1 00:00:05,760 --> 00:00:08,000 WELCOME, EVERYONE, TO THE 15th 2 00:00:08,000 --> 00:00:11,040 MEETING OF THE BRAIN NEUROETHICS 3 00:00:11,040 --> 00:00:12,800 WORKING GROUP, NEWG FOR SHORT. 4 00:00:12,800 --> 00:00:14,120 I WANT TO ESPECIALLY EXTEND A 5 00:00:14,120 --> 00:00:16,840 WARM WELCOME TO OUR WORKING 6 00:00:16,840 --> 00:00:18,480 GROUP CO-CHAIRS, DOCTORS NINA 7 00:00:18,480 --> 00:00:19,360 FARAHANY AND CHRISTINE GRADY, AS 8 00:00:19,360 --> 00:00:21,280 WELL AS ALL THE MEMBERS OF THE 9 00:00:21,280 --> 00:00:23,080 WORKING GROUP AND OUR INVITED 10 00:00:23,080 --> 00:00:26,720 SPEAKERS AND PANELISTS WHO ARE 11 00:00:26,720 --> 00:00:29,600 JOINING US TODAY. 12 00:00:29,600 --> 00:00:30,760 I'M ANDREA BECKEL-MITCHENER, 13 00:00:30,760 --> 00:00:34,240 DEPUTY DIRECTOR OF NIH BRAIN 14 00:00:34,240 --> 00:00:35,160 INITIATIVE, DESIGNATED FEDERAL 15 00:00:35,160 --> 00:00:36,240 OFFICIAL FOR TODAY'S MEETING. 16 00:00:36,240 --> 00:00:37,800 MOST OF YOU KNOW, THE 17 00:00:37,800 --> 00:00:40,200 NEUROETHICS WORKING GROUP IS NOT 18 00:00:40,200 --> 00:00:42,480 A FORMAL ADVISORY GROUP, LIKE 19 00:00:42,480 --> 00:00:43,480 "BRAIN"'S MULTI-COUNCIL WORKING 20 00:00:43,480 --> 00:00:44,280 GROUP. 21 00:00:44,280 --> 00:00:46,160 THE NEWG IS A WORKING GROUP OF 22 00:00:46,160 --> 00:00:48,720 THE ADVISORY COUNCILS OF THE TEN 23 00:00:48,720 --> 00:00:50,360 NIH INSTITUTES THAT PARTICIPATE 24 00:00:50,360 --> 00:00:51,920 IN THE BRAIN INITIATIVE, AND 25 00:00:51,920 --> 00:00:53,120 NEWG WAS ESTABLISHED BECAUSE OF 26 00:00:53,120 --> 00:00:55,440 THE NEED FOR INPUT ON 27 00:00:55,440 --> 00:00:56,280 NEUROETHICS CONSIDERATIONS 28 00:00:56,280 --> 00:00:57,160 RELATED TO THE RESEARCH 29 00:00:57,160 --> 00:00:59,600 SUPPORTED THROUGH THE BRAIN 30 00:00:59,600 --> 00:00:59,880 INITIATIVE. 31 00:00:59,880 --> 00:01:02,000 SO, THE NEWG WILL DELIBERATE ON 32 00:01:02,000 --> 00:01:03,080 ETHICAL QUESTIONS THAT COME UP 33 00:01:03,080 --> 00:01:05,040 IN THE CONTEXT OF BRAIN 34 00:01:05,040 --> 00:01:06,800 INITIATIVE RESEARCH AND CAN 35 00:01:06,800 --> 00:01:08,080 OFFER POINTS TO CONSIDER. 36 00:01:08,080 --> 00:01:10,200 TODAY WE ONCE AGAIN HAVE A 37 00:01:10,200 --> 00:01:12,440 VIRTUAL MEETING, AND SLIGHTLY 38 00:01:12,440 --> 00:01:13,280 ABRIDGED FORMAT, BUT WE'RE 39 00:01:13,280 --> 00:01:17,080 HOPEFUL WE'LL BE ABLE TO MEET IN 40 00:01:17,080 --> 00:01:17,960 PERSON AGAIN SOON. 41 00:01:17,960 --> 00:01:19,720 WE'LL TODAY HAVE AN UPDATE FROM 42 00:01:19,720 --> 00:01:21,280 THE "BRAIN" DIRECTOR ON THE NIH 43 00:01:21,280 --> 00:01:23,640 BRAIN INITIATIVE, WE'LL BEGIN 44 00:01:23,640 --> 00:01:24,960 WITH THAT, FOLLOWING THAT 45 00:01:24,960 --> 00:01:27,800 SPENDING TIME THINKING ABOUT 46 00:01:27,800 --> 00:01:28,440 HEALTH-RELATED TECHNOLOGIES THAT 47 00:01:28,440 --> 00:01:29,240 AFFECT THE BRAIN. 48 00:01:29,240 --> 00:01:31,520 FIRST BY HEARING ABOUT TWO 49 00:01:31,520 --> 00:01:32,960 RECENT CASE STUDIES, AFTER THE 50 00:01:32,960 --> 00:01:34,480 BREAK WE'LL BE LOOKING FORWARD 51 00:01:34,480 --> 00:01:36,600 TO THE DISCUSSION TO THINK ABOUT 52 00:01:36,600 --> 00:01:39,520 THE STARTING PLACE, IF ANY, FOR 53 00:01:39,520 --> 00:01:40,720 NEWG ENGAGEMENT ON 54 00:01:40,720 --> 00:01:42,440 HEALTH-RELATED APPLICATIONS OF 55 00:01:42,440 --> 00:01:44,000 TECHNOLOGIES THAT MAY AFFECT THE 56 00:01:44,000 --> 00:01:44,320 BRAIN. 57 00:01:44,320 --> 00:01:48,600 AND AS USUAL WE'LL WRAP UP THE 58 00:01:48,600 --> 00:01:50,240 OPEN SESSION BY HEARING ANY 59 00:01:50,240 --> 00:01:51,680 UPDATES FROM NEWG MEMBERS ON 60 00:01:51,680 --> 00:01:53,520 WHAT EVERYONE HAS BEEN UP TO IN 61 00:01:53,520 --> 00:01:55,160 THE NEUROETHICS SPACE. 62 00:01:55,160 --> 00:02:03,680 BEFORE WE GET STARTED A FEW 63 00:02:03,680 --> 00:02:06,760 HOUSEKEEPING ITEMS. 64 00:02:06,760 --> 00:02:10,920 THIS OPEN SESSION IS LIVE TO TO 65 00:02:10,920 --> 00:02:12,440 ARCHIVE LATER ON THE WEBSITES. 66 00:02:12,440 --> 00:02:13,960 PLEASE MUTE YOUR LINE AND TURN 67 00:02:13,960 --> 00:02:17,160 OFF YOUR VIDEO WHEN NOT 68 00:02:17,160 --> 00:02:17,440 SPEAKING. 69 00:02:17,440 --> 00:02:18,360 DURING DISCUSSIONS, FOR NEWG 70 00:02:18,360 --> 00:02:21,080 MEMBERS, PLEASE TURN ON YOUR 71 00:02:21,080 --> 00:02:22,480 VIDEO AND USE THE RAISE-HAND 72 00:02:22,480 --> 00:02:26,240 OPTION IF YOU HAVE QUESTIONS OR 73 00:02:26,240 --> 00:02:28,960 COMMENTS, YOU'LL BE CALLED ON 74 00:02:28,960 --> 00:02:33,880 UPON TO UNMUTE IN TURN. 75 00:02:33,880 --> 00:02:36,160 OPT FOR THE RAISE-HAND FUTURE SO 76 00:02:36,160 --> 00:02:37,480 VIDEOCAST ATTENDEES CAN HEAR AND 77 00:02:37,480 --> 00:02:38,680 SEE THE QUESTIONS. 78 00:02:38,680 --> 00:02:40,360 WE KNOW EVERYONE IS BUSY. 79 00:02:40,360 --> 00:02:42,200 WE REALLY APPRECIATE YOUR TIME 80 00:02:42,200 --> 00:02:44,320 AND VALUE YOUR INPUT TODAY. 81 00:02:44,320 --> 00:02:46,720 FINALLY, NONE OF THIS CAN HAPPEN 82 00:02:46,720 --> 00:02:48,400 WITHOUT THE FABULOUS TEAM HERE 83 00:02:48,400 --> 00:02:49,480 INCLUDING STAFF FROM ACROSS THE 84 00:02:49,480 --> 00:02:51,240 BRAIN INSTITUTES AS WELL AS 85 00:02:51,240 --> 00:02:52,520 COLLEAGUES HELPING WITH THE 86 00:02:52,520 --> 00:02:53,080 BROADCAST. 87 00:02:53,080 --> 00:02:57,560 I ESPECIALLY WANT TO THANK DR. 88 00:02:57,560 --> 00:03:02,080 NINA HSU, COMMITTEE SPECIALIST, 89 00:03:02,080 --> 00:03:04,640 WITH DR. SASKIA HENDRIKS, 90 00:03:04,640 --> 00:03:06,360 CONSULTANT, AND DR. JOHN NGAI, 91 00:03:06,360 --> 00:03:08,080 BRAIN DIRECTOR, FOR HIS SUPPORT 92 00:03:08,080 --> 00:03:09,200 OF NEUROETHICS BROADLY. 93 00:03:09,200 --> 00:03:11,680 I'M GOING TO TURN IT OVER TO ONE 94 00:03:11,680 --> 00:03:20,120 OF THE CO-CHAIRS, DR. GRADY. 95 00:03:20,120 --> 00:03:21,360 IT IS ALL YOURS. 96 00:03:21,360 --> 00:03:22,840 >>THANK YOU, AND WELCOME. 97 00:03:22,840 --> 00:03:24,280 I EXTEND MY THANK YOU AND 98 00:03:24,280 --> 00:03:25,960 WELCOME TO THE MEMBERS OF THE 99 00:03:25,960 --> 00:03:28,480 NEWG AND OUR INVITED SPEAKERS AS 100 00:03:28,480 --> 00:03:28,960 WELL. 101 00:03:28,960 --> 00:03:31,320 THANK YOU FOR BEING HERE TODAY. 102 00:03:31,320 --> 00:03:32,960 I KNOW EVERYBODY'S BUSY. 103 00:03:32,960 --> 00:03:35,200 WE HAVE A FULL AGENDA, AN 104 00:03:35,200 --> 00:03:35,720 EXCITING AGENDA. 105 00:03:35,720 --> 00:03:37,440 I THINK I'M REALLY LOOKING 106 00:03:37,440 --> 00:03:39,760 FORWARD TO OUR DISCUSSIONS AND 107 00:03:39,760 --> 00:03:40,600 DELIBERATIONS TODAY. 108 00:03:40,600 --> 00:03:42,240 BUT FIRST I JUST WANT TO TAKE A 109 00:03:42,240 --> 00:03:44,080 MINUTE TO RECOGNIZE THAT THIS IS 110 00:03:44,080 --> 00:03:46,400 THE FIRST MEETING OF THE 111 00:03:46,400 --> 00:03:48,280 NEUROETHICS WORKING GROUP WITH 112 00:03:48,280 --> 00:03:49,600 NINA FARAHANY AS OUR CO-CHAIR, 113 00:03:49,600 --> 00:03:51,240 AND I WANT TO RECOGNIZE PUBLICLY 114 00:03:51,240 --> 00:03:54,760 IT IS WONDERFUL TO HAVE HER AS A 115 00:03:54,760 --> 00:03:55,200 CO-CHAIR. 116 00:03:55,200 --> 00:03:56,200 WE'RE ALL VERY FORTUNATE. 117 00:03:56,200 --> 00:03:59,120 AS MANY OF YOU KNOW NINA IS THE 118 00:03:59,120 --> 00:03:59,680 ROBINSON O. EVERETT 119 00:03:59,680 --> 00:04:03,920 DISTINGUISHED PROFESSOR OF LAW 120 00:04:03,920 --> 00:04:06,160 AND PHILOSOPHY AT DUKE 121 00:04:06,160 --> 00:04:08,920 UNIVERSITY LAW SCHOOL, IMMEDIATE 122 00:04:08,920 --> 00:04:10,720 PAST PRESIDENT OF NEUROETHICS 123 00:04:10,720 --> 00:04:11,400 SOCIETY AND WEARS OTHER HATS IN 124 00:04:11,400 --> 00:04:13,720 ADDITION TO HER WORK WITH US 125 00:04:13,720 --> 00:04:14,560 WITH THE NEUROETHICS WORKING 126 00:04:14,560 --> 00:04:14,800 GROUP. 127 00:04:14,800 --> 00:04:16,560 TODAY SHE'S GOING TO LEAD OUR 128 00:04:16,560 --> 00:04:19,200 FIRST DISCUSSION ON THE VARIOUS 129 00:04:19,200 --> 00:04:20,800 HEALTH-RELATED WAYS THE BRAIN 130 00:04:20,800 --> 00:04:21,960 CAN BE AFFECTED. 131 00:04:21,960 --> 00:04:23,560 BUT BEFORE WE DO THAT, I'M GOING 132 00:04:23,560 --> 00:04:26,280 TO TURN IT OVER TO JOHN NGAI, 133 00:04:26,280 --> 00:04:28,680 THE BRAIN DIRECTOR, TO GIVE US 134 00:04:28,680 --> 00:04:30,760 HIS UPDATE ON BRAIN INITIATIVE. 135 00:04:30,760 --> 00:04:31,320 THANK YOU, JOHN. 136 00:04:31,320 --> 00:04:34,200 >>THANKS VERY MUCH, CHRISTINE. 137 00:04:34,200 --> 00:04:35,280 WELCOME TO ALL. 138 00:04:35,280 --> 00:04:38,800 DELIGHTED TO HAVE YOU ALL HERE. 139 00:04:38,800 --> 00:04:41,400 ALSO WELCOMING OUR NEWG 140 00:04:41,400 --> 00:04:42,680 CO-CHAIR, DR. NINA FARAHANY. 141 00:04:42,680 --> 00:04:45,040 THE LUNAR NEW YEAR IS OFF TO A 142 00:04:45,040 --> 00:04:47,960 ROCKY START BUT I WISH YOU ALL A 143 00:04:47,960 --> 00:04:50,600 HAPPIER AND PROSPEROUS YEAR OF 144 00:04:50,600 --> 00:04:50,920 THE RABBIT. 145 00:04:50,920 --> 00:04:54,680 SO LET'S SEE IF I CAN DO THIS 146 00:04:54,680 --> 00:04:54,960 CORRECTLY. 147 00:04:54,960 --> 00:04:56,600 I JUST HAVE A FEW BRIEF COMMENTS 148 00:04:56,600 --> 00:04:59,720 AS CRITICAL CONDITION -- 149 00:04:59,720 --> 00:05:01,880 CHRISTINE SAID, WE HAVE A PACKED 150 00:05:01,880 --> 00:05:03,000 AGENDA. 151 00:05:03,000 --> 00:05:04,200 ARE WE SEEING THE CORRECT 152 00:05:04,200 --> 00:05:05,400 SCREEN, FOLKS? 153 00:05:05,400 --> 00:05:06,160 YES, NO? 154 00:05:06,160 --> 00:05:07,040 >>YES, LOOKS GOOD. 155 00:05:07,040 --> 00:05:08,280 >>PERFECT. 156 00:05:08,280 --> 00:05:10,480 >>A QUICK UPDATE, OF WHAT'S 157 00:05:10,480 --> 00:05:13,360 HAPPENING IN AND AROUND 158 00:05:13,360 --> 00:05:15,440 NEUROETHICS AND BRAIN, I WANT TO 159 00:05:15,440 --> 00:05:18,160 CALL YOUR ATTENTION TO THIS CALL 160 00:05:18,160 --> 00:05:20,240 FOR SUPPLEMENT APPLICATIONS, NOT 161 00:05:20,240 --> 00:05:20,880 FROM THE BRAIN INITIATIVE PER 162 00:05:20,880 --> 00:05:23,520 SE, BUT FROM THE NIH'S OFFICE OF 163 00:05:23,520 --> 00:05:25,480 SCIENCE POLICY OUT OF THE OFFICE 164 00:05:25,480 --> 00:05:28,640 OF DIRECTOR, WHICH IS SEEKENING 165 00:05:28,640 --> 00:05:31,640 APPLICATIONS FOR SUPPLEMENTS TO 166 00:05:31,640 --> 00:05:32,840 CURRENTLY FUNDED AWARDS, 167 00:05:32,840 --> 00:05:34,800 INCLUDING BRAIN INITIATIVE 168 00:05:34,800 --> 00:05:37,640 FUNDED AWARDS, WHERE THE AIM IS 169 00:05:37,640 --> 00:05:41,800 ENHANCE IMPACT OF CURRENTLY 170 00:05:41,800 --> 00:05:42,480 FUNDED PROJECTS INTEGRATING 171 00:05:42,480 --> 00:05:43,240 BIOETHICS PERSPECTIVES AND 172 00:05:43,240 --> 00:05:44,080 APPROACHES INTO THEM. 173 00:05:44,080 --> 00:05:45,960 HERE AT BRAIN WE FUND ALL KINDS 174 00:05:45,960 --> 00:05:49,760 OF DIFFERENT PROJECTS THAT COULD 175 00:05:49,760 --> 00:05:51,960 BE HIGHLY RELEVANT FOR SUCH A 176 00:05:51,960 --> 00:05:52,400 SUPPLEMENT. 177 00:05:52,400 --> 00:05:54,280 WE'VE TALKED HERE AND ELSEWHERE 178 00:05:54,280 --> 00:05:55,760 ABOUT THE ETHICAL IMPLICATIONS 179 00:05:55,760 --> 00:06:00,600 OF ACCESS AND USE OF EMERGING 180 00:06:00,600 --> 00:06:01,160 AND LEADING EDGE 181 00:06:01,160 --> 00:06:02,600 NEUROTECHNOLOGIES, HOW THEY 182 00:06:02,600 --> 00:06:06,520 RELATE TO IMPORTANT ISSUES OF 183 00:06:06,520 --> 00:06:06,920 INFORMED CONSENT. 184 00:06:06,920 --> 00:06:09,360 ONE EXAMPLE, WE'VE TALKED ABOUT 185 00:06:09,360 --> 00:06:12,200 THE BARRIERS TO ACCESS THAT 186 00:06:12,200 --> 00:06:13,960 INVOLVE VARIOUS FACTORS 187 00:06:13,960 --> 00:06:15,280 INCLUDING CULTURAL DIFFERENCES 188 00:06:15,280 --> 00:06:17,360 AND SOCIOECONOMIC FACTORS. 189 00:06:17,360 --> 00:06:20,200 WE ALSO HAVE TALKED ABOUT 190 00:06:20,200 --> 00:06:21,640 RESEARCH ON LONG-TERM 191 00:06:21,640 --> 00:06:25,920 OBLIGATIONS, OR POST OR 192 00:06:25,920 --> 00:06:26,680 CONTINUING OBLIGATIONS AND I'LL 193 00:06:26,680 --> 00:06:29,320 TOUCH ON THAT IN A MOMENT IN A 194 00:06:29,320 --> 00:06:31,080 DIFFERENT CONTEXT, AND VERY 195 00:06:31,080 --> 00:06:33,480 IMPORTANT CROSSING SUBJECTS, THE 196 00:06:33,480 --> 00:06:36,280 ISSUE OF WHAT IT MEANS TO START 197 00:06:36,280 --> 00:06:38,040 COLLECTING OR TO BE COLLECTING 198 00:06:38,040 --> 00:06:40,800 HUMAN NEURAL DATA AND WHAT CAN 199 00:06:40,800 --> 00:06:43,560 WE DO TO ASSURE SAFETY AND 200 00:06:43,560 --> 00:06:45,080 PRIVACY AND GUARD AGAINST 201 00:06:45,080 --> 00:06:46,440 UNINTENDED USES. 202 00:06:46,440 --> 00:06:50,040 SO THESE ARE ROLLING SUBMISSION 203 00:06:50,040 --> 00:06:51,120 APPLICATIONS, REVIEW WILL TAKE 204 00:06:51,120 --> 00:06:52,680 PLACE SOON SO THESE ARE DUE 205 00:06:52,680 --> 00:06:53,240 FEBRUARY 17. 206 00:06:53,240 --> 00:06:54,640 YOU DON'T HAVE A WHOLE LOT OF 207 00:06:54,640 --> 00:06:56,640 TIME BUT IF YOU'RE INTERESTED I 208 00:06:56,640 --> 00:06:58,040 WOULD DEFINITELY LOOK INTO THIS. 209 00:06:58,040 --> 00:06:59,920 THE IDEA IS SUPPORT RESEARCH 210 00:06:59,920 --> 00:07:01,200 ABOUT BOTH ETHICAL ISSUES TO 211 00:07:01,200 --> 00:07:04,400 DEVELOP OR SUPPORT AND EVIDENCE 212 00:07:04,400 --> 00:07:05,800 BASE TO INFORM FUTURE POLICY 213 00:07:05,800 --> 00:07:08,120 DECISIONS OR BE USED TO DEVELOP 214 00:07:08,120 --> 00:07:10,080 OTHER AUGMENT BIOETHICS RESEARCH 215 00:07:10,080 --> 00:07:10,560 CAPACITY. 216 00:07:10,560 --> 00:07:15,800 HERE AT BRAIN WE DO SUPPORT 217 00:07:15,800 --> 00:07:17,760 SCHOLARLY WORK IN THE 218 00:07:17,760 --> 00:07:18,440 NEUROETHICS FIELD. 219 00:07:18,440 --> 00:07:19,920 CHALLENGES IN MANY AREAS OF WHAT 220 00:07:19,920 --> 00:07:22,480 WE DO, THIS IS REALLY A GREAT 221 00:07:22,480 --> 00:07:26,040 OPPORTUNITY FOR SOME OF OUR 222 00:07:26,040 --> 00:07:26,480 BRAIN INVESTIGATORS. 223 00:07:26,480 --> 00:07:28,040 WE'RE INTERESTED AT NIH IN 224 00:07:28,040 --> 00:07:32,320 MAKING AN INVESTMENT IN 225 00:07:32,320 --> 00:07:33,720 INTEGRATING BIOET ETHICS 226 00:07:33,720 --> 00:07:37,120 RESEARCH TO FACILITATE PUBLIC 227 00:07:37,120 --> 00:07:38,760 ENGAGEMENT AND PARTICIPATION 228 00:07:38,760 --> 00:07:39,280 BUILDING THERE'S WITH THE 229 00:07:39,280 --> 00:07:40,040 RESEARCH ENTERPRISE. 230 00:07:40,040 --> 00:07:41,600 TAKE A LOOK AT THAT IF YOU'RE 231 00:07:41,600 --> 00:07:41,920 INTERESTED. 232 00:07:41,920 --> 00:07:43,520 FOR YOU FOLKS WITH CURRENTLY 233 00:07:43,520 --> 00:07:44,680 FUNDED BRAIN GRANTS THIS IS A 234 00:07:44,680 --> 00:07:45,440 GREAT OPPORTUNITY TO SUPPLEMENT 235 00:07:45,440 --> 00:07:46,240 YOUR WORK. 236 00:07:46,240 --> 00:07:47,920 IT HAS TO BE WITHIN THE SCOPE OF 237 00:07:47,920 --> 00:07:49,840 THE GENERAL SCOPE OF THE CURRENT 238 00:07:49,840 --> 00:07:51,760 AWARDS AS WITH ANY SUPPLEMENT 239 00:07:51,760 --> 00:07:52,880 TYPE OF PROJECT, BUT REALLY 240 00:07:52,880 --> 00:07:54,880 COULD BE A GREAT OPPORTUNITY TO 241 00:07:54,880 --> 00:07:56,040 EXPAND YOUR PROJECT IN AN 242 00:07:56,040 --> 00:08:02,520 INTERESTING AND VERY IMPORTANT 243 00:08:02,520 --> 00:08:03,080 WAY. 244 00:08:03,080 --> 00:08:04,200 I MENTIONED CONTINUING TRIAL 245 00:08:04,200 --> 00:08:05,240 RESPONSIBILITIES, THIS IS AN 246 00:08:05,240 --> 00:08:06,920 ISSUE AROUND WHAT HAPPENS AFTER 247 00:08:06,920 --> 00:08:10,720 A TRIAL IS OVER OR SOMETHING 248 00:08:10,720 --> 00:08:11,800 HAPPENS WHERE THE MANUFACTURERS 249 00:08:11,800 --> 00:08:14,000 OR FOLKS THAT ARE PARTICIPATING 250 00:08:14,000 --> 00:08:15,800 IN THE STUDIES AS RESEARCHERS 251 00:08:15,800 --> 00:08:20,920 ARE NO LONGER AVAILABLE. 252 00:08:20,920 --> 00:08:23,760 AND PARTICULARLY ACUTE CASE OF 253 00:08:23,760 --> 00:08:25,480 POST TRIAL RESPONSIBILITIES 254 00:08:25,480 --> 00:08:26,680 INVOLVES SO CALLED INTRACRANIAL 255 00:08:26,680 --> 00:08:28,600 APPROACHES WHERE WE'RE ACTUALLY 256 00:08:28,600 --> 00:08:31,520 PLACING ELECTRODES AND SUCH IN 257 00:08:31,520 --> 00:08:33,080 PEOPLE'S BRAINS. 258 00:08:33,080 --> 00:08:34,720 WE HELD A WORKSHOP, OH GOSH, 259 00:08:34,720 --> 00:08:37,880 ALREADY BACK IN MAY OF 2022, AND 260 00:08:37,880 --> 00:08:39,840 WE BROUGHT IN WHAT WE FELT WERE 261 00:08:39,840 --> 00:08:41,720 ALL THE STAKE HOLDERS WHO NEEDED 262 00:08:41,720 --> 00:08:43,240 TO BE INVOLVED IN THIS 263 00:08:43,240 --> 00:08:46,000 DISCUSSION ABOUT HOW TO CARE FOR 264 00:08:46,000 --> 00:08:48,160 OUR PATIENTS, OUR HUMAN 265 00:08:48,160 --> 00:08:50,240 PARTNERS, IN THESE ENDEAVORS. 266 00:08:50,240 --> 00:08:52,120 AND WE INCLUDED DEVICE 267 00:08:52,120 --> 00:08:53,120 MANUFACTURERS, INVESTIGATORS, 268 00:08:53,120 --> 00:08:55,000 THE RESEARCHERS THEMSELVES AND 269 00:08:55,000 --> 00:08:57,400 THE SURGEONS, ALSO FOLKS FROM 270 00:08:57,400 --> 00:08:59,240 THE REGULATORY SIDE, PATIENT 271 00:08:59,240 --> 00:08:59,480 ADVOCATES. 272 00:08:59,480 --> 00:09:01,520 I MEAN, THE PATIENTS AND 273 00:09:01,520 --> 00:09:03,080 ADVOCATES, THE MOST IMPORTANT 274 00:09:03,080 --> 00:09:05,360 VOICE IN THE ROOM ARGUABLY COMES 275 00:09:05,360 --> 00:09:07,440 FROM THE FOLKS BEING TESTED WITH 276 00:09:07,440 --> 00:09:09,200 THESE NEW DEVICES AND 277 00:09:09,200 --> 00:09:09,760 TREATMENTS. 278 00:09:09,760 --> 00:09:12,040 AND THEIR CAREGIVERS AND 279 00:09:12,040 --> 00:09:12,400 FAMILIES. 280 00:09:12,400 --> 00:09:13,480 INSURANCE PROVIDERS, WE HAD 281 00:09:13,480 --> 00:09:16,080 FOLKS FROM DIFFERENT FEDERAL 282 00:09:16,080 --> 00:09:18,520 AGENCIES, REALLY TO SEE HOW BEST 283 00:09:18,520 --> 00:09:20,600 TO COVER THE RESPONSIBILITIES 284 00:09:20,600 --> 00:09:24,360 THAT WE HAVE FOR THESE PATIENTS 285 00:09:24,360 --> 00:09:25,640 AND RESEARCH PARTICIPANTS, AND 286 00:09:25,640 --> 00:09:27,400 THERE WAS A CONSENSUS THAT THERE 287 00:09:27,400 --> 00:09:29,680 WAS A NEED, LESS OF A CONSENSUS 288 00:09:29,680 --> 00:09:32,840 ABOUT WHO ACTUALLY WOULD BE 289 00:09:32,840 --> 00:09:35,280 RESPONSIBLE FOR THESE DIFFERENT 290 00:09:35,280 --> 00:09:36,320 POST-TRIAL OR CONTINUING TRIAL 291 00:09:36,320 --> 00:09:39,640 NEEDS, BUT I THINK WE MADE GRADE 292 00:09:39,640 --> 00:09:41,160 HEADWAY IN IDENTIFYING THE 293 00:09:41,160 --> 00:09:42,040 ISSUES. 294 00:09:42,040 --> 00:09:43,920 WE I THINK CAME TO -- AT LEAST I 295 00:09:43,920 --> 00:09:45,200 CAME TO THE CONCLUSION THAT WE 296 00:09:45,200 --> 00:09:49,360 NEEDED TO MOVE THE NEEDLE 297 00:09:49,360 --> 00:09:51,120 SOMEWHAT, IF NOT TO PERFECTION 298 00:09:51,120 --> 00:09:52,640 AT LEAST TOWARD PERFECTION. 299 00:09:52,640 --> 00:09:55,200 RIGHT NOW THE CONVERSATIONS ARE 300 00:09:55,200 --> 00:09:55,520 ONGOING. 301 00:09:55,520 --> 00:09:58,880 WE HAVE FORMED -- WE MEANING THE 302 00:09:58,880 --> 00:10:00,360 OFFICE OF SCIENCE POLICY, OFFICE 303 00:10:00,360 --> 00:10:02,400 OF EXTRAMURAL RESEARCH AT NIH, 304 00:10:02,400 --> 00:10:03,440 HAS ACTUALLY FORMED A WORKING 305 00:10:03,440 --> 00:10:06,040 GROUP TO REALLY EXAMINE WHAT WE 306 00:10:06,040 --> 00:10:08,080 CAN AND CANNOT DO TO MAKE THIS A 307 00:10:08,080 --> 00:10:11,040 BETTER SITUATION SO THAT WE CAN 308 00:10:11,040 --> 00:10:13,320 ASSURE THAT THE FOLKS WHO 309 00:10:13,320 --> 00:10:14,520 PARTICIPATE IN THESE TRIALS ARE 310 00:10:14,520 --> 00:10:16,640 PROPERLY CARED FOR TO THE BEST 311 00:10:16,640 --> 00:10:17,640 OF OUR ABILITIES. 312 00:10:17,640 --> 00:10:18,400 STAY TUNED. 313 00:10:18,400 --> 00:10:19,960 WE'RE WORKING ON THIS LONG 314 00:10:19,960 --> 00:10:20,160 PROCESS. 315 00:10:20,160 --> 00:10:22,560 IT'S A COMPLEX SET OF ISSUES 316 00:10:22,560 --> 00:10:26,600 THAT NOT ONLY INVOLVE INVASIVE 317 00:10:26,600 --> 00:10:30,720 BRAIN IMPLANTS BUT ALSO REALLY 318 00:10:30,720 --> 00:10:32,240 IN PRINCIPAL ALSO AFFECTS MANY 319 00:10:32,240 --> 00:10:32,880 OTHER KINDS OF CLINICAL TRIALS. 320 00:10:32,880 --> 00:10:33,480 STAY TUNED. 321 00:10:33,480 --> 00:10:35,000 WE'RE HARD AT WORK ON THIS AND 322 00:10:35,000 --> 00:10:36,840 APPRECIATE INPUT FROM ALL THE 323 00:10:36,840 --> 00:10:38,400 STAKEHOLDERS WE'VE RECEIVED SO 324 00:10:38,400 --> 00:10:38,880 FAR. 325 00:10:38,880 --> 00:10:40,480 I THOUGHT I WOULD TOUCH VERY, 326 00:10:40,480 --> 00:10:44,080 VERY BRIEFLY ON SOME COOL 327 00:10:44,080 --> 00:10:45,280 SCIENCE THAT HAS ETHICAL 328 00:10:45,280 --> 00:10:47,280 IMPLICATIONS IN THE BRAIN SPACE, 329 00:10:47,280 --> 00:10:47,920 AS IT WERE. 330 00:10:47,920 --> 00:10:49,120 I DON'T KNOW THAT WE'LL HAVE 331 00:10:49,120 --> 00:10:51,960 MUCH TIME TO DIVE IN. 332 00:10:51,960 --> 00:10:53,160 THE SECOND CASE I'LL TALK ABOUT 333 00:10:53,160 --> 00:10:54,800 ACTUALLY IS VERY MUCH RELEVANT 334 00:10:54,800 --> 00:10:57,120 TO THE DISCUSSION WE'LL HAVE IN 335 00:10:57,120 --> 00:10:57,760 A MOMENT. 336 00:10:57,760 --> 00:11:07,920 HERE IS JUST A PAPER FROM THE 337 00:11:07,920 --> 00:11:11,080 DEVORE AND KUZUM LOOKING AT 338 00:11:11,080 --> 00:11:11,720 ORGANOIDS IMPLANTED INTO ADULT 339 00:11:11,720 --> 00:11:12,280 STAGE MICE. 340 00:11:12,280 --> 00:11:14,360 THERE ARE A COUPLE COOL THINGS. 341 00:11:14,360 --> 00:11:17,240 ONE IS THAT THEY DID IT AND USED 342 00:11:17,240 --> 00:11:20,720 VARIOUS MEASURES TO SHOW THAT 343 00:11:20,720 --> 00:11:23,040 THESE HUMAN-DERIVED BRAIN 344 00:11:23,040 --> 00:11:24,920 ORGANOIDS COULD ACTUALLY 345 00:11:24,920 --> 00:11:25,880 INCORPORATE INTO A MOUSE BRAIN 346 00:11:25,880 --> 00:11:28,080 AND BECOME PART OF THE LOCAL 347 00:11:28,080 --> 00:11:31,000 NETWORK, AND THE OTHER COOL 348 00:11:31,000 --> 00:11:32,120 THING WAS TECHNOLOGY I BELIEVED 349 00:11:32,120 --> 00:11:34,200 DEVELOPED BY THE DEVORE LAB 350 00:11:34,200 --> 00:11:35,760 WHERE THEY DEVELOPED THIS 351 00:11:35,760 --> 00:11:38,040 OPTICALLY CLEAR ELECTRODE THEY 352 00:11:38,040 --> 00:11:38,880 COULD PLACE OVER THE IMPLANT 353 00:11:38,880 --> 00:11:40,240 INCLUDING PART OF THE 354 00:11:40,240 --> 00:11:41,800 SURROUNDING TISSUE, SO THEY 355 00:11:41,800 --> 00:11:44,960 COULD ACTUALLY LOOK TO SEE HOW 356 00:11:44,960 --> 00:11:49,320 WELL THIS ORGANOID IMPLANT COULD 357 00:11:49,320 --> 00:11:51,720 INCORPORATE INTO THE RECIPIENT 358 00:11:51,720 --> 00:11:52,720 BRAIN PHYSIOLOGICALLY, 359 00:11:52,720 --> 00:11:55,040 ELECTRICALLY, AND COMPARE IT TO 360 00:11:55,040 --> 00:11:57,680 THE SURROUNDING TISSUE. 361 00:11:57,680 --> 00:11:58,760 SO, TECHNICAL INNOVATIONS FROM 362 00:11:58,760 --> 00:12:04,240 THE BIOLOGY SIDE AS WELL AS 363 00:12:04,240 --> 00:12:04,560 TECHNOLOGY -- 364 00:12:04,560 --> 00:12:10,040 ELECTROPHYSIOLOGICAL TECHNOLOGY 365 00:12:10,040 --> 00:12:13,240 SIDE WITH GRAPHINE 366 00:12:13,240 --> 00:12:14,240 MICROELECTRODES, SHOWING THE 367 00:12:14,240 --> 00:12:15,520 ORGANOIDS INCORPORATE 368 00:12:15,520 --> 00:12:17,040 FUNCTIONALLY INTO SURROUNDING 369 00:12:17,040 --> 00:12:18,320 TISSUE, AND ACTUALLY 370 00:12:18,320 --> 00:12:19,680 VASCULARIZED AND SHOW OTHER 371 00:12:19,680 --> 00:12:23,720 FEATURES OF INTEGRATION BASED ON 372 00:12:23,720 --> 00:12:24,760 BIOCHEMICAL MARKERS. 373 00:12:24,760 --> 00:12:27,280 NOW, IT'S NOT PERFECT. 374 00:12:27,280 --> 00:12:27,960 BUT IT'S ACTUALLY SHOWING -- 375 00:12:27,960 --> 00:12:30,320 THIS COULD BE A GREAT SYSTEM FOR 376 00:12:30,320 --> 00:12:31,000 UNDERSTANDING HOW THESE 377 00:12:31,000 --> 00:12:32,960 ORGANOIDS CAN FUNCTION AND MAYBE 378 00:12:32,960 --> 00:12:35,040 ONE DAY BE USED FOR LOCAL 379 00:12:35,040 --> 00:12:36,280 REPAIR. 380 00:12:36,280 --> 00:12:43,240 NOW, THESE WERE IMPLANTED INTO 381 00:12:43,240 --> 00:12:45,640 THE CORTEX, RESPONDING TO VISUAL 382 00:12:45,640 --> 00:12:49,160 STIMULI PROBABLY FROM LOCAL 383 00:12:49,160 --> 00:12:50,040 CONDUCTIVITY, NOT INPUT FROM 384 00:12:50,040 --> 00:12:51,680 SENSOR STREAM THROUGH THE 385 00:12:51,680 --> 00:12:54,280 THALAMUS, THESE WERE PLACED INTO 386 00:12:54,280 --> 00:12:56,840 ADULT MICE WHERE IT'S SHOWN IN 387 00:12:56,840 --> 00:13:00,120 SEPARATE STUDIES THAT LOCAL 388 00:13:00,120 --> 00:13:01,320 NEUROGENESIS PROBABLY ALSO ONLY 389 00:13:01,320 --> 00:13:02,080 INVOLVES LOCAL INTERACTIONS. 390 00:13:02,080 --> 00:13:06,120 IT'S IMPORTANT TO NOTE A SIMILAR 391 00:13:06,120 --> 00:13:07,760 STUDY FROM SERGIO'S LAB AT 392 00:13:07,760 --> 00:13:09,400 STANFORD CAME OUT END OF LAST 393 00:13:09,400 --> 00:13:12,160 YEAR WHICH LOOKED AT THE 394 00:13:12,160 --> 00:13:17,960 INCORPORATION OF HUMAN ORGANOIDS 395 00:13:17,960 --> 00:13:19,600 INTO NOW NEONATAL BRANDS, THEY 396 00:13:19,600 --> 00:13:21,800 INCORPORATE INTO THE CIRCUIT, IN 397 00:13:21,800 --> 00:13:24,640 THAT CASE THEY DO RECEIVE INPUT 398 00:13:24,640 --> 00:13:26,080 FROM THE THALAMUS AS THIS PART 399 00:13:26,080 --> 00:13:27,680 OF THE CORTEX NORMALLY WOULD, 400 00:13:27,680 --> 00:13:32,320 BUT VERY IMPORTANTLY WHAT THEY 401 00:13:32,320 --> 00:13:33,680 DID SHOW UNTIL THESE ORGANOIDS 402 00:13:33,680 --> 00:13:35,120 WERE IMPLANTED INTO A HOST 403 00:13:35,120 --> 00:13:37,200 RECIPIENT, IN THAT CASE A RAT, 404 00:13:37,200 --> 00:13:39,560 THEY DID NOT SHOW FULL 405 00:13:39,560 --> 00:13:41,360 MATURATION OF THE NEURONS OR 406 00:13:41,360 --> 00:13:42,040 OTHER CELLS. 407 00:13:42,040 --> 00:13:45,000 ORGANOIDS ARE A GREAT MODEL 408 00:13:45,000 --> 00:13:46,600 SYSTEM FOR STUDYING HUMAN BRAIN 409 00:13:46,600 --> 00:13:47,720 TISSUE AND HUMAN BRAIN CELL 410 00:13:47,720 --> 00:13:49,600 TYPES, BUT WE STILL ARE NOT AT 411 00:13:49,600 --> 00:13:51,320 THE STAGE WHERE THEY SERVE AS A 412 00:13:51,320 --> 00:13:52,000 PERFECT MODEL. 413 00:13:52,000 --> 00:13:53,520 THERE'S NO SUCH THING AS PERFECT 414 00:13:53,520 --> 00:13:55,400 MODEL, BUT A PERFECT MODEL FOR 415 00:13:55,400 --> 00:13:56,360 THE MATURE STATE. 416 00:13:56,360 --> 00:14:01,840 WE HAVE A WAYS TO GO BUT CAN 417 00:14:01,840 --> 00:14:03,160 HOPEFULLY LEARN GREAT LESSONS 418 00:14:03,160 --> 00:14:04,880 FROM THE ORGANIZE TO BE A 419 00:14:04,880 --> 00:14:05,760 POWERFUL SYSTEM FOR 420 00:14:05,760 --> 00:14:07,960 UNDERSTANDING THE HUMAN BIOLOGY 421 00:14:07,960 --> 00:14:09,600 OF THE BRAIN. 422 00:14:09,600 --> 00:14:10,920 SO CLOSER TO OUR DISCUSSION 423 00:14:10,920 --> 00:14:17,920 THAT'S COMING UP IS THIS PILOT 424 00:14:17,920 --> 00:14:21,520 STUDY, LOOKING AT THE USE OF 425 00:14:21,520 --> 00:14:22,520 ADAPTIVE OR RESPONSIVE DBS FOR 426 00:14:22,520 --> 00:14:24,800 EATING CONTROL. 427 00:14:24,800 --> 00:14:31,320 HERE IS A CASE STUDY SHOWING TWO 428 00:14:31,320 --> 00:14:35,960 PATIENTS WHO HAD LOSS OF CONTROL 429 00:14:35,960 --> 00:14:37,960 EATING THAT RESULTED IN BINGE 430 00:14:37,960 --> 00:14:38,680 EATING DISORDER. 431 00:14:38,680 --> 00:14:41,000 WHAT THEY DID HERE IS THEY 432 00:14:41,000 --> 00:14:42,320 RECORDED FROM THE NUCLEUS 433 00:14:42,320 --> 00:14:46,840 ACCUMBENS OF THE TWO PATIENTS 434 00:14:46,840 --> 00:14:52,400 AND IDENTIFIED PHYSIOLOGIC 435 00:14:52,400 --> 00:14:53,800 SIGNATURED THAT PRECEDED BINGE 436 00:14:53,800 --> 00:14:55,680 EAT AND COULD SEE INCREASE IN 437 00:14:55,680 --> 00:14:59,640 POWER OF LOW FREQUENC 438 00:14:59,640 --> 00:15:01,920 OSCILLATION AND USE THAT AS 439 00:15:01,920 --> 00:15:05,440 TRIGGER TO STIMULATE IN THE 440 00:15:05,440 --> 00:15:06,320 NUCLEUS ACCUMBENS AND SHOW IN 441 00:15:06,320 --> 00:15:08,080 THESE TWO PATIENTS INCREASE IN 442 00:15:08,080 --> 00:15:09,480 SELF-CONTROL FOR BINGE EATING 443 00:15:09,480 --> 00:15:10,800 BUT NOT NORMAL EATING, ALSO 444 00:15:10,800 --> 00:15:13,000 WEIGHT LOSS WHERE THEY DIDN'T 445 00:15:13,000 --> 00:15:15,320 ACTUALLY INSTRUCT THE PATIENTS 446 00:15:15,320 --> 00:15:16,920 TO GO THROUGH OTHER STRATEGIES 447 00:15:16,920 --> 00:15:20,280 FOR WEIGHT LOSS. 448 00:15:20,280 --> 00:15:22,280 AGAIN, JUST A CASE STUDY WITH 449 00:15:22,280 --> 00:15:26,000 TWO PATIENTS, THEY KNOW THE 450 00:15:26,000 --> 00:15:27,320 CHALLENGES IN TRAINING THE 451 00:15:27,320 --> 00:15:28,800 PATIENTS IN THE SETTING IN THE 452 00:15:28,800 --> 00:15:30,000 LAB VERSUS REAL WORLD SETTING, 453 00:15:30,000 --> 00:15:33,120 AND THIS IS AN ISSUE WITH THESE 454 00:15:33,120 --> 00:15:35,440 ADAPTIVE DBS STUDIES, BUT ARE 455 00:15:35,440 --> 00:15:37,160 REALLY MAYBE POINTING THE WAY TO 456 00:15:37,160 --> 00:15:44,280 POWER OF USING THESE KINDS OF 457 00:15:44,280 --> 00:15:47,560 NEUROMODULATORY APPROACHES, 458 00:15:47,560 --> 00:15:48,760 PERSONALIZED NEUROMODULATORY 459 00:15:48,760 --> 00:15:50,000 APPROACHES, TO AFFECT 460 00:15:50,000 --> 00:15:51,520 INDIVIDUALS WITH SUCH DISORDERS. 461 00:15:51,520 --> 00:15:53,160 NOW, THIS IS OPENS YOU WILL A 462 00:15:53,160 --> 00:15:55,120 WHOLE HOST OF ETHICAL 463 00:15:55,120 --> 00:15:57,320 CONSIDERATIONS ABOUT HOW WE 464 00:15:57,320 --> 00:15:59,480 AFFECT THE BRAIN, WITH THESE 465 00:15:59,480 --> 00:16:00,240 NEUROMODULATION TECHNIQUES, 466 00:16:00,240 --> 00:16:02,120 WHETHER THEY BE INVASIVE IN THE 467 00:16:02,120 --> 00:16:04,720 CASE HERE WITH USING DEEP BRAIN 468 00:16:04,720 --> 00:16:05,960 STIMULATION, OR NON-INVASIVELY 469 00:16:05,960 --> 00:16:07,840 AS WE'LL SEE USING OTHER 470 00:16:07,840 --> 00:16:09,120 TECHNIQUES INCLUDING AS WE'LL 471 00:16:09,120 --> 00:16:12,000 ALSO LEARN IN A BIT VIRTUAL 472 00:16:12,000 --> 00:16:12,240 REALITY. 473 00:16:12,240 --> 00:16:14,080 SO THIS WILL BE SURE A TOPIC OF 474 00:16:14,080 --> 00:16:15,160 GREAT DISCUSSION IN THE NEXT 475 00:16:15,160 --> 00:16:15,920 HOUR OR SO. 476 00:16:15,920 --> 00:16:17,680 BEFORE WE GET THERE I JUST WANT 477 00:16:17,680 --> 00:16:19,680 TO REMIND EVERYBODY TO SAVE THE 478 00:16:19,680 --> 00:16:21,720 DATE FOR THE 9th ANNUAL BRAIN 479 00:16:21,720 --> 00:16:23,720 INITIATIVE MEETING, WHICH IS 480 00:16:23,720 --> 00:16:25,000 SCHEDULED FOR JUNE 12 AND 13. 481 00:16:25,000 --> 00:16:26,200 YOU'LL SEE AN INITIAL 482 00:16:26,200 --> 00:16:27,960 ANNOUNCEMENT I HOPE SOON ONCE WE 483 00:16:27,960 --> 00:16:29,280 GET THE PAPERWORK STRAIGHTENED 484 00:16:29,280 --> 00:16:29,720 OUT. 485 00:16:29,720 --> 00:16:30,920 SO THIS IS NOT ETCHED IN STONE 486 00:16:30,920 --> 00:16:33,800 BUT IF YOU USE A VERY DARK TYPE 487 00:16:33,800 --> 00:16:36,320 1 PENCIL TO PUT IN YOUR 488 00:16:36,320 --> 00:16:37,600 CALENDAR, PLEASE MARK THE DATE 489 00:16:37,600 --> 00:16:39,720 OF JUNE 12 AND 13, MORE 490 00:16:39,720 --> 00:16:41,240 INFORMATION FORTHCOMING, AND YOU 491 00:16:41,240 --> 00:16:42,440 CAN LEARN MORE ABOUT THE BRAIN 492 00:16:42,440 --> 00:16:46,120 INITIATIVE AT THIS WEBSITE OR 493 00:16:46,120 --> 00:16:48,680 USE THIS SNAZZY NEW QR CODE. 494 00:16:48,680 --> 00:16:49,320 I WILL STOP THERE. 495 00:16:49,320 --> 00:16:54,040 I DON'T KNOW IF WE HAVE TIME FOR 496 00:16:54,040 --> 00:16:54,600 QUESTIONS BUT OTHERWISE I'LL 497 00:16:54,600 --> 00:17:02,360 TURN IT OVER TO THE CO-CHAIR, 498 00:17:02,360 --> 00:17:02,880 PROFESSOR FARAHANY. 499 00:17:02,880 --> 00:17:04,640 >>WE HAVE TWO MINUTES, JOHN, IF 500 00:17:04,640 --> 00:17:07,240 THERE ARE QUESTIONS BEFORE WE 501 00:17:07,240 --> 00:17:15,600 TRANSITION. 502 00:17:15,600 --> 00:17:16,440 ALL RIGHT. 503 00:17:16,440 --> 00:17:18,000 SEEING NONE, AT THIS MOMENT, 504 00:17:18,000 --> 00:17:23,280 WHICH I'M SURE WILL COME LATER 505 00:17:23,280 --> 00:17:24,680 WE'LL TRANSITION OVER. 506 00:17:24,680 --> 00:17:26,200 I WANT TO INTRODUCE THE SESSION 507 00:17:26,200 --> 00:17:28,320 AND MOTIVATION BEHIND THE 508 00:17:28,320 --> 00:17:28,840 SESSION TODAY. 509 00:17:28,840 --> 00:17:34,520 SO, WE WANTED TO FRAME THE 510 00:17:34,520 --> 00:17:35,600 CONVERSATION TODAY AROUND 511 00:17:35,600 --> 00:17:36,280 PERSUADING, ALTERING OR 512 00:17:36,280 --> 00:17:37,560 MANIPULATING THE BRAIN. 513 00:17:37,560 --> 00:17:39,800 WHAT IS THE LINE BETWEEN THEM 514 00:17:39,800 --> 00:17:45,240 AND HOW WE MIGHT AS NEWG ENGAGE 515 00:17:45,240 --> 00:17:47,360 WITH THESE ISSUES THAT WE'LL 516 00:17:47,360 --> 00:17:48,960 DISCUSS AT 2:00 P.M. 517 00:17:48,960 --> 00:17:50,920 EVERYTHING WE DO IMPACTS THE 518 00:17:50,920 --> 00:17:53,360 BRAIN, WHETHER IT'S FROM THIS 519 00:17:53,360 --> 00:17:55,320 CONVERSATION THAT WE'RE HAVING 520 00:17:55,320 --> 00:17:56,440 TOGETHER TO DIFFERENT 521 00:17:56,440 --> 00:17:59,840 INTERVENTIONS THAT MIGHT BE 522 00:17:59,840 --> 00:18:00,120 UNDERTAKEN. 523 00:18:00,120 --> 00:18:02,240 WHETHER IT IS IN THE MORE 524 00:18:02,240 --> 00:18:08,920 FOCUSED NEUROSIDE FROM NEURO 525 00:18:08,920 --> 00:18:09,760 FEEDBACK TO DIRECT STIMULATION, 526 00:18:09,760 --> 00:18:11,760 WE WANTED TO FRAME THE 527 00:18:11,760 --> 00:18:13,080 CONVERSATION TODAY MORE AROUND 528 00:18:13,080 --> 00:18:15,240 THE EFFECTS ON THE BRAIN, RATHER 529 00:18:15,240 --> 00:18:17,360 THAN NECESSARILY THE MODE OF 530 00:18:17,360 --> 00:18:18,440 INTERVENTION. 531 00:18:18,440 --> 00:18:22,360 AND WE WANTED TO INCLUDE WITHIN 532 00:18:22,360 --> 00:18:23,240 OUR CONVERSATION AND 533 00:18:23,240 --> 00:18:25,560 BRAINSTORMING WHERE AND HOW NEWG 534 00:18:25,560 --> 00:18:29,280 MIGHT ENGAGE IN THIS SPACE, THE 535 00:18:29,280 --> 00:18:30,600 BROADER CONSUMER-BASED DEVICES 536 00:18:30,600 --> 00:18:33,000 AND INTERVENTIONS THAT ARE 537 00:18:33,000 --> 00:18:36,320 LIKELY TO HAVE WIDER-SCALE 538 00:18:36,320 --> 00:18:38,280 ADOPTION AND IMPACT TO MORE 539 00:18:38,280 --> 00:18:39,160 TARGETED AND SELECTED 540 00:18:39,160 --> 00:18:40,240 INTERVENTIONS. 541 00:18:40,240 --> 00:18:42,120 IN SOME WAYS THE PRESENTATIONS 542 00:18:42,120 --> 00:18:43,960 THAT WILL FOLLOW ARE REALLY JUST 543 00:18:43,960 --> 00:18:46,240 A STARTING POINT FOR THINKING 544 00:18:46,240 --> 00:18:47,240 ABOUT THE SPECTRUM OF 545 00:18:47,240 --> 00:18:48,560 INTERVENTIONS THAT WE MIGHT 546 00:18:48,560 --> 00:18:50,960 THINK ABOUT, FROM A 547 00:18:50,960 --> 00:18:51,720 HEALTH-RELATED PERSPECTIVE FOR 548 00:18:51,720 --> 00:18:54,360 THE BRAIN, WHETHER THAT'S 549 00:18:54,360 --> 00:18:58,040 IMMERSIVE VIRTUAL REALITY IN A 550 00:18:58,040 --> 00:18:59,920 HEALTH-RELATED CONTEXT TO DIRECT 551 00:18:59,920 --> 00:19:01,120 STIMULATION OR INTERVENTION WITH 552 00:19:01,120 --> 00:19:02,080 THE BRAIN FOR TREATMENT. 553 00:19:02,080 --> 00:19:05,440 I'LL SAY I JUST GOT BACK FROM A 554 00:19:05,440 --> 00:19:07,800 TRIP LAST WEEK IN SWITZERLAND 555 00:19:07,800 --> 00:19:09,320 WHERE THE CONFERENCE AT THE 556 00:19:09,320 --> 00:19:11,120 WORLD ECONOMIC FORUM WAS VERY 557 00:19:11,120 --> 00:19:13,720 DEEPLY ENGAGED, THERE WERE MANY 558 00:19:13,720 --> 00:19:15,440 SESSIONS ON THE METAVERSE, 559 00:19:15,440 --> 00:19:16,560 VIRTUAL REALITY, SO I THINK 560 00:19:16,560 --> 00:19:18,320 THINKING ABOUT THIS IN A BROAD 561 00:19:18,320 --> 00:19:19,640 CONTEXT, THINKING ABOUT THE 562 00:19:19,640 --> 00:19:21,400 IMPLICATIONS AND APPLICATIONS IN 563 00:19:21,400 --> 00:19:22,600 A BROAD CONTEXT PARTICULARLY 564 00:19:22,600 --> 00:19:25,760 WHERE A LOT OF GLOBAL LEADERS 565 00:19:25,760 --> 00:19:27,280 SEE THE FUTURE COMING IS ONE OF 566 00:19:27,280 --> 00:19:29,600 THE TOUCH POINTS FOR OUR 567 00:19:29,600 --> 00:19:31,280 CONVERSATION. 568 00:19:31,280 --> 00:19:32,440 I'VE DONE A DEEP DIVE RECENTLY 569 00:19:32,440 --> 00:19:35,280 FOR A BOOK I'VE WRITTEN THAT 570 00:19:35,280 --> 00:19:37,680 LOOKS AT THE ISSUES ON 571 00:19:37,680 --> 00:19:38,360 MANIPULATION OF THE BRAIN, 572 00:19:38,360 --> 00:19:39,760 PERSUASION OF THE BRAIN. 573 00:19:39,760 --> 00:19:43,840 I'VE LOOKED AT ISSUES RANGING 574 00:19:43,840 --> 00:19:44,720 FROM DISINFORMATION AND 575 00:19:44,720 --> 00:19:46,280 MISINFORMATION TO APPEALING TO 576 00:19:46,280 --> 00:19:50,840 HUERISTICS OR SHORTCUTS IN THE 577 00:19:50,840 --> 00:19:51,560 BRAIN TO NEUROMARKETING 578 00:19:51,560 --> 00:19:53,400 TECHNIQUES FOR THE BRAIN OR 579 00:19:53,400 --> 00:19:54,480 ATTEMPTING TO INCUBATE DREAMS. 580 00:19:54,480 --> 00:19:55,800 WHAT WAS REALLY CLEAR TO ME IN 581 00:19:55,800 --> 00:19:59,200 THE DEEP DIVE I DID IS THAT 582 00:19:59,200 --> 00:19:59,840 THERE'S A SIGNIFICANT DIVERSITY 583 00:19:59,840 --> 00:20:03,280 OF THOUGHT ON HOW TO THINK ABOUT 584 00:20:03,280 --> 00:20:04,440 THESE ISSUES FROM A 585 00:20:04,440 --> 00:20:05,640 PHILOSOPHICAL PERSPECTIVE, FROM 586 00:20:05,640 --> 00:20:09,920 A LEGAL PERSPECTIVE, OR FROM A 587 00:20:09,920 --> 00:20:11,560 REGULATORY PERSPECTIVE. 588 00:20:11,560 --> 00:20:13,320 SOME OF THE CONCERNS THAT 589 00:20:13,320 --> 00:20:14,400 ACADEMICS AND OTHERS HAVE 590 00:20:14,400 --> 00:20:16,920 FOCUSED ON AS WE THINK ABOUT 591 00:20:16,920 --> 00:20:18,840 INTERVENTIONS IN THE BRAIN ARE 592 00:20:18,840 --> 00:20:20,000 HIDDEN INFLUENCES IN THE BRAIN. 593 00:20:20,000 --> 00:20:21,840 BUT THAT TURNS OUT TO BE A 594 00:20:21,840 --> 00:20:23,480 PRETTY DIFFICULT IF NOT 595 00:20:23,480 --> 00:20:25,560 UNTENABLE LINE AS A LOT OF THE 596 00:20:25,560 --> 00:20:26,480 MORE RECENT SCHOLARSHIPS SUGGEST 597 00:20:26,480 --> 00:20:29,600 THAT A LOT OF THE WAYS THAT ARE 598 00:20:29,600 --> 00:20:34,440 ATTEMPTING TO PERSUADE OR CHANGE 599 00:20:34,440 --> 00:20:38,160 THE BRAIN AREN'T HIDDEN BUT 600 00:20:38,160 --> 00:20:41,000 QUITE AAPPARENT, NEVERTHELESS 601 00:20:41,000 --> 00:20:41,680 MAY COMPROMISE AUTONOMY, 602 00:20:41,680 --> 00:20:43,520 DIGNITY, OR WELL-BEING OF THE 603 00:20:43,520 --> 00:20:43,840 INDIVIDUAL. 604 00:20:43,840 --> 00:20:45,360 MORE RECENT SCHOLARSHIP 605 00:20:45,360 --> 00:20:47,280 PARTICULARLY FROM BEHAVIORAL 606 00:20:47,280 --> 00:20:48,920 ECONOMICS, FOR EXAMPLE, 607 00:20:48,920 --> 00:20:52,400 RECOGNIZES THAT MANY INFLUENCES 608 00:20:52,400 --> 00:20:56,280 ON THE BRAIN ARE NOT HITTEN, ONE 609 00:20:56,280 --> 00:20:57,240 OF THE CONCERNS SHOULD BE 610 00:20:57,240 --> 00:20:58,320 INTENTION TO CAUSE HARM, 611 00:20:58,320 --> 00:21:00,520 IMPACTING THE BRAIN IN NEGATIVE 612 00:21:00,520 --> 00:21:00,960 WAYS. 613 00:21:00,960 --> 00:21:03,800 AND QUESTIONS ABOUT AUTONOMY AND 614 00:21:03,800 --> 00:21:07,840 CONSENT ARE PARAMOUNT IN MANY 615 00:21:07,840 --> 00:21:08,280 CONVERSATIONS. 616 00:21:08,280 --> 00:21:14,440 TODAY WE WANT TO FOCUS ON 617 00:21:14,440 --> 00:21:16,920 HEALTH-RELATED MODULATION OF THE 618 00:21:16,920 --> 00:21:17,400 BRAIN PRESUMABLY FOCUS 619 00:21:17,400 --> 00:21:18,040 INTENTIONALLY BENEFICIAL IMPACTS 620 00:21:18,040 --> 00:21:19,760 ON THE BRAIN SO THE QUESTION OF 621 00:21:19,760 --> 00:21:23,640 HARM WOULD BE PUT TO THE SIDE. 622 00:21:23,640 --> 00:21:24,880 BUT MAY NEVERTHELESS RAISE 623 00:21:24,880 --> 00:21:26,960 COMPLEX ETHICAL ISSUES FOR WHICH 624 00:21:26,960 --> 00:21:29,360 GUIDANCE OR DIRECTION FOR 625 00:21:29,360 --> 00:21:30,120 RESEARCHERS, CORPORATIONS, AND 626 00:21:30,120 --> 00:21:32,280 GOVERNING BODIES MAY BE A 627 00:21:32,280 --> 00:21:33,600 SIGNIFICANT VALUE. 628 00:21:33,600 --> 00:21:36,240 WE WANTED TO OFFER A SPECTRUM IN 629 00:21:36,240 --> 00:21:37,800 THE CONVERSATION AND 630 00:21:37,800 --> 00:21:38,880 PRESENTATIONS THAT WILL FOLLOW 631 00:21:38,880 --> 00:21:41,080 OF DIFFERENT WAYS OF IMPACTING 632 00:21:41,080 --> 00:21:43,440 THE BRAIN, FROM ENGAGING WITH IT 633 00:21:43,440 --> 00:21:45,600 FOR EXAMPLE THROUGH DEEP 634 00:21:45,600 --> 00:21:54,920 DISTRACTION, SO WE'VE LOT ABOUT 635 00:21:54,920 --> 00:21:56,640 CORPORATIONS USING IMMERSION TO 636 00:21:56,640 --> 00:21:58,920 ENGAGE THE BRAIN BUT WHAT ABOUT 637 00:21:58,920 --> 00:22:00,720 BENEFICIAL USES OF DOING SAME 638 00:22:00,720 --> 00:22:02,680 ACTIVATIONS IN THE BRAIN IN 639 00:22:02,680 --> 00:22:04,840 SURGICAL CONTEXTS OR IN OTHER 640 00:22:04,840 --> 00:22:05,120 CONTEXTS. 641 00:22:05,120 --> 00:22:06,160 WE ALSO WANTED TO LOOK AT WHAT 642 00:22:06,160 --> 00:22:08,040 WE SORT OF SAW AS OPPOSITE END 643 00:22:08,040 --> 00:22:11,760 OF THE SPECTRUM, WHICH IS MORE 644 00:22:11,760 --> 00:22:12,840 DIRECT INTERVENTIONS TO REWIRE 645 00:22:12,840 --> 00:22:15,880 OR CHANGE THE FUNCTIONING OF THE 646 00:22:15,880 --> 00:22:16,200 HUMAN BRAIN. 647 00:22:16,200 --> 00:22:17,440 WHILE THIS IS STARTING PLACE AND 648 00:22:17,440 --> 00:22:19,880 HOW WE WERE THINKING ABOUT A WAY 649 00:22:19,880 --> 00:22:21,600 TO DESIGN THE SPECTRUM OF THE 650 00:22:21,600 --> 00:22:22,920 CONVERSATION THAT WE MIGHT 651 00:22:22,920 --> 00:22:24,320 ENGAGE WITH, WE ALSO RECOGNIZED 652 00:22:24,320 --> 00:22:27,000 THIS MIGHT NOT BE THE WAY IN 653 00:22:27,000 --> 00:22:28,360 WHICH NEWG WOULD WANT TO SEGMENT 654 00:22:28,360 --> 00:22:31,520 THE WORLD AS WE THINK ABOUT 655 00:22:31,520 --> 00:22:32,960 MODULATION OF THE BRAIN OR THE 656 00:22:32,960 --> 00:22:34,680 RIGHT WAY TO THINK ABOUT IT. 657 00:22:34,680 --> 00:22:38,000 THE QUESTION IS WHETHER OR NOT 658 00:22:38,000 --> 00:22:39,560 SOMETHING LIKE IMPLANTED VERSUS 659 00:22:39,560 --> 00:22:41,000 WEARABLE TECHNOLOGY MAKES A 660 00:22:41,000 --> 00:22:42,800 DIFFERENCE, WHETHER OR NOT 661 00:22:42,800 --> 00:22:43,640 DIRECT VERSUS INDIRECT 662 00:22:43,640 --> 00:22:45,240 INTERVENTIONS ON THE BRAIN MAKE 663 00:22:45,240 --> 00:22:46,840 A DIFFERENCE, IF THOSE ARE 664 00:22:46,840 --> 00:22:47,920 USEFUL WAYS FOR US TO THINK 665 00:22:47,920 --> 00:22:51,040 ABOUT IT. AS WE TURN AFTER THIS 666 00:22:51,040 --> 00:22:52,480 CONVERSATION, WHAT I'D LIKE YOU 667 00:22:52,480 --> 00:22:54,480 TO KEEP IN MIND AS YOU HEAR THE 668 00:22:54,480 --> 00:22:56,120 PRESENTATIONS IS THINKING WHAT 669 00:22:56,120 --> 00:22:59,080 IS THE UNIQUE AND TARGETED VALUE 670 00:22:59,080 --> 00:23:00,320 ADD THAT NEWG COULD PROVIDE. 671 00:23:00,320 --> 00:23:02,000 AS YOU HEARD, THIS IS MY FIRST 672 00:23:02,000 --> 00:23:05,080 OPPORTUNITY TO SERVE AS 673 00:23:05,080 --> 00:23:05,320 CO-CHAIR. 674 00:23:05,320 --> 00:23:05,960 I'M DELIGHTED TO HAVE THE 675 00:23:05,960 --> 00:23:06,840 OPPORTUNITY TO DO SO. 676 00:23:06,840 --> 00:23:08,920 ONE OF THE THINGS I HOPE TO 677 00:23:08,920 --> 00:23:11,400 BRING IN MY ROLE AS CO-CHAIR IS 678 00:23:11,400 --> 00:23:13,960 A FOCUS AT THE BEGINNING OF EACH 679 00:23:13,960 --> 00:23:15,800 OF THESE CONVERSATIONS, REALLY 680 00:23:15,800 --> 00:23:18,000 DECIDING WHAT IS IT WE HOPE IS 681 00:23:18,000 --> 00:23:20,400 THE OUTPUT OR THE PRODUCT OF THE 682 00:23:20,400 --> 00:23:20,680 ENGAGEMENT. 683 00:23:20,680 --> 00:23:22,680 IT COULD BE A WORKSHOP THAT WE 684 00:23:22,680 --> 00:23:24,440 HOPE TO THEN HAVE PROCEEDINGS 685 00:23:24,440 --> 00:23:25,040 THAT FOLLOW FROM. 686 00:23:25,040 --> 00:23:27,000 IT COULD BE THAT WE HOPE WE 687 00:23:27,000 --> 00:23:29,160 WOULD HAVE TARGETED GUIDANCE 688 00:23:29,160 --> 00:23:31,280 THAT WE WOULD PROVIDE TO 689 00:23:31,280 --> 00:23:32,880 RESEARCHERS TO CORPORATIONS TO 690 00:23:32,880 --> 00:23:33,560 OTHER GOVERNING BODIES. 691 00:23:33,560 --> 00:23:36,080 IT COULD BE THAT WE HOPE THERE'S 692 00:23:36,080 --> 00:23:37,920 A WHITE PAPER OR ACADEMIC 693 00:23:37,920 --> 00:23:38,920 COLLABORATION THAT COULD BE BORN 694 00:23:38,920 --> 00:23:39,480 OUT OF IT. 695 00:23:39,480 --> 00:23:41,760 BUT AS YOU HEAR THE 696 00:23:41,760 --> 00:23:42,360 PRESENTATIONS THAT FOLLOW, I'D 697 00:23:42,360 --> 00:23:44,720 LOVE FOR YOU TO REALLY FOCUS ON 698 00:23:44,720 --> 00:23:45,960 THAT QUESTION, WHICH IS, WHAT IS 699 00:23:45,960 --> 00:23:48,120 THE RIGHT WAY FOR NEWG TO ENGAGE 700 00:23:48,120 --> 00:23:50,200 WITH THESE QUESTIONS AND WHAT IS 701 00:23:50,200 --> 00:23:51,520 THE INTENDED OUTPUT OR PRODUCT 702 00:23:51,520 --> 00:23:54,240 THAT WE LOPE TO HAVE AS A RESULT 703 00:23:54,240 --> 00:23:57,960 OF THESE CONVERSATIONS, AND IS 704 00:23:57,960 --> 00:23:59,640 THERE UTILITY TO OUR ENGAGING 705 00:23:59,640 --> 00:24:01,280 WITH THESE QUESTIONS UNIQUE OR 706 00:24:01,280 --> 00:24:02,160 DISTINCT FROM ACADEMIC OR OTHER 707 00:24:02,160 --> 00:24:03,280 ENGAGEMENT THAT HAS ALREADY 708 00:24:03,280 --> 00:24:04,320 OCCURRED ON THESE ISSUES. 709 00:24:04,320 --> 00:24:06,200 SO, WITH NO FURTHER ADO, I WILL 710 00:24:06,200 --> 00:24:10,560 HAND IT OVER TO CHRISTINE TO 711 00:24:10,560 --> 00:24:13,520 INTRODUCE OUR SPEAKERS FOR THE 712 00:24:13,520 --> 00:24:14,760 FOLLOWING CONVERSATION, AND, 713 00:24:14,760 --> 00:24:15,800 AGAIN, I'M DELIGHTED TO SERVE IN 714 00:24:15,800 --> 00:24:16,720 THIS ROLE. 715 00:24:16,720 --> 00:24:18,880 IT'S AN HONOR TO SERVE ALONGSIDE 716 00:24:18,880 --> 00:24:20,960 CHRISTINE AND AN HONOR TO BE 717 00:24:20,960 --> 00:24:25,560 GIVEN THE OPPORTUNITY TO SERVE 718 00:24:25,560 --> 00:24:29,400 IN THIS CAPACITY AND I LOOK 719 00:24:29,400 --> 00:24:31,560 FORWARD TO SERVING AS CO-CHAIR 720 00:24:31,560 --> 00:24:31,800 OF NEWG. 721 00:24:31,800 --> 00:24:36,240 >>THANK YOU, SHE'S GIVEN US A 722 00:24:36,240 --> 00:24:37,720 LOT TO THINK ABOUT. 723 00:24:37,720 --> 00:24:40,120 WE'RE PLEASED TO HAVE TWO 724 00:24:40,120 --> 00:24:42,880 SPEAKERS TO GET US STARTED ON 725 00:24:42,880 --> 00:24:44,640 THIS DISCUSSION TODAY. 726 00:24:44,640 --> 00:24:45,800 I'LL INTRODUCE EACH ONE 727 00:24:45,800 --> 00:24:46,800 SEPARATELY AND LET THE FIRST 728 00:24:46,800 --> 00:24:50,080 SPEAK AND THEN GO TO THE SECOND 729 00:24:50,080 --> 00:24:50,320 SPEAKER. 730 00:24:50,320 --> 00:24:52,360 FIRST SPEAKER IS DR. ANDREW 731 00:24:52,360 --> 00:24:54,040 CRYSTAL FROM UNIVERSITY OF 732 00:24:54,040 --> 00:24:55,800 CALIFORNIA IN SAN FRANCISCO. 733 00:24:55,800 --> 00:25:01,600 DR. KRYSTAL IS THE RAY AND 734 00:25:01,600 --> 00:25:02,240 DAGMAR DOLBY DISTINGUISHED 735 00:25:02,240 --> 00:25:04,920 PROFESSOR IN PSYCHOLOGY AND 736 00:25:04,920 --> 00:25:05,520 NEUROLOGY AT UNIVERSITY OF 737 00:25:05,520 --> 00:25:09,080 CALIFORNIA, SAN FRANCISCO, 738 00:25:09,080 --> 00:25:16,360 DIRECTOR OF UCSF LABORATORIES 739 00:25:16,360 --> 00:25:21,840 AND VICE CLAIRE -- VICE CHAIR N 740 00:25:21,840 --> 00:25:22,840 RESEARCH FOR PSYCHIATRY. 741 00:25:22,840 --> 00:25:25,480 I WONDER WHEN HE SLEEPS. 742 00:25:25,480 --> 00:25:26,560 HE FOCUSES ON DEVELOPMENT OF 743 00:25:26,560 --> 00:25:28,400 BIOMARKERS FOR MOOD AND SLEEP 744 00:25:28,400 --> 00:25:29,400 DISORDERS AND THEIR APPLICATION 745 00:25:29,400 --> 00:25:31,480 IN DEVELOPMENT OF NOVEL AND 746 00:25:31,480 --> 00:25:32,840 PERSONALIZED TREATMENTS FOR 747 00:25:32,840 --> 00:25:33,440 THESE CONDITIONS. 748 00:25:33,440 --> 00:25:37,400 TODAY HE'S GOING TO SPEAK TO US 749 00:25:37,400 --> 00:25:38,240 ABOUT CLOSED-LOOP 750 00:25:38,240 --> 00:25:40,800 NEUROMODULATION IN AN INDIVIDUAL 751 00:25:40,800 --> 00:25:42,280 WITH TREATMENT-RESISTANT 752 00:25:42,280 --> 00:25:42,800 DEPRESSION. 753 00:25:42,800 --> 00:25:43,520 WELCOME, DR. KRYSTAL. 754 00:25:43,520 --> 00:25:44,640 THANK YOU FOR JOINING US. 755 00:25:44,640 --> 00:25:46,040 >>THANK YOU VERY MUCH. 756 00:25:46,040 --> 00:25:47,800 IT'S WONDERFUL TO HAVE THE 757 00:25:47,800 --> 00:25:49,120 OPPORTUNITY TO BE ABLE TO TALK 758 00:25:49,120 --> 00:25:51,720 WITH YOU TODAY. 759 00:25:51,720 --> 00:25:53,120 I REALLY APPRECIATE IT. 760 00:25:53,120 --> 00:26:03,480 LET ME FIRST GET MY SLIDES UP. 761 00:26:03,480 --> 00:26:05,600 I'M PRESENTING THIS WORK ON 762 00:26:05,600 --> 00:26:08,040 BEHALF OF A SUBSTANTIAL TEAM OF 763 00:26:08,040 --> 00:26:09,640 WHICH I'VE NOT BEEN ABLE TO LIST 764 00:26:09,640 --> 00:26:12,240 ALL THE MEMBERS ON THIS SLIDE 765 00:26:12,240 --> 00:26:14,280 WHO HAVE BEEN JUST SPECTACULAR 766 00:26:14,280 --> 00:26:18,200 TO WORK WITH AND A GREAT 767 00:26:18,200 --> 00:26:20,040 OPPORTUNITY FOR ME. 768 00:26:20,040 --> 00:26:22,800 I WANT TO START BY RAISING THE 769 00:26:22,800 --> 00:26:24,360 QUESTION ABOUT HOW CHALLENGING 770 00:26:24,360 --> 00:26:27,880 IT IS TO DEVELOP A DEEP BRAIN 771 00:26:27,880 --> 00:26:29,360 STIMULATION TREATMENT FOR 772 00:26:29,360 --> 00:26:29,720 DEPRESSION. 773 00:26:29,720 --> 00:26:33,320 WHEN WE WORK WITH THE CONDITION 774 00:26:33,320 --> 00:26:35,000 WHERE IT'S NOT RESOLVED WHERE 775 00:26:35,000 --> 00:26:37,480 THE PATHOLOGY IS LOCATED IN THE 776 00:26:37,480 --> 00:26:38,360 BRAIN, IT LEAVES OPEN THE 777 00:26:38,360 --> 00:26:40,560 QUESTION OF WHERE SHOULD YOU 778 00:26:40,560 --> 00:26:42,720 STIMULATE, I THINK THAT IS NOT 779 00:26:42,720 --> 00:26:43,960 CLEAR BASED ON THE EXPERIENCE 780 00:26:43,960 --> 00:26:45,280 WE'VE HAD TO DATE. 781 00:26:45,280 --> 00:26:46,680 THERE ARE MANY, MANY STUDIES 782 00:26:46,680 --> 00:26:48,000 CARRIED OUT THAT ALL POINT TO 783 00:26:48,000 --> 00:26:51,480 DIFFERENT REGIONS OF THE BRAIN. 784 00:26:51,480 --> 00:26:53,920 SO IT SUGGESTS POSSIBILITY THAT 785 00:26:53,920 --> 00:26:55,440 THERE IS HETEROGENEITY AMONG 786 00:26:55,440 --> 00:26:55,680 PEOPLE. 787 00:26:55,680 --> 00:26:57,720 AND THAT'S BUILT INTO THE 788 00:26:57,720 --> 00:27:01,040 DIAGNOSTIC STRUCTURE OF THIS 789 00:27:01,040 --> 00:27:01,440 CONDITION. 790 00:27:01,440 --> 00:27:02,960 THE DSM DIAGNOSIS REQUIRES THAT 791 00:27:02,960 --> 00:27:05,320 A PERSON HAVE FIVE OUT OF NINE 792 00:27:05,320 --> 00:27:06,280 POSSIBLE SYMPTOMS, AND SO YOU 793 00:27:06,280 --> 00:27:08,240 COULD HAVE TWO PEOPLE WHO HAVE 794 00:27:08,240 --> 00:27:10,120 DEPRESSION AND HAVE ONLY ONE 795 00:27:10,120 --> 00:27:11,200 SYMPTOM IN COMMON. 796 00:27:11,200 --> 00:27:14,680 AND WE SEE HUGE VARIATIONS. 797 00:27:14,680 --> 00:27:16,120 SOME PEOPLE SLEEP TOO LITTLE, 798 00:27:16,120 --> 00:27:17,560 TOO MUCH, EAT TOO LITTLE, EAT 799 00:27:17,560 --> 00:27:18,720 MORE THAN USUAL. 800 00:27:18,720 --> 00:27:19,480 IT'S QUITE VARIED. 801 00:27:19,480 --> 00:27:26,320 WE DON'T KNOW IF THESE ARE TRUE 802 00:27:26,320 --> 00:27:29,360 PATHOLOGICAL PHENOTYPES BUT IT'S 803 00:27:29,360 --> 00:27:30,800 VERY CLEAR THERE'S -- THERE'S A 804 00:27:30,800 --> 00:27:32,680 LOT OF VARIETY IN THE PATIENTS 805 00:27:32,680 --> 00:27:34,080 AND RESULTS OF STUDIES WHICH 806 00:27:34,080 --> 00:27:37,480 SUGGEST THAT THIS IS LIKELY TO 807 00:27:37,480 --> 00:27:38,440 BE THE CASE. 808 00:27:38,440 --> 00:27:39,520 ANOTHER POINT IS THAT SO FAR 809 00:27:39,520 --> 00:27:41,640 THERE HAVE BEEN A NUMBER OF 810 00:27:41,640 --> 00:27:45,160 EFFORTS THAT HAVE TRIED TO DO 811 00:27:45,160 --> 00:27:47,040 DIRECT BRAIN STIMULATION AND 812 00:27:47,040 --> 00:27:51,400 THESE HAVE ALL INVOLVED 813 00:27:51,400 --> 00:27:52,240 CONTINUOUS STIMULATION WHERE 814 00:27:52,240 --> 00:27:53,880 ELECTRICAL STIMULUS IS TURNED 815 00:27:53,880 --> 00:27:57,640 ON, LEFT ON DAY AND NIGHT FOR 816 00:27:57,640 --> 00:27:59,800 DAYS TO YEARS. 817 00:27:59,800 --> 00:28:01,360 AND TO ME SOME IMPORTANT 818 00:28:01,360 --> 00:28:02,760 QUESTIONS EMERGE FROM WORKING 819 00:28:02,760 --> 00:28:05,120 WITH PATIENTS WITH DEPRESSION 820 00:28:05,120 --> 00:28:07,600 FOR ALMOST 40 YEARS, PEOPLE HAVE 821 00:28:07,600 --> 00:28:10,200 SYMPTOMS THAT VARY QUITE A BIT, 822 00:28:10,200 --> 00:28:12,840 EVEN THOSE WITH VERY SEVERE 823 00:28:12,840 --> 00:28:13,600 TREATMENT RESISTANT DEPRESSION, 824 00:28:13,600 --> 00:28:14,920 AND IT'S NOT CLEAR WHAT IT'S 825 00:28:14,920 --> 00:28:16,800 DOING WHEN YOU STIMULATE WHEN 826 00:28:16,800 --> 00:28:18,080 PEOPLE DON'T HAVE SYMPTOMS. 827 00:28:18,080 --> 00:28:21,400 WHAT'S IT DOING WHEN PEOPLE ARE 828 00:28:21,400 --> 00:28:21,840 ASLEEP? 829 00:28:21,840 --> 00:28:23,240 THESE QUESTIONS HAVE NOT REALLY 830 00:28:23,240 --> 00:28:24,880 BEEN DRILLED DOWN ON VERY DEEPLY 831 00:28:24,880 --> 00:28:26,000 AND WE DON'T HAVE GREAT 832 00:28:26,000 --> 00:28:28,400 UNDERSTANDING OF IT. 833 00:28:28,400 --> 00:28:31,680 TO ME, IT RAISES POSSIBILITY YOU 834 00:28:31,680 --> 00:28:34,080 COULD HAVE PRODUCTIVE NEURAL 835 00:28:34,080 --> 00:28:34,720 ADAPTATION THAT LIMIT HOW 836 00:28:34,720 --> 00:28:36,040 EFFECTIVE TREATMENTS CAN BE. 837 00:28:36,040 --> 00:28:36,920 THERE'S ANOTHER CHALLENGE, HOW 838 00:28:36,920 --> 00:28:43,160 DO YOU DOSE THE TREATMENTS? 839 00:28:43,160 --> 00:28:45,240 THE HISTORY OF DEPRESSION HAS 840 00:28:45,240 --> 00:28:46,000 PRIMARILY DOMINATED BY 841 00:28:46,000 --> 00:28:48,280 TREATMENTS THAT TAKE FOUR TO 842 00:28:48,280 --> 00:28:58,040 EIGHT WEEKS TO WORK, FOR EXAMPLE 843 00:28:58,040 --> 00:28:58,840 SEROTONIN REUPTAKE AND OTHERS. 844 00:28:58,840 --> 00:28:59,880 YOU HAVE TO WAIT. 845 00:28:59,880 --> 00:29:00,880 THAT LEAVES THE QUESTION HOW 846 00:29:00,880 --> 00:29:02,520 SHOULD I DOSE THIS INDIVIDUAL 847 00:29:02,520 --> 00:29:03,840 WHO I'M WORKING WITH TODAY WHEN 848 00:29:03,840 --> 00:29:06,920 I WON'T KNOW IF THAT IS GOING TO 849 00:29:06,920 --> 00:29:12,280 MANIFEST AND BENEFIT FOR QUITE A 850 00:29:12,280 --> 00:29:13,280 WHILE? 851 00:29:13,280 --> 00:29:14,920 AND THE ASSUMPTION SOME CHANGE 852 00:29:14,920 --> 00:29:19,480 HAPPENS IN THE BRAIN OVER TIME, 853 00:29:19,480 --> 00:29:20,240 SYNAPTONEOGENESIS, NEUROGENESIS, 854 00:29:20,240 --> 00:29:23,000 DEEP BRAIN STIMULATION TRIGGERS 855 00:29:23,000 --> 00:29:24,000 THAT MEDIATES THE 856 00:29:24,000 --> 00:29:25,200 ANTI-DEPRESSANT EFFECT THAT'S 857 00:29:25,200 --> 00:29:28,120 DISTINCT FROM WHAT HELPS WHEN 858 00:29:28,120 --> 00:29:29,360 YOU ORIGINALLY STIMULATE, AND 859 00:29:29,360 --> 00:29:30,640 WHETHER THERE'S ANY INDICATOR OF 860 00:29:30,640 --> 00:29:33,360 THAT IN THE INITIAL STIMULUS 861 00:29:33,360 --> 00:29:36,240 RESPONSE AND WHETHER OR NOT IT'S 862 00:29:36,240 --> 00:29:37,480 NECESSARY FOR THIS 4 TO 8 WEEK 863 00:29:37,480 --> 00:29:42,280 PERIOD TO HAPPEN TO GET A ROBUST 864 00:29:42,280 --> 00:29:43,040 ANTI-DEPRESSANT EFFECT IS 865 00:29:43,040 --> 00:29:44,120 LARGELY BASED ON THEORY AND 866 00:29:44,120 --> 00:29:45,520 HISTORY BUT WE KNOW FROM RECENT 867 00:29:45,520 --> 00:29:48,760 EXPERIENCE WITH DRUGS LIKE 868 00:29:48,760 --> 00:29:49,800 KETAMINE AND SOME OTHER 869 00:29:49,800 --> 00:29:51,120 EXPERIENCES ONE OF WHICH I'LL 870 00:29:51,120 --> 00:29:53,000 TALK ABOUT IN A LITTLE BIT THAT 871 00:29:53,000 --> 00:29:54,200 YOU CAN SEE IMMEDIATE BENEFIT. 872 00:29:54,200 --> 00:29:56,400 SO IF YOU CAN SEE IMMEDIATE 873 00:29:56,400 --> 00:29:59,320 BENEFIT, IT CALLS INTO QUESTION 874 00:29:59,320 --> 00:30:01,240 THAT THIS IS REALLY NECESSARY OR 875 00:30:01,240 --> 00:30:04,480 ACTUALLY REALLY FUNDAMENTAL TO 876 00:30:04,480 --> 00:30:06,120 THE WAY ANTIDEPRESSANTS WORK. 877 00:30:06,120 --> 00:30:10,000 GIVEN THESE CHALLENGES, IT'S NOT 878 00:30:10,000 --> 00:30:11,920 SURPRISING SOME OF THE PIVOTAL 879 00:30:11,920 --> 00:30:13,920 STUDIES CARRIED OUT TO DATE WITH 880 00:30:13,920 --> 00:30:16,720 DEEP BRAIN STIMULATION FOR 881 00:30:16,720 --> 00:30:18,600 DEPRESSION HAVE NOT SHOWN 882 00:30:18,600 --> 00:30:21,840 THERAPEUTIC EFFECTS, THIS IS ONE 883 00:30:21,840 --> 00:30:23,400 STUDY WITH VENTRAL CAPSULE 884 00:30:23,400 --> 00:30:26,920 STIMULATION, NO EFFECT VERSUS 885 00:30:26,920 --> 00:30:28,440 SHAM. 886 00:30:28,440 --> 00:30:35,360 AND ANOTHER WHERE TREATMENT WAS 887 00:30:35,360 --> 00:30:37,040 STOPPED IN THE MIDWAY ANALYSIS 888 00:30:37,040 --> 00:30:38,640 DUE TO LACK OF CLEAR EVIDENCE 889 00:30:38,640 --> 00:30:46,080 THAT THERE'S LIKELY TO BE 890 00:30:46,080 --> 00:30:47,360 BENEFIT, SUBCOLOSSAL 891 00:30:47,360 --> 00:30:49,480 STIMULATION, IN BOTH STUDIES I 892 00:30:49,480 --> 00:30:51,240 PARTICIPATED AND IT WAS 893 00:30:51,240 --> 00:30:56,120 COMPLICATED BECAUSE WE WERE TOLD 894 00:30:56,120 --> 00:30:59,320 TO TITHE RATE BASED ON IMMEDIATE 895 00:30:59,320 --> 00:31:02,600 EFFECT BUT WE SHOULD USE THAT AS 896 00:31:02,600 --> 00:31:04,120 WAY TO DOSE, CONFUSING BECAUSE 897 00:31:04,120 --> 00:31:06,080 IT'S NOT SO CLEAR THOSE ARE 898 00:31:06,080 --> 00:31:16,520 INTIMATELY RELATED TO EACH 899 00:31:17,200 --> 00:31:20,080 OTHER.. 900 00:31:20,080 --> 00:31:24,480 ONE THAT IS PROMISING IS TO 901 00:31:24,480 --> 00:31:26,480 ACTUALLY DO EXPLORATORY STIMULUS 902 00:31:26,480 --> 00:31:29,280 RESPONSE MAPPING TO TRY TO 903 00:31:29,280 --> 00:31:33,800 DETERMINE THE BEST LOCATION AND 904 00:31:33,800 --> 00:31:36,000 STIMULUS PARADIGM SETTINGS. 905 00:31:36,000 --> 00:31:36,880 FOR EXAMPLE, AMPLITUDE PULSE 906 00:31:36,880 --> 00:31:39,280 WITH FREQUENCY AND SO ON. 907 00:31:39,280 --> 00:31:44,920 THAT FOR EACH PERSON. 908 00:31:44,920 --> 00:31:46,600 AND THIS IS CONSISTENT WITH 909 00:31:46,600 --> 00:31:49,080 MODEL OF HETEROGENEITY, WE MIGHT 910 00:31:49,080 --> 00:31:51,160 NEED TO STIMULATE DIFFERENT 911 00:31:51,160 --> 00:31:53,480 PEOPLE IN DIFFERENT WAYS, BUT IT 912 00:31:53,480 --> 00:31:54,560 RAISES AN IMPORTANT QUESTION 913 00:31:54,560 --> 00:31:58,320 WITH RESPECT TO PREVAILING MODEL 914 00:31:58,320 --> 00:32:01,680 THAT YOU CAN'T DO THIS IF YOU 915 00:32:01,680 --> 00:32:02,760 CAN'T PREDICT THE THERAPEUTIC 916 00:32:02,760 --> 00:32:04,320 EFFECT RIGHT AWAY. 917 00:32:04,320 --> 00:32:06,520 YOU HAVE TO -- IDEALLY YOU WOULD 918 00:32:06,520 --> 00:32:07,600 SEE A THERAPEUTIC EFFECT RIGHT 919 00:32:07,600 --> 00:32:10,400 AWAY AND COULD TRY OUT A BUNCH 920 00:32:10,400 --> 00:32:11,200 OF LOCATIONS AND PARADIGMS AND 921 00:32:11,200 --> 00:32:12,960 SO ON BUT IMAGINE IF YOU WERE 922 00:32:12,960 --> 00:32:14,800 TRYING TO DO THIS IN THE CURRENT 923 00:32:14,800 --> 00:32:16,120 MODEL YOU'D HAVE TO TRY 924 00:32:16,120 --> 00:32:18,440 SOMETHING, WAIT 4 TO 8 WEEKS, 925 00:32:18,440 --> 00:32:19,720 TRY SOMETHING AGAIN AND SEE DOES 926 00:32:19,720 --> 00:32:20,840 IT WORK. 927 00:32:20,840 --> 00:32:23,480 IT'S JUST UNTENABLE. 928 00:32:23,480 --> 00:32:24,760 IT'S HUGELY LIMITING AND IF 929 00:32:24,760 --> 00:32:25,720 THAT'S WHAT'S NEEDED, THAT'S 930 00:32:25,720 --> 00:32:28,040 WHAT NEEDED AND PROGRESS WILL BE 931 00:32:28,040 --> 00:32:28,440 SLOW. 932 00:32:28,440 --> 00:32:29,320 BUT IF THERE'S AN ALTERNATIVE 933 00:32:29,320 --> 00:32:30,360 YOU CAN DO SOMETHING LIKE THIS 934 00:32:30,360 --> 00:32:33,120 IT WOULD BE A GAME CHANGER FOR 935 00:32:33,120 --> 00:32:37,280 BEING ABLE TO OPTIMIZE AND 936 00:32:37,280 --> 00:32:37,600 PERSONALIZE. 937 00:32:37,600 --> 00:32:38,920 SO, ANOTHER ELEMENT IS BASED ON 938 00:32:38,920 --> 00:32:40,520 THE IDEA THAT THE SYMPTOMS 939 00:32:40,520 --> 00:32:43,280 AREN'T PRESENT ALL THE TIME AND 940 00:32:43,280 --> 00:32:45,600 WHAT ARE WE DOING WHEN SYMPTOMS 941 00:32:45,600 --> 00:32:49,840 ARE ABSENT AND DURING SLEEP AND 942 00:32:49,840 --> 00:32:50,080 SO ON. 943 00:32:50,080 --> 00:32:52,520 AND THE STRATEGY IS TO USE 944 00:32:52,520 --> 00:32:55,240 CLOSED LOOP. 945 00:32:55,240 --> 00:32:57,160 CLOSED LOOP IS BASED ON ONLY 946 00:32:57,160 --> 00:32:58,600 STIMULATING WHEN NEEDED BASED ON 947 00:32:58,600 --> 00:32:59,800 BIOMARKER OF THE STATE YOU'RE 948 00:32:59,800 --> 00:33:02,520 HOPING TO TREAT SO YOU 949 00:33:02,520 --> 00:33:04,720 CONTINUOUSLY SENSE BRAIN -- IN 950 00:33:04,720 --> 00:33:06,840 THIS CASE BRAIN ELECTRICAL 951 00:33:06,840 --> 00:33:08,280 ACTIVITY RECORDED WITH 952 00:33:08,280 --> 00:33:10,200 INTRACRANIAL EEG AS BIOMARKER, 953 00:33:10,200 --> 00:33:12,320 SENSE THE SIGNALS CONTINUOUSLY, 954 00:33:12,320 --> 00:33:16,200 AND YOU HAVE A MODEL FOR WHAT 955 00:33:16,200 --> 00:33:17,640 CONSTITUTES THE BRAIN ELECTRICAL 956 00:33:17,640 --> 00:33:19,600 ACTIVITY DURING THE STATE OF 957 00:33:19,600 --> 00:33:23,040 INTEREST, IN OUR CASE SEVERE 958 00:33:23,040 --> 00:33:26,200 DEPRESSION, AND YOU DO SOME 959 00:33:26,200 --> 00:33:28,280 COMPUTATION CONTINUOUSLY TO 960 00:33:28,280 --> 00:33:30,440 ASSESS DOES THE BRAIN ELECTRICAL 961 00:33:30,440 --> 00:33:33,640 ACTIVITY CONFORM TO THE PATTERN 962 00:33:33,640 --> 00:33:35,800 THAT IS PREDICTIVE OF BEING IN A 963 00:33:35,800 --> 00:33:38,120 MORE SEVERE DEPRESSED STATE AND 964 00:33:38,120 --> 00:33:40,160 THEN ONLY TRIGGER STIMULATION 965 00:33:40,160 --> 00:33:41,800 WHEN THAT BRAIN ELECTRICAL 966 00:33:41,800 --> 00:33:43,000 ACTIVITY PATTERN IS PRESENT. 967 00:33:43,000 --> 00:33:45,960 SO USE THE BIOMARKER TO DRIVE 968 00:33:45,960 --> 00:33:47,800 TREATMENT, CLOSED LOOP COULD BE 969 00:33:47,800 --> 00:33:50,000 DONE WITH THINGS OTHER THAN 970 00:33:50,000 --> 00:33:51,200 BIOMARKER, COULD BE DONE WITH 971 00:33:51,200 --> 00:33:54,400 BEHAVIOR, WIDE VARIETY OF 972 00:33:54,400 --> 00:33:55,840 THINGS, BUT YOU'RE USING SOME 973 00:33:55,840 --> 00:33:56,920 METRIC OF THE STATE YOU'RE 974 00:33:56,920 --> 00:34:00,080 TRYING TO TREAT TO FEED IT BACK 975 00:34:00,080 --> 00:34:04,320 JUST LIKE YOU USE THE THERMOSTAT 976 00:34:04,320 --> 00:34:09,320 IN YOUR HOME, A DEVICE SIMILAR 977 00:34:09,320 --> 00:34:11,400 TO CLOSED LOOP FOR TREATMENT OF 978 00:34:11,400 --> 00:34:12,720 DEPRESSION TRIGGERS THE HEAT OR 979 00:34:12,720 --> 00:34:16,760 AIR CONDITIONING TO COME ON ONLY 980 00:34:16,760 --> 00:34:18,160 WHEN A MEASURE OF THE 981 00:34:18,160 --> 00:34:19,800 ENVIRONMENTAL TEMPERATURE SAYS 982 00:34:19,800 --> 00:34:20,600 THAT IT'S NEEDED. 983 00:34:20,600 --> 00:34:23,200 AND KICKS IN AND TURNS OFF SO 984 00:34:23,200 --> 00:34:25,400 YOU GET VERY LIMITED TIME PERIOD 985 00:34:25,400 --> 00:34:29,560 OF EFFECT BUT ONLY WHEN IT'S 986 00:34:29,560 --> 00:34:29,800 NEEDED. 987 00:34:29,800 --> 00:34:30,440 THE OPEN-LOOP APPROACH WOULD BE 988 00:34:30,440 --> 00:34:32,280 TURN ON HEAT AND LEAVE IT ON ALL 989 00:34:32,280 --> 00:34:34,600 THE TIME, AND IF THE HOUSE GETS 990 00:34:34,600 --> 00:34:37,760 TOO HOT YOU MANUALLY TURN IT 991 00:34:37,760 --> 00:34:37,920 OFF. 992 00:34:37,920 --> 00:34:40,840 BUT IN THEORY IT ONLY CAN MOVE 993 00:34:40,840 --> 00:34:45,200 IN ONE DIRECTION. 994 00:34:45,200 --> 00:34:48,160 SO, THIS REQUIRES AN IMMEDIACY 995 00:34:48,160 --> 00:34:49,280 MODEL BECAUSE YOU'RE HOPING 996 00:34:49,280 --> 00:34:50,240 YOU'LL GET BENEFIT WHEN YOU 997 00:34:50,240 --> 00:34:52,400 STIMULATE AND YOU'RE GOING TO 998 00:34:52,400 --> 00:34:54,720 STOP AND IF YOU CAN'T GET 999 00:34:54,720 --> 00:34:55,920 BENEFIT FROM THAT IT HAS TO BE 1000 00:34:55,920 --> 00:34:57,200 THE CASE THAT YOU NEED 1001 00:34:57,200 --> 00:34:59,120 CONTINUOUS TREATMENT FOR A LONG 1002 00:34:59,120 --> 00:35:02,840 PERIOD OF TIME THIS SHOULDN'T 1003 00:35:02,840 --> 00:35:07,520 WORK IN THE 4 TO 8 WEEK MODEL. 1004 00:35:07,520 --> 00:35:09,840 IT MEANS THERE'S A STABLE 1005 00:35:09,840 --> 00:35:10,600 BIOMARKER, A BIOMARKER CAN BE 1006 00:35:10,600 --> 00:35:12,480 FOUND AND THAT IT'S STABLE. 1007 00:35:12,480 --> 00:35:15,120 WE TOOK THIS APPROACH TO JUMP TO 1008 00:35:15,120 --> 00:35:16,720 THE CHASE, AND WE DID IT WITH 1009 00:35:16,720 --> 00:35:20,120 THE STRONG BELIEF THAT WE COULD 1010 00:35:20,120 --> 00:35:22,200 ACHIEVE IMMEDIATE THERAPEUTIC 1011 00:35:22,200 --> 00:35:27,600 EFFECTS WITH DEEP BRAIN 1012 00:35:27,600 --> 00:35:30,640 STIMULATION ON THE WORK OF OUR 1013 00:35:30,640 --> 00:35:34,920 TEAM DIE EDDIE CHANG, LEAD 1014 00:35:34,920 --> 00:35:43,480 INVESTIGATOR FOR THE DARPA 1015 00:35:43,480 --> 00:35:45,200 SUBNETS STUDY IN EPILEPSY, 1016 00:35:45,200 --> 00:35:46,440 ABILITY TO MODULATE MOOD 1017 00:35:46,440 --> 00:35:47,920 SYMPTOMS RIGHT AWAY, LED TO SOME 1018 00:35:47,920 --> 00:35:50,680 SENSE THIS COULD BE POSSIBLE. 1019 00:35:50,680 --> 00:35:54,400 HYPOTHESIS THAT WE COULD DO 1020 00:35:54,400 --> 00:35:56,800 STIMULUS RESPONSE MAPPING AND 1021 00:35:56,800 --> 00:35:57,720 OPTIMIZATION AND PERSONALIZATION 1022 00:35:57,720 --> 00:36:00,080 FOR DEPRESSION WITH DEEP BRAIN 1023 00:36:00,080 --> 00:36:02,720 STIMULATION AND THAT WE COULD 1024 00:36:02,720 --> 00:36:05,800 THEN USE THAT CLOSED-LOOP MODEL 1025 00:36:05,800 --> 00:36:07,080 AND THAT THIS WOULD BE POSSIBLE 1026 00:36:07,080 --> 00:36:07,760 AND FEASIBLE. 1027 00:36:07,760 --> 00:36:17,160 WE CARRIED OUT A STUDY, PRESIDIO 1028 00:36:17,160 --> 00:36:18,360 TRIAL, MEANT TO BE 1029 00:36:18,360 --> 00:36:19,600 PROOF-OF-CONCEPT APPROACH TO 1030 00:36:19,600 --> 00:36:20,960 THESE FEATURES, TO SEE IF WE 1031 00:36:20,960 --> 00:36:22,400 COULDN'T DO DEEP BRAIN 1032 00:36:22,400 --> 00:36:24,280 STIMULATION IN A CLOSED-LOOP 1033 00:36:24,280 --> 00:36:25,000 MODEL THAT'S PERSONALIZED WITH A 1034 00:36:25,000 --> 00:36:27,960 MODEST NUMBER OF PEOPLE WHO HAD 1035 00:36:27,960 --> 00:36:31,480 SEVERE TREATMENT RESISTANT 1036 00:36:31,480 --> 00:36:32,120 DEPRESSION, TARGETING TREATING 1037 00:36:32,120 --> 00:36:32,840 APPROXIMATELY 13 PEOPLE, AND 1038 00:36:32,840 --> 00:36:36,600 THESE PEOPLE HAD TO BE VERY 1039 00:36:36,600 --> 00:36:37,920 RESISTANT, FAIL EVERYTHING 1040 00:36:37,920 --> 00:36:42,640 BASICALLY OUT THERE, USING THE 1041 00:36:42,640 --> 00:36:44,400 NEUROPACE RNS DEVICE TO DELIVER 1042 00:36:44,400 --> 00:36:49,960 CLOSED LOOP TREATMENT, FDA 1043 00:36:49,960 --> 00:36:51,160 APPROVED FOR TREATING EPILEPSY, 1044 00:36:51,160 --> 00:36:52,800 SO IT'S AVAILABLE. 1045 00:36:52,800 --> 00:36:54,560 STUDY COMPRISED OF THREE STAGES. 1046 00:36:54,560 --> 00:36:58,600 FIRST WHERE PEOPLE ARE ADMITTED 1047 00:36:58,600 --> 00:37:01,160 TO EPILEPSY MONITORING UNIT, AND 1048 00:37:01,160 --> 00:37:03,960 WITH IMPLANTATION OF 10 DEPTH 1049 00:37:03,960 --> 00:37:05,800 ELECTRODES, EACH WITH 16 1050 00:37:05,800 --> 00:37:09,440 CONTACTS, AND WE DO A STIMULUS 1051 00:37:09,440 --> 00:37:13,040 RESPONSE MAPPING AND CONTINUOUS 1052 00:37:13,040 --> 00:37:14,920 EEG, RECORDING, WITH GOAL OF 1053 00:37:14,920 --> 00:37:15,640 DEVELOPING PERSONALIZED 1054 00:37:15,640 --> 00:37:18,000 STIMULATION STRATEGY FOR EACH 1055 00:37:18,000 --> 00:37:20,160 PERSON AND BIOMARKER, AND THEY 1056 00:37:20,160 --> 00:37:22,680 GET EXPLANTED AFTER 10 DAYS AND 1057 00:37:22,680 --> 00:37:25,320 THEY GET IMPLANTED WITH 1058 00:37:25,320 --> 00:37:28,520 NEUROPACE SYSTEM, RNS SYSTEM, 1059 00:37:28,520 --> 00:37:29,080 PROGRAMMED TO IMPLEMENT 1060 00:37:29,080 --> 00:37:30,920 CLOSED-LOOP OVER THE CAPACITY 1061 00:37:30,920 --> 00:37:33,560 FOR THAT, AND TO IMPLEMENT 1062 00:37:33,560 --> 00:37:36,080 CLOSED LOOP WITH STIMULATING IN 1063 00:37:36,080 --> 00:37:36,880 THE PERSONALIZED APPROACH 1064 00:37:36,880 --> 00:37:39,240 IDENTIFIED IN STAGE 1 AND USING 1065 00:37:39,240 --> 00:37:42,880 THE BIOMARKER TO TRIGGER 1066 00:37:42,880 --> 00:37:43,960 TREATMENT IN STAGE 2. 1067 00:37:43,960 --> 00:37:45,800 BIOMARKER THAT WAS ALSO 1068 00:37:45,800 --> 00:37:47,160 IDENTIFIED IN STAGE 1. 1069 00:37:47,160 --> 00:37:49,320 STAGE 2 INVOLVES ADDITIONAL 1070 00:37:49,320 --> 00:37:52,080 PERIOD OF REESTABLISHING THE 1071 00:37:52,080 --> 00:37:53,040 BIOMARKER AND THERAPEUTICS 1072 00:37:53,040 --> 00:37:54,360 EFFECTS BECAUSE ELECTRODES ARE 1073 00:37:54,360 --> 00:37:57,000 NOW NEW AND WHILE WE HOPE THEY 1074 00:37:57,000 --> 00:37:58,440 ARE IN EXACTLY THE SAME SPOT WE 1075 00:37:58,440 --> 00:38:00,600 KNOW IT'S NOT HUMANLY POSSIBLE 1076 00:38:00,600 --> 00:38:05,960 EVEN THOUGH EDDIE SEEMS TO BE 1077 00:38:05,960 --> 00:38:07,800 SUPER HUMAN, HE'S NOT AND THERE 1078 00:38:07,800 --> 00:38:08,800 ARE SLIGHT DIFFERENCES IN 1079 00:38:08,800 --> 00:38:09,200 LOCATION. 1080 00:38:09,200 --> 00:38:11,680 THEN WE HAVE A THIRD PHASE WHERE 1081 00:38:11,680 --> 00:38:16,600 WE DO A RANDOMIZED DOUBLE BIND 1082 00:38:16,600 --> 00:38:18,120 CROSSOVER STUDY OF EFFICACY 1083 00:38:18,120 --> 00:38:19,200 VERSUS SHAM AND SAFETY. 1084 00:38:19,200 --> 00:38:20,680 THIS IS A PICTORIAL 1085 00:38:20,680 --> 00:38:22,400 REPRESENTATION OF STAGE 1 WHERE 1086 00:38:22,400 --> 00:38:27,320 WE DO THIS 10-DAY 1087 00:38:27,320 --> 00:38:27,960 STIMULUS-RESPONSE MAPPING AND 1088 00:38:27,960 --> 00:38:30,920 RECORDING PERIOD, IF WE'RE 1089 00:38:30,920 --> 00:38:31,480 SUCCESSFUL IN IDENTIFYING 1090 00:38:31,480 --> 00:38:32,760 THERAPEUTIC EFFECT IN SOME AREA 1091 00:38:32,760 --> 00:38:34,840 WITH SOME SET OF STIMULUS 1092 00:38:34,840 --> 00:38:37,480 PARAMETERS WE MOVE TO STAGE 2, 1093 00:38:37,480 --> 00:38:42,360 DO THE VERIFICATION AND THEN 1094 00:38:42,360 --> 00:38:44,280 OPTIMIZATION IMPLEMENTS CLOSED 1095 00:38:44,280 --> 00:38:50,400 LOOP AND ONCE WE HAVE 1096 00:38:50,400 --> 00:38:52,440 IMPLEMENTED THAT AND SHOWN 50% 1097 00:38:52,440 --> 00:38:54,120 REDUCTION WE MOVE TO CROSSOVER 1098 00:38:54,120 --> 00:38:59,680 STUDY IN THE FOLLOWING STAGE. 1099 00:38:59,680 --> 00:39:01,680 SHOWING HERE WE IMPLANTED 10 1100 00:39:01,680 --> 00:39:08,120 DEPTH ELECTRODES IN FIVE 1101 00:39:08,120 --> 00:39:09,440 LOCATIONS BILATERALLY. 1102 00:39:09,440 --> 00:39:11,080 THIS IS BASED ON EXHAUSTIVE 1103 00:39:11,080 --> 00:39:12,720 REVIEW OF THE PUBLISHED 1104 00:39:12,720 --> 00:39:13,720 LITERATURE AND EXPERIENCE IN THE 1105 00:39:13,720 --> 00:39:15,000 FIELD WITH DEEP BRAIN 1106 00:39:15,000 --> 00:39:17,440 STIMULATION OF THE SITES MOST 1107 00:39:17,440 --> 00:39:19,800 EFFECTIVE AND WHERE BIOMARKERS 1108 00:39:19,800 --> 00:39:21,440 HAVE BEEN IDENTIFIED AND SO ON. 1109 00:39:21,440 --> 00:39:23,880 JUST TRYING TO PULL TOGETHER A 1110 00:39:23,880 --> 00:39:25,640 COMPLEX LITERATURE TO LOOK AT 1111 00:39:25,640 --> 00:39:27,040 THE MOST PROMISES SITES. 1112 00:39:27,040 --> 00:39:29,320 JUMP TO THE CHASE, WE'VE 1113 00:39:29,320 --> 00:39:31,960 ACTUALLY GOTTEN THREE PATIENTS 1114 00:39:31,960 --> 00:39:33,920 THROUGH STAGE 1, ONE PATIENT ALL 1115 00:39:33,920 --> 00:39:35,480 THE WAY THROUGH, ONE FINISHED 1116 00:39:35,480 --> 00:39:37,120 STAGE 2. 1117 00:39:37,120 --> 00:39:39,080 WE PUBLISHED A CASE REPORT, TWO 1118 00:39:39,080 --> 00:39:42,520 CASE REPORTS ACTUALLY OF THE 1119 00:39:42,520 --> 00:39:46,960 FIRST PATIENT, AND WE HAD DONE 1120 00:39:46,960 --> 00:39:48,160 THROUGHOUT OUR INITIAL 1121 00:39:48,160 --> 00:39:49,920 ASSESSMENT IN THE EPILEPSY 1122 00:39:49,920 --> 00:39:50,920 MONITORING UNIT INITIAL PERIOD 1123 00:39:50,920 --> 00:39:55,040 AND THROUGH ALL THE STAGES WE 1124 00:39:55,040 --> 00:39:57,600 USE A SERIES OF MEASURES TO 1125 00:39:57,600 --> 00:39:58,640 ASSESS DEPRESSION, A WHOLE OTHER 1126 00:39:58,640 --> 00:39:59,800 DISCUSSION HOW BEST TO DO THIS 1127 00:39:59,800 --> 00:40:03,840 BECAUSE WE HAVE TO GET REPEATED 1128 00:40:03,840 --> 00:40:04,840 ASSESSMENTS, EITHER OUT 1129 00:40:04,840 --> 00:40:06,040 SELF-RATED SHORT VERSION OF 1130 00:40:06,040 --> 00:40:07,480 HAMILTON THAT PICKS UP THINGS 1131 00:40:07,480 --> 00:40:13,680 THAT CHANGE QUICKLY OVER TIME, 1132 00:40:13,680 --> 00:40:14,960 VISUAL SCALE RATING. 1133 00:40:14,960 --> 00:40:16,520 IN ALL THREE EFFECTS OF 1134 00:40:16,520 --> 00:40:19,360 STIMULATION IN SOME PLACES ARE 1135 00:40:19,360 --> 00:40:20,480 IMMEDIATE AND REPRODUCIBLE, THAT 1136 00:40:20,480 --> 00:40:22,360 IS STIMULATE THE SAME AREA 1137 00:40:22,360 --> 00:40:25,160 MULTIPLE TIMES YOU ALMOST ALWAYS 1138 00:40:25,160 --> 00:40:26,920 SEE THE SAME EFFECT. 1139 00:40:26,920 --> 00:40:36,520 IT'S AN EFFECT LIKE AN RDoC 1140 00:40:36,520 --> 00:40:38,600 LIKE DIMENSION, INCREASING 1141 00:40:38,600 --> 00:40:39,120 ACTIVITIES, PLEASURE, NOT 1142 00:40:39,120 --> 00:40:41,240 NECESSARILY ANTI-DEPRESSANT AND 1143 00:40:41,240 --> 00:40:43,080 FOR SOME PEOPLE THAT GOES WITH 1144 00:40:43,080 --> 00:40:44,200 ANXIETY OR DOESN'T FIX THE 1145 00:40:44,200 --> 00:40:44,520 PROBLEM. 1146 00:40:44,520 --> 00:40:46,480 IF THEY DON'T HAVE A PROBLEM 1147 00:40:46,480 --> 00:40:48,920 WITH LOSS OF PLEASURE, DOING 1148 00:40:48,920 --> 00:40:50,520 SOMETHING THAT INCREASES 1149 00:40:50,520 --> 00:40:51,640 PLEASURE IN INTEREST DOESN'T FIX 1150 00:40:51,640 --> 00:40:52,400 THEIR PROBLEM. 1151 00:40:52,400 --> 00:40:55,240 WE SAW THIS LITERALLY THERE WAS 1152 00:40:55,240 --> 00:40:57,760 VARIATION WHETHER PEOPLE FOUND 1153 00:40:57,760 --> 00:41:01,160 THOSE INCREASES IN CAPACITY AND 1154 00:41:01,160 --> 00:41:02,200 SPECIFIC DIMENSIONS THERAPEUTIC, 1155 00:41:02,200 --> 00:41:08,440 SOME HELPFUL IN SOME CASES, SOME 1156 00:41:08,440 --> 00:41:10,280 HELPFUL IN OTHER PLACES. 1157 00:41:10,280 --> 00:41:12,120 IF WE STIMULATE FIVE MINUTES TO 1158 00:41:12,120 --> 00:41:13,440 KEY EFFECTS UP TO 30 MINUTES, 1159 00:41:13,440 --> 00:41:14,520 SOMETIMES AN HOUR. 1160 00:41:14,520 --> 00:41:15,560 WE COULDN'T HAVE LUXURY OF 1161 00:41:15,560 --> 00:41:18,120 WAITING TO SEE HOW LONG THEY 1162 00:41:18,120 --> 00:41:20,080 LASTED, ALMOST ALL CASES, 1163 00:41:20,080 --> 00:41:22,280 BECAUSE THE 10-DAY PERIOD OF 1164 00:41:22,280 --> 00:41:22,840 EXPLORATION WAS JAM-PACKED. 1165 00:41:22,840 --> 00:41:24,920 THE LONGEST WE WOULD SEE WAS 1166 00:41:24,920 --> 00:41:29,320 WHEN WE WOULD DO INTERMITTENT 1167 00:41:29,320 --> 00:41:31,680 STIM TESTING TO IDENTIFY OPTIMAL 1168 00:41:31,680 --> 00:41:32,680 SETTINGS AND SOMETIMES SEE FOR 1169 00:41:32,680 --> 00:41:35,000 UP TO 3 HOURS OF EFFECT. 1170 00:41:35,000 --> 00:41:36,320 WE ALSO SAW STATE DEPENDENCE 1171 00:41:36,320 --> 00:41:38,560 WHICH SHOULD HAVE BEEN 1172 00:41:38,560 --> 00:41:40,120 ANTICIPATED BUT I THINK I HADN'T 1173 00:41:40,120 --> 00:41:42,200 THOUGHT OF THIS THAT SOMETIMES 1174 00:41:42,200 --> 00:41:43,840 YOU DON'T SEE EFFECTS BUT THAT'S 1175 00:41:43,840 --> 00:41:46,360 BECAUSE THE STATE OF THE PERSON, 1176 00:41:46,360 --> 00:41:48,120 STATE OF THEIR BRAIN, VARIES. 1177 00:41:48,120 --> 00:41:52,480 SOMETIMES WHEN PEOPLE ARE SLEEPY 1178 00:41:52,480 --> 00:41:57,120 THE CIRCUITS ARE IN DIFFERENT 1179 00:41:57,120 --> 00:41:58,320 STATES THAN ALERT, DIFFERENT 1180 00:41:58,320 --> 00:41:59,160 NUMBER OF DEPENDENCIES, THIS WAS 1181 00:41:59,160 --> 00:42:01,360 A CLEAR ONE FROM OUR INITIAL 1182 00:42:01,360 --> 00:42:03,040 EFFORTS TO DO THIS, TURNED OUT 1183 00:42:03,040 --> 00:42:08,600 TO BE USEFUL IN STRIKE TO 1184 00:42:08,600 --> 00:42:08,920 UNDERSTAND. 1185 00:42:08,920 --> 00:42:14,840 QUICKLY SHOWING FIGURES ON THE 1186 00:42:14,840 --> 00:42:16,480 LEFT, DOSE-RESPONSE, EVIDENCE WE 1187 00:42:16,480 --> 00:42:25,120 SAW BENEFIT IN IMPROVEMENT IN 1188 00:42:25,120 --> 00:42:26,680 ANTI-DEPRESSANT EFFECTS, WE ONLY 1189 00:42:26,680 --> 00:42:28,200 HAD A 20-MINUTE PERIOD HERE 1190 00:42:28,200 --> 00:42:30,720 BETWEEN FIRST STIM AND NEXT 1191 00:42:30,720 --> 00:42:32,240 STIM, SO WE COULDN'T SAY IT 1192 00:42:32,240 --> 00:42:34,000 LASTED MORE THAN 30 MINUTES FROM 1193 00:42:34,000 --> 00:42:34,760 ONSET OF THE STIMULATION, 1194 00:42:34,760 --> 00:42:36,960 BECAUSE WE HAD TO GO ON TO THE 1195 00:42:36,960 --> 00:42:39,360 NEXT THING WE DID BUT SAW THIS 1196 00:42:39,360 --> 00:42:40,000 REPEATEDLY. 1197 00:42:40,000 --> 00:42:45,040 THE OTHER, ON THE RIGHT SIDE IS 1198 00:42:45,040 --> 00:42:47,160 THREE FIGURES, FIGURES THAT 1199 00:42:47,160 --> 00:42:47,800 DEPICT STATE DEPENDENCE. 1200 00:42:47,800 --> 00:42:51,960 ON THE LEFT YOU SEE THE LEVEL OF 1201 00:42:51,960 --> 00:42:53,240 AROUSAL, WHETHER POSITIVE ALERT, 1202 00:42:53,240 --> 00:42:54,360 IF YOU'RE NEGATIVE IT MEANS 1203 00:42:54,360 --> 00:42:56,520 YOU'RE MORE SEDATED. 1204 00:42:56,520 --> 00:42:59,400 AND THE ARROW GOING UP 1205 00:42:59,400 --> 00:43:00,280 ANTI-DEPRESSANT, GOING DOWN SAYS 1206 00:43:00,280 --> 00:43:02,560 YOU GOT WORK IN YOUR 1207 00:43:02,560 --> 00:43:04,720 ANTI-DEPRESSANT EFFECT AND THIS 1208 00:43:04,720 --> 00:43:07,160 SAYS WE FOUND IN THE CORTEX THE 1209 00:43:07,160 --> 00:43:08,560 PATIENT SLEEPY THAT IT MAKES 1210 00:43:08,560 --> 00:43:10,120 THEM WORSE, IF THEY ARE MORE 1211 00:43:10,120 --> 00:43:13,080 ALERT THEN IT IMPROVES THEIR 1212 00:43:13,080 --> 00:43:13,360 DEPRESSION. 1213 00:43:13,360 --> 00:43:16,160 WHEREAS THE SAME SORT OF PATTERN 1214 00:43:16,160 --> 00:43:19,840 WAS SEEN IN THE CINGULATE, THE 1215 00:43:19,840 --> 00:43:21,120 STRIATUM WAS NOT DEPENDENT ON 1216 00:43:21,120 --> 00:43:22,680 THIS AND THIS KIND OF THING 1217 00:43:22,680 --> 00:43:25,440 SEEMS TO VARY FROM SITE TO SITE. 1218 00:43:25,440 --> 00:43:27,000 LIMITING TIME I JUST NEED TO 1219 00:43:27,000 --> 00:43:29,400 SUMMARIZE A FEW THINGS AND THEN 1220 00:43:29,400 --> 00:43:32,280 I'LL STOP. 1221 00:43:32,280 --> 00:43:35,080 WE MOVE THEN TO THE NEXT PHASE. 1222 00:43:35,080 --> 00:43:39,000 FIRST WE WERE ABLE TO FIND A 1223 00:43:39,000 --> 00:43:49,560 BIOMARKER, 77% ACCURATE, LED TO 1224 00:43:50,080 --> 00:43:53,560 BENEFIT, A FEW TIMES IT DIDN'T. 1225 00:43:53,560 --> 00:43:55,560 THE SITE FUNCTIONED AS AN 1226 00:43:55,560 --> 00:43:57,200 INTERCONNECTED CIRCUIT AND WE 1227 00:43:57,200 --> 00:44:00,920 VERIFIED THIS BY DOING EVOKED 1228 00:44:00,920 --> 00:44:01,520 POTENTIAL MAPPING STIMULATING 1229 00:44:01,520 --> 00:44:04,080 STRIATUM, YOU CAN SEE THE DOTS 1230 00:44:04,080 --> 00:44:06,600 HOW MUCH RESPONSE DID YOU GET IN 1231 00:44:06,600 --> 00:44:08,240 DIFFERENT PARTS OF THE BRAIN. 1232 00:44:08,240 --> 00:44:10,320 ONE OF THE RELATIVELY HIGHER 1233 00:44:10,320 --> 00:44:14,160 RESPONDING PARTS WAS THE 1234 00:44:14,160 --> 00:44:14,920 BASOLATERAL AMYGDALA, THE 1235 00:44:14,920 --> 00:44:16,760 ORANGISH -- NOT THE BRIGHT 1236 00:44:16,760 --> 00:44:20,840 ORANGE, THAT WAS IN HIPPOCAMPUS, 1237 00:44:20,840 --> 00:44:24,120 BUT AMYGDALA LOTS OF SITES ARE 1238 00:44:24,120 --> 00:44:28,080 INTERCONNECTED BUT THE BIOMARKER 1239 00:44:28,080 --> 00:44:29,400 WAS PRESENT IN AMYGDALA, THE 1240 00:44:29,400 --> 00:44:30,920 FIGURE ON THE RIGHT SHOWS THAT 1241 00:44:30,920 --> 00:44:33,240 WHEN YOU STIMULATE IT AND 1242 00:44:33,240 --> 00:44:34,760 THERE'S IMPROVEMENT THEN YOU 1243 00:44:34,760 --> 00:44:40,000 NORMALIZE THE BIOMARKER WHICH IS 1244 00:44:40,000 --> 00:44:41,640 CRITICAL FOR IMPLEMENTING CLOSED 1245 00:44:41,640 --> 00:44:44,320 LOOP, YOUR STIMULATION DOESN'T 1246 00:44:44,320 --> 00:44:46,600 NORMALIZE THEN YOU DON'T STOP 1247 00:44:46,600 --> 00:44:48,240 SIMULATING SO THESE WERE THE 1248 00:44:48,240 --> 00:44:53,040 INGREDIENTS THAT LED US TO DO 1249 00:44:53,040 --> 00:44:57,560 THAT CHOICE, WE WENT TO STAGE 2, 1250 00:44:57,560 --> 00:45:05,520 VERIFIED THERAPEUTIC EFFECTS AT 1251 00:45:05,520 --> 00:45:08,600 TWO CONFIGURATIONS, IN THE 1252 00:45:08,600 --> 00:45:12,720 VENTRAL CAPSULE, TITRATED BELOW 1253 00:45:12,720 --> 00:45:15,000 DETECTED BY THE PATIENT, WE 1254 00:45:15,000 --> 00:45:17,120 WANTED THIS EFFECT TO BE AS 1255 00:45:17,120 --> 00:45:19,640 SUBTLE AS POSSIBLE, TURNED OUT 1256 00:45:19,640 --> 00:45:22,360 IT WAS POSSIBLE FOR LEADING TO 1257 00:45:22,360 --> 00:45:24,240 THERAPEUTIC EFFECT, VERIFIED 1258 00:45:24,240 --> 00:45:27,320 BIOMARKER WITH AMYGDALA GAMMA 1259 00:45:27,320 --> 00:45:29,600 BEING ASSOCIATED WITH THE 1260 00:45:29,600 --> 00:45:31,600 DEPRESSION OUTCOME. 1261 00:45:31,600 --> 00:45:32,880 AND WE FOUND CHRONICALLY THAT 1262 00:45:32,880 --> 00:45:36,400 THIS WAS QUITE THERAPEUTIC FOR 1263 00:45:36,400 --> 00:45:37,040 THIS PATIENT. 1264 00:45:37,040 --> 00:45:38,360 INTERESTINGLY, JUST TO GIVE A 1265 00:45:38,360 --> 00:45:40,520 DIFFERENCE BETWEEN CLOSED LOOP 1266 00:45:40,520 --> 00:45:44,480 AND OPEN LOOP, THIS PERSON IS 1267 00:45:44,480 --> 00:45:50,160 BEING STIMULATED IN 6-SECOND 1268 00:45:50,160 --> 00:45:51,360 BURSTS, AND GETS AROUND 470 OF 1269 00:45:51,360 --> 00:45:55,200 THESE A DAY, WHICH IS A TOTAL OF 1270 00:45:55,200 --> 00:45:56,280 AROUND -- BETWEEN 15 AND 30 1271 00:45:56,280 --> 00:45:57,760 MINUTES OF STIMULATION A DAY 1272 00:45:57,760 --> 00:45:59,920 VERSUS OPEN LOOP WHICH WOULD BE 1273 00:45:59,920 --> 00:46:00,680 24 HOURS. 1274 00:46:00,680 --> 00:46:05,040 SO A LOT LESS INTENSIVE IN 1275 00:46:05,040 --> 00:46:06,000 INTERVENTION, ALSO CONSERVES 1276 00:46:06,000 --> 00:46:07,680 BATTERY LIFE, ET CETERA. 1277 00:46:07,680 --> 00:46:09,240 THIS PERSON SAW DRAMATIC 1278 00:46:09,240 --> 00:46:09,880 REDUCTION IN SYMPTOMS 1279 00:46:09,880 --> 00:46:15,480 IMMEDIATELY FIRST TIME WE 1280 00:46:15,480 --> 00:46:16,560 STIMULATED VENTRAL CAPSULE, 1281 00:46:16,560 --> 00:46:17,520 EVERY TIME AFTERWARDS, LOWERED 1282 00:46:17,520 --> 00:46:21,320 TO WHERE YOU CAN DETECT IT, AND 1283 00:46:21,320 --> 00:46:22,920 DID CLOSED LOOP SHE HAD 1284 00:46:22,920 --> 00:46:23,440 SIGNIFICANT AND SUSTAINED 1285 00:46:23,440 --> 00:46:28,200 REDUCTION AS YOU CAN SEE ON THE 1286 00:46:28,200 --> 00:46:29,600 RIGHT, HAMILTON DEPRESSION, AND 1287 00:46:29,600 --> 00:46:30,720 SCALES DROPPED AND STATE DOWN 1288 00:46:30,720 --> 00:46:32,120 DRAMATICALLY AND HAVE DONE SO 1289 00:46:32,120 --> 00:46:33,120 FOR A YEAR. 1290 00:46:33,120 --> 00:46:34,320 THERE'S DETAILS TO THAT, I DON'T 1291 00:46:34,320 --> 00:46:39,320 HAVE TIME TO GO INTO, BUT ALSO 1292 00:46:39,320 --> 00:46:42,560 THE IMPROVEMENT IN SYMPTOMS WAS 1293 00:46:42,560 --> 00:46:46,520 LINKED TO THE BIOMARKER AND 1294 00:46:46,520 --> 00:46:47,320 STIMULATIONS RECEIVED. 1295 00:46:47,320 --> 00:46:49,280 THIS IS SOMETHING THAT WAS VERY 1296 00:46:49,280 --> 00:46:50,440 EVIDENT TO THIS INDIVIDUAL WHO 1297 00:46:50,440 --> 00:46:52,760 FEELS LIKE HER LIFE HAS BEEN 1298 00:46:52,760 --> 00:46:54,720 CHANGED BY THIS AND HAS BEEN 1299 00:46:54,720 --> 00:46:56,480 HUGELY VALUABLE IN HER ABILITY 1300 00:46:56,480 --> 00:46:58,680 TO FUNCTION AND GET ON WITH HER 1301 00:46:58,680 --> 00:47:00,760 LIFE WHICH WAS STYMIED BY SEVERE 1302 00:47:00,760 --> 00:47:01,360 TREATMENT RESISTANT DEPRESSION. 1303 00:47:01,360 --> 00:47:04,120 I WANT TO MAKE THE LAST POINT 1304 00:47:04,120 --> 00:47:05,400 THAT WE'VE TREATED A SECOND 1305 00:47:05,400 --> 00:47:06,760 PERSON WHO MADE IT THROUGH STAGE 1306 00:47:06,760 --> 00:47:08,400 2 AND WE'VE SEEN THE STADIUM 1307 00:47:08,400 --> 00:47:09,480 KIND OF RESULTS. 1308 00:47:09,480 --> 00:47:10,280 MORE COMPLICATED IN TERMS OF 1309 00:47:10,280 --> 00:47:13,200 THIS IS A PERSON WITH WAY MORE 1310 00:47:13,200 --> 00:47:14,960 VARIATION IN SYMPTOMS, AND AT 1311 00:47:14,960 --> 00:47:17,240 ONE POINT WE THOUGHT THAT SHAM 1312 00:47:17,240 --> 00:47:18,160 WAS BEING AFFECTED BECAUSE WHEN 1313 00:47:18,160 --> 00:47:21,880 WE STARTED TO DELIVER 1314 00:47:21,880 --> 00:47:23,000 TREATMENTS, THERE WERE 1315 00:47:23,000 --> 00:47:25,160 PRESUMABLY ADAPTATIONS WHETHER 1316 00:47:25,160 --> 00:47:28,480 THIS IS SEVERITY LEVEL DROPPED 1317 00:47:28,480 --> 00:47:31,120 ON AVERAGE SIGNIFICANTLY BELOW 1318 00:47:31,120 --> 00:47:34,720 BUT AT 10 HERTZ WAS MORE 1319 00:47:34,720 --> 00:47:36,240 EFFECTIVE THAN A SHAM AND HE'S 1320 00:47:36,240 --> 00:47:38,200 NOW GOING INTO OUR THIRD PHASE 1321 00:47:38,200 --> 00:47:39,720 FOR THE CROSSOVER STUDY IN THE 1322 00:47:39,720 --> 00:47:43,200 NEAR FUTURE. 1323 00:47:43,200 --> 00:47:46,400 SO TO CONCLUDE, WE HAVE SEEN 1324 00:47:46,400 --> 00:47:50,800 SOME PROOF OF CONCEPT HERE THAT 1325 00:47:50,800 --> 00:47:54,160 YOU CAN DO PERSONALIZED 1326 00:47:54,160 --> 00:47:55,040 TARGETING USING 1327 00:47:55,040 --> 00:47:57,480 STIMULUS-RESPONSE MAPPING AND WE 1328 00:47:57,480 --> 00:47:58,760 SEE CONSISTENT EFFECTS ACROSS 1329 00:47:58,760 --> 00:48:02,400 PEOPLE IN DIMENSIONS OF BEHAVIOR 1330 00:48:02,400 --> 00:48:08,320 BUT DIFFERENT TYPES ARE 1331 00:48:08,320 --> 00:48:08,840 EFFECTIVE. 1332 00:48:08,840 --> 00:48:11,120 WE TREATED THREE THROUGH STAGE 1333 00:48:11,120 --> 00:48:17,000 1, ALL WERE DIFFERENT. 1334 00:48:17,000 --> 00:48:20,720 VENTRAL CAPSULE, VENTRAL 1335 00:48:20,720 --> 00:48:22,160 STRIATUM IN ONE. 1336 00:48:22,160 --> 00:48:23,880 WE WERE ABLE TO FIND BIOMARKERS 1337 00:48:23,880 --> 00:48:26,640 IN ALL THREE, SOME PEOPLE THEY 1338 00:48:26,640 --> 00:48:28,640 WERE STRONGER RELATIONSHIP WITH 1339 00:48:28,640 --> 00:48:31,560 SYMPTOMS BUT BIOMARKERS IN 1340 00:48:31,560 --> 00:48:32,440 DIFFERENT LOCATIONS AND 1341 00:48:32,440 --> 00:48:35,920 DIFFERENT BANDS AND SO ON. 1342 00:48:35,920 --> 00:48:38,560 WE'VE SEEN THIS IS SAFE AND CAN 1343 00:48:38,560 --> 00:48:39,800 BE EFFECTIVE IN TWO PEOPLE 1344 00:48:39,800 --> 00:48:41,000 ESTABLISHING PROOF OF CONCEPT 1345 00:48:41,000 --> 00:48:43,600 FOR THE APPROACH, I THINK, AND 1346 00:48:43,600 --> 00:48:45,920 WE'VE SEEN OVER AND OVER 1347 00:48:45,920 --> 00:48:46,880 IMMEDIATE THERAPEUTIC EFFECTS 1348 00:48:46,880 --> 00:48:49,720 WHICH CHALLENGES THE MODEL TO 1349 00:48:49,720 --> 00:48:50,680 STIMULATE CONTINUOUSLY OR WAIT 4 1350 00:48:50,680 --> 00:48:52,240 TO 8 WEEKS AND WE'RE IN THE 1351 00:48:52,240 --> 00:48:54,240 MIDDLE OF THIS STUDY WHICH I 1352 00:48:54,240 --> 00:48:55,640 FEEL PRIVILEGED TO BE ABLE TO 1353 00:48:55,640 --> 00:48:56,200 CARRY OUT. 1354 00:48:56,200 --> 00:48:59,120 I'LL STOP AND SEE IF WE HAVE 1355 00:48:59,120 --> 00:49:01,120 TIME FOR QUESTIONS. 1356 00:49:01,120 --> 00:49:03,400 >>THANK YOU, DR. KRYSTAL. 1357 00:49:03,400 --> 00:49:05,960 DOES ANYONE HAVE AN IMMEDIATE 1358 00:49:05,960 --> 00:49:07,240 FACTUAL QUESTION FOR DR. 1359 00:49:07,240 --> 00:49:08,040 KRYSTAL? 1360 00:49:08,040 --> 00:49:10,400 IF SO NOW WOULD BE THE TIME, 1361 00:49:10,400 --> 00:49:12,160 BEFORE WE INTRODUCE THE SECOND 1362 00:49:12,160 --> 00:49:15,440 SPEAKER, AND THEN WE'LL HAVE A 1363 00:49:15,440 --> 00:49:17,080 DISCUSSION OF OVERARCHING 1364 00:49:17,080 --> 00:49:23,320 ETHICAL QUESTIONS THAT WERE PUT 1365 00:49:23,320 --> 00:49:23,480 UP. 1366 00:49:23,480 --> 00:49:23,680 NITA. 1367 00:49:23,680 --> 00:49:23,960 GO AHEAD. 1368 00:49:23,960 --> 00:49:25,840 >>THANK YOU FOR THE WONDERFUL 1369 00:49:25,840 --> 00:49:28,680 PRESENTATION, RICH AND DEEPLY 1370 00:49:28,680 --> 00:49:30,200 INFORMATIVE. 1371 00:49:30,200 --> 00:49:31,120 SINCE THE STIMULATION SITE IS 1372 00:49:31,120 --> 00:49:32,440 DIFFERENT PER PATIENT AND 1373 00:49:32,440 --> 00:49:34,480 BIOMARKERS ARE DIFFERENT CAN YOU 1374 00:49:34,480 --> 00:49:37,880 UNPACK A LITTLE BIT BOTH HOW 1375 00:49:37,880 --> 00:49:39,520 YOUR TRAINING ON PARTICULAR 1376 00:49:39,520 --> 00:49:40,880 SITES OF INDIVIDUALS -- HOW 1377 00:49:40,880 --> 00:49:41,680 YOU'RE TRAINING ON PARTICULAR 1378 00:49:41,680 --> 00:49:43,120 SITES OF THE INDIVIDUALS TO 1379 00:49:43,120 --> 00:49:44,320 FIGURE THAT OUT AND SINCE 1380 00:49:44,320 --> 00:49:46,640 STIMULATION IS CLOSED LOOP 1381 00:49:46,640 --> 00:49:47,760 VERSUS OPEN LOOP OVER TIME HOW 1382 00:49:47,760 --> 00:49:49,160 DO YOU ENSURE THE SITE IS STABLE 1383 00:49:49,160 --> 00:49:54,200 OVER TIME ONCE THE STIMULATION 1384 00:49:54,200 --> 00:49:54,600 ACTUALLY OCCURS? 1385 00:49:54,600 --> 00:49:55,520 >>GREAT QUESTIONS. 1386 00:49:55,520 --> 00:49:58,160 IF I HAD THREE HOURS I COULD 1387 00:49:58,160 --> 00:50:01,560 START TO DO JUSTICE TO THE 1388 00:50:01,560 --> 00:50:02,480 ANSWERS. 1389 00:50:02,480 --> 00:50:04,400 THE SHORT ANSWERS ARE WE GO IN 1390 00:50:04,400 --> 00:50:06,440 WITH THE ASSUMPTION WE DON'T 1391 00:50:06,440 --> 00:50:08,760 HAVE ANY IDEA WHERE THIS 1392 00:50:08,760 --> 00:50:10,480 STIMULATION WILL BE BEST, MOST 1393 00:50:10,480 --> 00:50:11,120 EFFECTIVE FOR PEOPLE, WHAT THE 1394 00:50:11,120 --> 00:50:14,120 BIOMARKER WILL BE. 1395 00:50:14,120 --> 00:50:16,000 WE DO STIMULUS/RESPONSE MAPPING 1396 00:50:16,000 --> 00:50:18,400 STARTING WITH A WIDE SET AND 1397 00:50:18,400 --> 00:50:21,560 BASED ON ASSUMPTION WE SHY SEE 1398 00:50:21,560 --> 00:50:22,160 IMMEDIATE THERAPEUTIC EFFECTS 1399 00:50:22,160 --> 00:50:23,640 HONE DOWN TO A SMALLER NUMBER 1400 00:50:23,640 --> 00:50:25,400 AND EACH PERSON WE GET A SET OF 1401 00:50:25,400 --> 00:50:26,720 FINALISTS BY THE END OF THAT 1402 00:50:26,720 --> 00:50:28,280 WEEK THAT WE TEST IN MORE DEPTH 1403 00:50:28,280 --> 00:50:30,520 SO WE START OUT WITH BASICALLY A 1404 00:50:30,520 --> 00:50:32,200 SAFETY SCREEN TO FIGURE OUT 1405 00:50:32,200 --> 00:50:38,840 MAKING SURE WE CAN BE IN A RANGE 1406 00:50:38,840 --> 00:50:42,120 WITHOUT EPILEPTIC ACTIVITY, AT 1407 00:50:42,120 --> 00:50:43,760 LEAST TWO STIMES IN EACH 1408 00:50:43,760 --> 00:50:45,080 LOCATION UNLESS THERE'S NEGATIVE 1409 00:50:45,080 --> 00:50:45,960 EFFECT ELICITED. 1410 00:50:45,960 --> 00:50:50,200 THE BIOMARKER IS WE TAKE ALL 1411 00:50:50,200 --> 00:50:53,600 THAT DATA THAT WE COLLECT FROM 1412 00:50:53,600 --> 00:51:00,360 THE INTRACRANIAL EEGs AND DO 1413 00:51:00,360 --> 00:51:02,120 EXPLORATORY ANALYSIS WITH HIGH 1414 00:51:02,120 --> 00:51:03,000 STANDARD REQUIRING HUGE EFFECTS 1415 00:51:03,000 --> 00:51:05,840 NOT SEEN BY CHANCE AND COME OUT 1416 00:51:05,840 --> 00:51:09,800 WITH AN EFFECT -- A PERSONALIZED 1417 00:51:09,800 --> 00:51:10,360 STRATEGY AND PERSONALIZED 1418 00:51:10,360 --> 00:51:11,440 BIOMARKER THAT THEN GET VERIFIED 1419 00:51:11,440 --> 00:51:12,840 IN STAGE 2. 1420 00:51:12,840 --> 00:51:14,840 SO THAT'S SORT OF HOW WE GET TO 1421 00:51:14,840 --> 00:51:15,400 DIFFERENT STRATEGIES OF 1422 00:51:15,400 --> 00:51:15,920 DIFFERENT PEOPLE. 1423 00:51:15,920 --> 00:51:20,200 THERE WAS A SECOND QUESTION I 1424 00:51:20,200 --> 00:51:20,440 FORGOT. 1425 00:51:20,440 --> 00:51:22,800 >>JUST THE STABILITY OF 1426 00:51:22,800 --> 00:51:23,680 STIMULATION OVER TIME. 1427 00:51:23,680 --> 00:51:24,520 >>RIGHT. 1428 00:51:24,520 --> 00:51:26,200 SO WE OF COURSE DON'T KNOW THAT 1429 00:51:26,200 --> 00:51:27,280 IN ANY GREAT WAY. 1430 00:51:27,280 --> 00:51:31,920 I WOULD SAY SO FAR WE'VE SEEN 1431 00:51:31,920 --> 00:51:32,600 SUSTAINED BENEFIT HAPPENING FOR 1432 00:51:32,600 --> 00:51:35,080 PERIODS UP TO A YEAR. 1433 00:51:35,080 --> 00:51:36,720 WE HAD ONE COMPLICATED THING, 1434 00:51:36,720 --> 00:51:40,000 ONE OF OUR -- OUR FIRST PATIENT 1435 00:51:40,000 --> 00:51:43,000 GOT COVID, AND ALSO WHAT LOOKS 1436 00:51:43,000 --> 00:51:45,720 LIKE LONG -- IS A LONG HAUL, 1437 00:51:45,720 --> 00:51:46,920 WHICH IS A COMPLICATION, YOU 1438 00:51:46,920 --> 00:51:50,640 KNOW, YOU HOPE IS NOT GOING TO 1439 00:51:50,640 --> 00:51:51,320 HAPPEN. 1440 00:51:51,320 --> 00:51:52,600 BUT SHE CAN TELL DIFFERENCE 1441 00:51:52,600 --> 00:51:54,040 BETWEEN HER DEPRESSION AND 1442 00:51:54,040 --> 00:51:56,280 THERAPEUTIC STIMULATION AND BY 1443 00:51:56,280 --> 00:51:57,880 AND LARGE THE STIMULUS HAS 1444 00:51:57,880 --> 00:51:59,080 REMAINED THERAPEUTIC OVER TIME 1445 00:51:59,080 --> 00:52:00,840 BUT IT'S VERY CLEAR THAT WE HAVE 1446 00:52:00,840 --> 00:52:03,920 IMMEDIATE EFFECTS THAT WE CAN 1447 00:52:03,920 --> 00:52:07,960 SEE, REFLECTED IN POWER AND 1448 00:52:07,960 --> 00:52:11,880 COHERENCE AND THINGS LIKE THAT 1449 00:52:11,880 --> 00:52:13,200 PROBABLY ACTIVITY RELATED BUT 1450 00:52:13,200 --> 00:52:15,280 OVER THE LONG TERM IT'S CLEAR WE 1451 00:52:15,280 --> 00:52:18,960 GET CHANGES IN CIRCUIT 1452 00:52:18,960 --> 00:52:20,520 CONNECTIVITY, CAN SEE WITH 1453 00:52:20,520 --> 00:52:24,880 EVOKED POTENTIAL, THE CIRCUIT IS 1454 00:52:24,880 --> 00:52:26,720 CHANGES, MAY NEED TO BE UPDATED 1455 00:52:26,720 --> 00:52:28,720 BUT WE'RE JUST LEARNING THIS. 1456 00:52:28,720 --> 00:52:29,480 I THINK INSTABILITY IS THE 1457 00:52:29,480 --> 00:52:32,320 NATURE OF THE BRAIN. 1458 00:52:32,320 --> 00:52:33,960 IT'S AN ADAPTIVE ORGAN. 1459 00:52:33,960 --> 00:52:36,280 THE FACT THAT WE SEE EFFECTS 1460 00:52:36,280 --> 00:52:37,480 THAT ARE THERAPEUTIC THAT 1461 00:52:37,480 --> 00:52:38,480 SUSTAIN IS SURPRISING TO ME. 1462 00:52:38,480 --> 00:52:40,400 I WOULD HAVE EXPECTED WE WOULD 1463 00:52:40,400 --> 00:52:41,640 HAVE TO ADAPT MORE THAN WE HAVE 1464 00:52:41,640 --> 00:52:43,520 BUT WITH BIOMARKER IT LOOKS LIKE 1465 00:52:43,520 --> 00:52:46,880 WE'RE GOING TO HAVE TO ADAPT 1466 00:52:46,880 --> 00:52:47,080 MORE. 1467 00:52:47,080 --> 00:52:47,680 >>GREAT. 1468 00:52:47,680 --> 00:52:50,400 MAY EVEN BE A GOOD THING. 1469 00:52:50,400 --> 00:52:53,040 JIM, NICE TO SEE YOU AGAIN. 1470 00:52:53,040 --> 00:52:54,600 >>YOU TOO, CHRISTINE. 1471 00:52:54,600 --> 00:52:56,880 THANKS, DR. KRYSTAL. 1472 00:52:56,880 --> 00:52:58,080 REALLY QUITE INTERESTING. 1473 00:52:58,080 --> 00:53:00,120 YOU PARTIALLY ADDRESSED THIS IN 1474 00:53:00,120 --> 00:53:06,000 YOUR COMMENTS TO NITA, WONDERING 1475 00:53:06,000 --> 00:53:07,400 THERAPEUTIC EFFECT IS IT GRADED? 1476 00:53:07,400 --> 00:53:08,720 IT'S NOT THE SAME EACH TIME I 1477 00:53:08,720 --> 00:53:09,200 PRESUME. 1478 00:53:09,200 --> 00:53:11,200 HOW DO YOU MEASURE AND MAKE 1479 00:53:11,200 --> 00:53:12,760 SENSE OF ALL OF THAT? 1480 00:53:12,760 --> 00:53:14,960 >>SO ANOTHER COMPLICATED 1481 00:53:14,960 --> 00:53:15,200 QUESTION. 1482 00:53:15,200 --> 00:53:17,800 IN THE INITIAL PHASE WE HIT THE 1483 00:53:17,800 --> 00:53:19,440 CIRCUITRY I THINK PRETTY HARD 1484 00:53:19,440 --> 00:53:23,680 AND WE SEE PEOPLE SAYING LIKE 1485 00:53:23,680 --> 00:53:27,320 WOW, I FEEL THIS LIKE BETTER 1486 00:53:27,320 --> 00:53:30,160 FEELING, I FEEL MORE ENERGY, 1487 00:53:30,160 --> 00:53:33,120 MORE ALERT, OR I FEEL BAD, I 1488 00:53:33,120 --> 00:53:34,960 FEEL ANXIOUS BUT THEY FEEL BIG 1489 00:53:34,960 --> 00:53:36,920 EFFECT WAS EVERY STIMULUS. 1490 00:53:36,920 --> 00:53:38,280 WHEN WE GET TO WHERE WE 1491 00:53:38,280 --> 00:53:40,880 IMPLEMENT WE DON'T WANT PEOPLE 1492 00:53:40,880 --> 00:53:45,720 TO HAVE AN UP EVERY TIME THEY 1493 00:53:45,720 --> 00:53:47,680 GET STIMULATE AND IT DISRUPTS 1494 00:53:47,680 --> 00:53:49,840 THEIR LIFE NOT CONDUCIVE WITH 1495 00:53:49,840 --> 00:53:51,400 GOOD FUNCTION, WE'RE NOT TRYING 1496 00:53:51,400 --> 00:53:53,120 TO MAKE PEOPLE HAPPY, WE'RE 1497 00:53:53,120 --> 00:53:54,200 TRYING TO TAKE AWAY DEPRESSION 1498 00:53:54,200 --> 00:53:56,280 WHICH IS DIFFERENT. 1499 00:53:56,280 --> 00:53:59,600 HIGH INTENSITY STIMULATION LIKE 1500 00:53:59,600 --> 00:54:01,800 IN THE VENTRAL CAPSULE LIKE THE 1501 00:54:01,800 --> 00:54:03,240 FIRST PATIENT WE COULD MAKE HER 1502 00:54:03,240 --> 00:54:05,200 HAPPY BUT I COULDN'T LIVE THIS 1503 00:54:05,200 --> 00:54:08,920 WAY, I'M LIKE TOO -- IT'S LIKE 1504 00:54:08,920 --> 00:54:10,560 I'M HIGH, THERE'S A DISCUSSION 1505 00:54:10,560 --> 00:54:13,640 TO BE HAD AROUND THAT. 1506 00:54:13,640 --> 00:54:16,360 WHEN WE LOWERED TO BELOW, I JUST 1507 00:54:16,360 --> 00:54:18,880 FEEL GOOD, THE PROBLEM IS GONE. 1508 00:54:18,880 --> 00:54:21,080 WHEN GOOD THINGS HAPPEN SHE 1509 00:54:21,080 --> 00:54:22,920 FEELS BETTER, WHEN BAD THINGS 1510 00:54:22,920 --> 00:54:23,920 HAPPEN SHE FEELS WORSE. 1511 00:54:23,920 --> 00:54:28,040 WE DON'T WANT TO TAKE THAT WE. 1512 00:54:28,040 --> 00:54:30,040 CRITICAL ADAPTIVE FUNCTIONS THAT 1513 00:54:30,040 --> 00:54:33,440 HUMANS HAVE THAT ARE HUGELY 1514 00:54:33,440 --> 00:54:36,840 IMPORTANT FOR THEIR EFFECTIVE 1515 00:54:36,840 --> 00:54:37,520 LIFE. 1516 00:54:37,520 --> 00:54:39,080 SO IT'S MORE BASICALLY WHAT THE 1517 00:54:39,080 --> 00:54:42,080 PATIENTS SAY IS I JUST DON'T 1518 00:54:42,080 --> 00:54:44,280 FEEL THE DEPRESSION NOW. 1519 00:54:44,280 --> 00:54:46,320 IT'S NOT THAT OH, I KNOW I'M 1520 00:54:46,320 --> 00:54:47,320 BEING STIMULATED. 1521 00:54:47,320 --> 00:54:49,760 THEY THINK THEY KNOW AND ARE 1522 00:54:49,760 --> 00:54:52,160 USUALLY WRONG ONCE WE GET TO THE 1523 00:54:52,160 --> 00:54:53,040 SUBDETECTION LEVEL. 1524 00:54:53,040 --> 00:54:55,120 I HOPE THAT ANSWERS THE 1525 00:54:55,120 --> 00:54:55,400 QUESTION. 1526 00:54:55,400 --> 00:54:58,000 >>THANK YOU, IT DOES. 1527 00:54:58,000 --> 00:54:59,600 I WONDER THOUGH IN THE 1528 00:54:59,600 --> 00:55:01,000 CLOSED-LOOP SYSTEM THEN SHOULD 1529 00:55:01,000 --> 00:55:03,240 YOU GEAR IT TOWARDS HOW THE 1530 00:55:03,240 --> 00:55:04,640 PATIENT IS FEELING OR TO THE 1531 00:55:04,640 --> 00:55:04,880 BIOMARKER? 1532 00:55:04,880 --> 00:55:06,840 >>THIS IS A GREAT QUESTION. 1533 00:55:06,840 --> 00:55:08,240 WHAT HAPPENED IS WE DEVELOP A 1534 00:55:08,240 --> 00:55:10,520 BIOMARKER THAT'S AT THE LEVEL 1535 00:55:10,520 --> 00:55:13,400 OF -- THIS IS A GUESS -- AT THE 1536 00:55:13,400 --> 00:55:14,800 LEVEL OF WHAT CORRELATES WITH 1537 00:55:14,800 --> 00:55:16,040 THEIR SYMPTOM REPORT. 1538 00:55:16,040 --> 00:55:17,800 BUT THEN WHEN IT OPERATES, IT 1539 00:55:17,800 --> 00:55:20,080 SEEMS TO BE PICKING UP SOMETHING 1540 00:55:20,080 --> 00:55:22,800 AT A LEVEL THAT'S BEFORE THAT. 1541 00:55:22,800 --> 00:55:24,280 THEY DON'T HAVE TO HAVE A -- YOU 1542 00:55:24,280 --> 00:55:27,960 KNOW, LET'S SAY WE HAVE A VISUAL 1543 00:55:27,960 --> 00:55:29,800 ANALOG SCALE 0 TO 100, 0 IS 1544 00:55:29,800 --> 00:55:31,360 GREAT, 100 IS TERRIBLE, THEY 1545 00:55:31,360 --> 00:55:33,640 DON'T HAVE TO -- WHILE THE 1546 00:55:33,640 --> 00:55:34,760 BIOMARKER IS DEVELOPED WITH 1547 00:55:34,760 --> 00:55:37,480 RANGE OF SYMPTOMS THAT GO FROM 0 1548 00:55:37,480 --> 00:55:40,120 TO 100, IT SEEMS MORE THAT WHEN 1549 00:55:40,120 --> 00:55:41,800 IN OPERATION THEY STAY IN A 1550 00:55:41,800 --> 00:55:45,120 RANGE OF LIKE 0 TO 40, AND THEY 1551 00:55:45,120 --> 00:55:46,600 DON'T -- IT'S DOING SOMETHING 1552 00:55:46,600 --> 00:55:48,080 OVER TIME THAT'S NOT COMPLETELY 1553 00:55:48,080 --> 00:55:50,920 CLEAR TO ME THAT IS PICKING THIS 1554 00:55:50,920 --> 00:55:53,560 UP BEFORE THEIR SYMPTOMS, BEFORE 1555 00:55:53,560 --> 00:55:58,040 THEY GET AN EXPERIENCE THAT 1556 00:55:58,040 --> 00:56:01,720 LEADS TO INCREASED SCORES BUT 1557 00:56:01,720 --> 00:56:04,600 SOMEHOW MORE SENSITIVE TO THE 1558 00:56:04,600 --> 00:56:06,000 PROCESS, IT SEEMS LIKE, THAN I 1559 00:56:06,000 --> 00:56:07,680 WOULD HAVE ANTICIPATED. 1560 00:56:07,680 --> 00:56:09,040 THE OTHER POSSIBILITY IS THAT 1561 00:56:09,040 --> 00:56:11,240 THE BIOMARKER IS DOING NOTHING 1562 00:56:11,240 --> 00:56:13,280 AND THAT IT'S JUST DRIVING 1563 00:56:13,280 --> 00:56:14,240 INTERMITTENT STIMULATION AND 1564 00:56:14,240 --> 00:56:15,680 BECAUSE OF THAT POSSIBILITY 1565 00:56:15,680 --> 00:56:18,880 WE'RE ACTUALLY ADDING A THIRD 1566 00:56:18,880 --> 00:56:21,120 ARM TO STAGE 3 OF INTERMITTENT 1567 00:56:21,120 --> 00:56:23,280 STIMULATION VERSUS CLOSED LOOP 1568 00:56:23,280 --> 00:56:23,920 STIMULATION VERSUS SHAM. 1569 00:56:23,920 --> 00:56:26,760 BECAUSE IT IS POSSIBLE THAT IT'S 1570 00:56:26,760 --> 00:56:29,160 NOT RELATED TO THE PATHOLOGICAL 1571 00:56:29,160 --> 00:56:33,680 PROCESS AND THE BIOMARKER IS 1572 00:56:33,680 --> 00:56:35,560 MEASURING SOMETHING ELSE IT'S 1573 00:56:35,560 --> 00:56:37,400 CREATING INTERMITTENT STIM THAT 1574 00:56:37,400 --> 00:56:39,240 WORKS, THAT'S ANOTHER 1575 00:56:39,240 --> 00:56:39,560 POSSIBILITY. 1576 00:56:39,560 --> 00:56:40,000 >>VERY INTERESTING. 1577 00:56:40,000 --> 00:56:42,240 DR. LANGEVIN AND WE'LL MOVE ON. 1578 00:56:42,240 --> 00:56:44,080 OH, I SEE ANOTHER HAND. 1579 00:56:44,080 --> 00:56:45,480 WE'LL DO TWO SHORT QUESTIONS AND 1580 00:56:45,480 --> 00:56:53,400 MOVE TO THE NEXT SPEAKER. 1581 00:56:53,400 --> 00:56:54,440 >>WHICH ONE FIRST? 1582 00:56:54,440 --> 00:56:55,000 >>DR. LANGEVIN. 1583 00:56:55,000 --> 00:56:56,360 >>I THINK YOU WERE AHEAD OF ME. 1584 00:56:56,360 --> 00:56:59,360 >>I DIDN'T SEE THE HAND. 1585 00:56:59,360 --> 00:56:59,760 SORRY. 1586 00:56:59,760 --> 00:57:01,120 >>DON'T WORRY ABOUT IT. 1587 00:57:01,120 --> 00:57:01,680 GO AHEAD. 1588 00:57:01,680 --> 00:57:02,440 >>OKAY. 1589 00:57:02,440 --> 00:57:03,200 THANK YOU. 1590 00:57:03,200 --> 00:57:05,200 SO, MY QUESTION IS QUICK. 1591 00:57:05,200 --> 00:57:07,360 YOU DESCRIBED A PRETTY ROBUST 1592 00:57:07,360 --> 00:57:08,920 PLACEBO EFFECT WHICH IS NOT 1593 00:57:08,920 --> 00:57:10,440 SURPRISING, IN FACT IT WOULD BE 1594 00:57:10,440 --> 00:57:12,040 SURPRISING IF THERE WASN'T ONE 1595 00:57:12,040 --> 00:57:14,280 BUT I'M CURIOUS ABOUT WHEN 1596 00:57:14,280 --> 00:57:15,440 YOU'RE DOING YOUR 1597 00:57:15,440 --> 00:57:16,040 STIMULUS/RESPONSE MAPPING YOU 1598 00:57:16,040 --> 00:57:17,880 JUST DESCRIBED HOW DO YOU KNOW 1599 00:57:17,880 --> 00:57:20,280 YOU'RE NOT MAPPING TO A PLACEBO 1600 00:57:20,280 --> 00:57:20,560 RESPONSE? 1601 00:57:20,560 --> 00:57:22,480 >>SO, THIS IS A GREAT QUESTION. 1602 00:57:22,480 --> 00:57:24,440 IN THE FIRST PATIENT AND THIRD 1603 00:57:24,440 --> 00:57:26,240 PATIENT WE DIDN'T HAVE MUCH OF A 1604 00:57:26,240 --> 00:57:27,760 PLACEBO EFFECT AT ALL BUT IN THE 1605 00:57:27,760 --> 00:57:30,800 SECOND ONE WE DID. 1606 00:57:30,800 --> 00:57:32,240 THAT CAUSED COMPLICATIONS. 1607 00:57:32,240 --> 00:57:36,160 WHAT WE HAD TO DO WAS DOING MANY 1608 00:57:36,160 --> 00:57:37,800 MORE TRIALS TO CONVINCE 1609 00:57:37,800 --> 00:57:40,120 OURSELVES WE HAD SOMETHING 1610 00:57:40,120 --> 00:57:40,400 THERAPEUTIC. 1611 00:57:40,400 --> 00:57:42,520 IT WAS PRETTY CLEAR IN THE 1612 00:57:42,520 --> 00:57:43,960 10-DAY STIMULUS/RESPONSE PERIOD 1613 00:57:43,960 --> 00:57:51,120 THIS WAS HAPPENING BECAUSE WE DO 1614 00:57:51,120 --> 00:57:52,120 BLINDED SHAM STIMULATION AND 1615 00:57:52,120 --> 00:57:53,560 STARTED TO SEE THINGS NOT 1616 00:57:53,560 --> 00:57:54,880 REPLICATES AS WELL AS WITH THE 1617 00:57:54,880 --> 00:57:56,960 FIRST PERSON AND STARTED TO 1618 00:57:56,960 --> 00:57:59,280 DISCOVER THAT IT WAS HAPPENING 1619 00:57:59,280 --> 00:58:01,320 BECAUSE OF A GREATER SHAM 1620 00:58:01,320 --> 00:58:01,640 RESPONSE. 1621 00:58:01,640 --> 00:58:04,320 BASICALLY WE UPPED OUR N OF 1622 00:58:04,320 --> 00:58:04,720 TRIALS. 1623 00:58:04,720 --> 00:58:07,560 BUT THAT DID LEAD TO SIGNIFICANT 1624 00:58:07,560 --> 00:58:08,760 COMPLICATIONS IN THE NEXT STAGE. 1625 00:58:08,760 --> 00:58:10,400 THE OTHER THING THAT HAPPENS, I 1626 00:58:10,400 --> 00:58:13,560 THINK AS WE START TO DO 1627 00:58:13,560 --> 00:58:15,120 STIMULATION, YOU GET ADAPTATION 1628 00:58:15,120 --> 00:58:17,200 OF CIRCUITRY AND WE'RE TRYING 1629 00:58:17,200 --> 00:58:18,840 DIFFERENT THINGS, THAT YOU MAY 1630 00:58:18,840 --> 00:58:20,800 END UP WITH A PERSON HAVING SOME 1631 00:58:20,800 --> 00:58:22,040 SUSTAINED BENEFIT FROM THE 1632 00:58:22,040 --> 00:58:24,840 THINGS THAT WERE DONE BEFORE. 1633 00:58:24,840 --> 00:58:29,080 AND SO THAT LED US TO -- WE WERE 1634 00:58:29,080 --> 00:58:30,800 AT THE VERGE FOR THE SECOND 1635 00:58:30,800 --> 00:58:32,320 PATIENT WE GOT TO A STATE HAVING 1636 00:58:32,320 --> 00:58:33,960 DONE A NUMBER OF TRIALS WITH 1637 00:58:33,960 --> 00:58:38,040 CLOSED LOOP WHEN WE DID TRIALS 1638 00:58:38,040 --> 00:58:40,200 OF SHAM HE DID WAY BETTER THAN 1639 00:58:40,200 --> 00:58:42,560 HAD HE WHEN WE DID SHAM LIKE 1640 00:58:42,560 --> 00:58:45,040 BEFORE WE STARTED DOING CLOSED 1641 00:58:45,040 --> 00:58:45,440 LOOP. 1642 00:58:45,440 --> 00:58:48,280 AND SO THAT WAS CORRELATED WITH 1643 00:58:48,280 --> 00:58:53,360 CHANGES IN HIS EVOKED POTENTIAL 1644 00:58:53,360 --> 00:58:55,320 RESPONSES, EVEN HARDER TO TELL 1645 00:58:55,320 --> 00:58:56,320 WE DID FIND CONFIGURATION THAT 1646 00:58:56,320 --> 00:58:59,280 WAS BETTER THAN THE SHAM 1647 00:58:59,280 --> 00:59:02,120 RELIABLY, BY FAR, BUT WE HAD TO 1648 00:59:02,120 --> 00:59:06,080 KEEP PUSHING ON. 1649 00:59:06,080 --> 00:59:07,400 IT DOES CREATE SIGNIFICANT 1650 00:59:07,400 --> 00:59:07,800 CHALLENGES. 1651 00:59:07,800 --> 00:59:09,920 >>WHAT'S GOING ON IN 1652 00:59:09,920 --> 00:59:10,760 ACUPUNCTURE LITERATURE, 25 YEARS 1653 00:59:10,760 --> 00:59:13,000 OF EXPERIENCE ON STUFF LIKE 1654 00:59:13,000 --> 00:59:14,160 THAT, SO, YEAH, GOOD LUCK. 1655 00:59:14,160 --> 00:59:19,480 THIS IS CHALLENGING FOR SURE. 1656 00:59:19,480 --> 00:59:22,600 >>SAMEER, THANK YOU FOR 1657 00:59:22,600 --> 00:59:22,840 WAITING. 1658 00:59:22,840 --> 00:59:24,240 >>I HAVE A COUPLE QUESTIONS, 1659 00:59:24,240 --> 00:59:26,000 I'LL KEEP IT TO ONE FOR THE SAKE 1660 00:59:26,000 --> 00:59:27,200 OF TIME, MAYBE GET BACK TO THE 1661 00:59:27,200 --> 00:59:29,000 OTHER ONE IN THE DISCUSSION. 1662 00:59:29,000 --> 00:59:33,040 THANKS A LOT FOR THE GREAT TALK, 1663 00:59:33,040 --> 00:59:33,560 ENJOYED IT. 1664 00:59:33,560 --> 00:59:35,120 KIND OF FOLLOWING FROM THE VERY 1665 00:59:35,120 --> 00:59:43,320 END OF YOUR RESPONSE TO JIM'S 1666 00:59:43,320 --> 00:59:44,320 QUESTION, RESPONSE VERSUS 1667 00:59:44,320 --> 00:59:44,920 INTERMITTENT, PHILOSOPHICALLY 1668 00:59:44,920 --> 00:59:51,080 HOW YOU KIND OF THINK ABOUT 1669 00:59:51,080 --> 00:59:57,760 VARIOUS VARIATIONS FOR 1670 00:59:57,760 --> 00:59:58,600 NEUROMODULATION. 1671 00:59:58,600 --> 01:00:04,880 CLOSED LOOP, WE TALKED ABOUT 1672 01:00:04,880 --> 01:00:06,200 TREMOR, EPISODIC, SOMETIMES NOT 1673 01:00:06,200 --> 01:00:08,720 THERE, YOU DON'T NEED IT WHEN 1674 01:00:08,720 --> 01:00:09,600 YOU'RE NOT SHAKING, LIKE 1675 01:00:09,600 --> 01:00:11,680 DEPRESSION SLIPPING IN AND OUT 1676 01:00:11,680 --> 01:00:13,880 BUT PERIODS OF DEPRESSION CAN 1677 01:00:13,880 --> 01:00:20,120 LAST LONG PERIODS OF TIME. 1678 01:00:20,120 --> 01:00:22,640 THE DIAGNOSE IT ITSELF IS 1679 01:00:22,640 --> 01:00:23,440 DEFINED IN TEMPORAL WINDOWS SO 1680 01:00:23,440 --> 01:00:29,040 DO YOU THINK OF EPISODIC ILLNESS 1681 01:00:29,040 --> 01:00:32,320 THAT REQUIRES PUNCTUATED 1682 01:00:32,320 --> 01:00:34,720 TREATMENT LIKE TREMOR, AN ENGINE 1683 01:00:34,720 --> 01:00:35,720 BACKFIRING AND TRIGGER PTSD 1684 01:00:35,720 --> 01:00:36,800 VERSUS SOMETHING THERE ALL THE 1685 01:00:36,800 --> 01:00:39,200 TIME WHERE YOU NEED SOMETHING 1686 01:00:39,200 --> 01:00:43,680 THAT IS MAYBE CONTINUOUS, MAYBE 1687 01:00:43,680 --> 01:00:44,480 INTERMITTENT, REALLY INTERESTED 1688 01:00:44,480 --> 01:00:46,960 IN THAT INTERMITTENT EXPERIMENT. 1689 01:00:46,960 --> 01:00:47,800 MAYBE YOU DON'T NEED CONTINUOUS, 1690 01:00:47,800 --> 01:00:55,960 MAYBE YOU NEED TO PING THE 1691 01:00:55,960 --> 01:00:58,440 CIRCUIT PERIODICALLY, IS IT THAT 1692 01:00:58,440 --> 01:01:01,200 YOU'RE SLIPPING IN AND OUT OF 1693 01:01:01,200 --> 01:01:01,840 PERIODS, STATES OF DEPRESSIVE 1694 01:01:01,840 --> 01:01:03,160 SYMPTOMS WHERE YOU NEED TO BE 1695 01:01:03,160 --> 01:01:05,680 KICKED BACK OUT WITH STIMULATION 1696 01:01:05,680 --> 01:01:09,760 WHICH IS SOMETHING THAT REQUIRES 1697 01:01:09,760 --> 01:01:10,600 RESPONSIVE ADAPTIVE CLOSED LOOP 1698 01:01:10,600 --> 01:01:16,080 ET CETERA VERSUS OTHER 1699 01:01:16,080 --> 01:01:16,440 ALTERNATIVES. 1700 01:01:16,440 --> 01:01:16,960 >>GREAT QUESTION. 1701 01:01:16,960 --> 01:01:19,600 YOU RAISED A BUNCH OF QUESTIONS. 1702 01:01:19,600 --> 01:01:21,040 I'VE WORKED WITH DEPRESSION 1703 01:01:21,040 --> 01:01:22,440 PATIENTS FOR A LONG TIME, NEVER 1704 01:01:22,440 --> 01:01:25,600 UNTIL I STARTED TO DO THIS STUDY 1705 01:01:25,600 --> 01:01:27,560 AND STUDIES LIKE IT DID I GET AN 1706 01:01:27,560 --> 01:01:29,560 OPPORTUNITY TO BE WITH A 1707 01:01:29,560 --> 01:01:31,080 DEPRESSED PATIENT MOMENT TO 1708 01:01:31,080 --> 01:01:32,160 MOMENT, ACTUALLY TRYING TO 1709 01:01:32,160 --> 01:01:34,120 ASSESS SEVERITY OF THEIR 1710 01:01:34,120 --> 01:01:34,400 DEPRESSION. 1711 01:01:34,400 --> 01:01:36,200 WHAT WE FOUND IS THAT WE HAVE 1712 01:01:36,200 --> 01:01:38,080 SOME PEOPLE WHO WHILE BEING IN 1713 01:01:38,080 --> 01:01:42,360 AN EPISODE OF SEVERE TREATMENT 1714 01:01:42,360 --> 01:01:42,880 RESISTANT DEPRESSION HAVE 1715 01:01:42,880 --> 01:01:44,440 SUBSTANTIAL VARIATION OVER THE 1716 01:01:44,440 --> 01:01:46,640 SYMPTOMS, ONE OF OUR PATIENTS 1717 01:01:46,640 --> 01:01:50,800 VERY LITTLE VARIATION IS 1718 01:01:50,800 --> 01:01:52,280 EXTREMELY SEVERE AND SORT OF 1719 01:01:52,280 --> 01:01:54,840 FIXED BUT WHEN WE STARTED TO DO 1720 01:01:54,840 --> 01:01:56,800 STIMULATIONS AND EXPLORE EFFECTS 1721 01:01:56,800 --> 01:01:58,680 WE FOUND VARIATION IN THAT 1722 01:01:58,680 --> 01:02:01,200 INDIVIDUAL AS WELL, MAYBE 1723 01:02:01,200 --> 01:02:04,040 TRIGGERED BY THIS STIM PROCESS. 1724 01:02:04,040 --> 01:02:07,200 AND THE OTHER IS PEOPLE ARE 1725 01:02:07,200 --> 01:02:07,880 AFFECTED DIFFERENTLY BY HAVING 1726 01:02:07,880 --> 01:02:08,960 OTHERS IN THE ROOM. 1727 01:02:08,960 --> 01:02:12,680 YOU KNOW, YOU START TO GET THESE 1728 01:02:12,680 --> 01:02:14,760 RELATIONSHIPS AND EXPECTATION 1729 01:02:14,760 --> 01:02:16,600 EFFECTS, WE TRY TO NOT DRIVE 1730 01:02:16,600 --> 01:02:18,600 THAT SO WE SEE VARIATION. 1731 01:02:18,600 --> 01:02:20,640 AND IN DEPRESSION THERE'S A 1732 01:02:20,640 --> 01:02:23,200 HISTORY OF PROBLEMS THAT IF YOU 1733 01:02:23,200 --> 01:02:26,840 STIMULATE A PERSON WHO HAS 1734 01:02:26,840 --> 01:02:28,280 DEPRESSION WITH A TREATMENT WHEN 1735 01:02:28,280 --> 01:02:30,240 THEY ARE NOT DEPRESSED YOU HAVE 1736 01:02:30,240 --> 01:02:31,880 THE RISK OF TRIGGERING MANIA. 1737 01:02:31,880 --> 01:02:34,160 THAT CAN ALSO HAPPEN WHEN THEY 1738 01:02:34,160 --> 01:02:36,760 ARE DEPRESSED, FOR EXAMPLE, 1739 01:02:36,760 --> 01:02:38,840 ANTI-DEPRESSANT MEDS HAVE A 1740 01:02:38,840 --> 01:02:40,080 REASONABLE CHANCE OF TRIGGERING 1741 01:02:40,080 --> 01:02:43,600 MANIA SO WE DON'T USE THEM IN 1742 01:02:43,600 --> 01:02:46,400 BIPOLAR PATIENTS WITH DEPRESSION 1743 01:02:46,400 --> 01:02:48,920 BUT IN UNIPOLAR, DBS STUDIES 1744 01:02:48,920 --> 01:02:50,120 TRIGGERED MANIA SO STIMULATING 1745 01:02:50,120 --> 01:02:51,320 WHEN PEOPLE DON'T HAVE 1746 01:02:51,320 --> 01:02:56,280 DEPRESSION DOES RUN SOME DEGREE 1747 01:02:56,280 --> 01:02:56,480 OF RISK. 1748 01:02:56,480 --> 01:03:00,400 AND BUT I CAN'T SAY FOR SURE 1749 01:03:00,400 --> 01:03:02,320 THAT THAT'S NOT SOME SUBGROUP OF 1750 01:03:02,320 --> 01:03:04,320 PEOPLE, THAT IT WOULD BE OKAY TO 1751 01:03:04,320 --> 01:03:05,600 STIMULATE SOME PEOPLE ALL THE 1752 01:03:05,600 --> 01:03:05,920 TIME. 1753 01:03:05,920 --> 01:03:10,160 I THINK THE QUESTION OF THE 1754 01:03:10,160 --> 01:03:11,240 INTERMITTENT STIMULATION VERSUS 1755 01:03:11,240 --> 01:03:13,760 OPEN, I DO THINK THAT THERE IS 1756 01:03:13,760 --> 01:03:15,400 SOME DEGREE TO WHICH 1757 01:03:15,400 --> 01:03:18,000 INTERMITTENT STIMULATION WAS THE 1758 01:03:18,000 --> 01:03:20,760 RIGHT STRATEGY, HAS THERAPEUTIC 1759 01:03:20,760 --> 01:03:23,400 EFFECTS THAT PROBABLY ARE NOT 1760 01:03:23,400 --> 01:03:24,680 SPECIFICALLY CRITICAL TO BEING 1761 01:03:24,680 --> 01:03:25,800 BIOMARKER DRIVEN. 1762 01:03:25,800 --> 01:03:26,880 WHEN WE'RE -- BEFORE WE HAVE A 1763 01:03:26,880 --> 01:03:29,200 BIOMARKER WHEN WE'RE TRYING TO 1764 01:03:29,200 --> 01:03:31,160 TEST PARADIGMS WE DO SOME 1765 01:03:31,160 --> 01:03:32,600 INTERMITTENT STIMULATION AND SEE 1766 01:03:32,600 --> 01:03:36,240 LIKE IF YOU TIME IT RIGHT, THIS 1767 01:03:36,240 --> 01:03:37,520 IS AN OPEN AREA OF RESEARCH THAT 1768 01:03:37,520 --> 01:03:39,720 NEEDS TO BE DONE, YOU CAN GET 1769 01:03:39,720 --> 01:03:41,000 LONGER LASTING EFFECTS. 1770 01:03:41,000 --> 01:03:45,280 WE HAD EFFECTS FOR 3 HOURS IN 1771 01:03:45,280 --> 01:03:48,080 STIMULATING IN LIKE 5-SECOND 1772 01:03:48,080 --> 01:03:49,120 CHUNKS INTERMITTENTLY FOR SOME 1773 01:03:49,120 --> 01:03:50,760 PERIOD IN STAGE 1, ONE OF THE 1774 01:03:50,760 --> 01:03:54,040 PATIENTS I WAS TALKING ABOUT. 1775 01:03:54,040 --> 01:03:59,040 IT'S CLEAR THERE IS 1776 01:03:59,040 --> 01:03:59,920 INTERMITTENTCY EFFECT, ALSO WITH 1777 01:03:59,920 --> 01:04:01,360 CLOSED LOOP WE'RE SEEING CHANGES 1778 01:04:01,360 --> 01:04:03,400 IN CIRCUITRY WHICH LEAD TO 1779 01:04:03,400 --> 01:04:04,760 SUSTAINED BENEFIT OVER TIME SO I 1780 01:04:04,760 --> 01:04:06,480 THINK I MENTIONED BEFORE IF YOU 1781 01:04:06,480 --> 01:04:07,840 START STIMULATING THIS MAY NOT 1782 01:04:07,840 --> 01:04:10,000 BE TRUE IN OTHERS BUT FOR 1783 01:04:10,000 --> 01:04:11,960 DEPRESSION IF YOU START 1784 01:04:11,960 --> 01:04:13,640 STIMULATING AND SO FAR IN PEOPLE 1785 01:04:13,640 --> 01:04:15,800 WE'VE SEEN YOU GET AN EFFECT 1786 01:04:15,800 --> 01:04:17,160 THAT LASTS 30 MINUTES, 40 1787 01:04:17,160 --> 01:04:18,120 MINUTES, BUT AFTER WE'VE BEEN 1788 01:04:18,120 --> 01:04:24,800 DOING CLOSED LOOP FOR A BIT YOU 1789 01:04:24,800 --> 01:04:28,320 STOP STIMULATING AND GET BENEFIT 1790 01:04:28,320 --> 01:04:31,520 THAT LASTS 3 TO 5 DAYS, MAYBE A 1791 01:04:31,520 --> 01:04:33,360 WEEK IN ONE PERSON. 1792 01:04:33,360 --> 01:04:34,680 SO IT'S HARD TO CONCEPTUALLY 1793 01:04:34,680 --> 01:04:35,400 THINK ABOUT IT. 1794 01:04:35,400 --> 01:04:38,280 DOES IT NEED TO BE LINKED TO 1795 01:04:38,280 --> 01:04:39,280 BIOMARKER ONCE YOU HAVE BENEFIT 1796 01:04:39,280 --> 01:04:40,920 SUSTAINING FOR A WEEK? 1797 01:04:40,920 --> 01:04:42,120 I SUSPECT PROBABLY NOT BUT I 1798 01:04:42,120 --> 01:04:52,640 THINK IT NEEDS TO BE RIGOROUSLY 1799 01:04:55,520 --> 01:04:55,680 TESTED. 1800 01:04:55,680 --> 01:04:56,320 INTERMITTENTSY IS THERAPEUTIC, 1801 01:04:56,320 --> 01:05:03,240 OPEN QUESTIONS, LOTS OF WORK TO 1802 01:05:03,240 --> 01:05:03,440 BE DONE. 1803 01:05:03,440 --> 01:05:04,320 >>THANK YOU. 1804 01:05:04,320 --> 01:05:08,160 I HOPE YOU CAN STICK AROUND FOR 1805 01:05:08,160 --> 01:05:09,840 MORE DISCUSSION AFTER THE NEXT 1806 01:05:09,840 --> 01:05:10,160 SPEAKER. 1807 01:05:10,160 --> 01:05:12,560 THE SECOND SPEAKER WILL TALK 1808 01:05:12,560 --> 01:05:16,320 ABOUT INCORRECT OR MORE INDIRECT 1809 01:05:16,320 --> 01:05:21,760 METHOD OF AFFECTING THE BRAIN. 1810 01:05:21,760 --> 01:05:25,040 DR. VIVEK PANDRANGI, FOURTH YEAR 1811 01:05:25,040 --> 01:05:26,560 OTOLARYNGOLOGY RESIDENT AT 1812 01:05:26,560 --> 01:05:28,560 OREGON HEALTH AND SCIENCE 1813 01:05:28,560 --> 01:05:29,240 UNIVERSITY, COMPLETED 1814 01:05:29,240 --> 01:05:31,480 UNDERGRADUATE DEGREE IN BIOLOGY 1815 01:05:31,480 --> 01:05:32,600 AND ANTHROPOLOGY AT WASHINGTON 1816 01:05:32,600 --> 01:05:35,760 UNIVERSITY IN ST. LOUIS, 1817 01:05:35,760 --> 01:05:38,920 OBTAINED MEDICAL DEGREE AT 1818 01:05:38,920 --> 01:05:39,840 VIRGINIA COMMONWEALTH UNIVERSITY 1819 01:05:39,840 --> 01:05:40,480 OF SCHOOL OF MEDICINE, INVOLVED 1820 01:05:40,480 --> 01:05:42,680 IN RESEARCH EXPLORING USE OF 1821 01:05:42,680 --> 01:05:43,920 VIRTUAL REALITY IN THE MEDICAL 1822 01:05:43,920 --> 01:05:46,160 FIELD ALONG WITH HIS MENTOR DR. 1823 01:05:46,160 --> 01:05:55,000 RYAN LEE, ASSOCIATE PROFESSOR OF 1824 01:05:55,000 --> 01:05:55,880 OTOLARYNGOLOGY AND OHSU AND 1825 01:05:55,880 --> 01:05:58,840 TODAY WILL SPEAK TO US ON THE 1826 01:05:58,840 --> 01:06:00,960 EFFECT OF VIRTUAL REALITY ON 1827 01:06:00,960 --> 01:06:04,200 PAIN MANAGEMENT AND OPIOID USE. 1828 01:06:04,200 --> 01:06:06,200 THANK YOU, DR. PANDRANGI, FOR 1829 01:06:06,200 --> 01:06:06,800 BEING WITH US TODAY. 1830 01:06:06,800 --> 01:06:07,480 >>THANK YOU. 1831 01:06:07,480 --> 01:06:10,560 IT'S AN HONOR TO BE HERE. 1832 01:06:10,560 --> 01:06:16,160 LET ME SEE IF MY SLIDES ARE 1833 01:06:16,160 --> 01:06:16,680 SHARED. 1834 01:06:16,680 --> 01:06:20,200 THAT LOOKS OKAY. 1835 01:06:20,200 --> 01:06:20,520 >>LOOKS GOOD. 1836 01:06:20,520 --> 01:06:21,840 >>THANKS SO MUCH. 1837 01:06:21,840 --> 01:06:22,600 AGAIN, GOOD AFTERNOON AND THANK 1838 01:06:22,600 --> 01:06:25,240 YOU FOR THE OPPORTUNITY FOR US 1839 01:06:25,240 --> 01:06:27,120 TO PRESENT RESEARCH, AND I LOOK 1840 01:06:27,120 --> 01:06:29,600 FORWARD TO DISCUSSION 1841 01:06:29,600 --> 01:06:29,920 AFTERWARDS. 1842 01:06:29,920 --> 01:06:31,040 AGAIN, I'M VIVEK, I'LL BE 1843 01:06:31,040 --> 01:06:32,240 PRESENTING RESEARCH, EFFECT OF 1844 01:06:32,240 --> 01:06:33,680 VIRTUAL REALITY ON PAIN 1845 01:06:33,680 --> 01:06:37,280 MANAGEMENT AND OPIOID USE AMONG 1846 01:06:37,280 --> 01:06:38,720 HOSPITALIZED PATIENTS AFTER HEAD 1847 01:06:38,720 --> 01:06:41,360 AND NECK SURGERY, A RANDOMIZED 1848 01:06:41,360 --> 01:06:41,880 CLINICAL TRIAL. 1849 01:06:41,880 --> 01:06:44,920 AND I HAVE NO DISCLOSURES. 1850 01:06:44,920 --> 01:06:46,600 POSTOPERATIVE PAIN AFTER SURGERY 1851 01:06:46,600 --> 01:06:48,760 RECEIVED GROWING ATTENTION TO 1852 01:06:48,760 --> 01:06:50,040 IMPROVED FUNCTIONAL RECOVERY, 1853 01:06:50,040 --> 01:06:51,840 REDUCE HOSPITAL STAYS, IMPROVE 1854 01:06:51,840 --> 01:06:53,680 QUALITY OF LIFE. 1855 01:06:53,680 --> 01:06:54,480 BUT POOR POSTOPERATIVE PAIN 1856 01:06:54,480 --> 01:07:01,320 CONTROL CAN LEAD TO POOR 1857 01:07:01,320 --> 01:07:02,440 FUNCTIONAL RECOVERY, DISCHARGE 1858 01:07:02,440 --> 01:07:04,320 AND CHRONIC PAIN, BALANCED WITH 1859 01:07:04,320 --> 01:07:06,240 RISKS OF PAIN MEDICATION 1860 01:07:06,240 --> 01:07:08,360 PARTICULARLY NARCOTICS, A MAJOR 1861 01:07:08,360 --> 01:07:11,000 PART OF THE POSTOPERATIVE PAIN 1862 01:07:11,000 --> 01:07:13,720 MANAGEMENT PATHWAY WITH KNOWN 1863 01:07:13,720 --> 01:07:16,440 RISKS, NAUSEA, SEDATION, 1864 01:07:16,440 --> 01:07:18,840 DEPENDENCE, CONSTIPATION AND 1865 01:07:18,840 --> 01:07:21,240 MORE, AND THIS REPRESENTS STAYS 1866 01:07:21,240 --> 01:07:22,280 65 AND OLDER. 1867 01:07:22,280 --> 01:07:25,760 AS YOU CAN SEE FROM 2015 DATA, 1868 01:07:25,760 --> 01:07:28,360 OREGON WAS AN UNFORTUNATE LEADER 1869 01:07:28,360 --> 01:07:29,120 IN THIS. 1870 01:07:29,120 --> 01:07:31,520 MULTI-MODAL ANALGESIA IS AN AREA 1871 01:07:31,520 --> 01:07:32,720 OF EXPLORATION FOR OPTIMAL PAIN 1872 01:07:32,720 --> 01:07:34,280 CONTROL AND THESE APPROACHES 1873 01:07:34,280 --> 01:07:36,800 MINIMIZE USE OF NARCOTICS AND 1874 01:07:36,800 --> 01:07:38,360 PROVIDE STABLE RELIABLE PAIN 1875 01:07:38,360 --> 01:07:40,200 CONTROL, BUT A MAJOR CHALLENGE 1876 01:07:40,200 --> 01:07:42,400 OF IMPLEMENTING THIS ARE 1877 01:07:42,400 --> 01:07:44,240 PATIENTS' MEDICAL COMORBIDITIES. 1878 01:07:44,240 --> 01:07:45,600 A PATIENT WITH KIDNEY DISEASE OR 1879 01:07:45,600 --> 01:07:48,840 HIGH BLEEDING RISK MAY NOT BE A 1880 01:07:48,840 --> 01:07:55,560 GOOD CANDIDATE FOR NSAIDs LIKE 1881 01:07:55,560 --> 01:08:00,160 IBUPROFEN OR WITH LIVER 1882 01:08:00,160 --> 01:08:02,200 DYSFUNCTION AND ACETAMINOPHEN. 1883 01:08:02,200 --> 01:08:03,520 NOVEL AND COST EFFECTIVE 1884 01:08:03,520 --> 01:08:06,080 STRATEGIES COULD CONFRONT THIS 1885 01:08:06,080 --> 01:08:08,680 COMPLEX ISSUE. 1886 01:08:08,680 --> 01:08:11,640 VIRTUAL REALITY, VR, PROVIDES A 1887 01:08:11,640 --> 01:08:12,320 THREE DIMENSIONAL IMERSIVE 1888 01:08:12,320 --> 01:08:14,040 EXPERIENCE USED IN A VARIETY OF 1889 01:08:14,040 --> 01:08:15,680 HEALTH CARE SETTINGS INCLUDING 1890 01:08:15,680 --> 01:08:23,120 TREATMENT OF ANXIETY, PHYSICAL 1891 01:08:23,120 --> 01:08:23,720 REHABILITATION, INTERMITTENT 1892 01:08:23,720 --> 01:08:24,560 PROCEDURE DISTRACTION, EVEN PAIN 1893 01:08:24,560 --> 01:08:24,960 CONTROL. 1894 01:08:24,960 --> 01:08:28,800 YOU CAN SEE USERS WEAR A 1895 01:08:28,800 --> 01:08:29,680 HEAD-MOUNTED DISPLAY, HELMET 1896 01:08:29,680 --> 01:08:32,760 WITH MOTION TRACKER SO USERS CAN 1897 01:08:32,760 --> 01:08:34,720 MOVE THROUGH SIMULATED 1898 01:08:34,720 --> 01:08:35,800 ENVIRONMENT, HEADPHONES OR 1899 01:08:35,800 --> 01:08:37,320 SPEAKERS FOR SOUND TO FACILITATE 1900 01:08:37,320 --> 01:08:40,600 IMMERSION, AND SOME SORT OF 1901 01:08:40,600 --> 01:08:42,960 INPUT DEVICE, HAND-HELD 1902 01:08:42,960 --> 01:08:45,560 CONTROLLERS OR GLOVES EVEN TO 1903 01:08:45,560 --> 01:08:47,840 ENABLE INTERACTION WITH VIRTUAL 1904 01:08:47,840 --> 01:08:48,160 OPTIONS. 1905 01:08:48,160 --> 01:08:51,560 THE THOUGHT IS VR CAN OFFER 1906 01:08:51,560 --> 01:08:57,480 DISTRACTION THROUGH THE 1907 01:08:57,480 --> 01:08:59,360 MULTI-SENSORY OF AUDITORY, 1908 01:08:59,360 --> 01:09:01,080 VISUAL, PROPRIOCEPTIVE STIMULI. 1909 01:09:01,080 --> 01:09:02,720 THERE'S SIGNIFICANT CONTENT FOR 1910 01:09:02,720 --> 01:09:05,880 PATIENTS TO USE FROM DIFFERENT 1911 01:09:05,880 --> 01:09:07,000 MEDITATION TO EXPLORATION 1912 01:09:07,000 --> 01:09:10,160 EXPERIENCES, EVEN SOME ACTIVE 1913 01:09:10,160 --> 01:09:10,960 GAMING EXPERIENCES. 1914 01:09:10,960 --> 01:09:13,440 USE OF VR IS GAINING SIGNIFICANT 1915 01:09:13,440 --> 01:09:15,680 TRACTION IN MANY ACADEMIC 1916 01:09:15,680 --> 01:09:17,160 CENTERS, NUMEROUS PUBLICATIONS 1917 01:09:17,160 --> 01:09:20,560 OUT NOW ON VR AROUND 400 1918 01:09:20,560 --> 01:09:24,000 PUBLISHED IN 2010 COMPARED TO 1919 01:09:24,000 --> 01:09:25,280 3,000 ARTICLES PUBLISHED IN 1920 01:09:25,280 --> 01:09:25,480 2022. 1921 01:09:25,480 --> 01:09:28,440 I SHOULD ADD THAT ONE OF THE 1922 01:09:28,440 --> 01:09:30,800 MAIN LIMITATIONS IN CURRENT VR 1923 01:09:30,800 --> 01:09:33,200 LITERATURE IS LACK OF 1924 01:09:33,200 --> 01:09:33,720 COMPARATIVE CONTROL GROUPS 1925 01:09:33,720 --> 01:09:35,800 BECAUSE OF THE DIFFERENT 1926 01:09:35,800 --> 01:09:37,480 EXPERIENCES OFFERED IN VR 1927 01:09:37,480 --> 01:09:39,120 COMPARED TO TRADITIONAL MEDIA 1928 01:09:39,120 --> 01:09:39,880 PLATFORMS. 1929 01:09:39,880 --> 01:09:42,600 SOME STUDIES WOULD BE COMPARING 1930 01:09:42,600 --> 01:09:43,920 VR INTERVENTIONS TO EITHER 1931 01:09:43,920 --> 01:09:45,760 PASSIVELY VIEWING SOME SORT OF 1932 01:09:45,760 --> 01:09:48,640 MEDIA ON A 2D SCREEN, BUT THESE 1933 01:09:48,640 --> 01:09:50,720 CAN BE DIFFERENT AND CONFOUND 1934 01:09:50,720 --> 01:09:53,120 POTENTIAL BENEFITS FROM USE OF 1935 01:09:53,120 --> 01:09:53,280 VR. 1936 01:09:53,280 --> 01:09:55,640 AND THEN ON TOP OF THAT 1937 01:09:55,640 --> 01:09:58,720 LITERATURE SPECIFIC ON USE OF VR 1938 01:09:58,720 --> 01:10:00,440 IN POSTOPERATIVE MANAGEMENT IS 1939 01:10:00,440 --> 01:10:00,920 SPARSE. 1940 01:10:00,920 --> 01:10:04,720 BUT VR MAY SERVE AS BOTH MEANS 1941 01:10:04,720 --> 01:10:05,840 FOR NON-PHARMACOLOGIC PAIN 1942 01:10:05,840 --> 01:10:07,800 MANAGEMENT AND MEANS TO IMPROVE 1943 01:10:07,800 --> 01:10:10,200 PATIENT QUALITY OF LIFE IN THE 1944 01:10:10,200 --> 01:10:13,280 HOSPITAL, BOTH OF WHICH MAY 1945 01:10:13,280 --> 01:10:14,080 FACILITATE POSTOPERATIVE 1946 01:10:14,080 --> 01:10:14,320 RECOVERY. 1947 01:10:14,320 --> 01:10:17,440 SO THE PURPOSE OF THIS STUDY WAS 1948 01:10:17,440 --> 01:10:19,080 TO EVALUATE THE IMPACT OF AN 1949 01:10:19,080 --> 01:10:21,800 ACTIVE VR GAME COMPARED TO A 1950 01:10:21,800 --> 01:10:25,960 SIMILAR 2D GAME ON POSTOPERATIVE 1951 01:10:25,960 --> 01:10:26,960 PAIN AMONG PATIENTS HOSPITALIZED 1952 01:10:26,960 --> 01:10:32,640 AND HEAD AND NECK SURGEONRY TO 1953 01:10:32,640 --> 01:10:33,600 EVALUATE CHANGES IN SUBJECTIVE 1954 01:10:33,600 --> 01:10:35,400 PAIN SCORES AND SECONDARY AIMS 1955 01:10:35,400 --> 01:10:38,240 TO EVALUATE CHANGES IN OPIOID 1956 01:10:38,240 --> 01:10:40,840 UTILIZATION AND SUBJECTIVE 1957 01:10:40,840 --> 01:10:43,880 PATIENT EXPERIENCES WITH THEIR 1958 01:10:43,880 --> 01:10:44,240 INTERVENTION. 1959 01:10:44,240 --> 01:10:51,480 WE HYPOTHESIZE PATIENTS USING IT 1960 01:10:51,480 --> 01:10:56,520 WOULD HAVE LOWER SCORES COMPARED 1961 01:10:56,520 --> 01:10:57,080 TO CONTROL GROUP. 1962 01:10:57,080 --> 01:11:00,960 THIS IS FROM JULY OF 2020 TO 1963 01:11:00,960 --> 01:11:03,800 OCTOBER 2021. 1964 01:11:03,800 --> 01:11:05,920 APPROVED BY OHSU IRB, REGISTERED 1965 01:11:05,920 --> 01:11:09,080 ON clinicaltrials.gov, 1966 01:11:09,080 --> 01:11:10,040 NUMEROUS INCLUSION CRITERIA 1967 01:11:10,040 --> 01:11:11,600 LISTED HERE, PATIENTS WHO WERE 1968 01:11:11,600 --> 01:11:13,800 HOSPITALIZED AFTER HEAD AND NECK 1969 01:11:13,800 --> 01:11:15,000 SURGERY WERE ASKED TO 1970 01:11:15,000 --> 01:11:17,080 PARTICIPATE IF THEY HAD MODERATE 1971 01:11:17,080 --> 01:11:18,800 TO SEVERE PAIN DEFINED BY 1972 01:11:18,800 --> 01:11:20,880 AVERAGE OF PAIN SCORE FROM THEIR 1973 01:11:20,880 --> 01:11:24,320 MEDICAL RECORD OF 3 OR HIGHER IN 1974 01:11:24,320 --> 01:11:27,280 THE 24 HOURS PRIOR TO SCREENING 1975 01:11:27,280 --> 01:11:29,440 FOR STUDY ELIGIBILITY AND 1976 01:11:29,440 --> 01:11:32,960 ENGLISH SPEAKING, AS THAT IS 1977 01:11:32,960 --> 01:11:34,800 WHERE MOST CONTENT AVAILABLE ON 1978 01:11:34,800 --> 01:11:35,800 CURRENT PLATFORMS, LANGUAGE IS 1979 01:11:35,800 --> 01:11:38,560 AN OPTION FOR PATIENTS TO USE. 1980 01:11:38,560 --> 01:11:41,800 AND THEN WE ALSO HAD EXCLUSION 1981 01:11:41,800 --> 01:11:43,040 CRITERIA INCLUDING INTENSIVE 1982 01:11:43,040 --> 01:11:46,400 CARE UNIT STAY, ACTIVE 1983 01:11:46,400 --> 01:11:48,280 INFECTIONS, NAUSEA, VERTIGO, 1984 01:11:48,280 --> 01:11:51,000 SEIZURE DISORDERS, ALSO NOTABLY 1985 01:11:51,000 --> 01:11:52,760 POSTOPERATIVE LIMITATIONS SUCH 1986 01:11:52,760 --> 01:11:54,640 AS RECONSTRUCTIONS OR WOUND CARE 1987 01:11:54,640 --> 01:11:56,280 CONDITIONS THAT WOULD PREVENT 1988 01:11:56,280 --> 01:12:00,840 THE SAFE OR COMFORTABLE USE OF A 1989 01:12:00,840 --> 01:12:02,520 VR HEADSET. 1990 01:12:02,520 --> 01:12:04,360 NUMEROUS DEMOGRAPHICS INCLUDING 1991 01:12:04,360 --> 01:12:09,200 AGE, SELF-REPORTED SEX, 1992 01:12:09,200 --> 01:12:10,600 COMORBIDITIES, PREOPERATIVE 1993 01:12:10,600 --> 01:12:17,840 OPIOID USE, SURGICAL 1994 01:12:17,840 --> 01:12:23,080 CHARACTERISTICS, OPIOID USE WAS 1995 01:12:23,080 --> 01:12:24,680 MEASUREDS MILLIGRAM EQUIVALENT. 1996 01:12:24,680 --> 01:12:29,200 PATIENTS WERE RANDOMLY ASSIGNED 1997 01:12:29,200 --> 01:12:29,840 USING SOFTWARE-GENERATED 1998 01:12:29,840 --> 01:12:31,360 RANDOMIZATION TO VR INTERVENTION 1999 01:12:31,360 --> 01:12:33,560 OR CONTROL GROUP. 2000 01:12:33,560 --> 01:12:44,040 VR HEAD SET USED WAS OCULUS 2001 01:12:46,320 --> 01:12:50,840 QUEST, A SILICON HEADSET, 2002 01:12:50,840 --> 01:12:52,840 DISPOSABLE SANITARY COVERS, EYE 2003 01:12:52,840 --> 01:12:55,240 MASKS, FACE MASKS BEFORE USE TO 2004 01:12:55,240 --> 01:12:58,080 MINIMIZE DIRECT DEVICE CONTACT. 2005 01:12:58,080 --> 01:13:00,800 PATIENTS IN THIS GROUP VR GROUP 2006 01:13:00,800 --> 01:13:03,240 PARTICIPATED IN THE 15-MINUTE 2007 01:13:03,240 --> 01:13:04,120 INTERACTIVE GAMING EXPERIENCE, 2008 01:13:04,120 --> 01:13:07,360 ANGRY BIRDS, AS YOU CAN SEE IN 2009 01:13:07,360 --> 01:13:08,800 THE PICTURE HERE PATIENTS 2010 01:13:08,800 --> 01:13:11,400 UTILIZING THIS GAME, USING 2011 01:13:11,400 --> 01:13:13,360 CONTROLLERS, SITTING IN BED, 2012 01:13:13,360 --> 01:13:15,920 CONTENT IS INTERRUPTION FREE, 2013 01:13:15,920 --> 01:13:17,200 INCLUDES MUSIC, SOUND, 2014 01:13:17,200 --> 01:13:18,560 ANIMATION, AND MEANWHILE 2015 01:13:18,560 --> 01:13:20,800 PATIENTS IN THE CONTROL GROUP 2016 01:13:20,800 --> 01:13:22,800 PLAYED SIMILAR GAME, ANGRY BIRDS 2017 01:13:22,800 --> 01:13:25,680 2, SIMILARLY FOR 15 MINUTES ON 2018 01:13:25,680 --> 01:13:26,360 HAND-HELD SMARTPHONE DEVICES 2019 01:13:26,360 --> 01:13:28,520 WHILE SITTING IN BED WITH THE 2020 01:13:28,520 --> 01:13:30,080 AUDIO PLAYED THROUGH THE 2021 01:13:30,080 --> 01:13:30,360 SPEAKER. 2022 01:13:30,360 --> 01:13:32,040 ALTHOUGH THE TWO GAMES HAD 2023 01:13:32,040 --> 01:13:33,480 DIFFERENCES BASED ON THE 2024 01:13:33,480 --> 01:13:38,120 PLATFORM USE, THERE THEY WERE 2025 01:13:38,120 --> 01:13:39,720 SIMILAR IN THEMES, AUTOMATION, 2026 01:13:39,720 --> 01:13:42,760 AUDIO, GENERAL GAME PLAYED 2027 01:13:42,760 --> 01:13:43,080 STYLE. 2028 01:13:43,080 --> 01:13:44,560 PRIMARY OUTCOME WAS CHANGE IN 2029 01:13:44,560 --> 01:13:46,800 PAIN SCORE AFTER INTERVENTION 2030 01:13:46,800 --> 01:13:48,360 USE, SO PRIOR TO INTERVENTION 2031 01:13:48,360 --> 01:13:51,520 PATIENTS SELF-REPORTED PAIN ON 2032 01:13:51,520 --> 01:13:57,440 AN 11-POINT SCALE FROM 0-10, 2033 01:13:57,440 --> 01:14:03,680 EASY TO ADMINISTER, PATIENTS 2034 01:14:03,680 --> 01:14:04,520 REPEATED IMMEDIATELY AFTER AND 2035 01:14:04,520 --> 01:14:07,680 HOURLY 4 HOURS AFTER USE. 2036 01:14:07,680 --> 01:14:08,440 SECONDARY OUTCOMES INCLUDED 2037 01:14:08,440 --> 01:14:11,640 CHANGES IN OPIOID USE AND 2038 01:14:11,640 --> 01:14:13,840 PATIENT SATISFACTION WITH 2039 01:14:13,840 --> 01:14:15,600 INTERVENTION, ANALGESIC USE 2040 01:14:15,600 --> 01:14:17,360 INCLUDING OPIOID AND NON-OPIOID 2041 01:14:17,360 --> 01:14:19,400 DOCUMENTED FROM THE MEDICAL 2042 01:14:19,400 --> 01:14:20,520 REPORT 8 HOURS PRE-INTERVENTION 2043 01:14:20,520 --> 01:14:22,800 AND 8 HOURS POST INTERVENTION. 2044 01:14:22,800 --> 01:14:24,200 AND AFTER THE INTERVENTION 2045 01:14:24,200 --> 01:14:26,000 PARTICIPANTS WERE ASKED TO 2046 01:14:26,000 --> 01:14:27,840 COMPLETE RESPONSES TO TWO 2047 01:14:27,840 --> 01:14:28,960 QUESTIONS REGARDING THEIR 2048 01:14:28,960 --> 01:14:31,360 EXPERIENCE AND DESIRE TO USE 2049 01:14:31,360 --> 01:14:33,320 AUDIO/VISUAL INTERVENTION IN THE 2050 01:14:33,320 --> 01:14:35,480 FUTURE, THESE WERE RATED ON FIVE 2051 01:14:35,480 --> 01:14:39,120 POINT LIKERT SCALES WITH THE 2052 01:14:39,120 --> 01:14:39,880 FOLLOWING ANSWER CHOICES. 2053 01:14:39,880 --> 01:14:43,720 THIS WAS A PILOT STUDY, THERE'S 2054 01:14:43,720 --> 01:14:44,520 INEFFICIENT COMPARATIVE 2055 01:14:44,520 --> 01:14:46,000 PUBLISHED DATA AVAILABLE BEFORE 2056 01:14:46,000 --> 01:14:47,520 THE STUDY. 2057 01:14:47,520 --> 01:14:53,880 MEAN VALUES WITH STANDARD 2058 01:14:53,880 --> 01:14:56,280 DEVIATION, WITH INTERQUARTILE 2059 01:14:56,280 --> 01:14:58,480 RANGES, CONFIDENCE INTERVALS 2060 01:14:58,480 --> 01:14:59,880 REPORTED, P-VALUES RESULT OF 2061 01:14:59,880 --> 01:15:03,720 TWO-SIDED TESTS. 2062 01:15:03,720 --> 01:15:07,120 THE FIRST FIGURE, 30 PATIENTS 2063 01:15:07,120 --> 01:15:08,640 RANDOMIZED FOR INCLUSION, ONE 2064 01:15:08,640 --> 01:15:10,280 ABLE TO COMPLETE UTILIZATION OF 2065 01:15:10,280 --> 01:15:11,920 THE VR INTERVENTION DUE TO 2066 01:15:11,920 --> 01:15:14,320 DISCOMFORT IN USING THE PERSONAL 2067 01:15:14,320 --> 01:15:16,040 PROTECTIVE EQUIPMENT, SO THE 2068 01:15:16,040 --> 01:15:17,160 FINAL POPULATION INCLUDED 14 2069 01:15:17,160 --> 01:15:19,720 PATIENTS IN OUR VIRTUAL REALITY 2070 01:15:19,720 --> 01:15:23,160 COHORT, 15 IN THE CONTROL 2071 01:15:23,160 --> 01:15:25,800 COHORT. 2072 01:15:25,800 --> 01:15:27,160 THIS TABLE HERE DEMONSTRATES 2073 01:15:27,160 --> 01:15:28,440 CHARACTERISTICS, NO DIFFERENCES 2074 01:15:28,440 --> 01:15:30,080 BETWEEN THE TWO GROUPS, MAJORITY 2075 01:15:30,080 --> 01:15:32,800 OF PATIENTS WERE MALE, MEAN AGE 2076 01:15:32,800 --> 01:15:34,120 AROUND 58 YEARS, PRIMARY 2077 01:15:34,120 --> 01:15:36,640 SURGICAL SITES WERE ORAL CAVITY 2078 01:15:36,640 --> 01:15:38,960 AND ORAL PHARYNX, MAJORITY OF 2079 01:15:38,960 --> 01:15:39,600 SECONDARY SURGICAL SIDES 2080 01:15:39,600 --> 01:15:42,320 INCLUDED NECK. 2081 01:15:42,320 --> 01:15:45,400 FOR THOSE UNFAMILIAR WITH THE 2082 01:15:45,400 --> 01:15:47,720 FIELD, THESE PROCEDURES 2083 01:15:47,720 --> 01:15:49,560 PRIMARILY INVOLVED CANCER 2084 01:15:49,560 --> 01:15:51,440 RESECTIONS FROM DIFFERENT SITES 2085 01:15:51,440 --> 01:15:53,440 INCLUDING RESECTION OF REGIONAL 2086 01:15:53,440 --> 01:15:54,320 METASTATIC DISEASE THAT SPREAD 2087 01:15:54,320 --> 01:15:56,720 TO NECK AND SOME RESECTIONS ARE 2088 01:15:56,720 --> 01:15:57,560 RECONSTRUCTED USING TISSUE FROM 2089 01:15:57,560 --> 01:16:02,280 THE OTHER PARTS OF THE BODY SUCH 2090 01:16:02,280 --> 01:16:04,480 AS RADIAL FOREARM, FIBULA AND 2091 01:16:04,480 --> 01:16:06,320 OTHER SITES. 2092 01:16:06,320 --> 01:16:08,080 ALL PATIENTS HAD OPIOIDS 2093 01:16:08,080 --> 01:16:11,240 AVAILABLE TO THEM TO USE FOR 2094 01:16:11,240 --> 01:16:12,800 POSTOPERATIVE ANALGESIA. 2095 01:16:12,800 --> 01:16:19,160 WE FOUND NO DIFFERENCE IN 2096 01:16:19,160 --> 01:16:20,680 PRE-INTERVENTION BETWEEN THE TWO 2097 01:16:20,680 --> 01:16:21,880 GROUPS AND DIDN'T FIND 2098 01:16:21,880 --> 01:16:23,440 DIFFERENCE IN TIME TO 2099 01:16:23,440 --> 01:16:26,040 INTERVENTION AFTER MOST RECENT 2100 01:16:26,040 --> 01:16:30,200 OPIOID USE, PRE-INTERVENTION 2101 01:16:30,200 --> 01:16:35,440 PAIN SCORES, 4-HOUR OPIOID USE 2102 01:16:35,440 --> 01:16:36,880 OR 8-HOUR USE BETWEEN THE 2103 01:16:36,880 --> 01:16:37,120 GROUPS. 2104 01:16:37,120 --> 01:16:40,800 WE LOOK AT CHANGES IN PAIN 2105 01:16:40,800 --> 01:16:41,200 SCORES. 2106 01:16:41,200 --> 01:16:42,000 GRAPHICAL ANALYSIS IDENTIFIED 2107 01:16:42,000 --> 01:16:43,800 ONE EXTREME OUTLIER IN THE 2108 01:16:43,800 --> 01:16:45,200 CONTROL GROUP WITH 2109 01:16:45,200 --> 01:16:47,920 PRE-INTERVENTION PAIN SCORE OF 7 2110 01:16:47,920 --> 01:16:50,120 TO POST PAIN SCORE OF ZERO, 2111 01:16:50,120 --> 01:16:51,880 AFTER WE REMOVED THE OUTLIER 2112 01:16:51,880 --> 01:16:53,720 AMONG 28 FOUND A MEANINGFUL 2113 01:16:53,720 --> 01:16:55,280 REDUCTION IN PAIN REDUCTION IN 2114 01:16:55,280 --> 01:16:57,240 THE VIRTUAL REALITY GROUP 2115 01:16:57,240 --> 01:16:58,320 IMMEDIATELY AFTER THE 2116 01:16:58,320 --> 01:17:00,880 INTERVENTION USE COMPARED TO THE 2117 01:17:00,880 --> 01:17:03,160 CONTROL GROUP, 1.4 POINTS, ALSO 2118 01:17:03,160 --> 01:17:05,760 SOME RELATIVE DIFFERENCES IN ONE 2119 01:17:05,760 --> 01:17:08,280 HOUR, TWO HOURS, THREE HOURS 2120 01:17:08,280 --> 01:17:09,480 POST INTERVENTION PAIN SCORE 2121 01:17:09,480 --> 01:17:11,240 IMPROVEMENTS IN THE VIRTUAL 2122 01:17:11,240 --> 01:17:14,400 REALITY GROUP COMPARED TO 2123 01:17:14,400 --> 01:17:17,360 CONTROL GROUP, THIS DIDN'T 2124 01:17:17,360 --> 01:17:21,640 APPEAR TO PERSIST UNTIL 4-HOUR 2125 01:17:21,640 --> 01:17:22,040 MARK. 2126 01:17:22,040 --> 01:17:24,080 WE ALSO LOOKED AT CHANGES IN 2127 01:17:24,080 --> 01:17:25,120 OPIOID USE AFTER THE 2128 01:17:25,120 --> 01:17:27,320 INTERVENTION, AND WHAT WE FOUND 2129 01:17:27,320 --> 01:17:29,320 WAS A MEANINGFUL DECREASE IN 2130 01:17:29,320 --> 01:17:31,160 4-HOUR POST INTERVENTION OPIOID 2131 01:17:31,160 --> 01:17:33,560 USE COMPARED TO 4-HOUR 2132 01:17:33,560 --> 01:17:35,640 PRE-INTERVENTION OPIOID USE, 2133 01:17:35,640 --> 01:17:37,360 PATIENTS UTILIZING VR HEADSET, 2134 01:17:37,360 --> 01:17:42,720 MEAN DIFFERENCE AROUND 9 MME, 2135 01:17:42,720 --> 01:17:48,240 AROUND 1 TO 2.5 MILLIGRAMS 2136 01:17:48,240 --> 01:17:51,400 TABLETS OF OXYCODONE, A 2137 01:17:51,400 --> 01:17:53,360 DIFFERENCE AMONG VR PATIENTS 2138 01:17:53,360 --> 01:17:57,640 WITH MEAN DIFFERENCE AROUND 14 2139 01:17:57,640 --> 01:17:59,600 MME, ALMOST ONE 10-MILLIGRAM 2140 01:17:59,600 --> 01:18:01,040 TABLET OF OXYCODONE. 2141 01:18:01,040 --> 01:18:02,560 WE DIDN'T FIND DIFFERENCES IN 2142 01:18:02,560 --> 01:18:05,920 RESPONSE TO QUESTION OF I 2143 01:18:05,920 --> 01:18:06,840 ENJOYED MY AUDIO/VISUAL 2144 01:18:06,840 --> 01:18:08,720 EXPERIENCE OR WOULD LIKE TO SEE 2145 01:18:08,720 --> 01:18:10,160 MY AUDIO/VISUAL EXPERIENCE USED 2146 01:18:10,160 --> 01:18:13,520 MORE OFTEN IN HEALTH CARE, BOTH 2147 01:18:13,520 --> 01:18:16,040 COHORTS HAD HIGH RATINGS OF 2148 01:18:16,040 --> 01:18:17,800 ENJOYMENT OF THEIR 2149 01:18:17,800 --> 01:18:18,240 INTERVENTIONS. 2150 01:18:18,240 --> 01:18:20,000 NO ADVERSE EVENTS RELATED TO 2151 01:18:20,000 --> 01:18:22,400 INTERVENTION USE IN EITHER 2152 01:18:22,400 --> 01:18:24,040 COHORT IDENTIFIED. 2153 01:18:24,040 --> 01:18:25,760 IN THIS STUDY USE OF VR 2154 01:18:25,760 --> 01:18:29,600 INTERVENTION WAS ASSOCIATED WITH 2155 01:18:29,600 --> 01:18:31,240 MEANINGFUL REDUCTION IN PAIN AND 2156 01:18:31,240 --> 01:18:36,320 OPIOID USE COMPARED TO SIMILAR 2157 01:18:36,320 --> 01:18:38,120 2D INTERVENTION. 2158 01:18:38,120 --> 01:18:39,680 IMMERSIVE ENVIRONMENT MAY 2159 01:18:39,680 --> 01:18:42,400 EXPLAIN THE PAIN ATTENUATION 2160 01:18:42,400 --> 01:18:43,480 COMPARED TO TRADITIONAL 2161 01:18:43,480 --> 01:18:48,320 DISTRACTION SUCH AS 2D VIDEO OR 2162 01:18:48,320 --> 01:18:48,520 MEDIA. 2163 01:18:48,520 --> 01:18:50,200 THERE'S A RISE OF STUDIES, ONLY 2164 01:18:50,200 --> 01:18:53,360 A FEW HAVE AIMED TO EVALUATE USE 2165 01:18:53,360 --> 01:18:57,640 OF VR AFTER SURGERY, NONE HAVE 2166 01:18:57,640 --> 01:19:02,880 EVALUATED OUTCOMES ON OPIOID 2167 01:19:02,880 --> 01:19:03,160 UTILIZATION. 2168 01:19:03,160 --> 01:19:05,720 WE THINK THIS IS A SIGNIFICANT 2169 01:19:05,720 --> 01:19:08,680 FINDING THAT MAY ENCOURAGE 2170 01:19:08,680 --> 01:19:09,880 LARGER ADOPTION AND APPLICATION 2171 01:19:09,880 --> 01:19:12,720 OF VR EXPERIENCES FOR MANAGEMENT 2172 01:19:12,720 --> 01:19:14,360 OF POST-OPERATIVE PAIN. 2173 01:19:14,360 --> 01:19:15,760 NOW,IVE NOTE THERE DID NOT APAIR 2174 01:19:15,760 --> 01:19:19,560 TO BE A PAIN SCORE DIFFERENT 2175 01:19:19,560 --> 01:19:26,080 PERSISTING UP TO 4 4-HOUR MARK, 2176 01:19:26,080 --> 01:19:27,720 POST OPIOID UP TO 8 HOURS, THERE 2177 01:19:27,720 --> 01:19:30,560 MAY BE OTHER FACTORS ASIDE FROM 2178 01:19:30,560 --> 01:19:32,760 SUBJECTIVE PAIN INTENSITY 2179 01:19:32,760 --> 01:19:34,480 INFLUENCING USE AMONG PATIENTS, 2180 01:19:34,480 --> 01:19:36,480 IT'S SHOWN IN THE PAST VR HAS 2181 01:19:36,480 --> 01:19:38,080 BEEN BENEFITING TREATMENT OF 2182 01:19:38,080 --> 01:19:39,280 ANXIETY AND DEPRESSION SO IT'S 2183 01:19:39,280 --> 01:19:41,480 POSSIBLE THAT THERE MAY HAVE 2184 01:19:41,480 --> 01:19:43,680 BEEN A THERAPEUTIC EFFECT ON 2185 01:19:43,680 --> 01:19:45,080 ETIOLOGY ASIDE FROM SUBJECTIVE 2186 01:19:45,080 --> 01:19:48,400 PAIN, ASSOCIATED WITH THE 2187 01:19:48,400 --> 01:19:49,720 REDUCTION IN OPIOID UTILIZATION. 2188 01:19:49,720 --> 01:19:51,560 PATIENTS WHO UNDERGO HEAD AND 2189 01:19:51,560 --> 01:19:52,360 NECK SURGERY POSE UNIQUE 2190 01:19:52,360 --> 01:19:55,280 CHALLENGE TO THE USE OF VR DUE 2191 01:19:55,280 --> 01:19:56,480 TO INCISIONS OR RECONSTRUCTS 2192 01:19:56,480 --> 01:19:58,760 THAT MAY PRECLUDE USE OF WEARING 2193 01:19:58,760 --> 01:20:00,080 THE HEADSET OR PREVENT 2194 01:20:00,080 --> 01:20:02,920 COMFORTABLE OR SAFE USE OF VR IN 2195 01:20:02,920 --> 01:20:04,360 THE POSTOPERATIVE PERIOD. 2196 01:20:04,360 --> 01:20:06,080 SO FUTURE STUDIES ARE NECESSARY 2197 01:20:06,080 --> 01:20:09,480 TO BETTER UNDERSTAND THE RISKS 2198 01:20:09,480 --> 01:20:13,000 OF UTILIZING VR HEADSET IN 2199 01:20:13,000 --> 01:20:15,720 POSTOPERATIVE PERIOD AND DEFINE 2200 01:20:15,720 --> 01:20:18,440 INCLUSION CRITERIA FOR SURGICAL 2201 01:20:18,440 --> 01:20:18,720 PATIENTS. 2202 01:20:18,720 --> 01:20:21,080 THERE'S A PILOT STUDY WITH A 2203 01:20:21,080 --> 01:20:22,600 SMALL SAMPLE SIZE, 23% OF 2204 01:20:22,600 --> 01:20:26,360 PATIENTS WHO WERE APPROACHED FOR 2205 01:20:26,360 --> 01:20:27,200 RECRUITMENT DECLINED 2206 01:20:27,200 --> 01:20:29,160 PARTICIPATION, THERE MAY BE BIAS 2207 01:20:29,160 --> 01:20:30,600 IN ENROLLMENT FOR SELECTING 2208 01:20:30,600 --> 01:20:33,360 PATIENTS MORE LIKELY TO BENEFIT 2209 01:20:33,360 --> 01:20:35,200 FROM OR ENJOY GAMING EXPERIENCE. 2210 01:20:35,200 --> 01:20:38,160 THIS WAS A ONE-TIME VR USE, SO 2211 01:20:38,160 --> 01:20:40,040 NOVELTY OF THE USE AMONG 2212 01:20:40,040 --> 01:20:41,520 PATIENTS WITHOUT EXPOSURE TO THE 2213 01:20:41,520 --> 01:20:45,920 TECHNOLOGY MAY ALSO PLAY A ROLE. 2214 01:20:45,920 --> 01:20:48,320 SO QUICKLY A COUPLE FUTURE 2215 01:20:48,320 --> 01:20:50,080 DIRECTIONS TO CONSIDER HOW TO 2216 01:20:50,080 --> 01:20:51,160 FURTHER EVALUATE THIS TECHNOLOGY 2217 01:20:51,160 --> 01:20:53,040 FOR PATIENT CARE AROUND 2218 01:20:53,040 --> 01:20:54,680 ESPECIALLY IN OUR SURGICAL 2219 01:20:54,680 --> 01:20:55,880 CONTEXT, OF COURSE LARGER SCALE 2220 01:20:55,880 --> 01:20:58,320 STUDIES ARE NEEDED TO FURTHER 2221 01:20:58,320 --> 01:21:00,160 EVALUATE UTILIZATION AND 2222 01:21:00,160 --> 01:21:00,480 EFFICACY. 2223 01:21:00,480 --> 01:21:02,120 ADDITIONAL OUTCOMES ASIDE FROM 2224 01:21:02,120 --> 01:21:03,320 SUBJECTIVE PAIN SHOULD BE 2225 01:21:03,320 --> 01:21:05,520 CONSIDERED SUCH AS ANXIETY AND 2226 01:21:05,520 --> 01:21:07,400 DEPRESSION, WHICH CAN BE COMMON 2227 01:21:07,400 --> 01:21:11,440 IN THE PERIOPERATIVE PERIOD. 2228 01:21:11,440 --> 01:21:13,440 THERE SHOULD BE A COMPARISON OF 2229 01:21:13,440 --> 01:21:15,400 DIFFERENT TYPES OF EXPERIENCE 2230 01:21:15,400 --> 01:21:17,480 AND OUTCOMES. 2231 01:21:17,480 --> 01:21:19,680 OUR GROUP COMPARED MINDFULNESS 2232 01:21:19,680 --> 01:21:23,680 EXPERIENCE TO VR GAMING 2233 01:21:23,680 --> 01:21:25,520 EXPERIENCE ON PREOPERATIVE 2234 01:21:25,520 --> 01:21:26,560 ANXIETY AND POSTOPERATIVE PAIN, 2235 01:21:26,560 --> 01:21:35,280 MANUSCRIPT UNDER REVIEW. 2236 01:21:35,280 --> 01:21:40,320 OUR GROUP FINISHED A LARGER 2237 01:21:40,320 --> 01:21:43,080 TRIAL PROVIDING SIMILAR TO 2238 01:21:43,080 --> 01:21:43,560 SCHEDULED MEDICATION 2239 01:21:43,560 --> 01:21:45,680 HOSPITALIZED AFTER HEAD AND NECK 2240 01:21:45,680 --> 01:21:47,440 SURGERY, JUST ENDING AND WE'RE 2241 01:21:47,440 --> 01:21:50,880 BEGINNING THE DATA EVALUATION 2242 01:21:50,880 --> 01:21:51,840 PROCESS. 2243 01:21:51,840 --> 01:21:54,280 IN CONCLUSION VIRTUAL REALITY 2244 01:21:54,280 --> 01:21:56,320 WAS ASSOCIATED WITH REDUCED PAIN 2245 01:21:56,320 --> 01:22:02,240 SCORES HOURS AFTER INTERVENTION, 2246 01:22:02,240 --> 01:22:11,320 8 HOURS OPIOID, MAY BE A 2247 01:22:11,320 --> 01:22:14,280 USEFUL ADJUNCT FOR PAIN CONTROL 2248 01:22:14,280 --> 01:22:14,800 AFTER SURGERY. 2249 01:22:14,800 --> 01:22:16,440 >>I CAN'T WAIT TO HEAR THE 2250 01:22:16,440 --> 01:22:19,200 RESULTS OF THE REPEATED USE AND 2251 01:22:19,200 --> 01:22:20,400 ALSO GAMING VERSUS MEDITATION 2252 01:22:20,400 --> 01:22:23,040 USE, WHETHER THEY WERE 2253 01:22:23,040 --> 01:22:24,120 DIFFERENT. 2254 01:22:24,120 --> 01:22:32,480 DO PEOPLE HAVE QUESTIONS FOR DR. 2255 01:22:32,480 --> 01:22:35,520 PANDRANGI ABOUT THIS STUDY OR 2256 01:22:35,520 --> 01:22:38,360 USE OF VR IN PAIN CONTROL? 2257 01:22:38,360 --> 01:22:38,640 CAROLINE? 2258 01:22:38,640 --> 01:22:42,360 SO NICE TO HAVE YOU HERE. 2259 01:22:42,360 --> 01:22:43,400 ARE YOU THERE? 2260 01:22:43,400 --> 01:22:45,800 >>YEAH. 2261 01:22:45,800 --> 01:22:46,080 THANK YOU. 2262 01:22:46,080 --> 01:22:47,520 CAN YOU HEAR ME? 2263 01:22:47,520 --> 01:22:48,400 MAYBE NOT. 2264 01:22:48,400 --> 01:22:49,040 CAN YOU HEAR ME? 2265 01:22:49,040 --> 01:22:59,480 >>WE CAN HEAR YOU, YEP. 2266 01:23:00,680 --> 01:23:04,840 NOW WE CAN'T. 2267 01:23:04,840 --> 01:23:06,920 >>CAN YOU HEAR ME NOW? 2268 01:23:06,920 --> 01:23:08,360 >>I THINK YOUR SOUND IS COMING 2269 01:23:08,360 --> 01:23:12,960 IN AND OUT A LITTLE BIT. 2270 01:23:12,960 --> 01:23:15,280 >>OKAY, LET ME SEE. 2271 01:23:15,280 --> 01:23:16,920 IS THAT BETTER, CHRISTINE? 2272 01:23:16,920 --> 01:23:19,240 >>THAT IS BETTER. 2273 01:23:19,240 --> 01:23:19,680 YEP, THAT'S BETTER. 2274 01:23:19,680 --> 01:23:20,760 >>THANK YOU. 2275 01:23:20,760 --> 01:23:23,000 YEAH, THANK YOU, DR. PANDRANGI, 2276 01:23:23,000 --> 01:23:28,560 FOR THE INTERESTING TALK. 2277 01:23:28,560 --> 01:23:30,840 IN YOUR STUDY WHETHER YOU WERE 2278 01:23:30,840 --> 01:23:34,080 ABLE TO ASK SUBJECTS ABOUT THEIR 2279 01:23:34,080 --> 01:23:35,920 PRIOR EXPERIENCE OR EXPOSURE TO 2280 01:23:35,920 --> 01:23:37,680 VR PLATFORMS, I THINK YOU HAD 2281 01:23:37,680 --> 01:23:39,360 ALLUDED TO THAT A LITTLE BIT 2282 01:23:39,360 --> 01:23:42,680 EARLIER, ONE OF THE AREAS OF 2283 01:23:42,680 --> 01:23:42,960 INTEREST. 2284 01:23:42,960 --> 01:23:45,320 AND I WAS ALSO INTERESTED IN THE 2285 01:23:45,320 --> 01:23:47,080 QUESTION ALSO THAT CHRISTINE 2286 01:23:47,080 --> 01:23:48,800 JUST POSED ABOUT SOME OF PERHAPS 2287 01:23:48,800 --> 01:23:53,480 SOME EARLY RESULTS IN LOOKING AT 2288 01:23:53,480 --> 01:23:54,800 THE DIFFERENT CONDITIONS UNDER 2289 01:23:54,800 --> 01:23:55,440 WHICH YOU'RE TESTING SUBJECTS, 2290 01:23:55,440 --> 01:23:57,000 IN THE BEGINNING YOU MENTIONED 2291 01:23:57,000 --> 01:23:59,200 NOT ONLY GAMING BUT MEDITATION 2292 01:23:59,200 --> 01:24:02,720 AND NATURE BEING ANOTHER 2293 01:24:02,720 --> 01:24:03,360 CONDITION. 2294 01:24:03,360 --> 01:24:06,440 CURIOUS ABOUT THOSE 2295 01:24:06,440 --> 01:24:08,280 >>YEAH, IN RESPONSE TO THE 2296 01:24:08,280 --> 01:24:10,360 FIRST QUESTION, WE DIDN'T 2297 01:24:10,360 --> 01:24:13,560 FORMALLY LOOK AT THIS BUT JUST 2298 01:24:13,560 --> 01:24:17,280 FROM MY OWN AN ANECDOTAL 2299 01:24:17,280 --> 01:24:19,760 EXPERIENCE, USE OF VR IS GAINING 2300 01:24:19,760 --> 01:24:21,200 TRACTION, CONSUMER HEAD SETS ARE 2301 01:24:21,200 --> 01:24:23,760 OUT THERE, IT'S STILL NOT NEARLY 2302 01:24:23,760 --> 01:24:25,160 MAINSTREAM AT ALL. 2303 01:24:25,160 --> 01:24:26,800 FROM THIS ONE STUDY I'M PRETTY 2304 01:24:26,800 --> 01:24:29,200 SURE EVEN THOUGH WE DIDN'T 2305 01:24:29,200 --> 01:24:30,480 FORMALLY LOOK AT THIS, NO MORE 2306 01:24:30,480 --> 01:24:33,120 THAN ONE OR TWO PATIENTS HAVE 2307 01:24:33,120 --> 01:24:33,920 USED VIRTUAL REALITY BEFORE, SO 2308 01:24:33,920 --> 01:24:37,440 THAT WAS PART OF THE LEARNING 2309 01:24:37,440 --> 01:24:39,280 CURVE, I HADN'T USED IT BEFORE, 2310 01:24:39,280 --> 01:24:42,120 TEACHING THEM HOW TO USE IS, 2311 01:24:42,120 --> 01:24:44,120 PART OF THE IMPLEMENTATION 2312 01:24:44,120 --> 01:24:46,160 ASPECT, CHALLENGING, THOSE WHO 2313 01:24:46,160 --> 01:24:47,520 MAY NOT BE FAMILIAR, NOT 2314 01:24:47,520 --> 01:24:49,440 COMFORTABLE WITH TECHNOLOGY, FOR 2315 01:24:49,440 --> 01:24:51,960 EXAMPLE, BARRIER IS HIGHER. 2316 01:24:51,960 --> 01:24:53,360 SO I WOULD SURPRISED THAT A LOT 2317 01:24:53,360 --> 01:24:56,000 OF PEOPLE HAD NOT EVEN HEARD 2318 01:24:56,000 --> 01:24:56,760 ABOUT VIRTUAL REALITY BEFORE 2319 01:24:56,760 --> 01:24:58,280 EVEN THOUGH WE THINK IT'S SO 2320 01:24:58,280 --> 01:24:59,520 COMMON IN THE MEDIA AT THIS 2321 01:24:59,520 --> 01:24:59,720 TIME. 2322 01:24:59,720 --> 01:25:02,560 STILL A LOT OF OUR PATIENTS HAVE 2323 01:25:02,560 --> 01:25:03,440 NOT BUT THAT BEING SAID 2324 01:25:03,440 --> 01:25:04,520 INTERESTING THAT THEY WERE ABLE 2325 01:25:04,520 --> 01:25:09,160 TO PICK IT UP QUICKLY AND HAVE 2326 01:25:09,160 --> 01:25:11,200 THE BENEFITS THEY DID. 2327 01:25:11,200 --> 01:25:12,480 SIMILARLY IN SOME REPEATED 2328 01:25:12,480 --> 01:25:14,920 STUDIES A FEW OF MY PATIENTS 2329 01:25:14,920 --> 01:25:17,120 HAVE USED BEFORE BUT MOSTLY THEY 2330 01:25:17,120 --> 01:25:18,200 BOUGHT AS GIFTS FOR 2331 01:25:18,200 --> 01:25:18,960 GRANDCHILDREN OR KIDS OR 2332 01:25:18,960 --> 01:25:21,080 SOMETHING LIKE THAT AND THEY 2333 01:25:21,080 --> 01:25:23,160 THEMSELVES HADN'T REALLY TRIED 2334 01:25:23,160 --> 01:25:23,800 THEM BEFORE. 2335 01:25:23,800 --> 01:25:28,320 SO FROM AT LEAST MY OWN 2336 01:25:28,320 --> 01:25:29,480 EXPERIENCE USING THE VIRTUAL 2337 01:25:29,480 --> 01:25:30,920 REALITY IN HEALTH CARE WAS THE 2338 01:25:30,920 --> 01:25:32,600 FIRST TIME MAJORITY OF PATIENTS 2339 01:25:32,600 --> 01:25:35,080 HAD USED IT AND THAT BUILDS TO 2340 01:25:35,080 --> 01:25:36,640 THE STUDY WE JUST FINISHED, 2341 01:25:36,640 --> 01:25:41,480 PATIENTS GOT THE OPPORTUNITY TO 2342 01:25:41,480 --> 01:25:42,840 USE IT REPEATED IN THE 2343 01:25:42,840 --> 01:25:43,960 HOSPITALIZATION, COMBING THROUGH 2344 01:25:43,960 --> 01:25:46,160 DATA I FELT LIKE ONE OF THE 2345 01:25:46,160 --> 01:25:48,360 THINGS STARTING TO APPEAR IS 2346 01:25:48,360 --> 01:25:50,200 WHATEVER SUBJECTIVE PAIN BENEFIT 2347 01:25:50,200 --> 01:25:51,520 THEY MAY HAVE PERCEIVED MAY NOT 2348 01:25:51,520 --> 01:25:54,920 JUST BE JUST FROM THE NOVELTY 2349 01:25:54,920 --> 01:25:58,560 BUT MAY BE PERSISTENCE WITH THAT 2350 01:25:58,560 --> 01:25:58,840 DISTRACTION. 2351 01:25:58,840 --> 01:26:01,560 I'M STILL INTERESTED TO SEE HOW 2352 01:26:01,560 --> 01:26:02,560 LONG THAT DISTRACTION PERIOD 2353 01:26:02,560 --> 01:26:03,120 LASTS FOR. 2354 01:26:03,120 --> 01:26:05,840 IS IT REALLY JUST AN HOUR OR SO, 2355 01:26:05,840 --> 01:26:08,680 CAN IT BE LONGER, WE'LL HAVE TO 2356 01:26:08,680 --> 01:26:10,640 SEE HOW IT PARSES OUT. 2357 01:26:10,640 --> 01:26:13,720 THE OTHER DATA, WE LOOKED AT THE 2358 01:26:13,720 --> 01:26:15,240 IDEA OF MINDFULNESS EXPERIENCE 2359 01:26:15,240 --> 01:26:16,120 FROM BIOFEEDBACK WHICH I THINK 2360 01:26:16,120 --> 01:26:18,000 WILL BE REALLY IMPORTANT WITH 2361 01:26:18,000 --> 01:26:20,400 THE USE OF EMERGING VIRTUAL 2362 01:26:20,400 --> 01:26:24,480 REALITY TECHNOLOGY ESPECIALLY IN 2363 01:26:24,480 --> 01:26:25,760 FIELD OF ANXIETY, FOR 2364 01:26:25,760 --> 01:26:26,840 PREOPERATIVE ANXIETY AND FROM 2365 01:26:26,840 --> 01:26:28,520 EARLY DATA IT DOESN'T LOOK LIKE 2366 01:26:28,520 --> 01:26:31,560 TO BE HONEST THERE'S ANY 2367 01:26:31,560 --> 01:26:32,640 DIFFERENCE BETWEEN THE 2368 01:26:32,640 --> 01:26:34,640 INTERVENTION USED IN VIRTUAL 2369 01:26:34,640 --> 01:26:36,160 REALITY AND OUTCOMES WE'RE 2370 01:26:36,160 --> 01:26:36,480 FINDING. 2371 01:26:36,480 --> 01:26:39,120 AND THAT WAS SURPRISING TO ME AT 2372 01:26:39,120 --> 01:26:42,600 FIRST BECAUSE I -- PART OF ME 2373 01:26:42,600 --> 01:26:43,400 WAS THINKING IF SOMEONE'S 2374 01:26:43,400 --> 01:26:46,440 PARTICIPATING IN A GAME IT GRABS 2375 01:26:46,440 --> 01:26:48,840 YOUR ATTENTION MORE, THOUGHT 2376 01:26:48,840 --> 01:26:51,040 THEY WOULD HAVE REDUCED PAIN OR 2377 01:26:51,040 --> 01:26:53,560 ANXIETY, BASICALLY THE DATA IS 2378 01:26:53,560 --> 01:26:57,400 NOT SHOWING REAL DIFFERENCE BUT 2379 01:26:57,400 --> 01:26:59,560 THERE'S STILL BENEFIT FROM 2380 01:26:59,560 --> 01:27:01,880 PRE-INTERVENTION SCORES 2381 01:27:01,880 --> 01:27:05,040 SUGGESTING MAYBE BEING IN 2382 01:27:05,040 --> 01:27:06,240 VIRTUAL REALITY RATHER THAN 2383 01:27:06,240 --> 01:27:07,200 TARGETED INTERVENTION, AN 2384 01:27:07,200 --> 01:27:08,120 INTERESTING AREA TO LOOK MORE 2385 01:27:08,120 --> 01:27:11,240 AND MORE NOT JUST COMPARING 2386 01:27:11,240 --> 01:27:11,800 EXISTING TECHNOLOGIES AND 2387 01:27:11,800 --> 01:27:15,000 EXPERIENCES BUT AS WE HAVE TO 2388 01:27:15,000 --> 01:27:16,280 MOVE TOWARDS CREATING 2389 01:27:16,280 --> 01:27:18,480 TECHNOLOGIES THAT WILL BE GEARED 2390 01:27:18,480 --> 01:27:21,560 TOWARDS CERTAIN SPECIFIC PATIENT 2391 01:27:21,560 --> 01:27:22,640 POPULATIONS AND HEALTHCARE 2392 01:27:22,640 --> 01:27:24,160 SCENARIOS. 2393 01:27:24,160 --> 01:27:24,440 >>GREAT. 2394 01:27:24,440 --> 01:27:24,720 THANK YOU. 2395 01:27:24,720 --> 01:27:26,080 SEVERAL PEOPLE HAVE HANDS UP AND 2396 01:27:26,080 --> 01:27:27,440 A QUESTION IN THE CHAT. 2397 01:27:27,440 --> 01:27:29,280 WHY DON'T YOU GO WITH THE PEOPLE 2398 01:27:29,280 --> 01:27:31,840 ON THE SCREEN AND ASK WALTER'S 2399 01:27:31,840 --> 01:27:36,960 QUESTION, UNLESS WALTER WANTS TO 2400 01:27:36,960 --> 01:27:37,960 ASK HIMSELF. 2401 01:27:37,960 --> 01:27:39,520 SYD? 2402 01:27:39,520 --> 01:27:41,800 >>THANKS. 2403 01:27:41,800 --> 01:27:42,440 REALLY INTERESTING. 2404 01:27:42,440 --> 01:27:47,280 SO YOUR COMMENT YOU JUST MADE 2405 01:27:47,280 --> 01:27:49,600 ABOUT BIOFEEDBACK AND SO I'M 2406 01:27:49,600 --> 01:27:52,760 CURIOUS IF YOU WERE DOING ANY 2407 01:27:52,760 --> 01:27:54,400 MEASUREMENTS LIKE THAT FOR THE 2408 01:27:54,400 --> 01:27:56,760 PATIENTS OTHER THAN THE SORT OF 2409 01:27:56,760 --> 01:27:57,800 SUBJECTIVE MEASURES YOU WERE 2410 01:27:57,800 --> 01:28:02,280 USING ABOUT THEIR OWN PAIN 2411 01:28:02,280 --> 01:28:09,400 RATING, BUT I'M CURIOUS ABOUT 2412 01:28:09,400 --> 01:28:11,840 WHAT'S YOUR HYPOTHESIS ABOUT WHY 2413 01:28:11,840 --> 01:28:18,200 VR IS MORE EFFECTIVE THAN A 2D 2414 01:28:18,200 --> 01:28:20,280 DISTRACTION WOULD BE IN TERMS OF 2415 01:28:20,280 --> 01:28:21,320 RELIEVING SUBJECTIVE EXPERIENCE 2416 01:28:21,320 --> 01:28:21,600 OF PAIN. 2417 01:28:21,600 --> 01:28:22,680 >>GREAT QUESTION. 2418 01:28:22,680 --> 01:28:25,400 TO THE FIRST POINT, I HAVEN'T 2419 01:28:25,400 --> 01:28:29,880 LOOKED AT ANYTHING SPECIFICALLY, 2420 01:28:29,880 --> 01:28:32,080 WE WEREN'T LOOKING AT 2421 01:28:32,080 --> 01:28:33,400 BIOFEEDBACK BUT MEDITATION 2422 01:28:33,400 --> 01:28:35,680 APPLICATION WE USED, IT 2423 01:28:35,680 --> 01:28:36,320 ENCOURAGES BIOFEEDBACK AS PART 2424 01:28:36,320 --> 01:28:38,200 OF THE PLATFORM SO ONE THING 2425 01:28:38,200 --> 01:28:40,720 THAT I WANT TO CONSIDER FOR 2426 01:28:40,720 --> 01:28:42,280 FUTURE STUDIES IS ACTUALLY 2427 01:28:42,280 --> 01:28:44,920 RATHER THAN LOOKING AT JUST 2428 01:28:44,920 --> 01:28:46,080 ASSESSMENTS OF ANXIETY OR PAIN 2429 01:28:46,080 --> 01:28:48,480 BEFORE THEY PUT ON THE HEADSET, 2430 01:28:48,480 --> 01:28:50,800 AFTER IT COMES OFF FINDING A WAY 2431 01:28:50,800 --> 01:28:52,680 TO GET SCORES DURING USE AND 2432 01:28:52,680 --> 01:28:56,240 DURING DIFFERENT TIME POINTS OF 2433 01:28:56,240 --> 01:28:57,240 THEIR INTERVENTION TO GAUGE 2434 01:28:57,240 --> 01:28:59,320 BASED ON WHAT THEY ARE ACTUALLY 2435 01:28:59,320 --> 01:29:01,520 DOING IN VR HOW THAT'S IMPACTING 2436 01:29:01,520 --> 01:29:02,960 WHATEVER SCORES THEY MIGHT HAVE. 2437 01:29:02,960 --> 01:29:05,800 SO I THINK THAT'S AN IMPORTANT 2438 01:29:05,800 --> 01:29:07,720 POINT, SOMETHING TO THINK ABOUT 2439 01:29:07,720 --> 01:29:09,400 BECAUSE ANOTHER AREA TO LOOK AT 2440 01:29:09,400 --> 01:29:12,680 IS HOW LONG CAN PATIENTS BE IN 2441 01:29:12,680 --> 01:29:15,400 VR FOR, SO SO FAR MOST STUDIES 2442 01:29:15,400 --> 01:29:18,160 SUGGEST UP TO 30 MINUTES IS 2443 01:29:18,160 --> 01:29:19,880 FINE, SOME RISK OF CYBER 2444 01:29:19,880 --> 01:29:24,040 SICKNESS IS THERE, EYE STRAIN, 2445 01:29:24,040 --> 01:29:25,600 BUT SHORTER INTERVALS ARE 2446 01:29:25,600 --> 01:29:28,000 REALISTIC, 15 OR 20 MINUTES, AND 2447 01:29:28,000 --> 01:29:30,520 IF WE SEE EVERY 5 MINUTES 2448 01:29:30,520 --> 01:29:31,480 THERE'S OBJECTIVE EVALUATION WE 2449 01:29:31,480 --> 01:29:34,320 CAN GET ON SOME SORT OF NUMBERS 2450 01:29:34,320 --> 01:29:36,520 AND WE KNOW IN THAT EXPERIENCE 2451 01:29:36,520 --> 01:29:39,360 AT THE 7-MINUTE MARK IS WHERE 2452 01:29:39,360 --> 01:29:41,360 THEY ARE DOING BIOFEEDBACK THAT 2453 01:29:41,360 --> 01:29:42,680 LASTS FOR 2 MINUTES, COLLECTING 2454 01:29:42,680 --> 01:29:43,720 SCORES BEFORE THE ACTUAL 2455 01:29:43,720 --> 01:29:45,720 SPECIFIC MEASURES ARE BEING DONE 2456 01:29:45,720 --> 01:29:49,320 VERSUS SIMPLY BEING IN THE 2457 01:29:49,320 --> 01:29:52,080 VIRTUAL REALITY WORLD, THOSE 2458 01:29:52,080 --> 01:29:52,840 MORE NUANCED POINTS WILL COME 2459 01:29:52,840 --> 01:29:54,680 FROM FUTURE WORK. 2460 01:29:54,680 --> 01:30:03,240 REGARDING -- REPEAT YOUR SECOND 2461 01:30:03,240 --> 01:30:03,480 QUESTION. 2462 01:30:03,480 --> 01:30:06,280 >>YOUR HYPOTHESIS WHY VR IS 2463 01:30:06,280 --> 01:30:08,120 BETTER THAN 2D? 2464 01:30:08,120 --> 01:30:09,440 I THINK IMMERSION. 2465 01:30:09,440 --> 01:30:11,280 MY PATIENTS RECOVERING FROM 2466 01:30:11,280 --> 01:30:11,960 SURGERY, THERE'S SO MUCH GOING 2467 01:30:11,960 --> 01:30:14,600 ON AROUND THEM IN THE HOSPITAL 2468 01:30:14,600 --> 01:30:17,320 ROOM, THAT'S TAKING THEIR 2469 01:30:17,320 --> 01:30:18,000 ATTENTION, TALKING TO THEM, 2470 01:30:18,000 --> 01:30:20,320 TRYING TO FOCUS ON RECOVERY, SO 2471 01:30:20,320 --> 01:30:21,720 MUCH EXTRA NOISE FROM MACHINES, 2472 01:30:21,720 --> 01:30:22,560 HOSPITAL LIFE. 2473 01:30:22,560 --> 01:30:26,560 BUT WHEN YOU'RE IN THE HEADSET 2474 01:30:26,560 --> 01:30:27,760 AND IMMERSIVE ENVIRONMENT YOU'RE 2475 01:30:27,760 --> 01:30:35,200 NOT PATION -- PAYING ATTENTION. 2476 01:30:35,200 --> 01:30:37,040 YOU'RE FULLY IN THE VIRTUAL 2477 01:30:37,040 --> 01:30:38,400 REALITY WORLD, I THINK IT'S JUST 2478 01:30:38,400 --> 01:30:39,840 THE ATTENTION THAT YOU'RE FULLY 2479 01:30:39,840 --> 01:30:41,680 THERE IN THIS SPACE, PUTTING 2480 01:30:41,680 --> 01:30:44,480 YOUR ATTENTION THERE IS, TO ME, 2481 01:30:44,480 --> 01:30:45,160 THAT DISTRACTING ELEMENT 2482 01:30:45,160 --> 01:30:48,120 COMPARED TO HAVING AN iPHONE 2483 01:30:48,120 --> 01:30:49,200 OR 2D SCREEN YOU'RE STILL 2484 01:30:49,200 --> 01:30:50,720 SOAKING IN THE REST OF THE ROOM, 2485 01:30:50,720 --> 01:30:51,840 EVERYTHING ELSE AROUND YOU EVEN 2486 01:30:51,840 --> 01:30:52,920 THOUGH YOU'RE TRYING TO PAY 2487 01:30:52,920 --> 01:30:53,600 ATTENTION TO SOMETHING I DON'T 2488 01:30:53,600 --> 01:30:56,200 THINK IT'S THE SAME. 2489 01:30:56,200 --> 01:31:04,320 I THINK THAT'S REALLY WHERE VR'S 2490 01:31:04,320 --> 01:31:04,720 IMPACT IS. 2491 01:31:04,720 --> 01:31:07,280 >>THANK YOU. 2492 01:31:07,280 --> 01:31:08,120 DR. TED ABEL? 2493 01:31:08,120 --> 01:31:09,920 >>THANKS FOR AN INTERESTING 2494 01:31:09,920 --> 01:31:10,880 TALK. 2495 01:31:10,880 --> 01:31:12,320 I HAVE A QUESTION, ANDREW HAS 2496 01:31:12,320 --> 01:31:14,720 LEFT BUT A QUESTION FOR BOTH OF 2497 01:31:14,720 --> 01:31:16,280 YOU. 2498 01:31:16,280 --> 01:31:17,680 I'LL ASK FOR YOU. 2499 01:31:17,680 --> 01:31:22,080 IT HAS TO DO WITH PERSPECTIVE 2500 01:31:22,080 --> 01:31:24,920 FROM CIRCADIAN MEDICINE. 2501 01:31:24,920 --> 01:31:30,160 THIS IDEA FROM JOHN HOEINGENESH 2502 01:31:30,160 --> 01:31:32,920 AND OTHERS THAT TIMING OF TAKING 2503 01:31:32,920 --> 01:31:34,200 PILLS CAN IMPACT EFFICACY AND IN 2504 01:31:34,200 --> 01:31:38,360 THE CONTEXT OF PAIN THERE'S A 2505 01:31:38,360 --> 01:31:39,440 CIRCADIAN RHYTHM IN OUR -- I 2506 01:31:39,440 --> 01:31:42,400 DON'T KNOW IF IT'S SENSITIVITY 2507 01:31:42,400 --> 01:31:44,040 OR RESPONSIVENESS, NOTICING OF 2508 01:31:44,040 --> 01:31:44,400 PAIN. 2509 01:31:44,400 --> 01:31:46,600 I WONDERED IF YOU THOUGHT ABOUT 2510 01:31:46,600 --> 01:31:48,240 THAT, WOULD SEEM LIKE ONE 2511 01:31:48,240 --> 01:31:51,400 DIFFERENCE BETWEEN A PILL AND VR 2512 01:31:51,400 --> 01:31:53,880 IS YOU HAVE TO DO VR AT SOME 2513 01:31:53,880 --> 01:31:56,000 TIME, A PILL AT SOME TIME TOO 2514 01:31:56,000 --> 01:31:57,680 BUT IT CAN HAVE A LONGER 2515 01:31:57,680 --> 01:32:01,440 DURATION ACTION, THERE'S SOME 2516 01:32:01,440 --> 01:32:02,880 EVIDENCE PAIN -- YOU EXPERIENCE 2517 01:32:02,880 --> 01:32:05,160 MORE PAIN AT NIGHT, YOU DON'T 2518 01:32:05,160 --> 01:32:09,960 WANT TO WAKE SOMEBODY UP TO GIVE 2519 01:32:09,960 --> 01:32:15,160 THEM VR BUT GIVE THEM A PILL 2520 01:32:15,160 --> 01:32:15,680 BEFORE SLEEP. 2521 01:32:15,680 --> 01:32:18,520 >>THAT TIES INTO THE STUDY WE 2522 01:32:18,520 --> 01:32:20,800 JUST FINISHED TRYING TO USE 2523 01:32:20,800 --> 01:32:22,560 VIRTUAL REALITY SIMILAR TO 2524 01:32:22,560 --> 01:32:23,240 SCHEDULED MEDICATION, BRING IT 2525 01:32:23,240 --> 01:32:26,200 TO PATIENTS TO USE EVERY 4 TO 6 2526 01:32:26,200 --> 01:32:27,840 HOURS IN THE DAYTIME TO GET THEM 2527 01:32:27,840 --> 01:32:28,600 TO USE THAT. 2528 01:32:28,600 --> 01:32:31,680 I THINK THAT'S REALLY ONE OF THE 2529 01:32:31,680 --> 01:32:33,760 CHALLENGES OF VR COMPARED TO THE 2530 01:32:33,760 --> 01:32:37,720 PILL, AS THINGS ARE RIGHT NOW 2531 01:32:37,720 --> 01:32:39,960 REALLY TO SAFELY GIVE SOMEONE VR 2532 01:32:39,960 --> 01:32:41,960 WE NEED TO HAVE SOMEONE WATCHING 2533 01:32:41,960 --> 01:32:44,040 THEM, BEING AROUND THEM, WE HAVE 2534 01:32:44,040 --> 01:32:46,680 TO -- IF WE HAVE NOT A MEMBER OF 2535 01:32:46,680 --> 01:32:48,120 THE RESEARCH TEAM BUT NURSING 2536 01:32:48,120 --> 01:32:49,320 STAFF OR SOMEONE ELSE THERE, 2537 01:32:49,320 --> 01:32:52,240 THEY HAVE TO BE TRAINED IN VR, 2538 01:32:52,240 --> 01:32:53,480 UNDERSTAND THE RISKS, EVEN 2539 01:32:53,480 --> 01:32:55,240 THOUGH THEY ARE MINIMAL, AND I 2540 01:32:55,240 --> 01:32:56,440 THINK THAT INFRASTRUCTURE IS 2541 01:32:56,440 --> 01:32:58,720 LACKING RIGHT NOW TO BE ABLE TO 2542 01:32:58,720 --> 01:33:02,000 LOOK AT THOSE POINTS BECAUSE IN 2543 01:33:02,000 --> 01:33:04,640 AN IDEAL SETTING PATIENTS WOULD 2544 01:33:04,640 --> 01:33:06,280 HAVE THE HEAD SET IN THE ROOM, 2545 01:33:06,280 --> 01:33:10,680 WE ASK THEM TO USE IT A FEW 2546 01:33:10,680 --> 01:33:12,400 TIMES AND WE ENCOURAGE IT BUT WE 2547 01:33:12,400 --> 01:33:14,160 HAVE TO HAVE SOMEONE TO BRING IT 2548 01:33:14,160 --> 01:33:17,800 TO THEM, MONITOR THEM, HAVE THEM 2549 01:33:17,800 --> 01:33:19,400 USE IT, A CHALLENGING 2550 01:33:19,400 --> 01:33:21,160 PERSPECTIVE FROM A REGULATION 2551 01:33:21,160 --> 01:33:21,920 AND INFRASTRUCTURE STANDPOINT 2552 01:33:21,920 --> 01:33:23,240 THAT I THINK THAT'S HARDER TO 2553 01:33:23,240 --> 01:33:26,400 ASSESS BUT I THINK THAT HAS TO 2554 01:33:26,400 --> 01:33:27,520 HAPPEN BECAUSE SIMILARLY I WANT 2555 01:33:27,520 --> 01:33:29,160 THE PATIENTS TO USE IT 2556 01:33:29,160 --> 01:33:30,880 ESPECIALLY AT NIGHT BEFORE THEY 2557 01:33:30,880 --> 01:33:32,880 BOW TO SLEEP EVEN THOSE 2558 01:33:32,880 --> 01:33:34,720 MEDITATION ONES BECAUSE MY 2559 01:33:34,720 --> 01:33:36,600 THOUGHT IS THOSE WERE HELPFUL 2560 01:33:36,600 --> 01:33:39,880 WITH SLEEP AND PAIN, MAYBE 2561 01:33:39,880 --> 01:33:40,960 CONFOUNDING MIGHT HELP IN 2562 01:33:40,960 --> 01:33:42,720 OUTCOMES BUT I DON'T THINK WE'RE 2563 01:33:42,720 --> 01:33:43,400 THERE FROM IMPLEMENTATION 2564 01:33:43,400 --> 01:33:45,400 STANDPOINT THAT LET US DO THAT. 2565 01:33:45,400 --> 01:33:47,200 THAT'S ONE OF THE PROBLEMS THAT 2566 01:33:47,200 --> 01:33:51,880 I HOPE GETS SOLVED IN THE NEXT 2567 01:33:51,880 --> 01:33:54,200 FOUR TO FIVE YEARS, DEVELOPING 2568 01:33:54,200 --> 01:33:55,080 HOSPITAL-BASED PROTOCOLS USING 2569 01:33:55,080 --> 01:34:00,280 VIRTUAL REALITY TO MAKE THIS 2570 01:34:00,280 --> 01:34:02,520 PART OF THE SYSTEM. 2571 01:34:02,520 --> 01:34:03,520 >>THERE'S A WILDER OLDER STUDY 2572 01:34:03,520 --> 01:34:07,120 WHERE THEY HAVE DONE THIS THING 2573 01:34:07,120 --> 01:34:08,440 TRYING TO REACTIVATE MEMORY 2574 01:34:08,440 --> 01:34:10,640 DURING SLEEP WHICH IS WILD, WITH 2575 01:34:10,640 --> 01:34:16,640 ODORS PRESENT AT THE TIME OF 2576 01:34:16,640 --> 01:34:17,080 LEARNING. 2577 01:34:17,080 --> 01:34:18,520 YOU CAN MAJOR PAIRING SOMETHING 2578 01:34:18,520 --> 01:34:21,360 WITH THE VR EXPERIENCE AND USE 2579 01:34:21,360 --> 01:34:23,400 THAT TO QUOTE/UNQUOTE TO REPLAY. 2580 01:34:23,400 --> 01:34:25,160 YOU'LL THINK I'VE LOST MY MIND. 2581 01:34:25,160 --> 01:34:30,080 I PROMISE YOU I HAVE NOT. 2582 01:34:30,080 --> 01:34:30,560 >>GREAT STORY. 2583 01:34:30,560 --> 01:34:35,320 >>THERE'S A BUNCH OF 2584 01:34:35,320 --> 01:34:36,280 NEUROMARKETING COMPANIES 2585 01:34:36,280 --> 01:34:37,080 CIRCLING AROUND INCUBATING 2586 01:34:37,080 --> 01:34:37,320 DREAMS. 2587 01:34:37,320 --> 01:34:39,280 IT'S A TECHNIQUE PEOPLE ARE 2588 01:34:39,280 --> 01:34:42,280 TRYING TO PAIR TOGETHER. 2589 01:34:42,280 --> 01:34:42,760 >>EXACTLY. 2590 01:34:42,760 --> 01:34:44,520 I DON'T KNOW IF WALTER WANTS TO 2591 01:34:44,520 --> 01:34:46,640 ASK HIM QUESTION OR MAYBE I CAN 2592 01:34:46,640 --> 01:34:47,400 INSERT IT. 2593 01:34:47,400 --> 01:34:50,680 HE WANTS TO KNOW ABOUT POTENTIAL 2594 01:34:50,680 --> 01:34:53,840 MISUSE OF VR, ARE THERE 2595 01:34:53,840 --> 01:35:00,000 CONCERNS, HOW WOULD YOU CLASSIFY 2596 01:35:00,000 --> 01:35:00,200 THEM? 2597 01:35:00,200 --> 01:35:03,200 >>INTERESTING QUESTION. 2598 01:35:03,200 --> 01:35:06,080 SOMEBODY IS PUTTING ON A 2599 01:35:06,080 --> 01:35:10,280 HEADSET, TRYING IT, BUT THAT'S 2600 01:35:10,280 --> 01:35:11,360 THEIR INTRODUCTION TO THE 2601 01:35:11,360 --> 01:35:12,480 EXPERIENCE. 2602 01:35:12,480 --> 01:35:13,640 MAYBE ON THE MISUSE SIDE THEY 2603 01:35:13,640 --> 01:35:14,960 DON'T KNOW WHAT THEY ARE GETTING 2604 01:35:14,960 --> 01:35:17,280 INTO UNTIL THEY ARE DOING IT 2605 01:35:17,280 --> 01:35:17,760 BASICALLY. 2606 01:35:17,760 --> 01:35:20,120 SO I THINK THAT COMES DOWN TO 2607 01:35:20,120 --> 01:35:20,760 EQUAL INFORMED CONSENT APPROACH 2608 01:35:20,760 --> 01:35:23,080 WHERE DO YOU YOUR BEST TO TELL 2609 01:35:23,080 --> 01:35:26,120 THE PATIENT WHAT TO EXPECT FROM 2610 01:35:26,120 --> 01:35:29,840 THE EXPERIENCE AND THEY CAN STOP 2611 01:35:29,840 --> 01:35:32,680 AT ANY TIME BUT THAT COMES INTO 2612 01:35:32,680 --> 01:35:33,960 THEN BEING AS DESCRIPTIVE AS YOU 2613 01:35:33,960 --> 01:35:36,000 CAN WITH WHAT THEY ARE GOING TO 2614 01:35:36,000 --> 01:35:39,840 BE GOING THROUGH AND, AGAIN, 2615 01:35:39,840 --> 01:35:42,240 MOST OF THESE -- IT'S HARD TO 2616 01:35:42,240 --> 01:35:43,080 CLASSIFY HOW PATIENTS WILL 2617 01:35:43,080 --> 01:35:44,400 INTERACT WITH WHAT THEY ARE 2618 01:35:44,400 --> 01:35:47,120 GOING THROUGH, YOU MAY THINK 2619 01:35:47,120 --> 01:35:47,920 SOMETHING IS PRETTY STANDARD, 2620 01:35:47,920 --> 01:35:48,960 ANGRY BIRDS GAME, THIS IS GOING 2621 01:35:48,960 --> 01:35:50,960 TO BE FINE FOR MOST PEOPLE, BUT 2622 01:35:50,960 --> 01:35:52,480 YOU NEVER KNOW, THERE CAN BE 2623 01:35:52,480 --> 01:35:54,040 SOMEONE WHO THAT TRIGGERS 2624 01:35:54,040 --> 01:35:56,720 SOMETHING AND THAT BECOMES AN 2625 01:35:56,720 --> 01:35:57,880 UNFORTUNATE OCCURRENCE AND SO AS 2626 01:35:57,880 --> 01:36:00,160 OF RIGHT NOW THE BEST I THOUGHT 2627 01:36:00,160 --> 01:36:03,800 ABOUT OF IT HOW TO BE AS 2628 01:36:03,800 --> 01:36:08,600 DETAILED AS POSSIBLE, SHOW 2629 01:36:08,600 --> 01:36:10,040 PICTURES TO ACCLIMATE THEM BUT 2630 01:36:10,040 --> 01:36:11,680 THAT'S A CHALLENGE, THEY WON'T 2631 01:36:11,680 --> 01:36:12,440 KNOW WHAT IT'S LIKE UNTIL THEY 2632 01:36:12,440 --> 01:36:13,640 ARE IN THERE. 2633 01:36:13,640 --> 01:36:19,760 YOU CAN ONLY DESCRIBE IT SO 2634 01:36:19,760 --> 01:36:19,960 WELL. 2635 01:36:19,960 --> 01:36:21,960 >>THANK YOU. 2636 01:36:21,960 --> 01:36:22,160 KAREN? 2637 01:36:22,160 --> 01:36:25,000 >>THANKS FOR THAT GREAT 2638 01:36:25,000 --> 01:36:25,920 PRESENTATION. 2639 01:36:25,920 --> 01:36:27,000 GREAT TO SEE EVERYBODY. 2640 01:36:27,000 --> 01:36:32,040 EVEN IF WE COULDN'T MEET IN 2641 01:36:32,040 --> 01:36:32,720 PERSON. 2642 01:36:32,720 --> 01:36:34,160 DR. PANDRANGI, I'M CURIOUS WHAT 2643 01:36:34,160 --> 01:36:36,560 YOUR CONSIDERATIONS WERE IN 2644 01:36:36,560 --> 01:36:38,520 PICKING THAT PARTICULAR DEVICE, 2645 01:36:38,520 --> 01:36:39,800 PICKING THOSE GAMES, AND I'M 2646 01:36:39,800 --> 01:36:40,800 SORRY IF YOU MENTIONED IT BUT 2647 01:36:40,800 --> 01:36:43,080 THE REASON I BRING IT UP IS IT 2648 01:36:43,080 --> 01:36:45,720 SEEMS THOSE WHO WORK IN LOOKING 2649 01:36:45,720 --> 01:36:48,120 AT THERAPEUTIC APPLICATIONS FOR 2650 01:36:48,120 --> 01:36:50,240 GAMING ARE REALLY FINDING IT 2651 01:36:50,240 --> 01:36:51,280 DIFFICULT TO DRAW COMPARISONS IN 2652 01:36:51,280 --> 01:36:53,680 THE FIELD BECAUSE THE GAMES ARE 2653 01:36:53,680 --> 01:36:54,560 SO DIFFERENT. 2654 01:36:54,560 --> 01:36:59,320 ALSO RELATED TO TECHNOLOGY 2655 01:36:59,320 --> 01:37:00,600 ITSELF, OFTEN CONSIDERATIONS ARE 2656 01:37:00,600 --> 01:37:03,440 LESS SCIENTIFIC AND MORE AROUND 2657 01:37:03,440 --> 01:37:06,160 CONVENIENCE, THAT DOESN'T MEAN 2658 01:37:06,160 --> 01:37:08,280 IT'S UNETHICAL, SOMETIMES IT 2659 01:37:08,280 --> 01:37:09,760 LEADS TO GREATER ACCESSIBILITY, 2660 01:37:09,760 --> 01:37:11,360 CURIOUS IF YOU COULD SHARE MORE 2661 01:37:11,360 --> 01:37:12,000 ABOUT THE DECISION-MAKING 2662 01:37:12,000 --> 01:37:12,200 PROCESS. 2663 01:37:12,200 --> 01:37:15,400 >>YEAH, AT THE TIME OF DOING 2664 01:37:15,400 --> 01:37:18,120 THE STUDY THE MAINSTREAM 2665 01:37:18,120 --> 01:37:20,840 HEADSET, CONSUMER HEADSET WAS 2666 01:37:20,840 --> 01:37:21,200 OCULUS QUEST. 2667 01:37:21,200 --> 01:37:23,920 OUR GOAL WAS TO USE SOMETHING 2668 01:37:23,920 --> 01:37:25,800 CONSUMER FACING, EASIER TO USE 2669 01:37:25,800 --> 01:37:27,080 THEORETICALLY THAN WHAT IS BEING 2670 01:37:27,080 --> 01:37:28,400 BROUGHT ABOUT FROM THE HEALTH 2671 01:37:28,400 --> 01:37:29,640 CARE SPACES, ALSO SOMETHING THAT 2672 01:37:29,640 --> 01:37:32,240 COULD BE COST EFFECTIVE IF WE'RE 2673 01:37:32,240 --> 01:37:34,320 THINKING HOW TO IMPLEMENT THIS 2674 01:37:34,320 --> 01:37:37,160 LIKE A MEDICATION, HEAD SETS IS 2675 01:37:37,160 --> 01:37:42,760 AROUND $400, IF YOU HAVE 2676 01:37:42,760 --> 01:37:46,680 SANITARY PROCESS, YOU BUY A GAME 2677 01:37:46,680 --> 01:37:48,440 TO REUSE FOR EVERY PATIENT, 2678 01:37:48,440 --> 01:37:49,440 UNLESS IT'S STANDARD OF PRACTICE 2679 01:37:49,440 --> 01:37:51,200 IN THE HOSPITAL, YOU DON'T NEED 2680 01:37:51,200 --> 01:37:53,680 A NEW HEADSET FOR EVERY TIME YOU 2681 01:37:53,680 --> 01:37:56,240 USE VR, YOU HAVE ONE, $500, THE 2682 01:37:56,240 --> 01:37:57,880 COST GOES AWAY PRETTY QUICKLY. 2683 01:37:57,880 --> 01:38:01,480 WE WANTED TO USE SOMETHING 2684 01:38:01,480 --> 01:38:02,520 CONSUMER FACING LIKE THAT AND 2685 01:38:02,520 --> 01:38:03,440 KNOWING THAT WOULD MAKE IT 2686 01:38:03,440 --> 01:38:05,880 EASIER TO TRAIN PATIENTS TO USE 2687 01:38:05,880 --> 01:38:07,600 VR BECAUSE IT'S EASIER FROM THAT 2688 01:38:07,600 --> 01:38:07,920 STANDPOINT. 2689 01:38:07,920 --> 01:38:11,480 IN TERMS OF THE ACTUAL 2690 01:38:11,480 --> 01:38:12,960 INTERVENTIONS, IT TOOK A LOT OF 2691 01:38:12,960 --> 01:38:15,400 RESEARCH AND ESSENTIALLY CAME 2692 01:38:15,400 --> 01:38:19,200 DOWN TO ME REALIZING THERE'S SO 2693 01:38:19,200 --> 01:38:20,520 LITTLE COMPARATIVE EXPERIENCES 2694 01:38:20,520 --> 01:38:22,880 IN WHAT'S OFFERED IN VR SPACES 2695 01:38:22,880 --> 01:38:23,760 VERSUS 2D SPACES. 2696 01:38:23,760 --> 01:38:27,800 WE WANTED TO USE A GAME BECAUSE 2697 01:38:27,800 --> 01:38:29,240 I WANTED SOMETHING MORE 2698 01:38:29,240 --> 01:38:30,080 DISTRACTING, SOME OTHER STUDIES 2699 01:38:30,080 --> 01:38:32,160 SAID IF YOU'RE DOING GAMING IT'S 2700 01:38:32,160 --> 01:38:33,400 GOING TO GETTINGS MORE BUT HOW 2701 01:38:33,400 --> 01:38:36,000 DO YOU FIND SOMETHING THAT'S 2702 01:38:36,000 --> 01:38:37,440 COMPARABLE AND FROM MY EARLIER 2703 01:38:37,440 --> 01:38:38,640 RESEARCH I COULDN'T FIND 2704 01:38:38,640 --> 01:38:40,080 ANYTHING IN THE LITERATURE THAT 2705 01:38:40,080 --> 01:38:42,760 HAD TRIED -- BEEN ABLE TO DO 2706 01:38:42,760 --> 01:38:44,840 BECAUSE THERE ISN'T THAT 2707 01:38:44,840 --> 01:38:45,160 COMPARISON. 2708 01:38:45,160 --> 01:38:47,160 I JUST THINK IT'S MORE LUCK AND 2709 01:38:47,160 --> 01:38:49,160 CHANCE THAT REALLY ONE OF THE 2710 01:38:49,160 --> 01:38:50,560 GAMES SO POPULAR IS ANGRY BIRDS 2711 01:38:50,560 --> 01:38:53,080 AND BECAUSE OF THAT THEY HAD 2712 01:38:53,080 --> 01:38:55,600 CREATED A VIRTUAL REALITY GAME. 2713 01:38:55,600 --> 01:38:57,120 SO AT LEAST BEING ABLE TO DO 2714 01:38:57,120 --> 01:38:59,640 THAT BOTH THE GAMES ON THE PHONE 2715 01:38:59,640 --> 01:39:00,840 AND IN VIRTUAL REALITY IT'S 2716 01:39:00,840 --> 01:39:05,440 REALLY THE SAME ANIMATION, 2717 01:39:05,440 --> 01:39:07,400 SOUNDS, CRITICAL THINKING HOW 2718 01:39:07,400 --> 01:39:11,320 YOU PROGRESS THROUGH A GAME. 2719 01:39:11,320 --> 01:39:14,840 BASICALLY HELPS MINIMIZE FACTORS 2720 01:39:14,840 --> 01:39:17,240 BETWEEN VR AND THE PHONE, SOME 2721 01:39:17,240 --> 01:39:18,360 MORE DIFFERENCES COME TO NOW 2722 01:39:18,360 --> 01:39:21,400 YOU'RE IN A 3D WORLD VERSUS ON 2723 01:39:21,400 --> 01:39:22,600 YOUR SCREEN, USING CONTROLLERS 2724 01:39:22,600 --> 01:39:25,680 TO FLING THINGS IN THE VIRTUAL 2725 01:39:25,680 --> 01:39:28,840 SPACE SO IT BRINGS 2726 01:39:28,840 --> 01:39:32,680 PROPRIOCEPTION DIFFERENCES AND 2727 01:39:32,680 --> 01:39:34,080 THAT SPATIAL DIFFERENCES THAT 2728 01:39:34,080 --> 01:39:35,320 COME WITH VR AND HOPEFULLY MAKE 2729 01:39:35,320 --> 01:39:38,160 IT MORE SO IT'S LOOKING AT THE 2730 01:39:38,160 --> 01:39:39,360 IMPACT OF VR SPECIFICALLY THAN 2731 01:39:39,360 --> 01:39:43,720 JUST WHAT WE'RE DOING IN VR. 2732 01:39:43,720 --> 01:39:45,920 SO THAT'S CHALLENGING, STILL A 2733 01:39:45,920 --> 01:39:48,000 BIG CHALLENGE FOR LITERATURE, 2734 01:39:48,000 --> 01:39:48,760 AND CURRENT RESEARCH PRACTICES, 2735 01:39:48,760 --> 01:39:51,080 BUT MY THOUGHT IS NOW BASED ON 2736 01:39:51,080 --> 01:39:53,360 THIS STUDY AND SOME OF OUR OTHER 2737 01:39:53,360 --> 01:39:55,120 STUDIES THAT I'M MORE AND MORE 2738 01:39:55,120 --> 01:39:56,760 OF THE LEARNING THAT I DON'T 2739 01:39:56,760 --> 01:39:58,080 NECESSARILY THINK THAT IT 2740 01:39:58,080 --> 01:40:00,680 MATTERS WHAT PATIENTS DO IN VR. 2741 01:40:00,680 --> 01:40:03,760 I DON'T NECESSARILY THINK THE 2742 01:40:03,760 --> 01:40:04,400 EXACT EXPERIENCE CARRIES THAT 2743 01:40:04,400 --> 01:40:05,640 MUCH WEIGHT RATHER THAN JUST 2744 01:40:05,640 --> 01:40:07,240 BEING IN THAT SPACE AND DOING 2745 01:40:07,240 --> 01:40:10,080 SOMETHING THEY WANT TO DO IN VR. 2746 01:40:10,080 --> 01:40:14,280 SO OUR LAST STUDY WE UTILIZED 2747 01:40:14,280 --> 01:40:17,320 APPLIED VR, A COMPANY THAT HAS A 2748 01:40:17,320 --> 01:40:18,520 CATALOG OF EXPERIENCES PATIENTS 2749 01:40:18,520 --> 01:40:20,600 CAN DO FROM GAMES TO MEDITATION 2750 01:40:20,600 --> 01:40:22,680 TO SEEING DIFFERENT THINGS, AND 2751 01:40:22,680 --> 01:40:23,800 WE LET PATIENTS CHOOSE WHATEVER 2752 01:40:23,800 --> 01:40:26,280 THEY WANT AND I THINK THAT'S 2753 01:40:26,280 --> 01:40:27,920 WHERE THINGS ARE MOVING TOWARDS 2754 01:40:27,920 --> 01:40:29,040 BECAUSE I THINK IF THEY CHOOSE 2755 01:40:29,040 --> 01:40:31,000 IT THEY ARE GOING TO GET MORE 2756 01:40:31,000 --> 01:40:32,520 BENEFIT, IT WILL BE MORE 2757 01:40:32,520 --> 01:40:34,160 ENGAGING FOR THEM AND MAY NOT BE 2758 01:40:34,160 --> 01:40:35,800 THAT I NEED THEM TO DO A GAME TO 2759 01:40:35,800 --> 01:40:37,240 GET MORE PAIN CONTROL OR NEED 2760 01:40:37,240 --> 01:40:39,520 THEM TO DO MEDITATION BUT 2761 01:40:39,520 --> 01:40:43,880 PERHAPS THEIR OWN WISHES WILL 2762 01:40:43,880 --> 01:40:49,480 HELP WITH THAT PROCESS. 2763 01:40:49,480 --> 01:40:50,360 >>INTERESTING. 2764 01:40:50,360 --> 01:40:50,520 JIM? 2765 01:40:50,520 --> 01:40:51,240 THANK YOU. 2766 01:40:51,240 --> 01:40:53,320 I HAVE A LONGER QUESTION, THAT 2767 01:40:53,320 --> 01:40:56,600 HAS TO DO WITH PATIENT CONSENT, 2768 01:40:56,600 --> 01:41:00,000 SINCE THE 3D VIRTUAL REALITY IS 2769 01:41:00,000 --> 01:41:01,200 DIFFERENT FROM 2D, THE PATIENT 2770 01:41:01,200 --> 01:41:03,960 MUST HAVE BEEN TOLD DIFFERENCE 2771 01:41:03,960 --> 01:41:07,920 THINGS, I WONTEDDER IF THEY WERE 2772 01:41:07,920 --> 01:41:10,400 TOLD ABOUT EXPECTATION, VIRTUAL 2773 01:41:10,400 --> 01:41:12,040 REALITY IS NOVEL, PROBABLY 2D 2774 01:41:12,040 --> 01:41:13,040 GAMING EXPERIENCE MANY HAD 2775 01:41:13,040 --> 01:41:17,880 PROBABLY ALREADY EXPERIENCED, SO 2776 01:41:17,880 --> 01:41:18,520 THINKING ABOUT THE THERAPEUTIC 2777 01:41:18,520 --> 01:41:20,840 BENEFIT IS IT RELATED TO ASPECTS 2778 01:41:20,840 --> 01:41:22,040 OF NOVELTY WHERE PATIENTS 2779 01:41:22,040 --> 01:41:23,120 EXPECT, AND IN PARTICULAR I'M 2780 01:41:23,120 --> 01:41:26,960 INTERESTED IN THIS FROM THE 2781 01:41:26,960 --> 01:41:30,680 LONGER TERM OPIATE EFFECT, WHAT 2782 01:41:30,680 --> 01:41:32,000 PATHWAY MIGHT BE IMPACTED BY 2783 01:41:32,000 --> 01:41:34,560 THIS DISTINCTION THAT WOULD 2784 01:41:34,560 --> 01:41:39,240 ALLOW FOR LONG-TERM EFFECT ON 2785 01:41:39,240 --> 01:41:39,560 OPIATE USE? 2786 01:41:39,560 --> 01:41:40,920 >>GOOD POINT, RAISES SEVERAL 2787 01:41:40,920 --> 01:41:42,400 IMPORTANT CONSIDERATIONS, ONE IS 2788 01:41:42,400 --> 01:41:44,280 THE FACT THIS IS HARD TO BLIND 2789 01:41:44,280 --> 01:41:45,080 PATIENTS TOWARDS WHAT THE 2790 01:41:45,080 --> 01:41:46,240 INTERVENTION IS BECAUSE THEY ARE 2791 01:41:46,240 --> 01:41:47,880 GOING TO KNOW IF THEY ARE DOING 2792 01:41:47,880 --> 01:41:50,480 VIRTUAL REALITY OR NOT. 2793 01:41:50,480 --> 01:41:55,640 YOU CAN'T DO A SHAM. 2794 01:41:55,640 --> 01:41:57,720 BUT MOST PATIENTS SURPRISINGLY 2795 01:41:57,720 --> 01:41:59,280 GIVEN OUR POPULATION, MOSTLY 2796 01:41:59,280 --> 01:42:00,680 CANCER PATIENTS, A LOT ARE 2797 01:42:00,680 --> 01:42:03,200 OLDER, A LOT OF THEM DON'T HAVE 2798 01:42:03,200 --> 01:42:06,800 THAT MUCH GAMING EXPERIENCE. 2799 01:42:06,800 --> 01:42:09,920 I DIDN'T FIND A BIG DIFFERENCE, 2800 01:42:09,920 --> 01:42:11,320 STILL EXPLAINING THE SAME 2801 01:42:11,320 --> 01:42:12,960 MECHANICS TO BOTH, BUT 2802 01:42:12,960 --> 01:42:15,080 ESSENTIALLY I HAD TO LEAVE IT, 2803 01:42:15,080 --> 01:42:17,440 WE'RE DOING DIFFERENT 2804 01:42:17,440 --> 01:42:18,240 AUDIO/VISUAL EXPERIENCES, 2805 01:42:18,240 --> 01:42:20,200 RANDOMIZED TO THIS GROUP, I 2806 01:42:20,200 --> 01:42:22,440 TRIED TO EXPLAIN VR SHOWING 2807 01:42:22,440 --> 01:42:29,480 PICTURES OF THE HEADSET BUT IT'S 2808 01:42:29,480 --> 01:42:30,080 CHALLENGING BECAUSE IT'S 2809 01:42:30,080 --> 01:42:31,680 DIFFERENT IF SOMEONE HAS NOT 2810 01:42:31,680 --> 01:42:32,920 USED VR BEFORE. 2811 01:42:32,920 --> 01:42:36,280 THE NOVELTY WAS AN IMPORTANT 2812 01:42:36,280 --> 01:42:37,040 CONSIDERATION BECAUSE, AGAIN, 2813 01:42:37,040 --> 01:42:38,920 MOST HADN'T USED IT BEFORE BUT 2814 01:42:38,920 --> 01:42:40,360 IN SOME FOLLOW-UP STUDIES 2815 01:42:40,360 --> 01:42:41,960 REPEATING USE OF VIRTUAL REALITY 2816 01:42:41,960 --> 01:42:43,280 I THINK WE'VE DONE WELL TO 2817 01:42:43,280 --> 01:42:46,800 ADDRESS THAT AND I DON'T THINK 2818 01:42:46,800 --> 01:42:47,560 THE NOVELTY CARRIES AS MUCH 2819 01:42:47,560 --> 01:42:48,800 WEIGHT AS I THOUGHT BECAUSE I 2820 01:42:48,800 --> 01:42:50,280 STILL THINK FOR A LOT OF THESE 2821 01:42:50,280 --> 01:42:51,920 PATIENTS EVEN THOUGH IT MAY BE 2822 01:42:51,920 --> 01:42:53,560 NOVEL IT'S NOT AN EASY 2823 01:42:53,560 --> 01:42:56,920 INTERVENTION BY ANY MEANS. 2824 01:42:56,920 --> 01:43:01,520 IT'S CUMBERSOME TO PUT ON THE 2825 01:43:01,520 --> 01:43:02,520 HEAD SET, USE CONTROLLERS, EVEN 2826 01:43:02,520 --> 01:43:04,600 THOUGH IT'S A NOVEL EXPERIENCE I 2827 01:43:04,600 --> 01:43:06,560 THINK IT'S HARDER TO USE AND USE 2828 01:43:06,560 --> 01:43:08,760 WELL THAN A SIMPLE HANDHELD GAME 2829 01:43:08,760 --> 01:43:10,520 AND I THINK WHEN I STARTED 2830 01:43:10,520 --> 01:43:11,600 WATCHING PATIENTS DO THAT SOME 2831 01:43:11,600 --> 01:43:13,240 OF THAT STRUGGLE AND LEARNING 2832 01:43:13,240 --> 01:43:14,280 CURVE I WOULD HAVE THOUGHT MAY 2833 01:43:14,280 --> 01:43:16,960 HAVE DONE SOME OF THE OPPOSITE, 2834 01:43:16,960 --> 01:43:18,480 YOU HAVE TO LEARN HOW TO USE A 2835 01:43:18,480 --> 01:43:19,800 NEW THING THEY ARE NOT USED TO 2836 01:43:19,800 --> 01:43:21,560 RATHER THAN JUST BEING ABLE TO 2837 01:43:21,560 --> 01:43:23,600 SAY, WOW, I'M IN THIS 3D WORLD. 2838 01:43:23,600 --> 01:43:26,040 SO I THINK IT SOMETIMES CAN WORK 2839 01:43:26,040 --> 01:43:28,640 AGAINST VR WITH THAT LEARNING 2840 01:43:28,640 --> 01:43:30,520 CURVE AND HOW CUMBERSOME IT IS. 2841 01:43:30,520 --> 01:43:33,080 IN TERMS OF WHERE I THINK THE 2842 01:43:33,080 --> 01:43:34,280 OPIOID PATH COMES FROM, I THINK 2843 01:43:34,280 --> 01:43:35,680 IT'S INTERESTING BECAUSE I THINK 2844 01:43:35,680 --> 01:43:37,960 THAT MORE AND MORE WE'RE 2845 01:43:37,960 --> 01:43:40,320 LEARNING HOW TO SEPARATE 2846 01:43:40,320 --> 01:43:43,200 SUBJECTIVE PAIN AND FEELING OF 2847 01:43:43,200 --> 01:43:45,760 PAIN FROM ACTUAL USING OPIATE 2848 01:43:45,760 --> 01:43:49,240 MEDICATIONS, WHETHER THAT 2849 01:43:49,240 --> 01:43:50,880 SUBJECTIVE FEELING OF PAIN IS 2850 01:43:50,880 --> 01:43:53,200 TRULY PAIN DERIVED THAT YOU NEED 2851 01:43:53,200 --> 01:43:58,880 MEDICATION TO TREAT OR IS IT 2852 01:43:58,880 --> 01:44:00,000 ACCUMULATION OF BOREDOM, 2853 01:44:00,000 --> 01:44:03,480 ANXIETY, AS YOU'RE RECOVERING 2854 01:44:03,480 --> 01:44:05,760 FROM A SIGNIFICANT SURGERY, AND 2855 01:44:05,760 --> 01:44:07,000 SO MOVING -- I'M STARTING TO GET 2856 01:44:07,000 --> 01:44:09,640 THE SENSE OF MOVING AWAY FROM 2857 01:44:09,640 --> 01:44:11,040 THESE SUBJECTIVE PAIN SCALES 2858 01:44:11,040 --> 01:44:13,560 THAT MAY NOT REALLY BE OBJECTIVE 2859 01:44:13,560 --> 01:44:16,720 MEASURES OF PAIN WHEREAS OPIOID 2860 01:44:16,720 --> 01:44:18,840 USE MAY BE OBJECTIVE BECAUSE 2861 01:44:18,840 --> 01:44:22,320 SOMEONE'S TREATING PAIN WITH 2862 01:44:22,320 --> 01:44:23,520 MEDICATION RATHER THAN SOMEONE 2863 01:44:23,520 --> 01:44:25,200 SAYING 7 OUT OF 10 ON A PAIN 2864 01:44:25,200 --> 01:44:26,400 SCALE, WHAT ELSE ARE THEY 2865 01:44:26,400 --> 01:44:29,120 FEELING IN TERMS OF ANXIETY AND 2866 01:44:29,120 --> 01:44:32,720 STRESS AND I'M STARTING TO SEE 2867 01:44:32,720 --> 01:44:33,680 MORE OF THAT PSYCHOSOCIAL STUFF 2868 01:44:33,680 --> 01:44:36,320 PLAY A ROLE, THAT'S WHERE I'M 2869 01:44:36,320 --> 01:44:38,600 ALSO INTERESTED SEEING HOW WE 2870 01:44:38,600 --> 01:44:39,720 CAN WORK TOWARDS SEPARATING THAT 2871 01:44:39,720 --> 01:44:41,120 WITH ACTUAL PHYSICAL PAIN AND 2872 01:44:41,120 --> 01:44:45,080 NEED FOR PAIN MEDICATION TO 2873 01:44:45,080 --> 01:44:46,960 TREAT THAT PAIN AFTER SURGERY. 2874 01:44:46,960 --> 01:44:48,120 >>WE ARE GOING TO TAKE BREAK 2875 01:44:48,120 --> 01:44:51,280 BUT I'D LIKE TO ASK YOU ONE LAST 2876 01:44:51,280 --> 01:44:53,920 QUESTION BEFORE WE DO, DR. 2877 01:44:53,920 --> 01:44:54,160 PANDRANGI. 2878 01:44:54,160 --> 01:44:56,760 IN YOUR EXPERIENCE WHAT ARE THE 2879 01:44:56,760 --> 01:44:58,960 ETHICAL QUESTIONS OR CHALLENGES 2880 01:44:58,960 --> 01:45:03,240 THAT HAVE BEEN SORT OF FACING 2881 01:45:03,240 --> 01:45:05,520 YOU IN THESE EXPERIMENTS? 2882 01:45:05,520 --> 01:45:06,960 ANYTHING THAT STANDS OUT? 2883 01:45:06,960 --> 01:45:09,400 >>YEAH, THERE ARE A FEW. 2884 01:45:09,400 --> 01:45:10,800 I THINK ONE IS CHALLENGING, 2885 01:45:10,800 --> 01:45:12,960 AGAIN FROM MY PERSPECTIVE IN 2886 01:45:12,960 --> 01:45:15,280 HEAD AND NECK SURGERY, PATIENT 2887 01:45:15,280 --> 01:45:17,000 INCLUSION AND EXCLUSION. 2888 01:45:17,000 --> 01:45:18,120 IT'S TOUGH BECAUSE IF WE'RE 2889 01:45:18,120 --> 01:45:20,000 STARTING TO SEE ALL THIS BENEFIT 2890 01:45:20,000 --> 01:45:22,120 FROM THIS TECHNOLOGY, START 2891 01:45:22,120 --> 01:45:23,160 SAYING, WOW, THIS CAN HELP 2892 01:45:23,160 --> 01:45:24,360 PATIENTS IN SOME WAY, HOW MANY 2893 01:45:24,360 --> 01:45:29,520 PATIENTS HAVE I HAD TO EXCLUDE 2894 01:45:29,520 --> 01:45:30,800 SIMPLY BECAUSE WE DIDN'T FEEL 2895 01:45:30,800 --> 01:45:33,280 SAFE USING THIS TECHNOLOGY IN 2896 01:45:33,280 --> 01:45:33,800 POSTOPERATIVE CARE. 2897 01:45:33,800 --> 01:45:35,600 A LOT OF PATIENTS HAVE WOUND 2898 01:45:35,600 --> 01:45:38,040 INCISIONS ON THE HEADS, 2899 01:45:38,040 --> 01:45:38,880 THEORETICAL RISK THAT WE DON'T 2900 01:45:38,880 --> 01:45:41,440 WANT THE PRESSURE OF THE HEADSET 2901 01:45:41,440 --> 01:45:43,720 ON THOSE INCISIONS IN THE OFF 2902 01:45:43,720 --> 01:45:44,840 CHANCE IT CAUSES WOUND 2903 01:45:44,840 --> 01:45:46,680 BREAKDOWN, THAT WOULD BE ITS OWN 2904 01:45:46,680 --> 01:45:49,000 THING BUT THERE'S NO DATA THAT I 2905 01:45:49,000 --> 01:45:54,680 CAN FIND THAT HELPS US GAUGE HOW 2906 01:45:54,680 --> 01:45:59,040 MUCH PRESSURE, HOW LIGHT THE 2907 01:45:59,040 --> 01:46:01,000 HEADSET IF WE'RE RAMPING UP USE, 2908 01:46:01,000 --> 01:46:04,320 NEEDS TO BE ADDRESSED, AND OTHER 2909 01:46:04,320 --> 01:46:06,040 TYPE OF HEAD SETS, HOW MUCH 2910 01:46:06,040 --> 01:46:07,600 PRESSURE IS APPLIED ON FACE, 2911 01:46:07,600 --> 01:46:08,880 NASAL BRIDGE, ALL THE PLACES 2912 01:46:08,880 --> 01:46:10,200 WE'RE OPERATING ON BECAUSE WE'RE 2913 01:46:10,200 --> 01:46:13,200 EXCLUDING A FAIR AMOUNT OF OUR 2914 01:46:13,200 --> 01:46:16,040 PATIENTS SIMPLY BECAUSE OF WHERE 2915 01:46:16,040 --> 01:46:17,760 THE SURGERY WAS, ONE FRUSTRATING 2916 01:46:17,760 --> 01:46:18,280 CHALLENGE. 2917 01:46:18,280 --> 01:46:24,520 THE OTHER PART OF IT, WE'VE BEEN 2918 01:46:24,520 --> 01:46:25,880 USING CONSUMER TECHNOLOGY, EVEN 2919 01:46:25,880 --> 01:46:28,080 WITH HEALTH CARE RELATED 2920 01:46:28,080 --> 01:46:30,040 TECHNOLOGY, IT'S GEARED TO 2921 01:46:30,040 --> 01:46:32,880 PEOPLE ENGLISH SPEAKING, SO THE 2922 01:46:32,880 --> 01:46:36,520 PATIENTS WE HAVE EXCLUDE A 2923 01:46:36,520 --> 01:46:37,160 SIGNIFICANT SPANISH-SPEAKING 2924 01:46:37,160 --> 01:46:38,800 POPULATIONS, CAN'T USE THE 2925 01:46:38,800 --> 01:46:39,480 TECHNOLOGIES EITHER, THOSE ARE 2926 01:46:39,480 --> 01:46:41,760 BEEN TWO OF THE MAIN THINGS THAT 2927 01:46:41,760 --> 01:46:52,200 COME TO MIND WITH STUDIES. 2928 01:46:52,880 --> 01:46:53,680 THEORETICAL RISK OF SEIZURES, 2929 01:46:53,680 --> 01:46:57,360 BUT THE RISK IS LOW, YOU KNOW AS 2930 01:46:57,360 --> 01:46:59,240 PEOPLE ARE TRYING TO CREATE 2931 01:46:59,240 --> 01:47:02,520 VIRTUAL REALITY HEAD SETS OR 2932 01:47:02,520 --> 01:47:03,120 EXPERIENCES GEARED TO HEALTH 2933 01:47:03,120 --> 01:47:04,800 CARE, I THINK IT'S IMPORTANT TO 2934 01:47:04,800 --> 01:47:07,560 START LOOKING AT HOW YOU 2935 01:47:07,560 --> 01:47:09,320 MINIMIZE RISKS TO PATIENTS BASED 2936 01:47:09,320 --> 01:47:12,280 ON WHAT YOU'RE CREATING COULD 2937 01:47:12,280 --> 01:47:13,960 YOU COULD HAVE SOMETHING 2938 01:47:13,960 --> 01:47:16,120 STANDARDIZED A WIDER GROUP CAN 2939 01:47:16,120 --> 01:47:16,360 UTILIZE. 2940 01:47:16,360 --> 01:47:18,160 >>THANK YOU VERY MUCH. 2941 01:47:18,160 --> 01:47:21,400 WE'RE GOING TO TAKE A BREAK 2942 01:47:21,400 --> 01:47:22,760 UNTIL 2:00, RIGHT, NITA? 2943 01:47:22,760 --> 01:47:23,960 AND EVERYBODY PLEASE COME BACK, 2944 01:47:23,960 --> 01:47:26,080 RIGHT AT 2:00 SO WE CAN DIVE 2945 01:47:26,080 --> 01:47:28,120 INTO THE DISCUSSION. 2946 01:47:28,120 --> 01:47:30,320 THANK YOU SO MUCH FOR JOINING 2947 01:47:30,320 --> 01:47:36,080 US, DR. PANDRANGI. 2948 01:47:36,080 --> 01:47:37,520 >>MAYBE WE CAN START BY 2949 01:47:37,520 --> 01:47:43,000 ADDRESSING SOME OF THE QUESTIONS 2950 01:47:43,000 --> 01:47:44,200 THAT NITA THOUGHTFULLY SENT OUT 2951 01:47:44,200 --> 01:47:46,840 AHEAD OF TIME. 2952 01:47:46,840 --> 01:47:48,280 YOU KNOW, TALKING AMONGST 2953 01:47:48,280 --> 01:47:50,440 OURSELVES ABOUT WHAT ARE THE 2954 01:47:50,440 --> 01:47:53,600 ETHICAL QUESTIONS RAISED BY SOME 2955 01:47:53,600 --> 01:47:56,160 OF THESE TECHNOLOGIES, 2956 01:47:56,160 --> 01:47:57,120 HEALTH-RELATED TECHNOLOGIES THAT 2957 01:47:57,120 --> 01:47:58,640 AFFECT THE BRAIN? 2958 01:47:58,640 --> 01:48:00,720 THE TWO WE HEARD ABOUT ARE USED 2959 01:48:00,720 --> 01:48:03,360 FOR CLINICAL PURPOSES BUT WE CAN 2960 01:48:03,360 --> 01:48:05,320 IMAGINE CERTAINLY THE LATTER 2961 01:48:05,320 --> 01:48:08,920 ONE, MAYBE THE FORMER ONE MAYBE 2962 01:48:08,920 --> 01:48:11,800 SOME DAY, MAYBE FOR ANYONE 2963 01:48:11,800 --> 01:48:13,160 CLINICAL PURPOSE, WHAT ARE THE 2964 01:48:13,160 --> 01:48:14,720 ETHICAL CHALLENGES WE SHOULD BE 2965 01:48:14,720 --> 01:48:15,520 TALKING ABOUT, THINKING ABOUT, 2966 01:48:15,520 --> 01:48:16,360 WORRYING ABOUT? 2967 01:48:16,360 --> 01:48:20,200 DOES IT MATTER WHETHER THE 2968 01:48:20,200 --> 01:48:25,160 TECHNOLOGIES ARE DIRECT OR 2969 01:48:25,160 --> 01:48:25,520 INDIRECT? 2970 01:48:25,520 --> 01:48:28,200 AS WERE EXEMPLIFIED AND ARE 2971 01:48:28,200 --> 01:48:29,200 THERE ADDITIONAL CONSIDERATIONS 2972 01:48:29,200 --> 01:48:32,160 IF WE USE THESE TECHNOLOGIES IN 2973 01:48:32,160 --> 01:48:33,200 PEOPLE CONSIDERED VULNERABLE. 2974 01:48:33,200 --> 01:48:36,400 LET'S START WITH THAT AND THEN 2975 01:48:36,400 --> 01:48:41,320 WE'RE GOING TO SEGUE INTO 2976 01:48:41,320 --> 01:48:43,160 DISCUSSING WHAT IN PARTICULAR 2977 01:48:43,160 --> 01:48:45,720 NEWG SHOULD DO ON THESE 2978 01:48:45,720 --> 01:48:49,000 QUESTIONS. 2979 01:48:49,000 --> 01:48:51,360 2980 01:48:51,360 --> 01:48:53,480 AND, AGAIN, THANKS TO NITA FOR 2981 01:48:53,480 --> 01:48:54,280 THESE QUESTIONS. 2982 01:48:54,280 --> 01:49:00,480 WHAT'S THE APPROPRIATE 2983 01:49:00,480 --> 01:49:02,120 CONTRIBUTION OF NEWG, SCOPE, 2984 01:49:02,120 --> 01:49:04,520 LET'S START WITH FRAMING ETHICAL 2985 01:49:04,520 --> 01:49:04,840 QUESTIONS. 2986 01:49:04,840 --> 01:49:08,240 BOTH PRESENTATIONS WE HAD WERE 2987 01:49:08,240 --> 01:49:09,680 VERY INTERESTING AND VERY -- 2988 01:49:09,680 --> 01:49:10,400 RAISED REALLY INTERESTING 2989 01:49:10,400 --> 01:49:11,720 QUESTIONS ABOUT THE KINDS OF 2990 01:49:11,720 --> 01:49:13,680 EFFECTS THAT WE CAN HAVE ON THE 2991 01:49:13,680 --> 01:49:14,680 BRAIN RIGHT NOW. 2992 01:49:14,680 --> 01:49:16,440 SO, WHAT ARE THE ETHICAL 2993 01:49:16,440 --> 01:49:18,200 QUESTIONS THAT YOU ALL SEE IN 2994 01:49:18,200 --> 01:49:20,360 TERMS OF THESE, THE USE OF THESE 2995 01:49:20,360 --> 01:49:23,240 KINDS OF TECHNOLOGIES THAT WE 2996 01:49:23,240 --> 01:49:26,520 SHOULD BE TALKING ABOUT? 2997 01:49:26,520 --> 01:49:28,680 WINSTON? 2998 01:49:28,680 --> 01:49:30,360 2999 01:49:30,360 --> 01:49:33,320 CAN'T HEAR YOU, WINSTON. 3000 01:49:33,320 --> 01:49:39,320 3001 01:49:39,320 --> 01:49:40,520 3002 01:49:40,520 --> 01:49:42,640 NO. 3003 01:49:42,640 --> 01:49:45,040 3004 01:49:45,040 --> 01:49:47,120 WE HEAR A SQUIGGLE BUT IT'S NOT 3005 01:49:47,120 --> 01:49:49,640 YOUR VOICE. 3006 01:49:49,640 --> 01:49:53,120 3007 01:49:53,120 --> 01:49:55,120 >>TRY SELECTING YOUR AUDIO ON 3008 01:49:55,120 --> 01:49:56,200 ZOOM AND RECONNECTING. 3009 01:49:56,200 --> 01:49:57,920 IF THAT DOESN'T WORK YOU MIGHT 3010 01:49:57,920 --> 01:49:59,120 HAVE TO REJOIN. 3011 01:49:59,120 --> 01:50:01,400 LIKE CLOSE AND REJOIN THE 3012 01:50:01,400 --> 01:50:03,600 MEETING. 3013 01:50:03,600 --> 01:50:06,680 3014 01:50:06,680 --> 01:50:11,400 >>SOUNDS LIKE HELIUM IS IN THE 3015 01:50:11,400 --> 01:50:11,600 ROOM. 3016 01:50:11,600 --> 01:50:11,960 >>EXACTLY. 3017 01:50:11,960 --> 01:50:12,960 >>WHILE YOU'RE WORKING ON THAT 3018 01:50:12,960 --> 01:50:15,600 I'LL GO TO JIM AND COME BACK TO 3019 01:50:15,600 --> 01:50:17,960 YOU WHEN YOU'RE READY. 3020 01:50:17,960 --> 01:50:20,200 GO AHEAD, JIM. 3021 01:50:20,200 --> 01:50:21,520 >>THANKS. 3022 01:50:21,520 --> 01:50:22,960 BOTH WERE INTERESTING 3023 01:50:22,960 --> 01:50:23,800 PRESENTATIONS, HIGHLIGHTING ONE 3024 01:50:23,800 --> 01:50:25,120 DISTINCTION THAT'S I THINK 3025 01:50:25,120 --> 01:50:26,840 IMPORTANT FOR ME ANYWAYS. 3026 01:50:26,840 --> 01:50:29,920 AND IT'S NOT SO MUCH THE DIRECT 3027 01:50:29,920 --> 01:50:32,000 VERSUS INDIRECT BUT IT'S MORE 3028 01:50:32,000 --> 01:50:36,160 HOW EASILY REVERSIBLE SOMETHING 3029 01:50:36,160 --> 01:50:37,040 IS. 3030 01:50:37,040 --> 01:50:40,120 SO, WITH IMPLANTATION, OBVIOUSLY 3031 01:50:40,120 --> 01:50:41,200 THAT'S A DIRECT INTERVENTION 3032 01:50:41,200 --> 01:50:43,400 THAT REALLY CAN'T BE REVERSED. 3033 01:50:43,400 --> 01:50:47,000 YOU CAN TAKE AN ELECTRODE OUT, 3034 01:50:47,000 --> 01:50:50,160 TAKE STIMULATING ELECTRODE OUT, 3035 01:50:50,160 --> 01:50:52,480 BUT FOR THE VR BY VIRTUE OF HOW 3036 01:50:52,480 --> 01:50:54,040 IT WORKS, WE REALLY DON'T KNOW 3037 01:50:54,040 --> 01:50:59,360 HOW IT REALLY WORKS BUT IF 3038 01:50:59,360 --> 01:51:02,880 OPIATE EFFECT IS REMODULATING 3039 01:51:02,880 --> 01:51:05,160 NEURAL CONNECTIVITY, LONG-TERM 3040 01:51:05,160 --> 01:51:07,240 VR EFFECTS, ACUTE EFFECTS, BUT 3041 01:51:07,240 --> 01:51:11,720 BY VIRTUE OF CAUSING A CHANGE IN 3042 01:51:11,720 --> 01:51:12,320 ADULT NEURONAL RESPONSIVENESS, 3043 01:51:12,320 --> 01:51:15,440 THAT TELLS YOU IT HAS TO BE 3044 01:51:15,440 --> 01:51:17,120 REVERSIBLE, EVEN IF WE DON'T 3045 01:51:17,120 --> 01:51:18,960 KNOW HOW TO REVERSIBLE. 3046 01:51:18,960 --> 01:51:21,240 FOR ME A DISTINGUISHING FEATURE 3047 01:51:21,240 --> 01:51:23,040 IS HOW EASILY REVERSIBLE 3048 01:51:23,040 --> 01:51:27,040 SOMETHING IS, VERSUS NOT 3049 01:51:27,040 --> 01:51:27,360 REVERSIBLE. 3050 01:51:27,360 --> 01:51:29,480 >>THAT'S A REALLY IMPORTANT 3051 01:51:29,480 --> 01:51:30,000 POINT. 3052 01:51:30,000 --> 01:51:32,280 THERE'S ANOTHER QUESTION 3053 01:51:32,280 --> 01:51:35,160 ABOUT -- FOR BOTH MODALITIES, 3054 01:51:35,160 --> 01:51:35,920 THE MEASURED EFFECT WAS 3055 01:51:35,920 --> 01:51:37,040 RELATIVELY SHORT TERM BUT WE 3056 01:51:37,040 --> 01:51:40,000 DON'T KNOW THAT'S THE ONLY 3057 01:51:40,000 --> 01:51:50,520 EFFECT THAT THOSE ARE HAVING. 3058 01:51:52,200 --> 01:51:53,960 JOHN AND THEN WINSTON. 3059 01:51:53,960 --> 01:51:56,760 >>IF I COULD AMPLIFY IT 3060 01:51:56,760 --> 01:51:57,840 UNDERSCORES IMPORTANCE OF 3061 01:51:57,840 --> 01:51:58,720 UNDERSTANDING MECHANISM BECAUSE 3062 01:51:58,720 --> 01:52:00,040 WE DON'T -- WE'RE NOT GOING TO 3063 01:52:00,040 --> 01:52:02,680 HAVE A WAY OF UNDERSTANDING WHAT 3064 01:52:02,680 --> 01:52:04,280 THE LONG TERM CONSEQUENCES WILL 3065 01:52:04,280 --> 01:52:05,520 BE WHEN YOU'RE USING THERAPY, 3066 01:52:05,520 --> 01:52:07,360 WHAT HAPPENS WHEN YOU WITHDRAW, 3067 01:52:07,360 --> 01:52:08,880 IF WE DON'T UNDERSTAND THE 3068 01:52:08,880 --> 01:52:12,720 UNDERLYING MECHANISM AT ANY 3069 01:52:12,720 --> 01:52:13,400 LEVEL, MOLECULAR, CELLULAR, 3070 01:52:13,400 --> 01:52:14,480 SYSTEM CIRCUITS, WHAT HAVE YOU, 3071 01:52:14,480 --> 01:52:18,520 SOMETHING WE SHOULD KEEP TOP OF 3072 01:52:18,520 --> 01:52:18,720 MINE. 3073 01:52:18,720 --> 01:52:20,480 >>I AGREE. 3074 01:52:20,480 --> 01:52:22,800 IS DR. PANDRANGI STILL ON WITH 3075 01:52:22,800 --> 01:52:23,640 US? 3076 01:52:23,640 --> 01:52:25,160 I DON'T THINK SO. 3077 01:52:25,160 --> 01:52:27,400 >>NO, HE HAD TO LEAVE FOR THE 3078 01:52:27,400 --> 01:52:27,880 OPERATING ROOM. 3079 01:52:27,880 --> 01:52:28,360 >>OKAY. 3080 01:52:28,360 --> 01:52:31,560 I WAS GOING TO ASK IF THEY ARE 3081 01:52:31,560 --> 01:52:32,760 MEASURING ANYTHING BEYOND 3082 01:52:32,760 --> 01:52:34,040 SUBJECTIVE EFFECTS BUT DOESN'T 3083 01:52:34,040 --> 01:52:34,720 SOUND LIKE IT. 3084 01:52:34,720 --> 01:52:37,080 WINSTON, ARE YOU WITH US? 3085 01:52:37,080 --> 01:52:39,080 >>I DON'T KNOW, CAN YOU HEAR ME 3086 01:52:39,080 --> 01:52:39,280 NOW? 3087 01:52:39,280 --> 01:52:42,080 DO I SOUND LIKE MYSELF AGAIN? 3088 01:52:42,080 --> 01:52:44,160 >>YOU SOUND LIKE YOURSELF. 3089 01:52:44,160 --> 01:52:45,440 >>I WAS STRUGGLING WITH THE 3090 01:52:45,440 --> 01:52:46,720 SCOPE OF TECHNOLOGIES THAT 3091 01:52:46,720 --> 01:52:47,720 AFFECT THE BRAIN. 3092 01:52:47,720 --> 01:52:49,360 NITA SAID AT THE BEGINNING 3093 01:52:49,360 --> 01:52:50,360 EVERYTHING THAT AFFECTS BRAIN, 3094 01:52:50,360 --> 01:52:52,360 MAYBE NOT EVERYTHING, BUT MOST 3095 01:52:52,360 --> 01:52:54,520 OF THE THINGS THAT IMPACT THE 3096 01:52:54,520 --> 01:52:55,840 BRAIN BY DIFFERENT MECHANISMS, 3097 01:52:55,840 --> 01:52:58,800 THE TWO THINGS WE HEARD ABOUT 3098 01:52:58,800 --> 01:53:01,840 WERE QUITE DIFFERENT IN TERMS OF 3099 01:53:01,840 --> 01:53:02,720 HOW EFFECTS WERE DELIVERED AND 3100 01:53:02,720 --> 01:53:05,040 SO I GUESS I WAS STRUGGLING TO 3101 01:53:05,040 --> 01:53:06,560 GET MY ARMS AROUND WHAT IS THE 3102 01:53:06,560 --> 01:53:09,200 SCOPE OF THE QUESTION THAT'S 3103 01:53:09,200 --> 01:53:09,720 BEING ASKED HERE. 3104 01:53:09,720 --> 01:53:12,240 I THINK WE CAN TAKE THESE AS TWO 3105 01:53:12,240 --> 01:53:14,520 EXAMPLES BUT OUR ABILITY TO 3106 01:53:14,520 --> 01:53:15,520 GENERATE EXAMPLES DEPENDING ON 3107 01:53:15,520 --> 01:53:18,040 WHAT WE CONSIDER UNDER THE 3108 01:53:18,040 --> 01:53:19,320 HEADING OF TECHNOLOGY, WHAT 3109 01:53:19,320 --> 01:53:22,960 EFFECTS ON THE BRAIN WE THINK 3110 01:53:22,960 --> 01:53:23,760 WE'RE INTERESTED IN, JUST 3111 01:53:23,760 --> 01:53:25,160 BECAUSE, YOU KNOW, ANYWAY THE 3112 01:53:25,160 --> 01:53:28,440 BOUNDARIES OF BOTH OF THOSE SEEM 3113 01:53:28,440 --> 01:53:31,080 VERY BLURRY TO ME. 3114 01:53:31,080 --> 01:53:36,760 MAYBE ONE GOAL, I MIGHT HAVE FOR 3115 01:53:36,760 --> 01:53:38,840 MYSELF TO GET A BEAD ON BETTER 3116 01:53:38,840 --> 01:53:40,920 SET OF TECHNOLOGIES OR BRAIN 3117 01:53:40,920 --> 01:53:44,680 EFFECTS THAT WE'RE TRYING TO 3118 01:53:44,680 --> 01:53:47,400 FOCUS ON AND WHETHER THERE'S 3119 01:53:47,400 --> 01:53:48,920 SOME KIND OF INTERESTING 3120 01:53:48,920 --> 01:53:50,120 COMMONALITY TO THE ETHICAL 3121 01:53:50,120 --> 01:53:51,120 QUESTIONS THAT MAKES IT 3122 01:53:51,120 --> 01:53:53,840 WORTHWHILE FOR US TO CONSIDER 3123 01:53:53,840 --> 01:53:54,320 THEM TOGETHER. 3124 01:53:54,320 --> 01:53:58,480 >>WINSTON, I WANT TO RESPOND. 3125 01:53:58,480 --> 01:53:59,560 INTENTIONALLY THESE ARE EXTREMES 3126 01:53:59,560 --> 01:54:02,320 THAT WE WANTED TO BRING TO THE 3127 01:54:02,320 --> 01:54:02,880 CONVERSATION. 3128 01:54:02,880 --> 01:54:05,160 WHICH IS TO LOOK AT WHAT IS, YOU 3129 01:54:05,160 --> 01:54:07,080 KNOW, THROUGH A CONSUMER 3130 01:54:07,080 --> 01:54:08,760 HEADSET, A VERY DIFFERENT KIND 3131 01:54:08,760 --> 01:54:11,960 OF EFFECT ON THE BRAIN, 3132 01:54:11,960 --> 01:54:18,280 IMMERSIVE EFFECT, HAS A 3133 01:54:18,280 --> 01:54:19,040 HEALTH-BASED APPLICATION VERSUS 3134 01:54:19,040 --> 01:54:20,040 INTERVENTIONAL EFFECT, WHETHER 3135 01:54:20,040 --> 01:54:21,560 OR NOT ETHICAL ISSUES ARE 3136 01:54:21,560 --> 01:54:23,440 DIFFERENT, THE SAME, WITHIN A 3137 01:54:23,440 --> 01:54:26,600 SPECTRUM, BUT REALLY TO TRY TO 3138 01:54:26,600 --> 01:54:27,920 MAKE THAT SCOPE MODULATING THE 3139 01:54:27,920 --> 01:54:29,680 BRAIN AND HOW WE MIGHT THINK 3140 01:54:29,680 --> 01:54:31,760 ABOUT IT FROM NEWG, WE MIGHT 3141 01:54:31,760 --> 01:54:34,160 WANT TO NARROW THE SCOPE IF WE 3142 01:54:34,160 --> 01:54:35,680 THINK ETHICAL ISSUES ARE QUITE 3143 01:54:35,680 --> 01:54:38,000 DIFFERENT ACROSS THE SPECTRUM OR 3144 01:54:38,000 --> 01:54:39,960 MIGHT THINK IT'S REALLY, YOU 3145 01:54:39,960 --> 01:54:40,760 KNOW, TECHNOLOGIES THAT IMPACT 3146 01:54:40,760 --> 01:54:43,600 THE BRAIN FROM A HEALTH-RELATED 3147 01:54:43,600 --> 01:54:44,560 PERSPECTIVE AND THINKING ABOUT 3148 01:54:44,560 --> 01:54:46,840 THAT IN THAT WAY. 3149 01:54:46,840 --> 01:54:49,480 BUT IT WAS INTENTIONAL TO MAKE 3150 01:54:49,480 --> 01:54:52,000 THE SCOPE LARGE IN THE NATURE OF 3151 01:54:52,000 --> 01:54:52,960 THE INTERVENTION TO STIMULATE 3152 01:54:52,960 --> 01:54:55,400 OUR THINKING ON THIS TOPIC. 3153 01:54:55,400 --> 01:54:57,040 >>I GUESS I'M STIM STRUGGLING A 3154 01:54:57,040 --> 01:55:01,160 LITTLE BIT WITH LIKE HOW TO DRAW 3155 01:55:01,160 --> 01:55:03,480 BOUNDARIES AROUND -- A LOT OF 3156 01:55:03,480 --> 01:55:04,200 THINGS INVOLVE TECHNOLOGY, 3157 01:55:04,200 --> 01:55:09,480 AFFECT THE BRAIN, I'M NOT SURE 3158 01:55:09,480 --> 01:55:11,440 SO LIKE TELEPSYCHOTHERAPY 3159 01:55:11,440 --> 01:55:12,360 AFFECTS THE BRAIN, OR ONLINE 3160 01:55:12,360 --> 01:55:14,200 EDUCATION IS A TECHNOLOGY THAT 3161 01:55:14,200 --> 01:55:17,880 AFFECTS THE BRAIN, SO I GUESS 3162 01:55:17,880 --> 01:55:21,080 HOW TO, YOU KNOW, GET MY ARMS 3163 01:55:21,080 --> 01:55:23,280 AROUND WHAT WE THINK IS IN SCOPE 3164 01:55:23,280 --> 01:55:24,920 AND WHAT'S NOT IN SCOPE. 3165 01:55:24,920 --> 01:55:26,520 >>I THINK IT DEPENDS ON WHAT IT 3166 01:55:26,520 --> 01:55:29,520 IS WE WANT TO DO WITH IT, RIGHT? 3167 01:55:29,520 --> 01:55:31,920 SO IF WHAT WE WANT TO DO IS A 3168 01:55:31,920 --> 01:55:33,000 WORKSHOP TO EXPLORE ISSUES MORE 3169 01:55:33,000 --> 01:55:35,400 BROADLY AND THEN TO DECIDE WHAT 3170 01:55:35,400 --> 01:55:37,760 A PRODUCT MAY BE, A BROADER 3171 01:55:37,760 --> 01:55:39,360 CONVERSATION MAY MAKE SENSE TO 3172 01:55:39,360 --> 01:55:40,680 NARROW IN SCOPE. 3173 01:55:40,680 --> 01:55:43,080 IF WE THINK IT'S SPECIFIC WE'RE 3174 01:55:43,080 --> 01:55:44,200 READY TO DIVE INTO THINKING 3175 01:55:44,200 --> 01:55:48,920 ABOUT WORKING ON A WHITE PAPER 3176 01:55:48,920 --> 01:55:50,240 OR GUIDANCE, THINKING ABOUT 3177 01:55:50,240 --> 01:55:52,200 THESE ISSUES WITHIN THE CONTEXT 3178 01:55:52,200 --> 01:55:54,400 OF GIVEN THE BREADTH, THE 3179 01:55:54,400 --> 01:55:57,040 EFFECT, WHAT IS THE NEXT STEP 3180 01:55:57,040 --> 01:56:01,480 FOR NEWG WITH RESPECT TO 3181 01:56:01,480 --> 01:56:06,640 TARGETED GUIDANCE OR TARGETED -- 3182 01:56:06,640 --> 01:56:08,560 NOT GUIDANCE BUT TARGETED 3183 01:56:08,560 --> 01:56:10,160 CONTRIBUTIONS AND HOW MIGHT WE 3184 01:56:10,160 --> 01:56:11,160 DO THAT. 3185 01:56:11,160 --> 01:56:12,760 IT MAY BE WE NEED TO NARROW 3186 01:56:12,760 --> 01:56:16,960 THROUGH A WORK SHORTSTOP OR 3187 01:56:16,960 --> 01:56:17,480 ADDITIONAL CONVERSATIONS. 3188 01:56:17,480 --> 01:56:19,640 >>MAYBE I CAN ADD ONE THING 3189 01:56:19,640 --> 01:56:23,960 BEFORE I HAVE A WHOLE ARRAY OF 3190 01:56:23,960 --> 01:56:24,720 HANDS UP. 3191 01:56:24,720 --> 01:56:26,480 WE TALKED AT SOME POINT IN THE 3192 01:56:26,480 --> 01:56:28,320 PLANNING OF THIS DAY, WE TALKED 3193 01:56:28,320 --> 01:56:30,480 ABOUT THE QUESTION OF SHOULD 3194 01:56:30,480 --> 01:56:32,360 THERE BE I DON'T KNOW, LIMITS I 3195 01:56:32,360 --> 01:56:34,520 GUESS IS THE WORD I WOULD USE, 3196 01:56:34,520 --> 01:56:36,760 THAT'S PROBABLY NOT THE RIGHT 3197 01:56:36,760 --> 01:56:39,080 WORD, LIMITS ON INTERVENTIONS 3198 01:56:39,080 --> 01:56:41,440 THAT AFFECT THE BRAIN. 3199 01:56:41,440 --> 01:56:45,600 AND AS NITA POINTED OUT TO US 3200 01:56:45,600 --> 01:56:47,480 THEN, AND YOU SAID, WINSTON, THE 3201 01:56:47,480 --> 01:56:48,680 NUMBER OF THINGS THAT AFFECT THE 3202 01:56:48,680 --> 01:56:50,000 BRAIN IS HUGE. 3203 01:56:50,000 --> 01:56:52,040 SO THE QUESTION IS, IF THERE ARE 3204 01:56:52,040 --> 01:56:54,040 LIMITS ARE THERE LIMITS FOR 3205 01:56:54,040 --> 01:56:55,000 CERTAIN KINDS OF INTERVENTIONS 3206 01:56:55,000 --> 01:56:58,520 ONLY AND IF SO WHY? 3207 01:56:58,520 --> 01:57:01,480 AND/OR ARE THERE NO LIMITS? 3208 01:57:01,480 --> 01:57:05,640 HOW TO THINK ABOUT QUOTES -- 3209 01:57:05,640 --> 01:57:06,960 THOSE KINDS OF QUESTIONS DROVE 3210 01:57:06,960 --> 01:57:14,880 US TO THINK ABOUT TODAY AS 3211 01:57:14,880 --> 01:57:15,120 PLANNED. 3212 01:57:15,120 --> 01:57:15,760 SO, JIM? 3213 01:57:15,760 --> 01:57:16,520 >>THANKS. 3214 01:57:16,520 --> 01:57:18,040 ONE ORB COMMENT. 3215 01:57:18,040 --> 01:57:19,280 SORRY, KAREN, MAYBE I JUMPED 3216 01:57:19,280 --> 01:57:20,880 AHEAD OF YOU. 3217 01:57:20,880 --> 01:57:21,960 SORRY ABOUT THAT. 3218 01:57:21,960 --> 01:57:24,040 ONE OF THE THINGS STRIKING, 3219 01:57:24,040 --> 01:57:25,040 THERE'S REALLY NOTHING THESE 3220 01:57:25,040 --> 01:57:27,680 GUYS CAN DO ABOUT IT, BUT I 3221 01:57:27,680 --> 01:57:30,520 WORRY ABOUT GOING TOO FAR DOWN 3222 01:57:30,520 --> 01:57:31,640 THE ROAD OF ETHICAL 3223 01:57:31,640 --> 01:57:32,920 CONSIDERATIONS WHEN THE POWER OF 3224 01:57:32,920 --> 01:57:36,440 A STUDY IS SO LOW. 3225 01:57:36,440 --> 01:57:37,760 SO I WONDER ABOUT WHETHER OR NOT 3226 01:57:37,760 --> 01:57:39,880 IN THINKING ABOUT THESE TYPES OF 3227 01:57:39,880 --> 01:57:41,040 NEURAL INTERVENTIONS WHETHER OR 3228 01:57:41,040 --> 01:57:43,720 NOT THERE'S SOME GUIDANCE WE CAN 3229 01:57:43,720 --> 01:57:47,400 GIVE ABOUT POWER OF THE STUDIES, 3230 01:57:47,400 --> 01:57:48,280 OR GETTING DATA. 3231 01:57:48,280 --> 01:57:52,360 IN MY FIELD IT CAN TAKE TWO 3232 01:57:52,360 --> 01:57:55,160 YEARS TO GET A PAPER PUBLISHED. 3233 01:57:55,160 --> 01:57:57,040 I DON'T KNOW ABOUT THIS FIELD 3234 01:57:57,040 --> 01:57:59,440 BUT I WONDER IF THERE'S GUIDANCE 3235 01:57:59,440 --> 01:58:01,200 GETTING DATA OUT MORE RAPIDLY SO 3236 01:58:01,200 --> 01:58:02,640 MORE DECISIONS OR INSIGHT CAN BE 3237 01:58:02,640 --> 01:58:09,200 PROVIDED WITH RESPECT TO THESE 3238 01:58:09,200 --> 01:58:09,880 TYPES OF CONSIDERATIONS. 3239 01:58:09,880 --> 01:58:11,160 >>INTERESTING POINT. 3240 01:58:11,160 --> 01:58:13,120 I'M GOING FROM LEFT TO RIGHT, 3241 01:58:13,120 --> 01:58:16,640 MAYBE THAT'S NOT THE RIGHT WAY. 3242 01:58:16,640 --> 01:58:21,120 IF I'M DOING IT RIGHT, TED ABEL 3243 01:58:21,120 --> 01:58:25,520 IS NEXT. 3244 01:58:25,520 --> 01:58:27,120 YOU'RE ON MUTE, TED. 3245 01:58:27,120 --> 01:58:30,640 >>LET KAREN GO. 3246 01:58:30,640 --> 01:58:33,160 SHE WAS -- I WAS GOING TO ASK 3247 01:58:33,160 --> 01:58:34,480 BASICALLY THE SAME QUESTION THAT 3248 01:58:34,480 --> 01:58:38,400 JIM ASKED, SEEMS LIKE WITH THE 3249 01:58:38,400 --> 01:58:40,360 NEUROSURGICAL STUDIES YOU COULD 3250 01:58:40,360 --> 01:58:42,800 ALMOST NEVER HAVE THE N, AND I'M 3251 01:58:42,800 --> 01:58:45,320 ON A WORKING GROUP OF THE 3252 01:58:45,320 --> 01:58:46,640 NATIONAL ADVISORY MENTAL HEALTH 3253 01:58:46,640 --> 01:58:48,800 COUNCIL THAT'S THINKING ABOUT 3254 01:58:48,800 --> 01:58:51,280 HIGH DIMENSIONAL DATASETS, AND 3255 01:58:51,280 --> 01:58:53,200 HOW TO HANDLE THEM. 3256 01:58:53,200 --> 01:58:55,600 YOU KNOW, WE'RE REMINISCING ON 3257 01:58:55,600 --> 01:59:01,760 Ns OF SIX SCIENCE PAPERS OF 3258 01:59:01,760 --> 01:59:02,480 GENETIC IMAGING STUDIES, YOU 3259 01:59:02,480 --> 01:59:03,960 KNOW, WHATEVER. 3260 01:59:03,960 --> 01:59:05,280 IT'S REALLY A CONCERN. 3261 01:59:05,280 --> 01:59:07,840 SO I REALLY WANT TO UNDERSCORE 3262 01:59:07,840 --> 01:59:10,080 THAT, WHAT JIM JUST SAID. 3263 01:59:10,080 --> 01:59:11,720 I THINK THE MECHANISM MIGHT HELP 3264 01:59:11,720 --> 01:59:13,040 YOU IF YOU HAVE A SENSE OF IT 3265 01:59:13,040 --> 01:59:14,640 BUT ONE OF THE THINGS YOU 3266 01:59:14,640 --> 01:59:16,760 OBVIOUSLY REALLY HAVE TO BE 3267 01:59:16,760 --> 01:59:18,480 CONCERNED ABOUT IS SELECTION 3268 01:59:18,480 --> 01:59:20,520 BIAS, IN TERMS OF THE PATIENTS, 3269 01:59:20,520 --> 01:59:22,560 NOT JUST WILLING TO DO THIS BUT 3270 01:59:22,560 --> 01:59:24,720 AT THAT LEVEL OF BEING -- 3271 01:59:24,720 --> 01:59:26,520 NEEDING THE NEUROSURGERY AND 3272 01:59:26,520 --> 01:59:28,560 BEING DEPRESSED, SEEMS LIKE IT'S 3273 01:59:28,560 --> 01:59:30,400 HARD TO GENERALIZE SO I THINK 3274 01:59:30,400 --> 01:59:31,760 IT'S VERY CHALLENGING. 3275 01:59:31,760 --> 01:59:33,360 THE OTHER POINT I WANT TO MAKE, 3276 01:59:33,360 --> 01:59:37,880 QUESTION I WANT TO ASK, THERE 3277 01:59:37,880 --> 01:59:39,760 WAS THIS -- THERE IS THE 3278 01:59:39,760 --> 01:59:43,480 THINKING ABOUT THE BLACK BOX 3279 01:59:43,480 --> 01:59:45,920 WARNING ON ANTIDEPRESSANTS, AND 3280 01:59:45,920 --> 01:59:46,840 YOU WONDER, OBVIOUSLY THERE'S A 3281 01:59:46,840 --> 01:59:49,480 LOT OF CONTROVERSY ABOUT THAT, 3282 01:59:49,480 --> 01:59:52,560 WE JUST DID AN INTERESTING STUDY 3283 01:59:52,560 --> 01:59:55,520 GROUP HERE ON SO CALLED TWICE 3284 01:59:55,520 --> 01:59:56,160 EXCEPTIONAL INDIVIDUALS 3285 01:59:56,160 --> 01:59:57,280 DIAGNOSED WITH AUTISM WITH A 3286 01:59:57,280 --> 01:59:59,880 GIFTED I.Q., THEY HAVE INCREASED 3287 01:59:59,880 --> 02:00:02,360 SUICIDAL IDEATION AND THAT GOT A 3288 02:00:02,360 --> 02:00:03,800 LOT OF RESPONSES ON SOCIAL 3289 02:00:03,800 --> 02:00:04,160 MEDIA. 3290 02:00:04,160 --> 02:00:05,920 IT'S AN IMPORTANT ISSUE. 3291 02:00:05,920 --> 02:00:07,440 I WONDER HOW MUCH WE'RE THINKING 3292 02:00:07,440 --> 02:00:08,120 ABOUT THAT. 3293 02:00:08,120 --> 02:00:11,400 I WAS STRUCK BY THE 3294 02:00:11,400 --> 02:00:11,720 DESCRIPTION 3295 02:00:11,720 --> 02:00:12,560 OF THE PATIENT. 3296 02:00:12,560 --> 02:00:14,240 I'M NOT A HUMAN PSYCHIATRIST, 3297 02:00:14,240 --> 02:00:15,760 I'M A MOUSE PSYCHIATRIST, BUT 3298 02:00:15,760 --> 02:00:17,280 STRUCK BY THE DESCRIPTION OF THE 3299 02:00:17,280 --> 02:00:18,840 PATIENT ANDREW GAVE BECAUSE IT 3300 02:00:18,840 --> 02:00:20,240 SEEMED LIKE SOMEBODY WHO WOULD 3301 02:00:20,240 --> 02:00:22,560 BE SUFFICIENTLY NOT DEPRESSED TO 3302 02:00:22,560 --> 02:00:25,400 BE ACTIVATED TO MAYBE BE ABLE TO 3303 02:00:25,400 --> 02:00:27,640 COMMIT SUICIDE. 3304 02:00:27,640 --> 02:00:29,000 OBVIOUSLY CAN'T DO THAT BUT I 3305 02:00:29,000 --> 02:00:30,320 WONDER HOW WE HANDLE SIDE 3306 02:00:30,320 --> 02:00:33,080 EFFECTS OF THIS AND THERE'S AN 3307 02:00:33,080 --> 02:00:35,320 OBVIOUS ONE HERE WHICH IS THAT. 3308 02:00:35,320 --> 02:00:38,320 AND I DIDN'T REALLY HEAR THAT. 3309 02:00:38,320 --> 02:00:43,120 I HEARD EVERYONE FOLKING FOLKI- 3310 02:00:43,120 --> 02:00:45,200 FOCUSING ON IMPACT, HOW WOULD WE 3311 02:00:45,200 --> 02:00:47,240 THINK ABOUT THE SIDE EFFECT -- 3312 02:00:47,240 --> 02:00:49,240 NOT SIDE EFFECTS BECAUSE I DON'T 3313 02:00:49,240 --> 02:00:52,840 KNOW THAT SUICIDE IDEATION IS 3314 02:00:52,840 --> 02:00:53,720 NECESSARILY A SIDE EFFECT. 3315 02:00:53,720 --> 02:00:57,120 >>IMPORTANT PART OF THE 3316 02:00:57,120 --> 02:00:59,080 PROBLEM. 3317 02:00:59,080 --> 02:00:59,920 DID WE LOSE KAREN? 3318 02:00:59,920 --> 02:01:03,120 THERE SHE IS. 3319 02:01:03,120 --> 02:01:03,520 KAREN, GO AHEAD. 3320 02:01:03,520 --> 02:01:08,160 >>SORRY, I HAVE A FUSSY PUPPY. 3321 02:01:08,160 --> 02:01:11,760 SO, I REALLY LIKED THE BREADTH 3322 02:01:11,760 --> 02:01:17,960 AND INVITATION FOR US TO THINK 3323 02:01:17,960 --> 02:01:18,800 ABOUT EVEN MORE FOUNDATIONAL 3324 02:01:18,800 --> 02:01:20,000 NEUROETHICS ISSUES WE DON'T DIVE 3325 02:01:20,000 --> 02:01:21,440 INTO BECAUSE I THINK THERE IS A 3326 02:01:21,440 --> 02:01:24,920 BIG PROBLEM ON THE HORIZON, OR 3327 02:01:24,920 --> 02:01:26,600 CHALLENGE AND INTENTION AROUND 3328 02:01:26,600 --> 02:01:29,000 MAKING KIND OF THE INVISIBLE -- 3329 02:01:29,000 --> 02:01:30,640 SOMETHING THAT'S INVISIBLE TO 3330 02:01:30,640 --> 02:01:31,720 THE PATIENT OR PARTICIPANT 3331 02:01:31,720 --> 02:01:32,920 VISIBLE TO THEM. 3332 02:01:32,920 --> 02:01:34,400 AND WHETHER THAT REALLY 3333 02:01:34,400 --> 02:01:35,800 RESEMBLES THEIR TRUTH. 3334 02:01:35,800 --> 02:01:39,280 AND WHETHER THAT REALLY EMPOWERS 3335 02:01:39,280 --> 02:01:39,760 THEM. 3336 02:01:39,760 --> 02:01:43,880 SO, YOU KNOW, I THINK FOR THE 3337 02:01:43,880 --> 02:01:45,640 DBS EXAMPLE, DR. KRYSTAL SAID I 3338 02:01:45,640 --> 02:01:47,960 THINK WE'RE ADDRESSING A POINT 3339 02:01:47,960 --> 02:01:50,360 IN THE PROCESS BEFORE MAYBE A 3340 02:01:50,360 --> 02:01:52,080 PATIENT IS EVEN AWARE OF WHAT'S 3341 02:01:52,080 --> 02:01:53,200 HAPPENING TO THEM. 3342 02:01:53,200 --> 02:01:54,120 SO THAT'S A POSITIVE 3343 02:01:54,120 --> 02:01:55,240 INTERVENTION, RIGHT? 3344 02:01:55,240 --> 02:01:56,560 MAYBE YOU DON'T WANT A PATIENT 3345 02:01:56,560 --> 02:02:01,040 TO BECOME AWARE IF YOU'RE 3346 02:02:01,040 --> 02:02:01,560 DEPRESSED. 3347 02:02:01,560 --> 02:02:03,480 AND DR. PANDRANGI SAID -- HE WAS 3348 02:02:03,480 --> 02:02:04,200 TALKING ABOUT SOMETHING 3349 02:02:04,200 --> 02:02:06,680 INVISIBLE, SOMETHING ABOUT THE 3350 02:02:06,680 --> 02:02:07,880 SUBJECTIVE NATURE OF PAIN, WHICH 3351 02:02:07,880 --> 02:02:09,720 HAS ALWAYS BEEN A PROBLEM. 3352 02:02:09,720 --> 02:02:12,480 IT'S EVEN MORE PROBLEMATIC FOR 3353 02:02:12,480 --> 02:02:13,000 THE PATIENT. 3354 02:02:13,000 --> 02:02:16,680 SO, I THINK THAT AS WE -- AND 3355 02:02:16,680 --> 02:02:22,320 THE BRAIN BEHAVIOR 3356 02:02:22,320 --> 02:02:22,840 QUANTIFICATION AND 3357 02:02:22,840 --> 02:02:25,040 SYNCHRONIZATION EFFORT TRYING TO 3358 02:02:25,040 --> 02:02:26,880 QUANTIFY BEHAVIORAL COMPONENTS 3359 02:02:26,880 --> 02:02:28,440 FITS TOGETHER IN STILL 3360 02:02:28,440 --> 02:02:30,520 ADDRESSING THAT TENSION AND WHAT 3361 02:02:30,520 --> 02:02:35,000 HAPPENS IF WHAT WE RECORD OR 3362 02:02:35,000 --> 02:02:37,080 WHAT WE QUANTITATIVELY THINK 3363 02:02:37,080 --> 02:02:38,400 WE'RE ASSESS DIFFERS FROM THE 3364 02:02:38,400 --> 02:02:39,480 SUBJECTIVE EXPERIENCE IN THE 3365 02:02:39,480 --> 02:02:40,880 PARTICIPANT AND HOW DO WE MAKE 3366 02:02:40,880 --> 02:02:44,440 THAT RIGHT AND THE PARTICIPANT 3367 02:02:44,440 --> 02:02:46,080 IS EMPOWERED OR PATIENT IS 3368 02:02:46,080 --> 02:02:47,280 EMPOWERED, IT'S A HARD QUESTION 3369 02:02:47,280 --> 02:02:49,120 BUT SOMETHING THAT'S GOING TO BE 3370 02:02:49,120 --> 02:02:53,800 RELEVANT TO A LOT OF BIOMETRIC 3371 02:02:53,800 --> 02:02:56,560 TECHNOLOGY, EVEN MORE TRICKY 3372 02:02:56,560 --> 02:02:58,080 WITH BRAIN TECHNOLOGY. 3373 02:02:58,080 --> 02:03:00,600 AND I THINK AS FAR AS SCOPE, I 3374 02:03:00,600 --> 02:03:02,680 MEAN, WE'VE BEEN -- MAYBE FOR 3375 02:03:02,680 --> 02:03:06,080 GOOD REASONS, WE'VE BEEN PRETTY 3376 02:03:06,080 --> 02:03:09,480 TRADITIONAL HOW WE'VE SCOPED OUR 3377 02:03:09,480 --> 02:03:11,120 NEUROETHICS ISSUES, TRYING TO 3378 02:03:11,120 --> 02:03:15,160 PUSH BEYOND THAT AS WE THINK 3379 02:03:15,160 --> 02:03:16,360 DEEPLY ABOUT JUSTICE ISSUES, 3380 02:03:16,360 --> 02:03:18,720 D.E.I., AND HOW IT INTERSECTS. 3381 02:03:18,720 --> 02:03:21,080 I WAS PLEASED TO SEE HELENE 3382 02:03:21,080 --> 02:03:24,000 LANGEVIN ON THEIR TALKING ABOUT 3383 02:03:24,000 --> 02:03:25,760 PLACEBO, WHAT A BIG DEAL TO HAVE 3384 02:03:25,760 --> 02:03:27,120 NOT TALKED ABOUT YET BUT MAYBE 3385 02:03:27,120 --> 02:03:29,960 THIS OFFERS AN OPPORTUNITY TO 3386 02:03:29,960 --> 02:03:31,600 TALK ABOUT BRAIN MECHANISMS. 3387 02:03:31,600 --> 02:03:33,880 AND MAYBE WE COULD SCOPE IT AT 3388 02:03:33,880 --> 02:03:36,000 FIRST ON TECHNOLOGY THAT BRAIN 3389 02:03:36,000 --> 02:03:37,160 FUNDS, SO WE'RE NOT LOOKING AT 3390 02:03:37,160 --> 02:03:39,880 EVERYTHING BECAUSE PART OF OUR 3391 02:03:39,880 --> 02:03:42,080 APPROACH SHOULD BE USING THE 3392 02:03:42,080 --> 02:03:45,680 BRAIN INITIATIVE KIND OF AS A 3393 02:03:45,680 --> 02:03:48,440 PILOT AREA WHERE WE DISSEMINATE 3394 02:03:48,440 --> 02:03:51,840 TOOLS AND BEST PRACTICES THAT 3395 02:03:51,840 --> 02:03:52,480 OTHERS CAN USE. 3396 02:03:52,480 --> 02:03:54,480 >>GREAT POINTS. 3397 02:03:54,480 --> 02:03:58,160 THANK YOU, KAREN. 3398 02:03:58,160 --> 02:03:58,560 CAROLINE? 3399 02:03:58,560 --> 02:04:00,240 >>YEAH, THANK YOU, CHRISTINE. 3400 02:04:00,240 --> 02:04:03,080 I ALSO WANT TO THANK NITA AS 3401 02:04:03,080 --> 02:04:09,440 WELL FOR INVITING US TO OPEN 3402 02:04:09,440 --> 02:04:10,440 THIS CONVERSATION AND CONSIDER 3403 02:04:10,440 --> 02:04:12,080 WHAT NEWG COULD DO AND ENVISION 3404 02:04:12,080 --> 02:04:13,840 THAT FOR THE FUTURE. 3405 02:04:13,840 --> 02:04:14,800 I THINK THIS PROMPT WAS 3406 02:04:14,800 --> 02:04:16,000 INTERESTING TO ME BECAUSE IT 3407 02:04:16,000 --> 02:04:17,920 MADE ME THINK ABOUT THE 3408 02:04:17,920 --> 02:04:20,480 EVOLUTION OF THE BRAIN 3409 02:04:20,480 --> 02:04:20,840 INITIATIVE. 3410 02:04:20,840 --> 02:04:23,000 AND ITS START IN THE DEVELOPMENT 3411 02:04:23,000 --> 02:04:26,520 OF NEW TOOLS AND TECHNOLOGY TO 3412 02:04:26,520 --> 02:04:27,840 BETTER MAP AND STUDY THE BRAIN 3413 02:04:27,840 --> 02:04:30,680 AND THEN WITH THE SECOND PHASE 3414 02:04:30,680 --> 02:04:31,960 THE BRAIN INITIATIVE BUILDING ON 3415 02:04:31,960 --> 02:04:36,040 THE PROGRESS OF THAT FIRST 3416 02:04:36,040 --> 02:04:36,360 PHASE. 3417 02:04:36,360 --> 02:04:38,120 AND APPLYING THAT TOWARD 3418 02:04:38,120 --> 02:04:40,080 DISCOVERY-DRIVEN SCIENCE, IN 3419 02:04:40,080 --> 02:04:42,480 SOME CASES WE'RE ALREADY SEEING 3420 02:04:42,480 --> 02:04:43,160 NEAR-TERM HEALTH POTENTIAL 3421 02:04:43,160 --> 02:04:46,440 APPLICATIONS AS WE SAW TODAY 3422 02:04:46,440 --> 02:04:47,520 FROM THESE TWO TALKS. 3423 02:04:47,520 --> 02:04:51,680 AND WHILE I'M STILL NEW TO THE 3424 02:04:51,680 --> 02:04:53,680 NEWG, I HAD MY FIRST MEETING 3425 02:04:53,680 --> 02:04:57,160 LAST TIME, I THINK WHAT THIS 3426 02:04:57,160 --> 02:04:59,560 PROMPT HELPED ME THINK ABOUT IS 3427 02:04:59,560 --> 02:05:01,160 HOW THE NEWG COULD EVEN STAND 3428 02:05:01,160 --> 02:05:05,280 WHAT IT'S DONE IN THE PAST TO 3429 02:05:05,280 --> 02:05:05,760 THINKING ABOUT HEALTH 3430 02:05:05,760 --> 02:05:07,360 APPLICATIONS, IN TERMS OF SCOPE 3431 02:05:07,360 --> 02:05:08,600 PERHAPS THINKING ABOUT IT IN 3432 02:05:08,600 --> 02:05:11,720 TERMS OF SOME OF THE BREAD AND 3433 02:05:11,720 --> 02:05:15,760 BUTTER OF WHAT NIH AND "BRAIN" 3434 02:05:15,760 --> 02:05:17,720 HAVE CONTINUED TO FOCUS ON. 3435 02:05:17,720 --> 02:05:18,640 ONE DIMENSION TO THIS I THINK 3436 02:05:18,640 --> 02:05:22,040 THAT CAME TO MY MIND WAS 3437 02:05:22,040 --> 02:05:24,640 THINKING ABOUT THE SBIR PATH, 3438 02:05:24,640 --> 02:05:29,520 AND THINKING ABOUT AN SBIR PATH, 3439 02:05:29,520 --> 02:05:31,640 HAVING THE NEWG ENGAGE MORE 3440 02:05:31,640 --> 02:05:32,440 CLOSELY WITH APPLICATIONS AND 3441 02:05:32,440 --> 02:05:34,920 PROJECTS THAT ARE GOING THROUGH 3442 02:05:34,920 --> 02:05:36,640 THAT PIPELINE COULD BE A 3443 02:05:36,640 --> 02:05:38,320 UNIQUE -- I THINK THAT'S HOW YOU 3444 02:05:38,320 --> 02:05:40,800 PUT IT, NITA, A UNIQUE 3445 02:05:40,800 --> 02:05:42,440 APPLICATION TO LEVERAGE SKILL 3446 02:05:42,440 --> 02:05:45,080 SETS OF NEWG MEMBERS INCLUDING 3447 02:05:45,080 --> 02:05:45,840 YOURSELF, NITA, KAREN, MANY 3448 02:05:45,840 --> 02:05:47,680 OTHERS WHO HAVE BEEN INVOLVED IN 3449 02:05:47,680 --> 02:05:48,480 TRANSLATION OF NEUROTECHNOLOGIES 3450 02:05:48,480 --> 02:05:52,000 AS WELL AS ETHICAL COMPONENTS OF 3451 02:05:52,000 --> 02:05:52,200 IT. 3452 02:05:52,200 --> 02:05:53,400 ONE THE OTHER REASONS I THOUGHT 3453 02:05:53,400 --> 02:05:54,920 ABOUT THIS TOO IN THE CONTEXT OF 3454 02:05:54,920 --> 02:05:57,440 THOSE TWO TALKS IS BECAUSE IT'S 3455 02:05:57,440 --> 02:05:59,960 STILL SOMEWHAT AGNOSTIC TO 3456 02:05:59,960 --> 02:06:02,240 PARTICULAR TYPE OF BRAIN 3457 02:06:02,240 --> 02:06:02,800 INTERVENTION. 3458 02:06:02,800 --> 02:06:04,440 INSTEAD, THE DIE MENTION IS HOW 3459 02:06:04,440 --> 02:06:06,880 FAR ALONG ARE THESE TECHNOLOGIES 3460 02:06:06,880 --> 02:06:09,480 IN LET'S SAY POTENTIAL 3461 02:06:09,480 --> 02:06:10,400 COMMERCIALIZATION. 3462 02:06:10,400 --> 02:06:11,360 IT'S ALSO SOMEWHAT AGNOSTIC TO 3463 02:06:11,360 --> 02:06:14,520 THE LEVEL OF EXPLANATION OF 3464 02:06:14,520 --> 02:06:17,400 MECHANISM, AS JOHN HAD PUT, SO 3465 02:06:17,400 --> 02:06:20,000 FOR BETTER OR WORSE THAT PATHWAY 3466 02:06:20,000 --> 02:06:21,400 COULD BE BETTER OR NOT SO 3467 02:06:21,400 --> 02:06:24,600 EXPLAINED IN TERMS OF MECHANISM. 3468 02:06:24,600 --> 02:06:26,800 SO THAT WAS ONE MODEL I THINK 3469 02:06:26,800 --> 02:06:28,640 THAT I THOUGHT ABOUT THAT COULD 3470 02:06:28,640 --> 02:06:30,640 BE UNIQUE FOR THIS GROUP. 3471 02:06:30,640 --> 02:06:33,480 IT COULD, AS KAREN HAD TALKED 3472 02:06:33,480 --> 02:06:36,320 ABOUT EARLIER, BE A CHUNK THAT 3473 02:06:36,320 --> 02:06:38,920 COULD BE BITTEN OFF OF IN A MORE 3474 02:06:38,920 --> 02:06:40,120 MANAGEABLE STYLE, BUT I THINK WE 3475 02:06:40,120 --> 02:06:43,200 ALSO HAVE A LOT OF MODELS THAT 3476 02:06:43,200 --> 02:06:48,360 KIND OF ADVISING FROM VARIOUS 3477 02:06:48,360 --> 02:06:53,480 DOMAINS, WHETHER IT BE IEEE 3478 02:06:53,480 --> 02:06:55,000 BRAIN NEUROETHICS, THE SEE 3479 02:06:55,000 --> 02:06:56,560 KAREN'S LOGO BEHIND HER, PERHAPS 3480 02:06:56,560 --> 02:07:00,400 THAT COULD BE ONE AVENUE FOR A 3481 02:07:00,400 --> 02:07:01,480 NEW TYPE OF ENGAGEMENT. 3482 02:07:01,480 --> 02:07:03,480 THAT WAS ONE THOUGHT. 3483 02:07:03,480 --> 02:07:07,080 THE SECOND THOUGHT I HAD, AS I 3484 02:07:07,080 --> 02:07:10,280 WATCHED THESE TALKS, ALSO 3485 02:07:10,280 --> 02:07:11,920 REFLECTED ON NEWG MEETING, POST 3486 02:07:11,920 --> 02:07:14,640 TRIAL RESPONSIBILITIES WORKSHOP 3487 02:07:14,640 --> 02:07:19,160 BACK IN MAY, IS THAT IT SEEMS 3488 02:07:19,160 --> 02:07:20,880 LIKE THE INVITATION TO INCLUDE 3489 02:07:20,880 --> 02:07:23,960 PATIENT OR END USER PERSPECTIVE 3490 02:07:23,960 --> 02:07:24,640 IN THESE CONVERSATIONS WAS 3491 02:07:24,640 --> 02:07:25,200 REALLY STRONG. 3492 02:07:25,200 --> 02:07:27,200 I THINK THAT IT COULD BE A 3493 02:07:27,200 --> 02:07:29,280 STARTING POINT FOR EVEN DEEPER 3494 02:07:29,280 --> 02:07:32,600 ENGAGEMENT THROUGH LET'S SAY 3495 02:07:32,600 --> 02:07:33,960 FOLLOW-ON RESEARCH GRANTS OR 3496 02:07:33,960 --> 02:07:37,720 GRANTS THAT CAN FUND ENGAGEMENT 3497 02:07:37,720 --> 02:07:38,200 OPPORTUNITIES BETWEEN 3498 02:07:38,200 --> 02:07:39,360 RESEARCHERS AND PATIENTS. 3499 02:07:39,360 --> 02:07:40,680 SO THAT'S ANOTHER AVENUE JUST 3500 02:07:40,680 --> 02:07:44,280 BASED ON WHAT I'VE OBSERVED SO 3501 02:07:44,280 --> 02:07:44,520 FAR. 3502 02:07:44,520 --> 02:07:44,760 >>GREAT. 3503 02:07:44,760 --> 02:07:46,680 >>LET ME JUMP IN FOR JUST A 3504 02:07:46,680 --> 02:07:48,680 MOMENT TO SAY THANK YOU, 3505 02:07:48,680 --> 02:07:50,320 CAROLINE, FOR THOSE. 3506 02:07:50,320 --> 02:07:52,800 AND I THINK THINKING ABOUT EACH 3507 02:07:52,800 --> 02:07:54,000 OF THOSE ENGAGEMENTS IS PART OF 3508 02:07:54,000 --> 02:07:55,760 WHAT I'M HOPING WE'RE GOING TO 3509 02:07:55,760 --> 02:07:57,320 BE THINKING ABOUT, WHERE ARE WE 3510 02:07:57,320 --> 02:07:59,040 GOING, WHAT'S THE IMPACT WE WANT 3511 02:07:59,040 --> 02:07:59,600 TO HAVE. 3512 02:07:59,600 --> 02:08:02,240 I WANT TO CONNECT UP THE TWO 3513 02:08:02,240 --> 02:08:04,320 TALKS FOR A MOMENT AS FOLKS ARE 3514 02:08:04,320 --> 02:08:05,440 THINKING ABOUT IT. 3515 02:08:05,440 --> 02:08:09,800 A LOT OF THE EMERGING VR 3516 02:08:09,800 --> 02:08:13,200 HEADSETS ALSO HAVE INTEGRATED 3517 02:08:13,200 --> 02:08:15,360 SENSORS FOR EEG TO PICK UP BRAIN 3518 02:08:15,360 --> 02:08:16,920 WAVE ACTIVITY, AT LEAST TO A 3519 02:08:16,920 --> 02:08:18,000 LIMITED EXTENT. 3520 02:08:18,000 --> 02:08:20,600 AS WE THINK ABOUT CLOSED LOOP 3521 02:08:20,600 --> 02:08:22,520 VERSUS OPEN LOOP, JUST TO PUT AN 3522 02:08:22,520 --> 02:08:24,480 ETHICAL PIECE ON THE TABLE FOR 3523 02:08:24,480 --> 02:08:26,200 US TO THINK ABOUT, SOME OF IT IS 3524 02:08:26,200 --> 02:08:27,880 ABOUT CLOSED LOOP EVEN WITHIN 3525 02:08:27,880 --> 02:08:28,760 VR, RIGHT? 3526 02:08:28,760 --> 02:08:30,240 THAT ISN'T LIMITED JUST AT ONE 3527 02:08:30,240 --> 02:08:31,600 END OF THE SPECTRUM OR THE 3528 02:08:31,600 --> 02:08:31,920 OTHER. 3529 02:08:31,920 --> 02:08:36,000 AS WE THINK ABOUT WHAT WE MIGHT 3530 02:08:36,000 --> 02:08:39,040 DO AND DIMENSIONS AND ETHICAL 3531 02:08:39,040 --> 02:08:41,360 PIECES AND ENGAGING WITH OTHERS, 3532 02:08:41,360 --> 02:08:42,800 IT'S NOT REALLY THAT THESE ARE 3533 02:08:42,800 --> 02:08:44,880 TWO ENDS OF THE SPECTRUM. 3534 02:08:44,880 --> 02:08:46,720 THEY ARE INTEGRATED IN A LOT OF 3535 02:08:46,720 --> 02:08:48,480 ETHICAL ISSUES WE MIGHT CONFRONT 3536 02:08:48,480 --> 02:08:51,000 AND THINK ABOUT AND HOW WE MIGHT 3537 02:08:51,000 --> 02:08:51,960 THINK ABOUT ENGAGING OTHER 3538 02:08:51,960 --> 02:08:54,160 EFFORTS THAT ARE UNDERWAY FOR 3539 02:08:54,160 --> 02:08:54,920 TRANSLATIONAL IMPACT AS CAROLINE 3540 02:08:54,920 --> 02:08:57,560 POINTS TO. 3541 02:08:57,560 --> 02:09:00,600 >>GREAT. 3542 02:09:00,600 --> 02:09:09,120 BE . 3543 02:09:09,120 --> 02:09:15,080 >>ANDREA DID WE LOSE YOU'RE 3544 02:09:15,080 --> 02:09:15,280 HAND? 3545 02:09:15,280 --> 02:09:16,720 >>YOU'RE NICELY BROUGHT IT BACK 3546 02:09:16,720 --> 02:09:18,480 TO BRAIN AND IN TERMS OF 3547 02:09:18,480 --> 02:09:19,920 RESEARCH SO WE DO GET AWAY FROM 3548 02:09:19,920 --> 02:09:22,560 SOME OF THE THINGS THAT ARE 3549 02:09:22,560 --> 02:09:23,520 STILL VERY INTERESTING BUT 3550 02:09:23,520 --> 02:09:25,160 WINSTON RAISED THE SCOPE ISSUE. 3551 02:09:25,160 --> 02:09:26,840 BUT I FEEL LIKE YOU'VE ALREADY 3552 02:09:26,840 --> 02:09:31,400 GOTTEN THERE WITHOUT MY HELP. 3553 02:09:31,400 --> 02:09:32,320 >>OKAY. 3554 02:09:32,320 --> 02:09:36,600 WITH YOUR HELP THOUGH. 3555 02:09:36,600 --> 02:09:36,760 JIM? 3556 02:09:36,760 --> 02:09:37,120 >>THANKS. 3557 02:09:37,120 --> 02:09:39,520 I PROMISE THIS WILL BE MY LAST 3558 02:09:39,520 --> 02:09:39,760 COMMENT. 3559 02:09:39,760 --> 02:09:41,800 I WANTED TO FOLLOW UP ON WHAT 3560 02:09:41,800 --> 02:09:44,000 SOME OTHER HAD SAID, IN 3561 02:09:44,000 --> 02:09:46,640 PARTICULAR, CAROLINE. 3562 02:09:46,640 --> 02:09:49,240 JUST AS REMINDER, THE 3563 02:09:49,240 --> 02:09:50,360 NEUROETHICS ROAD MAP HAD 3564 02:09:50,360 --> 02:09:51,680 SUGGESTIONS AND COMMENTS WITH 3565 02:09:51,680 --> 02:09:53,760 RESPECT TO THESE VARIOUS ISSUES, 3566 02:09:53,760 --> 02:09:57,560 AND SO DRAWING ATTENTION TO IT 3567 02:09:57,560 --> 02:10:00,040 AND HOW NEWG OR OTHER ENTITIES 3568 02:10:00,040 --> 02:10:02,080 MIGHT BE INVOLVED IN HELPING TO 3569 02:10:02,080 --> 02:10:03,080 ADDRESS SOME OF THESE, 3570 02:10:03,080 --> 02:10:04,760 RECOGNIZING THESE ISSUES AND 3571 02:10:04,760 --> 02:10:06,480 HELPING ADDRESS THEM BUT I 3572 02:10:06,480 --> 02:10:09,120 ACTUALLY THOUGHT CAROLYN'S 3573 02:10:09,120 --> 02:10:10,560 SUGGESTION ABOUT THE SBIR 3574 02:10:10,560 --> 02:10:11,400 MECHANISM IS REALLY INTRIGUING. 3575 02:10:11,400 --> 02:10:16,880 I DON'T KNOW THAT BRAIN DOES 3576 02:10:16,880 --> 02:10:18,120 SBIRs, BUT TO ENGAGE COMPANIES 3577 02:10:18,120 --> 02:10:21,680 EARLY ON WHEN THEY ARE JUST 3578 02:10:21,680 --> 02:10:23,120 STARTING OUT WITH ETHICAL 3579 02:10:23,120 --> 02:10:25,840 GUIDANCE, IF YOU WILL, OR AT 3580 02:10:25,840 --> 02:10:28,560 LEAST AN OPPORTUNITY TO INTERACT 3581 02:10:28,560 --> 02:10:31,720 ON ETHICAL ISSUES, IT'S A REALLY 3582 02:10:31,720 --> 02:10:32,880 GOOD IDEA, IT'S SOMETHING THAT 3583 02:10:32,880 --> 02:10:35,360 NEWG COULD BE INVOLVED WITH. 3584 02:10:35,360 --> 02:10:38,200 AND MIGHT HAVE AN IMPACT VERY ON 3585 02:10:38,200 --> 02:10:42,800 IN DEVELOPMENT OF THESE 3586 02:10:42,800 --> 02:10:43,160 TECHNOLOGIES. 3587 02:10:43,160 --> 02:10:44,760 >>GO AHEAD, JOHN. 3588 02:10:44,760 --> 02:10:47,200 >>WE DO INDEED FUND SBIRs. 3589 02:10:47,200 --> 02:10:50,280 WE'RE MANDATED BUT WE ACTUALLY 3590 02:10:50,280 --> 02:10:52,240 DO SELECT OUT ONES THAT FIT OUR 3591 02:10:52,240 --> 02:10:52,440 SPACE. 3592 02:10:52,440 --> 02:10:55,400 I THINK WE SHOULD LOOK INTO. 3593 02:10:55,400 --> 02:10:56,040 THERE'S CERTAINLY ONES THAT 3594 02:10:56,040 --> 02:10:58,360 WOULD BENEFIT AS TO MANY OF OUR 3595 02:10:58,360 --> 02:11:02,440 OTHER FUNDED STUDIES, FOR THEIR 3596 02:11:02,440 --> 02:11:04,280 CONSIDERATION, WE MIGHT EXPAND 3597 02:11:04,280 --> 02:11:06,240 OUR THINKING WHAT MIGHT BE 3598 02:11:06,240 --> 02:11:07,240 APPROPRIATE AND RELEVANT. 3599 02:11:07,240 --> 02:11:08,520 THAT'S A GREAT POINT. 3600 02:11:08,520 --> 02:11:08,800 THANK YOU. 3601 02:11:08,800 --> 02:11:10,040 >>WE DO HAVE MEMBERS OF THAT 3602 02:11:10,040 --> 02:11:11,600 TEAM ON THIS CALL SO I'M SURE 3603 02:11:11,600 --> 02:11:13,440 THEY HEARD THE COMMENT AS WELL. 3604 02:11:13,440 --> 02:11:14,360 >>RIGHT. 3605 02:11:14,360 --> 02:11:16,840 >>JIM, I WOULD ENCOURAGE YOU TO 3606 02:11:16,840 --> 02:11:17,960 HIGHLIGHT SOME OF -- KAREN PUT 3607 02:11:17,960 --> 02:11:20,600 THE REPORT BACK UP BUT SOME WAYS 3608 02:11:20,600 --> 02:11:21,800 NEWG COULD ENGAGE ON THESE 3609 02:11:21,800 --> 02:11:22,680 ISSUES PULLING THEM OUT OF THE 3610 02:11:22,680 --> 02:11:24,080 REPORT INTO THE CHAT FOR US TO 3611 02:11:24,080 --> 02:11:25,360 BRING BACK AS A THREAD THROUGH 3612 02:11:25,360 --> 02:11:29,360 THE CONVERSATION WOULD BE 3613 02:11:29,360 --> 02:11:29,720 TERRIFIC. 3614 02:11:29,720 --> 02:11:32,960 INCLUDING OBVIOUSLY THE SBIRs 3615 02:11:32,960 --> 02:11:36,120 THAT YOU HIGHLIGHTED. 3616 02:11:36,120 --> 02:11:36,480 >>THANKS. 3617 02:11:36,480 --> 02:11:36,720 >>SYD? 3618 02:11:36,720 --> 02:11:41,040 >>YEAH, THIS IS A FOLLOW-UP ON 3619 02:11:41,040 --> 02:11:42,840 JOHN'S COMMENT ABOUT MECHANISM 3620 02:11:42,840 --> 02:11:45,560 BUT ONE OF THE KIND OF STRIKING 3621 02:11:45,560 --> 02:11:46,960 DIFFERENCES FOR ME BETWEEN THESE 3622 02:11:46,960 --> 02:11:48,800 TWO STUDIES THAT WE HEARD ABOUT 3623 02:11:48,800 --> 02:11:53,400 IS THE FIRST ONE, DBS FOR 3624 02:11:53,400 --> 02:11:54,200 DEPRESSION, IS VERY HYPOTHESIS 3625 02:11:54,200 --> 02:11:55,120 DRIVEN. 3626 02:11:55,120 --> 02:11:56,240 THEY HAVE, YOU KNOW, TARGET 3627 02:11:56,240 --> 02:11:58,360 AREAS OF THE BRAIN WHICH HAVE 3628 02:11:58,360 --> 02:11:59,760 BEEN STUDIED, WHICH THEY ARE 3629 02:11:59,760 --> 02:12:04,360 GOING TO TRY TO INTERVENE ON, 3630 02:12:04,360 --> 02:12:06,320 WHEREAS THE VR STUDY STRUCK ME 3631 02:12:06,320 --> 02:12:08,280 AS BEING A LITTLE UNDERBAKED. 3632 02:12:08,280 --> 02:12:14,440 THEY DIDN'T SEEM TO HAVE AN IDEA 3633 02:12:14,440 --> 02:12:16,080 OF HOW THIS MIGHT WORK OTHER 3634 02:12:16,080 --> 02:12:19,480 THAN, YOU KNOW, IT'S MORE 3635 02:12:19,480 --> 02:12:20,760 DISTRACTING OR SOMETHING, THAN A 3636 02:12:20,760 --> 02:12:23,280 2D ENVIRONMENT MIGHT BE. 3637 02:12:23,280 --> 02:12:24,280 AND SO, YOU KNOW, REALLY NOT 3638 02:12:24,280 --> 02:12:28,960 HIGH 3639 02:12:28,960 --> 02:12:30,480 HYPOTHESIS DRIVEN, I TRIED TO 3640 02:12:30,480 --> 02:12:33,440 PUSH ON WHAT QUESTION, WHAT IS 3641 02:12:33,440 --> 02:12:41,280 YOUR HIGH -- HYPOTHESIS, COOL, 3642 02:12:41,280 --> 02:12:42,360 THEY WORK, BUT NOT UNDERSTANDING 3643 02:12:42,360 --> 02:12:45,400 HOW OR WHY THEY WORK, YOU KNOW, 3644 02:12:45,400 --> 02:12:46,920 OBVIOUSLY THE BRAIN IS INVOLVED 3645 02:12:46,920 --> 02:12:48,000 WHEN WE'RE TALKING ABOUT PAIN 3646 02:12:48,000 --> 02:12:52,080 BOTH IN TERMS OF THE SUBJECTIVE 3647 02:12:52,080 --> 02:12:55,040 EXPERIENCE BUT THERE ARE ALSO, 3648 02:12:55,040 --> 02:12:56,680 YOU KNOW, OBJECTIVE MEASURES OF 3649 02:12:56,680 --> 02:12:57,800 PAIN, RIGHT? 3650 02:12:57,800 --> 02:13:00,040 SOMEONE'S HEART RATE AND HOW 3651 02:13:00,040 --> 02:13:02,680 FAST THEY ARE BREATHING AND ALSO 3652 02:13:02,680 --> 02:13:04,440 OBVIOUSLY THINGS GOING ON IN THE 3653 02:13:04,440 --> 02:13:08,640 BRAIN SO THERE'S ALL KINDS OF 3654 02:13:08,640 --> 02:13:11,280 BIOMARKERS OR BIOFEEDBACK THEY 3655 02:13:11,280 --> 02:13:13,440 MIGHT BE STUDYING TO HAVE A 3656 02:13:13,440 --> 02:13:14,680 HYPOTHESIS ABOUT WHAT'S GOING ON 3657 02:13:14,680 --> 02:13:18,280 WHEN THEY ARE USING THAT. 3658 02:13:18,280 --> 02:13:20,320 SO, I DON'T KNOW TO WHAT EXTENT 3659 02:13:20,320 --> 02:13:24,280 WE WANT TO GET INTO THAT ISSUE 3660 02:13:24,280 --> 02:13:27,120 OF SHOULD OUR RESEARCH BE 3661 02:13:27,120 --> 02:13:27,920 HYPOTHESIS DRIVEN THIS WAY OR, 3662 02:13:27,920 --> 02:13:29,640 YOU KNOW, IS THIS JUST KIND OF 3663 02:13:29,640 --> 02:13:31,720 AN INTERESTING THING AND MAYBE 3664 02:13:31,720 --> 02:13:33,320 WE WANT TO SEE WHAT HAPPENS. 3665 02:13:33,320 --> 02:13:35,880 I WOULD LIKE TO SEE RESEARCHERS 3666 02:13:35,880 --> 02:13:38,960 WHO ARE THINKING MORE CAREFULLY 3667 02:13:38,960 --> 02:13:41,360 AND DEEPLY ABOUT WHY SOMETHING 3668 02:13:41,360 --> 02:13:44,960 MIGHT WORK AND WHY IT IS 3669 02:13:44,960 --> 02:13:45,200 WORKING. 3670 02:13:45,200 --> 02:13:46,840 WITH THE VR ONE REASON IS 3671 02:13:46,840 --> 02:13:48,160 BECAUSE I THINK THERE IS 3672 02:13:48,160 --> 02:13:50,800 POTENTIAL FOR ABUSE WITH A 3673 02:13:50,800 --> 02:13:51,520 COMMERCIALLY AVAILABLE PRODUCT 3674 02:13:51,520 --> 02:13:53,120 THAT PEOPLE MIGHT JUST SAY, HEY, 3675 02:13:53,120 --> 02:13:54,760 I FEEL BETTER WITH THIS, I'M 3676 02:13:54,760 --> 02:13:59,120 GOING TO KEEP DOING IT. 3677 02:13:59,120 --> 02:14:01,120 3678 02:14:01,120 --> 02:14:04,760 >>GOOD POINT. 3679 02:14:04,760 --> 02:14:05,000 SAMEER? 3680 02:14:05,000 --> 02:14:10,960 >>YEAH, I WANT TO PICK UP A 3681 02:14:10,960 --> 02:14:12,360 COUPLE THREADS, NITA, CAROLINE, 3682 02:14:12,360 --> 02:14:14,440 A COUPLE OTHERS, AND MAYBE KIND 3683 02:14:14,440 --> 02:14:20,840 OF PUT UNDER CATEGORY OF THIS 3684 02:14:20,840 --> 02:14:21,200 CONFLICT BETWEEN 3685 02:14:21,200 --> 02:14:23,680 INDIVIDUALIZATION VERSUS 3686 02:14:23,680 --> 02:14:24,480 GENERALIZABILITY. 3687 02:14:24,480 --> 02:14:25,800 SO, WE TALKED ABOUT THE WORKSHOP 3688 02:14:25,800 --> 02:14:30,920 BACK IN MAY, IT WAS AMAZING. 3689 02:14:30,920 --> 02:14:33,120 UNANIMOUSLY EVERYONE ENJOYED 3690 02:14:33,120 --> 02:14:35,280 HEARING FROM THE RESEARCH 3691 02:14:35,280 --> 02:14:36,920 SUBJECT PATIENT INDIVIDUAL AND 3692 02:14:36,920 --> 02:14:38,800 HEARING THEIR THOUGHTS ABOUT WHY 3693 02:14:38,800 --> 02:14:39,720 THEY PARTICIPATED, WHAT THEY GOT 3694 02:14:39,720 --> 02:14:42,840 OUT OF IT, ET CETERA, SOMEONE 3695 02:14:42,840 --> 02:14:47,080 COMMENTED HERE ABOUT ANDREW'S 3696 02:14:47,080 --> 02:14:48,840 PRESENTATION. 3697 02:14:48,840 --> 02:14:50,400 YOU KNOW, UNDERSTANDING THE 3698 02:14:50,400 --> 02:14:52,280 HUMAN -- YOU TALKED ABOUT THIS 3699 02:14:52,280 --> 02:14:54,200 IN THE MOUSE PSYCHIATRY THING 3700 02:14:54,200 --> 02:14:55,880 ABOUT, YOU KNOW, KNOWING WHAT IT 3701 02:14:55,880 --> 02:14:57,080 IS FROM THEIR PERSPECTIVE, WHAT 3702 02:14:57,080 --> 02:15:00,040 THEY FELT LIKE, WHAT THEY WENT 3703 02:15:00,040 --> 02:15:00,280 THROUGH. 3704 02:15:00,280 --> 02:15:05,120 SO, THIS IS OVER A HUMAN NATURAL 3705 02:15:05,120 --> 02:15:06,360 IDENTIFIABLE POIGNANT, I THINK 3706 02:15:06,360 --> 02:15:09,360 THE CONFLICT THERE IS PERHAPS 3707 02:15:09,360 --> 02:15:12,000 WITH HOW FAR DOWN THIS 3708 02:15:12,000 --> 02:15:14,280 INDIVIDUALIZATION RABBIT HOLE DO 3709 02:15:14,280 --> 02:15:17,440 WE GO VERSUS IDENTIFYING 3710 02:15:17,440 --> 02:15:18,440 THERAPIES THAT ARE 3711 02:15:18,440 --> 02:15:20,440 GENERALIZABLE, BECAUSE IF YOU GO 3712 02:15:20,440 --> 02:15:22,680 DOWN REALLY FAR THEN YOU'RE IN 3713 02:15:22,680 --> 02:15:25,440 THE SITUATION WHERE YOU HAVE TO 3714 02:15:25,440 --> 02:15:28,920 DO THIS VERY -- TO TAKE ANDREA'S 3715 02:15:28,920 --> 02:15:29,920 EXAMPLE, THIS COMPLEX IMPLANT, A 3716 02:15:29,920 --> 02:15:32,520 LOT OF TIME, MONEY, EFFORTS, ET 3717 02:15:32,520 --> 02:15:33,920 CETERA, PERHAPS EVERY SINGLE 3718 02:15:33,920 --> 02:15:36,560 PATIENT WHICH IS JUST NOT 3719 02:15:36,560 --> 02:15:36,840 FEASIBLE. 3720 02:15:36,840 --> 02:15:38,560 I WANTED TO ASK THE QUESTION. 3721 02:15:38,560 --> 02:15:40,160 WE HAVE A STUDY IN SOME WAYS 3722 02:15:40,160 --> 02:15:42,160 SIMILAR BUT IN THAT WAY VERY 3723 02:15:42,160 --> 02:15:42,560 DIFFERENT. 3724 02:15:42,560 --> 02:15:44,880 IT WOULD BE FUN TO TALK ABOUT 3725 02:15:44,880 --> 02:15:45,200 THAT. 3726 02:15:45,200 --> 02:15:48,400 I THINK THIS GETS INTO THE 3727 02:15:48,400 --> 02:15:49,840 NEUROETHICS SPACE BECAUSE IT'S A 3728 02:15:49,840 --> 02:15:52,440 MATTER OF ACCESS AND USE OF 3729 02:15:52,440 --> 02:15:53,240 RESOURCES. 3730 02:15:53,240 --> 02:15:56,600 SO HOW MANY -- HOW MUCH CAN WE 3731 02:15:56,600 --> 02:15:57,880 INVEST IN BEING SO 3732 02:15:57,880 --> 02:15:58,880 HYPERINDIVIDUAL THAT EVERYONE IS 3733 02:15:58,880 --> 02:16:02,600 SUPER DIFFERENT AND WE HAVE TO 3734 02:16:02,600 --> 02:16:04,920 DO SOMETHING THAT'S EXPENSIVE OR 3735 02:16:04,920 --> 02:16:06,520 TIME CONSUMING OR EFFORT 3736 02:16:06,520 --> 02:16:07,440 CONSUMING, YOU KNOW, FOR EVERY 3737 02:16:07,440 --> 02:16:08,640 PERSON BECAUSE WE KNOW THERE'S 3738 02:16:08,640 --> 02:16:10,080 GOING TO BE SLIGHT DIFFERENCES 3739 02:16:10,080 --> 02:16:12,800 VERSUS HOW MUCH DO WE SAY, LOOK, 3740 02:16:12,800 --> 02:16:15,160 WE HAVE TO FIND THINGS THAT ARE 3741 02:16:15,160 --> 02:16:16,320 GENERALIZABLE AND IT'S OKAY THAT 3742 02:16:16,320 --> 02:16:20,760 MAYBE NOT EVERY SINGLE ONE IS AN 3743 02:16:20,760 --> 02:16:23,000 ABSOLUTE, LIKE BOTTOM OF THE 3744 02:16:23,000 --> 02:16:26,840 9th GRAND SLAM BUT THERE'S 3745 02:16:26,840 --> 02:16:28,240 MANY THAT ARE SOLID TWO-BASE 3746 02:16:28,240 --> 02:16:30,960 HITS THAT STILL WIN THE GAME. 3747 02:16:30,960 --> 02:16:34,360 THIS I THINK CUTS THROUGH A 3748 02:16:34,360 --> 02:16:37,000 COUPLE DIFFERENT -- MANY OF THE 3749 02:16:37,000 --> 02:16:39,320 ISSUES WE TALKED ABOUT. 3750 02:16:39,320 --> 02:16:41,720 IT'S NOT SPECIFIC TO INVASIVE OR 3751 02:16:41,720 --> 02:16:44,640 NON-INVASIVE OR HUMAN OR ANIMAL, 3752 02:16:44,640 --> 02:16:44,920 WHATEVER. 3753 02:16:44,920 --> 02:16:46,960 THIS MAY SOMETHING THAT WE COULD 3754 02:16:46,960 --> 02:16:48,600 IDENTIFY AS MAYBE A 3755 02:16:48,600 --> 02:16:50,360 CROSS-CUTTING THEME THAT IS 3756 02:16:50,360 --> 02:16:58,760 WORTH THINKING ABOUT AT VARIOUS 3757 02:16:58,760 --> 02:17:00,040 DIFFERENT LEVELS. 3758 02:17:00,040 --> 02:17:01,680 >>DO YOU SEE WALTER'S QUESTION 3759 02:17:01,680 --> 02:17:05,920 FOR YOU IN THE CHAT, SAMEER? 3760 02:17:05,920 --> 02:17:06,800 >>THANKS, WALTER. 3761 02:17:06,800 --> 02:17:09,080 HOW IS THIS DIFFERENT THAN WHAT 3762 02:17:09,080 --> 02:17:10,720 OCCURS IN EPILEPSY? 3763 02:17:10,720 --> 02:17:11,520 IT'S NOT. 3764 02:17:11,520 --> 02:17:12,920 IT'S JUST HARDER TO FIND 3765 02:17:12,920 --> 02:17:13,920 DEPRESSION BECAUSE WE DON'T KNOW 3766 02:17:13,920 --> 02:17:14,640 WHAT WE'RE LOOKING FOR. 3767 02:17:14,640 --> 02:17:15,120 IT'S NOT. 3768 02:17:15,120 --> 02:17:16,840 THIS IS WHERE IT'S BORROWED 3769 02:17:16,840 --> 02:17:17,280 FROM. 3770 02:17:17,280 --> 02:17:19,320 WE DO THIS IN EPILEPSY, BUT DO 3771 02:17:19,320 --> 02:17:20,000 WE REALLY? 3772 02:17:20,000 --> 02:17:22,000 HOW MANY PEOPLE CAN ACTUALLY 3773 02:17:22,000 --> 02:17:25,960 HAVE THAT DEGREE OF ACCESS AND 3774 02:17:25,960 --> 02:17:27,720 SO WE DO IT THEORETICALLY AND A 3775 02:17:27,720 --> 02:17:32,040 LOT OF CENTERS OF COURSE DO IT 3776 02:17:32,040 --> 02:17:32,720 PRACTICALLY. 3777 02:17:32,720 --> 02:17:35,360 BUT NOW ARE ARE GOING TO DO THAT 3778 02:17:35,360 --> 02:17:40,680 FOR EVERY BRAIN-BASED DISORDER, 3779 02:17:40,680 --> 02:17:41,360 EVERY NERVOUS SYSTEM-BASED 3780 02:17:41,360 --> 02:17:46,320 DISORBED? 3781 02:17:46,320 --> 02:17:46,560 DISORDER? 3782 02:17:46,560 --> 02:17:49,680 WHAT CAN WE DO THAT IT'S GOING 3783 02:17:49,680 --> 02:17:51,680 TO BENEFIT MANY MORE PEOPLE, 3784 02:17:51,680 --> 02:17:56,480 MAYBE NOT TO THE Nth DEGREE 3785 02:17:56,480 --> 02:18:04,640 BUT ENOUGH TO GET THEM BETTER, 3786 02:18:04,640 --> 02:18:04,960 FUNCTIONAL. 3787 02:18:04,960 --> 02:18:05,440 >>GREAT POINTS. 3788 02:18:05,440 --> 02:18:07,840 WE TALKED ABOUT THIS AS WELL. 3789 02:18:07,840 --> 02:18:11,240 ON THE ONE HAND VARIABILITY 3790 02:18:11,240 --> 02:18:13,360 SEEMS TO BE VEXING, OBSTACLE. 3791 02:18:13,360 --> 02:18:15,800 ON THE OTHER HAND VARIABILITY 3792 02:18:15,800 --> 02:18:18,560 ONCE YOU FOLKS HAVE ENOUGH 3793 02:18:18,560 --> 02:18:19,960 PATIENTS THAT YOU'VE WORKED 3794 02:18:19,960 --> 02:18:23,600 WITH, YOU MIGHT UNDERSTAND 3795 02:18:23,600 --> 02:18:25,560 BETTER THE SOURCES AND 3796 02:18:25,560 --> 02:18:27,120 VARIABILITY, AT LEAST WHAT THEY 3797 02:18:27,120 --> 02:18:28,600 MEAN IN TERMS OF PATIENT'S 3798 02:18:28,600 --> 02:18:29,600 CONDITION AND RESPONSE TO 3799 02:18:29,600 --> 02:18:30,920 DIFFERENT THERAPIES. 3800 02:18:30,920 --> 02:18:33,080 I MEAN, NOT TO BE TOTAL 3801 02:18:33,080 --> 02:18:34,320 POLLYANNA BUT I THINK THESE ARE 3802 02:18:34,320 --> 02:18:35,200 STILL EARLY DAYS. 3803 02:18:35,200 --> 02:18:38,680 WE HAVE A LOT YET TO LEARN. 3804 02:18:38,680 --> 02:18:43,400 I SEE IN ALL AREAS OF BIOLOGY 3805 02:18:43,400 --> 02:18:46,360 THERE'S THE INITIAL KIND OF 3806 02:18:46,360 --> 02:18:48,000 REACTION TO RUN, BUT IF YOU 3807 02:18:48,000 --> 02:18:50,400 EMBRACE IT, IT CAN TEACH US 3808 02:18:50,400 --> 02:18:51,520 SOMETHING, SOMETHING TO KEEP OUR 3809 02:18:51,520 --> 02:18:52,800 MINDS ON. 3810 02:18:52,800 --> 02:18:55,440 THE OTHER THING, IF WE ARE TRULY 3811 02:18:55,440 --> 02:18:57,960 AS A FIELD TO DEMOCRATIZE THESE 3812 02:18:57,960 --> 02:18:59,600 KINDS OF TECHNOLOGIES FOR THESE 3813 02:18:59,600 --> 02:19:01,560 DISORDERS, YOU WON'T BE ABLE TO 3814 02:19:01,560 --> 02:19:04,320 IMPLANT THEM AND STUDY THEM FOR 3815 02:19:04,320 --> 02:19:05,800 TEN DAYS, IT'S JUST NOT GOING TO 3816 02:19:05,800 --> 02:19:07,240 BE I DON'T THINK FEASIBLE. 3817 02:19:07,240 --> 02:19:09,000 BUT TO THE EXTENT THAT YOU CAN 3818 02:19:09,000 --> 02:19:11,440 GENERATE GOOD DATA, UNDERSTAND 3819 02:19:11,440 --> 02:19:14,800 THE VARIABILITY, MAYBE ONE DAY 3820 02:19:14,800 --> 02:19:15,640 USING NON-INVASIVE RECORDING 3821 02:19:15,640 --> 02:19:18,080 METHODS MIGHT GET YOU CLOSE 3822 02:19:18,080 --> 02:19:19,640 ENOUGH TO HELP PEOPLE OUT. 3823 02:19:19,640 --> 02:19:21,600 THESE ARE ISSUES WE WANT TO KEEP 3824 02:19:21,600 --> 02:19:23,440 OUR EYES ON BUT THE EXPECTATION 3825 02:19:23,440 --> 02:19:25,000 IS THE TECHNOLOGY AND OUR 3826 02:19:25,000 --> 02:19:26,520 UNDERSTANDING IS NOT GOING TO BE 3827 02:19:26,520 --> 02:19:27,400 STATIC, RIGHT? 3828 02:19:27,400 --> 02:19:30,680 IF WE ASSUME THAT, WE WOULDN'T 3829 02:19:30,680 --> 02:19:31,680 BE DOING THIS. 3830 02:19:31,680 --> 02:19:33,320 IT'S IMPORTANT TO KEEP OUR EYES 3831 02:19:33,320 --> 02:19:37,600 KIND OF ON THAT LONGER TERM 3832 02:19:37,600 --> 02:19:39,560 GOAL, AND WITH THE -- REALLY 3833 02:19:39,560 --> 02:19:42,280 WITH THE EXPECTATION IT'S GOING 3834 02:19:42,280 --> 02:19:44,600 TO GET BETTER ENOUGH TO DO THIS 3835 02:19:44,600 --> 02:19:47,120 IN A DIFFERENT WAY MORE SCALABLE 3836 02:19:47,120 --> 02:19:49,080 BECAUSE ULTIMATELY WE DO NEED TO 3837 02:19:49,080 --> 02:19:49,520 SCALE THIS. 3838 02:19:49,520 --> 02:19:50,440 >>RIGHT. 3839 02:19:50,440 --> 02:19:52,480 THAT'S ONE ANSWER, MAYBE ONE OF 3840 02:19:52,480 --> 02:19:54,800 THE BETTER OR BEST ANSWERS. 3841 02:19:54,800 --> 02:19:56,720 YOU KNOW, LIKE, RIGHT, WE HAVE 3842 02:19:56,720 --> 02:19:59,400 TO DO DISCOVERY, UNDERSTAND WHAT 3843 02:19:59,400 --> 02:20:02,120 OF THE VARIABILITY, WHAT ARE THE 3844 02:20:02,120 --> 02:20:03,200 FIRST COUPLE PRINCIPLE 3845 02:20:03,200 --> 02:20:05,080 COMPONENTS OF IT, AND WE HAVE TO 3846 02:20:05,080 --> 02:20:07,040 HAVE SOME SENSE OF BREADTH 3847 02:20:07,040 --> 02:20:08,480 BEFORE WE CAN IDENTIFY WHAT 3848 02:20:08,480 --> 02:20:12,760 THOSE ARE SO MAYBE ONE POTENTIAL 3849 02:20:12,760 --> 02:20:15,160 ANSWER TO THE QUESTION IS WE 3850 02:20:15,160 --> 02:20:18,200 NEED TO THINK OF, VISUALIZE SOME 3851 02:20:18,200 --> 02:20:19,760 PATHWAY TOWARDS HOW THIS IS 3852 02:20:19,760 --> 02:20:21,640 GOING TO HELP WITH EVENTUAL 3853 02:20:21,640 --> 02:20:27,080 GENERALIZATION BECAUSE OF 3854 02:20:27,080 --> 02:20:28,920 UNPROVEN TECHNOLOGY THAT MAKES 3855 02:20:28,920 --> 02:20:29,920 IT COSTLY, WHATEVER, BUT THAT 3856 02:20:29,920 --> 02:20:32,760 KEEPS US ON TRACK SO WE DON'T 3857 02:20:32,760 --> 02:20:34,840 GET SO OFF THE TRAIL THAT WE'RE 3858 02:20:34,840 --> 02:20:35,920 LIKE REALLY FOCUSING ON ONE 3859 02:20:35,920 --> 02:20:37,360 INDIVIDUAL IN THE WORLD AT THE 3860 02:20:37,360 --> 02:20:40,760 EXPENSE OF MANY, MANY OTHERS. 3861 02:20:40,760 --> 02:20:43,360 3862 02:20:43,360 --> 02:20:46,200 >>GREAT POINT. 3863 02:20:46,200 --> 02:20:46,400 NITA? 3864 02:20:46,400 --> 02:20:49,280 >>YES, SO THIS IS A RICH AND 3865 02:20:49,280 --> 02:20:51,120 REALLY GREAT STARTING POINT I 3866 02:20:51,120 --> 02:20:54,280 THINK TO THE CONVERSATION. 3867 02:20:54,280 --> 02:20:55,720 FOCUSING ON WHAT IF ANYTHING 3868 02:20:55,720 --> 02:20:59,880 NEWG MIGHT DO IN THIS SPACE THAT 3869 02:20:59,880 --> 02:21:01,880 COULD BE SPECIFIC, CONCRETE, 3870 02:21:01,880 --> 02:21:03,280 IMPACTFUL. 3871 02:21:03,280 --> 02:21:04,800 I THINK THE QUESTION IS WHERE 3872 02:21:04,800 --> 02:21:08,640 AND HOW WE MIGHT WANT TO ENGAGE, 3873 02:21:08,640 --> 02:21:11,040 AND JIM MENTIONED THAT THE 3874 02:21:11,040 --> 02:21:12,920 REPORT TALKED THROUGH SOME OF 3875 02:21:12,920 --> 02:21:13,560 THE OPPORTUNITIES FOR 3876 02:21:13,560 --> 02:21:14,880 ENGAGEMENT, AND I WONDER IF I 3877 02:21:14,880 --> 02:21:16,720 MIGHT PUT HIM ON THE SPOT AND 3878 02:21:16,720 --> 02:21:17,720 INVITE HIM TO PUT SOME OF THOSE 3879 02:21:17,720 --> 02:21:21,200 ON THE TABLE FOR US TO DISCUSS 3880 02:21:21,200 --> 02:21:23,960 AS A STARTING PLACE RATHER THAN 3881 02:21:23,960 --> 02:21:25,840 REINVENTING THE WHEEL. 3882 02:21:25,840 --> 02:21:28,080 BUT THE QUESTION I THINK AT HAND 3883 02:21:28,080 --> 02:21:30,280 IS, YOU KNOW, FIRST SHOULD WE, 3884 02:21:30,280 --> 02:21:32,880 AND I THINK THE ANSWER TO SHOULD 3885 02:21:32,880 --> 02:21:35,960 WE, IF WE CAN DO SOMETHING 3886 02:21:35,960 --> 02:21:37,080 CONCRETE, SPECIFIC, IMPACTFUL, 3887 02:21:37,080 --> 02:21:39,920 COULD BE WE NEED FURTHER 3888 02:21:39,920 --> 02:21:41,000 CONVERSATIONS, WE'RE READY TO 3889 02:21:41,000 --> 02:21:44,400 DIVE INTO A PAPER OR SPECIFIC 3890 02:21:44,400 --> 02:21:45,960 KINDS OF RECOMMENDATIONS ACROSS 3891 02:21:45,960 --> 02:21:48,400 A PARTICULAR SPACE, BUT 3892 02:21:48,400 --> 02:21:51,320 SOMETHING THAT COULD BE USEFUL 3893 02:21:51,320 --> 02:21:52,840 IS MY HOPE WE'LL FOCUS OUR 3894 02:21:52,840 --> 02:21:53,400 EFFORTS ON. 3895 02:21:53,400 --> 02:21:55,760 JIM, COULD I ASK YOU TO PUT YOU 3896 02:21:55,760 --> 02:21:57,240 ON THE SPOT TO SAY PUT SOME OF 3897 02:21:57,240 --> 02:22:00,640 THOSE ON THE TABLE SO WE DON'T 3898 02:22:00,640 --> 02:22:01,600 REINVENT THE WHEEL OF THE 3899 02:22:01,600 --> 02:22:02,920 IMPORTANT WORK YOU'VE ALREADY 3900 02:22:02,920 --> 02:22:03,560 DONE ON THIS? 3901 02:22:03,560 --> 02:22:07,080 >>YOU CAN CERTAINLY ASK BUT 3902 02:22:07,080 --> 02:22:07,880 UNFORTUNATELY I HAVEN'T LOOKED 3903 02:22:07,880 --> 02:22:10,280 AT THE REPORT IN A WHILE. 3904 02:22:10,280 --> 02:22:12,560 WHAT I HAVE TO DO IS LOOK 3905 02:22:12,560 --> 02:22:14,080 THROUGH AND SEND PEOPLE AN 3906 02:22:14,080 --> 02:22:16,080 E-MAIL WITH, TO WHAT 3907 02:22:16,080 --> 02:22:17,680 RECOMMENDATIONS WERE UNLESS 3908 02:22:17,680 --> 02:22:20,680 KAREN OR CHRISTINE, ALSO ON THE 3909 02:22:20,680 --> 02:22:22,200 COMMITTEE, MIGHT REMEMBER MORE 3910 02:22:22,200 --> 02:22:22,760 SELECTIVELY. 3911 02:22:22,760 --> 02:22:24,040 WE DID HIGHLIGHT VARIOUS ISSUES 3912 02:22:24,040 --> 02:22:26,440 THAT MAY COME UP AND MIGHT BE 3913 02:22:26,440 --> 02:22:28,560 ADDRESSABLE, AND THERE WERE SOME 3914 02:22:28,560 --> 02:22:29,400 RECOMMENDATIONS ALONG THE WAY 3915 02:22:29,400 --> 02:22:32,480 BUT UNFORTUNATELY WHAT I HAVE TO 3916 02:22:32,480 --> 02:22:33,440 DO IS SEND AN E-MAIL FOLLOW-UP 3917 02:22:33,440 --> 02:22:35,880 WITH RESPECT TO IT. 3918 02:22:35,880 --> 02:22:36,440 SORRY, NITA. 3919 02:22:36,440 --> 02:22:37,440 >>THAT'S OKAY. 3920 02:22:37,440 --> 02:22:39,720 LET ME OPEN THE CONVERSATION 3921 02:22:39,720 --> 02:22:40,200 THEN -- 3922 02:22:40,200 --> 02:22:42,480 >>I CAN ADD A FEW RELATED TO 3923 02:22:42,480 --> 02:22:44,640 THAT IF YOU'D LIKE. 3924 02:22:44,640 --> 02:22:45,240 >>PLEASE, KAREN. 3925 02:22:45,240 --> 02:22:48,280 >>I THINK ACTUALLY FOR FUTURE 3926 02:22:48,280 --> 02:22:51,160 REFERENCE, CHAPTERS 5 AND 6 ARE 3927 02:22:51,160 --> 02:22:52,120 PARTICULARLY HELPFUL, AND AT THE 3928 02:22:52,120 --> 02:22:55,720 END OF ALL OF THEM WE HAD A 3929 02:22:55,720 --> 02:22:56,360 GREAT STRUCTURE, THERE'S 3930 02:22:56,360 --> 02:22:58,800 BULLETED POINTS IN THE END, 3931 02:22:58,800 --> 02:23:00,080 ACTION ITEMS. 3932 02:23:00,080 --> 02:23:01,720 A LOT OF THEM I THINK HAVE 3933 02:23:01,720 --> 02:23:04,880 SPECIFIC THINGS BUT FIT AROUND 3934 02:23:04,880 --> 02:23:06,080 GENERAL THEMES THAT WITHIN WHAT 3935 02:23:06,080 --> 02:23:09,000 MOST OF US THINK NEWG SHOULD BE 3936 02:23:09,000 --> 02:23:12,520 DOING, AND A LOT OF THAT PROCESS 3937 02:23:12,520 --> 02:23:14,000 AND METHODOLOGY IS RAISING 3938 02:23:14,000 --> 02:23:16,080 AWARENESS, AND SOME OF THAT WILL 3939 02:23:16,080 --> 02:23:18,720 BE A DEVELOPMENT OF CERTAIN 3940 02:23:18,720 --> 02:23:19,600 RESOURCES, TOOLS, WE TALKED 3941 02:23:19,600 --> 02:23:24,000 ABOUT THAT FOR A LONG TIME BUT 3942 02:23:24,000 --> 02:23:25,840 NEUROETHICS ROADMAP DEMOCRATIZES 3943 02:23:25,840 --> 02:23:26,600 THAT. 3944 02:23:26,600 --> 02:23:29,760 THE OTHER IS ABOUT CONVENING, 3945 02:23:29,760 --> 02:23:31,760 SOMETHING WE'VE DONE WELL, AND I 3946 02:23:31,760 --> 02:23:32,840 THINK ALSO CAROLINE MENTIONED 3947 02:23:32,840 --> 02:23:34,960 SOMETHING IMPORTANT THAT I HOPE 3948 02:23:34,960 --> 02:23:39,520 COMES BACK TOO, WHICH IS 3949 02:23:39,520 --> 02:23:41,240 INVITATION TO INCLUDE ADVOCATES, 3950 02:23:41,240 --> 02:23:44,240 AND CHAPTER 5 ESPECIALLY TALKS 3951 02:23:44,240 --> 02:23:45,200 ABOUT REAL WORLD TRANSLATION SO 3952 02:23:45,200 --> 02:23:46,960 I THINK THERE'S PIECES IN THERE 3953 02:23:46,960 --> 02:23:49,040 THAT TALK ABOUT BUILDING 3954 02:23:49,040 --> 02:23:51,000 COMMUNITY THAT RAISE AWARENESS, 3955 02:23:51,000 --> 02:23:53,920 BUILDING TOOLS, THAT WE COULD 3956 02:23:53,920 --> 02:23:57,240 SPEAK TOWARDS. 3957 02:23:57,240 --> 02:23:59,000 TOOLS COULD BE CERTAINLY BREAD 3958 02:23:59,000 --> 02:24:01,320 AND BUTTER OF THIS ECOSYSTEM, 3959 02:24:01,320 --> 02:24:02,360 HIGH IMPACT ACADEMIC PAPER, BUT 3960 02:24:02,360 --> 02:24:05,800 THERE MIGHT BE SOME OTHER THINGS 3961 02:24:05,800 --> 02:24:07,400 THAT WE CO-CREATE TOO. 3962 02:24:07,400 --> 02:24:09,640 GENERALLY THOSE ARE THINGS I 3963 02:24:09,640 --> 02:24:11,360 WOULD ENCOURAGE US TO LOOK AT 3964 02:24:11,360 --> 02:24:12,800 THOSE SPECIFIC BULLETED POINTS 3965 02:24:12,800 --> 02:24:20,880 AND CALL OUT BOXES AROUND THOSE 3966 02:24:20,880 --> 02:24:21,640 THEMATIC AREAS. 3967 02:24:21,640 --> 02:24:23,360 I'LL LEAVE IT AT THAT. 3968 02:24:23,360 --> 02:24:25,480 >>YOU MAY REMEMBER WE HAD A 3969 02:24:25,480 --> 02:24:29,520 LIST OF THINGS THAT CAME OUT OF 3970 02:24:29,520 --> 02:24:31,960 THE ROADMAP THAT WERE POSSIBLE 3971 02:24:31,960 --> 02:24:33,560 TOPICS FOR THE NEWG TO WORK ON. 3972 02:24:33,560 --> 02:24:35,120 AND I HAVE THAT LIST, I THINK. 3973 02:24:35,120 --> 02:24:37,520 I DON'T KNOW IF IT'S THE MOST 3974 02:24:37,520 --> 02:24:38,920 UP-TO-DATE ONE BUT I COULD PULL 3975 02:24:38,920 --> 02:24:39,640 IT UP. 3976 02:24:39,640 --> 02:24:43,880 IT'S GOT A LOT OF STUFF ON IT. 3977 02:24:43,880 --> 02:24:46,280 AS KAREN SAID, SOME OF IT IS 3978 02:24:46,280 --> 02:24:48,040 SPECIFIC CHAPTERS BUT THERE'S 3979 02:24:48,040 --> 02:24:50,080 IDEAS THROUGHOUT THE ROADMAP FOR 3980 02:24:50,080 --> 02:24:51,400 DIFFERENT THINGS THAT MIGHT BE 3981 02:24:51,400 --> 02:24:54,600 RELEVANT TO WHAT WE'RE TALKING 3982 02:24:54,600 --> 02:24:54,880 ABOUT TODAY. 3983 02:24:54,880 --> 02:24:58,200 >>IT WOULD BE GREAT TO FOLLOW 3984 02:24:58,200 --> 02:24:59,120 THAT UP, CHRISTINE. 3985 02:24:59,120 --> 02:25:01,600 WHILE YOU DO THAT, I MIGHT 3986 02:25:01,600 --> 02:25:02,800 INVITE US TO THINK ABOUT 3987 02:25:02,800 --> 02:25:06,320 WHATEVER WE LAND ON IN THIS 3988 02:25:06,320 --> 02:25:08,120 SPACE THAT WINSTON SAID HE WAS 3989 02:25:08,120 --> 02:25:09,200 TRYING TO WRAP HIS HEAD AROUND 3990 02:25:09,200 --> 02:25:12,360 WHAT THE SCOPE OF THE 3991 02:25:12,360 --> 02:25:13,600 CONVERSATION REALLY IS ABOUT. 3992 02:25:13,600 --> 02:25:18,040 AND I WANT TO INVITE REFLECTIONS 3993 02:25:18,040 --> 02:25:22,560 ON THAT, THE CONVERSATION ON 3994 02:25:22,560 --> 02:25:23,040 PERSUADING, MODULATING, 3995 02:25:23,040 --> 02:25:23,680 MANIPULATING, CHANGING THE BRAIN 3996 02:25:23,680 --> 02:25:26,600 WHICH, AGAIN, COULD BE AN 3997 02:25:26,600 --> 02:25:27,560 ENORMOUS SCOPE. 3998 02:25:27,560 --> 02:25:29,480 ANDREA'S POINT IT'S FOCUSED ON 3999 02:25:29,480 --> 02:25:32,080 HEALTH AND BRAIN IS A LIMITING 4000 02:25:32,080 --> 02:25:33,240 FACTOR BUT NOT PRECISELY 4001 02:25:33,240 --> 02:25:35,560 LIMITING FACTOR SO I WANT TO 4002 02:25:35,560 --> 02:25:38,920 INVITE ANY COMMENTS ON INTEREST 4003 02:25:38,920 --> 02:25:40,560 IN SCOPING THE PROBLEM FOR 4004 02:25:40,560 --> 02:25:43,280 CONSIDERATION BY NEWG. 4005 02:25:43,280 --> 02:25:48,520 4006 02:25:48,520 --> 02:25:51,160 >>JOHN, YOU HAD A HAND THAT 4007 02:25:51,160 --> 02:25:52,800 WENT UP FOR A MILLISECOND? 4008 02:25:52,800 --> 02:25:53,640 NO? 4009 02:25:53,640 --> 02:25:57,160 IT WAS MY EYES PLAYING TRICKS ON 4010 02:25:57,160 --> 02:25:58,160 ME. 4011 02:25:58,160 --> 02:25:58,320 JIM? 4012 02:25:58,320 --> 02:26:00,760 >>YEAH, THANKS, NITA. 4013 02:26:00,760 --> 02:26:02,320 YEAH, WITH RESPECT TO THE SCOPE, 4014 02:26:02,320 --> 02:26:04,280 AGAIN MAYBE GOING BACK TO WHAT I 4015 02:26:04,280 --> 02:26:05,720 MENTIONED AT THE VERY BEGINNING 4016 02:26:05,720 --> 02:26:06,680 OF THIS DISCUSSION, FOR ME 4017 02:26:06,680 --> 02:26:10,400 REALLY ONE OF THE MOST IMPORTANT 4018 02:26:10,400 --> 02:26:16,600 ASPECTS IS REVERSIBLE VERSUS 4019 02:26:16,600 --> 02:26:16,960 NON-REVERSIBLE. 4020 02:26:16,960 --> 02:26:20,480 REVERSIBLE COULD BE PROBLEMATIC 4021 02:26:20,480 --> 02:26:23,520 BUT SOMETHING THAT'S NOT 4022 02:26:23,520 --> 02:26:24,320 REVERSIBLE MAYBE THERAPEUTIC FOR 4023 02:26:24,320 --> 02:26:27,280 A WHILE BUT THE TRIAL STOPS AND 4024 02:26:27,280 --> 02:26:29,760 THERE'S NO RECOURSE FOR THE 4025 02:26:29,760 --> 02:26:32,880 PATIENT AFTER THAT, I THINK THEY 4026 02:26:32,880 --> 02:26:33,640 DO REQUIRE DIFFERENT ETHICAL 4027 02:26:33,640 --> 02:26:34,600 CONSIDERATIONS AND WE MAY WANT 4028 02:26:34,600 --> 02:26:38,560 TO LIMIT OURSELVES TO ONE VERSUS 4029 02:26:38,560 --> 02:26:39,760 THE OTHER, MAYBE DISCUSS 4030 02:26:39,760 --> 02:26:40,760 DISTINCTIONS MORE BUT I THINK 4031 02:26:40,760 --> 02:26:44,920 THAT'S ONE OF THE KEY ASPECTS 4032 02:26:44,920 --> 02:26:45,240 FOR ME. 4033 02:26:45,240 --> 02:26:47,920 >>THAT'S HELPFUL. 4034 02:26:47,920 --> 02:26:50,400 I WILL SAY ONE IS A CATEGORY IS 4035 02:26:50,400 --> 02:26:51,200 IMPACT, RIGHT? 4036 02:26:51,200 --> 02:26:53,160 AS JIM HAS PUT WITHIN THAT 4037 02:26:53,160 --> 02:26:55,240 IMPACT WHETHER IT'S REVERSIBLE 4038 02:26:55,240 --> 02:26:57,200 OR IRREVERSIBLE. 4039 02:26:57,200 --> 02:26:58,520 TO ME PART OF THE QUESTION IS 4040 02:26:58,520 --> 02:27:00,160 HOW IT'S DONE AS WELL SO THAT'S 4041 02:27:00,160 --> 02:27:03,160 WHY I RAISE THE OPEN LOOP VERSUS 4042 02:27:03,160 --> 02:27:05,320 CLOSED LOOP, BECAUSE I THINK 4043 02:27:05,320 --> 02:27:06,960 THAT HAS INTERESTING DIFFERENCES 4044 02:27:06,960 --> 02:27:08,320 AND IMPLICATIONS PARTICULARLY AS 4045 02:27:08,320 --> 02:27:12,320 YOU BRING MORE A.I. INTO THE 4046 02:27:12,320 --> 02:27:14,520 PICTURE OF CLOSED LOOP FOR WHAT 4047 02:27:14,520 --> 02:27:16,800 MEANS AND HOW WE MONITOR AND 4048 02:27:16,800 --> 02:27:18,960 EFFECTS AND POSSIBLE RISKS AS 4049 02:27:18,960 --> 02:27:19,320 WELL. 4050 02:27:19,320 --> 02:27:19,560 WINSTON? 4051 02:27:19,560 --> 02:27:21,840 >>IF I COULD JUMP IN TO FOLLOW 4052 02:27:21,840 --> 02:27:23,680 UP ON JIM'S COMMENT. 4053 02:27:23,680 --> 02:27:24,800 THAT'S AN IMPORTANT POINT BUT 4054 02:27:24,800 --> 02:27:29,280 JUST TO MAKE IT A LITTLE BIT 4055 02:27:29,280 --> 02:27:31,240 MORE INTERESTING I MEAN HOW WILL 4056 02:27:31,240 --> 02:27:32,560 WE NECESSARILY KNOW AHEAD OF 4057 02:27:32,560 --> 02:27:35,960 TIME WHAT WILL BE REVERSIBLE OR 4058 02:27:35,960 --> 02:27:36,360 NOT REVERSIBLE? 4059 02:27:36,360 --> 02:27:40,000 >>AND WHAT DOES THAT EVEN MEAN, 4060 02:27:40,000 --> 02:27:40,200 RIGHT? 4061 02:27:40,200 --> 02:27:41,880 >>I WAS GOING TO PIVOT OFF OF 4062 02:27:41,880 --> 02:27:43,280 THAT ALSO. 4063 02:27:43,280 --> 02:27:45,320 I THINK THAT, YOU KNOW, IT'S 4064 02:27:45,320 --> 02:27:46,720 MAYBE IMPORTANT TO THINK ABOUT 4065 02:27:46,720 --> 02:27:48,120 BUT THERE'S A CONTEXT OF OTHER 4066 02:27:48,120 --> 02:27:51,160 THINGS THAT PEOPLE ARE DOING TO 4067 02:27:51,160 --> 02:27:53,920 AFFECT BRAIN FUNCTION, AS WE 4068 02:27:53,920 --> 02:27:55,400 SAID BEFORE, PROBABLY WOULDN'T 4069 02:27:55,400 --> 02:27:56,520 FULL UNDER THE SCOPE OF THIS 4070 02:27:56,520 --> 02:27:58,600 TECHNOLOGY BUT HAVE WIDE RANGING 4071 02:27:58,600 --> 02:28:00,480 IMPACTS WE DON'T UNDERSTAND. 4072 02:28:00,480 --> 02:28:02,200 YOU KNOW, THE NOVEL TECHNOLOGIES 4073 02:28:02,200 --> 02:28:03,640 ARE IN A SPACE WHERE THOSE OTHER 4074 02:28:03,640 --> 02:28:05,960 THINGS THAT ARE GOING ON WHERE 4075 02:28:05,960 --> 02:28:08,880 WE REALLY DON'T KNOW, I THINK 4076 02:28:08,880 --> 02:28:10,960 THAT, YOU KNOW, FOR ALL WE SAID 4077 02:28:10,960 --> 02:28:13,160 ABOUT MECHANISM OF ACTION LIKE A 4078 02:28:13,160 --> 02:28:14,480 LOT OF MEDICATIONS WIDELY USED 4079 02:28:14,480 --> 02:28:16,800 IN THE BRAIN WE DON'T REALLY 4080 02:28:16,800 --> 02:28:18,440 UNDERSTAND MECHANISM OF ACTION 4081 02:28:18,440 --> 02:28:21,160 AND STATISTICS IS 1 IN 8 4082 02:28:21,160 --> 02:28:24,000 AMERICANS IS TAKING AN SSRI, WE 4083 02:28:24,000 --> 02:28:25,560 DON'T REALLY KNOW HOW THEY WORK, 4084 02:28:25,560 --> 02:28:27,800 THERE'S A LOT OF CONTROVERSY 4085 02:28:27,800 --> 02:28:29,160 ABOUT WHAT THE LONG-TERM EFFECTS 4086 02:28:29,160 --> 02:28:32,200 OF THESE MEDICATIONS ARE AND SO 4087 02:28:32,200 --> 02:28:32,400 FORTH. 4088 02:28:32,400 --> 02:28:33,240 OF COURSE, THE CLINICAL TRIALS 4089 02:28:33,240 --> 02:28:35,840 ON WHICH THEY WERE APPROVED 4090 02:28:35,840 --> 02:28:37,600 FOLLOWED PEOPLE FOR MUCH SHORTER 4091 02:28:37,600 --> 02:28:41,960 PERIODS OF TIME AND WITH A 4092 02:28:41,960 --> 02:28:42,960 DIFFERENT MODEL FOR 4093 02:28:42,960 --> 02:28:44,200 PSYCHOPHARMACOLOGIC TREATMENT 4094 02:28:44,200 --> 02:28:46,840 THAN IS CURRENTLY BEING USED. 4095 02:28:46,840 --> 02:28:48,120 THERE'S SIMILAR QUESTIONS THAT 4096 02:28:48,120 --> 02:28:53,080 MIGHT -- THAT WE MIGHT HAVE 4097 02:28:53,080 --> 02:28:55,720 ABOUT OTHER WIDESPREAD 4098 02:28:55,720 --> 02:28:58,120 INTERVENTIONS, THINGS LIKE 4099 02:28:58,120 --> 02:28:59,040 UNIVERSAL CHILDHOOD EDUCATION IS 4100 02:28:59,040 --> 02:29:01,520 ONE THING WITH THE MOST 4101 02:29:01,520 --> 02:29:02,840 INFLUENCE ON BRAIN FUNCTION, WE 4102 02:29:02,840 --> 02:29:05,240 SEE IT IN MY FIELD OF DEMENTIA, 4103 02:29:05,240 --> 02:29:07,320 WHY AGE ADJUST THE RATES ARE 4104 02:29:07,320 --> 02:29:07,880 FOLLOWING IN MANY PLACES, 4105 02:29:07,880 --> 02:29:09,200 PROBABLY HAS TO DO WITH THINGS 4106 02:29:09,200 --> 02:29:11,920 LIKE THAT AS WELL AS OTHER SORT 4107 02:29:11,920 --> 02:29:16,720 OF HEALTH BEHAVIORS. 4108 02:29:16,720 --> 02:29:19,680 SO, I THINK THIS ISSUE OF 4109 02:29:19,680 --> 02:29:20,800 DISENTANGLING LONG-TERM EFFECT 4110 02:29:20,800 --> 02:29:22,080 IT'S OF BRAIN INTERVENTIONS FROM 4111 02:29:22,080 --> 02:29:24,840 ALL KINDS OF OTHER DOWNSTREAM 4112 02:29:24,840 --> 02:29:26,040 EFFECTS OF LIFESTYLE CHANGES OR 4113 02:29:26,040 --> 02:29:29,000 CHANGES IN THE KINDS OF LINES 4114 02:29:29,000 --> 02:29:30,320 OPENED UP TO PEOPLE, I THINK 4115 02:29:30,320 --> 02:29:33,280 GETS US INTO SOME OF THE REAL 4116 02:29:33,280 --> 02:29:34,160 MESSINESS ABOUT TRYING TO STUDY 4117 02:29:34,160 --> 02:29:37,280 THE BRAIN IN THE FIRST PLACE. 4118 02:29:37,280 --> 02:29:41,720 >>I THINK THAT'S RIGHT. 4119 02:29:41,720 --> 02:29:42,160 JOHN? 4120 02:29:42,160 --> 02:29:43,640 >>YEAH, THANKS, WINSTON. 4121 02:29:43,640 --> 02:29:46,400 IN TERMS OF WHAT WOULD HELP 4122 02:29:46,400 --> 02:29:47,920 "BRAIN," FROM OUR POINT OF VIEW, 4123 02:29:47,920 --> 02:29:52,280 REALLY THIS IS I THINK NEWG'S 4124 02:29:52,280 --> 02:29:54,080 ROLE AND THE VALUE TO "BRAIN" IS 4125 02:29:54,080 --> 02:29:55,880 LET ME TRY TO SYNTHESIZE A 4126 02:29:55,880 --> 02:29:57,560 COUPLE POINTS RAISED. 4127 02:29:57,560 --> 02:30:00,160 THERE'S AN ISSUE THAT CAME UP 4128 02:30:00,160 --> 02:30:01,840 ABOUT HAVING MECHANISM OR EVEN 4129 02:30:01,840 --> 02:30:03,360 ABSENT MECHANISM AT LEAST HAVING 4130 02:30:03,360 --> 02:30:05,120 A HYPOTHESIS FOR WHAT MIGHT BE 4131 02:30:05,120 --> 02:30:06,760 GOING ON, WHETHER YOU'RE GIVING 4132 02:30:06,760 --> 02:30:11,880 A PATIENT, YOU KNOW, A PILL OR 4133 02:30:11,880 --> 02:30:13,520 IMMERSIVE EXPERIENCE OR DIRECTLY 4134 02:30:13,520 --> 02:30:16,480 STIMULATING THE BRAIN WITH AN 4135 02:30:16,480 --> 02:30:18,440 IMPLANT OR INDIRECTLY SAY 4136 02:30:18,440 --> 02:30:19,440 THROUGH FOCUSED ULTRASOUND, 4137 02:30:19,440 --> 02:30:21,960 WHATEVER THE CASE, TO THE EXTENT 4138 02:30:21,960 --> 02:30:23,440 THAT WE UNDERSTAND MECHANISM 4139 02:30:23,440 --> 02:30:26,880 WOULD HELP US TRY TO NAVIGATE 4140 02:30:26,880 --> 02:30:29,160 THESE ISSUES, I THINK IT'S SAFE 4141 02:30:29,160 --> 02:30:31,560 TO SAY THAT THE BRAIN INITIATIVE 4142 02:30:31,560 --> 02:30:33,320 IS A NEUROSCIENCE INITIATIVE, 4143 02:30:33,320 --> 02:30:34,200 NEUROTECHNOLOGY INITIATIVE, NOT 4144 02:30:34,200 --> 02:30:35,720 A BRAIN SCIENCE. 4145 02:30:35,720 --> 02:30:37,080 WHEN WE'RE ULTIMATELY WORKING 4146 02:30:37,080 --> 02:30:40,680 WITH THE BRAIN IT'S BIOLOGICAL 4147 02:30:40,680 --> 02:30:41,640 ORGAN, BIOLOGICAL SYSTEM. 4148 02:30:41,640 --> 02:30:45,360 SO TO THE EXTENT WE MIGHT 4149 02:30:45,360 --> 02:30:48,200 CONSIDER HOW TO NOT SO MUCH 4150 02:30:48,200 --> 02:30:49,840 LIMIT BUT CONSTRAIN AT LEAST THE 4151 02:30:49,840 --> 02:30:50,960 INITIAL SET OF ARGUMENTS OR 4152 02:30:50,960 --> 02:30:54,000 QUESTIONS IN ORDER TO GET SOME 4153 02:30:54,000 --> 02:30:56,000 TRACTION I THINK IF WE STAY 4154 02:30:56,000 --> 02:30:58,080 WITHIN THE SPACE OF LOOKING AT 4155 02:30:58,080 --> 02:31:00,920 STUDIES OR FIELDS WHERE WE MAY 4156 02:31:00,920 --> 02:31:03,440 NOT UNDERSTAND -- WE STILL DON'T 4157 02:31:03,440 --> 02:31:05,120 UNDERSTAND FULLY THE MECHANISM 4158 02:31:05,120 --> 02:31:06,880 OF HOW THE BRAIN WORKS AND 4159 02:31:06,880 --> 02:31:09,120 THAT'S WHY WE'RE HERE, FOR MANY 4160 02:31:09,120 --> 02:31:10,560 GENERATIONS TO COME, BUT IF WE 4161 02:31:10,560 --> 02:31:13,080 CAN KEEP THE CONVERSATION IN THE 4162 02:31:13,080 --> 02:31:14,520 REALM OF WHAT'S BIOLOGICALLY 4163 02:31:14,520 --> 02:31:15,960 POSSIBLE AND WHAT'S 4164 02:31:15,960 --> 02:31:16,800 EXPERIMENTALLY TESTABLE, I THINK 4165 02:31:16,800 --> 02:31:18,560 THAT MIGHT KIND OF KEEP THE 4166 02:31:18,560 --> 02:31:20,400 CONVERSATION A LITTLE BIT MORE 4167 02:31:20,400 --> 02:31:25,120 REAL AND FROM, YOU KNOW, GETTING 4168 02:31:25,120 --> 02:31:26,960 TOO DIFFUSE BECAUSE ULTIMATELY 4169 02:31:26,960 --> 02:31:28,720 FROM -- I HATE TO BE 4170 02:31:28,720 --> 02:31:29,600 TRANSACTIONAL FROM THE BRAIN 4171 02:31:29,600 --> 02:31:31,880 STANDPOINT WE NEED TO UNDERSTAND 4172 02:31:31,880 --> 02:31:33,640 THE IMPACT OF WHAT WE'RE 4173 02:31:33,640 --> 02:31:34,960 SUPPORTING IN THESE DIFFERENT 4174 02:31:34,960 --> 02:31:36,280 AREAS THAT AFFECT HUMANS. 4175 02:31:36,280 --> 02:31:38,360 AND IT'S HARD FOR ME TO KIND OF 4176 02:31:38,360 --> 02:31:40,200 UNDERSTAND HOW WE'RE GOING DO 4177 02:31:40,200 --> 02:31:42,840 THAT IF WE'RE NOT THINKING ABOUT 4178 02:31:42,840 --> 02:31:45,240 A TESTABLE HYPOTHESES OR REALITY 4179 02:31:45,240 --> 02:31:47,520 OF MECHANISMS SO THAT'S MY 4180 02:31:47,520 --> 02:31:49,160 THOUGHTS FROM HEARING A LOT OF 4181 02:31:49,160 --> 02:31:53,360 YOUR INPUT HERE TODAY BASED ON 4182 02:31:53,360 --> 02:31:55,520 THE PRESENTATIONS AND 4183 02:31:55,520 --> 02:31:55,920 CONVERSATION HERE. 4184 02:31:55,920 --> 02:31:58,960 >>THANKS, JOHN. 4185 02:31:58,960 --> 02:31:59,320 TED? 4186 02:31:59,320 --> 02:32:01,360 >>YEAH, JOHN, TO EXTEND THAT 4187 02:32:01,360 --> 02:32:02,880 MORE, I'M THINKING BACK TO SOME 4188 02:32:02,880 --> 02:32:06,600 DISCUSSIONS WE HAD THINKING 4189 02:32:06,600 --> 02:32:07,800 ABOUT BRAIN-COMPUTER INTERFACE, 4190 02:32:07,800 --> 02:32:09,000 AND THE NEUROETHICS AROUND THAT, 4191 02:32:09,000 --> 02:32:12,520 THAT THAT SEEMS LIKE A MORE 4192 02:32:12,520 --> 02:32:13,400 CONCRETE DISCUSSION IN SOME WAYS 4193 02:32:13,400 --> 02:32:16,320 BECAUSE WHAT I WAS GOING TO SAY 4194 02:32:16,320 --> 02:32:18,560 IS WE'RE ACTUALLY ASSUMING -- I 4195 02:32:18,560 --> 02:32:21,000 MEAN ALL THESE THINGS AFFECT THE 4196 02:32:21,000 --> 02:32:22,720 BRAIN, DEPRESSION AND ET CETERA, 4197 02:32:22,720 --> 02:32:25,200 BUT WHAT THEY ARE AND THE NATURE 4198 02:32:25,200 --> 02:32:29,920 AS A DISORDER AND WHETHER THEY 4199 02:32:29,920 --> 02:32:32,440 ARE MICROBIOME OR OUR MOTHER'S 4200 02:32:32,440 --> 02:32:34,840 PLACENTA OR OUR ADRENAL OR OTHER 4201 02:32:34,840 --> 02:32:36,600 THINGS THAT ARE NOT NECESSARILY 4202 02:32:36,600 --> 02:32:38,360 MAPPED TO THE PREFRONTAL CORTEX 4203 02:32:38,360 --> 02:32:39,560 OR SOMETHING IS SOMETHING THAT 4204 02:32:39,560 --> 02:32:41,720 YOU KIND OF GET INTO WHEN YOU 4205 02:32:41,720 --> 02:32:43,160 THINK ABOUT THESE AS DISEASE 4206 02:32:43,160 --> 02:32:43,480 ENTITIES. 4207 02:32:43,480 --> 02:32:47,200 WHICH IS NOT WHAT WE'RE DOING, 4208 02:32:47,200 --> 02:32:47,520 RIGHT? 4209 02:32:47,520 --> 02:32:49,720 SO THAT'S I THINK WHAT YOU SAID, 4210 02:32:49,720 --> 02:32:52,760 JOHN, IS AN IMPORTANT AND ANDREA 4211 02:32:52,760 --> 02:32:54,080 CHIMED IN TO KEEP US THINKING 4212 02:32:54,080 --> 02:32:55,600 ABOUT THE BRAIN INITIATIVE. 4213 02:32:55,600 --> 02:32:57,800 THAT MAY MEAN THERE ARE 4214 02:32:57,800 --> 02:32:58,920 PARTICULAR ASPECTS IN THIS SPACE 4215 02:32:58,920 --> 02:33:02,080 WE MIGHT WANT TO FOCUS ON, AND 4216 02:33:02,080 --> 02:33:04,040 THE NEUROETHICS ISSUES OF THAT, 4217 02:33:04,040 --> 02:33:05,920 FOR EXAMPLE, THE BRAIN-COMPUTER 4218 02:33:05,920 --> 02:33:08,440 INTERFACE WORK. 4219 02:33:08,440 --> 02:33:11,960 4220 02:33:11,960 --> 02:33:13,960 >>PERFECT. 4221 02:33:13,960 --> 02:33:16,560 KAREN? 4222 02:33:16,560 --> 02:33:18,880 >>AGAIN, I REALLY LIKED THESE 4223 02:33:18,880 --> 02:33:21,200 THREE QUESTIONS. 4224 02:33:21,200 --> 02:33:24,400 I REALLY APPRECIATE THIS 4225 02:33:24,400 --> 02:33:24,680 APPROACH. 4226 02:33:24,680 --> 02:33:28,240 I THINK I WANT TO RESONATE WITH 4227 02:33:28,240 --> 02:33:31,200 OTHERS THE APPROPRIATE SCOPE 4228 02:33:31,200 --> 02:33:33,280 SEEMS TO BE WHATEVER "BRAIN" IS 4229 02:33:33,280 --> 02:33:35,920 DOING AND FUNDING, AND WHAT I 4230 02:33:35,920 --> 02:33:37,560 APPRECIATED CHRISTINE DID AT ONE 4231 02:33:37,560 --> 02:33:39,640 POINT, HANK ALSO DID AT EACH 4232 02:33:39,640 --> 02:33:41,400 MEETING, ASK THE RESEARCHERS WHO 4233 02:33:41,400 --> 02:33:43,120 WE INVITED TO ATTEND WHAT THEY 4234 02:33:43,120 --> 02:33:45,960 NEED AND WHAT WE CAN DO TO HELP 4235 02:33:45,960 --> 02:33:46,160 THEM. 4236 02:33:46,160 --> 02:33:48,160 AND I THINK KIND OF MY VISION, 4237 02:33:48,160 --> 02:33:49,280 MY PERSONAL VISION STATEMENT FOR 4238 02:33:49,280 --> 02:33:51,240 THIS GROUP HAS ALWAYS BEEN THAT 4239 02:33:51,240 --> 02:33:52,520 WE'RE EMPOWERING THE RESEARCHERS 4240 02:33:52,520 --> 02:33:54,920 SO THEY CAN EMPOWER THE PUBLIC 4241 02:33:54,920 --> 02:33:58,440 TO RECEIVE THE BENEFITS OF THEIR 4242 02:33:58,440 --> 02:33:58,800 SCIENCE. 4243 02:33:58,800 --> 02:34:00,080 THAT'S AN ORIENTATION, HOW CAN 4244 02:34:00,080 --> 02:34:03,760 WE HELP THE BRAIN RESEARCHERS? 4245 02:34:03,760 --> 02:34:05,360 AN OPEN QUESTION WHICH DOESN'T 4246 02:34:05,360 --> 02:34:07,400 FOCUS HERE LIKE FOR SCOPE BUT 4247 02:34:07,400 --> 02:34:10,920 STILL WHETHER WE WANT TO SERVE 4248 02:34:10,920 --> 02:34:13,320 IN A FORESIGHT FUNCTION OR EVEN 4249 02:34:13,320 --> 02:34:14,520 A FOUNDATIONAL ISSUE, KIND OF 4250 02:34:14,520 --> 02:34:15,920 ADDRESSING ISSUES LIKE WHAT IT 4251 02:34:15,920 --> 02:34:18,120 MEANS TO QUANTIFY THE HUMAN 4252 02:34:18,120 --> 02:34:18,480 EXPERIENCE. 4253 02:34:18,480 --> 02:34:19,880 MAYBE THIS IS DISTINCTION THAT 4254 02:34:19,880 --> 02:34:21,280 "BRAIN" HAS ON PURPOSE FROM THE 4255 02:34:21,280 --> 02:34:23,480 HUMAN BRAIN PROJECT BUT THE 4256 02:34:23,480 --> 02:34:26,440 HUMAN BRAIN PROJECT PUT OUT A 4257 02:34:26,440 --> 02:34:29,120 LOT OF MATERIALS ON THOSE TYPES 4258 02:34:29,120 --> 02:34:30,360 OF ISSUES THAT REALLY INTERESTED 4259 02:34:30,360 --> 02:34:31,360 THE SCIENTISTS IN THAT GROUP. 4260 02:34:31,360 --> 02:34:32,560 YOU'D BE SURPRISED. 4261 02:34:32,560 --> 02:34:34,440 THAT FURTHER CALLED FOR THEM TO 4262 02:34:34,440 --> 02:34:36,520 DEVELOP MODULES FOR THE 4263 02:34:36,520 --> 02:34:37,720 SCIENTISTS ON THESE SPECIFIC 4264 02:34:37,720 --> 02:34:40,240 TARGETED ISSUES, AND NOW WE SEE 4265 02:34:40,240 --> 02:34:41,640 IN THE SECOND GENERATION TOWARDS 4266 02:34:41,640 --> 02:34:44,080 E BRAINS, A COMMUNITY OF 4267 02:34:44,080 --> 02:34:45,640 RESEARCHERS READY TO BE ENGAGED. 4268 02:34:45,640 --> 02:34:46,960 IT'S NOT FREE OF PROBLEMS. 4269 02:34:46,960 --> 02:34:48,240 THEY HAVE HAD A LOT OF 4270 02:34:48,240 --> 02:34:49,560 CHALLENGES TOO BUT IT'S 4271 02:34:49,560 --> 02:34:50,440 INTERESTING MODEL. 4272 02:34:50,440 --> 02:34:52,920 I GUESS AS FAR AS SCOPE I THINK 4273 02:34:52,920 --> 02:34:56,520 I'M CLEAR ABOUT THINKING ABOUT 4274 02:34:56,520 --> 02:34:59,160 WHAT BRAIN RESEARCHERS WANT AND 4275 02:34:59,160 --> 02:35:00,120 NEED, BUT ALSO A QUESTION 4276 02:35:00,120 --> 02:35:02,720 WHETHER WE WANT TO THINK ABOUT 4277 02:35:02,720 --> 02:35:03,400 FORESIGHT AND FOUNDATIONAL 4278 02:35:03,400 --> 02:35:05,080 ISSUES BECAUSE IF WE'RE GOING TO 4279 02:35:05,080 --> 02:35:08,560 DO THOSE THINGS WE MIGHT HAVE 4280 02:35:08,560 --> 02:35:11,200 BROADER REACH, PARTICULARLY 4281 02:35:11,200 --> 02:35:14,200 WALTER KEPT PUSHING US TO ASK 4282 02:35:14,200 --> 02:35:18,360 ABOUT MISUSE, AND CHRISTINE ALSO 4283 02:35:18,360 --> 02:35:19,440 ASKED ABOUT THAT TOO. 4284 02:35:19,440 --> 02:35:21,280 YOU COULD SEE IT WAS QUITE 4285 02:35:21,280 --> 02:35:23,800 DIFFICULT FOR THEM TO GO BEYOND 4286 02:35:23,800 --> 02:35:27,080 HARM, LIKE THE TYPICAL RCR 4287 02:35:27,080 --> 02:35:28,360 COMPLIANCE TRAINING THAT WE 4288 02:35:28,360 --> 02:35:30,160 REQUIRE PEOPLE TO TAKE. 4289 02:35:30,160 --> 02:35:33,320 SO I THINK THAT'S A NON-TRIVIAL 4290 02:35:33,320 --> 02:35:43,320 ISSUE FOR US TO DISCUSS. 4291 02:35:43,320 --> 02:35:44,280 >>THANKS, KAREN. 4292 02:35:44,280 --> 02:35:44,920 THAT'S HELPFUL. 4293 02:35:44,920 --> 02:35:49,280 I AGREE, WE ALL AGREE ON SCOPE 4294 02:35:49,280 --> 02:35:51,360 STARTING WITH AT LEAST BRAIN, 4295 02:35:51,360 --> 02:35:51,560 RIGHT? 4296 02:35:51,560 --> 02:35:54,440 THAT'S PART OF WHY WE ROOTED 4297 02:35:54,440 --> 02:35:55,440 THIS CONVERSATION IN BRAIN, 4298 02:35:55,440 --> 02:35:56,160 GOING FORWARD OBVIOUSLY THAT'S 4299 02:35:56,160 --> 02:35:59,360 WHERE IT COULD BE MOST IMPACTFUL 4300 02:35:59,360 --> 02:35:59,680 AND HELPFUL. 4301 02:35:59,680 --> 02:36:01,760 AGREED ALSO WE NEED TO FIGURE 4302 02:36:01,760 --> 02:36:05,920 OUT FROM THE RESEARCHER'S 4303 02:36:05,920 --> 02:36:06,520 PERSPECTIVE, PROGRAM OFFICERS' 4304 02:36:06,520 --> 02:36:08,440 PERSPECTIVE, WHAT ARE THE BIG 4305 02:36:08,440 --> 02:36:08,960 QUESTIONS. 4306 02:36:08,960 --> 02:36:11,960 BUT PART OF IT IS FORESIGHT, 4307 02:36:11,960 --> 02:36:14,160 KAREN, FORESIGHT WITH RESPECT TO 4308 02:36:14,160 --> 02:36:16,440 THE EMERGING ETHICAL ISSUES THAT 4309 02:36:16,440 --> 02:36:20,600 ARE BEYOND RCR, AND HELPING TO 4310 02:36:20,600 --> 02:36:22,040 HAVE FORESIGHT WITH RESPECT TO 4311 02:36:22,040 --> 02:36:23,560 WHAT THOSE ISSUES ARE. 4312 02:36:23,560 --> 02:36:25,440 CHRISTINE WILL SHARE WITH US 4313 02:36:25,440 --> 02:36:29,360 HERE JUST THE SLIDES FROM BRAIN 4314 02:36:29,360 --> 02:36:33,880 2.0, BUT LET ME SUGGEST BASED ON 4315 02:36:33,880 --> 02:36:34,840 THIS CONVERSATION GIVEN WE'RE IN 4316 02:36:34,840 --> 02:36:36,720 THE EARLY STAGES OF IT MAYBE A 4317 02:36:36,720 --> 02:36:38,320 WORKSHOP IS A GOOD NEXT STEP FOR 4318 02:36:38,320 --> 02:36:44,320 US TO FLESH OUT THESE ISSUES, 4319 02:36:44,320 --> 02:36:47,640 DOESN'T SOUND LIKE WE'RE READY 4320 02:36:47,640 --> 02:36:49,480 TO COALESCE AROUND CO-CREATED 4321 02:36:49,480 --> 02:36:51,680 PAPER OR SOMETHING TO THAT 4322 02:36:51,680 --> 02:36:52,080 EFFECT. 4323 02:36:52,080 --> 02:36:53,320 SO I'M PUTTING THAT OUT THERE 4324 02:36:53,320 --> 02:36:54,560 FOR A TEMPERATURE CHECK TO SEE 4325 02:36:54,560 --> 02:36:56,720 HOW PEOPLE FEEL ABOUT THAT AS A 4326 02:36:56,720 --> 02:36:58,600 POSSIBILITY FOR MOVING AHEAD. 4327 02:36:58,600 --> 02:36:59,440 CHRISTINE, WILL YOU SHARE THAT 4328 02:36:59,440 --> 02:37:02,240 IN THIS IS A DEEP DIVE, 4329 02:37:02,240 --> 02:37:03,600 COMPREHENSIVE WITH JUST 8 4330 02:37:03,600 --> 02:37:04,480 MINUTES REMAINING WE'RE NOT 4331 02:37:04,480 --> 02:37:07,240 GOING TO GO THROUGH ALL OF IT 4332 02:37:07,240 --> 02:37:08,000 BUT JUST REFRESH OUR 4333 02:37:08,000 --> 02:37:10,240 RECOLLECTION AS TO THE ISSUES ON 4334 02:37:10,240 --> 02:37:10,440 THIS. 4335 02:37:10,440 --> 02:37:10,840 >>SURE. 4336 02:37:10,840 --> 02:37:14,880 I THINK IT MIGHT TAKE US IN A 4337 02:37:14,880 --> 02:37:16,320 DIFFERENT DIRECTION BUT I'LL PUT 4338 02:37:16,320 --> 02:37:18,240 THEM UP BECAUSE IT IS WORTH 4339 02:37:18,240 --> 02:37:18,840 SEEING. 4340 02:37:18,840 --> 02:37:21,320 THIS IS FROM JANUARY OF 2021. 4341 02:37:21,320 --> 02:37:25,280 SO TWO YEARS AGO. 4342 02:37:25,280 --> 02:37:27,120 >>I WONDER IF YOU COULD DO IT 4343 02:37:27,120 --> 02:37:30,000 AS A SLIDE SHOW BECAUSE IT'S 4344 02:37:30,000 --> 02:37:30,200 SMALL. 4345 02:37:30,200 --> 02:37:30,840 >>I CAN. 4346 02:37:30,840 --> 02:37:32,840 IT TAKES ME A MINUTE TO FIGURE 4347 02:37:32,840 --> 02:37:33,400 IT OUT. 4348 02:37:33,400 --> 02:37:34,880 CAN YOU SEE THAT? 4349 02:37:34,880 --> 02:37:35,440 >>YES, GREAT. 4350 02:37:35,440 --> 02:37:37,640 >>SO, THIS WAS TWO YEARS AGO. 4351 02:37:37,640 --> 02:37:40,240 AND WE ASKED OURSELVES SOME OF 4352 02:37:40,240 --> 02:37:40,880 THE SAME QUESTIONS. 4353 02:37:40,880 --> 02:37:45,240 >>CAN YOU FLIP THE SCREEN? 4354 02:37:45,240 --> 02:37:48,040 >>WHAT THE SCREEN? 4355 02:37:48,040 --> 02:37:48,240 MAYBE. 4356 02:37:48,240 --> 02:37:53,360 >>YOU'RE IN PRESENTER MODE. 4357 02:37:53,360 --> 02:37:54,360 >>THAT WAY? 4358 02:37:54,360 --> 02:37:55,160 >>YEP, YEP. 4359 02:37:55,160 --> 02:37:55,360 >>OKAY. 4360 02:37:55,360 --> 02:37:57,240 WE WERE ASKING OURSELVES WHAT WE 4361 02:37:57,240 --> 02:37:58,680 SHOULD DO THEN. 4362 02:37:58,680 --> 02:38:04,360 THIS WAS THE SORT OF SUMMARY OF 4363 02:38:04,360 --> 02:38:08,200 THE ENTIRE SET OF CHAPTERS 4364 02:38:08,200 --> 02:38:10,040 WITHIN THE ROADMAP. 4365 02:38:10,040 --> 02:38:11,400 NO, SORRY. 4366 02:38:11,400 --> 02:38:13,560 THIS IS THE CHARGE TO THE 4367 02:38:13,560 --> 02:38:14,560 NEUROETHICS WORKING GROUP, 4368 02:38:14,560 --> 02:38:18,720 REMIND THE PEOPLE WHAT OUR 4369 02:38:18,720 --> 02:38:20,240 CHARGE WAS. 4370 02:38:20,240 --> 02:38:21,760 PRETTY FAMILIAR, I WON'T READ 4371 02:38:21,760 --> 02:38:21,960 THEM. 4372 02:38:21,960 --> 02:38:31,840 YOU CAN SEE IT IS A VERY USEFUL 4373 02:38:31,840 --> 02:38:32,840 SET OF REMINDERS. 4374 02:38:32,840 --> 02:38:34,920 THESE WHY THE CATEGORIES FROM 4375 02:38:34,920 --> 02:38:36,880 THE ROADMAP. 4376 02:38:36,880 --> 02:38:38,440 JIM, JUMP IN IF THERE'S ANYTHING 4377 02:38:38,440 --> 02:38:40,040 YOU SEE TO HIGHLIGHT. 4378 02:38:40,040 --> 02:38:44,320 THESE WERE THE CHAPTERS. 4379 02:38:44,320 --> 02:38:46,520 AND THEN WE LISTED, AGAIN THIS 4380 02:38:46,520 --> 02:38:48,840 IS -- WE LISTED SOME THINGS THAT 4381 02:38:48,840 --> 02:38:53,520 WERE INCLUDED IN THE CONCEPTUAL 4382 02:38:53,520 --> 02:38:56,600 AND EMPIRICAL SPACE, BACK FROM 4383 02:38:56,600 --> 02:39:01,760 THE ROADMAP INCLUDING EQUITY, 4384 02:39:01,760 --> 02:39:02,520 PRIVACY, VULNERABILITY, 4385 02:39:02,520 --> 02:39:03,600 LONG-TERM OBLIGATIONS, ANIMAL 4386 02:39:03,600 --> 02:39:03,960 MODELS. 4387 02:39:03,960 --> 02:39:09,200 AND OF COURSE HAD SOME VERY 4388 02:39:09,200 --> 02:39:13,360 SPECIFIC EXAMPLES OF THINGS 4389 02:39:13,360 --> 02:39:14,200 UNDER THOSE CATEGORIES. 4390 02:39:14,200 --> 02:39:16,080 I'LL GIVE YOU A MINUTE TO LOOK 4391 02:39:16,080 --> 02:39:21,240 AT THEM WITHOUT READING THEM. 4392 02:39:21,240 --> 02:39:26,120 4393 02:39:26,120 --> 02:39:27,200 4394 02:39:27,200 --> 02:39:36,760 AND THEN WE ASKED THIS QUESTION 4395 02:39:36,760 --> 02:39:39,200 WE HAD SOME IDEAS FOR GUIDANCE 4396 02:39:39,200 --> 02:39:41,000 NOT CALLED GUIDANCE, THINGS WE 4397 02:39:41,000 --> 02:39:43,320 COULD THINK ABOUT SPECIFICALLY 4398 02:39:43,320 --> 02:39:45,080 FOR RESEARCHERS RELATED TO THE 4399 02:39:45,080 --> 02:39:50,000 DESIGN OF RESEARCH AND CONDUCT 4400 02:39:50,000 --> 02:39:50,760 OF RESEARCH. 4401 02:39:50,760 --> 02:39:54,240 IF I'M GOING TOO FAST, TELL ME. 4402 02:39:54,240 --> 02:39:58,520 4403 02:39:58,520 --> 02:40:04,000 WE HAD IDEAS OF IMPROVEMENT AND 4404 02:40:04,000 --> 02:40:14,400 GUIDANCE FOR REGULATORS, 4405 02:40:17,320 --> 02:40:18,240 POLICYMAKERS, IRBs, FUNDERS. 4406 02:40:18,240 --> 02:40:20,120 >>INTERESTING WE DON'T HAVE 4407 02:40:20,120 --> 02:40:20,840 ANYTHING ON MODULATING CHANGING 4408 02:40:20,840 --> 02:40:21,760 ON THE BRAIN. 4409 02:40:21,760 --> 02:40:23,480 >>WE DON'T. 4410 02:40:23,480 --> 02:40:28,280 I MEAN, OTHER THAN THE SORT 4411 02:40:28,280 --> 02:40:33,120 OF -- THERE WAS GENERAL STUFF N 4412 02:40:33,120 --> 02:40:43,600 RISK BUT IT WASN'T SPECIFIC. 4413 02:40:49,080 --> 02:40:49,640 ETHICAL FRAMEWORKS. 4414 02:40:49,640 --> 02:40:52,840 RESOURCES. 4415 02:40:52,840 --> 02:40:53,600 INTEGRATING NEURAL SCIENCE AND 4416 02:40:53,600 --> 02:41:01,680 NEUROETHICS. 4417 02:41:01,680 --> 02:41:05,320 4418 02:41:05,320 --> 02:41:08,040 AND TRAINING IDEAS. 4419 02:41:08,040 --> 02:41:15,200 4420 02:41:15,200 --> 02:41:19,400 4421 02:41:19,400 --> 02:41:21,320 4422 02:41:21,320 --> 02:41:24,000 AND PUBLIC ENGAGEMENT. 4423 02:41:24,000 --> 02:41:27,960 4424 02:41:27,960 --> 02:41:31,880 WE ALSO HAD I THINK THE LAST 4425 02:41:31,880 --> 02:41:36,680 SLIDE -- OH, HERE WE GO. 4426 02:41:36,680 --> 02:41:38,120 POSSIBLE NEWG ACTIVITIES. 4427 02:41:38,120 --> 02:41:40,640 RECOMMENDING RESEARCH TOPICS, 4428 02:41:40,640 --> 02:41:42,840 HOLDING WORKSHOPS, SUPPORTING 4429 02:41:42,840 --> 02:41:45,360 CHANGES TO NEUROSCIENCE RESEARCH 4430 02:41:45,360 --> 02:41:46,680 OR REVIEW, AND ENDORSING 4431 02:41:46,680 --> 02:41:48,720 TRAINING AND INTEGRATION OF 4432 02:41:48,720 --> 02:41:49,320 PUBLIC ENGAGEMENT. 4433 02:41:49,320 --> 02:41:52,040 I THINK THERE'S A SLIDE -- I 4434 02:41:52,040 --> 02:41:56,280 THOUGHT THERE WAS ONE ON THE 4435 02:41:56,280 --> 02:41:59,360 TRANSFORMATIVE IDEAS THAT JIM 4436 02:41:59,360 --> 02:41:59,720 WILL REMEMBER. 4437 02:41:59,720 --> 02:42:02,320 >>YEAH, MAYBE I COULD JUMP IN 4438 02:42:02,320 --> 02:42:03,200 FOR A MOMENT, CHRISTINE. 4439 02:42:03,200 --> 02:42:05,480 THIS IS A GOOD HELICOPTER VIEW 4440 02:42:05,480 --> 02:42:08,040 OF THE REPORT BUT THERE WAS VERY 4441 02:42:08,040 --> 02:42:10,280 LITTLE ON CHAPTER 6, WHICH IS 4442 02:42:10,280 --> 02:42:11,480 WHAT ACTUALLY PRIMARILY DEALT 4443 02:42:11,480 --> 02:42:14,920 WITH WHAT WE DISCUSSED TODAY. 4444 02:42:14,920 --> 02:42:17,640 THERE ARE THINGS WITH RESPECT TO 4445 02:42:17,640 --> 02:42:18,320 BRAIN STIMULATION, EARLIER 4446 02:42:18,320 --> 02:42:20,000 CHAPTER, I THINK CHAPTER 2. 4447 02:42:20,000 --> 02:42:22,120 I ENCOURAGE PEOPLE TO LOOK AT 4448 02:42:22,120 --> 02:42:26,200 CHAPTER 6 IN PARTICULAR, AND 4449 02:42:26,200 --> 02:42:27,800 CHAPTER 5 AS KAREN MENTIONED, 4450 02:42:27,800 --> 02:42:30,440 DEALING MORE WITH THE ISSUE OF 4451 02:42:30,440 --> 02:42:32,760 DIFFERENT RANGE OF TECHNOLOGIES 4452 02:42:32,760 --> 02:42:37,560 IN PARTICULAR CONSUMER POTENTIAL 4453 02:42:37,560 --> 02:42:39,800 TECHNOLOGIES, SUCH AS VR AND 4454 02:42:39,800 --> 02:42:40,920 TRYING TO, YOU KNOW, ASSESS SOME 4455 02:42:40,920 --> 02:42:43,880 OF THE ISSUES THAT MIGHT COME UP 4456 02:42:43,880 --> 02:42:45,200 AND SOME PARTICULAR 4457 02:42:45,200 --> 02:42:47,400 RECOMMENDATIONS SO THOSE WEREN'T 4458 02:42:47,400 --> 02:42:48,560 SPECIFICALLY IN THIS 4459 02:42:48,560 --> 02:42:49,200 PRESENTATION SINCE CHAPTER 6 4460 02:42:49,200 --> 02:42:52,640 SEEMED TO BE A LITTLE BIT BEYOND 4461 02:42:52,640 --> 02:42:53,840 WHAT NEWG MIGHT BE ADDRESSING AT 4462 02:42:53,840 --> 02:42:56,040 THE MOMENT WHEN THIS WAS PUT 4463 02:42:56,040 --> 02:42:56,320 TOGETHER. 4464 02:42:56,320 --> 02:42:59,400 >>I THINK IT ALSO GOES BACK TO 4465 02:42:59,400 --> 02:43:00,760 SOMETHING WE JUST DISCUSSED 4466 02:43:00,760 --> 02:43:01,280 TODAY. 4467 02:43:01,280 --> 02:43:03,400 I DO HAVE NOTES ON THESE THINGS 4468 02:43:03,400 --> 02:43:07,000 THAT SAID, YOU KNOW, SOME OF THE 4469 02:43:07,000 --> 02:43:10,160 TOPICS RAISED IN CHAPTER 6 WERE 4470 02:43:10,160 --> 02:43:12,760 SPECIFICALLY ABOUT USING NEURAL 4471 02:43:12,760 --> 02:43:13,960 TECHNOLOGIES OUTSIDE OF THE 4472 02:43:13,960 --> 02:43:16,040 CLINICAL SPACE, YOU KNOW, IN 4473 02:43:16,040 --> 02:43:17,840 EDUCATION, LEGAL AREAS, ET 4474 02:43:17,840 --> 02:43:20,240 CETERA, EMPLOYMENT, NATIONAL 4475 02:43:20,240 --> 02:43:20,520 SECURITY. 4476 02:43:20,520 --> 02:43:21,520 AND THE DISCUSSION AT THE TIME 4477 02:43:21,520 --> 02:43:23,800 WE DISCUSSED THIS A COUPLE YEARS 4478 02:43:23,800 --> 02:43:26,800 AGO WAS THAT WAS OUTSIDE THE 4479 02:43:26,800 --> 02:43:29,400 SCOPE OF BRAIN. 4480 02:43:29,400 --> 02:43:32,040 4481 02:43:32,040 --> 02:43:34,920 >>WELL, THAT'S A LOT FOR US TO 4482 02:43:34,920 --> 02:43:35,200 DIGEST. 4483 02:43:35,200 --> 02:43:37,160 WE PUT A PARTICULAR TOPIC THAT 4484 02:43:37,160 --> 02:43:39,200 ISN'T ON THE CLEAR LIST THERE 4485 02:43:39,200 --> 02:43:40,840 BUT THIS GIVES US A LOT OF SCOPE 4486 02:43:40,840 --> 02:43:43,880 TO THINK ABOUT THAT. 4487 02:43:43,880 --> 02:43:46,200 I MIGHT SUGGEST THAT FOLKS -- WE 4488 02:43:46,200 --> 02:43:46,880 WON'T MAKE ANY DECISIONS I DON'T 4489 02:43:46,880 --> 02:43:49,280 THINK HERE IN A MINUTE AND 15 4490 02:43:49,280 --> 02:43:51,240 SECONDS, BUT I WOULD SUGGEST 4491 02:43:51,240 --> 02:43:55,280 THAT WE, YOU KNOW, RECIRCULATE 4492 02:43:55,280 --> 02:43:56,600 THAT POWERPOINT AND IT WOULD BE 4493 02:43:56,600 --> 02:43:58,560 TERRIFIC TO HAVE PEOPLE WEIGH IN 4494 02:43:58,560 --> 02:44:06,000 BY QUICK E-MAIL,ER WHO NEXT ST, 4495 02:44:06,000 --> 02:44:07,640 MODULATING, CHOOSING SOMETHING, 4496 02:44:07,640 --> 02:44:10,480 THINKING ABOUT SPECIFIC CONCRETE 4497 02:44:10,480 --> 02:44:11,640 IMPACTFUL CONTRIBUTIONS THAT WE 4498 02:44:11,640 --> 02:44:17,000 COULD MAKE IN NEWG FOR THE BRAIN 4499 02:44:17,000 --> 02:44:17,520 INITIATIVE. 4500 02:44:17,520 --> 02:44:19,720 KAREN, YOU GET THE LAST WORD ON 4501 02:44:19,720 --> 02:44:20,080 THIS TOPIC. 4502 02:44:20,080 --> 02:44:25,520 >>I WAS JUST GOING TO SUGGEST 4503 02:44:25,520 --> 02:44:26,840 ACTUALLY WORKSHOP FOR NEWG IN 4504 02:44:26,840 --> 02:44:29,320 ITS NEW COMPOSITION AND NEW 4505 02:44:29,320 --> 02:44:31,880 LEADERSHIP TO INTERNALLY THINK 4506 02:44:31,880 --> 02:44:35,280 ABOUT HOW TO ALIGN OUR DESIRED 4507 02:44:35,280 --> 02:44:37,240 IMPACT WITH THE EXPECTED IMPACT 4508 02:44:37,240 --> 02:44:39,080 THAT OUR STAKEHOLDERS MIGHT HAVE 4509 02:44:39,080 --> 02:44:40,960 FOR US, AND I THINK USING YOUR 4510 02:44:40,960 --> 02:44:42,040 RUBRIC OF THE THREE QUESTIONS 4511 02:44:42,040 --> 02:44:43,600 WOULD BE WONDERFUL AND ALSO 4512 02:44:43,600 --> 02:44:44,680 GOING BACK TO WHAT A LOT OF 4513 02:44:44,680 --> 02:44:47,200 GREAT STUFF THAT WAS IN THE 4514 02:44:47,200 --> 02:44:49,600 NEUROETHICS ROAD MAP. 4515 02:44:49,600 --> 02:44:52,120 THANKS AGAIN TO JIM, HEROIC 4516 02:44:52,120 --> 02:44:53,320 LEADER OF THAT EFFORT. 4517 02:44:53,320 --> 02:44:55,640 >>THANKS, KAREN. 4518 02:44:55,640 --> 02:44:57,880 THAT'S A GREAT SUGGESTION. 4519 02:44:57,880 --> 02:44:59,440 WE'LL SUGGEST EVERYBODY TAKE 4520 02:44:59,440 --> 02:45:02,520 THAT INTO CONSIDERATION AND ALSO 4521 02:45:02,520 --> 02:45:06,240 TAKE INTO CONSIDERATION THE 4522 02:45:06,240 --> 02:45:07,960 CONVERSATION TODAY AS WELL AS 4523 02:45:07,960 --> 02:45:10,160 WHAT RECIRCULATES, WEIGH IN ON 4524 02:45:10,160 --> 02:45:12,040 YOUR NEXT STEPS, MINI VIRTUAL 4525 02:45:12,040 --> 02:45:13,680 RETREAT AS WE DO EXACTLY THAT 4526 02:45:13,680 --> 02:45:16,520 WHICH IS TO FIGURE OUT OUR NEXT 4527 02:45:16,520 --> 02:45:17,680 STEPS TOGETHER. 4528 02:45:17,680 --> 02:45:20,880 SHOULD I CLOSE US OUT, 4529 02:45:20,880 --> 02:45:21,320 CHRISTINE? 4530 02:45:21,320 --> 02:45:21,840 OKAY. 4531 02:45:21,840 --> 02:45:23,000 WELL, THANK YOU, EVERYBODY, FOR 4532 02:45:23,000 --> 02:45:24,400 JOINING US TODAY. 4533 02:45:24,400 --> 02:45:27,400 THIS HAS BEEN A RICH AND 4534 02:45:27,400 --> 02:45:27,880 VALUABLE CONVERSATION, 4535 02:45:27,880 --> 02:45:29,280 STIMULATED A LOT OF THINKING AND 4536 02:45:29,280 --> 02:45:29,960 CHANGED MY BRAIN. 4537 02:45:29,960 --> 02:45:31,080 HA, HA. 4538 02:45:31,080 --> 02:45:32,560 I HOPE IT CHANGED ALL OF YOURS 4539 02:45:32,560 --> 02:45:35,880 IN WAYS THAT ARE BENEFICIAL. 4540 02:45:35,880 --> 02:45:38,840 AS ALWAYS, GRATEFUL FOR YOUR 4541 02:45:38,840 --> 02:45:40,160 TIME AND CONTRIBUTIONS, AND 4542 02:45:40,160 --> 02:45:42,360 SERVICE, IN THIS EFFORT. 4543 02:45:42,360 --> 02:45:44,680 THANKS, EVERYBODY. 4544 02:45:44,680 --> 02:45:46,400 LOOKING FORWARD TO THE CONTINUED 4545 02:45:46,400 --> 02:45:49,240 CONVERSATIONS ON THIS TOPIC. 4546 02:45:49,240 --> 02:45:51,400 4547 02:45:51,400 --> 02:45:54,480 >>COME BACK FOR THE CLOSED 4548 02:45:54,480 --> 02:45:54,720 SESSION. 4549 02:45:54,720 --> 02:45:56,120 >>WAIT, CHRISTINE, WE HAVE ONE 4550 02:45:56,120 --> 02:45:59,440 MORE ITEM ON THE AGENDA. 4551 02:45:59,440 --> 02:46:04,560 >>OH, YES, SORRY, SORRY. 4552 02:46:04,560 --> 02:46:05,880 NITA WILL RETURN THAT. 4553 02:46:05,880 --> 02:46:07,320 >>YOUR CHARTER IS WAITING FOR 4554 02:46:07,320 --> 02:46:07,480 YOU. 4555 02:46:07,480 --> 02:46:10,480 >>I'VE GOT TO GO, GREAT TO SEE 4556 02:46:10,480 --> 02:46:11,240 YOU ALL. 4557 02:46:11,240 --> 02:46:14,680 >>TAKE PICTURES, SEND PICTURES. 4558 02:46:14,680 --> 02:46:14,960 >>I WILL. 4559 02:46:14,960 --> 02:46:16,280 >>SO JUST BEFORE THE BREAK 4560 02:46:16,280 --> 02:46:19,000 WE'RE GOING TO DO OUR ROUNDTABLE 4561 02:46:19,000 --> 02:46:21,240 UPDATE TO SEE WHAT ALL THE NEWG 4562 02:46:21,240 --> 02:46:23,920 MEMBERS HAVE BEEN UP TO IN THE 4563 02:46:23,920 --> 02:46:24,400 SPACE. 4564 02:46:24,400 --> 02:46:26,240 SO I'LL CALL ON FOLKS ONE BY 4565 02:46:26,240 --> 02:46:28,240 ONE, FEEL FREE TO SHARE AND LET 4566 02:46:28,240 --> 02:46:29,200 US KNOW WHAT'S BEEN HAPPENING 4567 02:46:29,200 --> 02:46:32,480 SINCE THE LAST TIME WE MET. 4568 02:46:32,480 --> 02:46:37,000 NITA, WE'LL START WITH YOU. 4569 02:46:37,000 --> 02:46:38,440 >>THANKS, EVERYBODY. 4570 02:46:38,440 --> 02:46:40,080 I'VE ENJOYED A LOT OF RICH 4571 02:46:40,080 --> 02:46:43,040 CONVERSATIONS IN THE SPACE 4572 02:46:43,040 --> 02:46:44,040 AROUND NEUROTECHNOLOGIES, MOST 4573 02:46:44,040 --> 02:46:46,200 RECENTLY, AND THE LAST WEEK WAS 4574 02:46:46,200 --> 02:46:47,640 AT THE WORLD ECONOMIC FORUM IN 4575 02:46:47,640 --> 02:46:50,360 DAVOS WHERE I HAD AN OPPORTUNITY 4576 02:46:50,360 --> 02:46:51,680 TO PRESENT ON BRAIN TRANSPARENCY 4577 02:46:51,680 --> 02:46:53,840 AS A TOPIC, THERE WAS A LOT OF 4578 02:46:53,840 --> 02:46:56,200 INTEREST I THINK FROM DIFFERENT 4579 02:46:56,200 --> 02:46:57,480 STAKEHOLDERS ACROSS THE WORLD 4580 02:46:57,480 --> 02:46:58,800 ENGAGING ON THAT TOPIC, ALSO HAD 4581 02:46:58,800 --> 02:47:01,040 AN OPPORTUNITY TO ENGAGE IN A 4582 02:47:01,040 --> 02:47:03,160 PANEL ABOUT REIMAGINING HEALTH 4583 02:47:03,160 --> 02:47:04,480 CARE AND TRANSFORMATIVE ISSUES 4584 02:47:04,480 --> 02:47:05,120 IN THAT SPACE. 4585 02:47:05,120 --> 02:47:07,080 I THINK TOP OF MIND FOR A LOT OF 4586 02:47:07,080 --> 02:47:10,080 PEOPLE ARE ISSUES AROUND 4587 02:47:10,080 --> 02:47:12,120 PRIVACY, AND THINKING ABOUT DATA 4588 02:47:12,120 --> 02:47:14,000 SHARING AND HOW WE MIGHT MOVE TO 4589 02:47:14,000 --> 02:47:15,400 A PLACE IN WHICH DATA SHARING 4590 02:47:15,400 --> 02:47:17,960 COULD BE SOMETHING THAT IS DONE 4591 02:47:17,960 --> 02:47:19,720 CONFIDENTLY BY INDIVIDUALS WHILE 4592 02:47:19,720 --> 02:47:21,240 SAFEGUARDING AGAINST RISK OF 4593 02:47:21,240 --> 02:47:21,960 MISUSE. 4594 02:47:21,960 --> 02:47:23,440 THAT'S WHAT I'VE BEEN UP TO, AND 4595 02:47:23,440 --> 02:47:26,600 MY BOOK, THE BATTLE FOR YOUR 4596 02:47:26,600 --> 02:47:28,680 BRAIN, COMES OUT IN MARCH, I'LL 4597 02:47:28,680 --> 02:47:30,080 BE ON THE ROAD TALKING ABOUT 4598 02:47:30,080 --> 02:47:40,560 THAT OVER THE NEXT COUPLE OF 4599 02:47:44,920 --> 02:47:45,120 MONTHS. 4600 02:47:45,120 --> 02:47:45,480 >>WINSTON? 4601 02:47:45,480 --> 02:47:48,080 >>MAJOR UPDATES FOR ME IS I'VE 4602 02:47:48,080 --> 02:47:51,880 BEEN NAMED EXECUTIVE DIRECTOR OF 4603 02:47:51,880 --> 02:47:54,600 BIOETHICS AT UCSF, THINKING 4604 02:47:54,600 --> 02:47:55,840 ABOUT THE RELATIONSHIP BETWEEN 4605 02:47:55,840 --> 02:47:59,200 SOME QUESTIONS WE'RE ASKING IN 4606 02:47:59,200 --> 02:48:01,200 NEUROETHICS AND A LONG HISTORY 4607 02:48:01,200 --> 02:48:03,400 OF SCHOLARSHIP AND BIOETHICS 4608 02:48:03,400 --> 02:48:06,560 THAT IS OVERLAPPING. 4609 02:48:06,560 --> 02:48:07,640 SO, HOW TO INCORPORATE 4610 02:48:07,640 --> 02:48:09,200 PARTICULARLY AS WE'RE TALKING 4611 02:48:09,200 --> 02:48:11,880 ABOUT THINGS LIKE CLINICAL OR 4612 02:48:11,880 --> 02:48:12,880 HEALTH-RELATED APPLICATIONS OF 4613 02:48:12,880 --> 02:48:14,320 NEUROTECHNOLOGY, THERE'S A LOT 4614 02:48:14,320 --> 02:48:17,680 TO DRAW ON, AND THERE'S A LOT OF 4615 02:48:17,680 --> 02:48:19,680 OVERLAP ALSO WITH OUR COLLEAGUES 4616 02:48:19,680 --> 02:48:21,200 IN GERIATRICS AND PEDIATRICS, 4617 02:48:21,200 --> 02:48:23,960 YOU THINK ABOUT BRAIN 4618 02:48:23,960 --> 02:48:24,520 DEVELOPMENT THROUGHOUT THE 4619 02:48:24,520 --> 02:48:26,560 LIFESPAN. 4620 02:48:26,560 --> 02:48:27,560 4621 02:48:27,560 --> 02:48:30,280 >>THANKS, WINSTON. 4622 02:48:30,280 --> 02:48:30,440 JIM? 4623 02:48:30,440 --> 02:48:32,600 >>THIS WILL BE SHORT. 4624 02:48:32,600 --> 02:48:34,040 I HAVE NO NEUROETHICS UPDATE FOR 4625 02:48:34,040 --> 02:48:36,200 EVERYONE. 4626 02:48:36,200 --> 02:48:38,320 4627 02:48:38,320 --> 02:48:40,480 >>THANKS, JIM. 4628 02:48:40,480 --> 02:48:40,640 SYD? 4629 02:48:40,640 --> 02:48:44,440 >>I'VE HAD A COUPLE OF PAPERS 4630 02:48:44,440 --> 02:48:51,880 ON -- A PAPER AND A BOOK CHAPTER 4631 02:48:51,880 --> 02:48:53,520 ON BRAIN DEATH RECENTLY, AND 4632 02:48:53,520 --> 02:48:55,920 MONDAY I'LL BE IN D.C. FOR A 4633 02:48:55,920 --> 02:48:58,440 CONGRESSIONAL BRIEFING WHICH 4634 02:48:58,440 --> 02:49:02,480 I'VE NEVER DONE BEFORE, AND SO 4635 02:49:02,480 --> 02:49:04,880 KIND OF EXCITED AND ANXIOUS 4636 02:49:04,880 --> 02:49:05,200 ABOUT THAT. 4637 02:49:05,200 --> 02:49:06,960 THAT'S GOING TO BE ON ANIMAL 4638 02:49:06,960 --> 02:49:09,360 RESEARCH. 4639 02:49:09,360 --> 02:49:13,960 4640 02:49:13,960 --> 02:49:15,600 >>THANKS, SYD. 4641 02:49:15,600 --> 02:49:18,240 COME SAY HI TO NIH IF YOU'RE IN 4642 02:49:18,240 --> 02:49:20,640 THE AREA. 4643 02:49:20,640 --> 02:49:20,880 CAROLINE? 4644 02:49:20,880 --> 02:49:22,920 >>YEAH, THANK YOU, NINA. 4645 02:49:22,920 --> 02:49:27,520 A LOT OF UPDATES ACTUALLY COMING 4646 02:49:27,520 --> 02:49:28,720 FROM OUR SIDE. 4647 02:49:28,720 --> 02:49:30,720 IT'S BEEN A BUSY SET OF MONTHS 4648 02:49:30,720 --> 02:49:32,240 SINCE WE LAST MET. 4649 02:49:32,240 --> 02:49:36,040 MANY PEOPLE ON THE CALL ARE 4650 02:49:36,040 --> 02:49:36,800 AWARE THE DANA FOUNDATION 4651 02:49:36,800 --> 02:49:40,000 REFINED ITS MISSION TO ADVANCING 4652 02:49:40,000 --> 02:49:41,320 NEUROSCIENCE THAT BENEFITS 4653 02:49:41,320 --> 02:49:43,000 SOCIETY AND REFLECTS ASPIRATIONS 4654 02:49:43,000 --> 02:49:46,240 OF ALL PEOPLE, AND SO UNDER THAT 4655 02:49:46,240 --> 02:49:49,320 MISSION AREA WE'VE DEVELOPED OUR 4656 02:49:49,320 --> 02:49:52,160 THREE PROGRAMMATIC PILLARS, 4657 02:49:52,160 --> 02:49:54,280 PROGRAMMATIC STRATEGIES LED BY 4658 02:49:54,280 --> 02:49:55,240 KAREN RAMOS FORMERLY AT NIH, 4659 02:49:55,240 --> 02:50:00,520 VERY GLAD TO HAVE HER, ALSO THE 4660 02:50:00,520 --> 02:50:03,440 PROGRAMMATIC PILLARS ARE DINA 4661 02:50:03,440 --> 02:50:09,280 EDUCATION, NEXT GEN AND DINA 4662 02:50:09,280 --> 02:50:11,960 FRONTIERS, AND SO A FEW RELEVANT 4663 02:50:11,960 --> 02:50:13,760 I THINK NEWG UPDATES, JUST 4664 02:50:13,760 --> 02:50:15,400 UPDATES FROM THE NEUROETHICS 4665 02:50:15,400 --> 02:50:18,400 COMMUNITY, ONE OF THEM COMING 4666 02:50:18,400 --> 02:50:21,040 FROM THE DINA EDUCATION PILLAR 4667 02:50:21,040 --> 02:50:25,960 IS BRAIN AWARENESS WEEK WHICH 4668 02:50:25,960 --> 02:50:32,640 THE FOUNDATION SPONSORS, COMING 4669 02:50:32,640 --> 02:50:34,520 UP MARCH 13-19. 4670 02:50:34,520 --> 02:50:36,720 YOU MIGHT HAVE DIFFERENT 4671 02:50:36,720 --> 02:50:38,360 ACTIVITIES AT THAT TIME, SO WE 4672 02:50:38,360 --> 02:50:46,000 TRY TO HELP PROMOTE ALL OF THOSE 4673 02:50:46,000 --> 02:50:46,640 ACTIVITIES. 4674 02:50:46,640 --> 02:50:48,320 ANOTHER RELATED UPDATE IS COMING 4675 02:50:48,320 --> 02:50:49,840 FROM THE DINA NEXT GEN PROGRAM, 4676 02:50:49,840 --> 02:50:53,680 THE SIGNATURE OF THAT PROGRAM IS 4677 02:50:53,680 --> 02:50:55,080 THE CENTERS IN NEUROSCIENCE AND 4678 02:50:55,080 --> 02:50:56,400 SOCIETY WHICH I SHARED ABOUT 4679 02:50:56,400 --> 02:50:58,800 WITH EVERYBODY HERE DURING OUR 4680 02:50:58,800 --> 02:51:01,960 LAST MEETING, WE WERE VERY HAPPY 4681 02:51:01,960 --> 02:51:04,880 LAST FALL TO AWARD 11 PLANNING 4682 02:51:04,880 --> 02:51:07,320 GRANTS FOR THE DINA CENTERS, IN 4683 02:51:07,320 --> 02:51:09,720 THE PROCESS OF COMPLETING 4684 02:51:09,720 --> 02:51:10,480 DEMONSTRATION PROJECTS, TO 4685 02:51:10,480 --> 02:51:12,040 ILLUSTRATE THE SPIRIT OF THE 4686 02:51:12,040 --> 02:51:14,000 KIND OF WORK THE DINA CENTERS 4687 02:51:14,000 --> 02:51:16,840 SHOULD THEY BE ESTABLISHED THERE 4688 02:51:16,840 --> 02:51:20,800 WOULD BE UNDERGOING, AND SO THE 4689 02:51:20,800 --> 02:51:22,880 TIMELINE, PLAN TO SELECT TWO 4690 02:51:22,880 --> 02:51:25,800 CENTERS BY THIS COMING FALL. 4691 02:51:25,800 --> 02:51:32,720 AND WE -- A SHOUT OUT TO THE 4692 02:51:32,720 --> 02:51:34,600 SUMMIT HELD TODAY FUNDING GRANTS 4693 02:51:34,600 --> 02:51:36,280 APPLICANTS FROM HARVARD, HOSTED 4694 02:51:36,280 --> 02:51:38,360 A REALLY INTERESTING SET OF 4695 02:51:38,360 --> 02:51:40,880 TALKS THAT ARE RELATED TO SOME 4696 02:51:40,880 --> 02:51:43,400 OF THE WORK THEY WOULD BE 4697 02:51:43,400 --> 02:51:45,680 PROPOSING FOR A DANA CENTER, AND 4698 02:51:45,680 --> 02:51:48,840 FROM THE DANA FRONTIERS PROGRAM 4699 02:51:48,840 --> 02:51:50,360 FOCUSING ON GROWING CAPACITY FOR 4700 02:51:50,360 --> 02:51:53,680 INFORMED PUBLIC REFLECTION ON 4701 02:51:53,680 --> 02:51:54,800 NEUROSCIENCE AND NEUROSCIENCE IN 4702 02:51:54,800 --> 02:51:56,200 SOCIETY, SOMETHING THAT MIGHT BE 4703 02:51:56,200 --> 02:52:01,360 OF INTEREST TO FOLKS HERE IS A 4704 02:52:01,360 --> 02:52:03,240 PUBLIC POLLING -- PUBLIC SURVEY 4705 02:52:03,240 --> 02:52:05,400 WE DID IN COLLABORATION WITH 4706 02:52:05,400 --> 02:52:07,600 RESEARCH AMERICA, TO TEST OUR 4707 02:52:07,600 --> 02:52:09,880 ASSUMPTION, QUESTION OUR OWN 4708 02:52:09,880 --> 02:52:11,280 ASSUMPTION OF PUBLIC PERCEPTION 4709 02:52:11,280 --> 02:52:15,520 AND UNDERSTANDING AROUND 4710 02:52:15,520 --> 02:52:16,440 NEUROSCIENCE, INTERESTING FOR US 4711 02:52:16,440 --> 02:52:19,520 TO GO THROUGH THE PROCESS SO IT 4712 02:52:19,520 --> 02:52:20,280 COULD HELP INFORM OUR STRATEGY 4713 02:52:20,280 --> 02:52:23,000 AROUND WHAT THE NEEDS ARE IN 4714 02:52:23,000 --> 02:52:24,320 PUBLIC ENGAGEMENT. 4715 02:52:24,320 --> 02:52:27,920 WE FOUND THAT THERE'S A DESIRE 4716 02:52:27,920 --> 02:52:30,360 FOR AN INCREASE IN PATIENT 4717 02:52:30,360 --> 02:52:31,200 VOICES IN SETTING RESEARCH 4718 02:52:31,200 --> 02:52:32,640 PRIORITIES WHICH IS VERY 4719 02:52:32,640 --> 02:52:34,440 RELEVANT TO THE CONVERSATIONS 4720 02:52:34,440 --> 02:52:36,600 WE'VE BEEN HAVING TODAY. 4721 02:52:36,600 --> 02:52:38,560 AND SO I THINK THAT'S IT IN A 4722 02:52:38,560 --> 02:52:39,800 NUTSHELL SOME THINGS HAPPENING 4723 02:52:39,800 --> 02:52:40,040 HERE. 4724 02:52:40,040 --> 02:52:42,960 YOU'LL FIND OUT MORE ABOUT THIS 4725 02:52:42,960 --> 02:52:48,200 FROM A NEW WEBSITE THAT WE'RE 4726 02:52:48,200 --> 02:52:50,520 LAUNCHING THIS SUMMER 4727 02:52:50,520 --> 02:52:51,120 ENCAPSULATING VISION MISSION, 4728 02:52:51,120 --> 02:52:52,160 PILLARS AND ACTIVITIES THAT 4729 02:52:52,160 --> 02:52:54,440 WE'RE HAVING BUT IT'S ALL VERY 4730 02:52:54,440 --> 02:52:55,960 RELATED TO THIS GROUP AND WE'RE 4731 02:52:55,960 --> 02:52:59,040 SO EXCITED TO THINK ABOUT HOW WE 4732 02:52:59,040 --> 02:53:00,680 CAN COMPLEMENT AND PARTNER WITH 4733 02:53:00,680 --> 02:53:05,400 ALL OF YOU IN HELPING TO PUSH 4734 02:53:05,400 --> 02:53:06,920 FORTH THE ELEVATED VISIBILITY OF 4735 02:53:06,920 --> 02:53:09,040 THE NEEDS IN NEUROSCIENCE AND 4736 02:53:09,040 --> 02:53:11,360 SOCIETY. 4737 02:53:11,360 --> 02:53:15,160 I'LL END WITH THAT. 4738 02:53:15,160 --> 02:53:21,080 >>THANKS, CAROLINE. 4739 02:53:21,080 --> 02:53:21,800 KAREN? 4740 02:53:21,800 --> 02:53:23,120 >>GREAT. 4741 02:53:23,120 --> 02:53:24,760 I THINK WHAT I'D LIKE TO SHARE 4742 02:53:24,760 --> 02:53:27,400 ARE SOME UPDATES ON THE 4743 02:53:27,400 --> 02:53:31,440 INTERNATIONAL STAGE, AND THEN 4744 02:53:31,440 --> 02:53:32,960 ONE MORE NATIONALLY ORIENTED 4745 02:53:32,960 --> 02:53:33,240 UPDATE. 4746 02:53:33,240 --> 02:53:34,320 ON THE INTERNATIONAL FRONT 4747 02:53:34,320 --> 02:53:36,400 THERE'S BEEN A LOT OF DISCUSSION 4748 02:53:36,400 --> 02:53:39,240 IN REGULATION AND POLICY AND 4749 02:53:39,240 --> 02:53:41,120 GUIDANCE AROUND NEUROTECHNOLOGY 4750 02:53:41,120 --> 02:53:42,920 IN SPECIFIC, SEEMS TO BE 4751 02:53:42,920 --> 02:53:43,800 PROLIFERATING RAPIDLY MORE THAN 4752 02:53:43,800 --> 02:53:45,480 I'VE SEEN IN THE PAST. 4753 02:53:45,480 --> 02:53:49,960 WHAT YOU MAY HAVE HEARD ABOUT IS 4754 02:53:49,960 --> 02:53:51,600 AN INFAMOUS NEURAL RIGHTS 4755 02:53:51,600 --> 02:53:53,880 CONVERSATION, THAT PROPOSES 4756 02:53:53,880 --> 02:53:57,280 NOVEL HUMAN RIGHTS RELATED TO 4757 02:53:57,280 --> 02:53:58,480 NEUROTECHNOLOGY AND 4758 02:53:58,480 --> 02:53:58,920 NEUROSCIENCE. 4759 02:53:58,920 --> 02:54:03,720 AND IN I THINK IT WAS NOVEMBER 4760 02:54:03,720 --> 02:54:05,920 OR DECEMBER THE UNESCO 4761 02:54:05,920 --> 02:54:07,200 INTERNATIONAL BIOETHICS 4762 02:54:07,200 --> 02:54:07,920 COMMUNITY CREATED A 4763 02:54:07,920 --> 02:54:08,720 NEUROTECHNOLOGY REPORT THAT 4764 02:54:08,720 --> 02:54:11,040 TALKED ABOUT A NUMBER OF 4765 02:54:11,040 --> 02:54:11,600 RECOMMENDATIONS FOR 4766 02:54:11,600 --> 02:54:13,360 NEUROTECHNOLOGY, SOME RESONATE 4767 02:54:13,360 --> 02:54:15,240 WITH SOME OF THE ACTIVITIES 4768 02:54:15,240 --> 02:54:17,280 WE'VE PROPOSED IN WHAT CHRISTINE 4769 02:54:17,280 --> 02:54:21,040 SHOWED, BUT ALSO CONCLUDES 4770 02:54:21,040 --> 02:54:22,800 THERE'S NO NEED FOR NEW RIGHTS 4771 02:54:22,800 --> 02:54:33,320 BUT A NEED TO TAILOR EXISTING 4772 02:54:33,760 --> 02:54:34,800 REGULATION. 4773 02:54:34,800 --> 02:54:38,200 NITA SPOKE AT OECD EVENT, DO WE 4774 02:54:38,200 --> 02:54:40,960 NEED NEURAL RIGHTS, THAT WAS 4775 02:54:40,960 --> 02:54:43,080 FINALIZED IN EARLIER -- ACTUALLY 4776 02:54:43,080 --> 02:54:44,440 IN DECEMBER, EARLIER THIS YEAR, 4777 02:54:44,440 --> 02:54:46,440 COMING OUT SOON WITH A SERIES OF 4778 02:54:46,440 --> 02:54:56,800 VIDEOS AND, AGAIN, THE 4779 02:55:00,840 --> 02:55:01,000 FINDING 4780 02:55:01,000 --> 02:55:02,160 IS THE SAME. 4781 02:55:02,160 --> 02:55:03,920 AROUND DATA, MAYBE OUR 4782 02:55:03,920 --> 02:55:05,920 CONVERSATION HERE TODAY IS MORE 4783 02:55:05,920 --> 02:55:08,960 RELEVANT THAN WE MIGHT 4784 02:55:08,960 --> 02:55:09,280 ANTICIPATE. 4785 02:55:09,280 --> 02:55:11,320 AND SO WE DO KNOW THAT ACTUALLY 4786 02:55:11,320 --> 02:55:14,240 YOU MAY BE AWARE MANY OF YOU 4787 02:55:14,240 --> 02:55:16,400 WERE INVOLVED IN OECD 4788 02:55:16,400 --> 02:55:18,800 RECOMMENDATION ON RESPONSIBLE 4789 02:55:18,800 --> 02:55:19,640 INNOVATION AND NEUROTECHNOLOGY 4790 02:55:19,640 --> 02:55:22,240 ADOPTED AS A LEGAL INSTRUMENT IN 4791 02:55:22,240 --> 02:55:24,080 DECEMBER 2019, BY 2024 ALL 4792 02:55:24,080 --> 02:55:26,560 MEMBER COUNTRIES ARE -- ALL 38 4793 02:55:26,560 --> 02:55:27,480 MEMBER COUNTRIES ARE EXPECTED TO 4794 02:55:27,480 --> 02:55:30,720 DEMONSTRATE HOW THEY HAVE 4795 02:55:30,720 --> 02:55:32,920 IMPLEMENTED THIS DOCUMENT. 4796 02:55:32,920 --> 02:55:34,040 OECD CONSIDERS THIS FIRST 4797 02:55:34,040 --> 02:55:35,680 INTERNATIONAL STANDARD IN 4798 02:55:35,680 --> 02:55:36,320 RESPONSIBLE INNOVATION IN 4799 02:55:36,320 --> 02:55:37,320 NEUROTECHNOLOGY BUT REALLY IT'S 4800 02:55:37,320 --> 02:55:41,040 A BUNCH OF PRINCIPLES THAT NEED 4801 02:55:41,040 --> 02:55:43,200 TRANSLATION AND IMPLEMENTATION. 4802 02:55:43,200 --> 02:55:46,400 SO WE'VE JUST WORKED THROUGH THE 4803 02:55:46,400 --> 02:55:47,400 FIRST IMPLEMENTATION GUIDE WHICH 4804 02:55:47,400 --> 02:55:49,600 SHOULD BE -- IS BEING FINALIZED 4805 02:55:49,600 --> 02:55:53,840 TO BE FORTH COMING SOON. 4806 02:55:53,840 --> 02:55:55,160 I WON'T MENTION OTHER ENTITIES 4807 02:55:55,160 --> 02:55:58,840 AND WILL GO STRAIGHT TO 4808 02:55:58,840 --> 02:56:00,240 NATIONAL. 4809 02:56:00,240 --> 02:56:01,240 FEBRUARY 16 AND 17 THE 4810 02:56:01,240 --> 02:56:02,040 DEPARTMENT OF COMMERCE, SOME OF 4811 02:56:02,040 --> 02:56:05,680 YOU WILL BE INVOLVED IN THAT 4812 02:56:05,680 --> 02:56:08,920 EVENT, HOSTING A WORKSHOP, 4813 02:56:08,920 --> 02:56:11,360 PUBLICLY WEBCAST EVENT ON BCI 4814 02:56:11,360 --> 02:56:12,800 EXPERT CONTROL REGULATION, 4815 02:56:12,800 --> 02:56:14,960 WHAT'S THE STATE OF THE ART AND 4816 02:56:14,960 --> 02:56:19,360 WHAT MIGHT BE NEEDED FOR EXPERT 4817 02:56:19,360 --> 02:56:19,960 CONTROL REGULATION, AND THERE 4818 02:56:19,960 --> 02:56:21,720 WILL NEED TO BE MORE RELATED TO 4819 02:56:21,720 --> 02:56:21,920 THAT. 4820 02:56:21,920 --> 02:56:23,600 I DON'T THINK YOU CAN FIND 4821 02:56:23,600 --> 02:56:26,560 ANYTHING ONLINE ABOUT IT YET BUT 4822 02:56:26,560 --> 02:56:29,600 THEY DO HAVE THEIR CALL FOR 4823 02:56:29,600 --> 02:56:31,920 COMMENT IN THE FEDERAL REGISTER 4824 02:56:31,920 --> 02:56:36,320 FOR BCI EXPERT CONTROL CLOSED 4825 02:56:36,320 --> 02:56:37,280 NOVEMBER 21, COMPILED RESPONSES, 4826 02:56:37,280 --> 02:56:39,080 DIDN'T GET A LOT LIKE WE DON'T 4827 02:56:39,080 --> 02:56:42,000 GET A LOT WHEN WE ASK FOR 4828 02:56:42,000 --> 02:56:43,240 RESPONSES AT NIH, AND THEN ARE 4829 02:56:43,240 --> 02:56:45,080 TRYING TO FIGURE OUT HOW TO 4830 02:56:45,080 --> 02:56:47,960 ENGAGE MORE OF A BROAD AUDIENCE 4831 02:56:47,960 --> 02:56:57,120 FOR THIS EVENT. 4832 02:56:57,120 --> 02:56:57,400 THAT'S IT. 4833 02:56:57,400 --> 02:56:59,440 >>THANKS, KAREN. 4834 02:56:59,440 --> 02:56:59,640 ELBA? 4835 02:56:59,640 --> 02:57:00,280 >>SORRY I'M LATE. 4836 02:57:00,280 --> 02:57:01,920 THIS IS A BIG TEACHING DAY FOR 4837 02:57:01,920 --> 02:57:02,160 ME. 4838 02:57:02,160 --> 02:57:03,800 GOOD TO SEE EVERYBODY. 4839 02:57:03,800 --> 02:57:10,480 WHAT I HAVE TO SHARE IS 4840 02:57:10,480 --> 02:57:13,680 TANGENTALLY RELATED, THE SOCIETY 4841 02:57:13,680 --> 02:57:15,320 FOR NEUROSCIENCE OFFERS RESPONSE 4842 02:57:15,320 --> 02:57:16,200 CONDUCT IN RESEARCH WORKSHOPS, 4843 02:57:16,200 --> 02:57:17,960 THE ONE IN THE FALL WAS 4844 02:57:17,960 --> 02:57:18,280 OUTSTANDING. 4845 02:57:18,280 --> 02:57:21,360 IT WAS ON DATA SCIENCE, DATA 4846 02:57:21,360 --> 02:57:23,560 MANAGEMENT, DATA CURATION, RIGOR 4847 02:57:23,560 --> 02:57:24,200 AND REPRODUCIBILITY, PROTECTION, 4848 02:57:24,200 --> 02:57:26,840 ALL THE ISSUES THAT ARE JUST 4849 02:57:26,840 --> 02:57:28,720 GOING TO ESCALATE REGARDING THE 4850 02:57:28,720 --> 02:57:30,400 AVAILABILITY OF DATA, 4851 02:57:30,400 --> 02:57:31,840 ORGANIZATION OF DATA, META DATA 4852 02:57:31,840 --> 02:57:34,080 TAGGING AND OF COURSE PROTECTION 4853 02:57:34,080 --> 02:57:35,360 OF HUMAN SUBJECTS DATA. 4854 02:57:35,360 --> 02:57:37,040 I'LL POST THAT IN THE CHAT AND I 4855 02:57:37,040 --> 02:57:39,760 DON'T KNOW IF THERE WOULD BE AN 4856 02:57:39,760 --> 02:57:41,200 OPPORTUNITY FOR THIS COMMUNITY 4857 02:57:41,200 --> 02:57:50,720 OR THIS GROUP TO PERHAPS 4858 02:57:50,720 --> 02:57:52,040 SPONSOR, ASSEMBLE ON A PAGE 4859 02:57:52,040 --> 02:57:53,680 SCIENTISTS DEALING WITH DATA. 4860 02:57:53,680 --> 02:57:54,840 I CANNOT PUBLISH ANYTHING 4861 02:57:54,840 --> 02:57:56,160 WITHOUT MAKING ALL THE DATA 4862 02:57:56,160 --> 02:57:57,480 AVAILABLE ON A WEBSITE LIKE 4863 02:57:57,480 --> 02:57:59,680 DRYAD, SO THIS IS A NEW 4864 02:57:59,680 --> 02:58:01,120 REQUIREMENT AND IT'S A REALLY 4865 02:58:01,120 --> 02:58:02,560 IMPORTANT ONE. 4866 02:58:02,560 --> 02:58:06,160 SO THAT'S IT. 4867 02:58:06,160 --> 02:58:11,760 >>THANKS, ELBA. 4868 02:58:11,760 --> 02:58:12,040 AND SAMEER? 4869 02:58:12,040 --> 02:58:17,240 >>YEAH, TWO QUICK THINGS. 4870 02:58:17,240 --> 02:58:18,880 THERE'S APPARENTLY A FLASH FLOOD 4871 02:58:18,880 --> 02:58:20,320 OUTSIDE MY WINDOW, TWO INCHES OF 4872 02:58:20,320 --> 02:58:21,600 WATER, THIS WILL BE FUN. 4873 02:58:21,600 --> 02:58:27,760 THE OTHER ONE MORE RELEVANT IS 4874 02:58:27,760 --> 02:58:30,560 IN PARALLEL, I HAD THE PLEASURE, 4875 02:58:30,560 --> 02:58:33,240 REALLY LEARNED A LOT FROM 4876 02:58:33,240 --> 02:58:42,960 WORKING WITH A PARALLEL GROUP, 4877 02:58:42,960 --> 02:58:45,240 NEUROETHICS WORKING GROUP IN A 4878 02:58:45,240 --> 02:58:46,520 BRANCH WITHIN "BRAIN," WE PUT 4879 02:58:46,520 --> 02:58:51,840 OUT A PAPER A YEAR AGO, NOW 4880 02:58:51,840 --> 02:58:57,080 WE'RE OFF TO THE NEXT PROJECT, A 4881 02:58:57,080 --> 02:58:58,520 FUN PROJECT, LOOKING AT ISSUES 4882 02:58:58,520 --> 02:59:02,960 AROUND DATA SHARING, DATA REUSE, 4883 02:59:02,960 --> 02:59:04,760 WHAT ARE THE ADVANTAGES, 4884 02:59:04,760 --> 02:59:08,240 DISADVANTAGES FROM ALL THE 4885 02:59:08,240 --> 02:59:09,640 DIFFERENT PERSPECTIVES. 4886 02:59:09,640 --> 02:59:11,520 DOING THIS WITH AMY MAGUIRE 4887 02:59:11,520 --> 02:59:16,880 HERE, DIRECTOR OF CENTER FOR 4888 02:59:16,880 --> 02:59:18,640 MEDICAL ETHICS AT BAYLOR WHO I 4889 02:59:18,640 --> 02:59:20,920 WORK WITH A LOT THROUGH THE 4890 02:59:20,920 --> 02:59:23,320 SHARED R01, BRAIN SHARE THROUGH 4891 02:59:23,320 --> 02:59:24,880 BRAIN, THIS IS NEAT BECAUSE IT 4892 02:59:24,880 --> 02:59:26,400 ADDRESSES A LOT OF ISSUES WE 4893 02:59:26,400 --> 02:59:29,120 TALKED ABOUT TODAY, A COUPLE 4894 02:59:29,120 --> 02:59:31,200 THINGS IN THE CHAT, AND SPANS A 4895 02:59:31,200 --> 02:59:36,560 BUNCH OF AREAS, WE'RE FOCUSING 4896 02:59:36,560 --> 02:59:40,400 LARGELY ON THE ROH ITSELF, 4897 02:59:40,400 --> 02:59:41,920 INVASIVE OPPORTUNITIES IN HUMANS 4898 02:59:41,920 --> 02:59:44,000 TO LEARN HOW THE BRAIN WORKS, 4899 02:59:44,000 --> 02:59:45,840 AND THINGS WE'VE TALKED ABOUT 4900 02:59:45,840 --> 02:59:47,080 EVEN RELATED TO THIS DEPRESSION 4901 02:59:47,080 --> 02:59:48,160 PROJECT, DATA THAT COMES FROM 4902 02:59:48,160 --> 02:59:51,440 THIS, HOW IS IT USED, HOW SHOULD 4903 02:59:51,440 --> 02:59:54,200 IT BE USED, WHO HAS ACCESS, WHO 4904 02:59:54,200 --> 02:59:58,440 OWNS IT, AND HOW CAN WE 4905 02:59:58,440 --> 03:00:03,280 INCENTIVIZE REUSE OF DATA, FROM 4906 03:00:03,280 --> 03:00:05,120 THE PERSPECTIVE OF INVESTIGATORS 4907 03:00:05,120 --> 03:00:09,280 AND JOURNALS, THE PUBLIC, 4908 03:00:09,280 --> 03:00:10,600 PATIENT, PARTICIPANTS, ET 4909 03:00:10,600 --> 03:00:11,040 CETERA. 4910 03:00:11,040 --> 03:00:11,720 THIS IS ONGOING. 4911 03:00:11,720 --> 03:00:13,800 WE HAVE A WORKING GROUP ASSIGNED 4912 03:00:13,800 --> 03:00:15,320 TO THIS, IN THE PROCESS OF 4913 03:00:15,320 --> 03:00:17,600 SKETCHING OUT A DRAFT WITH 4914 03:00:17,600 --> 03:00:20,360 CERTAIN CASE USES, PERHAPS THREE 4915 03:00:20,360 --> 03:00:22,640 SPECIFIC CASE USES THAT SPAN 4916 03:00:22,640 --> 03:00:25,960 DIFFERENT ASPECTS OF THIS TOPIC. 4917 03:00:25,960 --> 03:00:26,600 STAY TUNED. 4918 03:00:26,600 --> 03:00:28,680 NEXT TIME WE MEET IT WILL BE 4919 03:00:28,680 --> 03:00:31,280 PUBLISHED HOPEFULLY. 4920 03:00:31,280 --> 03:00:32,080 PROBABLY NOT. 4921 03:00:32,080 --> 03:00:42,560 BUT FURTHER THAN IT IS NOW. 4922 03:00:46,280 --> 03:00:50,160 >>I'M GOING TO TOSS TO SASKIA 4923 03:00:50,160 --> 03:00:50,480 BRIEFLY. 4924 03:00:50,480 --> 03:00:52,200 >>IT MIGHT BE A GOOD TIME TO 4925 03:00:52,200 --> 03:00:53,760 MENTION WE'RE WORKING A WORKSHOP 4926 03:00:53,760 --> 03:00:54,840 FOR THE NEUROETHICS WORKING 4927 03:00:54,840 --> 03:00:57,160 GROUP RELATED TO DATA AND 4928 03:00:57,160 --> 03:00:58,800 PRIVACY AND DATA SHARING. 4929 03:00:58,800 --> 03:01:01,760 WE'RE HOPING TO HAVE IT THIS 4930 03:01:01,760 --> 03:01:03,920 SUMMER, I THINK THE SAVE THE 4931 03:01:03,920 --> 03:01:07,720 DATES WILL GO OUT SOON-ISH. 4932 03:01:07,720 --> 03:01:09,760 YEAH, WE HOPE TO PULL TOGETHER 4933 03:01:09,760 --> 03:01:11,080 ALL OF THE THREADS THAT WE'VE 4934 03:01:11,080 --> 03:01:13,720 HEARD IN THE LAST COUPLE OF 4935 03:01:13,720 --> 03:01:16,640 MINUTES ABOUT DATA AND PRIVACY. 4936 03:01:16,640 --> 03:01:17,200 4937 03:01:17,200 --> 03:01:17,760 >>THANKS. 4938 03:01:17,760 --> 03:01:18,760 YEAH, STAY TUNED. 4939 03:01:18,760 --> 03:01:25,080 I'LL TURN IT NOW OVER TO JOHN 4940 03:01:25,080 --> 03:01:26,960 AND ANDREA TO CLOSE US OUT. 4941 03:01:26,960 --> 03:01:28,040 >>GO AHEAD, JOHN. 4942 03:01:28,040 --> 03:01:29,560 I'LL DO THE HOUSEKEEPING WHEN 4943 03:01:29,560 --> 03:01:30,040 YOU'RE DONE. 4944 03:01:30,040 --> 03:01:32,880 >>YOU'LL HAVE THE TIME WORD, 4945 03:01:32,880 --> 03:01:35,040 THE IMPORTANT PART. 4946 03:01:35,040 --> 03:01:35,280 THANKS. 4947 03:01:35,280 --> 03:01:38,760 IT'S BEEN A GREAT SET OF 4948 03:01:38,760 --> 03:01:40,840 DISCUSSIONS, AND REALLY ENJOYED 4949 03:01:40,840 --> 03:01:41,520 THE PRESENTATIONS AND 4950 03:01:41,520 --> 03:01:43,480 DISCUSSIONS THAT FOLLOWED. 4951 03:01:43,480 --> 03:01:45,520 I THINK WE SURFACED A LOT OF 4952 03:01:45,520 --> 03:01:47,560 IMPORTANT ISSUES, AND I ASK YOU 4953 03:01:47,560 --> 03:01:49,360 AS YOU LEAVE HERE AND THINK 4954 03:01:49,360 --> 03:01:52,240 ABOUT WHAT WE TALKED ABOUT IN 4955 03:01:52,240 --> 03:01:55,720 TERMS OF WHAT CAN NEWG DO AND 4956 03:01:55,720 --> 03:01:57,480 HOW CAN NEWG HELP TO CONSIDER 4957 03:01:57,480 --> 03:02:00,760 THE THINGS THAT CAME UP ABOUT 4958 03:02:00,760 --> 03:02:03,200 ONE BEING KIND OF LET'S -- WE 4959 03:02:03,200 --> 03:02:04,920 CAN START WITH BRAIN AS OUR 4960 03:02:04,920 --> 03:02:07,040 FOCUS, NOT TO SAY THAT WE 4961 03:02:07,040 --> 03:02:10,640 WOULDN'T WANT THE IMPACT TO BE 4962 03:02:10,640 --> 03:02:12,920 MUCH LARGER BUT ONE COOL THING 4963 03:02:12,920 --> 03:02:13,920 ABOUT THE BRAIN INITIATIVE, SOME 4964 03:02:13,920 --> 03:02:16,440 THINGS WE START HERE ARE 4965 03:02:16,440 --> 03:02:20,280 APPLICABLE MORE PRODUCTLY IN NOT 4966 03:02:20,280 --> 03:02:20,960 JUST NEUROSCIENCE BUT ACROSS 4967 03:02:20,960 --> 03:02:23,000 BIOMEDICINE, FOR EXAMPLE MANY 4968 03:02:23,000 --> 03:02:26,120 ISSUES COMING UP ACUTELY IN THE 4969 03:02:26,120 --> 03:02:33,440 POST-TRIAL SPACE ARE DISCUSSED 4970 03:02:33,440 --> 03:02:35,280 ACROSS NIH AND BIOMEDICINE. 4971 03:02:35,280 --> 03:02:37,440 AND AGAIN TO THINK ABOUT THIS AS 4972 03:02:37,440 --> 03:02:39,760 A NEUROSCIENCE INITIATIVE WHERE 4973 03:02:39,760 --> 03:02:42,720 WE'RE LOOKING AT BUILDING TOOLS 4974 03:02:42,720 --> 03:02:43,480 ETHICALLY TO UNDERSTAND 4975 03:02:43,480 --> 03:02:45,000 MECHANISM AND IF YOU UNDERSTAND 4976 03:02:45,000 --> 03:02:46,240 MECHANISM YOU GET A LOT FURTHER 4977 03:02:46,240 --> 03:02:49,720 IN ALL WE DO. 4978 03:02:49,720 --> 03:02:51,040 AND FINALLY I THINK BRAIN 4979 03:02:51,040 --> 03:02:53,680 INITIATIVE FROM THE OUTSET HAS 4980 03:02:53,680 --> 03:02:55,520 MADE THE ETHICAL CONSIDERATIONS 4981 03:02:55,520 --> 03:02:58,040 TO BE INTEGRAL TO WHAT WE DO AND 4982 03:02:58,040 --> 03:03:00,120 HENCE WHY WE'RE ALL HERE TODAY 4983 03:03:00,120 --> 03:03:02,520 AND REALLY THE VALUE OF THE NEWG 4984 03:03:02,520 --> 03:03:05,800 AND HOW CAN WE MORE FULLY 4985 03:03:05,800 --> 03:03:09,320 INTEGRATE THESE VIEWS INTO THE 4986 03:03:09,320 --> 03:03:11,720 RESEARCH NOT AS AN ADD-ON AT THE 4987 03:03:11,720 --> 03:03:15,480 END BECAUSE BY THEN WE ALL KNOW 4988 03:03:15,480 --> 03:03:17,680 IT'S TOO LITTLE TOO LATE. 4989 03:03:17,680 --> 03:03:18,960 WE CAN WORK TOWARDS AN 4990 03:03:18,960 --> 03:03:19,680 INTERESTING AND PRODUCTIVE 4991 03:03:19,680 --> 03:03:21,040 CONVERSATION IN THE FUTURE, 4992 03:03:21,040 --> 03:03:23,320 WHETHER HERE AT NEWG MEETINGS OR 4993 03:03:23,320 --> 03:03:25,720 IN WRITING UP SOME SCHOLARLY 4994 03:03:25,720 --> 03:03:30,040 PAPERS, TRYING TO FIGURE OUT OR 4995 03:03:30,040 --> 03:03:32,200 TO SOLICIT INTERESTING 4996 03:03:32,200 --> 03:03:33,560 APPLICATIONS TO FUND IN THE 4997 03:03:33,560 --> 03:03:35,520 NEUROETHICS SPACE AND ALSO OF 4998 03:03:35,520 --> 03:03:36,960 COURSE HOLDING WORKSHOPS THAT 4999 03:03:36,960 --> 03:03:39,440 DIG IN DEEPER. 5000 03:03:39,440 --> 03:03:41,800 WE LOOK FORWARD TO YOUR INPUT AS 5001 03:03:41,800 --> 03:03:43,200 WE CHART FORWARD IN THE NEXT 5002 03:03:43,200 --> 03:03:43,920 YEAR PLUS. 5003 03:03:43,920 --> 03:03:46,120 I'LL HAND IT OVER TO ANDREA WITH 5004 03:03:46,120 --> 03:03:48,880 MY THANKS FOR YOUR PARTICIPATION 5005 03:03:48,880 --> 03:03:49,520 AND ATTENTION TODAY. 5006 03:03:49,520 --> 03:03:51,280 >>JOHN GETS THE MORE FUN 5007 03:03:51,280 --> 03:03:51,800 CLOSING REMARKS. 5008 03:03:51,800 --> 03:03:54,520 MY JOB IS TO LET YOU KNOW THAT 5009 03:03:54,520 --> 03:03:56,920 WE ARE CONCLUDING THE OPEN 5010 03:03:56,920 --> 03:03:59,320 SESSION OF THE NEUROETHICS WORK 5011 03:03:59,320 --> 03:04:01,440 GROUP, TRANSITIONING TO CLOSED 5012 03:04:01,440 --> 03:04:03,600 SESSION AT 45 MINUTES PAST THE 5013 03:04:03,600 --> 03:04:04,960 HOUR, THE ZOOM ROOM WILL BE OPEN 5014 03:04:04,960 --> 03:04:09,240 EARLY TO GET STARTED ON TIME. 5015 03:04:09,240 --> 03:04:10,360 FOR NEWG MEMBERS, INVITED 5016 03:04:10,360 --> 03:04:13,200 GUESTS, YOU HAVE A SEPARATE LINK 5017 03:04:13,200 --> 03:04:15,600 IN YOUR MEETING INVITATION OR 5018 03:04:15,600 --> 03:04:17,640 E-MAIL OR PROBABLY BOTH. 5019 03:04:17,640 --> 03:04:19,720 ALSO A QUICK PLUG, MULTI-COUNCIL 5020 03:04:19,720 --> 03:04:20,600 WORK GROUP TOMORROW, OPEN 5021 03:04:20,600 --> 03:04:23,360 SESSION AT NOON EASTERN TIME. 5022 03:04:23,360 --> 03:04:26,200 SO FOR NOW WE ADJOURN OUR OPEN 5023 03:04:26,200 --> 03:04:28,080 SESSION, AND WE WILL SEE NEWG 5024 03:04:28,080 --> 03:04:29,720 MEMBERS FOR CLOSED SESSION AGAIN 5025 03:04:29,720 --> 03:04:31,800 AT 45 MINUTES PAST THE HOUR. 5026 03:04:31,800 --> 00:00:00,000 THANK YOU ALL.