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The 9 Best Conference Call Services – TechEye

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Conference calls are still the best choice for phone meetings and communication with multiple people. Conference calls are cheap, effective, and are a simple way to get people together and share information.

Pretty much every small business should have conference call capabilities, and every large business too. Being able to conference call greatly streamlines meetings and allows for more flexible scheduling as not everyone needs to be physically present.

There are free conference calling services, such as Skype and they can be perfectly functional. However, paid services give you access to more varied features, like recording, screen share, video calling, and more.

No matter what your budget is, there is a conference call solution that will work for you. So we put together this list of the best free conference call services and paid conference call services for your business. We put together this list based on each service’s overall capabilities, ease-of-use, support options, and overall price.

The 9 Best Conference Call Services (2020)

We will cover each of the conference call services below and talk about their features, pros, cons so you can compare and make a decision.

1. RingCentral

RingCentral offers modern VoIP solutions for modern businesses. RingCentral is more than just a conference call tool, but a full-blown business phone system that operates over the internet. So with RingCentral, you also get an entire business-wide phone network for any kind of communication need.

RingCentral offers a free plan that allows up to 100 participants, although it caps calls at 40 minutes. That is not too shabby compared to some other free plans and is a good choice for individual solo entrepreneurs. Upgrading to a larger plan is also easy and they start at $19.99, a perfectly affordable monthly rate.

RingCentral’s VoIP suite offers basically every call-feature you could want, including greetings, directories, hold music, extensions, voicemail, call forwarding, conference calls, conference lines, HD video conferencing, page/intercom systems, and more. It is a cloud-based service so there is no extra equipment and not maintenance required. All you need is an internet connection.

RingCentral is an excellent VoIP conferencing solution for enterprise-level businesses and can save you a lot of money compared to a traditional PBX business phone system.

RingCentral

RingCentral offers modern VoIP solutions for modern businesses. RingCentral is more than just a conference call tool, but a full-blown business phone system that operates over the internet.


2. GoToMeeting

GoToMeeting is a paid teleconferencing service that is possibly one of the best services on the market. GoToMeeting has a high-quality solution that is perfect for business owners of any size. GoToMeeting’s features are simple and to-the-point, not filled with distractions.

Unfortunately, GoToMeeting does NOT have a free basic plan. But, they do offer a free 15-day trial so you can try the software out.

There are 3 paid plans:

  • Pro – $12/month
  • Business – $16/month
  • Enterprise – Custom

The Pro and Business plans allow for up to 150 and 250 participants while the Enterprise plans have solutions for up to 3,000 people at once. All plans come with the following features:

  • HD video capabilities
  • Screen sharing
  • Dial-in lines
  • Unlimited meetings
  • Unlimited call duration
  • Private meeting rooms
  • Chat messaging
  • Mobile phone compatibility
  • App integrations (e.g. Slack)
  • Live customer support

GoToMeeting also has unlimited recording capabilities and automatic transcription features. It is an excellent choice if you have a large remote team.

Performance for GoToMeeting is strong. Many conference call services, even the paid ones, lack in audio quality. GoToMeeting has clear sound and the connection rarely jumps in and out. It may not be as impressive as BlueJeans, but it is still on the higher end of the spectrum.

A few flaws though: GoToMeeting does not have some other features that are considered standard. For example, you don’t have any hold music and no presentation/whiteboard tools, but what is there works extremely well. Conference call software can be really simple and still be good. GoToMeeting is also very affordable and has great value for its price.

GoToMeeting

GoToMeeting is a paid teleconferencing service that is possibly one of the best services on the market.


3. BlueJeans

BlueJeans is another conference call service known for its excellent video and audio quality. Bluejeans can allow you to communicate with your team from virtually any device.

BlueJeans offers plans starting as low as $12.49 per month. The basic plan allows for 50 participants per call and has no duration limit on calls. The upgraded plan starts at $16.65 per month and allows up to 75 participants. The upgraded plan has recording and cloud storage features.

If you have a larger business, you can contact BlueJeans and create a custom enterprise-level plan, though even these plans have a limit of 150 participants. BlueJeans has one of the smaller enterprise-level conferencing solutions we have covered on this list.

BlueJeans does have some street cred though. Big companies like Facebook, LinkedIn, and Zillow rely on BlueJeans to host conference calls, so that is a good sign it’s a reliable service.

BlueJeans exceptional audio quality is due to DolbyVoice that it uses on all its calls. DolbyVoice is designed to make it sound like participants are placed in the same room. This setup ensures that you can hear all sounds faithfully.

BlueJeans

BlueJeans is another conference call service known for its excellent video and audio quality.


4. UberConference

UberConference is a good place to start if you are looking for a simple and reliable conference call service. UberConference is easy-to-use and offers a wide range of calling options for businesses.

You can use UberConference for free for calls for up to 10 people. You can also make as many calls as you want with a 45-minute duration limit for individual calls. The free services even come with screen sharing capabilities, call recording, HD audio/video quality, and mobile app integration. That is a lot of features, absolutely for free.

If you need more services, then you can sign up for the paid tier plans. Paid plans start as low as $15/month On this plan, the call duration limit is raised to 5 hours and comes with some extra benefits, including:

  • Call numbers
  • Analytics
  • International conference dialing
  • Dial out channels
  • Hold music
  • Voice command capabilities
  • Management tools

You can also add a toll-free number for an extra $30 a month.

The best feature from UberConference is the mobile app. The mobile app is available on Android devices or iPhone and comes free with the standard edition so you don’t even need to pay to get access to the best feature. You can do everything on the app that you can do on the desktop version so you can make conference calls on the go. Participants can also drop in from virtually anywhere.

It is fast to start up too. You can start making calls as soon as you sign up. If you have technical issues, then there is a resource portal with training articles for troubleshooting issues.

One downside with UberConference is the audio conference quality. Sometimes calls can pick up static. It is not a huge deal though and does not ruin the quality of the call.

UberConference

UberConference is a good place to start if you are looking for a simple and reliable conference call service.


5. Zoom

Zoom has become extremely popular in the past few years and has made a name for itself by supplying efficient and sophisticated video conferencing options for businesses and organizations of all stripes

Here are a few quick facts about Zoom’s plans and pricing structure. Zoom offers 4 tiers.

Basic:

  • Free to use
  • 100 participants per call
  • 40-minute max duration limit
  • 1080p HD video calling capabilities
  • Group management tools

Pro:

  • Starts at $14.99/month
  • 100 participants
  • 24-hour max duration limit
  • Recording and cloud storage
  • Admin privileges
  • Analysis and reporting features

Business:

  • Starts at $19.99 per host (10 host minimum)
  • 300 participants
  • Live support options
  • Transcription services
  • Cloud storage
  • Whitelisting features
  • Email templates

Enterprise:

  • $19.99 per host (50 host minimum)
  • 1,000 participants
  • Unlimited storage
  • Priority support
  • Business review options for executives

Most businesses will be just fine with the Basic or Pro option as these are ideal for startups and smaller teams. If you have a slightly larger business, then the Business option is relatively easy to scale.

Zoom has been extremely well received due to its excellent video conferencing capabilities and ample cloud storage. It is also particularly useful if you need to share presentations and powerpoints during meetings.

Zoom is sort of the go-to standard at the enterprise level. Their top tier Enterprise plan is used by several large organizations like Uber, Ticketmaster, and GoDaddy. Many more large firms rely on Zoom for their conference call needs.

Lastly, Zoom has excellent support options. They have 24/7 live phone support and live training sessions. The only criticism we have is audio conferencing quality can fluctuate sometimes.

Zoom

Zoom has become extremely popular in the past few years and has made a name for itself by supplying efficient and sophisticated video conferencing options for businesses and organizations of all stripes


6. FreeConferenceCall.com

As you would expect from the name, FreeConferenceCall.com offers free conference calling software. People have made over 2 billion calls using FreeConferenceCall.com, meaning that it is probably the most popular free service in the world.

All you have to do is create a free account. You can do this in seconds and start making calls immediately.

Even though it is completely free, FreeConferenceCall.com has some of the highest limits for free services out there. You can have up to 1,000 participants per cal, which is absurdly high for a free web conferencing and webinar platform.

FreeConferenceCall.com also has real-time video meeting services in addition to audio calls. Here are some other nifty features that you can use:

  • Change presentations/presenters
  • Drawing tools
  • Presentation sharing
  • Private chat rooms
  • International dial
  • Screenshare

These are the kinds of features you would have to pay extra for with different services. With FreeConferenceCall.com, you get them for $0.

You can also access your call history and archived recordings from your account dashboard, which includes reports, notes, and details.

FreeConferenceCall.com does have some paid options. You can pick and choose features to make a custom plan for your business.

  • Custom greeting – $2 per months
  • Custom hold music – $2 per month
  • Storage – 40GB for $ per month

None of these options are really required to host conference calls, though some might get things like hold music or greetings to appear more professional. Storage might be useful, especially if you make a lot of conference calls and like to go over past calls.

FreeConferenceCall.com also offers a mobile app on Android devices and iOS that lets you create, manage, and join calls from your device. Some people prefer conference calling with their mobile devices so this is a good feature.

The main drawback of FreeConferenceCall.com is its limited storage capabilities. You can upgrade storage but you have to pay extra per month.

FreeConferenceCall.com

As you would expect from the name, FreeConferenceCall.com offers free conference calling software. People have made over 2 billion calls using FreeConferenceCall.com, meaning that it is probably the most popular free service in the world.


7. Webex

Webex is made by Cisco, a global leader in IT and networking solutions. So, right off the bat, Webex has a powerhouse technology company running its infrastructures so you know it is reliable and efficient. Webex is one of the better conference calling options in the business and offers both video and audio calls.

Free:

  • $0
  • 50 participants
  • 40-minute duration limit
  • 1 GB cloud storage

Starter:

  • $13.50/month
  • 50 participants
  • No duration limits for calls
  • 5 GB storage

Plus:

  • $17.95/month
  • 100 participants
  • No duration limits
  • Alternate host options
  • Live customer support

Business:

  • $26.95 per month
  • 200 participants
  • 10 GB storage
  • Whitelisting options

Webex does offer a free plan but it is fairly limited due to the low storage and call durations. All paid plans allow unlimited conference calls and ample storage. It is worth mentioning that the highest option plan only allows for 200 participants, compared to the 1,000 allowed by something like Zoom. If you want support, you also have to at least have the Plus plan.

Webex works well for businesses of any size and is a great option if many workers are remote. The video and audio technology is crisp, clear, and runs smoothly on a number of devices. The top-tier plan is small, so there is no genuine enterprise option. But what is available is some of the best quality conference call software you can buy.

Webex

Webex is made by Cisco, a global leader in IT and networking solutions. So, right off the bat, Webex has a powerhouse technology company running its infrastructures so you know it is reliable and efficient.


8. Vast Conference

Vast Conference offers conference call services for all-sized businesses. They offer a 14-day free trial which gives you full access to the instant conference call tools. They also offer operator-assisted calls.

Vast Conference offers 4 plans:

  • Essential – $11.99/month
  • Standard – $15.99/month
  • Pro – $31.99/month
  • Enterprise – Custom

The main difference between the 4 plans is how many participants are allowed on each call. The limits are 10, 100, 250, and 500, in that order. The first three plans come with unlimited cloud storage whereas the Enterprise plans only come with 1 GB of storage per user.

One of Vast Conference’s strongest features is its intuitive interface. Setting up and executing a call is very straightforward and navigating the interface is easy, even if you have 0 technical skills.

Vast Conference is probably best suited for businesses that want personalized operator-assisted calls. Operator-assisted calls add a level of professionalism to your organization and the audio/video chat quality is top-notch.

Of course, Vast Conference is not perfect. The biggest flaw in our opinion is the mobile app. Mobile app calling is just not very good quality and calls are dropped and jump in and out frequently. That being said, you do not have to use the mobile feature and the desktop tools are very good. If mobile calling is that important to you then you probably should look elsewhere.

If you do choose Vast, you will get excellent customer service. Even the most basic plan comes with 24/7 customer support so you can get help whenever you need it.

Vast Conference

Vast Conference offers conference call services for all-sized businesses. They offer a 14-day free trial which gives you full access to the instant conference call tools.


9. Google Hangouts

Google Hangouts is created by—you guessed it—Google, so you know that it is built on a solid and reliable architecture. Google Hangouts is completely free for anyone to use; all you need is a Gmail account (which is 100% free).

Hangouts automatically connects to your Gmail account so you can access it directly from your mail or from the Gsuite taskbar. It also automatically integrates with your contacts list and Google calendar as well. This makes it much easier to manage your contacts and set up rooms. You can set up a conference room using your desktop, phone, and chrome extension.

Google Hangouts is used most of the time for one-on-one meetings, but it can handle conference calls for up to 25 people. Participants can easily share their screen and the platform can handle video calls as well.

If you want to get the most out of Google Hangouts, then you will need a G Suite account. It costs $6 per month for an account and G Suite has a lot of other uses, so it’s worth the purchase.

The best part of Google Hangouts is how simple and straightforward it is. But, it does have a few drawbacks.

First off, Google Hangouts is not exactly designed for business-wide communications so the quality on some calls can be poor. Also, there is no customer support so you have to rely on FAQs and forums if you run into an issue. Lastly, there is no recording option so you won’t be able to go over old calls. This feature is pretty standard in other conference call software so it’s a letdown that Hangouts doesn’t offer it.

That being said, you can expect to use Google Hangouts frequently as it also has a good chat and messaging system. If you need a reliable free video conferencing service, then Google Hangouts is a good choice.

Google Hangouts

Google Hangouts is created by—you guessed it—Google, so you know that it is built on a solid and reliable architecture. Google Hangouts is completely free for anyone to use; all you need is a Gmail account (which is 100% free).


How to Find the Best Conference Call Services

There are a lot of conference call services out there and not all are equal. You need to find the right service with the right features for your business. So, when shopping around for a conference call service, make sure to consider the following features.

Call Limits

One of the most important parts of a conference call service is how many people it can host at once. Many services put restrictions on the number of people that can be on a call at the same time and how long the call can last.

Some providers have a free option that will give you a limited number of people and time, like 10 people and 40 minutes per call. Paid services usually have much higher call limits and durations. Some services allow up to 1,000 atrendees and unlimited calls.

You don’t need to shell out for a big fancy service if you can handle a more restricted plan. If you are part of a small business with around 20 employees, you probably won’t have to purchase a service that can hold 1,000 people at a time.

We do recommend finding a service that allows unlimited duration calls. Cutting meetings short because of an imposed time limit is highly inefficient and hard to plan around, so try to find a service that allows for unlimited calls.

Call Recording

Call recording is another useful teleconference feature that has many benefits. Not every conference call service allows for call recording, though.

Conference call services can handle recording in different ways. Some will allow you to record the call then store it locally, either on a computer, smartphone, or other devices you are using. Other services may have cloud storage options for recorded calls. Regardless of which kind you choose, it is always useful to have recorded calls so you can go over notes from past meetings.

Also, make sure you check for recording storage limits. Some services will limit the number of calls you can store and require you to upgrade to higher-level plans to get more storage space. For example, a service might limit you to 1 GB of storage but will allow you to upgrade to 10 GB.

Also, some conference call plans allow for automatic call transcription. You can turn a call into a written document. This feature makes it much easier to go over past meetings without having to comb through the audio for important points.

Additionally, if the service offers video calls, figure out if they allow video recording or only audio recording. Recorded videos can be even more useful than recorded audio calls.

Account and Call Setup

There are two main factors to look at when judging ease-of-use:

  1. Creating a new account
  2. Setting up a conference call

Some services let you create a new account and start making calls immediately. Setting up a call can take just a few seconds. For instance, if you have Gmail, then you can pull up Google Hangouts immediately and set up a reservationless call. Free and out-of-the-box conference calling software is designed with this simplicity and accessibility in mind.

If you need a custom or enterprise-level solution, the setup process is a bit more involved. This may be because you have to connect physical lines, install new software on office devices, or figure out networking details. Most likely, you’ll have to go directly through a sales agent, which takes more time.

Regardless of which route you go, starting a conference call with the service should be easy. You should be able to create calls, add participants, and schedule rooms simply and without hassle. There should also be robust customer support that you can contact if you face issues.

Video Conferencing

It is not always necessary, but we highly recommend getting a service with high-quality video conference capabilities. Video conference calls can make your meetings more effective by providing features like screen shares, presentations, and streamlined visual graphics. If you have many workers remote or do a lot of collaborations, then a video conferencing tool is practically essential. Video conference tools make online meetings more involved and let you pitch ideas and concepts more accurately than just over audio.

There are some services that specialize specifically in video conference options. If you have a large need for video services, then find a service that specializes in the tech.

Call Quality

Conference calls are much less effective if the audio of video quality is poor. Bad connections make online meetings much more inefficient because you have to keep stopping to address issues and reiterate points. This point is especially important if you need calls with a large number of attendees. The larger the group, the more bandwidth and call quality you’ll need.

The only real way to know a service’s quality is to try it yourself. If your provider has a free trial, take it so you can gauge the quality. The more you use it, the better judgment you can make.

Operator Assistance

Many conference call organizations aimed at enterprise-level businesses have to handle call participants in the thousands. So, they will include operator-assistance options. With this option, a live operator will assist with managing the conference event. Operator-assistance is useful as it will help manage large groups of participants and can streamline the process of getting things set up.

Generally, you will have to reserve an operator ahead of time and then schedule a call. The best reason to have an operator on hand is to ensure that nothing goes wrong. No corporation wants to waste time dealing with technical issues when they have hundreds of people listening on the other line.

Some services off an automated operator while others offer a boutique operator. The latter is normally more expensive than the former. Most businesses are not large enough to require operator services, but it is still something that is worth looking into.

Customer Support

As is the case with any product or service, customer support is an extremely important factor to consider when buying. This goes double for tech-related products and services that might require specialized knowledge. If something goes wrong during a call, you want a person you can call to get help.

Many services offer 24/7 support but some might only allow calls during normal business hours. Other services use a support ticket model, which can take very long to get a response. Others might have a “self-help” FAQ section in addition to any live support options they have.

In the worst-case scenario, if you can’t get a hold of a customer service rep, there should be a library of training and troubleshooting resources. It may not be a very common option, but live chat support is a new and highly favored troubleshooting model.

Price

You also need to figure out your budget. Conference call plans can range in price from totally free to $1,000s of dollar for enterprise-level solutions. However, based on our estimations, a viable solution for a small to medium-sized business optimally should cost about $20-$40 per month. $20-$40 a month should get you a decent amount of features, including but not limited to call recording, video conferencing, storage, and customer support options.

One more note: You can often get a discount on subscription costs if you sign up for an annual contract instead of a long-term one. You would be spying more all at once but over the course of a year would pay less than if you opted for month-to-month billing. Take advantage of any free trial, if you can.

Free and Paid Features

Conference calls offer additional solutions to convince people to sign up. Some of the more common features you will see include:

  • Live chat
  • Call reporting
  • Software integration
  • Toll-free numbers
  • Mobile apps
  • International conference calling
  • Custom greetings
  • File sharing and presentation tools
  • Management tools

And so on, and so on. Some features will be free but others you’ll have to pay for. There are a lot of choices, but the upshot is that you can find a genuine customer solution that is tailored specifically for your needs. You just need to figure out what you need and see which plan gives you the best value for your dollar.


Takeaway

Every business will need to make conference calls at some point; they are just an unavoidable part of today’s business environment. So, finding a good conference call service is important for virtually any enterprise. Increased demand and competition have led to a wide range of conference call services at competitive prices.

No matter if you are an individual or run a large business, conference call services are essential So do your research, and follow the tips you read in this guide, and you can find a service that works for you.




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EU-backed project to trial uncrewed flight ecosystem in Shannon

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The Shannon-based project aims to integrate the operations of uncrewed and conventional aircraft to modernise air traffic management in Europe.

A European consortium based in Shannon has received EU funding to develop a flight ecosystem for drones and help integrate uncrewed aircraft into our airspace.

Coordinated by Future Mobility Campus Ireland (FMCI), this consortium will conduct a three-year engineering project to develop, deploy and optimise this type of system in Europe.

Describing itself as Ireland’s “first testbed for future mobility”, FMCI is a development centre based in the Shannon Free Zone focused on innovation in both ground and air mobility tech.

Illustration of an unmanned vehicle testing site, with drones visible. A landing and take off zone is highlighted, along with a mobile operations unit where a van is parked. A small building is labelled as the AAM operations centre.

Illustration of the Advanced Aerial Mobility Hub at FMCI. Image: FMCI

FMCI said the research project, known as EALU-AER, represents a “major vote of confidence” in Ireland’s local expertise, industry operators and the resourcing of air mobility development.

Other members of the consortium include Shannon Group, the Irish Aviation Authority, Collins Aerospace, Dublin-based Avtrain, and Deep Blue in Italy.

The consortium has received the three-year funding award to develop uncrewed aviation business opportunities in Ireland, as part of a collaborative research project that could help modernise air traffic management in Europe.

The consortium said the new funding will help build an end-to-end ecosystem that supports the safe operation of uncrewed flights. The goal is to help integrate the operations of both uncrewed and conventional aircraft.

“This will result in developing and building out the critical infrastructure to allow advanced air mobility proliferate across Europe,” FMCI CEO Russell Vickers said.

“It will secure access to airspace for large numbers of drones and eVTOL [electric vertical take-off and landing] aircraft, resulting in safe, cost-effective and sustainable transport of freight and people in the future.”

The project’s work will be based at FMCI’s Advanced Aerial Mobility Research Test and Development Facilities in Shannon, but will include a network of Advanced Air Mobility routes across Ireland.

FMCI has already worked with Avtrain and Shannon Group to trial freight delivery services using beyond visual line of sight (BVLOS) drones.

“We are entering a new era of innovation where the success of the industry will depend on the integration of uncrewed aircraft into our airspace, rather than the segregation of airspace,” Avtrain CEO Julie Garland said.

Funding for the project came from the SESAR 3 Joint Undertaking, which is partnership of private and public sector entities in the EU that aim to accelerate the delivery of the Digital European Sky through research and innovation.

It comes as people are increasingly looking at the potential of drones and uncrewed flight technology. A Dublin City Council initiative recently looked to show how local government can utilise drones in areas such as civil defence, emergency response, public safety and environmental monitoring.

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Goodbye silicone? A new era of breast reconstruction is on the horizon | Breast cancer

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Having an ice pack strapped to your chest – that’s how some describe the experience of taking a walk in cold weather when you have breast implants. Silicone only slowly reaches body temperature once out of the cold, so that icy feeling can persist for hours. As well as being uncomfortable, for breast cancer survivors it can be an unwelcome reminder of a disease they would rather put behind them.

Every year, 2 million people worldwide are diagnosed with breast cancer and the treatment often involves removing at least one breast. But most choose not to have their breasts reconstructed; in the UK, it is only about 30%. Now a handful of startups want to change that, armed with 3D-printed implants that grow new breast tissue before breaking down without a trace. “The whole implant is fully degradable,” says Julien Payen, CEO of the startup Lattice Medical, “so after 18 months you don’t have any product in your body.”

It could spell the end not only of cold breasts, but the high complication rates and long surgeries associated with conventional breast reconstruction. The first human trial of such an implant, Lattice Medical’s Mattisse implant, is scheduled to begin on 11 July in Georgia. Others will soon follow. “We expect to start clinical trials in two years’ time,” says Sophie Brac de la Perrière, CEO of another startup, Healshape.

“It’s exciting,” says Stephanie Willerth, professor of biomedical engineering at the University of Victoria, Canada, who is not involved with the companies. “As engineers, we’ve been playing with 3D printing for half a decade”, but having a clinical use that doctors recognise as useful for patients is key to getting the technology out there, she says.

But in a field fraught with difficult medical compromises, unequal access issues and expectations about what women want, the question is how big an impact the new technology will actually have.


Today, there are two main types of breast reconstruction: silicone implants and flap surgery. While implants are easy to install, flap surgery is a highly specialised business that requires a tissue “flap” being taken from the stomach, thigh or back. Surgeons often recommend flaps because, while there’s a lot of initial surgery and a longer recovery period, it gives a good, long-lasting result.

Silicone is still the most common choice. It is easy and simple, which appeals to cancer patients who either medically can’t have or mentally can’t face having tissue removed from another part of their body. But “it’s far from perfect”, says Shelley Potter, an oncoplastic surgeon at the University of Bristol and the Bristol Breast Care Centre. “It’s quite high risk. There’s a 10% chance of losing an implant.”

Healshape’s 3D-printed hydrogel implant
Healshape’s 3D-printed hydrogel implant, designed to be colonised by the patient’s fat cells over six to nine months. The company hopes to start trials in two years’ time. Photograph: Healshape

Silicone implants also require replacement every 10 or so years and they have had their fair share of scandals: the 2010s PIP scandal, in which a major implant manufacturer was found to have made its implants of dodgy silicone, and the 2018 Allergan scandal, in which popular textured implants were linked to an increased risk of a rare lymphoma. And as an American study from last year shows, it is mainly the idea of having that foreign object stuck inside your body that puts many off reconstruction altogether.

“So what we want to do,” says Brac de la Perrière, “is to give the benefits of the different solutions without the constraints.” In other words: the single, simple surgery of an implant, but without any lingering foreign material to cause trouble.

This can be achieved in different ways. Healshape uses a hydrogel to 3D-print a soft implant that will slowly be colonised by the person’s own fat cells, the initial batch of which is injected, while the implant disappears over six to nine months. The company CollPlant is developing something similar using a special collagen bioink, extracted from tobacco leaves it has genetically engineered to produce human collagen. “I think it will change the opinion of many patients,” says CEO, Yehiel Tal.

Lattice Medical has a different approach. Its implant is a 3D-printed cage made of a degradable biopolymer, in which they encase a small flap from underneath the breast area. This flap then grows to fill the cage with fat tissue, while the cage itself is absorbed by the body, ultimately leaving a regrown breast in its place.

Lattice Medical’s Mattisse implant
Lattice Medical’s Mattisse implant. Vascular adipose tissue is inserted into a bio-resorbable ‘tissue engineering chamber’, which degrades over 18 months. Trials are imminent. Photograph: Lattice Medical

Regrowing breasts using a cage has been shown to work in humans before, in a 2016 trial. However, it only worked in one of five women and the cages were not degradable. Andrea O’Connor from the University of Melbourne, Australia, who led the trial’s engineering team, hopes the new trial will address the problems raised in the first – for example, that patient responses can vary greatly. But if successful, it “would have the potential to help many women to achieve a superior reconstruction”, she says. Lattice Medical says its cage is an improvement because a flat base and larger pores help the tissue grow.

One big unknown is how much feeling the regrown breasts will have. A mastectomy usually means losing some sensation and, according to plastic surgeon Stefania Tuinder from the Maastricht University Medical Centre+ in the Netherlands, reconstruction affects it too. “From our data, it seems that implants have a negative effect on sensation, so the feeling in the skin is less than when you have only a mastectomy,” she says. In comparison, reconstruction from a flap with connected nerves can bring back some feeling within a few years.

Tuinder suspects the implant numbness is both because of nerve damage when the implants are inserted, and because the nerves can’t grow back once they are blocked by a lump of silicone. Whether that will also apply to the new implants remains to be seen, but since eventually there will be nothing to block the nerves, hopes are that sensation will be better.


Tissue engineered implants, however, are not the only recent innovations in the field. Many groups are working on perfecting a reconstruction technique using injections of the person’s own fat, boosted with extra stem cells to help the tissue survive. Medical professionals are still debating the safety and how the breasts hold up long term. In contrast to the new implants, the procedure might have to be done several times.

While any of these new techniques could result in something better than what’s currently on offer, Potter warns that we have a tendency to jump at new and shiny tech – an optimism bias. “We always think it’s going to be brilliant,” she says, but “we don’t want a situation like with vaginal mesh, where in 10 years’ time … we find out we have done something that isn’t helpful.”

Other solutions to the problems of reconstruction do exist. One is living without breasts, known as “going flat”. Contrary to the companies that think they can turn the reconstruction statistics around, people within the flat movement argue that if people were better informed, even more would opt out. “I reckon if [going flat] was given as an equal option,” says Gilly Cant, founder of the charity Flat Friends, “at least another 30-50% of women wouldn’t have [reconstruction].”

A Healshape scientist using software to determine the shape of an implant prior to 3D printing. The implants can be custom-made to suit the patient.
A Healshape scientist using software to determine the shape of an implant prior to 3D printing. The implants can be custom-made to suit the patient. Photograph: Healshape

At the moment, the guidance from the National Institute for Health and Care Excellence (Nice) says that doctors should be aware that some might not want reconstruction. But Cant says it is often presented to people as part of the treatment process. “It’s like, ‘OK, we need to do a mastectomy. Then you have chemo. Then you’ll have your radiotherapy and then we’ll do reconstruction.’ So women live for that reconstruction at the end,” she says. It comes to signal the finish line.

It is particularly contentious when only one breast is removed, because some might want the other taken off to feel and look symmetrical, rather than have a new one made. But according to Cant, many doctors don’t want to remove a healthy breast. Part of the doctors’ concern is that women will regret their decision, says Potter, but “women know what they want to do with their own bodies. We should help and support them to do what they want to do.”

Potter herself would like to see more of the ultimate alternative: not having a mastectomy in the first place. “There’s no evidence that mastectomy gives you better cancer outcomes than a breast-conserving operation,” she says. In this case, the tumour is removed but the breast is kept. For example, one of her patients had a breast reduction that removed her cancer while giving her breasts a lift. “She calls them her silver lining breasts.”


So even without tissue-engineered implants, there are enough options to make the choice a hard one. To help people choose, some charities pair up people considering a specific procedure with someone who has already been through it. At the charity Keeping Abreast, show and tell sessions give people the chance to ask the questions they might be uncomfortable asking their doctor and see the results for themselves.

But according to a 2018 report by the all-party parliamentary group on breast cancer, knowing what you want is not the same as having access to it. “There’s a massive postcode lottery,” says Potter. It stems from flap surgery being so involved that it often requires specialist plastic surgeons who can do minute surgery under a microscope. Many clinics don’t have such experts in-house and while the Nice guidance says people should still have the option, in practice it limits access.

The companies say this won’t be a problem with the new implants, because they are specifically designed to be easy to put in. Flap surgery can take from three to 12 hours depending on the flap, but insertion of Lattice Medical’s implant, for example, takes only one hour and 15 minutes. “It’s really accessible to all plastic surgeons,” says Payen.

This accessibility will no doubt be crucial in taking the new implants from a cool technology to something with real impact. But from Potter’s perspective, it’s just one potential piece in a big puzzle, not a techno-fix. The implants “would be an option for a lot of women”, she says. “But I think the main advance is all around access, proper information, giving women choice and hopefully reducing the number of mastectomies that we need.”

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What to do about inherent security flaws in ICS? • The Register

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The latest threat security research into operational technology (OT) and industrial systems identified a bunch of issues — 56 to be exact — that criminals could use to launch cyberattacks against critical infrastructure. 

But many of them are unfixable, due to insecure protocols and architectural designs. And this highlights a larger security problem with devices that control electric grids and keep clean water flowing through faucets, according to some industrial cybersecurity experts.

“Industrial control systems have these inherent vulnerabilities,” Ron Fabela, CTO of OT cybersecurity firm SynSaber told The Register. “That’s just the way they were designed. They don’t have patches in the traditional sense like, oh, Windows has a vulnerability, apply this KB.”

In research published last week, Forescout’s Vedere Labs detailed 56 bugs in devices built by ten vendors and collectively named the security flaws OT:ICEFALL. 

As the report authors acknowledged, many of these holes are a result of OT products’ being built with no basic security controls. Indeed, Forescout’s analysis comes ten years after Digital Bond’s Project Basecamp that also looked at OT devices and protocols and deemed them “insecure by design.”

A few hours after Forescout published its research, CISA issued its own security warnings related to the OT:ICEFALL vulnerabilities.

CVEs: The problem? Or the fix?

“Up until this point, CVEs haven’t been generated for these insecure-by-design-things, and there’s a reason for that,” Fabela said. “It’s bad for the industry.”

Once a CVE is generated, it sets into motion a series of actions by industrial systems’ operators, especially in heavily regulated industries like electric utilities and oil and gas pipelines. 

First, they have to determine if the environment contains any affected products. But unlike enterprise IT, which usually has centralized visibility and control over IT assets, in OT environments, “everything is distributed,” Fabela noted.

If industrial and manufacturing environments do have any products impacted by the vulnerability, that triggers an internal review and regulatory process that involves responding to CISA and developing a plan to improve security.

One SynSaber customer sarcastically described OT:ICEFALL as “the gift that keeps on giving,” Fabela said. “He said, ‘Now I have this on top of all my other like, the real vulnerabilities’,” which present a slew of other problems when it comes to patching — such as having to wait until a planned maintenance outage that may be months out — if the manufacturer has a patch at all.

OT protocols don’t use authentication

For example: The current Modbus protocol, which is very commonly used in industrial environments, does not have authentication. 

Forescout’s analysis details nine vulnerabilities related to unauthenticated protocols and disputes the argument that against assigning a CVE ID to a product with an insecurity OT protocol.

“On the contrary, we believe a CVE is a community recognized marker that aids in vulnerability visibility and actionability by helping push vendors to fix issues and asset owners to assess risks and apply patches,” the authors wrote.

While this makes sense from an IT security perspective, Fabela said it’s unrealistic from an OT perspective, and ultimately doesn’t make critical infrastructure any more secure.

Modbus, as a protocol that does not use authentication, could generate “thousands” of CVEs that “affect every product line in the world,” he Fabela. “You’re tying up the product security teams with the OEMs and you’re tying up the customers, the asset owners with CVE that they can’t do anything about.” 

Basecamp researcher weighs in

Reid Wightman is a senior vulnerability researcher with OT security shop Dragos’ threat intel team. He’s also one of the original Project Basecamp researchers, and, more recently has done work on the ProConOs and MultiProg software vulnerabilities.

Forescout cited some of his research, and dedicated a section of the ICEFALL analysis to security flaws with the ProConOS runtime in PLCs.

In an email to The Register, Wightman noted that a lot of industrial controllers have the same set of problems that isn’t going away: “they allow unauthenticated code to run on the PLC.” 

“This means that one malicious logic transfer to the PLC may permanently compromise the PLC,” he added, noting that, because the control logic is causing the change, it can happen outside of a normal firmware update. “It’s kind of a thing I’ve harped on since the Basecamp days, but may be worth repeating. Over and over again. Until the sun burns out, probably.”

Lately, one of Wightman’s “big, personal concerns” is that some vendors say they can use TLS and client certificates to secure controllers, presumably to avoid. In reality, this would just make the traffic more difficult to inspect, Wightman said.

“If an attacker gets onto the engineering system, they may load a malicious payload using CVE-2022-31800/CVE-2022-31801 (or any of the similar problems that exist in almost every logic runtime) into the controller,” he added. “Only, now we have no way of telling whether they did it because the traffic is encrypted.”

So how do we fix the problem? 

“I guess my answer would be: if your engineering system is compromised, throw away all of the controllers that it was allowed to talk to,” Wightman said. “And I doubt most end users would go to that level of paranoia.”

Which, again, points to the insecure-by-design nature of how these systems are engineered.

“Thankfully, we see no signs of any widespread abuse of these protocols or ‘features’ in spite of some of the bugs being well-known for years,” Wightman added. “I really do hope it stays that way.” ®

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