1 00:00:05,480 --> 00:00:08,880 >> WELCOME, EVERYONE. 2 00:00:08,880 --> 00:00:10,560 I SEE MEMBERS OF THE HEAL 3 00:00:10,560 --> 00:00:12,600 EXECUTIVE COMMITTEE AND MEMBERS 4 00:00:12,600 --> 00:00:16,800 OF THE HEAL MULTI-DISCIPLINARY 5 00:00:16,800 --> 00:00:17,760 WORKING GROUP JOINING. 6 00:00:17,760 --> 00:00:19,360 THANK YOU, ESPECIALLY FROM THE 7 00:00:19,360 --> 00:00:25,200 WEST COAST, IT'S A LITTLE BIT 8 00:00:25,200 --> 00:00:25,640 EARLY. 9 00:00:25,640 --> 00:00:33,440 PARISA, ARE YOU ABLE TO TAKE US 10 00:00:33,440 --> 00:00:33,840 THROUGH ROLL. 11 00:00:33,840 --> 00:00:34,520 >> I'M HERE. 12 00:00:34,520 --> 00:00:37,960 HOPEFULLY YOU CAN HEAR ME. 13 00:00:37,960 --> 00:00:40,960 DR. TABAK IS HERE. 14 00:00:40,960 --> 00:00:45,360 LET'S SEE. 15 00:00:45,360 --> 00:00:48,880 WE HAVE DR. CRISWELL, DR. 16 00:00:48,880 --> 00:00:59,360 WEBSTER, DR. LANGEVIN, I SEE 17 00:01:01,880 --> 00:01:02,080 VOLKOW. 18 00:01:02,080 --> 00:01:02,520 >> DR. NUSSBAUM. 19 00:01:02,520 --> 00:01:03,680 >> CAN WE HAVE THE MEMBERS SAY 20 00:01:03,680 --> 00:01:06,440 GOOD MORNING AND MAKE SURE THEIR 21 00:01:06,440 --> 00:01:07,120 AUDIO WORKS? 22 00:01:07,120 --> 00:01:11,360 >> IT WORKS, I'M HERE. 23 00:01:11,360 --> 00:01:13,840 >> THANK YOU. 24 00:01:13,840 --> 00:01:21,480 25 00:01:21,480 --> 00:01:26,440 >> KEEP GOING. 26 00:01:26,440 --> 00:01:27,840 >> DR. DONOFRIO? 27 00:01:27,840 --> 00:01:28,480 >> HERE. 28 00:01:28,480 --> 00:01:30,280 >> DR. DEBAR? 29 00:01:30,280 --> 00:01:32,120 >> HERE, THANKS. 30 00:01:32,120 --> 00:01:32,840 >> DR. GARLAND? 31 00:01:32,840 --> 00:01:36,240 >> I'M HERE, GOOD TO SEE 32 00:01:36,240 --> 00:01:36,520 EVERYONE. 33 00:01:36,520 --> 00:01:39,160 >> DR. JARREAU. 34 00:01:39,160 --> 00:01:41,240 >> GOOD MORNING, EVERYONE. 35 00:01:41,240 --> 00:01:41,920 >> DR. JERNIGAN. 36 00:01:41,920 --> 00:01:46,920 >> HI, I'M HERE, GOOD MORNING. 37 00:01:46,920 --> 00:01:48,560 >> DR. HENRY? 38 00:01:48,560 --> 00:01:49,360 >> GOOD MORNING. 39 00:01:49,360 --> 00:01:55,560 >> PERFECT. 40 00:01:55,560 --> 00:01:56,320 DR. KUNTZ? 41 00:01:56,320 --> 00:02:01,440 NOT ON YET, OKAY. 42 00:02:01,440 --> 00:02:04,000 DR. NUÑEZ? 43 00:02:04,000 --> 00:02:04,200 OKAY. 44 00:02:04,200 --> 00:02:05,280 DR. PACE? 45 00:02:05,280 --> 00:02:07,520 >> HERE, GOOD MORNING. 46 00:02:07,520 --> 00:02:10,120 >> GOOD MORNING. 47 00:02:10,120 --> 00:02:11,000 DR. SMITH? 48 00:02:11,000 --> 00:02:11,280 >> HI. 49 00:02:11,280 --> 00:02:14,360 >> HELLO. 50 00:02:14,360 --> 00:02:14,760 AND CHRIS BEASLEY. 51 00:02:14,760 --> 00:02:21,280 >> -- CHRIS 52 00:02:21,280 --> 00:02:21,760 VEASLEY. 53 00:02:21,760 --> 00:02:22,200 >> GOOD MORNING. 54 00:02:22,200 --> 00:02:27,080 >> FROM NIH I SEE DR. GORDON 55 00:02:27,080 --> 00:02:28,280 ALSO JOINED. 56 00:02:28,280 --> 00:02:36,040 LET'S SEE HERE. 57 00:02:36,040 --> 00:02:36,240 OKAY. 58 00:02:36,240 --> 00:02:46,640 DR. KOROSHETZ IS HERE. 59 00:02:47,720 --> 00:02:48,440 HELLO. 60 00:02:48,440 --> 00:02:48,680 >> HEY. 61 00:02:48,680 --> 00:02:50,600 >> THAT'S PRETTY GOOD. 62 00:02:50,600 --> 00:02:51,280 THANK YOU. 63 00:02:51,280 --> 00:02:53,680 I WILL EXTEND A WELCOME TO THE 64 00:02:53,680 --> 00:02:55,160 MEMBERS OF THE HEAL EXECUTIVE 65 00:02:55,160 --> 00:03:04,880 COMMITTEE AND MEMBERS OF THE 66 00:03:04,880 --> 00:03:05,520 HEAL MULTI-DISCIPLINARY WORKING 67 00:03:05,520 --> 00:03:05,720 GROUP. 68 00:03:05,720 --> 00:03:07,400 THANK YOU FOR JOINING US AT THE 69 00:03:07,400 --> 00:03:09,120 END OF MAY FOR A BRIEF OPEN 70 00:03:09,120 --> 00:03:10,880 SESSION AND UPDATES AND 71 00:03:10,880 --> 00:03:12,840 INFORMATION ABOUT PROGRESS OF 72 00:03:12,840 --> 00:03:13,920 "HEAL" RESEARCH UNDERWAY. 73 00:03:13,920 --> 00:03:17,680 AND THEN WE'LL SWITCH TO CLOSED 74 00:03:17,680 --> 00:03:19,760 SESSION, WHERE WE WILL DISCUSS 75 00:03:19,760 --> 00:03:21,720 SOME HEAL RESEARCH PROJECTS 76 00:03:21,720 --> 00:03:23,600 UNDER CONSIDERATION. 77 00:03:23,600 --> 00:03:27,080 I'LL NOW TURN IT OVER TO DR. 78 00:03:27,080 --> 00:03:29,000 LAWRENCE TABAK, ACTING DIRECTOR 79 00:03:29,000 --> 00:03:33,560 OF THE NATIONAL NATIONAL INSTIF 80 00:03:33,560 --> 00:03:36,520 HEALTH, TO START US OFF. 81 00:03:36,520 --> 00:03:37,040 GO AHEAD, LARRY. 82 00:03:37,040 --> 00:03:38,040 >> THANKS, REBECCA. 83 00:03:38,040 --> 00:03:39,840 I APPRECIATE YOUR LEADERSHIP OF 84 00:03:39,840 --> 00:03:41,560 THIS RATHER LARGE AND COMPLEX 85 00:03:41,560 --> 00:03:43,960 ENDEAVOR, AND I REALLY WANT TO 86 00:03:43,960 --> 00:03:46,160 THANK YOUR TEAM AS WELL FOR ALL 87 00:03:46,160 --> 00:03:47,360 THAT THEY ARE DOING. 88 00:03:47,360 --> 00:03:50,760 WELCOME TO ALL THE MEMBERS OF 89 00:03:50,760 --> 00:03:51,120 THE GROUP. 90 00:03:51,120 --> 00:03:55,080 I THINK, YOU KNOW, IT'S NOT 91 00:03:55,080 --> 00:03:57,800 HYPERBOLE TO SAY THAT "HEAL" 92 00:03:57,800 --> 00:04:00,120 RESEARCH IS PROVIDING HOPE TO 93 00:04:00,120 --> 00:04:01,080 MILLIONS OF PEOPLE. 94 00:04:01,080 --> 00:04:03,600 AND WHAT WE DO WITH THIS WORKING 95 00:04:03,600 --> 00:04:05,320 GROUP IS WE SEEK A REALITY CHECK 96 00:04:05,320 --> 00:04:08,640 ON WHAT IT IS THAT WE'RE DOING. 97 00:04:08,640 --> 00:04:11,240 THIS GROUP IS ONE OF SEVERAL 98 00:04:11,240 --> 00:04:12,880 WHICH HELPS ENSURE THAT WHAT 99 00:04:12,880 --> 00:04:15,160 WE'RE DOING IS RELEVANT AND 100 00:04:15,160 --> 00:04:20,160 ALIGNED WITH THE STATE OF THE 101 00:04:20,160 --> 00:04:20,720 SCIENCE. 102 00:04:20,720 --> 00:04:22,040 PUBLIC HEALTH CHALLENGE, YOU ALL 103 00:04:22,040 --> 00:04:24,520 KNOW ALL TOO WELL, REMAINS 104 00:04:24,520 --> 00:04:24,760 URGENT. 105 00:04:24,760 --> 00:04:27,040 WE NEED TO BE STRATEGIC ABOUT 106 00:04:27,040 --> 00:04:28,560 OUR RESEARCH PROGRAMS. 107 00:04:28,560 --> 00:04:32,120 AND WE NEED TO GET RESULTS OUT 108 00:04:32,120 --> 00:04:34,720 TO SCIENTISTS AND COMMUNITIES AS 109 00:04:34,720 --> 00:04:36,680 QUICKLY AS POSSIBLE. 110 00:04:36,680 --> 00:04:39,400 I'M VERY PLEASED "HEAL" 111 00:04:39,400 --> 00:04:40,960 CONTINUES TO PUSH FORWARD 112 00:04:40,960 --> 00:04:43,240 NIH-WIDE EFFORTS FOR MORE OPEN 113 00:04:43,240 --> 00:04:47,040 SCIENCE, AND FOR MORE RAPID 114 00:04:47,040 --> 00:04:47,720 DISSEMINATION OF FINDINGS, AND 115 00:04:47,720 --> 00:04:50,880 ALL OF YOU CAN HELP US AMPLIFY 116 00:04:50,880 --> 00:04:53,880 THESE EFFORTS, AND WE THANK YOU 117 00:04:53,880 --> 00:04:57,800 FOR YOUR WILLINGNESS TO DO SO. 118 00:04:57,800 --> 00:05:00,440 NOW, AGAIN, I NEED NOT TELL THIS 119 00:05:00,440 --> 00:05:02,720 GROUP CHRONIC PAIN REMAINS AN 120 00:05:02,720 --> 00:05:04,240 ENORMOUS PUBLIC HEALTH 121 00:05:04,240 --> 00:05:04,600 CHALLENGE. 122 00:05:04,600 --> 00:05:06,200 AND WE KNOW CERTAINLY THAT 123 00:05:06,200 --> 00:05:09,520 CHRONIC PAIN IS JUST NOT A 124 00:05:09,520 --> 00:05:12,240 LONGER-LASTING VERSION OF ACUTE 125 00:05:12,240 --> 00:05:13,120 PAIN. 126 00:05:13,120 --> 00:05:14,200 I THINK WHAT EMERGES IS THAT 127 00:05:14,200 --> 00:05:16,640 WHEN YOU'VE SEEN A PATIENT IN 128 00:05:16,640 --> 00:05:18,480 CHRONIC PAIN, YOU'VE SEEN A 129 00:05:18,480 --> 00:05:20,320 PATIENT IN CHRONIC PAIN. 130 00:05:20,320 --> 00:05:24,480 AND THAT SORT OF GENERIC 131 00:05:24,480 --> 00:05:27,240 APPROACH WON'T NECESSARILY WORK. 132 00:05:27,240 --> 00:05:30,400 AND SO THE WHOLE-PERSON APPROACH 133 00:05:30,400 --> 00:05:32,920 THAT "HEAL" HAS EMBARKED ON DOES 134 00:05:32,920 --> 00:05:34,680 SEEM TO BE IN SYNCHRONY WITH 135 00:05:34,680 --> 00:05:38,360 WHAT WE THINK IS A NEED TO 136 00:05:38,360 --> 00:05:39,920 DEVELOP PERSONALIZED TREATMENT 137 00:05:39,920 --> 00:05:40,920 PLANS FOR PAIN. 138 00:05:40,920 --> 00:05:43,640 JUST A FEW WEEKS AGO, THE 139 00:05:43,640 --> 00:05:45,600 NATIONAL CENTER FOR 140 00:05:45,600 --> 00:05:46,480 COMPLEMENTARY AND INTEGRATIVE 141 00:05:46,480 --> 00:05:48,640 HEALTH PUBLISHED A PAPER ABOUT 142 00:05:48,640 --> 00:05:52,840 CHRONIC PAIN IN THE U.S. 143 00:05:52,840 --> 00:05:55,120 THE STUDY ANALYZED NATIONAL 144 00:05:55,120 --> 00:05:57,200 HEALTH INTERVIEW SURVEY DATA AND 145 00:05:57,200 --> 00:05:59,480 FOUND THAT CHRONIC PAIN IS MORE 146 00:05:59,480 --> 00:06:04,200 COMMON THAN EITHER DEPRESSION OR 147 00:06:04,200 --> 00:06:04,520 DIABETES. 148 00:06:04,520 --> 00:06:07,400 AND THAT I THINK REPRESENTS A 149 00:06:07,400 --> 00:06:09,120 CLEAR CALL TO ACTION FOR THE 150 00:06:09,120 --> 00:06:13,200 IMPORTANT WORK THAT WE'RE ALL 151 00:06:13,200 --> 00:06:15,080 DOING TOGETHER TO CONTINUE. 152 00:06:15,080 --> 00:06:17,680 UNTREATED PAIN CONTINUES TO BE A 153 00:06:17,680 --> 00:06:20,600 TROUBLESOME DRIVER OF OPIOID 154 00:06:20,600 --> 00:06:22,000 USE, AND ITS OBVIOUS 155 00:06:22,000 --> 00:06:23,360 CONSEQUENCES BUT WE'RE MAKING 156 00:06:23,360 --> 00:06:24,800 SOME HEADWAY. 157 00:06:24,800 --> 00:06:28,720 SO TODAY YOU'LL HEAR ABOUT PAIN 158 00:06:28,720 --> 00:06:29,840 MANAGEMENT RESEARCH THAT 159 00:06:29,840 --> 00:06:31,680 INCLUDES THE CONTINUING SEARCH 160 00:06:31,680 --> 00:06:35,640 FOR NEW DRUG PAIN -- NEW PAIN 161 00:06:35,640 --> 00:06:38,120 TARGETS, DEVELOPING BETTER PAIN 162 00:06:38,120 --> 00:06:41,960 MODEL SYSTEMS, AND TESTING 163 00:06:41,960 --> 00:06:43,280 DRUG-FREE PAIN MANAGEMENT 164 00:06:43,280 --> 00:06:43,560 STRATEGIES. 165 00:06:43,560 --> 00:06:44,920 "HEAL" HAS REALLY OPENED UP LOTS 166 00:06:44,920 --> 00:06:50,200 OF THINGS TO ADDRESS THIS MAJOR 167 00:06:50,200 --> 00:06:51,400 HEALTH PROBLEM, HURDLES ARE 168 00:06:51,400 --> 00:06:51,800 MANY. 169 00:06:51,800 --> 00:06:53,000 FOR EXAMPLE, INCLUDING FIGURING 170 00:06:53,000 --> 00:06:55,840 OUT HOW TO INCREASE ACCESS TO 171 00:06:55,840 --> 00:06:57,560 TREATMENTS THAT WORK, HOW TO PAY 172 00:06:57,560 --> 00:07:02,280 FOR THEM, HOW TO BE FAIR AND 173 00:07:02,280 --> 00:07:02,880 EQUITABLE. 174 00:07:02,880 --> 00:07:05,040 BUT "HEAL" IS ALSO WELL 175 00:07:05,040 --> 00:07:06,480 POSITIONED TO ADDRESS THESE 176 00:07:06,480 --> 00:07:09,960 CHALLENGES AS WELL AT MYRIAD OF 177 00:07:09,960 --> 00:07:10,840 WORKFORCE-RELATED ISSUES. 178 00:07:10,840 --> 00:07:15,920 "HEAL" HAS RECENTLY STOOD UP 179 00:07:15,920 --> 00:07:17,200 SEVERAL TRAINING PROGRAMS FOR 180 00:07:17,200 --> 00:07:17,760 INNOVATEIVE RESEARCH FOR 181 00:07:17,760 --> 00:07:19,520 ADDICTION AND PAIN. 182 00:07:19,520 --> 00:07:22,680 ONE IS THE SO-CALLED PURPOSE 183 00:07:22,680 --> 00:07:25,520 NETWORK, WHICH IS A BRAND-NEW 184 00:07:25,520 --> 00:07:27,040 NATIONAL PAIN RESEARCH NETWORK, 185 00:07:27,040 --> 00:07:30,640 BY CONNECTING PAIN SCIENTISTS 186 00:07:30,640 --> 00:07:33,040 FROM ALL DISCIPLINES AT VARIOUS 187 00:07:33,040 --> 00:07:35,880 CAREER STAGES, "HEAL" IS FILLING 188 00:07:35,880 --> 00:07:38,440 A MAJOR GAP BY DEVELOPING AND 189 00:07:38,440 --> 00:07:40,280 NURTURING A COMMUNITY OF 190 00:07:40,280 --> 00:07:41,760 PRACTICE AND MUTUAL LEARNING. 191 00:07:41,760 --> 00:07:45,120 AND JUST LAST WEEK A STUDY 192 00:07:45,120 --> 00:07:48,280 FUNDED BY THE NIH BRAIN 193 00:07:48,280 --> 00:07:49,600 INITIATIVE, HEAL, AND DARPA 194 00:07:49,600 --> 00:07:51,160 REPORTED ON BRAIN SIGNATURES FOR 195 00:07:51,160 --> 00:07:53,640 CHRONIC PAIN AND A SMALL NUMBER 196 00:07:53,640 --> 00:07:56,040 OF FOLKS USING SURGICALLY 197 00:07:56,040 --> 00:07:57,400 IMPLANTED ELECTRODES, TARGETING 198 00:07:57,400 --> 00:08:02,280 THEIR ANTERIOR CINGULATE CORTEX 199 00:08:02,280 --> 00:08:04,040 AND ORBITAL FRONTAL CORTEX, AS 200 00:08:04,040 --> 00:08:04,840 THE PARTICIPANTS ACTUALLY 201 00:08:04,840 --> 00:08:07,120 REPORTED ON CURRENT LEVELS OF 202 00:08:07,120 --> 00:08:07,400 PAIN. 203 00:08:07,400 --> 00:08:11,880 IT REALLY OPENS YOU WILL A WHOE 204 00:08:11,880 --> 00:08:13,440 NEW SET OF THINGS THAT CAN BE 205 00:08:13,440 --> 00:08:15,080 DONE IN THE FUTURE. 206 00:08:15,080 --> 00:08:16,280 THE FEDERAL RESPONSE, BECAUSE 207 00:08:16,280 --> 00:08:18,040 "HEAL" IS AN NIH-WIDE INITIATIVE 208 00:08:18,040 --> 00:08:21,080 DOES BENEFIT FROM A LARGE AND 209 00:08:21,080 --> 00:08:22,720 DIVERSE RESEARCH PORTFOLIO THAT 210 00:08:22,720 --> 00:08:26,360 IS SUPPORTED BY MANY OF THE NIH 211 00:08:26,360 --> 00:08:28,200 INSTITUTES AND CENTERS. 212 00:08:28,200 --> 00:08:30,200 AS YOU KNOW, NIH WORKS VERY 213 00:08:30,200 --> 00:08:33,000 CLOSELY WITH OUR FEDERAL 214 00:08:33,000 --> 00:08:38,840 PARTNERS, INCLUDING THE CDC, 215 00:08:38,840 --> 00:08:43,440 FDA, SAMHSA, DEA, AND OTHERS. 216 00:08:43,440 --> 00:08:45,440 SCIENTIFIC SOLUTIONS ARE REALLY 217 00:08:45,440 --> 00:08:46,840 IMPORTANT TO INFORM UNMET 218 00:08:46,840 --> 00:08:49,120 MEDICAL NEEDS, BUT CLEARLY LAWS 219 00:08:49,120 --> 00:08:51,240 AND POLICY INFORMED BY SCIENCE 220 00:08:51,240 --> 00:08:52,440 ARE ALSO CRITICAL. 221 00:08:52,440 --> 00:08:56,800 WE MEET MONTHLY WITH OUR FEDERAL 222 00:08:56,800 --> 00:08:58,000 PARTNERS AND OUR WORK TOGETHER 223 00:08:58,000 --> 00:09:02,640 WE FEEL IS HAVING AN IMPORTANT 224 00:09:02,640 --> 00:09:04,080 IMPACT ON THE NATIONAL LANDSCAPE 225 00:09:04,080 --> 00:09:06,440 ON WHICH HEAL RESEARCH IS 226 00:09:06,440 --> 00:09:06,760 CONDUCTED. 227 00:09:06,760 --> 00:09:09,040 AS YOU'VE HEARD IN MARCH, THE 228 00:09:09,040 --> 00:09:14,120 FDA APPROVED OVER THE COUNTER 229 00:09:14,120 --> 00:09:15,320 NALOXONE, AN IMPORTANT STEP 230 00:09:15,320 --> 00:09:17,520 GUIDED BY A PRODUCTER FEDERAL 231 00:09:17,520 --> 00:09:19,360 RESPONSE INCLUDING OUTREACH TO 232 00:09:19,360 --> 00:09:20,880 STATES THROUGH SAMHSA, AND WORK 233 00:09:20,880 --> 00:09:23,880 IS UNDERWAY TO FIGURE OUT HOW TO 234 00:09:23,880 --> 00:09:26,920 INCREASE ACCESS TO THIS 235 00:09:26,920 --> 00:09:27,920 LIFE-SAVING MEDICATION. 236 00:09:27,920 --> 00:09:30,000 UNFORTUNATELY COST REMAINS A 237 00:09:30,000 --> 00:09:30,480 BARRIER. 238 00:09:30,480 --> 00:09:33,800 AND SOME RESEARCHERS ARE USING 239 00:09:33,800 --> 00:09:35,200 THESE INNOVATIVE APPROACHES 240 00:09:35,200 --> 00:09:37,240 TAKING ADVANTAGE OF A.I. AND 241 00:09:37,240 --> 00:09:39,000 SOCIAL MEDIA TO SEE IF THEY CAN 242 00:09:39,000 --> 00:09:40,840 FIGURE OUT BETTER WAYS TO TRACK 243 00:09:40,840 --> 00:09:46,520 OVERDOSE AND DRUG USE PATTERNS 244 00:09:46,520 --> 00:09:48,640 SO THEY CAN MAP THE PLACE WHERE 245 00:09:48,640 --> 00:09:50,480 HELP IS MOST NEEDED. 246 00:09:50,480 --> 00:09:52,680 NOW, IN ADDITION, JUST LAST WEEK 247 00:09:52,680 --> 00:09:55,000 FDA APPROVED TWO NEW MEDICATIONS 248 00:09:55,000 --> 00:09:57,960 TO HELP PEOPLE KEEP SAFE AND 249 00:09:57,960 --> 00:09:59,520 FIND LONG-TERM RECOVERY. 250 00:09:59,520 --> 00:10:03,120 ONE IS A NALOXONE ALTERNATIVE, A 251 00:10:03,120 --> 00:10:09,560 NASAL SPRAY VERSION OF NALOPHANE 252 00:10:09,560 --> 00:10:10,800 THAT CAN QUICKLY RESUSCITATE 253 00:10:10,800 --> 00:10:12,520 USERS AND PROTECT FROM RELAPSE, 254 00:10:12,520 --> 00:10:15,040 USED FOR DECADES TO REVERSE 255 00:10:15,040 --> 00:10:20,840 OVERDOSES OF HEROIN, FENTANYL, 256 00:10:20,840 --> 00:10:22,080 AND PRESCRIPTION PAIN KILLERS, 257 00:10:22,080 --> 00:10:23,480 AND THIS UNLIKE NALOXONE ENTERS 258 00:10:23,480 --> 00:10:25,200 THE BRAIN VERY QUICKLY AND 259 00:10:25,200 --> 00:10:28,520 REMAINS LONGER IN THE BODY. 260 00:10:28,520 --> 00:10:31,800 THE SECOND APPROVAL PROVIDES A 261 00:10:31,800 --> 00:10:35,960 NEW BUPRENORPHINE DOSING OPTION, 262 00:10:35,960 --> 00:10:38,720 SPECIFICALLY THE FDA APPROVED 263 00:10:38,720 --> 00:10:40,880 THE EXTENDED RELEASE 264 00:10:40,880 --> 00:10:43,400 BUPRENORPHINE INJECTION TO TREAT 265 00:10:43,400 --> 00:10:45,960 MINOR TO SEVERE OPIOID USE 266 00:10:45,960 --> 00:10:52,280 DISORDER, AVAILABLE IN DIFFERENT 267 00:10:52,280 --> 00:10:55,240 FORMULATIONS THAT COULD BE 268 00:10:55,240 --> 00:10:56,040 ADMINISTERED WEEKLY OR MONTHLY, 269 00:10:56,040 --> 00:10:58,880 REFLECTING A REAL AND MEANINGFUL 270 00:10:58,880 --> 00:10:59,480 COLLABORATION ONGOING BETWEEN 271 00:10:59,480 --> 00:11:02,600 THE NIH AND THE FDA. 272 00:11:02,600 --> 00:11:05,920 BUT OBVIOUSLY WE CAN'T JUST REST 273 00:11:05,920 --> 00:11:07,640 ON THESE RECENT SUCCESSES. 274 00:11:07,640 --> 00:11:14,000 THERE ARE MANY NEW THREATS LIKE 275 00:11:14,000 --> 00:11:15,840 XYLAZINE AND DRUG COMBINATIONS 276 00:11:15,840 --> 00:11:18,840 THAT MAKE OUR ONGOING WORK 277 00:11:18,840 --> 00:11:20,520 CHALLENGING AN UNPREDICTABLE. 278 00:11:20,520 --> 00:11:21,480 XYLAZINE IS A MAJOR CHALLENGE 279 00:11:21,480 --> 00:11:24,440 FOR PUBLIC HEALTH. 280 00:11:24,440 --> 00:11:28,040 THIS NON-OPIOID ANIMAL 281 00:11:28,040 --> 00:11:29,480 TRANQUILIZER, HENCE THE NICKNAME 282 00:11:29,480 --> 00:11:31,480 TRANQ ON THE STREET IS MIXED 283 00:11:31,480 --> 00:11:32,960 WITH OTHER DRUGS SUCH AS 284 00:11:32,960 --> 00:11:37,800 FENTANYL ARE NO GOOD ANTIDOTE 285 00:11:37,800 --> 00:11:38,760 FOR THIS. 286 00:11:38,760 --> 00:11:41,400 IT CAN LEAD TO SERIOUS TISSUE 287 00:11:41,400 --> 00:11:45,720 DAMAGE AT THE INJECTION SITE. 288 00:11:45,720 --> 00:11:47,000 PREVIOUSLY XYLAZINE WAS MAINLY 289 00:11:47,000 --> 00:11:49,520 USED IN A FEW CITIES ON THE EAST 290 00:11:49,520 --> 00:11:53,240 COAST BUT NOW THIS DEVASTATING 291 00:11:53,240 --> 00:11:55,600 DRUG HAS SPREAD RAPIDLY ACROSS 292 00:11:55,600 --> 00:11:56,600 THE COUNTRY. 293 00:11:56,600 --> 00:11:59,040 JUST LAST MONTH THE WHITE HOUSE 294 00:11:59,040 --> 00:12:03,520 OFFICE OF NATIONAL DRUG CONTROL 295 00:12:03,520 --> 00:12:07,040 POLICY DESIGNATED FENTANYL 296 00:12:07,040 --> 00:12:09,080 ADULTERATED WITH XYLAZINE AS AN 297 00:12:09,080 --> 00:12:09,520 EMERGING THREAT. 298 00:12:09,520 --> 00:12:11,360 THE BIDEN ADMINISTRATION WILL BE 299 00:12:11,360 --> 00:12:13,800 RELEASING A RESPONSE PLAN AND 300 00:12:13,800 --> 00:12:14,680 IMPLEMENTATION GUIDANCE TO 301 00:12:14,680 --> 00:12:15,680 ADDRESS THIS THREAT. 302 00:12:15,680 --> 00:12:19,840 THE PLAN WILL INVOLVE TESTING, 303 00:12:19,840 --> 00:12:20,360 EPIDEMIOLOGY, PREVENTION, 304 00:12:20,360 --> 00:12:23,400 TREATMENT, AND CARE, AS WELL AS 305 00:12:23,400 --> 00:12:28,240 THE NECESSARY DATA SYSTEMS AND 306 00:12:28,240 --> 00:12:29,040 STRATEGIES TO ADDRESS SUPPLY 307 00:12:29,040 --> 00:12:30,120 CHAIN ISSUES. 308 00:12:30,120 --> 00:12:32,760 THE PLAN WILL CALL FOR 309 00:12:32,760 --> 00:12:33,640 COLLABORATION ACROSS FEDERAL 310 00:12:33,640 --> 00:12:37,040 AGENCIES AND WILL CALL FOR 311 00:12:37,040 --> 00:12:39,640 RESEARCH, INCLUDING STUDIES TO 312 00:12:39,640 --> 00:12:41,720 UNDERSTAND INTERACTION BETWEEN 313 00:12:41,720 --> 00:12:44,680 FENTANYL AND XYLAZINE. 314 00:12:44,680 --> 00:12:47,200 FEDERAL POLICY CERTAINLY AFFECTS 315 00:12:47,200 --> 00:12:51,000 "HEAL" RESEARCH AND THE 316 00:12:51,000 --> 00:12:53,000 POPULATION RESEARCH AND POLICY 317 00:12:53,000 --> 00:12:54,400 SURROUNDING TELEHEALTH LOOM 318 00:12:54,400 --> 00:12:54,960 LARGE. 319 00:12:54,960 --> 00:12:56,360 NOW, MEMORIES OF THE PANDEMIC 320 00:12:56,360 --> 00:12:58,440 LIFE ARE STILL VERY FRESH IN ALL 321 00:12:58,440 --> 00:13:01,200 OF OUR MINDS, AND MANY PEOPLE 322 00:13:01,200 --> 00:13:04,040 HAVE COME TO APPRECIATE THE 323 00:13:04,040 --> 00:13:06,600 FLEXIBILITY OF THE VARIOUS 324 00:13:06,600 --> 00:13:08,040 TELEHEALTH PLATFORMS FOR 325 00:13:08,040 --> 00:13:08,920 RECEIVING CARE FROM PHYSICIANS 326 00:13:08,920 --> 00:13:11,520 AND OTHER HEALTH CARE PROVIDERS 327 00:13:11,520 --> 00:13:13,920 TO ACCESS MEDICATIONS AND MENTAL 328 00:13:13,920 --> 00:13:14,400 HEALTH TREATMENT. 329 00:13:14,400 --> 00:13:18,760 YOU MAY HAVE HEARD THAT THE DEA 330 00:13:18,760 --> 00:13:20,640 IN CONCERT WITH HHS ISSUED A 331 00:13:20,640 --> 00:13:26,360 TEMPORARY RULE EXTENDING ALL 332 00:13:26,360 --> 00:13:28,160 THESE FLEXIBILITIES BUT 333 00:13:28,160 --> 00:13:29,960 TELEHEALTH PRESCRIBING SERVICES 334 00:13:29,960 --> 00:13:32,240 THROUGH NOVEMBER 11 INCLUDES 335 00:13:32,240 --> 00:13:36,000 BOTH PRESCRIPTION OF METHADONE 336 00:13:36,000 --> 00:13:37,160 AND BUPRENORPHINE. 337 00:13:37,160 --> 00:13:40,240 DEAE AND HHS HOSTED A TOWN HALL 338 00:13:40,240 --> 00:13:46,720 IN MARCH TO DISCUSS 339 00:13:46,720 --> 00:13:48,160 BUPRENORPHINE AVAILABILITY WITH 340 00:13:48,160 --> 00:13:48,880 PHARMACEUTICALS ORGANIZATIONS, 341 00:13:48,880 --> 00:13:53,840 WHOLE WHOLESALERS. 342 00:13:53,840 --> 00:13:55,280 TELEHEALTH IS A FLUID 343 00:13:55,280 --> 00:13:56,680 ENVIRONMENT THAT WILL BENEFIT 344 00:13:56,680 --> 00:13:57,920 FROM RESEARCH AND POLICY 345 00:13:57,920 --> 00:13:59,320 PRACTICE, AND NO DOUBT WHEN THIS 346 00:13:59,320 --> 00:14:01,520 GROUP MEETS AGAIN WE'LL HAVE AN 347 00:14:01,520 --> 00:14:07,600 UPDATE ON THE STATUS OF 348 00:14:07,600 --> 00:14:07,920 TELEHEALTH. 349 00:14:07,920 --> 00:14:09,800 WHEN YOU MET IN FEBRUARY YOU 350 00:14:09,800 --> 00:14:11,800 HEARD ABOUT NEW LEGISLATION THAT 351 00:14:11,800 --> 00:14:15,280 AFFECTS THE CONTEXT OF "HEAL" 352 00:14:15,280 --> 00:14:16,040 RESEARCH, THE MAINSTREAMING 353 00:14:16,040 --> 00:14:19,440 ADDICTION TREATMENT ACT AND 354 00:14:19,440 --> 00:14:21,280 MEDICATION ACCESS AND TRAINING 355 00:14:21,280 --> 00:14:24,040 EXPANSION ACT PROVIDED HISTORIC 356 00:14:24,040 --> 00:14:25,680 FUNDING FOR MENTAL AND 357 00:14:25,680 --> 00:14:28,520 BEHAVIORAL HEALTH PROGRAMS. 358 00:14:28,520 --> 00:14:31,800 THE LAWS WILL UPDATE TRAINING 359 00:14:31,800 --> 00:14:32,920 REQUIREMENTS FOR CLINICAL 360 00:14:32,920 --> 00:14:35,520 WORKERS, AND PUT MORE DOLLARS 361 00:14:35,520 --> 00:14:36,800 INTO THE GROWING BEHAVIORAL 362 00:14:36,800 --> 00:14:38,160 HEALTH WORKFORCE WHICH AS YOU 363 00:14:38,160 --> 00:14:42,000 ALL KNOW IS UNDER SEVERE STRESS. 364 00:14:42,000 --> 00:14:44,840 "HEAL"'S EFFORTS TO STRENGTHEN 365 00:14:44,840 --> 00:14:46,680 THE PAIN WORKFORCE ARE AN 366 00:14:46,680 --> 00:14:50,920 IMPORTANT ADJUNCT TO THESE NEW 367 00:14:50,920 --> 00:14:52,040 LAWS. 368 00:14:52,040 --> 00:14:54,440 NOW, TO CONCLUDE, THE NATIONAL 369 00:14:54,440 --> 00:14:56,760 CRISIS OF UNDERTREATED PAIN 370 00:14:56,760 --> 00:15:00,760 SUBSTANCE USE AND OVERDOSE IS A 371 00:15:00,760 --> 00:15:02,440 SIGNIFICANT CHALLENGE, TO BE 372 00:15:02,440 --> 00:15:02,640 SURE. 373 00:15:02,640 --> 00:15:05,080 SEEMS THAT EVERY FEW MONTHS A 374 00:15:05,080 --> 00:15:06,920 NEW WRINKLE EMERGES, COMPLICATED 375 00:15:06,920 --> 00:15:10,080 AN ALREADY COMPLEX SUITE OF 376 00:15:10,080 --> 00:15:11,520 HEALTH CONDITIONS, INFLUENCED BY 377 00:15:11,520 --> 00:15:15,840 OF COURSE MANY SOCIETAL FACTORS. 378 00:15:15,840 --> 00:15:18,080 WHAT RESEARCHERS HOPE, IT IS 379 00:15:18,080 --> 00:15:19,200 IMMENSELY GRATIFYING TO SEE 380 00:15:19,200 --> 00:15:20,920 MAJOR RESULTS NOW COMING 381 00:15:20,920 --> 00:15:22,440 THROUGH, AND REBECCA WILL SHARE 382 00:15:22,440 --> 00:15:25,000 MANY OF THESE WITH YOU SHORTLY. 383 00:15:25,000 --> 00:15:29,480 THROUGH THE POWER OF SCIENCE AND 384 00:15:29,480 --> 00:15:30,360 EMPOWERING COMMUNITIES, "HEAL" 385 00:15:30,360 --> 00:15:32,440 IS MAKING A DIFFERENCE IN LIVES 386 00:15:32,440 --> 00:15:34,600 OF INDIVIDUALS AND COMMUNITIES 387 00:15:34,600 --> 00:15:36,160 ACROSS THE NATION. 388 00:15:36,160 --> 00:15:37,760 I WANT TO THANK YOU AGAIN FOR 389 00:15:37,760 --> 00:15:41,160 YOUR TIME, FOR YOUR TALENT, AND 390 00:15:41,160 --> 00:15:42,720 YOUR DEDICATION TO THESE 391 00:15:42,720 --> 00:15:42,960 PROGRAMS. 392 00:15:42,960 --> 00:15:45,000 WE CERTAINLY RELY ON YOU TO HELP 393 00:15:45,000 --> 00:15:47,200 ENSURE THAT WE'RE ON THE BEST 394 00:15:47,200 --> 00:15:50,840 PATH FORWARD, TO ACHIEVE THE 395 00:15:50,840 --> 00:15:52,240 "HEAL" MISSION OF ENDING 396 00:15:52,240 --> 00:15:52,800 ADDICTION LONG TERM. 397 00:15:52,800 --> 00:15:55,440 AND SO WITH THAT I THANK YOU 398 00:15:55,440 --> 00:15:57,040 AND, REBECCA, I WILL TURN IT 399 00:15:57,040 --> 00:15:57,360 BACK TO YOU. 400 00:15:57,360 --> 00:15:59,600 >> THANK YOU SO MUCH, DR. 401 00:15:59,600 --> 00:16:01,120 TABAK. 402 00:16:01,120 --> 00:16:03,000 IT'S NOW MY PLEASURE TO TURN IT 403 00:16:03,000 --> 00:16:05,720 OVER TO DR. WALTER KOROSHETZ, 404 00:16:05,720 --> 00:16:16,160 DIRECTOR OF THE NATIONAL 405 00:16:17,960 --> 00:16:18,400 INSTITUTE OF NEUROLOGICAL 406 00:16:18,400 --> 00:16:20,200 DISORDERS AND STROKE. 407 00:16:20,200 --> 00:16:21,280 TAKE IT AWAY, WALTER. 408 00:16:21,280 --> 00:16:23,360 >> THANKS VERY MUCH, REBECCA. 409 00:16:23,360 --> 00:16:24,840 THANKS VERY MUCH, LARRY. 410 00:16:24,840 --> 00:16:28,040 AND, YES, I'M GOING TO TALK 411 00:16:28,040 --> 00:16:30,280 ABOUT THE OVERVIEW OF THE 412 00:16:30,280 --> 00:16:33,040 CLINICAL PAIN REVIEW. 413 00:16:33,040 --> 00:16:37,200 NEXT SLIDE. 414 00:16:37,200 --> 00:16:40,480 SO, JUST TO -- I'M NOT MUTED, AM 415 00:16:40,480 --> 00:16:40,720 I? 416 00:16:40,720 --> 00:16:41,360 NO, OKAY. 417 00:16:41,360 --> 00:16:43,520 >> WE HEAR YOU. 418 00:16:43,520 --> 00:16:44,440 >> OKAY. 419 00:16:44,440 --> 00:16:47,480 YEAH, JUST TO GO BACK A SECOND, 420 00:16:47,480 --> 00:16:50,360 AS WE STARTED "HEAL," THE 421 00:16:50,360 --> 00:16:53,960 PURPOSE WAS TO DEVELOP 422 00:16:53,960 --> 00:16:55,040 NON-ADDICTIVE TREATMENTS FOR 423 00:16:55,040 --> 00:16:58,440 PAIN, AND THAT WAS DEVELOPING 424 00:16:58,440 --> 00:17:00,640 NOVEL TREATMENTS BUT ALSO 425 00:17:00,640 --> 00:17:02,440 TESTING THINGS THAT ARE ALREADY, 426 00:17:02,440 --> 00:17:06,960 YOU KNOW, IN THE ARMAMENTARIUM 427 00:17:06,960 --> 00:17:08,440 TO IMPROVE MANAGEMENT OF PAIN, 428 00:17:08,440 --> 00:17:09,880 WHICH LARRY TOLD US HOW BIG A 429 00:17:09,880 --> 00:17:14,120 PROBLEM IT IS, BUT ALSO TO 430 00:17:14,120 --> 00:17:15,640 REDUCE ADDICTION AS A 431 00:17:15,640 --> 00:17:16,400 CONSEQUENCE BECAUSE THAT'S KIND 432 00:17:16,400 --> 00:17:20,360 OF HOW WE GOT INTO THE EPIDEMIC 433 00:17:20,360 --> 00:17:22,000 OF OPIOID OVERUSE DISORDERS IN 434 00:17:22,000 --> 00:17:23,240 THE FIRST PLACE. 435 00:17:23,240 --> 00:17:26,960 SO IN THE PAIN SPACE, THE 436 00:17:26,960 --> 00:17:29,200 DISCOVERY PART IS DONE PRIMARILY 437 00:17:29,200 --> 00:17:31,320 BY THE INSTITUTES. 438 00:17:31,320 --> 00:17:33,640 BUT THEN "HEAL" HAS PROGRAMS TO 439 00:17:33,640 --> 00:17:36,040 MOVE DISCOVERY THROUGH THE 440 00:17:36,040 --> 00:17:37,520 PRE-CLINICAL DEVELOPMENT SPACE, 441 00:17:37,520 --> 00:17:39,640 TO DEVELOP A NOVEL THERAPY THAT 442 00:17:39,640 --> 00:17:41,400 WOULD HOPEFULLY GET PICKED UP BY 443 00:17:41,400 --> 00:17:44,680 INDUSTRY FOLKS AND BROUGHT TO 444 00:17:44,680 --> 00:17:45,080 COMMERCIALIZATION. 445 00:17:45,080 --> 00:17:46,920 NOW, UNFORTUNATELY, THAT IS A 446 00:17:46,920 --> 00:17:47,840 PROBLEM BECAUSE THERE'S VERY 447 00:17:47,840 --> 00:17:49,800 LITTLE INTEREST ON THE PART OF 448 00:17:49,800 --> 00:17:55,520 THE INDUSTRY DUE TO PREVIOUS 449 00:17:55,520 --> 00:17:56,000 FAILURES. 450 00:17:56,000 --> 00:17:57,800 BUT THERE ARE BIOTECH COMPANIES 451 00:17:57,800 --> 00:17:59,760 IN THIS SPACE, AND WE'RE HOPING 452 00:17:59,760 --> 00:18:02,920 TO DE-RISK SOME OF THIS PROCESS 453 00:18:02,920 --> 00:18:04,240 SO EVENTUALLY PATIENTS WILL SEE 454 00:18:04,240 --> 00:18:05,240 MUCH MORE EFFECTIVE TREATMENTS 455 00:18:05,240 --> 00:18:07,640 FOR CHRONIC PAIN THAT DON'T 456 00:18:07,640 --> 00:18:08,480 CAUSE ADDICTION. 457 00:18:08,480 --> 00:18:13,320 BUT IN THAT SPACE WE DO SOME 458 00:18:13,320 --> 00:18:14,280 CLINICAL TRIALS, SAY EPPIC-NET 459 00:18:14,280 --> 00:18:18,480 PHASE 2 STUDY OF NOVEL 460 00:18:18,480 --> 00:18:20,200 THERAPIES, WE ARE DOING CLINICAL 461 00:18:20,200 --> 00:18:22,080 TRIALS TO TEST DIFFERENT WAYS 462 00:18:22,080 --> 00:18:23,160 MANAGING DIFFERENT TYPES OF PAIN 463 00:18:23,160 --> 00:18:27,120 IN A MUCH MORE EFFECTIVE MANNER, 464 00:18:27,120 --> 00:18:31,040 AND ALSO IN DOING SO REDUCING 465 00:18:31,040 --> 00:18:33,440 THE RISK OF ADDICTION. 466 00:18:33,440 --> 00:18:35,760 SO, IN TERMS OF THE SPACES THAT 467 00:18:35,760 --> 00:18:38,480 WE'RE IN NOW, WE'RE LOOKING 468 00:18:38,480 --> 00:18:39,600 HEAVILY AT CLINICAL BIOMARKERS 469 00:18:39,600 --> 00:18:41,360 BECAUSE ONE THING THAT'S KEEPING 470 00:18:41,360 --> 00:18:44,200 THE COMPANIES OUT OF THE PAIN 471 00:18:44,200 --> 00:18:50,720 SPACE IS THAT THIS RELIANCE ON 472 00:18:50,720 --> 00:18:51,360 PAIN ASSESSMENT 1-10 SCALE HOW 473 00:18:51,360 --> 00:18:52,800 MUCH PAIN DO YOU HAVE, THERE 474 00:18:52,800 --> 00:18:54,640 AREN'T THE KIND OF BIOLOGICAL 475 00:18:54,640 --> 00:18:57,080 MARKERS THAT YOU NEED TO TEST 476 00:18:57,080 --> 00:18:58,960 YOUR DRUG AGAINST A TARGET TO 477 00:18:58,960 --> 00:19:01,680 KNOW IF YOU HAVE TARGET 478 00:19:01,680 --> 00:19:02,640 ENGAGEMENT OR PROOF OF 479 00:19:02,640 --> 00:19:02,920 PRINCIPLE. 480 00:19:02,920 --> 00:19:05,560 SO WE HAVE A BIOMARKER PROGRAM, 481 00:19:05,560 --> 00:19:06,800 AGAIN VERY DIFFICULT IN THE PAIN 482 00:19:06,800 --> 00:19:10,200 SPACE BUT WE'RE MAKING SOME 483 00:19:10,200 --> 00:19:10,840 PROGRESS. 484 00:19:10,840 --> 00:19:11,520 NOW, MUSCULOSKELETAL PAIN 485 00:19:11,520 --> 00:19:12,600 ESPECIALLY LOW BACK PAIN AND 486 00:19:12,600 --> 00:19:14,080 NECK PAIN ARE LEADING CAUSE OF 487 00:19:14,080 --> 00:19:16,640 DISABILITY IN THE U.S. 488 00:19:16,640 --> 00:19:19,200 AND WE HAVE A PROGRAM BACPAC 489 00:19:19,200 --> 00:19:23,880 WHICH IS RUN BY DR. CRISWELL'S 490 00:19:23,880 --> 00:19:25,720 INSTITUTE, NIAMS, TRYING TO GET 491 00:19:25,720 --> 00:19:28,520 AT THE UNDERLYING DIFFERENT 492 00:19:28,520 --> 00:19:32,120 CAUSES OF THIS VERY TROUBLESOME 493 00:19:32,120 --> 00:19:35,160 PROBLEM, AND DEVELOPING KIND OF 494 00:19:35,160 --> 00:19:35,920 CUSTOMIZED TREATMENTS DEPENDING 495 00:19:35,920 --> 00:19:38,240 ON WHAT IS THE NATURE OF THE 496 00:19:38,240 --> 00:19:38,520 CONDITION. 497 00:19:38,520 --> 00:19:42,080 AS I MENTIONED, WE HAVE THE 498 00:19:42,080 --> 00:19:43,600 EPPIC-NET PROGRAM TO BRING 499 00:19:43,600 --> 00:19:46,040 THINGS IN USUALLY FROM BIOTECH 500 00:19:46,040 --> 00:19:47,360 COMPANIES INTO FIRST-IN-HUMAN 501 00:19:47,360 --> 00:19:50,080 TRIALS, A VERY INTERESTING STUDY 502 00:19:50,080 --> 00:19:54,880 IN PEOPLE ON DIALYSIS WHO SUFFER 503 00:19:54,880 --> 00:19:58,200 PAIN, VERY COMMONLY, TO GET MORE 504 00:19:58,200 --> 00:19:58,800 EFFECTIVE NON-ADDICTIVE 505 00:19:58,800 --> 00:19:59,120 TREATMENTS. 506 00:19:59,120 --> 00:20:05,080 WE HAVE A NUMBER OF 507 00:20:05,080 --> 00:20:07,480 EFFECTIVENESS TRIALS, THE EARN 508 00:20:07,480 --> 00:20:12,640 NETWORK TESTING DIFFERENT WAYS 509 00:20:12,640 --> 00:20:14,200 OF TESTING PAINING WITH 510 00:20:14,200 --> 00:20:16,800 PHARMACOLOGICAL, AND A SUITE OF 511 00:20:16,800 --> 00:20:19,040 PRAGMATIC TRIALS RUN BY DR. 512 00:20:19,040 --> 00:20:21,760 LANGEVIN'S GROUP PRIMARILY, 513 00:20:21,760 --> 00:20:22,960 TESTING MOSTLY 514 00:20:22,960 --> 00:20:24,040 NON-PHARMACOLOGICAL THERAPIES IN 515 00:20:24,040 --> 00:20:26,480 HEALTH CARE SYSTEMS, WE HAVE 516 00:20:26,480 --> 00:20:28,120 RESEARCH TO IMPROVE HEALTH 517 00:20:28,120 --> 00:20:30,680 EQUITY IN TERMS OF TREATMENT OF 518 00:20:30,680 --> 00:20:31,240 PAIN. 519 00:20:31,240 --> 00:20:32,920 AND THE BIG PROBLEM IS HOW TO 520 00:20:32,920 --> 00:20:35,320 MANAGE PEOPLE WHO HAVE A 521 00:20:35,320 --> 00:20:37,640 COMBINATION OF PAIN AND OPIOID 522 00:20:37,640 --> 00:20:40,160 OVERUSE DISORDER, OR PAIN AND 523 00:20:40,160 --> 00:20:41,640 CHRONIC OPIOID USE. 524 00:20:41,640 --> 00:20:44,400 AND A BIG PUSH TO TRY TO MOVE 525 00:20:44,400 --> 00:20:46,040 INTO RURAL POPULATIONS WHERE THE 526 00:20:46,040 --> 00:20:47,400 PAIN PROBLEM IS ACTUALLY WORSE 527 00:20:47,400 --> 00:20:51,080 THAN IT IS IN URBAN AREAS, AND, 528 00:20:51,080 --> 00:20:54,800 AGAIN, ACCESS TO THERAPIES IS 529 00:20:54,800 --> 00:20:55,080 NOT AS GOOD. 530 00:20:55,080 --> 00:20:56,600 A NUMBER OF THINGS THAT WE DO I 531 00:20:56,600 --> 00:20:58,440 THINK IS GOING TO REALLY 532 00:20:58,440 --> 00:21:01,400 TRANSFORM THE FUTURE OF PAIN 533 00:21:01,400 --> 00:21:02,160 RESEARCH. 534 00:21:02,160 --> 00:21:03,920 WE'RE DEVELOPING SYSTEMS TO 535 00:21:03,920 --> 00:21:05,320 ENGAGE PATIENTS LIKE NEVER 536 00:21:05,320 --> 00:21:05,560 BEFORE. 537 00:21:05,560 --> 00:21:08,280 OF COURSE FOR PAIN THIS IS SO 538 00:21:08,280 --> 00:21:09,400 INCREDIBLY IMPORTANT BECAUSE 539 00:21:09,400 --> 00:21:11,560 IT'S THAT EXPERIENCE OF PAIN IS 540 00:21:11,560 --> 00:21:13,440 WHAT WE'RE TRYING TO GET AT, AND 541 00:21:13,440 --> 00:21:15,600 SUFFERING CAUSED BY THE PAIN NOT 542 00:21:15,600 --> 00:21:16,720 NECESSARILY SENSATION OF PAIN 543 00:21:16,720 --> 00:21:18,600 BUT THAT SUFFERING THAT GOES 544 00:21:18,600 --> 00:21:21,520 ALONG WITH IT. 545 00:21:21,520 --> 00:21:22,960 THE PAIN WORKFORCE IS ALSO 546 00:21:22,960 --> 00:21:24,000 SOMETHING THAT WE'RE 547 00:21:24,000 --> 00:21:25,920 CONCENTRATING ON, PARTICULARLY 548 00:21:25,920 --> 00:21:30,640 IN THE CLINICAL SIDE. 549 00:21:30,640 --> 00:21:31,920 AS CLINICIANS SPECIALIZING IN 550 00:21:31,920 --> 00:21:33,880 PAIN ARE BECOMING QUITE RARE, 551 00:21:33,880 --> 00:21:37,840 BUT YET THE RESEARCH THAT'S 552 00:21:37,840 --> 00:21:40,360 COMING OUT OF THE DISCOVERY PAIN 553 00:21:40,360 --> 00:21:44,760 SCIENCE IS REALLY QUITE 554 00:21:44,760 --> 00:21:45,960 STRIKING, ADVANCED, TRYING TO 555 00:21:45,960 --> 00:21:47,160 MATCH UP A CLINICAL WORKFORCE 556 00:21:47,160 --> 00:21:51,560 THAT CAN TAKE ADVANTAGE OF THESE 557 00:21:51,560 --> 00:21:52,440 EXPLOSIONS IN THE NEUROSCIENCE I 558 00:21:52,440 --> 00:21:54,200 THINK IS WHAT WE'RE HOPING TO 559 00:21:54,200 --> 00:21:54,400 DO. 560 00:21:54,400 --> 00:21:55,400 AGAIN, WE'RE TRYING TO IMPROVE 561 00:21:55,400 --> 00:21:57,440 THE DIVERSITY OF THE WORKFORCE 562 00:21:57,440 --> 00:21:58,880 AND THROUGH ALL THIS THE IDEA IS 563 00:21:58,880 --> 00:22:01,640 TO TRY AND BRING ALL THE DATA 564 00:22:01,640 --> 00:22:04,240 TOGETHER SO THAT ONE CAN COMPARE 565 00:22:04,240 --> 00:22:05,280 ACROSS DIFFERENT PAIN 566 00:22:05,280 --> 00:22:05,960 CONDITIONS, DIFFERENT 567 00:22:05,960 --> 00:22:06,960 TREATMENTS. 568 00:22:06,960 --> 00:22:11,040 SO THIS IS KIND OF THE CLINICAL 569 00:22:11,040 --> 00:22:13,360 PAIN PROGRAM IN TOTO AS IT 570 00:22:13,360 --> 00:22:15,440 STANDS RIGHT NOW, NOT WITH ALL 571 00:22:15,440 --> 00:22:19,960 THE DETAILS BUT IN BROAD 572 00:22:19,960 --> 00:22:20,160 STROKES. 573 00:22:20,160 --> 00:22:20,720 NEXT SLIDE. 574 00:22:20,720 --> 00:22:21,800 THE NEXT SLIDE SHOWS WHERE WE 575 00:22:21,800 --> 00:22:24,400 ARE IN TERMS OF TYPE OF PAIN 576 00:22:24,400 --> 00:22:24,880 CONDITIONS. 577 00:22:24,880 --> 00:22:28,040 IN TERMS OF LOOKING AT THE 578 00:22:28,040 --> 00:22:31,320 BIOMARKERS AND THE DIFFERENT 579 00:22:31,320 --> 00:22:33,160 BIOMARKER ASSAYS PEOPLE ARE 580 00:22:33,160 --> 00:22:35,360 LOOKING AT IN FLUIDS, 581 00:22:35,360 --> 00:22:37,240 MULTI-MODALITY BIOMARKERS, EVEN 582 00:22:37,240 --> 00:22:39,080 SOME EEG BIOMARKERS, MANY OF 583 00:22:39,080 --> 00:22:47,680 THEM GETTING AT PROGNOSTIC, 584 00:22:47,680 --> 00:22:48,720 PARTICULARLY IN POST-SURGICAL 585 00:22:48,720 --> 00:22:50,120 PAIN WHERE YOU LIKE TO KNOW WHO 586 00:22:50,120 --> 00:22:52,640 IS AT RISK FOR DEVELOPING 587 00:22:52,640 --> 00:22:53,840 POST-SURGICAL PAIN AND 588 00:22:53,840 --> 00:22:54,720 POTENTIALLY DO SOMETHING TO 589 00:22:54,720 --> 00:22:56,560 PREVENT IT. 590 00:22:56,560 --> 00:22:59,840 THANKS TO HELENE LANGEVIN WE 591 00:22:59,840 --> 00:23:01,720 HAVE AN AMBITIOUS PROGRAM 592 00:23:01,720 --> 00:23:02,720 LOOKING AT MYOFASCIAL TISSUES 593 00:23:02,720 --> 00:23:08,200 AND THE CAUSE OF PAIN THERE. 594 00:23:08,200 --> 00:23:09,160 VERY UNDERSTUDIED AREA. 595 00:23:09,160 --> 00:23:11,680 I HAVE EXPERIENCE IN IT 596 00:23:11,680 --> 00:23:13,760 PERSONALLY, AND IT'S NOT FUN. 597 00:23:13,760 --> 00:23:15,400 BUT WHAT CAUSES IT IS REALLY 598 00:23:15,400 --> 00:23:16,840 QUITE A MYSTERY. 599 00:23:16,840 --> 00:23:20,920 YOU KNOW, IT'S THE JOINTS, 600 00:23:20,920 --> 00:23:22,960 MUSCLES, FASCIA, ASSOCIATED SOFT 601 00:23:22,960 --> 00:23:24,160 TISSUES, AND REALLY GETTING AT 602 00:23:24,160 --> 00:23:27,120 THIS IN A WAY THAT'S NEVER BEEN 603 00:23:27,120 --> 00:23:28,560 ACCOMPLISHED BEFORE, 604 00:23:28,560 --> 00:23:31,080 PARTICULARLY IN GETTING 605 00:23:31,080 --> 00:23:32,800 BIOMARKERS OF THE CONDITION, 606 00:23:32,800 --> 00:23:38,560 WE'RE USING THINGS LIKE 607 00:23:38,560 --> 00:23:39,280 ULTRASOUND, PET, 608 00:23:39,280 --> 00:23:42,000 ELECTROPHYSIOLOGY, M.R., 609 00:23:42,000 --> 00:23:44,200 MEASUREMENTS OF STIFFNESS, O2 610 00:23:44,200 --> 00:23:47,080 PERFUSION, MARKERS OF FIBROSIS, 611 00:23:47,080 --> 00:23:48,880 PARTICULARLY ULTRASOUND, 612 00:23:48,880 --> 00:23:51,440 BRINGING INTO MULTI-SCALE 613 00:23:51,440 --> 00:23:52,920 MODELING TYPE OF ENVIRONMENT IS 614 00:23:52,920 --> 00:23:55,480 POTENTIALLY GOING TO BE 615 00:23:55,480 --> 00:23:56,320 TRANSFORMATIVE, HOW WE THINK 616 00:23:56,320 --> 00:23:57,120 ABOUT IT. 617 00:23:57,120 --> 00:23:59,440 THE MOST COMMON PAIN CONDITION 618 00:23:59,440 --> 00:24:03,680 IS MUSCULOSKELETAL PAIN 619 00:24:03,680 --> 00:24:06,200 CONDITIONS. 620 00:24:06,200 --> 00:24:07,400 NEXT SLIDE. 621 00:24:07,400 --> 00:24:10,800 HELENE WILL CORRECT ME IN I MADE 622 00:24:10,800 --> 00:24:14,840 MISTAKE, EPPIC-NET HAS WHO 623 00:24:14,840 --> 00:24:16,600 TRIALS ONGOING, ARTHRITIS AND 624 00:24:16,600 --> 00:24:21,640 DIABETIC PRIVILEGE NAIL -- 625 00:24:21,640 --> 00:24:22,400 PERIPHERAL NEUROPATHY, THERE'S 626 00:24:22,400 --> 00:24:25,800 INTEREST ON A BUNCH OF COMPANIES 627 00:24:25,800 --> 00:24:28,720 OUT THERE TO TEST THEIR 628 00:24:28,720 --> 00:24:31,280 THERAPIES IN THIS DIABETIC 629 00:24:31,280 --> 00:24:36,760 PERIPHERAL NEUROPATHY CONDITION. 630 00:24:36,760 --> 00:24:37,360 NEXT SLIDE. 631 00:24:37,360 --> 00:24:41,600 THIS IS GOING TOWARDS 632 00:24:41,600 --> 00:24:43,760 EFFECTIVENESS RESEARCH NETWORK, 633 00:24:43,760 --> 00:24:46,800 RUN HEAVILY OUT OF NCATS AND 634 00:24:46,800 --> 00:24:48,000 JANE ATKINSON I SHOULD HAVE 635 00:24:48,000 --> 00:24:49,520 MENTIONED FROM THE BEGINNING ALL 636 00:24:49,520 --> 00:24:54,360 THESE PROGRAMS ARE RUN BY TEAMS, 637 00:24:54,360 --> 00:24:57,960 THAT HAVE PROGRAM DIRECTORS FROM 638 00:24:57,960 --> 00:25:00,880 MULTIPLE INSTITUTES ON THEM, AND 639 00:25:00,880 --> 00:25:02,600 JANE ATKINSON AND LINDA PORTER 640 00:25:02,600 --> 00:25:05,120 ARE KIND OF THE CHAIRS OF THOSE 641 00:25:05,120 --> 00:25:06,400 TEAMS, AND THAT'S WHERE THE 642 00:25:06,400 --> 00:25:08,000 PEOPLE HERE WHO ARE DOING ALL 643 00:25:08,000 --> 00:25:09,920 THE WORK. 644 00:25:09,920 --> 00:25:11,880 IN THE EFFECTIVENESS RESEARCH 645 00:25:11,880 --> 00:25:14,360 SPACE WE HAVE LOOK -- LOOKING AT 646 00:25:14,360 --> 00:25:22,720 DIFFERENT TRIALS ON A NUMBER OF 647 00:25:22,720 --> 00:25:24,600 CONDITIONS, ACTUALLY ARTHRITIS, 648 00:25:24,600 --> 00:25:27,080 POST-CESAREAN, POST MASTECTOMY, 649 00:25:27,080 --> 00:25:27,880 CHRONIC MUSCULOSKELETAL, RURAL 650 00:25:27,880 --> 00:25:31,160 AREAS, CHRONIC PAIN AND OUD, 651 00:25:31,160 --> 00:25:34,920 CANCER PAIN, PERIOPERATIVE PAIN 652 00:25:34,920 --> 00:25:36,320 IN ADULTS AND ADOLESCENTS, IF 653 00:25:36,320 --> 00:25:38,600 YOU FACTOR IN ACUTE TO CHRONIC 654 00:25:38,600 --> 00:25:40,360 PAIN PROGRAM BEING RUN OUT OF 655 00:25:40,360 --> 00:25:43,360 THE COMMON FUND. 656 00:25:43,360 --> 00:25:45,440 THE INTERVENTIONS ARE STEPPED UP 657 00:25:45,440 --> 00:25:47,040 MEDICAL INTERVENTIONS AS MIGHT 658 00:25:47,040 --> 00:25:50,160 OCCUR IN THE PRACTICE SITUATION, 659 00:25:50,160 --> 00:25:52,560 SHARED DECISION MAKING AND USE 660 00:25:52,560 --> 00:25:54,840 OF OPIOIDS AND REALLY CAUTIOUS 661 00:25:54,840 --> 00:25:57,240 AND DELIBERATE MANNER, DRUG 662 00:25:57,240 --> 00:25:59,000 INTERVENTIONS, DRUG AND 663 00:25:59,000 --> 00:26:01,320 BEHAVIORAL INTERVENTIONS, AND 664 00:26:01,320 --> 00:26:03,160 BEHAVIORAL INTERVENTIONS. 665 00:26:03,160 --> 00:26:06,200 NEXT SLIDE. 666 00:26:06,200 --> 00:26:07,960 IN THE PRAGMATIC STUDIES, AGAIN 667 00:26:07,960 --> 00:26:12,440 HEAVILY RUN OUT OF NCCIH, IN 668 00:26:12,440 --> 00:26:14,760 FACT HELENE LANGEVIN'S 669 00:26:14,760 --> 00:26:17,160 INSTITUTE, LOOKING AT NERVE 670 00:26:17,160 --> 00:26:19,240 STIMULATION, PHYSICAL THERAPY, 671 00:26:19,240 --> 00:26:21,640 ACUPUNCTURE, RELAXATION, 672 00:26:21,640 --> 00:26:23,080 MINDFULNESS, DECISION SUPPORT, 673 00:26:23,080 --> 00:26:24,320 MOSTLY NON-PHARMACOLOGICAL 674 00:26:24,320 --> 00:26:25,040 TREATMENTS IN THESE DIFFERENT 675 00:26:25,040 --> 00:26:28,000 PAIN CONDITIONS AND MANY ARE RUN 676 00:26:28,000 --> 00:26:30,640 IN HEALTH CARE SYSTEMS, 677 00:26:30,640 --> 00:26:32,280 EFFECTIVENESS RESEARCH NETWORKS 678 00:26:32,280 --> 00:26:37,200 ARE PRIMARILY IN ACADEMIC 679 00:26:37,200 --> 00:26:37,560 INSTITUTIONS. 680 00:26:37,560 --> 00:26:38,080 NEXT SLIDE. 681 00:26:38,080 --> 00:26:39,840 HERE YOU SEE THE DIFFERENT PAIN 682 00:26:39,840 --> 00:26:42,480 CONDITIONS AND NUMBER OF AWARDS 683 00:26:42,480 --> 00:26:44,400 AND DIFFERENT PAIN CONDITIONS, 684 00:26:44,400 --> 00:26:46,600 SO THEY ARE PRETTY MUCH ALL 685 00:26:46,600 --> 00:26:50,120 CHRONIC PAIN, NOT DOING A LOT IN 686 00:26:50,120 --> 00:26:52,600 THE ACUTE PAIN SPACE, BUT 687 00:26:52,600 --> 00:26:54,600 BECAUSE CHRONIC PAIN AS LARRY 688 00:26:54,600 --> 00:26:56,440 MENTIONED IS THE PROBLEM AT HAND 689 00:26:56,440 --> 00:26:58,000 THAT GETS YOU INTO TROUBLE WITH 690 00:26:58,000 --> 00:27:00,920 OPIOIDS BUT ALSO IS WHAT CAUSES 691 00:27:00,920 --> 00:27:02,160 THE LONG-TERM SUFFERING. 692 00:27:02,160 --> 00:27:05,200 BACK PAIN IS SEVERAL AS I 693 00:27:05,200 --> 00:27:10,040 MENTIONED THE BIGGEST OF ALL. 694 00:27:10,040 --> 00:27:11,680 POST-SURGICAL PAIN, CANCER PAIN, 695 00:27:11,680 --> 00:27:15,360 TRAUMA PAIN, PARTICULARLY OF 696 00:27:15,360 --> 00:27:17,440 INTEREST TO NIDCR IS 697 00:27:17,440 --> 00:27:19,840 TEMPOROMANDIBULAR DISORDER. 698 00:27:19,840 --> 00:27:20,840 AGAIN, FOCUSING SIMILARLY IN ON 699 00:27:20,840 --> 00:27:22,720 WHAT WE TALKED ABOUT WITH 700 00:27:22,720 --> 00:27:24,880 MYOFASCIAL PAIN, WHERE YOU HAVE 701 00:27:24,880 --> 00:27:27,960 A VERY COMPLEX JOINT, YOU HAVE 702 00:27:27,960 --> 00:27:32,640 MULTIPLE DIFFERENT TISSUES 703 00:27:32,640 --> 00:27:33,440 INVOLVED, MUSCLE, FASCIA, 704 00:27:33,440 --> 00:27:35,200 NERVED, AND IS A FOCUS OF A 705 00:27:35,200 --> 00:27:36,920 NUMBER OF OUR PROGRAMS. 706 00:27:36,920 --> 00:27:39,480 WE ALSO HAVE PROGRAMS IN SICKLE 707 00:27:39,480 --> 00:27:42,480 CELL DISEASE, A VERY COMMON PAIN 708 00:27:42,480 --> 00:27:44,280 CONDITION, AND ONE WHICH DOES 709 00:27:44,280 --> 00:27:45,920 REQUIRE OPIOIDS TO TREAT THE 710 00:27:45,920 --> 00:27:46,920 ACUTE STAGES. 711 00:27:46,920 --> 00:27:48,760 SO, KIND OF THREADING THAT 712 00:27:48,760 --> 00:27:52,560 NEEDLE OF GETTING REALLY GOOD 713 00:27:52,560 --> 00:27:54,200 EFFECTIVE PAIN CONTROL, AND 714 00:27:54,200 --> 00:27:55,960 REDUCING THE CHANCE OF ADDICTION 715 00:27:55,960 --> 00:27:57,520 IS A REAL CHALLENGE BUT ONE 716 00:27:57,520 --> 00:27:58,840 THAT'S REALLY BEEN TAKEN ON BY A 717 00:27:58,840 --> 00:28:03,080 NUMBER OF PROJECTS IN THE HEAL 718 00:28:03,080 --> 00:28:03,480 INITIATIVE. 719 00:28:03,480 --> 00:28:05,920 NEXT SLIDE. 720 00:28:05,920 --> 00:28:07,560 AND THE INTERVENTIONS, WE 721 00:28:07,560 --> 00:28:09,240 MENTIONED IN THE PREVIOUS SLIDE 722 00:28:09,240 --> 00:28:11,840 WHAT THE INTERVENTIONS ARE. 723 00:28:11,840 --> 00:28:13,080 THE SETTINGS, YOU KNOW, MAJORITY 724 00:28:13,080 --> 00:28:15,440 ARE DONE IN THE OUTPATIENT 725 00:28:15,440 --> 00:28:16,440 CLINIC, CERTAINLY CHRONIC PAIN 726 00:28:16,440 --> 00:28:18,920 IS PRIMARILY GOING TO BE SEEN IN 727 00:28:18,920 --> 00:28:21,120 THE OUTPATIENT CENTER. 728 00:28:21,120 --> 00:28:22,120 ACADEMIC MEDICAL CENTERS ARE, 729 00:28:22,120 --> 00:28:26,360 YOU KNOW, THE DRIVERS OF 730 00:28:26,360 --> 00:28:30,080 RESEARCH IN OUR SYSTEM HERE, 731 00:28:30,080 --> 00:28:32,080 LARGELY OUTPATIENT CLINIC BASED 732 00:28:32,080 --> 00:28:34,480 AND BASED OUT OF HOSPITALS, 733 00:28:34,480 --> 00:28:36,080 PRIMARY CARE. 734 00:28:36,080 --> 00:28:38,000 WE HAVE A PRETTY INTERESTING 735 00:28:38,000 --> 00:28:38,640 COMPONENT OF TELEHEALTH, 736 00:28:38,640 --> 00:28:42,480 PARTICULARLY WHEN IT GETS OUT TO 737 00:28:42,480 --> 00:28:43,640 GETTING TREATMENTS IN RESEARCH 738 00:28:43,640 --> 00:28:48,920 IN THE RURAL SPACE, SOME, AS 739 00:28:48,920 --> 00:28:50,280 MENTIONED, PARTICULARLY PRISM 740 00:28:50,280 --> 00:28:53,320 PRAGMATIC STUDIES, WE WORK WITH 741 00:28:53,320 --> 00:28:58,160 THE V.A. 742 00:28:58,160 --> 00:28:59,880 DR. LANGEVIN RUNS A PROGRAM IN 743 00:28:59,880 --> 00:29:01,760 PAIN WITH THE DoD AND V.A. 744 00:29:01,760 --> 00:29:06,280 HERE IS THE DIALYSIS CLINIC FOR 745 00:29:06,280 --> 00:29:07,880 THE H.O.P.E. STUDY. 746 00:29:07,880 --> 00:29:11,920 WE'RE HOPING TO DO MORE DENTAL 747 00:29:11,920 --> 00:29:12,440 PAIN. 748 00:29:12,440 --> 00:29:13,360 ENCOURAGED AT EVERY OPPORTUNITY 749 00:29:13,360 --> 00:29:15,640 AND SHOULD BE DOING THAT. 750 00:29:15,640 --> 00:29:21,040 THAT'S HOW MOST OF US RUN INTO 751 00:29:21,040 --> 00:29:23,760 SERIOUS PAIN ISSUES. 752 00:29:23,760 --> 00:29:24,680 NEXT SLIDE. 753 00:29:24,680 --> 00:29:27,840 I STILL REMEMBER AS A KID GOING 754 00:29:27,840 --> 00:29:29,480 TO THE DENTIST AND WAS NOT GOOD 755 00:29:29,480 --> 00:29:35,160 FOR ME BECAUSE I AVOIDED 756 00:29:35,160 --> 00:29:37,320 DENTISTS THEREAFTER. 757 00:29:37,320 --> 00:29:40,520 AND NOW THE MOST VEXING PROBLEM 758 00:29:40,520 --> 00:29:43,680 THEN IS BEING ATTACKED BY THESE 759 00:29:43,680 --> 00:29:45,360 "HEAL" TRIALS INTEGRATED 760 00:29:45,360 --> 00:29:47,200 MANAGEMENT OF CHRONIC PAIN 761 00:29:47,200 --> 00:29:49,520 OPIOID OVERUSE DISORDER. 762 00:29:49,520 --> 00:29:52,000 SO WE HAVE, YOU KNOW, 2 MILLION 763 00:29:52,000 --> 00:29:55,080 PEOPLE ARE OPIOID OVERUSE 764 00:29:55,080 --> 00:29:56,360 DISORDER, 40 TO 60% HAVE CHRONIC 765 00:29:56,360 --> 00:29:56,840 PAIN. 766 00:29:56,840 --> 00:29:59,880 THIS IS SOMETHING THAT THE 767 00:29:59,880 --> 00:30:00,640 PHYSICIANS, PRIMARY CARE 768 00:30:00,640 --> 00:30:01,840 PHYSICIANS, REALLY TRY AND STAY 769 00:30:01,840 --> 00:30:03,040 AWAY FROM AND UNFORTUNATELY 770 00:30:03,040 --> 00:30:06,000 THESE PEOPLE ARE POORLY SERVED. 771 00:30:06,000 --> 00:30:07,680 IT PROBABLY MAKES THEIR -- 772 00:30:07,680 --> 00:30:09,080 DEFINITELY MAKES THEIR PAIN 773 00:30:09,080 --> 00:30:12,360 WORSE, PROBABLY ALSO LEADS TO 774 00:30:12,360 --> 00:30:15,200 WORSE OPIOID OVERUSE DISORDER, 775 00:30:15,200 --> 00:30:18,000 LESS CHANCE OF GETTING INTO AND 776 00:30:18,000 --> 00:30:21,280 GETTING A RECOVERY, GOOD 777 00:30:21,280 --> 00:30:21,640 RECOVERY STATUS. 778 00:30:21,640 --> 00:30:23,520 BUT WE HAVE A NUMBER OF 779 00:30:23,520 --> 00:30:25,720 POPULATIONS THAT WE'RE LOOKING 780 00:30:25,720 --> 00:30:31,080 AT IN THIS SPACE. 781 00:30:31,080 --> 00:30:34,280 MAT IS MEDICATION-ASSISTED 782 00:30:34,280 --> 00:30:34,720 THERAPY. 783 00:30:34,720 --> 00:30:37,880 AND THE INTERVENTIONS SEEN HERE. 784 00:30:37,880 --> 00:30:43,200 AGAIN, THEY SPAN MEDICAL, BUT 785 00:30:43,200 --> 00:30:46,400 ALSO COMBINING WITH 786 00:30:46,400 --> 00:30:47,600 SELF-MANAGEMENT, PAIN 787 00:30:47,600 --> 00:30:48,480 SELF-MANAGEMENT, MINDFULNESS AND 788 00:30:48,480 --> 00:30:53,280 EXERCISE, FOR INSTANCE. 789 00:30:53,280 --> 00:30:54,640 AND THE SETTINGS SEEN HERE GOING 790 00:30:54,640 --> 00:31:00,080 TO BE A PLACE WHERE THESE FOLKS 791 00:31:00,080 --> 00:31:04,040 ARE POTENTIALLY RECRUITABLE, 792 00:31:04,040 --> 00:31:05,720 PRIMARY CARE, AND THE V.A. AND 793 00:31:05,720 --> 00:31:13,480 SOMETIMES HOSPITAL SETTINGS AS 794 00:31:13,480 --> 00:31:13,800 WELL. 795 00:31:13,800 --> 00:31:15,560 NEXT SLIDE. 796 00:31:15,560 --> 00:31:17,160 TRYING TO ADVANCE HEALTH EQUITY 797 00:31:17,160 --> 00:31:19,800 IN THE PAIN SPACE, I THINK WE 798 00:31:19,800 --> 00:31:24,080 HAVE TO THINK ABOUT THIS AS A 799 00:31:24,080 --> 00:31:25,520 SYSTEMIC ISSUE THAT HAS 800 00:31:25,520 --> 00:31:26,720 DIFFERENT FACTORS, EACH OF WHICH 801 00:31:26,720 --> 00:31:29,240 HAVE TO BE INCORPORATED INTO ANY 802 00:31:29,240 --> 00:31:29,680 PLAN. 803 00:31:29,680 --> 00:31:32,880 SO THERE ARE INDIVIDUAL 804 00:31:32,880 --> 00:31:36,280 BIOSOCIAL FACTORS WHICH PROBABLY 805 00:31:36,280 --> 00:31:38,520 AFFECT HOW PEOPLE PERCEIVE PAIN 806 00:31:38,520 --> 00:31:41,080 AND HOW MUCH SUFFERING IS 807 00:31:41,080 --> 00:31:44,560 ASSOCIATED WITH DIFFERENT 808 00:31:44,560 --> 00:31:46,560 NATURAL STIMULI, PROBABLY 809 00:31:46,560 --> 00:31:48,600 CULTURAL VARIATIONS NOT ONLY 810 00:31:48,600 --> 00:31:49,800 WHAT PEOPLE EXPERIENCE, REALLY 811 00:31:49,800 --> 00:31:52,320 HARD TO UNDERSTAND, BUT MAYBE 812 00:31:52,320 --> 00:31:54,320 MORE SO IN HOW PEOPLE 813 00:31:54,320 --> 00:31:56,160 COMMUNICATE WHAT THEY ARE 814 00:31:56,160 --> 00:31:56,600 EXPERIENCING. 815 00:31:56,600 --> 00:32:02,640 THIS CAN CERTAINLY LEAD TO REAL 816 00:32:02,640 --> 00:32:04,320 HEALTH INEQUITIES IF PEOPLE -- 817 00:32:04,320 --> 00:32:10,280 IF THE PERSON IN FRONT OF YOU IS 818 00:32:10,280 --> 00:32:12,720 NOT QUESTIONED TO GET AT THE 819 00:32:12,720 --> 00:32:14,480 BASIS OF WHAT DEGREE OF 820 00:32:14,480 --> 00:32:20,680 SUFFERING THEY ARE HAVING. 821 00:32:20,680 --> 00:32:22,000 INTERPERSONAL PATIENT-PROVIDER 822 00:32:22,000 --> 00:32:22,880 INTERACTIONS ARE IMPORTANT, 823 00:32:22,880 --> 00:32:24,600 SUCCESS RELIES ON TRUST OF 824 00:32:24,600 --> 00:32:27,240 PROVIDER AND PATIENT, HOW TO 825 00:32:27,240 --> 00:32:28,280 BUILD TRUST, PARTICULARLY WHEN 826 00:32:28,280 --> 00:32:34,280 THE WORKFORCE DOESN'T LOOK LIKE 827 00:32:34,280 --> 00:32:36,800 THE PERSON WHO IS TRYING TO COME 828 00:32:36,800 --> 00:32:39,760 TREATMENT OF PAIN.MS OF THE%- 829 00:32:39,760 --> 00:32:44,160 AND SO HOW TO WORK THIS SO WE 830 00:32:44,160 --> 00:32:45,720 GET THE BEST OUTCOMES IS REALLY 831 00:32:45,720 --> 00:32:46,120 IMPORTANT. 832 00:32:46,120 --> 00:32:47,800 THEN THERE ARE COMMUNITY AND 833 00:32:47,800 --> 00:32:48,880 SOCIOECONOMIC FACTORS IN A HAVE 834 00:32:48,880 --> 00:32:52,360 TO BE TAKEN INTO ACCOUNT, SOME 835 00:32:52,360 --> 00:32:54,040 OF THESE ARE, YOU KNOW, ACCESS 836 00:32:54,040 --> 00:32:54,760 TO THERAPY. 837 00:32:54,760 --> 00:32:57,160 IF YOU CAN'T TAKE OFF FROM WORK 838 00:32:57,160 --> 00:32:59,160 TO GET TO THE CLINIC OR YOU 839 00:32:59,160 --> 00:33:02,560 DON'T HAVE THE FUNDING TO GET 840 00:33:02,560 --> 00:33:04,080 THE TRANSPORTATION, AGAIN, THESE 841 00:33:04,080 --> 00:33:06,440 ARE THINGS THAT YOU DON'T THINK 842 00:33:06,440 --> 00:33:09,040 ABOUT THEM, THEY CAN REALLY 843 00:33:09,040 --> 00:33:11,440 AFFECT THE RESEARCH OUTCOME AND 844 00:33:11,440 --> 00:33:13,720 ALSO AFFECT THE POPULUS THAT 845 00:33:13,720 --> 00:33:15,560 YOU'RE ACTUALLY RELEVANT TO. 846 00:33:15,560 --> 00:33:17,760 AND WE HAVE TO WORK WITHIN THE 847 00:33:17,760 --> 00:33:19,800 SYSTEMS THAT WE HAVE, BUT WE 848 00:33:19,800 --> 00:33:22,600 HAVE THE OPPORTUNITY AS THE NIH 849 00:33:22,600 --> 00:33:25,360 TO WORK WITH HEALTHCARE SYSTEMS 850 00:33:25,360 --> 00:33:28,480 TO GENERATE KIND OF BETTER WAYS 851 00:33:28,480 --> 00:33:30,760 OF DEALING WITH CHRONIC PAIN 852 00:33:30,760 --> 00:33:32,400 THAT BENEFITS THE PATIENTS AND 853 00:33:32,400 --> 00:33:38,640 BENEFITS THE HEALTHCARE SYSTEM. 854 00:33:38,640 --> 00:33:42,040 AGAIN, POPULATIONS THAT WE'RE 855 00:33:42,040 --> 00:33:44,560 TRYING TO ENGAGE IN OUR EFFORTS 856 00:33:44,560 --> 00:33:46,960 TO IMPROVE HEALTH EQUITY, AND 857 00:33:46,960 --> 00:33:48,720 THE PAIN CONDITIONS AND THE 858 00:33:48,720 --> 00:33:51,560 INTERVENTIONS THAT ARE BEING 859 00:33:51,560 --> 00:33:53,440 TESTED AND DIFFERENT SETTINGS AT 860 00:33:53,440 --> 00:33:58,040 WHICH THESE ARE OCCURRING, AND 861 00:33:58,040 --> 00:34:01,440 THEN, AGAIN, THESE TABLES WERE 862 00:34:01,440 --> 00:34:03,360 BUILT BY CLINICAL RESEARCH TEAMS 863 00:34:03,360 --> 00:34:04,960 WHO KNOW EXACTLY WHICH GRANT IS 864 00:34:04,960 --> 00:34:11,600 TESTING WHAT AND WHAT SETTING 865 00:34:11,600 --> 00:34:14,560 AND FOR WHAT POPULATION. 866 00:34:14,560 --> 00:34:17,160 NOW, I MENTIONED EARLIER THAT 867 00:34:17,160 --> 00:34:21,240 THE WORKFORCE, PARTICULARLY IN 868 00:34:21,240 --> 00:34:24,480 THE CLINICAL PAIN SPACE, NEEDS 869 00:34:24,480 --> 00:34:25,920 TO BE STRENGTHENED GREATLY. 870 00:34:25,920 --> 00:34:27,480 AS I MENTIONED EARLIER, THERE'S 871 00:34:27,480 --> 00:34:29,320 BEEN EXPLOSION IN THE 872 00:34:29,320 --> 00:34:30,960 NEUROSCIENCE OF PAIN. 873 00:34:30,960 --> 00:34:33,560 LARRY TALKED TO YOU ABOUT, YOU 874 00:34:33,560 --> 00:34:35,120 KNOW, THIS NEW STUDY THAT JUST 875 00:34:35,120 --> 00:34:39,800 CAME OUT WHERE YOU CAN ACTUALLY 876 00:34:39,800 --> 00:34:45,080 SEE SIGNATURES IN THE 877 00:34:45,080 --> 00:34:45,960 OSCILLATORY PATTERNS, ELECTRICAL 878 00:34:45,960 --> 00:34:47,160 ACTIVITY IN CERTAIN PARTS OF THE 879 00:34:47,160 --> 00:34:47,440 BRAIN. 880 00:34:47,440 --> 00:34:49,480 NOT ONLY THAT, YOU CAN STIMULATE 881 00:34:49,480 --> 00:34:51,240 REGIONS TO CHANGE THAT 882 00:34:51,240 --> 00:34:52,880 OSCILLATORY ACTIVITY AND IMPROVE 883 00:34:52,880 --> 00:34:55,280 THE PERCEPTION OF PAIN. 884 00:34:55,280 --> 00:34:57,680 THIS WAS, YOU KNOW, AS WAS 885 00:34:57,680 --> 00:34:59,440 MENTIONED A VERY SMALL GROUP, 886 00:34:59,440 --> 00:35:01,880 PEOPLE WHO HAD PAIN DUE TO 887 00:35:01,880 --> 00:35:05,560 DAMAGE TO THEIR BRAIN, SO 888 00:35:05,560 --> 00:35:07,320 NEUROGENIC PAIN REALLY, BUT THIS 889 00:35:07,320 --> 00:35:09,160 IS WHAT -- THIS IS THE ORIGIN OF 890 00:35:09,160 --> 00:35:11,920 THE PAIN PERCEPTION THAT WE'RE 891 00:35:11,920 --> 00:35:13,120 FINALLY GETTING AT, AND TAKING 892 00:35:13,120 --> 00:35:15,640 THIS KIND OF KNOWLEDGE AND 893 00:35:15,640 --> 00:35:20,840 PUTTING IT TO PRACTICE TAKES 894 00:35:20,840 --> 00:35:21,760 REALLY SPECIALTY HIGH-EXPERIENCE 895 00:35:21,760 --> 00:35:23,640 PEOPLE AND NEED TO BUILD THAT. 896 00:35:23,640 --> 00:35:25,680 "HEAL" HAS A NUMBER OF PROGRAMS, 897 00:35:25,680 --> 00:35:29,000 I DON'T THINK THEY ARE EVEN ALL 898 00:35:29,000 --> 00:35:33,360 ON THIS LIST, K FELLOWSHIP 899 00:35:33,360 --> 00:35:33,960 PROGRAMS, ADMINISTRATIVE 900 00:35:33,960 --> 00:35:36,440 SUPPLEMENTS OF SUPPORT FOR 901 00:35:36,440 --> 00:35:38,560 CAREER ENHANCEMENT, MID-YEAR 902 00:35:38,560 --> 00:35:39,400 INVESTIGATOR AWARD, 903 00:35:39,400 --> 00:35:41,720 PATIENT-ORIENTED RESEARCH, A NEW 904 00:35:41,720 --> 00:35:43,360 K-12 PROGRAM RUN BY UNIVERSITY 905 00:35:43,360 --> 00:35:45,760 OF MICHIGAN, AND THEY RECRUIT 906 00:35:45,760 --> 00:35:50,200 PEOPLE AND THEY WILL MENTOR OVER 907 00:35:50,200 --> 00:35:52,240 THE YEARS AND DEVELOP THEIR 908 00:35:52,240 --> 00:35:56,040 CAREERS IN PAIN RESEARCH. 909 00:35:56,040 --> 00:35:58,240 AND AS LARRY MENTIONED, THIS 910 00:35:58,240 --> 00:36:00,000 ACROSS THE COUNTRY, COORDINATING 911 00:36:00,000 --> 00:36:02,080 ALL OUR TRAINING PROGRAMS UNDER 912 00:36:02,080 --> 00:36:04,280 THIS PURPOSE GROUP WHICH IS 913 00:36:04,280 --> 00:36:07,120 ACTUALLY A COMPANY THAT DOES 914 00:36:07,120 --> 00:36:09,160 EDUCATION, HEALTH EDUCATION, SO 915 00:36:09,160 --> 00:36:10,080 REAL PROFESSIONALS. 916 00:36:10,080 --> 00:36:11,720 I WAS HAPPY TO GO TO THE LAUNCH 917 00:36:11,720 --> 00:36:13,360 OF THEIR FIRST MEETING WHERE 918 00:36:13,360 --> 00:36:16,080 THEY BROUGHT IN TRAINEES AND 919 00:36:16,080 --> 00:36:16,960 MENTORS FROM ALL OVER THE 920 00:36:16,960 --> 00:36:19,600 COUNTRY IN THE HEAL INITIATIVE 921 00:36:19,600 --> 00:36:22,360 AND DID A FANTASTIC JOB KIND OF 922 00:36:22,360 --> 00:36:26,160 CREATING THE IMPORTANT 923 00:36:26,160 --> 00:36:27,360 CONVERSATIONS AND DISCUSSIONS 924 00:36:27,360 --> 00:36:32,520 AND I THINK IT'S A REALLY UNIQUE 925 00:36:32,520 --> 00:36:37,280 BUT REALLY POWERFUL PROGRAM THAT 926 00:36:37,280 --> 00:36:44,320 "HEAL" IS PILOTING HERE. 927 00:36:44,320 --> 00:36:45,640 NEXT SLIDE. 928 00:36:45,640 --> 00:36:48,040 AND, YES, WE MENTIONED ALREADY 929 00:36:48,040 --> 00:36:51,000 THAT IN THE PAIN SPACE WE ARE 930 00:36:51,000 --> 00:36:52,640 ATTEMPTING TO REDUCE THE 931 00:36:52,640 --> 00:36:54,800 SUFFERING THAT'S RELATED TO THIS 932 00:36:54,800 --> 00:36:56,680 ACTIVATION OF THE NOCICEPTIVE 933 00:36:56,680 --> 00:36:58,240 SYSTEMS, WHICH THEN CHANGE WITH 934 00:36:58,240 --> 00:37:03,440 CHRONIC PAIN OVER TIME. 935 00:37:03,440 --> 00:37:07,720 AND SO PAIN IS BY DEFINITION A 936 00:37:07,720 --> 00:37:08,720 VERY SUBJECTIVE EXPERIENCE, AND 937 00:37:08,720 --> 00:37:11,120 TO UNDERSTAND HOW WE MOVE 938 00:37:11,120 --> 00:37:12,520 FORWARD WE REALLY NEED TO BE 939 00:37:12,520 --> 00:37:16,080 LISTENING TO THE PEOPLE WHO ARE 940 00:37:16,080 --> 00:37:17,920 ACTUALLY THE PARTICIPANTS IN THE 941 00:37:17,920 --> 00:37:19,560 RESEARCH, AND PEOPLE WITH LIVED 942 00:37:19,560 --> 00:37:22,400 EXPERIENCE, AND WE HAVE A GREAT 943 00:37:22,400 --> 00:37:25,600 "HEAL" COMMUNITY PARTNERSHIP 944 00:37:25,600 --> 00:37:27,800 COMMITTEE THAT IS GIVING I THINK 945 00:37:27,800 --> 00:37:29,000 REALLY AMAZING INPUT ON KEY 946 00:37:29,000 --> 00:37:30,960 ISSUES, NOT ONLY FOR THOSE 947 00:37:30,960 --> 00:37:32,840 AFFECTED BY PAIN BUT ALSO 948 00:37:32,840 --> 00:37:34,360 SUBSTANCE ABUSE AND CLEARLY 949 00:37:34,360 --> 00:37:36,640 THERE'S THAT INTERACTION BETWEEN 950 00:37:36,640 --> 00:37:37,720 THESE TWO ISSUES. 951 00:37:37,720 --> 00:37:41,440 AND THEY HELPED US TO IDENTIFY, 952 00:37:41,440 --> 00:37:42,960 REFINE, PRIORITIZE ENGAGEMENT 953 00:37:42,960 --> 00:37:44,080 ACTIVITIES IN THE "HEAL" 954 00:37:44,080 --> 00:37:44,320 PROGRAMS. 955 00:37:44,320 --> 00:37:47,520 WHEN I LOOK ACROSS WHAT WE DO AT 956 00:37:47,520 --> 00:37:49,240 NINDS, "HEAL" IS REALLY THE ROLE 957 00:37:49,240 --> 00:37:50,880 MODEL RIGHT NOW FOR COMMUNITY 958 00:37:50,880 --> 00:37:53,160 ENGAGEMENT. 959 00:37:53,160 --> 00:37:56,640 WE'RE TRYING TO TAKE THIS WORK 960 00:37:56,640 --> 00:37:58,320 PACKAGE AND EXPORT IT TO A LOT 961 00:37:58,320 --> 00:38:01,040 OF THINGS THAT WE DO AT NINDS, 962 00:38:01,040 --> 00:38:04,080 BECAUSE WE THINK IT'S SO 963 00:38:04,080 --> 00:38:04,360 IMPORTANT. 964 00:38:04,360 --> 00:38:06,080 AND WE ALSO MAKE SUPPLEMENTS TO 965 00:38:06,080 --> 00:38:07,040 THE PROGRAM. 966 00:38:07,040 --> 00:38:12,000 YOU CAN'T ASK PEOPLE TO DO THIS 967 00:38:12,000 --> 00:38:13,280 JUST ON ALTRUISM. 968 00:38:13,280 --> 00:38:15,600 WE NEED TO PAY PEOPLE WITH LIVED 969 00:38:15,600 --> 00:38:17,040 EXPERIENCE THAT TAKE PART IN THE 970 00:38:17,040 --> 00:38:18,080 RESEARCH LIKE WE WOULD PAY 971 00:38:18,080 --> 00:38:20,840 ANYBODY ELSE IN THE RESEARCH 972 00:38:20,840 --> 00:38:21,080 PROGRAM. 973 00:38:21,080 --> 00:38:23,320 THEIR INPUT IS NO LESS VALUABLE 974 00:38:23,320 --> 00:38:25,480 THAN ANYONE ELSE'S, AND SO THESE 975 00:38:25,480 --> 00:38:29,520 SUPPLEMENTS ARE I THINK 976 00:38:29,520 --> 00:38:31,040 IMPORTANT IN BUILDING COMMUNITY 977 00:38:31,040 --> 00:38:36,000 PARTICIPATION INTO THE "HEAL" 978 00:38:36,000 --> 00:38:36,200 PROGRAM. 979 00:38:36,200 --> 00:38:38,160 NEXT SLIDE. 980 00:38:38,160 --> 00:38:45,720 AND JUST TO SAY THAT THE HOPE 981 00:38:45,720 --> 00:38:50,680 TRIAL IS COMPLETING ITS 982 00:38:50,680 --> 00:38:53,080 RECRUITMENT, 643, IN 2023, A 983 00:38:53,080 --> 00:38:54,040 HIGHLY ENGAGED PATIENT 984 00:38:54,040 --> 00:38:54,480 POPULATION. 985 00:38:54,480 --> 00:38:56,040 WE TALK ABOUT PATIENT 986 00:38:56,040 --> 00:38:58,320 ENGAGEMENT, "HEAL" IS A MODEL 987 00:38:58,320 --> 00:39:00,520 FOR NINDS, THE HOPE PROJECT WAS 988 00:39:00,520 --> 00:39:02,000 A MODEL FOR "HEAL." 989 00:39:02,000 --> 00:39:05,080 SO WE REALLY LEARNED A LOT BY 990 00:39:05,080 --> 00:39:06,400 WORKING WITH THE FOLKS IN THE 991 00:39:06,400 --> 00:39:10,360 HOPE PROJECT. 992 00:39:10,360 --> 00:39:13,640 NEXT SLIDE. 993 00:39:13,640 --> 00:39:21,280 ALSO, THE PRESCRIPTION AFTER 994 00:39:21,280 --> 00:39:22,920 CASAREAN TRIAL, WOMEN ARE 995 00:39:22,920 --> 00:39:33,480 PRESCRIBED AFTER C-SECTIONS, 20 996 00:39:35,040 --> 00:39:37,760 TABLETS, 15 TABLETS, AND THE 997 00:39:37,760 --> 00:39:48,280 IDEA IS TO SHOW AND THEY SHOWED 998 00:39:50,040 --> 00:39:51,160 ONE WEEK POST-DISCHARGE. 999 00:39:51,160 --> 00:39:56,680 AND THERE WAS NO DIFFERENCE IN 1000 00:39:56,680 --> 00:39:58,960 FULFILLING REFILLS. 1001 00:39:58,960 --> 00:40:02,040 THE RESOLVE STUDY WHICH I THINK 1002 00:40:02,040 --> 00:40:09,920 IS LINDA, IF I'M NOT MISTAKEN, 1003 00:40:09,920 --> 00:40:13,200 MULTI-CENTER TRIAL FROM KAISER 1004 00:40:13,200 --> 00:40:17,680 WASHINGTON, NORTHWEST, AND 1005 00:40:17,680 --> 00:40:19,240 GEORGIA, AND ESENTIA HEALTH, 1006 00:40:19,240 --> 00:40:20,440 TELEPHONE AND VIDEO CONFERENCE 1007 00:40:20,440 --> 00:40:24,160 SO COULD WORK DURING COVID, A 1008 00:40:24,160 --> 00:40:29,480 WEB PROGRAM, PAIN TRAINER, 3-ARM 1009 00:40:29,480 --> 00:40:31,600 PARALLEL INTERVENTION DESIGN, 1010 00:40:31,600 --> 00:40:34,200 COMPLETE ENROLLMENT OF 2231 1011 00:40:34,200 --> 00:40:37,520 PATIENTS, MANY RURAL AND OLDER 1012 00:40:37,520 --> 00:40:38,480 ADULTS, 30% REDUCTION OVERALL 1013 00:40:38,480 --> 00:40:39,360 PAIN SCORE. 1014 00:40:39,360 --> 00:40:41,120 SO HOPEFULLY THESE KIND OF 1015 00:40:41,120 --> 00:40:43,520 THINGS CAN THEN -- THEY ARE IN 1016 00:40:43,520 --> 00:40:45,400 THE KAISER SYSTEM, HOPEFULLY THE 1017 00:40:45,400 --> 00:40:46,800 HEALTHCARE SYSTEM CAN ADAPT 1018 00:40:46,800 --> 00:40:48,920 THESE PROGRAMS WHEN WE SHOW THEM 1019 00:40:48,920 --> 00:40:50,880 TO BE SUCCESSFUL. 1020 00:40:50,880 --> 00:40:51,520 NEXT SLIDE. 1021 00:40:51,520 --> 00:40:55,400 AND WITH THAT I WANT TO CONCLUDE 1022 00:40:55,400 --> 00:40:56,240 AND CAN'T CONCLUDE WITHOUT 1023 00:40:56,240 --> 00:40:58,080 THANKING ALL THE PEOPLE WHO DID 1024 00:40:58,080 --> 00:41:00,520 SO MUCH WORK TO BUILD THE HEAL 1025 00:41:00,520 --> 00:41:03,360 INITIATIVE, BOTH IN THE OFFICE 1026 00:41:03,360 --> 00:41:05,280 OF THE DIRECTOR, MULTIPLE 1027 00:41:05,280 --> 00:41:08,360 DIFFERENT INSTITUTES, DIFFERENT 1028 00:41:08,360 --> 00:41:09,920 I.C. DIRECTORS, SUCH A VIBRANT 1029 00:41:09,920 --> 00:41:11,000 PROGRAM, AND IT'S BEEN JUST A 1030 00:41:11,000 --> 00:41:19,760 JOY TO BE PART OF IT. 1031 00:41:19,760 --> 00:41:21,520 THANK YOU. 1032 00:41:21,520 --> 00:41:26,240 >> THANK YOU FOR THE BROAD AND 1033 00:41:26,240 --> 00:41:27,640 DEEP OVERVIEW. 1034 00:41:27,640 --> 00:41:31,080 DO WE HAVE DR. CRISWELL? 1035 00:41:31,080 --> 00:41:33,560 >> YES, I'M HERE. 1036 00:41:33,560 --> 00:41:34,360 CAN YOU HEAR ME? 1037 00:41:34,360 --> 00:41:36,480 >>I'M GOING TO JUST POINT OUT 1038 00:41:36,480 --> 00:41:40,240 WE'RE A LITTLE BIT OVER TIME 1039 00:41:40,240 --> 00:41:40,520 RIGHT NOW. 1040 00:41:40,520 --> 00:41:42,640 AND SO PLEASE KEEP THAT IN MIND 1041 00:41:42,640 --> 00:41:45,920 AS YOU GIVE US THIS MUCH-AWAITED 1042 00:41:45,920 --> 00:41:48,640 UPDATE ON THE BACK PAIN 1043 00:41:48,640 --> 00:41:49,960 CONSORTIUM RESEARCH PROGRAM, 1044 00:41:49,960 --> 00:41:51,160 WHAT WE CALL BACPAC. 1045 00:41:51,160 --> 00:41:54,160 ONE OF THE MORE FOCUSED PAIN 1046 00:41:54,160 --> 00:41:59,720 MANAGEMENT RESEARCH EFFORTS BUT 1047 00:41:59,720 --> 00:42:03,000 HIGHLY COLLABORATIVE AND 1048 00:42:03,000 --> 00:42:03,760 INTERDISCIPLINARY EFFORTS 1049 00:42:03,760 --> 00:42:04,760 UNDERWAY LED BY NIAMS. 1050 00:42:04,760 --> 00:42:06,760 >> THANKS FOR THE OPPORTUNITY 1051 00:42:06,760 --> 00:42:08,040 TO PROVIDE THIS UPDATE. 1052 00:42:08,040 --> 00:42:10,680 "HEAL" IS CONCERNED NOT ONLY 1053 00:42:10,680 --> 00:42:14,320 WITH OPIOID ADDICTION BUT CAUSES 1054 00:42:14,320 --> 00:42:15,200 OF OPIOID ADDICTION, CERTAINLY 1055 00:42:15,200 --> 00:42:17,560 CHRONIC PAIN IS A COMMON CAUSE 1056 00:42:17,560 --> 00:42:18,480 OF OPIOID ADDICTION, AS YOU 1057 00:42:18,480 --> 00:42:20,560 HEARD ALREADY BACK PAIN IS A 1058 00:42:20,560 --> 00:42:21,960 VERY COMMON CAUSE OF ACUTE AND 1059 00:42:21,960 --> 00:42:23,040 CHRONIC PAIN. 1060 00:42:23,040 --> 00:42:27,200 SO HENCE THE FOCUS OF THE 1061 00:42:27,200 --> 00:42:28,200 PROGRAM. 1062 00:42:28,200 --> 00:42:28,760 NEXT SLIDE. 1063 00:42:28,760 --> 00:42:34,840 SO, THE BACK PAIN CONSORTIUM, 1064 00:42:34,840 --> 00:42:36,720 BACPAC, AIMS TO PROVIDE 1065 00:42:36,720 --> 00:42:38,040 TREATMENT FOR INDIVIDUALS 1066 00:42:38,040 --> 00:42:38,880 THROUGH DISCOVERING MECHANISMS 1067 00:42:38,880 --> 00:42:40,880 OF CHRONIC LOW BACK PAIN AND 1068 00:42:40,880 --> 00:42:42,880 IDENTIFYING AND TESTING NEW 1069 00:42:42,880 --> 00:42:44,920 INTERVENTIONS TARGETED TO 1070 00:42:44,920 --> 00:42:46,040 INDIVIDUAL PATIENTS, A REALLY 1071 00:42:46,040 --> 00:42:48,120 IMPORTANT FEATURE. 1072 00:42:48,120 --> 00:42:50,720 SO, ON THE NEXT SLIDE, BACPAC IS 1073 00:42:50,720 --> 00:42:52,400 A PATIENT CENTERED RESEARCH 1074 00:42:52,400 --> 00:42:54,040 PROGRAM, AT THE BASIC RESEARCH 1075 00:42:54,040 --> 00:42:57,320 LEVEL BACPAC WILL DEVELOP AN 1076 00:42:57,320 --> 00:42:58,400 INTEGRATED THEORETICAL MODEL OF 1077 00:42:58,400 --> 00:43:00,480 CHRONIC LOW BACK PAIN BASED ON 1078 00:43:00,480 --> 00:43:10,920 IMPROVED UNDERSTANDING OF 1079 00:43:11,280 --> 00:43:13,520 MECHANISMS AND CLINICAL TRIALS 1080 00:43:13,520 --> 00:43:14,600 AND MULTI-MODAL, CREATING 1081 00:43:14,600 --> 00:43:17,680 CLINICAL COHORTS WITH VERY DEEP 1082 00:43:17,680 --> 00:43:18,280 PHENOTYPING INCLUDING 1083 00:43:18,280 --> 00:43:19,520 PATIENT-REPORTED OUTCOMES, AND 1084 00:43:19,520 --> 00:43:21,720 AT THE CLINICAL LEVEL BACPAC 1085 00:43:21,720 --> 00:43:23,240 AIMS TO CREATE ALGORITHMS TO 1086 00:43:23,240 --> 00:43:25,800 MATCH EACH PATIENT TO THE BEST 1087 00:43:25,800 --> 00:43:27,760 TREATMENTS BASED ON THEIR 1088 00:43:27,760 --> 00:43:31,640 PHENOTYPE AND THEIR PSYCHOSOCIAL 1089 00:43:31,640 --> 00:43:31,880 CONTEXT. 1090 00:43:31,880 --> 00:43:33,160 SO, NEXT SLIDE. 1091 00:43:33,160 --> 00:43:36,120 SO, TO ADDRESS THESE VARIOUS 1092 00:43:36,120 --> 00:43:39,000 ELEMENTS BACPAC INCLUDES SEVERAL 1093 00:43:39,000 --> 00:43:39,680 COMPONENTS, THREE RESEARCH 1094 00:43:39,680 --> 00:43:42,480 CENTERS, EACH RUN THEIR OWN 1095 00:43:42,480 --> 00:43:44,040 STUDIES, COLLECT BIOLOGICAL, 1096 00:43:44,040 --> 00:43:44,800 MECHANICAL, PSYCHOSOCIAL, AND 1097 00:43:44,800 --> 00:43:47,880 OTHER DATA FROM PATIENTS TO 1098 00:43:47,880 --> 00:43:48,840 IDENTIFY DIFFERENT PHENOTYPES, 1099 00:43:48,840 --> 00:43:51,360 AND HENCE POSSIBLE MARKERS OF 1100 00:43:51,360 --> 00:43:53,520 TREATMENT RESPONSE. 1101 00:43:53,520 --> 00:43:55,520 THE TECHNOLOGY RESEARCH SITES 1102 00:43:55,520 --> 00:43:57,040 CREATE, TEST, AND DISTRIBUTE 1103 00:43:57,040 --> 00:43:59,160 TECHNOLOGY AND METHODS TO TEST 1104 00:43:59,160 --> 00:44:01,200 AND QUANTIFY AND RELIEVE CHRONIC 1105 00:44:01,200 --> 00:44:01,880 LOW BACK PAIN. 1106 00:44:01,880 --> 00:44:05,240 AND THEN THERE ARE THREE PHASE 2 1107 00:44:05,240 --> 00:44:07,360 CLINICAL TRIALS ADDRESSING 1108 00:44:07,360 --> 00:44:07,840 DIFFERENT INTERVENTIONS. 1109 00:44:07,840 --> 00:44:10,080 IMPORTANTLY THERE'S A DATA 1110 00:44:10,080 --> 00:44:11,280 INTEGRATION ALGORITHM 1111 00:44:11,280 --> 00:44:13,040 DEVELOPMENT AND OPERATION CENTER 1112 00:44:13,040 --> 00:44:15,240 THAT PLAYS A CRUCIAL ROLE TO 1113 00:44:15,240 --> 00:44:16,840 COORDINATE AND HARMONIZE DATA 1114 00:44:16,840 --> 00:44:17,840 AND CONSORTIUM ACTIVITIES. 1115 00:44:17,840 --> 00:44:20,560 I'M GOING TO VERY BRIEFLY TOUCH 1116 00:44:20,560 --> 00:44:22,160 UPON THESE COMPONENTS IN THE 1117 00:44:22,160 --> 00:44:25,480 NEXT FEW SLIDES, IF YOU CAN GO 1118 00:44:25,480 --> 00:44:27,280 ON. 1119 00:44:27,280 --> 00:44:30,320 SO FIRST THE MECHANISTIC 1120 00:44:30,320 --> 00:44:35,040 RESEARCH CENTERS, REACH MRC 1121 00:44:35,040 --> 00:44:36,960 EXAMINING BIOSOCIAL, RELIES UPON 1122 00:44:36,960 --> 00:44:38,160 TWO OBSERVATIONAL COHORTS, AS 1123 00:44:38,160 --> 00:44:46,520 SHOWN ON THE SLIDE, AND THE 1124 00:44:46,520 --> 00:44:49,600 HEALING LB3P IS COLLECTING DATA 1125 00:44:49,600 --> 00:44:51,760 WITH OVER 750 ENROLLEES TO DATE, 1126 00:44:51,760 --> 00:44:56,680 AND THEN THE THIRD MECHANIC MEC 1127 00:44:56,680 --> 00:44:59,960 CENTER IS RUNNING WITH A SMART 1128 00:44:59,960 --> 00:45:01,400 DESIGN TO IDENTIFIED PREDICTING 1129 00:45:01,400 --> 00:45:07,840 RESPONSES TO FOUR INTERVENTIONS, 1130 00:45:07,840 --> 00:45:10,600 MINDFULNESS, PHYSICAL THERAPY, 1131 00:45:10,600 --> 00:45:11,960 ACUPRESSURE AND DULOXETINE, WITH 1132 00:45:11,960 --> 00:45:13,000 A SIGNIFICANT AMOUNT OF WORK 1133 00:45:13,000 --> 00:45:14,000 BEFORE THE STUDIES BEGAN. 1134 00:45:14,000 --> 00:45:15,840 FOR EXAMPLE ALL THE DATA 1135 00:45:15,840 --> 00:45:19,360 COLLECTION APPROACHES WERE 1136 00:45:19,360 --> 00:45:20,840 STANDARDIZED AND HARMONIZED 1137 00:45:20,840 --> 00:45:22,640 ENSURING VERY RICH DATASETS THAT 1138 00:45:22,640 --> 00:45:24,600 CAN BE ACCESSED AND INTEGRATED 1139 00:45:24,600 --> 00:45:26,040 ACROSS EFFORTS. 1140 00:45:26,040 --> 00:45:30,200 SO ON THE NEXT SLIDE, THIS 1141 00:45:30,200 --> 00:45:31,480 HIGHLIGHTS THE EXCITING 1142 00:45:31,480 --> 00:45:32,080 TECHNOLOGY DEVELOPMENT SITES, 1143 00:45:32,080 --> 00:45:35,200 THERE ARE SEVEN OF THESE. 1144 00:45:35,200 --> 00:45:36,200 I WON'T GO THROUGH ALL BUT 1145 00:45:36,200 --> 00:45:38,520 STARTING AT THE LOWER LEFT 1146 00:45:38,520 --> 00:45:44,080 YOU'LL SEE THAT THESE DEVELOP 1147 00:45:44,080 --> 00:45:45,480 ROBOTIC APPAREL, DIGITAL 1148 00:45:45,480 --> 00:45:50,000 PLATFORM EFFORTS, MEASURING END 1149 00:45:50,000 --> 00:45:51,080 PLATE PATHOLOGY, MEASURING 1150 00:45:51,080 --> 00:45:54,240 DENSITY IN THE BRAIN, USE OF 1151 00:45:54,240 --> 00:45:55,240 NANOCOMPOSITE SENSORS IN 1152 00:45:55,240 --> 00:45:58,960 ADDITION LASTLY TO USE OF 1153 00:45:58,960 --> 00:46:00,080 FOCUSED ULTRASOUND, EXCITING 1154 00:46:00,080 --> 00:46:01,280 TECHNOLOGIES THAT ARE BEING 1155 00:46:01,280 --> 00:46:03,240 STUDIED, AND SOME OF THESE 1156 00:46:03,240 --> 00:46:04,960 RESULTS HAVE BEEN PUBLISHED SUCH 1157 00:46:04,960 --> 00:46:07,520 AS IMPROVEMENTS IN THE 1158 00:46:07,520 --> 00:46:08,720 TECHNOLOGY AROUND SPINE MRIs. 1159 00:46:08,720 --> 00:46:12,400 SO IF YOU GO TO THE NEXT SLIDE, 1160 00:46:12,400 --> 00:46:15,240 THE THIRD COMPONENT IS THE THREE 1161 00:46:15,240 --> 00:46:18,640 PHASE 2 CLINICAL TRIALS, 1162 00:46:18,640 --> 00:46:21,400 DEPICTED ON THE SLIDE EXAMINING 1163 00:46:21,400 --> 00:46:25,840 VIRTUAL REALITY PROTOCOLS TO 1164 00:46:25,840 --> 00:46:28,280 MANAGE BACK PAIN, EXPLORING 1165 00:46:28,280 --> 00:46:30,800 COMBINATION OF ANTIDEPRESSANTS 1166 00:46:30,800 --> 00:46:33,320 AND ENHANCED FEAR AVOIDANCE 1167 00:46:33,320 --> 00:46:34,080 REHABILITATION PROTOCOL FOR 1168 00:46:34,080 --> 00:46:37,080 PATIENTS WITH LOW BACK PAIN AND 1169 00:46:37,080 --> 00:46:38,920 DEPRESSION OR ANXIETY, AND A 1170 00:46:38,920 --> 00:46:40,760 TRIAL BY FRITZ AND COLLEAGUES 1171 00:46:40,760 --> 00:46:42,880 THAT LOOKS FOR WHETHER A 1172 00:46:42,880 --> 00:46:44,600 COMPREHENSIVE PROGRAM TO IMPROVE 1173 00:46:44,600 --> 00:46:45,720 THE PATIENT'S ABILITY AND 1174 00:46:45,720 --> 00:46:48,560 CONFIDENCE IN MANAGING THEIR OWN 1175 00:46:48,560 --> 00:46:51,960 PAIN BEFORE SURGERY CAN REDUCE 1176 00:46:51,960 --> 00:46:53,360 RISK OF POST-SURGICAL OPIOID 1177 00:46:53,360 --> 00:46:54,480 USE. 1178 00:46:54,480 --> 00:46:56,560 NEXT SLIDE JUST ILLUSTRATES THE 1179 00:46:56,560 --> 00:46:57,760 THREE VIRTUAL REALITY PROTOCOLS 1180 00:46:57,760 --> 00:47:00,840 FOR THAT FIRST TRIAL THAT I 1181 00:47:00,840 --> 00:47:02,680 MENTIONED, ONE BEING SHAM 1182 00:47:02,680 --> 00:47:05,520 INTERVENTION, ANOTHER BEING AN 1183 00:47:05,520 --> 00:47:06,200 IMMERSIVE DISTRACTIVE 1184 00:47:06,200 --> 00:47:09,480 INTERVENTION AND THEN THE THIRD 1185 00:47:09,480 --> 00:47:11,440 IS IMMERSIVE SKILLS-BASED 1186 00:47:11,440 --> 00:47:12,520 VIRTUAL REALITY PROTOCOL. 1187 00:47:12,520 --> 00:47:13,840 WE'RE REALLY EXCITED ABOUT ALL 1188 00:47:13,840 --> 00:47:16,360 OF THESE EFFORTS. 1189 00:47:16,360 --> 00:47:17,920 ON THE NEXT SLIDE, COLLABORATION 1190 00:47:17,920 --> 00:47:23,040 IS VERY IMPORTANT AT "HEAL," AND 1191 00:47:23,040 --> 00:47:26,200 IMPORTANT IN BACPAC, AIMING TO 1192 00:47:26,200 --> 00:47:28,080 CAPITALIZE ON DATA AND 1193 00:47:28,080 --> 00:47:29,920 BRAINPOWER ACROSS THE CONSORTIUM 1194 00:47:29,920 --> 00:47:31,040 TO ENABLE NEW PARADIGMS IN THE 1195 00:47:31,040 --> 00:47:33,880 TREATMENT OF CHRONIC LOW BACK 1196 00:47:33,880 --> 00:47:35,640 PAIN, THIS INCLUDES OF COURSE 1197 00:47:35,640 --> 00:47:38,160 HARMONIZING DATA COLLECTION AS 1198 00:47:38,160 --> 00:47:39,480 I'VE MENTIONED, CREATING 1199 00:47:39,480 --> 00:47:42,400 THEORETICAL MODEL OF CHRONIC LOW 1200 00:47:42,400 --> 00:47:45,360 BACK PAIN AND ALSO LAUNCHING A 1201 00:47:45,360 --> 00:47:46,080 COLLABORATIVE MULTI-SITE 1202 00:47:46,080 --> 00:47:48,120 CLINICAL TRIAL CALLED THE BEST 1203 00:47:48,120 --> 00:47:49,520 TRIAL, WHICH I'LL ALSO DESCRIBE 1204 00:47:49,520 --> 00:47:51,520 IN JUST A MINUTE. 1205 00:47:51,520 --> 00:47:52,720 BUT TO ENSURE HARMONIZATION OF 1206 00:47:52,720 --> 00:47:55,200 THE DATA COLLECTION MEASURES AND 1207 00:47:55,200 --> 00:47:58,160 PROTOCOLS, WORKING GROUPS WERE 1208 00:47:58,160 --> 00:48:01,600 CREATED TO STANDARDIZE 1209 00:48:01,600 --> 00:48:03,000 BIOBEHAVIORAL, BIOMECHANICAL, 1210 00:48:03,000 --> 00:48:06,600 BIOSPECIMEN AND IMAGING AND DATA 1211 00:48:06,600 --> 00:48:09,360 COLLECTION IN BACPAC, MADE 1212 00:48:09,360 --> 00:48:10,880 PUBLICLY AVAILABLE. 1213 00:48:10,880 --> 00:48:13,280 I MENTIONED THIS THEORETICAL 1214 00:48:13,280 --> 00:48:16,240 MODEL, AN IMPORTANT ASPECT OF 1215 00:48:16,240 --> 00:48:22,120 THE EFFORTS, SHOWN ON THE NEXT 1216 00:48:22,120 --> 00:48:24,960 SLIDE. 1217 00:48:24,960 --> 00:48:26,720 THE BACPAC INVESTIGATORS 1218 00:48:26,720 --> 00:48:28,680 ESTABLISHED THIS FOR PHENOTYPES, 1219 00:48:28,680 --> 00:48:29,720 INTERVENTIONS, EXPLANATORY 1220 00:48:29,720 --> 00:48:33,280 THEORIES, MACHINE LEARNING, ET 1221 00:48:33,280 --> 00:48:33,720 CETERA. 1222 00:48:33,720 --> 00:48:36,360 THE MODEL AIMS TO INTEGRATE 1223 00:48:36,360 --> 00:48:38,000 FACTORS INTERNAL AND EXTERNAL, 1224 00:48:38,000 --> 00:48:40,160 THAT AFFECT PAIN PROCESSING. 1225 00:48:40,160 --> 00:48:42,160 THIS INCLUDES MECHANISMS IN THE 1226 00:48:42,160 --> 00:48:44,640 LOWER BACK, THAT'S REPRESENTED 1227 00:48:44,640 --> 00:48:47,440 IN THE BOTTOM CIRCLE, DORSAL 1228 00:48:47,440 --> 00:48:48,840 HORN AND SPINAL CORD, 1229 00:48:48,840 --> 00:48:50,400 REPRESENTED IN THE MIDDLE 1230 00:48:50,400 --> 00:48:51,800 CIRCLE, AND THEN THE BRAIN 1231 00:48:51,800 --> 00:48:53,520 CAPTURED IN THE UPPER CIRCLE. 1232 00:48:53,520 --> 00:48:56,160 SO THESE ALL CONTRIBUTE TO AN 1233 00:48:56,160 --> 00:48:57,280 INDIVIDUAL'S EXPERIENCE OF PAIN, 1234 00:48:57,280 --> 00:49:00,440 AND THIS EXPERIENCE CAN BE 1235 00:49:00,440 --> 00:49:01,360 INDIRECTLY ASSESSED USING 1236 00:49:01,360 --> 00:49:03,480 VARIOUS MEASURES OF PAIN AND 1237 00:49:03,480 --> 00:49:03,760 DISABILITY. 1238 00:49:03,760 --> 00:49:06,320 SO THE MODEL WAS DERIVED BY 1239 00:49:06,320 --> 00:49:08,560 INTEGRATING EXPERT OPINIONS ON 1240 00:49:08,560 --> 00:49:10,600 THE RISK AND PROGNOSTIC FACTORS 1241 00:49:10,600 --> 00:49:13,040 WITH RESULTS OF EXTENSIVE 1242 00:49:13,040 --> 00:49:14,360 LITERATURE REVIEW WHICH ASSESSED 1243 00:49:14,360 --> 00:49:16,960 OVERALL STRENGTH OF EVIDENCE FOR 1244 00:49:16,960 --> 00:49:18,240 IDENTIFIED RISK FACTORS AND OF 1245 00:49:18,240 --> 00:49:19,360 COURSE OVER THE COURSE OF THIS 1246 00:49:19,360 --> 00:49:22,000 PROGRAM THE MODEL WILL BE 1247 00:49:22,000 --> 00:49:24,400 REFINED BASED ON BACPAC DATA AND 1248 00:49:24,400 --> 00:49:25,480 OTHER DATA TO REFLECT A 1249 00:49:25,480 --> 00:49:26,360 STATE-OF-THE-ART MODEL FOR 1250 00:49:26,360 --> 00:49:27,800 CHRONIC LOW BACK PAIN. 1251 00:49:27,800 --> 00:49:30,200 AND AS THE SLIDE INDICATES, THE 1252 00:49:30,200 --> 00:49:32,080 MODEL AND PROCESS TO DEVELOP 1253 00:49:32,080 --> 00:49:32,840 WERE RECENTLY PUBLISHED. 1254 00:49:32,840 --> 00:49:36,240 SO IF YOU GO TO THE NEXT SLIDE. 1255 00:49:36,240 --> 00:49:37,760 I MENTIONED ANOTHER FEATURE OF 1256 00:49:37,760 --> 00:49:39,400 THIS PROGRAM THAT WE'RE EXCITED 1257 00:49:39,400 --> 00:49:43,000 ABOUT WHICH IS THE BEST TRIAL, 1258 00:49:43,000 --> 00:49:45,800 THE BIOMARKERS FOR EVALUATING 1259 00:49:45,800 --> 00:49:47,840 SPINE TREATMENTS, A FOUR-ARM 1260 00:49:47,840 --> 00:49:50,160 SMART TRIAL, DESIGNED TO 1261 00:49:50,160 --> 00:49:51,440 ESTIMATE AN ALGORITHM, ASSIGN 1262 00:49:51,440 --> 00:49:53,760 SEQUENCE OF TWO TREATMENTS FOR 1263 00:49:53,760 --> 00:49:56,480 CHRONIC LOW BACK PAIN, BASED ON 1264 00:49:56,480 --> 00:49:57,600 A PATIENT'S PHENOTYPIC MARKERS 1265 00:49:57,600 --> 00:49:59,680 SO THE TRIAL IS EXPLORING FOUR 1266 00:49:59,680 --> 00:50:00,520 INTERVENTIONS THAT HAVE BEEN 1267 00:50:00,520 --> 00:50:02,840 SHOWN TO HAVE SOME EFFECTIVENESS 1268 00:50:02,840 --> 00:50:05,120 FOR CHRONIC LOW BACK PAIN 1269 00:50:05,120 --> 00:50:06,240 PATIENTS. 1270 00:50:06,240 --> 00:50:07,640 THIS INCLUDES ENHANCED 1271 00:50:07,640 --> 00:50:11,240 SELF-CARE, ACCEPTANCE AND 1272 00:50:11,240 --> 00:50:12,000 COMMITMENT THERAPY, EVIDENCE 1273 00:50:12,000 --> 00:50:14,600 BASED EXERCISE AND MANUAL 1274 00:50:14,600 --> 00:50:16,040 THERAPY, AND THEN DULOXETINE. 1275 00:50:16,040 --> 00:50:18,280 IMPORTANTLY THE TRIAL IS POWERED 1276 00:50:18,280 --> 00:50:20,360 TO IDENTIFY WHICH TREATMENT WILL 1277 00:50:20,360 --> 00:50:22,840 BE BEST FOR WHICH SUBGROUP OF 1278 00:50:22,840 --> 00:50:24,360 PATIENTS, INSTEAD OF FOCUSING ON 1279 00:50:24,360 --> 00:50:28,320 AVERAGE EFFECTS ON A GROUP OF 1280 00:50:28,320 --> 00:50:28,600 PATIENTS. 1281 00:50:28,600 --> 00:50:31,600 NEXT SLIDE, WHICH I WON'T GO 1282 00:50:31,600 --> 00:50:34,120 OVER IN DETAIL, SHOWS THE 1283 00:50:34,120 --> 00:50:35,080 PROTOCOL. 1284 00:50:35,080 --> 00:50:37,200 THERE ARE TWO TREATMENT PERIODS, 1285 00:50:37,200 --> 00:50:38,240 ALL PARTICIPANTS ARE RANDOMIZED 1286 00:50:38,240 --> 00:50:45,080 TO ONE OF THE FOUR IN THE FIRST 1287 00:50:45,080 --> 00:50:46,200 PERIOD, TREATMENT IN SECOND 1288 00:50:46,200 --> 00:50:48,840 PERIOD DEPENDS ON INITIAL 1289 00:50:48,840 --> 00:50:51,120 RESPONSE TO FIRST TREATMENT. 1290 00:50:51,120 --> 00:50:53,240 PARTICIPANTS ARE PHENOTYPED AT 1291 00:50:53,240 --> 00:50:54,440 THREE TIME POINTS, IMPORTANT 1292 00:50:54,440 --> 00:50:57,120 GIVEN THE GOALS, BEFORE EACH OF 1293 00:50:57,120 --> 00:50:59,240 THE TWO TREATMENT PERIODS, 1294 00:50:59,240 --> 00:51:01,400 DURING THE FOLLOW-UP. 1295 00:51:01,400 --> 00:51:09,200 ALL PARTICIPANTS UNDERGO LIGHT 1296 00:51:09,200 --> 00:51:09,720 PHENOTYPING 1297 00:51:09,720 --> 00:51:11,480 BASIC BIOMECHANICS, CLINICAL 1298 00:51:11,480 --> 00:51:13,240 SPINE MRI FINDINGS, X-RAY 1299 00:51:13,240 --> 00:51:17,040 IMAGES, AND A SUBSET ALSO 1300 00:51:17,040 --> 00:51:20,680 UNDERGO DEEP PHENOTYPING 1301 00:51:20,680 --> 00:51:23,520 ADVANCED BIOMECHANICS, ADVANCED 1302 00:51:23,520 --> 00:51:24,720 MRI, BRAIN MRI, QUANTITATIVE 1303 00:51:24,720 --> 00:51:26,720 SENSORY TESTING RESULTS. 1304 00:51:26,720 --> 00:51:28,040 NEXT SLIDE. 1305 00:51:28,040 --> 00:51:30,720 THIS SHOWS THE TIMELINE. 1306 00:51:30,720 --> 00:51:34,880 THE TRIAL WAS LAUNCHED LAST 1307 00:51:34,880 --> 00:51:35,160 SEPTEMBER. 1308 00:51:35,160 --> 00:51:36,000 WE ANTICIPATE ENROLLMENT TO END 1309 00:51:36,000 --> 00:51:38,920 IN SEPTEMBER OF THIS YEAR ALLOW 1310 00:51:38,920 --> 00:51:40,720 THE TRIAL TO COMPLETE IN 1311 00:51:40,720 --> 00:51:44,320 SEPTEMBER OF 2024. 1312 00:51:44,320 --> 00:51:47,040 AND LASTLY, THINKING ABOUT THE 1313 00:51:47,040 --> 00:51:51,120 WHOLE SYSTEM, AS YOU'VE HEARD, 1314 00:51:51,120 --> 00:51:54,400 MOVING FORWARD, NEXT SLIDE, 1315 00:51:54,400 --> 00:51:56,240 SORRY, WE AIM TO BUILD ON BACPAC 1316 00:51:56,240 --> 00:51:58,440 AS WELL AS OTHER "HEAL" PROGRAMS 1317 00:51:58,440 --> 00:51:59,760 SUCH AS REJOIN THAT SOME OF YOU 1318 00:51:59,760 --> 00:52:01,840 MAY HAVE HEARD ABOUT TO DEVELOP 1319 00:52:01,840 --> 00:52:03,600 A WHOLE JOINT PERSPECTIVE. 1320 00:52:03,600 --> 00:52:06,440 SO, WE RECOGNIZE THE NEED TO 1321 00:52:06,440 --> 00:52:07,720 INTEGRATE INFORMATION ACROSS ALL 1322 00:52:07,720 --> 00:52:10,120 DOMAINS, MANY ARE DEPICTED HERE, 1323 00:52:10,120 --> 00:52:10,680 ENVIRONMENT, BEHAVIOR, 1324 00:52:10,680 --> 00:52:14,080 MECHANICS, AS WELL AS TISSUE, 1325 00:52:14,080 --> 00:52:15,840 CELLULAR, MOLECULAR PROCESSES, 1326 00:52:15,840 --> 00:52:18,440 TO MAINTAIN HEALTH, PREVENT OR 1327 00:52:18,440 --> 00:52:20,560 ADDRESS PAIN AND PREVENT 1328 00:52:20,560 --> 00:52:20,800 ADDICTION. 1329 00:52:20,800 --> 00:52:22,720 SO, THIS WILL BEGIN BY 1330 00:52:22,720 --> 00:52:23,920 INTEGRATING INFORMATION FROM THE 1331 00:52:23,920 --> 00:52:25,360 VARIOUS "HEAL" PROGRAMS, I'VE 1332 00:52:25,360 --> 00:52:27,080 TALKED ABOUT BACPAC THIS MORNING 1333 00:52:27,080 --> 00:52:32,560 BUT WE ALSO HOPE TO LEARN ABOUT 1334 00:52:32,560 --> 00:52:35,280 KNEE AND TMJ INNERVATION TO 1335 00:52:35,280 --> 00:52:38,800 REJOIN, APPLY TO BACK PAIN AND 1336 00:52:38,800 --> 00:52:39,880 OTHER JOINT PAIN, BUILD ON 1337 00:52:39,880 --> 00:52:41,440 BIOMARKERS THAT YOU ALSO HEARD 1338 00:52:41,440 --> 00:52:43,920 ABOUT TO DEVELOP BIOMARKERS FOR 1339 00:52:43,920 --> 00:52:45,440 PAIN IN OTHER JOINTS, EXPLORING 1340 00:52:45,440 --> 00:52:48,760 HOW CELLULAR MOLECULAR AND 1341 00:52:48,760 --> 00:52:49,960 GENETIC INFORMATION FROM THE PRO 1342 00:52:49,960 --> 00:52:51,040 SITUATION PROGRAM WILL INFORM 1343 00:52:51,040 --> 00:52:54,760 DEVELOPMENT OF BIOMARKERS FOR 1344 00:52:54,760 --> 00:52:58,360 OTHER TYPES OF PAIN AND EXAMINE 1345 00:52:58,360 --> 00:53:00,600 WAYS TO SHARE CLINICAL DATA, 1346 00:53:00,600 --> 00:53:01,440 TISSUES, AND OTHER RESOURCES 1347 00:53:01,440 --> 00:53:05,520 ACROSS PROGRAMS TO BETTER 1348 00:53:05,520 --> 00:53:08,440 LEVERAGE RESEARCH OPPORTUNITIES. 1349 00:53:08,440 --> 00:53:11,320 MY LAST SLIDE, WHICH IS MOSTLY 1350 00:53:11,320 --> 00:53:13,080 BLANK BUT REPRESENTS MANY, MANY, 1351 00:53:13,080 --> 00:53:16,480 MANY PEOPLE, I WANT TO THANK THE 1352 00:53:16,480 --> 00:53:17,880 RESEARCHERS PARTICIPATING IN 1353 00:53:17,880 --> 00:53:19,280 BACPAC, BACPAC STAKEHOLDERS AND 1354 00:53:19,280 --> 00:53:20,720 BOARD MEMBERS, I CERTAINLY WANT 1355 00:53:20,720 --> 00:53:23,560 TO ACKNOWLEDGE THE NIH PROGRAM 1356 00:53:23,560 --> 00:53:29,440 STAFF WHO MANAGE THIS COMPLEX -- 1357 00:53:29,440 --> 00:53:31,960 THESE COMPLEX AWARDS, INCLUDING 1358 00:53:31,960 --> 00:53:34,760 LESLIE AND ERIN, CHUCK, TED, AND 1359 00:53:34,760 --> 00:53:38,200 MANY OTHER PROJECT SCIENTISTS 1360 00:53:38,200 --> 00:53:40,520 AND PROJECT COORDINATORS FROM 1361 00:53:40,520 --> 00:53:43,920 MULTIPLE INSTITUTES, CENTERS, 1362 00:53:43,920 --> 00:53:49,720 OFFICES, AND OF COURSE 1363 00:53:49,720 --> 00:53:51,040 ACKNOWLEDGE THE PATIENTS WITHOUT 1364 00:53:51,040 --> 00:53:53,240 WHOM WISH THIS WOULDN'T BE 1365 00:53:53,240 --> 00:53:53,520 POSSIBLE. 1366 00:53:53,520 --> 00:53:55,080 OUR HOPE IS DEVELOP CLEAR 1367 00:53:55,080 --> 00:53:56,080 GUIDELINES TO INDIVIDUALIZE 1368 00:53:56,080 --> 00:53:57,720 TREATMENT FOR CHRONIC LOW BACK 1369 00:53:57,720 --> 00:54:00,200 PAIN. 1370 00:54:00,200 --> 00:54:02,200 BACK TO YOU, DR. BAKER. 1371 00:54:02,200 --> 00:54:05,080 >> THANK YOU, DR. CRISWELL. 1372 00:54:05,080 --> 00:54:07,680 I WOULD LIKE TO MAKE SURE WE 1373 00:54:07,680 --> 00:54:09,640 HAVE TIME FOR DISCUSSION. 1374 00:54:09,640 --> 00:54:14,240 I'LL GO THROUGH MY SLIDES NOW 1375 00:54:14,240 --> 00:54:16,240 QUICKLY AND THOSE OF YOU WHO 1376 00:54:16,240 --> 00:54:18,920 HAVE QUESTIONS FOR DR. KOROSHETZ 1377 00:54:18,920 --> 00:54:21,000 OR CRISWELL PLEASE SAVE THEM FOR 1378 00:54:21,000 --> 00:54:22,200 THE GENERAL DISCUSSION THAT WILL 1379 00:54:22,200 --> 00:54:25,280 FOLLOW MY BRIEF TALK NOW. 1380 00:54:25,280 --> 00:54:29,120 YOU HAVE HEARD A LOT ABOUT 1381 00:54:29,120 --> 00:54:32,080 SPECIFIC PROGRAMS AND PROJECTS 1382 00:54:32,080 --> 00:54:32,640 WITHIN "HEAL." 1383 00:54:32,640 --> 00:54:36,240 I'LL NOW TAKE A STEP OR TWO BACK 1384 00:54:36,240 --> 00:54:40,280 AND JUST REMIND YOU IN THE NEXT 1385 00:54:40,280 --> 00:54:43,360 SLIDE OF WHAT THE OVERARCHING 1386 00:54:43,360 --> 00:54:49,400 VISION IS FOR THIS, HELPING TO 1387 00:54:49,400 --> 00:54:50,840 END ADDICTION LONG-TERM 1388 00:54:50,840 --> 00:54:52,320 INITIATIVE TO COMBINE SCIENCE, 1389 00:54:52,320 --> 00:54:54,000 EFFORTS OF SCIENTISTS AND 1390 00:54:54,000 --> 00:54:55,360 RESEARCH COMMUNITY TO THE 1391 00:54:55,360 --> 00:54:56,840 STRENGTHS AND POWER OF THE 1392 00:54:56,840 --> 00:54:58,600 COMMUNITIES IN WHICH OUR 1393 00:54:58,600 --> 00:55:01,520 PATIENTS AND STAKEHOLDERS LIVE 1394 00:55:01,520 --> 00:55:03,840 TO PROVIDE SCIENTIFIC SOLUTIONS 1395 00:55:03,840 --> 00:55:07,000 AND HELP END ADDICTION LONG 1396 00:55:07,000 --> 00:55:07,560 TERM. 1397 00:55:07,560 --> 00:55:10,160 THIS MISSION INCLUDES EFFORTS TO 1398 00:55:10,160 --> 00:55:15,440 ACCELERATE DEVELOPMENT OF NEW 1399 00:55:15,440 --> 00:55:16,880 TREATMENTS, SAFE, NON-ADDICTIVE 1400 00:55:16,880 --> 00:55:19,480 STRATEGIES TO PREVENT AND TREAT 1401 00:55:19,480 --> 00:55:21,440 PAIN, OPIOID MISUSE, ADDICTION, 1402 00:55:21,440 --> 00:55:23,960 TO REVERSE OVERDOSE. 1403 00:55:23,960 --> 00:55:29,680 IN THE NEXT SLIDE I SHOW JUST -- 1404 00:55:29,680 --> 00:55:31,440 DR. TABAK MENTIONED THESE SO 1405 00:55:31,440 --> 00:55:32,960 I'LL BE QUICK, BUT CHRONIC PAIN 1406 00:55:32,960 --> 00:55:34,400 IS NOT GOING AWAY. 1407 00:55:34,400 --> 00:55:37,760 IT AFFECTS SO MANY MILLIONS OF 1408 00:55:37,760 --> 00:55:38,640 AMERICANS, HAS INCREDIBLE BURDEN 1409 00:55:38,640 --> 00:55:40,760 OF DISEASE AND REALLY AFFECTS 1410 00:55:40,760 --> 00:55:42,360 QUALITY OF LIFE FOR MANY PEOPLE 1411 00:55:42,360 --> 00:55:47,080 AND MANY PEOPLE WITH OTHER 1412 00:55:47,080 --> 00:55:48,720 HEALTH CONDITIONS. 1413 00:55:48,720 --> 00:55:51,360 AND A PARALLEL TRACK, WE HAVE 1414 00:55:51,360 --> 00:55:56,160 RECORD NUMBERS OF DRUG OVERDOSES 1415 00:55:56,160 --> 00:55:57,680 AFFECTING FAMILIES, COMMUNITIES, 1416 00:55:57,680 --> 00:56:01,320 INDIVIDUALS ACROSS THE COUNTRY, 1417 00:56:01,320 --> 00:56:03,480 DRIVEN BY THE INCREASING 1418 00:56:03,480 --> 00:56:05,080 ACCESSIBILITY OF FENTANYL AND 1419 00:56:05,080 --> 00:56:07,120 CONTAMINATION OF FENTANYL AND 1420 00:56:07,120 --> 00:56:11,280 DIFFERENT DRUGS, BUT ALSO A LACK 1421 00:56:11,280 --> 00:56:12,160 OF INFRASTRUCTURE AND COMMUNITY 1422 00:56:12,160 --> 00:56:14,120 SUPPORT FOR SOME OF THE 1423 00:56:14,120 --> 00:56:15,520 EFFECTIVE INTERVENTIONS THAT WE 1424 00:56:15,520 --> 00:56:16,760 HAVE. 1425 00:56:16,760 --> 00:56:21,000 AND THEN LASTLY WE HAVE OUR 1426 00:56:21,000 --> 00:56:23,000 BIOPHARMACEUTICAL PARTNERS WHO 1427 00:56:23,000 --> 00:56:24,280 HAVE INTERESTING, INNOVATIVE 1428 00:56:24,280 --> 00:56:25,160 APPROACHES AND ABILITY TO 1429 00:56:25,160 --> 00:56:27,240 COMMERCIALIZE THESE TO PROVIDE 1430 00:56:27,240 --> 00:56:31,280 THESE NEW TREATMENTS, AND YET 1431 00:56:31,280 --> 00:56:32,440 WE'RE NOT SEEING INVESTMENTS AND 1432 00:56:32,440 --> 00:56:35,080 PROGRESS OF MANY OF THE PROGRAMS 1433 00:56:35,080 --> 00:56:37,880 THAT WE'RE AWARE OF AND THAT 1434 00:56:37,880 --> 00:56:38,680 COULD BE SCIENTIFIC SOLUTIONS 1435 00:56:38,680 --> 00:56:40,040 WE'RE SEEKING FOR PEOPLE WITH 1436 00:56:40,040 --> 00:56:41,680 PAIN AND ADDICTION. 1437 00:56:41,680 --> 00:56:44,160 SO THIS IS OUR LANDSCAPE. 1438 00:56:44,160 --> 00:56:45,520 AND NEXT SLIDE, I BEGIN TO TALK 1439 00:56:45,520 --> 00:56:47,920 ABOUT SOME OF THE WAYS "HEAL" 1440 00:56:47,920 --> 00:56:50,320 RESEARCH IS MEETING THIS 1441 00:56:50,320 --> 00:56:50,840 CHALLENGE. 1442 00:56:50,840 --> 00:56:57,280 THE FIRST EXAMPLE, NEXT SLIDE, 1443 00:56:57,280 --> 00:57:02,040 IS THE STUDY, YOU WILL RECALL 1444 00:57:02,040 --> 00:57:04,560 THE GROUP OF NEONATOLOGISTS AND 1445 00:57:04,560 --> 00:57:06,520 NURSES WHO CONTRIBUTED TO THIS 1446 00:57:06,520 --> 00:57:11,080 STUDY LED BY THE ECHO PROGRAM 1447 00:57:11,080 --> 00:57:13,200 WITH NICHD, NATIONAL INSTITUTE 1448 00:57:13,200 --> 00:57:15,400 ON CHILD HEALTH. 1449 00:57:15,400 --> 00:57:17,760 WE HAVE INFANTS BORN EXPOSED TO 1450 00:57:17,760 --> 00:57:19,760 OPIOIDS, UNDERGOING WITHDRAWAL 1451 00:57:19,760 --> 00:57:21,400 IN THE NICU, RESEARCH UNDERWAY 1452 00:57:21,400 --> 00:57:25,560 TO UNDERSTAND THE BEST WAY OF 1453 00:57:25,560 --> 00:57:28,080 EVALUATING THEIR LONG-TERM 1454 00:57:28,080 --> 00:57:30,240 DEVELOPMENT BUT IN THE SHORT 1455 00:57:30,240 --> 00:57:38,120 TERM WAYS TO ADDRESS WITHDRAWAL 1456 00:57:38,120 --> 00:57:39,120 SYSTEMS; THE EAT, SLEEP, CONSOLE 1457 00:57:39,120 --> 00:57:41,880 APPROACH, WHETHER THEY ARE ABLE 1458 00:57:41,880 --> 00:57:46,800 TO EAT, SLEEP, BE CONSOLED WAS 1459 00:57:46,800 --> 00:57:47,680 TESTED, RANDOMIZED CLINICAL 1460 00:57:47,680 --> 00:57:48,880 TRIAL FOUND TO REDUCE TIME IN 1461 00:57:48,880 --> 00:57:53,040 THE HOSPITAL AND REDUCE AMOUNT 1462 00:57:53,040 --> 00:57:56,320 OF OPIOID MEDICATIONS NEEDED TO 1463 00:57:56,320 --> 00:57:58,600 ADDRESS THOSE WITHDRAWAL 1464 00:57:58,600 --> 00:58:00,000 SYMPTOMS. 1465 00:58:00,000 --> 00:58:00,800 NEXT SLIDE. 1466 00:58:00,800 --> 00:58:01,880 FINDINGS THAT DR. KOROSHETZ 1467 00:58:01,880 --> 00:58:04,000 MENTIONED, I WON'T LINGER ON, 1468 00:58:04,000 --> 00:58:08,240 BUT THERE ARE BEGINNING TO BE 1469 00:58:08,240 --> 00:58:10,960 STUDIES THAT CAN IMAGE THE BRAIN 1470 00:58:10,960 --> 00:58:13,160 AND UNDERSTAND THE CHRONIC PAIN 1471 00:58:13,160 --> 00:58:16,400 SIGNATURES THAT ARE DIFFERENT 1472 00:58:16,400 --> 00:58:17,880 AMONG INDIVIDUALS, IN THIS CASE 1473 00:58:17,880 --> 00:58:22,240 PAIN CAUSED BY STROKE OR 1474 00:58:22,240 --> 00:58:23,120 AMPUTATION, AND THESE 1475 00:58:23,120 --> 00:58:23,920 PATIENT-SPECIFIC SIGNALS CAN 1476 00:58:23,920 --> 00:58:26,600 GIVE A PROMISE TO OUR COMMUNITY 1477 00:58:26,600 --> 00:58:28,440 IN TERMS OF WHAT WE COULD BEGIN 1478 00:58:28,440 --> 00:58:30,160 TO ADDRESS, HOW WE COULD BEGIN 1479 00:58:30,160 --> 00:58:31,800 TO PERSONALIZE THE TREATMENT FOR 1480 00:58:31,800 --> 00:58:35,320 PEOPLE WITH CHRONIC PAIN. 1481 00:58:35,320 --> 00:58:40,360 NEXT SLIDE PLEASE. 1482 00:58:40,360 --> 00:58:42,640 WE ALSO HAVE -- DR. D'ONOFRIO IS 1483 00:58:42,640 --> 00:58:46,480 ONE OF THE LEADS FOR THIS TRIAL, 1484 00:58:46,480 --> 00:58:57,040 OR THE LEAD, THRUST WITHIN HEAL, 1485 00:59:00,880 --> 00:59:01,440 BUPRENORPHINE FOR TREATMENT OF 1486 00:59:01,440 --> 00:59:03,200 OPIOID USE DISORDER, IN THE 1487 00:59:03,200 --> 00:59:05,400 EMERGENCY DEPARTMENT, HOPEFULLY 1488 00:59:05,400 --> 00:59:07,400 RESULTING IN GREATER ACCESS AND 1489 00:59:07,400 --> 00:59:08,920 USE OF THE LIFE-SAVING 1490 00:59:08,920 --> 00:59:09,520 MEDICATIONS FOR TREATMENT OF 1491 00:59:09,520 --> 00:59:11,640 OPIOID USE DISORDER THAT WE 1492 00:59:11,640 --> 00:59:14,160 HAVE, WE KNOW WORK, AND WAYS TO 1493 00:59:14,160 --> 00:59:17,000 INTEGRATE INTO CLINICAL CARE. 1494 00:59:17,000 --> 00:59:19,880 SO, SIGNS OF PROGRESS TO ADDRESS 1495 00:59:19,880 --> 00:59:21,240 THE REALLY SIGNIFICANT 1496 00:59:21,240 --> 00:59:22,840 CHALLENGES WE'RE FACING AS A 1497 00:59:22,840 --> 00:59:25,920 COUNTRY IN OUR PAIN AND 1498 00:59:25,920 --> 00:59:27,120 ADDICTION CRISES. 1499 00:59:27,120 --> 00:59:28,080 NEXT SLIDE PLEASE. 1500 00:59:28,080 --> 00:59:29,920 A REMINDER OF WHAT WE'RE SEEKING 1501 00:59:29,920 --> 00:59:31,000 TO DO. 1502 00:59:31,000 --> 00:59:38,440 THIS KIND OF IS INTENDED TO 1503 00:59:38,440 --> 00:59:40,000 PROVIDE INTRODUCTION TO SOME OF 1504 00:59:40,000 --> 00:59:40,600 THE RESEARCH PROGRAMS YOU'LL 1505 00:59:40,600 --> 00:59:49,840 HEAR ABOUT IN THE SECOND HALF F 1506 00:59:49,840 --> 00:59:50,880 THE MEETING, STRATEGIES TO 1507 00:59:50,880 --> 00:59:52,800 REDUCE RISK OF ADDICTION AND 1508 00:59:52,800 --> 00:59:54,760 INTEGRATE EFFECTIVE AND 1509 00:59:54,760 --> 00:59:57,440 SUSTAINABLE PREVENTION AND 1510 00:59:57,440 --> 00:59:58,400 TREATMENT STRATEGIES, INCLUDING 1511 00:59:58,400 --> 01:00:02,000 IMPLEMENTING INTO COMMUNITY AND 1512 01:00:02,000 --> 01:00:03,840 SUSTAINABLE FRAMEWORKS THAT CAN 1513 01:00:03,840 --> 01:00:07,560 BE TAKEN UP AND USED TO SAVE 1514 01:00:07,560 --> 01:00:08,360 LIVES. 1515 01:00:08,360 --> 01:00:09,760 RESEARCH TO SUPPORT HEALTHY 1516 01:00:09,760 --> 01:00:12,280 DEVELOPMENTAL PATHS FOR BABIES 1517 01:00:12,280 --> 01:00:13,280 EXPOSED TO OPIOIDS USING 1518 01:00:13,280 --> 01:00:14,600 UNDERSTANDING HOW A MOTHER'S 1519 01:00:14,600 --> 01:00:17,520 SUBSTANCE USE CAN CONTRIBUTE TO 1520 01:00:17,520 --> 01:00:25,080 THEIR LONG-TERM HEALTH AND NEW 1521 01:00:25,080 --> 01:00:26,400 THERAPEUTICS FOR THE CYCLE, 1522 01:00:26,400 --> 01:00:27,680 WITHDRAWAL, OPIOID USE DISORDER, 1523 01:00:27,680 --> 01:00:31,000 AND OVERDOSE. 1524 01:00:31,000 --> 01:00:31,960 NEXT SLIDE PLEASE. 1525 01:00:31,960 --> 01:00:33,720 PLEASE GO TO OUR WEBSITE, YOU'LL 1526 01:00:33,720 --> 01:00:35,920 SEE A LOT MORE INFORMATION ABOUT 1527 01:00:35,920 --> 01:00:37,520 THE RESEARCH FINDINGS THAT ARE 1528 01:00:37,520 --> 01:00:40,360 COMING THROUGH, AND ALSO THE 1529 01:00:40,360 --> 01:00:41,800 WAYS THAT WE'RE SEEKING TO BUILD 1530 01:00:41,800 --> 01:00:43,120 THE RESEARCH COMMUNITY TO BETTER 1531 01:00:43,120 --> 01:00:45,440 PREPARE FOR THESE CRISES AS THEY 1532 01:00:45,440 --> 01:00:49,920 CONTINUE TO EVOLVE. 1533 01:00:49,920 --> 01:00:50,760 NEXT SLIDE PLEASE. 1534 01:00:50,760 --> 01:00:53,840 A LITTLE BIT OF WHERE WE ARE NOW 1535 01:00:53,840 --> 01:00:57,680 IS IN THE FOLLOWING SLIDE. 1536 01:00:57,680 --> 01:01:00,000 1537 01:01:00,000 --> 01:01:03,920 WE HAVE AN ANNUAL REPORT THAT 1538 01:01:03,920 --> 01:01:06,240 DETAILS A LOT MORE PROGRESS AND 1539 01:01:06,240 --> 01:01:08,440 UPDATES ON THE RESEARCH THAT WE 1540 01:01:08,440 --> 01:01:10,600 HAVE LAUNCHED SINCE YOU STARTED 1541 01:01:10,600 --> 01:01:12,920 WORKING WITH US, DEVELOPING AND 1542 01:01:12,920 --> 01:01:14,200 BUILDING THE HEAL INITIATIVE, 1543 01:01:14,200 --> 01:01:17,360 INCLUDING SOME OF THE SCREENING 1544 01:01:17,360 --> 01:01:20,200 PLATFORMS, DECISION TOOLS, 1545 01:01:20,200 --> 01:01:21,320 COMMUNITY-BASED APPROACHES TO 1546 01:01:21,320 --> 01:01:22,640 HELP END ADDICTION LONG TERM AS 1547 01:01:22,640 --> 01:01:25,080 WELL AS SOME WAYS WE'RE 1548 01:01:25,080 --> 01:01:26,280 LEVERAGING OUR DATA ECOSYSTEM, I 1549 01:01:26,280 --> 01:01:27,840 HOLD YOU ABOUT THOSE IN THE 1550 01:01:27,840 --> 01:01:31,000 PAST, AND CONTINUING TO BUILD 1551 01:01:31,000 --> 01:01:32,760 CONNECTIONS WITH THE USERS AND 1552 01:01:32,760 --> 01:01:34,080 PRACTITIONERS WHO ARE GOING TO 1553 01:01:34,080 --> 01:01:35,160 TAKE RESEARCH FINDINGS AND TURN 1554 01:01:35,160 --> 01:01:36,600 THEM INTO SOLUTIONS FOR PEOPLE 1555 01:01:36,600 --> 01:01:39,960 WITH PAIN AND ADDICTION. 1556 01:01:39,960 --> 01:01:41,920 NEXT SLIDE PLEASE. 1557 01:01:41,920 --> 01:01:43,600 WE CONVENED THE "HEAL" 1558 01:01:43,600 --> 01:01:45,480 INVESTIGATORS COMMUNITY, THERE 1559 01:01:45,480 --> 01:01:49,520 WERE OVER 600 PEOPLE THERE, 1560 01:01:49,520 --> 01:01:52,240 VIRTUAL AND IN PERSON, FOCUS ON 1561 01:01:52,240 --> 01:01:53,200 EARLY STAGE INVESTIGATORS AND 1562 01:01:53,200 --> 01:01:54,840 SOME OF THE EXCITING AREAS OF 1563 01:01:54,840 --> 01:01:56,040 SCIENCE THAT ARE COMING THROUGH. 1564 01:01:56,040 --> 01:01:58,320 SO THANK YOU FOR THOSE WHO TOOK 1565 01:01:58,320 --> 01:02:02,080 PART AND TUNED IN. 1566 01:02:02,080 --> 01:02:03,040 NEXT SLIDE PLEASE. 1567 01:02:03,040 --> 01:02:07,760 AND WHERE ARE WE NOW? 1568 01:02:07,760 --> 01:02:08,400 WITH OVER $2.5 BILLION DIRECTED 1569 01:02:08,400 --> 01:02:10,320 TOWARDS RESEARCH IN PAIN AND 1570 01:02:10,320 --> 01:02:13,520 ADDICTION, OVER 1,000 PROJECTS, 1571 01:02:13,520 --> 01:02:15,960 ALL 50 STATES, YOU HEARD ABOUT 1572 01:02:15,960 --> 01:02:20,160 OVER 300 CLINICAL TRIALS THAT WE 1573 01:02:20,160 --> 01:02:21,480 HAVE UNDERWAY, INCLUDING OVER 1574 01:02:21,480 --> 01:02:23,440 100 PROJECTS ADDRESSING BACK 1575 01:02:23,440 --> 01:02:27,920 PAIN, THIS HAS LED TO OVER 40 1576 01:02:27,920 --> 01:02:28,680 FDA APPROVALS FOR 1577 01:02:28,680 --> 01:02:31,080 INVESTIGATIONAL NEW DRUGS AND 1578 01:02:31,080 --> 01:02:32,240 DEVICES. 1579 01:02:32,240 --> 01:02:34,720 THESE ARE IND SUBMISSIONS TO THE 1580 01:02:34,720 --> 01:02:37,440 FDA THAT SEEK TO BRING FORWARD 1581 01:02:37,440 --> 01:02:38,240 THOSE INNOVATIONS TO PRODUCTS 1582 01:02:38,240 --> 01:02:40,400 THAT CAN BE USED BY PATIENTS, 1583 01:02:40,400 --> 01:02:43,040 AND OF COURSE ACTIVE ONGOING 1584 01:02:43,040 --> 01:02:44,120 PARTNERSHIPS WITH FEDERAL 1585 01:02:44,120 --> 01:02:46,440 AGENCIES AND OUR PARTNERS IN 1586 01:02:46,440 --> 01:02:49,920 PRIVATE SECTOR, ACADEMIA, AND 1587 01:02:49,920 --> 01:02:50,200 COMMUNITIES. 1588 01:02:50,200 --> 01:02:51,320 NEXT SLIDE PLEASE. 1589 01:02:51,320 --> 01:02:54,640 HERE IS WHERE OUR FUNDING GOES 1590 01:02:54,640 --> 01:02:57,040 IN TERMS OF BREAKDOWN INTO 1591 01:02:57,040 --> 01:02:59,440 DIFFERENT AREAS OF RESEARCH 1592 01:02:59,440 --> 01:03:00,880 FOCUS. 1593 01:03:00,880 --> 01:03:02,760 YOU'LL SEE OVER TIME AN 1594 01:03:02,760 --> 01:03:04,680 EXPANSION OF THE PRE-CLINICAL 1595 01:03:04,680 --> 01:03:06,240 AND TRANSLATIONAL RESEARCH IN 1596 01:03:06,240 --> 01:03:07,840 PAIN MANAGEMENT. 1597 01:03:07,840 --> 01:03:10,240 AND ONGOING EFFORTS IN ALL OF 1598 01:03:10,240 --> 01:03:12,720 THE DIFFERENT DOMAINS OF THE 1599 01:03:12,720 --> 01:03:14,080 HEAL INITIATIVE AS OUR BUDGET 1600 01:03:14,080 --> 01:03:17,680 HAS GROWN OVER TIME. 1601 01:03:17,680 --> 01:03:19,920 NEXT SLIDE PLEASE. 1602 01:03:19,920 --> 01:03:21,160 AND SOME OF OUR ONGOING 1603 01:03:21,160 --> 01:03:22,120 PRIORITIES THAT WE'VE DISCUSSED 1604 01:03:22,120 --> 01:03:24,120 WITH THIS GROUP IN THE PAST, AND 1605 01:03:24,120 --> 01:03:27,320 KEEP IN MIND FOR TODAY THE NEEDS 1606 01:03:27,320 --> 01:03:29,600 TO SET THE RIGHT BALANCE FOR 1607 01:03:29,600 --> 01:03:30,880 PAIN AND ADDICTION RESEARCH, 1608 01:03:30,880 --> 01:03:31,840 RECOGNIZING THAT THERE'S A LOT 1609 01:03:31,840 --> 01:03:34,040 OF OVERLAP BOTH OF THE MOLECULAR 1610 01:03:34,040 --> 01:03:37,280 LEVEL AND AT THE POPULATION 1611 01:03:37,280 --> 01:03:37,480 LEVEL. 1612 01:03:37,480 --> 01:03:38,720 FOCUS ON CO-OCCURRING CONDITIONS 1613 01:03:38,720 --> 01:03:39,920 BECAUSE NO ONE INTERVENTION IS 1614 01:03:39,920 --> 01:03:42,760 GOING TO BE STRONG ENOUGH TO 1615 01:03:42,760 --> 01:03:43,440 SOLVE EVERY HEALTH PROBLEM, AND 1616 01:03:43,440 --> 01:03:45,920 SO WE HAVE TO BE LOOKING AT THE 1617 01:03:45,920 --> 01:03:48,320 WHOLE PERSON AND CONSIDERING 1618 01:03:48,320 --> 01:03:50,880 THAT IN OUR RESEARCH. 1619 01:03:50,880 --> 01:03:53,280 RESEARCH FOCUSED ON STIGMA AND 1620 01:03:53,280 --> 01:03:54,400 INEQUITIES IN OUR HEALTH CARE 1621 01:03:54,400 --> 01:03:57,120 SYSTEM BEING REALISTIC IN THE 1622 01:03:57,120 --> 01:03:58,640 RESEARCH WE CONDUCT SO WE BEGIN 1623 01:03:58,640 --> 01:04:02,920 TO BREAK DOWN THOSE BARRIERS TO 1624 01:04:02,920 --> 01:04:04,560 HIGH-QUALITY CARE FOR ALL, 1625 01:04:04,560 --> 01:04:05,640 INTEGRATING VOICE OF LIVED 1626 01:04:05,640 --> 01:04:07,040 EXPERIENCE IS A REALLY IMPORTANT 1627 01:04:07,040 --> 01:04:09,000 TALL TOWARD THAT GOAL, BUT NOT 1628 01:04:09,000 --> 01:04:10,600 THE ONLY ONE. 1629 01:04:10,600 --> 01:04:12,000 WE'RE ALSO LEVERAGING THE POWER 1630 01:04:12,000 --> 01:04:13,960 OF THE DATA COMING OUT OF OUR 1631 01:04:13,960 --> 01:04:16,120 STUDIES, TO PROVIDE NEW LINES OF 1632 01:04:16,120 --> 01:04:18,000 INQUIRY AND BETTER UNDERSTAND 1633 01:04:18,000 --> 01:04:19,240 THE CONDITIONS WE'RE STUDYING, 1634 01:04:19,240 --> 01:04:21,160 AND OF COURSE TRAINING THE NEXT 1635 01:04:21,160 --> 01:04:22,840 GENERATION OF RESEARCHERS, YOU 1636 01:04:22,840 --> 01:04:26,240 HEARD FROM DR. KOROSHETZ, IT'S A 1637 01:04:26,240 --> 01:04:29,320 KEY TOOL FOR LONG TERM AND 1638 01:04:29,320 --> 01:04:30,400 SUSTAINABLE INITIATIVE TO 1639 01:04:30,400 --> 01:04:32,800 ADDRESS THESE CHALLENGES. 1640 01:04:32,800 --> 01:04:33,480 NEXT SLIDE PLEASE. 1641 01:04:33,480 --> 01:04:35,120 THIS IS OUR AGENDA. 1642 01:04:35,120 --> 01:04:37,160 WE'RE OVER TIME, AS YOU'LL SEE. 1643 01:04:37,160 --> 01:04:39,480 BUT I DO WANT TO MAKE SURE THAT 1644 01:04:39,480 --> 01:04:41,160 WE HAVE A MOMENT FOR DISCUSSION, 1645 01:04:41,160 --> 01:04:42,800 BOTH OF WHAT WE HEARD ABOUT FROM 1646 01:04:42,800 --> 01:04:44,560 THE PREVIOUS SPEAKERS AND ALSO 1647 01:04:44,560 --> 01:04:47,400 THE OVERVIEW I JUST PROVIDED. 1648 01:04:47,400 --> 01:04:51,640 WE'LL MAKE A FEW TWEAKS TO THE 1649 01:04:51,640 --> 01:04:53,640 AFTERNOON'S PROGRAM BUT THE KEY 1650 01:04:53,640 --> 01:04:56,280 QUESTION WILL BE ASKING HOW DO 1651 01:04:56,280 --> 01:04:58,480 THESE PROGRAMS FIT TOGETHER, HOW 1652 01:04:58,480 --> 01:04:59,680 DO THE NEW RESEARCH PROJECTS 1653 01:04:59,680 --> 01:05:01,320 THAT THE TEAMS HAVE COME 1654 01:05:01,320 --> 01:05:04,360 TOGETHER TO PROPOSE AND ADVANCE 1655 01:05:04,360 --> 01:05:08,320 THE OVERALL GOAL OF SCIENTIFIC 1656 01:05:08,320 --> 01:05:10,400 SOLUTIONS TO HELP BRING ABOUT AN 1657 01:05:10,400 --> 01:05:19,600 END TO THE OPIOID CRISIS, 1658 01:05:19,600 --> 01:05:20,800 INCLUDING STRATEGIES, TREATING 1659 01:05:20,800 --> 01:05:22,440 PAIN, ENHANCED OUTCOMES FOR 1660 01:05:22,440 --> 01:05:23,880 INFANTS EXPOSED TO OPIOIDS 1661 01:05:23,880 --> 01:05:26,680 DURING A MOTHER'S PREGNANCY. 1662 01:05:26,680 --> 01:05:28,880 I'LL NOW PAUSE AND INVITE 1663 01:05:28,880 --> 01:05:30,080 QUESTIONS FROM THE 1664 01:05:30,080 --> 01:05:30,760 MULTI-DISCIPLINARY WORKING GROUP 1665 01:05:30,760 --> 01:05:31,720 AND OTHERS ON THE CALL. 1666 01:05:31,720 --> 01:05:34,360 THANK YOU VERY MUCH FOR YOUR 1667 01:05:34,360 --> 01:05:36,160 ATTENTION. 1668 01:05:36,160 --> 01:05:38,640 >> I'LL START. 1669 01:05:38,640 --> 01:05:40,360 >> GO AHEAD. 1670 01:05:40,360 --> 01:05:42,760 >> VERY AMBITIOUS PORTFOLIO, 1671 01:05:42,760 --> 01:05:44,680 IT'S VERY EXCITING. 1672 01:05:44,680 --> 01:05:46,680 THERE ARE -- I THINK THAT YOU'VE 1673 01:05:46,680 --> 01:05:51,520 HIT ON ALL THE DIFFERENT AREAS, 1674 01:05:51,520 --> 01:05:52,600 EVERYONE HAS, WALTER'S 1675 01:05:52,600 --> 01:05:53,720 PRESENTATION, I THINK WE'RE 1676 01:05:53,720 --> 01:05:55,000 LOOKING FORWARD TO SEEING 1677 01:05:55,000 --> 01:06:01,040 RESULTS OF MORE OF THESE 1678 01:06:01,040 --> 01:06:01,680 STUDIES. 1679 01:06:01,680 --> 01:06:05,760 >> THANK YOU, GAIL. 1680 01:06:05,760 --> 01:06:07,320 1681 01:06:07,320 --> 01:06:08,400 GO AHEAD, ERIC. 1682 01:06:08,400 --> 01:06:08,680 >> THANKS. 1683 01:06:08,680 --> 01:06:10,240 I'M VERY IMPRESSED BY THIS 1684 01:06:10,240 --> 01:06:11,000 ENTIRE PORTFOLIO. 1685 01:06:11,000 --> 01:06:15,080 I HAD A QUESTION ABOUT THE 1686 01:06:15,080 --> 01:06:17,480 BACPAC INITIATIVE WITH RESPECT 1687 01:06:17,480 --> 01:06:18,920 TO THE CLINICAL TRIALS. 1688 01:06:18,920 --> 01:06:23,280 HOW ARE THE MECHANISTIC EFFORTS 1689 01:06:23,280 --> 01:06:25,920 IN THE OTHER STAGES AND PHASES 1690 01:06:25,920 --> 01:06:27,960 OF THE BACPAC PROGRAM BEING 1691 01:06:27,960 --> 01:06:29,160 ROLLED INTO THESE CLINICAL 1692 01:06:29,160 --> 01:06:29,640 TRIALS? 1693 01:06:29,640 --> 01:06:33,960 ARE WE GOING TO BE USING THE 1694 01:06:33,960 --> 01:06:36,800 METHODOLOGY -- IN PARTICULAR THE 1695 01:06:36,800 --> 01:06:38,000 NEUROSCIENTIFIC METHODOLOGIES 1696 01:06:38,000 --> 01:06:39,920 THAT ARE BEING PUSHED FORWARD IN 1697 01:06:39,920 --> 01:06:42,120 THE EARLIER FOUNDATIONAL STAGES 1698 01:06:42,120 --> 01:06:45,240 OF BACPAC INTO THESE CLINICAL 1699 01:06:45,240 --> 01:06:45,480 TRIALS? 1700 01:06:45,480 --> 01:06:49,680 >> YEAH, THANK YOU FOR THAT 1701 01:06:49,680 --> 01:06:51,200 QUESTION. 1702 01:06:51,200 --> 01:06:52,400 SO, I THINK YOU'RE TALKING IN 1703 01:06:52,400 --> 01:06:53,600 PARTICULAR ABOUT THE TECHNOLOGY 1704 01:06:53,600 --> 01:06:55,280 CENTERS THAT ARE IDENTIFYING AND 1705 01:06:55,280 --> 01:06:57,320 TESTING NEW TECHNOLOGIES. 1706 01:06:57,320 --> 01:06:59,840 WE HAVE TO UNDERSTAND FIRST 1707 01:06:59,840 --> 01:07:01,160 THEIR EFFECTIVENESS, EFFICACY, 1708 01:07:01,160 --> 01:07:03,360 BEFORE WE CAN INCORPORATE THEM 1709 01:07:03,360 --> 01:07:04,320 INTO FUTURE WORK WHICH I THINK 1710 01:07:04,320 --> 01:07:09,480 SPEAKS TO THE FACT THAT FOR US 1711 01:07:09,480 --> 01:07:13,960 TO FULLY BENEFIT FROM WHAT WE'RE 1712 01:07:13,960 --> 01:07:15,600 LEARNING IN THE FIRST PHASE 1713 01:07:15,600 --> 01:07:19,520 WE'LL CONTINUE TO FOCUS ON 1714 01:07:19,520 --> 01:07:20,960 TAKING TECHNOLOGIES AND APPLYING 1715 01:07:20,960 --> 01:07:22,080 THEM IN FUTURE STUDIES. 1716 01:07:22,080 --> 01:07:23,640 THAT I THINK IS PART OF THE 1717 01:07:23,640 --> 01:07:25,680 REASON WE SPENT SO MUCH TIME 1718 01:07:25,680 --> 01:07:29,080 FOCUSING ON THE INFRASTRUCTURE 1719 01:07:29,080 --> 01:07:29,960 AND ESTABLISHING DATA COLLECTION 1720 01:07:29,960 --> 01:07:31,520 METHODS, ET CETERA, SO THAT NOT 1721 01:07:31,520 --> 01:07:33,000 ONLY ARE WE HARMONIZING EFFORTS 1722 01:07:33,000 --> 01:07:36,160 IN THIS CURRENT PHASE BUT SO WE 1723 01:07:36,160 --> 01:07:37,960 CAN FULLY LEVERAGE AND INTEGRATE 1724 01:07:37,960 --> 01:07:40,240 FUTURE STUDIES WITH THE CURRENT 1725 01:07:40,240 --> 01:07:40,440 DATA. 1726 01:07:40,440 --> 01:07:44,520 SO, I HOPE THAT ADDRESSES TO 1727 01:07:44,520 --> 01:07:46,160 SOME EXTENT YOUR QUESTION. 1728 01:07:46,160 --> 01:07:47,440 WE FULLY INTEND TO CONTINUE WORK 1729 01:07:47,440 --> 01:07:49,000 IN THIS AREA BUT AS I MENTIONED 1730 01:07:49,000 --> 01:07:51,040 WE WANT TO MAKE SURE WE'RE ALSO 1731 01:07:51,040 --> 01:07:52,920 LEVERAGING NOT ONLY WHAT WE'RE 1732 01:07:52,920 --> 01:07:54,680 LEARNING THROUGH THE TECHNOLOGY 1733 01:07:54,680 --> 01:08:03,920 AND MECHANIC MECHANISTIC CENTET 1734 01:08:03,920 --> 01:08:05,680 REJOIN, MYOFASCIAL PAIN, 1735 01:08:05,680 --> 01:08:07,440 THINKING ABOUT THE LANDSCAPE TO 1736 01:08:07,440 --> 01:08:11,160 FORMULATE OUR PLANS MOVING 1737 01:08:11,160 --> 01:08:11,400 FORWARD. 1738 01:08:11,400 --> 01:08:13,200 >> THAT'S REALLY HELPFUL. 1739 01:08:13,200 --> 01:08:17,400 I GUESS I'M HOPING THAT THE DEEP 1740 01:08:17,400 --> 01:08:20,000 PHENOTYPING THAT'S HAPPENING AT 1741 01:08:20,000 --> 01:08:21,760 MULTIPLE BIOPSYCHOSOCIAL LEVELS 1742 01:08:21,760 --> 01:08:22,440 INCLUDING NEUROBIOLOGICAL LEVEL, 1743 01:08:22,440 --> 01:08:25,240 I'M HOPING THAT WE'LL SEE SOME 1744 01:08:25,240 --> 01:08:28,320 DEEP PHENOTYPING FOLLOWING THESE 1745 01:08:28,320 --> 01:08:28,920 VARIOUS INTERVENTION PACKAGES 1746 01:08:28,920 --> 01:08:33,880 AND TREATMENTS SO WE CAN SEE IF 1747 01:08:33,880 --> 01:08:36,400 THE MULTIVARIATE SIGNATURE OF 1748 01:08:36,400 --> 01:08:37,720 RESPONSIVENESS TO THIS 1749 01:08:37,720 --> 01:08:39,080 INTERVENTION, IF IT CHANGES 1750 01:08:39,080 --> 01:08:40,120 ACROSS THESE DEEP PHENOTYPES. 1751 01:08:40,120 --> 01:08:41,360 I THINK THAT WOULD BE REALLY 1752 01:08:41,360 --> 01:08:43,600 INTERESTING AND PUSH THE FIELD 1753 01:08:43,600 --> 01:08:43,840 FORWARD. 1754 01:08:43,840 --> 01:08:44,760 >> ABSOLUTELY. 1755 01:08:44,760 --> 01:08:47,440 I THINK THIS THEORETICAL MODEL 1756 01:08:47,440 --> 01:08:49,960 THAT I MENTIONED ACKNOWLEDGES OR 1757 01:08:49,960 --> 01:08:52,280 RECOGNIZES THE FACT THERE ARE SO 1758 01:08:52,280 --> 01:08:55,360 MANY DIMENSIONS TO THE PROBLEM, 1759 01:08:55,360 --> 01:08:57,840 WHY IT'S SO DIFFICULT TO TACKLE. 1760 01:08:57,840 --> 01:09:01,360 WITHOUT DATA WE CAN'T ANSWER 1761 01:09:01,360 --> 01:09:03,240 QUESTIONS, SO I DEGREE IT'S 1762 01:09:03,240 --> 01:09:04,080 IMPORTANT BUT THE 1763 01:09:04,080 --> 01:09:05,520 INDIVIDUALIZATION, SO HOW THESE 1764 01:09:05,520 --> 01:09:06,920 DIFFERENT PHENOTYPES CORRESPOND 1765 01:09:06,920 --> 01:09:08,360 OR RELATE TO DIFFERENT SUBGROUPS 1766 01:09:08,360 --> 01:09:09,920 OF PATIENTS IS GOING TO BE 1767 01:09:09,920 --> 01:09:10,920 REALLY IMPORTANT AND INFORMATIVE 1768 01:09:10,920 --> 01:09:14,160 SO WE CAN BE EFFICIENT MOVING 1769 01:09:14,160 --> 01:09:14,400 FORWARD. 1770 01:09:14,400 --> 01:09:16,360 >> THANK YOU. 1771 01:09:16,360 --> 01:09:16,800 WONDERFUL PROGRAM. 1772 01:09:16,800 --> 01:09:20,520 >> THANKS. 1773 01:09:20,520 --> 01:09:25,120 >> THANK YOU, ERIC. 1774 01:09:25,120 --> 01:09:26,120 OTHER QUESTIONS FOR THE GENERAL 1775 01:09:26,120 --> 01:09:27,960 DISCUSSION IN THE OPEN SESSION 1776 01:09:27,960 --> 01:09:32,440 OF TODAY'S MEETING? 1777 01:09:32,440 --> 01:09:32,560 1778 01:09:32,560 --> 01:09:34,720 >> A SMALL COMMENT. 1779 01:09:34,720 --> 01:09:37,040 IT WAS REALLY IMPRESSIVE. 1780 01:09:37,040 --> 01:09:38,600 IT MIGHT BE WORTH TELLING THE 1781 01:09:38,600 --> 01:09:42,960 PUBLIC THERE'S A BIG EFFORT NOW 1782 01:09:42,960 --> 01:09:47,760 TO LOOK AT THE, IF YOU WILL, 1783 01:09:47,760 --> 01:09:51,760 TRANSCRIPTOMES AND PROTEOMES IN 1784 01:09:51,760 --> 01:09:53,560 HUMAN TISSUE WITH THE HOPE IT 1785 01:09:53,560 --> 01:09:56,560 WILL SPEED UP DEVELOPMENT OF 1786 01:09:56,560 --> 01:09:57,640 THERAPIES SPECIFICALLY DIRECTED 1787 01:09:57,640 --> 01:09:59,600 AT HUMAN, CERTAINLY OBVIOUSLY I 1788 01:09:59,600 --> 01:10:01,880 ENDORSE THE ANIMAL MODELS BUT AT 1789 01:10:01,880 --> 01:10:04,840 SOME POINT WE'RE GOING TO 1790 01:10:04,840 --> 01:10:05,200 TRANSLATE IT. 1791 01:10:05,200 --> 01:10:06,840 >> THANK YOU. 1792 01:10:06,840 --> 01:10:08,800 YEAH, WE'LL THINK ABOUT WAYS TO 1793 01:10:08,800 --> 01:10:12,160 WORK TO COMMUNICATE THAT. 1794 01:10:12,160 --> 01:10:14,720 I AGREE IT'S SOMETHING WE'VE 1795 01:10:14,720 --> 01:10:19,840 BEEN WORKING ON IN "HEAL" AND 1796 01:10:19,840 --> 01:10:20,920 EVERYONE KNOWS. 1797 01:10:20,920 --> 01:10:21,120 OKAY. 1798 01:10:21,120 --> 01:10:24,960 I THINK IF THERE ARE NO 1799 01:10:24,960 --> 01:10:26,080 ADDITIONAL QUESTIONS WE CAN END 1800 01:10:26,080 --> 01:10:27,360 THE OPEN SESSION OF TODAY'S 1801 01:10:27,360 --> 01:10:28,400 HEALTH MULTI-DISCIPLINARY 1802 01:10:28,400 --> 00:00:00,000 WORKING GROUP MEETING