1 00:00:07,006 --> 00:00:08,107 >> GOOD AFTERNOON, EVERYONE, AND 2 00:00:08,107 --> 00:00:10,710 WELCOME TO THE 187TH MEETING OF 3 00:00:10,710 --> 00:00:14,580 THE NICHD ADVISORY COUNCIL. 4 00:00:14,580 --> 00:00:15,548 TODAY'S MEETING IS OPEN TO THE 5 00:00:15,548 --> 00:00:18,951 PUBLIC AND BROADCAST ON THE NIH 6 00:00:18,951 --> 00:00:20,019 VIDEOCAST NETWORK. 7 00:00:20,019 --> 00:00:20,920 TOMORROW, ON DAY TWO OF THE 8 00:00:20,920 --> 00:00:24,423 MEETING, WE WILL HOLD OUR CLOSED 9 00:00:24,423 --> 00:00:25,625 SESSION. 10 00:00:25,625 --> 00:00:27,059 I DO APPRECIATE EVERYONE WHO 11 00:00:27,059 --> 00:00:29,128 THAT'S JOINED US TODAY BY ZOOM 12 00:00:29,128 --> 00:00:30,963 OR ON THE VIDEOCAST. 13 00:00:30,963 --> 00:00:32,298 WITH THIS VIRTUAL MEETING 14 00:00:32,298 --> 00:00:35,802 FORMAT, PLEASE REMEMBER TO 15 00:00:35,802 --> 00:00:39,305 UNMUTE YOURSELF BEFORE SPEAKING 16 00:00:39,305 --> 00:00:40,540 INTO YOUR HOME MICROPHONES AND 17 00:00:40,540 --> 00:00:42,141 STATE YOUR NAME SO THE 18 00:00:42,141 --> 00:00:43,442 TRANSCRIBER AND VIDEOCAST 19 00:00:43,442 --> 00:00:45,678 OBSERVERS WILL KNOW WHO'S 20 00:00:45,678 --> 00:00:46,279 SPEAKING. 21 00:00:46,279 --> 00:00:47,213 AFTER YOU SPEAK, PLEASE BE SURE 22 00:00:47,213 --> 00:00:49,315 TO MUTE YOUR MICROPHONE TO 23 00:00:49,315 --> 00:00:52,251 PREVENT ANY FEEDBACK LOOPS OR 24 00:00:52,251 --> 00:01:02,395 AUDITORY 25 00:01:04,997 --> 00:01:06,465 WELCOME TO ALL OF YOU AND THANK 26 00:01:06,465 --> 00:01:07,633 YOU FOR AGREEING TO PARTICIPATE 27 00:01:07,633 --> 00:01:09,836 AS A MEMBER OF OUR ADVISORY 28 00:01:09,836 --> 00:01:10,069 COUNCIL. 29 00:01:10,069 --> 00:01:12,939 I'D NOW LIKE TO CALL ON THEM TO 30 00:01:12,939 --> 00:01:14,440 BRIEFLY INTRODUCE YOURSELVES. 31 00:01:14,440 --> 00:01:15,875 PLEASE PUT ON YOUR VIDEO AT 32 00:01:15,875 --> 00:01:16,976 LEAST FOR THIS PART OF IT SO 33 00:01:16,976 --> 00:01:19,045 EVERYBODY CAN SEE YOU WHO ARE 34 00:01:19,045 --> 00:01:20,246 AND THEY'LL RECOGNIZE YOU WHEN 35 00:01:20,246 --> 00:01:21,013 WE MEET IN JUNE. 36 00:01:21,013 --> 00:01:23,516 SO THE FIRST PERSON IS 37 00:01:23,516 --> 00:01:24,283 MS. SHANNON COHN. 38 00:01:24,283 --> 00:01:31,390 SHANNON, ARE YOU ON? 39 00:01:31,390 --> 00:01:32,825 SHE'S THE EXECUTIVE DIRECTOR OF 40 00:01:32,825 --> 00:01:34,861 THE ENDO COLLECTIVE IN NEW YORK 41 00:01:34,861 --> 00:01:38,831 AND SHE'S A FILMMAKER. 42 00:01:38,831 --> 00:01:41,567 THE NEXT PERSON IS FROM FRANCIS 43 00:01:41,567 --> 00:01:45,004 COLE KNOWN AS SESH, EMERITUS 44 00:01:45,004 --> 00:01:45,938 PROFESSOR IN THE DIVISION OF 45 00:01:45,938 --> 00:01:47,206 NEWBORN MEDICINE AT THE 46 00:01:47,206 --> 00:01:48,708 WASHINGTON UNIVERSITY SCHOOL OF 47 00:01:48,708 --> 00:01:51,210 MEDICINE. 48 00:01:51,210 --> 00:01:53,179 SO SESH, DO YOU WANT TO SAY JUST 49 00:01:53,179 --> 00:01:54,280 A COUPLE OF THINGS ABOUT 50 00:01:54,280 --> 00:01:54,547 YOURSELF? 51 00:01:54,547 --> 00:01:56,482 >> THANKS, DIANA, VERY MUCH. 52 00:01:56,482 --> 00:01:57,683 IT'S A GREAT PLEASURE FOR ME TO 53 00:01:57,683 --> 00:01:58,451 BE HERE. 54 00:01:58,451 --> 00:02:00,353 I AM A NEONATOLOGIST AT 55 00:02:00,353 --> 00:02:03,756 WASHINGTON UNIVERSITY IN 56 00:02:03,756 --> 00:02:05,291 ST. LOUIS. 57 00:02:05,291 --> 00:02:06,726 MY PRIMARY AREA OF INTEREST HAS 58 00:02:06,726 --> 00:02:08,060 BEEN NOT ONLY TAKING CARE OF 59 00:02:08,060 --> 00:02:11,330 SICK BABIES BUT ALSO IN 60 00:02:11,330 --> 00:02:12,632 LEVERAGING ADVANCED GENOMIC 61 00:02:12,632 --> 00:02:13,599 TECHNOLOGIES FOR MAKING 62 00:02:13,599 --> 00:02:16,235 DIAGNOSES NOT ONLY IN BABIES BUT 63 00:02:16,235 --> 00:02:17,970 IN OLDER CHILDREN AND ADULTS. 64 00:02:17,970 --> 00:02:20,573 THANK YOU VERY MUCH. 65 00:02:20,573 --> 00:02:22,108 >> THANK YOU FOR JOINING US. 66 00:02:22,108 --> 00:02:25,144 THE NEXT PERSON IS DR. EDELLE I 67 00:02:25,144 --> 00:02:28,614 THINK KNOWN AT EDE FIELD-FOTE, 68 00:02:28,614 --> 00:02:31,684 AND SHE IS THE DIRECTOR OF 69 00:02:31,684 --> 00:02:32,852 SPINAL CORD INJURY RESEARCH 70 00:02:32,852 --> 00:02:34,787 PROGRAM AT THE SHEPHERD CENTER 71 00:02:34,787 --> 00:02:36,422 IN ATLANTA, GEORGIA. 72 00:02:36,422 --> 00:02:37,757 DO YOU WANT TO SAY HELLO? 73 00:02:37,757 --> 00:02:38,491 >> THANK YOU SO MUCH. 74 00:02:38,491 --> 00:02:39,592 IT'S A PLEASURE TO BE PART OF 75 00:02:39,592 --> 00:02:40,126 THIS GROUP. 76 00:02:40,126 --> 00:02:41,560 I AM A PHYSICAL THERAPIST BY 77 00:02:41,560 --> 00:02:43,529 CLINICAL TRAINING AND I DID MY 78 00:02:43,529 --> 00:02:45,131 PH.D. WORK AT WASHINGTON 79 00:02:45,131 --> 00:02:46,933 UNIVERSITY IN ST. LOUIS, SO VERY 80 00:02:46,933 --> 00:02:52,405 NICE TO MEET YOU, SESH. 81 00:02:52,405 --> 00:02:54,340 I AM AT THE SHEPHERD CENTER IN 82 00:02:54,340 --> 00:02:56,208 ATLANTA AND I HAVE ACADEMIC 83 00:02:56,208 --> 00:02:57,877 APPOINTMENTS AT EMMY IN THE 84 00:02:57,877 --> 00:02:59,445 DIVISION OF PHYSICAL THERAPY AND 85 00:02:59,445 --> 00:03:00,880 GEORGIA TECH IN THE SCHOOL OF 86 00:03:00,880 --> 00:03:01,614 APPLIED PHYSIOLOGY. 87 00:03:01,614 --> 00:03:04,951 SO WONDERFUL TO JOIN YOU. 88 00:03:04,951 --> 00:03:05,952 >> THANK YOU. 89 00:03:05,952 --> 00:03:07,153 SHANNON IS ON? 90 00:03:07,153 --> 00:03:08,688 SHANNON, WOULD YOU LIKE TO GIVE 91 00:03:08,688 --> 00:03:10,323 A FEW WORDS ABOUT YOUR 92 00:03:10,323 --> 00:03:10,623 BACKGROUND? 93 00:03:10,623 --> 00:03:13,192 THANK YOU FOR JOINING US. 94 00:03:13,192 --> 00:03:14,593 >> YES, HI, EVERYONE. 95 00:03:14,593 --> 00:03:16,696 I HOPE THAT MY CAMERA IS 96 00:03:16,696 --> 00:03:18,197 STARTING TO COME. 97 00:03:18,197 --> 00:03:20,266 YES, I AM A DOCUMENTARY 98 00:03:20,266 --> 00:03:21,467 FILMMAKER, ATTORNEY AND SOCIAL 99 00:03:21,467 --> 00:03:22,268 IMPACT PRODUCER. 100 00:03:22,268 --> 00:03:23,803 I'VE WORKED WITHIN THE WOMEN'S 101 00:03:23,803 --> 00:03:25,438 HEALTH SPACE FOR ABOUT A DECADE 102 00:03:25,438 --> 00:03:27,173 NOW, LOOKING AT A LOT OF HEALTH 103 00:03:27,173 --> 00:03:28,808 CONDITIONS THAT 104 00:03:28,808 --> 00:03:29,809 DISPROPORTIONATELY AFFECT WOMEN 105 00:03:29,809 --> 00:03:31,110 OR AFFECT WOMEN DIFFERENTLY. 106 00:03:31,110 --> 00:03:32,678 MOST RECENTLY ENDOMETRIOSIS, 107 00:03:32,678 --> 00:03:34,380 WHICH I'M SURE MANY OF YOU ARE 108 00:03:34,380 --> 00:03:36,248 FAMILIAR WITH IS REALLY A 109 00:03:36,248 --> 00:03:37,450 MICROCHASM OF SO MANY THINGS 110 00:03:37,450 --> 00:03:41,053 THAT AFFECT WOMEN'S HEALTH, 111 00:03:41,053 --> 00:03:42,154 EVERYTHING FROM GENDER BIAS AND 112 00:03:42,154 --> 00:03:43,456 RACIAL BIAS IN MEDICINE TO 113 00:03:43,456 --> 00:03:47,626 BARRIERS TO CARE WHETHER THEY BE 114 00:03:47,626 --> 00:03:48,494 FINANCIAL, INSTITUTIONAL, 115 00:03:48,494 --> 00:03:50,262 CULTURAL, AND BASICALLY THE 116 00:03:50,262 --> 00:03:53,099 HISTORICAL LACK OF EMPHASIS IN 117 00:03:53,099 --> 00:03:54,200 MEDICAL EDUCATION ON CERTAIN 118 00:03:54,200 --> 00:03:56,936 CONDITIONS THAT AFFECT WOMEN 119 00:03:56,936 --> 00:03:57,403 DISPROPORTIONATELY OR 120 00:03:57,403 --> 00:03:57,703 DIFFERENTLY. 121 00:03:57,703 --> 00:03:59,038 SO IT AN HONOR TO BE HERE. 122 00:03:59,038 --> 00:04:00,639 I'VE WORKED A LOT WITHIN POLICY 123 00:04:00,639 --> 00:04:04,477 IN THE PAST SEVERAL YEARS AND 124 00:04:04,477 --> 00:04:06,012 WITHIN RESEARCH IN THE MEDICAL 125 00:04:06,012 --> 00:04:09,081 EDUCATION SPACE. 126 00:04:09,081 --> 00:04:10,149 SO THANK YOU FOR THE INVITATION 127 00:04:10,149 --> 00:04:11,917 TO JOIN AND IT'S AN HONOR TO BE 128 00:04:11,917 --> 00:04:12,118 HERE. 129 00:04:12,118 --> 00:04:15,521 >> THANK YOU. 130 00:04:15,521 --> 00:04:19,525 THE NEXT PERSON IS 131 00:04:19,525 --> 00:04:21,127 DR. ZHANZHI OR “MIKE” HU IS THE 132 00:04:21,127 --> 00:04:21,761 CO-FOUNDER AND PRESIDENT OF 133 00:04:21,761 --> 00:04:22,628 BINGO BIOTECH IN UNION CITY, 134 00:04:22,628 --> 00:04:24,096 CALIFORNIA. 135 00:04:24,096 --> 00:04:25,965 MIKE, THANK YOU FOR JOINING US. 136 00:04:25,965 --> 00:04:27,366 >> HI, EVERYONE. 137 00:04:27,366 --> 00:04:28,667 MY NAME IS MIKE. 138 00:04:28,667 --> 00:04:30,870 I LIVE IN CALIFORNIA. 139 00:04:30,870 --> 00:04:32,738 I AM A GENOMIC SCIENTIST BY 140 00:04:32,738 --> 00:04:33,272 TRAINING. 141 00:04:33,272 --> 00:04:35,241 I CURRENTLY CONDUCT NEWBORN 142 00:04:35,241 --> 00:04:37,109 SCREENING RESEARCH AFFILIATED 143 00:04:37,109 --> 00:04:39,078 WITH COLUMBIA UNIVERSITY. 144 00:04:39,078 --> 00:04:41,213 I ALSO RUN A NON-PROFIT 145 00:04:41,213 --> 00:04:42,581 ORGANIZATION CALLED PROJECT 146 00:04:42,581 --> 00:04:44,116 GUARDIAN, AND ASIDE FROM THAT, I 147 00:04:44,116 --> 00:04:47,253 AM A FATHER OF TWO CHILDREN 148 00:04:47,253 --> 00:04:48,621 DIAGNOSED WITH A RARE GENETIC 149 00:04:48,621 --> 00:04:50,990 DISEASE, SO I DO CARE FOR 150 00:04:50,990 --> 00:04:52,091 PATIENTS MAYBE NOT IN THE 151 00:04:52,091 --> 00:04:54,160 CLINICAL SETTINGS LIKE MOST OF 152 00:04:54,160 --> 00:04:54,593 YOU. 153 00:04:54,593 --> 00:04:55,561 IT'S AN HONOR TO BE HERE. 154 00:04:55,561 --> 00:04:59,665 THANK YOU FOR REMINDING ME. 155 00:04:59,665 --> 00:05:00,733 >> THANK YOU. 156 00:05:00,733 --> 00:05:05,604 CAYOU I CAN SEE WHAT A BROAD MIN 157 00:05:05,604 --> 00:05:06,639 WE HAVE AND WE'VE SELECTED ALL 158 00:05:06,639 --> 00:05:09,575 OF YOU FOR YOUR EXPERTISE IN 159 00:05:09,575 --> 00:05:10,576 SPECIFIC AREAS. 160 00:05:10,576 --> 00:05:12,912 NEXT IS DR. KEN MANDL, DIRECTOR 161 00:05:12,912 --> 00:05:15,614 OF THE COMPUTATIONAL HEALTH 162 00:05:15,614 --> 00:05:17,249 INFORMATICS PROGRAM AT BOSTON 163 00:05:17,249 --> 00:05:17,716 CHILDREN'S HOSPITAL IN 164 00:05:17,716 --> 00:05:18,784 MASSACHUSETTS. 165 00:05:18,784 --> 00:05:20,219 KEN? 166 00:05:20,219 --> 00:05:22,488 >> THANK YOU, DIANA. 167 00:05:22,488 --> 00:05:26,659 THIS IS WONDERFUL TO BE HERE AS 168 00:05:26,659 --> 00:05:27,760 AN AD HOC COMMITTEE MEMBER TODAY 169 00:05:27,760 --> 00:05:29,929 AND I REALLY LOOK FORWARD TO THE 170 00:05:29,929 --> 00:05:31,730 AGENDA. 171 00:05:31,730 --> 00:05:33,666 I'M ONCE UPON A TIME A PEDIATRIC 172 00:05:33,666 --> 00:05:34,733 EMERGENCY PHYSICIAN, I HAVEN'T 173 00:05:34,733 --> 00:05:36,102 PRACTICED IN A WHILE. 174 00:05:36,102 --> 00:05:37,703 I'VE RUN A PROGRAM CALLED THE 175 00:05:37,703 --> 00:05:39,305 COMPUTATIONAL HEALTH INFORMATICS 176 00:05:39,305 --> 00:05:40,206 PROGRAM AT BOSTON CHILDREN'S 177 00:05:40,206 --> 00:05:42,541 HOSPITAL, WHICH IS A 178 00:05:42,541 --> 00:05:43,509 MULTIDISCIPLINARY 179 00:05:43,509 --> 00:05:44,276 INTERDEPARTMENTAL PROM AND I'M A 180 00:05:44,276 --> 00:05:47,213 PROFESSOR OF PEDIATRICS AND 181 00:05:47,213 --> 00:05:49,882 BIOMEDICAL INFORMATICS AT 182 00:05:49,882 --> 00:05:50,649 HARVARD MEDICAL SCHOOL. 183 00:05:50,649 --> 00:05:52,017 >> THANK YOU, KEN, FOR JOINING 184 00:05:52,017 --> 00:05:52,451 US. 185 00:05:52,451 --> 00:05:54,320 NEXT IS DR. MEGAN MORENO, WHO IS 186 00:05:54,320 --> 00:05:56,989 A PROFESSOR OF PEDIATRICS AT THE 187 00:05:56,989 --> 00:05:58,357 UNIVERSITY OF WISCONSIN-MADISON. 188 00:05:58,357 --> 00:05:59,692 HELLO, MEGAN. 189 00:05:59,692 --> 00:06:00,593 >> HELLO. 190 00:06:00,593 --> 00:06:02,728 THANK YOU SO MUCH FOR THE 191 00:06:02,728 --> 00:06:03,829 INVITATION TO BE HERE. 192 00:06:03,829 --> 00:06:06,499 I AM AN ADOLESCENT MEDICINE 193 00:06:06,499 --> 00:06:08,767 PHYSICIAN AND RESEARCHER AND MY 194 00:06:08,767 --> 00:06:10,703 RESEARCH FOCUSES ON THE 195 00:06:10,703 --> 00:06:11,670 INTERSECTION OF ADOLESCENT 196 00:06:11,670 --> 00:06:13,472 HEALTH AND DIGITAL MEDIA AND I 197 00:06:13,472 --> 00:06:15,474 ALSO SERVE AS A COMEDICAL 198 00:06:15,474 --> 00:06:19,512 DIRECTOR FOR THE AMERICAN 199 00:06:19,512 --> 00:06:22,648 ACADEMY OF PEDIATRICS CENT CENTF 200 00:06:22,648 --> 00:06:24,717 EXCELLENCE ON SOCIAL MEDIA AND 201 00:06:24,717 --> 00:06:26,519 YOUTH MENTAL HEALTH. 202 00:06:26,519 --> 00:06:32,424 >> NEXT IS DR. KISHORE VELLODY, 203 00:06:32,424 --> 00:06:33,959 PROFESSOR OF PEDIATRICS AT THE 204 00:06:33,959 --> 00:06:35,227 UNIVERSITY OF PITTSBURGH IN 205 00:06:35,227 --> 00:06:36,128 PITTSBURGH, PENNSYLVANIA. 206 00:06:36,128 --> 00:06:36,362 WELCOME. 207 00:06:36,362 --> 00:06:39,165 >> HAPPY TO BE HERE AND YES, I 208 00:06:39,165 --> 00:06:41,133 WORK AS A PEDIATRIC HOSPITALIST 209 00:06:41,133 --> 00:06:43,936 FOR ABOUT HALF MY TIME AT THE 210 00:06:43,936 --> 00:06:44,970 CHILDREN'S HOSPITAL OF 211 00:06:44,970 --> 00:06:45,738 PITTSBURGH AND THEN THE OTHER 212 00:06:45,738 --> 00:06:48,407 HALF OF MY TIME, I DIRECT OUR 213 00:06:48,407 --> 00:06:52,945 DOWN SYNDROME CENTER HERE AT 214 00:06:52,945 --> 00:06:54,480 CHILDREN'S HOSPITAL AND MY MAJOR 215 00:06:54,480 --> 00:06:56,182 MOTIVATION IS MY BROTHER WHO HAS 216 00:06:56,182 --> 00:06:57,416 DOWN'S SYNDROME, SO HAPPY TO BE 217 00:06:57,416 --> 00:06:59,451 HERE AND HELP IN THESE EFFORTS. 218 00:06:59,451 --> 00:07:02,555 >> THANK YOU SO MUCH. 219 00:07:02,555 --> 00:07:05,724 AND LAST OF THE EIGHT AD HOC 220 00:07:05,724 --> 00:07:07,960 MEMBER IS DR. MARIANA WOLFNER, 221 00:07:07,960 --> 00:07:11,530 WHO IS THE GOLDWIN SMITH 222 00:07:11,530 --> 00:07:12,631 PROFESSOR OF ARTS AND SCIENCES 223 00:07:12,631 --> 00:07:14,934 IN MOLECULAR BIOLOGY AND 224 00:07:14,934 --> 00:07:17,536 GENETICS AT CORNELL UNIVERSITY 225 00:07:17,536 --> 00:07:20,172 AT THE UPSTATE CAMPUS IN ITHACA, 226 00:07:20,172 --> 00:07:20,439 NEW YORK. 227 00:07:20,439 --> 00:07:21,473 >> THANK YOU SO MUCH. 228 00:07:21,473 --> 00:07:23,342 IT'S A REAL HONOR TO BE HERE. 229 00:07:23,342 --> 00:07:27,947 I'M A BASIC RESEARCHER WITH 230 00:07:27,947 --> 00:07:29,949 EXPERTISE IN GAMETES AND THEIR 231 00:07:29,949 --> 00:07:32,518 BIOLOGY, THE REPRODUCTIVE TRACT, 232 00:07:32,518 --> 00:07:33,786 FERTILIZATION AND EARLY 233 00:07:33,786 --> 00:07:34,386 EMRYOGENESIS. 234 00:07:34,386 --> 00:07:37,790 WE STUDY HOW REPRODUCTIVE TRACT 235 00:07:37,790 --> 00:07:39,358 SECRETIONS PROMOTE THE STABILITY 236 00:07:39,358 --> 00:07:42,061 OF EGGS AND SPERM AND 237 00:07:42,061 --> 00:07:43,262 FERTILIZATION AND HOW A 238 00:07:43,262 --> 00:07:44,396 FERTILIZED EGG INITIATES ITS 239 00:07:44,396 --> 00:07:47,399 DEVELOPMENT. 240 00:07:47,399 --> 00:07:47,866 THANK YOU. 241 00:07:47,866 --> 00:07:48,500 >> THANK YOU. 242 00:07:48,500 --> 00:07:53,539 AND TODAY, IN ADDITION WE HAVE 243 00:07:53,539 --> 00:07:54,640 TWO SUBJECT MATTER EXPERTS 244 00:07:54,640 --> 00:07:55,708 PARTICIPATING IN THIS COUNCIL 245 00:07:55,708 --> 00:07:55,941 MEETING. 246 00:07:55,941 --> 00:07:59,778 I'D LIKE TO CALL ON EACH OF THEM 247 00:07:59,778 --> 00:08:00,779 TO ALSO BRIEFLY INTRODUCE THEY 248 00:08:00,779 --> 00:08:03,048 WILL SEFS. 249 00:08:03,048 --> 00:08:04,149 THEMSELVES. 250 00:08:04,149 --> 00:08:05,351 DR. KIM BREG REIS THE HELPING 251 00:08:05,351 --> 00:08:06,885 HAND OF LOS ANGELES, I HOPE 252 00:08:06,885 --> 00:08:08,187 SHE'S ABLE TO BE ON THE CALL, 253 00:08:08,187 --> 00:08:09,989 YES, I SEE HER THERE. 254 00:08:09,989 --> 00:08:11,957 WE'RE THINKING OF YOU ESPECIALLY 255 00:08:11,957 --> 00:08:13,259 BEING IN LOS ANGELES, BUT THE 256 00:08:13,259 --> 00:08:15,461 HELPING HAND OF LOS ANGELES, 257 00:08:15,461 --> 00:08:17,096 MIRIAM JACOBS CHAIRMAN IN 258 00:08:17,096 --> 00:08:19,765 MATERNAL FETAL MEDICINE AT 259 00:08:19,765 --> 00:08:21,467 CEDARS-SINAI MEDICAL CENTER IN 260 00:08:21,467 --> 00:08:22,001 LOS ANGELES. 261 00:08:22,001 --> 00:08:23,102 WE HOPE YOU ARE SAFE. 262 00:08:23,102 --> 00:08:24,970 DO YOU HAVE A FEW MOMENTS TO 263 00:08:24,970 --> 00:08:26,538 INTRODUCE YOURSELF? 264 00:08:26,538 --> 00:08:28,240 >> I AM SAFE BUT SOME OF MY 265 00:08:28,240 --> 00:08:29,241 PEERS ARE NOT. 266 00:08:29,241 --> 00:08:33,078 SO WE APPRECIATE YOUR PRAYERS 267 00:08:33,078 --> 00:08:34,913 AND WELL WISHES, AND I'M HONORED 268 00:08:34,913 --> 00:08:35,781 TO BE HERE. 269 00:08:35,781 --> 00:08:39,852 I AM VICE CHAIR OF WOMEN'S 270 00:08:39,852 --> 00:08:42,688 HEALTHCARE QUALITY AT 271 00:08:42,688 --> 00:08:44,757 CEDARS-SINAI MEDICAL CENTER, 272 00:08:44,757 --> 00:08:46,158 FELLOWSHIP DIRECTOR, MATERNAL 273 00:08:46,158 --> 00:08:46,525 FETAL MEDICINE. 274 00:08:46,525 --> 00:08:47,726 I'M A HEALTH SERVICES RESEARCHER 275 00:08:47,726 --> 00:08:49,795 ARE A FOCUS ON SAFETY, QUALITY 276 00:08:49,795 --> 00:08:51,964 AND MATERNAL MORBIDITY AND 277 00:08:51,964 --> 00:08:53,932 MORTALITY, AND MEASURING 278 00:08:53,932 --> 00:08:55,501 CHILDBIRTH EXPERIENCES AND 279 00:08:55,501 --> 00:08:56,769 SATISFACTION WITH THEIR CARE. 280 00:08:56,769 --> 00:08:58,771 SO I HOPE THAT I HAVE AN 281 00:08:58,771 --> 00:09:01,073 OPPORTUNITY TO SHARE MY WISDOM 282 00:09:01,073 --> 00:09:01,607 AS NEEDED TODAY. 283 00:09:01,607 --> 00:09:03,809 THANK YOU VERY MUCH FOR THE 284 00:09:03,809 --> 00:09:04,109 INVITATION. 285 00:09:04,109 --> 00:09:05,911 >> WE ESPECIALLY THANK YOU GIVEN 286 00:09:05,911 --> 00:09:09,815 THE CIRCUMSTANCES FOR JOINING US 287 00:09:09,815 --> 00:09:11,216 TODAY. 288 00:09:11,216 --> 00:09:13,319 LAST BUT BY NO MEANS LEAST IS 289 00:09:13,319 --> 00:09:16,655 DR. JAMES ALSO KNOWN AS JIM RO 290 00:09:16,655 --> 00:09:17,656 BERTS, PROFESSOR IN THE 291 00:09:17,656 --> 00:09:22,728 DEPARTMENT OF O OBSTETRICS AND 292 00:09:22,728 --> 00:09:23,796 GYNECOLOGY AND REPRODUCTIVE 293 00:09:23,796 --> 00:09:25,297 SCIENCES AT THE UNIVERSITY OF 294 00:09:25,297 --> 00:09:25,597 PITTSBURGH. 295 00:09:25,597 --> 00:09:27,966 >> I'M JIM ROBERTS, OBSTETRICIAN 296 00:09:27,966 --> 00:09:29,635 GYNECOLOGIST MATERNAL FETAL 297 00:09:29,635 --> 00:09:30,703 MEDICINE SPECIALIST BY TRAINING 298 00:09:30,703 --> 00:09:34,106 FOR THE LAST 30 YEARS I'VE DONE 299 00:09:34,106 --> 00:09:36,809 RESEARCH PRIMARILY AND PRIMARILY 300 00:09:36,809 --> 00:09:39,445 ON ADVERSE OUTCOMES IN 301 00:09:39,445 --> 00:09:40,546 PARTICULAR PRE-ECLAMPSIA FOR THE 302 00:09:40,546 --> 00:09:41,513 LAST SEVERAL YEARS, I'VE BEEN 303 00:09:41,513 --> 00:09:44,850 WORKING WITH A GROUP CALLED THE 304 00:09:44,850 --> 00:09:45,584 GLOBAL -- COLLABORATION AND IN 305 00:09:45,584 --> 00:09:48,187 THAT GROUP WE TRY TO FACILITATE 306 00:09:48,187 --> 00:09:50,289 COLLABORATION BY DATA SHARING, 307 00:09:50,289 --> 00:09:51,757 INTELLECT SHARING AND 308 00:09:51,757 --> 00:09:52,891 IDENTIFYING PROBLEMS THAT WE 309 00:09:52,891 --> 00:09:54,993 THINK DESERVE THE ATTENTION OF 310 00:09:54,993 --> 00:09:56,862 THE RESEARCH GROUP AT LARGE. 311 00:09:56,862 --> 00:10:00,666 IT'S REAL EXCITING TO BE HERE. 312 00:10:00,666 --> 00:10:01,867 I'VE READ ALL MY NOTES AND ALL 313 00:10:01,867 --> 00:10:05,037 THE MINUTES AND YOU CAN ASK ME 314 00:10:05,037 --> 00:10:05,471 ANYTHING. 315 00:10:05,471 --> 00:10:06,138 I'M READY. 316 00:10:06,138 --> 00:10:06,972 THANK YOU. 317 00:10:06,972 --> 00:10:10,709 >> THANK YOU FOR JOINING US. 318 00:10:10,709 --> 00:10:12,244 WE APPRECIATE YOUR DEDICATION. 319 00:10:12,244 --> 00:10:14,446 NOW I'LL TURN THE MEETING OVER 320 00:10:14,446 --> 00:10:15,314 TO DR. REBEKAH RASOOLY, OUR 321 00:10:15,314 --> 00:10:17,383 DIRECTOR OF THE DIVISION OF 322 00:10:17,383 --> 00:10:20,586 EXTRAMURAL ACTIVITIES. 323 00:10:20,586 --> 00:10:22,087 >> THANK YOU AND GOOD AFTERNOON, 324 00:10:22,087 --> 00:10:24,957 EVERYONE. 325 00:10:24,957 --> 00:10:26,358 ON THE COUNCILMEMBER WEBSITE, 326 00:10:26,358 --> 00:10:29,895 YOU SHOULD ALL HAVE READ, AGREED 327 00:10:29,895 --> 00:10:31,530 TO AND SIGNED THE 328 00:10:31,530 --> 00:10:34,466 CONFIDENTIALITY AND 329 00:10:34,466 --> 00:10:36,001 NON-DISCLOSURE RULES FOR SPECIAL 330 00:10:36,001 --> 00:10:37,102 GOVERNMENT EMPLOYEES BEFORE 331 00:10:37,102 --> 00:10:40,706 EVALUATING ANY NIH GRANT 332 00:10:40,706 --> 00:10:41,039 APPLICATIONS. 333 00:10:41,039 --> 00:10:46,011 FOR THOSE OF YOU WHO ARE NOT 334 00:10:46,011 --> 00:10:47,279 OFFICIAL COUNCILMEMBERS YET OR 335 00:10:47,279 --> 00:10:48,747 AD HOCS AND ARE SUBJECT MATTER 336 00:10:48,747 --> 00:10:52,985 EXPERTS, WE SENT YOU A SEPARATE 337 00:10:52,985 --> 00:10:53,852 CONFIDENTIALITY AND 338 00:10:53,852 --> 00:10:54,620 NON-DISCLOSURE FORM WHICH YOU 339 00:10:54,620 --> 00:10:58,424 HAVE ALL SIGNED. 340 00:10:58,424 --> 00:11:00,292 ALSO REMEMBER, PLEASE, THAT YOU 341 00:11:00,292 --> 00:11:02,361 CANNOT SERVE ON ANY NIH PEER 342 00:11:02,361 --> 00:11:04,129 REVIEW PANEL WHILE YOU SERVE AS 343 00:11:04,129 --> 00:11:07,199 A COUNCILMEMBER. 344 00:11:07,199 --> 00:11:10,602 AND YOU CANNOT PROVIDE SECOND 345 00:11:10,602 --> 00:11:12,438 LEVEL REVIEW OF COUNCIL FOR ANY 346 00:11:12,438 --> 00:11:13,405 APPLICATION IN WHICH YOU 347 00:11:13,405 --> 00:11:14,740 PARTICIPATED IN THE FIRST LEVEL 348 00:11:14,740 --> 00:11:16,041 OF PEER REVIEW. 349 00:11:16,041 --> 00:11:21,280 IT IS NIH'S POLICY THAT A SINGLE 350 00:11:21,280 --> 00:11:22,714 INDIVIDUAL CANNOT SERVE ON BOTH 351 00:11:22,714 --> 00:11:23,849 THE FIRST AND SECOND LEVELS OF 352 00:11:23,849 --> 00:11:27,085 PEER REVIEW. 353 00:11:27,085 --> 00:11:29,388 NOW TURNING OUR ATTENTION TO THE 354 00:11:29,388 --> 00:11:32,224 COUNCIL MINUTES. 355 00:11:32,224 --> 00:11:33,525 THE MINUTES FOR THE 356 00:11:33,525 --> 00:11:35,527 SEPTEMBER 4TH AND 5TH, 2024 357 00:11:35,527 --> 00:11:36,728 MEETING WERE POSTED ON THE 358 00:11:36,728 --> 00:11:41,834 COUNCILMEMBER WEBSITE FOR YOUR 359 00:11:41,834 --> 00:11:42,401 CONSIDERATION LAST WEEK. 360 00:11:42,401 --> 00:11:46,438 SO I'M GOING TO ASK NOW FOR A 361 00:11:46,438 --> 00:11:47,539 MOTION TO APPROVE THOSE MINUTES 362 00:11:47,539 --> 00:11:48,841 AND THEN ONCE I HAVE THAT MOTION 363 00:11:48,841 --> 00:11:51,376 AND A SECOND, I'M GOING TO ASK 364 00:11:51,376 --> 00:11:52,578 YOU TO VOTE AND JUST TO REMIND 365 00:11:52,578 --> 00:11:56,515 YOU THAT THE WAY TO VOTE ON ZOOM 366 00:11:56,515 --> 00:11:58,817 IS TO GO TO THE REACTIONS BUTTON 367 00:11:58,817 --> 00:12:03,722 ON THE BOTTOM AND SEARCH FOR THE 368 00:12:03,722 --> 00:12:05,357 GREEN CIRCLE FOR YES OR THE RED 369 00:12:05,357 --> 00:12:06,792 CIRCLE FOR NO OR SIMPLY RAISE 370 00:12:06,792 --> 00:12:08,327 YOUR HAND IF YOU WANT TO 371 00:12:08,327 --> 00:12:09,294 ABSTAIN. 372 00:12:09,294 --> 00:12:10,295 ALL RIGHT? 373 00:12:10,295 --> 00:12:12,030 SO LET'S GO AHEAD AND LET'S GET 374 00:12:12,030 --> 00:12:14,800 A MOTION TO APPROVE THE MINUTES. 375 00:12:14,800 --> 00:12:16,668 >> SO MOVED. 376 00:12:16,668 --> 00:12:18,270 >> AND THAT WAS? 377 00:12:18,270 --> 00:12:20,372 >> MARCELLE CEDARS. 378 00:12:20,372 --> 00:12:21,340 >> DR. CEDARS. 379 00:12:21,340 --> 00:12:23,242 AND A SECOND? 380 00:12:23,242 --> 00:12:26,178 >> SECOND. 381 00:12:26,178 --> 00:12:27,679 >> ALL RIGHT. 382 00:12:27,679 --> 00:12:30,649 AND ALL IN FAVOR, PLEASE VOTE 383 00:12:30,649 --> 00:12:40,792 YES OR NO. 384 00:12:40,792 --> 00:12:41,693 DR. AIZER, DID YOU HAVE A 385 00:12:41,693 --> 00:12:47,599 QUESTION OR IS THAT ABSTAINING? 386 00:12:47,599 --> 00:12:48,901 >> NO, NO QUESTION. 387 00:12:48,901 --> 00:12:49,101 SORRY. 388 00:12:49,101 --> 00:12:54,973 >> OH, OKAY. 389 00:12:54,973 --> 00:12:56,875 ALL RIGHT, THANK YOU VERY MUCH. 390 00:12:56,875 --> 00:13:01,046 ALSO WANTED TO ASK ALL THE 391 00:13:01,046 --> 00:13:02,014 COUNCILMEMBERS AND AD HOCS TO 392 00:13:02,014 --> 00:13:04,116 PLEASE NOTE ON YOUR AGENDA, THE 393 00:13:04,116 --> 00:13:07,719 FUTURE MEETING DATES. 394 00:13:07,719 --> 00:13:09,688 AS YOU CAN SEE, WE RESERVE THESE 395 00:13:09,688 --> 00:13:11,557 DATES WAY IN ADVANCE AND WE LOOK 396 00:13:11,557 --> 00:13:13,292 FORWARD TO HAVING THESE COUNCIL 397 00:13:13,292 --> 00:13:14,560 MEETINGS AND HAVING ALL OF YOU 398 00:13:14,560 --> 00:13:17,729 AT THE MEETINGS. 399 00:13:17,729 --> 00:13:19,064 SO THE NEXT MEETING COMING UP 400 00:13:19,064 --> 00:13:19,631 WILL BE IN PERSON. 401 00:13:19,631 --> 00:13:22,267 IT WILL BE ON JUNE 9 AND 10 OF 402 00:13:22,267 --> 00:13:26,305 THIS YEAR. 403 00:13:26,305 --> 00:13:27,839 FOLLOWED BY ANOTHER IN-PERSON 404 00:13:27,839 --> 00:13:29,274 MEETING ON SEPTEMBER 9TH AND 405 00:13:29,274 --> 00:13:32,010 10TH AND THEN THE DATES FOR THE 406 00:13:32,010 --> 00:13:33,512 2026 MEETINGS ARE ALSO THERE AND 407 00:13:33,512 --> 00:13:35,714 I'LL ASK YOU AGAIN TO PLEASE 408 00:13:35,714 --> 00:13:38,350 NOTE YOUR CALENDARS. 409 00:13:38,350 --> 00:13:40,419 NOW I'LL TURN THE MEETING BACK 410 00:13:40,419 --> 00:13:41,620 TO DR. BIANCHI. 411 00:13:41,620 --> 00:13:43,055 >> THANK YOU SO MUCH, REBECCA. 412 00:13:43,055 --> 00:13:50,062 . MYPRESENTATION IS GOING TO BE 413 00:13:50,062 --> 00:13:51,830 ABOUT 30 MINUTES AND HOPEFULLY 414 00:13:51,830 --> 00:13:53,198 THINGS WORK OUT WELL, I'LL LEAVE 415 00:13:53,198 --> 00:13:55,200 15 MINUTES FOR QUESTIONS. 416 00:13:55,200 --> 00:13:56,535 FEEL FREE TO PUT YOUR QUESTIONS 417 00:13:56,535 --> 00:13:59,004 IN THE CHAT BOX BUT I CAN'T 418 00:13:59,004 --> 00:14:02,608 SIMULTANEOUSLY SEE THE CHAT BOX 419 00:14:02,608 --> 00:14:03,375 AND MY SLIDES. 420 00:14:03,375 --> 00:14:05,777 SO WE WILL ADDRESS -- FEEL FREE 421 00:14:05,777 --> 00:14:07,212 TO WRITE THEM IN AS YOU THINK OF 422 00:14:07,212 --> 00:14:09,414 THEM OR WE'LL HOLD THEM FOR THE 423 00:14:09,414 --> 00:14:11,149 END, BUT WE'LL GO BACK TO THE 424 00:14:11,149 --> 00:14:21,460 CHAT BOX WHEN I'M DONE. 425 00:14:21,460 --> 00:14:26,031 SO WE HAVE A LITTLE PRESIDENTIAL 426 00:14:26,031 --> 00:14:26,765 TRANSITION COMING UP NEXT WEEK 427 00:14:26,765 --> 00:14:28,100 SO I'LL BE TALKING BRIEFLY ABOUT 428 00:14:28,100 --> 00:14:29,735 THAT AND SOME CONGRESSIONAL 429 00:14:29,735 --> 00:14:30,168 UPDATE. 430 00:14:30,168 --> 00:14:32,137 I'D THEN LIKE TO HIGHLIGHT SOME 431 00:14:32,137 --> 00:14:34,539 RESEARCH COMING OUT OF NICHD, 432 00:14:34,539 --> 00:14:38,510 AND THEN THE UPDATES ON THE 433 00:14:38,510 --> 00:14:41,213 STRATEGIC PLAN, AS WELL AS OTHER 434 00:14:41,213 --> 00:14:44,616 COMMENTS RELATED TO WOMEN'S 435 00:14:44,616 --> 00:14:45,517 HEALTH RESEARCH AND PEAD 436 00:14:45,517 --> 00:14:49,354 TRICKERY PEDIATRICRESEARCH AND H 437 00:14:49,354 --> 00:14:56,528 SOME STAFF UPDATES AT NICHD. 438 00:14:56,528 --> 00:14:57,529 SO IF YOU WERE FOLLOWING THE 439 00:14:57,529 --> 00:14:59,164 NEWS BEFORE THE HOLIDAYS, YOU 440 00:14:59,164 --> 00:15:03,201 KNOW THAT WE NOW HAVE A 441 00:15:03,201 --> 00:15:04,970 CONTINUING RESOLUTION UNTIL 442 00:15:04,970 --> 00:15:05,303 MARCH 14TH. 443 00:15:05,303 --> 00:15:09,141 WE ARE NEARLY HALFWAY THROUGH 444 00:15:09,141 --> 00:15:12,844 THE FISCAL YEAR THAT BEGAN ON 445 00:15:12,844 --> 00:15:17,315 OCTOBER 1ST. 446 00:15:17,315 --> 00:15:18,750 YOU'LL PROBABLY HEAR MORE ABOUT 447 00:15:18,750 --> 00:15:20,285 THIS FROM ALEXIS CLARKE IN THE 448 00:15:20,285 --> 00:15:21,687 AFTERNOON, WHEN WE HAVE A 449 00:15:21,687 --> 00:15:24,189 CONTINUING RESOLUTION, WE ARE 450 00:15:24,189 --> 00:15:26,525 ESSENTIALLY OP RATING ON A 451 00:15:26,525 --> 00:15:27,492 FANTASIZED FLAT BUDGET. 452 00:15:27,492 --> 00:15:29,428 WE DON'T REALLY KNOW HOW MUCH 453 00:15:29,428 --> 00:15:30,462 MONEY WE WILL HAVE IN THE BUDGET 454 00:15:30,462 --> 00:15:31,663 UNTIL WE ACTUALLY HAVE A BUDGET, 455 00:15:31,663 --> 00:15:33,732 SO FOR THAT REASON, WE ARE 456 00:15:33,732 --> 00:15:36,368 UNUSUALLY CONSERVATIVE. 457 00:15:36,368 --> 00:15:41,506 IT DOES MAKE ADMINISTRATION AND 458 00:15:41,506 --> 00:15:42,374 PROCESSING OF ALL OF THE GRANTS 459 00:15:42,374 --> 00:15:43,675 THAT HAVE BEEN APPROVED FOR 460 00:15:43,675 --> 00:15:45,444 FUNDING MUCH HARDER TO DO 461 00:15:45,444 --> 00:15:49,581 BECAUSE ESSENTIALLY OUR 462 00:15:49,581 --> 00:15:50,582 WONDERFUL STAFF ARE WORKING 463 00:15:50,582 --> 00:15:52,651 TWICE AS HARD IN THE SECOND HALF 464 00:15:52,651 --> 00:15:53,518 OF THE YEAR BECAUSE THERE ARE A 465 00:15:53,518 --> 00:15:55,721 LOT OF THINGS THAT THEY COULD 466 00:15:55,721 --> 00:15:57,155 NOT PROCESS AND FUND BECAUSE WE 467 00:15:57,155 --> 00:15:58,623 DIDN'T HAVE A BUDGET, IF THAT 468 00:15:58,623 --> 00:16:00,859 MAKES SENSE. 469 00:16:00,859 --> 00:16:04,596 IN ADDITION, AS OF NEXT WEEK, 470 00:16:04,596 --> 00:16:06,331 NEXT MONDAY AT NOON, WE WILL 471 00:16:06,331 --> 00:16:11,236 HAVE A NEW PRESIDENT AND A NEW 472 00:16:11,236 --> 00:16:11,937 ADMINISTRATION. 473 00:16:11,937 --> 00:16:14,873 THIS IS A PROCESS THAT OCCURS 474 00:16:14,873 --> 00:16:18,810 FREQUENTLY, AND THE NIH IS VERY 475 00:16:18,810 --> 00:16:20,445 EXPERIENCED IN HOW TO HANDLE A 476 00:16:20,445 --> 00:16:22,614 TRANSITION AND ACTUALLY FOR 477 00:16:22,614 --> 00:16:25,784 MONTHS, OUR STAFF HAVE BEEN 478 00:16:25,784 --> 00:16:27,119 WORKING ON TRANSITION DOCUMENTS 479 00:16:27,119 --> 00:16:28,520 REGARDLESS OF WHO WON THE 480 00:16:28,520 --> 00:16:28,954 ELECTION. 481 00:16:28,954 --> 00:16:33,658 SO WE ARE SOMEWHAT PREPARED. 482 00:16:33,658 --> 00:16:36,728 HERE IS THE ANTICIPATED 483 00:16:36,728 --> 00:16:37,996 CONGRESSIONAL TIMELINE THAT 484 00:16:37,996 --> 00:16:39,464 AFFECTS ALL OF US. 485 00:16:39,464 --> 00:16:42,334 SO WE ARE NOW AT JANUARY 13TH, 486 00:16:42,334 --> 00:16:45,170 SO THE ELECTION RESULTS HAVE 487 00:16:45,170 --> 00:16:45,871 BEEN CERTIFIED. 488 00:16:45,871 --> 00:16:49,207 THERE IS A NEW SPEAKER OF THE 489 00:16:49,207 --> 00:16:50,442 HOUSE. 490 00:16:50,442 --> 00:16:51,176 INAUGURATION DAY IS NEXT MONDAY 491 00:16:51,176 --> 00:16:52,477 AND IF YOU'RE IN THE D.C. AREA, 492 00:16:52,477 --> 00:16:55,881 YOU CAN SEE ALL THE PARADE 493 00:16:55,881 --> 00:16:57,415 CONSTRUCTION AND THE VIEWING 494 00:16:57,415 --> 00:17:01,019 BOXES ARE ALL DONE. 495 00:17:01,019 --> 00:17:04,723 AND THEN ONCE THE INCOMING 496 00:17:04,723 --> 00:17:08,460 PRESIDENT IS INAUGURATED, THE 497 00:17:08,460 --> 00:17:14,132 CONFIRMATION PROCESS WILL BEGIN. 498 00:17:14,132 --> 00:17:16,868 SO HOW DO WE CONFIRM A NEW NIH 499 00:17:16,868 --> 00:17:17,302 DIRECTOR? 500 00:17:17,302 --> 00:17:18,937 WELL, IT'S NOT US, IT'S CONGRESS 501 00:17:18,937 --> 00:17:21,373 THAT'S CONFIRMING THE NEW NIH 502 00:17:21,373 --> 00:17:22,140 DIRECTOR. 503 00:17:22,140 --> 00:17:23,208 SO THE PRESIDENT HAS ANNOUNCED 504 00:17:23,208 --> 00:17:25,610 THE NOMINATION OF WHO HE WOULD 505 00:17:25,610 --> 00:17:29,447 LIKE TO HAVE AS THE NEW NIH 506 00:17:29,447 --> 00:17:30,982 DIRECTOR. 507 00:17:30,982 --> 00:17:33,051 DR. BERTAGNOLLI WILL BE REQUIRED 508 00:17:33,051 --> 00:17:34,686 BY LEGISLATION TO SUBMIT HER 509 00:17:34,686 --> 00:17:39,958 LETTER OF RESIGNATION AND SHE 510 00:17:39,958 --> 00:17:41,393 WILL BE MOVING ON TO ANOTHER 511 00:17:41,393 --> 00:17:43,662 POSITION. 512 00:17:43,662 --> 00:17:50,135 THE PRESIDENT HAS ANNOUNCED THAT 513 00:17:50,135 --> 00:17:51,603 DR. JAY BHATTACHARYA IS HIS 514 00:17:51,603 --> 00:17:53,738 PREFERRED NOMINEE, AND 515 00:17:53,738 --> 00:17:54,272 DR. BHATTACHARYA HAS BEEN 516 00:17:54,272 --> 00:17:55,607 MEETING WITH MEMBERS OF THE 517 00:17:55,607 --> 00:17:56,374 SENATE. 518 00:17:56,374 --> 00:18:02,714 FOLLOWING THAT, THERE IS A 519 00:18:02,714 --> 00:18:04,449 SENATE HEALTH COMMITTEE HEARING, 520 00:18:04,449 --> 00:18:05,650 SO THE SENATE HEALTH COMMITTEE 521 00:18:05,650 --> 00:18:07,452 IS THE HEALTH EDUCATION LABOR 522 00:18:07,452 --> 00:18:08,453 AND PENSIONS COMMITTEE THAT 523 00:18:08,453 --> 00:18:09,921 GIVES THE BUDGET TO THE NIH. 524 00:18:09,921 --> 00:18:13,091 THEN THERE'S A VOTE, AND THEN 525 00:18:13,091 --> 00:18:14,626 EVENTUALLY THE NOMINEE IS 526 00:18:14,626 --> 00:18:16,494 BROUGHT TO THE FULL SENATE FOR 527 00:18:16,494 --> 00:18:17,829 CONFIRMATION. 528 00:18:17,829 --> 00:18:19,331 WE DO NOT KNOW WHAT THE TIMING 529 00:18:19,331 --> 00:18:25,237 OF THIS PROCESS WILL BE. 530 00:18:25,237 --> 00:18:26,671 IN TERMS OF RESEARCH HIGHLIGHTS, 531 00:18:26,671 --> 00:18:30,609 I WOULD LIKE TO ENCOURAGE ALL OF 532 00:18:30,609 --> 00:18:35,714 YOU TO VISIT THE NICHD'S 2024 533 00:18:35,714 --> 00:18:37,148 SELECTED RESEARCH ADVANCES 534 00:18:37,148 --> 00:18:39,351 SHOWCASE, WHICH HAS A LINK ON MY 535 00:18:39,351 --> 00:18:41,519 BLOG SITE AS WELL AS IF YOU JUST 536 00:18:41,519 --> 00:18:43,488 USE THIS LANGUAGE, YOU WILL FIND 537 00:18:43,488 --> 00:18:43,955 IT. 538 00:18:43,955 --> 00:18:46,791 HERE ARE SOME OF THE TOPICS THAT 539 00:18:46,791 --> 00:18:52,030 WE HAVE HIGHLIGHTED IN OUR 540 00:18:52,030 --> 00:18:54,099 SHOWCASE OF WHAT WE'VE DONE IN 541 00:18:54,099 --> 00:18:56,201 THE PAST YEAR LOOKING AT WOMEN'S 542 00:18:56,201 --> 00:18:58,603 HEALTH, IMPROVING POSTPARTUM 543 00:18:58,603 --> 00:19:00,672 HEALTH OUTCOMES, ADVANCING FETAL 544 00:19:00,672 --> 00:19:02,741 AND NEONATAL HEALTH, IMPROVING 545 00:19:02,741 --> 00:19:05,277 CARE FOR PEDIATRIC INJURY, 546 00:19:05,277 --> 00:19:06,678 ADVANCING CHILD AND ADOLESCENT 547 00:19:06,678 --> 00:19:08,013 HEALTH, TREATING AND 548 00:19:08,013 --> 00:19:10,415 UNDERSTANDING PEDIATRIC 549 00:19:10,415 --> 00:19:11,950 INFECTIONS, ADDRESSING HEALTH 550 00:19:11,950 --> 00:19:14,352 DISPARITIES FOR PEOPLE WITH 551 00:19:14,352 --> 00:19:15,987 DISABILITIES, EXPANDING RESEARCH 552 00:19:15,987 --> 00:19:17,622 ON INTELLECTUAL AND 553 00:19:17,622 --> 00:19:18,924 DEVELOPMENTAL DISABILITIES, 554 00:19:18,924 --> 00:19:20,692 ADVANCING MEDICAL REHABILITATION 555 00:19:20,692 --> 00:19:22,127 RESEARCH AND DISCOVERING HOW 556 00:19:22,127 --> 00:19:22,994 CELLS ARE PROGRAMMED. 557 00:19:22,994 --> 00:19:24,729 SO WITHIN EACH OF THESE TOPICS, 558 00:19:24,729 --> 00:19:26,932 WE'VE HIGHLIGHTED SOME OF THE 559 00:19:26,932 --> 00:19:29,434 MOST IMPACTFUL RESEARCH THAT WAS 560 00:19:29,434 --> 00:19:36,207 PUBLISHED DURING THE PAST YEAR. 561 00:19:36,207 --> 00:19:38,510 NOW THOSE OF YOU WHO ARE NEW AD 562 00:19:38,510 --> 00:19:40,245 HOC MEMBERS KNOW THAT WE HAVE 563 00:19:40,245 --> 00:19:42,781 BEEN PRESENTING PERIODIC UPDATES 564 00:19:42,781 --> 00:19:46,051 TO YOU ON OUR REFRESHED 565 00:19:46,051 --> 00:19:47,052 STRATEGIC PLAN. 566 00:19:47,052 --> 00:19:49,554 WE LAST CAME OUT WITH THE 567 00:19:49,554 --> 00:19:53,725 STRATEGIC PLAN IN 2020, AND IN 568 00:19:53,725 --> 00:19:55,627 THE 21ST CENTURY CURES ACT, IT 569 00:19:55,627 --> 00:19:57,562 WAS STATED THAT ALL OF THE 570 00:19:57,562 --> 00:19:59,731 INSTITUTES AND CENTERS MUST HAVE 571 00:19:59,731 --> 00:20:02,367 A NEW STRATEGIC PLAN EVERY FIVE 572 00:20:02,367 --> 00:20:03,768 YEARS. 573 00:20:03,768 --> 00:20:06,071 SO OUR PLAN IS ALMOST FINALIZED. 574 00:20:06,071 --> 00:20:07,272 WE'RE HOPEFUL THAT YOU ARE GOING 575 00:20:07,272 --> 00:20:09,708 TO SEE IT ONLINE IN THE NEXT FEW 576 00:20:09,708 --> 00:20:10,275 WEEKS. 577 00:20:10,275 --> 00:20:13,745 WE'RE JUST UNDERGOING THE LAST 578 00:20:13,745 --> 00:20:16,247 BIT OF PROOFREADING AND MAKING 579 00:20:16,247 --> 00:20:22,587 SURE THAT EVERYTHING, ALL THE 580 00:20:22,587 --> 00:20:24,356 I'S HAVE DOTS AND THE T'S ARE 581 00:20:24,356 --> 00:20:24,789 CROSSED. 582 00:20:24,789 --> 00:20:26,324 BUT IF YOU'VE LOOKED AT OUR 583 00:20:26,324 --> 00:20:29,394 PRIOR STRATEGIC PLAN, THE 584 00:20:29,394 --> 00:20:30,395 OVERALL SCIENTIFIC GOALS REMAIN 585 00:20:30,395 --> 00:20:31,162 THE SAME. 586 00:20:31,162 --> 00:20:34,299 SO WE HAD FIVE SCIENTIFIC GOALS 587 00:20:34,299 --> 00:20:36,401 THAT IN A VERY BROAD SENSE ARE 588 00:20:36,401 --> 00:20:40,105 REFLECTING THE SCIENCE THAT WE 589 00:20:40,105 --> 00:20:40,438 FUND. 590 00:20:40,438 --> 00:20:42,707 WHAT WE DID, HOWEVER, WAS UPDATE 591 00:20:42,707 --> 00:20:45,777 THE OBJECTIVES WITHIN THESE 592 00:20:45,777 --> 00:20:47,412 GOALS, AND WE'VE ALSO 593 00:20:47,412 --> 00:20:49,381 SIGNIFICANTLY UPDATED THE 594 00:20:49,381 --> 00:20:50,815 SCIENTIFIC STEWARDSHIP AND 595 00:20:50,815 --> 00:20:52,117 MANAGEMENT AND ACCOUNTABILITY 596 00:20:52,117 --> 00:20:53,351 GOALS. 597 00:20:53,351 --> 00:20:55,086 WE REALLY APPRECIATE COUNCIL'S 598 00:20:55,086 --> 00:20:56,521 FEEDBACK THROUGHOUT THE PROCESS 599 00:20:56,521 --> 00:21:00,325 AT THE PREVIOUS COUNCIL MEETING. 600 00:21:00,325 --> 00:21:01,860 COUNCILMEMBERS ARE A NUMBER OF 601 00:21:01,860 --> 00:21:03,395 VERY IMPORTANT COMMENTS, AND YOU 602 00:21:03,395 --> 00:21:06,898 WILL SEE THAT WE LISTEN TO YOU 603 00:21:06,898 --> 00:21:08,967 AND WE INTEGRATED THE 604 00:21:08,967 --> 00:21:11,803 INFORMATION INTO THE EXT STRATEC 605 00:21:11,803 --> 00:21:12,303 PLAN. 606 00:21:12,303 --> 00:21:13,571 I'D ALSO LIKE TO ACKNOWLEDGE THE 607 00:21:13,571 --> 00:21:18,043 INTERNAL STAFF MEMBERS, 608 00:21:18,043 --> 00:21:19,044 VIRTUALLY EVERYONE PLAYED A ROLE 609 00:21:19,044 --> 00:21:21,646 IN UPDATING THE STRATEGIC PLAN. 610 00:21:21,646 --> 00:21:23,314 MANY, MANY EYES HAVE LOOKED AT 611 00:21:23,314 --> 00:21:25,550 IT, AND WE THINK IT A TERRIFIC 612 00:21:25,550 --> 00:21:26,885 ROAD MAP FOR THE NEXT FIVE 613 00:21:26,885 --> 00:21:36,327 YEARS. 614 00:21:36,327 --> 00:21:38,163 SO JUST TO HIGHLIGHT SOME OF THE 615 00:21:38,163 --> 00:21:39,497 NEW OBJECTIVES. 616 00:21:39,497 --> 00:21:40,698 SO THE FIRST GOAL IS 617 00:21:40,698 --> 00:21:41,599 UNDERSTANDING THE MOLECULAR, 618 00:21:41,599 --> 00:21:42,767 CELLULAR AND STRUCTURAL BASIS OF 619 00:21:42,767 --> 00:21:45,603 DEVELOPMENT. 620 00:21:45,603 --> 00:21:46,805 OUR NEW OBJECTIVES TAKE 621 00:21:46,805 --> 00:21:48,773 ADVANTAGE OF NEW TECHNOLOGIES IN 622 00:21:48,773 --> 00:21:50,642 THIS RESEARCH AREA, INCLUDING 623 00:21:50,642 --> 00:21:51,743 ARTIFICIAL INTELLIGENCE. 624 00:21:51,743 --> 00:21:54,145 THE COUNCIL IN OUR LAST MEETING 625 00:21:54,145 --> 00:21:56,748 MADE A VERY STRONG POINT ABOUT 626 00:21:56,748 --> 00:21:59,084 THE FACT THAT WE WEREN'T SAYING 627 00:21:59,084 --> 00:22:02,654 ENOUGH ABOUT TECHNOLOGIES SUCH 628 00:22:02,654 --> 00:22:03,655 AS A.I. THAT ARE ALREADY 629 00:22:03,655 --> 00:22:06,925 CHANGING EVERYTHING THAT WE DO. 630 00:22:06,925 --> 00:22:09,461 THEME TWO IS ADVANCING 631 00:22:09,461 --> 00:22:13,298 GYNECOLOGIC, ANDRO LOGLOGIC AND 632 00:22:13,298 --> 00:22:13,832 REPRODUCTIVE HEALTH. 633 00:22:13,832 --> 00:22:16,234 THERE'S A STRONGER EMPHASIS IN 634 00:22:16,234 --> 00:22:18,536 THIS PLAN ON GYNECOLOGIC 635 00:22:18,536 --> 00:22:21,606 CONDITIONS AND CONTRACEPTION. 636 00:22:21,606 --> 00:22:23,741 THE PRIOR STRATEGIC PLAN FOCUSED 637 00:22:23,741 --> 00:22:25,777 MORE ON DEVELOPING FUNDAMENTAL 638 00:22:25,777 --> 00:22:26,945 KNOWLEDGE IN REPRODUCTIVE 639 00:22:26,945 --> 00:22:28,613 HEALTH, AND WE HAVE MADE GREAT 640 00:22:28,613 --> 00:22:30,682 STRIDES IN THIS AREA. 641 00:22:30,682 --> 00:22:33,518 WHAT THE 2025 PLAN DOES IS IT 642 00:22:33,518 --> 00:22:36,020 SHIFTS A FOCUS TO TRANSLATION 643 00:22:36,020 --> 00:22:38,556 AND INTERVENTIONS TO IMPROVE 644 00:22:38,556 --> 00:22:42,594 GYNECOLOGIC HEALTH. 645 00:22:42,594 --> 00:22:44,662 THE THIRD THEME IS SETTING THE 646 00:22:44,662 --> 00:22:46,431 FOUNDATION FOR HEALTHY 647 00:22:46,431 --> 00:22:47,699 PREGNANCIES AND LIFELONG 648 00:22:47,699 --> 00:22:49,934 WELLNESS. 649 00:22:49,934 --> 00:22:51,035 THE IMPROVE INITIATIVE 650 00:22:51,035 --> 00:22:52,670 IMPLEMENTING A MATERNAL HEALTH 651 00:22:52,670 --> 00:22:56,808 AND PREGNANCY OUTCOMES VISION 652 00:22:56,808 --> 00:22:58,009 FOR EVERYONE AND OTHER PROGRAMS 653 00:22:58,009 --> 00:23:00,311 HAVE BROUGHT INCREASED FOCUS ON 654 00:23:00,311 --> 00:23:02,614 MATERNAL INTERVENTIONS TO ALIGN 655 00:23:02,614 --> 00:23:03,815 WITH COMMUNITY NEEDS AND 656 00:23:03,815 --> 00:23:07,085 PREFERENCES. 657 00:23:07,085 --> 00:23:08,186 THE 2025 PLAN CONTINUES ITS 658 00:23:08,186 --> 00:23:10,255 FOCUS ON MATERNAL AND INFANT 659 00:23:10,255 --> 00:23:13,424 HEALTH BUT BUILDS ON THE 660 00:23:13,424 --> 00:23:14,659 SUCCESSES AND THE FACT THAT WE 661 00:23:14,659 --> 00:23:17,061 HAVE REALLY REACHED ACROSS THE 662 00:23:17,061 --> 00:23:19,130 COUNTRY TO WORK ON REDUCING 663 00:23:19,130 --> 00:23:20,865 MATERNAL MORTALITY. 664 00:23:20,865 --> 00:23:23,067 IN ADDITION, THE LAST FIVE 665 00:23:23,067 --> 00:23:25,470 YEARS, WE HAVE HAD A SHARPENED 666 00:23:25,470 --> 00:23:28,640 FOCUS ON PREVENTION OF 667 00:23:28,640 --> 00:23:30,074 STILLBIRTH, AND ALSO CONTINUING 668 00:23:30,074 --> 00:23:32,810 OUR ACTIVITIES IN PREVENTION OF 669 00:23:32,810 --> 00:23:34,946 PRETERM BIRTH AS WELL AS 670 00:23:34,946 --> 00:23:36,948 TREATING PREMATURE BABIES AND 671 00:23:36,948 --> 00:23:38,049 PREVENTING SOME OF THE 672 00:23:38,049 --> 00:23:40,785 DEVASTATING CONDITIONS THAT THEY 673 00:23:40,785 --> 00:23:43,755 ACQUIRE AS A RESULT OF BEING 674 00:23:43,755 --> 00:23:47,559 PREMATURE. 675 00:23:47,559 --> 00:23:48,893 THE NEXT THEME HAVE IMPROVING 676 00:23:48,893 --> 00:23:50,195 CHILD AND ADOLESCENT HEALTH AND 677 00:23:50,195 --> 00:23:51,629 THE TRANSITION TO ADULTHOOD. 678 00:23:51,629 --> 00:23:53,264 WE'VE ADDED A FOCUS ON PEDIATRIC 679 00:23:53,264 --> 00:23:54,265 PRIMARY CARE AND INTERVENTIONS 680 00:23:54,265 --> 00:23:55,233 TO IMPROVE THE HEALTH OF 681 00:23:55,233 --> 00:23:57,335 CHILDREN OF ALL AGES. 682 00:23:57,335 --> 00:23:59,737 WE FELT THAT THAT WAS NOT 683 00:23:59,737 --> 00:24:01,439 EMPHASIZED ENOUGH IN THE 2020 684 00:24:01,439 --> 00:24:04,509 PLAN. 685 00:24:04,509 --> 00:24:06,611 WE HAVE RETAPED THE FOCUS ON 686 00:24:06,611 --> 00:24:07,912 ADOLESCENT TRANSITION TO 687 00:24:07,912 --> 00:24:09,013 ADULTHOOD, AS WELL AS 688 00:24:09,013 --> 00:24:10,615 ADOLESCENTS IN GENERAL, BUILDING 689 00:24:10,615 --> 00:24:12,483 ON WHAT WAS STARTED IN THE 2020 690 00:24:12,483 --> 00:24:13,918 PLAN WHEN IT WAS RECOGNIZED THAT 691 00:24:13,918 --> 00:24:15,887 THERE WAS NEVER ANYTHING 692 00:24:15,887 --> 00:24:17,555 MENTIONED ABOUT ADOLESCENTS IN 693 00:24:17,555 --> 00:24:23,228 PREVIOUS PLANS ACROSS NIH. 694 00:24:23,228 --> 00:24:24,862 AND THE LAST THEME, THEME FIVE, 695 00:24:24,862 --> 00:24:28,032 IS FOSTERING SAFE AND EFFECTIVE 696 00:24:28,032 --> 00:24:31,569 THERAPEUTICS AND DEVICES FOR 697 00:24:31,569 --> 00:24:32,971 PREGNANT WOMEN, LACTATING WOMEN, 698 00:24:32,971 --> 00:24:33,605 CHILDREN AND PEOPLE WITH 699 00:24:33,605 --> 00:24:35,707 DISABILITIES. 700 00:24:35,707 --> 00:24:38,643 WE ARE BUILDING ON THE PRGLAC 701 00:24:38,643 --> 00:24:41,179 IMPLEMENTATION PLAN, SO PRGLAC 702 00:24:41,179 --> 00:24:42,847 IS AN ACRONYM FOR RESEARCH ON 703 00:24:42,847 --> 00:24:46,117 PREGNANT AND LACTATING WOMEN. 704 00:24:46,117 --> 00:24:48,820 THE WORKSHOP AND THE STUDY OF 705 00:24:48,820 --> 00:24:51,122 HOW TO IMPROVE RESEARCH IN 706 00:24:51,122 --> 00:24:52,323 PREGNANT AND LACTATING WOMEN WAS 707 00:24:52,323 --> 00:24:55,059 PART OF THE 21ST CENTURY CURES 708 00:24:55,059 --> 00:24:55,260 ACT. 709 00:24:55,260 --> 00:24:57,028 WE'VE MADE OUR RECOMMENDATIONS, 710 00:24:57,028 --> 00:24:58,663 WE'VE IMPLEMENTED MANY OF THEM, 711 00:24:58,663 --> 00:25:00,632 BUT WE ARE CONTINUING TO 712 00:25:00,632 --> 00:25:07,705 IMPLEMENT ALL OF THEM, AS WELL 713 00:25:07,705 --> 00:25:10,375 AS INCREASING OUR ACTIVITIES IN 714 00:25:10,375 --> 00:25:12,543 THE M PRINT, THE MATERNAL AND 715 00:25:12,543 --> 00:25:14,078 PEDIATRIC PRECISION IN 716 00:25:14,078 --> 00:25:15,179 THERAPEUTICS PROGRAM, 717 00:25:15,179 --> 00:25:16,281 RECOGNIZING THAT THERE IS A 718 00:25:16,281 --> 00:25:21,986 SERIOUS NEED FOR MORE DATA ON 719 00:25:21,986 --> 00:25:23,288 HOW PREGNANT PEOPLE AND 720 00:25:23,288 --> 00:25:25,923 LACTATING PEOPLE METABOLIZE 721 00:25:25,923 --> 00:25:29,227 THERAPEUTICS WITH THE GOAL BEING 722 00:25:29,227 --> 00:25:30,361 THAT PEOPLE SHOULD BE TAKING 723 00:25:30,361 --> 00:25:31,429 MEDICATIONS THEY NEED FOR THEIR 724 00:25:31,429 --> 00:25:32,997 OWN HEALTH AND REASSURING THEM 725 00:25:32,997 --> 00:25:35,933 ABOUT ITS SAFETY IN THEIR 726 00:25:35,933 --> 00:25:40,305 FETUSES AND INFANTS. 727 00:25:40,305 --> 00:25:42,607 THIS PARTICULAR THEME EMPHASIZES 728 00:25:42,607 --> 00:25:44,342 COLLABORATIONS WITH OTHER NIH 729 00:25:44,342 --> 00:25:46,878 INSTITUTES AND CENTERS AND OTHER 730 00:25:46,878 --> 00:25:48,179 ORGANIZATIONS WHICH HISTORICALLY 731 00:25:48,179 --> 00:25:53,117 HAVE BEEN SUCCESSFUL. 732 00:25:53,117 --> 00:25:54,852 I THINK THE AREA THAT GENERATED 733 00:25:54,852 --> 00:25:57,155 A LOT OF DISCUSSION WAS OUR 734 00:25:57,155 --> 00:25:57,922 ASPIRATIONAL GOALS. 735 00:25:57,922 --> 00:25:59,991 SO SOME OF THE ASPIRATIONAL 736 00:25:59,991 --> 00:26:00,325 GOALS. 737 00:26:00,325 --> 00:26:02,193 SO THE ASPIRATIONAL GOALS ARE 738 00:26:02,193 --> 00:26:03,594 AREAS IN WHICH WE REALLY WANT TO 739 00:26:03,594 --> 00:26:06,364 PUSH OURSELVES, AND WE NEED TO 740 00:26:06,364 --> 00:26:07,865 DO MORE. 741 00:26:07,865 --> 00:26:10,802 AND THE QUESTION WAS HOW AND 742 00:26:10,802 --> 00:26:14,105 WHAT SHOULD WE FOCUS ON. 743 00:26:14,105 --> 00:26:16,040 SO SOME OF THE GOALS THAT WERE 744 00:26:16,040 --> 00:26:18,810 RETAINED INCLUDED DIAGNOSING, 745 00:26:18,810 --> 00:26:21,179 PREVENTING AND TREATING 746 00:26:21,179 --> 00:26:22,080 ENDOMETRIOSIS, AS WELL AS LIMB 747 00:26:22,080 --> 00:26:23,181 REGENERATION. 748 00:26:23,181 --> 00:26:25,383 WE ADDED SOME EXCITING NEW GOALS 749 00:26:25,383 --> 00:26:27,952 RELATED TO IMPROVING FUNCTION 750 00:26:27,952 --> 00:26:30,288 FOR PEOPLE WITH NEUROLOGICAL 751 00:26:30,288 --> 00:26:34,892 IMPAIRMENT, ALSO USING MENSTRUAL 752 00:26:34,892 --> 00:26:37,095 EFFLUENT AND SEMEN TO DIAGNOSE 753 00:26:37,095 --> 00:26:38,496 ORDERS AND CONDITIONS. 754 00:26:38,496 --> 00:26:40,998 CONTINUING BUT EXPANDING AN 755 00:26:40,998 --> 00:26:42,533 EMPHASIS ON PREVENTING 756 00:26:42,533 --> 00:26:43,868 PREECLAMPSIA AND POSTPARTUM 757 00:26:43,868 --> 00:26:45,370 HEMORRHAGE AS MAJOR FACTORS IN 758 00:26:45,370 --> 00:26:48,239 MATERNAL MORTALITY. 759 00:26:48,239 --> 00:26:50,641 IMPROVING THE QUALITY OF HUMAN 760 00:26:50,641 --> 00:26:54,011 MILK, AND AGAIN LOOKING FOR HOW 761 00:26:54,011 --> 00:26:56,414 MEDICATIONS ARE METABOLIZED AND 762 00:26:56,414 --> 00:26:58,816 APPEAR IN HUMAN MILK. 763 00:26:58,816 --> 00:27:02,120 PREVENTION OF STILLBIRTH. 764 00:27:02,120 --> 00:27:03,988 IMPROVING THE HEALTH OF PRETERM 765 00:27:03,988 --> 00:27:06,824 INFANTS AS I ALREADY SAID. 766 00:27:06,824 --> 00:27:08,459 PEDIATRIC WELL CARE AND PRIMARY 767 00:27:08,459 --> 00:27:10,762 CARE, AND THEN EXPANDING GENE 768 00:27:10,762 --> 00:27:19,070 THERAPY FOR THE FUTURE. 769 00:27:19,070 --> 00:27:21,172 WE TALKED LAST TIME IN OUR 770 00:27:21,172 --> 00:27:23,007 STRATEGIC PLAN ABOUT THE WARP 771 00:27:23,007 --> 00:27:25,376 AND THE WEFT, SO THINKING ABOUT 772 00:27:25,376 --> 00:27:26,077 CROSS-CUTTING THEMES. 773 00:27:26,077 --> 00:27:28,913 PREVIOUSLY THE ONES THAT ARE 774 00:27:28,913 --> 00:27:30,515 NON-BOLDED ARE OR WERE IN THE 775 00:27:30,515 --> 00:27:32,884 2020 STRATEGIC PLAN. 776 00:27:32,884 --> 00:27:35,353 THESE INCLUDE REDUCING HEALTH 777 00:27:35,353 --> 00:27:37,355 DISPARITIES, IMPROVING HEALTH 778 00:27:37,355 --> 00:27:38,122 EQUITY. 779 00:27:38,122 --> 00:27:40,758 FOCUSING ON PREVENTION. 780 00:27:40,758 --> 00:27:42,260 FOCUSING ON INFECTIOUS DISEASE, 781 00:27:42,260 --> 00:27:44,996 WHICH WAS VERY PRESCIENT BECAUSE 782 00:27:44,996 --> 00:27:47,231 OUR LAST STRATEGIC PLAN CAME OUT 783 00:27:47,231 --> 00:27:49,801 IN THE FALL OF 2019, NOT KNOWING 784 00:27:49,801 --> 00:27:53,738 THERE WAS A PANDEMIC TO COME. 785 00:27:53,738 --> 00:27:57,575 NUTRITION, AND GLOBAL HEALTH. 786 00:27:57,575 --> 00:28:00,311 WE'VE ADDED ADD ADVANTAGED 787 00:28:00,311 --> 00:28:02,180 TECHNOLOGIES AND ARTIFICIAL 788 00:28:02,180 --> 00:28:03,748 INTELLIGENCE, AGAIN A NOD TO THE 789 00:28:03,748 --> 00:28:04,816 COUNCIL'S RECOMMENDATIONS, AND 790 00:28:04,816 --> 00:28:07,185 ALTHOUGH WE DID TALK ABOUT 791 00:28:07,185 --> 00:28:08,619 EXPANDING AND IMPROVING RESEARCH 792 00:28:08,619 --> 00:28:10,054 TRAINING AND CAREER DEVELOPMENT, 793 00:28:10,054 --> 00:28:12,223 NOW WE HAVE MADE IT A SPECIFIC 794 00:28:12,223 --> 00:28:21,432 CROSS-CUTTING THEME. 795 00:28:21,432 --> 00:28:22,500 SO NOW WE'RE GOING TO TURN TO 796 00:28:22,500 --> 00:28:23,601 WOMEN'S HEALTH. 797 00:28:23,601 --> 00:28:25,670 SOME OR MANY OF YOU MAY BE AWARE 798 00:28:25,670 --> 00:28:29,941 THAT THE NATIONAL ACADE NATIONAF 799 00:28:29,941 --> 00:28:31,709 SCIENCE, ENGINEERING AND 800 00:28:31,709 --> 00:28:34,979 MEDICINE ALSO KNOWN AS NASEM 801 00:28:34,979 --> 00:28:36,714 RELEASED A REPORT IN DECEMBER ON 802 00:28:36,714 --> 00:28:42,286 THEIR ASSESSMENT ABOUT NIH'S 803 00:28:42,286 --> 00:28:43,621 COMMITMENT TO WOMEN'S HEALTH 804 00:28:43,621 --> 00:28:45,690 RESEARCH. 805 00:28:45,690 --> 00:28:48,526 THE NASEM REPORT STATED THAT 806 00:28:48,526 --> 00:28:50,061 FEMALE-SPECIFIC CONDITIONS SUCH 807 00:28:50,061 --> 00:28:53,998 AS FIBROIDS, ENDOMETRIOSIS, PCOS 808 00:28:53,998 --> 00:28:56,200 AND ASPECTS OF THE MENOPAUSE 809 00:28:56,200 --> 00:28:59,237 TRANSITION ARE NOT WITHIN THE 810 00:28:59,237 --> 00:29:01,906 PURVIEW OF ANY SPECIFIC IC OR 811 00:29:01,906 --> 00:29:08,679 INSTITUTE AND CENTER. 812 00:29:08,679 --> 00:29:10,114 THEY APPARENTLY DID NOT KNOW 813 00:29:10,114 --> 00:29:11,849 THAT IT IS ACTUALLY LEGISLATED 814 00:29:11,849 --> 00:29:14,685 THAT NICHD IS THE HO HOME FOR TS 815 00:29:14,685 --> 00:29:15,753 TYPE OF RESEARCH. 816 00:29:15,753 --> 00:29:21,692 HERE'S THE PASSAGE FROM 42 UCS 817 00:29:21,692 --> 00:29:23,227 285G SECTION 448, THE PURPOSE OF 818 00:29:23,227 --> 00:29:23,427 NICHD. 819 00:29:23,427 --> 00:29:25,396 IT PROVIDED LEGISLATIVE 820 00:29:25,396 --> 00:29:29,000 AUTHORITY FOR NICHD TO CONDUCT 821 00:29:29,000 --> 00:29:32,236 AND SUPPORT RESEARCH, TRAINING, 822 00:29:32,236 --> 00:29:33,704 HEALTH INFORMATION DISSEMINATION 823 00:29:33,704 --> 00:29:36,340 AND OTHER PROGRAMS WITH RESPECT 824 00:29:36,340 --> 00:29:37,542 TO GYNECOLOGIC HEALTH. 825 00:29:37,542 --> 00:29:40,278 IT ACTUALLY COMES FIRST. 826 00:29:40,278 --> 00:29:43,347 NICHD IS THE HOME FOR 827 00:29:43,347 --> 00:29:45,750 FEMALE-SPECIFIC CONDITIONS. 828 00:29:45,750 --> 00:29:47,051 RELATED TO THE REPRODUCTIVE 829 00:29:47,051 --> 00:29:48,920 AREA. 830 00:29:48,920 --> 00:29:50,755 ALSO MATERNAL HEALTH, CHILD 831 00:29:50,755 --> 00:29:55,760 HEALTH, IP INTELLECTUAL 832 00:29:55,760 --> 00:29:56,460 DISABILITIES, HUMAN GROWTH AND 833 00:29:56,460 --> 00:29:58,129 DEVELOPMENT INCLUDING PRENATAL 834 00:29:58,129 --> 00:29:59,196 DEVELOPMENT, POPULATION RESEARCH 835 00:29:59,196 --> 00:30:00,831 AND SPECIAL HEALTH PROBLEMS AND 836 00:30:00,831 --> 00:30:01,499 REQUIREMENTS IN MOTHERS AND 837 00:30:01,499 --> 00:30:01,766 CHILDREN. 838 00:30:01,766 --> 00:30:02,833 THOSE OF YOU WHO ARE NEW TO THE 839 00:30:02,833 --> 00:30:03,968 COUNCIL, THIS IS THE PARAGRAPH 840 00:30:03,968 --> 00:30:05,202 THAT YOU NEED TO FOCUS ON. 841 00:30:05,202 --> 00:30:06,437 THIS IS WHAT WE DO. 842 00:30:06,437 --> 00:30:07,838 THIS IS THE RESEARCH THAT WE 843 00:30:07,838 --> 00:30:14,278 FUND. 844 00:30:14,278 --> 00:30:18,215 WELL, WE AND OTHERS WERE VERY 845 00:30:18,215 --> 00:30:22,386 CONCERNED THAT THE REPORT 846 00:30:22,386 --> 00:30:25,990 SOMEWHAT MISSTATED THE FACTS AND 847 00:30:25,990 --> 00:30:28,392 DR. BERTAGNOLLI CAME OUT WITH A 848 00:30:28,392 --> 00:30:29,393 STATEMENT, AND I'M GOING TO 849 00:30:29,393 --> 00:30:32,263 QUOTE WHAT SHE WROTE. 850 00:30:32,263 --> 00:30:33,798 WHILE THE REPORT PROVIDES 851 00:30:33,798 --> 00:30:34,765 THOUGHTFUL RECOMMENDATIONS ON 852 00:30:34,765 --> 00:30:36,534 HOW NIH CAN EXPAND ITS RESEARCH 853 00:30:36,534 --> 00:30:38,469 EFFORTS, IT DOES NOT ACKNOWLEDGE 854 00:30:38,469 --> 00:30:40,905 THE FULL BREADTH OF NIH'S 855 00:30:40,905 --> 00:30:42,306 EXTENSIVE WORK ON WOMEN'S HEALTH 856 00:30:42,306 --> 00:30:43,941 RESEARCH. 857 00:30:43,941 --> 00:30:46,577 IT OMITS THE KEY CONGRESSIONAL 858 00:30:46,577 --> 00:30:48,346 LANGUAGE THAT ESTABLISHES THE 859 00:30:48,346 --> 00:30:51,749 STUDY OF GYNECOLOGICAL AND 860 00:30:51,749 --> 00:30:58,489 PREGNANCY-RELATED CONDITIONS AT 861 00:30:58,489 --> 00:30:59,290 NIH'S EUNICE KENNEDY SHRIVER 862 00:30:59,290 --> 00:31:00,224 NATIONAL INSTITUTE OF CHILD 863 00:31:00,224 --> 00:31:01,125 HEALTH AND HUMAN DEVELOPMENT, 864 00:31:01,125 --> 00:31:02,326 AND IT UNDERSTATES THE 865 00:31:02,326 --> 00:31:03,527 SIGNIFICANCE OF ONGOING WOMEN'S 866 00:31:03,527 --> 00:31:04,962 HEALTH INITIATIVES SUPPORTED BY 867 00:31:04,962 --> 00:31:09,533 NICHD AND OTHER NIH INSTITUTES. 868 00:31:09,533 --> 00:31:11,268 NICHD'S INVESTMENT IN 869 00:31:11,268 --> 00:31:12,503 GYNECOLOGIC HEALTH RESEARCH IS 870 00:31:12,503 --> 00:31:14,672 ACTIVE AND GROWING, AS YOU WILL 871 00:31:14,672 --> 00:31:16,674 LEARN FROM LISTENING TO OUR 872 00:31:16,674 --> 00:31:18,643 COUNCIL PRESENTATIONS. 873 00:31:18,643 --> 00:31:20,378 THE GYNECOLOGIC HEALTH AND 874 00:31:20,378 --> 00:31:22,213 DISEASE BRANCH IN DER, THE 875 00:31:22,213 --> 00:31:24,515 DIVISION OF EXTRAMURAL RESEARCH, 876 00:31:24,515 --> 00:31:26,717 MAINTAINS A RESEARCH PORTFOLIO 877 00:31:26,717 --> 00:31:28,486 IN ENDOMETRIOSIS, UTERINE 878 00:31:28,486 --> 00:31:31,088 FIBROIDS, PELVIC FLOOR 879 00:31:31,088 --> 00:31:32,390 DISORDERS, POLYCYSTIC OVARY 880 00:31:32,390 --> 00:31:37,428 SYNDROME, AND GYNECOLOGIC PAIN. 881 00:31:37,428 --> 00:31:39,296 I REALIZED THAT THIS IS ACTUALLY 882 00:31:39,296 --> 00:31:41,365 NOT THE RIGHT SLIDE PRESENTATION 883 00:31:41,365 --> 00:31:48,606 BECAUSE WE HAD IN THE SLIDE 884 00:31:48,606 --> 00:31:50,908 PRESENTATION A HIGHLIGHT FROM 885 00:31:50,908 --> 00:31:54,045 THE JAMA PAPER THAT WOMEN'S 886 00:31:54,045 --> 00:31:56,347 HEALTH ON NIH'S COMMITMENT TO 887 00:31:56,347 --> 00:32:00,851 WOMEN'S HEALTH RESEARCH, WHICH 888 00:32:00,851 --> 00:32:03,788 APPEARED JANUARY 6TH, I BELIEVE, 889 00:32:03,788 --> 00:32:06,290 SO WE CAN GET THAT PUBLICATION 890 00:32:06,290 --> 00:32:06,857 TO COUNCILMEMBERS. 891 00:32:06,857 --> 00:32:08,659 I DID HAVE A SLIDE IN HERE IN 892 00:32:08,659 --> 00:32:11,328 THE MOST RECENT VERSION, WHICH 893 00:32:11,328 --> 00:32:13,731 TALKED ABOUT THE SPECIFIC PAPER 894 00:32:13,731 --> 00:32:16,801 WHICH WAS WRITTEN MONTHS AGO, 895 00:32:16,801 --> 00:32:19,437 AND REALLY DOES SOMEWHAT CORRECT 896 00:32:19,437 --> 00:32:23,374 THE RECORD SHOWING NIH'S STRONG 897 00:32:23,374 --> 00:32:25,109 COMMITMENT TO WOMEN'S HEALTH 898 00:32:25,109 --> 00:32:28,179 RESEARCH ACROSS THE BOARD. 899 00:32:28,179 --> 00:32:31,582 SO AN EXAMPLE OF THIS IS THE 900 00:32:31,582 --> 00:32:33,884 RADX TECH ACT ENDO CHALLENGE. 901 00:32:33,884 --> 00:32:35,753 I TALKED ABOUT THIS AT THE 902 00:32:35,753 --> 00:32:39,557 PREVIOUS COUNCIL MEETING. 903 00:32:39,557 --> 00:32:41,325 ACT ENDO STANDS FOR ADVANCING 904 00:32:41,325 --> 00:32:43,627 CURES AND THERAPIES AND ENDING 905 00:32:43,627 --> 00:32:45,696 ENDOMETRIOSIS DIAGNOSTIC DELAYS. 906 00:32:45,696 --> 00:32:49,066 AND WE HAVE PARTNERED WITH NIBIB 907 00:32:49,066 --> 00:32:51,135 TO LEVERAGE THE RAPID 908 00:32:51,135 --> 00:32:53,237 ACCELERATION OF DIAGNOSTICS 909 00:32:53,237 --> 00:32:54,772 TECHNOLOGY INNOVATION FUNNEL 910 00:32:54,772 --> 00:32:56,707 PROGRAM TO ACCELERATE THE TIME 911 00:32:56,707 --> 00:32:59,910 TO DIAGNOSIS OF ENDOMETRIOSIS, 912 00:32:59,910 --> 00:33:03,280 ELIMINATE INVASIVE TECHNIQUES, 913 00:33:03,280 --> 00:33:05,249 AND IMPROVE ACCESSIBILITY. 914 00:33:05,249 --> 00:33:10,287 WE HAD A PRO BUST RES ROBUST REO 915 00:33:10,287 --> 00:33:11,388 PHASE ONE SUBMISSION. 916 00:33:11,388 --> 00:33:13,591 SOME OF THE DIAGNOSTIC 917 00:33:13,591 --> 00:33:15,426 APPROACHES THAT WERE IN 918 00:33:15,426 --> 00:33:17,061 THIBLECATIONS INCLUDED IMPROVED 919 00:33:17,061 --> 00:33:20,598 IMAGING, STOOL-BASED BIOMARKERS, 920 00:33:20,598 --> 00:33:24,535 MEASURING GI MOTILITY, EXAMINING 921 00:33:24,535 --> 00:33:31,642 MENSTRUAL EFFLUENT FOR DNA, RNA 922 00:33:31,642 --> 00:33:32,409 AND BIOMARKERS. 923 00:33:32,409 --> 00:33:33,844 THE NEXT STEPS INCLUDE THE PITCH 924 00:33:33,844 --> 00:33:35,246 EVENT, AND THEN THE TECHNOLOGY 925 00:33:35,246 --> 00:33:35,813 DEVELOPMENT SPRINT. 926 00:33:35,813 --> 00:33:37,448 THE FINAL WINNERS WILL BE 927 00:33:37,448 --> 00:33:42,787 ANNOUNCED IN MARCH OF 2026. 928 00:33:42,787 --> 00:33:43,954 SO THIS IS ONE OF MANY PROJECTS 929 00:33:43,954 --> 00:33:46,090 THAT WE ARE FUNDING RELATED TO 930 00:33:46,090 --> 00:33:52,429 ENDOMETRIOSIS. 931 00:33:52,429 --> 00:33:55,032 NOW PEDIATRIC RESEARCH INCLUDES, 932 00:33:55,032 --> 00:33:56,367 WE DO NOT FUND ALL OF PEDIATRIC 933 00:33:56,367 --> 00:33:58,869 RESEARCH ACROSS NIH, BUT WE HAVE 934 00:33:58,869 --> 00:34:00,938 RESEARCH THAT IS FUNDED WITHIN 935 00:34:00,938 --> 00:34:04,008 MANY OF THE BRANCHES THAT ARE 936 00:34:04,008 --> 00:34:04,708 LISTED HERE. 937 00:34:04,708 --> 00:34:06,544 THESE ARE OUR DIVISION OF 938 00:34:06,544 --> 00:34:09,213 EXTRAMURAL RESEARCH BRANCHES. 939 00:34:09,213 --> 00:34:10,514 SO WE'RE JUST GOING TO HIGHLIGHT 940 00:34:10,514 --> 00:34:17,755 A FEW THINGS. 941 00:34:17,755 --> 00:34:21,025 BLESS YOU. 942 00:34:21,025 --> 00:34:25,930 SO SIMILAR TO THE ANALYSIS OF 943 00:34:25,930 --> 00:34:27,364 OBSTETRIC AND GYNECOLOGY 944 00:34:27,364 --> 00:34:28,566 RESEARCH AS WELL AS WOMEN'S 945 00:34:28,566 --> 00:34:30,968 HEALTH RESEARCH FUNDED BY NIH, 946 00:34:30,968 --> 00:34:33,604 THERE'S A SIMILAR STUDY GOING ON 947 00:34:33,604 --> 00:34:35,673 IN PARALLEL BY THE NATIONAL 948 00:34:35,673 --> 00:34:38,676 ACADEMIES THAT WAS REQUIRED BY 949 00:34:38,676 --> 00:34:40,177 FISCAL YEAR 24 APPROPRIATIONS 950 00:34:40,177 --> 00:34:42,546 REPORT LANGUAGE. 951 00:34:42,546 --> 00:34:44,982 THE FIRST MEETING OF THE 952 00:34:44,982 --> 00:34:47,585 COMMITTEE MEMBERS WAS HELD ON 953 00:34:47,585 --> 00:34:49,687 DECEMBER 5TH AND 6TH. 954 00:34:49,687 --> 00:34:53,958 WE HAD A COUPLE OF STAFF FROM 955 00:34:53,958 --> 00:34:56,827 NICHD WHO PROVIDED THE SPONSOR 956 00:34:56,827 --> 00:34:57,094 BRIEFING. 957 00:34:57,094 --> 00:34:58,062 I UNFORTUNATELY HAD A CONFLICT 958 00:34:58,062 --> 00:35:00,397 SO I COULDN'T BE THERE. 959 00:35:00,397 --> 00:35:03,801 IT IS AN OPEN MEETING. 960 00:35:03,801 --> 00:35:04,902 PRESENTATION SLIDES AND VIDEO OF 961 00:35:04,902 --> 00:35:06,303 THE MEETING ARE AVAILABLE. 962 00:35:06,303 --> 00:35:08,505 THE INTENT IS, OVER THE NEXT 18 963 00:35:08,505 --> 00:35:10,674 MONTHS, THAT NASEM WILL HOLD 964 00:35:10,674 --> 00:35:12,543 THREE TO FIVE PUBLIC MEETINGS, 965 00:35:12,543 --> 00:35:15,946 AND THEY WILL PRODUCE A FINAL 966 00:35:15,946 --> 00:35:18,115 REPORT WITH RECOMMENDATIONS 967 00:35:18,115 --> 00:35:23,087 ANTICIPATED IN EARLY 2026. 968 00:35:23,087 --> 00:35:28,025 THERE IS A WEBPAGE FOR THIS 969 00:35:28,025 --> 00:35:28,492 COMMITTEE. 970 00:35:28,492 --> 00:35:30,628 AND THE COMMITTEE IS TASKED WITH 971 00:35:30,628 --> 00:35:32,296 EXAMINING THE CURRENT NIH 972 00:35:32,296 --> 00:35:34,899 PEDIATRIC RESEARCH PORTFOLIO AND 973 00:35:34,899 --> 00:35:36,901 STRUCTURE, INCLUDING THE METHODS 974 00:35:36,901 --> 00:35:39,169 AND RATIONALE INVOLVED IN 975 00:35:39,169 --> 00:35:41,472 CATEGORIZING PROJECTS AS 976 00:35:41,472 --> 00:35:44,208 PEDIATRICS RESEARCH USING THE 977 00:35:44,208 --> 00:35:46,610 RESEARCH CONDITION AND DISEASE 978 00:35:46,610 --> 00:35:47,711 CATEGORIZATION PROCESS, ALSO 979 00:35:47,711 --> 00:35:50,881 KNOWN AS RCDC. 980 00:35:50,881 --> 00:35:52,283 HOW PEDIATRIC COMPONENTS HAVE 981 00:35:52,283 --> 00:35:54,919 BEEN INCLUDED OR EXCLUDED FROM 982 00:35:54,919 --> 00:35:58,422 LARGER NIH-WIDE INITIATIVES, 983 00:35:58,422 --> 00:36:00,758 SUCH AS HELPING TO END ADDICTION 984 00:36:00,758 --> 00:36:03,494 LONG TERM, CLIMATE CHANGE AND 985 00:36:03,494 --> 00:36:05,863 HEALTH, ET CETERA. 986 00:36:05,863 --> 00:36:07,932 WHAT ARE THE STRUCTURAL OR 987 00:36:07,932 --> 00:36:09,800 PROCESS IMPEDIMENTS TO PEDIATRIC 988 00:36:09,800 --> 00:36:12,303 RESEARCH APPLICANTS? 989 00:36:12,303 --> 00:36:13,737 HOW PEDIATRIC RESEARCH PRIORITY 990 00:36:13,737 --> 00:36:15,906 ARE ESTABLISHED WITHIN AND 991 00:36:15,906 --> 00:36:18,242 ACROSS ICs. 992 00:36:18,242 --> 00:36:19,977 HOW PEDIATRIC RESEARCH ACTIVITY 993 00:36:19,977 --> 00:36:23,948 IS COORDINATED ACROSS NIH ICs. 994 00:36:23,948 --> 00:36:26,884 AND WAYS IN WHICH THE NIH 995 00:36:26,884 --> 00:36:29,053 CLINICAL CENTER, THE LARGEST 996 00:36:29,053 --> 00:36:29,954 RESEARCH HOSPITAL IN THE WORLD, 997 00:36:29,954 --> 00:36:32,022 COULD BE USED TO ADVANCE 998 00:36:32,022 --> 00:36:37,394 INNOVATIVE PEDIATRIC RESEARCH. 999 00:36:37,394 --> 00:36:39,163 SO THAT IS ONGOING. 1000 00:36:39,163 --> 00:36:42,333 THERE HAVE BEEN DATA REQUESTS. 1001 00:36:42,333 --> 00:36:43,734 ALTHOUGH WE ARE INDEPENDENT OF 1002 00:36:43,734 --> 00:36:46,170 THEIR EVALUATION PROCESS, WE ARE 1003 00:36:46,170 --> 00:36:48,439 VERY ACTIVE IN PROVIDING THEM 1004 00:36:48,439 --> 00:36:53,477 WHATEVER INFORMATION THEY NEED. 1005 00:36:53,477 --> 00:36:57,414 ANOTHER HIGHLIGHT, THIS SHOULD 1006 00:36:57,414 --> 00:36:58,515 HAVE BEEN PART OF THE 1007 00:36:58,515 --> 00:37:03,988 CONGRESSIONAL INFORMATION, BUT 1008 00:37:03,988 --> 00:37:05,389 GABRIELLA MILLER KIDS FIRST 1009 00:37:05,389 --> 00:37:07,157 RESEARCH ACT 2.0 WAS SIGNED INTO 1010 00:37:07,157 --> 00:37:07,391 LAW. 1011 00:37:07,391 --> 00:37:09,126 THOSE OF YOU WHO WERE FOLLOWING 1012 00:37:09,126 --> 00:37:10,661 THE BUDGET DISCUSSIONS JUST 1013 00:37:10,661 --> 00:37:11,762 PRIOR TO CHRISTMAS MIGHT HAVE 1014 00:37:11,762 --> 00:37:13,297 HEARD THE HEADLINE THAT THE KIDS 1015 00:37:13,297 --> 00:37:14,865 CANCER RESEARCH WAS NOT INCLUDED 1016 00:37:14,865 --> 00:37:17,868 IN THE BILL. 1017 00:37:17,868 --> 00:37:19,303 SO AFTER THE CONTINUING 1018 00:37:19,303 --> 00:37:23,140 RESOLUTION WAS SIGNED, THIS BILL 1019 00:37:23,140 --> 00:37:24,875 WAS SEPARATED OUT AND NOW 1020 00:37:24,875 --> 00:37:27,511 THERE'S A NEW LAW THAT IS 1021 00:37:27,511 --> 00:37:29,646 EXTENDING THE GABRIELLA MILLER 1022 00:37:29,646 --> 00:37:31,315 PROGRAM THROUGH 2028. 1023 00:37:31,315 --> 00:37:34,184 AND IT FOSTERS COLLABORATIVE 1024 00:37:34,184 --> 00:37:35,486 RESEARCH ACROSS NIH TO UNCOVER 1025 00:37:35,486 --> 00:37:38,222 THE CAUSES OF CHILDHOOD CANCERS 1026 00:37:38,222 --> 00:37:39,656 AND STRUCTURAL CONGENITAL 1027 00:37:39,656 --> 00:37:41,625 ANOMALIES. 1028 00:37:41,625 --> 00:37:43,394 SUPPORTS DATA SHARING WITHIN THE 1029 00:37:43,394 --> 00:37:45,129 PEDIATRIC RESEARCH COMMUNITY, 1030 00:37:45,129 --> 00:37:50,401 AND IN 2024 ALONE, 12,759 1031 00:37:50,401 --> 00:37:53,537 SAMPLES WERE SEQUENCED. 1032 00:37:53,537 --> 00:37:56,507 11,204 GENOMES WERE DELIVERED TO 1033 00:37:56,507 --> 00:37:59,443 INVESTIGATORS, AND 6,101 GENOMES 1034 00:37:59,443 --> 00:38:01,311 WERE RELEASED ON THE KIDS FIRST 1035 00:38:01,311 --> 00:38:03,947 DATA RESOURCE CENTER PORTAL. 1036 00:38:03,947 --> 00:38:06,750 THE KIDS FIRST PORTAL HAS OVER 1037 00:38:06,750 --> 00:38:09,720 6,500 USERS FROM OVER 50 1038 00:38:09,720 --> 00:38:11,588 COUNTRIES WHO CAN ACCESS 1039 00:38:11,588 --> 00:38:13,557 CLINICAL DATA, PHENOTYPES, AND 1040 00:38:13,557 --> 00:38:15,526 GENETIC VARIANTS. 1041 00:38:15,526 --> 00:38:18,162 THE NEXT STEPS INCLUDE ENHANCING 1042 00:38:18,162 --> 00:38:20,998 THE PROGRAM'S INTEROPERABILITY 1043 00:38:20,998 --> 00:38:22,633 EFFORTS, RELEASING MOST OF THE 1044 00:38:22,633 --> 00:38:25,502 DATA TO THE PORTAL IN A SINGLE 1045 00:38:25,502 --> 00:38:28,672 YEAR, AND CONTINUING MULTIMODAL 1046 00:38:28,672 --> 00:38:31,075 DATA INTEGRATION IN THE KIDS 1047 00:38:31,075 --> 00:38:33,043 FIRST PORTAL. 1048 00:38:33,043 --> 00:38:36,113 SO TYPICALLY, WE END THE 1049 00:38:36,113 --> 00:38:36,947 DIRECTOR'S PRESENTATION WITH 1050 00:38:36,947 --> 00:38:39,149 SOME STAFF UPDATES. 1051 00:38:39,149 --> 00:38:40,584 I'M HAPPY TO SAY THAT WE HAVE 1052 00:38:40,584 --> 00:38:43,987 NOW RECRUITED TWO BRANCH CHIEFS. 1053 00:38:43,987 --> 00:38:50,461 THE FIRST ONE IS LINDY THAKER, 1054 00:38:50,461 --> 00:38:51,261 OUR CHIEF OF THE PEDIATRIC 1055 00:38:51,261 --> 00:38:52,529 GROWTH AND NUTRITION BRANCH. 1056 00:38:52,529 --> 00:38:54,298 SHE IS A PEDIATRICIAN AND A 1057 00:38:54,298 --> 00:38:55,599 GLOBAL NUTRITION EXPERT. 1058 00:38:55,599 --> 00:38:59,636 SHE'S DONE PRIOR WORK WITH USAID 1059 00:38:59,636 --> 00:39:00,637 SUPPORTING FOOD AND NUTRITION 1060 00:39:00,637 --> 00:39:00,904 PROGRAMS. 1061 00:39:00,904 --> 00:39:03,407 SHE RECEIVED HER MD FROM THE 1062 00:39:03,407 --> 00:39:05,042 INDIANA UNIVERSITY SCHOOL OF 1063 00:39:05,042 --> 00:39:06,543 MEDICINE, HER MASTERS IN PUBLIC 1064 00:39:06,543 --> 00:39:09,813 HEALTH FROM THE JOHNS HOPKINS 1065 00:39:09,813 --> 00:39:11,081 BLOOMBERG SCHOOL OF PUBLIC 1066 00:39:11,081 --> 00:39:12,649 HEALTH, AND SHE DID HER 1067 00:39:12,649 --> 00:39:14,184 PEDIATRIC NUTRITION FELLOWSHIP 1068 00:39:14,184 --> 00:39:17,187 AT THE CHILDREN'S HOSPITAL OF 1069 00:39:17,187 --> 00:39:17,521 PHILADELPHIA. 1070 00:39:17,521 --> 00:39:19,690 SHE IS CREDENTIALED AS A 1071 00:39:19,690 --> 00:39:22,526 PHYSICIAN NUTRITION SPECIALIST. 1072 00:39:22,526 --> 00:39:26,797 SO WE'D LIKE TO WELCOME LINDY. 1073 00:39:26,797 --> 00:39:29,099 AND THE NEXT PERSON, OUR MOST 1074 00:39:29,099 --> 00:39:32,603 REASON HIRE IS DR. MARANKE 1075 00:39:32,603 --> 00:39:34,171 KOSTER, WHO IS THE NEW CHIEF OF 1076 00:39:34,171 --> 00:39:35,973 THE DEVELOPMENTAL BIOLOGY AND 1077 00:39:35,973 --> 00:39:38,075 CONGENITAL ANOMALIES BRANCH. 1078 00:39:38,075 --> 00:39:40,244 SHE RECEIVED HER PH.D. IN 1079 00:39:40,244 --> 00:39:43,213 DEVELOPMENTAL BIOLOGY FROM 1080 00:39:43,213 --> 00:39:44,214 BAYLOR COLLEGE OF MEDICINE. 1081 00:39:44,214 --> 00:39:46,283 HER RESEARCH HAS FOCUSED ON 1082 00:39:46,283 --> 00:39:47,718 INVESTIGATING MECHANISMS THAT 1083 00:39:47,718 --> 00:39:50,020 CONTROL NORMAL DEVELOPMENT OF 1084 00:39:50,020 --> 00:39:54,491 ECTODERMAL TISSUES AS WELL AS 1085 00:39:54,491 --> 00:39:55,292 PATHOLOGICAL MECHANISMS THAT 1086 00:39:55,292 --> 00:39:57,794 LEAD TO ECTODERMAL DYSPLASIAS. 1087 00:39:57,794 --> 00:39:59,663 SHE'S PREVIOUSLY HELD FACULTY 1088 00:39:59,663 --> 00:40:02,499 POSITIONS AT THE UNIVERSITY OF 1089 00:40:02,499 --> 00:40:04,134 COLORADO, AND MOST RECENTLY THE 1090 00:40:04,134 --> 00:40:05,335 BRODY SCHOOL OF MEDICINE AT EAST 1091 00:40:05,335 --> 00:40:07,871 CAROLINA UNIVERSITY. 1092 00:40:07,871 --> 00:40:12,576 SO WELCOME. 1093 00:40:12,576 --> 00:40:14,111 SO THAT SUMMARIZES MY 1094 00:40:14,111 --> 00:40:14,444 PRESENTATION. 1095 00:40:14,444 --> 00:40:15,646 I KNOW I MENTIONED THIS LAST 1096 00:40:15,646 --> 00:40:17,281 TIME BUT I WANT OUR NEW AD HOC 1097 00:40:17,281 --> 00:40:18,615 MEMBERS TO BE AWARE OF THE FACT 1098 00:40:18,615 --> 00:40:22,553 THAT WE HAVE NEW WOMEN'S HEALTH 1099 00:40:22,553 --> 00:40:24,421 RESEARCH FACT SHEET IF YOU SCAN 1100 00:40:24,421 --> 00:40:26,823 THE QR CODE, YOU CAN GET ACCESS 1101 00:40:26,823 --> 00:40:27,524 TO THESE. 1102 00:40:27,524 --> 00:40:31,662 THEY ARE PUBLICLY AVAILABLE. 1103 00:40:31,662 --> 00:40:32,729 PLEASE FEEL FREE TO DISTRIBUTE 1104 00:40:32,729 --> 00:40:35,199 THEM AS YOU SEE FIT. 1105 00:40:35,199 --> 00:40:38,368 THEY ARE ESSENTIALLY ONE PAGERS, 1106 00:40:38,368 --> 00:40:40,103 GIVING A LITTLE BIT OF 1107 00:40:40,103 --> 00:40:40,904 INFORMATION ABOUT THE CONDITION 1108 00:40:40,904 --> 00:40:43,740 AND THEN OUR RESEARCH EFFORTS AS 1109 00:40:43,740 --> 00:40:48,445 WELL AS OUR RECENT SUCCESSES. 1110 00:40:48,445 --> 00:40:50,113 SO AGAIN, WE'D LIKE PEOPLE TO BE 1111 00:40:50,113 --> 00:40:53,217 AWARE OF WHAT NICHD ACTUALLY 1112 00:40:53,217 --> 00:40:54,484 DOES FUND. 1113 00:40:54,484 --> 00:40:57,654 SO WITH THAT, I AM JUST ABOUT ON 1114 00:40:57,654 --> 00:40:59,856 TIME. 1115 00:40:59,856 --> 00:41:01,158 SO WE'RE RUNNING A LITTLE AHEAD 1116 00:41:01,158 --> 00:41:02,492 ACTUALLY. 1117 00:41:02,492 --> 00:41:04,027 SO I HAVE PLENTY OF TIME TO TAKE 1118 00:41:04,027 --> 00:41:05,329 QUESTIONS SO I'M GOING TO PUT ON 1119 00:41:05,329 --> 00:41:08,298 MY GLASSES AND HOPEFULLY I CAN 1120 00:41:08,298 --> 00:41:09,333 SEE THE CHAT BOX. 1121 00:41:09,333 --> 00:41:19,509 LET'S SEE. 1122 00:41:19,977 --> 00:41:22,746 SO SESH VERY HELPFULLY, I 1123 00:41:22,746 --> 00:41:24,381 BELIEVE, PUT IN THE JAMA 1124 00:41:24,381 --> 00:41:26,350 PUBLICATION SO YOU CAN DOWNLOAD 1125 00:41:26,350 --> 00:41:27,784 THAT. 1126 00:41:27,784 --> 00:41:30,621 I'M NOT SURE WHAT SLIDESET 1127 00:41:30,621 --> 00:41:32,623 ACTUALLY GOT TRANSMITTED. 1128 00:41:32,623 --> 00:41:33,824 THERE WERE SLIGHT DIFFERENCES IN 1129 00:41:33,824 --> 00:41:36,460 THE FINAL VERSION, BUT -- HAPPY 1130 00:41:36,460 --> 00:41:46,770 TO TAKE QUESTIONS. 1131 00:41:52,809 --> 00:41:55,045 SO SESH IS ASKING, GREAT SUMMARY 1132 00:41:55,045 --> 00:41:59,883 OF NICHD'S GREAT CONTRIBUTIONS 1133 00:41:59,883 --> 00:42:01,084 WILL PREGNANCY RELATED 1134 00:42:01,084 --> 00:42:03,053 CONDITIONS BE INCLUDED IN THE 1135 00:42:03,053 --> 00:42:03,553 PEDIATRIC NASEM REPORT? 1136 00:42:03,553 --> 00:42:03,954 IS THAT -- 1137 00:42:03,954 --> 00:42:04,488 >> THAT'S CORRECT. 1138 00:42:04,488 --> 00:42:05,689 BECAUSE IN MY OPINION, 1139 00:42:05,689 --> 00:42:08,325 LITERALLY, I MAY BE OUT OF LINE 1140 00:42:08,325 --> 00:42:12,029 HERE, WHAT HAPPENS IN THE 270 1141 00:42:12,029 --> 00:42:16,133 DAYS OF GESTATION INFLUENCE 1142 00:42:16,133 --> 00:42:18,068 SIGNIFICANTLY PEDIATRIC 1143 00:42:18,068 --> 00:42:20,270 OUTCOMES, AND I WONDER WHETHER 1144 00:42:20,270 --> 00:42:24,074 THOSE PEDIATRIC OUT COME 1145 00:42:24,074 --> 00:42:27,944 INFLUENCES WILL BE INCLUDED IN 1146 00:42:27,944 --> 00:42:29,813 FUNDING OPPORTUNITIES THAT ARE 1147 00:42:29,813 --> 00:42:33,450 EXAMINED BY THE NASEM COMMITTEE. 1148 00:42:33,450 --> 00:42:36,853 >> SO THAT IS A GREAT QUESTION. 1149 00:42:36,853 --> 00:42:39,356 IF YOU READ THE NASEM REPORT ON 1150 00:42:39,356 --> 00:42:43,293 WOMEN'S HEALTH, YOU WOULD SEE 1151 00:42:43,293 --> 00:42:45,962 THAT THAT COMMITTEE THOUGHT THAT 1152 00:42:45,962 --> 00:42:49,666 NICHD ONLY FUNDED 1153 00:42:49,666 --> 00:42:50,734 PREGNANCY-RELATED RESEARCH AND A 1154 00:42:50,734 --> 00:42:56,273 LITTLE BIT ON INFANTS AS WELL. 1155 00:42:56,273 --> 00:42:58,041 THE COMMITTEE THAT IS EXAMINING 1156 00:42:58,041 --> 00:42:59,042 PEDIATRIC RESEARCH, THEY HAVE 1157 00:42:59,042 --> 00:43:03,080 BEEN ASKING QUESTIONS ABOUT THE 1158 00:43:03,080 --> 00:43:05,716 UPPER END OF PEDIATRICS, LIKE AT 1159 00:43:05,716 --> 00:43:08,018 WHAT AGE DOES PEDIATRICS END. 1160 00:43:08,018 --> 00:43:11,188 I HAVEN'T SEEN QUITE AS MUCH ON 1161 00:43:11,188 --> 00:43:14,358 THE PREGNANCY-RELATED ASPECTS, 1162 00:43:14,358 --> 00:43:17,661 BUT THE COMMITTEE MEMBERS ARE 1163 00:43:17,661 --> 00:43:19,963 PUBLIC, AND I BELIEVE YOU WOULD 1164 00:43:19,963 --> 00:43:24,267 BE FREE TO ASK THEM DIRECTLY. 1165 00:43:24,267 --> 00:43:26,336 >> I'LL SPEAK TO PHYLLIS. 1166 00:43:26,336 --> 00:43:27,571 I'LL EMAIL PHYLLIS. 1167 00:43:27,571 --> 00:43:28,205 >> PERFECT. 1168 00:43:28,205 --> 00:43:29,840 THANK YOU. 1169 00:43:29,840 --> 00:43:30,040 PEPE. 1170 00:43:30,040 --> 00:43:32,342 >> THANK YOU, DR. BIANCHI, FOR 1171 00:43:32,342 --> 00:43:33,110 AN EXCELLENT REPORT. 1172 00:43:33,110 --> 00:43:36,546 I HAD A COUPLE OF COMMENTS 1173 00:43:36,546 --> 00:43:37,948 REGARDING THE REPORT FROM 1174 00:43:37,948 --> 00:43:39,049 NATIONAL ACADEMIES. 1175 00:43:39,049 --> 00:43:43,854 I WONDER IF -- I THINK IT'S 1176 00:43:43,854 --> 00:43:46,423 IMPORTANT TO -- SOMETHING THAT 1177 00:43:46,423 --> 00:43:48,492 THEY CAN PUBLISH BECAUSE PEOPLE 1178 00:43:48,492 --> 00:43:49,359 CONSULT THOSE REPORTS AND WE 1179 00:43:49,359 --> 00:43:51,228 DON'T WANT TO PROPAGATE THIS 1180 00:43:51,228 --> 00:43:51,795 ERROR ON THE REPORT. 1181 00:43:51,795 --> 00:43:53,764 I DON'T KNOW IF ANYBODY IS A 1182 00:43:53,764 --> 00:43:54,965 MEMBER OF THE NATIONAL ACADEMIES 1183 00:43:54,965 --> 00:43:56,400 HERE IN THIS MEETING BECAUSE 1184 00:43:56,400 --> 00:43:58,602 THAT WOULD BE ONE WAY TO 1185 00:43:58,602 --> 00:44:00,437 INITIATE THAT CORRECTION. 1186 00:44:00,437 --> 00:44:04,174 MY SECOND COMMENT IS REGARDING 1187 00:44:04,174 --> 00:44:06,810 THE WORKFORCE DEVELOPMENT, THE 1188 00:44:06,810 --> 00:44:09,679 PROMOTING COLLABORATION, 1189 00:44:09,679 --> 00:44:10,847 PARTICULARLY GLOBAL 1190 00:44:10,847 --> 00:44:12,416 COLLABORATIONS, IS THE TOPIC OF 1191 00:44:12,416 --> 00:44:12,949 TEAM SCIENCE. 1192 00:44:12,949 --> 00:44:15,385 AND WE DO A LOT OF THAT, BUT 1193 00:44:15,385 --> 00:44:19,856 IT'S REALLY IMPORTANT TO 1194 00:44:19,856 --> 00:44:21,057 EMPHASIZE THAT FROM WORKFORCE 1195 00:44:21,057 --> 00:44:24,461 DEVELOPMENT ALL THE WAY TO 1196 00:44:24,461 --> 00:44:25,095 THROUGHOUT THE INSTITUTE. 1197 00:44:25,095 --> 00:44:25,529 THANK YOU. 1198 00:44:25,529 --> 00:44:26,430 >> THANK YOU. 1199 00:44:26,430 --> 00:44:32,135 AND WE DO NOTE THE IMPORTANCE OF 1200 00:44:32,135 --> 00:44:33,336 TEAM SCIENCE. 1201 00:44:33,336 --> 00:44:35,605 AT THE RECENT LEADERSHIP FORUM 1202 00:44:35,605 --> 00:44:38,575 WHICH IS AN ANNUAL EVENT HELD 1203 00:44:38,575 --> 00:44:40,777 AMONGST ALL THE DIRECTORS OF THE 1204 00:44:40,777 --> 00:44:41,545 INSTITUTES AND CENTERS, THERE 1205 00:44:41,545 --> 00:44:43,513 WAS A BIG DISCUSSION ON TEAM 1206 00:44:43,513 --> 00:44:47,451 SCIENCE AND HOW TO APPROPRIATELY 1207 00:44:47,451 --> 00:44:48,785 RECOGNIZE PEOPLE, ESPECIALLY 1208 00:44:48,785 --> 00:44:50,787 EARLY STAGE INVESTIGATORS WHO 1209 00:44:50,787 --> 00:44:51,988 ARE PARTICIPATING IN TEAM 1210 00:44:51,988 --> 00:44:54,491 SCIENCE, SO THIS IS VERY MUCH ON 1211 00:44:54,491 --> 00:44:56,927 THE MINDSET OF EVERYONE. 1212 00:44:56,927 --> 00:44:59,896 IN TERMS OF THE NASEM REPORT, 1213 00:44:59,896 --> 00:45:02,732 IT'S A LITTLE BIT OF A SENSITIVE 1214 00:45:02,732 --> 00:45:03,500 TOPIC. 1215 00:45:03,500 --> 00:45:07,471 WE HAVE -- NOT WE. 1216 00:45:07,471 --> 00:45:08,772 NICHD BUT NIH. 1217 00:45:08,772 --> 00:45:12,275 I ONLY HIGHLIGHTED THE THINGS 1218 00:45:12,275 --> 00:45:13,810 THAT WERE QUITE INACCURATE IN 1219 00:45:13,810 --> 00:45:15,445 TERMS OF NICHD. 1220 00:45:15,445 --> 00:45:16,913 THERE WERE OTHER INACCURACIES AS 1221 00:45:16,913 --> 00:45:17,314 WELL. 1222 00:45:17,314 --> 00:45:22,719 SO WHAT HAPPENED WAS NIH PUT 1223 00:45:22,719 --> 00:45:23,920 TOGETHER A LIST AND WE ARE 1224 00:45:23,920 --> 00:45:28,291 SUPPOSED TO MEET WITH MEMBERS OF 1225 00:45:28,291 --> 00:45:29,326 THE COMMITTEE TO DISCUSS HOW 1226 00:45:29,326 --> 00:45:31,761 THEY CAN CORRECT SOME OF THESE. 1227 00:45:31,761 --> 00:45:33,597 WHAT WAS RELEASED PUBLICLY, I 1228 00:45:33,597 --> 00:45:34,397 BELIEVE WAS A DRAFT. 1229 00:45:34,397 --> 00:45:39,636 SO THERE STILL IS AN OPPORTUNITY 1230 00:45:39,636 --> 00:45:42,072 TO CREATE SOME OF THESE 1231 00:45:42,072 --> 00:45:42,606 INACCURACIES. 1232 00:45:42,606 --> 00:45:46,042 THE BOTTOM LINE WAS ONE OF THEIR 1233 00:45:46,042 --> 00:45:47,010 BIGGEST RECOMMENDATIONS WAS THE 1234 00:45:47,010 --> 00:45:49,179 FORMATION OF A SEPARATE WOMEN'S 1235 00:45:49,179 --> 00:45:51,414 HEALTH INSTITUTE BECAUSE SOME OF 1236 00:45:51,414 --> 00:45:53,917 THESE TOPICS WERE NOT THE 1237 00:45:53,917 --> 00:45:58,088 PURVIEW OF EXISTING INSTITUTES. 1238 00:45:58,088 --> 00:46:00,824 SO ANYWAY. 1239 00:46:00,824 --> 00:46:01,958 BUT IT IS SOMETHING THAT WE ARE 1240 00:46:01,958 --> 00:46:02,826 WORKING ON. 1241 00:46:02,826 --> 00:46:03,994 LET'S PUT IT THAT WAY. 1242 00:46:03,994 --> 00:46:06,663 >> THANK YOU. 1243 00:46:06,663 --> 00:46:08,532 >> CYNTHIA, DO YOU WANT TO COME 1244 00:46:08,532 --> 00:46:11,501 OFF MUTE AND -- 1245 00:46:11,501 --> 00:46:13,136 >> YES, THANK YOU. 1246 00:46:13,136 --> 00:46:14,671 THANKS, DR. BIANCHI. 1247 00:46:14,671 --> 00:46:16,006 YOUR COMMENTS WERE REALLY 1248 00:46:16,006 --> 00:46:16,873 WONDERFUL AND ON POINT AND 1249 00:46:16,873 --> 00:46:19,476 REALLY HELPING US TO UNDERSTAND 1250 00:46:19,476 --> 00:46:20,944 THIS TIME OF TRANSITION. 1251 00:46:20,944 --> 00:46:22,746 SO IN LOOKING AT YOUR REFRESH 1252 00:46:22,746 --> 00:46:24,814 FOR THE STRATEGIC PLAN, 1253 00:46:24,814 --> 00:46:28,952 INCREDIBLY PLEASED THAT MANY OF 1254 00:46:28,952 --> 00:46:30,520 THE PRIORITIES ARE REALLY 1255 00:46:30,520 --> 00:46:32,155 FOCUSING ON WOMEN'S HEALTH AND 1256 00:46:32,155 --> 00:46:32,589 PREGNANCY HEALTH. 1257 00:46:32,589 --> 00:46:35,091 AND WHILE THERE ARE EXCELLENT 1258 00:46:35,091 --> 00:46:36,326 OB-GYNs FROM A VARIETY, I 1259 00:46:36,326 --> 00:46:37,994 THINK, OF FOCUSES WITHIN NICHD, 1260 00:46:37,994 --> 00:46:41,231 I WONDER IF THERE IS ANY PLANS 1261 00:46:41,231 --> 00:46:44,267 TO MAYBE ENHANCE THAT BOTH ON 1262 00:46:44,267 --> 00:46:46,670 COUNCIL AS WE HAD LOST A COUPLE 1263 00:46:46,670 --> 00:46:47,971 OB-GYNs ROTATING OFF AND ALSO 1264 00:46:47,971 --> 00:46:49,272 JUST WITHIN NICHD. 1265 00:46:49,272 --> 00:46:52,642 THANK YOU FOR YOUR COMMENTS. 1266 00:46:52,642 --> 00:46:54,778 >> THANK YOU, CYNTHIA, FOR YOUR 1267 00:46:54,778 --> 00:46:55,278 QUESTION. 1268 00:46:55,278 --> 00:46:58,315 SO I BELIEVE WE HAVE THREE 1269 00:46:58,315 --> 00:46:58,748 OB-GYNs. 1270 00:46:58,748 --> 00:47:02,586 I MAY BE MISSING SOMEONE, BUT 1271 00:47:02,586 --> 00:47:08,291 YOURSELF, IGNA AND MARCEL. 1272 00:47:08,291 --> 00:47:09,626 IF I'M MISSING ANYONE, PLEASE 1273 00:47:09,626 --> 00:47:10,060 LET ME KNOW. 1274 00:47:10,060 --> 00:47:11,494 WE ARE ALWAYS VERY COGNIZANT OF 1275 00:47:11,494 --> 00:47:13,463 THE NEED TO BALANCE NOT ONLY 1276 00:47:13,463 --> 00:47:15,665 PEOPLE WITH EXPERTISE FROM A 1277 00:47:15,665 --> 00:47:16,866 MEDICAL AND SCIENTIFIC 1278 00:47:16,866 --> 00:47:19,736 PERSPECTIVE, BUT WE ALSO HAVE 1279 00:47:19,736 --> 00:47:22,138 SHANNON, WHO IS A MAJOR ADVOCATE 1280 00:47:22,138 --> 00:47:26,076 FOR MORE RESEARCH ON GYNECOLOGIC 1281 00:47:26,076 --> 00:47:30,547 HEALTH. 1282 00:47:30,547 --> 00:47:34,317 SO AGAIN WHEN YOU SEE THE 1283 00:47:34,317 --> 00:47:36,286 REFRESHED STRATEGIC PLAN, YOU 1284 00:47:36,286 --> 00:47:38,054 WILL SEE THE STRATEGIC PRIORITY 1285 00:47:38,054 --> 00:47:41,658 ARE HEAVILY FOCUSED ON WOMEN'S 1286 00:47:41,658 --> 00:47:42,425 HEALTH, INCLUDING GYNECOLOGIC 1287 00:47:42,425 --> 00:47:43,426 HEALTH AS WELL AS MATERNAL 1288 00:47:43,426 --> 00:47:45,061 HEALTH. 1289 00:47:45,061 --> 00:47:46,963 AGAIN, IT'S IN THAT PARAGRAPH 1290 00:47:46,963 --> 00:47:49,132 AND WE FEEL THAT THAT IS OUR 1291 00:47:49,132 --> 00:47:49,366 MISSION. 1292 00:47:49,366 --> 00:47:49,799 FOR SURE. 1293 00:47:49,799 --> 00:47:52,535 PART OF OUR MISSION. 1294 00:47:52,535 --> 00:47:57,407 >> THANK YOU. 1295 00:47:57,407 --> 00:48:03,213 >> MIMI, DID YOU WANT TO -- 1296 00:48:03,213 --> 00:48:04,948 >> LOOKING AT THE STATISTIC THAT 1297 00:48:04,948 --> 00:48:07,851 YOU GAVE REGARDING HOW MANY 1298 00:48:07,851 --> 00:48:10,553 GENOMES HAVE BEEN COMPLETELY 1299 00:48:10,553 --> 00:48:13,523 SEQUENCED THROUGH THE KIDS FIRST 1300 00:48:13,523 --> 00:48:15,659 PROGRAM, IT LOOKED LIKE ONLY 50% 1301 00:48:15,659 --> 00:48:17,827 OF THOSE GENOMES, THOUGH, WERE 1302 00:48:17,827 --> 00:48:23,733 AVAILABLE THROUGH THEIR PORTAL, 1303 00:48:23,733 --> 00:48:26,803 WILL THEY BE COMING OUT TO BE 1304 00:48:26,803 --> 00:48:28,838 AVAILABLE TO THE OTHER 50% IN 1305 00:48:28,838 --> 00:48:30,774 THE FUTURE OR HOW IS THAT BEING 1306 00:48:30,774 --> 00:48:30,940 TON? 1307 00:48:30,940 --> 00:48:33,309 >> I DDONE? 1308 00:48:33,309 --> 00:48:35,378 >> I DON'T WANT TO SPEAK OUT OF 1309 00:48:35,378 --> 00:48:36,913 TURN BECAUSE I'M NOT DIRECTLY IN 1310 00:48:36,913 --> 00:48:38,148 CHARGE OF THAT PROGRAM BUT, 1311 00:48:38,148 --> 00:48:39,482 AGAIN, THAT IS THEIR PLAN. 1312 00:48:39,482 --> 00:48:40,550 EVENTUALLY, EVERYTHING WILL BE 1313 00:48:40,550 --> 00:48:47,123 RELEASED PUBLICLY. 1314 00:48:47,123 --> 00:48:50,360 KEN HAD HIS HAND UP? 1315 00:48:50,360 --> 00:48:51,895 >> GREAT. 1316 00:48:51,895 --> 00:48:53,963 WHAT A FANTASTIC PRESENTATION. 1317 00:48:53,963 --> 00:48:57,033 I'LL JUST POINT OUT SOMETHING 1318 00:48:57,033 --> 00:48:59,035 THAT I'M SURE YOU'VE CONSIDERED, 1319 00:48:59,035 --> 00:49:01,304 BUT IT WOULD BE NICE PERHAPS IN 1320 00:49:01,304 --> 00:49:06,376 THE CORRECTION OF THE NATIONAL 1321 00:49:06,376 --> 00:49:10,313 ACADEMIES REPORT THAT INSTEAD 1322 00:49:10,313 --> 00:49:11,514 THEY RECOMMEND ADDITIONAL 1323 00:49:11,514 --> 00:49:12,515 FUNDING TO NICHD TO ADDRESS 1324 00:49:12,515 --> 00:49:15,685 THESE ISSUES. 1325 00:49:15,685 --> 00:49:17,187 RATHER THAN CREATION OF THE NEW 1326 00:49:17,187 --> 00:49:17,654 INS TAUGHT. 1327 00:49:17,654 --> 00:49:19,022 I'M SURE THERE ARE A NUMBER OF 1328 00:49:19,022 --> 00:49:21,558 US ON THE CALL WHO WOULD BE MORE 1329 00:49:21,558 --> 00:49:27,731 THAN PLEASED TO SUPPORT THAT 1330 00:49:27,731 --> 00:49:28,031 SUGGESTION. 1331 00:49:28,031 --> 00:49:31,301 AND I ALSO WONDER IF WITHIN THE 1332 00:49:31,301 --> 00:49:32,736 AGENDA PRIORITIES AND THE 1333 00:49:32,736 --> 00:49:35,805 STRATEGIC PLAN PRIORITIES, IF 1334 00:49:35,805 --> 00:49:40,610 THERE IS AN OPPORTUNITY TO 1335 00:49:40,610 --> 00:49:46,015 ADDRESS THE -- WITHOUT QUESTION 1336 00:49:46,015 --> 00:49:51,755 IMPACT OF PEDIATRIC WORKFORCE 1337 00:49:51,755 --> 00:49:54,557 ISSUES, AND AT THE INTERSECTION 1338 00:49:54,557 --> 00:49:56,192 OF LARGE SCALE CHANGES IN HOW 1339 00:49:56,192 --> 00:50:04,734 CARE IS DELIVERED, IS THE 1340 00:50:04,734 --> 00:50:05,835 INTERSECTION WITH ARTIFICIAL 1341 00:50:05,835 --> 00:50:06,302 INTELLIGENCE. 1342 00:50:06,302 --> 00:50:07,704 WOULD LOVE TO SEE NICHD 1343 00:50:07,704 --> 00:50:08,872 OPERATING AT THAT CROSSROADS. 1344 00:50:08,872 --> 00:50:09,939 >> THANK YOU, KEN. 1345 00:50:09,939 --> 00:50:15,378 SO FIRST OF ALL, WITH REGARD TO 1346 00:50:15,378 --> 00:50:18,114 A SOLUTION TO INCREASING WOMEN'S 1347 00:50:18,114 --> 00:50:19,916 HEALTH RESEARCH BEING INCREASING 1348 00:50:19,916 --> 00:50:22,085 FUNDING TO THE INSTITUTES AND 1349 00:50:22,085 --> 00:50:23,653 CENTERS AND OFFICES THAT PERFORM 1350 00:50:23,653 --> 00:50:26,956 THIS TYPE OF RESEARCH, FANTASTIC 1351 00:50:26,956 --> 00:50:27,357 IDEA. 1352 00:50:27,357 --> 00:50:28,691 ALL OF YOU HAVE THE ABILITY TO 1353 00:50:28,691 --> 00:50:30,994 SPEAK TO YOUR REPRESENTATIVES IN 1354 00:50:30,994 --> 00:50:36,466 CONGRESS ABOUT THAT. 1355 00:50:36,466 --> 00:50:39,035 THERE IS THE SCIENTIFIC 1356 00:50:39,035 --> 00:50:41,104 MANAGEMENT REVIEW BOARD THAT IS 1357 00:50:41,104 --> 00:50:44,374 MEETING TO TALK ABOUT WAYS TO 1358 00:50:44,374 --> 00:50:46,576 ADDRESS AREAS THAT ARE UNDER 1359 00:50:46,576 --> 00:50:47,744 DISCUSSION WITH REGARD TO THE 1360 00:50:47,744 --> 00:50:49,579 FUTURE OF NIH, AND I DON'T HAVE 1361 00:50:49,579 --> 00:50:51,014 ANYTHING MORE TO SAY ABOUT THAT 1362 00:50:51,014 --> 00:50:55,018 RIGHT NOW. 1363 00:50:55,018 --> 00:50:57,420 YOU SAW -- SO THAT'S ONE THING. 1364 00:50:57,420 --> 00:51:00,290 THE PEDIATRIC WORKFORCE ISSUE IS 1365 00:51:00,290 --> 00:51:01,057 A SIGNIFICANT ONE. 1366 00:51:01,057 --> 00:51:02,492 WE'RE VERY AWARE OF THAT, BOTH 1367 00:51:02,492 --> 00:51:04,828 AT THE CLINICAL TRAINING LEVEL, 1368 00:51:04,828 --> 00:51:06,830 NOT ONLY IN GENERAL PEDIATRICS 1369 00:51:06,830 --> 00:51:10,867 BUT SUBSPECIALTIES, AND WE ARE 1370 00:51:10,867 --> 00:51:15,905 WORKING SEPARATELY WITH 1371 00:51:15,905 --> 00:51:17,207 AMSPEDAC, WITH THE PEDIATRIC 1372 00:51:17,207 --> 00:51:18,408 MEDICAL DEPARTMENT CHAIRS TO 1373 00:51:18,408 --> 00:51:20,977 GIVE THEM INFORMATION AND WORK 1374 00:51:20,977 --> 00:51:24,480 WITH THEM TO PROVIDE EXTRA 1375 00:51:24,480 --> 00:51:26,649 FUNDING SLOTS, WHICH IDEALLY 1376 00:51:26,649 --> 00:51:28,751 SHOULD NOT COME EXCLUSIVELY FROM 1377 00:51:28,751 --> 00:51:30,987 NICHD, AND WE WILL BE PRESENTING 1378 00:51:30,987 --> 00:51:33,156 TO THEM LATER THIS MONTH WITH 1379 00:51:33,156 --> 00:51:35,124 SOME DATA THAT HAVE BEEN 1380 00:51:35,124 --> 00:51:38,328 REFRESHED TO SHOW EXACTLY HOW 1381 00:51:38,328 --> 00:51:41,197 MUCH EACH INSTITUTE IS 1382 00:51:41,197 --> 00:51:44,901 COMMITTING TOWARDS TRAINING OF 1383 00:51:44,901 --> 00:51:45,568 PEDIATRICIANS, AND WE'RE GOING 1384 00:51:45,568 --> 00:51:47,804 TO TRY TO DO WHATEVER WE CAN TO 1385 00:51:47,804 --> 00:51:48,905 ADDRESS THIS ISSUE. 1386 00:51:48,905 --> 00:51:50,106 BUT A LOT OF THE PROBLEMS AS YOU 1387 00:51:50,106 --> 00:51:53,877 KNOW HAVE TO DO WITH SALARY 1388 00:51:53,877 --> 00:51:56,713 DISCREPANCIES FOR PEDIATRIC 1389 00:51:56,713 --> 00:51:59,549 RESIDENTS AND OTHER ISSUES. 1390 00:51:59,549 --> 00:52:01,784 HOWEVER, AS I BELIEVE I'VE 1391 00:52:01,784 --> 00:52:02,886 MENTIONED IN THE LAST COUNCIL 1392 00:52:02,886 --> 00:52:06,256 MEETING, WE HAVE INCREASED OUR 1393 00:52:06,256 --> 00:52:08,124 SUPPORT OF THE LOAN REPAYMENT 1394 00:52:08,124 --> 00:52:09,392 PROGRAM FOR PEDIATRIC 1395 00:52:09,392 --> 00:52:14,330 RESEARCHERS BY 28% IN FISCAL 1396 00:52:14,330 --> 00:52:15,765 YEAR 24 OVER FISCAL YEE 23. 1397 00:52:15,765 --> 00:52:20,203 FISCAL YEAR 23.IS THAT CORRECT? 1398 00:52:20,203 --> 00:52:21,137 THAT WAS ON THE SLIDE. 1399 00:52:21,137 --> 00:52:22,238 I'M JUST CHECKING ON THE YEARS. 1400 00:52:22,238 --> 00:52:23,973 WE'RE IN FISCAL YEAR 25 NOW, SO 1401 00:52:23,973 --> 00:52:26,743 IT WAS FISCAL YEAR 24 OVER 23, 1402 00:52:26,743 --> 00:52:28,611 WE SIGNIFICANTLY INCREASED OUR 1403 00:52:28,611 --> 00:52:30,613 COMMITMENT TO THE PEDIATRIC LOAN 1404 00:52:30,613 --> 00:52:31,047 REPAYMENT PROGRAM. 1405 00:52:31,047 --> 00:52:34,684 SO WE'RE DOING WHAT WE CAN WITH 1406 00:52:34,684 --> 00:52:36,052 NOT HAVING A BUDGET, FOR 1407 00:52:36,052 --> 00:52:37,287 EXAMPLE. 1408 00:52:37,287 --> 00:52:38,755 I JUST WANT TO MAKE NOTE OF THE 1409 00:52:38,755 --> 00:52:42,158 FACT THAT REBEKAH RASOOLY PUT A 1410 00:52:42,158 --> 00:52:43,893 NOTE IN THE CHAT BOX THAT WE 1411 00:52:43,893 --> 00:52:45,662 HAVE ONE ADDITIONAL OB-GYN WHO 1412 00:52:45,662 --> 00:52:48,731 WILL BE JOINING US AT THE JUNE 1413 00:52:48,731 --> 00:52:49,065 COUNCIL. 1414 00:52:49,065 --> 00:52:56,072 SO THAT WILL MAKE FOUR OUT OF 1415 00:52:56,072 --> 00:52:57,974 18, SO ROUGHLY A QUARTER OF OUR 1416 00:52:57,974 --> 00:52:59,509 COUNCILMEMBERS WILL BE 1417 00:52:59,509 --> 00:53:09,652 OB-GYNs. 1418 00:53:13,256 --> 00:53:14,424 WE'RE DOING WELL ON TIMING. 1419 00:53:14,424 --> 00:53:16,192 YOU WILL GET MORE TIME IN YOUR 1420 00:53:16,192 --> 00:53:17,260 BREAK UNLESS YOU HAVE QUESTIONS. 1421 00:53:17,260 --> 00:53:26,703 HAPPY TO ANSWER QUESTIONS. 1422 00:53:26,703 --> 00:53:27,070 OKAY. 1423 00:53:27,070 --> 00:53:27,937 WELL, THANK YOU FOR YOUR 1424 00:53:27,937 --> 00:53:28,204 QUESTIONS. 1425 00:53:28,204 --> 00:53:29,272 OF COURSE WE'RE ALWAYS AVAILABLE 1426 00:53:29,272 --> 00:53:31,741 TO ANSWER YOUR QUESTIONS OFFLINE 1427 00:53:31,741 --> 00:53:33,776 AS WELL. 1428 00:53:33,776 --> 00:53:40,450 AND WITH THAT, WE ARE GOING TO 1429 00:53:40,450 --> 00:53:41,985 GO TO THE BUDGET REPORT. 1430 00:53:41,985 --> 00:53:45,388 SO I WOULD NOW LIKE TO ADDRESS 1431 00:53:45,388 --> 00:53:46,422 MS. ALEXIS CLARKE, WHO'S GOING 1432 00:53:46,422 --> 00:53:48,791 TO GIVE AN OVERVIEW OF THE NICHD 1433 00:53:48,791 --> 00:53:49,025 BUDGET. 1434 00:53:49,025 --> 00:53:50,994 I CAN SAY THAT WHEN I WAS ON THE 1435 00:53:50,994 --> 00:53:54,931 ADVISORY COUNCIL, ALEXIS' TALK 1436 00:53:54,931 --> 00:53:57,667 WAS THE SINGLE MOST INFORMATIVE 1437 00:53:57,667 --> 00:54:01,704 TALK I HEARD IN MY FOUR YEARS ON 1438 00:54:01,704 --> 00:54:02,171 COUNCIL. 1439 00:54:02,171 --> 00:54:04,407 SO SHE IS THE NICHD BUDGET 1440 00:54:04,407 --> 00:54:06,476 OFFICER, AND SHE IS CHIEF OF THE 1441 00:54:06,476 --> 00:54:10,413 FINANCIAL MANAGEMENT BRANCH, AND 1442 00:54:10,413 --> 00:54:12,615 SHE DOES AN OUTSTANDING JOB. 1443 00:54:12,615 --> 00:54:16,352 I DON'T THINK PEOPLE REALIZE HOW 1444 00:54:16,352 --> 00:54:17,653 COMPLEX IT IS, ESPECIALLY WHEN 1445 00:54:17,653 --> 00:54:20,723 THERE'S A CONTINUING RESOLUTION. 1446 00:54:20,723 --> 00:54:22,825 BECAUSE SHE AND HER STAFF HAVE 1447 00:54:22,825 --> 00:54:27,196 TO MAKE MULTIPLE CONTINGENCIES, 1448 00:54:27,196 --> 00:54:28,965 AND IMAGINE WHAT IT WOULD BE 1449 00:54:28,965 --> 00:54:32,168 LIKE IF WE GOT A 5% REDUCTION IN 1450 00:54:32,168 --> 00:54:33,803 OUR BUDGET, IF WE HAD A FLAT 1451 00:54:33,803 --> 00:54:37,407 BUDGET, IF WE GOT A 1% INCREASE, 1452 00:54:37,407 --> 00:54:37,874 ET CETERA. 1453 00:54:37,874 --> 00:54:42,045 SO WITH THAT, I'D LIKE TO HEAD 1454 00:54:42,045 --> 00:54:43,246 OVER TO ALEXIS. 1455 00:54:43,246 --> 00:54:43,980 THANK YOU. 1456 00:54:43,980 --> 00:54:46,816 >> WELL, NO PRESSURE, I GUESS, 1457 00:54:46,816 --> 00:54:52,355 ON HAVING THE MOST IMPACTFUL 1458 00:54:52,355 --> 00:54:52,688 PRESENTATION. 1459 00:54:52,688 --> 00:54:53,790 I'M TRYING TO FIGURE OUT THE 1460 00:54:53,790 --> 00:54:54,257 CAMERA HERE. 1461 00:54:54,257 --> 00:54:55,124 I DON'T REALLY LIKE THAT. 1462 00:54:55,124 --> 00:54:56,759 I'M GOING TO TRY TURNING ON THE 1463 00:54:56,759 --> 00:54:57,860 CAMERA ON MY COMPUTER. 1464 00:54:57,860 --> 00:54:59,962 WE'LL SEE IF THAT WORKS A LITTLE 1465 00:54:59,962 --> 00:55:02,932 BETTER. 1466 00:55:02,932 --> 00:55:04,801 THERE WE GO. 1467 00:55:04,801 --> 00:55:06,536 IS THAT BETTER FOR FOLKS? 1468 00:55:06,536 --> 00:55:09,305 YOU CAN SEE ME NOW, NOT JUST 1469 00:55:09,305 --> 00:55:09,972 FROM THE SIDE? 1470 00:55:09,972 --> 00:55:12,909 OKAY. 1471 00:55:12,909 --> 00:55:14,777 SO THANK YOU FOR HAVING ME 1472 00:55:14,777 --> 00:55:15,311 TODAY. 1473 00:55:15,311 --> 00:55:17,980 AS DR. BIANCHI SAID, MY NAME IS 1474 00:55:17,980 --> 00:55:18,414 ALEXIS CLARK. 1475 00:55:18,414 --> 00:55:20,049 I AM WHAT WE CALL THE BUDGET 1476 00:55:20,049 --> 00:55:22,251 OFFICER HERE AT NICHD. 1477 00:55:22,251 --> 00:55:24,387 I'M THE CHIEF OF THE FINANCIAL 1478 00:55:24,387 --> 00:55:27,890 MANAGEMENT BRANCH. 1479 00:55:27,890 --> 00:55:30,960 TODAY I'M GOING TO TALK TO YOU A 1480 00:55:30,960 --> 00:55:33,229 LITTLE ABOUT OUR FEDERAL BUDGET 1481 00:55:33,229 --> 00:55:35,898 PROCESS, THE PROCESS WE DO HERE 1482 00:55:35,898 --> 00:55:38,067 AT NIH, AND WE'LL TALK WITH 1483 00:55:38,067 --> 00:55:41,370 SOMETABOUTSOMETHING WE CALL MECM 1484 00:55:41,370 --> 00:55:42,805 TABLE, SOME OF OUR MANDATED 1485 00:55:42,805 --> 00:55:44,474 PROGRAMS, HOW WE DEVELOP OUR 1486 00:55:44,474 --> 00:55:46,542 GRANT BUDGETS AND PAYLINES, SOME 1487 00:55:46,542 --> 00:55:48,444 OF OUR SETASIDES AND THINGS LIKE 1488 00:55:48,444 --> 00:55:48,978 THAT. 1489 00:55:48,978 --> 00:55:50,079 REALLY WHAT I'M GOING TO TALK TO 1490 00:55:50,079 --> 00:55:52,615 YOU ABOUT IS SORT OF HOW WE 1491 00:55:52,615 --> 00:55:54,851 CREATE THE PLANS FOR A FISCAL 1492 00:55:54,851 --> 00:55:56,152 YEAR, HOW WE FIGURE OUT HOW MUCH 1493 00:55:56,152 --> 00:55:59,255 MONEY WE HAVE FOR NEW AWARDS, 1494 00:55:59,255 --> 00:56:02,458 AND HOW WE TRY TO GIVE 1495 00:56:02,458 --> 00:56:03,659 INFORMATION TO LEADERSHIP SO 1496 00:56:03,659 --> 00:56:05,628 THEY CAN MAKE DECISIONS ABOUT 1497 00:56:05,628 --> 00:56:11,801 FUNDING FOR GRANTS. 1498 00:56:11,801 --> 00:56:13,002 SO AGENCIES BEGIN DEVELOPING 1499 00:56:13,002 --> 00:56:14,203 THEIR BUDGETS OVER A YEAR IN 1500 00:56:14,203 --> 00:56:15,138 ADVANCE AT THE BEGINNING OF THE 1501 00:56:15,138 --> 00:56:16,672 FISCAL YEAR, SO WE HAVE BEEN 1502 00:56:16,672 --> 00:56:20,009 WORKING ON THE FY 26 PRESIDENT'S 1503 00:56:20,009 --> 00:56:20,510 BUDGET. 1504 00:56:20,510 --> 00:56:22,245 IT CONTAINS PROPOSALS TO 1505 00:56:22,245 --> 00:56:24,147 CONGRESS WHICH THEY MAY OR MAY 1506 00:56:24,147 --> 00:56:26,249 NOT ADOPT. 1507 00:56:26,249 --> 00:56:27,016 THIS PRESIDENT'S BUDGET IS 1508 00:56:27,016 --> 00:56:28,417 CALLED OUR CONGRESSIONAL 1509 00:56:28,417 --> 00:56:30,887 JUSTIFICATION. 1510 00:56:30,887 --> 00:56:35,158 AND IT'S TRADITIONALLY SEPTEMBEO 1511 00:56:35,158 --> 00:56:36,259 CONGRESS ON THE FIRST MONDAY IN 1512 00:56:36,259 --> 00:56:36,592 FEBRUARY. 1513 00:56:36,592 --> 00:56:38,261 THAT WILL NOT HAPPEN THIS YEAR 1514 00:56:38,261 --> 00:56:39,929 DUE TO HAVING A PRESIDENTIAL 1515 00:56:39,929 --> 00:56:40,229 TRANSITION. 1516 00:56:40,229 --> 00:56:44,300 THERE'S JUST NOT ENOUGH TIME. 1517 00:56:44,300 --> 00:56:45,768 SO THE CJ WILL BE A LITTLE 1518 00:56:45,768 --> 00:56:46,402 DELAYED THIS YEAR. 1519 00:56:46,402 --> 00:56:47,737 THAT PUTS PRESSURE ON CONGRESS 1520 00:56:47,737 --> 00:56:49,805 TO HOLD THEIR APPROPRIATION 1521 00:56:49,805 --> 00:56:51,674 HEARINGS IN THE SPRING. 1522 00:56:51,674 --> 00:56:54,677 AND THE COMMITTEES WILL WORK ON 1523 00:56:54,677 --> 00:56:56,212 MAKING LEGISLATIVE DECISIONS IN 1524 00:56:56,212 --> 00:56:57,847 THE SUMMER. 1525 00:56:57,847 --> 00:56:59,215 THE GOAL, OF COURSE, IS FOR 1526 00:56:59,215 --> 00:57:01,717 CONGRESS TO APPROPRIATE FUNDS BY 1527 00:57:01,717 --> 00:57:02,351 OCTOBER 1ST. 1528 00:57:02,351 --> 00:57:04,153 I WILL SAY I'VE BEEN WORKING IN 1529 00:57:04,153 --> 00:57:05,821 THE GOVERNMENT MORE THAN 25 1530 00:57:05,821 --> 00:57:06,389 YEARS. 1531 00:57:06,389 --> 00:57:09,659 I'VE ONLY SEEN THAT HAPPEN MAYBE 1532 00:57:09,659 --> 00:57:10,960 ONCE. 1533 00:57:10,960 --> 00:57:14,030 SO WHEN THAT DOES NOT HAPPEN, AS 1534 00:57:14,030 --> 00:57:16,265 DR. BIANCHI MENTIONED BEFORE, WE 1535 00:57:16,265 --> 00:57:18,467 HAVE WHAT WE CALL A CONTINUING 1536 00:57:18,467 --> 00:57:20,203 RESOLUTION OR A CR. 1537 00:57:20,203 --> 00:57:22,004 WE ARE CURRENTLY UNDER A CR 1538 00:57:22,004 --> 00:57:25,641 UNTIL MARCH 14TH, AND THE AMOUNT 1539 00:57:25,641 --> 00:57:27,910 OF THE CR IS BASICALLY BASED ON 1540 00:57:27,910 --> 00:57:29,812 A PERCENTAGE OF WHAT WAS 1541 00:57:29,812 --> 00:57:31,514 APPROPRIATED IN THE PREVIOUS 1542 00:57:31,514 --> 00:57:34,417 FISCAL YEAR. 1543 00:57:34,417 --> 00:57:35,518 SO WE'LL SWITCH, WE'LL TALK A 1544 00:57:35,518 --> 00:57:36,719 LITTLE BIT NOW ABOUT BUDGET AT 1545 00:57:36,719 --> 00:57:39,288 NIH. 1546 00:57:39,288 --> 00:57:42,458 SO AT NIH, THERE IS AN OFFICE OF 1547 00:57:42,458 --> 00:57:45,061 BUDGET WITHIN THE NIH OFFICE OF 1548 00:57:45,061 --> 00:57:46,596 THE DIRECTOR. 1549 00:57:46,596 --> 00:57:50,032 THAT OFFICE HAS A LOT OF THE 1550 00:57:50,032 --> 00:57:51,033 CENTRALIZED NIH BUDGET 1551 00:57:51,033 --> 00:57:51,934 INFORMATION. 1552 00:57:51,934 --> 00:57:52,902 THEY COORDINATE INFORMATION FROM 1553 00:57:52,902 --> 00:57:54,971 ALL OF THE 27 ICs. 1554 00:57:54,971 --> 00:57:57,106 THEY ALSO SERVE AS THE MAIN 1555 00:57:57,106 --> 00:58:00,109 CONTACT WITH THE DEPARTMENT OF 1556 00:58:00,109 --> 00:58:00,776 HEALTH AND HUMAN SERVICES, THE 1557 00:58:00,776 --> 00:58:02,678 OFFICE OF MANAGEMENT AND BUDGET, 1558 00:58:02,678 --> 00:58:03,679 AND CONGRESSIONAL APPROPRIATE 1559 00:58:03,679 --> 00:58:06,415 RANGE OF MOTION STAFF. 1560 00:58:06,415 --> 00:58:06,749 APPROPRIATION 1561 00:58:06,749 --> 00:58:06,949 STAFF. 1562 00:58:06,949 --> 00:58:08,284 HERE AT OUR INSTITUTE, WE HAVE 1563 00:58:08,284 --> 00:58:10,186 THE FINANCIAL MANAGEMENT BRANCH. 1564 00:58:10,186 --> 00:58:11,520 EVERY IC HAS THEIR OWN BUDGET 1565 00:58:11,520 --> 00:58:12,955 OFFICE. 1566 00:58:12,955 --> 00:58:14,790 OUR ROLE IS TO PROVIDE ADVICE 1567 00:58:14,790 --> 00:58:18,794 AND GUIDANCE TO LEADERSHIP AND 1568 00:58:18,794 --> 00:58:20,529 STAFF TO DEVELOP SPENDING PLANS 1569 00:58:20,529 --> 00:58:24,700 TO SUPPORT THE IC PRIORITIES. 1570 00:58:24,700 --> 00:58:26,068 TO PROVIDE INFORMATION TO GUIDE 1571 00:58:26,068 --> 00:58:28,037 PLANNING FOR FUTURE YEARS, AND 1572 00:58:28,037 --> 00:58:30,139 THEN TO MONITOR THE SPENDING 1573 00:58:30,139 --> 00:58:32,275 THAT WE DO IN THE FISCAL YEAR 1574 00:58:32,275 --> 00:58:35,177 FOR ADHERENCE TO THE PLAN WE'VE 1575 00:58:35,177 --> 00:58:37,179 LAID OUT AND TO THE FEDERAL 1576 00:58:37,179 --> 00:58:44,353 RULES THAT WE HAVE TO FOLLOW. 1577 00:58:44,353 --> 00:58:46,289 SO ONCE WE GET AN APPROPRIATION, 1578 00:58:46,289 --> 00:58:47,590 WE CREATE WHAT WE CALL AN 1579 00:58:47,590 --> 00:58:48,491 OPERATING PLAN AND THAT IS 1580 00:58:48,491 --> 00:58:50,393 REALLY THE PLAN FOR OUR YEAR, AS 1581 00:58:50,393 --> 00:58:52,495 WE FINISH OUT THE YEAR, WE WILL 1582 00:58:52,495 --> 00:58:54,263 RECONCILE WHAT ACTUALLY HAPPENED 1583 00:58:54,263 --> 00:58:56,098 COMPARED TO THE PLAN. 1584 00:58:56,098 --> 00:58:57,633 BUT THE PLAN IS VERY IMPORTANT 1585 00:58:57,633 --> 00:59:00,503 BECAUSE WE ARE PROHIBITED FROM 1586 00:59:00,503 --> 00:59:01,637 OVERSPENDING WHAT IS 1587 00:59:01,637 --> 00:59:03,372 APPROPRIATED TO US FROM 1588 00:59:03,372 --> 00:59:05,041 CONGRESS, AND WE DO TRY TO SPEND 1589 00:59:05,041 --> 00:59:07,810 AS MUCH AS POSSIBLE AND GET AS 1590 00:59:07,810 --> 00:59:10,413 CLOSE AS WE CAN BECAUSE ANY 1591 00:59:10,413 --> 00:59:11,947 UNSPENT FUNDS USUALLY ARE NOT 1592 00:59:11,947 --> 00:59:14,183 AVAILABLE TO US ONCE WE GET INTO 1593 00:59:14,183 --> 00:59:20,856 THE NEXT FISCAL YEAR. 1594 00:59:20,856 --> 00:59:22,825 SO THE PLAN FOR THE YEAR IS 1595 00:59:22,825 --> 00:59:24,427 DISPLAYED IN DETAIL ON WHAT WE 1596 00:59:24,427 --> 00:59:25,728 CALL A MECHANISM TABLE. 1597 00:59:25,728 --> 00:59:27,697 THE MECHANISM TABLE SHOWS HOW 1598 00:59:27,697 --> 00:59:29,065 THE IC WILL USE THE BUDGET THAT 1599 00:59:29,065 --> 00:59:30,499 WE'RE GIVEN. 1600 00:59:30,499 --> 00:59:32,034 GRANTS, CONTRACTS, INTRAMURAL 1601 00:59:32,034 --> 00:59:33,135 RESEARCH, OTHER ADMINISTRATIVE 1602 00:59:33,135 --> 00:59:34,170 COSTS. 1603 00:59:34,170 --> 00:59:35,805 IT'S DEVELOPED INITIALLY AS PART 1604 00:59:35,805 --> 00:59:37,139 OF THE PRESIDENT'S BUDGET AND 1605 00:59:37,139 --> 00:59:39,775 THEN WE REVISE TO REFLECT 1606 00:59:39,775 --> 00:59:41,277 CHANGES IN THE ACTUAL 1607 00:59:41,277 --> 00:59:42,778 APPROPRIATION OR THE OPERATING 1608 00:59:42,778 --> 00:59:44,080 PLAN. 1609 00:59:44,080 --> 00:59:45,614 WE UPDATE IT THROUGHOUT THE YEAR 1610 00:59:45,614 --> 00:59:48,284 AND THEN AS I SAID, WE RECONCILE 1611 00:59:48,284 --> 00:59:50,286 OUR FINAL SPENDING, ALSO IN A 1612 00:59:50,286 --> 00:59:51,921 MECHANISM FORMAT. 1613 00:59:51,921 --> 00:59:55,424 THE MECHANISM TABLE ALLOWS 1614 00:59:55,424 --> 00:59:56,992 COMPARISONS SORT OF ACROSS NIH 1615 00:59:56,992 --> 00:59:58,961 BECAUSE THE INSTITUTES REALLY 1616 00:59:58,961 --> 01:00:00,496 ARE DIFFERENT IN THE WAY THAT 1617 01:00:00,496 --> 01:00:06,736 THEY SUPPORT SCIENCE. 1618 01:00:06,736 --> 01:00:08,637 SO THIS IS A MECHANISM TABLE 1619 01:00:08,637 --> 01:00:11,040 THAT SHOWS OUR ACTUAL SPENDING 1620 01:00:11,040 --> 01:00:13,476 FROM FISCAL YEAR 23 AND 24. 1621 01:00:13,476 --> 01:00:16,679 YOU CAN SEE THAT IT IS SORT OF 1622 01:00:16,679 --> 01:00:19,081 SEGMENTED OUT INTO TYPES OF 1623 01:00:19,081 --> 01:00:21,717 GRANTS AT THE TOP. 1624 01:00:21,717 --> 01:00:23,786 RESEARCH PROJECT GRANTS, SMALL 1625 01:00:23,786 --> 01:00:26,689 BUSINESS, OUR CENTERS, YOU CAN 1626 01:00:26,689 --> 01:00:28,858 SEE RESEARCH CAREERS OR K 1627 01:00:28,858 --> 01:00:29,191 GRANTS. 1628 01:00:29,191 --> 01:00:34,764 WE HAVE OUR TRAINING GRANTS, R & 1629 01:00:34,764 --> 01:00:36,766 D CONTRACTS, INTRAMURAL RESEARCH 1630 01:00:36,766 --> 01:00:39,335 AND THEN AT THE BOTTOM, WE HAVE 1631 01:00:39,335 --> 01:00:40,202 RESEARCH MANAGEMENT AND SUPPORT 1632 01:00:40,202 --> 01:00:41,670 WHICH IS REALLY THE 1633 01:00:41,670 --> 01:00:42,972 ADMINISTRATIVE COSTS FOR 1634 01:00:42,972 --> 01:00:44,940 EVERYONE WHO DOESN'T WORK IN 1635 01:00:44,940 --> 01:00:45,374 INTRAMURAL RESEARCH. 1636 01:00:45,374 --> 01:00:47,643 YOU CAN SEE THAT WE DID HAVE A 1637 01:00:47,643 --> 01:00:53,649 SMALL BUDGET INCREASE OF ABOUT 1638 01:00:53,649 --> 01:00:56,585 $10 MILLION FROM FY 23 INTO FY 1639 01:00:56,585 --> 01:00:56,752 24. 1640 01:00:56,752 --> 01:00:58,387 IS THAT MONEY WAS REALLY TARTED 1641 01:00:58,387 --> 01:01:00,122 AT OUR IMPROVE PROGRAM 1642 01:01:00,122 --> 01:01:03,325 SPECIFICALLY BY CONGRESS. 1643 01:01:03,325 --> 01:01:05,094 WE DO TRY TO INCREASE OUR 1644 01:01:05,094 --> 01:01:06,262 TRAINING SPENDING. 1645 01:01:06,262 --> 01:01:09,732 WHEN WE HAVE INCREASES IN 1646 01:01:09,732 --> 01:01:11,066 APPROPRIATION, YOU CAN ALSO TELL 1647 01:01:11,066 --> 01:01:12,635 WE HAD A SIGNIFICANT AMOUNT OF 1648 01:01:12,635 --> 01:01:15,271 HIRING IN FY 24 WHICH INCREASED 1649 01:01:15,271 --> 01:01:23,045 OUR ADMINISTRATIVE SPENDING. 1650 01:01:23,045 --> 01:01:25,481 THIS IS JUST A PIE CHART SHOWING 1651 01:01:25,481 --> 01:01:26,382 THE FY 24 INFORMATION. 1652 01:01:26,382 --> 01:01:31,187 CAN YOU SEE WE SPEND 55% OF OUR 1653 01:01:31,187 --> 01:01:36,225 BUDGET ON RESEARCH PROJECT 1654 01:01:36,225 --> 01:01:37,793 GRANTS, ABOUT 5% ON THOSE 1655 01:01:37,793 --> 01:01:39,762 ADMINISTRATIVE COSTS, 13% ON 1656 01:01:39,762 --> 01:01:41,197 INTRAMURAL RESEARCH, AND THEN 1657 01:01:41,197 --> 01:01:42,765 THOSE OTHER GRANT CATEGORIES AND 1658 01:01:42,765 --> 01:01:45,835 THE R & D CONTRACTS ARE ALL LESS 1659 01:01:45,835 --> 01:01:54,910 THAN 10%. 1660 01:01:54,910 --> 01:01:56,011 SO WHEN WE'RE LOOKING AT 1661 01:01:56,011 --> 01:01:58,280 BUILDING A BUDGET, THERE'S ALSO 1662 01:01:58,280 --> 01:01:58,814 OTHER THINGS WE HAVE TO 1663 01:01:58,814 --> 01:02:02,651 CONSIDER. 1664 01:02:02,651 --> 01:02:04,053 ONE OF THOSE IMPORTANT THINGS IS 1665 01:02:04,053 --> 01:02:07,556 OUR MANDATED PROGRAM. 1666 01:02:07,556 --> 01:02:08,858 SO WITHIN OUR APPROPRIATION, 1667 01:02:08,858 --> 01:02:10,693 NICHD IS AN INSTITUTE THAT 1668 01:02:10,693 --> 01:02:11,660 PARTICIPATES IN AIDS FUNDING. 1669 01:02:11,660 --> 01:02:14,330 SO LAST YEAR, IN 24, WE WERE 1670 01:02:14,330 --> 01:02:17,733 REQUIRED TO SPEND ABOUT 1671 01:02:17,733 --> 01:02:19,468 $153 MILLION OF OUR 1672 01:02:19,468 --> 01:02:21,070 APPROPRIATION ON AIDS RESEARCH, 1673 01:02:21,070 --> 01:02:25,441 AND ALL OF THAT FUNDING BY THE 1674 01:02:25,441 --> 01:02:26,876 NIH OFFICE OF AIDS RESEARCH AND 1675 01:02:26,876 --> 01:02:29,078 ALL OF THE GRANTS AND PROJECTS 1676 01:02:29,078 --> 01:02:33,182 FUNDED MUST SORT OF HIT NIH AIDS 1677 01:02:33,182 --> 01:02:36,352 PRIORITY RESEARCH AREAS. 1678 01:02:36,352 --> 01:02:40,723 WE ALSO ARE REQUIRED TO SPEND A 1679 01:02:40,723 --> 01:02:42,057 PORTION OF OUR APPROPRIATION ON 1680 01:02:42,057 --> 01:02:42,958 SMALL BUSINESS INNOVATION 1681 01:02:42,958 --> 01:02:44,493 RESEARCH AND SMALL BUSINESS 1682 01:02:44,493 --> 01:02:47,463 TECHNOLOGY TRANSFER PROGRAMS. 1683 01:02:47,463 --> 01:02:50,032 WE USUALLY ABBREVIATE THAT TO 1684 01:02:50,032 --> 01:02:51,934 SBIR AND STTR. 1685 01:02:51,934 --> 01:02:53,402 LAST YEAR THAT WAS ABOUT 1686 01:02:53,402 --> 01:02:54,169 $52 MILLION. 1687 01:02:54,169 --> 01:02:55,771 AND THOSE ARE REQUIREMENTS AND 1688 01:02:55,771 --> 01:02:58,607 WE TRACK THOSE ACROSS ALL OF OUR 1689 01:02:58,607 --> 01:03:00,809 AREAS FOR THE FISCAL YEAR. 1690 01:03:00,809 --> 01:03:02,845 WE ALSO THEN ARE ALSO LOOKING AT 1691 01:03:02,845 --> 01:03:05,147 OUR NON-GRANT MECHANISMS EVERY 1692 01:03:05,147 --> 01:03:05,848 YEAR. 1693 01:03:05,848 --> 01:03:08,517 PERSONNEL COSTS, PAY RAISES FOR 1694 01:03:08,517 --> 01:03:11,353 STAFF, HIRING, PRINCIPAL 1695 01:03:11,353 --> 01:03:12,655 INVESTIGATORS WHO ARE BEING 1696 01:03:12,655 --> 01:03:14,423 RECRUITED INTO THE INTRAMURAL 1697 01:03:14,423 --> 01:03:14,823 PROGRAM. 1698 01:03:14,823 --> 01:03:17,026 WE HAVE MANDATED INCREASES IN 1699 01:03:17,026 --> 01:03:19,161 WHAT WE CALL OUR NIH ASSESSMENT, 1700 01:03:19,161 --> 01:03:22,398 SO THOSE ARE TRANS-NIH COSTS 1701 01:03:22,398 --> 01:03:24,199 THAT EVERY INSTITUTE HELPS TO 1702 01:03:24,199 --> 01:03:25,367 PAY FOR. 1703 01:03:25,367 --> 01:03:28,971 THINGS LIKE CYBERSECURITY, THE 1704 01:03:28,971 --> 01:03:30,706 CLINICAL CENTER, ANY RENOVATIONS 1705 01:03:30,706 --> 01:03:32,241 TO OUR LAB SPACE OR 1706 01:03:32,241 --> 01:03:35,911 ADMINISTRATIVE BUILDINGS, AND 1707 01:03:35,911 --> 01:03:37,112 OUR IC SERVICES THAT ARE 1708 01:03:37,112 --> 01:03:39,648 PROVIDED BY OUR ICs SUCH AS 1709 01:03:39,648 --> 01:03:40,716 INFORMATION TECHNOLOGY AND 1710 01:03:40,716 --> 01:03:43,752 COMMUNICATIONS. 1711 01:03:43,752 --> 01:03:45,287 WE ALSO ARE ALWAYS TRYING TO 1712 01:03:45,287 --> 01:03:47,556 PLAN FOR THE UNEXPECTED. 1713 01:03:47,556 --> 01:03:52,995 AS DR. BIANCHI ALLUDED TO. 1714 01:03:52,995 --> 01:03:54,730 SO RESCISSIONS ARE WHEN THE 1715 01:03:54,730 --> 01:03:56,165 CONGRESS MAKES REDUCTIONS TO OUR 1716 01:03:56,165 --> 01:03:56,599 BUDGET. 1717 01:03:56,599 --> 01:04:00,069 THAT CAN HAPPEN, AND YOU NEVER 1718 01:04:00,069 --> 01:04:01,604 KNOW WHAT THEY'RE GOING TO DO 1719 01:04:01,604 --> 01:04:02,104 HONESTLY. 1720 01:04:02,104 --> 01:04:04,773 WE HAVE OTHER TYPES OF 1721 01:04:04,773 --> 01:04:05,941 ASSESSMENTS OUTSIDE NIH 1722 01:04:05,941 --> 01:04:07,309 INCLUDING FOR THE DEPARTMENT OF 1723 01:04:07,309 --> 01:04:07,843 HEALTH AND HUMAN SERVICES. 1724 01:04:07,843 --> 01:04:10,312 THERE CAN BE UNEXPECTED NEEDS 1725 01:04:10,312 --> 01:04:12,448 AND EMERGENCIES SUCH AS COVID-19 1726 01:04:12,448 --> 01:04:14,650 OR ZIKA, FOR EXAMPLE. 1727 01:04:14,650 --> 01:04:17,286 AND WE DO HAVE TO FIGURE OUT HOW 1728 01:04:17,286 --> 01:04:19,688 TO ACCOMMODATE NEW NIH POLICIES 1729 01:04:19,688 --> 01:04:22,157 THAT WE DON'T CONTROL GENERALLY 1730 01:04:22,157 --> 01:04:23,592 THAT INCREASE PERCENTAGE FOR 1731 01:04:23,592 --> 01:04:24,660 TRAINING STIPENDS, SO WE'RE 1732 01:04:24,660 --> 01:04:26,362 ALWAYS TRYING TO PREDICT WHAT 1733 01:04:26,362 --> 01:04:27,997 THAT DECISION WILL BE. 1734 01:04:27,997 --> 01:04:30,432 AND THEN WE ALSO NEED TO ADAPT 1735 01:04:30,432 --> 01:04:32,501 FOR NEW LEGISLATIVE OR POLICY 1736 01:04:32,501 --> 01:04:35,971 MANDATES SUCH AS OUR IMPROV 1737 01:04:35,971 --> 01:04:37,573 PROGRAM AND WE USUALLY HAVE SOME 1738 01:04:37,573 --> 01:04:41,543 AMOUNT OF SAVINGS EVERY YEAR AND 1739 01:04:41,543 --> 01:04:42,711 SO WE'RE ALWAYS TRYING TO 1740 01:04:42,711 --> 01:04:43,679 PROJECT HOW MUCH THAT WILL BE IN 1741 01:04:43,679 --> 01:04:49,818 A GIVEN FISCAL YEAR. 1742 01:04:49,818 --> 01:04:52,388 THIS IS JUST A SNAPSHOT FOR 1743 01:04:52,388 --> 01:04:55,024 FOLKS OF OUR INTRAMURAL AND OUR 1744 01:04:55,024 --> 01:04:56,358 RMS BUDGETS JUST TO SHOW YOU HOW 1745 01:04:56,358 --> 01:04:57,993 MUCH WE ARE SPENDING ON 1746 01:04:57,993 --> 01:04:59,161 STAFFING, AS WELL AS OUR 1747 01:04:59,161 --> 01:05:00,362 ASSESSMENTS. 1748 01:05:00,362 --> 01:05:02,798 AND THEN THE OTHER CATEGORY, 1749 01:05:02,798 --> 01:05:04,400 WHICH INCLUDES THINGS LIKE 1750 01:05:04,400 --> 01:05:06,235 SUPPLIES, EQUIPMENT, TRAVEL, 1751 01:05:06,235 --> 01:05:08,537 TRAINING, ET CETERA. 1752 01:05:08,537 --> 01:05:11,240 AS YOU CAN SEE IN THE INTRAMURAL 1753 01:05:11,240 --> 01:05:13,409 RESEARCH SIDE OF THE PIE, THOSE 1754 01:05:13,409 --> 01:05:14,943 KINDS OF OTHER COSTS ARE A LOT 1755 01:05:14,943 --> 01:05:17,279 HIGHER THAN ON THE RESEARCH 1756 01:05:17,279 --> 01:05:18,547 MANAGEMENT AND SUPPORT SIDE, 1757 01:05:18,547 --> 01:05:20,282 WHERE SALARIES ARE REALLY OUR 1758 01:05:20,282 --> 01:05:27,489 BIGGEST COST. 1759 01:05:27,489 --> 01:05:30,459 SO I'M GOING TO SHIFT NOW INTO 1760 01:05:30,459 --> 01:05:31,660 OUR GRANT BUDGETS, WHICH IS 1761 01:05:31,660 --> 01:05:32,728 USUALLY WHAT FOLKS ARE MOST 1762 01:05:32,728 --> 01:05:35,230 INTERESTED IN. 1763 01:05:35,230 --> 01:05:37,433 SO WHEN WE'RE LOOKING AT 1764 01:05:37,433 --> 01:05:39,301 DEVELOPING A BUDGET FOR OUR 1765 01:05:39,301 --> 01:05:40,769 GRANTS, WE REALLY HAVE A LOT OF 1766 01:05:40,769 --> 01:05:41,670 FACTORS TO TAKE INTO 1767 01:05:41,670 --> 01:05:42,971 CONSIDERATION. 1768 01:05:42,971 --> 01:05:45,274 AS YOU MAY HAVE SPOTTED ON OUR 1769 01:05:45,274 --> 01:05:48,610 MECHANISM SLIDE, WE HAVE OVER 1770 01:05:48,610 --> 01:05:50,479 $700 MILLION IN NONCOMPETING 1771 01:05:50,479 --> 01:05:51,880 COMMITMENTS AT THE START OF THE 1772 01:05:51,880 --> 01:05:55,084 FISCAL YEAR RIGHT NOW. 1773 01:05:55,084 --> 01:05:57,219 SO THAT'S A BIG CHUNK OF WHAT 1774 01:05:57,219 --> 01:05:59,088 WE'RE PROJECTING WILL NEED TO BE 1775 01:05:59,088 --> 01:06:00,189 PAID THIS YEAR. 1776 01:06:00,189 --> 01:06:03,726 WE'RE ALSO LOOKING AT OUR RFA 1777 01:06:03,726 --> 01:06:06,729 COMMITMENTS THAT WE'VE ALREADY 1778 01:06:06,729 --> 01:06:09,231 ANNOUNCED, AND COFUNDING 1779 01:06:09,231 --> 01:06:10,332 COMMITMENTS FOR TRANS-NIH 1780 01:06:10,332 --> 01:06:11,500 INITIATIVES SUCH AS THE 1781 01:06:11,500 --> 01:06:12,901 BLUEPRINT FOR NEUROSCIENCE, THE 1782 01:06:12,901 --> 01:06:15,337 BRAIN INITIATIVE, OR CENTERS FOR 1783 01:06:15,337 --> 01:06:16,205 AIDS RESEARCH. 1784 01:06:16,205 --> 01:06:19,908 WE DO ALSO TRY TO SET ASIDE 1785 01:06:19,908 --> 01:06:21,977 FUNDS AND TARGET ESIs, EARLY 1786 01:06:21,977 --> 01:06:24,279 STAGE INVESTIGATORS, AND THEN 1787 01:06:24,279 --> 01:06:25,781 WHEN YOU TAKE INTO ACCOUNT THAT 1788 01:06:25,781 --> 01:06:29,284 WE'RE SPENDING MORE THAN 1789 01:06:29,284 --> 01:06:30,686 $300 MILLION ON INTRAMURAL AND 1790 01:06:30,686 --> 01:06:32,788 OTHER ADMINISTRATIVE EXPENSES, 1791 01:06:32,788 --> 01:06:36,391 WE REALLY HAVE ROUGHLY 1792 01:06:36,391 --> 01:06:38,227 $200 MILLION OR LESS EACH YEAR 1793 01:06:38,227 --> 01:06:40,429 FOR NEW INVESTIGATOR INITIATED 1794 01:06:40,429 --> 01:06:42,798 APPLICATIONS. 1795 01:06:42,798 --> 01:06:46,068 WE'RE ALSO VERY COGNIZANT OF 1796 01:06:46,068 --> 01:06:48,170 SUPPORTING FUNDING COMMITMENTS 1797 01:06:48,170 --> 01:06:51,206 WE'VE MADE, SO OUR NATIONAL 1798 01:06:51,206 --> 01:06:52,941 CENTER FOR MEDICAL 1799 01:06:52,941 --> 01:06:54,476 REHABILITATION RESEARCH IS 1800 01:06:54,476 --> 01:06:56,545 GENERALLY PROVIDED 6 1/2% OF OUR 1801 01:06:56,545 --> 01:06:59,448 EXTRAMURAL FUNDING FOR THEIR 1802 01:06:59,448 --> 01:06:59,681 SCIENCE. 1803 01:06:59,681 --> 01:07:02,084 WE ALSO LOOK AT OUR TRAINING 1804 01:07:02,084 --> 01:07:04,052 MECHANISMS, THE T, F AND K 1805 01:07:04,052 --> 01:07:05,754 GRANTS FOR THOSE FAMILIAR WITH 1806 01:07:05,754 --> 01:07:07,656 ACTIVITY CODES, AND WE TRY TO 1807 01:07:07,656 --> 01:07:09,491 TARGET ABOUT 6% OF OUR 1808 01:07:09,491 --> 01:07:11,193 EXTRAMURAL FUNDING TO THOSE 1809 01:07:11,193 --> 01:07:18,667 AREAS AS WELL. 1810 01:07:18,667 --> 01:07:20,636 SO PUTTING ALL OF THIS TOGETHER, 1811 01:07:20,636 --> 01:07:22,070 OUR NIH LEADERSHIP IS PROVIDING 1812 01:07:22,070 --> 01:07:27,943 GUIDANCE ON OVERALL LEVELS LEVER 1813 01:07:27,943 --> 01:07:28,977 THINGS YOU'LL SEE HERE ON THE 1814 01:07:28,977 --> 01:07:29,478 LEFT-HAND SIDE. 1815 01:07:29,478 --> 01:07:31,613 SO SUPPLEMENTS, BOTH DIVERSITY 1816 01:07:31,613 --> 01:07:33,682 SUPPLEMENTS, AND REGULAR 1817 01:07:33,682 --> 01:07:34,249 ADMINISTRATIVE SUPPLEMENTS, 1818 01:07:34,249 --> 01:07:35,217 WHETHER OR NOT WE SHOULD HAVE 1819 01:07:35,217 --> 01:07:37,953 ANY REDUCTIONS TO OUR 1820 01:07:37,953 --> 01:07:39,688 R01 APPLICATIONS, OUR RFAs OR 1821 01:07:39,688 --> 01:07:40,789 OUR NONCOMPETING GRANTS. 1822 01:07:40,789 --> 01:07:43,158 THEY HELP PROVIDE GUIDANCE ON 1823 01:07:43,158 --> 01:07:44,359 COLLABORATIONS WE'RE DOING, BOTH 1824 01:07:44,359 --> 01:07:46,662 FUNDS COMING IN TO THE IC AND 1825 01:07:46,662 --> 01:07:48,931 FUNDS LEAVING THE IC. 1826 01:07:48,931 --> 01:07:50,799 AND WE ALSO, EVERY YEAR, HAVE A 1827 01:07:50,799 --> 01:07:52,301 SMALL AMOUNT OF MONEY WE SET 1828 01:07:52,301 --> 01:07:54,136 ASIDE FOR WHAT WE CALL OUR 1829 01:07:54,136 --> 01:07:56,438 DIRECTOR'S RESERVES TO HELP US 1830 01:07:56,438 --> 01:07:57,439 ADDRESS PRIORITY AREAS THAT WE 1831 01:07:57,439 --> 01:07:58,941 MAY NOT HAVE KNOWN ABOUT AT THE 1832 01:07:58,941 --> 01:08:01,543 START OF THE FISCAL YEAR. 1833 01:08:01,543 --> 01:08:03,745 SO AS I SAID, WE LOOK AT OUR -- 1834 01:08:03,745 --> 01:08:06,014 ALSO LOOK AT OUR NONCOMPETING 1835 01:08:06,014 --> 01:08:06,849 COMMITMENTS. 1836 01:08:06,849 --> 01:08:08,283 THERE ARE ON OCCASION SOME 1837 01:08:08,283 --> 01:08:11,053 THINGS WHICH CANNOT BE PAID THAT 1838 01:08:11,053 --> 01:08:13,121 FACTORS INTO OUR SAVINGS, AND WE 1839 01:08:13,121 --> 01:08:16,391 SET ASIDE FUND FOR SOME OF OUR 1840 01:08:16,391 --> 01:08:17,793 TAPS AND ASSESSMENTS AND MAKE 1841 01:08:17,793 --> 01:08:19,528 SURE WE'RE MEETING OUR 1842 01:08:19,528 --> 01:08:20,262 CONGRESSIONALLY MANDATED 1843 01:08:20,262 --> 01:08:21,597 PROGRAMS SUCH AS AIDS AND 1844 01:08:21,597 --> 01:08:23,866 IMPROVE. 1845 01:08:23,866 --> 01:08:27,169 WE LOOK AT THESE EVERY YEAR. 1846 01:08:27,169 --> 01:08:32,708 AND CONSTANTLY RE-EVALUATING. 1847 01:08:32,708 --> 01:08:33,775 WHEN IT COMES TO FIGURING OUT 1848 01:08:33,775 --> 01:08:35,777 HOW MUCH WE HAVE FOR 1849 01:08:35,777 --> 01:08:39,181 INVESTIGATOR INITIATED PROJECTS, 1850 01:08:39,181 --> 01:08:40,916 WE ARE LOOKING AT ALL OF THE 1851 01:08:40,916 --> 01:08:42,317 FUNDS WE HAVE FOR THE YEAR AFTER 1852 01:08:42,317 --> 01:08:44,887 ALL OF OUR SETASIDES, ALL OF OUR 1853 01:08:44,887 --> 01:08:46,488 OTHER COSTS ARE PAID, AND WE 1854 01:08:46,488 --> 01:08:47,890 REALLY LOOK AT THE HISTORICAL 1855 01:08:47,890 --> 01:08:50,058 FUNDING AND LOOK AT A THREE-YEAR 1856 01:08:50,058 --> 01:08:52,027 AVERAGE TO TRY TO FIGURE OUT 1857 01:08:52,027 --> 01:08:54,096 ROUGHLY WHAT PERCENTAGE OF OUR 1858 01:08:54,096 --> 01:08:56,064 MONEY IS SPENT IN EACH COUNCIL 1859 01:08:56,064 --> 01:08:57,933 ROUND, AND THEN DIVIDE THE FUNDS 1860 01:08:57,933 --> 01:08:59,868 AVAILABLE FOR THE YEAR USING 1861 01:08:59,868 --> 01:09:01,270 THAT SPENDING PATTERN. 1862 01:09:01,270 --> 01:09:03,272 AND WE REVIEW APPLICATIONS AT 1863 01:09:03,272 --> 01:09:05,307 DIFFERENT SCORE BREAKS TO TRY TO 1864 01:09:05,307 --> 01:09:08,043 ASSESS COST AND FIGURE OUT AN 1865 01:09:08,043 --> 01:09:10,012 ALLOCATION WHICH CAN BE 1866 01:09:10,012 --> 01:09:11,246 CONSISTENT ACROSS THE COUNCIL 1867 01:09:11,246 --> 01:09:11,780 ROUNDS. 1868 01:09:11,780 --> 01:09:13,949 WE REALLY TRY IN THE BUDGET 1869 01:09:13,949 --> 01:09:16,785 OFFICE NOT TO DISADVANTAGE AN 1870 01:09:16,785 --> 01:09:18,086 INVESTIGATOR SIMPLY BECAUSE OF 1871 01:09:18,086 --> 01:09:20,188 WHICH RECEIPT DATE THEY SENT 1872 01:09:20,188 --> 01:09:21,056 THEIR APPLICATION IN. 1873 01:09:21,056 --> 01:09:23,091 YOU KNOW, WE DON'T WANT TO 1874 01:09:23,091 --> 01:09:25,160 PROVIDE SO MUCH FUNDING TO 1875 01:09:25,160 --> 01:09:26,595 OCTOBER COUNCIL FOR EXAMPLE, 1876 01:09:26,595 --> 01:09:29,164 THEN WHEN WE GET TO JUNE, WE 1877 01:09:29,164 --> 01:09:32,801 CAN'T HAVE SORT OF AN EVEN AWARD 1878 01:09:32,801 --> 01:09:34,436 STRUCTURE BASED -- FOR FOLKS WHO 1879 01:09:34,436 --> 01:09:37,272 GOT THE SAME SCORE. 1880 01:09:37,272 --> 01:09:39,675 YOU CAN SEE HERE THIS IS THE 1881 01:09:39,675 --> 01:09:42,644 PERCENTAGES FOR FY 22, 23 AND 1882 01:09:42,644 --> 01:09:43,178 24. 1883 01:09:43,178 --> 01:09:44,913 THERE IS VARIANCE YEAR TO YEAR 1884 01:09:44,913 --> 01:09:47,082 AND THAT'S WHY WE USUALLY RELY 1885 01:09:47,082 --> 01:09:54,723 ON A THREE-YEAR AVERAGE. 1886 01:09:54,723 --> 01:09:56,692 THIS IS FOR FOLKS TO SEE, 1887 01:09:56,692 --> 01:09:58,327 ESPECIALLY SOME OF OUR NEWER 1888 01:09:58,327 --> 01:09:58,660 FOLKS. 1889 01:09:58,660 --> 01:10:00,729 THIS IS OUR SUCCESS RATES FOR 1890 01:10:00,729 --> 01:10:04,333 OUR R01s FROM 2019 TO 2024. 1891 01:10:04,333 --> 01:10:05,867 THE 2024 NUMBERS ARE NOT YET 1892 01:10:05,867 --> 01:10:06,401 OFFICIAL. 1893 01:10:06,401 --> 01:10:08,904 THESE ARE JUST ESTIMATES AT THIS 1894 01:10:08,904 --> 01:10:09,838 POINT. 1895 01:10:09,838 --> 01:10:10,739 HOPEFULLY THEY'RE PRETTY CLOSE 1896 01:10:10,739 --> 01:10:12,274 TO WHAT WILL BE FINAL. 1897 01:10:12,274 --> 01:10:14,343 BUT YOU CAN SEE WE HAVE DONE A 1898 01:10:14,343 --> 01:10:15,978 PRETTY GOOD JOB IN THE RECENT 1899 01:10:15,978 --> 01:10:17,846 YEARS AT TRYING TO SORT OF KEEP 1900 01:10:17,846 --> 01:10:20,115 THAT SUCCESS RATE UP AND TO KEEP 1901 01:10:20,115 --> 01:10:25,020 IT RELATIVELY CONSTANT. 1902 01:10:25,020 --> 01:10:26,755 THE NEXT SLIDE, I ALSO HAVE 1903 01:10:26,755 --> 01:10:29,491 INFORMATION ON OUR EARLY STAGE 1904 01:10:29,491 --> 01:10:32,661 INVESTIGATORS, OR THE ESIs. 1905 01:10:32,661 --> 01:10:35,497 WE DO AS I MENTIONED SET ASIDE 1906 01:10:35,497 --> 01:10:38,667 ADDITIONAL FUNDS TO TRY TO FUND 1907 01:10:38,667 --> 01:10:41,203 MORE ESIs IF POSSIBLE, AND 1908 01:10:41,203 --> 01:10:43,205 THEN THIS IS OUR SUCCESS RATE 1909 01:10:43,205 --> 01:10:45,640 OVER THE LAST SEVERAL YEARS FOR 1910 01:10:45,640 --> 01:10:46,074 ESIs. 1911 01:10:46,074 --> 01:10:48,910 AGAIN WITH 2024 AS JUST AN 1912 01:10:48,910 --> 01:10:49,344 ESTIMATE. 1913 01:10:49,344 --> 01:10:55,484 AND NOT YET OFFICIAL. 1914 01:10:55,484 --> 01:10:57,652 WHEN WE LOOK AT OTHER MECHANISMS 1915 01:10:57,652 --> 01:11:03,992 ASIDE FROM RPGs, THERE MAY BE 1916 01:11:03,992 --> 01:11:06,595 A FEW DIFFERENT BUDGET 1917 01:11:06,595 --> 01:11:07,162 CONSIDERATIONS. 1918 01:11:07,162 --> 01:11:08,397 REDUCING THE AMOUNT FOR A NEW 1919 01:11:08,397 --> 01:11:09,664 GRANT MAY NOT BE FEASIBLE AS IT 1920 01:11:09,664 --> 01:11:13,068 MIGHT BE FOR AN R01. 1921 01:11:13,068 --> 01:11:16,538 WE ALSO LOOK AT OFFSETS THAT MAY 1922 01:11:16,538 --> 01:11:17,973 BE AVAILABLE WHICH OFFSETS LOOK 1923 01:11:17,973 --> 01:11:20,042 AT LARGE UNOBLIGATED BALANCES IN 1924 01:11:20,042 --> 01:11:21,777 RECOMPETING GRANTS, PARTICULARLY 1925 01:11:21,777 --> 01:11:25,814 K12s, T32s. 1926 01:11:25,814 --> 01:11:33,989 FOR TREA.FOR TRAINING MECHANISMR 1927 01:11:33,989 --> 01:11:35,190 F GRANTS WE TAKE INTO 1928 01:11:35,190 --> 01:11:36,725 CONSIDERATION THE 1929 01:11:36,725 --> 01:11:37,692 RECOMMENDATIONS OF THE NICHD 1930 01:11:37,692 --> 01:11:38,226 TRAINING COMMITTEE. 1931 01:11:38,226 --> 01:11:40,095 WE'RE LOOKING AT NIH WIDE 1932 01:11:40,095 --> 01:11:41,196 STIPEND INCREASE, MAKING SURE WE 1933 01:11:41,196 --> 01:11:43,165 SET ASIDE FUNDS FOR CHILD CARE 1934 01:11:43,165 --> 01:11:44,232 ASSISTANCE PAYMENTS THAT GO OUT 1935 01:11:44,232 --> 01:11:46,101 TO THOSE TRAINING GRANTEES. 1936 01:11:46,101 --> 01:11:48,303 WE DO SOLICIT INPUT FROM PROGRAM 1937 01:11:48,303 --> 01:11:50,138 STAFF WHEN WE HAVE A MECHANISM 1938 01:11:50,138 --> 01:11:51,239 THAT'S BEING USED THAT'S NOT 1939 01:11:51,239 --> 01:11:52,441 SOMETHING WE SEE ALL THE TIME TO 1940 01:11:52,441 --> 01:11:53,942 TRY TO GET INSIGHT INTO THOSE 1941 01:11:53,942 --> 01:11:55,177 AWARDS. 1942 01:11:55,177 --> 01:11:57,345 AND THEN HONESTLY, YOU KNOW IT'S 1943 01:11:57,345 --> 01:11:58,280 REALLY ABOUT AVAILABILITY OF 1944 01:11:58,280 --> 01:11:58,847 FUNDS. 1945 01:11:58,847 --> 01:12:00,382 AFTER WE'VE PAID ALL OF OUR 1946 01:12:00,382 --> 01:12:01,817 NONCOMPETING COMMITMENTS, HOW 1947 01:12:01,817 --> 01:12:03,785 MUCH MONEY IS REALLY LEFT OVER 1948 01:12:03,785 --> 01:12:06,354 FOR THOSE NEW AWARDS IN A GIVEN 1949 01:12:06,354 --> 01:12:09,991 YEAR. 1950 01:12:09,991 --> 01:12:11,093 THEN THE LAST THING I WAS GOING 1951 01:12:11,093 --> 01:12:12,961 TO SHOW YOU AT DR. BIANCHI 1952 01:12:12,961 --> 01:12:15,230 REFERENCED IT EARLIER, WE DO 1953 01:12:15,230 --> 01:12:17,332 SUPPORT FOR TRAINING SORT OF 1954 01:12:17,332 --> 01:12:19,067 PURPOSES OUR NIH EXTERNAL LOAN 1955 01:12:19,067 --> 01:12:22,771 REPAYMENT PROGRAMS. 1956 01:12:22,771 --> 01:12:25,273 THIS CHART SHOWS THE FUNDING 1957 01:12:25,273 --> 01:12:25,907 SINCE 2019. 1958 01:12:25,907 --> 01:12:28,844 WE DID HAVE A BIG INCREASE IN 1959 01:12:28,844 --> 01:12:29,978 2024. 1960 01:12:29,978 --> 01:12:31,713 THESE FUNDS GO OUT DIRECTLY TO 1961 01:12:31,713 --> 01:12:34,015 APPLICANTS WHO COMMIT TO 1962 01:12:34,015 --> 01:12:34,416 PURSUING RESEARCH. 1963 01:12:34,416 --> 01:12:36,184 THERE ARE SIX DIFFERENT LOAN 1964 01:12:36,184 --> 01:12:38,053 REPAYMENT PROGRAMS FOR THE 1965 01:12:38,053 --> 01:12:38,720 EXTRAMURAL COMMUNITY. 1966 01:12:38,720 --> 01:12:40,789 WE HAVE EXPANDED OUR 1967 01:12:40,789 --> 01:12:42,090 PARTICIPATION AND FUNDING AS YOU 1968 01:12:42,090 --> 01:12:46,128 CAN SEE OVER RECENT YEARS. 1969 01:12:46,128 --> 01:12:48,497 EVERY YEAR'S CONTRIBUTION IS 1970 01:12:48,497 --> 01:12:50,165 SORT OF SUBJECT TO OUR 1971 01:12:50,165 --> 01:12:51,933 APPROPRIATION. 1972 01:12:51,933 --> 01:12:53,235 SO WE'RE LOOKING TO SEE WHAT 1973 01:12:53,235 --> 01:12:54,302 CONGRESS DOES THIS YEAR, WHICH 1974 01:12:54,302 --> 01:12:56,271 WILL HELP US MAKE DECISIONS ON 1975 01:12:56,271 --> 01:12:57,606 HOW MUCH WILL GO INTO THIS 1976 01:12:57,606 --> 01:13:02,711 PROGRAM FOR 2025. 1977 01:13:02,711 --> 01:13:04,279 THAT'S THE END OF MY SLIDES. 1978 01:13:04,279 --> 01:13:06,114 I'M HAPPY TO 50 BACK TO A SLIDE 1979 01:13:06,114 --> 01:13:07,849 IF SOMEONE WANTS TO ASK A 1980 01:13:07,849 --> 01:13:11,753 QUESTION OR ASK ANY OTHER 1981 01:13:11,753 --> 01:13:15,724 QUESTIONS. 1982 01:13:15,724 --> 01:13:18,927 DR. MANDL. 1983 01:13:18,927 --> 01:13:20,495 >> GREAT AND INFORMATIVE 1984 01:13:20,495 --> 01:13:22,430 PRESENTATION. 1985 01:13:22,430 --> 01:13:25,233 I WONDER IF YOU CAN COMMENT, 1986 01:13:25,233 --> 01:13:26,768 EVEN IF NOT WITH THE EXACT 1987 01:13:26,768 --> 01:13:30,805 NUMBERS RIGHT NOW, ON THE 1988 01:13:30,805 --> 01:13:33,842 SUCCESS RATE THAT INCLUDES THE 1989 01:13:33,842 --> 01:13:34,309 REVISED APPLICATION. 1990 01:13:34,309 --> 01:13:36,378 IN OTHER WORDS, THE SUCCESS RATE 1991 01:13:36,378 --> 01:13:39,347 OVER A SUBMISSION AND A REVISION 1992 01:13:39,347 --> 01:13:40,715 OR WHETHER THOSE -- BECAUSE I 1993 01:13:40,715 --> 01:13:43,151 WAS ASSUMING THE SUCCESS RATES 1994 01:13:43,151 --> 01:13:48,423 IN YOUR TABLE FOR R01s WAS ON 1995 01:13:48,423 --> 01:13:49,691 THE FIRST SUBMISSION BUT I MIGHT 1996 01:13:49,691 --> 01:13:50,258 BE WRONG. 1997 01:13:50,258 --> 01:13:52,327 >> NO, SO THIS SUCCESS RATE 1998 01:13:52,327 --> 01:13:56,698 SHOULD BE FOR 01 OR 1999 01:13:56,698 --> 01:13:58,099 A1 APPLICATIONS COMBINED, SO 2000 01:13:58,099 --> 01:13:58,934 THIS WOULD BE EVERYBODY 2001 01:13:58,934 --> 01:13:59,201 TOGETHER. 2002 01:13:59,201 --> 01:14:00,602 I DON'T KNOW THE FIGURES FOR 2003 01:14:00,602 --> 01:14:03,238 THOSE THINGS SEPARATED OUT OFF 2004 01:14:03,238 --> 01:14:05,640 THE TOP OF MY HEAD, BUT I DO 2005 01:14:05,640 --> 01:14:07,075 BELIEVE -- WE TOOK THIS DATA 2006 01:14:07,075 --> 01:14:09,377 FROM THE NIH REPORTER, AND I 2007 01:14:09,377 --> 01:14:10,545 THINK THAT INFORMATION CAN BE 2008 01:14:10,545 --> 01:14:11,980 GOTTEN THERE, AND IF YOU'RE 2009 01:14:11,980 --> 01:14:13,949 INTERESTED, WE CAN LOOK AT THAT 2010 01:14:13,949 --> 01:14:15,283 AND SHARE THAT TOO. 2011 01:14:15,283 --> 01:14:16,985 >> OKAY, THAT'S VERY HELPFUL TO 2012 01:14:16,985 --> 01:14:18,587 KNOW THAT THIS IS INCLUDED IN 2013 01:14:18,587 --> 01:14:18,853 THE A1. 2014 01:14:18,853 --> 01:14:21,823 THANK YOU. 2015 01:14:21,823 --> 01:14:24,326 >> AND DR. CEDARS. 2016 01:14:24,326 --> 01:14:26,728 >> YES, THANK YOU SO MUCH. 2017 01:14:26,728 --> 01:14:30,432 THIS WAS REALLY INFORMATIVE AND 2018 01:14:30,432 --> 01:14:32,400 MY QUESTION IS ABOUT THE SAME 2019 01:14:32,400 --> 01:14:34,236 TOPIC, WHEN YOU SAY SUCCESS 2020 01:14:34,236 --> 01:14:36,871 RATE, I'M JUST TRYING TO THINK 2021 01:14:36,871 --> 01:14:38,640 ABOUT BEING ON A STUDY SECTION 2022 01:14:38,640 --> 01:14:40,575 AND PERCENTILE SCORES AND 2023 01:14:40,575 --> 01:14:43,745 PRIORITY SCORES AND KNOWING THAT 2024 01:14:43,745 --> 01:14:46,047 THE FUNDING LEVEL IN NICHD HAS 2025 01:14:46,047 --> 01:14:47,549 TRADITIONALLY BEEN QUITE LOW 2026 01:14:47,549 --> 01:14:50,952 COMPARED TO SOME OF THE OTHER 2027 01:14:50,952 --> 01:14:52,587 INSTITUTES. 2028 01:14:52,587 --> 01:14:55,123 THE 17.8%, CAN YOU -- HOW WOULD 2029 01:14:55,123 --> 01:14:57,125 THAT CORRELATE TO SOME OF THESE 2030 01:14:57,125 --> 01:15:00,729 OTHER METRICS? 2031 01:15:00,729 --> 01:15:04,532 >> IT'S A LITTLE DIFFICULT. 2032 01:15:04,532 --> 01:15:06,735 SO THE DENOMINATOR THAT 2033 01:15:06,735 --> 01:15:07,902 APPLICATIONS REVIEWED, I MEAN, 2034 01:15:07,902 --> 01:15:09,671 THAT REALLY IS EVERYTHING THAT 2035 01:15:09,671 --> 01:15:12,507 GOT REVIEWED. 2036 01:15:12,507 --> 01:15:13,908 WE DON'T, AS AN INSTITUTE, 2037 01:15:13,908 --> 01:15:14,409 CONTROL THAT. 2038 01:15:14,409 --> 01:15:15,877 ALL THE APPLICATIONS THAT CAME 2039 01:15:15,877 --> 01:15:17,979 IN, REGARDLESS OF STUDY SECTION 2040 01:15:17,979 --> 01:15:19,147 THAT GOT REVIEWED. 2041 01:15:19,147 --> 01:15:20,515 AND THEN IT REALLY IS JUST HOW 2042 01:15:20,515 --> 01:15:21,650 MANY OF THEM GOT PAID. 2043 01:15:21,650 --> 01:15:24,386 I WILL SAY THIS FIGURE INCLUDES 2044 01:15:24,386 --> 01:15:27,555 GRANTS THAT CAME IN UNDER 2045 01:15:27,555 --> 01:15:29,524 RFAs, AS WELL AS INVESTIGATOR 2046 01:15:29,524 --> 01:15:30,725 INITIATED APPLICATIONS. 2047 01:15:30,725 --> 01:15:34,763 SO THIS IS ALL R01 GRANTS. 2048 01:15:34,763 --> 01:15:35,430 SOLICITED OR NOT. 2049 01:15:35,430 --> 01:15:37,599 I MEAN, THAT'S THE WAY THE 2050 01:15:37,599 --> 01:15:38,600 SYSTEM DISTINGUISHES THEM, 2051 01:15:38,600 --> 01:15:39,834 RIGHT? 2052 01:15:39,834 --> 01:15:42,203 RFA IS SOLICITED, INVESTIGATOR 2053 01:15:42,203 --> 01:15:45,707 INITIATED IS UNSOLICITED. 2054 01:15:45,707 --> 01:15:47,442 SO WE DO OFTEN HAVE HIGHER 2055 01:15:47,442 --> 01:15:51,046 SUCCESS RATES FOR RFAs, FOR 2056 01:15:51,046 --> 01:15:51,680 EXAMPLE. 2057 01:15:51,680 --> 01:15:53,782 WE'VE SET ASIDE MONEYS FOR THOSE 2058 01:15:53,782 --> 01:15:54,616 AREAS OF SCIENCE. 2059 01:15:54,616 --> 01:15:58,186 KE WITH PWE CAN PICK UP AN APPLN 2060 01:15:58,186 --> 01:15:59,220 WITH A HIGHER SCORE. 2061 01:15:59,220 --> 01:16:00,855 THE ESIs ARE ALSO INCLUDED IN 2062 01:16:00,855 --> 01:16:02,924 THIS CHART HERE. 2063 01:16:02,924 --> 01:16:07,495 SO IF THERE'S ESIs, THESE 2064 01:16:07,495 --> 01:16:08,930 R01 APPLICATIONS, THAT IS ALSO 2065 01:16:08,930 --> 01:16:09,564 INCLUDED HERE. 2066 01:16:09,564 --> 01:16:13,501 SO I THINK A LOT OF TIMES SOME 2067 01:16:13,501 --> 01:16:16,471 OF THE CHALLENGE IS TEASING OUT 2068 01:16:16,471 --> 01:16:18,973 THE SUCCESS RATE FOR PURELY 2069 01:16:18,973 --> 01:16:19,507 UNSOLICITED THINGS. 2070 01:16:19,507 --> 01:16:22,143 FOR EXAMPLE, MAY NOT BE AS HIGH 2071 01:16:22,143 --> 01:16:27,716 AS FOR AN RFA RESPONSE OR 2072 01:16:27,716 --> 01:16:29,684 NON-ESI INVESTIGATORS. 2073 01:16:29,684 --> 01:16:31,019 AND THAT IS A CHALLENGE. 2074 01:16:31,019 --> 01:16:34,055 BUT I WILL TELL YOU, I CAME TO 2075 01:16:34,055 --> 01:16:37,659 NICHD IN 2010, AND WHEN I 2076 01:16:37,659 --> 01:16:39,327 STARTED HERE, THERE WERE YEARS 2077 01:16:39,327 --> 01:16:40,729 WHEN I WAS HERE AT THE BEGINNING 2078 01:16:40,729 --> 01:16:42,931 WHERE THE SUCCESS RATE WAS MORE 2079 01:16:42,931 --> 01:16:46,301 LIKE 11 OR 12% FOR R01s, SO WE 2080 01:16:46,301 --> 01:16:48,837 HAVE MADE SUBSTANTIAL 2081 01:16:48,837 --> 01:16:50,372 IMPROVEMENTS IN WHAT WE'VE BEEN 2082 01:16:50,372 --> 01:16:53,141 ABLE TO SUPPORT. 2083 01:16:53,141 --> 01:16:54,576 >> THANK YOU, THAT WAS HELPFUL. 2084 01:16:54,576 --> 01:16:55,944 >> SURE. 2085 01:16:55,944 --> 01:16:59,914 AND DR. AIZER? 2086 01:16:59,914 --> 01:17:01,416 >> THANK YOU. 2087 01:17:01,416 --> 01:17:03,151 I HAVE TWO QUESTIONS. 2088 01:17:03,151 --> 01:17:04,352 THE FIRST ONE, COULD YOU TALK A 2089 01:17:04,352 --> 01:17:06,221 LITTLE BIT MORE ABOUT THE 2090 01:17:06,221 --> 01:17:08,523 COFUNDING COMMITMENTS? 2091 01:17:08,523 --> 01:17:09,991 WHAT IS THAT EXACTLY? 2092 01:17:09,991 --> 01:17:13,762 >> SURE. 2093 01:17:13,762 --> 01:17:15,096 SO IT'S REALLY ABOUT 2094 01:17:15,096 --> 01:17:16,064 COLLABORATIONS BETWEEN 2095 01:17:16,064 --> 01:17:18,032 INSTITUTES. 2096 01:17:18,032 --> 01:17:19,367 SO IF -- LET ME THINK OF AN 2097 01:17:19,367 --> 01:17:22,070 EXAMPLE. 2098 01:17:22,070 --> 01:17:24,372 IF WE HAVE A PROGRAM, IN FACT I 2099 01:17:24,372 --> 01:17:27,675 THINK THERE'S AN ACTION PROBABLY 2100 01:17:27,675 --> 01:17:31,880 TOMORROW ON THE WELLSTONE CEN 2101 01:17:31,880 --> 01:17:33,581 CENTERS OF MUSCULAR DYSTROPHY, I 2102 01:17:33,581 --> 01:17:34,115 THINK. 2103 01:17:34,115 --> 01:17:35,683 THAT IS A COLLABORATION BETWEEN 2104 01:17:35,683 --> 01:17:36,518 THREE DIFFERENT INSTITUTES. 2105 01:17:36,518 --> 01:17:37,719 SO SOMETIMES WE ARE THE LEAD, 2106 01:17:37,719 --> 01:17:39,587 SOMETIMES WE ARE NOT THE LEAD. 2107 01:17:39,587 --> 01:17:40,655 WE MAY COMMIT TO THE OTHER 2108 01:17:40,655 --> 01:17:41,156 INSTITUTE. 2109 01:17:41,156 --> 01:17:43,725 WE'RE GOING TO GIVE YOU $500,000 2110 01:17:43,725 --> 01:17:46,027 FOR THIS RFA. 2111 01:17:46,027 --> 01:17:47,195 FOR GRANTS ON THIS TOPIC. 2112 01:17:47,195 --> 01:17:48,630 BECAUSE IT IS A PRIORITY FOR OUR 2113 01:17:48,630 --> 01:17:49,397 INSTITUTE BUT WE'RE NOT THE 2114 01:17:49,397 --> 01:17:51,366 LEAD. 2115 01:17:51,366 --> 01:17:52,767 SO THAT WOULD BE WHAT WE WOULD 2116 01:17:52,767 --> 01:17:56,504 CALL OUTGOING COFUNDING. 2117 01:17:56,504 --> 01:17:59,174 ON THE SAME TOKEN, ANOTHER IC 2118 01:17:59,174 --> 01:18:04,179 MAY SEE SCIENCE WE'RE DOING FOR 2119 01:18:04,179 --> 01:18:05,213 EXAMPLE THE OFFICE OF RESEARCH 2120 01:18:05,213 --> 01:18:08,283 FOR WOMEN'S HEALTH IN THE NIHOD 2121 01:18:08,283 --> 01:18:10,185 WILL PROVIDE COFUNDING TO US FOR 2122 01:18:10,185 --> 01:18:12,787 SOME OF OUR RESEARCH IN 2123 01:18:12,787 --> 01:18:13,388 GYNECOLOGICAL HEALTH BECAUSE 2124 01:18:13,388 --> 01:18:14,722 THAT'S A PRIORITY FOR THEM AND 2125 01:18:14,722 --> 01:18:15,657 THEY WANT TO BE ABLE TO SUPPORT 2126 01:18:15,657 --> 01:18:16,157 THAT. 2127 01:18:16,157 --> 01:18:18,460 THAT ESSENTIALLY GIVES US 2128 01:18:18,460 --> 01:18:19,761 RESOURCES ON TOP OF OUR OWN 2129 01:18:19,761 --> 01:18:20,862 APPROPRIATION WHEN THAT HAPPENS, 2130 01:18:20,862 --> 01:18:25,567 AND THAT'S INCOMING COFUNDING. 2131 01:18:25,567 --> 01:18:27,402 >> IS THAT GENERALLY 2132 01:18:27,402 --> 01:18:29,704 BUDGET-NEUTRAL? 2133 01:18:29,704 --> 01:18:32,874 >> IT IS -- HOW DO I PUT THIS? 2134 01:18:32,874 --> 01:18:34,409 SO OFFICE OF RESEARCH ON WOMEN'S 2135 01:18:34,409 --> 01:18:35,710 HEALTH HAS ITS OWN 2136 01:18:35,710 --> 01:18:37,345 APPROPRIATION, AND WE HAVE OURS. 2137 01:18:37,345 --> 01:18:41,249 WE CAN'T OVERSPEND, EITHER ONE 2138 01:18:41,249 --> 01:18:41,716 OF US. 2139 01:18:41,716 --> 01:18:42,917 SO WITHIN OUR BUDGETS, WE'RE 2140 01:18:42,917 --> 01:18:43,685 SPENDING WHAT WE HAVE. 2141 01:18:43,685 --> 01:18:44,552 >> I SEE. 2142 01:18:44,552 --> 01:18:46,421 >> BUT OFFICE OF RESEARCH ON 2143 01:18:46,421 --> 01:18:48,156 WOMEN'S HEALTH IS THEN HELPING 2144 01:18:48,156 --> 01:18:50,792 US TO MAYBE FUND MORE RESEARCH 2145 01:18:50,792 --> 01:18:51,993 ON WOMEN'S HEALTH BECAUSE THEY 2146 01:18:51,993 --> 01:18:53,528 ARE GIVING US SOME OF THEIR 2147 01:18:53,528 --> 01:18:53,862 MONEY. 2148 01:18:53,862 --> 01:18:54,729 >> GOT IT. 2149 01:18:54,729 --> 01:18:55,163 OKAY. 2150 01:18:55,163 --> 01:18:56,698 I JUST HAVE ANOTHER QUESTION 2151 01:18:56,698 --> 01:19:01,402 WHICH IS MORE OF A THINK 2152 01:19:01,402 --> 01:19:06,841 QUESTION IS, ARE THERE EFFORTS 2153 01:19:06,841 --> 01:19:08,109 OR SHOULD THERE BE EFFORTS TO 2154 01:19:08,109 --> 01:19:13,047 SORT OF LINK BUDGET PR PRIORITIS 2155 01:19:13,047 --> 01:19:17,385 WITH SOME METRIC OF SUCCESS? 2156 01:19:17,385 --> 01:19:19,020 >> I GUESS MY QUESTION IS, WHAT 2157 01:19:19,020 --> 01:19:21,723 KIND OF METRICS OF SUCCESS ARE 2158 01:19:21,723 --> 01:19:22,457 YOU THINKING OF? 2159 01:19:22,457 --> 01:19:24,025 >> I'D HAVE TO THINK ABOUT IT. 2160 01:19:24,025 --> 01:19:29,264 SOME MEASURES OF THE QUALITY AND 2161 01:19:29,264 --> 01:19:31,132 IMPORTANCE OF THE RESEARCH 2162 01:19:31,132 --> 01:19:31,366 OUTPUT. 2163 01:19:31,366 --> 01:19:31,900 >> YEAH. 2164 01:19:31,900 --> 01:19:36,170 I THINK THAT'S SOMETHING THAT 2165 01:19:36,170 --> 01:19:37,138 CERTAINLY GET DISCUSSED. 2166 01:19:37,138 --> 01:19:38,540 WE IN THE BUDGET OFFICE, WE 2167 01:19:38,540 --> 01:19:40,174 PROVIDE ALLOCATIONS TO THE 2168 01:19:40,174 --> 01:19:43,878 SCIENTIFIC BRANCHES FOR THEIR 2169 01:19:43,878 --> 01:19:44,779 BRANCH PORTFOLIOS. 2170 01:19:44,779 --> 01:19:47,615 AND THEY THEN MAKE THE DECISION 2171 01:19:47,615 --> 01:19:50,018 ABOUT HOW TO USE THAT MONEY. 2172 01:19:50,018 --> 01:19:51,319 AND SOMETIMES, YOU KNOW, THEY 2173 01:19:51,319 --> 01:19:53,421 MAY PICK SOMETHING THAT MAY NOT 2174 01:19:53,421 --> 01:19:55,123 HAVE, YOU KNOW, A THIRD 2175 01:19:55,123 --> 01:19:58,326 PERCENTILE SCORE BUT HAS REALLY 2176 01:19:58,326 --> 01:19:59,394 GOOD POTENTIAL FOR SOMETHING NEW 2177 01:19:59,394 --> 01:20:00,028 AND INNOVATIVE. 2178 01:20:00,028 --> 01:20:01,229 AND WE GIVE THEM THAT 2179 01:20:01,229 --> 01:20:03,998 FLEXIBILITY. 2180 01:20:03,998 --> 01:20:05,633 AND WE TRUST THAT THEY WILL LOOK 2181 01:20:05,633 --> 01:20:08,269 AT PRODUCTIVITY, LOOK -- AS THE 2182 01:20:08,269 --> 01:20:09,571 REVIEWERS HAVE ALREADY DONE TOO, 2183 01:20:09,571 --> 01:20:11,739 YOU KNOW, LOOK AT DEVELOPING 2184 01:20:11,739 --> 01:20:13,174 AREAS OF SCIENCE, THINGS LIKE 2185 01:20:13,174 --> 01:20:16,210 THAT. 2186 01:20:16,210 --> 01:20:17,645 AND TRY TO MAKE THOSE DECISIONS 2187 01:20:17,645 --> 01:20:18,613 WITH THE MONEY THAT WE PROVIDE 2188 01:20:18,613 --> 01:20:19,080 TO THEM. 2189 01:20:19,080 --> 01:20:20,715 I KNOW THEY WISH WE -- THEY 2190 01:20:20,715 --> 01:20:23,651 ALWAYS WISH WE COULD GIVE THEM 2191 01:20:23,651 --> 01:20:24,085 MORE. 2192 01:20:24,085 --> 01:20:24,953 MORE IS ALWAYS BETTER. 2193 01:20:24,953 --> 01:20:29,023 SO THERE ARE OFTEN A LOT OF 2194 01:20:29,023 --> 01:20:30,024 TRADEOFFS AND I THINK PROGRAM 2195 01:20:30,024 --> 01:20:33,828 STAFF IS REALLY LOOKING AT THOSE 2196 01:20:33,828 --> 01:20:34,796 KINDS OF THINGS WITHIN THEIR 2197 01:20:34,796 --> 01:20:35,897 FIELDS WHEN THEY ARE MAKING 2198 01:20:35,897 --> 01:20:37,765 DECISIONS ABOUT WHAT TO FUND. 2199 01:20:37,765 --> 01:20:39,500 >> I JUST WONDERED IF IT 2200 01:20:39,500 --> 01:20:42,537 WOULDN'T BE USEFUL TO DO 2201 01:20:42,537 --> 01:20:45,139 SOMETHING MORE RETROSPECTIVELY. 2202 01:20:45,139 --> 01:20:47,508 >> SO I THINK OUR OFFICE OF 2203 01:20:47,508 --> 01:20:49,177 SCIENCE POLICY RESEARCH, THEY DO 2204 01:20:49,177 --> 01:20:51,613 A LOT OF EVALUATION OF WHERE OUR 2205 01:20:51,613 --> 01:20:53,047 MONEY GOES AND SORT OF WHAT 2206 01:20:53,047 --> 01:20:55,416 COMES OUT OF IT, RIGHT? 2207 01:20:55,416 --> 01:20:56,618 ARE THERE CLINICAL PROTOCOLS 2208 01:20:56,618 --> 01:20:57,952 THAT ARE DEVELOPED THAT BECOME 2209 01:20:57,952 --> 01:20:59,754 ADOPTED WIDELY, PUBLICATIONS ARE 2210 01:20:59,754 --> 01:21:01,389 ALWAYS SOMETHING THAT PEOPLE -- 2211 01:21:01,389 --> 01:21:03,324 I'M NOT A SCIENTIST BUT I HEAR A 2212 01:21:03,324 --> 01:21:04,592 LOT OF ARGUMENTS ABOUT HOW MUCH 2213 01:21:04,592 --> 01:21:07,562 WE SHOULD RELY ON PUBLICATION, 2214 01:21:07,562 --> 01:21:11,499 YOU KNOW, AS A METRIC, SO THERE 2215 01:21:11,499 --> 01:21:12,667 ARE OTHER PARTS OF THE INSTITUTE 2216 01:21:12,667 --> 01:21:14,535 THAT ARE LOOKING AT THOSE KINDS 2217 01:21:14,535 --> 01:21:15,370 OF THINGS. 2218 01:21:15,370 --> 01:21:19,941 WE DO TRY TO DISCUSS HOW FUNDING 2219 01:21:19,941 --> 01:21:22,276 SHOULD OR SHOULD NOT FOLLOW. 2220 01:21:22,276 --> 01:21:24,345 I MEAN, SOMETIMES YOU WANT TO 2221 01:21:24,345 --> 01:21:26,514 FUND THE THING THAT MAY OR MAY 2222 01:21:26,514 --> 01:21:29,317 NOT, YOU KNOW -- IT MAY NOT WORK 2223 01:21:29,317 --> 01:21:33,988 BUT YOU TRIED IT. 2224 01:21:33,988 --> 01:21:37,125 >> ROHAN, DIRECTOR OF DER. 2225 01:21:37,125 --> 01:21:39,427 I THINK ONE CONCRETE EXAMPLE IS 2226 01:21:39,427 --> 01:21:41,763 EVIDENCE FROM THE LOAN REPAYMENT 2227 01:21:41,763 --> 01:21:43,264 ANALYSIS THAT LOAN REPAYMENT 2228 01:21:43,264 --> 01:21:44,899 RECIPIENTS WERE MUCH MORE 2229 01:21:44,899 --> 01:21:48,936 SUCCESSFUL AT SUBSEQUENT NIH -- 2230 01:21:48,936 --> 01:21:49,904 RECEIVING SUBSEQUENT NIH FUNDING 2231 01:21:49,904 --> 01:21:50,938 AND THAT WENT INTO OUR DECISION 2232 01:21:50,938 --> 01:21:52,040 TO INCREASE THE LOAN REPAYMENT 2233 01:21:52,040 --> 01:21:52,340 PROGRAM. 2234 01:21:52,340 --> 01:21:54,175 SO WE HAVE DONE AT LEAST ON A 2235 01:21:54,175 --> 01:21:55,710 SMALL SCALE, ANNA, SOME OF THE 2236 01:21:55,710 --> 01:21:56,711 THINGS THAT YOU'RE TALKING 2237 01:21:56,711 --> 01:21:56,911 ABOUT. 2238 01:21:56,911 --> 01:21:58,246 >> OKAY, THAT'S GREAT TO HEAR. 2239 01:21:58,246 --> 01:21:59,347 IF THERE ARE REPORTS THAT ARE 2240 01:21:59,347 --> 01:22:03,084 BEING PRODUCED, I WOULD BE VERY 2241 01:22:03,084 --> 01:22:06,020 INTERESTED IN READING THEM. 2242 01:22:06,020 --> 01:22:06,654 THANK YOU. 2243 01:22:06,654 --> 01:22:08,990 >> THANK YOU. 2244 01:22:08,990 --> 01:22:09,323 DR. SESSIONS? 2245 01:22:09,323 --> 01:22:10,291 >> THANK YOU VERY MUCH. 2246 01:22:10,291 --> 01:22:12,160 THIS IS VERY INTERESTING. 2247 01:22:12,160 --> 01:22:17,065 I WONDER WHAT YOU PREDICT OR 2248 01:22:17,065 --> 01:22:18,299 HAVE ACCESS TO PREDICTING IN 2249 01:22:18,299 --> 01:22:20,234 TERMS OF THE TOTAL NUMBER OF 2250 01:22:20,234 --> 01:22:22,670 APPLICATIONS YOU REVIEWED PER 2251 01:22:22,670 --> 01:22:23,538 YEAR. 2252 01:22:23,538 --> 01:22:26,140 MY INTUITION WOULD BE 2253 01:22:26,140 --> 01:22:27,675 SPECULATION WITH NO DATA, I 2254 01:22:27,675 --> 01:22:28,776 NEVER LET THE DATA GET IN THE 2255 01:22:28,776 --> 01:22:33,281 WAY OF MY SPECULATION, THAT I 2256 01:22:33,281 --> 01:22:38,519 WOULD SPECULATE THAT THE IN 2257 01:22:38,519 --> 01:22:40,054 INSTITUTE WOULD LIKE TO SEE AN 2258 01:22:40,054 --> 01:22:40,922 INCREASING NUMBER OF 2259 01:22:40,922 --> 01:22:42,790 APPLICATIONS PER YEAR. 2260 01:22:42,790 --> 01:22:45,526 >> I THINK THAT'S A MIXED BAG, 2261 01:22:45,526 --> 01:22:45,993 DR. SESSIONS. 2262 01:22:45,993 --> 01:22:49,597 SO I'M GOING TO SAY OVERALL, ALL 2263 01:22:49,597 --> 01:22:51,532 OUR PG MECHANISMS, ACTIVITY 2264 01:22:51,532 --> 01:22:53,401 CODES ALL TOGETHER, OUR 2265 01:22:53,401 --> 01:22:56,771 INSTITUTE LAST YEAR HAD ABOUT 2266 01:22:56,771 --> 01:22:57,772 2700 APPLICATIONS THAT WERE 2267 01:22:57,772 --> 01:22:58,973 REVIEWED. 2268 01:22:58,973 --> 01:23:02,477 SO IT INCLUDES THINGS OUTSIDE OF 2269 01:23:02,477 --> 01:23:09,050 R01s, INCLUDES R3s, R21s, 2270 01:23:09,050 --> 01:23:11,018 ALL THE LITTLE ODD DUCKS AS 2271 01:23:11,018 --> 01:23:11,419 WELL. 2272 01:23:11,419 --> 01:23:13,187 I THINK WE WANT TO HAVE MORE 2273 01:23:13,187 --> 01:23:14,522 APPLICATIONS IF THEY ARE 2274 01:23:14,522 --> 01:23:16,157 APPLICATIONS THAT APPLY TO OUR 2275 01:23:16,157 --> 01:23:17,358 SCIENCE. 2276 01:23:17,358 --> 01:23:20,094 WE HAVE HAD INSTANCES IN THE 2277 01:23:20,094 --> 01:23:22,830 PAST WHERE THE REVIEW CRITERIA, 2278 01:23:22,830 --> 01:23:24,365 AND THERE'S STAFF HERE AT THE 2279 01:23:24,365 --> 01:23:27,435 INSTITUTE WHO WORK VERY HARD ON 2280 01:23:27,435 --> 01:23:31,038 THE CRITERIA FOR NIH TO DECIDE 2281 01:23:31,038 --> 01:23:33,741 WHICH INSTITUTE GETS AN 2282 01:23:33,741 --> 01:23:34,041 APPLICATION. 2283 01:23:34,041 --> 01:23:34,242 RIGHT? 2284 01:23:34,242 --> 01:23:37,478 AND SO I THINK WE WOULD LIKE TO 2285 01:23:37,478 --> 01:23:38,346 SEE INCREASED APPLICATIONS IF 2286 01:23:38,346 --> 01:23:40,548 THERE REALLY ARE PRIORITY 2287 01:23:40,548 --> 01:23:40,882 SCIENCE. 2288 01:23:40,882 --> 01:23:42,617 WE DON'T WANT TO SEE AN INCREASE 2289 01:23:42,617 --> 01:23:44,585 IN APPLICATIONS WHEN THEY'RE 2290 01:23:44,585 --> 01:23:45,553 APPLICATIONS THAT SHOULD MAYBE 2291 01:23:45,553 --> 01:23:47,789 GO TO A DIFFERENT IC, BECAUSE 2292 01:23:47,789 --> 01:23:49,957 IT'S THAT IC'S PRIORITY AND NOT 2293 01:23:49,957 --> 01:23:51,592 OURS. 2294 01:23:51,592 --> 01:23:52,794 DR. BIANCHI, DID YOU WANT TO -- 2295 01:23:52,794 --> 01:23:55,530 >> IF I COULD COMMENT ON THAT, 2296 01:23:55,530 --> 01:23:58,032 SESH. 2297 01:23:58,032 --> 01:23:59,133 THAT'S ONE OF THE BENEFITS OF 2298 01:23:59,133 --> 01:24:01,335 HAVING A STRATEGIC PLAN. 2299 01:24:01,335 --> 01:24:03,838 I WOULD SAY THAT EIGHT YEARS 2300 01:24:03,838 --> 01:24:06,574 AGO, IF IT HAD THE WORD 2301 01:24:06,574 --> 01:24:09,310 "CHILDREN" OR "CHILD" OR 2302 01:24:09,310 --> 01:24:10,945 PEDIATRICS, OFTENTIMES IT WENT 2303 01:24:10,945 --> 01:24:14,348 FIRST TO NICHD AND IT DIDN'T 2304 01:24:14,348 --> 01:24:18,286 NECESSARILY ALIGN WITH AREAS OF 2305 01:24:18,286 --> 01:24:18,719 OUR INTEREST. 2306 01:24:18,719 --> 01:24:20,488 SO HAVING A STRATEGIC PLAN HAS 2307 01:24:20,488 --> 01:24:24,392 ALLOWED US TO ALIGN THE SCIENCE 2308 01:24:24,392 --> 01:24:28,763 WITH THE FUNDED APPLICATIONS. 2309 01:24:28,763 --> 01:24:31,966 AND WE CONTINUOUSLY TALK ABOUT 2310 01:24:31,966 --> 01:24:33,267 THIS, ALTHOUGH I THINK IT'S 2311 01:24:33,267 --> 01:24:34,902 GOTTEN BETTER WHAT CENTER FOR 2312 01:24:34,902 --> 01:24:36,671 SCIENTIFIC REVIEW SENDS US, I 2313 01:24:36,671 --> 01:24:37,972 THINK THEY HAVE A BETTER 2314 01:24:37,972 --> 01:24:41,142 UNDERSTANDING NOW OF WHAT OUR 2315 01:24:41,142 --> 01:24:43,644 PRIORITIES ARE, AND WHERE WE'RE 2316 01:24:43,644 --> 01:24:44,946 LIKELY TO ACCEPT SOMETHING FOR 2317 01:24:44,946 --> 01:24:48,182 REVIEW. 2318 01:24:48,182 --> 01:24:49,717 BUT I WOULD SAY EIGHT YEARS AGO, 2319 01:24:49,717 --> 01:24:51,118 THE APPLICATIONS THAT WE 2320 01:24:51,118 --> 01:24:56,390 RECEIVED WERE PRETTY UNFOCUSED 2321 01:24:56,390 --> 01:24:57,792 AND DIDN'T ALLOW US TO GO DEEP 2322 01:24:57,792 --> 01:24:58,559 IN ANY SPECIFIC AREA. 2323 01:24:58,559 --> 01:24:58,893 >> RIGHT. 2324 01:24:58,893 --> 01:25:02,263 THANK YOU VERY MUCH. 2325 01:25:02,263 --> 01:25:03,731 I -- AS AN EXAMPLE, I MIGHT 2326 01:25:03,731 --> 01:25:06,334 PREDICT THAT THE STRATEGIC 2327 01:25:06,334 --> 01:25:10,171 PLAN'S INCLUSION OF ARTIFICIAL 2328 01:25:10,171 --> 01:25:11,305 INTELLIGENCE MIGHT EXPAND THE 2329 01:25:11,305 --> 01:25:13,908 NUMBER OF APPLICATIONS IN TERMS 2330 01:25:13,908 --> 01:25:19,714 OF HOW WE STUDY DEVELOPMENT. 2331 01:25:19,714 --> 01:25:21,549 BECAUSE OF THE EXPANDING 2332 01:25:21,549 --> 01:25:22,917 UNDERSTANDING OF APPLICATION OF 2333 01:25:22,917 --> 01:25:28,589 ALREADY AVAILABLE DATA TO NEW 2334 01:25:28,589 --> 01:25:29,891 TECHNIQUES, WITH NEW TECHNIQUES. 2335 01:25:29,891 --> 01:25:31,125 AND I WOULD HOPE THAT WE WOULD 2336 01:25:31,125 --> 01:25:33,160 GET SOME OF THOSE, WHICH WOULD 2337 01:25:33,160 --> 01:25:36,230 BE DIFFERENT FROM THE ONES THAT 2338 01:25:36,230 --> 01:25:39,734 WE HAVE HISTORICALLY SORT OF 2339 01:25:39,734 --> 01:25:45,773 REVIEWED. 2340 01:25:45,773 --> 01:25:47,742 >> DR. JABS? 2341 01:25:47,742 --> 01:25:51,445 >> I THINK I HAVE TWO QUESTIONS. 2342 01:25:51,445 --> 01:25:56,150 MY FIRST QUESTION IS WE'VE HAD A 2343 01:25:56,150 --> 01:25:57,785 PRESENTATION OF THE INSTITUTE 2344 01:25:57,785 --> 01:26:02,256 ACE PRIORITY, AND WE'VE HAD A 2345 01:26:02,256 --> 01:26:03,024 PRESENTATION OF THE BUDGET. 2346 01:26:03,024 --> 01:26:09,630 I'M JUST WONDERING WITH 2347 01:26:09,630 --> 01:26:10,598 CHANGE -- THE POLITICAL CHANGE 2348 01:26:10,598 --> 01:26:14,201 THAT WILL HAPPEN THIS MONTH, HOW 2349 01:26:14,201 --> 01:26:19,040 MUCH OF THAT CAN CHANGE? 2350 01:26:19,040 --> 01:26:25,046 >> WELL, IT CAN CHANGE -- IF WE 2351 01:26:25,046 --> 01:26:27,114 GET DIRECTIVES FROM CONGRESS OR 2352 01:26:27,114 --> 01:26:28,582 WE GET DIRECTIVES FROM THE 2353 01:26:28,582 --> 01:26:29,884 PRESIDENT ABOUT AREAS OF SCIENCE 2354 01:26:29,884 --> 01:26:31,953 THAT THEY WISH US TO INVEST IN. 2355 01:26:31,953 --> 01:26:37,425 YOU KNOW, WE WORK ON THAT, HOW 2356 01:26:37,425 --> 01:26:39,293 DO WE PRIORITIZE THAT, WHAT'S 2357 01:26:39,293 --> 01:26:41,262 THE CHANGES THAT ARE NECESSARY? 2358 01:26:41,262 --> 01:26:43,798 THE IMPROVE PROGRAM STARTED OUT 2359 01:26:43,798 --> 01:26:45,433 AS SOMETHING WHICH DID NOT HAVE 2360 01:26:45,433 --> 01:26:49,670 A DEDICATED STREAM OF FUNDING AT 2361 01:26:49,670 --> 01:26:50,004 NIH. 2362 01:26:50,004 --> 01:26:51,539 IT WAS SOMETHING THE ICs CAME 2363 01:26:51,539 --> 01:26:52,773 TOGETHER TO FUND BUT IT DIDN'T 2364 01:26:52,773 --> 01:26:54,075 HAVE A DEDICATED STREAM AND THE 2365 01:26:54,075 --> 01:26:56,610 CONGRESS DECIDED THAT THAT WAS 2366 01:26:56,610 --> 01:26:57,278 NOT ENOUGH. 2367 01:26:57,278 --> 01:26:59,480 THEY WANTED A DEDICATED FUNDING 2368 01:26:59,480 --> 01:27:00,247 POT, FOR EXAMPLE. 2369 01:27:00,247 --> 01:27:03,117 SO THEY TOLD US HOW MUCH MONEY 2370 01:27:03,117 --> 01:27:04,185 WE SHOULD BE PUTTING INTO IT. 2371 01:27:04,185 --> 01:27:05,419 SO THAT IS ONE OF THOSE THINGS 2372 01:27:05,419 --> 01:27:07,355 WE HAVE TO THEN CONSIDER, HOW DO 2373 01:27:07,355 --> 01:27:10,324 WE SHIFT AND BALANCE. 2374 01:27:10,324 --> 01:27:13,594 I THINK THAT'S WHAT THE 2375 01:27:13,594 --> 01:27:14,895 LEADERSHIP DECISIONS OFTEN COME 2376 01:27:14,895 --> 01:27:16,864 DOWN TO, IS HOW DO WE SHIFT 2377 01:27:16,864 --> 01:27:18,532 PRIORITIES, HOW DO WE FOCUS 2378 01:27:18,532 --> 01:27:19,300 RESOURCES. 2379 01:27:19,300 --> 01:27:22,903 IF WE HAVE REDUCTIONS IN BUDGET 2380 01:27:22,903 --> 01:27:24,438 BUT INCREASED COST, WE HAVE TO 2381 01:27:24,438 --> 01:27:30,845 MAKE SOME TRADEOFFS. 2382 01:27:30,845 --> 01:27:33,881 >> I WOULD JUST SAY THAT EACH 2383 01:27:33,881 --> 01:27:34,749 ADMINISTRATION HAS THEIR 2384 01:27:34,749 --> 01:27:35,750 PRIORITIES AND THERE'S A LONG 2385 01:27:35,750 --> 01:27:37,818 TRACK RECORD AT NIH OF WORKING 2386 01:27:37,818 --> 01:27:40,454 WITH EACH ADMINISTRATION TO FIND 2387 01:27:40,454 --> 01:27:41,122 COMMON GROUND. 2388 01:27:41,122 --> 01:27:42,423 AND THAT'S WHAT WE WILL DO. 2389 01:27:42,423 --> 01:27:44,959 WE DON'T KNOW ANYTHING YET. 2390 01:27:44,959 --> 01:27:47,395 THE TRANSITION HASN'T OCCURRED. 2391 01:27:47,395 --> 01:27:49,463 SO ONCE IT OCCURS, WE LOOK 2392 01:27:49,463 --> 01:27:51,432 FORWARD TO WORKING WITH THE NEW 2393 01:27:51,432 --> 01:27:55,069 FOLKS WHO WILL BE IN CHARGE. 2394 01:27:55,069 --> 01:27:57,671 >> I GUESS MY OTHER QUESTION IS 2395 01:27:57,671 --> 01:28:02,710 SOME AREAS OF RESEARCH REQUIRE A 2396 01:28:02,710 --> 01:28:04,045 HIGHER BUDGET THAN OTHERS. 2397 01:28:04,045 --> 01:28:10,384 FOR EXAMPLE, A LOT OF THE OMICS 2398 01:28:10,384 --> 01:28:12,787 RESEARCH WITH HIGH COSTS OF 2399 01:28:12,787 --> 01:28:14,121 SEQUENCING AND THINGS, ALTHOUGH 2400 01:28:14,121 --> 01:28:15,222 THOSE COSTS ARE COMING DOWN WITH 2401 01:28:15,222 --> 01:28:17,191 TIME. 2402 01:28:17,191 --> 01:28:20,461 AND THEN ANOTHER AREA IS GENE 2403 01:28:20,461 --> 01:28:27,034 THERAPY, THE ACTUAL THERAPEUTIC 2404 01:28:27,034 --> 01:28:28,903 ITSELF COULD BE COSTLY TO 2405 01:28:28,903 --> 01:28:29,670 ADMINISTER, YOU KNOW. 2406 01:28:29,670 --> 01:28:33,374 AND SO THE QUESTION IS, HOW DO 2407 01:28:33,374 --> 01:28:36,043 YOU WEIGH PROJECTS THAT 2408 01:28:36,043 --> 01:28:37,144 INHERENTLY HAVE MORE COSTS TO 2409 01:28:37,144 --> 01:28:38,579 THEM THAN OTHERS THAT DO NOT. 2410 01:28:38,579 --> 01:28:44,685 FOR EXAMPLE, MY DROSOPHILA WORK 2411 01:28:44,685 --> 01:28:46,120 IS CHEAPER TO DO THAN MOUSE 2412 01:28:46,120 --> 01:28:46,454 WORK. 2413 01:28:46,454 --> 01:28:49,190 I'M JUST WONDERING HOW THAT'S 2414 01:28:49,190 --> 01:28:49,957 DONE. 2415 01:28:49,957 --> 01:28:53,260 >> SO I THINK WHAT WE TRY TO DO 2416 01:28:53,260 --> 01:28:54,995 IN BUDGET IS PROVIDE -- WE WORK 2417 01:28:54,995 --> 01:28:57,098 WITH OUR STAFF TO TRY TO PROVIDE 2418 01:28:57,098 --> 01:28:59,667 ALLOCATIONS OUT TO THE BRANCHES 2419 01:28:59,667 --> 01:29:01,702 THAT FOR EACH COUNCIL ROUND ARE 2420 01:29:01,702 --> 01:29:03,003 BASED ON THE APPLICATIONS THEY 2421 01:29:03,003 --> 01:29:06,707 HAVE IN HAND. 2422 01:29:06,707 --> 01:29:10,678 AND THEN THE BRANCHES THEN MAKE 2423 01:29:10,678 --> 01:29:12,847 DECISIONS ABOUT COULD YOU TRIM 2424 01:29:12,847 --> 01:29:13,948 AN APPLICATION OR NOT? 2425 01:29:13,948 --> 01:29:16,050 IF YOU TRIMMED IT, WOULD IT BE 2426 01:29:16,050 --> 01:29:16,817 DETRIMENTAL TO THE SCIENCE? 2427 01:29:16,817 --> 01:29:18,819 DO YOU HAVE TO LOOK AT -- YOU 2428 01:29:18,819 --> 01:29:19,987 HAVE TO LOOK AT THE AIMS AND 2429 01:29:19,987 --> 01:29:21,655 THINGS LIKE THAT. 2430 01:29:21,655 --> 01:29:25,159 SO BECAUSE WE'RE BASING OUR 2431 01:29:25,159 --> 01:29:26,460 ALLOCATIONS ON -- FOR EACH 2432 01:29:26,460 --> 01:29:27,761 COUNCIL ROUND ON THE 2433 01:29:27,761 --> 01:29:29,530 APPLICATIONS IN HAND, I THINK 2434 01:29:29,530 --> 01:29:32,266 OUR FUNDING IS TAKING INTO 2435 01:29:32,266 --> 01:29:33,901 ACCOUNT THE DIFFERENT COSTS OF 2436 01:29:33,901 --> 01:29:35,436 THAT DIFFERENT SCIENCE AS YOU 2437 01:29:35,436 --> 01:29:37,071 WERE OUTLINING. 2438 01:29:37,071 --> 01:29:39,006 IT MAY MEAN IF WE GET A LOT OF 2439 01:29:39,006 --> 01:29:41,041 CLINICAL TRIALS IN ONE ROUND, 2440 01:29:41,041 --> 01:29:42,309 HONESTLY, WE MAY NOT BE ABLE TO 2441 01:29:42,309 --> 01:29:44,044 FUND AS MANY GRANTS. 2442 01:29:44,044 --> 01:29:45,779 BUT YOU KNOW, WE'RE TRYING TO 2443 01:29:45,779 --> 01:29:48,182 BASE THE FUNDING WE GIVE TO OUR 2444 01:29:48,182 --> 01:29:49,416 BRANCHES ON WHAT THEY ACTUALLY 2445 01:29:49,416 --> 01:29:50,951 HAVE IN FRONT OF THEM FOR THAT 2446 01:29:50,951 --> 01:29:54,555 COUNCIL ROUND. 2447 01:29:54,555 --> 01:29:57,324 >> CAN I ASK ONE? 2448 01:29:57,324 --> 01:30:01,061 >> SURE. 2449 01:30:01,061 --> 01:30:03,964 >> MIMI, SOME OF THE BIG TICKET 2450 01:30:03,964 --> 01:30:05,499 ITEMS YOU WERE ALLUDING TO, 2451 01:30:05,499 --> 01:30:08,102 EITHER GENOMICS INITIATIVES OR 2452 01:30:08,102 --> 01:30:13,941 CLINICAL TRIALS OR BIG PROGRAMS, 2453 01:30:13,941 --> 01:30:16,677 THERE ARE FREQUENTLY NIH-WIDE 2454 01:30:16,677 --> 01:30:17,111 PROGRAMS. 2455 01:30:17,111 --> 01:30:18,012 SOME OF THEM WILL HAVE A 2456 01:30:18,012 --> 01:30:19,113 SEPARATE APPROPRIATION, SOME OF 2457 01:30:19,113 --> 01:30:19,780 THEM DO NOT. 2458 01:30:19,780 --> 01:30:22,183 SO THAT'S WHY WE HIGHLIGHTED THE 2459 01:30:22,183 --> 01:30:23,184 KIDS FIRST INITIATIVE THAT HAS A 2460 01:30:23,184 --> 01:30:26,253 SEPARATE INITIATIVE, AND IS 2461 01:30:26,253 --> 01:30:28,522 PAYING FOR A LOT OF GENOMIC 2462 01:30:28,522 --> 01:30:29,657 SEQUENCING FOR A LOT OF 2463 01:30:29,657 --> 01:30:32,493 RESEARCHERS WHO HAVE COHORTS OF 2464 01:30:32,493 --> 01:30:34,895 CHILDREN WITH EITHER CANCER OR 2465 01:30:34,895 --> 01:30:38,933 STRUCTURAL ANOMALIES. 2466 01:30:38,933 --> 01:30:41,035 IF IT SOMETHING THAT IS JUST 2467 01:30:41,035 --> 01:30:42,903 WITHIN OUR BUDGET, WE HAVE TO 2468 01:30:42,903 --> 01:30:46,273 MAKE DIFFICULT CHOICES. 2469 01:30:46,273 --> 01:30:48,175 THE PIE DOESN'T NECESSARILY GET 2470 01:30:48,175 --> 01:30:49,376 BIGGER, IN FACT, IT MIGHT GET 2471 01:30:49,376 --> 01:30:51,345 SMALLER NOW. 2472 01:30:51,345 --> 01:30:53,214 SO AGAIN, THE STRATEGIC PLAN IS 2473 01:30:53,214 --> 01:30:55,716 OUR STARTING POINT, AND IT KIND 2474 01:30:55,716 --> 01:30:57,685 OF WILL TELL YOU WHAT WE'RE NOT 2475 01:30:57,685 --> 01:30:59,620 GOING TO FUND, SO, THEREFORE, 2476 01:30:59,620 --> 01:31:01,522 THAT TYPE OF RESEARCH WILL HAVE 2477 01:31:01,522 --> 01:31:04,058 TO GO TO ANOTHER INSTITUTE OR 2478 01:31:04,058 --> 01:31:07,428 CENTER, AND AS ALWAYS, WE 2479 01:31:07,428 --> 01:31:08,562 ENCOURAGE PROSPECTIVE APPLICANTS 2480 01:31:08,562 --> 01:31:11,198 TO TALK TO PROJECT OFFICIALS OR 2481 01:31:11,198 --> 01:31:14,034 PROGRAM OFFICIALS TO INQUIRE 2482 01:31:14,034 --> 01:31:15,469 WHETHER THIS PARTICULAR AREA OF 2483 01:31:15,469 --> 01:31:17,438 RESEARCH IS OF INTEREST TO 2484 01:31:17,438 --> 01:31:21,475 NICHD. 2485 01:31:21,475 --> 01:31:23,444 >> DR. CEDARS? 2486 01:31:23,444 --> 01:31:24,979 >> THANK YOU. 2487 01:31:24,979 --> 01:31:29,049 THIS DISCUSSION AND DR. JABS' 2488 01:31:29,049 --> 01:31:30,751 QUESTIONS BROUGHT UP AN ISSUE 2489 01:31:30,751 --> 01:31:31,986 FOR ME KIND OF TYING TOGETHER 2490 01:31:31,986 --> 01:31:34,288 YOUR CONVERSATION AND 2491 01:31:34,288 --> 01:31:35,823 DR. BIANCHI'S PRESENTATION. 2492 01:31:35,823 --> 01:31:39,226 AND I JUST WANTED TO REVISIT THE 2493 01:31:39,226 --> 01:31:41,428 WOMEN'S HEALTH RESEARCH ISSUE 2494 01:31:41,428 --> 01:31:44,798 AND AGAIN, APPRECIATE NICHD'S 2495 01:31:44,798 --> 01:31:46,700 FOCUS ON THIS. 2496 01:31:46,700 --> 01:31:48,969 I DID LOOK QUICKLY AT THE 2497 01:31:48,969 --> 01:31:52,273 ARTICLE THAT WAS SENT, AND JUST 2498 01:31:52,273 --> 01:31:55,676 TO SO -- TWO SORT OF RELATED 2499 01:31:55,676 --> 01:31:56,110 QUESTIONS. 2500 01:31:56,110 --> 01:31:57,311 ONE IS EVEN IN THAT ARTICLE THEY 2501 01:31:57,311 --> 01:31:59,947 QUOTE ABOUT 10% OF NIH BUDGET 2502 01:31:59,947 --> 01:32:01,348 GOING TO WOMEN'S HEALTH 2503 01:32:01,348 --> 01:32:02,249 RESEARCH. 2504 01:32:02,249 --> 01:32:04,752 I THINK THE NASEM REPORT WAS 2505 01:32:04,752 --> 01:32:06,086 ABOUT 8%. 2506 01:32:06,086 --> 01:32:09,490 SO STILL IN THE SAME LEVEL AND 2507 01:32:09,490 --> 01:32:11,225 LOW, AND THERE WAS A LOT OF 2508 01:32:11,225 --> 01:32:14,962 DISCUSSION IN THE ARTICLE ABOUT 2509 01:32:14,962 --> 01:32:15,829 BIDEN'S -- THE WHITE HOUSE 2510 01:32:15,829 --> 01:32:16,964 INITIATIVE, AND I REALIZE YOU 2511 01:32:16,964 --> 01:32:19,033 HAVE NO CRYSTAL BALL, ALTHOUGH I 2512 01:32:19,033 --> 01:32:21,568 WISH WE ALL DID. 2513 01:32:21,568 --> 01:32:25,673 BUT GIVEN THE INCOMING CHANGE IN 2514 01:32:25,673 --> 01:32:27,007 THE WHITE HOUSE, WHAT'S GOING TO 2515 01:32:27,007 --> 01:32:29,610 HAPPEN TO THE WOMEN'S -- THE 2516 01:32:29,610 --> 01:32:30,678 WHITE HOUSE INITIATIVE FOR 2517 01:32:30,678 --> 01:32:34,848 WOMEN'S HEALTH RESEARCH, AND 2518 01:32:34,848 --> 01:32:37,584 AGAIN EVEN WITHIN NICHD, ARE 2519 01:32:37,584 --> 01:32:39,219 THERE CONSIDERATIONS FOR 2520 01:32:39,219 --> 01:32:40,754 INCREASING THE PERCENT OF FUNDS 2521 01:32:40,754 --> 01:32:43,324 THAT GO TO WOMEN'S HEALTH OVER 2522 01:32:43,324 --> 01:32:45,726 THIS ACROSS THE BOARD NIH 2523 01:32:45,726 --> 01:32:46,960 INCLUDING A REALLY HIGH AMOUNT 2524 01:32:46,960 --> 01:32:49,029 THAT GOES TO BREAST CANCER AND 2525 01:32:49,029 --> 01:32:50,764 OTHER ISSUES THAT'S INCLUDED IN 2526 01:32:50,764 --> 01:32:53,200 THAT WOMEN'S HEALTH RESEARCH? 2527 01:32:53,200 --> 01:32:55,269 ANY THOUGHT ABOUT HOW WE 2528 01:32:55,269 --> 01:32:56,503 INCREASE THE AMOUNT OF DOLLARS 2529 01:32:56,503 --> 01:32:58,906 THAT ACTUALLY GO TO WOMEN'S 2530 01:32:58,906 --> 01:33:00,607 HEALTH RESEARCH, PARTICULARLY IN 2531 01:33:00,607 --> 01:33:01,775 THE CURRENT POLITICAL 2532 01:33:01,775 --> 01:33:02,076 ENVIRONMENT? 2533 01:33:02,076 --> 01:33:08,315 THANK YOU. 2534 01:33:08,315 --> 01:33:10,017 >> I DREW THE SHORT STRAW TO 2535 01:33:10,017 --> 01:33:12,386 ANSWER YOU. 2536 01:33:12,386 --> 01:33:16,090 I MEAN, WE DON'T KNOW WHAT THE 2537 01:33:16,090 --> 01:33:17,424 NEW ADMINISTRATION IS THINKING 2538 01:33:17,424 --> 01:33:19,193 OR WILL BE THINKING. 2539 01:33:19,193 --> 01:33:20,961 WHAT I CAN TELL YOU IS THERE'S 2540 01:33:20,961 --> 01:33:23,130 BEEN AN ENORMOUS AMOUNT OF 2541 01:33:23,130 --> 01:33:26,667 EFFORT OVER THE PAST YEAR TO 2542 01:33:26,667 --> 01:33:29,403 INCREASE THE FOCUS ON WOMEN'S 2543 01:33:29,403 --> 01:33:30,170 HEALTH RESEARCH. 2544 01:33:30,170 --> 01:33:32,906 AND HOPEFULLY ONE OF THE 2545 01:33:32,906 --> 01:33:35,109 TAKEAWAYS OF THE NASEM REPORT 2546 01:33:35,109 --> 01:33:36,410 AND OF THE TREMENDOUS AMOUNT OF 2547 01:33:36,410 --> 01:33:37,644 WORK THAT'S BEEN DONE IN THE 2548 01:33:37,644 --> 01:33:40,748 PAST YEAR IS TO EDUCATE CONGRESS 2549 01:33:40,748 --> 01:33:44,118 ABOUT THE NEED FOR INCREASING 2550 01:33:44,118 --> 01:33:45,419 SUPPORT FOR WOMEN'S HEALTH 2551 01:33:45,419 --> 01:33:47,421 RESEARCH. 2552 01:33:47,421 --> 01:33:52,526 THAT BEING SAID, WE HAVE THE 2553 01:33:52,526 --> 01:33:55,629 ABILITY TO SHIFT PRIORITIES, 2554 01:33:55,629 --> 01:33:56,930 SHIFT PERCENTAGES AS YOU 2555 01:33:56,930 --> 01:33:58,565 MENTIONED AND WE SPECIFICALLY 2556 01:33:58,565 --> 01:34:01,101 MENTIONED THE ACT ENDO 2557 01:34:01,101 --> 01:34:05,773 INITIATIVE BECAUSE THAT, WE PUT 2558 01:34:05,773 --> 01:34:06,573 $3 MILLION ON THE TABLE 2559 01:34:06,573 --> 01:34:07,574 IMMEDIATELY AFTER OR AROUND THE 2560 01:34:07,574 --> 01:34:11,145 TIME THAT THE PRESIDENT -- THAT 2561 01:34:11,145 --> 01:34:12,146 PRESIDENT BIDEN MENTIONED IN THE 2562 01:34:12,146 --> 01:34:13,480 STATE OF THE UNION THAT HE 2563 01:34:13,480 --> 01:34:16,350 WANTED TO INCREASE SUPPORT FOR 2564 01:34:16,350 --> 01:34:17,217 WOMEN'S HEALTH RESEARCH. 2565 01:34:17,217 --> 01:34:21,722 SO WE CAN DO THINGS LIKE THAT, 2566 01:34:21,722 --> 01:34:27,194 YOU KNOW, IF IT COMES TO LARGE 2567 01:34:27,194 --> 01:34:28,829 ITEMS, THAT'S GOING TO BE 2568 01:34:28,829 --> 01:34:29,997 WHATEVER THE NEW ADMINISTRATION 2569 01:34:29,997 --> 01:34:30,964 LISTS AS A PRIORITY. 2570 01:34:30,964 --> 01:34:32,800 BUT YOU KNOW, THERE ARE 2571 01:34:32,800 --> 01:34:35,002 SIGNIFICANT NUMBER OF WOMEN IN 2572 01:34:35,002 --> 01:34:37,771 CONGRESS WHO ARE 2573 01:34:37,771 --> 01:34:41,141 REPRESENTATIVES, AND YOU KNOW, 2574 01:34:41,141 --> 01:34:43,343 PRESUMABLY THEY ARE AWARE OF 2575 01:34:43,343 --> 01:34:44,778 SOME OF THE ISSUES. 2576 01:34:44,778 --> 01:34:45,779 SOME OF THE THINGS LIKE, YOU 2577 01:34:45,779 --> 01:34:48,515 KNOW, MATERNAL MORTALITY, THOSE 2578 01:34:48,515 --> 01:34:50,717 ARE BIPARTISAN, BICAMERAL 2579 01:34:50,717 --> 01:34:50,951 ISSUES. 2580 01:34:50,951 --> 01:34:52,486 SO I THINK WE NEED TO FOCUS ON 2581 01:34:52,486 --> 01:34:52,920 THOSE. 2582 01:34:52,920 --> 01:34:55,656 THINGS THAT WE NEED TO WORK ON 2583 01:34:55,656 --> 01:34:57,324 TOGETHER TO SOLVE THE PROBLEMS. 2584 01:34:57,324 --> 01:34:59,193 BUT I DON'T HAVE A CRYSTAL BALL, 2585 01:34:59,193 --> 01:35:01,361 I DON'T KNOW WHAT THE NEW 2586 01:35:01,361 --> 01:35:03,897 PRIORITIES WILL BE, BUT ONCE WE 2587 01:35:03,897 --> 01:35:08,402 LEARN ABOUT THEM, WE WILL WORK 2588 01:35:08,402 --> 01:35:10,471 VERY HARD TO FIND COMMON GROUND 2589 01:35:10,471 --> 01:35:12,973 AND TO USE THE RESOURCES WE HAVE 2590 01:35:12,973 --> 01:35:15,309 TO ADDRESS THE PROBLEMS AND FIND 2591 01:35:15,309 --> 01:35:21,915 SOLUTIONS THROUGH RESEARCH. 2592 01:35:21,915 --> 01:35:22,950 >> THANK YOU. 2593 01:35:22,950 --> 01:35:29,256 >> ANY OTHER QUESTIONS OR 2594 01:35:29,256 --> 01:35:36,830 CONCERNS, COMMENTS? 2595 01:35:36,830 --> 01:35:37,798 ALL RIGHT. 2596 01:35:37,798 --> 01:35:38,799 WELL, THANK YOU VERY MUCH. 2597 01:35:38,799 --> 01:35:40,534 CERTAINLY IF YOU THINK OF ANY 2598 01:35:40,534 --> 01:35:41,969 QUESTIONS, I'M HAPPY TO ANSWER 2599 01:35:41,969 --> 01:35:44,071 THINGS IN THE FUTURE. 2600 01:35:44,071 --> 01:35:45,706 AND THANK YOU FOR YOUR TIME AND 2601 01:35:45,706 --> 01:35:47,474 ATTENTION. 2602 01:35:47,474 --> 01:35:49,877 >> THANK YOU, ALEXIS. 2603 01:35:49,877 --> 01:35:55,716 AGAIN, VERY, VERY IMPORTANT 2604 01:35:55,716 --> 01:35:56,250 PRESENTATION. 2605 01:35:56,250 --> 01:35:57,551 WE ALWAYS APPRECIATE YOUR 2606 01:35:57,551 --> 01:35:58,785 MASTERY AND MANAGEMENT OF THE 2607 01:35:58,785 --> 01:36:00,487 NIH BUDGET, AND YOU DO IT WITH 2608 01:36:00,487 --> 01:36:01,522 GOOD HUMOR TOO, WHICH IS 2609 01:36:01,522 --> 01:36:04,691 REQUIRED IN THIS POSITION. 2610 01:36:04,691 --> 01:36:06,560 SO AT THIS TIME, WE'RE GOING TO 2611 01:36:06,560 --> 01:36:09,863 TAKE A 10-MINUTE BREAK UNTIL -- 2612 01:36:09,863 --> 01:36:11,198 WE'RE NOT TAKING A 10-MINUTE 2613 01:36:11,198 --> 01:36:15,769 BREAK? 2614 01:36:15,769 --> 01:36:16,603 20 MINUTES. 2615 01:36:16,603 --> 01:36:17,971 ISN'T IT 1:55? 2616 01:36:17,971 --> 01:36:19,306 NO, IT'S NOT. 2617 01:36:19,306 --> 01:36:19,740 SORRY. 2618 01:36:19,740 --> 01:36:22,809 WE EARNED ANOTHER 10 MINUTES. 2619 01:36:22,809 --> 01:36:27,247 SO WE WILL COME BACK AT 2:05 -- 2620 01:36:27,247 --> 01:36:28,749 2:00. 2621 01:36:28,749 --> 01:36:34,121 BE ON AT 2:00. 2622 01:36:34,121 --> 01:36:35,756 WE'RE GOING TO HAVE A FANTASTIC 2623 01:36:35,756 --> 01:36:36,990 PRESENTATION FROM THE NEW -- 2624 01:36:36,990 --> 01:36:39,593 RELATIVELY NEW DIRECTOR OF 2625 01:36:39,593 --> 01:36:40,928 NIAID, DR. MARRAZZO. 2626 01:36:40,928 --> 01:36:42,263 SO ENJOY YOUR BREAK. 2627 01:36:44,622 --> 01:36:45,890 >> WELCOME BACK, EVERYONE. 2628 01:36:45,890 --> 01:36:48,526 IT IS NOW MY GREAT PLEASURE TO 2629 01:36:48,526 --> 01:36:50,695 INTRODUCE OUR NEXT SPEAKER, 2630 01:36:50,695 --> 01:36:55,232 DR. JEANNE MARRAZZO. 2631 01:36:55,232 --> 01:36:56,400 DR. MARRAZZO WAS APPOINTED AS 2632 01:36:56,400 --> 01:36:57,368 DIRECTOR OF THE NATIONAL 2633 01:36:57,368 --> 01:36:59,036 INSTITUTE OF ALLERGY AND 2634 01:36:59,036 --> 01:37:00,371 INFECTIOUS DISEASES, OTHERWISE 2635 01:37:00,371 --> 01:37:05,643 KNOWN ACI AS NIAID IN THE FALL F 2636 01:37:05,643 --> 01:37:08,946 2023, WHERE SHE OVERSEES A 2637 01:37:08,946 --> 01:37:09,614 $6.6 BILLION BUDGET JUST FOR 2638 01:37:09,614 --> 01:37:12,450 FRAME OF REFERENCE, OUR BUDGET 2639 01:37:12,450 --> 01:37:14,218 IS $1.75 BILLION. 2640 01:37:14,218 --> 01:37:16,387 SHE'S ALSO A LEADING RESEARCHER 2641 01:37:16,387 --> 01:37:18,055 IN THE FIELD OF SEXUALLY 2642 01:37:18,055 --> 01:37:20,491 TRANSMITTED INFECTIONS, 2643 01:37:20,491 --> 01:37:21,258 ESPECIALLY AS THEY AFFECT 2644 01:37:21,258 --> 01:37:25,096 WOMEN'S HEALTH. 2645 01:37:25,096 --> 01:37:27,264 PRIOR TO HER POSITION AT NIAID, 2646 01:37:27,264 --> 01:37:29,100 SHE WAS DIRECTOR OF THE DIVISION 2647 01:37:29,100 --> 01:37:29,734 OF INFECTIOUS DISEASES AT THE 2648 01:37:29,734 --> 01:37:32,236 UNIVERSITY OF ALABAMA AT 2649 01:37:32,236 --> 01:37:35,773 BIRMINGHAM, AND SHE HAS CHAIRED 2650 01:37:35,773 --> 01:37:38,275 THE AMERICAN BOARD OF INTERNAL 2651 01:37:38,275 --> 01:37:41,312 MEDICINE COUNCIL AND THE ABIM 2652 01:37:41,312 --> 01:37:41,879 INFECTIOUS DISEASE SPECIALTY 2653 01:37:41,879 --> 01:37:42,680 BOARD. 2654 01:37:42,680 --> 01:37:43,781 ORIGINALLY FROM SCRANTON, 2655 01:37:43,781 --> 01:37:45,216 PENNSYLVANIA, WHICH I LEARNED 2656 01:37:45,216 --> 01:37:48,152 THIS SPRING, DR. MARRAZZO 2657 01:37:48,152 --> 01:37:50,454 GRADUATED FROM HARVARD 2658 01:37:50,454 --> 01:37:50,755 UNIVERSITY. 2659 01:37:50,755 --> 01:37:53,324 SHE EARNED HER M.D. FROM THOMAS 2660 01:37:53,324 --> 01:37:55,926 JEFFERSON UNIVERSITY, AND HER 2661 01:37:55,926 --> 01:37:57,962 M.P.H. IN EPIDEMIOLOGY FROM THE 2662 01:37:57,962 --> 01:37:58,663 UNIVERSITY OF WASHINGTON, 2663 01:37:58,663 --> 01:37:59,463 SEATTLE. 2664 01:37:59,463 --> 01:38:01,432 SHE COMPLETED HER RESIDENCY AND 2665 01:38:01,432 --> 01:38:03,401 CHIEF RESIDENCY IN INTERNAL 2666 01:38:03,401 --> 01:38:05,603 MEDICINE AT YALE NEW HAIIVE 2667 01:38:05,603 --> 01:38:06,871 HOSPITAL. 2668 01:38:06,871 --> 01:38:10,341 NEW HAVENHOSPITAL. 2669 01:38:10,341 --> 01:38:11,776 SHE'S A FELLOW OF THE AMERICAN 2670 01:38:11,776 --> 01:38:14,845 COLLEGE OF PHYSICIANS AND OF THE 2671 01:38:14,845 --> 01:38:15,880 INFECTIOUS DISEASES SOCIETY OF 2672 01:38:15,880 --> 01:38:17,148 AMERICA AND SHE'S BOARD 2673 01:38:17,148 --> 01:38:18,916 CERTIFIED IN INFECTIOUS 2674 01:38:18,916 --> 01:38:19,183 DISEASES. 2675 01:38:19,183 --> 01:38:21,218 I'M SO HONORED AND PROUD TO HAVE 2676 01:38:21,218 --> 01:38:22,553 HER AS A COLLEAGUE. 2677 01:38:22,553 --> 01:38:23,621 TODAY, DR. MARRAZZO WILL BE 2678 01:38:23,621 --> 01:38:26,290 GIVING US AN UPDATE ON NIAID'S 2679 01:38:26,290 --> 01:38:28,693 PRIORITIES FOR RESEARCH IN WOMEN 2680 01:38:28,693 --> 01:38:29,126 AND CHILDREN. 2681 01:38:29,126 --> 01:38:32,229 OVER TO YOU, GENIE. 2682 01:38:32,229 --> 01:38:32,697 , JEANNE. 2683 01:38:32,697 --> 01:38:33,764 >> THANK YOU SO MUCH, DIANA. 2684 01:38:33,764 --> 01:38:36,867 CAN YOU ALL HEAR ME OKAY? 2685 01:38:36,867 --> 01:38:37,068 GREAT. 2686 01:38:37,068 --> 01:38:39,403 I'M GOING TO JUMP RIGHT IN AND 2687 01:38:39,403 --> 01:38:41,906 START SHARING MY SLIDES AND 2688 01:38:41,906 --> 01:38:44,542 HOPEFULLY THIS WILL WORK. 2689 01:38:44,542 --> 01:38:45,810 LOOKS LIKE HOPEFULLY YOU GUYS 2690 01:38:45,810 --> 01:38:47,445 CAN ALL SEE THAT. 2691 01:38:47,445 --> 01:38:51,282 SO IT'S JUST A HUGE HONOR TO BE 2692 01:38:51,282 --> 01:38:52,983 ABLE TO SPEAK WITH YOU TODAY. 2693 01:38:52,983 --> 01:38:54,985 I HOPE THAT WE HAVE TIME FOR AT 2694 01:38:54,985 --> 01:38:56,587 LEAST A COUPLE OF QUESTIONS IF 2695 01:38:56,587 --> 01:38:58,289 PEOPLE HAVE ANY, ALTHOUGH I DO 2696 01:38:58,289 --> 01:39:00,558 HAVE A LOT TO SAY BECAUSE WE 2697 01:39:00,558 --> 01:39:02,093 HAVE A LOT OF PRIORITIES FOR 2698 01:39:02,093 --> 01:39:04,195 RESEARCH IN WOMEN AND CHILDREN, 2699 01:39:04,195 --> 01:39:06,397 AND IT'S BEEN A REAL PLEASURE 2700 01:39:06,397 --> 01:39:09,934 GETTING TO KNOW THE NICHD TEAM A 2701 01:39:09,934 --> 01:39:13,537 BIT MORE AS I HAVE STARTED IN 2702 01:39:13,537 --> 01:39:13,971 THIS ROLE. 2703 01:39:13,971 --> 01:39:14,939 SO JUST BECAUSE I DON'T KNOW 2704 01:39:14,939 --> 01:39:16,640 MANY OF YOU, I'LL GIVE YOU A 2705 01:39:16,640 --> 01:39:18,843 VERY BRIEF BACKGROUND, ALTHOUGH 2706 01:39:18,843 --> 01:39:21,412 DIANA VERY KINDLY JUST GAVE YOU 2707 01:39:21,412 --> 01:39:23,080 SOME OF THE HIGHLIGHTS AT LEAST 2708 01:39:23,080 --> 01:39:24,482 OF WHERE I'VE SPENT MY TIME, BUT 2709 01:39:24,482 --> 01:39:26,117 THE BOTTOM LINE IS THAT I HAVE 2710 01:39:26,117 --> 01:39:27,084 BEEN INTERESTED IN WOMEN'S 2711 01:39:27,084 --> 01:39:29,687 HEALTH FOR A REALLY LONG TIME. 2712 01:39:29,687 --> 01:39:32,656 IT MAY HAVE STARTED WITH MY MOM, 2713 01:39:32,656 --> 01:39:35,659 WHO IS A RETIRED NURSE, THAT'S A 2714 01:39:35,659 --> 01:39:38,496 PHOTO OF HER WORKING AT AN ARMY 2715 01:39:38,496 --> 01:39:43,300 HOSPITAL IN ITALY, LIVORNO, 2716 01:39:43,300 --> 01:39:44,468 WHICH ACTUALLY IS WHERE I WAS 2717 01:39:44,468 --> 01:39:46,437 BORN, AND SHE WAS AN ONCOLOGY 2718 01:39:46,437 --> 01:39:48,139 NURSE IN THE LATE 80s IN 2719 01:39:48,139 --> 01:39:52,510 SCRANTON, MID TO LATE 80s, 2720 01:39:52,510 --> 01:39:54,245 ACTUALLY, AND STARTED TAKING 2721 01:39:54,245 --> 01:39:55,880 CARE OF A LOT OF YOUNG MEN WHO 2722 01:39:55,880 --> 01:39:58,716 WERE RETURNING HOME FROM THE BIG 2723 01:39:58,716 --> 01:40:00,684 CITIES LIKE NEW YORK AND 2724 01:40:00,684 --> 01:40:02,553 PHILADELPHIA MOSTLY, WHO WERE 2725 01:40:02,553 --> 01:40:04,688 DYING OF HIV AND CAME HOMEY 2726 01:40:04,688 --> 01:40:08,893 SENHOMEESSENTIALLY TO DIE, AND D 2727 01:40:08,893 --> 01:40:11,395 ON ME VERY EARLY THE NEED TO 2728 01:40:11,395 --> 01:40:11,962 PROVIDE COMPASSIONATE CARE, 2729 01:40:11,962 --> 01:40:12,930 BECAUSE MANY PROVIDERS AT THAT 2730 01:40:12,930 --> 01:40:15,733 TIME WERE REFUSING TO TAKE CARE 2731 01:40:15,733 --> 01:40:18,369 OF THESE PATIENTS, AND OBVIOUSLY 2732 01:40:18,369 --> 01:40:20,671 AT THAT POINT, AIDS CARE WAS 2733 01:40:20,671 --> 01:40:22,640 HOSPICE CARE, TOWARDS THE END OF 2734 01:40:22,640 --> 01:40:25,009 LIFE, AND SO ONCOLOGISTS DID 2735 01:40:25,009 --> 01:40:26,644 HOSPICE CARE AND THAT'S HOW MY 2736 01:40:26,644 --> 01:40:28,512 MOM GOT INVOLVED. 2737 01:40:28,512 --> 01:40:31,315 SO REALLY WAS INFORMED JUST IN 2738 01:40:31,315 --> 01:40:34,285 TERMS OF KIND OF COMPASSIONATE 2739 01:40:34,285 --> 01:40:36,353 CARE AND OUTREACH, AND MY MOM 2740 01:40:36,353 --> 01:40:38,055 DOING HER SOCIAL JUSTICE THING 2741 01:40:38,055 --> 01:40:40,558 IN HER QUIET WAY. 2742 01:40:40,558 --> 01:40:42,092 SO REALLY INFORMED A LOT OF 2743 01:40:42,092 --> 01:40:44,929 WHERE I ENDED UP GOING IN MY 2744 01:40:44,929 --> 01:40:48,332 RESIDENCY IN NEW HAVEN, LOTS OF 2745 01:40:48,332 --> 01:40:50,835 WOMEN AFFECTED BY HIV. 2746 01:40:50,835 --> 01:40:53,771 VERY MUCH A MICROCHASM OF 2747 01:40:53,771 --> 01:40:55,172 TRANSMISSION KIND OF NETWORK 2748 01:40:55,172 --> 01:40:57,141 THAT WAS SIMILAR TO WHAT WE SAW 2749 01:40:57,141 --> 01:40:59,310 IN SUB-SAHARAN AFRICA IN 2750 01:40:59,310 --> 01:40:59,710 SUBSEQUENT YEARS. 2751 01:40:59,710 --> 01:41:02,446 SO I WAS VERY FORTUNATE TO HAVE 2752 01:41:02,446 --> 01:41:03,948 TRAINED AT YALE AND TO GET 2753 01:41:03,948 --> 01:41:06,517 INVOLVED VERY EARLY WITH HIV 2754 01:41:06,517 --> 01:41:08,786 CARE, PARTICULARLY AS IT RELATED 2755 01:41:08,786 --> 01:41:10,087 TO WOMEN. 2756 01:41:10,087 --> 01:41:11,488 SPENT MOST OF MY CAREER THEN AT 2757 01:41:11,488 --> 01:41:12,923 THE UNIVERSITY OF WASHINGTON, 2758 01:41:12,923 --> 01:41:15,860 WHERE I DID STUDY QUITE A LOT OF 2759 01:41:15,860 --> 01:41:17,695 STIs AND GOT A REALLY BIG 2760 01:41:17,695 --> 01:41:19,964 START IN MY RESEARCH WORLD IN 2761 01:41:19,964 --> 01:41:22,399 THE VAGINAL MICROBIOME WORKING 2762 01:41:22,399 --> 01:41:23,968 WITH DAVID FREDERICKS AND HIS 2763 01:41:23,968 --> 01:41:25,502 TEAM AT THE FRED HUTCH, AND WE 2764 01:41:25,502 --> 01:41:28,038 WERE AMONG THE FIRST TO REALLY 2765 01:41:28,038 --> 01:41:31,308 DEFINE THE SPECTRUM, 2766 01:41:31,308 --> 01:41:32,343 PARTICULARLY ANAEROBIC 2767 01:41:32,343 --> 01:41:35,846 COMMUNITIES THAT CHARACTERIZE 2768 01:41:35,846 --> 01:41:39,149 THE VAGINAL MICROENVIRONMENT SO 2769 01:41:39,149 --> 01:41:40,551 USING 16S CULTIVATION, 2770 01:41:40,551 --> 01:41:41,585 INDEPENDENT TECHNIQUES, AND GOT 2771 01:41:41,585 --> 01:41:43,888 VERY INVOLVED WITH BOTH TOPICAL 2772 01:41:43,888 --> 01:41:46,190 AND SYSTEMIC BASED PRE-EXPOSURE 2773 01:41:46,190 --> 01:41:47,258 PROPHYLAXIS FOR HIV AND STILL 2774 01:41:47,258 --> 01:41:48,792 HAVE A VERY STRONG INTEREST IN 2775 01:41:48,792 --> 01:41:50,194 ITS EVOLUTION TOWARDS 2776 01:41:50,194 --> 01:41:50,995 MULTICOMPONENT PREVENTION, WHICH 2777 01:41:50,995 --> 01:41:54,531 IS AN AREA THAT WE HAVE BEEN 2778 01:41:54,531 --> 01:41:55,666 INSTITUTIONALLY, BOTH OF OUR 2779 01:41:55,666 --> 01:41:57,268 INSTITUTES, VERY INVOLVED IN, 2780 01:41:57,268 --> 01:41:58,369 I'LL COME BACK AND TALK ABOUT 2781 01:41:58,369 --> 01:42:00,070 THAT IF WE HAVE TIME. 2782 01:42:00,070 --> 01:42:01,071 IN 2016, I DID GO TO THE 2783 01:42:01,071 --> 01:42:02,773 UNIVERSITY OF ALABAMA AT 2784 01:42:02,773 --> 01:42:04,408 BIRMINGHAM, WHERE I WAS THE 2785 01:42:04,408 --> 01:42:06,911 DIVISION DIRECTOR UNTIL I CAME 2786 01:42:06,911 --> 01:42:10,581 HERE TO BEGIN MY TENURE AS THE 2787 01:42:10,581 --> 01:42:11,482 SIXTH NIAID DIRECTOR IN THE FALL 2788 01:42:11,482 --> 01:42:13,684 OF 2023. 2789 01:42:13,684 --> 01:42:15,419 AND THAT IS MY SWEARING IN 2790 01:42:15,419 --> 01:42:16,620 CEREMONY. 2791 01:42:16,620 --> 01:42:18,789 JUST TO GIVE YOU A SENSE OF A 2792 01:42:18,789 --> 01:42:20,858 COUPLE OF BIG PEOPLE ON MY TEAM, 2793 01:42:20,858 --> 01:42:22,693 MANY OF YOU MAY HAVE WORKED WITH 2794 01:42:22,693 --> 01:42:26,297 OR KNOW DR. HUGH AUCHINCLOSS. 2795 01:42:26,297 --> 01:42:29,233 HE WAS DR. FAUCI'S PRINCIPAL 2796 01:42:29,233 --> 01:42:30,234 DIRECTOR -- DEPUTY DIRECTOR FOR 2797 01:42:30,234 --> 01:42:33,570 MANY YEARS, AND THEN THE ACTING 2798 01:42:33,570 --> 01:42:35,873 DIRECTOR OF NIAID WHEN I CAME ON 2799 01:42:35,873 --> 01:42:37,308 TO THIS ROLE. 2800 01:42:37,308 --> 01:42:40,744 HE RETIRED LAST SEPTEMBER, AFTER 2801 01:42:40,744 --> 01:42:42,413 STAYING ON MANY EXTRA MONTHS 2802 01:42:42,413 --> 01:42:44,815 JUST TO MAKE THE JOB POSSIBLE 2803 01:42:44,815 --> 01:42:46,984 FOR ME, WAS REALLY AN INCREDIBLE 2804 01:42:46,984 --> 01:42:48,485 HELP IN THE TRANSITION, AND 2805 01:42:48,485 --> 01:42:51,221 WE'VE BEEN VERY FORTUNATE TO 2806 01:42:51,221 --> 01:42:54,725 HAVE DR. SARAH READ NOW JOIN WHO 2807 01:42:54,725 --> 01:42:56,994 BECAME THE NEW DEPUTY DIRECTOR 2808 01:42:56,994 --> 01:42:58,395 IN OCTOBER '24. 2809 01:42:58,395 --> 01:43:00,464 YOU MAY KNOW HER IF YOU HAVE 2810 01:43:00,464 --> 01:43:02,533 DONE ANY WORK IN THE FIELD OF TB 2811 01:43:02,533 --> 01:43:03,100 OR HIV. 2812 01:43:03,100 --> 01:43:05,002 SHE WAS THE DEPUTY DIRECTOR IN 2813 01:43:05,002 --> 01:43:07,071 THE DIVISION OF AIDS FOR SEVERAL 2814 01:43:07,071 --> 01:43:08,605 YEARS, AND HAS A VERY STRONG 2815 01:43:08,605 --> 01:43:10,374 INTEREST IN TB VACCINES IN 2816 01:43:10,374 --> 01:43:11,742 PARTICULAR. 2817 01:43:11,742 --> 01:43:14,578 SO REALLY NICELY BUILDING UP THE 2818 01:43:14,578 --> 01:43:15,779 FRONT OFFICE TEAM HERE. 2819 01:43:15,779 --> 01:43:18,682 SO WHAT DO WE DO HERE AT NIAID? 2820 01:43:18,682 --> 01:43:22,086 WELL, THE SORT OF ON PAPER 2821 01:43:22,086 --> 01:43:23,454 MISSION IS SHOWN THERE. 2822 01:43:23,454 --> 01:43:24,755 BIOMEDICAL RESEARCH TO BETTER 2823 01:43:24,755 --> 01:43:28,359 UNDERSTAND AND TREAT INFECTIOUS, 2824 01:43:28,359 --> 01:43:29,727 IMMUNOLOGIC AND ALLERGIC 2825 01:43:29,727 --> 01:43:29,994 DISEASES. 2826 01:43:29,994 --> 01:43:31,528 REMEMBER ALLERGY IS PURPOSELY IN 2827 01:43:31,528 --> 01:43:32,262 THAT DESCRIPTION AND I'M GOING 2828 01:43:32,262 --> 01:43:34,098 TO TALK TO YOU ABOUT A COUPLE OF 2829 01:43:34,098 --> 01:43:35,299 REALLY GOOD HIGH POINTS, I 2830 01:43:35,299 --> 01:43:36,266 THINK, THAT MAKE SENSE. 2831 01:43:36,266 --> 01:43:38,035 AND IF YOU LOOK AT THIS FROM THE 2832 01:43:38,035 --> 01:43:40,037 STANDPOINT OF WHERE WE SORT OF 2833 01:43:40,037 --> 01:43:41,271 SPEND MOST OF OUR TIME AND MOST 2834 01:43:41,271 --> 01:43:44,541 OF OUR RESOURCES, IT REALLY 2835 01:43:44,541 --> 01:43:47,678 TURNS OUT TO BE DIVIDED MOSTLY 2836 01:43:47,678 --> 01:43:49,747 LIKE THIS, ABOUT A THIRD OF OUR 2837 01:43:49,747 --> 01:43:51,949 BUDGET AND TIME, IMMUNOLOGIC 2838 01:43:51,949 --> 01:43:53,751 DISEASES INCLUDING ALLERGY AND 2839 01:43:53,751 --> 01:43:54,852 ALLERGIC PHENOMENON, ABOUT A 2840 01:43:54,852 --> 01:43:58,222 THIRD IN HIV-RELATED RESEARCH 2841 01:43:58,222 --> 01:44:00,357 OFTEN REALLY DUE TO SOME OF THE 2842 01:44:00,357 --> 01:44:02,893 MANDATES WE HAVE AROUND SPENDING 2843 01:44:02,893 --> 01:44:04,962 HIV FUNDS, AND THEN THE REST OF 2844 01:44:04,962 --> 01:44:06,930 IT IN EVERYTHING ELSE 2845 01:44:06,930 --> 01:44:08,432 INFECTIOUS. 2846 01:44:08,432 --> 01:44:10,601 SO THAT'S NOT HIV-RELATED. 2847 01:44:10,601 --> 01:44:13,003 AND YOU CAN SEE THAT SOME OF THE 2848 01:44:13,003 --> 01:44:14,471 TOPICS IN EACH OF THOSE AREAS 2849 01:44:14,471 --> 01:44:15,906 THAT WE HAVE FOCUSED ON IN THE 2850 01:44:15,906 --> 01:44:18,008 PAST SEVERAL YEARS ARE SHOWN 2851 01:44:18,008 --> 01:44:18,776 THERE. 2852 01:44:18,776 --> 01:44:20,911 BUT WHAT I LIKE TO TELL PEOPLE 2853 01:44:20,911 --> 01:44:24,948 IS THAT THIS IS A ENTITY THAT 2854 01:44:24,948 --> 01:44:28,452 HAS NOT JUST LED MUCH OF THE 2855 01:44:28,452 --> 01:44:31,355 BASIC SCIENCE LABORATORY-BASED 2856 01:44:31,355 --> 01:44:33,223 RESEARCH, BUT IN THE FIELD, BUT 2857 01:44:33,223 --> 01:44:35,659 REALLY INFORMS PUBLIC HEALTH 2858 01:44:35,659 --> 01:44:37,828 INTERVENTIONS, AND WE'VE LISTED 2859 01:44:37,828 --> 01:44:40,864 A FEW OF THE DEVELOPMENTS THAT I 2860 01:44:40,864 --> 01:44:42,499 THINK ARE VERY INTERESTING TO 2861 01:44:42,499 --> 01:44:44,902 THIS GROUP HERE ON THIS SLIDE. 2862 01:44:44,902 --> 01:44:47,104 SO FOR EXAMPLE, BARNEY GRAM'S 2863 01:44:47,104 --> 01:44:49,239 GROUP WAS THE FIRST TO LOCK THE 2864 01:44:49,239 --> 01:44:51,542 RSV F PROTEIN IN WHAT'S CALLED A 2865 01:44:51,542 --> 01:44:52,576 PREFUSION STATE, WHICH IS WHAT 2866 01:44:52,576 --> 01:44:54,278 YOU NEED TO DO IN ORDER TO 2867 01:44:54,278 --> 01:44:55,779 GENERATE A PROTECTIVE IMMUNE 2868 01:44:55,779 --> 01:44:57,314 RESPONSE WITH A VACCINE. 2869 01:44:57,314 --> 01:44:59,917 THAT TECHNOLOGY, OF COURSE, ALSO 2870 01:44:59,917 --> 01:45:02,686 WAS USED FOR SARS-COV-2, THE 2871 01:45:02,686 --> 01:45:04,321 REASON THAT WE WERE ABLE TO 2872 01:45:04,321 --> 01:45:09,827 GENERATE EFFECTIVE VACCINES 2873 01:45:09,827 --> 01:45:11,829 AGAINST SARS-COV-2 AND THAT'S 2874 01:45:11,829 --> 01:45:13,030 VERY MUCH OF INTEREST, I KNOW, 2875 01:45:13,030 --> 01:45:14,998 TO WOMEN WHO ARE PREGNANT IN 2876 01:45:14,998 --> 01:45:15,833 PARTICULAR AS WELL AS AGING 2877 01:45:15,833 --> 01:45:16,066 PEOPLE. 2878 01:45:16,066 --> 01:45:17,801 THE LEARNING EARLY ABOUT PEANUT 2879 01:45:17,801 --> 01:45:18,802 ALLERGY TRIAL RESULTS, I'M GOING 2880 01:45:18,802 --> 01:45:21,071 TO TALK ABOUT THAT BECAUSE IT'S 2881 01:45:21,071 --> 01:45:23,574 A REALLY COOL STORY OF HOW YOU 2882 01:45:23,574 --> 01:45:26,210 CAN DO THE BASIC SCIENCE WORK, 2883 01:45:26,210 --> 01:45:27,678 DESIGN CLINICAL TRIALS AND THEN 2884 01:45:27,678 --> 01:45:29,213 TRANSLATE THOSE INTO REALLY 2885 01:45:29,213 --> 01:45:30,747 MEANINGFUL UPDATED GUIDELINES. 2886 01:45:30,747 --> 01:45:38,155 YOU PROBABLY HAVE HEARD ABOUT 2887 01:45:38,155 --> 01:45:39,556 LENOCAPOVIR, WHICH IS AN 2888 01:45:39,556 --> 01:45:40,858 INCREDIBLE ADVANCE IN THE FIELD 2889 01:45:40,858 --> 01:45:42,726 OF BIOMEDICAL HIV PREVENTION. 2890 01:45:42,726 --> 01:45:44,661 IT'S AN EVERY SIX MONTH 2891 01:45:44,661 --> 01:45:46,096 INJECTION THAT SEEMS TO BE I 2892 01:45:46,096 --> 01:45:47,531 WON'T SAY FULL PROOF BUT PRETTY 2893 01:45:47,531 --> 01:45:49,099 CLOSE AT PREVENTING ACQUISITION 2894 01:45:49,099 --> 01:45:52,269 OF HIV SEXUALLY IN VERY DIVERSE 2895 01:45:52,269 --> 01:45:52,703 POPULATIONS. 2896 01:45:52,703 --> 01:45:56,039 WE WERE VERY INVOLVED IN THE 2897 01:45:56,039 --> 01:45:57,708 FIRST SORT OF ITERATION OF THAT 2898 01:45:57,708 --> 01:46:00,644 GROUP OF PRODUCTS CALLED 2899 01:46:00,644 --> 01:46:02,079 CABOTEGRAVIR, HAVE A LOT OF 2900 01:46:02,079 --> 01:46:03,113 FINGERPRINTS THERE, THEN OF 2901 01:46:03,113 --> 01:46:04,681 COURSE IN TRANSPLANT MEDICINE, 2902 01:46:04,681 --> 01:46:06,850 WE HAVE A DIVISION OF ALLERGY, 2903 01:46:06,850 --> 01:46:07,818 IMMUNOLOGY AND TRANSPLANT, AND 2904 01:46:07,818 --> 01:46:11,622 THE MILESTONE OF THE XENO 2905 01:46:11,622 --> 01:46:12,256 TRANSPLANTATION INVOLVING THE 2906 01:46:12,256 --> 01:46:13,690 PIG KIDNEY THAT OCCURRED LAST 2907 01:46:13,690 --> 01:46:15,492 YEAR WAS VERY MUCH INFORMED BY 2908 01:46:15,492 --> 01:46:17,895 WORK DONE BY OUR GRANTEES AND IN 2909 01:46:17,895 --> 01:46:18,462 OUR INSTITUTE. 2910 01:46:18,462 --> 01:46:19,763 SO JUST A COUPLE OF THINGS. 2911 01:46:19,763 --> 01:46:20,998 AND THEN, OF COURSE, WHEN YOU 2912 01:46:20,998 --> 01:46:24,001 LOOK AT THE EFFECT OF 2913 01:46:24,001 --> 01:46:24,968 IMMUNIZATION, IT'S HARD AND I 2914 01:46:24,968 --> 01:46:28,472 KNOW THIS GROUP IS EX-WIS ITALY 2915 01:46:28,472 --> 01:46:30,107 ATTUNED TO THIS CONTRIBUTION, 2916 01:46:30,107 --> 01:46:31,508 IT'S HARD TO UNDERSTATE THE 2917 01:46:31,508 --> 01:46:33,177 IMPACT OF THE WORK THAT WE AND 2918 01:46:33,177 --> 01:46:38,048 SO MANY PEOPLE HAVE DONE TO 2919 01:46:38,048 --> 01:46:39,149 IMPROVE PARTICULARLY CHILDHOOD 2920 01:46:39,149 --> 01:46:39,917 HEALTH. 2921 01:46:39,917 --> 01:46:41,785 AND HEALTH DURING PREGNANCY WITH 2922 01:46:41,785 --> 01:46:42,686 THESE VACCINES. 2923 01:46:42,686 --> 01:46:43,921 AND I WOULD JUST POINT OUT WHAT 2924 01:46:43,921 --> 01:46:46,223 I THINK IS AN INCREDIBLY USEFUL 2925 01:46:46,223 --> 01:46:47,291 PUBLICATION CAME OUT IN THE 2926 01:46:47,291 --> 01:46:52,429 LANCET LATE LAST YEAR THAT 2927 01:46:52,429 --> 01:46:56,967 LOOKED AT MULTIPLE METRICS OF 2928 01:46:56,967 --> 01:46:58,101 THE IMPACT OF IMMUNIZATION 2929 01:46:58,101 --> 01:46:59,503 PROGRAMS INCLUDING ON THIS GRAPH 2930 01:46:59,503 --> 01:47:01,271 DEATHS AVERTED, YEARS OF LIFE 2931 01:47:01,271 --> 01:47:02,472 SAVED, AND YEARS OF FULL HEALTH 2932 01:47:02,472 --> 01:47:03,707 GAINED BY VACCINATION. 2933 01:47:03,707 --> 01:47:04,675 I AM NOT SURE YOU CAN SEE AT THE 2934 01:47:04,675 --> 01:47:08,278 TOP, BECAUSE MY LITTLE THING IS 2935 01:47:08,278 --> 01:47:09,479 UNFORTUNATELY COVERING IT, BUT 2936 01:47:09,479 --> 01:47:13,617 EACH OF THESE COLORS REPRESENTS 2937 01:47:13,617 --> 01:47:15,352 A DIFFERENT PATHOGEN THAT HAS 2938 01:47:15,352 --> 01:47:18,322 BEEN TARGETED AND YOU CAN SEE 2939 01:47:18,322 --> 01:47:20,824 HOW MANY LIFE YEARS GAINED, ET 2940 01:47:20,824 --> 01:47:22,226 CETERA, HAVE OCCURRED IN JUST 2941 01:47:22,226 --> 01:47:23,760 THE LAST 50 YEARS AND IT'S 2942 01:47:23,760 --> 01:47:25,395 REALLY BEEN PRETTY ASTONISHING. 2943 01:47:25,395 --> 01:47:28,665 SO IT'S NOT JUST THE OLD DAYS OF 2944 01:47:28,665 --> 01:47:30,434 VACCINE ADVANCES, BUT ACTUALLY 2945 01:47:30,434 --> 01:47:32,402 PRETTY RECENTLY. 2946 01:47:32,402 --> 01:47:33,470 SO I'LL SHIFT VERY QUICKLY 2947 01:47:33,470 --> 01:47:35,973 BECAUSE I WANT TO TALK ABOUT OUR 2948 01:47:35,973 --> 01:47:37,374 NEW STRATEGIC PLAN WHICH IS 2949 01:47:37,374 --> 01:47:38,875 HOPEFULLY GOING TO COME OUT IN 2950 01:47:38,875 --> 01:47:40,944 THE NEXT MONTH OR SO, AND WHAT 2951 01:47:40,944 --> 01:47:41,945 WE'RE THINKING ABOUT FOR THE 2952 01:47:41,945 --> 01:47:43,780 FUTURE. 2953 01:47:43,780 --> 01:47:47,584 SO WE HAVE BEEN PROBABLY BY 2954 01:47:47,584 --> 01:47:50,120 NECESSITY A VERY 2955 01:47:50,120 --> 01:47:51,188 PATHOGEN-FOCUSED GROUP. 2956 01:47:51,188 --> 01:47:52,956 PEOPLE HAVE THEIR LABS BUILT 2957 01:47:52,956 --> 01:47:54,324 AROUND PATHOGENS, PEOPLE HAVE 2958 01:47:54,324 --> 01:47:56,193 THEIR FAVORITE PATHOGENS, BUT 2959 01:47:56,193 --> 01:47:58,929 WHAT I LIKE TO REALLY TALK ABOUT 2960 01:47:58,929 --> 01:48:01,231 AND THINK ABOUT IS MORE OF A 2961 01:48:01,231 --> 01:48:03,667 WHOLE PERSON APPROACH TO 2962 01:48:03,667 --> 01:48:05,802 INFECTIOUS DISEASES BECAUSE 2963 01:48:05,802 --> 01:48:07,771 PEOPLE GET INFECTIONS, THEY 2964 01:48:07,771 --> 01:48:09,172 AREN'T INFECTIONS, RIGHT? 2965 01:48:09,172 --> 01:48:10,574 SO YOU CAN TALK ABOUT PEOPLE 2966 01:48:10,574 --> 01:48:11,875 LIVING WITH HIV, BUT PEOPLE 2967 01:48:11,875 --> 01:48:14,278 LIVING WITH HIV ALSO GET 2968 01:48:14,278 --> 01:48:15,312 TUBERCULOSIS, THEY HAVE 2969 01:48:15,312 --> 01:48:16,113 METABOLIC DISORDERS, THEY WANT 2970 01:48:16,113 --> 01:48:17,414 TO GET PREGNANT, THEY WANT TO 2971 01:48:17,414 --> 01:48:18,615 HAVE HEALTHY BABIES. 2972 01:48:18,615 --> 01:48:21,551 SO WE ARE REALLY TRYING TO THINK 2973 01:48:21,551 --> 01:48:24,488 ABOUT THIS CONCEPT OF 2974 01:48:24,488 --> 01:48:26,690 UNDERSTANDING HUMAN IMMUNOLOGY, 2975 01:48:26,690 --> 01:48:28,158 PREVENTING ABERRANT RESPONSES, 2976 01:48:28,158 --> 01:48:30,060 FOR EXAMPLE, AUTOIMMUNITY, FOOD 2977 01:48:30,060 --> 01:48:31,261 ALLERGY, AND THINKING ABOUT HOW 2978 01:48:31,261 --> 01:48:33,130 WE ENHANCE OUR NATURAL DEFENSES 2979 01:48:33,130 --> 01:48:35,032 ALL IN THE SETTING OF CONTINUING 2980 01:48:35,032 --> 01:48:37,567 TO DEVELOP MEDICAL 2981 01:48:37,567 --> 01:48:38,669 COUNTERMEASURES FOR 2982 01:48:38,669 --> 01:48:42,406 BIOPREPAREDNESS AND FOR OTHER 2983 01:48:42,406 --> 01:48:48,345 EVENT ACTUALIT 2984 01:48:48,345 --> 01:48:48,679 EVENTUALITIES. 2985 01:48:48,679 --> 01:48:49,579 IT'S ALSO IMPORTANT TO MENTION 2986 01:48:49,579 --> 01:48:53,283 TOO THAT H WE HAVE A BIG IMPACT 2987 01:48:53,283 --> 01:48:55,452 ACROSS THE UNITED STATES. 2988 01:48:55,452 --> 01:48:57,187 DIANA MENTIONED OUR VERY 2989 01:48:57,187 --> 01:48:57,854 GENEROUS BUDGET WHICH I'LL SHOW 2990 01:48:57,854 --> 01:48:59,056 YOU A LITTLE BIT MORE ABOUT IN A 2991 01:48:59,056 --> 01:49:00,457 MINUTE BUT WE DISTRIBUTE MOST OF 2992 01:49:00,457 --> 01:49:03,160 THAT OUTSIDE THE NIH, SO OVER 2993 01:49:03,160 --> 01:49:04,261 $5 BILLION DISTRIBUTED ACROSS 2994 01:49:04,261 --> 01:49:06,463 THE U.S. IN FISCAL YEAR 2023. 2995 01:49:06,463 --> 01:49:08,065 THE OTHER THING I WANT TO 2996 01:49:08,065 --> 01:49:11,134 MENTION IS THAT WE ARE REALLY 2997 01:49:11,134 --> 01:49:14,871 FOCUSED RIGHT NOW ON OUR 2998 01:49:14,871 --> 01:49:15,505 WORKFORCE. 2999 01:49:15,505 --> 01:49:18,308 WE HAVE NOT HAD A GREAT TRACK 3000 01:49:18,308 --> 01:49:19,743 RECORD IN THE LAST FIVE YEARS, 3001 01:49:19,743 --> 01:49:21,712 AND THE PANDEMIC HAD A LOT TO DO 3002 01:49:21,712 --> 01:49:23,313 WITH THAT, TO BE HONEST, FOR 3003 01:49:23,313 --> 01:49:24,614 REASONS WE CAN TALK ABOUT IF WE 3004 01:49:24,614 --> 01:49:25,716 HAD TIME. 3005 01:49:25,716 --> 01:49:27,684 GETTING PEOPLE INTO INFECTIOUS 3006 01:49:27,684 --> 01:49:29,286 DISEASES, EITHER AS CLINICIANS 3007 01:49:29,286 --> 01:49:31,488 OR AS PHYSICIAN SCIENTISTS, OR 3008 01:49:31,488 --> 01:49:34,024 AS BASIC RESEARCHERS OR 3009 01:49:34,024 --> 01:49:35,592 TRANSLATIONAL RESEARCHERS. 3010 01:49:35,592 --> 01:49:38,762 SO WE HAVE BEEN REAL FOCUSED ON 3011 01:49:38,762 --> 01:49:40,664 TRYING TO SUPPORT RESEARCHERS 3012 01:49:40,664 --> 01:49:42,666 THROUGHOUT THE CAREER SPAN 3013 01:49:42,666 --> 01:49:43,900 BECAUSE IF WE CAN'T DO THAT, 3014 01:49:43,900 --> 01:49:45,402 WE'RE NOT GOING TO BE ABLE TO 3015 01:49:45,402 --> 01:49:49,005 CARRY OUT ANY OF THE MISSION 3016 01:49:49,005 --> 01:49:51,108 ITEMS THAT ARE SHOWN ON THIS 3017 01:49:51,108 --> 01:49:51,641 SLIDE. 3018 01:49:51,641 --> 01:49:53,176 AND ONE OF THE THINGS THAT I 3019 01:49:53,176 --> 01:49:55,345 FOUND WHEN I CAME HERE WAS THAT 3020 01:49:55,345 --> 01:49:57,214 WE AS AN INSTITUTE DESPITE OUR 3021 01:49:57,214 --> 01:49:59,149 VERY GENEROUS BUDGET HAVE NOT 3022 01:49:59,149 --> 01:50:01,885 REALLY KEPT UP WITH 3023 01:50:01,885 --> 01:50:04,287 PROPORTIONATELY FUNDING 3024 01:50:04,287 --> 01:50:05,789 TRAINING, AND OF COURSE THAT WAS 3025 01:50:05,789 --> 01:50:07,157 EXACERBATED BY THE NEED TO FOCUS 3026 01:50:07,157 --> 01:50:09,493 ON THE PANDEMIC IN THE LAST FIVE 3027 01:50:09,493 --> 01:50:09,693 YEARS. 3028 01:50:09,693 --> 01:50:13,330 SO THIS IS JUST TO POINT OUT 3029 01:50:13,330 --> 01:50:14,631 THAT WE HAVE COMMITTED TO 3030 01:50:14,631 --> 01:50:15,599 INCREASING OUR ALLOCATION FOR 3031 01:50:15,599 --> 01:50:16,900 OUR TRAINING BUDGET. 3032 01:50:16,900 --> 01:50:18,535 THESE ARE JUST TRENDS THROUGH 3033 01:50:18,535 --> 01:50:20,170 THE LAST SEVERAL YEARS AND AGAIN 3034 01:50:20,170 --> 01:50:21,605 THIS DOES INCLUDE THE PANDEMIC 3035 01:50:21,605 --> 01:50:23,206 WHICH HAS BEEN A CHALLENGING 3036 01:50:23,206 --> 01:50:24,508 TIME, BUT WE HAVE BEEN ABLE TO 3037 01:50:24,508 --> 01:50:26,076 INCREASE IT AND WE ARE PLANNING 3038 01:50:26,076 --> 01:50:28,445 TO DO SO ASSUMING THAT WE 3039 01:50:28,445 --> 01:50:30,814 CONTINUE TO HAVE THE BUDGET THAT 3040 01:50:30,814 --> 01:50:32,349 WE HAVE REQUESTED. 3041 01:50:32,349 --> 01:50:33,550 NOW IS THAT GOING TO HAPPEN? 3042 01:50:33,550 --> 01:50:34,985 WE REALLY DON'T KNOW. 3043 01:50:34,985 --> 01:50:38,855 THIS IS OUR FUNDING HISTORY FROM 3044 01:50:38,855 --> 01:50:40,090 2000 TO 2025. 3045 01:50:40,090 --> 01:50:42,492 AND WE HAVE HAD A NUMBER OF 3046 01:50:42,492 --> 01:50:44,861 INCREASES OFTEN RELATED TO 3047 01:50:44,861 --> 01:50:46,396 THREATS, FOR EXAMPLE, AROUND 3048 01:50:46,396 --> 01:50:47,831 2001 AND BIOPREPAREDNESS WITH 3049 01:50:47,831 --> 01:50:53,470 THE ANTHRAX EVENTS POST 9/11, 3050 01:50:53,470 --> 01:50:55,872 AND WITH VARIOUS OUTBREAKS, FOR 3051 01:50:55,872 --> 01:50:57,507 EXAMPLE, VIRAL HEMORRHAGIC 3052 01:50:57,507 --> 01:51:00,977 FEVERS LIKE EBOLA, AS WELL AS 3053 01:51:00,977 --> 01:51:03,814 THE PANDEMIC FLU IN 2009. 3054 01:51:03,814 --> 01:51:08,652 SO WE HAVE HAD VERY, VERY GOOD 3055 01:51:08,652 --> 01:51:11,922 BIPARTISAN SUPPORT FROM OUR 3056 01:51:11,922 --> 01:51:12,589 APPROPRIATORS. 3057 01:51:12,589 --> 01:51:15,826 THIS YEAR, WE ACTUALLY HAVE A 3058 01:51:15,826 --> 01:51:18,028 BUDGET REQUEST FROM THE 3059 01:51:18,028 --> 01:51:20,530 PRESIDENT THAT WAS STABLE, 3060 01:51:20,530 --> 01:51:23,934 SLIGHTLY OVER OUR FISCAL YEAR 3061 01:51:23,934 --> 01:51:27,304 2024, AND VERY SIMILAR IN THE 3062 01:51:27,304 --> 01:51:30,674 SENATE, AND TO I THINK OUR GREAT 3063 01:51:30,674 --> 01:51:31,541 RELIEF, ALSO SIMILAR IN THE 3064 01:51:31,541 --> 01:51:31,775 HOUSE. 3065 01:51:31,775 --> 01:51:35,912 WHEN I TOOK THIS JOB IN THE FALL 3066 01:51:35,912 --> 01:51:38,882 OF 2023, THE HOUSE PROPOSED A 3067 01:51:38,882 --> 01:51:45,522 CUT OF 23.9% FOR NIAID AND THAT 3068 01:51:45,522 --> 01:51:46,423 WAS VERY SPECIFIC TO US. 3069 01:51:46,423 --> 01:51:48,492 IT WAS NOT DIRECTED TOWARDS 3070 01:51:48,492 --> 01:51:49,392 OTHER INSTITUTES. 3071 01:51:49,392 --> 01:51:51,595 THIS YEAR, THEY DID NOT, WHICH I 3072 01:51:51,595 --> 01:51:53,430 AM VERY, VERY, VERY GRATEFUL 3073 01:51:53,430 --> 01:51:53,997 FOR. 3074 01:51:53,997 --> 01:51:56,099 THEY DID PROPOSE SPLITTING US 3075 01:51:56,099 --> 01:51:57,434 INTO TWO INSTITUTES, THE 3076 01:51:57,434 --> 01:51:59,069 NATIONAL INSTITUTE ON INFECTIOUS 3077 01:51:59,069 --> 01:52:00,504 DISEASES, AND THE NATIONAL 3078 01:52:00,504 --> 01:52:01,304 INSTITUTE ON THE IMMUNE SYSTEM 3079 01:52:01,304 --> 01:52:02,839 AND ARTHRITIS. 3080 01:52:02,839 --> 01:52:04,474 SO THERE IS THAT TO WORK 3081 01:52:04,474 --> 01:52:05,208 THROUGH. 3082 01:52:05,208 --> 01:52:06,843 AND AS I THINK EVERYBODY KNOWS, 3083 01:52:06,843 --> 01:52:08,812 WE ARE ON A CONTINUING 3084 01:52:08,812 --> 01:52:11,081 RESOLUTION THROUGH MARCH 14TH. 3085 01:52:11,081 --> 01:52:13,483 SO THIS IS JUST A SNAPSHOT OF 3086 01:52:13,483 --> 01:52:14,351 WHAT THOSE PROPOSALS LOOK LIKE 3087 01:52:14,351 --> 01:52:16,019 AND WHERE WE STAND. 3088 01:52:16,019 --> 01:52:18,722 AS DIANA MENTIONED, WE ARE 3089 01:52:18,722 --> 01:52:20,257 SECOND ONLY TO THE NATIONAL 3090 01:52:20,257 --> 01:52:21,591 CANCER INSTITUTE AND THIS IS THE 3091 01:52:21,591 --> 01:52:23,226 HOUSE AND THE SENATE BUDGET AND 3092 01:52:23,226 --> 01:52:25,195 THIS IS WHAT WE HAD LAST YEAR. 3093 01:52:25,195 --> 01:52:31,268 SO WE WILL SEE WHAT HAPPENS AND 3094 01:52:31,268 --> 01:52:32,636 HOPE THAT WE CAN CONTINUE TO DO 3095 01:52:32,636 --> 01:52:33,937 WHAT WE NEED TO DO WITH THE 3096 01:52:33,937 --> 01:52:35,205 RESOURCES THAT WE NEED. 3097 01:52:35,205 --> 01:52:37,641 WE HAVE PRETTY ROBUST FUNDING 3098 01:52:37,641 --> 01:52:40,477 THAT IS TRACEABLE AND ACTIONABLE 3099 01:52:40,477 --> 01:52:42,212 TO PEDIATRIC FOCUS. 3100 01:52:42,212 --> 01:52:43,513 AGAIN, A HUGE FOCUS OF THIS 3101 01:52:43,513 --> 01:52:47,017 GROUP, OF COURSE, SO IF YOU LOOK 3102 01:52:47,017 --> 01:52:48,852 AT OUR FUNDING FROM 2008 TO TWEP 3103 01:52:48,852 --> 01:52:50,520 23, WE HAVE HAD A PRETTY 3104 01:52:50,520 --> 01:52:52,255 SUSTAINED INCREASE AND IN FACT 3105 01:52:52,255 --> 01:52:55,225 ALMOST A THREE FOLD INCREASE 3106 01:52:55,225 --> 01:52:57,661 SINCE 2008, WHICH I THINK IS 3107 01:52:57,661 --> 01:53:01,264 REALLY QUITE REMARKABLE AND 3108 01:53:01,264 --> 01:53:04,568 VERY, VERY WELL-DESERVED AND 3109 01:53:04,568 --> 01:53:05,035 INDICATED. 3110 01:53:05,035 --> 01:53:06,770 THESE DECLINES WERE REALLY MORE 3111 01:53:06,770 --> 01:53:09,472 RELATED TO PANDEMIC 3112 01:53:09,472 --> 01:53:10,373 REDISTRIBUTION, NOT TO ANY LOSS 3113 01:53:10,373 --> 01:53:15,045 OF COMMITMENT TO OUR EFFORTS IN 3114 01:53:15,045 --> 01:53:16,346 THIS AREA. 3115 01:53:16,346 --> 01:53:17,781 SO WHERE HAS THIS GOTTEN US? 3116 01:53:17,781 --> 01:53:19,416 I JUST WANT TO HIGHLIGHT A FEW 3117 01:53:19,416 --> 01:53:23,987 ADVANCES THAT I THINK ARE BOTH 3118 01:53:23,987 --> 01:53:25,855 AMAZING AND ALSO INDICATIVE OF 3119 01:53:25,855 --> 01:53:29,359 THE KIND OF WORK WE CAN GET DONE 3120 01:53:29,359 --> 01:53:30,860 WHEN WE WORK TOGETHER AS 3121 01:53:30,860 --> 01:53:31,161 INSTITUTES. 3122 01:53:31,161 --> 01:53:32,696 SO I MENTIONED THE LEARNING 3123 01:53:32,696 --> 01:53:34,864 EARLY ABOUT PEANUT ALLERGY 3124 01:53:34,864 --> 01:53:35,832 TRIAL, THE LEAP TRIAL. 3125 01:53:35,832 --> 01:53:38,335 THIS IS ACTUALLY THREE TRIALS 3126 01:53:38,335 --> 01:53:40,070 WHICH HAVE BEEN DESIGNED AND 3127 01:53:40,070 --> 01:53:43,607 BUILT ON EACH OTHER OVER DECADES 3128 01:53:43,607 --> 01:53:44,574 NOW. 3129 01:53:44,574 --> 01:53:48,445 WHICH IS I THINK A GREAT EXAMPLE 3130 01:53:48,445 --> 01:53:49,446 AGAIN OF WHAT YOU CAN DO WITH A 3131 01:53:49,446 --> 01:53:51,314 STABLE BASE OF FUNDING, STABLE 3132 01:53:51,314 --> 01:53:53,783 LEADERSHIP COMMITMENT TO SEEING 3133 01:53:53,783 --> 01:53:58,188 A PROBLEM THROUGH ALL THE 3134 01:53:58,188 --> 01:53:58,955 TRANSLATIONAL ASPECTS OF WHAT 3135 01:53:58,955 --> 01:54:00,590 YOU FIND AS YOU GO ALONG. 3136 01:54:00,590 --> 01:54:03,326 SO THE FIRST STUDY CAME OUT IN 3137 01:54:03,326 --> 01:54:04,761 THE NEW ENGLAND JOURNAL IN 2015 3138 01:54:04,761 --> 01:54:06,496 AND MANY OF YOU KNOW ABOUT THIS. 3139 01:54:06,496 --> 01:54:08,331 BUT THIS BASICALLY SHOWED TO 3140 01:54:08,331 --> 01:54:09,966 MANY PEOPLE THE SURPRISING 3141 01:54:09,966 --> 01:54:11,067 FINDING THAT EARLY INTRODUCTION 3142 01:54:11,067 --> 01:54:13,136 OF PEANUT PRODUCTS ACTUALLY 3143 01:54:13,136 --> 01:54:15,639 REDUCED THE RISK OF PEANUT 3144 01:54:15,639 --> 01:54:19,743 ALLERGY AT AGE 5 BY A STAGGERIG 3145 01:54:19,743 --> 01:54:19,909 81%. 3146 01:54:19,909 --> 01:54:21,945 SO THIS WAS A GOOD IDEA TO GET 3147 01:54:21,945 --> 01:54:22,712 KIDS DONE. 3148 01:54:22,712 --> 01:54:25,015 THEN THE QUESTION BECAME HOW 3149 01:54:25,015 --> 01:54:29,185 LONG DID THAT LAST, AND WHAT 3150 01:54:29,185 --> 01:54:32,856 COULD YOU DO TO CONTINUE TO 3151 01:54:32,856 --> 01:54:34,624 BUILD ON THAT. 3152 01:54:34,624 --> 01:54:36,459 THE LEAP ON STUDY SHOWED THAT 3153 01:54:36,459 --> 01:54:37,994 THE PEOPLE IN THE EARLIER STUDY 3154 01:54:37,994 --> 01:54:41,698 WHO WERE IN THE CONSUMPTION 3155 01:54:41,698 --> 01:54:44,000 GROUP REMAINED PROTECTED AT AGE 3156 01:54:44,000 --> 01:54:45,869 6 EVEN AFTER THEY AVOIDED PEANUT 3157 01:54:45,869 --> 01:54:47,270 PRODUCT FOR ONE YEAR. 3158 01:54:47,270 --> 01:54:49,873 SO THE LEAP TRIO STUDY WHICH WAS 3159 01:54:49,873 --> 01:54:51,408 JUST PUBLISHED LAST YEAR SHOWED 3160 01:54:51,408 --> 01:54:53,476 THAT PEANUT CONSUMPTION FROM 3161 01:54:53,476 --> 01:54:55,345 INFANCY TO AGE 5 YEARS PROVIDED 3162 01:54:55,345 --> 01:54:59,149 LASTING TOLERANCE TO PEANUT -- 3163 01:54:59,149 --> 01:55:00,050 ADOLESCENCE IRRESPECTIVE OF 3164 01:55:00,050 --> 01:55:00,884 PEANUT CONSUMPTION. 3165 01:55:00,884 --> 01:55:02,052 SO WHY IS THIS A BEAUTIFUL 3166 01:55:02,052 --> 01:55:02,419 THING? 3167 01:55:02,419 --> 01:55:03,520 BECAUSE AGAIN, YOU'VE GOT A 3168 01:55:03,520 --> 01:55:05,789 COHORT THAT HAS PARTICIPATED IN 3169 01:55:05,789 --> 01:55:10,160 THESE STUDIES FROM INFANCY TO 3170 01:55:10,160 --> 01:55:11,695 ADOLESCENCE, AND ALMOST 80% OF 3171 01:55:11,695 --> 01:55:13,296 THE ORIGINAL LEAP STUDY 3172 01:55:13,296 --> 01:55:14,964 PARTICIPANTS WERE ENROLLED IN 3173 01:55:14,964 --> 01:55:16,066 LEAP TRIO. 3174 01:55:16,066 --> 01:55:18,134 SO THIS IS WHAT AGAIN STABLE 3175 01:55:18,134 --> 01:55:19,469 RESOURCES, ALLOCATION, STABLE 3176 01:55:19,469 --> 01:55:22,872 COMMITMENT AND REALLY SCIENTIFIC 3177 01:55:22,872 --> 01:55:25,975 VISION THAT ADDRESSES CONCERNS 3178 01:55:25,975 --> 01:55:27,477 OVER THE LIFESPAN AS PEOPLE 3179 01:55:27,477 --> 01:55:29,112 MATURE CAN GET YOU SO I REALLY, 3180 01:55:29,112 --> 01:55:30,080 REALLY LIKE THAT STUDY. 3181 01:55:30,080 --> 01:55:31,848 ON THE OTHER END OF THE 3182 01:55:31,848 --> 01:55:32,816 SPECTRUM, YOU'VE GOT THE VERY 3183 01:55:32,816 --> 01:55:36,086 RARE DISEASES THAT WE SEE A ANDD 3184 01:55:36,086 --> 01:55:37,387 TAKE CARE OF PARTICULARLY IN THE 3185 01:55:37,387 --> 01:55:38,488 CLINICAL CENTER HERE AT NIH, AND 3186 01:55:38,488 --> 01:55:41,891 I JUST WANT TO GIVE YOU AN 3187 01:55:41,891 --> 01:55:43,827 EXAMPLE OF HOW OUR CLINICAL 3188 01:55:43,827 --> 01:55:45,795 GENOMICS PROGRAM HAS MADE SOME 3189 01:55:45,795 --> 01:55:47,130 REALLY SIGNAL DISCOVERIES. 3190 01:55:47,130 --> 01:55:49,766 THE EXAMPLE I WILL TALK ABOUT 3191 01:55:49,766 --> 01:55:53,169 VERY BRIEFLY IS CHAPEL SYNDROME. 3192 01:55:53,169 --> 01:55:54,104 YOU MAY BE FAMILIAR WITH THIS. 3193 01:55:54,104 --> 01:55:59,743 THIS IS CAUSED BY A CD55 3194 01:55:59,743 --> 01:56:01,878 DEFICIENCY THAT RESULTS IN 3195 01:56:01,878 --> 01:56:05,815 ABNORMAL COMPLEMENT ACTIVATION. 3196 01:56:05,815 --> 01:56:09,853 YOU GET BIALELIC LOSS OF 3197 01:56:09,853 --> 01:56:11,688 FUNCTION MUTATIONS IN THE CD55 3198 01:56:11,688 --> 01:56:13,323 GENE AND SO YOU LOSE PROTEIN 3199 01:56:13,323 --> 01:56:13,656 EXPRESSION. 3200 01:56:13,656 --> 01:56:16,726 IF IT'S NOT FIXED, PATIENTS DIE 3201 01:56:16,726 --> 01:56:17,393 OF STARVATION BEFORE 30 YEARS 3202 01:56:17,393 --> 01:56:17,761 OLD. 3203 01:56:17,761 --> 01:56:19,229 IT'S A REALLY, REALLY 3204 01:56:19,229 --> 01:56:20,130 DEVASTATING CONDITION, LARGELY 3205 01:56:20,130 --> 01:56:22,966 BECAUSE OF A PROTEIN LOSING 3206 01:56:22,966 --> 01:56:26,136 ENTEROPATHY, BUT THEY ALSO GET 3207 01:56:26,136 --> 01:56:27,003 ANGIOPATHIC THROM POEISIS 3208 01:56:27,003 --> 01:56:27,871 BECAUSE OF THE COMPLEMENT 3209 01:56:27,871 --> 01:56:33,409 DYSFUNCTION. 3210 01:56:33,409 --> 01:56:35,845 SO THE DISCOVERY OF THE GENE 3211 01:56:35,845 --> 01:56:37,180 ASSOCIATED WITH CHAPLE SYNDROME 3212 01:56:37,180 --> 01:56:38,515 WAS MADE, WE HAD A SERIES OF 3213 01:56:38,515 --> 01:56:39,649 PATIENTS HERE THAT WE THEN 3214 01:56:39,649 --> 01:56:40,850 SEQUENCED AND FIGURED OUT 3215 01:56:40,850 --> 01:56:42,485 EXACTLY WHAT WAS GOING ON. 3216 01:56:42,485 --> 01:56:46,222 THAT LED TO A TRIAL OF A DRUG 3217 01:56:46,222 --> 01:56:49,392 CALLED POZELIMAB WHICH INHIBITS 3218 01:56:49,392 --> 01:56:51,361 COMPLEMENT OVERACTIVATION AND 3219 01:56:51,361 --> 01:56:52,395 ESSENTIALLY RESOLVES 3220 01:56:52,395 --> 01:56:53,263 MANIFESTATIONS OF CHAPLE 3221 01:56:53,263 --> 01:56:55,665 DISEASE, SO DEFINED HERE IN 2017 3222 01:56:55,665 --> 01:56:56,933 IN THE NEW ENGLAND JOURNAL, 3223 01:56:56,933 --> 01:56:59,502 LOOKING AT THAT DRUG IN 2024 3224 01:56:59,502 --> 01:57:01,371 JUST LAST YEAR PUBLISHED IN THE 3225 01:57:01,371 --> 01:57:04,440 LANCET, AND THEN RESULTING IN 3226 01:57:04,440 --> 01:57:05,508 THE FDA APPROVING THAT DRUG, AND 3227 01:57:05,508 --> 01:57:07,010 THIS IS JUST A PICTURE OF A 3228 01:57:07,010 --> 01:57:09,546 CHILD BORN WITH CHAPLE DISEASE 3229 01:57:09,546 --> 01:57:10,947 BEFORE AND AFTER TREATMENT WITH 3230 01:57:10,947 --> 01:57:11,581 THIS DRUG. 3231 01:57:11,581 --> 01:57:15,118 SO TO ME, IT DOESN'T REALLY GET 3232 01:57:15,118 --> 01:57:16,085 ANY BETTER THAN THIS. 3233 01:57:16,085 --> 01:57:18,688 IT'S AN AMAZING TESTAMENT TO THE 3234 01:57:18,688 --> 01:57:20,957 CAPACITY THAT WE HAVE TO DO 3235 01:57:20,957 --> 01:57:22,592 THESE KINDS OF VERY 3236 01:57:22,592 --> 01:57:25,428 SOPHISTICATED STUDIES AND THEN 3237 01:57:25,428 --> 01:57:27,697 PURSUE THE FINDING TO DEVELOP AN 3238 01:57:27,697 --> 01:57:30,133 INTERVENTION THAT ULTIMATELY CAN 3239 01:57:30,133 --> 01:57:30,867 BENEFIT PEOPLE. 3240 01:57:30,867 --> 01:57:35,138 WE HAVE MANY EXCITING, I THINK, 3241 01:57:35,138 --> 01:57:38,508 OTHER ACTIVITIES THAT ARE 3242 01:57:38,508 --> 01:57:39,509 EXTREMELY IMPORTANT FOR BOTH OF 3243 01:57:39,509 --> 01:57:41,144 OUR INSTITUTES AND I THINK THE 3244 01:57:41,144 --> 01:57:43,246 OTHER ONE THAT I'LL JUST 3245 01:57:43,246 --> 01:57:47,951 HIGHLIGHT IS THE IMPAACT 3246 01:57:47,951 --> 01:57:50,253 NETWORK, ONE OF OUR HIV-RELATED 3247 01:57:50,253 --> 01:57:51,588 NETWORKS, THE INTERNATIONAL 3248 01:57:51,588 --> 01:57:53,089 MATERNAL PEDIATRIC ADOLESCENT 3249 01:57:53,089 --> 01:57:54,624 AIDS CLINICAL TRIAL NETWORK. 3250 01:57:54,624 --> 01:57:55,925 THAT'S BEEN AROUND NOW FOR AT 3251 01:57:55,925 --> 01:57:57,560 LEAST I THINK 20 YEARS, IF I'M 3252 01:57:57,560 --> 01:57:57,894 NOT MISTAKEN. 3253 01:57:57,894 --> 01:58:01,497 A COUPLE OF REALLY EXCITING 3254 01:58:01,497 --> 01:58:04,267 DEVELOPMENTS IN THIS AREA ARE 3255 01:58:04,267 --> 01:58:06,436 SHOWN HERE. 3256 01:58:06,436 --> 01:58:10,940 OBVIOUSLY WE ARE LOOKING AT NEW 3257 01:58:10,940 --> 01:58:13,109 AGENTS FOR PREVENTION AND 3258 01:58:13,109 --> 01:58:17,814 TREATMENT OF HIV IN NEONATES IN 3259 01:58:17,814 --> 01:58:20,850 PARTICULAR, AND THE EXAMPLE IN 3260 01:58:20,850 --> 01:58:25,355 THE LEFT-HAND SIDE HIGHLIGHTS 3261 01:58:25,355 --> 01:58:27,190 DOLUTEGRAVIR THAT'S INCREASINGLY 3262 01:58:27,190 --> 01:58:29,926 USED GLOBALLY FOR THE TREATMENT 3263 01:58:29,926 --> 01:58:32,562 OF HIV, AND ACTUALLY WAS IN 3264 01:58:32,562 --> 01:58:36,199 SOUTH AFRICA IN AUGUST AND GOT 3265 01:58:36,199 --> 01:58:40,670 TO SEE A COUPLE OF INFANTS 3266 01:58:40,670 --> 01:58:41,771 ENROLLED IN THIS AND TO SEE 3267 01:58:41,771 --> 01:58:43,740 PEOPLE DOING INTENSIVE 3268 01:58:43,740 --> 01:58:45,074 PHARMACOKINETIC STUDIES ON THESE 3269 01:58:45,074 --> 01:58:47,143 BABIES WITH THEIR MOMS IN THESE 3270 01:58:47,143 --> 01:58:49,545 SETTINGS WAS REALLY PRETTY 3271 01:58:49,545 --> 01:58:53,716 REMARKABLE. 3272 01:58:53,716 --> 01:58:55,018 THE OTHER SORT OF TANGIBLE THING 3273 01:58:55,018 --> 01:58:57,987 THAT CAME OUT QUITE RECENTLY 3274 01:58:57,987 --> 01:59:00,290 APPROVAL FROM THE EUROPEAN 3275 01:59:00,290 --> 01:59:06,396 MEDICINES AGENCY APPROVING 3276 01:59:06,396 --> 01:59:08,464 TRIUMEQ IN CHILDREN LIVING WITH 3277 01:59:08,464 --> 01:59:10,199 HIV, SO SAFE, WELL TOLERATED AND 3278 01:59:10,199 --> 01:59:10,867 VERY EFFECTIVE. 3279 01:59:10,867 --> 01:59:12,402 SO THESE STUDIES ARE HARD TO DO 3280 01:59:12,402 --> 01:59:13,069 AS YOU KNOW. 3281 01:59:13,069 --> 01:59:15,038 IT'S HARD TO DO STUDIES IN 3282 01:59:15,038 --> 01:59:16,572 CHILDREN IN GENERAL BUT WHEN YOU 3283 01:59:16,572 --> 01:59:18,007 LOOK AT WHERE WE NEED TO DO 3284 01:59:18,007 --> 01:59:21,277 THESE AND HOW CHALLENGING SOME 3285 01:59:21,277 --> 01:59:23,012 OF THE OTHER CONCOMITANT 3286 01:59:23,012 --> 01:59:25,114 CONDITIONS ARE, IT'S REALLY, I 3287 01:59:25,114 --> 01:59:26,950 THINK, AGAIN A TESTAMENT TO 3288 01:59:26,950 --> 01:59:27,951 PEEP'S COMMITMENT TO MAKE THIS 3289 01:59:27,951 --> 01:59:29,452 HAPPEN. 3290 01:59:29,452 --> 01:59:31,321 I WANT TO SAY A WORD ABOUT 3291 01:59:31,321 --> 01:59:33,523 MALARIA, AND MANY OF YOU KNOW 3292 01:59:33,523 --> 01:59:38,094 THAT MALARIA IS A HUGE KILLER OF 3293 01:59:38,094 --> 01:59:39,629 CHILDREN, SO CEREBRAL MALARIA IN 3294 01:59:39,629 --> 01:59:44,367 PARTICULAR IS OFTEN FATAL IN 3295 01:59:44,367 --> 01:59:45,735 YOUNG CHILDREN AND ALSO VERY 3296 01:59:45,735 --> 01:59:46,269 PROBLEMATIC IN PREGNANCY. 3297 01:59:46,269 --> 01:59:49,372 IT'S A HUGE -- WELL, I DON'T 3298 01:59:49,372 --> 01:59:50,807 KNOW IF IT'S A HUGE CAUSE BUT 3299 01:59:50,807 --> 01:59:52,542 IT'S A SIGNIFICANT CAUSE OF 3300 01:59:52,542 --> 01:59:56,813 SPONTANEOUS ABORTION, 3301 01:59:56,813 --> 01:59:58,114 MISCARRIAGE, AS WELL AS EARLY 3302 01:59:58,114 --> 01:59:58,381 PREGNANCY. 3303 01:59:58,381 --> 02:00:00,216 SO LOTS GOING ON THERE WITH THE 3304 02:00:00,216 --> 02:00:01,818 MATERNAL PLACENTAL INTERFACE IN 3305 02:00:01,818 --> 02:00:03,920 THE SETTING OF MALARIA INFECTION 3306 02:00:03,920 --> 02:00:07,790 DURING PREGNANCY. 3307 02:00:07,790 --> 02:00:09,425 WE HAVE DEVELOPED IN OUR 3308 02:00:09,425 --> 02:00:15,131 INTRAMURAL PROGRAM A SERIES OF 3309 02:00:15,131 --> 02:00:20,703 NON-CLONAL ANTIBODIES THAT ARE 3310 02:00:20,703 --> 02:00:22,405 AIMED AT A HIGHLY CONSERVED AREA 3311 02:00:22,405 --> 02:00:26,943 OF THE PLASMODIUM FALCIPARUM 3312 02:00:26,943 --> 02:00:32,048 PROTEIN WHICH IS THE PREHEPATIC 3313 02:00:32,048 --> 02:00:33,116 PHASE, SO THIS IS WHAT GETS 3314 02:00:33,116 --> 02:00:35,451 INJECTED INTO YOU WHEN THE 3315 02:00:35,451 --> 02:00:35,985 MOSQUITOES BITE YOU. 3316 02:00:35,985 --> 02:00:37,653 THE IDEA OF THIS MONOCLONAL IS 3317 02:00:37,653 --> 02:00:40,590 TO TRY TO BIND THAT PROTEIN 3318 02:00:40,590 --> 02:00:42,859 BEFORE THE PATHOGEN HAS THE 3319 02:00:42,859 --> 02:00:44,394 OPPORTUNITY TO INFECT THE LIVER. 3320 02:00:44,394 --> 02:00:45,962 THAT WAY, YOU'RE DEALING WITH A 3321 02:00:45,962 --> 02:00:48,898 COUPLE OF HUNDRED PARASITES IF 3322 02:00:48,898 --> 02:00:51,100 THAT, AS OPPOSED TO MILLIONS OF 3323 02:00:51,100 --> 02:00:53,169 PARASITES ONCE YOU'VE GOT THE 3324 02:00:53,169 --> 02:00:54,270 HEPATIC PHASE ESTABLISHED. 3325 02:00:54,270 --> 02:00:56,005 SO THIS IS JUST A REALLY NICE 3326 02:00:56,005 --> 02:01:00,843 STUDY DONE WITH OUR COLLEAGUES 3327 02:01:00,843 --> 02:01:02,145 DONE IN CHILDREN 6 TO 10 YEARS 3328 02:01:02,145 --> 02:01:03,880 OF AGE WHERE WE LOOKED AT THE 3329 02:01:03,880 --> 02:01:05,948 EFFICACY OF A SINGLE SUBQ 3330 02:01:05,948 --> 02:01:08,684 INJECTION OF THIS MONOCLONAL 3331 02:01:08,684 --> 02:01:09,786 ANTIBODY, AND SHOWED AS YOU CAN 3332 02:01:09,786 --> 02:01:12,055 SEE IN THIS SLIDE THAT DEPENDING 3333 02:01:12,055 --> 02:01:14,524 ON THE DOSE USED, THERE WAS AN 3334 02:01:14,524 --> 02:01:17,693 EFFICACY OF BETWEEN 66 AND 77%. 3335 02:01:17,693 --> 02:01:19,896 WHETHER YOU LOOKED AT THE FIRST 3336 02:01:19,896 --> 02:01:22,198 INCIDENCE OF MALARIA AS DEFINED 3337 02:01:22,198 --> 02:01:24,133 BY BLOOD SMEARS OR WHETHER YOU 3338 02:01:24,133 --> 02:01:28,204 LOOKED AT CLINICAL EVIDENCE OF A 3339 02:01:28,204 --> 02:01:30,039 MALARIA EPISODE. 3340 02:01:30,039 --> 02:01:31,707 SO -- AND WHY DOES IT LAST SO 3341 02:01:31,707 --> 02:01:32,809 LONG? 3342 02:01:32,809 --> 02:01:35,545 BECAUSE THE ANTIBODY IS DESIGNED 3343 02:01:35,545 --> 02:01:37,613 SPECIFICALLY TO PROVIDE 3344 02:01:37,613 --> 02:01:38,714 APPROXIMATELY 6 MONTHS OF 3345 02:01:38,714 --> 02:01:39,148 PROTECTION. 3346 02:01:39,148 --> 02:01:39,816 WHY? 3347 02:01:39,816 --> 02:01:40,883 BECAUSE THAT'S THE DURATION OF 3348 02:01:40,883 --> 02:01:42,985 THE MALARIA SEASON, RIGHT? 3349 02:01:42,985 --> 02:01:44,387 IF YOU CAN GET PEOPLE THROUGH 3350 02:01:44,387 --> 02:01:45,755 THE RAINY SEASON, SEASON WHERE 3351 02:01:45,755 --> 02:01:48,558 THE MOSQUITOES ARE REALLY 3352 02:01:48,558 --> 02:01:50,526 REPLICATING AND BITING PEOPLE, 3353 02:01:50,526 --> 02:01:52,829 THEN YOU CAN ACTUALLY MAKE A 3354 02:01:52,829 --> 02:01:53,729 MAJOR DENT. 3355 02:01:53,729 --> 02:01:58,401 SO THIS IS PRETTY EXCITING AND 3356 02:01:58,401 --> 02:02:00,103 REALLY, REALLY COOL TO SEE THIS. 3357 02:02:00,103 --> 02:02:01,938 SO HOW CAN WE COLLABORATE, HOW 3358 02:02:01,938 --> 02:02:04,240 CAN WE CONTINUE TO GROW THIS? 3359 02:02:04,240 --> 02:02:05,641 JUST A FEW THOUGHTS HERE. 3360 02:02:05,641 --> 02:02:07,844 IF YOU KNOW ME, YOU KNOW THAT I 3361 02:02:07,844 --> 02:02:09,612 AM INTERESTED IN SEXUALLY 3362 02:02:09,612 --> 02:02:10,913 TRANSMITTED INFECTIONS AND HAVE 3363 02:02:10,913 --> 02:02:12,782 WATCHED WITH SOME HORROR AS WE 3364 02:02:12,782 --> 02:02:15,418 WENT FROM HAVING NO CONGENITAL 3365 02:02:15,418 --> 02:02:16,452 SYPHILIS INFECTIONS IN THE 3366 02:02:16,452 --> 02:02:17,487 UNITED STATES DURING MY TRAINING 3367 02:02:17,487 --> 02:02:19,789 AND DURING MOST OF MY CAREER TO 3368 02:02:19,789 --> 02:02:22,091 STARTING TO SEE A BIT IN THE 3369 02:02:22,091 --> 02:02:25,061 EARLY 2000s TO THE POINT WHERE 3370 02:02:25,061 --> 02:02:28,131 IF 2022, AND IN 2023, WE HAD 3371 02:02:28,131 --> 02:02:31,067 OVER 3700 SYPHILIS CASES IN THE 3372 02:02:31,067 --> 02:02:33,703 UNITED STATES WITH SEVERAL 3373 02:02:33,703 --> 02:02:36,772 HUNDRED DEATHS DUE IN NEONATES 3374 02:02:36,772 --> 02:02:37,540 TO SYPHILIS. 3375 02:02:37,540 --> 02:02:42,044 SO LOTS OF THINGS TO THINK ABOUT 3376 02:02:42,044 --> 02:02:42,245 HERE. 3377 02:02:42,245 --> 02:02:43,246 IT IS DEFINITELY SOMETHING THAT 3378 02:02:43,246 --> 02:02:45,882 WE NEED TO UNDERSTAND IN TERMS 3379 02:02:45,882 --> 02:02:49,252 OF, AGAIN, WHAT IS CAUSING THE 3380 02:02:49,252 --> 02:02:49,919 BIOPATHOLOGY. 3381 02:02:49,919 --> 02:02:51,621 WE STILL REALLY DON'T UNDERSTAND 3382 02:02:51,621 --> 02:02:52,755 VERY MUCH ABOUT CONGENITAL 3383 02:02:52,755 --> 02:02:53,589 SYPHILIS. 3384 02:02:53,589 --> 02:02:55,391 NOT SURPRISING BECAUSE IT WAS 3385 02:02:55,391 --> 02:02:57,026 GONE FOR SO LONG OR MOSTLY GONE, 3386 02:02:57,026 --> 02:02:58,995 SO WE'VE FUNDED SOME RESEARCH TO 3387 02:02:58,995 --> 02:03:00,263 START LOOKING AGAIN AT SOME OF 3388 02:03:00,263 --> 02:03:01,931 THE PLACENTAL INTERACTIONS TO 3389 02:03:01,931 --> 02:03:03,966 LOOK AT TREATMENT IN PREGNANCY, 3390 02:03:03,966 --> 02:03:06,402 BUT I JUST WANT TO POINT OUT 3391 02:03:06,402 --> 02:03:10,072 THAT WE ARE ALSO VERY INTERESTED 3392 02:03:10,072 --> 02:03:12,041 IN SOME OF THE IMPLEMENTATION 3393 02:03:12,041 --> 02:03:12,742 SCIENCE AROUND THIS. 3394 02:03:12,742 --> 02:03:15,578 WHEN YOU START LOOKING AT WHY 3395 02:03:15,578 --> 02:03:16,879 CONGENITAL SYPHILIS HAPPENS, 3396 02:03:16,879 --> 02:03:19,282 IT'S NOT JUST AS SIMPLE AS, OH, 3397 02:03:19,282 --> 02:03:22,351 PEOPLE DIDN'T GET TREATED. 3398 02:03:22,351 --> 02:03:23,553 THEY'RE ALL THE REASONS THAT 3399 02:03:23,553 --> 02:03:24,387 PEOPLE DIDN'T GET TREATED, 3400 02:03:24,387 --> 02:03:25,421 THEY'RE ALL THE REASONS THAT 3401 02:03:25,421 --> 02:03:26,622 PEOPLE DIDN'T COMPLETE 3402 02:03:26,622 --> 02:03:27,256 TREATMENT. 3403 02:03:27,256 --> 02:03:29,458 SO REALLY, REALLY COMPLICATED, 3404 02:03:29,458 --> 02:03:31,227 AND JUST POINTING OUT THIS NICE 3405 02:03:31,227 --> 02:03:33,262 STUDY THAT IS PART OF OUR 3406 02:03:33,262 --> 02:03:36,666 PORTFOLIO OF FUNDING WHERE THESE 3407 02:03:36,666 --> 02:03:38,401 INVESTIGATORS OFFERED OPTIONAL 3408 02:03:38,401 --> 02:03:39,735 SYPHILIS TESTS TO MOST PEOPLE 3409 02:03:39,735 --> 02:03:42,338 SEEKING CARE AT A LARGE 3410 02:03:42,338 --> 02:03:43,105 EMERGENCY DEPARTMENT, AND JUST 3411 02:03:43,105 --> 02:03:45,074 THIS SIMPLE INTERVENTION 3412 02:03:45,074 --> 02:03:47,310 DRAMATICALLY INCREASES, YOU CAN 3413 02:03:47,310 --> 02:03:49,045 SEE IN RED HERE, THE PROPORTION 3414 02:03:49,045 --> 02:03:51,013 OF PEOPLE SCREENED AND THAT WAS 3415 02:03:51,013 --> 02:03:52,481 ESPECIALLY TRUE FOR PREGNANT 3416 02:03:52,481 --> 02:03:52,915 WOMEN. 3417 02:03:52,915 --> 02:03:54,116 SO PREGNANT PATIENTS OR PREGNANT 3418 02:03:54,116 --> 02:03:54,750 PEOPLE. 3419 02:03:54,750 --> 02:03:56,285 SO LOOK AT THIS, THIS IS WHEN 3420 02:03:56,285 --> 02:04:00,790 THE INTERVENTION STARTED IN 3421 02:04:00,790 --> 02:04:03,192 APRIL/MAY OF 2019, VERY FEW 3422 02:04:03,192 --> 02:04:04,627 PEOPLE WHO WERE PREGNANT WERE 3423 02:04:04,627 --> 02:04:05,695 SCREENED BEFORE THAT, WHICH IS 3424 02:04:05,695 --> 02:04:06,662 KIND OF SHOCKING IF YOU DO THIS 3425 02:04:06,662 --> 02:04:07,096 WORK. 3426 02:04:07,096 --> 02:04:08,831 BUT THEN WHEN YOU GO HERE AND 3427 02:04:08,831 --> 02:04:11,367 YOU LOOK AT HOW MANY PEOPLE WERE 3428 02:04:11,367 --> 02:04:15,605 SCREENED, YOU SEE QUITE A BIG 3429 02:04:15,605 --> 02:04:16,205 INCREASE. 3430 02:04:16,205 --> 02:04:18,574 AND NOT ONLY WERE PEOPLE 3431 02:04:18,574 --> 02:04:20,876 SCREENED, WE ACTUALLY DETECTED, 3432 02:04:20,876 --> 02:04:21,877 THEY DETECTED INFECTIONS. 3433 02:04:21,877 --> 02:04:24,814 AND THIS IS JUST AN EXAMPLE OF 3434 02:04:24,814 --> 02:04:28,351 LOTS OF THE ENCOUNTERS THAT WERE 3435 02:04:28,351 --> 02:04:29,352 IMPACTED BY THIS OPPORTUNITY, 3436 02:04:29,352 --> 02:04:31,420 AGAIN, BEFORE THE INTERVENTION, 3437 02:04:31,420 --> 02:04:33,522 6% OF PREGNANT PEOPLE WERE 3438 02:04:33,522 --> 02:04:35,258 SCREENED, AFTER 50% WERE 3439 02:04:35,258 --> 02:04:37,426 SCREENED, AND THERE WAS A 750% 3440 02:04:37,426 --> 02:04:38,861 INCREASE IN CONFIRMED CASES. 3441 02:04:38,861 --> 02:04:41,931 NOW IT'S ONLY TWO CASES TO 15, 3442 02:04:41,931 --> 02:04:44,900 BUT THOSE ARE POTENTIAL LIFE 3443 02:04:44,900 --> 02:04:49,605 SAVING DETECTIONS. 3444 02:04:49,605 --> 02:04:50,940 AND I DON'T OVERSTATE THAT WHEN 3445 02:04:50,940 --> 02:04:53,442 YOU THINK ABOUT THE CONSEQUENCES 3446 02:04:53,442 --> 02:04:54,543 OF CONGENITAL SYPHILIS. 3447 02:04:54,543 --> 02:04:55,845 AND JUST OVERALL, YOU CAN TAKE A 3448 02:04:55,845 --> 02:04:56,946 LOOK AT THOSE NUMBERS HERE IF 3449 02:04:56,946 --> 02:05:00,983 YOU WANT TO -- REALLY CRITICAL, 3450 02:05:00,983 --> 02:05:01,584 MOST PEOPLE WITH SYPHILIS WHO 3451 02:05:01,584 --> 02:05:03,085 WERE PICKED UP IN THIS EFFORT 3452 02:05:03,085 --> 02:05:06,856 DID NOT EXHIBIT STI ESTIMATES. 3453 02:05:06,856 --> 02:05:11,427 I LIKE TO SAY IT'S HIGHLY LIKELY 3454 02:05:11,427 --> 02:05:14,930 THAT THEY WEREN'T REALLY EMAM 3455 02:05:14,930 --> 02:05:16,699 INNED -- HOW POOR GENITAL EXAMS 3456 02:05:16,699 --> 02:05:18,434 AND PELVIC EXAMS FOR THAT MATTER 3457 02:05:18,434 --> 02:05:19,869 ARE DONE IN THIS SETTING BUT 3458 02:05:19,869 --> 02:05:20,503 IT'S A REALLY NICE EXAMPLE OF 3459 02:05:20,503 --> 02:05:22,204 WHAT YOU CAN DO EVEN WITH SOME 3460 02:05:22,204 --> 02:05:23,406 IMPLEMENTATION OR TRANSLATIONAL 3461 02:05:23,406 --> 02:05:24,640 SCIENCE TO FIGURE OUT HOW TO GO 3462 02:05:24,640 --> 02:05:25,941 HERE. 3463 02:05:25,941 --> 02:05:30,079 WE HAVE ALSO DONE MUCH BETTER 3464 02:05:30,079 --> 02:05:32,982 WITH PREV PREVENTION OF VERTICAL 3465 02:05:32,982 --> 02:05:33,449 TRANSMISSION OF HIV. 3466 02:05:33,449 --> 02:05:37,320 WE STILL, HOWEVER, IN 2021, 3467 02:05:37,320 --> 02:05:39,622 SHOCKINGLY, GLOBALLY, SAW 3468 02:05:39,622 --> 02:05:41,157 160,000 NEW PERINATAL 3469 02:05:41,157 --> 02:05:41,791 INFECTIONS. 3470 02:05:41,791 --> 02:05:42,158 WHY IS THAT? 3471 02:05:42,158 --> 02:05:43,592 WELL, YOU MIGHT HAVE WHERE IS 3472 02:05:43,592 --> 02:05:43,893 THAT? 3473 02:05:43,893 --> 02:05:45,127 IT'S LARGELY IN THE COUNTRIES 3474 02:05:45,127 --> 02:05:46,862 THAT DID NOT HAVE PEPFAR. 3475 02:05:46,862 --> 02:05:48,964 SO THE ANSWER IS, IF YOU DON'T 3476 02:05:48,964 --> 02:05:50,700 HAVE ANTIRETROVIRAL THERAPY THAT 3477 02:05:50,700 --> 02:05:52,335 IS SUPPRESSIVE DURING PREGNANCY, 3478 02:05:52,335 --> 02:05:55,504 YOU'RE NOT GOING TO ATTAIN 3479 02:05:55,504 --> 02:05:57,907 SUPPRESSION OR ELIMINATION OF 3480 02:05:57,907 --> 02:05:59,241 VERTICAL TRANSMISSION OF HIV. 3481 02:05:59,241 --> 02:06:00,543 AND IF YOU LOOKED AT THOSE 3482 02:06:00,543 --> 02:06:02,511 INFECTIONS THAT OCCURRED IN 3483 02:06:02,511 --> 02:06:04,613 2021, YOU CAN SEE THAT WOMEN 3484 02:06:04,613 --> 02:06:06,382 DIDN'T KNOW THEIR STATUS, THEY 3485 02:06:06,382 --> 02:06:08,351 MIGHT HAVE ACQUIRED HIV DURING 3486 02:06:08,351 --> 02:06:09,852 PREGNANCY OR BREASTFEEDING WHICH 3487 02:06:09,852 --> 02:06:12,321 WE KNOW ARE HEIGHTENED TIMES OF 3488 02:06:12,321 --> 02:06:13,389 VULNERABILITY, THEY MIGHT HAVE 3489 02:06:13,389 --> 02:06:14,924 STOPPED THEIR ART OR THEY WERE 3490 02:06:14,924 --> 02:06:16,258 TAKING IT BUT THEY WEREN'T 3491 02:06:16,258 --> 02:06:16,792 SUPPRESSED. 3492 02:06:16,792 --> 02:06:19,328 SO THIS IS A MAJOR PUBLIC HEALTH 3493 02:06:19,328 --> 02:06:22,598 CHALLENGE, AND I JUST POINT IT 3494 02:06:22,598 --> 02:06:26,135 OUT BECAUSE WE CAN'T CONTINUE 3495 02:06:26,135 --> 02:06:27,002 LEAVING PREGNANT WOMEN OR WOMEN 3496 02:06:27,002 --> 02:06:29,305 WHO WANT TO GET PREGNANT AND 3497 02:06:29,305 --> 02:06:36,078 AREN'T CONTRASEPTEMBERRING CONTD 3498 02:06:36,078 --> 02:06:40,015 THIS IS JUST A NICE SLIDE THAT 3499 02:06:40,015 --> 02:06:42,251 MY COLLEAGUE MADE JUST TALKING 3500 02:06:42,251 --> 02:06:44,320 ABOUT ALL OF THE BIOMEDICAL 3501 02:06:44,320 --> 02:06:45,521 INTERVENTIONS THAT HAVE BEEN 3502 02:06:45,521 --> 02:06:45,955 LOOKED AT. 3503 02:06:45,955 --> 02:06:49,892 I MENTIONED LENACAPAVIR, THERE'S 3504 02:06:49,892 --> 02:06:50,459 CABOTEGRAVIR. 3505 02:06:50,459 --> 02:06:58,834 WE ACTUALLY HAVE A DIPIVIRINE 3506 02:06:58,834 --> 02:07:00,369 VAGINAL RING AND THERE ARE 3507 02:07:00,369 --> 02:07:01,337 REASSURING DATA FOR MANY OF 3508 02:07:01,337 --> 02:07:02,538 THESE INTERVENTIONS BUT FEW HAVE 3509 02:07:02,538 --> 02:07:04,206 BEEN STUDIED REALLY 3510 02:07:04,206 --> 02:07:04,974 SYSTEMATICALLY. 3511 02:07:04,974 --> 02:07:08,344 AN EXCEPTION IS THE DIPIVIRINE 3512 02:07:08,344 --> 02:07:09,145 RING, WHICH WOULD HAVE A VERY, I 3513 02:07:09,145 --> 02:07:10,646 WOULD SAY, TAILORED APPROACH TO 3514 02:07:10,646 --> 02:07:12,248 GETTING THIS STUDIED. 3515 02:07:12,248 --> 02:07:15,951 YOU KNOW, WE'RE TALKING ABOUT 3516 02:07:15,951 --> 02:07:20,656 BROADLY NEUTRALIZING ANTIBODY 3517 02:07:20,656 --> 02:07:22,124 THERAPY, MONOCLONAL ANTIBODY 3518 02:07:22,124 --> 02:07:24,059 THERAPY FOR HIV, REALLY NEED TO 3519 02:07:24,059 --> 02:07:25,394 START THINKING ABOUT HOW WE GET 3520 02:07:25,394 --> 02:07:26,262 WOMEN WHO ARE PREGNANT OR 3521 02:07:26,262 --> 02:07:27,963 PLANNING TO GET PREGNANT INTO 3522 02:07:27,963 --> 02:07:28,898 THESE STUDIES REALLY SOON. 3523 02:07:28,898 --> 02:07:32,935 SO IT'S REALLY ALSO REMARKABLE 3524 02:07:32,935 --> 02:07:35,805 THAT WE REALLY HAVE NOT FIGURED 3525 02:07:35,805 --> 02:07:37,473 THIS OUT YET GIVEN THAT WE DO 3526 02:07:37,473 --> 02:07:38,874 HAVE THE TOOLS. 3527 02:07:38,874 --> 02:07:40,743 WE DO HAVE GOOD GUIDELINES, AND 3528 02:07:40,743 --> 02:07:43,045 REMEMBER WE'VE DONE VERY WELL IN 3529 02:07:43,045 --> 02:07:43,813 THE UNITED STATES. 3530 02:07:43,813 --> 02:07:48,851 AND I WOULD SAY THAT THE VAST 3531 02:07:48,851 --> 02:07:53,122 MAJORITY OF -- ARE LEADING TO 3532 02:07:53,122 --> 02:07:55,224 THE OBSERVATION THERE THAT HIV 3533 02:07:55,224 --> 02:07:56,859 TRANSMISSION RISK IN THE U.S. IS 3534 02:07:56,859 --> 02:07:58,494 NOW DECREASED TO LESS THAN 1%. 3535 02:07:58,494 --> 02:08:00,396 BUT I WILL POINT OUT THAT, 3536 02:08:00,396 --> 02:08:01,397 AGAIN, HAVING COME FROM THE DEEP 3537 02:08:01,397 --> 02:08:03,599 SOUTH AND HAVING LIVED THERE FOR 3538 02:08:03,599 --> 02:08:05,601 SEVEN YEARS, AND EVEN IN 3539 02:08:05,601 --> 02:08:08,137 MARYLAND AND D.C. , YOU STILL 3540 02:08:08,137 --> 02:08:10,239 SEE CASES OF PERINATAL 3541 02:08:10,239 --> 02:08:12,074 TRANSMISSION OR I SHOULD SAY WE 3542 02:08:12,074 --> 02:08:13,742 STILL SEE CASES OF PERINATAL 3543 02:08:13,742 --> 02:08:14,143 TRANSMISSION. 3544 02:08:14,143 --> 02:08:16,111 I LIKE THIS SLIDE FROM THE 3545 02:08:16,111 --> 02:08:16,846 MARYLAND DEPARTMENT OF HEALTH 3546 02:08:16,846 --> 02:08:19,748 BECAUSE IT TAKES YOU THROUGH THE 3547 02:08:19,748 --> 02:08:21,517 AMAZING, AMAZING PROGRESS WE'VE 3548 02:08:21,517 --> 02:08:23,719 MADE SINCE THE MID 80s, BUT 3549 02:08:23,719 --> 02:08:26,589 THEN YOU GO TO 2020, 21, AND YOU 3550 02:08:26,589 --> 02:08:30,092 SEE HERE THIS LITTLE BUMP. 3551 02:08:30,092 --> 02:08:32,962 AGAIN, MANY OF THE 3552 02:08:32,962 --> 02:08:35,030 CHARACTERISTICS THAT DEFINE OR 3553 02:08:35,030 --> 02:08:37,666 CHARACTERIZE THE PEOPLE WHO ARE 3554 02:08:37,666 --> 02:08:38,868 AFFECTED ARE VERY SIMILAR TO 3555 02:08:38,868 --> 02:08:40,669 WHAT WE ARE SEEING WITH 3556 02:08:40,669 --> 02:08:41,604 CONGENITAL SYPHILIS. 3557 02:08:41,604 --> 02:08:43,472 SO IT SAYS AGAIN THAT THERE IS 3558 02:08:43,472 --> 02:08:47,009 NO MAGIC PILL, THERE IS NO MAGIC 3559 02:08:47,009 --> 02:08:47,209 SHOT. 3560 02:08:47,209 --> 02:08:48,978 THERE IS JUST A SUITE OF 3561 02:08:48,978 --> 02:08:50,279 INTERVENTIONS THAT REALLY NEED 3562 02:08:50,279 --> 02:08:55,551 TO TRY TO REACH THE PEOPLE WHO 3563 02:08:55,551 --> 02:08:56,652 CAN BENEFIT THE MOST FROM THIS. 3564 02:08:56,652 --> 02:08:58,087 A COUPLE OF OTHER THINGS I 3565 02:08:58,087 --> 02:09:00,022 WORKED ON REALLY CLOSELY WITH 3566 02:09:00,022 --> 02:09:01,891 NICHD, THE IMMUNE MECHANISMS AT 3567 02:09:01,891 --> 02:09:03,359 THE MATERNAL-FETAL INTERFACE. 3568 02:09:03,359 --> 02:09:05,094 I KNOW THIS IS A PROGRAM THAT 3569 02:09:05,094 --> 02:09:06,862 DIANA HAS BEEN PARTICULARLY 3570 02:09:06,862 --> 02:09:07,730 INTERESTED IN. 3571 02:09:07,730 --> 02:09:09,498 THIS IS AN EFFORT TO UNDERSTAND 3572 02:09:09,498 --> 02:09:11,033 THE INTERACTIONS OF IMMUNE CELLS 3573 02:09:11,033 --> 02:09:13,002 THAT ENABLE PREGNANCY AND 3574 02:09:13,002 --> 02:09:15,404 MODULATE IMMUNITY AND OFFSPRING 3575 02:09:15,404 --> 02:09:18,574 AND SO MANY DOMAINS AS ARE SHOWN 3576 02:09:18,574 --> 02:09:23,312 IN THAT GRAPHIC ARE PART OF THIS 3577 02:09:23,312 --> 02:09:24,079 EFFORT. 3578 02:09:24,079 --> 02:09:25,481 THE CORONAVIRUS DISEASE 2019 3579 02:09:25,481 --> 02:09:27,249 VACCINE RESPONSE IN PREGNANT AND 3580 02:09:27,249 --> 02:09:28,584 LACTATING WOMEN WAS A BEAUTIFUL 3581 02:09:28,584 --> 02:09:30,986 EXAMPLE OF REALLY THE NICHD TEAM 3582 02:09:30,986 --> 02:09:34,056 TAKING THE LEAD WITH US AND MANY 3583 02:09:34,056 --> 02:09:37,893 OTHERS TO STUDY VERY EARLY AND 3584 02:09:37,893 --> 02:09:39,762 VERY WELL THESE VACCINES IN A 3585 02:09:39,762 --> 02:09:41,297 VERY VULNERABLE POPULATION. 3586 02:09:41,297 --> 02:09:44,567 AND ALSO DOING SOME OF THE 3587 02:09:44,567 --> 02:09:45,801 PATHOBIOLOGIC ANCILLARY STUDIES 3588 02:09:45,801 --> 02:09:49,505 LOOKING AT, FOR EXAMPLE, THE 3589 02:09:49,505 --> 02:09:51,507 TRANSFER OF IMMUNITY TO NEONATES 3590 02:09:51,507 --> 02:09:52,808 AND HOW THAT HAPPENED, WHETHER 3591 02:09:52,808 --> 02:09:55,110 IT WAS THE PLACENTA OR BREAST 3592 02:09:55,110 --> 02:09:56,412 MILK. 3593 02:09:56,412 --> 02:09:59,248 WE ALSO HAVE A VERY COOL 3594 02:09:59,248 --> 02:10:01,016 TRANSLATIONAL RESEARCH IN MA 3595 02:10:01,016 --> 02:10:04,420 TERM AND PEDIATRIC PHARMACOLOGY 3596 02:10:04,420 --> 02:10:05,521 AND THERAPEUTICS PROGRAM. 3597 02:10:05,521 --> 02:10:07,289 THAT'S AN ANNOUNCEMENT THAT'S 3598 02:10:07,289 --> 02:10:08,724 BEEN ON THE STREET THAT'S 3599 02:10:08,724 --> 02:10:09,425 CO-SPONSORED BY THE INSTITUTE 3600 02:10:09,425 --> 02:10:11,794 SHOWN THERE, AND THE IDEA HERE 3601 02:10:11,794 --> 02:10:16,865 IS TO TRY TO GET BETTER 3602 02:10:16,865 --> 02:10:19,268 PRECISION THERAPEUTICS FOR THESE 3603 02:10:19,268 --> 02:10:20,569 POPULATIONS INCLUDING TOOLS, 3604 02:10:20,569 --> 02:10:23,005 MODELS AND OTHER TECHNOLOGIES. 3605 02:10:23,005 --> 02:10:24,640 ALSO LOOK AT UNDERLYING 3606 02:10:24,640 --> 02:10:26,942 MECHANISMS OF DRUG ACTION AND 3607 02:10:26,942 --> 02:10:29,111 ULTIMATELY TO MAKE SURE WE HAVE 3608 02:10:29,111 --> 02:10:30,813 A HEALTHIER PIPELINE FOR PRODUCT 3609 02:10:30,813 --> 02:10:32,114 THAT CAN BE USED IN THIS 3610 02:10:32,114 --> 02:10:33,849 SETTING. 3611 02:10:33,849 --> 02:10:35,818 SO JUST A FEW THINGS ABOUT WHAT 3612 02:10:35,818 --> 02:10:38,354 I WOULD LIKE TO SEE AND IN OUR 3613 02:10:38,354 --> 02:10:42,725 NEXT SORT OF FIVE YEARS IDEALLY, 3614 02:10:42,725 --> 02:10:45,728 I THINK WE CAN CONTINUE TO APPLY 3615 02:10:45,728 --> 02:10:47,596 GENOMICS TO TREAT PEDIATRIC 3616 02:10:47,596 --> 02:10:48,030 INFECTIOUS DISEASES. 3617 02:10:48,030 --> 02:10:49,031 THAT IS CERTAINLY BEING DONE TO 3618 02:10:49,031 --> 02:10:52,635 SOME EBBS TEN EXTENT IN OUR CLIL 3619 02:10:52,635 --> 02:10:53,736 CENTER BUT I THINK THERE ARE 3620 02:10:53,736 --> 02:10:54,837 MANY, MANY OPPORTUNITIES TO RAMP 3621 02:10:54,837 --> 02:10:55,971 THAT UP AND ALSO TO MAKE SOME OF 3622 02:10:55,971 --> 02:11:01,877 OUR RESOURCES AVAILABLE 3623 02:11:01,877 --> 02:11:03,312 POTENTIALLY TO EXTERNAL 3624 02:11:03,312 --> 02:11:03,646 INVESTIGATORS. 3625 02:11:03,646 --> 02:11:05,080 WOULD REALLY LIKE US TO SEE AN 3626 02:11:05,080 --> 02:11:07,282 ELIMINATION OF SOME OF THE MOST 3627 02:11:07,282 --> 02:11:09,084 DEVASTATING PERINATAL INFECTIOUS 3628 02:11:09,084 --> 02:11:09,785 DISEASE TRANSMISSIONS. 3629 02:11:09,785 --> 02:11:10,786 HIV, OF COURSE, COMES TO MIND 3630 02:11:10,786 --> 02:11:12,655 BUT NOW WE'VE GOT SYPHILIS TO 3631 02:11:12,655 --> 02:11:13,589 CONTEND WITH BUT THERE ARE 3632 02:11:13,589 --> 02:11:15,424 OTHERS AS WELL, OF COURSE. 3633 02:11:15,424 --> 02:11:18,494 REDUCING THE BURDEN OF CHILDHOOD 3634 02:11:18,494 --> 02:11:20,029 ASTHMA AND ALLERGY, WORKING 3635 02:11:20,029 --> 02:11:21,263 TOWARDS THAT, AND WE CANNOT 3636 02:11:21,263 --> 02:11:22,564 FORGET VACCINES. 3637 02:11:22,564 --> 02:11:27,503 CANNOT FORGET THE OUT SIZE 3638 02:11:27,503 --> 02:11:29,705 EFFECT THAT VACCINES HAVE HAD TO 3639 02:11:29,705 --> 02:11:31,040 ENHANCE SURVIVAL AS WELL AS THE 3640 02:11:31,040 --> 02:11:33,242 QUALITY OF LIFE OF OUR PEDIATRIC 3641 02:11:33,242 --> 02:11:34,376 PATIENTS. 3642 02:11:34,376 --> 02:11:36,311 AND OUR PREGNANT PATIENTS. 3643 02:11:36,311 --> 02:11:37,079 I'LL STOP HERE. 3644 02:11:37,079 --> 02:11:38,814 THIS IS A PHOTO I REALLY LOVE. 3645 02:11:38,814 --> 02:11:42,084 I VISITED THE CHILDREN'S INN 3646 02:11:42,084 --> 02:11:44,953 SEVERAL MONTHS AGO AND THIS IS A 3647 02:11:44,953 --> 02:11:47,256 PATIENT WHO CAME FROM OUT OF 3648 02:11:47,256 --> 02:11:52,161 STATE WITH HIS DAD TO SPEND 3649 02:11:52,161 --> 02:11:53,562 THEIR -- MANY VISIT OVER THE 3650 02:11:53,562 --> 02:11:54,630 YEARS, AND IT'S JUST AN 3651 02:11:54,630 --> 02:11:55,931 INCREDIBLE PRIVILEGE AND 3652 02:11:55,931 --> 02:11:58,133 OPPORTUNITY TO GET TO DO THAT. 3653 02:11:58,133 --> 02:11:59,334 SO I'LL STOP THERE. 3654 02:11:59,334 --> 02:12:00,869 I'M GOING TO STOP SHARING AND I 3655 02:12:00,869 --> 02:12:04,473 WILL TURN IT BACK OVER TO DIANA. 3656 02:12:04,473 --> 02:12:07,609 THANK YOU AGAIN. 3657 02:12:07,609 --> 02:12:08,744 >> THANK YOU, JEANNE. 3658 02:12:08,744 --> 02:12:10,479 THAT WAS A GREAT TALK AND REALLY 3659 02:12:10,479 --> 02:12:11,914 HIGHLIGHTED SOME OPPORTUNITIES 3660 02:12:11,914 --> 02:12:14,683 FOR COLLABORATION AND NEW AREAS. 3661 02:12:14,683 --> 02:12:16,819 I THINK WE HAVE TIME FOR ONE OR 3662 02:12:16,819 --> 02:12:20,189 TWO QUESTIONS, IF COUNCILMEMBERS 3663 02:12:20,189 --> 02:12:22,624 WOULD LIKE TO RAISE THEIR HANDS 3664 02:12:22,624 --> 02:12:29,565 OR COME ON THE CHAT? 3665 02:12:29,565 --> 02:12:29,765 IGNA. 3666 02:12:29,765 --> 02:12:31,934 >> YES, DR. MARRAZZO, THANK YOU 3667 02:12:31,934 --> 02:12:34,636 FOR THIS GREAT TALK. 3668 02:12:34,636 --> 02:12:36,605 YOU HIGHLIGHTED THE IMPORTANCE 3669 02:12:36,605 --> 02:12:38,674 OF IMPLEMENTATION SCIENCE 3670 02:12:38,674 --> 02:12:42,177 RESEARCH RELATED TO STI, 3671 02:12:42,177 --> 02:12:45,447 SYPHILIS AND PERINATAL HIV. 3672 02:12:45,447 --> 02:12:50,152 ONE IMPORTANT PROBLEM RIGHT NOW 3673 02:12:50,152 --> 02:12:52,087 IS VACCINE HESITANCY, SO I'M 3674 02:12:52,087 --> 02:12:53,255 CURIOUS WHAT NIAID IS DOING IN 3675 02:12:53,255 --> 02:12:55,891 THAT AREA. 3676 02:12:55,891 --> 02:12:59,928 >> SO YOU KNOW, IT'S AN 3677 02:12:59,928 --> 02:13:04,066 INTERESTING QUESTION BECAUSE THE 3678 02:13:04,066 --> 02:13:06,068 SPECTRUM FROM DISCOVERY TO 3679 02:13:06,068 --> 02:13:10,639 GETTING IT INTO PEOPLE IS A VERY 3680 02:13:10,639 --> 02:13:11,406 COMPLICATED AND LONG ONE. 3681 02:13:11,406 --> 02:13:13,575 SO WE HAVE TRADITIONALLY BEEN ON 3682 02:13:13,575 --> 02:13:14,143 THE DISCOVERY SIDE. 3683 02:13:14,143 --> 02:13:17,079 ALL OF OUR WORK BOTH IN 3684 02:13:17,079 --> 02:13:21,350 DISCOVERY AT THE BENCH AS WELL 3685 02:13:21,350 --> 02:13:23,552 AS THE CLINICAL TRIAL STUDY OF 3686 02:13:23,552 --> 02:13:24,853 VACCINE AND THAT'S REALLY 3687 02:13:24,853 --> 02:13:26,054 TRADITIONALLY WHERE WE HAVE 3688 02:13:26,054 --> 02:13:29,892 BEEN -- WE DO THAT WORK, THE 3689 02:13:29,892 --> 02:13:32,728 DATA INFORM THE RECOMMENDATIONS 3690 02:13:32,728 --> 02:13:34,997 THAT YOU HEAR FROM CDC, ACIP, ET 3691 02:13:34,997 --> 02:13:35,230 CETERA. 3692 02:13:35,230 --> 02:13:40,669 I THINK THE QUESTION IS, CAN 3693 02:13:40,669 --> 02:13:42,237 MORE BE DONE TO UNDERSTAND 3694 02:13:42,237 --> 02:13:46,275 WHAT'S INFORMING PEOPLE'S 3695 02:13:46,275 --> 02:13:48,877 RELUCTANCE TO ACTUALLY GET 3696 02:13:48,877 --> 02:13:53,081 VACCINES THAT HAVE BEEN SHOWN TO 3697 02:13:53,081 --> 02:13:54,449 BE SAFE AND EFFECTIVE IN 3698 02:13:54,449 --> 02:13:55,050 CLINICAL TRIALS. 3699 02:13:55,050 --> 02:13:57,252 AND TO ME, THAT'S A VERY VALID 3700 02:13:57,252 --> 02:14:03,592 RESEARCH QUESTION. 3701 02:14:03,592 --> 02:14:04,660 I THINK THE MORE WE CAN 3702 02:14:04,660 --> 02:14:06,128 UNDERSTAND ABOUT WHAT'S DRIVING 3703 02:14:06,128 --> 02:14:10,132 LOWER RATES OF VACCINES, THE 3704 02:14:10,132 --> 02:14:11,667 BETTER OFF WE ARE IN TERMS OF 3705 02:14:11,667 --> 02:14:13,535 HOW TRANSPARENT THE PUBLIC 3706 02:14:13,535 --> 02:14:15,304 DIALOGUE IS AS WELL AS 3707 02:14:15,304 --> 02:14:16,171 ADDRESSING WHATEVER THOSE 3708 02:14:16,171 --> 02:14:17,806 CONCERNS ARE. 3709 02:14:17,806 --> 02:14:19,341 SO WE ARE COMMITTED TO CONTINUE 3710 02:14:19,341 --> 02:14:23,612 THAT DIALOGUE. 3711 02:14:23,612 --> 02:14:25,047 AS FAR AS FUNDING THAT WORK, 3712 02:14:25,047 --> 02:14:26,348 AGAIN, OUR PRIORITIES HAVE 3713 02:14:26,348 --> 02:14:29,651 MOSTLY BEEN IN THAT EARLIER PART 3714 02:14:29,651 --> 02:14:31,920 OF THE SPECTRUM, AND WITH AN 3715 02:14:31,920 --> 02:14:33,255 UNKNOWN BUDGET ENVIRONMENT AT 3716 02:14:33,255 --> 02:14:34,556 THIS POINT, IT'S GOING TO BE 3717 02:14:34,556 --> 02:14:36,091 REALLY TOUGH TO TAKE ON OR 3718 02:14:36,091 --> 02:14:37,292 EXPAND TOO MUCH MORE. 3719 02:14:37,292 --> 02:14:41,363 BUT I HEAR YOU AND I THINK IT'S 3720 02:14:41,363 --> 02:14:42,464 AN INCREDIBLY IMPORTANT TOPIC 3721 02:14:42,464 --> 02:14:43,999 FOR US TO UNDERSTAND BETTER. 3722 02:14:43,999 --> 02:14:45,100 >> SESH? 3723 02:14:45,100 --> 02:14:46,735 >> I DON'T WANT TO TAKE AWAY 3724 02:14:46,735 --> 02:14:50,472 FROM THE NEXT TALK, BUT I'M 3725 02:14:50,472 --> 02:14:51,840 INVOLVED WITH A NETWORK THAT IS 3726 02:14:51,840 --> 02:14:55,677 ALSO INTERESTED IN ENGAGING 3727 02:14:55,677 --> 02:14:59,948 HISTORICALLY UNDERREPRESENTED 3728 02:14:59,948 --> 02:15:00,816 POPULATIONS IN RESEARCH. 3729 02:15:00,816 --> 02:15:05,754 IF YOU HAVE A EXEAND YU COMPENDT 3730 02:15:05,754 --> 02:15:06,955 OF IMPLEMENTATION SCIENCE TOOLS 3731 02:15:06,955 --> 02:15:10,692 THAT YOU HAVE FOUND WORKED IN 3732 02:15:10,692 --> 02:15:11,260 DIFFERENT POPULATIONS, THAT 3733 02:15:11,260 --> 02:15:13,328 WOULD BE A TREMENDOUS RESOURCE. 3734 02:15:13,328 --> 02:15:14,730 I KNOW THERE ARE MANY OUT THERE, 3735 02:15:14,730 --> 02:15:18,800 BUT I WOULD CERTAINLY SAY THAT 3736 02:15:18,800 --> 02:15:22,638 THE NIAID HAS DONE GREAT WORK IN 3737 02:15:22,638 --> 02:15:25,040 THIS AREA, AND THAT LIST WOULD 3738 02:15:25,040 --> 02:15:25,574 BE VERY MUCH APPRECIATED. 3739 02:15:25,574 --> 02:15:25,874 THANK YOU. 3740 02:15:25,874 --> 02:15:28,443 >> I REALLY APPRECIATE THAT, AND 3741 02:15:28,443 --> 02:15:29,945 KIND OF WADING INTO THE LONG 3742 02:15:29,945 --> 02:15:34,149 COVID WORLD, UNDERSTANDING HOW I 3743 02:15:34,149 --> 02:15:35,684 THINK ADVANCED PARTICULARLY THE 3744 02:15:35,684 --> 02:15:39,154 HIV TEAMS IN NIAID HAVE BEEN 3745 02:15:39,154 --> 02:15:42,124 WITH THAT KIND OF WORK HAVE BEEN 3746 02:15:42,124 --> 02:15:42,557 EYE OPENING. 3747 02:15:42,557 --> 02:15:44,192 SO HAPPY TO SHARE THAT, AND I'LL 3748 02:15:44,192 --> 02:15:45,961 GET BACK TO THE GROUP ON HOW WE 3749 02:15:45,961 --> 02:15:48,830 MIGHT DO THAT. 3750 02:15:48,830 --> 02:15:49,798 >> THANK YOU. 3751 02:15:49,798 --> 02:15:51,667 WE'LL TAKE THE LAST QUESTION OR 3752 02:15:51,667 --> 02:15:55,370 COMMENT FROM BONNIE MALDONADO. 3753 02:15:55,370 --> 02:15:56,471 >> HEY, JEANNE. 3754 02:15:56,471 --> 02:15:57,272 THANKS SO MUCH FOR ALL OF THE 3755 02:15:57,272 --> 02:15:58,340 WORK THAT YOU'VE DONE AND 3756 02:15:58,340 --> 02:15:59,608 EVERYTHING YOU'VE EXPLAINED 3757 02:15:59,608 --> 02:16:00,242 TODAY AND WHAT YOU'VE DONE IN 3758 02:16:00,242 --> 02:16:03,278 YOUR CAREER. 3759 02:16:03,278 --> 02:16:05,047 I DON'T KNOW IF YOU KNOW BUT I 3760 02:16:05,047 --> 02:16:08,550 WAS ONE OF THE ORIGINAL MEMBERS 3761 02:16:08,550 --> 02:16:11,053 OF THE EXECUTIVE COMMITTEE AND 3762 02:16:11,053 --> 02:16:11,820 SCIENTIFIC COMMITTEE FOR IMPACT, 3763 02:16:11,820 --> 02:16:15,657 SO WE'VE SPENT MOST OF MY CAREER 3764 02:16:15,657 --> 02:16:17,359 WORKING WITH PEOPLE LIKE ROHAN 3765 02:16:17,359 --> 02:16:21,063 AND OTHERS TO REALLY LOOK AT HIV 3766 02:16:21,063 --> 02:16:24,266 IN THE PLACES WHERE IT'S HIT THE 3767 02:16:24,266 --> 02:16:25,767 HARDEST, FIRST STARTING IN THE 3768 02:16:25,767 --> 02:16:28,403 U.S. AND THEN WORKING IN 3769 02:16:28,403 --> 02:16:29,371 SUB-SAHARAN AFER CANNED A OTHER 3770 02:16:29,371 --> 02:16:30,272 PLACES. 3771 02:16:30,272 --> 02:16:31,473 SO MY QUESTION IS HOW DO YOU 3772 02:16:31,473 --> 02:16:33,008 THINK WE'LL BE WORKING IN OTHER 3773 02:16:33,008 --> 02:16:35,377 AREAS OF GLOBAL HEALTH AND 3774 02:16:35,377 --> 02:16:37,045 INFECTIOUS DISEASE IMPACT ALONG 3775 02:16:37,045 --> 02:16:38,246 WITH, FOR EXAMPLE, FOGARTY, DO 3776 02:16:38,246 --> 02:16:40,115 YOU FEEL LIKE THERE WILL BE 3777 02:16:40,115 --> 02:16:42,517 OVERLAP THERE? 3778 02:16:42,517 --> 02:16:45,020 THERE ARE, AS YOU MENTIONED, HPD 3779 02:16:45,020 --> 02:16:48,557 FOR EXAMPLE IS STILL ONE OF THE 3780 02:16:48,557 --> 02:16:51,093 MOST -- ONE OF THE BIGGEST 3781 02:16:51,093 --> 02:16:53,562 KILLERS OF WOMEN IN SUB-SAHARAN 3782 02:16:53,562 --> 02:16:54,596 AFRICA AND OTHER PARTS OF THE 3783 02:16:54,596 --> 02:16:56,231 WORLD, AND TO WHAT EXTENT WILL 3784 02:16:56,231 --> 02:16:57,466 WE BE ABLE TO WORK NOT ONLY IN 3785 02:16:57,466 --> 02:16:59,501 THE U.S. ON THESE ISSUES BUT 3786 02:16:59,501 --> 02:17:04,973 ACROSS THE WORLD TO REALLY MODEL 3787 02:17:04,973 --> 02:17:07,576 THE REDUCTION OF THESE DEADLY 3788 02:17:07,576 --> 02:17:09,144 DISEASES AND EITHER CURRENT OR 3789 02:17:09,144 --> 02:17:10,779 EMERGING DISEASES IN THE WORLD? 3790 02:17:10,779 --> 02:17:11,380 THANK YOU. 3791 02:17:11,380 --> 02:17:13,849 >> THANK YOU FOR YOUR WORK AS 3792 02:17:13,849 --> 02:17:14,483 WELL, BONNIE. 3793 02:17:14,483 --> 02:17:16,385 I COULDN'T AGREE MORE. 3794 02:17:16,385 --> 02:17:18,353 MY ARGUMENT HAS ALWAYS BEEN THAT 3795 02:17:18,353 --> 02:17:20,322 GLOBAL HEALTH IS HUMAN HEALTH 3796 02:17:20,322 --> 02:17:23,625 AND VICE VERSA, AND IF WE CAN'T 3797 02:17:23,625 --> 02:17:24,726 REALLY CONTINUE TO DO THE WORK 3798 02:17:24,726 --> 02:17:26,261 THAT WE NEED TO DO GLOBALLY, 3799 02:17:26,261 --> 02:17:28,463 IT'S GOING TO BE JUST 3800 02:17:28,463 --> 02:17:28,764 DEVASTATING. 3801 02:17:28,764 --> 02:17:29,464 NOT JUST FOR THE PEOPLE THERE, 3802 02:17:29,464 --> 02:17:32,200 BUT FOR THE PEOPLE HERE, RIGHT? 3803 02:17:32,200 --> 02:17:33,502 FOR ALL THE REASONS THAT YOU 3804 02:17:33,502 --> 02:17:34,403 MENTIONED. 3805 02:17:34,403 --> 02:17:36,138 ABOUT 10% OF OUR BUDGET IS SPENT 3806 02:17:36,138 --> 02:17:36,838 GLOBALLY. 3807 02:17:36,838 --> 02:17:39,941 SO IT'S A SUBSTANTIAL PORTION 3808 02:17:39,941 --> 02:17:43,945 AND A LOT OF THAT INFORMS THE 3809 02:17:43,945 --> 02:17:44,780 DEVELOPMENT AND MAINTENANCE OF 3810 02:17:44,780 --> 02:17:47,649 SOME OF THESE NE NETWORKS JUST E 3811 02:17:47,649 --> 02:17:48,617 YOU MENTIONED. 3812 02:17:48,617 --> 02:17:49,851 THESE NETWORKS REALLY SHOWED 3813 02:17:49,851 --> 02:17:50,919 THEIR WORTH WHEN THEY WERE ABLE 3814 02:17:50,919 --> 02:17:53,221 TO BE USED ON A DIME PRETTY MUCH 3815 02:17:53,221 --> 02:17:54,122 DURING COVID, RIGHT? 3816 02:17:54,122 --> 02:17:56,958 SO WE WERE ABLE TO RAMP UP 3817 02:17:56,958 --> 02:17:57,826 STUDYING PARTICULARLY VACCINES 3818 02:17:57,826 --> 02:17:59,161 REALLY QUICKLY. 3819 02:17:59,161 --> 02:18:00,695 SO WE HAVE TO KEEP MAKING THE 3820 02:18:00,695 --> 02:18:01,563 CASE FOR THAT. 3821 02:18:01,563 --> 02:18:03,865 THERE'S NO QUESTION. 3822 02:18:03,865 --> 02:18:06,168 AND YOU CAN COUNT ON US TO KEEP 3823 02:18:06,168 --> 02:18:09,805 DOING THAT. 3824 02:18:09,805 --> 02:18:11,540 >> THANK YOU, EVERYONE, FOR YOUR 3825 02:18:11,540 --> 02:18:12,074 QUESTIONS. 3826 02:18:12,074 --> 02:18:13,608 JEANNE, THIS WAS TERRIFIC. 3827 02:18:13,608 --> 02:18:17,345 IS THERE ONE MORE COMMENT FROM 3828 02:18:17,345 --> 02:18:18,213 CYNTHIA IN THE CHAT BOX? 3829 02:18:18,213 --> 02:18:19,448 >> YES, SORRY. 3830 02:18:19,448 --> 02:18:21,183 I JUST -- IT WAS MORE OF A 3831 02:18:21,183 --> 02:18:22,951 COMMENT, BUT THERE IS A 3832 02:18:22,951 --> 02:18:26,688 DIFFERENCE IN THE WAGE STATE 3833 02:18:26,688 --> 02:18:28,123 SCREENS HAVING MOVED BETWEEN 3834 02:18:28,123 --> 02:18:28,857 STATE RECENTLY. 3835 02:18:28,857 --> 02:18:30,525 IT'S VERY CURIOUS AND I WONDER 3836 02:18:30,525 --> 02:18:31,526 IF THERE'S SOME PUBLIC HEALTH 3837 02:18:31,526 --> 02:18:34,262 INITIATIVE THAT WE COULD ESPOUSE 3838 02:18:34,262 --> 02:18:34,729 TO MAYBE -- 3839 02:18:34,729 --> 02:18:37,332 >> I THINK CDC MIGHT HAVE JUST 3840 02:18:37,332 --> 02:18:40,602 UPDATED THE GUIDANCE AND I THINK 3841 02:18:40,602 --> 02:18:42,170 IT GOING TO BE A MATTER -- SO 3842 02:18:42,170 --> 02:18:43,338 THAT THERE'S MORE ROUTINE 3843 02:18:43,338 --> 02:18:44,406 SCREENING FREQUENTLY DURING 3844 02:18:44,406 --> 02:18:45,240 PREGNANCY, BECAUSE THERE USED TO 3845 02:18:45,240 --> 02:18:47,442 BE THAT WISHY WASHY THING DURING 3846 02:18:47,442 --> 02:18:48,877 THE THIRD TRIMESTER IF YOU'RE AT 3847 02:18:48,877 --> 02:18:51,513 RISK, WHICH DID NOT -- DOESN'T 3848 02:18:51,513 --> 02:18:51,947 MEAN ANYTHING. 3849 02:18:51,947 --> 02:18:53,281 NOT KNOWING. 3850 02:18:53,281 --> 02:18:55,016 SO I THINK THAT I'D HAVE TO 3851 02:18:55,016 --> 02:18:56,451 CHECK BUT I THINK THEY JUST 3852 02:18:56,451 --> 02:18:57,786 UPDATED THE GUIDANCE IN AN 3853 02:18:57,786 --> 02:18:58,753 ATTEMPT TO MAKE IT MORE 3854 02:18:58,753 --> 02:18:59,321 CONSISTENT. 3855 02:18:59,321 --> 02:19:01,089 IT MAY TAKE STATES A BIT TO 3856 02:19:01,089 --> 02:19:02,190 CATCH UP BUT YOU'RE RIGHT, THERE 3857 02:19:02,190 --> 02:19:03,391 SHOULDN'T BE ANY DIFFERENCE AT 3858 02:19:03,391 --> 02:19:03,558 ALL. 3859 02:19:03,558 --> 02:19:06,261 >> THANK YOU. 3860 02:19:06,261 --> 02:19:07,996 >> WELL, JEANNE, THIS WAS JUST 3861 02:19:07,996 --> 02:19:08,263 TERRIFIC. 3862 02:19:08,263 --> 02:19:10,298 >> THANK YOU. 3863 02:19:10,298 --> 02:19:11,633 >> WE'RE VERY APPRECIATIVE OF 3864 02:19:11,633 --> 02:19:15,237 YOUR TIME AND YOUR EXPERTISE AND 3865 02:19:15,237 --> 02:19:18,874 THIS IS GREAT FOUNDATION FOR OUR 3866 02:19:18,874 --> 02:19:19,541 SUBSEQUENT DISCUSSION. 3867 02:19:19,541 --> 02:19:20,742 YOU'RE WELCOME TO STAY FOR THE 3868 02:19:20,742 --> 02:19:24,112 NEXT SESSION, WHICH IS USUALLY 3869 02:19:24,112 --> 02:19:25,580 THE HIGHLIGHT OF OUR COUNCIL 3870 02:19:25,580 --> 02:19:25,814 MEETING. 3871 02:19:25,814 --> 02:19:26,915 I KNOW YOU HAVE A BUSY SCHEDULE. 3872 02:19:26,915 --> 02:19:28,884 BUT FOR OUR NEW MEMBERS, WE 3873 02:19:28,884 --> 02:19:32,621 REGULARLY FEATURE A SEGMENT 3874 02:19:32,621 --> 02:19:33,822 CALLED THE VOICE OF THE 3875 02:19:33,822 --> 02:19:34,356 PARTICIPANT. 3876 02:19:34,356 --> 02:19:35,257 THIS GIVES US A CHANCE TO HEAR 3877 02:19:35,257 --> 02:19:37,792 FROM THOSE WHO HAVE HAD PERSONAL 3878 02:19:37,792 --> 02:19:39,995 EXPERIENCES RELATED TO RESEARCH 3879 02:19:39,995 --> 02:19:43,265 THAT NICHD FUNDS. 3880 02:19:43,265 --> 02:19:45,467 TODAY WE ARE WELCOMING MS. APRIL 3881 02:19:45,467 --> 02:19:46,768 CHAVEZ, WHO WILL SPEAK ABOUT HER 3882 02:19:46,768 --> 02:19:48,837 EXPERIENCE AS A PATIENT WHO 3883 02:19:48,837 --> 02:19:50,272 SUFFERED FROM MATERNAL SEPSIS 3884 02:19:50,272 --> 02:19:52,941 AND HER PERSPECTIVE ON BEING A 3885 02:19:52,941 --> 02:19:54,676 PARTICIPANT IN A RESEARCH STUDY 3886 02:19:54,676 --> 02:19:57,412 THAT AIMS TO IMPROVE THE CARE 3887 02:19:57,412 --> 02:19:58,813 FOR PREGNANT WOMEN. 3888 02:19:58,813 --> 02:20:00,182 WELCOME, MS. CHAVEZ. 3889 02:20:00,182 --> 02:20:01,383 WE'RE SO GRATEFUL THAT YOU COULD 3890 02:20:01,383 --> 02:20:08,823 JOIN US. 3891 02:20:08,823 --> 02:20:15,297 >> WE CAN'T HEAR YOU. 3892 02:20:15,297 --> 02:20:16,731 >> CAN YOU HEAR ME NOW? 3893 02:20:16,731 --> 02:20:17,999 >> YES. 3894 02:20:17,999 --> 02:20:20,769 >> THAT IS NOT THE FOOT I WANTED 3895 02:20:20,769 --> 02:20:22,604 TO START ON, SO GLAD WE GOT THAT 3896 02:20:22,604 --> 02:20:23,438 ONE OUT OF THE WAY. 3897 02:20:23,438 --> 02:20:25,173 THANK YOU ALL SO MUCH FOR 3898 02:20:25,173 --> 02:20:26,675 ALLOWING ME TO BE HERE TODAY. 3899 02:20:26,675 --> 02:20:29,678 I AM GOING TO PULL UP MY SLIDES 3900 02:20:29,678 --> 02:20:33,281 REALLY QUICKLY AND THEN WE WILL 3901 02:20:33,281 --> 02:20:36,785 JUMP INTO -- OKAY. 3902 02:20:36,785 --> 02:20:37,986 CAN YOU ALL SEE THAT 3903 02:20:37,986 --> 02:20:40,889 PRESENTATION ON THE SCREEN NOW? 3904 02:20:40,889 --> 02:20:43,858 PERFECT. 3905 02:20:43,858 --> 02:20:44,526 OKAY. 3906 02:20:44,526 --> 02:20:48,697 MU NAMY NAME IS APRIL CHAVEZ, IA 3907 02:20:48,697 --> 02:20:49,564 MATERNAL SEPSIS SURVIVOR. 3908 02:20:49,564 --> 02:20:50,899 I'M REALLY EXCITED TO BE HERE 3909 02:20:50,899 --> 02:20:51,199 TODAY. 3910 02:20:51,199 --> 02:20:53,068 I'VE SHARED MY STORY IN A LOT OF 3911 02:20:53,068 --> 02:20:53,835 PLACES IN DIFFERENT ENVIRONMENTS 3912 02:20:53,835 --> 02:20:55,370 BUT BEING HERE TODAY WITH 3913 02:20:55,370 --> 02:20:59,541 DR. BAUER, THIS IS REALLY A FULL 3914 02:20:59,541 --> 02:21:01,076 CIRCLE MOMENT FOR ME SO I THINK 3915 02:21:01,076 --> 02:21:02,611 YOU'LL SEE WHY AS WE GO THROUGH 3916 02:21:02,611 --> 02:21:03,912 THINGS AND AS DR. BAUER PRESENTS 3917 02:21:03,912 --> 02:21:04,479 AS WELL. 3918 02:21:04,479 --> 02:21:05,780 AS I JUMP INTO THINGS, I JUST 3919 02:21:05,780 --> 02:21:07,749 WANT TO REMIND YOU THAT THERE 3920 02:21:07,749 --> 02:21:10,819 ARE REAL WOMEN BEHIND EACH 3921 02:21:10,819 --> 02:21:12,087 NUMBER AND EACH STATISTIC THAT 3922 02:21:12,087 --> 02:21:15,757 WE TALK ABOUT IN THESE TYPES OF 3923 02:21:15,757 --> 02:21:16,424 SETTINGS. 3924 02:21:16,424 --> 02:21:19,794 MY GOAL HERE IS TO REMIND THIS 3925 02:21:19,794 --> 02:21:22,264 GROUP ABOUT THE POWER THAT 3926 02:21:22,264 --> 02:21:23,298 MYSELF AND OTHER WOMEN MIGHT 3927 02:21:23,298 --> 02:21:25,033 BRING TO THE TABLE EVEN THOUGH 3928 02:21:25,033 --> 02:21:25,767 WE'RE NOT MEDICAL EXPERTS OR 3929 02:21:25,767 --> 02:21:29,204 ANYTHING OF THAT MEANS, WE DO 3930 02:21:29,204 --> 02:21:31,640 HAVE A VOICE AND THIS LIVED 3931 02:21:31,640 --> 02:21:33,275 EXPERIENCE IS REALLY IMPORTANT 3932 02:21:33,275 --> 02:21:35,510 WHEN IT BECOMES TO CREATING 3933 02:21:35,510 --> 02:21:36,945 CHANGE TO SOME OF OUR BIGGEST 3934 02:21:36,945 --> 02:21:38,480 MATERNAL HEALTH CHALLENGES. 3935 02:21:38,480 --> 02:21:40,315 SO, AFTER YEARS OF TRYING TO GET 3936 02:21:40,315 --> 02:21:41,449 PREGNANT, MY HUSBAND AND I 3937 02:21:41,449 --> 02:21:42,884 FINALLY FOUND OUT THAT WE WERE 3938 02:21:42,884 --> 02:21:45,453 GOING TO BE PARENTS AT THE 3939 02:21:45,453 --> 02:21:46,488 BEGINNING OF 2017. 3940 02:21:46,488 --> 02:21:49,257 WE WERE OVER THE MOON. 3941 02:21:49,257 --> 02:21:50,959 I HAVE A VERY TYPE A PERSONALITY 3942 02:21:50,959 --> 02:21:52,961 SO I THINK IT'S SAFE TO SAY THAT 3943 02:21:52,961 --> 02:21:54,496 I WENT STRAIGHT TO AMAZON AND 3944 02:21:54,496 --> 02:21:56,164 WENT A LITTLE BIT OVERBOARD WITH 3945 02:21:56,164 --> 02:22:00,435 ALL OF THE BABY BOOKS. 3946 02:22:00,435 --> 02:22:01,970 I GOT EVERY SINGLE APP ON MY 3947 02:22:01,970 --> 02:22:03,405 PHONE TO KNOW HOW BIG THE BABY 3948 02:22:03,405 --> 02:22:04,439 WAS AND WHAT SHOULD BE HAPPENING 3949 02:22:04,439 --> 02:22:06,374 AND I WAS JUST REALLY IN TUNE 3950 02:22:06,374 --> 02:22:08,910 WITH WHAT I WAS ABOUT TO 3951 02:22:08,910 --> 02:22:10,011 EXPERIENCE BECAUSE WE WERE TOLD 3952 02:22:10,011 --> 02:22:11,212 PREVIOUSLY THAT IT MIGHT NOT 3953 02:22:11,212 --> 02:22:16,251 EVER HAPPEN FOR US. 3954 02:22:16,251 --> 02:22:19,120 BUT I WAS REALLY EXCITED ON 3955 02:22:19,120 --> 02:22:21,289 SEPTEMBER 2ND MY SON CRUZ MADE 3956 02:22:21,289 --> 02:22:22,290 HIS ENTRANCE INTO THE WORLD. 3957 02:22:22,290 --> 02:22:23,925 HE WAS HEALTHY, I WAS HEALTHY, 3958 02:22:23,925 --> 02:22:25,160 EVERYTHING WAS NORMAL AND HE HAD 3959 02:22:25,160 --> 02:22:26,561 ALL THE NURSES SWOONING WITH HIS 3960 02:22:26,561 --> 02:22:30,065 FULL HEAD OF HAIR. 3961 02:22:30,065 --> 02:22:32,267 SO THIS WAS IT, THIS WAS ABOUT 3962 02:22:32,267 --> 02:22:35,570 TO BE THE START OF MY FAIRY TALE 3963 02:22:35,570 --> 02:22:36,438 THAT I ALWAYS WANTED. 3964 02:22:36,438 --> 02:22:40,175 WHAT I DIDN'T REALIZE THEN WAS 3965 02:22:40,175 --> 02:22:42,310 THAT MY FAIRY TALE WAS ABOUT TO 3966 02:22:42,310 --> 02:22:44,612 TAKE A TURN TO BASICALLY A 3967 02:22:44,612 --> 02:22:45,347 FULL-ON NIGHTMARE. 3968 02:22:45,347 --> 02:22:47,449 ON THE DAY I WAS SUPPOSED TO BE 3969 02:22:47,449 --> 02:22:48,416 DISCHARGED FROM THE HOSPITAL, I 3970 02:22:48,416 --> 02:22:49,784 STARTED TO FEEL TERRIBLE. 3971 02:22:49,784 --> 02:22:51,519 I FELT LIKE MY HEART WAS RACING, 3972 02:22:51,519 --> 02:22:53,254 I COULDN'T CATCH MY BREATH, AND 3973 02:22:53,254 --> 02:22:55,156 EVEN THINGS JUST LIKE STANDING 3974 02:22:55,156 --> 02:22:56,591 UP WERE A CHALLENGE. 3975 02:22:56,591 --> 02:22:59,294 I STARTED TO RUN A FEVER BUT 3976 02:22:59,294 --> 02:23:01,229 WHEN I SHARED ALL THESE SYMPTOMS 3977 02:23:01,229 --> 02:23:02,731 WITH MY MEDICAL TEAM, THERE WAS 3978 02:23:02,731 --> 02:23:05,266 NO REAL CONCERN OR SENSE OF 3979 02:23:05,266 --> 02:23:06,668 URGENCY, THEY BASICALLY KEPT 3980 02:23:06,668 --> 02:23:08,903 REMINDING ME THAT I JUST HAD A 3981 02:23:08,903 --> 02:23:13,375 BABY, IT'S NORMAL TO FEEL TIRED, 3982 02:23:13,375 --> 02:23:14,909 IT'S NORMAL FOR YOUR WHITE BLOOD 3983 02:23:14,909 --> 02:23:16,144 CELL COUNT TO INCREASE SO 3984 02:23:16,144 --> 02:23:16,778 BASICALLY ANY OF THE SYMPTOMS 3985 02:23:16,778 --> 02:23:17,812 THAT I BROUGHT UP, THEY WERE 3986 02:23:17,812 --> 02:23:23,084 KIND OF EXPLAINED AWAY OR 3987 02:23:23,084 --> 02:23:23,752 DISMISSED. 3988 02:23:23,752 --> 02:23:28,323 AT ONE POINT I WAS LI LITERALLY 3989 02:23:28,323 --> 02:23:32,327 LAYING IN THE BED JACKHAMMERING 3990 02:23:32,327 --> 02:23:34,896 WITH CHILLS, A DOCTOR CAME IN 3991 02:23:34,896 --> 02:23:37,232 AND CRANKED MY THERMOSTAT UP TO 3992 02:23:37,232 --> 02:23:38,733 80 DEGREES AND I WAS TOLD TO 3993 02:23:38,733 --> 02:23:39,801 TAKE A HOT SHOWER AND JUST TRY 3994 02:23:39,801 --> 02:23:40,335 TO RELAX. 3995 02:23:40,335 --> 02:23:42,404 WHEN MY CHILLS TURNED TO SWEATS 3996 02:23:42,404 --> 02:23:48,576 I WAS BROUGHT A FAN TO MY 3997 02:23:48,576 --> 02:23:50,678 BEDSIDE, THEY KEPT REMINDING ME 3998 02:23:50,678 --> 02:23:52,180 EVERYTHING WAS FINE, THIS IS 3999 02:23:52,180 --> 02:23:54,082 NORMAL AFTER CHILDBIRTH, IT 4000 02:23:54,082 --> 02:23:55,417 MIGHT JUST BE THE THERMOSTAT IN 4001 02:23:55,417 --> 02:23:55,850 YOUR ROOM. 4002 02:23:55,850 --> 02:23:57,485 WHEN I TALKED ABOUT MY RACING 4003 02:23:57,485 --> 02:23:58,520 HEART THEY SAID YOU'RE PROBABLY 4004 02:23:58,520 --> 02:24:00,155 JUST ANXIOUS ABOUT BEING A NEW 4005 02:24:00,155 --> 02:24:00,588 MOM. 4006 02:24:00,588 --> 02:24:02,223 AS SOMEBODY LIKE I SAID, NO 4007 02:24:02,223 --> 02:24:03,691 MEDICAL DEGREE, NO IDEA WHAT A 4008 02:24:03,691 --> 02:24:04,559 RACING HEART, FEVER, PAIN, 4009 02:24:04,559 --> 02:24:06,628 TROUBLE BREATHING, HEADACHE AND 4010 02:24:06,628 --> 02:24:10,365 ALL OF THESE SYMPTOMS MEANT FOR 4011 02:24:10,365 --> 02:24:14,002 ME, AND I HAD STRUGGLED WITH 4012 02:24:14,002 --> 02:24:15,970 ANXIETY ABOUT 10 YEARS PRIOR, MY 4013 02:24:15,970 --> 02:24:17,839 BIGGEST REGRET WAS I LET THEM 4014 02:24:17,839 --> 02:24:20,608 CONVINCE ME THIS WAS ALL NORMAL. 4015 02:24:20,608 --> 02:24:22,143 ALL NEW MOMS FEEL THIS WAY AND 4016 02:24:22,143 --> 02:24:23,445 MAYBE JUST CHILDBIRTH WAS HARDER 4017 02:24:23,445 --> 02:24:24,212 THAN I THOUGHT. 4018 02:24:24,212 --> 02:24:25,680 THEY WERE THE EXPERTS AND 4019 02:24:25,680 --> 02:24:26,748 REGARDLESS OF HOW MANY TIMES I 4020 02:24:26,748 --> 02:24:28,416 SHARED MY SYMPTOMS OR CONCERNS, 4021 02:24:28,416 --> 02:24:30,285 THEY SAID THAT EVERYTHING WAS 4022 02:24:30,285 --> 02:24:32,520 NORMAL, SO I THOUGHT SURELY IT 4023 02:24:32,520 --> 02:24:34,355 IS. 4024 02:24:34,355 --> 02:24:35,423 SOMETHING I'LL NEVER FORGET IS 4025 02:24:35,423 --> 02:24:36,558 THERE WAS A DOCTOR IN THE MIDDLE 4026 02:24:36,558 --> 02:24:39,194 OF THE NIGHT WHO I WAS TALKING 4027 02:24:39,194 --> 02:24:40,829 TO HIM ABOUT HOW I WAS FEELING 4028 02:24:40,829 --> 02:24:42,497 AND HE SAID YOU'RE BEING CRAZY 4029 02:24:42,497 --> 02:24:46,534 AND YOU NEED TO STOP. 4030 02:24:46,534 --> 02:24:50,805 SO AT THAT POINT, I LET THEM 4031 02:24:50,805 --> 02:24:51,172 SEND ME HOME. 4032 02:24:51,172 --> 02:24:52,407 THEY SAID YOU'LL FEEL BETTER 4033 02:24:52,407 --> 02:24:53,575 ONCE YOU GET HOME, WE'RE GOING 4034 02:24:53,575 --> 02:24:56,778 TO GIVE YOU SOME ANXIETY MEDS, 4035 02:24:56,778 --> 02:24:58,079 JUST GO HOME AND RELAX AND 4036 02:24:58,079 --> 02:25:01,282 YOU'LL FEEL BETTER. 4037 02:25:01,282 --> 02:25:03,117 SO I WENT HOME WITH MY SON AND 4038 02:25:03,117 --> 02:25:05,019 MY HUSBAND, BUT THINGS REALLY 4039 02:25:05,019 --> 02:25:09,924 STARTED TO GET WORSE. 4040 02:25:09,924 --> 02:25:11,259 I COULDN'T EAT, I COULDN'T 4041 02:25:11,259 --> 02:25:12,694 SLEEP, I COULDN'T GO TO THE 4042 02:25:12,694 --> 02:25:14,462 BATHROOM, I COULDN'T CARE FOR 4043 02:25:14,462 --> 02:25:15,763 MYSELF MUCH LESS A NEWBORN BABY 4044 02:25:15,763 --> 02:25:16,331 AT THAT POINT. 4045 02:25:16,331 --> 02:25:18,266 SO I STARTED TO KEEP A LIST AND 4046 02:25:18,266 --> 02:25:19,367 THIS SCREENSHOT THAT YOU'LL SEE 4047 02:25:19,367 --> 02:25:23,905 ON THE LEFT-HAND SIDE, THAT'S 4048 02:25:23,905 --> 02:25:25,039 ACTUAL NOTES FROM MY PHONE OF 4049 02:25:25,039 --> 02:25:26,508 JUST KIND OF EVERYTHING I WAS 4050 02:25:26,508 --> 02:25:27,976 FEELING AT THAT TIME JUST 4051 02:25:27,976 --> 02:25:28,643 BECAUSE THERE WAS SO MUCH GOING 4052 02:25:28,643 --> 02:25:30,512 ON WITH MY BODY THAT I COULDN'T 4053 02:25:30,512 --> 02:25:31,479 EVEN KEEP THINGS STRAIGHT AT 4054 02:25:31,479 --> 02:25:32,180 THAT POINT. 4055 02:25:32,180 --> 02:25:33,281 SO I STARTED TO MAKE A LIST 4056 02:25:33,281 --> 02:25:35,783 KNOWING THAT THE NEXT TIME I GOT 4057 02:25:35,783 --> 02:25:37,352 BACK OR WAS ABLE TO CALL A 4058 02:25:37,352 --> 02:25:38,152 HEALTHCARE PROVIDER, I WOULD 4059 02:25:38,152 --> 02:25:39,988 TALK ABOUT ALL THESE THINGS. 4060 02:25:39,988 --> 02:25:41,523 THESE THINGS WERE ALL THINGS 4061 02:25:41,523 --> 02:25:43,758 THAT IN ONE WAY OR ANOTHER I HAD 4062 02:25:43,758 --> 02:25:45,093 ALREADY EXPRESSED BUT I REALLY 4063 02:25:45,093 --> 02:25:46,294 JUST WANTED TO KEEP A LIST OF 4064 02:25:46,294 --> 02:25:49,898 THINGS THAT WERE STRAIGHT. 4065 02:25:49,898 --> 02:25:52,534 SO THAT'S MY LIST ON THE LEFT OF 4066 02:25:52,534 --> 02:25:53,768 THE SCREEN SHOTS OF WHAT I NOTED 4067 02:25:53,768 --> 02:25:57,705 AND THE SIGNS ON THE RIGHT ARE 4068 02:25:57,705 --> 02:25:59,407 ACTUALLY THE WARNING SIGNS, PART 4069 02:25:59,407 --> 02:26:00,808 OF AN INITIATIVE THAT I WAS PART 4070 02:26:00,808 --> 02:26:02,443 OF WITH DR. BAUER WHO YOU'LL 4071 02:26:02,443 --> 02:26:03,678 HEAR FROM SHORTLY. 4072 02:26:03,678 --> 02:26:05,880 SO I WANTED TO REALLY QUICKLY 4073 02:26:05,880 --> 02:26:07,549 SHOW YOU THE POWER IN A TOOL 4074 02:26:07,549 --> 02:26:09,183 LIKE THIS. 4075 02:26:09,183 --> 02:26:11,619 AT MY HOSPITAL, THERE WAS NO 4076 02:26:11,619 --> 02:26:13,688 SIGNAGE THAT TALKED ABOUT SEPSIS 4077 02:26:13,688 --> 02:26:15,023 OR URGENT MATERNAL WARNING 4078 02:26:15,023 --> 02:26:16,324 SIGNS. 4079 02:26:16,324 --> 02:26:18,259 BUT I WISH THERE HAD BEEN. 4080 02:26:18,259 --> 02:26:19,761 ALL OF THESE THINGS CIRCLED WERE 4081 02:26:19,761 --> 02:26:21,829 THINGS THAT I SPECIFICALLY HAD 4082 02:26:21,829 --> 02:26:23,798 MENTIONED TO MY MEDICAL TEAM 4083 02:26:23,798 --> 02:26:27,168 BEFORE I WAS EVER DISCHARGED. 4084 02:26:27,168 --> 02:26:31,639 AND AS YOU CAN SEE, IF A TOOL 4085 02:26:31,639 --> 02:26:33,241 LIKE THIS HAD BEEN IN MY ROOM OR 4086 02:26:33,241 --> 02:26:34,275 IN THE HOSPITAL SOMEWHERE OR 4087 02:26:34,275 --> 02:26:35,510 GIVEN TO ME, I WOULD HAVE BEEN 4088 02:26:35,510 --> 02:26:37,145 ABLE TO SAY LOOK HOW MANY OF 4089 02:26:37,145 --> 02:26:37,679 THESE I HAVE. 4090 02:26:37,679 --> 02:26:39,147 YOU ARE NOT SENDING ME HOME. 4091 02:26:39,147 --> 02:26:40,582 SOMETHING IS WRONG. 4092 02:26:40,582 --> 02:26:42,417 BUT AT THAT POINT, I DIDN'T HAVE 4093 02:26:42,417 --> 02:26:46,187 THE TOOLS OR THE KNOWLEDGE TO 4094 02:26:46,187 --> 02:26:47,088 REALLY GO AGAINST WHAT THEY WERE 4095 02:26:47,088 --> 02:26:47,322 SAYING. 4096 02:26:47,322 --> 02:26:51,125 I HAD TO TRUST THAT THEY WERE 4097 02:26:51,125 --> 02:26:51,993 THE EXPERTS, EVERYTHING WAS 4098 02:26:51,993 --> 02:26:53,428 FINE. 4099 02:26:53,428 --> 02:26:56,831 SO THIS IS ONE OF THE TOOLS THAT 4100 02:26:56,831 --> 02:26:58,266 I KNOW IS GOING TO MAKE THINGS 4101 02:26:58,266 --> 02:27:06,240 BETTER FOR OTHER WOMEN AS WELL. 4102 02:27:06,240 --> 02:27:07,842 WHEN I WAS AT HOME -- SORRY, I 4103 02:27:07,842 --> 02:27:09,410 GOT A LITTLE OUT OF ORDER THERE, 4104 02:27:09,410 --> 02:27:11,112 BUT WHEN I WAS HOME, I WASN'T 4105 02:27:11,112 --> 02:27:12,447 FEELING BETTER SO I KEPT THAT 4106 02:27:12,447 --> 02:27:14,415 LIST AND EVENTUALLY MY MOM 4107 02:27:14,415 --> 02:27:15,183 INSISTED THAT SOMETHING WAS 4108 02:27:15,183 --> 02:27:16,618 WRONG AND SHE SAID WE NEED TO GO 4109 02:27:16,618 --> 02:27:21,489 BACK. 4110 02:27:21,489 --> 02:27:22,690 I JUST KEPT THINKING ABOUT HOW 4111 02:27:22,690 --> 02:27:24,025 NOT WORRIED MY TEAM OF EXPERT 4112 02:27:24,025 --> 02:27:24,425 WERE BEFORE. 4113 02:27:24,425 --> 02:27:26,661 THE DOCTOR TELLING ME I WAS 4114 02:27:26,661 --> 02:27:27,996 CRAZY AND I REALLY WAS JUST 4115 02:27:27,996 --> 02:27:29,230 HESITANT TO GO BACK BECAUSE THEY 4116 02:27:29,230 --> 02:27:30,665 ALREADY TOLD ME I WAS FINE, I 4117 02:27:30,665 --> 02:27:32,166 DIDN'T WANT TO -- I DIDN'T WANT 4118 02:27:32,166 --> 02:27:34,135 TO UPSET THEM IN A LOT OF WAYS 4119 02:27:34,135 --> 02:27:35,803 BECAUSE AT THAT POINT, THEY HAD 4120 02:27:35,803 --> 02:27:37,372 MADE ME FEEL LIKE A BURDEN, NOT 4121 02:27:37,372 --> 02:27:39,340 LIKE A PATIENT WHO WAS TREATED 4122 02:27:39,340 --> 02:27:42,610 WITH RESPECT AND EMPATHY. 4123 02:27:42,610 --> 02:27:47,048 SO MY MOM INSISTED THAT I GO 4124 02:27:47,048 --> 02:27:47,382 BACK. 4125 02:27:47,382 --> 02:27:48,683 WHEN I WAS TOOK BACK TO THE 4126 02:27:48,683 --> 02:27:50,818 HOSPITAL, I WAS BASICALLY PUT IN 4127 02:27:50,818 --> 02:27:52,120 TRIAGE AND LEFT TO SIT. 4128 02:27:52,120 --> 02:27:55,957 THERE WAS STILL NO URGENCY, NO 4129 02:27:55,957 --> 02:27:56,591 QUESTIONS, NO CONCERNS. 4130 02:27:56,591 --> 02:27:59,727 SO I LAID IN THAT BED IN TRIAGE 4131 02:27:59,727 --> 02:28:01,262 ALL DAY AND I GREW SICKER AND 4132 02:28:01,262 --> 02:28:02,030 SICKER. 4133 02:28:02,030 --> 02:28:03,531 MY MOM AT ONE POINT BROUGHT UP 4134 02:28:03,531 --> 02:28:05,967 TO THE NURSE THAT MY BLOOD 4135 02:28:05,967 --> 02:28:06,834 PRESSURE WAS PLUMMETING AND SHE 4136 02:28:06,834 --> 02:28:07,735 WAS TOLD THAT THERE WAS NO 4137 02:28:07,735 --> 02:28:09,370 REASON FOR CONCERN, AND THAT'S 4138 02:28:09,370 --> 02:28:10,471 WHAT MY BLOOD PRESSURE WAS WHEN 4139 02:28:10,471 --> 02:28:11,939 I HAD DELIVERED MY BABY. 4140 02:28:11,939 --> 02:28:14,409 AND IT WAS PROBABLY JUST MY 4141 02:28:14,409 --> 02:28:16,978 NORMAL, SO AGAIN, MY WHOLE TEAM 4142 02:28:16,978 --> 02:28:17,578 JUST CONTINUED TO SAY THAT 4143 02:28:17,578 --> 02:28:20,081 EVERYTHING WAS FINE. 4144 02:28:20,081 --> 02:28:21,482 IT WASN'T UNTIL THEY COULDN'T 4145 02:28:21,482 --> 02:28:22,817 FIND MY VEINS AND THEY HAD TO 4146 02:28:22,817 --> 02:28:25,253 CALL A RAPID RESPONSE NURSE THAT 4147 02:28:25,253 --> 02:28:26,254 FINALLY SOMEBODY REALIZED THAT 4148 02:28:26,254 --> 02:28:28,222 SOMETHING WAS WRONG. 4149 02:28:28,222 --> 02:28:29,957 THE NURSE TOOK ONE LOOK AT MY 4150 02:28:29,957 --> 02:28:32,593 CHART AND HE KNEW THAT SOMETHING 4151 02:28:32,593 --> 02:28:34,629 WAS WRONG AND HE ASKED WHY I 4152 02:28:34,629 --> 02:28:41,035 HADN'T BEEN SENT UP TO THE ICU. 4153 02:28:41,035 --> 02:28:43,871 ACTUALLY INSTEAD OF WAITING FOR 4154 02:28:43,871 --> 02:28:45,073 THE TRANSPORT TEAM HE TOOK ME UP 4155 02:28:45,073 --> 02:28:50,311 TO THE ICU HIMSELF WHICH OF 4156 02:28:50,311 --> 02:28:51,112 COURSE GROAK BROAK HOSPITAL 4157 02:28:51,112 --> 02:28:52,447 PROTOCOL AND I LEARNED HE WAS 4158 02:28:52,447 --> 02:28:54,282 WRILT ENUP FOR HIS ACTIONS BUT 4159 02:28:54,282 --> 02:28:55,450 THERE WAS NO DOUBT IN MY MIND 4160 02:28:55,450 --> 02:28:56,584 THAT WITHOUT HIM I PROBABLY 4161 02:28:56,584 --> 02:28:59,554 WOULD HAVE DIED IN TRIAGE 4162 02:28:59,554 --> 02:29:02,056 BECAUSE THERE WAS NO UR URGENCY, 4163 02:29:02,056 --> 02:29:03,157 NOBODY WAS TAKING ME SERIOUSLY 4164 02:29:03,157 --> 02:29:04,292 AND IF IT WASN'T FOR HIM, I 4165 02:29:04,292 --> 02:29:05,493 WOULD HAVE BEEN JUST THE ANXIOUS 4166 02:29:05,493 --> 02:29:07,295 NEW MOM WHO WAS OVERREACTING AND 4167 02:29:07,295 --> 02:29:08,930 I KNOW I WOULD HAVE DIED THERE 4168 02:29:08,930 --> 02:29:13,301 BECAUSE NOBODY LISTENED. 4169 02:29:13,301 --> 02:29:15,770 WHEN I WAS TAKEN UP TO THE ICU, 4170 02:29:15,770 --> 02:29:16,971 THAT'S WHERE MY FAMILY WAS TOLD 4171 02:29:16,971 --> 02:29:18,372 I WAS IN SEPTIC SHOCK. 4172 02:29:18,372 --> 02:29:22,577 I WAS PLACED ON A VEN L VENTILA, 4173 02:29:22,577 --> 02:29:23,578 DIALYSIS AND EVENTUALLY THEY 4174 02:29:23,578 --> 02:29:24,746 TOLD MY FAMILY TO CALL THOSE 4175 02:29:24,746 --> 02:29:26,681 THAT WERE CLOSEST TO ME TO SAY 4176 02:29:26,681 --> 02:29:27,915 GOODBYE BECAUSE I HAVE PROBABLY 4177 02:29:27,915 --> 02:29:33,387 WASN'T GOING TO MAKE IT. 4178 02:29:33,387 --> 02:29:34,889 ALL DURING THIS TIME, MY SON WAS 4179 02:29:34,889 --> 02:29:39,193 AT HOME WITH FAMILY CARING FOR 4180 02:29:39,193 --> 02:29:40,962 HIM BUT I CAN'T HELP THINK THIS 4181 02:29:40,962 --> 02:29:43,030 ISN'T HOW IT'S SUPPOSED TO BE. 4182 02:29:43,030 --> 02:29:44,499 I WAS FIGHTING FOR MY LIFE AND I 4183 02:29:44,499 --> 02:29:46,701 WAS IN A FULL-ON MIGHT MAYOR AT 4184 02:29:46,701 --> 02:29:48,770 THAT POINT. 4185 02:29:48,770 --> 02:29:50,571 BUT MY FAMILY REFUSED TO GIVE UP 4186 02:29:50,571 --> 02:29:52,540 ON ME AND ALL OF THE ODDS WERE 4187 02:29:52,540 --> 02:29:55,877 STACKED AGAINST ME, I SURVIVED. 4188 02:29:55,877 --> 02:29:57,211 I TRULY DO BELIEVE THAT PART OF 4189 02:29:57,211 --> 02:29:59,380 THE REASON THAT I SURVIVED IS TO 4190 02:29:59,380 --> 02:30:01,015 SHARE MY STORY AND DO WHATEVER I 4191 02:30:01,015 --> 02:30:02,383 CAN TO MAKE SURE THAT NO OTHER 4192 02:30:02,383 --> 02:30:05,787 WOMAN IS TREATED THE WAY THAT I 4193 02:30:05,787 --> 02:30:06,554 WAS. 4194 02:30:06,554 --> 02:30:08,856 I MISSED THE ENTIRE FIRST MONTH 4195 02:30:08,856 --> 02:30:09,423 OF MY SON'S LIFE. 4196 02:30:09,423 --> 02:30:10,758 I HAD TO LEARN HOW TO WALK 4197 02:30:10,758 --> 02:30:11,726 AGAIN. 4198 02:30:11,726 --> 02:30:14,896 MY MOTHER HAD TO HELP ME SHOWER 4199 02:30:14,896 --> 02:30:17,031 EVEN AFTER I WAS RELEASED FROM 4200 02:30:17,031 --> 02:30:18,332 THE HOSPITAL WHICH WAS ABOUT A 4201 02:30:18,332 --> 02:30:19,534 LITTLE OVER A MONTH AFTER I HAD 4202 02:30:19,534 --> 02:30:21,502 MY SON. 4203 02:30:21,502 --> 02:30:23,304 I COULDN'T CARE FOR MYSELF, I 4204 02:30:23,304 --> 02:30:24,172 COULDN'T CARE FOR MY SON. 4205 02:30:24,172 --> 02:30:25,706 I HAD TO RELY ON OTHERS TO DO 4206 02:30:25,706 --> 02:30:31,012 ALL OF THAT. 4207 02:30:31,012 --> 02:30:32,647 I'M REALLY THANKFUL TO HAVE 4208 02:30:32,647 --> 02:30:34,382 SURVIVED BUT AS YOU'LL HEAR FROM 4209 02:30:34,382 --> 02:30:35,616 DR. BAUER SHORTLY AND AS I'M 4210 02:30:35,616 --> 02:30:37,285 SURE YOU ALREADY KNOW MATERNAL 4211 02:30:37,285 --> 02:30:38,386 SEPSIS DEATHS ARE OFTEN 4212 02:30:38,386 --> 02:30:39,387 PREVENTABLE WITH EARLY DIAGNOSIS 4213 02:30:39,387 --> 02:30:41,222 AND TREATMENT. 4214 02:30:41,222 --> 02:30:42,790 I CONSTANTLY WONDER WHAT MY 4215 02:30:42,790 --> 02:30:44,859 JOURNEY WOULD HAVE BEEN LIKE IF 4216 02:30:44,859 --> 02:30:46,060 SOMEONE WOULD HAVE JUST LISTENED 4217 02:30:46,060 --> 02:30:47,662 TO ME INSTEAD OF BRUSHING ME OFF 4218 02:30:47,662 --> 02:30:50,164 AND BRANDING ME AS THE ANXIOUS 4219 02:30:50,164 --> 02:30:54,001 CRAZY LADY. 4220 02:30:54,001 --> 02:30:56,270 THIS IS SOME PHOTOS OF WHEN MY 4221 02:30:56,270 --> 02:30:58,239 SON WAS FINALLY ABLE TO COME IN 4222 02:30:58,239 --> 02:30:59,874 AND KIND OF RECONNECT WITH ME IN 4223 02:30:59,874 --> 02:31:01,742 THE HOSPITAL, BUT I WAS COVERED 4224 02:31:01,742 --> 02:31:06,080 IN WIRES AND GOWNS AND I JUST 4225 02:31:06,080 --> 02:31:07,381 REMEMBER CRYING BECAUSE THIS 4226 02:31:07,381 --> 02:31:08,382 ISN'T THE WAY THAT IT WAS 4227 02:31:08,382 --> 02:31:09,016 SUPPOSED TO BE. 4228 02:31:09,016 --> 02:31:10,484 I COULDN'T EVEN STAND UP ON MY 4229 02:31:10,484 --> 02:31:11,552 OWN. 4230 02:31:11,552 --> 02:31:12,787 YOU'LL NOTICE THAT I'M NOT 4231 02:31:12,787 --> 02:31:15,623 REALLY HOLDING HIM BECAUSE MY 4232 02:31:15,623 --> 02:31:17,558 HANDS HAD BASICALLY -- ALL THE 4233 02:31:17,558 --> 02:31:19,393 SKIN HAD PEELED SO I COULDN'T 4234 02:31:19,393 --> 02:31:20,394 EVEN HOLD HIM. 4235 02:31:20,394 --> 02:31:23,264 AND IT WAS JUST -- IT WAS A 4236 02:31:23,264 --> 02:31:24,031 REALLY EMOTIONAL, HARD TIME, 4237 02:31:24,031 --> 02:31:25,633 WHICH OBVIOUSLY I WAS THANKFUL 4238 02:31:25,633 --> 02:31:28,636 TO BE ALIVE, BUT KNOWING THAT 4239 02:31:28,636 --> 02:31:30,304 THAT WHOLE MONTH LONG PLUS 4240 02:31:30,304 --> 02:31:31,505 JOURNEY IN THE HOSPITAL COULD 4241 02:31:31,505 --> 02:31:33,708 HAVE BEEN PREVENTED BY PEOPLE 4242 02:31:33,708 --> 02:31:35,509 LISTENING TO ME IS SOMETHING 4243 02:31:35,509 --> 02:31:36,978 THAT I WANT TO MAKE SURE DOESN'T 4244 02:31:36,978 --> 02:31:38,713 HAPPEN TO ANYBODY ELSE AND AGAIN 4245 02:31:38,713 --> 02:31:39,680 THAT'S PART OF THE REASON I 4246 02:31:39,680 --> 02:31:43,751 SHARE MY STORY. 4247 02:31:43,751 --> 02:31:47,288 I'VE ACTUALLY FOUND A LOT OF 4248 02:31:47,288 --> 02:31:48,623 HEALING IN ADVOCACY WORK THAT 4249 02:31:48,623 --> 02:31:49,824 I'VE BEEN DOING THE LAST SIX 4250 02:31:49,824 --> 02:31:50,691 YEARS OR SO. 4251 02:31:50,691 --> 02:31:54,128 I'VE GOTTEN INVOLVED WITH MAMA'S 4252 02:31:54,128 --> 02:31:56,764 VOICES AND SEPSIS AND LOTS OF 4253 02:31:56,764 --> 02:31:58,065 OPPORTUNITIES, THANKFUL FOR 4254 02:31:58,065 --> 02:31:59,433 DR. BAUER, WHO ALWAYS PASSES 4255 02:31:59,433 --> 02:32:02,637 THINGS ALONG AND DR. MAINE, BUT 4256 02:32:02,637 --> 02:32:04,805 IT'S KIND OF FUELED THIS FIRE IN 4257 02:32:04,805 --> 02:32:07,608 ME TO PUSH OUR MEDICAL SYSTEMS 4258 02:32:07,608 --> 02:32:08,476 TO DO BETTER. 4259 02:32:08,476 --> 02:32:10,144 I MENTIONED EARLIER THAT I'M AT 4260 02:32:10,144 --> 02:32:11,112 THE POINT WHERE THINGS ARE 4261 02:32:11,112 --> 02:32:13,881 REALLY COMING FULL CIRCLE BUT 4262 02:32:13,881 --> 02:32:16,083 BEING ABLE TO CONTRIBUTE TO 4263 02:32:16,083 --> 02:32:17,051 THINGS LIKE THE URGENT MATERNAL 4264 02:32:17,051 --> 02:32:22,957 WARNING SIGNS -- BEING PART OF 4265 02:32:22,957 --> 02:32:25,426 THE PROJECT, IT MAKES MY STORY 4266 02:32:25,426 --> 02:32:28,062 AND MY JOURNEY JUST A LITTLE BIT 4267 02:32:28,062 --> 02:32:30,464 EASIER TO SWALLOW SOME DAYS 4268 02:32:30,464 --> 02:32:33,167 KNOWING THAT THE WORK THAT I'VE 4269 02:32:33,167 --> 02:32:35,236 BEEN GIVEN AN OPPORTUNITY TO DO 4270 02:32:35,236 --> 02:32:36,871 IS GOING TO CHANGE OUTCOMES FOR 4271 02:32:36,871 --> 02:32:38,839 OTHER WOMEN. 4272 02:32:38,839 --> 02:32:42,743 WHAT VAL YOU DPO VALUE DO YOU H? 4273 02:32:42,743 --> 02:32:43,945 YOU'RE NOT A DOCTOR OR YOU 4274 02:32:43,945 --> 02:32:45,813 DON'T, YOU MIGHT NOT UNDERSTAND 4275 02:32:45,813 --> 02:32:46,314 THINGS. 4276 02:32:46,314 --> 02:32:48,382 I OFTEN FELT THAT WAY WHEN I WAS 4277 02:32:48,382 --> 02:32:49,684 TRYING TO GET INVOLVED IN THESE 4278 02:32:49,684 --> 02:32:51,619 THINGS LIKE I FELT OVERWHELMED 4279 02:32:51,619 --> 02:32:54,255 LIKE I DON'T KNOW IF I REQUEST 4280 02:32:54,255 --> 02:32:57,692 SICAN SITIN A ROOM AND TALK ABOL 4281 02:32:57,692 --> 02:32:58,359 THESE THINGS BECAUSE I DON'T 4282 02:32:58,359 --> 02:32:59,327 HAVE THAT SORT OF EXPERIENCE BUT 4283 02:32:59,327 --> 02:33:00,828 THERE'S SO MUCH VALUE. 4284 02:33:00,828 --> 02:33:02,129 I'VE BEEN FORTUNATE TO BE ABLE 4285 02:33:02,129 --> 02:33:04,665 TO SPEAK UP WHEN WE'RE TALKING 4286 02:33:04,665 --> 02:33:15,109 ABOUT THINGS LIKE -- BEING 4287 02:33:24,518 --> 02:33:25,820 INVAIPTED TO DO THAT AND SAY 4288 02:33:25,820 --> 02:33:27,455 HEY, IT MIGHT NOT BE A GOOD IDEA 4289 02:33:27,455 --> 02:33:28,789 FOR EVERYONE TO BE INVITED 4290 02:33:28,789 --> 02:33:30,358 BECAUSE YOU DON'T KNOW WHAT THE 4291 02:33:30,358 --> 02:33:30,958 PATIENT'S EXPERIENCE WAS LIKE 4292 02:33:30,958 --> 02:33:32,126 WITH THAT PARTICULAR INDIVIDUAL. 4293 02:33:32,126 --> 02:33:35,296 WHY DON'T WE ASK THE PATIENT OR 4294 02:33:35,296 --> 02:33:36,731 HOW ABOUT WE THINK ABOUT THESE 4295 02:33:36,731 --> 02:33:38,399 THINGS OR EVEN HOW WE 4296 02:33:38,399 --> 02:33:39,400 COMMUNICATE THESE THINGS TO 4297 02:33:39,400 --> 02:33:42,003 WOMEN, HOW WE EMPOWER THEM WITH 4298 02:33:42,003 --> 02:33:43,738 LANGUAGE IF THEY'RE NOT BEING 4299 02:33:43,738 --> 02:33:44,739 LISTENED TO LIKE I WAS. 4300 02:33:44,739 --> 02:33:47,675 I THINK IT'S JUST AN INCREDIBLE 4301 02:33:47,675 --> 02:33:49,977 EXPERIENCE TO BE ABLE TO BE A 4302 02:33:49,977 --> 02:33:52,780 PART OF THESE CIRCLES AND KNOW 4303 02:33:52,780 --> 02:33:54,448 THAT WHAT I WENT THROUGH ISN'T 4304 02:33:54,448 --> 02:33:55,216 FOR NOTHING. 4305 02:33:55,216 --> 02:33:56,617 THAT THERE ARE OTHER PEOPLE THAT 4306 02:33:56,617 --> 02:33:58,586 ARE WORKING TO CREATE CHANGE AND 4307 02:33:58,586 --> 02:33:59,954 I'VE BEEN INVITED INTO THOSE 4308 02:33:59,954 --> 02:34:02,156 SPACES TO HELP DO THE SAME. 4309 02:34:02,156 --> 02:34:03,791 SO THAT'S KIND OF WHERE I THINK 4310 02:34:03,791 --> 02:34:06,494 I WILL END THINGS AND PASS IT 4311 02:34:06,494 --> 02:34:07,895 OFF TO DR. BAUER TODAY. 4312 02:34:07,895 --> 02:34:10,031 SO THANK YOU ALL SO MUCH FOR 4313 02:34:10,031 --> 02:34:11,198 GIVING ME AN OPPORTUNITY TO 4314 02:34:11,198 --> 02:34:14,535 SHARE NOT ONLY MY STORY BUT HOW 4315 02:34:14,535 --> 02:34:15,870 ADVOCACY WORK AND BEING INVOLVED 4316 02:34:15,870 --> 02:34:17,138 IN SOME OF THESE THINGS HAS 4317 02:34:17,138 --> 02:34:18,739 REALLY CHANGED THE TRAJECTORY 4318 02:34:18,739 --> 02:34:20,074 ABOUT HOW I THINK ABOUT MY STORY 4319 02:34:20,074 --> 02:34:21,942 AND HOW I KIND OF MOVE FORWARD 4320 02:34:21,942 --> 02:34:27,515 FROM HERE. 4321 02:34:27,515 --> 02:34:29,550 >> THANK YOU, APRIL, FOR WILLING 4322 02:34:29,550 --> 02:34:31,185 TO BE SO PUBLIC, TRULY PUBLIC 4323 02:34:31,185 --> 02:34:32,920 WITH YOUR STORY AND THERE ARE 4324 02:34:32,920 --> 02:34:34,188 COMMENTS IN THE CHAT BOX. 4325 02:34:34,188 --> 02:34:37,024 I JUST HAD A QUESTION, IS RORY 4326 02:34:37,024 --> 02:34:38,659 YOUR SON BECAUSE ON THE FIRST 4327 02:34:38,659 --> 02:34:40,494 SLIDE, IT ACKNOWLEDGED SOMEONE 4328 02:34:40,494 --> 02:34:43,164 NAMED RORY STANTON. 4329 02:34:43,164 --> 02:34:44,231 IS THAT YOUR SON? 4330 02:34:44,231 --> 02:34:46,934 >> NO, ACTUALLY MY SON'S NAME 4331 02:34:46,934 --> 02:34:50,504 IS CRUZ. 4332 02:34:50,504 --> 02:34:53,240 RORY STANTON IS -- ONE OF THE 4333 02:34:53,240 --> 02:34:54,675 FIRST ORGANIZATIONS I GOT 4334 02:34:54,675 --> 02:34:56,610 INVOLVED IN WAS END SEPSIS, THE 4335 02:34:56,610 --> 02:34:58,245 LEGACY OF RORY STANTON, AND HE 4336 02:34:58,245 --> 02:35:00,481 DIED FROM SEPSIS WHEN HE WAS 10 4337 02:35:00,481 --> 02:35:02,550 YEARS OLD FROM A SCRATCH IN GYM 4338 02:35:02,550 --> 02:35:04,485 CLASS, AND I MET HIS MOM AND 4339 02:35:04,485 --> 02:35:05,519 REALLY I NEVER WANTED TO TALK 4340 02:35:05,519 --> 02:35:06,654 ABOUT MY STORY BEFORE I BECAUSE 4341 02:35:06,654 --> 02:35:07,688 I FELT IT WAS REALLY PERSONAL 4342 02:35:07,688 --> 02:35:08,956 AND I WOULD CRY ALL THE TIME 4343 02:35:08,956 --> 02:35:10,391 THINKING ABOUT IT. 4344 02:35:10,391 --> 02:35:12,626 BUT AFTER I GOT TO MEET RORY' 4345 02:35:12,626 --> 02:35:14,528 MOM, I REALIZED THAT IF I DIDN'T 4346 02:35:14,528 --> 02:35:16,397 SPEAK UP, IT WOULD CONTINUE TO 4347 02:35:16,397 --> 02:35:18,065 HAPPEN AND I HAD POWER TO CREATE 4348 02:35:18,065 --> 02:35:19,266 REAL CHANGE. 4349 02:35:19,266 --> 02:35:21,602 SO RORY IS SOMEBODY WHO'S REALLY 4350 02:35:21,602 --> 02:35:22,837 IMPORTANT TO ME AND HAS INSPIRED 4351 02:35:22,837 --> 02:35:24,238 ME TO DO A LOT OF THE WORK. 4352 02:35:24,238 --> 02:35:25,439 >> THANK YOU FOR EXPLAINING 4353 02:35:25,439 --> 02:35:25,639 THAT. 4354 02:35:25,639 --> 02:35:28,075 >> OF COURSE. 4355 02:35:28,075 --> 02:35:30,444 >> SO AGAIN, WE REALLY TREASURE 4356 02:35:30,444 --> 02:35:34,181 THESE PERSONAL STORIES WHICH 4357 02:35:34,181 --> 02:35:35,549 PROVIDE CONTEXT AND MEANING TO 4358 02:35:35,549 --> 02:35:36,217 THE RESEARCH THAT YOU'RE GOING 4359 02:35:36,217 --> 02:35:37,751 TO HEAR ABOUT FROM DR. BAUER. 4360 02:35:37,751 --> 02:35:40,020 I ALSO WANT TO MENTION, APRIL, 4361 02:35:40,020 --> 02:35:42,189 THAT THIS PART OF OUR COUNCIL 4362 02:35:42,189 --> 02:35:46,026 MEETING IS LISTENED TO BY ALL OF 4363 02:35:46,026 --> 02:35:48,762 OUR STAFF AND IT INFLUENCES 4364 02:35:48,762 --> 02:35:50,898 PEOPLE WHO, FOR EXAMPLE, HAVE 4365 02:35:50,898 --> 02:35:52,633 ADMINISTRATIVE JOBS WHO NEVER 4366 02:35:52,633 --> 02:35:55,369 REALLY DIRECTLY INTERACT WITH 4367 02:35:55,369 --> 02:35:57,771 THE PEOPLE IMPACTED BY OUR 4368 02:35:57,771 --> 02:35:58,339 RESEARCH. 4369 02:35:58,339 --> 02:36:00,708 SO YOU'RE ALSO AFFECTING THEM AS 4370 02:36:00,708 --> 02:36:01,242 WELL. 4371 02:36:01,242 --> 02:36:02,643 SO THANK YOU. 4372 02:36:02,643 --> 02:36:05,379 AND LET ME NOW INTRODUCE 4373 02:36:05,379 --> 02:36:07,414 DR. MELISSA BAUER FOR A 4374 02:36:07,414 --> 02:36:08,015 SCIENTIFIC PRESENTATION ABOUT 4375 02:36:08,015 --> 02:36:10,050 HER WORK THAT'S ALREADY BEEN 4376 02:36:10,050 --> 02:36:11,252 ACKNOWLEDGED ON THE EARLY 4377 02:36:11,252 --> 02:36:12,553 IDENTIFICATION AND TREATMENT OF 4378 02:36:12,553 --> 02:36:22,830 MATERNAL SEPSIS. 4379 02:36:23,297 --> 02:36:25,466 DR. BAUER IS DUAL CERTIFIED IN 4380 02:36:25,466 --> 02:36:27,168 CRITICAL CARE AND 4381 02:36:27,168 --> 02:36:27,935 ANESTHESIOLOGY. 4382 02:36:27,935 --> 02:36:30,471 SHE RECEIVED HER D.O. DEGREE 4383 02:36:30,471 --> 02:36:31,071 FROM MICHIGAN STATE AND 4384 02:36:31,071 --> 02:36:33,307 COMPLETED HER RESIDENCY IN 4385 02:36:33,307 --> 02:36:35,342 ANESTHESIOLOGY AT THE UNIVERSITY 4386 02:36:35,342 --> 02:36:36,944 OF MICHIGAN ANN ARBOR FOLLOWED 4387 02:36:36,944 --> 02:36:38,679 BY FELLOWSHIP STUDIES IN 4388 02:36:38,679 --> 02:36:39,613 OBSTETRIC ANESTHESIA AT THE 4389 02:36:39,613 --> 02:36:40,814 UNIVERSITY OF MICHIGAN AND IN 4390 02:36:40,814 --> 02:36:44,852 CRITICAL CARE ANESTHESIA AT 4391 02:36:44,852 --> 02:36:45,653 COLUMBIA UNIVERSITY. 4392 02:36:45,653 --> 02:36:48,923 AMONG HER MANY ACHIEVEMENTS, DRR 4393 02:36:48,923 --> 02:36:51,091 FOR THE CALIFORNIA MATERNAL 4394 02:36:51,091 --> 02:36:53,827 QUALITY CARE COLLABORATIVE 4395 02:36:53,827 --> 02:36:55,696 PATERNAL SEPSIS TOOLKIT WHICH 4396 02:36:55,696 --> 02:36:57,231 PROVIDES STEP BY STEP 4397 02:36:57,231 --> 02:36:58,499 INSTRUCTIONS FOR HOSPITALS ON 4398 02:36:58,499 --> 02:37:01,435 HOW TO IMPLEMENT SCREENING AND 4399 02:37:01,435 --> 02:37:10,411 TREATMENT FOR MATERNAL SEPSIS. 4400 02:37:10,411 --> 02:37:12,112 HER TALK TODAY IS TITLED 4401 02:37:12,112 --> 02:37:13,113 IMPROVING MATERNAL SEPSIS CARE 4402 02:37:13,113 --> 02:37:15,716 TO PATIENT AND COMMUNITY. 4403 02:37:15,716 --> 02:37:17,484 >> THANK YOU FOR THE HONOR TO 4404 02:37:17,484 --> 02:37:18,819 SPEAK HERE TODAY AND TO APRIL 4405 02:37:18,819 --> 02:37:19,687 FOR SHARING YOUR STORY. 4406 02:37:19,687 --> 02:37:21,155 SHE'S BEEN A REALLY INTEGRAL 4407 02:37:21,155 --> 02:37:22,823 PART OF OUR TEAM AND I'M REALLY 4408 02:37:22,823 --> 02:37:24,024 EXCITED TO SHARE WITH YOU WHAT 4409 02:37:24,024 --> 02:37:26,427 WE'VE BEEN DOING. 4410 02:37:26,427 --> 02:37:28,729 SO LET ME GO AHEAD AND PULL UP 4411 02:37:28,729 --> 02:37:38,906 MY SLIDES. 4412 02:37:40,574 --> 02:37:42,810 THIS WORK IS IN COMPLEMENT WITH 4413 02:37:42,810 --> 02:37:44,545 ELLIOTT MAINE, MULTIPLE PI AND 4414 02:37:44,545 --> 02:37:46,180 I'M THE COP TACT PI OF THIS 4415 02:37:46,180 --> 02:37:46,880 PROJECT. 4416 02:37:46,880 --> 02:37:47,781 WE'VE BEEN WORKING TOGETHER 4417 02:37:47,781 --> 02:37:48,983 EVERY STEP OF THE WAY. 4418 02:37:48,983 --> 02:37:50,417 SO LET'S GO AHEAD AND GET 4419 02:37:50,417 --> 02:37:50,751 STARTED. 4420 02:37:50,751 --> 02:37:54,121 I'D LIKE TO ACKNOWLEDGE THE 4421 02:37:54,121 --> 02:37:55,489 FUNDING THAT MADE THIS WORK 4422 02:37:55,489 --> 02:37:58,892 POSSIBLE. 4423 02:37:58,892 --> 02:38:00,327 SO MATERNAL SEPSIS IS THE 4424 02:38:00,327 --> 02:38:02,363 LEADING CAUSE OF MATERNAL 4425 02:38:02,363 --> 02:38:03,864 MORTALITY FROM THE MOST RECENT 4426 02:38:03,864 --> 02:38:05,966 REPORT FROM THE CDC THAT 4427 02:38:05,966 --> 02:38:07,368 INCLUDED THE COVID PANDEMIC. 4428 02:38:07,368 --> 02:38:09,503 IT IS THE THRD LEADING CAUSE OF 4429 02:38:09,503 --> 02:38:10,838 SEVERE MATERNAL MORBIDITY AT THE 4430 02:38:10,838 --> 02:38:13,107 TIME OF DELIVERY BUT IT IS THE 4431 02:38:13,107 --> 02:38:14,875 FIRST LEADING CAUSE IN THE 4432 02:38:14,875 --> 02:38:16,143 ANTEPARTUM AND POSTPARTUM 4433 02:38:16,143 --> 02:38:16,577 PERIODS. 4434 02:38:16,577 --> 02:38:18,779 THERE ARE SIGNIFICANT RACIAL 4435 02:38:18,779 --> 02:38:20,314 INEQUITIES IN THOSE WHO 4436 02:38:20,314 --> 02:38:22,516 EXPERIENCE SEPSIS. 4437 02:38:22,516 --> 02:38:25,786 THESE STEPS ARE LARGELY 4438 02:38:25,786 --> 02:38:27,054 PREVENTABLE. 4439 02:38:27,054 --> 02:38:28,689 THREE STATE MATERNAL MORTALITY 4440 02:38:28,689 --> 02:38:29,690 COMMITTEES REVIEWED THEIR DEATHS 4441 02:38:29,690 --> 02:38:30,557 AND FOUND THESE DEATHS WOULD 4442 02:38:30,557 --> 02:38:32,159 HAVE BEEN PREVENTABLE AT LEAST 4443 02:38:32,159 --> 02:38:33,093 40% OF THE TIME WITH APPROPRIATE 4444 02:38:33,093 --> 02:38:34,762 CARE. 4445 02:38:34,762 --> 02:38:36,530 THERE ARE A NUMBER OF RESOURCES 4446 02:38:36,530 --> 02:38:38,932 AVAILABLE TO PROVIDE GUIDANCE 4447 02:38:38,932 --> 02:38:40,768 FOR CARE PRACTICES WITHIN THE 4448 02:38:40,768 --> 02:38:43,270 HOSPITAL SETTING. 4449 02:38:43,270 --> 02:38:45,005 BUT WE KNOW THAT PATIENTS DON'T 4450 02:38:45,005 --> 02:38:47,107 LIVE THEIR LIVES IN A HOSPITAL 4451 02:38:47,107 --> 02:38:48,575 AND SO WE WANTED TO SEE HOW WE 4452 02:38:48,575 --> 02:38:52,212 COULD MAKE THE MOST IMPACT IN 4453 02:38:52,212 --> 02:38:55,382 REDUCING MATERNAL SEPSIS DEATHS 4454 02:38:55,382 --> 02:38:56,750 AS WELL AS SEVERE MATERNAL 4455 02:38:56,750 --> 02:38:57,851 MORBIDITY FROM IT BECAUSE WE 4456 02:38:57,851 --> 02:38:59,720 KNOW THAT THE TIME IN THE 4457 02:38:59,720 --> 02:39:03,590 HOSPITAL THAT ALL THE RESOURCES 4458 02:39:03,590 --> 02:39:06,126 ARE FOCUSED ON ARE DURING THAT 4459 02:39:06,126 --> 02:39:07,828 THREE TO FOUR DAYS IF EVERYTHING 4460 02:39:07,828 --> 02:39:09,196 GOES WELL DURING THAT TIME IN 4461 02:39:09,196 --> 02:39:12,333 THE HOSPITAL, BUT IF A PATIENT 4462 02:39:12,333 --> 02:39:15,069 IS CARRIED TO TERM, IT COULD BE 4463 02:39:15,069 --> 02:39:17,571 280 DAYS AND THEN ALSO THEY 4464 02:39:17,571 --> 02:39:20,040 WOULD BE POSTPARTUM 365 DAYS. 4465 02:39:20,040 --> 02:39:22,109 SO IF WE ONLY FOCUS ON THOSE 4466 02:39:22,109 --> 02:39:23,210 THREE TO FOUR DAYS, WE'LL MISS A 4467 02:39:23,210 --> 02:39:25,145 LOT OF OPPORTUNITIES TO MAKE AN 4468 02:39:25,145 --> 02:39:25,813 IMPACT. 4469 02:39:25,813 --> 02:39:27,247 BECAUSE PATIENTS AS WE SAID 4470 02:39:27,247 --> 02:39:28,549 DON'T LIVE THEIR LIVES IN A 4471 02:39:28,549 --> 02:39:29,917 HOSPITAL. 4472 02:39:29,917 --> 02:39:34,755 SO WHAT WE WANTED TO DO WAS 4473 02:39:34,755 --> 02:39:35,255 LEVERAGE USING COMMUNITY 4474 02:39:35,255 --> 02:39:36,724 ENGAGEMENT TO WORK SIDE BY SIDE 4475 02:39:36,724 --> 02:39:39,793 WITH OUR PARTNERS AS YOU SEE AS 4476 02:39:39,793 --> 02:39:41,495 YOU MET APRIL ALREADY TO 4477 02:39:41,495 --> 02:39:43,797 IDENTIFY BARRIERS AND STRATEGIES 4478 02:39:43,797 --> 02:39:46,500 TO ADDRESS THEM AND HELP 4479 02:39:46,500 --> 02:39:47,167 DISSEMINATE THESE FINDINGS 4480 02:39:47,167 --> 02:39:48,135 WITHIN COMMUNITIES. 4481 02:39:48,135 --> 02:39:49,470 AND THERE'S MANY DIFFERENT 4482 02:39:49,470 --> 02:39:50,537 LEVELS OF COMMUNITY ENGAGEMENT 4483 02:39:50,537 --> 02:39:52,039 AND WE CHOSE TO WORK AT THE 4484 02:39:52,039 --> 02:39:53,340 HIGHEST LEVEL OF SHARED 4485 02:39:53,340 --> 02:39:56,076 LEADERSHIP AND THAT WE WORKED TO 4486 02:39:56,076 --> 02:39:59,580 SHARE POWER, WE ALSO CREATED 4487 02:39:59,580 --> 02:40:01,281 VERBAL AGREEMENT ON HOW WE WOULD 4488 02:40:01,281 --> 02:40:03,150 WORK TOGETHER, AND ALSO JUST 4489 02:40:03,150 --> 02:40:06,320 REALLY WORKING TOGETHER BECAUSE 4490 02:40:06,320 --> 02:40:10,424 WE WANTED TO WORK IN -- MAKE 4491 02:40:10,424 --> 02:40:11,325 SURE WE WERE ADDRESSING 4492 02:40:11,325 --> 02:40:13,627 EVERYTHING AND REALLY HEARING 4493 02:40:13,627 --> 02:40:14,728 THE PATIENT'S VOICE WITHIN OUR 4494 02:40:14,728 --> 02:40:16,463 WORK. 4495 02:40:16,463 --> 02:40:17,531 SO ONE OF THE FIRST THINGS THAT 4496 02:40:17,531 --> 02:40:19,533 WE DID WITH THIS FUNDING WAS WE 4497 02:40:19,533 --> 02:40:21,802 RECRUITED AND CREATED THE 4498 02:40:21,802 --> 02:40:23,003 COMMUNITY -- THE SEPSIS 4499 02:40:23,003 --> 02:40:25,506 COMMUNITY LEADERSHIP BOARD, AND 4500 02:40:25,506 --> 02:40:27,040 KENDRA SMITH IS OUR COMMUNITY 4501 02:40:27,040 --> 02:40:27,908 ENGAGEMENT LIAISON. 4502 02:40:27,908 --> 02:40:29,610 SHE'S AN INCREDIBLE EXPERT IN 4503 02:40:29,610 --> 02:40:31,044 THAT FIELD AND WE WANTED TO MAKE 4504 02:40:31,044 --> 02:40:32,980 SURE THAT WE WERE DOING 4505 02:40:32,980 --> 02:40:35,182 EVERYTHING RIGHT AS FAR AS 4506 02:40:35,182 --> 02:40:37,017 LISTENING AND INCORPORATING AND 4507 02:40:37,017 --> 02:40:38,452 SUGGESTIONS AND THEY CREATED A 4508 02:40:38,452 --> 02:40:40,421 STANDARD OPERATING PROCEDURES 4509 02:40:40,421 --> 02:40:41,889 AND THEY ALSO -- THEIR PURPOSE 4510 02:40:41,889 --> 02:40:43,123 WAS TO ENGAGE IN RESEARCH 4511 02:40:43,123 --> 02:40:44,758 ACTIVITY DESIGNED TO UNDERSTAND 4512 02:40:44,758 --> 02:40:47,594 OR REDUCE MATERNAL MORBIDITY AND 4513 02:40:47,594 --> 02:40:49,363 MORTALITY FOR MATERNAL SEPSIS 4514 02:40:49,363 --> 02:40:51,532 WHILE LEVERAGING COMMUNITY 4515 02:40:51,532 --> 02:40:52,866 EXPERIENCES AND VOICES. 4516 02:40:52,866 --> 02:40:54,768 AND OUR MEMBERSHIP WAS COMPOSED 4517 02:40:54,768 --> 02:40:58,038 OF MATERNAL SEPSIS SURVIVORS, 4518 02:40:58,038 --> 02:41:00,207 HEALTH EQUITY ADVOCATES, PUBLIC 4519 02:41:00,207 --> 02:41:02,509 HEALTH EXPERTS, AND COMMUNITY 4520 02:41:02,509 --> 02:41:03,577 LEADERS THAT WERE REALLY 4521 02:41:03,577 --> 02:41:04,845 INTERESTED IN IMPROVING MATERNAL 4522 02:41:04,845 --> 02:41:05,979 HEALTH WITHIN THEIR COMMUNITIES 4523 02:41:05,979 --> 02:41:08,048 AND WE HAD REPRESENTATIVES FROM 4524 02:41:08,048 --> 02:41:09,249 URBAN, RURAL AND TRIBAL 4525 02:41:09,249 --> 02:41:14,288 COMMUNITIES. 4526 02:41:14,288 --> 02:41:15,255 THE ULTIMATE GOAL OF THIS 4527 02:41:15,255 --> 02:41:18,992 PROJECT WAS TO DO OUR HOSPITAL 4528 02:41:18,992 --> 02:41:21,562 IMPLEMENTATION AND THIS WAS DONE 4529 02:41:21,562 --> 02:41:23,130 IN 66 -- ALL 66 BIRTHING 4530 02:41:23,130 --> 02:41:23,664 HOSPITALS IN THE STATE OF 4531 02:41:23,664 --> 02:41:26,867 MICHIGAN AND ALSO 60 HOSPITALS 4532 02:41:26,867 --> 02:41:30,637 IN CALIFORNIA THAT WAS LED BY 4533 02:41:30,637 --> 02:41:32,940 ELLIOTT MAINE AND WE USED 4534 02:41:32,940 --> 02:41:34,007 MENTORSHIP TEAMS AS THEY WERE 4535 02:41:34,007 --> 02:41:34,875 IMPLEMENTING THESE PRACTICES 4536 02:41:34,875 --> 02:41:36,710 THAT WE RECOMMENDED THROUGHOUT 4537 02:41:36,710 --> 02:41:39,913 THEIR HOSPITALS AND WE MET 4538 02:41:39,913 --> 02:41:42,082 MONTHLY TO WORK TOGETHER AND 4539 02:41:42,082 --> 02:41:47,187 GIVE THEM SOME COPING ON HOW TOW 4540 02:41:47,187 --> 02:41:48,822 TO DO THIS IN THE BEST WAY. 4541 02:41:48,822 --> 02:41:50,023 NORMALLY IN CALIFORNIA, THEY'VE 4542 02:41:50,023 --> 02:41:53,293 DONE SOME GREAT WORK IN REDUCING 4543 02:41:53,293 --> 02:41:54,962 THEIR MATERNAL MORBIDITY AND 4544 02:41:54,962 --> 02:41:57,231 MORTALITY BY HAVING THESE 4545 02:41:57,231 --> 02:41:59,600 MENTORSHIP TEAMS BE DOCTORS AND 4546 02:41:59,600 --> 02:42:02,135 NURSES THAT WOULD MEET WITH 4547 02:42:02,135 --> 02:42:03,437 HOSPITALS AND WE WANTED TO GO A 4548 02:42:03,437 --> 02:42:06,907 STEP FURTHER IN THAT WE ALSO 4549 02:42:06,907 --> 02:42:08,976 INCLUDED COMMUNITY LEADERS AND 4550 02:42:08,976 --> 02:42:10,844 CONSULTANTS WITH LIVED 4551 02:42:10,844 --> 02:42:12,346 EXPERIENCE, OUR PATIENTS, 4552 02:42:12,346 --> 02:42:13,447 SURVIVORS, TO ALSO BE A PART OF 4553 02:42:13,447 --> 02:42:14,414 THIS TEAM AND MEET WITH 4554 02:42:14,414 --> 02:42:15,849 HOSPITALS AND GIVE THEM FEEDBACK 4555 02:42:15,849 --> 02:42:16,750 ABOUT DIFFERENT THINGS THAT THEY 4556 02:42:16,750 --> 02:42:18,585 WANTED TO TRY AND GIVING THAT 4557 02:42:18,585 --> 02:42:19,453 PATIENT AND COMMUNITY 4558 02:42:19,453 --> 02:42:20,921 PERSPECTIVE AS WELL. 4559 02:42:20,921 --> 02:42:22,155 BUT BEFORE WE GOT THERE, I WANT 4560 02:42:22,155 --> 02:42:23,557 TO SHARE WITH YOU ALL OF THE 4561 02:42:23,557 --> 02:42:24,525 PROCESS AND EVERYTHING THAT WE 4562 02:42:24,525 --> 02:42:29,863 DID WITH THE COMMUNITY BOARD TO 4563 02:42:29,863 --> 02:42:30,631 MAKE THIS POSSIBLE. 4564 02:42:30,631 --> 02:42:31,832 SO WE KNOW THAT MATERNAL DEATHS 4565 02:42:31,832 --> 02:42:33,600 ARE DUE TO THREE KEY DEADLY 4566 02:42:33,600 --> 02:42:34,902 DELAYS FOR SEPSIS AND WE FOUND 4567 02:42:34,902 --> 02:42:38,839 THIS A NUMBER OF YEARS AGO IN 4568 02:42:38,839 --> 02:42:41,141 OUR WORK, AND CALIFORNIA 4569 02:42:41,141 --> 02:42:42,209 CONFIRMED IT WHEN THEY DID A 4570 02:42:42,209 --> 02:42:44,811 STUDY A NUMB NUMBER OF YEARS LR 4571 02:42:44,811 --> 02:42:46,246 BUT THESE DELAYS ARE DUE TO 4572 02:42:46,246 --> 02:42:47,514 DELAYS IN RECOGNITION, DELAYS IN 4573 02:42:47,514 --> 02:42:48,282 TREATMENT AND DELAYS IN 4574 02:42:48,282 --> 02:42:48,949 ESCALATION OF CARE. 4575 02:42:48,949 --> 02:42:49,917 SO THE REST OF THIS TALK IS 4576 02:42:49,917 --> 02:42:53,520 GOING TO GO THROUGH HOW WE WENT 4577 02:42:53,520 --> 02:42:55,355 TO COMBAT EACH ONE OF THOSE 4578 02:42:55,355 --> 02:42:57,891 DELAYS WITH THIS WORK AND MOST 4579 02:42:57,891 --> 02:42:59,426 OF THIS TALK AS YOU'LL SEE WILL 4580 02:42:59,426 --> 02:43:00,494 GO THROUGH RECOGNITION BECAUSE 4581 02:43:00,494 --> 02:43:01,595 IF YOU DON'T HAVE RECOGNITION, 4582 02:43:01,595 --> 02:43:02,896 YOU CAN'T HAVE TREATMENT OR 4583 02:43:02,896 --> 02:43:04,197 ESCALATION OF CARE. 4584 02:43:04,197 --> 02:43:07,901 SO LET'S GO THROUGH THIS HERE. 4585 02:43:07,901 --> 02:43:09,670 SO RECOGNITION, WHY IS MATERNAL 4586 02:43:09,670 --> 02:43:10,103 SEPSIS DIFFERENT? 4587 02:43:10,103 --> 02:43:11,838 WE KNOW IT'S REALLY CHALLENGING 4588 02:43:11,838 --> 02:43:12,940 BECAUSE A NUMBER OF THE SIGNS 4589 02:43:12,940 --> 02:43:14,675 THAT PEOPLE START TO LOOK FOR IN 4590 02:43:14,675 --> 02:43:16,410 THE DEVELOPMENT OF SEPSIS ARE 4591 02:43:16,410 --> 02:43:19,580 VERY SIMILAR TO THE SIGNS THAT 4592 02:43:19,580 --> 02:43:20,581 PREGNANT PATIENTS EXPERIENCE 4593 02:43:20,581 --> 02:43:22,649 GOING THROUGH CHANGES WITH 4594 02:43:22,649 --> 02:43:23,850 MATERNAL PHYSIOLOGICAL CHANGES 4595 02:43:23,850 --> 02:43:24,952 OF PREGNANCY. 4596 02:43:24,952 --> 02:43:28,422 THE CHALLENGE WITH THAT IS THAT 4597 02:43:28,422 --> 02:43:29,590 THEY DON'T STAND OUT BECAUSE IF 4598 02:43:29,590 --> 02:43:30,624 YOU DON'T KNOW THAT PERSON, IF 4599 02:43:30,624 --> 02:43:31,959 THAT PERSON IS JUST COMING IN TO 4600 02:43:31,959 --> 02:43:33,226 THE HOSPITAL, YOU DON'T KNOW 4601 02:43:33,226 --> 02:43:37,364 WHERE THEIR BASELINES ARE, MANY 4602 02:43:37,364 --> 02:43:38,398 PEOPLE WILL EVALUATE THAT 4603 02:43:38,398 --> 02:43:39,533 PATIENT AND IT MIGHT BE 4604 02:43:39,533 --> 02:43:40,300 CHALLENGING BECAUSE THEY ALREADY 4605 02:43:40,300 --> 02:43:44,905 DO HAVE THIS INCREASE IN HEART 4606 02:43:44,905 --> 02:43:45,772 RATE JUST BEING PREGNANT AND IT 4607 02:43:45,772 --> 02:43:47,074 MAKES IT REALLY CHALLENGING FOR 4608 02:43:47,074 --> 02:43:49,042 THESE PATIENTS TO STAND OUT 4609 02:43:49,042 --> 02:43:49,710 UNTIL MUCH LATER. 4610 02:43:49,710 --> 02:43:52,012 SO WE WANTED TO WORK ON THAT BY 4611 02:43:52,012 --> 02:43:56,216 PULLING SOME DATA FROM HOSPITALS 4612 02:43:56,216 --> 02:43:57,451 AND THIS GRANT THAT FUNDED THIS 4613 02:43:57,451 --> 02:43:59,586 WORK THAT WE WORKED WITH A NUMB 4614 02:43:59,586 --> 02:44:01,688 NUMBER OF INSTITUTIONS ACROSS 4615 02:44:01,688 --> 02:44:05,258 THE COUNTRY, 12 DIFFERENT SITES, 4616 02:44:05,258 --> 02:44:06,026 71 HOSPITALS IN 12 STATES AND WE 4617 02:44:06,026 --> 02:44:09,096 PULLED THEIR EHR DATA TO HAVE 4618 02:44:09,096 --> 02:44:10,631 THEIR VITAL SIGNS AS WELL AS 4619 02:44:10,631 --> 02:44:11,798 THEIR ICD CODES, DEMOGRAPHICS 4620 02:44:11,798 --> 02:44:13,100 AND ALL SORTS OF BITS OF 4621 02:44:13,100 --> 02:44:13,934 INFORMATION SO THAT WE COULD SEE 4622 02:44:13,934 --> 02:44:15,636 WHAT WOULD BE MAYBE THE BEST 4623 02:44:15,636 --> 02:44:18,905 SCREENING TOOL TO USE, SO GOING 4624 02:44:18,905 --> 02:44:23,844 THROUGH THIS HERE, WE HAD A 4625 02:44:23,844 --> 02:44:25,579 COHORT OF THE DELIVERY COHORT, 4626 02:44:25,579 --> 02:44:27,714 WE ALSO HAD A COHORT LOOKING AT 4627 02:44:27,714 --> 02:44:29,149 ANTEPARTUM ADMISSIONS AS WELL AS 4628 02:44:29,149 --> 02:44:32,219 POST PPOSTPARTUM ADMISSIONS. 4629 02:44:32,219 --> 02:44:34,254 WE HAD ABOUT 2900 CASES OF 4630 02:44:34,254 --> 02:44:35,489 MATERNAL SEPSIS THAT WERE 4631 02:44:35,489 --> 02:44:37,958 IDENTIFIED BY USING THE SEVERE 4632 02:44:37,958 --> 02:44:39,393 MATERNAL MORBIDITY CODES FOR 4633 02:44:39,393 --> 02:44:39,626 SEPSIS. 4634 02:44:39,626 --> 02:44:41,161 SO WITHIN THIS GROUP, LOOKING AT 4635 02:44:41,161 --> 02:44:42,562 THE DELIVERY HOSPITALIZATIONS, 4636 02:44:42,562 --> 02:44:45,265 THERE WERE ONLY 59 OF THOSE 71 4637 02:44:45,265 --> 02:44:47,701 HOSPITALS THAT HAD A LABOR AND 4638 02:44:47,701 --> 02:44:49,236 DELIVERY WARD, SO WE HAVE THAT 4639 02:44:49,236 --> 02:44:52,639 DATA FOR DELIVERY HOSPITALS, AND 4640 02:44:52,639 --> 02:44:54,174 IT COVERED A NUMBER OF REGIONS. 4641 02:44:54,174 --> 02:44:55,542 YOU'LL SEE IT WAS ALL OVER THE 4642 02:44:55,542 --> 02:44:55,776 COUNTRY. 4643 02:44:55,776 --> 02:44:57,978 WE HAD VARIATION IN DELIVERY 4644 02:44:57,978 --> 02:44:59,279 VOLUME, WE HAD SOME HOSPITALS 4645 02:44:59,279 --> 02:45:00,847 DELIVERING LESS THAN 50 A YEAR, 4646 02:45:00,847 --> 02:45:04,551 ALL THE WAY UP INTO SEVERAL OVER 4647 02:45:04,551 --> 02:45:04,785 10,000. 4648 02:45:04,785 --> 02:45:08,055 WE ALSO HAD VARIATION IN 4649 02:45:08,055 --> 02:45:10,090 TEACHING STATUS, ABOUT 80% WERE 4650 02:45:10,090 --> 02:45:12,526 NON-TEACHING HOSPITALS AND THEN 4651 02:45:12,526 --> 02:45:15,028 WE HAD PLACES IN RURAL 4652 02:45:15,028 --> 02:45:16,663 COMMUNITIES AS WELL AS VERY 4653 02:45:16,663 --> 02:45:18,932 POPULATED AREAS THAT SUBMITTED 4654 02:45:18,932 --> 02:45:20,033 DATA. 4655 02:45:20,033 --> 02:45:22,335 SO GOING THROUGH THE DELIVERY 4656 02:45:22,335 --> 02:45:23,336 HOSPITALIZATIONS, WE SEPARATED 4657 02:45:23,336 --> 02:45:25,272 THIS INTO TWO COHORTS AND WE 4658 02:45:25,272 --> 02:45:28,642 NEEDED TO LOOK AT 4659 02:45:28,642 --> 02:45:29,643 CHORIOAMNIONITIS A LITTLE 4660 02:45:29,643 --> 02:45:30,510 DIFFERENTLY BUT STARTING WITH 4661 02:45:30,510 --> 02:45:37,484 THE FIRST COHORT, THIS EXCLUDED 4662 02:45:37,484 --> 02:45:38,251 CHORIOAMNIONITIS AND -- THE 4663 02:45:38,251 --> 02:45:39,419 REASON FOR THAT IS THERE HAS 4664 02:45:39,419 --> 02:45:40,887 BEEN SOME CRITICISM OF USING 4665 02:45:40,887 --> 02:45:42,189 SOME SCREENING SYSTEMS TO 4666 02:45:42,189 --> 02:45:45,192 IDENTIFY SEVERE MORBIDITY 4667 02:45:45,192 --> 02:45:46,460 WHETHER THAT'S SEPSIS OR OTHER 4668 02:45:46,460 --> 02:45:47,627 CASES BECAUSE THERE'S A HIGH 4669 02:45:47,627 --> 02:45:48,729 AMOUNT OF FALSE POSITIVES SO WE 4670 02:45:48,729 --> 02:45:50,263 WANTED TO SAY WELL, IF 4671 02:45:50,263 --> 02:45:51,465 PATIENTS -- THESE ARE JUST 4672 02:45:51,465 --> 02:45:53,533 PATIENTS THAT HAVE NORMAL 4673 02:45:53,533 --> 02:45:54,634 MATERNAL PHYSIOLOGICAL CHANGES 4674 02:45:54,634 --> 02:45:57,037 OF PREGNANCY, WOULD THIS BE 4675 02:45:57,037 --> 02:45:59,139 HELPFUL IN IDENTIFYING THE 4676 02:45:59,139 --> 02:46:00,874 DIFFERENCE BETWEEN SOMEONE WHO'S 4677 02:46:00,874 --> 02:46:02,476 STARTING -- WHO'S HAVING SEPSIS 4678 02:46:02,476 --> 02:46:04,578 AND SOMEONE WHO JUST HAS THOSE 4679 02:46:04,578 --> 02:46:07,981 CHANGES OF PREGNANCY. 4680 02:46:07,981 --> 02:46:09,483 SO WE MATCHED THEM IN A CASE 4681 02:46:09,483 --> 02:46:10,684 CONTROL FASHION, WE CHOSE TO USE 4682 02:46:10,684 --> 02:46:12,219 THAT, WE WERE RECEIVING AN 4683 02:46:12,219 --> 02:46:14,187 ENORMOUS AMOUNT OF DATA FROM 4684 02:46:14,187 --> 02:46:15,722 EACH PATIENT TO MAKE DATA 4685 02:46:15,722 --> 02:46:20,093 TRANSFER A LITTLE EASIER, WE DID 4686 02:46:20,093 --> 02:46:21,194 THIS COMPARISON GROUP AND THEN 4687 02:46:21,194 --> 02:46:23,597 WE LOOKED AT ICD CODES FOR 4688 02:46:23,597 --> 02:46:24,765 SEPSIS BUT WE ALSO WENT A STEP 4689 02:46:24,765 --> 02:46:26,767 FURTHER AND LOOKED AT END ORGAN 4690 02:46:26,767 --> 02:46:27,701 INJURY CODES. 4691 02:46:27,701 --> 02:46:32,339 NOW I KNOW THAT SEPSIS DOES 4692 02:46:32,339 --> 02:46:33,540 INCLUDE -- REQUIRES END ORGAN 4693 02:46:33,540 --> 02:46:34,808 INJURY, HOWEVER, THERE ARE SOME 4694 02:46:34,808 --> 02:46:35,809 CHALLENGES WITH CODING IN THAT 4695 02:46:35,809 --> 02:46:37,344 WHEN WE STARTED LOOKING AT THE 4696 02:46:37,344 --> 02:46:38,445 EHR DATA, THERE WERE SOME 4697 02:46:38,445 --> 02:46:42,048 PATIENTS THAT PROBABLY DIDN'T 4698 02:46:42,048 --> 02:46:43,450 REALLY MEET THE CRITERIA FOR 4699 02:46:43,450 --> 02:46:45,085 HAVING SEPSIS BASED ON THAT 4700 02:46:45,085 --> 02:46:45,685 DEFINITION. 4701 02:46:45,685 --> 02:46:49,156 AND WE WANTED TO MAKE SURE THAT 4702 02:46:49,156 --> 02:46:51,091 WE WERE CAPTURING THE SICKEST 4703 02:46:51,091 --> 02:46:53,393 PATIENTS AND SO WE USE SOME 4704 02:46:53,393 --> 02:46:54,694 CODES THAT HAVE BEEN USED IN 4705 02:46:54,694 --> 02:46:55,896 OTHER ADMINISTRATIVE DATABASES 4706 02:46:55,896 --> 02:47:01,434 SUCH AS USING THE ANGUS AND 4707 02:47:01,434 --> 02:47:03,970 DEMROMO VSKI CRITERIA TO 4708 02:47:03,970 --> 02:47:04,504 IDENTIFY THOSE PATIENTS. 4709 02:47:04,504 --> 02:47:09,409 AND THEN WE LOOKED AT 4710 02:47:09,409 --> 02:47:15,315 CHORIOAMNIONIGHTS AND ENDOME 4711 02:47:15,315 --> 02:47:16,750 TTRIOITIS, THEY WERE ALREADY 4712 02:47:16,750 --> 02:47:18,752 INFECTED AND THEY ALSO HAD 4713 02:47:18,752 --> 02:47:19,686 PHYSICIAN LODGE CHANGES OF 4714 02:47:19,686 --> 02:47:21,121 PREGNANCY SO THAT'S A SEPARATE 4715 02:47:21,121 --> 02:47:23,390 GROUP TO TAKE A LOOK AND TRY TO 4716 02:47:23,390 --> 02:47:24,057 FIGURE OUT OF THOSE PATIENTS HOW 4717 02:47:24,057 --> 02:47:25,258 MANY OF THEM WOULD PROGRESS TO 4718 02:47:25,258 --> 02:47:26,359 SEPSIS, WHAT WOULD BE THE BEST 4719 02:47:26,359 --> 02:47:27,727 SCREENING TOOL TO HELP IDENTIFY 4720 02:47:27,727 --> 02:47:28,728 THAT. 4721 02:47:28,728 --> 02:47:32,199 AND SO WE LOOKED AT PATIENTS WHO 4722 02:47:32,199 --> 02:47:33,967 HAD CHORIO WITHOUT SEPSIS AND 4723 02:47:33,967 --> 02:47:35,402 THEN PATIENTS WITH SEPSIS AND 4724 02:47:35,402 --> 02:47:36,603 ADDITIONAL END ORGAN INJURY 4725 02:47:36,603 --> 02:47:37,003 CODES. 4726 02:47:37,003 --> 02:47:38,772 SO WE LOOKED AT A NUMBER OF 4727 02:47:38,772 --> 02:47:42,809 SCREENING SYSTEMS. 4728 02:47:42,809 --> 02:47:45,445 ONE OF THE SCREENING SYSTEMS WAS 4729 02:47:45,445 --> 02:47:47,080 LOOKING ADD SIRS WHICH IS WHAT 4730 02:47:47,080 --> 02:47:49,416 USED TO DEFINE SEPSIS IN 4731 02:47:49,416 --> 02:47:50,350 NON-PREGNANT ADULTS SO WE LOOKED 4732 02:47:50,350 --> 02:47:51,551 AT THAT CRITERIA. 4733 02:47:51,551 --> 02:47:54,855 WE ALSO LOOKED AT SOME PREGNANCY 4734 02:47:54,855 --> 02:47:59,960 SCREENS FOR SEVERE RETURN OF 4735 02:47:59,960 --> 02:48:01,061 MORBIDITY, MATERNAL EARLY 4736 02:48:01,061 --> 02:48:02,362 WARNING CRITERIA AND THE 4737 02:48:02,362 --> 02:48:03,597 MATERNAL EARLY WARNING TRIGGER 4738 02:48:03,597 --> 02:48:05,065 TOOL TO SEE HOW THOSE WOULD WORK 4739 02:48:05,065 --> 02:48:06,499 BECAUSE THERE ARE A NUMBER OF 4740 02:48:06,499 --> 02:48:07,701 TOOLS THAT ARE AVAILABLE THAT 4741 02:48:07,701 --> 02:48:08,902 PEOPLE MAY WANT TO TRY AND WE 4742 02:48:08,902 --> 02:48:10,437 WANTED TO SEE EXACTLY IN THIS 4743 02:48:10,437 --> 02:48:12,072 POPULATION WHAT WOULD YOU EXPECT 4744 02:48:12,072 --> 02:48:13,874 THE SCREEN POSITIVE RATE TO BE 4745 02:48:13,874 --> 02:48:15,141 AS WELL AS HOW WELL WOULD IT 4746 02:48:15,141 --> 02:48:15,575 WORK. 4747 02:48:15,575 --> 02:48:17,210 AND THEN WE ALSO USED SOME 4748 02:48:17,210 --> 02:48:20,480 PREGNANCY ADJUSTED SCREENS FOR 4749 02:48:20,480 --> 02:48:21,381 SEPSIS SPECIFICALLY. 4750 02:48:21,381 --> 02:48:25,652 THE CMQ CC, THE CALIFORNIA 4751 02:48:25,652 --> 02:48:27,287 MATERNAL QUALITY CARE 4752 02:48:27,287 --> 02:48:28,588 COLLABORATIVE TOOLKIT SCREENING 4753 02:48:28,588 --> 02:48:30,457 SYSTEM AS WELL AS UKOSS WHICH IS 4754 02:48:30,457 --> 02:48:32,425 USED IN THE UNITED KINGDOM. 4755 02:48:32,425 --> 02:48:35,662 AND OUR GOAL WAS TO FIND THE PAL 4756 02:48:35,662 --> 02:48:37,764 ABALANCE BETWEEN SENSITIVITY AND 4757 02:48:37,764 --> 02:48:38,965 SCREEN POSITIVE RATE BECAUSE 4758 02:48:38,965 --> 02:48:40,400 EVEN IF YOU HAVE A SENSITIVITY 4759 02:48:40,400 --> 02:48:43,436 OF 99%, IF YOU HAVE A SCREEN -- 4760 02:48:43,436 --> 02:48:44,971 A FALSE POSITIVE RATE OF 40%, 4761 02:48:44,971 --> 02:48:46,606 IT'S REALLY NOT GOING TO BE A 4762 02:48:46,606 --> 02:48:48,575 USEFUL TOOL TO BE IMPLEMENTING 4763 02:48:48,575 --> 02:48:50,777 BECAUSE WHEN YOU USE A NUMBER OF 4764 02:48:50,777 --> 02:48:51,811 RESOURCES AWAY FROM THE PATIENTS 4765 02:48:51,811 --> 02:48:54,915 THAT NEED IT. 4766 02:48:54,915 --> 02:48:56,349 SO HERE ARE SOME OF THE RESULTS. 4767 02:48:56,349 --> 02:48:57,884 THIS WAS COHORT ONE WITHOUT ANY 4768 02:48:57,884 --> 02:49:02,889 OF THE PATIENTS WITH 4769 02:49:02,889 --> 02:49:03,390 CHORIOAMNIONITIS -- THE 4770 02:49:03,390 --> 02:49:04,324 SENSITIVITY FOR MOST OF THE 4771 02:49:04,324 --> 02:49:06,326 TOOLS WAS QUITE GOOD IN THAT IT 4772 02:49:06,326 --> 02:49:10,096 WAS GREATER THAN 90%. 4773 02:49:10,096 --> 02:49:11,398 BUT I WANTED TO FOCUS A LITTLE 4774 02:49:11,398 --> 02:49:13,366 BIT ON THIS SCREEN POSITIVE RATE 4775 02:49:13,366 --> 02:49:14,801 SO THIS WAS HOW MANY PATIENTS 4776 02:49:14,801 --> 02:49:18,505 SCREEN POSITIVE AND THE CMQCC 4777 02:49:18,505 --> 02:49:22,742 TOOL WAS 6.9%, UKOSS WAS 9.6 BUT 4778 02:49:22,742 --> 02:49:24,411 THE OTHER TOOLS WERE ABOUT 15% 4779 02:49:24,411 --> 02:49:25,812 GOING UP EVEN HIGHER THAN THAT 4780 02:49:25,812 --> 02:49:27,013 WHICH MAKES IT REALLY 4781 02:49:27,013 --> 02:49:28,648 CHALLENGING TO USE THESE TOOLS 4782 02:49:28,648 --> 02:49:31,051 UNLESS YOU COME UP WITH EXACTLY 4783 02:49:31,051 --> 02:49:33,787 WHAT THE SECOND STEP WOULD BE. 4784 02:49:33,787 --> 02:49:35,322 AND THE PLAN FOR THIS IS THAT 4785 02:49:35,322 --> 02:49:38,124 THIS IS SCREENING AND THEN THE 4786 02:49:38,124 --> 02:49:39,759 DIAGNOSTIC BEDSIDE EVALUATION 4787 02:49:39,759 --> 02:49:42,529 AND SOME LABS WOULD BE SENT OFF 4788 02:49:42,529 --> 02:49:43,396 AFTER THAT. 4789 02:49:43,396 --> 02:49:45,765 SO WE WANTED TO FIGURE OUT WHAT 4790 02:49:45,765 --> 02:49:47,200 WOULD BE THE BEST TOOL AND WHAT 4791 02:49:47,200 --> 02:49:49,502 PEOPLE COULD USE AND WHATEVER 4792 02:49:49,502 --> 02:49:50,603 THEY'RE COMFORTABLE WITH, WHAT 4793 02:49:50,603 --> 02:49:53,173 THEY SHOULD EXPECT TO SEE AS FAR 4794 02:49:53,173 --> 02:49:54,741 AS FALSE POSITIVES. 4795 02:49:54,741 --> 02:49:58,578 NOW LOOKING AT THE PATIENTS WITH 4796 02:49:58,578 --> 02:50:02,048 CHORIOAMNIONITIS AND ENDO 4797 02:50:02,048 --> 02:50:04,150 METRITIS YOU SEE THEY CERTAINLY 4798 02:50:04,150 --> 02:50:05,352 WOULD EXPERIENCE THOSE SIGNS OF 4799 02:50:05,352 --> 02:50:06,886 INFECTION AND YOU WOULD BE ABLE 4800 02:50:06,886 --> 02:50:10,924 TO IDENTIFY THEM EARLY AND 4801 02:50:10,924 --> 02:50:15,495 ALTHOUGH THE SCREEN POSITIVE 4802 02:50:15,495 --> 02:50:18,665 RATE WAS REALLY HIGH IN THAT AT 4803 02:50:18,665 --> 02:50:19,733 LEAST 45% OF THE PATIENTS WOULD 4804 02:50:19,733 --> 02:50:23,403 BE POSITIVE, I THINK THAT IT'S 4805 02:50:23,403 --> 02:50:24,671 NOT A GOOD TOOL IN IDENTIFYING 4806 02:50:24,671 --> 02:50:28,441 THE PATIENTS THAT ARE DEVELOPING 4807 02:50:28,441 --> 02:50:29,743 SEPSIS BUT TTION HELPFUL IN THAT 4808 02:50:29,743 --> 02:50:31,378 IT CAN IDENTIFY PATIENTS EARLY 4809 02:50:31,378 --> 02:50:32,846 SO THEY GET THAT EARLY TREATMENT 4810 02:50:32,846 --> 02:50:36,082 THAT WE'RE LOOKING FOR AND 4811 02:50:36,082 --> 02:50:36,950 POSSIBLE ESCALATION OF CARE. 4812 02:50:36,950 --> 02:50:40,687 SO WE'RE DOING MORE WORK TO HELP 4813 02:50:40,687 --> 02:50:41,988 IDENTIFY PATIENTS THAT YOU MIGHT 4814 02:50:41,988 --> 02:50:43,323 EXPECT TO DECOMPENSATE OR 4815 02:50:43,323 --> 02:50:44,824 DEVELOP SEPSIS SO THAT WE CAN 4816 02:50:44,824 --> 02:50:46,026 MAKE SURE THOSE PATIENTS GET THE 4817 02:50:46,026 --> 02:50:48,461 CARE THAT THEY NEED EARLY 4818 02:50:48,461 --> 02:50:49,529 BECAUSE CHORIOAMNIONITIS IS NOT 4819 02:50:49,529 --> 02:50:50,096 UNCOMMON. 4820 02:50:50,096 --> 02:50:52,599 IT'S ABOUT 2 TO 5% OF PATIENTS. 4821 02:50:52,599 --> 02:50:57,737 SO IN SUMMARY, FOR THAT WORK, 4822 02:50:57,737 --> 02:51:01,107 INTRAPARTUM SCREENING WE 4823 02:51:01,107 --> 02:51:05,145 DISCUSSED, ENDOMETRITIS AND 4824 02:51:05,145 --> 02:51:06,579 CHORIOAMNIONITIS IS A CHALLENGE 4825 02:51:06,579 --> 02:51:07,680 BECAUSE OF THE VERY HIGH RATES 4826 02:51:07,680 --> 02:51:11,618 OF FALSE POSITIVES BUT ONE OTHER 4827 02:51:11,618 --> 02:51:14,287 THING I DIDN'T SHARE BECAUSE WE 4828 02:51:14,287 --> 02:51:16,756 DON'T HAVE TIME FOR THAT BUT IN 4829 02:51:16,756 --> 02:51:18,191 THE ANSWER TO PART OF MY 4830 02:51:18,191 --> 02:51:19,025 POSTPARTUM SCREENING WE FOUND 4831 02:51:19,025 --> 02:51:20,560 THAT THE BEST TIME TO USE THE 4832 02:51:20,560 --> 02:51:22,429 PREGNANCY ADJUSTED TOOLS ARE 4833 02:51:22,429 --> 02:51:25,698 AFTER 20 WEEKS GOING UP UNTIL 4834 02:51:25,698 --> 02:51:27,233 ABOUT THREE DAYS POSTPARTUM 4835 02:51:27,233 --> 02:51:28,968 AROUND THE TIME PATIENT GO HOME 4836 02:51:28,968 --> 02:51:29,402 FROM THE HOSPITAL. 4837 02:51:29,402 --> 02:51:30,303 THE REASON FOR THAT IS THAT 4838 02:51:30,303 --> 02:51:31,938 PRIOR TO THAT TIME, LESS THAN 20 4839 02:51:31,938 --> 02:51:36,876 WEEKS AND THEN ALSO AFTER THE 72 4840 02:51:36,876 --> 02:51:38,945 HOURS, 48 TO 72 HOURS AFTER 4841 02:51:38,945 --> 02:51:41,014 DELIVERY, THE CHANGES LIKE TO 4842 02:51:41,014 --> 02:51:42,882 INCREASE THE HEART RATE THE 4843 02:51:42,882 --> 02:51:44,617 FIRST 20 WEEKS, IT TAKES TIME 4844 02:51:44,617 --> 02:51:45,585 AND THESE PREGNANCY ADJUSTED 4845 02:51:45,585 --> 02:51:47,454 TOOLS HAVE AN ELEVATED HEART 4846 02:51:47,454 --> 02:51:49,656 RATE THRESHOLD AND A NUMBER OF 4847 02:51:49,656 --> 02:51:51,057 OTHER THINGS THAT IF YOU WERE TO 4848 02:51:51,057 --> 02:51:54,461 USE THE PREGNANCY ADJUSTED 4849 02:51:54,461 --> 02:51:55,095 CRITERIA AS SOON AS SOMEONE 4850 02:51:55,095 --> 02:51:56,463 BECAME PREGNANT ALL THE WAY UP 4851 02:51:56,463 --> 02:51:57,430 UNTIL SIX WEEKS YOU WOULD 4852 02:51:57,430 --> 02:51:58,531 ACTUALLY MISS SEVERAL PATIENTS 4853 02:51:58,531 --> 02:52:00,266 AND THE REASON FOR THAT IS THAT 4854 02:52:00,266 --> 02:52:01,801 THEY MAY NOT HAVE INCREASED 4855 02:52:01,801 --> 02:52:04,003 THEIR HEART RATE YET EARLY IN 4856 02:52:04,003 --> 02:52:05,105 PREGNANCY AND AFTERWARD THEY MAY 4857 02:52:05,105 --> 02:52:07,040 HAVE DECREASED THEIR HEART RATE 4858 02:52:07,040 --> 02:52:11,544 PRETTY QUICKLY, AND THAT 4859 02:52:11,544 --> 02:52:13,179 ELEVATED THRESHOLD IS GOING TO 4860 02:52:13,179 --> 02:52:14,514 MAKE IT WHERE THEY MAY NOT MEET 4861 02:52:14,514 --> 02:52:15,381 THEIR CRITERIA. 4862 02:52:15,381 --> 02:52:16,916 SO THIS CONVENIENTLY LINES UP 4863 02:52:16,916 --> 02:52:18,451 WITH IN THE ER MANY PATIENTS AND 4864 02:52:18,451 --> 02:52:22,922 MANY HOSPITALS, THEY SEE 4865 02:52:22,922 --> 02:52:23,957 PATIENTS LESS THAN 20 WEEKS AND 4866 02:52:23,957 --> 02:52:25,024 THEN ALSO ONCE THEY'RE 4867 02:52:25,024 --> 02:52:26,025 DISCHARGED HOME FROM THE 4868 02:52:26,025 --> 02:52:27,293 HOSPITAL WITH READMISSION FROM 4869 02:52:27,293 --> 02:52:30,830 THE HOSPITAL AND PRIOR TO THIS 4870 02:52:30,830 --> 02:52:31,931 MANY TIMES IN THE ER THEY DON'T 4871 02:52:31,931 --> 02:52:33,900 WANT TO BE USING THEIR SCREENING 4872 02:52:33,900 --> 02:52:35,435 CRITERIA BECAUSE, WELL, WE KNOW 4873 02:52:35,435 --> 02:52:38,271 PREGNANT PATIENTS MIGHT NEED 4874 02:52:38,271 --> 02:52:39,172 DIFFERENT CRITERIA AND IT'S 4875 02:52:39,172 --> 02:52:42,642 JESUS GOING TO BE FA JUST 4876 02:52:42,642 --> 02:52:45,478 GOING TO BE FALSELY POSITIVE, 4877 02:52:45,478 --> 02:52:46,946 BUT THE GREAT THING THAT THIS 4878 02:52:46,946 --> 02:52:48,248 SHOWS IS THAT THERE ARE STILL A 4879 02:52:48,248 --> 02:52:50,116 LOT OF FALSE POSITIVES, I WON'T 4880 02:52:50,116 --> 02:52:52,552 SAY THAT THERE ARE NOT, BUT WE 4881 02:52:52,552 --> 02:52:53,953 STILL SAY THEY CAN USE THEIR OWN 4882 02:52:53,953 --> 02:52:54,787 CRITERIA THAT THEY'RE 4883 02:52:54,787 --> 02:52:55,588 COMFORTABLE WITH USING ALREADY 4884 02:52:55,588 --> 02:52:57,357 IN THE NON-PREGNANT PATIENTS AND 4885 02:52:57,357 --> 02:52:59,325 THAT WAY WE WON'T MISS AS MANY 4886 02:52:59,325 --> 02:52:59,592 PATIENTS. 4887 02:52:59,592 --> 02:53:01,528 SO I THINK THAT THAT WAS AN 4888 02:53:01,528 --> 02:53:02,162 IMPORTANT FINDING. 4889 02:53:02,162 --> 02:53:03,763 SO WE TALKED ABOUT IN THE 4890 02:53:03,763 --> 02:53:04,030 HOSPITAL. 4891 02:53:04,030 --> 02:53:04,898 REMEMBER WE TALKED ABOUT THAT'S 4892 02:53:04,898 --> 02:53:07,634 JUST THAT SMALL DOT, THAT THREE 4893 02:53:07,634 --> 02:53:08,635 TO FOUR DAYS WHILE THEY'RE IN 4894 02:53:08,635 --> 02:53:09,502 THE HOSPITAL. 4895 02:53:09,502 --> 02:53:11,137 AND AS WE KNOW PATIENTS DON'T 4896 02:53:11,137 --> 02:53:12,438 LIVE THEIR LIVES IN A HOSPITAL 4897 02:53:12,438 --> 02:53:16,509 SO HOW CAN WE HELP THEM IDENTIFY 4898 02:53:16,509 --> 02:53:19,279 WHEN TO SEEK CARE AND HELP THE 4899 02:53:19,279 --> 02:53:20,580 PATIENT BE LISTENED TO AND FEEL 4900 02:53:20,580 --> 02:53:21,681 HEARD BECAUSE MOST CASES 4901 02:53:21,681 --> 02:53:23,082 ACTUALLY OCCUR OUTSIDE OF THE 4902 02:53:23,082 --> 02:53:24,184 HOSPITAL. 4903 02:53:24,184 --> 02:53:27,787 SO WE DID SOME QUALITATIVE WORK 4904 02:53:27,787 --> 02:53:30,223 INTERVIEWING PATIENTS AND WE 4905 02:53:30,223 --> 02:53:31,624 INTERVIEWS 20 PATIENTS IN THE 4906 02:53:31,624 --> 02:53:37,530 QUALITATIVE STUDY, WE FOUND WE 4907 02:53:37,530 --> 02:53:38,831 INTERVIEWED 19 SURVIVORS, WE 4908 02:53:38,831 --> 02:53:39,832 INVITED THEM TO BRING ANY 4909 02:53:39,832 --> 02:53:41,467 SUPPORT PERSON, THIS CAME OUT OF 4910 02:53:41,467 --> 02:53:42,902 HOUR COMMUNITY BOARD, THAT MANY 4911 02:53:42,902 --> 02:53:48,575 PEOPLE WERE SEDATED, THEY WERE 4912 02:53:48,575 --> 02:53:51,544 EITHER CONFUSED BUT THEY MAY NOT 4913 02:53:51,544 --> 02:53:52,979 REMEMBER EVERYTHING SO WE WANTED 4914 02:53:52,979 --> 02:53:54,380 TO MAKE SURE THE SUPPORT PERSON 4915 02:53:54,380 --> 02:53:55,815 WAS THERE TO HELP FILL IN THE 4916 02:53:55,815 --> 02:53:56,816 GAPS THERE SO PEOPLE BROUGHT 4917 02:53:56,816 --> 02:53:58,117 THEIR SUPPORT PERSON AND THEN WE 4918 02:53:58,117 --> 02:53:59,519 WERE ALSO ABLE TO TALK TO A 4919 02:53:59,519 --> 02:54:01,087 SUPPORT PERSON OF A NON-SURVIVOR 4920 02:54:01,087 --> 02:54:02,155 AND THESE WERE RECRUITED 4921 02:54:02,155 --> 02:54:02,922 THROUGHOUT THE COUNTRY. 4922 02:54:02,922 --> 02:54:04,557 WE ALSO USED OUR COMMUNITY 4923 02:54:04,557 --> 02:54:06,993 BOARD, THEY WERE VERY HELPFUL IN 4924 02:54:06,993 --> 02:54:09,495 SHARING THE FLYER WITHIN THEIR 4925 02:54:09,495 --> 02:54:11,497 COMMUNITIES LIKE THEIR CLOSED 4926 02:54:11,497 --> 02:54:12,999 FACEBOOK GROUPS OF SURVIVORS AND 4927 02:54:12,999 --> 02:54:15,735 WE GOT SOME REALLY RICH DATA 4928 02:54:15,735 --> 02:54:16,502 FROM THAT. 4929 02:54:16,502 --> 02:54:19,138 AND OUR GOALS WERE TO IDENTIFY 4930 02:54:19,138 --> 02:54:20,974 BARRIERS TO CARE, LISTEN TO 4931 02:54:20,974 --> 02:54:24,310 PATIENT STORIES AND LESSONS 4932 02:54:24,310 --> 02:54:25,945 LEARNED AND TO CREATE SOLUTIONS 4933 02:54:25,945 --> 02:54:26,980 TO THOSE BARRIERS. 4934 02:54:26,980 --> 02:54:28,448 SO WE HAD A WIDE RANGE OF AGES 4935 02:54:28,448 --> 02:54:30,316 AS WELL AS YEARS THAT SEPSIS 4936 02:54:30,316 --> 02:54:32,051 OCCURRED AND WE HAD A DIVERSE 4937 02:54:32,051 --> 02:54:33,419 GROUP THAT WE INTERVIEWED AND 4938 02:54:33,419 --> 02:54:35,021 MOST PATIENTS WERE FROM 4939 02:54:35,021 --> 02:54:35,555 UNDERREPRESENTED MINORITY 4940 02:54:35,555 --> 02:54:36,689 GROUPS. 4941 02:54:36,689 --> 02:54:38,424 ONE OF THE FIRST FINDINGS THAT 4942 02:54:38,424 --> 02:54:40,260 WE HAD, ONE OF THE THEMES WAS 4943 02:54:40,260 --> 02:54:42,795 THAT PATIENTS DID NOT REMEMBER 4944 02:54:42,795 --> 02:54:43,896 EDUCATION ABOUT THE WARNING 4945 02:54:43,896 --> 02:54:44,330 SIGNS. 4946 02:54:44,330 --> 02:54:47,300 SO WE EITHER WERE NOT GIVING TO 4947 02:54:47,300 --> 02:54:49,602 THEM OR NOT GIVING TO THEM IN A 4948 02:54:49,602 --> 02:54:50,703 WAY THAT WAS ACCESSIBLE. 4949 02:54:50,703 --> 02:54:54,741 AND ONE OF THE EXEMPLARY QUOTES 4950 02:54:54,741 --> 02:54:58,678 WAS, I THINK IF WHEN THEY 4951 02:54:58,678 --> 02:54:59,979 DISCHARGED ME IF THEY HAD SAID 4952 02:54:59,979 --> 02:55:03,816 BE ON THE LOOKOUT FOR THESE, IF 4953 02:55:03,816 --> 02:55:05,151 THEY HAD TAKEN FIVE MINUTES TO 4954 02:55:05,151 --> 02:55:06,452 DO THAT I THINK IT WOULD HAVE 4955 02:55:06,452 --> 02:55:07,654 MAIJ A HUGE DIFFERENCE. 4956 02:55:07,654 --> 02:55:09,956 SO AS APRIL TALKED ABOUT THESE 4957 02:55:09,956 --> 02:55:11,924 URGENT MATERNAL WARNING SIGNS, 4958 02:55:11,924 --> 02:55:13,826 THESE WERE CREATED BY THE 4959 02:55:13,826 --> 02:55:15,094 COUNCIL FOR PATIENT SAFETY AND 4960 02:55:15,094 --> 02:55:17,030 WOMEN'S HEALTHCARE, THEY ARE 4961 02:55:17,030 --> 02:55:18,898 COPYRIGHTED BY THE AMERICAN 4962 02:55:18,898 --> 02:55:19,465 COLLEGE OF OBSTETRICIANS AND 4963 02:55:19,465 --> 02:55:21,968 GYNECOLOGISTS AND THEY ARE ALSO 4964 02:55:21,968 --> 02:55:23,936 USED BY THE HEAR HER CAMPAIGN BY 4965 02:55:23,936 --> 02:55:24,170 CDC. 4966 02:55:24,170 --> 02:55:26,139 THEY'VE NOW BEEN TRANSLATED INTO 4967 02:55:26,139 --> 02:55:28,541 80 LANGUAGES AND IT PROVIDES 4968 02:55:28,541 --> 02:55:29,142 STANDARDIZED PATIENT EDUCATION 4969 02:55:29,142 --> 02:55:30,310 SO THAT PATIENTS CAN REALLY HEAR 4970 02:55:30,310 --> 02:55:31,844 WHAT THESE WARNING SIGNS ARE AND 4971 02:55:31,844 --> 02:55:34,681 ALSO HAVE SOME INFO GRAPHICS TO 4972 02:55:34,681 --> 02:55:37,116 REFER TO IF THEY HAVE ANY 4973 02:55:37,116 --> 02:55:38,217 THOUGHTS, ANY QUESTIONS ABOUT 4974 02:55:38,217 --> 02:55:42,789 WHAT'S GOING ON. 4975 02:55:42,789 --> 02:55:43,890 WE ALSO TALKED ABOUT THIS WITH 4976 02:55:43,890 --> 02:55:45,491 THE PEOPLE WE INTERVIEWED AS 4977 02:55:45,491 --> 02:55:46,559 WELL AS THE COMMUNITY LEADERSHIP 4978 02:55:46,559 --> 02:55:48,828 BOARD AND THIS CAME OUT OF 4979 02:55:48,828 --> 02:55:50,363 THEIR -- ALL OF THESE 4980 02:55:50,363 --> 02:55:53,099 DISCUSSIONS WAS THAT WE REALLY 4981 02:55:53,099 --> 02:55:54,200 WANTED -- THE PATIENTS REALLY 4982 02:55:54,200 --> 02:55:55,401 WANTED SOMETHING ON THEIR PHONE. 4983 02:55:55,401 --> 02:55:57,036 THEY SAID THIS AGAIN AND AGAIN, 4984 02:55:57,036 --> 02:55:58,204 WE ASKED THEM IN THE INTERVIEW 4985 02:55:58,204 --> 02:55:59,238 WHAT WOULD BE HELPFUL TO GIVE 4986 02:55:59,238 --> 02:56:00,340 YOU THIS INFORMATION, HOW WOULD 4987 02:56:00,340 --> 02:56:02,542 YOU LIKE TO RECEIVE IT. 4988 02:56:02,542 --> 02:56:03,509 EVERYONE SAID THEY WANTED IT ON 4989 02:56:03,509 --> 02:56:05,378 THEIR PHONE, NO ONE WANTED THE 4990 02:56:05,378 --> 02:56:08,114 PACKETS THAT PEOPLE GIVE OUT ON 4991 02:56:08,114 --> 02:56:10,817 L & D, THEY NEVER MADE IT OUT OF 4992 02:56:10,817 --> 02:56:11,951 THE CAR, THEY WENT INTO THE 4993 02:56:11,951 --> 02:56:12,185 GARBAGE. 4994 02:56:12,185 --> 02:56:14,153 SO WE CREATED A BADGE BUDDY THAT 4995 02:56:14,153 --> 02:56:18,524 WE DISTRIBUTED ACROSS THE STATE 4996 02:56:18,524 --> 02:56:20,159 TO HAVE THIS QR CODE, THIS IS 4997 02:56:20,159 --> 02:56:22,161 LIVE, YOU CAN SCAN IT, AND USE 4998 02:56:22,161 --> 02:56:23,363 THE INSTRUCTIONS TO MAKE A 4999 02:56:23,363 --> 02:56:24,764 BOOKMARK ON YOUR PHONE SO THAT 5000 02:56:24,764 --> 02:56:26,632 YOU HAVE ACCESS TO THESE 5001 02:56:26,632 --> 02:56:30,403 RESOURCES, THE WARNING SIGNS, AS 5002 02:56:30,403 --> 02:56:31,471 WELL AS OTHER RESOURCES THAT I 5003 02:56:31,471 --> 02:56:33,206 WANT TO SHARE WITH YOU. 5004 02:56:33,206 --> 02:56:36,709 SO THIS WAS GREAT IN THAT WE -- 5005 02:56:36,709 --> 02:56:37,710 ONE OF THE COMMENTS THAT WE 5006 02:56:37,710 --> 02:56:38,678 HEARD FROM THE COMMUNITY BOARD 5007 02:56:38,678 --> 02:56:40,213 WAS THAT WE CAN'T JUST GIVE 5008 02:56:40,213 --> 02:56:41,214 PEOPLE THE WARNING SIGNS. 5009 02:56:41,214 --> 02:56:42,982 WE ACTUALLY HAVE TO HELP THEM 5010 02:56:42,982 --> 02:56:44,617 ADVOCATE FOR THEMSELVES AS WELL 5011 02:56:44,617 --> 02:56:47,353 BECAUSE MANY PEOPLE JUST WEREN'T 5012 02:56:47,353 --> 02:56:49,889 BEING HEARD AS YOU HEARD IN 5013 02:56:49,889 --> 02:56:53,159 APRIL'S STORY. 5014 02:56:53,159 --> 02:56:57,163 SO WE DID SOME ADVOCACY LANGUAGE 5015 02:56:57,163 --> 02:56:59,532 AND ACTIONS BUT -- NOT JUST 5016 02:56:59,532 --> 02:57:01,367 PATIENTS THAT WERE PREGNANT OR 5017 02:57:01,367 --> 02:57:02,034 THEIR SUPPORT PERSON. 5018 02:57:02,034 --> 02:57:04,871 WE KNOW THAT WHEN SOMEONE'S 5019 02:57:04,871 --> 02:57:06,305 EXPERIENCING SYMPTOMS, THEY 5020 02:57:06,305 --> 02:57:07,273 USUALLY CALL THEIR FRIENDS OR 5021 02:57:07,273 --> 02:57:12,545 FAMILY SO FOR AN EXAMPLE, WHEN 5022 02:57:12,545 --> 02:57:14,614 MEN EXPERIENCE CHEST PAIN THEY 5023 02:57:14,614 --> 02:57:15,715 USUALLY CALL THEIR PARTNER, AND 5024 02:57:15,715 --> 02:57:18,151 IT'S BASED ON THEIR PARTNER'S 5025 02:57:18,151 --> 02:57:19,018 RESPONSE IS WHY -- HOW URGENT 5026 02:57:19,018 --> 02:57:20,753 AND WHEN THEY SEEK MEDICAL CARE. 5027 02:57:20,753 --> 02:57:22,054 AND UNFORTUNATELY, THERE'S ALSO 5028 02:57:22,054 --> 02:57:24,891 SOME DATA THAT SOME WOMEN, WHEN 5029 02:57:24,891 --> 02:57:25,892 THEY EXPERIENCE CHEST PAIN, THEY 5030 02:57:25,892 --> 02:57:27,527 DO THE SAME THING. 5031 02:57:27,527 --> 02:57:29,695 AND DESPITE THAT IT ONE OF THE 5032 02:57:29,695 --> 02:57:31,364 LEADING CAUSES OF DEATH FOR 5033 02:57:31,364 --> 02:57:34,434 WOMEN, CARDIOVASCULAR DISEASE, 5034 02:57:34,434 --> 02:57:36,169 THEY DON'T GET THE SAME URGENCY 5035 02:57:36,169 --> 02:57:38,704 AND THEY ACTUALLY HAVE DELAYED 5036 02:57:38,704 --> 02:57:39,906 CARE SOMETIMES BECAUSE OF 5037 02:57:39,906 --> 02:57:41,741 CHEST -- WITH CHEST PAIN. 5038 02:57:41,741 --> 02:57:43,609 AND SO WE THOUGHT THAT MAYBE THE 5039 02:57:43,609 --> 02:57:46,012 SAME THING IS HAPPENING WITH 5040 02:57:46,012 --> 02:57:46,679 PREGNANT PATIENTS IN THAT THEY 5041 02:57:46,679 --> 02:57:51,517 DON'T KNOW THE WARNING SIGNS SO 5042 02:57:51,517 --> 02:57:52,285 MAYBE THEY'RE EXPERIENCING A 5043 02:57:52,285 --> 02:57:53,920 HEADACHE THAT'S PRETTY SEVERE, 5044 02:57:53,920 --> 02:57:55,154 THEY CALL ONE OF THEIR FRIENDS 5045 02:57:55,154 --> 02:57:57,323 OR A FAMILY MEMBER, WHY DON'T 5046 02:57:57,323 --> 02:57:59,959 YOU TAKE SOME TYLENOL, TAKE A 5047 02:57:59,959 --> 02:58:01,060 NAP, NOT REALIZING THAT COULD BE 5048 02:58:01,060 --> 02:58:02,929 A WARNING SIGN FOR PRE-ECLAMPSIA 5049 02:58:02,929 --> 02:58:04,997 ALL OF THOSE WARNING SIGNS I 5050 02:58:04,997 --> 02:58:06,632 SHOWED ARE NOT ONLY FOR SEPSIS, 5051 02:58:06,632 --> 02:58:08,067 THEY'RE ALSO FOR MATERNAL 5052 02:58:08,067 --> 02:58:08,334 MORBIDITY. 5053 02:58:08,334 --> 02:58:10,803 SO WE DID A REALLY INCREDIBLE 5054 02:58:10,803 --> 02:58:13,673 COMMUNITY AND PUBLIC HEALTH 5055 02:58:13,673 --> 02:58:15,208 DISSEMINATION OF THESE BADGE 5056 02:58:15,208 --> 02:58:19,145 BUDDIES AND THAT PUBLIC HEALTH 5057 02:58:19,145 --> 02:58:21,214 IN THE STATE AS WELL AS THE WIC 5058 02:58:21,214 --> 02:58:22,849 AGENCIES WERE USING THE BADGE 5059 02:58:22,849 --> 02:58:24,150 BUDDIES, MAKING SURE PEOPLE HAD 5060 02:58:24,150 --> 02:58:25,251 THE INFORMATION ON THEM. 5061 02:58:25,251 --> 02:58:26,385 THERE WERE ALSO COMMUNITY-BASED 5062 02:58:26,385 --> 02:58:28,154 ORGANIZES WE WORKED WHO MADE 5063 02:58:28,154 --> 02:58:30,723 SURE THE BADGE BUDDY WAS THE 5064 02:58:30,723 --> 02:58:31,891 SIZE OF A CREDIT CARD SO IT 5065 02:58:31,891 --> 02:58:33,860 WOULD FIT IN A WALLET SO IF 5066 02:58:33,860 --> 02:58:35,094 PEOPLE, IF THEY WEREN'T WEARING 5067 02:58:35,094 --> 02:58:36,128 A BADGE, THEY COULD BE A 5068 02:58:36,128 --> 02:58:37,597 CHAMPION OF THAT. 5069 02:58:37,597 --> 02:58:38,598 THEY COULD SCAN THE BADGE AND 5070 02:58:38,598 --> 02:58:39,465 SHARE THAT WITH PEOPLE. 5071 02:58:39,465 --> 02:58:40,900 AS WELL AS HOUSES OF WORSHIP 5072 02:58:40,900 --> 02:58:41,901 WILL ALSO HELPING US WITH THIS, 5073 02:58:41,901 --> 02:58:45,171 AND THE MEDICAID SUPPORTED 5074 02:58:45,171 --> 02:58:46,005 DOULAS IN THE STATE OF MICHIGAN 5075 02:58:46,005 --> 02:58:47,607 AS WELL AS THE HOME VISITING 5076 02:58:47,607 --> 02:58:48,574 NURSING PROGRAM THAT SERVES 5077 02:58:48,574 --> 02:58:50,343 THOUSANDS OF POSTPARTUM 5078 02:58:50,343 --> 02:58:50,776 PATIENTS. 5079 02:58:50,776 --> 02:58:52,178 WE WERE ALL DISTRIBUTING IT 5080 02:58:52,178 --> 02:58:55,681 THROUGHOUT THAT STATE SO THAT WE 5081 02:58:55,681 --> 02:58:57,116 COULD MAKE SURE EVERYONE KNEW 5082 02:58:57,116 --> 02:58:58,751 ABOUT IT SO IF THEY WERE CALLED, 5083 02:58:58,751 --> 02:59:00,319 THEY KNEW LET ME CHECK MY LIST 5084 02:59:00,319 --> 02:59:00,987 AND SEE IF THAT'S SOMETHING WE 5085 02:59:00,987 --> 02:59:04,557 SHOULD BE CONCERNED ABOUT. 5086 02:59:04,557 --> 02:59:05,925 SO REMEMBER WE TALKED ABOUT ADD 5087 02:59:05,925 --> 02:59:06,893 ADVOCACY. 5088 02:59:06,893 --> 02:59:08,094 WE REALIZED WE HAD TO DO 5089 02:59:08,094 --> 02:59:09,595 SOMETHING NOT SAYING THAT WE 5090 02:59:09,595 --> 02:59:11,264 NEED TO PUT THE ONUS ON THE 5091 02:59:11,264 --> 02:59:11,931 PATIENT THAT THEY HAVE TO 5092 02:59:11,931 --> 02:59:12,899 ADVOCATE FOR THEMSELVES TO GET 5093 02:59:12,899 --> 02:59:16,736 THE CARE THAT THEY NEED, BUT WE 5094 02:59:16,736 --> 02:59:18,237 WANTED TO HE'LLIZE THAT WE NEED 5095 02:59:18,237 --> 02:59:20,573 TO DO BETTER LISTEN TO PATIENTS 5096 02:59:20,573 --> 02:59:21,674 BUT IN THE MEANTIME WE NEED TO 5097 02:59:21,674 --> 02:59:22,975 GIVE PEOPLE THE TOOLS. 5098 02:59:22,975 --> 02:59:23,876 SO ONE OF THE THEMES THAT WE 5099 02:59:23,876 --> 02:59:25,177 FOUND WAS THAT PATIENTS WANTED 5100 02:59:25,177 --> 02:59:26,279 TO ADVOCATE FOR THEMSELVES AND 5101 02:59:26,279 --> 02:59:30,016 THEY WANTED TO LEARN HOW TO DO 5102 02:59:30,016 --> 02:59:30,583 THAT. 5103 02:59:30,583 --> 02:59:31,851 ONE OF THE QUOTES, I WISH 5104 02:59:31,851 --> 02:59:34,720 SOMEONE WOULD HAVE EXPLAINED IT 5105 02:59:34,720 --> 02:59:35,388 ZOO SCIENCE AND HOW TO ADVOCATE 5106 02:59:35,388 --> 02:59:36,022 FOR THEMSELVES. 5107 02:59:36,022 --> 02:59:38,224 LIKE IF YOU CALL AND THEY TELL 5108 02:59:38,224 --> 02:59:39,659 YOU DON'T COME, STILL GO. 5109 02:59:39,659 --> 02:59:40,860 SO WE WORKED WITH OUR COMMUNITY 5110 02:59:40,860 --> 02:59:41,861 LEADERSHIP BOARD AS WELL AS OUR 5111 02:59:41,861 --> 02:59:43,496 CLINICAL ADVISORY BOARD TO 5112 02:59:43,496 --> 02:59:45,031 CREATE ADVOCACY LANGUAGE AND 5113 02:59:45,031 --> 02:59:45,798 ACTIONS. 5114 02:59:45,798 --> 02:59:47,667 WE DID A PROCESS, WE DID 5115 02:59:47,667 --> 02:59:49,735 MULTIPLE MEETINGS, MULTIPLE 5116 02:59:49,735 --> 02:59:51,404 ITERATIONS, WE USED JAMBOARD, 5117 02:59:51,404 --> 02:59:53,706 AND EVERYONE PUT THEIR COMMENTS 5118 02:59:53,706 --> 02:59:55,708 IN THERE SO THAT WE COULD TAKE A 5119 02:59:55,708 --> 02:59:57,076 LOOK AND PUT TOGETHER A DOCUMENT 5120 02:59:57,076 --> 02:59:58,945 THAT WE COULD SHARE WITH 5121 02:59:58,945 --> 03:00:03,649 PATIENTS WITH THAT BADGE BUDDY. 5122 03:00:03,649 --> 03:00:05,818 SO HERE IS THE ADVOCACY LANGUAGE 5123 03:00:05,818 --> 03:00:07,620 AND ACTIONS, AND SO JUST SOME 5124 03:00:07,620 --> 03:00:11,624 EXAMPLES OF ADVOCACY LANGUAGE IS 5125 03:00:11,624 --> 03:00:13,225 THAT IF THEY WERE BEING BRUSHED 5126 03:00:13,225 --> 03:00:14,360 OFF, THEY COULD SAY SOMETHING 5127 03:00:14,360 --> 03:00:16,796 THAT'S ON THIS LIST SUCH AS THIS 5128 03:00:16,796 --> 03:00:18,030 IS SOMETHING REALLY DIFFERENT 5129 03:00:18,030 --> 03:00:20,132 FOR ME, I'VE NEVER FELT THIS WAY 5130 03:00:20,132 --> 03:00:20,766 IN HIGH LIFE. 5131 03:00:20,766 --> 03:00:22,635 FOR MY BENEFIT AND MY FAMILY'S 5132 03:00:22,635 --> 03:00:24,503 BENEFIT, I SHOULD BE SEEN. 5133 03:00:24,503 --> 03:00:25,271 THEN ADVOCACY ACTION TIPS SUCH 5134 03:00:25,271 --> 03:00:27,006 AS BRINGING SOMEONE WITH YOU TO 5135 03:00:27,006 --> 03:00:28,674 HELP ADVOCATE FOR YOU, AND THEN 5136 03:00:28,674 --> 03:00:30,309 ALSO MANY PATIENTS DIDN'T KNOW 5137 03:00:30,309 --> 03:00:32,178 THAT IF THEY WERE GETTING A 5138 03:00:32,178 --> 03:00:33,479 CALL -- THEY WERE CALLING 5139 03:00:33,479 --> 03:00:35,047 THROUGH TRIAGE OR THROUGH 5140 03:00:35,047 --> 03:00:36,682 CLINIC, IF THEY WERE BEING TOLD 5141 03:00:36,682 --> 03:00:38,784 THAT THEY DIDN'T NEED TO BE 5142 03:00:38,784 --> 03:00:39,986 EVALUATED, EVEN IF THEY DIDN'T 5143 03:00:39,986 --> 03:00:42,321 FEEL RIGHT OR IF THINGS 5144 03:00:42,321 --> 03:00:43,089 WORSENED, THEY DIDN'T REALIZE 5145 03:00:43,089 --> 03:00:44,824 THAT THEY ACTUALLY COULD GO TO 5146 03:00:44,824 --> 03:00:48,694 THE ER OR 5 GO TO TRIAGE. 5147 03:00:48,694 --> 03:00:50,429 THAT CAME UP A NUMBER OF TIMES. 5148 03:00:50,429 --> 03:00:52,198 SO WE WANTED TO GIVE THEM THAT 5149 03:00:52,198 --> 03:00:53,099 REASSURANCE AND HEAR THAT THIS 5150 03:00:53,099 --> 03:00:54,500 IS SOMETHING THAT COULD BE 5151 03:00:54,500 --> 03:00:55,067 SHARED. 5152 03:00:55,067 --> 03:00:56,836 WE HAD A LOT OF REALLY GREAT 5153 03:00:56,836 --> 03:00:58,170 RESPONSE FROM THIS DOCUMENT, 5154 03:00:58,170 --> 03:01:00,206 FROM THE COMMUNITY-BASED 5155 03:01:00,206 --> 03:01:00,973 ORGANIZATIONS AND THAT'S WHY 5156 03:01:00,973 --> 03:01:02,975 THEY ALSO WANTED TO START 5157 03:01:02,975 --> 03:01:06,679 PARTICIPATING IN SHARING THIS. 5158 03:01:06,679 --> 03:01:08,447 YOU HEARD APRIL'S STORY AND 5159 03:01:08,447 --> 03:01:10,282 ALSO -- HER STORY IS 5160 03:01:10,282 --> 03:01:11,517 UNFORTUNATELY SOMEWHAT TYPICAL 5161 03:01:11,517 --> 03:01:14,020 OF THE PATIENTS THAT WE 5162 03:01:14,020 --> 03:01:15,121 INTERVIEWED, AND I'M SURE THAT 5163 03:01:15,121 --> 03:01:20,593 THAT'S NOT ALL OF THE STORIES 5164 03:01:20,593 --> 03:01:22,361 THAT I'M SURE WERE SHARED 5165 03:01:22,361 --> 03:01:25,665 EVERYWHERE, BUT THIS WAS AN 5166 03:01:25,665 --> 03:01:27,700 IMPORTANT ONE. 5167 03:01:27,700 --> 03:01:31,537 THIS QUOTE WAS FROM THE SPOUSE 5168 03:01:31,537 --> 03:01:35,107 WHOSE WIFE DIED, SHE'S DISMISSED 5169 03:01:35,107 --> 03:01:36,375 THERE AND THROUGHOUT THE WHOLE 5170 03:01:36,375 --> 03:01:38,344 STAY WHENEVER WE BROUGHT THESE 5171 03:01:38,344 --> 03:01:40,346 THINGS UP WAS YOU JUST HAD A 5172 03:01:40,346 --> 03:01:41,213 BABY, EVERYTHING'S OKAY, DON'T 5173 03:01:41,213 --> 03:01:42,748 WORRY, YOU JUST HAD A BABY, AND 5174 03:01:42,748 --> 03:01:45,284 THAT WAS THE RECURRING THEME 5175 03:01:45,284 --> 03:01:45,851 THROUGHOUT OUR STAY. 5176 03:01:45,851 --> 03:01:46,919 BUT THEY DIDN'T REALLY ASK 5177 03:01:46,919 --> 03:01:47,520 FURTHER AND GET MORE 5178 03:01:47,520 --> 03:01:47,820 INFORMATION. 5179 03:01:47,820 --> 03:01:49,355 A LOT OF PEOPLE JUST RECEIVED A 5180 03:01:49,355 --> 03:01:50,356 LOT OF REASSURANCE BECAUSE MOST 5181 03:01:50,356 --> 03:01:52,425 OF THE TIME, EVERYTHING IS OKAY. 5182 03:01:52,425 --> 03:01:54,827 BUT THEY DIDN'T GET A LOT OF 5183 03:01:54,827 --> 03:01:58,364 DEPTH ABOUT WHAT WAS GOING ON. 5184 03:01:58,364 --> 03:01:59,565 SO THERE WERE SOME OTHER PEOPLE 5185 03:01:59,565 --> 03:02:01,534 THAT WE HAD INTERVIEWED THAT IS 5186 03:02:01,534 --> 03:02:03,235 PRETTY COMMON TO TALK ABOUT THE 5187 03:02:03,235 --> 03:02:04,236 ENTIRE POSTPARTUM, BUT NO ONE 5188 03:02:04,236 --> 03:02:05,805 REALLY ASKED THEM, WHAT DOES 5189 03:02:05,805 --> 03:02:06,906 THAT MEAN TO YOU? 5190 03:02:06,906 --> 03:02:10,309 WHAT DO YOU MEAN BY THAT? 5191 03:02:10,309 --> 03:02:12,611 SO MANY OF THESE QUOTES, THREE 5192 03:02:12,611 --> 03:02:13,713 DIFFERENT PEOPLE, I HAD NO 5193 03:02:13,713 --> 03:02:15,381 STRENGTH, I COULDN'T EVEN GO TO 5194 03:02:15,381 --> 03:02:16,348 THE KITCHEN TO GET A GLASS OF 5195 03:02:16,348 --> 03:02:16,682 WATER. 5196 03:02:16,682 --> 03:02:17,917 I WAS SO WEAK I COULDN'T STAND 5197 03:02:17,917 --> 03:02:18,217 UP. 5198 03:02:18,217 --> 03:02:20,119 I WAS SHORT OF BREATH AFTER 5199 03:02:20,119 --> 03:02:21,187 BRUSHING MY TEETH AND HAD TO LIE 5200 03:02:21,187 --> 03:02:21,754 DOWN ON THE BED. 5201 03:02:21,754 --> 03:02:24,156 THIS IS MUCH MORE SERIOUS IN 5202 03:02:24,156 --> 03:02:25,624 THAT THESE PEOPLE COULD NOT DO 5203 03:02:25,624 --> 03:02:29,962 ACTIVITIES OF DAILY LIVING. 5204 03:02:29,962 --> 03:02:31,330 SO WE WORKED WITH OUR COMMUNITY 5205 03:02:31,330 --> 03:02:33,032 BOARD AS WELL AS OUR CLINICAL 5206 03:02:33,032 --> 03:02:34,700 ADVISORY BOARD TO CREATE A 5207 03:02:34,700 --> 03:02:36,202 WARNING SIGNS FOLLOW-UP GUIDE 5208 03:02:36,202 --> 03:02:38,738 AND WE DID THE SAME PROCESS AND 5209 03:02:38,738 --> 03:02:41,574 THIS IS A SET OF QUESTIONS, GIVE 5210 03:02:41,574 --> 03:02:42,675 SOME INFORMATION ABOUT WHAT 5211 03:02:42,675 --> 03:02:45,745 LESSONS LEARNED FROM THIS STUDY 5212 03:02:45,745 --> 03:02:48,581 AS WELL AS IN OTHER DATA THAT'S 5213 03:02:48,581 --> 03:02:50,049 OUT THERE, BUT GIVING SOME 5214 03:02:50,049 --> 03:02:51,383 FOLLOW-UP QUESTIONS ABOUT REALLY 5215 03:02:51,383 --> 03:02:54,120 GETTING A GOOD HISTORY FROM 5216 03:02:54,120 --> 03:02:55,888 THOSE PATIENTS BEFORE 5217 03:02:55,888 --> 03:02:56,956 REASSURING, AND THEN ALSO JUST 5218 03:02:56,956 --> 03:02:58,290 GIVING SOME ACTION ITEMS OF 5219 03:02:58,290 --> 03:02:59,592 TELLING THAT PATIENT EVEN IF 5220 03:02:59,592 --> 03:03:01,494 THEY DON'T NEED TO BE EVALUATED 5221 03:03:01,494 --> 03:03:03,996 NOW, WHEN SHOULD THEY, IF IT 5222 03:03:03,996 --> 03:03:05,765 PERSISTS, IF IT GOT WORSE, A LOT 5223 03:03:05,765 --> 03:03:06,766 OF PEOPLE REALIZED THAT THEY HAD 5224 03:03:06,766 --> 03:03:08,501 TALKED TO SOMEONE, AND THEY 5225 03:03:08,501 --> 03:03:13,539 THOUGHT EVERYTHING WAS CLEARED 5226 03:03:13,539 --> 03:03:15,141 UP THEY DIDN'T HAVE TO CHECK IN 5227 03:03:15,141 --> 03:03:16,108 AGAIN BUT THEY DIDN'T REALIZE IF 5228 03:03:16,108 --> 03:03:17,977 THINGS PERSISTED OR IF THEY GOT 5229 03:03:17,977 --> 03:03:18,944 WORSE, THEY DIDN'T KNOW WHAT 5230 03:03:18,944 --> 03:03:20,179 SIGNS THEY SHOULD BE AWARE OF TO 5231 03:03:20,179 --> 03:03:21,480 SEEK CARE. 5232 03:03:21,480 --> 03:03:22,815 THERE'S ALSO SOME RED FLAGS HERE 5233 03:03:22,815 --> 03:03:24,650 FROM OUR DATA AS WELL AS OTHER 5234 03:03:24,650 --> 03:03:26,018 DATA ABOUT WHEN PEOPLE SHOULD 5235 03:03:26,018 --> 03:03:28,554 REALLY BE SEEN IN PERSON, THAT 5236 03:03:28,554 --> 03:03:31,724 WE CONVENIENTLY PUT ON THE BADGE 5237 03:03:31,724 --> 03:03:34,160 BUDDY, YOU'LL SEE THERE'S 5238 03:03:34,160 --> 03:03:37,129 PATIENT RESOURCES AND PROVIDER 5239 03:03:37,129 --> 03:03:38,864 RESOURCES, IT'S HELPFUL FOR 5240 03:03:38,864 --> 03:03:39,632 PEOPLE, THEY'RE ALREADY WEARING 5241 03:03:39,632 --> 03:03:41,400 IT AROUND THEIR NECK TO BE ABLE 5242 03:03:41,400 --> 03:03:44,937 TO ACCESS THOSE RESOURCES AS 5243 03:03:44,937 --> 03:03:46,172 NEEDED. 5244 03:03:46,172 --> 03:03:48,974 >> I THINK WE'RE AT TIME, SO 5245 03:03:48,974 --> 03:03:50,376 PERHAPS YOU COULD WRAP UP? 5246 03:03:50,376 --> 03:03:50,810 >> OH, SURE. 5247 03:03:50,810 --> 03:03:51,143 SORRY. 5248 03:03:51,143 --> 03:03:54,880 AND THEN TREAT TREATMENT, WE TAD 5249 03:03:54,880 --> 03:03:56,582 ABOUT ANTIBIOTICS ARE INCREDIBLY 5250 03:03:56,582 --> 03:03:56,849 IMPORTANT. 5251 03:03:56,849 --> 03:03:58,050 I HAVE LIKE TWO MORE SLIDES 5252 03:03:58,050 --> 03:03:59,051 HERE. 5253 03:03:59,051 --> 03:04:02,988 AND THEN ALSO GIVING SOME 5254 03:04:02,988 --> 03:04:05,624 STRATEGIES ON GIVING THOSE 5255 03:04:05,624 --> 03:04:06,392 ANTIBIOTICS IN QUICKLY. 5256 03:04:06,392 --> 03:04:08,227 AND THENS CLAITION OF RESOURCE, 5257 03:04:08,227 --> 03:04:10,896 WE ALSO PROVIDED TO PEOPLE USING 5258 03:04:10,896 --> 03:04:14,366 THE SEPSIS OBSTETRICS SCORE WITH 5259 03:04:14,366 --> 03:04:19,638 THE RESOURCE CONVENIENTLY, AND 5260 03:04:19,638 --> 03:04:22,074 NEXT STEPS WE'RE COMPLETING OUR 5261 03:04:22,074 --> 03:04:23,509 IMPLEMENTATION, DOING OUR DATA 5262 03:04:23,509 --> 03:04:25,578 ANALYSIS AND PATIENT-CENTERED 5263 03:04:25,578 --> 03:04:26,245 QUALITATIVE ASSESSMENT OF THE 5264 03:04:26,245 --> 03:04:26,779 TOOLS. 5265 03:04:26,779 --> 03:04:28,214 I CAN'T SAY ENOUGH ABOUT THIS 5266 03:04:28,214 --> 03:04:28,581 INCREDIBLE TEAM. 5267 03:04:28,581 --> 03:04:29,815 I WANT TO THANK ALL OF THE 5268 03:04:29,815 --> 03:04:30,749 PEOPLE YOU SEE HERE AS WELL AS 5269 03:04:30,749 --> 03:04:31,851 THE CLINICAL ADVISORY BOARD AND 5270 03:04:31,851 --> 03:04:35,454 THE COMMUNITY LEADERSHIP BOARD. 5271 03:04:35,454 --> 03:04:36,555 AND THANK YOU FOR OPPORTUNITY TO 5272 03:04:36,555 --> 03:04:43,562 SPEAK HERE TODAY. 5273 03:04:43,562 --> 03:04:44,663 I'M HAPPY TO PASS IT BACK OVER. 5274 03:04:44,663 --> 03:04:46,432 >> THANK YOU, DR. BAUER. 5275 03:04:46,432 --> 03:04:47,099 UNFORTUNATELY WE DON'T HAVE TIME 5276 03:04:47,099 --> 03:04:47,733 FOR QUESTIONS BECAUSE WE STILL 5277 03:04:47,733 --> 03:04:49,635 HAVE A NUMBER OF PRESENTATIONS 5278 03:04:49,635 --> 03:04:50,936 TO GO THROUGH. 5279 03:04:50,936 --> 03:04:53,706 BUT IF PEOPLE HAVE QUESTIONS FOR 5280 03:04:53,706 --> 03:04:54,907 DR. BAUER, PUT THEM IN THE CHAT 5281 03:04:54,907 --> 03:04:59,078 BOX, AND WE CAN GET THEM TO HER. 5282 03:04:59,078 --> 03:05:03,449 BUT IT WAS REALLY A VERY 5283 03:05:03,449 --> 03:05:04,450 IMPACTFUL TALK, PARTICULARLY IN 5284 03:05:04,450 --> 03:05:05,417 THE CONTEXT OF APRIL PRESENTING 5285 03:05:05,417 --> 03:05:07,019 WHAT SHE HAD BEEN THROUGH. 5286 03:05:07,019 --> 03:05:09,688 SO AT THIS TIME, WE'RE GOING TO 5287 03:05:09,688 --> 03:05:11,724 TAKE ANOTHER 10-MINUTE BREAK. 5288 03:05:11,724 --> 03:05:17,329 WE WILL COME BACK AT 3:40. 5289 03:05:17,329 --> 03:05:18,998 AND THEN WE WILL GO THROUGH THE 5290 03:05:18,998 --> 03:05:20,933 CONCEPT CLEARANCES. 5291 03:05:20,933 --> 03:05:24,470 SO THANK YOU, DR. BAUER, 5292 03:05:24,470 --> 03:05:26,238 DR. MARRAZZO, IF YOU'RE STILL ON 5293 03:05:26,238 --> 03:05:27,516 AND MS. CHAVEZ. 5294 03:05:30,184 --> 03:05:31,852 >> IT'S EXACTLY 340 TYPE, AND 5295 03:05:31,852 --> 03:05:36,257 I'M GOING TO HAND THE MICROPHONE 5296 03:05:36,257 --> 03:05:41,529 OVER FOR THE CONCEPT CLEARANCES. 5297 03:05:41,529 --> 03:05:42,596 >> WELCOME BACK. 5298 03:05:42,596 --> 03:05:46,867 WE'RE NOW GOING TO PRESENT FOUR 5299 03:05:46,867 --> 03:05:48,202 CONCEPTS FOR YOUR CONSIDERATION. 5300 03:05:48,202 --> 03:05:51,272 FOR EACH CONCEPT, I WILL ASK THE 5301 03:05:51,272 --> 03:05:52,807 STAFF TO PROVIDE A BRIEF 5302 03:05:52,807 --> 03:05:57,511 OVERVIEW OF THE INITIATIVE AND 5303 03:05:57,511 --> 03:06:00,214 THEN ASK COUNCIL FOR DISCUSSION 5304 03:06:00,214 --> 03:06:01,549 REGARDING THE CONCEPT. 5305 03:06:01,549 --> 03:06:02,716 AT THE CONCLUSION OF THE 5306 03:06:02,716 --> 03:06:04,018 DISCUSSION FOR EACH CONCEPT, 5307 03:06:04,018 --> 03:06:05,753 I'LL ASK COUNCILMEMBERS WHETHER 5308 03:06:05,753 --> 03:06:06,220 THEY CONCUR OR NOT. 5309 03:06:06,220 --> 03:06:08,856 I JUST WANTED TO REMIND 5310 03:06:08,856 --> 03:06:14,028 ESPECIALLY WITH ALL OUR NEW AD 5311 03:06:14,028 --> 03:06:18,432 HOC MEMBERS AND SUBJECT MATTER 5312 03:06:18,432 --> 03:06:19,967 EXPERTS REMIND YOU, CONCEPTS 5313 03:06:19,967 --> 03:06:20,935 REPRESENT THE EARLY PLANNING 5314 03:06:20,935 --> 03:06:22,703 STAGES FOR FUNDING INITIATIVES 5315 03:06:22,703 --> 03:06:25,339 SUCH AS A REQUEST FOR 5316 03:06:25,339 --> 03:06:26,440 APPLICATIONS OR A CONTRACT 5317 03:06:26,440 --> 03:06:27,107 SOLICITATION. 5318 03:06:27,107 --> 03:06:30,377 ACCORDING TO LAW, EXPERTS IN THE 5319 03:06:30,377 --> 03:06:32,480 FIELD WHICH ARE USUALLY 5320 03:06:32,480 --> 03:06:34,148 COUNCILMEMBERS MUST APPROVE A 5321 03:06:34,148 --> 03:06:35,349 CONCEPT BEFORE IT CAN BE 5322 03:06:35,349 --> 03:06:36,784 ANNOUNCED OR DEVELOPED INTO A 5323 03:06:36,784 --> 03:06:41,322 FUNDING INITIATIVE. 5324 03:06:41,322 --> 03:06:42,690 COUNCILMEMBERS ARE ASKED TO 5325 03:06:42,690 --> 03:06:45,259 REVIEW, COMMENT ON AND APPROVE 5326 03:06:45,259 --> 03:06:47,294 THE CONCEPT'S SCIENTIFIC MERIT 5327 03:06:47,294 --> 03:06:48,629 AND RELATIVE PRIORITY. 5328 03:06:48,629 --> 03:06:50,464 BUT PLEASE REMEMBER THAT NOT ALL 5329 03:06:50,464 --> 03:06:51,832 CONCEPTS ARE DEVELOPED INTO 5330 03:06:51,832 --> 03:06:55,870 FORMAL INITIATIVES. 5331 03:06:55,870 --> 03:06:57,404 AND EVEN IF A CONCEPT DOES LEAD 5332 03:06:57,404 --> 03:06:59,640 TO AN INITIATIVE, THE DETAILS 5333 03:06:59,640 --> 03:07:01,942 MAY DIFFER FROM THE ORIGINAL 5334 03:07:01,942 --> 03:07:02,910 PROPOSAL. 5335 03:07:02,910 --> 03:07:05,112 CONCEPTS ARE PRESENTED IN OPEN 5336 03:07:05,112 --> 03:07:09,383 SESSION, THEY DO NOT INCLUDE 5337 03:07:09,383 --> 03:07:11,051 SPECIFIC DETAILS ABOUT POTENTIAL 5338 03:07:11,051 --> 03:07:12,453 FUTURE FUNDING INITIATIVES, AND 5339 03:07:12,453 --> 03:07:13,921 THIS IS ACTUALLY A PROTECTION 5340 03:07:13,921 --> 03:07:15,823 FOR YOU, THE COUNCILMEMBERS, 5341 03:07:15,823 --> 03:07:19,293 SINCE THERE WAS NO, SO TO SPEAK, 5342 03:07:19,293 --> 03:07:20,828 INSIDE INFORMATION, YOU ARE 5343 03:07:20,828 --> 03:07:22,596 PERMITTED TO APPLY TO ANY FUTURE 5344 03:07:22,596 --> 03:07:24,031 INITIATIVES. 5345 03:07:24,031 --> 03:07:27,101 SO HAVING SAID THAT, LET ME 5346 03:07:27,101 --> 03:07:28,869 INTRODUCE DR. FRANKLIN YATES 5347 03:07:28,869 --> 03:07:31,872 FROM THE MATERNAL AND PEDIATRIC 5348 03:07:31,872 --> 03:07:35,109 INFECTIOUS DISEASE BRANCH, WHO 5349 03:07:35,109 --> 03:07:36,644 WILL PRESENT ADVANCING 5350 03:07:36,644 --> 03:07:38,112 PREVENTION AND TREATMENT OF 5351 03:07:38,112 --> 03:07:41,282 BACTERIAL STIs IN HIV-AFFECTED 5352 03:07:41,282 --> 03:07:42,249 ADOLESCENT AND MATERNAL 5353 03:07:42,249 --> 03:07:47,555 POPULATIONS. 5354 03:07:47,555 --> 03:07:52,660 >> THANK YOU AND GOOD AFTERNOON. 5355 03:07:52,660 --> 03:07:53,994 PROGRAM SEEKS COUNCIL APPROVAL 5356 03:07:53,994 --> 03:07:56,964 NEW INITIATIVES TITLED ADVANCING 5357 03:07:56,964 --> 03:07:58,065 PREVENTION AND TREATMENT OF 5358 03:07:58,065 --> 03:08:00,801 BACTERIAL STI IN HIV AFFECTED 5359 03:08:00,801 --> 03:08:01,902 ADOLESCENT AND MATERNAL 5360 03:08:01,902 --> 03:08:04,004 POPULATIONS. 5361 03:08:04,004 --> 03:08:07,174 DESPITE DEVELOPMENTS -- DATA 5362 03:08:07,174 --> 03:08:08,342 FROM THE U.S. CENTERS FOR 5363 03:08:08,342 --> 03:08:09,109 DISEASE CONTROL AND PREVENTION 5364 03:08:09,109 --> 03:08:10,511 SHOW THAT RATES OF INFECTION 5365 03:08:10,511 --> 03:08:13,247 WITH SYPHILIS, GONORRHEA AND 5366 03:08:13,247 --> 03:08:14,381 CHLAMYDIA MARKEDLY INCREASED 5367 03:08:14,381 --> 03:08:18,285 OVER THE PAST 10 YEARS AMONG 5368 03:08:18,285 --> 03:08:20,821 ADOLESCENTS -- OR GREATER 5369 03:08:20,821 --> 03:08:22,022 LIKELIHOOD OF HIV. 5370 03:08:22,022 --> 03:08:23,958 SIMILARLY A DISPROPORTIONATE 5371 03:08:23,958 --> 03:08:27,528 INCREASE IN SYPHILIS RATES AMONG 5372 03:08:27,528 --> 03:08:30,564 ADOLESCENT GIRLS AND YOUNG -- OF 5373 03:08:30,564 --> 03:08:31,665 REPRODUCTIVE AGE HAS LED TO 5374 03:08:31,665 --> 03:08:33,667 POINTED INCREASE IN CONGENITAL 5375 03:08:33,667 --> 03:08:36,637 SYPHILIS CASES NATIONWIDE. 5376 03:08:36,637 --> 03:08:40,908 AS ON A RISE IN THE U.S. 5377 03:08:40,908 --> 03:08:47,147 AFFECT -- AT ALARMING RATES, STI 5378 03:08:47,147 --> 03:08:48,382 RESEARCH OUTPUT POPULATIONS HAS 5379 03:08:48,382 --> 03:08:52,086 NOT BEEN -- WHILE 5380 03:08:52,086 --> 03:08:53,187 PATHOPHYSIOLOGY, DIAGNOSTICS AND 5381 03:08:53,187 --> 03:08:54,221 THERAPEUTICS HAVE BEEN STUDIED 5382 03:08:54,221 --> 03:08:56,523 IN ADULTS, RESEARCH ON CLINICAL 5383 03:08:56,523 --> 03:08:58,158 MANAGEMENT AND DISSEMINATION AND 5384 03:08:58,158 --> 03:09:00,327 IMPLEMENTATION FOCUSING ON 5385 03:09:00,327 --> 03:09:03,897 MATERNAL -- POPULATIONS AFFECTED 5386 03:09:03,897 --> 03:09:04,798 BY HIV IS LACKING. 5387 03:09:04,798 --> 03:09:05,733 THE GOALS OF THIS INITIATIVE 5388 03:09:05,733 --> 03:09:06,700 INCLUDE THE FOLLOWING. 5389 03:09:06,700 --> 03:09:08,869 ONE, TO IMPROVE OUR 5390 03:09:08,869 --> 03:09:10,170 UNDERSTANDING OF HIV AND 5391 03:09:10,170 --> 03:09:16,043 BACTERIAL STI EP DE EPIDEMIOLOGC 5392 03:09:16,043 --> 03:09:17,678 TRENDS, RELATIONSHIPS, 5393 03:09:17,678 --> 03:09:18,646 CAUSALITIES AMONG THESE HIGH 5394 03:09:18,646 --> 03:09:20,981 BURDEN POPULATIONS, TWO, TO 5395 03:09:20,981 --> 03:09:22,616 AUGMENT RESEARCH ON DIAGNOSTIC 5396 03:09:22,616 --> 03:09:26,020 MODALITIES AND SAFE AND 5397 03:09:26,020 --> 03:09:27,121 EFFECTIVE MICROBE CIDAL AGENTS 5398 03:09:27,121 --> 03:09:28,622 AND THEIR CLINICAL 5399 03:09:28,622 --> 03:09:28,989 IMPLEMENTATION. 5400 03:09:28,989 --> 03:09:30,424 THREE, TO AUGMENT DISSEMINATION 5401 03:09:30,424 --> 03:09:32,726 AND IMPLEMENTATION RESEARCH ON 5402 03:09:32,726 --> 03:09:33,794 EVIDENCE-BASED STI PREVENTION 5403 03:09:33,794 --> 03:09:34,762 AND TREATMENT STRATEGIES FOR 5404 03:09:34,762 --> 03:09:38,365 YOUTH AND MATERNAL HIV AFFECTED 5405 03:09:38,365 --> 03:09:38,899 POPULATIONS. 5406 03:09:38,899 --> 03:09:40,567 THIS PROPOSED CONCEPT ALLIANCE 5407 03:09:40,567 --> 03:09:42,770 WITH THE NICHD'S STRATEGIC 5408 03:09:42,770 --> 03:09:45,372 THEMES THREE, FOUR AND FIVE, AND 5409 03:09:45,372 --> 03:09:47,941 WITH THREE MATERNAL AND 5410 03:09:47,941 --> 03:09:49,043 PEDIATRIC INFECTIOUS DISEASE 5411 03:09:49,043 --> 03:09:51,779 BRANCH PROGRAMMATIC PRIORITIES. 5412 03:09:51,779 --> 03:09:54,281 THE INITIATIVE ALSO ADDRESSES 5413 03:09:54,281 --> 03:09:55,949 THREE OVERARCHING HIV/AIDS 5414 03:09:55,949 --> 03:09:58,318 PRIORITIES INCLUDING RESEARCH ON 5415 03:09:58,318 --> 03:10:01,855 HIV ASSOCIATED COINFECTIONS, 5416 03:10:01,855 --> 03:10:04,091 REDUCING HEALTH DISPARITIES AND 5417 03:10:04,091 --> 03:10:05,292 TRAINING OF THE RESEARCH 5418 03:10:05,292 --> 03:10:05,626 WORKFORCE. 5419 03:10:05,626 --> 03:10:11,231 THANK YOU. 5420 03:10:11,231 --> 03:10:12,399 >> THANK YOU, DR. YATES. 5421 03:10:12,399 --> 03:10:14,535 ARE THERE ANY COMMENTS OR 5422 03:10:14,535 --> 03:10:17,371 QUESTIONS ABOUT THIS CONCEPT? 5423 03:10:17,371 --> 03:10:17,671 DR. CEDARS? 5424 03:10:17,671 --> 03:10:20,340 >> YES, THANK YOU FOR THAT 5425 03:10:20,340 --> 03:10:22,843 PROPOSAL AND PARTICULARLY IN THE 5426 03:10:22,843 --> 03:10:25,713 CONTEXT OF THE EXCELLENT 5427 03:10:25,713 --> 03:10:28,916 PRESENTATION FROM DR. MARRAZZO. 5428 03:10:28,916 --> 03:10:34,254 IS THERE COORDINATION WITH NIAID 5429 03:10:34,254 --> 03:10:36,657 ON THIS GIVEN THE STRONG OVERLAP 5430 03:10:36,657 --> 03:10:39,326 IN THE GOALS? 5431 03:10:39,326 --> 03:10:40,728 >> YES, THERE IS. 5432 03:10:40,728 --> 03:10:43,697 WE HAVE BEEN IN COORDINATION 5433 03:10:43,697 --> 03:10:47,434 WITH THE STD BRANCH IN NIAID'S 5434 03:10:47,434 --> 03:10:49,136 DIVISION OF MICROBIOLOGY AND 5435 03:10:49,136 --> 03:10:51,605 INFECTIOUS DISEASES, AND WE HAVE 5436 03:10:51,605 --> 03:10:53,674 SO FAR RECEIVED THEIR 5437 03:10:53,674 --> 03:10:54,808 INTELLECTUAL SUPPORT AND MORE 5438 03:10:54,808 --> 03:10:58,979 POTENTIALLY TO COME? 5439 03:10:58,979 --> 03:11:01,248 >> ANOTHER COMMENT FROM 5440 03:11:01,248 --> 03:11:02,716 DR. WOLFNER ALSO IN THE CHAT 5441 03:11:02,716 --> 03:11:05,252 ALONG SIMILAR LINES ABOUT 5442 03:11:05,252 --> 03:11:10,824 COLLABORATING WITH NIAID. 5443 03:11:10,824 --> 03:11:16,497 DR. COLE? 5444 03:11:16,497 --> 03:11:26,840 YOU MIGHT BE MUTED. 5445 03:11:37,151 --> 03:11:47,561 >> SESH, WE CAN'T HEAR YOU. 5446 03:11:48,362 --> 03:11:50,230 >> CAN YOU HEAR ME NOW? 5447 03:11:50,230 --> 03:11:51,031 >> YEAH. 5448 03:11:51,031 --> 03:11:56,804 >> YES. 5449 03:11:56,804 --> 03:11:58,705 >> NO, I'M AFRAID WE'VE LOST YOU 5450 03:11:58,705 --> 03:12:01,341 AGAIN. 5451 03:12:01,341 --> 03:12:02,309 >> HOW ABOUT NOW? 5452 03:12:02,309 --> 03:12:02,876 >> THAT'S GOOD. 5453 03:12:02,876 --> 03:12:03,877 THANK YOU. 5454 03:12:03,877 --> 03:12:05,512 >> SORRY. 5455 03:12:05,512 --> 03:12:07,481 MY TECHNICAL DETAILS HERE. 5456 03:12:07,481 --> 03:12:12,085 SO THIS IS A GREAT INITIATIVE. 5457 03:12:12,085 --> 03:12:14,621 WITH THE NOTICE OF FUNDING 5458 03:12:14,621 --> 03:12:18,559 OPPORTUNITY LIKELY INCLUDE AN 5459 03:12:18,559 --> 03:12:23,931 INTENTIONAL EXPECTATION OF 5460 03:12:23,931 --> 03:12:25,666 ENGAGING POPULATIONS WHO HAVE 5461 03:12:25,666 --> 03:12:30,971 EXPERIENCED HEALTH DISPARITIES? 5462 03:12:30,971 --> 03:12:33,040 >> YES, I THINK THAT'S GOING 5463 03:12:33,040 --> 03:12:37,277 TO -- THAT WILL BE PART OF THE 5464 03:12:37,277 --> 03:12:37,477 NOFO. 5465 03:12:37,477 --> 03:12:40,414 >> I THINK THAT'S IMPORTANT, TO 5466 03:12:40,414 --> 03:12:46,653 BE SURE THAT THERE ARE 5467 03:12:46,653 --> 03:12:47,955 IDENTIFIABLE AND REVIEWABLE 5468 03:12:47,955 --> 03:12:48,822 STRATEGIES FOR THAT. 5469 03:12:48,822 --> 03:12:52,459 THANK YOU. 5470 03:12:52,459 --> 03:12:53,894 >> THANK YOU. 5471 03:12:53,894 --> 03:12:56,029 >> ARE THERE ANY OTHER 5472 03:12:56,029 --> 03:12:56,897 ADDITIONAL COMMENTS OR 5473 03:12:56,897 --> 03:13:02,369 QUESTIONS? 5474 03:13:02,369 --> 03:13:04,104 NOT HEARING ANY, CAN I HAVE A 5475 03:13:04,104 --> 03:13:07,841 MOTION FOR APPROVAL? 5476 03:13:07,841 --> 03:13:08,809 >> SO MOVED. 5477 03:13:08,809 --> 03:13:11,712 THIS IS DR. COLE. 5478 03:13:11,712 --> 03:13:14,314 >> SO I'M GOING TO ASK FOR THE 5479 03:13:14,314 --> 03:13:16,083 MOTIONS AND THE VOTES AND 5480 03:13:16,083 --> 03:13:18,118 THE SECONDS TO COME FROM OUR 5481 03:13:18,118 --> 03:13:19,086 SEVEN COUNCILMEMBERS. 5482 03:13:19,086 --> 03:13:20,053 >> SORRY. 5483 03:13:20,053 --> 03:13:21,955 >> NO, NOT AT ALL. 5484 03:13:21,955 --> 03:13:26,226 IT'S JUST FORMALITY. 5485 03:13:26,226 --> 03:13:28,195 SO COUNCILMEMBERS? 5486 03:13:28,195 --> 03:13:32,933 >> THIS IS IGNA. 5487 03:13:32,933 --> 03:13:33,634 MOVE IT BE APPROVED. 5488 03:13:33,634 --> 03:13:34,902 >> CYNTHIA, SECOND. 5489 03:13:34,902 --> 03:13:36,036 >> THANK YOU SO MUCH. 5490 03:13:36,036 --> 03:13:44,211 ALL IN FAVOR? 5491 03:13:44,211 --> 03:13:46,046 >> WE HAVE SEVEN YESES. 5492 03:13:46,046 --> 03:13:46,880 >> ALL RIGHT, THANK YOU. 5493 03:13:46,880 --> 03:13:49,549 WE'LL NOW MOVE ON TO THE SECOND 5494 03:13:49,549 --> 03:13:49,783 CONCEPT. 5495 03:13:49,783 --> 03:13:56,256 I'M GOING TO INTRODUCE DR. LESLY 5496 03:13:56,256 --> 03:13:58,792 SAMEDY-BATES FROM THE OBSTETRIC 5497 03:13:58,792 --> 03:14:00,827 AND PEDIATRIC PHARMACOLOGY AND 5498 03:14:00,827 --> 03:14:04,865 THERAPEUTICS BRANCH WHO WILL 5499 03:14:04,865 --> 03:14:06,166 PRESENT MATERNAL AND PEDIATRIC 5500 03:14:06,166 --> 03:14:07,935 PRECISION IN THERAPEUTICS OR 5501 03:14:07,935 --> 03:14:08,168 MPRINT. 5502 03:14:08,168 --> 03:14:09,503 >> THANK YOU AND GOOD AFTERNOON. 5503 03:14:09,503 --> 03:14:11,371 COUNCIL SEEKS APPROVAL FOR THE 5504 03:14:11,371 --> 03:14:13,340 MATERNAL AND PEDIATRIC PRECISION 5505 03:14:13,340 --> 03:14:14,708 AND THERAPEUTICS INITIATIVE 5506 03:14:14,708 --> 03:14:16,677 OTHERWISE KNOWN AS MPRINT 5507 03:14:16,677 --> 03:14:17,544 VERSION 2.0. 5508 03:14:17,544 --> 03:14:19,646 MPRINT WILL AGGREGATE, EXPAND 5509 03:14:19,646 --> 03:14:21,548 AND PRESENT KNOWLEDGE, TOOLS AND 5510 03:14:21,548 --> 03:14:23,150 EXPERTISE IN MATERNAL, LACTATION 5511 03:14:23,150 --> 03:14:25,585 AND PEDIATRIC THERAPEUTICS 5512 03:14:25,585 --> 03:14:26,586 ULTIMATELY BENEFITING THE 5513 03:14:26,586 --> 03:14:27,854 BROADER RESEARCH REGULATORY 5514 03:14:27,854 --> 03:14:29,056 SCIENCE AND DRUG DEVELOPMENT 5515 03:14:29,056 --> 03:14:29,356 COMMUNITIES. 5516 03:14:29,356 --> 03:14:32,426 THIS IS DESIGNED TO ADVANCE 5517 03:14:32,426 --> 03:14:33,593 PROGRESS IN THERAPEUTIC RESEARCH 5518 03:14:33,593 --> 03:14:35,228 AND POPULATIONS THAT HAVE 5519 03:14:35,228 --> 03:14:37,931 HISTORICALLY LAGGED IN ADVANCES. 5520 03:14:37,931 --> 03:14:39,466 PROPOSED GOALS WILL COMPLEMENT 5521 03:14:39,466 --> 03:14:40,968 AND BUILD ON ONGOING MPRINT 5522 03:14:40,968 --> 03:14:41,301 EFFORTS. 5523 03:14:41,301 --> 03:14:42,803 THERE WILL BE A FOCUSED SCOPE 5524 03:14:42,803 --> 03:14:44,237 FOREKNOWLEDGE BASED INTEGRATION, 5525 03:14:44,237 --> 03:14:46,606 STRONGER PRESENCE IN NICHD 5526 03:14:46,606 --> 03:14:47,908 CLINICAL TRIAL NETWORKS AND 5527 03:14:47,908 --> 03:14:49,109 ENHANCED RESOURCE FOR 5528 03:14:49,109 --> 03:14:49,609 DISSEMINATION EFFORTS. 5529 03:14:49,609 --> 03:14:50,944 THERE WILL BE A COMMITTED FOCUS 5530 03:14:50,944 --> 03:14:52,312 ON EXPLORING THE EFFECTS OF 5531 03:14:52,312 --> 03:14:55,515 MEDICATION CLASSES ON HUMAN MILK 5532 03:14:55,515 --> 03:14:57,617 COMPOSITION, ON PEDIATRIC AND 5533 03:14:57,617 --> 03:14:59,353 MATERNAL PHARMACOGENOMICS AND ON 5534 03:14:59,353 --> 03:15:00,454 LEVERAGING REAL WORLD EVIDENCE 5535 03:15:00,454 --> 03:15:03,023 TO ADDRESS KEY KNOWLEDGE DPAPS. 5536 03:15:03,023 --> 03:15:03,357 GAPS. 5537 03:15:03,357 --> 03:15:05,225 THIS ALIGNS WITH NICHD'S 5538 03:15:05,225 --> 03:15:06,526 STRATEGIC PLAN, PARTICULARLY 5539 03:15:06,526 --> 03:15:07,394 THEME FIVE, THAT WILL SUPPORT 5540 03:15:07,394 --> 03:15:09,663 THE BEST PHARMACEUTICALS FOR 5541 03:15:09,663 --> 03:15:11,732 CHILDREN AFTER BPCA AS WELL AS 5542 03:15:11,732 --> 03:15:13,066 THE RESEARCH SPECIFIC TO 5543 03:15:13,066 --> 03:15:14,401 PREGNANT AND LACTATING WOMEN 5544 03:15:14,401 --> 03:15:15,602 EFFORTS OTHERWISE KNOWN AT 5545 03:15:15,602 --> 03:15:16,169 PRGLAC. 5546 03:15:16,169 --> 03:15:18,438 IT ALSO ADDRESSES RESEARCH 5547 03:15:18,438 --> 03:15:19,906 PRIORITIES OVER SEVERAL NICHD 5548 03:15:19,906 --> 03:15:20,807 BRANCHES. 5549 03:15:20,807 --> 03:15:24,811 ADDITIONALLY, MPRINT HAS THE 5550 03:15:24,811 --> 03:15:26,113 POTENTIAL TO ACCELERATE HIV AND 5551 03:15:26,113 --> 03:15:28,482 AIDS RESEARCH THROUGH 5552 03:15:28,482 --> 03:15:30,017 MULTIDISCIPLINARY COLLABORATIONS 5553 03:15:30,017 --> 03:15:31,918 AND INNOVATIVE APPROACHES. 5554 03:15:31,918 --> 03:15:34,187 KEY EFFORTS INCLUDE 5555 03:15:34,187 --> 03:15:36,490 PHARMACOMETRIC ANALYSES AND 5556 03:15:36,490 --> 03:15:37,124 ANTIINFECTED DRUG DEVELOPMENT 5557 03:15:37,124 --> 03:15:39,226 AND STUDIES ON THE EFFECTS OF 5558 03:15:39,226 --> 03:15:41,028 ANTIINFECTIVE AGENTS ON HUMAN 5559 03:15:41,028 --> 03:15:42,763 MILK COMPOSITION. 5560 03:15:42,763 --> 03:15:44,331 CREATING SYNERGIES ACROSS 5561 03:15:44,331 --> 03:15:45,966 INSTITUTE FUNDED INITIATIVES 5562 03:15:45,966 --> 03:15:46,433 PAVING THE WAY FOR THE 5563 03:15:46,433 --> 03:15:48,068 DEVELOPMENT OF SAFE AND 5564 03:15:48,068 --> 03:15:50,270 EFFECTIVE THERAPEUTICS FOR 5565 03:15:50,270 --> 03:15:51,438 MATERNAL AND PEDIATRIC 5566 03:15:51,438 --> 03:15:51,738 POPULATIONS. 5567 03:15:51,738 --> 03:15:53,273 SOME KEY OUTCOMES OF THE CURRENT 5568 03:15:53,273 --> 03:15:53,907 INITIATIVE INCLUDE DEVELOPMENT 5569 03:15:53,907 --> 03:15:58,211 OF THE KNOWLEDGE BASE, THE 5570 03:15:58,211 --> 03:16:00,013 ONTOLOGY AND LITERATURE DATA 5571 03:16:00,013 --> 03:16:02,649 EX-TRACK TOOL IN PORTAL, 5572 03:16:02,649 --> 03:16:03,383 DEVELOPMENT -- AND DEVELOPMENT 5573 03:16:03,383 --> 03:16:04,918 OF PEDIATRIC FEE CODES AND TOOLS 5574 03:16:04,918 --> 03:16:06,953 TO TRACK MATERNAL OPIOID USE. 5575 03:16:06,953 --> 03:16:08,355 MPRINT HAS BEEN TREMENDOUSLY 5576 03:16:08,355 --> 03:16:10,323 SUCCESSFUL IN MAKING PROGRESS 5577 03:16:10,323 --> 03:16:11,691 TOWARDS ITS CURRENT GOALS. 5578 03:16:11,691 --> 03:16:14,327 THANK YOU. 5579 03:16:14,327 --> 03:16:14,995 >> THANK YOU. 5580 03:16:14,995 --> 03:16:25,539 ARE THERE QUESTIONS OR COMMENTS? 5581 03:16:26,873 --> 03:16:28,975 NOT HEARING ANY, OR SEEING ANY 5582 03:16:28,975 --> 03:16:31,978 IN THE CHAT, MAY I ASK FOR A 5583 03:16:31,978 --> 03:16:33,346 MOTION TO APPROVE? 5584 03:16:33,346 --> 03:16:36,850 >> MOTION TO APPROVE. 5585 03:16:36,850 --> 03:16:38,218 >> THANK YOU. 5586 03:16:38,218 --> 03:16:40,053 AND A SECOND? 5587 03:16:40,053 --> 03:16:40,320 >> SECOND. 5588 03:16:40,320 --> 03:16:42,823 >> I'LL SECOND. 5589 03:16:42,823 --> 03:16:51,465 >> AND ALL IN FAVOR? 5590 03:16:51,465 --> 03:16:53,100 >> WE HAVE SEVEN YES VOTES. 5591 03:16:53,100 --> 03:16:55,001 >> THANK YOU SO MUCH. 5592 03:16:55,001 --> 03:16:58,338 NEXT UP, WE HAVE DR. LEIGH ALLEN 5593 03:16:58,338 --> 03:17:01,308 FROM THE CONTRACEPTION RESEARCH 5594 03:17:01,308 --> 03:17:02,609 BRANCH, WHO WILL BE PRESENTING 5595 03:17:02,609 --> 03:17:04,144 EFFECTS OF CONTRACEPTION AS 5596 03:17:04,144 --> 03:17:05,445 TREATMENT FOR GYNECOLOGIC 5597 03:17:05,445 --> 03:17:08,882 DISORDERS. 5598 03:17:08,882 --> 03:17:09,149 DR. ALLEN. 5599 03:17:09,149 --> 03:17:10,350 >> GOOD AFTERNOON, EVERYONE, AND 5600 03:17:10,350 --> 03:17:14,688 THANK YOU. 5601 03:17:14,688 --> 03:17:15,489 PROGRAM SEEKS COUNCIL APPROVAL 5602 03:17:15,489 --> 03:17:18,125 FOR AN INITIATIVE TITLED EFFECTS 5603 03:17:18,125 --> 03:17:19,559 OF CONTRACEPTION AS TREATMENT 5604 03:17:19,559 --> 03:17:21,962 FOR GYNECOLOGIC DISORDERS. 5605 03:17:21,962 --> 03:17:24,331 THE ROUGHLY 100 U.S. MARKETED 5606 03:17:24,331 --> 03:17:25,632 CONTRACEPTIVES ARE USED SAFELY 5607 03:17:25,632 --> 03:17:27,067 BY MOST PEOPLE FOR 5608 03:17:27,067 --> 03:17:28,468 CONTRACEPTION. 5609 03:17:28,468 --> 03:17:30,303 HOWEVER, MANY OF THE PRODUCTS 5610 03:17:30,303 --> 03:17:32,672 ARE USED LONG TERM, OFTEN OFF 5611 03:17:32,672 --> 03:17:34,341 LABEL, TO TREAT GYNECOLOGIC 5612 03:17:34,341 --> 03:17:37,410 CONDITIONS SUCH AS POLYCYSTIC 5613 03:17:37,410 --> 03:17:38,512 OVARY SYNDROME, ENDOMETRIOSIS, 5614 03:17:38,512 --> 03:17:41,381 AND FIBROIDS, WHICH AFFECT 5615 03:17:41,381 --> 03:17:42,349 MILLIONS OF U.S. WOMEN. 5616 03:17:42,349 --> 03:17:44,050 THE COMMON THEME ACROSS THESE 5617 03:17:44,050 --> 03:17:44,918 INDICATIONS IS A LACK OF 5618 03:17:44,918 --> 03:17:46,887 SPECIFIC TREATMENTS. 5619 03:17:46,887 --> 03:17:48,922 THOUGH HORMONAL CONTRACEPTIVES 5620 03:17:48,922 --> 03:17:50,457 ARE TYPICALLY USED BUT THERE ARE 5621 03:17:50,457 --> 03:17:51,892 SCANT DATA ON THE EFFECTIVENESS 5622 03:17:51,892 --> 03:17:53,193 OF DIFFERENT HORMONAL PRODUCTS 5623 03:17:53,193 --> 03:17:55,028 AND REGIMENS. 5624 03:17:55,028 --> 03:17:57,063 THE GOALS OF THIS INITIATIVE ARE 5625 03:17:57,063 --> 03:17:59,266 TO, ONE, SUGGEST TREATMENT 5626 03:17:59,266 --> 03:18:00,667 GUIDELINES TO AID PATIENT 5627 03:18:00,667 --> 03:18:03,336 OUTCOMES AND SATISFACTION WHILE 5628 03:18:03,336 --> 03:18:05,338 GENERATING DATA TO DRIVE BEST 5629 03:18:05,338 --> 03:18:07,507 PRACTICES, AND TWO, OBTAIN 5630 03:18:07,507 --> 03:18:09,809 INSIGHT INTO DRIVERS OF 5631 03:18:09,809 --> 03:18:11,311 CONTRACEPTIVE CHOICE IN TREATING 5632 03:18:11,311 --> 03:18:12,746 GYNECOLOGIC CONDITIONS. 5633 03:18:12,746 --> 03:18:14,247 THE CURRENT SCIENTIFIC 5634 03:18:14,247 --> 03:18:16,016 LITERATURE IS INADEQUATE AS TO 5635 03:18:16,016 --> 03:18:17,717 RELATIVE EFFECTIVENESS OF 5636 03:18:17,717 --> 03:18:19,686 CONTRACEPTIVE TREATMENTS IN THE 5637 03:18:19,686 --> 03:18:21,221 CONTEXT OF OPTIMIZING 5638 03:18:21,221 --> 03:18:24,157 GYNECOLOGIC DISEASE OUTCOMES. 5639 03:18:24,157 --> 03:18:25,225 THIS INITIATIVE WOULD ADDRESS 5640 03:18:25,225 --> 03:18:26,860 THE CURRENT LACK OF SUPPORTING 5641 03:18:26,860 --> 03:18:28,295 DATA AND RIGOR. 5642 03:18:28,295 --> 03:18:30,197 THIS PROPOSED CONCEPT ALIGNS 5643 03:18:30,197 --> 03:18:32,632 WITH NICHD'S STRATEGIC THEMES 5644 03:18:32,632 --> 03:18:36,436 TWO AND FIVE, AND NICHD 5645 03:18:36,436 --> 03:18:39,139 ASPIRATIONAL GOAL, A 5646 03:18:39,139 --> 03:18:40,040 CROSS-CUTTING TOPIC OF HEALTH 5647 03:18:40,040 --> 03:18:41,241 DISPARITIES, INTEREST ACROSS 5648 03:18:41,241 --> 03:18:43,076 MULTIPLE BRANCHES, AND A 5649 03:18:43,076 --> 03:18:44,544 CONTRACEPTION RESEARCH BRANCH 5650 03:18:44,544 --> 03:18:45,011 PROGRAMMATIC PRIORITY. 5651 03:18:45,011 --> 03:18:48,615 THANK YOU. 5652 03:18:48,615 --> 03:18:49,816 >> THANK YOU VERY MUCH. 5653 03:18:49,816 --> 03:18:52,319 ARE THERE QUESTIONS OR COMMENTS 5654 03:18:52,319 --> 03:18:58,525 ABOUT THIS CONCEPT? 5655 03:18:58,525 --> 03:18:58,792 DR. AIZER? 5656 03:18:58,792 --> 03:18:59,192 >> THANK YOU. 5657 03:18:59,192 --> 03:19:01,561 JUST A QUICK QUESTION ABOUT THIS 5658 03:19:01,561 --> 03:19:03,396 AS WELL AS I THINK IT ALSO 5659 03:19:03,396 --> 03:19:07,767 APPLIES TO THE FIRST CONCEPT. 5660 03:19:07,767 --> 03:19:08,902 THAT WAS INTRODUCED WHICH IS 5661 03:19:08,902 --> 03:19:11,071 SORT OF THE IDEA OF LOOKING AT 5662 03:19:11,071 --> 03:19:14,841 DETERMINANTS OF TAKE-UP OF 5663 03:19:14,841 --> 03:19:16,576 CONTRACEPTION USE AND WHETHER OR 5664 03:19:16,576 --> 03:19:17,677 NOT THAT WILL ALSO BE INCLUDED 5665 03:19:17,677 --> 03:19:20,347 AS PART OF THIS CONCEPT AND 5666 03:19:20,347 --> 03:19:22,015 RESEARCH PROGRAM. 5667 03:19:22,015 --> 03:19:25,118 >> THANK YOU FOR THAT FEEDBACK 5668 03:19:25,118 --> 03:19:26,019 OR KIND OF QUESTION ON WHETHER 5669 03:19:26,019 --> 03:19:28,121 OR NOT IT WILL BE INCLUDED. 5670 03:19:28,121 --> 03:19:29,522 WE'LL TAKE THAT INTO ACCOUNT 5671 03:19:29,522 --> 03:19:30,857 WHEN DESIGNING THE OUTCOMES, BUT 5672 03:19:30,857 --> 03:19:32,692 I THINK THAT THAT'S A GREAT 5673 03:19:32,692 --> 03:19:34,394 POINT, AND WOULD LIKELY BE 5674 03:19:34,394 --> 03:19:35,929 INCLUDED IN A NOTICE OF FUNDING 5675 03:19:35,929 --> 03:19:38,999 OPPORTUNITY. 5676 03:19:38,999 --> 03:19:40,533 >> THANKS. 5677 03:19:40,533 --> 03:19:42,569 >> DR. MORENO. 5678 03:19:42,569 --> 03:19:43,370 >> THANK YOU. 5679 03:19:43,370 --> 03:19:44,771 THIS SOUNDS LIKE A REALLY 5680 03:19:44,771 --> 03:19:45,272 EXCITING CONCEPT. 5681 03:19:45,272 --> 03:19:48,275 I WAS CURIOUS IF THERE WERE 5682 03:19:48,275 --> 03:19:49,909 SPECIFICS AROUND THINKING ABOUT 5683 03:19:49,909 --> 03:19:52,045 AGE RANGE OF TYPES OF 5684 03:19:52,045 --> 03:19:53,913 PARTICIPANTS THAT THIS APPROACH 5685 03:19:53,913 --> 03:19:54,981 MIGHT REACH. 5686 03:19:54,981 --> 03:19:56,516 FOR EXAMPLE, WHETHER IT WOULD 5687 03:19:56,516 --> 03:19:58,451 REACH OLDER CHILDREN OR YOUNGER 5688 03:19:58,451 --> 03:20:00,287 ADOLESCENTS AS WELL AS THROUGH 5689 03:20:00,287 --> 03:20:03,256 THE UPPER AGE RANGES. 5690 03:20:03,256 --> 03:20:05,558 >> SO PART OF THE CONTRACEPTION 5691 03:20:05,558 --> 03:20:06,593 RESEARCH BRANCH PROGRAMMATIC 5692 03:20:06,593 --> 03:20:08,561 PRIORITIES IS TO INCLUDE 5693 03:20:08,561 --> 03:20:08,895 ADOLESCENTS. 5694 03:20:08,895 --> 03:20:10,864 AS WAS MENTIONED KIND OF IN THE 5695 03:20:10,864 --> 03:20:12,432 PREAMBLE, WE TRY NOT TO GIVE 5696 03:20:12,432 --> 03:20:14,067 SPECIFICS. 5697 03:20:14,067 --> 03:20:17,137 BUT CERTAINLY OUR PRIORITY COVER 5698 03:20:17,137 --> 03:20:19,739 THE WIDE RANGE OF AGES FOR THOSE 5699 03:20:19,739 --> 03:20:25,578 USING CONTRACEPTION. 5700 03:20:25,578 --> 03:20:32,118 >> DR. VAN DEN VEYVER? 5701 03:20:32,118 --> 03:20:33,720 >> YES, I WOULD LIKE TO ASK IF 5702 03:20:33,720 --> 03:20:35,021 YOU WOULD ALSO INCLUDE OTHER 5703 03:20:35,021 --> 03:20:35,722 HORMONAL TREATMENTS THAT ARE 5704 03:20:35,722 --> 03:20:39,059 LIKE THE EXISTING 5705 03:20:39,059 --> 03:20:40,093 CONTRACEPTIVES, OR IS THIS GOING 5706 03:20:40,093 --> 03:20:43,730 TO BE FOCUSED ON EXISTING 5707 03:20:43,730 --> 03:20:45,031 MARKETED CONTRACEPTIVE AGENTS 5708 03:20:45,031 --> 03:20:48,768 USED FOR THIS PURPOSE? 5709 03:20:48,768 --> 03:20:50,236 >> CAN YOU GIVE ME AN EXAMPLE OF 5710 03:20:50,236 --> 03:20:51,204 WHAT YOU'RE TALKING ABOUT OTHER 5711 03:20:51,204 --> 03:20:52,739 THAN THE MARKETED HORMONAL 5712 03:20:52,739 --> 03:20:54,741 CONTRACEPTIVES? 5713 03:20:54,741 --> 03:20:58,378 >> I GUESS IS IT GOING TO SPAN A 5714 03:20:58,378 --> 03:21:02,315 WIDER NET IN CASE THERE IS A 5715 03:21:02,315 --> 03:21:03,750 NOVEL POTENTIAL FORMULATION 5716 03:21:03,750 --> 03:21:05,819 DEVELOPED THAT IS NOT CURRENTLY 5717 03:21:05,819 --> 03:21:10,123 ON THE MARKET MORE DEDICATED TO 5718 03:21:10,123 --> 03:21:13,526 THESE GYNECOLOGIC PATHOLOGIES? 5719 03:21:13,526 --> 03:21:15,495 >> SO WILL THE SCOPE GO BEYOND 5720 03:21:15,495 --> 03:21:17,430 CURRENTLY MARKETED 5721 03:21:17,430 --> 03:21:18,231 CONTRACEPTIVES? 5722 03:21:18,231 --> 03:21:20,400 WE CAN TAKE THAT INTO 5723 03:21:20,400 --> 03:21:20,834 CONSIDERATION. 5724 03:21:20,834 --> 03:21:22,102 I APPRECIATE THAT FEEDBACK. 5725 03:21:22,102 --> 03:21:24,938 BECAUSE THE LANGUAGE IN THIS WAS 5726 03:21:24,938 --> 03:21:34,681 MARKETED CONTRACEPTIVES. 5727 03:21:34,681 --> 03:21:35,215 >> THANK YOU. 5728 03:21:35,215 --> 03:21:39,986 I SEE THAT THERE IS A COMMENT 5729 03:21:39,986 --> 03:21:41,187 FROM DR. COLE HERE. 5730 03:21:41,187 --> 03:21:42,188 DR. COLE, DO YOU WANT TO JUST 5731 03:21:42,188 --> 03:21:43,690 COME OFF MUTE AND READ YOUR 5732 03:21:43,690 --> 03:21:46,993 QUESTION? 5733 03:21:46,993 --> 03:21:48,595 >> YES, I'VE HAD A CONVERSATION 5734 03:21:48,595 --> 03:21:51,197 WITH DR. BATES VIA THE CHAT, SO 5735 03:21:51,197 --> 03:21:52,532 I THINK WE'RE GOOD TO GO. 5736 03:21:52,532 --> 03:21:56,870 THANK YOU. 5737 03:21:56,870 --> 03:21:58,738 >> OKAY. 5738 03:21:58,738 --> 03:22:00,039 EXCELLENT. 5739 03:22:00,039 --> 03:22:01,241 ALL RIGHT. 5740 03:22:01,241 --> 03:22:02,976 WELL THEN, IF THERE ARE NO 5741 03:22:02,976 --> 03:22:06,913 FURTHER QUESTIONS OR COMMENTS, 5742 03:22:06,913 --> 03:22:08,415 LET ME ASK FOR A MOTION TO 5743 03:22:08,415 --> 03:22:10,183 APPROVE. 5744 03:22:10,183 --> 03:22:12,352 >> SO MOVED. 5745 03:22:12,352 --> 03:22:20,260 >> AND A SECOND? 5746 03:22:20,260 --> 03:22:20,927 ALL RIGHT. 5747 03:22:20,927 --> 03:22:30,703 AND ALL IN FAVOR? 5748 03:22:30,703 --> 03:22:32,305 >> WE HAVE SEVEN YESES. 5749 03:22:32,305 --> 03:22:42,649 >> OKAY, THANK YOU. 5750 03:22:43,616 --> 03:22:46,085 FINALLY, I'M GOING TO INTRODUCE 5751 03:22:46,085 --> 03:22:47,720 DR. MIN LEE FROM THE DIVISION OF 5752 03:22:47,720 --> 03:22:51,491 POPULATION HEALTH RESEARCH 5753 03:22:51,491 --> 03:22:52,492 DIVISION TO PRESENT THE 5754 03:22:52,492 --> 03:22:54,260 BIOLOGICAL TESTING FACILITY. 5755 03:22:54,260 --> 03:22:57,297 >> THANK YOU. 5756 03:22:57,297 --> 03:22:58,498 PROGRAM SEEKS COUNCIL APPROVAL 5757 03:22:58,498 --> 03:23:00,300 FOR A RECOMPETE OF AN INITIATIVE 5758 03:23:00,300 --> 03:23:02,502 TITLED BIOLOGICAL TESTING 5759 03:23:02,502 --> 03:23:03,269 FACILITY. 5760 03:23:03,269 --> 03:23:03,837 BTF. 5761 03:23:03,837 --> 03:23:06,306 THIS INITIATIVE SPANS BOTH DI R 5762 03:23:06,306 --> 03:23:08,141 AND D ER IN RESEARCH AND 5763 03:23:08,141 --> 03:23:10,310 DEVELOPMENT OF SAFE AND 5764 03:23:10,310 --> 03:23:14,013 EFFECTIVE CONTRACEPTION 5765 03:23:14,013 --> 03:23:14,681 REPRODUCTIVE HEALTH AND 5766 03:23:14,681 --> 03:23:15,548 THERAPEUTICS FOR WOMEN AND MEN. 5767 03:23:15,548 --> 03:23:17,083 IN THE UNITED STATES, NEARLY 5768 03:23:17,083 --> 03:23:20,420 HALF OF ALL PREGNANCIES ARE 5769 03:23:20,420 --> 03:23:21,421 UNINTENDED. 5770 03:23:21,421 --> 03:23:22,922 THIS RATE IS THE HIGHEST AMONG 5771 03:23:22,922 --> 03:23:25,558 DEVELOPED NATIONS. 5772 03:23:25,558 --> 03:23:27,360 THERE IS A CLEAR NEED FOR 5773 03:23:27,360 --> 03:23:29,562 ALTERNATIVE OR IMPROVED 5774 03:23:29,562 --> 03:23:30,997 CONTRACEPTIVE METHODS THAT MEET 5775 03:23:30,997 --> 03:23:32,165 THE REQUIREMENTS OF BOTH WOMEN 5776 03:23:32,165 --> 03:23:33,766 AND MEN. 5777 03:23:33,766 --> 03:23:34,767 THROUGHOUT THEIR 5778 03:23:34,767 --> 03:23:35,869 REPRODUCTIVE LIVES. 5779 03:23:35,869 --> 03:23:37,504 ADDITIONALLY, THERE'S A CRITICAL 5780 03:23:37,504 --> 03:23:39,138 NEED TO FACILITATE THE 5781 03:23:39,138 --> 03:23:40,974 DEVELOPMENT OF NEW REPRODUCTIVE 5782 03:23:40,974 --> 03:23:43,576 HEALTH-RELATED THERAPIES. 5783 03:23:43,576 --> 03:23:46,379 THE BTF WITH SEVERAL CYCLES OF 5784 03:23:46,379 --> 03:23:47,914 HISTORY FULFILLS A UNIQUE ROLE 5785 03:23:47,914 --> 03:23:50,517 IN BRIDGING THE DISCOVERY TO THE 5786 03:23:50,517 --> 03:23:53,653 DEVELOPMENT AND APPROVAL OF THE 5787 03:23:53,653 --> 03:23:54,654 CONTRACEPTIVE AND REPRODUCTIVE 5788 03:23:54,654 --> 03:23:55,955 HEALTH PRODUCTS. 5789 03:23:55,955 --> 03:23:58,525 THIS FACILITY PROVIDES IN VITRO 5790 03:23:58,525 --> 03:23:59,759 AND IN VIVO STUDIES THAT ARE 5791 03:23:59,759 --> 03:24:03,029 NEEDED AS PART OF A PRE-CLINICAL 5792 03:24:03,029 --> 03:24:08,768 DATA PACKAGE NECESSARY FOR FIL 5793 03:24:08,768 --> 03:24:10,203 FILING AN NIND. 5794 03:24:10,203 --> 03:24:16,209 THE BTF PROITS A PRE-CLINICAL 5795 03:24:16,209 --> 03:24:18,811 DATA FOR NUMEROUS PHASE ONE AND 5796 03:24:18,811 --> 03:24:19,646 PHASE TWO CLINICAL STUDIES AND 5797 03:24:19,646 --> 03:24:28,288 AN APPROVED DRUG 5798 03:24:28,288 --> 03:24:29,122 ULLIPISALACETATE. 5799 03:24:29,122 --> 03:24:30,023 THIS CLINICAL STUDIES CONDUCTED 5800 03:24:30,023 --> 03:24:31,858 BY OUR CONTRACEPTIVE CLINICAL 5801 03:24:31,858 --> 03:24:33,393 TRIALS NETWORK. 5802 03:24:33,393 --> 03:24:34,260 THE PRIMARY GOAL OF THIS 5803 03:24:34,260 --> 03:24:35,695 INITIATIVE IS TO DEVELOP NOVEL 5804 03:24:35,695 --> 03:24:36,896 AND IMPROVE METHODS OF 5805 03:24:36,896 --> 03:24:38,464 CONTRACEPTION WITH ADDITIONAL 5806 03:24:38,464 --> 03:24:41,334 INDICATIONS FOR REPRODUCTIVE 5807 03:24:41,334 --> 03:24:43,636 HEALTH AND THERAPEUTICS TO FILL 5808 03:24:43,636 --> 03:24:44,504 THE UNMET NEEDS. 5809 03:24:44,504 --> 03:24:46,205 THIS CONCEPT CLEARANCE IS IN 5810 03:24:46,205 --> 03:24:48,308 ALIGNMENT WITH NICHD STRATEGIC 5811 03:24:48,308 --> 03:24:53,046 PLAN THEME TWO IN PROMOTING 5812 03:24:53,046 --> 03:24:55,148 GYNECOLOGIC, ANDROLOGIC AND 5813 03:24:55,148 --> 03:24:57,884 REPRODUCTIVE HEALTH AND A 5814 03:24:57,884 --> 03:24:58,651 CONTRACEPTIVE DEVELOPMENT 5815 03:24:58,651 --> 03:24:59,052 PROGRAMS PRIORITY. 5816 03:24:59,052 --> 03:25:00,153 THANK YOU. 5817 03:25:00,153 --> 03:25:01,588 >> THANK YOU VERY MUCH. 5818 03:25:01,588 --> 03:25:04,223 ARE THERE ANY COMMENTS OR 5819 03:25:04,223 --> 03:25:12,332 QUESTIONS FOR DR. LEE? 5820 03:25:12,332 --> 03:25:16,002 NOT SEEING OR HEARING ANY, DO WE 5821 03:25:16,002 --> 03:25:17,971 HAVE A MOTION TO APPROVE THIS 5822 03:25:17,971 --> 03:25:22,709 CONCEPT? 5823 03:25:22,709 --> 03:25:26,212 >DO YOU HAVE A QUESTION? 5824 03:25:26,212 --> 03:25:26,746 >> I DO. 5825 03:25:26,746 --> 03:25:27,880 DO YOU HAVE A SENSE OF HOW MUCH 5826 03:25:27,880 --> 03:25:30,049 OF THIS WILL BE FOCUSED ON 5827 03:25:30,049 --> 03:25:32,585 CONTRACEPTION METHODS FOR MEN 5828 03:25:32,585 --> 03:25:33,620 VERSUS WOMEN? 5829 03:25:33,620 --> 03:25:35,355 JUST SORT OF READING THROUGH IT. 5830 03:25:35,355 --> 03:25:40,393 THERE SEEMS TO BE AT LEAST 5831 03:25:40,393 --> 03:25:41,561 PRELIMINARILY SLIGHTLY MORE 5832 03:25:41,561 --> 03:25:42,996 EMPHASIS ON MALE CONTRACEPTION. 5833 03:25:42,996 --> 03:25:45,498 >> NO, THIS IS NOT PURELY ON 5834 03:25:45,498 --> 03:25:48,401 MALE CONTRACEPTION. 5835 03:25:48,401 --> 03:25:50,269 THROUGH THIS PROGRAM, WE FUNDED 5836 03:25:50,269 --> 03:25:54,407 AND DID A LOT OF RESEARCH ON 5837 03:25:54,407 --> 03:25:56,476 WOMEN'S INJECTABLE WHICH WE ARE 5838 03:25:56,476 --> 03:26:00,380 CONTINUOUSLY DOING, SO AT THIS 5839 03:26:00,380 --> 03:26:02,482 POINT, YES, SO I THINK I WOULD 5840 03:26:02,482 --> 03:26:06,753 SAY RIGHT NOW, IT'S PROBABLY 5841 03:26:06,753 --> 03:26:10,757 HALF AND HALF. 5842 03:26:10,757 --> 03:26:12,258 I DON'T KNOW EXACT FUNDING BUT 5843 03:26:12,258 --> 03:26:14,127 THAT IS CURRENT THOUGHT. 5844 03:26:14,127 --> 03:26:17,463 >> SO IT WILL CONTINUE AT THAT 5845 03:26:17,463 --> 03:26:17,997 RATE, THAT BREAKDOWN? 5846 03:26:17,997 --> 03:26:22,502 >> NO, FOR US, WE'RE VERY 5847 03:26:22,502 --> 03:26:28,441 FLEXIBLE IN TERMS OF DOING A LOT 5848 03:26:28,441 --> 03:26:29,809 OF THE -- WORK AND THE 5849 03:26:29,809 --> 03:26:30,343 PRE-CLINICAL WORK. 5850 03:26:30,343 --> 03:26:32,845 SO IF WE ARE FACED WITH SOME 5851 03:26:32,845 --> 03:26:34,080 DIFFICULTY IN ONE AREA AND WE 5852 03:26:34,080 --> 03:26:36,749 NEED TO WAIT FOR CERTAIN DATA TO 5853 03:26:36,749 --> 03:26:38,518 COME BACK TO US, THEN WE CAN 5854 03:26:38,518 --> 03:26:42,121 PRIORITIZE ANOTHER PROGRAM OR 5855 03:26:42,121 --> 03:26:46,592 ANOTHER STUDY TO CONTINUE AND 5856 03:26:46,592 --> 03:26:48,795 WORK ON THAT ISSUE. 5857 03:26:48,795 --> 03:26:50,596 >> LET ME JUST REMIND YOU THAT 5858 03:26:50,596 --> 03:26:52,165 OF COURSE THIS IS A CONCEPT 5859 03:26:52,165 --> 03:26:54,300 RATHER THAN A DISCUSSION OF THE 5860 03:26:54,300 --> 03:26:57,904 EXACT WORK THAT WILL BE 5861 03:26:57,904 --> 03:26:59,338 SUPPORTED ON THE PROJECTS. 5862 03:26:59,338 --> 03:27:00,339 DR. CEDARS? 5863 03:27:00,339 --> 03:27:02,775 >> I WAS JUST CURIOUS, I THINK 5864 03:27:02,775 --> 03:27:05,411 THIS MAY HAVE BEEN RAISED AS A 5865 03:27:05,411 --> 03:27:06,612 CONCEPT AT THE SEPTEMBER 5866 03:27:06,612 --> 03:27:08,781 MEETING, AND I JUST -- IS THIS A 5867 03:27:08,781 --> 03:27:09,649 CONTINUATION OF THAT? 5868 03:27:09,649 --> 03:27:11,918 IS THIS A RENEWAL? 5869 03:27:11,918 --> 03:27:14,020 HOW IS THAT SORT OF -- SOME OF 5870 03:27:14,020 --> 03:27:16,155 THESE ARE NEW AND SOME SEEM LIKE 5871 03:27:16,155 --> 03:27:16,489 CONTINUATION. 5872 03:27:16,489 --> 03:27:18,391 I JUST WANTED TO CLARIFY. 5873 03:27:18,391 --> 03:27:19,459 >> O I SEE. 5874 03:27:19,459 --> 03:27:20,393 OKAY. 5875 03:27:20,393 --> 03:27:22,695 SO THANK YOU FOR THAT QUESTION. 5876 03:27:22,695 --> 03:27:23,563 QUESTION/COMMENT. 5877 03:27:23,563 --> 03:27:28,768 SO THE FIRST -- SEPTEMBER, WE 5878 03:27:28,768 --> 03:27:30,203 DID GET APPROVAL FOR THIS 5879 03:27:30,203 --> 03:27:31,571 CONCEPT, BUT WHAT WE WANTED TO 5880 03:27:31,571 --> 03:27:33,039 DO WAS CLARIFY THE FACT THAT 5881 03:27:33,039 --> 03:27:35,875 THIS ALSO INCLUDES REPRODUCTIVE 5882 03:27:35,875 --> 03:27:36,109 HEALTH. 5883 03:27:36,109 --> 03:27:38,377 AND WE WANTED TO MAKE CLEAR THAT 5884 03:27:38,377 --> 03:27:40,580 THIS CONCEPT HAS THAT LANGUAGE. 5885 03:27:40,580 --> 03:27:43,249 SO THIS IS THE REASON WHY WE'RE 5886 03:27:43,249 --> 03:27:44,884 PRESENTING THIS AGAIN. 5887 03:27:44,884 --> 03:27:51,691 THANK YOU. 5888 03:27:51,691 --> 03:27:58,898 >> OTHER COMMENTS OR QUESTIONS? 5889 03:27:58,898 --> 03:28:00,099 ALL RIGHT THEN. 5890 03:28:00,099 --> 03:28:03,269 CAN I HAVE A MOTION TO APPROVE? 5891 03:28:03,269 --> 03:28:05,538 >> SO MOVED. 5892 03:28:05,538 --> 03:28:07,406 >> AND A SECOND 70 5893 03:28:07,406 --> 03:28:12,478 >> SECOND. 5894 03:28:12,478 --> 03:28:12,645 70? 5895 03:28:12,645 --> 03:28:13,146 >> SECOND. 5896 03:28:13,146 --> 03:28:19,185 >> ALL IN FAVOR, PLEASE VOTE. 5897 03:28:19,185 --> 03:28:20,186 >> SEVEN YESES. 5898 03:28:20,186 --> 03:28:21,087 >> ALL RIGHT, THANK YOU. 5899 03:28:21,087 --> 03:28:25,091 AND JUST BEFORE WE MOVE ON, I 5900 03:28:25,091 --> 03:28:28,628 WONDER, DR. SAMEDY-BATES, IF YOU 5901 03:28:28,628 --> 03:28:30,630 COULD COME BACK ON FOR ONE 5902 03:28:30,630 --> 03:28:31,597 MOMENT. 5903 03:28:31,597 --> 03:28:33,232 MY COLLEAGUES POINT OUT THAT OF 5904 03:28:33,232 --> 03:28:35,668 COURSE NO ONE CAN SEE DR. COLE'S 5905 03:28:35,668 --> 03:28:36,302 COMMENTS IN THE CHAT IF THEY'RE 5906 03:28:36,302 --> 03:28:37,069 ON THE VIDEOCAST. 5907 03:28:37,069 --> 03:28:41,107 SO I'M JUST GOING TO READ OUT 5908 03:28:41,107 --> 03:28:42,942 HIS COMMENT, AND OF COURSE HE'S 5909 03:28:42,942 --> 03:28:43,943 WELCOME TO COME ON ALSO, AND IF 5910 03:28:43,943 --> 03:28:47,113 YOU JUST WANT TO TELL US, KIND 5911 03:28:47,113 --> 03:28:48,714 OF WHAT IT WAS YOU CHATTED ABOUT 5912 03:28:48,714 --> 03:28:51,117 WITH HIM AND THAT WAY IT WILL 5913 03:28:51,117 --> 03:28:51,984 BENEFIT WHOEVER WAS VIEWING. 5914 03:28:51,984 --> 03:28:56,222 SO WHAT DR. COLE WROTE WAS, WILL 5915 03:28:56,222 --> 03:28:58,191 C-PATH BE THE PRIMARY 5916 03:28:58,191 --> 03:28:58,825 COLLABORATIVE CONNECTION WITH 5917 03:28:58,825 --> 03:29:00,693 THE FDA AND WILL PHARMACEUTICAL 5918 03:29:00,693 --> 03:29:01,994 VENDORS BE INCLUDED? 5919 03:29:01,994 --> 03:29:03,296 AND IF YOU JUST WANTED TO 5920 03:29:03,296 --> 03:29:04,297 COMMENT BRIEFLY. 5921 03:29:04,297 --> 03:29:05,932 >> YES. 5922 03:29:05,932 --> 03:29:09,001 WHAT I HAD MENTIONED TO DR. COLE 5923 03:29:09,001 --> 03:29:10,503 WAS THAT MPRINT INVESTIGATORS 5924 03:29:10,503 --> 03:29:13,673 ARE IN COLLABORATIONS WITH 5925 03:29:13,673 --> 03:29:15,408 C-PATH, IN ADDITION TO SOME 5926 03:29:15,408 --> 03:29:16,809 OTHER COLLABORATIONS WITH FDA 5927 03:29:16,809 --> 03:29:18,444 BUT I DID WANT TO LET HIM KNOW 5928 03:29:18,444 --> 03:29:21,514 THAT WE ARE WORKING WITH C-PATH 5929 03:29:21,514 --> 03:29:23,449 AND HOPEFULLY WE PLAN TO BUILD A 5930 03:29:23,449 --> 03:29:26,285 STRONGER COLLABORATION WITH 5931 03:29:26,285 --> 03:29:26,619 VERSION 2.0. 5932 03:29:26,619 --> 03:29:27,920 ALSO MENTIONED THAT WE DON'T 5933 03:29:27,920 --> 03:29:29,989 YET -- WE HAVE NOT YET INCLUDED 5934 03:29:29,989 --> 03:29:30,957 PHARMACEUTICAL VENDORS BUT THIS 5935 03:29:30,957 --> 03:29:32,391 IS ALSO SOMETHING THAT WE COULD 5936 03:29:32,391 --> 03:29:37,263 POTENTIALLY THINK ABOUT FOR 5937 03:29:37,263 --> 03:29:38,130 MPRINT VERSION 2.0. 5938 03:29:38,130 --> 03:29:39,899 AND THEN ALSO JUST WANTED TO 5939 03:29:39,899 --> 03:29:44,003 MAKE EVERYONE AWARE OF MPRINT'S 5940 03:29:44,003 --> 03:29:45,872 ANNUAL MEETING, WHERE WE SHARE 5941 03:29:45,872 --> 03:29:46,973 MORE SPECIFIC INFORMATION FOR 5942 03:29:46,973 --> 03:29:48,741 THOSE THAT ARE INTERESTED, AND 5943 03:29:48,741 --> 03:29:50,710 THAT'S PUBLICLY AVAILABLE. 5944 03:29:50,710 --> 03:29:53,112 >> I WAS JUST TRYING TO MAKE THE 5945 03:29:53,112 --> 03:29:54,380 POINT THAT IN MY VERY LIMITED 5946 03:29:54,380 --> 03:29:57,316 EXPERIENCE WITH DRUG 5947 03:29:57,316 --> 03:30:01,888 DEVELOPMENT, THAT THE FDA IS AN 5948 03:30:01,888 --> 03:30:02,288 IMPORTANT PARTNER. 5949 03:30:02,288 --> 03:30:05,091 THE FDA HAS MANY DIFFERENT 5950 03:30:05,091 --> 03:30:05,625 PARTS. 5951 03:30:05,625 --> 03:30:07,059 SOMETIMES THE PARTS DO NOT 5952 03:30:07,059 --> 03:30:08,594 ALWAYS AGREE. 5953 03:30:08,594 --> 03:30:12,064 SO HAVING AN INTERNAL FDA 5954 03:30:12,064 --> 03:30:15,568 ADVOCATE MIGHT -- INVOLVED EARLY 5955 03:30:15,568 --> 03:30:17,169 ON IN THE PROCESS OR IN THE 5956 03:30:17,169 --> 03:30:18,170 PROCESS MIGHT BE A 5957 03:30:18,170 --> 03:30:22,975 CONSIDERATION, AND ALSO I THINK 5958 03:30:22,975 --> 03:30:26,279 ENGAGING POTENTIALLY INTERESTED 5959 03:30:26,279 --> 03:30:29,448 PHARMACEUTICAL COMPANIES, 5960 03:30:29,448 --> 03:30:32,818 ESPECIALLY WHEN THE FDA IS 5961 03:30:32,818 --> 03:30:34,754 PROVIDING INFORMATION FOR THOSE 5962 03:30:34,754 --> 03:30:40,359 COMPANIES, MIGHT BE A WAY OF 5963 03:30:40,359 --> 03:30:42,028 ACCELERATING IMPLEMENTATION OF 5964 03:30:42,028 --> 03:30:42,628 CLINICAL TRIALS. 5965 03:30:42,628 --> 03:30:45,564 THANK YOU VERY MUCH. 5966 03:30:45,564 --> 03:30:47,466 >> THANK YOU. 5967 03:30:47,466 --> 03:30:49,669 I SEE AARON POLLACK, WHO'S THE 5968 03:30:49,669 --> 03:30:51,337 CHIEF OF THIS BRANCH, WANTED TO 5969 03:30:51,337 --> 03:30:53,306 MAKE A COMMENT. 5970 03:30:53,306 --> 03:30:53,506 AARON? 5971 03:30:53,506 --> 03:30:54,640 >> THAT'S A FANTASTIC QUESTION 5972 03:30:54,640 --> 03:30:55,341 AND LINE OF THOUGHTS. 5973 03:30:55,341 --> 03:30:56,976 IN ADDITION TO WHAT LESLIE 5974 03:30:56,976 --> 03:30:57,877 MENTIONED, I DO WANT TO ADD A 5975 03:30:57,877 --> 03:31:00,079 LITTLE BIT MORE BROADLY ABOUT 5976 03:31:00,079 --> 03:31:04,283 INTERACTIONS THAT OBBTB HAS. 5977 03:31:04,283 --> 03:31:05,584 WE MEET WITH MULTIPLE OFFICES 5978 03:31:05,584 --> 03:31:07,053 WITHIN THE FDA TO DISCUSS 5979 03:31:07,053 --> 03:31:08,554 PEDIATRIC AS WELL AS MATERNAL 5980 03:31:08,554 --> 03:31:09,722 THERAPEUTIC AND DRUG 5981 03:31:09,722 --> 03:31:10,723 DEVELOPMENT, AND ACTUALLY WE DID 5982 03:31:10,723 --> 03:31:12,158 WORK WITH SEVERAL OF THEM SINCE 5983 03:31:12,158 --> 03:31:13,359 THEY ARE WITHIN THE FEDERAL 5984 03:31:13,359 --> 03:31:14,860 GOVERNMENT DURING THE 5985 03:31:14,860 --> 03:31:16,629 DEVELOPMENT OF THE RFAs FOR 5986 03:31:16,629 --> 03:31:17,596 MPRINT VERSION 1. 5987 03:31:17,596 --> 03:31:19,031 AND WE WILL, OF COURSE, REACH 5988 03:31:19,031 --> 03:31:21,400 OUT TO THEM FOR SOME INPUT. 5989 03:31:21,400 --> 03:31:22,368 WE OF COURSE CAN'T GET THAT 5990 03:31:22,368 --> 03:31:24,136 LEVEL OF INPUT FROM THE 5991 03:31:24,136 --> 03:31:24,904 PHARMACEUTICAL INDUSTRY, BUT I 5992 03:31:24,904 --> 03:31:26,272 ALSO DO WANT TO HIGHLIGHT THAT 5993 03:31:26,272 --> 03:31:28,808 THE BRANCH WORKS VERY CLOSELY 5994 03:31:28,808 --> 03:31:30,843 WITH THE FOUNDATION FOR THE NIH 5995 03:31:30,843 --> 03:31:33,879 AS WELL AS C-PATH IN TERMS -- AS 5996 03:31:33,879 --> 03:31:34,480 WELL AS ALSO THE NATIONAL 5997 03:31:34,480 --> 03:31:36,649 ACADEMY OF SCIENCE'S DRUG FORUM 5998 03:31:36,649 --> 03:31:40,453 IN TERMS OF SEEKING INPUT FROM 5999 03:31:40,453 --> 03:31:41,554 THE PHARMACEUTICAL SECTOR AND 6000 03:31:41,554 --> 03:31:41,921 COMPANIES THERE. 6001 03:31:41,921 --> 03:31:45,391 WE HAVE TO HANDLE THAT 6002 03:31:45,391 --> 03:31:46,158 APPROPRIATELY THROUGH GROUPS 6003 03:31:46,158 --> 03:31:48,461 SUCH AS THAT. 6004 03:31:48,461 --> 03:31:50,296 >> THAT'S GREAT. 6005 03:31:50,296 --> 03:31:50,863 THANK YOU VERY MUCH. 6006 03:31:50,863 --> 03:31:52,932 I THINK THE FNIH WOULD BE A 6007 03:31:52,932 --> 03:31:55,134 GREAT PARTNER AS WELL. 6008 03:31:55,134 --> 03:31:56,168 >> THANK YOU. 6009 03:31:56,168 --> 03:31:57,303 THIS WAS A GREAT DISCUSSION. 6010 03:31:57,303 --> 03:32:00,039 THANK YOU VERY, VERY MUCH. 6011 03:32:00,039 --> 03:32:01,574 DR. BIANCHI. 6012 03:32:01,574 --> 03:32:09,548 >> THANK YOU, DR. RASOOLY. 6013 03:32:09,548 --> 03:32:10,216 THROUGH ALL FOR YOUR 6014 03:32:10,216 --> 03:32:10,950 CONSIDERATION OF THE CONCEPTS. 6015 03:32:10,950 --> 03:32:13,686 WE ARE NOW GOING TO HEAR FROM 6016 03:32:13,686 --> 03:32:15,855 DR. THERESA CRUZ, DIRECTOR OF 6017 03:32:15,855 --> 03:32:17,490 THE NATIONAL CENTER FOR MEDICAL 6018 03:32:17,490 --> 03:32:18,257 REHABILITATION RESEARCH WHICH IS 6019 03:32:18,257 --> 03:32:22,294 HOUSED IN NICHD. 6020 03:32:22,294 --> 03:32:25,765 THE NCMRR IS PART OF NICHD AND 6021 03:32:25,765 --> 03:32:27,633 COORDINATES NIH MEDICAL 6022 03:32:27,633 --> 03:32:30,136 REHABILITATION RESEARCH. 6023 03:32:30,136 --> 03:32:32,438 EVERY FIVE YEARS, NCMRR IS 6024 03:32:32,438 --> 03:32:36,075 CHARGED WITH REVIEWING THE NIH 6025 03:32:36,075 --> 03:32:37,910 RESEARCH PLAN ON REHABILITATION. 6026 03:32:37,910 --> 03:32:40,413 THAT'S THE OVERALL NIH RESEARCH 6027 03:32:40,413 --> 03:32:43,682 PLAN. 6028 03:32:43,682 --> 03:32:44,583 DR. CRUZ IS GOING TO PRESENT 6029 03:32:44,583 --> 03:32:47,286 SOME OF THE HIGHLIGHTS OF THE 6030 03:32:47,286 --> 03:32:49,688 DRAFT 2025 PLAN TO YOU. 6031 03:32:49,688 --> 03:32:51,023 DR. CRUZ, OVER TO YOU. 6032 03:32:51,023 --> 03:32:53,526 >> THANK YOU, AND THANK YOU FOR 6033 03:32:53,526 --> 03:32:54,794 THE OPPORTUNITY TO TELL YOU A 6034 03:32:54,794 --> 03:32:56,762 LITTLE BIT ABOUT NCMRR. 6035 03:32:56,762 --> 03:32:59,198 WE HAVE SO MANY NEW 6036 03:32:59,198 --> 03:32:59,632 COUNCILMEMBERS. 6037 03:32:59,632 --> 03:33:01,367 SEVERAL ARE VERY FAMILIAR WITH 6038 03:33:01,367 --> 03:33:02,301 OUR WORK. 6039 03:33:02,301 --> 03:33:03,903 BUT MANY DO NOT KNOW WHO WE ARE. 6040 03:33:03,903 --> 03:33:06,305 SO I'M GOING TO TAKE A COUPLE 6041 03:33:06,305 --> 03:33:06,906 MINUTES, IF YOU COULD GO AHEAD 6042 03:33:06,906 --> 03:33:10,209 TO THE NEXT SLIDE AND ONE MORE. 6043 03:33:10,209 --> 03:33:12,678 TO TELL YOU A LITTLE BIT ABOUT 6044 03:33:12,678 --> 03:33:12,945 NCMRR. 6045 03:33:12,945 --> 03:33:16,449 WE WERE ESTABLISHED IN 1990. 6046 03:33:16,449 --> 03:33:18,651 A FEW MONTHS AFTER THE SIGNING 6047 03:33:18,651 --> 03:33:19,985 OF THE AMERICANS WITH 6048 03:33:19,985 --> 03:33:21,253 DISABILITIES ACT. 6049 03:33:21,253 --> 03:33:24,857 AND WE WERE CREATED TO BE A HOME 6050 03:33:24,857 --> 03:33:26,492 AT NIH TO CONDUCT AND SUPPORT 6051 03:33:26,492 --> 03:33:28,561 RESEARCH AND TRAINING ON THE 6052 03:33:28,561 --> 03:33:29,762 SCIENCE NEEDED TO SUPPORT PEOPLE 6053 03:33:29,762 --> 03:33:31,831 WITH PHYSICAL DISABILITIES. 6054 03:33:31,831 --> 03:33:33,799 AND WE'VE HAD A GREAT HOME AT 6055 03:33:33,799 --> 03:33:38,003 NICHD SINCE THEN. 6056 03:33:38,003 --> 03:33:40,606 SO HERE YOU CAN SEE IS OUR 6057 03:33:40,606 --> 03:33:42,141 MISSION TO SUPPORT THE 6058 03:33:42,141 --> 03:33:43,676 SCIENTIFIC KNOWLEDGE NEEDED TO 6059 03:33:43,676 --> 03:33:45,644 ENHANCE THE HEALTH, 6060 03:33:45,644 --> 03:33:46,278 PRODUCTIVITY, INDEPENDENCE AND 6061 03:33:46,278 --> 03:33:48,914 QUALITY OF LIFE FOR PEOPLE WITH 6062 03:33:48,914 --> 03:33:50,649 PHYSICAL DISABILITIES. 6063 03:33:50,649 --> 03:33:53,052 WE ALSO HAVE SPECIAL LANGUAGE 6064 03:33:53,052 --> 03:33:55,354 CALLING OUT THE SUPPORTIVE 6065 03:33:55,354 --> 03:33:56,655 PROSTHETICS AND ORTHOTICS 6066 03:33:56,655 --> 03:33:59,058 RESEARCH, FOR EXAMPLE. 6067 03:33:59,058 --> 03:34:01,260 WE ALSO HAVE LANGUAGE THAT 6068 03:34:01,260 --> 03:34:03,996 INSTRUCTS US TO COLLABORATE AND 6069 03:34:03,996 --> 03:34:05,931 COORDINATE WITH OTHER FEDERAL 6070 03:34:05,931 --> 03:34:08,400 AGENCIES AS WELL AS ACROSS NIH 6071 03:34:08,400 --> 03:34:11,303 IN SUPPORTING REHAB RESEARCH. 6072 03:34:11,303 --> 03:34:15,141 BUT WE OPERATE LARGELY LIKE A 6073 03:34:15,141 --> 03:34:16,542 DER BRANCH DIVISION OF 6074 03:34:16,542 --> 03:34:18,410 EXTRAMURAL RESEARCH BRANCH, SO 6075 03:34:18,410 --> 03:34:20,813 WE SUPPORT RESEARCH GRANTS, 6076 03:34:20,813 --> 03:34:22,448 TRAINING, CAREER DEVELOPMENT 6077 03:34:22,448 --> 03:34:24,083 ACTIVITY, SMALL BUSINESS, AND 6078 03:34:24,083 --> 03:34:29,755 INFRASTRUCTURE. 6079 03:34:29,755 --> 03:34:31,524 SO I MENTIONED WE WERE FOUNDED 6080 03:34:31,524 --> 03:34:34,026 IN 1990 BUT OUR LEGISLATION WAS 6081 03:34:34,026 --> 03:34:37,196 UPDATED IN 2016 WITH THE 21ST 6082 03:34:37,196 --> 03:34:38,164 CENTURY CURES ACT. 6083 03:34:38,164 --> 03:34:41,700 SO HERE WE WERE GIVEN A LITTLE 6084 03:34:41,700 --> 03:34:43,536 BIT MORE GUIDANCE ON OUR 6085 03:34:43,536 --> 03:34:44,103 ACTIVITIES. 6086 03:34:44,103 --> 03:34:48,474 SO WE HAVE TO REVISE AND PUBLISH 6087 03:34:48,474 --> 03:34:50,075 A RESEARCH PLAN EVERY FIVE 6088 03:34:50,075 --> 03:34:51,277 YEARS. 6089 03:34:51,277 --> 03:34:53,712 WE HAVE A COORDINATING COMMITTEE 6090 03:34:53,712 --> 03:34:56,749 THAT IS CHAIRED BY MYSELF AND 6091 03:34:56,749 --> 03:34:59,919 ANOTHER NIH INSTITUTE TO REPORT 6092 03:34:59,919 --> 03:35:02,321 OUT ON OUR PROGRESS OF THAT 6093 03:35:02,321 --> 03:35:02,755 RESEARCH PLAN. 6094 03:35:02,755 --> 03:35:09,228 WE ALSO HAVE AN ADVISORY BOARD, 6095 03:35:09,228 --> 03:35:11,497 WE HAVE A LIAISON BETWEEN THAT 6096 03:35:11,497 --> 03:35:13,165 ADVISORY BOARD AND THIS ADVISORY 6097 03:35:13,165 --> 03:35:13,632 BOARD. 6098 03:35:13,632 --> 03:35:17,336 OUR NEW MEMBER, DR. FIELD-FOTE 6099 03:35:17,336 --> 03:35:18,370 WAS A PREVIOUS CHAIR OF THAT 6100 03:35:18,370 --> 03:35:19,838 BOARD. 6101 03:35:19,838 --> 03:35:21,674 AND DR. DORN HAS THE PRIVILEGE 6102 03:35:21,674 --> 03:35:26,712 OF BEING ON BOTH AS WELL. 6103 03:35:26,712 --> 03:35:35,988 SO WE HAVE THESE GUIDANCE FROM 6104 03:35:35,988 --> 03:35:38,490 CONGRESS. 6105 03:35:38,490 --> 03:35:40,259 SO WHAT HAVE WE BEEN DOING 6106 03:35:40,259 --> 03:35:41,894 PREVIOUSLY? 6107 03:35:41,894 --> 03:35:43,996 WE HAD ESTABLISHED A RESEARCH 6108 03:35:43,996 --> 03:35:46,899 PLAN QUITE EARLY, 1993. 6109 03:35:46,899 --> 03:35:50,336 AND THEN IT HADN'T REALLY BEEN 6110 03:35:50,336 --> 03:35:53,372 UPDATED UNTIL 2016. 6111 03:35:53,372 --> 03:35:55,908 YOU'VE HEARD QUITE A BIT ABOUT 6112 03:35:55,908 --> 03:35:57,977 STRATEGIC PLANS TODAY. 6113 03:35:57,977 --> 03:36:00,713 NICHD STRATEGIC PLAN, NIAID 6114 03:36:00,713 --> 03:36:02,014 STRATEGIC PLAN. 6115 03:36:02,014 --> 03:36:05,284 AND SIMILAR RESEARCH PLAN 6116 03:36:05,284 --> 03:36:06,485 FOLLOWS THE SAME TYPE OF 6117 03:36:06,485 --> 03:36:07,486 PATTERN. 6118 03:36:07,486 --> 03:36:12,491 SO IN 2016, WE DEVELOPED THESE 6119 03:36:12,491 --> 03:36:13,259 SIX THEMES. 6120 03:36:13,259 --> 03:36:16,195 WE DECIDED TO REFRESH AND KEEP 6121 03:36:16,195 --> 03:36:21,567 THOSE SAME THEMES IN 2021. 6122 03:36:21,567 --> 03:36:25,938 THERE'S AN ANIMATION, I THINK. 6123 03:36:25,938 --> 03:36:26,705 MAYBE. 6124 03:36:26,705 --> 03:36:28,474 OKAY, THERE WE GO. 6125 03:36:28,474 --> 03:36:32,611 SO KIND OF KEEPING THE MAIN 6126 03:36:32,611 --> 03:36:34,046 THEMES BUT ADDING A LITTLE BIT 6127 03:36:34,046 --> 03:36:35,881 MORE ACTION TO THEM. 6128 03:36:35,881 --> 03:36:39,618 IN OUR 2021 VERSION. 6129 03:36:39,618 --> 03:36:41,687 SO WHEN WE STARTED THINKING 6130 03:36:41,687 --> 03:36:43,656 ABOUT WHAT KIND OF IMPACT DOES 6131 03:36:43,656 --> 03:36:46,725 HAVING A RESEARCH PLAN MAKE, 6132 03:36:46,725 --> 03:36:48,227 BECAUSE WE DON'T HAVE OUR OWN 6133 03:36:48,227 --> 03:36:50,429 APPROPRIATION, WE DON'T HAVE OUR 6134 03:36:50,429 --> 03:36:54,900 OWN BUDGET FROM CONGRESS, I 6135 03:36:54,900 --> 03:36:57,970 CAN'T SAY THAT THIS IS A CAUSAL 6136 03:36:57,970 --> 03:36:58,604 RELATIONSHIP. 6137 03:36:58,604 --> 03:37:01,373 BUT I DO THINK THAT HAVING A 6138 03:37:01,373 --> 03:37:03,776 RESEARCH PLAN OUT THERE WAS 6139 03:37:03,776 --> 03:37:06,745 HELPFUL IN GROWING THE 6140 03:37:06,745 --> 03:37:08,347 REHABILITATION PORTFOLIO AT NIH 6141 03:37:08,347 --> 03:37:11,650 AND YOU CAN SEE IT'S GONE FROM 6142 03:37:11,650 --> 03:37:13,252 ABOUT 500 MILLION TO OVER 6143 03:37:13,252 --> 03:37:14,253 900 MILLION. 6144 03:37:14,253 --> 03:37:18,857 AND THIS IS AN EXTRAMURAL 6145 03:37:18,857 --> 03:37:19,291 GRANTS. 6146 03:37:19,291 --> 03:37:24,997 THIS IS 10 TIMES WHAT NCMRR'S 6147 03:37:24,997 --> 03:37:25,297 BUDGET. 6148 03:37:25,297 --> 03:37:27,499 SO HAVING A RESEARCH PLAN THAT 6149 03:37:27,499 --> 03:37:28,834 HAS INVOLVEMENT OF ALL OF THE 6150 03:37:28,834 --> 03:37:29,835 NIH INSTITUTIONS THAT SUPPORT 6151 03:37:29,835 --> 03:37:31,270 REHAB IS REALLY IMPORTANT FOR US 6152 03:37:31,270 --> 03:37:36,275 TO GROW THIS FIELD. 6153 03:37:36,275 --> 03:37:39,078 SO WHAT ARE WE DOING IN 2025, 6154 03:37:39,078 --> 03:37:43,582 26? 6155 03:37:43,582 --> 03:37:45,884 SO IT TAKES A LONG TIME TO MAKE 6156 03:37:45,884 --> 03:37:48,721 A RESEARCH PLAN, TAKES A LONG 6157 03:37:48,721 --> 03:37:50,723 TIME TO DO A STRATEGIC PLAN, SO 6158 03:37:50,723 --> 03:37:52,758 WE STARTED ABOUT A YEAR AGO. 6159 03:37:52,758 --> 03:37:53,759 AND WE'VE BEEN WORKING QUITE 6160 03:37:53,759 --> 03:37:56,161 HARD ON IT. 6161 03:37:56,161 --> 03:37:58,330 AND IF WE GO TO THE NEXT SLIDE, 6162 03:37:58,330 --> 03:37:59,598 WE CAN TALK A LITTLE BIT MORE 6163 03:37:59,598 --> 03:38:02,167 ABOUT THE DETAILS. 6164 03:38:02,167 --> 03:38:04,036 SO THE FIRST THING WE DID WAS IN 6165 03:38:04,036 --> 03:38:05,337 FEBRUARY OF LAST YEAR, WE PUT 6166 03:38:05,337 --> 03:38:08,073 OUT A REQUEST FOR INFORMATION, 6167 03:38:08,073 --> 03:38:09,475 JUST TRYING TO GET A PULSE OF 6168 03:38:09,475 --> 03:38:10,909 THE FIELD ON HOW THEY WERE 6169 03:38:10,909 --> 03:38:12,978 THINKING ABOUT THE CURRENT 6170 03:38:12,978 --> 03:38:15,047 RESEARCH PLAN, WHAT SHOULD BE 6171 03:38:15,047 --> 03:38:18,450 RETAINED, WHAT SHOULD BE ADDED. 6172 03:38:18,450 --> 03:38:19,685 10 YEARS IS A LONG TIME IN 6173 03:38:19,685 --> 03:38:22,955 SCIENCE, SO HOW ARE WE DOING? 6174 03:38:22,955 --> 03:38:25,290 AND WE DISCUSSED THAT FEEDBACK 6175 03:38:25,290 --> 03:38:28,961 WITH OUR ADVISORY BOARD IN MAY. 6176 03:38:28,961 --> 03:38:32,364 THE NIH MEDICAL REHABILITATION 6177 03:38:32,364 --> 03:38:35,300 COORDINATING COMMITTEE IS A 6178 03:38:35,300 --> 03:38:39,238 GROUP OF ABOUT 25 TO 30 PROGRAM 6179 03:38:39,238 --> 03:38:44,042 OFFICERS FROM 20ICOs AFTER 6180 03:38:44,042 --> 03:38:44,276 NIH. 6181 03:38:44,276 --> 03:38:44,910 WE MEET MONTHLY. 6182 03:38:44,910 --> 03:38:46,211 I HAVE THE PRIVILEGE OF CHAIRING 6183 03:38:46,211 --> 03:38:47,446 THAT WITH A REPRESENTATIVE FROM 6184 03:38:47,446 --> 03:38:48,747 THE DEAFNESS AND OTHER 6185 03:38:48,747 --> 03:38:50,516 COMMUNICATION DISORDERS 6186 03:38:50,516 --> 03:38:54,153 INSTITUTE, NIDCD. 6187 03:38:54,153 --> 03:38:55,788 WE ROTATE THAT POSITION, 6188 03:38:55,788 --> 03:38:58,624 PREVIOUSLY AGING, NEUROLOGY, 6189 03:38:58,624 --> 03:39:01,894 NIAMS HAVE FILLED THAT ROLE WITH 6190 03:39:01,894 --> 03:39:06,165 THE NCMRR DIRECTOR. 6191 03:39:06,165 --> 03:39:07,566 SO WE TOOK THAT FEEDBACK AS WELL 6192 03:39:07,566 --> 03:39:10,135 AS OUR OWN INTERNAL ANALYSES AND 6193 03:39:10,135 --> 03:39:14,840 WE DRAFTED NEW THEMES OVER THE 6194 03:39:14,840 --> 03:39:18,977 SUMMER, JUNE THROUGH SEPTEMBER. 6195 03:39:18,977 --> 03:39:20,913 AND, TA DA, OKAY, WE'RE GOING TO 6196 03:39:20,913 --> 03:39:22,381 TALK A LITTLE BIT ABOUT WHAT 6197 03:39:22,381 --> 03:39:24,917 THOSE PROPOSED THEMES ARE. 6198 03:39:24,917 --> 03:39:26,118 I WOULD JUST HIGHLIGHT THAT 6199 03:39:26,118 --> 03:39:27,252 THESE ARE AREAS THAT WE THINK 6200 03:39:27,252 --> 03:39:28,654 ARE GOING TO SEE A LOT OF GROWTH 6201 03:39:28,654 --> 03:39:31,457 IN THE NEXT FIVE YEARS. 6202 03:39:31,457 --> 03:39:33,425 WE REALIZE THAT THEY MAY NOT BE 6203 03:39:33,425 --> 03:39:36,328 INCLUSIVE OF ALL REHAB RESEARCH, 6204 03:39:36,328 --> 03:39:38,363 BUT WHEN YOU THINK ABOUT WHERE 6205 03:39:38,363 --> 03:39:40,532 WE WERE 10 YEARS AGO TO WHERE WE 6206 03:39:40,532 --> 03:39:44,036 ARE NOW, WE THINK WE CAN BE A 6207 03:39:44,036 --> 03:39:45,471 LITTLE BIT MORE TARGETED IN THIS 6208 03:39:45,471 --> 03:39:48,240 RESEARCH PLAN. 6209 03:39:48,240 --> 03:39:50,809 AND THE MOST IMPORTANT THING IS 6210 03:39:50,809 --> 03:39:52,478 THAT PEOPLE WITH DISABILITIES 6211 03:39:52,478 --> 03:39:54,112 NEED TO BE THE CENTER OF ALL OF 6212 03:39:54,112 --> 03:39:57,082 THIS RESEARCH. 6213 03:39:57,082 --> 03:39:58,617 AND THEIR INPUT IS REQUIRED AT 6214 03:39:58,617 --> 03:39:59,718 ALL STAGES. 6215 03:39:59,718 --> 03:40:01,553 SO IF THAT DOESN'T EXPLICITLY 6216 03:40:01,553 --> 03:40:03,255 SAY IN EVERY SINGLE BULLET, KNOW 6217 03:40:03,255 --> 03:40:05,958 THAT THAT IS THE CORE PRINCIPLE 6218 03:40:05,958 --> 03:40:08,894 THAT GOES ACROSS ALL OF THESE 6219 03:40:08,894 --> 03:40:16,468 FIVE PROPOSED THEMES. 6220 03:40:16,468 --> 03:40:17,903 SO THE FIRST ONE INVOLVED BASIC 6221 03:40:17,903 --> 03:40:18,971 AND MECHANISTIC STUDIES. 6222 03:40:18,971 --> 03:40:21,073 SO HERE WE'RE REALLY TRYING TO 6223 03:40:21,073 --> 03:40:23,141 SEEK TO UNDERSTAND AND PREDICT 6224 03:40:23,141 --> 03:40:24,676 INDIVIDUAL RECOVERY FROM A 6225 03:40:24,676 --> 03:40:28,180 DISABLING DISEASE OR INJURY. 6226 03:40:28,180 --> 03:40:29,515 THERE'S STILL JUST A LOT OF 6227 03:40:29,515 --> 03:40:30,482 FOUNDATIONAL KNOWLEDGE THAT WE 6228 03:40:30,482 --> 03:40:32,584 NEED IN ORDER TO BETTER HELP 6229 03:40:32,584 --> 03:40:33,585 PEOPLE GET THE FUNCTION THEY 6230 03:40:33,585 --> 03:40:38,056 WOULD LIKE. 6231 03:40:38,056 --> 03:40:39,691 WE ALSO CONSIDER PRECISION REHAB 6232 03:40:39,691 --> 03:40:40,926 TO FALL UNDER THIS CATEGORY. 6233 03:40:40,926 --> 03:40:44,563 HOW CAN WE DEVELOP AND USE 6234 03:40:44,563 --> 03:40:46,498 BIOMARKERS TO TAILOR THE GUIDE 6235 03:40:46,498 --> 03:40:47,833 OF PRESCRIPTION REHAB 6236 03:40:47,833 --> 03:40:53,939 INTERVENTIONS. 6237 03:40:53,939 --> 03:40:57,442 THE SECOND THEME IS SOCIAL 6238 03:40:57,442 --> 03:40:59,311 DETERMINANTS OF HEALTH. 6239 03:40:59,311 --> 03:41:00,979 THE LAST FEW YEARS, WE'VE DONE A 6240 03:41:00,979 --> 03:41:04,349 LOT OF WORK LOOKING AT PEOPLE 6241 03:41:04,349 --> 03:41:09,254 WITH DISABILITIES A AS A 6242 03:41:09,254 --> 03:41:10,122 POPULATION THAT EXPERIENCES 6243 03:41:10,122 --> 03:41:15,193 HEALTH DISPARITIES. 6244 03:41:15,193 --> 03:41:17,829 WE'VE WORKED WITH NICHD TO MAKE 6245 03:41:17,829 --> 03:41:18,897 THAT CHANGE AT NIH AND WE'VE 6246 03:41:18,897 --> 03:41:20,699 BEEN REALLY CHAMPIONING THE 6247 03:41:20,699 --> 03:41:21,667 SCIENCE AROUND ABLEISM SO WE 6248 03:41:21,667 --> 03:41:23,502 THINK THAT'S A VERY IMPORTANT 6249 03:41:23,502 --> 03:41:24,603 ASPECT OF THE HEALTH FOR PEOPLE 6250 03:41:24,603 --> 03:41:25,203 WITH DISABILITIES. 6251 03:41:25,203 --> 03:41:26,471 AND THEN OF COURSE THERE'S ALSO 6252 03:41:26,471 --> 03:41:29,408 THE INTERSECTION OF MULTIPLE 6253 03:41:29,408 --> 03:41:31,944 IDENTITIES, SO HOW DOES HAVING 6254 03:41:31,944 --> 03:41:34,980 ANOTHER MINORITIZED IDENTITY 6255 03:41:34,980 --> 03:41:37,549 INFLUENCE A PERSON'S HEALTH, 6256 03:41:37,549 --> 03:41:40,285 WHAT ARE THE BARRIERS AND 6257 03:41:40,285 --> 03:41:42,354 FACILITATORS TO GETTING THE CARE 6258 03:41:42,354 --> 03:41:44,122 THEY NEED. 6259 03:41:44,122 --> 03:41:46,391 WE'RE ALSO INTERESTED IN WHERE 6260 03:41:46,391 --> 03:41:47,826 CARE IS DELIVERED. 6261 03:41:47,826 --> 03:41:49,595 WE KNOW THAT THERE'S DIFFERENT 6262 03:41:49,595 --> 03:41:51,663 OUTCOMES DEPENDING ON WHERE A 6263 03:41:51,663 --> 03:41:53,966 PERSON RECEIVES THEIR 6264 03:41:53,966 --> 03:41:55,734 REHABILITATION CARE. 6265 03:41:55,734 --> 03:41:56,902 AND THERE'S OPPORTUNITIES THERE 6266 03:41:56,902 --> 03:42:02,074 TO LEARN MORE. 6267 03:42:02,074 --> 03:42:04,343 THIRD, IS REHABILITATIVE AND 6268 03:42:04,343 --> 03:42:05,811 ASSISTIVE TECHNOLOGIES. 6269 03:42:05,811 --> 03:42:08,013 I MENTIONED EARLIER WE HAVE 6270 03:42:08,013 --> 03:42:11,950 SPECIFIC LEGISLATION THAT 6271 03:42:11,950 --> 03:42:13,151 DIRECTS US TO SUPPORT RESEARCH 6272 03:42:13,151 --> 03:42:20,559 IN THIS AREA, AND THE ROLE FOR 6273 03:42:20,559 --> 03:42:21,660 NIH IS KIND OF TWOFOLD. 6274 03:42:21,660 --> 03:42:23,061 WE SEE OURSELVES BEING VERY 6275 03:42:23,061 --> 03:42:24,062 IMPORTANT IN KIND OF EARLY STAGE 6276 03:42:24,062 --> 03:42:27,032 TECHNOLOGY DEVELOPMENT. 6277 03:42:27,032 --> 03:42:31,603 AND WE ALSO SEE A ROLE FOR 6278 03:42:31,603 --> 03:42:34,272 COMMERCIALIZATION SO USING THE 6279 03:42:34,272 --> 03:42:38,176 SMALL BUSINESS PROGRAM, NCMRR 6280 03:42:38,176 --> 03:42:39,711 SPENDS ABOUT 10 TO 12% OF OUR 6281 03:42:39,711 --> 03:42:41,813 BUDGET ON SMALL BUSINESS. 6282 03:42:41,813 --> 03:42:43,315 BECAUSE IT'S IMPORTANT THAT WE 6283 03:42:43,315 --> 03:42:45,384 GET THE TECHNOLOGIES OUT OF THE 6284 03:42:45,384 --> 03:42:47,919 LAB AND INTO PEOPLE'S HOMES OR 6285 03:42:47,919 --> 03:42:48,887 HOSPITALS OR WHEREVER THAT CARE 6286 03:42:48,887 --> 03:42:56,895 IS DELIVERED. 6287 03:42:56,895 --> 03:42:58,096 WE'VE ALSO HEARD A LOT TODAY 6288 03:42:58,096 --> 03:43:01,066 ABOUT THE IMPORTANCE OF 6289 03:43:01,066 --> 03:43:02,367 IMPLEMENTATION RESEARCH, AND 6290 03:43:02,367 --> 03:43:04,102 THIS IS AN AREA THAT WE ACTUALLY 6291 03:43:04,102 --> 03:43:06,171 HAVEN'T DONE AS MUCH AS WE THINK 6292 03:43:06,171 --> 03:43:10,142 WE COULD, AGAIN PUTTING THE 6293 03:43:10,142 --> 03:43:10,909 CONSUMERS OF REHAB AT THE FRONT 6294 03:43:10,909 --> 03:43:11,777 OF IT. 6295 03:43:11,777 --> 03:43:13,412 MAKING SURE THAT WE'RE 6296 03:43:13,412 --> 03:43:15,614 DEVELOPING THERAPIES THAT ARE 6297 03:43:15,614 --> 03:43:18,150 DESIRED, ACCEPTABLE, 6298 03:43:18,150 --> 03:43:22,087 COST-EFFICIENT AND EASY TO USE. 6299 03:43:22,087 --> 03:43:26,324 AND DEVELOPING THE EVIDENCE BASE 6300 03:43:26,324 --> 03:43:28,026 IN PRAGMATIC STUDIES TO MAKE 6301 03:43:28,026 --> 03:43:31,697 SURE THAT THE WORK THAT WE FIND 6302 03:43:31,697 --> 03:43:36,535 IN EFFICACY STUDIES TR TRANSLATS 6303 03:43:36,535 --> 03:43:36,968 TO THE REAL WORLD. 6304 03:43:36,968 --> 03:43:40,672 AND THEN OUR FINAL THEME, 6305 03:43:40,672 --> 03:43:41,740 TRAINING AND CAREER DEVELOPMENT 6306 03:43:41,740 --> 03:43:44,509 AND INFRASTRUCTURE, THOSE HAVE 6307 03:43:44,509 --> 03:43:48,914 ALL BEEN CORE TO WHAT NCMRR DO 6308 03:43:48,914 --> 03:43:49,548 DOES. 6309 03:43:49,548 --> 03:43:50,882 WE CONSIDER IT A SERVICE THAT WE 6310 03:43:50,882 --> 03:43:52,851 DO WHEN PEOPLE THAT WE HAVE 6311 03:43:52,851 --> 03:43:57,989 TRAINED GO AND GET R01s FROM 6312 03:43:57,989 --> 03:43:58,657 OTHER INSTITUTES AT NIH. 6313 03:43:58,657 --> 03:44:00,158 THAT IS PART OF OUR SUCCESS 6314 03:44:00,158 --> 03:44:00,492 STORIES. 6315 03:44:00,492 --> 03:44:05,630 SO WE ARE MAKING NEW INVE 6316 03:44:05,630 --> 03:44:05,931 INVESTMENTS. 6317 03:44:05,931 --> 03:44:07,666 WE'VE JUST REISSUED OUR K12 6318 03:44:07,666 --> 03:44:08,834 PROGRAMS WHICH WE'RE EXCITED TO 6319 03:44:08,834 --> 03:44:10,168 BRING BACK. 6320 03:44:10,168 --> 03:44:11,136 OUR INFRASTRUCTURE, YOU'LL BE 6321 03:44:11,136 --> 03:44:15,173 HEARING ABOUT THAT IN THE 6322 03:44:15,173 --> 03:44:19,644 MAY/JUNE COUNCIL MEETING. 6323 03:44:19,644 --> 03:44:21,079 SO WE'RE WELL ON OUR WAY IN 6324 03:44:21,079 --> 03:44:22,180 GETTING CAREER AND TRAINING 6325 03:44:22,180 --> 03:44:23,448 DEVELOPMENT NUMBERS BACK UP TO 6326 03:44:23,448 --> 03:44:31,690 WHERE WE THINK THEY SHOULD BE. 6327 03:44:31,690 --> 03:44:33,358 SO I'VE BEEN MAKING THE ROUNDS 6328 03:44:33,358 --> 03:44:35,861 WITH THESE THEMES. 6329 03:44:35,861 --> 03:44:37,629 WE TALKED TO A SUBCOMMITTEE OF 6330 03:44:37,629 --> 03:44:39,698 OUR ADVISORY BOARD, AND 6331 03:44:39,698 --> 03:44:43,869 PRESENTED TO OUR FULL BOARD IN 6332 03:44:43,869 --> 03:44:46,271 DECEMBER. 6333 03:44:46,271 --> 03:44:49,875 I WANT TO THE SHIRLEY RYAN 6334 03:44:49,875 --> 03:44:50,642 ABILITY LAB AND DID MORE ROUNDS 6335 03:44:50,642 --> 03:44:52,077 TO GET MORE FEEDBACK AND THEN I 6336 03:44:52,077 --> 03:44:53,578 PRESENTED A SPECIAL SECTION AT 6337 03:44:53,578 --> 03:44:54,880 THE AMERICAN CONGRESS OF REHAB 6338 03:44:54,880 --> 03:44:56,782 MEDICINE. 6339 03:44:56,782 --> 03:44:57,649 WORKING WITH COMMUNICATIONS TO 6340 03:44:57,649 --> 03:45:01,186 MAKE SURE THIS IS GOING TO BE A 6341 03:45:01,186 --> 03:45:02,454 PRETTY DOCUMENT, AND I WANT TO 6342 03:45:02,454 --> 03:45:09,828 THANK THEM FOR THEIR HELP. 6343 03:45:09,828 --> 03:45:14,132 SO WHERE DO WE GO FROM NOW? 6344 03:45:14,132 --> 03:45:15,500 HOPEFULLY IN A WEEK OR SO, WE'LL 6345 03:45:15,500 --> 03:45:18,036 HAVE A REQUEST FOR INFORMATION 6346 03:45:18,036 --> 03:45:22,307 OUT WITH THESE DRAFT THEMES TO 6347 03:45:22,307 --> 03:45:24,409 GET ONE MORE ROUND OF FEEDBACK 6348 03:45:24,409 --> 03:45:26,878 FROM THE WIDER COMMUNITY. 6349 03:45:26,878 --> 03:45:30,816 I'LL BE MEETING WITH THE GUY 6350 03:45:30,816 --> 03:45:42,093 SIF ITHE THEPHYSIATRISTS AT THEN 6351 03:45:43,061 --> 03:45:43,261 FEBRUARY. 6352 03:45:43,261 --> 03:45:44,196 WE'RE HOSTING OUR REHAB 6353 03:45:44,196 --> 03:45:46,164 CONFERENCE IN MARCH, YOU'RE ALL 6354 03:45:46,164 --> 03:45:47,799 INVITED, PLEASE JOIN US. 6355 03:45:47,799 --> 03:45:48,433 WE ARE VERY MUCH LOOKING FORWARD 6356 03:45:48,433 --> 03:45:50,035 TO HAVING OUR FIRST BIG IN 6357 03:45:50,035 --> 03:45:52,637 PERSON MEETING SINCE 2016. 6358 03:45:52,637 --> 03:45:54,539 OUR 2021 HAD TO BE MOVED TO 6359 03:45:54,539 --> 03:45:55,507 VIRTUAL, SO WE'RE EXCITED TO 6360 03:45:55,507 --> 03:45:56,374 BRING THAT BACK. 6361 03:45:56,374 --> 03:45:58,143 AND THEN WE WILL ALSO BE 6362 03:45:58,143 --> 03:46:01,079 PRESENTING A AT THE AMERICAN 6363 03:46:01,079 --> 03:46:01,947 SOCIETY OF NEURAL REHAB. 6364 03:46:01,947 --> 03:46:04,916 SO HAPPY TO TALK TO OTHER GROUPS 6365 03:46:04,916 --> 03:46:06,985 AS SUGGESTED. 6366 03:46:06,985 --> 03:46:09,287 AND GET THEIR INPUT ON THIS 6367 03:46:09,287 --> 03:46:11,489 BECAUSE REHAB IS QUITE 6368 03:46:11,489 --> 03:46:13,425 MULTIDISCIPLINARY. 6369 03:46:13,425 --> 03:46:15,360 AND WE NEED EVERYONE'S BUY-IN ON 6370 03:46:15,360 --> 03:46:18,163 IT. 6371 03:46:18,163 --> 03:46:21,333 SO JUST TO WRAP UP AS I SAID, 6372 03:46:21,333 --> 03:46:23,535 WE'RE PUTTING OUT THE REQUEST 6373 03:46:23,535 --> 03:46:25,103 FOR INFORMATION, WE'RE HOPING TO 6374 03:46:25,103 --> 03:46:29,674 GET OUR FINAL EDITS TO THOSE 6375 03:46:29,674 --> 03:46:33,912 THEMES IN APRIL AND GET 6376 03:46:33,912 --> 03:46:35,247 CONCURRENCE WITH THE THEMES AT 6377 03:46:35,247 --> 03:46:36,848 OUR MAY BOARD MEETING AND THEN 6378 03:46:36,848 --> 03:46:39,517 WE'LL GET OUR CLEARANCES, IT 6379 03:46:39,517 --> 03:46:40,819 GETS SUBMITTED TO BOTH THE 6380 03:46:40,819 --> 03:46:51,296 CONGRESS AND THE PRESIDENT. 6381 03:47:01,373 --> 03:47:02,574 IF YOU'RE INTERESTED IN KEEPING 6382 03:47:02,574 --> 03:47:09,314 UP WITH US, PLEASE JOIN OUR 6383 03:47:09,314 --> 03:47:09,514 LIST. 6384 03:47:09,514 --> 03:47:10,515 >> THANK YOU, THE QUESTIONS ARE 6385 03:47:10,515 --> 03:47:11,616 LINING UP HERE. 6386 03:47:11,616 --> 03:47:12,083 FIRST IS BONNIE. 6387 03:47:12,083 --> 03:47:13,251 >> SORRY. 6388 03:47:13,251 --> 03:47:14,586 I'M TRYING TO FIGURE OUT MY 6389 03:47:14,586 --> 03:47:15,253 CAMERA HERE. 6390 03:47:15,253 --> 03:47:16,521 OH, WELL. 6391 03:47:16,521 --> 03:47:17,989 I'LL JUST SPEAK WITH MY CAMERA 6392 03:47:17,989 --> 03:47:18,156 OFF. 6393 03:47:18,156 --> 03:47:19,524 THERE WE GO. 6394 03:47:19,524 --> 03:47:23,361 THANK YOU. 6395 03:47:23,361 --> 03:47:24,896 THAT WAS A WONDERFUL 6396 03:47:24,896 --> 03:47:27,766 PRESENTATION. 6397 03:47:27,766 --> 03:47:28,867 I JUST WANT TO HIGHLIGHT ONE 6398 03:47:28,867 --> 03:47:29,935 THING THAT YOU MAY ALREADY BE 6399 03:47:29,935 --> 03:47:35,407 AWARE OF BUT JUST FOR GENERAL 6400 03:47:35,407 --> 03:47:36,408 UNDERSTANDING, WE'VE DONE A 6401 03:47:36,408 --> 03:47:37,943 COUPLE OF SURVEYS WITH OUR 6402 03:47:37,943 --> 03:47:39,577 FACULTY AND OUR STAFF ACROSS NOT 6403 03:47:39,577 --> 03:47:41,713 JUST THE MEDICAL SCHOOL BUT THE 6404 03:47:41,713 --> 03:47:42,647 HOSPITALS, THE CHILDREN'S 6405 03:47:42,647 --> 03:47:53,191 HOSPITAL AND THE ADULT HOSPITAL. 6406 03:47:59,798 --> 03:48:01,099 WHETHER THEY IDENTIFY SPECIFIC 6407 03:48:01,099 --> 03:48:02,033 DISABILITIES AND THOSE ARE TWO 6408 03:48:02,033 --> 03:48:02,434 DIFFERENT THINGS. 6409 03:48:02,434 --> 03:48:06,104 ONE IS IDENTIFYING WITH AS BEING 6410 03:48:06,104 --> 03:48:07,939 DISABLED AND THE OTHER IS BEING 6411 03:48:07,939 --> 03:48:08,940 IDENTIFIED AS HAVING 6412 03:48:08,940 --> 03:48:09,274 DISABILITIES. 6413 03:48:09,274 --> 03:48:12,877 WHAT WE FOUND IS THAT 1 IN 4 TO 6414 03:48:12,877 --> 03:48:15,146 1 IN 5 PEOPLE IDENTIFIED AS 6415 03:48:15,146 --> 03:48:19,551 HAVING A SYMPTOM OR A DEFINED 6416 03:48:19,551 --> 03:48:20,552 DISABILITY, BUT THE PERCEPTION 6417 03:48:20,552 --> 03:48:22,153 OF BEING DISABLED WAS MUCH LOWER 6418 03:48:22,153 --> 03:48:24,255 THAN THAT. 6419 03:48:24,255 --> 03:48:28,760 SO I THINK THAT -- THERE'S OTHER 6420 03:48:28,760 --> 03:48:31,363 DATA AROUND HEALTH DISPARITIES, 6421 03:48:31,363 --> 03:48:33,231 OTHER THINGS ARE INCREDIBLY 6422 03:48:33,231 --> 03:48:34,666 IMPORTANT BUT I ALSO WANTED TO 6423 03:48:34,666 --> 03:48:35,633 POINT OUT THAT PEOPLE'S 6424 03:48:35,633 --> 03:48:36,735 PERCEPTION OF WHETHER THEY'RE 6425 03:48:36,735 --> 03:48:39,571 DISABLED OR NOT ARE ALSO VERY -- 6426 03:48:39,571 --> 03:48:41,539 MAY NOT ALIGN WITH ACTUAL 6427 03:48:41,539 --> 03:48:44,075 DISABILITIES AND I THINK THE 6428 03:48:44,075 --> 03:48:47,145 ISSUE OF STIGMA OR OTHER 6429 03:48:47,145 --> 03:48:49,447 UNINTENDED BIASES OR UNINTENDED 6430 03:48:49,447 --> 03:48:51,316 FEELINGS OF NOT WANTING TO BE 6431 03:48:51,316 --> 03:48:54,786 CATEGORIZED IN A PARTICULAR WAY 6432 03:48:54,786 --> 03:48:56,054 REALLY DID SHOW UP IN THIS 6433 03:48:56,054 --> 03:48:56,388 SURVEY. 6434 03:48:56,388 --> 03:48:57,989 THIS IS JUST ONE INSTITUTION, SO 6435 03:48:57,989 --> 03:49:00,191 I HOPE THAT THIS IS SOMETHING 6436 03:49:00,191 --> 03:49:02,193 THAT CAN ALSO BE ADDRESSED IN 6437 03:49:02,193 --> 03:49:04,262 TERMS OF SOCIAL DETERMINANTS. 6438 03:49:04,262 --> 03:49:05,930 THIS IS AN IMPORTANT AREA AND 6439 03:49:05,930 --> 03:49:08,099 THESE ARE HEALTHCARE 6440 03:49:08,099 --> 03:49:09,300 PROFESSIONALS AND PEOPLE THAT 6441 03:49:09,300 --> 03:49:10,535 WORK IN THE HEALTHCARE SPACE WHO 6442 03:49:10,535 --> 03:49:13,638 DID NOT THEMSELVES IDENTIFY 6443 03:49:13,638 --> 03:49:14,139 WELL. 6444 03:49:14,139 --> 03:49:16,641 SO NOT GENERALIZABLE, BUT I 6445 03:49:16,641 --> 03:49:17,609 IMAGINE THAT THERE WOULD BE MORE 6446 03:49:17,609 --> 03:49:19,377 WORK TO BE DONE IN THAT AREA, SO 6447 03:49:19,377 --> 03:49:20,345 THANK YOU SO MUCH FOR YOUR WORK 6448 03:49:20,345 --> 03:49:22,647 IN THESE REALLY IMPORTANT TOPICS 6449 03:49:22,647 --> 03:49:23,214 AROUND REHABILITATION. 6450 03:49:23,214 --> 03:49:26,284 THANK YOU. 6451 03:49:26,284 --> 03:49:27,685 >> THANK YOU, BONNIE. 6452 03:49:27,685 --> 03:49:33,058 YOU HIT ON LIKE 20 THINGS THERE. 6453 03:49:33,058 --> 03:49:34,259 THE MEASUREMENT OF DISABILITY IS 6454 03:49:34,259 --> 03:49:36,995 A HUGE AREA THAT NEEDS MORE 6455 03:49:36,995 --> 03:49:37,195 WORK. 6456 03:49:37,195 --> 03:49:39,064 THERE'S QUITE A DISCUSSION WITH 6457 03:49:39,064 --> 03:49:40,231 CENSUS AND HOW THEY WERE 6458 03:49:40,231 --> 03:49:42,801 THINKING OF CHANGING HOW TO 6459 03:49:42,801 --> 03:49:43,568 MEASURE DISABILITY AND I FEEL 6460 03:49:43,568 --> 03:49:47,405 LIKE WE NEED TO DO A BETTER JOB 6461 03:49:47,405 --> 03:49:49,274 OF THAT AND I THINK THAT'S AN 6462 03:49:49,274 --> 03:49:50,408 OPPORTUNITY WHERE NIH COULD DO 6463 03:49:50,408 --> 03:49:50,775 MORE RESEARCH. 6464 03:49:50,775 --> 03:49:53,545 YOU BROUGHT UP STIGMA AND 6465 03:49:53,545 --> 03:49:54,946 SELF-REPORTING AND REASONS WHY 6466 03:49:54,946 --> 03:49:56,381 PEOPLE MAY OR MAY NOT FEEL 6467 03:49:56,381 --> 03:49:59,984 COMFORTABLE DOING THAT. 6468 03:49:59,984 --> 03:50:01,886 OUR DATA SHOWS THAT ONLY 1% OF 6469 03:50:01,886 --> 03:50:12,430 OUR PIs DISCLOSE HAVING OUR 6470 03:50:12,864 --> 03:50:14,199 PIs DISCLOSE A DISABILITY, 6471 03:50:14,199 --> 03:50:15,667 EITHER THEY'RE NOT FEELING 6472 03:50:15,667 --> 03:50:17,735 COMFORTABLE REPORTING OR WE'RE 6473 03:50:17,735 --> 03:50:21,706 NOT GETTING THEM INTO THE SYSTEM 6474 03:50:21,706 --> 03:50:24,342 SO WE'RE WORKING IN SEVERAL 6475 03:50:24,342 --> 03:50:27,479 AREAS TO TRY TO MAKE THAT KIND 6476 03:50:27,479 --> 03:50:29,781 OF A SAFER PLACE AND WE JUST 6477 03:50:29,781 --> 03:50:31,382 PUBLISHED A WEBPAGE ON RESOURCES 6478 03:50:31,382 --> 03:50:33,952 FOR PIs WITH DISABILITIES. 6479 03:50:33,952 --> 03:50:38,323 SO WE HEAR YOU AND WE'RE TRYING 6480 03:50:38,323 --> 03:50:39,023 TO ADDRESS THAT. 6481 03:50:39,023 --> 03:50:43,394 THANK YOU. 6482 03:50:43,394 --> 03:50:44,562 >> SESH? 6483 03:50:44,562 --> 03:50:47,532 >> THAT WAS A GREAT SET OF 6484 03:50:47,532 --> 03:50:47,866 INITIATIVES. 6485 03:50:47,866 --> 03:50:49,634 COMPLIEN CAL HOME IS THE 6486 03:50:49,634 --> 03:50:50,502 NEONATIVE INTENSIVE CARE UNIT, 6487 03:50:50,502 --> 03:50:54,172 AND WE HAVE RECOGNIZED RECENTLY 6488 03:50:54,172 --> 03:50:59,511 THE GREAT VALUE OF PRNM IN THE 6489 03:50:59,511 --> 03:51:00,378 NEONATIVE INTENSIVE CARE UNIT. 6490 03:51:00,378 --> 03:51:01,579 I WOULD JUST THROW OUT THE IDEA 6491 03:51:01,579 --> 03:51:04,315 THAT THERE IS A CRESCENDO OF 6492 03:51:04,315 --> 03:51:06,851 WHOLE GENOME SEQUENCING GOING ON 6493 03:51:06,851 --> 03:51:09,020 AMONG NICU BABIES. 6494 03:51:09,020 --> 03:51:13,725 SO THAT VENUE, PRNM, 6495 03:51:13,725 --> 03:51:15,059 NEONATOLOGISTS, GENOMICISTS 6496 03:51:15,059 --> 03:51:17,762 MIGHT BE AN INTERESTING AREA 6497 03:51:17,762 --> 03:51:20,732 WHERE PRECISION MEDICINE COULD 6498 03:51:20,732 --> 03:51:26,538 BE LINKED WITH IMPACT OF PRNM. 6499 03:51:26,538 --> 03:51:30,575 JUST A THOUGHT. 6500 03:51:30,575 --> 03:51:33,912 >> NO, THAT'S GREAT. 6501 03:51:33,912 --> 03:51:35,813 ACTUALLY ONE OF OUR R01 6502 03:51:35,813 --> 03:51:37,248 RESEARCHERS WAS TRAINED ON A K 6503 03:51:37,248 --> 03:51:39,784 AWARD THROUGH THE PREGNANCY AND 6504 03:51:39,784 --> 03:51:40,985 PERINATOLOGY BRANCH, AND SHE IS 6505 03:51:40,985 --> 03:51:45,657 NOW BRINGING THAT EXPERTISE 6506 03:51:45,657 --> 03:51:46,558 SPECIFIC TO CEREBRAL PALSY, 6507 03:51:46,558 --> 03:51:50,428 WHICH WE'RE NOW LURING HAS MANY 6508 03:51:50,428 --> 03:51:53,364 MORE GENETIC FACTORS AND CAUSES 6509 03:51:53,364 --> 03:51:57,068 TO BRING PMNR TO THE NICU. 6510 03:51:57,068 --> 03:51:59,737 >> ANYTHING YOU CAN DO TO INDUCE 6511 03:51:59,737 --> 03:52:01,472 INTEREST AMONG MY NEONATAL 6512 03:52:01,472 --> 03:52:03,541 COLLEAGUES, I THINK WOULD BE A 6513 03:52:03,541 --> 03:52:09,581 GOOD IDEA. 6514 03:52:09,581 --> 03:52:11,182 I'M HAPPY TO HELP WITH THAT. 6515 03:52:11,182 --> 03:52:13,518 >> THANK YOU, SESH. 6516 03:52:13,518 --> 03:52:15,086 EDE? 6517 03:52:15,086 --> 03:52:22,393 >> YOU'RE MUTED. 6518 03:52:22,393 --> 03:52:23,361 >> SORRY ABOUT THAT. 6519 03:52:23,361 --> 03:52:28,533 THOUGHT I HAD CLUCKE HAD CLICKE. 6520 03:52:28,533 --> 03:52:30,068 THANKS FOR YOUR GREAT 6521 03:52:30,068 --> 03:52:30,702 PRESENTATION, TERESA. 6522 03:52:30,702 --> 03:52:31,936 IT'S SO GREAT TO SEE YOU. 6523 03:52:31,936 --> 03:52:33,838 I NOTICED SOMETHING LAST WEEK AT 6524 03:52:33,838 --> 03:52:37,842 A WORKSHOP WHERE TOYEN WAS 6525 03:52:37,842 --> 03:52:39,277 PRESENTED, WHO IS A PROGRAM 6526 03:52:39,277 --> 03:52:41,479 OFFICER IN NCMRR, AND I NOTICED 6527 03:52:41,479 --> 03:52:44,682 FOR THE FIRST TIME THAT THE 6528 03:52:44,682 --> 03:52:46,751 NCMRR MISSION SPECIFICALLY SAYS 6529 03:52:46,751 --> 03:52:48,720 PHYSICAL DISABILITY, AND I HAD 6530 03:52:48,720 --> 03:52:50,788 NEVER NOTICED THAT BEFORE, AND I 6531 03:52:50,788 --> 03:52:52,724 LOOKED BACK THROUGH THE RESEARCH 6532 03:52:52,724 --> 03:52:55,193 PLAN AND I DIDN'T NOTICE -- I 6533 03:52:55,193 --> 03:52:56,394 DIDN'T NOTICE ANYWHERE IN THE 6534 03:52:56,394 --> 03:52:58,263 RESEARCH PLAN WHERE IT 6535 03:52:58,263 --> 03:52:59,430 SPECIFICALLY SAID PHYSICAL 6536 03:52:59,430 --> 03:53:00,598 DISABILITY AS OPPOSED TO THINGS 6537 03:53:00,598 --> 03:53:02,200 LIKE COGNITIVE DISABILITY, 6538 03:53:02,200 --> 03:53:04,068 HEARING DISABILITY, VISUAL 6539 03:53:04,068 --> 03:53:04,836 DISABILITY, AND I WONDER IF THAT 6540 03:53:04,836 --> 03:53:07,272 WAS SOMETHING NEW OR JUST -- IF 6541 03:53:07,272 --> 03:53:10,475 YOU COULD EXPAND ON THE FOCUS ON 6542 03:53:10,475 --> 03:53:12,343 PHYSICAL DISABILITY. 6543 03:53:12,343 --> 03:53:15,179 >> SO NCMRR'S LANGUAGE, OUR 6544 03:53:15,179 --> 03:53:16,281 CONGRESSIONAL LANGUAGE HAS 6545 03:53:16,281 --> 03:53:21,185 PHYSICAL IN IT. 6546 03:53:21,185 --> 03:53:22,587 BUT THE MEDICAL REHAB 6547 03:53:22,587 --> 03:53:24,656 COORDINATING COMMITTEE HAS 6548 03:53:24,656 --> 03:53:25,757 SENSORY, HAS COGNITIVE, HAS ALL 6549 03:53:25,757 --> 03:53:26,791 OF THOSE. 6550 03:53:26,791 --> 03:53:28,192 SO JUST THE NCMRR PART. 6551 03:53:28,192 --> 03:53:30,695 SO THAT HELPS US JUST KIND OF 6552 03:53:30,695 --> 03:53:32,563 DIVIDE UP THE WORK SO WE HAVE 6553 03:53:32,563 --> 03:53:35,366 OUR IDD BRANCH, THEY HAVE THE 6554 03:53:35,366 --> 03:53:37,001 INTELLECTUAL AND DEVELOPMENTAL 6555 03:53:37,001 --> 03:53:38,536 DISABILITIES, SO WE HAVE MORE OF 6556 03:53:38,536 --> 03:53:41,606 THE PHYSICAL. 6557 03:53:41,606 --> 03:53:44,542 BUT THIS IS SO TRANSDISCIPLINARY 6558 03:53:44,542 --> 03:53:48,980 AND WE CERTAINLY DO SUPPORT 6559 03:53:48,980 --> 03:53:51,049 COGNITIVE REHAB WHEN IT RELATES 6560 03:53:51,049 --> 03:53:52,350 TO SOMETHING LIKE TBI. 6561 03:53:52,350 --> 03:53:53,785 SO THAT HASN'T CHANGED. 6562 03:53:53,785 --> 03:53:59,257 >> THANK YOU. 6563 03:53:59,257 --> 03:54:01,025 >> AND ALSO THE LAST PART OF OUR 6564 03:54:01,025 --> 03:54:03,628 MISSION STATEMENT SAID OPTIMIZE 6565 03:54:03,628 --> 03:54:04,862 ABILITIES FOR ALL, SO THAT'S 6566 03:54:04,862 --> 03:54:07,098 MEANT TO ENCOMPASS BOTH PHYSICAL 6567 03:54:07,098 --> 03:54:08,700 DISABILITIES AS WELL AS 6568 03:54:08,700 --> 03:54:11,102 COGNITIVE AND OTHER POTENTIAL 6569 03:54:11,102 --> 03:54:12,303 DISABILITIES. 6570 03:54:12,303 --> 03:54:14,272 SO THANK YOU, TERESA, FOR THIS 6571 03:54:14,272 --> 03:54:15,973 REPORT AND FOR LEADING THE 6572 03:54:15,973 --> 03:54:18,476 CREATION OF THE NEW VERSION OF 6573 03:54:18,476 --> 03:54:22,280 THE NIH REHABILITATION RESEARCH 6574 03:54:22,280 --> 03:54:23,581 PLAN. 6575 03:54:23,581 --> 03:54:27,618 OKAY, COUNCIL, YOU'RE DOING 6576 03:54:27,618 --> 03:54:28,920 GREAT. 6577 03:54:28,920 --> 03:54:29,687 LAST PRESENTATION. 6578 03:54:29,687 --> 03:54:30,455 FINALLY THIS AFTERNOON WE'RE 6579 03:54:30,455 --> 03:54:36,627 GOING TO HEAR FROM DR. RONNA 6580 03:54:36,627 --> 03:54:38,696 POPKIN ABOUT THE NICHD TRY 6581 03:54:38,696 --> 03:54:39,897 ENYELL REPORT ON THE INCLUSION 6582 03:54:39,897 --> 03:54:41,699 OF WOMEN AND MINORITIES IN 6583 03:54:41,699 --> 03:54:43,234 CLINICAL RESEARCH. 6584 03:54:43,234 --> 03:54:46,637 AS YOU MAY KNOW, NIH IS MANDATED 6585 03:54:46,637 --> 03:54:50,975 BY LAW TO ENSURE THE APPROPRIATE 6586 03:54:50,975 --> 03:54:52,043 INCLUSION OF WOMEN AND MEMBERS 6587 03:54:52,043 --> 03:54:54,011 OF RACIAL AND ETHNIC MINORITY 6588 03:54:54,011 --> 03:54:55,947 GROUPS IN ALL NIH FUNDED 6589 03:54:55,947 --> 03:55:00,318 CLINICAL RESEARCH STUDIES. 6590 03:55:00,318 --> 03:55:02,086 SO THAT RESEARCH FINDINGS CAN BE 6591 03:55:02,086 --> 03:55:03,521 GENERALIZABLE TO THE ENTIRE 6592 03:55:03,521 --> 03:55:03,821 POPULATION. 6593 03:55:03,821 --> 03:55:06,190 A PART OF IMPLEMENTATION OF THIS 6594 03:55:06,190 --> 03:55:07,492 LAW AS PART OF IMPLEMENTATION OF 6595 03:55:07,492 --> 03:55:11,729 THIS LAW, NIH REQUIRES 6596 03:55:11,729 --> 03:55:13,564 INVESTIGATORS WHO CONDUCT 6597 03:55:13,564 --> 03:55:15,433 CLINICAL RESEARCH TO 6598 03:55:15,433 --> 03:55:17,402 REPORT ANNUALLY ON THE SEX OR 6599 03:55:17,402 --> 03:55:19,604 GENDER, RACE, AGE AND ETHNICITY 6600 03:55:19,604 --> 03:55:22,440 OF PARTICIPANTS. 6601 03:55:22,440 --> 03:55:24,509 EVERY THREE YEARS, NIH MUST 6602 03:55:24,509 --> 03:55:26,711 ASSEMBLE ALL OF ITS ENROLLMENT 6603 03:55:26,711 --> 03:55:29,680 DATA AND CREATE A TRIENNIAL 6604 03:55:29,680 --> 03:55:31,883 REPORT FOR CONGRESS. 6605 03:55:31,883 --> 03:55:35,219 RONNA IS NICHD'S INCLUSION 6606 03:55:35,219 --> 03:55:36,421 OFFICER, AND SHE WILL DESCRIBE 6607 03:55:36,421 --> 03:55:38,389 SOME OF THE HIGHLIGHTS OF THE 6608 03:55:38,389 --> 03:55:40,458 ANALYSIS OF NICHD ENROLLMENT 6609 03:55:40,458 --> 03:55:44,629 DATA FROM THE PAST THREE YEARS. 6610 03:55:44,629 --> 03:55:45,530 THE ENTIRE DRAFT NICHD REPORT 6611 03:55:45,530 --> 03:55:47,298 WAS INCLUDED IN YOUR COUNCIL 6612 03:55:47,298 --> 03:55:47,932 MATERIALS FOR YOUR 6613 03:55:47,932 --> 03:55:50,968 CONSIDERATION. 6614 03:55:50,968 --> 03:55:52,870 AFTER RONNA'S PRESENTATION, WE 6615 03:55:52,870 --> 03:55:55,039 WILL ASK COUNCIL TO VOTE ON 6616 03:55:55,039 --> 03:55:56,674 CONCURRENCE WITH THE REPORT. 6617 03:55:56,674 --> 03:55:58,342 I JUST WANT TO ACKNOWLEDGE THE 6618 03:55:58,342 --> 03:56:00,545 ENORMOUS AMOUNT OF WORK THIS 6619 03:56:00,545 --> 03:56:01,746 ENTAILED AND WE ARE GRATEFUL TO 6620 03:56:01,746 --> 03:56:04,015 RS 6621 03:56:04,816 --> 03:56:06,918 TO RONNA AND MANY OTHER PEOPLE. 6622 03:56:06,918 --> 03:56:07,952 SO OVER TO YOU. 6623 03:56:07,952 --> 03:56:18,329 >> THANK YOU SO MUCH. 6624 03:56:19,197 --> 03:56:20,731 >> NOW CAN EVERYONE HEAR ME 6625 03:56:20,731 --> 03:56:21,499 OKAY? 6626 03:56:21,499 --> 03:56:21,766 WONDERFUL. 6627 03:56:21,766 --> 03:56:26,871 ALL RIGHT. 6628 03:56:26,871 --> 03:56:29,006 THANK YOU SO MUCH, DR. BIANCHI. 6629 03:56:29,006 --> 03:56:29,841 WHILE I AM PERSON PRESENTING 6630 03:56:29,841 --> 03:56:31,175 HERE TODAY, I AM PRESENTING ON 6631 03:56:31,175 --> 03:56:34,078 BEHALF OF A MASSIVE TEAM, AND I 6632 03:56:34,078 --> 03:56:36,147 KNOW I AM LIKELY TO FORGET SOME 6633 03:56:36,147 --> 03:56:37,782 NAMES BUT I DO WANT TO TAKE A 6634 03:56:37,782 --> 03:56:40,585 MOMENT TO EXPLICITLY THANK HERE 6635 03:56:40,585 --> 03:56:44,288 AT NICHD SANDY DALCOR, CATHERINE 6636 03:56:44,288 --> 03:56:47,191 ADAMS, ANDREA MARCUS, LISA JATA, 6637 03:56:47,191 --> 03:56:51,896 KEITH RIVERS, JOE AGAINHART AND 6638 03:56:51,896 --> 03:56:55,333 SARAH GLAVIN ALL WHO HAVE WORKED 6639 03:56:55,333 --> 03:56:57,869 TIRELESSLY ON THIS REPORT IN 6640 03:56:57,869 --> 03:56:59,704 CONJUNCTION WITH ME, AND ALSO 6641 03:56:59,704 --> 03:57:02,039 OUR FOLKS IN THE NIH INCLUSION 6642 03:57:02,039 --> 03:57:03,574 OFFICE, REBECCA FABER AND DON 6643 03:57:03,574 --> 03:57:04,008 CORBETT. 6644 03:57:04,008 --> 03:57:08,179 SO YEAH, THIS IS A HERCULEAN 6645 03:57:08,179 --> 03:57:09,247 EFFORT SO THANKS TO EVERYBODY 6646 03:57:09,247 --> 03:57:10,248 FOR GETTING US TO WHERE WE ARE 6647 03:57:10,248 --> 03:57:10,948 RIGHT NOW. 6648 03:57:10,948 --> 03:57:12,717 BEFORE WE DIVE INTO THE DATA, 6649 03:57:12,717 --> 03:57:14,285 AND THE CHARTS IN THE REPORT, I 6650 03:57:14,285 --> 03:57:17,688 JUST WANT TO TAKE A MOMENT TO 6651 03:57:17,688 --> 03:57:19,991 STEP BACK AND TALK ABOUT WHY 6652 03:57:19,991 --> 03:57:22,627 THESE DATA MATTER. 6653 03:57:22,627 --> 03:57:26,163 SO ON THE SLIDE, WE SEE A 6654 03:57:26,163 --> 03:57:27,465 TIMELINE OF THE VARIOUS 6655 03:57:27,465 --> 03:57:28,566 INCLUSION POLICIES THAT HAVE 6656 03:57:28,566 --> 03:57:30,134 BEEN IMPLEMENTED ACROSS THE 6657 03:57:30,134 --> 03:57:32,770 YEARS AT NIH. 6658 03:57:32,770 --> 03:57:35,840 MOST OF THESE POLICIES HAVE 6659 03:57:35,840 --> 03:57:38,009 EMERGED BECAUSE CERTAIN 6660 03:57:38,009 --> 03:57:45,783 POPULATIONS IN THE U.S. WERE 6661 03:57:45,783 --> 03:57:46,384 EITHER BEING APPROPRIATELY 6662 03:57:46,384 --> 03:57:47,585 TARGETED FOR INCLUSION IN 6663 03:57:47,585 --> 03:57:49,020 RESEARCH OR SYSTEMATICALLY 6664 03:57:49,020 --> 03:57:50,221 EXCLUDED FROM RESEARCH. 6665 03:57:50,221 --> 03:57:51,689 SO THERE WERE STORIES OR STUDIES 6666 03:57:51,689 --> 03:57:54,191 THAT EMERGED, AND THESE POLICIES 6667 03:57:54,191 --> 03:57:56,427 EMERGED IN RESPONSE TO THAT. 6668 03:57:56,427 --> 03:57:58,496 AND SO REQUIRING APPROPRIATE 6669 03:57:58,496 --> 03:57:59,597 INCLUSION IS ONE OF THE THINGS 6670 03:57:59,597 --> 03:58:02,900 THAT ENSURES THAT WE ARE 6671 03:58:02,900 --> 03:58:04,669 SUPPORTING THAT STRONGEST AND 6672 03:58:04,669 --> 03:58:05,970 BEST SCIENCE POSSIBLE AT THE 6673 03:58:05,970 --> 03:58:07,838 NIH. 6674 03:58:07,838 --> 03:58:09,373 SO TODAY WHAT WE'RE GOING TO DO 6675 03:58:09,373 --> 03:58:13,911 IS FOCUS ON DATA IN RESPONSE TO 6676 03:58:13,911 --> 03:58:18,049 REALLY TWO OF THESE KEY 6677 03:58:18,049 --> 03:58:18,382 REQUIREMENTS. 6678 03:58:18,382 --> 03:58:20,151 THE 1994 POLICY THAT REQUIRED 6679 03:58:20,151 --> 03:58:21,185 INCLUSION OF WOMEN AND MEMBERS 6680 03:58:21,185 --> 03:58:23,154 OF RACIAL AND ETHNIC MINORITY 6681 03:58:23,154 --> 03:58:26,591 GROUPS, AND THEN THE MORE RECENT 6682 03:58:26,591 --> 03:58:27,892 2019 POLICY, THAT ALSO REQUIRED 6683 03:58:27,892 --> 03:58:30,094 INCLUSION OF INDIVIDUALS OF AGES 6684 03:58:30,094 --> 03:58:31,395 ACROSS THE LIFESPAN. 6685 03:58:31,395 --> 03:58:32,763 AND ONE THING TO NOTE IS THAT 6686 03:58:32,763 --> 03:58:36,033 FOR ALL OF THESE DEMOGRAPHIC 6687 03:58:36,033 --> 03:58:39,870 CATEGORIES, PEOPLE'S INCLUSION 6688 03:58:39,870 --> 03:58:41,772 IS REQUIRED UNLESS THERE ARE 6689 03:58:41,772 --> 03:58:44,175 VALID SCIENTIFIC OR ETHICAL 6690 03:58:44,175 --> 03:58:45,509 REASONS FOR THEIR EXCLUSION. 6691 03:58:45,509 --> 03:58:47,144 SO THIS IS RELEVANT ACTUALLY IN 6692 03:58:47,144 --> 03:58:48,279 RELATION TO SOME OF THE 6693 03:58:48,279 --> 03:58:49,614 QUESTIONS WE GOT EARLIER ON 6694 03:58:49,614 --> 03:58:51,449 CONCEPTS, LIKE ARE YOU GOING TO 6695 03:58:51,449 --> 03:58:52,249 INCLUDE ADOLESCENTS. 6696 03:58:52,249 --> 03:58:54,585 IF THE TOPIC IS RELEVANT TO 6697 03:58:54,585 --> 03:58:56,554 ADOLESCENTS, UNLESS THERE'S A 6698 03:58:56,554 --> 03:58:57,855 JUSTIFICATION FOR EXCLUDING THEM 6699 03:58:57,855 --> 03:58:59,657 FROM THE RESEARCH, THEY SHOULD 6700 03:58:59,657 --> 03:59:03,060 BE INCLUDED IN ANY KIND OF 6701 03:59:03,060 --> 03:59:04,362 PROPOSAL THAT SUBMITTED IN 6702 03:59:04,362 --> 03:59:07,365 RESPONSE TO ANY KIND OF FUNDING 6703 03:59:07,365 --> 03:59:14,138 OPPORTUNITY ANNOUNCEMENT. 6704 03:59:14,138 --> 03:59:15,673 SO THE CENTRAL GOAL OF OUR 6705 03:59:15,673 --> 03:59:17,675 INCLUSION POLICIES AT 6706 03:59:17,675 --> 03:59:19,210 DR. BIANCHI NOTED IS REALLY TO 6707 03:59:19,210 --> 03:59:20,478 MINIMIZE BIAS IN RESEARCH DESIGN 6708 03:59:20,478 --> 03:59:22,246 IN ORDER TO ENSURE THAT ALL 6709 03:59:22,246 --> 03:59:23,547 NIH-SUPPORTED CLINICAL RESEARCH 6710 03:59:23,547 --> 03:59:25,850 IS GENERALIZABLE TO THE BROADEST 6711 03:59:25,850 --> 03:59:27,585 POPULATION POSSIBLE. 6712 03:59:27,585 --> 03:59:31,288 SO THE GOAL IS NOT TO ACHIEVE 6713 03:59:31,288 --> 03:59:32,456 POPULATION REPRESENTATIVENESS IN 6714 03:59:32,456 --> 03:59:33,457 EVERY STUDY. 6715 03:59:33,457 --> 03:59:36,060 IN FACT, IN ORDER TO ACHIEVE OUR 6716 03:59:36,060 --> 03:59:37,561 SCIENTIFIC GOALS THAT WOULD 6717 03:59:37,561 --> 03:59:38,996 OFTEN NOT BE THE CASE. 6718 03:59:38,996 --> 03:59:40,331 BECAUSE WHAT IS SCIENTIFICALLY 6719 03:59:40,331 --> 03:59:41,832 AND ETHICALLY VALID AND 6720 03:59:41,832 --> 03:59:44,435 APPROPRIATE FOR RESEARCH IS 6721 03:59:44,435 --> 03:59:45,069 STUDY-SPECIFIC. 6722 03:59:45,069 --> 03:59:47,471 SO FOR EXAMPLE, IF A PROJECT IS 6723 03:59:47,471 --> 03:59:50,574 LOOKING TO STUDY DISPARITIES, 6724 03:59:50,574 --> 03:59:52,209 RACIAL OR ETHNIC DISPARITY, THEN 6725 03:59:52,209 --> 03:59:54,745 THAT MIGHT REQUIRE OVERSAMPLING 6726 03:59:54,745 --> 03:59:56,714 THOSE SMALLER MINORITY 6727 03:59:56,714 --> 03:59:59,283 POPULATIONS IN ORDER TO DRAW 6728 03:59:59,283 --> 04:00:00,751 VALID STATISTICAL CONCLUSIONS 6729 04:00:00,751 --> 04:00:04,955 ABOUT CERTAIN GROUPS. 6730 04:00:04,955 --> 04:00:05,923 SO IN ADDITION I WANT YOU TO 6731 04:00:05,923 --> 04:00:07,291 NOTE THAT THE POLICY LANGUAGE 6732 04:00:07,291 --> 04:00:09,260 ALSO APPLIES TO ALL CLINICAL 6733 04:00:09,260 --> 04:00:10,561 RESEARCH. 6734 04:00:10,561 --> 04:00:12,229 SO THAT DOESN'T MEAN CLINICAL 6735 04:00:12,229 --> 04:00:12,663 TRIALS. 6736 04:00:12,663 --> 04:00:15,199 NIH HAS A VERY BROAD DEFINITION 6737 04:00:15,199 --> 04:00:18,269 OF CLINICAL RESEARCH, AND IT YOU 6738 04:00:18,269 --> 04:00:19,603 INCLUDES ESSENTIALLY ALL 6739 04:00:19,603 --> 04:00:22,373 RESEARCH INVOLVING INTERACTIONS 6740 04:00:22,373 --> 04:00:23,941 WITH HUMAN SUBJECTS. 6741 04:00:23,941 --> 04:00:25,876 SO ANY HUMAN SUBJECTS RESEARCH 6742 04:00:25,876 --> 04:00:30,881 THAT IS NOT UTILIZING PREVIOUSLY 6743 04:00:30,881 --> 04:00:32,383 COLLECTED DATA. 6744 04:00:32,383 --> 04:00:34,685 AND I DO HAVE THE FULL FORMAL 6745 04:00:34,685 --> 04:00:35,886 DEFINITION OF CLINICAL RESEARCH 6746 04:00:35,886 --> 04:00:37,354 IF ANYBODY WANTS TO ASK ME ABOUT 6747 04:00:37,354 --> 04:00:40,091 IT LATER. 6748 04:00:40,091 --> 04:00:40,991 YOU A 'NOTHER THING I WANT YOU 6749 04:00:40,991 --> 04:00:43,794 ALL TO KEEP IN MIND AS WE REVIEW 6750 04:00:43,794 --> 04:00:44,628 THIS DATA IS THEY ARE 6751 04:00:44,628 --> 04:00:45,196 ADMINISTRATIVE DATA. 6752 04:00:45,196 --> 04:00:46,163 THESE ARE NOT ALL OF THE DATA 6753 04:00:46,163 --> 04:00:47,798 THAT THE RESEARCHERS COLLECT. 6754 04:00:47,798 --> 04:00:49,767 THIS IS JUST A SUBSAMPLE OF 6755 04:00:49,767 --> 04:00:51,969 THOSE DATA THAT WE ASK THEM TO 6756 04:00:51,969 --> 04:00:56,640 REPORT TO US TO ASSESS ADHERENCE 6757 04:00:56,640 --> 04:00:57,808 TO OUR POLICIES. 6758 04:00:57,808 --> 04:00:59,243 AND THE DATA THAT THEY REPORT TO 6759 04:00:59,243 --> 04:01:01,078 US ARE ONLY THEIR PROSPECTIVE 6760 04:01:01,078 --> 04:01:02,246 DATA. 6761 04:01:02,246 --> 04:01:03,981 SO IT DOES NOT INCLUDE ANY 6762 04:01:03,981 --> 04:01:05,950 EXISTING DATA THAT ANY OF OUR 6763 04:01:05,950 --> 04:01:08,586 INVESTIGATORS ARE ALREADY 6764 04:01:08,586 --> 04:01:18,796 WORKING AT. 6765 04:01:23,267 --> 04:01:23,934 SO IF THERE'S ONE THING THAT I 6766 04:01:23,934 --> 04:01:25,903 WANT YOU ALL TO WALK AWAY WITH 6767 04:01:25,903 --> 04:01:29,740 TODAY, IT IS THAT INCLUSION AT 6768 04:01:29,740 --> 04:01:31,876 NICHD IS ROBUST AND STRONGLY 6769 04:01:31,876 --> 04:01:34,278 ALIGNED WITH OUR MISSION AND 6770 04:01:34,278 --> 04:01:37,882 SCIENTIFIC PRIORITIES. 6771 04:01:37,882 --> 04:01:39,650 SO I'M GOING TO DEMONSTRATE THAT 6772 04:01:39,650 --> 04:01:40,651 WITH OUR UPCOMING CHARTS AND 6773 04:01:40,651 --> 04:01:41,986 TABLES AND WHAT I'M GOING TO 6774 04:01:41,986 --> 04:01:45,689 SHOW YOU IS A DEEPER DIVE INTO 6775 04:01:45,689 --> 04:01:47,057 SECTION 3 OF THE FULL REPORT. 6776 04:01:47,057 --> 04:01:49,593 WHICH IS THE ENROLLMENT DATA 6777 04:01:49,593 --> 04:01:50,995 ANALYSIS AND INTERPRETATION. 6778 04:01:50,995 --> 04:01:52,730 AND AS DR. BIANCHI SAID, THE 6779 04:01:52,730 --> 04:01:54,565 FULL REPORT IS AVAILABLE FOR YOU 6780 04:01:54,565 --> 04:01:57,434 TO READ AND WE DO WELCOME YOUR 6781 04:01:57,434 --> 04:01:59,904 FEEDBACK. 6782 04:01:59,904 --> 04:02:01,338 SO PLEASE, PLEASE SHARE THAT 6783 04:02:01,338 --> 04:02:09,280 WITH US. 6784 04:02:09,280 --> 04:02:10,915 SO NEXT BY LOOKING AT ENROLLMENT 6785 04:02:10,915 --> 04:02:13,217 BY SEX AN AND GENDER, A QUICK N, 6786 04:02:13,217 --> 04:02:14,351 THE CATEGORY REALLY IS SEX OR 6787 04:02:14,351 --> 04:02:15,352 GENDER. 6788 04:02:15,352 --> 04:02:16,420 SO PRINCIPAL INVESTIGATORS CAN 6789 04:02:16,420 --> 04:02:18,589 REPORT EITHER SEX DATA OR GENDER 6790 04:02:18,589 --> 04:02:21,325 DATA IN THAT ONE FIELD IN OUR 6791 04:02:21,325 --> 04:02:30,167 ENROLLMENT TABLES. 6792 04:02:30,167 --> 04:02:32,970 SO THIS CHART SHOWS A PROPORTION 6793 04:02:32,970 --> 04:02:34,939 OF MEN AND WOMEN ENROLL IN NICHD 6794 04:02:34,939 --> 04:02:36,340 CLINICAL RESEARCH IN EACH YEAR 6795 04:02:36,340 --> 04:02:38,876 OF THE REPORTING PERIOD. 6796 04:02:38,876 --> 04:02:40,911 AND WE SEE THAT WOMEN WERE A 6797 04:02:40,911 --> 04:02:44,748 MAJORITY OF NICHD PARTICIPANTS 6798 04:02:44,748 --> 04:02:47,051 BETWEEN 2022 AND 2024 RANGING 6799 04:02:47,051 --> 04:02:51,455 FROM BETWEEN 63% AND 73% OF 6800 04:02:51,455 --> 04:02:52,656 PARTICIPANTS ACROSS THE THREE 6801 04:02:52,656 --> 04:02:52,990 YEARS. 6802 04:02:52,990 --> 04:02:55,492 SO THE WOMEN ARE THE BLUE BARS 6803 04:02:55,492 --> 04:02:58,028 AT THE BOTTOM THAT ARE ALSO 6804 04:02:58,028 --> 04:03:03,601 POLKA DOTTED, AND THAT REFLECTS 6805 04:03:03,601 --> 04:03:05,769 NICHD'S RESEARCH PRIORITIES. 6806 04:03:05,769 --> 04:03:08,472 BECAUSE OUR PRIORITIES FOCUS ON 6807 04:03:08,472 --> 04:03:10,107 SEVERAL TOPICS THAT WOULD FOCUS 6808 04:03:10,107 --> 04:03:11,642 ON WOMEN'S HEALTH AND ON 6809 04:03:11,642 --> 04:03:12,409 MATERNAL HEALTH. 6810 04:03:12,409 --> 04:03:14,645 SO THAT WOULD REQUIRE A 6811 04:03:14,645 --> 04:03:15,646 DISPROPORTIONATE ENROLLMENT OF 6812 04:03:15,646 --> 04:03:17,715 WOMEN IN OUR STUDIES. 6813 04:03:17,715 --> 04:03:20,351 AND AS WOOR GOING TO SEE AS WE 6814 04:03:20,351 --> 04:03:23,053 MOVE INTO LOOKING AT ENROLLMENT 6815 04:03:23,053 --> 04:03:25,556 ACROSS RACE AND ETHNICITY, WHEN 6816 04:03:25,556 --> 04:03:26,891 WE LOOK AT THE INTERSECTION OF 6817 04:03:26,891 --> 04:03:28,459 SEX AND GENDER AND RACE AND 6818 04:03:28,459 --> 04:03:30,861 ETHNICITY, WE WILL FURTHER SEE 6819 04:03:30,861 --> 04:03:32,396 OUR SCIENTIFIC PRIORITIES 6820 04:03:32,396 --> 04:03:34,198 REFLECTED IN OUR ENROLLMENT 6821 04:03:34,198 --> 04:03:37,935 DATA. 6822 04:03:37,935 --> 04:03:39,270 SO BEFORE WITH WE LOOK AT THE 6823 04:03:39,270 --> 04:03:40,638 MINORITY DATA, I ALSO WANT TO 6824 04:03:40,638 --> 04:03:43,574 TAKE A MOMENT TO JUST EXPLAIN 6825 04:03:43,574 --> 04:03:45,109 THAT AS WE LOOK AT THE MINORITY 6826 04:03:45,109 --> 04:03:46,410 ENROLLMENT DATA, WE ARE ONLY 6827 04:03:46,410 --> 04:03:49,780 GOING TO BE LOOKING AT 6828 04:03:49,780 --> 04:03:50,314 ENROLLMENT IN U.S. SITES. 6829 04:03:50,314 --> 04:03:51,448 SO THE DATA THAT I JUST SHOWED 6830 04:03:51,448 --> 04:03:53,617 YOU ON SEX AND GENDER, THOSE 6831 04:03:53,617 --> 04:03:56,854 WERE FOR ENROLLMENT IN FOREIGN 6832 04:03:56,854 --> 04:03:57,721 AND DOMESTIC SITES. 6833 04:03:57,721 --> 04:03:59,723 BUT FOR MINORITY RACIAL AND 6834 04:03:59,723 --> 04:04:01,025 ETHNIC MINORITY DATA, WE LOOK 6835 04:04:01,025 --> 04:04:02,860 ONLY AT U.S. SITES AND THAT'S 6836 04:04:02,860 --> 04:04:04,161 BECAUSE RACE IS A SOCIAL 6837 04:04:04,161 --> 04:04:05,596 CATEGORY. 6838 04:04:05,596 --> 04:04:07,765 SO ITS MEANINGS AND ITS 6839 04:04:07,765 --> 04:04:09,133 RELATIONSHIPS TO HEALTH VARY 6840 04:04:09,133 --> 04:04:10,334 ACROSS TIME, CULTURE AND 6841 04:04:10,334 --> 04:04:11,902 COUNTRIES. 6842 04:04:11,902 --> 04:04:13,170 AND THE RACIAL AND ETHNIC 6843 04:04:13,170 --> 04:04:15,639 CATEGORIES THAT WE USE IN NIH 6844 04:04:15,639 --> 04:04:17,274 INCLUSION TABLE, THOSE ARE 6845 04:04:17,274 --> 04:04:20,644 U.S.-BASED RACE AND ETHNICITY 6846 04:04:20,644 --> 04:04:21,345 CATEGORIES. 6847 04:04:21,345 --> 04:04:22,713 SO THEIR MEANING AND THEIR 6848 04:04:22,713 --> 04:04:24,782 RELEVANCE TO RESEARCH, THAT'S 6849 04:04:24,782 --> 04:04:27,084 NOT STABLE ACROSS VARIOUS 6850 04:04:27,084 --> 04:04:28,686 SOCIOCULTURAL CONTEXTS. 6851 04:04:28,686 --> 04:04:30,888 SO FOR EXAMPLE, MANY OF THE 6852 04:04:30,888 --> 04:04:32,256 PARTICIPANTS IN CLINICAL 6853 04:04:32,256 --> 04:04:34,158 RESEARCH AT NON-U.S. SITES, THEY 6854 04:04:34,158 --> 04:04:36,527 WOULD BE CONSIDERED MEMBERS OF A 6855 04:04:36,527 --> 04:04:37,695 MINORITY RACIAL OR ETHNIC GROUP 6856 04:04:37,695 --> 04:04:40,130 IN THE U.S. BUT IN THEIR OWN 6857 04:04:40,130 --> 04:04:42,266 COUNTRY, THEY MIGHT BE A 6858 04:04:42,266 --> 04:04:43,968 MAJORITY GROUP AND IN ADDITION, 6859 04:04:43,968 --> 04:04:45,235 THEIR RACE OR ETHNICITY, THAT 6860 04:04:45,235 --> 04:04:48,605 MIGHT NOT BE THE OPERATIVE 6861 04:04:48,605 --> 04:04:49,773 SOCIAL CATEGORY ALONG WITH 6862 04:04:49,773 --> 04:04:55,212 ISSUES OF POWER INEQUALITY 6863 04:04:55,212 --> 04:04:57,982 CLEAVE. 6864 04:04:57,982 --> 04:05:00,818 SO THAT INCREASES THE STABILITY 6865 04:05:00,818 --> 04:05:02,186 OF THE MEANING OF THOSE 6866 04:05:02,186 --> 04:05:03,387 CATEGORIES AND THEREFORE THE 6867 04:05:03,387 --> 04:05:05,689 VALIDITY OF THE ANALYSIS OF OUR 6868 04:05:05,689 --> 04:05:12,997 INCLUSION PRACTICES. 6869 04:05:12,997 --> 04:05:16,033 SO IN THIS TABLE WE SEE RACIAL 6870 04:05:16,033 --> 04:05:17,668 AND ETHNIC MINORITY ENROLLMENT 6871 04:05:17,668 --> 04:05:19,870 IN NICHD CLINICAL RESEARCH AT 6872 04:05:19,870 --> 04:05:20,704 U.S. SITES ACROSS THE THREE-YEAR 6873 04:05:20,704 --> 04:05:21,672 PERIOD. 6874 04:05:21,672 --> 04:05:24,641 AND IT'S BROKEN DOWN IN THREE 6875 04:05:24,641 --> 04:05:26,710 DIFFERENT MINORITY ENROLLMENT 6876 04:05:26,710 --> 04:05:27,111 CATEGORIES. 6877 04:05:27,111 --> 04:05:30,047 THE SHADED COLUMN IS ALL 6878 04:05:30,047 --> 04:05:30,814 MINORITIES. 6879 04:05:30,814 --> 04:05:33,884 SO THAT INCLUDES RACIAL 6880 04:05:33,884 --> 04:05:35,652 MINORITIES AND WHITE HISPANICS 6881 04:05:35,652 --> 04:05:37,821 AND LATINOS, BECAUSE HISPANICS 6882 04:05:37,821 --> 04:05:41,392 AND LATINOS OF OTHER RACIAL 6883 04:05:41,392 --> 04:05:42,860 GROUPS WOULD ALREADY BE INCLUDED 6884 04:05:42,860 --> 04:05:43,927 IN THE RACIAL MINORITIES WHO ARE 6885 04:05:43,927 --> 04:05:44,661 IN THAT CATEGORY. 6886 04:05:44,661 --> 04:05:46,797 THEN THERE'S ALSO THE HISPANIC 6887 04:05:46,797 --> 04:05:47,464 LATINO COLUMN AND THEN JUST 6888 04:05:47,464 --> 04:05:49,199 RACIAL MINORITIES WHICH WOULD 6889 04:05:49,199 --> 04:05:51,168 INCLUDE RACIAL MINORITIES OF ANY 6890 04:05:51,168 --> 04:05:53,937 ETHNICITY. 6891 04:05:53,937 --> 04:05:55,939 AND SO ONE THING TO LOOK AT IS 6892 04:05:55,939 --> 04:05:57,574 WHEN YOU LOOK DOWN EACH COLUMN, 6893 04:05:57,574 --> 04:06:00,411 SO IN EACH RACIAL OR ETHNIC 6894 04:06:00,411 --> 04:06:02,246 MINORITY CATEGORY, THERE'S 6895 04:06:02,246 --> 04:06:04,882 REMARKABLE CONSISTENCY IN OUR 6896 04:06:04,882 --> 04:06:06,216 PERCENTAGE ENROLLMENT ACROSS 6897 04:06:06,216 --> 04:06:09,353 YEARS. 6898 04:06:09,353 --> 04:06:11,221 NOW IN ADDITION, IF YOU LOOK AT 6899 04:06:11,221 --> 04:06:12,823 THAT SHADED COLUMN, THE ALL 6900 04:06:12,823 --> 04:06:14,758 MINORITIES COLUMN, WE SEE THAT 6901 04:06:14,758 --> 04:06:17,928 AT NICHD, APPROXIMATELY HALF OF 6902 04:06:17,928 --> 04:06:20,731 ALL OF OUR CLINICAL RESEARCH 6903 04:06:20,731 --> 04:06:22,166 PARTICIPANTS AT U.S. SITES ARE 6904 04:06:22,166 --> 04:06:23,033 MINORITIES. 6905 04:06:23,033 --> 04:06:25,669 AND THEN IF WE LOOK AT THE 6906 04:06:25,669 --> 04:06:27,137 COLUMN ON THE RIGHT HAND, THE 6907 04:06:27,137 --> 04:06:28,005 FURTHEST RIGHT COLUMN, THE 6908 04:06:28,005 --> 04:06:32,076 RACIAL MINORITIES COLUMN, WE SEE 6909 04:06:32,076 --> 04:06:33,477 THAT JUST OVER A THIRD ARE 6910 04:06:33,477 --> 04:06:35,879 RACIAL MINORITIES. 6911 04:06:35,879 --> 04:06:37,514 NOW WHEN WE COMPARE THAT TO THE 6912 04:06:37,514 --> 04:06:41,985 REST OF MINORITY ENROLLMENT AT 6913 04:06:41,985 --> 04:06:48,792 NIH, WE SEE THAT THE LARGE 6914 04:06:48,792 --> 04:06:49,960 PERCENTAGES OF MINORITY 6915 04:06:49,960 --> 04:06:53,697 ENROLLMENT THAT WE HAVE AT NICHD 6916 04:06:53,697 --> 04:06:58,302 ARE NOT TYPICAL ACROSS ALL OTHER 6917 04:06:58,302 --> 04:06:59,536 INSTITUTES AND CENTERS. 6918 04:06:59,536 --> 04:07:02,272 SO IN THIS TABLE, WE'RE 6919 04:07:02,272 --> 04:07:04,241 COMPARING NICHD'S MINORITY 6920 04:07:04,241 --> 04:07:07,678 ENROLLMENT TO WHAT ENROLLMENT IS 6921 04:07:07,678 --> 04:07:14,017 AT NIH OVERALL. 6922 04:07:14,017 --> 04:07:17,321 AND WHEN WE SEE THAT NICHD'S 6923 04:07:17,321 --> 04:07:18,822 ENROLLMENT IN EVERY SINGLE 6924 04:07:18,822 --> 04:07:21,091 CATEGORY IS HIGHER THAN AT NIH 6925 04:07:21,091 --> 04:07:23,627 OVERALL, BUT ENROLLMENT OF ALL 6926 04:07:23,627 --> 04:07:25,562 MINORITIES AND RACIAL MINORITIES 6927 04:07:25,562 --> 04:07:29,032 IS ABOUT 50% HIGHER IN NICHD 6928 04:07:29,032 --> 04:07:33,737 CLINICAL RESEARCH. 6929 04:07:33,737 --> 04:07:35,072 THAT TOO REFLECTS OUR SCIENTIFIC 6930 04:07:35,072 --> 04:07:36,540 PRIOR ORTS WHICH INCLUDE MANY 6931 04:07:36,540 --> 04:07:38,842 PROGRAMMATIC AREAS THAT HAVE 6932 04:07:38,842 --> 04:07:40,944 LARGE RACIAL DISPARITIES 6933 04:07:40,944 --> 04:07:43,981 SPECIFICALLY. 6934 04:07:43,981 --> 04:07:45,516 SO MATERNAL MORBIDITY AND 6935 04:07:45,516 --> 04:07:47,217 MORTALITY. 6936 04:07:47,217 --> 04:07:48,418 UTERINE FIBROIDS, INFANT 6937 04:07:48,418 --> 04:07:48,852 MORTALITY. 6938 04:07:48,852 --> 04:07:49,820 I'M JUST NAMING A FEW. 6939 04:07:49,820 --> 04:07:54,057 THERE ARE MANY, MANY OTHERS. 6940 04:07:54,057 --> 04:07:55,459 SO THAT IS A REFLECTION OF OUR 6941 04:07:55,459 --> 04:07:57,761 PRIORITIES BUT IT IS ALSO A 6942 04:07:57,761 --> 04:08:00,797 REFLECTION OF THE HARD WORK OF 6943 04:08:00,797 --> 04:08:03,433 ENSURING THAT THAT ENROLLMENT IS 6944 04:08:03,433 --> 04:08:05,169 PRIORITIZED AND ACHIEVED. 6945 04:08:05,169 --> 04:08:08,071 AND THAT IS WORK THAT IS 6946 04:08:08,071 --> 04:08:10,174 UNDERTAKEN BY OUR INVESTIGATORS 6947 04:08:10,174 --> 04:08:12,042 AND OUR PROGRAM TO MAKE SURE 6948 04:08:12,042 --> 04:08:17,047 THAT THAT HAPPENS. 6949 04:08:17,047 --> 04:08:18,982 SO IT REFLECTS A LOT OF WORK. 6950 04:08:18,982 --> 04:08:21,151 AND I MENTIONED THAT IT'S 6951 04:08:21,151 --> 04:08:22,252 SPECIFICALLY RACIAL, THERE'S 6952 04:08:22,252 --> 04:08:23,954 RACIAL DISPARITIES SPECIFICALLY 6953 04:08:23,954 --> 04:08:25,489 AND THAT'S WHY WE WOULD EXPECT 6954 04:08:25,489 --> 04:08:27,691 TO SEE THE GREATEST KIND OF 6955 04:08:27,691 --> 04:08:29,426 OVERENROLLMENT IN THOSE 6956 04:08:29,426 --> 04:08:33,697 CATEGORIES AT NICHD. 6957 04:08:33,697 --> 04:08:34,965 SPECIFICALLY MANY OF THOSE 6958 04:08:34,965 --> 04:08:37,467 DISPARITIES ARE CONCENTRATED 6959 04:08:37,467 --> 04:08:39,970 AMONG AFRICAN AMERICAN AND BLACK 6960 04:08:39,970 --> 04:08:45,209 FOLKS IN THE UNITED STATES. 6961 04:08:45,209 --> 04:08:47,244 SO SO IF WE LOOK AT THIS BREAK 6962 04:08:47,244 --> 04:08:47,945 DOWN BY RACIAL GROUPS, AGAIN WE 6963 04:08:47,945 --> 04:08:50,113 SEE THIS REFLECTED IN OUR 6964 04:08:50,113 --> 04:08:53,584 ENROLLMENT DATA. 6965 04:08:53,584 --> 04:08:55,419 SO THIS SLIDE SHOWS YOU THE 6966 04:08:55,419 --> 04:08:59,356 BREAK DOWN OF RACIAL MINORITIES 6967 04:08:59,356 --> 04:09:02,826 AND WE SEE THAT THE 6968 04:09:02,826 --> 04:09:04,695 DISPROPORTIONATE ENROLLMENT 6969 04:09:04,695 --> 04:09:06,230 AMONG RACIAL MINORITIES IS 6970 04:09:06,230 --> 04:09:06,997 CONCENTRATED IN AFRICAN 6971 04:09:06,997 --> 04:09:07,364 AMERICANS. 6972 04:09:07,364 --> 04:09:09,032 AND IF I SHOWED YOU ANOTHER 6973 04:09:09,032 --> 04:09:10,467 SLIDE BUT WE DIDN'T HAVE TIME TO 6974 04:09:10,467 --> 04:09:11,768 GO THROUGH ALL THE CHARTS AND 6975 04:09:11,768 --> 04:09:14,605 TABLES TODAY BUT YOU'D SEE THAT 6976 04:09:14,605 --> 04:09:16,039 IT'S DISPROPORTIONATELY AFRICAN 6977 04:09:16,039 --> 04:09:16,406 AMERICAN WOMEN. 6978 04:09:16,406 --> 04:09:19,409 SO THIS ALL MAKES SENSE IN THE 6979 04:09:19,409 --> 04:09:21,778 CONTEXT OF OUR SCIENTIFIC 6980 04:09:21,778 --> 04:09:23,747 PRIORITIES AND OUR MISSION AND 6981 04:09:23,747 --> 04:09:25,816 WHAT TYPES OF SCIENCE AND THE 6982 04:09:25,816 --> 04:09:28,352 TOPIC AREAS HAVE BEEN HIGHEST 6983 04:09:28,352 --> 04:09:30,387 PRIORITY TO US OVER THE PAST 6984 04:09:30,387 --> 04:09:35,525 SEVERAL YEARS. 6985 04:09:35,525 --> 04:09:36,526 SO TOGETHER WHAT THESE SLIDES 6986 04:09:36,526 --> 04:09:37,928 SHOW IS THAT OUR INCLUSION IS 6987 04:09:37,928 --> 04:09:39,363 VERY STRONGLY ALIGNED WITH OUR 6988 04:09:39,363 --> 04:09:44,234 MISSION AND OUR SCIENCE. 6989 04:09:44,234 --> 04:09:45,435 STUDYING THESE TYPES OF 6990 04:09:45,435 --> 04:09:49,573 DISPARITIES, MATERNAL AND INFANT 6991 04:09:49,573 --> 04:09:50,574 MORTALITY, MATERNAL HEALTH 6992 04:09:50,574 --> 04:09:52,542 DISPARITIES, THAT REQUIRES THIS 6993 04:09:52,542 --> 04:09:54,278 KIND OF DISPROPORTIONATE 6994 04:09:54,278 --> 04:09:56,947 REPRESENTATION AND RESEARCH THAT 6995 04:09:56,947 --> 04:09:57,481 EVERYBODY HAS BEEN WORKING 6996 04:09:57,481 --> 04:10:02,319 REALLY HARD TO ACHIEVE AT NICHD. 6997 04:10:02,319 --> 04:10:05,055 SO FINALLY I WANT US TO TAKE A 6998 04:10:05,055 --> 04:10:08,525 LOOK AT INCLUSION ACROSS THE I 6999 04:10:08,525 --> 04:10:09,593 LIFESPAN BECAUSE THAT IS ALSO A 7000 04:10:09,593 --> 04:10:10,694 TOPIC THAT IS VERY IMPORTANT TO 7001 04:10:10,694 --> 04:10:12,195 US AT NICHD BECAUSE AFTER ALL WE 7002 04:10:12,195 --> 04:10:13,597 ARE THE INSTITUTE OF CHILD 7003 04:10:13,597 --> 04:10:20,304 HEALTH AND HUMAN DEVELOPMENT. 7004 04:10:20,304 --> 04:10:22,005 SO A COUPLE OF QUICK NOTES, 7005 04:10:22,005 --> 04:10:23,206 BECAUSE THE INCLUSION ACROSS THE 7006 04:10:23,206 --> 04:10:24,741 LIFESPAN POLICY WAS FIRST 7007 04:10:24,741 --> 04:10:25,942 IMPLEMENTED FOR ANY RESEARCH 7008 04:10:25,942 --> 04:10:27,144 APPLICATIONS THAT WERE SUBMITTED 7009 04:10:27,144 --> 04:10:32,449 IN JANUARY OF 2019, REPORTING ON 7010 04:10:32,449 --> 04:10:33,550 ENROLLMENT BY AGE REALLY DIDN'T 7011 04:10:33,550 --> 04:10:35,585 BEGIN, IT STARTED TO TRICKLE IN 7012 04:10:35,585 --> 04:10:37,220 IN 2021, REALLY STARTED TO PICK 7013 04:10:37,220 --> 04:10:41,591 UP IN 2022, BUT IT'S NOT REALLY 7014 04:10:41,591 --> 04:10:43,226 UNTIL 2024 THAT A MAJORITY OF 7015 04:10:43,226 --> 04:10:47,164 OUR STUDIES HAVE REQUIRED 7016 04:10:47,164 --> 04:10:49,399 REPORTING ON AGE AND ENROLLMENT. 7017 04:10:49,399 --> 04:10:52,803 SO I'M JUST SHOWING YOU THE 2024 7018 04:10:52,803 --> 04:10:54,771 DATA THIS YEAR IN OUR NEXT 7019 04:10:54,771 --> 04:10:56,039 TRIENNIAL REPORT WE'LL REALLY 7020 04:10:56,039 --> 04:10:57,774 HAVE MUCH MORE ROBUST AGE DATA. 7021 04:10:57,774 --> 04:11:00,210 IN THIS SLIDE, WHAT I'VE ALSO 7022 04:11:00,210 --> 04:11:02,813 DONE IS WE'RE COMPARING NICHD, 7023 04:11:02,813 --> 04:11:05,415 THE PIE CHART ON THE LEFT, TO 7024 04:11:05,415 --> 04:11:06,583 OTHER INSTITUTES AND CENTERS ON 7025 04:11:06,583 --> 04:11:09,886 THE RIGHT. 7026 04:11:09,886 --> 04:11:12,923 I HAVE EXPLICITLY PULLED NICHD'S 7027 04:11:12,923 --> 04:11:14,124 CHILDREN OUT OF THE OTHER NIH 7028 04:11:14,124 --> 04:11:16,526 DATA BECAUSE WE ENROLL SO MANY 7029 04:11:16,526 --> 04:11:18,462 OF THE CHILDREN IN RESEARCH 7030 04:11:18,462 --> 04:11:19,896 STUDIES AT NIH THAT I DIDN'T 7031 04:11:19,896 --> 04:11:24,501 WANT TO BE COMPARING US TO US. 7032 04:11:24,501 --> 04:11:26,303 I WANT TO BE COMPARING US TO THE 7033 04:11:26,303 --> 04:11:28,638 REST OF NIH. 7034 04:11:28,638 --> 04:11:30,807 NOT SURPRISINGLY, WE ENROLL MANY 7035 04:11:30,807 --> 04:11:34,378 MORE CHILDREN THAN THE REST OF 7036 04:11:34,378 --> 04:11:37,581 THE INSTITUTES AND CENTERS AT 7037 04:11:37,581 --> 04:11:38,348 THE NIH. 7038 04:11:38,348 --> 04:11:40,083 SO CHILDREN ARE THE BLUE PIE 7039 04:11:40,083 --> 04:11:44,321 CHART SO FROM APPROXIMATELY NOON 7040 04:11:44,321 --> 04:11:50,127 ON BOTH PIE CHART OVER, ON THE 7041 04:11:50,127 --> 04:11:52,429 NICHD PIE CHART, IT'S 34% SO 7042 04:11:52,429 --> 04:11:53,397 ABOUT A THIRD OF OUR 7043 04:11:53,397 --> 04:11:54,531 PARTICIPANTS ARE CHILDREN, AND 7044 04:11:54,531 --> 04:11:56,433 AT OTHER ICs, IT'S 9%. 7045 04:11:56,433 --> 04:11:58,869 SO WE ENROLL APPROXIMATELY FOUR 7046 04:11:58,869 --> 04:12:02,372 TIMES THE PERCENTAGE OF 7047 04:12:02,372 --> 04:12:02,739 CHILDREN. 7048 04:12:02,739 --> 04:12:05,041 AND AGAIN, NOT SO SURPRISINGLY, 7049 04:12:05,041 --> 04:12:10,480 WE ENROLL VERY FEW OLDER ADULTS. 7050 04:12:10,480 --> 04:12:11,481 THAT'S THE TINY LITTLE SLIVER OF 7051 04:12:11,481 --> 04:12:13,350 GREY COMPARED TO THE REST OF THE 7052 04:12:13,350 --> 04:12:16,153 NIH, WHICH ENROLLS ABOUT 16% OF 7053 04:12:16,153 --> 04:12:16,486 OLDER ADULTS. 7054 04:12:16,486 --> 04:12:18,555 BUT OUR MISSION IS TO DO 7055 04:12:18,555 --> 04:12:20,357 LIFECOURSE RESEARCH UP THROUGH 7056 04:12:20,357 --> 04:12:22,025 MIDDLE ADULTHOOD, RIGHT, IN 7057 04:12:22,025 --> 04:12:22,559 TERMS OF OUR PRIORITIES. 7058 04:12:22,559 --> 04:12:24,661 SO AGAIN, WE SEE THIS ALIGNMENT. 7059 04:12:24,661 --> 04:12:26,329 NOW ONE THING I REALLY WANT TO 7060 04:12:26,329 --> 04:12:27,097 HIGHLIGHT HERE, BECAUSE THIS IS 7061 04:12:27,097 --> 04:12:30,100 ALSO TAKEN -- HAS ALSO TAKEN A 7062 04:12:30,100 --> 04:12:31,635 LOT OF WORK BY OUR GRANTS 7063 04:12:31,635 --> 04:12:33,203 MANAGEMENT STAFF, OUR PROGRAM 7064 04:12:33,203 --> 04:12:36,440 STAFF, AND OUR INVESTIGATORS, IS 7065 04:12:36,440 --> 04:12:37,307 THE YELLOW PART OF THE PIE 7066 04:12:37,307 --> 04:12:37,841 CHART. 7067 04:12:37,841 --> 04:12:39,609 THE FINAL SLICE LEADING BACK UP 7068 04:12:39,609 --> 04:12:40,043 TO NOON. 7069 04:12:40,043 --> 04:12:41,445 ON BOTH SIDES. 7070 04:12:41,445 --> 04:12:43,313 AND NOTICE THAT FOR NICHD, IT'S 7071 04:12:43,313 --> 04:12:43,980 3%. 7072 04:12:43,980 --> 04:12:45,916 THAT IS PARTICIPANTS OF UNKNOWN 7073 04:12:45,916 --> 04:12:48,051 OR NOT REPORTED AGE, COMPARED TO 7074 04:12:48,051 --> 04:12:52,923 THE REST OF NIH, WHICH IS 29%. 7075 04:12:52,923 --> 04:12:57,594 SO COMPLIANCE WITH REPORTING OF 7076 04:12:57,594 --> 04:12:59,563 AGE IN THE INCLUSION ACROSS THE 7077 04:12:59,563 --> 04:13:00,564 LIFESPAN POLICY HAS BEEN A 7078 04:13:00,564 --> 04:13:01,164 CHALLENGE BECAUSE IT'S NEW. 7079 04:13:01,164 --> 04:13:02,599 PEOPLE HAVE BEEN REPORTING ON 7080 04:13:02,599 --> 04:13:04,367 ETHNICITY AND RACE AND SEX AND 7081 04:13:04,367 --> 04:13:06,970 GENDER FOR 30 YEARS AT THE NIH 7082 04:13:06,970 --> 04:13:08,772 BUT THE AGE REPORTING IS NEW AND 7083 04:13:08,772 --> 04:13:10,440 IT'S ALSO IN A NEW FORMAT AND 7084 04:13:10,440 --> 04:13:12,742 IT'S TAKEN A LOT OF WORK, AND SO 7085 04:13:12,742 --> 04:13:16,646 I THINK WE SHOULD BE REALLY 7086 04:13:16,646 --> 04:13:17,981 PROUD AT NICHD OF HOW WELL WE 7087 04:13:17,981 --> 04:13:19,983 HAVE DONE IN ENSURING COMPLIANCE 7088 04:13:19,983 --> 04:13:21,918 WITH THE REPORTING BY AGE. 7089 04:13:21,918 --> 04:13:25,355 IT'S REALLY REMARKABLE THAT OUR 7090 04:13:25,355 --> 04:13:26,690 UNKNOWN AND NOT REPORTED 7091 04:13:26,690 --> 04:13:27,557 PERCENTAGES ARE THAT LOW. 7092 04:13:27,557 --> 04:13:29,292 SO GREAT JOB, EVERYBODY. 7093 04:13:29,292 --> 04:13:30,160 BRAVO. 7094 04:13:30,160 --> 04:13:32,996 NEXT SLIDE, PLEASE. 7095 04:13:32,996 --> 04:13:34,664 AND OUR FINAL SLIDE ON AGE IS 7096 04:13:34,664 --> 04:13:37,467 JUST LOOKING AT AMONG THE 7097 04:13:37,467 --> 04:13:38,902 CHILDREN WHO ARE ENROLLED, SO 7098 04:13:38,902 --> 04:13:42,172 THIS IS ZOOMING IN ON THAT 34%, 7099 04:13:42,172 --> 04:13:45,108 AND THEN 9% OF CHILDREN WHO ARE 7100 04:13:45,108 --> 04:13:46,076 ENROLLED, DOES THE DISTRIBUTION 7101 04:13:46,076 --> 04:13:50,146 OF THOSE AGES LOOK DIFFERENT AT 7102 04:13:50,146 --> 04:13:52,449 NICHD VERSUS OTHER ICs AND THE 7103 04:13:52,449 --> 04:13:53,416 ANSWER IS YES. 7104 04:13:53,416 --> 04:13:54,951 WE ENROLL A MUCH GREATER 7105 04:13:54,951 --> 04:13:56,686 PROPORTION OF YOUNG CHILDREN AND 7106 04:13:56,686 --> 04:14:00,156 THE OTHER ICs ENROLL A GREATER 7107 04:14:00,156 --> 04:14:02,359 PROPORTION OF ADOLESCENTS. 7108 04:14:02,359 --> 04:14:05,996 SO IN 2024, AGAIN, THAT'S THE 7109 04:14:05,996 --> 04:14:08,164 SNAPSHOT HERE THAT WE'RE LOOKING 7110 04:14:08,164 --> 04:14:11,434 AT, 51% OF OUR PARTICIPANTS WERE 7111 04:14:11,434 --> 04:14:12,736 UNDER ONE YEAR, THAT HAPPENS TO 7112 04:14:12,736 --> 04:14:15,539 BE IN THAT YEAR BECAUSE THERE 7113 04:14:15,539 --> 04:14:17,641 WAS A NEW STUDY -- A NEW PROJECT 7114 04:14:17,641 --> 04:14:19,609 THAT BEGAN ON NEWBORN SCREENING, 7115 04:14:19,609 --> 04:14:22,512 BUT IN OTHER YEARS, IT'S STILL 7116 04:14:22,512 --> 04:14:23,747 QUITE HIGH COMPARED TO OTHER 7117 04:14:23,747 --> 04:14:26,016 ICs IF YOU LOOK AT THE 7118 04:14:26,016 --> 04:14:27,017 PARTICIPANTS 5 AND UNDER. 7119 04:14:27,017 --> 04:14:29,185 WE ENROLL A DISPROPORTIONATE 7120 04:14:29,185 --> 04:14:31,588 NUMBER OF THE PARTICIPANTS 5 AND 7121 04:14:31,588 --> 04:14:34,758 UNDER AT THE NIH. 7122 04:14:34,758 --> 04:14:36,293 SO IF YOU LOOK AT THIS, IT'S 7123 04:14:36,293 --> 04:14:38,428 ABOUT TWO THIRDS OF OUR 7124 04:14:38,428 --> 04:14:39,429 PARTICIPANTS ARE AGE 5 AND 7125 04:14:39,429 --> 04:14:40,530 UNDER. 7126 04:14:40,530 --> 04:14:45,068 66% IF YOU ADD THE 1 TO A AND 5D 7127 04:14:45,068 --> 04:14:48,572 THE UNDER 1 YEAR, COMPARED TO 7128 04:14:48,572 --> 04:14:51,341 21% AT THE OTHER ICs. 7129 04:14:51,341 --> 04:14:52,309 WHEREAS AT THE OTHER ICs, 7130 04:14:52,309 --> 04:14:53,276 ALMOST HALF OF THEIR 7131 04:14:53,276 --> 04:14:54,811 PARTICIPANTS ARE EITHER EARLY OR 7132 04:14:54,811 --> 04:14:56,646 LATER ADOLESCENTS COMPARED TO 7133 04:14:56,646 --> 04:14:57,647 JUST 15% OF THE CHILDREN 7134 04:14:57,647 --> 04:14:59,282 ENROLLED IN OUR RESEARCH. 7135 04:14:59,282 --> 04:15:00,584 SO JUST DIFFERENT AGES WHICH 7136 04:15:00,584 --> 04:15:03,119 MEANS AGAIN WE'RE FILLING 7137 04:15:03,119 --> 04:15:09,359 IMPORTANT SCIENTIFIC GAPS. 7138 04:15:09,359 --> 04:15:11,194 SO I'M NOT GOING TO TAKE TIME 7139 04:15:11,194 --> 04:15:12,395 BECAUSE WE'RE RUNNING SHORT ON 7140 04:15:12,395 --> 04:15:14,564 TIME HERE, I'M NOT GOING TO TAKE 7141 04:15:14,564 --> 04:15:16,299 TIME ABOUT THE LIMITATIONS. 7142 04:15:16,299 --> 04:15:18,068 I WANT TO HAVE THIS SLIDE HERE 7143 04:15:18,068 --> 04:15:19,269 IF ANYBODY WANTED TO TALK TO ME 7144 04:15:19,269 --> 04:15:20,236 ABOUT THESE. 7145 04:15:20,236 --> 04:15:21,037 THESE ARE SOME OF THE KEY 7146 04:15:21,037 --> 04:15:22,205 LIMITATIONS TO OUR INCLUSION 7147 04:15:22,205 --> 04:15:23,540 DATA AND I'M HAPPY TO CHAT WITH 7148 04:15:23,540 --> 04:15:27,243 FOLKS WI ABOUT THESE. 7149 04:15:27,243 --> 04:15:29,646 SO JUST IN CONCLUSION, I DO WANT 7150 04:15:29,646 --> 04:15:31,214 TO EMPHASIZE AGAIN, WE HAVE 7151 04:15:31,214 --> 04:15:33,783 REALLY EFFECTIVE INCLUSION 7152 04:15:33,783 --> 04:15:35,952 PRACTICES IN PLACE TO ENSURE 7153 04:15:35,952 --> 04:15:39,122 ADHERENCE WITH OUR POLICIES. 7154 04:15:39,122 --> 04:15:41,491 WE EXCEL IN INCLUDING WOMEN, 7155 04:15:41,491 --> 04:15:43,460 MINORITIES AND PEOPLE OF AGES 7156 04:15:43,460 --> 04:15:46,563 ACROSS THE LIFESPAN WITHIN OUR 7157 04:15:46,563 --> 04:15:47,497 MISSION, SO ESPECIALLY CHILDREN, 7158 04:15:47,497 --> 04:15:50,133 AND OUR DIVERSE ENROLLMENT IS 7159 04:15:50,133 --> 04:15:51,368 STRONGLY ALIGNED WITH THAT 7160 04:15:51,368 --> 04:15:53,703 MISSION AND PRIORITIES AND AGAIN 7161 04:15:53,703 --> 04:15:54,904 IF PEOPLE WANT TO CHAT WITH ME 7162 04:15:54,904 --> 04:15:56,439 ABOUT VISION AND FUTURE EFFORTS, 7163 04:15:56,439 --> 04:15:57,807 HAPPY TO DO THAT BUT I DO WANT 7164 04:15:57,807 --> 04:15:59,476 TO MENTION THAT MIDDLE BULLET. 7165 04:15:59,476 --> 04:16:00,443 APPROVING METRICS ACROSS THE 7166 04:16:00,443 --> 04:16:01,945 OTHER ICs FOR ASSESSING 7167 04:16:01,945 --> 04:16:02,245 INCLUSION. 7168 04:16:02,245 --> 04:16:04,681 SO WE ARE WORKING ON MANY OF THE 7169 04:16:04,681 --> 04:16:06,850 APPROPRIATE COMMITTEES ACROSS 7170 04:16:06,850 --> 04:16:08,818 NIH TO IMPROVE OUR INCLUSION 7171 04:16:08,818 --> 04:16:09,719 PRACTICES. 7172 04:16:09,719 --> 04:16:11,021 AND ONE OF THOSE THINGS THAT WE 7173 04:16:11,021 --> 04:16:12,756 HOPE TO DO OVER TIME AND THAT 7174 04:16:12,756 --> 04:16:15,025 WE'VE BEEN WORKING ON IS 7175 04:16:15,025 --> 04:16:15,792 COLLABORATING WITH THOSE 7176 04:16:15,792 --> 04:16:18,194 APPROPRIATE COMMITTEES TO 7177 04:16:18,194 --> 04:16:20,196 POTENTIALLY EXPAND OUR INCLUSION 7178 04:16:20,196 --> 04:16:22,065 AND WORK TOWARDS THINGS THAT ARE 7179 04:16:22,065 --> 04:16:23,433 MORE ALIGNED WITH OUR MISSION 7180 04:16:23,433 --> 04:16:25,068 LIKE INCLUSION OF FOLKS WITH 7181 04:16:25,068 --> 04:16:26,803 DISABILITIES AND INCLUSION OF 7182 04:16:26,803 --> 04:16:28,872 PREGNANT AND LACTATING PEOPLE. 7183 04:16:28,872 --> 04:16:30,306 BECAUSE THIS IS PART OF OUR 7184 04:16:30,306 --> 04:16:31,641 GOAL. 7185 04:16:31,641 --> 04:16:32,509 SO THANKS VERY MUCH. 7186 04:16:32,509 --> 04:16:35,478 HAPPY TO TAKE ANY QUESTIONS. 7187 04:16:35,478 --> 04:16:36,513 >> GREAT. 7188 04:16:36,513 --> 04:16:37,947 THANK YOU SO MUCH, RONNA. 7189 04:16:37,947 --> 04:16:39,482 I'M SURE THERE ARE QUESTIONS. 7190 04:16:39,482 --> 04:16:41,217 IT LOOKS LIKE KEN HAS A 7191 04:16:41,217 --> 04:16:45,989 QUESTION. 7192 04:16:45,989 --> 04:16:48,692 >> GREAT PRESENTATION. 7193 04:16:48,692 --> 04:16:49,292 REALLY, CONGRATULATIONS ON THE 7194 04:16:49,292 --> 04:16:50,927 NUMBERS BEATING OUT THE OTHER 7195 04:16:50,927 --> 04:16:51,361 ICs. 7196 04:16:51,361 --> 04:16:53,797 THAT'S FAN TAS TECH. 7197 04:16:53,797 --> 04:16:56,766 FANTASTIC WE CAN BE 7198 04:16:56,766 --> 04:16:58,201 COMPETITIVE. 7199 04:16:58,201 --> 04:17:01,705 I JUST WANTED TO OBSERVE THAT IN 7200 04:17:01,705 --> 04:17:02,806 JUST CIRCLING BACK TO SOME OF 7201 04:17:02,806 --> 04:17:03,973 THE EARLY COMMENTS ABOUT OUR 7202 04:17:03,973 --> 04:17:06,176 OPPORTUNITIES AND OUR CURRENT 7203 04:17:06,176 --> 04:17:13,950 WORK IN MATERNAL HEALTH, IN 7204 04:17:13,950 --> 04:17:14,918 PERINATAL HEALTH, IT WOULD BE 7205 04:17:14,918 --> 04:17:20,724 USEFUL TO KNOW WOMEN OF 7206 04:17:20,724 --> 04:17:21,991 REPRODUCTIVE AGE, AND I KNOW 7207 04:17:21,991 --> 04:17:23,660 THESE CATEGORIES ARE NOT EASY TO 7208 04:17:23,660 --> 04:17:26,429 DEFINE, I UNDERSTAND THAT, BUT 7209 04:17:26,429 --> 04:17:27,964 AS A REACH GOAL, IT WOULD BE 7210 04:17:27,964 --> 04:17:32,936 USEFUL TO KNOW THAT, AND ALSO 7211 04:17:32,936 --> 04:17:38,508 FOR THE KIDS, ALSO TO KNOW, THE 7212 04:17:38,508 --> 04:17:38,775 NEONATES. 7213 04:17:38,775 --> 04:17:42,645 >> AND IN MOST OF OUR RESEARCH, 7214 04:17:42,645 --> 04:17:45,615 BECAUSE AGE AT ENROLLMENT IS 7215 04:17:45,615 --> 04:17:47,117 REQUIRED OF PARTICIPANTS, WE 7216 04:17:47,117 --> 04:17:50,186 SHOULD BE ABLE TO HAVE THE DATA 7217 04:17:50,186 --> 04:17:51,488 BECAUSE IT'S A SPECIFIC YEAR OF 7218 04:17:51,488 --> 04:17:52,255 AGE, RIGHT? 7219 04:17:52,255 --> 04:17:53,990 IT'S NOT JUST A FIVE-YEAR AGE 7220 04:17:53,990 --> 04:17:56,292 SPAN OR ANYTHING LIKE THAT. 7221 04:17:56,292 --> 04:17:59,896 SO MOSTLY WE CAN GET A LOT OF 7222 04:17:59,896 --> 04:18:01,097 THAT DATA. 7223 04:18:01,097 --> 04:18:03,833 WHETHER PEOPLE ARE ACTUALLY 7224 04:18:03,833 --> 04:18:05,368 PREGNANT OR LACTATING, THAT'S A 7225 04:18:05,368 --> 04:18:06,202 DIFFERENT STORY. 7226 04:18:06,202 --> 04:18:07,303 THAT'S NOT SOMETHING WE'RE ABLE 7227 04:18:07,303 --> 04:18:09,672 TO DISCERN RIGHT NOW IN OUR 7228 04:18:09,672 --> 04:18:10,440 INCLUSION DATA AND THAT'S WHY 7229 04:18:10,440 --> 04:18:11,441 WE'RE SAYING THAT'S KIND OF A 7230 04:18:11,441 --> 04:18:12,976 VISION AND FUTURE GOAL. 7231 04:18:12,976 --> 04:18:16,112 BUT WHETHER THEY ARE OF REA 7232 04:18:16,112 --> 04:18:17,113 PRODUCTIVE AGE IS CERTAINLY 7233 04:18:17,113 --> 04:18:18,748 SOMETHING WE SHOULD, PER OUR 7234 04:18:18,748 --> 04:18:20,950 POLICIES, BE ABLE TO DETERMINE. 7235 04:18:20,950 --> 04:18:22,585 >> AND IF IT COULD BE COMPARED 7236 04:18:22,585 --> 04:18:24,020 TO THE OTHER INSTITUTES, IT 7237 04:18:24,020 --> 04:18:24,888 MIGHT BE INTERESTING. 7238 04:18:24,888 --> 04:18:26,022 >> YEAH. 7239 04:18:26,022 --> 04:18:29,359 OUR DATA, THESE DATA ARE MOSTLY 7240 04:18:29,359 --> 04:18:30,693 AGGREGATED, BUT WE MAY BE ABLE 7241 04:18:30,693 --> 04:18:36,599 TO GET MORE GRANULAR OVER TIME. 7242 04:18:36,599 --> 04:18:38,001 >> GREAT SUGGESTIONS, THANK YOU. 7243 04:18:38,001 --> 04:18:38,935 NEXT IS CYNTHIA. 7244 04:18:38,935 --> 04:18:39,636 >> YES, THANK YOU. 7245 04:18:39,636 --> 04:18:42,071 AND THANKS, RONNA, FOR THAT 7246 04:18:42,071 --> 04:18:42,972 REALLY WONDERFUL PRESENTATION. 7247 04:18:42,972 --> 04:18:44,674 I HAVE TO SAY, MY COMMENTS ARE 7248 04:18:44,674 --> 04:18:46,843 VERY SIMILAR TO THE PRIOR 7249 04:18:46,843 --> 04:18:47,377 COMMENTS. 7250 04:18:47,377 --> 04:18:49,813 MAYBE EVEN A STEP FURTHER. 7251 04:18:49,813 --> 04:18:51,447 I UNDERSTAND AT THE END OF YOUR 7252 04:18:51,447 --> 04:18:52,949 PRESENTATION, YOU MENTIONED 7253 04:18:52,949 --> 04:18:54,284 PREGNANCY IS A BIT OF A 7254 04:18:54,284 --> 04:18:57,654 CHALLENGE, BUT UNDERSTANDING THE 7255 04:18:57,654 --> 04:18:59,355 NUMBERS OF PREGNANT PEOPLE WHO 7256 04:18:59,355 --> 04:19:00,156 ARE INCLUDED IN CLINICAL TRIALS, 7257 04:19:00,156 --> 04:19:03,660 FOR ME AS A MATERNAL FETAL 7258 04:19:03,660 --> 04:19:04,861 MEDICINE PERSON IS SUPER 7259 04:19:04,861 --> 04:19:07,197 IMPORTANT, AND I JUST POINT TO 7260 04:19:07,197 --> 04:19:08,364 THE COVID VACCINE AS THE 7261 04:19:08,364 --> 04:19:09,232 PERENNIAL EXAMPLE OF WHERE 7262 04:19:09,232 --> 04:19:10,533 PREGNANT PEOPLE WERE 7263 04:19:10,533 --> 04:19:11,734 SYSTEMATICALLY EXCLUDED FROM 7264 04:19:11,734 --> 04:19:12,368 THOSE TRIALS AND AT THE SAME 7265 04:19:12,368 --> 04:19:13,369 TIME, WE HAD TO MAKE 7266 04:19:13,369 --> 04:19:14,237 RECOMMENDATIONS IN PREGNANCY ON 7267 04:19:14,237 --> 04:19:16,206 HOW TO USE THEM. 7268 04:19:16,206 --> 04:19:18,608 SO IF THERE IS ANY EFFORT 7269 04:19:18,608 --> 04:19:22,011 WHATSOEVER TO TRY TO IDENTIFY 7270 04:19:22,011 --> 04:19:22,979 PREGNANT PEOPLE AND MANDATE 7271 04:19:22,979 --> 04:19:25,682 THEIR INCLUSION IN CL CLINICAL 7272 04:19:25,682 --> 04:19:28,651 TRIALS WHERE IT'S APPROPRIATE, 7273 04:19:28,651 --> 04:19:30,954 WITH THE GUIDANCE OF NICHD'S 7274 04:19:30,954 --> 04:19:31,788 LEADERSHIP, I THINK THAT THAT 7275 04:19:31,788 --> 04:19:35,091 WOULD BE REALLY HELPFUL FOR ALL 7276 04:19:35,091 --> 04:19:36,159 OF YOU. 7277 04:19:36,159 --> 04:19:39,829 >> THANK YOU FOR THAT. 7278 04:19:39,829 --> 04:19:40,496 DR. BIANCHI, IF YOU WANT TO 7279 04:19:40,496 --> 04:19:41,531 SPEAK TO THAT. 7280 04:19:41,531 --> 04:19:42,165 I KNOW THIS HAS BEEN SOMETHING 7281 04:19:42,165 --> 04:19:43,933 THAT HAS BEEN REALLY IMPORTANT 7282 04:19:43,933 --> 04:19:47,237 TO OUR INSTITUTE AS A WHOLE. 7283 04:19:47,237 --> 04:19:50,240 AND IT IS CERTAINLY SOMETHING -- 7284 04:19:50,240 --> 04:19:52,809 I SIT ON THE INCLUSION 7285 04:19:52,809 --> 04:19:53,676 GOVERNANCE COMMITTEE AT THE NIH 7286 04:19:53,676 --> 04:19:56,145 AND THIS IS SOMETHING THAT, YOU 7287 04:19:56,145 --> 04:19:57,046 KNOW, WE'VE BEEN BRINGING 7288 04:19:57,046 --> 04:19:57,847 FORWARD. 7289 04:19:57,847 --> 04:19:59,015 DR. AARON POLLACK WHO WAS JUST 7290 04:19:59,015 --> 04:20:00,617 SPEAKING, THIS IS SOMETHING THAT 7291 04:20:00,617 --> 04:20:02,719 HE'S BEEN REALLY WORKING ON 7292 04:20:02,719 --> 04:20:05,655 WITHIN HIS BRANCH, DR. THERESA 7293 04:20:05,655 --> 04:20:07,323 CRUZ HAS BEEN WORKING ON THE 7294 04:20:07,323 --> 04:20:07,924 DISABILITY PIECE SO THERE'S A 7295 04:20:07,924 --> 04:20:08,958 LOT OF COORDINATION AND EFFORT 7296 04:20:08,958 --> 04:20:11,227 WITHIN OUR INSTITUTE TO BRING 7297 04:20:11,227 --> 04:20:14,230 THIS TO NIH AS A WHOLE AND TO 7298 04:20:14,230 --> 04:20:15,698 HOPE TO MOVE THE NEEDLE ON THESE 7299 04:20:15,698 --> 04:20:16,566 FRONTS. 7300 04:20:16,566 --> 04:20:18,468 THANK YOU. 7301 04:20:18,468 --> 04:20:21,905 >> I THINK THE DATA SPEAK FOR 7302 04:20:21,905 --> 04:20:22,205 THEMSELVES. 7303 04:20:22,205 --> 04:20:25,041 I MEAN, IT'S REALLY REMARKABLE 7304 04:20:25,041 --> 04:20:27,543 COMPARED TO OTHER INSTITUTES AND 7305 04:20:27,543 --> 04:20:30,613 CENTERS, THE DIFFERENCE. 7306 04:20:30,613 --> 04:20:32,348 AND I KNOW THAT CERTAINLY IN THE 7307 04:20:32,348 --> 04:20:33,016 INTRAMURAL PROGRAMS, IT'S 7308 04:20:33,016 --> 04:20:34,117 PROBABLY EVEN MORE DRAMATIC 7309 04:20:34,117 --> 04:20:37,720 BECAUSE THE CLINICAL CENTER, 7310 04:20:37,720 --> 04:20:40,456 FIRST OF ALL, IN GENERAL, 7311 04:20:40,456 --> 04:20:42,392 CHILDREN UNDER AGE 2 CANNOT BE 7312 04:20:42,392 --> 04:20:44,327 ON PROTOCOL IN THE CLINICAL 7313 04:20:44,327 --> 04:20:49,966 CENTER, BUT ALSO STUDYING 7314 04:20:49,966 --> 04:20:51,935 PREGNANT PEOPLE IN A PRIMARY 7315 04:20:51,935 --> 04:20:53,803 PROTOCOL, PEOPLE WHO ARE 7316 04:20:53,803 --> 04:20:55,305 PREGNANT AND THEY'RE REQUIRED TO 7317 04:20:55,305 --> 04:20:57,073 BE PREGNANT AS PART OF THE 7318 04:20:57,073 --> 04:21:00,443 ENROLLMENT CRITERIA IS STILL IN 7319 04:21:00,443 --> 04:21:02,679 THE DARK AGES IN THE CLINICAL 7320 04:21:02,679 --> 04:21:05,915 CENTER. 7321 04:21:05,915 --> 04:21:07,550 WHEREAS THEY WILL ACCOMMODATE 7322 04:21:07,550 --> 04:21:08,318 PEOPLE, FOR EXAMPLE, WHO ARE 7323 04:21:08,318 --> 04:21:11,154 BEING TREATED FOR CANCER AS THE 7324 04:21:11,154 --> 04:21:12,488 PRIMARY ISSUE BUT WHO HAPPEN TO 7325 04:21:12,488 --> 04:21:12,922 BE PREGNANT. 7326 04:21:12,922 --> 04:21:16,159 SO I THINK WE HAVE A LONG WAY TO 7327 04:21:16,159 --> 04:21:17,827 GO TO CHANGE THE CULTURE. 7328 04:21:17,827 --> 04:21:21,164 THERE ARE ALREADY SOME IMPORTANT 7329 04:21:21,164 --> 04:21:22,131 CHANGES AND THERE'S PROGRESS 7330 04:21:22,131 --> 04:21:23,399 BEING MADE, BUT WE STILL HAVE A 7331 04:21:23,399 --> 04:21:28,905 LONG WAY TO GO. 7332 04:21:28,905 --> 04:21:31,274 >> I THINK, IGNA, YOU HAD A 7333 04:21:31,274 --> 04:21:32,709 QUESTION, BUT YOU TOOK YOUR HAND 7334 04:21:32,709 --> 04:21:32,909 DOWN. 7335 04:21:32,909 --> 04:21:34,344 >> YEAH, I DIDN'T WANT TO BE 7336 04:21:34,344 --> 04:21:38,047 RUDE AND TURN MY CAMERA OFF BUT 7337 04:21:38,047 --> 04:21:39,916 ACTUALLY THEY WERE VERY MUCH 7338 04:21:39,916 --> 04:21:41,284 OVERLAPPING WITH THE OTHER 7339 04:21:41,284 --> 04:21:42,085 QUESTIONS THAT WERE ALREADY 7340 04:21:42,085 --> 04:21:45,955 ASKED, SO. 7341 04:21:45,955 --> 04:21:48,658 >> OKAY. 7342 04:21:48,658 --> 04:21:50,927 WELL, RONNA, THIS WAS FANTASTIC, 7343 04:21:50,927 --> 04:21:52,695 THE REPORT IS REALLY IMPORTANT. 7344 04:21:52,695 --> 04:21:54,664 THANK YOU FOR LEADING THE 7345 04:21:54,664 --> 04:22:00,837 ANALYSIS AND THE -- DESCRIBING 7346 04:22:00,837 --> 04:22:02,739 IT AND ADVOCATING FOR MORE 7347 04:22:02,739 --> 04:22:04,273 INCLUSION NIH-WIDE. 7348 04:22:04,273 --> 04:22:07,977 SO IS THERE ANY FURTHER 7349 04:22:07,977 --> 04:22:12,482 DISCUSSION? 7350 04:22:12,482 --> 04:22:15,084 YOU'RE GETTING A LOT OF CU KUDON 7351 04:22:15,084 --> 04:22:16,285 THE CHAT BOX, BY THE WAY, FROM 7352 04:22:16,285 --> 04:22:16,686 YOUR COLLEAGUES. 7353 04:22:16,686 --> 04:22:18,254 IF NOT, MAY I HAVE A MOTION FOR 7354 04:22:18,254 --> 04:22:20,056 APPROVAL OF THE NICHD TRIENNIAL 7355 04:22:20,056 --> 04:22:23,726 REPORT? 7356 04:22:23,726 --> 04:22:26,162 >> MOTION TO APPROVE. 7357 04:22:26,162 --> 04:22:27,530 >> THANK YOU, CYNTHIA. 7358 04:22:27,530 --> 04:22:28,664 AND DO WE HAVE A SECOND? 7359 04:22:28,664 --> 04:22:29,298 >> SECOND. 7360 04:22:29,298 --> 04:22:34,670 >> THANK YOU, MARCELLE. 7361 04:22:34,670 --> 04:22:35,505 PLEASE VOTE WITH YOUR LITTLE 7362 04:22:35,505 --> 04:22:41,778 CHECKMARKS. 7363 04:22:41,778 --> 04:22:43,413 >> YOU HAVE SEVEN YES VOTES. 7364 04:22:43,413 --> 04:22:44,147 >> OKAY. 7365 04:22:44,147 --> 04:22:49,052 SO THE MOTION IS APPROVED. 7366 04:22:49,052 --> 04:22:50,286 AND REMARKABLY, WE ARE ON TIME. 7367 04:22:50,286 --> 04:22:51,587 IT'S ALWAYS INTERESTING HOW THE 7368 04:22:51,587 --> 04:22:52,855 COUNCIL PLAYS OUT. 7369 04:22:52,855 --> 04:22:56,259 I WANT TO THANK YOU ALL IN YOUR 7370 04:22:56,259 --> 04:23:01,164 VARIOUS TIME ZONES FOR YOUR 7371 04:23:01,164 --> 04:23:02,765 ATTENTION AND YOUR ENGAGEMENT 7372 04:23:02,765 --> 04:23:03,566 AND THE FACT THAT YOU'VE ASKED 7373 04:23:03,566 --> 04:23:04,567 SUCH GREAT QUESTIONS. 7374 04:23:04,567 --> 04:23:05,868 THIS CONCLUDES THE FIRST DAY OF 7375 04:23:05,868 --> 04:23:08,504 OUR TWO-DAY NICHD ADVISORY 7376 04:23:08,504 --> 04:23:10,807 COUNCIL MEETING. 7377 04:23:10,807 --> 04:23:12,341 THANK YOU ALL FOR ATTENDING, AND 7378 04:23:12,341 --> 04:23:13,409 THAT INCLUDES MEMBERS OF THE 7379 04:23:13,409 --> 04:23:14,944 PUBLIC AND ADVOCACY GROUPS WHO 7380 04:23:14,944 --> 04:23:16,245 HAVE BEEN LISTENING IN. 7381 04:23:16,245 --> 04:23:20,917 WE LACK FORWAR LOOK FORWARD TO G 7382 04:23:20,917 --> 04:23:22,318 EVERYONE TOMORROW AT 9:00 A.M. 7383 04:23:22,318 --> 04:23:23,686 FOR OUR CLOSED SESSION. 7384 04:23:23,686 --> 04:23:27,423 AGAIN, UNLIKE TODAY, THE START 7385 04:23:27,423 --> 04:23:29,492 TIME WILL BE 9:00 A.M. EASTERN 7386 04:23:29,492 --> 04:23:29,926 STANDARD TIME. 7387 04:23:29,926 --> 04:23:31,894 HAVE A GREAT EVENING, EVERYONE, 7388 04:23:31,894 --> 04:23:34,230 AND WE'LL SEE THE COUNCILMEMBERS 7389 04:23:34,230 --> 04:23:34,497 TOMORROW. 7390 04:23:34,497 --> 04:23:44,674 THANK YOU.