So in the UK Biobank, when it started around 2006, they collected blood samples from half a million participants. And these participants were healthy individuals at the time of collecting the samples. So everyone was taking a blood sample, the blood sample in the, there is an icon in the bottom of the slide, the blood sample was put into freezer. And then the icon on top of the slide, that describes the health records that the biobank started to collect. So the biobank started to collect all the health records of all the participants. And these health records, they include If someone developed a disease, someone got cardiovascular disease, someone got diabetes, someone got kidney disease, if someone was hit by a bus. So there is like, I mean, all the health incidents that have happened to those people have been recorded over 15 years and put into a database. Now the blood that was collected when those individuals were still healthy has been in the freezers all this time. And Nightingale has got access to these blood samples, and we have measured all of these samples with our technology. So from every sample, we have yield this wide, broad biomarker panel from every single sample. And now because the sample was collected at the time when those people were healthy, and we know from the health records what has happened to those people, now we can combine these biomarkers we have measured from the blood to the actual health outcomes of those people. And because we have a half a million people, which is by the way, the largest collection in the world, This has never been done before. We can have the multi-disease risk assessment capability. And to answer the question I asked earlier, so how this is possible, why this has not been done before? Well, it has not been possible before. That's why it has not existed before. Think about how long time it takes, what kind of effort it takes to collect this kind of data sets, what kind of efforts it takes to build this kind of biotechnology that can actually capture these broad biomarker signatures and build it in a way that it's fully healthcare compliant. It takes a long time and it's pretty difficult. But when you get all the pieces of the puzzle, when you get it done, when you put it together, you create something exceptional. This is why we are far superior to the current risk assessment tools in healthcare. Those tools have been created long, long time ago, the foundations. And this is now created with the latest biotechnology, with the latest data assets available. We are, I mentioned already, we are not only that the previous slide was just an example, we are not only doing this with a single biobank, we are actually doing, we are using our technology in medical research worldwide. Nightingale is the gold standard in blood profiling in large population collections. more than 30 countries, more than 170 institutions, more than 600 peer-reviewed publications, scientific publications, more than 2 million samples analyzed. With these numbers, I'm of course biased, but we are number one in the world with these numbers. And the numbers matter here because validating the technology, this is a numbers game. This is a data game. You have to get access to these datasets to do the research that is needed to validate the technology so that it can be used in healthcare. And we've been doing this for 10 years. So 10 years ago when we started, it really started from the beginning. So we have been steadily building up the number of samples analyzed, the amount of evidence. Here you see the number of samples, the number of publications. This describes what it takes to build this kind of a technology that can be utilized in primary care settings, that can be scaled into population-wide use. So it's a long-term effort, but this position where we are today is very, very exciting. And the example of that is that this is already being used in national scale clinical implementation. So here in Finland, together with our partner Terveystalo, we replaced occupational health checkups. They were doing it the kind of the current way, how healthcare is doing these things everywhere. So they adopted Nightingale's technology and replaced the risk assessments with our solution. And this is now really nationwide operation here in Finland. 30% of the Finnish workforce are benefiting already of this technology. And many, many more conversations around the world are ongoing to adapt this approach because As I said, it brings so clear benefits to the current way of assessing health risks. All right, so let's move to the next section and talk about business targets for financial year, so the ongoing financial year. The status update of the business targets is that the first target, winning an international commercial contract with healthcare industry partner is already done. I will talk about that a bit later. And then the target two and target three are moving well forward. So the key achievements during the past half year, we have split these into scientific validation commercial activities that start from the scientific side. So we completed during this first half of the fiscal year, we completed the analysis of the UK Biobank, half a million samples analyzed. We are very proud about this achievement. It has created a lot of benefits for different stakeholders. So, of course, for Nightingale, getting our technology to be used in clinical healthcare, this UK Biobank project has had a big significance for that. But it's also more than that. So scientists around the world, they can actually access the data from the UK Biobank. So there is tons of scientific discoveries done all the time with Nightingale's data and combining Nightingale's data to other data modalities. And this is benefiting medicine in general, as with the new discoveries, we can then also take those into the clinical use because nightingale technology can be used also in large-scale clinical implementation. For example, if we can detect some new disease risks, that the Nightingale's biomarker panel can detect, we can actually bring those into healthcare with a very straightforward way. And this is very exceptional, translating the scientific findings into the clinical use. It's extremely difficult. And what we have built, we have actually built a platform that allows this translation to happen in a very straightforward way. The UK Biobank project also concludes in a way a very long research and development phase for Nightingale. We of course continue with different R&D initiatives, but this has been one of the flagship initiatives for us in-house. So we are very pleased and very proud that we have completed this initiative. And as mentioned, the project with Terveystalo, a lot of validation, a lot of data analytics have been possible because of the UK Biobank data set, a lot of replication between we have managed to kind of compare what has been done in the UK with the Biobank collaborations we have in Finland. So we have been able to compare the differences between UK and Finland, and it's It has been enabled because we operate in such a big, large scale with very big sample numbers. We can actually then make projects like the project with Tervastalo happen with very strong validation in the background. I already talked about this a bit. I think the important point is that this project is now in full production and operates countrywide. Then let's move to Singapore. So this is our fiscal year, the first achievement or the first target in the fiscal year. So this deal in Singapore concluded that. So in Singapore, we are working with InnoQuest. That is part of, it's a subsidiary of Pathology Asia. So it's a very big... diagnostic, it's the biggest diagnostic service provider in Southeast Asia region. And now, because they are so well integrated into the different health systems in the region, then partnering with them is a great opportunity for Nightingale to distribute the advantages of this technology also in Southeast Asia. And the population that this covers is more than 500 million. So it's a very, very significant collaboration. How that project is moving forward. We are at the moment establishing the laboratory operations. in Singapore. We also received the first regulatory approvals over there, so we are making very good progress. We are looking to have the commercial lounge in the second half of this year. And then expanding to other countries when we move forward. But the project is moving nicely forward. Then in the United States, we announced a collaboration with Mass General Precum. We have several different initiatives in the United States ongoing at the moment. There seems to be quite a lot of interest towards our technology, and then collaborations like Mass General Precum are sending a very good message that the big health systems are very keen to to study the benefits of Nightingale's technology. Moving to UK. In the UK, we... We have the laboratory established in Portland Science Park. We are fully staffed and first samples have already been received. And now we are ramping up the full scale production over there. So things are also moving well forward in the UK. And many of these initiatives, like in Singapore, in the UK, setting up the local laboratory, that is the way how we can then start expanding the business in the respective regions. Moving to a remote blood collection business. This is something that when we provided the strategy update last autumn and decided to focus more into B2B, B2G markets, we have also steered the strategy particularly with this kind of self-testing capability. and went with this white label model. So in this white label business model, we work B2B2C. So we work with partners who are offering already some home testing services to their customers. And we bring Nightingale's technology so they can use it in a white label fashion to serve their customers. This way we can faster expand the market and serve various customers at the same time. Here we are aiming to win the first deals in Europe, but we are in parallel expanding to new markets. And then we are working with some of the flagship deals. So we have those three things in parallel and we are following closely which of the tracks will... move first forward, and then we aim to scale the sales based on the feedback we get from the market. So that was the milestones. Next section, I have some significant events after the H1 period. We actually announced today that we acquired Veltus Inc. in Japan. And I wanted to say a couple of words about the logic and the reasoning for this. So as you know, we've been working for a long time in the Japanese market already, and the partnership structure has looked like this. So we have been operating in a way as a subcontractor or in a partnership model for Veltus. And Veltus is a company that is a subsidiary of our big Japanese partners, Mitsui and Kirin. And then Veltus has been working with the centralized laboratories, and then they have a connection to the medical clinics. So this structure is, first of all, it's a bit complicated. And secondly, our partners Mitsui and Kirin, they are very, very large companies. They have made some changes in their strategy, and then they have been selling many assets in this domain to get aligned with their updated strategy. So this gave an opportunity also for Nightingale to acquire Veltus, And after the acquisition, the structure will be much simplified. What we can do, we are now working directly with the centralized laboratories. The centralized laboratories are important because that is how we can access the blood sample network in Japan. And we have a very good and very solid network already there. So we can benefit from that. But moreover, we can also start working directly with the customers in Japan. We can work with the existing customers that are part of the Ninkendog occupational health system in Japan, but this now also allows us and opens new possibilities where we can expand the commercial avenues in the Japanese market. I think the timing for this is very good because what we have accomplished, I think we have accomplished one of the most difficult things in that market, and that is to establish your existence in the market and actually running the laboratory operations and integrate into the ecosystem. in Japan. And Japan is one of the most difficult countries in the world to do that. So we highly appreciate the partnership we've had with Mitsui and Kirin, and we have built together this capability. now when we after the acquisition we are in a very very good position then to see growth in Japan and then bring also the global assets we have even more clearly available in the Japanese market so the deal was signed today and announced today And the expected close of the transaction is in the end of this month. All right. That's all from that part. Let's move to financial review together with our CFO, Tuukka Paavola. Welcome, Tuukka. and talk a bit about money.

Yeah, thank you Teemu. And good afternoon to all from my side as well. So let's look at our financials for the first half of this fiscal year. And let's actually start from what we think is the most important part of our financials, which is actually our strong financial position. So, For a long time, we've had a solid plan to scale globally our business, and that of course requires investments. And for that, we also raised this 100 plus million euros in the IPO in early 2021. But making change happen is slow, and more so in healthcare. So to make it happen, we, of course, need to focus our actions, what we do, prioritize, manage our time carefully, and also manage our money really carefully. And given our ambition level and given the scope of what we are trying to do, and also compared to many other globally companies that have similar ambition levels, our cost level and our burn rate is actually really, really moderate. So if you look at historically from the IPO, our average annual cash burn has been roughly around 16 million euros a year, which is really, really moderate cost level. So we are running a really tight ship. We are focusing our actions. We are prioritizing. Yet at the same time, we know that it is enough for us to do what we need to do in order to scale the business. So we are. in really good, strong financial position. Our cash balance was 73 million euros at the end of the first half, i.e. at the end of December, which enables us to fully execute our plan and do what we need to do in order to achieve our mission in the end. And of course, all of these actions need to turn into revenue and eventually into bottom line. So looking at our historical half year revenues, we actually managed to do a step change a year ago from a roughly one million euro revenue level in half year period to a roughly two million euro level. and the previous half-year period is also on the same higher level. The slight decrease from the two previous half-year periods is mostly explained by the change in strategy that we announced in autumn last year and by normal seasonal fluctuation in the research business. But it is also evident that the lead times to convert our actions and activities into revenue are long. Sometimes it takes even multiple years to see something we do today to convert into revenue. And many of the new income streams we have been working on and are working with are still not seen in these numbers. For instance, the terrestrial occupational health service, which only started now this January. So it's evidently not visible in these numbers, but will be, of course, now in the second half. So patience is needed, but we are certain that all the great things we are doing and have been doing will be then seen in the numbers eventually. And finally, and also a little bit repeating myself, looking at the actual numbers for the first half. So the revenue landed at roughly 1.7 million euros, slight drop from the previous half year periods, but actually the EBITDA and net income are virtually unchanged. We continue to have a strong financial position as mentioned with 73 million roughly cash at hand. And the net cash change for the first half was at around 8 million, which is aligned with the historical burn rate. And we repeat the target to keep the net cash change for the full fiscal year under 20 million euros. That's it briefly from the financials. Back to you, Teemu.

All right. So next segment, we have the Q&A, and I would like to ask Laura Pulkkinen to join us on stage. Let's have some questions. I think we have plenty of time.

Yes. Hi, everyone. Happy to be hosting the Q&A for you today. Tuukka, Teemu, are you ready for some questions then?

Yeah, go ahead.

Excellent. So let's start with the health check that you talked a lot about today, Teemu. Can you just a little bit clarify the competitive landscape? So what are the competitors and how is Nightingale better?

Yeah. So I think the important thing here is that actually what we are comparing the health check against is the current way of doing risk assessment. So it's not that much about having like a competition from the technology point of view. This is all about making the current health assessments, doing those better. So I don't know if it's even like a competitive landscape. It's more about adopting new technologies into large scale use in healthcare. It's complicated. It takes time. But I think Nightingale ticks all the boxes. There is the scalability. There is the validation. There is the performance. There's everything. We tick all the boxes. But I think many people are asking, so why is it not happening yet? Well, it's... The adoption takes a lot of time because these are like big systems. They're like big questions, like how to replace and how to run the pilots extending and doing it in large scale.

And maybe to then bridge a little bit into Terveystalo collaboration. So just to clarify, is it this health check that you talked about today that is in use in Terveystalo or is that something else?

Yes, that's exactly the same thing.

Okay, great. But yeah, let's continue with terveystalo. So collaboration started in January. How has it been going?

Well, it's been going very, very well. Of course, it's something that when we build it, this is like a nationwide operation. And when we build it, it takes a lot of effort and it's not like walking a park. But we have managed to do it very well. And these kind of very large sample numbers are running every day. So it's in full production. And I'm very, very proud that we managed to do that, managed to implement it so well. And now we are kind of in a pretty steady production phase in that project.

Great. Maybe then more towards Tuukka. Can you just clarify a bit further? The scale is large, so how does it then show in the numbers in the coming halves of the fiscal years?

Yes, of course, we haven't discussed any details with regards to the deal, but just to clarify, it's not the pilot case, it's a real commercial case, which will bring revenue to us, which will be then visible in the H2 numbers and, of course, going forward.

Great. I think that was all on, might have been all on terveys, so let's come back if new questions come. Then going to Singapore. So can you just a little bit repeat maybe about what kind of the collaboration is and the roles of the different partners, so InnerQuest and Pathology Asia?

Yeah, so the InnoQuest is a subsidiary of Pathology Asia, and InnoQuest is their main business in Singapore. And now the first laboratory implementation, it's a lab-in-lab in InnoQuest lab in Singapore. And why that is a lab-in-lab structure is that the sample flows are already coming in to the InnoQuest lab. And because of that, when we bring the Nightingale's technology there, we can access these large sample quantities from the beginning. And then on the other hand, InnoQuest can then also provide this service to a large group of customers. And with that, we can get the benefits to be used also in the Singaporean health system. And maybe to continue in the region, Singapore is a very important reference. So then the other countries, when looking at the neighboring countries, expanding to those, everything starts by setting up first the Singapore operation. And we do it as we do everything. We do it carefully. We make it work and then it's time to expand. But it's definitely a very exciting opportunity because when we look at the population in the region. It's a size of Europe in terms of population. So it's quite interesting.

Definitely. And maybe to continue a little bit on the timeline outside of Singapore. So are you able to give any type of timeline when the test might be used outside of Singapore in Southeast Asia?

It's very difficult to evaluate at this point. So maybe we also in this case, we make it work, we build it carefully. Once it's ready, we are confident that the value of this technology, as I was talking about the value we can do in health risk assessment, I believe that it will have demand in the market, but it needs to be built up step by step. So we continue doing things the way we have been building things from the start of this company. We build it carefully. We make it work. The value is there. The business will be there as well.

Great, thank you. Let's then go to Japan. So I think you explained quite well during the presentation the kind of the background of the acquisition. So maybe we can look a bit to the future. So what are the next steps in Japan?

Yeah, so now the situation that we are after the acquisition. So we have the capabilities to run the... We are running the laboratory. We have the integration to the diagnostic company network. So all the sample flows are there. We have all the setup. We have the staffing. We have the packets completed. But now the new areas that comes to us, there are some of the commercial opportunities. So we will be doing a couple of very targeted recruitments in Japan to then ramp up also the other side, kind of the commercial side, to have a bit more strength in there. And at the same time, the business we have already in Japan, that will continue, but then exploring the new opportunities in the Japanese market. So a couple of recruitments, and I think we are good to go.

Great. Thank you. Then let's continue then to the U.S. next. Maybe first question for Tuukka. So in the report published today, U.S. revenue had grown significantly compared to the previous periods. Was the background story of this the Mass General Brigham case or something else?

Yes, like Teemu mentioned, we have several ongoing discussions and ongoing cases in the US. There's a lot of good interest in the US towards our service and what we can do. Naturally, Master General Brigham explains part of the US revenue growth, but it's not the only reason.

And what are then the wider plans for the US, wider commercial plans?

Yeah, we are having many conversations in the US market. As I mentioned, there seems to be a lot of demand for Nightingale's technology. I think many of these international processes we are running in Europe, things we are doing in Japan, now in Singapore, there's a lot of credibility also in the US market. And the problems and challenges in the health system, they are the same everywhere. There are too many sick people, and the preventative side of the health system is not working very efficiently. But now when we go to the US market, it's very different. The structure of the American market is quite different to the European market, for example. So I think the mass general pre-cum is a good example of a collaboration that is then also kind of can be seen as a roadmap also to broader use and a kind of a roadmap towards clinical use also in the US. But it starts from this kind of collaborations and we see a lot of value with this collaborations, and we actually demonstrated in Europe already. I mean, we worked with the biobanks in Europe, UK Biobank, biobanks in Finland, other countries in Europe, and then we translated the findings and the scientific validation to real clinical application. We already did it here. So we can do it also in the US. But because the structure is different, I think there can be a much more accelerated way, because many of these sample collections are actually collected from the clinical workflows. So then translating that into the clinical cases, I think there is a very good opportunity, and I think we have commercially rather clear plan how we are going to do that. But we will tell more about it, but I think it's quite exciting.

I was just going to say that looking forward to those news. I think we are almost out of time, but I saw the word AI or letters AI here. So I'll ask this question. Are you going to use AI in the future to detect even more possible diseases?

Yeah, well, this is a very interesting question. So I think the how data is being utilized to discover new findings, to do things that have not been possible before. I think AI, I see AI as a kind of a broader term, if we are not thinking about it in a technical sense. I see it as a broader term, how we can turn data into valuable things that can advance the humanity. um so we have actually already done it in a way that um i i talked about the um i talked about the um detecting the health risks and how the current system is working and how we are doing doing things we have already utilized some data sets that have not been available before put those different like putting biotechnology putting the the capability to detect the biomarkers of the molecular data with the health records and then done it in a scale and in a way that has never done before. And that creates value that is very, very beneficial, very actionable in real world use. So in a sense, we have already done it. We will continue it. The question about do we technically use, are we talking technically and mathematically, are we talking about AI or machine learning or regression models? It's not very relevant. What is relevant is how do we extract value real value that can be used in the real world. And we have very good track record how to do it. And we will definitely continue.

Great. Thank you Teemu. Thank you Tuukka. I think that's all we have time for today.

All right. Thank you Laura. This concludes the presentation today. Thank you for listening and have a nice day.