We are Under a Bit of Pressure | Brian Anthony | TEDxBeaconStreet

so we’re all under a little bit of

so we’re all under a little bit of pressure some of us more than others I’m

pressure some of us more than others I’m

pressure some of us more than others I’m a presumably under a little more

a presumably under a little more

a presumably under a little more pressure up here if you’ve ever been to

pressure up here if you’ve ever been to

pressure up here if you’ve ever been to the the doctor and I think probably

the the doctor and I think probably

the the doctor and I think probably everybody listening has been your

everybody listening has been your

everybody listening has been your pressure has been measured you know how

pressure has been measured you know how

pressure has been measured you know how about you what your internal pressure is

about you what your internal pressure is

about you what your internal pressure is and as you can see on the screen your

and as you can see on the screen your

and as you can see on the screen your your blood pressure was probably

your blood pressure was probably

your blood pressure was probably measured with a blood pressure cuff that

measured with a blood pressure cuff that

measured with a blood pressure cuff that looks something like this so what does

looks something like this so what does

looks something like this so what does blood pressure come from it’s the the

blood pressure come from it’s the the

blood pressure come from it’s the the force the pressure of the blood pumping

force the pressure of the blood pumping

force the pressure of the blood pumping through your body pressing on your

through your body pressing on your

through your body pressing on your artery what is measured as a function of

artery what is measured as a function of

artery what is measured as a function of the stiffness of the artery so your age

the stiffness of the artery so your age

the stiffness of the artery so your age your your physical condition whether or

your your physical condition whether or

your your physical condition whether or not you’re giving a talk to an audience

not you’re giving a talk to an audience

not you’re giving a talk to an audience of hundreds whether you’re relaxed in

of hundreds whether you’re relaxed in

of hundreds whether you’re relaxed in the back of the room we’re hopefully

the back of the room we’re hopefully

the back of the room we’re hopefully tweeting but blood pressure has been

tweeting but blood pressure has been

tweeting but blood pressure has been used for a long time and one of the

used for a long time and one of the

used for a long time and one of the reasons that it’s it’s it’s a biomarker

reasons that it’s it’s it’s a biomarker

reasons that it’s it’s it’s a biomarker that doctors like is that they have a

that doctors like is that they have a

that doctors like is that they have a lot of data on it and there’s a lot of

lot of data on it and there’s a lot of

lot of data on it and there’s a lot of history in terms of what it means to

history in terms of what it means to

history in terms of what it means to have a normal blood pressure or an

have a normal blood pressure or an

have a normal blood pressure or an abnormal blood pressure but it’s

abnormal blood pressure but it’s

abnormal blood pressure but it’s actually kind of complicated to get you

actually kind of complicated to get you

actually kind of complicated to get you have this blood pressure cuff you can do

have this blood pressure cuff you can do

have this blood pressure cuff you can do that in the home you can do that at the

that in the home you can do that at the

that in the home you can do that at the doctor I have a vision where we make it

doctor I have a vision where we make it

doctor I have a vision where we make it a little bit easier but how do we make

a little bit easier but how do we make

a little bit easier but how do we make it easier if you were to take your your

it easier if you were to take your your

it easier if you were to take your your fingers and put them next to your

fingers and put them next to your

fingers and put them next to your esophagus either on the left or the

esophagus either on the left or the

esophagus either on the left or the right of your of your neck if you’re to

right of your of your neck if you’re to

right of your of your neck if you’re to stop talking for a second you can feel

stop talking for a second you can feel

stop talking for a second you can feel your pulse and if your fingers were very

your pulse and if your fingers were very

your pulse and if your fingers were very very sensitive I argue that your fingers

very sensitive I argue that your fingers

very sensitive I argue that your fingers could actually tell you your blood

could actually tell you your blood

could actually tell you your blood pressure so if you sort of pressed a

pressure so if you sort of pressed a

pressure so if you sort of pressed a little bit on your neck your relax a

little bit on your neck your relax a

little bit on your neck your relax a little bit on your neck how your your

little bit on your neck how your your

little bit on your neck how your your blood pressure I have that stiffness of

blood pressure I have that stiffness of

blood pressure I have that stiffness of your neck felt as you were pressing on

your neck felt as you were pressing on

your neck felt as you were pressing on it might tell you something about what

it might tell you something about what

it might tell you something about what your bread your blood pressure actually

your bread your blood pressure actually

your bread your blood pressure actually was so what you’re seeing on the screen

was so what you’re seeing on the screen

was so what you’re seeing on the screen is an exploration of the act of

is an exploration of the act of

is an exploration of the act of deforming tissue so your body is there’s

deforming tissue so your body is there’s

deforming tissue so your body is there’s bones inside but most of its the soft

bones inside but most of its the soft

bones inside but most of its the soft tissue that you deform

tissue that you deform

tissue that you deform and tissue deforms from the blood

and tissue deforms from the blood

and tissue deforms from the blood pumping through it so internal pressure

pumping through it so internal pressure

pumping through it so internal pressure making the tissue to form and you can

making the tissue to form and you can

making the tissue to form and you can deform your tissue by applying external

deform your tissue by applying external

deform your tissue by applying external pressure but pressing on your body what

pressure but pressing on your body what

pressure but pressing on your body what you’re looking at here is an ultrasound

you’re looking at here is an ultrasound

you’re looking at here is an ultrasound probe analogous to what you’d find at

probe analogous to what you’d find at

probe analogous to what you’d find at MGH or Beth Israel Hospital or any

MGH or Beth Israel Hospital or any

MGH or Beth Israel Hospital or any Hospital around the world and there’s an

Hospital around the world and there’s an

Hospital around the world and there’s an ultrasound image of in this case the

ultrasound image of in this case the

ultrasound image of in this case the brachial artery but we’ve measured the

brachial artery but we’ve measured the

brachial artery but we’ve measured the amount of force that is being applied

amount of force that is being applied

amount of force that is being applied during the image acquisition so it’s an

during the image acquisition so it’s an

during the image acquisition so it’s an ultrasound probe what you’re seeing this

ultrasound probe what you’re seeing this

ultrasound probe what you’re seeing this blue frame around the ultrasound probe

blue frame around the ultrasound probe

blue frame around the ultrasound probe is a 3d printed clamshell that attaches

is a 3d printed clamshell that attaches

is a 3d printed clamshell that attaches to the outside of the probe and inside

to the outside of the probe and inside

to the outside of the probe and inside of that clamshell is a force sensor that

of that clamshell is a force sensor that

of that clamshell is a force sensor that allows us to measure how hard were

allows us to measure how hard were

allows us to measure how hard were pressing how hard we’re trying to deform

pressing how hard we’re trying to deform

pressing how hard we’re trying to deform the tissue from the outside of the body

the tissue from the outside of the body

the tissue from the outside of the body while the blood pressure is pushing on

while the blood pressure is pushing on

while the blood pressure is pushing on the inside and you can see when you

the inside and you can see when you

the inside and you can see when you apply just a little bit of force I would

apply just a little bit of force I would

apply just a little bit of force I would normally point with a laser pointer but

normally point with a laser pointer but

normally point with a laser pointer but I guess the image on the Left far left

I guess the image on the Left far left

I guess the image on the Left far left where we’re applying one Newton of force

where we’re applying one Newton of force

where we’re applying one Newton of force the the artery the brachial artery in

the the artery the brachial artery in

the the artery the brachial artery in this case is not very deformed as we

this case is not very deformed as we

this case is not very deformed as we increase the force a little bit more up

increase the force a little bit more up

increase the force a little bit more up to five Newtons the artery is getting a

to five Newtons the artery is getting a

to five Newtons the artery is getting a little more a little more compressed so

little more a little more compressed so

little more a little more compressed so this is an observation how do we use

this is an observation how do we use

this is an observation how do we use this now so the and this notion that we

this now so the and this notion that we

this now so the and this notion that we can sort of feel our pulse to get to a

can sort of feel our pulse to get to a

can sort of feel our pulse to get to a vision where we can potentially just

vision where we can potentially just

vision where we can potentially just measure our blood pressure we’ll get up

measure our blood pressure we’ll get up

measure our blood pressure we’ll get up in the morning when we’re shaving I have

in the morning when we’re shaving I have

in the morning when we’re shaving I have a lot of experience with shaving maybe

a lot of experience with shaving maybe

a lot of experience with shaving maybe not the face but certainly in my head or

not the face but certainly in my head or

not the face but certainly in my head or applying makeup so I have a vision where

applying makeup so I have a vision where

applying makeup so I have a vision where we want to just take a device that sort

we want to just take a device that sort

we want to just take a device that sort of comfortably fits into the palm of

of comfortably fits into the palm of

of comfortably fits into the palm of your hand you just touch it to your neck

your hand you just touch it to your neck

your hand you just touch it to your neck again in five seconds I have a measure

again in five seconds I have a measure

again in five seconds I have a measure of blood pressure so how do we do that

of blood pressure so how do we do that

of blood pressure so how do we do that so a little bit of an anatomy lesson

so a little bit of an anatomy lesson

so a little bit of an anatomy lesson first so this is the on the top we’re

first so this is the on the top we’re

first so this is the on the top we’re seeing the carotid artery around the

seeing the carotid artery around the

seeing the carotid artery around the carotid artery we see the esophagus we

carotid artery we see the esophagus we

carotid artery we see the esophagus we see the vertebrae and in the bottom

see the vertebrae and in the bottom

see the vertebrae and in the bottom image we see an ultrasound probe that’s

image we see an ultrasound probe that’s

image we see an ultrasound probe that’s been used to acquire a cross-sectional

been used to acquire a cross-sectional

been used to acquire a cross-sectional slice of that anatomy in the center you

slice of that anatomy in the center you

slice of that anatomy in the center you see the carotid you see the esophagus or

see the carotid you see the esophagus or

see the carotid you see the esophagus or the shadow and the the right half of the

the shadow and the the right half of the

the shadow and the the right half of the image and you see the vertebra sort of

image and you see the vertebra sort of

image and you see the vertebra sort of deep below on the backside of the art

so what we’re looking at in this video

so what we’re looking at in this video sequence is a application of an

sequence is a application of an

sequence is a application of an ultrasound probe slightly resting on the

ultrasound probe slightly resting on the

ultrasound probe slightly resting on the carotid artery where the patient or a

carotid artery where the patient or a

carotid artery where the patient or a caregiver is just modulating the amount

caregiver is just modulating the amount

caregiver is just modulating the amount of external pressure that’s being

of external pressure that’s being

of external pressure that’s being applied and so you can see that in the

applied and so you can see that in the

applied and so you can see that in the video by the the distance between the

video by the the distance between the

video by the the distance between the surface of the skin and say the

surface of the skin and say the

surface of the skin and say the musculature to the left of the artery

musculature to the left of the artery

musculature to the left of the artery getting slower or getting smaller and

getting slower or getting smaller and

getting slower or getting smaller and smaller and smaller so we’re steadily

smaller and smaller so we’re steadily

smaller and smaller so we’re steadily increasing the amount of pressure that’s

increasing the amount of pressure that’s

increasing the amount of pressure that’s applied from the outside of the body at

applied from the outside of the body at

applied from the outside of the body at the same time you’re seeing the

the same time you’re seeing the

the same time you’re seeing the pulsating of the artery from the inside

pulsating of the artery from the inside

pulsating of the artery from the inside of the body you seeing this pulsation of

of the body you seeing this pulsation of

of the body you seeing this pulsation of the of the blood pressure pumping

the of the blood pressure pumping

the of the blood pressure pumping through the carotid artery so we were to

through the carotid artery so we were to

through the carotid artery so we were to take that video and that that sequence

take that video and that that sequence

take that video and that that sequence of ultrasound imagery and select a few

of ultrasound imagery and select a few

of ultrasound imagery and select a few frames of it we see sort of a low a

frames of it we see sort of a low a

frames of it we see sort of a low a medium and a high level of force on the

medium and a high level of force on the

medium and a high level of force on the left to the right of the frame and the

left to the right of the frame and the

left to the right of the frame and the plot that we’re seeing in the bottom of

plot that we’re seeing in the bottom of

plot that we’re seeing in the bottom of the screen is a is the diameter of the

the screen is a is the diameter of the

the screen is a is the diameter of the minor axis of the artery so it’s the the

minor axis of the artery so it’s the the

minor axis of the artery so it’s the the distance from the top to the bottom of

distance from the top to the bottom of

distance from the top to the bottom of the artery as we’re slowly increasing

the artery as we’re slowly increasing

the artery as we’re slowly increasing our force so as you would expect if if

our force so as you would expect if if

our force so as you would expect if if we didn’t have any blood pressure and we

we didn’t have any blood pressure and we

we didn’t have any blood pressure and we just had this too filled with fluid we

just had this too filled with fluid we

just had this too filled with fluid we press it press it press it we get narrow

press it press it press it we get narrow

press it press it press it we get narrow and narrow narrow and you’re seeing that

and narrow narrow and you’re seeing that

and narrow narrow and you’re seeing that general trend of decreasing and but

general trend of decreasing and but

general trend of decreasing and but you’re seeing the internal pressure of

you’re seeing the internal pressure of

you’re seeing the internal pressure of the of the blood pulsating the artery

the of the blood pulsating the artery

the of the blood pulsating the artery bigger bigger bigger as we go

bigger bigger bigger as we go

bigger bigger bigger as we go so those three frames that we’re seeing

so those three frames that we’re seeing

so those three frames that we’re seeing correspond to those three peaks and so

correspond to those three peaks and so

correspond to those three peaks and so this is the data that we can use

this is the data that we can use

this is the data that we can use destroyed that start to understand if

destroyed that start to understand if

destroyed that start to understand if our fingers were sensitive enough and

our fingers were sensitive enough and

our fingers were sensitive enough and could measure the diameter how did we do

could measure the diameter how did we do

could measure the diameter how did we do that not sure yet I think it measures

that not sure yet I think it measures

that not sure yet I think it measures the diameter of the of the artery and

the diameter of the of the artery and

the diameter of the of the artery and maybe we can get something about blood

maybe we can get something about blood

maybe we can get something about blood pressure this changing diameter and this

pressure this changing diameter and this

pressure this changing diameter and this changing diameter is impacted by how

changing diameter is impacted by how

changing diameter is impacted by how we’re pressing up from the outside and

we’re pressing up from the outside and

we’re pressing up from the outside and how blood is pressing on the inside okay

how blood is pressing on the inside okay

how blood is pressing on the inside okay so this is what we do so to try to

so this is what we do so to try to

so this is what we do so to try to answer this question

answer this question

answer this question started collecting a bunch of data at

started collecting a bunch of data at

started collecting a bunch of data at Mass General Hospital and a couple of

Mass General Hospital and a couple of

Mass General Hospital and a couple of clinical trials used a conventionally a

clinical trials used a conventionally a

clinical trials used a conventionally a commercially available ultrasound probe

commercially available ultrasound probe

commercially available ultrasound probe and again on the outside of this probe

and again on the outside of this probe

and again on the outside of this probe we mounted a a force sensor that

we mounted a a force sensor that

we mounted a a force sensor that measures how hard were pressing the

measures how hard were pressing the

measures how hard were pressing the probe against the body and then use that

probe against the body and then use that

probe against the body and then use that to acquire really two pieces of data the

to acquire really two pieces of data the

to acquire really two pieces of data the the bottom video or the video is again

the bottom video or the video is again

the bottom video or the video is again the sequence of acquiring the ultrasound

the sequence of acquiring the ultrasound

the sequence of acquiring the ultrasound imagery across the carotid and you see

imagery across the carotid and you see

imagery across the carotid and you see the forces being increased and you see

the forces being increased and you see

the forces being increased and you see the pulsation of the carotid from the

the pulsation of the carotid from the

the pulsation of the carotid from the internal force and the the plot on the

internal force and the the plot on the

internal force and the the plot on the bottom right is the force that we

bottom right is the force that we

bottom right is the force that we applied during the imaging process how

applied during the imaging process how

applied during the imaging process how hard we’ve pushed on the outside of the

hard we’ve pushed on the outside of the

hard we’ve pushed on the outside of the body as we’re acquiring this imagery

body as we’re acquiring this imagery

body as we’re acquiring this imagery I’ll just point out there’s these three

I’ll just point out there’s these three

I’ll just point out there’s these three little peaks at the beginning of the

little peaks at the beginning of the

little peaks at the beginning of the force sequence and that’s just to allow

force sequence and that’s just to allow

force sequence and that’s just to allow us to synchronize the data so the our

us to synchronize the data so the our

us to synchronize the data so the our ability to measure force and our ability

ability to measure force and our ability

ability to measure force and our ability to acquire this ultrasound data they’re

to acquire this ultrasound data they’re

to acquire this ultrasound data they’re not tied together two separate systems

not tied together two separate systems

not tied together two separate systems so that we can align the data we do this

so that we can align the data we do this

so that we can align the data we do this pulse pulse pulse so we can synchronize

pulse pulse pulse so we can synchronize

pulse pulse pulse so we can synchronize and then slowly ramp up our force and

and then slowly ramp up our force and

and then slowly ramp up our force and acquire that force data and it’s imagery

acquire that force data and it’s imagery

acquire that force data and it’s imagery data so we have this data set now and we

data so we have this data set now and we

data so we have this data set now and we really solved this this massive

really solved this this massive

really solved this this massive computational problem which as it turns

computational problem which as it turns

computational problem which as it turns out with enough work and a doctoral

out with enough work and a doctoral

out with enough work and a doctoral student working on it for five years can

student working on it for five years can

student working on it for five years can give it to the point where this massive

give it to the point where this massive

give it to the point where this massive computation runs in real time

computation runs in real time

computation runs in real time but as input we use this ultrasound data

but as input we use this ultrasound data

but as input we use this ultrasound data as a function of known applied force so

as a function of known applied force so

as a function of known applied force so at the top of us the input is image

at the top of us the input is image

at the top of us the input is image image image image and each image has an

image image image and each image has an

image image image and each image has an applied force associated with it now we

applied force associated with it now we

applied force associated with it now we model the tissue we model the carotid

model the tissue we model the carotid

model the tissue we model the carotid artery we model the bone as a as a slab

artery we model the bone as a as a slab

artery we model the bone as a as a slab of tissue with a an artery or pressure

of tissue with a an artery or pressure

of tissue with a an artery or pressure vessel that has a certain diameter that

vessel that has a certain diameter that

vessel that has a certain diameter that we don’t know it has an internal

we don’t know it has an internal

we don’t know it has an internal pressure that we don’t know and we don’t

pressure that we don’t know and we don’t

pressure that we don’t know and we don’t know the properties of the tissue so we

know the properties of the tissue so we

know the properties of the tissue so we use this complete observed data set of

use this complete observed data set of

use this complete observed data set of applied pressure and what the ultrasound

applied pressure and what the ultrasound

applied pressure and what the ultrasound imagery is giving us and from the

imagery is giving us and from the

imagery is giving us and from the ultrasound imagery we can see how the

ultrasound imagery we can see how the

ultrasound imagery we can see how the tissue is deforming and we iteratively

tissue is deforming and we iteratively

tissue is deforming and we iteratively solve this very large

solve this very large

solve this very large model just this numerical model using

model just this numerical model using

model just this numerical model using what’s called finite element modeling

what’s called finite element modeling

what’s called finite element modeling but it’s a sort of a network of little

but it’s a sort of a network of little

but it’s a sort of a network of little Springs and masses connected together to

Springs and masses connected together to

Springs and masses connected together to simulate what tissue actually is and out

simulate what tissue actually is and out

simulate what tissue actually is and out of that model we estimate a large number

of that model we estimate a large number

of that model we estimate a large number of things we estimate well what is the

of things we estimate well what is the

of things we estimate well what is the actual average tissue stiffness what is

actual average tissue stiffness what is

actual average tissue stiffness what is the average stiffness of the artery what

the average stiffness of the artery what

the average stiffness of the artery what is the diameter of the artery and most

is the diameter of the artery and most

is the diameter of the artery and most importantly what is the internal

importantly what is the internal

importantly what is the internal pressure of the artery so we just

pressure of the artery so we just

pressure of the artery so we just published a paper earlier this year as

published a paper earlier this year as

published a paper earlier this year as it’s sort of hot off the presses work

it’s sort of hot off the presses work

it’s sort of hot off the presses work that’s happening in my group this was

that’s happening in my group this was

that’s happening in my group this was sort of our first clinical trial on 24

sort of our first clinical trial on 24

sort of our first clinical trial on 24 single visit volunteers the ground truth

single visit volunteers the ground truth

single visit volunteers the ground truth that we can compare our measurement to

that we can compare our measurement to

that we can compare our measurement to is the blood pressure cuff our accuracy

is the blood pressure cuff our accuracy

is the blood pressure cuff our accuracy here compared to the blood pressure cuff

here compared to the blood pressure cuff

here compared to the blood pressure cuff on both systolic and diastolic 7% and 9%

on both systolic and diastolic 7% and 9%

on both systolic and diastolic 7% and 9% which is actually very very good because

which is actually very very good because

which is actually very very good because the blood pressure cuff itself is only

the blood pressure cuff itself is only

the blood pressure cuff itself is only good to about 10% so we don’t know

good to about 10% so we don’t know

good to about 10% so we don’t know whether the error is in the cuff for the

whether the error is in the cuff for the

whether the error is in the cuff for the errors in our measurement but also the

errors in our measurement but also the

errors in our measurement but also the other thing that gives us a lot of

other thing that gives us a lot of

other thing that gives us a lot of extreme confidence there we go is now

extreme confidence there we go is now

extreme confidence there we go is now following an individual over a long

following an individual over a long

following an individual over a long period of time so this is a another

period of time so this is a another

period of time so this is a another volunteer this is a actually a

volunteer this is a actually a

volunteer this is a actually a hypertensive medicated hypertensive

hypertensive medicated hypertensive

hypertensive medicated hypertensive volunteer who came into the lab seven

volunteer who came into the lab seven

volunteer who came into the lab seven visits over a one-month period and this

visits over a one-month period and this

visits over a one-month period and this individual came in right after being

individual came in right after being

individual came in right after being medicated right after taking the

medicated right after taking the

medicated right after taking the medication and that tends to drop the

medication and that tends to drop the

medication and that tends to drop the blood pressure and then we tracked over

blood pressure and then we tracked over

blood pressure and then we tracked over a period of time as the medication sort

a period of time as the medication sort

a period of time as the medication sort of works through the system and blood

of works through the system and blood

of works through the system and blood pressure increases until it gets to the

pressure increases until it gets to the

pressure increases until it gets to the end of the month where that probably be

end of the month where that probably be

end of the month where that probably be another dose to be required but what

another dose to be required but what

another dose to be required but what we’re seeing is very very good tracking

we’re seeing is very very good tracking

we’re seeing is very very good tracking agreement for the individual on a

agreement for the individual on a

agreement for the individual on a measure of blood pressure from the blood

measure of blood pressure from the blood

measure of blood pressure from the blood pressure cuff and from our technique of

pressure cuff and from our technique of

pressure cuff and from our technique of taking a little handheld device that

taking a little handheld device that

taking a little handheld device that almost looks like an ultrasound probe

almost looks like an ultrasound probe

almost looks like an ultrasound probe and just getting an image of the carotid

and just getting an image of the carotid

and just getting an image of the carotid artery and applying a little bit of load

so ultimately we want to try to enable

so ultimately we want to try to enable at the bedside at the at the vanity

at the bedside at the at the vanity

at the bedside at the at the vanity while you’re shaving or applying makeup

while you’re shaving or applying makeup

while you’re shaving or applying makeup you know instead of just shaving pick up

you know instead of just shaving pick up

you know instead of just shaving pick up this device touch it get a measure of

this device touch it get a measure of

this device touch it get a measure of blood pressure and that gives you far

blood pressure and that gives you far

blood pressure and that gives you far more frequent measurements so we don’t

more frequent measurements so we don’t

more frequent measurements so we don’t really understand in the context of

really understand in the context of

really understand in the context of daily living how our blood pressure

daily living how our blood pressure

daily living how our blood pressure varies if you want to get your blood

varies if you want to get your blood

varies if you want to get your blood pressure now you typically have to get

pressure now you typically have to get

pressure now you typically have to get the cuff out so this would give us a

the cuff out so this would give us a

the cuff out so this would give us a weight of more far more frequently get

weight of more far more frequently get

weight of more far more frequently get our underlying physiological data and

our underlying physiological data and

our underlying physiological data and that can teach us a lot about the

that can teach us a lot about the

that can teach us a lot about the physiology about our normal variation

physiology about our normal variation

physiology about our normal variation but ultimately the direction that we’re

but ultimately the direction that we’re

but ultimately the direction that we’re going is how do we now use this to

going is how do we now use this to

going is how do we now use this to enable a blood pressure patch and I’m

enable a blood pressure patch and I’m

enable a blood pressure patch and I’m gonna leave this as the teaser because

gonna leave this as the teaser because

gonna leave this as the teaser because of something we’re working on now and to

of something we’re working on now and to

of something we’re working on now and to do this blood pressure patch I argue you

do this blood pressure patch I argue you

do this blood pressure patch I argue you need three things you need an approach

need three things you need an approach

need three things you need an approach an algorithm a way to make this

an algorithm a way to make this

an algorithm a way to make this measurement and that’s what we’ve

measurement and that’s what we’ve

measurement and that’s what we’ve demonstrated was sort of this handheld

demonstrated was sort of this handheld

demonstrated was sort of this handheld device a way to acquire data that’s

device a way to acquire data that’s

device a way to acquire data that’s ultrasound and force and to process that

ultrasound and force and to process that

ultrasound and force and to process that data and give a very strong estimate of

data and give a very strong estimate of

data and give a very strong estimate of the internal pressure our blood pressure

the internal pressure our blood pressure

the internal pressure our blood pressure but then you also need a a way to make

but then you also need a a way to make

but then you also need a a way to make this a thing that you wear and then you

this a thing that you wear and then you

this a thing that you wear and then you also need a manufacturing process so

also need a manufacturing process so

also need a manufacturing process so I’ll leave that as a teaser for maybe

I’ll leave that as a teaser for maybe

I’ll leave that as a teaser for maybe for next year

for next year

for next year and our ongoing work is miniaturizing

and our ongoing work is miniaturizing

and our ongoing work is miniaturizing these devices getting more data on other

these devices getting more data on other

these devices getting more data on other hypertensive patients there’s a lot of

hypertensive patients there’s a lot of

hypertensive patients there’s a lot of application in other areas where

application in other areas where

application in other areas where pressure may be interesting so blood

pressure may be interesting so blood

pressure may be interesting so blood pressure is certainly one arterial

pressure is certainly one arterial

pressure is certainly one arterial pressure but venous pressure is another

pressure but venous pressure is another

pressure but venous pressure is another area and with that thank you for

area and with that thank you for

area and with that thank you for listening