WEBVTT 00:01.279 --> 00:03.696 (soft music) 00:10.919 --> 00:13.502 (snappy music) 00:33.030 --> 00:35.280 So I have to tell you 00:35.280 --> 00:38.883 that I have an invisible disability. 00:39.720 --> 00:44.673 It is temporary and it is my shoulder, 00:45.600 --> 00:48.990 so I've been having some shoulder problems, some range 00:48.990 --> 00:50.250 of motion problems 00:50.250 --> 00:54.630 for about a year or two if my wife were here, 00:54.630 --> 00:57.690 she would say it's been going on for four or five years. 00:57.690 --> 00:59.670 I keep telling her, we need a new mattress. 00:59.670 --> 01:02.700 She says, "It's not the mattress, it's your shoulder, 01:02.700 --> 01:04.320 Go see your doctor." 01:04.320 --> 01:05.550 I did. 01:05.550 --> 01:08.250 So my doctor did a little bit of testing 01:08.250 --> 01:11.097 and he said, "Of course, well go get an MRI." 01:12.000 --> 01:14.253 So this is my MRI. 01:15.180 --> 01:17.433 And any radiologist in the room? 01:18.780 --> 01:21.780 So what this shows is a little bit 01:21.780 --> 01:25.980 of rotator cuff deterioration, no tears. 01:25.980 --> 01:30.060 It's got a biceps tendon problem 01:30.060 --> 01:31.920 and it's been causing pain 01:31.920 --> 01:34.680 and that is really what the diagnosis was. 01:34.680 --> 01:36.090 Sat down with the radiologist. 01:36.090 --> 01:38.990 What do you think the radiologist recommended I should do? 01:40.020 --> 01:45.020 Surgery, I didn't really wanna end up like this guy. 01:45.690 --> 01:47.996 I've had friends, I've had family members 01:47.996 --> 01:52.230 get the rotator cuff surgery, it's not fine, it's painful 01:52.230 --> 01:54.840 and it takes six to 12 months to recover from. 01:54.840 --> 01:56.310 So I went back to my doc 01:56.310 --> 01:59.760 and he said, well, why don't you try stem cell therapy? 01:59.760 --> 02:01.530 So stem cell therapy was done 02:01.530 --> 02:05.070 at the Premier Stem Cell Institute in Loveland, 02:05.070 --> 02:08.250 and this was just a week and a half ago. 02:08.250 --> 02:12.630 What they did was they extracted stem cells from bone marrow 02:12.630 --> 02:16.660 out of my hip and reinjected that into my shoulder 02:17.640 --> 02:19.590 and it's actually starting to feel better. 02:19.590 --> 02:22.020 It takes about three to six months for the stem cells 02:22.020 --> 02:24.900 to start making new connective tissue, 02:24.900 --> 02:27.240 but I didn't wanna end up doing this. 02:27.240 --> 02:29.010 Proper diagnosis 02:29.010 --> 02:33.090 led to a really good treatment solution, I think. 02:33.090 --> 02:35.940 I'll be able to report more in about six months, 02:35.940 --> 02:37.503 but so far, so good. 02:38.910 --> 02:41.519 Diagnosis though, is one of the problems 02:41.519 --> 02:46.519 that is starting to gain more awareness in the country. 02:48.120 --> 02:50.910 The National Academy of Sciences 02:50.910 --> 02:55.560 is one of the premier institutes in the US. 02:55.560 --> 02:57.780 It was formed by an act of Congress. 02:57.780 --> 03:00.273 It was signed into law by the president, 03:02.010 --> 03:07.010 this president, and it's been around for over 150 years 03:07.590 --> 03:09.851 and it is populated with members 03:09.851 --> 03:13.672 of top tier universities around the country. 03:13.672 --> 03:17.938 And the purpose of the academy is to advise the nation 03:17.938 --> 03:22.938 on matters of science and technology and medicine 03:24.180 --> 03:28.773 and help us all understand what the state of art is. 03:31.350 --> 03:32.520 They recently came out 03:32.520 --> 03:35.553 with a report called Improving Diagnosis in Healthcare. 03:37.470 --> 03:40.920 When I say recently, this was just last month 03:40.920 --> 03:42.690 that they came out with this report. 03:42.690 --> 03:44.160 They had been working on this study 03:44.160 --> 03:45.610 for the past couple of years. 03:48.000 --> 03:51.908 Some of the highlights of the study indicate 03:51.908 --> 03:56.853 that in a conservative estimate, 5% of us, 03:58.170 --> 04:02.370 seeking outpatient care, will experience a diagnostic error. 04:02.370 --> 04:03.780 Now you think about 5%. 04:03.780 --> 04:07.080 Well, that doesn't seem like a very large number. 04:07.080 --> 04:09.213 That number is actually 12 million people. 04:10.530 --> 04:13.670 So if you think about if you were one of those 12 million... 04:15.420 --> 04:19.300 Postmortem research shows that diagnostic errors contribute 04:19.300 --> 04:23.580 to approximately 10% of patient deaths, 04:23.580 --> 04:25.023 this is all in this report. 04:26.130 --> 04:28.080 Diagnostic errors are the leading type 04:28.080 --> 04:30.423 of paid medical malpractice claims. 04:33.990 --> 04:35.880 The best estimates indicate 04:35.880 --> 04:37.860 that every one of us will experience 04:37.860 --> 04:41.433 a meaningful diagnostic error in our lifetime. 04:42.870 --> 04:45.420 Now, we've had some speakers today talk about some 04:45.420 --> 04:47.310 of the diagnoses that they went through 04:47.310 --> 04:49.233 over and over and over, 04:50.070 --> 04:52.220 hopefully finding the one that was correct. 04:54.510 --> 04:57.183 We find this at CereScan in our own research. 04:58.380 --> 05:00.832 What we have looked at is brain-related 05:00.832 --> 05:02.520 misdiagnosis rates, 05:02.520 --> 05:07.173 TBI is misdiagnosed up to 33% of the time. 05:08.820 --> 05:10.707 Now, Jim was just talking about PTSD. 05:10.707 --> 05:15.707 The symptoms between PTSD and TBI overlap tremendously. 05:16.140 --> 05:19.170 So when you're presenting clinically, 05:19.170 --> 05:23.460 you may not really know what the problem actually is. 05:23.460 --> 05:27.150 It looks a lot alike in the clinic, 05:27.150 --> 05:29.450 but they're actually very different disorders. 05:30.720 --> 05:35.490 ADHD is overdiagnosed, 20% in high school boys. 05:35.490 --> 05:36.990 Boys just tend to wiggle. 05:36.990 --> 05:38.070 They tend to be active. 05:38.070 --> 05:40.410 They tend to be overactive sometimes 05:40.410 --> 05:42.210 and it gets misdiagnosed. 05:42.210 --> 05:47.210 The resulting overmedication of boys in particular 05:48.605 --> 05:50.973 is one of the problems that goes with this. 05:51.930 --> 05:56.100 Bipolar disorder Up to 69% of the time. 05:56.100 --> 06:00.300 If a person is pres presenting in the clinic as depressed, 06:00.300 --> 06:05.220 oftentimes they are diagnosed with depression, 06:05.220 --> 06:07.710 when in fact they may have bipolar 06:07.710 --> 06:11.463 and they're simply on the depression side of that syndrome. 06:12.660 --> 06:16.923 Parkinson's is misdiagnosed up to 25% of the time. 06:18.240 --> 06:21.709 Today, the technology is such that we can give an up 06:21.709 --> 06:25.623 or down diagnosis of Parkinson's using SPECT imaging. 06:28.080 --> 06:31.893 Alzheimer's is misdiagnosed up to 30% of the time. 06:32.970 --> 06:36.690 Frontotemporal dementia is not the same as Alzheimer's 06:36.690 --> 06:39.330 and we heard about Alzheimer's earlier today. 06:39.330 --> 06:41.850 These are two different types of dementia. 06:41.850 --> 06:44.613 We can differentiate that at CereScan. 06:46.470 --> 06:49.740 But this report was about improving diagnosis, 06:49.740 --> 06:52.110 it didn't just get stuck in all the problems 06:52.110 --> 06:53.670 and all the misdiagnosis rates. 06:53.670 --> 06:56.583 It talked about how to go about trying to do that. 06:59.250 --> 07:03.300 Improving the diagnostic process is not only possible, 07:03.300 --> 07:05.830 it represents a moral imperative 07:07.110 --> 07:07.943 and it's something 07:07.943 --> 07:09.900 that the National Academy of Sciences 07:09.900 --> 07:11.523 is pushing more and more today. 07:12.990 --> 07:15.990 There are several recommendations in this report 07:15.990 --> 07:19.770 to improve the utility of health information technology, 07:19.770 --> 07:22.563 data and the diagnostic process. 07:23.490 --> 07:27.630 Health IT, the data that goes with assessments 07:27.630 --> 07:29.670 has the potential to improve diagnosis 07:29.670 --> 07:33.030 and reduce these errors by facilitating timely 07:33.030 --> 07:34.863 and easy access to information. 07:36.870 --> 07:40.710 The mission at CereScan, the reason that we exist, 07:40.710 --> 07:42.450 is to provide the most advanced, 07:42.450 --> 07:46.230 comprehensive brain data analytics 07:46.230 --> 07:48.930 for the purpose of improving diagnoses, 07:48.930 --> 07:51.003 patient outcomes and science. 07:54.450 --> 07:58.590 The struggle that we run into is this type of thing. 07:58.590 --> 08:01.440 When medical doctors think about SPECT imaging, 08:01.440 --> 08:04.110 they're thinking about the way it used to be. 08:04.110 --> 08:08.433 We call this the blob, that's what it is. 08:10.110 --> 08:12.813 You can't diagnose much by looking at this, 08:14.040 --> 08:17.520 but this is what medical professionals, 08:17.520 --> 08:18.930 what doctors think about 08:18.930 --> 08:20.880 when they think about SPECT imaging today, 08:20.880 --> 08:23.670 if they are not up on what's going on. 08:23.670 --> 08:26.670 There is a saying that we have at CereScan, 08:26.670 --> 08:28.200 and you've heard this before, 08:28.200 --> 08:29.490 doctors tend to be down 08:29.490 --> 08:31.340 on the things that they're not up on. 08:33.989 --> 08:36.993 This is what our images look like. 08:38.820 --> 08:41.913 Now, I'll tell you that this is my brain. 08:43.500 --> 08:46.260 It's always a little bit precarious when I drag my brain 08:46.260 --> 08:47.703 out in public like this. 08:50.910 --> 08:52.980 One of the speakers earlier said that we need 08:52.980 --> 08:54.510 to know our brains. 08:54.510 --> 08:56.373 Well, I know my brain. 08:57.780 --> 09:00.010 This was a scan from a couple of years ago 09:01.560 --> 09:03.450 and the first thing to note 09:03.450 --> 09:05.490 about this image is 09:05.490 --> 09:08.313 that when you look at the color scale, gray is good. 09:09.210 --> 09:13.533 Gray is within the normal range of this color palette. 09:14.520 --> 09:17.997 Green is two standard deviations below normal in terms 09:17.997 --> 09:21.543 of cerebral blood flow in that particular region. 09:22.440 --> 09:25.290 Blue is three standard deviations. 09:25.290 --> 09:28.533 Dark blue would be four, black would be five. 09:29.910 --> 09:32.520 Red is actually two standard deviations 09:32.520 --> 09:34.917 above normal in terms of blood flow 09:34.917 --> 09:37.410 and that particular region. 09:37.410 --> 09:40.650 So what we're looking for are patterns of blood flow 09:40.650 --> 09:43.590 in a patient's brain. 09:43.590 --> 09:48.540 Now, what you'll see here are the brain sits inside 09:48.540 --> 09:51.240 of the skull and it has bony ridges. 09:51.240 --> 09:53.910 When I was a kid, I was always hitting my head. 09:53.910 --> 09:56.010 I had my head stitched up a couple of times. 09:56.010 --> 09:58.170 I was in accidents. 09:58.170 --> 10:01.227 I was a fairly typical boy doing boy things 10:01.227 --> 10:03.120 and most boys growing up, 10:03.120 --> 10:06.630 most of the men in this room have probably bumped their head 10:06.630 --> 10:08.433 or knocked their head several times. 10:13.140 --> 10:15.540 Everything that we do though is about data. 10:15.540 --> 10:19.410 We generate nice pictures, but it's based on data. 10:19.410 --> 10:22.350 No one's sitting there coloring the color palette. 10:22.350 --> 10:24.033 This is being produced by data. 10:26.820 --> 10:28.680 We look at normative data. 10:28.680 --> 10:31.980 When we take a patient's images, 10:31.980 --> 10:35.580 the data that we get from that goes through our software 10:35.580 --> 10:38.520 and it's compared to normative databases. 10:38.520 --> 10:43.520 We collect for every scan that we do, 262,000 data points. 10:43.770 --> 10:47.050 It's a 64 by 64 by 64 matrix 10:48.090 --> 10:50.790 of voxels in 3D space, 10:50.790 --> 10:53.763 and it's all compared to normative data. 10:56.160 --> 10:58.380 What we're doing is advanced neuroimaging 10:58.380 --> 11:00.060 and neuro analytics. 11:00.060 --> 11:02.490 So what we do is called qSPECT, 11:02.490 --> 11:06.390 quantitative single photon emission computed tomography. 11:06.390 --> 11:08.463 We also do PET/CT imaging, 11:09.390 --> 11:12.183 this is nuclear medicine using radioisotopes. 11:15.540 --> 11:16.860 Now, let me shift gears for a minute 11:16.860 --> 11:18.210 and tell you about a study. 11:19.920 --> 11:24.920 We know that the veterans that have served our country 11:24.941 --> 11:28.260 have gone through quite a bit 11:28.260 --> 11:32.340 and some of the data that has come out recently 11:32.340 --> 11:34.560 is kind of astonishing. 11:34.560 --> 11:37.023 Military suicides are at their highest rate, 11:38.040 --> 11:41.943 more military deaths by suicide than in combat in 2012, 11:43.350 --> 11:48.350 over 300,000 TBIs in the last 15 years among veterans. 11:52.530 --> 11:55.200 The VA has put out data 11:55.200 --> 12:00.000 that says that there are 22 suicides per day 12:00.000 --> 12:04.833 among veterans in this country, think about that, 12:06.030 --> 12:11.030 22 per day among veterans in this country. 12:13.200 --> 12:15.270 We wanted to do a study 12:15.270 --> 12:17.550 and part of the reason that we wanted to do a study is 12:17.550 --> 12:20.040 that we're looking for things that can help 12:20.040 --> 12:24.303 fix TBI can help reverse the brain damage that we see here, 12:25.530 --> 12:26.643 so we did a study. 12:27.840 --> 12:28.980 And this study was done, 12:28.980 --> 12:31.260 we call it the Invisible Brain Injury Project. 12:31.260 --> 12:33.900 It was funded by the Tug McGraw Foundation. 12:33.900 --> 12:37.350 We partnered with Colorado Neurological Institute, 12:37.350 --> 12:40.170 who provided oversight in this study. 12:40.170 --> 12:41.070 They're a great partner. 12:41.070 --> 12:45.180 They are a great community resource here in Denver 12:45.180 --> 12:46.830 and in Colorado. 12:46.830 --> 12:50.370 Do many, many research projects, it's a small study. 12:50.370 --> 12:53.013 We only had 12 veterans in the study. 12:54.420 --> 12:58.860 TBI, six weeks of treatment three times a week, 12:58.860 --> 13:03.210 Monday, Wednesday, Friday usually, and 20 minutes a session. 13:03.210 --> 13:04.500 When you do the math on that, 13:04.500 --> 13:08.220 that is a total of six hours of treatment. 13:08.220 --> 13:11.400 We wanted to look at the impact of this treatment 13:11.400 --> 13:13.053 on TBI symptoms, 13:14.040 --> 13:16.690 cognitive performance using neuropsych tests 13:17.550 --> 13:19.833 and blood flow using qSPECT. 13:24.510 --> 13:28.833 Again, I want you to think about this is my brain. 13:31.470 --> 13:34.410 This is one of the soldiers that we worked with. 13:34.410 --> 13:38.043 One of the patients, again, think about gray is good. 13:40.380 --> 13:43.140 Dark blue is four standard deviations 13:43.140 --> 13:46.113 below normal black is five standard deviations. 13:47.790 --> 13:51.060 When you talk to this patient, 13:51.060 --> 13:54.030 it was difficult for him to look you in the eye. 13:54.030 --> 13:57.210 He had feelings of rage. 13:57.210 --> 13:59.670 He looked like if you said the wrong thing, 13:59.670 --> 14:02.520 he might explode all over you. 14:02.520 --> 14:03.753 He was depressed. 14:04.710 --> 14:07.680 He had all kinds of the normal symptoms 14:07.680 --> 14:09.453 that we think about with TBI. 14:12.720 --> 14:13.953 This was the treatment, 14:14.970 --> 14:18.112 this is polychromatic light therapy, polychromatic, 14:18.112 --> 14:22.020 because we're using two wavelengths of light here, 14:22.020 --> 14:24.393 red light and near infrared. 14:25.950 --> 14:27.450 Now, this looks a little bit kludgy, 14:27.450 --> 14:29.730 again, this is a pilot study. 14:29.730 --> 14:33.030 So we put together some pads and some devices 14:33.030 --> 14:38.030 and the near infrared and the red lights are transcranial 14:38.310 --> 14:42.573 and they bathe the brain in the light. 14:43.680 --> 14:44.980 And what's happening here 14:46.740 --> 14:48.990 is we are stimulating the production 14:48.990 --> 14:51.960 of a molecule called nitric oxide. 14:51.960 --> 14:54.810 Now, nitric oxide is in our bodies. 14:54.810 --> 14:56.310 It's in the food that we eat. 14:56.310 --> 14:58.020 It's in the medications that we take. 14:58.020 --> 15:00.060 It's in aspirin, it's in morphine, 15:00.060 --> 15:03.003 it's in that little blue pill that some men take for ED. 15:04.650 --> 15:07.260 Nitric oxide is a vasodilator, 15:07.260 --> 15:09.360 It opens up the blood vessels 15:09.360 --> 15:12.750 and that's what's happening in in the brain. 15:12.750 --> 15:15.930 It is opening up damaged blood vessels 15:15.930 --> 15:20.400 in order to generate blood flow through the brain. 15:20.400 --> 15:23.100 Neurons eat glucose 15:23.100 --> 15:26.943 and they need oxygen to be able to metabolize that glucose. 15:27.930 --> 15:31.260 The only thing that gets it there is blood. 15:31.260 --> 15:34.500 You've got to have blood flow going in the brain, 15:34.500 --> 15:35.853 that's what this is doing. 15:39.360 --> 15:40.263 What happened? 15:41.130 --> 15:42.330 These were the symptoms, 15:42.330 --> 15:44.943 we had everyone do a symptoms checklist. 15:46.380 --> 15:48.930 The blue was pre-treatment, 15:48.930 --> 15:52.350 so you look at some of these things, 15:52.350 --> 15:55.710 the first set are all physical kinds of symptoms, headache, 15:55.710 --> 15:58.470 dizziness, sleep problems, et cetera. 15:58.470 --> 16:02.730 The middle ones are really more psychological, 16:02.730 --> 16:05.340 depression, irritability, things like that 16:05.340 --> 16:08.756 and then the last group are really cognitive problems. 16:08.756 --> 16:13.113 Everything went down, symptoms went down, 16:15.119 --> 16:19.590 I'm reminding you that this is six weeks of treatment, 16:19.590 --> 16:21.630 a total of six hours of exposure 16:21.630 --> 16:23.553 to the polychromatic light therapy. 16:25.170 --> 16:28.350 The only one that didn't really register was nausea, 16:28.350 --> 16:30.090 but it never was seemed to be a problem, 16:30.090 --> 16:33.000 at least among these 12 in the first place. 16:33.000 --> 16:34.830 But all of these symptoms went down. 16:34.830 --> 16:37.320 Now, these are self-reported symptoms. 16:37.320 --> 16:39.150 You might say, well, there's placebo 16:39.150 --> 16:40.950 and you can fake that sort of thing. 16:42.540 --> 16:45.090 We also looked at neuropsychological test performance. 16:45.090 --> 16:46.790 Basically looking at subscales 16:46.790 --> 16:48.870 of the Wechsler Adult Intelligence Scale, 16:48.870 --> 16:53.103 which is one of the IQ tests used today. 16:54.630 --> 16:59.190 And what we saw is an improvement across the board 16:59.190 --> 17:02.880 in cognitive performance, auditory learning, 17:02.880 --> 17:06.840 the memory subscales, cognitive processing speed, 17:06.840 --> 17:08.700 all of these got better 17:08.700 --> 17:11.733 from pre-treatment to post-treatment. 17:16.740 --> 17:20.973 So what happened to our one patient's brain? 17:22.320 --> 17:25.290 So as I mentioned this particular one 17:25.290 --> 17:27.030 and and this is kind of typical 17:27.030 --> 17:30.753 of what we saw in this study was pretty messed up. 17:31.650 --> 17:36.630 This is a lot of low blood flow in the brain. 17:36.630 --> 17:38.820 So after six weeks of treatment, 17:38.820 --> 17:40.570 this is what his brain looked like, 17:42.180 --> 17:43.683 it's a remarkable difference. 17:45.060 --> 17:47.730 And the only way that you can get to this sort of thing is 17:47.730 --> 17:51.690 by looking at qSPECT and actually measuring this 17:51.690 --> 17:54.093 and taking a look at blood flow in the brain. 17:58.230 --> 17:59.910 One of the divisions that we have inside 17:59.910 --> 18:01.690 of CereScan is CereLab 18:02.580 --> 18:05.210 and what we're interested in is more research 18:05.210 --> 18:06.903 along these lines. 18:07.740 --> 18:12.643 So, for example, this is a GyroStim. 18:12.643 --> 18:15.726 (GyroStim whooshing) 18:17.850 --> 18:20.700 And what GyroStim is doing here 18:20.700 --> 18:25.080 is basically stimulating the vestibular aspects of the brain 18:26.190 --> 18:28.710 And the marketing on this particular device, 18:28.710 --> 18:31.920 by the way, the inventor lives in Colorado Springs, 18:31.920 --> 18:34.380 it's manufactured here in the state, 18:34.380 --> 18:36.003 but it's sold around the world. 18:37.680 --> 18:39.360 It is stimulating the vestibular 18:39.360 --> 18:41.340 aspects and it's for balance. 18:41.340 --> 18:44.250 Right now the claim is around balance training, 18:44.250 --> 18:47.220 but he believes that this is a therapy 18:47.220 --> 18:51.330 for traumatic brain injury as well. 18:51.330 --> 18:54.993 We don't know. He's had some anecdotal evidence of that. 18:58.350 --> 19:00.633 This is hyperbaric oxygen therapy tank. 19:01.740 --> 19:04.320 There is evidence that HBOT 19:04.320 --> 19:07.443 is doing tremendous things for TBI. 19:08.880 --> 19:11.520 There's certain studies that show that it's very effective 19:11.520 --> 19:13.350 and there's some that, in particular, 19:13.350 --> 19:14.850 the military doesn't seem to think 19:14.850 --> 19:16.680 that it works on military people, 19:16.680 --> 19:18.480 but seems to work in civilians. 19:18.480 --> 19:19.440 I don't quite get that, 19:19.440 --> 19:22.170 but this is a therapy 19:22.170 --> 19:23.670 that we're very interested in. 19:27.060 --> 19:31.350 This is CVAC, cyclical variations and adaptive conditioning. 19:31.350 --> 19:34.950 Essentially you get into this chamber, closes down, 19:34.950 --> 19:38.610 there's a plexiglass thing so you can see out 19:38.610 --> 19:42.390 and it takes you through pressure profiles between sea level 19:42.390 --> 19:44.370 and about 22,000 feet, 19:44.370 --> 19:46.980 up and down, not the whole way. 19:46.980 --> 19:50.010 You might go up to 5,000 back down to two, up to seven, 19:50.010 --> 19:54.030 back down to four, up and down, up and down. 19:54.030 --> 19:58.590 It is for extreme athletes for conditioning, 19:58.590 --> 20:00.540 but they also have found some evidence 20:00.540 --> 20:03.510 that this could be a treatment for traumatic brain injury. 20:03.510 --> 20:04.343 We don't know. 20:07.710 --> 20:12.710 Neurofeedback is a very popular therapy today 20:12.840 --> 20:16.623 for a variety of brain disorders. 20:17.460 --> 20:20.040 We are talking with Denver Sports Recovery. 20:20.040 --> 20:21.210 We had one 20:21.210 --> 20:26.080 of the board certified neurofeedback therapist 20:26.940 --> 20:30.760 from Denver Sports Recovery here today. 20:30.760 --> 20:34.800 But this patient is moving things 20:34.800 --> 20:37.953 using brainwaves in that video game. 20:40.470 --> 20:43.050 Is this a treatment for traumatic brain injury? 20:43.050 --> 20:45.573 Possibly, we don't know. 20:50.760 --> 20:52.770 It doesn't have to be like this, 20:52.770 --> 20:57.770 it doesn't have to be 22 suicides a day. 20:59.850 --> 21:03.660 There actually, I think is a lot of hope 21:03.660 --> 21:07.620 for where we're going, what CereScan is trying to do. 21:07.620 --> 21:10.800 We wanna find out what works, what doesn't work, 21:10.800 --> 21:15.695 and we wanna pursue those things, thank you. 21:15.695 --> 21:18.528 (energetic music) 21:31.064 --> 21:33.481 (soft music)