Using AI to diagnose Dementia with Vistim Labs James Hamet + Jason LIVE at iConnections | E1757

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1:27so we're seeing it affect things like advertising copywriting press releases reviews strategy documents but ai is also having a tremendous impact in healthcare and one of the leading diseases that sadly many of us have had to deal with in our families or maybe even personally sadly is alzheimer's um early detection is a key piece of this and my guest today is working on using ai and a bit of hardware uh to track treat detect uh this really pernicious and horrible disease his name is james ammet and he is with vistem labs welcome to the program james jason thank you for having me it's a pleasure to be here it's great to have you um Tell us a little bit about what you're attempting to do.

2:23And then let's look at the hardware here and we'll sportscast it for those of you listening. And just, yeah, tell us about what you're trying to solve for here and how it's going. Thank you. Yeah, I really appreciate the opportunity. So, what I'm working on specifically is, I believe it's the biggest barrier to effective neurological care. And that is the diagnostic piece of the puzzle. because today so many patients, you know, they come to the clinic, they want to get help, but the existing tests that we have are individually inconclusive, they're costly, they're invasive. And what this means usually for a patient is that they have to pay a lot of money out of pocket.

3:01They get results that don't necessarily help them. And it takes a very long time for them to actually get the right diagnosis. For example, Alzheimer's disease. But in dementia, there are actually 105 different cases of different types of dementia. And so figuring out which test is the right one to run, that is a problem that AI is able to solve. And the way that we solve it is in a very unique way. We've come up with a type of brain scan that is able to look at how your brain processes visual information. And from there, we can actually figure out in advance how you'll perform on a PET scan, on a spinal tap on you know a variety of these tests that you would normally pay big money and a lot of time to get the average american it's going to take them you know about 18 months lead time to get a pet scan and uh we think that what we do is very cool you can get results in the same day so uh right now in order to test if you have alzheimer's or to get early detection of it there are physical tests and kind of uh test a doctor could administer like your speech or eye movements coordination that kind of stuff and then if those don't go well they see signs there my understanding is you do this um brain imaging right it's not an mri it's pet positron emission tomography yeah so you basically got it the the world of today is you walk in as a patient and your neurologist is going to ask you questions right it's kind of like a physical evaluation a physical test they don't actually necessarily listen to your speech or look at your eye movements it's more basic than that as wild as that sounds it might be hey can you count backwards from 100?

4:45Do you know what country you live in? Can you draw this shape on this new piece of paper? It's pretty wild because of how subjective it is. And another problem, of course, is that if you are advancing in stages with dementia, you may still be able to count. You may still know where you live, right? I mean, these are questions that I hope I don't get wrong early on into the disease because that really is a sign of late stage. So the world of today, we wait for the symptoms to get so severe that the person can't even count numbers anymore. And that's when we say, OK, let's do a PET scan. It makes sense to do a PET scan.

5:26Very rarely will you do a PET scan on a patient who says, hey, you know, I can't remember people's phone numbers. I can't remember my garage door code. You know, maybe I'm like forgetting my phone and I normally always know where it is. Little tiny things. There's no solution for that type of patient. And PET scans are not cheap and they require a bit of time to do, right? You have to, you take some sort of, I guess you get an injection or you digest some sort of a dye and then it does the scan. But we're talking about to do it for your brain. What does it cost? Five, 10 grand, right? Like this is not cheap.

6:02It's a range. It's between five and 10. Yeah. Yeah. I mean, having. And by the way, it's also inconclusive because you could get inclusive. Of course, you know, none of these tests that exist today are definitive. In order to know that you have the disease, one of the reasons why they wait to get to do the PET scan is because they need to show symptoms. They need to show that your cognition has changed. And so one of the problems that we believe we're solving is we have a test that measures your cognitive ability. It measures, you know, amyloid proteins in your brain, just like a PET scan would.

6:36And it measures signs of neurodegeneration, you know, physical volume changes in the brain. And you need really all three in order to say this is Alzheimer's or something like this. So there has to be a better way. And you have a hardware product plus software to do this? Yeah. So our product is entirely AI, entirely software. We do leverage equipment that's already in the clinic. We use what's called EEG, electroencephalography. It's not our proprietary device. We're not pushing any single unit. The neurologist already has these devices, usually for epilepsy and for sleep monitoring. All that we ask is that the patient wear that device that the physician already has, and then watch our video.

7:19And what our AI does is it looks at how the person's brain interprets the pictures. And we can see what types of pictures, what types of activities, animations the person's brain struggles to interpret. And that's how we know what type of damage it is, where the damage is, how severe it is as well. It's pretty amazing. Some people, from what I'm seeing, become blind to certain types of images based on their brain damage. Oh, really? Wow. That's nuts. It's not really surprising either. Most of your brain is visual cortex. And if you have any one of these diseases, your cortex gets damaged physically.

7:55So some of those links are broken. EEGs are super easy. you put these on your head it's like a bunch of you know diodes or something and it just measures brain activity am i correct yeah there it is we're showing it here so this is a device that you don't make this is a standard device and they use this for sleeping right if they want to if you have narcolepsy or you can't sleep um you wear these and they test your sleeping patterns yeah and this by the way this is not a device that you might see in the clinic this is a little bit more of a like a consumer product just so you know um but yeah uh it's exactly that you have these little tiny uh metal pieces and and then they touch your head just like what was shown in the picture um and typically with a with a medical eeg those will be positions all across your head it looks like a swim cap yeah you know uh it looks yeah and in in that one it looks like an octopus or a swim cap and it's just basically you can get the electrical activity in a brain and then so you have a video of this at work you will um give them a series of tests record the brain activity and then the ai does what and maybe we could show this a little bit yeah yeah and so what the ai does is it looks at all those electrodes and how they correlate with what is being shown on the screen across all the patients in our clinical database so we've used our method yeah that i mean that's how the AI works.

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10:23And we're using it for founder university now. So if you're ready to join the sufficiency revolution with Coda, you can take advantage of the special limited time offer. It's just for startups. Sign up today at Coda.io slash twist and get$1 ,000 in startup credit on your first statement. That's CODA.io slash twist to sign up and get startup credit for$1 ,000 CODA.io slash twist. How many people have you done this with? Yeah, so we've done this with over 150 people, you know, internationally as well. We did this at Columbia University. We also did this in Germany as well at LMU Munich, which is a very reputable university.

11:00And we collected this data with, almost 160 patients. We have amyloid activity, sorry, amyloid protein levels from PET. We also have tau protein levels from Spinal Tap and a variety of other endpoints. And so, what our AI has done is it's trained itself on their EEG to use new EEG to figure out what those endpoints would look like for that new person. And of those 160 odd people who you've had do this, did some of them have certain degrees of alzheimer's and that's how you benchmarked it yeah and some of them were just young healthy people who had none yeah so uh to accurately describe our demographics um i need to say that we didn't use the product on anyone younger than 50 okay um so we don't have you know healthy young people but we do have what's called healthy elders they exist okay that would be me 52 i'm healthy and i'm an elder yes and hopefully you know you'll stay healthy too yeah um and and and so in our in our population that we studied we have these great healthy people um who are staying fit who are highly educated um we have other people who are at the early stages of cognitive decline this is what we call subjective cognitive impairment this is where the patient believes that they're suffering from a disease but there's no clinical evidence that would corroborate that claim uh we also have patients who are considered mild cognitive impairment.

12:30This is where there is evidence. For example, maybe they can't count backwards from 100. Maybe they can't redraw the picture, right? So, there's real symptomatic evidence that's hard to refute, but we don't know what the cause is. And then we also have diagnosed Alzheimer's patients. And so, those are the four cohorts in our population. And so, where are you at in terms of this product being in the market? Because does it fall under a medical device it's diagnostic is this something that's sold to consumers who can then take the information they collect from it like they might with their apple watch or fitbit or their aura and consult their doctor because it's quite a path from what i understand i guess it's the fda that who does medical devices so yeah it regulates it so so how does this work as a startup because i've heard ones you know people who have different technologies say oh we're doing this for quantified itself so we can get it into the field early and then people can use it to gain information as they're allowed to do but it's not for diagnostics or for like a medical treatment so how does this all fall into place as a go-to market strategy if you will so as an entrepreneur and a serial entrepreneur who's also been in the neurotech fields with other businesses uh i i do know this field pretty well so maybe maybe i can move faster than most um but i will say that we will be in the market this year with clinics.

13:55And we're looking right now at having our launch in September, we already have three clinics that we'll be launching to. And the reason that I can move this quickly is that our product is actually exempt from FDA approval. And that's because of our ability to measure cognitive performance of people. Because we're doing that, and because it's clinical cognitive performance, we are classified as a cognitive assessment aid, which creates a special product code which exempts us from the you know advanced fda approvals what this means for our product is that we are not claiming to diagnose alzheimer's with our product our product is simply an ai engine it produces the endpoints that the doctor is interested in getting anyway like the like the pet results and the mri results um we'll provide similar results but we're not we're not claiming that it's alzheimer's now in a future iteration of the products with 510k approval we may but it's not necessary for our go-to-market got it so this is the i mean this is quite reasonable do we have a reasonable framework here in the united states for allowing innovation like you're doing and then also protecting people from like claims it's it seems reasonable explain it to us like um you know for people who are not in the industry how it works getting from one stage to the other?

15:14Yeah. So I will say that not all products will have this opportunity. Not all products will be recognized as FDA exempt. It's all based on the intended use of the product. And so you have to, when you're planning your go-to-market strategy, you have to investigate what those exemption codes are and see if maybe your product does fit with one. I am not an expert. I have experience, but I'm not an expert. We've hired a company called RQM Plus. They've provided us with regulatory advice and guidance. And I guess this is a little plug for them. But they help us make sure that we are not making these decisions in a box and in a silo.

15:56And so for any aspiring entrepreneurs out there listening to this, I would recommend the same thing. Find a consultant, a regulatory consultant who can help you. You can do your own research. What you need at least though is to have a third party just double check your research, right? Lend their experience, confirm with what you're saying. And so the place that we're at right now is we've identified this product code that as long as we are providing cognitive performance indicators, then we are able to be a cognitive assessment aid. And when I say cognitive performance indicators, I don't mean a subjective metric.

16:31I mean, specifically, we are predicting with AI, we are predicting specific cognitive evaluation scores. So the FCSRT test, you know, if you're a neuropsychologist or neuropsychiatrist, you might recognize what that is. The free and queued recall test, it's a memory test. We are able to predict someone's performance for taking that test. And so that is what really is allowing us to take advantage of this code. And yeah, we're not making big claims. We're not saying these are the results of a PET scan, right? That would be dishonest. but what we are saying is we're saying if you took a PET scan this is the type of result you should expect to see if you take an MRI this is the type of result you expect to see and and there's nothing there's nothing wrong with that could there be products out there that take advantage of this yes I believe so the challenge that I would put to those companies is good luck because selling to doctors and hospitals is really really hard they're going to want to see the evidence not just okay it's fda exempt awesome um fda approval exemption whatever whatever it is that's enough to sell legally but you still have to sell to your market and they have their own important criteria for making their buying decision and clinical data is one of them yeah and the and these are broken up into different classes and like you know there's like band-aids and you know then there's like taking your temperature or like a pregnancy test and and you know then you got heart valves you know yeah being implanted by a surgeon and i think the fda does a pretty good job ours is just software too so yeah so it's probably i don't know if it's class one or two or where it falls in all this i'm no expert like i said and um but you'll be able to get that 5 10k at some point to you know as you go but people can just use it for informational purposes now.

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19:32So here is your call to action. To access our new Miroverse template, sign up today for a free Miro account at Miro.com slash startups. That's M-I-R-O.com slash startups to sign up for free. And then have you had any like great results so far in the market or in this testing? Yeah, yeah. So we haven't deployed our product with clinics yet because the product will be launched this year. But then we will start to collect that data and get their feedback. And we believe that will be profitable starting in Q1 of next year. So it's a very quick turnaround. It's very nice that we have an opportunity to make profit even before that 510k opportunity.

20:13And another thing we want to do is expand into other disease states. I mentioned that there are 105 types of dementia. There's also Parkinson's, traumatic brain injuries. So these are areas that we want to help and that we know we can. I do have a video that I can share just to give a little bit more color. Yeah. And so the video is here. I turned off the sound. Yeah, let's see it. So, so this is, there we go. I paused it. This is what a medical EEG device might look like. You can see that it's a little bit more sci-fi, a little bit more like a pretty cool looking strange days. If you know that, uh, uh, great science fiction film at the turn of the century.

20:55Uh, but yeah, it's like a skull cap that's got a bunch of webs on it and it records your brain activity. Yeah. Yeah. And so what we do is we put this device onto the patient, the clinician, you know, loads the software onto the computer and um in a quick instant we'll have the patients uh actually wear it where is this part what does that device cost uh here we go so so the patient here is wearing the eeg and they're they're watching some of our some of our video got it so they're sitting there with that cap on the swim cap like you said and the screen changes and then a report comes out yeah and this is an example of one of our reports so you can see you know activity within the brain you can see where we expect distributions of amyloid um you can actually see these are these are continuums for those different endpoints uh we we you know create a range of where we expect the patient to fall we also have on the bottom here this is progression data how we expect those endpoints to change in the future i think that there might be a close-up that's a little bit better to see um yeah how much does that device cost that goes on people's heads i'm curious oh here we go so that that was just slightly zoomed in here um so you can see here just some of our endpoints so you asked me about the cost so we're not selling the hardware uh since that's not part of our business um i've seen prices range between you know 5 000 on the low end um Um, and on the high end, 40 ,000, uh, just for that, that system for the head to record brain activity.

22:34Yes. And it's not just for the system itself. It's also, it comes with an amplifier, which is a, which is a box that does all the, you know, amplification and a signal collection and all that. It's a big, pretty serious piece of hardware for, um, for clinical systems that you'll see in, you know, the regular neurologist office, um, a better, more accurate range is 10 to$15 ,000. Amazing. $40 ,000. The most expensive one I've ever seen was a university, you know, research equipment with I think it was 248 electrodes. This the one I showed on the video is about 60 electrodes. And so there is no consumer version of that yet in the world.

23:12But just going off script here, and a little bit of a tangent, are there other uses for that thing? At some point, are we all going to have those as like brain interfaces for our computer and be able to think of a question have chat gpt 17 answer it or play a video game with it or drive a car or be in other words like professor x so so i'm actually a a pretty cool guy um you you probably know about neural link right yeah sure you may have heard about a company called neurable neurable was my was my last company and we used eeg to like you said drive a car play video games control things like phone calls and music.

23:53And so, yeah, I mean, I built that technology. And that's where I get my expertise in EEG specifically. Got it. How did that company wind up? Does it actually work? Can it work? Yeah, yeah. No, the company is very successful. It's based in Boston. It's actually continued to raise money and grow without me, which is honestly the dream of any entrepreneur. So, So I get to say that something has outlived me in a sense, at least outlived my exit. And so, yeah, it works very, very well. I'm very proud of the team that's still working on it. I think that we've raised over$10 million to date with that business.

24:33And yeah, we were able to do some amazing projects with some pretty large companies. I don't know what I'm allowed to share, but we used it in pro sports situations. We used it to control virtual reality video games. uh wheelchairs cars um it is some precedent to this with you know there's some precedent to using these things to help with people who are optimizing for sports basketball players whatever reaction time ability to shoot the puck or kick the ball or whatever this is like a known science yeah yeah i mean i got a publication in nature's scientific reports because i invented a type of a way to use this technology to measure how tired somebody was.

25:16I could use EEG to figure out how much sleep the person had the night before and when they'll fall asleep next. And when I say next, I mean, you know, are they going to fall asleep while driving? Is it going to be in the next 30 minutes? I was actually taking that technology to market following Neurable when COVID started and the transportation industry crashed. And so I sort of left that one on the shelf. What would it cost to run your test if like, you know, getting your doctor to check for Alzheimer's, you know, and getting that, you know, special scan? You know, you were talking about 510k.

25:51What do you think you can get it down to this early warning system and how often should people be tested then? Yeah, that's a great question. I believe that every American should be tested from the age of 45 onwards. I would like to suggest an annual test. I believe that you know one test every five years would be the minimum that I would do myself less than that you know you're probably going to miss it you're going to miss the first signs because our technology can pick up the signs of disease up to 10 years before clinical diagnosis and so you would want to catch that 10-year window as soon as you can so I would I would recommends you know uh between once every five years and once every year um the critical question that you're going to ask me is well what's the price right because that determines how often i want to do it yeah uh this is less than a thousand dollars and it's almost entirely covered by insurance for people with for people with medicare medicaid it's fully covered for people who don't have medicare medicaid it's about a hundred dollars that they're paying out of pocket otherwise it's completely it's a completely covered procedure well and if you catch alzheimer's early i guess if people are getting tested for this every year from the age of 45 on and you catch it early in one patient i'm guessing the drugs per month to for people with alzheimer's is probably going to be close or the first couple of months on that drug could be the cost or you know the treatment uh for getting the prevention yeah or something in that range so so if you don't catch alzheimer's early if you try to treat it late that's when the treatments become very expensive um we have like you know attic atahelm and aducanumab and some other treatments that are coming to market now um and it's been a it's had a very big backlash because these drugs some of them cost about a hundred thousand dollars a year that's a ridiculously expensive treatment meanwhile on the flip side uh you know if you're taking preventative medication if you're taking medication that slows symptomatic decline like galantamine and denazepil and there are a couple others i'm not a physician by the way but just sharing some names of some drugs that i've heard from physicians have worked yeah um you know these these drugs are you know a hundred dollars or less um you're saving yeah 99 of your spend with preventative care.

28:21And by the way, I should also share an opinion, but it's an opinion that has some substantiated evidence in literature that these are preventable diseases. The effects of the genetic factors for someone to develop something like Alzheimer's, it's there, but it's not the largest one. The largest correlates that we've seen for people who develop these diseases, You know, it's comorbidities, it's insomnia, it's dietary, it's behavioral. One of the things that we see, and it's hard to explain, but people who isolate themselves from society, who have like more hermit-like existences, they're the ones who are the most prone for developing dementia.

29:02And it's speculated that the social engagements that they have with other people actually keep their brain functioning longer. um so i i believe that there are behavioral solutions as well as pharmaceuticals wow so we can prevent alzheimer's um through a number of just behavioral changes and lifestyle changes exercising healthy lifestyles balanced diet all that kind of stuff and then there's something in these um where mental stimulation or social mental stimulation perhaps um putting aside the comorbidities of like i think it's cardiovascular is the main comorbidity or diabetes diabetes is a big one yeah yeah um there's actually there are some scientists who describe alzheimer's as diabetes type 3 ah alzheimer's that's interesting and this is the thing about and this is really important for entrepreneurs getting good sleep if you don't get good sleep that is a precursor to alzheimer's if you have your sleep interrupted constantly so if you're in a noisy city um and you got garbage trucks in your backyard like i did during my 20s and i had to get like you know like a noise machine and headphones to just block out like the new york city garbage trucks and ambulances that were constantly going by that kind of stuff getting woken up all the time that can be a contributing factor according to you know the research right yes yeah again it's it's a significant factor i um i don't have the statistics on me right now but i believe that it's a 30 increase or more of likelihood to develop alzheimer's yeah all right and so and it's based on how much sleep you don't have right so if you're trying to be a hero and get less sleep you could have less cognitive function in your final years on the planet i know like young people like to make trade-offs but i gotta tell you the sleep thing it's not much of a trade-off because if you get eight hours of sleep or six hours of sleep that two hours you're going to gain quote unquote is going to cost you because your productivity is not going to be as good so you might as well try to get i try to get seven eight i usually get six but i try for seven eight and i'm in the same way as you yeah you get the six but you try for seven eight is that thing yeah yeah yeah i have really worked on it you know the bulldog sleeping with two bulldogs will get you uh yeah that that is a bit of a challenge sometimes it works in your favor sometimes it doesn't well you know what one one interesting thought experiment that you know the audience can think about is uh if it were advantageous to sleep less then how come every single animal sleeps right darwin would have made the adaptation exactly yes and it's not and we don't sleep less than other animals you know we sleep quite a bit um the very intelligent animals sleep more uh it's likely that sleep plays a restorative function for our brain a critical and unskippable restorative function yeah i mean all the sports teams now are tracking i know a lot of nba teams and there's different software companies that do this and they are tracking the sleep of their players as the primary goal i mean diet right after that but it's sleep and diet that they and stress and those things are obviously all related um but yeah sleep so critical to performance uh especially in elite athletes um what do you think just broadly in uh ai while i have you here what what do you what else do you think are going to be you know i think they peter attila calls them like the four horsemen of uh uh death and you know obviously diabetes is one heart uh lungs and you got brain function i'm not sure what they all are but these uh you know diseases what else is going to fall what what other things could we see cancer obviously what other things can we see fall in the future you know through ai what because you must have contemporaries who are working on stuff are you talking about like what other ailments we can detect early detect early and or prevent yeah Yeah, yeah.

33:10So, truly, I believe that most of these disorders that we face are preventable. And I think that that's because of what we've seen now with epigenetics, with the effect of stress and diet on the human body and its ability to turn on and turn off genes. That is mind-blowing to me. um and so i believe that symptom-free living is possible not just in dementia but yeah across these other endpoints there is a lot of really great work happening right now in diabetes there's even some great work in reversing diabetes i think that diabetes and i think that a lot of people would agree with me um that it can be prevented and it can be successfully and effectively prevented as well if you can track that the person is developing the condition early one of the challenges that we have today is that we're still looking at endpoints that we don't fully understand.

34:01We're looking at cholesterol, blood pressure, things that may be indicative of a problem, but things that don't necessarily tell you what the problem is. And so that's the power and opportunity of AI, that we can take all these endpoints that we traditionally look at to distinguish these diseases. And we can have the AI essentially figure out this hyper parameter, this hyper endpoint if you're familiar with that term a meta endpoint um that helps us know what this is because you have like your blood glucose level and you also have your age you got your weight blood pressure family history i mean there's so many things that come into it and what you're saying is you throw all that data into an algorithm do some learning on it it might spit back out like hey this person needs to get this under control um yes before diabetes shows up well this is like amazing what i would like to do uh if i had enough time and actually after my success with this business it's to go into you know some of these more vascular problems and stroke i think is another key area where we need more preventative measures i believe strokes are preventable um and that's an area where if you don't prevent it you have huge consequences so So prevention is the only option in the case of stroke, truly.

35:20It's not like you can necessarily treat it. Sometimes stroke will kill the patient. So what I would like to have is a warning system. Can I, as a patient, go to see my doctor in sci-fi, right? They would sit on the bed and get the whole scan. And okay, in five years, you're going to have your first tumor. That's what I want. Yeah, that's what I want. And that's the future that I hope that I'm building, starting with the brain. Yeah. Yeah. Because then you can change the future if you know it's coming, right? If you know it's coming and you know what? A lot of doctors tell people, hey, listen, you got to lose some weight and you got to stop smoking and people just disregard it and they had a stroke.

35:57Well, and you've been speaking a lot about like, yeah, this like performance type medicine. How powerful is it to have that feedback loop? Yeah. Okay. I go and I change my diet for a week. I come back. Doctor, is it helping me? When the doctor says, I don't know, that's when the patient's like, all right, well, I'm going to go have that cheeseburger later. um but if a doctor does another scan and says hey look yeah you've reduced your your odds by five percent is that motivating i mean yeah super motivating this is why this is why i think weighing yourself every day is such a good practice this is why i think the sleep you know the aura and the and the apple watch fit fitbit the eight sleep all this stuff that helps people get a little bit of metrics um nutrisense and different glucose levels if you start getting that stuff you're like maybe i shouldn't have that bowl of cereal at midnight because my glucose is going to spike and then i'm not going to sleep while you get the double whammy right that was what i was doing that was so uh pernicious and why i gained so much weight is because i was eating like a bowl of cereal or two at midnight make my stomach do backflips wake me up in the middle of the night and my spike in my sugar terrible in the interest of the health of all listeners um uh ice cream at night is uh very bad for you know your alzheimer's future yeah i like ice cream but yeah if you eat it like within two hours of bedtime um that that's a problem i'm not entirely sure why but as our brains uh age we crave sugar more especially in the evening um and that has a very strong link to alzheimer's so i you know i i really believe in this power of like just a little little bit of activity so i just try to walk 20 minutes after dinner or if i eat something if i'm going to reward myself with a little bit of ice cream i just tell people i'll get ice cream we got to walk to the gelato store and we got to walk back so it's a mile or a half mile and i'm like let's walk to the one further away and get the ice cream and then we'll walk back to the car very simple techniques like just park your car five blocks away from the ice cream store and then walk for your ice cream now you got a half mile walk in and why you know i have to I did before.

38:00I care a lot about my health. I think that it's easier to adopt healthy behaviors like that, like walking more, exercising more than it is to cut yourself off. I mean, sometimes you want ice cream. There's nothing wrong with that, but you should, you should get your 20 minutes of exercise a day. And that's been pretty well documented. 20 minutes a day. Life-changing. That is the best thing that you can do for your body if you're not doing it already. all right everybody great job on the company and continued success are you hiring uh and where can people learn more about the company if they want to yeah jason thank you so much so i can be found on linkedin you know uh also our website vistumlabs.com you can email me i'm james at vistumlabs.com please don't spam um but do you need a headhunter are are we are we hiring people um not at the moment we just closed around we just we just brought in some some new team members which is awesome we will be raising later this year i think we will be growing our sales team so if there are people who want to help on that end if you know clinicians what i would ask is if you know clinicians who are working in dementia alzheimer's um and they're interested in learning more please do connect us because the only way that i can create a good product is by speaking with more doctors.

39:17Love it. Got to talk to those customers. All right. And we'll see you all next time on this week in startups. Bye bye. Listen, I'm doing six video podcasts a week. Think that through. Oh my god, this week in startups five days a week for your listening and visual enjoyment. And the video is becoming such a big part of this because we like to show AI tools. And then of course, you know, people love to watch all in the video there because it's dynamic. You see us laughing or rolling our eyes. And I can tell you, when you have this much video, it becomes super expensive. It is at least 10, I would say 20 times more expensive to do a video podcast than an audio one.

39:50And you need powerful tools to do this. But you know how many audio only clips you see going viral 0.0 audio does not go viral videos go viral all day long. I know that because we'll put out 10 clips and all of a sudden boom, one gets 100 ,000 views. So you need to start leveling up your clips game. You need to check out Veed to do that. Veed is a web based video editor that makes it easy for anyone to create great video content. And the best part, no editing skills are required. Veed has every editing feature you'll ever need, including automatic subtitles. This is saving our producers a ton of time.