1 00:00:11,010 --> 00:00:12,011 >> THANK YOU EVERYBODY. WELCOME 2 00:00:12,078 --> 00:00:12,579 TO BIG DATA APPROACHES FOR 3 00:00:12,645 --> 00:00:13,179 NOVEL MECHANISTIC INSIGHTS ON 4 00:00:13,246 --> 00:00:13,780 DISORDERS OF SLEEP AND 5 00:00:13,847 --> 00:00:14,080 CIRCADIAN RHYTHMS. 6 00:00:14,147 --> 00:00:14,347 I AM DOCTOR 7 00:00:14,414 --> 00:00:14,814 LAWRENCE BAIZER, PROGRAM 8 00:00:14,881 --> 00:00:18,818 OFFICER THE NATIONAL CENTER OF 9 00:00:18,885 --> 00:00:19,452 SLEEP RESEARCH AND TO ORGANIZE 10 00:00:19,519 --> 00:00:26,760 THIS EVENT WE HAD GREAT 11 00:00:26,826 --> 00:00:27,327 PRESENTATIONS AND WE TALKED 12 00:00:27,394 --> 00:00:27,861 ABOUT RESOURCES FOR SLEEP 13 00:00:27,927 --> 00:00:28,528 ANALYSIS AND HAD A ROBUST PANEL 14 00:00:28,595 --> 00:00:31,164 DISCUSSION AT THE END. 15 00:00:31,231 --> 00:00:31,664 THE WORKSHOP CHAIRS WILL 16 00:00:31,731 --> 00:00:32,198 PROVIDE A MORE DETAILED 17 00:00:32,265 --> 00:00:36,035 SUMMARY. AS WELL AS A BRIEF 18 00:00:36,102 --> 00:00:36,669 OVERVIEW OF TODAY'S SESSIONS IN 19 00:00:36,736 --> 00:00:38,271 A COUPLE OF MINUTES AND WE 20 00:00:38,338 --> 00:00:39,506 COVERED MOST OF THE 21 00:00:39,572 --> 00:00:41,040 HOUSEKEEPING ISSUES, QUESTIONS 22 00:00:41,107 --> 00:00:42,475 AND ANSWERS. THE SCHEDULE IS 23 00:00:42,542 --> 00:00:46,379 FOR 15 MINUTE TALKS WITH FIVE 24 00:00:46,446 --> 00:00:46,913 MINUTES FOR QUESTIONS AND 25 00:00:46,980 --> 00:00:48,248 ANSWERS AT THE END. FOR EACH 26 00:00:48,314 --> 00:00:51,851 TALK AND QUESTION AND ANSWERS 27 00:00:51,918 --> 00:00:52,452 IS SUPPOSED TO BE 20 MINUTES 28 00:00:52,519 --> 00:00:56,723 BUT WE NEED TO WATCH THE TIME. 29 00:00:56,790 --> 00:00:57,290 SO IF WE HAVE TIME AT THE END 30 00:00:57,357 --> 00:00:57,924 OF THE PRESENTATIONS, WE COULD 31 00:00:57,991 --> 00:00:59,859 MAYBE HAVE TIME FOR ONE OR TWO 32 00:00:59,926 --> 00:01:01,561 QUESTIONS. BUT THERE IS ALSO A 33 00:01:01,628 --> 00:01:03,329 LOT OF Q&A SESSIONS AT THE END 34 00:01:03,396 --> 00:01:05,899 OF EACH SESSION. EACH SESSION 35 00:01:05,965 --> 00:01:12,939 IS 2-4 TALKS. IT WOULD BE MORE 36 00:01:13,006 --> 00:01:13,573 FEASIBLE TO ASK QUESTIONS THEN. 37 00:01:13,640 --> 00:01:16,342 BUT SEND THEM IN, AND THE 38 00:01:16,409 --> 00:01:16,943 MODERATOR CAN POST QUESTIONS 39 00:01:17,010 --> 00:01:17,577 WHENEVER IT IS MOST CONVENIENT 40 00:01:17,644 --> 00:01:18,912 THE WORSHIP TEAM WILL PROVIDE 41 00:01:18,978 --> 00:01:21,414 WARNINGS AT 18 MINUTES. 42 00:01:21,481 --> 00:01:22,115 SO MANY THANKS TO THE WORKSHOP 43 00:01:22,182 --> 00:01:25,351 COCHAIRS, DR. SHAUN PURCELL 44 00:01:25,418 --> 00:01:28,855 FROM HARVARD, LAUREN HALE, 45 00:01:28,922 --> 00:01:33,860 STONY BROOK MEDICINE. AND AS 46 00:01:33,927 --> 00:01:36,930 WELL WITH THE NIH PROGRAM 47 00:01:36,996 --> 00:01:40,400 COLLEAGUES WHO PARTICIPATED IN 48 00:01:40,467 --> 00:01:41,034 THIS WORKSHOP AND THANK YOU FOR 49 00:01:41,100 --> 00:01:41,634 THE TEAM FOR THEIR EFFORTS IN 50 00:01:41,701 --> 00:01:42,202 MAKING THIS EVENT POSSIBLE. 51 00:01:42,268 --> 00:01:42,669 THANKS AGAIN FOR YOUR 52 00:01:42,735 --> 00:01:43,670 ATTENTION. OVER TO THE 53 00:01:43,736 --> 00:01:48,575 WORKSHOP COCHAIRS DR. PURCELL 54 00:01:48,641 --> 00:01:51,945 AND HALE FOR THE REEFER MARKS 55 00:01:52,011 --> 00:01:52,545 FORWARD GET STARTED. 56 00:01:52,612 --> 00:01:53,813 >> DR. PURCELL: HELLO WELCOME 57 00:01:53,880 --> 00:01:59,152 TO DAY 2. FOR THOSE WHO MISSED 58 00:01:59,219 --> 00:02:00,854 YESTERDAY'S SESSION, THEY WILL 59 00:02:00,920 --> 00:02:01,488 BE AVAILABLE ONLINE SO YOU CAN 60 00:02:01,554 --> 00:02:05,058 GO TO THAT AT SOME FUTURE DATE. 61 00:02:05,124 --> 00:02:06,893 BRIEFLY, I THINK WE HEARD ABOUT 62 00:02:06,960 --> 00:02:08,194 THE RICH VARIETY OF DATA 63 00:02:08,261 --> 00:02:12,599 RESULTS AND TOOLS AVAILABLE FOR 64 00:02:12,665 --> 00:02:13,166 IN-DEPTH SLEEP ANALYSIS AND 65 00:02:13,233 --> 00:02:13,600 SEVERAL EXAMPLES OF 66 00:02:13,666 --> 00:02:14,801 APPLICATIONS. 67 00:02:14,868 --> 00:02:19,405 ONE CLEAR THING IS IMPORTANT OF 68 00:02:19,472 --> 00:02:20,006 DIFFERENT MODALITIES OF DATA, 69 00:02:20,073 --> 00:02:24,010 SLEEP. BUT PERHAPS WITH THE 70 00:02:24,077 --> 00:02:24,644 QUALIFICATION THAT THESE DO NOT 71 00:02:24,711 --> 00:02:25,144 NECESSARILY NEED TO BE 72 00:02:25,211 --> 00:02:25,778 CONCURRENTLY MEASURED, AS PER 73 00:02:25,845 --> 00:02:34,587 THE TRADITIONAL PSG. RATHER 74 00:02:34,654 --> 00:02:35,088 THE VALUE OF DECOUPLING 75 00:02:35,154 --> 00:02:35,722 DIFFERENT SENSES WAS RAISED FOR 76 00:02:35,788 --> 00:02:36,322 POTENTIAL MORE EFFICIENT AND 77 00:02:36,389 --> 00:02:40,126 GETTABLE STUDIES. AND I THINK 78 00:02:40,193 --> 00:02:42,395 THESE THINGS WERE ALREADY 79 00:02:42,462 --> 00:02:43,463 ECHOED. WITH TOOLS FOCUSED ON 80 00:02:43,530 --> 00:02:45,798 THE PSG, AND WITH THE DIVERSITY 81 00:02:45,865 --> 00:02:49,135 OF TALKS PRESENTED. 82 00:02:49,202 --> 00:02:49,536 SECOND AND SOMEWHAT 83 00:02:49,602 --> 00:02:51,170 HAND-IN-HAND WITH THIS, I THINK 84 00:02:51,237 --> 00:02:55,642 THERE WAS ENTHUSIASM FOR THE 85 00:02:55,708 --> 00:02:56,242 QUALIFICATIONS, SLEEP SIGNALS 86 00:02:56,309 --> 00:02:56,876 WHATEVER THEIR SOURCE IN A WAY 87 00:02:56,943 --> 00:02:57,477 THAT IS NOT NECESSARILY QUITE 88 00:02:57,544 --> 00:03:02,649 SO YOKED TO TRADITIONAL R&K 89 00:03:02,715 --> 00:03:05,151 CLASSIFICATIONS. I THINK IT IS 90 00:03:05,218 --> 00:03:07,387 APPEALING IN MANY WAYS 91 00:03:07,453 --> 00:03:07,987 SPECIALLY DOUBT AND AMOUNT OF 92 00:03:08,054 --> 00:03:09,422 THE FOCUS IS ON METRICS PERHAPS 93 00:03:09,489 --> 00:03:09,989 WITH GREATER CROSS SPECIES 94 00:03:10,056 --> 00:03:13,459 TRANSFERABILITY WHERE R&K 95 00:03:13,526 --> 00:03:14,060 HEURISTICS DON'T APPLY IN ANY 96 00:03:14,127 --> 00:03:16,629 CASE. 97 00:03:16,696 --> 00:03:18,698 I'VE SEEN THESE TYPES OF IDEAS 98 00:03:18,765 --> 00:03:19,165 PERCOLATE THROUGH THE 99 00:03:19,232 --> 00:03:19,699 LITERATURE GOING BACK TWO 100 00:03:19,766 --> 00:03:21,768 DECADES. I THINK THE INCREASE 101 00:03:21,834 --> 00:03:23,903 IN DATA AND ANALYTICS WE ARE 102 00:03:23,970 --> 00:03:27,173 WITNESSING NOW MAY BE A GAME 103 00:03:27,240 --> 00:03:27,740 CHANGER IN HELPING TO PUSH 104 00:03:27,807 --> 00:03:29,842 FORWARD SOME OF THESE EFFORTS 105 00:03:29,909 --> 00:03:30,476 FOR MORE EMPIRICALLY GROUNDED 106 00:03:30,543 --> 00:03:33,580 MEASUREMENTS OF SLEEP, TO 107 00:03:33,646 --> 00:03:36,115 COMPLEMENT TRADITIONAL STAGING. 108 00:03:36,182 --> 00:03:36,683 WE HAD A PANEL DISCUSSION IS 109 00:03:36,749 --> 00:03:37,884 NOTED THAT CONTINUED SOME OF 110 00:03:37,951 --> 00:03:40,153 THESE THEMES, AND SOME LARGER 111 00:03:40,219 --> 00:03:42,121 QUESTIONS LIKE WHAT SLEEP 112 00:03:42,188 --> 00:03:42,755 MEASURES ARE ESSENTIAL AND WHAT 113 00:03:42,822 --> 00:03:45,858 IS THE BEST WAYS TO OBTAIN THEM? 114 00:03:45,925 --> 00:03:46,392 AND ALSO UNDERSCORE THE 115 00:03:46,459 --> 00:03:46,993 IMPORTANCE OF NON-THEOLOGICAL 116 00:03:47,060 --> 00:03:50,330 FACTORS IN MEASURING SLEEP, 117 00:03:50,396 --> 00:03:50,797 ENVIRONMENTAL, SOCIAL 118 00:03:50,863 --> 00:03:53,099 INFLUENCES AND SUBJECTIVE 119 00:03:53,166 --> 00:03:53,733 PATIENT REPORTED OUTCOMES AND I 120 00:03:53,800 --> 00:03:54,701 THINK THESE ARE SOME OF THE 121 00:03:54,767 --> 00:03:55,301 THEMES WILL GO INTO TODAY IN 122 00:03:55,368 --> 00:03:57,737 MORE DEPTH IN THIS RECESSION SO 123 00:03:57,804 --> 00:03:58,404 I THINK WILL TURN IT OVER TO MY 124 00:03:58,471 --> 00:04:00,773 COCHAIR DR. HALE WHO WILL I 125 00:04:00,840 --> 00:04:02,442 BELIEVE INTRODUCED TODAY'S 126 00:04:02,508 --> 00:04:03,209 SESSIONS THANK YOU. 127 00:04:03,276 --> 00:04:05,411 >> DR. HALE: THAT IS RIGHT 128 00:04:05,478 --> 00:04:06,746 TODAY WE HAVE THREE REALLY 129 00:04:06,813 --> 00:04:09,148 EXCITING PANELS. THE FIRST 130 00:04:09,215 --> 00:04:12,952 WILL BE LOOKING AT THE EFFECTS 131 00:04:13,019 --> 00:04:16,055 OF SLEEP DISORDERS ON ADVERSE 132 00:04:16,122 --> 00:04:17,957 HEALTH OUTCOMES, USING BIG DATA. 133 00:04:18,024 --> 00:04:21,127 THE SECOND, LOOKING AT IT OVER 134 00:04:21,194 --> 00:04:22,362 THE LIFE COURSE WHICH IS OF 135 00:04:22,428 --> 00:04:26,966 INTEREST TO ME. AND FINALLY I 136 00:04:27,033 --> 00:04:27,600 THINK ALL OF US ARE INTERESTED 137 00:04:27,667 --> 00:04:28,234 IN WHAT THE LARGER IMPLICATIONS 138 00:04:28,301 --> 00:04:31,738 ARE FOR POPULATION, WELL-BEING, 139 00:04:31,804 --> 00:04:33,940 THE ENVIRONMENTAL INFLUENCES, 140 00:04:34,007 --> 00:04:35,675 THE ETHICAL INFLUENCES ISSUES. 141 00:04:35,742 --> 00:04:37,644 LET ME INTRODUCE OUR THREE 142 00:04:37,710 --> 00:04:44,150 MODERATORS FOR TODAY. HERE IS 143 00:04:44,217 --> 00:04:47,153 WHAT THEY ARE. SESSION 3 IS 144 00:04:47,220 --> 00:04:53,993 MODERATED BY INNA BELFER, 145 00:04:54,060 --> 00:04:54,494 PROGRAM OFFICER FOR THE 146 00:04:54,560 --> 00:04:55,294 NATIONAL CENTER FOR INTEGRATED 147 00:04:55,361 --> 00:04:58,197 HEALTH, DEPUTY BRANCH CHIEF 148 00:04:58,264 --> 00:04:58,731 FOR BASIC AND MECHANISTIC 149 00:04:58,798 --> 00:05:02,769 RESEARCH BRANCH. THE SESSION 4 150 00:05:02,835 --> 00:05:05,938 IS MODERATED BY TODD HORWITZ 151 00:05:06,005 --> 00:05:11,144 PROGRAM OFFICER AT NCI AND IN 152 00:05:11,210 --> 00:05:15,415 THE BEHAVIORAL SCIENCES AND 153 00:05:15,481 --> 00:05:16,049 BEHAVIORAL RESEARCH PROGRAM IN 154 00:05:16,115 --> 00:05:16,683 SESSION 5, THE LASTING FOR THE 155 00:05:16,749 --> 00:05:22,055 DAY MODERATED BY DANISH LAZAR 156 00:05:22,121 --> 00:05:22,655 (PHONETIC) PROGRAM OFFICER IN 157 00:05:22,722 --> 00:05:25,591 THE OFFICE OF BEHAVIOR IN 158 00:05:25,658 --> 00:05:26,225 SOCIAL SCIENCE RESEARCH AND THE 159 00:05:26,292 --> 00:05:29,262 OFFICE OF THE DIRECTOR. 160 00:05:29,328 --> 00:05:29,829 SO WITHOUT FURTHER ADO, LET'S 161 00:05:29,896 --> 00:05:31,097 GET STARTED. I AM SUPER EXCITED 162 00:05:31,164 --> 00:05:33,399 FOR TODAY. 163 00:05:33,466 --> 00:05:38,438 >> THANK YOU SO MUCH LAUREN. 164 00:05:38,504 --> 00:05:38,971 HELLO EVERYBODY I AM VERY 165 00:05:39,038 --> 00:05:39,806 EXCITED TO WELCOME EVERYBODY 166 00:05:39,872 --> 00:05:43,910 FOR SESSION 3. SO MY NAME IS 167 00:05:43,976 --> 00:05:46,579 INNA BEIFER, FROM THE NATIONAL 168 00:05:46,646 --> 00:05:49,248 CENTER FOR INTEGRATED HEALTH 169 00:05:49,315 --> 00:05:51,617 AND COMPLEMENTARY HEALTH, IN 170 00:05:51,684 --> 00:05:54,020 SLEEP RESEARCH ESPECIALLY IN 171 00:05:54,087 --> 00:05:57,857 THE CONTEXT OF COMPLEMENTARY 172 00:05:57,924 --> 00:05:58,458 AND INTEGRATED APPROACHES TO 173 00:05:58,524 --> 00:06:02,495 SLEEP DISORDERS AND ALSO TO THE 174 00:06:02,562 --> 00:06:05,231 EFFECTS OF SLEEP DISORDERS. SO 175 00:06:05,298 --> 00:06:08,267 THIS PARTICULAR SESSION IS VERY 176 00:06:08,334 --> 00:06:15,408 IMPORTANT TO US. 177 00:06:15,475 --> 00:06:17,410 EXAMPLES OF APPLICATIONS OF BIG 178 00:06:17,477 --> 00:06:20,580 DATA APPROACHES, TO CORRECT 179 00:06:20,646 --> 00:06:21,481 SLEEP DISORDERS OUR FIRST 180 00:06:21,547 --> 00:06:26,018 SPEAKER IS DOCTORDIEGO MAZZOTTI. 181 00:06:26,085 --> 00:06:29,388 ASSISTANT PROFESSOR IN THE 182 00:06:29,455 --> 00:06:31,290 DIVISION OF MEDICAL INFORMATICS 183 00:06:31,357 --> 00:06:31,858 AT THE UNIVERSITY OF KANSAS 184 00:06:31,924 --> 00:06:38,030 MEDICAL CENTER. HE USES BIG 185 00:06:38,097 --> 00:06:38,598 DATA SETS, CULMINATION OF 186 00:06:38,664 --> 00:06:39,932 COMPETITION WILL METHOD IN 187 00:06:39,999 --> 00:06:40,566 MACHINE LEARNING TO STUDY SLEEP 188 00:06:40,633 --> 00:06:41,834 DISORDERS. 189 00:06:41,901 --> 00:06:47,373 AND HE IS CURRENTLY FOCUSING ON 190 00:06:47,440 --> 00:06:47,974 THE APPLICATION OF INNOVATIVE 191 00:06:48,040 --> 00:06:54,614 METHODS TO THE ANALYSIS OF ... 192 00:06:54,680 --> 00:06:55,248 BEHAVIORS AND GENETICAL DATA ON 193 00:06:55,314 --> 00:06:56,282 SLEEP DISORDERS TO UNDERSTAND 194 00:06:56,349 --> 00:06:57,884 HOW THEY CAN BE TRANSLATED INTO 195 00:06:57,950 --> 00:07:08,494 CRITICAL KNOWLEDGE AND INTEREST 196 00:07:10,396 --> 00:07:14,934 APPLICATIONS THAT CAN ADVANCE 197 00:07:15,001 --> 00:07:16,068 HEALTHCARE. THE TALK IS ON 198 00:07:16,135 --> 00:07:17,737 DISSECTING (INDISCERNIBLE) 199 00:07:17,804 --> 00:07:18,938 SLEEP APNEA. 200 00:07:19,005 --> 00:07:29,415 >> THANK YOU DR. BAIFER FOR 201 00:07:35,388 --> 00:07:35,888 YOUR INVITATION TO PARTICIPATE 202 00:07:35,955 --> 00:07:36,489 IN THIS WORKSHOP I'M GOING TO 203 00:07:36,556 --> 00:07:37,089 BE TALKING A LITTLE BIT ABOUT 204 00:07:37,156 --> 00:07:37,690 SOME OF THE WORK WE HAVE BEEN 205 00:07:37,757 --> 00:07:38,257 DOING OVER THE LAST SEVERAL 206 00:07:38,324 --> 00:07:41,460 YEARS AND TRYING TO UNDERSTAND 207 00:07:41,527 --> 00:07:42,061 HETEROGENEITY OF OBSTRUCTIVE 208 00:07:42,128 --> 00:07:45,598 SLEEP APNEA, A HIGHLY PREVALENT 209 00:07:45,665 --> 00:07:49,735 SLEEP DISORDER. 210 00:07:49,802 --> 00:07:50,203 A LOT OF WHAT WE COULD 211 00:07:50,269 --> 00:07:52,004 CHARACTERIZE OVER THE LAST FEW 212 00:07:52,071 --> 00:07:52,605 YEARS RELATES TO HOW COMPLEX 213 00:07:52,672 --> 00:07:56,943 THE DISEASE IS. AND HOPING TO 214 00:07:57,009 --> 00:07:57,577 TALK A LITTLE BIT ABOUT SOME OF 215 00:07:57,643 --> 00:07:59,178 THE WORK THAT WE HAVE BEEN 216 00:07:59,245 --> 00:08:00,346 DOING AND HOW WE CAN UNDERSTAND 217 00:08:00,413 --> 00:08:04,350 THE RESEARCH. NEXT SLIDE PLEASE. 218 00:08:04,417 --> 00:08:07,620 SO THERE ARE MANY MECHANISMS, 219 00:08:07,687 --> 00:08:11,057 IF WE LOOK AT WHAT SLEEP DOES 220 00:08:11,123 --> 00:08:20,733 TO A PATIENT THAT EXPRESSES THE 221 00:08:20,800 --> 00:08:21,234 DISEASE, THAT COULD BE 222 00:08:21,300 --> 00:08:21,767 IMPORTANT DETERMINANTS OF 223 00:08:21,834 --> 00:08:22,401 CARDIOVASCULAR VESSEL AT RISK. 224 00:08:22,468 --> 00:08:23,736 THIS REVIEW IS AN ARTICLE 225 00:08:23,803 --> 00:08:24,937 DISCOVERING THE PHYSIOLOGICAL 226 00:08:25,004 --> 00:08:25,972 COMPONENTS FOR PATIENTS THAT 227 00:08:26,038 --> 00:08:29,342 HAVE EXPRESSED CPAP SOME OF 228 00:08:29,408 --> 00:08:31,010 THOSE ARE CURRENTLY BEING 229 00:08:31,077 --> 00:08:31,611 CAPTURED BY MORE CONVENTIONAL 230 00:08:31,677 --> 00:08:33,846 MATRIX SUCH AS THE APNEA 231 00:08:33,913 --> 00:08:36,916 HYPOXIA INDEX INTERACTION, 232 00:08:36,983 --> 00:08:38,985 AROUSALS AND OXYGEN SATURATION. 233 00:08:39,051 --> 00:08:41,220 OVER THE LAST FEW YEARS THERE 234 00:08:41,287 --> 00:08:46,459 WAS A LOT OF INVESTMENT IN 235 00:08:46,525 --> 00:08:47,059 TRYING TO IDENTIFY BIOMARKERS 236 00:08:47,126 --> 00:08:47,593 AND HOW THEY COULD BETTER 237 00:08:47,660 --> 00:08:48,828 RELATE AND BETTER EXPLAIN SOME 238 00:08:48,895 --> 00:08:51,597 OF THE POTENTIAL RISKS OF 239 00:08:51,664 --> 00:08:53,933 OBSTRUCTIVE SLEEP APNEA ON 240 00:08:54,000 --> 00:08:54,500 CARDIOVASCULAR DISEASES AND 241 00:08:54,567 --> 00:08:55,635 SOME OF THOSE MECHANISMS ARE 242 00:08:55,701 --> 00:08:59,205 EXPLAINED IN THIS FIGURE, SUCH 243 00:08:59,272 --> 00:09:06,145 A SYMPATHETIC ACTIVATION AND 244 00:09:06,212 --> 00:09:06,746 OTHERS WHICH PUTS THE PATIENT 245 00:09:06,812 --> 00:09:13,853 AT GREATER RISK. 246 00:09:13,920 --> 00:09:16,289 ONE COMPONENT THAT SOMETIMES 247 00:09:16,355 --> 00:09:16,889 GETS FORGOTTEN AND YESTERDAY 248 00:09:16,956 --> 00:09:17,490 PRESENTATION REPORTED ON HOW 249 00:09:17,556 --> 00:09:18,124 THE CLINICAL PRESENTATION OF A 250 00:09:18,190 --> 00:09:19,191 PATIENT WITH SLEEP APNEA CAN 251 00:09:19,258 --> 00:09:22,328 ALSO BE FORMATIVE, THE 252 00:09:22,395 --> 00:09:24,463 FRAMEWORK OF UNDERSTANDING THE 253 00:09:24,530 --> 00:09:24,997 HETEROGENEITY OF SYMPTOM 254 00:09:25,064 --> 00:09:25,598 PRESENTATION WHICH HAS HELPED 255 00:09:25,665 --> 00:09:30,069 US TO UNDERSTAND THAT THE 256 00:09:30,136 --> 00:09:30,703 CLINICAL IMPACT OF OBSTRUCTIVE 257 00:09:30,770 --> 00:09:34,740 SLEEP APNEA. NEXT SLIDE PLEASE. 258 00:09:34,807 --> 00:09:45,217 WITHOUT REGARD IT'S BEEN 10 259 00:09:47,887 --> 00:09:49,855 YEARS AND THE FIRST STUDY WHICH 260 00:09:49,922 --> 00:09:52,959 WAS PUBLISHED... A STUDY THAT 261 00:09:53,025 --> 00:09:58,464 DESCRIBED THE SYMPTOMS OF 262 00:09:58,531 --> 00:09:59,098 OBSTRUCTIVE SLEEP APNEA AND THE 263 00:09:59,165 --> 00:09:59,699 METHOD THAT IS COMMONLY USED 264 00:09:59,765 --> 00:10:01,100 LIKE A NOT SUPERVISE METHOD TO 265 00:10:01,167 --> 00:10:01,701 IDENTIFY SLEEPING CLASSES OR 266 00:10:01,767 --> 00:10:03,669 LATENT CLASS ANALYSIS, WHICH IN 267 00:10:03,736 --> 00:10:07,006 THAT STUDY, INVESTIGATORS 268 00:10:07,073 --> 00:10:08,140 IDENTIFIED IN NUMBER OF KEY 269 00:10:08,207 --> 00:10:10,276 SYMPTOMS THAT ARE OFTEN 270 00:10:10,343 --> 00:10:13,479 REPORTED BY PATIENTS WITH SLEEP 271 00:10:13,546 --> 00:10:14,013 APNEA. AND THEY USED THIS 272 00:10:14,080 --> 00:10:16,949 METHOD TO TRY TO FIND AND TRY 273 00:10:17,016 --> 00:10:18,851 TO DISSECT AND UNDERSTAND THE 274 00:10:18,918 --> 00:10:19,485 HETEROGENEITY OF THOSE SYMPTOMS 275 00:10:19,552 --> 00:10:21,921 AND MINIMIZE THOSE THREE MAJOR 276 00:10:21,988 --> 00:10:23,990 SYMPTOM CLUSTERS. WHICH ARE THE 277 00:10:24,056 --> 00:10:31,430 DISTURBED SLEEP, MINIMALISM 278 00:10:31,497 --> 00:10:32,031 SYMPTOMATIC IN EXCESS OF THE 279 00:10:32,098 --> 00:10:34,033 SLEEPING IN THE FIRST STUDY WAS 280 00:10:34,100 --> 00:10:34,667 PUBLISHED IN ICELAND, THE FIRST 281 00:10:34,734 --> 00:10:36,469 TIME THAT HAS BEEN DESCRIBED. 282 00:10:36,535 --> 00:10:37,103 AND SINCE THEN ALL OF THE OTHER 283 00:10:37,169 --> 00:10:39,038 STUDIES AROUND THE GLOBE, 284 00:10:39,105 --> 00:10:39,538 PARTICULARLY AROUND THE 285 00:10:39,605 --> 00:10:43,743 FOLLOW-UP STUDIES FROM THE 286 00:10:43,809 --> 00:10:44,176 SLEEP APNEA GLOBAL 287 00:10:44,243 --> 00:10:46,746 INTERDISCIPLINARY CONSORTIUM 288 00:10:46,812 --> 00:10:47,346 HAD THE ABILITY TO REPLICATE 289 00:10:47,413 --> 00:10:49,348 THE EXISTENCE OF THOSE SUBTYPES 290 00:10:49,415 --> 00:10:49,915 IN A MUCH BROADER AND MORE 291 00:10:49,982 --> 00:10:52,018 DIVERSE POPULATION. WITH SOME 292 00:10:52,084 --> 00:10:52,618 DIFFERENCES IN HOW OFTEN THEY 293 00:10:52,685 --> 00:10:54,520 APPEAR. BUT MORE OR LESS 294 00:10:54,587 --> 00:10:59,525 GIVING US THE SAME CONCEPT OF 295 00:10:59,592 --> 00:11:00,059 THOSE THREE MAJOR SYMPTOM 296 00:11:00,126 --> 00:11:07,833 CLUSTERS. NEXT SLIDE PLEASE. 297 00:11:07,900 --> 00:11:08,401 ONE OF THE THINGS THAT REALLY 298 00:11:08,467 --> 00:11:09,001 HELPED US UNDERSTAND WHETHER 299 00:11:09,068 --> 00:11:09,602 UNDERSTANDING THOSE CLINICAL 300 00:11:09,668 --> 00:11:14,774 SUBTYPES ARE RELEVANT, WAS THE 301 00:11:14,840 --> 00:11:17,209 STUDY THAT WE CONDUCTED ON THE 302 00:11:17,276 --> 00:11:17,810 HEALTH STUDY WHICH ONLY TO BE 303 00:11:17,877 --> 00:11:23,015 ABLE TO TO BE CONDUCTED DUE TO 304 00:11:23,082 --> 00:11:23,682 SOME OF THE RESOURCES THAT HAVE 305 00:11:23,749 --> 00:11:27,253 BEEN INVESTED, PUTTING TOGETHER 306 00:11:27,319 --> 00:11:27,820 THIS IN AMAZING REPOSITORY 307 00:11:27,887 --> 00:11:29,221 WHICH ALLOWED ME AS AN EARLY 308 00:11:29,288 --> 00:11:33,626 CAREER INVESTIGATOR TO TRY TO 309 00:11:33,692 --> 00:11:34,226 UNDERSTAND, HOW TO USE DATA 310 00:11:34,293 --> 00:11:35,428 THAT IS AVAILABLE AND CAN BE 311 00:11:35,494 --> 00:11:35,928 UTILIZED FOR SECONDARY 312 00:11:35,995 --> 00:11:37,930 RESEARCH. AND IN THIS CASE WE 313 00:11:37,997 --> 00:11:42,968 WERE ABLE TO THEN DESCRIBE 314 00:11:43,035 --> 00:11:44,970 THOSE SUBTYPES IN THE COMMUNITY 315 00:11:45,037 --> 00:11:46,472 BASE CLINICAL POPULATIONS WHICH 316 00:11:46,539 --> 00:11:47,373 ARE THE BEST STUDIES WE 317 00:11:47,440 --> 00:11:51,110 IDENTIFY THOSE FOUR SUBTYPES, 318 00:11:51,177 --> 00:11:51,710 THE THREE MAIN ONES THAT WERE 319 00:11:51,777 --> 00:11:54,480 DESCRIBED ORIGINALLY, DISTURBED 320 00:11:54,547 --> 00:11:57,883 SLEEP, WITH PATIENTS GREATER 321 00:11:57,950 --> 00:11:59,618 REPORT OF INSOMNIA. MINIMAL IS 322 00:11:59,685 --> 00:12:01,821 SYMPTOMATIC, EXCESSIVELY SLEEPY 323 00:12:01,887 --> 00:12:02,455 AND MODERATELY SLEEPY AND WHAT 324 00:12:02,521 --> 00:12:06,125 WE CAN DESCRIBE IN THE 325 00:12:06,192 --> 00:12:06,725 SELF-STUDY IS THAT WE SEEM TO 326 00:12:06,792 --> 00:12:07,259 HAVE LONGITUDINAL DATA IN 327 00:12:07,326 --> 00:12:08,694 INCIDENTS OR EVENTS. 328 00:12:08,761 --> 00:12:10,429 WE COULD SEE WHICH OF THE 329 00:12:10,496 --> 00:12:10,996 SUBTYPES WILL BE ASSOCIATED 330 00:12:11,063 --> 00:12:11,797 WITH GREATER INCIDENCE OF 331 00:12:11,864 --> 00:12:15,734 CARDIOVASCULAR DISEASE. AND WE 332 00:12:15,801 --> 00:12:17,203 OBSERVED THAT THE EXCESSIVE 333 00:12:17,269 --> 00:12:17,837 SLEEP SUBTYPE WAS THE ONE WITH 334 00:12:17,903 --> 00:12:18,404 GREATER INCIDENCE OF THOSE 335 00:12:18,471 --> 00:12:21,874 EVENTS. THAT WAS TRUE WHEN 336 00:12:21,941 --> 00:12:22,508 COMPARED BOTH TO THOSE WITHOUT 337 00:12:22,575 --> 00:12:26,579 SLEEP APNEA, BUT ALSO ACROSS IN 338 00:12:26,645 --> 00:12:29,248 BETWEEN ALL THE OTHER SUBTYPES 339 00:12:29,315 --> 00:12:31,884 WHEN LOOKING AT THOSE WITH 340 00:12:31,951 --> 00:12:33,452 MODERATE/ SEVERE SLEEP APNEA 341 00:12:33,519 --> 00:12:41,760 WHICH SUGGESTS THAT AS DR. 342 00:12:41,827 --> 00:12:42,294 PURCELL INDICATED IN THE 343 00:12:42,361 --> 00:12:42,828 BEGINNING LOOKING AT THE 344 00:12:42,895 --> 00:12:45,097 PHYSIOLOGICAL PARAMETERS WE CAN 345 00:12:45,164 --> 00:12:45,731 OBSERVE WE CAN UNDERSTAND A LOT 346 00:12:45,798 --> 00:12:48,033 OF CLINICAL RELEVANCE OF THE 347 00:12:48,100 --> 00:12:48,501 METRICS, OR OF THOSE 348 00:12:48,567 --> 00:12:51,403 EXPRESSIONS OF SYMPTOMS OF 349 00:12:51,470 --> 00:12:52,004 PATIENTS THAT CAN HELP US 350 00:12:52,071 --> 00:12:57,409 UNDERSTAND. NEXT SLIDE PLEASE. 351 00:12:57,476 --> 00:12:57,943 SO THOSE FINDINGS WERE THEN 352 00:12:58,010 --> 00:13:00,713 FURTHER REPLICATED BY MANY 353 00:13:00,779 --> 00:13:01,347 OTHER STUDIES AROUND THE GLOBE 354 00:13:01,413 --> 00:13:02,047 INCLUDING CLINICAL POPULATIONS 355 00:13:02,114 --> 00:13:06,819 IN CHILE, COMMUNITY POPULATIONS 356 00:13:06,886 --> 00:13:08,187 AMONG HISPANICS AND LATINOS IN 357 00:13:08,254 --> 00:13:08,754 THE UNITED STATES, CLINICAL 358 00:13:08,821 --> 00:13:09,755 POPULATIONS IN CANADA. AND I 359 00:13:09,822 --> 00:13:12,758 THINK THERE WAS ONE STUDY IN 360 00:13:12,825 --> 00:13:14,894 FRANCE, WHERE THE ASSOCIATE WAS 361 00:13:14,960 --> 00:13:17,596 NOT WHAT THEY FOUND. AND I 362 00:13:17,663 --> 00:13:21,367 THINK THAT JUST SHOWS SOMETIMES 363 00:13:21,433 --> 00:13:22,001 HOW HETEROGENEOUS THE DISEASES 364 00:13:22,067 --> 00:13:23,135 AND HOW WE NEED TO BETTER 365 00:13:23,202 --> 00:13:25,004 UNDERSTAND OR EVEN BETTER 366 00:13:25,070 --> 00:13:25,571 CHARACTERIZE SOME OF THOSE 367 00:13:25,638 --> 00:13:28,307 PARAMETERS ARE PERHAPS TRY TO 368 00:13:28,374 --> 00:13:31,177 COME UP WITH BETTER WAYS TO 369 00:13:31,243 --> 00:13:31,777 STANDARDIZE HOW SOME OF THOSE 370 00:13:31,844 --> 00:13:32,344 ASSESSMENTS ARE BEING MADE 371 00:13:32,411 --> 00:13:35,948 WHICH I THINK THAT IS ANOTHER 372 00:13:36,015 --> 00:13:36,549 TOPIC THAT WAS BEEN DISCUSSED 373 00:13:36,615 --> 00:13:38,217 YESTERDAY QUITE A LOT, HOW WE 374 00:13:38,284 --> 00:13:39,818 ARE COLLECTING AND REPRESENTING 375 00:13:39,885 --> 00:13:48,394 AND STERILIZING THIS DATA. AND 376 00:13:48,460 --> 00:13:48,928 SOMETIMES WE SEE THAT THE 377 00:13:48,994 --> 00:13:49,528 HETEROGENEITY IN STUDIES THAT 378 00:13:49,595 --> 00:13:50,129 COULD BE PARTIALLY EXPLAINING 379 00:13:50,196 --> 00:13:51,797 HOW TO COLLECT ANSWERS TO THE 380 00:13:51,864 --> 00:13:52,731 QUESTIONS WE ARE ASKING. NEXT 381 00:13:52,798 --> 00:13:55,568 SLIDE PLEASE. 382 00:13:55,634 --> 00:13:57,136 ONE WAY TO TRY TO MINIMIZE AND 383 00:13:57,203 --> 00:14:00,139 HELP STANDARDIZE SOME OF THOSE 384 00:14:00,206 --> 00:14:01,974 PARAMETERS CAN BE DONE BY 385 00:14:02,041 --> 00:14:03,342 PROVIDING LIKE AVAILABLE OPEN 386 00:14:03,409 --> 00:14:06,612 SOURCE TOOLS THAT FOLKS CAN USE 387 00:14:06,679 --> 00:14:07,213 TO REALLY COME UP WITH THOSE 388 00:14:07,279 --> 00:14:09,615 METRICS. AND WE DID THE STUDY 389 00:14:09,682 --> 00:14:11,951 WHICH WE TRIED TO UNDERSTAND 390 00:14:12,017 --> 00:14:16,155 WHAT WAS THE RELATIVE IMPACT OF 391 00:14:16,222 --> 00:14:16,789 SYMPTOM SUBTYPES IN PREDICTING 392 00:14:16,855 --> 00:14:19,158 CARDIOVASCULAR RISK AND WHAT 393 00:14:19,225 --> 00:14:19,758 WAS THE IMPACT OF SOME OF THE 394 00:14:19,825 --> 00:14:20,392 PHYSIOLOGICAL METRICS THAT HAVE 395 00:14:20,459 --> 00:14:20,993 BEEN REPORTED OVER THE LAST 396 00:14:21,060 --> 00:14:24,830 SEVERAL YEARS. AND ALSO BEING 397 00:14:24,897 --> 00:14:25,264 MORE IMPORTANT THAN 398 00:14:25,331 --> 00:14:28,000 CONVENTIONAL MATRIX SUCH AS THE 399 00:14:28,067 --> 00:14:29,868 AJI, SUCH AS THE HYPOXIC 400 00:14:29,935 --> 00:14:32,705 COMPONENT DESCRIBED BY 401 00:14:32,771 --> 00:14:39,945 AZARBAZRZIN ET AL IN 2019. 402 00:14:40,012 --> 00:14:40,546 IS IT HYPOXIC BURDEN OR SYMPTOM 403 00:14:40,613 --> 00:14:41,146 SUBTYPE THAT EXPLAIN MOST OF 404 00:14:41,213 --> 00:14:51,624 THE CARGO VESSEL RISK? 405 00:14:55,894 --> 00:14:56,328 (CORRECTION) CARDIOVASCULAR 406 00:14:56,395 --> 00:14:56,662 RISK? 407 00:14:56,729 --> 00:15:03,369 AND SO AS PART OF THIS 408 00:15:03,435 --> 00:15:03,936 PROCESS... DESCRIBED IN THE 409 00:15:04,003 --> 00:15:04,536 ORIGINAL APPLICATION AND ALSO 410 00:15:04,603 --> 00:15:06,372 BY THE LAB. NEXT SLIDE PLEASE. 411 00:15:06,438 --> 00:15:07,773 FIRST WE TRY TO UNDERSTAND, CAN 412 00:15:07,840 --> 00:15:10,576 WE SEE, WHAT ARE THE 413 00:15:10,643 --> 00:15:15,147 DIFFERENCES IN THE HYPOXIC 414 00:15:15,214 --> 00:15:16,248 BURDEN DISTRIBUTION WHEN WE 415 00:15:16,315 --> 00:15:16,882 COMPARE THOSE SYMPTOM SUBTYPES? 416 00:15:16,949 --> 00:15:17,516 NOT SURPRISINGLY AS YOU CAN SEE 417 00:15:17,583 --> 00:15:21,053 IN THE LEFT, FOLKS WITH SLEEP 418 00:15:21,120 --> 00:15:27,326 APNEA, WITH DEFINED HERE AS -- 419 00:15:27,393 --> 00:15:32,064 THEY DO HAVE A HIGHER HYPOXIC 420 00:15:32,131 --> 00:15:32,698 BURDEN ACROSS THE BOARD AND WE 421 00:15:32,765 --> 00:15:33,299 SEE THAT THOSE MODERATELY OR 422 00:15:33,365 --> 00:15:33,932 EXCESSIVELY SLEEPING THEY TEND 423 00:15:33,999 --> 00:15:38,203 TO HAVE SLIGHTLY HIGHER. NOT A 424 00:15:38,270 --> 00:15:38,837 DRAMATIC HIGHER EFFECT BUT THEY 425 00:15:38,904 --> 00:15:40,839 TEND TO HAVE SLIGHTLY HIGHER. 426 00:15:40,906 --> 00:15:41,473 THAT IS EVEN MORE APPARENT WHEN 427 00:15:41,540 --> 00:15:42,107 WE LOOK ONLY AT THOSE WITH MORE 428 00:15:42,174 --> 00:15:42,708 ESTABLISHED DISEASE BY 429 00:15:42,775 --> 00:15:45,210 CONVENTIONAL MEANS USING AN AJI 430 00:15:45,277 --> 00:15:48,280 15. SO THERE BE SOME 431 00:15:48,347 --> 00:15:52,117 NONRATIONAL THAT MAYBE HYPOXIC 432 00:15:52,184 --> 00:15:56,789 BURDEN TO BE EXPLIAN SOME OF 433 00:15:56,855 --> 00:15:57,856 THE CARDIOVASCULAR DISEASE. 434 00:15:57,923 --> 00:16:03,796 NEXT SLIDE PLEASE. 435 00:16:03,862 --> 00:16:05,230 WHAT WE DID IS TRY TO REPLICATE 436 00:16:05,297 --> 00:16:06,198 THE ORIGINAL I█NVESTIGATION 437 00:16:06,265 --> 00:16:12,104 BETWEEN BOTH HYPOXIC BURDEN AND 438 00:16:12,171 --> 00:16:12,705 THE SYMPTOMS OBTAINED BY OUR 439 00:16:12,771 --> 00:16:13,272 GROUP AND SEE WHETHER THOSE 440 00:16:13,339 --> 00:16:13,906 THINGS WENT TOGETHER, AND COULD 441 00:16:13,972 --> 00:16:15,374 BETTER EXPLAIN THE 442 00:16:15,441 --> 00:16:17,343 CARDIOVASCULAR DISEASE. AND WE 443 00:16:17,409 --> 00:16:19,478 DID THIS FOR BOTH OUTCOMES, 444 00:16:19,545 --> 00:16:19,978 CARDIOVASCULAR DISEASE 445 00:16:20,045 --> 00:16:20,512 MORTALITY AND MAJOR RISK 446 00:16:20,579 --> 00:16:25,284 CARDIOVASCULAR EVENTS AND WHAT 447 00:16:25,351 --> 00:16:26,385 WE SAW IS THAT THE PENNY ON THE 448 00:16:26,452 --> 00:16:30,222 OUTCOME, DEPENDING FOR 449 00:16:30,289 --> 00:16:31,490 CARDIOVASCULAR MORTALITY 450 00:16:31,557 --> 00:16:33,926 HYPOXIC DEPRIVATION IS A 451 00:16:33,992 --> 00:16:34,893 SIGNIFICANT PREDICTOR DEPENDING 452 00:16:34,960 --> 00:16:35,494 ON THE SUBTYPE AS YOU CAN SEE 453 00:16:35,561 --> 00:16:37,129 IN THE LEFT BOTTOM PART. AND 454 00:16:37,196 --> 00:16:43,168 FOR INSTANCE OF NEW MAJOR 455 00:16:43,235 --> 00:16:43,702 CARDIOVASCULAR EVENTS THE 456 00:16:43,769 --> 00:16:45,337 EXCESSIVE SLEEPY SUBTYPE IS AN 457 00:16:45,404 --> 00:16:45,938 IMPORTANT PREDICTOR EVEN WHEN 458 00:16:46,004 --> 00:16:49,508 YOU CONTROL FOR THOSE CHANGES 459 00:16:49,575 --> 00:16:50,042 IN HYPOXIC BURDEN. 460 00:16:50,109 --> 00:16:55,547 SO IN THE CONTEXT, I THINK BOTH 461 00:16:55,614 --> 00:16:58,884 MEASURES ARE IMPORTANT. AND IT 462 00:16:58,951 --> 00:16:59,485 HIGHLIGHTS THE IMPORTANCE OF 463 00:16:59,551 --> 00:17:00,018 RECOLLECTING BOTH PATIENT 464 00:17:00,085 --> 00:17:01,253 REPORTED OUTCOMES AND SYMPTOM 465 00:17:01,320 --> 00:17:02,121 PRESENTATION AND ALSO SOME OF 466 00:17:02,187 --> 00:17:05,758 THOSE PHYSIOLOGICAL METRICS. 467 00:17:05,824 --> 00:17:06,392 PERHAPS THE ANSWER IN TRYING TO 468 00:17:06,458 --> 00:17:07,493 UNDERSTAND THE HETEROGENEITY IS 469 00:17:07,559 --> 00:17:09,328 IN THIS MULTIMODAL COMPONENT, 470 00:17:09,395 --> 00:17:09,962 WERE PATIENT REPORTED OUTCOMES 471 00:17:10,028 --> 00:17:11,130 IS JUST ANOTHER DATA MODALITY 472 00:17:11,196 --> 00:17:19,037 OF INTEREST. NEXT SLIDE PLEASE. 473 00:17:19,104 --> 00:17:21,373 ONE THING I'M INTERESTED TOO, 474 00:17:21,440 --> 00:17:24,443 IS HOW CAN WE TRANSLATE THOSE 475 00:17:24,510 --> 00:17:25,043 TO USE MORE READILY AVAILABLE 476 00:17:25,110 --> 00:17:26,178 IN CLINICAL PRACTICE? SO WE 477 00:17:26,245 --> 00:17:29,615 KNOW THAT THE APNEA SLEEP SCALE 478 00:17:29,681 --> 00:17:33,886 WAS WIDELY UTILIZED ALTHOUGH 479 00:17:33,952 --> 00:17:34,653 THERE ARE SEVERAL ITERATIONS 480 00:17:34,720 --> 00:17:38,157 ABOUT ITS UTILIZATION AND IT IS 481 00:17:38,223 --> 00:17:38,757 READILY AVAILABLE. IF WE LOOK 482 00:17:38,824 --> 00:17:42,728 AT CLINICAL NOTES OR EHR DATA, 483 00:17:42,795 --> 00:17:46,899 IT TENDS TO BE AVAILABLE ONE 484 00:17:46,965 --> 00:17:47,533 WAY OR THE OTHER SO IT IS EASY 485 00:17:47,599 --> 00:17:49,001 TO ACCESS IF YOU'RE THINKING 486 00:17:49,067 --> 00:17:49,568 ABOUT A LARGER PERSPECTIVE 487 00:17:49,635 --> 00:17:50,269 STUDIES INTEGRATING DATA. BUT 488 00:17:50,335 --> 00:17:57,242 ONE THING THAT WE ASKED IS THE 489 00:17:57,309 --> 00:17:58,043 SCALE SUFFICIENT TO REALLY 490 00:17:58,110 --> 00:18:02,080 EXPLAIN THE ACCESSIBILITY OF 491 00:18:02,147 --> 00:18:02,714 SLEEPINESS USING THE FRAMEWORK 492 00:18:02,781 --> 00:18:04,917 OF THE SYMPTOM SUBTYPES OR NOT? 493 00:18:04,983 --> 00:18:05,617 AS YOU CAN SEE HERE WE COMPARE 494 00:18:05,684 --> 00:18:08,687 THE SCALES ACROSS THE DIFFERENT 495 00:18:08,754 --> 00:18:10,055 FOUR SUBTYPES IN THREE 496 00:18:10,122 --> 00:18:11,323 DIFFERENT COHORTS, THERE IS A 497 00:18:11,390 --> 00:18:12,858 GREATER VARIABILITY. IF YOU ARE 498 00:18:12,925 --> 00:18:19,131 THINKING ABOUT SOME OF THE 499 00:18:19,198 --> 00:18:19,765 CUTOFFS THAT HAVE BEEN USED IN 500 00:18:19,832 --> 00:18:20,332 THE PAST TO EXCLUDE CERTAIN 501 00:18:20,399 --> 00:18:20,866 PARTICIPANTS FROM TRIALS, 502 00:18:20,933 --> 00:18:21,767 LOOKING AT THERAPISTS FOR 503 00:18:21,834 --> 00:18:24,837 OBSTRUCTIVE SLEEP APNEA, 504 00:18:24,903 --> 00:18:27,639 GREATER THAN 15, WE ARE 505 00:18:27,706 --> 00:18:32,511 EXCLUDING LOTS OF PATIENTS OF 506 00:18:32,578 --> 00:18:34,112 THE EXCESSIVE SLEEP SUBTYPE 507 00:18:34,179 --> 00:18:34,713 WHICH ARE PROBABLY AT GREATER 508 00:18:34,780 --> 00:18:36,114 RISK. BUT IT DOES NOT EXPLAIN 509 00:18:36,181 --> 00:18:38,383 EVERYTHING. NEXT SLIDE PLEASE. 510 00:18:38,450 --> 00:18:45,858 SO WE CAME UP WITH A WAY OF 511 00:18:45,924 --> 00:18:46,492 TRYING TO IDENTIFY THE MINIMUM 512 00:18:46,558 --> 00:18:50,462 SET OF SYMPTOMS SOME OF THE 513 00:18:50,529 --> 00:18:52,831 DIFFERENCES WE OBSERVED USING 514 00:18:52,898 --> 00:18:53,432 MAYBE LAST QUESTIONS AND HERE 515 00:18:53,499 --> 00:18:53,932 IS AN EXAMPLE OF LIKE A 516 00:18:53,999 --> 00:18:56,368 DECISION TREE THAT ACTUALLY 517 00:18:56,435 --> 00:18:57,002 PERFORMED PRETTY WELL BASED ON 518 00:18:57,069 --> 00:18:59,438 THE METRICS I REPORTED HERE TO 519 00:18:59,505 --> 00:19:01,139 IDENTIFIED PATIENTS AT RISK. 520 00:19:01,206 --> 00:19:08,847 AND THOSE QUESTIONS ARE NOT 521 00:19:08,914 --> 00:19:12,050 REALLY A MUCH GREATER BURDEN. 522 00:19:12,117 --> 00:19:12,651 THAT IS AN EXAMPLE OF HOW WE 523 00:19:12,718 --> 00:19:15,988 CAN TRY TO SIMPLIFY SOME OF 524 00:19:16,054 --> 00:19:21,193 THOSE MORE CLUSTERING BASES, 525 00:19:21,260 --> 00:19:21,627 THAT CAN BE EASILY 526 00:19:21,693 --> 00:19:23,195 INTERPRETABLE BY CLINICIANS IN 527 00:19:23,262 --> 00:19:23,829 THOSE DIRECTLY INTERACTING WITH 528 00:19:23,896 --> 00:19:29,768 PATIENTS. NEXT SLIDE PLEASE. 529 00:19:29,835 --> 00:19:30,302 SO I WANT TO SWITCH GEARS A 530 00:19:30,369 --> 00:19:33,071 LITTLE BIT AND TALK A LITTLE 531 00:19:33,138 --> 00:19:33,672 BIT ABOUT HOW WE CAN USE SOME 532 00:19:33,739 --> 00:19:34,172 OF THIS INFORMATION TO 533 00:19:34,239 --> 00:19:36,341 UNDERSTAND THERAPIES. ONE OF 534 00:19:36,408 --> 00:19:38,677 THE BIG CHALLENGES THAT WE 535 00:19:38,744 --> 00:19:39,278 OBSERVED TODAY IS ABOUT THIS 536 00:19:39,344 --> 00:19:40,579 GREATER AVAILABILITY OF 537 00:19:40,646 --> 00:19:41,179 CLINICAL DATA, THAT IS ACROSS 538 00:19:41,246 --> 00:19:45,317 THE BOARD. BUT NOT REALLY A LOT 539 00:19:45,384 --> 00:19:46,385 OF GRANULARITY IN TERMS OF 540 00:19:46,451 --> 00:19:49,588 CHARACTERIZING SLEEP DISORDERS. 541 00:19:49,655 --> 00:19:50,188 AND THEN ONE EXAMPLE THAT I 542 00:19:50,255 --> 00:19:53,325 WANT TO KIND OF SHOW HERE 543 00:19:53,392 --> 00:19:53,959 TODAY, IS HOW WE CAN STILL USE 544 00:19:54,026 --> 00:19:56,328 SOME OF THIS LESS GRANULAR, YET 545 00:19:56,395 --> 00:19:59,798 VERY BIG, BIG DATA SET TO HELP 546 00:19:59,865 --> 00:20:01,700 US INFORM THE EFFECTS OF 547 00:20:01,767 --> 00:20:12,210 THERAPIES FOR SLEEP APNEA TO 548 00:20:12,277 --> 00:20:12,844 DRIVE INCENTIVES TO FACILITATE 549 00:20:12,911 --> 00:20:13,345 THE INTEGRATION OF MORE 550 00:20:13,412 --> 00:20:15,514 GRANULAR DATA WE DISCUSSED OVER 551 00:20:15,581 --> 00:20:16,081 THE COURSE OF THIS WORKSHOP 552 00:20:16,148 --> 00:20:16,615 INTO THOSE CLINICAL DATA 553 00:20:16,682 --> 00:20:17,516 REPOSITORIES. 554 00:20:17,583 --> 00:20:20,385 IN THIS STUDY WE LOOKED AT A 555 00:20:20,452 --> 00:20:21,019 VERY LARGE MEDICARE BENEFICIARY 556 00:20:21,086 --> 00:20:28,193 DATA SET, REPRESENTING ALL 557 00:20:28,260 --> 00:20:29,328 INDIVIDUALS GREATER THAN 65 558 00:20:29,394 --> 00:20:30,963 YEARS OLD THAT ARE MEDICARE 559 00:20:31,029 --> 00:20:32,097 BENEFICIARIES ACROSS NINE 560 00:20:32,164 --> 00:20:32,698 STATES IN THE CENTRAL UNITED 561 00:20:32,764 --> 00:20:36,301 STATES. THIS IS PART OF THIS 562 00:20:36,368 --> 00:20:38,236 GREATER COLLABORATIVE WHICH IS 563 00:20:38,303 --> 00:20:44,876 THE (INDISCERNIBLE) NETWORK. 564 00:20:44,943 --> 00:20:45,310 IN THIS STUDY WE WERE 565 00:20:45,377 --> 00:20:45,811 INTERESTED IN TRYING TO 566 00:20:45,877 --> 00:20:46,311 UNDERSTAND WHETHER THE 567 00:20:46,378 --> 00:20:47,512 UTILIZATION OF CONTINUOUS 568 00:20:47,579 --> 00:20:50,382 POSITIVE PRESSURE, BASED ON 569 00:20:50,449 --> 00:20:53,285 CLAIMS, MEDICARE CLAIMS, AND 570 00:20:53,352 --> 00:20:55,721 THE INITIATION AND UTILIZATION 571 00:20:55,787 --> 00:20:58,357 BE ASSOCIATED WITH DECREASED 572 00:20:58,423 --> 00:20:59,858 VASCULAR RISK AND MORTALITY. 573 00:20:59,925 --> 00:21:02,694 IN THAT SENSE WE DEFINED-- 574 00:21:02,761 --> 00:21:03,195 BECAUSE IN SOME OF THE 575 00:21:03,261 --> 00:21:05,364 PRESENTATIONS WE DISCUSSED HOW 576 00:21:05,430 --> 00:21:10,202 SOMETIMES CLINICAL QUOTES MIGHT 577 00:21:10,268 --> 00:21:10,836 NOT EXPLAIN SUFFICIENTLY HOW TO 578 00:21:10,902 --> 00:21:12,804 DEFINE A PATIENT. 579 00:21:12,871 --> 00:21:15,440 UNFORTUNATELY SOME OF THOSE 580 00:21:15,507 --> 00:21:15,941 MASSIVE ADMINISTRATIVE 581 00:21:16,008 --> 00:21:16,575 DATABASES DON'T REALLY HAVE ANY 582 00:21:16,642 --> 00:21:25,884 MORE INFORMATION BEYOND THOSE 583 00:21:25,951 --> 00:21:26,518 CLINICAL CODES. SO THEN WE HAVE 584 00:21:26,585 --> 00:21:29,554 TO COME UP WITH PHENOTYPES TO 585 00:21:29,621 --> 00:21:30,255 BETTER CHARACTERIZE THE 586 00:21:30,322 --> 00:21:30,889 PATIENTS AND EVEN THOUGH IT IS 587 00:21:30,956 --> 00:21:31,857 NOT A PERFECT DEFINITION IT IS 588 00:21:31,923 --> 00:21:32,891 BETTER THAN JUST USING ONE CODE 589 00:21:32,958 --> 00:21:34,259 TO SAY THAT SOMEONE HAS SLEEP 590 00:21:34,326 --> 00:21:36,862 APNEA. 591 00:21:36,928 --> 00:21:37,429 SO WE IDENTIFIED A COHORT OF 592 00:21:37,496 --> 00:21:40,065 PATIENTS WITH SLEEP APNEA BASED 593 00:21:40,132 --> 00:21:40,832 ON CLAIMS USING VALIDATED 594 00:21:40,899 --> 00:21:43,468 ALGORITHMS. NEXT SLIDE PLEASE. 595 00:21:43,535 --> 00:21:46,304 AND THEN WE DESIGNED TWO 596 00:21:46,371 --> 00:21:48,373 STUDIES. 597 00:21:48,440 --> 00:21:48,874 THE DESIGN OF THE STUDIES 598 00:21:48,940 --> 00:21:50,609 IMPORTANT TO MENTION BECAUSE 599 00:21:50,676 --> 00:21:53,211 THEY REALLY FOLLOW LIKE A VERY 600 00:21:53,278 --> 00:21:55,213 ROBUST FRAMEWORK OF CAUSAL 601 00:21:55,280 --> 00:21:55,814 REFERENCE WHICH IS REALLY ONE 602 00:21:55,881 --> 00:21:57,315 OF THE BIGGEST CHALLENGES THAT 603 00:21:57,382 --> 00:21:58,850 WE HAVE PARTICULARLY IN THE 604 00:21:58,917 --> 00:22:02,454 FIELD, WHERE WE CANNOT 605 00:22:02,521 --> 00:22:04,723 DETERMINE CERTAIN CAUSAL 606 00:22:04,790 --> 00:22:05,357 EFFECTS, IF YOU ARE NOT DOING A 607 00:22:05,424 --> 00:22:10,028 RANDOMIZED CONTROLLED TRIAL. 608 00:22:10,095 --> 00:22:10,629 HOWEVER THERE ARE MANY METHODS 609 00:22:10,696 --> 00:22:11,229 TODAY CAN MINIMIZE AS MUCH AS 610 00:22:11,296 --> 00:22:13,098 WE CAN SOME OF THE BIASES WE 611 00:22:13,165 --> 00:22:13,732 OBSERVED, AND IT IS ABOUT TIME 612 00:22:13,799 --> 00:22:15,067 FOR US TO START USING SOME OF 613 00:22:15,133 --> 00:22:16,568 THOSE RESOURCES TO ASK SOME OF 614 00:22:16,635 --> 00:22:17,536 THE QUESTIONS THAT WE CANNOT 615 00:22:17,602 --> 00:22:20,038 ANSWER WITH CLINICAL TRIALS. 616 00:22:20,105 --> 00:22:20,906 SUCH AS FOR EXAMPLE WHETHER 617 00:22:20,972 --> 00:22:25,410 PATIENTS WITH SLEEP APNEA USING 618 00:22:25,477 --> 00:22:32,484 CPAP HAVE LOWER CARGO VASCULAR 619 00:22:32,551 --> 00:22:33,018 RISK, WHICH WE CANNOT DO 620 00:22:33,085 --> 00:22:34,052 ETHICALLY. SO WE DID STUDIES, 621 00:22:34,119 --> 00:22:39,057 DID ASSIMILATION WHICH DR. 622 00:22:39,124 --> 00:22:39,691 PURCELL MENTIONED A LITTLE BIT 623 00:22:39,758 --> 00:22:43,061 ABOUT SO WE TRY TO RELATE HOW 624 00:22:43,128 --> 00:22:43,695 TRIALS WOULD HAPPEN BY LOOKING 625 00:22:43,762 --> 00:22:45,397 AT OBSERVATIONAL DATA, BUT TRY 626 00:22:45,464 --> 00:22:46,698 TO MINIMIZE AS MUCH AS WE CAN 627 00:22:46,765 --> 00:22:48,767 ALL THE BIASES WE OBSERVED FROM 628 00:22:48,834 --> 00:22:52,237 LOOKING AT OBSERVATIONAL DATA. 629 00:22:52,304 --> 00:22:55,373 SUCH AS PORTAL TIME BIAS, IN 630 00:22:55,440 --> 00:22:56,975 TRYING TO DO AS MUCH AS YOU CAN 631 00:22:57,042 --> 00:22:57,542 EVEN THOUGH THERE WILL BE A 632 00:22:57,609 --> 00:23:07,986 MEASURE COMPOUNDING. 633 00:23:10,689 --> 00:23:11,189 SO WE LOOKED AT THIS DATABASE 634 00:23:11,256 --> 00:23:11,656 OF 2 MILLION MEDICARE 635 00:23:11,723 --> 00:23:12,224 BENEFICIARIES ABOUT HUNDRED 636 00:23:12,290 --> 00:23:12,824 88,000 ASSOCIATED, IDENTIFIED 637 00:23:12,891 --> 00:23:13,458 AS HAVING SLEEP APNEA BASED ON 638 00:23:13,525 --> 00:23:14,092 THE UPDATED ALGORITHM AND THEN 639 00:23:14,159 --> 00:23:16,728 WE COMPARE THOSE THAT INITIATED 640 00:23:16,795 --> 00:23:18,130 CPAP WITH THE ONES THAT DID NOT 641 00:23:18,196 --> 00:23:19,965 INITIATE CPAP IN ONE STUDY AND 642 00:23:20,031 --> 00:23:23,401 AMONG THOSE THAT INITIATED CPAP 643 00:23:23,468 --> 00:23:24,035 WE LOOKED AT THE THE DIVISION 644 00:23:24,102 --> 00:23:28,106 OF UTILIZATION OF CPAP OVER THE 645 00:23:28,173 --> 00:23:28,707 FIRST YEAR OF UTILIZATION, TO 646 00:23:28,774 --> 00:23:30,242 SEE IF IT WAS ASSOCIATED WITH 647 00:23:30,308 --> 00:23:33,578 MORTALITY AND CARDIOVASCULAR 648 00:23:33,645 --> 00:23:37,415 RISK. NEXT SLIDE PLEASE. 649 00:23:37,482 --> 00:23:38,083 AS YOU CAN SEE HERE FROM THE 650 00:23:38,150 --> 00:23:40,552 OBSERVATIONAL DATA, ROBUST 651 00:23:40,619 --> 00:23:41,086 DESIGN STUDY WE ARE STILL 652 00:23:41,153 --> 00:23:45,090 SUBJECTED TO POTENTIAL MEASURE 653 00:23:45,157 --> 00:23:47,025 CONFOUNDING. WE PERFORM AN 654 00:23:47,092 --> 00:23:47,659 ANALYSIS TO HELP MINIMIZE THIS 655 00:23:47,726 --> 00:23:49,394 AND WE SEE AN ASSOCIATION 656 00:23:49,461 --> 00:23:52,164 BETWEEN CPAP UTILIZATION AND 657 00:23:52,230 --> 00:23:52,697 LOWER MORTALITY AND LOWER 658 00:23:52,764 --> 00:23:54,366 INCIDENCES FOR CARDIOVASCULAR 659 00:23:54,432 --> 00:23:57,269 DISEASES. THE ANALYSIS WAS 660 00:23:57,335 --> 00:23:57,803 CONSISTENT WHEN WE LOOKED 661 00:23:57,869 --> 00:23:59,271 ACROSS DIFFERENT GROUPS, 662 00:23:59,337 --> 00:24:01,039 SUBGROUPS OF THE DATA SET THAT 663 00:24:01,106 --> 00:24:01,673 SUGGEST THE DATA BEING ROBUST. 664 00:24:01,740 --> 00:24:07,412 NEXT SLIDE PLEASE. 665 00:24:07,479 --> 00:24:07,846 AND THEN WE LOOKED AT 666 00:24:07,913 --> 00:24:09,714 UTILIZATION WHICH AGAIN CAN 667 00:24:09,781 --> 00:24:10,315 ONLY BE BASED ON A NUMBER OF 668 00:24:10,382 --> 00:24:12,984 CLAIMS. 669 00:24:13,051 --> 00:24:13,451 BUT ONE THING THAT WAS 670 00:24:13,518 --> 00:24:14,586 INTERESTING BY LOOKING AT THIS 671 00:24:14,653 --> 00:24:16,588 HISTOGRAM, IS THAT THE PATTERNS 672 00:24:16,655 --> 00:24:18,123 OF THE NUMBER OF CLAIMS A 673 00:24:18,190 --> 00:24:21,159 PATIENT HAS WITHIN THE FIRST 674 00:24:21,226 --> 00:24:22,627 YEAR, THEY REFLECT VERY WELL 675 00:24:22,694 --> 00:24:25,897 WITH HOW SOME OF THIS CPAP IS 676 00:24:25,964 --> 00:24:29,134 REVERSED BY MEDICARE. WHERE WE 677 00:24:29,201 --> 00:24:30,435 HAVE LIKE THE FIRST MODE, THE 678 00:24:30,502 --> 00:24:32,270 FIRST BUMP IN THE DISTRIBUTION, 679 00:24:32,337 --> 00:24:36,741 WHERE IT IS MORE OR LESS 3-4 680 00:24:36,808 --> 00:24:37,309 AIMS, WHEN THE PARTICIPANTS 681 00:24:37,375 --> 00:24:46,484 DIDN'T REALLY NEED THE ADHERENT 682 00:24:46,551 --> 00:24:47,085 CRITERIA AND THE BIGGER BUMP 683 00:24:47,152 --> 00:24:47,719 WHEN PATIENTS DO. AND WE LOOKED 684 00:24:47,786 --> 00:24:48,253 AT THE DISTRIBUTION INTO 685 00:24:48,320 --> 00:24:48,753 QUARTILES AND WE SEE A 686 00:24:48,820 --> 00:24:51,590 PROGRESSIVE LOWER RISK OR LOWER 687 00:24:51,656 --> 00:24:53,024 INCIDENCE OF MORTALITY IN MAJOR 688 00:24:53,091 --> 00:25:02,500 RISK OF CARDIOVASCULAR EVENTS 689 00:25:02,567 --> 00:25:03,068 AND ALSO SUGGESTING ROBUST 690 00:25:03,134 --> 00:25:06,738 FINDINGS. NEXT SLIDE PLEASE. 691 00:25:06,805 --> 00:25:07,339 SOLD MESSAGES ABOUT WHAT I JUST 692 00:25:07,405 --> 00:25:11,209 TALKED ABOUT TODAY. I THINK 693 00:25:11,276 --> 00:25:11,843 SLEEP APNEA IS A HETEROGENEOUS 694 00:25:11,910 --> 00:25:16,214 DISEASE. IT SHOULD BE 695 00:25:16,281 --> 00:25:16,815 ADDRESSED AT DIFFERENT LEVELS 696 00:25:16,882 --> 00:25:17,449 INCLUDING SYMPTOM PRESENTATIONS 697 00:25:17,515 --> 00:25:18,083 AS AN ADDITIONAL DATA MODALITY 698 00:25:18,149 --> 00:25:18,817 THEY SHOULD CONSIDER. 699 00:25:18,884 --> 00:25:23,121 THERE NEEDS TO BE A NEED FOR 700 00:25:23,188 --> 00:25:23,722 TOOLS FOR BETTER PHENOTYPING 701 00:25:23,788 --> 00:25:25,423 SLEEP APNEA AND THOSE SHOULD BE 702 00:25:25,490 --> 00:25:26,057 AVAILABLE FOR CLINICAL RESEARCH 703 00:25:26,124 --> 00:25:26,524 ACROSS DIFFERENT DATA 704 00:25:26,591 --> 00:25:28,693 MODALITIES. NOT JUST FOR 705 00:25:28,760 --> 00:25:31,329 SYMPTOMS, FOR PHYSIOLOGY, AND I 706 00:25:31,396 --> 00:25:31,963 THINK THERE IS A LOT OF WORK IN 707 00:25:32,030 --> 00:25:33,365 THIS AREA THAT IS HAPPENING 708 00:25:33,431 --> 00:25:40,906 CURRENTLY. 709 00:25:40,972 --> 00:25:41,506 THERE IS ALSO AN IMPORTANCE OF 710 00:25:41,573 --> 00:25:42,040 THE VERY LARGE MULTI SITE 711 00:25:42,107 --> 00:25:42,674 CRITICAL RESEARCH NETWORKS 712 00:25:42,741 --> 00:25:43,174 CURRENTLY THEY ARE NOT 713 00:25:43,241 --> 00:25:45,577 INTEGRATED WITH SLEEP DATA. I 714 00:25:45,644 --> 00:25:46,177 THINK THERE ARE SOME EFFORTS 715 00:25:46,244 --> 00:25:47,946 OUT THERE THAT WE SAW 716 00:25:48,013 --> 00:25:50,348 YESTERDAY, TRYING TO DO THIS. 717 00:25:50,415 --> 00:25:53,418 BUT IDEALLY WE WANT TO HAVE THE 718 00:25:53,485 --> 00:25:54,786 ABILITY TO BETTER CHARACTERIZE 719 00:25:54,853 --> 00:25:58,757 PATIENTS WITH SLEEP APNEA USE 720 00:25:58,823 --> 00:26:01,126 AND CUTTING AGE WAYS OF 721 00:26:01,192 --> 00:26:01,993 DEFINING THE DISEASE USING THE 722 00:26:02,060 --> 00:26:03,094 RAW SIGNALS, AND WHAT WE TALKED 723 00:26:03,161 --> 00:26:04,930 ABOUT YESTERDAY. BUT THEN LINK 724 00:26:04,996 --> 00:26:08,099 THOSE TWO OUTCOMES IN THE EHR 725 00:26:08,166 --> 00:26:08,667 OR TO THERAPY DATA WHICH IS 726 00:26:08,733 --> 00:26:11,002 VERY GRANULAR. BUT IT BECOMES 727 00:26:11,069 --> 00:26:13,605 CHALLENGING TO INTEGRATE THEM. 728 00:26:13,672 --> 00:26:15,840 MOSTLY HOSTED OF VENDORS OF 729 00:26:15,907 --> 00:26:18,009 CPAP DEVICES AND NOT ONLY CPAP 730 00:26:18,076 --> 00:26:21,680 BUT ALSO OTHER THERAPIES AS 731 00:26:21,746 --> 00:26:22,213 WELL WHICH WE ARE SEEING 732 00:26:22,280 --> 00:26:23,815 DEVELOPED MORE AND MORE. 733 00:26:23,882 --> 00:26:30,188 ANOTHER COMPONENT THAT IS VERY, 734 00:26:30,255 --> 00:26:30,789 VERY IMPORTANT THAN HAS BEEN 735 00:26:30,855 --> 00:26:31,323 VERY UNDEREXPLORED IN THE 736 00:26:31,389 --> 00:26:37,829 CONTEXT OF SLEEP APNEA, IS 737 00:26:37,896 --> 00:26:38,430 WHETHER THE 1990 VARIABILITY 738 00:26:38,496 --> 00:26:38,930 OF THE DISEASE IS NOT A 739 00:26:38,997 --> 00:26:41,499 CONTRIBUTOR TO HETEROGENEITY. 740 00:26:41,566 --> 00:26:42,100 AND THERE ARE SEVERAL STUDIES 741 00:26:42,167 --> 00:26:45,203 WE TRY TO CLASSIFY PATIENTS, 742 00:26:45,270 --> 00:26:45,737 AND CAPTURE STUDIES ABOUT 743 00:26:45,804 --> 00:26:51,309 SOMEONE WHO HAS OR HAS NOT THAT 744 00:26:51,376 --> 00:26:51,876 WE DO NOT KNOW WHETHER THE 745 00:26:51,943 --> 00:26:52,377 VARIABILITY SOMEONE IS 746 00:26:52,444 --> 00:26:53,378 ASSOCIATED OR CAN PREDICT SOME 747 00:26:53,445 --> 00:26:54,713 PHYSIOLOGICAL CHANGES THAT 748 00:26:54,779 --> 00:26:55,313 COULD PUT THEM AT RISK AND SO 749 00:26:55,380 --> 00:26:56,081 THOSE ARE THE AREAS OF INTEREST 750 00:26:56,147 --> 00:26:56,948 THAT OUR GROUP IS WORKING ON. 751 00:26:57,015 --> 00:27:00,151 NEXT SLIDE PLEASE. 752 00:27:00,218 --> 00:27:04,089 >> YOU HAVE TWO MINUTES LEFT. 753 00:27:04,155 --> 00:27:04,656 >> THAT IS MY ACKNOWLEDGMENT 754 00:27:04,723 --> 00:27:06,758 SLIDE. THANK YOU FOR THE 755 00:27:06,825 --> 00:27:08,994 OPPORTUNITY TO TALK TODAY AND I 756 00:27:09,060 --> 00:27:09,594 WOULD LIKE TO ACKNOWLEDGE ALL 757 00:27:09,661 --> 00:27:12,831 OF MY COLLABORATORS. IT IS 758 00:27:12,897 --> 00:27:13,431 REALLY A GREAT PLEASURE TO BE 759 00:27:13,498 --> 00:27:14,666 WORKING WITH THIS GROUP, AND 760 00:27:14,733 --> 00:27:17,836 REALLY COULD NOT DO ANY OF THAT 761 00:27:17,902 --> 00:27:23,775 WITHOUT THEIR SUPPORT AND THEIR 762 00:27:23,842 --> 00:27:24,309 HELP, AND ALL THE FUNDING 763 00:27:24,376 --> 00:27:24,876 AGENCIES AND AGAIN A GREAT 764 00:27:24,943 --> 00:27:31,049 SHOUT OUT TO THE NSR FOR THEIR 765 00:27:31,116 --> 00:27:36,154 HELP IN THIS WORK. 766 00:27:36,221 --> 00:27:36,755 >> THANK YOU FOR YOUR EXCELLENT 767 00:27:36,821 --> 00:27:37,355 PRESENTATION. I DON'T SEE ANY 768 00:27:37,422 --> 00:27:39,024 QUESTIONS IN THE Q&A. SO WE 769 00:27:39,090 --> 00:27:39,557 ARE DELIVERED BEHIND THE 770 00:27:39,624 --> 00:27:40,725 SCHEDULE. I WOULD LIKE TO 771 00:27:40,792 --> 00:27:47,198 INVITE NOW OUR NEXT SPEAKER AND 772 00:27:47,265 --> 00:27:49,100 ALL THE QUESTIONS PLEASE PUT 773 00:27:49,167 --> 00:27:51,703 THEM INTO THE Q&A. WE WILL 774 00:27:51,770 --> 00:27:56,041 HAVE THIS Q&A SESSION FOLLOWING 775 00:27:56,107 --> 00:27:58,143 THE LAST PRESENTATION. 776 00:27:58,209 --> 00:27:59,277 OUR NEXT SPEAKER IS DOCTOR 777 00:27:59,344 --> 00:28:05,550 SOOMI LEE, ASSOCIATE PROFESSOR 778 00:28:05,617 --> 00:28:06,117 IN THE DEPART ENOUGH HUMAN 779 00:28:06,184 --> 00:28:06,751 DEVELOPMENT AND FAMILY STUDIES 780 00:28:06,818 --> 00:28:13,358 AT PENN STATE UNIVERSITY. SHE 781 00:28:13,425 --> 00:28:15,660 DIRECTS THE SLEEP AND HEALTH 782 00:28:15,727 --> 00:28:19,998 LABORATORIES AND HER EFFORTS 783 00:28:20,065 --> 00:28:20,532 ARE TO IMPROVE SLEEP AND 784 00:28:20,598 --> 00:28:21,099 DECREASE STRESS IN ORDER TO 785 00:28:21,166 --> 00:28:23,501 SUPPORT HEALTH. AND HER TITLE 786 00:28:23,568 --> 00:28:27,939 IS SLEEP HEALTH PROFILES, PAIN 787 00:28:28,006 --> 00:28:28,540 AND BIOLOGICAL AND BEHAVIORAL 788 00:28:28,606 --> 00:28:30,008 MECHANISMS. DR. LEE? 789 00:28:30,075 --> 00:28:32,410 >> DR. LEE: THANK YOU FOR THE 790 00:28:32,477 --> 00:28:34,279 INTRODUCTION AND IMITATION. 791 00:28:34,345 --> 00:28:36,881 TODAY I WILL TALK ABOUT MY 792 00:28:36,948 --> 00:28:37,482 PREVIOUS AND RECENT FINDINGS 793 00:28:37,549 --> 00:28:40,218 RELATED TO SLEEP HEALTH AND 794 00:28:40,285 --> 00:28:48,359 CHRONIC PAIN. AND POTENTIAL 795 00:28:48,426 --> 00:28:48,893 BIOLOGICAL AND BEHAVIORAL 796 00:28:48,960 --> 00:28:52,430 MECHANISMS. NEXT SLIDE PLEASE. 797 00:28:52,497 --> 00:28:54,499 CHRONIC PAIN IS PREVALENT, 798 00:28:54,566 --> 00:28:57,502 ACCORDING TO A CDC REPORT, 20% 799 00:28:57,569 --> 00:29:01,005 OF US ADULTS HAVE CHRONIC PAIN. 800 00:29:01,072 --> 00:29:01,573 WITH 8% HAVING HIGH IMPACT 801 00:29:01,639 --> 00:29:05,510 CHRONIC PAIN. MOREOVER, IN 802 00:29:05,577 --> 00:29:08,246 THE NATIONAL HEALTH INTERVIEW 803 00:29:08,313 --> 00:29:09,914 SURVEY, ONE FIFTH OF THE 804 00:29:09,981 --> 00:29:11,349 POPULATION EXPERIENCED FREQUENT 805 00:29:11,416 --> 00:29:15,253 DAILY PAIN. WE OFTEN DO NOT 806 00:29:15,320 --> 00:29:18,923 PAY MUCH ATTENTION TO THE 807 00:29:18,990 --> 00:29:21,426 SYMPTOMS SUCH AS BACK PAIN, 808 00:29:21,493 --> 00:29:23,761 HEADACHE AND OTHER DISCOMFORTS 809 00:29:23,828 --> 00:29:24,329 BECAUSE THEY MAY SEEM LIKE 810 00:29:24,395 --> 00:29:25,130 TRIVIAL 811 00:29:25,196 --> 00:29:32,203 BUT THEY MATTER. ESPECIALLY 812 00:29:32,270 --> 00:29:32,737 WHEN THOSE SYMPTOMS I CAN 813 00:29:32,804 --> 00:29:35,974 RELATE OVER TIME 814 00:29:36,040 --> 00:29:46,518 MY RESEARCH USES MULTIPLE DATA 815 00:29:47,819 --> 00:29:48,286 TO CAPTURE HOW PAIN MANIFESTS 816 00:29:48,353 --> 00:29:52,190 OVER TIME, INCLUDING AGING. 817 00:29:52,257 --> 00:29:53,858 TODAY OUR FOCUS ON STUDIES THAT 818 00:29:53,925 --> 00:29:54,359 WILL TRACK CHANGES OVER 819 00:29:54,425 --> 00:29:55,627 MULTIPLE YEARS AND TIME 820 00:29:55,693 --> 00:29:57,729 CONSTRAINTS. 821 00:29:57,795 --> 00:29:58,329 WE ALSO KNOW THAT PAIN SYMPTOMS 822 00:29:58,396 --> 00:30:03,101 ARE MORE PREVALENT AMONG ADULTS 823 00:30:03,168 --> 00:30:03,701 LIVING IN POVERTY, AND THOSE 824 00:30:03,768 --> 00:30:06,004 WITH LOWER EDUCATION. CREATING 825 00:30:06,070 --> 00:30:06,471 CONCERNS WITH HEALTH 826 00:30:06,538 --> 00:30:08,339 DISPARITIES. 827 00:30:08,406 --> 00:30:11,643 MORE IMPORTANTLY, PAIN MAY 828 00:30:11,709 --> 00:30:13,478 SHARE COMMON MECHANISMS WITH 829 00:30:13,545 --> 00:30:17,782 POOR SLEEP. NEXT SLIDE PLEASE. 830 00:30:17,849 --> 00:30:20,251 FOR EXAMPLE, THERE ARE 831 00:30:20,318 --> 00:30:22,720 GEOGRAPHIC OVERLAPS BETWEEN 832 00:30:22,787 --> 00:30:23,955 HIGH PAIN AND SHORT SLEEP. THE 833 00:30:24,022 --> 00:30:33,364 MAP ON THE LEFT SHOWS MEAN PAIN 834 00:30:33,431 --> 00:30:33,998 SCORES BY STATE MEASURED BY THE 835 00:30:34,065 --> 00:30:34,599 PRODUCT OF THE SELF REPORTING 836 00:30:34,666 --> 00:30:36,768 FREQUENCY AND PAIN 837 00:30:36,834 --> 00:30:37,402 INTERFERENCE. STATES WITH HIGH 838 00:30:37,468 --> 00:30:44,375 PAIN SCORES ARE RED. AND STATES 839 00:30:44,442 --> 00:30:44,909 WITH LOW PAIN SCORES ARE 840 00:30:44,976 --> 00:30:45,543 CURRENTLY BLUE. AND MIDDLE PAIN 841 00:30:45,610 --> 00:30:47,946 IS ON YELLOW. 842 00:30:48,012 --> 00:30:48,513 ON THE RIGHT SIDE YOU SEE THE 843 00:30:48,580 --> 00:30:50,014 PREVALENCE OF SHORT SLEEP 844 00:30:50,081 --> 00:30:53,084 DURATION BY STATE. DARK COLORS 845 00:30:53,151 --> 00:30:53,618 INDICATE STATES WITH HIGH 846 00:30:53,685 --> 00:30:56,321 PREVALENCE OF SHORT SLEEP. 847 00:30:56,387 --> 00:30:58,723 CLEARLY, THERE IS AN OVERLAP 848 00:30:58,790 --> 00:30:59,591 BETWEEN HIGH PAIN AND SHORT 849 00:30:59,657 --> 00:31:02,894 SLEEP. 850 00:31:02,961 --> 00:31:05,463 ARKANSAS, KENTUCKY, MISSOURI, 851 00:31:05,530 --> 00:31:06,664 ALABAMA AND GEORGIA HAVE HIGH 852 00:31:06,731 --> 00:31:07,365 PREVALENCE FOR BOTH. NEXT SLIDE 853 00:31:07,432 --> 00:31:11,636 PLEASE. 854 00:31:11,703 --> 00:31:15,340 HERE, I INCLUDED THE 855 00:31:15,406 --> 00:31:15,974 ANTECEDENTS AND CONSEQUENCES OF 856 00:31:16,040 --> 00:31:21,646 POOR SLEEP AND PAIN, SHOWN IN 857 00:31:21,713 --> 00:31:24,115 PREVIOUS PUBLICATIONS. THE 858 00:31:24,182 --> 00:31:25,950 LIST HERE MAY NOT BE 859 00:31:26,017 --> 00:31:26,417 COMPREHENSIVE BUT THE 860 00:31:26,484 --> 00:31:27,919 LITERATURE REPORTS THE CLOSE, 861 00:31:27,986 --> 00:31:30,255 BIDIRECTIONAL RELATIONSHIPS 862 00:31:30,321 --> 00:31:32,190 BETWEEN POOR SLEEP AND PAIN. 863 00:31:32,257 --> 00:31:36,261 IN MANY CASES, FACTORS 864 00:31:36,327 --> 00:31:37,328 ASSOCIATED WITH SLEEP ARE ALSO 865 00:31:37,395 --> 00:31:41,165 RELATED TO PAIN. FOR BOTH THE 866 00:31:41,232 --> 00:31:41,699 SLEEP AND PAIN, PREVIOUS 867 00:31:41,766 --> 00:31:45,503 STUDIES HAVE SOME LIMITATIONS. 868 00:31:45,570 --> 00:31:46,037 ONE OF THEM IS RELATED TO 869 00:31:46,104 --> 00:31:48,539 MEASUREMENT. 870 00:31:48,606 --> 00:31:52,143 FOR EXAMPLE, ABOUT HALF OF THE 871 00:31:52,210 --> 00:31:57,248 STUDIES ALONG WITH MOST 872 00:31:57,315 --> 00:31:57,715 PREVIOUS STUDIES HAVE 873 00:31:57,782 --> 00:31:58,283 ASSOCIATED INDIVIDUAL SLEEP 874 00:31:58,349 --> 00:31:58,916 VARIABLES WITH HEALTH OUTCOMES. 875 00:31:58,983 --> 00:32:01,352 MOSTLY USING ONE SLEEP 876 00:32:01,419 --> 00:32:05,556 VARIABLE AT A TIME. 877 00:32:05,623 --> 00:32:06,090 MOREOVER, MOST STUDIES HAVE 878 00:32:06,157 --> 00:32:11,262 FOCUSED ON SLEEP DISORDERS. 879 00:32:11,329 --> 00:32:11,863 BUILDING ON THOSE STUDIES, I 880 00:32:11,929 --> 00:32:15,433 WILL SHOW YOU HOW IT POSITIVE 881 00:32:15,500 --> 00:32:18,036 FRAMING, OR PREVENTION APPROACH 882 00:32:18,102 --> 00:32:21,873 FOCUSING ON SLEEP HEALTH CAN 883 00:32:21,939 --> 00:32:22,473 IMPROVE OUR KNOWLEDGE OF THE 884 00:32:22,540 --> 00:32:23,107 IMPORTANCE OF SLEEP ON HEALTH. 885 00:32:23,174 --> 00:32:29,714 NEXT SLIDE PLEASE. 886 00:32:29,781 --> 00:32:30,248 JUST LIKE HEALTH IS NOT THE 887 00:32:30,315 --> 00:32:32,984 ABSENCE OF DISEASE, SLEEP 888 00:32:33,051 --> 00:32:33,651 HEALTH IS ALSO BEYOND HAVING NO 889 00:32:33,718 --> 00:32:37,455 SLEEP DISORDER. AND THERE IS 890 00:32:37,522 --> 00:32:42,593 INCREASING AWARENESS THAT SLEEP 891 00:32:42,660 --> 00:32:43,194 HEALTH NEEDS TO BE UNDERSTOOD 892 00:32:43,261 --> 00:32:44,395 BY MULTIPLE DIMENSIONS. 893 00:32:44,462 --> 00:32:48,900 SPECIFICALLY DOCTOR DANIEL 894 00:32:48,966 --> 00:32:54,639 BUYSSE SUGGESTED THAT THESE 895 00:32:54,706 --> 00:32:55,206 DIMENSIONS ARE CRITICAL FOR 896 00:32:55,273 --> 00:32:57,075 HEALTH I AM NOT GOING TO GO 897 00:32:57,141 --> 00:32:57,675 OVER THESE DIMENSIONS BUT TO 898 00:32:57,742 --> 00:33:00,411 MENTION SOME REGULARITY, HOW 899 00:33:00,478 --> 00:33:01,012 REGULAR YOU ARE IN THE TIMING 900 00:33:01,079 --> 00:33:01,913 AND QUANTITY OF THE SLEEP. 901 00:33:01,979 --> 00:33:04,582 ALERTNESS. HOW ALERT YOU ARE 902 00:33:04,649 --> 00:33:08,219 DURING DAYTIME? HAVING LESS 903 00:33:08,286 --> 00:33:08,820 SLEEPINESS, AND TAKING FEWER 904 00:33:08,886 --> 00:33:13,624 NAPS. AND EFFICIENCY. WHETHER 905 00:33:13,691 --> 00:33:14,158 YOU CAN FALL ASLEEP IN A 906 00:33:14,225 --> 00:33:15,093 RELATIVELY SHORT PERIOD OF 907 00:33:15,159 --> 00:33:16,494 TIME. AND NOT WAKING UP IN THE 908 00:33:16,561 --> 00:33:18,162 MIDDLE OF THE NIGHT OR TOO 909 00:33:18,229 --> 00:33:23,935 EARLY IN THE MORNING. 910 00:33:24,001 --> 00:33:25,937 IMPORTANTLY, THESE SLEEP 911 00:33:26,003 --> 00:33:26,537 DIMENSIONS ARE STATISTICALLY 912 00:33:26,604 --> 00:33:30,942 DEPENDENT. THEY ARE INFLUENCED 913 00:33:31,008 --> 00:33:31,442 ON HOW HEALTH IS OFTEN 914 00:33:31,509 --> 00:33:32,310 INTERACTIVE. 915 00:33:32,377 --> 00:33:35,813 FOR EXAMPLE, PREVIOUS RESEARCH 916 00:33:35,880 --> 00:33:37,915 RECORDED SHORT-TERM SLEEP 917 00:33:37,982 --> 00:33:41,419 COMBINED WITH POOR SLEEP 918 00:33:41,486 --> 00:33:46,290 QUALITY, ASSOCIATED WITH HIGHER 919 00:33:46,357 --> 00:33:48,559 RISK HYPERTENSION, DIABETES AND 920 00:33:48,626 --> 00:33:49,093 HEART DISEASE. NEXT SLIDE 921 00:33:49,160 --> 00:33:51,529 PLEASE. 922 00:33:51,596 --> 00:33:53,698 MY COLLABORATIVE WORK FUNDED BY 923 00:33:53,765 --> 00:33:58,436 NIH EXAMINED SLEEP HEALTH 924 00:33:58,503 --> 00:33:59,070 PROFILES THAT MEASURE HOW MANY 925 00:33:59,137 --> 00:34:02,974 AND WHICH TYPES OF SLEEP 926 00:34:03,040 --> 00:34:05,410 PROBLEMS COOCCUR WITHIN THE 927 00:34:05,476 --> 00:34:08,146 VISUALS. AND LINK TO DIVERSE 928 00:34:08,212 --> 00:34:11,649 HEALTH AND OUTCOMES. 929 00:34:11,716 --> 00:34:12,216 THESE TWO APPROACHES REQUIRED 930 00:34:12,283 --> 00:34:15,219 USING DIFFERENT METHODS. FOR 931 00:34:15,286 --> 00:34:16,988 EXAMPLE HOW MANY APPROACHES USE 932 00:34:17,054 --> 00:34:23,027 A COMPOSITE SCORE. BINARY 933 00:34:23,094 --> 00:34:23,661 INDICATORS THAT ARE OPTIMAL OR 934 00:34:23,728 --> 00:34:25,196 SUBOPTIMAL OF SLEEP. 935 00:34:25,263 --> 00:34:28,299 WHICH TYPE OF APPROACH USES A 936 00:34:28,366 --> 00:34:31,335 PERSON- CENTERED METHODOLOGY? 937 00:34:31,402 --> 00:34:38,843 SUCH AS LATENT CLASS ANALYSIS 938 00:34:38,910 --> 00:34:39,544 OR LATENT PROFILE ANALYSIS TO 939 00:34:39,610 --> 00:34:42,380 IDENTIFY (INDISCERNIBLE) OF 940 00:34:42,447 --> 00:34:42,914 HEALTH THAT ARE COMMON IN 941 00:34:42,980 --> 00:34:44,882 SPECIFIC POPULATION. I WILL 942 00:34:44,949 --> 00:34:46,017 SHOW YOU SOME OF MY WORK USING 943 00:34:46,083 --> 00:34:46,717 THESE TRUE APPROACHES. NEXT 944 00:34:46,784 --> 00:34:49,987 SLIDE PLEASE. 945 00:34:50,054 --> 00:34:54,725 FIRST, WHICH TYPE OF APPROACH? 946 00:34:54,792 --> 00:34:58,129 USING MULTIDIMENSIONAL SLEEP 947 00:34:58,196 --> 00:35:05,136 DIMENSIONS, OUR PREVIOUS WORK 948 00:35:05,203 --> 00:35:05,703 IDENTIFIED (INDISCERNIBLE) 949 00:35:05,770 --> 00:35:06,304 HEALTH PHENOTYPES, IN MIDDLE 950 00:35:06,370 --> 00:35:09,941 LIFE ADULT. THIS FIGURE SHOWS 951 00:35:10,007 --> 00:35:11,742 THREE COMMON SLEEP PHENOTYPES 952 00:35:11,809 --> 00:35:14,712 IDENTIFIED AT BASELINE. 953 00:35:14,779 --> 00:35:18,850 ON THIS RADAR PLOT, LOCATED 954 00:35:18,916 --> 00:35:20,418 CLOSER TO THE CENTER INDICATES 955 00:35:20,485 --> 00:35:23,187 BETTER SLEEP. THE FIRST 956 00:35:23,254 --> 00:35:25,890 PHENOTYPE, POOR SLEEPERS. THE 957 00:35:25,957 --> 00:35:30,027 GREEN SOLID LINE. THEY WERE 958 00:35:30,094 --> 00:35:30,595 CHARACTERIZED BY POOR SLEEP 959 00:35:30,661 --> 00:35:32,830 ACROSS ALL DIMENSIONS. 960 00:35:32,897 --> 00:35:36,767 THE SECOND PHENOTYPE, CATCH UP 961 00:35:36,834 --> 00:35:38,903 SLEEPERS OR IRREGULAR SLEEPERS, 962 00:35:38,970 --> 00:35:41,239 THE BLUE DOTTED LINE, WERE 963 00:35:41,305 --> 00:35:45,743 CHARACTERIZED BY HIGH NAP 964 00:35:45,810 --> 00:35:46,344 FREQUENCY AND IRREGULAR SLEEP 965 00:35:46,410 --> 00:35:48,880 SUCH AS (INDISCERNIBLE) SLEEP 966 00:35:48,946 --> 00:35:51,415 COMPARED TO SHORT SLEEP. 967 00:35:51,482 --> 00:35:57,188 THE THIRD PHENOTYPE, INSOMNIA 968 00:35:57,255 --> 00:36:00,758 SLEEPERS, IN THE ORANGE LINE, 969 00:36:00,825 --> 00:36:01,325 WERE CHARACTERIZED BY HIGH 970 00:36:01,392 --> 00:36:06,998 INSOMNIA SYMPTOMS, SHORT SLEEP 971 00:36:07,064 --> 00:36:07,598 DURATION, LONG SLEEP LATENCY, 972 00:36:07,665 --> 00:36:08,232 AND SOMEWHAT IRREGULAR SLEEP, 973 00:36:08,299 --> 00:36:11,836 ALL OF WHICH MAPPED ONTO 974 00:36:11,903 --> 00:36:13,538 CLINICAL INSOMNIA SYMPTOMS. 975 00:36:13,604 --> 00:36:16,140 NEXT. 976 00:36:16,207 --> 00:36:17,408 THESE PHENOTYPES WERE 977 00:36:17,475 --> 00:36:20,811 REPLICATED APPROXIMATELY ONE 978 00:36:20,878 --> 00:36:21,412 DECADE LATER, WITHIN THE SAME 979 00:36:21,479 --> 00:36:26,083 PARTICIPANTS. AS YOU SEE HERE, 980 00:36:26,150 --> 00:36:26,717 THE SHAPE OF EACH PHENOTYPE WAS 981 00:36:26,784 --> 00:36:29,353 VERY SIMILAR ACROSS THE TWO 982 00:36:29,420 --> 00:36:35,092 TIME POINTS. NEXT. 983 00:36:35,159 --> 00:36:40,565 WE HAVE SHOWN THAT 984 00:36:40,631 --> 00:36:41,065 MULTIDIMENSIONAL HEALTH 985 00:36:41,132 --> 00:36:41,699 PHENOTYPES ARE GOOD MARKERS OF 986 00:36:41,766 --> 00:36:45,736 HEALTH. FOR EXAMPLE IN THE 987 00:36:45,803 --> 00:36:46,270 STUDY WE FOUND THAT THESE 988 00:36:46,337 --> 00:36:49,907 PHENOTYPES DIVERTING CHRONIC 989 00:36:49,974 --> 00:36:54,679 PHYSICAL CONDITIONS; IRREGULAR 990 00:36:54,745 --> 00:36:59,450 OR CATCH UP SLEEPERS REPORTED 991 00:36:59,517 --> 00:37:00,017 25% MORE CHRONIC CONDITIONS 992 00:37:00,084 --> 00:37:01,852 THAN GOOD SLEEPERS AND INSOMNIA 993 00:37:01,919 --> 00:37:02,486 SLEEPERS REPORTED ALMOST TWICE 994 00:37:02,553 --> 00:37:05,923 AS MANY CHRONIC PHYSICAL 995 00:37:05,990 --> 00:37:06,991 CONDITIONS, COMPARED TO GOOD 996 00:37:07,058 --> 00:37:11,462 SLEEPERS. NEXT SLIDE PLEASE. 997 00:37:11,529 --> 00:37:13,698 THIS IS ANOTHER STUDY SHOWING 998 00:37:13,764 --> 00:37:17,802 SLEEP HEALTH PHENOTYPES, ALSO 999 00:37:17,868 --> 00:37:18,369 ASSOCIATED WITH THE RISK OF 1000 00:37:18,436 --> 00:37:20,004 HEART DISEASE, WHICH INVOLVES 1001 00:37:20,071 --> 00:37:26,577 CHEST PAIN. SPECIFICALLY, 1002 00:37:26,644 --> 00:37:29,246 MEMBERSHIP IN THE INSOMNIA 1003 00:37:29,313 --> 00:37:29,880 SLEEPER PHENOTYPE IS ASSOCIATED 1004 00:37:29,947 --> 00:37:31,916 WITH 50% HIGHER RISK OF HEART 1005 00:37:31,983 --> 00:37:33,851 DISEASE COMPARED TO GOOD 1006 00:37:33,918 --> 00:37:37,188 SLEEPERS. 1007 00:37:37,254 --> 00:37:37,622 AND THE FINDINGS WERE 1008 00:37:37,688 --> 00:37:39,690 REPLICATED ACROSS THE TWO 1009 00:37:39,757 --> 00:37:42,627 INDEPENDENT SAMPLES OF THE 1010 00:37:42,693 --> 00:37:45,096 MIDUS. NEXT SLIDE PLEASE. 1011 00:37:45,162 --> 00:37:55,606 MY CURRENT R01, TITLED SPAI, 1012 00:37:57,875 --> 00:38:01,345 MEASURES HOW CHRONIC PAIN IS 1013 00:38:01,412 --> 00:38:01,979 MEDIATED BY SOCIAL LEFT OUT AND 1014 00:38:02,046 --> 00:38:03,714 INFORMATION IN THREE DIFFERENT 1015 00:38:03,781 --> 00:38:07,018 COHORTS OF ADULTS. THIS IS TO 1016 00:38:07,084 --> 00:38:10,588 DO SECONDARY DATA ANALYSIS. 1017 00:38:10,655 --> 00:38:12,156 WE WERE EXAMINING ACTIVE SOCIAL 1018 00:38:12,223 --> 00:38:17,128 LIFE AS A BEHAVIOR MECHANISM. 1019 00:38:17,194 --> 00:38:17,762 AND SYSTEMIC INFLAMMATION IS A 1020 00:38:17,828 --> 00:38:20,898 BIOLOGICAL MECHANISM. WE HAVE 1021 00:38:20,965 --> 00:38:21,666 JUST STARTED ANALYZING DATA TO 1022 00:38:21,732 --> 00:38:26,837 ADDRESS AIM 1. 1023 00:38:26,904 --> 00:38:27,405 DURING THE REST OF MY TALK I 1024 00:38:27,471 --> 00:38:32,443 WILL SHOW YOU FINDINGS OF AIM 1 1025 00:38:32,510 --> 00:38:35,379 USING HOW MANY APPROACH IN A 1026 00:38:35,446 --> 00:38:38,516 (INDISCERNIBLE) SAMPLE. 1027 00:38:38,582 --> 00:38:39,116 I WILL ALSO SHOW YOU MY 1028 00:38:39,183 --> 00:38:39,950 PREVIOUS FINDINGS RELATED TO 1029 00:38:40,017 --> 00:38:42,920 THESE BEHAVIORAL AND 1030 00:38:42,987 --> 00:38:50,194 INFLAMMATORY MECHANISMS. NEXT. 1031 00:38:50,261 --> 00:38:50,761 SLEEP HEALTH COMPOSITE SCORE 1032 00:38:50,828 --> 00:38:54,932 WAS MEASURED BY BOTH THE 1033 00:38:54,999 --> 00:39:01,005 SELF-REPORT AND 1034 00:39:01,072 --> 00:39:01,605 (INDISCERNIBLE), RE-CREATING 1035 00:39:01,672 --> 00:39:02,173 THE BINARY INDICATORS WHICH 1036 00:39:02,239 --> 00:39:05,609 REPRESENT POOR SLEEP. 1037 00:39:05,676 --> 00:39:11,782 WE SUMMED UP THE BINARY 1038 00:39:11,849 --> 00:39:12,349 INDICATORS TO RECONSTRUCT A 1039 00:39:12,416 --> 00:39:12,983 COMPOSITE SCORE OF SLEEP HEALTH 1040 00:39:13,050 --> 00:39:13,451 SUCH AS HIGHER SCORE 1041 00:39:13,517 --> 00:39:14,051 REPRESENTED MORE SLEEP HEALTH 1042 00:39:14,118 --> 00:39:18,122 PROBLEMS. 1043 00:39:18,189 --> 00:39:21,826 IN A SAMPLE OF OLDER MEN IN 1044 00:39:21,892 --> 00:39:24,795 MROS, PARTICIPANTS HAD 1.4 1045 00:39:24,862 --> 00:39:26,263 SLEEP HEALTH PROBLEMS ON 1046 00:39:26,330 --> 00:39:28,132 AVERAGE. NEXT. 1047 00:39:28,199 --> 00:39:35,406 WE USED THE DEPENDENT MODELS TO 1048 00:39:35,473 --> 00:39:37,341 TEST POTENTIAL BIDIRECTIONAL 1049 00:39:37,408 --> 00:39:38,008 ASSOCIATIONS BETWEEN BACK PAIN 1050 00:39:38,075 --> 00:39:41,445 AND SLEEP HEALTH. HERE BLACK 1051 00:39:41,512 --> 00:39:47,184 SOLID LINES REPRESENT 1052 00:39:47,251 --> 00:39:48,719 AUTOREGRESSIVE PATH, SUCH THAT 1053 00:39:48,786 --> 00:39:53,190 BACK PAIN TIME 1 AND BACK PAIN 1054 00:39:53,257 --> 00:39:56,393 TIME 2. AND HAVING ANY BACK 1055 00:39:56,460 --> 00:39:59,964 PAIN AT TIME 1 PREDICTED MORE 1056 00:40:00,030 --> 00:40:01,665 SLEEP HEALTH PROBLEMS AT TIME 1057 00:40:01,732 --> 00:40:03,968 2. 1058 00:40:04,034 --> 00:40:05,436 THIS WAS FOUND AFTER 1059 00:40:05,503 --> 00:40:09,707 CONTROLLING FOR EXTENSIVE 1060 00:40:09,774 --> 00:40:10,307 COVARIATES, INCLUDING SOCIAL 1061 00:40:10,374 --> 00:40:10,908 DEMOGRAPHICS, SLEEP DISORDER 1062 00:40:10,975 --> 00:40:14,111 DIAGNOSIS, BMI, HEALTH 1063 00:40:14,178 --> 00:40:16,814 BEHAVIORS, CHRONIC CONDITIONS, 1064 00:40:16,881 --> 00:40:17,782 MEDICATION USE AND SOMEONE. 1065 00:40:17,848 --> 00:40:23,487 NEXT. 1066 00:40:23,554 --> 00:40:24,021 RESULTS WERE CONSISTENT FOR 1067 00:40:24,088 --> 00:40:26,891 THOSE WHO HAD PERSISTENT BACK 1068 00:40:26,957 --> 00:40:30,628 PAIN, WHICH REFERS TO THREE 1069 00:40:30,694 --> 00:40:32,363 CONSECUTIVE REPORTS OF PAIN 1070 00:40:32,429 --> 00:40:42,173 OVER ONE YEAR. 1071 00:40:42,239 --> 00:40:42,740 WE ALSO TESTED WITH THE BACK 1072 00:40:42,807 --> 00:40:43,307 PAIN SEVERITY AND ACTIVITY 1073 00:40:43,374 --> 00:40:43,874 LIMITING BACK PAIN. RESULTS 1074 00:40:43,941 --> 00:40:47,311 WERE CONSISTENT. NEXT. 1075 00:40:47,378 --> 00:40:48,045 THIS IS FROM A PREVIOUS 1076 00:40:48,112 --> 00:40:51,849 PUBLICATION USING BASELINE MROS 1077 00:40:51,916 --> 00:40:58,689 SAMPLES, WHICH SHOWS THAT 1078 00:40:58,756 --> 00:40:59,256 OSTEOARTHRITIS, POOR SLEEP 1079 00:40:59,323 --> 00:40:59,924 HEALTH, AND INFLAMMATION MAY GO 1080 00:40:59,990 --> 00:41:03,294 TOGETHER. WE FOUND THAT OLDER 1081 00:41:03,360 --> 00:41:05,930 MEN WITH OSTEOARTHRITIS OR OA 1082 00:41:05,996 --> 00:41:07,565 HAD A SIGNIFICANTLY POOR SLEEP 1083 00:41:07,631 --> 00:41:11,335 HEALTH. IN THIS STUDY WE USED 1084 00:41:11,402 --> 00:41:11,902 A COMPOSITE SCORE OF SLEEP 1085 00:41:11,969 --> 00:41:15,306 HEALTH. 1086 00:41:15,372 --> 00:41:22,012 POORER SLEEP HEALTH WAS IN TURN 1087 00:41:22,079 --> 00:41:22,646 ASSOCIATED WITH 16% HIGHER ODDS 1088 00:41:22,713 --> 00:41:24,882 OF ELEVATED CRP, AS WELL AS 12% 1089 00:41:24,949 --> 00:41:30,654 HIGHER ARTS OF ELEVATED IL-6. 1090 00:41:30,721 --> 00:41:31,255 NOTE THAT THERE WERE NO DIRECT 1091 00:41:31,322 --> 00:41:34,925 ASSOCIATIONS OF OA WITH THIS 1092 00:41:34,992 --> 00:41:37,561 INFLAMMATORY BIOMARKERS. 1093 00:41:37,628 --> 00:41:44,235 THUS OLDER MEN WITH OA DO NOT 1094 00:41:44,301 --> 00:41:45,903 NECESSARILY HAVE A HIGHER RISK 1095 00:41:45,970 --> 00:41:47,571 OF INFLAMMATION. BUT WHEN THEY 1096 00:41:47,638 --> 00:41:50,808 HAD THE POORER SLEEP HEALTH THE 1097 00:41:50,875 --> 00:41:51,809 RISK OF INFLAMMATION WAS 1098 00:41:51,876 --> 00:41:57,314 ELEVATED. 1099 00:41:57,381 --> 00:41:57,882 THE RESULTS MAY BE RELATED TO 1100 00:41:57,948 --> 00:41:58,515 POTENTIAL JOINT PAIN ASSOCIATED 1101 00:41:58,582 --> 00:42:01,685 WITH OA WHICH MAY HAVE BEEN 1102 00:42:01,752 --> 00:42:02,286 ASSOCIATED WITH POOR SLEEP AT 1103 00:42:02,353 --> 00:42:06,991 NIGHT. NEXT. 1104 00:42:07,057 --> 00:42:07,524 I WANT TO BRIEFLY TOUCH ON 1105 00:42:07,591 --> 00:42:07,992 POTENTIAL BEHAVIORAL 1106 00:42:08,058 --> 00:42:11,495 MECHANISMS. THERE IS UNDER 1107 00:42:11,562 --> 00:42:13,998 RECOGNIZED EVIDENCE THAT 1108 00:42:14,064 --> 00:42:16,467 PHYSICAL PAIN IS AFFECTED BY 1109 00:42:16,533 --> 00:42:18,402 ADVERSE SOCIAL EXPERIENCES. 1110 00:42:18,469 --> 00:42:24,775 FOR EXAMPLE, IN A CLINICAL CASE 1111 00:42:24,842 --> 00:42:35,219 STUDY, A PATIENT WITH 1112 00:42:39,256 --> 00:42:39,757 INSENSITIVITY TO PAIN REPORTED 1113 00:42:39,823 --> 00:42:40,357 FEELING PHYSICAL PAIN FOR THE 1114 00:42:40,424 --> 00:42:40,958 FIRST TIME SHORTLY AFTER THE 1115 00:42:41,025 --> 00:42:41,558 UNEXPECTED DEATH OF A YOUNGER 1116 00:42:41,625 --> 00:42:44,728 SIBLING. 1117 00:42:44,795 --> 00:42:45,329 THE RESEARCH DEMONSTRATED THAT 1118 00:42:45,396 --> 00:42:45,863 THE EXPERIENCES OF SOCIAL 1119 00:42:45,930 --> 00:42:46,397 EXCLUSIVE, PREDOMINANTLY 1120 00:42:46,463 --> 00:42:53,003 ACTIVATE THE ACC AND AI, 1121 00:42:53,070 --> 00:42:53,537 REASONS KNOWN TO HAVE AN 1122 00:42:53,604 --> 00:42:54,171 OVERALL DISTRESSING EXPERIENCE 1123 00:42:54,238 --> 00:42:57,942 OF PHYSICAL PAIN. 1124 00:42:58,008 --> 00:42:58,509 IN ADDITION, SEVERAL LINES OF 1125 00:42:58,575 --> 00:43:00,544 RESEARCH HAVE SHOWN THAT 1126 00:43:00,611 --> 00:43:09,219 EXPERIENCES OF NEGATIVE, SOCIAL 1127 00:43:09,286 --> 00:43:09,787 EVALUATION, RESECTION OF A 1128 00:43:09,853 --> 00:43:10,254 ROMANTIC PARTNER AND 1129 00:43:10,321 --> 00:43:10,821 BEREAVEMENT ARE RELATED TO 1130 00:43:10,888 --> 00:43:18,562 ACTIVITY IN THE DACC AND AI. 1131 00:43:18,629 --> 00:43:19,096 GIVEN THE SHARED MECHANISM 1132 00:43:19,163 --> 00:43:22,099 TWEEN SOCIAL PAIN AND PHYSICAL 1133 00:43:22,166 --> 00:43:23,834 PAIN WE WERE CURIOUS WHETHER 1134 00:43:23,901 --> 00:43:24,468 LOWERING SOCIAL PAIN CAN REDUCE 1135 00:43:24,535 --> 00:43:27,404 CHRONIC PHYSICAL PAIN. NEXT. 1136 00:43:27,471 --> 00:43:31,709 NEXT SLIDE PLEASE. 1137 00:43:31,775 --> 00:43:33,911 THIS SHOWS THAT SOCIAL PAIN 1138 00:43:33,978 --> 00:43:35,446 MEASURED BY LONELINESS AND 1139 00:43:35,512 --> 00:43:36,747 SOCIAL ISOLATION ARE CORRELATES 1140 00:43:36,814 --> 00:43:38,682 OF PHYSICAL PAIN, AND MEASURED 1141 00:43:38,749 --> 00:43:43,554 BY PAIN INTERFERENCE IN MIDUS. 1142 00:43:43,620 --> 00:43:45,656 AS YOU CAN SEE HERE WHEN SOCIAL 1143 00:43:45,723 --> 00:43:48,292 ISOLATION IS HIGHER, AND 1144 00:43:48,359 --> 00:43:50,894 LONELINESS IS HIGHER, THE 1145 00:43:50,961 --> 00:43:51,528 ESTIMATED PAIN INTERFERENCE IS 1146 00:43:51,595 --> 00:43:54,631 ALSO HIGHER. I THINK THIS IS 1147 00:43:54,698 --> 00:43:58,168 SUCH A STORY THAT ADDRESSING 1148 00:43:58,235 --> 00:43:59,069 SOCIAL PAIN MAY HELP REDUCE THE 1149 00:43:59,136 --> 00:43:59,670 CHRONIC PHYSICAL PAIN. NEXT 1150 00:43:59,737 --> 00:44:05,909 SLIDE PLEASE. 1151 00:44:05,976 --> 00:44:10,848 AS EXPECTED WE FOUND THAT IN 1152 00:44:10,914 --> 00:44:11,915 MIDUS EXAMPLE LONELINESS WAS 1153 00:44:11,982 --> 00:44:12,516 ASSOCIATED WITH CHRONIC PAIN 1154 00:44:12,583 --> 00:44:14,852 OVER TIME. SPECIFICALLY 1155 00:44:14,918 --> 00:44:15,886 INDIVIDUALS WITH HIGHER 1156 00:44:15,953 --> 00:44:20,724 LONELINESS AT BASELINE. AND 1157 00:44:20,791 --> 00:44:21,959 THOSE WHO INCREASED LONELINESS 1158 00:44:22,026 --> 00:44:25,996 OVER TIME, HAD HIGHER ODDS OF 1159 00:44:26,063 --> 00:44:29,166 HAVING ANY CHRONIC PAIN, 1160 00:44:29,233 --> 00:44:29,767 GREATER PAIN INTERFERENCE AND 1161 00:44:29,833 --> 00:44:30,434 MORE PAINT LOCATIONS AT 1162 00:44:30,501 --> 00:44:37,708 FOLLOW-UP. 1163 00:44:37,775 --> 00:44:38,275 MOREOVER, THERE WAS EVIDENCE 1164 00:44:38,342 --> 00:44:39,209 THAT GREATER SOCIAL ACTIVITY 1165 00:44:39,276 --> 00:44:39,676 DIVERSITY, MAY REDUCE 1166 00:44:39,743 --> 00:44:43,714 LONELINESS. HIGHER SCORES OF 1167 00:44:43,781 --> 00:44:47,718 SOCIAL ACTIVITY DIVERSITY 1168 00:44:47,785 --> 00:44:51,055 REPRESENTED GREATER VARIETY, 1169 00:44:51,121 --> 00:44:52,823 WITH GREATER REGULARITY IN 1170 00:44:52,890 --> 00:44:55,059 SOCIAL ACTIVITY ENGAGEMENT. 1171 00:44:55,125 --> 00:44:56,660 THIS STUDY SHOWS THE 1172 00:44:56,727 --> 00:44:58,228 POSSIBILITY THAT SOCIAL 1173 00:44:58,295 --> 00:45:01,598 ACTIVITY DIVERSITY MAY HELP 1174 00:45:01,665 --> 00:45:04,034 ALLEVIATE CHRONIC PHYSICAL PAIN 1175 00:45:04,101 --> 00:45:05,569 BY LOWERING FEELINGS OF 1176 00:45:05,636 --> 00:45:09,139 LONELINESS. 1177 00:45:09,206 --> 00:45:11,108 OUR FUTURE ANALYSIS WILL 1178 00:45:11,175 --> 00:45:13,110 EXAMINE POTENTIAL MECHANISMS BY 1179 00:45:13,177 --> 00:45:16,346 SOCIAL ACTIVITY DIVERSITY, AS 1180 00:45:16,413 --> 00:45:20,217 WELL AS BY INFLAMMATION IN THE 1181 00:45:20,284 --> 00:45:20,784 RELATIONSHIP BETWEEN SLEEP 1182 00:45:20,851 --> 00:45:21,351 HEALTH PROFILES AND CHRONIC 1183 00:45:21,418 --> 00:45:27,124 PAIN. NEXT SLIDE PLEASE. 1184 00:45:27,191 --> 00:45:29,860 SO TO SUMMARIZE, SLEEP IS 1185 00:45:29,927 --> 00:45:34,498 CLOSELY RELATED TO PAIN IN 1186 00:45:34,565 --> 00:45:38,435 DIVERSE AGE-RELATED HEALTH 1187 00:45:38,502 --> 00:45:39,036 OUTCOMES. (INDISCERNIBLE) IS 1188 00:45:39,103 --> 00:45:43,407 OFTEN FORGOTTEN IN LITERATURE 1189 00:45:43,474 --> 00:45:51,014 BUT CHANGES IN RELATIONSHIP TO 1190 00:45:51,081 --> 00:45:53,250 HEALTH MAY BEGIN FROM MIDDLE 1191 00:45:53,317 --> 00:45:53,817 ADULTHOOD, AND TO IDENTIFY 1192 00:45:53,884 --> 00:45:56,720 EARLY RISK FACTORS. 1193 00:45:56,787 --> 00:45:59,189 I SHOWED YOU SEVERAL EXAMPLE 1194 00:45:59,256 --> 00:45:59,756 STUDIES THAT USED MULTIPLE 1195 00:45:59,823 --> 00:46:04,661 SLEEP PARAMETERS. IMPORTANTLY, 1196 00:46:04,728 --> 00:46:06,730 MULTIDIMENSIONAL SLEEP HEALTH 1197 00:46:06,797 --> 00:46:08,999 APPROACH CAN MORE 1198 00:46:09,066 --> 00:46:09,566 COMPREHENSIVELY CAPTURE THE 1199 00:46:09,633 --> 00:46:12,136 EFFECTS OF SLEEP ON HEALTH. 1200 00:46:12,202 --> 00:46:16,607 LAST, BUT NOT LEAST, SOCIAL 1201 00:46:16,673 --> 00:46:17,107 ACTIVITY DIVERSITY AND 1202 00:46:17,174 --> 00:46:21,044 INFLAMMATION MAY BE POTENTIAL 1203 00:46:21,111 --> 00:46:22,246 MECHANISMS TO REDUCE POOR SLEEP 1204 00:46:22,312 --> 00:46:22,880 HEALTH AND CHRONIC PAIN. NEXT 1205 00:46:22,946 --> 00:46:26,483 SLIDE PLEASE. 1206 00:46:26,550 --> 00:46:29,419 THIS IS MY LAST SLIDE. I WOULD 1207 00:46:29,486 --> 00:46:30,220 LIKE TO THANK MY COLLABORATORS 1208 00:46:30,287 --> 00:46:36,059 FOR THIS SPAI R01, AS WELL AS 1209 00:46:36,126 --> 00:46:36,627 MY RESEARCH ASSISTANT IN MY 1210 00:46:36,693 --> 00:46:38,095 RESEARCH LAB FOR THIS HELP. 1211 00:46:38,162 --> 00:46:39,429 THANK YOU. 1212 00:46:39,496 --> 00:46:44,868 >> THANK YOU VERY MUCH DR. LEE. 1213 00:46:44,935 --> 00:46:45,435 THIS IS EXCITING DATA, PEER 1214 00:46:45,502 --> 00:46:46,670 INTERESTED IN BIDIRECTIONAL 1215 00:46:46,737 --> 00:46:48,739 RELATIONSHIP BETWEEN SLEEP AND 1216 00:46:48,805 --> 00:46:49,273 PAIN. ESPECIALLY FOR THE 1217 00:46:49,339 --> 00:46:53,043 POTENTIAL TO MODULATE SLEEPER 1218 00:46:53,110 --> 00:46:54,811 BETTER PAIN OUTCOMES. 1219 00:46:54,878 --> 00:46:57,714 WITH THIS, I AM INVITING OUR 1220 00:46:57,781 --> 00:46:58,348 FINAL SPEAKER FOR THE SESSION, 1221 00:46:58,415 --> 00:47:06,523 DR. DINA KATABI, PROFESSOR OF 1222 00:47:06,590 --> 00:47:07,090 ELECTRICAL ENGINEERING AND 1223 00:47:07,157 --> 00:47:14,131 COMPUTER SCIENCE FROM THE 1224 00:47:14,198 --> 00:47:14,698 MASSACHUSETTS INSTITUTE OF 1225 00:47:14,765 --> 00:47:15,199 TECHNOLOGY IN SHE IS A 1226 00:47:15,265 --> 00:47:18,035 COMMUNICATIONS RESEARCHER 1227 00:47:18,101 --> 00:47:21,805 WORKING AT THE INTERSECTION OF 1228 00:47:21,872 --> 00:47:27,844 ... THE TOP OF HER TALK IS AI 1229 00:47:27,911 --> 00:47:28,445 FOR MEASURING BRAIN DISEASES 1230 00:47:28,512 --> 00:47:32,716 AND THERAPIES DURING SLEEP. 1231 00:47:32,783 --> 00:47:34,551 >> I NEED TO SEE MY SLIDES. I 1232 00:47:34,618 --> 00:47:37,921 HAVE MANY ANIMATIONS, AS WE 1233 00:47:37,988 --> 00:47:40,958 AGREED EARLIER. CURRENTLY THE 1234 00:47:41,024 --> 00:47:43,560 HOST SHARING IS DISABLED. CAN 1235 00:47:43,627 --> 00:47:45,963 SOMEONE ENABLE IT PLEASE? 1236 00:47:46,029 --> 00:47:50,767 >> HELLO DR. KATABI. I WILL BE 1237 00:47:50,834 --> 00:47:54,371 SHOWING THE SLIDES FOR YOU. 1238 00:47:54,438 --> 00:48:01,912 >> EXCUSE ME? I REALLY NEED, 1239 00:48:01,979 --> 00:48:03,146 BECAUSE OF THE ANIMATION AND WE 1240 00:48:03,213 --> 00:48:04,381 AGREED I WOULD ADVANCE MY 1241 00:48:04,448 --> 00:48:08,285 SLIDES MYSELF. CAN YOU PLEASE 1242 00:48:08,352 --> 00:48:11,488 ALLOW ME TO SHARE THE SCREEN? 1243 00:48:11,555 --> 00:48:17,861 >> SORRY DR. KATABAI. WE HAVE 1244 00:48:17,928 --> 00:48:18,462 INHIBITED ALL THE ANIMATIONS, 1245 00:48:18,528 --> 00:48:19,596 DUE TO THE BANDWIDTH WE DON'T 1246 00:48:19,663 --> 00:48:20,731 WANT THOSE TO CAUSE ANYTHING. 1247 00:48:20,797 --> 00:48:23,700 SO YOU JUST HAVE TO SAY NEXT. 1248 00:48:23,767 --> 00:48:30,941 ALL THE ANIMATIONS ARE THERE. 1249 00:48:31,008 --> 00:48:31,508 I ASSURE YOU THAT EVERYTHING 1250 00:48:31,575 --> 00:48:33,744 PRESENTED WILL BE SHARED. 1251 00:48:33,810 --> 00:48:40,517 >> OKAY. LET'S TRY. VERY 1252 00:48:40,584 --> 00:48:42,019 INCONVENIENT TO BE HONEST WITH 1253 00:48:42,085 --> 00:48:43,420 YOU, AND DIFFERENT FROM WHAT WE 1254 00:48:43,487 --> 00:48:46,623 AGREED, BUT LET'S TRY. 1255 00:48:46,690 --> 00:48:49,393 THANK YOU VERY MUCH FOR BEING 1256 00:48:49,459 --> 00:48:52,596 HERE TO LISTEN TO ME. MY WORK 1257 00:48:52,663 --> 00:48:53,497 IS, I AM A COMPUTER SCIENTIST, 1258 00:48:53,563 --> 00:48:58,035 INTERESTED IN HOW AI CAN BE 1259 00:48:58,101 --> 00:48:59,503 USED TO MEASURING BRAIN 1260 00:48:59,569 --> 00:49:06,143 DISEASES AND THERAPIES. IN 1261 00:49:06,209 --> 00:49:06,710 PARTICULAR HOW TO DO THOSE 1262 00:49:06,777 --> 00:49:08,345 MEASUREMENTS DURING SLEEP. 1263 00:49:08,412 --> 00:49:12,082 ONE QUESTION IS, WIDE TO USE AI 1264 00:49:12,149 --> 00:49:15,952 TO MEASURE THE BRAIN? THE REAL 1265 00:49:16,019 --> 00:49:18,722 ANSWER IS, WE DO NOT HAVE VERY 1266 00:49:18,789 --> 00:49:19,289 GOOD WAYS OF MEASURING THE 1267 00:49:19,356 --> 00:49:23,493 BRAIN TODAY. NOT LIKE WE HAVE, 1268 00:49:23,560 --> 00:49:26,229 LIKE A TEST THAT WOULD ALLOW US 1269 00:49:26,296 --> 00:49:27,064 TO HAVE THE MEASUREMENT OF THE 1270 00:49:27,130 --> 00:49:28,699 BRAIN. SO IF AI CAN HELP US 1271 00:49:28,765 --> 00:49:30,734 ADDRESS ISSUES OF HOW DO WE 1272 00:49:30,801 --> 00:49:40,777 UNDERSTAND THE BRAIN AND ITS 1273 00:49:40,844 --> 00:49:41,411 DISEASEASES THAT COULD ADDRESS 1274 00:49:41,478 --> 00:49:41,978 UNSTEADY DISEASES LIKE MOOD 1275 00:49:42,045 --> 00:49:45,515 DISORDER, ETC. NEXT. 1276 00:49:45,582 --> 00:49:46,350 THE NATURAL QUESTION IS, HOW 1277 00:49:46,416 --> 00:49:49,920 CAN WE USE AI TO UNDERSTAND THE 1278 00:49:49,986 --> 00:49:53,790 BRAIN? PARTICULARLY OF COURSE 1279 00:49:53,857 --> 00:49:55,492 WE WANT TO UNDERSTAND IT IN 1280 00:49:55,559 --> 00:49:58,762 HUMANS, BECAUSE WE KNOW THAT 1281 00:49:58,829 --> 00:50:00,597 PARTICULARLY IN NEUROLOGICAL 1282 00:50:00,664 --> 00:50:01,231 DISEASES, THE TRANSLATION FROM 1283 00:50:01,298 --> 00:50:03,200 ANIMAL MODELS TO HUMANS IS NOT 1284 00:50:03,266 --> 00:50:07,904 DONE VERY WELL. IF WE ARE GOING 1285 00:50:07,971 --> 00:50:10,006 TO GET INFORMATION AND MEASURE 1286 00:50:10,073 --> 00:50:12,175 THE BRAIN IN HUMANS, THEN OF 1287 00:50:12,242 --> 00:50:13,944 COURSE WE WANT TO DO IT 1288 00:50:14,010 --> 00:50:14,978 CONTINUOUSLY WITHOUT PUTTING 1289 00:50:15,045 --> 00:50:18,148 ELECTRODES INTO PEOPLE'S HEADS. 1290 00:50:18,215 --> 00:50:20,550 SO THE NATURAL QUESTION IS, HOW 1291 00:50:20,617 --> 00:50:21,952 CAN WE DO THAT? NEXT SLIDE 1292 00:50:22,018 --> 00:50:26,056 PLEASE. 1293 00:50:26,123 --> 00:50:29,960 SO, WHAT WE HAVE DEVELOPED IN 1294 00:50:30,026 --> 00:50:30,594 MY LAB AT MIT IS A DEVICE THAT 1295 00:50:30,660 --> 00:50:34,898 LOOKS LIKE YOUR WI-FI BOX. 1296 00:50:34,965 --> 00:50:35,465 HOWEVER IT IS MUCH SMARTER 1297 00:50:35,532 --> 00:50:37,701 WI-FI BOX. IT ANALYZES THE 1298 00:50:37,768 --> 00:50:41,471 RADIO SIGNAL THAT BOUNCES 1299 00:50:41,538 --> 00:50:44,274 AROUND. AND USING THOSE 1300 00:50:44,341 --> 00:50:45,909 SIGNALS, WE ARE ABLE TO EXTRACT 1301 00:50:45,976 --> 00:50:47,077 PHYSIOLOGICAL SIGNALS. 1302 00:50:47,144 --> 00:50:47,677 PARTICULARLY ABLE TO EXTRACT 1303 00:50:47,744 --> 00:50:50,614 SLEEP. AT THE VERY DETAILED 1304 00:50:50,680 --> 00:50:55,085 LEVEL. IT CAN ALSO EXTRACT 1305 00:50:55,152 --> 00:50:56,153 INFORMATION ABOUT RESPIRATORY 1306 00:50:56,219 --> 00:50:59,689 SIGNALS, NOCTURNAL BREATHING, 1307 00:50:59,756 --> 00:51:02,492 APNEA, AND CAN EXTRACT 1308 00:51:02,559 --> 00:51:03,059 INFORMATION ABOUT MOVEMENT 1309 00:51:03,126 --> 00:51:04,928 DISORDERS. AND MULTI-SYMPTOMS 1310 00:51:04,995 --> 00:51:06,163 AND INTERACTIONS WITH 1311 00:51:06,229 --> 00:51:11,668 CAREGIVERS. 1312 00:51:11,735 --> 00:51:12,202 REASON WHAT WE CAN DO THIS 1313 00:51:12,269 --> 00:51:12,803 USING RADIO SIGNALS WITHOUT 1314 00:51:12,869 --> 00:51:17,908 ASKING PEOPLE TO WEAR WEARABLE 1315 00:51:17,974 --> 00:51:23,847 EQUIPMENT UNDER BODIES OR ANY 1316 00:51:23,914 --> 00:51:24,448 PIOS, IS BECAUSE WE ARE USING 1317 00:51:24,514 --> 00:51:25,048 THE POWER OF AI FOR ANALYZING 1318 00:51:25,115 --> 00:51:29,319 THESE AUTONOMIC WAYS. NEXT. 1319 00:51:29,386 --> 00:51:32,122 PARTICULARLY AS I SAID, WE WANT 1320 00:51:32,189 --> 00:51:34,291 TO USE THE POWER OF SLEEP. ON 1321 00:51:34,357 --> 00:51:37,661 THE ONE HAND WE WANT TO BE ABLE 1322 00:51:37,727 --> 00:51:38,228 TO UNDERSTAND SLEEP, USING 1323 00:51:38,295 --> 00:51:39,129 THESE RADIO SIGNALS WITHOUT 1324 00:51:39,196 --> 00:51:41,731 ASKING PEOPLE TO DO A FULL 1325 00:51:41,798 --> 00:51:44,901 STUDY. THE OTHER THING IS THAT 1326 00:51:44,968 --> 00:51:48,171 WE WANT TO BE ABLE TO LEVERAGE 1327 00:51:48,238 --> 00:51:49,105 SLEEP FOR UNDERSTANDING OTHER 1328 00:51:49,172 --> 00:51:50,774 DISEASES. NEXT. 1329 00:51:50,841 --> 00:51:55,545 SO, WE KNOW THAT WHEN WE GO TO 1330 00:51:55,612 --> 00:51:56,480 SLEEP OUR BRAIN WAVES ENTER 1331 00:51:56,546 --> 00:51:58,415 DIFFERENT STAGES. AWAKE. LIGHT 1332 00:51:58,482 --> 00:52:01,585 SLEEP. DEEP SLEEP AND REM, 1333 00:52:01,651 --> 00:52:03,887 RAPID EYE MOVEMENT. AND THE 1334 00:52:03,954 --> 00:52:06,523 SLEEP STAGES OF COURSE VERY 1335 00:52:06,590 --> 00:52:07,090 MUCH IMPORTANT FOR VARIOUS 1336 00:52:07,157 --> 00:52:12,395 SLEEP DISORDERS. BUT AS I SAID 1337 00:52:12,462 --> 00:52:13,029 EARLIER, WE ARE ALSO INTERESTED 1338 00:52:13,096 --> 00:52:13,630 TO UNDERSTAND HOW THESE SLEEP 1339 00:52:13,697 --> 00:52:14,297 STAGES INTERACT WITH DIFFERENT 1340 00:52:14,364 --> 00:52:15,966 DISEASES. 1341 00:52:16,032 --> 00:52:22,472 FOR EXAMPLE IT IS WIDELY KNOWN 1342 00:52:22,539 --> 00:52:23,106 THAT IN ALZHEIMER'S, SLOW WAVE 1343 00:52:23,173 --> 00:52:25,542 DURING DEEP SLEEP GETS 1344 00:52:25,609 --> 00:52:26,910 IMPACTED. IN DEPRESSION, FOR 1345 00:52:26,977 --> 00:52:27,511 EXAMPLE, WE TEND TO SEE RAPID 1346 00:52:27,577 --> 00:52:29,613 EYE MOVEMENTS OR REM HAPPENING 1347 00:52:29,679 --> 00:52:31,214 EARLY IN THE SLEEP. NEXT SLIDE 1348 00:52:31,281 --> 00:52:37,320 PLEASE. 1349 00:52:37,387 --> 00:52:37,888 SO, TODAY IF YOU WANT TO GET 1350 00:52:37,954 --> 00:52:39,890 SLEEP STAGING VERY ACCURATELY, 1351 00:52:39,956 --> 00:52:40,490 YOU HAVE TO SEND SOMEONE TO A 1352 00:52:40,557 --> 00:52:42,626 SLEEP LAB AND PUT ELECTRODES ON 1353 00:52:42,692 --> 00:52:44,461 THE HEAD AND BODY AND ASKED 1354 00:52:44,528 --> 00:52:47,364 THEM TO SLEEP LIKE THIS. THIS 1355 00:52:47,430 --> 00:52:47,998 IS THE STANDARD CLINICAL WAY OF 1356 00:52:48,064 --> 00:52:50,433 MEASURING SLEEP. SOMETHING 1357 00:52:50,500 --> 00:52:54,671 CALLED PSG. AND I'M SURE ALL 1358 00:52:54,738 --> 00:52:56,740 OF YOU GUYS ARE AWARE OF IT. 1359 00:52:56,806 --> 00:53:00,810 THE PROBLEM WITH PSG, IS THAT 1360 00:53:00,877 --> 00:53:01,444 THE PERSON IS SLEEPING WITH ALL 1361 00:53:01,511 --> 00:53:02,045 OF THESE ELECTRODES ON THEIR 1362 00:53:02,112 --> 00:53:06,116 HEAD AND BODY. THAT ITSELF IS 1363 00:53:06,182 --> 00:53:06,750 INTERACTING WITH OUR ABILITY TO 1364 00:53:06,816 --> 00:53:09,386 MEASURE NORMAL SLEEP. 1365 00:53:09,452 --> 00:53:09,920 THE SECOND THING IS THAT IT 1366 00:53:09,986 --> 00:53:13,423 HAPPENS IN THE CLINIC. SO YOU 1367 00:53:13,490 --> 00:53:13,990 CANNOT GET THIS SLEEP STUDY 1368 00:53:14,057 --> 00:53:17,360 EVERY SINGLE NIGHT. SO ONE OF 1369 00:53:17,427 --> 00:53:17,994 THE VERY IMPORTANT THINGS THAT 1370 00:53:18,061 --> 00:53:23,633 WE AIM TO DO, AND WE DID 1371 00:53:23,700 --> 00:53:24,267 SUCCESSFULLY, IS TO BE ABLE TO 1372 00:53:24,334 --> 00:53:26,836 EXTRACT INFORMATION ABOUT SLEEP 1373 00:53:26,903 --> 00:53:28,505 STAGING FROM WIRELESS SIGNALS. 1374 00:53:28,572 --> 00:53:32,375 NEXT SLIDE PLEASE. 1375 00:53:32,442 --> 00:53:37,547 HERE YOU SEE HOW OUR DEVICE 1376 00:53:37,614 --> 00:53:38,181 TRANSMITS SIGNALS AND ANALYZES 1377 00:53:38,248 --> 00:53:43,353 THE REFLECTION USING AI. AND 1378 00:53:43,420 --> 00:53:47,490 THAT IS BECAUSE OF THE 1379 00:53:47,557 --> 00:53:48,091 HIPNOGROUND, USED TO ANALYZE 1380 00:53:48,158 --> 00:53:52,095 THEIR SLEEP. IT TELLS YOU FOR 1381 00:53:52,162 --> 00:53:53,096 EVERY 30 SECONDS OF SLEEP, 1382 00:53:53,163 --> 00:53:57,334 WHETHER THE PERSON IS IN LIGHT 1383 00:53:57,400 --> 00:53:59,603 SLEEP, DEEP SLEEP OR REM. 1384 00:53:59,669 --> 00:54:07,877 TODAY WE ARE ABLE, OR THE 1385 00:54:07,944 --> 00:54:10,180 TYPICAL WAY OF DOING A SLEEP 1386 00:54:10,246 --> 00:54:10,780 STUDY IS TO SEND SOMEONE TO A 1387 00:54:10,847 --> 00:54:11,915 SLEEP LAB, AND PUTTING THE 1388 00:54:11,982 --> 00:54:12,549 ELECTRODES THAT I SHOWED YOU ON 1389 00:54:12,616 --> 00:54:14,050 THE PREVIOUS SLIDE ON SOMEONE'S 1390 00:54:14,117 --> 00:54:17,487 HEAD AND BODY. BUT EVEN WHEN 1391 00:54:17,554 --> 00:54:18,154 WE DO SLEEP STUDIES IN THE 1392 00:54:18,221 --> 00:54:19,656 HOME, WITH TYPICALLY DO NOT GET 1393 00:54:19,723 --> 00:54:21,791 THE HIPNOGRAM. FOR HOMESTUDY 1394 00:54:21,858 --> 00:54:31,635 WE USE A BREATHING BELT TO 1395 00:54:31,701 --> 00:54:34,671 MEASURE APNEA BUT NOT GET THE 1396 00:54:34,738 --> 00:54:39,442 HIPNOGRAM. HERE WE CAN GET THE 1397 00:54:39,509 --> 00:54:40,043 HIPNOGRAM AT HOME EVERY NIGHT 1398 00:54:40,110 --> 00:54:41,111 AND COMPARED TO THE PSG, AND 1399 00:54:41,177 --> 00:54:42,579 THEN FROM THE LAB WE CAN SHOW 1400 00:54:42,646 --> 00:54:45,615 THE ACCURACY IS COMPARABLE TO 1401 00:54:45,682 --> 00:54:51,054 TWO SLEEP TECHNICIANS, AND THE 1402 00:54:51,121 --> 00:54:51,621 CONSISTENCY BETWEEN THEM AS 1403 00:54:51,688 --> 00:54:52,188 THEY LOOK AT THE DATA IN A 1404 00:54:52,255 --> 00:54:52,756 MANUALLY SCREEN FOR SLEEP 1405 00:54:52,822 --> 00:54:56,192 STAGES. NEXT SLIDE PLEASE. 1406 00:54:56,259 --> 00:55:00,030 OF COURSE NOT ONLY WE'RE ABLE TO 1407 00:55:00,096 --> 00:55:02,832 SEE SLEEP STAGES, WE CAN ALSO 1408 00:55:02,899 --> 00:55:11,741 GET RESPIRATORY SIGNAL, HERE YOU 1409 00:55:11,808 --> 00:55:14,010 SEE SOMEONE, INHALE, EXHALE, HE 1410 00:55:14,077 --> 00:55:24,621 EXHALES, DOES NOT INHALE, WE CAN 1411 00:55:25,889 --> 00:55:26,322 GET HYPNOGRAM, RESPIRATORY 1412 00:55:26,389 --> 00:55:29,359 SIGNAL, COMPARING TO THE GOLD 1413 00:55:29,426 --> 00:55:31,294 STANDARD, IN THE CASE OF 1414 00:55:31,361 --> 00:55:34,564 BREATHING, SIMILAR TO THE 1415 00:55:34,631 --> 00:55:38,301 BREATHING BELT YOU USE IN THE 1416 00:55:38,368 --> 00:55:39,803 FDA APPROVED BREATHING BELT IN 1417 00:55:39,869 --> 00:55:43,339 SLEEP STUDIES IN THE SLEEP LAB. 1418 00:55:43,406 --> 00:55:43,673 NEXT. 1419 00:55:43,740 --> 00:55:48,211 SO, I'M GOING TO SHOW YOU A FEW 1420 00:55:48,278 --> 00:55:51,214 WAYS THAT WE USE THIS SLEEP 1421 00:55:51,281 --> 00:55:51,815 DATA, NOCTURNAL BREATHING, AND 1422 00:55:51,881 --> 00:55:56,186 ONE OF THEM IS HOW WE USE IT TO 1423 00:55:56,252 --> 00:55:58,154 ANALYZE AND DETECT PARKINSON'S 1424 00:55:58,221 --> 00:55:58,421 DISEASE. 1425 00:55:58,488 --> 00:56:00,523 SO PARKINSON'S IS THE FASTEST 1426 00:56:00,590 --> 00:56:01,691 GROWING NEUROLOGICAL DISEASE IN 1427 00:56:01,758 --> 00:56:04,928 THE WORLD, SECOND MOST COMMON 1428 00:56:04,994 --> 00:56:05,962 NEUROLOGICAL DISEASE AFTER 1429 00:56:06,029 --> 00:56:06,463 ALZHEIMER'S. 1430 00:56:06,529 --> 00:56:09,966 ONE OF THE BIG PROBLEMS WITH 1431 00:56:10,033 --> 00:56:11,067 PARKINSON'S SIMILAR TO 1432 00:56:11,134 --> 00:56:13,703 ALZHEIMER'S, WE DETECT THE 1433 00:56:13,770 --> 00:56:15,405 DISEASE LATE, TYPICALLY LIKE TEN 1434 00:56:15,472 --> 00:56:17,040 YEARS AFTER ONSET OF THE 1435 00:56:17,107 --> 00:56:17,507 DISEASE. 1436 00:56:17,574 --> 00:56:21,211 AND THE REASON FOR THAT IS THAT 1437 00:56:21,277 --> 00:56:24,547 WHEN WE DETECT IT, WE'RE 1438 00:56:24,614 --> 00:56:25,148 DETECTING MOTOR SYMPTOMS BUT 1439 00:56:25,215 --> 00:56:27,717 THEY HAPPEN LATER IN DISEASE. 1440 00:56:27,784 --> 00:56:29,753 BY THE TIME THE MOTOR SYMPTOMS 1441 00:56:29,819 --> 00:56:33,857 HAPPEN AND WE DIAGNOSE 1442 00:56:33,923 --> 00:56:37,727 PARKINSON'S, BETWEEN 50% TO 80% 1443 00:56:37,794 --> 00:56:39,763 OF THE DOPAMINERGIC NEURONS IN 1444 00:56:39,829 --> 00:56:41,364 THE BRAIN, THE NEURONS RELATED 1445 00:56:41,431 --> 00:56:44,200 TO DOPAMINE, IMPORTANT FOR THE 1446 00:56:44,267 --> 00:56:47,837 CASE OF PARKINSON'S, IS ALREADY 1447 00:56:47,904 --> 00:56:48,104 IMPAIRED. 1448 00:56:48,171 --> 00:56:49,973 THAT THE VERY IMPORTANT IF WE 1449 00:56:50,039 --> 00:56:52,776 WANT TO MAKE ADVANCEMENT IN 1450 00:56:52,842 --> 00:56:54,177 PARKINSON'S, TO DETECT THE 1451 00:56:54,244 --> 00:56:55,578 DISEASE EARLY. 1452 00:56:55,645 --> 00:56:59,015 WHAT WE DID, WE TRIED TO USE 1453 00:56:59,082 --> 00:57:00,183 NOCTURNAL BREATHING, TO USE 1454 00:57:00,250 --> 00:57:01,384 SOMETHING OTHER THAN MOTOR 1455 00:57:01,451 --> 00:57:02,886 SYMPTOMS, SOMETHING THAT HAPPENS 1456 00:57:02,952 --> 00:57:05,421 EARLY IN THE DISEASE, WHICH IS 1457 00:57:05,488 --> 00:57:06,956 SO BREATHING CHANGES EARLY IN 1458 00:57:07,023 --> 00:57:08,958 THE DISEASE, SO THAT WE TRY TO 1459 00:57:09,025 --> 00:57:12,061 SEE WHETHER WE CAN USE BREATHING 1460 00:57:12,128 --> 00:57:15,865 AS A WAY TO DETECT PARKINSON'S. 1461 00:57:15,932 --> 00:57:16,199 NEXT. 1462 00:57:16,266 --> 00:57:17,801 SO, WE ASKED A VERY SIMPLE 1463 00:57:17,867 --> 00:57:19,536 QUESTION. 1464 00:57:19,602 --> 00:57:20,470 CAN A.I. DETECT PARKINSON'S 1465 00:57:20,537 --> 00:57:29,479 DISEASE FROM NOCTURNAL 1466 00:57:29,546 --> 00:57:29,746 BREATHING. 1467 00:57:29,813 --> 00:57:31,981 WE TAKE THE RESPIRATORY SIGNAL 1468 00:57:32,048 --> 00:57:36,953 DURING SLEEP, NOCTURNAL 1469 00:57:37,020 --> 00:57:39,522 BREATHING. 1470 00:57:39,589 --> 00:57:40,490 NEXT. 1471 00:57:40,557 --> 00:57:42,759 TO ANALYZE ONE SAMPLE, ONE 1472 00:57:42,826 --> 00:57:45,295 NIGHT, NOCTURNAL BREATHING. 1473 00:57:45,361 --> 00:57:45,528 NEXT. 1474 00:57:45,595 --> 00:57:47,197 AND NEURAL NETWORK TRIES TO 1475 00:57:47,263 --> 00:57:48,364 ANSWER TWO QUESTIONS. 1476 00:57:48,431 --> 00:57:50,667 DOES THIS PERSON FROM 1477 00:57:50,733 --> 00:57:52,335 PARKINSON'S, IF THEY DO WHAT IS 1478 00:57:52,402 --> 00:57:53,603 THE SEVERITY OF THESE DISEASE 1479 00:57:53,670 --> 00:57:58,675 ACCORDING TO THE GOLD STANDARD? 1480 00:57:58,741 --> 00:57:59,342 NEXT. 1481 00:57:59,409 --> 00:58:04,347 THIS IS A LARGE STUDY THAT 1482 00:58:04,414 --> 00:58:06,015 INVOLVES OVER 7,000 INDIVIDUALS, 1483 00:58:06,082 --> 00:58:07,984 700 WITH PARKINSON'S, AND WE DID 1484 00:58:08,051 --> 00:58:11,754 THIS IN COLLABORATION WITH MASS 1485 00:58:11,821 --> 00:58:13,289 GENERAL, MAYO CLINIC, UNIVERSITY 1486 00:58:13,356 --> 00:58:17,126 OF ROCHESTER MEDICAL SCHOOL, AND 1487 00:58:17,193 --> 00:58:20,597 THE RESULTS APPEARED IN "NATURE 1488 00:58:20,663 --> 00:58:20,864 MEDICINE." 1489 00:58:20,930 --> 00:58:21,064 NEXT. 1490 00:58:21,130 --> 00:58:22,932 SO, HERE THE RESULTS FROM THE 1491 00:58:22,999 --> 00:58:25,602 STUDY, YOU SEE ON THE X-AXIS THE 1492 00:58:25,668 --> 00:58:28,071 SENSITIVITY, ON THE Y-AXIS -- 1493 00:58:28,137 --> 00:58:29,806 SORRY, ON X-AXIS SPECIFICITY, ON 1494 00:58:29,873 --> 00:58:32,008 Y-AXIS SENSITIVITY. 1495 00:58:32,075 --> 00:58:38,147 THESE ARE STANDARD WAYS OF 1496 00:58:38,214 --> 00:58:39,916 ASSESSING MACHINE LEARNING AND 1497 00:58:39,983 --> 00:58:42,318 MEDICINE, THE IMPORTANT NUMBER 1498 00:58:42,385 --> 00:58:44,821 IS THIS AUC, WHICH YOU CAN 1499 00:58:44,888 --> 00:58:46,022 INTERPRET AS ACCURACY, 90% IN 1500 00:58:46,089 --> 00:58:46,723 THIS CASE. 1501 00:58:46,789 --> 00:58:48,691 SO WHAT THIS GRAPH IS TELLING US 1502 00:58:48,758 --> 00:58:51,928 IS THAT WE CAN DETECT WHETHER 1503 00:58:51,995 --> 00:58:54,898 SOMEBODY HAS PARKINSON'S JUST BY 1504 00:58:54,964 --> 00:58:55,932 ANALYZING THEIR BREATHING DURING 1505 00:58:55,999 --> 00:58:59,435 SLEEP AND EVEN WE CAN GET THE 1506 00:58:59,502 --> 00:59:00,703 BREATHING FROM A SIGNAL, DON'T 1507 00:59:00,770 --> 00:59:02,572 HAVE TO WEAR THEM WEAR A 1508 00:59:02,639 --> 00:59:02,939 BREATHING BELT. 1509 00:59:03,006 --> 00:59:04,173 THIS IS QUITE POWERFUL. 1510 00:59:04,240 --> 00:59:06,376 IT'S A FIRST TIME ANYONE HAS 1511 00:59:06,442 --> 00:59:13,316 SHOWN YOU CAN DETECT PARKINSON'S 1512 00:59:13,383 --> 00:59:14,217 FROM SOMEONE'S NOCTURNAL 1513 00:59:14,284 --> 00:59:15,885 BREATHING. 1514 00:59:15,952 --> 00:59:16,152 NEXT. 1515 00:59:16,219 --> 00:59:19,088 WE CAN DETECT PARKINSON'S FROM 1516 00:59:19,155 --> 00:59:20,056 NOCTURNAL BREATHING BUT ANOTHER 1517 00:59:20,123 --> 00:59:21,491 INTERESTING QUESTION CAN WE 1518 00:59:21,557 --> 00:59:24,894 DETECT IT EARLIER BEFORE 1519 00:59:24,961 --> 00:59:25,662 DIAGNOSIS. 1520 00:59:25,728 --> 00:59:28,197 SO, OF COURSE, THIS IS MUCH 1521 00:59:28,264 --> 00:59:30,400 HARDER STUDY BECAUSE WE NEED TO 1522 00:59:30,466 --> 00:59:32,235 MONITOR PEOPLE BEFORE THEY WERE 1523 00:59:32,302 --> 00:59:34,103 DIAGNOSED FOR PARKINSON'S, LIKE 1524 00:59:34,170 --> 00:59:35,772 A CHECKEN AND EGG PROBLEM, YOU 1525 00:59:35,838 --> 00:59:37,040 DON'T KNOW YET WHO IS GOING TO 1526 00:59:37,106 --> 00:59:38,441 BE DIAGNOSED LATER. 1527 00:59:38,508 --> 00:59:41,311 WE FOUND THE STUDY, A SLEEP 1528 00:59:41,377 --> 00:59:42,278 STUDY, WHICH HAS TWO VISITS TO 1529 00:59:42,345 --> 00:59:44,180 THE SLEEP LAB AND IT HAS THE 1530 00:59:44,247 --> 00:59:46,683 BREATHING FROM THOSE TWO VISITS. 1531 00:59:46,749 --> 00:59:49,786 PEOPLE GO TO TWO VISITS AND 1532 00:59:49,852 --> 00:59:52,522 THEIR BREATHING SIGNAL IS 1533 00:59:52,588 --> 00:59:53,022 COLLECTED. 1534 00:59:53,089 --> 00:59:55,458 THE FIRST VISIT IS -- SECOND IS 1535 00:59:55,525 --> 00:59:57,860 SEPARATED BY SIX YEARS FROM THE 1536 00:59:57,927 --> 00:59:59,062 FIRST VISIT. 1537 00:59:59,128 --> 01:00:01,097 SO, WE ANALYZED WHETHER WE CAN 1538 01:00:01,164 --> 01:00:03,399 USE THE FIRST VISIT AND WE SEE 1539 01:00:03,466 --> 01:00:07,804 THAT PEOPLE WHO GOT SIX YEARS 1540 01:00:07,870 --> 01:00:09,205 LATER, THEY DECLARED THAT THEY 1541 01:00:09,272 --> 01:00:11,607 HAVE PARKINSON DIAGNOSIS. 1542 01:00:11,674 --> 01:00:12,642 NEXT. 1543 01:00:12,709 --> 01:00:15,645 SO, HERE YOU CAN SEE LIKE THIS 1544 01:00:15,712 --> 01:00:19,682 STUDY HAS ABOUT 500 INDIVIDUALS. 1545 01:00:19,749 --> 01:00:23,386 THE GUYS DURING THE FIRST VISIT 1546 01:00:23,453 --> 01:00:24,854 HAVE PARKINSON'S, AND EVEN SIX 1547 01:00:24,921 --> 01:00:26,723 YEARS LATER, THEY STILL DON'T 1548 01:00:26,789 --> 01:00:27,557 HAVE PARKINSON'S. 1549 01:00:27,623 --> 01:00:31,260 NOW, THE DATA IN BLUE ARE FOR 1550 01:00:31,327 --> 01:00:33,629 PEOPLE IN THE FIRST VISIT DIDN'T 1551 01:00:33,696 --> 01:00:35,064 HAVE PARKINSON'S, BUT SIX YEARS 1552 01:00:35,131 --> 01:00:37,200 LATER THEY CAME, AS I SAID, OH, 1553 01:00:37,266 --> 01:00:38,501 I WAS DIAGNOSED WITH 1554 01:00:38,568 --> 01:00:39,202 PARKINSON'S. 1555 01:00:39,268 --> 01:00:41,270 BUT WE ARE ANALYZING THEIR 1556 01:00:41,337 --> 01:00:41,871 BREATHING, NOCTURNAL BREATHING 1557 01:00:41,938 --> 01:00:43,706 DURING SLEEP FROM THE FIRST 1558 01:00:43,773 --> 01:00:44,340 VISIT. 1559 01:00:44,407 --> 01:00:46,409 AS YOU CAN CLEARLY SEE, THE 1560 01:00:46,476 --> 01:00:49,145 ALGORITHM ALREADY IS SAYING 1561 01:00:49,212 --> 01:00:51,547 THESE GUYS ARE DIFFERENT, 75% OF 1562 01:00:51,614 --> 01:00:54,517 THEM, A.I. ALGORITHM, DIAGNOSED 1563 01:00:54,584 --> 01:00:58,354 AS HAVING PARKINSON'S ALREADY. 1564 01:00:58,421 --> 01:00:59,922 SIX YEARS EARLIER THAN WHEN THEY 1565 01:00:59,989 --> 01:01:02,859 TOLD US THEY HAD PARKINSON'S. 1566 01:01:02,925 --> 01:01:03,326 NEXT. 1567 01:01:03,393 --> 01:01:06,029 SO, I TOLD YOU ABOUT HOW WE 1568 01:01:06,095 --> 01:01:08,131 CAN -- A.I. CAN EXTRACT 1569 01:01:08,197 --> 01:01:09,599 INFORMATION ABOUT PARKINSON'S, A 1570 01:01:09,665 --> 01:01:10,433 NEURAL DEGENERATIVE DISEASE. 1571 01:01:10,500 --> 01:01:14,670 I WANT TO TELL YOU HOW IT CAN 1572 01:01:14,737 --> 01:01:17,273 EXACT INFORMATION FROM SLEEP AND 1573 01:01:17,340 --> 01:01:19,842 BREATHING DURING SLEEP ABOUT 1574 01:01:19,909 --> 01:01:20,977 DEPRESSION AND ANTIDEPRESSANTS. 1575 01:01:21,044 --> 01:01:24,213 WE ASKED PEOPLE LIKE WHEN WE 1576 01:01:24,280 --> 01:01:25,214 GIVE ANTI-DEPRESSANT, IS IT 1577 01:01:25,281 --> 01:01:27,016 WORKING FOR YOU, DO YOU FEEL 1578 01:01:27,083 --> 01:01:27,250 BETTER. 1579 01:01:27,316 --> 01:01:29,052 WE DON'T HAVE ANY CONCRETE 1580 01:01:29,118 --> 01:01:31,821 MEASUREMENT AND IT IS WIDELY 1581 01:01:31,888 --> 01:01:34,257 KNOWN THERE IS A HUGE PLACEBO 1582 01:01:34,323 --> 01:01:35,491 RESPONSE, SO ONE OF THE THINGS 1583 01:01:35,558 --> 01:01:38,694 THAT WE TRIED TO UNDERSTAND IS 1584 01:01:38,761 --> 01:01:43,433 CAN MACHINE LEARNING BE ABLE TO 1585 01:01:43,499 --> 01:01:46,936 USE SLEEP AND BREATHING DURING 1586 01:01:47,003 --> 01:01:49,772 SLEEP TO UNDERSTAND ARE THEY 1587 01:01:49,839 --> 01:01:50,039 DEPRESSED. 1588 01:01:50,106 --> 01:01:52,008 LIKE IN PARKINSON'S, WE TAKE THE 1589 01:01:52,075 --> 01:01:53,476 WIRELESS SIGNAL, TRANSFORM IT 1590 01:01:53,543 --> 01:01:54,911 INTO THE RESPIRATORY SIGNAL, AND 1591 01:01:54,977 --> 01:02:03,419 THEN WE TRAIN A NEURAL NETWORK 1592 01:02:03,486 --> 01:02:06,789 THAT TAKES NOCTURNAL BREATHING. 1593 01:02:06,856 --> 01:02:08,724 SO DOES THIS PERSON TAKE 1594 01:02:08,791 --> 01:02:09,492 ANTI-DEPRESSANT OR NOT? 1595 01:02:09,559 --> 01:02:13,229 THE OBJECTIVE IS NOT KNOW THAT, 1596 01:02:13,296 --> 01:02:14,697 THAT YOU CAN ASK THE PERSON. 1597 01:02:14,764 --> 01:02:17,934 BUT IF THE NEURAL NETWORK FROM 1598 01:02:18,000 --> 01:02:19,469 NOCTURNAL BREATHING DURING SLEEP 1599 01:02:19,535 --> 01:02:21,604 BE ABLE TO DETECT IMPACT OF 1600 01:02:21,671 --> 01:02:23,206 ANTI-DEPRESSANT THAT THE PERSON 1601 01:02:23,272 --> 01:02:24,407 IS TAKING ANTI-DEPRESSANT IT 1602 01:02:24,474 --> 01:02:26,609 MEANS IT IS DISCOVERING A CHANGE 1603 01:02:26,676 --> 01:02:28,644 IN THE PHYSIOLOGY OF THE PERSON 1604 01:02:28,711 --> 01:02:32,281 ASSOCIATED WITH SLEEP AND IMPACT 1605 01:02:32,348 --> 01:02:34,383 OF ANTI-DEPRESSANT ON SLEEP. 1606 01:02:34,450 --> 01:02:39,455 THIS STUDY HAS 2,000 1607 01:02:39,522 --> 01:02:40,590 INDIVIDUALS, 200 TAKING 1608 01:02:40,656 --> 01:02:40,957 ANTI-DEPRESSANT. 1609 01:02:41,023 --> 01:02:42,792 YOU SEE THE RESULT. 1610 01:02:42,859 --> 01:02:44,293 AGAIN, THESE ARE SIMILAR TO THE 1611 01:02:44,360 --> 01:02:45,695 CURVE YOU SAW EARLIER, 1612 01:02:45,761 --> 01:02:46,963 SENSITIVITY AND SPECIFICITY ON 1613 01:02:47,029 --> 01:02:50,633 THE TWO AXES, BUT THE LONGER YOU 1614 01:02:50,700 --> 01:02:52,135 SEE, YOU CAN INTERPRET THIS AS 1615 01:02:52,201 --> 01:02:54,504 ACCURACY AS WE SAID EARLIER, SO 1616 01:02:54,570 --> 01:02:57,006 IT TELLS YOU THAT FROM ONE NIGHT 1617 01:02:57,073 --> 01:02:59,075 OF NOCTURNAL BREATHING DURING 1618 01:02:59,142 --> 01:03:01,377 SLEEP, THE NEURAL NETWORK CAN 1619 01:03:01,444 --> 01:03:04,747 TELL WHETHER THIS PERSON HAS -- 1620 01:03:04,814 --> 01:03:10,786 IS TAKING ANTIDEPRESSANTS WITH 1621 01:03:10,853 --> 01:03:11,888 ACCURACY 86%. 1622 01:03:11,954 --> 01:03:12,221 NEXT. 1623 01:03:12,288 --> 01:03:16,626 HERE I SHOW YOU AN EXAMPLE FROM 1624 01:03:16,692 --> 01:03:20,830 ONE PERSON WHO WAS MOVED, ON 1625 01:03:20,897 --> 01:03:21,464 ANTI-DEPRESSANT, PUT ON PROZAC 1626 01:03:21,531 --> 01:03:24,467 IN THE MIDDLE OF THE STUDY. 1627 01:03:24,534 --> 01:03:26,402 ON THE X-AXIS TIME, ON THE 1628 01:03:26,469 --> 01:03:30,273 Y-AXIS YOU SEE THE OUTPUT OF THE 1629 01:03:30,339 --> 01:03:31,174 MACHINE LEARNING. 1630 01:03:31,240 --> 01:03:33,776 AND THE ORANGE LINE IS JUST THIS 1631 01:03:33,843 --> 01:03:35,545 OUTPUT OF THE MACHINE LEARNING. 1632 01:03:35,611 --> 01:03:36,979 YOU CAN SEE THAT AT THE 1633 01:03:37,046 --> 01:03:38,214 BEGINNING LIKE THIS PERSON IN 1634 01:03:38,281 --> 01:03:41,083 THE MIDDLE OF THIS STUDY WAS PUT 1635 01:03:41,150 --> 01:03:43,019 LIKE AT THE TIME WHEN YOU SEE 1636 01:03:43,085 --> 01:03:44,820 THE ORANGE LINE GOING HIGH THE 1637 01:03:44,887 --> 01:03:48,124 PERSON WAS PUT ON 1638 01:03:48,191 --> 01:03:49,125 ANTI-DEPRESSANT, STARTED PROZAC. 1639 01:03:49,192 --> 01:03:51,627 BEFORE THAT POINT THE ORANGE 1640 01:03:51,694 --> 01:03:53,596 LINE IS LOW, MACHINE LEARNING OR 1641 01:03:53,663 --> 01:03:57,800 A.I. IS SAYING, NO, THIS PERSON 1642 01:03:57,867 --> 01:04:00,703 IS NOT TAKING ANTI-DEPRESSANT. 1643 01:04:00,770 --> 01:04:02,471 THEN YOU CAN SEE HOW THE ORANGE 1644 01:04:02,538 --> 01:04:05,608 LINE JUMPS, CROSSING THE 1645 01:04:05,675 --> 01:04:09,445 THRESHOLD OF .5, 50%, WHICH SAYS 1646 01:04:09,512 --> 01:04:10,146 THIS PERSON STARTED TAKING 1647 01:04:10,213 --> 01:04:12,181 ANTI-DEPRESSANT AND YOU CAN SEE 1648 01:04:12,248 --> 01:04:13,616 IT RAMPS UP SLOWLY, VERY 1649 01:04:13,683 --> 01:04:15,585 INTERESTING BECAUSE WE KNOW THAT 1650 01:04:15,651 --> 01:04:26,195 THE IMPACT OF ANTI-DEPRESSANT IS 1651 01:04:27,063 --> 01:04:28,431 NOT IMMEDIATE, BUILDS EVERY OVER 1652 01:04:28,497 --> 01:04:28,631 TIME. 1653 01:04:28,698 --> 01:04:31,167 A I. A.I. IS DETECTING CHANGES 1654 01:04:31,234 --> 01:04:35,204 IN SLEEP AND NOCTURNAL BREATHING 1655 01:04:35,271 --> 01:04:37,039 IN THIS INDIVIDUAL. 1656 01:04:37,106 --> 01:04:37,406 NEXT. 1657 01:04:37,473 --> 01:04:40,776 I WANT TO END WITH TALKING ABOUT 1658 01:04:40,843 --> 01:04:42,078 GENERATIVE A.I. 1659 01:04:42,144 --> 01:04:43,613 AND FOR BRAIN DATA. 1660 01:04:43,679 --> 01:04:45,781 AGAIN, IN THE CONTEXT OF SLEEP. 1661 01:04:45,848 --> 01:04:51,354 SO OF COURSE WE ALL KNOW ABOUT 1662 01:04:51,420 --> 01:04:54,657 CHATGPT, YOU TRIED YOU THE, AT 1663 01:04:54,724 --> 01:04:57,860 LEAST THE VAST MAJORITY TRIED 1664 01:04:57,927 --> 01:04:58,361 ChatGPT. 1665 01:04:58,427 --> 01:04:59,061 NEXT. 1666 01:04:59,128 --> 01:05:03,566 SO, IN TODAY GENERATIVE MODEL 1667 01:05:03,633 --> 01:05:06,502 FROM TEXT LIKE IN ChatGPT OR 1668 01:05:06,569 --> 01:05:07,603 WE GENERATE IMAGES FROM TEXT. 1669 01:05:07,670 --> 01:05:11,207 HERE YOU SEE AN EXAMPLE WHERE 1670 01:05:11,274 --> 01:05:14,744 YOU PROMPT THE GENERATIVE MODEL 1671 01:05:14,810 --> 01:05:16,879 WITH TEXT, GENERATE FOR ME A 1672 01:05:16,946 --> 01:05:23,719 PICTURE, PHOTO OF A CORGI 1673 01:05:23,786 --> 01:05:24,520 PLAYING A TRUMPET, IT GENERATES 1674 01:05:24,587 --> 01:05:27,490 WHAT YOU SAY AT THE PROMPT. 1675 01:05:27,556 --> 01:05:31,861 SO CAN WE USE GENERATIVE MODELS 1676 01:05:31,927 --> 01:05:33,863 SIMILARLY TO GENERATE A 1677 01:05:33,929 --> 01:05:35,298 MEASUREMENT AS THE PERSON'S 1678 01:05:35,364 --> 01:05:38,234 BRAIN DATA, THE EEG. 1679 01:05:38,301 --> 01:05:38,434 NEXT. 1680 01:05:38,501 --> 01:05:43,072 SO HERE YOU SEE WHAT WE ARE 1681 01:05:43,139 --> 01:05:45,041 LOOKING INTO, WE'RE LOOKING TO 1682 01:05:45,107 --> 01:05:47,810 TAKE RADIO SIGNAL, FROM RADIO 1683 01:05:47,877 --> 01:05:49,745 SIGNAL WE WANT TO BE ABLE -- OF 1684 01:05:49,812 --> 01:05:52,148 COURSE WE KNOW FROM RADIO 1685 01:05:52,214 --> 01:05:53,416 SIGNALS WE CAN EXTRACT 1686 01:05:53,482 --> 01:05:54,617 BREATHING, NOCTURNAL BREATHING 1687 01:05:54,684 --> 01:05:56,285 DURING SLEEP, AS I SAID, WHICH 1688 01:05:56,352 --> 01:05:57,186 IS VERY POWERFUL. 1689 01:05:57,253 --> 01:05:59,355 AND FROM THAT, WE WANT TO BE 1690 01:05:59,422 --> 01:06:06,562 ABLE TO GENERATE SOMEONE'S EEG. 1691 01:06:06,629 --> 01:06:06,762 NEXT. 1692 01:06:06,829 --> 01:06:10,199 SO INITIAL RESULTS THAT SHOWS 1693 01:06:10,266 --> 01:06:11,734 ACTUALLY THIS CAN WORK. 1694 01:06:11,801 --> 01:06:14,170 WE CAN GENERATE THE EEG DURING 1695 01:06:14,236 --> 01:06:17,106 SLEEP IN AN INDIVIDUAL JUST BY 1696 01:06:17,173 --> 01:06:18,641 LOOKING AT RESPIRATORY SIGNAL 1697 01:06:18,708 --> 01:06:19,942 AND THAT RESPIRATORY SIGNAL WE 1698 01:06:20,009 --> 01:06:22,411 CAN EVEN GET FROM WIRELESS 1699 01:06:22,478 --> 01:06:26,682 SIGNALS WITHOUT TOUCHING THEIR 1700 01:06:26,749 --> 01:06:26,882 BODY. 1701 01:06:26,949 --> 01:06:27,983 NEXT. 1702 01:06:28,050 --> 01:06:30,553 THIS IS THE EEG, GROUND TRUTH 1703 01:06:30,619 --> 01:06:32,822 EEG DURING SLEEP, ONE NIGHT OF 1704 01:06:32,888 --> 01:06:36,859 SLEEP, FOR A PATIENT OF 1705 01:06:36,926 --> 01:06:38,027 ALZHEIMER'S, 83 OLD. 1706 01:06:38,094 --> 01:06:40,763 AND YOU CAN SEE THIS IS ONE 1707 01:06:40,830 --> 01:06:42,932 NIGHT, LIKE THE PERSON ENTERED 1708 01:06:42,998 --> 01:06:43,833 LIKE DIFFERENT SLEEP STAGES AND 1709 01:06:43,899 --> 01:06:49,338 THIS IS WHAT'S CALLED EEG 1710 01:06:49,405 --> 01:06:50,339 SPECTRO GRAM. 1711 01:06:50,406 --> 01:06:53,476 NOW YOU SEE THE GENERATED EEG. 1712 01:06:53,542 --> 01:06:55,711 AGAIN, THIS IS GENERATED WITH 1713 01:06:55,778 --> 01:07:01,550 THE MODEL BY TAKING WIRELESS 1714 01:07:01,617 --> 01:07:02,318 SIGNAL, TRANSFORMING BREATHING 1715 01:07:02,385 --> 01:07:03,786 DURING SLEEP, WE TAKE THE 1716 01:07:03,853 --> 01:07:06,889 BREATHING DURING SLEEP AND WE 1717 01:07:06,956 --> 01:07:12,061 GENERATE THE SIGNAL, THE EEG 1718 01:07:12,128 --> 01:07:14,630 SPECTROGRAM, YOU CAN SEE IT'S 1719 01:07:14,697 --> 01:07:15,631 PRETTY ACCURATE. 1720 01:07:15,698 --> 01:07:17,133 REALLY, SLEEP IS VERY POWERFUL. 1721 01:07:17,199 --> 01:07:20,903 A.I. CAN ALLOW US TO UNDERSTAND 1722 01:07:20,970 --> 01:07:22,338 SLEEP MUCH, MUCH MORE 1723 01:07:22,405 --> 01:07:24,740 INTERESTING AND POWERFUL WAY TO 1724 01:07:24,807 --> 01:07:28,010 UNDERSTAND OUR DISEASES AND OUR 1725 01:07:28,077 --> 01:07:29,712 BRAIN SIGNAL. 1726 01:07:29,779 --> 01:07:29,912 NEXT. 1727 01:07:29,979 --> 01:07:35,050 SO, THIS GETS ME TO THE END OF 1728 01:07:35,117 --> 01:07:36,986 MY PRESENTATION WHERE I SHOWED 1729 01:07:37,052 --> 01:07:38,954 YOU THAT YOU NEED WIRELESS 1730 01:07:39,021 --> 01:07:41,023 SIGNAL IN THE ENVIRONMENT WE CAN 1731 01:07:41,090 --> 01:07:45,694 DO EVERY NIGHT SLEEP STUDY THAT 1732 01:07:45,761 --> 01:07:47,797 GENERATES HYPNOGRAM, GENERATES 1733 01:07:47,863 --> 01:07:49,365 NOCTURNAL BREATHING SIGNAL ON 1734 01:07:49,432 --> 01:07:51,767 THE PERSON'S OWN BEDROOM AND 1735 01:07:51,834 --> 01:07:54,370 USING THAT INFORMATION CAN START 1736 01:07:54,437 --> 01:07:56,839 UNDERSTANDING AND STUDYING 1737 01:07:56,906 --> 01:07:59,308 DIFFERENT NEUROLOGICAL DISEASES 1738 01:07:59,375 --> 01:08:01,877 AND THE IMPACT OF EVEN 1739 01:08:01,944 --> 01:08:03,946 MEDICATION AND THERAPY ON THESE 1740 01:08:04,013 --> 01:08:07,950 NEUROLOGICAL DISEASES. 1741 01:08:08,017 --> 01:08:10,686 THANK YOU VERY MUCH. 1742 01:08:10,753 --> 01:08:14,623 >> THANK YOU VERY MUCH, DR. 1743 01:08:14,690 --> 01:08:15,257 KATABI, THIS IS FASCINATING 1744 01:08:15,324 --> 01:08:15,825 DATA. 1745 01:08:15,891 --> 01:08:17,593 THANK YOU TO ALL THE SPEAKERS. 1746 01:08:17,660 --> 01:08:19,428 WE HAVE ABOUT THREE MINUTES 1747 01:08:19,495 --> 01:08:22,264 BEFORE THE NEXT SESSION. 1748 01:08:22,331 --> 01:08:27,303 I KNOW THAT WE'VE GOT SEVERAL 1749 01:08:27,369 --> 01:08:29,138 QUESTIONS DURING THIS SESSION 1750 01:08:29,205 --> 01:08:34,276 NUMBER THREE FROM THE VIDEOCAST 1751 01:08:34,343 --> 01:08:36,412 AUDIENCE. 1752 01:08:36,479 --> 01:08:38,214 I WILL ASK FOR SOME QUESTIONS. 1753 01:08:38,280 --> 01:08:39,915 THANK YOU ALL VERY MUCH FOR 1754 01:08:39,982 --> 01:08:41,484 WATCHING THIS SESSION. 1755 01:08:41,550 --> 01:08:44,320 THANK YOU. 1756 01:08:44,386 --> 01:08:45,120 >> THANKS. 1757 01:08:45,187 --> 01:08:46,355 FASCINATING PRESENTATION, 1758 01:08:46,422 --> 01:08:47,957 PARTICULARLY DR. KATABI RAISING 1759 01:08:48,023 --> 01:08:49,792 ONE OF THE POINTS I WANTED TO 1760 01:08:49,859 --> 01:08:50,960 MAKE CLEAR DURING THIS WORKSHOP, 1761 01:08:51,026 --> 01:08:56,799 THERE'S A LOT OF SIGNALS THAT 1762 01:08:56,866 --> 01:08:58,934 ARE DETECTABLE DURING SLEEP THAT 1763 01:08:59,001 --> 01:09:00,803 REFLECT DISEASE, REFLECT HEALTH 1764 01:09:00,870 --> 01:09:02,404 STATES OF THE PERSON SLEEPING. 1765 01:09:02,471 --> 01:09:06,108 WE NEED SOMETHING LIKE A.I. TO 1766 01:09:06,175 --> 01:09:10,379 BE ABLE TO DETECT AND ANALYZE 1767 01:09:10,446 --> 01:09:11,180 SIGNALS ACCURATELY. 1768 01:09:11,247 --> 01:09:13,516 I HAVE A COUPLE QUESTIONS. 1769 01:09:13,582 --> 01:09:17,953 YOU MAY HAVE MENTIONED THIS, 1770 01:09:18,020 --> 01:09:21,323 STUDIES LOOKING WHETHER CPAP 1771 01:09:21,390 --> 01:09:24,860 EFFICACY VARIES IN SUBTYPES, IS 1772 01:09:24,927 --> 01:09:26,629 IT MORE EFFECTIVE, HAVE PEOPLE 1773 01:09:26,695 --> 01:09:27,129 LOOKED AT THAT? 1774 01:09:27,196 --> 01:09:30,132 >> YEAH, THERE'S LIKE A SINGLE 1775 01:09:30,199 --> 01:09:33,002 STUDY BUT NOT UNDER LIKE A TRIAL 1776 01:09:33,068 --> 01:09:35,738 FRAMEWORK SO IT WAS MORE LIKE AN 1777 01:09:35,804 --> 01:09:38,874 OBSERVATIONAL SETTING. 1778 01:09:38,941 --> 01:09:39,942 THE ORIGINAL COHORT FROM ICELAND 1779 01:09:40,009 --> 01:09:45,681 WAS FOLLOWED FOR TWO YEARS, SOME 1780 01:09:45,748 --> 01:09:47,616 WEARING CPAPs, SOME NOT, THEY 1781 01:09:47,683 --> 01:09:49,084 DID SEE EFFECTS ON LIKE SYMPTOM 1782 01:09:49,151 --> 01:09:53,122 PRESENTATION TO BE STRONGER 1783 01:09:53,188 --> 01:09:55,057 AMONG THOSE THAT HAVE MORE 1784 01:09:55,124 --> 01:09:55,424 SYMPTOMS. 1785 01:09:55,491 --> 01:09:59,328 NOT LIKE ANY OTHER MARKER, SUCH 1786 01:09:59,395 --> 01:10:00,529 AS INTERMEDIATE CARDIOVASCULAR 1787 01:10:00,596 --> 01:10:02,064 ENDPOINT IN THAT STUDY, SO 1788 01:10:02,131 --> 01:10:05,167 THAT'S LIKE AN AREA OF FUTURE 1789 01:10:05,234 --> 01:10:05,701 INVESTIGATION. 1790 01:10:05,768 --> 01:10:06,101 >> SURE. 1791 01:10:06,168 --> 01:10:07,970 WHILE I HAVE YOUR ATTENTION, 1792 01:10:08,037 --> 01:10:10,306 THIS IS MORE OF A GENERAL 1793 01:10:10,372 --> 01:10:11,140 COMMENT FROM ROBERT THOMAS, YOU 1794 01:10:11,206 --> 01:10:17,012 MAY KNOW AT HARVARD, HAS A 1795 01:10:17,079 --> 01:10:21,050 GENERAL COMMENT ABOUT HYPOXIC 1796 01:10:21,116 --> 01:10:21,584 BURDEN. 1797 01:10:21,650 --> 01:10:24,587 IN HIS OPINION CARES MORE ABOUT 1798 01:10:24,653 --> 01:10:27,823 SLEEP QUALITY AND SLEEPINESS AND 1799 01:10:27,890 --> 01:10:29,825 FATIGUE, NOT SEEKING THERAPY FOR 1800 01:10:29,892 --> 01:10:31,860 PREVENTION, NO NEED NOR HYPOXIA, 1801 01:10:31,927 --> 01:10:35,798 FOR THEM TO FEEL MISERABLE IN 1802 01:10:35,864 --> 01:10:39,969 ONE TREATMENT. 1803 01:10:40,035 --> 01:10:41,971 IN EPIDEMIOLOGICAL STUDIES USING 1804 01:10:42,037 --> 01:10:43,405 SCORING, DIMENSIONS ARE NOT 1805 01:10:43,472 --> 01:10:44,073 PROPERLY CAPTURED. 1806 01:10:44,139 --> 01:10:46,875 AT THE INDIVIDUAL LEVEL WE CAN 1807 01:10:46,942 --> 01:10:49,345 USE THE BURDEN EHI AS A 1808 01:10:49,411 --> 01:10:51,347 MOTIVATIONAL FACTOR, LOW BURDEN 1809 01:10:51,413 --> 01:10:53,582 IN ITSELF SHOULD NOT BE 1810 01:10:53,649 --> 01:10:56,318 CONSIDERED MILD APNEA, BASED ON 1811 01:10:56,385 --> 01:10:58,487 AHI, BECAUSE AS WE'RE SAYING, WE 1812 01:10:58,554 --> 01:10:59,388 REALLY NEED TO LISTEN TO THE 1813 01:10:59,455 --> 01:11:07,763 PATIENTS AND WHAT THEY ARE 1814 01:11:07,830 --> 01:11:09,698 EXPERIENCING. 1815 01:11:09,765 --> 01:11:10,065 >> ABSOLUTELY. 1816 01:11:10,132 --> 01:11:12,868 I THINK THAT'S WHY ADDING 1817 01:11:12,935 --> 01:11:14,637 DIMENSION OF PATIENT-REPORTED 1818 01:11:14,703 --> 01:11:15,971 OUTCOMES, MORE IMPORTANTLY 1819 01:11:16,038 --> 01:11:20,909 BRINGING BACK MY LAST TOPIC, MY 1820 01:11:20,976 --> 01:11:22,077 TAKEAWAY MESSAGES, ABOUT 1821 01:11:22,144 --> 01:11:22,511 VIABILITY. 1822 01:11:22,578 --> 01:11:25,881 WE DON'T REALLY KNOW A LOT ABOUT 1823 01:11:25,948 --> 01:11:27,983 WHAT HAPPENS, IF SOMEONE HAS 1824 01:11:28,050 --> 01:11:32,755 CHANGES IN SEVERITY OF DISEASE 1825 01:11:32,821 --> 01:11:39,695 HOWEVER WE'RE DEFINING, AHI, 1826 01:11:39,762 --> 01:11:41,163 HYPOXIC BURDEN, NOW THERE ARE 1827 01:11:41,230 --> 01:11:42,965 STUDIES, PARTICULARLY FROM THE 1828 01:11:43,032 --> 01:11:46,602 GROUP IN AUSTRALIA USING OTHER 1829 01:11:46,669 --> 01:11:49,004 METRICS WITHIN LIKE SENSORS 1830 01:11:49,071 --> 01:11:49,538 DEMONSTRATING CORRELATIONS 1831 01:11:49,605 --> 01:11:50,572 BETWEEN DIFFERENCES LIKE CHANGES 1832 01:11:50,639 --> 01:11:53,208 IN SLEEP, DURATION AND CHANGES 1833 01:11:53,275 --> 01:11:55,644 IN AHI, WITH TRACKING WITH 1834 01:11:55,711 --> 01:11:57,479 CHANGES IN BLOOD PRESSURE AND I 1835 01:11:57,546 --> 01:12:00,082 THINK MY HYPOTHESIS IS THAT 1836 01:12:00,149 --> 01:12:02,651 WE'RE MISSING THIS COMPONENT OF 1837 01:12:02,718 --> 01:12:03,485 HETEROGENEITY THAT'S RIGHT THERE 1838 01:12:03,552 --> 01:12:06,355 THAT WE JUST DON'T HAVE LIKE THE 1839 01:12:06,422 --> 01:12:09,425 FACTOLOGY YET TO MEASURE AT 1840 01:12:09,491 --> 01:12:12,027 LARGE SCALE BUT GIVING 1841 01:12:12,094 --> 01:12:13,829 RESULTING, MAYBE WE CAN PREDICT 1842 01:12:13,896 --> 01:12:15,330 SEVERITY METRICS FROM THOSE 1843 01:12:15,397 --> 01:12:17,366 WIRELESS SENSORS WOULD BE VERY 1844 01:12:17,433 --> 01:12:19,168 INTERESTING TO START DOING THOSE 1845 01:12:19,234 --> 01:12:21,704 MEASUREMENTS FROM A LONG TERM, 1846 01:12:21,770 --> 01:12:22,037 YEAH. 1847 01:12:22,104 --> 01:12:23,305 >> THE INFORMATION IS THERE. 1848 01:12:23,372 --> 01:12:25,107 WE JUST HAVE TO DETECT AND 1849 01:12:25,174 --> 01:12:27,910 ANALYZE IT. 1850 01:12:27,976 --> 01:12:30,746 A COUPLE THINGS FOR DR. LEE, ONE 1851 01:12:30,813 --> 01:12:33,015 THING HAS SLEEP EXTENSION 1852 01:12:33,082 --> 01:12:34,483 PROTOCOLS BEEN TRIED FOR CHRONIC 1853 01:12:34,550 --> 01:12:40,723 PAIN, THAT YOU KNOW OF? 1854 01:12:40,789 --> 01:12:48,564 SOOMI, YOU'RE ON. 1855 01:12:48,630 --> 01:12:50,466 YOU'RE MUTED. 1856 01:12:50,532 --> 01:12:53,769 >> MOST INTERVENTION STUDIES, AS 1857 01:12:53,836 --> 01:13:02,411 FAR AS I KNOW, USED CBT-I OR CBT 1858 01:13:02,478 --> 01:13:04,046 PROTOCOL, SLEEP EXTENSION, WHEN 1859 01:13:04,113 --> 01:13:07,049 WE THINK ABOUT CHRONIC PAIN AS 1860 01:13:07,116 --> 01:13:10,719 THE OUTCOME, THE POPULATION OF 1861 01:13:10,786 --> 01:13:15,457 INTEREST IS OLDER ADULTS, AND 1862 01:13:15,524 --> 01:13:16,825 OLDER ADULTS, SHORTER DURATION, 1863 01:13:16,892 --> 01:13:19,695 THEY HAVE A DIFFERENT SLEEP 1864 01:13:19,762 --> 01:13:20,529 ISSUE. 1865 01:13:20,596 --> 01:13:23,899 SO I THINK, YEAH, IN TERMS OF 1866 01:13:23,966 --> 01:13:25,868 EFFECT OF SLEEP EXTENSION, OF 1867 01:13:25,934 --> 01:13:27,870 PAIN, WE DON'T KNOW MUCH ABOUT 1868 01:13:27,936 --> 01:13:33,408 IT AND THERE'S LACK OF EVIDENCE, 1869 01:13:33,475 --> 01:13:33,809 I THINK. 1870 01:13:33,876 --> 01:13:37,379 >> I 1871 01:13:37,446 --> 01:13:42,818 >> A COMMENT FROM ROBERT THOMAS, 1872 01:13:42,885 --> 01:13:45,387 YOU SAY FROM DAN BICE, A 1873 01:13:45,454 --> 01:13:47,556 SUBJECTIVE MEASURE, WHY NOT 1874 01:13:47,623 --> 01:13:49,925 INTEGRATE CHANGES IN BREATHING, 1875 01:13:49,992 --> 01:13:51,293 AUTONOMIC FUNCTION, OBJECTIVE 1876 01:13:51,360 --> 01:13:53,128 SLEEP QUALITY SO WE KNOW -- 1877 01:13:53,195 --> 01:13:54,630 THAT'S THE HOLY GRAIL, RIGHT? 1878 01:13:54,696 --> 01:13:57,866 HOW DO WE KNOW WHEN PEOPLE ARE 1879 01:13:57,933 --> 01:13:58,767 SATISFIED WITH SLEEP EXPERIENCE 1880 01:13:58,834 --> 01:14:00,068 AND I DON'T KNOW IF ANYBODY HAS 1881 01:14:00,135 --> 01:14:01,904 COME UP WITH A GOOD INDEX OF 1882 01:14:01,970 --> 01:14:04,973 THAT YET BUT THAT'S WHAT HE'S 1883 01:14:05,040 --> 01:14:05,874 ASKING ABOUT. 1884 01:14:05,941 --> 01:14:08,177 IF THERE'S A GOOD OBJECTIVE 1885 01:14:08,243 --> 01:14:10,846 MEASURE OF IT. 1886 01:14:10,913 --> 01:14:13,015 >> RIGHT. 1887 01:14:13,081 --> 01:14:15,250 THE SLEEP HEALTH DIMENSIONS, CAN 1888 01:14:15,317 --> 01:14:19,421 BE MEASURED BY DIFFERENT 1889 01:14:19,488 --> 01:14:26,862 MODALITIES, INCORPORATING SOFT 1890 01:14:26,929 --> 01:14:27,963 REPORT ACTIGRAPHY. 1891 01:14:28,030 --> 01:14:30,933 IT IS BEST UNDERSTAND BY 1892 01:14:30,999 --> 01:14:32,301 SELF-REPORT BECAUSE WE'RE 1893 01:14:32,367 --> 01:14:35,237 CONCERNED ABOUT PERCEIVED 1894 01:14:35,304 --> 01:14:35,571 SATISFACTION. 1895 01:14:35,637 --> 01:14:39,808 BUT OTHER DIMENSIONS CAN BE 1896 01:14:39,875 --> 01:14:41,376 MEASURED TO SELF-REPORT. 1897 01:14:41,443 --> 01:14:42,845 >> THE HOLY GRAIL IS THE 1898 01:14:42,911 --> 01:14:44,680 BIOMARKER FOR SLEEP, RIGHT? 1899 01:14:44,746 --> 01:14:46,114 REFLECTS SLEEP OR SLEEP 1900 01:14:46,181 --> 01:14:46,548 DISTURBANCES. 1901 01:14:46,615 --> 01:14:47,716 AND THERE ARE MANY PEOPLE 1902 01:14:47,783 --> 01:14:48,951 WORKING ON THAT. 1903 01:14:49,017 --> 01:14:53,155 I DON'T THINK THERE'S ANY BIG 1904 01:14:53,222 --> 01:14:54,323 BREAKTHROUGHS YET. 1905 01:14:54,389 --> 01:15:00,529 DR. KATABI IS STILL ON. 1906 01:15:00,596 --> 01:15:01,997 WI-FI ANALYSIS IS INTRIGUING. 1907 01:15:02,064 --> 01:15:04,933 CAN IT DETECT CHANGES IN GAIT OF 1908 01:15:05,000 --> 01:15:06,368 INDIVIDUALS ASSOCIATED WITH DAY 1909 01:15:06,435 --> 01:15:08,871 TIME SLEEPINESS AND RISK OF 1910 01:15:08,937 --> 01:15:09,104 FALLS? 1911 01:15:09,171 --> 01:15:10,839 >> YEAH, SO, WE CAN TRACK THE 1912 01:15:10,906 --> 01:15:12,040 GAIT. 1913 01:15:12,107 --> 01:15:15,677 IN FACT WE HAVE EVEN NEWER 1914 01:15:15,744 --> 01:15:18,247 RESULTS THAT SHOW NOT JUST THAT, 1915 01:15:18,313 --> 01:15:22,117 WE CAN TRACK FULL LIKE STICK 1916 01:15:22,184 --> 01:15:22,851 ANYTHING, LIKE THE SKELETON OF 1917 01:15:22,918 --> 01:15:25,754 THE PERSON AS THEY ARE MOVING. 1918 01:15:25,821 --> 01:15:27,222 WE CAN ALSO DETECT FALLS. 1919 01:15:27,289 --> 01:15:29,458 WE HAVE PEOPLE WHERE WE SHOW WE 1920 01:15:29,524 --> 01:15:30,826 CAN DETECT THE FALL. 1921 01:15:30,893 --> 01:15:36,164 WE HAVEN'T LOOKED AT THE ISSUE 1922 01:15:36,231 --> 01:15:37,366 CAN YOU PREDICT SUSCEPTIBILITY 1923 01:15:37,432 --> 01:15:40,569 OR RISK TO FALLING BUT THE 1924 01:15:40,636 --> 01:15:44,773 LITERATURE SHOWS CHANGES OF GAIT 1925 01:15:44,840 --> 01:15:47,009 ARE PREDICTOR FOR LATER -- FULL 1926 01:15:47,075 --> 01:15:48,710 REST, I WOULD SAY THE ANSWER AT 1927 01:15:48,777 --> 01:15:51,580 THE HIGH LEVEL IS YES BUT WE 1928 01:15:51,647 --> 01:15:55,017 HAVEN'T PARTICULARLY LOOKED AT 1929 01:15:55,083 --> 01:15:56,618 THAT PARTICULAR PROBLEM. 1930 01:15:56,685 --> 01:15:57,019 >> GREAT. 1931 01:15:57,085 --> 01:15:58,587 THANKS, AMAZING WHAT YOU CAN 1932 01:15:58,654 --> 01:16:01,623 DETECT WITH ABILITIES YOU HAVE. 1933 01:16:01,690 --> 01:16:03,225 A COUPLE MORE QUESTIONS, I'M 1934 01:16:03,292 --> 01:16:04,026 PUSHING TIME HERE. 1935 01:16:04,092 --> 01:16:14,636 THIS IS A Q&A SESSION FOR THIS 1936 01:16:15,037 --> 01:16:16,104 GROUP OF TALKS. 1937 01:16:16,171 --> 01:16:19,608 IS IT POSSIBLE TO -- IT'S 1938 01:16:19,675 --> 01:16:22,611 DIFFICULT TO COMPARE, UTILIZE 1939 01:16:22,678 --> 01:16:23,745 DIFFERENT SETS BETWEEN 1940 01:16:23,812 --> 01:16:24,646 MODALITIES, YOU WOULD 1941 01:16:24,713 --> 01:16:25,213 ACKNOWLEDGE THAT. 1942 01:16:25,280 --> 01:16:28,150 DO YOU HAVE ANY COMMENTS ON 1943 01:16:28,216 --> 01:16:28,583 THAT? 1944 01:16:28,650 --> 01:16:30,485 >> YEAH, I DO HAVE A COMMENT. 1945 01:16:30,552 --> 01:16:31,753 I AGREE. 1946 01:16:31,820 --> 01:16:34,656 I THINK THAT ONE OF THE REASONS 1947 01:16:34,723 --> 01:16:38,160 WHY SOME RESULTS ARE NOT FULLY 1948 01:16:38,226 --> 01:16:39,394 APPLICABLE BECAUSE PEOPLE ARE 1949 01:16:39,461 --> 01:16:40,362 MEASURING SIMILAR THINGS BUT NOT 1950 01:16:40,429 --> 01:16:42,965 EXACTLY THE SAME WAY. 1951 01:16:43,031 --> 01:16:44,900 I THINK THAT JUST BRINGS WHAT 1952 01:16:44,967 --> 01:16:48,804 WAS DISCUSSED LAST TIME, 1953 01:16:48,870 --> 01:16:49,371 YESTERDAY, ABOUT 1954 01:16:49,438 --> 01:16:50,038 STANDARDIZATION, THERE'S JUST SO 1955 01:16:50,105 --> 01:16:52,341 MUCH WE CAN DO WHEN TRYING TO 1956 01:16:52,407 --> 01:16:55,110 HARMONIZE DATA, BUT I KNOW THERE 1957 01:16:55,177 --> 01:16:57,446 ARE SOME -- MANY INCREDIBLE 1958 01:16:57,512 --> 01:17:00,082 EFFORTS FROM THE NSRR GROUP 1959 01:17:00,148 --> 01:17:03,752 WORKING TOWARDS HARMONIZING BOTH 1960 01:17:03,819 --> 01:17:04,586 CONCEPTUALLY AND TECHNICALLY 1961 01:17:04,653 --> 01:17:06,989 ELEMENTS ABOUT SLEEP BEING THAT 1962 01:17:07,055 --> 01:17:09,257 SELF-REPORT, BEING THAT SOME 1963 01:17:09,324 --> 01:17:11,159 OBJECTIVE METRICS THAT WILL HELP 1964 01:17:11,226 --> 01:17:13,362 US MEASURE THIS AND PERHAPS 1965 01:17:13,428 --> 01:17:15,130 UNDERSTAND WHETHER THOSE 1966 01:17:15,197 --> 01:17:17,332 DIFFERENCES CAN EXPLAIN, REALLY 1967 01:17:17,399 --> 01:17:19,701 DETECT OR EXPLAIN DIFFERENCES 1968 01:17:19,768 --> 01:17:20,836 SEEN ACROSS STUDIES. 1969 01:17:20,902 --> 01:17:22,204 I THINK THAT COULD EXPLAIN PART 1970 01:17:22,270 --> 01:17:24,606 OF THE PROBLEM BUT I THINK THERE 1971 01:17:24,673 --> 01:17:28,677 ARE OTHER APPROACHES THINKING 1972 01:17:28,744 --> 01:17:29,711 ABOUT PERSPECTIVE STUDIES AND 1973 01:17:29,778 --> 01:17:30,078 MEASURING THIS. 1974 01:17:30,145 --> 01:17:33,415 THERE'S A LOT OF TALK OF USING 1975 01:17:33,482 --> 01:17:37,419 STANDARDIZED MEASURES SUCH AS 1976 01:17:37,486 --> 01:17:38,120 PROMIS FOR CAPTURING 1977 01:17:38,186 --> 01:17:38,887 PATIENT-REPORTED OUTCOMES IN 1978 01:17:38,954 --> 01:17:40,389 CONTEXT AND I THINK WE SHOULD 1979 01:17:40,455 --> 01:17:43,158 START THINKING ABOUT USING 1980 01:17:43,225 --> 01:17:44,626 THOSE, CHARACTERIZING THOSE MORE 1981 01:17:44,693 --> 01:17:46,628 SO WE HAVE A REFERENCE. 1982 01:17:46,695 --> 01:17:48,063 NOW, WHETHER THOSE ARE BEST 1983 01:17:48,130 --> 01:17:50,132 MEASURES ARE NOT IS ANOTHER 1984 01:17:50,198 --> 01:17:50,632 QUESTION. 1985 01:17:50,699 --> 01:17:53,301 BUT ADDITIONAL STUDIES TO BETTER 1986 01:17:53,368 --> 01:17:55,670 CHARACTERIZE THOSE AND PROMOTE 1987 01:17:55,737 --> 01:17:57,773 MEASURES THAT ARE SYNERGIZED 1988 01:17:57,839 --> 01:17:59,975 ACROSS THE BOARD FOR PROSPECTIVE 1989 01:18:00,042 --> 01:18:01,410 STUDIES IS DEFINITELY WARRANTED. 1990 01:18:01,476 --> 01:18:02,711 >> ANOTHER QUESTION IN THE 1991 01:18:02,778 --> 01:18:05,680 OPPOSITE DIRECTION, IF YOU HAVE 1992 01:18:05,747 --> 01:18:07,849 A LARGE EPIDEMIOLOGIC STUDY WITH 1993 01:18:07,916 --> 01:18:08,950 MORE DATA MODALITIES RECORDED 1994 01:18:09,017 --> 01:18:10,452 HOW ABOUT EXPANDING NUMBER OF 1995 01:18:10,519 --> 01:18:11,887 PHENOTYPES THAT YOU'RE LOOKING 1996 01:18:11,953 --> 01:18:16,992 AT, WILL IT GIVE YOU LIKE FIND A 1997 01:18:17,059 --> 01:18:18,160 RESOLUTION, THE QUESTION 1998 01:18:18,226 --> 01:18:19,327 ULTIMATELY HOW DETAILED OR 1999 01:18:19,394 --> 01:18:25,133 DEEPLY DO WE NEED TO GO WITH 2000 01:18:25,200 --> 01:18:25,700 PHENOTYPING? 2001 01:18:25,767 --> 01:18:27,002 >> GREAT QUESTION. 2002 01:18:27,069 --> 01:18:28,437 IT DEPENDS ON THE RESOURCES THAT 2003 01:18:28,503 --> 01:18:30,005 ARE AVAILABLE TO ACTUALLY DO 2004 01:18:30,072 --> 01:18:32,240 THAT, RIGHT? 2005 01:18:32,307 --> 01:18:38,180 IF WE CAN DEEP PHENOTYPE, LIKE A 2006 01:18:38,246 --> 01:18:39,448 WELL-DEFINED PATIENT OR 2007 01:18:39,514 --> 01:18:40,348 POPULATION, THAT'S 2008 01:18:40,415 --> 01:18:41,550 REPRESENTATIVE, THAT'S BEING 2009 01:18:41,616 --> 01:18:45,353 COLLECTED ACROSS SETTINGS, 2010 01:18:45,420 --> 01:18:46,988 THAT'S NOT NECESSARILY 2011 01:18:47,055 --> 01:18:47,889 EPIDEMIOLOGICAL STUDIES 2012 01:18:47,956 --> 01:18:48,657 HISTORICAL DONE IN CERTAIN 2013 01:18:48,723 --> 01:18:51,693 GROUPS WE SHOULD EXTEND THAT, IF 2014 01:18:51,760 --> 01:18:54,262 WE CAN DO INVESTMENTS THAT'S A 2015 01:18:54,329 --> 01:18:56,231 GREAT PERSPECTIVE, LIKE I DO 2016 01:18:56,298 --> 01:18:58,433 BELIEVE THAT TECHNOLOGY IS 2017 01:18:58,500 --> 01:19:01,403 IMPROVING, ACCESS TO TECHNOLOGY, 2018 01:19:01,470 --> 01:19:03,738 ACCESS TO DIVERSE COHORTS OF 2019 01:19:03,805 --> 01:19:05,107 PATIENTS, IMPORTANCE OF PATIENT 2020 01:19:05,173 --> 01:19:07,109 STAKEHOLDERS, IN ORDER FOR US 2021 01:19:07,175 --> 01:19:08,009 ENROLLED PARTICIPANTS FROM 2022 01:19:08,076 --> 01:19:09,578 DIFFERENT GROUPS, I'M EXCITED 2023 01:19:09,644 --> 01:19:12,581 FOR THIS SESSION ON ETHICS LATER 2024 01:19:12,647 --> 01:19:13,849 ON, THAT HOPEFULLY WILL BRING 2025 01:19:13,915 --> 01:19:16,151 SOME OF THAT TO LIGHT AND HOW WE 2026 01:19:16,218 --> 01:19:21,990 CAN DRIVE A PICTURE OF THAT 2027 01:19:22,057 --> 01:19:22,290 PERSPECTIVE. 2028 01:19:22,357 --> 01:19:26,595 >> I'M GOING TO TURN IT OVER TO 2029 01:19:26,661 --> 01:19:28,497 MY PROGRAM OFFICER FROM NCI 2030 01:19:28,563 --> 01:19:29,831 MODERATING THE NEXT SESSION. 2031 01:19:29,898 --> 01:19:32,701 THANKS TO THE SPEAKERS FROM THE 2032 01:19:32,767 --> 01:19:37,272 MOST RECENT SESSION, INTRIGUING 2033 01:19:37,339 --> 01:19:37,506 RESULTS. 2034 01:19:37,572 --> 01:19:40,275 >> THANKS, TODD. 2035 01:19:50,585 --> 01:19:52,821 >> WELCOME TO SESSION NUMBER 4, 2036 01:19:52,888 --> 01:19:58,493 WE HAVE THREE GREAT SPEAKERS FOR 2037 01:19:58,560 --> 01:20:01,296 YOU, DR. KISS, S PIRA, MORIES. 2038 01:20:01,363 --> 01:20:04,633 WE'LL START WITH DR. KISS, A 2039 01:20:04,699 --> 01:20:05,867 RESEARCH SCIENTIST AT SRI 2040 01:20:05,934 --> 01:20:08,737 INTERNATIONAL CENTER FOR HEALTH 2041 01:20:08,803 --> 01:20:10,238 SCIENCES, BACKGROUND FORMS THE 2042 01:20:10,305 --> 01:20:11,006 FOUNDATION FOR HER RESEARCH AT 2043 01:20:11,072 --> 01:20:14,743 THE INTERSECTION OF DATA SCIENCE 2044 01:20:14,809 --> 01:20:15,810 AND NEUROSCIENCE. 2045 01:20:15,877 --> 01:20:17,979 DR. KISS SPECIALIZES IN 2046 01:20:18,046 --> 01:20:20,415 ANALYZING MULTI-MODAL LARGE 2047 01:20:20,482 --> 01:20:22,651 SCALE BIOMEDICAL DATASETS TO 2048 01:20:22,717 --> 01:20:25,854 INVESTIGATE HOW SLEEP PATTERNS, 2049 01:20:25,921 --> 01:20:36,398 BRAIN FUNCTIONS AND SOCIAL 2050 01:20:37,766 --> 01:20:41,870 CONNECTEDNESS INTERSECT WITH 2051 01:20:41,937 --> 01:20:44,005 HEALTH. 2052 01:20:46,408 --> 01:20:49,077 >> THANK YOU VERY MUCH. 2053 01:20:53,215 --> 01:20:55,183 >> WE CAN'T HEAR YOU RIGHT NOW. 2054 01:20:55,250 --> 01:20:56,518 >> CAN YOU HEAR ME NOW? 2055 01:20:56,585 --> 01:20:58,286 >> YES, I CAN HEAR YOU. 2056 01:20:58,353 --> 01:20:58,687 >> WONDERFUL. 2057 01:20:58,753 --> 01:20:59,654 >> THANK YOU. 2058 01:20:59,721 --> 01:20:59,988 NOW YOU'RE ON. 2059 01:21:00,055 --> 01:21:02,357 >> THANK YOU VERY MUCH FOR THIS 2060 01:21:02,424 --> 01:21:04,092 KIND INTRODUCTION. 2061 01:21:04,159 --> 01:21:05,794 I'M HONORED BY THIS OPPORTUNITY 2062 01:21:05,860 --> 01:21:08,029 TO TALK ABOUT OUR RECENT 2063 01:21:08,096 --> 01:21:09,164 PROJECT. 2064 01:21:09,231 --> 01:21:10,131 IN ADDITION TO PRESENTING 2065 01:21:10,198 --> 01:21:13,868 SCIENTIFIC RESULTS MY AIM TO 2066 01:21:13,935 --> 01:21:16,037 GIVE BROADER PERSPECTIVE ON USE 2067 01:21:16,104 --> 01:21:18,440 OF MACHINE MODELS BY 2068 01:21:18,506 --> 01:21:20,542 HIGHLIGHTING POTENTIALS AND SOME 2069 01:21:20,609 --> 01:21:28,383 CHALLENGES THAT WE'RE FACING. 2070 01:21:28,450 --> 01:21:29,184 NEXT SLIDE PLEASE. 2071 01:21:29,251 --> 01:21:31,886 THIS IS PART OF A PROJECT 2072 01:21:31,953 --> 01:21:34,623 BETWEEN OUR LAB AND UCSF. 2073 01:21:34,689 --> 01:21:37,192 LET'S GET STARTED. 2074 01:21:37,259 --> 01:21:39,661 OBESITY AND CO-MORBIDITIES 2075 01:21:39,728 --> 01:21:41,563 REPRESENT THE MOST SERIOUS RISK 2076 01:21:41,630 --> 01:21:43,932 FACING U.S. ADOLESCENTS. 2077 01:21:43,999 --> 01:21:45,734 BETWEEN 2017 AND 2020 THE 2078 01:21:45,800 --> 01:21:56,344 PERCENTAGE OF OBES ADOLESCENCE 2079 01:21:59,814 --> 01:22:01,483 WAS 22%. 2080 01:22:01,549 --> 01:22:05,387 EARLY ADOLESCENCE IS HIGH-RISK 2081 01:22:05,453 --> 01:22:11,326 FOR ADULT OBESITY BUT ALSO 2082 01:22:11,393 --> 01:22:12,761 CARDIOVASCULAR HEALTH PROBLEMS. 2083 01:22:12,827 --> 01:22:19,434 SLEEP IS A CRITICAL RISK 2084 01:22:19,501 --> 01:22:21,870 FACTOR, ASSOCIATED WITH 80% 2085 01:22:21,936 --> 01:22:24,406 INCREASE IN OBESITY AMONG 2086 01:22:24,472 --> 01:22:24,873 ADOLESCENTS. 2087 01:22:24,939 --> 01:22:26,775 NEXT SLIDE PLEASE. 2088 01:22:26,841 --> 01:22:28,843 SOME PROPOSED MECHANISMS 2089 01:22:28,910 --> 01:22:30,111 INCLUDED SLEEP-RELATED CHANGES 2090 01:22:30,178 --> 01:22:38,820 IN ENERGY INTAKE, DECREASED 2091 01:22:38,887 --> 01:22:45,860 PHYSICAL ACTIVITY, NEGATIVE 2092 01:22:45,927 --> 01:22:47,362 EMOTIONS. 2093 01:22:47,429 --> 01:22:48,797 NEXT SLIDE PLEASE. 2094 01:22:48,863 --> 01:22:53,001 WE AIM TO EXPLORE OBESITY CAN BE 2095 01:22:53,068 --> 01:22:56,004 PREDICTED USING DATA RECORDED IN 2096 01:22:56,071 --> 01:22:57,272 THE ADOLESCENT BRAIN COGNITIVE 2097 01:22:57,339 --> 01:22:58,073 STUDY. 2098 01:22:58,139 --> 01:23:05,313 OUR GOAL WAS TO IDENTIFY MOST 2099 01:23:05,380 --> 01:23:06,348 IMPORTANT MEASURES. 2100 01:23:06,414 --> 01:23:09,951 PRIOR STUDIES SHOW SLEEP AND 2101 01:23:10,018 --> 01:23:10,452 ACTIVITY MEASURES IMPACT 2102 01:23:10,518 --> 01:23:13,455 OBESITY, IT IS IMPORTANT TO NOTE 2103 01:23:13,521 --> 01:23:15,290 THAT IN TRADITIONAL APPROACHES 2104 01:23:15,357 --> 01:23:16,524 SIGNIFICANT EFFECT DOES NOT 2105 01:23:16,591 --> 01:23:19,761 NECESSARILY MEAN A LARGE EFFECT 2106 01:23:19,828 --> 01:23:23,331 SIZE OR ACCURATE PREDICTION. 2107 01:23:23,398 --> 01:23:24,733 HERE MACHINE LEARNING MODELS 2108 01:23:24,799 --> 01:23:27,736 ASSESS ACCURATE PREDICT STATUS 2109 01:23:27,802 --> 01:23:30,338 FROM THESE DATA, DIFFERENTIATING 2110 01:23:30,405 --> 01:23:40,782 OBESE FROM NON-OBESE. 2111 01:23:43,885 --> 01:23:45,854 NEXT SLIDE PLEASE. 2112 01:23:45,920 --> 01:23:49,858 ABCD STUDY IS THE LARGEST 2113 01:23:49,924 --> 01:23:56,731 INITIATED IN 2018 WITH 11,000 2114 01:23:56,798 --> 01:23:59,134 PARTICIPATING, PUBLICLY 2115 01:23:59,200 --> 01:23:59,968 AVAILABLE, QUITE BIG. 2116 01:24:00,034 --> 01:24:03,037 DURING THE SECOND YEAR VISIT 2117 01:24:03,104 --> 01:24:04,372 PARTICIPANTS WERE INVITED TO 2118 01:24:04,439 --> 01:24:08,309 WEAR DEVICES FOR THREE WEEKS. 2119 01:24:08,376 --> 01:24:12,313 PRESENTING SUBSAMPLE OF COHORT. 2120 01:24:12,380 --> 01:24:15,617 WE INCLUDED PARTICIPANTS WITH 2121 01:24:15,683 --> 01:24:23,258 BOTH FITBIT AND BMI DATA. 2122 01:24:23,324 --> 01:24:25,860 17% OF ADOLESCENTS CLASSIFIED 2123 01:24:25,927 --> 01:24:30,298 AS BEING OBESE. 2124 01:24:30,365 --> 01:24:31,199 YES? 2125 01:24:31,266 --> 01:24:36,304 THIS RATIO WAS 13%. 2126 01:24:36,371 --> 01:24:37,939 NEXT SLIDE PLEASE. 2127 01:24:38,006 --> 01:24:39,174 WE ALL KNOW WEARABLE INDUSTRY 2128 01:24:39,240 --> 01:24:41,543 OFFERS WIDE RANGE OF 2129 01:24:41,609 --> 01:24:43,111 COMMERCIALLY AVAILABLE DEVICES 2130 01:24:43,178 --> 01:24:46,681 THAT HAVE INCREASED OUR HEALTH 2131 01:24:46,748 --> 01:24:54,489 AWARENESS BY MEASURING SLEEP AND 2132 01:24:54,556 --> 01:25:02,831 PHYSICAL ACTIVITY. 2133 01:25:02,897 --> 01:25:05,099 IN OUR MODEL, WE INCLUDED 2134 01:25:05,166 --> 01:25:07,402 MEASURES OF PHYSICAL ACTIVITY 2135 01:25:07,469 --> 01:25:08,703 AND CARDIOVASCULAR IN TERMS OF 2136 01:25:08,770 --> 01:25:10,839 SLEEP AND RESTING HEART RATE AND 2137 01:25:10,905 --> 01:25:13,107 STEP COUNTS. 2138 01:25:13,174 --> 01:25:15,109 AND WE INCORPORATES MEASURES 2139 01:25:15,176 --> 01:25:16,277 CONCERNING SLEEP TIMING, 2140 01:25:16,344 --> 01:25:17,045 QUALITY, REGULARITY. 2141 01:25:17,111 --> 01:25:20,448 WHEN I SAY REGULARITY I MEAN DAY 2142 01:25:20,515 --> 01:25:22,684 TO DAY VARIABILITY MEASURED 2143 01:25:22,750 --> 01:25:24,819 DIFFERENT WAYS. 2144 01:25:24,886 --> 01:25:27,589 AND WE ANALYZED DAILY MEASURES. 2145 01:25:27,655 --> 01:25:32,427 GRAPH HERE SHOWS PHYSICAL 2146 01:25:32,494 --> 01:25:33,828 ACTIVITY LEVELS ACROSS THE DAYS 2147 01:25:33,895 --> 01:25:36,130 OF THE WEEK WITH DIFFERENT LINES 2148 01:25:36,197 --> 01:25:39,067 REPRESENTING THREE WEEKS OF DATA 2149 01:25:39,133 --> 01:25:40,368 COLLECTION. 2150 01:25:40,435 --> 01:25:41,102 NOTABLY PHYSICAL ACTIVITY LEVELS 2151 01:25:41,169 --> 01:25:43,204 WHY HIGHER DURING THE FIRST WEEK 2152 01:25:43,271 --> 01:25:44,973 OF THE DATA COLLECTION. 2153 01:25:45,039 --> 01:25:46,741 LEADING US TO FOCUS ON THE 2154 01:25:46,808 --> 01:25:48,977 SUBSEQUENT TWO WEEKS FOR MORE 2155 01:25:49,043 --> 01:25:51,546 TYPICAL REPRESENTATION OF 2156 01:25:51,613 --> 01:25:53,348 ACTIVITY AND SLEEP PATTERNS. 2157 01:25:53,414 --> 01:25:58,419 I WANT TO NOTE THAT WE PAY LOTS 2158 01:25:58,486 --> 01:26:00,288 OF ATTENTION ON DATA PROCESSING 2159 01:26:00,355 --> 01:26:02,156 AND FEATURE SELECTION, AND OUR 2160 01:26:02,223 --> 01:26:04,659 MODELS ARE INFORMED IN THE SENSE 2161 01:26:04,726 --> 01:26:08,062 THAT THEY ARE CONSTRUCTED FROM 2162 01:26:08,129 --> 01:26:09,831 CAREFULLY CHOSEN MEASURES THAT 2163 01:26:09,898 --> 01:26:13,868 ALIGN WITH EVIDENCE AND 2164 01:26:13,935 --> 01:26:14,602 THEORETICAL CONSIDERATIONS. 2165 01:26:14,669 --> 01:26:15,470 MOSTLY AVOIDING REDUNDANT 2166 01:26:15,537 --> 01:26:16,337 INFORMATION. 2167 01:26:16,404 --> 01:26:18,640 THIS ENSURES OUR MODELS DO MORE 2168 01:26:18,706 --> 01:26:22,710 THAN JUST PREDICT. 2169 01:26:22,777 --> 01:26:24,879 THEY OFFER MEANFUL INSIGHT 2170 01:26:24,946 --> 01:26:27,715 CRUCIAL FOR UNDERSTANDING 2171 01:26:27,782 --> 01:26:29,951 NUANCES OF OBESITY IN 2172 01:26:30,018 --> 01:26:31,352 ADOLESCENTS. 2173 01:26:31,419 --> 01:26:34,255 NEXT SLIDE PLEASE. 2174 01:26:34,322 --> 01:26:35,823 WE EVALUATED MODELS, COMMON IN 2175 01:26:35,890 --> 01:26:38,593 MACHINE LEARNING, AND FOUND OUR 2176 01:26:38,660 --> 01:26:40,161 PRIMARY METHOD, EXPLAINABLE 2177 01:26:40,228 --> 01:26:41,863 BOOSTING MACHINES, WHICH IS 2178 01:26:41,930 --> 01:26:45,767 BASED ON DECISION TREES, 2179 01:26:45,833 --> 01:26:46,234 PERFORMED WELL. 2180 01:26:46,301 --> 01:26:49,337 AND AFTER ADDRESSING AND 2181 01:26:49,404 --> 01:26:55,276 SELECTING 70 PREDICTORS, WE 2182 01:26:55,343 --> 01:26:57,145 CONDUCTED GRID SEARCH, THIS IS A 2183 01:26:57,211 --> 01:26:59,213 CRUCIAL STEP TO ENSURE 2184 01:26:59,280 --> 01:27:01,549 GENERALIZABILITY OF OUR RESULTS. 2185 01:27:01,616 --> 01:27:04,953 THE FIGURE HERE IS ITERATIVE 2186 01:27:05,019 --> 01:27:06,387 PROCESS, EBM MODEL FOR 2187 01:27:06,454 --> 01:27:07,622 CLASSIFICATION. 2188 01:27:07,689 --> 01:27:10,625 STARTING WITH BASIC MODEL, EBM 2189 01:27:10,692 --> 01:27:11,859 SEQUENTIALLY UPDATED PREDICTIONS 2190 01:27:11,926 --> 01:27:14,295 BY CYCLING THROUGH EACH FEATURE 2191 01:27:14,362 --> 01:27:16,764 TO LEARN UNIQUE CONTRIBUTIONS TO 2192 01:27:16,831 --> 01:27:19,300 GRADIENT BOOSTING. 2193 01:27:19,367 --> 01:27:22,437 IT EXPLORES DIRECTIONS BETWEEN 2194 01:27:22,503 --> 01:27:25,840 PAIRS OF FEATURES, ENHANCING THE 2195 01:27:25,907 --> 01:27:26,240 MODEL'S ACCURACY. 2196 01:27:26,307 --> 01:27:34,082 THIS APPROACH RESULTS AND 2197 01:27:34,148 --> 01:27:35,617 PROVIDES INSIGHT INTO INDIVIDUAL 2198 01:27:35,683 --> 01:27:36,918 FEATURES AND THEIR INTERACTIONS 2199 01:27:36,985 --> 01:27:37,685 ON THE OUTCOME. 2200 01:27:37,752 --> 01:27:40,421 WHICH IS IN OUR CASE THE 2201 01:27:40,488 --> 01:27:40,655 OBESITY. 2202 01:27:40,722 --> 01:27:43,057 AND THAT IS WHY WE CHOSE TO 2203 01:27:43,124 --> 01:27:49,063 APPLY THIS MODEL IN OUR STUDY. 2204 01:27:49,130 --> 01:27:49,998 IN OTHER PROJECTS, 2205 01:27:50,064 --> 01:27:52,800 CONSIDERATIONS APPLY, THEY DO 2206 01:27:52,867 --> 01:27:54,002 NOT NECESSARILY PRESENT 2207 01:27:54,068 --> 01:27:55,670 DIRECTIONS, MIGHT CHOOSE 2208 01:27:55,737 --> 01:27:56,537 DIFFERENT APPROACH. 2209 01:27:56,604 --> 01:27:58,272 THE DECISION-MAKING PROCESS IS 2210 01:27:58,339 --> 01:28:00,775 CALLED MODEL SELECTION, AND I 2211 01:28:00,842 --> 01:28:02,644 BELIEVE IT'S CRUCIAL TO 2212 01:28:02,710 --> 01:28:04,679 EMPHASIZE THAT WE HAVE TO STAY 2213 01:28:04,746 --> 01:28:06,047 UPDATED WITH THE ADVANCEMENTS IN 2214 01:28:06,114 --> 01:28:07,882 THE FIELD. 2215 01:28:07,949 --> 01:28:09,584 AND TO INVEST INTO NEW METHODS. 2216 01:28:09,651 --> 01:28:11,285 HOWEVER, IT'S ALSO EQUALLY 2217 01:28:11,352 --> 01:28:14,022 IMPORTANT TO REMEMBER SIMPLER 2218 01:28:14,088 --> 01:28:15,390 APPROACHES SOMETIMES, FOR EARLY 2219 01:28:15,456 --> 01:28:17,992 STAGES OF THE MACHINE LEARNING 2220 01:28:18,059 --> 01:28:18,393 DEVELOPMENT. 2221 01:28:18,459 --> 01:28:20,828 AS BASELINE MODELS OFTEN ARE 2222 01:28:20,895 --> 01:28:22,697 PERFORMED MORE COMPLEX ONES, 2223 01:28:22,764 --> 01:28:29,637 ESPECIALLY IN DATASETS THAT ARE 2224 01:28:29,704 --> 01:28:35,176 BRIDGE BE THE -- BRIDGING THE 2225 01:28:35,243 --> 01:28:36,344 GAP LIKE ABCD MODEL. 2226 01:28:36,411 --> 01:28:39,547 WE COMBINE TO GAIN MORE 2227 01:28:39,614 --> 01:28:44,485 UNDERSTANDING FROM THIS 2228 01:28:44,552 --> 01:28:44,786 POPULATION. 2229 01:28:44,852 --> 01:28:45,787 NEXT SLIDE PLEASE. 2230 01:28:45,853 --> 01:28:49,691 TOP 20 FEATURES RANK FROM TOP TO 2231 01:28:49,757 --> 01:28:51,325 BOTTOM, FOR BETTER 2232 01:28:51,392 --> 01:28:53,728 INTERPRETABILITY ASSIGNED INTO 2233 01:28:53,795 --> 01:28:55,229 COLOR CODED CATEGORIES, YELLOW 2234 01:28:55,296 --> 01:28:56,230 REPRESENTING DEMOGRAPHIC 2235 01:28:56,297 --> 01:28:56,864 INFORMATION. 2236 01:28:56,931 --> 01:28:59,667 IN THIS LIST THE FIRST FIVE 2237 01:28:59,734 --> 01:29:02,070 PREDICTORS ARE INTERACTION TERMS 2238 01:29:02,136 --> 01:29:04,572 IDENTIFIED BY THE MODEL, NOT US 2239 01:29:04,639 --> 01:29:05,873 DEFINING INTERACTIONS. 2240 01:29:05,940 --> 01:29:10,378 HOWEVER, THE MODEL POINTED US TO 2241 01:29:10,445 --> 01:29:11,546 SIGNIFICANT IMPACT. 2242 01:29:11,612 --> 01:29:13,614 YOU CAN ALSO SEE MULTIPLE 2243 01:29:13,681 --> 01:29:16,350 INDICATORS OF SES IN THIS LIST 2244 01:29:16,417 --> 01:29:18,319 WHICH SHOWS ADOLESCENTS WITH 2245 01:29:18,386 --> 01:29:21,923 LOWER SOCIOECONOMIC STATUS ARE 2246 01:29:21,989 --> 01:29:28,563 MORE LIKELY TO BE OBESE. 2247 01:29:28,629 --> 01:29:31,532 SLEEP PREDICTORS IN PURPLE. 2248 01:29:31,599 --> 01:29:33,868 LATER BEDTIME AND HIGHER DAY TO 2249 01:29:33,935 --> 01:29:35,937 DAY VARIABILITY, MID-SLEEP 2250 01:29:36,003 --> 01:29:41,109 ASSOCIATED WITH OBESITY. 2251 01:29:41,175 --> 01:29:43,511 NEXT SLIDE PLEASE. 2252 01:29:43,578 --> 01:29:46,147 WE IDENTIFIED CRUCIAL TIPPING 2253 01:29:46,214 --> 01:29:47,882 POINTS IN THE PREDICTORS, 2254 01:29:47,949 --> 01:29:50,284 SPECIFIC BEHAVIORS BEGAN TO PUT 2255 01:29:50,351 --> 01:29:53,888 ADOLESCENTS AT HEIGHTENED RISK 2256 01:29:53,955 --> 01:29:58,926 FOR OBESITY. 2257 01:29:58,993 --> 01:30:00,361 INTERACTION EMERGED AS TOP RANK 2258 01:30:00,428 --> 01:30:03,598 THE SCORE WITHIN THE MODEL. 2259 01:30:03,664 --> 01:30:04,799 THIS INTERACTION REVEALS 2260 01:30:04,866 --> 01:30:08,436 ELEVATED RISK OF OBESITY AMONG 2261 01:30:08,503 --> 01:30:09,470 INDIVIDUALS WHO IDENTIFIED AS 2262 01:30:09,537 --> 01:30:11,939 ANY OTHER RACE THAN WHITE, ALSO 2263 01:30:12,006 --> 01:30:14,242 HAVE A SLEEPING HEART RATE 2264 01:30:14,308 --> 01:30:17,211 GREATER THAN 72 BEATS PER 2265 01:30:17,278 --> 01:30:17,645 MINUTE. 2266 01:30:17,712 --> 01:30:19,614 CORRESPONDING INCREASE IN 2267 01:30:19,680 --> 01:30:21,349 OBESITY RISK AMONG WHITE 2268 01:30:21,415 --> 01:30:22,984 INDIVIDUALS, ASSOCIATED WITH 2269 01:30:23,050 --> 01:30:26,587 HEART RATE OF 80 BEATS PER 2270 01:30:26,654 --> 01:30:28,689 MINUTE OR HIGHER. 2271 01:30:28,756 --> 01:30:29,557 SIMILARLY IDENTIFIED 2272 01:30:29,624 --> 01:30:30,491 INTERACTIONS BETWEEN SLEEPING 2273 01:30:30,558 --> 01:30:33,494 HEART RATE AND TOTAL COMBINED 2274 01:30:33,561 --> 01:30:35,229 FAMILY INCOME REVEALING NUANCED 2275 01:30:35,296 --> 01:30:36,264 RISK PROFILES. 2276 01:30:36,330 --> 01:30:38,099 SPECIFICALLY PARTICIPANTS FROM 2277 01:30:38,166 --> 01:30:39,867 FAMILIES WITH INCOME RANGING 2278 01:30:39,934 --> 01:30:41,102 BETWEEN FIVE THOUSAND AND 2279 01:30:41,169 --> 01:30:43,271 SIXTEEN THOUSAND, ALSO HAD 2280 01:30:43,337 --> 01:30:43,938 ELEVATED SLEEPING HEART RATES 2281 01:30:44,005 --> 01:30:47,842 WERE FOUNDING TO AT HIGHEST RISK 2282 01:30:47,909 --> 01:30:48,843 FOR OBESITY. 2283 01:30:48,910 --> 01:30:52,814 CONVERSELY HAVING A FAMILY 2284 01:30:52,880 --> 01:30:56,284 INCOME ABOVE $100,000 AND 2285 01:30:56,350 --> 01:30:58,052 SLEEPING HEART RATE LOWER 2286 01:30:58,119 --> 01:30:59,821 ASSOCIATED WITH DECREASED RISK 2287 01:30:59,887 --> 01:31:01,222 OF OBESITY. 2288 01:31:01,289 --> 01:31:04,025 IDENTIFYING THESE THRESHOLDS ARE 2289 01:31:04,091 --> 01:31:06,427 RELEVANT FOR INTERVENTIONS, 2290 01:31:06,494 --> 01:31:07,695 ESPECIALLY DURING DEVELOPMENT 2291 01:31:07,762 --> 01:31:15,536 WHEN WE CAN INTERVENE AND 2292 01:31:15,603 --> 01:31:24,545 SUPPORT HEALTHY MATURATION. 2293 01:31:24,612 --> 01:31:25,646 OUR RESULTS IDENTIFIED AND 2294 01:31:25,713 --> 01:31:27,348 CONFIRMED EARLIER BEDTIMES ARE 2295 01:31:27,415 --> 01:31:30,852 PROTECTIVE BY THE LATER BEDTIMES 2296 01:31:30,918 --> 01:31:33,487 INCREASING RISK OF OBESITY. 2297 01:31:33,554 --> 01:31:35,556 SIMILARLY, I COULD LIST 2298 01:31:35,623 --> 01:31:36,324 THRESHOLDS FOR EACH PREDICTOR 2299 01:31:36,390 --> 01:31:40,795 BUT HOPE YOU GET THE IDEA WE'RE 2300 01:31:40,862 --> 01:31:51,505 LOOKING AT PATTERNS RATHER THAN 2301 01:31:51,572 --> 01:31:52,840 SOLE PREDICTORS HERE. 2302 01:31:52,907 --> 01:31:53,875 THIS SHOWS IMPORTANCE OF 2303 01:31:53,941 --> 01:32:03,417 CONTINUOUS MONITORING. 2304 01:32:03,484 --> 01:32:07,755 THEY SHOW POTENTIAL METHODS FOR 2305 01:32:07,822 --> 01:32:08,789 GLASS BOX MODELS. 2306 01:32:08,856 --> 01:32:14,128 AND FOR THE FIRST TIME WE CAN 2307 01:32:14,195 --> 01:32:16,097 REALLY HARMONIZE DATASET, ALSO 2308 01:32:16,163 --> 01:32:19,200 IDENTIFY PATTERNS AND RISK 2309 01:32:19,267 --> 01:32:19,734 THRESHOLDS AND POTENTIALLY 2310 01:32:19,800 --> 01:32:23,271 FORECAST FUTURE SYMPTOMS EVEN 2311 01:32:23,337 --> 01:32:24,705 BEFORE THE CLINICAL 2312 01:32:24,772 --> 01:32:25,573 MANIFESTATION. 2313 01:32:25,640 --> 01:32:27,775 INFORMED MODELS WE CAN 2314 01:32:27,842 --> 01:32:28,976 CHARACTERIZE SYSTEMS AND RANK 2315 01:32:29,043 --> 01:32:33,180 EFFECTS IN A MORE EFFICIENT WAY 2316 01:32:33,247 --> 01:32:33,814 THAN BEFORE. 2317 01:32:33,881 --> 01:32:36,550 AND I WANT TO MENTION THAT 2318 01:32:36,617 --> 01:32:38,286 EXPLOREATIVE MODELS CAN ALSO SET 2319 01:32:38,352 --> 01:32:40,955 THE STAGE FOR FOLLOW-UP 2320 01:32:41,022 --> 01:32:41,622 ANALYSIS, MORE EXPERIMENTAL 2321 01:32:41,689 --> 01:32:42,390 ANALYSES IN THE FUTURE. 2322 01:32:42,456 --> 01:32:44,558 AND I WANT TO GIVE AN EXAMPLE 2323 01:32:44,625 --> 01:32:47,895 FOR THIS. 2324 01:32:47,962 --> 01:32:52,333 NEXT SLIDE PLEASE. 2325 01:32:52,400 --> 01:32:54,402 VERY BRIEFLY, APPLIED SIMILAR 2326 01:32:54,468 --> 01:32:55,202 APPROACH, TO PREDICT ADOLESCENT 2327 01:32:55,269 --> 01:32:57,705 MENTAL HEALTH DURING THE EARLY 2328 01:32:57,772 --> 01:32:58,873 STAGES OF PANDEMIC. 2329 01:32:58,940 --> 01:33:01,042 IN SITUATIONS LIKE THIS, IT IS 2330 01:33:01,108 --> 01:33:02,643 VERY NATURAL THAT WE DON'T HAVE 2331 01:33:02,710 --> 01:33:04,445 A CLEAR EXPECTATION ON THE 2332 01:33:04,512 --> 01:33:04,812 OUTCOMES. 2333 01:33:04,879 --> 01:33:07,949 SO WE MEASURE EVERYTHING THAT WE 2334 01:33:08,015 --> 01:33:10,584 CAN AND GOING FOR FISHING 2335 01:33:10,651 --> 01:33:12,620 EXPEDITION DECIDED TO OPT FOR 2336 01:33:12,687 --> 01:33:16,357 MACHINE LEARNING MODEL, SINCE 2337 01:33:16,424 --> 01:33:17,892 THESE ARE DESIGNED FOR 2338 01:33:17,959 --> 01:33:19,126 EXPERIMENTAL ANALYSIS AND DO IN 2339 01:33:19,193 --> 01:33:20,328 THE INCREASE RISK OF ERROR. 2340 01:33:20,394 --> 01:33:22,730 YOU CAN SEE WE IDENTIFIED 2341 01:33:22,797 --> 01:33:23,497 PRE-PANDEMIC SLEEP MEASURES 2342 01:33:23,564 --> 01:33:25,466 AMONG OTHER THINGS THAT WERE 2343 01:33:25,533 --> 01:33:27,468 ASSOCIATED WITH HIGH ANXIETY 2344 01:33:27,535 --> 01:33:28,869 LEVELS, ANXIETY SYMPTOMS DURING 2345 01:33:28,936 --> 01:33:30,671 THE EARLY STAGES OF THE 2346 01:33:30,738 --> 01:33:36,177 PANDEMIC, IN THE ABCD COHORT. 2347 01:33:36,243 --> 01:33:38,012 NEXT SLIDE PLEASE. 2348 01:33:38,079 --> 01:33:41,582 MODELS REVEAL HOW IMPORTANT 2349 01:33:41,649 --> 01:33:45,786 SOCIAL CONNECTIONS WERE DURING 2350 01:33:45,853 --> 01:33:46,620 THIS TIME. 2351 01:33:46,687 --> 01:33:49,056 TOP PREDICTOR IN THE PREDICTION 2352 01:33:49,123 --> 01:33:52,793 OF POSITIVE EFFECT, QUITE 2353 01:33:52,860 --> 01:33:54,929 SURPRISING FOR ME, AND THIS DATA 2354 01:33:54,996 --> 01:33:55,629 WAS SELF-REPORTED MOSTLY. 2355 01:33:55,696 --> 01:33:58,199 THIS IS ALSO THE EARLY FEW 2356 01:33:58,265 --> 01:34:02,603 MONTHS OF THE PANDEMIC. 2357 01:34:02,670 --> 01:34:03,337 NEXT SLIDE PLEASE. 2358 01:34:03,404 --> 01:34:07,508 THIS IS THE LAST EXAMPLE. 2359 01:34:07,575 --> 01:34:09,110 APPLIED MACHINE LEARNING BASED 2360 01:34:09,176 --> 01:34:12,313 TRAJECTORY ANALYSIS TO IDENTIF 2361 01:34:12,380 --> 01:34:16,250 ADOLESCENTS IN THE ABCD STUDY 2362 01:34:16,317 --> 01:34:18,085 PERSISTENTLY STRESSED, THE FIRST 2363 01:34:18,152 --> 01:34:19,420 SIX -- TIMES SIX -- SORRY, 2364 01:34:19,487 --> 01:34:21,989 ACROSS THE FIRST YEAR OF THE 2365 01:34:22,056 --> 01:34:24,158 PANDEMIC, SIX TIME POINTS. 2366 01:34:24,225 --> 01:34:26,660 THE ABCD STUDY INVITED 2367 01:34:26,727 --> 01:34:27,395 PARTICIPANTS TO COMPLETE 2368 01:34:27,461 --> 01:34:31,032 SURVEYS, AND YOU ARE IS VASE -- 2369 01:34:31,098 --> 01:34:33,501 SURVEYS COVERED FIRST YEAR THE 2370 01:34:33,567 --> 01:34:34,635 PANDEMIC. 2371 01:34:34,702 --> 01:34:35,136 LONGITUDINAL DATA SHOW 2372 01:34:35,202 --> 01:34:37,438 TRAJECTORIES IN STRESS FIRST 2373 01:34:37,505 --> 01:34:39,673 YEAR OF THE PANDEMIC. 2374 01:34:39,740 --> 01:34:41,909 5% OF ADOLESCENTS HAVING HIGH 2375 01:34:41,976 --> 01:34:45,880 STRESS LEVELS, ACROSS ALL SIX 2376 01:34:45,946 --> 01:34:50,551 ASSESSMENTS, MAY 2020 TO MARCH 2377 01:34:50,618 --> 01:34:50,818 2021. 2378 01:34:50,885 --> 01:34:52,453 THE HIGH PREVALENCE OF STRESS IN 2379 01:34:52,520 --> 01:34:54,755 OUR SAMPLE IS PARTICULARLY 2380 01:34:54,822 --> 01:34:56,924 ALARMING, GIVEN THE DURATION OF 2381 01:34:56,991 --> 01:34:59,360 STRESS IS CRITICAL FOR LATER 2382 01:34:59,427 --> 01:35:01,262 PSYCHOLOGICAL AND BRAIN 2383 01:35:01,328 --> 01:35:03,097 FUNCTIONING IN ADOLESCENTS AND 2384 01:35:03,164 --> 01:35:10,471 YOUNG ADULTS. 2385 01:35:10,538 --> 01:35:13,040 NEXT SLIDE PLEASE. 2386 01:35:13,107 --> 01:35:14,041 NEXT STEPS, IDENTIFIED 2387 01:35:14,108 --> 01:35:16,343 PRE-PANDEMIC BRAIN AND SLEEP 2388 01:35:16,410 --> 01:35:17,344 MEASURES THAT WERE COLLECTED 2389 01:35:17,411 --> 01:35:24,618 PRIOR TO THE PANDEMIC AND OTHER 2390 01:35:24,685 --> 01:35:26,287 FACTORS, THAT COULD POTENTIALLY 2391 01:35:26,353 --> 01:35:26,554 EXPLAIN. 2392 01:35:26,620 --> 01:35:27,922 AND THE RESULT HIGHLIGHT ROLE OF 2393 01:35:27,988 --> 01:35:32,393 SLEEP AND BRAIN STRUCTURE IN 2394 01:35:32,460 --> 01:35:34,195 EARLY ADOLESCENCE, RESILIENCE TO 2395 01:35:34,261 --> 01:35:35,529 CHRONIC STRESSORS. 2396 01:35:35,596 --> 01:35:36,931 ADDING SLEEP ASSESSMENTS INTO 2397 01:35:36,997 --> 01:35:39,633 THE CLINICAL ROUTINE AND ASKING 2398 01:35:39,700 --> 01:35:42,903 ADOLESCENTS ABOUT SLEEP WOULD BE 2399 01:35:42,970 --> 01:35:45,773 CRITICALLY IMPORTANT FOR EARLY 2400 01:35:45,840 --> 01:35:46,340 INTERVENTION. 2401 01:35:46,407 --> 01:35:47,408 THESE RESULTS ARE NOT PUBLISHED. 2402 01:35:47,475 --> 01:35:48,776 YOU CAN FIND MORE INFORMATION 2403 01:35:48,843 --> 01:35:52,213 ABOUT OUR MODELS AND APPROACHES 2404 01:35:52,279 --> 01:35:54,081 IN THE PAPERS, AND I'D LIKE TO 2405 01:35:54,148 --> 01:35:57,618 SAVE TIME FOR QUESTIONS. 2406 01:35:57,685 --> 01:35:58,018 NEXT SLIDE PLEASE. 2407 01:35:58,085 --> 01:36:01,956 SO THANK YOU VERY MUCH FOR YOUR 2408 01:36:02,022 --> 01:36:02,223 ATTENTION. 2409 01:36:02,289 --> 01:36:04,525 THIS IS A TEAM EFFORT. 2410 01:36:04,592 --> 01:36:06,227 I'M GRATEFUL TO THE SRI SLEEP 2411 01:36:06,293 --> 01:36:14,702 MEMBERS AND ALL THE 2412 01:36:14,768 --> 01:36:16,403 COLLABORATORS, I'D LIKE TO THANK 2413 01:36:16,470 --> 01:36:17,671 ABCD PARTICIPANTS FOR THEIR 2414 01:36:17,738 --> 01:36:19,807 EFFORTS AND ALL THE INSTITUTIONS 2415 01:36:19,874 --> 01:36:20,608 WHO SUPPORTED US. 2416 01:36:20,674 --> 01:36:25,012 THANK YOU. 2417 01:36:30,384 --> 01:36:34,588 >> THANK YOU FOR THE IMPRESSIVE 2418 01:36:34,655 --> 01:36:34,922 PRESENTATION. 2419 01:36:34,989 --> 01:36:37,992 I'M NOT -- WE HAVE ABOUT FIVE 2420 01:36:38,058 --> 01:36:43,164 MINUTES FOR QUESTIONS. 2421 01:36:43,230 --> 01:36:49,270 I'M NOT SEEING ANYTHING IN THE 2422 01:36:49,336 --> 01:36:50,037 QUAY. 2423 01:36:50,104 --> 01:36:50,237 Q&A. 2424 01:36:50,304 --> 01:36:52,339 THERE'S A QUESTION THROUGH THE 2425 01:36:52,406 --> 01:36:54,408 VIDEOCAST I'M GOING TO -- LET'S 2426 01:36:54,475 --> 01:37:01,315 SEE IF I CAN EXTRACT THE SALIENT 2427 01:37:01,382 --> 01:37:02,917 POINT, HOW MUCH -- GIVEN THE 2428 01:37:02,983 --> 01:37:11,492 AMOUNT OF DATA THE ABCD STUDY 2429 01:37:11,559 --> 01:37:13,894 HAS COLLECTED, ARE YOU -- WHAT 2430 01:37:13,961 --> 01:37:18,933 SORT OF PRIVACY PROTECTIONS ARE 2431 01:37:18,999 --> 01:37:22,503 THERE TO PREVENT SORT OF A.I. 2432 01:37:22,570 --> 01:37:24,305 APPROACH FROM UNMASK INDIVIDUALS 2433 01:37:24,371 --> 01:37:26,240 IN THIS STUDY, IS THAT SOMETHING 2434 01:37:26,307 --> 01:37:27,608 YOU COULD SPEAK TO? 2435 01:37:27,675 --> 01:37:30,177 >> SO THE ABCD STUDY DATA IS 2436 01:37:30,244 --> 01:37:32,279 PUBLICLY AVAILABLE, AND THERE 2437 01:37:32,346 --> 01:37:33,614 ARE MANY CONSIDERATIONS AROUND 2438 01:37:33,681 --> 01:37:34,281 PRIVACY. 2439 01:37:34,348 --> 01:37:37,685 AND ALL THE DATA USED HERE AND 2440 01:37:37,751 --> 01:37:45,659 ANY ANALYSES REGARDING ABCD DATA 2441 01:37:45,726 --> 01:37:47,628 IS DE-IDENTIFIED AND DATA IS 2442 01:37:47,695 --> 01:37:52,399 COLLECTED, I CAN ASSURE EVERYONE 2443 01:37:52,466 --> 01:37:56,737 THAT PRIVACY IS THE BIGGEST 2444 01:37:56,804 --> 01:37:57,938 CONCERN AND WE MAKE EVERYTHING 2445 01:37:58,005 --> 01:38:05,179 THAT WE CAN TO PROTECT THE 2446 01:38:05,246 --> 01:38:07,815 PARTICIPANTS OF THE STUDY. 2447 01:38:07,881 --> 01:38:09,350 >> THANK YOU. 2448 01:38:09,416 --> 01:38:09,683 LARRY? 2449 01:38:09,750 --> 01:38:11,118 >> A COUPLE THINGS. 2450 01:38:11,185 --> 01:38:13,287 IN YOUR MODELS DID THEY ALLOW 2451 01:38:13,354 --> 01:38:18,759 YOU TO PREDICT OR DETECT 2452 01:38:18,826 --> 01:38:19,293 CAUSALITY? 2453 01:38:19,360 --> 01:38:23,063 CAN YOU SEE POOR SLEEP CAUSES OR 2454 01:38:23,130 --> 01:38:24,999 LEADS TO OBESITY? 2455 01:38:25,065 --> 01:38:29,103 >> SO THESE ARE ASSOCIATED 2456 01:38:29,169 --> 01:38:29,336 MODELS. 2457 01:38:29,403 --> 01:38:31,138 THEY DO NOT POINT TO CAUSALITY. 2458 01:38:31,205 --> 01:38:32,806 THAT'S WHY I THINK IT'S 2459 01:38:32,873 --> 01:38:33,907 IMPORTANT TO EMPHASIZE THESE 2460 01:38:33,974 --> 01:38:37,344 MODELS SET THE STAGE FOR MORE 2461 01:38:37,411 --> 01:38:38,379 EXPERIMENTAL APPROACHES. 2462 01:38:38,445 --> 01:38:40,781 THEY ARE NUANCED. 2463 01:38:40,848 --> 01:38:43,050 WE CAN DESIGN BUILDING UPON 2464 01:38:43,117 --> 01:38:44,418 THESE RESULTS. 2465 01:38:44,485 --> 01:38:46,020 CAREFULLY CONTROLLED 2466 01:38:46,086 --> 01:38:47,321 EXPERIMENTS. 2467 01:38:47,388 --> 01:38:49,823 IN THE FUTURE, HOWEVER, THIS 2468 01:38:49,890 --> 01:38:51,692 DATA IS NOT MEANT TO BE CAUSAL, 2469 01:38:51,759 --> 01:38:53,694 POINT TO CAUSALITY IN THE 2470 01:38:53,761 --> 01:38:55,162 FUTURE, START FORECASTING THE 2471 01:38:55,229 --> 01:38:56,697 FUTURE I THINK WE GET A CHANCE 2472 01:38:56,764 --> 01:39:03,203 TO BE A LITTLE BIT MORE 2473 01:39:03,270 --> 01:39:05,039 CONFIDENT IN OUR -- IN THE 2474 01:39:05,105 --> 01:39:06,407 IMPACT OF THE PREDICTORS. 2475 01:39:06,473 --> 01:39:08,375 HOWEVER, AT THIS POINT I WOULD 2476 01:39:08,442 --> 01:39:13,213 SAY, NO, THIS IS NOT MEANT TO BE 2477 01:39:13,280 --> 01:39:14,048 CAUSAL. 2478 01:39:14,114 --> 01:39:14,315 >> OKAY. 2479 01:39:14,381 --> 01:39:16,050 CLEARLY THERE'S CONCERN OBESITY 2480 01:39:16,116 --> 01:39:19,620 IS INCREASING ON AMONG 2481 01:39:19,687 --> 01:39:20,421 ADOLESCENTS, EPIDEMIC 2482 01:39:20,487 --> 01:39:22,589 PROPORTIONS, NOT SURE IF ABCD 2483 01:39:22,656 --> 01:39:24,391 HAS THE CAPABILITY TO DETECT 2484 01:39:24,458 --> 01:39:28,595 THAT, LOOK AT THOSE TRENDS OVER 2485 01:39:28,662 --> 01:39:28,929 TIME. 2486 01:39:28,996 --> 01:39:30,397 >> ABCD IS LOOKING AT TRENDS 2487 01:39:30,464 --> 01:39:31,832 OVER TIME. 2488 01:39:31,899 --> 01:39:37,438 THIS IS A STUDY FOR TEN YEARS, 2489 01:39:37,504 --> 01:39:38,839 VERY GOOD RETENTION RATES. 2490 01:39:38,906 --> 01:39:41,875 AND WE'RE LOOKING INTO THE 2491 01:39:41,942 --> 01:39:43,344 TRAJECTORIES. 2492 01:39:43,410 --> 01:39:46,513 THE DATA IS CURRENTLY AVAILABLE 2493 01:39:46,580 --> 01:39:48,449 DATA, COVERS THE FIRST THREE 2494 01:39:48,515 --> 01:39:51,418 YEARS AND A HALF AND HOPEFULLY 2495 01:39:51,485 --> 01:39:54,488 SOON THE FIRST FOUR YEARS OF THE 2496 01:39:54,555 --> 01:39:57,057 ABCD STUDY, AND WE KEEP GOING 2497 01:39:57,124 --> 01:39:57,925 COLLECTING DATA SO, YES, I THINK 2498 01:39:57,991 --> 01:39:59,426 YOU CAN SAY IN THE FUTURE WE'LL 2499 01:39:59,493 --> 01:40:02,563 HAVE A LOT MORE CLEAR 2500 01:40:02,629 --> 01:40:03,630 UNDERSTANDING ABOUT THE 2501 01:40:03,697 --> 01:40:07,768 DEVELOPMENT OF OBESITY. 2502 01:40:07,835 --> 01:40:09,370 >> ONE MORE QUICK THING. 2503 01:40:09,436 --> 01:40:11,705 >> YES, PARTICIPANTS WERE 2504 01:40:11,772 --> 01:40:17,144 ENROLLED, THEY BECAME NINE AND 2505 01:40:17,211 --> 01:40:18,679 TEN YEARS OLD AND WE'RE 2506 01:40:18,746 --> 01:40:20,614 FOLLOWING THEM TO YOUNG 2507 01:40:20,681 --> 01:40:21,749 ADULTHOOD HOPEFULLY. 2508 01:40:21,815 --> 01:40:22,483 >> TODD, THERE'S A QUESTION IN 2509 01:40:22,549 --> 01:40:25,586 THE CHAT IF YOU WANT TO RELAY 2510 01:40:25,652 --> 01:40:26,086 IT. 2511 01:40:26,153 --> 01:40:27,788 >> YEAH, SO ONE QUESTION IS WHAT 2512 01:40:27,855 --> 01:40:28,822 SLEEP REGULARITY MEASURES DID 2513 01:40:28,889 --> 01:40:31,358 YOU USE TO DEVELOP THE SLEEP 2514 01:40:31,425 --> 01:40:34,027 TIMING ASSOCIATIONS? 2515 01:40:34,094 --> 01:40:34,962 >> VERY GOOD QUESTION. 2516 01:40:35,028 --> 01:40:36,296 THIS IS A MACHINE LEARNING 2517 01:40:36,363 --> 01:40:39,566 APPROACH SO I'M NOT LIMITED TO 2518 01:40:39,633 --> 01:40:43,303 CALCULATING A FEW PREDICTORS AND 2519 01:40:43,370 --> 01:40:45,272 I CALCULATE VARIABILITY MEASURES 2520 01:40:45,339 --> 01:40:47,541 CONSIDERING WIDE RANGE OF 2521 01:40:47,608 --> 01:40:49,443 POTENTIAL WEIGHT, MOST RELEVANT 2522 01:40:49,510 --> 01:40:53,113 ONES IN THIS PARTICULAR 2523 01:40:53,180 --> 01:40:54,681 ANALYSIS, MAIN SEQUENTIAL 2524 01:40:54,748 --> 01:40:56,550 STANDARD ERROR THAT COVERS 2525 01:40:56,617 --> 01:40:58,952 DAY-TO-DAY VARIABILITY QUITE 2526 01:40:59,019 --> 01:41:03,690 WELL, BUT IN SOME DEFINING 2527 01:41:03,757 --> 01:41:04,858 VARIABILITY DIFFERENTLY, 2528 01:41:04,925 --> 01:41:05,526 SOMETIMES USING STANDARD 2529 01:41:05,592 --> 01:41:06,326 DEVIATION EVEN. 2530 01:41:06,393 --> 01:41:09,663 >> THANK YOU. 2531 01:41:09,730 --> 01:41:12,099 ONE MORE QUICK QUESTION. 2532 01:41:12,166 --> 01:41:14,001 CAN YOU SPEAK TO THE 2533 01:41:14,067 --> 01:41:15,002 ASSOCIATIONS BETWEEN SCREEN TIME 2534 01:41:15,068 --> 01:41:20,407 AND SLEEP OUTCOMES IN THE ABCD? 2535 01:41:20,474 --> 01:41:21,108 >> YES. 2536 01:41:21,175 --> 01:41:23,010 ACTUALLY IN BETWEEN THOSE, IF WE 2537 01:41:23,076 --> 01:41:29,249 COULD SEE THAT THE SCREEN USE 2538 01:41:29,316 --> 01:41:31,785 ESPECIALLY DURING THE PANDEMIC 2539 01:41:31,852 --> 01:41:33,353 VERY IMPORTANT IN PREDICTOR OF 2540 01:41:33,420 --> 01:41:35,656 MENTAL HEALTH, SO WE DO HAVE 2541 01:41:35,722 --> 01:41:38,826 LOTS OF FOLLOW-UP STUDIES THAT 2542 01:41:38,892 --> 01:41:41,128 SHOW SCREEN USE IN ADOLESCENTS 2543 01:41:41,195 --> 01:41:46,700 HAS A VERY IMPORTANT ROLE IN 2544 01:41:46,767 --> 01:41:50,003 MENTAL HEALTHMENT . 2545 01:41:50,070 --> 01:41:52,306 WE HAVE LOTS OF STUDIES 2546 01:41:52,372 --> 01:41:53,807 PUBLISHED AROUND THOSE 2547 01:41:53,874 --> 01:42:01,715 QUESTIONS, HOPING TO APPLY 2548 01:42:01,782 --> 01:42:03,517 MACHINE LEARNING. 2549 01:42:03,584 --> 01:42:04,952 THIS POPULATION IS NOT WELL 2550 01:42:05,018 --> 01:42:05,686 CHARACTERIZED. 2551 01:42:05,752 --> 01:42:06,487 >> THANK YOU. 2552 01:42:06,553 --> 01:42:08,555 WE HAVE TO MOVE ON. 2553 01:42:08,622 --> 01:42:14,027 THANK YOU VERY MUCH, DR. KISS. 2554 01:42:14,094 --> 01:42:15,062 NEXT SPEAKER ADAM SPIRA, 2555 01:42:15,128 --> 01:42:17,097 PROFESSOR AND VICE CHAIR FOR 2556 01:42:17,164 --> 01:42:19,066 RESEARCH AND FACULTY, DEPARTMENT 2557 01:42:19,132 --> 01:42:20,634 OF MENTAL HEALTH, JOHNS HOPKINS 2558 01:42:20,701 --> 01:42:23,070 BLOOMBERG SCHOOL OF PUBLIC 2559 01:42:23,136 --> 01:42:23,303 HEALTH. 2560 01:42:23,370 --> 01:42:24,037 JOINT APPOINTMENT IN DEPARTMENT 2561 01:42:24,104 --> 01:42:25,138 OF PSYCHIATRY AND BEHAVIORAL 2562 01:42:25,205 --> 01:42:26,940 SCIENCES AT THE JOHNS HOPKINS 2563 01:42:27,007 --> 01:42:28,075 SCHOOL OF MEDICINE. 2564 01:42:28,141 --> 01:42:28,909 CORE FACULTY OF THE JOHNS 2565 01:42:28,976 --> 01:42:31,545 HOPKINS CENTER ON AGING AND 2566 01:42:31,612 --> 01:42:31,778 HEALTH. 2567 01:42:31,845 --> 01:42:34,715 TRAINING IN CLINICAL PSYCHOLOGY 2568 01:42:34,781 --> 01:42:35,616 AND EPIDEMIOLOGY, RESEARCH 2569 01:42:35,682 --> 01:42:37,584 FOCUSES ON ASSOCIATION OF SLEEP 2570 01:42:37,651 --> 01:42:39,520 DISTURBANCE WITH COGNITIVE AND 2571 01:42:39,586 --> 01:42:41,188 FUNCTIONAL DECLINE IN 2572 01:42:41,255 --> 01:42:41,889 ALZHEIMER'S DISEASE. 2573 01:42:41,955 --> 01:42:44,525 HE WILL BE SPEAKING ABOUT BIG 2574 01:42:44,591 --> 01:42:46,894 DATA AND SLEEP, FINDINGS ACROSS 2575 01:42:46,960 --> 01:42:52,799 ADULTHOOD. 2576 01:42:52,866 --> 01:42:58,805 >> THANK YOU VERY MUCH. 2577 01:42:58,872 --> 01:43:01,708 THANKS FOR THE INVITATION. 2578 01:43:01,775 --> 01:43:04,077 NEXT SLIDE PLEASE. 2579 01:43:04,144 --> 01:43:05,279 SOME DISCLOSURES TO REVIEW 2580 01:43:05,345 --> 01:43:07,948 BRIEFLY. 2581 01:43:12,619 --> 01:43:14,221 NEXT SLIDE PLEASE. 2582 01:43:14,288 --> 01:43:17,090 SO, AS YOU LIKELY KNOW, THE 2583 01:43:17,157 --> 01:43:17,691 POPULATION IS AGING. 2584 01:43:17,758 --> 01:43:20,427 IF YOU LOOK AT THIS TABLE ON THE 2585 01:43:20,494 --> 01:43:21,995 LEFT, YOU CAN SEE THAT 2586 01:43:22,062 --> 01:43:24,264 BEGINNING -- IF YOU LOOK AT 2012 2587 01:43:24,331 --> 01:43:26,066 OVER 40 MILLION PEOPLE AGE 65 2588 01:43:26,133 --> 01:43:29,870 AND OLDER IN THE UNITED STATES. 2589 01:43:29,937 --> 01:43:33,574 AND BY 2050 PROJECTED TO DOUBLE 2590 01:43:33,640 --> 01:43:36,343 BEYOND 80 MILLION. 2591 01:43:36,410 --> 01:43:37,611 I RECENTLY SAW A NEWER FIGURE 2592 01:43:37,678 --> 01:43:38,278 EVEN HIGHER THAN THAT. 2593 01:43:38,345 --> 01:43:40,747 THIS IS IMPORTANT WITH RESPECT 2594 01:43:40,814 --> 01:43:43,584 TO DEMENTIA, BECAUSE DEMENTIA IS 2595 01:43:43,650 --> 01:43:44,952 PREVALENT AMONG OLDER ADULTS. 2596 01:43:45,018 --> 01:43:48,488 ALZHEIMER'S DISEASE IS THE MOST 2597 01:43:48,555 --> 01:43:51,224 COMMON CAUSE. 2598 01:43:51,291 --> 01:43:52,526 IT'S CHARACTERIZED BY 2599 01:43:52,593 --> 01:43:55,596 EXTRACELLULAR BETA AMYLOID 2600 01:43:55,662 --> 01:43:57,064 PRACTICALS, INTRANEURONAL 2601 01:43:57,130 --> 01:44:01,168 FIBRILLARY TANGLES, MADE OF TAU, 2602 01:44:01,234 --> 01:44:03,904 PHOSPHORYLATED TAU, AND IT'S 2603 01:44:03,971 --> 01:44:07,808 ESTIMATED THAT IN 2010 THERE 2604 01:44:07,874 --> 01:44:09,643 WERE 4.7 MILLION U.S. ADULTS 65 2605 01:44:09,710 --> 01:44:14,114 AND OLDER WITH A.D. AND BY 2050 2606 01:44:14,181 --> 01:44:17,584 WE EXPECT TO SEE ALMOST 14 2607 01:44:17,651 --> 01:44:17,818 MILLION. 2608 01:44:17,884 --> 01:44:19,586 AND IT'S CRITICALLY IMPORTANT AS 2609 01:44:19,653 --> 01:44:22,489 A PUBLIC HEALTH CONCERN BECAUSE 2610 01:44:22,556 --> 01:44:24,024 THERE'S NO CURE FOR ALZHEIMER'S 2611 01:44:24,091 --> 01:44:26,393 DISEASE AND DEMENTIA. 2612 01:44:26,460 --> 01:44:29,863 SO PREVENTION IS CRITICAL. 2613 01:44:29,930 --> 01:44:31,498 NEXT SLIDE PLEASE. 2614 01:44:31,565 --> 01:44:32,666 SO YOU MIGHT ASK, WELL, WHAT 2615 01:44:32,733 --> 01:44:37,471 DOES THIS HAVE TO DO WITH SLEEP? 2616 01:44:37,537 --> 01:44:39,072 AND SLEEP DISTURBANCES ARE 2617 01:44:39,139 --> 01:44:42,876 COMMON IN OLDER ADULTS BROADLY. 2618 01:44:42,943 --> 01:44:44,111 POOR SLEEP IS INCREASINGLY 2619 01:44:44,177 --> 01:44:49,416 LINKED TO POOR LATER LIFE HEALTH 2620 01:44:49,483 --> 01:44:51,118 OUTCOMES, INCLUDING COGNITIVE 2621 01:44:51,184 --> 01:44:53,887 DECLINE, FUNCTIONAL DECLINE, 2622 01:44:53,954 --> 01:44:55,689 ALZHEIMER'S DISEASE PATHOLOGY 2623 01:44:55,756 --> 01:45:01,094 AND DEMENTIAS DUE TO ALZHEIMER'S 2624 01:45:01,161 --> 01:45:02,329 DISEASE AND ALZHEIMER'S 2625 01:45:02,396 --> 01:45:02,929 DISEASE-RELATED DEMENTIA 2626 01:45:02,996 --> 01:45:03,597 DISEASES. 2627 01:45:03,664 --> 01:45:06,633 SLEEP DISTURBANCE IS TREATABLE 2628 01:45:06,700 --> 01:45:08,602 OFTEN, MAKING SLEEP DISTURBANCE 2629 01:45:08,669 --> 01:45:10,437 POTENTIAL MODIFIABLE RISK FACTOR 2630 01:45:10,504 --> 01:45:14,975 FOR DEMENTIA. 2631 01:45:15,042 --> 01:45:16,343 NEXT SLIDE PLEASE. 2632 01:45:16,410 --> 01:45:23,884 PEOPLE HAVE THOUGHT ABOUT THE 2633 01:45:23,950 --> 01:45:24,985 LINK BETWEEN NEURODEGENERATIVE 2634 01:45:25,052 --> 01:45:29,356 DISEASE AND SLEEP MODEL, THIS IS 2635 01:45:29,423 --> 01:45:32,526 LIKELY BECAUSE OF THE 2636 01:45:32,592 --> 01:45:34,261 SIGNIFICANT SALIENT SLEEP/WAKE 2637 01:45:34,327 --> 01:45:38,865 PROBLEMS OBSERVED AMONG PEOPLE 2638 01:45:38,932 --> 01:45:40,100 WITH CLINICAL ALZHEIMER'S 2639 01:45:40,167 --> 01:45:43,336 DISEASE AND RELATED DEMENTIA, A 2640 01:45:43,403 --> 01:45:44,971 MAJOR STRESSOR FOR DEMENTIA, 2641 01:45:45,038 --> 01:45:47,007 FAMILY CAREGIVERS, ONE OF THE 2642 01:45:47,074 --> 01:45:49,242 REASONS THAT THOSE CAREGIVERS 2643 01:45:49,309 --> 01:45:50,677 GIVE FOR HAVING PLACED THEIR 2644 01:45:50,744 --> 01:45:56,016 LOVED ONES IN A LONG-TERM CARE 2645 01:45:56,083 --> 01:45:56,917 FACILITY. 2646 01:45:56,983 --> 01:45:57,617 COMMONLY. 2647 01:45:57,684 --> 01:46:00,320 AND SO IT'S NOT SURPRISING THAT 2648 01:46:00,387 --> 01:46:01,321 THIS HAS BEEN THE MOST OBVIOUS 2649 01:46:01,388 --> 01:46:04,291 WAY TO THINK ABOUT THE LINK 2650 01:46:04,357 --> 01:46:04,825 BETWEEN NEURODEGENERATIVE 2651 01:46:04,891 --> 01:46:07,761 DISEASE AND SLEEP/WAKE 2652 01:46:07,828 --> 01:46:09,329 DISTURBANCE. 2653 01:46:09,396 --> 01:46:09,963 NEXT SLIDE PLEASE. 2654 01:46:10,030 --> 01:46:14,167 HERE YOU SEE AN OLD EXAMPLE OF 2655 01:46:14,234 --> 01:46:16,570 SOME BIG DATA FROM 2656 01:46:16,636 --> 01:46:18,071 ACCELEROMETRY, A SMALL END STUDY 2657 01:46:18,138 --> 01:46:23,577 MORE OF A CASE STUDY. 2658 01:46:23,643 --> 01:46:31,685 AT THE TOP WE SEE THIS TIME 2659 01:46:31,752 --> 01:46:32,986 SERIES OF ACCELEROMETER DATA 2660 01:46:33,053 --> 01:46:34,821 WITH ACTIVITY COUNTS REPRESENTED 2661 01:46:34,888 --> 01:46:37,591 BY THESE BLACK BARS, VERTICAL 2662 01:46:37,657 --> 01:46:38,692 BARS, OVER A NIGHT. 2663 01:46:38,759 --> 01:46:44,197 IN THE TOP PANEL YOU SEE A 2664 01:46:44,264 --> 01:46:47,100 REALLY FRAGMENTED PATTERN, 2665 01:46:47,167 --> 01:46:49,469 WITH -- IT'S HARD TO FIND 2666 01:46:49,536 --> 01:46:50,704 PERIODS OF REST OR CONTINUOUS 2667 01:46:50,771 --> 01:46:52,973 PERIODS OF ACTIVITY HERE. 2668 01:46:53,039 --> 01:46:56,910 THERE'S A LOT OF FRAGMENTATION. 2669 01:46:56,977 --> 01:47:00,480 BOTTOM PANEL YOU CAN SEE A 2670 01:47:00,547 --> 01:47:04,284 PERIOD OF RELATIVE QUIET, 2671 01:47:04,351 --> 01:47:06,486 BEHAVIORAL OR MOTOR IMMOBILITY 2672 01:47:06,553 --> 01:47:09,723 BETWEEN AROUND 11:30 P.M. AND 2673 01:47:09,790 --> 01:47:11,825 4:30 OR SO A.M. 2674 01:47:11,892 --> 01:47:14,861 AND WE MIGHT ASSUME THAT HAS TO 2675 01:47:14,928 --> 01:47:15,929 BE -- LIKELY WHERE SLEEP 2676 01:47:15,996 --> 01:47:19,533 OCCURRED BUT THIS IS JUST TO 2677 01:47:19,599 --> 01:47:21,201 ILLUSTRATE SLEEP/WAKE 2678 01:47:21,268 --> 01:47:23,770 DISTURBANCES CAN CERTAINLY BE 2679 01:47:23,837 --> 01:47:26,706 PROMINENT IN PEOPLE WITH 2680 01:47:26,773 --> 01:47:27,808 DEMENTIAING ILLNESS LIKELY I DO 2681 01:47:27,874 --> 01:47:31,845 OF -- DUE IN PART TO CHANGES IN 2682 01:47:31,912 --> 01:47:35,949 THE BRAIN. 2683 01:47:36,016 --> 01:47:37,951 NEXT PLEASE. 2684 01:47:38,018 --> 01:47:39,686 A STUDY IN ALZHEIMER'S DISEASE 2685 01:47:39,753 --> 01:47:42,355 MOUSE MODEL BY ROWE AND 2686 01:47:42,422 --> 01:47:44,858 COLLEAGUES FROM THE GROUP AT 2687 01:47:44,925 --> 01:47:47,861 WashU SHOWED IN AN A.D. MOUSE 2688 01:47:47,928 --> 01:47:51,331 AS AMYLOID BEGINS TO AGGREGATE 2689 01:47:51,398 --> 01:47:57,871 THERE'S A LOSS OF THE SLEEP/WAKE 2690 01:47:57,938 --> 01:47:58,071 CYCLE. 2691 01:47:58,138 --> 01:47:59,472 SO, AGAIN, NOT SURPRISING THAT 2692 01:47:59,539 --> 01:48:01,575 PEOPLE WOULD START TO -- WOULD 2693 01:48:01,641 --> 01:48:03,009 THINK ABOUT BRAIN CHANGES 2694 01:48:03,076 --> 01:48:05,312 LEADING TO POOR SLEEP. 2695 01:48:05,378 --> 01:48:09,216 HOWEVER, IF YOU CLICK ON THE 2696 01:48:09,282 --> 01:48:10,684 NEXT SLIDE PLEASE, THERE STARTED 2697 01:48:10,750 --> 01:48:12,986 TO EMERGE STUDIES IN THE LAST 20 2698 01:48:13,053 --> 01:48:14,387 YEARS THAT REALLY HAVE CHANGED 2699 01:48:14,454 --> 01:48:17,724 THE WAY WE'VE BEEN THINKING 2700 01:48:17,791 --> 01:48:18,391 ABOUT SLEEP DISTURBANCE AND 2701 01:48:18,458 --> 01:48:19,092 ALZHEIMER'S DISEASE. 2702 01:48:19,159 --> 01:48:24,397 THIS IS A FIGURE FROM A PAPER BY 2703 01:48:24,464 --> 01:48:30,036 ANDREW LIM AND COLLEAGUES. 2704 01:48:30,103 --> 01:48:35,942 IN 737 ADULTS AGE 8 2 AT 2705 01:48:36,009 --> 01:48:38,278 BASELINE, FOLLOWED WITH 2706 01:48:38,345 --> 01:48:44,818 ACCELEROMETRY AND DEVELOPED A 2707 01:48:44,885 --> 01:48:47,320 FRAGMENTATION INDEX, IT'S A 2708 01:48:47,387 --> 01:48:48,421 PROBABILISTIC EQUATION THAT 2709 01:48:48,488 --> 01:48:49,289 LOOKS AT PROBABILITY OF 2710 01:48:49,356 --> 01:48:54,261 TRANSITIONING FROM REST TO 2711 01:48:54,327 --> 01:48:54,828 ACTIVITY. 2712 01:48:54,895 --> 01:48:56,296 AND INFERS SLEEP FRAGMENTATION 2713 01:48:56,363 --> 01:48:56,830 FROM THAT. 2714 01:48:56,897 --> 01:48:58,865 OVER 3.3 YEARS OF FOLLOW-UP THEY 2715 01:48:58,932 --> 01:49:01,668 SHOWED THAT FOR EVERY STANDARD 2716 01:49:01,735 --> 01:49:04,004 DEVIATION INCREASE IN THIS KRA 2717 01:49:04,070 --> 01:49:08,441 METRIC, RISK OF INCIDENT 2718 01:49:08,508 --> 01:49:09,142 ALZHEIMER'S DEMENTIA DIAGNOSED 2719 01:49:09,209 --> 01:49:13,813 CLINICALLY USING STRICT RESEARCH 2720 01:49:13,880 --> 01:49:16,683 STANDARDS INCREASED BY 22% PER 2721 01:49:16,750 --> 01:49:18,251 INCREASE OF KRA METRIC, SHOWING 2722 01:49:18,318 --> 01:49:21,922 IF YOU LOOK AT THE SOLID LINE, 2723 01:49:21,988 --> 01:49:24,791 THAT REPRESENTS PEOPLE IN THE 2724 01:49:24,858 --> 01:49:30,130 90th PERCENTILE OF THIS KRA 2725 01:49:30,196 --> 01:49:31,898 FRAGMENTATION, AND THEY HAD 1 2726 01:49:31,965 --> 01:49:34,367 1/2 TIMES THE RISK OF INCIDENT 2727 01:49:34,434 --> 01:49:36,703 ALZHEIMER'S DEMENTIA COMPARED TO 2728 01:49:36,770 --> 01:49:38,872 THOSE WITH TENTH PERCENTILE IN 2729 01:49:38,939 --> 01:49:43,476 THE DOTTED LINE. 2730 01:49:43,543 --> 01:49:45,512 NEXT SLIDE PLEASE. 2731 01:49:45,578 --> 01:49:50,817 SO, THIS IS -- THE ONE ON LEFT 2732 01:49:50,884 --> 01:49:53,019 SAYING SLEEP FRAGMENTATION, 2733 01:49:53,086 --> 01:49:54,120 SUPPOSED SLEEP FRAGMENTATION, 2734 01:49:54,187 --> 01:49:55,522 BAD BRAIN HEALTH OUTCOME, 2735 01:49:55,588 --> 01:49:56,957 DEMENTIA. 2736 01:49:57,023 --> 01:50:01,661 IN THE MIDDLE A PAPER THAT I 2737 01:50:01,728 --> 01:50:02,963 CO-AUTHORED IN 2011, LOOKED AT 2738 01:50:03,029 --> 01:50:04,631 THE ASSOCIATION BETWEEN SLEEP 2739 01:50:04,698 --> 01:50:06,199 DISORDERED BREATHING AND 2740 01:50:06,266 --> 01:50:09,069 SUBSEQUENT MCI OR DEMENTIA, IN 2741 01:50:09,135 --> 01:50:11,504 OLDER WOMEN. 2742 01:50:11,571 --> 01:50:15,008 STUDY OF OSTEOPOROTIC FRACTURE 2743 01:50:15,075 --> 01:50:15,508 IT'S. 2744 01:50:15,575 --> 01:50:20,246 THERE WERE 298, MEAN AGE OF 82. 2745 01:50:20,313 --> 01:50:22,315 MEDIAN AHI OF 10. 2746 01:50:22,382 --> 01:50:25,352 35% OF THEM HAD AN AHI OF 15+ 2747 01:50:25,418 --> 01:50:26,419 WHICH WE CONSIDERED SLEEP 2748 01:50:26,486 --> 01:50:28,922 DISORDERED BREATHING TO BE 2749 01:50:28,989 --> 01:50:29,723 POSITIVE FOR SVB. 2750 01:50:29,789 --> 01:50:33,293 AND COMPARED TO THOSE WHO DID 2751 01:50:33,360 --> 01:50:37,864 NOT HAVE SVB, THEY HAD 85% 2752 01:50:37,931 --> 01:50:40,000 GREATER ODDS OF HAVING MCI OR 2753 01:50:40,066 --> 01:50:42,669 DEMENTIA, FIVE YEARS LATER. 2754 01:50:42,736 --> 01:50:48,341 AND IT REALLY APPEARED TO BE 2755 01:50:48,408 --> 01:50:49,576 HYPOXEMIA THAT EXPLAINED THAT 2756 01:50:49,642 --> 01:50:50,110 ASSOCIATION. 2757 01:50:50,176 --> 01:50:53,113 WE DIDN'T SEE ASSOCIATIONS OF 2758 01:50:53,179 --> 01:50:54,714 SLEEP DURATION OR SLEEP 2759 01:50:54,781 --> 01:50:57,283 FRAGMENTATION WITH THAT OUTCOME. 2760 01:50:57,350 --> 01:51:00,120 SO SLEEP DISORDERED BREATHING, 2761 01:51:00,186 --> 01:51:01,621 NOT SURPRISING, BAD FOR THE 2762 01:51:01,688 --> 01:51:02,822 BRAIN, THE TAKEAWAY THERE. 2763 01:51:02,889 --> 01:51:05,859 ALONG WITH A LOT OF OTHER 2764 01:51:05,925 --> 01:51:07,227 STUDIES IN THAT DIRECTION. 2765 01:51:07,293 --> 01:51:09,429 YOU LOOK AT THE STUDIES LIKE 2766 01:51:09,496 --> 01:51:11,331 THIS, YOU THINK TO YOURSELF, 2767 01:51:11,398 --> 01:51:12,332 WELL, COULDN'T THIS BE CHANGES 2768 01:51:12,399 --> 01:51:16,236 IN THE BRAIN ARE LEADING TO BOTH 2769 01:51:16,302 --> 01:51:19,039 POOR SLEEP PROBLEMS, POOR SLEEP, 2770 01:51:19,105 --> 01:51:20,640 BROADLY, EVEN RESPIRATORY 2771 01:51:20,707 --> 01:51:22,175 CHANGES DURING SLEEP, AND POOR 2772 01:51:22,242 --> 01:51:24,077 COGNITIVE OUTCOMES. 2773 01:51:24,144 --> 01:51:28,081 YES, THAT'S PLAUSIBLE. 2774 01:51:28,148 --> 01:51:31,751 BUT IN 2009, NEXT SLIDE PLEASE, 2775 01:51:31,818 --> 01:51:32,685 THE GROUP AT WashU SHOWED US 2776 01:51:32,752 --> 01:51:37,023 IF YOU LOOK AT THE TOP FIGURE 2777 01:51:37,090 --> 01:51:38,391 HERE IF YOU SLEEP DEPRIVE 2778 01:51:38,458 --> 01:51:40,593 ALZHEIMER'S DISEASE MOUSE MODEL 2779 01:51:40,660 --> 01:51:41,828 YOU'LL GET MARKEDLY GREATER 2780 01:51:41,895 --> 01:51:43,129 AMYLOID PLAQUE BURDEN IN THE 2781 01:51:43,196 --> 01:51:45,732 BRAINS OF THOSE MICE. 2782 01:51:45,799 --> 01:51:48,601 AND THE BLACK BARS INDICATE THE 2783 01:51:48,668 --> 01:51:50,870 PERCENT PLAQUE BURDEN IN SLEEP 2784 01:51:50,937 --> 01:51:52,806 RESTRICTED MICE AND WHITE BARS 2785 01:51:52,872 --> 01:51:54,074 ARE THE CONTROLS. 2786 01:51:54,140 --> 01:51:57,710 AND THIS WAS EXCITING BECAUSE IT 2787 01:51:57,777 --> 01:52:01,214 PROVIDED THE FIRST EVIDENCE OF A 2788 01:52:01,281 --> 01:52:02,949 CAUSAL LINK BETWEEN INSUFFICIENT 2789 01:52:03,016 --> 01:52:06,419 SLEEP, SLEEP LOSS, OR SLEEP 2790 01:52:06,486 --> 01:52:09,189 RESTRICTION I GUESS, AND 2791 01:52:09,255 --> 01:52:13,226 ALZHEIMER'S DISEASE. 2792 01:52:13,293 --> 01:52:15,762 IN MARK WU'S LAB AT JOHNS 2793 01:52:15,829 --> 01:52:17,730 HOPKINS, A STUDY IN 2015 SHOWING 2794 01:52:17,797 --> 01:52:19,766 IN DROSOPHILA MODEL OF SLEEP OF 2795 01:52:19,833 --> 01:52:21,734 ALZHEIMER'S SHE'S, SORRY, 2796 01:52:21,801 --> 01:52:23,736 DROSOPHILA MODEL OF ALZHEIMER'S 2797 01:52:23,803 --> 01:52:26,106 DISEASE, THAT IF YOU SLEEP 2798 01:52:26,172 --> 01:52:29,142 DEPRIVE THESE FLIES, YOU GET 2799 01:52:29,209 --> 01:52:31,644 MARKEDLY GREATER AMYLOID 2800 01:52:31,711 --> 01:52:36,616 DEPOSITION IN THEIR BRAINS, THAN 2801 01:52:36,683 --> 01:52:38,485 IF YOU DON'T. 2802 01:52:38,551 --> 01:52:39,853 BOTTOM SLIDE, THAT'S WHEN THE 2803 01:52:39,919 --> 01:52:41,654 TUBES THEY LIVE IN ARE SHAKEN 2804 01:52:41,721 --> 01:52:47,494 DURING THE NIGHT HOURS WHEN THEY 2805 01:52:47,560 --> 01:52:49,395 WOULD ORDINARILY BE ASLEEP AND 2806 01:52:49,462 --> 01:52:53,299 AT THE TOP IS THE -- REPRESENTS 2807 01:52:53,366 --> 01:52:55,034 THE BRAIN OF THE FLIES WHO HAD 2808 01:52:55,101 --> 01:52:56,369 TUBES SHAKEN DURING THE DAY WHEN 2809 01:52:56,436 --> 01:52:58,471 THEY WERE AWAKE ANYWAY. 2810 01:52:58,538 --> 01:53:01,875 FURTHER EVIDENCE IN A DIFFERENT 2811 01:53:01,941 --> 01:53:08,948 SPECIES OF POTENTIAL CAUSAL 2812 01:53:09,015 --> 01:53:09,182 LINK. 2813 01:53:09,249 --> 01:53:10,650 GROWING LITERATURE INDICATES NOT 2814 01:53:10,717 --> 01:53:15,822 JUST A LINK OF NEURODEGENERATIVE 2815 01:53:15,889 --> 01:53:17,223 DISEASE TO SLEEP/WAKE 2816 01:53:17,290 --> 01:53:19,492 DISTURBANCE BUT ALSO, NEXT SLIDE 2817 01:53:19,559 --> 01:53:24,697 PLEASE, LINK IN THE OTHER 2818 01:53:24,764 --> 01:53:25,565 DIRECTION. 2819 01:53:25,632 --> 01:53:27,400 NOW WE KNOW THERE'S MORE STUDIES 2820 01:53:27,467 --> 01:53:29,869 COMING OUT TO SUPPORT A 2821 01:53:29,936 --> 01:53:31,070 BIDIRECTIONAL LINK BETWEEN 2822 01:53:31,137 --> 01:53:33,773 SLEEP/WAKE DISTURBANCE AND 2823 01:53:33,840 --> 01:53:34,874 ALZHEIMER'S DISEASE. 2824 01:53:34,941 --> 01:53:37,510 AND TODAY I'LL SHARE WITH YOU A 2825 01:53:37,577 --> 01:53:40,947 COUPLE OF STUDIES THAT I'VE BEEN 2826 01:53:41,014 --> 01:53:45,852 INVOLVED WITH THAT LEVERAGE BIG 2827 01:53:45,919 --> 01:53:47,453 DATA, USING POPULATION BASED 2828 01:53:47,520 --> 01:53:48,955 DATA, ANOTHER FROM 2829 01:53:49,022 --> 01:53:50,857 ACCELEROMETERS TO INVESTIGATE 2830 01:53:50,924 --> 01:53:54,561 LINKS BETWEEN SLEEP AND 2831 01:53:54,627 --> 01:53:54,961 DEMENTIA. 2832 01:53:55,028 --> 01:53:57,363 THIS IS A STUDY I COLLABORATED 2833 01:53:57,430 --> 01:53:59,766 ON WITH COLLEAGUES IN DENMARK 2834 01:53:59,832 --> 01:54:04,404 USING DATA FROM THE DANISH 2835 01:54:04,470 --> 01:54:05,838 NATIONAL PATIENT REGISTRY, 2836 01:54:05,905 --> 01:54:07,707 PSYCHIATRIC CENTRAL RESEARCH 2837 01:54:07,774 --> 01:54:11,177 REGISTER AND DANISH NATIONAL 2838 01:54:11,244 --> 01:54:12,545 PRESCRIPTION REGISTRY. 2839 01:54:12,612 --> 01:54:14,314 WE WANTED TO STUDY ASSOCIATION 2840 01:54:14,380 --> 01:54:16,549 OF SLEEP DISORDER DIAGNOSIS IN 2841 01:54:16,616 --> 01:54:18,351 MID-LIFE STARTING IN MID-LIFE, 2842 01:54:18,418 --> 01:54:21,187 FROM AGE 50 ON, WITH RISK OF 2843 01:54:21,254 --> 01:54:23,022 DEMENTIA AT AGE 65 AND OLDER. 2844 01:54:23,089 --> 01:54:25,391 WE CLOSE THAT BECAUSE THAT'S 2845 01:54:25,458 --> 01:54:27,627 LATE ONSET DEMENTIA, WHICH IS 2846 01:54:27,694 --> 01:54:31,464 BELIEVED TO BE A DISTINCT 2847 01:54:31,531 --> 01:54:33,333 DISEASE ENTITY OR COLLECTION OF 2848 01:54:33,399 --> 01:54:34,534 ENTITIES FROM EARLY ONSET 2849 01:54:34,601 --> 01:54:35,034 DEMENTIA. 2850 01:54:35,101 --> 01:54:37,270 WE STUDY PEOPLE IN THAT AGE 2851 01:54:37,337 --> 01:54:40,440 RANGE WITH REGISTERED DATA AFTER 2852 01:54:40,506 --> 01:54:42,041 EXCLUDING THOSE WHO DEVELOP 2853 01:54:42,108 --> 01:54:46,813 DEMENTIA IN THIS BIRTH COHORT 2854 01:54:46,879 --> 01:54:50,216 BEFORE THE AGE OF 65. 2855 01:54:50,283 --> 01:54:53,086 YOU CAN SEE SO ONE THING I WANT 2856 01:54:53,152 --> 01:54:55,321 TO POINT OUT IS THAT SLEEP 2857 01:54:55,388 --> 01:54:57,323 DISORDER DIAGNOSES IN THESE DATA 2858 01:54:57,390 --> 01:54:59,959 WERE ONLY AVAILABLE IN RECORDS 2859 01:55:00,026 --> 01:55:01,961 FROM HOSPITAL CONTACTS INCLUDING 2860 01:55:02,028 --> 01:55:04,397 OUTPATIENT VISITS, BUT THEY ARE 2861 01:55:04,464 --> 01:55:04,797 NOT PRIMARY CARE. 2862 01:55:04,864 --> 01:55:05,798 THIS IS A LIMITATION OF THE 2863 01:55:05,865 --> 01:55:07,367 STUDY THAT HAS TO BE CONSIDERED 2864 01:55:07,433 --> 01:55:16,109 WHEN WE INTERPRET THE RESULTS. 2865 01:55:16,175 --> 01:55:18,344 WE WANTED TO LOOK AT SEX 2866 01:55:18,411 --> 01:55:20,380 DIFFERENCES, DUE TO KNOWN SEX 2867 01:55:20,446 --> 01:55:21,281 DIFFERENCES IN BOTH SLEEP 2868 01:55:21,347 --> 01:55:29,589 DISTURBANCE AND IN DEMENTIA 2869 01:55:29,656 --> 01:55:29,789 RISK. 2870 01:55:29,856 --> 01:55:38,698 WE ENDED UP WITH JUST ABOUT 1.5 2871 01:55:38,765 --> 01:55:49,175 MILLION PEOPLE TO STUDY. 2872 01:55:52,245 --> 01:55:54,981 BASED ON ICD 8 AND 10 CODES, ONE 2873 01:55:55,048 --> 01:55:58,084 OF THEM, BROAD CATEGORIES WERE 2874 01:55:58,151 --> 01:56:07,760 SLEEP APNEA, NARCOLEPSY AND 2875 01:56:07,827 --> 01:56:10,330 CATAPLEXY, INSOMNIA VERY RARE AS 2876 01:56:10,396 --> 01:56:13,800 A DIAGNOSIS FROM THE HOSPITAL 2877 01:56:13,866 --> 01:56:14,767 RECORD, HYPERSOMNIA, DISORDERS 2878 01:56:14,834 --> 01:56:19,572 OF THE SLEEP/WAKE SCHEDULE, 2879 01:56:19,639 --> 01:56:20,340 PARASOMNIA, SLEEP-RELATED 2880 01:56:20,406 --> 01:56:22,342 MOVEMENT DISORDERS INCLUDING 2881 01:56:22,408 --> 01:56:25,545 PERIODIC LIMB MOVEMENT DISORDER, 2882 01:56:25,611 --> 01:56:28,381 BRUXISM, AND LEG CRAMPS. 2883 01:56:28,448 --> 01:56:30,750 NON-ORGANIC SLEEP DISORDERS, AND 2884 01:56:30,817 --> 01:56:31,851 OTHER -- SORRY, NON-ORGANIC 2885 01:56:31,918 --> 01:56:33,619 SLEEP DISORDERS. 2886 01:56:33,686 --> 01:56:36,089 ANOTHER CATEGORY, UNSPECIFIED 2887 01:56:36,155 --> 01:56:36,456 SLEEP DISORDERS. 2888 01:56:36,522 --> 01:56:39,192 THAT INCLUDED OTHER SLEEP 2889 01:56:39,258 --> 01:56:41,027 DISORDERS, AND WHICH WERE NOT IN 2890 01:56:41,094 --> 01:56:43,229 THE OTHER SPECIFIC SLEEP 2891 01:56:43,296 --> 01:56:48,334 DISORDERS GROUP, AND UNSPECIFIED 2892 01:56:48,401 --> 01:56:48,701 SLEEP DISORDER. 2893 01:56:48,768 --> 01:56:50,870 SO, I WANT TO POINT OUT THE SEX 2894 01:56:50,937 --> 01:56:51,904 DIFFERENCE HERE. 2895 01:56:51,971 --> 01:56:53,172 YOU CAN SEE MEN WERE MUCH MORE 2896 01:56:53,239 --> 01:56:56,109 LIKELY TO HAVE A SLEEP DISORDER 2897 01:56:56,175 --> 01:56:57,777 THAN WOMEN IN THIS STUDY. 2898 01:56:57,844 --> 01:57:00,046 THIS WAS LIKELY AMPLIFIED BY THE 2899 01:57:00,113 --> 01:57:02,815 NEAR ABSENCE OF INSOMNIA 2900 01:57:02,882 --> 01:57:05,785 DIAGNOSES FROM THESE REGISTERS. 2901 01:57:05,852 --> 01:57:06,753 INSOMNIA IS TREATED MORE 2902 01:57:06,819 --> 01:57:09,922 FREQUENTLY IN THE PRIMARY CARE 2903 01:57:09,989 --> 01:57:14,293 SETTING, FROM WHICH REGISTRY 2904 01:57:14,360 --> 01:57:16,562 DATA WERE NOT AVAILABLE. 2905 01:57:16,629 --> 01:57:17,630 NEXT SLIDE PLEASE. 2906 01:57:17,697 --> 01:57:21,768 AND WHAT YOU CAN SEE, WE 2907 01:57:21,834 --> 01:57:24,036 COMPUTED INCIDENT RATIOS FOR 2908 01:57:24,103 --> 01:57:29,475 DEMENTIA, ADJUSTED FOR AGE, SEX, 2909 01:57:29,542 --> 01:57:30,076 CALENDAR YEAR, EDUCATION, 2910 01:57:30,143 --> 01:57:32,378 SOMATIC COMORBIDITY, WE PUT 2911 01:57:32,445 --> 01:57:40,253 TOGETHER A CHARLESTON 2912 01:57:40,319 --> 01:57:42,822 COMORBIDITY INDEX AND 2913 01:57:42,889 --> 01:57:44,590 PSYCHIATRIC CO-MORBIDITY. 2914 01:57:44,657 --> 01:57:46,559 ANY SLEEP DISORDER, 17% GREATER 2915 01:57:46,626 --> 01:57:48,628 RISK OVER FOLLOW-UP OF 2916 01:57:48,694 --> 01:57:52,932 DEVELOPING DEMENTIA IN THOSE 2917 01:57:52,999 --> 01:57:53,332 ADJUSTED ANALYSES. 2918 01:57:53,399 --> 01:57:56,936 BY SEX YOU CAN SEE THIS WAS 2919 01:57:57,003 --> 01:58:00,406 DRIVEN MUCH MORE STRONGLY BY MEN 2920 01:58:00,473 --> 01:58:03,109 AND THEN WE LOOKED AT 2921 01:58:03,176 --> 01:58:05,445 NARCOLEPSY, WE DID NOT FIND A 2922 01:58:05,511 --> 01:58:06,179 SIGNIFICANT ASSOCIATION THAT 2923 01:58:06,245 --> 01:58:08,848 COULD HAVE BEEN DUE TO THE 2924 01:58:08,915 --> 01:58:11,217 RELATIVELY LOW NUMBER OF PEOPLE 2925 01:58:11,284 --> 01:58:21,828 WITH DIAGNOSED NARCOLEPSY IN THE 2926 01:58:25,565 --> 01:58:25,665 SAMPLE. 2927 01:58:25,731 --> 01:58:26,532 BREATHING WAS ASSOCIATED WITH 2928 01:58:26,599 --> 01:58:32,004 13% GREATER ODDS OF DEMENTIA, 2929 01:58:32,071 --> 01:58:40,880 REALLY DRIVEN BY MEN, ONLY IN 2930 01:58:40,947 --> 01:58:41,047 MEN. 2931 01:58:41,113 --> 01:58:47,253 OTHERS INCLUDED, WELL, THE MOST 2932 01:58:47,320 --> 01:58:48,387 STRONGLY ASSOCIATED WITH 2933 01:58:48,454 --> 01:58:48,654 DEMENTIA. 2934 01:58:48,721 --> 01:58:50,790 IF YOU HAD ANOTHER SPECIFIC 2935 01:58:50,857 --> 01:58:54,594 DISORDER YOU HAD 80% GREATER 2936 01:58:54,660 --> 01:58:55,862 RISK OF DEVELOPING DEMENTIA, 2937 01:58:55,928 --> 01:59:01,667 THIS MAY WELL HAVE BEEN DRIVEN 2938 01:59:01,734 --> 01:59:02,802 BY PARASOMNIA. 2939 01:59:02,869 --> 01:59:05,938 THE CATEGORY DROVE THIS ALMOST 2940 01:59:06,005 --> 01:59:06,239 ENTIRELY. 2941 01:59:06,305 --> 01:59:12,845 AND IT WAS -- WE KNOW REM SLEEP 2942 01:59:12,912 --> 01:59:14,447 BEHAVIOR FITS IN THAT CATEGORY, 2943 01:59:14,514 --> 01:59:17,517 THAT MAY BE WHAT'S ACCOUNTING 2944 01:59:17,583 --> 01:59:19,151 FOR THIS. 2945 01:59:19,218 --> 01:59:25,658 AND NO ASSOCIATION OF 2946 01:59:25,725 --> 01:59:26,125 UNSPECIFIED DISORDER. 2947 01:59:26,192 --> 01:59:28,995 THIS WAS AN INTERESTING EXERCISE 2948 01:59:29,061 --> 01:59:31,330 FOR ME, SLEEP RESEARCHER, JUST 2949 01:59:31,397 --> 01:59:33,533 GETTING INTO THIS ASPECT OF BIG 2950 01:59:33,599 --> 01:59:34,634 DATA, REALLY LARGE NUMBERS. 2951 01:59:34,700 --> 01:59:39,005 AND REST BLING WITH SOME OF THE 2952 01:59:39,071 --> 01:59:41,173 LIMITATIONS OF CERTAIN DATA 2953 01:59:41,240 --> 01:59:41,407 SOURCES. 2954 01:59:41,474 --> 01:59:51,517 AND THAT'S SOMETHING WE CAN TALK 2955 01:59:51,584 --> 01:59:52,318 ABOUT MORE. 2956 01:59:52,385 --> 01:59:55,354 BIG DATA ON A SMALL KALE, IT'S 2957 01:59:55,421 --> 01:59:59,358 TWO STUDIES. 2958 01:59:59,425 --> 02:00:00,359 NEXT SLIDE PLEASE. 2959 02:00:00,426 --> 02:00:03,429 THIS IS A STUDY WE DID, PAUL 2960 02:00:03,496 --> 02:00:05,064 ROSENBERG AND I, RECEIVED 2961 02:00:05,131 --> 02:00:08,234 FUNDING FROM NIA. 2962 02:00:08,301 --> 02:00:10,903 THANK YOU, NIA. 2963 02:00:10,970 --> 02:00:17,743 TO ADD RISK ACTI GRAPHY TO THE 2964 02:00:17,810 --> 02:00:25,551 A4 TRIAL, IT WAS A RANDOMIZED 2965 02:00:25,618 --> 02:00:29,956 TRIAL OF A MONOCLONAL ANTIBODY 2966 02:00:30,022 --> 02:00:31,891 FROM THE BASELINE PHASE OF THE 2967 02:00:31,958 --> 02:00:32,892 TRIAL. 2968 02:00:32,959 --> 02:00:35,695 AS YOU KNOW, THEY REAL 2969 02:00:35,761 --> 02:00:38,097 VOLUMINOUS DATA AND WE WANTED TO 2970 02:00:38,164 --> 02:00:41,500 LEVERAGE THOSE DATA TO EVALUATE 2971 02:00:41,567 --> 02:00:43,936 SLEEP AND 24-HOUR REST ACTIVITY 2972 02:00:44,003 --> 02:00:44,370 RHYTHM DATA. 2973 02:00:44,437 --> 02:00:54,981 SOME PEOPLE CAUGHT IT CIRCADIAN 2974 02:00:55,781 --> 02:00:56,315 POTENTIAL MARKERS OF 2975 02:00:56,382 --> 02:00:56,983 PRE-CLINICAL AMYLOID DEPOSITION 2976 02:00:57,049 --> 02:01:01,287 IN THE CONTEXT OF THIS 2977 02:01:01,354 --> 02:01:03,389 RANDOMIZED TRIAL BASELINE. 2978 02:01:03,456 --> 02:01:05,891 AND WE COMPARED STANDARD 2979 02:01:05,958 --> 02:01:07,927 CIRCADIAN METRICS INCLUDING -- 2980 02:01:07,994 --> 02:01:09,195 THIS WAS 59 COGNITIVELY NORMAL, 2981 02:01:09,261 --> 02:01:18,404 THIS WAS AN IMPORTANT PIECE, AND 2982 02:01:18,471 --> 02:01:20,239 IF THEY A-BETA DEPOSITION WERE 2983 02:01:20,306 --> 02:01:23,442 ENROLLED IN THE A4 TRIAL. 2984 02:01:23,509 --> 02:01:26,946 IF THEY WERE NEGATIVE FOR BETA 2985 02:01:27,013 --> 02:01:29,215 AMYLOID ON PET SCAN, THEY WERE 2986 02:01:29,281 --> 02:01:33,319 PUT INTO THE LEARN COHORT, 2987 02:01:33,386 --> 02:01:34,754 LONGITUDINAL EVALUATION OF 2988 02:01:34,820 --> 02:01:36,389 AMYLOID RISK AND DEGENERATION 2989 02:01:36,455 --> 02:01:36,722 STUDY. 2990 02:01:36,789 --> 02:01:43,262 WE USED THE A-BETA POSITIVE 2991 02:01:43,329 --> 02:01:44,330 PEOPLE, AND DATA FROM NEGATIVE 2992 02:01:44,397 --> 02:01:48,834 FOLKS FROM THE LEARN STUDY FOR 2993 02:01:48,901 --> 02:01:53,639 THIS AND COMPARED TOTAL SLEEP 2994 02:01:53,706 --> 02:02:04,216 TIME, SLEEP EFFICIENCY, SLEEP 2995 02:02:08,554 --> 02:02:11,991 ONSET LATENCY. 2996 02:02:12,058 --> 02:02:12,792 NON-PARAMETRIC INDICES. 2997 02:02:12,858 --> 02:02:13,859 YOU CAN SEE DESCRIPTION OF THE 2998 02:02:13,926 --> 02:02:15,294 SAMPLE ON THE RIGHT. 2999 02:02:15,361 --> 02:02:18,297 THE IMPORTANT THING TO NOTE HERE 3000 02:02:18,364 --> 02:02:22,568 IS THERE WERE NO DIFFERENCES 3001 02:02:22,635 --> 02:02:25,504 BETWEEN USING THESE STANDARD 3002 02:02:25,571 --> 02:02:26,772 METRICS, WHICH TEND TO AVERAGE 3003 02:02:26,839 --> 02:02:31,711 OVER A WEEK OF DATA COLLECTION 3004 02:02:31,777 --> 02:02:33,546 OR SO, CAN OBSCURE SOME 3005 02:02:33,612 --> 02:02:34,447 IMPORTANT DIFFERENCES 3006 02:02:34,513 --> 02:02:36,182 POTENTIALLY THAT ARE OCCURRING 3007 02:02:36,248 --> 02:02:39,185 IN A FINER GRAIN LEVEL IN DATA. 3008 02:02:39,251 --> 02:02:43,422 SO WE ALSO WANTED TO APPLY 3009 02:02:43,489 --> 02:02:46,292 FUNCTION ON SCALE OF REGRESSION, 3010 02:02:46,358 --> 02:02:48,094 A DATA DRIVEN NON-PARAMETRIC 3011 02:02:48,160 --> 02:02:49,862 APPROACH TO IDENTIFY POTENTIAL 3012 02:02:49,929 --> 02:02:53,766 DIFFERENCES BETWEEN THESE 3013 02:02:53,833 --> 02:02:53,999 GROUPS. 3014 02:02:54,066 --> 02:02:59,238 AND MANY THANKS TO MY CO-AUTHOR, 3015 02:02:59,305 --> 02:03:05,010 AS ALWAYS A TREMENDOUS HELP WITH 3016 02:03:05,077 --> 02:03:07,980 THIS STUFF. 3017 02:03:08,047 --> 02:03:09,915 WE FOUND INTERESTING THINGS, 3018 02:03:09,982 --> 02:03:15,688 REFRESHING BECAUSE WE FOUND 3019 02:03:15,755 --> 02:03:18,057 NOTHING USING STANDARD METRICS. 3020 02:03:18,124 --> 02:03:22,161 >> TWO MINUTES LEFT. 3021 02:03:22,228 --> 02:03:24,396 >> OKAY. 3022 02:03:24,463 --> 02:03:25,397 NEXT SLIDE PLEASE. 3023 02:03:25,464 --> 02:03:27,299 IF YOU LOOK ACROSS 30-MINUTE 3024 02:03:27,366 --> 02:03:29,869 INTERVALS IN THE DAY, THE TIME 3025 02:03:29,935 --> 02:03:31,804 OF DAY GOES ACROSS THE X-AXIS, 3026 02:03:31,871 --> 02:03:32,371 OKAY? 3027 02:03:32,438 --> 02:03:36,609 AND THE RED CURVE IS THE A-BETA 3028 02:03:36,675 --> 02:03:39,245 POSITIVE FOLKS, BLUE IS A-BETA 3029 02:03:39,311 --> 02:03:40,279 NEGATIVE FOLKS. 3030 02:03:40,346 --> 02:03:44,216 VERTICAL BARS INDICATE TIMES OF 3031 02:03:44,283 --> 02:03:45,951 DAY DIFFERENCE IN ACTIVITY 3032 02:03:46,018 --> 02:03:47,486 COUNTS BETWEEN TWO GROUPS 3033 02:03:47,553 --> 02:03:49,755 SIGNIFICANT AFTER ADJUSTING FOR 3034 02:03:49,822 --> 02:03:53,592 AGE, SEX, EDUCATION. 3035 02:03:53,659 --> 02:03:57,296 AND THE PINK BARS INDICATE 3036 02:03:57,363 --> 02:03:58,764 SIGNIFICANCE USING CONSERVATIVE 3037 02:03:58,831 --> 02:04:00,599 STATISTICAL METHOD THAT ACCOUNTS 3038 02:04:00,666 --> 02:04:03,669 FOR THE CORRELATION OF ADJACENT 3039 02:04:03,736 --> 02:04:04,737 TIME POINTS. 3040 02:04:04,804 --> 02:04:07,506 BLUE BARS ARE FROM THE LESS 3041 02:04:07,573 --> 02:04:08,007 CONSERVATIVE APPROACH. 3042 02:04:08,073 --> 02:04:10,509 YOU SEE BROADER INTERVALS OF 3043 02:04:10,576 --> 02:04:11,677 SIGNIFICANT DIFFERENCES. 3044 02:04:11,744 --> 02:04:13,746 WHAT WE NOTED IS IF YOU LOOK 3045 02:04:13,813 --> 02:04:23,122 BETWEEN 12 P.M. ROUGHLY AND, OH, 3046 02:04:23,189 --> 02:04:24,790 17, 1800, AROUND 6 P.M., HIGHER 3047 02:04:24,857 --> 02:04:29,361 LEVEL OF ACTIVITY IN THE RED 3048 02:04:29,428 --> 02:04:35,534 BAR, THAN IN THE BLUE GROUP. 3049 02:04:35,601 --> 02:04:40,573 WE SAW STARTING JUST BEFORE 3050 02:04:40,639 --> 02:04:43,375 MIDNIGHT LOWER LEVEL OF 3051 02:04:43,442 --> 02:04:46,879 ACTIVITY, FOLKS ALL COGNITIVELY 3052 02:04:46,946 --> 02:04:50,382 NORMAL, AND COMPARED TO THE BLUE 3053 02:04:50,449 --> 02:04:54,854 GROUP, AND THIS REVERSED 3054 02:04:54,920 --> 02:04:55,754 DIRECTIONS IN STARTING AROUND 5 3055 02:04:55,821 --> 02:04:57,723 A.M. TO 8 A.M. 3056 02:04:57,790 --> 02:05:03,395 THIS IS USING THE MORE 3057 02:05:03,462 --> 02:05:04,597 CONSERVATIVE SIGNIFICANCE 3058 02:05:04,663 --> 02:05:05,631 THRESHOLD. 3059 02:05:05,698 --> 02:05:09,435 WE LOOKED AT VARIABILITY AND SAW 3060 02:05:09,501 --> 02:05:10,569 SEVERAL FINDINGS. 3061 02:05:10,636 --> 02:05:13,038 SO THERE WAS -- THE ONE I WANT 3062 02:05:13,105 --> 02:05:17,409 TO POINT OUT THAT WE SAW A BUNCH 3063 02:05:17,476 --> 02:05:19,211 OF TIMES DURING WHICH THERE WERE 3064 02:05:19,278 --> 02:05:22,715 HIGHER OR LOWER LEVELS OF 3065 02:05:22,781 --> 02:05:25,117 VARIABILITY IN ACTIVITY ACROSS 3066 02:05:25,184 --> 02:05:26,652 DAYS, BETWEEN THOSE WHO HAD 3067 02:05:26,719 --> 02:05:27,887 A-BETA IN THEIR BRAIN AND THOSE 3068 02:05:27,953 --> 02:05:28,587 WHO DID NOT. 3069 02:05:28,654 --> 02:05:32,725 I WANT TO DRAW YOUR ATTENTION TO 3070 02:05:32,791 --> 02:05:40,566 THE ONE THAT'S ON THE RIGHT-HAND 3071 02:05:40,633 --> 02:05:42,735 SIDE, EXCLUSIVELY BLUE. 3072 02:05:42,801 --> 02:05:45,504 LOWER VARIABILITY VERSUS THOSE 3073 02:05:45,571 --> 02:05:47,740 WHO DID NOT. 3074 02:05:47,806 --> 02:05:49,775 THESE WERE POST HOC ANALYSES AND 3075 02:05:49,842 --> 02:05:52,478 NEEDED TO BE REPLICATED SO WE 3076 02:05:52,544 --> 02:05:54,914 DID THAT IN AN INDEPENDENT 3077 02:05:54,980 --> 02:06:03,622 COHORT USING THE SAME 3078 02:06:03,689 --> 02:06:07,059 ACCELEROMETERS ON THE WRIST, AND 3079 02:06:07,126 --> 02:06:07,927 DIFFERENT RADIO TRACER, 3080 02:06:07,993 --> 02:06:09,361 INDEPENDENT SAMPLE. 3081 02:06:09,428 --> 02:06:11,964 SO WHAT DO WE FIND? 3082 02:06:12,031 --> 02:06:12,965 NEXT SLIDE PLEASE. 3083 02:06:13,032 --> 02:06:16,135 WE PUBLISHED THIS IN SLEEP, THE 3084 02:06:16,201 --> 02:06:17,536 ONE PREVIOUSLY WAS SLEEP 3085 02:06:17,603 --> 02:06:20,572 ADVANCES, THIS ONE IN SLEEP. 3086 02:06:20,639 --> 02:06:26,111 WHAT WE SHOWED, 82 COGNITIVELY 3087 02:06:26,178 --> 02:06:28,547 NORMAL ADULTS, AGAIN, SOME 3088 02:06:28,614 --> 02:06:30,749 A-BETA POSITIVE, SOME NEGATIVE, 3089 02:06:30,816 --> 02:06:31,350 GREATER ACTIVITY IN THIS 3090 02:06:31,417 --> 02:06:35,788 AFTERNOON PERIOD IF YOU LOOK ON 3091 02:06:35,854 --> 02:06:38,223 PANEL A AMONG THOSE WHO HAD -- 3092 02:06:38,290 --> 02:06:41,560 WERE POSITIVE FOR A-BETA ON A 3093 02:06:41,627 --> 02:06:47,166 PITTSBURGH COMPOUND B SCAN. 3094 02:06:47,232 --> 02:06:51,003 AND THAT WAS SORT OF SATISFYING 3095 02:06:51,070 --> 02:06:53,806 BECAUSE IT POINTED TO -- THIS IS 3096 02:06:53,872 --> 02:06:55,307 A SMALLER PERIOD WE SAW 3097 02:06:55,374 --> 02:06:56,508 SIGNIFICANT DIFFERENCE IN THE 3098 02:06:56,575 --> 02:06:57,977 OTHER STUDY, IN THE SAME TIME OF 3099 02:06:58,043 --> 02:07:00,813 DAY WHERE WE SAW THIS DIFFERENCE 3100 02:07:00,879 --> 02:07:01,647 IN ACTIVITY LEVELS. 3101 02:07:01,714 --> 02:07:04,183 IF YOU LOOK AT PANEL B THAT'S 3102 02:07:04,249 --> 02:07:05,351 THE VARIABILITY. 3103 02:07:05,417 --> 02:07:06,785 THE ONLY ONE THAT OVERLAPPED 3104 02:07:06,852 --> 02:07:08,787 WITH THE ONE WE SAW BEFORE WAS 3105 02:07:08,854 --> 02:07:11,357 THIS SAME PATTERN OF REDUCED 3106 02:07:11,423 --> 02:07:15,127 VARIABILITY IN ACTIVITY COUNTS 3107 02:07:15,194 --> 02:07:17,997 IN THIS AFTERNOON PERIOD, THAT 3108 02:07:18,063 --> 02:07:20,699 OVERLAPS IN PART WITH PERIOD OF 3109 02:07:20,766 --> 02:07:23,569 ELEVATED ACTIVITY AMONG THOSE 3110 02:07:23,635 --> 02:07:30,909 WHO HAVE A-BETA IN THEIR BRAINS. 3111 02:07:30,976 --> 02:07:33,846 I THINK THIS POINTS TO THE VALUE 3112 02:07:33,912 --> 02:07:38,717 OF BIG DATA OR SMALL BIG DATA 3113 02:07:38,784 --> 02:07:40,119 AND DATA-DRIVEN APPROACHES TO 3114 02:07:40,185 --> 02:07:41,587 SCIENTIFIC DISCOVERY THAT ARE 3115 02:07:41,653 --> 02:07:43,655 AFFORDED BY THE HIGH DIMENSIONAL 3116 02:07:43,722 --> 02:07:45,190 DATA WE GET FROM SLEEP MEASURES 3117 02:07:45,257 --> 02:07:51,163 IN GENERAL. 3118 02:07:51,230 --> 02:07:53,098 NEXT SLIDE PLEASE. 3119 02:07:53,165 --> 02:07:56,735 BRIEFLY, WHAT ARE FUTURE 3120 02:07:56,802 --> 02:07:57,302 DIRECTIONS? 3121 02:07:57,369 --> 02:08:01,440 MANY OTHER PEOPLE ARE DOING WORK 3122 02:08:01,507 --> 02:08:05,077 THAT IS FANTASTIC IN THIS AREA. 3123 02:08:05,144 --> 02:08:06,812 FORGIVE ME FOR SHOWING ONLY MY 3124 02:08:06,879 --> 02:08:07,880 OWN HERE. 3125 02:08:07,946 --> 02:08:12,217 WE NEED TO MOVE BEYOND AVERAGES 3126 02:08:12,284 --> 02:08:14,019 AND MAIN EFFECTS TO CHARACTERIZE 3127 02:08:14,086 --> 02:08:14,420 RISK. 3128 02:08:14,486 --> 02:08:15,821 BY MOVING BEYOND AVERAGES I MEAN 3129 02:08:15,888 --> 02:08:17,022 TWO THINGS. 3130 02:08:17,089 --> 02:08:17,890 IN THE SLEEP AND ALZHEIMER'S 3131 02:08:17,956 --> 02:08:20,859 DISEASE AREA, THE FIRST IS 3132 02:08:20,926 --> 02:08:24,863 MOVING BEYOND POPULATION 3133 02:08:24,930 --> 02:08:26,231 AVERAGES TO INVESTIGATE 3134 02:08:26,298 --> 02:08:26,865 MODERATORS. 3135 02:08:26,932 --> 02:08:34,807 NOT JUST MAIN EFFECTS BUT 3136 02:08:34,873 --> 02:08:36,909 LOOKING AT FACTORS THAT MODIFY 3137 02:08:36,975 --> 02:08:40,979 WITH DEMENTIA, INCLUDING SEX 3138 02:08:41,046 --> 02:08:43,148 DIFFERENCE OR THOSE BASED ON 3139 02:08:43,215 --> 02:08:45,851 FINER GRAINED DEMOGRAPHIC AND 3140 02:08:45,918 --> 02:08:47,619 CLINICAL CHARACTERISTICS OR 3141 02:08:47,686 --> 02:08:50,122 CHARACTERISTICS IDENTIFIED BY 3142 02:08:50,189 --> 02:08:52,224 DATA DRIVEN METRICS, OR A.I. 3143 02:08:52,291 --> 02:08:56,161 WHO IS AT THE RISK, MOST AT 3144 02:08:56,228 --> 02:08:58,430 RISK, OF SLEEP DISTURBANCE 3145 02:08:58,497 --> 02:08:58,831 INDUCED DEMENTIA? 3146 02:08:58,897 --> 02:09:00,566 THE SECOND THING I MEAN BY 3147 02:09:00,632 --> 02:09:09,875 MOVING BEYOND AVERAGES IS MOVING 3148 02:09:09,942 --> 02:09:11,643 BEYOND CONVENTIONAL COURSE 3149 02:09:11,710 --> 02:09:12,444 METRICS MEASURED OVER FOUR OR 3150 02:09:12,511 --> 02:09:14,446 FIVE NIGHTS THAT WE CONVENTIONAL 3151 02:09:14,513 --> 02:09:14,613 USE. 3152 02:09:14,680 --> 02:09:17,049 I THINK THAT IN THIS FIELD WE 3153 02:09:17,116 --> 02:09:19,284 HAVE -- THERE'S SUCH POTENTIAL 3154 02:09:19,351 --> 02:09:22,454 TO LEVERAGE PSG AND WEARABLE 3155 02:09:22,521 --> 02:09:23,722 DATA FOR PREDICTION, FOR 3156 02:09:23,789 --> 02:09:24,790 PREVENTION BY IDENTIFYING PEOPLE 3157 02:09:24,857 --> 02:09:27,126 AT RISK WHO MIGHT NEED MORE 3158 02:09:27,192 --> 02:09:28,594 INTERVENTION, IN ORDER TO 3159 02:09:28,660 --> 02:09:32,598 PREVENT, AND FOR MONITORING OF 3160 02:09:32,664 --> 02:09:34,333 TREATMENTS AS OTHER PEOPLE 3161 02:09:34,399 --> 02:09:35,567 PRESENTED TODAY. 3162 02:09:35,634 --> 02:09:38,003 AND THEN FINALLY I THINK IT'S 3163 02:09:38,070 --> 02:09:39,805 CRITICAL WE COLLABORATE AND 3164 02:09:39,872 --> 02:09:44,176 SHARE DATA AND WORK TOGETHER TO 3165 02:09:44,243 --> 02:09:45,310 HARMONIZE AND STANDARDIZE, SO 3166 02:09:45,377 --> 02:09:47,179 THAT'S IT. 3167 02:09:47,246 --> 02:09:49,515 MY LAST SLIDE PLEASE. 3168 02:09:49,581 --> 02:09:51,116 JUST A THANK YOU. 3169 02:09:51,183 --> 02:09:52,784 FIRST TO THE ORGANIZERS, FOR 3170 02:09:52,851 --> 02:09:54,386 HAVING ME PRESENT TODAY. 3171 02:09:54,453 --> 02:09:57,122 AND TO NATIONAL INSTITUTE ON 3172 02:09:57,189 --> 02:10:00,192 AGING, SUPPORTED ME SINCE MY K 3173 02:10:00,259 --> 02:10:02,361 AWARD AND FANTASTIC. 3174 02:10:02,427 --> 02:10:06,665 MY CO-AUTHORS AND COLLABORATORS, 3175 02:10:06,732 --> 02:10:08,800 TRAINEES, PARTICIPANTS WHO MAKE 3176 02:10:08,867 --> 02:10:16,842 THIS POSSIBLE. 3177 02:10:16,909 --> 02:10:21,213 THANK YOU. 3178 02:10:21,280 --> 02:10:23,015 >> THANK YOU. 3179 02:10:23,081 --> 02:10:27,586 WE'RE RUNNING BEHIND AND LET'S 3180 02:10:27,653 --> 02:10:33,091 SAVE QUESTIONS FOR THE OVERALL 3181 02:10:33,158 --> 02:10:34,793 Q&A FOR THIS SESSION. 3182 02:10:34,860 --> 02:10:41,633 AND SO LET'S MOVE ON TO DR. 3183 02:10:41,700 --> 02:10:42,634 MORRIS, ASSISTANT PROFESSOR AT 3184 02:10:42,701 --> 02:10:45,504 THE UNIVERSITY OF PITTSBURGH 3185 02:10:45,571 --> 02:10:46,605 SCHOOL OF NURSING, PRIMARY GOAL 3186 02:10:46,672 --> 02:10:48,507 OF THE RESEARCH PROGRAM TO 3187 02:10:48,574 --> 02:10:49,474 GENERATE KNOWLEDGE TO IMPROVE 3188 02:10:49,541 --> 02:10:51,243 CARE AROUND CLINICAL OUTCOMES OF 3189 02:10:51,310 --> 02:10:54,446 WOMEN WITH OBSTRUCTIVE SLEEP 3190 02:10:54,513 --> 02:10:56,882 APNEA, FOCUSED ON 3191 02:10:56,949 --> 02:11:00,319 MULTI-FACTORIAL INFLUENCES OF 3192 02:11:00,385 --> 02:11:02,287 GENDER THAT AFFECT PRESENTATION 3193 02:11:02,354 --> 02:11:06,525 IN WOMEN, AND SUCCESS WITH SLEEP 3194 02:11:06,592 --> 02:11:09,661 SPEAKING ON SEX DIFFERENCES IN 3195 02:11:09,728 --> 02:11:11,463 OBSTRUCTIVE SLEEP APNEA. 3196 02:11:11,530 --> 02:11:13,966 PLEASE GO AHEAD, DR. MORRIS. 3197 02:11:14,032 --> 02:11:15,734 >> THANK YOU FOR THE 3198 02:11:15,801 --> 02:11:16,068 INTRODUCTION. 3199 02:11:16,134 --> 02:11:17,002 I'M ASSISTANT PROFESSOR AT THE 3200 02:11:17,069 --> 02:11:18,237 UNIVERSITY OF PITTSBURGH SCHOOL 3201 02:11:18,303 --> 02:11:23,809 OF NURSING, HONORED TO BE HERE 3202 02:11:23,875 --> 02:11:24,009 TODAY. 3203 02:11:24,076 --> 02:11:26,912 AND I HAVE -- HOPING YOU WILL 3204 02:11:26,979 --> 02:11:28,880 HAVE A GREATER UNDERSTAND OF HOW 3205 02:11:28,947 --> 02:11:31,950 SEX DIFFERENCES ARE CONTRIBUTING 3206 02:11:32,017 --> 02:11:35,520 TO HETEROGENEITY. 3207 02:11:35,587 --> 02:11:37,389 SO SINCE YESTERDAY, MY PLAN FOR 3208 02:11:37,456 --> 02:11:40,525 TODAY IS TO INTRODUCE TOPIC 3209 02:11:40,592 --> 02:11:43,395 EFFECTS IN HEALTH CARE, A REALLY 3210 02:11:43,462 --> 02:11:44,930 BRIEF OVERVIEW OF HOW OTHER 3211 02:11:44,997 --> 02:11:47,499 CONDITIONS HAVE LOOKED AT SEX 3212 02:11:47,566 --> 02:11:50,502 DIFFERENCES IN BIG DATA, AND 3213 02:11:50,569 --> 02:11:54,539 THEN GIVE YOU IDEAS FOR HOW 3214 02:11:54,606 --> 02:11:57,175 THAT MIGHT BE DONE, A FEW 3215 02:11:57,242 --> 02:12:01,713 EXAMPLES FROM WORK AND LASTLY 3216 02:12:01,780 --> 02:12:03,815 WILL GO OVER SOME OF THE 3217 02:12:03,882 --> 02:12:05,751 CHALLENGES THAT WE MIGHT 3218 02:12:05,817 --> 02:12:07,219 EXPERIENCE, SOMEBODY MENTIONED 3219 02:12:07,286 --> 02:12:08,020 YESTERDAY FROM LATENT BIASES, 3220 02:12:08,086 --> 02:12:12,491 I'LL HIT ON SOME OF THOSE AT THE 3221 02:12:12,557 --> 02:12:13,592 END. 3222 02:12:13,659 --> 02:12:18,463 I WANT TO TELL YOU WHAT I MEAN 3223 02:12:18,530 --> 02:12:19,998 ABOUT SEX AND GENDER. 3224 02:12:20,065 --> 02:12:22,467 FOR GENDER I'M REFERRING TO 3225 02:12:22,534 --> 02:12:25,404 SOCIETAL ROLES, EXPECTATIONS, 3226 02:12:25,470 --> 02:12:26,438 POWER STRUCTURES DIFFERENTIALLY 3227 02:12:26,505 --> 02:12:28,874 IMPACT WOMEN'S AND MEN'S HEALTH. 3228 02:12:28,940 --> 02:12:33,245 I WILL BE USING SEX DIFFERENCES 3229 02:12:33,312 --> 02:12:43,855 BROADLY DIFFERENCES BETWEEN MEN 3230 02:12:55,334 --> 02:12:57,803 AND WOMEN. 3231 02:12:57,869 --> 02:12:59,771 FACTORS AFFECTED WOMEN'S HEALTH, 3232 02:12:59,838 --> 02:13:05,577 IN TERMS OF WOMEN'S REPRODUCTIVE 3233 02:13:05,644 --> 02:13:06,545 LIFESPAN, PUBERTY, PREGNANCY, 3234 02:13:06,611 --> 02:13:08,113 MENOPAUSE, LESS ATTENTION PAID 3235 02:13:08,180 --> 02:13:10,315 TO EXTERNAL FACTORS THAT AFFECT 3236 02:13:10,382 --> 02:13:11,350 WOMEN'S HEALTH SUCH AS SOCIAL 3237 02:13:11,416 --> 02:13:13,852 DETERMINANTS OF HEALTH, 3238 02:13:13,919 --> 02:13:14,553 BEHAVIORS, ENVIRONMENT, 3239 02:13:14,619 --> 02:13:16,955 POLICIES, ET CETERA, MY INTEREST 3240 02:13:17,022 --> 02:13:20,792 HAS BEEN IN THE IMPACT OF 3241 02:13:20,859 --> 02:13:21,360 GENDER. 3242 02:13:21,426 --> 02:13:23,195 NOT JUST GENDER SOCIETAL ROLES 3243 02:13:23,261 --> 02:13:25,330 BUT HOW GENDER ITSELF IS 3244 02:13:25,397 --> 02:13:25,931 INFLUENCING RESEARCH QUESTIONS 3245 02:13:25,997 --> 02:13:30,702 THAT WE'VE BEEN ASKING IN OSA 3246 02:13:30,769 --> 02:13:33,872 RESEARCH. 3247 02:13:33,939 --> 02:13:34,873 NEXT SLIDE PLEASE. 3248 02:13:34,940 --> 02:13:45,384 SO, I WANT TO REVIEW A FEW 3249 02:13:47,953 --> 02:13:49,321 SLIDES. 3250 02:13:49,388 --> 02:13:52,257 I APPRECIATE DR. SPIRA 3251 02:13:52,324 --> 02:13:53,925 STRATIFYING BY SEX. 3252 02:13:53,992 --> 02:13:57,662 I WANT TO SHOW MORE WHAT'S GOING 3253 02:13:57,729 --> 02:14:06,605 ON. 3254 02:14:06,671 --> 02:14:09,241 U.K. BIOBANK DATA, WOMEN WITH 3255 02:14:09,307 --> 02:14:11,676 HEART DISEASE MORE LIKELY TO 3256 02:14:11,743 --> 02:14:14,946 HAVE ALL-CAUSE DEMENTIA. 3257 02:14:15,013 --> 02:14:16,114 SEX DIFFERENCE RESEARCH, 3258 02:14:16,181 --> 02:14:17,315 STANFORD HOSPITAL AND CLINIC, 3259 02:14:17,382 --> 02:14:18,216 PAIN DATA. 3260 02:14:18,283 --> 02:14:22,587 THEY LOOKED AT SEX DIFFERENCES 3261 02:14:22,654 --> 02:14:25,857 AND PAIN REPORTS. 3262 02:14:25,924 --> 02:14:35,634 160,000 DATA POINTS, 250,000 3263 02:14:35,700 --> 02:14:36,067 DIAGNOSES, FOUND SEX 3264 02:14:36,134 --> 02:14:37,402 DIFFERENCES, BIG DATA CAN ALLOW 3265 02:14:37,469 --> 02:14:41,072 US TO DRILL DOWN AND SEE THESE 3266 02:14:41,139 --> 02:14:41,373 EFFECTS. 3267 02:14:41,440 --> 02:14:43,875 LAST STUDY HERE, LONGITUDINAL 3268 02:14:43,942 --> 02:14:45,944 SURVEYS, U.S. HEALTH AND 3269 02:14:46,011 --> 02:14:48,246 RETIREMENT STUDY, CHINA HEALTH 3270 02:14:48,313 --> 02:14:49,181 AND RETIREMENT LONGITUDINAL 3271 02:14:49,247 --> 02:14:49,381 STUDY. 3272 02:14:49,448 --> 02:14:51,183 THE POINT I WANT TO MAKE YOU CAN 3273 02:14:51,249 --> 02:14:55,253 SEE IN THE U.S. SIDE THAT MORE 3274 02:14:55,320 --> 02:14:57,756 MEN HAVE HEART DISEASE AT ANY 3275 02:14:57,823 --> 02:14:59,124 AGE BUT IN CHINA IT LOOKS LIKE 3276 02:14:59,191 --> 02:15:02,360 THE WOMEN HAVE MORE HEART 3277 02:15:02,427 --> 02:15:03,795 DISEASE. 3278 02:15:03,862 --> 02:15:07,132 POINTING TO CULTURAL FACTORS 3279 02:15:07,199 --> 02:15:08,266 THAT MIGHT BE DIFFERENT. 3280 02:15:08,333 --> 02:15:10,735 WE WANT TO TAKE INTO MIND 3281 02:15:10,802 --> 02:15:14,539 DIFFERENCES, SEX DIFFERENCES 3282 02:15:14,606 --> 02:15:19,611 WITHIN CULTURES. 3283 02:15:19,678 --> 02:15:23,248 SO, NEXT SLIDE PLEASE. 3284 02:15:23,315 --> 02:15:24,249 THE WORK IN CARDIOVASCULAR 3285 02:15:24,316 --> 02:15:26,318 DISEASE, THEY HAVE MODELS, MOST 3286 02:15:26,384 --> 02:15:27,886 MODELS THAT PEOPLE ARE COMING 3287 02:15:27,953 --> 02:15:31,323 OUT WITH DON'T JUST LOOK AT SEX 3288 02:15:31,389 --> 02:15:32,090 SPECIFIC DIFFERENCES BUT 3289 02:15:32,157 --> 02:15:40,499 INCORPORATE GENDER AND 3290 02:15:40,565 --> 02:15:40,966 ENVIRONMENTAL FACTORS. 3291 02:15:41,032 --> 02:15:43,768 AND I THINK THAT'S WHAT I WANTED 3292 02:15:43,835 --> 02:15:46,872 TO SHOW HERE. 3293 02:15:46,938 --> 02:15:49,241 NEXT SLIDE PLEASE. 3294 02:15:49,307 --> 02:15:51,309 SO THIS IS ABBREVIATED SUMMARY 3295 02:15:51,376 --> 02:15:55,614 OF SEX DIFFERENCES IN OSA, THIS 3296 02:15:55,680 --> 02:15:57,082 CANNOT BE COMPREHENSIVE TO 3297 02:15:57,148 --> 02:16:00,919 EVERYTHING WE KNOW BUT THESE ARE 3298 02:16:00,986 --> 02:16:02,387 AREAS I'M INTERESTED IN AND SO 3299 02:16:02,454 --> 02:16:04,389 HOPEFULLY YOU'LL FIND THEM 3300 02:16:04,456 --> 02:16:06,825 INTERESTING TOO. 3301 02:16:06,892 --> 02:16:09,160 IN PREVALENCE, THERE'S A BIG 3302 02:16:09,227 --> 02:16:10,161 SPREAD. 3303 02:16:10,228 --> 02:16:12,998 THIS PARTICULAR NUMBERS, THESE 3304 02:16:13,064 --> 02:16:16,668 NUMBERS CAME FROM A TABLE FROM 3305 02:16:16,735 --> 02:16:18,803 2016, PUT TOGETHER A BUNCH OF 3306 02:16:18,870 --> 02:16:20,505 PREVALENCE STUDIES TO SHOW 3307 02:16:20,572 --> 02:16:22,807 WIDESPREAD IN HOW MUCH WE KNOW 3308 02:16:22,874 --> 02:16:24,042 ABOUT PREVALENCE IN MEN AND 3309 02:16:24,109 --> 02:16:24,576 WOMEN. 3310 02:16:24,643 --> 02:16:26,645 ONE THING ABOUT THAT, IT DOES 3311 02:16:26,711 --> 02:16:29,080 NOT TELL US MUCH ABOUT 3312 02:16:29,147 --> 02:16:30,415 PREVALENCE LOOKING FOR 3313 02:16:30,482 --> 02:16:31,149 MENOPAUSAL STATUS AND AGE, 3314 02:16:31,216 --> 02:16:33,051 THINGS LIKE THAT. 3315 02:16:33,118 --> 02:16:34,920 STILL RATHER LIMITED. 3316 02:16:34,986 --> 02:16:38,857 WE KNOW ABOUT PHYSIOLOGY 3317 02:16:38,924 --> 02:16:44,796 DIFFERENCES, IN AIRWAY ANATOMY, 3318 02:16:44,863 --> 02:16:47,566 AND RESPIRATORY CONTROL, AND WE 3319 02:16:47,632 --> 02:16:53,238 KNOW THAT MEN HAVE MORE 3320 02:16:53,305 --> 02:16:54,639 COLLAPSIBLE AIRWAY THAN WOMEN. 3321 02:16:54,706 --> 02:16:56,875 IF YOU LOOK AT THE FIGURE DOWN 3322 02:16:56,942 --> 02:16:59,544 IN THE LEFT HAND CORNER IN 3323 02:16:59,611 --> 02:17:02,447 HEALTHY PEOPLE THERE ARE SOME 3324 02:17:02,514 --> 02:17:04,983 SEX DIFFERENCES, IN SLEEP 3325 02:17:05,050 --> 02:17:05,317 ARCHITECTURE. 3326 02:17:05,383 --> 02:17:07,018 FIND THERE'S AN INTERESTING SEX 3327 02:17:07,085 --> 02:17:10,322 DIFFERENCE WHEN IT COMES TO 3328 02:17:10,388 --> 02:17:11,590 REM/NON-RECOMMEND, THAT HAS 3329 02:17:11,656 --> 02:17:13,024 GREAT APPLICABILITY TO OSA. 3330 02:17:13,091 --> 02:17:15,493 YOU CAN SEE TOP TWO LINES 3331 02:17:15,560 --> 02:17:19,798 INDICATE REM OSA, MEN AND WOMEN, 3332 02:17:19,864 --> 02:17:23,401 AGE ROUGHLY EQUIVALENT. 3333 02:17:23,468 --> 02:17:25,770 BOTTOM TWO LINES, SORT OF DOTTED 3334 02:17:25,837 --> 02:17:27,872 LINE, MEN AND THEN BELOW THAT IS 3335 02:17:27,939 --> 02:17:28,206 WOMEN. 3336 02:17:28,273 --> 02:17:33,878 WE CAN SEE DIFFERENCE IN AHI IN 3337 02:17:33,945 --> 02:17:35,880 NON-REM OSA VERSUS REM OSA MEN 3338 02:17:35,947 --> 02:17:42,754 AND WOMEN HAVE SIMILAR AHI. 3339 02:17:42,821 --> 02:17:44,422 I LOOK FORWARD TO LEARNING MORE 3340 02:17:44,489 --> 02:17:45,156 ABOUT THAT. 3341 02:17:45,223 --> 02:17:47,125 AND THEN ALL THESE STUDIES THAT 3342 02:17:47,192 --> 02:17:53,365 I'VE BEEN TALKING ABOUT SO FAR 3343 02:17:53,431 --> 02:17:57,402 HAVE BEEN IN SMALLER SETS. 3344 02:17:57,469 --> 02:18:01,239 ON THE RIGHT IS BY SANJAY PATEL, 3345 02:18:01,306 --> 02:18:04,109 A LARGE STUDY FROM A CPAP 3346 02:18:04,175 --> 02:18:06,578 COMPANY, HE LOOKED AT CPAP 3347 02:18:06,645 --> 02:18:07,812 ADHERENCE IN MEN, WOMEN, BY AGE 3348 02:18:07,879 --> 02:18:09,447 OVER THREE MONTHS. 3349 02:18:09,514 --> 02:18:18,056 YOU CAN SEE IN THIS WOMEN LESS 3350 02:18:18,123 --> 02:18:18,523 ADHERENT. 3351 02:18:18,590 --> 02:18:19,958 IT'S REALLY INTERESTING 3352 02:18:20,025 --> 02:18:20,959 DIFFERENCES EXIST. 3353 02:18:21,026 --> 02:18:23,995 IT DOESN'T TELL US WHY THEY 3354 02:18:24,062 --> 02:18:24,195 EXIST. 3355 02:18:24,262 --> 02:18:26,398 THAT'S ONE OF THE CHALLENGES OF 3356 02:18:26,464 --> 02:18:29,701 BIG DATA BUT GIVES A DIRECTION 3357 02:18:29,768 --> 02:18:32,337 FOR RESEARCH. 3358 02:18:32,404 --> 02:18:32,737 NEXT STUDY PLEASE. 3359 02:18:32,804 --> 02:18:35,840 NEXT SLIDE PLEASE. 3360 02:18:35,907 --> 02:18:38,643 SO ANOTHER SEX DIFFERENCE IS 3361 02:18:38,710 --> 02:18:39,911 MENOPAUSAL STATUS. 3362 02:18:39,978 --> 02:18:41,312 IT'S WELL KNOWN MENOPAUSAL 3363 02:18:41,379 --> 02:18:45,250 STATUS IS ASSOCIATED WITH 3364 02:18:45,316 --> 02:18:47,786 INCREASED RISK FOR OSA AND YOU 3365 02:18:47,852 --> 02:18:58,329 CAN SEE HERE IN THIS STUDY, 3366 02:19:00,131 --> 02:19:01,766 LIGHT BARS WITH POSTMENOPAUSAL, 3367 02:19:01,833 --> 02:19:08,406 AND IN ALL CASE POSTMENOPAUSAL 3368 02:19:08,473 --> 02:19:09,340 WOMEN HAVE GREATER RATES. 3369 02:19:09,407 --> 02:19:12,444 OTHER THING TO POINT OUT THERE, 3370 02:19:12,510 --> 02:19:20,518 IF YOU LOOK AT AGE COLUMNS, 3371 02:19:20,585 --> 02:19:22,420 DIAGNOSIS OF OSA, RATES BECOME 3372 02:19:22,487 --> 02:19:26,891 ALMOST EQUIVALENT TO MEN'S 3373 02:19:26,958 --> 02:19:27,726 RATES. 3374 02:19:27,792 --> 02:19:31,262 THAT'S IMPORTANT THAT WE SHOULD 3375 02:19:31,329 --> 02:19:35,266 CONSIDER MENOPAUSAL STATUS IN 3376 02:19:35,333 --> 02:19:39,070 OSA. 3377 02:19:39,137 --> 02:19:40,138 NEXT SLIDE PLEASE. 3378 02:19:40,205 --> 02:19:44,442 IT'S UNCLEAR IF INCREASE IN 3379 02:19:44,509 --> 02:19:45,677 RATES OF OSA IN POSTMENOPAUSAL 3380 02:19:45,744 --> 02:19:49,080 IS DUE TO INCREASE IN ESTROGEN 3381 02:19:49,147 --> 02:19:51,282 AND MENOPAUSAL TRANSITION, USING 3382 02:19:51,349 --> 02:19:52,684 DATA FROM THE STUDY, COMPARED 3383 02:19:52,751 --> 02:19:58,623 RATES OF OSA BETWEEN PRE, PERI, 3384 02:19:58,690 --> 02:20:00,992 POSTMENOPAUSAL WOMEN. 3385 02:20:01,059 --> 02:20:01,926 AND BOTH USED SELF-REPORTED DATA 3386 02:20:01,993 --> 02:20:06,097 TO DETERMINE WHETHER OR NOT 3387 02:20:06,164 --> 02:20:07,398 WOMEN MENOPAUSAL STATUS. 3388 02:20:07,465 --> 02:20:10,635 THEY CONTROLLED FOR AGE, 3389 02:20:10,702 --> 02:20:10,869 OBESITY. 3390 02:20:10,935 --> 02:20:14,072 BECAUSE IT WASN'T -- IT'S NOT 3391 02:20:14,139 --> 02:20:16,141 CLEAR IF WOMEN -- CONTROLLED FOR 3392 02:20:16,207 --> 02:20:18,309 AGE AND OBESITY AND WHEN DOING 3393 02:20:18,376 --> 02:20:21,846 SO FOUND EACH ADDITIONAL YEAR OF 3394 02:20:21,913 --> 02:20:22,680 MENOPAUSE ASSOCIATED WITH 3395 02:20:22,747 --> 02:20:23,481 GREATER AHI. 3396 02:20:23,548 --> 02:20:27,619 IT IS IMPORTANT TO MAKE SURE WE 3397 02:20:27,685 --> 02:20:28,486 INCORPORATE THIS MENOPAUSAL 3398 02:20:28,553 --> 02:20:28,720 STATUS. 3399 02:20:28,787 --> 02:20:32,157 HOW DO WE DETERMINE USING BIG 3400 02:20:32,223 --> 02:20:33,191 DATA? 3401 02:20:33,258 --> 02:20:36,361 IT'S DETERMINED BY SELF-REPORT, 3402 02:20:36,427 --> 02:20:40,899 EVEN USING AGE AS PROXY. 3403 02:20:40,965 --> 02:20:45,770 WE'RE CONSIDERING A BIG DATA 3404 02:20:45,837 --> 02:20:46,871 ANALYSIS, SEX DIFFERENCES, 3405 02:20:46,938 --> 02:20:49,641 BETWEEN MEN AND WOMEN. 3406 02:20:49,707 --> 02:20:54,312 SO, IN THIS STUDY OVER 300,000 3407 02:20:54,379 --> 02:20:55,780 FEMALE VETERANS, STRUCTURED 3408 02:20:55,847 --> 02:20:57,615 FIELD DATA AND NATURAL LANGUAGE 3409 02:20:57,682 --> 02:21:00,985 PROCESSING TO IMPROVE 3410 02:21:01,052 --> 02:21:02,620 CLASSIFICATION OF STATUS, 3411 02:21:02,687 --> 02:21:04,956 STRUCTURED FIELDS WERE PATIENT 3412 02:21:05,023 --> 02:21:07,625 LAST MENSTRUAL PERIOD, 3413 02:21:07,692 --> 02:21:08,226 REPRODUCTIVE SURGERIES, 3414 02:21:08,293 --> 02:21:11,596 POSTMENOPAUSE DIAGNOSIS, USE OF 3415 02:21:11,663 --> 02:21:13,464 BIRTH CONTROL. 3416 02:21:13,531 --> 02:21:17,869 YOU'LL SEE ON THE LEFT 27% 3417 02:21:17,936 --> 02:21:19,003 CHANCE DETERMINING MENOPAUSAL 3418 02:21:19,070 --> 02:21:19,838 STATUS. 3419 02:21:19,904 --> 02:21:28,746 WHEN THEY ADDED NATURAL LANGUAGE 3420 02:21:28,813 --> 02:21:31,616 PROCESSING, INCREASE OF 55%. 3421 02:21:31,683 --> 02:21:33,251 THIS DOES GIVE POTENTIAL FOR 3422 02:21:33,318 --> 02:21:38,690 USING EHR DATA TO LOOK AT SEX 3423 02:21:38,756 --> 02:21:41,392 DIFFERENCES IN BIG DATA. 3424 02:21:41,459 --> 02:21:45,864 NEXT SLIDE PLEASE. 3425 02:21:45,930 --> 02:21:46,564 ANOTHER IMPORTANT ADVANTAGE IN 3426 02:21:46,631 --> 02:21:51,236 USING BIG DATA IS TO UNDERSTAND 3427 02:21:51,302 --> 02:21:55,440 OSA HETEROGENEITY, AND THROUGH 3428 02:21:55,506 --> 02:21:55,974 PHENOTYPING. 3429 02:21:56,040 --> 02:21:58,409 IN THIS REVIEW, FINDINGS FROM 3430 02:21:58,476 --> 02:21:59,510 MULTIPLE CLUSTER ANALYSES 3431 02:21:59,577 --> 02:22:00,078 STUDIES, A LOT OF YOU ARE 3432 02:22:00,144 --> 02:22:03,615 FAMILIAR WITH THIS. 3433 02:22:03,681 --> 02:22:05,483 THIS FIGURE SHOWS OVERARCHING 3434 02:22:05,550 --> 02:22:07,752 SUBTYPE WHERE THEY COMBINED 3435 02:22:07,819 --> 02:22:10,421 DIFFERENT STUDIES INTO 3436 02:22:10,488 --> 02:22:15,059 OVERARCHING SUBTYPE AND BASED ON 3437 02:22:15,126 --> 02:22:15,760 DEMOGRAPHICS, CO-MORBIDITIES, 3438 02:22:15,827 --> 02:22:16,060 SYMPTOMS. 3439 02:22:16,127 --> 02:22:20,932 AND MY GOAL IS NOT TO GO THROUGH 3440 02:22:20,999 --> 02:22:22,033 ALL OF THIS PHENO-- YOU KNOW, 3441 02:22:22,100 --> 02:22:24,168 ALL OF THIS, ARE WE ON THE RIGHT 3442 02:22:24,235 --> 02:22:26,537 SLIDE? 3443 02:22:34,846 --> 02:22:35,813 THANK YOU, SORRY, I DIDN'T HAVE 3444 02:22:35,880 --> 02:22:41,286 IT IN FRONT OF ME FOR A SECOND. 3445 02:22:41,352 --> 02:22:44,956 THIS IS ABOUT PHENOTYPING. 3446 02:22:45,023 --> 02:22:48,359 AND SO PHENOTYPING, THE POINT OF 3447 02:22:48,426 --> 02:22:50,929 THE SLIDE TO SHOW THAT THERE'S 3448 02:22:50,995 --> 02:22:55,433 MEN IN SLIDE A, B, C,D, AND 3449 02:22:55,500 --> 02:23:01,039 NO -- ONLY ONE PHENOTYPE WOMEN, 3450 02:23:01,105 --> 02:23:04,175 WE HAVE MORE INFORMATION ABOUT 3451 02:23:04,242 --> 02:23:06,577 MEN WHEN WE LOOK AT PHENOTYPING 3452 02:23:06,644 --> 02:23:14,052 THIS WAY. 3453 02:23:14,118 --> 02:23:17,322 NEXT SLIDE PLEASE. 3454 02:23:17,388 --> 02:23:19,390 SO NOW I'M GOING TO GIVE AN 3455 02:23:19,457 --> 02:23:21,893 EXAMPLE FROM MY OWN RESEARCH, 3456 02:23:21,960 --> 02:23:23,661 ANOTHER WAY TO CONSIDER 3457 02:23:23,728 --> 02:23:25,830 ASSESSING SEX DIFFERENCES IN OSA 3458 02:23:25,897 --> 02:23:29,867 IS THAT WOMEN ARE MORE LIKELY TO 3459 02:23:29,934 --> 02:23:32,637 HAVE MILDER THAN MODERATE TO 3460 02:23:32,704 --> 02:23:37,475 SEVERE OSA. 3461 02:23:37,542 --> 02:23:38,910 WOMEN HAVE BEEN UNDERSTUDIED. 3462 02:23:38,977 --> 02:23:41,412 IT'S IMPORTANT THAT WE CONSIDER 3463 02:23:41,479 --> 02:23:44,515 LOOKING AT MILD OSA, CONSIDER 3464 02:23:44,582 --> 02:23:46,117 OVERALL SEX DIFFERENCES. 3465 02:23:46,184 --> 02:23:49,854 USING A COHORT FROM SLEEP HEART 3466 02:23:49,921 --> 02:23:53,124 HEALTH STUDY INVESTED SEX 3467 02:23:53,191 --> 02:23:56,294 DIFFERENCES AND SUBTYPES, SO 3468 02:23:56,361 --> 02:24:04,702 EVERYONE HAD AHI BETWEEN 5 AND 3469 02:24:04,769 --> 02:24:07,271 15, SAMPLE BY SEX. 3470 02:24:07,338 --> 02:24:09,540 WE DETERMINED SUBTYPES. 3471 02:24:09,607 --> 02:24:11,809 WE FOUND FOUR SYMPTOM SUBTYPES 3472 02:24:11,876 --> 02:24:13,711 SIMILAR TO PREVIOUSLY WELL KNOWN 3473 02:24:13,778 --> 02:24:16,347 AND CITED PAPER BY MY COLLEAGUE 3474 02:24:16,414 --> 02:24:18,916 WHO YOU JUST HEARD FROM. 3475 02:24:18,983 --> 02:24:22,487 WE DID A STUDY IN THE COHORT, 3476 02:24:22,553 --> 02:24:24,522 AND SO WE FOUND SAME SUBTYPES, 3477 02:24:24,589 --> 02:24:25,923 EVEN THOUGH I WAS LOOKING AT 3478 02:24:25,990 --> 02:24:32,830 MILD HE WAS LOOKING AT MODERATE 3479 02:24:32,897 --> 02:24:34,065 TO SEVERE, MINIMAL, DISTURBED 3480 02:24:34,132 --> 02:24:35,199 SLEEP. 3481 02:24:35,266 --> 02:24:39,504 NEXT SLIDE PLEASE. 3482 02:24:39,570 --> 02:24:40,805 MODERATELY AND EXCESSIBLEY 3483 02:24:40,872 --> 02:24:41,272 SLEEPY. 3484 02:24:41,339 --> 02:24:45,710 DIFFERENCES BY SEX IN DISTURBED 3485 02:24:45,777 --> 02:24:48,279 SLEEP, MODERATE, THERE WEREN'T 3486 02:24:48,346 --> 02:24:49,747 DIFFERENCES BETWEEN MINIMAL AND 3487 02:24:49,814 --> 02:24:52,016 EXCESSIVELY SLEEPY. 3488 02:24:52,083 --> 02:24:56,254 NEXT SLIDE PLEASE. 3489 02:24:56,320 --> 02:25:01,592 WE ALSO COMPARED SYMPTOM 3490 02:25:01,659 --> 02:25:02,794 SUBTYPES WITH MILD OSA TO 3491 02:25:02,860 --> 02:25:05,096 MODERATE TO SEVERE, VERY LITTLE 3492 02:25:05,163 --> 02:25:06,397 SEX DIFFERENCES BETWEEN THE MEN 3493 02:25:06,464 --> 02:25:11,402 AND THE WOMEN IN TERMS OF OSA, 3494 02:25:11,469 --> 02:25:13,371 SEVERITY, OSA CATEGORY OF 3495 02:25:13,438 --> 02:25:13,638 SEVERITY. 3496 02:25:13,704 --> 02:25:24,148 SO THE COLUMNS ON THE LEFT 3497 02:25:27,518 --> 02:25:28,786 N--WE ALSO SEE THE RED BOXES 3498 02:25:28,853 --> 02:25:31,489 THAT WOMEN SHOWED THEY WERE MORE 3499 02:25:31,556 --> 02:25:34,125 FOUND IN THE DISTURBED SUBTYPE 3500 02:25:34,192 --> 02:25:36,127 AND THE MEN HAD BOXES THAT WERE 3501 02:25:36,194 --> 02:25:37,962 MUCH SMALLER BUT IT'S A MORE 3502 02:25:38,029 --> 02:25:39,931 COMPLEX STORY THAN JUST SAYING 3503 02:25:39,997 --> 02:25:42,433 THAT WOMEN HAVE MORE DISTURBED 3504 02:25:42,500 --> 02:25:45,603 SLEEP THAN MEN, WE ALSO SEE THAT 3505 02:25:45,670 --> 02:25:52,410 THE MEN HAD MORE MODERATELY 3506 02:25:52,477 --> 02:25:56,848 SLEEPY AND LESS DIFFERENCES IN 3507 02:25:56,914 --> 02:25:58,282 THE EXCESSIVELY SLEEPY SUBTYPE. 3508 02:25:58,349 --> 02:26:00,318 SO MY POINT HERE IS THAT 3509 02:26:00,384 --> 02:26:02,620 ALTHOUGH THROUGH DIRECT 3510 02:26:02,687 --> 02:26:05,790 COMPARISONS, WE'RE ABLE TO BE 3511 02:26:05,857 --> 02:26:12,697 GAIN MORE INFORMATION WITH 3512 02:26:12,763 --> 02:26:14,866 WOMEN, SO THE LAST SLIDE IS WE 3513 02:26:14,932 --> 02:26:18,035 DID A BUNCH OF BRAINSTORMING OF 3514 02:26:18,102 --> 02:26:20,638 COLLEAGUES AND CONDITIONS TO SEE 3515 02:26:20,705 --> 02:26:23,274 THE CHALLENGES THEY FACE WHEN 3516 02:26:23,341 --> 02:26:24,675 ASSESSING SEX DIFFERENCES IN BIG 3517 02:26:24,742 --> 02:26:24,876 DATA. 3518 02:26:24,942 --> 02:26:28,112 AS I SAID YESTERDAY, SUBTLE 3519 02:26:28,179 --> 02:26:29,480 DIFFERENCES CAN BE AMPLIFIED. 3520 02:26:29,547 --> 02:26:31,716 THE FIRST 1 HERE IS EHR DAT 3521 02:26:31,782 --> 02:26:33,618 AHERE WE FOUND THAT--WE TALKED 3522 02:26:33,684 --> 02:26:34,986 ALREADY IN THE MENOPAUSE SLIDE 3523 02:26:35,052 --> 02:26:36,821 THAT THERE WERE FEW STRUCTURED 3524 02:26:36,888 --> 02:26:39,290 FIELDS DATA SPECIFIC TO WOMEN, 3525 02:26:39,357 --> 02:26:40,958 SO THAT'S 1 STRUGGLE WITH THE HR 3526 02:26:41,025 --> 02:26:42,260 DATA AND THE SECOND 1 I WANT TO 3527 02:26:42,326 --> 02:26:46,264 SPEND A MOMENT ON IS THIS IDEA 3528 02:26:46,330 --> 02:26:49,033 THAT BALANCED SAMPLES SO WE--WE 3529 02:26:49,100 --> 02:26:50,968 MIGHT WELL, A FAIRLY EQUAL 3530 02:26:51,035 --> 02:26:54,272 AMOUNT OF MEN AND WOMEN, BUT 3531 02:26:54,338 --> 02:26:56,607 THERE IS SOME DATA THAT WOMEN 3532 02:26:56,674 --> 02:26:57,909 ARE UNDERDIAGNOSED FOR OSA, AND 3533 02:26:57,975 --> 02:27:00,311 SOME OF IT MIGHT BE BECAUSE MORE 3534 02:27:00,378 --> 02:27:01,913 WOMEN WERE LIKELY SLEEPING IN 3535 02:27:01,979 --> 02:27:04,215 POVERTY EXPE DON'T FIND THEIR 3536 02:27:04,282 --> 02:27:05,416 WAY INTO THE HEALTHCARE SYSTEM, 3537 02:27:05,483 --> 02:27:09,120 IT COULD BE BECAUSE THERE'S BIAS 3538 02:27:09,187 --> 02:27:09,887 AND FAMILY CARE PROVIDERS, 3539 02:27:09,954 --> 02:27:11,889 WHATEVER THEY MIGHT NOT BE 3540 02:27:11,956 --> 02:27:13,958 PLANNING THEMSELVES INTO THE EHR 3541 02:27:14,025 --> 02:27:16,027 DATA TO BE STUDIED SO THERE 3542 02:27:16,093 --> 02:27:19,664 MIGHT BE A PROBLEM WITH SORT OF 3543 02:27:19,730 --> 02:27:22,433 MISSING WOMEN, AND MIGHT PLAY A 3544 02:27:22,500 --> 02:27:24,702 ROLE IN BIAS AND OTHER BIASES 3545 02:27:24,769 --> 02:27:26,837 AND ALSO WITH THE EHR DATA THERE 3546 02:27:26,904 --> 02:27:29,907 MIGHT BE LACK OF DIFFERENCES 3547 02:27:29,974 --> 02:27:31,142 THAT DIFFERENTIALLY IMPACT WOMEN 3548 02:27:31,209 --> 02:27:35,112 COMPARED TO MEN. 3549 02:27:35,179 --> 02:27:38,149 LIVING IN POVERTY AND LITTLER 3550 02:27:38,216 --> 02:27:39,750 ISSUES, ADHERENCE DATA I TALKED 3551 02:27:39,817 --> 02:27:45,223 TO A CP A P REP IT THAT THEY'RE 3552 02:27:45,289 --> 02:27:46,624 SIMILAR TO PREDICT ADHERENCE 3553 02:27:46,691 --> 02:27:49,493 USING THEIR DATA SETS BUT THEY 3554 02:27:49,560 --> 02:27:53,030 DON'T HAVE LOOSE GENDER 3555 02:27:53,097 --> 02:27:53,731 VARIABLES, CULTURAL VARIABLES 3556 02:27:53,798 --> 02:27:57,802 THAT WE COULD USE TO DETERMINE, 3557 02:27:57,868 --> 02:28:01,272 YOU KNOW TEASE CO VARIANTS AND 3558 02:28:01,339 --> 02:28:03,174 CONFOUNDERS THAT MIGHT AFFECT 3559 02:28:03,241 --> 02:28:03,741 ADHERENCE. 3560 02:28:03,808 --> 02:28:08,212 HEALTH INSURANCE CLAIMS DATA IS 3561 02:28:08,279 --> 02:28:09,046 ANOTHER 1. 3562 02:28:09,113 --> 02:28:12,149 THIS IS AN IMPORTANT SOURCE FOR 3563 02:28:12,216 --> 02:28:13,985 OSA INVESTIGATIONS, I HAVE 3564 02:28:14,051 --> 02:28:15,586 WORKED IN THIS, SOME THINGS TO 3565 02:28:15,653 --> 02:28:18,489 KEEP IN MIND HERE IS THAT THE 3566 02:28:18,556 --> 02:28:20,258 WORLD ECONOMIC FORUMS, GENDER 3567 02:28:20,324 --> 02:28:21,692 GAP REPORT REPORTED THAT AVERAGE 3568 02:28:21,759 --> 02:28:22,760 WORKING WOMAN, THE AVERAGE 3569 02:28:22,827 --> 02:28:24,829 WORKING WOMAN IN THE U.S. SPENDS 3570 02:28:24,895 --> 02:28:26,364 18% MORE ON HEALTHCARE COSTS 3571 02:28:26,430 --> 02:28:27,064 THAN MEN. 3572 02:28:27,131 --> 02:28:29,066 AND WOMEN ARE MORE LIKELY TO 3573 02:28:29,133 --> 02:28:30,134 VISIT MORE HEALTHCARE 3574 02:28:30,201 --> 02:28:31,068 PROFESSIONALS MORE OFTEN THAN 3575 02:28:31,135 --> 02:28:32,737 MEN SO IN THIS INSTANCE WE MIGHT 3576 02:28:32,803 --> 02:28:35,473 HAVE MORE INFORMATION ON WOMEN 3577 02:28:35,539 --> 02:28:39,910 THAN MEN. 3578 02:28:39,977 --> 02:28:42,046 THERE IS MUCH PROMISE IN THE 3579 02:28:42,113 --> 02:28:43,114 BIOMETRICS AND WEARABLE DEVICES 3580 02:28:43,180 --> 02:28:47,618 BUT AGAIN WE WILL NEED TO 3581 02:28:47,685 --> 02:28:48,519 INCORPORATE SOCIAL VARIABLES, 3582 02:28:48,586 --> 02:28:49,654 HEALTH VARIABLES BECAUSE I THINK 3583 02:28:49,720 --> 02:28:51,656 IT'S EASY TO FIND SEX DRVESS AND 3584 02:28:51,722 --> 02:28:55,026 THEN SORT OF INTERPRET THEM AND 3585 02:28:55,092 --> 02:28:56,861 NOT INTERPRET THEM IN A SUBTLE 3586 02:28:56,927 --> 02:29:00,431 WAY, AND WE NEED THE ADDITIONAL 3587 02:29:00,498 --> 02:29:00,731 INFORMATION. 3588 02:29:00,798 --> 02:29:04,502 AND THEN, SOCIAL MEDIA, YOU KNOW 3589 02:29:04,568 --> 02:29:06,037 THERE'S ALWAYS BIAS BUT I DO 3590 02:29:06,103 --> 02:29:07,605 WORK WITH WITH A COLLEAGUE THAT 3591 02:29:07,672 --> 02:29:09,907 USES SOCIAL MEDIA BUT WE DO KNOW 3592 02:29:09,974 --> 02:29:12,777 THAT THEY DO HAVE LESS ACCESS TO 3593 02:29:12,843 --> 02:29:14,545 SOCIAL MEDIA. 3594 02:29:14,612 --> 02:29:15,780 AND THEN RESEARCH REPOSITORIES, 3595 02:29:15,846 --> 02:29:17,114 WE DO KNOW THAT THEY'RE NOT 3596 02:29:17,181 --> 02:29:19,216 ALWAYS GOING TO HAVE DATA THAT 3597 02:29:19,283 --> 02:29:21,485 ARE NOT SPECIFIC TO WOMEN, THEY 3598 02:29:21,552 --> 02:29:23,020 MAY NOT BE BALANCED FOR WOMEN, 3599 02:29:23,087 --> 02:29:24,522 AND THE LAST THING THAT'S NOT ON 3600 02:29:24,588 --> 02:29:26,624 HERE THAT I SHOULD MENTION IS 3601 02:29:26,691 --> 02:29:29,260 SURVIVAL BIAS IN LOWNGITUDEINAL 3602 02:29:29,327 --> 02:29:30,795 STUDIES AND THOSE WOMEN TEND TO 3603 02:29:30,861 --> 02:29:32,830 HAVE A LONGER LIFE SPAN, SO ALL 3604 02:29:32,897 --> 02:29:34,365 OF THESE ARE OUR SUBTLE BIAS 3605 02:29:34,432 --> 02:29:35,900 THAT WE NEED TO BE AWARE OF WHEN 3606 02:29:35,966 --> 02:29:39,503 WE DO THESE STUDIES. 3607 02:29:39,570 --> 02:29:40,404 NEXT SLIDE, PLEASE. 3608 02:29:40,471 --> 02:29:41,806 >> DOCTOR, YOU HAVE 2 MINUES 3609 02:29:41,872 --> 02:29:43,741 LEFT NOKAY, THANK YOU. 3610 02:29:43,808 --> 02:29:46,510 SO THE LAST COUPLE SLIDES HERE, 3611 02:29:46,577 --> 02:29:48,913 THE OTHER THINGS TO THINK ABOUT 3612 02:29:48,979 --> 02:29:50,681 IS THE UP WARD SLEEPINESS SCALE 3613 02:29:50,748 --> 02:29:51,949 IS BEING COLLECTED IN THE CLINIC 3614 02:29:52,016 --> 02:29:54,085 I WORK WITH ON ALMOST EVERY 3615 02:29:54,151 --> 02:29:55,486 SINGLE PATIENT, HOWEVER THERE IS 3616 02:29:55,553 --> 02:29:57,254 A FAIR AMOUNT OF DATA THAT IS 3617 02:29:57,321 --> 02:29:58,556 NOT AS RELIABLE IN WOMEN, IT'S 3618 02:29:58,622 --> 02:30:00,524 MORE RELIABLE IN MEN, MOST OF 3619 02:30:00,591 --> 02:30:02,460 THE OSA SCREENING TOOLS, MANY OF 3620 02:30:02,526 --> 02:30:04,862 THE OSA SCREENING TOOLS ARE MORE 3621 02:30:04,929 --> 02:30:06,630 RELIABLE IN MEN THAN WOMEN AND I 3622 02:30:06,697 --> 02:30:09,200 PUBLISHED A STUDY RECENTLY ABOUT 3623 02:30:09,266 --> 02:30:10,134 THE--I PUBLISHED A STUDY 3624 02:30:10,201 --> 02:30:12,203 RECENTLY THAT WE SHOWED CUT 3625 02:30:12,269 --> 02:30:14,372 POINTS FOR THE MAP SCALE BUT 3626 02:30:14,438 --> 02:30:16,140 WEEE THIS ALSO IN SOME OF THE 3627 02:30:16,207 --> 02:30:20,511 OTHER SCALE SCALES, SO THERE 3628 02:30:20,578 --> 02:30:21,712 COULD BE--SO WE HAVE TO BE 3629 02:30:21,779 --> 02:30:23,581 CAREFUL WHEN WE USE THEM IN BIG 3630 02:30:23,647 --> 02:30:25,316 DATA, WE ALSO KNOW THAT MEN AND 3631 02:30:25,383 --> 02:30:26,517 WOMEN MIGHT HAVE DIFFERENT 3632 02:30:26,584 --> 02:30:27,651 DEFINITIONS OF SLEEP QUALITY AND 3633 02:30:27,718 --> 02:30:30,087 IT GOES WITHOUT SAYING ALL THOSE 3634 02:30:30,154 --> 02:30:31,021 INTERSECTIONAL CONSIDERATIONS WE 3635 02:30:31,088 --> 02:30:32,990 WANT TO BE SURE WOOER 3636 02:30:33,057 --> 02:30:34,525 INCORPORATE, WOMEN ARE NOT A 3637 02:30:34,592 --> 02:30:37,395 MONOLITH SO WE NEED TO THINK 3638 02:30:37,461 --> 02:30:39,697 ABOUT, BLACK WOMEN, ETHNICITY, 3639 02:30:39,764 --> 02:30:42,266 AGE, GENDER IDENTITY, SEXUAL 3640 02:30:42,333 --> 02:30:46,871 ORYEBTATION, SWREP CODE, 3641 02:30:46,937 --> 02:30:47,838 COMORBID CONDITIONS AND 3642 02:30:47,905 --> 02:30:48,973 EVERYTHING LIKE THAT. 3643 02:30:49,039 --> 02:30:50,708 NEXT SLIDE, PLEASE SO THERE ARE 3644 02:30:50,775 --> 02:30:51,909 FURTHER OPPORTUNITIES FOR 3645 02:30:51,976 --> 02:30:53,544 EXPLORATION OF OSA USING BIG 3646 02:30:53,611 --> 02:30:54,779 DATA AND AI, I THINK THESE ARE 3647 02:30:54,845 --> 02:30:57,148 SOME OF THE IDEAS I HAVE BUT I 3648 02:30:57,214 --> 02:30:59,450 HOPE THAT YOU WILL HAVE--MAKE 3649 02:30:59,517 --> 02:31:00,651 SURE YOU ALL HAVE DEFINITE 3650 02:31:00,718 --> 02:31:02,753 IDEAS, SO WHAT ARE THE RATES OF 3651 02:31:02,820 --> 02:31:06,924 OSA DIAGNOSIS OF MEN COMPARED TO 3652 02:31:06,991 --> 02:31:10,594 WOMEN ARE WOMEN STILL BEING 3653 02:31:10,661 --> 02:31:12,229 UNDERDIAGNOSED, ARE THERE 3654 02:31:12,296 --> 02:31:15,099 OUTCOMES FOR METABOLIC DIN 3655 02:31:15,166 --> 02:31:16,600 DROAMS OR DIABETES, I WAS 3656 02:31:16,667 --> 02:31:20,037 INTERESTED IN HEARING HOW AI 3657 02:31:20,104 --> 02:31:22,406 COULD HELP INCORPORATE 3658 02:31:22,473 --> 02:31:23,441 DIFFERENCES IN SLEEP 3659 02:31:23,507 --> 02:31:25,376 ARCHITECTURE AND ALSO THOSE 3660 02:31:25,443 --> 02:31:27,244 BENEFITING FROM CP A P 3661 02:31:27,311 --> 02:31:32,116 TREATMENT, AND THEN THE NEXT 3662 02:31:32,183 --> 02:31:32,950 SLIDE PLEASE. 3663 02:31:33,017 --> 02:31:34,151 SO IN CONCLUSION, A LOT OF WHAT 3664 02:31:34,218 --> 02:31:36,120 WE KNOW, A LOT OF KNOWLEDGE WE 3665 02:31:36,187 --> 02:31:37,488 HAVE ABOUT WOMEN AND SLEEP HAS 3666 02:31:37,555 --> 02:31:39,056 BEEN FOUND IN SMALL DATA SETS 3667 02:31:39,123 --> 02:31:43,160 AND THERE'S NOT BEEN A LOT OF 3668 02:31:43,227 --> 02:31:44,361 DIVERSITY, SO REALLY THIS 3669 02:31:44,428 --> 02:31:46,096 WORKSHOP HAS BEEN GREAT, I 3670 02:31:46,163 --> 02:31:47,465 LEARNED ABOUT OPPORTUNITIES THAT 3671 02:31:47,531 --> 02:31:50,134 EXIST FOR BIG DATA, AI AND 3672 02:31:50,201 --> 02:31:52,603 PROCESSING AND IMPROVING OUR SEX 3673 02:31:52,670 --> 02:31:54,605 DIFFERENCES IN OSA,--THERE ARE 3674 02:31:54,672 --> 02:31:56,807 LOTS OF NOVEL METHODOLOGY 3675 02:31:56,874 --> 02:31:58,642 INCLUDING PROCESSING FOR 3676 02:31:58,709 --> 02:31:59,810 MENOPAUSE, THE BIGGEST THING I 3677 02:31:59,877 --> 02:32:01,345 JUST WANT TO SAY IS, YOU KNOW 3678 02:32:01,412 --> 02:32:03,314 WHEN WE DO OUR STUDIES, WE JUST 3679 02:32:03,380 --> 02:32:06,517 NEED TO CONSIDER STRATIFYING BY 3680 02:32:06,584 --> 02:32:09,720 SEX AND RECORDING OUR RESULTS 3681 02:32:09,787 --> 02:32:12,590 BECAUSE MANY TIMES WOMEN HAVE 3682 02:32:12,656 --> 02:32:14,225 DATA SETS BUT WE DON'T FIND OUT 3683 02:32:14,291 --> 02:32:17,127 IF THERE WERE DIFFERENCES IN SEX 3684 02:32:17,194 --> 02:32:17,428 DIFFERENCES. 3685 02:32:17,495 --> 02:32:19,897 SO INCLUDE THOSE DATA SETS WHEN 3686 02:32:19,964 --> 02:32:20,865 POSSIBLE AND EVALUATE 3687 02:32:20,931 --> 02:32:27,705 QUESTIONNAIRES, AND THE NEXT 3688 02:32:27,771 --> 02:32:27,905 SLIDE. 3689 02:32:27,972 --> 02:32:28,272 THANK YOU. 3690 02:32:28,339 --> 02:32:30,908 THAT'S ALL I HAVE RIGHT NOW. 3691 02:32:30,975 --> 02:32:39,250 JUST THAIRNG YOU SO MUCH I WILL 3692 02:32:39,316 --> 02:32:42,119 TAKE ANY QUESTIONS. 3693 02:32:42,186 --> 02:32:43,621 >> THANKS SO MUCH FOR THE TALK. 3694 02:32:43,687 --> 02:32:46,423 GIVEN THE TIME I THINK WE SHOULD 3695 02:32:46,490 --> 02:32:49,059 GO INTO THE Q&A, SO WHY DON'T WE 3696 02:32:49,126 --> 02:32:57,001 OPEN THE FLOOR TO ALL OF OUR 3697 02:32:57,067 --> 02:33:07,511 SPEAKERS IN THIS SESSION. 3698 02:33:08,279 --> 02:33:12,850 >> I HAVE NO QUESTIONS IN THE 3699 02:33:12,917 --> 02:33:16,153 Q&A, SO IF ANYBODY WANTS TO ASK 3700 02:33:16,220 --> 02:33:18,556 ANY NOW, THERE'S A WELCOME BUT 3701 02:33:18,622 --> 02:33:25,095 WE HAVEN'T GOTTEN ANY PRIOR TO 3702 02:33:25,162 --> 02:33:25,296 THIS. 3703 02:33:25,362 --> 02:33:26,297 >> I GUESS 1 QUESTION IS, 1 3704 02:33:26,363 --> 02:33:27,831 THING I WOULD LIKE TO KNOW IS, 3705 02:33:27,898 --> 02:33:29,366 WELL IN GENERAL I WOULD LIKE TO 3706 02:33:29,433 --> 02:33:32,870 GET A LITTLE CROSS TALK GOING 3707 02:33:32,937 --> 02:33:34,471 BETWEEN THESE--AMONG THESE TALKS 3708 02:33:34,538 --> 02:33:38,409 WHICH ARE GENERALLY EXCELLENT 3709 02:33:38,475 --> 02:33:43,581 BUY-IN WHAT DO--BUT WHAT DO YOU 3710 02:33:43,647 --> 02:33:47,785 THINK, MAYBE START WITH 3711 02:33:47,851 --> 02:33:49,653 DR. MORRIS AND DR. SPIRA, ARE 3712 02:33:49,720 --> 02:33:53,324 THERE SEX OR GENDER VARIABLES 3713 02:33:53,390 --> 02:33:55,359 THAT WERE NOT THINKING OF TAKING 3714 02:33:55,426 --> 02:34:01,165 INTO,A --ACCOUNT WHEN SAY 3715 02:34:01,231 --> 02:34:02,967 PREDICTING THE INCIDENCE OF 3716 02:34:03,033 --> 02:34:06,837 ALZHEIMER'S DISEASE FROM SLEEP 3717 02:34:06,904 --> 02:34:07,037 DATA. 3718 02:34:07,104 --> 02:34:08,439 IS THERE--IS THERE SOME MORE 3719 02:34:08,505 --> 02:34:13,978 NUANCE WE NEED TO BRING INTO THE 3720 02:34:14,044 --> 02:34:14,445 CONVERSATION? 3721 02:34:14,511 --> 02:34:17,381 >> SO, I'M HAPPY TO JUMP IN AND 3722 02:34:17,448 --> 02:34:18,649 JUST SAY THAT I THINK THAT 3723 02:34:18,716 --> 02:34:21,018 SOMETHING THAT I'VE BEEN VERY 3724 02:34:21,085 --> 02:34:24,822 INTERESTED IN IS WE HAVE A SEX 3725 02:34:24,888 --> 02:34:25,956 DIFFERENCE IN DEMENTIA 3726 02:34:26,023 --> 02:34:27,691 PREVALENCE AND WOMEN ARE MORE 3727 02:34:27,758 --> 02:34:31,662 LIKELY TO HAVE DEMENTIA, AND I 3728 02:34:31,729 --> 02:34:34,898 KNOW--I THINK JONAH WORKS WITH 3729 02:34:34,965 --> 02:34:37,134 REBECCA THURSTON IN THIS AREA, 3730 02:34:37,201 --> 02:34:37,701 INCLUDING THE ALZHEIMER'S 3731 02:34:37,768 --> 02:34:40,704 DISEASE AREA WITH RESPECT 3732 02:34:40,771 --> 02:34:42,139 TO--AND THERE ARE ACTUALLY--SO, 3733 02:34:42,206 --> 02:34:43,207 EVERYONE ON THIS CALL HAS A LINK 3734 02:34:43,273 --> 02:34:46,176 TO PEOPLE WHO ARE DOING A LOT OF 3735 02:34:46,243 --> 02:34:47,811 WORK ON SEX DIFFERENCES AND 3736 02:34:47,878 --> 02:34:53,784 SLEEP, I KNOW FIONA BAKER WITH 3737 02:34:53,851 --> 02:34:55,319 SSRI HAS BEEN DEEPLY INVOLVED IN 3738 02:34:55,386 --> 02:34:58,489 THAT BUT I'VE ALWAYS BEEN VERY 3739 02:34:58,555 --> 02:35:00,224 CURIOUS ABOUT THE EXTENT TO 3740 02:35:00,290 --> 02:35:03,193 WHICH SEX DIFFERENCES AND SLEEP 3741 02:35:03,260 --> 02:35:04,962 IS ATTRIBUTABLE TO SO MANY 3742 02:35:05,029 --> 02:35:07,431 FACTORS INCLUDING CHILD REARING, 3743 02:35:07,498 --> 02:35:09,199 PREGNANCY, FAMILY CARE GIVING, 3744 02:35:09,266 --> 02:35:11,502 MENOPAUSE, ALL OF THESE THINGS 3745 02:35:11,568 --> 02:35:13,570 MIGHT ADD UP TO CONTRIBUTE TO A 3746 02:35:13,637 --> 02:35:16,540 GREATER RISK FOR DEMENTIA. 3747 02:35:16,607 --> 02:35:19,309 AND NOT TO MENTION--DID I 3748 02:35:19,376 --> 02:35:21,211 MENTION [INDISCERNIBLE], AND WE 3749 02:35:21,278 --> 02:35:23,380 KNOW SLEEP CHANGES ACROSS THE 3750 02:35:23,447 --> 02:35:23,781 MENSTRUAL CYCLE. 3751 02:35:23,847 --> 02:35:26,583 SO I THINK THERE ARE THINGS TO 3752 02:35:26,650 --> 02:35:27,584 CONSIDER, THERE'S A LOT TO SAY 3753 02:35:27,651 --> 02:35:30,421 THERE, AND I KNOW MUCH MORE 3754 02:35:30,487 --> 02:35:33,390 ABOUT THE SLEEP AND DEMENTIA 3755 02:35:33,457 --> 02:35:35,025 SIDE THAN THE SLEEP AND SEX AND 3756 02:35:35,092 --> 02:35:36,460 GENDER SIDE SO I WILL STOP 3757 02:35:36,527 --> 02:35:36,694 TALKING. 3758 02:35:36,760 --> 02:35:38,862 >> YEAH, IF I CAN JUMP IN, I 3759 02:35:38,929 --> 02:35:40,631 THINK--I ACTUALLY TALKED TO 3760 02:35:40,698 --> 02:35:42,933 FIONA BAKER BEFORE I GAVE THIS 3761 02:35:43,000 --> 02:35:44,568 TALK BUT I REALLY WISH SHE 3762 02:35:44,635 --> 02:35:46,070 TALKED ABOUT A STUDY THAT WASN'T 3763 02:35:46,136 --> 02:35:47,838 QUITE READY BUT I WOULD HAVE 3764 02:35:47,905 --> 02:35:50,607 LOVE TO PRESENT IT WHICH WAS IN 3765 02:35:50,674 --> 02:35:52,376 BIG DATA, BUT, THE--I THINK, 3766 02:35:52,443 --> 02:35:54,478 TOO, WHEN WE THINK ABOUT THESE 3767 02:35:54,545 --> 02:35:55,879 THINGS, THE DIFFERENCES, DO THEY 3768 02:35:55,946 --> 02:35:57,881 ADD UP TO WHEN WE THINK ABOUT 3769 02:35:57,948 --> 02:35:59,483 EVERYTHING YOU JUST MENTIONED, 3770 02:35:59,550 --> 02:36:03,754 DO THEY ADD UP TO ME FINDING IN 3771 02:36:03,821 --> 02:36:06,390 MANY, MANY WAYS, JUST WHAT WE 3772 02:36:06,457 --> 02:36:07,791 CONSIDER OBSTRUCTIVE SLEEP APNEA 3773 02:36:07,858 --> 02:36:10,561 IN SLEEP BECAUSE THERE'S SO MANY 3774 02:36:10,627 --> 02:36:12,396 THAT WE HAVE, WE MIGHT HAVE THE 3775 02:36:12,463 --> 02:36:14,698 OPPORTUNITY TO THINK ABOUT 3776 02:36:14,765 --> 02:36:17,468 REDEFINING HELP SOME OF THESE 3777 02:36:17,534 --> 02:36:18,202 DISORDER--THERE'S SO MANY 3778 02:36:18,268 --> 02:36:19,236 DIFFERENCES AND HOW WE MEASURE 3779 02:36:19,303 --> 02:36:23,640 IT AND EVERYTHING ELSE LIKE 3780 02:36:23,707 --> 02:36:23,874 THAT. 3781 02:36:23,941 --> 02:36:26,310 SO YEAH, AS FAR AS MEASURES, 3782 02:36:26,376 --> 02:36:27,845 WE'RE TRYING TO ACCOUNT FOR AS 3783 02:36:27,911 --> 02:36:29,546 MANY AS POSSIBLE ESPECIALLY WHEN 3784 02:36:29,613 --> 02:36:33,584 WE'RE THINKING ABOUT WOMEN, 3785 02:36:33,650 --> 02:36:34,618 INCLUDING MENOPAUSAL STATUS. 3786 02:36:34,685 --> 02:36:36,620 NWELL, LET ME JUST BRIEFLY 3787 02:36:36,687 --> 02:36:39,556 INCLUDE AN ADDITIONAL POINT HERE 3788 02:36:39,623 --> 02:36:40,491 THAT [INDISCERNIBLE] IN ORDER TO 3789 02:36:40,557 --> 02:36:43,160 SEE THAT YOU'RE IN THIS 3790 02:36:43,227 --> 02:36:44,061 TRANSITIONAL PERIOD, EXTENDED 3791 02:36:44,128 --> 02:36:47,598 PERIOD, BUT A LESSON 3792 02:36:47,664 --> 02:36:48,799 [INDISCERNIBLE] SEEMS TO HAVE 3793 02:36:48,866 --> 02:36:50,400 QUALITIES FROM BOYS TOO AND WE 3794 02:36:50,467 --> 02:36:51,835 DO SEE FROM EARLY AGES THAT 3795 02:36:51,902 --> 02:36:53,237 THERE ARE DIFFERENCES AND 3796 02:36:53,303 --> 02:36:56,039 ASSOCIATIONS BETWEEN SLEEP 3797 02:36:56,106 --> 02:36:57,207 PROBLEMS AND MENTAL HEALTH. 3798 02:36:57,274 --> 02:37:00,277 WE HAD A RECENT STUDY WHERE WE 3799 02:37:00,344 --> 02:37:04,081 SHOWED THAT AS PART OF THE ABCD 3800 02:37:04,148 --> 02:37:08,619 STUDY, THE LESSON FEMALES REPORT 3801 02:37:08,685 --> 02:37:10,053 SHORTER SLEEP DURATIONS, LATER 3802 02:37:10,120 --> 02:37:11,221 BED TIMES, MORE PROBLEMS FALLING 3803 02:37:11,288 --> 02:37:12,656 TO SLEEP AND ALL THESE THINGS 3804 02:37:12,723 --> 02:37:14,057 THAT ARE ASSOCIATED WITH 3805 02:37:14,124 --> 02:37:15,459 MENSTRUATION ISSUES, SO I THINK 3806 02:37:15,526 --> 02:37:25,803 WE HAVE TO START 3807 02:37:29,239 --> 02:37:32,409 BROADENING--THESE EXPERIMENTS. 3808 02:37:32,476 --> 02:37:32,676 >> YES. 3809 02:37:32,743 --> 02:37:38,715 >> YOU HAVE A QUESTION FROM THE 3810 02:37:38,782 --> 02:37:40,450 VIDEOCAST AUDIENCE. 3811 02:37:40,517 --> 02:37:43,520 HOW CAN PRACTICING CLINICIANS 3812 02:37:43,587 --> 02:37:45,689 PARTICIPATE IN A BROAD RATE IN 3813 02:37:45,756 --> 02:37:53,297 THESE RESEARCH PROJECTS. 3814 02:37:53,363 --> 02:37:55,966 >> SO I CAN ANSWER SOME OF THAT 3815 02:37:56,033 --> 02:38:01,271 ANYWAY, I COLLABORATE WITH QUITE 3816 02:38:01,338 --> 02:38:02,906 A FEW CLINICIANS IN STUDIES I 3817 02:38:02,973 --> 02:38:05,843 DO, I'M A HUGE HUMAN RESEARCHER 3818 02:38:05,909 --> 02:38:07,878 SO I HAVE STUDIES, AND I COULD 3819 02:38:07,945 --> 02:38:09,513 BT DO IT WITHOUT THE CLIN IPGZS 3820 02:38:09,580 --> 02:38:10,414 WHO ARE THE PEOPLE WHO ARE 3821 02:38:10,480 --> 02:38:11,715 SEEING THE EMPLOYMENT PROGRAMS 3822 02:38:11,782 --> 02:38:14,818 AND CAN PROVIDE ME WITH SOME OF 3823 02:38:14,885 --> 02:38:16,653 THE CHALLENGES THAT THEY HAVE 3824 02:38:16,720 --> 02:38:18,689 AND WEARING CP A P, AND SOME OF 3825 02:38:18,755 --> 02:38:21,024 THE CHALLENGES THEY HAVE 3826 02:38:21,091 --> 02:38:21,859 INITIATING AND QUALITATIVELY WHY 3827 02:38:21,925 --> 02:38:24,494 THEY HAVE CONTINUED TO WEAR IT. 3828 02:38:24,561 --> 02:38:27,531 SO I THINK IT IS IMPORTANT FOR 3829 02:38:27,598 --> 02:38:32,035 US WHO ARE SEEING OUR PATIENTS 3830 02:38:32,102 --> 02:38:32,603 EVERY DAY. 3831 02:38:32,669 --> 02:38:38,542 >> ANYBODY ELSE WANT TO CHIME 3832 02:38:38,609 --> 02:38:38,775 IN? 3833 02:38:38,842 --> 02:38:41,645 >> IF NOT WE CAN GO TO LARRY WHO 3834 02:38:41,712 --> 02:38:46,383 HAS HIS HAND UP? 3835 02:38:46,450 --> 02:38:48,452 >> YEAH, SO DR. MORRIS, YOU 3836 02:38:48,518 --> 02:38:51,355 SHOWED ON 1 OF YOUR EARLIER 3837 02:38:51,421 --> 02:38:52,055 SLIDES THE DIFFERENCES BETWEEN 3838 02:38:52,122 --> 02:38:53,924 MEN AND WOMEN AND THE RANGES 3839 02:38:53,991 --> 02:38:56,627 WERE HUGE, SO DOES THAT INDICATE 3840 02:38:56,693 --> 02:38:59,663 A PROBLEM WITH DIAGNOSIS OR 3841 02:38:59,730 --> 02:39:01,064 HETEROGENEITY OR WHAT? 3842 02:39:01,131 --> 02:39:01,965 BECAUSE THAT'S HISTORICALLY BEEN 3843 02:39:02,032 --> 02:39:05,435 THE DIFFICULT THING TO ESTIMATE, 3844 02:39:05,502 --> 02:39:06,203 I KNOW? 3845 02:39:06,270 --> 02:39:08,872 THE ESTIMATES HAVE NOT GOTTEN 3846 02:39:08,939 --> 02:39:09,940 BETTER OVER TIME. 3847 02:39:10,007 --> 02:39:12,109 >> NO, THAT'S ACTUALLY SOME OF 3848 02:39:12,175 --> 02:39:16,246 THE WORK THAT I'M ACTUALLY DOING 3849 02:39:16,313 --> 02:39:17,080 WITH DIEGO, YEAH, BECAUSE WHEN 3850 02:39:17,147 --> 02:39:20,183 WE LOOK AT THE HI AND WE LOOK 3851 02:39:20,250 --> 02:39:24,354 THEA THE DIFFERENCE BETWEEN REM 3852 02:39:24,421 --> 02:39:26,556 AND NONREM, THE CMS GUIDELINES 3853 02:39:26,623 --> 02:39:29,192 WE CAN ONLY LOOK AT AND CONSIDER 3854 02:39:29,259 --> 02:39:31,828 SOMEBODY DIAGNOSED WITH AHI, BUT 3855 02:39:31,895 --> 02:39:35,299 WITH OSA, WE'RE AT 3 OF 5% OF 3856 02:39:35,365 --> 02:39:37,467 THE OX GENERATEDDATION, THE AHI 3857 02:39:37,534 --> 02:39:40,003 SHOW IT SHOULD BE 4% OX 3858 02:39:40,070 --> 02:39:41,605 GENERATEDDATION SO WE'RE LOSING 3859 02:39:41,672 --> 02:39:42,806 A LOT OF WOMEN THAT ARE NOT 3860 02:39:42,873 --> 02:39:46,143 DIAGNOSED BECAUSE WE'RE USING 3861 02:39:46,209 --> 02:39:49,313 THE CMS GUIDELINES, SO YES, I 3862 02:39:49,379 --> 02:39:51,181 THINK THOSE SPREADS ARE 3863 02:39:51,248 --> 02:39:53,650 DEFINITELY AS A RESULT, WE 3864 02:39:53,717 --> 02:39:55,285 TALKED ABOUT THE MODALITIES, 3865 02:39:55,352 --> 02:39:57,554 THEY'RE DEFINITELY A RESULT OF 3866 02:39:57,621 --> 02:39:59,523 JUST, MAYBE BE MORE CONSISTENT, 3867 02:39:59,589 --> 02:40:04,194 I'M NOT SURE IN HO WE DIAGNOSE 3868 02:40:04,261 --> 02:40:06,229 WOMEN AND MEN. 3869 02:40:06,296 --> 02:40:10,100 >> YEAH, IT'S A CONTINUING 3870 02:40:10,167 --> 02:40:11,034 PROBLEM. 3871 02:40:11,101 --> 02:40:11,268 NTHANKS. 3872 02:40:11,335 --> 02:40:12,202 >> ALL RIGHT, THANK YOU VERY 3873 02:40:12,269 --> 02:40:14,738 MUCH, THANKS FOR THIS BRIEF BUT 3874 02:40:14,805 --> 02:40:15,672 ENLIGHTENING DISCUSSION AND 3875 02:40:15,739 --> 02:40:17,741 THANKS FOR THOSE GREAT TALKS AND 3876 02:40:17,808 --> 02:40:21,511 AT THIS POINT, LET'S GO TO OUR 3877 02:40:21,578 --> 02:40:22,913 10 MINUTE BREAK AND WE WILL SEE 3878 02:40:22,980 --> 02:40:25,916 EVERYBODY BACK HERE AT 2:55. 3879 02:40:25,983 --> 02:40:26,416 THANK YOU. 3880 02:40:26,483 --> 02:40:29,519 >> THANKS TO THE SPEAKERS 3881 02:40:29,586 --> 02:40:29,987 APPRECIATE YOUR TALKS. 3882 02:40:30,053 --> 02:40:34,057 >> THANK YOU. 3883 02:40:34,124 --> 02:40:34,992 THANK YOU FOR BEING HERE TODAY 3884 02:40:35,058 --> 02:40:39,396 AND I AM VERYY HAPPY TO KICKOFF 3885 02:40:39,463 --> 02:40:41,164 OFF SESSION 5 WHICH IS ON THE 3886 02:40:41,231 --> 02:40:42,766 FOCUS ON POPULATION AND 3887 02:40:42,833 --> 02:40:47,704 ENVIRONMENTAL IPT --INFLUENCES D 3888 02:40:47,771 --> 02:40:48,672 ELGTICAL ISSUES. 3889 02:40:48,739 --> 02:40:49,840 THE FIRST SPEAKER TODAY THAT WE 3890 02:40:49,906 --> 02:40:58,115 HAVE FOR THIS SESSION WILL BE 3891 02:40:58,181 --> 02:40:58,849 DR. AZIZI SEIXAS FROM THE 3892 02:40:58,915 --> 02:41:00,250 UNIVERSITY OF MIAMI TALKING 3893 02:41:00,317 --> 02:41:03,120 ABOUT PRECISION AND PERSONALIZED 3894 02:41:03,186 --> 02:41:08,225 POPULATION SLEEP HEGHT: SMART 3895 02:41:08,291 --> 02:41:11,194 AND CONNECTIVE SYSTEMS. 3896 02:41:11,261 --> 02:41:13,030 DR. SEIXAS IS THE INTERIM AND 3897 02:41:13,096 --> 02:41:14,664 INAUGURAL CHAIR FOR THE 3898 02:41:14,731 --> 02:41:15,932 DEPARTMENT OF INFORMATICS OF 3899 02:41:15,999 --> 02:41:19,036 HEALTH DATA SCIENCE AT THE 3900 02:41:19,102 --> 02:41:19,269 MIAMI 3901 02:41:19,336 --> 02:41:21,338 SCHOOL OF MEDICINE AND HE'S ALSO 3902 02:41:21,405 --> 02:41:23,173 A FUNDED LEADER WITH THE AIM 3903 02:41:23,240 --> 02:41:27,110 PROGRAM, WHICH AIMS TO INCREASE 3904 02:41:27,177 --> 02:41:28,278 PARTICIPATION AND REPRESENTATION 3905 02:41:28,345 --> 02:41:30,580 OF COMMUNITIES THAT ARE 3906 02:41:30,647 --> 02:41:31,848 CURRENTLY UNDERREPRESENTED IN AI 3907 02:41:31,915 --> 02:41:34,351 AND NL, WITH THAT I WILL HAND 3908 02:41:34,418 --> 02:41:37,721 THE STAGE OVER TO DR. ZIZI. 3909 02:41:37,788 --> 02:41:38,789 NTHANK YOU EVERYONE, REALLY, 3910 02:41:38,855 --> 02:41:42,492 THANK YOU FOR THAT VERY GRACIOUS 3911 02:41:42,559 --> 02:41:43,593 INTRODUCE, FIRST OF ALL, YOU 3912 02:41:43,660 --> 02:41:46,997 KNOW I AM FEELING VERY GRATEFUL 3913 02:41:47,064 --> 02:41:50,033 FOR BEING ASKED TO PRESENT TO 3914 02:41:50,100 --> 02:41:51,802 YOU BECAUSE AS I HAVE BEEN 3915 02:41:51,868 --> 02:41:54,838 REFLECTING ON THESE LAST 2 DAYS, 3916 02:41:54,905 --> 02:42:00,177 I HAVE NOTHING BUT FEELINGS OF 3917 02:42:00,243 --> 02:42:02,446 FULLNESS AND GRATITUDE BECAUSE 3918 02:42:02,512 --> 02:42:03,914 PREVIOUSLY DR. MICHAEL 3919 02:42:03,980 --> 02:42:06,750 [INDISCERNIBLE] WHO HOSTED A 3920 02:42:06,817 --> 02:42:09,820 SIMILAR SLEEP 101 TALK WHEN HE 3921 02:42:09,886 --> 02:42:11,755 ASKED ME THIS TO PRESENT, YOU 3922 02:42:11,822 --> 02:42:13,623 KNOW THERE ARE ABOUT 2 OR 3 3923 02:42:13,690 --> 02:42:15,625 SPEAKERS I KNOW TODAY, WE HAVE 2 3924 02:42:15,692 --> 02:42:19,062 FULL DAYS WORTH OF SPEAKERS. 3925 02:42:19,129 --> 02:42:22,899 SO HUGE KUDOS TO 3926 02:42:22,966 --> 02:42:23,400 DR. [INDISCERNIBLE] AND 3927 02:42:23,467 --> 02:42:25,535 DR. BROWN AND HER TEAM FOR 3928 02:42:25,602 --> 02:42:28,271 INVESTING IN THIS SPACE. 3929 02:42:28,338 --> 02:42:30,674 AND AS MUCH AS I AM VERY FULL, 3930 02:42:30,740 --> 02:42:33,076 AND GRATEFUL FOR THIS 3931 02:42:33,143 --> 02:42:35,479 INVITATION, I ALSO AM AWARE THAT 3932 02:42:35,545 --> 02:42:38,482 MYSELF AS WELL AS MY ESTEEMED 3933 02:42:38,548 --> 02:42:41,685 PANELISTS ARE THE LAST SPEAKERS 3934 02:42:41,751 --> 02:42:45,288 FOR THESE 2 DAYS, AS WELL AS WE 3935 02:42:45,355 --> 02:42:46,556 ARE ESSENTIALLY CAUGHT BETWEEN A 3936 02:42:46,623 --> 02:42:49,426 ROCK AND A HARD PLACE BECAUSE, 3937 02:42:49,493 --> 02:42:52,062 YOU KNOW WE SERVE--YOU KNOW WE 3938 02:42:52,129 --> 02:42:55,832 ARE BETWEEN A VERY LONG WEEK AND 3939 02:42:55,899 --> 02:42:59,102 HOPEFULLY EXCITING WEEKEND SO I 3940 02:42:59,169 --> 02:43:00,770 NOT SURE IF I SHOULD SEE THIS 3941 02:43:00,837 --> 02:43:02,739 HAS AN HONOR OR A CHALLENGE, I 3942 02:43:02,806 --> 02:43:04,274 WILL SEE IT AS BOTH AND MY HOPE 3943 02:43:04,341 --> 02:43:05,842 IS THAT I WILL SHOW YOU WHO I 3944 02:43:05,909 --> 02:43:08,044 AM, MY HOPE IS THAT I WILL 3945 02:43:08,111 --> 02:43:09,546 INFORM YOU, I WILL AROUSE YOU 3946 02:43:09,613 --> 02:43:10,747 AND MOVE YOU BECAUSE I THINK 3947 02:43:10,814 --> 02:43:14,384 THIS IS WHAT THIS SESSION CALLS 3948 02:43:14,451 --> 02:43:15,418 FOR. 3949 02:43:15,485 --> 02:43:17,154 YOU KNOW THE, THE FOCUS ON 3950 02:43:17,220 --> 02:43:18,889 POPULATIONS AND ETHICAL ISSUES 3951 02:43:18,955 --> 02:43:21,591 ARE NOT AN AFTERTHOUGHT BUT 3952 02:43:21,658 --> 02:43:23,126 SHOULD ALWAYS BE CONTEXTUALIZED 3953 02:43:23,193 --> 02:43:24,661 BECAUSE AS WE'RE TALKING ABOUT 3954 02:43:24,728 --> 02:43:27,631 DATA, DATA I CONSIDER DATA AS 3955 02:43:27,697 --> 02:43:30,901 THE RAW MATERIAL AND INFORMATION 3956 02:43:30,967 --> 02:43:32,536 WHICH IS MAKING MEANINGFUL 3957 02:43:32,602 --> 02:43:35,172 INSIGHTS FROM DATA SHOULD ALWAYS 3958 02:43:35,238 --> 02:43:38,475 BE SEEN IN CONTEXT AND SO NEXT 3959 02:43:38,542 --> 02:43:38,942 SLIDE, PLEASE. 3960 02:43:39,009 --> 02:43:40,911 AND SO 1 OF THE THINGS THAT I 3961 02:43:40,977 --> 02:43:42,979 WILL FOCUS ON TODAY, IS THAT I 3962 02:43:43,046 --> 02:43:47,350 HOPE I WILL KICK OUR PANEL OFF 3963 02:43:47,417 --> 02:43:49,219 BY FOCUSING ON REFLECTIONS AND 3964 02:43:49,286 --> 02:43:50,620 ASPIRATIONS IN TERMS OF WHERE WE 3965 02:43:50,687 --> 02:43:53,490 WANT TO GO, I WON'T PROVIDE TOO 3966 02:43:53,557 --> 02:43:55,692 MUCH, YOU KNOW STATISTICAL 3967 02:43:55,759 --> 02:43:59,162 ANALYSIS BECAUSE I REALLY WANT 3968 02:43:59,229 --> 02:44:01,231 YOU ALL TO LISTEN WITH YOUR 3969 02:44:01,298 --> 02:44:03,233 EYES, AND SEE WITH YOUR EARS AND 3970 02:44:03,300 --> 02:44:06,770 I KNOW THAT SEEMS COUNTER 3971 02:44:06,836 --> 02:44:08,939 INTUITIVE BUT WHEN YOU LISTEN 3972 02:44:09,005 --> 02:44:12,375 WITH YOUR EYES, YOU HAVE A SENSE 3973 02:44:12,442 --> 02:44:13,877 OF DIGESTION WHERE YOU 3974 02:44:13,944 --> 02:44:16,680 UNDERSTAND THE MEANING AND 3975 02:44:16,746 --> 02:44:19,049 IMPORTANCE WHATEVER YOU SEE AND 3976 02:44:19,115 --> 02:44:21,017 WHEN YOU LISTEN WITH YOUR EARS, 3977 02:44:21,084 --> 02:44:24,221 I WANT YOU TO FEEL MOVED BUT 3978 02:44:24,287 --> 02:44:27,424 ALSO MOVED AND COMPELLED TO 3979 02:44:27,490 --> 02:44:28,124 SEARCH FOR TRUTH AND JUSTICE 3980 02:44:28,191 --> 02:44:31,194 BECAUSE THIS IS NOT JUST ABOUT 3981 02:44:31,261 --> 02:44:33,697 SLEEP HEALTH, THIS IS ABOUT 3982 02:44:33,763 --> 02:44:35,065 HEALTH IN GENERAL AND HOW WE'VE 3983 02:44:35,131 --> 02:44:36,366 GONE ABOUT DO THANKSGIVING IS 3984 02:44:36,433 --> 02:44:39,569 THAT WE CREATED AN ENTEAR BODY 3985 02:44:39,636 --> 02:44:41,304 OF FRAMEWORK, A BODY OF RESEARCH 3986 02:44:41,371 --> 02:44:44,975 THAT LOOKS LIKE PRECISION AND 3987 02:44:45,041 --> 02:44:46,576 PERSONALIZED POPULATION ON HEGHT 3988 02:44:46,643 --> 02:44:50,080 WHERE WE FOCUS ON DESCRIBING 3989 02:44:50,146 --> 02:44:51,715 PHENOMENA, FOCUS ALSO ON 3990 02:44:51,781 --> 02:44:52,849 DISCOVERY PARTICULARLY LOOKING 3991 02:44:52,916 --> 02:44:56,586 AT WHAT ARE SOME UNIQUE CAUSES 3992 02:44:56,653 --> 02:44:59,656 AND ETIOLOGIES OF DISEASE, IN 3993 02:44:59,723 --> 02:45:01,191 THIS CASE, SLEEP HEALTH AND THEN 3994 02:45:01,258 --> 02:45:02,559 TRY TO UNDERSTAND AND DISCOVER 3995 02:45:02,626 --> 02:45:04,894 WHAT THESE SOLUTIONS ARE, WHO 3996 02:45:04,961 --> 02:45:06,263 MIGHT THESE SOLUTIONS WORK FOR 3997 02:45:06,329 --> 02:45:09,232 AND THEN LASTLY WE FOCUS ON 3998 02:45:09,299 --> 02:45:13,236 SOLVING IT, HOW CAN WE PROVIDE 3999 02:45:13,303 --> 02:45:16,640 PERSONALIZED AND COMMUNITY BASED 4000 02:45:16,706 --> 02:45:18,908 SLEEP INTERVENTIONS FOR ALL. 4001 02:45:18,975 --> 02:45:19,509 NEXT SLIDE, PLEASE. 4002 02:45:19,576 --> 02:45:21,811 ONE OF THE FRAMEWORKS WE HAVE 4003 02:45:21,878 --> 02:45:24,648 LED IN THIS SPACE, MY COLLEAGUES 4004 02:45:24,714 --> 02:45:27,384 AND I, YOU KNOW PRIMARILY 4005 02:45:27,450 --> 02:45:28,885 DR. [INDISCERNIBLE] WHO IS A 4006 02:45:28,952 --> 02:45:29,452 DEAR COLLEAGUE. 4007 02:45:29,519 --> 02:45:33,023 WE LEAD THE CENTER FOR SLEEP AND 4008 02:45:33,089 --> 02:45:33,957 CIRCADIAN SCIENCES AT UNIVERSITY 4009 02:45:34,024 --> 02:45:36,459 OF MIAMI IS THAT WHEN YOU'RE 4010 02:45:36,526 --> 02:45:37,861 INTERESTED IN STUDYING 4011 02:45:37,927 --> 02:45:39,562 POPULATIONS, WHETHER IT BE 4012 02:45:39,629 --> 02:45:42,165 THROUGH THE LENS OF EQUITY OR 4013 02:45:42,232 --> 02:45:44,734 DISPARITIES THAT YOU MUST HAVE 4014 02:45:44,801 --> 02:45:46,169 THE LASER FOCUSED ON WHAT YOU 4015 02:45:46,236 --> 02:45:48,271 FIND AND A WORK FLOW AS TO HOW 4016 02:45:48,338 --> 02:45:51,341 TO GET HERE, FIRST YOU MUST 4017 02:45:51,408 --> 02:45:53,943 DEFINE THIS DEFINITION PROVIDES 4018 02:45:54,010 --> 02:45:56,946 THIS LENS THROUGH WHICH YOU CAN 4019 02:45:57,013 --> 02:45:58,882 OBSERVE DISPARITIES OR 4020 02:45:58,948 --> 02:45:59,849 INNEREQUITIES, BUT YOU ALSO NEED 4021 02:45:59,916 --> 02:46:01,017 TO HAVE A GOOD SENSE OF HOW ARE 4022 02:46:01,084 --> 02:46:03,586 YOU GOING TO MEASURE THESE 4023 02:46:03,653 --> 02:46:04,287 DIFFERENCES, VERSUS DISPARITIES, 4024 02:46:04,354 --> 02:46:05,588 HOW ARE YOU GOING TO MEASURE 4025 02:46:05,655 --> 02:46:07,691 EQUITY AND WHAT KIND OF 4026 02:46:07,757 --> 02:46:10,193 ANALYTICAL TOOLS ARE NEEDED FOR 4027 02:46:10,260 --> 02:46:10,493 THIS? 4028 02:46:10,560 --> 02:46:12,729 THEN WE'RE GOING TO NEED TO 4029 02:46:12,796 --> 02:46:13,963 FOCUS ON DESCRIPTION EMPLOY DO 4030 02:46:14,030 --> 02:46:15,398 WE FOCUS ON THE LIVED 4031 02:46:15,465 --> 02:46:18,101 EXPERIENCE, OR DO WE ALSO FOCUS 4032 02:46:18,168 --> 02:46:19,069 ON MULTILEVEL DETERMINANT ANDS 4033 02:46:19,135 --> 02:46:21,004 CORRELATES AND THE REASON WHY 4034 02:46:21,071 --> 02:46:22,072 THIS IS IMPORTANT, SOME OF YOU 4035 02:46:22,138 --> 02:46:24,507 WHO HAVE HEARD ME PEEK BEFORE, 4036 02:46:24,574 --> 02:46:26,776 THAT I BELIEVE AND HAVE ALWAYS 4037 02:46:26,843 --> 02:46:29,012 SAID THAT SLEEP AND PARTICULARLY 4038 02:46:29,079 --> 02:46:32,582 SLEEP HEALTH IS THE 4039 02:46:32,649 --> 02:46:33,183 QUINTESSENTIAL OMNIPHENOMENON 4040 02:46:33,249 --> 02:46:34,784 WHERE IT CAN BE SEEN AS A CAUSE 4041 02:46:34,851 --> 02:46:37,454 OF RISK OR DETERMINANT, A 4042 02:46:37,520 --> 02:46:40,323 PREDICTER AND AN ARTIFACTOR OF 4043 02:46:40,390 --> 02:46:41,825 CONSEQUENCE, SO WE NEED THOSE 4044 02:46:41,891 --> 02:46:44,027 LENS TO BETTER UNDERSTAND, TO 4045 02:46:44,094 --> 02:46:45,328 SEE WHAT ARE WE ACTUALLY SEEING 4046 02:46:45,395 --> 02:46:48,298 AND FROM THERE WE WILL EXPLAIN 4047 02:46:48,365 --> 02:46:49,566 AND DEFINE MECHANISMS AND THEN 4048 02:46:49,632 --> 02:46:52,669 WE WILL SOLVE TO FIND PLAUSIBLE 4049 02:46:52,736 --> 02:46:53,837 AND STRATEGIC UNSCALABLE 4050 02:46:53,903 --> 02:46:58,675 SOLUTIONS. 4051 02:46:58,742 --> 02:46:59,576 NEXT SLIDE, PLEASE. 4052 02:46:59,642 --> 02:47:02,011 THE VISION OF PRECISION AND 4053 02:47:02,078 --> 02:47:03,346 PERSONALIZED POPULATION HEALTH 4054 02:47:03,413 --> 02:47:05,982 HAS AT ITSELF CORE ANALYTICAL 4055 02:47:06,049 --> 02:47:08,385 TOOLS BUT ALSO PRECISION 4056 02:47:08,451 --> 02:47:10,320 EXPOETIC SOMMIC RESEARCH WHERE 4057 02:47:10,387 --> 02:47:12,188 YOU'RE FOCUSING ON PRECISION 4058 02:47:12,255 --> 02:47:15,258 EXPOSOMES THAT LEAD TO PRECISION 4059 02:47:15,325 --> 02:47:16,393 MEDICINE BECAUSE OFTEN TIMES AND 4060 02:47:16,459 --> 02:47:17,727 WE TALK ABOUT PRECISION 4061 02:47:17,794 --> 02:47:20,363 MEDICINE, WE ARE TRYING TO BE 4062 02:47:20,430 --> 02:47:22,365 PRECISE TO 1 INDIVIDUAL. 4063 02:47:22,432 --> 02:47:26,136 BUT WHAT WE HAVE LED OVER THE 4064 02:47:26,202 --> 02:47:28,505 LAST DECADE OR SO IS A NEW WORK 4065 02:47:28,571 --> 02:47:31,441 FLOW IS A NEW FORM OF ANALYTICAL 4066 02:47:31,508 --> 02:47:34,310 METHODOLOGIES THAT INCLUDES 4067 02:47:34,377 --> 02:47:36,946 TRADITIONAL STATISTICS AS WELL 4068 02:47:37,013 --> 02:47:37,747 AS ADVANCED MATHEMATICAL 4069 02:47:37,814 --> 02:47:39,849 MODELING AS WELL AS SIMULATION 4070 02:47:39,916 --> 02:47:41,584 MODELING WHERE WE CAN LEARN FROM 4071 02:47:41,651 --> 02:47:43,420 THE POPULATION TO INFORM THE 4072 02:47:43,486 --> 02:47:44,721 INDIVIDUAL AND THEN LEARNING 4073 02:47:44,788 --> 02:47:47,123 FROM INDIVIDUALS TO INFORM OUR 4074 02:47:47,190 --> 02:47:48,291 UNDERSTANDING OF A GROUP OF 4075 02:47:48,358 --> 02:47:49,959 INDIVIDUALS WITHIN A POPULATION 4076 02:47:50,026 --> 02:47:52,495 WILL BE CALLED PROFILES AND ONCE 4077 02:47:52,562 --> 02:47:53,797 YOU'VE UNDERSTOOD WHAT THESE 4078 02:47:53,863 --> 02:47:55,064 CLUSTER PROFILES ARE AND WHO 4079 02:47:55,131 --> 02:47:58,935 THOSE ARE, THEN WE CAN CREATE AN 4080 02:47:59,002 --> 02:48:00,503 ITERATIVE REFINEMENT AND 4081 02:48:00,570 --> 02:48:03,706 UNDERSTANDING OF AN INDIVIDUAL. 4082 02:48:03,773 --> 02:48:04,274 NEXT SLIDE, PLEASE. 4083 02:48:04,340 --> 02:48:06,009 AND SO I JUST WANTED TO SHARE 4084 02:48:06,075 --> 02:48:08,111 WITH YOU, 1 OF THE STUDIES THAT 4085 02:48:08,178 --> 02:48:11,514 WE HAVE CURRENTLY UNDERWAY. 4086 02:48:11,581 --> 02:48:15,452 BECAUSE WE BELIEVE THAT IN THE 4087 02:48:15,518 --> 02:48:17,854 PRESENCE AND THE NEED TO WEAR 4088 02:48:17,921 --> 02:48:20,924 THESE NEW THEORETICAL AND METHOD 4089 02:48:20,990 --> 02:48:22,592 LOGICAL LENS TO UNDERSTAND HELG 4090 02:48:22,659 --> 02:48:23,426 DISPARITIES AT POPULATION 4091 02:48:23,493 --> 02:48:24,794 LEVELS, THAT THERE IS A VERY 4092 02:48:24,861 --> 02:48:28,598 CLEAR AREA THAT WE HAVEN'T DONE 4093 02:48:28,665 --> 02:48:29,933 AS MUCH WORK. 4094 02:48:29,999 --> 02:48:31,601 SO I RECOGNIZE THE AUDIENCE WE 4095 02:48:31,668 --> 02:48:33,236 HAVE, PARTICULARLY MY PEERS BUT 4096 02:48:33,303 --> 02:48:36,206 ALSO THE NIH BECAUSE WHAT I WILL 4097 02:48:36,272 --> 02:48:37,907 SHOW YOU WHAT WE'VE DONE THIS 4098 02:48:37,974 --> 02:48:39,342 FAR, WE JUST DON'T WANT TO BE 4099 02:48:39,409 --> 02:48:41,911 THE ONLY 1S DO THIS, WE WANT TO 4100 02:48:41,978 --> 02:48:44,214 ENCOURAGE THE NIH TO PROVIDE US 4101 02:48:44,280 --> 02:48:46,516 MANY RESOURCES TO BE ABLE TO 4102 02:48:46,583 --> 02:48:47,450 UNDERSTAND URBACTIVITIES AND 4103 02:48:47,517 --> 02:48:48,785 PROJECTS AND RURAL DIVIDES. 4104 02:48:48,852 --> 02:48:53,389 AND SO NEXT SLIDE, PLEASE. 4105 02:48:53,456 --> 02:48:56,025 WE CREATED THE DORMIR STUDY 4106 02:48:56,092 --> 02:48:58,528 BECAUSE WE RECOGNIZE THAT THE 4107 02:48:58,595 --> 02:49:02,198 RURAL AND URBAN HEALTH DIVIDE 4108 02:49:02,265 --> 02:49:03,233 AND VERY STARK. 4109 02:49:03,299 --> 02:49:04,734 WHEN YOU LOOK AT HEALTH RELATED 4110 02:49:04,801 --> 02:49:06,102 QUALITY OF LIFE TO HEALTHCARE 4111 02:49:06,169 --> 02:49:08,338 ACCESS AND USE TO CHRONIC HEALTH 4112 02:49:08,404 --> 02:49:09,839 CONDITIONS AND HEALTH BEHAVIORS, 4113 02:49:09,906 --> 02:49:13,076 AND WHEN YOU STRATIFY A CROSS 4114 02:49:13,142 --> 02:49:13,676 RACIAL ETHNIC GROUPS THAT YOU 4115 02:49:13,743 --> 02:49:17,881 SLEEP APNEA AND OBESITYY THAT 4116 02:49:17,947 --> 02:49:19,115 YOU'RE--SEE THAT THERE ARE STARK 4117 02:49:19,182 --> 02:49:20,450 CONFERENCES AND IF YOU WERE TO 4118 02:49:20,517 --> 02:49:21,651 CONTRAST THAT WITH AN URBAN 4119 02:49:21,718 --> 02:49:24,554 AREA, THAT YOU WILL SEE 4120 02:49:24,621 --> 02:49:25,722 VARIABILITY NOT JUST BETWEEN 4121 02:49:25,788 --> 02:49:28,358 RURAL AND URBAN AREAS BUT ACROSS 4122 02:49:28,424 --> 02:49:30,026 RACIAL ETHNIC COUNTERPARTS IN 4123 02:49:30,093 --> 02:49:30,727 RURAL AND URBAN AREAS. 4124 02:49:30,793 --> 02:49:34,964 SO THIS IS AN AREA THAT IS RIPE 4125 02:49:35,031 --> 02:49:37,233 FOR EXPLORATION. 4126 02:49:37,300 --> 02:49:38,001 NEXT SLIDE, PLEASE. 4127 02:49:38,067 --> 02:49:42,672 WHEN WE DREW DOWN ON THIS, THAT 4128 02:49:42,739 --> 02:49:44,240 THE CDC HAS CLEARLY HIGHLIGHTED 4129 02:49:44,307 --> 02:49:47,810 AND HAS BEEN DOING SO FOR QUITE 4130 02:49:47,877 --> 02:49:48,778 SOMETIME FOR SLEEP DURATION, 4131 02:49:48,845 --> 02:49:49,879 THAT WHEN YOU LOOK AT THE AREAS 4132 02:49:49,946 --> 02:49:52,415 THAT HAVE THE HIGHEST AGE 4133 02:49:52,482 --> 02:49:53,783 ADJUSTED PREVALENCE OF SHORT 4134 02:49:53,850 --> 02:49:56,519 SLEEP, THAT WHEN YOU ARE TO 4135 02:49:56,586 --> 02:49:58,922 TRACK WHERE THESE ARE THAT THESE 4136 02:49:58,988 --> 02:50:03,560 ARE IN TRADITIONAL RURAL AREAS 4137 02:50:03,626 --> 02:50:04,894 AND URBAN AREAS AND THE FIGURE 4138 02:50:04,961 --> 02:50:06,396 TO THE RIGHT, WHEN YOU DRILL 4139 02:50:06,462 --> 02:50:07,697 DOWN MORE AT THE COUNTY LEVEL 4140 02:50:07,764 --> 02:50:09,699 THAT THERE ARE POCKETS, 4141 02:50:09,766 --> 02:50:10,934 PARTICULARLY RURAL PIECE OF 4142 02:50:11,000 --> 02:50:14,037 CONTENTYS AND URBAN POCKETS 4143 02:50:14,103 --> 02:50:15,338 TYPICALLY OFTEN TIMES, THE 4144 02:50:15,405 --> 02:50:19,108 COMMONALITY HAVE TO DO WITH 4145 02:50:19,175 --> 02:50:21,177 SOCIOECONOMIC STATUS OR SOCIAL 4146 02:50:21,244 --> 02:50:22,712 DETERMINANTS OF HEALTH, BUT WE 4147 02:50:22,779 --> 02:50:26,816 HAVE CREATED A FRAMEWORK CALLED 4148 02:50:26,883 --> 02:50:28,885 SPEDO, SOCIAL BEHAVIORIAL AND 4149 02:50:28,952 --> 02:50:29,719 POLITICAL AND ENVIRONMENTAL 4150 02:50:29,786 --> 02:50:31,788 DETERMINANTS OF HEALTH WHICH WE 4151 02:50:31,854 --> 02:50:33,523 BELIEVE ACTUALLY DRIVE MANY OF 4152 02:50:33,590 --> 02:50:35,124 THE COMMONALITIES ON DIFFERENCES 4153 02:50:35,191 --> 02:50:36,459 WE'VE SEEN IN URBAN AND RURAL 4154 02:50:36,526 --> 02:50:38,761 AREAS EMPLOY NEXT SLIDE, PLEASE. 4155 02:50:38,828 --> 02:50:40,997 WHEN YOU DRILL DOWN, NOT JUST 4156 02:50:41,064 --> 02:50:42,498 BEYOND GOING BEYOND SLEEP 4157 02:50:42,565 --> 02:50:46,536 DURATION, WE CAN ALSO SEE IT IN 4158 02:50:46,603 --> 02:50:48,271 TERMS OF SLEEP DISORDER 4159 02:50:48,338 --> 02:50:49,205 SEQUENCES WHERE PARTICULARLY 4160 02:50:49,272 --> 02:50:51,074 INDIVIDUALS EXPRESSING THAT THEY 4161 02:50:51,140 --> 02:50:53,443 HAVE, YOU KNOW INSOMNIA LIKE 4162 02:50:53,509 --> 02:50:56,179 SYMPTOMS WHEN YOU CUT ACROSS THE 4163 02:50:56,245 --> 02:50:56,879 DEFINITE AREAS THAT INDIVIDUAL 4164 02:50:56,946 --> 02:50:59,549 WHO IS LIVE IN NONURBAN AREAS OR 4165 02:50:59,616 --> 02:51:01,985 WHAT WE CALL NONMETROAREAS HOW 4166 02:51:02,051 --> 02:51:03,953 ABOUT REPORT HIGHER LEVELS OF 4167 02:51:04,020 --> 02:51:06,255 ISSUES FALLING ASLEEP AS WELL AS 4168 02:51:06,322 --> 02:51:09,125 STAYING ASLEEP AND SO, THESE ARE 4169 02:51:09,192 --> 02:51:10,960 SOME CRITICAL AREAS THAT WE NEED 4170 02:51:11,027 --> 02:51:14,731 TO BE AWARE OF, NEXT SLIDE, 4171 02:51:14,797 --> 02:51:15,298 PLEASE. 4172 02:51:15,365 --> 02:51:17,934 SO WHAT MIGHT BE DRIVING, WHAT 4173 02:51:18,001 --> 02:51:19,535 MIGHT BE SOME COMMONALITIES 4174 02:51:19,602 --> 02:51:21,504 BETWEEN URBAN AND RURAL AREAS, 4175 02:51:21,571 --> 02:51:22,605 OF COURSE, I DON'T WANT YOU ALL 4176 02:51:22,672 --> 02:51:25,475 TO THINK THAT I AM SAYING THAT 4177 02:51:25,541 --> 02:51:29,045 EVERY URBAN OR EVERY RURAL AREA 4178 02:51:29,112 --> 02:51:31,347 IS A MONOLITH BUT HERE ARE SOME 4179 02:51:31,414 --> 02:51:32,749 GBL FEATURES THAT IF YOU ARE 4180 02:51:32,815 --> 02:51:34,617 TRYING TO GET INTO THIS LINE OF 4181 02:51:34,684 --> 02:51:37,487 WORK, LOOKING AT DIFFERENT 4182 02:51:37,553 --> 02:51:38,221 POPPULESS, PARTICULARLY PLACE 4183 02:51:38,287 --> 02:51:39,622 BASED POPULATIONS THAT YOU MUST 4184 02:51:39,689 --> 02:51:42,792 LOOK AT WHAT WE CALL THE GENERAL 4185 02:51:42,859 --> 02:51:43,760 DESCRIPTIONS OF THIS THAT AREA, 4186 02:51:43,826 --> 02:51:45,294 WHAT IS THE POPULATION LIKE AND 4187 02:51:45,361 --> 02:51:49,065 WHAT ARE THE LIFESTYLES, WHAT'S 4188 02:51:49,132 --> 02:51:50,933 THE LEARNING LIKE, WHAT'S THE 4189 02:51:51,000 --> 02:51:53,036 MOBILITY LIKE, WHAT'S THE 4190 02:51:53,102 --> 02:51:54,570 ECONOMIC ACTIFORTS, WHAT IS SOME 4191 02:51:54,637 --> 02:51:56,606 ENVIRONMENTAL IMPACT THAT MIGHT 4192 02:51:56,673 --> 02:51:58,741 BE DRIVING THESE DISPARATE 4193 02:51:58,808 --> 02:52:00,843 OUTCOMES WHARKS IS SLEEP AND 4194 02:52:00,910 --> 02:52:02,445 TIMING LIKE, ISSUES AROUND 4195 02:52:02,512 --> 02:52:04,380 SOCIAL JETLAG THAT SOME OF MY 4196 02:52:04,447 --> 02:52:05,348 OTHER COLLEAGUES DISCUSSED 4197 02:52:05,415 --> 02:52:07,316 EARLIER, WHAT ARE THE DIFFERENT 4198 02:52:07,383 --> 02:52:09,118 LIGHT EXPOSURES AND THEN WHEN 4199 02:52:09,185 --> 02:52:10,520 ARE THE DIFFERENT SLEEP QUALITY 4200 02:52:10,586 --> 02:52:13,956 AND HEALTH IMP LIAISON KAIGS. 4201 02:52:14,023 --> 02:52:14,390 NEXT SLIDE, PLEASE. 4202 02:52:14,457 --> 02:52:16,959 NOW IF YOU WERE TO FRAME THIS 4203 02:52:17,026 --> 02:52:18,394 INTO AN ECOLOGICAL MODEL, IN 4204 02:52:18,461 --> 02:52:20,530 TERMS OF TRYING TO UNDERSTAND 4205 02:52:20,596 --> 02:52:22,932 WHAT MIGHT BE DIFFERENT AND WHAT 4206 02:52:22,999 --> 02:52:24,500 MIGHT BE SIMILAR CREASES URBAN 4207 02:52:24,567 --> 02:52:27,570 AND RURAL AREAS, THAT WE HAVE 4208 02:52:27,637 --> 02:52:31,374 LAID OUT THE BIOLOGICAL AND 4209 02:52:31,441 --> 02:52:32,275 CLINICAL, VIERMAL, PSYCHOSOCIAL 4210 02:52:32,341 --> 02:52:33,776 AND SOCIAL DETERMINANTS THAT 4211 02:52:33,843 --> 02:52:35,411 MIGHT SHED LIGHT AS TO WHY IS IT 4212 02:52:35,478 --> 02:52:39,816 THAT WE'RE SEEING SOME OF THESE 4213 02:52:39,882 --> 02:52:41,284 DIFFERENCES BETWEEN URBAN AND 4214 02:52:41,350 --> 02:52:42,151 RURAL AREAS. 4215 02:52:42,218 --> 02:52:44,120 I AM ONLY HIGHLIGHTING THIS NOT 4216 02:52:44,187 --> 02:52:45,755 TO BE EXHAUSTED BUT I'M ONLY 4217 02:52:45,822 --> 02:52:47,190 HIGHLIGHTING THIS TO SHOW THE 4218 02:52:47,256 --> 02:52:48,024 BREDTH AND COMPLEXITY OF THIS 4219 02:52:48,091 --> 02:52:49,659 ISSUE AND MY HOPE IS THAT IT 4220 02:52:49,726 --> 02:52:53,396 WILL MOVE YOU TO CONSIDER OTHER 4221 02:52:53,463 --> 02:52:55,965 UNIQUE AND NOVEL IBD'RE 4222 02:52:56,032 --> 02:52:56,799 INDICATOR ANDS DETERMINANTS IN 4223 02:52:56,866 --> 02:52:58,668 YOUR OWN RESEARCH AS WELL AS 4224 02:52:58,735 --> 02:52:59,168 KROWR CLINICAL PRACTICE. 4225 02:52:59,235 --> 02:53:01,270 SO IF YOU'RE LOOKING AT 4226 02:53:01,337 --> 02:53:02,338 BEHAVIORIAL FACTORS, LOOKING AT 4227 02:53:02,405 --> 02:53:04,173 URBAN AREAS, HIGH LEVEL OF 4228 02:53:04,240 --> 02:53:06,242 CAFFEINE USE AND TECHNOLOGY USE, 4229 02:53:06,309 --> 02:53:07,443 CONTRASTING THAT WITH RURAL 4230 02:53:07,510 --> 02:53:09,746 AREAS THAT THERE HAS BEEN A 4231 02:53:09,812 --> 02:53:10,713 LOWER CAFFEINE USE AND 4232 02:53:10,780 --> 02:53:14,117 TECHNOLOGY USE AND THAT'S WELL 4233 02:53:14,183 --> 02:53:14,383 EVIDENCED. 4234 02:53:14,450 --> 02:53:16,085 SIMILARLY IN TERMS OF 4235 02:53:16,152 --> 02:53:16,552 ENVIRONMENTAL FACTORS, 4236 02:53:16,619 --> 02:53:17,453 URBACTIVITIES AND PROJECTS 4237 02:53:17,520 --> 02:53:18,821 AREAS, GREATER LIGHT AND NOISE 4238 02:53:18,888 --> 02:53:20,857 POLLUTION, AS WELL AS TRAFFIC 4239 02:53:20,923 --> 02:53:22,024 AND INDUSTRY, SIGNIFICANT URBAN 4240 02:53:22,091 --> 02:53:23,793 HEAT ISLANDS, YOU KNOW THAT 4241 02:53:23,860 --> 02:53:25,394 DISRUPT SLEEP COMFORT WHEN YOU 4242 02:53:25,461 --> 02:53:27,463 CONTRAST THAT WITH RURAL AREAS 4243 02:53:27,530 --> 02:53:29,599 THAT IS TYPICALLY QUIET, DARKER, 4244 02:53:29,665 --> 02:53:30,533 COOLER AREAS, NATURAL SETTINGS 4245 02:53:30,600 --> 02:53:34,103 THAT MAY BE MORE CONDUCIVE, NOW 4246 02:53:34,170 --> 02:53:39,475 I AM NOT JUXTAPOSING THE 2 4247 02:53:39,542 --> 02:53:40,643 DIAMETRICALLY OPPOSITE TO EACH 4248 02:53:40,710 --> 02:53:41,811 OTHER PER SE, BUT THIS IS WHERE 4249 02:53:41,878 --> 02:53:42,879 OUR STUDY IS TRYING TO 4250 02:53:42,945 --> 02:53:44,947 UNDERSTAND WHERE THERE ARE 4251 02:53:45,014 --> 02:53:45,982 COMMONALITIES, WHERE THERE ARE 4252 02:53:46,048 --> 02:53:48,417 DIFFERENCES AND DO THOSE 4253 02:53:48,484 --> 02:53:50,286 COMMONALITIES OR DIFFERENCES 4254 02:53:50,353 --> 02:53:51,554 PREDICT HEALTH OUTCOMES, 4255 02:53:51,621 --> 02:53:53,756 PARTICULARLY SLEEP HEALTH 4256 02:53:53,823 --> 02:53:55,091 OUTCOMES AND POTENTIAL DOWN 4257 02:53:55,158 --> 02:53:57,994 STREAM HEALTH CONQUENCES SUCH AS 4258 02:53:58,060 --> 02:54:00,530 CARDIO METABOLIC HEALTH, SUCH AS 4259 02:54:00,596 --> 02:54:01,831 CARDIOVASCULAR DISEASE, SUCH AS 4260 02:54:01,898 --> 02:54:06,469 AGING AND DEMENTIA AND THE LIKE, 4261 02:54:06,536 --> 02:54:06,969 NEXT SLIDE, PLEASE. 4262 02:54:07,036 --> 02:54:08,171 NOW IF YOU ARE INTERESTED IN 4263 02:54:08,237 --> 02:54:11,040 DOING THIS TYPE OF WORK, HOW DO 4264 02:54:11,107 --> 02:54:14,343 YOU DO THIS, IT WAS KIND OF HARD 4265 02:54:14,410 --> 02:54:16,212 FOR ME TO KIND OF CATEGORIZE 4266 02:54:16,279 --> 02:54:18,314 THIS FOR YOU, BUT 1 OF THE 4267 02:54:18,381 --> 02:54:19,482 THINGS THAT I WANT PEOPLE TO 4268 02:54:19,549 --> 02:54:25,988 REALIZE AND FOR THOSE WHO DON'T, 4269 02:54:26,055 --> 02:54:27,490 YOU KNOW, DOING COMMUNITY WORK 4270 02:54:27,557 --> 02:54:28,524 OR POPULATION WORK, THE MOST 4271 02:54:28,591 --> 02:54:30,593 IMPORTANT THING IS SETTING UP 4272 02:54:30,660 --> 02:54:31,260 YOUR INFRASTRUCTURE. 4273 02:54:31,327 --> 02:54:32,094 NEXT SLIDE, PLEASE. 4274 02:54:32,161 --> 02:54:35,231 SO LET'S FOCUS ON WHAT KIND OF 4275 02:54:35,298 --> 02:54:36,098 ADMINISTRATIVE STRUCTURES YOU 4276 02:54:36,165 --> 02:54:37,567 WILL NEED, FIRST YOU HAVE TO 4277 02:54:37,633 --> 02:54:40,770 ENGAGE THE COMMUNITY AND I WILL 4278 02:54:40,837 --> 02:54:42,405 SHARE IT IN TERMS OF HOW WE'VE 4279 02:54:42,471 --> 02:54:45,374 DONE THIS FOR RURAL AREAS AND 4280 02:54:45,441 --> 02:54:47,643 IT'S NOT VERY DISSIMILAR TO HOW 4281 02:54:47,710 --> 02:54:48,978 WE'VE DONE THIS IN RURAL AREAS 4282 02:54:49,045 --> 02:54:49,345 AS WELL. 4283 02:54:49,412 --> 02:54:51,781 HOW ARE YOU GOING TO ROLL OUT 4284 02:54:51,848 --> 02:54:53,316 SCREENING AND RECRUITING PEOPLE 4285 02:54:53,382 --> 02:54:54,684 AND SERVING PEOPLE CONSECUTIVELY 4286 02:54:54,750 --> 02:54:56,586 IN HOW ARE YOU GOING TO ENGAGE 4287 02:54:56,652 --> 02:54:58,621 PEOPLE TO PROVIDE A WIDE VARIETY 4288 02:54:58,688 --> 02:55:00,356 OF CLINICAL DATA ON BEHAVIORIAL 4289 02:55:00,423 --> 02:55:02,692 OUTCOMES IN AND THEN HOW CAN YOU 4290 02:55:02,758 --> 02:55:04,360 ACTUALLY ELEVATE YOUR LEVEL OF 4291 02:55:04,427 --> 02:55:05,528 ANALYSIS WHICH IS NOT JUST 4292 02:55:05,595 --> 02:55:06,462 FOCUSED ON THE INDIVIDUAL BUT 4293 02:55:06,529 --> 02:55:08,831 YOU CAN LOOK AT WHETHER IT BE 4294 02:55:08,898 --> 02:55:10,933 FAMILY BASED, COMMUNITY BASED, 4295 02:55:11,000 --> 02:55:14,804 COUNTY BASED, REGION BASED 4296 02:55:14,871 --> 02:55:16,706 BECAUSE LAYERING DOORS, UNITS OF 4297 02:55:16,772 --> 02:55:18,241 ANALYSIS WILL PROVIDE DEEPER, 4298 02:55:18,307 --> 02:55:19,976 RICHER INSIGHTS FOR US TO BETTER 4299 02:55:20,042 --> 02:55:22,044 UNDERSTAND WHAT MIGHT BE DRIVING 4300 02:55:22,111 --> 02:55:22,645 POPULATION HEALTH DIFFERENCES 4301 02:55:22,712 --> 02:55:25,381 AND HOW WE CAN GO ABOUT CHANGING 4302 02:55:25,448 --> 02:55:26,415 IT WHETHER THROUGH INTERVENTIONS 4303 02:55:26,482 --> 02:55:32,321 OR WHETHER IT BE THROUGH POLICY 4304 02:55:32,388 --> 02:55:33,055 NEXT SLIDE, PLEASE. 4305 02:55:33,122 --> 02:55:34,290 SO LOOT ME SHOW YOU HOW WE'VE 4306 02:55:34,357 --> 02:55:36,525 DONE THIS SO WE HAVE CREATED A 4307 02:55:36,592 --> 02:55:38,394 HUB AND SPOKE MODEL ABOUT HOW WE 4308 02:55:38,461 --> 02:55:40,830 GO ABOUT RECRUITING PEOPLE AND 4309 02:55:40,897 --> 02:55:41,931 SETTING UP AN ADMINISTRATIVE 4310 02:55:41,998 --> 02:55:44,433 STRUCTURE IN RURAL AREAS, SO 4311 02:55:44,500 --> 02:55:46,936 WE'RE CURRENTLY IN SOUTH MR. 4312 02:55:47,003 --> 02:55:48,604 SPEAKER FLOOR AND WHAT WE'VE 4313 02:55:48,671 --> 02:55:50,106 GONE ABOUT TO DO IS THAT WE 4314 02:55:50,172 --> 02:55:52,074 CREATED A HOOK AND THERE'S 4315 02:55:52,141 --> 02:55:52,608 OPERATIONAL DEVELOPMENTAL 4316 02:55:52,675 --> 02:55:53,576 ENDOCRINOLOGY MISSION AND I 4317 02:55:53,643 --> 02:55:54,744 WON'T GET BO WRITING THEM 4318 02:55:54,810 --> 02:55:56,245 BECAUSE I KNOW WE'RE RUNNING 4319 02:55:56,312 --> 02:55:57,580 AGAINST TIME BUT HA WE SET UP 4320 02:55:57,647 --> 02:55:59,115 THE HUB, THE AREA THAT MOST 4321 02:55:59,181 --> 02:56:00,516 COMMUNITY MEMBERS IN THIS CASE 4322 02:56:00,583 --> 02:56:02,051 WERE FOCUSED ON LATINO ANDS 4323 02:56:02,118 --> 02:56:03,653 URBAN AND RURAL AREAS AND WE TRY 4324 02:56:03,719 --> 02:56:05,321 TO FIND A HUB AS TO WHERE THEY 4325 02:56:05,388 --> 02:56:08,257 CAN SERVE AS THE RESOURCE FOR 4326 02:56:08,324 --> 02:56:09,892 THAT COMMUNITY AND BE AICIAL TO 4327 02:56:09,959 --> 02:56:11,761 HELP US WITH RECRUITMENT BUT 4328 02:56:11,827 --> 02:56:13,262 ALSO THEY'RE THE CONDUITS OF THE 4329 02:56:13,329 --> 02:56:15,698 COMMUNITY AND THESE ARE OFTEN 4330 02:56:15,765 --> 02:56:17,900 TIMES TRUSTED MESSENGERS BUT 4331 02:56:17,967 --> 02:56:18,734 TRUSTED ORGANIZATIONS WITHIN THE 4332 02:56:18,801 --> 02:56:19,001 COMMUNITY. 4333 02:56:19,068 --> 02:56:21,837 WE HAVE TEAMED UP WITH OTHER 4334 02:56:21,904 --> 02:56:23,839 ISSUES WHAT WE CALL SPOKES, LIKE 4335 02:56:23,906 --> 02:56:26,609 A QUEST, LIKE A CVS, LIKE THE 4336 02:56:26,676 --> 02:56:28,244 LOCAL HIGH SCHOOL, LIKE THE 4337 02:56:28,311 --> 02:56:30,046 REGIONAL MEDICAL, LIKE THE 4338 02:56:30,112 --> 02:56:31,847 LIBRARIES, LIKE THE WALGREEN'S 4339 02:56:31,914 --> 02:56:33,549 IT'S IMPORTANT TO HAVE THE HUB 4340 02:56:33,616 --> 02:56:34,817 AND SPOKE MODEL TO SHOW THE 4341 02:56:34,884 --> 02:56:36,852 COMMUNITY AS WELL AS A SET OF 4342 02:56:36,919 --> 02:56:37,787 ROBUST INFRASTRUCTURE TO 4343 02:56:37,853 --> 02:56:39,188 INCREASE RECRUITMENT AND 4344 02:56:39,255 --> 02:56:39,789 RETENTION. 4345 02:56:39,855 --> 02:56:40,823 NEXT SLIDE, PLEASE. 4346 02:56:40,890 --> 02:56:43,092 SIMILARLY WE'VE DONE THIS IN 4347 02:56:43,159 --> 02:56:44,260 ANOTHER COMMUNITY, A RURAL 4348 02:56:44,327 --> 02:56:44,961 COMMUNITY BUT IT'S VERY 4349 02:56:45,027 --> 02:56:46,495 DIFFERENT AS YOU CAN SEE. 4350 02:56:46,562 --> 02:56:49,332 IN THIS CASE, THAT THE HUB 4351 02:56:49,398 --> 02:56:54,503 ITSELF IS A CATHOLIC CHURCH, YOU 4352 02:56:54,570 --> 02:56:56,939 KNOW THIS COMMUNITY IS 4353 02:56:57,006 --> 02:56:57,640 TRADITIONALLY CATHOLIC LATINAS 4354 02:56:57,707 --> 02:56:59,275 AND WE HAVE FORMED A SPOKE 4355 02:56:59,342 --> 02:57:03,646 AROUND THIS HUB AND NOW 4356 02:57:03,713 --> 02:57:04,580 WE'RE--WE'VE ENLISTED THE 4357 02:57:04,647 --> 02:57:07,316 COLLEGE OF LOOR FLOOR KEYS, 4358 02:57:07,383 --> 02:57:08,951 AGAIN QUEST DIAGNOSTICS AND CVS, 4359 02:57:09,018 --> 02:57:13,289 AND A FREE CLINIC IN FLOWER 4360 02:57:13,356 --> 02:57:15,124 FLOOR AS WELL AS DIFFERENT 4361 02:57:15,191 --> 02:57:16,892 HEALTH SYSTEMS AS WELL AS 4362 02:57:16,959 --> 02:57:17,226 SUPERMARKETS. 4363 02:57:17,293 --> 02:57:18,060 NEXT SLIDE, PLEASE. 4364 02:57:18,127 --> 02:57:21,030 YOU CAN SKIP THROUGH AGAIN, 4365 02:57:21,097 --> 02:57:21,364 PLEASE. 4366 02:57:21,430 --> 02:57:22,898 SO NOW I WILL SHARE WITH YOU, 4367 02:57:22,965 --> 02:57:26,235 HOW CAN WE GO ABOUT ESTABLISHING 4368 02:57:26,302 --> 02:57:27,203 THIS ADMIN TRAITIVE 4369 02:57:27,269 --> 02:57:28,237 INFRASTRUCTURE, I JUST SHARED 4370 02:57:28,304 --> 02:57:29,672 WITH YOU, HOW IS IT YOU'RE GOING 4371 02:57:29,739 --> 02:57:31,207 TO RECRUIT PEOPLE, AND I WILL 4372 02:57:31,273 --> 02:57:34,143 TALK ABOUT HOW IS IT THAT WE CAN 4373 02:57:34,210 --> 02:57:35,678 ROLL OUT YOU KNOW VERY 4374 02:57:35,745 --> 02:57:37,546 COMPLICATED AS WELL AS SIMPLE 4375 02:57:37,613 --> 02:57:40,416 STUDIES AND SO WHAT WE'VE DONE, 4376 02:57:40,483 --> 02:57:41,684 WE'VE CREATED ADDITIONAL HEALTH 4377 02:57:41,751 --> 02:57:45,021 EQUITY MODEL WITH MY COLLEAGUE 4378 02:57:45,087 --> 02:57:46,322 DR. JUDY LONG AND OTHERS WHERE 4379 02:57:46,389 --> 02:57:48,424 WE WANT TO FOCUS ON FIRST, YOU 4380 02:57:48,491 --> 02:57:49,725 HAVE TO TRAIN THE STAFF WHAT TO 4381 02:57:49,792 --> 02:57:51,494 DO AND THEN YOU FOCUS ON 4382 02:57:51,560 --> 02:57:52,895 ADAPTATION OF STUDY RECALL 4383 02:57:52,962 --> 02:57:55,398 MATERIALS AND THEN FOCUS ON 4384 02:57:55,464 --> 02:57:57,233 MODIFICATION AND WE CREATE A 4385 02:57:57,299 --> 02:57:57,833 COMMUNITY STEERING COMMITTEE 4386 02:57:57,900 --> 02:58:00,936 WHICH IS A DIFFERENT THING FROM 4387 02:58:01,003 --> 02:58:03,205 AN ADVISORY BOARD. 4388 02:58:03,272 --> 02:58:04,540 NEXT SLIDE, PLEASE. 4389 02:58:04,607 --> 02:58:06,175 ADDITIONAL HEALTH EQUITY AND 4390 02:58:06,242 --> 02:58:07,543 INCLUSION MODEL FOCUSES ON 4391 02:58:07,610 --> 02:58:09,712 TRYING TO IDENTIFY BARRIERS, AS 4392 02:58:09,779 --> 02:58:12,815 WELL AS FINDING DIGITAL 4393 02:58:12,882 --> 02:58:13,916 SOLUTIONS TO OVERCOME THOSE AS 4394 02:58:13,983 --> 02:58:17,319 WELL, NEXT SLIDE, PLEASE. 4395 02:58:17,386 --> 02:58:20,156 ONE OF THE THINGS WE FOCUS ON 4396 02:58:20,222 --> 02:58:22,725 AND WE BELIEVE THAT IN 4397 02:58:22,792 --> 02:58:23,959 ADDITIONAL SOLUTIONS, THE 4398 02:58:24,026 --> 02:58:26,729 PANACEA THAT CAN KILL ALL ILLS 4399 02:58:26,796 --> 02:58:28,130 IN THE SIGNIFICANT BOLT NECKS 4400 02:58:28,197 --> 02:58:31,901 AND BARRIERS IN TRANSLATIONAL 4401 02:58:31,967 --> 02:58:32,501 RESEARCH TRADITIONAL RESEARCH, 4402 02:58:32,568 --> 02:58:34,737 BUT WE THINK IT'S A REALLY, 4403 02:58:34,804 --> 02:58:35,638 REALLY NICE CREATIVE STRATEGY, 4404 02:58:35,704 --> 02:58:38,007 IT HELPS US WITH ENGAGEMENT, IT 4405 02:58:38,074 --> 02:58:40,276 HELPS US WITH RECRUITMENT, AND 4406 02:58:40,342 --> 02:58:41,343 KREENING AND CONSENT THELPS US 4407 02:58:41,410 --> 02:58:42,178 WITH ADMINISTRATION OF SERVICE 4408 02:58:42,244 --> 02:58:46,348 AS WELL AS STUDY EXECUTION AND 4409 02:58:46,415 --> 02:58:47,349 DISSEMINATION, NEXT, SLIDE, 4410 02:58:47,416 --> 02:58:47,583 PLEASE. 4411 02:58:47,650 --> 02:58:50,352 WHAT WE HAVE DONE IS THAT WE 4412 02:58:50,419 --> 02:58:54,657 HAVE CREATED OUR IN-HOME HOME 4413 02:58:54,723 --> 02:58:55,491 GROWN MONITORING CALLED THE MAIL 4414 02:58:55,558 --> 02:58:58,561 CONTROLLER OF BANK WHEREBY WE 4415 02:58:58,627 --> 02:58:59,995 HAVE PUT ESSENTIALLY, NOT 4416 02:59:00,062 --> 02:59:00,996 PHYSICALLY IN THE BOX BECAUSE 4417 02:59:01,063 --> 02:59:02,998 WEB CONNECTED RECOGNIZE IN URBAN 4418 02:59:03,065 --> 02:59:03,933 AND RURAL AREAS IN PARTICULAR 4419 02:59:03,999 --> 02:59:06,836 THAT PEOPLE MAY NOT HAVE THE 4420 02:59:06,902 --> 02:59:08,537 TRANSPORTATION RESOURCES TO COME 4421 02:59:08,604 --> 02:59:11,040 TO HEALTH ASSISTANCE SO WE FILL 4422 02:59:11,107 --> 02:59:13,042 UP THE ENTIRE RESEARCH PROCESS 4423 02:59:13,109 --> 02:59:15,611 BY PUTTING THE PARTICIPANT IN 4424 02:59:15,678 --> 02:59:16,512 THE CENTER OF THE RESEARCH 4425 02:59:16,579 --> 02:59:18,447 EXPERIENCE AND SO WE ANY TO 4426 02:59:18,514 --> 02:59:18,647 THEM. 4427 02:59:18,714 --> 02:59:22,618 SO THIS IS A HIGHLY 4428 02:59:22,685 --> 02:59:23,786 SOPHISTICATED AND COMPLICATED, 4429 02:59:23,853 --> 02:59:25,054 YOU KNOW MONITORING SOLUTION AND 4430 02:59:25,121 --> 02:59:28,824 THUS FAR, WE HAVE DISTRIBUTED 4431 02:59:28,891 --> 02:59:31,227 OVER 700 ACROSS 3 OF OUR NIH 4432 02:59:31,293 --> 02:59:33,129 STUDIES, SO THIS HAS BEEN A VERY 4433 02:59:33,195 --> 02:59:36,832 SUCCESSFUL IN THAT WE'RE 4434 02:59:36,899 --> 02:59:38,334 COLLECTING SLEEP ACTIVITY, WE 4435 02:59:38,400 --> 02:59:41,871 SEND PEOPLE'S HOMES A MART 4436 02:59:41,937 --> 02:59:43,506 PHONE, WE COLLECT MONITORS, WE 4437 02:59:43,572 --> 02:59:45,808 SEND OUT AN AIR QUALITY DEVICE 4438 02:59:45,875 --> 02:59:48,677 THAT MEASURES AIR QUALITY AND 4439 02:59:48,744 --> 02:59:49,478 HUMIDITY, WE MONITOR BLOOD 4440 02:59:49,545 --> 02:59:51,213 PRESSURE, WE HAVE A SLEEP 4441 02:59:51,280 --> 02:59:52,414 MEASURE THAT MEASURES CARDIO 4442 02:59:52,481 --> 02:59:53,916 PULMONARY AS WELL AS A SMART 4443 02:59:53,983 --> 02:59:56,218 SCALE AND ALL THAT GETS INGESTED 4444 02:59:56,285 --> 02:59:57,653 AND WE PROVIDE THAT JUST WALKING 4445 02:59:57,720 --> 02:59:59,421 IN THROUGH THE ENTIRE PROCESS, 4446 02:59:59,488 --> 03:00:01,257 SO IT'S NOT TOO MUCH OF A BURDEN 4447 03:00:01,323 --> 03:00:04,727 AS WELL AS WHEN WE'RE COLLECTING 4448 03:00:04,793 --> 03:00:07,163 BIOSPECIMEN DATA, WE ACTUALLY, 4449 03:00:07,229 --> 03:00:09,098 YOU KNOW FLIP TO THAT. 4450 03:00:09,165 --> 03:00:11,400 SO WHAT WE HAVE DONE IS WE 4451 03:00:11,467 --> 03:00:14,270 PILOTED USING SOME VERY NOVEL 4452 03:00:14,336 --> 03:00:15,571 DRY BLOOD SPOTS, SAMPLING AS TO 4453 03:00:15,638 --> 03:00:17,339 HOW WE WILL DO THAT, I THINK 4454 03:00:17,406 --> 03:00:19,408 THAT WE WILL PRESENT THAT AT OUR 4455 03:00:19,475 --> 03:00:21,210 SLEEP MEETING BUT WE PARTNERED 4456 03:00:21,277 --> 03:00:23,946 WITH QUEST DIAGNOSTICS AS WELL 4457 03:00:24,013 --> 03:00:25,915 AS LOCAL FLEBOT ME CUTCHES WHERE 4458 03:00:25,981 --> 03:00:27,650 WE TAKE ALL THE BARRIERS OUT SO 4459 03:00:27,716 --> 03:00:28,984 THE POINT I'M TRYING TO DRIVE 4460 03:00:29,051 --> 03:00:30,252 HOME IS THAT WHEN YOU'RE DOING 4461 03:00:30,319 --> 03:00:31,554 RESEARCH IN THESE SPACES, YOU 4462 03:00:31,620 --> 03:00:36,425 WANT TO INCREASE YOUR CHANCES OF 4463 03:00:36,492 --> 03:00:37,259 COLLECTING COMPLETE FULL QUALITY 4464 03:00:37,326 --> 03:00:41,530 DATA AND THESE ARE SOME OTHER 4465 03:00:41,597 --> 03:00:42,331 STRATEGIES WE'VE UTILIZED TO 4466 03:00:42,398 --> 03:00:44,433 INSURE THAT WE'VE GOTTEN THOSE. 4467 03:00:44,500 --> 03:00:45,901 NEXCUSE ME, DOCTOR, HAVE YOU 2 4468 03:00:45,968 --> 03:00:48,237 MINUTES LEFT. 4469 03:00:48,304 --> 03:00:48,571 >> PERFECT. 4470 03:00:48,637 --> 03:00:50,005 ONE AREA THAT WE TRY TO WORK ON 4471 03:00:50,072 --> 03:00:52,208 AS WELL IS WAKIND OF DATA AND 4472 03:00:52,274 --> 03:00:53,842 TOOLS, YOU KNOW IF YOU'RE 4473 03:00:53,909 --> 03:00:55,844 INTERESTED IN USING DIGITAL 4474 03:00:55,911 --> 03:00:59,248 SOLUTIONS, TO DO THIS TYPE OF 4475 03:00:59,315 --> 03:00:59,982 EXPOETICSOME WORK, YOU WANT TO 4476 03:01:00,049 --> 03:01:02,851 MAKE SURE YOU HAVE THE NECESSARY 4477 03:01:02,918 --> 03:01:07,856 DATA, INFRASTRUCTURE TO DO SO, 4478 03:01:07,923 --> 03:01:08,691 NEXT SLIDE, PLEASE. 4479 03:01:08,757 --> 03:01:09,725 NEXT SLIDE, PLEASE, THIS WAS 4480 03:01:09,792 --> 03:01:10,726 SAYING THE SAME THING IN TERMS 4481 03:01:10,793 --> 03:01:12,595 OF HOW YOU WANT TO DO IT, THIS 4482 03:01:12,661 --> 03:01:14,363 IS FOCUSED ON HOW WE GO ABOUT 4483 03:01:14,430 --> 03:01:16,098 IT, 1 THINK THIS I WANT TO SHOW 4484 03:01:16,165 --> 03:01:17,833 OR TALK ABOUT BREFLY IS THAT 4485 03:01:17,900 --> 03:01:21,170 WHEN WE TALK ABOUT URBAN AND 4486 03:01:21,237 --> 03:01:23,872 RURAL RESEARCH STUDIES, OFTEN 4487 03:01:23,939 --> 03:01:26,709 TIMES THESE TAKE ON 4488 03:01:26,775 --> 03:01:27,776 EPI-FRAMEWORK AND I AM NOT 4489 03:01:27,843 --> 03:01:28,611 SAYING ANYTHING IS WRONG WITH 4490 03:01:28,677 --> 03:01:30,512 THAT BUT WE DO HAVE A WONDERFUL 4491 03:01:30,579 --> 03:01:33,449 OPPORTUNITY TO ROLL OUT 4492 03:01:33,515 --> 03:01:35,451 INTERVENTIONS TO SEE PLACE BASED 4493 03:01:35,517 --> 03:01:37,620 TYPES OF EFFECTS ON HOW 4494 03:01:37,686 --> 03:01:39,021 SUCCESSFUL CLINICAL TRIALS ARE. 4495 03:01:39,088 --> 03:01:42,024 WE HAVE LED SEVERAL DIGITAL 4496 03:01:42,091 --> 03:01:45,327 SOLUTIONS, BY USING, YOU KNOW, 4497 03:01:45,394 --> 03:01:46,262 DIGITAL SOLUTIONS TO DO THAT AND 4498 03:01:46,328 --> 03:01:48,631 WE ROLL THIS OUT AND HAVE BEEN 4499 03:01:48,697 --> 03:01:51,433 EXTREMELY SUCCESSFUL, NEXT 4500 03:01:51,500 --> 03:01:52,401 SLIDE, PLEASE. 4501 03:01:52,468 --> 03:01:54,370 WE USED PEER HEALTH EDUCATORS TO 4502 03:01:54,436 --> 03:01:56,205 SUPPORT US DURING THIS IN BOTH 4503 03:01:56,272 --> 03:01:59,108 URBAN AS WELL AS RURAL AREAS. 4504 03:01:59,174 --> 03:02:00,042 NEXT SLIDE, PLEASE. 4505 03:02:00,109 --> 03:02:03,779 YOU COULD ADVANCE PLEASE, NEXT 4506 03:02:03,846 --> 03:02:03,979 SLIDE. 4507 03:02:04,046 --> 03:02:05,347 ONE OF THE THINGS YOU WANT TO BE 4508 03:02:05,414 --> 03:02:08,784 AWARE OF IS THAT WHEN YOU'RE 4509 03:02:08,851 --> 03:02:09,918 LOOKING AT ADHERENCE, THAT YOU 4510 03:02:09,985 --> 03:02:12,421 WANT TO TAKE INTO FULL 4511 03:02:12,488 --> 03:02:12,921 CONSIDERATION, SOCIAL 4512 03:02:12,988 --> 03:02:14,623 DETERMINANTS OF HEALTH, NEXT 4513 03:02:14,690 --> 03:02:16,158 SLIDE, PLEASE. 4514 03:02:16,225 --> 03:02:17,760 SOCIAL DETERMINANTS OF HEALTH 4515 03:02:17,826 --> 03:02:18,594 SPAN MANY DIFFERENT CATEGORIES 4516 03:02:18,661 --> 03:02:22,431 AND WE TAKE THOSE INTO 4517 03:02:22,498 --> 03:02:22,765 CONSIDERATION. 4518 03:02:22,831 --> 03:02:23,632 NEXT SLIDE ISSUE PLEASE AND WHAT 4519 03:02:23,699 --> 03:02:25,868 WE HAVE DONE IS THAT WE HAVE A 4520 03:02:25,934 --> 03:02:27,303 CLINICAL TRIAL THANKS TO THE NIA 4521 03:02:27,369 --> 03:02:29,371 WHERE WE'RE LOOKING AT WAYS IN 4522 03:02:29,438 --> 03:02:33,709 WHICH WE CAN OPTIMIZE SLEEP 4523 03:02:33,776 --> 03:02:34,476 APNEA ADHERENCE IN INSTANCES 4524 03:02:34,543 --> 03:02:36,345 WHERE WE WANT TO BE ABLE TO 4525 03:02:36,412 --> 03:02:37,079 CAPTURE SOCIAL DETERMINANTS OF 4526 03:02:37,146 --> 03:02:40,349 HEALTH AS WELL AS PROVIDING CARE 4527 03:02:40,416 --> 03:02:42,017 NAVIGATION TO ADDRESS SOME OF 4528 03:02:42,084 --> 03:02:45,087 THE SIGNIFICANT BARRIERS THAT 4529 03:02:45,154 --> 03:02:46,955 COULD IMPAC SOMEONE'S ADHERENCE 4530 03:02:47,022 --> 03:02:49,358 TO SLEEP APNEA. 4531 03:02:49,425 --> 03:02:51,827 NEXT SLIDE, PLEASE. 4532 03:02:51,894 --> 03:02:52,861 >> SO I'LL FINISH HERE. 4533 03:02:52,928 --> 03:02:54,063 ONE OF THE THINGS I LOOK TO 4534 03:02:54,129 --> 03:02:57,266 LEAVE YOU ALL WITH IS THAT WE 4535 03:02:57,333 --> 03:02:59,435 HAVE A REALLY GREAT OPPORTUNITY, 4536 03:02:59,501 --> 03:03:00,736 THIS IS NOT JUST ABOUT LOOKING 4537 03:03:00,803 --> 03:03:04,406 AT SLEEP AND BIG DATA, THIS IS 4538 03:03:04,473 --> 03:03:06,375 REALLY SITUATING SLEEP AS BIG 4539 03:03:06,442 --> 03:03:08,110 DATA TO INFLUENCE AND INFORM 4540 03:03:08,177 --> 03:03:08,677 OVERALL HEALTH. 4541 03:03:08,744 --> 03:03:12,915 SO THE PROGRAM WE LAID OUT HERE 4542 03:03:12,981 --> 03:03:15,150 IN MIAMI, IF YOU'RE MOVING FROM 4543 03:03:15,217 --> 03:03:16,652 RIGHT TO LEFT, WE BUILT THE MAIL 4544 03:03:16,719 --> 03:03:19,188 BOX AND OUR GOAL IS TO CREATE 4545 03:03:19,254 --> 03:03:20,489 DIGITAL TWINS OF INDIVIDUALS AS 4546 03:03:20,556 --> 03:03:22,458 YOU CAN SEE WITH THE MONITORING 4547 03:03:22,524 --> 03:03:24,226 SOLUTION, THEN FROM THERE WE 4548 03:03:24,293 --> 03:03:25,394 ALSO ARE CREATING SMART MEMORY 4549 03:03:25,461 --> 03:03:27,429 CLONE TECHNOLOGIES BECAUSE WE 4550 03:03:27,496 --> 03:03:28,630 BELIEVE IN AMBIENT TECHNOLOGY, 4551 03:03:28,697 --> 03:03:29,598 THAT'S THE WAY FORWARD. 4552 03:03:29,665 --> 03:03:32,434 IT'S NOT JUST LOOKING AT 4553 03:03:32,501 --> 03:03:33,702 TRADITIONAL MEASUREMENTS OR 4554 03:03:33,769 --> 03:03:35,237 COLLECTING SLEEP DATA BUT HOW 4555 03:03:35,304 --> 03:03:37,673 OTHER FORMS OF DATA THROUGH 4556 03:03:37,740 --> 03:03:39,842 AMBIENT DATA COLLECTION AND WE 4557 03:03:39,908 --> 03:03:42,911 WANT TO ALSO INCLUDE SMART CITY 4558 03:03:42,978 --> 03:03:43,612 COMPONENTS BECAUSE INDIVIDUALS 4559 03:03:43,679 --> 03:03:46,215 ARE NESTED IN HOMES AND HOMES 4560 03:03:46,281 --> 03:03:47,483 ARE NESTED IN NEIGHBORHOODS AND 4561 03:03:47,549 --> 03:03:52,020 THIS I BELIEVE WILL ALLOW US TO 4562 03:03:52,087 --> 03:03:53,989 MOVE BEYOND INDIVIDUAL BASED 4563 03:03:54,056 --> 03:03:55,023 MOTEL MONITORING SOLUTION AS YOU 4564 03:03:55,090 --> 03:03:59,027 SEE IN THE MAIL BOX TO A 4565 03:03:59,094 --> 03:03:59,862 COMMUNITY POPULATION BASED AND 4566 03:03:59,928 --> 03:04:01,830 THAT'S THE PROGRAM THAT WE CALL 4567 03:04:01,897 --> 03:04:02,765 MILEAGE, SO WITH THAT THANK YOU 4568 03:04:02,831 --> 03:04:04,199 SO MUCH AND I AM LOOKING FORWARD 4569 03:04:04,266 --> 03:04:05,534 TO HEARING THE OTHER SPEAKERS 4570 03:04:05,601 --> 03:04:06,802 AND HEARING YOUR WONDERFUL 4571 03:04:06,869 --> 03:04:07,503 QUESTIONS. 4572 03:04:07,569 --> 03:04:14,376 THANK YOU FOR THE OPPORTUNITY. 4573 03:04:14,443 --> 03:04:17,246 >> THANK YOU SO MUCH FOR THAT 4574 03:04:17,312 --> 03:04:17,646 WONDERFUL TALK. 4575 03:04:17,713 --> 03:04:18,814 IN THE INTEREST OF TIME WE WILL 4576 03:04:18,881 --> 03:04:19,915 MOVE TO OUR NEXT SPEAKER AND 4577 03:04:19,982 --> 03:04:21,550 SAVE ALL THE QUESTIONS FOR THE 4578 03:04:21,617 --> 03:04:21,784 END. 4579 03:04:21,850 --> 03:04:23,285 PLEASE PUT YOUR QUESTIONS IN THE 4580 03:04:23,352 --> 03:04:26,321 CHAT SO THAT WE CAN OR Q&A SO 4581 03:04:26,388 --> 03:04:30,058 THAT WE CAN CAPTURE THOSE EMPLOY 4582 03:04:30,125 --> 03:04:39,501 SO OUR NEXT SPEAKER IS 4583 03:04:39,568 --> 03:04:39,935 DR. MARIANTHI-ANNA, 4584 03:04:40,002 --> 03:04:41,170 KIOUMOURTZOGLOU, AND I AM SORRY 4585 03:04:41,236 --> 03:04:42,337 IF I MISPRONOUNCED THAT WHICH I 4586 03:04:42,404 --> 03:04:44,106 AM SURE I DID. 4587 03:04:44,173 --> 03:04:45,507 SHE IS AT COLUMBIA UNIVERSITY, 4588 03:04:45,574 --> 03:04:47,342 SHE WILL PRESENT ON BIG 4589 03:04:47,409 --> 03:04:49,578 ENVIRONMENTAL DATA FOR SLEEP 4590 03:04:49,645 --> 03:04:50,145 CIRCADIAN RHYTHM RESEARCH. 4591 03:04:50,212 --> 03:04:56,351 HE IS AN ENVIRONMENTAL ENGINEER 4592 03:04:56,418 --> 03:04:58,620 IN EPIDEMIOLOGIST AND CURRENTLY 4593 03:04:58,687 --> 03:05:02,357 ASSOCIATE PROFESSOR FOR 4594 03:05:02,424 --> 03:05:04,760 ENVIRONMENTAL SOCIAL SCIENCES AT 4595 03:05:04,827 --> 03:05:07,296 COLUMBIA, WHERE SHE RESEARCHES 4596 03:05:07,362 --> 03:05:08,764 STATISTICAL ISSUES RELATED TO 4597 03:05:08,831 --> 03:05:09,364 ENVIRONMENTAL EPIDEMIOLOGY. 4598 03:05:09,431 --> 03:05:15,304 I WILL HAND THE FLOOR OVER TO 4599 03:05:15,370 --> 03:05:16,672 YOU MARIANTHI-KNOWA ANA, AND YOU 4600 03:05:16,738 --> 03:05:21,176 HAVE A GREAT SESSION. 4601 03:05:21,243 --> 03:05:22,311 NTHANK YOU DOCTOR, AND YOU SAID 4602 03:05:22,377 --> 03:05:25,414 MY LAST NAME GREAT, THAT WAS 4603 03:05:25,481 --> 03:05:25,647 PERFECT. 4604 03:05:25,714 --> 03:05:26,348 THANK YOU. 4605 03:05:26,415 --> 03:05:31,253 SO IT'S GREAT THAT I FOLLOW 4606 03:05:31,320 --> 03:05:32,688 DR. SEIXAS, AND WHAT I WILL SAY 4607 03:05:32,754 --> 03:05:34,289 HERE IS VERY COMPLIMENTARY TO 4608 03:05:34,356 --> 03:05:39,728 THE TOOLS THAT HE DRIEBED, SO 4609 03:05:39,795 --> 03:05:41,396 THIS IS NOT THAT WAY OR THIS WAY 4610 03:05:41,463 --> 03:05:42,698 OF GETTING TO DATA. 4611 03:05:42,764 --> 03:05:46,568 IDEALLY WE WOULD LIKE TO DO 4612 03:05:46,635 --> 03:05:46,902 BOTH. 4613 03:05:46,969 --> 03:05:56,211 SO NEXT SLIDE, PLEASE. 4614 03:05:56,278 --> 03:05:57,713 SLEEP, WE ALL HEAR KNOW THAT 4615 03:05:57,779 --> 03:05:59,114 BECAUSE OF RESEARCH AND PERSONAL 4616 03:05:59,181 --> 03:06:00,716 EXPERIENCE IS VERY IMPORTANT FOR 4617 03:06:00,782 --> 03:06:03,585 PHYSICAL AND MENTAL COMELGT WELL 4618 03:06:03,652 --> 03:06:05,521 BEING AND ENVIRONMENTAL 4619 03:06:05,587 --> 03:06:07,823 EXPOSURES CAN INFLUENCE OUR 4620 03:06:07,890 --> 03:06:10,058 SLEEP QUALITY SO THE--MAYBE 4621 03:06:10,125 --> 03:06:11,827 OBVIOUS 1S OR MORE OBVIOUS ARE 4622 03:06:11,894 --> 03:06:13,629 TEMPERATURE AND NOISE, OF COURSE 4623 03:06:13,695 --> 03:06:15,063 THEY CAN DISRUPT SLEEP BUT 4624 03:06:15,130 --> 03:06:15,764 THERE'S INCREASING EVIDENCE FOR 4625 03:06:15,831 --> 03:06:18,433 THE ROLE OF LIGHT AND AIR 4626 03:06:18,500 --> 03:06:20,202 POLLUTION AND POTENTIALLY OTHERS 4627 03:06:20,269 --> 03:06:22,204 DIRECT AND INDIRECT PATHWAYS. 4628 03:06:22,271 --> 03:06:23,272 SO ACCURATELY ASSESSING 4629 03:06:23,338 --> 03:06:24,106 ENVIRONMENTAL EXPOSE IRBS AND 4630 03:06:24,172 --> 03:06:26,675 LINKING THOSE TO SLEEP AND 4631 03:06:26,742 --> 03:06:29,177 CIRCADIAN RHYTHM DATA IS KEY TO 4632 03:06:29,244 --> 03:06:32,447 UNDERSTANDING THEIR ROLE IN 4633 03:06:32,514 --> 03:06:33,015 SLEEP HEALTH. 4634 03:06:33,081 --> 03:06:36,652 AND CAVEAT THAT I WILL NOT 4635 03:06:36,718 --> 03:06:38,086 DISKESES OR EXPOSE BIOMARKERS 4636 03:06:38,153 --> 03:06:42,824 DURING THIS TALK, I WILL NOT 4637 03:06:42,891 --> 03:06:46,061 TALK ABOUT EXPOETICSOMICS, 4638 03:06:46,128 --> 03:06:48,463 DR. SEIXAS DID AN AMAZING WITH 4639 03:06:48,530 --> 03:06:53,068 THAT BUT INSTEAD I WILL DISCUSS 4640 03:06:53,135 --> 03:06:55,637 SLEEP QUALITY AND ENVIRONMENTAL 4641 03:06:55,704 --> 03:06:57,139 EXPOSURES LINKING SLEEP AND 4642 03:06:57,205 --> 03:06:58,507 CIRCADIAN RHYTHM EMPLOY NEXT 4643 03:06:58,574 --> 03:06:58,874 SLIDE, PLEASE. 4644 03:06:58,941 --> 03:07:00,776 I KEEP TRYING TO DO IT MYSELF. 4645 03:07:00,842 --> 03:07:02,311 SO CONSIDERATIONS FOR LINKING 4646 03:07:02,377 --> 03:07:06,415 DATA, FIRST OF ALL, I AM NOT 4647 03:07:06,481 --> 03:07:08,016 PROVIDING HERE SOURCES. 4648 03:07:08,083 --> 03:07:09,751 IF YOU HAVE ANY QUESTIONS ABOUT 4649 03:07:09,818 --> 03:07:12,287 SPECIFIC DATA SOURCES OR 4650 03:07:12,354 --> 03:07:13,922 SPECIFIC AMBIENT EXPOSURES 4651 03:07:13,989 --> 03:07:15,290 DEFINITELY PLEASE LET ME KNOW, 4652 03:07:15,357 --> 03:07:16,425 CERTAINLY--CERTAINLY MAIL ME AND 4653 03:07:16,491 --> 03:07:19,962 I'M HAPPY TO PROVIDE THOSE, BUT 4654 03:07:20,028 --> 03:07:21,563 CONSIDERATIONS FOR LINKAGE ARE 4655 03:07:21,630 --> 03:07:24,533 FIRST OF ALL SPATIAL AND 4656 03:07:24,600 --> 03:07:25,701 TEMPERRAL RESOLUTION OF THE 4657 03:07:25,767 --> 03:07:26,535 ENVIRONMENTAL DATA SO FOR 4658 03:07:26,602 --> 03:07:29,371 EXAMPLE WITH WE TALK ABOUT 4659 03:07:29,438 --> 03:07:30,772 TEMPORALITY, ARE WE INTERESTED 4660 03:07:30,839 --> 03:07:33,175 IN THE ANNUAL AVERAGE, SOMETHING 4661 03:07:33,241 --> 03:07:35,277 THAT DIFFERENT CHANGE OR TIME 4662 03:07:35,344 --> 03:07:37,279 BUT VERY, VERY SLOWLY CHANGES 4663 03:07:37,346 --> 03:07:38,814 OVER TIME OR DO WE WANT 4664 03:07:38,880 --> 03:07:41,850 SOMETHING ASSESSED DAILY AND 4665 03:07:41,917 --> 03:07:43,719 THEN ALSO, THE SPATIAL 4666 03:07:43,785 --> 03:07:46,555 RESOLUTION, WELL, LET ME GIVE 4667 03:07:46,622 --> 03:07:49,625 EXAMPLES, FOR EXAMPLE, SOMETHING 4668 03:07:49,691 --> 03:07:51,760 THAT DIFFERENT REALLY CHANGE 4669 03:07:51,827 --> 03:07:54,596 THAT QUICKLY, IS OUR BUILT 4670 03:07:54,663 --> 03:07:56,298 ENVIRONMENT, OF COURSE IT 4671 03:07:56,365 --> 03:07:58,734 CHANGES BUT NOT DRASTICALLY 4672 03:07:58,800 --> 03:08:00,035 OVERTIME, THAT TAKES YEARS SO 4673 03:08:00,102 --> 03:08:01,603 WHEREAS IF QUIEWR THINKING ABOUT 4674 03:08:01,670 --> 03:08:03,205 TEMPERATURE OR MAYBE EVEN AIR 4675 03:08:03,271 --> 03:08:04,406 POLLUTION THEN MAYBE WE'RE MORE 4676 03:08:04,473 --> 03:08:08,243 INTERESTED IN A DAY-TO-DAY 4677 03:08:08,310 --> 03:08:09,044 VARIABILITY. 4678 03:08:09,111 --> 03:08:10,412 AND THE SPATIAL RESOLUTION IS 4679 03:08:10,479 --> 03:08:11,947 ALSO THE AVAILABILITY OF THE 4680 03:08:12,014 --> 03:08:15,584 DATA BUT THAT FOR EXAMPLE, IS 4681 03:08:15,651 --> 03:08:17,419 DATA AVAILABLE AT THE COUNTY 4682 03:08:17,486 --> 03:08:19,855 LEVEL OR VERY HIGH SPATIAL 4683 03:08:19,921 --> 03:08:22,224 RESOLUTION FOR EXAMPLE, LIKE 30 4684 03:08:22,290 --> 03:08:25,260 SQUARE METER GRIDS, AND FOR SOME 4685 03:08:25,327 --> 03:08:27,562 EXPOSURES, COUNTY DATA MAY BE 4686 03:08:27,629 --> 03:08:32,300 OKAY, THE EXPOSURE'S QUITE 4687 03:08:32,367 --> 03:08:33,802 HOMODPEENIOUS IN SPACE, CERTAIN 4688 03:08:33,869 --> 03:08:36,705 AIR POLLUTANTS NOT THAT MANY, 4689 03:08:36,772 --> 03:08:37,339 TEMPERATURES MOSTLY HOMOGENIUS 4690 03:08:37,406 --> 03:08:39,908 SO IT WOULD BE ACCEPTABLE AT 4691 03:08:39,975 --> 03:08:40,509 COUNTY LEVEL. 4692 03:08:40,575 --> 03:08:43,712 IF WE'RE INTERESTED IN A VERY 4693 03:08:43,779 --> 03:08:45,213 SPECIFIC URBAN ISLAND EFFECT, WE 4694 03:08:45,280 --> 03:08:49,651 OBVIOUSLY WANT SOMETHING THAT IS 4695 03:08:49,718 --> 03:08:52,054 MORE FINELY RESOLVED THAN COUNTY 4696 03:08:52,120 --> 03:08:52,621 LEVEL. 4697 03:08:52,688 --> 03:08:54,489 THE RELEVANT TIMES OF ECPOSURE 4698 03:08:54,556 --> 03:08:55,657 IS ALSO IMPORTANT FOR THE 4699 03:08:55,724 --> 03:08:57,926 SPECIFIC OUTCOME OF INTEREST, SO 4700 03:08:57,993 --> 03:08:59,561 THAT'S NOT ONLY THE AVAILABILITY 4701 03:08:59,628 --> 03:09:01,563 OF THE DATA, BUT ALSO WHAT WE 4702 03:09:01,630 --> 03:09:03,699 ARE INTERESTED IN, SO IS THE 4703 03:09:03,765 --> 03:09:05,567 STUDY ABOUT ACUTE SLEEP 4704 03:09:05,634 --> 03:09:09,104 DISTURBANCES, IN WHICH CASE, YOU 4705 03:09:09,171 --> 03:09:12,040 KNOW URBAN, THE BUILT 4706 03:09:12,107 --> 03:09:13,408 ENVIRONMENT AROUND US, WON'T BE 4707 03:09:13,475 --> 03:09:15,377 REEL KEEPSAKES VABT FOR THAT, 4708 03:09:15,444 --> 03:09:19,214 VERSUS CHRONIC SLEEP QUALITY 4709 03:09:19,281 --> 03:09:19,548 ISSUES. 4710 03:09:19,614 --> 03:09:22,284 SO THE LAST THING IN THIS SLIDE 4711 03:09:22,350 --> 03:09:25,120 IS THE ADDRESS, WHAT LOCAL 4712 03:09:25,187 --> 03:09:25,921 INFORMATION, WHAT RESIDENTIAL 4713 03:09:25,987 --> 03:09:28,123 INFORMATION DO I HAVE IN THE 4714 03:09:28,190 --> 03:09:32,928 STUDY PARTICIPANTS IN DO I HAVE 4715 03:09:32,994 --> 03:09:34,196 SOME GEOGRAPHY RELATED TO THEM 4716 03:09:34,262 --> 03:09:36,198 ON WHICH I CAN ASSIGN THE DATA 4717 03:09:36,264 --> 03:09:38,467 BECAUSE IF I DO NOT KNOW 4718 03:09:38,533 --> 03:09:40,168 ANYTHING, ABOUT WHERE THEY ARE, 4719 03:09:40,235 --> 03:09:42,938 IF I ONLY KNOW STATE FOR 4720 03:09:43,004 --> 03:09:47,008 EXAMPLE, THAT'S NOT VERY HELPFUL 4721 03:09:47,075 --> 03:09:48,376 FOR ENVIRONMENTAL DATA, IF I 4722 03:09:48,443 --> 03:09:50,278 KNOW COUNTY OR CITY, VERSUS NOT 4723 03:09:50,345 --> 03:09:52,247 SOME BUT OTHERS, IF I HAVE 4724 03:09:52,314 --> 03:09:53,782 ADDRESS, I HAVE ACCESS TO ALL 4725 03:09:53,849 --> 03:09:56,184 TYPES OF DATA AND THEN I CAN 4726 03:09:56,251 --> 03:09:58,887 EITHER USE AGGREGATE OR ASSIGN 4727 03:09:58,954 --> 03:10:02,557 AT THE EXACT ADDRESS EXPOSURES, 4728 03:10:02,624 --> 03:10:03,024 NEXT SLIDE, PLEASE. 4729 03:10:03,091 --> 03:10:05,360 OH AND IF THESE ARE TOO VAGUE, 4730 03:10:05,427 --> 03:10:07,763 WHAT I'M SAYING BECAUSE I'M NOT 4731 03:10:07,829 --> 03:10:08,497 GIVING SPECIFIC EXAMPLES, PLEASE 4732 03:10:08,563 --> 03:10:11,233 LET ME KNOW IN THE QUESTIONS AND 4733 03:10:11,299 --> 03:10:15,904 I CAN ADDRESS IN THE Q&A PART. 4734 03:10:15,971 --> 03:10:17,672 OTHER CONSIDERATIONS ARE 4735 03:10:17,739 --> 03:10:19,574 PROTECTIONS OF IDENTIFIABLE 4736 03:10:19,641 --> 03:10:22,310 DATA, EVEN IF WE LINK PEOPLE SAY 4737 03:10:22,377 --> 03:10:24,412 ON THEIR ZIP CODE AND THEN WE 4738 03:10:24,479 --> 03:10:26,148 COMPLETELY TAKE THE ZIP CODES 4739 03:10:26,214 --> 03:10:28,450 AFTER THE LINKAGE OUT OF THE 4740 03:10:28,517 --> 03:10:31,319 FILE, ONCE WE LINK PEOPLE TO 4741 03:10:31,386 --> 03:10:32,687 PUBLICLY AVAILABLE ENVIRONMENTAL 4742 03:10:32,754 --> 03:10:38,026 DATA, THAT MEANS THAT IT'S 4743 03:10:38,093 --> 03:10:41,096 POSSIBLE THAT OTHERS MAY 4744 03:10:41,163 --> 03:10:43,131 IDENTIFY OUR STUDY SUBJEKS. 4745 03:10:43,198 --> 03:10:45,333 THIS IS SOMETHING THAT MIGHT NOT 4746 03:10:45,400 --> 03:10:47,803 BE SUPER CLEAR, SO IT'S VERY 4747 03:10:47,869 --> 03:10:50,338 IMPORTANT TO THINK THAT NOW THE 4748 03:10:50,405 --> 03:10:53,275 DATA, EVEN IF THE LIFE LONG ARE 4749 03:10:53,341 --> 03:10:55,844 STRIPPED FROM THE RECORDS BEING 4750 03:10:55,911 --> 03:10:57,479 BE IDENTIFIABLE SO WE NEED EXTRA 4751 03:10:57,546 --> 03:10:58,446 PROTECTION, WE NEED TO HAVE THE 4752 03:10:58,513 --> 03:11:00,782 SET UP FOR THAT, COMPUTATIONAL 4753 03:11:00,849 --> 03:11:02,884 SCALABILITY, EVEN IF MY COHORT 4754 03:11:02,951 --> 03:11:06,721 IS ONLY 100 PEOPLE AND I WANT TO 4755 03:11:06,788 --> 03:11:08,924 YOU KNOW SIGN TO THEM ANNUAL 4756 03:11:08,990 --> 03:11:10,525 EXPOSURES OF FINE PARTICLE THIS, 4757 03:11:10,592 --> 03:11:14,429 IS AN AIR POLLUTANT, THE DATA 4758 03:11:14,496 --> 03:11:16,731 SETS TO DOWNLOAD, TO GET THAT 4759 03:11:16,798 --> 03:11:18,733 WILL PROBABLY BE GIGA BITES OR 4760 03:11:18,800 --> 03:11:22,838 TERRA BYTES, SO DO I HAVE THE 4761 03:11:22,904 --> 03:11:24,005 CACA PASQUANTINOITY TO DEAL WITH 4762 03:11:24,072 --> 03:11:25,440 THOSE DATA OR DO I HAVE 4763 03:11:25,507 --> 03:11:28,510 COLLABORATORS THAT CAN HELP ME 4764 03:11:28,577 --> 03:11:29,110 WITH THAT. 4765 03:11:29,177 --> 03:11:32,881 CONSULT WITH EX PERS ON 4766 03:11:32,948 --> 03:11:33,148 EXPOSURES. 4767 03:11:33,215 --> 03:11:36,017 I AM ON THE EXPOSURE SIDE, MY 4768 03:11:36,084 --> 03:11:37,953 EXPERTISE AND VERY OFTEN I 4769 03:11:38,019 --> 03:11:40,655 COLLABORATE WITH EX PERS ON THE 4770 03:11:40,722 --> 03:11:42,724 OUTCOME SIDE AND VERY OFTEN I 4771 03:11:42,791 --> 03:11:45,894 SEE THAT, YOU KNOW EBPOSURES ARE 4772 03:11:45,961 --> 03:11:46,862 JUST NUMBERS. 4773 03:11:46,928 --> 03:11:48,263 BUT TALKING WITH EXPOSURE 4774 03:11:48,330 --> 03:11:51,800 EXPERTS CAN HELP US UNDERSTAND 4775 03:11:51,867 --> 03:11:54,002 THE NUANCES, THE DIFFERENT 4776 03:11:54,069 --> 03:11:57,439 ERRORS, DIFFERENT POTENTIAL 4777 03:11:57,505 --> 03:11:58,473 CONFOUNDERS, OR PREDICTERS, OR 4778 03:11:58,540 --> 03:12:00,242 YOU KNOW ALL THESE THINGS THAT 4779 03:12:00,308 --> 03:12:03,245 COULD HELP US WHICHEVER OUR 4780 03:12:03,311 --> 03:12:05,347 ANALYSIS IS, WHETHER IT'S 4781 03:12:05,413 --> 03:12:06,414 EPIDEMIOLOGIC OR PREDICTION 4782 03:12:06,481 --> 03:12:07,916 MODEL, AND THEN FINALLY, IT'S 4783 03:12:07,983 --> 03:12:10,886 IMPORTANT TO KEEP IN MIND THAT 4784 03:12:10,952 --> 03:12:16,157 AMBIENT LEVELS ARE NOT PERSONAL 4785 03:12:16,224 --> 03:12:19,861 EXPOSURES SO WHAT DR. SEIXAS 4786 03:12:19,928 --> 03:12:21,496 PRESENTED EARLIER, THOSE GET 4787 03:12:21,563 --> 03:12:24,266 CLOSER TO PERSONAL SOLUTIONS OF 4788 03:12:24,332 --> 03:12:25,333 EXPOSURE AND SOUND FOR EXAMPLE, 4789 03:12:25,400 --> 03:12:27,569 HOWEVER, THAT IS NOT ASSESSING 4790 03:12:27,636 --> 03:12:30,772 EXPOSURES THAT WAY, IT'S BETTER 4791 03:12:30,839 --> 03:12:34,376 BUT IT'S NOT REALISTIC IF WE 4792 03:12:34,442 --> 03:12:36,044 WANT, YOU KNOW, IF WE DON'T HAVE 4793 03:12:36,111 --> 03:12:40,148 THE FUNDS, OR IF WE HAVE 4794 03:12:40,215 --> 03:12:42,083 3 MILLION SUBJECTS BECAUSE THIS 4795 03:12:42,150 --> 03:12:44,019 IS ADMINISTRATIVE DATA SET OR 4796 03:12:44,085 --> 03:12:46,721 EVEN A FEW THOUSAND SUBJEKS, SO 4797 03:12:46,788 --> 03:12:48,757 THINKING THE POTENTIAL OF 4798 03:12:48,823 --> 03:12:49,958 EXPOSURE MEASUREMENT OR AT 4799 03:12:50,025 --> 03:12:51,793 UNCERTAINTY AND THE IMPACTS IT 4800 03:12:51,860 --> 03:12:54,429 MAY HAVE ON THE MAGNITUDE AND 4801 03:12:54,496 --> 03:12:55,830 DIRECTION OF BIAS IS IMPORTANT, 4802 03:12:55,897 --> 03:12:57,432 IT'S ALSO IMPORTANT TO CONSIDER 4803 03:12:57,499 --> 03:13:00,302 WHETHER THE ERROR MAY BE 4804 03:13:00,368 --> 03:13:02,837 CORRELATED WITH THE OUTCOME IN 4805 03:13:02,904 --> 03:13:07,475 WHICH IT'S DIFFERENTIAL. 4806 03:13:07,542 --> 03:13:08,109 NEXT SLIDE, PLEASE. 4807 03:13:08,176 --> 03:13:10,211 SO I WILL TALK ABOUT AIR 4808 03:13:10,278 --> 03:13:11,947 POLLUTION SPECIFICALLY HERE 4809 03:13:12,013 --> 03:13:16,685 WHICH IS UBIQUITOUS EXPOSURE, WE 4810 03:13:16,751 --> 03:13:18,520 ALL BREATHE, WE ARE ALL EXPOSED 4811 03:13:18,586 --> 03:13:19,821 TO AIR POLLUTION EVERY MINUTE OF 4812 03:13:19,888 --> 03:13:21,222 OUR LIVES AND AIR POLLUTION HAS 4813 03:13:21,289 --> 03:13:23,658 BEEN LINKED TO NUMEROUS ADVERSE 4814 03:13:23,725 --> 03:13:25,827 HEALTH OUTCOMES ACROSS THE LIFE 4815 03:13:25,894 --> 03:13:27,362 SPAN FROM PREGNANCY AND BIRTH 4816 03:13:27,429 --> 03:13:31,766 OUTCOMES TO MOOD DISORDERS, 4817 03:13:31,833 --> 03:13:33,635 RESPIRATION AND MORTALITY, 4818 03:13:33,702 --> 03:13:34,970 NEURODEGENERATION, ALL CAUSE 4819 03:13:35,036 --> 03:13:36,271 MORTALITY, IT'S A ERROR LONG 4820 03:13:36,338 --> 03:13:39,774 LIST, MANY OF THESE ARE 4821 03:13:39,841 --> 03:13:40,842 CAUSEALLY RELATED, THE AIR 4822 03:13:40,909 --> 03:13:42,344 POLLUTION HAS CAUSAL EFFECTS ON 4823 03:13:42,410 --> 03:13:46,881 THESE OUTCOMES. 4824 03:13:46,948 --> 03:13:48,016 NEXT SLIDE, PLEASE. 4825 03:13:48,083 --> 03:13:49,851 NOW, INDIVIDUAL RISKS IN AIR 4826 03:13:49,918 --> 03:13:51,586 POLLUTION STUDIES ARE NOT 4827 03:13:51,653 --> 03:13:54,389 PARTICULARLY HIGH SO FOR 4828 03:13:54,456 --> 03:13:56,925 EXAMPLE, IF YOU SEE ISSUES OR 4829 03:13:56,992 --> 03:13:59,594 OTHER ISSUES FOR AIR POLLUTION 4830 03:13:59,661 --> 03:14:00,895 ON CERTAIN OUTCOMES AND THEN YOU 4831 03:14:00,962 --> 03:14:03,832 COMPARE THOSE WITH LET'S SAY 4832 03:14:03,898 --> 03:14:05,934 SMOKING, THEY'RE MUCH, MUCH MORE 4833 03:14:06,001 --> 03:14:09,838 MODEST AND SMALLER, HOWEVER, THE 4834 03:14:09,904 --> 03:14:11,072 IMPLICATIONS FOR POPULATION 4835 03:14:11,139 --> 03:14:12,240 HEALTH ARE VERY, VERY HIGH 4836 03:14:12,307 --> 03:14:16,011 BECAUSE AS I SAID EARLIER, WE 4837 03:14:16,077 --> 03:14:18,113 ALL BREATHE. 4838 03:14:18,179 --> 03:14:20,048 SO EACH IF OUR INDIVIDUAL RISKS 4839 03:14:20,115 --> 03:14:21,483 ARE LOW, AT THE POPULATION 4840 03:14:21,549 --> 03:14:23,551 LEVEL, THE NUMBERS CAN BE LARGE, 4841 03:14:23,618 --> 03:14:26,321 AND FOR THIS REASON, IN 2019, 4842 03:14:26,388 --> 03:14:28,623 THAT'S THE MOST RECENT GBT, 4843 03:14:28,690 --> 03:14:30,392 EXPOSE TOWER AIR POLLUTION WAS 4844 03:14:30,458 --> 03:14:33,595 REPORTED TO HAVE RESULT IN 4845 03:14:33,661 --> 03:14:34,963 7 MILLION PREMATURE DEATHS PER 4846 03:14:35,030 --> 03:14:36,498 YEAR, SO AIR POLLUTION IS 4847 03:14:36,564 --> 03:14:37,565 CURRENTLY THE LEADING 4848 03:14:37,632 --> 03:14:39,634 ENVIRONMENTAL RISK FACTOR FOR 4849 03:14:39,701 --> 03:14:40,368 DISABILITY AJUSTED LIFE YEARS 4850 03:14:40,435 --> 03:14:43,338 AND THIS IS THE FOURTH RISK 4851 03:14:43,405 --> 03:14:45,874 FACTOR OVERALL, AND THIS IS 4852 03:14:45,940 --> 03:14:46,808 LIKELY AN UNDERESTIMATE ISSUES 4853 03:14:46,875 --> 03:14:51,513 BECAUSE THIS DID NOT INCLUDE ALL 4854 03:14:51,579 --> 03:14:53,381 OUTCOMES THAT ARE BEEN LINKED TO 4855 03:14:53,448 --> 03:14:57,318 AIR POLLUTION, SLEEP QUALITY IS 4856 03:14:57,385 --> 03:14:58,119 1 OF THEM. 4857 03:14:58,186 --> 03:14:59,888 SO THERE HAVE BEEN ONLY A FEW 4858 03:14:59,954 --> 03:15:01,623 STUDIES, NOT THAT MANY LOOKING 4859 03:15:01,689 --> 03:15:06,594 AT AIR POLLUTION AND SLEEP 4860 03:15:06,661 --> 03:15:07,028 QUALITY. 4861 03:15:07,095 --> 03:15:10,198 THE RESULTS ARE NEGATIVE MEANING 4862 03:15:10,265 --> 03:15:12,834 THAT AIR POLLUTION IS ASSOCIATED 4863 03:15:12,901 --> 03:15:17,172 WITH WORSE SLEEP QUALITY AND THE 4864 03:15:17,238 --> 03:15:19,140 MECHANISMS, THE HYPOTHESIZED 4865 03:15:19,207 --> 03:15:20,742 MECHANISMS MAY INVOLVE 4866 03:15:20,809 --> 03:15:24,045 NEUROCHEMICAL AND/OR 4867 03:15:24,112 --> 03:15:24,512 PHYSIOLOGICAL EFFECTS. 4868 03:15:24,579 --> 03:15:26,081 NEXT, PLEASE. 4869 03:15:26,147 --> 03:15:31,219 SO, AS I SAID EARLIER FOR LARGE 4870 03:15:31,286 --> 03:15:32,287 POPULATIONS, PERSONAL 4871 03:15:32,353 --> 03:15:34,989 MEASUREMENTS ARE EXPENSIVE AND 4872 03:15:35,056 --> 03:15:36,825 NOT VERY FEASIBLE ESPECIALLY IF 4873 03:15:36,891 --> 03:15:38,259 WE WANT PEOPLE OVER EXTENDED 4874 03:15:38,326 --> 03:15:38,726 PERIOD. 4875 03:15:38,793 --> 03:15:41,362 IF WE'RE INTERESTED IN LET'S SAY 4876 03:15:41,429 --> 03:15:42,897 CHRONIC IMPACTS OR LONG-TERM 4877 03:15:42,964 --> 03:15:47,368 EXPOSE TOWER AIR POLLUTION AND 4878 03:15:47,435 --> 03:15:48,436 CHRONIC IMPACT IN SLEEP HEALTH, 4879 03:15:48,503 --> 03:15:51,239 WE WOULD LIKE TO KNOW PEOPLE'S 4880 03:15:51,306 --> 03:15:53,141 EXPOSURES FOR 1 OR 2 YEARS. 4881 03:15:53,208 --> 03:15:56,578 IT'S NOT EASY TO HAVE PERSONAL 4882 03:15:56,644 --> 03:16:00,048 MEASUREMENTS FOR THIS LONG. 4883 03:16:00,115 --> 03:16:04,152 FOR MAYBE IT'S OKAY FOR A 4884 03:16:04,219 --> 03:16:05,787 HUNDRED, 300 SUBRECYCLINGS, 4885 03:16:05,854 --> 03:16:07,755 MUCH, MUCH HARDER FOR BUDGETS 4886 03:16:07,822 --> 03:16:09,390 BUT ALSO LOGISTICALLY TO DO THIS 4887 03:16:09,457 --> 03:16:11,126 FOR DOZENS OF THOUSANDS OF 4888 03:16:11,192 --> 03:16:13,795 PEOPLE. 4889 03:16:13,862 --> 03:16:15,196 SO THE DEVELOPMENT OF AND THIS 4890 03:16:15,263 --> 03:16:17,565 HAS LED TO THE DEVELOPMENT OF 4891 03:16:17,632 --> 03:16:19,634 ADVANCED TEMPERRAL MODELS TO 4892 03:16:19,701 --> 03:16:20,935 PREDICT CONCENTRATIONS AT 4893 03:16:21,002 --> 03:16:22,604 PARTICIPANTS ADDRESSES AND THIS 4894 03:16:22,670 --> 03:16:26,474 IS JUST 1 EXAMPLE OF VERY 4895 03:16:26,541 --> 03:16:31,779 COMMONLY USED MODEL THAT WAS 4896 03:16:31,846 --> 03:16:35,650 DEVELOPED BY DISPEAZ ET EALL, 4897 03:16:35,717 --> 03:16:37,719 THAT IS THE HARVARD GROUP BUT 4898 03:16:37,785 --> 03:16:40,822 HAD 4899 03:16:40,889 --> 03:16:43,124 THERE ARE CURRENTLY MULTIPLE 4900 03:16:43,191 --> 03:16:44,526 MODELS EXISTING, BUT THEY DON'T 4901 03:16:44,592 --> 03:16:45,560 GIVE THE SAME INFORMATION AT 4902 03:16:45,627 --> 03:16:50,398 EVERY DAY AND EVERY POINT 4903 03:16:50,465 --> 03:16:50,965 LOCATION, NEXT, PLEASE. 4904 03:16:51,032 --> 03:16:56,404 MY MY GROUP AND I DEVELOPED 4905 03:16:56,471 --> 03:17:03,211 SOMETHING CALLED THE BIOMETRIC 4906 03:17:03,278 --> 03:17:04,512 ENSEMBLE, THAT INTEGRATES 4907 03:17:04,579 --> 03:17:05,647 INFORMATION ACROSS TEMPERRAL 4908 03:17:05,713 --> 03:17:13,521 MODELS AND IF WE DO THAT, THE 4909 03:17:13,588 --> 03:17:15,857 DI ET ALL IS 1 EXISTING MODEL, 4910 03:17:15,924 --> 03:17:19,561 WE HAVE 7 OR 8 OF THEM 4911 03:17:19,627 --> 03:17:21,963 CURRENTLY, BY TEMPERRAL, 4912 03:17:22,030 --> 03:17:22,730 PREDICTIVE ACCURACY, HOW 4913 03:17:22,797 --> 03:17:24,532 ACCURATE IS THE MODEL AT AIM 4914 03:17:24,599 --> 03:17:27,402 TIME AND AT EACH POINT IN SPACE 4915 03:17:27,468 --> 03:17:28,369 AND TIME. 4916 03:17:28,436 --> 03:17:30,071 SO WE'RE ESTIMATING SPATIAL 4917 03:17:30,138 --> 03:17:32,507 TEMPERRAL WEIGHT ANDS THEN WE 4918 03:17:32,574 --> 03:17:37,545 ARE ENSEMBLING ALL OF THESE TO 4919 03:17:37,612 --> 03:17:41,649 CREATE 1 SURFACE, WELL, DAILY 4920 03:17:41,716 --> 03:17:44,385 SURFACE AND IMPORTANTLY BECAUSE 4921 03:17:44,452 --> 03:17:46,688 WE DO THIS [INDISCERNIBLE] 4922 03:17:46,754 --> 03:17:48,656 FRAMEWORK, THIS PROVIDES 4923 03:17:48,723 --> 03:17:49,824 TEMPERRAL UNCERTAINTY OF THIS 4924 03:17:49,891 --> 03:17:51,826 PREDICTION, SO WE DON'T ONLY GET 4925 03:17:51,893 --> 03:17:52,627 THE PREDICTIVE CONCENTRATION 4926 03:17:52,694 --> 03:17:54,295 WHICH IS WHAT ALL OTHERS MODELS 4927 03:17:54,362 --> 03:18:01,135 PROVIDE BUT ALSO WE GET FOR EACH 4928 03:18:01,202 --> 03:18:03,871 CONCENTRATION, IT'S UNSSHT AND 4929 03:18:03,938 --> 03:18:05,173 THAT UNCERTAINTY SHOWS THE 4930 03:18:05,240 --> 03:18:06,107 PREDICTED UPCERTAINTY AT THAT 4931 03:18:06,174 --> 03:18:09,911 LOCATION AND TIME BUT ALSO 4932 03:18:09,978 --> 03:18:10,511 THE--INCORPORATES THE 4933 03:18:10,578 --> 03:18:11,312 DISAGREEMENT BETWEEN EXISTING 4934 03:18:11,379 --> 03:18:16,651 MODELS SO IF WE'RE INTERESTED IN 4935 03:18:16,718 --> 03:18:19,354 VARIANCES THAT'S IMPORTANT. 4936 03:18:19,420 --> 03:18:21,189 NEXT SLIDE, PLEASE. 4937 03:18:21,256 --> 03:18:23,057 YES, SO WHEN WE STARTED THIS, WE 4938 03:18:23,124 --> 03:18:25,994 ACTUALLY THOUGHT THAT OUR MODEL 4939 03:18:26,060 --> 03:18:29,063 WOULD YIELD THE BEST PREDICTIVE 4940 03:18:29,130 --> 03:18:30,298 ACCURACY, IT DOES NOT, I WILL 4941 03:18:30,365 --> 03:18:32,500 SAY THAT, BUT WHAT IT DOES IS WE 4942 03:18:32,567 --> 03:18:34,402 LOOKED AT THE PREDICTIVE 4943 03:18:34,469 --> 03:18:37,839 ACCURACYS BY REGION OF ALL THE 4944 03:18:37,905 --> 03:18:39,240 AIDS INPUT MODELS AND EVEN 4945 03:18:39,307 --> 03:18:41,509 THOUGH OUR MODEL WAS NOT THE 4946 03:18:41,576 --> 03:18:44,846 BEST AT EVERY REGION, IT WAS 4947 03:18:44,912 --> 03:18:48,082 CONSISTENTLY IN THE TOP 3 OF THE 4948 03:18:48,149 --> 03:18:49,951 8 MODELS IN EVERY REGION, NO 4949 03:18:50,018 --> 03:18:54,289 OTHER MODEL DID THAT, SO, WE 4950 03:18:54,355 --> 03:18:56,491 HAVE A CONSISTENT EXPOSURE 4951 03:18:56,557 --> 03:18:57,091 MEASUREMENT ACROSS THE UNITED 4952 03:18:57,158 --> 03:19:01,496 STATES, SO BRINGING IT BACK TO 4953 03:19:01,562 --> 03:19:03,564 SLEEP QUALITY, IF I WANT TO 4954 03:19:03,631 --> 03:19:05,833 COMPARE THE ASSOCIATION BETWEEN 4955 03:19:05,900 --> 03:19:07,535 AIR POLLUTION AMONG PEOPLE IN 4956 03:19:07,602 --> 03:19:12,206 LOS ANGELES AND IN NEW YORK, IF 4957 03:19:12,273 --> 03:19:13,908 I FIND DIFFERENCES THAT AFFECT 4958 03:19:13,975 --> 03:19:16,177 ESTIMATES, NOW THIS IS NOT 4959 03:19:16,244 --> 03:19:17,812 BECAUSE OF DIFFERENT EXPOSURE 4960 03:19:17,879 --> 03:19:19,213 ERROR BY REGION THIS, IS BECAUSE 4961 03:19:19,280 --> 03:19:21,949 AIR POLLUTION MAY HAVE A 4962 03:19:22,016 --> 03:19:23,351 DIFFERENT COMPOSITION OR OTHER 4963 03:19:23,418 --> 03:19:25,186 DIFFERENT FACTORS IN THE 2 4964 03:19:25,253 --> 03:19:26,487 POPULATION BUT NOT BECAUSE OF 4965 03:19:26,554 --> 03:19:27,855 ERROR WHICH IS GREAT BECAUSE 4966 03:19:27,922 --> 03:19:31,993 IT'S 1 THING OFF THE LIST. 4967 03:19:32,060 --> 03:19:33,127 UNCERTAINTY ESTIMATION IS VERY 4968 03:19:33,194 --> 03:19:34,662 IMPORTANT BECAUSE THIS CAN HELP 4969 03:19:34,729 --> 03:19:36,264 US WITH VALID INFERENCES OF 4970 03:19:36,331 --> 03:19:37,665 HEALTH EFFECT ESTIMATE ANDS THE 4971 03:19:37,732 --> 03:19:40,268 LAST 2 ARE NOT NECESSARILY THAT 4972 03:19:40,335 --> 03:19:42,670 RELEVANT FOR THIS PANEL, THIS 1 4973 03:19:42,737 --> 03:19:44,539 SHOP BUT THE EVALUATION OF 4974 03:19:44,605 --> 03:19:46,074 SPECIFIC MODEL WEIGHTS CAN LEAD 4975 03:19:46,140 --> 03:19:49,911 TO IMPROVEMENT OF EACH BASE 4976 03:19:49,977 --> 03:19:52,780 MODEL AND THEN, THE 4977 03:19:52,847 --> 03:19:54,282 IDENTIFICATION OF HIGHEST 4978 03:19:54,349 --> 03:19:55,783 UNCERTAINTY LOCATIONS CAN HELP 4979 03:19:55,850 --> 03:19:58,820 EFFICIENT PLACING OF NEW 4980 03:19:58,886 --> 03:20:03,024 MONITORING STATIONS. 4981 03:20:03,091 --> 03:20:03,491 NEXT, PLEASE. 4982 03:20:03,558 --> 03:20:07,595 O THIS IS JUST AN ANNUAL AVERAGE 4983 03:20:07,662 --> 03:20:10,465 OF 2010 FOR FINE PARTICLES, AND 4984 03:20:10,531 --> 03:20:11,566 FINE PARTICLES ARE THESE TINY 4985 03:20:11,632 --> 03:20:12,533 LITTLE PARTICLES IN THE AIR, 4986 03:20:12,600 --> 03:20:15,536 THEY ARE LESS THAN 4987 03:20:15,603 --> 03:20:16,237 2.5-MICROMETERS WE CANNOT SEE 4988 03:20:16,304 --> 03:20:17,772 THEM WITH THE NAKED EYE BECAUSE 4989 03:20:17,839 --> 03:20:19,407 OF THEIR SIZE, THEY CAN 4990 03:20:19,474 --> 03:20:20,808 PENETRATE DEEP BO OUR LUNGS AND 4991 03:20:20,875 --> 03:20:23,077 IF THAT'S WHERE THEY CAN CAUSE 4992 03:20:23,144 --> 03:20:26,481 INITIALLY SOME LOCAL 4993 03:20:26,547 --> 03:20:27,749 INFLAMMATION AND LOCALOX CAITIFF 4994 03:20:27,815 --> 03:20:30,318 STRESS AND THEN GO SYSTEMIC AND 4995 03:20:30,385 --> 03:20:31,919 PROVIDE IT CAN IMPACT ALL OUR 4996 03:20:31,986 --> 03:20:35,356 ORGANS AND ALL OUR SYSTEMS. 4997 03:20:35,423 --> 03:20:37,125 SO ON THE LEFT-HAND SIDE, THIS 4998 03:20:37,191 --> 03:20:41,729 IS THE ANNUAL AVERAGE FOR 2010 4999 03:20:41,796 --> 03:20:44,132 CONCENTRATION OF PM2.5. 5000 03:20:44,198 --> 03:20:47,001 AND ON THE LEFT-HAND SIDE, 5001 03:20:47,068 --> 03:20:48,436 THAT'S THE NOVELTY IS THAT THIS 5002 03:20:48,503 --> 03:20:51,606 IS THE UNCERTAINTY THAT WE HAVE 5003 03:20:51,672 --> 03:20:53,040 IN THESE PREDICTIONS SO AS YOU 5004 03:20:53,107 --> 03:20:56,878 CAN SEE IN THIS MAP, THERE ARE 5005 03:20:56,944 --> 03:21:00,114 CERTAIN AREAS THAT FOR WHICH WE 5006 03:21:00,181 --> 03:21:03,785 DO--WE'RE NOT VERY CONFIDENT IN 5007 03:21:03,851 --> 03:21:06,287 THE PREDICTIVE CONCENTRATIONS. 5008 03:21:06,354 --> 03:21:08,089 NEXT SLIDE, PLEASE. 5009 03:21:08,156 --> 03:21:12,727 NOW WHY THIS BECOMES IMPORTANT. 5010 03:21:12,794 --> 03:21:17,298 SO STUDIES HAVE CONSISTENTLY 5011 03:21:17,365 --> 03:21:18,299 REPORTED HIGHER CONCENTRATIONS 5012 03:21:18,366 --> 03:21:21,502 IN LOW INCOME AND MARGINALIZED 5013 03:21:21,569 --> 03:21:25,106 COMMUNITIES AND AGAIN DR. SEIXAS 5014 03:21:25,173 --> 03:21:29,076 ALREADY DISCUSSED THIS IN THE 5015 03:21:29,143 --> 03:21:30,244 PREVIOUS PRESENTATIONS, WELL I 5016 03:21:30,311 --> 03:21:33,514 DON'T KNOW ABOUT SPECIFICALLY 5017 03:21:33,581 --> 03:21:35,249 2.5 THAT THESE DISPARITIES EXIST 5018 03:21:35,316 --> 03:21:37,351 IN THE HOALGT OUTCOME AS WELL. 5019 03:21:37,418 --> 03:21:40,321 SO HOWEVER THE MONITOR PLACEMENT 5020 03:21:40,388 --> 03:21:43,658 IS NOT RANDOM IN SPACE. 5021 03:21:43,724 --> 03:21:46,494 HOW DOES UNCERTAINTY VARY ACROSS 5022 03:21:46,561 --> 03:21:50,364 THE SES GRAYIENT IN THIS HAS 5023 03:21:50,431 --> 03:21:52,200 IMPLICATIONS FOR INTERPRETING 5024 03:21:52,266 --> 03:21:54,836 THE RESULTS, RIGHT IN THE 5025 03:21:54,902 --> 03:21:57,338 CONCENTRATIONS, SO HOW DO, NOW 5026 03:21:57,405 --> 03:21:59,207 ONLY HOW DID UNCERTAINTY IN THE 5027 03:21:59,273 --> 03:22:01,309 EXPOSURE VARIES BUT HOW DO 5028 03:22:01,375 --> 03:22:03,277 CONCENTRATIONS VARY AFTER 5029 03:22:03,344 --> 03:22:06,280 ACCOUNTING FOR VARIATIONS IN 5030 03:22:06,347 --> 03:22:06,581 UNCERTAINTY. 5031 03:22:06,647 --> 03:22:09,617 NEXT, PLEASE. 5032 03:22:09,684 --> 03:22:11,519 SO, THESE ARE BUSY PLOTS, I WILL 5033 03:22:11,586 --> 03:22:13,020 DRIEB THEM IN JUST A SECOND, I 5034 03:22:13,087 --> 03:22:14,989 WOULD JUST LIKE TO SAY THAT 5035 03:22:15,056 --> 03:22:16,757 THESE ARE PRELIMINARY DATA, 5036 03:22:16,824 --> 03:22:18,392 THESE ARE DRIEWBTED AND I KNOW 5037 03:22:18,459 --> 03:22:20,895 THIS IS BEING RECORDED BUT JUST 5038 03:22:20,962 --> 03:22:22,763 IF YOU SEE THIS IN THE PUBLISHED 5039 03:22:22,830 --> 03:22:25,066 PAPER IN A FEW MONTHS, IT MIGHT 5040 03:22:25,132 --> 03:22:26,234 LOOK A LITTLE DIFFERENT 5041 03:22:26,300 --> 03:22:27,602 DEPENDING ON WHAT THE REVIEWERS 5042 03:22:27,668 --> 03:22:31,506 ASK US TO DO. 5043 03:22:31,572 --> 03:22:33,941 SO HERE WE'RE COMPARING, THIS IS 5044 03:22:34,008 --> 03:22:35,309 THE CENSUS TRACK LEVEL 5045 03:22:35,376 --> 03:22:41,849 PROPORTION OF BLACK RESIDENTS ON 5046 03:22:41,916 --> 03:22:45,219 THE LEFT, AND Y-ON THE AXIS--ON 5047 03:22:45,286 --> 03:22:48,356 THE X-AXIS, I'M SORRY, ON THE 5048 03:22:48,422 --> 03:22:51,926 Y-AXIS IS THE UNCERTAINTY OF PF2 5049 03:22:51,993 --> 03:22:52,860 PBT 5 CONCENTRATION AND PLEASE 5050 03:22:52,927 --> 03:22:57,365 NOTE THAT RIGHT NOW, THE AXES 5051 03:22:57,431 --> 03:22:59,767 ARE IN DIFFERENT SCALE, SO THIS 5052 03:22:59,834 --> 03:23:02,770 GOES UP TO .6 SO THEY'RE NOT 5053 03:23:02,837 --> 03:23:04,972 EXACTLY COMPARABLE HOWEVER WHAT 5054 03:23:05,039 --> 03:23:06,841 IS VERY CLEAR IS THAT WITH 5055 03:23:06,908 --> 03:23:09,810 INCREASING PROPORTION AT PLOKS 5056 03:23:09,877 --> 03:23:10,978 AND REGISTERING THE CENSUS 5057 03:23:11,045 --> 03:23:12,813 TRACK, THE UNCERTAINTY ALSO 5058 03:23:12,880 --> 03:23:13,848 INCREASES WHEREAS FOR WIDE 5059 03:23:13,915 --> 03:23:20,488 RESIDENT ANDS FOR TRACKS WITH 5060 03:23:20,555 --> 03:23:21,556 WHITE RESIDENTS, PROPORTION OF 5061 03:23:21,622 --> 03:23:23,190 WHITE RESIDENTS ISSUES THE 5062 03:23:23,257 --> 03:23:29,363 UNCERTAINTY IS HIGHEST WHEN THE 5063 03:23:29,430 --> 03:23:30,665 WHITE RESIDENTS ARE LOWEST. 5064 03:23:30,731 --> 03:23:32,066 SO IT PICKS UP AGAIN YOU GO IT'S 5065 03:23:32,133 --> 03:23:34,035 NOT QUITE THE SAME. 5066 03:23:34,101 --> 03:23:35,803 SO WITH THESE RESULTS WE WERE 5067 03:23:35,870 --> 03:23:37,438 QUITE WORRIED DOES THIS MEAN NOW 5068 03:23:37,505 --> 03:23:42,410 THAT EVERYBODY HAS CONSISTENTLY 5069 03:23:42,476 --> 03:23:43,578 REPORTED ALL COMMUNITIES OF 5070 03:23:43,644 --> 03:23:45,313 CENSUS TRACKS WITH HIGHER 5071 03:23:45,379 --> 03:23:46,948 PROPORTIONS OF PLAQUE RESIDENT 5072 03:23:47,014 --> 03:23:48,883 VS EXPERIENCING HIGHER 5073 03:23:48,950 --> 03:23:50,384 CONCENTRATIONS WILL THE RESULTS 5074 03:23:50,451 --> 03:23:52,954 CHANGE ONCE YOU TAKE INTO 5075 03:23:53,020 --> 03:23:58,726 ACCOUNT THIS UNCERTAINTY. 5076 03:23:58,793 --> 03:23:59,760 NEXT SLIDE. 5077 03:23:59,827 --> 03:24:01,195 TURNS OUT NO, THESE ARE THE 5078 03:24:01,262 --> 03:24:03,130 RESULTS TAKING THE ASSOCIATIONS 5079 03:24:03,197 --> 03:24:04,131 BETWEEN PROPORTION OF PLAQUEOT 5080 03:24:04,198 --> 03:24:07,969 LEFT AND WHITE ON THE RIGHT, 5081 03:24:08,035 --> 03:24:09,437 RESIDENTS WITH THE CONITRATION 5082 03:24:09,503 --> 03:24:11,639 OF FINE PARTICLES NOW WHILE 5083 03:24:11,706 --> 03:24:15,610 TAKING INTO ACCOUNT THAT 5084 03:24:15,676 --> 03:24:16,243 UNCERTAINTY. 5085 03:24:16,310 --> 03:24:17,478 SO IT'S VERY, VERY CLEAR THAT 5086 03:24:17,545 --> 03:24:23,017 EVEN IF WE TAKE THAT DIFFERENCE 5087 03:24:23,084 --> 03:24:23,985 INTO ACCOUNT, IN UNCERTAINTIES, 5088 03:24:24,051 --> 03:24:26,387 TRACKS WITH HIGHER PROPORTIONS 5089 03:24:26,454 --> 03:24:31,792 OF BLACK RESIDENTS ARE 5090 03:24:31,859 --> 03:24:32,493 SIGNIFICANTLY EXPERIENCING 5091 03:24:32,560 --> 03:24:35,463 HIGHER LEVELS OF THIS VERY TOXIC 5092 03:24:35,529 --> 03:24:41,435 AIR POLLUTANT COMPARED TO ON THE 5093 03:24:41,502 --> 03:24:43,437 OTHER HAND, THE MORE THE HIGHER 5094 03:24:43,504 --> 03:24:48,175 PROPORTION OF THIS HAS, THE MUCH 5095 03:24:48,242 --> 03:24:49,844 STRIKINGLY LOWER AIR POLLUTION 5096 03:24:49,910 --> 03:24:53,447 CONCENTRATIONS, THE TRACK 5097 03:24:53,514 --> 03:24:57,385 EXPERIENCES, NEXT PLEASE. 5098 03:24:57,451 --> 03:24:59,453 SO IN CONCLUSION, PUB LIKELY 5099 03:24:59,520 --> 03:25:01,822 AVAILABLE DATA CAN BE VALUABLE 5100 03:25:01,889 --> 03:25:04,492 FOR LINKING CERTAIN 5101 03:25:04,558 --> 03:25:05,426 ENVIRONMENTAL EXPOSURES, 5102 03:25:05,493 --> 03:25:06,093 SPECIFICALLY ENVIRONMENTAL 5103 03:25:06,160 --> 03:25:09,096 EXPOSURES TO SLEEP AND CIRCADIAN 5104 03:25:09,163 --> 03:25:11,165 RHYTHM RESEARCH, THERE ARE 5105 03:25:11,232 --> 03:25:12,333 CONSIDERATIONS FOR LINKAGE AND 5106 03:25:12,400 --> 03:25:14,068 ANALYSIS WITH THIS DATA THAT 5107 03:25:14,135 --> 03:25:17,705 NEED TO BE TAKEN INTO ACCOUNT 5108 03:25:17,772 --> 03:25:20,975 AND ENVIRONMENTAL JUSTICE IS 5109 03:25:21,042 --> 03:25:23,177 KEY, IS COMPLEX, IT'S PLULTY 5110 03:25:23,244 --> 03:25:24,645 DIMENSIONAL, AND WE CANNOT 5111 03:25:24,712 --> 03:25:28,983 IGNORE IT IF OUR GOAL IS TO 5112 03:25:29,050 --> 03:25:34,188 EQUITABLY IMPROVE SLEEP HEALTH, 5113 03:25:34,255 --> 03:25:34,989 NEXT SLIDE, PLEASE. 5114 03:25:35,056 --> 03:25:37,058 AND YES, I WOULD JUST LIKE TO 5115 03:25:37,124 --> 03:25:37,992 ACKNOWLEDGE MY AMAZING GROUP 5116 03:25:38,059 --> 03:25:39,293 BECAUSE IT'S THEM THAT DO ALL 5117 03:25:39,360 --> 03:25:42,363 THE WORK, IT'S NOT ME, I'M YOU 5118 03:25:42,430 --> 03:25:43,798 JUST HERE TO PRESENT THE AMAZING 5119 03:25:43,864 --> 03:25:44,765 WORK THAT THEY'RE DOING. 5120 03:25:44,832 --> 03:25:55,242 SO THANK YOU VERY MUCH. 5121 03:26:00,347 --> 03:26:08,456 THAT'S IT. 5122 03:26:08,522 --> 03:26:09,657 >> THAT DOUBLE MUTE IS GOING TO 5123 03:26:09,724 --> 03:26:14,495 KILL ME TODAY, I HAVE MY CELL 5124 03:26:14,562 --> 03:26:15,796 PHONE GOING BECAUSE NIGH NETWORK 5125 03:26:15,863 --> 03:26:17,865 IS UNSTABLE SO I DON'T WANT TO 5126 03:26:17,932 --> 03:26:18,365 MISS ANYTHING. 5127 03:26:18,432 --> 03:26:20,367 THANK YOU SO MUCH FOR THE GREAT 5128 03:26:20,434 --> 03:26:20,568 TALK. 5129 03:26:20,634 --> 03:26:22,103 IF YOU DON'T MIND, WE WILL HOLD 5130 03:26:22,169 --> 03:26:23,204 QUESTIONS TO THE VERY END AND 5131 03:26:23,270 --> 03:26:24,605 HOPEFULLY WE WILL BE ABLE TO GET 5132 03:26:24,672 --> 03:26:26,240 TO ALL THOSE AND EVERYBODY CAN 5133 03:26:26,307 --> 03:26:27,742 ACTUALLY PUT YOUR QUESTIONS INTO 5134 03:26:27,808 --> 03:26:35,483 THE CHAT AND WE WILL MOVE TO OUR 5135 03:26:35,549 --> 03:26:39,920 NEXT SPEAKER WHO IS DR. JOHN 5136 03:26:39,987 --> 03:26:40,621 BRIDGES FROM OHIO STATE 5137 03:26:40,688 --> 03:26:41,822 UNIVERSITY THAT WILL TALK ABOUT 5138 03:26:41,889 --> 03:26:44,391 THE ETHICAL, LEGAL AND SOCIAL 5139 03:26:44,458 --> 03:26:47,328 EMPLICATIONS OF ARTIFICIAL 5140 03:26:47,394 --> 03:26:49,230 INTELLIGENCE IN MEDICINE. 5141 03:26:49,296 --> 03:26:50,564 SO DR. BRIDGES, IS A PROFESSOR 5142 03:26:50,631 --> 03:26:52,900 IN THE DEPARTMENT OF BIOMEDICAL 5143 03:26:52,967 --> 03:26:55,603 INFORMATICS AT THE OHIO STATE 5144 03:26:55,669 --> 03:26:57,338 UNIVERSITY COLLEGE OF MEDICINE. 5145 03:26:57,404 --> 03:27:00,641 HE'S ALSO AN ECONOMIST BY 5146 03:27:00,708 --> 03:27:01,842 TRAINING, AND DEVOTES HIS CAREER 5147 03:27:01,909 --> 03:27:06,380 TO ADVANCING THE SCIENCE OF 5148 03:27:06,447 --> 03:27:07,948 PATIENT ENGAINMENT AND HIS 5149 03:27:08,015 --> 03:27:08,916 RESEARCH USING THEORY DRIVEN 5150 03:27:08,983 --> 03:27:09,850 SURVEY PUTTING PHOSPHORYLATED 5151 03:27:09,917 --> 03:27:11,085 UNDERSTAND THE PREFERENCES AND 5152 03:27:11,152 --> 03:27:12,720 PRIORITIES OF PATIENT ANDS OTHER 5153 03:27:12,787 --> 03:27:15,956 STAKEHOLDERS IN MEDICINE. 5154 03:27:16,023 --> 03:27:17,224 I WILL LEAVE THE FLOOR TO YOU 5155 03:27:17,291 --> 03:27:18,225 JOHN, THANK YOU VERY MUCH. 5156 03:27:18,292 --> 03:27:19,794 NTHANK YOU VERY MUCH, DANA, 5157 03:27:19,860 --> 03:27:23,330 COULD I HAVE THE NEXT SLIDE. 5158 03:27:23,397 --> 03:27:24,598 I WANT TO ACKNOWLEDGE SUPPORT 5159 03:27:24,665 --> 03:27:29,804 FROM NCATS AND FROM THE 5160 03:27:29,870 --> 03:27:30,738 [INDISCERNIBLE] FUNDS, THERE'S 5161 03:27:30,805 --> 03:27:32,873 NO OTHER CONFLICTS I NEED TO 5162 03:27:32,940 --> 03:27:33,107 DECLARE. 5163 03:27:33,174 --> 03:27:33,774 NEXT SLIDE. 5164 03:27:33,841 --> 03:27:34,842 SO DURING THE 2 DAY MEETING 5165 03:27:34,909 --> 03:27:39,079 WE'VE HEARD A NUMBER OF USES OF 5166 03:27:39,146 --> 03:27:39,914 ARTIFICIAL INTELIENCE AND 5167 03:27:39,980 --> 03:27:41,382 MACHINE LEARNING, YOU KNOW 5168 03:27:41,448 --> 03:27:43,484 AROUND THE COLLEGE OF MEDICINE 5169 03:27:43,551 --> 03:27:45,319 AND OTHER PLACES THERE, IS A 5170 03:27:45,386 --> 03:27:46,854 DOMINANCE OF DISCUSSION OF THE 5171 03:27:46,921 --> 03:27:52,393 APPLICATIONS OF THESE METHODS IN 5172 03:27:52,459 --> 03:27:52,993 MEDICINE AND HEALTHCARE. 5173 03:27:53,060 --> 03:27:55,596 A LOT OF THE FOCUS HAS BEEN ON 5174 03:27:55,663 --> 03:27:57,298 THE TYPES OF METHODDINGS OR THE 5175 03:27:57,364 --> 03:27:59,867 CATEGORIES OF METHODS AND 5176 03:27:59,934 --> 03:28:01,802 ADVANCING ALGORITHMS, WE HEARD A 5177 03:28:01,869 --> 03:28:04,138 FEW OF THOSE TODAY AND NOVEL 5178 03:28:04,205 --> 03:28:05,673 APPLICATIONS OF THAT, BUT, 1 OF 5179 03:28:05,739 --> 03:28:09,210 THE KIND OF KEY QUESTIONS THAT I 5180 03:28:09,276 --> 03:28:13,047 HAVE BEEN MEDITATING ABOUT IS 5181 03:28:13,113 --> 03:28:13,981 BROADER DISCUSSIONS AND 5182 03:28:14,048 --> 03:28:15,616 OCCASIONS OF THE USE OF 5183 03:28:15,683 --> 03:28:17,418 ARTIFICIAL INTELIENCE AND 5184 03:28:17,484 --> 03:28:19,954 MACHINE LEARNING IN PRACTICE IN 5185 03:28:20,020 --> 03:28:23,390 SOCIETY, ARE LAGGING, WE HEARD 5186 03:28:23,457 --> 03:28:24,925 SOME OF COMPONENTS OF THAT AND 5187 03:28:24,992 --> 03:28:26,727 THAT'S 1 OF THE MOTIVATIONS FOR 5188 03:28:26,794 --> 03:28:29,830 THE WORK THAT I'VE BEEN DOING 5189 03:28:29,897 --> 03:28:31,332 AND THE PRESENTATION I'VE PUT 5190 03:28:31,398 --> 03:28:31,732 TOGETHER. 5191 03:28:31,799 --> 03:28:38,739 THE NEXT SLIDE. 5192 03:28:38,806 --> 03:28:39,940 SO FROM MY POINT OF VIEW, 5193 03:28:40,007 --> 03:28:42,710 THERE'S A RANGE OF FACES AND AI 5194 03:28:42,776 --> 03:28:46,280 USED PROCESSING A LARGE AMOUNTS 5195 03:28:46,347 --> 03:28:47,114 OF DATA, DIAGNOSIS OF DISEASE 5196 03:28:47,181 --> 03:28:48,649 OVER THE LAST COUPLE DAYS OTHERS 5197 03:28:48,716 --> 03:28:52,386 OTHER FORMS OF PREDICTIVE 5198 03:28:52,453 --> 03:28:53,554 ANALYTICS, INCREASINGLY AND 5199 03:28:53,621 --> 03:28:55,522 PERSONALIZED MEDICINE AND IN 5200 03:28:55,589 --> 03:28:59,159 MANY RESPECTS, WITH THE GOAL OF 5201 03:28:59,226 --> 03:28:59,960 PROMOTING PATIENT EMPOWER XMENT 5202 03:29:00,027 --> 03:29:03,030 1 OF THE MOST INTERESTING AND 5203 03:29:03,097 --> 03:29:03,831 CONCERNING APPLICATIONS OF AI 5204 03:29:03,898 --> 03:29:06,000 THAT I'VE SEEN IN THE LITERATURE 5205 03:29:06,066 --> 03:29:08,369 IS ACTUALLY THE PREDICTION OF 5206 03:29:08,435 --> 03:29:09,103 PATIENT PREFERENCES, TRYING TO 5207 03:29:09,169 --> 03:29:10,838 USE THIS TO UNDERSTAND WHAT THE 5208 03:29:10,905 --> 03:29:12,907 PATIENT WOULD WANT AND THAT 5209 03:29:12,973 --> 03:29:13,941 THERE'S INTERESTING APPLICATIONS 5210 03:29:14,008 --> 03:29:22,650 WHERE THAT MIGHT BE NECESSARY 5211 03:29:22,716 --> 03:29:24,318 BUT IT ALSO POSES SOME 5212 03:29:24,385 --> 03:29:26,186 INTERESTING ETHICAL QUESTIONS. 5213 03:29:26,253 --> 03:29:26,587 NEXT SLIDE. 5214 03:29:26,654 --> 03:29:27,788 SO 1 OF THE ARGUE AMS THAT I'M 5215 03:29:27,855 --> 03:29:30,090 GOING TO MAKE IS MUCH LIKE OTHER 5216 03:29:30,157 --> 03:29:33,661 PLACES WHERE WE USE LARGE DATA 5217 03:29:33,727 --> 03:29:39,033 PARTICULARLY GENETICS AND 5218 03:29:39,099 --> 03:29:40,868 GENOMICS AND THEY HAVE AN FIELD 5219 03:29:40,935 --> 03:29:43,170 CALLED LC AND WHAT I WOULD LIKE 5220 03:29:43,237 --> 03:29:45,306 TO SUGGEST IS THAT LC MEDES TO 5221 03:29:45,372 --> 03:29:47,541 BE APPLIED TO OTHER FORMS OF BIG 5222 03:29:47,608 --> 03:29:49,843 DATA AND ALSO TO THE APPLICATION 5223 03:29:49,910 --> 03:29:51,245 OF ARTIFICIAL INTELIENCE AND 5224 03:29:51,312 --> 03:29:51,979 MACHINE LEARNING. 5225 03:29:52,046 --> 03:29:54,848 LC STANDS FOR THE ETHICAL LEGAL 5226 03:29:54,915 --> 03:29:57,518 AND SOCIAL IMPLICATIONS, IT'S A 5227 03:29:57,584 --> 03:29:59,019 TRANSDISCIPLINARY RESEARCH THAT 5228 03:29:59,086 --> 03:30:02,089 WAS SPECIFICALLY FOCUSED 5229 03:30:02,156 --> 03:30:04,158 INITIALLY ON GENETICS AND 5230 03:30:04,224 --> 03:30:06,093 GENOMICS BUT IT'S STARTING TO 5231 03:30:06,160 --> 03:30:07,661 FORM TARA LENS LENS LENS LENS 5232 03:30:07,728 --> 03:30:08,262 LITERATURES, PARTICULARLY IN 5233 03:30:08,329 --> 03:30:09,330 CANCER RESEARCH WHERE WE'RE 5234 03:30:09,396 --> 03:30:10,631 SEEING MORE GENETIC ANDS 5235 03:30:10,698 --> 03:30:12,299 GENOMICS BUT WE'RE SEEING THE 5236 03:30:12,366 --> 03:30:13,133 PRINCIPLES BEING APPLIED FOR 5237 03:30:13,200 --> 03:30:17,304 EXAMPLE TO OTHER FORMS OF 5238 03:30:17,371 --> 03:30:18,672 COMMUNITY ENGAGEMENT OR CLINICAL 5239 03:30:18,739 --> 03:30:19,907 TRIAL PARTICIPATION. 5240 03:30:19,974 --> 03:30:23,644 IN OTHER COUNTRIES, THIS IS 5241 03:30:23,711 --> 03:30:29,516 CALLED DIFFERENT THINGS, JILLS, 5242 03:30:29,583 --> 03:30:30,818 AND INTERNATIONALLY, THIS IS A 5243 03:30:30,884 --> 03:30:33,921 COMMENNENT OF A LARGER FIELD OF 5244 03:30:33,988 --> 03:30:34,655 HEALTH TECHNOLOGY ASSESSMENT 5245 03:30:34,722 --> 03:30:38,058 WHERE HEALTH SYSTEMS AND THE 5246 03:30:38,125 --> 03:30:38,892 PUBLIC ENVIRONMENTAL 5247 03:30:38,959 --> 03:30:41,895 IMPLICATIONS OF TECHNOLOGIES ARE 5248 03:30:41,962 --> 03:30:45,699 CONSIDERED MORE WHOLISTICALLY. 5249 03:30:45,766 --> 03:30:46,266 THE NEXT SLIDE. 5250 03:30:46,333 --> 03:30:50,037 THERE HAVE BEEN A NUMBER OF ELSI 5251 03:30:50,104 --> 03:30:51,438 CONCERNS RAISED BUT WHAT I WOULD 5252 03:30:51,505 --> 03:30:56,477 ARGUE IS A NUMBER OF THESE HAVE 5253 03:30:56,543 --> 03:30:59,146 JUST FOCUSED IN ON TRADITIONAL 5254 03:30:59,213 --> 03:31:00,280 ETHICAL ISSUES SURROUNDING 5255 03:31:00,347 --> 03:31:03,684 CONSENT, SAFETY AND 5256 03:31:03,751 --> 03:31:09,323 TRANSPARENCY, FAIRNESS, ARE 5257 03:31:09,390 --> 03:31:10,257 PARTICULARLY POTENTIAL BIASES 5258 03:31:10,324 --> 03:31:12,493 INVOLVED IN ALGORITHMS AND DATA 5259 03:31:12,559 --> 03:31:13,460 PRIVACY, WHEN YOU WOONG ABOUT 5260 03:31:13,527 --> 03:31:14,762 THE LEGAL ISSUES THERE ARE 5261 03:31:14,828 --> 03:31:17,598 SAFETY ASK EFFICACY ISSUES, 5262 03:31:17,664 --> 03:31:20,634 LIABILITY, DAILY BASIS THEA 5263 03:31:20,701 --> 03:31:23,037 PROTECTION AND SELECTION, AND 5264 03:31:23,103 --> 03:31:23,637 SECURITY AND INTELLECTUAL 5265 03:31:23,704 --> 03:31:26,807 PROPERTY, THESE ARE SOME 5266 03:31:26,874 --> 03:31:27,975 INTERESTING COMPONENTS BUT THEY 5267 03:31:28,042 --> 03:31:29,810 HAVE BEEN DISCUSSED IN THIS 5268 03:31:29,877 --> 03:31:30,978 CONTEXT. 5269 03:31:31,045 --> 03:31:31,445 THE NEXT SLIDE. 5270 03:31:31,512 --> 03:31:33,047 SOME OF THE THINGS THAT I THINK 5271 03:31:33,113 --> 03:31:39,319 ARE NOT BEING DISCUSSED AS 5272 03:31:39,386 --> 03:31:42,156 BROADER, SOCIAL CONCERNS AND 5273 03:31:42,222 --> 03:31:44,825 THAT IS, ARE WE ADEQUATELY 5274 03:31:44,892 --> 03:31:46,794 ENGAGING AND EMPOWERING THE 5275 03:31:46,860 --> 03:31:48,195 PUBLIC IN DISCUSSIONS ABOUT THE 5276 03:31:48,262 --> 03:31:50,230 USE OF THESE TECHNOLOGIES. 5277 03:31:50,297 --> 03:31:53,767 WHAT ARE OUR MECHANISMS FOR 5278 03:31:53,834 --> 03:31:55,402 OVERSIGHT AND SURVEILLANCE IF 5279 03:31:55,469 --> 03:32:00,007 THESE TECHNOLOGIES WERE TO BE 5280 03:32:00,074 --> 03:32:01,675 USED IN SOCIETY, HOW DO WE 5281 03:32:01,742 --> 03:32:04,078 ADDRESS FAIRNESS AND EQUITY IN 5282 03:32:04,144 --> 03:32:04,478 THEIR APPLICATION? 5283 03:32:04,545 --> 03:32:09,083 WHAT ARE THE ISSUES IN TERMS OF 5284 03:32:09,149 --> 03:32:10,384 ECONOMICS, THE COST OF THE 5285 03:32:10,451 --> 03:32:11,418 HEALTHCARE SYSTEM, COST TO 5286 03:32:11,485 --> 03:32:15,522 PATIENTS AND THE COST TO THE 5287 03:32:15,589 --> 03:32:17,124 ECONOMY AND EMPLOYMENT AND THESE 5288 03:32:17,191 --> 03:32:19,593 CAN BE BOTH INTENDED AND 5289 03:32:19,660 --> 03:32:20,260 UNINTENDED CONSEQUENCES OF THE 5290 03:32:20,327 --> 03:32:21,762 USE AND THEN I THINK WE ALSO 5291 03:32:21,829 --> 03:32:24,198 HAVE TO THINK MORE 5292 03:32:24,264 --> 03:32:26,166 WHOLISTICALLY, ABOUT HOW THE USE 5293 03:32:26,233 --> 03:32:29,269 OF THESE TECHNOLOGIES MIGHT 5294 03:32:29,336 --> 03:32:32,072 CHANGE HUMAN RELATIONSHIPS. 5295 03:32:32,139 --> 03:32:35,909 NEXT SLIDE, WE RECENTLY DID OUR 5296 03:32:35,976 --> 03:32:38,345 REVIEW OF EXISTING GUIDELINES 5297 03:32:38,412 --> 03:32:40,781 FOR THE DEVELOPMENT AND 5298 03:32:40,848 --> 03:32:41,548 APPLICATION OF ARTIFICIAL 5299 03:32:41,615 --> 03:32:43,851 INTELLIGENCE AND MACHINE 5300 03:32:43,917 --> 03:32:46,487 LEARNING TO THINK ABOUT ALL THE 5301 03:32:46,553 --> 03:32:48,655 EXISTING GUIDELINES WHAT ARE THE 5302 03:32:48,722 --> 03:32:50,991 DOMINANT ISSUES THAT HAVE BEEN 5303 03:32:51,058 --> 03:32:52,459 FOCUSED ON, AND YOU CAN SEE 5304 03:32:52,526 --> 03:32:54,795 THERE IN KIND OF LIKE THE DARK 5305 03:32:54,862 --> 03:32:58,132 BLUE, IT REALLY IS FOCUSED ON AN 5306 03:32:58,198 --> 03:32:59,533 ACADEMIC EXERCISE OF 5307 03:32:59,600 --> 03:33:00,701 DEVELOPMENT, VALIDATION AND 5308 03:33:00,767 --> 03:33:04,638 REPORTING OF RESULTS AND DURING 5309 03:33:04,705 --> 03:33:09,243 THIS TRANSPEARNS AND 5310 03:33:09,309 --> 03:33:10,377 DEMONSTRATING THE EFFICACY, 5311 03:33:10,444 --> 03:33:15,516 ETHICS IS AN EMERGING ISSUE SO 5312 03:33:15,582 --> 03:33:16,383 IS REPRODUCIBILITY, BUT USUALLY 5313 03:33:16,450 --> 03:33:18,051 ONLY IN DEVELOPMENT, NOT IN THE 5314 03:33:18,118 --> 03:33:18,619 APPLICATION. 5315 03:33:18,685 --> 03:33:23,123 THERE IS EMERGING LITERATURE, IN 5316 03:33:23,190 --> 03:33:26,093 THE LIGHTER BLUES THERE WITH 5317 03:33:26,160 --> 03:33:27,261 REKNARRED TO IMP LEMMATION BUT 1 5318 03:33:27,327 --> 03:33:29,897 OF THE AREAS BOTH IN TERMS OF 5319 03:33:29,963 --> 03:33:31,732 THE DOMAINS AND INVOLVEMENT IS 5320 03:33:31,798 --> 03:33:34,501 THIS ISSUE OF AN ABSENT IN THE 5321 03:33:34,568 --> 03:33:37,137 EXISTING GUIDELINES ON ISSUES OF 5322 03:33:37,204 --> 03:33:39,206 SURVEILLANCE, IF THESE 5323 03:33:39,273 --> 03:33:41,475 TECHNOLOGIES WERE IMPLEMENTED 5324 03:33:41,542 --> 03:33:42,776 INTO PRACTICE, WHO WOULD INSURE 5325 03:33:42,843 --> 03:33:44,978 THAT THEY CONTINUE TO BE USED 5326 03:33:45,045 --> 03:33:46,246 APPROPRIATELY, THOUGH, THEY 5327 03:33:46,313 --> 03:33:47,748 DON'T HAVE UNINTENDED 5328 03:33:47,814 --> 03:33:49,917 CONSEQUENCES THAT THEY DON'T 5329 03:33:49,983 --> 03:33:51,451 CAUSE BIASES, AND WHAT IS THE 5330 03:33:51,518 --> 03:33:53,787 ROLE FOR ENGAGEMENT, THE 5331 03:33:53,854 --> 03:33:57,758 ENGAGEMENT OF HEALTHCARE 5332 03:33:57,824 --> 03:33:59,126 PROVIDERS, HEALTHCARE SYSTEMS, 5333 03:33:59,193 --> 03:34:00,327 AND PATIENTS THEMSELVES AND 5334 03:34:00,394 --> 03:34:02,429 THEIR FAMILY MEMBERS, SO WE CAN 5335 03:34:02,496 --> 03:34:03,931 KIND OF SEE HERE SOME OF THE 5336 03:34:03,997 --> 03:34:06,567 ISSUES THAT HAVE KIND OF FOCUSED 5337 03:34:06,633 --> 03:34:10,504 IN ON AGENCIES SUCH AS PC ORI, 5338 03:34:10,571 --> 03:34:13,240 BUT INCREASINGLY, THE FDA HAS 5339 03:34:13,307 --> 03:34:16,176 FOCUSED A LOT ON ENGAGEMENT AND 5340 03:34:16,243 --> 03:34:17,177 SURVEILLANCE, 1 WAY THEY'VE DONE 5341 03:34:17,244 --> 03:34:22,716 THAT IN THE NEXT SLIDE IS 5342 03:34:22,783 --> 03:34:25,152 THROUGH THE 21st CENTURY CURES 5343 03:34:25,219 --> 03:34:27,554 ACT, ENIMAIJING THE FDA IN 5344 03:34:27,621 --> 03:34:29,790 FOCUSING MORE ON OVERSIGHT AND 5345 03:34:29,856 --> 03:34:31,291 PARTICULARLY WITH REGARDS TO THE 5346 03:34:31,358 --> 03:34:37,264 USE OF REAL WORLD DATA IN 5347 03:34:37,331 --> 03:34:40,367 ASSESSING THE TECHNOLOGY, THINGS 5348 03:34:40,434 --> 03:34:42,202 LIKE PROVISIONAL APPROVAL, BUT 5349 03:34:42,269 --> 03:34:47,574 THEN ALSO, DICK 8ING 8ING--DICG 5350 03:34:47,641 --> 03:34:50,277 TO THE FDA THAT WE NEEDED 5351 03:34:50,344 --> 03:34:50,978 GREATER COMMUNITY ENGAGEMENT. 5352 03:34:51,044 --> 03:34:52,479 THROUGH THIS AND OTHER 5353 03:34:52,546 --> 03:34:58,619 REGULATIONS AT THE FDA, ARE A 5354 03:34:58,685 --> 03:35:00,721 WIDE ARRAY OF CONSTITUENCIES, 5355 03:35:00,787 --> 03:35:02,055 INCLUDING THE FDA INDUSTRY, 5356 03:35:02,122 --> 03:35:03,991 ENGAGING IN THINGS CALLED 5357 03:35:04,057 --> 03:35:05,292 PATIENT FOCUS DRUG DEVELOPMENT, 5358 03:35:05,359 --> 03:35:08,795 THERE WAS A SPECIFIC TRIAL 5359 03:35:08,862 --> 03:35:12,733 MEETINGS WAS ON NARCOLEPSY, AND 5360 03:35:12,799 --> 03:35:16,036 THIS ALLOWED THE FDA TO HAVE 5361 03:35:16,103 --> 03:35:17,904 DIRECT CONTACT WITH THE 5362 03:35:17,971 --> 03:35:18,605 NARCOLEPSY COMMUNITY TO 5363 03:35:18,672 --> 03:35:24,211 UNDERSTAND THE DEC FROM THEIR 5364 03:35:24,278 --> 03:35:25,412 LIVED EXPERIENCE. 5365 03:35:25,479 --> 03:35:28,015 THERE ARE A NUMBER OF OTHER 5366 03:35:28,081 --> 03:35:30,317 APPROACHES DONE ON THAT NUMBER 5367 03:35:30,384 --> 03:35:34,488 AT THE CDHR AND CBER, THEY WERE 5368 03:35:34,554 --> 03:35:35,889 VERY MUCH ENGAGED IN PHOBEUS 5369 03:35:35,956 --> 03:35:38,191 GROUPS BUT MEASURING THINGS LIKE 5370 03:35:38,258 --> 03:35:39,493 SURVEYS AND THROUGHOUT THE FDA 5371 03:35:39,559 --> 03:35:42,062 THERE HAS BEEN A LOT MORE FOCUS 5372 03:35:42,129 --> 03:35:46,400 ON THE USE OF PATIENT 5373 03:35:46,466 --> 03:35:47,668 PREFERENCES AND PREFERENCE 5374 03:35:47,734 --> 03:35:49,336 TRIEWMENTS AND THE ENGAGEMENT OF 5375 03:35:49,403 --> 03:35:50,504 RESEARCHERS AND DETERMINING THE 5376 03:35:50,570 --> 03:35:51,204 RIGHT OUTCOMES ARE BEING 5377 03:35:51,271 --> 03:35:52,472 MEASURED AND THAT PEOPLE HAVE 5378 03:35:52,539 --> 03:35:54,107 VIEW POINTS THAT ARE SHARED. 5379 03:35:54,174 --> 03:35:58,011 IF WE WERE TO SHARE THIS AS PART 5380 03:35:58,078 --> 03:36:00,147 OF THE PATIENT FOCUS DRUG 5381 03:36:00,213 --> 03:36:01,948 DEVELOPMENT OR NOW PATIENT 5382 03:36:02,015 --> 03:36:03,850 MEDICAL FOCUS MEDICAL TECHNOLOGY 5383 03:36:03,917 --> 03:36:05,018 DEVELOPMENT, THE FDA AND OTHERS 5384 03:36:05,085 --> 03:36:06,853 NEED TO UNDERSTAND UNMET NEEDS, 5385 03:36:06,920 --> 03:36:08,455 THEY HAVE TO ADDRESS OUTCOMES 5386 03:36:08,522 --> 03:36:09,589 THAT MATTER, AND THEY HAVE TO 5387 03:36:09,656 --> 03:36:13,694 MAKE SURE THAT WE HAVE 5388 03:36:13,760 --> 03:36:15,629 ACCEPTABLE TRADE-OFFS, THE FOCUS 5389 03:36:15,696 --> 03:36:17,698 OF 21st CENTURY CURES WAS TO 5390 03:36:17,764 --> 03:36:19,232 MAKE SURE WE OVERCAME THE VALLEY 5391 03:36:19,299 --> 03:36:22,202 OF DEATH WITH REGARDS TO MEDICAL 5392 03:36:22,269 --> 03:36:24,938 TECHNOLOGY DEVELOPMENT AND THE 5393 03:36:25,005 --> 03:36:26,773 VERY FEW MEDICAL TECHNOLOGIES 5394 03:36:26,840 --> 03:36:29,609 THAT ACTUALLY HAVE BENEFIT AND 5395 03:36:29,676 --> 03:36:30,210 REAL WORLD PRACTICE. 5396 03:36:30,277 --> 03:36:33,347 I WOULD ARGUE THAT MANY OF OUR 5397 03:36:33,413 --> 03:36:35,082 BIG DATA APPROACHES AND 5398 03:36:35,148 --> 03:36:36,016 APPLICATIONS OF ARTIFICIAL 5399 03:36:36,083 --> 03:36:38,051 INTELIENCE AND MACHINE LEARNING 5400 03:36:38,118 --> 03:36:40,387 COULD BENEFIT FROM BETTER 5401 03:36:40,454 --> 03:36:42,422 INTEGRATION AND UNDERSTANDING OF 5402 03:36:42,489 --> 03:36:43,824 THE UNMET NEEDS AND WHAT 5403 03:36:43,890 --> 03:36:45,525 OUTCOMES MATTER THE MOST AND 5404 03:36:45,592 --> 03:36:50,263 WHAT IS ACCEPTABLE TRADE-OFFS BY 5405 03:36:50,330 --> 03:36:51,498 DIRECTLY ENGAGING WITH 5406 03:36:51,565 --> 03:36:53,500 CONSTITUENCIES SUCH AS 5407 03:36:53,567 --> 03:36:54,434 HEALTHCARE PROVIDERS AND THE 5408 03:36:54,501 --> 03:36:56,169 PATIENT, WE HAVE TO COME OUT OF 5409 03:36:56,236 --> 03:36:58,939 THE IVORY TOWER TO DO THAT, AND 5410 03:36:59,005 --> 03:37:01,041 MEET PEOPLE WHERE THEY ARE TO 5411 03:37:01,108 --> 03:37:03,677 UNDERSTAND THEIR NEEDS AND LIVED 5412 03:37:03,744 --> 03:37:06,346 REAL WORLD EXPERIENCES. 5413 03:37:06,413 --> 03:37:06,813 NEXT SLIDE. 5414 03:37:06,880 --> 03:37:08,448 THERE ARE A NUMBER OF WAYS THAT 5415 03:37:08,515 --> 03:37:12,853 WE DO THIS IN ELSI RESEARCH. 5416 03:37:12,919 --> 03:37:13,687 TRADITIONALLY THIS HAS BEEN DONE 5417 03:37:13,754 --> 03:37:15,756 WITH THE USE OF A VIGNETTE STUDY 5418 03:37:15,822 --> 03:37:18,158 WHERE A PARTICULAR FRAMEWORK IS 5419 03:37:18,225 --> 03:37:20,961 USED, VERY MUCH LIKE A CLINICAL 5420 03:37:21,027 --> 03:37:22,095 TRIAL, WE'RE DIFFERING 5421 03:37:22,162 --> 03:37:25,766 PERSPECTIVES ARE DONE IN THIS 5422 03:37:25,832 --> 03:37:26,900 PAPER, WE--THE VIGNETTE IS KIND 5423 03:37:26,967 --> 03:37:28,902 OF CONSIDERING A COUPLE 5424 03:37:28,969 --> 03:37:32,506 DIFFERENT CLINICAL APPROACHES, 5425 03:37:32,572 --> 03:37:34,107 BUT, THE DEGREE OF ACCEPTANCE 5426 03:37:34,174 --> 03:37:36,309 WHEN YOU USE AN AUTOMATIC TOOL, 5427 03:37:36,376 --> 03:37:38,145 THE PHYSICIAN USES AN AUTOMATED 5428 03:37:38,211 --> 03:37:39,913 TOOL OR PHYSICIAN DOESN'T USE AN 5429 03:37:39,980 --> 03:37:41,581 AUTOMATED TOOL, HERE WE CAN 5430 03:37:41,648 --> 03:37:43,917 UNDERSTAND THE POTENTIAL 5431 03:37:43,984 --> 03:37:45,986 IMPLICATIONS OF THIS BY 5432 03:37:46,052 --> 03:37:47,721 UNDERSTANDING HOW THE PUBLIC 5433 03:37:47,788 --> 03:37:53,059 MIKE REACT IN THESE DIFFERENT 5434 03:37:53,126 --> 03:37:53,460 SITUATIONS. 5435 03:37:53,527 --> 03:37:54,127 THE NEXT SLIDE. 5436 03:37:54,194 --> 03:37:56,430 THIS COULD BE GENERALIZED TO 5437 03:37:56,496 --> 03:37:58,265 CONSIDER MORE FACTORS OR WHAT'S 5438 03:37:58,331 --> 03:37:59,232 CONSIDERED A FACTOR VIGNETTE, 5439 03:37:59,299 --> 03:38:01,001 THIS IS STARTING TO MOVE WHAT WE 5440 03:38:01,067 --> 03:38:02,502 MIGHT CALL A DISCREET CHOICE 5441 03:38:02,569 --> 03:38:04,204 EXPERIENCE OR FROM A PREFERENCE 5442 03:38:04,271 --> 03:38:07,174 RESEARCH, WE WOULD HAVE A 5443 03:38:07,240 --> 03:38:08,108 MULTIPLE VIGNETTES PRACTICES 5444 03:38:08,175 --> 03:38:11,378 SENTED TO AN INDIVIDUAL 5445 03:38:11,445 --> 03:38:13,046 COMBINING A RANGE OF DIFFERENT 5446 03:38:13,113 --> 03:38:14,648 COMBINATIONS OR PROFILES AND 5447 03:38:14,714 --> 03:38:17,384 THEN THINKING ABOUT THE 5448 03:38:17,451 --> 03:38:18,885 ACCEPTABLE OF USE, BY DOING THIS 5449 03:38:18,952 --> 03:38:22,489 TYPE OF SURVEY RESEARCH, WE CAN 5450 03:38:22,556 --> 03:38:23,790 NOTE ONLY UNDERSTAND WHAT PEOPLE 5451 03:38:23,857 --> 03:38:26,326 VALUE BUT WHAT THEY COULD ACCEPT 5452 03:38:26,393 --> 03:38:33,533 IN TERMS OF THE IMPLICATIONS OF 5453 03:38:33,600 --> 03:38:34,501 PROVIDING TECHNOLOGY OR 5454 03:38:34,568 --> 03:38:36,636 APPROACHES TO DATA ANALYSIS OR 5455 03:38:36,703 --> 03:38:37,504 DATA SHARING. 5456 03:38:37,571 --> 03:38:40,240 THIS COULD BE EXTENDED THROUGH 5457 03:38:40,307 --> 03:38:44,644 THE NEXT SLIDE TO A FULL BLOWN 5458 03:38:44,711 --> 03:38:45,679 DISCREET CHOICE EXPERIMENT WHERE 5459 03:38:45,745 --> 03:38:47,981 A MEMBER OF DIFFERENT APPROACHES 5460 03:38:48,048 --> 03:38:49,449 ARE COMPETING AGAINST 1 ANOTHER, 5461 03:38:49,516 --> 03:38:51,718 SO IN THIS WE JUST DON'T SHOW A 5462 03:38:51,785 --> 03:38:53,353 SINGLE VIGNETTE, BUT WE SHOW 5463 03:38:53,420 --> 03:38:55,489 THROUGH THIS MULTIPLE FACTORIAL 5464 03:38:55,555 --> 03:38:57,557 DESIGNS, COMBINATIONS OF 5465 03:38:57,624 --> 03:38:59,025 VIGNETTE AND ASK, WOULD YOU 5466 03:38:59,092 --> 03:39:02,095 CONSIDER THESE DIFFERENT 5467 03:39:02,162 --> 03:39:03,897 OFFERINGS IS NONE OF THESE 5468 03:39:03,964 --> 03:39:04,731 POTENTIALLY ACCEPTABLE AND THEN 5469 03:39:04,798 --> 03:39:08,802 WE CAN GO IN USING A MORE 5470 03:39:08,869 --> 03:39:09,302 COMPLICATED ECONOMETRIC 5471 03:39:09,369 --> 03:39:11,104 TECHNIQUES TO UNDERSTAND WHAT 5472 03:39:11,171 --> 03:39:12,405 ARE THE DIFFERENT VALUES AND WE 5473 03:39:12,472 --> 03:39:17,611 CAN APPLY THIS TYPE OF WORK TO 5474 03:39:17,677 --> 03:39:18,812 BOTH PROVIDERS, PATIENTS AND TO 5475 03:39:18,879 --> 03:39:21,248 THE GENERAL PUBLIC TO KIND OF 5476 03:39:21,314 --> 03:39:23,917 UNDERSTAND WHAT IT IS THAT THEY 5477 03:39:23,984 --> 03:39:27,420 VALUE. 5478 03:39:27,487 --> 03:39:28,255 THE NEXT SLIDE. 5479 03:39:28,321 --> 03:39:32,125 WELL IS 1 OTHER APPROACH THAT IS 5480 03:39:32,192 --> 03:39:32,859 INCREASINGLY BEING APPLIED IN 5481 03:39:32,926 --> 03:39:35,729 HELT CARE AND IN OTHER AREA ANDS 5482 03:39:35,795 --> 03:39:37,697 THAT'S TRYING TO UNDERSTAND WHAT 5483 03:39:37,764 --> 03:39:38,632 MATTERS MOST. 5484 03:39:38,698 --> 03:39:42,002 IN THIS PAPER, I COLLABORATED 5485 03:39:42,068 --> 03:39:43,870 WITH FOLKS AT BAYLOR TO 5486 03:39:43,937 --> 03:39:45,205 UNDERSTAND WHAT ETHICAL ISSUES, 5487 03:39:45,272 --> 03:39:47,274 RATHER THAN JUST SAYING, WE 5488 03:39:47,340 --> 03:39:51,545 BELIEVE THAT THIS ISSUE IS MOST 5489 03:39:51,611 --> 03:39:52,812 ETHICALLY IMPORTANT, WE ACTUALLY 5490 03:39:52,879 --> 03:39:55,115 PUT AN EXPERIMENT TOGETHER WHERE 5491 03:39:55,181 --> 03:39:58,451 WE COMPARED A WHOLE SERIES IN 5492 03:39:58,518 --> 03:40:00,020 THIS STUDY, 11 DIFFERENT ETHICAL 5493 03:40:00,086 --> 03:40:01,655 CONCERNS THAT HAD BEEN RAISED 5494 03:40:01,721 --> 03:40:04,124 ASSOCIATED WITH THE USE OF 5495 03:40:04,190 --> 03:40:06,326 CITIZEN SCIENCE, A COULDN'T FIND 5496 03:40:06,393 --> 03:40:10,096 AN AI APPLICATION OF THIS, BUT 5497 03:40:10,163 --> 03:40:12,666 HERE WE COULD BOTH UNDERSTAND 5498 03:40:12,732 --> 03:40:14,534 WHICH OF THESE ARE MOST 5499 03:40:14,601 --> 03:40:16,369 IMPORTANT, OR WHICH OF THE 5500 03:40:16,436 --> 03:40:17,404 ISSUES ARE MOST IMPORTANT BUT 5501 03:40:17,470 --> 03:40:19,839 ALSO LOOK AT LATENT CLASSES OR 5502 03:40:19,906 --> 03:40:22,909 TRYING TO FIND OUT NICHES IN THE 5503 03:40:22,976 --> 03:40:26,880 COMMUNITY THAT MIGHT FOCUS ON 1 5504 03:40:26,947 --> 03:40:28,582 AREA RATHER THAN ANOTHER AND IN 5505 03:40:28,648 --> 03:40:30,216 THIS STUDY, WE FOUND 1 GROUP 5506 03:40:30,283 --> 03:40:34,421 THAT HAD FOCUSED ON POWER AND 5507 03:40:34,487 --> 03:40:36,289 IMBALANCE, AND THE EXPLOITATION 5508 03:40:36,356 --> 03:40:37,591 OF PEOPLE AND 1 PEOPLE WHO 5509 03:40:37,657 --> 03:40:40,260 REALLY WANTED TO VALIDATE THE 5510 03:40:40,327 --> 03:40:42,028 DATA, AND THIS WAS VERY 5511 03:40:42,095 --> 03:40:45,632 INDICATIVE OF THE UNDERLYING 5512 03:40:45,699 --> 03:40:50,737 CONVERSATIONS THAT IT HAD BUT AT 5513 03:40:50,804 --> 03:40:52,439 A DELIBERATATIVE PROCESS MEETING 5514 03:40:52,505 --> 03:40:54,307 THAT WAS DISCUSSING THESE ISSUES 5515 03:40:54,374 --> 03:40:55,609 BUT USING STATISTICAL TECHNIQUES 5516 03:40:55,675 --> 03:40:56,643 WE CAN GENERALIZE THIS AND 5517 03:40:56,710 --> 03:40:58,945 UNDERSTAND IN A BROADER 5518 03:40:59,012 --> 03:41:00,814 COMMUNITY, BUT ALSO QUANTIFY 5519 03:41:00,880 --> 03:41:02,315 THEM IN THE NUMERICAL VALUE SO 5520 03:41:02,382 --> 03:41:04,517 RATHER THAN JUST SAYING 5521 03:41:04,584 --> 03:41:06,686 ANECDOTALLY WE BELIEVE THIS, 5522 03:41:06,753 --> 03:41:07,754 PREFERENCE METHODS AND THESE 5523 03:41:07,821 --> 03:41:10,090 TYPES OF VIGNETTE METHODS AND 5524 03:41:10,156 --> 03:41:10,857 PRIORITIZATION METHODS ALLOW US 5525 03:41:10,924 --> 03:41:14,661 TO COME IN AND USE THIS TO 5526 03:41:14,728 --> 03:41:17,263 UNDERSTAND THE BELIEFS AND NEEDS 5527 03:41:17,330 --> 03:41:20,033 AND WANTS OF A BROADER 5528 03:41:20,100 --> 03:41:21,134 CONSTITUENCY INCLUDING THE 5529 03:41:21,201 --> 03:41:23,236 GENERAL PUBLIC. 5530 03:41:23,303 --> 03:41:26,373 THE NEXT SLIDE. 5531 03:41:26,439 --> 03:41:31,645 SO, THE ARGUMENT IS THAT THERE 5532 03:41:31,711 --> 03:41:35,448 IS A MAJOR NEED IN THE 5533 03:41:35,515 --> 03:41:36,950 APPLICATION OF AI WHETHER IT BE 5534 03:41:37,017 --> 03:41:38,485 TO SLEEP STUDIES OR TO MORE 5535 03:41:38,551 --> 03:41:41,321 GENERALLY TO HAVE A DEEPER 5536 03:41:41,388 --> 03:41:42,722 UNDERSTANDING OR PROVIDER 5537 03:41:42,789 --> 03:41:43,523 PATIENT AND COMMUNITY AND WE 5538 03:41:43,590 --> 03:41:46,159 HAVE TO DO THAT THROUGH 5539 03:41:46,226 --> 03:41:46,526 ENGAGEMENT. 5540 03:41:46,593 --> 03:41:48,361 WE HAVE TO FOCUS ON 5541 03:41:48,428 --> 03:41:50,196 IMPLEMENTATION, AND USE IN THE 5542 03:41:50,263 --> 03:41:51,831 REAL WORLD RATHER THAN JUST THE 5543 03:41:51,898 --> 03:41:55,035 DEVELOPMENT OF THIS, SO WE HAVE 5544 03:41:55,101 --> 03:41:57,437 TO MOVE AWAY FROM THE RO-1 TO 5545 03:41:57,504 --> 03:41:59,739 THINK ABOUT MORE ABOUT THE 5546 03:41:59,806 --> 03:42:00,573 IMPLEMENTATION OF THESE 5547 03:42:00,640 --> 03:42:02,075 TECHNOLOGIES IN PRACTICE AND 5548 03:42:02,142 --> 03:42:04,277 WHAT THAT WOULD HAVE IN TERMS OF 5549 03:42:04,344 --> 03:42:06,880 END USER EXPERIENCE AND PATIENT 5550 03:42:06,946 --> 03:42:08,948 EXPERIENCE, WE HAVE TO THINK 5551 03:42:09,015 --> 03:42:11,151 ABOUT OUR MEASURES OF 5552 03:42:11,217 --> 03:42:12,752 EFFECTIVENESS AND IMPACT, ON 5553 03:42:12,819 --> 03:42:14,621 BOTH SYSTEMS AND PATIENT 5554 03:42:14,688 --> 03:42:15,355 OUTCOMES. 5555 03:42:15,422 --> 03:42:17,824 WE HAVE TO MOVE BEYOND JUST 5556 03:42:17,891 --> 03:42:20,093 MAXIMIZING THE AREA UNDER THE 5557 03:42:20,160 --> 03:42:23,096 ROC CURVE AND ASK QUESTIONS LIKE 5558 03:42:23,163 --> 03:42:24,364 HOW DOES THIS IMPACT TRUST? 5559 03:42:24,431 --> 03:42:26,332 HOW DOES THIS IMPACT USE OF 5560 03:42:26,399 --> 03:42:28,334 MEDICAL TECHNOLOGIES? 5561 03:42:28,401 --> 03:42:30,336 HOW DOES THIS IMPACT THE USE OF 5562 03:42:30,403 --> 03:42:32,572 OTHER MEDICAL TECHNOLOGIES? 5563 03:42:32,639 --> 03:42:35,208 AND THINKING ABOUT THIS MORE 5564 03:42:35,275 --> 03:42:35,575 WHOLISTICALLY. 5565 03:42:35,642 --> 03:42:38,812 FOR ME WORK, AREAS OF USING 5566 03:42:38,878 --> 03:42:39,879 VIGNETTE STUDIES, PREFERENCE 5567 03:42:39,946 --> 03:42:42,182 STUDIES AND PRIORITIZATION 5568 03:42:42,248 --> 03:42:44,751 STUDIES PROVIDE 1 VEHICLE THAT 5569 03:42:44,818 --> 03:42:46,753 WE CAN APPLY ELSI AND SOCIAL 5570 03:42:46,820 --> 03:42:49,622 IMPACT TYPES OF RESEARCH TO 5571 03:42:49,689 --> 03:42:51,791 STUDY THE APPLICATION OF AI. 5572 03:42:51,858 --> 03:42:57,097 AND I JUST HAVE 1 MORE SLIDE. 5573 03:42:57,163 --> 03:42:58,398 IF YOU'RE INTERESTED IN THIS, 5574 03:42:58,465 --> 03:43:00,066 I'M VERY INTERESTED IN FORMING 5575 03:43:00,133 --> 03:43:01,234 COLLABORATIONS AND APPLYING 5576 03:43:01,301 --> 03:43:03,603 THESE TYPES OF METHODOLOGIES TO 5577 03:43:03,670 --> 03:43:09,476 LOCK AT NEW AND EMERGING USES OF 5578 03:43:09,542 --> 03:43:11,344 DATA AND THE APPLICATION OF AI 5579 03:43:11,411 --> 03:43:14,047 AND THE IMPACTS ON SOCIETY AND 5580 03:43:14,114 --> 03:43:23,156 PATIENTS, THANK YOU VERY MUCH. 5581 03:43:23,223 --> 03:43:24,557 >> THANK YOU SO MUCH DR. BRIDGES 5582 03:43:24,624 --> 03:43:26,760 THAT WAS A FANTASTIC TALK. 5583 03:43:26,826 --> 03:43:28,862 I WANTED TO GO AHEAD AND KICKOFF 5584 03:43:28,928 --> 03:43:33,133 THE Q&A SESSION. 5585 03:43:33,199 --> 03:43:35,135 SO IF ALL OF THE SPEAKERS COULD 5586 03:43:35,201 --> 03:43:37,771 PUT THEIR CAMERAS BACK ON AND IF 5587 03:43:37,837 --> 03:43:40,173 PEOPLE CAN PUT THEIR QUESTIONS 5588 03:43:40,240 --> 03:43:41,908 IN CHAT OR RAISE THEIR HAND, 5589 03:43:41,975 --> 03:43:48,982 THAT WOULD BE TERRIFIC. 5590 03:43:49,048 --> 03:43:50,550 AND I'LL GO ARK HEAD AND START. 5591 03:43:50,617 --> 03:43:51,518 THERE WAS 1 QUESTION IN CHAT 5592 03:43:51,584 --> 03:43:53,119 ALREADY WHICH I KNOW WAS 5593 03:43:53,186 --> 03:43:55,321 ANSWERED BUT I THINK IT'S WORTH 5594 03:43:55,388 --> 03:43:58,958 REPEATING FOR THE AUDIENCE 5595 03:43:59,025 --> 03:44:01,227 MEMBERS AND VIDEOCAST, AND IT'S 5596 03:44:01,294 --> 03:44:05,698 A QUESTION THAT DR. SEIXAS ABOUT 5597 03:44:05,765 --> 03:44:07,333 THE LISTS NUMBER OF FACTORS 5598 03:44:07,400 --> 03:44:09,669 WHICH LEAD TO MUCH BETTER SLEEP 5599 03:44:09,736 --> 03:44:12,672 IN RURAL AREAS, COMPARED TO THE 5600 03:44:12,739 --> 03:44:13,506 URBAN AREAS, HOWEVER, WHEN LOOK 5601 03:44:13,573 --> 03:44:15,508 BEING AT THE GRAPHS IT LOOKED 5602 03:44:15,575 --> 03:44:20,246 LIKE OR THE DATA THAT YOU SHARED 5603 03:44:20,313 --> 03:44:21,281 THAT IT LOOKED LIKE THAT 5604 03:44:21,347 --> 03:44:22,749 ACTUALLY THAT WAS THE REVERSE, 5605 03:44:22,816 --> 03:44:25,084 IT LOOKED LIKE THERE WERE MORE 5606 03:44:25,151 --> 03:44:27,253 PROBLEMS IN NONMETROAREAS, CAN 5607 03:44:27,320 --> 03:44:29,222 YOU EXPLAIN THIS DISCREPANCY? 5608 03:44:29,289 --> 03:44:31,758 >> LET ME JUST BE VERY CLEAR, 5609 03:44:31,825 --> 03:44:32,926 --I ANSWERED IT ALREADY BUT 5610 03:44:32,992 --> 03:44:34,127 THANKS FOR THE OPPORTUNITY TO 5611 03:44:34,194 --> 03:44:37,297 ADDRESS IT, WHAT I SHOWED WAS 5612 03:44:37,363 --> 03:44:43,203 THAT AND YOU LOOK AT THE 5613 03:44:43,269 --> 03:44:44,037 EPIDEMIOLOGICAL FIGURURES THAT 5614 03:44:44,103 --> 03:44:46,773 THERE IS A SCATTERING OF HIGH 5615 03:44:46,840 --> 03:44:47,841 PREVALENCE OF SHORT SLEEP BOTH 5616 03:44:47,907 --> 03:44:51,144 IN URBAN AND RURAL AREAS, AND 5617 03:44:51,211 --> 03:44:53,479 THEN I ALSO SHOWED A TABLE FROM 5618 03:44:53,546 --> 03:44:55,582 THE CDC, THESE ARE NOT MY 5619 03:44:55,648 --> 03:44:57,917 FINDINGS, THESE ARE PULLED FROM 5620 03:44:57,984 --> 03:45:01,120 CDC, AND PUBLISHED WORK FROM 5621 03:45:01,187 --> 03:45:04,390 BRRFS, THAT WHEN YOU'RE LOOKING 5622 03:45:04,457 --> 03:45:07,427 AT INSOMNIA SYMPTOMS WHICH I 5623 03:45:07,493 --> 03:45:11,631 THINK I DID ELUCIDATE THAT IN 5624 03:45:11,698 --> 03:45:12,799 NONMETROAREAS WHICH DOESN'T 5625 03:45:12,866 --> 03:45:14,534 NECESSARILY MEAN THEY ARE RURAL 5626 03:45:14,601 --> 03:45:17,270 AREAS, THAT THERE IS A 5627 03:45:17,337 --> 03:45:20,607 LIKELIHOOD THERE WILL BE RURAL 5628 03:45:20,673 --> 03:45:23,376 AREAS, THAT THERE WAS A HIGHER 5629 03:45:23,443 --> 03:45:27,881 DEGREE OF ISSUES REGARDING 5630 03:45:27,947 --> 03:45:29,682 PROBLEMS FALLING ASLEEP, 5631 03:45:29,749 --> 03:45:30,350 PROBLEMS STAYING ASLEEP. 5632 03:45:30,416 --> 03:45:34,320 SO I UNDERSTAND THE QUESTION 5633 03:45:34,387 --> 03:45:36,155 IT'S NOT NECESSARILY A 5634 03:45:36,222 --> 03:45:40,393 DISCREPANCY PER SE IN HOW I 5635 03:45:40,460 --> 03:45:41,761 PRECEPTED IT, THE DISCREPANCY 5636 03:45:41,828 --> 03:45:42,996 ITSELF EXISTS AND SO THIS WHERE 5637 03:45:43,062 --> 03:45:45,064 I WAS SAYING IT'S AN OPPORTUNITY 5638 03:45:45,131 --> 03:45:50,503 FOR US TO DIVE IN DEEPER TO 5639 03:45:50,570 --> 03:45:52,505 UNDERSTAND WHY IS IT THAT SHORT 5640 03:45:52,572 --> 03:45:54,007 SLEEP DURATION SEEMS TO BE 5641 03:45:54,073 --> 03:45:55,808 RELATIVELY THE SAME IN URBAN AND 5642 03:45:55,875 --> 03:45:56,276 RURAL AREAS. 5643 03:45:56,342 --> 03:46:01,915 NOW I THINK FROM AN ETHICAL 5644 03:46:01,981 --> 03:46:03,116 STANDPOINT, THE POSITIONING OF 5645 03:46:03,182 --> 03:46:07,954 URBAN AND RURAL DIVIDE IS 5646 03:46:08,021 --> 03:46:12,625 LOOSELYITATED LY--LOOSELY STATEY 5647 03:46:12,692 --> 03:46:14,160 NOT CAPTURE THE NUANCES IN 5648 03:46:14,227 --> 03:46:15,662 DIFFERENCES WHICH IS WHY I 5649 03:46:15,728 --> 03:46:17,430 STARTED OUT MY PRESENTATION 5650 03:46:17,497 --> 03:46:18,464 ABOUT HAVING THOSE 5651 03:46:18,531 --> 03:46:21,000 OPERATIONALIZED LENS TO BE ABLE 5652 03:46:21,067 --> 03:46:22,769 TO IDENTIFY DIFFERENCES VERSUS 5653 03:46:22,835 --> 03:46:23,069 DISPARITIES. 5654 03:46:23,136 --> 03:46:24,504 SO WITH THE GIVEN TIME, 5655 03:46:24,570 --> 03:46:26,372 OBVIOUSLY I'M MORE THAN HAPPY 5656 03:46:26,439 --> 03:46:28,675 AND THANKS FOR THE OPPORTUNITY 5657 03:46:28,741 --> 03:46:30,576 TO FURTHER ELUCIDATE, BUT THOSE 5658 03:46:30,643 --> 03:46:33,680 ARE SOME OF THE KEY NOT 5659 03:46:33,746 --> 03:46:34,480 NECESSARILY DIFFERENCES BECAUSE 5660 03:46:34,547 --> 03:46:37,917 SLEEP DURATION IS DIFFERENT FROM 5661 03:46:37,984 --> 03:46:39,419 INSOMNIA, THAT THERE ARE 5662 03:46:39,485 --> 03:46:41,521 OPPORTUNITIES FOR US TO DIVE IN 5663 03:46:41,587 --> 03:46:46,426 DEEPER TO FURTHER ELUCIDATE THE 5664 03:46:46,492 --> 03:46:48,594 FEATURED THAT I HIGHLIGHTED WERE 5665 03:46:48,661 --> 03:46:49,562 NOT FEATURED THAT PARTICULARLY 5666 03:46:49,629 --> 03:46:56,336 SAID THAT IS THE REASON WHY 5667 03:46:56,402 --> 03:46:57,270 SPECIFICALLY URBAN AND RURAL 5668 03:46:57,337 --> 03:46:59,505 AREAS MAY BE MORE LIKELY. 5669 03:46:59,572 --> 03:47:02,575 THESE ARE POTENTIAL FACTORS THAT 5670 03:47:02,642 --> 03:47:03,876 FOLKS IN THE PAST, NOT JUST IN 5671 03:47:03,943 --> 03:47:06,479 THE U.S. BUT SOME OF THESE 5672 03:47:06,546 --> 03:47:08,247 STUDIES ARE SUPER OTHER AREAS 5673 03:47:08,314 --> 03:47:09,782 LIKE CHINA AND INDIA WHERE THERE 5674 03:47:09,849 --> 03:47:13,186 IS A GREATER CONCENTRATION OF 5675 03:47:13,252 --> 03:47:14,487 RESEARCH IN RURAL AREA ANDS 5676 03:47:14,554 --> 03:47:16,990 THERE'S MORE DATA THERE THAT WE 5677 03:47:17,056 --> 03:47:19,625 CAN CERTAINLY BORROW FROM, TO 5678 03:47:19,692 --> 03:47:22,695 REALLY ROLL OUT A MORE ROBUST 5679 03:47:22,762 --> 03:47:23,629 RURAL SLEEP HEALTH RESEARCH 5680 03:47:23,696 --> 03:47:23,863 PROGRAM. 5681 03:47:23,930 --> 03:47:25,631 SO THANK YOU SO MUCH FOR THE 5682 03:47:25,698 --> 03:47:26,466 OPPORTUNITY TO CLARIFY. 5683 03:47:26,532 --> 03:47:28,201 >> FREIGHT, THANK YOU SO MUCH, 5684 03:47:28,267 --> 03:47:29,702 AND THAT'S THE POINT THEY REALLY 5685 03:47:29,769 --> 03:47:31,337 WANTED YOU TO GET TO DRIVE HOME. 5686 03:47:31,404 --> 03:47:34,273 SO THANK YOU SO MUCH FOR 5687 03:47:34,340 --> 03:47:34,874 ANSWERING THAT. 5688 03:47:34,941 --> 03:47:36,642 ARE THERE ANY OTHER QUESTIONS OR 5689 03:47:36,709 --> 03:47:39,078 DO ANY OF THE PANELISTS HAVE 5690 03:47:39,145 --> 03:47:40,346 QUESTIONS OF EACH OTHER? 5691 03:47:40,413 --> 03:47:47,086 >> I HAVE A QUESTION FOR 5692 03:47:47,153 --> 03:47:48,721 DR. KIOMORTZOGLOU, IF I MAY ASK. 5693 03:47:48,788 --> 03:47:50,923 THANKS FOR THE PRESENTATION ON 5694 03:47:50,990 --> 03:47:52,325 GEOSPATTIAL EFFECTS ON HEALTH 5695 03:47:52,392 --> 03:47:55,061 AND WE'RE STARTING TO UNDERSTAND 5696 03:47:55,128 --> 03:47:55,995 THE GEOSPATTIAL EFFECTS 5697 03:47:56,062 --> 03:47:56,596 DISTRIBUTION OF HEALTH CENTER 5698 03:47:56,662 --> 03:47:57,964 FOR EXCELLENCE ON CENTER 5699 03:47:58,031 --> 03:48:02,835 FOR EXCELLENCE ON AGING--HEALTH 5700 03:48:02,902 --> 03:48:03,970 SLEEP AND DISPARITIES FOR SURE, 5701 03:48:04,037 --> 03:48:06,272 AND IN THAT REGARD, THE GENERAL 5702 03:48:06,339 --> 03:48:07,673 AREA OF GEOGRAPHY AS YOU THINK 5703 03:48:07,740 --> 03:48:10,109 OF AS A NEIGHBORHOOD BECAUSE 5704 03:48:10,176 --> 03:48:10,710 PARTICULARLY NEIGHBORHOODS IN 5705 03:48:10,777 --> 03:48:14,480 URBAN ENVIRONMENTS THAT COULD 5706 03:48:14,547 --> 03:48:15,281 BEING DRAMATIC DIFFERENCES, SO 5707 03:48:15,348 --> 03:48:16,682 THEY'RE CLOSE TO EACH OTHER IN 5708 03:48:16,749 --> 03:48:18,418 TERMS OF MILEAGE AND THE CITY, 5709 03:48:18,484 --> 03:48:19,952 SO I GUESS IT'S A LONG WINDED 5710 03:48:20,019 --> 03:48:21,020 QUESTION BUT THE QUESTION IS 5711 03:48:21,087 --> 03:48:22,522 WHAT KIND OF RESOLUTION CAN WE 5712 03:48:22,588 --> 03:48:23,923 GET IN THOSE SITUATIONS, BECAUSE 5713 03:48:23,990 --> 03:48:27,560 SOME OF THESE DIFFERENCES AMONG 5714 03:48:27,627 --> 03:48:28,728 THESE DIFFERENT NEIGHBORHOODS IN 5715 03:48:28,795 --> 03:48:32,065 URBAN AREAS MUST BE DUE TO SOME 5716 03:48:32,131 --> 03:48:33,433 KIND OF--OR AT LEAST PARTIALLY 5717 03:48:33,499 --> 03:48:34,634 DUE TO SOME ENVIRONMENTAL 5718 03:48:34,700 --> 03:48:36,069 FACTORS SO CAN WE GET THAT KIND 5719 03:48:36,135 --> 03:48:38,004 OF RESOLUTION TO LOOK AT THOSE 5720 03:48:38,071 --> 03:48:39,972 KINDS OF QUESTIONS AND URBAN 5721 03:48:40,039 --> 03:48:40,306 ENVIRONMENTS. 5722 03:48:40,373 --> 03:48:41,941 IS THAT WHAT WE CALL CENSUS 5723 03:48:42,008 --> 03:48:45,411 TRACT OR FINDING A LEVEL OF 5724 03:48:45,478 --> 03:48:46,145 RESOLUTION? 5725 03:48:46,212 --> 03:48:46,612 THANKS. 5726 03:48:46,679 --> 03:48:46,979 >> ABSOLUTELY. 5727 03:48:47,046 --> 03:48:47,747 THANK YOU. 5728 03:48:47,814 --> 03:48:48,514 EXCELLENT QUESTION. 5729 03:48:48,581 --> 03:48:53,219 IT VARIES FROM DATA SET TO DATA 5730 03:48:53,286 --> 03:48:56,456 SET AND IT ALSO VARIES FROM 5731 03:48:56,522 --> 03:48:57,156 POLLUTANT TO POLLUTANT. 5732 03:48:57,223 --> 03:48:58,624 IF WE'RE THINKING ABOUT 5733 03:48:58,691 --> 03:48:59,225 SOMETHING LIKE TEMPERATURE, 5734 03:48:59,292 --> 03:49:01,861 WHETHER WE HAVE AT THE ADVERSE 5735 03:49:01,928 --> 03:49:03,262 LEVEL TEMPERATURE CAN BE--RIGHT 5736 03:49:03,329 --> 03:49:06,032 NOW THERE ARE MODELS IN THE 5737 03:49:06,099 --> 03:49:11,437 NORTHEAST THAT PREDICT HOURLY 5738 03:49:11,504 --> 03:49:15,074 TEMPERATURE AT I THINK SOMETHING 5739 03:49:15,141 --> 03:49:17,243 50-METERS, TWEBT METERS HIGHLY 5740 03:49:17,310 --> 03:49:19,245 RESULT, RIGHT SO WE CAN HAVE AT 5741 03:49:19,312 --> 03:49:23,616 THE RESIDENTIAL LEVEL OR WE CAN 5742 03:49:23,683 --> 03:49:24,317 HAVE SOMETHING [INDISCERNIBLE] 5743 03:49:24,383 --> 03:49:26,619 OR EACH A ZIP CODE BECAUSE OF 5744 03:49:26,686 --> 03:49:33,793 THE HOMOGENERATED --HOMOGENERATD 5745 03:49:33,860 --> 03:49:37,296 AITY MIGHT BE LARGER BUT CERTAIN 5746 03:49:37,363 --> 03:49:39,365 POLLUTANTS THAT MIGHT BE 5747 03:49:39,432 --> 03:49:43,102 SPATIALLY RELEVANT AS WELL, ALSO 5748 03:49:43,169 --> 03:49:43,736 HOMOGENIUS, THEN ZIP COULD YOU 5749 03:49:43,803 --> 03:49:49,408 TELL MIGHT BE OKAY, BUT THERE 5750 03:49:49,475 --> 03:49:52,011 ARE OTHER EXTENTS--LIKE NOISE 5751 03:49:52,078 --> 03:49:53,212 POLLUTION, AIR POLLUTION, LIGHT 5752 03:49:53,279 --> 03:49:55,815 POLLUTION, THOSE TEBD TO BE VERY 5753 03:49:55,882 --> 03:49:58,050 HETEROGENIUS IN SPACE AND CAN 5754 03:49:58,117 --> 03:49:59,852 VARY A LOT BETWEEN 2 PARALLEL 5755 03:49:59,919 --> 03:50:03,556 STREETS SO WE CAN GET A WAY FROM 5756 03:50:03,623 --> 03:50:06,092 WITH THE CENSUS TRACT AVERAGE, 5757 03:50:06,159 --> 03:50:12,365 IT'S NOT IDEAL, IDEALLY WE WOULD 5758 03:50:12,431 --> 03:50:14,367 WANT SOMETHING FURTHER. 5759 03:50:14,433 --> 03:50:15,535 FINALLY, THERE ARE DATA 5760 03:50:15,601 --> 03:50:18,404 DEPENDING ON WHERE, THE MAIN 5761 03:50:18,471 --> 03:50:19,572 NITROGEN DIOXIDE MODELS IN THE 5762 03:50:19,639 --> 03:50:21,574 UNITED STATES, AND NITROGEN 5763 03:50:21,641 --> 03:50:24,177 DIOXIDE IS TRAFFIC TRACER FOR 5764 03:50:24,243 --> 03:50:24,810 EMISSIONS, TRAFFIC 5765 03:50:24,877 --> 03:50:25,411 CERTAINLY--CERTAINLY MISSIONS, 5766 03:50:25,478 --> 03:50:28,047 SO I THINK THE NATIONWIDE MODEL, 5767 03:50:28,114 --> 03:50:30,783 THE BEST PERFORMING 1 IS 5768 03:50:30,850 --> 03:50:32,285 AROUND 1 KILOMETER RESOLUTION, 5769 03:50:32,351 --> 03:50:36,689 IT'S A BIT LARGE BUT WHAT'S ALSO 5770 03:50:36,756 --> 03:50:39,725 IMPORTANT IS THE STUDY AREA OF 5771 03:50:39,792 --> 03:50:42,128 INTEREST, IS MY COHORT WITHIN A 5772 03:50:42,195 --> 03:50:44,430 NEIGHBORHOOD ONLY THEN I 5773 03:50:44,497 --> 03:50:45,698 DEFINITELY NEED MORE RESOLVED 5774 03:50:45,765 --> 03:50:48,234 DATA OR AM I DOING THE 5775 03:50:48,301 --> 03:50:50,236 NATIONWIDE, OR A STATEWIDE 5776 03:50:50,303 --> 03:50:52,205 ANALYSIS, IN WHICH CASE, YOU 5777 03:50:52,271 --> 03:50:54,574 KNOW, EVEN IF THERE'S SOME 5778 03:50:54,640 --> 03:50:55,741 SPECIFICATION BECAUSE I DON'T 5779 03:50:55,808 --> 03:50:58,277 HAVE ADDRESS LEVEL DATA OR DO 5780 03:50:58,344 --> 03:50:59,579 FINALLY RESOLVE AND HAVE ZIP 5781 03:50:59,645 --> 03:51:03,649 CODE LEVEL DATA, THE CONTRAST 5782 03:51:03,716 --> 03:51:06,185 WILL KEEP THEM RUNNING SO THAT'S 5783 03:51:06,252 --> 03:51:06,419 FINE. 5784 03:51:06,485 --> 03:51:07,720 THERE ARE LOTS OF THINGS TO 5785 03:51:07,787 --> 03:51:09,388 CONSIDER, I HAD A THOUGHT AND I 5786 03:51:09,455 --> 03:51:11,490 MISS TODAY, OH THERE ARE ALSO IF 5787 03:51:11,557 --> 03:51:12,658 WE ARE WITHIN--I KNOW FOR 5788 03:51:12,725 --> 03:51:15,194 EXAMPLE, NEW YORK CITY HAS 5789 03:51:15,261 --> 03:51:17,463 MAIRKSZING DATA, IF THE ANALYSIS 5790 03:51:17,530 --> 03:51:20,566 IN NEW YORK STAR AIR POLLUTION, 5791 03:51:20,633 --> 03:51:22,768 WE HAVE DATA 300 SQUARE METERS, 5792 03:51:22,835 --> 03:51:25,071 CAVEAT THEIR ANNUAL PREDICTIONS 5793 03:51:25,137 --> 03:51:28,608 AND NOT DAILY SO THERE'S ALWAYS 5794 03:51:28,674 --> 03:51:32,478 THIS BALANCE THAT DAILY 5795 03:51:32,545 --> 03:51:34,647 PREDICTIONS EXTENDS NOT ALWAYS 5796 03:51:34,714 --> 03:51:37,283 BUT SOMETIMES ARE MORE COARSELY 5797 03:51:37,350 --> 03:51:38,451 RESOLVED THAN ANNUAL AND THE 5798 03:51:38,517 --> 03:51:40,353 OTHER QUESTION IS, AGAIN, THAT'S 5799 03:51:40,419 --> 03:51:42,355 THE IMPORTANCE OF SPEAKING TO 5800 03:51:42,421 --> 03:51:46,859 EXPERTS IS CAN WE BRING IN EX 5801 03:51:46,926 --> 03:51:48,728 PERS TO IMPROVE THE ASSESSMENTS 5802 03:51:48,794 --> 03:51:51,597 IN THE SPECIFIC LOCATION THAT I 5803 03:51:51,664 --> 03:51:53,766 AM INTERESTED IN, CAN I 5804 03:51:53,833 --> 03:51:54,734 COMPLEMENT THE DATA SOMEHOW, 5805 03:51:54,800 --> 03:51:58,938 JUST FOR MY COHORT JUST GIVEN 5806 03:51:59,005 --> 03:52:02,074 THE AVAILABLE LOCAL DATA. 5807 03:52:02,141 --> 03:52:03,309 I HOPE THIS ANSWERS THE 5808 03:52:03,376 --> 03:52:03,743 QUESTION. 5809 03:52:03,809 --> 03:52:05,044 I KNOW IT DID NOT ANSWER THE 5810 03:52:05,111 --> 03:52:06,345 QUESTION BUT I HOPE IT HELPED 5811 03:52:06,412 --> 03:52:10,850 THINK ABOUT THE QUESTION. 5812 03:52:10,916 --> 03:52:11,117 HOPEFULLY. 5813 03:52:11,183 --> 03:52:12,985 NTHANK YOU. 5814 03:52:13,052 --> 03:52:14,954 YES, GO AHEAD AND WITH A QUICK 5815 03:52:15,021 --> 03:52:17,356 QUESTION N1 MORE THING, FOLLOW 5816 03:52:17,423 --> 03:52:22,728 ON, SORRY, SO YOU RAISE THE 5817 03:52:22,795 --> 03:52:25,031 ISSUE THAT THESE DIFFERENT 5818 03:52:25,097 --> 03:52:26,198 ELMETROPOLITANS OF EXPOSURE HAD 5819 03:52:26,265 --> 03:52:27,066 DIFFERENT SPATIAL RESOLUTION SO 5820 03:52:27,133 --> 03:52:29,035 IF YOU'RE REALLY INTERESTED IN 5821 03:52:29,101 --> 03:52:30,202 THE COMBINED EXPOSURE OF ALL 5822 03:52:30,269 --> 03:52:32,605 THESE THINGS IN 1 GEOGRAPHICAL 5823 03:52:32,672 --> 03:52:34,573 AREA, IT MIGHT GET COMP LIT 5824 03:52:34,640 --> 03:52:40,279 KAYED IN TRYING TO COM--COMP 5825 03:52:40,346 --> 03:52:40,413 C 5826 03:52:40,479 --> 03:52:41,681 OMPLICATED TO COMBINE THE 5827 03:52:41,747 --> 03:52:43,949 DATA NTHE SOLUTION IS NOT--NIF 5828 03:52:44,016 --> 03:52:45,451 THEY OVERLAP NYES, EXACTLY. 5829 03:52:45,518 --> 03:52:47,186 BECAUSE NO MATTER WHAT I HAVE 5830 03:52:47,253 --> 03:52:49,255 THE RESOLUTION IS, IF I HAVE 5831 03:52:49,322 --> 03:52:51,123 ADDRESS, 1 DATA CAN BE AT ZIP 5832 03:52:51,190 --> 03:52:53,092 CODE LEVEL, ANOTHER CAN BE AT 5833 03:52:53,159 --> 03:52:54,360 THE COUNTY LEVEL, ANOTHER DATA 5834 03:52:54,427 --> 03:52:57,129 SET CAN BE AT THE STREET LEVEL, 5835 03:52:57,196 --> 03:52:59,432 I CAN ASSIGN WHATEVERERALUE MY 5836 03:52:59,498 --> 03:53:00,466 STREET LEVEL HAS WHETHER IT'S 5837 03:53:00,533 --> 03:53:02,935 THE ZIP CODE AVERAGE OR COUNTY 5838 03:53:03,002 --> 03:53:03,636 AVERAGE, RIGHT? 5839 03:53:03,703 --> 03:53:08,774 SO THAT'S NOT SO MUCH A CONCERN, 5840 03:53:08,841 --> 03:53:11,911 AND THEN EVEN IF THEY ARE 5841 03:53:11,977 --> 03:53:13,079 DIFFERENT--1'S ZIP CODE, 1'S 5842 03:53:13,145 --> 03:53:16,882 CENSUS TRACT, WE CAN HARMONIZE 5843 03:53:16,949 --> 03:53:18,584 AS WELL. 5844 03:53:18,651 --> 03:53:18,884 >> GREAT. 5845 03:53:18,951 --> 03:53:20,653 >> NO, NO, THIS IS GREAT. 5846 03:53:20,720 --> 03:53:26,792 AND THANK YOU TO MY ESTEEMED 5847 03:53:26,859 --> 03:53:27,059 PANELISTS. 5848 03:53:27,126 --> 03:53:28,160 WHAT SHE MENTION SIDE SOMETHING 5849 03:53:28,227 --> 03:53:30,029 I WAS GOING TO UNDERSCORE, 5850 03:53:30,096 --> 03:53:32,164 SOMETHING WE'RE BUILDING AS 5851 03:53:32,231 --> 03:53:35,134 WELL, I'LL USE THIS OPPORTUNITY, 5852 03:53:35,201 --> 03:53:37,670 YOU KNOW TO ENCOURAGE THE NIH, 5853 03:53:37,737 --> 03:53:39,672 WHICH IS WHY WE'VE CREATED THIS 5854 03:53:39,739 --> 03:53:41,307 PRECISION ON PERSONALIZED 5855 03:53:41,374 --> 03:53:46,946 POPULATION ON HEALTH, IS THAT AS 5856 03:53:47,012 --> 03:53:49,048 YOU ARE GATHERING DATA AT THE 5857 03:53:49,115 --> 03:53:50,683 MACROLEVEL, EVEN IF YOU DRILL 5858 03:53:50,750 --> 03:53:54,253 DOWN TO THE ZIP CODE OR CENSUS 5859 03:53:54,320 --> 03:53:55,621 TRACT, IT'S STILL MACROWHICH IS 5860 03:53:55,688 --> 03:53:57,056 WHY WE BELIEVE IT'S IMPORTANT TO 5861 03:53:57,123 --> 03:53:58,991 GATHER DATA AT THE INDIVIDUAL AT 5862 03:53:59,058 --> 03:54:01,193 A HOME LEVEL AND TO TRY 5863 03:54:01,260 --> 03:54:02,128 INCASSULATE AND THAT'S WHAT 5864 03:54:02,194 --> 03:54:04,764 WE'RE WORKING ON AS WELL BECAUSE 5865 03:54:04,830 --> 03:54:08,167 THE ASSUMPTION AS MY ESTEEMED 5866 03:54:08,234 --> 03:54:09,368 PANELISTS MENTIONED THAT 5867 03:54:09,435 --> 03:54:12,304 WHATEVER YOUR QUALITY EXPOSURE 5868 03:54:12,371 --> 03:54:14,974 OR WHATEVER, YOU KNOW KIND OF 5869 03:54:15,040 --> 03:54:16,842 EXPOETIC SOMMIC TOXIC EXPOSURE 5870 03:54:16,909 --> 03:54:18,577 THERE THERE'S AN ASSUMPTION THAT 5871 03:54:18,644 --> 03:54:19,979 THERE'S AN AVERAGE AND THE 5872 03:54:20,045 --> 03:54:21,013 YEAR'S AVERAGE, NOT NECESSARILY 5873 03:54:21,080 --> 03:54:22,815 IN REALTIME AND I THINK THAT'S 5874 03:54:22,882 --> 03:54:26,452 WHERE WE REALLY NEED TO DO SOME 5875 03:54:26,519 --> 03:54:27,520 MORE INVESTMENTS, PARTICULARLY 5876 03:54:27,586 --> 03:54:28,821 WHERE WE'RE SEEING, WHAT WE'RE 5877 03:54:28,888 --> 03:54:31,257 TALKING ABOUT IS, WE NEED MORE 5878 03:54:31,323 --> 03:54:33,993 FORMS OF NOT JUST CLOUD COMPUTE 5879 03:54:34,059 --> 03:54:35,561 BUT ALSO EDGE COMPUTE TO BE ABLE 5880 03:54:35,628 --> 03:54:39,098 TO CAPTURE THOSE DATA IN 5881 03:54:39,165 --> 03:54:40,499 REALTIME, NOT ONLY FROM A 5882 03:54:40,566 --> 03:54:41,801 RESEARCH STANDPOINT BUT FROM A 5883 03:54:41,867 --> 03:54:43,269 CLINICAL STABBED POINT WHERE IF 5884 03:54:43,335 --> 03:54:46,705 A CHILD HAS ASTHMA OR SOME 5885 03:54:46,772 --> 03:54:47,807 INDIVIDUAL HAS A RESPIRATORY 5886 03:54:47,873 --> 03:54:48,774 ISSUE, THAT CAN BE CRITICAL AND 5887 03:54:48,841 --> 03:54:50,843 I THINK THIS IS WHERE OUR 5888 03:54:50,910 --> 03:54:52,678 RESEARCH, THAT WE'RE PROPOSING 5889 03:54:52,745 --> 03:54:54,180 CAN REALLY PROVIDE THAT ROADMAP 5890 03:54:54,246 --> 03:54:57,450 AS TO HOW TO BUILD OUT THE 5891 03:54:57,516 --> 03:54:58,818 INFORMATICS INFRASTRUCTURE AS 5892 03:54:58,884 --> 03:55:00,319 WELL AS DATA INFRASTRUCTURE TO 5893 03:55:00,386 --> 03:55:01,754 COLLECT THOSE DATA IN REALTIME 5894 03:55:01,821 --> 03:55:04,056 AS WELL AS PROCESS THEM AND TO 5895 03:55:04,123 --> 03:55:14,500 MAKE MEANING OF THEM. 5896 03:55:15,267 --> 03:55:15,768 >> THANK YOU. 5897 03:55:15,835 --> 03:55:17,069 DOES ANYONE ELSE HAVE A 5898 03:55:17,136 --> 03:55:17,436 QUESTION. 5899 03:55:17,503 --> 03:55:20,139 IF NOT I HAVE 1 QUICK 1 FOR ANY 5900 03:55:20,206 --> 03:55:25,744 OF YOU ON THE PANEL ESPECIALLY I 5901 03:55:25,811 --> 03:55:26,178 THINK DR. BRIDGES. 5902 03:55:26,245 --> 03:55:28,848 WITH ALL OF THE HYPE AND NEWS 5903 03:55:28,914 --> 03:55:35,287 AROUND AI AND THE POTENTIAL FOR 5904 03:55:35,354 --> 03:55:37,723 HARM AND POTENTIALLY MARGINAL 5905 03:55:37,790 --> 03:55:38,924 POPULATIONS THAT THE ALGORITHMS 5906 03:55:38,991 --> 03:55:40,226 THAT THESE THINGS ARE TRAINED 5907 03:55:40,292 --> 03:55:42,294 ON, YOU KNOW WE'RE LOOKING AT 5908 03:55:42,361 --> 03:55:44,597 THESE VERY DIVERSE POPULATIONS, 5909 03:55:44,663 --> 03:55:47,666 WHETHER IT'S IN THE U.S. RURAL 5910 03:55:47,733 --> 03:55:52,938 VERSUS URBAN AND VERY DISTINCT 5911 03:55:53,005 --> 03:55:54,206 DIFFERENT GROUPS OF PEOPLE BUT 5912 03:55:54,273 --> 03:55:56,775 ALSO IF YOU'RE THINKING ABOUT 5913 03:55:56,842 --> 03:55:59,411 RURAL VERSUS, VURRAL AND U.S. 5914 03:55:59,478 --> 03:55:59,845 VERSUS CHINA. 5915 03:55:59,912 --> 03:56:02,314 HOW ARE YOU GOING TO MAKE--HOW 5916 03:56:02,381 --> 03:56:03,516 CAN WE COME TO TERMS WITH THAT 5917 03:56:03,582 --> 03:56:07,086 AND KNOW THAT THE TRUTH THAT WE 5918 03:56:07,152 --> 03:56:08,654 REALLY ARE GETTING IS REALLY THE 5919 03:56:08,721 --> 03:56:11,056 TRUTH AND NOT SOMETHING THAT'S 5920 03:56:11,123 --> 03:56:13,759 BIASED BY THE ALGORITHMS OR THE 5921 03:56:13,826 --> 03:56:15,995 THINGS WE'RE TRAINING AND 5922 03:56:16,061 --> 03:56:18,163 EXKIEWZ MY CRUDE LANGUAGE, THIS 5923 03:56:18,230 --> 03:56:20,165 IS NOT MY EXACT FIELD BUT I'M 5924 03:56:20,232 --> 03:56:22,001 JUST DANGEROUS ENOUGH TO KNOW A 5925 03:56:22,067 --> 03:56:22,234 LITTLE. 5926 03:56:22,301 --> 03:56:24,336 >> I THINK THE ISSUE IS A BIT 5927 03:56:24,403 --> 03:56:27,373 MORE FUNDAMENTAL THAN THAT. 5928 03:56:27,439 --> 03:56:29,875 SO THE ISSUE OF INCREASE OF BIAS 5929 03:56:29,942 --> 03:56:31,977 IN DATA SETS IS STILL VERY MUCH 5930 03:56:32,044 --> 03:56:34,213 AN ACADEMIC 1. 5931 03:56:34,280 --> 03:56:37,049 WE DON'T EVEN KNOW IN MANY OF 5932 03:56:37,116 --> 03:56:37,850 THE INSTANCES THAT THE COMMUNITY 5933 03:56:37,917 --> 03:56:48,060 WANT OR WILL USE THE TECHNOLOGY 5934 03:56:48,127 --> 03:56:51,163 EVEN BEFORE YOU ASSESS THE 5935 03:56:51,230 --> 03:56:52,364 POTENTIAL BIASES INVOLVED IN THE 5936 03:56:52,431 --> 03:56:54,233 DATA, YOU HAVE TO ASK WHAT IS 5937 03:56:54,300 --> 03:56:55,301 THE GENERAL LEVEL OF COMMUNITY 5938 03:56:55,367 --> 03:56:58,404 SUPPORT FOR THE TECHNOLOGIES, 5939 03:56:58,470 --> 03:56:59,672 SURPRISINGLY, THERE ARE OTHER 5940 03:56:59,738 --> 03:57:02,708 AREAS WHERE PEOPLE CAN BE VERY 5941 03:57:02,775 --> 03:57:07,146 FORGIVING OR ACCEPTING THAT IT 5942 03:57:07,212 --> 03:57:09,348 MIGHT BE, YOU KNOW NOT INCLUDING 5943 03:57:09,415 --> 03:57:11,183 THEM OR IT COULD BE THE BEST USE 5944 03:57:11,250 --> 03:57:14,486 OF THE DATA THAT'S AVAILABLE, 5945 03:57:14,553 --> 03:57:15,854 AND SOMETIMES PEOPLE ARE VERY 5946 03:57:15,921 --> 03:57:17,957 HAPPY TO HAVE THEIR DATA USED. 5947 03:57:18,023 --> 03:57:20,192 WE SOMETIMES GET VERY FOCUSED ON 5948 03:57:20,259 --> 03:57:24,496 DATA PROTECTION, BUT IF YOU 5949 03:57:24,563 --> 03:57:25,731 APPROPRIATELY PARTNER, I THINK 5950 03:57:25,798 --> 03:57:27,967 THAT'S IN OF THE ISSUES 5951 03:57:28,033 --> 03:57:30,102 ASSOCIATED WITH YOU KNOW WHAT 5952 03:57:30,169 --> 03:57:33,772 WE'RE HEARING IN PC ORI, OR AT 5953 03:57:33,839 --> 03:57:38,611 AHRQ, HAD IS THIS DEVELOPING 5954 03:57:38,677 --> 03:57:39,078 LONG-TERM MEANINGFUL 5955 03:57:39,144 --> 03:57:39,912 PARTNERSHIP, SO WHEN THE 5956 03:57:39,979 --> 03:57:42,014 COMMUNITY IS A PARTNER IN THE 5957 03:57:42,081 --> 03:57:44,183 DEVELOPMENT AND CAN PROVIDE 5958 03:57:44,249 --> 03:57:48,287 OVERSIGHT, ON THE DEVELOPMENT 5959 03:57:48,354 --> 03:57:51,156 AND POTENTIAL IMPLEMENTATION, 5960 03:57:51,223 --> 03:57:52,224 THEN I THINK--THAT'S OUR FIRST 5961 03:57:52,291 --> 03:57:55,094 ORDER EFFECT AND I THINK THE 5962 03:57:55,160 --> 03:57:57,262 ISSUES OF IMPLICIT DATA BIAS IS 5963 03:57:57,329 --> 03:57:58,797 A SECOND ORDER ISSUER EFFECT SO 5964 03:57:58,864 --> 03:58:02,234 I WOULD SAY, IS A MUCH GREATER 5965 03:58:02,301 --> 03:58:05,170 URGENT NEED UNLESS WE JUST LIKE 5966 03:58:05,237 --> 03:58:06,438 IN MEDICAL PRODUCT DEVELOPMENT 5967 03:58:06,505 --> 03:58:09,208 CAN ACCEPT THAT MAYBE ONLY 1 IN 5968 03:58:09,274 --> 03:58:11,510 1000 TECHNOLOGIES COME TO MARKET 5969 03:58:11,577 --> 03:58:13,345 AND ARE SUCCESSFUL, BUT, 5970 03:58:13,412 --> 03:58:17,850 CONGRESS AND OTHER GROUPS HAVE 5971 03:58:17,916 --> 03:58:19,184 BEEN VERY ADAM ANT THAT THAT'S 5972 03:58:19,251 --> 03:58:21,387 NOT GOOD ENOUGH AND WE'RE SEEING 5973 03:58:21,453 --> 03:58:23,889 MAJOR CHANGES IN BIOLOGICS FOR 5974 03:58:23,956 --> 03:58:25,958 RARE DECS, ADVOCACY AND 5975 03:58:26,025 --> 03:58:29,294 ENGAGEMENT OPERATOR DISEASE 5976 03:58:29,361 --> 03:58:30,996 GROUPS THROUGH PEAK 5977 03:58:31,063 --> 03:58:31,664 ORGANIZATIONS, PATRON 5978 03:58:31,730 --> 03:58:33,866 ORGANIZATIONS WHERE THEY NOW 5979 03:58:33,932 --> 03:58:34,600 BECOME PROFESSIONAL ENTITIES, I 5980 03:58:34,667 --> 03:58:36,368 THINK THAT'S REALLY GOOD, I WE 5981 03:58:36,435 --> 03:58:38,303 HAVE TO START ENGAGING AND 5982 03:58:38,370 --> 03:58:40,072 HAVING PATIENT VOICE IN WHAT 5983 03:58:40,139 --> 03:58:45,244 WE'RE DOING IS I INCREASINGLY 5984 03:58:45,310 --> 03:58:47,212 ASK AI AND BIG DATA RESEARCHERS 5985 03:58:47,279 --> 03:58:48,847 WHERE'S THE PATIENT VOICE IN 5986 03:58:48,914 --> 03:58:52,017 HERE AND THEY WENT, WELL, I 5987 03:58:52,084 --> 03:58:53,152 COULD INCORPORATE IT. 5988 03:58:53,218 --> 03:58:55,421 THEY MAKE ASSUMPTIONS ABOUT WHAT 5989 03:58:55,487 --> 03:58:59,825 THE PEOPLE WANT WITHOUT DOING 5990 03:58:59,892 --> 03:59:04,296 THE LEG WORK TO ACTUALLY 5991 03:59:04,363 --> 03:59:05,264 UNDERSTAND THAT. 5992 03:59:05,330 --> 03:59:06,799 IN ANOTHER PROJECT I'M DOING WE 5993 03:59:06,865 --> 03:59:09,168 ARE COLLECTING BIG DATA IN 5994 03:59:09,234 --> 03:59:11,503 PATIENTS WISHES AND COMMUNITY 5995 03:59:11,570 --> 03:59:12,204 ENGAGEMENT BUT UNFORTUNATELY, 5996 03:59:12,271 --> 03:59:14,440 THEY HAVE TO GO GENOMIC DATA, 5997 03:59:14,506 --> 03:59:18,110 HAS TO GO IN 1 DATABASE AND THE 5998 03:59:18,177 --> 03:59:19,978 PUBLIC WISHES HAVE TO GO IN 5999 03:59:20,045 --> 03:59:22,047 ANOTHER DATABASE SO WE HAVE TO 6000 03:59:22,114 --> 03:59:23,115 DECOUPLE GOING TO GREAT LENGTHS 6001 03:59:23,182 --> 03:59:25,317 TO HAVE THE COMMUNITY VOICE 6002 03:59:25,384 --> 03:59:27,052 PAIRED WITH THE DATA THAT WE'RE 6003 03:59:27,119 --> 03:59:28,287 CLICKING BUT CURRENT DATA IS 6004 03:59:28,353 --> 03:59:29,888 PULLING THOSE 2 THINGS APART, SO 6005 03:59:29,955 --> 03:59:31,990 I THINK WE HAVE TO TAKE A HARD 6006 03:59:32,057 --> 03:59:34,193 LOOK AT OURSELVES, NOT JUST ON 6007 03:59:34,259 --> 03:59:36,028 THE ACADEMIC ISSUES, BUT ON THE 6008 03:59:36,095 --> 03:59:39,565 REAL NEEDS AND DESIRES OF THE 6009 03:59:39,631 --> 03:59:42,868 COMMUNITY AND BRING THEM ALONG 6010 03:59:42,935 --> 03:59:43,902 AS PARTNERS. 6011 03:59:43,969 --> 03:59:45,604 >> THANK YOU SO MUCH. 6012 03:59:45,671 --> 03:59:49,575 I KNOW WE'RE COMING CLOSE TO THE 6013 03:59:49,641 --> 03:59:52,177 END, SO, FOR AZIZI, AND MARRIANA 6014 03:59:52,244 --> 03:59:53,278 IF YOU HAVE A COMMENT TO THIS, 6015 03:59:53,345 --> 03:59:55,280 IF YOU CAN KEEP IT TO LESS THAN 6016 03:59:55,347 --> 03:59:57,382 A MINUTE, A MINUTE OR LESS EACH, 6017 03:59:57,449 --> 04:00:01,820 GO AHEAD AND ADD YOUR COMMENTS. 6018 04:00:01,887 --> 04:00:04,790 >> I WILL HAVE HER GO FIRST, 6019 04:00:04,857 --> 04:00:07,126 PLEASE NTHANK YOU AZIZI. 6020 04:00:07,192 --> 04:00:09,695 NLET ME LOWER MY HAND. 6021 04:00:09,762 --> 04:00:10,529 YES, ABSOLUTELY AGREE, 6022 04:00:10,596 --> 04:00:12,865 COMMUNITIES THIS SHOULD BE 6023 04:00:12,931 --> 04:00:15,467 INVOLVED TIMES WE DEVELOP THESE 6024 04:00:15,534 --> 04:00:17,035 TOOLS USING AI INDEPENDENTLY OF 6025 04:00:17,102 --> 04:00:18,203 COMMUNITY, THE MODELS I 6026 04:00:18,270 --> 04:00:18,904 DEVELOPED ARE NATIONWIDE AND WE 6027 04:00:18,971 --> 04:00:21,840 KNOW THAT THE SOURCES ARE NOT 6028 04:00:21,907 --> 04:00:25,277 RANDOMIZED TRIAL AMLY 6029 04:00:25,344 --> 04:00:27,913 DESCRIEWBED, WE KNOW THAT 6030 04:00:27,980 --> 04:00:29,548 CURRENT MONITORING SITES ARE 6031 04:00:29,615 --> 04:00:30,382 RANDOMLY DRIEWBED SO I THINK 6032 04:00:30,449 --> 04:00:32,251 IT'S ON THE RESEARCHERS SIDE TO 6033 04:00:32,317 --> 04:00:35,687 MAKE SURE THAT WE TEST WHAT WE 6034 04:00:35,754 --> 04:00:35,921 DEVELOP. 6035 04:00:35,988 --> 04:00:38,357 WE DO OUR BEST, WE TALK WITH 6036 04:00:38,423 --> 04:00:39,658 EXPERTS, WE FIND VALIDATION DATA 6037 04:00:39,725 --> 04:00:41,393 SETS THAT ARE INDEPENDENT OF THE 6038 04:00:41,460 --> 04:00:44,163 DATA SETS THAT WE ARE USING TO 6039 04:00:44,229 --> 04:00:48,000 DEVELOP THE MODELS AND WE TEST 6040 04:00:48,066 --> 04:00:49,434 UNSUPPORTS AS I SHOWED. 6041 04:00:49,501 --> 04:00:50,769 WE KNOW THAT CERTAINTY 6042 04:00:50,836 --> 04:00:53,572 COMMUNITIES HAVE MUCH HIGHER 6043 04:00:53,639 --> 04:00:54,840 UNCERTAINTIES THAT THAT'S 6044 04:00:54,907 --> 04:00:58,143 EVIDENCE OF THE LACK OF THE 6045 04:00:58,210 --> 04:00:59,578 FAIRNESS IN PREVIOUS MODELS IF 6046 04:00:59,645 --> 04:01:00,412 YOU WOULD LIKE. 6047 04:01:00,479 --> 04:01:02,114 SO IT'S ALL ON US, I THINK WE 6048 04:01:02,181 --> 04:01:03,849 HAVE A VERY BIG RESPONSIBILITY 6049 04:01:03,916 --> 04:01:10,322 HERE, ON US AND OUR PEERS, TO 6050 04:01:10,389 --> 04:01:11,423 MAKING--YOU KNOW, WE KEEP EACH 6051 04:01:11,490 --> 04:01:16,061 OTHER ON TRACK. 6052 04:01:16,128 --> 04:01:16,261 SORRY. 6053 04:01:16,328 --> 04:01:20,165 >> YEAH, SURE, THANK YOU. 6054 04:01:20,232 --> 04:01:21,500 GREAT, GREAT, SEGUE AND JUST TO 6055 04:01:21,567 --> 04:01:22,668 HIGHLIGHT WHEN WE'RE TALKING 6056 04:01:22,734 --> 04:01:25,671 ABOUT BIAS, BIAS IS NOT A 6057 04:01:25,737 --> 04:01:26,205 MONOLITHIC TERM, THEY'RE 9 6058 04:01:26,271 --> 04:01:30,342 DIFFERENT FOR THE PURPOSES OF 6059 04:01:30,409 --> 04:01:34,546 BIASES IN AI FROM SELECTION TO 6060 04:01:34,613 --> 04:01:36,181 OVERLIERS, OBSERVER BIAS 6061 04:01:36,248 --> 04:01:37,583 EXCLUSION, BIAS RACIAL, ABOUT I 6062 04:01:37,649 --> 04:01:38,884 AS IN ASSOCIATION, BIAS AND THE 6063 04:01:38,951 --> 04:01:40,085 REASON WHY I HIGHLIGHT THOSE IS 6064 04:01:40,152 --> 04:01:43,856 THAT IF WE ARE GOING TO GET VERY 6065 04:01:43,922 --> 04:01:45,057 SERIOUS ABOUT TACKLING BIAS IN 6066 04:01:45,123 --> 04:01:47,259 AI, THAT WE NEED TO DECOUPLE 6067 04:01:47,326 --> 04:01:49,561 MANY OF THE DIFFERENT BIASES 6068 04:01:49,628 --> 04:01:52,598 THAT ARE INHERENT, WHAT I WOULD 6069 04:01:52,664 --> 04:01:53,198 HIGHLY RECOMMEND AND ENCOURAGE 6070 04:01:53,265 --> 04:01:55,000 US TO DO IS THAT BIAS IS NOT AT 6071 04:01:55,067 --> 04:01:56,902 THE LEVEL OF THE ALGORITHM BUT 6072 04:01:56,969 --> 04:01:58,770 IT'S ALSO AT THE LEVEL OF THE 6073 04:01:58,837 --> 04:02:00,272 SENSOR AND THE DEVICE WHICH IS 6074 04:02:00,339 --> 04:02:01,607 WHY ANY SOLUTION THAT WE UTILIZE 6075 04:02:01,673 --> 04:02:04,243 IN OUR STUDY THAT WE HAVE--IT 6076 04:02:04,309 --> 04:02:06,645 HAS TO PASS THE POPULATION 6077 04:02:06,712 --> 04:02:09,715 HEALTH VALIDITY TEST THAT WE'VE 6078 04:02:09,781 --> 04:02:11,550 DEVELOPED, WHICH PARTICULARLY IN 6079 04:02:11,617 --> 04:02:14,319 A PULSE OX SYMMETRY IT MUST BE 6080 04:02:14,386 --> 04:02:16,421 UTILIZED IN PEOPLE WITH DARKER 6081 04:02:16,488 --> 04:02:19,024 SKIN PIGMENTATION, THAT IS 6082 04:02:19,091 --> 04:02:20,626 CRITICAL BECAUSE THIS WILL HELP 6083 04:02:20,692 --> 04:02:22,261 WITH THE ENTIRE WORK FLOW IN 6084 04:02:22,327 --> 04:02:23,695 TERMS OF THE QUALITY OF THE DATA 6085 04:02:23,762 --> 04:02:25,864 AND HOW IT'S PROCESSED AND THE 6086 04:02:25,931 --> 04:02:28,400 LAST POINT IS ABOUT THE 6087 04:02:28,467 --> 04:02:31,403 ONTOLOGY, THE KNOWLEDGE GRASP 6088 04:02:31,470 --> 04:02:34,239 THAT UNDER GIRD MANY OF THESE AI 6089 04:02:34,306 --> 04:02:35,841 ALGORITHMS THAT ARE CRITICAL, I 6090 04:02:35,908 --> 04:02:39,611 KNOW 1 OF MY MENTEES, HUGE SHOUT 6091 04:02:39,678 --> 04:02:41,914 OUT TO HER, SHE WORKING ON THOSE 6092 04:02:41,980 --> 04:02:44,316 LOOKING AT SLEEP HEALTH 6093 04:02:44,383 --> 04:02:45,817 DISPARITIES IN NLP NATURAL 6094 04:02:45,884 --> 04:02:46,985 LANGUAGE PROCESSING AND WE'RE 6095 04:02:47,052 --> 04:02:48,620 GOING AT THE ROOT LEVEL TRYING 6096 04:02:48,687 --> 04:02:50,489 TO FIND BETTER WAYS IN WHICH WE 6097 04:02:50,555 --> 04:02:51,890 CAN UNROOT BIASES IN THESE 6098 04:02:51,957 --> 04:02:55,994 ONTOLOGIES SO THAT WE CAN HAVE 6099 04:02:56,061 --> 04:02:57,529 REDICTIVE MODELS AND NATURAL 6100 04:02:57,596 --> 04:02:58,830 LANGUAGE ALGORITHMS BE MORE 6101 04:02:58,897 --> 04:03:01,233 REFLECTIVE AND MORE ACCURATE AND 6102 04:03:01,300 --> 04:03:02,801 MORE REPRESENTATIVE. 6103 04:03:02,868 --> 04:03:03,235 THANK YOU. 6104 04:03:03,302 --> 04:03:04,369 >> THANK YOU. 6105 04:03:04,436 --> 04:03:06,438 THOSE ARE GREAT POINTS. 6106 04:03:06,505 --> 04:03:08,206 THIS IS WAY TO SHORT OF A TIME 6107 04:03:08,273 --> 04:03:09,274 FOR THIS CONVERSATION AND I HOPE 6108 04:03:09,341 --> 04:03:11,009 WE CAN KEEP THIS AND I'M SURE 6109 04:03:11,076 --> 04:03:13,412 KEEP THIS CONVERSATION GOING ON 6110 04:03:13,478 --> 04:03:13,679 OFFLINE. 6111 04:03:13,745 --> 04:03:16,481 WITH THAT, I AM GOING TO LET US 6112 04:03:16,548 --> 04:03:18,250 MOVE ON TO THE SUMMARY AND 6113 04:03:18,317 --> 04:03:20,886 CONCLUSIONS WHICH I BELIEVE IS 6114 04:03:20,953 --> 04:03:22,421 BY THE CHAIRS OF THIS MEETING, 6115 04:03:22,487 --> 04:03:24,356 SO I WILL TAKE MYSELF OFF CAMERA 6116 04:03:24,423 --> 04:03:26,692 AND IF THE CHAIR CAN COME ON, I 6117 04:03:26,758 --> 04:03:28,760 AM HANDING THIS OVER TO YOU ALL. 6118 04:03:28,827 --> 04:03:29,828 >> YEAH, THANK YOU DANA, THANK 6119 04:03:29,895 --> 04:03:32,397 YOU FOR THE GREAT DISCUSSION, I 6120 04:03:32,464 --> 04:03:33,699 WISH WE COULD CONTINUE IT 6121 04:03:33,765 --> 04:03:35,567 FURTHER BUT PERHAPS IN THE 6122 04:03:35,634 --> 04:03:35,801 FUTURE. 6123 04:03:35,867 --> 04:03:39,004 >> YES, SO, I THINK I'M GOING TO 6124 04:03:39,071 --> 04:03:40,405 KICKOFF THE FINAL REMARKS AND I 6125 04:03:40,472 --> 04:03:42,307 RECOGNIZE WE ARE ABOUT 20 6126 04:03:42,374 --> 04:03:43,775 MINUTES BAOF THE THE CONCLUDING 6127 04:03:43,842 --> 04:03:45,610 TIME SO I WILL MAKE IT SUPER 6128 04:03:45,677 --> 04:03:50,482 QUICK BUT I WANT TO THANK 6129 04:03:50,549 --> 04:03:52,584 LAWRENCE FOR CONCEIVING OF THIS 6130 04:03:52,651 --> 04:03:54,720 INCREDIBLE WORKSHOP, IT'S BEEN A 6131 04:03:54,786 --> 04:03:56,488 TRUE WHIRL WIND FROM LIKE 6132 04:03:56,555 --> 04:03:58,156 STARTING WITH PUBLICLY AVAILABLE 6133 04:03:58,223 --> 04:04:01,626 DATA RESOURCES TO LOOKING AT 6134 04:04:01,693 --> 04:04:04,262 MEASUREMENT ISSUES, METHODS, THE 6135 04:04:04,329 --> 04:04:04,930 DEMOGRAPHIC AND DEGEOGRAPHIC, 6136 04:04:04,997 --> 04:04:08,300 THERE HAVE BEEN SO MANY 6137 04:04:08,367 --> 04:04:10,902 INCREDIBLE TOPICS INCLUDING, YOU 6138 04:04:10,969 --> 04:04:14,439 KNOW SLEEP DISORDERS AND HEALTH 6139 04:04:14,506 --> 04:04:16,508 OUTCOMES AND LIKE SUCH A RANGE 6140 04:04:16,575 --> 04:04:20,645 AND I WAS INSPIRED BY AZIZI 'S 6141 04:04:20,712 --> 04:04:22,280 START WHEN HE SAYS I'M SO 6142 04:04:22,347 --> 04:04:23,348 GRATEFUL BECAUSE I AM ALSO SO 6143 04:04:23,415 --> 04:04:24,516 GRATEFUL THAT WE HAVE THIS 6144 04:04:24,583 --> 04:04:27,019 COMMUNITY AND HOPE THAT WE CAN 6145 04:04:27,085 --> 04:04:28,754 CONTINUE TO WORK TOGETHER AND 6146 04:04:28,820 --> 04:04:30,155 MAKE CONNECTION ANDS HOPEFULLY 6147 04:04:30,222 --> 04:04:33,892 MEET UP IN HOUSTON OR OTHER 6148 04:04:33,959 --> 04:04:36,428 SLEEP MEETINGS AND I WAS 6149 04:04:36,495 --> 04:04:39,631 REMINDED DURING THESE PAST FEW 6150 04:04:39,698 --> 04:04:42,000 DAYS, OF ABOUT 20 YEARS AGO, I 6151 04:04:42,067 --> 04:04:45,604 SAW A TALK ABOUT DR. STICKGOLD, 6152 04:04:45,670 --> 04:04:47,472 WHO USED TO RUN THE CENTER FOR 6153 04:04:47,539 --> 04:04:49,207 SLEEP AND COGNITION AT HARVARD, 6154 04:04:49,274 --> 04:04:55,480 AND HE ENDED THIS TALK WITH SOME 6155 04:04:55,547 --> 04:04:57,349 PICTURES OF AFRICAN AMERICAN 6156 04:04:57,416 --> 04:05:00,952 KIDS SLEEPING IN ROOMS THAT WERE 6157 04:05:01,019 --> 04:05:02,120 CROWDED OR CLUTTERED AND HE SAID 6158 04:05:02,187 --> 04:05:03,455 YOU KNOW WHAT LEAP IS SO 6159 04:05:03,522 --> 04:05:05,924 IMPORTANT FOR LEARNING BUT WE 6160 04:05:05,991 --> 04:05:09,361 DON'T KNOW ANYTHING ABOUT THE 6161 04:05:09,428 --> 04:05:09,861 DEMOGRAPHICS OF SLEEP. 6162 04:05:09,928 --> 04:05:11,496 AND HE SAID THAT TO ME AND THAT 6163 04:05:11,563 --> 04:05:14,032 INSPIRES ME TO SAY, HEY, WHAT 6164 04:05:14,099 --> 04:05:16,968 WOPPULATION BASED DATA IS 6165 04:05:17,035 --> 04:05:18,603 AVAILABLE TO LOOK AT DISPARITIES 6166 04:05:18,670 --> 04:05:21,973 IN SLEEP AND THE DEMOGRAPHICS 6167 04:05:22,040 --> 04:05:23,041 OR, YOU KNOW, DEMOGRAPHY OF 6168 04:05:23,108 --> 04:05:26,378 SLEEP AND AT THE TIME THERE WAS 6169 04:05:26,445 --> 04:05:29,381 VERY LITTLE, THAT'S WHEN I 6170 04:05:29,448 --> 04:05:31,683 LOOKED AT NHS, AND NHANES BUT IF 6171 04:05:31,750 --> 04:05:33,552 YOU ATTEND TODAY OR PAST 2 DAYS, 6172 04:05:33,618 --> 04:05:34,853 THERE'S SO MUCH MORE, SO MUCH 6173 04:05:34,920 --> 04:05:40,125 MORE OPPORTUNITY AND MY CALL FOR 6174 04:05:40,192 --> 04:05:41,760 ALL OF YOU IS TO LEARN FROM EACH 6175 04:05:41,827 --> 04:05:42,961 OTHER AS I'VE LEARNED FROM YOU 6176 04:05:43,028 --> 04:05:46,932 AND SAY HOW CAN WE HARNESS ALL 6177 04:05:46,998 --> 04:05:48,100 OF THIS EXPLOSIVE DATA 6178 04:05:48,166 --> 04:05:50,502 OPPORTUNITY AND NEW METHODS OF 6179 04:05:50,569 --> 04:05:53,371 MEASURING AND ANALYZING DATA FOR 6180 04:05:53,438 --> 04:05:56,341 GOOD, TO HELP IMPROVE NOT JUST 6181 04:05:56,408 --> 04:05:58,610 SLEEP, BUT BEING ESPECIALLY AT 6182 04:05:58,677 --> 04:05:59,578 THE MOST VULNERABLE POPULATION 6183 04:05:59,644 --> 04:06:01,246 EMPLOY SO I THINK WE ALL CARRIED 6184 04:06:01,313 --> 04:06:02,747 THAT SORT OF UNDERLYING MESSAGE 6185 04:06:02,814 --> 04:06:04,249 WITH US OVER LAST 2 DAYS BUT 6186 04:06:04,316 --> 04:06:06,118 WHAT I WANT US TO DO IS MAKE 6187 04:06:06,184 --> 04:06:08,086 SURE THAT WE CARRY IT FORWARD 6188 04:06:08,153 --> 04:06:10,922 AND STAY CONNECTED AND I THINK 6189 04:06:10,989 --> 04:06:12,324 SEAN HAD A COUPLE OTHER REMARKS 6190 04:06:12,390 --> 04:06:15,360 AND THEN WE'RE GOING TO HAVE 6191 04:06:15,427 --> 04:06:16,428 DR. BAZER WRAP US UP WITH WHAT 6192 04:06:16,495 --> 04:06:18,663 THE GOALS ARE FOR NHLBI AND WHAT 6193 04:06:18,730 --> 04:06:19,831 THE NEXT STEPS ARE. 6194 04:06:19,898 --> 04:06:24,503 SO SEAN, DO YOU WANT TO POP ON? 6195 04:06:24,569 --> 04:06:24,769 >> SURE. 6196 04:06:24,836 --> 04:06:26,104 SO YEAH, THANK YOU. 6197 04:06:26,171 --> 04:06:28,773 SO I AGREE WITH ALL OF THOSE 6198 04:06:28,840 --> 04:06:30,142 POINTS AND I GUESS I'LL QUICKLY 6199 04:06:30,208 --> 04:06:33,512 JUST TRY TO TAKE THE CO-CHAIR'S 6200 04:06:33,578 --> 04:06:34,346 PREROGATIVE TO HIGHLIGHT 1 THING 6201 04:06:34,412 --> 04:06:37,682 THAT TRUCK ME RELATE TOTD FUTURE 6202 04:06:37,749 --> 04:06:38,350 DIRECTIONS AND CHALLENGES, SO AS 6203 04:06:38,416 --> 04:06:40,452 I SEE IT WE COVERED ADVANCES IN 6204 04:06:40,519 --> 04:06:43,221 THE DATA SETS, DEVICES AND 6205 04:06:43,288 --> 04:06:44,923 PREDICTIVE NL MODELS AND TO ME, 6206 04:06:44,990 --> 04:06:46,057 TO A FIRST APPROXIMATION, MY 6207 04:06:46,124 --> 04:06:48,360 SENSE WAS THAT AT LEAST IN THE 6208 04:06:48,426 --> 04:06:50,695 RESEARCH SLEEP FIELD, IT'S VERY 6209 04:06:50,762 --> 04:06:52,197 SUCCESSFULLY ON TRACK FOR 6210 04:06:52,264 --> 04:06:53,064 LEVERAGES MANY OF THESE ADVANCES 6211 04:06:53,131 --> 04:06:54,900 AND I THINK IN MANY WAYS IT'S 6212 04:06:54,966 --> 04:06:56,535 PROBABLY A NO BRAINER BUT IF A 6213 04:06:56,601 --> 04:06:59,137 RESEARCH FIELD CAN AND WILL 6214 04:06:59,204 --> 04:07:01,006 BENEFIT FROM AN OLD MINTED 6215 04:07:01,072 --> 04:07:03,041 ARSENAL OF MEASURES AND TOOLS, I 6216 04:07:03,108 --> 04:07:03,542 THINK GOING FORWARDS 2 6217 04:07:03,608 --> 04:07:06,811 PRIORITIES THAT WERE TOUCHED ON, 6218 04:07:06,878 --> 04:07:08,680 THE NEED FOR SUSTAINED EFFORTS 6219 04:07:08,747 --> 04:07:10,115 AND SUSTAIN ARDIZEATION AS 6220 04:07:10,182 --> 04:07:11,183 EVALUATION OF TOOLS AS DATA 6221 04:07:11,249 --> 04:07:14,152 SHARING AND JUST AS IMPORTANT AS 6222 04:07:14,219 --> 04:07:15,554 WE DISCUSSED, WE NEED ONGOING 6223 04:07:15,620 --> 04:07:17,322 WORK TO SIN SURE THAT BOTH 6224 04:07:17,389 --> 04:07:18,823 DEVICES AND MODELS PERFORM 6225 04:07:18,890 --> 04:07:22,394 EQUIVALENT LYE IN DIFFERENT 6226 04:07:22,460 --> 04:07:23,061 POPULATIONS WITHOUT BIAS. 6227 04:07:23,128 --> 04:07:24,229 N1 THING I THOUGHT WAS 6228 04:07:24,296 --> 04:07:26,097 INTERESTING AND SO IF I HAD TO 6229 04:07:26,164 --> 04:07:27,766 MAKE A PREDICTION ABOUT FUTURE 6230 04:07:27,832 --> 04:07:28,433 DIRECTIONS AND POTENTIALLY 6231 04:07:28,500 --> 04:07:29,334 FORMING ISSUES IN AM CANNING 6232 04:07:29,401 --> 04:07:30,869 YEARS BUT I THINK IN ADDITION TO 6233 04:07:30,936 --> 04:07:31,937 EVERYTHING THAT DR. BRIDGES 6234 04:07:32,003 --> 04:07:33,572 TALKED ABOUT IN THE CLINICAL 6235 04:07:33,638 --> 04:07:35,507 CONTEXT, I THINK SOMETHING ELSE 6236 04:07:35,574 --> 04:07:36,575 WE MAY FIND OURSELVES TALKING 6237 04:07:36,641 --> 04:07:39,244 ABOUT IS REALLY THE ROLE OF 6238 04:07:39,311 --> 04:07:40,645 GENERATIVE, RATHER THAN 6239 04:07:40,712 --> 04:07:43,281 PREDICTIVE AI IN THIS CONTEXT. 6240 04:07:43,348 --> 04:07:44,950 SO THIS OBVIOUSLY WASN'T A FOCUS 6241 04:07:45,016 --> 04:07:48,119 OF THIS MEETING AND IT HASN'T 6242 04:07:48,186 --> 04:07:49,187 REALLY EMERGED IN SLEEP RESEARCH 6243 04:07:49,254 --> 04:07:51,990 YET BUT I WAS--YOU KNOW I WAS 6244 04:07:52,057 --> 04:07:54,626 IMPRESSED THAT DR. KATABI'S 6245 04:07:54,693 --> 04:07:57,295 EXCELLENT TALK LEFT US WITH A 6246 04:07:57,362 --> 04:07:58,797 KIND OF PROVOCATIVE GLIMPSE OF 6247 04:07:58,863 --> 04:08:00,398 GENERATIVE AI AND MAKING 6248 04:08:00,465 --> 04:08:01,433 PARALENS 6249 04:08:01,499 --> 04:08:02,567 PARALLELWITH THE WORLD'S MOST 6250 04:08:02,634 --> 04:08:06,071 WELL KNOWN EXAMPLE OF GENERATIVE 6251 04:08:06,137 --> 04:08:08,139 AI AND FOR CHAT GPT. 6252 04:08:08,206 --> 04:08:09,941 AND WITHOUT A DOUBT THERE'S 6253 04:08:10,008 --> 04:08:11,076 FANTASTIC POTENTIAL AND WE'RE 6254 04:08:11,142 --> 04:08:11,910 SEEING EMERGE FREE RADICALS 6255 04:08:11,977 --> 04:08:13,912 GENERATED OTHER FEEM FIELDS FROM 6256 04:08:13,979 --> 04:08:14,913 PROTEIN PREDICTION AND MEDICAL 6257 04:08:14,980 --> 04:08:17,249 IMAGES AND SO ON, AND YOU CAN 6258 04:08:17,315 --> 04:08:21,786 IMAGINE NONCONTROVERSIAL USES, 6259 04:08:21,853 --> 04:08:22,754 GENETIC DATA SETS, DENOISING 6260 04:08:22,821 --> 04:08:24,522 IMAGES AND SO ON, AND ACTUALLY 6261 04:08:24,589 --> 04:08:26,258 IN SOME SLEEP TAIJING MODELS USE 6262 04:08:26,324 --> 04:08:28,126 IT SAY FOR DATA AUGMENTATION TO 6263 04:08:28,193 --> 04:08:30,428 HELP TRAIN THE MODELS. 6264 04:08:30,495 --> 04:08:32,397 WHY I SAY IT'S THORNY IS IT DOES 6265 04:08:32,464 --> 04:08:34,899 IN SOME WAY AND IT BLURS THE 6266 04:08:34,966 --> 04:08:38,670 LINE BETWEEN MEASUREMENT OR DATA 6267 04:08:38,737 --> 04:08:41,640 AND THEN MODEL OR ANALYSIS, WITH 6268 04:08:41,706 --> 04:08:42,607 THIS SECOND ARROW GOING 6269 04:08:42,674 --> 04:08:44,242 BACKWARDS BETWEEN THEM AND SO 6270 04:08:44,309 --> 04:08:46,544 INHERENTLY FOR US THERE ARE SOME 6271 04:08:46,611 --> 04:08:48,280 LIMITS THERE, WE DO APPRECIATE 6272 04:08:48,346 --> 04:08:50,015 THE CHAT GPT REFERENCE WAS JUST 6273 04:08:50,081 --> 04:08:51,916 AN EXAMPLE, TO FRAME THINGS AND 6274 04:08:51,983 --> 04:08:53,852 NOT MEANT TO BE TAKEN LITERALLY 6275 04:08:53,918 --> 04:08:56,154 BUT JUST TO USE THAT NONETHELESS 6276 04:08:56,221 --> 04:08:59,691 AS THE MEASUREMENT TOOL, RIGHT? 6277 04:08:59,758 --> 04:09:02,093 , THE EXACT ANALOGY WOULD 6278 04:09:02,160 --> 04:09:02,994 INVOLVE GENERATING 1 PARTICULAR 6279 04:09:03,061 --> 04:09:04,963 IMAGE OF A KIND OF PARTICULAR 6280 04:09:05,030 --> 04:09:08,533 DOG OR WHATEVER IT WAS, GIVEN 6281 04:09:08,600 --> 04:09:08,967 THE LIMITED PROMPT. 6282 04:09:09,034 --> 04:09:11,536 AS IT IS OF COURSE IT WOULD 6283 04:09:11,603 --> 04:09:13,405 DPENERATE JUST A RANDOM IMAGE 6284 04:09:13,471 --> 04:09:14,572 CONSISTENT WITH THE PROMPT BUT 1 6285 04:09:14,639 --> 04:09:15,640 THAT WILL BE DIFFERENT EACH TIME 6286 04:09:15,707 --> 04:09:17,275 YOU RUN IT SO OBVIOUSLY JUST 6287 04:09:17,342 --> 04:09:20,145 DIFFERS FROM THE TYPICAL CONCEPT 6288 04:09:20,211 --> 04:09:22,013 OF MORE REFINED MEASURE AM SO 6289 04:09:22,080 --> 04:09:23,281 IT'S A PURPOSELY BLUNT STRONG 6290 04:09:23,348 --> 04:09:25,383 MAN I BEING GIVE A SLEEP TECH A 6291 04:09:25,450 --> 04:09:26,685 BOX OF CRAYONS AND THEY WOULD BE 6292 04:09:26,751 --> 04:09:29,254 ABLE TO DRAW ME A SPECTROGRAM 6293 04:09:29,321 --> 04:09:30,855 THAT LOOKED SUPERFICIALLY 6294 04:09:30,922 --> 04:09:32,891 CONSISTENT WITH A GIVEN HIPIT 6295 04:09:32,957 --> 04:09:35,226 GRAM BUT WE WOULDN'T ASSUME THAT 6296 04:09:35,293 --> 04:09:36,795 PROVIDES A NEW MEANINGFUL LAYER 6297 04:09:36,861 --> 04:09:38,630 OF SOLUTION, I AM NOT SAYING 6298 04:09:38,697 --> 04:09:40,198 THIS PARTICULAR MODEL IS DOING 6299 04:09:40,265 --> 04:09:41,666 NOTHING MORE THAN THAT, I AM 6300 04:09:41,733 --> 04:09:43,368 SURE IT IS AND I DON'T MEAN TO 6301 04:09:43,435 --> 04:09:45,770 PLAY DOWN THE POTENTIAL FOR 6302 04:09:45,837 --> 04:09:48,406 GENERATIVE AI BUT IT STRUCK ME 6303 04:09:48,473 --> 04:09:51,576 AS KNOWING HOW CLOSE WE ARE TO 6304 04:09:51,643 --> 04:09:52,410 THAT SUPERFICIAL ANSWER WHERE 6305 04:09:52,477 --> 04:09:55,013 SOMETHING IS REALLY ADDING TO TD 6306 04:09:55,080 --> 04:09:56,815 DATA, I THINK IS JUST GOING TO 6307 04:09:56,881 --> 04:09:58,650 BE INCREDIBLE LOAMACYY 6308 04:09:58,717 --> 04:10:00,352 CHALLENGING SO I THINK IT WILL 6309 04:10:00,418 --> 04:10:02,454 BE FOR BEYOND PREDICTIVE MODELS, 6310 04:10:02,520 --> 04:10:04,122 A WHOLE NEW SET OF CAPABILITIES 6311 04:10:04,189 --> 04:10:05,857 BUT WITH THAT INCREASED POWER, I 6312 04:10:05,924 --> 04:10:08,593 THINK WILL BE MANY, MANY MORE 6313 04:10:08,660 --> 04:10:10,095 CHALLENGES BUT WILL REALLY 6314 04:10:10,161 --> 04:10:11,763 PROMPT US TO YOU KNOW THINK 6315 04:10:11,830 --> 04:10:13,832 CAREFULLY AND I THINK BE 6316 04:10:13,898 --> 04:10:15,500 CAUTIOUS IN ROLLING OUT SOME OF 6317 04:10:15,567 --> 04:10:17,769 THOSE TECHNOLOGIES, I WILL END 6318 04:10:17,836 --> 04:10:20,872 THERE, AND HAND IT OVER TO LARRY 6319 04:10:20,939 --> 04:10:23,108 WHO I WILL JUST THANK ONCE MORE 6320 04:10:23,174 --> 04:10:24,509 JOINING MY CO-CHAIR FOR 6321 04:10:24,576 --> 04:10:25,443 ORGANIZING THIS MEETING WHICH 6322 04:10:25,510 --> 04:10:26,845 HAS BEEN IMRAIT NTHANK YOU SO 6323 04:10:26,911 --> 04:10:28,747 MUCH TO THE CO-CHAIRS AND THE 6324 04:10:28,813 --> 04:10:29,814 WONDERFUL SPEAKS AND EVERYBODY 6325 04:10:29,881 --> 04:10:31,116 THAT PARTICIPATE INDEED IN 6326 04:10:31,182 --> 04:10:31,349 MEETING. 6327 04:10:31,416 --> 04:10:34,319 I AM ECHO LAUREN'S KIND OF 6328 04:10:34,386 --> 04:10:35,487 CONCLUSION, TAKE HOME MESSAGE 6329 04:10:35,553 --> 04:10:36,888 FROM THIS TAKE HOME MEETING FOR 6330 04:10:36,955 --> 04:10:38,757 ME ANYWAY AND HOPEFULLY FOR THE 6331 04:10:38,823 --> 04:10:41,860 NIH AS WELL WITH REGARD TO SLEEP 6332 04:10:41,926 --> 04:10:43,128 HEALTH, PARTICULARLY BUT MAYBE 6333 04:10:43,194 --> 04:10:44,329 WITH REGARD TO HEALTH OVERALL, 6334 04:10:44,396 --> 04:10:45,497 IT BEINGLY FOR THE SESSIONS 6335 04:10:45,563 --> 04:10:49,534 TODAY WE HEARD ABOUT THE VAST 6336 04:10:49,601 --> 04:10:51,302 NUMBER OF INDIVIDUAL INFLUENCES 6337 04:10:51,369 --> 04:10:54,839 AND ENVIRONMENTAL INFLUENCES ON 6338 04:10:54,906 --> 04:10:56,274 SLEEP AND SLEEP HEALTH AND WE'RE 6339 04:10:56,341 --> 04:10:57,909 JUST BEGINNING TO UNDERSTAND 6340 04:10:57,976 --> 04:10:59,844 WHAT THOSE INFLUENCES ARE AND 6341 04:10:59,911 --> 04:11:01,146 IDIDN'TIFY THEM, LET ALONE 6342 04:11:01,212 --> 04:11:02,814 FIGURE OUT WHAT IT REALLY MEANS 6343 04:11:02,881 --> 04:11:04,682 TO HAVE THOSE INFLUENCES ACTING 6344 04:11:04,749 --> 04:11:08,953 IN CONCERT ON AN INDIVIDUAL 6345 04:11:09,020 --> 04:11:10,789 POPULATION, WHATEVER, THE 6346 04:11:10,855 --> 04:11:11,956 VECTORS BECOME ALMOST 6347 04:11:12,023 --> 04:11:13,224 OVERWHELMING, IN TERMS OF THE 6348 04:11:13,291 --> 04:11:15,026 AMOUNT OF DATA WE WANT TO 6349 04:11:15,093 --> 04:11:15,860 INCORPORATE, THERE, BUT 6350 04:11:15,927 --> 04:11:18,363 THANKFULLY WE DO HAVE THE TOOLS, 6351 04:11:18,430 --> 04:11:19,197 THAT WERE DESCRIBED YESTERDAY 6352 04:11:19,264 --> 04:11:22,300 WHERE WE COULDN'T START THE DEAL 6353 04:11:22,367 --> 04:11:24,836 WITH THIS ENORMOUS AMOUNT OF 6354 04:11:24,903 --> 04:11:26,504 DATA AND MAKE SENSE OF IT NERMAL 6355 04:11:26,571 --> 04:11:28,506 ITS OF RATIONAL OUTCOMES OF WHAT 6356 04:11:28,573 --> 04:11:31,276 THESE ENORMOUS NUMBERS OF 6357 04:11:31,342 --> 04:11:32,076 INFLUENZS BECAUSE THEY'RE FAIRLY 6358 04:11:32,143 --> 04:11:33,445 PREVALENT IN SOME ENVIRONMENTS 6359 04:11:33,511 --> 04:11:35,280 CAN HAVE ON HEALTH AND SLEEP 6360 04:11:35,346 --> 04:11:37,282 HEALTH IN PARTICULAR, LIKEWISE, 6361 04:11:37,348 --> 04:11:41,319 BOTH YESTERDAY, AND TODAY, WE 6362 04:11:41,386 --> 04:11:43,188 KIND OF QUESTIONED THE 6363 04:11:43,254 --> 04:11:44,088 TRADITIONAL METRICS OF SLEEP 6364 04:11:44,155 --> 04:11:45,523 HEALTH AND GOOD SLEEP AND THOSE 6365 04:11:45,590 --> 04:11:47,759 KINDS OF THINGS WOO WE WONDERED 6366 04:11:47,826 --> 04:11:51,463 THROUGH DISCUSSIONS YESTERDAY 6367 04:11:51,529 --> 04:11:53,298 AND ALSO KIND OF SPEILING OVER 6368 04:11:53,364 --> 04:11:54,699 INTO TODAY WHETHER WE'RE REALLY 6369 04:11:54,766 --> 04:11:56,000 GETTING A COMPLETE PICTURE OF 6370 04:11:56,067 --> 04:11:57,402 SLEEP HEALTH AND GOOD SLEEP AND 6371 04:11:57,469 --> 04:11:58,603 THOSE KINDS OF THINGS IN 6372 04:11:58,670 --> 04:12:03,274 INDIVIDUALS OR IN 6373 04:12:03,341 --> 04:12:04,409 POPULATIONSUING THE TRADITIONAL 6374 04:12:04,476 --> 04:12:06,478 METRICS WE'RE STILL USING AND 6375 04:12:06,544 --> 04:12:08,580 FOR EXAMPLE, 1 THING WE MAY NOT 6376 04:12:08,646 --> 04:12:10,014 HAVE PAID ATTENTION TO ENOUGH 6377 04:12:10,081 --> 04:12:10,782 AND PATIENT REPORTED OUTCOMES 6378 04:12:10,849 --> 04:12:12,484 AND SOME OF THE TALKS HAVE 6379 04:12:12,550 --> 04:12:13,518 SHOWN, MAYBE THAT'S AN IMPORTANT 6380 04:12:13,585 --> 04:12:18,356 THING TO CONSIDER WHEN WE'RE 6381 04:12:18,423 --> 04:12:20,658 KIND OF QUANTIFYING SLEEP 6382 04:12:20,725 --> 04:12:22,660 HEALTH, INFLUENCES OF 6383 04:12:22,727 --> 04:12:24,028 THERAPEUTICS INFLUENCES OF OTHER 6384 04:12:24,095 --> 04:12:24,762 THINGS ON SLEEP HEALTH. 6385 04:12:24,829 --> 04:12:26,431 I THINK WHAT WE WANT TO DO WITH 6386 04:12:26,498 --> 04:12:28,867 NIH IS GET A COMPREHENSIVE 6387 04:12:28,933 --> 04:12:30,401 PICTURE OF THE INFLUENCES ON 6388 04:12:30,468 --> 04:12:33,905 SLEEP HEGHT, THESE ENVIRONMENTAL 6389 04:12:33,972 --> 04:12:35,306 INFLUENCES AND USE PROBABLY AI 6390 04:12:35,373 --> 04:12:40,011 TO DO THAT AND LIKEWISE, GET A 6391 04:12:40,078 --> 04:12:41,479 COMPREHENSIVE PICTURE OF WHAT 6392 04:12:41,546 --> 04:12:44,716 SLEEP HEALTH IS, AND THERA'S SO 6393 04:12:44,782 --> 04:12:46,017 MANY VARIABLES THERE, THAT WE'RE 6394 04:12:46,084 --> 04:12:48,152 GOING TO RELY ON THAT MACHINE 6395 04:12:48,219 --> 04:12:49,187 LEARNING DATABASE TOOLS, WE 6396 04:12:49,254 --> 04:12:51,022 HEARD ABOUT YESTERDAY, TO REALLY 6397 04:12:51,089 --> 04:12:53,691 KIND OF GENERATE THIS KIND OF 6398 04:12:53,758 --> 04:12:55,593 OVERALL COMPLETE PICTURE OF WHAT 6399 04:12:55,660 --> 04:12:57,462 SLEEP HEALTH IS, WHAT DISTURBS 6400 04:12:57,529 --> 04:12:58,730 SLEEP HEALTH AND WHAT WE CAN DO 6401 04:12:58,796 --> 04:13:00,298 ABOUT THAT IN THE FUTURE AND 6402 04:13:00,365 --> 04:13:01,132 HOPEFULLY, THAT'S SOMETHING THAT 6403 04:13:01,199 --> 04:13:04,369 COULD BE A FUTURE PRIORITY OF 6404 04:13:04,435 --> 04:13:05,570 NIH BECAUSE WE DO HAVE THESE 6405 04:13:05,637 --> 04:13:08,439 TOOLS AVAILABLE AND WE ARE 6406 04:13:08,506 --> 04:13:09,607 STARTING TO IDENTIFY, WHAT IS IT 6407 04:13:09,674 --> 04:13:10,909 WE NEED TO LOOK AT IN THE 6408 04:13:10,975 --> 04:13:12,510 ENVIRONMENT AND WHAT WE REALLY 6409 04:13:12,577 --> 04:13:15,146 NEED TO ASK ABOUT SLEEP THAT 6410 04:13:15,213 --> 04:13:17,849 MAKE ITS GOOD SLEEP, BAD SLEEP, 6411 04:13:17,916 --> 04:13:19,751 DISRUPTED SLEEP, SO HOPEFULLY 6412 04:13:19,817 --> 04:13:21,753 STAY TUNED AND HOPEFULLY WE WILL 6413 04:13:21,819 --> 04:13:23,121 BE LOOKING FOR STIMMULING 6414 04:13:23,187 --> 04:13:26,958 RESEARCH IN THAT DIRECTION IN 6415 04:13:27,025 --> 04:13:28,159 THE FUTURE EMPLOY AND THAT'S 1 6416 04:13:28,226 --> 04:13:29,894 OF THE THINGS I WAS HOPING WOULD 6417 04:13:29,961 --> 04:13:33,464 COME OUT OF THIS WORKSHOP IS A 6418 04:13:33,531 --> 04:13:34,766 MORE COMPREHENSIVE PICTURE OF 6419 04:13:34,832 --> 04:13:35,934 INFLUENCES ON SLEEP AND WHAT 6420 04:13:36,000 --> 04:13:38,603 SLEEP REALLY IS AND HOW AI CAN 6421 04:13:38,670 --> 04:13:40,138 HELP US UNDERSTAND THOSE KINDS 6422 04:13:40,204 --> 04:13:41,773 OF THINGS SEPARATELY IN AN 6423 04:13:41,839 --> 04:13:42,607 AGGREGATE AND PROBABLY MOST OF 6424 04:13:42,674 --> 04:13:44,242 THE PEOPLE WHO GAVE 6425 04:13:44,309 --> 04:13:46,044 PRESENTATIONS YESTERDAY, MAY NOT 6426 04:13:46,110 --> 04:13:49,547 BE ON THIS CALL TODAY, BUT WHAT 6427 04:13:49,614 --> 04:13:52,584 MY SORT OF SHORT-TERM GOAL FOR 6428 04:13:52,650 --> 04:13:54,118 THIS--FOR THE RESULTS FOR THIS 6429 04:13:54,185 --> 04:13:55,853 WORKSHOP THIS MORNING, THIS 6430 04:13:55,920 --> 04:13:58,089 WONDERFUL WORKSHOP SO MANY GOOD 6431 04:13:58,156 --> 04:13:58,756 DISCUSSIONS AND PRESENTATIONS, 1 6432 04:13:58,823 --> 04:14:01,893 OF THE SHORT-TERM GOAL IS TO 6433 04:14:01,960 --> 04:14:03,861 PUBLISH A MANUSCRIPT SUMMARIZING 6434 04:14:03,928 --> 04:14:05,029 RESULTS BECAUSE I REALLY WANT TO 6435 04:14:05,096 --> 04:14:08,800 GET THEM OUT THERE SO WE HAVE 6436 04:14:08,866 --> 04:14:11,803 RECORDINGS FROM THE SESSIONS, I 6437 04:14:11,869 --> 04:14:14,105 HAVE A VERY DILIGENT SCIENCE 6438 04:14:14,172 --> 04:14:14,906 WRITER WHO'S TAKING EVERYTHING 6439 04:14:14,973 --> 04:14:17,675 DOWN, I HAVE YOUR SLIDES AS A 6440 04:14:17,742 --> 04:14:22,513 RESULT, THE RECORDINGS, AND YOU 6441 04:14:22,580 --> 04:14:23,915 SENT US ALL YOUR SLIDES AND WE 6442 04:14:23,982 --> 04:14:26,150 HAVE THEM ALL IN OUR FILES AT 6443 04:14:26,217 --> 04:14:27,785 NIH BUT I TILL MAY HAVE 6444 04:14:27,852 --> 04:14:30,154 QUESTIONS, KIND OF NUANCES IN 6445 04:14:30,221 --> 04:14:31,656 THE PRESENTATIONS, NUANCES MAY 6446 04:14:31,723 --> 04:14:33,424 BE IN MY UNDERSTANDINGS OF YOUR 6447 04:14:33,491 --> 04:14:34,726 PRESENTATIONS AS WELL, AND I 6448 04:14:34,792 --> 04:14:37,295 WANT TO MAKE SURE I REPRESENT 6449 04:14:37,362 --> 04:14:38,096 EVERYTHING COMPLETELY ACCURATELY 6450 04:14:38,162 --> 04:14:39,831 AS POSSIBLE, AND GET THIS BIG 6451 04:14:39,897 --> 04:14:42,500 PICTURE OF WHAT WE REALLY KIND 6452 04:14:42,567 --> 04:14:43,935 OF DISCUSSED AND LEARNED FROM 6453 04:14:44,002 --> 04:14:45,203 THIS WORKSHOP AND GET IT 6454 04:14:45,269 --> 04:14:47,572 PUBLISHED SO WE CAN DISSEMINATE 6455 04:14:47,639 --> 04:14:49,107 AS BROADLY AS POSSIBLE TO PEOPLE 6456 04:14:49,173 --> 04:14:51,309 THAT WERE ABLE TO ENJOY THE 6457 04:14:51,376 --> 04:14:53,011 WORKSHOP BUT ALSO PEOPLE WHO ARE 6458 04:14:53,077 --> 04:14:55,213 NOT ABLE TO INVITE OR BE 6459 04:14:55,279 --> 04:14:56,514 INTERESTED IN THESE QUESTIONS, 6460 04:14:56,581 --> 04:14:57,915 SO THANKS AGAIN AND THAT'S WHERE 6461 04:14:57,982 --> 04:14:59,417 THINGS WILL BE GOING, BOTH IN 6462 04:14:59,484 --> 04:15:02,620 THE NEAR FUTURE WITH THE 6463 04:15:02,687 --> 04:15:04,022 MANUSCRIPT AND MAYBE, MAYBE 6464 04:15:04,088 --> 04:15:07,592 DEPENDING AS WE SAY, ON 6465 04:15:07,659 --> 04:15:08,426 AVAILABILITY RESOURCES, AS WE 6466 04:15:08,493 --> 04:15:11,462 SEE AT THE NIH, HOPEFULLY IN 6467 04:15:11,529 --> 04:15:12,630 TERMS OF STIMULATING RESEARCH IN 6468 04:15:12,697 --> 04:15:13,131 THE FUTURE. 6469 04:15:13,197 --> 04:15:15,299 SO THANKS EVERYBODY FOR A 6470 04:15:15,366 --> 04:15:22,173 WONDERFUL SESSION. 6471 04:15:22,240 --> 04:15:25,043 >> ANYTHING ELSE? 6472 04:15:25,109 --> 04:15:25,376 SEAN? 6473 04:15:25,443 --> 04:15:25,610 LAUREN? 6474 04:15:25,677 --> 04:15:28,046 THAIRNGS TO THE WORD, THESE 2 6475 04:15:28,112 --> 04:15:29,347 DPIES WHO HELPED SHAPE THE 6476 04:15:29,414 --> 04:15:31,349 AGENDA FOR THIS AND KEPT IT 6477 04:15:31,416 --> 04:15:35,653 MOVING ALONG, THANKS TO MY 6478 04:15:35,720 --> 04:15:36,821 PROGRAM OFFICER COLLEAGUES, NIH, 6479 04:15:36,888 --> 04:15:39,891 AT THE VARIOUS INSTITUTES, THAT 6480 04:15:39,957 --> 04:15:41,059 ARE INVOLVED IN SLEEP RESEARCH 6481 04:15:41,125 --> 04:15:43,161 AND NIH FOR SERVING AS 6482 04:15:43,227 --> 04:15:44,429 MODERATORS AND THANKS, THANKS 6483 04:15:44,495 --> 04:15:46,664 ABOVE ALL TO THE WONDERFUL 6484 04:15:46,731 --> 04:15:47,598 SPEAKERS WE HAD, REALLY OPEN 6485 04:15:47,665 --> 04:15:48,666 THEIR EYES TO THE NEW 6486 04:15:48,733 --> 04:15:50,735 POSSIBILITIES IN THE FIELD OF 6487 04:15:50,802 --> 04:15:52,270 SLEEP, AND SLEEP HEALTH AND BIG 6488 04:15:52,336 --> 04:15:53,771 DATA AND THE IRPT SECTION AMONG 6489 04:15:53,838 --> 04:15:56,908 ALL THESE DIFFERENT KIND OF 6490 04:15:56,974 --> 04:15:57,842 VARIOUS DIFFERENT STREAMS AND 6491 04:15:57,909 --> 04:16:00,578 THE INSIGHTS WE CAN GAIN FROM 6492 04:16:00,645 --> 04:16:01,145 THAT INTERSECTION. 6493 04:16:01,212 --> 04:16:02,980 SO I HOPE EVERYBODY HAS A 6494 04:16:03,047 --> 04:16:03,981 WONDERFUL WEEKEND. 6495 04:16:04,048 --> 04:16:05,650 IF THERE'S NO MORE COMMENTS, I 6496 04:16:05,717 WILL CLOSE THE MEETING.