Dr. Yvette Groszmann, OB/GYN - What is Sonology? (Ultrasound Imaging)

HealthTech Reporter is proud to present our next expert in the field of imaging. YVETTE S. GROSZMANN, MD, MPH, completed a residency in Obstetrics and Gynecology at Pennsylvania Hospital, Philadelphia. In 2009, she left general ob-gyn practice to pursue a fellowship in ob-gyn diagnostic ultrasound with Dr Benacerraf and is now an expert sonologist in early pregnancy and gynecologic ultrasound. She is a fellow of the American College of Obstetrics and Gynecology, a Fellow of the American Institute of Ultrasound (AIUM), former vice president of the American Institute of Ultrasound (AIUM), Chair of the AIUM Gynecology Community of Practice, and a lecturer at Harvard Medical School. She teaches gynecologic ultrasound to the Brigham and Women’s ob-gyn residents and REI fellows, has co-authored a textbook on gynecologic ultrasound, and lectures nationally and internationally.

 

In a recent interview, Dr. Groszmann shares her vision for improved patient care through the philosophy of direct contact with the patient and ultrasound probe. The concept of investigating and recognizing pathology is more efficiently captured by the physician and she discusses this in an excerpt from HTR newscast.

INTERVIEW TRANSCRIPT from Podcast (AIUM Speaker Series)- 5/2024
I became a Gynecologic Sonologist because two of the other physicians in my group were maternal fetal medicine doctors who also did gynecologic ultrasound, but they were more interested in the fetuses.  I frankly, was more interested in the pelvis. I transitioned over the years and I became a specialist in GYN ultrasound. I co-wrote a textbook on this topic. Maybe half of our practice is second opinions, especially in GYN ultrasound. Ultrasound is not typically performed by the physician. It's performed by sonographers (ultrasound technicians). They're taught very well but there is an added layer of validity when you, the physician is the one taking the images, when you understand the physiology and what you're looking at-- it affects interpretation. Our sonographers are excellent-   there's so much more control in scanning the patient if YOU the physician are the one navigating the probe firsthand.

 

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Cohort Study (Part 1)- Dense Breast Scanning Survey / Molloy University: 

ACADEMIC PREFLIGHT STUDY OF ULTRASOUND SCREENING APPLICATIONS FOR DENSE BREAST CASES

Transcript by: Noelle Cutter, Ph.D.

Edited by: Roberta Kline, MD and Lennard M. Goetze, Ed.D

We started working with the Terason 3200t Ultrasound (hereinafter shall be referred to as the Terason) in the summer of 2022. The goal of the project was to be able to scan a limited number of younger premenopausal women under the age of 40 who are more likely to have dense breasts based on their status as being endurance based athletes. We have been exclusively using the Terason based on the recommendation of our lead radiologist Dr. Robert Bard.  The Terason became our lab scanner of choice to conduct the screening of 10 individuals in the lab on a voluntary basis to get a readout for their breast density. Endurance athletes are more prone to dense breast tissue, especially athletes under the age of 40. Mammographic density is the strongest risk factor for non-familial breast cancer among women, especially those under the age of 40.   Metastasis, tumor relapse, and resistance to therapy remain the principal causes of death for breast cancer patients and the lack of effective therapies calls for an improved understanding of the molecular mechanisms driving breast cancer progression. Early identification of mammographic density is an essential step in preventative health.

*** See Dr. Noelle Cutter's Overview on this Phase 1 Study of Dense Breast Survey

REMOTE COLLABORATIVE TEAM

The Dense Breast paradigm continues to plague our population of the underdiagnosed and underserved women. uniting with public advocates and legislative change makers like the ARE YOU DENSE? FOUNDATION raises significant public awareness in both the clinical and patient communities (see news feature).  Meanwhile, this cohort study received great support from the medical research and diagnostic society whereby scientific leaders like Dr. Robert L. Bard (diagnostic imaging specialist) and Dr. Roberta Kline (epigenetics expert in women's health) helped to spearhead their own respective areas of study to help offer new insight and data in support of the launch of this field research program.  

PORTABLE, HOSPITAL GRADE AND FIELD FRIENDLY

My technicians and I found the Terason to be "super portable" and upon scanning our first few subjects, we immediately understood why Dr. Bard suggested this brand and model. The picture quality and imaging system is very clear and the user interface is very easy to read. For someone who is not experienced or well trained in using an ultrasound, with one or two training sessions I was able to easily use the machine to work with our volunteer subjects. 

An underlying test is the feasibility of using the Terason itself in actual field work. The portability is astounding (to me). This means we can pack it up. I don't even need any sort of a car. I could throw it on my back and get on a bicycle and bring it to a, uh, a destination.  

Click image to see full scan report

As far as its' performance, my group and I did our own homework about its accuracy and reliability and what we often found was the common statement about it being "battle-tested"- in the EMS world). Targeting the triathlete community, all these features are critical advantages to roadside screening! It's easy to use and even easier to train other research assistants in the lab to use it. And with Dr. Bard (and his expert interpretation) on the receiving end of our scans, that is the ultimate peace of mind and a COMPLETE tele-health scanning paradigm. 

FINAL STATEMENT
Breast density is a key factor in early detection because mammograms routinely miss breast cancer in dense breasts, especially in younger and more athletic women. Ultrasound offers a supplemental scan and peace of mind because it finds the pathology and almost instantaneously distinguishes from a benign cyst from a possible cancer - or a definite cancer. Ultrasound even goes further because if there is a definite cancer or something highly suspicious of a cancer, you can look at the other organs such as the glands under the arm to see if it's spread into the lining of the lungs to see if it's invading the pleura or the lymph nodes in the abdomen or the brain. Since we are now armed with expert diagnostic over-readers and remote collaborative imaging options, I urge our gynecologic and obstetric community to take advantage of this affordable non-invasive screening solution. 

DR. NOELLE CUTTER is a professor of biology, ironman finisher, and advocate for dense breast screening.  United with an expanding research team dedicated to collecting data on women with dense breasts and screening options for these patients, her initiative aims to investigate and gather conclusive information about dense breasts in specific groups- including age, body mass index, and amount of physical activity and the underlying diagnostics of breast cancer tumors. This research program is under a partnership with Molloy College and Dr. Robert Bard, expert diagnostic cancer imaging specialist in NYC and other colleagues from the NY Cancer Resource Alliance. 

 

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Epigenetic Research Notes: Profiling the Dense Breast Paradigm

A Clinical Report by: Dr. Roberta Kline

LINKING DENSE BREAST WITH BREAST CANCER

We have known for a very long time that there is an increased risk of breast cancer for women who have dense breasts. Until recently, the research has been lagging in terms of what's the molecular mechanism, why do dense breasts present an increased risk of breast cancer? Without this knowledge, we can’t address the root causes, and are left with a lot of trial and error based on incomplete understanding. 

It's very encouraging to know that currently there are 124 clinical trials ongoing looking at dense breasts and the relationship with breast cancer, anywhere from improved diagnostics, to treatment, to prevention, and, what’s close to my heart, to understanding the molecular mechanisms - what's happening at the cell level, at the genetic level that is causing different women to have an elevated risk of breast cancer.  One of the striking features that we're learning about dense breasts and what is creating that density is the microenvironment, which means the environment in the supporting tissue surrounding the glands. This includes fibroblasts and collagen. It seems that rather than estrogen being the dominant factor, it is inflammation that is creating the increased density of breast tissue. 

(See full report @ PINKSMARTNEWS)

 

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WHAT'S NEXT AFTER CANCER?

The Importance of Maintaining a Healthy Lifestyle and Monitoring

Written by: Dr. Leslie Valle-Montoya 

Cancer recurrence can occur months or even years after initial treatment, and it’s important to be aware that cancer can return in different tissues, not just where it was originally diagnosed. While this is a challenging possibility, there are proactive steps you can take to reduce the risk and protect your health.

Staying vigilant with regular check-ups, lifestyle adjustments, and continued screenings is essential. Early detection of any signs of recurrence greatly increases the chances of successful treatment. Maintaining a healthy lifestyle after being declared “cancer-free” is not always easy, but it’s vital. We are constantly exposed to environmental toxins in our food, water, and surroundings, so addressing the root causes of disease and making healthier choices is crucial. A nutritious diet, physical activity, and stress management all support overall wellness and strengthen the immune system. I often guide patients in addressing lingering dental infections and maintaining a healthy internal environment, whether by enhancing the microbiome or reducing bodily acidity, which cancer thrives on.

Avoiding smoking, limiting alcohol, and maintaining a healthy weight are also key to lowering the risk of recurrence. By focusing on what you can control—your health and regular monitoring—you empower yourself to stay well and ensure long-term health.

WOMEN’S HEALTH COLLABORATIVE GOES TO ALBANY

May 21, 2024, leading members of the NY Cancer Resource Alliance (NYCRA) held a special meeting with State Senator Patricia Canzoneri‐Fitzpa...

27 Year Old Stage 3 Breast Cancer Victim Survived - Despite of Docs Who MISDIAGNOSED!   The Women's Health Collaborative and EARLIER DETECTION advocate Alexandra Fiederlein interviewed breast cancer survivor Jamie Butera a...

 

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Rough Cut: Prof. Robert Langer

VIDEO PART 1: Introduction & Nancy Spotlight

Natl Dense Breast Disclosure Law (9/10/2024) Video Part 1

Brain Health & Technology: PEMF Insights with Dr. Barbara Bartlik (NY Psychiatrist)

SPINAL ALIGNMENT INNOVATION REVEALS NEW BENEFITS

SONIK Treatment Solution for Post-Neurosurgery Imbalance
By: Russ Allen, correspondent for HealthTech Reporter

Around the end of 2019, my wife, Kaye was diagnosed with a non-cancerous tumor of the brain, the size of a golf ball. It was determined that surgery was needed. The tumor was sitting right on top of her Pineal gland and resulted in a number of different symptoms. A neurovascular surgeon from New York (Dr. Ng Lin) conducted an MRI guided surgery and was able to successfully excise the tumor without any apparent damage to the brain. 

After that, she had a number of issues with balance and her gait, suspected to be a rare, poorly understood disorder called MAL DE DEBARQUEMENT (MDD) – an issue in the vestibular system that results in a phantom perception of self- motion typically described as rocking, bobbing or swaying. The symptoms tend to be exacerbated when a patient is not moving, for example, when sleeping or standing still- appearing like motion sickness. (1)The inventor of the MRI, Dr. Robert Damadian conducted a post-surgery Fonar MRI while she was sitting up (upper left image) and was able to monitor the brain. He detected a certain amount of seepage of cerebral fluid into the lower left posterior portion of the brain, which he surmised caused Kaye’s MDD symptoms. 

Kaye and I sought a non-surgical solution to this disorder.  We identified the work of Dr. Aslam Khan, the inventor of the SONIK treatment solution as our best option. In discussions with Dr Khan, we learned of the benefits of Dr. Khan’s medical solutions technology utilizing the SONIK medical device which uses sound waves to mitigate the many issues from spine injuries.  A precursor to the SONIK device has been in the clinical market for over 20 years and continues to support the orthopedic community with compelling results(3). It targets the core issues of spinal-related conditions that often lead to painful structural, muscular, and neurological challenges.

In Kaye’s case, she was treated with the device (emitting the pulsed impulses through the device stylus) which is a scientifically validated, non-invasive treatment methodology(2).

We were hoping for an improvement in her gait and balance, which was achieved. An additional unexpected benefit also emerged. The condition observed from the pre-treatment FONAR MRI by Dr Damadian, which displayed  the seepage of cerebral fluid did not appear in the MRI scan by Dr Lin that was done post SONIK treatment. 

Through to date, my wife feels great. Her imbalance symptoms have been resolved. She functions normally; she hikes, she rides bikes daily and goes up and down stairs regularly.  She remains careful with stairs.

Our experience and assessment of the SONIK treatment and Dr. Khan’s concepts of SONIK medicine remains a remarkable find.  Our confidence in Dr. Khan also continues to grow as clinics are expanding throughout the globe- from Canada, the US, Saudi Arabia, Germany, Taiwan, Qatar and more.  As a supporter of breakthrough alternative and functional innovations, this technology continues to inspire exploration.  Having the privilege of experiencing this innovation, my wife and I both fully embrace and endorse the expanded research on the use of this impressive science which Dr. Khan’s clinical leadership had pioneered.

Dr Damadian Pretreatment MRI Scan

Dr Lin Post MRI Scan

EPILOGUE

8/13/2024- Dr. Aslam Khan and Dr. Robert Bard meet for the first time in person to explore collaborative partnerships in support of breakthrough therapeutic technologies.  Dr. Bard, the founder and patriarch of clinical imaging validation through advanced (quantitative) 3D Ultrasound imaging and key principal researcher for IHRC (Integrative Health Research Center, NYC) has expressed major interest in supporting  the expansion of Dr. Khan’s Sonik solution and the vast potential applications of the SONIK technology.  Dr. Bard helped pioneer the use of ultrasound technology in the paradigm of image guided therapies for cancer care and tumor management.  His commitment to advance the expansion of point-of-care ultrasound globally and his support of the non-invasive (non-surgical) movement in medicine aligns with Dr. Khan’s philosophies for treatment and pain care.  “To explore where science and medicine has yet to boldly go where no one has gone before- like the TRICORDER, (a Star Trek Reference) its  where we need to be.  Cutting into the body would someday be a thing of the past… and the impact of energy medicine like this is truly the future that we are finally driving right now”, says Dr. Bard.

References:

1) National Organization for Rare Disorders [Mal de Debarquement]: https://rarediseases.org/rare-diseases/mal-de-debarquement/

2) KKT is a neurospinal innovation/ https://sonik.health/sonik-treatment.php

3) Innovation factory: https://innovationfactory.ca/clients/neuro-spinal-innovation/

TechReview: Exploring the DermaSensor™

Until recently, the approach of identifying skin cancers was commonly a visual self-exam or a clinical exam conducted by a health care provider and/or a dermatologist.  A skin biopsy is the only way to definitively diagnose skin cancer- where a small sample of the suspicious skin is removed and sent to a lab for examination (under a microscope) in search of cancer cells.

HEALTHTECH REPORTER is proud to introduce another non-invasive advancement in skin cancer diagnostics. DermaSensor™ is an AI powered, FDA-cleared innovation designed to help physicians detect skin cancer at the point of care. According to a recent DEMO DAY @ Bard Diagnostics in NYC, clinical educators provided a comprehensive tour of what appears to be a ground-breaking innovation for primary care physicians "offering actionable results to aid in skin cancer detection by assessing cellular and sub-cellular features that cannot be seen visually or dermoscopically". 

DermaSensor™ was designed as a portable and fast-access noninvasive point-of-care assessment tool for primary care physicians to offer additional information about a lesion to aid in their consideration of a referral decision. (DermaSensor™ does not definitively determine whether or not cancer is present, specify what type of cancer may be present, or make any decision for the user.)

By examining the difference in light scattering, DermaSensor™ determines if the skin lesion suggests to “Investigate Further” or “Monitor” - as an immediate output. Elastic Scattering Spectroscopy (ESS) has been validated in 30+ publications on clinical studies. Many studies have shown ESS to provide information that is comparable to histopathologic assessment in the analysis of cellular microscopic structure.*

 

(Image 1-Right) The solid red line is malignant melanocytic lesions. The solid blue line is benign melanocytic lesions and the dotted lines are for malignant non-melanocytic and benign non-melanocytic lesions. And the separation here is the varying spectral signatures for these different categories, and it uses dozens of these wavelengths to discern malignant from benign tissue. for example, it does not use ~600 microns in the center where the lines overlap. That's the reflectance of hemoglobin.

According to Dr. Kiran Chatha (medical science liaison), DermaSensor™ uses the science of Elastic Scattering  Spectroscopy layered with a machine learning algorithm. ESS shines visual light from approximately 350 to 850 nanometers of light onto a given lesion. Based on the reflectance of the intensity of the photons of light, it's able to create a chart which is then compared to spectral signatures which are validated for different tissue types. DermaSensor’s™ tip reflects and records pulses of light off the lesion’s cellular and sub-cellular content. The built-in computer analyzes the light to provide information to help physicians assess skin lesions (including melanomas, squamous cell carcinomas, and basal cell carcinomas) to aid in a referral decision.

DEMO DAY: 

DERMASENSOR PERFORMANCE TEST By Dr. Robert L. Bard

When our scheduler locked down an official device demo of the DermaSensor™, my skin imaging team and I were excited to explore the future of skin cancer detection and how AI truly plays a role in intelligent scanning.  This is the first that we have experienced that inspired the level of confidence to provide immediate objective cancer risk information to PCPs. We originally learned about this technology from Dr. Alina Bridges, Dermatopathologist @ Northwell Health and research collaborator for the DermaSensor™ team. She presented her involvement in an upcoming (FDNY) firefighter skin cancer screening promoted by the American Academy of Dermatology. She also mentioned the technology was being considered for the program. Though the AAD did not learn of this technology in time to evaluate it for this program, she piqued our interest in this device and the science of Elastic Scattering Spectroscopy (EES) as one that may raise the bar for skin cancer detection. 

We stacked the day with patients with chronic skin disorders from basal cell carcinoma, squamous cell carcinoma, and melanoma.  We also brought in patients who recently underwent mohs surgeries to remove malignant lesions.  One by one, the device was surprisingly 'spot on' with its challenge to determine the skin pathologies of each volunteer. We found this performance test to fully quantify each lesion.

My research group conducted their own homework on the technology and found their R&D efforts to rank highly in accuracy and efficacy. With their reported sensitivity rating of 96% and a negative predictive value of 97%, the science of a non-invasive, portable, AI-powered data scanning aligns with our entire med-tech movement trends. 

As a skin cancer radiologist, I have always been passionate about validating pathologies based on a comparative (side by side) view from above the skin and underneath. I relied on the latest quantitative imaging solutions (3D Doppler Ultrasound, Reflectance Confocal Microscopy etc). This DermaSensor™ satisfies both the current status of the malignancy, but its database guides the physician as far as what the malignancy could mean and recommends next steps.

Beneath this simple-looking device holds a vast amount of data to identify a skin anomaly and its malignancy.  I'm told that it is a common question to ask whether this competes with dermatologists, but I immediately see how this actually elevates the reliance between the PCP and the skin specialist. My colleagues in the dermatology society would certainly welcome the benefits that it provides in 1) resulting in more skin cancers detected and referred from primary care, and 2) the objective risk output helps PCPs prioritize referral of high-risk lesions with a PPV of 40% for 8-10 scores (i.e. a NNR of 2.5).

Overall, we found the technology to be quite intelligent and expect the patient care market to embrace this device. It is priced well and is backed by a significant amount of proven research. Their team of dermatology and primary care medical advisors and research collaborators are certainly well recognized in the industry, winning significant votes of confidence within the medical community.

DERMASENSOR MAKES MEDICAL NEWS

The first medical news headline about DermaSensor™  began in May of 2021 where the developers of DermaSensor™  were awarded Breakthrough Device Designation by the FDA-  acknowledging that the DermaSensor™ device is a supportive tool to primary care providers by addressing life-threatening disease and is expected to offer improved effectiveness compared to currently available products. “DermaSensor’s ability to analyze cellular-level features, which is invisible to the human eye even when aided by a dermatoscope, and to accomplish this in seconds, is already empowering clinicians at the important moment of patient assessment and medical decision making", said Cody Simmons, co-founder and Chief Executive Officer of DermaSensor. 

In January 2024, DermaSensor™ received official FDA clearance of its First-In-Class Device and is shaping the future of its market by winning deserved recognition and innovation awards for its continued advancement in cancer diagnostics. An article in Nature agrees, as it describes the FDA’s authorization of this device as “a pivotal moment in digital health innovation” and “establishes a new regulatory precedent for FDA authorization of medical devices incorporating AI and ML technologies within dermatology.”

SPECIAL THANKS:  We wish to express our deep appreciation for the generosity of Mr. Cody Simmons (CEO), Dr. Kiran Chatha, Ms. Ruth Stachura and Dr. Alina Bridges- with whose kind efforts this report could not have been made possible. Healthtech Reporter and Dr. Bard are in no way compensated nor otherwise conflicted with DermaSensor, Inc.

Copyright Notice: The materials provided on this website/web-based article are copyrighted and the intellectual property of the publishers/producers (HealthTechReporter.com, Alliance/IntermediaWorx inc. and The AngioFoundation). It is provided publicly strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

KHAN

 this device kind of falls between, um, so from a realignment perspective, you know, we, we do what we do, uh, and very, very, very, you know, very objectively, and it's also, uh, very visually appealing. Um, and it re it removes the need for, you know, cracking and pulling people's back and, and snapping them and giving them TIAs. Um, so, so that's one side of it, uh, does it consistently without any, you know, with, without any deliberation whatsoever. Um, and as precisely as it's humanly possible. So that's one side of it. On the other side, from a regenerative standpoint, it almost, you know, people who would normally be using PRP and, and, and trying to, you know, uh, experiment with stem cells and all of that, this kind of knocks it out out of the park. So we get tremendous immediate outcomes where there is to the knee, to the shoulder, to soft tissue, and, and most importantly, to cartilage and ligaments. Where that, where that sort of Absolutely. 

So, so where we are with the technology is that, is that currently, I mean, our, our most, the most important thing right now is to be able to put this hand, the technology to the hands of, of clinicians, you know, across the country. That's got to happen. I mean, we just cannot delay anymore. It's, it's, uh, you know, it's, it's, it's, it's, it's so delayed in for, you know, in getting to, into the hands of the clinicians to begin with that I feel guilty about it every single day. And, um, and I think, you know, the, the needless pain and suffering of patients is, is what kind of drives me crazy. You know, every time I think about all the people who are, you know, suffering where this technology in a matter of minutes can change their life, um, you know, and they don't have access to it. And now we've got an FDA clearance, we have the whole, everything is wide open for us. And, uh, now it's just a matter of really placing into the hands of, of, well-meaning people. 

 I can take all the credit for it, but, you know, somewhere, somehow things came and happened and I walked into it and, uh, and I think it was, it was truly a game changer for us to be able to use sound in, in treatment, uh, starting many years ago. And, um, and I think what you'll, what you'll find is that, um, in the years to come, this is going to be the cornerstone of how we apply medicine. There is no question. If there's one thing I can leave behind in this conversation, it's that watch out because there is laser use and there's, you know, there's many other uses as well, uh, chemical use of drugs and surgery and, and, uh, and when it comes to the non-invasive sites, some of the injections and everything, and now they've, they've done their part. 

But when it comes to sound, the, the, the, the implication, the opportunity of being able to tailor it to each person's individual, you know, their own profile, their own individual profile, we just don't have anything that even comes close to that with any other technology. And, you know, and so, um, you know, I think it was, I was very fortunate I walked into it by mistake. And, um, and, you know, I, I opened the curtain and I said, what the hell is this? And, and before I knew it, I had engineers, scientists, researchers working on it, and they spent 10 years of, you know, I spent 10 years of my life just going through the, you know, the grind. And, um, and, but at every corner, the beauty was that at every corner, whenever I would, you know, I would make the next, you know, I would open up the next chapter, I would see something amazing that was even bigger than I imagined. 

I think, I think the beauty is that today, um, the technology has arrived, you know, and, um, and, and, and now in terms of the clinicians, I mean, you know, the joy is that, you know, the more brilliant a clinician and the more thoughtful a clinician is, the more they'll enjoy it and the more they'll discover things that nobody else has discovered and it's at their fingertips, they can apply it. And as long as they're able to capture before and after, they'll know what needs to be done. 

this is gonna be the future of medicine in a big way. It's not gonna be exclusively to this obviously, like everything else, but it's gonna be, it's gonna take on a huge part of our life. If you remember how our man on Star Trek would hold up this, this device and, you know, every time Bones would see somebody with, with an injury, he'd put it up against him. And well, you know, everything else came true in, of Star Trek, whether it was a cell phone or whatever else there was out there in those days. Um, I'm talking about, I'm going back to the original Star Trek, by the way. Unfortunately, I'm dating myself.