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00:00:09.240Welcome to "Quantum Potential," a podcast dedicated to curiosity, discovery and the bold new ideas shaping our future.
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00:00:12.810I'm Cybele Raver, provost of Vanderbilt University.
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00:00:26.699Today's guest is a rising star whose work is at the frontier of what's possible for medicine, health and society.
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00:00:32.024Jack Noble is an associate professor of electrical and computer engineering here at Vanderbilt.
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00:00:43.515Importantly, Jack has been super successful in winning federal funding from the National Institutes of Health for his groundbreaking research on ways to restore hearing for people who have profound hearing loss.
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00:00:49.664If you or someone you love has ever experienced severe hearing loss, this conversation is going to feel very personal.
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00:00:57.479Jack, it's such a pleasure to have you as my guest today.
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00:01:06.450I really look forward to diving deep into the details of your incredibly innovative work as a researcher at the intersection of engineering, surgical medicine and AI.
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00:01:11.234But first, I wanted to give our audience a sense of the magnitude of the kinds of challenges you're taking on.
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00:01:20.689Your recently federally funded grant frames your work by highlighting the ways that hundreds of thousands of people get surgery to try to restore their hearing.
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00:01:25.399But the past effort that's been pursued by surgeons has been pretty imprecise.
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00:01:29.509Tell us a little bit more about the scope of the problem that you're trying to solve.
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00:01:33.289Well, first thank you for that very generous, uh, introduction.
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00:01:35.129I'm really honored to be here.
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00:01:39.060This is a wonderful opportunity to, to talk about this, this work.
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00:01:43.469Cochlear implants are generally a very remarkable technology.
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00:01:49.469They work, uh, remarkably well for, uh, so many people, but there's a lot of variability in outcomes.
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00:02:06.554One thing that we know that contributes to this and impacts the ability of, of some individuals to be able to recognize speech is how the electrode array that's surgically implanted into the inner ear interfaces with the auditory nerve.
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00:02:07.094Okay.
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00:02:18.525And just to slow down enough so that I understand, an electrode array sounds like it's 12 to 24 tiny wires, what's going on there?
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00:02:26.984I mean, I think about the electrodes that get stuck on my skin if we're doing an EKG, for example, but that's a big old patch that can't possibly be squeezed into my ear, right?
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00:02:35.449So help me understand how this array of electrodes looks, and how it is possible to get all of those things inside one's ear.
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00:02:36.049Sure.
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00:02:51.560So the electrode arrays differ a little bit, uh, from one manufacturer to another, but basically they're all these kind of floppy tubes, uh, that have, uh, a sequence of contacts sort of placed along the length of the tube.
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00:02:54.649And these contacts are sub-millimetric. They're tiny.
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00:03:03.419Uh, the surface of them is maybe about 0.3 millimeters by 0.3 millimeters wide, and they're arranged on this tube that's maybe about a centimeter long.
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00:03:08.550Um, and so in surgery, uh, the surgeon has to, uh, gain access to the inner ear.
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00:03:25.664Um, this requires making, uh, an incision behind the ear, then drilling away, uh, some of the mastoid bone behind the ear to get access first to the middle ear, where they can then see the bony surface of the cochlea, which is also called the inner ear.
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00:03:32.775So in surgery, and I've inspected thousands of, uh, of video recordings of, of surgeries.
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00:03:38.444So I've had a chance to really get a, a good sense for, uh, what the surgeons can see and what they can't see.
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00:03:55.979But in surgery, what they see is this bony surface anatomy of the inner ear, as well as one tiny membrane that's called the round window membrane, uh, which is what they call the entrance to the cochlea, and this is where they make a tiny incision to thread that tube, uh, into the inner ear.
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00:04:01.500I think a lot of people would be familiar with sort of the shape of the cochlea, which is the snail-shaped organ.
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00:04:15.900So as they thread this sort of floppy tube of electrodes into the entrance to the cochlea, it uh, sort of snakes into the inner ear, following this snail- shaped curvature of the outer walls of the cochlea for certain types of arrays.
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00:04:16.709Incredible.
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00:04:22.259And so we're talking about adults' ears. That space can't possibly be very large, right?
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00:04:33.194The inner ear, uh, is composed of, of several intra-cochlear tubes, intra-cochlear cavities, uh, each of which is probably no more than about a millimeter wide.
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00:04:35.055It's a very confined space.
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00:04:46.468The surgery, uh, we, we call it a microsurgery because everything is, um, at a microscopic level, and the surgeon is actually looking through a surgical microscope while performing this whole procedure.
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00:04:49.408And then, so there are nerves inside the ear.
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00:04:55.228That is the essentially what is picking up the signal of sound and transmitting it into the brain.
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00:05:04.079And somehow this array of electrodes has to be correctly placed next to or inside the nerve, but in ways that make the nerve be able to function.
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00:05:05.295Right.
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00:05:05.654Yeah.
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00:05:12.764So in, in natural hearing, um, an acoustic wave is propagated through the ear canal, um, and then hits your eardrum.
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00:05:22.845It's also what we call the tympanic membrane, and that transfers that acoustic energy, those sound vibrations, uh, to the inner ear, which is filled with a fluid.
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00:05:29.129And so that fluid transmits the acoustic energy along the lumen, along the canal of the inner ear.
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00:05:35.459And that vibrates, uh, small hair cells that are at the ends of, of auditory nerve fibers.
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00:05:42.600And as those hair cells bend back and forth, uh, it allows the auditory nerves to be, uh, stimulated naturally.
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00:05:45.959So we call this a transduction mechanism.
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00:05:51.853So the inner ear is transducing acoustic energy into electrical signals that get sent to the brain.
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00:06:01.334For folks who are experiencing severe to profound hearing loss, something has gone wrong in that acoustic transduction.
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00:06:06.464Something's gone wrong with the ability of the body to take that acoustic signal and activate the auditory nerve fibers.
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00:06:24.300So with the cochlear implant, we're really bypassing all of that acoustic part and doing direct electrical stimulation of the auditory nerve, which it sounds like it's singular when you say "the auditory nerve," but actually, uh, in a healthy ear there are about 20 to 30,000
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00:06:27.389Wow.
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00:06:29.670...that are, um, composing the auditory nerve.
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00:06:33.944I mean, it's just so amazing as a person who likes to listen to the radio on the way into work, right?
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00:06:42.555I don't think about all of the things that are happening in that moment, and when you break it down that way, it's just incredibly intricate, incredibly complex.
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00:07:02.625When you are doing this work with surgeons, I'm super curious about how surgeons relate to the new technology.
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00:07:33.764I mean, obviously the new technology itself is fascinating, but then you know, in addition you have both the user, the surgeon, and you have the patient or the client, um, and you know, I'm just immediately curious as to how that has changed both the life of the surgeon and the life of the person who now has a much better functioning piece of technology, um, very carefully implanted, uh, very close to their brain and, uh, assisting them in a different way than prior to that implement.
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00:07:34.875Yeah.
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00:07:52.814So, uh, with this augmented reality system that we're developing, we're still pretty early on, so I'm working closely with, with a handful of surgeons who are awesome clinical collaborators to try to design this system so that, uh, most surgeons will be excited to use it.
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00:08:21.029We haven't tried this on a patient yet, so this, this is, this is still pretty early on, but, um, we certainly have a lot more experience in some prior and ongoing projects that aren't augmented-reality based, but rather trying to model how that electrode array is interfacing with the patient's auditory nerve to try to help, not the surgeons, but rather the clinicians who see the patients after surgery—who are professionals called audiologists.
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00:08:32.654They're the experts in trying to figure out how to tune parameters on the implant processor to try to help the patients hear better, not only right after surgery, but really through the rest of their life.
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00:08:32.804Mm-hmm.
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00:08:39.975So that's a lifelong form of tuning and improvement in terms of getting that technology to work.
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00:08:48.225And that AI piece that you are so expert at using, is really strengthening and improving that capability?
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00:08:49.063It is.
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00:09:06.764So these devices have hundreds, if not thousands of different settings that can be customized for individual patients, but it's a really challenging job for the audiologist to figure out which parameters to, to change and how to change them.
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00:09:09.360It's a perfect problem for the computer, right?
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00:09:10.559Yeah, it's...
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00:09:17.100I mean, I just think about that multivariate space and how machines are so much better at solving multiple equations simultaneously.
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00:09:18.360Indeed.
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00:09:24.450And as I said, typically, you know, the, the surgeon can only see the surface anatomy in the operating room.
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00:09:34.590They have to thread this array into the cochlea without really seeing where the electrodes end up, and that without really knowing how they're interfacing with the auditory nerve.
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00:09:38.850So the, the electrodes, generally, they're not in direct contact with the auditory nerve.
00:09:38.850 -->
00:09:46.139The auditory nerve is, uh, sort of in the middle of the cochlea, and the snail shape, uh, of the cochlea is wrapped around it.
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00:09:57.990So these electrodes, they, they just basically, they use very simple, uh, stimulation pulses with the hope that they're stimulating the right parts of the nerve.
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00:10:02.188And that's just how these things have operated for the last 30 years.
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00:10:06.884So it's actually quite remarkable how well they do for a lot of people.
00:10:06.943 -->
00:10:10.424But the variability in outcomes is a, is a big problem.
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00:10:25.813The N-I-D-C-D, the sub branch of the National Institutes of Health, that is called the National Institute for Deafness and Communication Disorders, they estimate that only about 5% of people who could benefit from an implant actually receive one.
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00:10:26.563Wow.
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00:10:27.554And...
00:10:27.554 -->
00:10:32.054So 95% of people who could benefit don't receive one.
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00:10:32.865Correct.
00:10:32.924 -->
00:10:36.044Because of expense? Or because it's so difficult to do this surgery?
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00:10:40.154Or because of preference? Or what would you say is the biggest barrier?
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00:10:48.938I think it's, it's a mixture of a number of those different factors, but I do think a big one is that there is a high variability in outcomes and so...
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00:10:52.500Yeah, so why go through it if it isn't gonna necessarily yield benefit?
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00:10:53.615Correct.
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00:10:54.154Yeah.
00:10:54.154 -->
00:10:56.975And even, you know, in the audiology community, right?
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00:11:05.943So typically how patients end up with a cochlear implant is first having their, uh, hearing loss addressed with a hearing aid, right?
00:11:05.943 -->
00:11:15.693And then once a hearing aid is no longer useful because the hearing loss has become so severe, then the cochlear implant becomes the preferred, uh, treatment.
00:11:15.754 -->
00:11:26.594But even amongst hearing aid audiologists, this perception of variability and outcomes can lead them to not counsel their patients to seek that next step.
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00:11:26.924Yeah.
00:11:27.764 -->
00:11:43.063And when it does work, I would imagine that the individuals with, um, really successful cochlear implants are able to not only, you know, produce speech and hear speech, but truly, really engage in communication, right?
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00:11:49.464That there's not, um, sort of that lag, that microsecond lag in engagement.
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00:11:57.804Have you seen, um, that change over time or with this improved, um, ability to tune the machine to work more effectively?
00:11:58.105 -->
00:12:01.943There's a number of ways that we can improve things.
00:12:02.154 -->
00:12:04.105We started with talking about the surgery.
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00:12:10.198So can we place the device better in the first place so that it better interfaces with the auditory nerve.
00:12:10.799 -->
00:12:12.240We think we'll be able to do that.
00:12:12.240 -->
00:12:16.259We're sort of, we have to build this system first before we can test it and, and prove it.
00:12:16.620 -->
00:12:26.309We do have some preliminary data that, you know, is strong enough to suggest that we'll be successful, that we were able to secure this, this funding to build the system.
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00:12:28.740So I'm confident that we will get there.
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00:12:37.860But the, the other way is, after surgery can we help the audiologist figure out better parameters, uh, that are custom for that particular patient?
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00:12:48.419And we have started, uh, clinical trials of various strategies to do that and have seen some really remarkable results for, uh, quite a few, uh, patients.
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00:12:52.529Typically what we're doing is we're measuring speech recognition rates.
00:12:52.919 -->
00:12:59.323Uh, what this means is when the patient comes and sees the audiologist, the patient will get into, uh, what's called a sound booth.
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00:13:17.745So it's like a quiet room with speakers, loudspeakers that the audiologist can play a certain list of, of words or sentences, and the patient's asked to, uh, repeat back what they hear, and then the audiologist can score what percentage of words were correctly recognized.
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00:13:29.404So that's one metric that we look at for can we help improve outcomes, is can we make some manipulations that will improve the number of, of words that they recognize in these speech recognition tests.
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00:13:32.953Another metric is not so quantitative.
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00:13:34.844It's more just the qualitative feedback and...
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00:13:34.934Right.
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00:13:35.684How's my life?
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00:13:35.984Yeah.
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00:13:36.254Right.
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00:13:36.764Yeah.
00:13:36.764 -->
00:13:40.693And, and what kind of impression that patients get from, from the changes.
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00:13:47.924One thing that makes it it challenging is that the implant is just one part of the hearing equation.
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00:13:50.730We're delivering signals to the auditory nerve.
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00:13:59.340Those signals are being transmitted to the brain, and then the brain is learning how to hear in a completely new way, and it is very different from natural hearing.
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00:14:05.190So I mentioned in natural hearing you have 20 to 30,000 different, uh, auditory nerve fibers.
00:14:05.549 -->
00:14:11.250Those all individually correspond to very finely tuned pitches.
00:14:11.833 -->
00:14:13.875Think of, you know, pianos on a keyboard.
00:14:14.144 -->
00:14:16.453I don't know off the top of my head how many pianos on a keyboard?
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00:14:21.073Well, your ear has something like 20 to 30,000—very finely tuned.
00:14:21.764 -->
00:14:32.865We're replacing that with 12 to 22 electrodes, and each of these electrodes is stimulating thousands of individual auditory nerve fibers.
00:14:33.434 -->
00:14:41.894And so you're basically going from having 20,000 unique pitches available to you, to maybe as few as 12.
00:14:42.345 -->
00:14:51.855And it's actually even a little bit worse than that because since we're not doing direct stimulation of the auditory nerve, there's a lot of spread of excitation, and these channels are all kind of muddy.
00:14:51.855 -->
00:14:53.115They're overlapping with each other.
00:14:53.565 -->
00:15:03.825So imagine if in your car you tune your radio to a station, if your radio wasn't selective enough, you'd be hearing three stations at once, and everything would be really, really muddy.
00:15:03.884 -->
00:15:04.274Right.
00:15:04.904 -->
00:15:20.490So we had a lot to overcome to really, uh, be able to recover what, what I would call natural fidelity, but there is certainly room to be able to improve people's ability to just be connected, have conversations.
00:15:20.610 -->
00:15:23.789Understanding speech and noise is, is one of the biggest problems.
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00:15:23.940Yeah.
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00:15:28.200So can you go with your friends to a noisy restaurant, have a conversation?
00:15:28.529 -->
00:15:30.750It's a challenge for, for implant listeners.
00:15:40.664 -->
00:15:43.544What makes a true story more compelling than fiction?
00:15:44.325 -->
00:15:55.169In the next episode of the"Quantum Potential" podcast, I talk with documentary filmmaker and Vanderbilt Professor Mariah Kramer about the method and the magic of showcasing real life on film.
00:15:56.129 -->
00:15:58.590But now let's get back to my conversation with Jeff.
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00:16:15.208I really wanted to ask you more about this idea of digital twins, this idea that you can customize that model to each of the patients that come in.
00:16:15.568 -->
00:16:19.259Can you say a little bit more about how, um, that methodology works?
00:16:19.500 -->
00:16:29.490You know, I think we hear the phrase digital twin, um, increasingly as we think about the ways in which technological advances are gonna dramatically change medical care, for example.
00:16:29.490 -->
00:16:35.458But just give us a little bit of that texture of what you mean when you say digital twins and how that works.
00:16:35.860 -->
00:16:36.269Okay.
00:16:36.450 -->
00:16:40.679Every patient has a unique situation in multiple ways.
00:16:41.190 -->
00:16:42.899The shape of their anatomy is unique.
00:16:43.379 -->
00:16:55.500The electrical properties of the tissues of their ear is unique. By the way, these folks are suffering from severe hearing loss, so oftentimes their auditory nerve may not be all that healthy.
00:16:56.129 -->
00:17:01.080Um, and there may be some of those auditory nerve fibers that are no longer alive.
00:17:01.110 -->
00:17:04.950We, we may not have 20,000 of them anymore to target stimulation.
00:17:04.950 -->
00:17:10.829There may be maybe 5,000 and may, maybe the distribution is, is kind of patchy.
00:17:11.220 -->
00:17:21.269Uh, we've seen a lot of evidence from that, from, uh, histological studies, that you may have some regions of, of nerve fibers that are healthy, and then some spots where they're not healthy.
00:17:21.345 -->
00:17:21.463Hmm.
00:17:21.568 -->
00:17:29.279And all of these things factor into how the electrical energy that's getting delivered by the electrode array is interfacing with the auditory nerve.
00:17:29.878 -->
00:17:41.279So, um, one of the things that we've been working on is for an individual patient, create a digital twin that tries to capture all of these unique aspects of an individual.
00:17:41.339 -->
00:17:50.309And of course, we can't cover everything, but we, um, we do try to cover account for, uh, as many of these variables as we can.
00:17:50.970 -->
00:18:11.279So to capture a patient's unique anatomy, uh, what we use is a preoperative CT, uh, that's a computed tomography scan or an MRI scan, and that gives us a spatial map, a 3D volumetric map of where all of that individual's anatomical structures are located and what, what's the shape of their inner ear.
00:18:11.730 -->
00:18:14.819It's basically a map of, of the different tissues.
00:18:15.359 -->
00:18:27.480Postoperatively we can, or intraoperatively, we can use a, uh, a computed tomography scan to then find exactly where those, uh, electrodes ended up in surgery.
00:18:27.869 -->
00:18:40.904And by using a process called registration—it's basically just aligning the preoperative and postoperative images together— we can see where those electrodes are relative to all of those, uh, tissues that we're interested in.
00:18:40.904 -->
00:18:45.494So that kind of helps us do a, a spatial customization for an individual patient.
00:18:45.825 -->
00:18:51.494And then there are a, a number of pieces of data we can collect from the patient's cochlear implant itself.
00:18:51.555 -->
00:19:08.565We can take these electrical recordings of different types of, uh, or in response to different types of electrical stimuli, and that gives us a sense for the, uh, individual electrical properties of that patient's tissue that we can feed into our digital twin model.
00:19:08.775 -->
00:19:16.154And we use, also use some of those electrical recordings to try to get a sense for the health of the auditory nerve as well.
00:19:16.845 -->
00:19:26.954Um, and this is kind of a, an iterative process where we, we start with maybe some assumptions about an assumed neural health situation for the patient.
00:19:27.464 -->
00:19:38.084We use our digital twin model to predict what measurements we should get if that was true, Then we can compare that to the actual measurements we get from the patient and then adjust...
00:19:38.115 -->
00:19:39.404Totally fascinating.
00:19:39.404 -->
00:19:46.934...until we, we've customized that model to produce the same or close to the same measurements that we, that we collect from the patient.
00:19:47.025 -->
00:20:01.394Yeah, I mean, it never, it never occurred to me that the implanted technology could be evaluative and sending you information in an ongoing way, not simply stimulative or in some way transmitting, right?
00:20:01.515 -->
00:20:03.914It's transmitting out as well as in.
00:20:04.095 -->
00:20:10.170Thankfully um, the hardware is designed with this capability where we can collect a number of different uh, sources of data.
00:20:10.529 -->
00:20:24.299For the most part, these different measurements have really just, uh, been used in the research community and haven't really been translated for a clinical purpose yet, um, because it's, it's difficult to really interpret them on their own.
00:20:24.900 -->
00:20:29.039That's really where the digital twin approach has a lot of value.
00:20:29.069 -->
00:20:29.549So cool.
00:20:29.549 -->
00:20:49.515It's because instead of just seeing the individual measurements in isolation and not really understanding where they're coming from, in the digital twin, we're representing the individual auditory nerve fibers, and we have accounted for patient-specific variables, and we can see what's leading to those measurements and, and explain them.
00:20:50.355 -->
00:21:02.819Does it take hours, days or weeks to make that digital twin model run at the level that you feel confident that it's a fairly accurate ... its, its predictions are relatively close to reality.
00:21:04.814 -->
00:21:05.564Yes.
00:21:05.684 -->
00:21:07.424Uh, so, um,
00:21:08.250 -->
00:21:08.709All of those?
00:21:09.134 -->
00:21:25.664Initial, uh, yes, our, our initial software that we have, have, have built to create the digital twin models, uh, leverages the, uh, computing cluster here and, uh, can take, uh, a couple of weeks to be able to construct the model.
00:21:26.054 -->
00:21:37.964But we're making a lot, a lot of progress and speeding that up to where we hope we'll be able to actually do it within a few minutes in the same visit where we're collecting the electrical measurement from the patient.
00:21:37.964 -->
00:21:38.023Yeah.
00:21:38.023 -->
00:21:42.375If your provost would spend more on, on computing, maybe, uh, it would speed things up a bit.
00:21:43.154 -->
00:21:52.394Well, yeah, the computing power is part of the problem, um, but also, you know, we can, we can improve the methods, as well, so they don't require quite so much computing power.
00:21:52.424 -->
00:21:53.594No, it makes total sense.
00:21:54.375 -->
00:21:57.674I'm really interested in the way in which you have 12 patents.
00:21:57.674 -->
00:21:58.365Is that right?
00:21:58.784 -->
00:21:59.444I think so.
00:21:59.444 -->
00:22:01.349I, I don't, I don't keep a running total in my head.
00:22:01.680 -->
00:22:08.250You know, last I checked your CV, you had 12 patents and a number of licenses for your software.
00:22:08.670 -->
00:22:42.154And I'm just fascinated, um, by the way in which you know how to leverage the market, essentially, um, you know, how to partner with corporate partners, um, to be able to make this incredibly innovative work more impactful—that it's not gonna sit in a journal article for three to five to seven years, but that it's moving out into the world, not only in the way that you're training surgeons, but prospectively in the way that the technology is being designed and built and then, you know, marketed and, and, uh, manufactured so that many, many more people have access to higher quality technology.
00:22:42.184 -->
00:22:43.534Can you say a little bit about that?
00:22:44.105 -->
00:22:50.314Yeah, it's, it's a very, uh, complicated question because there, there's so many different variables that are involved.
00:22:51.075 -->
00:22:53.744One of them is market forces.
00:22:54.315 -->
00:23:07.424So these devices are basically, the money that the implant manufacturers make on these devices is really tied to, uh, insurance reimbursement rates, which are, are kind of fixed.
00:23:07.785 -->
00:23:18.839And so, uh, the companies have a difficult time putting too much investment in new technologies that may still have some risk.
00:23:19.289 -->
00:23:25.589And so this is, this is exactly why the NIH is such a wonderful thing ...
00:23:25.589 -->
00:23:37.244because, uh, the NIH will provide funding for, uh, earlier-stage research that may not be completely proven, but they're fine with taking risks that companies won't.
00:23:37.454 -->
00:23:46.575So they're essentially willing to place a bet on a really bold idea, where a company doesn't have the enough financial incentive to place that same bet.
00:23:46.994 -->
00:23:47.535Correct.
00:23:47.865 -->
00:23:53.730It's also a little bit different than, let's say, the market for a cell phone, right?
00:23:53.730 -->
00:23:57.930So you could go to a store, they present you with a dozen different phones.
00:23:57.930 -->
00:24:09.269You can try them, see what you like and then make a choice. With an implantable medical device, you don't really get to try out different devices and see which one you like the best.
00:24:09.269 -->
00:24:17.160You kind of have to trust what you're reading online, which of course every company is gonna have data that says that their device is the best.
00:24:17.160 -->
00:24:18.329So who do you believe?
00:24:18.839 -->
00:24:34.859And so unfortunately, it's just a situation where, you know, for these companies, where they see the most profit is in, uh, sort of unique features, uh, like the ability to have Bluetooth connection or, uh, have a waterproof device that you could swim with.
00:24:35.220 -->
00:24:49.244And so it's, it's just difficult for them to put a lot of money to invest in, in things that improve the operation of the device and improve, uh, speech recognition reach, which is, I think largely why these devices haven't changed much in the, in the past few decades.
00:24:49.394 -->
00:24:50.744Totally fascinating.
00:24:50.954 -->
00:25:01.994So another approach is with NIH funding, we, we can, we can develop the technology to a point where we, we prove it's working well, and it makes the risk much less to invest in.
00:25:02.565 -->
00:25:17.444Um, but also it gives us an opportunity to build systems that can be just open source and freely available, and then we don't, we can just make it freely available to the end user, and then the companies don't really have to make an agreement on it, right?
00:25:17.534 -->
00:25:22.574So there, there's sort of multiple avenues to try to get the technology, uh, out there.
00:25:22.964 -->
00:25:34.394It sounds like get the technology out there at a lower price and with high enough usability that actually it drives people's faith and-or trust in the technology, right?
00:25:34.664 -->
00:25:36.494That's the long-term goal, yes.
00:25:36.494 -->
00:25:36.763Goal, yeah.
00:25:36.944 -->
00:25:49.094I kind of like to think of, of of an end goal being, can I help a cochlear implant user hear well enough to, for example, serve as a composer for a symphony.
00:25:49.694 -->
00:25:52.844If I can get to that point, I, I'll feel like I've accomplished a lot,
00:25:52.844 -->
00:25:53.654An amazing goal.
00:25:53.970 -->
00:25:54.480It's great.
00:26:10.589 -->
00:26:11.700And how about your students?
00:26:11.700 -->
00:26:25.694I mean, it's so cool to see that just as you were a research assistant, as an undergrad, you now regularly win awards, um, for supervising undergrads and make sure that they get funding for their summer research project in your lab.
00:26:25.994 -->
00:26:29.549Can you tell us a little bit about what it's like to pass it forward in that way?
00:26:29.549 -->
00:26:54.630Of course, for me, as your provost, it makes me super proud and, you know, really happy because I want undergrads to be excited and inspired to do research, but also I'm just really grateful to you for mentoring students and for taking the time and really committing that kind of effort to helping them pursue their dreams, whether it's to support, um, someone with hearing loss to be a composer or some other future awesome dream.
00:26:55.034 -->
00:27:03.105It's really a privileged, uh, position to be in, to get to interact with, uh, the amazing students that we have here at Vanderbilt.
00:27:03.105 -->
00:27:05.115They're all, uh, incredible.
00:27:05.115 -->
00:27:09.194By the way, I don't think I could get into Vanderbilt now if I applied.
00:27:09.824 -->
00:27:12.914No. You're supposed to say that you're not sure whether your roommate could have gotten in.
00:27:14.474 -->
00:27:21.750But yeah, they're, they're all so, so brilliant and, um, the difficult part often is, um, keeping up with them, right?
00:27:21.750 -->
00:27:29.460They're, they're so amazing and passionate and I feel like, you know, I get to learn more from them than they learn from me sometimes.
00:27:30.000 -->
00:27:36.825In terms of learning curves, I think a lot about, um, your commitment to collaborating with people in very different fields.
00:27:37.035 -->
00:27:44.085That's so true to the ethos that is, um, Vanderbilt's kind of foundational value in terms of radical collaboration.
00:27:44.414 -->
00:27:51.585Tell me a little bit about what it's like to collaborate with, uh, physician scientists in the medical center at Vanderbilt.
00:27:51.914 -->
00:28:03.464I see that you have all these co-investigators who do really fascinating work, but very much in a different field. And, you know, what do they think of you as an electrical and computing engineer.
00:28:03.464 -->
00:28:06.854And how does it work, um, in terms of you understanding what they do?
00:28:07.273 -->
00:28:13.214It's such a great opportunity here that we have, uh, when we're trying to innovate in the medical fields.
00:28:13.244 -->
00:28:41.128So, uh, we have an institute that the acronym is VISE, it stands for the Vanderbilt Institute for Surgery and Engineering, um, and really it's a collective of more than 20 labs across the School of Engineering here at Vanderbilt and, uh, Vanderbilt University Medical Center with a shared research space that's provided, uh, within the medical center, housed within the medical center where, uh, the labs can work together on various projects.
00:28:41.460 -->
00:28:52.169And there's, uh, for example, a mock O.R., operating room, where we can do experiments with novel image-guided procedures, which is just a, a fantastic resource.
00:28:52.169 -->
00:28:56.220And there's not really many places like it anywhere else in the world...
00:28:56.279 -->
00:28:56.460Yeah.
00:28:56.878 -->
00:29:07.829...where, you know, I'm a five- minute walk from my office in the School of Engineering to, uh, the operating rooms where, uh, these implants are, are actually placed.
00:29:08.339 -->
00:29:33.869And I honestly, I, I feel like Vanderbilt and VUMC have both really had a concerted effort over the last few decades to hire people and bring in people that are, uh, very collaborative, have a very collaborative attitude and want to work together to try to solve these important clinical problems without a lot of, you know, internal competitiveness, right?
00:29:33.869 -->
00:29:37.920We, we, we wanna work together and, and create solutions to these problems.
00:29:38.250 -->
00:29:53.055And so just being able to bring together in one place the faculty and students that we have in engineering who have the expertise to come up with these technical solutions to problems with the clinicians who have the pain points.
00:29:53.085 -->
00:29:59.444They know what their pain points are in treating their patients, but may not have the expertise to know how to fix those problems.
00:30:00.509 -->
00:30:24.329And just putting people in the same room, making sure that we have a lot of interactions with each other so that the folks who know how to create the solutions can learn what the problems are and work with the folks who are, uh, on the leading edge, you know, the, the clinicians like the audiologists and the surgeons, to try to come up with ways to improve outcomes for patients and clinical workflows of, of various types of interventions.
00:30:24.419 -->
00:30:26.699Yeah, it's an amazing set of collaborations.
00:30:26.699 -->
00:30:29.549It's really, really impressive.
00:30:29.669 -->
00:30:39.929And, you know, kudos to you and to your collaborators for seeing the strengths in each other's, um, expertise rather than feeling like, "Well, that person just doesn't speak my language.
00:30:39.929 -->
00:30:49.619I don't know, you know, how to relate." It's, it's tremendous in terms of sort of a spirit of curiosity and open-mindedness, but also commitment, shared commitment to problem-solving.
00:30:50.460 -->
00:30:54.809I'm really interested in, um, what makes you hopeful as you think about the future.
00:30:55.200 -->
00:31:03.419You've described so many of the incredible challenges, Jack. What gives you hope as you think about the next three to five to 10 years in your own field?
00:31:04.650 -->
00:31:14.880So I think, in general, I'm really encouraged by this trend towards, uh, developing open-source, freely available solutions.
00:31:14.880 -->
00:31:19.109And the boom in AI is, is really helping to do that.
00:31:19.710 -->
00:31:34.919So I really hope that a, a lot of these, a lot of these challenges that often, you know, government funding goes to projects that do the work, complete the work, but maybe it never leaves the bench to make it to the bedside and get, get translated.
00:31:35.189 -->
00:31:52.824And often that's not for a technical reason, it's, it's more because there's just, uh, such a, a long sequence of events that has to happen to cross the regulatory hurdles or put the right people in the room to create that startup company that's actually going to market the product.
00:31:53.564 -->
00:32:04.125But with AI, I think we're gonna more and more see a lot of these solutions that are just developed and put up freely available where anyone can use them.
00:32:05.099 -->
00:32:09.029And I think that's gonna open the door to a lot of new advancements.
00:32:09.299 -->
00:32:19.170So cool to think not only about acceleration in terms of discovery, but access—and widening access might also lead to acceleration.
00:32:19.170 -->
00:32:21.329That's, it is really hopeful.
00:32:21.388 -->
00:32:25.888Anything else that you'd love, um, our audience to know or anything you'd like to leave us with?
00:32:26.789 -->
00:32:32.549I just feel really, uh, fortunate to have been sort of put in a position here to be able to do this research.
00:32:33.179 -->
00:32:38.819There is a, a quote that I like to think about when I think about the work that we're doing.
00:32:39.329 -->
00:32:44.159Uh, it's a quote from, uh, Helen Keller who said, "Blindness separates you from things.
00:32:44.189 -->
00:32:59.398Deafness separates you from people." And, uh, it's just really, uh, fun and and rewarding to be able to do research in an area where I think we're able to do things that, that help people stay connected and communicate with each other.
00:32:59.759 -->
00:33:00.509I love that.
00:33:00.569 -->
00:33:01.859Great way to close.
00:33:01.859 -->
00:33:02.865Thank you so much.
00:33:04.845 -->
00:33:19.184Jack, thank you so much for opening our eyes or really opening our minds and our ears to a world most of us don't really fully understand, and certainly a part of the body, I think in terms of anatomy, that we really can't see in terms of the inner ear.
00:33:19.784 -->
00:33:29.785It's inspiring to see Vanderbilt researchers pushing the boundaries of both medicine and our imagination, frankly. We can't wait to watch what you and your collaborators do next.
00:33:29.785 -->
00:33:32.424And I'm thrilled to have had you, um, join us today.
00:33:32.424 -->
00:33:33.174Thanks so much.
00:33:33.474 -->
00:33:33.924Thank you.
00:33:33.924 -->
00:33:34.525It's been an honor.
00:33:41.424 -->
00:33:46.974Thank you to our guest, Jack Noble, who's the epitome of the trans-institutional researcher here at Vanderbilt.
00:33:47.575 -->
00:33:55.769Jack is an assistant professor of electrical and computer engineering in the School of Engineering and a faculty fellow at the Vanderbilt Institute for Surgery and Engineering.
00:33:56.429 -->
00:34:12.480Jack also holds an impressive four secondary appointments, including biomedical engineering within the School of Engineering, computer science within the new College of Connected Computing, and two appointments within the School of Medicine, including hearing and speech sciences and head and neck surgery.
00:34:19.409 -->
00:34:22.530The "Quantum Potential" podcast comes from Vanderbilt University.
00:34:23.130 -->
00:34:28.679I'm your host, Cybele Raver, provost and vice chancellor for academic affairs with Vanderbilt University.
00:34:29.730 -->
00:34:33.960This episode was edited and mixed by the team at Sound On Sound Off.
00:34:34.019 -->
00:34:37.980You can learn more about their work at Sound On Sound Off dot com.
00:34:38.804 -->
00:34:44.114For more information about"Quantum Potential," go to vanderbilt.edu/quantum potential.
00:34:45.224 -->
00:34:48.255Thank you for joining us today for the "Quantum Potential" podcast.
00:34:48.945 -->
00:34:54.135Stay tuned for more conversations with the thinkers and innovators reshaping our world.
00:34:54.824 -->
00:34:58.784I'm Cybele Raver, and this has been "Quantum Potential."
