1 00:00:05,560 --> 00:00:09,520 >>WELCOME TO TODAY'S 2 00:00:09,520 --> 00:00:11,840 HEAL, MULTIDISCIPLINARY WORKING 3 00:00:11,840 --> 00:00:15,280 GROUP MEETING. 4 00:00:15,280 --> 00:00:16,320 NEXT SLIDE, PLEASE. 5 00:00:16,320 --> 00:00:19,680 OKAY, SO, IN OUR LAST MEETING, 6 00:00:19,680 --> 00:00:20,840 FEBRUARY 6th LAST WEEK, WE 7 00:00:20,840 --> 00:00:22,560 TALKED A LITTLE BIT ABOUT SOME 8 00:00:22,560 --> 00:00:24,920 OF THE RESEARCH THAT HEAL 9 00:00:24,920 --> 00:00:26,480 LAUNCHED AT THE BEGINNING OF THE 10 00:00:26,480 --> 00:00:28,360 INITIATIVE THAT IS NOW BEGINNING 11 00:00:28,360 --> 00:00:30,880 TO MAKE PROGRESS, RETURN RESULTS 12 00:00:30,880 --> 00:00:36,440 AND WE ASK FOR YOUR THOUGHTS AND 13 00:00:36,440 --> 00:00:39,280 DISCUSSION AROUND THESE RESEARCH 14 00:00:39,280 --> 00:00:39,680 PROJECTS. 15 00:00:39,680 --> 00:00:41,280 NOW TODAY AND PART OF TOMORROW, 16 00:00:41,280 --> 00:00:44,000 WE'RE GOING TO DISCUSS SOME OF 17 00:00:44,000 --> 00:00:45,040 THE RESEARCH GOING FORWARD THAT 18 00:00:45,040 --> 00:00:47,640 IS PROPOSED FOR THE NIH HEAL 19 00:00:47,640 --> 00:00:50,080 INITIATIVE BY OUR SCIENTIFIC 20 00:00:50,080 --> 00:00:50,280 TEAMS. 21 00:00:50,280 --> 00:00:51,520 RESEARCH THAT IS DESIGNED TO 22 00:00:51,520 --> 00:00:57,280 FILL GAPS IN OUR PORTFOLIO AND 23 00:00:57,280 --> 00:01:00,960 STRENGTHEN OUR OVERALL RESEARCH 24 00:01:00,960 --> 00:01:02,080 INITIATIVES, DEDICATION IS 25 00:01:02,080 --> 00:01:02,760 COMMITMENT TO PROVIDING 26 00:01:02,760 --> 00:01:04,160 SCIENTIFIC SOLUTIONS TO THE 27 00:01:04,160 --> 00:01:08,200 NATIONAL CRISIS OF OPIOID 28 00:01:08,200 --> 00:01:10,680 MISUSE, ADDICTION, OVERDOSE AND 29 00:01:10,680 --> 00:01:13,480 PAIN WHILE ALSO MAKING SURE THAT 30 00:01:13,480 --> 00:01:15,240 WE CONTINUE TO SERVE THE 31 00:01:15,240 --> 00:01:16,240 POPULATIONS AND THE PEOPLE WITH 32 00:01:16,240 --> 00:01:17,960 PAIN AND ADDICTION TO COME TO US 33 00:01:17,960 --> 00:01:24,480 LOOKING FOR A SOLUTION. 34 00:01:24,480 --> 00:01:26,440 SO THIS IS GOING TO END TOMORROW 35 00:01:26,440 --> 00:01:29,000 AFTERNOON WITH A SYNTHESIS OF 36 00:01:29,000 --> 00:01:29,960 THE RESEARCH WE HAVE LAUNCHED 37 00:01:29,960 --> 00:01:31,120 AND WHAT WE'RE CONDUCTING 38 00:01:31,120 --> 00:01:32,640 ALREADY AND WHAT WE HAVE UNDER 39 00:01:32,640 --> 00:01:42,280 CONSIDERATION FOR THE FUTURE. 40 00:01:42,280 --> 00:01:42,880 NEXT SLIDE, PLEASE. 41 00:01:42,880 --> 00:01:44,000 STARTING WITH THE BROADEST 42 00:01:44,000 --> 00:01:45,240 OVERVIEW, AND YOU KNOW THIS 43 00:01:45,240 --> 00:01:46,440 WELL, BUT CONSIDERING HOW MUCH 44 00:01:46,440 --> 00:01:47,960 WE WILL COVER AND HAVE ALREADY 45 00:01:47,960 --> 00:01:49,240 COVERED STARTING WITH THE VERY 46 00:01:49,240 --> 00:01:51,640 BIG PICTURE WHEN WE FIRST SET 47 00:01:51,640 --> 00:01:53,200 OUT TO PROVIDE THESE SCIENTIFIC 48 00:01:53,200 --> 00:01:58,280 SOLUTIONS AND WE LAUNCHED THE 49 00:01:58,280 --> 00:01:59,320 HEAL INITIATIVE, WE SAT FORTH 50 00:01:59,320 --> 00:02:02,120 WITH CERTAIN GOALS THAT YOU KNOW 51 00:02:02,120 --> 00:02:04,120 WELL, SO THE FIRST BEING THE 52 00:02:04,120 --> 00:02:06,280 NEED TO DISCOVER AND ACCELERATE 53 00:02:06,280 --> 00:02:08,920 THE DEVELOPMENT OF SAFE AND 54 00:02:08,920 --> 00:02:09,760 NONADDICTIVE TREATMENT OPTIONS 55 00:02:09,760 --> 00:02:14,240 FOR A VARIETY OF PAIN 56 00:02:14,240 --> 00:02:14,560 CONDITIONS. 57 00:02:14,560 --> 00:02:15,240 TO UNDERSTAND, IDENTIFY AND 58 00:02:15,240 --> 00:02:17,880 REDUCE THE RISK OF SUBSTANCE USE 59 00:02:17,880 --> 00:02:20,920 DISORDER ADDICTION AS WELL AS 60 00:02:20,920 --> 00:02:23,480 CHRONIC PAIN AND MINIMIZE THE 61 00:02:23,480 --> 00:02:25,840 RISK OF SUICIDE. 62 00:02:25,840 --> 00:02:28,600 TO INTEGRATE EFFECTIVE AND 63 00:02:28,600 --> 00:02:30,360 SUSTAINABLE STRATEGIES FOR 64 00:02:30,360 --> 00:02:31,600 PREVENTING OPIOID USE DISORDER 65 00:02:31,600 --> 00:02:34,720 BEFORE IT BECOMES SEVERE, 66 00:02:34,720 --> 00:02:35,920 IMPLEMENTING COMMUNITY FRIENDLY 67 00:02:35,920 --> 00:02:36,880 AND EVIDENCE BASED INTERVENTIONS 68 00:02:36,880 --> 00:02:39,080 THAT WE ALREADY HAD A LOT OF 69 00:02:39,080 --> 00:02:42,360 DATA FOR, FOR REDUCING OVERDOSE, 70 00:02:42,360 --> 00:02:47,520 AND PREVENTING OVERDOSE DEATH. 71 00:02:47,520 --> 00:02:49,320 SUPPORTING PATHS FOR HEALTHY 72 00:02:49,320 --> 00:02:50,800 DEVELOPMENT OF CHILDREN BORN 73 00:02:50,800 --> 00:02:52,760 EXPOSED TO OPIOIDS DURING A 74 00:02:52,760 --> 00:02:53,280 MOTHER'S PREGNANCY, 75 00:02:53,280 --> 00:02:54,760 UNDERSTANDING THE CONS CONVINCES 76 00:02:54,760 --> 00:02:57,560 OF THOSE EXPOSURES AND PROVIDING 77 00:02:57,560 --> 00:03:00,240 EVIDENCE-BASED CARE IN THE 78 00:03:00,240 --> 00:03:01,320 HOSPITAL, IMMEDIATELY FOLLOWING 79 00:03:01,320 --> 00:03:05,920 BIRTH AND LASTLY, DEVELOPING AND 80 00:03:05,920 --> 00:03:07,520 PROVIDING TO PATIENTS, A SUITE 81 00:03:07,520 --> 00:03:10,440 OF USER FRIENDLY OPTIONS FOR 82 00:03:10,440 --> 00:03:11,960 TREATING THEIR SUBSTANCE USE 83 00:03:11,960 --> 00:03:14,160 DISORDER, OPIOID USE DISORDER 84 00:03:14,160 --> 00:03:16,720 THAT REFLECTS THE WHOLE CYCLE OF 85 00:03:16,720 --> 00:03:17,560 ADDICTION, CRAVING, WITHDRAWAL, 86 00:03:17,560 --> 00:03:22,000 ALL THE ASSPECS THAT A PERSON 87 00:03:22,000 --> 00:03:24,360 EXPERIENCES IN ADDITION TO THEIR 88 00:03:24,360 --> 00:03:26,240 OPIOID USE DISORDER OR AS PART 89 00:03:26,240 --> 00:03:27,760 OF THEIR OPIOID USE DISORDER SO 90 00:03:27,760 --> 00:03:29,760 WE STARTED HERE WITH A REALLY 91 00:03:29,760 --> 00:03:31,640 BIG PICTURE AND HERE ON THE 92 00:03:31,640 --> 00:03:33,480 RIGHT SHOWS THE DIFFERENT 93 00:03:33,480 --> 00:03:35,080 SCIENTIFIC TEAMS WHO COME TO YOU 94 00:03:35,080 --> 00:03:36,880 BASED ON AREAS OF RESEARCH FOCUS 95 00:03:36,880 --> 00:03:38,000 TO TALK ABOUT THE PROGRESS 96 00:03:38,000 --> 00:03:39,560 THEY'VE MADE AND WHAT THEY 97 00:03:39,560 --> 00:03:41,480 PROPOSE GOING FORWARD AND YOU 98 00:03:41,480 --> 00:03:44,120 WILL SEE THIS IMAGE AND HEAR 99 00:03:44,120 --> 00:03:47,200 FROM THESE TEAMS LATER OVER THE 100 00:03:47,200 --> 00:03:52,000 NEXT 2 DAYS, NEXT SLIDE, PLEASE. 101 00:03:52,000 --> 00:03:54,640 WHERE ARE WE NOW AND WHAT HAVE 102 00:03:54,640 --> 00:03:56,200 WE ACCOMPLISHED TOWARDS THESE 103 00:03:56,200 --> 00:03:56,800 GOALS. 104 00:03:56,800 --> 00:03:58,400 AT THIS POINT, WE'VE SUPPORTED 105 00:03:58,400 --> 00:04:02,680 OVER 2 AND HALF MILLION DOLLARS 106 00:04:02,680 --> 00:04:04,520 OF RESEARCH, CONTRACTS 107 00:04:04,520 --> 00:04:06,880 COOPERATIVE AGREEMENTS AND 108 00:04:06,880 --> 00:04:08,240 GRANTS, OVER A THOUSAND 109 00:04:08,240 --> 00:04:09,800 DIFFERENT RESEARCH PROJECTS, 110 00:04:09,800 --> 00:04:11,960 ACROSS THE SPECTRUM, THESE ARE 111 00:04:11,960 --> 00:04:13,120 ORGANIZE EDUCATIONAL INTO OVER 112 00:04:13,120 --> 00:04:13,960 40 DIFFERENT PROGRAMS AND 113 00:04:13,960 --> 00:04:16,120 SOMETIMES WE CALL THESE BY NAME 114 00:04:16,120 --> 00:04:18,120 AND YOU'RE FAMILIAR WITH THE 115 00:04:18,120 --> 00:04:19,320 COOPERATIVES AND COLLABORATIVES 116 00:04:19,320 --> 00:04:21,160 THAT ARE PULLING TOGETHER THESE 117 00:04:21,160 --> 00:04:24,840 MULTIPLE PIECES INTO COORDINATED 118 00:04:24,840 --> 00:04:28,000 EFFORTS AND THESE PROJECTS ARE 119 00:04:28,000 --> 00:04:29,040 UNDERWAY ACROSS ALL FIRST STATES 120 00:04:29,040 --> 00:04:31,160 AND IN PUERTO RICO AND IN 121 00:04:31,160 --> 00:04:31,880 INTERNATIONAL LOCATIONS, REALLY 122 00:04:31,880 --> 00:04:34,880 SEEKING TO BUILD UPON ALL THE 123 00:04:34,880 --> 00:04:35,680 EXPERTISE WE HAVE. 124 00:04:35,680 --> 00:04:37,000 THIS IS THE BIOMEDICAL RESEARCH 125 00:04:37,000 --> 00:04:39,280 COMMUNITY TO ROUGH ATOM VIED 126 00:04:39,280 --> 00:04:39,840 THESE SCIENTIFIC SOLUTIONS. 127 00:04:39,840 --> 00:04:44,080 WE HAVE A LARGE NUMBER OF 128 00:04:44,080 --> 00:04:49,480 CLINICAL TRIALS, 314, ACTUALLY 129 00:04:49,480 --> 00:04:51,240 WHICH IS REALLY IMPRESSIVE IN MY 130 00:04:51,240 --> 00:04:52,880 OPINION, A LOT OF CLINICAL 131 00:04:52,880 --> 00:04:54,600 TRIALS TESTING FOR OPIOID USE 132 00:04:54,600 --> 00:04:55,800 DISORDER AS WELL AS PAIN. 133 00:04:55,800 --> 00:04:58,360 OVER A HUNDRED DIFFERENT PRONL 134 00:04:58,360 --> 00:04:59,560 ECTOMYOSINS FOCUSING ON BACK 135 00:04:59,560 --> 00:05:00,560 PAIN SPECIFICALLY, LEADING CAUSE 136 00:05:00,560 --> 00:05:02,320 OF DISABILITY IN THE UNITED 137 00:05:02,320 --> 00:05:03,360 STATES, OVER WOHUNDRED PROJECTS 138 00:05:03,360 --> 00:05:06,240 THAT ARE LOOKING SPECIFICALLY AT 139 00:05:06,240 --> 00:05:07,280 DIFFERENT THERAPEUTIC STRATEGIES 140 00:05:07,280 --> 00:05:08,480 FOR TREATING OPIOID USE DISORDER 141 00:05:08,480 --> 00:05:10,600 WITH THE GOAL OF MORE USER 142 00:05:10,600 --> 00:05:11,880 FRIENDLY OPTIONS FOR PATIENTS. 143 00:05:11,880 --> 00:05:19,720 THIS HAS LED TO OVER 40 FDA, IND 144 00:05:19,720 --> 00:05:23,800 APPLICATIONS, AND QUITE A FEW 145 00:05:23,800 --> 00:05:25,760 ONGOING ACTIVE AND REALLY 146 00:05:25,760 --> 00:05:26,560 INTERDISCIPLINARY PARTNERSHIPS 147 00:05:26,560 --> 00:05:28,360 WITH OUR SISTER AGENCIES ACROSS 148 00:05:28,360 --> 00:05:29,280 THE GOVERNMENT WITH OUR 149 00:05:29,280 --> 00:05:32,080 COLLEAGUES IN THE PRIVATE SECTOR 150 00:05:32,080 --> 00:05:33,960 ADVANCING THESE THERAPEUTIC 151 00:05:33,960 --> 00:05:34,920 CANDIDATES TOWARDS 152 00:05:34,920 --> 00:05:36,600 COMMERCIALIZATION, ACADEMICS AND 153 00:05:36,600 --> 00:05:38,000 INSTITUTIONS WHERE WE'RE WORKING 154 00:05:38,000 --> 00:05:39,840 TO BUILD IN THE NEXT GENERATION 155 00:05:39,840 --> 00:05:43,280 OF RESEARCHERS AND COMMUNITIES 156 00:05:43,280 --> 00:05:44,760 ACROSS THE COUNTRY. 157 00:05:44,760 --> 00:05:47,800 SO NEXT SLIDE WILL SHOW A LITTLE 158 00:05:47,800 --> 00:05:50,040 BIT MORE ABOUT THE BUDGET, SO 159 00:05:50,040 --> 00:05:52,280 WHEN WE MET LAST WEEK, I THINK 160 00:05:52,280 --> 00:05:53,800 THAT THERE WERE SOME FORMATTING 161 00:05:53,800 --> 00:05:55,560 ISSUES IN THE WAY THIS WAS 162 00:05:55,560 --> 00:05:57,120 DISPLAYED SO WE BROKE IN DOWN IN 163 00:05:57,120 --> 00:06:00,440 A LITTLE BIT MORE SPECIFICS FOR 164 00:06:00,440 --> 00:06:03,360 YOU ALL, 1 PIECE OF KIND OF 165 00:06:03,360 --> 00:06:05,200 TRIVIA IS THAT IN 2019 BECAUSE 166 00:06:05,200 --> 00:06:07,720 WE WERE GIVEN SO LITTLE TIME IN 167 00:06:07,720 --> 00:06:10,800 2018 TO LAUNCH OUR FIRST SET OF 168 00:06:10,800 --> 00:06:12,560 RESEARCH PROJECTS THROUGH THE 169 00:06:12,560 --> 00:06:13,720 INITIATIVE, WE HAD KIND OF AN 170 00:06:13,720 --> 00:06:17,360 EXTRA HALF YEAR AND SO IN FISCAL 171 00:06:17,360 --> 00:06:19,920 YEAR 2019 WE SPENT 2 YEARS WORTH 172 00:06:19,920 --> 00:06:22,240 OF MONEY IN 1 YEAR, THAT'S WHY 173 00:06:22,240 --> 00:06:25,200 THIS BUDGET LINE GOES SO FAR 174 00:06:25,200 --> 00:06:29,360 INTO FOR ME THE RIGHT SIDE OF 175 00:06:29,360 --> 00:06:30,720 THE PAGE. 176 00:06:30,720 --> 00:06:32,640 BROKEN DOWN INTO THE 6 DEFINITE 177 00:06:32,640 --> 00:06:34,560 AREAS OF RESEARCH FOCUS THAT I 178 00:06:34,560 --> 00:06:35,560 SHOWED YOU EARLIER, PRECLINICAL 179 00:06:35,560 --> 00:06:39,360 AND THEN CLINICAL RESEARCH IN 180 00:06:39,360 --> 00:06:40,480 PAIN MANAGEMENT ENHANCE OUTCOMES 181 00:06:40,480 --> 00:06:42,480 FOR CHILDREN AND INFANTS AS 182 00:06:42,480 --> 00:06:45,920 SHOWN IN YELLOW, NEW STRATEGIES 183 00:06:45,920 --> 00:06:47,320 FOR PREVENTING AND TREATING 184 00:06:47,320 --> 00:06:48,440 ADDICTION IN GROWN, TRANSLATING 185 00:06:48,440 --> 00:06:53,920 RESEARCH TO PRACTICE IS IN THIS 186 00:06:53,920 --> 00:06:57,680 SURELIAN BLUE, AND THE DARK BLUE 187 00:06:57,680 --> 00:06:59,080 FOR OPIOID USE DISORDER AND 188 00:06:59,080 --> 00:07:00,640 PREVENTING OVERDOSE AND OVER THE 189 00:07:00,640 --> 00:07:02,840 TIME YOU SEE THE EMERGENCE OF A 190 00:07:02,840 --> 00:07:03,960 CROSS CUTTING AND CAREER 191 00:07:03,960 --> 00:07:05,720 DEVELOPMENT SET OF INVESTMENTS 192 00:07:05,720 --> 00:07:07,280 REALLY FOCUSING ON BUILDING ON 193 00:07:07,280 --> 00:07:09,760 THIS RESEARCH AS IT MOVES 194 00:07:09,760 --> 00:07:11,760 FORWARD BOTH AT THE HUMAN LEVEL 195 00:07:11,760 --> 00:07:12,720 AND THE RESEARCHER LEVEL AND 196 00:07:12,720 --> 00:07:15,480 ALSO IN SOME OF OUR DATA AND 197 00:07:15,480 --> 00:07:16,320 COLLABORATIVE EFFORTS COMING OUT 198 00:07:16,320 --> 00:07:24,840 OF THE RESEARCH. 199 00:07:24,840 --> 00:07:25,280 NEXT SLIDE, PLEASE. 200 00:07:25,280 --> 00:07:26,880 AND ANOTHER WAY OF SHOWING KIND 201 00:07:26,880 --> 00:07:29,880 OF WHERE WE ARE NOW IS OUR 202 00:07:29,880 --> 00:07:32,080 OVERALL BALANCE BETWEEN OPIOID 203 00:07:32,080 --> 00:07:33,520 ADDICTION AND OVERDOSE RESEARCH, 204 00:07:33,520 --> 00:07:36,920 PAIN RESEARCH IN THE AREAS WHERE 205 00:07:36,920 --> 00:07:37,920 THOSE CATEGORIES REALLY OVERLAP, 206 00:07:37,920 --> 00:07:41,240 SO THAT'S SHOWN TO YOU ON THE 207 00:07:41,240 --> 00:07:41,560 RIGHT. 208 00:07:41,560 --> 00:07:42,600 OVER TIME WE'VE HEARD BOTH FROM 209 00:07:42,600 --> 00:07:44,480 YOU AND FROM OUR EXTRAMURAL 210 00:07:44,480 --> 00:07:47,160 COMMUNITY THAT IT'S REALLY 211 00:07:47,160 --> 00:07:51,240 IMPORTANT TO CONTINUE TO SUPPORT 212 00:07:51,240 --> 00:07:53,200 BOTH AREAS OF RESEARCH AND WHILE 213 00:07:53,200 --> 00:07:54,360 THE ADDICTION FIELD WAS REALLY 214 00:07:54,360 --> 00:07:56,920 READY TO GO IN CERTAIN ASPECTS 215 00:07:56,920 --> 00:08:00,160 IN 2019, THE PAIN COMMUNITY IS 216 00:08:00,160 --> 00:08:02,120 CONTINUING TO GROW AND SO 217 00:08:02,120 --> 00:08:04,280 PROVIDING RESEARCH OPPORTUNITIES 218 00:08:04,280 --> 00:08:06,040 TO SUPPORT THAT GROWTH. 219 00:08:06,040 --> 00:08:08,520 WE'VE ALSO BUILT IN INTO OUR 220 00:08:08,520 --> 00:08:11,280 RESEARCH PORTFOLIO A REAL FOCUS 221 00:08:11,280 --> 00:08:13,040 ON CO-OCCURRING CONDITIONS THAT 222 00:08:13,040 --> 00:08:13,960 INCLUDES MENTAL HEALTH 223 00:08:13,960 --> 00:08:15,240 CONDITIONS RECOGNIZING THAT IN 224 00:08:15,240 --> 00:08:16,600 REAL PEOPLE THESE CONDITIONS 225 00:08:16,600 --> 00:08:18,880 COEXIST AND THAT OUR RESEARCH 226 00:08:18,880 --> 00:08:20,280 SHOULD REFLECT THAT. 227 00:08:20,280 --> 00:08:22,160 WE'VE INTEGRATED INTO OUR 228 00:08:22,160 --> 00:08:25,040 OVERALL PORTFOLIO OF FOCUS ON 229 00:08:25,040 --> 00:08:25,600 ADDRESSING STIGMA DIRECTLY 230 00:08:25,600 --> 00:08:29,160 THROUGH RESEARCH AS WELL AS 231 00:08:29,160 --> 00:08:31,000 RESEARCHERS CHOSE TO ADDRESS 232 00:08:31,000 --> 00:08:32,240 INIQUITIES IN OUR HEALTHCARE 233 00:08:32,240 --> 00:08:33,680 SYSTEM AND ACCESS TO HIGH 234 00:08:33,680 --> 00:08:37,400 QUALITY CARE. 235 00:08:37,400 --> 00:08:39,920 WE'VE DONE ALAN'S VIDEO WAS JUST 236 00:08:39,920 --> 00:08:41,520 1 WAY THAT WE'VE SOUGHT TO LEARN 237 00:08:41,520 --> 00:08:45,480 FROM THE VOICES OF LIVED 238 00:08:45,480 --> 00:08:46,760 EXPERIENCE AND BUILT CONNECTION 239 00:08:46,760 --> 00:08:47,560 BETWEEN PEOPLE WHO EXPERIENCE 240 00:08:47,560 --> 00:08:50,840 PAIN AND ADDICTION AND THE 241 00:08:50,840 --> 00:08:52,360 RESEARCH WE SUPPORT TOWARDS 242 00:08:52,360 --> 00:08:56,960 PROVIDING THEM WITH SOLUTIONS. 243 00:08:56,960 --> 00:08:58,280 WE HAVE SOUGHT TO LEVERAGE THE 244 00:08:58,280 --> 00:09:00,040 POWER OF THE DATA COMING THROUGH 245 00:09:00,040 --> 00:09:01,320 OUR RESEARCH INITIATIVES AND 246 00:09:01,320 --> 00:09:03,960 ALSO TO SUPPORT TRAINING 247 00:09:03,960 --> 00:09:09,880 OPPORTUNITIES AND EARLY CAREER 248 00:09:09,880 --> 00:09:10,200 OPPORTUNITIES. 249 00:09:10,200 --> 00:09:12,760 SO, ROB, CAN YOU GO BACK 1 250 00:09:12,760 --> 00:09:14,240 SLIDE? 251 00:09:14,240 --> 00:09:16,560 THIS IS REALLY THE OVER TIME 252 00:09:16,560 --> 00:09:19,040 PERSPECTIVE IF YOU LOOK AT THE 253 00:09:19,040 --> 00:09:19,960 CATAGORYS OF-- 254 00:09:19,960 --> 00:09:21,800 >>YEAH, IT'S YOU HAVE TO GO 255 00:09:21,800 --> 00:09:23,800 BACK--LITTLE HARD TO KIND OF-- 256 00:09:23,800 --> 00:09:24,760 >>YEAH, THE RED AND ORANGE 257 00:09:24,760 --> 00:09:25,960 TOGETHER ARE THE CLOSEST WE HAVE 258 00:09:25,960 --> 00:09:28,600 TO PAIN BUT YOU DO SEE THE 259 00:09:28,600 --> 00:09:31,560 PURPLE GROWING OVER TIME WHICH 260 00:09:31,560 --> 00:09:36,440 ADDS NUANCE AS WELL. 261 00:09:36,440 --> 00:09:39,160 OKAY, SO GOOD FORWARD 2 PLEASE? 262 00:09:39,160 --> 00:09:40,480 ACROSS ALL OF THESE DIFFERENT 263 00:09:40,480 --> 00:09:42,440 AREAS OF RESEARCH FOCUS, WE DO 264 00:09:42,440 --> 00:09:43,920 HAVE CERTAIN CROSS CUTTING 265 00:09:43,920 --> 00:09:45,840 THEMES THAT HAVE BEEN IN PLACE 266 00:09:45,840 --> 00:09:49,320 AT THE BEGINNING AND THAT WE 267 00:09:49,320 --> 00:09:52,000 HAVE REALLY EMBRACED AND PUT OUR 268 00:09:52,000 --> 00:09:54,560 DEDICATED EFFORT INTO AS TD 269 00:09:54,560 --> 00:09:56,040 INITIATIVE HAS EVOLVED. 270 00:09:56,040 --> 00:09:58,960 FIRST LOOKING AT THE BIOLOGY OF 271 00:09:58,960 --> 00:10:00,400 PAIN AND ADDICTION AND 272 00:10:00,400 --> 00:10:02,000 LEVERAGING WHAT WE HAVE ALREADY 273 00:10:02,000 --> 00:10:03,320 LEARNED AND WHAT WE ARE LEARNING 274 00:10:03,320 --> 00:10:05,280 THROUGH ALL OF THESE NEW CUTTING 275 00:10:05,280 --> 00:10:07,000 EDGE APPROACHES TO REALLY FOCUS 276 00:10:07,000 --> 00:10:08,640 ON PAIN AND ADDICTION AND WHAT 277 00:10:08,640 --> 00:10:11,640 WE CAN OFFER TO PEOPLE WITH 278 00:10:11,640 --> 00:10:12,200 THOSE HEALTH CONDITIONS. 279 00:10:12,200 --> 00:10:15,640 THAT BRINGS ME TO THE NEXT CROSS 280 00:10:15,640 --> 00:10:17,120 CUTTING THEME FOCUSING ON THE 281 00:10:17,120 --> 00:10:21,640 NEEDS OF THE WHOLE PERSON. 282 00:10:21,640 --> 00:10:23,160 IN THE THIRD THEME HERE WORKING 283 00:10:23,160 --> 00:10:25,960 WITH COMMUNITIES TO BRING 284 00:10:25,960 --> 00:10:27,000 RESEARCH TO LIFE, WE HEARD FROM 285 00:10:27,000 --> 00:10:28,400 YOU VERY EARLY ON THAT HEAL 286 00:10:28,400 --> 00:10:30,360 WOULD NOT BE SUCCESSFUL IF WE 287 00:10:30,360 --> 00:10:32,840 FOCUSED ONLY ON THE RESEARCH AND 288 00:10:32,840 --> 00:10:33,640 THE RESEARCH PROJECTS. 289 00:10:33,640 --> 00:10:35,040 WE NEEDED TO FIND THOSE THAT ARE 290 00:10:35,040 --> 00:10:37,560 GOING TO HELP OUR RESEARCH 291 00:10:37,560 --> 00:10:39,160 FINDINGS, WORK WITH THEM TO 292 00:10:39,160 --> 00:10:40,680 TRANSLATE THEM AND BE PREPARED 293 00:10:40,680 --> 00:10:42,680 TO MAKE CHANGES IN POLICY AND 294 00:10:42,680 --> 00:10:44,960 PRACTICE BASED ON OUR RESEARCH 295 00:10:44,960 --> 00:10:47,920 RESULTS AND THEN LASTLY BE VERY 296 00:10:47,920 --> 00:10:51,800 REALISTIC AND UNDERSTAND THAT 297 00:10:51,800 --> 00:10:53,120 THERE ARE SYSTEMIC INEQUITIES 298 00:10:53,120 --> 00:10:57,720 AND CHALLENGES THAT KEEP OUR 299 00:10:57,720 --> 00:11:00,520 RESEARCH ADVANCES FROM ACCESSING 300 00:11:00,520 --> 00:11:01,760 PROVIDING BENEFIT TO ALL OF THE 301 00:11:01,760 --> 00:11:03,080 COMMUNITIES WE SERVE AND SO 302 00:11:03,080 --> 00:11:04,960 REALLY LOOKING AT THOSE SYSTEMIC 303 00:11:04,960 --> 00:11:06,920 CHALLENGES AND TRYING TO ADDRESS 304 00:11:06,920 --> 00:11:07,800 THEM WITH OUR RESEARCH. 305 00:11:07,800 --> 00:11:12,400 SO NEXT SLIDE, PLEASE. 306 00:11:12,400 --> 00:11:14,800 SO WHERE WE ARE TODAY IS REALLY, 307 00:11:14,800 --> 00:11:16,440 I THINK AN INFLECTION POINT FOR 308 00:11:16,440 --> 00:11:18,040 THE HEAL INIT WHYATIVE. 309 00:11:18,040 --> 00:11:20,560 WE ARE BOTH LOOKING BACK OVER 310 00:11:20,560 --> 00:11:23,280 WHAT WE'VE DONE AND ALSO LOOKING 311 00:11:23,280 --> 00:11:25,120 FORWARD TOWARDS WHAT WE HOPE TO 312 00:11:25,120 --> 00:11:27,800 BE ABLE TO DO AND TAKING A 313 00:11:27,800 --> 00:11:33,240 MOMENT TO PAUSE AND KIND OF 314 00:11:33,240 --> 00:11:34,440 CONSIDER IT ALTOGETHER. 315 00:11:34,440 --> 00:11:36,160 ARE WE ACCOMPLISHING OUR CORE 316 00:11:36,160 --> 00:11:40,400 GOALS AND ARE WE ADAPTING IN THE 317 00:11:40,400 --> 00:11:42,200 RIGHT WAYS TO HAVE THE EVOLVING 318 00:11:42,200 --> 00:11:43,560 DRIVERS, BOTH FOR PAIN AND 319 00:11:43,560 --> 00:11:45,000 ADDICTION IN THE COUNTRY. 320 00:11:45,000 --> 00:11:46,040 WHAT CHANGES ARE WE EXPERIENCING 321 00:11:46,040 --> 00:11:48,640 AND ARE WE ABLE TO ADDRESS THEM 322 00:11:48,640 --> 00:11:49,960 THROUGH OUR RESEARCH AND ARE WE 323 00:11:49,960 --> 00:11:53,880 DOING THAT THE RIGHT WAY? 324 00:11:53,880 --> 00:11:55,720 FOR THE PROGRAMS THAT WERE 325 00:11:55,720 --> 00:11:58,280 LAUNCHED IN THAT LARGE FIRST 326 00:11:58,280 --> 00:12:00,960 YEAR OF HEAL THERE NOW COMING TO 327 00:12:00,960 --> 00:12:03,480 THE END OF THEIR FIRST PERIOD 328 00:12:03,480 --> 00:12:05,640 AND WE HAVE TO DECIDE IN WHAT 329 00:12:05,640 --> 00:12:07,240 WAYS THEY SHOULD CONTINUE AT 330 00:12:07,240 --> 00:12:09,480 WHAT LEVEL, OR WITH WHAT AREAS 331 00:12:09,480 --> 00:12:09,960 OF FOCUS. 332 00:12:09,960 --> 00:12:12,360 AND AT THE SAME TIME WE'RE 333 00:12:12,360 --> 00:12:14,440 CONSIDERING NEW AREAS OF 334 00:12:14,440 --> 00:12:14,720 RESEARCH. 335 00:12:14,720 --> 00:12:19,360 AND AT THE SAME TIME, LOOKING TO 336 00:12:19,360 --> 00:12:20,560 BALANCE OUR OVERALL PORTFOLIO AS 337 00:12:20,560 --> 00:12:22,200 WE HAVE FOR THE PAST COUPLE 338 00:12:22,200 --> 00:12:26,000 YEARS BETWEEN ALL OF THESE 339 00:12:26,000 --> 00:12:27,280 DIFFERENT ASPECTS AND ELEMENTS 340 00:12:27,280 --> 00:12:29,760 OF THE SPECTRUM SO THAT WE 341 00:12:29,760 --> 00:12:31,280 CONTINUE TO ADVANCE A NUMBER OF 342 00:12:31,280 --> 00:12:33,120 DIFFERENT DIRECTIONS. 343 00:12:33,120 --> 00:12:36,000 SO, I THINK THAT THAT'S KIND OF 344 00:12:36,000 --> 00:12:38,280 A GOOD PLACE TO STOP AND ASK IF 345 00:12:38,280 --> 00:12:38,840 THERE ARE QUESTIONS. 346 00:12:38,840 --> 00:12:40,560 I HAVE A FEW MORE SLIDES LEADING 347 00:12:40,560 --> 00:12:43,320 INTO THE NEXT DISCUSSION, BUT, 348 00:12:43,320 --> 00:12:53,840 ARE ANY THOUGHTS OR QUESTIONS AT 349 00:12:58,640 --> 00:12:59,720 THIS TIME? 350 00:12:59,720 --> 00:13:01,480 OKAY, THEN, I WILL PROCEED. 351 00:13:01,480 --> 00:13:04,680 NEXT SLIDE, PLEASE. 352 00:13:04,680 --> 00:13:05,960 SO, SELECTED RESEARCH 353 00:13:05,960 --> 00:13:08,920 ACCOMPLISHMENTS IS NEXT, SO LAST 354 00:13:08,920 --> 00:13:10,920 WEEK YOU DID HEAR ABOUT AREAS 355 00:13:10,920 --> 00:13:12,320 WHERE HEAL HAS LARGE PROGRAMS 356 00:13:12,320 --> 00:13:13,720 THAT ARE MAKING PROGRESS, NOW 357 00:13:13,720 --> 00:13:15,320 I'M JUST GOING TO CHERRY PICK 358 00:13:15,320 --> 00:13:17,200 FROM A FEW DIFFERENT AREAS OF 359 00:13:17,200 --> 00:13:18,240 RESEARCH FOCUS ACROSS THE 360 00:13:18,240 --> 00:13:21,600 INITIATIVE AND TELL YOU ABOUT 361 00:13:21,600 --> 00:13:22,280 WHAT ACCOMPLISHMENTS OUR 362 00:13:22,280 --> 00:13:23,320 SCIENTISTS HAVE MADE OVER THE 363 00:13:23,320 --> 00:13:27,200 PAST YEAR. 364 00:13:27,200 --> 00:13:27,640 NEXT SLIDE. 365 00:13:27,640 --> 00:13:31,040 HERE ARE ALL OF THE INCREDIBLE 366 00:13:31,040 --> 00:13:32,680 SCIENTIFIC TEAMS, YOU KNOW THESE 367 00:13:32,680 --> 00:13:35,560 FOLKS WELL, THE CO CHAIRS ARE 368 00:13:35,560 --> 00:13:37,080 LISTED AND THE COLLABORATING 369 00:13:37,080 --> 00:13:39,400 INSTITUTES AND CENTERS WHO 370 00:13:39,400 --> 00:13:41,760 PARTICIPATEOT SCIENTIFIC TEAM 371 00:13:41,760 --> 00:13:42,560 DEVELOPING AND CONDUCTING 372 00:13:42,560 --> 00:13:45,840 RESEARCH ARE ALSO LISTED. 373 00:13:45,840 --> 00:13:48,480 BIG THANK YOU TO ALL OF THESE 374 00:13:48,480 --> 00:13:50,720 BRILLIANT INDIVIDUALS FOR THEIR 375 00:13:50,720 --> 00:13:54,800 COMMITMENT AND HARD WORK. 376 00:13:54,800 --> 00:13:55,720 NEXT SLIDE, PLEASE. 377 00:13:55,720 --> 00:13:57,560 FIRST IN THE PRECLINICAL, AND 378 00:13:57,560 --> 00:13:59,560 TRANSLATIONAL RESEARCH FOR PAIN 379 00:13:59,560 --> 00:14:03,240 MANAGEMENT, THIS IS A VERY RICH 380 00:14:03,240 --> 00:14:05,320 SLIDE IN TERMS OF DATA. 381 00:14:05,320 --> 00:14:07,520 I WON'T GO THROUGH NAMING EACH 382 00:14:07,520 --> 00:14:09,240 INDIVIDUAL PROGRAM, BUT WHEN I 383 00:14:09,240 --> 00:14:11,080 SAID WE HAVE LAUNCHED OVER 40 384 00:14:11,080 --> 00:14:14,400 PROGRAMS, HERE ARE THE 1S THAT 385 00:14:14,400 --> 00:14:17,800 WE KIND OF REFER TO BY NAME AND 386 00:14:17,800 --> 00:14:19,680 TALK ABOUT AND OUR INTERNAL 387 00:14:19,680 --> 00:14:20,240 CONVERSATIONS AND SOMETIMES 388 00:14:20,240 --> 00:14:22,360 REFLECTED IN THE NAMES OF OUR 389 00:14:22,360 --> 00:14:22,800 FUNDING OPPORTUNITY 390 00:14:22,800 --> 00:14:24,800 ANNOUNCEMENTS AND YOU CAN SEE 391 00:14:24,800 --> 00:14:26,800 FROM THIS SLIDE, WHEN THEY WERE 392 00:14:26,800 --> 00:14:28,520 LAUNCHED, SO SOME OF THESE 393 00:14:28,520 --> 00:14:30,200 PROGRAMS WERE LAUNCHED AT THE 394 00:14:30,200 --> 00:14:34,120 VERY BEGINNING OF HEAL IN 2018, 395 00:14:34,120 --> 00:14:34,320 2019. 396 00:14:34,320 --> 00:14:36,520 SOME TOOK MORE TIME IN CERTAIN 397 00:14:36,520 --> 00:14:37,360 CASES, WE HEARD DIRECTLY FROM 398 00:14:37,360 --> 00:14:39,880 YOU ALL AND WE SAID WE HAVE TO 399 00:14:39,880 --> 00:14:42,720 MAKE SURE THAT WE CONTINUE TO 400 00:14:42,720 --> 00:14:44,000 SUPPORT RESEARCH AND ANALGESIC 401 00:14:44,000 --> 00:14:45,360 DEVELOPMENT AND THAT BECAME SOME 402 00:14:45,360 --> 00:14:48,800 OF THE NEW ADDITIONS TO THE 403 00:14:48,800 --> 00:14:50,120 OVERALL PORTFOLIO AND THEN AT 404 00:14:50,120 --> 00:14:54,000 THE VERY BOTTOM, HERE ARE THE 405 00:14:54,000 --> 00:14:55,520 LIGHTER BLUE COLOR, ARE THE 406 00:14:55,520 --> 00:14:58,160 PROGRAMS THAT ARE PROPOSED FOR 407 00:14:58,160 --> 00:15:01,840 THE UPCOMING FISCAL YEAR, FISCAL 408 00:15:01,840 --> 00:15:02,400 YEAR 24. 409 00:15:02,400 --> 00:15:04,600 SO YOU WILL HEAR LATER TODAY IN 410 00:15:04,600 --> 00:15:06,200 MORE DETAIL ABOUT THOSE SPECIFIC 411 00:15:06,200 --> 00:15:08,400 PROGRAMS AND WHY THE LEADS OF 412 00:15:08,400 --> 00:15:09,320 THE SCIENTIFIC TEAM BELIEVE THAT 413 00:15:09,320 --> 00:15:11,080 NOW IS THE RIGHT TIME TO ADD 414 00:15:11,080 --> 00:15:14,080 THEM TO THIS PORTFOLIO, AND HOW 415 00:15:14,080 --> 00:15:16,040 THEY WILL FILL IMPORTANT GAPS. 416 00:15:16,040 --> 00:15:20,600 SO NEXT SLIDE, PLEASE. 417 00:15:20,600 --> 00:15:22,480 THROUGH ALL OF THESE DIFFERENT 418 00:15:22,480 --> 00:15:24,040 RESEARCH PROGRAMS WE'VE REALLY 419 00:15:24,040 --> 00:15:25,200 MADE INCREDIBLE PROGRESS AND 420 00:15:25,200 --> 00:15:28,640 SOME OF THESE INVOLVE DIFFERENT 421 00:15:28,640 --> 00:15:32,240 WAYS TO CREATE OR WORK IN THE 422 00:15:32,240 --> 00:15:34,120 LAB TO ADVANCE THERAPEUTIC 423 00:15:34,120 --> 00:15:36,960 DEVELOPMENT BY CREATING CERTAIN 424 00:15:36,960 --> 00:15:37,560 TYPES OF CELLS. 425 00:15:37,560 --> 00:15:40,040 MODELS OF THE BODY, MODELS OF 426 00:15:40,040 --> 00:15:41,080 DIFFERENT DISEASE CONDITIONS AND 427 00:15:41,080 --> 00:15:42,840 THEN LIBRARIES OF TARGETS AND 428 00:15:42,840 --> 00:15:45,080 COMPOUNDS TO TEST THROUGH THESE 429 00:15:45,080 --> 00:15:49,440 MANY DIFFERENT MODEL SYSTEMS TO 430 00:15:49,440 --> 00:15:51,160 BETTER ACCELERATE THE 431 00:15:51,160 --> 00:15:52,280 DEVELOPMENT OF NOVEL TREATMENTS 432 00:15:52,280 --> 00:15:56,120 FOR PAIN. 433 00:15:56,120 --> 00:15:57,280 NEXT SLIDE, PLEASE. 434 00:15:57,280 --> 00:15:58,520 NOW IN THE CLINICAL SPACE, YOU 435 00:15:58,520 --> 00:15:59,640 SEE ALL THE DIFFERENT PROGRAMS 436 00:15:59,640 --> 00:16:01,520 IN THE DARKER BLUE THAT WE HAVE 437 00:16:01,520 --> 00:16:02,960 LAUNCHED OVER THE YEARS AND THEN 438 00:16:02,960 --> 00:16:04,920 IN THE LIGHTER COLOR, WHAT IS 439 00:16:04,920 --> 00:16:08,000 PROPOSED FOR THIS UPCOMING 440 00:16:08,000 --> 00:16:14,440 FISCAL YEAR AND THEN FOLLOWING 441 00:16:14,440 --> 00:16:15,600 SLIDE,-- 442 00:16:15,600 --> 00:16:17,480 >>CAN I ASK A QUICK QUESTION. 443 00:16:17,480 --> 00:16:19,480 >>YES, GO AHEAD. 444 00:16:19,480 --> 00:16:21,120 >>ON THE TIMELINES WHICH ARE 445 00:16:21,120 --> 00:16:24,000 HELPFUL AT THE END OF THE ERA IS 446 00:16:24,000 --> 00:16:26,160 IT TELLING US SOMETHING ABOUT 447 00:16:26,160 --> 00:16:30,920 [INDISCERNIBLE] AND THINGS LIKE 448 00:16:30,920 --> 00:16:31,400 THAT? 449 00:16:31,400 --> 00:16:34,240 >>WELL, IT MOSTLY REFLECTS WHAT 450 00:16:34,240 --> 00:16:37,480 WE HAVE COMMITTED TO FUNDING AT 451 00:16:37,480 --> 00:16:38,120 THIS TIME. 452 00:16:38,120 --> 00:16:40,120 SO IF SOMETHING IS ENDING IN THE 453 00:16:40,120 --> 00:16:41,200 FUTURE, THAT DOESN'T REALLY MEAN 454 00:16:41,200 --> 00:16:43,200 TOO MUCH BECAUSE WE HAVEN'T HAD 455 00:16:43,200 --> 00:16:46,480 A CHANCE TO DISCUSS IT, EVALUATE 456 00:16:46,480 --> 00:16:47,360 ITS PROGRESS AND EVALUATE 457 00:16:47,360 --> 00:16:49,040 WHETHER IT WILL CONTINUE. 458 00:16:49,040 --> 00:16:50,080 IT CERTAINLY DOESN'T MEAN 459 00:16:50,080 --> 00:16:50,840 THEY'RE EXPECTED TO END. 460 00:16:50,840 --> 00:16:56,240 IF YOU GO BACK 2, PLEASE. 461 00:16:56,240 --> 00:16:57,480 TWO SLIDES PLEASE, YEAH, SO YOU 462 00:16:57,480 --> 00:16:59,480 CAN SEE HERE SOME OF THE 1S THAT 463 00:16:59,480 --> 00:17:01,080 ARE SHOWN ENDING IN 2024, THESE 464 00:17:01,080 --> 00:17:06,760 ARE THE 1 1S THAT WE TALKED TO 465 00:17:06,760 --> 00:17:08,280 LAST WEEK BECAUSE THEY'RE THE 1S 466 00:17:08,280 --> 00:17:10,040 WE'RE CONSIDERING HOW BEST 467 00:17:10,040 --> 00:17:10,400 CONTINUE. 468 00:17:10,400 --> 00:17:13,360 SOME OF THE PROGRAMS THAT ENDED 469 00:17:13,360 --> 00:17:14,640 EVOLVED INTO OTHER PROGRAMS, SO 470 00:17:14,640 --> 00:17:16,400 FOR INSTANCE IF YOU SEE DEVICES 471 00:17:16,400 --> 00:17:21,160 FOR PAIN, YOU REALIZE THAT WE 472 00:17:21,160 --> 00:17:23,960 HAVE KIND OF SUPPLEMENTED OR 473 00:17:23,960 --> 00:17:25,920 ADDED TO THAT RESEARCH THROUGH 474 00:17:25,920 --> 00:17:27,880 CLINICAL TRANSLATION BY 475 00:17:27,880 --> 00:17:28,600 BLUEPRINT AND TRANSLATIONAL 476 00:17:28,600 --> 00:17:29,520 DEVICE DEVELOPMENT SO THAT 477 00:17:29,520 --> 00:17:31,160 PROGRAM WE DON'T REALLY SEE AS 478 00:17:31,160 --> 00:17:32,280 ENDING BUT RATHER HAVING EVOLVED 479 00:17:32,280 --> 00:17:33,640 INTO A DIFFERENT SET OF PROGRAMS 480 00:17:33,640 --> 00:17:36,080 BUT FOR THOSE THAT HAVEN'T 481 00:17:36,080 --> 00:17:37,680 REALLY GONE THROUGH THAT 482 00:17:37,680 --> 00:17:38,880 PROCESS, A SUBSET OF THOSE ARE 483 00:17:38,880 --> 00:17:40,160 NOW AT THE POINT THAT WE TALK TO 484 00:17:40,160 --> 00:17:41,560 YOU ABOUT THEM LAST WEEK AND A 485 00:17:41,560 --> 00:17:43,200 SUBSET OF THEM IF YOU GO 486 00:17:43,200 --> 00:17:44,320 FORWARD, 2 MORE, 2 SLIDES BACK 487 00:17:44,320 --> 00:17:47,640 TO WHERE WE WERE, THESE PROGRAMS 488 00:17:47,640 --> 00:17:51,000 BECAUSE THEY'RE CLINICAL TRIALS 489 00:17:51,000 --> 00:17:53,640 AND CLINICAL TRIALS OFTEN LAST A 490 00:17:53,640 --> 00:17:55,880 LITTLE BIT LONGER THAN 491 00:17:55,880 --> 00:17:58,240 ORIGINALALLY ENVISIONED BY THE 492 00:17:58,240 --> 00:17:58,840 RESEARCHERS ESPECIALLY WHEN 493 00:17:58,840 --> 00:18:01,360 COVID AND SOME OF THE ARE 494 00:18:01,360 --> 00:18:02,200 INTERRUPTIONS TO THE CLINICAL 495 00:18:02,200 --> 00:18:06,160 SITES THAT DO THIS RESEARCH SO 496 00:18:06,160 --> 00:18:08,560 OVER THE PAST COUPLE YEARS, 497 00:18:08,560 --> 00:18:10,520 THESE ARE NOT AT A DECISION 498 00:18:10,520 --> 00:18:12,440 POINT, THEY HAVE NOT YET 499 00:18:12,440 --> 00:18:13,680 RELEASED THEIR FINDINGS, WE HAVE 500 00:18:13,680 --> 00:18:15,360 GOTTEN TO A POINT WE CAN 501 00:18:15,360 --> 00:18:16,520 DETERMINE AND HOW AND AT WHAT 502 00:18:16,520 --> 00:18:18,040 LEVEL AND CONDITION THEY SHOULD 503 00:18:18,040 --> 00:18:18,400 CONTINUE. 504 00:18:18,400 --> 00:18:20,360 SORRY, SO THAT'S WHY THESE ARE 505 00:18:20,360 --> 00:18:21,880 REALLY NOT BEING BROUGHT FORWARD 506 00:18:21,880 --> 00:18:23,960 FOR DISCUSSION AS PART OF THE 507 00:18:23,960 --> 00:18:25,560 ONGOING RESEARCH OF THE 508 00:18:25,560 --> 00:18:26,080 POPULATION. 509 00:18:26,080 --> 00:18:27,080 >>I WAS THINKING ABOUT 510 00:18:27,080 --> 00:18:27,960 BALANCING IN TERMS OF 511 00:18:27,960 --> 00:18:34,280 CONSIDERING THE NEW PROGRAMS AND 512 00:18:34,280 --> 00:18:37,000 UNDERSTANDING ITS 0-SUM-GAIN 513 00:18:37,000 --> 00:18:38,760 NATURE AND WHAT IT IS. 514 00:18:38,760 --> 00:18:39,680 >>THAT'S VERY SMART OF YOU 515 00:18:39,680 --> 00:18:42,080 BECAUSE WE HAVE LAUNCHED A LOT 516 00:18:42,080 --> 00:18:43,520 AND WE CAN'T YOU KNOW CONTINUE 517 00:18:43,520 --> 00:18:45,560 TO LAUNCH AND LAUNCH AND LAUNCH, 518 00:18:45,560 --> 00:18:46,960 THINGS WILL NEED TO SUN SET IF 519 00:18:46,960 --> 00:18:52,120 WE CONTINUE TO LAUNCH NEW 520 00:18:52,120 --> 00:18:52,360 THINGS. 521 00:18:52,360 --> 00:18:54,800 AND THAT IS PART OF THE OVERALL 522 00:18:54,800 --> 00:18:57,440 BALANCE DISCUSSION THAT WE WILL 523 00:18:57,440 --> 00:18:57,680 HAVE. 524 00:18:57,680 --> 00:19:03,360 I THINK--ARE THERE ANY MORE 525 00:19:03,360 --> 00:19:03,840 QUESTIONS RIGHT NOW? 526 00:19:03,840 --> 00:19:05,200 >>THEN WE CAN CONTINUE, NEXT 527 00:19:05,200 --> 00:19:06,400 SLIDE, PLEASE TO SOME OF THE 528 00:19:06,400 --> 00:19:10,480 ADVANCES IN RESEARCH AND 529 00:19:10,480 --> 00:19:11,240 CLINICAL PAIN MANAGEMENT. 530 00:19:11,240 --> 00:19:15,680 WE HAVE A LOT OF RESEARCH 531 00:19:15,680 --> 00:19:18,520 COMPARING DIFFERENT APPROACHES, 532 00:19:18,520 --> 00:19:21,800 ESPECIALLY COMPLIMENTARY AND 533 00:19:21,800 --> 00:19:23,160 NONPHARMAICOLOGGICCAL APPROACHES 534 00:19:23,160 --> 00:19:26,280 FOR BEHAVIOR MANAGEMENT SUCH AS 535 00:19:26,280 --> 00:19:27,840 COGNITIVE BEHAVIORIAL THERAPY, 536 00:19:27,840 --> 00:19:28,640 INCLUDING MODALITIES NOW AND 537 00:19:28,640 --> 00:19:30,720 THIS IS REALLY VALUABLE RIGHT 538 00:19:30,720 --> 00:19:32,280 NOW, THE TELEHEALTH AND VIRTUAL 539 00:19:32,280 --> 00:19:34,120 APPROACHES ARE REALLY TAKING 540 00:19:34,120 --> 00:19:34,920 OVER FOLLOWING COVID. 541 00:19:34,920 --> 00:19:37,560 WE HAVE RESEARCH SUPPORTING 542 00:19:37,560 --> 00:19:40,280 PROVIDER PATIENT CO-DECISION 543 00:19:40,280 --> 00:19:41,120 MAKING FOLLOWING CAESAREAN 544 00:19:41,120 --> 00:19:42,880 SECTION, A VERY COMMON 545 00:19:42,880 --> 00:19:47,680 PROCEDURE, RESULTING IN OPIOID 546 00:19:47,680 --> 00:19:48,240 PRESCRIPTIONS. 547 00:19:48,240 --> 00:19:50,160 MINDFULNESS BASED, RELAPSE 548 00:19:50,160 --> 00:19:56,120 PREVENTION, IN COMBINATION WITH 549 00:19:56,120 --> 00:20:03,120 MEDICATION FOR THE TREATMENT. 550 00:20:03,120 --> 00:20:04,400 --DISCOVER WAYS TO INFORM 551 00:20:04,400 --> 00:20:06,120 PATIENTS OF WAYS TO TREAT 552 00:20:06,120 --> 00:20:08,800 CHRONIC BACK PAIN, ALL OF THIS 553 00:20:08,800 --> 00:20:11,160 WITH FULL PERSON AND 554 00:20:11,160 --> 00:20:11,640 PATIENT-CENTRIC CARE. 555 00:20:11,640 --> 00:20:12,840 MOVING ALONG TO THE NEXT SLIDE, 556 00:20:12,840 --> 00:20:14,720 HERE IS OUR TRANSLATION OF 557 00:20:14,720 --> 00:20:16,200 RESEARCH FOR PRACTICE FOR THE 558 00:20:16,200 --> 00:20:17,640 TREATMENT OF OPIOID USE DISORDER 559 00:20:17,640 --> 00:20:19,160 AND YOU CAN SEE 3 OF THE 560 00:20:19,160 --> 00:20:21,640 PROGRAMS THAT WE TOLD YOU ABOUT 561 00:20:21,640 --> 00:20:23,520 LAST WEEK AS WELL AS SOME OTHERS 562 00:20:23,520 --> 00:20:27,600 THAT HAVE BEEN LAUNCHED OVER THE 563 00:20:27,600 --> 00:20:29,360 YEARS. 564 00:20:29,360 --> 00:20:33,440 NEXT SLIDE PLEASE. 565 00:20:33,440 --> 00:20:35,080 SOME PROGRESS IN THIS AREA, YOU 566 00:20:35,080 --> 00:20:38,280 MAY HAVE ALREADY HEARD THROUGH 567 00:20:38,280 --> 00:20:40,560 THE JUSTICE COLLABORATIVE OPIOID 568 00:20:40,560 --> 00:20:42,560 INNOVATION PROGRAM NETWORK OR 569 00:20:42,560 --> 00:20:45,400 J-YOIN COIN RESEARCH ON MAKING 570 00:20:45,400 --> 00:20:47,120 MEDICATION BASED TREATMENT FOR 571 00:20:47,120 --> 00:20:52,080 OPIOID USE DISORDER AVAILABLE IN 572 00:20:52,080 --> 00:20:53,120 MASSACHUSETTS RURAL JAILS, FOUND 573 00:20:53,120 --> 00:20:54,320 THAT ACCESS TO MEDICATION FOR 574 00:20:54,320 --> 00:20:59,680 THE TREATMENT OF OPIOID USE 575 00:20:59,680 --> 00:21:00,520 DISORDER, REDUCED REARREST. 576 00:21:00,520 --> 00:21:02,000 THEY'VE ALSO REALLY BUILT THE 577 00:21:02,000 --> 00:21:03,280 RELATIONSHIPS WITH JAILS AND 578 00:21:03,280 --> 00:21:06,360 DECISION MAKERS IN THE JUSTICE 579 00:21:06,360 --> 00:21:09,400 SETTING TO PROMULGATE AND SHARE 580 00:21:09,400 --> 00:21:11,680 THIS INFORMATION TO INFORM OTHER 581 00:21:11,680 --> 00:21:16,320 TREATMENTS AND DECISIONS AND 582 00:21:16,320 --> 00:21:16,880 NEXT SLIDE, PLEASE. 583 00:21:16,880 --> 00:21:20,320 IN THE AREA OF PREVENTION AND 584 00:21:20,320 --> 00:21:21,720 TREATMENT FOR OPIOID USE 585 00:21:21,720 --> 00:21:23,360 DISORDER, YOU CAN SEE ALL THE 586 00:21:23,360 --> 00:21:29,000 THINGS WE STARTED WITH IN 2019 587 00:21:29,000 --> 00:21:29,720 INCLUDING THE PORTFOLIO YOU 588 00:21:29,720 --> 00:21:31,440 HEARD ABOUT FROM AMY LAST WEEK 589 00:21:31,440 --> 00:21:33,560 AND THE MANY DIFFERENT PROGRAMS 590 00:21:33,560 --> 00:21:38,920 WE HAVE LAUNCHED SINCE THEN. 591 00:21:38,920 --> 00:21:39,680 NEXT SLIDE, PLEASE. 592 00:21:39,680 --> 00:21:42,480 THERE HAS BEEN A LOT, A LOT OF 593 00:21:42,480 --> 00:21:45,040 RESEARCH UNDERWAY, A LOT OF IT 594 00:21:45,040 --> 00:21:47,760 THROUGH THE NIDA CLINICAL TRIALS 595 00:21:47,760 --> 00:21:50,040 NETWORK, INCLUDING RETROSPECTIVE 596 00:21:50,040 --> 00:21:51,640 ANALYSIS, INFORMING HOW 597 00:21:51,640 --> 00:21:54,000 CLINICIANS CAN SUPPORT 598 00:21:54,000 --> 00:21:57,720 INDIVIDUALS ON BUPRENORPH FOR 599 00:21:57,720 --> 00:21:59,680 THE TREATMENT OF OPIOID USE 600 00:21:59,680 --> 00:21:59,960 DISORDER. 601 00:21:59,960 --> 00:22:02,960 IT'S COMMON FOR PEOPLE TO WANT 602 00:22:02,960 --> 00:22:05,800 TO OR FEEL PRESSURE TO 603 00:22:05,800 --> 00:22:08,560 DISCONTINUE THIS TREATMENT 604 00:22:08,560 --> 00:22:11,400 INFORMING CLINICIANS ABOUT THE 605 00:22:11,400 --> 00:22:12,600 RISKS OF FOLLOWING 606 00:22:12,600 --> 00:22:14,440 DISCONTINUATION OF THE TREATMENT 607 00:22:14,440 --> 00:22:15,360 OF BUPRENORPHINE DISORDER AND 608 00:22:15,360 --> 00:22:16,760 THAT WILL BE FOLLOWED BY ONGOING 609 00:22:16,760 --> 00:22:18,720 RESEARCH ON HOW TO BEST SUPPORT 610 00:22:18,720 --> 00:22:20,840 HAVE INDIVIDUALS WHO DO 611 00:22:20,840 --> 00:22:23,760 DISCONTINUE THIS TREATMENT. 612 00:22:23,760 --> 00:22:24,320 NEXT SLIDE, PLEASE. 613 00:22:24,320 --> 00:22:26,640 IN THE SPACE OF NOVEL 614 00:22:26,640 --> 00:22:27,840 THERAPEUTIC OPTIONS, VISIT AS 615 00:22:27,840 --> 00:22:30,600 YOU SAW THE BEGINNING A REALLY 616 00:22:30,600 --> 00:22:31,680 SIGNIFICANT POINT OF EMPHASIS 617 00:22:31,680 --> 00:22:33,200 FOR HEAL, WE REALLY KNOW THESE 618 00:22:33,200 --> 00:22:35,120 MEDICATIONS CAN BE LIFE SAVING 619 00:22:35,120 --> 00:22:37,560 AND ALTHOUGH WE HAVE MULTIPLE 620 00:22:37,560 --> 00:22:38,640 LIFE SAVING MEDICATIONS WE WANT 621 00:22:38,640 --> 00:22:42,160 MORE AND MORE EASIER FRIENDLY 622 00:22:42,160 --> 00:22:49,000 VERSIONS OF THEM, NEXT SLIDE, 623 00:22:49,000 --> 00:22:49,240 PLEASE. 624 00:22:49,240 --> 00:22:52,000 WE'VE SUPPORTED A LOT OF 625 00:22:52,000 --> 00:22:54,880 INNOVATION IN THIS SPACE, MANY 626 00:22:54,880 --> 00:22:56,240 FORMS OF MOUD, AS WELL AS 627 00:22:56,240 --> 00:22:59,160 DEVICES AND FIRST IN HUMAN 628 00:22:59,160 --> 00:23:01,600 TESTING OF A VACCINE FOR 629 00:23:01,600 --> 00:23:03,240 INDIVIDUALS WITH OPIOID USE 630 00:23:03,240 --> 00:23:04,640 DISORDER. 631 00:23:04,640 --> 00:23:08,040 NEXT SLIDE, PLEASE. 632 00:23:08,040 --> 00:23:08,960 VACCINE TO PREVENT OVERDOSE, AND 633 00:23:08,960 --> 00:23:12,720 LASTLY IN THE SPACE OF OUTCOMES 634 00:23:12,720 --> 00:23:15,240 FOR ENHANCED OUTCOMES IN INFANTS 635 00:23:15,240 --> 00:23:15,840 AND CHILDREN, LARGE PROGRAMS 636 00:23:15,840 --> 00:23:17,360 FOCUSING ON THE BRAIN AND 637 00:23:17,360 --> 00:23:18,680 DEVELOPMENT OF CHILDREN EXPOSED 638 00:23:18,680 --> 00:23:21,640 TO OPIOIDS AND OTHER SUBSTANCES 639 00:23:21,640 --> 00:23:24,040 AS WELL AS CLINICAL TRIALS 640 00:23:24,040 --> 00:23:27,200 FOCUSING ON BEST WAYS TO TREAT 641 00:23:27,200 --> 00:23:31,040 INFANTS EXPOSED TO OPIOIDS. 642 00:23:31,040 --> 00:23:34,600 NEXT SLIDE, PLEASE EMPLOY I 643 00:23:34,600 --> 00:23:35,680 THINK THE EAT-SLEEP-CONSOLE IS 644 00:23:35,680 --> 00:23:38,000 WINDING DOWN AND LIKELY TO GIVE 645 00:23:38,000 --> 00:23:40,360 US INTERESTING FINDINGS AROUND 646 00:23:40,360 --> 00:23:47,960 THAT PARTICULAR ASSESSMENT TOOL 647 00:23:47,960 --> 00:23:52,000 FOR INFANTS BORN TO THOSE WITH 648 00:23:52,000 --> 00:23:55,400 SEVERENYONATAL OPIOID 649 00:23:55,400 --> 00:23:57,320 WITHDRAWAL, SYNDROME OR NOWS AND 650 00:23:57,320 --> 00:23:58,760 THEY'RE MEASURING HOW MUCH TIME 651 00:23:58,760 --> 00:23:59,920 THESE INFANTS ARE IN THE 652 00:23:59,920 --> 00:24:01,880 HOSPITAL AND HOW MANY OPIOIDS 653 00:24:01,880 --> 00:24:03,520 THEY'RE EXPOSED TO SO PLEASE 654 00:24:03,520 --> 00:24:05,680 LOOK FORWARD TO THOSE RESULTS 655 00:24:05,680 --> 00:24:10,560 AND NEXT SLIDE, PLEASE. 656 00:24:10,560 --> 00:24:12,960 AND HERE WE ARE, RESEARCH UNDER 657 00:24:12,960 --> 00:24:14,520 CONSIDERATION, SO ALL OF THAT IS 658 00:24:14,520 --> 00:24:16,440 KIND OF WHAT'S ONGOING, WHAT'S 659 00:24:16,440 --> 00:24:18,160 HAPPENING ALREADY AND WHAT 660 00:24:18,160 --> 00:24:22,000 YOU'VE SEEN BEFORE, NOW, TO KIND 661 00:24:22,000 --> 00:24:25,760 OF THE IMMEDIATE NEXT TOPIC ON 662 00:24:25,760 --> 00:24:26,720 OUR AGENDA, RESEARCH UNDER 663 00:24:26,720 --> 00:24:30,200 CONSIDERATION. 664 00:24:30,200 --> 00:24:31,600 NEXT SLIDE, PLEASE. 665 00:24:31,600 --> 00:24:33,040 AND I THINK YOU WILL HEAR IN 666 00:24:33,040 --> 00:24:34,280 QUITE A BIT OF DETAIL FROM THE 667 00:24:34,280 --> 00:24:35,480 CO CHAIRS OF THE SCIENTIFIC 668 00:24:35,480 --> 00:24:37,200 TEAMS ON EACH OF THESE CONCEPTS, 669 00:24:37,200 --> 00:24:39,240 THEY WERE SHARED WITH YOU 670 00:24:39,240 --> 00:24:41,080 ELECTRONICALLY IN A LOT MORE 671 00:24:41,080 --> 00:24:43,920 DETAIL THAN WE WILL GO OVER IN 672 00:24:43,920 --> 00:24:44,480 THE SLIDES. 673 00:24:44,480 --> 00:24:46,560 SO IF YOU DON'T HAVE THOSE 674 00:24:46,560 --> 00:24:48,200 PACKETS OR ANYTHING HANDY, 675 00:24:48,200 --> 00:24:49,320 PLEASE LET US KNOW. 676 00:24:49,320 --> 00:24:51,160 BUT HERE IS WHAT HAS BEEN 677 00:24:51,160 --> 00:24:54,480 PROPOSED BY THE SCIENTIFIC TEAMS 678 00:24:54,480 --> 00:24:57,240 FOR 2024, THE NEXT YEAR WE'RE 679 00:24:57,240 --> 00:24:58,880 CONSIDERING RESEARCH IDEAS ON 680 00:24:58,880 --> 00:25:00,240 THE PRECLINICAL SIDE, REALLY 681 00:25:00,240 --> 00:25:02,640 SEEKING TO UNDERSTAND 682 00:25:02,640 --> 00:25:04,960 DIFFERENCES AMONG HUMANS AND 683 00:25:04,960 --> 00:25:07,040 PAIN CONDITIONS, AND THEIR 684 00:25:07,040 --> 00:25:08,040 CO-MORBIDITIES WELL AS WELL AS 685 00:25:08,040 --> 00:25:09,760 THINGS THAT PEOPLE HAVE BEEN 686 00:25:09,760 --> 00:25:12,840 EXPOSED TO AND THE CLINICAL 687 00:25:12,840 --> 00:25:14,360 SIDE, LOOKING AT PEDIATRIC PAIN 688 00:25:14,360 --> 00:25:17,080 CONDITIONS AND BEST WAYS TO 689 00:25:17,080 --> 00:25:18,680 TREAT AND UNDERSTAND THOSE AS 690 00:25:18,680 --> 00:25:22,520 WELL AS SOME WORKFORCE MED 691 00:25:22,520 --> 00:25:25,120 TECHS, SLEEP, AND BIOMARKER 692 00:25:25,120 --> 00:25:26,440 FOCUSED RESEARCH. 693 00:25:26,440 --> 00:25:28,960 NEXT SLIDE, PLEASE. 694 00:25:28,960 --> 00:25:31,160 AND WITH THAT, I THINK I WILL 695 00:25:31,160 --> 00:25:33,760 TURN IT OVER TO IT IS EXPERTS 696 00:25:33,760 --> 00:25:35,200 BUT BEFORE I DO SO, WALTER ARE 697 00:25:35,200 --> 00:25:35,800 YOU STILL WITH US AND 698 00:25:35,800 --> 00:25:37,400 APPROXIMATE WOULD YOU LIKE TO 699 00:25:37,400 --> 00:25:39,200 SAY ANYTHING BEFORE I HAND IT 700 00:25:39,200 --> 00:25:46,720 OVER TO CHRISTINE AND MICHAEL? 701 00:25:46,720 --> 00:25:48,120 >>WELL, I HESITATE TO SAY 702 00:25:48,120 --> 00:25:51,680 ANYTHING BECAUSE I THINK I SAID 703 00:25:51,680 --> 00:25:53,920 IT ALL BEFORE BUT CERTAINLY FOR 704 00:25:53,920 --> 00:25:56,000 PAIN HEAL HAS CHANGED THE WHOLE 705 00:25:56,000 --> 00:25:59,160 LANDSCAPE OF PAIN RESEARCH AT 706 00:25:59,160 --> 00:26:00,960 NIH AND SO I THINK WE'VE DONE 707 00:26:00,960 --> 00:26:02,200 SOME GOOD THINGS BUT IESM 708 00:26:02,200 --> 00:26:03,960 LOOKING FORWARD TO DOING BETTER 709 00:26:03,960 --> 00:26:06,360 THINGS IN THE FUTURE AND THAT'S 710 00:26:06,360 --> 00:26:08,520 WHERE THE PLRKS DWG COMES IN AND 711 00:26:08,520 --> 00:26:11,480 GIVING US ADVICE ON HOW TO 712 00:26:11,480 --> 00:26:11,880 ALWAYS GET BETTER. 713 00:26:11,880 --> 00:26:13,720 SO THAT'S MY SPEIL AND I'M 714 00:26:13,720 --> 00:26:17,760 STICKING TO IT. 715 00:26:17,760 --> 00:26:18,120 >>EXCELLENT. 716 00:26:18,120 --> 00:26:19,640 THANK YOU. 717 00:26:19,640 --> 00:26:24,080 SO I SEE MICHAEL OSHINSKY. 718 00:26:24,080 --> 00:26:26,600 WILL YOU LEAD US THROUGH? 719 00:26:26,600 --> 00:26:28,800 >>THANK YOU SO MUCH REBECCA AND 720 00:26:28,800 --> 00:26:31,000 GREETINGS TO THE MDWG, AGAIN AND 721 00:26:31,000 --> 00:26:33,120 I WANT TO THANK YOU FOR HELP AND 722 00:26:33,120 --> 00:26:34,640 ADVICE ON PUT ON THE INITTIAIVE 723 00:26:34,640 --> 00:26:35,560 ITS WE BROUGHT FORWARD TO YOU IN 724 00:26:35,560 --> 00:26:37,360 THE PAST AND TODAY WE WILL BE 725 00:26:37,360 --> 00:26:39,080 BRINGING FROM THE PRECLINICAL 726 00:26:39,080 --> 00:26:40,680 AND TRANSLATIONAL RESEARCH AND 727 00:26:40,680 --> 00:26:43,440 PAIN MANAGEMENT WORK GROUP, 2 728 00:26:43,440 --> 00:26:44,760 INITIATIVES WE'RE LOOKING FOR 729 00:26:44,760 --> 00:26:52,280 YOUR FEEDBACK AND ADVICE ON 730 00:26:52,280 --> 00:26:56,040 RELATED TO PAIN AND PAIN 731 00:26:56,040 --> 00:26:56,680 MANAGEMENT. 732 00:26:56,680 --> 00:26:57,200 NEXT SLIDE. 733 00:26:57,200 --> 00:26:59,200 I THINK IT'S IMPORTANT TO START 734 00:26:59,200 --> 00:27:00,600 WITH THIS DOCUMENT AND THANK YOU 735 00:27:00,600 --> 00:27:03,120 FOR YOUR COMMENTS, EARLIER ROB 736 00:27:03,120 --> 00:27:05,160 RELATED TO, YOU KNOW WHEN 737 00:27:05,160 --> 00:27:06,600 PROGRAMS HAVE STARTED AND STOPS, 738 00:27:06,600 --> 00:27:07,720 ET CETERA, YOU CAN SEE HERE THAT 739 00:27:07,720 --> 00:27:12,520 THERE ARE A LOT OF ONGOING 740 00:27:12,520 --> 00:27:14,680 PROGRAMS INSIDE THE PRECLINICAL 741 00:27:14,680 --> 00:27:16,400 AND TRANSLATIONAL RESEARCH AND 742 00:27:16,400 --> 00:27:18,000 PAIN RESEARCH WORK GROUP INSIDE 743 00:27:18,000 --> 00:27:19,000 OF HEAL. 744 00:27:19,000 --> 00:27:21,040 SOME OF THEM HAVE STARTED RIGHT 745 00:27:21,040 --> 00:27:22,800 AT THE BEGINNING OF HEAL, SUCH 746 00:27:22,800 --> 00:27:24,720 AS THE TARGETS DISCOVERY AND 747 00:27:24,720 --> 00:27:27,120 VALIDATION AND SOME OF THEM ARE 748 00:27:27,120 --> 00:27:28,880 VERY NEW AND IT'S JUST, IF YOU 749 00:27:28,880 --> 00:27:34,480 LOOK AT THE BOTTOM OF THE SLIDE, 750 00:27:34,480 --> 00:27:37,760 JUST GOTTEN SOME RECENT 751 00:27:37,760 --> 00:27:38,640 APPLICATIONS ASSOCIATED WITH 752 00:27:38,640 --> 00:27:40,680 THEM AND WE'RE IN THE PROCESS OF 753 00:27:40,680 --> 00:27:42,040 EVALUATING THEM, ET CETERA AND 754 00:27:42,040 --> 00:27:43,880 THEN WAY AT THE BOTTOM OF THE 755 00:27:43,880 --> 00:27:49,200 SLIDE, YOU SEE 2 NEW ADDITIONAL 756 00:27:49,200 --> 00:27:50,000 INITIATIVES THAT WE'RE BRINGING 757 00:27:50,000 --> 00:27:51,600 BACK FOR YOUR FEEDBACK, 1 OF 758 00:27:51,600 --> 00:27:55,200 THEM IS INDIVIDUAL DIFFERENCES 759 00:27:55,200 --> 00:28:00,360 IN HUMAN PAIN CO-MORBIDITIES AND 760 00:28:00,360 --> 00:28:01,440 THE CHECKANISTIC EXPOSOME ON 761 00:28:01,440 --> 00:28:02,480 ACUTE ASK CHRONIC PAIN. 762 00:28:02,480 --> 00:28:05,280 SO IN THE CONTEXT OF DEVELOPING 763 00:28:05,280 --> 00:28:06,560 NEW INITIATIVES, WHAT WE'RE 764 00:28:06,560 --> 00:28:08,520 LOOKING FOR IS THE FILLING GAP, 765 00:28:08,520 --> 00:28:11,200 WHAT THE WORK GROUP IS FOCUSED 766 00:28:11,200 --> 00:28:14,120 ON, AND WE'RE ALSO INTERESTED IN 767 00:28:14,120 --> 00:28:16,840 DEVELOPING INITIATIVES, THAT ARE 768 00:28:16,840 --> 00:28:18,520 NOT GAPS IN HEAL BUT GAPS IN THE 769 00:28:18,520 --> 00:28:22,000 WAY OR THE TYPE OF RESEARCH THAT 770 00:28:22,000 --> 00:28:25,480 IS DONE ACROSS ALL THE NIH, 771 00:28:25,480 --> 00:28:26,520 INSTITUTES. 772 00:28:26,520 --> 00:28:28,920 SO DEVELOPING INITIATIVES, THAT 773 00:28:28,920 --> 00:28:32,280 REALLY REQUIRE THE INPUT FROM 774 00:28:32,280 --> 00:28:34,600 MULTIPLE INSTITUTES AND THE 775 00:28:34,600 --> 00:28:36,040 INITIATIVE ITSELF WOULDN'T SEE 776 00:28:36,040 --> 00:28:37,240 IT INTO 1 PARTICULAR INSTITUTE. 777 00:28:37,240 --> 00:28:40,800 IT'S SOMETHING THAT NEEDS THE 778 00:28:40,800 --> 00:28:42,240 COLLABORATION FROM MANY NIH 779 00:28:42,240 --> 00:28:43,680 INSTITUTES AND ICs AND THE 780 00:28:43,680 --> 00:28:44,920 EXPERTISE THAT THEY BRING TO THE 781 00:28:44,920 --> 00:28:45,200 GROUP. 782 00:28:45,200 --> 00:28:49,760 SO I HOPE YOU LOOK AT THOSE, 783 00:28:49,760 --> 00:28:50,800 THESE INITIATIVES THAT WE'RE 784 00:28:50,800 --> 00:28:53,760 BRINGING FORWARD FROM THAT 785 00:28:53,760 --> 00:29:02,120 PERSPECTIVE. 786 00:29:02,120 --> 00:29:02,600 NEXT SLIDE. 787 00:29:02,600 --> 00:29:04,760 SO THIS IS A COMMON DIAGRAM 788 00:29:04,760 --> 00:29:05,840 WE'VE SHOWED YOU BREFLY, AND I 789 00:29:05,840 --> 00:29:08,480 WILL GO THROUGH THIS QUICKLY AND 790 00:29:08,480 --> 00:29:09,840 SHOW THE NEW INITTIAIVE ITS, SO 791 00:29:09,840 --> 00:29:14,840 FROM THE TOP OF THE DIAGRAM, 792 00:29:14,840 --> 00:29:16,920 FROM DISCOVERY TO PRECLINICAL TO 793 00:29:16,920 --> 00:29:18,200 CLINICAL AND IMPLEMENTATION AND 794 00:29:18,200 --> 00:29:19,640 DISSEMINATION, YOU SEE THE BREAK 795 00:29:19,640 --> 00:29:21,360 UP OF THE PRECLINICAL WORK 796 00:29:21,360 --> 00:29:22,200 THAT'S DONE IN LIGHT BLUE AND 797 00:29:22,200 --> 00:29:27,520 THE 1S THAT ARE IN GRAY FALL 798 00:29:27,520 --> 00:29:29,800 INTO THE CLINICAL PAIN RESEARCH 799 00:29:29,800 --> 00:29:31,800 WORK GROWP THAT'S KIND OF HOW 800 00:29:31,800 --> 00:29:33,280 THAT'S BROKEN UP HERE AND WHY 801 00:29:33,280 --> 00:29:34,840 THERE'S 2 SEPARATE COLORS OVER 802 00:29:34,840 --> 00:29:35,040 THERE. 803 00:29:35,040 --> 00:29:36,840 WHEN SEE SEE THESE, WE DEVELOP 804 00:29:36,840 --> 00:29:38,400 THESE PROGRAMS AT THE TOP LEFT 805 00:29:38,400 --> 00:29:42,840 OF THE SLIDE FOR THERAPEUTIC 806 00:29:42,840 --> 00:29:45,080 DEVELOPMENT TARGET DISCOVERY AND 807 00:29:45,080 --> 00:29:48,640 VALIDATION, FOR INTERNAL AUDIT I 808 00:29:48,640 --> 00:29:49,480 SHALL ANALGESIC DEVELOPMENTS 809 00:29:49,480 --> 00:29:52,680 STUDY TO FEED INTO THE PAIN 810 00:29:52,680 --> 00:29:53,400 THERAPEUTIC DEVELOPMENT PROGRAM 811 00:29:53,400 --> 00:29:55,600 WHICH BRINGS THOSE GROUPS TO 812 00:29:55,600 --> 00:29:57,640 THEIR IND FILING AND THEN OF 813 00:29:57,640 --> 00:29:59,600 COURSE PHASE 1 CLINICAL TRIAL 814 00:29:59,600 --> 00:30:03,920 WHICH WAS SO ESSENTIAL; AND THE 815 00:30:03,920 --> 00:30:05,200 SUPPLEMENT PROGRAM LIKE THE 816 00:30:05,200 --> 00:30:07,120 COLLABORATION FOR PAIN AND THEN 817 00:30:07,120 --> 00:30:10,040 OF COURSE THE MECHANISMS OF 818 00:30:10,040 --> 00:30:13,800 DEVICE BASED RELEASE, IT'S NOT 819 00:30:13,800 --> 00:30:14,680 JUST SMALL BIOLOGICS BUT WHAT 820 00:30:14,680 --> 00:30:16,080 ARE WE LOOKING AT HERE, 821 00:30:16,080 --> 00:30:20,120 INDIVIDUAL DIFFERENCES OR 822 00:30:20,120 --> 00:30:21,760 LOOKING AT ACTORS THAT 823 00:30:21,760 --> 00:30:22,920 CONTRIBUTE TO PAIN WHICH COULD 824 00:30:22,920 --> 00:30:25,600 SEE THE OUTPUT OR EFFECTIVENESS 825 00:30:25,600 --> 00:30:27,000 OF INTERVENTIONAL PAIN 826 00:30:27,000 --> 00:30:29,080 THERAPIES, THESE SMALL MOLECULES 827 00:30:29,080 --> 00:30:30,440 AND DEVICES ARE ABLE TO 828 00:30:30,440 --> 00:30:32,440 INTERVENTIONS AND THAT IS--THOSE 829 00:30:32,440 --> 00:30:35,280 ARE THE GAPS FROM A THERT 830 00:30:35,280 --> 00:30:37,000 THOUSAND PETE THAT WE'VE 831 00:30:37,000 --> 00:30:40,600 IDENTIFY THAD WE WANT TO PRESENT 832 00:30:40,600 --> 00:30:41,640 TO YOU TODAY. 833 00:30:41,640 --> 00:30:44,760 AND I WILL HIGHLIGHT 1 MORE TIME 834 00:30:44,760 --> 00:30:46,200 THE SMALL BUSINESS PORTFOLIO 835 00:30:46,200 --> 00:30:49,080 WHICH REALLY HAD DOZENS OF 836 00:30:49,080 --> 00:30:50,080 COMPANIES TRYING PRODUCE PROD 837 00:30:50,080 --> 00:30:52,360 UBTS TO TREAT PAIN IN THE ARENA 838 00:30:52,360 --> 00:30:55,840 WHICH IS ESSENTIAL FOR THE 839 00:30:55,840 --> 00:31:06,000 TREATMENT. 840 00:31:16,080 --> 00:31:16,440 NEXT SLIDE. 841 00:31:16,440 --> 00:31:23,040 ALL RIGHT, SO LET'S REALLY 842 00:31:23,040 --> 00:31:26,480 IDENTIFY THE PROBLEM FIRST. AND 843 00:31:26,480 --> 00:31:29,120 WHAT THIS IS TO FILL OR GAP 844 00:31:29,120 --> 00:31:31,160 HERE, THAT IS THAT INDIVIDUAL 845 00:31:31,160 --> 00:31:33,200 DIFFERENCES IN PAIN EXPERIENCE 846 00:31:33,200 --> 00:31:33,920 COMPLICATE PROVIDING EFFECTIVE 847 00:31:33,920 --> 00:31:34,360 PAIN MANAGEMENT. 848 00:31:34,360 --> 00:31:36,480 I THINK WE ALL AGREE WITH THIS 849 00:31:36,480 --> 00:31:40,480 AND THIS WAS ACTUALLY IDENTIFIED 850 00:31:40,480 --> 00:31:43,520 IN THE IPRCC, THE WORK THAT THEY 851 00:31:43,520 --> 00:31:48,160 DID, IDENTIFYING GAPS OR THE OR 852 00:31:48,160 --> 00:31:51,400 A FEDERAL PLAN FOR RESEARCH IN 853 00:31:51,400 --> 00:31:53,720 THE PAIN ARENA AND IT'S 854 00:31:53,720 --> 00:31:55,240 UNDERSTANDING INDIVIDUAL 855 00:31:55,240 --> 00:31:57,360 DIFFERENCE AND PERSONS LIVED 856 00:31:57,360 --> 00:31:58,080 WITH PAIN. 857 00:31:58,080 --> 00:31:59,560 SO FILLING THIS GAP IS REALLY 858 00:31:59,560 --> 00:32:01,720 THE GOAL OF THIS INITIATIVE AND 859 00:32:01,720 --> 00:32:03,200 TO DO THAT IS TO ADDRESS 860 00:32:03,200 --> 00:32:05,000 INDIVIDUAL DIFFERENCES IN THE 861 00:32:05,000 --> 00:32:06,520 IDEA OF FULL PERSON HELT THROUGH 862 00:32:06,520 --> 00:32:08,520 THE CLINICAL AND/OR PRECLINICAL 863 00:32:08,520 --> 00:32:13,720 DATA TO UNDERSTAND THE MECHANISM 864 00:32:13,720 --> 00:32:14,680 TO ENABLE EVIDENCE-BASED 865 00:32:14,680 --> 00:32:17,560 MODELING OF THIS DATA OF CO 866 00:32:17,560 --> 00:32:20,040 EXISTING CONDITIONS, CO EXISTING 867 00:32:20,040 --> 00:32:24,440 SUBSTANCE USE BE IT OPIOID, 868 00:32:24,440 --> 00:32:25,920 STIMULANTS, CONTROL, ET CETERA 869 00:32:25,920 --> 00:32:26,760 ALONG WITH THOSE PATHOLOGICAL 870 00:32:26,760 --> 00:32:29,400 PAIN CONDITIONS SO THAT WE CAN 871 00:32:29,400 --> 00:32:32,880 ANSWER THE QUESTION, WHICH TYPE 872 00:32:32,880 --> 00:32:33,960 OF PATIENT ARE APPROPRIATE FOR 873 00:32:33,960 --> 00:32:38,360 CERTAIN TYPES OF TREATMENTS AND 874 00:32:38,360 --> 00:32:40,320 ARE THERE GROUPS OF 875 00:32:40,320 --> 00:32:44,400 CO-MORBIDITIES OR CO EXISTING 876 00:32:44,400 --> 00:32:46,360 CONDITIONS THAT LEAD THE PATIENT 877 00:32:46,360 --> 00:32:48,640 TO HAVING INCREASED SUSCEPTIBLE 878 00:32:48,640 --> 00:32:51,800 TO INTENSE PAIN OR RESISTANCE TO 879 00:32:51,800 --> 00:32:52,240 TREATMENTS, ET CETERA. 880 00:32:52,240 --> 00:32:56,000 SO THE GOAL IS TO COLLECT 881 00:32:56,000 --> 00:32:57,400 CLINICAL DAT OF THEIR PAIN AND 882 00:32:57,400 --> 00:32:58,280 THEIR PAIN CONDITIONS IN 883 00:32:58,280 --> 00:33:02,880 INDIVIDUALS WITH 2 OR MORE PAIN 884 00:33:02,880 --> 00:33:04,120 CONDITIONS ALONG WITH THEIR 885 00:33:04,120 --> 00:33:06,120 MENTAL HEALTH CONDITIONS OTHERS 886 00:33:06,120 --> 00:33:08,080 OTHER PHYSICAL HEALTH 887 00:33:08,080 --> 00:33:08,840 CONDITIONS, THEIR SUBSTANCE 888 00:33:08,840 --> 00:33:12,720 ABUSE, AND ET CETERA AND THEN 889 00:33:12,720 --> 00:33:15,560 PRODUCE THESE MODELING 890 00:33:15,560 --> 00:33:17,200 EXPERIMENTS OR STUDIES TO 891 00:33:17,200 --> 00:33:20,480 UNDERSTAND THE PLEKANISMS OF THE 892 00:33:20,480 --> 00:33:21,560 INTERACTING OF THOSE COMORBID 893 00:33:21,560 --> 00:33:22,120 CONDITIONS, RIGHT? 894 00:33:22,120 --> 00:33:23,960 AND THE GOAL AGAIN IS TO 895 00:33:23,960 --> 00:33:26,000 ACCELERATE THE DEVELOPMENT OF 896 00:33:26,000 --> 00:33:27,760 TARGETED, AND THAT'S THE FOCUS 897 00:33:27,760 --> 00:33:29,200 HERE, ON THESE INDIVIDUALS OF 898 00:33:29,200 --> 00:33:31,640 THE PAIN THERAPIES AND PAIN 899 00:33:31,640 --> 00:33:33,800 MANAGEMENT STRATEGIES, RIGHT? 900 00:33:33,800 --> 00:33:36,360 AGAIN, NOT SPECIFIC FOR 901 00:33:36,360 --> 00:33:41,080 MOLECULAR DEVICES OR BIOLOGICS 902 00:33:41,080 --> 00:33:41,880 OR BEHAVIORIAL INTERVINGZS AND 903 00:33:41,880 --> 00:33:43,960 ALL THAT IS INCLUDED BUT 904 00:33:43,960 --> 00:33:45,280 HOPEFULLY WE CAN INFORM PATIENTS 905 00:33:45,280 --> 00:33:47,440 WHAT'S BEST FOR THEM. 906 00:33:47,440 --> 00:33:48,880 AND IS NOT, I WANT TO MAKE IT 907 00:33:48,880 --> 00:33:52,000 REALLY CLEAR, THIS IS NOT A 908 00:33:52,000 --> 00:33:53,680 BIOMARKER IN THIS, ALL RIGHT. 909 00:33:53,680 --> 00:33:55,240 THAT'S THE FIRST INITIATIVE. 910 00:33:55,240 --> 00:33:57,400 SECOND 1, NEXT SLIDE, PLEASE, 911 00:33:57,400 --> 00:33:59,200 I'M SORRY THERE'S MORE DETAIL ON 912 00:33:59,200 --> 00:34:00,160 THIS 1. 913 00:34:00,160 --> 00:34:02,120 SO HOW DOES THAT FIT AND 914 00:34:02,120 --> 00:34:03,800 COMPLEMENT OTHER HEAL PROGRAMS, 915 00:34:03,800 --> 00:34:04,440 SO UNDERSTANDING INDIVIDUAL 916 00:34:04,440 --> 00:34:06,440 DIFFERENCES AND PERSONS WITH 917 00:34:06,440 --> 00:34:07,680 LIVED PAINS AND CO-MORBIDITIES 918 00:34:07,680 --> 00:34:11,640 IS REALLY A FOCUS OF MANY OF THE 919 00:34:11,640 --> 00:34:16,520 HEAL PRECLINICAL AND 920 00:34:16,520 --> 00:34:19,840 TRANSLATIONAL AND CLINICAL 921 00:34:19,840 --> 00:34:21,320 INITIATIVES, SO INFORMING THOSE 922 00:34:21,320 --> 00:34:25,360 WITH THE DATA SETS THAT WILL 923 00:34:25,360 --> 00:34:28,360 COMPLEMENT THE WORK IN THOSE 924 00:34:28,360 --> 00:34:29,600 PARTICULAR INITIATIVES, TOO. 925 00:34:29,600 --> 00:34:34,680 THIS DATA CAN ALSO BE USING FOR 926 00:34:34,680 --> 00:34:35,960 BACK TRANSLATING AS A 927 00:34:35,960 --> 00:34:38,160 PRECLINICAL MODEL AND UNDERSTAND 928 00:34:38,160 --> 00:34:39,760 HOW THESE CO-MORBIDITIES ARE 929 00:34:39,760 --> 00:34:41,040 INFLUENCING PAIN OR THE RESPONSE 930 00:34:41,040 --> 00:34:44,800 TO TREATMENT. 931 00:34:44,800 --> 00:34:47,600 AND THEN, CENTRAL TO THE NIH 932 00:34:47,600 --> 00:34:48,320 HEAL INITIATIVE, THE OVERALL 933 00:34:48,320 --> 00:34:51,360 GOAL IS OKAYING AT THE IMPACT OF 934 00:34:51,360 --> 00:34:53,640 SUBSTANCE USE, OPIOID USE, 935 00:34:53,640 --> 00:34:55,800 STIMULANTS, ALCOHOL, ET CETERA 936 00:34:55,800 --> 00:34:58,560 AND ON MENTAL HEALTH ON THE 937 00:34:58,560 --> 00:34:59,960 EXPRESSION OF PAIN. 938 00:34:59,960 --> 00:35:01,720 AND THERE'S A WHOLE LIST OF THE 939 00:35:01,720 --> 00:35:02,960 PROGRAMS THAT THIS COULD 940 00:35:02,960 --> 00:35:06,440 INTERACT WITH OF COURSE, THERE'S 941 00:35:06,440 --> 00:35:08,400 BEEN REJOINED, BACP A C AND THE 942 00:35:08,400 --> 00:35:10,880 PATIENTS THAT WE'RE RECRUITING 943 00:35:10,880 --> 00:35:11,800 INTO EPPIC-NET, ET CETERA, ET 944 00:35:11,800 --> 00:35:13,880 CETERA SO THIS COULD FORM A LOT 945 00:35:13,880 --> 00:35:15,920 OF DIFFERENT PROGRAMS. 946 00:35:15,920 --> 00:35:16,280 >>MICHAEL? 947 00:35:16,280 --> 00:35:17,600 >>YES, PLEASE,AL AN? 948 00:35:17,600 --> 00:35:18,880 >>JUST CURIOUS, I THINK THIS 949 00:35:18,880 --> 00:35:25,800 FITS IN, BUT SO IF YOU'RE--IS 950 00:35:25,800 --> 00:35:27,920 DEPRESSION CONSIDERED A COMORBID 951 00:35:27,920 --> 00:35:28,160 CONDITION. 952 00:35:28,160 --> 00:35:28,440 >>YES. 953 00:35:28,440 --> 00:35:30,000 >>SO IT WOULD BE HERE, OKAY, 954 00:35:30,000 --> 00:35:30,600 THANK YOU. 955 00:35:30,600 --> 00:35:31,160 >>NO PROBLEM. 956 00:35:31,160 --> 00:35:41,400 GREAT QUESTION. 957 00:35:41,640 --> 00:35:42,360 NEXT SLIDE. 958 00:35:42,360 --> 00:35:43,640 SO HERE'S A FEW QUESTIONS THAT 959 00:35:43,640 --> 00:35:46,760 WE LAID OUT TO GET FEEDBACK FROM 960 00:35:46,760 --> 00:35:49,360 THE MDWG ASSOCIATED WITH THIS 961 00:35:49,360 --> 00:35:51,080 FIRST INITIATIVE. 962 00:35:51,080 --> 00:35:52,280 ARE THERE SPECIFIC COMORBID 963 00:35:52,280 --> 00:35:55,000 OCCURRING CONDITIONS SUCH AS 964 00:35:55,000 --> 00:35:55,840 ALAN MENTIONED LIKE DEPRESSION 965 00:35:55,840 --> 00:35:58,320 THAT WE SHOULD BE LOOKING AT OR 966 00:35:58,320 --> 00:36:01,200 FOCUSING IN HERE AND MAYBE, YOU 967 00:36:01,200 --> 00:36:03,160 KNOW FOCUS A PROGRAM AROUND 968 00:36:03,160 --> 00:36:05,640 THOSE AS OPPOSE TO A GENERAL 969 00:36:05,640 --> 00:36:08,520 OPEN CALL, AND CAN THEY HELP US 970 00:36:08,520 --> 00:36:11,160 INFORM WHAT WE'RE SEEING IN 971 00:36:11,160 --> 00:36:12,320 OTHER HEAL CONDITIONS, WILL IT 972 00:36:12,320 --> 00:36:14,040 BE POSSIBLE TO EXAMINE THESE 973 00:36:14,040 --> 00:36:16,360 INDIVIDUAL DIFFERENCES MAYBE IN 974 00:36:16,360 --> 00:36:17,640 RECOVERY, AND INCLUDE THOSE 975 00:36:17,640 --> 00:36:19,440 THERE, TOO SUCH AS ENVIRONMENTAL 976 00:36:19,440 --> 00:36:21,920 SOCIAL FACTORS AND THEN WHAT 977 00:36:21,920 --> 00:36:24,040 SPECIFIC POPULATIONS WOULD IT BE 978 00:36:24,040 --> 00:36:25,080 HELPFUL TO PRIORITIZE, SOME 979 00:36:25,080 --> 00:36:28,360 EXAMPLES OF THAT ARE USHED 980 00:36:28,360 --> 00:36:29,960 REPRESENTED GROUPS, MARGINALIZED 981 00:36:29,960 --> 00:36:31,480 GROUP OR POPULATIONS WITH HEALTH 982 00:36:31,480 --> 00:36:33,240 DISPARITIES AND GO AHEAD, ROB, 983 00:36:33,240 --> 00:36:36,640 WE'RE READY. 984 00:36:36,640 --> 00:36:37,680 >>OKAY, THANK YOU. 985 00:36:37,680 --> 00:36:39,160 SO THESE QUESTIONS KIND OF 986 00:36:39,160 --> 00:36:43,920 ADDRESS WHAT OCCURRED TO ME AS I 987 00:36:43,920 --> 00:36:45,200 WAS READING THESE 2 CENTRAL 988 00:36:45,200 --> 00:36:47,120 PROGRAMS WHICH TO ME IT'S 989 00:36:47,120 --> 00:36:49,400 UNCLEAR WHERE THE LINE BETWEEN 990 00:36:49,400 --> 00:36:50,240 INDIVIDUAL DIFFERENCES AND 991 00:36:50,240 --> 00:36:53,280 TRYING TO REMEMBER THE TERM FOR 992 00:36:53,280 --> 00:36:55,160 THE NEXT 1, EXPOSE OHM, BECAUSE 993 00:36:55,160 --> 00:36:58,000 A LOT OF WHAT YOU'RE TALKING 994 00:36:58,000 --> 00:36:59,280 ABOUT HEAR SHOULD ENVIRONMENTAL 995 00:36:59,280 --> 00:37:01,400 OR SOCIAL FACTORS BE INCLUDED, 996 00:37:01,400 --> 00:37:05,680 DOESN'T THAT FACTOR INTO THIS 997 00:37:05,680 --> 00:37:06,120 EXPOSOME THING? 998 00:37:06,120 --> 00:37:09,320 SO FIRST OF ALL OVERALL I THINK 999 00:37:09,320 --> 00:37:14,280 THE NOTION OF USING THESE BIG 1000 00:37:14,280 --> 00:37:16,080 DATA SETS AND BRINGING IN ALL 1001 00:37:16,080 --> 00:37:17,600 THESE FACTORS TO REALLY LOOK AT 1002 00:37:17,600 --> 00:37:21,840 OUTCOMES I THINK IS VERY 1003 00:37:21,840 --> 00:37:22,240 IMPORTANT. 1004 00:37:22,240 --> 00:37:24,440 AND I THINK THE FIELD IS READY, 1005 00:37:24,440 --> 00:37:25,400 THE TECHNOLOGY IS THERE AND 1006 00:37:25,400 --> 00:37:27,240 THERE ARE PEOPLE SORT OF WORKING 1007 00:37:27,240 --> 00:37:30,080 ON THIS ALREADY AND THERE'S NOT 1008 00:37:30,080 --> 00:37:31,520 A GREAT FIT OR FUNDING FOR THAT 1009 00:37:31,520 --> 00:37:34,080 TYPE OF WORK, SO I THINK THIS IS 1010 00:37:34,080 --> 00:37:36,480 A GOOD, GOOD THING TO ADDRESS, I 1011 00:37:36,480 --> 00:37:38,120 JUST WONDER IF THESE ARE 1012 00:37:38,120 --> 00:37:39,280 ACTUALLY 2 SEPARATE PROGRAMS, 1013 00:37:39,280 --> 00:37:40,080 JUST FOR THE GENERAL 1014 00:37:40,080 --> 00:37:41,760 CONVERSATION AS WE GO THROUGH 1015 00:37:41,760 --> 00:37:43,560 THESE 2 THINGS, ARE THESE SORT 1016 00:37:43,560 --> 00:37:45,640 OF PART AND PARCEL THE SAME 1017 00:37:45,640 --> 00:37:47,840 THING, AND WE SHOULD BE ASKING 1018 00:37:47,840 --> 00:37:49,640 THESE QUESTIONS, BIGGER OR IS 1019 00:37:49,640 --> 00:37:52,920 THERE A SPECIFIC REASON TO FOCUS 1020 00:37:52,920 --> 00:37:53,800 ON THE EXPOSOME? 1021 00:37:53,800 --> 00:37:54,560 >>I THINK THAT'S A GREAT 1022 00:37:54,560 --> 00:37:57,200 QUESTION AND YOU READ IT JUST 1023 00:37:57,200 --> 00:38:01,120 LIKE OUR WORK GROUP DISCUSSED 1024 00:38:01,120 --> 00:38:01,280 IT. 1025 00:38:01,280 --> 00:38:03,000 AND THAT'S WHY THERE'S THIS 1026 00:38:03,000 --> 00:38:04,720 EMPHASIS TO THE CLINICAL DATA 1027 00:38:04,720 --> 00:38:06,120 SET, IN THE FIRST INITIATIVE TO 1028 00:38:06,120 --> 00:38:07,680 KIND OF GET THAT DATA AND THE 1029 00:38:07,680 --> 00:38:10,920 SECOND 1 IS A MECHANISTIC 1030 00:38:10,920 --> 00:38:12,040 UNDERSTANDING OF THINGS THAT 1031 00:38:12,040 --> 00:38:14,440 HAVE BEEN IDENTIFIED AND WE HAVE 1032 00:38:14,440 --> 00:38:16,440 GOOD AND YOU KNOW LITERATURE, 1033 00:38:16,440 --> 00:38:17,760 PUBLISHED ON IT LIKE YOU 1034 00:38:17,760 --> 00:38:18,960 MENTIONED IN THIS AREA, LIKE 1035 00:38:18,960 --> 00:38:23,240 SLEEP AND PAIN AND EXPOSOME, AND 1036 00:38:23,240 --> 00:38:27,720 I KNOW I'M JUMPING AHEAD BUT 1037 00:38:27,720 --> 00:38:29,320 THAT'S A MECHANISTIC INITIATIVE 1038 00:38:29,320 --> 00:38:31,080 AND THIS 1'S MORE GATHERING DATA 1039 00:38:31,080 --> 00:38:32,880 AND FACTORS AND FOLLOWING INTO 1040 00:38:32,880 --> 00:38:33,120 GROUPS. 1041 00:38:33,120 --> 00:38:34,480 I HOPE THAT HELPS. 1042 00:38:34,480 --> 00:38:36,160 >>YEAH, I THINK SO BUT WE CAN 1043 00:38:36,160 --> 00:38:36,600 DISCUSS IT FURTHER. 1044 00:38:36,600 --> 00:38:38,480 ONE OF THE THINGS THAT COMING TO 1045 00:38:38,480 --> 00:38:40,840 MIND IN TERMS OF POPULATIONS IS 1046 00:38:40,840 --> 00:38:41,680 TO THINK ABOUT, BECAUSE WHAT 1047 00:38:41,680 --> 00:38:45,200 THIS TYPE OF WORK IS GOING TO 1048 00:38:45,200 --> 00:38:48,760 RELY ON IS LARGE, EMR SYSTEMS 1049 00:38:48,760 --> 00:38:52,760 AND WHO ARE WE MISSING AT THE 1050 00:38:52,760 --> 00:38:54,280 POPULATION LEVEL, YOU KNOW MAYBE 1051 00:38:54,280 --> 00:38:56,600 THOSE DATA SETS, I MEAN MAYBE 1052 00:38:56,600 --> 00:38:59,640 WE'RE NOT CAPTURING DATA BROADLY 1053 00:38:59,640 --> 00:39:01,960 FROM RURAL COMMUNITIES OR FROM 1054 00:39:01,960 --> 00:39:02,600 POORER COMMUNITIES THAT'S 1055 00:39:02,600 --> 00:39:04,320 SOMETHING WE CAN CONSIDER AND 1056 00:39:04,320 --> 00:39:04,880 THAT'S PROBABLY KNOWN. 1057 00:39:04,880 --> 00:39:06,720 I DON'T KNOW WHAT THAT IS BUT 1058 00:39:06,720 --> 00:39:09,720 I'M JUST MINDFUL OF THE--IF 1059 00:39:09,720 --> 00:39:10,680 WE'RE LOOKING, WHERE WE'RE 1060 00:39:10,680 --> 00:39:13,880 PLUGGED IN DATA WE MIGHT BE 1061 00:39:13,880 --> 00:39:22,120 MISSING LARGE SWATHS OF PEOPLE. 1062 00:39:22,120 --> 00:39:23,720 >>EXCELLENT SUGGESTION. 1063 00:39:23,720 --> 00:39:25,440 GO AHEAD, CHRIS. 1064 00:39:25,440 --> 00:39:26,280 >>THANKS, MICHAEL. 1065 00:39:26,280 --> 00:39:27,440 OBVIOUSLY I'M A LITTLE BIASED 1066 00:39:27,440 --> 00:39:28,480 HERE BUT IESM IN GREAT SUPPORT 1067 00:39:28,480 --> 00:39:30,000 OF THIS TYPE OF PROGRAM 1068 00:39:30,000 --> 00:39:31,000 PARTICULARLY FROM THE WHOLE 1069 00:39:31,000 --> 00:39:34,920 PERSON HEALTH APPROACH WHICH I 1070 00:39:34,920 --> 00:39:36,320 THINK IS VITAL GIVEN WHAT WE'VE 1071 00:39:36,320 --> 00:39:37,360 LEARNED THROUGH HEAL AND 1072 00:39:37,360 --> 00:39:39,840 PROBABLY KNEW A BIT BEFORE THEN 1073 00:39:39,840 --> 00:39:41,280 THAT, YOU KNOW THESE THINGS DO 1074 00:39:41,280 --> 00:39:42,800 NOT OCCUR IN ISOLATION, RIGHT? 1075 00:39:42,800 --> 00:39:44,480 AND SO IF WE'RE REALLY GOING TO 1076 00:39:44,480 --> 00:39:46,760 BE ABLE TO TRANSLATE AND PROVIDE 1077 00:39:46,760 --> 00:39:48,760 GOOD CLINICAL CARE AND 1078 00:39:48,760 --> 00:39:49,360 THERAPEUTIC INTERVENTIONS, YOU 1079 00:39:49,360 --> 00:39:51,200 REALLY NEED TO TAKE THESE THINGS 1080 00:39:51,200 --> 00:39:53,000 INTO CONSIDERATION AS THEY 1081 00:39:53,000 --> 00:39:53,240 OCCUR. 1082 00:39:53,240 --> 00:39:56,120 CRITERIA YOU KNOW IN PEOPLE. 1083 00:39:56,120 --> 00:39:56,840 IN REGARDS TO THE FIRST 1084 00:39:56,840 --> 00:39:58,960 QUESTION, JUST A COUPLE 1085 00:39:58,960 --> 00:40:00,920 SUGGESTIONS, THERE ARE, YOU KNOW 1086 00:40:00,920 --> 00:40:02,440 NIH FUNDED STUDIES AND 1087 00:40:02,440 --> 00:40:04,400 INVESTIGATORS THAT HAVE ALREADY 1088 00:40:04,400 --> 00:40:09,800 LARGE DATA SETS ISSUE LOOKING 1089 00:40:09,800 --> 00:40:12,840 AT, 1 IS SEAN MACKEY, THE 1090 00:40:12,840 --> 00:40:14,680 REGISTRY HE HAS AT STANFORD, 1091 00:40:14,680 --> 00:40:16,320 DAVE CLAW AND WILLIAMS AT 1092 00:40:16,320 --> 00:40:17,840 UNIVERSITY OF MICHIGAN, THE BACP 1093 00:40:17,840 --> 00:40:20,480 A C IS USING THE COPE SCREENING 1094 00:40:20,480 --> 00:40:23,320 TOOLS AND THEN YOU ALL HAVE 1095 00:40:23,320 --> 00:40:24,520 GIVEN COPE SUPPLEMENTS TO LOOK 1096 00:40:24,520 --> 00:40:26,520 AT LARGE DATA SETS SO I THINK IT 1097 00:40:26,520 --> 00:40:27,480 WILL BE REALLY INTERESTING TO 1098 00:40:27,480 --> 00:40:28,560 THE EXTENT THAT THE DATA IS 1099 00:40:28,560 --> 00:40:31,520 AVAILABLE TO BE ABLE TO DO, YOU 1100 00:40:31,520 --> 00:40:33,360 KNOW QUICK ANALYSIS, PRELIMINARY 1101 00:40:33,360 --> 00:40:37,400 ANALYSIS AND SEE WHAT THOSE 1102 00:40:37,400 --> 00:40:38,720 SPECIFIC COMBINATIONS OF CO 1103 00:40:38,720 --> 00:40:40,000 OCCURRING CONDITIONS ARE THAT 1104 00:40:40,000 --> 00:40:42,160 WILL HELP YOU REALLY TO BETTER 1105 00:40:42,160 --> 00:40:43,360 INFORM WHERE YOU MIGHT WANT TO 1106 00:40:43,360 --> 00:40:45,360 FOCUS OR WHETHER THERE'S TRENDS 1107 00:40:45,360 --> 00:40:48,520 THAT CAN BE IDENTIFIED. 1108 00:40:48,520 --> 00:40:50,960 AND THEN THE OTHER QUESTION, 1109 00:40:50,960 --> 00:40:51,400 THAT'S 1 COMMENT. 1110 00:40:51,400 --> 00:40:53,720 AND THEN THE QUESTION I HAD 1111 00:40:53,720 --> 00:40:54,240 ABOUT BIOMARKERS WAS, I 1112 00:40:54,240 --> 00:40:57,320 UNDERSTAND THIS IS NOT A 1113 00:40:57,320 --> 00:40:59,800 BIOMARKER PROGRAM, RESEARCH 1114 00:40:59,800 --> 00:41:01,760 PROGRAM BUT WILL YOU ACCEPT 1115 00:41:01,760 --> 00:41:04,560 PROFOAZALS THAT POTENTIALLY HAVE 1116 00:41:04,560 --> 00:41:06,240 A BIOMARKER COMPONENT, EVEN IF 1117 00:41:06,240 --> 00:41:07,880 IT'S NOT THE MAJORITY OF IT 1118 00:41:07,880 --> 00:41:09,040 BECAUSE THE REASON WHY I ASK 1119 00:41:09,040 --> 00:41:10,160 THAT IS JUST BECAUSE THERE'S 1120 00:41:10,160 --> 00:41:14,640 SUCH A GREAT NEED TO UNDERSTAND 1121 00:41:14,640 --> 00:41:17,040 BIOPSYCHOSOCIAL BIOMARKERS IN 1122 00:41:17,040 --> 00:41:19,280 TERMS OF PREDICTABILITY OF WHICH 1123 00:41:19,280 --> 00:41:20,280 PATIENT POPULATIONS 1124 00:41:20,280 --> 00:41:22,480 PARTICULARLY, THOSE WITH CO 1125 00:41:22,480 --> 00:41:23,400 OCCURRING CONDITIONS, PROGRESS 1126 00:41:23,400 --> 00:41:25,760 TO GET BETTER OR PROGRESS TO GET 1127 00:41:25,760 --> 00:41:30,320 WORSE AND WHAT THOSE 1128 00:41:30,320 --> 00:41:31,520 INTERVENTIONAL FACTORS MAY BE UP 1129 00:41:31,520 --> 00:41:31,960 FRONT. 1130 00:41:31,960 --> 00:41:34,080 THERE'S BEEN A COUPLE FUNDED 1131 00:41:34,080 --> 00:41:35,000 THROUGH THE ACTUAL BIOMARKER 1132 00:41:35,000 --> 00:41:36,400 PROGRAM BUT WE KNOW SO LITTLE 1133 00:41:36,400 --> 00:41:37,840 ABOUT THIS I JUST WONDER IF THAT 1134 00:41:37,840 --> 00:41:39,120 WILL BE ACCEPTED AS PART OF THE 1135 00:41:39,120 --> 00:41:40,760 RESEARCH PROGRAM OR WHETHER 1136 00:41:40,760 --> 00:41:44,040 THEY'RE COMPLETELY NOT ALLOWED. 1137 00:41:44,040 --> 00:41:45,800 >>SO WE HAD THIS DISCUSSION, 1138 00:41:45,800 --> 00:41:46,680 OBVIOUSLY, THAT'S WHY I PUT IT 1139 00:41:46,680 --> 00:41:47,640 ON THE SLIDE AND IT'S GREAT THAT 1140 00:41:47,640 --> 00:41:50,280 YOU BROUGHT IT UP AND YOUR SHOW 1141 00:41:50,280 --> 00:41:51,440 OF SUPPORT FOR BIOMARKERS IN 1142 00:41:51,440 --> 00:41:55,400 THIS AREA AND THE CONSISTENT 1143 00:41:55,400 --> 00:41:57,720 SUPPORT FROM THIS AREA FROM THE 1144 00:41:57,720 --> 00:41:59,600 MDWG WE HEAR IT REALLY LOUD AND 1145 00:41:59,600 --> 00:42:03,600 CLEAR, IT'S THAT THIS PARTICULAR 1146 00:42:03,600 --> 00:42:06,680 INITIATIVE, IF WE INCLUDE IT 1147 00:42:06,680 --> 00:42:08,240 BIOMARKER STUDIES THAT THAT 1148 00:42:08,240 --> 00:42:10,760 COULD EITHER DILUTE THE WORK 1149 00:42:10,760 --> 00:42:12,480 THAT'S BEING DONE AND THE FOCUS 1150 00:42:12,480 --> 00:42:19,160 WE HAVE HERE, AND ALSO NOT BE 1151 00:42:19,160 --> 00:42:20,720 PROPER BIOMARKER, YOU KNOW 1152 00:42:20,720 --> 00:42:23,040 VALIDATION OR DISCOVERY WORK. 1153 00:42:23,040 --> 00:42:25,240 SO WE FELT THAT THOSE SHOULD BE 1154 00:42:25,240 --> 00:42:27,680 INDEPENDENT APPLICATIONS AND 1155 00:42:27,680 --> 00:42:29,200 EVALUATED FROM THE QUALITY OF 1156 00:42:29,200 --> 00:42:32,160 THE EXPERIMENTS TO DEVELOP THAT 1157 00:42:32,160 --> 00:42:34,040 BIOMARKER AND NOT JUST DILUTE IT 1158 00:42:34,040 --> 00:42:38,360 AND SPLIT IT INTO 2 DIFFERENT 1159 00:42:38,360 --> 00:42:38,880 TYPES OF RESEARCH. 1160 00:42:38,880 --> 00:42:40,560 SO I HOPE THAT HELPS. 1161 00:42:40,560 --> 00:42:42,440 WE DO HEAR YOU LOUD AND CLEAR 1162 00:42:42,440 --> 00:42:43,760 THAT BIOMARKERS AND PAIN ARE 1163 00:42:43,760 --> 00:42:44,440 ABSOLUTELY IMPORTANT AND WE'RE 1164 00:42:44,440 --> 00:42:46,200 NOT TRYING TO TAKE AWAY FROM 1165 00:42:46,200 --> 00:42:48,560 THAT WITH THIS INITIATIVE, TO 1166 00:42:48,560 --> 00:42:49,600 REALLY PRODUCE THESE DATA SETS 1167 00:42:49,600 --> 00:42:51,520 THAT COULD INFORNL NAIN OTHER 1168 00:42:51,520 --> 00:42:53,640 WAYS IN IF THE FUTURE WHEN 1169 00:42:53,640 --> 00:42:54,800 BIOMARKER WORK COULD BEING DONE 1170 00:42:54,800 --> 00:42:56,240 IN ANOTHER PART OF THE 1171 00:42:56,240 --> 00:42:58,800 INITIATIVE OR PART OF THE 1172 00:42:58,800 --> 00:43:00,320 ONGOING INITIATIVE FOR 1173 00:43:00,320 --> 00:43:00,760 BIOMARKERS OF PAIN. 1174 00:43:00,760 --> 00:43:02,480 >>I GET THAT AND I APPRECIATE 1175 00:43:02,480 --> 00:43:04,040 THE RESPONSE, I THINK IT WOULD 1176 00:43:04,040 --> 00:43:05,640 BE INTERESTING TO POTENTIALLY 1177 00:43:05,640 --> 00:43:06,920 LOOK AT PROVIDING SUPPLEMENTARY 1178 00:43:06,920 --> 00:43:09,440 FUNDING TO DO ANALYSIS OF THESE 1179 00:43:09,440 --> 00:43:10,000 LARGE DATA SETS. 1180 00:43:10,000 --> 00:43:12,560 IT MAY NOT BE VALIDATION OF A 1181 00:43:12,560 --> 00:43:14,000 BLOOD BIOMARKER, WHATEVER, BUT 1182 00:43:14,000 --> 00:43:15,280 WHAT WE'RE TRYING--WHAT I THINK 1183 00:43:15,280 --> 00:43:16,840 A LOT OF RECENT RESEARCH HAS 1184 00:43:16,840 --> 00:43:18,880 SHOWN IS THAT, THERE'S LIKELY 1185 00:43:18,880 --> 00:43:21,360 GOING TO BE COMPLEX 1186 00:43:21,360 --> 00:43:23,400 BIOPSYCHOSOCIAL IGF NATURES OF 1187 00:43:23,400 --> 00:43:25,120 PATIENTS THAT HAVE DIFFERENT 1188 00:43:25,120 --> 00:43:25,960 OCCUR TRING CONDITIONS THAT WE 1189 00:43:25,960 --> 00:43:28,440 MAY BE ABLE TO IDENTIFY AT LEAST 1190 00:43:28,440 --> 00:43:29,440 THROUGH SCOPING WORK THROUGH 1191 00:43:29,440 --> 00:43:31,160 LARGE DATA SETS THAT MAY INFORM 1192 00:43:31,160 --> 00:43:33,360 THAT TYPE OF VALIDATION AND 1193 00:43:33,360 --> 00:43:34,360 DISCOVERY WORK THAT YOU'RE 1194 00:43:34,360 --> 00:43:36,760 TALKING ABOUT IN FUTURE 1195 00:43:36,760 --> 00:43:37,200 APPLICATIONS. 1196 00:43:37,200 --> 00:43:38,560 >>THAT'S EXACTLY THE KIND OF 1197 00:43:38,560 --> 00:43:40,920 WORK WE'RE LOOKING FOR IN IT 1198 00:43:40,920 --> 00:43:42,000 INITIATIVE, APPRECIATE YOU HIGH 1199 00:43:42,000 --> 00:43:47,400 LIELTING --LIGHTING THAT. 1200 00:43:47,400 --> 00:43:47,920 THANK YOU ERIC? 1201 00:43:47,920 --> 00:43:49,240 >>I HAVE A SEPARATE COMMENT BUT 1202 00:43:49,240 --> 00:43:50,720 I WANT TO SUPPORT WHAT CHRIS 1203 00:43:50,720 --> 00:43:51,960 BROUGHT UP. 1204 00:43:51,960 --> 00:43:52,800 IT'S INCREDIBLY IMPORTANT IF YOU 1205 00:43:52,800 --> 00:43:53,760 WANT TO UNDERSTAND THESE 1206 00:43:53,760 --> 00:43:55,600 INDIVIDUAL DIFFERENCES TO TAKE A 1207 00:43:55,600 --> 00:43:57,000 BIOPSYCHOSOCIAL VIEW AND THAT'S 1208 00:43:57,000 --> 00:44:00,240 NOT THE SAME AS VALIDATING NEW 1209 00:44:00,240 --> 00:44:04,280 BIOMARKERS BUT IF THE PROPOSED 1210 00:44:04,280 --> 00:44:05,120 APPLICATIONS HAVE BIOMARKERS 1211 00:44:05,120 --> 00:44:08,240 AVAILABLE, OR SOME SORT OF 1212 00:44:08,240 --> 00:44:08,880 NEUROPHYSIOLOGICAL MECHANISTIC 1213 00:44:08,880 --> 00:44:12,720 DATA THAT CAN BE REALLY USEFUL 1214 00:44:12,720 --> 00:44:13,800 APPROXIMATE IN DISCRIMINATING 1215 00:44:13,800 --> 00:44:15,080 THESE PHENOTYPES BUT WHAT I WANT 1216 00:44:15,080 --> 00:44:19,400 TO ACTUALLY COMMENT ON WAS IN 1217 00:44:19,400 --> 00:44:20,920 TERMS OF 1 PARTICULAR CO 1218 00:44:20,920 --> 00:44:23,360 OCCURRING CONDITION, THAT MIGHT 1219 00:44:23,360 --> 00:44:26,080 BE INTERESTING TO STUDY HERE, TO 1220 00:44:26,080 --> 00:44:28,000 EMPHASIZE IS THE CO-MORBIDITY 1221 00:44:28,000 --> 00:44:29,280 BETWEEN PTSD AND CHRONIC PAIN 1222 00:44:29,280 --> 00:44:31,200 WHICH WE KNOW IS PREVALENCE 1223 00:44:31,200 --> 00:44:33,000 RATES ARE INCREDIBLE LOAMACYY 1224 00:44:33,000 --> 00:44:35,840 HIGH AND PEOPLE STILL DON'T 1225 00:44:35,840 --> 00:44:38,680 REALLY UNDERSTAND THE PATHWAYS 1226 00:44:38,680 --> 00:44:43,440 BY WHICH PSYCHOLOGICAL TRAUMA, 1227 00:44:43,440 --> 00:44:46,200 IT IMPACTS PHYSICAL PAIN AND 1228 00:44:46,200 --> 00:44:47,800 PERHAPS IS TRANSDUCED INTO 1229 00:44:47,800 --> 00:44:49,520 PHYSICAL PAIN AND THAT'S 1230 00:44:49,520 --> 00:44:51,080 CERTAINLY A BELIEF OUT THERE IN 1231 00:44:51,080 --> 00:44:52,560 THE CLINICAL LITERATURE BUT I 1232 00:44:52,560 --> 00:44:54,200 THINK MORE LIGHT CAN BE SHED ON 1233 00:44:54,200 --> 00:44:57,400 HOW THESE 2 CONDITIONS INTERSECT 1234 00:44:57,400 --> 00:44:59,920 WITH 1 ANOTHER. 1235 00:44:59,920 --> 00:45:03,120 >>EXCELLENT SUGGESTION, ERIC, 1236 00:45:03,120 --> 00:45:07,960 THANK YOU. 1237 00:45:07,960 --> 00:45:08,360 ED? 1238 00:45:08,360 --> 00:45:10,280 >>YEAH, WELL, I ECHO AS A 1239 00:45:10,280 --> 00:45:14,720 CLINICIAN, I REALLY SUPPORT THIS 1240 00:45:14,720 --> 00:45:16,000 INITIATIVE AND THE COMMENTS THAT 1241 00:45:16,000 --> 00:45:17,320 HAVE BEEN MADE ALREADY, WHAT I 1242 00:45:17,320 --> 00:45:18,800 WANTED TO SAY, YOU MAY ALREADY 1243 00:45:18,800 --> 00:45:23,320 BE ALL OVER THIS, BUT DIFFERENT 1244 00:45:23,320 --> 00:45:24,640 MEDICAL SPECIALTIES SEE THESE 1245 00:45:24,640 --> 00:45:26,040 DIFFERENT PAIN SYNDROMES, RIGHT? 1246 00:45:26,040 --> 00:45:31,080 SO INTERN ICHTS SEE CHRONIC 1247 00:45:31,080 --> 00:45:33,720 FATIGUE, UROLOGISTS SEE 1248 00:45:33,720 --> 00:45:38,200 INTERSTITIAL CYSTITISI 1249 00:45:38,200 --> 00:45:38,880 RHEUMATOLOGIST SIGN FIBROMYALGIA 1250 00:45:38,880 --> 00:45:43,440 AND A LOT OF THEM RESPOND 1251 00:45:43,440 --> 00:45:44,840 PARTIALLY TO [INDISCERNIBLE] 1252 00:45:44,840 --> 00:45:50,280 DEPRESS ANTS BUT THEY PRESENT AS 1253 00:45:50,280 --> 00:45:51,640 DISTINCT SYNDROMES 1254 00:45:51,640 --> 00:45:53,880 [INDISCERNIBLE] BUT 1 WONDERS IF 1255 00:45:53,880 --> 00:45:55,200 THERE'S UNDERLYING MECHANIST 1256 00:45:55,200 --> 00:45:56,760 INCREASE IN BODY CONDITIONS ARE 1257 00:45:56,760 --> 00:45:58,120 ARE THEY CONNECTED 1258 00:45:58,120 --> 00:45:58,880 MECHANISTICALLY SO I WONDER IF 1259 00:45:58,880 --> 00:46:00,320 YOU HAVE IN MIND TO FOCUS ON 1260 00:46:00,320 --> 00:46:01,840 THAT AT ALL AND CERTAIN LE 1261 00:46:01,840 --> 00:46:04,160 THAT'S A BIG PART OF WHAT 1262 00:46:04,160 --> 00:46:05,680 CLINICIANS, WHAT CLINICIANS ARE 1263 00:46:05,680 --> 00:46:08,000 SEEING, PHYSICIANS OF DIFFERENT 1264 00:46:08,000 --> 00:46:08,280 TYPES? 1265 00:46:08,280 --> 00:46:09,880 NTHANK YOU SO MUCH FOR BRINGING 1266 00:46:09,880 --> 00:46:10,400 THAT UP ED. 1267 00:46:10,400 --> 00:46:13,360 THAT'S 1 OF THE REASONS WHY 1268 00:46:13,360 --> 00:46:15,520 WE'RE LOOKING FOR INCLUDING ONLY 1269 00:46:15,520 --> 00:46:17,400 INDIVIDUALS WITH AT LEAST 2 1270 00:46:17,400 --> 00:46:20,240 CHRONIC PAIN CONDITIONS, RIGHT? 1271 00:46:20,240 --> 00:46:21,560 SO THE--THE--FOR ALL THE REASONS 1272 00:46:21,560 --> 00:46:25,080 THAT YOU JUST LAID OUT, THERE 1273 00:46:25,080 --> 00:46:26,720 ARE COMMON MECHANISMS THAT 1274 00:46:26,720 --> 00:46:28,040 CLINICIANS SEE TWE'RE LOOKING 1275 00:46:28,040 --> 00:46:29,400 FOR WHERE THEY'RE COMING 1276 00:46:29,400 --> 00:46:30,240 TOGETHER, THERE'S BEEN GREAT 1277 00:46:30,240 --> 00:46:32,520 RESEARCH DONE IN THE PAST EVERY 1278 00:46:32,520 --> 00:46:33,800 YEAR THAT THE LATE HAS DONE A 1279 00:46:33,800 --> 00:46:39,200 LOT OF WORK IN THIS AREA FOR 1280 00:46:39,200 --> 00:46:42,680 EXAMPLE, AND THEN THE DATA SETS 1281 00:46:42,680 --> 00:46:44,800 THAT YOU KNOW CHRIS BEESLY 1282 00:46:44,800 --> 00:46:45,680 MENTIONED, THEY'RE ASKING THE 1283 00:46:45,680 --> 00:46:49,000 QUESTION THAT YOU'RE ADDRESSING. 1284 00:46:49,000 --> 00:46:50,480 WHAT WE'RE REALLY TRYING TO DO 1285 00:46:50,480 --> 00:46:53,240 HERE IN ADDITION TO 1286 00:46:53,240 --> 00:46:54,080 THOSE--LOOKING AT THOSE LARGE 1287 00:46:54,080 --> 00:46:56,400 DATA SETS AND LOOKING AT 1288 00:46:56,400 --> 00:46:58,120 POPULATION SIMILARITIES BETWEEN 1289 00:46:58,120 --> 00:47:01,080 THOSE WITH CHRONIC MIGRAINE AND 1290 00:47:01,080 --> 00:47:03,320 INTERSTITIAL SUBICITIS IS TO ASK 1291 00:47:03,320 --> 00:47:04,840 IN THOSE INDIVIDUALS THAT HAVE 1292 00:47:04,840 --> 00:47:07,520 THOSE MIXED 1S, WHERE IS THE 1293 00:47:07,520 --> 00:47:08,040 COMPLEXITY THERE? 1294 00:47:08,040 --> 00:47:14,880 WHAT ASPECTS WITH THE INDIVIDUL 1295 00:47:14,880 --> 00:47:16,440 VARIANT OF PAIN WITH THEIR OWN 1296 00:47:16,440 --> 00:47:17,680 SOCIAL ENVIRONMENT, ET CETERA 1297 00:47:17,680 --> 00:47:19,600 AND MORE IMPORTANTLY THERE 1298 00:47:19,600 --> 00:47:21,680 COMORBID HEALTH CONDITION SYSTEM 1299 00:47:21,680 --> 00:47:23,280 LEADING TO RESISTANCE FOR 1300 00:47:23,280 --> 00:47:24,960 SUCCESSFUL PAIN MANAGEMENT IN 1301 00:47:24,960 --> 00:47:26,760 THAT INDIVIDUAL? 1302 00:47:26,760 --> 00:47:29,760 IT IS A SUBTLY BUT IT IS MOVING 1303 00:47:29,760 --> 00:47:30,800 THAT RESEARCH FORWARD THAT'S 1304 00:47:30,800 --> 00:47:41,320 BEEN DONE ON A POPULATION LEVEL. 1305 00:47:41,720 --> 00:47:43,920 >>THIS IS SOMEWHAT RHETORICAL, 1306 00:47:43,920 --> 00:47:44,960 BUT I OOH SIEWM IT'S ADDRESSING 1307 00:47:44,960 --> 00:47:46,880 THE QUESTION, IF YOU HAVE AN 1308 00:47:46,880 --> 00:47:48,600 INDIVIDUAL WITH A COMORBID 1309 00:47:48,600 --> 00:47:50,240 CONDITION LET'S SAY MIGRAINE AND 1310 00:47:50,240 --> 00:47:51,960 IBS, SO DIFFERENT, IF YOU TREAT 1311 00:47:51,960 --> 00:47:54,040 1 SUCCESSFULLY, WHAT'S THE 1312 00:47:54,040 --> 00:47:55,840 LIKELIHOOD OF THE OTHER 1 1313 00:47:55,840 --> 00:47:57,160 ACTUALLY RESPONDING. 1314 00:47:57,160 --> 00:47:57,640 >>YEP, SURE. 1315 00:47:57,640 --> 00:47:59,400 THAT COULD BE INCLUDED HERE. 1316 00:47:59,400 --> 00:48:01,360 AND THERE ARE THOSE THAT HAVE 1317 00:48:01,360 --> 00:48:02,520 ASKED THESE QUESTIONS BUT ALSO 1318 00:48:02,520 --> 00:48:04,400 THAT, YOU KNOW THIS RESEARCH IS 1319 00:48:04,400 --> 00:48:05,600 REALLY FRACTURED AT THIS POINT. 1320 00:48:05,600 --> 00:48:08,280 PUTTING IT TOGETHER LIKE THIS IS 1321 00:48:08,280 --> 00:48:10,400 REALLY AN INNOVATION, I THINK. 1322 00:48:10,400 --> 00:48:12,240 >>THE OTHER PROBLEM I'VE SEEN 1323 00:48:12,240 --> 00:48:13,880 AND I NOTICED A LONG TIME AGO 1324 00:48:13,880 --> 00:48:15,760 WHEN I LOOKEDDA THE MEMBERSHIP 1325 00:48:15,760 --> 00:48:16,200 FOR THE INTERNATIONAL 1326 00:48:16,200 --> 00:48:20,720 ASSOCIATION FOR THE STUDY OF 1327 00:48:20,720 --> 00:48:29,080 PAIN, IT'S ABOUT IT'S ABOUT 40%, 1328 00:48:29,080 --> 00:48:29,680 50% ANESTHESIOLOGISTS, 30-40% 1329 00:48:29,680 --> 00:48:33,600 PSYCHOLOGISTS, THE REST ARE 1330 00:48:33,600 --> 00:48:36,400 BASIC NEUROSCIENTISTS, PHYSICAL 1331 00:48:36,400 --> 00:48:37,040 THERAPISTS, BASICALLY YOU COULD 1332 00:48:37,040 --> 00:48:38,840 COUNT THE NUMBER OF 1333 00:48:38,840 --> 00:48:42,320 RHEUMATOLOGISTS ON YOUR HAND. 1334 00:48:42,320 --> 00:48:43,360 ONCOLOGISTS FORGET IT. 1335 00:48:43,360 --> 00:48:45,520 AND IT'S INTERESTING BECAUSE 1336 00:48:45,520 --> 00:48:46,360 EITHER THOSE DISCIPLINES DON'T 1337 00:48:46,360 --> 00:48:50,720 SEE PAIN AS A PROBLEM OR THEY 1338 00:48:50,720 --> 00:48:52,840 DON'T--OR THEY THINK THEY CAN 1339 00:48:52,840 --> 00:48:57,280 DEAL WITH IT. 1340 00:48:57,280 --> 00:48:59,960 AND I WONDER WHETHER THE 1341 00:48:59,960 --> 00:49:02,240 INDIVIDUAL WHO CHOSES TO GO TO 1342 00:49:02,240 --> 00:49:03,640 THE RHEUMATOLOGIST AS OPPOSE TO 1343 00:49:03,640 --> 00:49:08,680 A PAIN CLINIC GETS COMPLETELY 1344 00:49:08,680 --> 00:49:10,640 DIFFERENTLY DIAGNOSED. 1345 00:49:10,640 --> 00:49:12,720 >>GOOD QUESTION. 1346 00:49:12,720 --> 00:49:14,280 >>I'M HAVING TROUBLE WITH THE 1347 00:49:14,280 --> 00:49:15,320 NEW INSTALLATION OF ZOOM SO I 1348 00:49:15,320 --> 00:49:17,040 DON'T KNOW HOW TO RAISE MY HAND, 1349 00:49:17,040 --> 00:49:19,840 BUT WHEN IT'S MY TURN, I WILL 1350 00:49:19,840 --> 00:49:20,040 SPEAK. 1351 00:49:20,040 --> 00:49:24,360 >>I GOT YOU ON THE LIST, WALLY? 1352 00:49:24,360 --> 00:49:26,160 CHRIS, YOU'RE NEXT AND THEN 1353 00:49:26,160 --> 00:49:26,480 WALLY. 1354 00:49:26,480 --> 00:49:27,920 >>I WANT TO QUICKLY COMMENT 1355 00:49:27,920 --> 00:49:30,080 THAT 1 OF THE REALLY KEY NEEDED 1356 00:49:30,080 --> 00:49:32,440 AREAS OF RESEARCH IS LOOKING AT 1357 00:49:32,440 --> 00:49:34,480 THE TEMPORALITY OF THE CO 1358 00:49:34,480 --> 00:49:35,880 OCCURRENCE OF THESE CONDITIONS, 1359 00:49:35,880 --> 00:49:36,080 RIGHT? 1360 00:49:36,080 --> 00:49:38,880 BECAUSE USUALLY BY THE TIME THAT 1361 00:49:38,880 --> 00:49:39,920 WE'RE IDENTIFYING PEOPLE THAT 1362 00:49:39,920 --> 00:49:41,400 FALL INTO THIS CATEGORY THEY'VE 1363 00:49:41,400 --> 00:49:43,080 EITHER HAD PAIN FOR 5 YEARS, 10 1364 00:49:43,080 --> 00:49:44,800 YEARS, SO ON AND SO FORTH, WE 1365 00:49:44,800 --> 00:49:48,080 REALLY JUST DON'T KNOW A WHOLE 1366 00:49:48,080 --> 00:49:52,520 LOT ABOUT HOW THE PERSON 1367 00:49:52,520 --> 00:49:54,280 PROGRESSES THROUGH THIS COMORBID 1368 00:49:54,280 --> 00:49:55,240 PATTERN, ARE THERE CERTAIN 1369 00:49:55,240 --> 00:49:58,560 CONDITIONS THAT ARE MORE LIKELY 1370 00:49:58,560 --> 00:49:59,280 TO PROCEED OTHERS? 1371 00:49:59,280 --> 00:50:01,200 DEVELOPMENT AT THE SAME TIME, SO 1372 00:50:01,200 --> 00:50:03,520 ON AND SO FORTH AND AT THE SAME 1373 00:50:03,520 --> 00:50:04,720 TIME DOES THAT COMBINE WITH 1374 00:50:04,720 --> 00:50:06,240 THEIR GENETIC AND ENVIRONMENTAL 1375 00:50:06,240 --> 00:50:07,120 EXPOSURES, SO I DON'T KNOW IF 1376 00:50:07,120 --> 00:50:08,840 THIS CAN ADDRESS THAT BUT 1377 00:50:08,840 --> 00:50:10,400 HOPEFULLY THAT CAN BE INCLUDED 1378 00:50:10,400 --> 00:50:12,040 IN THE IF, OA AS PART OF THE 1379 00:50:12,040 --> 00:50:13,040 DATA THAT ECTOMYOSIN KLF-TWOD 1380 00:50:13,040 --> 00:50:15,000 CAN INFORM THIS TYPE OF RESEARCH 1381 00:50:15,000 --> 00:50:17,080 IN THE FUTURE, I MEAN OPRA DID 1382 00:50:17,080 --> 00:50:19,400 LOOK AT THAT A BIT, MAP A LITTLE 1383 00:50:19,400 --> 00:50:20,920 BIT BUT NOT MUCH, THERE'S REALLY 1384 00:50:20,920 --> 00:50:23,760 A NEED TO DO THAT BECAUSE WE 1385 00:50:23,760 --> 00:50:26,280 JUST DON'T KNOW WHETHER PEOPLE 1386 00:50:26,280 --> 00:50:27,440 REMIT, CAN WE INTERVENE EARLY 1387 00:50:27,440 --> 00:50:29,760 AND STOP THE PROGRESSION OF 1388 00:50:29,760 --> 00:50:32,880 THESE OTHER COMORBID EITHER PAIN 1389 00:50:32,880 --> 00:50:33,440 OR NONPAIN CONDITIONS? 1390 00:50:33,440 --> 00:50:36,800 AND IT'S JUST A REALLY NEEDED 1391 00:50:36,800 --> 00:50:37,960 AREA OF RESEARCH. 1392 00:50:37,960 --> 00:50:43,320 >>THAT'S AN EXCELLENT 1393 00:50:43,320 --> 00:50:43,640 SUGGESTION. 1394 00:50:43,640 --> 00:50:44,480 DEFINITELY GOING TO BRING THAT 1395 00:50:44,480 --> 00:50:46,440 BACK TO THE TEAM AND HOPEFULLY 1396 00:50:46,440 --> 00:50:48,240 GENERATING THE NOVEL GROUPS IN 1397 00:50:48,240 --> 00:50:49,680 IN DATA SET AND STRONG DATA 1398 00:50:49,680 --> 00:50:50,680 SHARING RIERMS WILL PROVIDE THAT 1399 00:50:50,680 --> 00:50:52,480 DATA FOR OTHER WHO IS WANT TO 1400 00:50:52,480 --> 00:50:54,000 ASK THAT QUESTION ACROSS THE 1401 00:50:54,000 --> 00:50:56,560 DIFFERENT STUDIES THAT WE HAVE. 1402 00:50:56,560 --> 00:50:59,400 YOU KNOW BUT THIS IDEA OF 1403 00:50:59,400 --> 00:51:00,520 LONG-TERM LONGITUDINAL STUDIES, 1404 00:51:00,520 --> 00:51:03,760 THAT MIGHT BE A BIT OF A STRETCH 1405 00:51:03,760 --> 00:51:05,280 FOR THIS PARTICULAR INITIATIVE, 1406 00:51:05,280 --> 00:51:08,560 BUT ASKING QUESTIONS ABOUT HOW 1407 00:51:08,560 --> 00:51:10,200 LONG THAT THEY'VE SUFFERED FROM 1408 00:51:10,200 --> 00:51:11,360 THE CONDITIONS, YOU KNOW 1409 00:51:11,360 --> 00:51:17,720 OBVIOUSLY CAN BE INCLUDED. 1410 00:51:17,720 --> 00:51:18,200 WALLY? 1411 00:51:18,200 --> 00:51:19,840 >>I THINK CHRIS PRETTY MUCH 1412 00:51:19,840 --> 00:51:21,800 COVERED WHAT I WAS GOING TO SAY, 1413 00:51:21,800 --> 00:51:28,040 IESM VERY --I'M VERY INTERESTED 1414 00:51:28,040 --> 00:51:30,200 IN THIS NEEDLESS TO SAY AND 1415 00:51:30,200 --> 00:51:33,920 REALLY STRUCK BY WHAT ED NUNES 1416 00:51:33,920 --> 00:51:37,080 SAID EARLIER . 1417 00:51:37,080 --> 00:51:38,600 THE SATTA SET TO WHAT YOU WANT 1418 00:51:38,600 --> 00:51:40,480 DONE MIGHT NEED TO BE COMBINED 1419 00:51:40,480 --> 00:51:42,800 DATA SETS FROM DIFFERENT 1420 00:51:42,800 --> 00:51:49,200 SPECIALISTS OR TEAMS OF DISEASE 1421 00:51:49,200 --> 00:51:50,640 SPECIALISTS WHO SEE CO 1422 00:51:50,640 --> 00:51:51,800 OCCURRENCES THAT WE DON'T EVEN 1423 00:51:51,800 --> 00:51:53,240 KNOW EXIST BECAUSE WE HAVEN'T 1424 00:51:53,240 --> 00:51:56,760 COMBINED THE DATA SETS BEFORE. 1425 00:51:56,760 --> 00:52:01,080 SO I WOULD VERY MUCH INVITE 1426 00:52:01,080 --> 00:52:02,240 RESEARCHERS FROM DIFFERENT PAIN 1427 00:52:02,240 --> 00:52:07,720 FIELDS, THANK YOU ALAN FOR THAT 1428 00:52:07,720 --> 00:52:08,960 EXCELLENT IASP MEMBERSHIP 1429 00:52:08,960 --> 00:52:10,080 ANALYSIS THAT YOU PROVIDED. 1430 00:52:10,080 --> 00:52:11,400 I WAS NOT AWARE OF THAT ALTHOUGH 1431 00:52:11,400 --> 00:52:14,400 I DID SUSPECT IT. 1432 00:52:14,400 --> 00:52:17,160 AND WHAT WE'RE LOOKING FOR IS 1433 00:52:17,160 --> 00:52:18,360 THE PATIENTS OF THE DOCS WHO ARE 1434 00:52:18,360 --> 00:52:20,880 NOT MEMBERS OF THE IASP. 1435 00:52:20,880 --> 00:52:22,240 AND WE'RE LOOKING FOR DOC WHO IS 1436 00:52:22,240 --> 00:52:24,080 DON'T TALK TO EACH OTHER, 1437 00:52:24,080 --> 00:52:29,880 RHEUMATOLOGISTS AND CANCER 1438 00:52:29,880 --> 00:52:34,480 SPECIALISTS, ENDOCRINOLOGISTS 1439 00:52:34,480 --> 00:52:35,160 AND GASTROENTHUSIASMERROLOGYISTS 1440 00:52:35,160 --> 00:52:37,320 AND I'M NOT LEAVING OUT 1441 00:52:37,320 --> 00:52:38,760 ANESTHESIOLOGISTS BUT I'M SAYING 1442 00:52:38,760 --> 00:52:40,520 THAT THOSE DATA SETS THAT YOU'RE 1443 00:52:40,520 --> 00:52:43,280 LOOKING TO DO THIS ANALYSIS ON, 1444 00:52:43,280 --> 00:52:45,760 ARE MAYBE DATA SETS THAT HAVE TO 1445 00:52:45,760 --> 00:52:47,280 BE CREATED. 1446 00:52:47,280 --> 00:52:49,600 MAYBE THEY'RE SITTING AROUND 1447 00:52:49,600 --> 00:52:52,240 INDEPENDENT OF EACH OTHER RIGHT 1448 00:52:52,240 --> 00:52:55,080 NOW AND THEY HAVE TO BE CREATED. 1449 00:52:55,080 --> 00:52:57,040 >>YEAH, SO, AGAIN, THIS WE HEAR 1450 00:52:57,040 --> 00:52:58,440 LOUD AND CLEAR EXPW WE AGREE 1451 00:52:58,440 --> 00:52:59,800 WITH YOU, THIS IS 1 OF THE 1452 00:52:59,800 --> 00:53:01,920 REASON YES WE'RE PUTTING THAT 1453 00:53:01,920 --> 00:53:04,000 REQUIREMENT ON MULTIPLE PAIN 1454 00:53:04,000 --> 00:53:05,680 CONDITIONS, BUT I THINK THAT ON 1455 00:53:05,680 --> 00:53:08,480 THIS CALL AND THE SUGGESTION 1456 00:53:08,480 --> 00:53:10,040 FROM THE MDWG IS REALLY SPELLING 1457 00:53:10,040 --> 00:53:12,120 IT OUT THAT IT'S COMING FROM 1458 00:53:12,120 --> 00:53:15,160 DIFFERENT SOURCES, SUCH AS THOSE 1459 00:53:15,160 --> 00:53:16,400 WITH DIFFERENT EXPERTISE, 1460 00:53:16,400 --> 00:53:17,200 RHEUMATOLOGISTS, NEUROLOGISTS, 1461 00:53:17,200 --> 00:53:19,320 THOSE WITH, YOU KNOW GI 1462 00:53:19,320 --> 00:53:20,160 EXPERTISE, ET CETERA, ET CETERA, 1463 00:53:20,160 --> 00:53:27,000 WE HEAR YOU LOUD AND CLEAR, IT'S 1464 00:53:27,000 --> 00:53:28,200 GREAT SUGGESTIONS. 1465 00:53:28,200 --> 00:53:28,440 KAREN? 1466 00:53:28,440 --> 00:53:31,240 >>THE OTHER THING YOU WANT TO 1467 00:53:31,240 --> 00:53:33,200 LOOK FOR IS FAMILY PHYSICIANS 1468 00:53:33,200 --> 00:53:34,920 BUT THEY SHOULD BE HERE TOO, BUT 1469 00:53:34,920 --> 00:53:35,880 THE GREAT OPPORTUNITY YOU HAVE 1470 00:53:35,880 --> 00:53:37,760 HERE IS TO LOOK AT THE 1471 00:53:37,760 --> 00:53:40,120 TRAJECTORY AND THE ORDER IN 1472 00:53:40,120 --> 00:53:41,560 WHICH PATIENTS SOUGHT CARE, WHO 1473 00:53:41,560 --> 00:53:42,960 DID THEY SEE FIRST, NEXT, WHO 1474 00:53:42,960 --> 00:53:44,120 DID THEY SEE NEXT? 1475 00:53:44,120 --> 00:53:45,320 BECAUSE THERE IS EMERGING DAT 1476 00:53:45,320 --> 00:53:47,440 THAT IF YOU CHANGE THE ORDER, WE 1477 00:53:47,440 --> 00:53:49,160 ACTUALLY DECREASE PAIN AND 1478 00:53:49,160 --> 00:53:50,680 INCREASE FUNCTION AND DECREASE 1479 00:53:50,680 --> 00:53:50,880 COSTS. 1480 00:53:50,880 --> 00:53:52,400 SO YOU HAVE BY COMBINING THESE 1481 00:53:52,400 --> 00:53:55,480 DATAET ISS HAVE YOU THE 1482 00:53:55,480 --> 00:53:57,240 OPPORTUNITY TO AS A SECONDARY 1483 00:53:57,240 --> 00:53:59,360 ANALYSIS, LOOK AT WHERE DO THEY 1484 00:53:59,360 --> 00:54:01,120 SEEK CARE AND WHAT HAPPENS IF 1485 00:54:01,120 --> 00:54:04,880 THE ORDER IS DIFFERENT. 1486 00:54:04,880 --> 00:54:05,200 >>GREAT. 1487 00:54:05,200 --> 00:54:06,200 THANK YOU. 1488 00:54:06,200 --> 00:54:07,480 ALL THESE SUGGESTIONS HAVE BEEN 1489 00:54:07,480 --> 00:54:07,920 REALLY EXCELLENT. 1490 00:54:07,920 --> 00:54:10,880 I THINK WE NEED TO GO ON TO THE 1491 00:54:10,880 --> 00:54:12,520 NEXT INITIATIVE UNLESS SOMEBODY 1492 00:54:12,520 --> 00:54:13,280 HAS A BURNING QUESTION. 1493 00:54:13,280 --> 00:54:16,480 >>I WANT TO MAKE 1 MORE POINT. 1494 00:54:16,480 --> 00:54:18,240 NOW, ALAN, I THINK YOU'RE 1495 00:54:18,240 --> 00:54:19,600 ABSOLUTELY WRONG, WE DON'T THINK 1496 00:54:19,600 --> 00:54:22,960 THAT WE GOT IT UNDER CONTROL. 1497 00:54:22,960 --> 00:54:33,400 IN FACT, IT'S THE OPPOSITE. 1498 00:54:36,680 --> 00:54:39,280 >>DID I SAY IT WASN'T UNDER 1499 00:54:39,280 --> 00:54:39,520 CONTROL. 1500 00:54:39,520 --> 00:54:41,880 >>WELL YOU SAID SOMETHING ABOUT 1501 00:54:41,880 --> 00:54:42,520 THEM-- 1502 00:54:42,520 --> 00:54:43,480 >>OH I COMPLETELY AGREE WITH 1503 00:54:43,480 --> 00:54:43,640 YOU. 1504 00:54:43,640 --> 00:54:44,800 >>IT'S NOT THAT THEY THINK THEY 1505 00:54:44,800 --> 00:54:46,680 CAN DEAL WITH THE FRAIN OF THEIR 1506 00:54:46,680 --> 00:54:47,960 PAICIALTS, IT'S THAT THEY'RE SO 1507 00:54:47,960 --> 00:54:49,560 FRUSTRATED BY THE PAIN THAT THEY 1508 00:54:49,560 --> 00:54:51,640 JUST IGNORE IT RATHER THAN TRY 1509 00:54:51,640 --> 00:54:56,960 TO DEAL WITH IT OR WORSE, THEY 1510 00:54:56,960 --> 00:55:00,560 TREAT IT WITH LESS THAN IDEAL 1511 00:55:00,560 --> 00:55:01,000 TREATMENTS. 1512 00:55:01,000 --> 00:55:03,680 SO, I WANT TO GO ON RECORD AS 1513 00:55:03,680 --> 00:55:06,080 SAYING, WHEN WE PUT THIS RFP 1514 00:55:06,080 --> 00:55:07,360 OUT, THOSE ARE SOME OF THE 1515 00:55:07,360 --> 00:55:09,680 PEOPLE WE NEED TO BE APPEALING 1516 00:55:09,680 --> 00:55:12,760 TOO. 1517 00:55:12,760 --> 00:55:14,040 >>I ACTUALLY HAD A COROLLARY 1518 00:55:14,040 --> 00:55:15,880 THOUGHT TO THAT, I COMPLETELY 1519 00:55:15,880 --> 00:55:18,640 AGREE WITH YOU WALLY, BUT TAKE 1520 00:55:18,640 --> 00:55:19,640 THE ONCOLOGISTS WHO OBVIOUSLY 1521 00:55:19,640 --> 00:55:24,000 DEAL WITH PAIN ALL THE TIME, AND 1522 00:55:24,000 --> 00:55:25,640 OPIOIDS ARE VERY COMMONLY USED 1523 00:55:25,640 --> 00:55:28,040 AND IN SOME CASES APPROPRIATE IN 1524 00:55:28,040 --> 00:55:31,240 A PATIENT, CERTAINLY A PATIENT 1525 00:55:31,240 --> 00:55:32,360 WHO'S TERMINAL. 1526 00:55:32,360 --> 00:55:35,360 BUT I HAD THIS CRAZY THOUGHT IN 1527 00:55:35,360 --> 00:55:39,200 THE CONDITION OF WHICH I THINK 1528 00:55:39,200 --> 00:55:41,600 IS SOMEWHAT INTERESTING BUT 1529 00:55:41,600 --> 00:55:42,800 CONTROVERSIAL OPIOID INDUCED 1530 00:55:42,800 --> 00:55:44,240 HYPER ALGEESIA, SO HERE'S A 1531 00:55:44,240 --> 00:55:45,480 POPULATION OF PATIENTS THAT 1532 00:55:45,480 --> 00:55:48,680 RECEIVED LOTS OF NARCOTICS, THEY 1533 00:55:48,680 --> 00:55:51,200 MAY HAVE UNDERLYING RPGHT PAIN 1534 00:55:51,200 --> 00:55:55,200 CONDITIONS, WHEN THERE IS HYPER 1535 00:55:55,200 --> 00:55:58,640 ALGEESIA, DOES IT MANIFEST INTO 1536 00:55:58,640 --> 00:55:59,360 DIFFERENT CO-MORBIDITIES? 1537 00:55:59,360 --> 00:56:03,800 OR DOES IT MANIFEST IN THE 1538 00:56:03,800 --> 00:56:05,880 CONDITION THAT WAS--WHAT THE 1539 00:56:05,880 --> 00:56:08,840 ONCOLOGIST THINKS HE OR SHE IS 1540 00:56:08,840 --> 00:56:09,200 TREATING. 1541 00:56:09,200 --> 00:56:10,000 >>YEAH, EXCELLENT QUESTION. 1542 00:56:10,000 --> 00:56:12,800 I DON'T KNOW THE ANSWER. 1543 00:56:12,800 --> 00:56:13,760 >>THANKS, EVERYBODY FOR YOUR 1544 00:56:13,760 --> 00:56:14,000 INPUT. 1545 00:56:14,000 --> 00:56:15,600 WE REALLY DO NEED TO GO ON 1546 00:56:15,600 --> 00:56:17,640 BECAUSE THERE'S A WHOLE BUNCH 1547 00:56:17,640 --> 00:56:18,640 MORE INITIATIVES TO PRESENT. 1548 00:56:18,640 --> 00:56:21,160 I MEAN THIS IS-- 1549 00:56:21,160 --> 00:56:21,640 >>[SPEAKING AT ONCE ] 1550 00:56:21,640 --> 00:56:22,920 >>IF YOU GET THE WHYED THAT 1551 00:56:22,920 --> 00:56:24,280 WE'RE INTERESTED IN THIS. 1552 00:56:24,280 --> 00:56:24,760 >>YES! 1553 00:56:24,760 --> 00:56:25,000 YES? 1554 00:56:25,000 --> 00:56:28,480 THIS IS GREAT! 1555 00:56:28,480 --> 00:56:28,880 >>OKAY. 1556 00:56:28,880 --> 00:56:31,800 >>WE HAVE A RHEUMATOLOGIST HERE 1557 00:56:31,800 --> 00:56:33,120 AMONG US, DR. LINDSAY CRISWELL, 1558 00:56:33,120 --> 00:56:37,520 WHO IS THE DIRECTOR OF THE 1559 00:56:37,520 --> 00:56:38,200 NATIONAL ENITUTE OF--OOH, 1560 00:56:38,200 --> 00:56:40,520 ARTHRITIS AND MUSK LO SKELETAL, 1561 00:56:40,520 --> 00:56:42,320 AND SHE HAS ENTERED COMMENTS IN 1562 00:56:42,320 --> 00:56:45,640 THE CHAT VERY MUCH IN LINE WITH 1563 00:56:45,640 --> 00:56:47,280 WHAT WALLY AND ALAN WERE JUST 1564 00:56:47,280 --> 00:56:49,440 DISCUSSING BUT WILL BRENG YOUR 1565 00:56:49,440 --> 00:56:51,080 ATTENTION TO THAT, AND THANK YOU 1566 00:56:51,080 --> 00:56:53,800 LINDSAY BUT PLEASE GO AHEAD. 1567 00:56:53,800 --> 00:57:04,200 >>NEXT SLIDE, PLEASE. 1568 00:57:19,320 --> 00:57:21,800 --SOME DATA HERE ARE NOT STRONG 1569 00:57:21,800 --> 00:57:23,880 MECHANISTIC CATASO THE GOAL OF 1570 00:57:23,880 --> 00:57:25,280 THE INIAATIVATIVE IS TO SUPPORT 1571 00:57:25,280 --> 00:57:27,000 MECHANIST BEING RESEARCH TO 1572 00:57:27,000 --> 00:57:28,960 TODAY HOW THE EXPOSOME INTERACT 1573 00:57:28,960 --> 00:57:32,240 WITH KNOWN AND NEW TARGETS THAT 1574 00:57:32,240 --> 00:57:34,280 COULD AFFECT PAIN, ITS OUTCOME 1575 00:57:34,280 --> 00:57:36,280 AND ITS EXPRESSION. 1576 00:57:36,280 --> 00:57:37,720 THE EXPOSOME FACTORS COULD 1577 00:57:37,720 --> 00:57:39,920 INCLUDE THE MICROBIOME, DRUGS 1578 00:57:39,920 --> 00:57:41,080 AND ALCOHOL, SLEEP, STRESS ASK 1579 00:57:41,080 --> 00:57:47,960 REALLY DOING THE MECHANISTIC 1580 00:57:47,960 --> 00:57:51,680 STUDIES AS WELL AS PSYCHOSOCIAL 1581 00:57:51,680 --> 00:57:52,160 MEDS. 1582 00:57:52,160 --> 00:57:58,640 PREVENTIVEIOUSLY DISCUSSED ON 1583 00:57:58,640 --> 00:57:59,840 THIS CALL. 1584 00:57:59,840 --> 00:58:01,160 WE WANT TO STUDY HOW THESE 1585 00:58:01,160 --> 00:58:03,480 EFFECTS ARE KNOWN AND OW THE 1586 00:58:03,480 --> 00:58:04,920 PAIN AFFECTS OUTCOME AND THESE 1587 00:58:04,920 --> 00:58:08,280 PRECLINICAL STUDIES ARE THE 1588 00:58:08,280 --> 00:58:09,360 FOCUS BUT MECHANISTIC CLINICAL 1589 00:58:09,360 --> 00:58:10,920 TRIALS WILL NOT BE EXCLUDED AND 1590 00:58:10,920 --> 00:58:12,640 WHERE APPROPRIATE THEY COULD BE 1591 00:58:12,640 --> 00:58:15,960 INCLUDED IN THE APPLICATION. 1592 00:58:15,960 --> 00:58:18,240 AND THEN THE GOAL OF THE 1593 00:58:18,240 --> 00:58:19,760 APPLICATION FROM OUR PERSPECTIVE 1594 00:58:19,760 --> 00:58:21,560 WHICH WILL BE TO SHOW CLEAR 1595 00:58:21,560 --> 00:58:27,040 ASSOCIATION WITH A CHOSEN 1596 00:58:27,040 --> 00:58:28,760 EXPOSOME FACTOR WITH A PAIN 1597 00:58:28,760 --> 00:58:30,760 CONDITION IN HUMANS AND THEN 1598 00:58:30,760 --> 00:58:33,280 KIND OF BACK TRANSLATE INTO THAT 1599 00:58:33,280 --> 00:58:38,240 MECHANISTIC STUDY. 1600 00:58:38,240 --> 00:58:39,040 NEXT SLIDE. 1601 00:58:39,040 --> 00:58:40,640 SO HOW DOES THIS FIT INTO THE 1602 00:58:40,640 --> 00:58:41,840 HEAL PROGRAMS, I THINK WE 1603 00:58:41,840 --> 00:58:42,520 MENTIONED IT SIMILAR TO THE 1604 00:58:42,520 --> 00:58:43,800 OTHER 1S AND WE DON'T BE HAVE TO 1605 00:58:43,800 --> 00:58:45,000 GO THROUGH ALL OF THEM, BUT THE 1606 00:58:45,000 --> 00:58:46,600 GOAL HERE IS TO ROUGH ATOM VIED 1607 00:58:46,600 --> 00:58:49,240 THE MECHANIST BEING SUPPORT, FOR 1608 00:58:49,240 --> 00:58:50,920 A CLINICAL PERCEPTION THAT THE 1609 00:58:50,920 --> 00:58:52,040 CLINICIANS HAVE OR HAVE BEEN 1610 00:58:52,040 --> 00:58:55,240 SHOWN IN THE LITERATURE TO AN 1611 00:58:55,240 --> 00:58:57,000 EXISTING EXPOSOME FACTOR THAT'S 1612 00:58:57,000 --> 00:58:58,840 BEEN KNOWN TO INFLUENCE PAIN. 1613 00:58:58,840 --> 00:58:59,800 THAT'S THE GENERAL OVERALL GOAL 1614 00:58:59,800 --> 00:59:02,680 OVER HERE AND THIS IS A BUNCH OF 1615 00:59:02,680 --> 00:59:07,720 DETAILS ASSOCIATED WITH IT. 1616 00:59:07,720 --> 00:59:08,640 NEXT SLIDE. 1617 00:59:08,640 --> 00:59:09,840 LET'S SETTLE IN HERE ON THE 1618 00:59:09,840 --> 00:59:11,480 QUESTIONS, DOES THE EXISTING 1619 00:59:11,480 --> 00:59:12,760 LITERATURE WITH HUMANS PROVIDE 1620 00:59:12,760 --> 00:59:14,280 ROBUST EVIDENCE FOR SOME 1621 00:59:14,280 --> 00:59:16,160 EXPOSOME FACTORS THAT CAN BE 1622 00:59:16,160 --> 00:59:19,680 INCLUDED HERE, ALL RIGHT, AND 1623 00:59:19,680 --> 00:59:20,800 YOU KNOW IS THERE THAT 1624 00:59:20,800 --> 00:59:21,680 SCIENTIFIC EVIDENCE TO SAY THAT 1625 00:59:21,680 --> 00:59:25,040 WE'RE READY TO LOOK AT SOME OF 1626 00:59:25,040 --> 00:59:26,520 THESE MECHANISMS? 1627 00:59:26,520 --> 00:59:29,200 WHAT EXPOSOME FACTORS SHOULD BE 1628 00:59:29,200 --> 00:59:30,320 PRIORITIZED IF ANY? 1629 00:59:30,320 --> 00:59:31,360 SHOULD BE OPEN. 1630 00:59:31,360 --> 00:59:32,400 ARE THERE PARTICULAR 1631 00:59:32,400 --> 00:59:33,560 STAKEHOLDERS THAT WE SHOULD 1632 00:59:33,560 --> 00:59:38,160 ENGAGE TO INSURE THE SUCCESS OF 1633 00:59:38,160 --> 00:59:39,920 THESE STUDIES OR THE--FIGURE OUT 1634 00:59:39,920 --> 00:59:41,360 WHICH EMPHASIS OF THIS 1635 00:59:41,360 --> 00:59:42,000 PARTICULAR INITIATIVE SHOULD BE 1636 00:59:42,000 --> 00:59:45,360 AND I WILL STOP THERE AND OPEN 1637 00:59:45,360 --> 00:59:47,240 IT FOR QUESTIONS. 1638 00:59:47,240 --> 00:59:48,480 >>I THINK THE FIRST BULLET 1639 00:59:48,480 --> 00:59:51,800 POINT IS AN IMPORTANT QUESTION I 1640 00:59:51,800 --> 00:59:54,760 KNOW YOU'RE PART OF THAT PAPER, 1641 00:59:54,760 --> 00:59:59,680 TOO, IT HAS DISCUSSION ABOUT 1642 00:59:59,680 --> 01:00:01,120 THIS BUT SEE THANKSGIVING WAS 1643 01:00:01,120 --> 01:00:06,120 THE FIRST TIME I HEARD THE TERM 1644 01:00:06,120 --> 01:00:06,880 EXPOSESOME AND WOULD BE 1645 01:00:06,880 --> 01:00:17,400 INTERESTED TO HEAR MORE ABOUT 1646 01:00:19,280 --> 01:00:20,000 THAT. 1647 01:00:20,000 --> 01:00:21,640 >>YEAH, I WANT TO TALK ABOUT 1648 01:00:21,640 --> 01:00:23,600 THE TERM EXPOSOME, WHAT I HAVE 1649 01:00:23,600 --> 01:00:26,200 ASSOCIATED WITH THE EXPOSOME, IS 1650 01:00:26,200 --> 01:00:29,000 THE NOTION THAT YOU'RE CAPTURING 1651 01:00:29,000 --> 01:00:29,960 THE COMPREHENSIVE TOTALITY OF 1652 01:00:29,960 --> 01:00:31,600 EXPOSURES THAT MIGHT BE RELEVANT 1653 01:00:31,600 --> 01:00:33,480 AND HERE IT SEEMS LIKE THERE'S 1654 01:00:33,480 --> 01:00:34,560 PARTICULAR EXPOSURES THAT ARE 1655 01:00:34,560 --> 01:00:37,600 MEASURABLE FOR WHICH WE HAVE 1656 01:00:37,600 --> 01:00:38,960 SOME INFORMATION ABOUT SO I 1657 01:00:38,960 --> 01:00:41,600 WONDER WHETHER JUST TALKING 1658 01:00:41,600 --> 01:00:43,480 ABOUT THE EXPOSURES AS OPPOSE TO 1659 01:00:43,480 --> 01:00:45,720 THE EXPOSOME, SO THERE MIGHT BE 1660 01:00:45,720 --> 01:00:48,480 CONFUSION GENERATED BY USING THE 1661 01:00:48,480 --> 01:00:50,360 TERM EXPOETICSOME, JUST A 1662 01:00:50,360 --> 01:00:51,880 THOUGHT TO SHARE AS SOMEONE WHO 1663 01:00:51,880 --> 01:00:59,000 HAS BEEN THINKING ABOUT EXPO 1664 01:00:59,000 --> 01:01:00,280 STUDIES OF MULTIPLE ENDOCRINIC 1665 01:01:00,280 --> 01:01:02,600 RESEARCH IN THAT CONTEXT. 1666 01:01:02,600 --> 01:01:03,280 >>GOOD POINT LINDE. 1667 01:01:03,280 --> 01:01:05,360 DAVE IS ON, DO YOU WANT TO 1668 01:01:05,360 --> 01:01:08,920 ADDRESS THAT QUESTION ABOUT THE 1669 01:01:08,920 --> 01:01:13,240 USE OF THE EXPOSOME TONE OVER 1670 01:01:13,240 --> 01:01:15,080 HERE AND FOCUSING ON PARTICULAR 1671 01:01:15,080 --> 01:01:17,840 FACTORS OR ONLY FACTORS THAT ARE 1672 01:01:17,840 --> 01:01:19,520 REALLY MEASURABLE OR 1673 01:01:19,520 --> 01:01:19,840 QUANTIFIABLE. 1674 01:01:19,840 --> 01:01:21,480 NYEAH, CAN YOU HEAR ME. 1675 01:01:21,480 --> 01:01:28,280 >>YEAH, WE CAN HEAR YOU GO FOR 1676 01:01:28,280 --> 01:01:28,440 IT. 1677 01:01:28,440 --> 01:01:30,960 >>JEA, SO SO THIS IS PROBABLY 1678 01:01:30,960 --> 01:01:32,120 GOES BACK TO--I WON'T GO THROUGH 1679 01:01:32,120 --> 01:01:35,040 A LONG SPEECH BUT IT GOES BACK 1680 01:01:35,040 --> 01:01:38,680 TO PROBABLY 2005 AND A LOT OF 1681 01:01:38,680 --> 01:01:40,000 THE ICs AND AT INSTITUTES AND 1682 01:01:40,000 --> 01:01:42,080 CENTERS HERE AT NIH ARE WORKING 1683 01:01:42,080 --> 01:01:44,960 ON THIS CONCEPT AND IN FACT WE 1684 01:01:44,960 --> 01:01:47,480 HAVE A NEW OFFICE HERE CALLED 1685 01:01:47,480 --> 01:01:49,480 THE NEURAL EXPOSOME AND 1686 01:01:49,480 --> 01:01:50,200 NEUROTOXICOLOGY WHICH I LEAD, 1687 01:01:50,200 --> 01:01:57,400 AND I THINK IT DID REALLY JUST 1688 01:01:57,400 --> 01:01:59,000 BY ITS DEFINITION INCLUDE JUST 1689 01:01:59,000 --> 01:02:00,200 ABOUT EVERYTHING THAT'S NOT 1690 01:02:00,200 --> 01:02:02,840 INHERITABLE AND IT DOES INCLUDE 1691 01:02:02,840 --> 01:02:04,760 LOOKINGA THE THESE TOGETHER AND 1692 01:02:04,760 --> 01:02:06,800 NOT JUST IN THE AN ISOLATED 1693 01:02:06,800 --> 01:02:10,680 PART, THAT'S NOT WHAT THE 1694 01:02:10,680 --> 01:02:12,320 CONCEPT IS ABOUT. 1695 01:02:12,320 --> 01:02:15,440 SO LET'S SEE--SORRY, I WAS 1696 01:02:15,440 --> 01:02:16,600 TALKING TO SOMEONE ELSE BUT WHAT 1697 01:02:16,600 --> 01:02:19,160 WAS THE OTHER QUESTION? 1698 01:02:19,160 --> 01:02:21,120 >>NO, THAT'S OKAY, YOU 1699 01:02:21,120 --> 01:02:22,600 ADDRESSED THAT QUESTION VERY 1700 01:02:22,600 --> 01:02:23,120 WELL. 1701 01:02:23,120 --> 01:02:25,920 >>SO IS THERE A DIFFERENCE 1702 01:02:25,920 --> 01:02:27,560 BETWEEN BIOPSYCHOSOCIAL AND 1703 01:02:27,560 --> 01:02:30,680 ENVIRONMENTAL FACTORS AND 1704 01:02:30,680 --> 01:02:32,080 EXPOSOMIC FACTORS ARE ARE WE 1705 01:02:32,080 --> 01:02:33,000 USING DIFFERENT WORDS TO TALK 1706 01:02:33,000 --> 01:02:35,080 ABOUT THE SAME THING. 1707 01:02:35,080 --> 01:02:36,600 >>GO AHEAD, GAVE. 1708 01:02:36,600 --> 01:02:39,360 NO, NO, NO, IT ABSOLUTELY IS 1709 01:02:39,360 --> 01:02:43,080 INCLUDED AT LEAST IN OUR CONCEPT 1710 01:02:43,080 --> 01:02:45,760 OF THE NEUROEXPOETICSOME. 1711 01:02:45,760 --> 01:02:48,040 SO, YEAH, IT'S MAYBE YOU'RE 1712 01:02:48,040 --> 01:02:52,000 RIGHT IN SOME WAY IT IS SORT OF 1713 01:02:52,000 --> 01:02:56,280 THE SAME THING BUT IT'S 1714 01:02:56,280 --> 01:02:56,840 DEFINITELY INCLUDED. 1715 01:02:56,840 --> 01:02:58,040 >>EXCEPT NOT THE GENETIC 1716 01:02:58,040 --> 01:03:00,440 FACTORS WHICH IS A BIOFACTOR, 1717 01:03:00,440 --> 01:03:02,680 RIGHT, SO THAT'S THE ONLY PART-- 1718 01:03:02,680 --> 01:03:04,440 >>OKAY, SO THAT RAISES THE 1719 01:03:04,440 --> 01:03:11,320 QUESTION FOR ME, NEW TERM FOR ME 1720 01:03:11,320 --> 01:03:12,000 AS WELL, EXPOSOME. 1721 01:03:12,000 --> 01:03:16,760 ARE YOU LOOKING FOR EPIGENETIC 1722 01:03:16,760 --> 01:03:17,560 STUDIES HERE? 1723 01:03:17,560 --> 01:03:18,560 >>ABSOLUTELY. 1724 01:03:18,560 --> 01:03:18,800 >>OKAY. 1725 01:03:18,800 --> 01:03:25,800 >>THAT'S PART OF IT. 1726 01:03:25,800 --> 01:03:29,200 >>FOR YOUR POINT, MICHAEL, BY 1727 01:03:29,200 --> 01:03:31,800 COMBINING DRUGS AND WHOLE, MY 1728 01:03:31,800 --> 01:03:34,040 INITIAL REACTION WITH THAT THOSE 1729 01:03:34,040 --> 01:03:35,640 ARE ILLICIT DRUGS BUT THE FACT 1730 01:03:35,640 --> 01:03:37,600 IS I WOULD THINK PART OF THE 1731 01:03:37,600 --> 01:03:39,600 EXPOETIC STUDIES OF MULTIPLE 1732 01:03:39,600 --> 01:03:40,320 ENDOCRINE ARE ACTUALLY 1733 01:03:40,320 --> 01:03:44,520 ANALGESICS THAT ARE USED IN THE 1734 01:03:44,520 --> 01:03:44,880 INDIVIDUALS. 1735 01:03:44,880 --> 01:03:49,960 >>I LIKE IT. 1736 01:03:49,960 --> 01:03:56,840 SOUNDS GOOD. 1737 01:03:56,840 --> 01:03:57,240 >>ABSOLUTELY. 1738 01:03:57,240 --> 01:03:57,560 >>CHRIS? 1739 01:03:57,560 --> 01:03:58,800 >>SO SOME OF THE DATA I'VE 1740 01:03:58,800 --> 01:04:03,240 SEEN, THERE ARE CERTAINLY BY O 1741 01:04:03,240 --> 01:04:04,840 PSYCHOSOCIAL FACTORS THAT ARE 1742 01:04:04,840 --> 01:04:06,720 OOH DENTIFIED AS BEING MORE 1743 01:04:06,720 --> 01:04:07,760 COMMON IN PEOPLE WITH CHRONIC 1744 01:04:07,760 --> 01:04:09,640 PAIN BUT WHAT RECENTLY I'VE SEEN 1745 01:04:09,640 --> 01:04:10,840 STUDIES FOCUS ON AND SOME OF THE 1746 01:04:10,840 --> 01:04:13,080 DATA SUGGEST IS THAT IT'S NOT 1747 01:04:13,080 --> 01:04:15,280 NECESSARILY THE FACTORS ALONE, 1748 01:04:15,280 --> 01:04:19,800 IT'S THE BIOPSYCHOSOCIAL FACTORS 1749 01:04:19,800 --> 01:04:20,280 IN COMBINATION. 1750 01:04:20,280 --> 01:04:23,720 SO IF YOU'RE NOT ALLOWED AM I 1751 01:04:23,720 --> 01:04:24,920 CORRECT IN UNDERSTANDING THESE 1752 01:04:24,920 --> 01:04:27,040 STTDS WILL NOT AT ALL FOCUS ON 1753 01:04:27,040 --> 01:04:27,600 BIOFACTORS? 1754 01:04:27,600 --> 01:04:29,440 AND IF SO, AREN'T WE KIND OF 1755 01:04:29,440 --> 01:04:31,760 MISSING SOMETHING BY NOT LOOKING 1756 01:04:31,760 --> 01:04:33,960 AT THE INTERPLAY OR 1757 01:04:33,960 --> 01:04:35,160 BI-DIRECTIONAL ASSOCIATION 1758 01:04:35,160 --> 01:04:39,760 BETWEEN BIOLOGIC AND EXPOSOMIC 1759 01:04:39,760 --> 01:04:41,240 FACTORS? 1760 01:04:41,240 --> 01:04:43,560 >>I CAN TAKE THAT, WELL, 1761 01:04:43,560 --> 01:04:45,280 ACTUALLY, THAT'S THE WHOLE--WELL 1762 01:04:45,280 --> 01:04:46,880 1 OF THE MAJOR PARTS OF THIS IS 1763 01:04:46,880 --> 01:04:53,800 TO TRY TO SEE HOW THESE FACTORS 1764 01:04:53,800 --> 01:04:54,880 INTERACT WITH SOME OF THE 1765 01:04:54,880 --> 01:04:56,880 TARGETS SO SOME OF THE 1766 01:04:56,880 --> 01:04:58,960 BIOLOGICAL TARGETS. 1767 01:04:58,960 --> 01:04:59,960 >>BIOLOGICS INCLUDED YOU'RE 1768 01:04:59,960 --> 01:05:03,400 JUST NOT SPECIFICALLY GENETIC 1769 01:05:03,400 --> 01:05:04,800 FACTORS, INNER HITTABLE FACTORS. 1770 01:05:04,800 --> 01:05:06,920 >>THAT MAKES SENSE. 1771 01:05:06,920 --> 01:05:07,160 THANKS. 1772 01:05:07,160 --> 01:05:10,840 >>PRESUMABLY FAMILY IS 1773 01:05:10,840 --> 01:05:13,000 INCLUDED? 1774 01:05:13,000 --> 01:05:16,520 >>THEY'RE SOCIAL INTERACTIONS. 1775 01:05:16,520 --> 01:05:16,960 >>OKAY. 1776 01:05:16,960 --> 01:05:18,400 >>JUST IT'S SO BROAD. 1777 01:05:18,400 --> 01:05:18,680 >>YES. 1778 01:05:18,680 --> 01:05:21,600 >>IT IS BROAD AND THE DATA 1779 01:05:21,600 --> 01:05:22,520 SETS, PARTICULARLY IF YOU'RE 1780 01:05:22,520 --> 01:05:24,120 LOOKING FOR STUDIES OF 1781 01:05:24,120 --> 01:05:27,000 EPIGENETICS, THE DATA SETS HAVE 1782 01:05:27,000 --> 01:05:33,360 TO BE OUT --I WOULD EXPECT HAVE 1783 01:05:33,360 --> 01:05:38,360 TO BE HUGE SO THE GOAL IS TO GET 1784 01:05:38,360 --> 01:05:39,880 ENVISIONING STUDIES SO THE 1785 01:05:39,880 --> 01:05:41,240 APPLICANT WILL PICK 1 OR A FEW 1786 01:05:41,240 --> 01:05:42,800 FACTORS AND THEN ASK THE 1787 01:05:42,800 --> 01:05:43,640 MECHANISTIC QUESTIONS. 1788 01:05:43,640 --> 01:05:46,040 SO THE GOAL HERE ISN'T TO 1789 01:05:46,040 --> 01:05:48,640 DETERMINE WHAT EVERY FACTOR IS, 1790 01:05:48,640 --> 01:05:50,840 BUT REALLY ASK QUESTIONS ON 1791 01:05:50,840 --> 01:05:52,720 PARTICULAR FACTORS THAT THERE 1792 01:05:52,720 --> 01:05:55,240 ARE EXISTING DATA SETS OR HINTS 1793 01:05:55,240 --> 01:05:56,760 IN THE LITERATURE THAT THOSE 1794 01:05:56,760 --> 01:05:59,880 FACTORS THAT DO HAVE AN EFFECT 1795 01:05:59,880 --> 01:06:00,320 ON PAIN. 1796 01:06:00,320 --> 01:06:02,760 >>YEAH, RIGHT. 1797 01:06:02,760 --> 01:06:06,760 AND THIS IS ALL RELATED TO 1798 01:06:06,760 --> 01:06:08,960 BETTER AND MORE BIOLOGICAL 1799 01:06:08,960 --> 01:06:10,480 PLAUSIBILITY IF YOU WILL FOR THE 1800 01:06:10,480 --> 01:06:11,880 CLINICAL RELEVANCE OF SOME OF 1801 01:06:11,880 --> 01:06:14,480 THESE FACTORS THAT LOOK LIKE 1802 01:06:14,480 --> 01:06:19,920 THEY ARE ASSOCIATE WITH PAIN. 1803 01:06:19,920 --> 01:06:22,680 >>YEAH, ALL IN FAVOR OF THAT 1, 1804 01:06:22,680 --> 01:06:24,560 I THINK THAT 1 IS CLEAR TO ME 1805 01:06:24,560 --> 01:06:29,280 BUT I'M NOT A GOOD ENOUGH 1806 01:06:29,280 --> 01:06:32,120 SCIENTIST TO TELL YOU WHERE I 1807 01:06:32,120 --> 01:06:36,960 WOULD GO TO FIND A DATABASE WITH 1808 01:06:36,960 --> 01:06:40,400 THAT KIND OF CLINICAL RICHNESS 1809 01:06:40,400 --> 01:06:45,720 BUT ALSO THE ABILITY TO DO THE 1810 01:06:45,720 --> 01:06:46,000 EPIGENETICS. 1811 01:06:46,000 --> 01:06:47,520 I KEEP HARPING ON THAT 1 BECAUSE 1812 01:06:47,520 --> 01:06:51,840 THAT 1 FOR ME-- YOU HAVE TO BE 1813 01:06:51,840 --> 01:06:52,440 PURPOSEFUL IN COLLECTING THE 1814 01:06:52,440 --> 01:06:55,600 DAILY BASIS THEA IN ORDER TO DO 1815 01:06:55,600 --> 01:06:58,760 THE EPIGENETIC STUDIES. 1816 01:06:58,760 --> 01:07:03,520 >>IS A MISTAKE TO TRY TO 1817 01:07:03,520 --> 01:07:04,040 PRIORITIZE THE PARTICULAR 1818 01:07:04,040 --> 01:07:04,840 EXPOETIC STUDIES OF MULTIPLE 1819 01:07:04,840 --> 01:07:05,760 ENDOCRINIC FACTORS IF THAT IS A 1820 01:07:05,760 --> 01:07:07,520 WORD THAT WE MIGHT WANT TO 1821 01:07:07,520 --> 01:07:10,320 STUDY, RATHER THAN LEAVING IT SO 1822 01:07:10,320 --> 01:07:11,360 COMPLETELY OPEN ENDED AND 1823 01:07:11,360 --> 01:07:13,280 SOMEBODY SAYS I'LL DO THIS AND 1824 01:07:13,280 --> 01:07:14,560 SOMEONE ELSE SAYS I'LL DO THIS 1 1825 01:07:14,560 --> 01:07:17,240 AND I'LL DO THIS 1 AND THEN YOU 1826 01:07:17,240 --> 01:07:19,320 WILL END UP WITH RANDOM 1827 01:07:19,320 --> 01:07:21,800 OBSERVATIONS BUT IF WE 1828 01:07:21,800 --> 01:07:24,680 PRIORITIZE PERHAPS WE'LL GET A 1829 01:07:24,680 --> 01:07:26,000 FEW MORE GROUPS FOCUSING ON THE 1830 01:07:26,000 --> 01:07:27,880 SAME QUESTION AND THEN WE MIGHT 1831 01:07:27,880 --> 01:07:32,200 ACTUALLY HAVE MORE MEANINGFUL 1832 01:07:32,200 --> 01:07:33,400 RESULTS SO 1 WAY TO PRIORITIZE 1833 01:07:33,400 --> 01:07:36,840 IS TO SAY THERE HAS TO BE A 1834 01:07:36,840 --> 01:07:39,120 STRONG RATIONAL FROM EXISTING 1835 01:07:39,120 --> 01:07:42,760 DATA SETS THAT THIS PARTICULAR 1836 01:07:42,760 --> 01:07:43,760 EXPOSOMIC FACTOR IS RIGHT TO BE 1837 01:07:43,760 --> 01:07:47,960 STUDIED IN A MECHANISTIC TODAY. 1838 01:07:47,960 --> 01:07:50,320 IN ORDER FOR THE APPLICANT DO IT 1839 01:07:50,320 --> 01:07:52,000 AS OPPOSE TO HAVING A SMALL 1840 01:07:52,000 --> 01:07:54,080 NUMBER OF PEOPLE CHOOSING WHICH 1841 01:07:54,080 --> 01:07:55,280 FACTORS COULD BE DONE WHICH 1842 01:07:55,280 --> 01:07:57,240 COULD HAVE A BIAS. 1843 01:07:57,240 --> 01:07:58,440 , FAIR ENOUGH. 1844 01:07:58,440 --> 01:08:00,440 >>A FEW WAYS TO DO IT AND TO 1845 01:08:00,440 --> 01:08:02,000 ADD TO THAT THERE'S A LOT OF 1846 01:08:02,000 --> 01:08:03,480 PEOPLE WORKING IN THIS SPACE. 1847 01:08:03,480 --> 01:08:04,680 IT'S KIND OF WEIRD NAMING 1848 01:08:04,680 --> 01:08:06,280 EVERYTHING BUT WE'RE HOPING TO 1849 01:08:06,280 --> 01:08:09,800 HAVE SOME GOOD REVIEWERS THAT 1850 01:08:09,800 --> 01:08:11,360 WILL BE ABLE TO--BECAUSE THAT'S 1851 01:08:11,360 --> 01:08:13,520 A GREAT QUESTION. 1852 01:08:13,520 --> 01:08:17,160 I WAS WORRIED ABOUT THAT. 1853 01:08:17,160 --> 01:08:17,400 >>ERIC? 1854 01:08:17,400 --> 01:08:20,080 >>JUST TO ECHO CHRIS' EARLIER 1855 01:08:20,080 --> 01:08:21,360 COMMENT THOUGH, DON'T WE WANT TO 1856 01:08:21,360 --> 01:08:22,880 LOOK AT THIS SORE SHOULDN'T THIS 1857 01:08:22,880 --> 01:08:24,880 BE LOOKED AT IN EMERGING ITS OF 1858 01:08:24,880 --> 01:08:26,000 A MULTIVARIANT PROCESS BECAUSE 1859 01:08:26,000 --> 01:08:27,320 PEOPLE AREN'T GETTING EXPOSED TO 1860 01:08:27,320 --> 01:08:30,080 1 FACTOR. 1861 01:08:30,080 --> 01:08:31,520 THEY'RE GETTING ECPOSED TO A 1862 01:08:31,520 --> 01:08:31,920 SYSTEM. 1863 01:08:31,920 --> 01:08:33,720 >>THAT WOULD BE RESPONSIVE TO 1864 01:08:33,720 --> 01:08:35,920 THIS IF THEY CAME IN WITH 1865 01:08:35,920 --> 01:08:37,200 MULTIPLE FACTORS. 1866 01:08:37,200 --> 01:08:37,480 >>OKAY. 1867 01:08:37,480 --> 01:08:38,720 >>AND THEN MAYBE I DON'T KNOW 1868 01:08:38,720 --> 01:08:40,080 SOME SORT OF MACHINE LEARNING 1869 01:08:40,080 --> 01:08:41,480 FOR EXAMPLE. 1870 01:08:41,480 --> 01:08:43,480 >>YEAH, YEAH. 1871 01:08:43,480 --> 01:08:45,040 >>MACHINE LEARNING TO COMBINE 1872 01:08:45,040 --> 01:08:47,120 OR LOOK FOR CLUSTERS OF 1873 01:08:47,120 --> 01:08:49,120 EXPOSURES OR PATTERNS AND THAT 1874 01:08:49,120 --> 01:08:51,120 BECOMES THE BASIS FOR TRYING TO 1875 01:08:51,120 --> 01:08:51,840 FIND THE MECHANISM. 1876 01:08:51,840 --> 01:08:56,920 I THINK I'M STARTING TO GET 1877 01:08:56,920 --> 01:08:57,320 THIS, THANK YOU. 1878 01:08:57,320 --> 01:08:58,680 >>IF YOU WANT TO LEARN MORE, 1879 01:08:58,680 --> 01:09:00,320 THERE'S ALL SORTS OF THINGS 1880 01:09:00,320 --> 01:09:01,880 THERE'S BOOT CAMPSA THE 1881 01:09:01,880 --> 01:09:03,400 COLUMBIA, ALL SORTS OF PEOPLE 1882 01:09:03,400 --> 01:09:07,880 WORKING IN THIS SPACE AND EVEN 1883 01:09:07,880 --> 01:09:09,800 THINGS HERE AT NIH THAT YOU 1884 01:09:09,800 --> 01:09:10,960 COULD LOOK AT THOSE FACTORS AND 1885 01:09:10,960 --> 01:09:15,400 IF AND HOW THEY ARE RELATED. 1886 01:09:15,400 --> 01:09:16,520 I AM HAPPY TO GIVE MORE 1887 01:09:16,520 --> 01:09:16,840 INFORMATION. 1888 01:09:16,840 --> 01:09:20,200 WE HAVE A WEBSITE, TOO, IF YOU 1889 01:09:20,200 --> 01:09:20,960 WANT TO LOOK. 1890 01:09:20,960 --> 01:09:22,320 >>YEAH, THERE'S A WEBSITE IN 1891 01:09:22,320 --> 01:09:23,960 THE CHAT, THERE THAT YOU CAN 1892 01:09:23,960 --> 01:09:31,200 TAKE A LACK AT FOR DAVE'S OFFICE 1893 01:09:31,200 --> 01:09:33,400 AT NINDS, FOR THE EXPOSURES ON 1894 01:09:33,400 --> 01:09:34,000 THE EXPOSOME. 1895 01:09:34,000 --> 01:09:39,240 ANY OTHER QUESTIONS OR 1896 01:09:39,240 --> 01:09:39,520 SUGGESTIONS? 1897 01:09:39,520 --> 01:09:42,800 OKAY, THANKS TO THE MDWG FOR 1898 01:09:42,800 --> 01:09:44,200 YOUR TREMENDOUS ENGAGEMENT WITH 1899 01:09:44,200 --> 01:09:45,400 THESE TBO INITIATIVES AND YOUR 1900 01:09:45,400 --> 01:09:49,080 ADSLICE, ALL OF THEM ARE GREAT 1901 01:09:49,080 --> 01:09:49,360 SUGGESTIONS. 1902 01:09:49,360 --> 01:09:50,160 >>MICHAEL AND WALTER, I THINK 1903 01:09:50,160 --> 01:09:51,800 WE'RE KIND OF NOW IN GENERAL 1904 01:09:51,800 --> 01:09:58,320 DISCUSSION IS THAT CORRECT? 1905 01:09:58,320 --> 01:09:59,160 >>MM-HMAMERICA. 1906 01:09:59,160 --> 01:09:59,560 >>THANK YOU. 1907 01:09:59,560 --> 01:10:02,840 I WOULD ASK THE GROUP JUST FOR A 1908 01:10:02,840 --> 01:10:05,440 GENERAL LEVEL OF ENTHUSIASM FOR 1909 01:10:05,440 --> 01:10:07,960 THESE NEW CONCEPTS AND ALSO 1910 01:10:07,960 --> 01:10:11,960 TAKING INTO CONSIDERATION WHAT 1911 01:10:11,960 --> 01:10:15,400 YOU SAW EARLIER IN TERMS OF THE 1912 01:10:15,400 --> 01:10:17,160 MANY MORE FOCUSED THERAPEUTIC 1913 01:10:17,160 --> 01:10:21,280 DEVELOPMENT OR TARGETED 1914 01:10:21,280 --> 01:10:22,720 APPROACHES HOW THIS MORE 1915 01:10:22,720 --> 01:10:23,920 INVESTIGATIONAL APPROACH THAT 1916 01:10:23,920 --> 01:10:25,520 MICHAEL JUST--OR THE APPROACHES 1917 01:10:25,520 --> 01:10:28,160 WE JUST DISCUSSED FIT IN AND I 1918 01:10:28,160 --> 01:10:31,880 WOULD INVITE WALTER AND LINDSAY 1919 01:10:31,880 --> 01:10:34,160 AND ELEN AND ALL OF THE MEMBERS 1920 01:10:34,160 --> 01:10:35,480 OF THE EXECUTIVE COMMITTEE TO 1921 01:10:35,480 --> 01:10:36,640 WEIGH IN WITH THEIR QUESTIONS OR 1922 01:10:36,640 --> 01:10:38,080 AREAS WHERE THEY WOULD LIKE 1923 01:10:38,080 --> 01:10:40,960 ADDITIONAL FEEDBACK FROM THE 1924 01:10:40,960 --> 01:10:41,600 MULTIDISCIPLINARY WORKING GROUP 1925 01:10:41,600 --> 01:10:48,440 ABOUT THIS AREA OF RESEARCH 1926 01:10:48,440 --> 01:10:49,160 FOCUS FOR HEAL. 1927 01:10:49,160 --> 01:10:50,280 I WOULD JUST PUT IN THE CHAT 1928 01:10:50,280 --> 01:10:52,720 THAT YOU KNOW I THINK EVERYBODY 1929 01:10:52,720 --> 01:10:53,560 REALIZES, THESE ARE IMPORTANT 1930 01:10:53,560 --> 01:10:55,560 AND THAT'S KREBS CYCLE WE'RE 1931 01:10:55,560 --> 01:10:56,840 DOING THEM. 1932 01:10:56,840 --> 01:10:59,760 IN MY MIND, THESE ARE REALLY 1933 01:10:59,760 --> 01:11:04,600 HARD PROBLEMS TO GET SOMETHING 1934 01:11:04,600 --> 01:11:06,360 SIGNIFICANT OUT OF, SO I THINK 1935 01:11:06,360 --> 01:11:09,920 OUR CHALLENGE WILL BE TO GO FROM 1936 01:11:09,920 --> 01:11:11,280 ASSOCIATIONS TO CAUSALITY, AND 1937 01:11:11,280 --> 01:11:16,920 THAT'S NOT GOING TO BE EASY AND 1938 01:11:16,920 --> 01:11:18,080 THERE, YOU KNOW YOU MAY HAVE TO 1939 01:11:18,080 --> 01:11:20,720 BREAK IT DOWN AND GO AFTER 1 1940 01:11:20,720 --> 01:11:22,720 THING AT A TIME, MAYBE 2 THINGS 1941 01:11:22,720 --> 01:11:25,360 AT A TIME AT MOST, I THINK WE 1942 01:11:25,360 --> 01:11:28,600 WILL SEE A LOT OF ASSOCIATIONS, 1943 01:11:28,600 --> 01:11:31,040 THERE WILL BE HYPOTHESIS 1944 01:11:31,040 --> 01:11:32,320 GENERATING, BUT THEN TO REALLY 1945 01:11:32,320 --> 01:11:33,120 MAKE PROGRESS, I THINK WE'RE 1946 01:11:33,120 --> 01:11:36,000 GOING TO HAVE TO LOOK AT HOW AN 1947 01:11:36,000 --> 01:11:36,680 INTERVENTION ACTUALLY AFFECTS, 1948 01:11:36,680 --> 01:11:41,720 SO WE HAVE MULTIPLE 1949 01:11:41,720 --> 01:11:42,520 CO-MORBIDITIES, YOU WOULD LIKE 1950 01:11:42,520 --> 01:11:44,680 TO MAKE THE WHOLE PERSON FINE 1951 01:11:44,680 --> 01:11:48,440 BUT THAT'S NOT GOING TO HAPPEN. 1952 01:11:48,440 --> 01:11:52,640 SO, YOU KNOW THEY HAVE SEVERE 1953 01:11:52,640 --> 01:11:53,840 OFTIO ARTHRITIS, YOU CAN'T MAKE 1954 01:11:53,840 --> 01:11:55,400 IT GO AWAY, THEY HAVE 1955 01:11:55,400 --> 01:11:58,560 DEPRESSION, THEY HAVE PAIN, SO 1956 01:11:58,560 --> 01:12:00,640 THEN ATTACKING THE DEPRESSION 1957 01:12:00,640 --> 01:12:03,640 FOR THE EFFECTS OF PAIN, MAYBE 1958 01:12:03,640 --> 01:12:05,160 COMBINATIONS, I THINK WE WILL 1959 01:12:05,160 --> 01:12:08,240 HAVE--THE ANSWER WILL BE IN HOW 1960 01:12:08,240 --> 01:12:11,440 THESE DIFFERENT GROUPS RESPOND 1961 01:12:11,440 --> 01:12:12,280 TO THE INTERVENTIONS. 1962 01:12:12,280 --> 01:12:14,960 WITH RESPECT TO EXPOSOME, AGAIN, 1963 01:12:14,960 --> 01:12:16,960 IT'S HARD BECAUSE IT'S 1964 01:12:16,960 --> 01:12:19,960 EVERYTHING THAT'S NOT GENETIC 1965 01:12:19,960 --> 01:12:22,920 BUT YOU KNOW IN PAIN, I THINK 1966 01:12:22,920 --> 01:12:26,800 YOU COULD MAKE STRONG CASES FOR 1967 01:12:26,800 --> 01:12:29,200 THINGS LIKE CHILDHOOD INJURY OR 1968 01:12:29,200 --> 01:12:31,840 YOU KNOW CHILDHOOD EXPOSURE, THE 1969 01:12:31,840 --> 01:12:34,120 PAIN MEDS OR SOMETHING LIKE THAT 1970 01:12:34,120 --> 01:12:36,280 AND HAVE THAT INFLUENCES 1971 01:12:36,280 --> 01:12:42,400 SOMEONE'S RESPONSE TO PAIN PAIN 1972 01:12:42,400 --> 01:12:43,640 IN THE FUTURE, CERTAINLY ALL OF 1973 01:12:43,640 --> 01:12:47,600 THESE RELATED TO INJURY, HEAVILY 1974 01:12:47,600 --> 01:12:49,880 RELITTED TO OCCUPATIONAL OR 1975 01:12:49,880 --> 01:12:51,200 SPORTS ACTIVITIES THAT PEOPLE 1976 01:12:51,200 --> 01:12:53,240 ARE EXPOSED TO THAT THEN GET 1977 01:12:53,240 --> 01:12:53,760 THEM INTO TROUBLE. 1978 01:12:53,760 --> 01:12:56,160 I DON'T THINK WE HAVE A HANDLE 1979 01:12:56,160 --> 01:12:59,920 ON YOU KNOW WHAT THAT IN TOTAL 1980 01:12:59,920 --> 01:13:02,520 LOOKS LIKE, THE INTEGRAL OVER 1981 01:13:02,520 --> 01:13:04,720 TIME SO I THINK THERE'S LOTS OF 1982 01:13:04,720 --> 01:13:07,600 AREAS TO GO INTO HERE, BUT 1983 01:13:07,600 --> 01:13:08,760 IT'S--IT'S ALMOST LIKE GOING TO 1984 01:13:08,760 --> 01:13:11,160 ANOTHER PLANET AND SETTING UP A 1985 01:13:11,160 --> 01:13:14,240 SPACE STATION IN A SENSE AND 1986 01:13:14,240 --> 01:13:15,680 THEN TRY TO BUILD OUT SO THAT'S 1987 01:13:15,680 --> 01:13:18,520 WHAT HE CAN DO, YOU KNOW NO 1988 01:13:18,520 --> 01:13:27,080 INSTITUTE CAN DO THOSE KIND OF 1989 01:13:27,080 --> 01:13:27,320 THINGS. 1990 01:13:27,320 --> 01:13:28,720 >>LINDE, DO YOU HAVE THOUGHTS? 1991 01:13:28,720 --> 01:13:30,000 >>YEAH, BOTH OF THESE ARE 1992 01:13:30,000 --> 01:13:30,800 REALLY IMPORTANT AREAS WHERE 1993 01:13:30,800 --> 01:13:32,640 MUCH RESEARCH IS NEEDED I JUST 1994 01:13:32,640 --> 01:13:37,920 WOULD REITERATE WHAT I THINK I 1995 01:13:37,920 --> 01:13:43,840 HEARDAL AN SEE I THINK IN TERMS 1996 01:13:43,840 --> 01:13:45,760 OF EXPOETICSOMICS PROJECT, IF 1997 01:13:45,760 --> 01:13:47,520 SOME STRUCTURE OR PRIORITIZATION 1998 01:13:47,520 --> 01:13:48,920 IS NOT OFFERED UP FRONT, YOU 1999 01:13:48,920 --> 01:13:51,640 COULD GET EVERYTHING FROM AN 2000 01:13:51,640 --> 01:13:53,040 EXPOETICSOMIC STUDY WHERE SERUM 2001 01:13:53,040 --> 01:13:56,120 IS ANALYZED WITH YOU KNOW STATE 2002 01:13:56,120 --> 01:14:00,360 OF THE MASCULINIZED SPEC LIQUID 2003 01:14:00,360 --> 01:14:01,600 CHROMEATOGRAPHY TECHNOLOGIES TO 2004 01:14:01,600 --> 01:14:03,840 IDENTIFY DIFFERENCES IN CHEMICAL 2005 01:14:03,840 --> 01:14:04,680 EXPOSURES BETWEEN GROUPS TO 2006 01:14:04,680 --> 01:14:08,640 FOCUS STUDIES THAT LOOK AT 2007 01:14:08,640 --> 01:14:10,880 SPECIFIC FACTORS THAT ARE 2008 01:14:10,880 --> 01:14:11,760 ALREADY IMPLICATED IN PAIN 2009 01:14:11,760 --> 01:14:13,840 MECHANISMS BUT I THINK THAT IF 2010 01:14:13,840 --> 01:14:15,440 IT'S LEFT OPEN, YOU SHOULD BE 2011 01:14:15,440 --> 01:14:16,480 PREPARED TO ACCEPT ANYTHING 2012 01:14:16,480 --> 01:14:17,920 ACROSS THAT BROAD SPECTRUM SO 2013 01:14:17,920 --> 01:14:21,200 YOU KNOW I WONDER WHETHER IT'S 2014 01:14:21,200 --> 01:14:23,840 WORTH ADDITIONAL DISCUSSION 2015 01:14:23,840 --> 01:14:27,680 AMONG MDWJ AND STAFF TO THINK 2016 01:14:27,680 --> 01:14:29,600 ABOUT WHETHER THEY WANT TO 2017 01:14:29,600 --> 01:14:31,320 IDENTIFY HIGH PRORRITY AREAS AS 2018 01:14:31,320 --> 01:14:35,320 A STARTING POINT TO BUILD UPON 2019 01:14:35,320 --> 01:14:36,640 VERSUS ALLOW ALL COMERS SO I 2020 01:14:36,640 --> 01:14:38,520 THINK THE FIRST PROJECT IS MORE 2021 01:14:38,520 --> 01:14:43,360 MANAGEABLE IN THAT RESPECT BUT 2022 01:14:43,360 --> 01:14:46,880 BUT I'M REACTING AGAIN TO THE 2023 01:14:46,880 --> 01:14:49,080 TERM EXPOETICSOMICS AND THE VAST 2024 01:14:49,080 --> 01:14:50,320 RANGE OF POTENTIAL PROPOSALS YOU 2025 01:14:50,320 --> 01:14:54,880 MIGHT SEE IF IT'S FRAMED IN THAT 2026 01:14:54,880 --> 01:14:55,040 WAY. 2027 01:14:55,040 --> 01:14:56,640 >>THANKS, LINDE AND THEN, 2028 01:14:56,640 --> 01:14:58,960 CHRIS, YOU'RE NEXT AND THEN I 2029 01:14:58,960 --> 01:14:59,880 HAVE NORA. 2030 01:14:59,880 --> 01:15:01,760 >>YEAH, I JUST WANT TO 2031 01:15:01,760 --> 01:15:04,560 PIGGYBACK OFF THAT AND WHAT ALAN 2032 01:15:04,560 --> 01:15:04,960 SAID. 2033 01:15:04,960 --> 01:15:06,000 I'M OBVIOUSLY VERY SUPPORTIVE OF 2034 01:15:06,000 --> 01:15:09,560 BOTH OF THESE CONCEPTS I JUST 2035 01:15:09,560 --> 01:15:11,040 WONDER IF THERE'S A POSSIBILITY 2036 01:15:11,040 --> 01:15:13,040 AND I KNOW IT TAKES MORE ACCORD 2037 01:15:13,040 --> 01:15:14,440 NATION ON YOUR SIDE BUT WHETHER 2038 01:15:14,440 --> 01:15:18,520 THIS COULD BE CONSIDERED LIKE A 2039 01:15:18,520 --> 01:15:19,160 COLLABORATIVE RESEARCH PROJECT 2040 01:15:19,160 --> 01:15:21,760 SO THAT YOU DON'T HAVE, YOU KNOW 2041 01:15:21,760 --> 01:15:23,160 JUST DESPERATE STUDIES THAT ARE 2042 01:15:23,160 --> 01:15:26,120 WORKING IN ISOLATION BUT MAYBE 2043 01:15:26,120 --> 01:15:28,320 THERE'S MORE OF A COLLABORATIVE 2044 01:15:28,320 --> 01:15:30,560 APPROACH ON IDENTIFYING WHAT THE 2045 01:15:30,560 --> 01:15:32,280 HIGH PRIORITY FACTORS MAY BE TO 2046 01:15:32,280 --> 01:15:35,200 INVESTIGATE AND THEN DOING THAT 2047 01:15:35,200 --> 01:15:38,440 ACROSS OBVIOUSLY YOU HAVE TO SEE 2048 01:15:38,440 --> 01:15:39,720 WHO'S INTERESTED AND WHAT 2049 01:15:39,720 --> 01:15:42,600 SPECIFIC GROIPS MIGHT HAVE THE 2050 01:15:42,600 --> 01:15:44,160 CAPABILITIES TO RESEARCH WHICH 2051 01:15:44,160 --> 01:15:46,760 BUT I'M ALWAYS IN FAVOR OF KIND 2052 01:15:46,760 --> 01:15:48,520 OF MORE OF THE TEAM BASED 2053 01:15:48,520 --> 01:15:50,600 COLLABORATIVE APPROACH BECAUSE I 2054 01:15:50,600 --> 01:15:51,800 FEEL LIKE YOU MAX MID WHAT WE 2055 01:15:51,800 --> 01:15:54,320 LEARN IN A SHORTER PERIOD OF 2056 01:15:54,320 --> 01:15:57,720 TIME RATHER THAN FUNDING 2 OR 5 2057 01:15:57,720 --> 01:15:59,240 DESPERATE STUDIES WHICH LIKAL AN 2058 01:15:59,240 --> 01:16:00,440 SAID, 1 LOOKING AT THIS AND THE 2059 01:16:00,440 --> 01:16:06,840 OTHER LOOKINGA THE THAT. 2060 01:16:06,840 --> 01:16:08,000 >>THAIRNG YOU. 2061 01:16:08,000 --> 01:16:09,160 AND THEN NORA. 2062 01:16:09,160 --> 01:16:14,960 >>I TOTAL AGREE THAT THESE 2063 01:16:14,960 --> 01:16:15,640 STORIES ARE NOT JUST 2064 01:16:15,640 --> 01:16:16,960 COLLABORATIVE BUT IN ISOLATION, 2065 01:16:16,960 --> 01:16:18,640 WE HAVE PROJECTS TO MAXIMIZE 2066 01:16:18,640 --> 01:16:20,440 THAT FROM HAPPENING, I ALSO 2067 01:16:20,440 --> 01:16:22,720 AGREE WITH WALTER AND I THINK 2068 01:16:22,720 --> 01:16:25,560 THAT THE NOTION IS IN TERMS OF 2069 01:16:25,560 --> 01:16:27,080 THIS IS VERY VOLUNTEERSUBLE, IT 2070 01:16:27,080 --> 01:16:29,880 CAN HELP US IDENTIFY POTENTIAL 2071 01:16:29,880 --> 01:16:34,120 BIOMARKERS, EVEN IF OUR AIM IS 2072 01:16:34,120 --> 01:16:35,080 NOT FACT Y'ALLLY TO LOOK AT THAT 2073 01:16:35,080 --> 01:16:37,840 AND THAT WILL BE A CHALLENGE, 2074 01:16:37,840 --> 01:16:38,360 IT'S ABSOLUTELY RIGHT. 2075 01:16:38,360 --> 01:16:41,320 BUT WHEN I THINK ABOUT IT, IT 2076 01:16:41,320 --> 01:16:43,120 BEHOOVES US TO UNDERSTAND AS IT 2077 01:16:43,120 --> 01:16:45,720 HAS BEEN SAID BY OTHERS IS THE 2078 01:16:45,720 --> 01:16:47,200 NOTION THAT WE HAVE TO MAKE 2079 01:16:47,200 --> 01:16:51,640 DECISIONS IN TERMS OF WHAT OUR 2080 01:16:51,640 --> 01:16:54,480 PRIORITY PROJECTS AND AND THAT'S 2081 01:16:54,480 --> 01:16:56,560 WHERE HAVING TO REPORT BECOMES 2082 01:16:56,560 --> 01:16:58,440 IMPORTANT AND ALSO RECOGNIZING 2083 01:16:58,440 --> 01:17:00,280 THAT IS AN INITIATIVE WHICH I AM 2084 01:17:00,280 --> 01:17:01,680 VERY SUPPORTIVE, IT'S VALUABLE, 2085 01:17:01,680 --> 01:17:04,120 BUT THERE ARE ALSO OTHER WAYS 2086 01:17:04,120 --> 01:17:06,880 PERHAPS THAT WE CAN GET THAT 2087 01:17:06,880 --> 01:17:09,600 SIMILAR TYPE OF INFORMATION BY 2088 01:17:09,600 --> 01:17:10,800 TAKING ADVANTAGE ALREADY OF 2089 01:17:10,800 --> 01:17:12,440 ONGOING PROJECTS THAT ARE 2090 01:17:12,440 --> 01:17:14,040 HAPPENING, AND OBVIOUSLY 1 OF 2091 01:17:14,040 --> 01:17:16,280 THE 1S THAT IS THE LOW HANGING 2092 01:17:16,280 --> 01:17:18,000 FRUIT IS THE ALL OF US PROJECT 2093 01:17:18,000 --> 01:17:20,920 WHERE THERE HAVE BEEN ENORMOUS 2094 01:17:20,920 --> 01:17:23,440 AMOUNTS OF RESOURCES IN TOARDER 2095 01:17:23,440 --> 01:17:24,200 TO BUILD AN INFRANCIS COLLINS 2096 01:17:24,200 --> 01:17:24,800 STRAWCTURE TO FOLLOW UP 2097 01:17:24,800 --> 01:17:27,920 INDIVIDUALS AND THAT WILL 2098 01:17:27,920 --> 01:17:28,520 INCLUDE OBTAINING THE 2099 01:17:28,520 --> 01:17:30,360 BIOMARKERS, AND SO THAT'S WHAT I 2100 01:17:30,360 --> 01:17:32,760 WANTED TO PUT FORWARD. 2101 01:17:32,760 --> 01:17:36,000 I MEAN, WE RELY ON YOU TO GET 2102 01:17:36,000 --> 01:17:37,680 THE PERSPECTIVES BUT I WANT YOU 2103 01:17:37,680 --> 01:17:40,080 TO BE AWARE ABOUT THE OTHER 2104 01:17:40,080 --> 01:17:43,120 PLAYERS THAT MAY BE BEHIND THE 2105 01:17:43,120 --> 01:17:45,120 SCENES THAT WHERE 1 MAY BE ALSO 2106 01:17:45,120 --> 01:17:48,800 TO ADVANCE THIS AREA OF SCIENCE. 2107 01:17:48,800 --> 01:17:51,360 SO WE, ALL OF THE INSTITUTES ARE 2108 01:17:51,360 --> 01:17:52,840 PUTTING RESOURCES THAT MAY BE 2109 01:17:52,840 --> 01:17:54,720 VERY RELEVANT TOWARDS THESE AND 2110 01:17:54,720 --> 01:17:59,040 PERHAPS IF WE CAN USE THAT HEAL 2111 01:17:59,040 --> 01:18:01,680 COMPONENT TO BRING THEM IN A 2112 01:18:01,680 --> 01:18:02,520 COLLABORATIVE FASHION, WE CAN 2113 01:18:02,520 --> 01:18:05,800 MACK MYSELF THE ABILITY OF 2114 01:18:05,800 --> 01:18:07,160 EXTRACT RELEVANT INFORMATION FOR 2115 01:18:07,160 --> 01:18:17,520 BIOMARKERS FOR PAIN. 2116 01:18:18,800 --> 01:18:19,160 >>THANK YOU NORA. 2117 01:18:19,160 --> 01:18:20,560 MAYBE WHEN WE GET TO THE END 2118 01:18:20,560 --> 01:18:23,240 AFTER WE HAVE THE CLINICAL TEAMS 2119 01:18:23,240 --> 01:18:24,840 PRESENT TO THINK ABOUT OF THAT 2120 01:18:24,840 --> 01:18:25,120 TOGETHER. 2121 01:18:25,120 --> 01:18:28,400 WE HAD A LOLT OF CONVERSATIONS 2122 01:18:28,400 --> 01:18:30,120 WITH THE ALL OF US RESEARCH 2123 01:18:30,120 --> 01:18:33,840 PROGRAM AT NIH WHICH IS VERY 2124 01:18:33,840 --> 01:18:41,640 LARGE LONGITUDINAL COHORT TODAY 2125 01:18:41,640 --> 01:18:42,560 WITH AMERICANS DONATING THEIR 2126 01:18:42,560 --> 01:18:43,680 HEALTH RECORDS TO THIS NEW 2127 01:18:43,680 --> 01:18:44,360 RESEARCH PROGRAM. 2128 01:18:44,360 --> 01:18:46,280 MY UNDERSTAND SUGGEST RIGHT NOW 2129 01:18:46,280 --> 01:18:48,200 THEY DO NOT COLLECT THAT MUCH 2130 01:18:48,200 --> 01:18:50,040 INFORMATION ABOUT PAIN, HOWEVER, 2131 01:18:50,040 --> 01:18:52,000 THEY HAVE AN ANNUAL SURVEY THAT 2132 01:18:52,000 --> 01:18:53,400 THEY'RE HOPING TO ADD PAIN 2133 01:18:53,400 --> 01:18:56,760 QUESTIONS TO AND UNFORTUNATELY, 2134 01:18:56,760 --> 01:18:58,680 OUR CLINICAL PHYSICIAN PAIN 2135 01:18:58,680 --> 01:19:01,440 MANAGEMENT TEAM HAS DONE A 2136 01:19:01,440 --> 01:19:03,400 TREMENDOUS JOB IDENTIFYING AND 2137 01:19:03,400 --> 01:19:04,720 PUBLISHING COMMON DATA ELEMENTS 2138 01:19:04,720 --> 01:19:08,240 FOR THE MEASUREMENT OF PAIN AND 2139 01:19:08,240 --> 01:19:09,400 SOME ASSOCIATED MEASURES IN 2140 01:19:09,400 --> 01:19:10,600 CLINICAL POPULATIONS SO THAT'S 2141 01:19:10,600 --> 01:19:13,000 JUST READY FOR THEM TO USE AND 2142 01:19:13,000 --> 01:19:14,880 TO BE KIND OF INCORPORATED INTO 2143 01:19:14,880 --> 01:19:16,120 A FUTURE SET OF RESEARCH 2144 01:19:16,120 --> 01:19:17,240 QUESTIONS, SO WE CAN TALK ABOUT 2145 01:19:17,240 --> 01:19:21,680 THAT A LITTLE BIT MORE AND LINDA 2146 01:19:21,680 --> 01:19:23,280 AND JANE ARE WITH THAT GROUP AND 2147 01:19:23,280 --> 01:19:25,160 WE CAN ASK THEM TO SPEAK IT TO 2148 01:19:25,160 --> 01:19:28,560 IT TOO BUT IT'S A REALLY 2149 01:19:28,560 --> 01:19:29,560 IMPORTANT DIRECTION FOR HEAL. 2150 01:19:29,560 --> 01:19:30,800 AND IT'S GOOD TO THINK ABOUT 2151 01:19:30,800 --> 01:19:33,040 THEM AS THE SAME TIME AS 2152 01:19:33,040 --> 01:19:38,120 THESE--THE DISCUSSION WE JUST 2153 01:19:38,120 --> 01:19:38,440 HAD. 2154 01:19:38,440 --> 01:19:39,560 SO, HELENE, I WILL GIVE YOU THE 2155 01:19:39,560 --> 01:19:40,520 LAST QUESTION AND THEN WE WILL 2156 01:19:40,520 --> 01:19:42,040 GO FOR A QUICK BREAK. 2157 01:19:42,040 --> 01:19:44,840 >>WELL I WANTED TO ADD 1 QUICK 2158 01:19:44,840 --> 01:19:47,040 THOUGHT TO THIS EXPOSESOME 2159 01:19:47,040 --> 01:19:47,560 INTERESTING CONVERSATION, 2160 01:19:47,560 --> 01:19:49,240 PERHAPS 1 WAY TO FOCUS THIS A 2161 01:19:49,240 --> 01:19:53,520 LITTLE BIT MIGHT BE TO THINK 2162 01:19:53,520 --> 01:19:57,080 ABOUT SPECIAL POPULATIONS OF 2163 01:19:57,080 --> 01:20:01,080 PATIENTS WHO HAVE SEVERE AND 2164 01:20:01,080 --> 01:20:03,800 PERHAPS COMPLEX COMBINATIONS OF 2165 01:20:03,800 --> 01:20:04,480 ENVIRONMENTAL EXPOSURES. 2166 01:20:04,480 --> 01:20:07,080 FOR EXAMPLE, I WAS THINKING 2167 01:20:07,080 --> 01:20:07,800 PERHAPS LIKE FIREFIGHTERS OR 2168 01:20:07,800 --> 01:20:10,280 PEOPLE WHO ARE EXPOSED TO A 2169 01:20:10,280 --> 01:20:11,280 COMBINATION OF HIGH PSYCHOLOGY 2170 01:20:11,280 --> 01:20:16,240 STRESS BUT ALSO THAT HAVE 2171 01:20:16,240 --> 01:20:16,840 ENVIRONMENTAL EXPOSE--PHYSICAL 2172 01:20:16,840 --> 01:20:17,760 EXPOSURES, THAT MIGHT BE A VERY 2173 01:20:17,760 --> 01:20:21,080 INTERESTING QUESTION AS TO THE 2174 01:20:21,080 --> 01:20:22,360 IMPACT THAT THESE COMBINATIONS 2175 01:20:22,360 --> 01:20:24,440 OF EXPOSURES CAN HAVE ON 2176 01:20:24,440 --> 01:20:27,120 SOMETHING LIKE PAIN. 2177 01:20:27,120 --> 01:20:29,200 YOU KNOW, AND FIGURE OUT WHAT 2178 01:20:29,200 --> 01:20:30,720 ARE THE MODULATING FACTORS IS 2179 01:20:30,720 --> 01:20:34,160 HOW THESE CAN BE ADDRESSED MAYBE 2180 01:20:34,160 --> 01:20:40,200 THAT'S 1 WAY TO THINK ABOUT THAT 2181 01:20:40,200 --> 01:20:44,920 EXPOSOME TO NARROW IT A LITTLE 2182 01:20:44,920 --> 01:20:45,120 BIT. 2183 01:20:45,120 --> 01:20:45,440 >>GREAT. 2184 01:20:45,440 --> 01:20:48,640 THANK YOU FOR THAT SUGGESTION. 2185 01:20:48,640 --> 01:20:54,480 SO, WE HAVE A SCHEDULED BREAK 2186 01:20:54,480 --> 01:20:55,480 NOW UNTIL 12:35. 2187 01:20:55,480 --> 01:20:56,560 OH THAT'S EASTERN TIME. 2188 01:20:56,560 --> 01:21:01,200 SORRY FOR THOSE OF YOU SO IT'S 2189 01:21:01,200 --> 01:21:03,520 ABOUT 7-8 MINUTES, QUICK 2190 01:21:03,520 --> 01:21:04,600 BIOBREAK, STRETCH, BREAK, WALK 2191 01:21:04,600 --> 01:21:06,360 AROUND, GET READY FOR THE NEXT 2192 01:21:06,360 --> 01:21:08,960 SET OF REALLY GREAT 2193 01:21:08,960 --> 01:21:10,240 PRESENTATIONS FROM OUR CLINICAL 2194 01:21:10,240 --> 01:21:12,400 RESEARCH AND PAIN MANAGEMENT 2195 01:21:12,400 --> 01:21:12,720 TEAM. 2196 01:21:12,720 --> 01:21:16,720 THANK YOU EVERYONE SO FOR FOR 2197 01:21:16,720 --> 01:21:20,240 YOUR THOUGHTFUL CONTRIBUTIONS. 2198 01:21:20,240 --> 01:21:22,280 >>IT'S EXPOSOMIC BREAK. 2199 01:21:22,280 --> 01:21:23,000 >>NO, IS IT? 2200 01:21:23,000 --> 01:21:26,480 >>BE CAREFUL OUT THERE. 2201 01:21:26,480 --> 01:21:27,880 [LAUGHTER] 2202 01:21:27,880 --> 01:21:28,320 THANKS EVERYONE. 2203 01:21:28,320 --> 01:21:29,720 >>I WILL CALL US 2204 01:21:29,720 --> 01:21:33,200 BACK FROM A SHORT BREAK AND I 2205 01:21:33,200 --> 01:21:34,520 WILL INTRODUCE THE CO CHAIRS OF 2206 01:21:34,520 --> 01:21:44,840 THE CLINICAL RESEARCH AND PAIN 2207 01:21:44,840 --> 01:21:48,360 MANAGEMENT TEAM DR. LINDA PORTER 2208 01:21:48,360 --> 01:21:49,280 AND JANE ATKINSON. 2209 01:21:49,280 --> 01:21:50,920 THEY HAVE A TERRIFIC SET OF 2210 01:21:50,920 --> 01:21:52,200 CONCEPTS TO TALK ABOUT FOOD SO 2211 01:21:52,200 --> 01:21:53,520 AND WE ANTICIPATE A LOT OF 2212 01:21:53,520 --> 01:21:55,120 DISCUSSION SO I DON'T WANT TO 2213 01:21:55,120 --> 01:21:56,440 DELAY US ANY FURTHER. 2214 01:21:56,440 --> 01:22:00,560 LINDA PLEASE TAKE IT AWAY. 2215 01:22:00,560 --> 01:22:01,600 >>I WILL INDEED. 2216 01:22:01,600 --> 01:22:02,960 THANK YOU VERY MUCH. 2217 01:22:02,960 --> 01:22:04,960 SO JANE AND I ARE GOING TO TAG 2218 01:22:04,960 --> 01:22:06,280 TEEM A LITTLE BIT THIS MORNING, 2219 01:22:06,280 --> 01:22:07,680 I WILL START OUT WITH A VERY 2220 01:22:07,680 --> 01:22:13,760 QUICK OVERVIEW OF WHAT THE HEAL 2221 01:22:13,760 --> 01:22:14,840 CLINICAL PAIN MANAGEMENT 2222 01:22:14,840 --> 01:22:15,760 RESEARCH PORTFOLIO LOOKS LIKE, 2223 01:22:15,760 --> 01:22:16,960 VERY HIGH LEVEL SO IF YOU GO TO 2224 01:22:16,960 --> 01:22:21,040 THE NEXT SLIDE ISSUE PLEASE AS A 2225 01:22:21,040 --> 01:22:23,880 REMINDER SOME OF THESE PROGRAMS 2226 01:22:23,880 --> 01:22:27,920 GO BACK TO 2019 OF THE VERY 2227 01:22:27,920 --> 01:22:30,840 EARLY START OF HEAL, AND THEN 2228 01:22:30,840 --> 01:22:32,160 OVER TIME, A LOT OF NEW 2229 01:22:32,160 --> 01:22:34,520 PROGRAMS, A LOT OF EXCITING 2230 01:22:34,520 --> 01:22:35,440 PROGRAMS HAVE BEEN ADDED AND 2231 01:22:35,440 --> 01:22:37,400 THEN WE HAVE A LARGE SET OF 2232 01:22:37,400 --> 01:22:41,400 CONCEPTS THAT WE WANT TO PRESENT 2233 01:22:41,400 --> 01:22:43,880 TODAY, FOR FUTURE SUPPORT, FROM 2234 01:22:43,880 --> 01:22:46,520 HEAL, SO AT THE FAR LEFT, WE 2235 01:22:46,520 --> 01:22:50,480 HAVE THE EPIC NET WHICH IS OUR 2236 01:22:50,480 --> 01:22:53,080 FACE 2 TRIALS, 2 BEING ON NOW, 1 2237 01:22:53,080 --> 01:22:57,040 IN OFTIO ARTHRITIS AND 1 IN 2238 01:22:57,040 --> 01:22:57,880 DIABETIC NERVE PAIN. 2239 01:22:57,880 --> 01:22:59,800 THE BACK PAIN CONSORTIUM IS A 2240 01:22:59,800 --> 01:23:01,320 LARGE PROGRAM THAT HAS MULTILE 2241 01:23:01,320 --> 01:23:07,440 DIFFERENT TYPES OF APPROACHES TO 2242 01:23:07,440 --> 01:23:08,840 DIAGNOSING, TREATING DEVELOPING 2243 01:23:08,840 --> 01:23:09,880 THERAPIES FOR THOSE, FOR THE 2244 01:23:09,880 --> 01:23:11,400 TRIAL GOING ON NOW THAT JUST 2245 01:23:11,400 --> 01:23:17,920 LAUNCHED USING SOME OF THE 2246 01:23:17,920 --> 01:23:20,000 RESOURCES IN THE CONSORTIUM 2247 01:23:20,000 --> 01:23:23,040 THERE, IT'S LOOKING AT A COHORT 2248 01:23:23,040 --> 01:23:27,680 OF PATIENTS TO LOOK AT THEIR 2249 01:23:27,680 --> 01:23:30,480 DEEPLY PHENOTYPE THEM AND LOOK 2250 01:23:30,480 --> 01:23:31,840 AT WHAT INTERVENTIONS LOOK BEST 2251 01:23:31,840 --> 01:23:34,600 AND HELPING TO DEVELOP TAILOR'S 2252 01:23:34,600 --> 01:23:38,360 PERSONALIZED TREATMENTS. 2253 01:23:38,360 --> 01:23:41,000 WE'VE GOT THE PRAGMATIC STUDIES 2254 01:23:41,000 --> 01:23:42,240 THAT'S PRISM, THAT'S FINE 2255 01:23:42,240 --> 01:23:43,880 STUDIES THERE, THE PAIN 2256 01:23:43,880 --> 01:23:44,600 MANAGEMENT EFFECTIVENESS 2257 01:23:44,600 --> 01:23:45,440 RESEARCH NETWORK, THERE ARE 8 2258 01:23:45,440 --> 01:23:47,320 STUDIES GOING ON THERE, 1 2259 01:23:47,320 --> 01:23:51,400 ACTUALLY HAS FINISHED AND IS 2260 01:23:51,400 --> 01:23:52,920 ABOUT READY TO PUBLISH DATA ON 2261 01:23:52,920 --> 01:23:56,000 THE FINDINGS THIS, IS THE 1 ON 2262 01:23:56,000 --> 01:23:58,560 CAESAREAN PAIN AND OPIOIDS AND 2263 01:23:58,560 --> 01:24:01,360 ALTERNATIVES TO HELP REDUCE 2264 01:24:01,360 --> 01:24:04,000 OPIOID USE AFTER CAESAREAN 2265 01:24:04,000 --> 01:24:04,320 SECTION. 2266 01:24:04,320 --> 01:24:06,400 A HIGH PROPORTION OF PEOPLE WHO 2267 01:24:06,400 --> 01:24:09,880 HAVE CAESAREAN SECTIONS GO ON TO 2268 01:24:09,880 --> 01:24:11,120 DEVELOP OUD, UNFORTUNATELY AND 2269 01:24:11,120 --> 01:24:14,080 THERE'S 1 LARGE TRIAL TO PAIN 2270 01:24:14,080 --> 01:24:18,760 MANAGEMENT AND END STAGE KIDNEY 2271 01:24:18,760 --> 01:24:20,920 DISEASE WHERE CHEMODIALYSIS IS 2272 01:24:20,920 --> 01:24:22,920 THE FOCUS OF PAIN MANAGEMENT 2273 01:24:22,920 --> 01:24:25,280 THERE AND A LITTLE BIT LATER WE 2274 01:24:25,280 --> 01:24:27,600 ADDED THE EMPOWER STUDY WHICH IS 2275 01:24:27,600 --> 01:24:30,120 SOMETHING THAT THE MDWG HAD KEPT 2276 01:24:30,120 --> 01:24:31,200 REMINDING US THAT WE NEED TO 2277 01:24:31,200 --> 01:24:32,800 LOOK AT HOW TO MANAGE PEOPLE 2278 01:24:32,800 --> 01:24:35,240 WITH BOTH PAIN AND OUD AND 2279 01:24:35,240 --> 01:24:41,680 EMPOWER IS DOING THAT AND THEY 2280 01:24:41,680 --> 01:24:44,440 HAVE LIFE STUDIES EMBEDDED IN 2281 01:24:44,440 --> 01:24:45,760 MULTIPLE TRIALS TO LOOK AT 2282 01:24:45,760 --> 01:24:48,360 STUDIES TO TREAT PEOPLE WHO HAVE 2283 01:24:48,360 --> 01:24:49,360 OPIOID USE DISORDER AND CURRENT 2284 01:24:49,360 --> 01:24:51,480 PAIN AND THEN WE HAVE A 2285 01:24:51,480 --> 01:24:57,840 BIOMARKER PROGRAM THAT'S 2286 01:24:57,840 --> 01:25:00,320 EVOLVING, STARTED OUT AS AN 2287 01:25:00,320 --> 01:25:02,520 EARLY PROGRAM TO DEVELOP 2288 01:25:02,520 --> 01:25:04,680 DIAGNOSTIC MARKERS FOR PAIN AND 2289 01:25:04,680 --> 01:25:07,480 DIFFERENT CONDITIONS AND THEN 2290 01:25:07,480 --> 01:25:09,240 MOVING INTO ANOTHER PROGRAM THAT 2291 01:25:09,240 --> 01:25:10,880 WAS MORE TAIL LORA RODRIGUEZED 2292 01:25:10,880 --> 01:25:11,880 TO DEVELOPING BIOMARKERS FOR 2293 01:25:11,880 --> 01:25:17,920 TRIALS AND THEN WE'LL TALK TODAY 2294 01:25:17,920 --> 01:25:21,120 ABOUT A NEW 1 THAT IS QUITE 2295 01:25:21,120 --> 01:25:22,720 WEARABLE FOR BIOMARKER DEVICES. 2296 01:25:22,720 --> 01:25:24,400 BIG PROGRAM ON HEALTH EQUITY AND 2297 01:25:24,400 --> 01:25:26,000 MAIN AND POPULATIONS WITH HEALTH 2298 01:25:26,000 --> 01:25:27,880 DISPARITIES AND THIS 1 HAS 11 2299 01:25:27,880 --> 01:25:30,240 TRIALS THAT HAVE ALREADY STARTED 2300 01:25:30,240 --> 01:25:37,240 INTO THEIR PHASE 1 PLANNING AND 2301 01:25:37,240 --> 01:25:38,280 THEN WE'VE GOT GROUPS AND WE 2302 01:25:38,280 --> 01:25:39,680 HAVE A NUMBER OF DIFFERENT 2303 01:25:39,680 --> 01:25:40,800 APPLICATIONS SORT OF IN THE 2304 01:25:40,800 --> 01:25:43,240 REVIEW PROCESS FOR THE NEXT 3 IN 2305 01:25:43,240 --> 01:25:45,080 THE SET FOR SICKLE CELL DISEASE 2306 01:25:45,080 --> 01:25:46,720 PAIN MANAGEMENT ACCIDENT THIS 2307 01:25:46,720 --> 01:25:48,560 CAN BE ACUTE OR PROPONENTIC PAIN 2308 01:25:48,560 --> 01:25:49,720 AND THEN PAIN MANAGEMENT IN 2309 01:25:49,720 --> 01:25:51,280 PEOPLE WHO LIVE IN RURAL 2310 01:25:51,280 --> 01:25:56,480 POPULATIONS WE KNOW PAIN IS 2311 01:25:56,480 --> 01:25:57,760 HIGHER--MORE HIGHLY PREVALENT IN 2312 01:25:57,760 --> 01:26:03,600 RURAL THAN URBAN POPULATIONS AND 2313 01:26:03,600 --> 01:26:05,120 THEN ANOTHER PROGRAM THAT'S 2314 01:26:05,120 --> 01:26:07,640 LINKED INTO THE POWER STUDY THE 2315 01:26:07,640 --> 01:26:09,160 MULTILEVEL INTERVENTIONS FOR 2316 01:26:09,160 --> 01:26:10,640 THOSE ON OPIOIDS SO THIS IS 2317 01:26:10,640 --> 01:26:13,200 MANAGING PAIN IN PEOPLE WHO ARE 2318 01:26:13,200 --> 01:26:16,760 AT RISK FOR OPIOID USE DISORDER 2319 01:26:16,760 --> 01:26:19,560 THAT HAVE BEEN ON OPIOID 2320 01:26:19,560 --> 01:26:19,840 THERAPIES. 2321 01:26:19,840 --> 01:26:22,920 SO AGAIN, THESE ARE APPROVED, WE 2322 01:26:22,920 --> 01:26:24,560 HAVE APPLICATIONS IN AND HOPE TO 2323 01:26:24,560 --> 01:26:26,840 BE ABLE TO TELL YOU MORE ABOUT 2324 01:26:26,840 --> 01:26:28,080 WHAT THOSE TARGETED APPLICATIONS 2325 01:26:28,080 --> 01:26:31,400 FOR AWARDS WILL BE. 2326 01:26:31,400 --> 01:26:34,040 SO THE 1S WE WILL TALK ABOUT 2327 01:26:34,040 --> 01:26:36,040 TODAY IS IN LIGHT BLUE, THESE 2328 01:26:36,040 --> 01:26:37,640 ARE APROGRAMS FOR ACUTE AND 2329 01:26:37,640 --> 01:26:39,040 CHRONIC PAIN MANAGEMENT IN 2330 01:26:39,040 --> 01:26:41,440 CHILDREN, 1 TO BEEF UP OUR 2331 01:26:41,440 --> 01:26:48,800 WORKFORCE IN THE PAIN RESEARCH 2332 01:26:48,800 --> 01:26:50,280 ARENA, THE WEARABLE DEVICES, I 2333 01:26:50,280 --> 01:26:53,880 MENTIONED SLEEP AND THE REISSUE 2334 01:26:53,880 --> 01:26:55,480 OF THE BIOMARKER FOR MY'S FACIAL 2335 01:26:55,480 --> 01:26:55,680 PAIN. 2336 01:26:55,680 --> 01:27:02,280 THE NEXT SLIDE GIVES YOU A VERY 2337 01:27:02,280 --> 01:27:03,760 HIGH LEVEL OVERVIEW OF ALL THESE 2338 01:27:03,760 --> 01:27:05,160 DIFFERENT CLINICAL PAIN STUDIES 2339 01:27:05,160 --> 01:27:06,720 WHETHER THEY ARE BIOMARKER 2340 01:27:06,720 --> 01:27:08,000 VALIDATION STUDIES IN HUMANS, 2341 01:27:08,000 --> 01:27:09,280 WHETHER THEY'RE CLINICAL TRIALS, 2342 01:27:09,280 --> 01:27:11,200 OR WHETHER THEY ARE LONGITUDINAL 2343 01:27:11,200 --> 01:27:15,240 STUDIES AND LOOKING ACROSS THOSE 2344 01:27:15,240 --> 01:27:16,840 STUDIES HOW MANY STUDIES ARE 2345 01:27:16,840 --> 01:27:17,920 LOOKING AT DIFFERENT PAIN 2346 01:27:17,920 --> 01:27:19,320 CONDITIONS SO THIS CHART GIVES 2347 01:27:19,320 --> 01:27:21,760 YOU AN OVERVIEW OF CHRONIC PAIN 2348 01:27:21,760 --> 01:27:23,520 IN GENERAL, IT'S OBVIOUSLY THE 1 2349 01:27:23,520 --> 01:27:25,000 WITH THE HIGHEST, THIS IS SORT 2350 01:27:25,000 --> 01:27:27,320 OF NOT A SPECIFIC PAIN 2351 01:27:27,320 --> 01:27:29,400 CONDITIONING STUDY, AND BACK 2352 01:27:29,400 --> 01:27:30,040 PAIN, HIGHLY PREVALENT ACROSS 2353 01:27:30,040 --> 01:27:35,760 THE WORLD AND SO, THAT 1 HAS 2354 01:27:35,760 --> 01:27:37,000 ONGOING STUDIES AS WELL AND YOU 2355 01:27:37,000 --> 01:27:38,640 CAN LOOK ON YOUR WAY DOWN THE 2356 01:27:38,640 --> 01:27:39,960 CHART TO SETHAT SOME CONDITIONS 2357 01:27:39,960 --> 01:27:45,720 HAVE NOT YET BEEN SPECIFICALLY 2358 01:27:45,720 --> 01:27:48,520 ADDRESSED BUT MIGHT FIT INTO 2359 01:27:48,520 --> 01:27:49,760 CHRONIC PAIN OR BACK PAIN BUT 2360 01:27:49,760 --> 01:27:53,080 THIS GIVES YOU THE TYPE OF PAIN 2361 01:27:53,080 --> 01:27:53,680 CONDITIONS INCLUDED BETTER 2362 01:27:53,680 --> 01:27:55,440 INTERNAL AUDIT CLUEDED IN THE 2363 01:27:55,440 --> 01:27:56,640 PORTFOLIO AND LAST TIME WHEN WE 2364 01:27:56,640 --> 01:27:58,160 LAUNCHED INTO THE NEW CONCEPTS, 2365 01:27:58,160 --> 01:28:00,560 NEXT 1, PLEASE, GIVES YOU--NEXT 2366 01:28:00,560 --> 01:28:01,720 SLIDE, THANK YOU. 2367 01:28:01,720 --> 01:28:04,000 GIVES YOU A SENSE OF THE 2368 01:28:04,000 --> 01:28:07,280 INTERVENTIONS THAT ARE BEING 2369 01:28:07,280 --> 01:28:12,320 TESTED IN THE DIFFERENT TRIALS 2370 01:28:12,320 --> 01:28:14,200 ACROSS HEAL AND IN THE DIFFERENT 2371 01:28:14,200 --> 01:28:15,320 SETTINGS WHERE THESE TRIALS ARE 2372 01:28:15,320 --> 01:28:16,280 TAKING PLACE. 2373 01:28:16,280 --> 01:28:18,960 SO THIS SET OF APPLICATIONS, SET 2374 01:28:18,960 --> 01:28:21,840 OF AWARDS RATHER DOESN'T INCLUDE 2375 01:28:21,840 --> 01:28:24,640 THE BIOMARKERS FOR LONGITUDINAL 2376 01:28:24,640 --> 01:28:26,040 STUDIES BECAUSE THOSE ARE NOT 2377 01:28:26,040 --> 01:28:26,400 INTERVENTIONAL. 2378 01:28:26,400 --> 01:28:28,200 THESE ARE SORT OF CATEGORIES 2379 01:28:28,200 --> 01:28:32,960 THAT WE HAVE PULLED TOGETHER 2380 01:28:32,960 --> 01:28:34,600 FROM LARGER GROUPINGS OF THE 2381 01:28:34,600 --> 01:28:35,960 TYPES OF INTERVENTIONS SO THIS 2382 01:28:35,960 --> 01:28:39,960 IS KIND OF HIGH LEVEL, BEHAVIOR 2383 01:28:39,960 --> 01:28:43,000 HEALTH WOULD INCLUDE MINDFULNESS 2384 01:28:43,000 --> 01:28:50,320 AND CBT AND SOME OTHER TYPES OF 2385 01:28:50,320 --> 01:28:51,280 INTERVENTIONS THERE. 2386 01:28:51,280 --> 01:28:53,120 AND EXERCISE COULD BE THROUGH A 2387 01:28:53,120 --> 01:28:54,440 PHYSICAL THERAPIST OR YOGA OR 2388 01:28:54,440 --> 01:28:55,520 OTHER TYPES OF PROGRAMS. 2389 01:28:55,520 --> 01:28:57,000 SO AGAIN, HIGH LEVEL TO GIVE YOU 2390 01:28:57,000 --> 01:28:59,360 A SENSE OF THE BREDTH OF THE 2391 01:28:59,360 --> 01:29:05,560 TYPES OF INTERVENTIONS THAT ARE 2392 01:29:05,560 --> 01:29:06,800 INCLUDED SOME ARE 2393 01:29:06,800 --> 01:29:10,680 PHARMAICOLOGICAL, SOME ARE NOT, 2394 01:29:10,680 --> 01:29:13,080 SOME ARE INTERVENTIONAL, AND THE 2395 01:29:13,080 --> 01:29:14,520 BREDTH OF SETTINGS, PAIN IS 2396 01:29:14,520 --> 01:29:16,000 TREATED IN A NUMBER OF DIFFERENT 2397 01:29:16,000 --> 01:29:17,640 PLACES AND THEY THINK HEAL 2398 01:29:17,640 --> 01:29:18,920 APPROPRIATELY HAS A GOOD RANGE 2399 01:29:18,920 --> 01:29:20,240 OF SETTINGS FOR THE CLINICAL 2400 01:29:20,240 --> 01:29:25,760 TRIALS THAT ARE GOING ON ON 2401 01:29:25,760 --> 01:29:26,240 THROUGH THE PROGRAM. 2402 01:29:26,240 --> 01:29:28,320 SO WITH THAT AS A LITTLE BIT OF 2403 01:29:28,320 --> 01:29:30,440 BACKGROUND FOR THE BEDTH THAT WE 2404 01:29:30,440 --> 01:29:32,040 HAVE READY, JANE IS GOING TO 2405 01:29:32,040 --> 01:29:34,440 PICK UP THE NEXT WITH THE NEXT 2406 01:29:34,440 --> 01:29:39,600 SLIDE, THE FIRST OF THE CONCEPTS 2407 01:29:39,600 --> 01:29:40,960 THAT WE ARE PRESENTING SO WE 2408 01:29:40,960 --> 01:29:51,520 HAVE 6 DIFFERENT CONCEPTS WE'RE 2409 01:30:04,360 --> 01:30:04,680 PRESENTING TODAY. 2410 01:30:04,680 --> 01:30:06,760 SO I WILL TOSS IT TO JANE AND WE 2411 01:30:06,760 --> 01:30:08,520 WILL PICK UP THERE. 2412 01:30:08,520 --> 01:30:09,080 >>THANK YOU LIBDA. 2413 01:30:09,080 --> 01:30:09,480 NEXT SLIDE. 2414 01:30:09,480 --> 01:30:11,640 I HAVE THE PLEASURE OF 2415 01:30:11,640 --> 01:30:13,040 PRESENTING THE HEAL KNOWLEDGE 2416 01:30:13,040 --> 01:30:19,360 INNOVATION AND DISCOVERY STUDIES 2417 01:30:19,360 --> 01:30:22,640 PAIN INITIATIVE ALSO KNOWN AS 2418 01:30:22,640 --> 01:30:25,040 HEAL KIDS, THE BACKGROUND FOR IT 2419 01:30:25,040 --> 01:30:27,240 IS ACUTE AND CHRONIC PAIN IN 2420 01:30:27,240 --> 01:30:28,920 CHILDREN AND ADOLESCENTS ARE 2421 01:30:28,920 --> 01:30:30,240 COMMON AND OFTEN UNDERRECOGNIZED 2422 01:30:30,240 --> 01:30:32,920 SO SELF-ORDER OF MICRONS MEASURE 2423 01:30:32,920 --> 01:30:34,000 AND INCONSISTENTLY TREATED. 2424 01:30:34,000 --> 01:30:36,680 STUDIES SUGGEST A CHRONIC PAIN 2425 01:30:36,680 --> 01:30:39,240 IS EXPERIENCED BY APPROXIMATELY 2426 01:30:39,240 --> 01:30:40,760 1 QUARTER TO ONE-THIRD OF 2427 01:30:40,760 --> 01:30:43,000 CHILDREN AND UNTREATED PAIN CAN 2428 01:30:43,000 --> 01:30:45,120 LEAD TO LONG-TERM ADVERSE 2429 01:30:45,120 --> 01:30:46,360 OUTCOMES. 2430 01:30:46,360 --> 01:30:48,800 IN FACT, THE RESEARCH, REISSUE 2431 01:30:48,800 --> 01:30:53,560 OF THE CDC GUIDELINES FOR 2432 01:30:53,560 --> 01:30:54,760 PRESCRIBING OPILOT PROJECT 2433 01:30:54,760 --> 01:30:56,680 OITDOIDS DOESN'T HAVE ANY 2434 01:30:56,680 --> 01:30:57,640 RECOMMENDATIONS FOR THOSE UNDER 2435 01:30:57,640 --> 01:30:59,920 THE AGE OF 18, SO TO ADDRESS 2436 01:30:59,920 --> 01:31:02,120 THIS GREAT CLINICAL NEED FOR 2437 01:31:02,120 --> 01:31:04,040 BETTER MANAGEMENT OF PAIN IN 2438 01:31:04,040 --> 01:31:05,720 CHILDREN, THIS CONCEPT HAS BEEN 2439 01:31:05,720 --> 01:31:09,920 DEVELOPED WHICH HAS 3 2440 01:31:09,920 --> 01:31:10,840 COMPONENTS. 2441 01:31:10,840 --> 01:31:13,200 THE FIRST IS A KARKS CUTE 2442 01:31:13,200 --> 01:31:14,440 CLINICAL TRIAL COMPONENT. 2443 01:31:14,440 --> 01:31:17,960 THIS WILL FUND IMPROVEMENT THE 2444 01:31:17,960 --> 01:31:19,120 ASSESSMENT MANAGEMENT AND ACUTE 2445 01:31:19,120 --> 01:31:20,960 TREATMENT OF PAIN IN PEDIATRIC 2446 01:31:20,960 --> 01:31:22,920 PATIENTS ACROSS THE SPECTRUM OF 2447 01:31:22,920 --> 01:31:27,920 CARE USING INNOVATIVE CLINICAL 2448 01:31:27,920 --> 01:31:28,640 TRIAL DESIGNS. 2449 01:31:28,640 --> 01:31:29,160 THE SECOND COMOPPOSITE 2450 01:31:29,160 --> 01:31:31,160 BEHAVIORIAL PHENOTYPE SEPTORS A 2451 01:31:31,160 --> 01:31:32,840 CHRONIC PAIN EVALUATION AND 2452 01:31:32,840 --> 01:31:33,480 MEASUREMENT COMPONENT AND THERE 2453 01:31:33,480 --> 01:31:36,560 IS A NEED TO IMPROVE THE CURRENT 2454 01:31:36,560 --> 01:31:41,960 AND/OR CREATE NEW ROBUST 2455 01:31:41,960 --> 01:31:43,040 VALIDATED AGE APPROPRIATE 2456 01:31:43,040 --> 01:31:44,080 CHRONIC PAIN MEASUREMENTS AND 2457 01:31:44,080 --> 01:31:48,080 APPROACHES FOR USE IN CLINICAL 2458 01:31:48,080 --> 01:31:49,360 RESEARCH AND PRACTICE. 2459 01:31:49,360 --> 01:31:53,320 TO ACCOMPLISH THESE GOALS, THIS 2460 01:31:53,320 --> 01:32:00,160 COMPONENT WILL UTILIZE 2461 01:32:00,160 --> 01:32:03,200 LONGITUDINAL STUDIES AND THEN 2462 01:32:03,200 --> 01:32:05,200 THERE IS A RESOURCE AND 2463 01:32:05,200 --> 01:32:07,000 COMPONENTS CENTER, AND IT IS 2464 01:32:07,000 --> 01:32:09,680 SHARED CENTER TO FACILITATE DATA 2465 01:32:09,680 --> 01:32:11,120 COLLABORATION AND SHARING ACROSS 2466 01:32:11,120 --> 01:32:12,600 THE COMPONENTS AND THE 2467 01:32:12,600 --> 01:32:15,440 INVESTIGATOR GROUPS INCLUDING 2468 01:32:15,440 --> 01:32:16,720 DEVELOPING COMMON DATA ELEMENTS 2469 01:32:16,720 --> 01:32:18,360 WHICH REALLY HAVE NOT BEEN 2470 01:32:18,360 --> 01:32:19,640 DEVELOPED FULLY FOR CHILDREN, 2471 01:32:19,640 --> 01:32:23,920 COMMON ARK --ASSESSMENT AND 2472 01:32:23,920 --> 01:32:25,800 MEASUREMENT TOOLS AND DATA 2473 01:32:25,800 --> 01:32:28,200 MEASURING STANDARDSA WELL AS 2474 01:32:28,200 --> 01:32:28,920 CLINICAL TRIAL COORDINATING 2475 01:32:28,920 --> 01:32:31,560 CENTER UNIT. 2476 01:32:31,560 --> 01:32:37,280 SO NEXT SLIDE. 2477 01:32:37,280 --> 01:32:38,800 THIS SCHEMATIC WAS DRAWN BY THE 2478 01:32:38,800 --> 01:32:40,680 DEVELOPER OF THIS CONCEPT AND 2479 01:32:40,680 --> 01:32:43,200 THIS NICELY LAYS OUT HOW THESE 2 2480 01:32:43,200 --> 01:32:44,960 COMPONENTS ARE JOINED AND THE 2481 01:32:44,960 --> 01:32:48,680 ACUTE PAIN TRIALS PROGRAM HELPS 2482 01:32:48,680 --> 01:32:50,280 TO DEVELOP OR GENERATE ROBUST 2483 01:32:50,280 --> 01:32:52,040 EVIDENCE TO DEVELOP 2484 01:32:52,040 --> 01:32:53,680 EVIDENCE-BASED MANAGEMENT AND 2485 01:32:53,680 --> 01:32:55,440 TREATMENT GUIDELINES FOR ACUTE 2486 01:32:55,440 --> 01:32:59,120 PAIN IN DIFFERENT AGE GROUPS AND 2487 01:32:59,120 --> 01:32:59,400 SETTINGS. 2488 01:32:59,400 --> 01:33:04,760 THE OVERALL GOAL OF THE CHRONIC 2489 01:33:04,760 --> 01:33:07,440 PAIN RESEARCH PROGRAM IS TO 2490 01:33:07,440 --> 01:33:08,280 DEVELOP PRECISION MEASUREMENT 2491 01:33:08,280 --> 01:33:09,200 TOOLS FOR CHRONIC PAIN IN 2492 01:33:09,200 --> 01:33:09,480 CHILDREN. 2493 01:33:09,480 --> 01:33:11,680 THEY WILL AWLTS LOOK AT CHRONIC 2494 01:33:11,680 --> 01:33:16,880 PAIN RISK FACTORS INCLUDING 2495 01:33:16,880 --> 01:33:18,400 HEALTH EREQUESTITY AND SOCIAL 2496 01:33:18,400 --> 01:33:20,080 DETERMINANTS OF HEALTH 2497 01:33:20,080 --> 01:33:20,840 CONSIDERATIONS, BEHAVIORIAL 2498 01:33:20,840 --> 01:33:22,880 ASPECTS RELATED TO PAIN 2499 01:33:22,880 --> 01:33:28,000 SEVERITY, DURATION, TREATMENT 2500 01:33:28,000 --> 01:33:30,120 RESPONSE, AND RISK OF MENTAL 2501 01:33:30,120 --> 01:33:30,960 HEALTH DISORDERS. 2502 01:33:30,960 --> 01:33:33,040 ALL STUDIES WILL AIM TO ENROLL 2503 01:33:33,040 --> 01:33:34,280 DIVERSE POPULATIONS AND CONSIDER 2504 01:33:34,280 --> 01:33:35,720 HEALTH EQUITY AND SOCIAL 2505 01:33:35,720 --> 01:33:40,360 DETERMINANTS OF HEALTH IN THEIR 2506 01:33:40,360 --> 01:33:47,840 DESIGNS. 2507 01:33:47,840 --> 01:33:48,720 SO NEXT SLIDE. 2508 01:33:48,720 --> 01:33:50,480 SOPHISTICATED HOW DOES THAT 2509 01:33:50,480 --> 01:33:52,160 LARGE CONCEPT FIT WITHIN AND 2510 01:33:52,160 --> 01:33:53,280 COMPLEMENT CURRENT PROGRAMS. 2511 01:33:53,280 --> 01:33:54,240 THE ACUTE PAIN CLINICAL TRIALS 2512 01:33:54,240 --> 01:33:56,240 WILL FILL A LITERATURE GAP, 2513 01:33:56,240 --> 01:33:59,400 IMPROVE PATIENT OUTCOMES AND 2514 01:33:59,400 --> 01:34:01,120 PROVIDE EVIDENCE FOR CDE 2515 01:34:01,120 --> 01:34:02,880 DEVELOPMENT AND COMMON 2516 01:34:02,880 --> 01:34:03,120 PROTOCOLS. 2517 01:34:03,120 --> 01:34:09,080 THE CHRONIC PAIN EVALUATION AND 2518 01:34:09,080 --> 01:34:10,520 MEASUREMENT STUDIES WILL INFORM 2519 01:34:10,520 --> 01:34:11,680 PEDIATRIC PAIN OUTCOME AND 2520 01:34:11,680 --> 01:34:13,280 MEASURES ACROSS DISEASES AND 2521 01:34:13,280 --> 01:34:15,120 CONDITIONS. 2522 01:34:15,120 --> 01:34:16,680 WE BELIEVE DEVELOPING OUTCOME 2523 01:34:16,680 --> 01:34:21,160 MEASURES AND INTEGRATING DATA 2524 01:34:21,160 --> 01:34:26,640 ANALYSIS INTO THIS CONCEPT MAY 2525 01:34:26,640 --> 01:34:28,840 CONTRIBUTE OR MAY ACCELERATE 2526 01:34:28,840 --> 01:34:30,440 NONDRUG DEVELOPMENT AND TESTING 2527 01:34:30,440 --> 01:34:32,240 IN ADOLESCENTS WITH CHRONIC 2528 01:34:32,240 --> 01:34:36,160 PAIN, RIGHT NOW WE OFTEN JUST 2529 01:34:36,160 --> 01:34:37,920 TREAT CHILDREN AND SMALL ADULTS 2530 01:34:37,920 --> 01:34:40,920 WHICH IS PROBABLY NOT 2531 01:34:40,920 --> 01:34:43,320 APPROPRIATE, AND ALL STUDIES 2532 01:34:43,320 --> 01:34:44,400 WILL CONSIDER THE 2533 01:34:44,400 --> 01:34:46,000 BIOPSYCHOSOCIAL MODEL OF PAIN 2534 01:34:46,000 --> 01:34:47,080 AND EMPHASIZE SOCIAL 2535 01:34:47,080 --> 01:34:48,240 DETERMINANTS OF HEALTH AND 2536 01:34:48,240 --> 01:34:51,640 SOCIAL NEEDS WHICH ARE CRITICAL 2537 01:34:51,640 --> 01:34:54,840 TO OUR UNDERSTANDING OF PAIN 2538 01:34:54,840 --> 01:34:56,240 EXPERIENCES, ADDRESSING HELT 2539 01:34:56,240 --> 01:34:58,000 DISPARITY, HEALTH DISPARITIES 2540 01:34:58,000 --> 01:35:08,040 AND DEVELOPING EFFECTIVE 2541 01:35:08,040 --> 01:35:08,600 INTERVENTIONS. 2542 01:35:08,600 --> 01:35:12,880 SO WE HAVE DISCUSSION QUESTIONS, 2543 01:35:12,880 --> 01:35:13,480 NEXT SLOYD. 2544 01:35:13,480 --> 01:35:14,880 THERE ARE ANY PARTICULAR 2545 01:35:14,880 --> 01:35:16,000 STAKEHOLDERS THAT SHOULD BE 2546 01:35:16,000 --> 01:35:18,240 INGAUGED TO INSURE THE SUCCESS 2547 01:35:18,240 --> 01:35:19,760 OF THESE STUDIES AND I'M GOING 2548 01:35:19,760 --> 01:35:25,600 TO OPEN IT TO INVITATIONS TO 2549 01:35:25,600 --> 01:35:36,160 DISCUSSION WITH DR. LINDA BARR, 2550 01:35:36,400 --> 01:35:38,000 I DON'T KNOW IF LINDA IS ON? 2551 01:35:38,000 --> 01:35:41,840 >>I DON'T THINK LINDA WAS ABLE 2552 01:35:41,840 --> 01:35:44,520 TO MAKE IT. 2553 01:35:44,520 --> 01:35:49,640 >>OTHER DISCUSS ANTS? 2554 01:35:49,640 --> 01:35:53,280 DR. SMITH? 2555 01:35:53,280 --> 01:35:55,440 >>WELL, TO SAY THAT THERE'S A 2556 01:35:55,440 --> 01:35:56,280 DIRGT OF INFORMATION ABOUT 2557 01:35:56,280 --> 01:36:01,240 TREATING PAIN IN CHILDREN IS 2558 01:36:01,240 --> 01:36:02,520 REPETITIVE, AND MY AREA OF 2559 01:36:02,520 --> 01:36:09,640 INTEREST IS SICKLE CELL DISEASE 2560 01:36:09,640 --> 01:36:11,040 SO I'LL COMMENT THAT I'M 2561 01:36:11,040 --> 01:36:12,240 PARTICULARLY INTERESTED IN THE 2562 01:36:12,240 --> 01:36:13,480 PROGRESSION OF PAIN OF SICKLE 2563 01:36:13,480 --> 01:36:19,320 CELL DISEASE IN CHILDREN. 2564 01:36:19,320 --> 01:36:22,360 FROM MOSTLY ACUTE MANIFESTED BY 2565 01:36:22,360 --> 01:36:24,320 VISITIS FOR [INDISCERNIBLE] 2566 01:36:24,320 --> 01:36:26,640 CRISIS TO SOMEWHERE AROUND 14-20 2567 01:36:26,640 --> 01:36:31,280 YEARS OF AGE, MOSTLY CHRONIC AND 2568 01:36:31,280 --> 01:36:40,080 ADDED TO THAT ACUTE PAIN ARE 3 2569 01:36:40,080 --> 01:36:40,800 POSSIBLE HYPOTHESIZED 2570 01:36:40,800 --> 01:36:41,440 COMPLICATIONS. 2571 01:36:41,440 --> 01:36:44,880 ONE IS CHRONIC NEUROPATHIC PAIN 2572 01:36:44,880 --> 01:36:47,400 CENTRALLY AND/OR PERIPHERALLY 2573 01:36:47,400 --> 01:36:53,920 FROM DAMAGED DUE TO THE SICKLE 2574 01:36:53,920 --> 01:36:56,520 CELL DISEASE ITSELF. 2575 01:36:56,520 --> 01:36:58,880 SECOND IS OPIOID ALGESIA AND 2576 01:36:58,880 --> 01:37:06,240 THIRD IS CHRONIC ORGAN PAIN AND 2577 01:37:06,240 --> 01:37:08,520 DYSFUNCTION PARTICULARLY BONE 2578 01:37:08,520 --> 01:37:11,920 PAIN DEE TO BONE DISEASE, LEG 2579 01:37:11,920 --> 01:37:13,760 ULCERS AND OTHER ESCHEMIC 2580 01:37:13,760 --> 01:37:16,640 COMPLICATIONS AND WE HAVE NO 2581 01:37:16,640 --> 01:37:20,040 THEORY OR EVIDENCE FOR THAT 2582 01:37:20,040 --> 01:37:20,480 PROGRESSION. 2583 01:37:20,480 --> 01:37:22,320 SO, IMAGINE DOING THAT SAME 2584 01:37:22,320 --> 01:37:23,160 THING FOR DIABETES, IMAGINE 2585 01:37:23,160 --> 01:37:29,560 DOING THAT SAME THING FOR OTHER 2586 01:37:29,560 --> 01:37:30,760 CONGENITAL DISEASES WHICH MAY OR 2587 01:37:30,760 --> 01:37:36,600 MAY NOT BE PAINFUL AT THE START 2588 01:37:36,600 --> 01:37:38,120 BUT THEN AFTER YEARS AND YEARS 2589 01:37:38,120 --> 01:37:41,000 OF TREATMENT AND ORGAN 2590 01:37:41,000 --> 01:37:42,400 DYSFUNCTION BECOME MULTIPAINFUL 2591 01:37:42,400 --> 01:37:52,680 DISEASES OR PICK 2592 01:37:58,720 --> 01:37:59,120 MULTIMECHANISTIC PAINFUL 2593 01:37:59,120 --> 01:37:59,400 DISEASES. 2594 01:37:59,400 --> 01:38:01,400 >>THANK YOU AND I'M TAKING LOTS 2595 01:38:01,400 --> 01:38:01,920 OF NOTES. 2596 01:38:01,920 --> 01:38:03,920 DR. PACE DID YOU WANT TO MAKE 2597 01:38:03,920 --> 01:38:04,240 ANY COMMENTS. 2598 01:38:04,240 --> 01:38:07,920 >>NO, I'M NOT SURE WE HAVE THEM 2599 01:38:07,920 --> 01:38:08,360 EITHER? 2600 01:38:08,360 --> 01:38:10,360 >>HOW ABOUT I KNOW DR. HENRY 2601 01:38:10,360 --> 01:38:11,840 YOU'RE ON. 2602 01:38:11,840 --> 01:38:12,600 >>YES, I AM. 2603 01:38:12,600 --> 01:38:15,800 THANK YOU JANE. 2604 01:38:15,800 --> 01:38:18,680 AS OF 5:30 LAST NIGHT, THANK 2605 01:38:18,680 --> 01:38:18,840 YOU. 2606 01:38:18,840 --> 01:38:20,040 SO I'M VERY EXCITED ABOUT THIS 2607 01:38:20,040 --> 01:38:23,680 PROJECT BECAUSE THERE IS AN 2608 01:38:23,680 --> 01:38:24,640 ABSOLUTE BREDTH OF KNOWLEDGE IN 2609 01:38:24,640 --> 01:38:29,880 HERE AND I THINK IN PARTICULAR 2610 01:38:29,880 --> 01:38:33,720 INVITING APPLICATIONS THAT WILL 2611 01:38:33,720 --> 01:38:34,680 HELP US EVALUATE APPLICATIONS 2612 01:38:34,680 --> 01:38:37,200 FOR KIDS THAT ARE NONVERBAL AND 2613 01:38:37,200 --> 01:38:39,040 THOSE WITH INTELLECTUAL 2614 01:38:39,040 --> 01:38:40,400 DISABILITIES THOSE ARE 2615 01:38:40,400 --> 01:38:41,080 CHALLENGING CLINICAL SITUATIONS 2616 01:38:41,080 --> 01:38:42,200 AND WE DON'T KNOW WHAT TO DO SO 2617 01:38:42,200 --> 01:38:45,680 IF WE CAN GET A BASE LINE, IT'S 2618 01:38:45,680 --> 01:38:47,560 HARD TO DECIDE IS THE TREATMENT 2619 01:38:47,560 --> 01:38:49,160 BEING SUCCESSFUL OR NOT. 2620 01:38:49,160 --> 01:38:51,600 I'M EXCITED BECAUSE WHAT YOU'VE 2621 01:38:51,600 --> 01:38:54,120 OUTLINED HERE, YOU'RE DESCRIBING 2622 01:38:54,120 --> 01:38:57,160 LOOKING AT FAMILIES SYSTEMS SO 2623 01:38:57,160 --> 01:38:58,240 THE WHOLE BIOPSYCHOSOCIAL 2624 01:38:58,240 --> 01:39:00,560 COMPONENT, NOT JUST THE PATIENT 2625 01:39:00,560 --> 01:39:06,640 BUT OF THE FAMILY BECAUSE I 2626 01:39:06,640 --> 01:39:08,160 THINK FAMILIES WITH CHILDREN WHO 2627 01:39:08,160 --> 01:39:09,400 HAVE MEDICAL CONDITIONS OFTEN 2628 01:39:09,400 --> 01:39:10,160 THE SIBLINGS ARE IMPACTED AS 2629 01:39:10,160 --> 01:39:12,600 WELL AND I THINK THAT'S ALSO 2630 01:39:12,600 --> 01:39:16,480 OVERLOOKED COMPONENT HERE THAT 2631 01:39:16,480 --> 01:39:21,200 PERHAPS YOU COULD GATHER 2632 01:39:21,200 --> 01:39:22,160 INFORMATION ON THAT, AND ALONG 2633 01:39:22,160 --> 01:39:23,600 WITH THAT, GIVEN THAT THE 2634 01:39:23,600 --> 01:39:25,320 FAMILIES ARE MANAGING A LOT, I 2635 01:39:25,320 --> 01:39:26,640 THINK THERE SHOULD BE CAREFUL 2636 01:39:26,640 --> 01:39:29,240 ATTENTION PAID TO THE 2637 01:39:29,240 --> 01:39:31,520 RECRUITMENT PLAN, WHATEVER 2638 01:39:31,520 --> 01:39:39,880 POPULATION OR CONDITIONS YOU MAY 2639 01:39:39,880 --> 01:39:43,120 CHOOSE TO STUDY SO IN TERMS OF 2640 01:39:43,120 --> 01:39:44,320 STAKEHOLDERS ENGAGING PARENT, 2641 01:39:44,320 --> 01:39:49,440 OBVIOUSLY IS ABSOLUTELY CRITICAL 2642 01:39:49,440 --> 01:39:50,760 AND AND MAKING SURE THAT THE 2643 01:39:50,760 --> 01:39:52,600 SCIENCE IS SERVING THE CHILD IN 2644 01:39:52,600 --> 01:39:54,360 THE FAMILY AND THE FAMILY AND 2645 01:39:54,360 --> 01:39:56,200 CHILD ISN'T JUST SERVING SCIENCE 2646 01:39:56,200 --> 01:40:01,120 WHICH IS OFTEN A PERCEPTION THAT 2647 01:40:01,120 --> 01:40:03,040 IS OUT THERE WITH THEIR KIDS AND 2648 01:40:03,040 --> 01:40:06,840 WHO HAVE MULTIPLE DISABILITIES. 2649 01:40:06,840 --> 01:40:09,240 THOSE ARE MY INITIAL THOUGHTS. 2650 01:40:09,240 --> 01:40:11,080 I APOLOGIZE FOR MY SORE THROAT, 2651 01:40:11,080 --> 01:40:14,280 TOO, I JUST CAUGHT IT FROM 2652 01:40:14,280 --> 01:40:14,520 REBECCA. 2653 01:40:14,520 --> 01:40:24,920 >>OH NOR, I'M SORRY. 2654 01:40:26,480 --> 01:40:28,840 >>I SEE HANDS RAISED BYINANCE 2655 01:40:28,840 --> 01:40:32,080 EXPE NEDRA GO,A HEAD NED. 2656 01:40:32,080 --> 01:40:33,240 >>THIS MIGHT NOT BE WHAT YOU 2657 01:40:33,240 --> 01:40:35,120 HAD IN MIND BUT CROSS CUTTING TO 2658 01:40:35,120 --> 01:40:38,280 ADDICTION, IT'S NOT UNCOMMON TO 2659 01:40:38,280 --> 01:40:39,600 HEAR THE STORY FROM A YOUNG 2660 01:40:39,600 --> 01:40:41,760 ADULT THAT I GOT EXPOSED TO 2661 01:40:41,760 --> 01:40:49,000 OPIOIDS WHEN I BROKE MY LEG, 2662 01:40:49,000 --> 01:40:51,360 PLAYING FOOTBALL AND AND I HAD A 2663 01:40:51,360 --> 01:40:52,960 REMARKABLE RESPONSE TO THEM AND 2664 01:40:52,960 --> 01:40:54,800 GOT ADDICTED. 2665 01:40:54,800 --> 01:41:04,600 YOU KNOW THERE'S SOME SUBSET OF 2666 01:41:04,600 --> 01:41:06,440 KIDS ACUTELY AT RISK TO GO TO TO 2667 01:41:06,440 --> 01:41:07,640 BE EXPOSED TO ADDICTION BECAUSE 2668 01:41:07,640 --> 01:41:08,960 THEY HAVE A PARTICULAR REACTION 2669 01:41:08,960 --> 01:41:11,400 TO THE OPIOID THAT THEY FIND IT 2670 01:41:11,400 --> 01:41:12,800 MORE REINFORCING THAN AVERAGE. 2671 01:41:12,800 --> 01:41:16,680 SO I WAS WONDERING IF YOU HAVE 2672 01:41:16,680 --> 01:41:19,760 IN MIND TO LOOK AT THAT AS PART 2673 01:41:19,760 --> 01:41:21,800 OF THIS? 2674 01:41:21,800 --> 01:41:25,200 TO WHAT EXTENT IS EXPOSURE TO 2675 01:41:25,200 --> 01:41:25,840 OPIATES PARTICULARLY INCREASED 2676 01:41:25,840 --> 01:41:28,400 RISK FOR MAIN AND FOR WHOM COULD 2677 01:41:28,400 --> 01:41:33,320 WE FIGURE OUT WHICH KIDS ARE AT 2678 01:41:33,320 --> 01:41:33,520 RISK. 2679 01:41:33,520 --> 01:41:35,480 I THINK THAT WOULD BE PART OF 2680 01:41:35,480 --> 01:41:38,800 THE CHRONIC PAIN COMPONENT OF 2681 01:41:38,800 --> 01:41:40,240 THIS AND I'LL CERTAINLY PASS 2682 01:41:40,240 --> 01:41:50,400 THAT ON TO THE DEVELOPERS OF THE 2683 01:41:50,400 --> 01:41:52,800 CONCEPT. 2684 01:41:52,800 --> 01:41:53,120 >>THANKS. 2685 01:41:53,120 --> 01:41:56,040 SO I HAD 1 SORT OF OFF THE WALL 2686 01:41:56,040 --> 01:41:56,320 THOUGHT. 2687 01:41:56,320 --> 01:41:59,160 IT SEEMS THAT THIS IS A CASE 2688 01:41:59,160 --> 01:42:00,960 WHERE TWIN STUDIES MIGHT BE 2689 01:42:00,960 --> 01:42:01,720 EXTREMELY USEFUL. 2690 01:42:01,720 --> 01:42:06,640 I KNOW THAT THERE HAVE BEEN TWIN 2691 01:42:06,640 --> 01:42:07,720 STUDIES IN THE STUDIES IN THE 2692 01:42:07,720 --> 01:42:09,240 PAST BUT HERE THE ISSUE IS, YOU 2693 01:42:09,240 --> 01:42:18,080 KNOW YOU GET A HANDLE TO GENETIC 2694 01:42:18,080 --> 01:42:18,680 PREDISPOSITION, ENVIRONMENTAL 2695 01:42:18,680 --> 01:42:22,040 CONTRIBUTIONS AND I THINK IT'S 2696 01:42:22,040 --> 01:42:23,680 BEEN A LONG TIME SINCE TWIN 2697 01:42:23,680 --> 01:42:24,960 STUDIES HAVE BEEN DONE FOR PAIN 2698 01:42:24,960 --> 01:42:26,360 BUT I WOULD JUST SORT OF PUT IT 2699 01:42:26,360 --> 01:42:27,720 ON THE LIST AS SOMETHING THAT 2700 01:42:27,720 --> 01:42:33,640 MIGHT BE USEFUL TO IDENTIFY 2701 01:42:33,640 --> 01:42:35,400 RELEVANT FACTORS. 2702 01:42:35,400 --> 01:42:37,400 >>YEAH, SO, ERIN HAS JUST 2703 01:42:37,400 --> 01:42:38,920 POINTED OUT SUZANNEA ARE YOU ON? 2704 01:42:38,920 --> 01:42:41,520 WHEN WOULD LIKE TO ADDRESS THAT? 2705 01:42:41,520 --> 01:42:45,240 >>YES, IESM --I'M ON. 2706 01:42:45,240 --> 01:42:48,200 CERTAINLY THE TWIN STUDIES ARE 2707 01:42:48,200 --> 01:42:49,240 EXTREMELY INTERESTING IN VIEW OF 2708 01:42:49,240 --> 01:42:52,520 THE FACT THAT THERE SEEMS THERE 2709 01:42:52,520 --> 01:42:54,160 ARE SOME CHANGES THAT OCCUR 2710 01:42:54,160 --> 01:43:00,880 PRIOR TO THE ONSET OF CHRONIC 2711 01:43:00,880 --> 01:43:03,400 PAIN IN CHILDREN THAT CAN BE 2712 01:43:03,400 --> 01:43:04,920 OBSERVED WITH IMAGING STUDIES, 2713 01:43:04,920 --> 01:43:07,160 WE HAVE NOT, WE ARE PROPOSING TO 2714 01:43:07,160 --> 01:43:16,040 RELY ON EXISTING COHORTS TO TAKE 2715 01:43:16,040 --> 01:43:18,040 ADVANTAGE OF THE RESOURCES THAT 2716 01:43:18,040 --> 01:43:19,320 HAVE BEEN CREATED FOR DIFFERENT 2717 01:43:19,320 --> 01:43:22,000 EFFORTS ACROSS THE INSTITUTES 2718 01:43:22,000 --> 01:43:24,480 BUT SUDDENLY, THE INCLUSION OF 2719 01:43:24,480 --> 01:43:27,400 TWIN COHORTS, IT COULD BE 2720 01:43:27,400 --> 01:43:28,520 CONSIDERED ESPECIALLY TO 2721 01:43:28,520 --> 01:43:30,120 IDENTIFY RISK FACTORS FOR 2722 01:43:30,120 --> 01:43:31,680 CHRONIC PAIN, RISK FACTORS FOR 2723 01:43:31,680 --> 01:43:37,960 THE TRANSITION FROM ACUTE TO 2724 01:43:37,960 --> 01:43:41,160 CHRONIC PAIN HOW THE EXPERIENCE 2725 01:43:41,160 --> 01:43:44,160 OF CHILDHOOD PAIN MAY INFLUENCE 2726 01:43:44,160 --> 01:43:46,440 THIS IN CHILDHOOD AND ALL THE IN 2727 01:43:46,440 --> 01:43:49,200 ADULTHOOD SO CERTAINLY AN 2728 01:43:49,200 --> 01:43:50,400 INTERESTING GROUP OF PATIENTS 2729 01:43:50,400 --> 01:43:52,400 AND FAMILY BASED TO CONSIDER TO 2730 01:43:52,400 --> 01:43:53,000 BE INCLUDED. 2731 01:43:53,000 --> 01:43:57,040 I ALSO WANTED TO ADD THAT IN 2732 01:43:57,040 --> 01:43:59,400 TERMS OF SICKLE CELL AND I DON'T 2733 01:43:59,400 --> 01:44:01,560 KNOW WITH WENDY WEBER IS ON THE 2734 01:44:01,560 --> 01:44:03,640 CALL BUT WE DO HAVE HEAL EFFORT 2735 01:44:03,640 --> 01:44:06,800 AND SICKLE CELL DISEASE AND 2736 01:44:06,800 --> 01:44:09,360 THERE MIGHT BE OPPORTUNITIES FOR 2737 01:44:09,360 --> 01:44:10,640 INTERACTION IF THIS 2738 01:44:10,640 --> 01:44:11,240 IBT--INTEGRATISHIAATIVE MOVES 2739 01:44:11,240 --> 01:44:15,400 FORWARD WITH THE GROUP OF THESE 2740 01:44:15,400 --> 01:44:21,480 IN SICKLE CELL AND WE DO HAVE A 2741 01:44:21,480 --> 01:44:22,920 SEPARATE PROJECT I DON'T KNOW 2742 01:44:22,920 --> 01:44:24,120 JANE OR LINDA IF YOU WANT TO 2743 01:44:24,120 --> 01:44:25,400 COMMENT WHICH WILL BE LOOKING 2744 01:44:25,400 --> 01:44:28,480 ALSO AT CHILDREN AND ADOLESCENTS 2745 01:44:28,480 --> 01:44:38,960 WHO GET EXPOSED IN PATIENTS TO 2746 01:44:38,960 --> 01:44:42,600 OPIOIDS WHO TO ASSESS SOME OF 2747 01:44:42,600 --> 01:44:43,520 THE POPULATIONS THROUGH SURVEY 2748 01:44:43,520 --> 01:44:44,760 STUDIES AND TO OBSERVE AND GET 2749 01:44:44,760 --> 01:44:49,640 DATA ABOUT THE DEVELOPMENT OF 2750 01:44:49,640 --> 01:44:52,360 CHRONIC PAIN, SO YOU MAY WANT TO 2751 01:44:52,360 --> 01:44:55,400 COMMENT THAT, IF--IS THIS THE 1 2752 01:44:55,400 --> 01:44:59,480 SUZANNEA THAT WAS PUT FORWARD BY 2753 01:44:59,480 --> 01:45:00,800 THE PREVENTION AND TREATMENT. 2754 01:45:00,800 --> 01:45:01,200 >>YEAH, YEAH. 2755 01:45:01,200 --> 01:45:06,040 >>SO THIS IS FOLLOWING POST 2756 01:45:06,040 --> 01:45:07,080 SURGERY ADOLESCENCE WHO'S 2757 01:45:07,080 --> 01:45:09,680 PROCEDURE IS GOING TO INVOLVE 2758 01:45:09,680 --> 01:45:10,880 SOME OPIOID EXPOSURE AND 2759 01:45:10,880 --> 01:45:18,560 FOLLOWING THEM, FOLLOWING THE 2760 01:45:18,560 --> 01:45:18,800 SURGERY. 2761 01:45:18,800 --> 01:45:20,520 >>I THINK WE CAN GO TO CHRIS 2762 01:45:20,520 --> 01:45:21,840 AND THEN DIANEA, JANE IF YOU 2763 01:45:21,840 --> 01:45:23,120 HAVE ADDITIONAL THOUGHTS ABOUT 2764 01:45:23,120 --> 01:45:23,440 THAT? 2765 01:45:23,440 --> 01:45:25,520 >>NO, I THINK LEVERAGING 2766 01:45:25,520 --> 01:45:29,920 WHATEVER EXISTING COHORTS ACROSS 2767 01:45:29,920 --> 01:45:30,640 HEAL IS REALLY SOMETHING WE 2768 01:45:30,640 --> 01:45:32,640 SHOULD LOOK AT CAREFULLY. 2769 01:45:32,640 --> 01:45:33,360 >>THANK YOU. 2770 01:45:33,360 --> 01:45:34,520 GO AHEAD CHRIS. 2771 01:45:34,520 --> 01:45:35,920 >>THANKS REBECCA SO SUZANNEA 2772 01:45:35,920 --> 01:45:37,240 JUST MENTIONED OR TALKED A BIT 2773 01:45:37,240 --> 01:45:38,720 ABOUT A COMMENT THAT I'M GOING 2774 01:45:38,720 --> 01:45:40,840 TO MAKE WHICH SOUNDS LIKE YOU'RE 2775 01:45:40,840 --> 01:45:41,640 ALREADY THINKING ABOUT 2776 01:45:41,640 --> 01:45:43,480 ADDRESSING IT BUT CIRCLING BACK 2777 01:45:43,480 --> 01:45:44,520 TO THE CONVERSATION WE HAD 2778 01:45:44,520 --> 01:45:46,960 EARLIER ABOUT THE TEMPORAL 2779 01:45:46,960 --> 01:45:48,120 DEVELOPMENT, OF ACUTE AND 2780 01:45:48,120 --> 01:45:50,080 CHRONIC PAIN, THIS POPULATION 2781 01:45:50,080 --> 01:45:52,000 OBVIOUSLY THERE'S A GREAT NEED 2782 01:45:52,000 --> 01:45:54,000 TO STUDY AND ADDRESS AND HOW TO 2783 01:45:54,000 --> 01:45:59,320 TREAT KIDS WHO ALREADY HAVE 2784 01:45:59,320 --> 01:46:00,960 CHRONIC PAIN CONDITIONS BUT I 2785 01:46:00,960 --> 01:46:03,320 WOULD ENCOURAGE YOU TO LOOK AT 2786 01:46:03,320 --> 01:46:04,280 THIS WITH A PREVENTION LENS 2787 01:46:04,280 --> 01:46:06,080 BECAUSE YOU KNOW WE KNOW SO 2788 01:46:06,080 --> 01:46:08,280 LITTLE ABOUT THE TEMPORAL 2789 01:46:08,280 --> 01:46:09,320 DEVELOPMENT OF PAIN AND THERE 2790 01:46:09,320 --> 01:46:10,840 CERTAINLY HAVE BEEN A LOT OF 2791 01:46:10,840 --> 01:46:12,160 FACTORS THAT HAVE BEEN 2792 01:46:12,160 --> 01:46:16,240 IDENTIFIED IN DIFFERENT STUDIES 2793 01:46:16,240 --> 01:46:19,240 FOR EXAMPLE, IN GERLS, EARLIER 2794 01:46:19,240 --> 01:46:20,840 AGE IN DISMENNOREA ARE IN A 2795 01:46:20,840 --> 01:46:22,400 KNOWN RISK FACTOR FOR THE 2796 01:46:22,400 --> 01:46:23,800 DEVELOPMENT OF CHRONIC PAIN 2797 01:46:23,800 --> 01:46:25,920 LATER IN LIFE, AND SO THE EXTENT 2798 01:46:25,920 --> 01:46:28,040 THAT IT'S POSSIBLE, IT WOULD BE 2799 01:46:28,040 --> 01:46:33,200 REALLY BE GREAT TO TRY TO USE 2800 01:46:33,200 --> 01:46:34,800 THIS PARTICULAR RESEARCH PROGRAM 2801 01:46:34,800 --> 01:46:36,360 TO IDENTIFY WHAT THOSE 2802 01:46:36,360 --> 01:46:37,160 PSYCHOSOCIAL AND ENVIRONMENTAL 2803 01:46:37,160 --> 01:46:40,520 FACTORS MAY BE THAT DO PUT 2804 01:46:40,520 --> 01:46:42,480 ADULTS AT RISK OF DEVELOPING 2805 01:46:42,480 --> 01:46:43,680 CHRONIC PAIN BUT IT COULD START 2806 01:46:43,680 --> 01:46:50,680 A LOT EARLIER IN LIFE. 2807 01:46:50,680 --> 01:46:51,000 >>GREAT. 2808 01:46:51,000 --> 01:46:51,880 THANK YOU. 2809 01:46:51,880 --> 01:46:53,280 AND THEN DIANEA. 2810 01:46:53,280 --> 01:46:54,320 >>YEAH, SO I WOULD LIKE TO 2811 01:46:54,320 --> 01:46:56,080 THANK THE GROUP FOR THEIR 2812 01:46:56,080 --> 01:46:58,800 POSITIVE COMMENTS, THIS IS 2813 01:46:58,800 --> 01:47:00,760 CLEARLY AN AREA THAT'S LARGELY 2814 01:47:00,760 --> 01:47:03,080 NOT ADDRESSED WITH ANY HEAL 2815 01:47:03,080 --> 01:47:06,280 INITIATIVES, I DID WANT TO 2816 01:47:06,280 --> 01:47:08,880 COMMENT ON NED'S COMMENT BECAUSE 2817 01:47:08,880 --> 01:47:11,400 I'VE ALWAYS WONDERED AS THE 2818 01:47:11,400 --> 01:47:13,120 NORMALNYONATOLOGYIST, WHERE IN 2819 01:47:13,120 --> 01:47:18,360 THE NICU, WE--THESE ARE NOT THE 2820 01:47:18,360 --> 01:47:22,680 BABIES THAT ARE CEREBELLUMS 2821 01:47:22,680 --> 01:47:24,720 POSED IN UTERO, BUT BABIES THAT 2822 01:47:24,720 --> 01:47:26,800 OFTEN GET OVERMEDICATED TO MAKE 2823 01:47:26,800 --> 01:47:28,120 THEM COMFORTABLE WHILE THEY'RE 2824 01:47:28,120 --> 01:47:30,840 INTUBATED LET'S SAY OR GET 2825 01:47:30,840 --> 01:47:32,480 SUBSTANTIAL MEDICATION PRIOR TO 2826 01:47:32,480 --> 01:47:38,520 PROCEDURES, SO THERE'S A 2827 01:47:38,520 --> 01:47:39,800 POPULATION THAT HAS ACUTE PAIN 2828 01:47:39,800 --> 01:47:42,000 AND THEY'RE NOT VERBAL SO HOW DO 2829 01:47:42,000 --> 01:47:43,800 YOU ASSESS PAIN IN NAPOPPULATION 2830 01:47:43,800 --> 01:47:45,200 AND WHAT IMPLICATIONS DOES IT 2831 01:47:45,200 --> 01:47:46,840 HAVE LONG-TERM SO THAT'S ANOTHER 2832 01:47:46,840 --> 01:47:47,880 POPULATION THAT WE REALLY 2833 01:47:47,880 --> 01:47:56,600 HAVEN'T DISCUSSED AND THE SECOND 2834 01:47:56,600 --> 01:48:00,600 THING IS THESE KIDS HAVE 20, 30, 2835 01:48:00,600 --> 01:48:02,000 40 FRACTURES THROUGH ADOLESCENTS 2836 01:48:02,000 --> 01:48:04,520 AND IT'S SIMILAR IN MANY WAYS TO 2837 01:48:04,520 --> 01:48:09,200 SICKLE CELL BUT THIS--THIS IS 2838 01:48:09,200 --> 01:48:12,080 JUST AN INCREDIBLE DISEASE WHERE 2839 01:48:12,080 --> 01:48:15,040 HAVING TAKEN CARE OF THESE 2840 01:48:15,040 --> 01:48:16,280 PATIENTS, THESE KIDS, THATTENER 2841 01:48:16,280 --> 01:48:20,360 CONSTANT PAIN AND WHAT CAN WE 2842 01:48:20,360 --> 01:48:21,240 OFFER THEM. 2843 01:48:21,240 --> 01:48:25,640 AND I APPRECIATE WHAT CHRIS SAID 2844 01:48:25,640 --> 01:48:27,080 BECAUSE DISMENNOREA IS SOMETHING 2845 01:48:27,080 --> 01:48:31,120 THAT'S ALSO IN OUR RADAR SCREEN. 2846 01:48:31,120 --> 01:48:32,200 SEVERE DISMENNOREA, ALSO LOOKING 2847 01:48:32,200 --> 01:48:35,640 AT PREDICTIVE BI ONY MARKERS FOR 2848 01:48:35,640 --> 01:48:37,800 ENDOMEET REOSEIS BUT THEY MAY 2849 01:48:37,800 --> 01:48:38,800 PRESENT AS CHRONIC MENSTRUAL 2850 01:48:38,800 --> 01:48:44,160 PAIN AS PART OF THE PIEWBERAL 2851 01:48:44,160 --> 01:48:45,520 DEVELOPMENT. 2852 01:48:45,520 --> 01:48:46,240 THANK YOU. 2853 01:48:46,240 --> 01:48:49,120 OKAY, I WILL GIVE YOU, SO DIANEA 2854 01:48:49,120 --> 01:48:51,240 THANK YOU, SO MANY, SO MANY 2855 01:48:51,240 --> 01:48:55,760 AREAS TO EXPLORE AND THEN SHARON 2856 01:48:55,760 --> 01:48:57,720 I WILL GIVE YOU THE LAST-- 2857 01:48:57,720 --> 01:49:00,680 >>I KNOW THIS IS FOCUSED ON 2858 01:49:00,680 --> 01:49:02,960 KIDDOS BUT WHAT WE CAN LEARN 2859 01:49:02,960 --> 01:49:05,920 ABOUT EVALUATING KIDS WHO ARE 2860 01:49:05,920 --> 01:49:06,480 NONVERBAL AND INTELLECTUAL 2861 01:49:06,480 --> 01:49:07,600 DISABILITIES AND HOW TO TREAT 2862 01:49:07,600 --> 01:49:10,040 THERAPIST PAIN COULD BE VERY 2863 01:49:10,040 --> 01:49:13,440 HELPFUL IN HELPING US ADDRESS 2864 01:49:13,440 --> 01:49:16,760 PAIN IN THE ELDER LAP, SOME OF 2865 01:49:16,760 --> 01:49:18,360 WHOM ARE NONVERBAL AND HAVE 2866 01:49:18,360 --> 01:49:22,560 OTHER COGNITIVE ISSUES SO JUST A 2867 01:49:22,560 --> 01:49:24,520 PLUG THERE TO USE THE DATA WE 2868 01:49:24,520 --> 01:49:28,440 CAN AND USE IT WISELY. 2869 01:49:28,440 --> 01:49:28,840 >>THANK YOU. 2870 01:49:28,840 --> 01:49:30,080 I SEE THERE ARE A FEW MORE 2871 01:49:30,080 --> 01:49:32,240 COMMENTS IN THE CHAT. 2872 01:49:32,240 --> 01:49:34,040 FEEL FREE IF YOU HAVE ADDITIONAL 2873 01:49:34,040 --> 01:49:36,120 THOUGHTS TO ADD THOSE THERE, 2874 01:49:36,120 --> 01:49:38,080 LIPPEDDA AND JANE, I WONDER JUST 2875 01:49:38,080 --> 01:49:40,720 CONSIDERING, YOU KNOW YOU HAVE 2876 01:49:40,720 --> 01:49:43,720 THE--ABOUT AN HOUR LEFT FOR A 2877 01:49:43,720 --> 01:49:45,400 FEW MORE CONCEPTS AND 2878 01:49:45,400 --> 01:49:46,560 DISCUSSION, WOULD IT MAKE MORE 2879 01:49:46,560 --> 01:49:48,480 SENSE TO KIND OF GO THROUGH WHAT 2880 01:49:48,480 --> 01:49:51,040 THE CONCEPTS AND THEN JUST HOLD 2881 01:49:51,040 --> 01:49:52,480 A BIG DISCUSSION AT THE END SO 2882 01:49:52,480 --> 01:49:56,560 THAT WE'RE NOT INTERRUPTING OR 2883 01:49:56,560 --> 01:50:07,080 TRYING TO SWITCH GEARS TOO MANY 2884 01:50:07,400 --> 01:50:07,520 TIMES? 2885 01:50:07,520 --> 01:50:08,760 >>THAT'S FINE WITH ME, I KNOW 2886 01:50:08,760 --> 01:50:10,360 WE WILL BE TIGHT ON TIME SO 2887 01:50:10,360 --> 01:50:11,560 MAYBE THE DISCUSSION AT THE END 2888 01:50:11,560 --> 01:50:12,760 WILL BE A GOOD THING. 2889 01:50:12,760 --> 01:50:14,080 >>OKAY, SO WHY DON'T WE GO TO 2890 01:50:14,080 --> 01:50:15,040 THE NEXT SLIDE THEN AND I WILL 2891 01:50:15,040 --> 01:50:18,440 START IN ON THE NEXT 1. 2892 01:50:18,440 --> 01:50:21,960 >>SO THIS 1 IS ON EXPANDING THE 2893 01:50:21,960 --> 01:50:26,280 CLINICAL PAIN WORK HORSE IN THIS 2894 01:50:26,280 --> 01:50:28,160 A LEVEL OF TRAINING AS FAR AS 2895 01:50:28,160 --> 01:50:32,760 CAREER STAGE GOES THAT WE 2896 01:50:32,760 --> 01:50:34,200 HAVEN'T CORED BEFORE, THE NEED 2897 01:50:34,200 --> 01:50:36,600 TO BRING IN AND KEEP CLINICAL 2898 01:50:36,600 --> 01:50:37,640 PAIN RESEARCHERS HAS BEEN A 2899 01:50:37,640 --> 01:50:43,080 CONCERN FOR QUITE A LONG TIME WE 2900 01:50:43,080 --> 01:50:45,000 DID A SURVEY ACROSS A NUMBER OF 2901 01:50:45,000 --> 01:50:51,360 PROFESSIONAL GROUPS AND LARGE 2902 01:50:51,360 --> 01:50:52,560 PROFESSIONAL MEETINGS OF PAIN 2903 01:50:52,560 --> 01:50:53,200 RESEARCHERS AND QUESTIONS ABOUT 2904 01:50:53,200 --> 01:50:54,360 WHY YOU'RE NOT DOING RESEARCH, 2905 01:50:54,360 --> 01:50:57,560 HOW YOU GOT INTO RESEARCH IF YOU 2906 01:50:57,560 --> 01:50:59,240 ARE DOING IT AND WHAT WAS 2907 01:50:59,240 --> 01:51:00,160 HELPFUL, WHAT DID YOU NEED FOR 2908 01:51:00,160 --> 01:51:03,880 SUPPORT TO STAY THERE. 2909 01:51:03,880 --> 01:51:09,200 AND SO WHAT WE FOUND WAS THAT 2910 01:51:09,200 --> 01:51:10,920 PROTECTED TIME WAS IMPORTANT FOR 2911 01:51:10,920 --> 01:51:12,680 PEOPLE WHO ARE MENTORING EARLY 2912 01:51:12,680 --> 01:51:17,400 TRAINING, YOUNGER AND EARLY 2913 01:51:17,400 --> 01:51:18,320 STAGE CAREERS IS IMPORTANT AND 2914 01:51:18,320 --> 01:51:19,920 HEAL HAS A NUMBER OF DIFFERENT 2915 01:51:19,920 --> 01:51:23,840 PROGRAMS TO SUPPORT MENTORING 2916 01:51:23,840 --> 01:51:24,960 AND TO SUPPORT EARLY STAGE 2917 01:51:24,960 --> 01:51:26,600 CAREER RESEARCHERS IN THE 2918 01:51:26,600 --> 01:51:27,280 CLINICAL PAIN WORKFORCE. 2919 01:51:27,280 --> 01:51:28,800 BUT WHAT WOE DON'T HAVE SO FAR 2920 01:51:28,800 --> 01:51:31,440 AND WHAT WE'VE BEEN TOLD BY THE 2921 01:51:31,440 --> 01:51:32,400 COMMUNITY IS WHERE WE REALLY 2922 01:51:32,400 --> 01:51:36,240 NEED TO START IS WITH THE 2923 01:51:36,240 --> 01:51:37,800 FELLOWS AT THEIR--POST DOCTORAL 2924 01:51:37,800 --> 01:51:38,960 FELLOWS AT THEIR LEVEL OF CAREER 2925 01:51:38,960 --> 01:51:40,520 STAGE AND SO THIS 1 IS A LITTLE 2926 01:51:40,520 --> 01:51:47,240 BIT OF A UNIQUE TYPE OF A 2927 01:51:47,240 --> 01:51:47,760 TRAINING MENTORS PROGRAM. 2928 01:51:47,760 --> 01:51:48,360 TARGETING SYSTEM GETTED TO 2929 01:51:48,360 --> 01:51:49,000 PEOPLE AT THAT CLINICAL STAGE 2930 01:51:49,000 --> 01:51:51,320 WHO HAVE A DEGREE OR ARE LOOKING 2931 01:51:51,320 --> 01:51:54,560 TO DO CLINICAL RESEARCH FROM THE 2932 01:51:54,560 --> 01:51:55,320 POST DOCS FORWARD. 2933 01:51:55,320 --> 01:51:57,960 SO THE GOAL IS TO BRING IN A 2934 01:51:57,960 --> 01:52:02,800 DIVERSE POOL OF HIGHLY TRAINED 2935 01:52:02,800 --> 01:52:05,200 SCIENTISTS TO EXPAND OUR 2936 01:52:05,200 --> 01:52:05,840 DISCIPLINARY MIN ISSUING 2937 01:52:05,840 --> 01:52:07,200 RESEARCH IN SPITE OF THE FUNDS 2938 01:52:07,200 --> 01:52:09,200 WE GOT AND THE WONDERFUL WORK 2939 01:52:09,200 --> 01:52:10,840 THAT CAN BE DONE THROUGH HEAL, 2940 01:52:10,840 --> 01:52:12,400 WE'RE NOT EXPANDING OR EVEN 2941 01:52:12,400 --> 01:52:13,320 MAINTAINING OR RESEARCH 2942 01:52:13,320 --> 01:52:14,600 WORKFORCE AT THIS POINT. 2943 01:52:14,600 --> 01:52:16,560 SO IT'S A POST DOC TRAINING 2944 01:52:16,560 --> 01:52:17,680 PROGRAM, USING A MECHANISM 2945 01:52:17,680 --> 01:52:20,360 THAT'S A LITTLE BIT UNUSUAL 2946 01:52:20,360 --> 01:52:22,320 BECAUSE IT GIVES SUPPORT FOR 2947 01:52:22,320 --> 01:52:23,840 PROTECTED TIME FROM MENTORS AND 2948 01:52:23,840 --> 01:52:28,720 ALSO SUPPORT TO THE TRAINEES IT 2949 01:52:28,720 --> 01:52:30,800 BRINGS THE TRAINEES IN AND KEEPS 2950 01:52:30,800 --> 01:52:32,240 THEM TOGETHER OVERTIME AS A 2951 01:52:32,240 --> 01:52:32,680 COHORT. 2952 01:52:32,680 --> 01:52:37,400 SO THE IDEA HERE IS TO CREATE 2953 01:52:37,400 --> 01:52:39,960 THIS TEAM WORK AND POTENTIAL 2954 01:52:39,960 --> 01:52:40,560 LONG-TERM COLLABORATIONS AND 2955 01:52:40,560 --> 01:52:43,000 ALSO TO TIE THOSE COHORTS INTO 2956 01:52:43,000 --> 01:52:44,680 SOME OTHER PROGRAMS THAT WE'RE 2957 01:52:44,680 --> 01:52:45,520 ALREADY DOING THROUGH HEAL WHICH 2958 01:52:45,520 --> 01:52:47,880 I THINK IS A REALLY IMPORTANT 2959 01:52:47,880 --> 01:52:57,640 COMPONENT OF THIS PARTICULAR 2960 01:52:57,640 --> 01:52:58,000 CONCEPT. 2961 01:52:58,000 --> 01:53:01,080 WE HAVE A HEAL EARLY NETWORKING 2962 01:53:01,080 --> 01:53:03,000 PLATFORM, FOR EARLY STAGE 2963 01:53:03,000 --> 01:53:04,720 INVESTIGATORS TO HOLD AN ANNUAL 2964 01:53:04,720 --> 01:53:06,880 MEETING, BRING THEM TOGETHER, 2965 01:53:06,880 --> 01:53:08,160 COLLABORATE, FIND MENTORS, GET 2966 01:53:08,160 --> 01:53:10,360 TRAINING AND ALSO TIES THAT IN 2967 01:53:10,360 --> 01:53:11,440 TOGETHER WITH A K12 AT THE 2968 01:53:11,440 --> 01:53:12,560 NATIONAL LEVEL WHICH HAS BEEN 2969 01:53:12,560 --> 01:53:17,200 SET EPIGENETIC AT THE UNIVERSITY 2970 01:53:17,200 --> 01:53:18,720 OF MICHIGAN FOR EARLY STAGE 2971 01:53:18,720 --> 01:53:19,640 CAREER TRAINEES THAT DON'T COME 2972 01:53:19,640 --> 01:53:21,280 FROM UNIVERSITY OF MICHIGAN BUT 2973 01:53:21,280 --> 01:53:22,360 COME FROM NATIONWIDE PROGRAMS. 2974 01:53:22,360 --> 01:53:25,040 SO THIS IS REALLY TIED INTO OUR 2975 01:53:25,040 --> 01:53:26,160 OTHER PROGRAMS TO REALLY WORK 2976 01:53:26,160 --> 01:53:28,080 HARD AND HIT ALL THE LEVELS OF 2977 01:53:28,080 --> 01:53:29,680 EARLY STAGE CAREERS THAT WE NEED 2978 01:53:29,680 --> 01:53:34,520 TO BUILD AND KEEP THIS 2979 01:53:34,520 --> 01:53:34,800 WORKFORCE. 2980 01:53:34,800 --> 01:53:36,080 THE OTHER THING THAT'S IMPORTANT 2981 01:53:36,080 --> 01:53:37,760 ABOUT THIS CONCEPT IS NOT ONLY 2982 01:53:37,760 --> 01:53:41,000 IS THE APPLICANT INSTITUTION 2983 01:53:41,000 --> 01:53:43,160 REQUIRED TO OFFER TRAINING IN A 2984 01:53:43,160 --> 01:53:45,880 TRADITIONAL AREA OF PAIN 2985 01:53:45,880 --> 01:53:47,960 RESEARCH, SO, YOU KNOW SORT OF 2986 01:53:47,960 --> 01:53:49,680 THE THINGS THAT ANESTHESIOLOGY 2987 01:53:49,680 --> 01:53:54,440 OR YOU KNOW WHATEVER WE ARE 2988 01:53:54,440 --> 01:53:55,680 CURRENTLY TRAINING IN BUT IT 2989 01:53:55,680 --> 01:54:00,560 ALSO HAS TO FOCUS ON 2990 01:54:00,560 --> 01:54:01,480 BIOPSYCHOSOCIAL MODEL, AND HAS 2991 01:54:01,480 --> 01:54:03,320 REQUIREMENTS FOR DATA SCIENCE, 2992 01:54:03,320 --> 01:54:08,880 ET CETERA, THE OTHER PART OF THE 2993 01:54:08,880 --> 01:54:10,400 TRAINING PROGRAM THEY HAVE TO 2994 01:54:10,400 --> 01:54:11,880 PARTNER WITH A DIFFERENT 2995 01:54:11,880 --> 01:54:13,920 DEPARTMENT IN A TRADITIONAL 2996 01:54:13,920 --> 01:54:14,760 NONPAIN RESEARCH AREA. 2997 01:54:14,760 --> 01:54:15,760 SO PAIN RESEARCHERS NEED TO KNOW 2998 01:54:15,760 --> 01:54:18,640 AND WE NEED TO BRING INTO THE 2999 01:54:18,640 --> 01:54:20,800 FIELD ENGINEERS, ADDICTION 3000 01:54:20,800 --> 01:54:23,760 MEDICINE, PUBLIC HEALTH 3001 01:54:23,760 --> 01:54:24,600 SPECIALISTS, MENTAL HEALTH 3002 01:54:24,600 --> 01:54:28,200 SPECIALISTS SO THIS THING, THIS 3003 01:54:28,200 --> 01:54:28,920 PARTICULAR MECHANISM WOULD TIE 3004 01:54:28,920 --> 01:54:31,440 IN WHAT WE THINK OF HAS 3005 01:54:31,440 --> 01:54:32,400 TRADITIONAL PAIN RESEARCH 3006 01:54:32,400 --> 01:54:34,320 MENTORING SITUATIONS AND OTHER 3007 01:54:34,320 --> 01:54:37,760 TYPES AND SO REALLY TO CREATE A 3008 01:54:37,760 --> 01:54:40,520 MORE INTERDISCIPLINARY MORE 3009 01:54:40,520 --> 01:54:42,840 BROADLY TRAINED COHORT. 3010 01:54:42,840 --> 01:54:46,520 AND, THE LAST THING THAT IS A 3011 01:54:46,520 --> 01:54:49,120 LITTLE BIT UNIQUE HERE OVER 3012 01:54:49,120 --> 01:54:50,240 REGULAR T TRIEP TRAINING 3013 01:54:50,240 --> 01:54:52,040 MECHANISM IS THAT WE CAN FUND, 3014 01:54:52,040 --> 01:54:55,720 WE CAN SUPPORT TRAINEES WHO ARE 3015 01:54:55,720 --> 01:54:57,680 U.S. CITIZEN AND WE CAN ALSO 3016 01:54:57,680 --> 01:54:59,000 SUPPORT TRAINEES WHO ARE 3017 01:54:59,000 --> 01:54:59,880 FOREIGNERS AND WOULD LIKE TO 3018 01:54:59,880 --> 01:55:03,040 STAY IN THE COUNTRY AND DO PAIN 3019 01:55:03,040 --> 01:55:04,560 RESEARCH, SO THAT'S AN UNUSUAL 3020 01:55:04,560 --> 01:55:04,840 SITUATION. 3021 01:55:04,840 --> 01:55:09,520 AND THE NEXT SLIDE. 3022 01:55:09,520 --> 01:55:10,800 GIVINGS A LITTLE BIT OF A SENSE 3023 01:55:10,800 --> 01:55:12,880 OF HOW THIS WILL ALIGN WITH 3024 01:55:12,880 --> 01:55:15,080 OTHER HEAL PROGRAMS AND I 3025 01:55:15,080 --> 01:55:21,960 MENTIONED THESE BRIEFLY BUT THE 3026 01:55:21,960 --> 01:55:26,800 NETWORKING PROGRAM WHICH IS 3027 01:55:26,800 --> 01:55:29,760 CALLED PURPOSE, POSITIVELY UNITE 3028 01:55:29,760 --> 01:55:36,800 BE RESEARCHERS TO PROPOSE AND 3029 01:55:36,800 --> 01:55:38,920 PAIN, THAT'S WHERE WE CALL IT 3030 01:55:38,920 --> 01:55:40,120 PURPOSE, THE ANNUAL MEETING WILL 3031 01:55:40,120 --> 01:55:40,920 COME UP THIS SPRING AND THE FOLK 3032 01:55:40,920 --> 01:55:42,560 WHO IS ARE IN THE TYPES OF 3033 01:55:42,560 --> 01:55:43,480 RESEARCH PROGRAMS THAT WE HAVE 3034 01:55:43,480 --> 01:55:45,360 WILL BE REQUIRED TO COME, 3035 01:55:45,360 --> 01:55:46,880 THERE'S FUNDING TO SUPPORT THEM, 3036 01:55:46,880 --> 01:55:49,640 TO GET THEM THERE, AND THEY CAN 3037 01:55:49,640 --> 01:55:54,640 ENGAGE IN A LOT OF DIFFERENT 3038 01:55:54,640 --> 01:55:55,480 NETWORKING TRAINING PROGRAMS 3039 01:55:55,480 --> 01:55:56,640 THROUGH INTEGRATION WITH THAT 3040 01:55:56,640 --> 01:55:59,280 NETWORK AND THE K12 THAT I 3041 01:55:59,280 --> 01:56:00,720 MENTIONED WILL HELP WITH SOME 3042 01:56:00,720 --> 01:56:02,280 TRAINING RESOURCES BUT AGAIN, 3043 01:56:02,280 --> 01:56:04,800 THIS IS REALLY TO BROADLY ENGAGE 3044 01:56:04,800 --> 01:56:06,760 PEOPLE ACROSS THE DIFFERENT HEAL 3045 01:56:06,760 --> 01:56:10,760 PROGRAMS TO SUPPORT TRAINEES AND 3046 01:56:10,760 --> 01:56:16,000 MENTORS SO THE NEXT SLIDE, 3047 01:56:16,000 --> 01:56:16,880 QUESTIONS AND PERHAPS WE WILL 3048 01:56:16,880 --> 01:56:19,320 JUST COME BACK TO THESE AT THE 3049 01:56:19,320 --> 01:56:29,400 END, AND MOVE ON TO THE NEXT 1, 3050 01:56:29,400 --> 01:56:31,200 SO I'M REALLY CHANGING GEARS ON 3051 01:56:31,200 --> 01:56:31,760 THIS SLIDE. 3052 01:56:31,760 --> 01:56:33,120 SO CAN WE REMEMBER THAT, AND 3053 01:56:33,120 --> 01:56:33,840 MOVE FORWARD. 3054 01:56:33,840 --> 01:56:38,560 WE TALKED ON THE EARLIER PART OF 3055 01:56:38,560 --> 01:56:39,840 THIS PRESENTATION, ABOUT THE 3056 01:56:39,840 --> 01:56:41,240 BIOMARKER PROGRAM AND THE 3057 01:56:41,240 --> 01:56:42,720 DIFFERENT STAGES OF EVOLUTION, 3058 01:56:42,720 --> 01:56:46,360 THE HEAL PAIN BIOMARKER PROGRAM 3059 01:56:46,360 --> 01:56:47,880 HAS GONE THROUGH, THOSE ARE 3060 01:56:47,880 --> 01:56:52,080 STILL ACTIVE, THIS WOULD BE AN 3061 01:56:52,080 --> 01:56:55,960 ADDITIONAL--A DIFFERENT APPROACH 3062 01:56:55,960 --> 01:57:00,560 TO BIOMARKERS TO DEVELOP 3063 01:57:00,560 --> 01:57:02,800 WEARABLE DEVICES TO PULL 3064 01:57:02,800 --> 01:57:04,880 OBJECTIVE BIOSIGNATURES NATURES 3065 01:57:04,880 --> 01:57:07,600 OR FUNCTIONAL ASSESSMENTS FOR 3066 01:57:07,600 --> 01:57:09,240 MONITORING PAIN AND END POINTS 3067 01:57:09,240 --> 01:57:11,080 IN PAIN CLINICAL TRIALS. 3068 01:57:11,080 --> 01:57:13,400 SO, WE KNOW THAT WEARABLE 3069 01:57:13,400 --> 01:57:16,640 DEVICES ARE BEING USED IN 3070 01:57:16,640 --> 01:57:18,080 CLINICAL SETTINGS AND 3071 01:57:18,080 --> 01:57:18,920 [INDISCERNIBLE], I DON'T THINK 3072 01:57:18,920 --> 01:57:21,280 WE HAVE A GOOD SENSE OF WHICH 1S 3073 01:57:21,280 --> 01:57:23,120 ARE SENSITIVE, WHICH 1S ARE WELL 3074 01:57:23,120 --> 01:57:25,640 VALIDATED AND HAVE BEEN WELL 3075 01:57:25,640 --> 01:57:30,520 EXPLORED AS USEFUL TOOLS, SO 3076 01:57:30,520 --> 01:57:34,160 THIS--THIS PROGRAM WILL APPROACH 3077 01:57:34,160 --> 01:57:37,600 THAT, THOSE--THOSE NEEDS AND SO, 3078 01:57:37,600 --> 01:57:40,200 IT'S--A COMBINATION OF MEASURES 3079 01:57:40,200 --> 01:57:43,200 DEVELOPMENT OF THESE TOOLS, TO 3080 01:57:43,200 --> 01:57:45,640 DO FUNCTIONAL ASSESSMENTS SO 3081 01:57:45,640 --> 01:57:47,400 THESE MIGHT BE FUNCTIONAL 3082 01:57:47,400 --> 01:57:51,240 MEASURES OF ACTIVITY, OR SLEEP, 3083 01:57:51,240 --> 01:57:53,480 OR OTHER THINGS, THAT WOULD BE 3084 01:57:53,480 --> 01:57:55,200 IMPORTANT IN MONITORING PAIN 3085 01:57:55,200 --> 01:57:58,800 DURING A TRIAL, OR IN THE 3086 01:57:58,800 --> 01:58:01,040 CLINICAL CENTER, ULTIMATELY AND 3087 01:58:01,040 --> 01:58:04,920 ALSO, TO DEVELOP BIOMARKERS 3088 01:58:04,920 --> 01:58:06,360 SIGNATURES FROM PHYSIOLOGICAL 3089 01:58:06,360 --> 01:58:10,520 MEASURES THAT CAN BE TAKEN FROM 3090 01:58:10,520 --> 01:58:13,440 DIFFERENT WEARABLE DEVICES, AND 3091 01:58:13,440 --> 01:58:14,640 SO THERE'S BEENs SOME WORK 3092 01:58:14,640 --> 01:58:20,360 DONE IN THAT ARENA IN THE BACP A 3093 01:58:20,360 --> 01:58:23,240 C PROGRAM THAT LOOKS PROMISING 3094 01:58:23,240 --> 01:58:24,840 AND THAT WOULD OPEN UP THAT TOOL 3095 01:58:24,840 --> 01:58:25,960 OR RESOURCE DEVELOPMENT TO OTHER 3096 01:58:25,960 --> 01:58:27,640 DIFFERENT TYPES OF PAIN 3097 01:58:27,640 --> 01:58:28,080 CONDITIONS. 3098 01:58:28,080 --> 01:58:30,120 SO THE OVERALL OBJECTIVE IS TO 3099 01:58:30,120 --> 01:58:37,960 BE ABLE TO USE THESE TOOLS BOTH 3100 01:58:37,960 --> 01:58:40,360 THE BI OR MARKERS AND MEASURES 3101 01:58:40,360 --> 01:58:41,640 TO ENHANCE THE TRIALS AND 3102 01:58:41,640 --> 01:58:43,960 ENHANCE IT IS LIKELY SUCCESS OF 3103 01:58:43,960 --> 01:58:46,920 TRIALS AND ALSO TO FARRINGET 3104 01:58:46,920 --> 01:58:47,800 SPECIFIC INTERVENTIONS TO 3105 01:58:47,800 --> 01:58:49,000 PATIENTS, AND AGAIN THIS WAS 3106 01:58:49,000 --> 01:58:54,400 WHAT THE BEST TRIAL IS LAUNCHING 3107 01:58:54,400 --> 01:58:56,280 TO DO FOR BACP A C. 3108 01:58:56,280 --> 01:58:59,800 AND THE DELIVERABLES FOR THE 3109 01:58:59,800 --> 01:59:02,960 PROGRAM WILL BE VALIDATED DEVICE 3110 01:59:02,960 --> 01:59:04,680 DIVIDED BIOSIGNATTURES TO,A 3111 01:59:04,680 --> 01:59:05,880 ASSESSES THERAPEUTICS AND 3112 01:59:05,880 --> 01:59:07,520 IDENTIFY NEW CLINICAL END 3113 01:59:07,520 --> 01:59:08,480 POINTS, THE PRODUCTS WILL 3114 01:59:08,480 --> 01:59:09,760 INCLUDE NOT ONLY THE DEVELOPMENT 3115 01:59:09,760 --> 01:59:12,520 OF THOSE DEVICES BUT THE ALGOGHT 3116 01:59:12,520 --> 01:59:16,840 RIM IMPEDIMENTSS AND THE 3117 01:59:16,840 --> 01:59:17,640 SOFTWARE TO--ALGORITHMS TO 3118 01:59:17,640 --> 01:59:19,040 ANALYZE THE DATA THAT CAN BE 3119 01:59:19,040 --> 01:59:20,680 TAKE KNOW TO USE THESE DEVICES 3120 01:59:20,680 --> 01:59:22,320 AND THAT'S OFTEN A VERY 3121 01:59:22,320 --> 01:59:23,240 CHALLENGING AREA BECAUSE IT CAN 3122 01:59:23,240 --> 01:59:27,480 BE A LOT OF DATA OVER A LONG 3123 01:59:27,480 --> 01:59:28,040 PERIOD OF TIME. 3124 01:59:28,040 --> 01:59:29,840 SO THE NEXT 1 I THINK IS THE 1 3125 01:59:29,840 --> 01:59:34,240 THAT HOW THIS IS SUPPLYING IS 3126 01:59:34,240 --> 01:59:36,280 THESE PROGRAMS AND THEY 3127 01:59:36,280 --> 01:59:37,800 HAVE--THE POTENTIAL TO USE THESE 3128 01:59:37,800 --> 01:59:43,120 DEVICES IN OUR PHASE 2 EPPIC-NET 3129 01:59:43,120 --> 01:59:43,440 STUDIES. 3130 01:59:43,440 --> 01:59:44,600 THEY'VE BEEN TALKING THE 3131 01:59:44,600 --> 01:59:47,280 DEVELOPERS OF THE CONCEPT WITH 3132 01:59:47,280 --> 01:59:49,040 THE BACPARKS AC PROGRAM, THEY'RE 3133 01:59:49,040 --> 01:59:49,840 DOING SENSOR TECHNOLOGY 3134 01:59:49,840 --> 01:59:52,640 DEVELOPMENT AND WITH AN AIM 3135 01:59:52,640 --> 01:59:53,840 TOWARDS OBJECTIVE BIOSIGNATTURES 3136 01:59:53,840 --> 01:59:55,000 OR ASSESSMENTS OF END POINTS AND 3137 01:59:55,000 --> 01:59:57,040 THEY'VE TALKED TO A NUMBER OF 3138 01:59:57,040 --> 01:59:59,720 SMALL FORM SUITICAL COMPANIES, 3139 01:59:59,720 --> 02:00:01,120 BIOTECH COMPANIES, THE 3140 02:00:01,120 --> 02:00:05,600 SBIRR PROGRAM HAS SOME OF THESE 3141 02:00:05,600 --> 02:00:07,560 DEVICES POTENTIA WILY, POTENTIAL 3142 02:00:07,560 --> 02:00:09,080 DEVICES GOING INTO DEVELOPMENT 3143 02:00:09,080 --> 02:00:11,280 THROUGH THOSE PROGRAMS AS WELL. 3144 02:00:11,280 --> 02:00:14,280 WORKING CLOSELY WITH NIBIB, 3145 02:00:14,280 --> 02:00:17,160 ALSO. 3146 02:00:17,160 --> 02:00:18,440 >>OKAY, SO I THINK IF WE CAN 3147 02:00:18,440 --> 02:00:19,880 JUST GO TO THE NEXT SLIDE, WE 3148 02:00:19,880 --> 02:00:21,280 CAN LOOK QUICKLY AT THE 3149 02:00:21,280 --> 02:00:26,720 SELECTION QUESTIONS THAT WERE 3150 02:00:26,720 --> 02:00:28,240 DEVELOPED SO, INDUSTRY, 3151 02:00:28,240 --> 02:00:30,040 POTENTIALLY, WE WILL COME BACK 3152 02:00:30,040 --> 02:00:31,240 TO THESE, AND THEN HOW THE 3153 02:00:31,240 --> 02:00:33,640 INFORMATION CAN GET INTO THE 3154 02:00:33,640 --> 02:00:38,880 CLINICAL TRIALS AND INTO 3155 02:00:38,880 --> 02:00:39,880 PRACTICE AND WHAT STAKEHOLDERS 3156 02:00:39,880 --> 02:00:42,000 DO WE NEED TO ENGAGE? 3157 02:00:42,000 --> 02:00:43,160 AND SO LET'S KEEP THOSE IN THE 3158 02:00:43,160 --> 02:00:44,920 BACK OF YOUR MIND AND THAT WILL 3159 02:00:44,920 --> 02:00:46,520 HELPFULLY LEAD US TO THE NEXT 1 3160 02:00:46,520 --> 02:00:48,880 WHICH JANE WILL PRESENT WHICH IS 3161 02:00:48,880 --> 02:00:59,160 SLEEP AND PAIN. 3162 02:01:00,800 --> 02:01:03,600 >>THANK YOU OUR NEXT TOPIC IS 3163 02:01:03,600 --> 02:01:07,400 SLEEP AND CIRCADIAN RHYTHMS AS 3164 02:01:07,400 --> 02:01:09,440 INTERVENTION TARGETS FOR ACUTE 3165 02:01:09,440 --> 02:01:12,800 AND CHRONIC PAIN SYMPTOMATOLOGY, 3166 02:01:12,800 --> 02:01:13,800 PATHOBIOLOGY AND TREATMENT 3167 02:01:13,800 --> 02:01:16,040 RESPONSE, SO SLEEP DEFICIENCY IS 3168 02:01:16,040 --> 02:01:18,080 A FREQUENT CO-MORBIDITY IN ACUTE 3169 02:01:18,080 --> 02:01:19,080 CHRONIC PAIN CONDITIONS AND 3170 02:01:19,080 --> 02:01:21,440 EVIDENCE POINTS TO A 3171 02:01:21,440 --> 02:01:23,120 BI-DIRECTIONAL RELATIONSHIP 3172 02:01:23,120 --> 02:01:24,440 WHERE SLEEP DEFICIENCY 3173 02:01:24,440 --> 02:01:25,840 EXACERBATES PAIN SENSITIVITY AND 3174 02:01:25,840 --> 02:01:27,120 PAIN TRIGGERS SLEEP 3175 02:01:27,120 --> 02:01:27,440 DISPUSHANCES. 3176 02:01:27,440 --> 02:01:29,920 THIS CONCEPT WILL EXAMINE 3177 02:01:29,920 --> 02:01:32,360 INTERVENTIONS TARGETED AT SLEEP 3178 02:01:32,360 --> 02:01:34,000 AND CIRCADIAN DISTURBANCES TO 3179 02:01:34,000 --> 02:01:40,360 IMPROVE ACUTE AND CHRONIC PAIN 3180 02:01:40,360 --> 02:01:41,000 SYMPTOMATOLOGY, PATHOBIOLOGY AND 3181 02:01:41,000 --> 02:01:43,240 TREATMENT RESPONSE AND IT WILL 3182 02:01:43,240 --> 02:01:44,840 DELINEATE SLEEP AND CIRCADIAN 3183 02:01:44,840 --> 02:01:46,880 RHYTHMS AS DIRECT THERAPEUTIC 3184 02:01:46,880 --> 02:01:48,040 TARGETS TO IMPROVE OUTCOMES IN 3185 02:01:48,040 --> 02:01:53,520 INDIVIDUALS WITH ACUTE AND 3186 02:01:53,520 --> 02:01:57,120 CHRONIC PAIN CONDITIONS. 3187 02:01:57,120 --> 02:01:59,160 SO NEXT SLIDE. 3188 02:01:59,160 --> 02:02:04,200 SO THIS CONCEPT, FOCUSESSED ON 3189 02:02:04,200 --> 02:02:05,760 IDENTIFYING NOVEL INTERVENTION 3190 02:02:05,760 --> 02:02:07,280 TARGETS FOR ACUTE AND CHRONIC 3191 02:02:07,280 --> 02:02:08,800 PAIN CONDITIONS, IT SHOULD 3192 02:02:08,800 --> 02:02:09,840 ADVANCE OUR EVIDENCE BASE 3193 02:02:09,840 --> 02:02:11,240 STRATEGIES TO IMPROVE THE 3194 02:02:11,240 --> 02:02:13,800 EFFECTIVENESS OF PAIN TREATMENTS 3195 02:02:13,800 --> 02:02:15,600 AND CLINICAL OUTCOMES. 3196 02:02:15,600 --> 02:02:18,840 IT SHOULD CATALYZE CLINICAL 3197 02:02:18,840 --> 02:02:20,640 RESEARCH ON SLEEP AND CIRCADIAN 3198 02:02:20,640 --> 02:02:22,880 DISTURBANCES ON A PREVALENT CO 3199 02:02:22,880 --> 02:02:24,960 MORIT AND MAIN CONDITIONS THAT'S 3200 02:02:24,960 --> 02:02:26,560 NOT CURRENTLY WELL REPRESENTED 3201 02:02:26,560 --> 02:02:31,120 IN THE HEAL PAIN PORTFOLIO AND 3202 02:02:31,120 --> 02:02:33,560 IT ADDRESSES A POTENTIAL 3203 02:02:33,560 --> 02:02:36,720 INTERSECTION BETWEEN PAIN AND 3204 02:02:36,720 --> 02:02:43,400 OUD MISUSE, OPIOID MISUSE AND 3205 02:02:43,400 --> 02:02:44,080 OUD. 3206 02:02:44,080 --> 02:02:46,160 NEXT SLIDE. 3207 02:02:46,160 --> 02:02:47,640 SO WE HAVE SOME DISCUSSION 3208 02:02:47,640 --> 02:02:49,000 QUESTIONS, WE WOULD LIKE TO KNOW 3209 02:02:49,000 --> 02:02:51,160 HOW WE CAN ENCOURAGE NEW 3210 02:02:51,160 --> 02:02:52,120 INVESTIGATORS TO APPLY AND 3211 02:02:52,120 --> 02:02:54,080 INCREASE THE NUMBER OF 3212 02:02:54,080 --> 02:03:01,600 APPLICATIONS FROM SLEEP AND PAIN 3213 02:03:01,600 --> 02:03:02,080 RESEARCHERS. 3214 02:03:02,080 --> 02:03:04,520 IS THERE AN INDICATION OR ARE 3215 02:03:04,520 --> 02:03:05,760 THERE SPECIFIC COMPONENTS OR 3216 02:03:05,760 --> 02:03:07,760 MECHANISMS OF SLEEP THAT COULD 3217 02:03:07,760 --> 02:03:13,720 BE TARGETED FOR INTERVENTIONS? 3218 02:03:13,720 --> 02:03:15,840 SO THOSE WERE OUR DISCUSSION 3219 02:03:15,840 --> 02:03:16,400 QUESTIONS. 3220 02:03:16,400 --> 02:03:18,640 WE WOULD LIKE TO FOCUS ON DURING 3221 02:03:18,640 --> 02:03:21,240 OUR DITION CUSHION SESSION. 3222 02:03:21,240 --> 02:03:23,080 --DISCUSSION SESSION. 3223 02:03:23,080 --> 02:03:23,800 DISCLOSURE FRAMEWORK PROJECT. 3224 02:03:23,800 --> 02:03:28,280 SO LINDA I THINK IT'S BACK TO 3225 02:03:28,280 --> 02:03:28,440 YOU. 3226 02:03:28,440 --> 02:03:30,040 >>YES, SO WE HAVE 1 MORE TO 3227 02:03:30,040 --> 02:03:31,560 PRESENT AND THEN WE CAN GO ON TO 3228 02:03:31,560 --> 02:03:39,000 OPEN UP FOR QUESTIONS, NEXT 3229 02:03:39,000 --> 02:03:39,200 SLIDE. 3230 02:03:39,200 --> 02:03:41,720 THIS IS A PROGRAM THAT YOU 3231 02:03:41,720 --> 02:03:43,120 SHOULD BE SOMEWHAT FAMILIAR WITH 3232 02:03:43,120 --> 02:03:45,440 BECAUSE IT'S A PROGRAM THAT DID 3233 02:03:45,440 --> 02:03:49,600 LAUNCH FOR 2022 AND DEVELOPING 3234 02:03:49,600 --> 02:03:51,000 TEAM--DEVELOPMENT TEAM IS 3235 02:03:51,000 --> 02:03:54,240 LOOKING TO MAKE SLIGHT CHANGES 3236 02:03:54,240 --> 02:03:58,000 AND ASK FOR REISSUE OF THIS 3237 02:03:58,000 --> 02:04:01,960 CONCEPT THROUGH A LATER FOA IF 3238 02:04:01,960 --> 02:04:07,240 YOU WILL TO ADD ON TO AREAS, ADD 3239 02:04:07,240 --> 02:04:08,800 IN AREAS WHERE THAT WEREN'T 3240 02:04:08,800 --> 02:04:10,680 NECESSARILY COVERED BY THE FIRST 3241 02:04:10,680 --> 02:04:11,920 ROUND OF APPLICATIONS SO LET ME 3242 02:04:11,920 --> 02:04:13,520 BACK UP A LITTLE BIT AND GO 3243 02:04:13,520 --> 02:04:17,200 THROUGH THE GOALS OF THIS. 3244 02:04:17,200 --> 02:04:21,240 MY'S FACIAL PAIN AND BIOMARKERS 3245 02:04:21,240 --> 02:04:25,160 OR IMAGING TOOLS TO MEASURE 3246 02:04:25,160 --> 02:04:26,800 NORMAL CHARACTERISTICS AND 3247 02:04:26,800 --> 02:04:30,480 FEATURES OF MY O FACIAL TISSUES, 3248 02:04:30,480 --> 02:04:32,040 SO THE MUSCLE, THE FACIAL 3249 02:04:32,040 --> 02:04:33,480 INTERFACE AND THE ASSOCIATED 3250 02:04:33,480 --> 02:04:35,840 TISSUES ARE SOMETHING THAT WE 3251 02:04:35,840 --> 02:04:37,360 REALLY HAVEN'T TACKLED BEFORE 3252 02:04:37,360 --> 02:04:41,080 DESPITE THE FACT THAT MYOFACIAL 3253 02:04:41,080 --> 02:04:42,720 PAIN IS PROBABLY A UNDERLYING 3254 02:04:42,720 --> 02:04:45,880 ISSUE FOR A NUMBER OF DIFFERENT 3255 02:04:45,880 --> 02:04:49,400 PAIN CONDITIONS, IT SEEMS LIKE 3256 02:04:49,400 --> 02:04:53,160 HEADACHE, BACK PAIN, TEMP ROMAN 3257 02:04:53,160 --> 02:04:54,880 DIBULAR JOINT DISORDER AND MANY 3258 02:04:54,880 --> 02:04:56,240 OTHERS, MY O FACIAL PAIN IS 3259 02:04:56,240 --> 02:04:59,920 PROBABLY 1 OF THE DRIVING FORCES 3260 02:04:59,920 --> 02:05:00,480 OF PAIN. 3261 02:05:00,480 --> 02:05:03,240 SO WE NEEDED BETTER WAYS TO 3262 02:05:03,240 --> 02:05:05,320 MEASURE THE CHARACTERISTICS OF 3263 02:05:05,320 --> 02:05:07,520 THE NEURONAL TISSUE, NORMAL MY O 3264 02:05:07,520 --> 02:05:09,880 FACIAL TISSUE AND INTERFACES, 3265 02:05:09,880 --> 02:05:15,160 AND ALSO TO LOOK AT TO FIND 3266 02:05:15,160 --> 02:05:17,720 TOOLS TO QUANTITATIVELY ASSESS, 3267 02:05:17,720 --> 02:05:20,760 WHAT--HOW THOSE STRUCTURES AND 3268 02:05:20,760 --> 02:05:22,360 PHYSIOLOGICAL CHANGES OCCUR 3269 02:05:22,360 --> 02:05:27,000 AFTER PAIN HAS SET IN, AND SO, 3270 02:05:27,000 --> 02:05:28,840 THE EARLY PROGRAM, THE FIRST 3271 02:05:28,840 --> 02:05:37,400 ITERATION OF THE MY O FACIAL 3272 02:05:37,400 --> 02:05:40,320 TISSUES, WITH 7 DIFFERENT AWARDS 3273 02:05:40,320 --> 02:05:46,360 AND THESE COVERED A RANGE OF 3274 02:05:46,360 --> 02:05:48,280 DIFFERENT TYPES OF PAIN BUT NOT 3275 02:05:48,280 --> 02:05:49,520 AS COMPREHENSIVE AS WE WOULD 3276 02:05:49,520 --> 02:05:51,920 HAVE LIKED SO THEY WERE FOCUSED 3277 02:05:51,920 --> 02:05:53,800 ON NECK AND BACK PAIN AND 3278 02:05:53,800 --> 02:05:55,400 SHOULDER PAIN AND THEY ALSO 3279 02:05:55,400 --> 02:05:58,400 COVERED A NUMBER OF DIFFERENT 3280 02:05:58,400 --> 02:06:00,280 EXCITING NEW TECHNOLOGIES, SO 3281 02:06:00,280 --> 02:06:01,440 THESE ARE QUANTITATIVE 3282 02:06:01,440 --> 02:06:03,400 ASSESSMENT TOOLS THAT WE'RE 3283 02:06:03,400 --> 02:06:06,280 LOOKING FOR THAT CONSERVE AS 3284 02:06:06,280 --> 02:06:09,080 PREDICTIVE BIOMARKERS OF MY O 3285 02:06:09,080 --> 02:06:09,920 FACIAL TISSUE CHANGES WITH 3286 02:06:09,920 --> 02:06:12,840 HEALTH TO HELP OUT IN TRIALS TO 3287 02:06:12,840 --> 02:06:15,760 HELP IN DEVELOPMENT OF NEW 3288 02:06:15,760 --> 02:06:19,960 THERAPEUTIC APPROACHES AND SO, 3289 02:06:19,960 --> 02:06:21,160 THE TECHNOLOGIES ARE 3290 02:06:21,160 --> 02:06:22,640 NONINVASIVE, THEY SPAN A NUMBER 3291 02:06:22,640 --> 02:06:27,640 OF DIFFERENT NOVEL AREAS, THAT'S 3292 02:06:27,640 --> 02:06:29,520 HELPED THIS PAIN SORT OF 3293 02:06:29,520 --> 02:06:30,560 IDENTIFY WHAT TECHNOLOGIES WILL 3294 02:06:30,560 --> 02:06:34,360 BE USEFUL IN THIS AREA, AND WHAT 3295 02:06:34,360 --> 02:06:37,520 1'S VIA INITIAL SET OF 3296 02:06:37,520 --> 02:06:39,360 APPLICATIONS DIDN'T ACTUALLY 3297 02:06:39,360 --> 02:06:44,640 COVER AND SO, THE KINDS OF 3298 02:06:44,640 --> 02:06:47,880 MEASURES, THE VISCOSITY, TISSUE 3299 02:06:47,880 --> 02:06:48,680 STIFFNESS, INFLAMMATION, 3300 02:06:48,680 --> 02:06:49,280 CIRCULATION, ADHESION, ET 3301 02:06:49,280 --> 02:06:50,920 CETERA, ET CETERA ARE THINGS 3302 02:06:50,920 --> 02:06:52,040 LIKE THAT DEALING WITH THAT IN 3303 02:06:52,040 --> 02:06:54,480 THE EARLY STUDIES BUT NOT ACROS 3304 02:06:54,480 --> 02:06:58,320 A NUMBER OF PAIN CONDITIONS AND 3305 02:06:58,320 --> 02:06:59,400 ARE PUBLIC COULD BENEFIT FROM 3306 02:06:59,400 --> 02:07:04,680 OTHER TECHNOLOGIES TO COME IN. 3307 02:07:04,680 --> 02:07:08,440 AND SO THE ASK IS FOR A REISSUE 3308 02:07:08,440 --> 02:07:11,120 AND THIS WOULD BE PRIORITIZING 3309 02:07:11,120 --> 02:07:17,440 THINGS LIKE TMD, AND HEADACHE, 3310 02:07:17,440 --> 02:07:18,240 PELVIC PAIN, PAIN CONDITIONS 3311 02:07:18,240 --> 02:07:19,800 THAT WERE NOT COVERED IN THE 3312 02:07:19,800 --> 02:07:21,720 FIRST ITERATION BUT CLEARLY 3313 02:07:21,720 --> 02:07:24,560 WOULD BE LINKED TO MY O FACIAL 3314 02:07:24,560 --> 02:07:24,920 PAIN. 3315 02:07:24,920 --> 02:07:26,400 AND AGAIN, SOME NEW TECHNOLOGIES 3316 02:07:26,400 --> 02:07:29,120 THAT COULD BE APPLICABLE TO THIS 3317 02:07:29,120 --> 02:07:33,200 PROGRAM SO THE NEXT SLIDE. 3318 02:07:33,200 --> 02:07:34,720 >>QUICK QUESTION, LINDA, DOES 3319 02:07:34,720 --> 02:07:36,880 THIS RULE OUT O. A.? 3320 02:07:36,880 --> 02:07:38,000 >>NO. 3321 02:07:38,000 --> 02:07:40,080 IT DOESN'T RULE OUT O. A. 3322 02:07:40,080 --> 02:07:42,400 >>BUT IT IS MY O FACIAL TISSUES 3323 02:07:42,400 --> 02:07:44,240 BUT I DON'T THINK ANYTHING'S 3324 02:07:44,240 --> 02:07:45,520 BEING RULED OUT AS LONG AS 3325 02:07:45,520 --> 02:07:47,240 THEY'RE LOOKING AT THE MY O 3326 02:07:47,240 --> 02:07:49,360 FACIAL INTERFACE RELATED TO O. 3327 02:07:49,360 --> 02:07:54,160 A. 3328 02:07:54,160 --> 02:07:55,000 >>OKAY, THANK YOU. 3329 02:07:55,000 --> 02:07:57,520 >>AND SO, HERE'S A LIST OF THE 3330 02:07:57,520 --> 02:07:58,680 DISCUSSION QUESTIONS THAT WE 3331 02:07:58,680 --> 02:08:01,200 THOUGHT WERE APPROPRIATE FOR THE 3332 02:08:01,200 --> 02:08:02,640 OPEN DISCUSSION WHICH MEANS, CAN 3333 02:08:02,640 --> 02:08:05,520 YOU GO 1 MORE SLIDE, I FEEL LIKE 3334 02:08:05,520 --> 02:08:09,280 THE ALIGNMENT 1 IS MISSING HERE. 3335 02:08:09,280 --> 02:08:13,360 NOPE, I GUESS NOT, IT'S JUST NOT 3336 02:08:13,360 --> 02:08:15,400 IN THE DECK, SO I THINK PERHAPS 3337 02:08:15,400 --> 02:08:19,120 AT THIS POINT THEN, WE CAN OPEN 3338 02:08:19,120 --> 02:08:19,800 FOR QUESTIONS. 3339 02:08:19,800 --> 02:08:22,000 JANE IS ON AND WE HAVE SOME OF 3340 02:08:22,000 --> 02:08:24,640 OUR DEVELOPMENT TEAM LEADS IN 3341 02:08:24,640 --> 02:08:26,840 THE AUDIENCE AS WELL. 3342 02:08:26,840 --> 02:08:28,520 SO JUST TO REMIND YOU, WE HAVE 3343 02:08:28,520 --> 02:08:30,400 THE KIDS 1, WHICH WE TALKED 3344 02:08:30,400 --> 02:08:32,480 ABOUT HERE A BIT, WE HAVE THE MY 3345 02:08:32,480 --> 02:08:35,480 O FACIAL PAIN, WE HAVE THE 3346 02:08:35,480 --> 02:08:36,040 WEARABLE DEVICES, WE'VE GOT 3347 02:08:36,040 --> 02:08:39,520 SLEEP AND WE HAVE THE WORKFORCE. 3348 02:08:39,520 --> 02:08:41,120 >>I FEEL LIKE WE SHOULD 3349 02:08:41,120 --> 02:08:42,520 STRUCTURE THIS IN SOME WAY, 3350 02:08:42,520 --> 02:08:44,760 THERE'S A LOT TO GET THROUGH. 3351 02:08:44,760 --> 02:08:48,600 RATHER THAN JUST LEAVING IT OPEN 3352 02:08:48,600 --> 02:08:49,000 TO EVERYTHING. 3353 02:08:49,000 --> 02:08:50,480 >>DO WE WANT TO START IN THE 3354 02:08:50,480 --> 02:08:50,680 ORDER. 3355 02:08:50,680 --> 02:08:53,480 >>LET'S START WITH WORKFORCE. 3356 02:08:53,480 --> 02:08:57,320 >>WELL THE'S GO IN ORDER. 3357 02:08:57,320 --> 02:08:58,520 >>I HAVE A QUESTION. 3358 02:08:58,520 --> 02:09:01,040 I THINK THAT'S A GREAT PROGRAM 3359 02:09:01,040 --> 02:09:06,320 AND A REALLY BIG GAP A REAL 3360 02:09:06,320 --> 02:09:07,200 OPPORTUNITY IN ALLOWING PEOPLE 3361 02:09:07,200 --> 02:09:10,000 WHO ARE NOT NIH ELIGIBLE TO 3362 02:09:10,000 --> 02:09:10,720 SERVE AS TRAINEES. 3363 02:09:10,720 --> 02:09:12,920 I WONDER A COUPLE THINGS WHAT'S 3364 02:09:12,920 --> 02:09:18,280 THE SCOPE OF NUMBER OF TRAINEES 3365 02:09:18,280 --> 02:09:18,840 PER SITE? 3366 02:09:18,840 --> 02:09:21,280 AND WITH RESPECT TO THE NONU.S. 3367 02:09:21,280 --> 02:09:23,240 CITIZEN QUESTION, IS THERE SOME 3368 02:09:23,240 --> 02:09:25,120 KIND OF A REQUIREMENT FOR THEM 3369 02:09:25,120 --> 02:09:28,440 TO STAY--I MEAN EXPECTATION FOR 3370 02:09:28,440 --> 02:09:31,120 THEM TO STAY OR IS THAT JUST NOT 3371 02:09:31,120 --> 02:09:32,440 RELEVANT BECAUSE IT'S STILL JUST 3372 02:09:32,440 --> 02:09:34,880 BROADLY A PAIN FOR THE CLINICAL 3373 02:09:34,880 --> 02:09:36,320 RESEARCH WORKFORCE? 3374 02:09:36,320 --> 02:09:42,920 >>YEAH, SO THE EXPECTED NUMBER, 3375 02:09:42,920 --> 02:09:45,040 THE HOPED FOR NUMBER WOULD BE 4 3376 02:09:45,040 --> 02:09:47,680 OR 5 TRAINEES AT EACH SITE AND 3377 02:09:47,680 --> 02:09:49,400 THEN THE THERE WOULD BE MENTORS 3378 02:09:49,400 --> 02:09:50,640 AND SO THE MENTORS GET A 3379 02:09:50,640 --> 02:09:51,840 PROTECTED TYPE AS WELL AND I 3380 02:09:51,840 --> 02:09:53,120 THINK THEY'RE LOOKING FOR A 3381 02:09:53,120 --> 02:09:55,600 RATIO OF 4 TO 1, SO 4 U.S. 3382 02:09:55,600 --> 02:09:58,720 CITIZEN TO 1 FOREIGN. 3383 02:09:58,720 --> 02:09:59,880 IT'S HARD, THE EXPECTATION IS 3384 02:09:59,880 --> 02:10:01,720 THAT WE WOULD HAVE PEOPLE WHO WE 3385 02:10:01,720 --> 02:10:05,920 HOPE WOULD STAY IN THE COUNTRY 3386 02:10:05,920 --> 02:10:08,360 AND BENEFIT OUR WORKFORCE 3387 02:10:08,360 --> 02:10:10,960 ENHANCEMENT BUT I'M NOT SURE HOW 3388 02:10:10,960 --> 02:10:15,120 EASY IT WOULD BE TO JUDGE THAT. 3389 02:10:15,120 --> 02:10:16,200 BUT IT IS SOMETHING WE WOULD 3390 02:10:16,200 --> 02:10:18,080 LOOK AT, IT WOULD HAVE TO BE 3391 02:10:18,080 --> 02:10:19,960 JUSTIFIED AS FAR AS--NOT 3392 02:10:19,960 --> 02:10:23,000 JUSTIFIED, THAT'S NOT THE RIGHT 3393 02:10:23,000 --> 02:10:24,480 WORD BUT, YOU KNOW I GUESS YOU 3394 02:10:24,480 --> 02:10:25,760 COULD COME UP WITH QUESTIONS FOR 3395 02:10:25,760 --> 02:10:26,840 THEM, HOW LONG HAVE YOU BEEN 3396 02:10:26,840 --> 02:10:30,320 HERE, HOW LONG TO YOU EXPECT TO 3397 02:10:30,320 --> 02:10:30,680 STAY, ET CETERA. 3398 02:10:30,680 --> 02:10:31,520 >>RHYME NOT SURE WHAT YOU CAN 3399 02:10:31,520 --> 02:10:33,200 DO TO PUT TEETH IN THAT BUT JUST 3400 02:10:33,200 --> 02:10:34,520 YOU'RE COULD YOU SAY WHAT IT 3401 02:10:34,520 --> 02:10:34,680 WAS. 3402 02:10:34,680 --> 02:10:35,480 I VERY MUCH SUPPORT THIS 3403 02:10:35,480 --> 02:10:35,720 PROGRAM. 3404 02:10:35,720 --> 02:10:39,480 I THINK THAT WOULD BE A HUGE 3405 02:10:39,480 --> 02:10:39,840 BENEFIT. 3406 02:10:39,840 --> 02:10:41,240 >>THANKS, RALPH. 3407 02:10:41,240 --> 02:10:42,800 ANYBODY ELSE ON THIS 1? 3408 02:10:42,800 --> 02:10:44,560 SHARON YOUR HAND IS UP. 3409 02:10:44,560 --> 02:10:45,400 >>YES, SO LINDA WHAT THOUGHT 3410 02:10:45,400 --> 02:10:49,720 HAVE YOU GIVEN TO THE MENTEE OR 3411 02:10:49,720 --> 02:10:57,360 THE TRAINEES WHO HAVE CLINICAL 3412 02:10:57,360 --> 02:10:58,640 DEGREES ALREADY, FROM QUHA 3413 02:10:58,640 --> 02:11:00,000 PROCESSIONS ARE YOU RECRUITING 3414 02:11:00,000 --> 02:11:02,000 OR HOW DO YOU DEFER THERE, YOU 3415 02:11:02,000 --> 02:11:04,120 DON'T WANT ALL PHYSICIANS, YOU 3416 02:11:04,120 --> 02:11:05,960 DON'T WANT 1 TYPE OF CLINICIAN. 3417 02:11:05,960 --> 02:11:07,840 >>YES, SO THIS WOULD HOPEFULLY 3418 02:11:07,840 --> 02:11:09,480 BE ACROSS THE RANGE AND THESE 3419 02:11:09,480 --> 02:11:10,440 ARE CLINICAL DEGREES. 3420 02:11:10,440 --> 02:11:14,080 SO, YOU CAN GO FROM 3421 02:11:14,080 --> 02:11:21,040 PSYCHOLOGISTS TO SOCIAL WORKERS, 3422 02:11:21,040 --> 02:11:23,120 EARLY STAGE--WHAT AM I MISSING 3423 02:11:23,120 --> 02:11:24,440 HORMONE SO ACROSS ALL 3424 02:11:24,440 --> 02:11:25,280 DISCIPLINES WOULD BE ELIGIBLE 3425 02:11:25,280 --> 02:11:28,240 BUT IT HAS TO BE AT THE POST DOC 3426 02:11:28,240 --> 02:11:29,680 FELLOWSHIP STAGE TO MAKE SURE 3427 02:11:29,680 --> 02:11:30,240 WE'RE GETTING REALLY EARLY 3428 02:11:30,240 --> 02:11:33,920 PEOPLE IN HERE AND IF WE GET A 3429 02:11:33,920 --> 02:11:36,080 NUMBER OF DIFFERENT AWARDS, THE 3430 02:11:36,080 --> 02:11:40,080 HOPE IS THAT WE WILL BE ACROSS A 3431 02:11:40,080 --> 02:11:42,120 NUMBER OF DIFFERENT TYPES OF 3432 02:11:42,120 --> 02:11:46,160 DISCIPLINES BUT ALSO BECAUSE 3433 02:11:46,160 --> 02:11:48,800 WE'RE ASKING FOR A PARTNERING 3434 02:11:48,800 --> 02:11:50,480 BETWEEN NONTRADITIONAL PAIN 3435 02:11:50,480 --> 02:11:54,280 AREA, WE HOPE WE CAN GET PEOPLE 3436 02:11:54,280 --> 02:11:56,320 IN WHO ARE ANTHROPOLOGISTS, 3437 02:11:56,320 --> 02:11:58,320 STATISTICIANS WHO ARE INTERESTED 3438 02:11:58,320 --> 02:12:00,920 IN CLINICAL RESEARCH AND 3439 02:12:00,920 --> 02:12:02,760 HOPEFULLY THIS KIND OF A 3440 02:12:02,760 --> 02:12:05,280 TRAINING PROGRAM WOULD GET THEM 3441 02:12:05,280 --> 02:12:07,360 INTERESTED, WOULD GET THEM 3442 02:12:07,360 --> 02:12:08,720 TRAINED AND HOPE THAT THEY WOULD 3443 02:12:08,720 --> 02:12:13,000 BE RETAINED AND MOVE FORWARD 3444 02:12:13,000 --> 02:12:14,040 INTO FURTHER AREAS. 3445 02:12:14,040 --> 02:12:15,040 AGAIN, NO GUARANTEES THEY'RE 3446 02:12:15,040 --> 02:12:16,880 GOING TO LEARN ALL THIS AND BE 3447 02:12:16,880 --> 02:12:21,120 MENTORED AND THEN MOVE INTO 3448 02:12:21,120 --> 02:12:22,040 SOMETHING COMPLETELY DIFFERENT. 3449 02:12:22,040 --> 02:12:22,320 >>RIGHT. 3450 02:12:22,320 --> 02:12:22,680 ONE THOUGHT. 3451 02:12:22,680 --> 02:12:24,240 IF YOU GO BACK TO YOUR SLIDE ON 3452 02:12:24,240 --> 02:12:26,680 NUMBER 41 WHERE YOU SHOWED ALL 3453 02:12:26,680 --> 02:12:28,320 OF THE SETTINGS IN WHICH 3454 02:12:28,320 --> 02:12:29,920 PATIENTS WITH PAIN OR CHRONIC 3455 02:12:29,920 --> 02:12:31,120 PAIN ARE SEEN, IT SEEMS LIKE YOU 3456 02:12:31,120 --> 02:12:35,120 WOULD WANT TO GET A DIVERSE 3457 02:12:35,120 --> 02:12:36,160 REPRESENTATION OF THOSE CLINICAL 3458 02:12:36,160 --> 02:12:36,480 PROFESSIONS. 3459 02:12:36,480 --> 02:12:39,600 IT'S ALL THE 1S THAT YOU NAMED 3460 02:12:39,600 --> 02:12:43,000 PLUS THE NURSES, THE PTs, 3461 02:12:43,000 --> 02:12:43,560 OTs, PSYCHOLOGISTS, CASE 3462 02:12:43,560 --> 02:12:45,200 MANAGERS AND SO FORTH SO THAT'S 3463 02:12:45,200 --> 02:12:52,960 JUST 1 THOUGHT AND IT'S--IT'S 3464 02:12:52,960 --> 02:12:54,240 IT'S TOUGH TO EMPELEMENT THAT 3465 02:12:54,240 --> 02:12:55,400 BECAUSE THE PATIENT INTERACTING 3466 02:12:55,400 --> 02:12:57,240 WITH ALL THESE PEOPLE, IT'S NOT 3467 02:12:57,240 --> 02:12:59,120 JUST THE PAIN ANESTHESIOLOGIST 3468 02:12:59,120 --> 02:12:59,680 AND SO FORTH. 3469 02:12:59,680 --> 02:13:03,920 THE OTHER THING IS TO TRY AND 3470 02:13:03,920 --> 02:13:06,280 AMPLIFY THIS INVESTMENT, CAN THE 3471 02:13:06,280 --> 02:13:11,960 TRAINEE THEN HAVE SOME SORT OF 3472 02:13:11,960 --> 02:13:13,120 OBLIGATION TO--DURING THE PERIOD 3473 02:13:13,120 --> 02:13:15,680 UNDER WHICH HE OR SHE IS COVERED 3474 02:13:15,680 --> 02:13:17,880 BY THE FELLOWSHIP, HAVE SOME 3475 02:13:17,880 --> 02:13:19,400 SORT OF OBLIGATION TO GO INTO 3476 02:13:19,400 --> 02:13:21,840 THE CLINIC OR GIVE LECTURES OR 3477 02:13:21,840 --> 02:13:26,040 TRAIN CLINICIANS FROM THESE 3478 02:13:26,040 --> 02:13:26,680 VARIOUS DISCIPLINES, BECAUSE, 3479 02:13:26,680 --> 02:13:28,280 YOU KNOW THE MESSAGE, WE HAVE TO 3480 02:13:28,280 --> 02:13:33,360 GET THE MESSAGE OUT TO THE FRONT 3481 02:13:33,360 --> 02:13:34,800 LINE CLINICIANS, STILL. 3482 02:13:34,800 --> 02:13:36,520 I MEAN ALAN RAISES A GREAT POINT 3483 02:13:36,520 --> 02:13:38,760 THAT WE DON'T HAVE LOSS OF 3484 02:13:38,760 --> 02:13:39,560 CLINICIAN REPRESENTATION ON 3485 02:13:39,560 --> 02:13:42,160 CERTAIN CONFERENCES ON PAIN, 3486 02:13:42,160 --> 02:13:43,680 THAT'S ABSOLUTELY TRUE. 3487 02:13:43,680 --> 02:13:45,400 PRIMARY CARE PROVIDERS PRACTICE 3488 02:13:45,400 --> 02:13:47,880 DOCS, ET CETERA, SO WITH THESE 3489 02:13:47,880 --> 02:13:49,480 MENTEES COULD AT LEAST THEN GO 3490 02:13:49,480 --> 02:13:51,120 OUT AS PART OF THEIR WORK 3491 02:13:51,120 --> 02:13:52,000 ASSIGNMENT AND ADDRESS THAT, 3492 02:13:52,000 --> 02:13:55,080 THAT WOULD BE A WONDERFUL 3493 02:13:55,080 --> 02:13:55,440 SERVICE. 3494 02:13:55,440 --> 02:13:56,840 >>YEAH, SO I REALLY LIKE THAT 3495 02:13:56,840 --> 02:13:59,200 IDEA, AND I THINK THAT'S 3496 02:13:59,200 --> 02:14:01,960 SOMETHING THAT WE COULD BUILD 3497 02:14:01,960 --> 02:14:04,240 INTO A FUNDING OPPORTUNITY 3498 02:14:04,240 --> 02:14:05,640 ANNOUNCEMENT THAT AT A CERTAIN 3499 02:14:05,640 --> 02:14:10,360 STAGE, AT THE END OF THEIR 3500 02:14:10,360 --> 02:14:12,000 TRAINING OR THEIR YEARS OR 3501 02:14:12,000 --> 02:14:13,440 WHATEVER THEY COULD FULFILL THAT 3502 02:14:13,440 --> 02:14:14,480 OBLIGATION, SO THAT'S A GREAT 3503 02:14:14,480 --> 02:14:14,760 IDEA. 3504 02:14:14,760 --> 02:14:17,040 AS FAR AS REACHING OUT TO FOLKS 3505 02:14:17,040 --> 02:14:19,680 WHO WOULD BE IN THESE DIFFERENT 3506 02:14:19,680 --> 02:14:22,320 SETTINGS, WHETHER IT'S PT, OT, 3507 02:14:22,320 --> 02:14:24,000 NURSING, DENTAL, ET CETERA, ET 3508 02:14:24,000 --> 02:14:25,400 CETERA, WE WILL HAVE WEBINARS, 3509 02:14:25,400 --> 02:14:26,920 AND WE WILL REACH OUT BROADLY TO 3510 02:14:26,920 --> 02:14:30,120 MAKE SURE THAT WE COVER THOSE 3511 02:14:30,120 --> 02:14:31,040 DIFFERENT DISCIPLINES, TO INVITE 3512 02:14:31,040 --> 02:14:32,600 THEM TO LISTEN TO THE WEBINAR 3513 02:14:32,600 --> 02:14:37,080 AND MAKE SURE THAT THE 3514 02:14:37,080 --> 02:14:38,080 FOA ANNOUNCEMENT GETS OUT THERE 3515 02:14:38,080 --> 02:14:41,160 AND I THINK AT SOME POINT POST 3516 02:14:41,160 --> 02:14:44,400 REVIEW WHEN WE LOOK AT OUR PAY 3517 02:14:44,400 --> 02:14:45,720 PLANS WE TRY TO BALANCE THE 3518 02:14:45,720 --> 02:14:47,040 AWARDS THAT ARE MADE AND MAKE 3519 02:14:47,040 --> 02:14:50,200 SURE THERE'S A GOOD DIVERSITY 3520 02:14:50,200 --> 02:14:50,920 THERE. 3521 02:14:50,920 --> 02:14:52,320 SO OTHER THINGS TO CONSIDER. 3522 02:14:52,320 --> 02:14:54,080 >>AND THEN THE LAST IDEA, YOU 3523 02:14:54,080 --> 02:14:56,280 KNOW ALAN'S VIDEO WAS GREAT 3524 02:14:56,280 --> 02:14:58,800 WHERE HE HAS HIS TRAINEES GO OUT 3525 02:14:58,800 --> 02:15:00,440 AND THE BASIC SCIENTIST TALKS TO 3526 02:15:00,440 --> 02:15:05,120 THE CLINICIAN AND WATCHES A 3527 02:15:05,120 --> 02:15:07,520 CARE, A CARE EPISODE BUT 3528 02:15:07,520 --> 02:15:08,840 PATIENTS INTERACT, I THINK WOULD 3529 02:15:08,840 --> 02:15:10,880 MAKE THAT MORE INNOVATIVE WOULD 3530 02:15:10,880 --> 02:15:16,720 BE TO HAVE TRAINEES GO INTO THE 3531 02:15:16,720 --> 02:15:17,920 CLINICAL SIMULATION LAB WHERE 3532 02:15:17,920 --> 02:15:19,720 SCENARIOS ARE SET UP AND THE 3533 02:15:19,720 --> 02:15:21,320 TRAINEE OBSERVES WHEN THE 3534 02:15:21,320 --> 02:15:22,800 PATIENT INTERACTING WITH THE 3535 02:15:22,800 --> 02:15:24,440 PRIMARY CARE DOCTOR WITH THE 3536 02:15:24,440 --> 02:15:25,560 PHYSICAL THERAPIST, WITH THE ET 3537 02:15:25,560 --> 02:15:30,600 CETERA, ET CETERA, WITH THE 3538 02:15:30,600 --> 02:15:31,200 PSYCHOLOGIST BECAUSE I THINK 1 3539 02:15:31,200 --> 02:15:32,880 OF THE THINGS THAT HAPPENS ON 3540 02:15:32,880 --> 02:15:36,400 THE FRONT LINES IS THAT PATIENTS 3541 02:15:36,400 --> 02:15:38,040 HEAR DIFFERENT MESSAGES FROM 3542 02:15:38,040 --> 02:15:39,240 DIFFERENT PROVIDERS AND WE IN 3543 02:15:39,240 --> 02:15:41,520 FACT ARE CONTRIBUTING TO THE 3544 02:15:41,520 --> 02:15:42,160 DISABILITY ASSOCIATE WIDE 3545 02:15:42,160 --> 02:15:45,440 CHRONIC PAIN BECAUSE WE AS 3546 02:15:45,440 --> 02:15:47,080 PROVIDERS AREN'T GIVING A 3547 02:15:47,080 --> 02:15:48,120 UNIFIED MESSAGE. 3548 02:15:48,120 --> 02:15:50,120 SO FOR TRAINEES TO SEE THAT THEN 3549 02:15:50,120 --> 02:15:51,400 THEY COULD BE PART OF, HELP TO 3550 02:15:51,400 --> 02:15:53,520 BE PART OF THE SOLUTION OVER 3551 02:15:53,520 --> 02:15:55,640 TIME SO THOSE ARE MY 3 BIG IDEAS 3552 02:15:55,640 --> 02:15:56,840 BUT VERY EXCITING ABOUT THIS. 3553 02:15:56,840 --> 02:15:57,440 THIS IS GREAT. 3554 02:15:57,440 --> 02:16:00,160 YOU SEE HOW MUCH GRAY HAIR IS ON 3555 02:16:00,160 --> 02:16:04,680 THIS CALL, WE DEFINITELY NEED 3556 02:16:04,680 --> 02:16:04,960 THIS. 3557 02:16:04,960 --> 02:16:06,600 >>WELL, THANK YOU FOR YOUR BIG 3558 02:16:06,600 --> 02:16:10,480 IDEAS, WE WILL PASS THEM ALONG. 3559 02:16:10,480 --> 02:16:12,040 CHRIS, THEN ED. 3560 02:16:12,040 --> 02:16:12,480 >>SURE. 3561 02:16:12,480 --> 02:16:13,240 OBVIOUSLY VERY SUPPORTIVE OF 3562 02:16:13,240 --> 02:16:14,680 THIS PROGRAM AND PART OF THE K12 3563 02:16:14,680 --> 02:16:17,000 AT UNIVERSITY OF MICHIGAN, 3564 02:16:17,000 --> 02:16:18,480 ADVISORY COMMITTEE THERE, I WAS 3565 02:16:18,480 --> 02:16:20,000 WONDERING IF YOU COULD TALK FOR 3566 02:16:20,000 --> 02:16:24,960 A MINUTE ABOUT MORE ABOUT THE 3567 02:16:24,960 --> 02:16:26,320 OVERSIGHT OF THESE 3 PROGRAMS. 3568 02:16:26,320 --> 02:16:27,120 MY UNDERSTANDING AND THEN THE 3569 02:16:27,120 --> 02:16:29,560 SECOND PART OF IT IS HOW THEY 3570 02:16:29,560 --> 02:16:30,960 MAY GROW OVER TIME BECAUSE MY 3571 02:16:30,960 --> 02:16:31,920 UNDERSTANDING RIGHT NOW LIKE 3572 02:16:31,920 --> 02:16:34,080 WITH THE K12 THAT WE MAY BE ABLE 3573 02:16:34,080 --> 02:16:39,680 TO SELECT 2 OR 3, MENTEES AT 3574 02:16:39,680 --> 02:16:40,000 THIS POINT. 3575 02:16:40,000 --> 02:16:41,400 SO I'M PART OF THAT, I READ 3576 02:16:41,400 --> 02:16:42,840 ABOUT THE PURPOSE NETWORK AND I 3577 02:16:42,840 --> 02:16:45,360 SEE THE PRESENTATION OF THIS, 3578 02:16:45,360 --> 02:16:46,920 NEW, PROGRAM, IS THERE GOING TO 3579 02:16:46,920 --> 02:16:48,760 BE OVERSITE WITHIN YOUR OFFICE 3580 02:16:48,760 --> 02:16:51,080 OR HEAL OR NIH TO MAKE SURE THAT 3581 02:16:51,080 --> 02:16:52,360 ALL THESE PROGRAMS ARE ARE, EVEN 3582 02:16:52,360 --> 02:16:54,240 THOUGH THEY HAVE A BIT DIFFERENT 3583 02:16:54,240 --> 02:16:56,120 OF A SCOPE, THERE'S OBVIOUSLY 3584 02:16:56,120 --> 02:16:58,720 OVERLAP AND THEY'RE MAXIMALLY 3585 02:16:58,720 --> 02:16:59,000 COORDINATED. 3586 02:16:59,000 --> 02:17:01,400 >>YEAH, SO 1 THING THAT WE 3587 02:17:01,400 --> 02:17:02,360 THINK IS REALLY IMPORTANT FOR 3588 02:17:02,360 --> 02:17:07,000 THIS NEW PROGRAM, IF IT DOES GO 3589 02:17:07,000 --> 02:17:09,000 THROUGH, IS THAT IT DOES GET 3590 02:17:09,000 --> 02:17:09,960 ALIGNED WITH THE PURPOSE 3591 02:17:09,960 --> 02:17:15,640 PROGRAM, WHICH IS THE NETWORKING 3592 02:17:15,640 --> 02:17:16,760 PROGRAM AND THAT THERE'S 3593 02:17:16,760 --> 02:17:18,360 ACTUALLY BUILT INTO THE ASK FOR 3594 02:17:18,360 --> 02:17:21,120 THE BUDGET FOR THIS FOR 3595 02:17:21,120 --> 02:17:22,280 SUPPLEMENTAL FUNDS BECAUSE WHEN 3596 02:17:22,280 --> 02:17:23,560 PURPOSE WAS FIRST ESTABLISHED, 3597 02:17:23,560 --> 02:17:25,760 WE DIDN'T EXPECT THAT WE HAVE 3598 02:17:25,760 --> 02:17:27,400 ANOTHER WHOLE COHORT OF TRAINEES 3599 02:17:27,400 --> 02:17:28,560 THAT THEY COULD SUPPORT FOR 3600 02:17:28,560 --> 02:17:30,840 THEIR MEETINGS AND THINGS LIKE 3601 02:17:30,840 --> 02:17:31,080 THAT. 3602 02:17:31,080 --> 02:17:36,600 THERE IS NOT CURRENTLY AN 3603 02:17:36,600 --> 02:17:39,120 EVALUATION OF THE 3 PROGRAMS, 3604 02:17:39,120 --> 02:17:40,360 THERE ARE INDIVIDUAL EVALUATIONS 3605 02:17:40,360 --> 02:17:43,400 FOR THE K12 AND THE PURPOSE THAT 3606 02:17:43,400 --> 02:17:44,120 ARE LINKED TOGETHER. 3607 02:17:44,120 --> 02:17:48,000 WE ARE STILL IN CONVERSATIONS 3608 02:17:48,000 --> 02:17:49,400 ABOUT THE EVALUATION OF THE 3609 02:17:49,400 --> 02:17:51,040 SUCCESS OF THIS PROGRAM AND I 3610 02:17:51,040 --> 02:17:53,880 THINK THAT WAS 1 OF THE 3611 02:17:53,880 --> 02:17:56,560 DISCUSSION QUESTIONS AND HOW WE 3612 02:17:56,560 --> 02:17:58,560 MIGHT LINK THAT TO THE OTHER 3613 02:17:58,560 --> 02:18:02,840 PROGRAMS BUT CERTAINLY, YOU KNOW 3614 02:18:02,840 --> 02:18:06,600 THERE'S OVERSITE HERE, AND MEANS 3615 02:18:06,600 --> 02:18:08,040 TO MONITOR THE SUCCESS OF THE 3616 02:18:08,040 --> 02:18:12,680 TRAINEES AS THEY GO OUT. 3617 02:18:12,680 --> 02:18:14,520 THE MENTORING EVALUATION THAT'S 3618 02:18:14,520 --> 02:18:16,000 CURRENTLY BUILT IN IS INTERNAL 3619 02:18:16,000 --> 02:18:17,240 FOR THIS PARTICULAR PROGRAM, NOT 3620 02:18:17,240 --> 02:18:23,360 FOR THE OTHER 2 BUT FOR THIS 1. 3621 02:18:23,360 --> 02:18:23,680 >>GREAT. 3622 02:18:23,680 --> 02:18:25,440 AND THEN IN TERMS OF LIKE 3623 02:18:25,440 --> 02:18:26,840 EXPANSION, IT'S GREAT WE ARE 3624 02:18:26,840 --> 02:18:29,080 STARTING THESE, WE HAVE A 3625 02:18:29,080 --> 02:18:31,000 WORKFORCE ISSUE DOING 2 TO 3 3626 02:18:31,000 --> 02:18:32,480 MENTEES IN 1 PROGRAM AND MAYBE A 3627 02:18:32,480 --> 02:18:34,280 HANDFUL IN ANOTHER, I MEAN YOU 3628 02:18:34,280 --> 02:18:35,440 HAVE TO START SOMEWHERE BUT IT 3629 02:18:35,440 --> 02:18:37,480 SEEMS LIKE WE NEED TO 3630 02:18:37,480 --> 02:18:38,440 EXPONENTIALLY INCREASE THAT 3631 02:18:38,440 --> 02:18:39,880 NUMBER IN A VERY SHORT PERIOD OF 3632 02:18:39,880 --> 02:18:41,360 TIME IF WE'RE GOING TO 3633 02:18:41,360 --> 02:18:42,720 ADEQUATELY ADDRESS THE WORKFORCE 3634 02:18:42,720 --> 02:18:43,240 ISSUE, RIGHT? 3635 02:18:43,240 --> 02:18:45,240 SO I'M JUST CURIOUS IF THERE'S 3636 02:18:45,240 --> 02:18:46,160 CONVERSATIONS ARE THESE LIKE 3637 02:18:46,160 --> 02:18:47,800 TRIAL PROGRAMS WHICH WILL THEN 3638 02:18:47,800 --> 02:18:48,520 BE EVALUATED TO SEE WHETHER 3639 02:18:48,520 --> 02:18:50,640 THEY'RE GOING TO BE EXPANDED OR 3640 02:18:50,640 --> 02:18:50,960 NOT? 3641 02:18:50,960 --> 02:18:53,800 >>YEAH, SO I THINK THE HOPE IS 3642 02:18:53,800 --> 02:18:57,240 FOR THE K12 SPECIFICALLY IS 3643 02:18:57,240 --> 02:18:58,680 THAT'S MODELED ON NATIONAL K12S 3644 02:18:58,680 --> 02:19:01,480 THAT WE HAVE FOR NEUROSURGERY 3645 02:19:01,480 --> 02:19:05,080 AND ON PEDIATRIC NEUROLOGY AT 3646 02:19:05,080 --> 02:19:05,880 NINDS. 3647 02:19:05,880 --> 02:19:07,680 IF YOU BUILT-IN A CERTAIN NUMBER 3648 02:19:07,680 --> 02:19:09,880 OF TRAINEES COMING IN ALL THE 3649 02:19:09,880 --> 02:19:10,560 WAY THROUGH THE PROGRAM, THEN 3650 02:19:10,560 --> 02:19:13,240 THE HOPE IS IF THE PROGRAM IS 3651 02:19:13,240 --> 02:19:16,040 SUCCESSFUL, THAT THE NEXT 3652 02:19:16,040 --> 02:19:17,960 ITERATION WILL TAKE THEM INTO 3653 02:19:17,960 --> 02:19:20,560 THE NEXT ITERATION IF IT'S 3654 02:19:20,560 --> 02:19:21,600 SUCCESSFUL AND THE FIELD STILL 3655 02:19:21,600 --> 02:19:25,440 WANTS TO SUPPORT IT, SO IT WOULD 3656 02:19:25,440 --> 02:19:27,160 BE AN CONTINUOUS EXPANDING, 3657 02:19:27,160 --> 02:19:28,880 INSTEAD OF LIKE OVER 5 YEARS, 3658 02:19:28,880 --> 02:19:30,400 YOU WOULD USUALLY INCREASE YOUR 3659 02:19:30,400 --> 02:19:31,520 COHORT AND DECREASE IT BECAUSE 3660 02:19:31,520 --> 02:19:34,080 YOU HAVE A LIMITED AMOUNT OF 3661 02:19:34,080 --> 02:19:35,600 MONEY TO GET PEOPLE THROUGH THE 3662 02:19:35,600 --> 02:19:37,880 END, SO IN SOME WAY THEY'RE 3663 02:19:37,880 --> 02:19:40,080 STRUCTURED WITH THE HOPE AND 3664 02:19:40,080 --> 02:19:42,320 EXPECTATION THAT THEY'LL KEEP 3665 02:19:42,320 --> 02:19:45,560 GOING BUT AGAIN, WE HAVE TO SEE 3666 02:19:45,560 --> 02:19:46,680 IF THEY'RE SUCCESSFUL AND I 3667 02:19:46,680 --> 02:19:48,200 MEAN, SO FAR, I THINK THERE'S A 3668 02:19:48,200 --> 02:19:50,160 LOT OF EXCITEMENT FOR THE 3669 02:19:50,160 --> 02:19:51,480 PURPOSE PROGRAM AND THAT 3670 02:19:51,480 --> 02:19:52,760 ACCOUNTED BE THE LINK THAT 3671 02:19:52,760 --> 02:19:57,720 REALLY KEEPS ALL THESE TOGETHER 3672 02:19:57,720 --> 02:20:03,560 AND REALLY BRINGS A WHOLE NEW 3673 02:20:03,560 --> 02:20:05,440 FUTURE RESEARCH GROUP AT SOME 3674 02:20:05,440 --> 02:20:07,320 LINK AT SOME POINT IN THEIR 3675 02:20:07,320 --> 02:20:07,680 LIVES. 3676 02:20:07,680 --> 02:20:07,880 ED? 3677 02:20:07,880 --> 02:20:09,560 >>YEAH, JUDGE OF THE A VERY 3678 02:20:09,560 --> 02:20:10,840 CONCRETE QUESTION, I THINK I 3679 02:20:10,840 --> 02:20:17,720 KNOW THE ANSWER TO BUT THE 3680 02:20:17,720 --> 02:20:19,480 T90/R90 PROGRAM 1 OF THE ISSUES 3681 02:20:19,480 --> 02:20:20,640 WAS ATTRACTING PHYSICIANS INTO 3682 02:20:20,640 --> 02:20:23,160 RESEARCH CAREERS, IS THAT THESE 3683 02:20:23,160 --> 02:20:25,760 TRAINING GRANTS DON'T PROVIDE A 3684 02:20:25,760 --> 02:20:26,160 COMPETITIVE SALARY. 3685 02:20:26,160 --> 02:20:30,080 I TAKE IT THAT THE T90/R90 IS 3686 02:20:30,080 --> 02:20:32,920 THE SAME SALARY LEVELS FOR 3687 02:20:32,920 --> 02:20:35,640 TRAINEES AS THE T32s. 3688 02:20:35,640 --> 02:20:40,440 OR IS THERE MORE FLEXIBILITY? 3689 02:20:40,440 --> 02:20:42,080 AND THIS MAY BE SOMETHING WE 3690 02:20:42,080 --> 02:20:43,480 CAN'T DO ANYTHING ABOUT BUT 3691 02:20:43,480 --> 02:20:45,480 ANYTHING TO MAKE IT A LITTLE 3692 02:20:45,480 --> 02:20:47,920 MORE FLEXIBLE, HOW YOU CAN PAY 3693 02:20:47,920 --> 02:20:51,000 TRAINEES, PARTICULARLY CLINICIAN 3694 02:20:51,000 --> 02:20:51,640 TRAINEES, PHYSICIAN TRAINEES, 3695 02:20:51,640 --> 02:20:54,040 ESPECIALLY WHO CAN MAKE A LOT OF 3696 02:20:54,040 --> 02:20:57,960 MONEY DOING CLINICAL WORK. 3697 02:20:57,960 --> 02:20:58,200 >>YEAH. 3698 02:20:58,200 --> 02:20:58,960 >>IT COMPETES. 3699 02:20:58,960 --> 02:21:00,600 >>YEAH, THIS 1 IS EARLIER ON SO 3700 02:21:00,600 --> 02:21:06,360 IT'S NOT SO MUCH LINKED TO 3701 02:21:06,360 --> 02:21:07,800 PHYSICIAN LEVEL SALARY SUPPORT. 3702 02:21:07,800 --> 02:21:10,760 THE LATER PROGRAMS ARE LIMITED 3703 02:21:10,760 --> 02:21:13,440 AND WE HAVE CAPS ON THE SALARY 3704 02:21:13,440 --> 02:21:15,240 BUT THIS 1 IS POST DOC AND IT'S 3705 02:21:15,240 --> 02:21:20,920 NOT GOING TO COVER ALL THE 3706 02:21:20,920 --> 02:21:21,160 SALARY. 3707 02:21:21,160 --> 02:21:22,600 I DON'T KNOW IF THOSE 3708 02:21:22,600 --> 02:21:24,160 LIMITATIONS ARE BUILT IN OR IT'S 3709 02:21:24,160 --> 02:21:25,120 A BUDGETARY ISSUE, I THINK IT'S 3710 02:21:25,120 --> 02:21:27,120 A BIT OF A COMBINATION OF BOTH. 3711 02:21:27,120 --> 02:21:30,960 I CAN FIND OUT WHAT THE LIMITS 3712 02:21:30,960 --> 02:21:32,880 ARE AND HAVE--UNLESS, I DON'T 3713 02:21:32,880 --> 02:21:33,800 THINK [INDISCERNIBLE] AS YOU 3714 02:21:33,800 --> 02:21:34,000 KNOW. 3715 02:21:34,000 --> 02:21:36,560 >>I AM ON IF YOU WANT ME TO 3716 02:21:36,560 --> 02:21:37,760 QUICKLY JUMP IN. 3717 02:21:37,760 --> 02:21:38,120 >>YEAH. 3718 02:21:38,120 --> 02:21:41,000 >>THE POST DOCKERS FOR THE T90 3719 02:21:41,000 --> 02:21:43,520 AND R90 ARE LIMITED TO THE NRSA 3720 02:21:43,520 --> 02:21:45,760 SALARY CAP SO IT WOULD BE THE 3721 02:21:45,760 --> 02:21:53,000 SAME POST DOC SOLRYS AS THE 3722 02:21:53,000 --> 02:21:53,280 T32S. 3723 02:21:53,280 --> 02:21:53,680 >>THANKS, LAURA. 3724 02:21:53,680 --> 02:21:55,440 WE DON'T HAVE ANY WAY AROUND 3725 02:21:55,440 --> 02:21:58,440 THAT, NOT AT THIS POINT. 3726 02:21:58,440 --> 02:22:01,760 >>SO WHEN WE SAY CLINICAL, AND 3727 02:22:01,760 --> 02:22:03,360 WE EXPAND THAT TO PEOPLE WHO ARE 3728 02:22:03,360 --> 02:22:04,040 WORKING IN A CLINICAL 3729 02:22:04,040 --> 02:22:07,080 REQUIREMENT BUT DON'T HAVE AN M. 3730 02:22:07,080 --> 02:22:10,960 D. BECAUSE THOSE PEOPLE'S 3731 02:22:10,960 --> 02:22:12,320 SALARIES ARE CHEAPER? 3732 02:22:12,320 --> 02:22:17,200 >>FOR THIS PARTICULAR 1, YES. 3733 02:22:17,200 --> 02:22:19,000 >>SO Ph.D.s CAN BE INCLUDED 3734 02:22:19,000 --> 02:22:27,240 THEN? 3735 02:22:27,240 --> 02:22:28,360 >>ABSOLUTELY. 3736 02:22:28,360 --> 02:22:28,560 YEAH. 3737 02:22:28,560 --> 02:22:32,840 >>AND LINDA IT SHOULD INCLUDE 3738 02:22:32,840 --> 02:22:34,240 ADDICTION AND I THINK IT SHOULD 3739 02:22:34,240 --> 02:22:36,160 BE MADE DLEER THAT NEEDS TO GO 3740 02:22:36,160 --> 02:22:37,080 HAND AND HAND. 3741 02:22:37,080 --> 02:22:37,760 >>YEAH, WE'VE BEEN WORKING ON 3742 02:22:37,760 --> 02:22:40,960 GETTING THAT LANGUAGE INTO THE 3743 02:22:40,960 --> 02:22:42,040 FOA, LORA'S BEEN WORKING HARD ON 3744 02:22:42,040 --> 02:22:43,600 THAT BECAUSE I THINK IT'S 3745 02:22:43,600 --> 02:22:46,600 ESSENTIAL AND AN ADDICTION 3746 02:22:46,600 --> 02:22:49,040 PROGRAM COULD SERVE AS THE 3747 02:22:49,040 --> 02:22:49,840 PARTNERING WITHIN AN INSTITUTION 3748 02:22:49,840 --> 02:22:52,760 WHERE YOU HAVE THE OTHER 3749 02:22:52,760 --> 02:22:53,240 DISCIPLINE BESIDE THE 3750 02:22:53,240 --> 02:22:58,640 TRADITIONAL PAIN WOULD BE MOST 3751 02:22:58,640 --> 02:22:58,880 HELPFUL. 3752 02:22:58,880 --> 02:23:01,640 >>I WANT TO COMMENT AND SAY YOU 3753 02:23:01,640 --> 02:23:04,520 REALLY GLAD YOU INVOKED THE 3754 02:23:04,520 --> 02:23:05,880 DISCIPLINE EVER SOCIAL WORK 3755 02:23:05,880 --> 02:23:07,280 BECAUSE SOCIAL WORK PROVIDES THE 3756 02:23:07,280 --> 02:23:09,560 MA JO ARITY OF BEHAVIORIAL WORK 3757 02:23:09,560 --> 02:23:11,800 IN THIS COUNTRY AND THERE'S VERY 3758 02:23:11,800 --> 02:23:13,160 LITTLE ATTENTION BEING PAID IN 3759 02:23:13,160 --> 02:23:14,600 SOCIAL WORK IN RESEARCH THANE 3760 02:23:14,600 --> 02:23:15,880 DIRECTING CLINICAL TRAINING TO 3761 02:23:15,880 --> 02:23:17,280 CHRONIC PAIN, SO I'M GLAD 3762 02:23:17,280 --> 02:23:18,920 THERE'S GOING TO BE AN EFFORT TO 3763 02:23:18,920 --> 02:23:20,000 TRY TO LOOP IT IN THIS 3764 02:23:20,000 --> 02:23:22,680 DISCIPLINE AND I LIKE THE IDEA 3765 02:23:22,680 --> 02:23:25,240 OF HAVING THESE RESEARCH 3766 02:23:25,240 --> 02:23:27,000 TRAINEES BEING SORT OF CLINICAL 3767 02:23:27,000 --> 02:23:28,040 AMBASSADORS IN THEIR FINAL WREER 3768 02:23:28,040 --> 02:23:34,920 AND HELP TO DO EDUCATION TO 3769 02:23:34,920 --> 02:23:35,720 CLINICIANS. 3770 02:23:35,720 --> 02:23:36,320 >>ALL RIGHT, THANK YOU VERY 3771 02:23:36,320 --> 02:23:37,720 MUCH. 3772 02:23:37,720 --> 02:23:39,720 SUPER HELP EMPLOY AND SOME 3773 02:23:39,720 --> 02:23:41,560 REALLY, REALLY EXCITING IDEAS SO 3774 02:23:41,560 --> 02:23:46,600 PERHAPS SHE SHOULD GO NEXT TO-- 3775 02:23:46,600 --> 02:23:48,000 >>HEY, LINDA. 3776 02:23:48,000 --> 02:23:54,040 JUST TO PIGGYBACK ON WHAT ERIC 3777 02:23:54,040 --> 02:23:55,840 IS SAYING PAIN MANAGEMENT IS A 3778 02:23:55,840 --> 02:24:00,520 TEAM SCIENCE THESE DAYS. 3779 02:24:00,520 --> 02:24:02,280 SO, YOU KNOW WE WERE TALKING 3780 02:24:02,280 --> 02:24:03,760 ABOUT THOSE CLINICIANS IN THE 3781 02:24:03,760 --> 02:24:05,880 PREVIOUS SESSION WITH MANAGING 3782 02:24:05,880 --> 02:24:06,960 CANCER AND RHEUMATOLOGY, WELL, 3783 02:24:06,960 --> 02:24:08,000 HELL THEY HAVE PEOPLE WHO REALLY 3784 02:24:08,000 --> 02:24:11,160 KNOW WHAT THEY'RE DOING BESIDE 3785 02:24:11,160 --> 02:24:14,960 THEM, LIKE ERIC AND OTHER PEOPLE 3786 02:24:14,960 --> 02:24:16,160 IN THE BEHAVIORIAL SPACE WHO 3787 02:24:16,160 --> 02:24:19,240 THEY TURN TO AND SAY, NOW HELP 3788 02:24:19,240 --> 02:24:24,200 ME MANAGE MY PATIENTS PAIN. 3789 02:24:24,200 --> 02:24:27,080 SO WE REALLY AREN'T TRYING TO 3790 02:24:27,080 --> 02:24:29,800 GET THOSE CLINICIANS TO BECOME A 3791 02:24:29,800 --> 02:24:31,440 SOCIAL WORKER OR BECOME A 3792 02:24:31,440 --> 02:24:32,720 BEHAVIORIST AS MUCH AS WE'RE 3793 02:24:32,720 --> 02:24:34,680 TRYING TO GET THEM TO RECOGNIZE 3794 02:24:34,680 --> 02:24:36,680 THE VALUE OF HAVING PEOPLE LIKE 3795 02:24:36,680 --> 02:24:37,880 THAT ON THEIR TEAMS AND 3796 02:24:37,880 --> 02:24:39,040 INTEGRATING THEM INTO THEIR 3797 02:24:39,040 --> 02:24:41,960 TEAMS AND TRAINING UP PEOPLE TO 3798 02:24:41,960 --> 02:24:51,720 WORK ALONGSIDE THEM IN THEIR 3799 02:24:51,720 --> 02:24:51,920 TEAMS. 3800 02:24:51,920 --> 02:24:53,000 NYES, THANK YOU FOR THAT. 3801 02:24:53,000 --> 02:24:54,560 ALL RIGHTY WITH THAT, THE NEXT 1 3802 02:24:54,560 --> 02:25:00,200 ON THE LIST WAS THE WEARABLES. 3803 02:25:00,200 --> 02:25:01,000 FOR THE BIOMARKER PROGRAM. 3804 02:25:01,000 --> 02:25:04,440 I THINK AND THEN WE WENT TO 3805 02:25:04,440 --> 02:25:08,560 SLEEP, RIGHT? 3806 02:25:08,560 --> 02:25:08,800 YES. 3807 02:25:08,800 --> 02:25:10,760 SO THIS IS WEARABLE DEVICES P.M. 3808 02:25:10,760 --> 02:25:14,000 THAT WILL FIT INTO THE OVERALL 3809 02:25:14,000 --> 02:25:18,520 HEAL PAIN BIOMARKER PROGRAM. 3810 02:25:18,520 --> 02:25:21,240 AND WE COULD GO--IF WE CAN FIND 3811 02:25:21,240 --> 02:25:22,760 THAT SLIDE, I DON'T KNOW WHERE 3812 02:25:22,760 --> 02:25:23,000 IT WENT. 3813 02:25:23,000 --> 02:25:24,960 >>I'M LOOKING IF ARE IT NOW. 3814 02:25:24,960 --> 02:25:28,120 >>I THINK IT'S 2? 3815 02:25:28,120 --> 02:25:29,520 >>SO I'LL COMMENT VERY BRIEFLY, 3816 02:25:29,520 --> 02:25:32,520 JUST I THINK THIS IS A REALLY 3817 02:25:32,520 --> 02:25:33,400 EXCITING AND IMPORTANT PROGRAM. 3818 02:25:33,400 --> 02:25:36,640 I THINK THE USE OF WEARABLES TO 3819 02:25:36,640 --> 02:25:37,760 DEVELOP THESE BIOSIGNATTURES OF 3820 02:25:37,760 --> 02:25:40,240 CHRONIC PAIN, I THINK IS A TON 3821 02:25:40,240 --> 02:25:42,400 OF CLINICAL UTILITY, BOTH IN 3822 02:25:42,400 --> 02:25:46,280 TERLS OF ITS FORMING, BOTH 3823 02:25:46,280 --> 02:25:47,080 PROVIDERS ABOUT THE PROGRESSION 3824 02:25:47,080 --> 02:25:49,320 OF THE CHRONIC PAIN CONDITION, 3825 02:25:49,320 --> 02:25:52,040 BUT I THINK, MAYBE EVEN MORE 3826 02:25:52,040 --> 02:25:54,120 IMPORTANTLY, THERE COULD BE SOME 3827 02:25:54,120 --> 02:25:59,520 SORT OF MACHINE LEARNING MODELS 3828 02:25:59,520 --> 02:26:01,680 THAT COULD ACTUALLY HELP INFORM 3829 02:26:01,680 --> 02:26:04,040 JUST IN TIME INTERVENTIONS THAT 3830 02:26:04,040 --> 02:26:05,160 ARE DELIVERED BY [INDISCERNIBLE] 3831 02:26:05,160 --> 02:26:06,520 TYPE OF APPROACHES SO I STRONGLY 3832 02:26:06,520 --> 02:26:07,000 SUPPORT THIS. 3833 02:26:07,000 --> 02:26:11,640 I THINK IT'S A GREAT, GREAT 3834 02:26:11,640 --> 02:26:11,840 IDEA. 3835 02:26:11,840 --> 02:26:13,200 >>THANKS, ERIC AND PART OF 3836 02:26:13,200 --> 02:26:14,760 PRODUCT THAT'S EXPECTED OR 3837 02:26:14,760 --> 02:26:16,520 DELIVERABLE FROM THE PROGRAM IS 3838 02:26:16,520 --> 02:26:26,920 OLYMPIC GOR RHYTHMS AND 3839 02:26:40,200 --> 02:26:40,400 SOFTWARE-- 3840 02:26:40,400 --> 02:26:43,120 >>BEING ABLE TO PREDICT WHOSE 3841 02:26:43,120 --> 02:26:46,800 GAIT IS UNTABLE AND WHO IS AT 3842 02:26:46,800 --> 02:26:48,480 RISK FOR FALLS IS CONE 3843 02:26:48,480 --> 02:26:49,480 FORWEARABLES AND THEN YOU CAN 3844 02:26:49,480 --> 02:26:51,280 BRING THE PATIENT IN FOR 3845 02:26:51,280 --> 02:26:52,040 ADDITIONAL, VALUATION AND 3846 02:26:52,040 --> 02:26:55,440 EXERCISE AND SO FORTH TO TRY AND 3847 02:26:55,440 --> 02:26:56,120 PREVENT THE FALL. 3848 02:26:56,120 --> 02:26:58,440 SO IF WE CAN GET A BIOSIGNATTURE 3849 02:26:58,440 --> 02:27:03,240 ON OUR PATIENTS WITH PAIN, THAT 3850 02:27:03,240 --> 02:27:05,360 WILL ONLY HELP DIRECT SOME 3851 02:27:05,360 --> 02:27:06,200 CLINICAL DECISION MAKING, I 3852 02:27:06,200 --> 02:27:08,520 THINK THE OTHER VALUE HERE IS 3853 02:27:08,520 --> 02:27:11,440 THE POTENTIAL OR OPPORTUNITY TO 3854 02:27:11,440 --> 02:27:12,840 REINFORCE CERTAIN BEHAVIORS AND 3855 02:27:12,840 --> 02:27:13,520 PERHAPS EXTINGUISH RECOLLECTS 3856 02:27:13,520 --> 02:27:18,720 THAT ARE LESS HELPFUL FOR THE 3857 02:27:18,720 --> 02:27:20,240 PATIENTS ABILITY TO FUNCTION SO 3858 02:27:20,240 --> 02:27:21,280 PROVIDING FEETD BACK ABOUT 3859 02:27:21,280 --> 02:27:22,840 CERTAIN MOVEMENTS FOR EXAMPLE 3860 02:27:22,840 --> 02:27:24,480 WILL BE A GREAT WAY TO LEVERAGE 3861 02:27:24,480 --> 02:27:25,880 THIS TECHNOLOGY AND HELP 3862 02:27:25,880 --> 02:27:36,320 CLINICIANS AND BETTER HELP 3863 02:27:53,240 --> 02:27:53,440 PATIENTS. 3864 02:27:53,440 --> 02:27:55,760 >>SO COLLECTING DATA THAT IS 3865 02:27:55,760 --> 02:27:59,280 CLINICALLY MEANINGFUL THAT WILL 3866 02:27:59,280 --> 02:28:00,600 DIRECT INTERVENTION SELECTION 3867 02:28:00,600 --> 02:28:03,960 AND GID TREATMENT BUT ALSO 3868 02:28:03,960 --> 02:28:06,040 THAT'S DATA THAT IS OF VALUE TO 3869 02:28:06,040 --> 02:28:07,120 THE PATIENT FOR WHATEVER GOALS 3870 02:28:07,120 --> 02:28:09,240 HE HAS SET FOR HIS TREATMENT AND 3871 02:28:09,240 --> 02:28:11,600 HIS GOALS. 3872 02:28:11,600 --> 02:28:13,240 IT ISN'T--THE GOALS ARE OFTEN 3873 02:28:13,240 --> 02:28:14,920 ABOUT INCREASING FUNCTION, 3874 02:28:14,920 --> 02:28:16,800 THEY'RE NOT FSESLY ABOUT 3875 02:28:16,800 --> 02:28:18,440 DECREASING PAIN INITIALLY AND BY 3876 02:28:18,440 --> 02:28:20,960 MOVING MORE, YES, WE DECREASE 3877 02:28:20,960 --> 02:28:23,440 PAIN, SO BUT IT HAS TO BE A 3878 02:28:23,440 --> 02:28:24,920 VALUE, SEEN AS A VALUE TO THE 3879 02:28:24,920 --> 02:28:26,360 PATIENT BECAUSE IF THE CLINICIAN 3880 02:28:26,360 --> 02:28:27,920 DOESN'T SEE IT AS VALUABLE THEN 3881 02:28:27,920 --> 02:28:29,360 THE PATIENT WILL NOT DAWN THE 3882 02:28:29,360 --> 02:28:30,440 WEARABLE, THEY WILL NOT TAKE IT 3883 02:28:30,440 --> 02:28:31,840 HOME, THEY WILL TAKE IT HOME BUT 3884 02:28:31,840 --> 02:28:33,040 WILL NEVER PUT IT ON. 3885 02:28:33,040 --> 02:28:34,080 SO THOSE ARE SOME OF THE 3886 02:28:34,080 --> 02:28:41,080 REALITIES OF HAVING DONE SOME OF 3887 02:28:41,080 --> 02:28:43,640 THIS WORK. 3888 02:28:43,640 --> 02:28:46,440 >>OKAY, GREAT, I THANK YOU FOR 3889 02:28:46,440 --> 02:28:46,760 THAT. 3890 02:28:46,760 --> 02:28:49,800 I THINK THE PROGRAM LEAD IS 3891 02:28:49,800 --> 02:28:50,200 LISTENING IN. 3892 02:28:50,200 --> 02:28:52,320 >>TERRY'S HAND IS RAISED. 3893 02:28:52,320 --> 02:28:52,800 >>TERRY? 3894 02:28:52,800 --> 02:28:58,040 >>YES, I THINK THAT THIS 3895 02:28:58,040 --> 02:28:59,640 PARTICULAR KIND OF DATA BECAUSE 3896 02:28:59,640 --> 02:29:01,240 IT'S SO NOVEL AND BECAUSE 3897 02:29:01,240 --> 02:29:02,560 THERE'S SO MUCH INFORMATION 3898 02:29:02,560 --> 02:29:03,440 EMBEDDED IN IT, IT'S REALLY 3899 02:29:03,440 --> 02:29:07,280 IMPORTANT TO THINK ABOUT HOW TO 3900 02:29:07,280 --> 02:29:08,880 PRESERVE THE RAW DATA SETS WITH 3901 02:29:08,880 --> 02:29:10,040 THE KIND OF METADATA THAT WOULD 3902 02:29:10,040 --> 02:29:12,000 ALLOW PEOPLE TO CONTINUE TO TAKE 3903 02:29:12,000 --> 02:29:13,320 ADVANTAGE OF IT THROUGH A SORT 3904 02:29:13,320 --> 02:29:15,160 OF DATA SHARING MECHANISM 3905 02:29:15,160 --> 02:29:17,760 BECAUSE, YOU KNOW THE 3906 02:29:17,760 --> 02:29:18,640 COMMENTMACHINE LEARNING 3907 02:29:18,640 --> 02:29:20,160 ALGORITHMS THAT ARE ASTUTE BUT 3908 02:29:20,160 --> 02:29:21,320 THEY'RE DEVELOPING RAPIDLY AND 3909 02:29:21,320 --> 02:29:25,800 SO HAVING THESE VERY IMPORTANT 3910 02:29:25,800 --> 02:29:27,840 RAW DATA SETS WITH ALL OF 3911 02:29:27,840 --> 02:29:29,120 THE--INSTEAD OF A VERY REDUCED 3912 02:29:29,120 --> 02:29:31,040 VERSION OF THEM, I THINK IN THE 3913 02:29:31,040 --> 02:29:32,280 FUTURE COULD REALLY BE IMPORTANT 3914 02:29:32,280 --> 02:29:36,880 BECAUSE THE PEOPLE WILL BRING 3915 02:29:36,880 --> 02:29:38,760 THEIR NEW METHODS AND WAYS OF 3916 02:29:38,760 --> 02:29:40,840 INTERROGATING THESE DATA SETS TO 3917 02:29:40,840 --> 02:29:43,040 PROBE MANY DIFFERENT QUESTIONS 3918 02:29:43,040 --> 02:29:44,520 IN THE FUTURE. 3919 02:29:44,520 --> 02:29:46,560 SO I THINK, YOU KNOW HOPEFULLY 3920 02:29:46,560 --> 02:29:48,120 THERE WILL BE AN OPPORTUNITY TO 3921 02:29:48,120 --> 02:29:50,360 ARCHIVE THESE DATA SETS, TO HAVE 3922 02:29:50,360 --> 02:29:51,320 THE KIND OF METADATA ASSOCIATED 3923 02:29:51,320 --> 02:29:54,040 WITH THEM THAT WOULD MAKE THEM 3924 02:29:54,040 --> 02:29:55,360 USEFUL OVER THE LONG HALL AND 3925 02:29:55,360 --> 02:29:56,800 THEN TO HAVE DATA SHARING 3926 02:29:56,800 --> 02:30:00,320 MECHANISM SO YOU COULD INVITE 3927 02:30:00,320 --> 02:30:02,240 TEAMS INCLUDING DATA SCIENTISTS 3928 02:30:02,240 --> 02:30:04,040 BHO HAVE NOVEL METHODS TO USE TO 3929 02:30:04,040 --> 02:30:05,080 TRY TO FIND, DISCOVER THINGS AND 3930 02:30:05,080 --> 02:30:07,400 I JUST THINK THIS IS A 3931 02:30:07,400 --> 02:30:12,880 REAL--SHOULD BE A VERY IMPORTANT 3932 02:30:12,880 --> 02:30:13,920 PRIORITY. 3933 02:30:13,920 --> 02:30:14,640 >>THANKS, TERRY, JENNIFER HAS 3934 02:30:14,640 --> 02:30:16,400 HER HAND UP AS WELL. 3935 02:30:16,400 --> 02:30:20,720 >>YES, I'M ALSO THINK BEING TE 3936 02:30:20,720 --> 02:30:23,720 POTENTIAL TO COLLECT BIOMARKERS 3937 02:30:23,720 --> 02:30:25,800 LIKE CYTOKINES OR CORTISOL, 3938 02:30:25,800 --> 02:30:28,720 PERHAPS IN AN ORAL BIOSENSOR SO 3939 02:30:28,720 --> 02:30:30,880 SUBJECTIVE DATA RELATED TO PAIN 3940 02:30:30,880 --> 02:30:32,280 OR OTHER THINGS THAT MAY BE 3941 02:30:32,280 --> 02:30:34,920 PICKED UP IN A WEARABLE THAT'S 3942 02:30:34,920 --> 02:30:36,640 ON YOUR ARM OR SOMETHING, BUT 3943 02:30:36,640 --> 02:30:37,960 IT'S ANOTHER WAY TO COLLECT 3944 02:30:37,960 --> 02:30:39,440 INFORMATION THAT WE KNOW IS 3945 02:30:39,440 --> 02:30:41,840 OCCURRING WHEN PEOPLE ARE IN 3946 02:30:41,840 --> 02:30:44,880 PAIN, THAT WILL PROVIDE 3947 02:30:44,880 --> 02:30:45,880 ADDITIONAL OBJECTATIVITY AND IT 3948 02:30:45,880 --> 02:30:48,800 CAN BE LIKE AN ORTHODONTIC TOOTH 3949 02:30:48,800 --> 02:30:50,920 BRACKET OR SOMETHING LIKE THAT. 3950 02:30:50,920 --> 02:30:51,960 >>YEAH IS THAT'S DEFINITELY 3951 02:30:51,960 --> 02:30:53,640 WITHIN THE SCOPE OF WHAT THEY'RE 3952 02:30:53,640 --> 02:30:55,800 LOOKING FOR IN THE PROGRAM, SO 3953 02:30:55,800 --> 02:30:56,920 THEY'RE LOOKING FOR 3954 02:30:56,920 --> 02:30:58,880 PHYSIOLOGICAL DATA TO CREATE THE 3955 02:30:58,880 --> 02:31:02,000 BIOSIGNATTURE, BUT, YOU KNOW THE 3956 02:31:02,000 --> 02:31:03,280 DENTAL PAIN BRINGS UP A LOT OF 3957 02:31:03,280 --> 02:31:04,440 QUESTIONS ABOUT WHAT COULD BE 3958 02:31:04,440 --> 02:31:07,800 USED IN THOSE SITUATIONS AS 3959 02:31:07,800 --> 02:31:09,960 WELL, SO, AGAIN, WE'LL MAKE SURE 3960 02:31:09,960 --> 02:31:12,400 THAT GETS PASSED ON TO THE 3961 02:31:12,400 --> 02:31:12,840 DEVELOPMENT TEAM BUT. 3962 02:31:12,840 --> 02:31:15,280 >>YEAH, BUT LINDA I WILL SHARE 3963 02:31:15,280 --> 02:31:16,400 VERY BRIEFLY BEYOND DENTAL PAIN, 3964 02:31:16,400 --> 02:31:18,120 IF YOU ARE HAVING PAIN ANY 3965 02:31:18,120 --> 02:31:19,200 PLACE, IT'S LIKELY THAT YOUR 3966 02:31:19,200 --> 02:31:20,920 STRESS RESPONSE WILL BE RECORDED 3967 02:31:20,920 --> 02:31:23,920 IN YOUR SALIVA TERMS OF 3968 02:31:23,920 --> 02:31:25,000 BIOMARKERS AND THINGS. 3969 02:31:25,000 --> 02:31:29,000 >>YEAH, THANK YOU. 3970 02:31:29,000 --> 02:31:30,560 >>OKAY, WELL WE HAVE ABOUT 15 3971 02:31:30,560 --> 02:31:32,120 MINUTES LEFT AND WE WANT TO 3972 02:31:32,120 --> 02:31:33,720 PRESERVE TIME FOR FINAL 3973 02:31:33,720 --> 02:31:35,560 DISCUSSION, SO LET'S KEEP MOVING 3974 02:31:35,560 --> 02:31:41,840 TO THE SLEEP CONCEPT. 3975 02:31:41,840 --> 02:31:46,080 CAN WE ADVANCE MAYBE 2 OR 3 3976 02:31:46,080 --> 02:31:47,240 SLIDES. 3977 02:31:47,240 --> 02:31:50,480 THOUGHTS AND REACTIONS TO SLEEP 3978 02:31:50,480 --> 02:31:52,480 AND CIRCADIAN RHYTHMS FOR 3979 02:31:52,480 --> 02:32:01,800 TARGETING ACUTE AND CHRONIC 3980 02:32:01,800 --> 02:32:02,320 PAIN. 3981 02:32:02,320 --> 02:32:02,640 >>CHRIS? 3982 02:32:02,640 --> 02:32:04,640 >>I WILL JUST SAY LIKE THE 3983 02:32:04,640 --> 02:32:06,080 OTHER PROGRAMS, I'M ENORMOUSLY 3984 02:32:06,080 --> 02:32:07,480 SUPPORTIVE OF THIS 1, SLEEP HAS 3985 02:32:07,480 --> 02:32:09,800 BEEN 1, I'M STILL AMAZED, THAT A 3986 02:32:09,800 --> 02:32:11,200 LARGE PERCENTAGE OF PAIN STUDIES 3987 02:32:11,200 --> 02:32:12,840 REPORT ON SLEEP OR STUDY SLEEP 3988 02:32:12,840 --> 02:32:14,480 BUT THERE'S STILL A GOOD 3989 02:32:14,480 --> 02:32:15,440 PERCENTAGE OF THEM THAT DON'T 3990 02:32:15,440 --> 02:32:16,960 AND EVEN THOUGH, YOU KNOW THE 3991 02:32:16,960 --> 02:32:22,560 EVIDENCE SUGGESTS THAT THIS IS A 3992 02:32:22,560 --> 02:32:24,080 HUGE BI-DIRECTIONAL INFLUENCE ON 3993 02:32:24,080 --> 02:32:25,600 PAIN AND TRAJECTORIES FOR PAIN, 3994 02:32:25,600 --> 02:32:27,320 MY ONLY COMMENT ON THIS WOULD BE 3995 02:32:27,320 --> 02:32:29,320 TO AND I'M SURE THIS IS ALREADY 3996 02:32:29,320 --> 02:32:30,920 BEING DISCUSSED BUT USING SOME 3997 02:32:30,920 --> 02:32:35,560 SORT OF OUR SUGGESTING SOME SORT 3998 02:32:35,560 --> 02:32:37,760 OF CORE DOMAIN MEASURES THAT WE 3999 02:32:37,760 --> 02:32:40,440 ALSO KNOW DON'T INTERACT WITH 4000 02:32:40,440 --> 02:32:42,200 SLEEP LIKE COGNITIVE, SPEAKING 4001 02:32:42,200 --> 02:32:42,920 OF COGNITIVE DYSFUNCTION, I 4002 02:32:42,920 --> 02:32:46,240 CAN'T SAY THE WORD. 4003 02:32:46,240 --> 02:32:47,560 COGNITIVE DYSFUNCTION, PHYSICAL 4004 02:32:47,560 --> 02:32:48,320 DISABILITY, SOCIAL ACTIVITIES, 4005 02:32:48,320 --> 02:32:52,040 SO ON AND SO FORTH. 4006 02:32:52,040 --> 02:32:54,040 SO JUST A THOUGHT TO THINK ABOUT 4007 02:32:54,040 --> 02:32:55,920 HOW WE CAN REALLY MAXIMIZE 4008 02:32:55,920 --> 02:32:57,640 STUDIES COMING OUT OF THIS, NOT 4009 02:32:57,640 --> 02:32:59,560 JUST TO LOOK AT SLEEP AND PAIN 4010 02:32:59,560 --> 02:33:02,560 BUT ALSO THE OTHER DOMAINS THAT 4011 02:33:02,560 --> 02:33:06,480 WE KNOW INTERACT IN AND ARE 4012 02:33:06,480 --> 02:33:07,320 AFFECTED BY SLEEP. 4013 02:33:07,320 --> 02:33:12,240 >>THANK YOU. 4014 02:33:12,240 --> 02:33:18,360 GOOD SUGGESTIONS. 4015 02:33:18,360 --> 02:33:18,600 >>BOB? 4016 02:33:18,600 --> 02:33:22,400 >>I THINK YOU'RE MUTED. 4017 02:33:22,400 --> 02:33:23,800 >>SORRY ABOUT THAT. 4018 02:33:23,800 --> 02:33:24,920 JUST AGREEING WITH WHAT CHRIS 4019 02:33:24,920 --> 02:33:26,440 JUST SAID, THAT WAS OVERLA 4020 02:33:26,440 --> 02:33:28,040 LAPPING WITH WHAT I WAS GOING TO 4021 02:33:28,040 --> 02:33:30,560 SAY BUT THIS IS SOMETHING THAT 4022 02:33:30,560 --> 02:33:32,640 REALLY SORT OF OBVIOUSLY VERY 4023 02:33:32,640 --> 02:33:33,680 IMPORTANT BUT ALSO RIPE FOR 4024 02:33:33,680 --> 02:33:41,920 STUDY, YOU KNOW I THINK THERE'S 4025 02:33:41,920 --> 02:33:43,560 A VERY SUBSTANTIAL INTERFACE FOR 4026 02:33:43,560 --> 02:33:44,960 THE PAIN RESEARCH COMMUNITY 4027 02:33:44,960 --> 02:33:47,360 NECESSARILY BUT ENCOURAGING 4028 02:33:47,360 --> 02:33:50,440 THESE APPLICATIONS TO INVOLVE, 4029 02:33:50,440 --> 02:33:51,560 YOU KNOW BONA FIDE SLEEP 4030 02:33:51,560 --> 02:33:53,720 RESEARCHERS IN THIS CONTEXT, I 4031 02:33:53,720 --> 02:33:56,000 THINK WOULD BE REALLY IMPORTANT 4032 02:33:56,000 --> 02:33:58,200 TO KNOW OF, I DON'T KNOW IF IT'S 4033 02:33:58,200 --> 02:33:59,840 FACTORED IN AS FAR AS TEAM 4034 02:33:59,840 --> 02:34:01,640 SCIENCE BUT THERE'S SPECIALIZED 4035 02:34:01,640 --> 02:34:02,560 METHODOLOGY AND DETAILS THAT ARE 4036 02:34:02,560 --> 02:34:03,600 REQUIRED IN THE SLEEP STUDIES 4037 02:34:03,600 --> 02:34:05,680 THAT WILL BE BETTER BUT THERE 4038 02:34:05,680 --> 02:34:07,520 ARE PLENTY OF PLACES THAT HAVE 4039 02:34:07,520 --> 02:34:09,920 PEOPLE WHO HAVE EXPERTISE IN 4040 02:34:09,920 --> 02:34:11,120 CIRCADIAN BIOLOGY AND SLEEP THAT 4041 02:34:11,120 --> 02:34:14,600 ARE NOT DRESSING THIS THAT 4042 02:34:14,600 --> 02:34:15,640 EVERYBODY KNOWS THAT SLEEP AND 4043 02:34:15,640 --> 02:34:17,760 HEAL IS A CRITICAL COMPONENT AND 4044 02:34:17,760 --> 02:34:24,480 CAN BE A MODIFIABLE RISK FACTOR 4045 02:34:24,480 --> 02:34:34,480 POTENTIALLY. 4046 02:34:34,480 --> 02:34:35,400 THANK YOU. 4047 02:34:35,400 --> 02:34:41,160 >>SO I THINK LINDA, IS THERE 1 4048 02:34:41,160 --> 02:34:41,440 MORE? 4049 02:34:41,440 --> 02:34:42,360 >>THERE'S THE LAST PAIN ISSUE 4050 02:34:42,360 --> 02:34:46,000 AND THERE WERE QUESTIONS FOR 4051 02:34:46,000 --> 02:34:47,080 DISCUSSION SUGGESTED AS WELL IF 4052 02:34:47,080 --> 02:34:49,760 WE COULD SKIP DOWN TO THEM OR IF 4053 02:34:49,760 --> 02:34:52,840 PEOPLE HAVE QUESTIONS READY, 4054 02:34:52,840 --> 02:34:54,880 ROB, I THINK YOUR HAND IS STILL 4055 02:34:54,880 --> 02:34:57,160 UP BUT IT'S FROM BEFORE, I 4056 02:34:57,160 --> 02:34:57,360 THINK. 4057 02:34:57,360 --> 02:34:58,200 SO ALAN? 4058 02:34:58,200 --> 02:35:00,360 >>MY ONLY COMMENT TO THAT IS 4059 02:35:00,360 --> 02:35:01,400 SOMETHING IT'S AGAIN SORT OF 4060 02:35:01,400 --> 02:35:02,720 RELEVANT WHAT I SAID BEFORE, SO 4061 02:35:02,720 --> 02:35:05,480 I'VE BEEN TALKING TO THE 4062 02:35:05,480 --> 02:35:07,760 ORTHOPEOPLE REEBTLY, AND I 4063 02:35:07,760 --> 02:35:09,840 ACTUALLY HAVE TO THANK HELENE, 4064 02:35:09,840 --> 02:35:13,400 BECAUSE SHE TURNED ME ON TO MUSK 4065 02:35:13,400 --> 02:35:15,760 LA SKELETAL PAIN AND IT WAS SO 4066 02:35:15,760 --> 02:35:19,720 INTERESTING TO TALK TO THEM 4067 02:35:19,720 --> 02:35:22,040 BECAUSE AND ESPECIALLY TO THE 4068 02:35:22,040 --> 02:35:23,600 Ph.D.s, NOT NECESSARILY THE 4069 02:35:23,600 --> 02:35:24,280 SURGEONS AND CO INSURE MARKET 4070 02:35:24,280 --> 02:35:28,120 DENTALLY MY WIFE JUST HAD A 4071 02:35:28,120 --> 02:35:30,280 TOTAL KNEE REPLACEMENT SO IT'S 4072 02:35:30,280 --> 02:35:31,400 KIND OF STRUCK HOME. 4073 02:35:31,400 --> 02:35:34,280 LOTS OF PAIN BUT THEY DON'T 4074 02:35:34,280 --> 02:35:35,880 STUDY PAIN. 4075 02:35:35,880 --> 02:35:40,640 THEY STUDY BONE, THEY STUDY BONE 4076 02:35:40,640 --> 02:35:43,160 DEVELOPMENT, BONE ARCHITECTURE, 4077 02:35:43,160 --> 02:35:46,080 STRUCTURE, IT'S REALLY QUITE 4078 02:35:46,080 --> 02:35:48,360 INTERESTING AND THEY'RE NOT EVEN 4079 02:35:48,360 --> 02:35:50,520 THINKING OR I GUESS IT'S JUST 4080 02:35:50,520 --> 02:35:52,720 THEIR TRAINING TO LOOK AT HOW 4081 02:35:52,720 --> 02:35:56,240 DOES THE BONE MILIEU EFFECT THE 4082 02:35:56,240 --> 02:35:57,080 NERVE THAT'S INNERIVATING IT AND 4083 02:35:57,080 --> 02:36:00,920 SO I JUST THINK THAT SOMEHOW 4084 02:36:00,920 --> 02:36:04,000 THIS PARTICULAR EFFORT NEEDS TO 4085 02:36:04,000 --> 02:36:05,800 REACH OUT TO THEM SOMEHOW, 4086 02:36:05,800 --> 02:36:08,160 THEY'RE LIVING IN ANOTHER WORLD. 4087 02:36:08,160 --> 02:36:09,840 AND YET THEY'RE DEALING WITH 4088 02:36:09,840 --> 02:36:13,960 MORE PAIN THAN PROBABLY ANYBODY. 4089 02:36:13,960 --> 02:36:15,120 >>I DON'T THINK WE HAVE ANYBODY 4090 02:36:15,120 --> 02:36:21,200 ON THE CALL HERE FROM THE REJOIN 4091 02:36:21,200 --> 02:36:21,880 PROGRAM, DO WE? 4092 02:36:21,880 --> 02:36:24,960 >>I CAN SPEAK TO THAT. 4093 02:36:24,960 --> 02:36:25,760 IS LINDE ON? 4094 02:36:25,760 --> 02:36:29,440 MAYBE SHE DROPPED OFF BUT-- 4095 02:36:29,440 --> 02:36:32,640 >>NO, I WAS-- 4096 02:36:32,640 --> 02:36:33,320 >>GO AHEAD, LINDSAY. 4097 02:36:33,320 --> 02:36:36,080 >>I WAS JUST GOING TO SAY, FROM 4098 02:36:36,080 --> 02:36:39,280 MY FIRST ORTHOPEDICS MEETING, 4099 02:36:39,280 --> 02:36:40,160 THE ORTHOPEDIC RESEARCH SOCIETY 4100 02:36:40,160 --> 02:36:41,880 MEETING THAT'S PORT OF OUR 4101 02:36:41,880 --> 02:36:43,640 PORTFOLIO AND THEY'RE ABSOLUTELY 4102 02:36:43,640 --> 02:36:44,840 INTERESTED IN UNDERSTANDING PAIN 4103 02:36:44,840 --> 02:36:46,120 MECHANISMS AND TRYING TO MAKE 4104 02:36:46,120 --> 02:36:47,440 PROGRESS IN THIS FIELD AND IN 4105 02:36:47,440 --> 02:36:49,680 FACT, I TALKED ABOUT THE HEAL, 4106 02:36:49,680 --> 02:36:52,320 AND I TALKED ABOUT REJOIN TO 4107 02:36:52,320 --> 02:36:54,520 THIS COMMUNITY SO I THINK 4108 02:36:54,520 --> 02:36:55,320 THERE'S TREMENDOUS OPPORTUNITY 4109 02:36:55,320 --> 02:36:56,520 THERE AND INTEREST AND 4110 02:36:56,520 --> 02:36:57,680 ABSOLUTELY SOMETHING THAT HAS 4111 02:36:57,680 --> 02:37:02,760 BEEN OVERLOOKED TO A GREAT 4112 02:37:02,760 --> 02:37:03,160 EXTENT. 4113 02:37:03,160 --> 02:37:04,400 FOR MANY, MANY YEARS AND SO 4114 02:37:04,400 --> 02:37:07,760 THANK FIST ARE THAT COMMENT 4115 02:37:07,760 --> 02:37:09,840 ALLAN, AND HELENE, THANK YOU FOR 4116 02:37:09,840 --> 02:37:12,160 INTRODUCING MUSK LO SKELETAL 4117 02:37:12,160 --> 02:37:13,960 PAIN TO ALLAN AS AN IMPORTANT 4118 02:37:13,960 --> 02:37:15,040 AREA OF FOCUS. 4119 02:37:15,040 --> 02:37:17,160 >>NO, SHE DOESN'T INTRODUCE ME, 4120 02:37:17,160 --> 02:37:18,080 I EXPERIENCE IT. 4121 02:37:18,080 --> 02:37:18,360 [LAUGHTER] 4122 02:37:18,360 --> 02:37:19,840 >>WELL, WE ALL DO. 4123 02:37:19,840 --> 02:37:22,320 , RIGHT. 4124 02:37:22,320 --> 02:37:26,520 >>BUT I CAN ECHO, I THINK 4125 02:37:26,520 --> 02:37:27,760 LINDSAY SAID, THE ORTHOCOMMUNITY 4126 02:37:27,760 --> 02:37:29,160 IS COMING AROUND TO THIS BUT 4127 02:37:29,160 --> 02:37:30,200 YOU'RE RIGHT, ALAN THIS IS 4128 02:37:30,200 --> 02:37:32,280 SOMETHING THAT HAS LAGGED BEHIND 4129 02:37:32,280 --> 02:37:36,520 BUT I'M GLAD TOO HEAR, LOOKING 4130 02:37:36,520 --> 02:37:39,360 AT ABSTRACTS AND PRESENTATIONS 4131 02:37:39,360 --> 02:37:42,000 AT THE MEETING THAT LINDSAY'S 4132 02:37:42,000 --> 02:37:44,400 AT, IT LOOKS PROMISE THAT THE 4133 02:37:44,400 --> 02:37:48,840 SHIP IS SLOWLY TURNING. 4134 02:37:48,840 --> 02:37:51,000 >>SO NOW WE NEED TO GET THEM TO 4135 02:37:51,000 --> 02:37:52,080 REALIZE THAT MUSCLES ARE 4136 02:37:52,080 --> 02:37:55,240 ATTACHED TO THE BONE AND. 4137 02:37:55,240 --> 02:37:56,880 >>AND THEY'RE THE 2 NBUT THAT'S 4138 02:37:56,880 --> 02:37:58,760 RIGHT THERE WITH THE MUSCLE. 4139 02:37:58,760 --> 02:37:59,080 >>RIGHT. 4140 02:37:59,080 --> 02:38:01,400 >>BUT BY THE WAY, A HUGE 4141 02:38:01,400 --> 02:38:02,280 IMPEDIMENT, THIS HAS BEEN 4142 02:38:02,280 --> 02:38:06,440 CAPTURED IN THE CHAT, TOO IS THE 4143 02:38:06,440 --> 02:38:06,760 SALARY ISSUES. 4144 02:38:06,760 --> 02:38:08,640 SO IF DEPARTMENT CHAIRS AREN'T 4145 02:38:08,640 --> 02:38:11,200 COMMITTED TO RESEARCH, THERE'S A 4146 02:38:11,200 --> 02:38:13,520 HUGE DISINCENTIVE TO ALLOW 4147 02:38:13,520 --> 02:38:16,200 ORTHOPEDIC SURGEONS AND 4148 02:38:16,200 --> 02:38:17,840 CLINICIANS TO GET TRAINED IN 4149 02:38:17,840 --> 02:38:20,160 THIS AREA AND TO DEVOTE TIME TO 4150 02:38:20,160 --> 02:38:22,000 RESEARCH SO THAT'S A HUGE 4151 02:38:22,000 --> 02:38:26,200 OBSTACLE TO THAT FIELD OF COURSE 4152 02:38:26,200 --> 02:38:28,120 LIKE MANY OTHERS. 4153 02:38:28,120 --> 02:38:29,280 >>--AT THE BEGINNING AND 4154 02:38:29,280 --> 02:38:30,520 TEACHING WHEN THE MEDICAL 4155 02:38:30,520 --> 02:38:32,600 STUDENTS AND ANATOMY. 4156 02:38:32,600 --> 02:38:34,040 THEY COMPLETELY DISREGARD AND 4157 02:38:34,040 --> 02:38:35,080 PLOA RIGHT THROUGH THE FASCIA 4158 02:38:35,080 --> 02:38:37,520 AND DON'T PAY ATTENTION IT, GET 4159 02:38:37,520 --> 02:38:42,960 RID OF THIS GET RID OF THIS AND 4160 02:38:42,960 --> 02:38:44,840 LET'S DOWN TO MUSCLES AND 4161 02:38:44,840 --> 02:38:45,920 NERVES. 4162 02:38:45,920 --> 02:38:46,960 >>OOH. 4163 02:38:46,960 --> 02:38:48,120 >>YOU'RE HURTING ALLAN'S HEART. 4164 02:38:48,120 --> 02:38:49,600 >>IT'S TRUE THOUGH, IT'S TRUE. 4165 02:38:49,600 --> 02:38:50,440 IT'S SAD BUT IT'S TRUE. 4166 02:38:50,440 --> 02:38:54,720 I THINK WE JUDGE UOF THE HAVE TO 4167 02:38:54,720 --> 02:38:55,440 OWN IT. 4168 02:38:55,440 --> 02:38:57,200 >>SO THE MY O FACIAL UNIT 4169 02:38:57,200 --> 02:39:02,400 CONTINUES TO BE NEGLECTED AND 4170 02:39:02,400 --> 02:39:06,000 THIS REISSUING OF THIS IS 4171 02:39:06,000 --> 02:39:07,640 CRITICAL TO BEGIN AT LEAST 4172 02:39:07,640 --> 02:39:09,320 DISCOVERING SOME OF THESE 4173 02:39:09,320 --> 02:39:11,360 THINGS, LOOKING AT ACUTE VERSUS 4174 02:39:11,360 --> 02:39:12,720 LATENT PHASES AND WHAT IS 4175 02:39:12,720 --> 02:39:14,640 CHANGING IN THE MY O FACIAL UNIT 4176 02:39:14,640 --> 02:39:17,440 DEVELOPING THE TECHNOLOGIES THAT 4177 02:39:17,440 --> 02:39:19,440 WILL HELP US MEASURE THEM THAT 4178 02:39:19,440 --> 02:39:21,520 HOPEFULLY WILL BECOME CLINICALLY 4179 02:39:21,520 --> 02:39:22,440 USEFUL AT SOME POINT IN TIME, 4180 02:39:22,440 --> 02:39:24,560 THIS IS VERY MUCH INFANCY AND 4181 02:39:24,560 --> 02:39:28,080 VERY MUCH LONG OVERDUE. 4182 02:39:28,080 --> 02:39:32,880 >>AND WE CALL IT REJOINT? 4183 02:39:32,880 --> 02:39:33,240 >>REJOINT? 4184 02:39:33,240 --> 02:39:36,640 >>SO THIS A RECENTLY AWARDED 4185 02:39:36,640 --> 02:39:39,760 PROGRAM ALLAN THAT YOU WOULD 4186 02:39:39,760 --> 02:39:41,880 HAVE SEEN I SUPPOSE AT THIS .1 4187 02:39:41,880 --> 02:39:43,800 AND HALF TO 2 YEARS AGO. 4188 02:39:43,800 --> 02:39:45,120 MAYBE SOMEONE ON THE TEAM CAN 4189 02:39:45,120 --> 02:39:47,200 PUT INFORMATION INTO THE CHAT 4190 02:39:47,200 --> 02:39:49,600 AROUND WHAT WE'VE DONE. 4191 02:39:49,600 --> 02:39:53,440 PUBLICIZED ABOUT IT BUT REALLY 4192 02:39:53,440 --> 02:39:54,360 PSYCHING TO UNDERSTAND 4193 02:39:54,360 --> 02:39:56,000 INNERVATION OF THE JOINTS AND 4194 02:39:56,000 --> 02:39:58,160 HOW THESE DIFFERENT PARTS OF THE 4195 02:39:58,160 --> 02:39:59,120 BODY CONNECTION. 4196 02:39:59,120 --> 02:39:59,760 >>SORRY TO INTERRUPT, 1 THINK 4197 02:39:59,760 --> 02:40:01,400 THIS I DID LEARN AND IT WILL 4198 02:40:01,400 --> 02:40:03,120 COME UP LATER IN MODELS, 1 THING 4199 02:40:03,120 --> 02:40:05,520 THEY DID TELL ME IS THEY HADE 4200 02:40:05,520 --> 02:40:07,640 THE MIA MODEL WHICH IS THE 1 4201 02:40:07,640 --> 02:40:11,680 THAT IS PREDOMINANTLY USED TO 4202 02:40:11,680 --> 02:40:13,560 STUDY O. A. AS A MODEL OF O. A. 4203 02:40:13,560 --> 02:40:17,240 AND THEY JUST UNIFORMLY SAY, 4204 02:40:17,240 --> 02:40:18,320 IT'S NOT. 4205 02:40:18,320 --> 02:40:20,960 THEY PREFER THE MUNICIPAL 4206 02:40:20,960 --> 02:40:22,200 MODELS,IME SURE HELENE AND 4207 02:40:22,200 --> 02:40:23,040 LINDSAY HAVE A PERSPECTIVE ON 4208 02:40:23,040 --> 02:40:24,560 THAT BUT THAT WAS NEWS TO ME 4209 02:40:24,560 --> 02:40:27,000 BECAUSE WE WERE READY TO SET UP 4210 02:40:27,000 --> 02:40:28,800 THE MIA MODEL. 4211 02:40:28,800 --> 02:40:33,720 >>WELL, I'M GOING TO ASK 4212 02:40:33,720 --> 02:40:34,800 LINDSAY AND HELENE HAVE THOUGHTS 4213 02:40:34,800 --> 02:40:35,840 ON THAT PARTICULAR MODEL THAT WE 4214 02:40:35,840 --> 02:40:37,480 PUT INTO THE CHAT BUT TURNING TO 4215 02:40:37,480 --> 02:40:40,840 KIND OF OUR LAST 5 MINUTES OF 4216 02:40:40,840 --> 02:40:44,480 THIS DISCUSSION, WE HEARD A LOT 4217 02:40:44,480 --> 02:40:45,840 TODAY ABOUT NEW RESEARCH 4218 02:40:45,840 --> 02:40:51,920 PROGRAMS THAT THE TEAMS HAVE, 4219 02:40:51,920 --> 02:40:53,920 AND YOU HEARD OF PRECLINICAL 4220 02:40:53,920 --> 02:40:56,520 SIDE ABOUT THEM LOOKING AT 4221 02:40:56,520 --> 02:41:00,760 PERSONNEL FACTORS AND CONDITIONS 4222 02:41:00,760 --> 02:41:01,800 AS CONTRIBUTORS CHRONIC 4223 02:41:01,800 --> 02:41:05,000 OVERLAPPING PAIN CONDITIONS AS 4224 02:41:05,000 --> 02:41:09,240 WELL AS EXPOSURE, ELEMENTS, TO 4225 02:41:09,240 --> 02:41:10,640 EXPOSOME AS FACTORS IN CHRONIC 4226 02:41:10,640 --> 02:41:12,200 PAIN AND THEN ON THE MORE 4227 02:41:12,200 --> 02:41:14,880 CLINICAL SIDE WE DISCUSSED BOTH 4228 02:41:14,880 --> 02:41:16,880 TREATING PAIN AND PEDIATRIC 4229 02:41:16,880 --> 02:41:20,040 POPULATIONS AND ALSO STUDYING 4230 02:41:20,040 --> 02:41:22,560 CHRONIC PAIN AMONG CHILDREN IN 4231 02:41:22,560 --> 02:41:22,880 ADOLESCENTS. 4232 02:41:22,880 --> 02:41:26,120 WE TALKED ABOUT WEARABLE 4233 02:41:26,120 --> 02:41:26,480 BIOSENSORS. 4234 02:41:26,480 --> 02:41:28,520 WE TALKED ABOUT CIRCADIAN 4235 02:41:28,520 --> 02:41:32,480 RHYTHMS AND SLEEP, WE TALKED 4236 02:41:32,480 --> 02:41:33,760 ABOUT TRAINING SPECIFICALLY AND 4237 02:41:33,760 --> 02:41:35,880 FINDING WAYS TO PROVIDE PAIN, 4238 02:41:35,880 --> 02:41:37,200 TRAINING FOR CLINICIANS OF 4239 02:41:37,200 --> 02:41:38,200 DIFFERENT STRIPES AND HOW 4240 02:41:38,200 --> 02:41:39,720 FEASIBLE THAT COULD BE, HOW TO 4241 02:41:39,720 --> 02:41:41,920 EXPAND IT TO BE MOST MEANINGFUL 4242 02:41:41,920 --> 02:41:43,680 AND THEN WE TALKED ABOUT MODELS 4243 02:41:43,680 --> 02:41:46,560 OF MY O FACIAL PAIN AND 4244 02:41:46,560 --> 02:41:48,160 BIOMARKERS SO I WOULD LIKE TO 4245 02:41:48,160 --> 02:41:51,600 JUST ASK THIS GROUP IN OUR FINAL 4246 02:41:51,600 --> 02:41:53,160 MOMENTS TO WEIGH IN WITH 4247 02:41:53,160 --> 02:41:55,440 YOUR--WHAT ARE YOU MOST 4248 02:41:55,440 --> 02:41:55,880 ENTHUSIASTIC ABOUT? 4249 02:41:55,880 --> 02:41:57,600 WE DIDN'T GET INTO INTO BUNLET 4250 02:41:57,600 --> 02:41:59,520 BUT IF HEAL SCOOBT SUPPORT ALL 4251 02:41:59,520 --> 02:42:01,200 OF THESE CONCEPTS WHAT WOULD YOU 4252 02:42:01,200 --> 02:42:05,640 WISH TO SEE INCLUDED, AND WE 4253 02:42:05,640 --> 02:42:16,160 NEED TO FOCUS ON WHAT THE MOST 4254 02:42:19,920 --> 02:42:28,080 INTENSITY? 4255 02:42:28,080 --> 02:42:28,320 >>WOW. 4256 02:42:28,320 --> 02:42:30,040 >>HOW'S THAT FOR AN OPEN ENDED 4257 02:42:30,040 --> 02:42:30,320 QUESTION. 4258 02:42:30,320 --> 02:42:32,440 >>I VOTE FOR TRAINING IN THE 4259 02:42:32,440 --> 02:42:33,640 WORKFORCE BECAUSE WE NEED TO 4260 02:42:33,640 --> 02:42:34,680 RESEARCHERS AND THEN IT TERMS OF 4261 02:42:34,680 --> 02:42:36,480 AREAS OF FOCUSED ONECUS, I THINK 4262 02:42:36,480 --> 02:42:38,520 THE VERY FIRST TOPICS PRESENTED 4263 02:42:38,520 --> 02:42:41,000 MAY BE GOT ME THE MOST EXCITED 4264 02:42:41,000 --> 02:42:42,920 OF ALL THE THINGS WE PRESENTED, 4265 02:42:42,920 --> 02:42:49,040 I SAY THAT AT THE RISK OF 4266 02:42:49,040 --> 02:42:52,360 PISSING SOMEBODY OFF. 4267 02:42:52,360 --> 02:42:52,920 >>APPRECIATE IT. 4268 02:42:52,920 --> 02:42:56,320 >>IF WE'RE HAVING TO LOCK AT 4269 02:42:56,320 --> 02:42:57,560 THINGS TO PRIORITIZE THE 4270 02:42:57,560 --> 02:42:59,480 INITIAL, THE FIRST TOPIC I THINK 4271 02:42:59,480 --> 02:43:00,680 WHILE YOU'RE TALKING ABOUT IS 4272 02:43:00,680 --> 02:43:02,520 THE INDIVIDUAL DIFFERENCES IN 4273 02:43:02,520 --> 02:43:05,160 PAIN AND CO-MORBIDITIES, IS THAT 4274 02:43:05,160 --> 02:43:05,440 THE--YEAH. 4275 02:43:05,440 --> 02:43:08,160 AND THEN WE TALKED ABOUT THE 4276 02:43:08,160 --> 02:43:10,000 RELATEDNESS OF THE EXPOSOME 4277 02:43:10,000 --> 02:43:10,200 STUDY. 4278 02:43:10,200 --> 02:43:12,120 I THINK THERE ARE A BUNCH OF US 4279 02:43:12,120 --> 02:43:13,800 WHO HAVE QUESTIONS ABOUT THE 4280 02:43:13,800 --> 02:43:15,360 STATE OF RAREADINESS OF THAT AND 4281 02:43:15,360 --> 02:43:17,280 I'M NOT AN EXPERT IN THAT SO I'M 4282 02:43:17,280 --> 02:43:20,840 NOT TRYING TO LIGHT IT ON FIRE 4283 02:43:20,840 --> 02:43:22,040 OR ANYTHING, BUT 1 OF THE THINGS 4284 02:43:22,040 --> 02:43:23,560 THAT WE ALSO TALKED ABOUT, THAT 4285 02:43:23,560 --> 02:43:25,040 I WOULD BE MORE INTERESTED IN 4286 02:43:25,040 --> 02:43:26,760 THOSE TYPES OF RESOURCES BEING 4287 02:43:26,760 --> 02:43:28,440 DEPLOYED TO IS, YOU KNOW THE ALL 4288 02:43:28,440 --> 02:43:30,160 OF US STUDY, WE TALKED ABOUT THE 4289 02:43:30,160 --> 02:43:32,360 DIRGT OF PAIN MEASURES THERE, IS 4290 02:43:32,360 --> 02:43:34,880 THERE A WAY FOR HEAL TO DEPLOY 4291 02:43:34,880 --> 02:43:38,800 SOME RESOURCES TO GET BETTER 4292 02:43:38,800 --> 02:43:39,840 GRANULARITY OF DATA ON PAIN 4293 02:43:39,840 --> 02:43:44,160 GOING FORWARD IN THE ALL OF US 4294 02:43:44,160 --> 02:43:46,360 BECAUSE I FEEL LIKE THAT TYPE OF 4295 02:43:46,360 --> 02:43:49,080 INFORMATION, THE SIZE AND SCOPE 4296 02:43:49,080 --> 02:43:51,080 OF THAT PROGRAM PROVIDES A LOT 4297 02:43:51,080 --> 02:43:51,920 BETTER POTENTIAL INSIGHT INTO 4298 02:43:51,920 --> 02:43:54,640 THINGS THAT MIGHT BE STUDIED IN 4299 02:43:54,640 --> 02:44:00,360 MORE DETAIL IN THE CONTEXT OF AN 4300 02:44:00,360 --> 02:44:02,040 EXPOSOME FUTURE STUDY. 4301 02:44:02,040 --> 02:44:04,360 ANYWAY, MY TWO-CENTS ON THAT. 4302 02:44:04,360 --> 02:44:06,880 I FEEL LIKE THAT 1 DOESN'T FEEL 4303 02:44:06,880 --> 02:44:08,480 READY FOR PRIME TIME TO ME. 4304 02:44:08,480 --> 02:44:09,920 AND THERE ARE OTHER WAYS TO 4305 02:44:09,920 --> 02:44:11,360 DEPLOY THE RESOURCES THAT MIGHT 4306 02:44:11,360 --> 02:44:14,600 GET US TOWARDS THAT GOAL 4307 02:44:14,600 --> 02:44:17,400 INCLUDING THE FIRST 1 ON 4308 02:44:17,400 --> 02:44:19,240 OVERLAPPING CO-MORBIDITIES. 4309 02:44:19,240 --> 02:44:20,240 >>THANKS, ROB. 4310 02:44:20,240 --> 02:44:22,640 >>I SEE NORA YOU HAVE YOUR HAND 4311 02:44:22,640 --> 02:44:26,640 RAISED, ARE THERE OTHER MEMBERS 4312 02:44:26,640 --> 02:44:31,120 OF THE MDWG WHO HAVE THOUGHTS ON 4313 02:44:31,120 --> 02:44:33,000 THIS OR WE CAN CONTINUE ON IT 4314 02:44:33,000 --> 02:44:34,760 TOMORROW, OR YOU CAN GERMINATE 4315 02:44:34,760 --> 02:44:36,280 OVER THE NEXT 24 HOURS AND WE 4316 02:44:36,280 --> 02:44:37,480 CAN TALK AGAIN, BUT NORA I WILL 4317 02:44:37,480 --> 02:44:40,480 TUN IT OVER TO YOU. 4318 02:44:40,480 --> 02:44:44,000 >>YEAH, NO, I COMPLETELY AGREE 4319 02:44:44,000 --> 02:44:46,800 AND THE ALL OF US AS AN EXAMPLE 4320 02:44:46,800 --> 02:44:48,000 BECAUSE JOSH GREEN IS VERY 4321 02:44:48,000 --> 02:44:51,160 RESIPTIVE AND IN FACT IT'S 4322 02:44:51,160 --> 02:44:52,000 ACTUALLY SEEKING FOR 4323 02:44:52,000 --> 02:44:53,520 OPPORTUNITIES THAT RELATE TO 4324 02:44:53,520 --> 02:44:57,160 SPECIFIC DISEASE CONDITIONS 4325 02:44:57,160 --> 02:44:59,800 WHERE THE ALL OF US CAN PROVIDE 4326 02:44:59,800 --> 02:45:00,680 INFORMATION SO WE'RE DISCUSSING 4327 02:45:00,680 --> 02:45:03,520 IT HERE IN TERMS OF EXAMPLES IT 4328 02:45:03,520 --> 02:45:05,920 CAN MAKE A PERSON MORE 4329 02:45:05,920 --> 02:45:07,000 VULNERABLE TO DEVELOPING PAIN 4330 02:45:07,000 --> 02:45:09,200 CONDITIONS OR SOMEONE HA IS AN 4331 02:45:09,200 --> 02:45:10,280 OPIOID THAT BASICALLY BECOMES 4332 02:45:10,280 --> 02:45:11,680 ADDICTED SO THERE IS AN 4333 02:45:11,680 --> 02:45:14,040 OPPORTUNITY OF ADDRESSING 4334 02:45:14,040 --> 02:45:15,680 QUESTIONS THAT ARE 4335 02:45:15,680 --> 02:45:16,720 EXTRAORDINARILY RELEVANT 4336 02:45:16,720 --> 02:45:18,560 INCLUDING THE 1 OF PEDIATRIC AND 4337 02:45:18,560 --> 02:45:20,720 WHILE INITIALLY THE ALL OF US 4338 02:45:20,720 --> 02:45:22,840 DID NOT START WITH THE GROUP IN 4339 02:45:22,840 --> 02:45:25,840 CHILDREN, THAT'S NOT NOW 4340 02:45:25,840 --> 02:45:28,800 DECADES, SO, THIS IS--THAT 4341 02:45:28,800 --> 02:45:29,920 WAS--WHY STUDIES LIKE THIS ARE 4342 02:45:29,920 --> 02:45:31,400 BEING DONE AND THEY'RE EXTREMELY 4343 02:45:31,400 --> 02:45:33,120 EXPENSIVE BUT IF YOU LOOK AT, IF 4344 02:45:33,120 --> 02:45:36,440 YOU USE THEM PROPERTILY, YOU CAN 4345 02:45:36,440 --> 02:45:37,640 GENERATE THE MASSIVE AMOUNT OF 4346 02:45:37,640 --> 02:45:38,840 INFORMATION SO PERHAPS I THINK 4347 02:45:38,840 --> 02:45:40,920 THAT OUR THOUGHTS ON ALL OF 4348 02:45:40,920 --> 02:45:42,640 THIS, INCLUDING THE FACT THAT 4349 02:45:42,640 --> 02:45:45,280 THEY ARE OBTAINING FOR EXAMPLE, 4350 02:45:45,280 --> 02:45:46,880 MEASURES THAT ENABLED YOU TO 4351 02:45:46,880 --> 02:45:49,720 LOOK AT SLEEP PATTERNS AND 4352 02:45:49,720 --> 02:45:50,600 ARCHITECTURE AND MOTOR ACTIVITY, 4353 02:45:50,600 --> 02:45:53,240 ALL OF THEM RELEVANT TO 4354 02:45:53,240 --> 02:45:57,640 BIOSENSORS FOR MANAGING PAIN AND 4355 02:45:57,640 --> 02:46:04,480 OUTCOMES, HOW CAN WE USE HEAL TO 4356 02:46:04,480 --> 02:46:06,920 ACTUALLY MOUNT OUR RESOURCES 4357 02:46:06,920 --> 02:46:08,800 THAT WILL ADD QUESTIONNAIRES OF 4358 02:46:08,800 --> 02:46:10,400 GREATER GRANULARITY OF PAIN BUT 4359 02:46:10,400 --> 02:46:13,800 HAPPENS OTHER METRICS AND TO 4360 02:46:13,800 --> 02:46:15,760 ALSO INSURE THATs CORRECT 4361 02:46:15,760 --> 02:46:16,600 PATIENTS POPULATIONS AND 4362 02:46:16,600 --> 02:46:18,240 PATIENTS GROUPS ARE BEING 4363 02:46:18,240 --> 02:46:18,480 ENGAGED. 4364 02:46:18,480 --> 02:46:21,240 SO, THAT IS WHAT I JUST WANTED 4365 02:46:21,240 --> 02:46:23,080 TO SAY BECAUSE THAT PROJECT IS 4366 02:46:23,080 --> 02:46:25,640 AN EXAMPLE THAT LINKS MULTIPLE 4367 02:46:25,640 --> 02:46:27,480 OF THE INITIATIVES THAT WERE 4368 02:46:27,480 --> 02:46:29,240 DISCUSSED TODAY, WE ALSO HAVE 4369 02:46:29,240 --> 02:46:30,400 THE ABCD STUDY WHERE WE'RE 4370 02:46:30,400 --> 02:46:32,320 FOLLOWING THE CHILDREN AS THEY 4371 02:46:32,320 --> 02:46:36,360 TRANSITION INTO ADULTHOOD, MANY 4372 02:46:36,360 --> 02:46:37,080 OF THEM APPROXIMATELY 12,000 ARE 4373 02:46:37,080 --> 02:46:38,760 GOING TO HAVE PAIN AND WE WILL 4374 02:46:38,760 --> 02:46:40,600 BE ABLE TO FIEBD OUTED WHICH 1S 4375 02:46:40,600 --> 02:46:41,640 ARE VULNERABLE TO ADDICTION 4376 02:46:41,640 --> 02:46:42,920 LATER ON OR NOT. 4377 02:46:42,920 --> 02:46:45,120 WE ALSO JUST RECENTLY LAWRVED 4378 02:46:45,120 --> 02:46:50,720 LAST YEAR THE HPC D WITH 4379 02:46:50,720 --> 02:46:54,600 THINKING HOW TO MESH THESE 4380 02:46:54,600 --> 02:46:57,240 QUESTIONS, INTO THIS PROJECTS TO 4381 02:46:57,240 --> 02:47:03,080 MEET, TELL BE THE EXTREMELY 4382 02:47:03,080 --> 02:47:03,320 VALUABLE. 4383 02:47:03,320 --> 02:47:03,760 >>THANKS, NORA. 4384 02:47:03,760 --> 02:47:05,760 >>JUST A HAVE A QUICK COMMENT 4385 02:47:05,760 --> 02:47:08,080 REGEK BECKA IS THAT TO ECHO WHAT 4386 02:47:08,080 --> 02:47:10,240 BOB SAID, NOT ONLY DO WE NEED TO 4387 02:47:10,240 --> 02:47:14,360 TRAIN THE RESEARCH WORKFORCE AND 4388 02:47:14,360 --> 02:47:15,800 THE CLINICIAN WORKFORCE, AND 4389 02:47:15,800 --> 02:47:17,040 DEVELOP THESE MEASURES BUT WHEN 4390 02:47:17,040 --> 02:47:18,680 YOU DO ACROSS THE AGE SPECTRUM 4391 02:47:18,680 --> 02:47:21,640 SO YOU KNOW I PUT HIGH EMPHASIS 4392 02:47:21,640 --> 02:47:25,680 ON THE KID PROJECT AS WELL AS 4393 02:47:25,680 --> 02:47:27,040 EVENNUALLY LOOKING AT THE PAIN 4394 02:47:27,040 --> 02:47:28,560 IN THE ELDERLY WITH COGNITIVE 4395 02:47:28,560 --> 02:47:30,160 IMPAIRMENT AND IF WE DON'T LOOK 4396 02:47:30,160 --> 02:47:31,560 DOWN TO LOOKING AT MY O FACIAL 4397 02:47:31,560 --> 02:47:34,240 PAIN WHICH IS THE MAJORITY OF 4398 02:47:34,240 --> 02:47:36,560 MUSK LO SKELETAL PAIN WHICH IS 4399 02:47:36,560 --> 02:47:37,600 WHAT DRIVES PEOPLE TO SEEK CARE 4400 02:47:37,600 --> 02:47:40,920 AND GOD US INTO THIS WHOLE 4401 02:47:40,920 --> 02:47:43,600 OPIOID ADDICTION ISSUE IN THE 4402 02:47:43,600 --> 02:47:44,920 FIRST PLACE, WE'RE NOTED GOING 4403 02:47:44,920 --> 02:47:46,080 TO MAKE AS MUCH IMPACT ON 4404 02:47:46,080 --> 02:47:47,280 PROGRESS AS WE WANT TO SO I 4405 02:47:47,280 --> 02:47:48,920 THINK THE MY O FACIAL PAIN 4406 02:47:48,920 --> 02:47:50,240 PROJECT IS IMPORTANT, TOO. 4407 02:47:50,240 --> 02:47:52,000 >>THANK YOU SHARON AND THEN 4408 02:47:52,000 --> 02:47:52,360 DIANEA? 4409 02:47:52,360 --> 02:47:53,840 >>I JUST WANT TO CORRECT FOR 4410 02:47:53,840 --> 02:47:56,840 THE RECORD THAT ALL OF US STILL 4411 02:47:56,840 --> 02:47:58,880 HAS NOT ENROLLED 1 CHILD, THEY 4412 02:47:58,880 --> 02:48:03,280 HAVE HIRED A DIRECTOR FOR 4413 02:48:03,280 --> 02:48:04,280 PEDIATRIC RESEARCH WHO'S CHARGED 4414 02:48:04,280 --> 02:48:06,520 WITH FINDING OUT WAYS TO ENROLL 4415 02:48:06,520 --> 02:48:07,400 CHILDREN BUT THERE ARE 0 4416 02:48:07,400 --> 02:48:10,560 CHILDREN IN ALL OF US. 4417 02:48:10,560 --> 02:48:13,560 AND WHILE I TOTALLY AGREE WITH 4418 02:48:13,560 --> 02:48:15,360 NORA THAT CURRENTLY FUNDED 4419 02:48:15,360 --> 02:48:17,920 INITIATIVES WILL PROVIDE 4420 02:48:17,920 --> 02:48:19,400 LONG-TERM INFORMATION ON 4421 02:48:19,400 --> 02:48:23,120 CHILDREN WHO MAY IN ADDITION 4422 02:48:23,120 --> 02:48:26,240 HAVE PAIN, THE FOCUS OF THE KIDS 4423 02:48:26,240 --> 02:48:27,520 PAIN PROJECT IS SOMEWHAT 4424 02:48:27,520 --> 02:48:27,800 DIFFERENT. 4425 02:48:27,800 --> 02:48:33,040 IT'S REALLY COMING IN, FROM A 4426 02:48:33,040 --> 02:48:34,480 PAIN FOCUS AND YOU KNOW 4427 02:48:34,480 --> 02:48:36,360 UNDERSTANDING THAT PAIN AND 4428 02:48:36,360 --> 02:48:39,280 TREATING THAT PAIN. 4429 02:48:39,280 --> 02:48:41,040 SO IT'S--THEY'RE NOT EXACTLY THE 4430 02:48:41,040 --> 02:48:42,520 SAME, THEY'RE ADDITIVE IN SOME 4431 02:48:42,520 --> 02:48:45,960 WAYS BUT REALLY PAIN IS SUCH AN 4432 02:48:45,960 --> 02:48:48,320 IMPORTANT PART OF HEAL AND 4433 02:48:48,320 --> 02:48:53,640 THAT'S A HUGE GAP AS I SAID, SO 4434 02:48:53,640 --> 02:48:55,440 FOR KIDS. 4435 02:48:55,440 --> 02:48:56,640 >>THANK YOU DIANEA, YEAH, 4436 02:48:56,640 --> 02:48:57,960 THERE'S A LOT TO CHEW ON IN 4437 02:48:57,960 --> 02:49:00,360 TERMS OF ALL OF US RESEARCH 4438 02:49:00,360 --> 02:49:02,040 PROGRAM AND HOW THEY MAKE 4439 02:49:02,040 --> 02:49:04,880 DECISIONS AND INCORPORATE THINGS 4440 02:49:04,880 --> 02:49:07,440 AND FORTUNATELY WE HAVE GOOD 4441 02:49:07,440 --> 02:49:08,120 COLLEAGUIAL CONNECTIONS BUT WE 4442 02:49:08,120 --> 02:49:09,720 CAN'T JUST TELL THEM WHAT TO DO, 4443 02:49:09,720 --> 02:49:11,680 THEY HAVE A WHOLE PROCESS. 4444 02:49:11,680 --> 02:49:14,160 SO WE ARE OVERTIME ALLAN AND I 4445 02:49:14,160 --> 02:49:16,160 WANT TO GIVE WALTER A CHANCE TO 4446 02:49:16,160 --> 02:49:18,960 SPEAK, TOO, BUT ALLAN YOUR 4447 02:49:18,960 --> 02:49:19,360 THOUGHTS. 4448 02:49:19,360 --> 02:49:20,280 >>QUICK QUESTION, AND I ASKED 4449 02:49:20,280 --> 02:49:21,960 IT YEARS AGO, I THINK NORA 4450 02:49:21,960 --> 02:49:26,800 ANSWERED IT BUT I NEED TO BE 4451 02:49:26,800 --> 02:49:28,680 REMINDED, IS REDUCING OPIOID USE 4452 02:49:28,680 --> 02:49:32,000 BY SAY A COMBINATION APPROACH 4453 02:49:32,000 --> 02:49:32,960 SOMETHING THAT HEAL WOULD 4454 02:49:32,960 --> 02:49:39,640 INDORSAL POSITION OR NOT 4455 02:49:39,640 --> 02:49:39,880 ENDORSE? 4456 02:49:39,880 --> 02:49:41,840 >>THE ANSWER IS YES, WE ENDORSE 4457 02:49:41,840 --> 02:49:43,000 WHAT THE EVIDENCE SHOWS. 4458 02:49:43,000 --> 02:49:51,960 >>FAIR ENOUGH, JUST WANT TO BE 4459 02:49:51,960 --> 02:49:52,640 SURE. 4460 02:49:52,640 --> 02:49:53,360 OKAY. 4461 02:49:53,360 --> 02:49:54,880 >>I WANT TO BE SURE WHEN I WAS 4462 02:49:54,880 --> 02:49:57,320 CLEAR, WHEN I SAY REDUCE, I MEAN 4463 02:49:57,320 --> 02:49:59,440 STILL USE BUT LOWER DOSES. 4464 02:49:59,440 --> 02:50:00,720 >>YEAH, YEAH, YEAH, ABSOLUTELY. 4465 02:50:00,720 --> 02:50:04,960 VERY CLEAR IN MY BRAIN, ALAN. 4466 02:50:04,960 --> 02:50:05,760 >>GREAT. 4467 02:50:05,760 --> 02:50:06,360 THANK YOU. 4468 02:50:06,360 --> 02:50:08,760 >>TOMORROW WE HAVE AN AGENDA 4469 02:50:08,760 --> 02:50:12,120 AND A SET OF CONCEPTS COMING 4470 02:50:12,120 --> 02:50:13,640 FROM SCIENTIFIC TEAMS FOCUSED ON 4471 02:50:13,640 --> 02:50:15,920 INFANTS AND CHILDREN, 4472 02:50:15,920 --> 02:50:16,960 THERAPEUTIC DEVELOPMENT, 4473 02:50:16,960 --> 02:50:18,280 PREVENTION, TREATMENT AND 4474 02:50:18,280 --> 02:50:21,200 IMELEMENTATION SCIENCE 4475 02:50:21,200 --> 02:50:23,520 APPROACHES FOR THE OPIOID USE, 4476 02:50:23,520 --> 02:50:24,800 ADDICTION AND OVERDOSE AND WE 4477 02:50:24,800 --> 02:50:26,200 ALSO HAVE SOME TIME AT THE END 4478 02:50:26,200 --> 02:50:28,320 FOR US TO DISCUSS ALL OF THE 4479 02:50:28,320 --> 02:50:31,400 DIFFERENT TOPICS IN AREAS OF 4480 02:50:31,400 --> 02:50:34,880 RESEARCH THAT HAVE COME UP, LAST 4481 02:50:34,880 --> 02:50:35,920 WEEK, TODAY AND TOMORROW AND 4482 02:50:35,920 --> 02:50:39,880 KIND OF LOOK AT THE BIG PICTURE 4483 02:50:39,880 --> 02:50:40,160 TOGETHER. 4484 02:50:40,160 --> 02:50:41,760 BEFORE WE END TODAY, WALTER I 4485 02:50:41,760 --> 02:50:43,440 WOULD LIKE TO TURN IT OVER TO 4486 02:50:43,440 --> 02:50:47,920 YOU FOR ANY FINAL THOUGHTS. 4487 02:50:47,920 --> 02:50:50,160 >>REALLY GOOD DISCUSSION, I 4488 02:50:50,160 --> 02:50:53,560 GUESS, IF YOU LOOK AT IT FROM 4489 02:50:53,560 --> 02:50:54,560 FAR OUT, THE POINT IS THAT 4490 02:50:54,560 --> 02:50:55,840 THERE'S SO MUCH TO DO AND YOU 4491 02:50:55,840 --> 02:51:01,160 HAVE TO KIND OF, YOU KNOW MAKE 4492 02:51:01,160 --> 02:51:02,440 YOUR STRATEGIC DISDID CISIONS ON 4493 02:51:02,440 --> 02:51:03,880 WHATY WILL BE MOST IMPACTFUL AND 4494 02:51:03,880 --> 02:51:05,000 SOME OF THAT WE HAVEN'T TALKED 4495 02:51:05,000 --> 02:51:09,760 ABOUT A LOT IS THE FACT THAT, 4496 02:51:09,760 --> 02:51:12,800 YOU KNOW HEAL CAN BE THE 4497 02:51:12,800 --> 02:51:13,840 [INDISCERNIBLE] AND SEED TO GROW 4498 02:51:13,840 --> 02:51:15,400 BUT THEN CAN GET TO A STAGE 4499 02:51:15,400 --> 02:51:16,800 WHERE THEY CAN ACCESS RESOURCES 4500 02:51:16,800 --> 02:51:18,520 AT ALL THE OTHER INSTITUTES. 4501 02:51:18,520 --> 02:51:19,880 SO, YOU KNOW ALL THE INSTITUTES 4502 02:51:19,880 --> 02:51:23,440 HERE ON THIS CALL, HAVE PAIN IN 4503 02:51:23,440 --> 02:51:26,520 THEIR PORTFOLIO, SO I REALLY DO 4504 02:51:26,520 --> 02:51:29,160 THINK, YOU KNOW AS WALLY SAID, 4505 02:51:29,160 --> 02:51:33,560 WE GET THE TRAINING YOU KNOW IN 4506 02:51:33,560 --> 02:51:35,040 PAIN RESEARCH EXPANDED, THEN, 4507 02:51:35,040 --> 02:51:38,000 THAT COULD HAVE A REAL 4508 02:51:38,000 --> 02:51:39,680 MULTIPLIER EFFECT AND WE HAVE 4509 02:51:39,680 --> 02:51:40,880 THE HEAL PLOJ ECTOMYOSIN BUT 4510 02:51:40,880 --> 02:51:43,400 EVERY TRAINEE THAT COULD BE A 4511 02:51:43,400 --> 02:51:46,160 HEAL PROJECT, IT COULD BE FOR A 4512 02:51:46,160 --> 02:51:46,800 NONHEAL PROJECT THAT THEY'RE 4513 02:51:46,800 --> 02:51:51,760 DOING SO I THINK THAT'S REALLY 4514 02:51:51,760 --> 02:51:54,040 IMPORTANT AND THEN, YOU KNOW 4515 02:51:54,040 --> 02:51:55,320 PICKING OUR PROBLEMS, YOU KNOW 4516 02:51:55,320 --> 02:51:57,320 KIND OF AS YOU CAN SEE 4517 02:51:57,320 --> 02:51:58,720 GRAVITATING TOWARDS MORE THE 4518 02:51:58,720 --> 02:52:02,160 COMPLEX ISSUES AND PAIN, THE 4519 02:52:02,160 --> 02:52:03,920 CO-MORBIDITIES, YOU KNOW, 1 OF 4520 02:52:03,920 --> 02:52:05,440 THE EXPOSURES THAT GETS YOU INTO 4521 02:52:05,440 --> 02:52:07,240 SITUATION WHERE YOU'RE GOING TO 4522 02:52:07,240 --> 02:52:10,000 DEVELOP CHRONIC PAIN, YOU KNOW 4523 02:52:10,000 --> 02:52:11,600 REALLY HARD PROBLEMS, BUT THEN 4524 02:52:11,600 --> 02:52:14,960 ON THE 1 HAND, YOU KNOW THE 4525 02:52:14,960 --> 02:52:16,640 SLEEP IS 1 EXAMPLE WHERE WE 4526 02:52:16,640 --> 02:52:18,840 THINK WE CAN REALLY HAVE 4527 02:52:18,840 --> 02:52:20,800 POTENTIAL TO MAKE A BIG 4528 02:52:20,800 --> 02:52:22,840 DIFFERENCE BY ATTACKING THE 4529 02:52:22,840 --> 02:52:27,360 SLEEP, PAIN INTERSECTION. 4530 02:52:27,360 --> 02:52:29,480 SO AGAIN, LOTS OF THINGS TO DO, 4531 02:52:29,480 --> 02:52:35,720 REALLY APPRECIATE YOUR HELP AND 4532 02:52:35,720 --> 02:52:41,040 GIVING US ADVICE ON HOW THINGS 4533 02:52:41,040 --> 02:52:41,920 GO INTERNALLY, AND EXTERNALLY, 4534 02:52:41,920 --> 02:52:42,880 IF YOU THINK THERE'S SOMETHING 4535 02:52:42,880 --> 02:52:47,480 ELSE THAT COULD BE REALLY 4536 02:52:47,480 --> 02:52:49,080 IMPORTANT AND REALLY IMPACTFUL, 4537 02:52:49,080 --> 02:52:50,960 PLEASE LET US KNOW, WE 4538 02:52:50,960 --> 02:52:53,560 DEFINITELY WANT TO HEAR FROM 4539 02:52:53,560 --> 02:52:56,760 OUTSIDE GROUPS IN TERMS OF WHERE 4540 02:52:56,760 --> 02:53:03,920 WE SHOULD BE GOING NEXT AS WELL. 4541 02:53:03,920 --> 02:53:05,520 >>OKAY, THAT SEEMS LIKE A GOOD 4542 02:53:05,520 --> 02:53:07,000 PLACE TO END. 4543 02:53:07,000 --> 02:53:09,360 I WOULD LIKE TO THANK OUR 4544 02:53:09,360 --> 02:53:10,680 PRESENTERS AND I WOULD LIKE TO 4545 02:53:10,680 --> 02:53:11,880 THANK THE AUTHORS OF THE 4546 02:53:11,880 --> 02:53:12,680 CONCEPTS YOU HEARD DISCUSSED 4547 02:53:12,680 --> 02:53:14,000 TODAY AND I WOULD LIKE TO THANK 4548 02:53:14,000 --> 02:53:19,760 YOU ALL FOR YOUR THOUGHTFUL 4549 02:53:19,760 --> 02:53:21,400 MEETING AND FEEDBACK TO THIS 4550 02:53:21,400 --> 02:53:23,000 MEETING FOR GIVING YOUR TIME TO 4551 02:53:23,000 --> 02:53:24,120 HEAL. 4552 02:53:24,120 --> 02:53:29,800 WE WILL CONVENE TOMORROW AT 11 4553 02:53:29,800 --> 02:53:30,480 AM EASTERN TIME, UNTIL THEN 4554 02:53:30,480 --> 00:00:00,000 THANK YOU VERY MUCH.