Grantees Giving Back: Highlighting Dr. Jacob Sunshine

March 23, 2023

Through its grants and programs, the Foundation for Anesthesia Education and Research (FAER) takes great pride in providing up-and-coming researchers with the tools they need to flourish as independent investigators. It’s always a delight to see past grantees go on to provide these tools to anesthesiology’s developing scholars. Every year, many FAER grantees do just that, paying it forward by becoming mentors themselves and through donations and volunteering to make FAER’s work not only possible, but profoundly successful. One such grantee, Jacob Sunshine, MD, MS, gave very generously to FAER in 2023. Dr. Sunshine’s current work is focused on exploring fascinating opportunities within technology-based translational research.

Awarded a Mentored Research Training Grant (MRTG) in 2016, Dr. Sunshine currently is an Associate Professor in the University of Washington Department of Anesthesiology and Pain Medicine, an Adjunct Professor in the Paul G. Allen School of Computer Science and Engineering, and a researcher at the Brotman Baty Institute. His research has been published in Science Translational Medicine, npj Digital Medicine, JAMA Network Open, and Health Affairs, and has been covered by the Washington Post, The Guardian, NPR, Scientific American, STAT and MIT Technology Review. In addition, in 2019 he cofounded a UW spinout company, Sound Life Sciences, which received an FDA clearance for sonar- based respiratory monitoring via a smartphone in 2021, before being acquired by Google in 2022. Suffice to say Dr. Sunshine keeps a busy schedule!

Despite this busy schedule, Dr. Sunshine kindly took time to correspond with FAER about his journey as an investigator and his recent gift.

As a medical student, what inspired you to pursue anesthesiology?

“I was drawn to anesthesiology because of the opportunity for real-time management and monitoring of patients and their physiology. Separately, I’ve always been interested in public health, the drivers of health across populations, and opportunities to make a direct impact on patients at a population level.”

At what point in your medical journey did you decide you wanted to pursue research? Did you know from the beginning, or was this something you discovered a passion for later in your journey?

“I was fairly certain in medical school that I wanted research to be a part of how I spent my time as a physician, so I tried to make sure along the way (in medical school, residency) that I was learning and developing new research skills and pursuing projects that would help enable that goal.”

Can you please tell our audience a bit about the research you conducted through your FAER Mentored Research Training Grant and how this grant contributed to your career?

“The work I do now is really different than what I did during my FAER award! Which is OK and a common refrain that you hear among members of the FAER community and physician scientists generally. My FAER MRTG was really my first significant grant. It was focused on the epidemiology of traumatic injuries, modelling of traumatic injury risk factors at the county level, and anesthesia staffing approaches in Levels I-V trauma centers.

“I was extremely fortunate to have received this grant in my final year of residency before starting my faculty position at the University of Washington. The easy-to-describe career contributions involve the support to pursue those MRTG research questions, develop new skills and the protected time early in my career to do this work, and prepare for my next grants. Looking back, this grant was also really important validation for me, as an anesthesiologist, to pursue research that was perhaps more public health-focused and less immediately tied to perioperative care or basic science. That FAER had, and continues to have, a more expansive view of how the specialty can contribute to health really speaks volumes to their leadership and vision.”

Building off the last question, can you tell us more about the research you’re now pursuing, and how your MRTG research helped lead to and prepare you for this?

“My lab focuses on technology-based translational research at the intersection of computer science, passive and active sensing and public health. More specifically, my work involves deployment of sensing techniques on low-cost, widely distributed computing platforms (e.g., smartphones and speakers) to identify select respiratory signs of urgent and emergent health conditions in out-of-hospital environments. The respiratory perturbations we focus on include agonal breathing in cardiac arrest, persistent apnea in opioid overdose, and the detection of subtle breathing changes in incipient respiratory infections. The common threads connecting these conditions are changes in respiratory patterns indicative of acute health conditions for which there are clear, evidence-based, and time-sensitive interventions.

“My work employs types of sensors that – unknown to many – are already embedded within common, everyday devices and are capable of sensing using active sonar¹, radar and computational (often machine-based)² classification of medically relevant non-speech sounds. By virtue of their inclusion in devices designed primarily for communication, information from these sensors--coupled with the capability to summon help in a moment of crisis--leads to opportunities for immediate medical response in unwitnessed emergencies such as overdose and cardiac arrest. So, in many respects, what I work on now nicely joins what drew me to the specialty (continuous monitoring of patients) with my interests in technology and public health.”

FAER places great importance on the role mentorship plays in preparing up-and-coming investigators for a career in research. How would you describe your relationship with your MRTG mentors, Drs. Ali Mokdad and Sam Sharar, and the role they’ve played in your current career?

“I can’t say enough about the outstanding mentorship I’ve received from Drs. Sharar and Mokdad and others within my department at the University of Washington and in the FAER community. These mentorship relationships are essential for helping junior investigators navigate the challenging path of launching a research program and building out a sustainable portfolio of inquiry-based work.”

At this point in your career, what inspired you to make such a generous gift to FAER? Why would you encourage your fellow investigators to donate to FAER?

“I still feel somewhat early in my career and thus still acutely appreciate the key role FAER plays in supporting research of young investigators in the specialty. FAER helps support young anesthesiologists at a critical and often challenging transition to launching an independent research career. I really credit FAER with helping me launch my research career and believe that it is important to support this mission.”

Please join FAER in thanking Dr. Sunshine for giving so generously in support of anesthesiology’s earl-career researchers. If you are interested in making a gift to FAER, you can do so at FAER.org/Donate. For large gifts, please contact FAER Development Officer Trevor Peterson.

Stay tuned for more donor and grantee highlights from FAER in the future! The last word goes to Dr. Sunshine with some advice from him for aspiring anesthesiology investigators – and us all.

“When choosing research directions, be open to taking thoughtful risks. Don’t be afraid to pursue research areas that may appear less conventional or outside of what’s traditionally thought of as a focus area of the specialty--sometimes that’s where really interesting opportunities are and anesthesiologists, because of their unique training, can have a differentiated perspective and approach to these questions.”

To learn more about Dr. Sunshine and his research, visit his website here.

THE FOUNDATION FOR ANESTHESIA EDUCATION AND RESEARCH (FAER)
FAER is a related organization of the American Society of Anesthesiologists (ASA). For over 35 years, FAER has been dedicated to developing the next generation of physician-investigators in anesthesiology. Charitable contributions and support to FAER help fuel the future of anesthesiology through scientific discovery. Funding priorities include: Research, Education, and Training. At the time of this article's publication, FAER has awarded more than $53 million in research grants and programs since 1986. To donate to FAER, visit FAER.org/donate.

1. Active sonar requires minimal hardware (one speaker, two or more microphones, and a processor) that are typically found in consumer electronics, especially smart speakers and smartphones. Using active sonar, a speaker emits ultrasound at frequencies that are inaudible to humans while a microphone array concurrently records audio, focusing primarily on the emitted ultrasonic frequencies via digital filtering (enabling speech and other audible sounds to be eliminated, thus preserving privacy). The sonar signal undergoes digital signal processing to identify known frequencies of chest motion associated with respiration, in addition to the transition from normal respiration to cessation of breathing (apnea), which can be observed in opioid toxicity events.


2. An important diagnostic element of out-of-hospital cardiac arrest (OHCA) is the presence of a distinctive type of disordered breathing: agonal breathing. Sometimes reported as “gasping” breaths, agonal breathing is a well-conserved brainstem reflex that occurs in the setting of severe hypoxia. Agonal breathing is clinically evident in upwards of two-thirds of witnessed OHCA reported to 911, indicates a relatively short duration from arrest, and is associated with higher survival rates. Importantly, agonal respirations are distinctive from both regular breathing and atypical sounds associated with sleep-disordered breathing. Because agonal breathing is a distinguishable, measurable, and audible biomarker, it is a compelling candidate for continuous, passive, machine-based audio classification using a commodity smart speaker. Using data from 911 which capture clearly agonal breathing audio, we have trained models to passively detect agonal breathing events in a lab environment.