SKRAPS of Science & Innovation

This is conclusion of the mini-series! In this episode, we uncover the question, is the "cholinergic anti-inflammatory reflex" nerves entirely vagal? The answer is not so straightforward. Building on good work by Davide Martelli and Robin McAllen, we uncover crucial role of the efferent arm of the reflex to "also" be sympathetic.And at the end, we also talk about the importance of understanding the referral and implantation pathway and why we remain muted in the ability of neuromodulation for immune-inflammation to be uptaken widely anytime soon. SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar Editing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

With the set up of how vagus signalling was deduced by careful and meticulous experiments of Linda Watkins, who built on some amazing results from Hugo Besedovsky, we turn our attention to how the hypothesis moved from tackling acute inflammatory models (e.g. Sepsis) to chronic inflammatory models and disease conditions like Rheumatoid Arthritis. We are joined by Tony Arnold, ex-CEO of SetPoint Medical and Dr. Paul-Peter Tak who pioneered the clinical trials in Rheumatoid Arthritis and Inflammatory Bowel Disease. Also, we cover some shocking moral plaigiarism from Feinstein Institute and Dr. Kevin Tracey in managing their public image. We now know that he was not the single pioneer of the transition to Arthritis and IBD trials as the news media claims or potrays him to be. It actually had many people's hand, especially Paul-Peter Tak's. SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun SridharEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

What happens in the vagus, stays in vagus?? Not with us at SKRAPS. “Science Is a Team Sport”If we truly mean this - I mean, really and truly mean that science is a group effort and not the effort of one person, let’s really dive in to this and embrace our opportunities to set the record straight. And I mean let’s start right now! As we endeavor to understand The Wanderer, we must also strive to understand the contributors - and not just the marquee names. We hope to shed light on the nerve, the possibilities, the history, and all of the major players - not just a solo artist. After all, as we near the end of another American football season, I think we can appreciate that Joe Montana was better because of Jerry Rice - Troy Aikman thrived with Michael Irvin, and Tom Brady is the GOAT because of his myriad weapons.Let’s be true to our intent to make science a team sport and go beyond the lip service.SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar Editing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE or you can buy us a coffee - here

Can you tell me the last time that you know of that we eulogised and attributed even the most difficult concepts to a single eureka moment? Was it yesterday? Was it last week?Was it last month? We have this image of a human jumping out of a bathtub and running naked, shedding your rica or an apple falling from a tree or in the case of psychedelic medicine, the famous bicycle trip of Albert Hoffman.If you think you love this romanticised version, let me break this idea for you.Website: www.skrapspodcast.com/season-5SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar Editing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

JoJo and Arun are producing some key content that will make you turn your heads in disbelief. Until then, we thought it would be good to get your mind focussed on that wonderful molecule - serotonin that has received fresh life due to its impact on mental health, be it with psychedelics or with electrical stimulation for depression etc. This episode details some wonderful history of how our body is complicated and yet so wonderful and how there are lessons for everyone irrespective of whether you are a pharmaceutical scientist or a bioelectrician. SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar & JoJo PlattEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedJoJo's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

What Is a BCI? And just as importantly, what isn’t a BCI?This is an unusual episode and an incredibly fun one. Arun and JoJo enlisted some of the field’s top folks to talk through what’s in and what’s out in this exciting field. Amy Kruse is a general partner at Prime Movers Lab and a self-professed Founder turned Funder (and a neuroscientist by training), Matt Angle is the founder and CEO of Paradromics - developing high data rate BCIs, and Marcus Gerhardt is the co-founder and CEO of Blackrock Neurotech and is hoping that their BCIs will disrupt the standard for patient care for the 600 million people that suffer from neurological disorders. This episode has it all - technical glitches, laughter, ruffled feathers (Arun’s specialty), and some tantalizing discussions around definitions, dystopia, and delivering on the promise of this incredible technology. Arun picks at and Matt defends the valuations of BCI companies - replete with funny characters and great voice acting. Amy chimes in with her point of view (plot twist: she’s on the side of massive market potential) while Marcus makes the claim that BCI companies are, in fact, under valued.In short, this episode is pretty much your best chance at eavesdropping on a tantalizing conversation among some truly brilliant people on a fascinating topic. SKRAPS is your podcast, where we on your behalf explores unsaid, under-appreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar & JoJo PlattEditing: Arun SridharSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedJoJo's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

At SKRAPS, we are always looking to get behind the veil of the happenings in the field. We want to go beyond the facade of the news headlines.In recognition of this, we are now reading the slug for part 1 of candid conversations or plainly put - “Cutting through the crap in Bioelectronics”. So, we are joining Dr. Robert Spoelgen, Head of Bioelectronics at Merck KGaA, Darmstadt, 🇩🇪 (They are very particular about this as Merck and Merck KGaA are two separate entities) about their entry, reason, strategy, tactics and thoughts. All references in this episode is to Merck KGaA. SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar & JoJo PlattEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedJoJo's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

Julia Child was a master. She was not a classically trained chef, but pursued cooking as a hobby. Her super power? Passion. A passion for making gastronomy accessible, to deliver an honest and attainable presentation, and she possessed a pure, unadulterated joy for her craft. While Michael Ackermann isn’t a neurotechnolgy hobbyist, he does share other qualities with the inimitable Child. He brings a passion for neurotechnology, mixes it with technical expertise picked up at Case Western Reserve University, panache earned through his time at Stanford BioDesign, and pairs it with an excellent vintage of management style. Hungry yet? We thought you might be. Ackermann was actually one of our early targets for an interview on Skraps. Perhaps it was his humility and desire to keep the focus on the science instead of the personalities that caused him to decline our first plea invitation to record with us, but maybe as we grew in our professionalism and track record, Michael became just a tiny bit more comfortable with the idea. But he did it. We did it. We finally got him on the podcast. I promise, it’s worth the wait. Listen on for the behind the science peek at Ackermann’s time in the BioDesign Program, check in as he deftly maneuvers Oculeve to success, and check out what’s happening now at Presidio Medical and beyond. Who knows what’s next? Perhaps a chocolate soufflé for his wife’s recent birthday (I know this because he was unable to join the Cleveland NeuroDesign faculty in person.)Bon appétit!Papers of interest: Presidio's published research Michael Ackermann's Patents on Nerve BlockSKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar & JoJo PlattEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedJoJo's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

Skraps is turning two. Or is it our second anniversary? I can't quite decide so let's celebrate both. Join us as we walk down memory lane with some highlights (and hopefully no lowlights) of the past two years of their audio partnership. Re-live some of our favorite moments - laughter, tears, learning, and even occasionally, listening. We revisit early episodes (and see how far we've come) with Kit Parker, Stanton Rowe, Sandy Greenberg, and more. With so many hours under our belts, it is impossible to pick "favorites" but we'd love to hear what some of your favorite moments have been, what you'd like to hear more of, and what we can leave on the cutting room floor (that's a reference for an increasingly limited audience - Arun and I are old.)SKRAPS is your podcast, where we, on your behalf, explore unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology, and innovation. Show CreditsCreated & Produced by: Arun Sridhar & JoJo PlattEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedJoJo's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

Funding for Bioelectronic Medicines does not come from traditional venture capital. It also comes from grant funding agencies. While the most well known grant funding bodies are NIH and DARPA in this area, there is also a renewed deeper interest in funding early research to develop products for clinical applications from the EU as well.So we invited, Dr. Enrique Claverol-Tinture (Enric), Program Manager of the Medical Technologies Program to talk about their most recent EIC pathfinder and accelerator challenges that they ran (2021 Pathfinder challenge results here). EIC is a new body and Enric has autonomy to propose new grant funding ideas for Medical Technologies (MedTech) and run funding cycles. He, inspired by the DARPA model can oversee a MedTech idea from conception to fruition. In this episode, we talk about: How the EIC interest in NeuroTech came to be? How does it operate? What did the last pool of successful applicants look like? How the proposals are evaluated? How does the project move from early feasibility to proof of concept to a clinical application? Trials and tribulations of establishing something from ground up. SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar & JoJo PlattEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedJoJo's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

“Laugh and the world laughs with you. Snore and you sleep alone” is a famous quote from the author Anthony Burgess.Sleep Apnea affects 425 million adults over the age of 40. Yet, good treatments are unavailable. In this episode we address how Bioelectronic Medicines helps to alleviate the problem.Links as promised:Inspire Medical - the first hypoglossal nerve stimulation product on the market. Kingman Strohl’s lecture A Ted Talk on Didgeridoo SKRAPS is your podcast, where we on your behalf explores unsaid, underappreciated and sometimes, untold stories of sparks of brilliance in science, technology and innovation. Show CreditsCreated & Produced by: Arun Sridhar & JoJo PlattEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamSound mixing and mastering: Swaminathan ThiruGnanaSambandamSocial Media: Twitter: @PodcastSkrapsLinkedIn: SKRAPSArun's Twitter FeedJoJo's Twitter FeedYou can help us fund the production costs by donating as little as $5 or £5 or in any currency of your choice as a one time or a recurring payment HERE

We are joined by Imran Eba of GlaxoSmithKline's Bioelectronic Medicine fund - Action Potential Venture Capital to talk about investing in Bioelectronic Medicines. APV is the only fund that invests exclusively in bioelectronic medicines - and they've been here since the beginning. This leads to the ongoing question: what is and what is not a bioelectronic medicine (hear all three answers.) After we get through the personal grooming habits of the hosts and our guest as well as the obligatory cricket references (it's hard to put JoJo on her heels in professional sports parlance - but Arun and Imran manage to  keep her quiet for a record time) we launch into a casual conversation about what's happening in neurotech investing. We talk about the trials and tribulations of how the world perceives Bioelectronic Medicines, what it should be, and what the reality is. Generously, Imran also shares with us some insights that every investigator, inventor, and investor should consider when preparing to raise funds in the field of neurotechnology, wait, no - BCIs, no -neuromodulation, gah - I mean... bioelectronic medicine. And if you are looking for the framework for Bioelectronic Medicine that we discuss, you can get it here. Special thanks to our sound engineer, Mr. Swaminathan ThiruGnanaSambandam for his artsy work on audio mixing/mastering and sound design for this episode. Special thanks to our sponsors, CorTec Neuro & Cirtec Medical.Podchaser: 6xQc3dDQaIFab7JcLAab

Most of us can pretty certainly say that we are alone within our heads. We may joke about inner voices, but what really happens when there genuinely is an external influence deep within a brain? The answer? In the case of two research pioneers, Ian Burkhart and Benjamin Stecher, the answer is nothing short of a miracle. These two souls both underwent life altering surgeries - not just in terms of literally allowing a device to tap into their brains, but surgeries that would do for them what no pill, no prayer, and no person could do for them.Ian Burkhart was paralysed after a spinal cord injury endured while on holiday. What should have been a celebratory day at the beach, enjoyed, recorded, and then stored in his memory bank for future reflection ended in severe physical disability. Ian now serves as a Vice President of the North American Spinal Cord Consortium and is an advocate, speaker, and research pioneer.Benjamin Stecher was handed a diagnosis of Parkinson’s Disease at the impossibly early age of 29. He should have been enjoying what many of us believe are the prime years of adulthood when, instead, he was trying desperately to hold on to a “normal” life. He scoured manuscripts, spoke to experts, tested pharmaceutical cocktails to curtail the progression of his disease. Benjamin is an author, advocate, and chair of the Rune Labs Patient Advisory Board.Both of these lionhearted men decided to do what few have done - they have invited a device to take up residence in their respective brains. Listen in to hear the first hand accounts of the what, why, and how they have gone to such lengths. We’ll share with you their stories and their triumphs, and certainly their challenges along the way. At the end of this tale, you will know that both are superhuman, but not for the reasons you may think. You’ll hear about their journeys that have turned them into authors and advocates, and above all, men of science.Learn more about Ian Burkhart through the Ian Burkhart Foundation and read Benjamin’s book, “Brain Fables”. Special thanks to our sponsors, CorTec Neuro & Cirtec Medical. Research & Interviews: JoJo PlattScript: Arun SridharEditing: Arun SridharSound design: Arun Sridhar & Swaminathan ThiruGnanaSambandamAudio engineering/mastering: Swaminathan ThiruGnanaSambandam

PUT YOUR HEADPHONES ON! What does a 4 cm long and 25g in weight crustacean have to teach us about Bioelectronic Medicine and human health? And what does its feeding habits have to tell us about how we deal with tumours? Well, there is more than what meets the eye! If we reveal more than this, we are breaking the plot to you and making your life easy. So, it is time to do the hard yards and go on this underwater exploration first, before we figure out a new frontier for Ultrasound modulation of nerve tumours (in this case - glioblastoma). We cover Dr. Vijay Agarwal and his company - Alpheus Medical for what they are dreaming of, having been inspired by this seemingly innocuous crustacean that has links to World War II, submarines, symbiotic relationships and sonodynamic therapy? Can Alpheus Medical help treat cancer? There is only way to find out. But first, listen to this journey! Our deepest thanks to CorTec Neuro and CirTec Medical for their kind help in bringing these episodes to you.Useful links:Our website: www.skrapspodcast.comDonation Page: www.skrapspodcast.com/donateOur LinkedIn Our Twitter 

The saying, as grotesque as it might be, goes "there's more than one way to skin a cat." In our case, there's more than one way to stimulate a nerve and we've gathered some experts leading the charge (pun very much intended.) Gather around the fire, bring some marshmallows and listen in as we chat with Hubert Lim of the University of Minnesota, Christopher Puleo of GE Research, and Mikhail Shapiro of CalTech about the power and the fury of ultrasound.There are two things that are guaranteed with this group - you will laugh and you will learn something. So, please forgive our indulgences as we dig into the when, the why, and the how this unlikely team came to be and all that they've accomplished so far.To kick off the laugh track, Hubert and Mikhail were kind enough to share some wicked awesome dance moves from each of their respective labs. The Solid Gold Dancers have been put on notice.Our deepest thanks to CorTec Neuro and CirTec Medical for their kind help in bringing these episodes to you.Useful links:Our website: www.skrapspodcast.comDonation Page: www.skrapspodcast.com/donateOur LinkedIn Our Twitter 

Have you ever wondered what decisions go behind deciding if  a pharmaceutical is to be administered either orally or intravenously or via inhalation. Who decides that? Well, the short answer is that it is decided based on a tested pharmaceutical developmental framework that has stood the test of time. First, it is determined by a clinical need, then by what the drug does to the body (pharmacodynamics) and what the body does to the drug (pharmacokinetics) married with other commercial question. Now, if we flip it to Bioelectronic Medicines, we have realized that the field does not have an established framework that is available for everyone to discuss. So we sought to establish that via this episode. We are joined by Dr. Victor Pikov,  who unpicks these crucial questions, as it pertains to Bioelectronic Medicines. We discuss all the crucial questions that needs to be discussed and considered. Special thanks to Laura Szklarski for providing us with a great testimonial and some key actions for you to consider. Our deepest thanks to CorTec Neuro and CirTec Medical for their kind help in bringing these episodes to you. SKRAPS will always remain free, but production of SKRAPS is not. We appreciate kind, recurring donations to help produce such content. You can find more information HERE.

Join Arun & JoJo as they go behind the wall of the science that underpins new treatments for Major Depressive Disorder (MDD). While MDD is the leading cause of both personal and societal disability, there are still inadequate treatment options. But the advent of two very areas are bringing hope! The first area is psychedelic assisted psychotherapy that we covered in our psychedelic series - Episode 7 and Episode 8. And second, more exciting and frankly a profound option is the use of the language that the brain uses to communicate and turn that into a treatment. In this episode, we are joined by two wonderful individuals - Dr. Nolan Williams, Asst Professor at Stanford University and Dr. Brett Wingeier. Nolan is both a psychiatrist and a neurologist and with an impressive training. He takes and compresses (quite literally) all the learnings from deep brain stimulation and Transcranial Magnetic stimulation into developing a bespoke theta burst stimulation, and identifying it for a distinct  patient population for its first adaptation - in hospital, psychiatric emergency.Brett Wingeier, the CEO of Magnus Medical is spearheading the development and commercialisation of the SAINT (Stanford Accelerated Intelligent Neuromodulation Trial) technology via his company, Magnus Medical. In fact, based on the results of their most recent trial, Magnus Medical was offered a breakthrough device designation by FDA. Join us as we uncover the science of this wonderful field and how Bioelectronic medicine is moving from movement disorders like Parkinson’s disease to positively impacting mental health. This is something that you will hopefully not get anywhere else in one piece. 

The NIH's Neuromodulation Prize was announced on Jan 17, 2002. The $9.8 million dollar prize pot will be awarded over three phases. So we did an interview for  Ladan Jiracek & Neural Implant Podcast around this prize, purely because Arun has experience in working as part of the team that did the GSK Innovation Prize. If anyone has not listened to Ladan's podcast and if you work in the area of #NeuroTech, you should definitely catch up with his interviews. Hope this cross-promo gives you the motivation to check out his podcast.  In fact, this prize is modelled on the GSK Innovation Prize, for which Arun wrote the success criteria for. In fact, Arun spoke to Luminary Labs to provide his feedback as he does now after  he was approached last year, based on his experience with the GSK Innovation Prize. More information on his points can be found HERE. Arun offers his frank comments and how this prize is not an optimal way to fund what NIH SPARC should be doing best, which is to unlock new targets for neuromodulation and bioelectronic medicine. He doesn't just stop with the criticism of the field but also provides critical gaps in the SPARC program and what they should have and should probably fund. This is constructive criticism and appraisal of the area and should not viewed as a controversy. Listen to our discussion with Ladan and make up your mind. Feel free to engage with us on Twitter or LinkedInArun can be reached on twitter HERE. 

What in the world is a Bioelectronic Medicine? As promised, link to schema below 👇🏻👇🏻Link to Schema on Bioelectronics Medicines Framework: hereSKRAPS will remain free, but the production is not. If you would like to help us, please visit here. Episode Description: “Tis but thy name that is my enemy; Thou art thyself, though not a Montague. What’s Montague? It is not hand, nor foot, Nor arm, nor face, nor any other partBelonging to a man. O, be some other name!What’s in a name? That which we call a roseBy any other name would smell as sweet; So Romeo would, were he not Romeo call’d, Retain that dear perfection which he owesWithout that title. Romeo, doff thy name, And for that name which is no part of theeTake all myself. For those of us in the field, we know conceptually what bioelectronic medicine is, but we’ve also spent a few years trying to clearly define it as it pertains to the larger fields of #neurotechnology and #neuromodulation. We all have an opinion. A theory. A thought. But in the end, which matters more? What we call it or what it is? In our Bioelectronic Medicine Series, we will endeavour to build consensus around a definition for Bioelectronic Medicine while digging into the history, opportunities, and future. We’ll start today with some background and an overview that will allow new listeners and people outside of the field to join us for another amazing Skraps journey.So, as Tim Dennison (Prof, University of Oxford and former head of engineering at Medtronic) is fond of saying (while toasting with an appropriate pint of suds) “Here’s to neuromodulation, in all of its forms.”If you are thinking of supporting us, please visit here.Recordings were mixed and mastered by Swaminathan Thirugnanasambandam. The content was created by Arun Sridhar & JoJo Platt and the episode was edited by Arun Sridhar. 

What is a Bioelectronic Medicine? How many of us really even know what it is and understand it? This trailer serves as a primer to the season dedicated to Bioelectronic Medicines where our hosts go behind the veil to explore the idea of how medicines that get on your nerves are made.