Think About TOMORROW Today - Man's Coming Interface to Technology

At this point I would like to introduce a Dr Jeff Bird Sutter Hill Ventures who'll introduced tonight's program. Jeff What we like to do I think first is just introduce the the panelists tonight and then they can go back and sit down so that they can see Rob's presentation. Dr. Jackler first if i may just go through and make our introductions. Now first, I'm Jeff Bird I'm at Sutter Hill, I'm a healthcare venture capitalist and was a graduate the MD PhD program at Stanford. I'm pleased to be h

ere with tonight's panelists, who are all professors full professors at Stanford University. So first to the far right to RobJackler, ah, Dr. Robert Jackler, professor and chairman Department the Otolaryngology and Head and Neck Surgery at Stanford Dr. Jackler was recruited to the department Stanford in 2003 prior to that time he was a faculty member is University California San Francisco where he was for seventeen years Dr. Jackler is the author of three books 25 textbook chapters and more tha

n 140 peer-reviewed papers so it's a really our honor to have him here. He's he is a microsurgeon of the ear and another fine structures at the base of the skull he has a keen interest in the human technical interface and technology interface and tonight's title is "Man's Coming Interface to Technology central role of the human ear" So, um, we'll look forward to Rob's talk in just a moment Ah, Stefan Heller PhD, next to my right here is a also professor in the Department of OHNS Otolaryngology

and Head and Neck Surgery at Stanford. Dr. Heller was recruited to Stanford from Harvard in 2006 after describing identification stem cells in the inner ear that could potentially replenish the hair cells that are responsible for hearing And he today leads research effort within the Stanford Institute for, to Cure Hearing Loss who's aim is to have clinical trials for new approaches to curing deafness within the next decade. Finally um, to my left Dr. Anthony Ricci PhD is professor in the Departm

ent at Stanford. Um, Dr. Ricci received his PhD at Tulane University and he's an expert in studying the mechanical function of cells at the atomic level much of his research is also focused on these hair cells that are the very rare receptors in the ear that are responsible for hearing. So they're only 15,000 the cells that you're born with and as we'll hear about they have very special role and as we loose our hearing we start to have that damage to those rare and important cells. Additionally

, Tony studies the mechanisms of damage for instance that occur with the use of certain antibiotics in hearing and he has made advances in and has ideas on the development of antibiotics that are safer as well. So if you'll just join me in thanking everybody for joining we'll start with Dr. Jackler [applause] Can you hear me? I'm an ear doctor it's the first thing I always ask. [laughter] Um, I want to thank Sally especially Krishna, as well, and Tom and all of you for having our group here from

Stanford today. We looked at the invitation it said business casual. I'm a doctor those two guys are scientists. They are in their new business uniform. It's perfectly normal. Now we're going to talk each myself and Dr. Heller for about 15 min and then we hope to have a very interactive discussion with all of you about some of the issues that we're bringing up. We're not only talking about interface technology between human senses and digital devices were also talking about some emerging biote

chnology which is revolutionary in the field of hearing and overcoming. We thought you'd be interested in both and we'll see. I'm even begin talking about the interface between the human body and digital technologies. If you think about what we started doing thirty years ago putting computers on people's desks distributed them in the last twenty years we've been linking them up within the enterprise outside by the internet. With huge advances have been in this area. But if you look at what we're

doing in that last two feet between person and the machine, it is still very primitive it's an area of great advancement I think in the future many great opportunities for innovation. Now the fact that the ear maybe a favored device for communication has been around a long time certainly it was well appreciated in the nineteen sixties, but the point that I'm going to make it tonight the underlying premise is that wearing an ear device will become a ubiquitous feature of modern life as a consume

r electronic product. And it will be more common than wearing a wrist watch. Now, let's talk a little bit about the general field of interface before we settle down in the ear. If you think about the way we input text in the most of our computers it is really very little changed from the era of the Underwood & Smith Corona to today other than in that day you ran out of ribbons and in this device you run out of batteries, which is maddening. Now, a few years ago I talked with Terry Winograd someo

ne many of you may know is the white-haired guy with a bunch of folks that look like high school students I'm but you know I said to him, "you know typing is so slow, even expert typers give very little information." and I've always remembered the answer that he gave me. He said, "you know, think about when a pianist plays Mozart think about the information flow that comes in situation." And he's right the human hands potentially can convey great information. Now you can imagine this sort of in

the Wii, although I don't think we're going to be looking at a hand based device that you can probably throw into your television screen. But probably you not be moving predictable keyboard ways but in some very eloquent and complicated hand motion that conveys information and position. Now of course we all know that we're speaking to our computers and this is really taking off in terms of text, but also in terms of the ability to command and and ask our computers, uh, to do things. Now I'll poi

nt now today the repetitive stress in using the computer is in carpal tunnel syndrome. But what we are going to find soon, as we give running text routinely to our computers, both with instructions and computations is that we're going to be speaking to our family, to our coworkers and to our computer all day if you think about the human vocal cords every time you're talking, they are knocking together like that, and that repetitive stress is going to come the human voice. So we have to develop i

nterface tools that allow very soft voice, so you are not banging together and still to be understandable to the device and that may well be the technological interface to the human larynx that enables something that is sustainable all day long in the different settings. Now, let me focus in on the ear because I think the ear is going to be very high-value real estate in the future, and to point out first of ball that wearing an ear device traditionally has carried a great stigma. If you had a d

evice so your ear, suddenly you are ten years older you lose 20 points of IQ. You are deaf and dumb, right? Now, I'll give you an example, I mean think about it fundamentally, you take a piece of glass metal or plastic, you stick it in front of your face it fundamentally blocks your face in changes your look but somehow culturally we see that as looking stylish, or your smart, or intelligent if you wear glasses. You stick something in your ear, suddenly old and dumb. It's true, and it's actually

more subtle and off to the side. And this is the traditional paradigm of a hearing aid user. In the past. But I will tell you if you go to University Avenue in Palo Alto when you see someone walking along acting like they're talking to Jesus they're probably on a cell phone and they're probably young people and today a senior citizen may go to the Senior Center go "Hey, look what I got!" you know. "Look at this latest sound id" So I'll give you an example of how bad that bias has been: we have

an operation call stapedectomy were you can go in and there is a frozen hearing bone, and you can replace it. It has, it's great success but it has a 1 in 100 change of utter deafness in the ear, no matter how good the surgeon is. LASIK on the other hand can get rid of your eyeglasses no I submit to you if I want to see you I can get rid of you eyeglasses, but there is a 1 in 100 chance of blindness in each eye I do, you'd tell me to totally stop it. There's no way you'd do that. On the other

hand, people routinely submit to ear surgery, to get away from wearing a hearing device, or an ear device. My point is this stigma is evaporating rapidly. It's changing it has very important implications so in the future and really in the present is that these devices canote style youthfulness they're elegant, they're beautiful. You have celebrities... David Beckham soccer player you have Brad Pitt, "Digital Gentlemen" and "Highly Evolved Human" [laughter] Didn't he just have some ad, of a perf

ume or something? Maybe he devolved since then. I don't know. You know, you get bling, and there are jewelry like things, people are proud, these are adornments Even Jesus Christ wears and ear pieces. okay so you know once you've got these things on your ear what you gonna do with them? Well first of all, and it's obvious it becomes your cell phone. And you can control the voice systems in your car that could do this today, "cell phone home." These are some early generation devices. of course

it's and of course it's computer interface device, needless to say, but you know what, it is also your ear pod this ear device can store all of your music, your audio books, but you know you walk into a museum if you want that picture will tell you about itself. You go to cross the road there's a bus coming it screams, "Stop! Look Right!" its a safety thing and you can just let your imagination flow once this thing is tied into knowledge and warnings and interactions not just classic of not ju

st classic with the iPod is there are many places to go with that, you know obviously interface for GPS. Your driving down the street wanna go to 1212 Pleasant Street it certainly is going to be able to tell you that. Now this is something which is profound not as instantaneous translation amongst languages this is not something that's going to reside in the near future simply in a n ear level device. But imagine with Bluetooth are some faster successor of Bluetooth, architectural computers in t

his building, in your home, in a restaurant. You can speak to me in Japanese and I can hear you in English, oh and by the way, if I want to select a nice Cockney British accent or if I want to have a New Orleans accent, Tony, I could choose whatever I would like. This is coming its an access to information there's a web in your ear. So your reaching 1212 Pleasant Street, You say, "Device 1212 Pleasant Street Jon Jones what's his wife's name?" and in your ear comes, "Cynthia." It is also possib

le once you have these devices on everyone's ear as a routine consumer electronic device to improve the human sense in the population at large. So that means, for example, if you want a program that thing so that you can hear a dog whistle you can. It just has to shift the frequency down to alert you. Right? If you want to be able to, you remember the comic books you know listen to people 50 feet away you know across at the party. There are possibilities of doing things like that. Not necessaril

y that you'd want to. But imagine in a sophisticated signal to noise ratio analysis and enhancement, you could sit it in these incredibly noisy restaurant, this this place is wonderful acoustics, but you sit restaurant we just can't understand or hear people you can have this thing analyze the background din and selectively reduce it and augment the frequency distributions in the cadence of speech so that weren't me human sense overall of course they can be programmed to protect you against noi

se injury. When a firecracker goes off, or when you walk by a jackhammer. And of course, right now if you look at the hearing loss world about a third of the people who need a hearing aid wear it. That's the nature of that stigma that's going away, but once these things are in everyone's ear, it's a simple matter to simply program them to accommodate for hearing loss. Now, just to give you an idea with these things can go once you have a telemetry device device on the human body full-time, why n

ot have a health monitor? You're going to be like the 1970s Apollo astronauts completely wired up. This thing can easily measure blood glucose, it can measure oxygen co2 you can have a little sender on the chest, sending EKG up to this device and outward on you can monitor many different physiologic function not just sporadically but in an ongoing way and recorded over time so that when you see your physician not only will they have your genome not only will they have your proteom, they'll also

have your normal physiological function throughout the days. So you worry about hypertension, for example, you know that's a very cyclical very variable thing, going to be able to do a statistical analysis of how that changes overtime. Now let's talk about the design implementation of the interface. Certainly everyone wants to make it subtle not least which these guys because wearing one of those things says simply, what? Shoot me first. [laughter] So modern hearing aids have come along with y

our they can be very subtle in this way presented at the entry of the ear, but I would submit to you presenting a sound the entry of the ear in many situations isn't the best way to do it. And the gradual tendency this for those devices to move further down in the ear even at some point in the future be entirely implanted. Now there are issues about implanting the microphone. One can actually, with piso-ceramic, turn the eardrum into a microphone interestingly enough. But, I think the fully impl

anted devices while there are some out there today in development are not likely to take over. I wanna, uh, mention Rob Perkins many you know kind enough that Rod came today. Rod, I think, has a fabulous new technology it's not yet out on the market, but it's really get into the concept of an extended wear contact lens for the eardrum. That is to say, it's a device the sits on the eardrum here, and it is a photovoltaic and that photovoltaic is powered by laser that shoots down and not only power

s the nanotech motor that drives the first bone of hearing, the malleus but it also conveys to signal. Sound enters the open ear canal naturally having all the resonances from the outer ear and is picked up by the microphone generating a current which travels to the processor. The DSP processes the signal translating it into light pulses which travel down the fiber-optic probe. The light emitted from the probe is captured by the photoreceptor creating a small current which drives the micro motor

to vibrate the eardrum, causing sound to be perceived. So these types of devices at sometime will be very commonly worn, or not only by hearing loss patients, and they will be, this is a wonderful new technology just just paradigm changing. And I'll tell you right away, for those of you who have ever looked at the hearing aid market, it is ridiculously expensive. Thirty dollars worth equipment is charged 2 - 3000 dollars And this is right, you, I actually have a the kid that just came through B

io Design at Stanford was working on a hearing aid based on an iPhone. There's a lot of poor people who can't afford 6000 dollars worth of hearing aids. Now let me shift over from technology to biotechnology, and I'm only gonna be the introduction for my colleague Stefan Heller. But I want to tell you about the biological basis of the hope that we'll be curing hearing loss in the coming years. Now to be able to are really understand this, we have to start understanding how the ear works - is tha

t sound, is that vibrations in air, it strikes the eardrum is carried through a cantilevered series of three bone to the cochlea, which is the actual place were the vibrations are converted to nerve impulses and thense into the brain and upward. So let's just take a close look inside the cochlea which means 'snail' and within the cochlea you have two and three quarter turns there's a membrane that vibrates and on that membrane is the organ called the organ of Corti which is really the business e

nd of the ear. Here's a beautiful illustration by an artist we work with at Stanford showing the hair cells that Stefan is going to talk about these are the cells their apices here the when they then bend, they actually fired. They are like a little variable potentiometers for the engineers in the room and they shoot the signals up. Um, within the cochlea [tone] all these different areas think this like a piano keyboard. There's a place pitch relationship so this group of nerves vs. this group o

f nerves have a different pitch and after the hair cells have bent they send the signal through the first order neurons, down the hearing nerve. Along the nerve towards the brain, and without getting into too much detail they go up to the brainstem to the cortex and thense are integrated into, knowledge, wisdom and hearing and even with vision and other senses. From a medical point of view there are basically two kinds of hearing loss. You're hearing loss that has to do with the ear canal, eard

rum, and hearing bones, and we can usually cure that today, with advances over the last 50 years in micro surgery. Then there's the inner ear which we are essentially nowhere with. There's almost nothing today, but we're on cusp of a revolution that is going to solve that, and I think we're going to be curing all forms of inner ear hearing loss in the coming years. To give you an idea, um, this is an example of the middle of the two bones are missing and we've reconnected with a piece of cerami

c. Here all three hearing bones are missing and there's a piece of titanium that is connecting up that can restore hearing. This is today's technology. If you have a hole in the ear drum, we simply move it aside, take a piece of your own tissue and repair it. 96-98 percent success rate in fixing holes in the eardrum. We've conquered what's called conductive loss. But when you've lost your hair cells when they've dialed back due to blast injury, due to aging, everyone in this room as some hearin

g loss in the high frequencies at very least, overtime. Whether it be medications or illness at effects, those hair cells dying back but the important thing to realize is the nerve does not. There's almost no one has nerve deafness accepting in Eduardo and my practice, but almost no one does, the nerves are still alive, and and because the nerves are still alive this scar, this substrate is what you're going to hear about from Dr. Heller. The concept of rebuilding an organ of Corti putting hair

cells back here and thereby restoring hearing and linking it together with the nerve fibers that still exist. Now there's a device today which is extraordinary called the cochlear implant .This is a multi-channel electronic stimulator, that stimulates the auditory nerve taking advantage little bipolar electrodes that stimulate individual frequency domains of the hearing system. This will take the child or adult who's utterly deaf, and bring them back to hard of hearing. But that is not our goal

today. Our goal is to bring to much better hearing than and of course not require such a surgical procedure. Now, um, what we're talking about is the goal of restoring hair cells with a variety of different means andy I'll leave Stefan to tell what we're largely looking today, very likely, at a variety of different its systems using induced pluripotential cells, or using chemicals that switch on, um, that switch on master regulatory genes, um, or turn on the proteins necessary for hearing, um,

that are missed. So what we have is at Stanford we have the world's leading group on regenerating hearing, and that we're trying and number different lanes in a number of different methods based upon where we are today with the advances in regenerative science as applied to the ear we're very optimistic great deal change is going to happen. So i'm talking to a group of businesspeople technology... What's the market? The market is enormous, something like 36 million Americans have hearing loss,

and probably many many hundreds of millions in the developed world. Two or three of every [thousand] child are born deaf. Now why is the ear the target that might work for stem cells and regeneration? You think about solid organs in the body. If you've lost your liver, all you have is a scared little nodule, no architecture. If you've gone deaf you still have the elegant cochlear spiral, you still have the basal membrane, you still have, um, all the nerves. So that it's not that it's trivial it'

s not, it is challenging, but you have a much greater possibility of doing something based upon that. I just wanted to up acknowledged really the team of folks - you like that picture Stefan? Stefan is a is a wonderful scientist as is Tony Ricci, who will be joining. These people are eminent. They are extraordinary in their field in their creativity this is also the place around the world were people come to learn about these techniques into further these techniques, and with that I think I'll s

tep aside and say --- Can you hear me? Thank you for, thank you Krishna, thank you Sally for having us here, uh, its been a pleasure, and I've been here before once and this is actually quite fascinating group who, coming out of the dungeon of science, um, and talking to people who are really really smart and understand, understand a lot of things that how you bring things market and how science translates into the real world and I think will it's exciting to to be here and exciting to talk to y

ou guys. I'd like to introduce the hair cells. I'm I'm a trained geneticist originally from Germany and I, I, I, cam to the hair cell field because it was fascinating was like the Wild West is a it's a land of opportunity because we don't know a lot of things hair cells and we don't know things about how hearing works but in order to repair it and to find cures for hearing loss, we need how hearing works. That's why Tony is very very important. He's the world leading scientist in, uh, hair cell

biophysics and we draw a lot from this knowledge and this is just this is a picture of a hair cell. Um, it shows you that it's a mechanical sensor. When you, the tip of hair cells is apical end you can see the cells, the cells are responding. Their extremely sensitive to uh, extremely sensitive motion detectors. And this helps them to integrates sound information which is a traveling wave along the cochlear basaler membrane, that is then transduced in a nerve signal and then conveyed to the

nervous system via nerve cells. Um, why do we know so little? Uh, its sort of embarrassing compared to other fields but there's a simple comparison. Look at this is a flat preparation of a mouse retina on there about 140 to 150 million photo receptor cells in this retina. We completely understand how photo reception, how conversion of light works in the retina. And in the ear we have about 30,000 to 50,000 hair cells per inner ear. In the cochlea its about 15,000 hair cells there are other hair

cells that are distributed throughout our vestibular system. In reality we can only get to about 5,000 cells if we are really good at dissecting these little tiny organs. Um, it takes quite a bit of practice to get to this point but you get only about 5,000 cells. So comparing this with one retina you need about 30,000 inner ears just to get the amount of cells that you would get from a simple retina. People in the retina research field go to the slaughter house and get eyeballs from, from bovi

nes. They can do a lot of Biochemistry and genetics on these cells. We we have a really hard time getting to those. That is part of the inspiration that I felt of for my work. Another comparison ah, New York City has about eight million people, if this would be the number of neurons in your brain then the amount of hair cells as you have in your head was correspond to a single person for down somewhere on 42nd Street. So how do we lose hair cells? This seems to be the major problem that we are a

ll having. These are some other environmental factors or hereditary causes that led to hair cells. The high frequency cells are more sensitive. We have some ideas why that is the case on and they go first, so all of us have high-frequency hearing loss you can download an application for the iPhone that has a dog whistle on it and you just crank it up over 12,000 Hz Uh, a lot of the males over 45 will not be able to hear this anymore. For for for some reason my wife, same age, hear it. Um, women

are not degenerating yet as fast as with men. [laughter] Rob explained to you how, um, how hearing loss affects you. This is how it happens. There are two types of hearing loss There are two types of hair cells in the inner ear, there are so-called outer hair cells and the so-called inner hair cells and you see from this wiring diagram is a simple wiring diagram the auditory nerve mainly goes inner hair cell, the blue cell, the outer hair cells fulfill a different function they are little ampli

fiers for sound. Without outer hair cells your amplification is gone and your vibrations your the basilar membrane is smaller. The inner hair cells work still work and in this case the auditory nerve still works and with hearing aids you can you're able to convey the information to the ear but as lots of people who wear hearing aids know hearing aids are not perfect and they're extremely expensive. So it would actually be nice to find ways to restore these outer hair cells somehow differently th

an with with the device. The inner hair cells, once they're gone there's no transduction at all. The auditory nerve is still there but it is silent because it's not being stimulated. And this is where the cochlear implant comes in. The cochlear implant can still stimulate the auditory nerve also they are only a few electrodes the who would represent the whole dynamic range hearing. Therefore it's very difficult for a profoundly deaf person to completely restore the hearing to the point where tha

t person is able to for example have a phone conversation, it requires a lot of training. Um,I don't think that a lot of cochlear implant people can enjoy music anymore it's really completely different kind of hearing that you have with that prosthesis. Silence for me sometimes it's beautiful. I like to go to the desert and just sit there and read the book and and it's enjoyable. But for people who are deaf, silence is not enjoyable. It leads to being outcast from society. It brings a lot of pr

oblems, people get depressed. Uh, and its not per say, life-threatening but it really reduces the quality of life that you have. There are about 30 350 million people or probably more the latest WHO estimates go up to 500 million mark, uh there are many many people in the third world that lose their hearing, uh, because a lot of drugs that are widely used are toxic to our hair cells. Aminoglycoside drugs, which are used for, which are cheap antibiotics, they are used in the third world all over

the place. They cause hearing loss. And this adds to the number of patients that loose their hearing every day. So so this market is very likely to to increase much more. Tony Ricci works on a novel antibiotic that is not threatening our hair cells and I think he may be able to talk more to us about this on its implications and also difficulties of bringing this to the market. Uh, Dr. Jackler mentioned the Stanford Initiative to to Cure Hearing Loss um, which is, um, in my mind this is what we

need to do. It is sort of the Manhattan Project of attacking the problem. The, uh, its it's impossible for single lab, like my lab - my lab focuses on stem cells and on developing cell-based technology and I will show you a tidbit of this in a second of but we cannot do this alone we need up other researchers we are now about six researchers. 3 clinicians and 3 basic sciences at Stanford, we're still building the program on that focus on multiple approaches to the problem. We focus on stem cell

therapy on gene therapy, molecular therapies and on, uh, developing novel devices and developing novel approaches to hearing. So there there is sort of the time line where we start pretty much now on and the at the end the goal is to treat patients. I'm not I can't predict the future so I can't tell you when this will happen. A lot of patients always ask me the question whether when will see a treatment that you are talking about, now will when will this be available for patients? Its difficult

, its so difficult to predict, you all know how difficult it is to bring anything market in the health care industry this is the same in israel has no precedent is even more complicated on the other hand we are very optimistic about this we also think more out-of-the-box here the John mobilize a researcher a clinician sciences no on who develops a novel devices which use noon for it spectroscopy which is already in clinical trials to investigate signals that arrive in the auditory cortex and in

the forties for a system in coffee implant patience these patients you can't put into an I'm re: im MRI machine because of the invitation so you need to be able to do something that is so much with him I and this technology up is able up to on to visualize on I'll brain function close to with with with with with the resolution is closed prices Rob mentioned advanced genetics I think this is going to be the future in few years from now every patients will have is a for GMC when they entered and t

his information will be are compiled together with healthcare data and with researched so that at some point we will be able to predict when a child is born with this trial has a susceptibility to certain drugs that could affect its hearing or whether this child has a susceptibility too loud noises well with a jew Ward up being exposed to fire truck driving along the street which for most of us is not threatening hearing for people who are susceptible this could cause serious problem particularl

y happens over over be we have to find out how to get get rocks compounds viruses gene therapy devices or sells inside the it's not so simple to as with other organs just delivers great you can just injected the new year when you through the whole you very likely cause more damage than you do good so we need to find ways to very smoothly and very carefully bring bring compounds into the urine and Tony again is is leading some research where way so using a drill he develops a system where you can

actually use enzymes too slowly fade away bone to have really time you actually axis the we all need this for you ever find stem cells that would be able to Andrew you we need to inside surgical simulation you cannot you cannot train someone on patient with these in this kind of technology so you need to similar 3 because these these operations really really on complicated answer just trade in that on for documents tension interface technologies and this is we're my what my life was great works

on we work on cell-based technology I'll and I mentioned the crux of dealing with yourselves we cannot do research on are a lot of these also the main motivation for me is assigned this not even thinking about medical application initially was well I need to do experiments on hair cells and in order to get enough here so they need to bring 50 mice into the lap I don't want I'll of and I don't want feel some so I thought there must be a way of getting here so yourselves from I'll renewable sourc

e namely embryonic stem cells so we develop on methods couple of years ago to generating the cells from embryonic stem cells on although this method is very tricky is not very efficient but we are now in version 2 for we're working hard on version 3 which very likely will be more efficient than the previous one and then the reason for the years always a difficulty you the reason for this is on these loopholes represents its when they start up as an embryonic cell so that is we hope to report you

can give rise to any cell in the body some cell types in the body much more preferred than other cell types for example generating euronews from embryonic stem cell is rather simple that's why trials with neuronal cells are and strengthening right now you can also generate epidermal cells muscles wealthy but with getting the cells to become alcee is little on working on this month rich and the cells always tend to become something else is like dealing with kids both young so so this is a major

challenge of but but I'm very confident that we will solve this the upcoming years mom so what happens when we sold we can you think about cell-based assets if you think about them so they always think about you get it fast I want to tell you that this is maybe not the way we will be stems willing to you cell based assay from stem cells weekend generate South or rehearsals both in results here cells and the surrounding supporting since and this is what we have achieved on there are some was sitt

ing there our one of his major findings published in 2000 was the I'll the the protocol that that that we can use embryonic stem cells to generate these kind of those in the issue was so kind to actually test with the cells become sensitive initial slide show and we were able to show that the so they're in the functional the No perfectly organized and we are not getting so we're working on better ways to so on efficiency is a major problem roadblock to emergency is another the cells need to be f

ew so we're working on proof proof I'm cells on so we are somewhere along this time line we don't know what we're we are going to be when these problems also up we think in the upcoming years and the sooner we sold them the sooner we are at the end on so what only 590 you here so your own him both very so some things we are thinking of on and on now talking businesspeople the technology that we have this is his license to biotechnology company in San Diego they are thinking about essays like thi

s so wanna say we r currently exploring is testing little city so you can test existing drugs that are on the market and see whether the are damaging your hearing and in fact there are some studies that show when you take the 1200 leaving up drugs that are FTA proof that accused by many many patients if you do stories like this on in recently about 20 rocks where identified that cause there so that it really depends on the susceptibility of person know that those so if you take much worth you ca

n't lose you overtime and we don't know exactly which so out there that causes if you know what sort you can actually find other groups that picked so finding drugs that protect overhearing are equally important then identified bad ones that course you and of course this is the holy grail to find drugs that lead to generation and this is something we have full you the here so once the no I the generates his you get this Court to issue but they are organisms and about 99 percent all animals on th

is world only a small number of animals name mammals us other on make me are losing here sells once they're gone third so finding ways bring them back learning from how for example chickens words or fish or regenerate here's what is really important schools were using artificial scents with you using a large library from pharmaceutical company name one of the big ones and throwing on these asses and funny what's that the regeneration be true then moving forward to investigation and support so us

ing these I threw content screens roadblocks or efficiency and particularly expansion both actually you cells and finally one thing that exact dimensions is %uh using patient arrives so I P S l's the the Nobel Prize for Medicine was given to doctor I'm not go and the cali out of them and I could develop miss that is from you love pan on to introduce up for reprogramming factors to turn any cell of your body into a cell that is it will to embryonic stem cell and we are now developing this protoco

l or implement approval laboratory so we can take cells from hearing loss patient and take a skin biopsy or you can love cell and current to sell rooms and then we move forward and generate in rehearsals from the station and we can analyze the the disease-causing mechanisms directly in the country this is this is very helpful because you can use patient to life tissue that you would have no access not just through a hole in the air intake pipes its is impossible you you know we know I for the fi

rst time the substrate we can start developing noble tree and I think this is extremely powerful we also up combine this method with some things that is called the whole genome-wide association study where once the gene what every patient is being sequenced known wouldn't the computers that that track the information the source you this information with on data on susceptibility namely whether a certain drug is causing is more efficient causing your souls for one patient who yet another patient

this information will be extremely important for predictions whether certain person is able to here open to all ages or whether a person really has is going to develop a problem and will and we will be able to tell what throughout work on environment was should Ward moving life so that they're not with that I would like to stop basic questions if there are some now was still come up with some topics ensure that does anyone have a question for ended this makes the rules will soon because I have t

wo sons denied us your mansions and I use would cause a scene means that more I it's not really here who once per se supposedly years is you resurge he did that as well here that's all actually tonight some hearing loss a flip side to the same so where this segment both yourself this insane very high frequency the nerve fibers that go to the the beginning destroyed with me even though no sound is is still because those nerves are hard-working very very here me older people most this have ivory a

ll the time quite most of us doesn't some people that bothers to some degree there are some interesting facet doesn't feel a few although if we've regenerate yourself we were able to replace lost urs satisfy what is causing with discharged really that frontal orlando's cast back to if well I will tell you there's a very interesting that the hearing your itself was even in the most place the hearing nerve is constantly active way with that tells you is that there is a sort of suitable random call

the who nerve destroyed that the brain regions I so if we can take on your regular with and superimpose on this sort of stochastic code the brain knows if we can sort that out we can restore trip the this summer the approaches people bottom line 0 you the things we can do to help no that's what make mom's whose to response FB particular some think should here here I think they're there there's a that that has evil language their own their own society and they are of people within the school the

were completely that they don't see themselves as being is able day they don't want to be your because I don't feel that have any kind these I think these people are %uh the life the way they want to live their life but I think them the vast majority of people with you it's also from my point of view I think her is the very first site you know if your your child porn the society outcomes Parenthood style and I think on with Ave I'll I'm I must say from my point of view being doing resource work

your I have nots really over the last 10 years me one between with people from have daily interactions emails from people want this research let me just call it presents very interested shared languages and if your child can speak side I'm they've lost the child your culture your friends people around you however working against is the fact thats majority children missus can generate is many months went deaf today we would continue to speak all like wheeler lip reading we would use various devi

ces that can we called however most children born deaf today Main Street they get a Coker their regular schools schools for the deaf to teach sign language and manual communication I just wei-wei so that whole populations close most deaf parents that Matt Gallagher or someplace have deftness for different genetic wheeze so they're offspring was there hustle mostly the recessive their children and that's that's the children %uh deaf community def really child but that you're back in the eighties

where the sign language message for coherent was ago with and and that there were radical people in that community that said if you as a hearing had a deaf child child us that's way and I think the paradigm shift people all would you know especially all me we're all hoping to live to a ripe old age very active very communicative very active we don't want to accept this hearing loss is a huge ice you world gets more when you can enjoy last can't enjoy things you can't go to life here and you know

in the biggest thing yes it's the compelling story child that is a huge partly all loss with his past I my name is Donna Kawasaki and I'm in development of the technology that will be shoes that will engage this time and use the high correlation to the ear and who would be you might be interested to moon for you there has been any research that is Dan must've with here with free in this year to carry and to give you an idea words with to enter these issues and ice skating actually that when you

go hugely Zend to spine help people for example with really the ear people that have evolve from shoes to bare feet any agency masses in the feeds I'm but your doctor and I'm in India he'd in Sioux and I'd gone into this because I had died debt had its and has fine surgeon myself very much interested on so I'm at that question since yesterday so that's a relief so remember that fuller knowledge is popular knows you ENT which for this purpose will be your nose totes few a sorry I some so so I th

ink this gets down the gate right so it's been said on if give you an example it's been said if you have to its right hyperactivity the nervous system it's intruding on your consciousness and disturbing you as I if you were a pair shoes one size too you created a countervailing staples that you would not pay attention to the it's a really big eighty it's like why the dentist pinches your cheek when they get the injection so this isn't really go to chiropractors they will tell you that the nerves

in the spinal intimately involved here if you go to people who study here in science is that always yes I'm physiologically I but an acupuncturist will tell you that that maybe there are ways to so I love my colleagues Tony do you have any wisdom about that but will email health is the so I this label faculty okay it was was actually studies unit H open me warm unit faces actually vibration sensors somewhat remarkable images because they actually Africa once yeah his water in bowl actually laid

out both vibration sensors and speakers so they can now playback the vibrations to the elephants that say desecrated the whole protect sir or you know now it's time drink basically synchronized dancing yeah but it's it's infers very resources both visitors is feels like that surprising just for the reasons that upset because a saliva sample forces I could happens posted this weight status scenes wind is feedback said between the court dates and without us that's regulated by the spontaneous act

ivity in their fight which is goes low years damage ethical so is also feedback said as well so think yeah with reinforced calm down I'm a kid I could see balls in prison for talking about already the actual process said how much percent boys coming through here nurses from body soon says hours is yeah so if you think the air is filled with fluid and sounds pocket so you have air to fluid interface you have to be mismanages that's what you're doing is a big place the bottom scabies is a small pl

ace the sort of 33 issue can't it's a pumping like history into the fluid-filled here could get you can certainly very efficiently do bold home tap your teeth together many different ways you can it doesn't sound quite the same way that conducted through the year but its quite interesting thing if you ever had a speaker system that feeds back to 12 30 the secular you always drive you crazy UK torque because we offer and and it turns out we have a very interesting system because you're constantly

your own speech is going here and this is oppressive system that actually every time he speaks tightens up the hearing bones your to try to hope that vibration here so you know constantly disturbing yourself as you speak it some people got breaks part these folks literally here everything they say he high with mister she's speaking someone's feels States here receiving say as uses show has called marriage do good for you up seems like this every a big growth as a businessman have a better oppor

tunity this is up thirty for me male baldness that of you let's listen that we yeah questions about stem cells for Android %uh the the origins of the year in the regions of the skin are actually they're related divers very early in development so your are the cells that I have here so yourself and the cells on your here i fundamentally differ so fine and actually was interesting system so that in the skin that actually to here regeneration have been identified Billy few said versity and there's

quite a business no and as a businessman if you have money to invest right now I would he I would split dirt but I'm a very diplomatic yeah a question this a free solution vessels here transplant yes we have their it up see other are you answers all for you said well so he said right I think it's it's a I think we we r cycle race fourth congress in every right now we r not putting anything on one on course we would try to get laps people you know in what we are doing though betting on every sing

le technology without because it's so difficult with the also if you think about on try to regenerate here's a strong person who has a mutation there's a there's a gene called connexin 26 it accounts for are about 50 percent hearing loss in in the in the general population that is out there that is here so there's one gene cause fifty percent all very your of so this is the G that you would like to address with gene therapy but you need first need to restore yourself so you get the idea cells fr

om the patient need to repair the gene re really so back patients who need to have already two technologies that you need to develop side to do that here so we cannot neglect any up its potentially you people at some point that will be you any through so I think finding general solution for everything in once that is both I think we will have a long only first through have a certain clinical trial going on hopefully within a decade that that dresses one form of hearing loss very precisely very e

fficiently own and this kind of treatment will like applied to another but you too was and neglecting will be will be bad this basic question is it possible evolve is as hood with here process two different use always so i'm good injuries educate multitask he teaches Stanford see undergraduates and graduates means in any given class computers and the question is I V anymore yes was elected what's going on or are the skinny rapidly back and forth between attention I think it's full I don't think

genuine multitasking inattention level specific sense Israel there you can actually measure certain very simplistic notions is how can you discriminate two things in time very short recruits actually a sense the pathologic year actually better description healthier integrates interest but I think you know the whole issue multitask is extraordinarily important his life today as your world has really changed what we'll do and I think the challenge we have is educate is that the multitasking done b

y here's is relevant to the call so that we create for them assertive Twitter feed that they can make about with lectures that we give them the opportunity reading literature about what it is and going back and forth looking at rich learning as opposed to be face both to of I feel so he is really interesting that more and more scholarship being done about the ability to multi-task and I think it's it's a very rapid scanning the truth muskie's yep news certain of these yours your the ethical issu

es you recalls you try these out yes offering office here UT a high wrister all with I think the answer to that is very gallagher's to the way cancer innovations trial first people people who are in fact little tourists firms function known as you a proof of concept he then moved to people who have less and less to lose it or becomes say half years there's no question whole concept just a embryonic stem cell throwing it system you know that's not like the but these guys have come wants this to m

e I would set point this week this guy's world famous for having develop step identified stem cells million develop progenitor cells it figured out biology to mature them into hair cells that actually function me if you ask somebody 10 years ago that would have been impossible so someone like me I may be more optimistic than clinical as opposed to careful sizes I'll tell you from where we are today so many things have happened last eight years we've never and looking at where things are all I re

ally very hopeful this will come out but it will first of as in the terminal cancer patient 100 and then move down we have to be very careful when you start deliveries restart inhibiting cell site burgers themselves restart pretty it rapidly woman no raft rapidly livery primitive cells as a kid it so you have to figure that out first ball safety issues become very no enhance a lot of things look at at the genetic protein or look at chemicals that could modulate the g8 as opposed to throwing AG c

ells I'm no expert these guys before those things that's why the number different having used this pretty system recognizes a grim reaper of another yep want one quick so is also the largest market for economy drug is actually a jeep how do you designing clinical trials for the aging population who that hearing gets so this is a really difficult situation issued soul when you when you bring it to the smart so I think the first the first patient which will be of very just me point with someone ha

s lost her cell population patch matter how will you make the device if you only do as well as the you can actually hear be the most elegant most wonderful I'd but that's why this there are there is one other strategy for people for example age is lost hired right side yeah and that is to stimulate caustic your partial an electrical the particle Saif saw fiber cope strategy together with class hits these are down story to really all this is a one of those the evenings where we all investment ban

kers have to the there perhaps occupations in life more critical than as the very quarterly earnings per share good and I think with a CG and in this valley have to recognize that staffer came first Stafford is probably a reason that this value exists and these gentlemen are pretty worthy represent representatives at the cutting edge if things that service will have difficulty understanding but I think we all we got ourselves is very privileged to have had a little bit earlier time tonight in ju

st thank you for forming this group thank you very much I'm mmm