>> GOOD MORNING AND WELCOME AND
COUNCIL MEMBER TO THE 237th
MEETING OF THE NATIONAL
INSTITUTE OF DENTAL AND
CRANIOFACIAL RESEARCH RESEARCH
COUNCIL.
I'M THE EXECUTIVE SECRETARY,
LYNN KING.
THIS MEETING IS BEING HELD
VIRTUALLY VIA ZOOM AND
ACCOMPANYING VIDEOCAST BY THE
PUBLIC.
QUESTIONS OR COMMENTS FROM THE
PUBLIC CAN BE SUBMITTED TO AN
NIDCR E-MAIL ADDRESS THAT WE
WILL POST AT THE END OF THE OPEN
SESSION.
AND COMMENTS ACCEPTED TO
SEPTEMBER 28, 2024.
ZOOM PARTICIPANTS SHOULD MAKE
SURE YOUR MICROPHONES AND VIDEOS
ARE OFF UNLESS YOU ARE SPEAKING
AND WHEN YOU ARE SPEAKING,
PLEASE STATE YOUR NAME SO WE CAN
ENSURE THE ACCURACY OF OUR
MEETING RECORDS.
COUNCIL MEMBERS WHO NEED
TECHNICAL ASSISTANCE CAN REACH
OUT TO JORDANO OR PATRICK AND
THEIR INFORMATION IS THIS THE
CHAT FOR ANY SUPPORT.
AND FIRST THE ORDER OF BUSINESS
IS THE APPROVAL OF THE MEETING
MINUTES OF THE PREVIOUS COUNCIL
MEETING.
THE MAY 2024 MEETING MINUTES
WERE MADE AVAILABLE TO THE
COUNCIL MEMBERS FOR THEIR
VIEWING AND I'D LIKE TO KNOW IF
THERE ARE ANY QUESTIONS OR
COMMENTS ABOUT THE MAY 2024
MINUTES.
IF THERE ARE NO COMMENTS OR
QUESTIONS WOULD A MEMBER OF
COUNCIL LIKE TO MAKE A MOTION TO
APPROVE THE MINUTES.
>> SO MOVED.
>> PAUL AND I'M SORRY, WHO ELSE?
PLEASE STATE YOUR NAME.
>> JOSÉ.
>> AND JOSÉ MORONCONCEPCION.
ALL IN FAVOR.
>> YES.
>> ANY OPPOSED?
I'LL TURN IT OVER TO
DR. WEBB-CYRIAQUE FOR HER
WELCOME AND PRESENTATION OF THE
DIRECTOR'S REPORT.
>> THANK YOU, DR. KING.
MAKE SURE YOU CAN SEE MY SCREEN.
WELCOME EVERYONE TO THE 237th
MEETING OF THE NATIONAL ADVISORY
NATIONAL INSTITUTE OF DENTAL AND
CRANIOFACIAL RESEARCH COUNCIL.
DR. D'SOUZA IS ON LEAVE AND I'M
SERVING AS ACTING DIRECTOR AND
WILL PROVIDE REMARKS TODAY.
TODAY, I'LL SHARE WITH YOU FIRST
UPDATES FROM THE WHITE HOUSE
FROM NIH AND NIDCR AND SECONDLY
SHARE WITH YOU HOW WE AS A FIELD
CAN LEVERAGE DATA AND PRIMARY
CARE TO MOVE TOWARDS ORAL HEALTH
FOR ALL.
AND LATER IN THE DAY, WE'LL HEAR
KEY EXAMPLES OF DATA CARE COMING
TOGETHER TO INFORM DISEASE AND
HEALTH IN THE CONTEXT OF ALL OF
US AND ALSO THE SJOGREN'S STAMP
PROJECT AND HEAR ABOUT
TRANSFORMATIVE INITIATIVES.
SO IT'S A GREAT DAY AND HAPPY TO
SHARE THESE WITH YOU.
FIRST STARTING WITH WHITE HOUSE
INITIATIVES.
ALIGNED WITH THE NATIONAL
STRATEGY FOR WOMEN'S HEALTH, IS
PRESIDENT BIDEN'S EXECUTIVE
ORDER FOCUSSED ON ADVANCING
WOMEN'S RESEARCH AND INNOVATION.
THIS INCLUDES THE STUDY AND
ANALYSIS OF CONDITIONS SPECIFIC
TO WOMEN THAT DISPROPORTIONATELY
AFFECT WOMEN AND THERE'S
INITIATIVES IN PROGRESS
INCLUDING MATERNAL HEALTH AND
THE DOC DEVELOPMENT OF CHILDREN
AND NATIONAL INSTITUTE OF DENTAL
AND CRANIOFACIAL RESEARCH AND
TWO TMD FOCUSSED INITIATIVES AS
TMD IS DISPROPORTIONATELY
OCCURRING IN WOMEN.
FIRST THE COLLABORATIVE FOR
IMPROVING PATIENT-CENTERED
TRANSFORMATIONAL RESEARCH OR
IMPACT AND ALSO FEASIBILITY
STUDIES THAT EXPLORE BOTH
HEALTHY AND DISEASED TMJ JOINTS
USING SINGLE CELL MULTI OMICS
ANALYSIS.
REGARDING THE BUDGET AND UPDATES
I'D LIKE TO SHARE A TIME LINE.
THIS PAST MARCH THE FY25 BUDGET
REQUEST THAT PROVIDES SPENDING
AND POLICY PROPOSALS INCLUDED
INCREASES TO BOTH NIH AT $49.8
BILLION AN INCREASE OF $1.25
BILLION AND TO NIDCR AT $521
BILLION WHICH WOULD BE AN
INCREASE OF $1.53 MILLION.
THAT WAS PRESIDENT BIDEN'S PLAN.
IN MAY THERE WAS A BUDGET
HEARING BY THE SENATE
APPROPRIATIONS WHERE SEVERAL OF
THE LARGER I.C.s PRESENTED OR
PARTICIPATED.
IN JULY THE HOUSE PROPOSED A
$48.5 BILLION FLAT BUDGET FOR
NIH AND PROPOSED SEVERAL REFORM
POLICIES THAT WILL SUGGEST AN
NIH RESTRUCTURE TO FORM AN
INSTITUTE FOCUSSED ON
NEUROSCIENCE AND BRAIN RESEARCH.
IN AUGUST, THE SENATE
APPROPRIATIONS PROPOSED A $53.5
BILLION AN INCREASE TO NIH AND
FLAT BUDGET TO NIDCR WHERE WHERE
HE WOULD CONTINUE AT FY24
LEVELS.
RIGHT NOW THERE'S A POTENTIAL
CONTINUING RESOLUTION BEING
WORKED ON TO FUND THE FULL
GOVERNMENT AT FY24.
HOT OFF THE PRESS YESTERDAY, THE
HOUSE PASSED A RULE THAT WOULD
ALLOW THEM TO CONSIDER HR9494 A
HOUSE GOP SUPPORTED CONTINUING
RESOLUTION EXTENDING GOVERNMENT
FUNDING THROUGH NEXT MARCH OF
2025.
RIGHT AFTER THE BIDEN
ADMINISTRATION RELEASED A
STATEMENT OF ADMINISTRATIVE
POLICY SAID IT WOULD LIKELY BE
VETOED IF PASSED AND THERE WAS
ADDITIONAL CRITIQUE OF THAT
PROPOSAL.
THE HOUSE IS PROJECTED TO VOTE
TODAY ON HR9494 AND WE'LL SEE
WHAT HAPPENS ON THE HOUSE FLOOR.
THIS YEAR FINAL APPROPRIATIONS
AGAIN JUST TO REITERATE WILL BE
$48.9 BILLION FOR NIH AN OVER
ALL 1% INCREASE AND $520 MILLION
NO INCREASE TO US.
OVER $400 MILLION OF THAT OR
CLOSE TO 80% GOES TO EXTRAMURAL.
ABOUT 14.5% GOES TO INTRAMURAL
SCIENCE AND THE REMAINDER GOES
TO RESEARCH MANAGEMENT OF 6% TO
KEEP OUR LIGHTS ON.
IF WE LOOK MORE CLOSELY AT THE
TWO CHARTS THAT DEMONSTRATE OUR
EXTRAMURAL SPENDING IN 2023
YOU'LL SEE ABOUT 80% GOES TO
THESE RESEARCH PROJECT GRANTS
AND OF THAT 80% THIS OTHER PIE
CHART ON YOUR RIGHT YOU SEE 60%
IS COVERING GRANT OUT YEARS AND
OF THE REMAINING 20%, 4% GOES TO
RFAs AND THERE'S FOURFOLD HIGHER
FUNDING THAT OCCURS AT 16% TO
INVESTIGATOR INITIATED RPGs AND
1% FOR SUPPLEMENTS.
WE LOOK AT THE LARGER PIE.
WE JUST TALKED ABOUT RESEARCH
PROJECT GRANTS.
WE HAVE ABOUT 6% THAT GOES TO
CAREERS AND TRAINING AND ANOTHER
6% THAT GOES TO CONTRACTS, 2% TO
CENTERS AND ABOUT 3% TO SMALL
BUSINESS AND STTR EFFORTS.
EVEN WITH THE HIGHER
APPROPRIATION AT 2023 OUR
PURCHASING POWER COUCHED IN 2019
DOLLARS IS ACTUALLY CONSIDERABLY
LOWER.
OUR PURCHASING POWER HAS
DECREASED SINCE 2021 HERE AT
NIDCR.
WE'VE BEEN ABLE TO MAINTAIN
SUCCESSION RATES OVER THE PAST
FIVE YEARS THAT HAVE BEEN
COMPARABLE OR HIGHER TO NIH.
AND WE REMAIN THE MAJOR FUNDER
OF DENTAL SCHOOLS AT 63% AND
THIS ACCOUNTS FOR JUST UNDER
HALF OF OUR EXTRAMURAL BUDGET AT
44%.
SO WE'RE PROUD OF THAT.
AND WE CAN ACTUALLY SEE THAT
FROM 2021 WE'VE HAD AN INCREASE
IN NIDCR FUNDING TO SCHOOLS.
SO WHAT'S HAPPENING AT NIH?
NIH IS WORKING TO DEVELOP A
VISION AND FRAMEWORK TO
INCORPORATE PUBLIC VOICES ACROSS
ALL PHASES AND TYPES OF CLINICAL
RESEARCH AND THIS PARTNERSHIP
WITH THE PUBLIC IS CALLED ENGAGE
AND THE RFI GATHERED INFORMATION
ON HOW BEST TO MAXIMIZE PUBLIC
ENGAGEMENT THIS PAST SUMMER AND
I WANT TO THANK YOU TO ALL OF
YOU WHO SHARED YOUR THOUGHTS AS
IT REALLY IS THE THOUGHTS THAT
WILL HELP US ASSURE RESEARCH
KEEPS THE PATIENT AT THE CENTER.
THE CHANGE IN REVIEW IS QUICKLY
APPROACHING AS GRANT REVIEW IS
GOING TO MOVE FROM FIVE
REGULATORY CRITERIA TO THREE
REGULATORY CRITERIA AFTER
JANUARY 25.
THIS WILL FOCUS ON THREE AREAS.
THE FIRST BEING THE IMPORTANCE
OF RESEARCH SIGNIFICANCE AND
INNOVATION THAT WILL BE SCORED.
THE SECOND ON RIGOR AND
FEASIBILITY, THAT'S THE
APPROACH, THAT WILL BE SCORED
AND THE THIRD AND FINAL ONE IS
EXPERTISE AND RESOURCES FORMALLY
INVESTIGATOR AND ENVIRONMENT.
THIS WILL NOT BE INDIVIDUALLY
SCORED BUT CONSIDERED AN OVER
ALL IMPACT.
SO THAT'S UPCOMING.
NOT FOR THIS CURRENT CYCLE FOR
OCTOBER GRANTS BUT IT WILL BEGIN
IN JANUARY.
THE NIH OFFICE OF SCIENCE POLICY
HAS RECENTLY UNVEILED A REALLY
VALUABLE RESOURCE FOCUSSED ON
ARTIFICIAL INTELLIGENCE
RESEARCH.
AND SO THERE'S GUIDANCE HERE.
AND THIS RESOURCE IS DESIGNED TO
RESPONSIBLY GUIDE AND GOVERN
ADVANCING SCIENCE AND EMERGING
TECHNOLOGIES INCLUDING THE
DEVELOPMENT AND USE OF A.I. IN
RESEARCH AND YOU'LL SEE THE QR
CODE IS HERE.
AS AN FYI, THERE'S A POSITION
OPEN AT THE NATIONAL INSTITUTE
OF ARTHRITIS, MUSCULOSKELETAL
AND SKIN DISEASES.
I'M SHARING THIS BECAUSE OF THE
MANY AREAS OF OVERLAP ACROSS OUR
INSTITUTES.
THE POSITION IS FOR DEPUTY
DIRECTOR AND APPLICATIONS ARE
DUE AT THE END OF THE MONTH.
SO PLEASE SEE THE WEBSITE IF YOU
HAVE AN INTEREST OR CONTACT
BRENDA FOGGAL WITH ANY QUESTIONS
AT THIS ADDRESS HERE.EGAL WITH
QUESTIONS AT THIS ADDRESS HERE.S
AT THIS ADDRESS HERE.L WITH ANY
AT THIS ADDRESS HERE.
IN TERMS OF STAFF UPDATES,
MICHAEL COLLINS, DR. COLLINS
RETIRED THIS SUMMER AT 25 YEARS
AT NIH.
HE'S A WONDERFUL MENTOR AND LED
THE SKELETAL DISORDERS AND
MINERAL HOMEOSTASIS SECTION AND
IS A LEADER IN THE AREA OF
TRANSLATIONAL BONE BIOLOGY.
THANK YOU, MIKE.
WE HAVE A SPECIAL REMEMBRANCE TO
TERRIE COWLEY WHO RECENTLY
PASSED THE FOUNDER OF THE TMJ
ASSOCIATION AND STALWART
SUPPORTER OF TMJ AND WORKED WITH
NIDCR AND FDA TO ESTABLISH ROUND
TABLES AND WHAT SHOW WOULD OFTEN
SHARE WITH MANY OF US IS THAT IF
YOU GOT A DOLLAR, SHE'S GOING TO
ASK FOR A DOLLAR FIFTY AND ASK
EVERY CENT GO TO TMD AND SHE WAS
A FIERCE ADVOCATE AND FORMED THE
CHRONIC OVERLAPPING PAIN ALI
ALIGNING ALLIANCE BRINGING
AWARENESS TO THE CO-OCCURRING
CONDITIONS AND TERRIE KNOW THAT
YOUR DEDICATION WILL NOT BE
FORGOTTEN AND THE WORK WILL
CONTINUE TO WORK TOWARDS RELIEF
FOR THE MANY AFFECTED WITH TMD.
IN TERMS OF INSTITUTE UPDATES,
OUR LEADERSHIP HAS HAD THE
PRIVILEGE TO TAKE PART OF THE
SUMMER RESEARCH DAY AT THE
UNIVERSITY OF MARYLAND AND THE
40th ANNUAL RESEARCH DAY AT THE
INVESTIGATION OF NORTH CAROLINA
SCHOOL OF DENTISTRY AND AT TO
THE A.T. STILL INSTITUTE AND AT
THE UNIVERSITY OF THE UNIVERSITY
PACIFIC FACULTY DEVELOPMENT DAY.
WE ALSO PRESENTED A LUNCH AND
LEARN FOR CONGRESSIONAL STAFF TO
SHARE WITH THEM INFORMATION
AROUND TMD AND ORAL FACIAL PAIN
AND CO-SPONSORED THE DAVID
BARMES LECTURE FOCUSSED ON
GLOBAL HEALTH IF HE TURING
DR. NKENGASONG.
WE PARTICIPATED AT MULTIPLE
NATIONAL MEETINGS INCLUDING THE
NATIONAL DENTAL ASSOCIATION
RESEARCH FORUM, THE HISPANIC
DENTAL ASSOCIATION WORKSHOP AND
THE UNITED STATES PUBLIC HEALTH
SERVICES SCIENTIFIC SYMPOSIUM.
WHAT HAVE WE BEEN UP TO WITH
RFAs AND THE REQUESTS FOR
APPLICATIONS AND CONCEPTS ARE
DRIVEN BY OUR FIVE STRATEGIC
PRIORITIES INTEGRATING ORAL AND
GENERAL HEALTH AND PRECISION
MEDICINE AND TRANSLATION AND
IMPLEMENTATION AND PARTNERING
AND COLLABORATING AND
DIVERSIFYING THE RESEARCH
PATHWAY.
HERE IF WE LOOK BACK AT THE NINE
RFA AWARDS MADE IN 2023 YOU'LL
NOTICE EACH IS ALIGNED WITH
STRATEGIC PRIORITIES THAT ARE
LISTED ON THE RIGHT HAND COLUMN.
SHE'S INCLUDE THE EXAMINATION OF
INTERSECTIONALITY BETWEEN ORAL
HEALTH AND HIV AND PRECISION
APPROACHES TO TREAT INTRACRANIAL
DENTAL CRANIOFACIAL DISORDERS
AND DRIVE THE DEVELOPMENT OF DOC
BIO MATERIALS AND UTILIZING
TECHNOLOGIES TO PROMOTE ORAL
HEALTH AND FINALLY LEVERAGING
DENTISTRY TO PREVENT OPIOID
MISUSE.
AMONG THE SIGNATURE INITIATIVES
IS THE PRIMED INITIATIVE OR
PRACTICED BASED RESEARCH IN
DENTAL SCHOOL BASED PRACTICE
NETWORK.
THE AHEAD PROGRAM TO ADVANCE
HEAD AND NECK CANCER EARLIER
DETECTION RESEARCH.
AND IMPACT FOCUS ON TMJ AND
PATIENT-CENTERED COLLABORATIVE
TOWARDS TREAT BEING TMJ.
CLEARLY WE'RE READY AND PRIMED
TO MOVE AHEAD WITH IMPACT ACROSS
THESE INITIATIVES.
IF WE LOOK AT THE CURRENT RFAs,
FY24, THEY'RE ALSO ALIGNED WITH
OUR STRATEGIC PRIORITIES AND
FOCUS ON EARLIER CANCER AND HPV
CO-INFECTIONS.
OPPORTUNITIES FOR TEAM SCIENCE
THROUGH DISRUPTIVE INNOVATION.
OPPORTUNITIES TO DEVELOP
THERAPEUTICS BASED ON SALIVARY
COMPONENTS AND THE SOAR AWARD
FOR OUTSTANDING ACHIEVEMENT IN
RESEARCH.
FUTURE RFAs AND INITIATIVES ON
THESE WILL BE THROUGH AND
BUILDING MENTORING NETWORKS FOR
UNDER REPRESENTED CAREER
ADVOCATORS.
USING IMAGING TO TREAT ORAL
LESIONS AND TOWARDS TRANSLATION
AND IMPLEMENTATION, FAST
TRACKING PRODUCTS FOR CLINICAL
ADOPTION THROUGH THE APEX
PROGRAM.
THERE'S A FOCUS ON ORAL HIV/AIDS
RESEARCH AND BUILDING ORAL
THERAPEUTICS BASED ON
BACTERIAPHAGE AND UTILIZING OF
COMMUNITY BASED APPROACHES AND
DATA TO ADDRESS ORAL HEALTH
DISPARITIES.
EXAMINING RELATIONSHIP BETWEEN
ORAL HEALTH AND NUTRITION AND
GENERAL HEALTH AND BUILDING WHAT
I'LL CALL AN ORAL ORGANSHIP ON A
CHIP.
IN TERMS OF NEW INITIATIVES
INTERACTION WITH AN NIH WIDE
INITIATIVE TO ADDRESS WHOLE
PERSON HEALTH FROM THE MOLECULAR
TO CELLULAR LEVEL TO ORGAN LEVEL
AND OUT TO THE WHOLE PERSON
BEGINNING WITH THE FIS YOEM.
PHYSIOME AND THIS PARTICULAR
SEEKING APPLICATIONS 20 STRAEB A
WHOLE PERSON RESEARCH AND
COORDINATION CENTER.
AND SO THIS WILL BE A WONDERFUL
WAY TO ENSURE INTEGRATION AND
THE WHOLE PERSON.
THERE'S A DISEASE AGNOSTIC
INITIATIVE THAT PROMOTES
INTEGRATED TEAMS WITH DIVERSE
PERSPECTIVES AND EXPERTISE WHO
TOGETHER CAN BUILD DISRUPTIVE
INNOVATIONS IN CRANIOFACIAL
RESEARCH AND PROBIOTIC
INTERVENTIONS.
THIS ENHANCING MECHANISTIC
RESEARCH ON PRECISION PROBIOTICS
WILL ENHANCE OUTCOMES BY
DETERMINING THE CHARACTERISTICS
OF INDIVIDUALS WHO RESPOND.
SO THIS IS PRECISION MEDICINE
FOR DENTISTRY.
AND IN THE CONTEXT OF THE
HELPING TO END ADDICTION
LONG-TERM, THERE ARE SEVERAL
INITIATIVES COMING UP INCLUDING
THE INTERACT INITIATIVE FOCUSSED
ON BACK PAIN.
THERE'S A HEAL KIDS PROGRAM
WHERE KIDS STANDS FOR KNOWLEDGE
INNOVATION AND DISCOVERY STUDIES
FOCUSES ON CHRONIC PAIN, THERE'S
A MENTORED CLINICAL SCIENTIST
AWARDS THAT ARE FOCUSSED ON PAIN
AND TRANSLATION OF DIAGNOSTIC
AND THERAPEUTIC DEVICES THROUGH
BLUEPRINT MED TECH.
UPCOMING NOTICES OF SPECIAL
INTEREST INCLUDE TMD IMPACT,
THERE'S A NOSI ON WOMEN'S HEALTH
RESEARCH ONE ON PHAGE BIOLOGY
AND UNDERSTANDING ADVERSE EVENTS
IN THE CONTEXT OF CANCER
THERAPY.
WHAT'S HAPPENING WITH REGARD TO
OUR FIELD AS WE CONSIDER GROWING
THE FIELD.
I'M PLEASED TO SHARE WITH YOU
SEVERAL OPPORTUNITIES.
THE FIRST IS NIDCR'S PUBLIC
HEALTH RESEARCH PROGRAM.
IT'S A THREE-YEAR PROGRAM THAT
INCLUDES 12-MONTH FULL TIME
RESIDENCY IN DENTAL PUBLIC
HEALTH FOLLOWED BY A 24-MONTH
POSTDOCTORAL RESEARCH
FELLOWSHIP.
HERE ARE OUR FIRST-YEAR FELLOWS
WHO RECENTLY COMPLETED THE
DEN
DENTAL PUBLIC HEALTH RESIDENCY
ON ORAL CANCER AND PRECANCER AND
HPV RISK RELATED PERCEPTION AND
DENTAL CARE UTILIZATION AMONG
SEXUAL GENDER MINORITY
POPULATIONS.
AND THIRD YEAR AS THEY BECOME
THOUGHT LEADERS IN COLLABORATION
WITH OTHER NIH INSTITUTES.
AND WE'RE SUPPORTING THE
EXPANSION OF BRINGING ENGINEERS
IN THE FIELD IN THE
DISSEMINATION OF BIOMEDICAL,
CLINICAL OR HEALTH-RELATED
RESEARCH TO HELP BUILD SOFTWARE
TOOLS AND ALGORITHMS THAT WILL
HELP US MOVE THE DOT FIELD
FORWARD.
THERE'S ALSO THE STRONG
OPPORTUNITY.
THIS IS FOCUSSED ON CAPACITY
BUILDING AND IS CALLED
STRENGTHENING RESEARCH
OPPORTUNITIES FOR NIH GRANTS.
THIS SUPPORT GOES TO RESEARCH
LIMITED INSTITUTIONS.
AGAIN TO ENHANCE CAPACITY FOR
INDIVIDUALS WHO ARE ALREADY
DOING RESEARCH AND ARE TRAINING
INDIVIDUALS FROM DIVERSE
BACKGROUNDS.
APPLICATIONS ARE DUE NEXT WEEK
FOR THIS YEAR AND THEN DUE
SEPTEMBER 18 FOR 2025 AS WELL.
LOOK AT THE QR CODE IF THERE'S
ANY INTEREST IN THIS.
IN TERMS OF GLOBAL TRAINING
RESOURCES THERE'S MUCH GOING ON.
I DO ENCOURAGE YOU TO LOOK AT
THE TOP QR CODE FOR AN OVERVIEW
OF EXTRAMURAL TRAINING AND
RESEARCH DEVELOPMENT FUNDING
OPPORTUNITIES AND THERE'S A
SLIDE SET THERE.
AND ON THE BOTTOM HERE ARE
RECORDINGS FROM EXTRAMURAL
TRAINING AND CAREER DEVELOPMENT
SESSIONS.
SO PLEASE TAKE A LOOK AT THESE
TWO RESOURCES AS THEY COULD BE
HELPFUL.
NIDCR CONTINUES TO PARTICIPATE
IN THE KIRSCHTEIN RESEARCH AWARD
FOR THOSE WHO HAVE POSTDOCTORAL
TRAINING PROGRAMS.
CONTACT RACIAL SCHUR IF THERE'S
INTEREST IN THAT.
THERE'S THE MENTOR CAREER
DEVELOPMENT AWARD TO PROMOTE
BROAD PARTICIPATION IN RESEARCH.
THIS IS FOR POSTDOCTORAL EARLY
CAREER RESEARCHERS.
THIS WILL OPEN NEXT JANUARY.
IF YOU HAVE AN INTEREST IN THAT
REACH OUT TO SHOBA.
THIS ALSO SUMMER RESEARCH
EXPERIENCE.
PROGRAM TO HELP BUILD TO THE
PATHWAY WITH EDUCATIONAL
ACTIVITIES DURING THE SUMMER
INCLUDING HIGH SCHOOLERS,
UNDERGRADS OR EVEN HIGH SCHOOL
TEACHERS.
THIS OPENS NEXT FEBRUARY IN
2025.
FEEL FREE TO REACH OUT TO RACHEL
FOR THAT.
AND THERE ARE RESOURCE
SUPPLEMENTS THAT WILL PROMOTE
PEOPLE COMING BACK AND
RE-INTEGRATING IN HEALTH RELATED
RESEARCH CAREERS.
SO THERE'S A RESEARCH
SUPPLEMENTS PROGRAM, A
RE-INTEGRATION PROGRAM AND A
RE-TRAINING AND RETOOLING
PROGRAM.
SO THESE ARE WONDERFUL
OPPORTUNITIES FOR PEOPLE TO COME
BACK AND RE-ESTABLISH THEMSELVES
IN SCIENCE AND PLEASE FEEL FREE
TO CONTACT DR. SHOBA FOR THIS
OPPORTUNITY.
FINALLY, WE HAVE THE SCIENCE
EDUCATION AND PARTNERSHIP AWARD
WHICH WE ARE PROUD TO BE
INVOLVED WITH THIS.
THIS REALLY WORKS TO HELP US
ENHANCE OUR PATHWAY TO INCREASE
NUMBERS OF URBAN, RURAL AND
MINORITY STUDENTS TO CONSIDER
RESEARCH AND MEDICAL AND DENTAL
RESEARCH CAREERS.
THIS IS ALSO USED TO HELP WITH
PUBLIC HEALTH LITERACY AND
APPLICATIONS ARE DUE IN JUNE OF
NEXT YEAR.
PLEASE CONSIDER SEPA IF YOU CAN.
UPCOMING ARE SOME EVENTS THAT
I'D LIKE TO SHARE WITH YOU.
THE FIRST IS THE NIH DIVERSITY
SUPPLEMENT DIVERSITY WORKSHOP.
IS THIS IS GOING TO OCCUR IN TWO
WEEKS, SEPTEMBER 24 TO 25.
AND NIDCR IS PARTICIPATING AND
IT WOULD BE WONDERFUL TO HAVE
YOU JOIN US IF YOU CAN.
PLEASE REGISTER FOR THE WORKSHOP
AND JOIN US.
THE OTHER THING THAT'S COMING UP
IS NIDCR'S CO-SPONSORING AN
IMPORTANT PUBLIC WORKSHOP.
IT'S A WORKSHOP THROUGH THE
NATIONAL ACADEMIES TO REALLY
BUILD AN ACTION ORIENTED PLAN
TOWARD ADVANCING ORAL HEALTH
ACROSS THE LIFE SPAN.
TO BUILD NATIONAL ORAL HEALTH
GOALS.
TO BUILD SUSTAINABLE SOLUTIONS
TOWARDS IMPROVING ACCESS TO ORAL
HEALTH AND SERVICES.
TOWARDS BUILDING INTEGRATION
MODELS AS WE HAVE IN OUR
STRATEGIC PLAN.
TOWARDS EMPOWERING CONSUMERS SO
THEY CAN MAKE CHOICES RELATED TO
THEIR ORAL HEALTH.
AND TOWARDS PUBLIC EDUCATION
CAMPAIGNS AND THE RESEARCH AND
INNOVATIONS MOVING US TOWARDS
ORAL HEALTH FOR ALL OVER THE
NEXT FIVE TO 10 YEARS.
THAT'S COMING THIS NOVEMBER.
WE'RE EXCITED TO BE SPONSORING
THAT AND I HOPE YOU ALL WILL
TAKE PART IN THAT.
I'M JUST GOING TO SHARE WITH YOU
SOME SELECTED SCIENCE ADVANCES
BECAUSE OUR SCIENCE REALLY IS
MOVING FORWARD.
HERE WITH REGARD TO BONE GROWTH.
THERE'S A NEW DRAMATICALLY
ENGINEERED MOUSE MODEL THAT HAS
DEMONSTRATED THE ABILITY NOW
TRACE OF CHONDROCYTES AND SEE
NOVEL MECHANISMS THAT FACILITATE
OUR UNDERSTANDING WHAT HAPPENS
IN THE RESTING ZONE OF THE BONE
GROWTH PLATE.
WITH REGARD TO CANCER TREATMENT,
THERE'S BEEN REAL CHALLENGES IN
UTILIZING PD1 THERAPEUTICS BUT
NOW THERE'S BEEN RESEARCH THAT
STAR GETS DENDRITIC CELLS THAT
HELPS CIRCUMVENT RESISTANCE IN
HEAD AND NECK CANCER.
AND WITH REGARD TO CRANIOFACIAL
DEVELOPMENT, THERE'S WORK
ONGOING TO EXPAND CALVARIAL
OSTEOBLASTS.
AND THIS RESEARCH IS HELPING
MOVE THINGS FORWARD.
WE'LL END THERE WITH UPDATES AND
WILL SHARE SCIENCE EXPERIMENTS
IN THE CONTEXT OF SECTION 2.
AGAIN, HERE WE'RE GOING TO FOCUS
ON HOW WE MOVE TOWARDS HEALTH
AND ORAL HEALTH FOR ALL.
AND SHARE HOW NIDCR IS ALIGNED
WITH THE DATA ON PRIMARY CARE
AND OUR NIH DIRECTOR WAS HERE
LAST COUNCIL TO SHARE WITH HER
WHAT THE VISION WAS.
AND WHAT SHE SHARED WAS THERE
WERE TWO CRITICAL PRIORITIES.
THE FIRST IS TO EXPAND NIH'S
CAPABILITIES FOR DATA SHARING
AND DATA USE FOR EVERYONE BY THE
BROADEST POSSIBLE RESEARCH
COMMUNITY.
AND THE SECOND IS TO EXTEND OUR
CLINICAL RESEARCH CAPABILITIES
TO ADDRESS GAPS IN EVIDENCE TO
GUIDE CLINICAL CARE AND SERVE
THE NEEDS OF EVERY COMMUNITY.
MAKING SURE THE RESEARCH IS
GETTING TO EVERYONE WHO NEEDS
IT.
AND WHAT WE KNOW IS IT WILL TAKE
DATA PLUS WHOLE PERSON HEALTH
APPROACH AND PRIMARY CARE
INTEGRATION WHERE WE RECOGNIZE
ORAL DISEASE AS A MODIFIABLE
RISK FACTOR.
AND THESE TWO THINGS TOGETHER
WILL HELP GET US TO ORAL HEALTH
AND IMPROVED HEALTH FOR ALL.
LET'S START WITH DATA SHARING
AND DATA USE.
SO NIDCR IS CLOSELY ALIGNED WITH
THE NIH DATA MANAGEMENT AND
SHARING POLICIES TO MAKE SURE
THAT ALL THE DATA COMING FROM
DIFFERENT DATA IS ACCESSIBLE TO
EVERYONE.
THEY ESTABLISH RELATIONSHIPS
THROUGH REPOSITORIES AND THE
ORAL MOOISH BIOMEDICAL DATABASE
AND SALIVARY PROTEOME.
IN FACT WE ASSEMBLED A DATA
SCIENCE STRATEGY WORKING GROUP
THROUGH OUR COUNCIL WITH A
SUBGROUP OF OUR COUNCIL WHO
DEVELOPED AND SHARED
RECOMMENDATIONS FOR US THAT I'LL
GO OVER IN A MOMENT.
BOTH ON THE INTRAMURAL AND
EXTRAMURAL SIDE THE SUPPORT ON
THE NIH CAMPUS, EVERY PRINCIPLE
INVESTIGATOR HAS INTEGRATED DETE
SHARING INTO THEIR PLANS.
WE ARE WORKING ON OUR PUBLIC
DATA INFRASTRUCTURE TO BETTER
DEMOCRATIZE LARGE DATA SETS AND
NIDCR'S CAPITALIZING ON EXISTING
NIH RESOURCES TO STORE AND
MANAGE DATA IN ORDER TO
FACILITATE ACCESS AND SHARING
FOR EVERYONE.
ON THE EXTRAMURAL SIDE ACROSS
THE U.S. AND AROUND THE WORLD,
WE'RE MAKING EXISTING DIVERSE
AND INCLUSIVE ORAL HEALTH
DATABASES ACCESSIBLE.
WE'RE EXPANDING AND DEVELOPING
COMMON DATA ELEMENTS ACROSS
RESEARCH INITIATIVES AND EFFORTS
SO WE'LL BE ABLE TO HARMONIZE
THE DATA AND BE ABLE TO SHARE
AND USE IT.
WE ARE SUPPORTING FUNDING
OPPORTUNITIES FOR DATA SCIENCE
AND SUPPORTING RESEARCH TRAINING
AND CAREER DEVELOPMENT THAT'S
DATA SCIENCE RELATED.
SO HOW ARE WE DOING IT THROUGH
TRAINING?
THERE ARE SEVERAL INITIATIVES
ONGOING INCLUDING THE NOSI
FOCUSSED ON APPLICATIONS OF DATA
SCIENCE IN DENTAL ORAL AND
CRANIOFACIAL RESEARCH.
AND THERE'S A K25 MENTORED AWARD
FOCUSSED ON QUANTITATIVE
RESEARCH AND INCLUDES DATA
SCIENCE AND THERE ARE
INSTITUTIONAL PROGRAM TRAINING
GRANTS THAT CAN FOCUS ON DATA
SCIENCE.
AND IN FACT RIGHT NOW WE'RE
SUPPORTING ABOUT 40 TRAINING
AWARDS FOCUSSED ON ARTIFICIAL
INTELLIGENCE AND MACHINE
LEARNING AND BIOINFORMATICS.
REGARDING OUR WORKING GROUP THE
REPORT HAS BEEN COMPLETED AND WE
ENCOURAGE YOU TO TAKE A LOOK AT
IT ON THE WEBSITE BUT HAD FIVE
MAJOR ELEMENT.
CREATING A DATA INFRASTRUCTURE
TAILORED TO DENTAL ORAL
CRANIOFACIAL RESEARCH AND
VISUALIZATION TOOLS FOR THE
FIELD AND ENHANCING THE DATA
SCIENCE WORKFORCE DEVELOPMENT
AND MAKING SURE THE TRAINING IS
INCLUSIVE AND PROMOTING DATA
STEWARDSHIP AS WELL AS
SUSTAINABLE DATA PRACTICES.
WE'RE MOVING IN THAT DIRECTION.
WE PARTNER WITH RESOURCES AND
COLLABORATORS ACROSS NIH AND
ELSE WHERE TO PROMOTE DATA
SHARING AND USE.
YOU CAN SEE A PLETHORA OUTLINED
HERE ACROSS MULTIPLE CONSORTIA
AND WE'RE BUILDING A DATA HUB.
IT WILL LAUNCH IN THE WINTER OF
2024.
SO WITHIN THE NEXT FEW MONTHS.
THIS DDS HUB, PUN INTENDED, HERE
STANDS FOR DATA DRIVEN SCIENCE.
THIS IS OUR RESPONSE TO THE NEED
TO HAVE A ONE-STOP-SHOP, A
CENTRALIZED PLACE TO CONNECT
DENTAL AND CRANIORESEARCHERS
THAT EXPAND THE SPECTRUM FROM
THE MOLECULAR LEVEL OUT TO THE
POPULATION LEVEL AND HAVE ALL
THOSE RESOURCES IN ONE PLACE.
HIGHLIGHTED WILL BE FAIR DATA S
SO THERE WILL BE ACCESS TO
SUMMARY INFORMATION ON THE
DIVERSITY AND DEMOGRAPHIC BREAK
DOWN OF THE DATA SETS.
THE HUB WILL FEATURE
COMPUTATIONAL AND ANALYTIC
RESOURCES FOR DATA SCIENCE
RESEARCH.
AND THIS WILL INCLUDE WORK
SPACES, NOTEBOOKS, CODE
REPOSITORIES AND TRAINING
MODULES.
FINALLY, THERE WILL BE GUIDANCE
ON DATA REUSE AND SHARING THAT
INCLUDES DATA MANAGEMENT AND
SHARING GUIDELINES AS WELL AS
TUTORIALS.
HERE'S A GRAPHIC THAT CAPTURES
THE SENTIMENT OF WHAT THIS DDS
HUB WILL DO.
THIS WILL BE A COMMUNITY-ENGAGED
AN DRIVEN HUB THAT WILL FOSTER
COLLABORATIONS AND PROMOTE
DISSEMINATION IN TERMS OF THE
ANALYTIC RESOURCES.
THEY ARE BEGINNER FRIENDLY.
THERE WILL BE INFORMING ON
GRANTS AND FUNDING THERE.
OPPORTUNITIES TO GENERATE FAIR
DATA USING STANDARDIZED
TERMINOLOGIES AND COMMON DATA
ELEMENTS.
THERE'LL BE DATA CURATION AND
REUSE THERE AT POPULATION AND
INDIVIDUAL LEVEL CLINICAL AND
BASIC SCIENCE DATA FOR RESEARCH.
AND FINALLY, WITH REGARD TO DATA
MANAGEMENT AND SHARING THERE'LL
BE GUIDELINES AND TUTORIALS TO
MAKE SURE THAT WE'RE PROMOTING
TRANSPARENCY, REPRODUCIBILITY
AND DATA REUSE AS WELL.
ALL THESE THINGS WILL HELP WITH
RIGOR IN OUR SCIENCE.
SO WE ARE WORKING HARD TO FORGE
CONNECTIONS ACROSS DATA SOURCES.
WE'RE COLLABORATING WITH MANY
PARTNERS AND OTHER FUNDERS.
OF COURSE WE HAVE THE ORAL
MICROBIOME PROTEOME DATABASES.
WE HAVE FACE BASE.
WITH REGARD TO COLLABORATION
WITH NCI WE HAVE THE EARLY
DETECTION RESEARCH INITIATIVE I
SPOKE ABOUT EARLIER AS WELL AS
THE OVER ALL NCI SUPPORTED
EARLIER RESEARCH DETECTION
NETWORK.
THERE ARE NCI DATA COMMONS THAT
INCLUDES IMAGING THAT WILL BE
AVAILABLE ON THE HUB AND ALSO
THE NCI BIO SPECIMEN RESOURCE.
WE ARE WORKING TO INCLUDE THE
AUTO IMMUNE RESEARCH COMMON DATA
ELEMENTS THROUGH ORWH AND WITHIN
SEVERAL MONTHS THERE WILL BE A
THINK TANK ON COMMON DATA
ELEMENTS FOR DENTAL ORAL AND
CRANIOFACIAL RESEARCH.
AND WE LOOK FORWARD TO YOUR
JOINING US AS WE MOVE FORWARD IN
THAT SPACE.
WE'RE WORKING WITH ALL OF US AND
YOU'LL HEAR MORE ABOUT THIS THIS
AFTERNOON AND WE HAVE CURATED
DATA FROM OUR NATIONAL DENTAL
PRACTICE-BASED RESEARCH NETWORK.
AND WE HAVE ALSO MULTIPLE SITES
THAT HAVE ALREADY SENT OR AGREED
TO SEND SUMMARY AND AGGREGATE
LEVEL LEVEL AND THE BIG MOUTH
REPOSITORY THE WISCONSIN
COLLABORATIVE FOR HEALTH CARE
EQUITY THE AMERICAN DENTAL
ASSOCIATION, OPERATION SMILE AND
WITHIN THE NEXT UPDATE WE'RE
EXPECTED TO HAVE THE ASSOCIATION
OF STATES AND TERRITORIES ORA
STDD CURATED SURVEYS AND WE'RE
MOVING FORWARD AND THERE ARE
OTHERS THAT WE'RE TRYING TO
BRING IN THAT WE'RE WORKING TO
BRING INTO THE FOLD TO HAVE
LARGE DATA SETS TO HELP US
ANSWER BIG PICTURE QUESTIONS.
THAT'S ACROSS OUR FIELD.
WE ARE BUILDING CURATED ANALYTIC
RESOURCES THAT WILL BE HELD AT
THE HUB.
THIS INCLUDES STRIDE, THE NIH
CLOUD, THE NIGMS SANDBOX AND THE
ALL OF US PUBLIC WORK SPACES AND
TERRA WORK SPACES AND SCHARE
I'LL PROVIDE MORE ABOUT IN A
SECOND.
ALL THESE THINGS WILL BE PRESENT
IN THE ONE-STOP-SHOP FOR US AND
OUR COMMUNITY.
WE HAVE AN INITIATIVE ONGOING
FOCUSSED ON UTILIZING COMMUNITY
ENGAGEMENT AND DATA SCIENCE TO
REALLY ACQUIRE THE EVIDENCE WE
NEED TO HELP DIMINISH ORAL
HEALTH DISPARITIES.
AS PART OF THIS BEING LED BY A
PROGRAM OFFICER THE
COLLABORATION WITH THE NIMHD
SCIENCE COLLABORATIVE FOR HEALTH
DISPARITIES AND ARTIFICIAL
INTELLIGENCE BIAS REDUCTION.
SO WHAT THEY'RE WORKING TO DO IS
INCREASE PARTICIPATION OF WOMEN
AND OTHER UNDER REPRESENTED
POPULATIONS IN DATA SCIENCE AND
CLOUD COMPUTING TOOLS AND
ADVANCING A.I. BIASSED
MITIGATION.
THIS CLOUD-BASED PLATFORM WILL
BE AVAILABLE TO OUR COMMUNITY
THROUGH OUR HUB.
THE INITIATIVE TO BUILD
SUSTAINABLE SOFTWARE TOOLS THAT
IS OPEN SCIENCE AND HELP US MOVE
FORWARD WITH DOC DATA ANALYSIS.
HOW ARE WE USING DATA DRIVEN
APPROACHES TO IMPROVE ORAL
HEALTH?
THERE'S ALREADY GREAT SCIENCE IN
THE PIPELINE.
HERE I'LL SHARE A FEW SCIENCE
ADVANCES THAT DEMONSTRATE THIS.
HERE FROM KIM ET AL. WE SEE THE
USE OF OMICS-LEVEL DATA AND
UTILIZATION OF THE TRANSCRIPTOME
TO HELP US UNDERSTAND RARE
IMMUNE CELL SUBSETS THAT OCCUR
IN CHILDREN WITH SJOGREN'S
DISEASE AND THERE'S ANOTHER
INITIATIVE THAT IS SLIDE FREE
HISTOLOGY WITH MACHINE LEARNING
PLATFORMS AND WE HAVE SOMETHING
AND THERE'S A GOOD EXAMPLE OF
HOW WE'RE LEVERAGING DATA TO
HELP US WITH CLINICAL
DIAGNOSTICS AND THIS IS FROM JEN
ET AL AND USING OMICS DATA TO
HELP US UNDERSTAND CHRONIC PAIN.
LOOKING AT TRANSCRIPTOMIC
PROFILES IN TMD PATIENTS.
THIS WORK IS FROM COLLOCA ET AL.
THESE FINDINGS WILL HELP LEAD TO
IDENTIFICATION OF BIOMARKERS FOR
PLACEBO.
SO THERE'S LOTS OF SPACE TO USE
DATA TO HELP US MOVE CLINICAL
CARE FORWARD.
THAT WAS DATA.
NOW WHERE ARE WE WITH PRIMARY
CARE INTEGRATION.
THERE WAS A 2000 SURGEON GENERAL
REPORT AND NEED TO GET TO
COMMUNITIES AND RESEARCH THERE.
WE ARE REALLY WORKING TO FOSTER
CLINICAL RESEARCH COLLABORATIONS
THAT ADVANCE DENTAL ORAL AND
CRANIOFACIAL CLINICAL WORK AND
STRATEGICALLY ADDRESS HEALTH
DISPARITIES.
IN FACT WE HAVE TWO NETWORKS.
ONE, THE 20-YEAR SUPPORT OF THE
DENTAL PRACTICE-BASED RESEARCH
NETWORK OR PBRN AND TO THE NEWLY
LAUNCHED DENTAL SCHOOL-BASED
PBRN.
THESE NETWORKS CAN HELP US WITH
ADDRESSING THE GAPS IN CLINICAL
CARE.
IN REAL TIME AND REAL-WORLD
SETTINGS.
WE HAVE RESEARCHERS MONITORING
CLINICAL STUDIES TO ENSURE
INCLUSION AND ESTABLISH NEW
COLLABORATIONS WITHIN
COMMUNITIES AND REVISIT
OPPORTUNITIES TO TRANSLATE AND
IMPLEMENT WITHIN AND ACROSS
COMMUNITIES AND STAFF ARE
WORKING HARD TO IDENTIFY NEEDS
AND RESEARCH GAPS THAT CAN HELP
WITH IMPROVING CLINICAL CARE AS
WELL AS ORIENTING CLINICAL
RESEARCHERS TO NIH AND NIDCR
EXPECTATIONS OVER THE LIFE SPAN
OF CLINICAL STUDIES AND
SPECIFICALLY HAVE DONE A RECENT
SYSTEMATIC REVIEW OF ALL OF OUR
FUNDED CLINICAL TRIALS TO
BENCHMARK OUR CURRENT
DISTRIBUTIONS, WHERE ARE WE WITH
UNDER SERVED POPULATIONS WITH
NETWORK INVOLVEMENT AND RESEARCH
AREAS.
WE'RE BUILDING WEB-BASED
CLINICAL-BASED RESOURCES.
WE'RE HOPING THESE WILL BE
RELEASED ON THE NEXT YEAR.
TO EDUCATE THE PUBLIC AND
RESEARCH COMMUNITY ON THE VALUE
AND METHOD RELATED TO BIOMEDICAL
RESEARCH AND DEVELOPING
ENROLLMENT AND RETENTION POLICY
AN ACCRUAL POLICY TO MAXIMIZE
OUR RETURN ON INVESTMENT.
THERE ARE MULTIPLE STUDIES AND
SCIENTIFIC ADVANCES THAT HAVE
BEEN ADDRESSING GAPS IN CLINICAL
CARE IN THE COMMUNITY.
AND THESE INCLUDE PREDICTING
DENTAL CARRIES IN YOUNG CHILDREN
AND REDUCING HEALTH DISPARITIES.
LOOKING AT HOW DENTAL VISITS CAN
INCREASE SUPPORT FROM PEDIATRIC
PROVIDERS AND WE TALKED ABOUT
EARLIER OUR COMMUNITY-BASED
PARTICIPATORY RESEARCH
CONSORTIUM IN THE CONTEXT OF
ADAPT.
WE'RE WORKING TO ENGAGE WHOLE
PERSON HEALTH AND ADVOCACY GROUP
AND TO CURATE A PLATFORM WHERE
THE MANNER AND TRAINING
INDIVIDUALS TO PROVIDE AND DO
CLINICAL RESEARCH.
HOW ARE WE TRAINING?
WE HAVE 60 DUAL-DEGREE
PREDOCTORAL SCIENTISTS AND
HERE'S JUST QUICK SCIENCE
ADVANCES.
CARIES.
THERE'S RANDOMIZED TRIAL THAT
DEMONSTRATED PEDIATRIC
CLINICIANS CAN INTEGRATE ORAL
HEALTH SERVICES INTO THEIR WORK
FLOW DURING WELL CHILD VISITS
AND IT WORKS JUST FINE.
THIS WAS WORK SPEARHEADED BY
NELSON ET AL.
THERE WAS A COST-EFFECTIVENESS
STUDY FROM JANUSZ ET AL. TO LOOK
AT RISK-BASED APPROACHES AS A
STRATEGY THAT LOOKED PROMISING.
AND QUANTITATIVE STUDIES AND
HERE'S A FLUORIDE FOCUSSED STUDY
PERFECT THE GROUP THAT
HIGHLIGHTS THE NEED FOR IMPROVED
EDUCATION AND TRAINING IN
EVIDENCE BASED COMMUNICATION.
THIS WILL IMPROVE PRIMARY CARE.
WE ALSO HAVE EXAMPLES HOW DATA
AND PRIMARY CARE COME TOGETHER
TO IMPROVE ORAL HEALTH.
SPECIFICALLY HERE WE'RE
HIGHLIGHTING THE HEATON PROJECT
USING COMPUTATIONAL APPROACHES
TO MODEL WHAT'S HAPPENING OUT IN
THE COMMUNITY.
SPECIFICALLY LOOKING AT HOUSING
DEVELOPMENTS IN BOSTON.
TOE UNDERSTAND WHAT CAN LEAD TO
IMPROVED ORAL HEALTH OUTCOMES.
ANOTHER EXAMPLE ARE USE OF
DATA-DRIVEN APPROACHES TO HELP
IN CLINICAL CARE.
HERE SOFTWARE BASED
OBSERVATIONAL CODING WAS USED TO
HELP WITH EVALUATION OF
PEDIATRIC DENTAL PAIN, ANXIETY
AND FEAR.
SO WE ARE WORKING TO FOSTER
CLINICAL CARE RESEARCH, TO
FORWARD DATA AND TO ESTABLISH
NID
NIDCR-FUNDED NETWORK AS A KEY
AND CENTRAL PART OF NIH WIDE
COMMUNITIES ADVANCING RESEARCH
EQUITY OR THE CARE NETWORK
DR. BERTAGNOLLI SHARED WITH US
WHEN VISITING AT LAST COUNCIL.
THE BOTTOM LINE IN CLOSING IS
THAT WE ARE WORKING COLLECTIVELY
THROUGH THE RESEARCH WE DO FROM
THE MOLECULAR LEVEL OUT TO THE
POPULATION LEVEL TOWARDS ORAL
HEALTH FOR ALL.
AND THAT MEANS ORAL HEALTH FOR
ALL OF US.
SO I'M GOING IT TAKE THIS MOMENT
TO INTRODUCE THE ALL OF US
RESEARCH PROGRAM AND IT IS MY
DISTINCT PLEASURE TO SHARE
SHERRI SCHULLY WILL BE JOINING
US FROM THE ALL OF US PROGRAM.
SHE SERVES AS DEPUTY CHIEF
MEDICAL AND SCIENTIFIC OFFICER
FOR ALL OF US.
PRIOR TO THIS ROLE, SHE WAS A
TEAM LEAD AND SENIOR ADVISER IN
THING OFF OF DISEASE PREVENTION
HERE AT NIH AND HER RESEARCH
TRDZ INCLUDE GENOMICS,
PERSONALIZED MEDICINE AND
GENETIC AND GENOMIC INFORMATION
INTO CLINICAL AND PUBLIC HEALTH
PRACTICES.
HER Ph.D. WAS IN BIOLOGICAL
SCIENCES WITH A CONCENTRATION OF
POPULATION GENETICS AND
RESOURCED HER BACHELOR'S IN
ZOOLOGY WITH A MINOR IN
CHEMISTRY FROM LOUISIANA STATE
UNIVERSITY.
IT IS MY PLEASURE TO HAVE
DR. SCHULLY JOIN US TODAY.
>> THANK YOU AND I'M GOING TO
SHARE MY SLIDES.
I WANT YOU TO KNOW THERE ARE A
LOT OF SLIDES HERE BUT I REALLY
WANT TO EMPHASIZE FOR SOME DATA
ACCESS SLIDES I'LL GO FAST
THROUGH THOSE I WANT PEOPLE TO
HAVE ACCESS TO OUR DATA AND
DIRECT YOUR TRAINEES TO OUR DATA
AS WELL AS YOUR OTHER CONTACTS.
DEFINITELY DO WANT TO MAKE SURE
EVERYONE HAS THAT.
I'M THE DEPUTY CHIEF MEDICAL AND
SCIENTIFIC OFFICER FOR THE ALL
OF US PROGRAM AND HERE FOR
LEADERSHIP AS A WHOLE.
WE'VE BEEN TALKING A LOT ABOUT
POTENTIAL COLLABORATIONS.
I'LL GIVE A LITTLE BIT OF
BACKGROUND ON THE PROGRAM.
OUR CURRENT DATA WHAT'S
AVAILABLE NOW AND WHERE ARE
COLLABORATIONS OPPORTUNITIES
WITH DENTAL ORAL CRANIOFACIAL
RESEARCH.
OUR MISSION IS TO ACCELERATE
HEALTH RESEARCH AND MEDICAL
BREAKTHROUGHS ENABLIZING
TREATMENT AND CARE FOR YOU WILL
OF US.
WE DO THIS IN THREE WAYS.
THE FIRST IS NURTURING
PARTNERSHIPS WITH DECADES WITH
AT LEAST $1 MILLION WHO REFLECT
THE DIVERSITY OF THE UNITED
STATES AS A WHOLE.
SECOND, WE WANT TO DELIVER ONE
OF THE LARGEST RICHEST
BIOMEDICAL DATA SETS AS BROADLY
AVAILABLE AND SECURE SO OUR DATA
THAT WAS DONATED BY PARTICIPANTS
ISN'T IDENTIFIABLE AND CAN BE
PUT OUT THERE IN A BROAD WAY.
FINALLY JUST BECAUSE WE HAVE THE
AMAZING PARTNERSHIPS AND
BUILDING THIS AMAZING
INFRASTRUCTURE DOESN'T MEAN
PEOPLE WILL NECESSARY COME TO
IT.
WE'RE HOPING TO CATALYZE AN ECO
SYSTEM OF COMMUNITIES,
RESEARCHERS AND FUNDERS WHO MAKE
ALL OF US AN INDISPENSABLE PART
OF RESEARCH AND SEE THIS IS A
REALLY AMAZING RESEARCH AND CAN
ANSWER LOTS OF QUESTIONS FOR
LOTS OF CONDITIONS.
THERE ARE SOME HOLES WE CAN FILL
INCLUDING MORE DENTAL RECORDS
AND THINGS LIKE THAT BUT WE CAN
LEAVE THAT FOR THE DISCUSSION
PART TOWARDS THE END.
I DO WANT TO START BY TALKING
OUR CORE VALUES.
WE WANT TO MAKE SURE THAT WE ARE
STICKING TO THESE CORE VALUES.
HOPEFULLY YOU'LL SEE WHAT WE
BUILT SO FAR AND REFLECT THE
CORE VALUES.
PARTS TO ALL OF US IS OPEN TO
ALL.
WE'RE NOT TURNING PEOPLE AWAY.
IT'S OPEN.
WE WANT PROPERTIES TO REFLECT
THE RICH DIVERSITY OF THE UNITED
STATES.
MOST DATA TO DATE HAS NOT BEEN
REPRESENTATIVE OF INDIVIDUALS IN
THE UNITED STATES AND THE CARE
BASED OFF THAT EVIDENCE IS ONE
SIZE FITS RAALL AND OUR PARTNER
HAVE INVOLVED AND TRUST WILL BE
EARNED THROUGH 42 TRANSPARENCY
AND MAKING SURE WE'RE
INTERACTIVE WITH OUR
PARTICIPANTS AND BEING CLEAR
WITH THEM.
PARTICIPANTS HAVE ACCESS TO
THEIR INFORMATION AND DATA
AVAILABLE BROADLY FOR RESEARCH
PURPOSES WITH SECURITY AT THE
HIGHEST IMPORTANCE BECAUSE OUR
PARTICIPANTS DONATE TO THE DATA
AND WE NEED TO PROTECT IT AND
WILL BE A CATALYST FOR CHANGE IN
RESEARCH AND HOPE YOU STARTED TO
SEE WE MADE THE CHANGE HAPPEN.
I'LL GIVE YOU A LITTLE BIT OF A
BACKGROUND OF THE PROGRAM.
TO DATE, WE CURRENTLY HAVE OVER
834,000 PARTICIPANTS ENROLLED OR
CONSENTED TO BE PART OF THE
PROGRAM.
AND 567,000 INDIVIDUALS HAVE
COMPLETED WHAT WE CALL THE
INITIAL STEPS OF THE PROGRAM.
COMPLETED THE FIRST THREE
SURVEYS, GIVEN A BIO SAMPLE OF
SOME SORT AND GIVEN US PHYSICAL
MEASUREMENTS VERY BASIC AND I'LL
GO THROUGH WHAT THOSE ARE.
WE HAVE LINK TO ELECTRONIC
HEALTH RECORDS FROM OVER 453,000
PARTICIPANT.
WE'RE HOPING TO CLOSE THE GAP
BETWEEN THE 567,000 AND 453,000
BUT WITH THE FEDERATED HEALTH
CARE SYSTEM IT'S DIFFICULT SO
THE E.H.R. LAGS A LITTLE BIT
BEHIND AND HAVE 587,000 WITH
SPECIMENS AT THE MAYO CLINIC.
WE HAVE PARTICIPANTS IN ALL 50
STATES.
AS WELL AS MANY U.S. TERRITORY.
THE DARKER YELLOW COLORS
INDICATE WHERE WE HAVE HIGHER
POPULATIONS AND REGIONAL MEDICAL
CENTERS THAT HAVE ENROLLMENT
CENTERS VERSUS OUR JOIN ALL OF
US.org SELF-JOURNEY.
SO ANYONE CAN JOIN FROM ANYWHERE
IN THE UNITED STATES BUT AND
THERE'S MORE OF A HANDS ON
EXPERIENCE.
WE WANT TO REFLECT THE BROAD
DIVERSITY OF THE UNITED STATES.
FOR ALL OF US WE'RE TRYING TO
COLLECT DATA ON THOSE WHO HAVE
BEEN UNDER REPRESENTED IN BIO
MEDICAL RESEARCH.
THAT'S NOT ONLY RACIAL AND
ETHNIC MINORITIES BUT ALSO
THINKING ABOUT THOSE WHO ARE
SEXUAL GENDER MINORITIES.
THOSE LOW INCOME OR MAY HAVE A
DISABILITY, LOW EDUCATION
ATTAINMENT, RURAL VERSUS URBAN
POPULATIONS.
WE'RE STRIVING TO BE 75% OF WHAT
WE CALL UNDER REPRESENTED IN BIO
MEDICAL RESEARCH WITH 50% OF
THAT ACTUALLY BEING RACIAL AND
ETHNIC MINORITIES.
SO WHEN YOU THINK ABOUT SOME OF
THE THINGS THAT JENNIFER
MENTIONED IN HER OPENING TALK,
WE'RE REALLY BRINGING IN THOSE
PARTICIPANTS THAT MAY HAVE THE
SAME GAP FOR DENTAL AND ORAL
CARE AND RESEARCH AND SO I THINK
THIS MIGHT BE A GOOD OPPORTUNITY
TO REACH SOME POPULATIONS THAT
HAVEN'T BEEN REACHED BEFORE.
WHAT I'LL BE TRA TALKING ABOUT
SPECIFICALLY FOR ADULTS, SO 18
YEARS AND OLDER.
WE STARTED PEDIATRIC ENROLLMENT.
I'LL TALK A LITTLE BIT ABOUT
THAT AND WHERE WE ARE TOWARDS
THE END.
I'LL START WITH E.H.R.
THE CONSENT IS INTERACTIVE VIDEO
ONLINE CONSENT.
DURING THAT CONSENT PARTICIPANTS
AUTHORIZE TO SHARE THEIR
ELECTRONIC HEALTH RECORD DATA
WITH RESEARCHERS.
RIGHT NOW WHAT WE'RE ABLE TO
GRAB FROM THE E.H.R. ARE
DEMOGRAPHICS, VISITS, DIAGNOSES,
PROCEDURES, MEDICATIONS, LAB
VISITS AND VITAL SIGNS.
WE'RE LOOKING TO EXPAND ON THAT
ESPECIALLY AS MACHINE LEARNING
AND ARTIFICIAL INTELLIGENCE GETS
BETTER TO INCLUDE CLINICAL NOTES
AND REPORTS, MENTAL HEALTH
REPORTS, SUBSTANCE ABUSE, MORE
LABORATORY RESULTS IN THE
VALUES.
AS YOU GUYS KNOW THOSE ARE
TYPICALLY IN PDF FORM OR HAVE
HIGHLY IDENTIFIABLE INFORMATION
ON THEM.
SO IT'S GOING TO TAKE A LITTLE
BIT MORE TO LOOK ACROSS 687,000
INDIVIDUALS E.H.R.s AND PULL
THAT INFORMATION IN A WAY THAT
REALLY SCRUBS IT OF IDENTIFYING
INFORMATION AND MAKES IT
DE-IDENTIFIED FOR OUR BROAD
RESEARCH PURPOSES.
WE HAVE PARTICIPANT PROVIDED
INFORMATION AND LIFE TIME AND
AFTER ENROLLMENT THEY GET OTHER
SURVEYS INCLUDING HEALTH CARE
ACCESS AND UTILIZING AND
PERSONAL AND FAMILY HEALTH
HISTORY, SOCIAL DETERMINATES,
EMOTIO
EMOTIONAL HEALTH HISTORY AND
WELL BEING AND AD HOC SURVEYS SO
WHEN THE COVID-19 PANDEMIC
HAPPENED WE HAD SURVEYS THAT
ASKED PARTICIPANTS ABOUT THEIR
EXPERIENCE WITH COVID-19 GOING
BEYOND SYMPTOMOLOGY AND WHO HAD
TESTED POSITIVE FOR COVID COVID
AND THINGS LIKE THAT BUT ASKING
WHAT WITH WAS THE IMPACT ON OUR
INDIVIDUAL PARTICIPANTS.
DID THEY LOSE THEIR JOB BECAUSE
THEY COULDN'T BE IN PERSON?
DID THEY LOSE INSURANCE?
WERE THEY SOCIALLY ISOLATED OR
HAVING MENTAL HEALTH ISSUES
ABOUT IT?
WE HAVE A DYNAMIC PLATFORM WHERE
WE CAN GET ANSWERS TO PUBLIC
HEALTH EMERGENCIES HAPPENING IN
THINGS LIKE THAT IN REAL TIME.
WE GOT BLOOD PRESSURE, HIP,
WEIGHT, BMI AND HIP AND WAIST
SCIRCUMFERENCE AND THEY GET A
NICE REPORT AND GUIDELINES FOR
VARIOUS COMPONENTS.
WE ALSO HAVE BIO SPECIMENS WE
ARE COLLECTING.
WE TYPICALLY COLLECT BLOOD AND
URINE FROM PARTICIPANTS AND
LISTED OUR STANDARD BLOOD AND
URINE COLLECT.
IF WE CANNOT COLLECT BLOOD OR IF
IT'S A REMOTE PARTICIPANT WE'RE
DOING A SALIVA COLLECTION AND
USING THE COLLECTION KIT FOR DNA
PURPOSES.
WE CAN'T USE IT FOR MICROBIOME
RIGHT NOW BUT WITH THE SAME AS
SURVEYS WE CAN RECONTACT OUR
PARTICIPANTS.
IF WE DECIDED TO DO A SECOND
COLLECTION TO LOOK AT ORAL
MICROBIOME IT COULD BE DONE
WITHIN THIS INFRASTRUCTURE.
WE'RE LINKING TO VARIABLE
TECHNOLOGIES.
THIS WILL INCLUDE FITBIT AND
APPLE HEALTH KIT AND HOPE TO
HAVE ADDITIONAL INTEGRATIONS
WITH THINGS LIKE THE GOOGLE
WATCH, GARMIN, ETCETERA.
AND OUR CURRENT DATA INCLUDES
HEART RATE BY ZONE, BY MINUTE,
DAILY ACTIVITY, ACTIVITY STEPS
AND SOME SLEEP DATA.
WE ALSO WITH THE BIO SAYS MEN
COLLECTION WE DO DO BOTH WHOLE
GENOME AND GENOTYPING ARRAYS.
WE WORK WITH OUR GENOME CENTER
TO DO THE WHOLE GENOME
SEQUENCING AND THEN RETURN
INFORMATION TO OUR PARTICIPANTS
AND THAT GENOMIC RETURN STARTS
OUT WITH WHAT WE CALL OUR
GENOMICS ENGAGEMENT MODULE AND
I'LL GIVE MER INFORMATION ON
THAT AND THE SECOND IS
HEALTH-RELATED RESEARCH REPORTS
THAT TALK ABOUT HERT TRY DISEASE
RISK AS WELL PHARMACO GENOMIC
VARIANTS OR MEDICINE IN YOUR
DNA.
OUR PARTICIPANTS ARE TRUE
PARTNERS AND WANT TO ENGAGE IN
WAYS THAT GIVE THEM INFORMATION
ABOUT THEMSELVES AND HELP THEM
EMPOWER THEIR HEALTH CARE JOU
JOURNEY AND PARTICIPANTS HAVE
ACCESS TO THEIR OWN INFORMATION.
WITH THE RETURN OF RESULTS I
MENTIONED THE ENGAGEMENT PIECE
AND IN THE HEALTH PIECE, WE GIVE
VERY BROAD GENOMIC ANCESTRY BAG
AS WELL AS FOUR TRAITS, EAR WAX
TYPE, BITTER TASTE, PREFERENCE,
CILANTRO PREFERENCE, LACTOSE
INTOLERANCE AND GIVE BACK A
HEREDITARY RISK DISEASE REPORT
AND MEDICINE IN YOUR DNA REPORT.
WE PARTNER TO DO GENETIC COU
COUNSELING AS WELL AS RETURNING
OF THE RESULTS.
THE ENGAGEMENT PIECE AND
PHARMACO GENOMICS PARTICIPANTS
WILL GET A REPORT ON THESE.
HOWEVER IF SOMEONE HAS A
PATHOGENIC OR VARIANT IN THE 59
GENES IN DISEASE RISK REPORT RER
DOING RESPONSIBLE RETURN AND
GETTING PEOPLE INFORMATION THAT
MAY LEAD THEM TO PANIC OR
ANXIETY OR ANYTHING LIKE THAT.
WE HAVE A CLINICAL CONFIRMATION
TO BRING THAT TO THEIR DOCTOR
AND TAKE THE NEXT STEP.
A LITTLE BIT OF DATA SINCE I'M
HERE IN THIS PIECE.
I'LL SAVE THE REST OF THE DATA
FOR LATER.
SO FAR OVER 220 PARTICIPANTS
HAVE LOOKED AT THE -- 220,000
PARTICIPANTS LOOKED AT THE
REPORT AND TRAIT REPORT AND
HEALTH RELATED REPORTS WE
RETURNED BUT HAVE SEEN ALMOST
150,000 INDIVIDUALS LOOK AT
THEIR HEREDITARY DISEASE RISK
REPORT AND ALSO SEEING 3% HAVE A
PATHOGENIC OR LIKELY PATHOGENIC
VARIANT ON AVERAGE WHAT THE
LITERATURE SHOWS IS THE
PREVALENCE ACROSS THE UNITED
STATES AND HAVE ABOUT 142,000
PARTICIPANTS WHO HAVE SEEN THEIR
MEDICINE IN YOUR DNA REPORT.
AS YOU CAN IMAGINE, MANY MORE
PEOPLE WILL GET SOME SORT OF
RESULT FROM THIS MEANING THEY
ARE WILL HAVE A VARIANT THAT
IMPACTS HOW THEY MAY PROFESSION
PROCESS MEDICATION AND THE
HEREDITARY DISEASE RISK REPORT
AND ALLOW PEOPLE TO CALL A
GENETIC COUNSELOR AND MAKE AN
APPOINTMENT AND SAYING I HAVE
THIS VARIANT AND TAKING THIS
DRUG WHAT DOES IT THIS MEAN TO
GET MORE INFORMATION AND HAVE A
REAL CONVERSATION WITH SOMEONE
WHO UNDERSTANDS.
NOW WE'LL TALK ABOUT ACCESSING
DATA IN RESEARCH TOOLS.
I'LL GO A LITTLE FAST THROUGH
THIS TO SAVE TIME FOR
DISCUSSION.
I DO WANT TO SHOW EVERYONE WHAT
WE HAVE AND ENCOURAGE TO SHARE
RESOURCES WITH YOUR COLLEAGUES
AND STUDENTS AND MORE.
SO AGAIN BRINGING BACK THE CORE
VALUES.
WE WANT TO MAKE SURE DATA IS
GOING TO BE ACCESSIBLE FOR
RESEARCH PURPOSES, SECURITY AND
PRIVACY ARE REALLY IMPORTANT TO
US AND SOMETHING WE HOLD TRUE TO
AND THE PROGRAM WILL BE A
CATALYST FOR POSITIVE CHANGE IN
RESEARCH AND I THINK JUST BY
CREATING THE RESEARCH WORK BENCH
WE ALREADY HAVE BROKE THE MODEL
ON THAT.
SO WE HAVE THREE TIERS OF DATA.
I'LL BRIEFLY TALK ABOUT ALL OF
THEM.
THE FIRST I'LL TALK ABOUT AND
WALK YOU THROUGH EXAMPLES OF IS
PUBLIC TIER.
IT'S CALLED OUR DATA BROWSER.
AND YOU CAN ACTUALLY LOOK AT
DATA SNAPSHOTS, DO AN
INTERACTIVE SEARCH WITH OUR DATA
BROWSER, LOOK AT OUR SURVEYS AND
EVEN DOWNLOAD SURVEYS AS WELL AS
THE INFORMATION OF WHAT
VALIDATED SURVEYS DO THEY COME
FROM AND HOW DO WE CHOOSE THEM
AND WHAT ARE THE ANSWER TYPE TO
VALIDATE ACROSS STUDIES AND
ESPECIALLY IF OTHER STUDIES ARE
USING THE SAME QUESTIONS AND
THEN OUR RESEARCH PROJECT
DIRECTORY SO EVERYONE CAN SEE
WHAT'S GOING ON IN THE WORK
BENCH RIGHT NOW.
YOU'LL SEE WE HAVE OVER 12,000
RESEARCHERS USING THIS DATA
ALREADY.
EACH ONE OF THOSE HAS TO CREATE
A DESCRIPTION OF WHAT THEIR
DOING IN THE WORK BENCH AND YOU
CAN SEARCH ACROSS TO SEE WHAT'S
HAPPENING IN AREAS YOU MIGHT BE
INTERESTED IN.
AND THEN SORT OF OUR MORE I
GUESS I WOULD SAY CLOSED AREA IS
REALLY ONLY AVAILABLE TO THOSE
WHO ARE REGISTERED RESEARCHERS.
AND THAT'S WHERE OUR MORE
IDENTIFIABLE INFORMATION IS.
AND SO THAT'S WHERE YOU'LL FIND
OUR GENOMICS, OUR HEALTH AND
LIFESTYLE SURVEYS AND YOU'RE
ABLE TO DO SOME DYNAMIC ANALYSES
IN EITHER R PYTHON OR STUDIO OR
SAS I'LL TALK ABOUT IN A SECOND.
IN OUR WORK BENCH WE HAVE A
VERSION COMING OUT SOMETIME SOON
IN SEPTEMBER AND THIS WILL
INCREASE DRAMATICALLY.
SO YOU CAN SEE HOW MANY SURVEYS
COMPLETED ALMOST 2 MILLION AND
16,000 FITBIT RECORDS, 245,000
WHOLE GENOME SEQUENCES PHYSICAL
MEASUREMENTS FROM MANY PEOPLE,
287,000 E.H.R.s.
IT'S REALLY AN AMAZING BIG DATA
PLATFORM AND IT'S GOING TO KEEP
GROWING OVER TIME.
NOT JUST BECAUSE WE'RE ADDING
ADDITIONAL PARTICIPANTS TO THE
DATA BUT ALSO BECAUSE WE'RE
EXPANDING THE DATA TYPES AND
I'LL SHOW YOU A LITTLE BIT ABOUT
THAT IN A SECOND.
BUT WITH THIS RELEASE THAT CAME
OUT LAST YEAR WE FOUND VARIATION
AND MORE THAN 1 BILLION
LOCATIONS, WUN -- ONE-THIRD OF
THE HUMAN GENOME AND WE'RE
ADDING TO THE SCIENCE THAT'S OUT
THERE AS WELL AS ALLOWING THE
BROAD ACCESS WHICH IS REALLY
BREAKING THE HOLD IN HOW DATA
SHARING IS HAPPENING.
I WILL TELL YOU THAT EVEN THOUGH
THE ALL OF US LAUNCH OFFICIALLY
HAPPENED IN 2018, MANY OF OUR
DATA TYPES ARE LONGITUDE FLAL.
YOU CAN SEE WE HAVE E.H.R. DATA
THAT GOES BACK TO THE '90s.
SOME IN THE '80s AND FIT BIT
DATA AND THERE'S LONGITUDINAL
DATA IN OUR WORK BENCH AND TALK
ABOUT OUR EFFORTS TO GET DATA
OVER TIME FROM PARTICIPANTS
DIRECTLY.
I'LL DO A QUICK WALK THROUGH OF
OUR DATA BROWSER.
THIS IS PART OF THE PUBLIC
PIECE.
ANYONE CAN LOG ON TO RESEARCH
ALL OF US.org.
NO LOG ON IS REQUIRED.
YOU CAN SEE THINGS ACROSS ALL OF
OUR DIFFERENT DATA TYPES WE'RE
COLLECTING.
YOU CAN EVEN DO A KEY WORD
SEARCH AND SEARCH ACROSS THE
DATA TYPE.
SO I DID ONE OR ORAL CANCER AND
IT DID SEE THAT WE HAD TWO
MATCHING E.H.R. DOMAINS THAT
CAME UP.
AND SO WHEN I CLICKED ON THE
E.H.R. DOMAIN TAB, I SAW THAT WE
HAD 840 PARTICIPANTS WHO HAD A
DIAGNOSIS OF MALIGNANT TUMOR OF
THE ORAL CAVITY.
I GOT INTERESTED.
THAT'S A FAIRLY LARGE NUMBER.
THERE'S ACTUALLY THESE TOOLS ON
THE SIDE WHERE YOU CAN GRAPH
THIS BY BOTH SEX ASSIGNED AT
BIRTH, AGE AND SOURCES.
SO I CLICKED ON THAT AND YOU CAN
SEE THE AGE DISTRIBUTION FOR
THOSE 840 PARTICIPANTS THAT ARE
THERE.
THIS IS AGGREGATE ROLLED UP
DATA BUT IT GIVES YOU AN IDEA OF
WHAT IS IN OUR DATA SET TO START
TO FORMULATE, OKAY, I WANT TO DO
MUCH MORE OR MRAB WRITE A GRANT
AND UNDERSTAND WHAT'S IN THE
DATABASE BETTER BEFORE I PUT THE
GRANT IN.
IT'S A POWERFUL TOOL.
I USE IT FOR PRESENTATIONS AND
THINGS LIKE THAT BUT WAYS TO
SHOW THAT WHAT YOU'RE LOOKING
FOR IS ACTUALLY HERE
POTENTIALLY.
AND LOOKING AT THAT.
WITHIN OUR REGISTERED AREA WE
HAVE A CLOUD BASED PLATFORM.
WE HAVE SEVERAL DIFFERENT TOOLS
AVAILABLE.
I MENTIONED THAT YOU CAN USE
JUPITER NOTE BOOKS BUT HAVE TO
CODE IN PYTHON OR R WITH THE
FIRST STEPS.
WE HAVE NOW OPENED UP R STUDIO
AS WELL AS SAS.
WE BROUGHT SAS TO A CLOUD
COMPUTING PLATFORM WHICH IS HUGE
THINKING ABOUT THE NUMBER OF
EPIDEMIOLOGISTS AND USE SAS AS
AN ANALYSIS TOOL.
IT OPENS UP THE TOOL FOR WHO CAN
USE THE WORK BENCH IN A
MEANINGFUL WAY.
THERE ARE GRAPHICAL TOOLS TO
HELP YOU PICK THE DATA SET YOU
WANT TO WORK WITH.
THERE ARE POINT AND CLICK TOOLS
TO HELP BUILD YOUR RESEARCH
STUDY COLLECTION.
IT'S OPEN TO RESEARCHERS AT
ACADEMIC INSTITUTIONS AND OPENED
UP COMMERCIAL ACCESS AS WELL AS
INTERNATIONAL ACCESS.
SO WE'RE TRYING TO MAKE THIS AS
BROAD AS POSSIBLE AND TRYING TO
LEVEL THE PLAYING FIELD BY
PUTTING IT IN A CLOUD-BASED
PLATFORM SO EVERYONE HAS THE
SAME COMPUTE POWER AND STARTING
AT THE SAME LEVEL AND YOU DON'T
HAVE TO BE AT A TOP-TIER
UNIVERSITY WITH A LARGE
COMPUTING CENTER.
WE USED A DATA PASSPORT ACCESS
MODEL DINE AMMIC -- DYNAMICALLY
CHANGING HOW WE SHARE ACCESS.
ONCE YOU HAVE YOUR WORK SPACE
CREATE AND HAVE IT ON THE
DIRECTORY YOU CAN START TO PULL
IN ADDITIONAL DATA TYPES AND
DON'T HAVE TO ASK OR REAPPLY
EACH TIME WHEN YOU WANT TO PULL
IN THE DATA TYPE OR LOOK AT IT
DIFFERENTLY.
WE ALL KNOW THAT TYPICAL DATA
SHARING IS PUTTING IN A REQUEST
TO I -- A STEERING COMMITTEE
AND PUT IN A REQUEST AND FOR
SOMETHING ELSE YOU NEED AN
AMENDMENT OR ANOTHER
APPLICATION.
THAT HAS GONE AWAY WITH THE
RESEARCHER WORK BENCH.
ONCE PEOPLE HAVE BECOME AN
AUTHORIZED USER WITHIN THE
RESEARCHER WORK BENCH THEY HAVE
ACCESS TO ALL THESE AMAZING
THINGS WHICH IS GREAT.
THERE'S NO IRB APPROVAL
NECESSARY.
WE ACTUALLY HAVE THIS ALL AS
NON-HUMAN SUBJECTS RESEARCH
APPROVED BY OUR CENTRAL IRB.
SO THERE'S A LOT OF POSITIVES TO
THE PLATFORM HERE.
I MENTIONED THE DIVERSITY IN
GENETICS BUT SPECIFICALLY IN
RACE AND ETHNICITY WITH ONE
RELEASE AND IT WILL GET HIGHER
WITH THE NEXT RELEASE CHANGING
WHAT THE GENETIC DATA SETS OUT
THERE LOOK LIKE BASED ON THE
DIVERSITY OF OUR PARTICIPANTS
AND WHAT WE'RE ADDING TO THE
FIELD AS A WHOLE.
THIS IS WIDELY OPEN NOW.
THE MAJORITY OF OUR PEOPLE ARE
IN THE U.S. BUT WE'RE TRYING TO
EXPAND THAT.
AND OVER 600 PUBLICATIONS AND
GROWING EXPONENTIALLY.
REALLY ARE GROWING BUT ALSO
MAKING SURE THAT WE'RE REACHING
OUT TO FOLKS WHO TYPICALLY HAVE
NOT BEEN PART OF THIS TYPE OF
RESEARCH.
SO REALLY HAVE A BIG FOCUS ON
HBCUs AND HISPANIC
ORGANIZATIONS.
WE HAVE TRAINING TRAMMING TO HOW
TO CODE WITHIN OUR RESEARCHER
WORK AND USING A TRAIN THE
TRAINER MODEL AND TRAINING
PEOPLE AND HAVING THEM GO OUT
AND TRAIN PEOPLE AT THEIR
INSTITUTIONS INCLUDING STUDENTS
AND OTHERS THAT MIGHT REALLY
BENEFIT FROM ANALYSES WITHIN OUR
RESEARCHER WORK BENCH.
I MENTIONED THIS IS GROWING OVER
TIME.
WE'VE SEEN HIGH PROFILE PAPERS
FROM OUR DATA ALREADY.
I'LL GIVE YOU ACCESS TO ALL
THESE QR CODES TOWARD THE END SO
DON'T WORRY ABOUT CATCHING THEM
NOW.
I MENTIONED ALREADY WHAT
DIFFERENT SUPPORT WE HAVE.
THIS WILL COME BACK ON GETTING
ACCESS TO THE RESEARCHER WORK
BENCH.
THIS IS BOTTOM LINE HOW YOU GO
ABOUT DOING THAT.
SO I WANT TO SPEND TIME TALKING
ABOUT THE BENEFITS OF LEVERAGING
ALL OF US.
AND NOT JUST FOR THE DATA PART
THOUGH THE DATA PART IS AMAZING
AND I'LL GO THROUGH SOME
EXAMPLES OF THINGS DONE SO FAR.
BUT THE FACT WE HAVE RECONT
RECONTACTABLE BIO BANKS.
I'LL START START SAYING WE DID A
PROGRAM WHERE WE DID FUND THREE
FROM NIDCR.
WE AWARDED 25 SUPPLEMENTS AND
THEY HAD A SPACE TO TALK ABOUT
HERE'S WHAT WORKED FOR ME AND
THIS BILLING ISN'T WORKING FOR
ME AND PEOPLE RESPOND HERE'S HOW
I GOT OVER THAT.
IT'S A COMMUNITY OF HELPING EACH
OTHER BUT ALSO GIVING US FEED
BA
BACK -- FEEDBACK AND TRANSFORM
BEING DATA.
THINKING 7% TO 8% OF OUR
PARTICIPANTS HAVE ANY DENTAL
RECORDS.
HOW DO WE GO ABOUT CHANGING
THAT?
BRINGING PROBLEMS AND SHORTFALLS
OF OUR CURRENT PLATFORM TO US SO
WE CAN WORK ON ITERATING THAT
OVER TIME.
ONE OF THESE WILL BE PUBLISHING
SOON SO IT WILL BE OUT IN THE
RESEARCH FIELD.
HOPEFULLY THAT WILL CATALYZE
PEOPLE TO GET IN THERE AND START
USING THE RESEARCHER WORK AS
WELL.
PEOPLE CAN LOOK AT EPIGENETICS
AND FITBIT IS GOING WAY UP.
WE HAVE ALMOST 60,000
INDIVIDUALS WITH FITBIT DATA IN
OUR NEXT RELEASE AND IT'S THE
FIRST TIME WE'RE RELEASING DATA
FROM OUR SELF-IDENTIFIED ALASKAN
NATIVE, AMERICAN INDIAN
POPULATIONS.
AND USING ALL OF US RESEARCH
PROGRAM INFRASTRUCTURE AS A
WHOLE SO NOT JUST THE DATA BUT
THE INFRASTRUCTURE AS A WHOLE
CAN REDUCE TIME AND RESOURCES TO
LAUNCH STUDIES WITHOUT THE TONS
AND YEARS OF PLANNING AND COSTS
IT TAKES TO RECRUIT DIVERSE
INDIVIDUALS AND GET THIS GOING.
THIS IS A CONTINUALLY GROWING
RESEARCH RESOURCE.
SO AS I MENTIONED WE'RE
RELEASING DATA RATE AND
INCREASING THE DATA TYPES AND
THE AMOUNT OF DATA THAT IS GOING
INTO THIS.
WE'RE EXPANDING A
MULTIDIMENSIONAL DATA.
YOU CAN THINK ABOUT HOW WE CAN
MOVE BEYOND JUST THE ONE OR TWO
VARIABLES AT A TIME WE'RE
LOOKING AT AND START TO LOOK
MORE AT THE WHOLE PERSON.
WHAT ARE THEIR SOCIAL
DETERMINATES OF HEALTH LOOK
LIKE?
WHAT ARE THEIR ENVIRONMENTAL
EXPOSURES, WHAT DO THEIR
BIOLOGICS SAY AND HOW'S THIS FIT
TOGETHER TO TELL US WHAT'S GOING
ON WITH THE INDIVIDUAL ABOUT
THEIR ORAL AND DENTAL HEALTH?
AND FINALLY BEING ABLE TO ACCESS
NOVEL TOOLS AND DATA.
I MENTIONED THE SUPPLEMENT
PROGRAM.
WE ASKED INDIVIDUALS TO PUBLIC
THEIR WORK SPACES ONCE DONE AND
SHARE ANY TOOLS THEY CREATED OR
BROUGHT IN FROM OTHER PURPOSES
TO USE WITHIN THE DATA TO BE
LEVERAGED BY THE NEXT
INVESTIGATORS THAT COME AND ADD
TO IT AND THOSE WORK SPACES
CARRY OVER THROUGH OUR DIFFERENT
VERSIONS AND SO THEY CAN UPDATE
DATA AS THE VERSIONS CHANGE.
JUST A LITTLE BIT ABOUT THE
DATA.
WE HAVE FOUR PETABYTES DATA.
IT'S A BIG ENTERPRISE.
AND ACROSS INSTITUTIONS WOULD BE
BILLIONS BUT WE'RE ABLE TO DO IT
FOR 1.14.
THAT'S RESULTING IN A MAJOR
SAVING AND ALLOWING THE BROAD
ACCESS FOR MANY UNIVERSITIES AND
HOPEFULLY SOON CITIZEN
SCIENTISTS TO GET IN AND ASK THE
QUESTIONS THAT HADN'T BEEN ASKED
BEFORE BECAUSE THE SAME
INVESTIGATORS HAVE HAD ACCESS TO
THIS DATA FOR SO MANY YEARS
WE'LL START TO SEE INNOVATIVE
QUESTIONS BECAUSE THE PEOPLE
ASKING THE QUESTIONS HAVE A
DIFFERENT LIVED EXPERIENCE THAN
THOSE WHO ASKED THE QUESTIONS IN
THE PAST.
HERE'S JUST ONE QUICK EXAMPLE
ABOUT THE GENETIC BASES OF
HYPERTHYROIDISM.
NHGRI'S EMERGE PROGRAM SPENT
ALMOST THREE YEARS WITH A
RESOURCE INTENSIVE LOOKING FOR A
GWAS FOR HYPERTHYROIDISM AND AN
UNDERGRAD IN JOSH DENNY'S LAB
CAME IN OVER THE SUMMER IN 2023
AND REPLICATED THIS IN THE ALL
OF US PLATFORM.
HE WAS AN UNDERGRADUATE WHO
DIDN'T HAVE A TON OF KNOWLEDGE
IN CODING AND LEARNED IN WEEKS
AND THE CASES AND CONTROLS
BETWEEN THE TWO ARE FASTLY
HIGHER.
AND WE SAW MORE OF A SIGNAL.
IT'S A GOOD WAY TO THINK OF
WHAT WE'VE DONE IN THE PAST AND
BUILD UPON THAT BY BRINGING IN
THE DATA SET.
I ALSO WANT TO MENTION THAT WE
RECENTLY FUNDED A CENTER FOR
LINKAGE AND ACQUISITION OF DATA.
THIS IS GOING TO HELP US TO LINK
TO AVAILABLE DATA SOURCES
INCLUDING MORTALITY DATA AND
CLAIMS DATA AND GEOCODING DATA,
ENVIRONMENTAL DATA AND OTHER
SOURCES FOR ELECTRONIC HEALTH
RECORDS AND HAVE BEEN TALKING
WITH JENNIFER AND OTHER
LEADERSHIP HOW WE LINK TO DENTAL
RECORDS AND THERE ARE A LOT OF
COLLABORATORS WE SHOULD BE
TALKING TO ABOUT HOW DO WE GET
ADDITIONAL HEALTH INFORMATION
BEYOND WHAT OUR CURRENT THINKING
IS.
I'M EXCITED TO POTENTIALLY HAVE
THIS LINKAGE FOR DENTAL RECORDS
COMING SOON.
AND THIS MAY BE A SURPRISE TO
COLLEAGUES WE'RE DOING A
REASSESSMENT OF THE COHORT IN Q1
OF 2025 AND INCLUDING ORAL AND
DENTAL DATA IN THAT
QUESTIONNAIRE.
WE HAVE FOUR QUESTIONS IN NHANES
INCLUDING THE LAST VISIT TO A
DENTIST AND THE MAIN REASON AND
WERE YOU ABLE TO GET ACCESS TO
DENTAL CARE AND THE REASONS WHY
YOU COULD NOT GET DENTAL CARE.
THOSE ARE IN NHANES AND WE HAVE
A PERSONAL AND FAMILY HEALTH
HISTORY MODULE AND INCLUDED ORAL
AND DENTAL HEALTH CONDITIONS IN
THAT MODULE AS WELL AND
REASSESSMENT.
IT'S A SELECT ALL THAT APPLY AND
FOR THE FAMILY HEALTH HISTORY,
IF YOU SELECT ONE OF THESE THEN
YOU SORT OF SAY WHO IN YOUR
FAMILY HAS IT AND GO A LITTLE
BIT FURTHER INTO THAT.
I'M EXCITED ABOUT THE
PARTICIPANT PROVIDED INFORMATION
BEING THERE TOO NOT ONLY DO YOU
GET THE E.H.R. FROM THE DENTAL
RECORD AND ALSO GET THE
PARTICIPANT'S EXPERIENCE WITH
THEIR UNDERSTANDING WE HAVE FIVE
SITE ENROLLING 0 TO 4.
IT WOULD BE A GREAT PLACE TO
ALSO GET DENTAL RECORDS FOR.
AND DISPARITIES IN WHO IS ABLE
TO GET CARE AND WHO IS NOT ABLE
TO GET CARE.
AND ANCILLARY STUDIES WITHIN THE
ALL OF US RESEARCH STUDIES.
I'VE TALKED ABOUT THE DATA
THAT'S GOING TO BE AVAILABLE OR
THAT IS AVAILABLE AND WHAT'S
COMING BUT WE'RE ENGAGING WITH
OUR INSTITUTES AND CENTERS TO DO
BIO SPECIMEN USE USING SPECIMENS
SELECTED TO DO RECONTACT FOR
PARTICIPANTS TO DO SURVEYS OR
SEND OUT NEW WEARABLES AND ASK
THEM TO USE IT AND HAVE A STUDY
CALLED NUTRITION FOR PRECISION
HEALTH FEATURED ON GOOD MORNING
AMERICA MAY 3 AND THIS STORY ON
GOOD MORNING AMERICA RESULTED IN
OVER 4 40 NEW CONCEPT FOR ALL OF
US THROUGH A WEEKEND.
AND THESE ANCILLARY STUDIES
ALLOW US TO DIVE DEEP IN ON
SUBJECTS WE ONLY TOUCHED THE
SURFACE OF LIKE THE ORAL HEALTH
QUESTIONS YOU SAW.
WE'RE PARTNERING TO DO ANCILLARY
STUDIES WHILE REWE'RE LAYING THE
GROUND WORK.
WOE WANT TO OPEN UP ACCESS FOR
EXTRAMURAL OR NIH INTRAMURAL
INVESTIGATORS TO COME IN THE
PROGRAM BUT WANT TO MAKE SURE WE
HAVE POLICIES IN PLACE, A WAY TO
SUBMIT FORMS AND MODALITIES AND
WANT TO BE TRANSPARENT ABOUT OUR
REVIEW CRITERIA IN ACCEPTING
APPLICATIONS.
WHILE WORKING WITH CENTERS WE'RE
LAYING GROUND WORK AND MAKING
PROGRESS THERE TO OPEN UP IN
2026.
TO INTEGRATE ORAL AND GENERAL
HEALTH.
I MENTIONED ALL OF US
LONGITUDINAL HEALTH RECORDS DATA
AND GENOMICS HEALTH DATA AND ONE
WAY TO LOOK AT HEALTHY COHORTS
ACROSS DISEASE STATES, WE KNOW
IT'S LACKING IN ORAL HEALTH DATA
BUT I HOPE THAT GETTING SOME OF
THESE LINKAGES IN PLACE AND AS
WE START TO BRING IN SURVEY
QUESTIONS AND OTHER THINGS WE
CAN BEEF UP WHAT CAN BE DONE
THERE.
WE ALREADY HEARD ABOUT PRECISION
DENTAL MEDICINE.
HOW DO WE LOOK AT EARLY DISEASE
DETECTION, THINGS THAT CAN
CONTRIBUTE TO DISPARITIES AND
TREATMENT.
TRANSLATION AND IMPLEMENTATION.
CONNECTING THE DENTAL RECORDS
WITHIN OUR ECO SYSTEM I THINK IS
GOING TO BE KEY TO THAT AND
ACCELERATING DISCOVERY AND
VALIDATION OF RESEARCH FINDINGS
THAT HAVE ALREADY HAPPENED AND
THAT VALIDATION CAN SERVE TO
PUSH THINGS TO MORE CLINICAL
PRACTICE AND NOT HAVE TO BE
RESEARCH BASED.
MAKING SURE WE'RE SUPPORTING OUR
DIVERSE RESEARCH PIPELINE.
I MENTIONED OUR EFFORTS AROUND
HBCUs AND HISPANIC INSTITUTIONS
IS OF INTEREST TO NIDCR AND
FINALLY PART, THE AND
COLLABORATE BEING ACROSS NIDCR
AND WITH ALL OF THE GRANTEES AND
INVESTIGATORS CAN HELP ADVANCE
OUR UNDERSTANDING OF THE
POPULATION LEVEL.
SO WITH THAT, I WOULD LOVE TO
CLOSE AND TAKE QUESTIONS OR HAVE
DISCUSSION AROUND THIS.
THANK YOU.
>> THANK YOU VERY MUCH,
DR. SCHULLY.
THAT WAS TERRIFIC.
VERY COMPREHENSIVE.
I'D LIKE TO OPEN QUESTIONS IN
RESPONSE TO DR. WEBB-CYRIAQUE'S
PRESENTATION OR DR. SCHULLY'S.
>> I'M WONDERING IF YOU COULD
TALK ABOUT ANY STRATEGIES TO GO
AFTER THE VULNERABLE POPULATIONS
PARTICULARLY SINCE WE KNOW SO
MUCH ABOUT THE SOCIAL
DETERMINATES OF HEALTH HAVING
SUCH AN IMPACT ON ALL FACETS OF
HEALTH AND THE POPULATIONS ARE
NOTORIOUSLY DIFFICULT TO
FOLLOW-UP WITH AND DISAPPEAR AND
NOT COMPLIANT WITH THEIR
MEDICATIONS.
I KNOW YOU'RE NOT THERE YET BUT
WHAT KIND OF STRATEGIES I'M SURE
YOU THOUGHT ABOUT TO CAPTURE
THIS POPULATION THAT'S SO
IMPORTANT.
>> I WILL SAY WE HAVE
ORGANIZATIONS THAT HELP US
THROUGH THIS AND I DON'T KNOW
THESE POPULATIONS ARE
NECESSARILY HARD TO FIND.
I THINK THEY JUST HAVE OTHER
PRIORITIES.
ONE OF THE THINGS WE'VE BEEN
DOING IS REALLY TRYING TO MEET
THEM WHERE THEY ARE.
HOW DO WE PARTNER WITH THEIR
CHURCHES THEY'RE NORMALLY
ATTENDING.
THE PLACES THEY GIVE RESOURCES
AND THERE'S SOME EXAMPLES OF
THINGS WE'RE DOING IN THE SOUTH
WHERE WE ACTUALLY ARE COMMUNITY
PARTNERS ARE GOING TO PLACES
THAT ON THURSDAY NIGHTS THERE
ARE FOOD BANK AND ALSO THEIR
CHURCH AND WHERE THEY MEET AS A
COMMUNITY BECAUSE THERE'S A
LARGE SPANISH SPEAKING
POPULATION AND HOW DO WE
INTEGRATE TO WHERE WE ARE?
WHEN YOU HAVE A MILLION THINGS
GOING ON SOMETIMES THE RESEARCH
ISN'T YOUR PRIORITY OR GETTING
THE MEDICATION MAY BE DIFFICULT
BECAUSE YOU LOST INSURANCE OR
CAN'T GET TO THE DOCTOR.
MEETING PEOPLE WHERE THEY ARE
AND AOUR COMMUNITY PARTNERS HAVE
HELPED US THROUGH THE CHANGE.
IT'S NOT THE POPULATIONS ARE
HARD TO REACH YOU JUST HAVE TO
THINK OF A DIFFERENT WAY TO
REACH THEM.
>> THANK YOU FOR SHARING YOUR
SLIDES TOO TO DIGEST THE
MATERIAL AND LOOK IT UP.
THANK YOU.
>> I JUST HAVE A QUESTION AND
COMMENT AND RELATED TO A QUERY.
FIRST, SINCE ORAL HEALTH IS
CENTRAL TO OVER ALL HEALTH IT'S
SO IMPORTANT ORAL HEALTH
QUESTIONS WILL BE A PART OF THE
CORE ALL OF US SURVEY.
WE APPLAUD YOU ON THAT.
IT'S SO CRITICAL.
GOOD NEWS, DR. WEINTRAUB SHARED
WITH US HER PUBLICATION WAS
ACCEPTED FOR LOOKING AT ALL OF
US DATA, DENTAL DATA FOR OLDER
ADULTS.
EXCELLENT NEWS THERE AND I THINK
THERE'S OPPORTUNITIES FOR MORE
COLLABORATION AS WE LOOK AT THE
ADAPT PROGRAM THAT I MENTIONED
EARLIER ON AND THAT INITIATIVE
IS FOCUSES ON COMMUNITY-BASED
PARTICIPATORY RESEARCH AND DATA
TOWARDS DIMINISHING ORAL HEALTH
DISPARITIES.
I THINK BEING CREATIVE ACROSS
HOW WE ENGAGE THE COMMUNITY AND
LEVERAGING THE DATA RESOURCES
MAY HELP US GET TO WHAT YOUR
SAYING, PAUL, TO WHAT YOU'RE
ASKING.
>> FROM AN NIH STANDPOINT IT MAY
BE TOO MANY PLACE TRYING TO
REACH OUT TO THE SAME PEOPLE.
HOW DO WE COME TOGETHER TO NOT
FATIGUE PEOPLE IN BEING ASKED TO
JOIN A STUDY.
THERE'S EFFORTS WE CAN DO TO
COORDINATE THAT INTERNALLY AS
WELL.
>> WE WOULD LOVE TO HAVE MORE
ENGAGEMENT FROM COMMUNITY
LEADERS ESPECIALLY IN PLACES
WHERE WE DON'T HAVE A LOT OF
RESEARCH HAPPENING.
OUR DIRECTOR OF ENGAGEMENT,
DR. CARRINE WATSON IS AMAZING
AND OUR GURU IN THIS.
I WOULD BE HAPPY TO FACILITATE A
CONVERSATION AROUND HOW MORE
COMMUNITY LEADERS CAN GET
INVOLVED IN ALL OF US AS WE
ARE -- THAT'S HOW WE ARE
REACHING THESE POPULATIONS THAT
HAVE HISTORICALLY NOT BEEN PART
OF RESEARCH TO DATE.
GREAT.
ARE THERE QUESTIONS?
>> YES, I'M SORRY, I COULDN'T
FIND THE AUDIO BUTTON.
I'M A PARTICIPANT IN ALL OF US.
I LOOK FORWARD TO SEEING
INFORMATION FROM Y'ALL.
I CAN'T REMEMBER WHEN I FIRST
START
STARTED FILLING OUT THE FORMS
WERE THERE INFORMING TO
UNDERSTAND TRAUMA INFORMED CARE?
FOR EXAMPLE, ADVERSE CHILDHOOD
EXPERIENCES?
>> WE HAVE BASIC QUESTIONS ON
OUR MENTAL HEALTH AND WELL BEING
SURVEY.
MANY SURVEYS ARE HIGH LEVEL
BECAUSE WE'RE SO DISEASE
AGNOSTIC.
IT WILL TAKE AN ANCILLARY STUDY
TO GET A DETAILED SURVEY ON WHAT
THAT LOOKS LIKE FOR AN
INDIVIDUAL AND THERE'S QUESTIONS
ON THE SOCIAL DETERMINATES OF
HEALTH SURVEY THAT MAY GET TO
THAT.
I WOULD SAY IT'S HIGH LEVEL
RIGHT NOW THOUGH.
>> THANK YOU.
>> MAKE -- BLAKE WARNER HAS A
QUESTION.
>> THIS IS DOWN THE ROAD I WOULD
GUESS BUT ARE THERE PLANS TO
PULL OTHER HUMAN DATA SETS FROM
TCGA OR GEOOR DB GAP THAT MAY
LINK TO THE "ALL OF US" DATA
SETS OR AT LEAST GIVE SOME
ACQUISITION THAT A MATCHED
SAMPLE -- AND I WOULD FORESEE
THAT LIKE MAYBE THE FURTHEST
ALONG MIGHT BE LIKE ANSWER DATA
SEQUENCING DATA OF TUMORS, SO
YOU COULD REALLY DO THIS BROAD
TRANSCRIPTIONAL ANALYSIS OR
PROTEOMIC ANALYSES.
IT'S ALREADY PUBLICALLY
AVAILABLE BUT OVERLAY IT WITH
GENOME.
>> TWO THINGS TO THAT POINT.
WE'RE WORKING ON WAYS FOR PEOPLE
TO BRING DATA TO ALL OF US IN
THEIR OWN WORK SPACES SO THEY
CAN DO ANALYSES SIDE BY SIDE.
THAT'S A LITTLE CLUNKY BUT WHAT
WE'RE IMPROVING TO MAKE SURE WE
CAN DO THAT.
AND CERTAINLY THINKING ABOUT HOW
DO WE KNOW NOT ONLY WHO IS IN
THE DATA SETS AND IN ALL OF US
BUT IN THE LARGE COHORT STUDIES
NIH IS FUNDING ACROSS THE BOARD
THAT MAY HAVE MUCH DEEPER
PHENOTYPING INFORMATION WE DON'T
HAVE ACCESS TO YET SO WE CAN
BRING THOSE THINGS TOGETHER.
THESE ARE THINGS WE HAVE PLANS
FOR AND CONCEPTS FOR BUT ARE NOT
CURRENTLY IN PLACE.
I WILL ALSO SAY WE ARE ALSO
DOING PILOTS AND MULTIOPICS AND
PILOTS IN RNA SEQ AND ADDITIONAL
LONG READS COMING WE'LL HAVE
DATA FROM EXPOSOMICS AN
ANCILLARY STUDY THAT JUST
LAUNCHED AND WE'RE GOING TO
START TO HAVE INDIVIDUALS THAT
HAVE ALL THE DIFFERENT DATA TYPE
BECAUSE WE'RE USING THE SAMPLE
TO GET A DEEP DATA SET ON THE
INDIVIDUALS.
I'LL SAY THE DATA SET IS
ENRICHED FOR DIVERSITY.
AND THERE'S TECHNOLOGIES COMING
OUT.
I LIKE THE IDEA OF WORKING WITH
AMP AND OTHER GROUP.
I PUT MY E-MAIL IN THE CHAT SO
IF ANYONE HAS IDEAS AND WANTS TO
BRAIN STORM AND TALK THROUGH
THEM, I CAN DO IT OR POINT YOU
IN THE RIGHT DIRECTION OF WHO
THE RIGHT PERSON TO TALK SO IS.
-- TALK TO IS.
>> WONDERFUL.
>> WITH THANKS SO MUCH AND
PLEASE DO REACH OUT TO ALL OF US
COLLEAGUES BECAUSE I THINK
THERE'S WONDERFUL OPPORTUNITIES
FOR ORAL HEALTH THAT WILL ONLY
GROW AS WE TAKE ADDITIONAL MERGE
AND DATA SETS WITH ORAL HEALTH
AND GREAT OPPORTUNITIES FOR OUR
WORKFORCE.
CRITICAL TO OUR FIELD IS
INTEGRATE BEING RESEARCH TO
CLINIC.
-- INTEGRATING RESEARCH TO
CLINIC.
HAVING THE WORKFORCE CAPACITY TO
DO THAT THROUGH THE TRAINING OF
CLINICIAN SCIENTISTS IS PIVOTAL.
AND WE MENTIONED THE COUNCIL FOR
DATA EARLIER AND TODAY WE'LL
HEAR FROM THE COUNCIL WORKING
GROUP ON CLINICIAN SCIENTIST
TRAINING AND DISCUSS
RECOMMENDATIONS WITH A FOCUS ON
THE EXECUTIVE SUMMARY OF THE
FINDINGS OF THE COMMITTEE THAT
WAS LED BY DR. GRAZE.
DR. GRAVES.
>> THANK YOU.
CAN YOU HEAR ME?
>> YES.
>> OKAY.
I'M GOING TO SHARE MY SCREEN.
THE CHARGE WAS TO BUILD A
DIVERSE WORKFORCE.
THE COMMITTEE WORKED ALMOST TWO
YEARS AND WORKED DILIGENTLY ON
THIS.
ALL MEMBERS WORKED HARD TO
PRODUCE THIS REPORT.
THE WORKFORCE RECOGNIZED THERE'S
LITTLE INFORMATION TO ASSESS THE
WORKFORCE AND TO ADDRESS THE
LIMITATION AN RFI WAS DEVELOPED
AND LEARNING SESSIONS HELD.
THE WORKING GROUP RECOGNIZED THE
IMPORTANCE OF DEI BUT FELT IT
WAS A COMPLEX ISSUE AND REQUIRED
A SEPARATE ANALYSIS.
THE CHALLENGES WERE BROUGHT
FORTH THROUGH THE RFI SUBMITTED
THROUGH SEVERAL LEARNING
SESSIONS THEY ARE INCLUDE THE
FACT THAT RELATIVELY LITTLES IS
KNOWN ABOUT FACTORS THAT PROMOTE
RECRUITMENT OF TRAINING AND
FACTORS THAT DETERMINE THE
LONG-TERM SUCCESSION OF TRAINING
IN CAREER DEVELOPMENT PROGRAMS.
AND DENTAL SCHOOLS LACK THE
STRUCTURE TO SUPPORT MANY
FULL-TIME RESEARCH PHYSICIANS
AND PROTECTIVE RESEARCH TIME TO
SIGNIFICANTLY CONTRIBUTE TO
RESEARCH ACTIVITIES.
ANOTHER KEY FINDING WAS THAT
THERE'S INADEQUATE MENTORING
DURING TRANSITION TO
INDEPENDENCE.
K AWARDS THAT HAVE INSUFFICIENT
RESEARCH FUNDS AND A GENERAL
INSUFFICIENT AWARENESS OF ALL
THE OPPORTUNITIES THAT NIDCR S
FOR TRAINING AND RECOMMENDATIONS
WERE DEVELOPED WITH THE
FOLLOWING GOALS IN MIND.
TO ENHANCE THE SUCCESS OF
TRAINEES AND EARLY STAGE
INVESTIGAT
INVESTIGATORS AND ENHANCE
TRAINING AND PROMOTE GREATER
OPPORTUNITIES IN RESEARCH AND
INCREASE OUTREACH MAKE DOC
RESEARCH TRAINING MORE APPEALING
AND REDUCE FINANCIAL
LIMITATIONS.
WITH THESE CHALLENGES IN MIND
THE FOLLOWING RECOMMENDATIONS
WERE MADE.
THEY WERE DEVELOPED AROUND FOUR
DIFFERENT APPROACHES.
ONE INCLUDED DEVELOPMENT OF AN
OFFICE TO FOSTER COLLABORATION.
SEVERAL ORGANIZATIONS EXPRESSED
AN INTEREST IN PART, THE WITH
NIDCR BUT INDICATE A LIMITING
FACTOR IN DEVELOPING
PARTNERSHIPS IS THE LACK OF A
CONTACT PERSON.
TO ADDRESS THIS ONE
RECOMMENDATION IS A CONTACT
PERSON TO FACILITATE ENGAGEMENT
IN PROFESSIONALS AND ORAL HEALTH
INDUSTRY AND PERTAINS TO THE
PRESENTATION GIVEN BEFORE ME IN
WHICH GREATER ENGAGEMENT WAS AN
ISSUE THE GROUP FACED.
TO PROMOTE PARTNERSHIPS TO
ENHANCE MENTORSHIP WITH AN
EMPHASIS ON CLINICIAN SCIENTIST
AND EARLY STAGE INVESTIGATORS IT
COULD HELP INCREASE NETWORK
OPPORTUNITIES FOR TRAINEES AND
DSI AND FACILITATE INTERACTIONS
BETWEEN LEADERS OF ORGANIZATIONS
TO ENHANCE PROGRAM DEVELOPMENT.
AND LEAD IN INNOVATIVE PROGRAMS
THAT PROVIDE RESEARCH AND
CLINICAL TEACHING AND PROMOTE
RESEARCH IN NIDCR OPPORTUNITIES
AND COULD ENHANCE OUTREACH.
AND ANOTHER RECOMMENDATION IS TO
ESTABLISH A CENTER TO ASSESS
TRAINING PROGRAMS AND CAREER
DEVELOPMENT OUTCOMES.
THIS COULD BE ACCOMPLISHED BY
DEVELOPING AN RFA OR CENTER THAT
DEVELOPS TRAINING GOALS, METRICS
AND ANALYZES OUTCOMES.
AND DEVELOP AND MONITOR OUTCOME
METRICS, COORDINATE EVALUATION
AND TRACK TRAINEES AND SERVE AS
A CENTRAL DATA REPOSITORY.
THE CENTER WOULD ALSO ANALYZE
DATA, INSIGHT AS TO PROGRAM
FACTORS AND TRAINEE FACTORS THAT
LEAD TO SUCCESS.
THE CENTER COULD ALSO CONSULT
WITH TRAINING PROGRAMS AND GUIDE
SELF-ASSESSMENT AND EVALUATION
AND PROVIDE DATA ANALYSIS TO
NIDCR TO ASSESS THE TYPES AND
LEVEL OF SUPPORT FOR TRAINING
AND CAREER DEVELOPMENT PROGRAMS.
THERE'S THE CREATION OF A
FUNDING OPPORTUNITIES THAT PAIR
AN EARLY STAGE INVESTIGATOR WITH
AN ESTABLISHED INVESTIGATOR AS
MPI OR CO-INVESTIGATOR,
EXPANSION OF PROGRAMS AND
PROVIDE INCENTIVES FOR EARLY
STAGE INVESTIGATOR CLINICIAN
SCIENTISTS.
AND THE SUPPORT OF LOCAL,
REGIONAL AND VIRTUAL RESEARCH
CONFERENCES THAT ARE TAILORED
FOR TRAINEES AND PSIs.
ESTABLISH RESEARCH TRAINING
PROGRAMS FOR CLINICIANS AT ALL
STAGES OF TRAINING OR CAREER
DEVELOPMENT AND TO DEVELOP
INITIATIVES TO FOSTER INNOVATIVE
TRAINING PROGRAMS THAT INCLUDE
PROHIBIT DEVELOPMENT.
AND ULTIMATELY ENHANCE CAREER
OPPORTUNITIES.
THESE INCLUDE INCORPORATION OF
INTERNSHIP TO INDUSTRY AND
ENCOURAGE ENTREPRENEURSHIP AND
SKILL ACQUISITION AS PART OF
TRAINING FOR CAREER DEVELOPMENT
PROGRAMS AND OPTIONS FOR GRANT
OR SUPPLEMENTAL AWARDS, TO WORK
WITH DENTAL SCHOOLS TO INCREASE
THE NUMBER OF FACULTY POSITIONS
THAT INCORPORATE CLINICAL
TEACHING WITH PROTECTIVE
RESEARCH TIME AND THE
DEVELOPMENT OF INTERDISCIPLINARY
OPPORTUNITIES FOR CLINICIAN
SCIENTIST COMBINE ORAL HEALTH
WITH OTHER FIELDS SUCH AS
COMPUTATIONAL SCIENCES.
RECOMMENDATIONS INCLUDE NUMBER
ONE ESTABLISHMENT OF AN OFFICE
THAT PROMOTES PARTNERSHIPS TO
IMPROVE OUTREACH, RESEARCH
OPPORTUNITIES AND PROGRAMS THAT
WOULD ENHANCE CLINICIAN
SCIENTIST CAREER DEVELOPMENT AND
TRAINING.
DEVELOPMENT OF GRANT PROGRAMS
THAT PROMOTE MENTORSHIP AT
MULTIPLE STAGES OF TRAINING AND
CAREER DEVELOPMENT AND PROGRAMS
THAT REDUCE FINANCIAL OPTICALS.
AND THE THIRD -- OBSTACLES.
THE THIRD IS TO FUND A CENTER TO
ASSESS TRAINING PROGRAMS,
TRAINEES AND CAREER OUTCOMES TO
ESTABLISH METRICS, COLLECT DATA
AND PROVIDE DATA ANALYSIS
REGARDING SPECIFIC ASPECTS OF
TRAINEES AND CAREER DEVELOPMENT
PROGRAMS THAT ARE SUCCESSFUL.
AND LOOK AT PROGRAMS THAT
PROVIDE INCENTIVES FOR EARLY
STAGE INVESTIGATORS CLINICIAN
SCIENTISTS AND CLINICAL TEACHING
AND PROTECTIVE RESEARCH TIME.
THAT'S A VERY BRIEF SUMMARY OF
THE RECOMMENDATIONS THAT WERE
DEVELOPED BY THE COMMITTEE AND A
FULL REPORT WILL BE RELEASED IN
THE NEAR FUTURE.
SO THANK YOU VERY MUCH.
>> THANK YOU, DR. GRAVES.
ONE QUICK COMMENT REGARDING
WORKING GROUPS OF COUNCIL,
WORKING GROUPS ARE ESTABLISHED
TO PROVIDE RECOMMENDATIONS TO
COUNCIL MEMBERS THEMSELVES AND
COUNCIL MEMBERS HAVE THE
RESPONSE TO ADVISE THE DIRECTOR.
AND THE COUNCIL MEMBERS ADVISE
THE DIRECTOR ON NEXT STEPS.
SO WHAT WE'RE LOOKING FOR IS
COUNCIL'S DISCUSSION OF THE
CONCEPT AND THIS WORKING GROUP
RECOMMENDATIONS AND IF THERE'S
ADDITIONAL CONSIDERATIONS.
>> THANK YOU, DANA AND THE TEAM
FOR THIS SPRE IMPORTANT WORK.
COULD YOU EXPAND ON HOW THE
NIDCR COULD INTERACT WITH DENTAL
SCHOOLS TO HELP SUPPORT THE
FACULTY LINES THAT INCLUDE TIME
PROTECTED FOR RESEARCH.
>> THAT'S A KEY POINT.
I'LL GIVE YOU ONE EXAMPLE.
THE K AWARDS LIMIT CLINICAL
TEACHING.
A RESEARCH SCIENTIST CAN SPEND
70% OF THE TIME CONSTITUTED NOW
AND THAT LEADS AND LEAVES 20%
CHANCE TO PRACTICE AND THEN
THERE'S NO TIME FOR CLINICAL
TEACHING.
THIS IS A PROBLEM FOR DENTAL
SCHOOLS ONE SOLUTION IS TO
REDUCE THE RESEARCH COMMITMENT
TO 40%.
IF IT WAS 40% IT COULD BE 20%
CLINICAL PRACTICE AND 20-40,
20-40 AND ONE WAY TO EXPAND THE
ABILITY OF CLINICIAN SCIENTIST
TO PARTICIPATE IN CLINICAL
RESEARCH OR EVEN BASIC RESEARCH.
CLINICAL PRACTICE AS WELL AS
CLINICAL TEACHING.
I THINK THIS TYPE OF APPROACH
KEEPING CLINICIAN SCIENTISTS IN
MIND THAT'S SOMETHING THAT COULD
BE CONSIDERED.
>> THANK YOU FOR THIS REPORT.
AND PULL ON THE COMMENT I WORK
IN A CLINICAL DEPARTMENT AT WASH
U AND ONE OF THE MAIN PROBLEMS
WE HAVE IN PHYSICIAN SCIENTISTS
IS IT HAS TO PAY.
I WONDER IF AND STILL GETTING
THE CLINICIAN SALARY AND BRING
IN REVENUE TO THE DEPARTMENT.
SO AND HOW WILL IT BE ABLE TO
SUPPORT?
AND PHYSICIAN SCIENTISTS TO
SPEND TIME AND SOMETIMES IT'S A
PROBLEM FOR THE DEPARTMENT AND
THIS APPLIES TO OTHER
DEPARTMENTS IT'S A BIG PROBLEM
TO RETAIN CLINICIANS TO STAY IN
ACADEMIA AND SOMETIMES GO BACK
TO THE WHAT I MENTIONED AND WHAT
WE COULD PROVIDE TOGETHER WITH
NIH.
>> YEAH, SO WITH MORE DENTAL
SCHOOLS AND FEWER FACULTY YOU
HAVE MORE COMPETITION FOR
FACULTY WHICH RAISES SALARY.
YOU HAVE MULTIPLE FACTORS THAT
ARE REALLY MAKING IT DIFFICULT
FOR DENTAL SCHOOLS TO HIRE
CLINICAL FACULTY TO DO RESEARCH.
I THINK THAT IS A MAJOR ISSUE.
ONE POTENTIAL AVENUE IS TO
DEVELOP A PROGRAM WHERE YOUR
RESEARCH COMPONENT WAS FUNDED BY
NIDCR AND FACULTY COMPONENT
RELATED TO TEACHING WAS FUNDED
BY A PROFESSIONAL SOCIETY.
SO THIS WOULD NOT VIOLATE
PRINCIPLES BUT THERE'S A VERY
MAJOR CONCERN FROM THE
PROFESSIONAL SOCIETIES THEY
CANNOT RETAIN CLINICIAN
SCIENTISTS TO TEACH.
THEY'RE VERY INTERESTED IN THIS
TYPE OF PROGRAM.
THERE ARE PROGRAMS WITH ASB AND
R THAT COMBINE FOUNDATION
SUPPORT COUPLED WITH NIH
SUPPORT.
YOU COULD IMAGINE AND THEY MAY
BE INTERESTED IN HAVING A K
AWARD THAT FUNDED 40% OF THE
RESEARCH ACTIVITY OR ANOTHER NR
AWARD.
AND THEY ARE TOOK THOSE
CANDIDATES AND FUNDED A SALARY
COMPONENT THAT WOULD HELP THE
DENTAL SCHOOLS ADDRESS THAT
ISSUE.
THIS COULD BE USED AS PART OF
RETENTION.
AN ACADEMIC ENVIRONMENT IS
SPECIAL AND THERE'S A
WILLINGNESS ON FACULTY IF
THEY'RE PURSUING SOMETHING
THEY'RE INTERESTED IN THEY'LL
STAY IN ACADEMIC AND AN ISSUE
BROUGHT UP BY TRAINEES AND
FORMER TRAINEES IS WHEN THEY
LOOK FOR POSITIONS, THEY'RE 80%
CLINICAL TEACHING AND 20%
PRACTICE.
THEY WERE TRAINED TO DO
RESEARCH.
IF THE RESEARCH OPPORTUNITY WAS
GIVEN TO THEM THEY MAY STAY.
IT MAY BE AN IMPORTANT PART OF
RETENTION.
GIVE THEM CONTINUED RESEARCH
EXPOSURE.
AND I THINK DENTAL SCHOOLS HAVE
A PROBLEM AND PROFESSIONAL
SOCIETIES HAVE A COMMON PROBLEM
AND CAN WORK TOGETHER TO HELP
ADDRESS IT IN A WAY I JUST
MENTIONED.
>> STEPHANIE.
>> WONDERING IF THE WORKING
GROUP HAD RECOMMENDATIONS BUT
THE DEPARTMENTS OF BIO MEDICAL
INFORMATICS THE PLAIN TRAINING
GROUND FOR INFORMATICIANS RARELY
INCLUDE INFORMATIC COMPONENTS.
>> IN THAT RECORD THERE WERE
SEVERAL RECOMMENDATIONS AND
ADDITIONAL TRAINING
OPPORTUNITIES FOR CLINICIANS.
AND YOU COULD THANK OF LIKE A
MINI K AWARD INSTEAD OF FIVE
YEARS AND MAYBE ONE YEAR WHERE A
CLINICIAN SCIENTIST COULD SPEND
A YEAR BEING IMMERSED IN A
MASTER'S PROGRAM IN BIO
INFORMATICS OR ARTIFICIAL
INTELLIGENCE.
YOU COULD EXPAND THE TYPES OF
TRAINING PROGRAMS THAT EXIST IS
ONE AVENUE TO ADDRESS THAT.
THE PROFESSIONAL SOCIETIES FELT
STRONGLY LET'S SAY
POST-RESIDENCY PROGRAM THAT WAS
FUNDED BY NIDCR WOULD BE QUITE
POPULAR.
SO THIS HAPPENS IN A LOT OF
SURGICAL SPECIALTIES WHERE
THERE'S A RESEARCH COMPONENT
THAT CAN BE USED POST RESIDENCY
THAT'S A GAP BETWEEN RESIDENCY
AND DEVELOP MENTORING AND
RELATIONSHIPS AND FIELDS LIKE
ARTIFICIAL INTELLIGENCE THERE'S
A TREMENDOUS INTEREST IN THAT.
AND MEDICAL SCHOOLS UP
PARTICULAR AND SCHOOLS OF ARTS
AND SCIENCES AND ENGINEERING
HAVE ADVANCED PROGRAMS THAT
CLINICIAN SCIENTISTS AND
DENTISTRY COULD BECOME A PART OF
AND IT'S A MATTER OF EXPANDING
THE OPPORTUNITIES.
THIS IS AN AREA WHERE
PROFESSIONALS SAID THEY'D LIKE
TO PARTNER WITH NIDCR IN
PRESENTING THE OPPORTUNITIES TO
CLINICIAN SCIENTISTS.
>> WAS THERE A DISCUSSION AROUND
COVERING PATIENTS THAT ARE
RESEARCH RELATED TO ENSURE AND
GETTING WHAT THEY KNEAD TO BE
SUCCESSFUL -- NEED TO BE
SUCCESSFUL BUT EVEN THAT TIME IN
THE CLINIC THERE'S THE
OPPORTUNITY TO SEE PATIENTS THAT
MOVE THE RESEARCH FORWARD AND
WANTED TO MAKE A COMMENT THE
FOUNDATION FOR NIH IS AN OFFICE
THAT DOES EXIST TO HELP BROKER
RELATIONSHIPS WITH INDUSTRY AND
WITH PROFESSIONAL SOCIETIES TO
ENSURE THERE'S NO CONFLICT OF
INTEREST.
AND THESE SOCIETIES AND FNIH
THERE'S A MECHANISM THAT
CURRENTLY EXISTS TO ENSURE THE
RELATIONSHIPS CAN OCCUR.
THE POINT BROUGHT UP FREQUENTLY
IS LET'S TAKE THE LAST EXAMPLE.
AND WANT TO DEVELOP A PROGRAM
WITH NIDCR, WHO DO THEY CONTACT?
I THINK AND THERE'S FRUSTRATION
INSOFAR AS THE PROFESSIONAL
AGENCIES KNOW THEY CAN'T DO IT
ALONE AND NEED NIDCR TO WORK
WITH THEM.
THERE'S THE ISSUE OF HOW DO YOU
PROVIDE OPPORTUNITIES FOR
CLINICIAN SCIENTISTS.
AND ONE WAY TO RETAIN AND
INTEREST THE CLINICIAN SCIENTIST
IS TO GIVE THEM A RESEARCH
OPPORTUNITY.
THEY DON'T KNOW THE NEXT STEP
AND ASKED ME TO TO DO THAT.
I'M NOT IN THAT POSITION.
AND YOU MENTIONED THAT OFFICE
BUT I WOULD NOT KNOW HOW TO
GUIDE SOMEBODY IF THE NEXT STEP
TO THAT OFFICE.
SO I THINK THAT'S WHY WE THOUGHT
THIS COULD BE A FULL-TIME JOB.
I KNOW THERE'S SOME RESTRICTIONS
ABOUT HAVING THE OFFICE WITHIN
NIDCR BUT HAVING AT LEAST A
PERSON WITH NIDCR WITH A CONTACT
WITH DIFFERENT PROGRAM OFFICERS
FACILITATE THESE INTERACTIONS IS
A CRITICAL STEP.
>> AND WE LOOK FORWARD TO THOSE
TYPES OF CLAN COLLABORATIONS
AND MOVING THAT FORWARD.
>> THANK YOU DANA AND YOUR XT
FOR THE THOUGHTFUL AND KRAEPTIVE
WORK.
I'M WONDERING ABOUT THE
FINANCIAL IMPACT.
IT MAY HAVE BEEN OUTSIDE OF YOUR
SCOPE AND THERE WOULD BE
STAFFING AND TRAVEL AND MAYBE
MORE THAN ONE PERSON.
WONDERING IF THAT CAME UP IN
YOUR DELIBERATIONS IN.
YOUR COMMITTEE.
>> I'M GLAD YOU MENTIONED THAT.
WE HAD AS ONE OF OUR GUIDING
UNDERLYING FACTORS THE CONCEPT
YOU CAN'T SIMPLY THROW MONEY AT
THE ISSUE.
THERE'S A COST AND NO FREE
LUNCH.
THERE'S MONEY SPENT ON RESEARCH
TRAINING AND THE IDEA OF
DEVELOPING A CENTER TO ANALYZE
THAT.
THE QUESTION IS THE MONEY WE
SPENT EFFICIENT AND EFFECTIVE.
IF THERE'S A GRANULAR ASSESSMENT
OF WHAT FACTORS LEAD TO SUCCESS
AND WHAT TYPES OF PROGRAMS LEAD
TO SUCCESS MAYBE IMPLEMENT A
GREATER VARIETY OF PROGRAMS THE
MONEY COULD BE USED MORE
EFFECTIVELY AND EFFICIENTLY.
I'M NOT SAYING IT CAN'T BE.
MAYBE THE WAY THINGS ARE NOW ARE
OPTIMAL.
I THINK HAVING A K AWARD WITH
40% PROTECTED RESEARCH TIME
WOULD REMOVE AN OBSTACLE TO
HIRING CLINICIAN SCIENTIST.
THIS IS MY PERSONAL VIEW POINT
NOT A COMMITTEE RECOMMENDATION.
DON'T GET MAD AT THE COMMITTEE
WORKING GROUP IF YOU DON'T LIKE
THAT.
>> ASKING ABOUT COST
EFFECTIVENESS OF COURSE WE DON'T
REALLY KNOW.
I THINK THOUGH IN THE
DISCUSSIONS WE HAD WITH LEADERS
OF SOCIETY AND THERE WAS SO MUCH
POSITIVITY TO THEM CONTRIBUTING
TO THESE TYPES OF EFFORTS.
IT WAS OVERWHELMING.
I THINK THERE'S A LOT TO BE
GAINED.
IT REMAINS TO BE SEEN BUT I
THINK THERE'S A LOT TO BE GAINED
IN TERMS OF RESOURCES AND
SUPPORTING CLINICIAN SCIENTISTS.
>> MICHELLE.
>> THANK YOU FOR PUTTING THIS
TOGETHER AND THE PRESSING NEED
FOR FUTURE GENERATIONS.
A QUESTION I HAVE TWO QUESTIONS.
GOING BACK TO WHAT WAS MENTIONED
EARLIER, I STILL DON'T THINK WE
HAVE A SOLUTION.
THEY ARE CARRY AN ENORMOUS
AMOUNT OF DEBT AND THE STIPEND
IS NOT COMPETITIVE.
ARE YOU PROPOSING NIDCR MAYBE
NEED TO INCREASE THE STIPEND
THAT WILL BE SUPPORTED OR MAKING
SURE THEY REMAIN COMPETITIVE IN
TERMS OF THEIR STIPEND?
WE'RE RUNNING INTO PROGRAMS WE
OFTEN HEAR -- WE SAID WE'LL DO
RESEARCH BUT AT THE END OF THE
DAY I'M RAISING A FAMILY.
A STIPEND BECOMES AN ISSUE.
I'M NOT SURE WHAT IS A PROPOSAL
AND A TWO-WAY PROCESS AND COMING
FROM INDUSTRY OR INSTITUTION
RECRUITING.
THAT'S ONE QUESTION FOR THE
COMMITTEE.
>> IN TERMS OF THE STIPEND,
THAT'S NOT THE FEEDBACK WE
GENERALLY GOT FROM THE TRAINEES.
WHAT WE GOT FROM THE TRAINEES IS
THAT THEY DON'T HAVE ENOUGH
AVAILABLE POSITIONS TO GO INTO
AND HAVE A RESEARCH COMPONENT.
SO IT WAS MORE THE STRUCTURE
DURING THIS TRANSITION.
THE COMMITTEE FOCUSSED MORE ON
L
LOAN REPAYMENT PROGRAMS AND
ESTABLISH FACULTY POSITIONS THAT
ALLOW MORE RESEARCH OPPORTUNITY.
WE DID NOT GET A LOT OF FEEDBACK
OF THE STIPENDS PER SE WERE TOO
LOW.
>> MAYBE WE SHOULD CLARIFY IN
TALKING ABOUT THE STIPENDS FOR
TRAINEES AT THE PREDOC OR
POSTDOC LEVEL.
>> THANK YOU, THAT'S A GOOD
POINT.
MENTIONED MORE AFTER THE
TRAINING PROGRAM.
THEY'RE NOW GOING TO FACULTY
POSITION.
>> SO EVEN A BIGGER ISSUE THAN
SALARY WAS THE LOAN
INDEBTEDNESS.
THE LOAN REPAYMENT PROGRAMS WE
THOUGHT PLAY BE A MORE COST
EFFECTIVE WAY OF APPROACHING
THIS.
THE WORKING GROUP MEMBERS WANTED
TO TIE THE LOAN REPAYMENT
PROGRAM TO YEARS IN ACADEMICS.
SO THERE WAS SOME CONCERN THAT
IF THE LOAN REPAYMENT SAY IT WAS
SUBSTANTIAL IN TWO YEARS ON YEAR
THREE THEY'LL LEAVE ACADEMICS
BECAUSE THE INCENTIVE IS GONE.
THERE WAS SOME THOUGHT OF HOW DO
YOU TIE IT TO A REAL COMMITMENT
TO ACADEMICS AND SOMETHING NIDCR
WOULD HAVE TO SORT OUT.
I WOULD SAY THE SALARIES ARE AN
ISSUE THAT WAS TIED TO THE LOAN
INDEBTEDNESS.
THE PROFESSIONAL SOCIETIES
INDICATED A WILLINGNESS FOR
SALARY SUPPORT IF COMBINING
PROGRAMS AND SOMETHING I
PERSONALLY WOULD BE SOMETHING
WORTH CONSIDERING IS TO DO A
40-20-40 TYPE OF SPLIT WHERE
NIDCR MIGHT FUND PART OF THE
RESEARCH COMPONENT PROFESSIONAL
SOCIETIES WOULD FUND A CLINICIAN
WHO DOES RESEARCH BUT FUND PART
OF THE TEACHING COMPONENT.
YOU CAN HAVE CLINICIAN
EDUCATORS.
I THINK RETHINKING SOME OF THE
PROGRAMS DEVELOPING PARTNERSHIPS
AND CREATIVE LOAN REPAYMENT
PROGRAM CAN GO A LONG WAY
TOWARDS INCREASING THE NUMBER OF
POSITIONS THAT ARE AVAILABLE FOR
CLINICIAN SCIENTISTS.
ONE OF THE THINGS I SHOULD
EMPHASIZE THE PEOPLE ONES WHO
COULD GO INTO RESEARCH LOVE
THEIR PROGRAMS.
IT WASN'T LIKE THE PROGRAMS WERE
BAD.
IT WAS THAT THE POSITIONS THEY
WERE OFFERED FOCUSSED ON
TEACHING AND HAD SMALL RESEARCH
OPPORTUNITY AND THOUGHT I SPENT
ALL THIS TIME LEARNING HOW TO DO
RESEARCH I WANT TO DO RESEARCH
BUT THE DENTAL SCHOOLS DON'T
GIVE ME THAT OPPORTUNITY.
THANK YOU, DANA.
>> YOU CAN OBTAIN THE DUAL
DEGREE AND THEN LEFT AND WENT TO
PRIVATE PRACTICE THEY COULD NOT
FIND THE RIGHT POSITION WITH
PROTECTED TIME TO DO RESEARCH
AND WERE FACED WITH THE
OPPORTUNITY OF HAVING A CLINICAL
TEACHING, ACADEMIC POSITION AND
WHEN THEY LOOKED AT THAT, THEY
CONSIDERED PRIVATE PRACTICE AS A
BETTER CHOICE AND BETTER
FINANCIAL COMPENSATION AND
EITHER WAY THEY WEREN'T GOING TO
GET TO DO WHAT THAT WANTED TO DO
AND PROVIDING A STRUCTURE FOR
PROTECTED TIME WOULD PROVIDE THE
POSITIONS FOR MANY MORE
TRAINEES.
>> AND TO AMPLIFY WHAT LOUIS
SAID IS THE IDEA OF RESEARCH IS
APPEALING AND THERE MAY NOT BE A
LARGE NUMBER THAT WANT TO DO
RESEARCH BUT THERE'S ENOUGH.
IT SEEMS FROM THE WORKING GROUP
PERSPECTIVE THERE'S MORE
INTERESTED IN DOING RESEARCH
THAN THERE ARE REAL RESEARCH
POSITIONS AVAILABLE TO THEM.
>> COULD YOU ADDRESS DENTAL
SCHOOLS' POSITIONS ON THIS.
>> THE POSITION UNDER LIES A LOT
OF THE COMMENTS I MADE WHICH IS
THERE'S A COMPETITION AND THERE
ARE FEWER FACULTY MEMBERS
AVAILABLE.
IT BECOMES EXPENSIVE AND HU DO
YOU PAY A DENTIST TO TEACH AND
SCHOOL AND SALARIES ARE TIED TO
TUITION.
WHO IS GOING TO PAY TO DO
RESEARCH 30% OR 40% OF THE TIME?
THE MARRIAGE OF A CLINICIAN THAT
DOES TEACHING AND RESEARCH THERE
AREN'T THAT MANY AF NOW'S FOR
DENTAL SCHOOLS AND THEY RAISE
THE QUESTION HOW TO ACHIEVE THIS
BECAUSE CURRENT MECHANISMS TO
ACHIEVE A CLINICIAN SCIENTIST
WHO SPENDS 40% OF THEIR TIME
TEACHING AND DOING RESEARCH IS A
DIFFICULT PROPOSITION.
THEY DON'T HAVE A WAY TO FUND
THE RESEARCH AND THE GRANT
MECHANISM IS NOT NECESSARILY
FRIENDLY TO THAT.
>> DO YOU THINK I RELAYED THAT
ACCURATELY OR ARE THERE OTHER
CONCERNS YOU PLAY HAVE?
>> I AGREE.
IT'S NOT QUITE AS SIMPLE BECAUSE
THERE ARE A RANGE OF TYPE OF
DENTAL SCHOOLS TOO.
A DENTAL SCHOOL LIKE YOU'RE IN
OR I'M IN OR JACQUES IS IN
VALUES THAT.
WE CARVE OUT THE SPACE AND TIME
AND FIGURE OUT A WAY TO DO IT.
THE MAJORITY OF THE DENTAL
SCHOOLS ARE NOT IN THE SAME
POSITION AND AND NOT EVEN AT A
UNIVERSITY THAT VALUES IT.
YOU NEED A UNIVERSITY OR SCHOOL
THAT VALUES IT AND A LEADER THAT
VALUES IT AND THEN THEY CAN MAKE
IT WORK BUT IT'S STILL A
STRUGGLE.
>>
>> YOU HAVE TROUBLE GIVING ALL
THE CLINICIANS WHO WANT TO DO
RESEARCH THAT OPPORTUNITIES.
I WOULD SAY THAT'S STILL A
STRUGGLE FOR SCHOOLS LIKE PENN.
YOU HAVE TENURE TRACK FACULTY
WHO DO RESEARCH AND CLINICAL
FACULTY WHO WANT TO DO MORE
RESEARCH BUT THE SCHOOLS CAN'T
AFFORD TO LET THEM DO THAT AND
TALKING ABOUT THAT CADRE OF
CLINICAL FACULTY.
>> I THINK WE COULD HAVE
CLINICAL FACULTY THAT SPENT A
MORE SIGNIFICANT TIME DOING
RESEARCH THAN WE CURRENTLY DO
AND HAVE TO ATTRACT AND BE
AWARDED SUBSTANTIAL FUNDING TO
DO IT AS WELL.
AND HAVE CLINICIANS WHO DO 40%
RESEARCH AND PUBLISH A PAPER
ONCE A YEAR OR SOMETHING WITHOUT
BRINGING THEIR FUNDING TO HELP
SUPPORT THAT.
THAT'S WHERE IT'S THE GRAY ZONE
IS TOUGH.
THE WORKING GROUP IS SUGGESTING
DIFFERENT WAYS YOU CAN APPROACH
THAT PROBLEM.
I MENTIONED ONE SPECIFIC EXAMPLE
WHERE THE K AWARDS LIMIT THAT.
THERE'S MULTIPLE WAYS THIS COULD
BE APPROACHED BUT I THINK THERE
IS A STRONG FEELING THAT
PARTNERSHIP AND RETHINKING SOME
OF THE TYPES OF TRAINING
PROGRAMS THAT EXIST WOULD BE
PRODUCTIVE.
>> ALL GREAT IDEAS.
>> ONE POINT, WE'RE STILL IN THE
CONUNDRUM BECAUSE THEY WANT TO
DO RESEARCH AND SCHOOLS ARE
WILLING TO PROVIDE SPACE AND
OPPORTUNITIES FOR THEM BUT THAT
COMES WITH A CATCH 22.
THEY NEED TO HAVE FUNDING TO DO
THEIR RESEARCH TO BE A CLINICIAN
SCIENTIST.
TO ME THAT'S A CONUNDRUM THAT
NEEDS TO BE RESOLVED.
I KNOW DANA IN YOUR PRESENTATION
YOU'RE PROPOSING MODELS AND
SUSTAINABILITY.
AND MAKE SURE THEY'RE SUCCESSFUL
FOR A LONG PERIOD OF TIME.
IT LOOKS LIKE THEY ARE NEED TO
HAVE SOME TYPE OF NEW GRANT
MECHANISM COMING FROM K'S OR
TRAINING PROGRAMS OR CLINICIAN
SCIENTISTS HAVE THE ABILITY TO
SECURE FUNDING AND FOR LONGER
PERIOD OF TIME.
CAN WE DISCUSS THE
RECOMMENDATIONS FROM THE
COMMITTEE ON THE CONUNDRUM.
>> THAT'S THE RECOMMENDATION TO
DEVELOP NEW GRANT MECHANISMS
WITH CLINICIAN SCIENTISTS IN
MIND.
THE CURRENT MECHANISM ARE VERY
MUCH TAILORED TO TENURE TRACK
FACULTY WHO ARE FULL-TIME
RESEARCHERS.
THAT IS VERY SIMPLY THE
RECOMMENDATION.
>> QUICK QUESTION DOES THE
COMMITTEE TALK ABOUT THE TIME
PERCENTAGES?
DOES THE COMMITTEE BELIEVE 40%
TIME IS ENOUGH TO BE
COMPETITIVE?
>> I THINK THERE'S NO MAGIC
NUMBER BUT 40% IS A NUMBER THE
WORKING GROUP BROUGHT UP AND
WITH WAS BROUGHT UP AS 40% AS A
REASONABLE TARGET.
I THROW THAT OUT BECAUSE I
REMEMBER FROM THE LISTENING
SESSION BUT THIS MIGHT BE
SOMETHING THAT EVOLVES AND NIDCR
HAS DIFFERENT TARGETS TO SEE
WHICH IS SUCCESSFUL.
THE PROBLEM IS IN MOST SCHOOLS
I'VE FAMILIAR WITH THE STANDARD
RESEARCH TIME FOR CLINICIAN
EDUCATORS IS 20%.
I THINK IT'S THOUGHT THAT IS NOT
SUSTAINABLE.
IT'S HARD TO REALLY LEAD A
PROGRAM IN 20% TIME.
TWO DAYS A WEEK I THINK THERE IS
A FEELING THAT THAT IS
SUFFICIENT.
I THINK THERE'S A LOT OF
CLINICIAN SCIENTISTS IN MEDICINE
THAT SPEND 40% TO 50% OF THEIR
TIME IN RESEARCH AND 40% TO 50%
IN TEACHING.
IT'S A GOAL WORTH ATTEMPTING.
>> WE'RE RUNNING SHORT ON TIME.
>> I WOULD SAY I DON'T KNOW WHAT
THE NUMBER OR PERCENT WOULD NEED
TO BE TO MAKE A SUCCESSFUL
EITHER.
HOWEVER, I WOULD SAY THAT IF
SOMEONE HAD STRONG TRAINING AND
WERE IN A SUPPORTIVE ENVIRONMENT
WITH COLLEAGUES WHO WOULD WITH
LIKE-MINDED PEOPLE IN SUPPORT
SYSTEMS AND COLLABORATIONS COULD
BE DONE.
IF AN INDIVIDUAL IS AT A
DEPARTMENT OR SCHOOL WHERE
THERE'S NO SUPPORT STRUCTURE OR
NO LIKE-MINDED PEOPLE AROUND
THEM I THINK THE 40% MAY NOT
FLY.
>> A RESEARCH CENTER CAN PROVIDE
SUPPORT AND WOULD LIKE
CLINICIANS MORE INVOLVED IN THE
RESEARCH AND CAN PARTICIPATE
THAT IN THAT AT A 20% LEVEL IS
NOT QUITE ENOUGH.
>> LAST COMMENT FROM SHAWN.
>> I'LL BE BRIEF.
ONE OF THE ISSUES WITH K AWARDS
IS THERE'S NO THE A WHOLE LOT OF
SUPPORT TO DO THE RESEARCH
PROJECT ITSELF.
INCREASING SUPPORT IN TERMS OF
EFFORT IN THE PROJECT OF 40%
THERE PERHAPS COULD BE AN
OPPORTUNITY TO INCREASE A LITTLE
BIT THE SUPPORT TO INCREASE A
LITTLE BIT OF THE SUPPORT TO DO
THE PROJECT.
>> THANK YOU FOR MENTIONED THAT
WAS ONE OF THE RECOMMENDATIONS
BY REDUCING THE EFFORT YOU COULD
MAKE THAT POSSIBLE.
>> SO WHAT I'M HEARING IS THAT
IT TAKES COMMUNICATION BETWEEN
DENTAL SCHOOLS, PROFESSIONAL
SOCIETIES AND NIDCR NOT
NECESSARILY NIDCR WITH
PROFESSIONAL SOCIETIES AND OF
COURSE OTHER GROUPS ARE ALWAYS
ABLE TO PROVIDE FUNDING
INDEPENDENT OF NIDCR.
IT'S NOT AS THOUGH THEY HAVE TO
BE JOINT PROGRAMS.
JUST WANT TO POINT THAT OUT IT'S
EASIER TO BE INDEPENDENT.
I WOULD LIKE TO KNOW IF COUNCIL
CONCURS WITH THE RECOMMENDATIONS
OR IF YOU HAVE SUGGESTION OR
THINGS THAT SHOULD BE CONSIDERED
ADDITIONALLY BEFORE THERE ARE
FINALIZED RECOMMENDATIONS.
IF THERE'S SPECIFIC FEEDBACK OR
CONCURRENCE OR LACK OF
CONCURRENCE WITH THE
RECOMMENDATIONS.
>> I THINK THE COMMITTEE DID A
GREAT JOB.
IT'S NOT AN EASY NUT TO CRACK.
WE'VE THOUGHT ABOUT NIDCR AND
I'VE BEEN THINKING ABOUT THICK
THIS FOR MANY DECADES.
6:
I APPLAUD THE CREATIVITY.
IF WE NEED TO SIT HERE AND VOTE
IT'S A LITTLE HARD.
I VOTE WE TAKE THIS DEEPER.
I THINK IT NEEDS MORE DISCUSSION
AND WITH THE NIH AND NIDCR
LEADERSHIP AND WITH THE
COMMITTEE.
THERE'S A LOT THERE.
>> THE COMMITTEE DID AN AMAZING
JOB BUT THERE'S SO MANY NUANCES
THERE I FEEL WE NEED TO DISCUSS.
IT'S GOING TO SIT DIFFERENTLY IN
SCHOOLS AND DIFFERENT
INSTITUTIONS WILL BE DIFFERENT.
YOU NEED TO GET THE SUPPORT AS
WELL.
>> ARE THERE OTHER COUNCIL
MEMBERS CONCUR OR --
>> I SECOND THAT.
>> THERE'S GREAT INITIAL EFFORT
BUT WE NEED TO GET TO THE
DETAILS.
THE DEVIL IS IN THE DETAILS.
GREAT EFFORT AND INITIATIVE BUT
SHOULD DIG IN TO FIND AN ETHICAL
ACTION ITEMS.
>> MAYBE WE CAN COME UP WITH
SPECIFIC THINGS TO MOVE FORWARD.
LOUISA.
>> WITH THE FULL REPORT IT'S
NIDCR'S DECISION AND IT WILL
DEPEND ON HOW THEY WANT TO USE
THEIR S TOO.
KEEP THAT IN MIND AS YOU REVIEW
THE RECOMMENDATIONS THAT THEY'RE
NOT ENTIRELY PRESCRIPTIVE ON HOW
SOMETHING COULD BE ACCOMPLISHED
AND WEREN'T ASKED TO DO THAT.
>> THANK YOU, THAT'S A VERY
IMPORTANT POINT.
THESE ARE RECOMMENDATIONS TO
COUNCIL AND YOU AGREE WITH WHAT
WAS DISCUSSED.
I HEAR A LOT OF AGREEMENT BUT
NOT NECESSARILY DETAILS.
AND WHAT NEED TO BE EXAMINED
WITH SUGGESTIONS.
DOES THAT CLARIFY?
OKAY.
THANK YOU VERY MUCH.
IF ANYBODY HAS ANY COMMENTS ON
THIS TOPIC SPECIFICALLY, PLEASE
FEEL FREE TO E-MAIL ME OR
DR. WEBB-CYRIAQUE AND WE HAVE A
GENERAL MAILBOX WE CAN TAKE MORE
COMMENTS FROM THE PUBLIC AND
PEOPLE WHO HAVE PARTICIPATED IN
THE MEETING TODAY.
IT'S TIME FOR OUR BREAK AND WE
WILL RETURN AT -- I'M FORGETTING
MY TIME, 1:15 TO BEGIN OUR THE
MINI SYMPOSIUM ON THE PROGRAM.
THANK YOU VERY MUCH.
>> WELCOME BACK EVERYONE TO THE
NIDCR COUNCIL MEETING.
I HOPE EVERYONE HAD A ROW --
REFRESHING BREAK NEXT WE WILL
HAVE A MINI SYMPOSIUM ON THE AMP
AIM PROGRAM BY
DR. WEBB-CYRIAQUE.
>> IN LINE WITH OUR EARLIER
DISCUSSIONS, THE SECOND HALF OF
OUR OPEN COUNCIL SESSION WILL
FOCUS ON EXEMPLAR OF
PUBLIC-PRIVATE PARTNERSHIPS
DRIVING RESEARCH AND SCIENTISTS
LEADING THE.
-- INITIATIVE.
THIS IS OCCURRING IN THE CON TO
THE SJOGREN'S FOCUSSED
ACCELERATING PARTNERSHIP.
NEXT IN THE TRAINING OF
MENTORSHIP THE LEADERSHIP
SCHOLARS PROGRAM AND WE'LL END
THIS AFTERNOON WITH INNOVATIVE
INITIATIVES SHARED BY OUR
PROGRAM STAFF.
THEY'RE ALIGNED WITH OUR
STRATEGIC PRIORITIES.
SO, AROUND THE ACCELERATING
MEDICINES PARTNERSHIP THAT WE
CALL AMP, THIS IS FACILITATED BY
THE FOUNDATION OF NIH I
MENTIONED EARLIER TODAY.
THIS ACCELERATING MEDICINES
PARTNERSHIP TOGETHER WITH THE
AUTO IMMUNE AND IMMUNE-MEDIATED
DISEASES PROGRAM OR AMP AIM IS
PUBLIC-PRIVATE FOR VALIDATING
BIOLOGIC TARGETS FOCUSSED IN THE
AREA OF AUTO IMMUNE.
THIS WAS CREATED BACK IN 2014 AS
A COLLABORATIVE EFFORT BETWEEN
THE NIH, THE U.S. FOOD AND DRUG
ADMINISTRATION AND MULTIPLE
PHARMACEUTICAL AND LIFE SCIENCE
COMPANIES AND NON-PROFITS AND
OTHER ORGANIZATIONS TO TRANSFORM
THE CURRENT MODEL OF HOW WE
DEVELOP NEW DIAGNOSTICS AND
TREATMENTS.
TO THE DEARTH OF WHAT WAS
PREEXISTING TO TREAT AUTO IMMUNE
DISEASES.
AMP AIM WAS THEN LAUNCHED IN
2021 AND BUDGETED F$2021 AND BU
$62.36 MILLION.
AMP AIM IS MARCHED THROUGH THE
SAME FOUNDATION FOR NIH WITH
SUPPORT FROM AND THE NATIONAL
INFECTIOUS DISEASE AND EYE
INSTITUTE AND THE OFFICE OF
RESEARCH ON WOMEN'S HEALTH.
TODAY WITH 13 PUBLIC AND PRIVATE
PARTNERS.
THE DISEASES INCLUDE RHEUMATOID
ARTHRITIS AND SJOGREN'S DISEASE
AND OTHER DISEASES BECAUSE WE
KNOW THERE ARE ORAL
MANIFESTATIONS.
SO THE AMP AIM NETWORK
TECHNOLOGIES ARE VAST AND RANGE
FROM CLINICAL TO CELL LEVEL AND
MOLECULAR LEVEL OMICS DATA.
THE FALLS INTO THREE CATEGORIES.
OPPORTUNITY FUND PROGRAMS, PAIN
SUPPLEMENTS AND LEADERSHIP
SCHOLARS PROGRAM.
THE OPPORTUNITY FUNDS EVALUATE
NEW TECHNOLOGIES OR POTENTIAL
ANALYTIC APPROACHES AND PILOT
THESE APPROACHES FOR USE ACROSS
THE NETWORK.
AND IT PROVIDES AN
INFRASTRUCTURE TO FACILITATE THE
WORK OF THE NETWORK.
ACTUALLY ONE OF THE FIVE
OPPORTUNITY FUNDS WAS USED TO
LEVERAGE TRANS-DISEASE
PARTNERSHIPS TO LOOK AT WOMEN
WHO HAD SJOGREN'S DISEASE.
THE MOMS AND THEIR INFANTS.
THERE ARE NIH PAIN SUPPLEMENTS
THE SECOND AREA, HELPING TO
DELINEATE THE PAIN PHENOTYPES IN
PATIENTS THAT HAPPEN TO HAVE
RHEUMATOID ARTHRITIS OR LUPUS OR
SJOGREN'S AND ASSESS THE
DIFFERENCES BETWEEN THE
BIOMARKERS AND FUNCTIONAL BRAIN
MRIs AMONG THE PATIENTS WHO HAVE
THESE DISEASES AND HAVE PAIN AND
THOSE THAT MAY NOT.
AND AMONG THE TWO PAIN
SUPPLEMENTS, ONE ACTUALLY IS
LOOKING AT PAIN PHENOTYPES IN
SJOGREN'S DISEASE.
THE THIRD AND FINAL INITIATIVE
THAT GOES WITH TEAM SCIENCE
LEADERSHIP IS THE SCHOLARS
PROGRAM.
THIS LEADERSHIP SCHOLARS PROGRAM
IS ALSO A COLLABORATIVE OVER THE
BETWEEN AMP AIM, THE OFFICE OF
RESEARCH ON WOMEN'S HEALTH AND
THE NIH OFFICE ON DATA SCIENCE
STRATEGY OR ODSS WITH GOALS TO I
AM WHY -- IMPROVE WOMEN'S
HEALTH BY SUPPORTING SCHOLARS
DOING THIS WORK TO PROVIDE
STRUCTURED EXPOSURE TO TEAM
SCIENCE FOCUSSED ON AUTO UME
DISEASES AND ENHANCE THE
SCHOLAR'S LEADERSHIP AND
MENTORSHIP EXPERIENCES AND TO
ENCOURAGE AND DEVELOP NEW
LEADERS TO EXPLORE UNIQUE
SCIENTIFIC QUESTIONS AND
APPROACH AND CAN UTILIZE AND
REALLY LEVERAGE THE AMP AIM
INFRASTRUCTURE.
WE'LL HEAR FROM ONE OF THE SIX
CURRENT LEADERSHIP PROGRAM
AWARDEES TODAY.
AS WE LOOK AT THE GEOGRAPHIC
LOCATION OF THE AMP AIM SITES
AND PARTNERS YOU CAN SEE THEY'RE
ACROSS THE UNITED STATES AND IN
YELLOW CIRCLES THE STAMP SITES
WHERE WE HAVE GREAT GEOGRAPHIC
DISTRIBUTION.
IN FACT, BEYOND THE THREE SITES,
ONE BEING AT UCSF, THE SECOND
BEING IN OKLAHOMA, JOHNS HOPKINS
UNIVERSITY, THE FOURTH IS NIDCR
INTRAMURAL PROGRAMS AND A
CRITICAL ADDITIONAL PARTNER THE
SJOGREN'S FOUNDATION SERVING AS
AN ACTIVE PARTNER IN THIS
PROGRAM.
SO BRINGING IN OUR AFFECTED
COMMUNITY.
HEARING THEIR VOICE AND PUTTING
THE PATIENT AT THE CENTER.
SO THE SJOGREN'S TEAM FOR
ACCELERATING MEDICINES
PARTNERSHIP IS WHERE WE'LL GO
NEXT TODAY.
STARTING WITH AN OVERVIEW OF
STAMP, WHICH IS THE ACRONYM AND
ITS CLINICAL PIPELINE.
WE'LL HEAR FROM DR. SHIBOSSKI
AND HEAR FROM DR. BLAKE WARNER
FROM THE DIVISION OF INTRAMURAL
RESEARCH ON THE SINGLE CELL
SPATIAL TECHNOLOGIES ON SALIVARY
GLAND AND REPRESENTING THE
LEADERSHIP SCHOLARS PROGRAM IS
DR. SARA McCOY OF THE UNIVERSITY
OF WISCONSIN MADISON AND TALK
ABOUT LEVERAGING AMP AIM TO LOOK
AND LEARN ABOUT SALIVARY ME
MESOCHYMAL CELLS.
>> ABOUT AFTERNOON AND THANK YOU
SO MUCH FOR INVITING OUR TEAM TO
PROVIDE AN UPDATE ON THE
PARTNERSHIP WITH THE SJOGREN'S
TEAM AND KICK OFF THE SESSION BY
PRESENTING AN OVERVIEW AS WELL
AS THE CLINICAL PIPELINE SO
HERE'S OUR STEERING COMMITTEE
THAT CONSISTS OF FOUR SLEERDSHIP
TEAM MEMBERS, I AM AT UCSF AND
WE HAVE UNIVERSITY OF BERKELEY
AND SARA McCOY JOINED IN
SEPTEMBER OF LAST YEAR AND WE'RE
VERY HAPPY THAT HER LEADERSHIP
SCHOLARS PROGRAM FOCUSES ON
SJOGREN'S.
HIGHLIGHTING THE
MULTI-DISCIPLINARY ASPECT OF
STAMP AND WITH RHEUMATOLOGY,
REPRESENTED IN EACH OF OUR FIVE
CLINICAL SITES AND IN ADDITION
TO EXPERTISE WE HAVE GENOMICS
AND COMPUTATIONAL BIOLOGY
REFLECTED IN THE PRESENTATION
AFTER MINE.
JENNIFER MENTIONED THE PATIENT'S
VOICE WHO WERE DELIGHTED TO HAVE
AS PART OF THE GROUP AND THEN AN
INTERESTING FACT IS AMONG 35
INVESTIGATORS AND COLLABORATORS
WITHIN STAMP, 63% ARE WOMEN
WORTH NOTING.
AFTER COMPLETING BOTH PLANNING
AND PILOT PHASES WE'RE IN THE
MIX OF A SCALE UP PHASE THAT AT
UNDERSTANDING THE PHENOTYPIC AND
MOLECU
MOLECULAR HETEROGENEITY IN THE
DISEASE AND ALL TO IDENTIFY
THERAPEUTIC TARGETS TO IMPROVE
ADVANCED DISEASE.
SO THE FIVE-YEAR SCIENTIFIC
AGENDA DEVELOPED IS FOCUSSED ON
THREE THEMES.
FIRST PREDICTION OF SJOGREN'S
DISEASE DEVELOPMENT AND
PROGRESSION.
WE HAVE THE OPPORTUNITY TO
RECALL PARTICIPANTS IN THE PRIOR
F COHORTS AND SOME OF THESE WERE
ENROLLED 20 YEARS AGO.
THAT'S A REALLY GOOD WAY TO
EXPLORE MOLECULAR CHANGES OVER
TIME WITHIN SALIVARY GLANDS AND
LOOK AT PHENOTYPIC FEATURES
ASSOCIATED WITH PROGRESSION.
THE SECOND THEME PERTAINS TO THE
ELUCIDATION OF SJOGREN'S DISEASE
HETEROGENEITY AND LOOK AT
COVARIANTS OF SJOGREN'S DISEASE
AND DISEASE ACTIVITY AND DAMAGE.
FINALLY, THE THIRD AIM FOCUSES
ON THE GRANULAR TROPISM AND
POSITIVE SJOGREN'S DISEASE AND
PARTICIPANTS AND ANTIGENS AND
HORMONES ARE AMONG THE POTENTIAL
DETERMINATES OF TROPISM WE'LL BE
EXPLORING.
WITH RESPECT TO INCLUSION
DESIGN, STAMP IS A
CROSS-SECTIONAL STUDY WITH A
SINGLE STUDY VISIT BUT DOES HAVE
A LONGITUDINAL COMPONENT BECAUSE
OF THE RECALL AND SOME WERE
RECRUITED IN THE SICC PROJECT
AND WE'LL RECALL 185 IN THE
STAMP FOLLOW-UP COHORT.
IN THE STAMP MAIN COHORT WE ARE
ENROLLING 300 PARTICIPANTS WITH
SIGNS AND SYMPTOMS OF SJOGREN'S
DISEASE WITH THE SAME INCLUSION
CRITERIA AND ESTIMATE 40% OF
THESE WILL MEET THE 2016 ACR
CRITERIA ONCE WORKED UP.
WE HAVE A SMALL GROUP OF
SJOGREN'S DISEASE SLE OVERLAP
COHORT THAT JENNIFER ALLUDED TO
AND 63 HEALTHY CONTROLS
RECRUITED AT NIDCR SO THE
SPECIAL HEALTHY CONTROL
RECRUITMENT PROJECT AND THROUGH
THE SITES.
AND WE HAVE DOMAINS EVALUATED
WHEN WE WORK SOMEBODY UP FOR
SJOGREN'S THE ORAL, SALIVARY AND
OCULAR AND WE INCLUDED SALIVARY
GLAND ULTRASOUND IMPORTANT TO
EXPLORE SALIVARY GLANDS IN THE
SQUEEZE AND INCLUDED DISEASE
ACTIVITY AND THE PATIENT
REPORTED AND CLINICALLY ASSESSED
S DYE.
JENNIFER REFERRED TO THE PAIN
SUPPLEMENTS.
WE HAVE EXTENSIVE PAIN
QUESTIONNAIRES THROUGH THE
SUPPLEMENT AND ACROSS ALL
DISEASES AND EXTENDED THE
NEUROLOGIC EXAM COMPARED TO WHAT
WE USED TO DO WITH SICCA AND
RMF.
IN RED ARE ALL THE SPECIMENS
COLLECTED, PROCESSED LOCALLY AND
SUBMITTED TO THE TISSUE
REPOSITORY CENTER OMRN.
ANOTHER TRANS DISEASE WHERE
MICROBIOME IS STUDIED IN STOOL
SPECIMENS BEING DONE ACROSS ALL
FOUR DISEASES.
SO WE'VE COMPLETED FOUR PILOTS.
WITH PILOT 1A AIMED AT ASSESSING
THE CLINICAL OPERATION, SAMPLE
PROCUREMENT AND FINALIZED AND
TESTED SOPs, CLINICAL RESEARCH
FORMS AND MANUALS ACROSS THE
FIVE SITES.
WE'VE DONE COLLABORATION OF THE
SALIVARY GRAND ULTRASOUND AND
HOW THE SCORE IS USED FOR THE
ULTRASOUNDS.
OUR PATHOLOGISTS WHO ARE LEADING
EVERY SINGLE HME ON THE PLATFORM
HALO.
SO MAKE AND RICHARD HAVE BEEN
CALIBRATED AND USING SICCA DATA
AND WE'VE ALSO DEVELOPED A DATA
SAFETY MONITORING PLAN THAT'S
BEEN APPROVED BY NIAMS AND NIDCR
AND SAFETY OFFICERS REVIEWED AND
APPROVED TWO OF OUR QUARTERLY
REPORTS.
THERE ARE THREE TISSUE-FOCUSSED
PILOTS THAT HAVE COMPARED
PROTOCOLS FOR CRYO PRESERVATION
AND DE-ASSOCIATION AND
PROCESSING AS WELL AS FIXATION
OF THE GLANDS AND SELECTION OF
SPATIAL PLATFORMS.
PART OF THIS IS FEASIBILITY OF
NEW TECHNOLOGY TO ASSESS THE
RESTORABLE PRESERVED GLANDULAR
TISSUE FROM SICCA AND OMRF AND
HEAR WHAT WAS CONDUCTED IN THE
LABS.
TO DATE WE HAVE ENROLLED 184
PARTICIPANTS ACROSS ALL OF OUR
CLINICAL SITES.
YOU CAN SEE THE LARGEST NUMBER
IS IN THE MAIN COHORT.
WE HAVE ALMOST 20 HEALTHY
CONTROLS AND FOLLOW-UP AND AMONG
THE PARTICIPANTS IN WHOM WE'VE
BEEN ABLE TO ESTABLISH THE
CLASSIFICATION CRITERIA AND HAVE
RESULTS AVAILABLE THIS IS A
DISTRIBUTION WHETHER OR NOT THEY
MEET CRITERIA OR WHETHER THEY'RE
A HEALTHY CONTROL.
IT'S INTERESTING TO LOOK AT HOW
WE'RE DOING COMPARED TO
EXPECTATIONS.
SO THE BLUE BARS REPRESENT A
PLANNED ENROLLMENT AND THE
MAGENTA BAR REPRESENTS ACTUAL
ENROLLMENT.
WE'RE A LITTLE BIT BEHIND
BECAUSE WE STARTED SIX MONTHS
AFTER THE EXPECTED STARTED DATE.
YOU CAN IMAGINE WE HAVE
EXTENSIVE SOPs NOT ONLY IN THE
SJOGREN'S BUT ACROSS OTHER
DISEASES AND THEY HAD TO BE
REVIEWED AND APPROVED CENTRALLY.
THAT TOOK A LITTLE BIT LONGER
THAN EXPECTED.
ALSO WHEN WE WERE PILOTING THE
CLINICAL ASSESSMENTS WE COULD
ONLY SEE ONE PARTICIPANT PER
SESSION WHEREAS NOW WE SEE EVERY
SINGLE CLINICAL SITE IS
TYPICALLY ENROLLING THREE
PARTICIPANTS PER SESSION.
AND WHAT'S INTERESTING IS WHEN
WE LOOK AT THE ENROLLMENT IN THE
DIFFERENT SUBCOHORTS YOU CAN SEE
WITH THE SOLID BAR IS THE ACTUAL
ENROLLMENT AND PATTERN BAR
REPRESENTING THE EXPECTED
ENROLLMENT, YOU CAN SEE AT UCSF,
U.C. BERKELEY AND JOHNS HOPKINS
AND WE'RE AHEAD OF ACTUAL
ENROLLMENT VERSUS PLANNED.
IT'S IN THE FOLLOW-UP COHORT
WE'RE BEHIND.
THIS IS A UNIQUE GROUP AND DID
NOT WANT TO START ENROLLMENT OF
THE GROUP TOO EARLY AS WE'RE
PILOTING THE CLINICAL PROTOCOL
SOMETIMES TISSUE GETS EXHAUSTED.
WE'RE KEEPING THIS FOR NOW AND
GEARED UP AND ARE ACTIVELY
FOLLOWING UP PARTICIPANTS AT
THIS POINT.
A FEW WORDS ABOUT THE NETWORK
EARLY DISEASE PROJECT THAT
SJOGREN'S IS PART OF THAT
INVESTIGATE THE SHARED MOLECULAR
PATHWAYS AND INTERACTIONS ACROSS
ALL FOUR DISEASES.
SO DISEASE-SPECIFIC TISSUES WILL
BE DEEPLY PHENOTYPE USING SINGLE
CELL ANALYSES, ETCETERA.
EACH OF THE DISEASE TEAM WILL
PROVIDE DISEASE-SPECIFIC TISSUE
IN AT LEAST 12 PARTICIPANTS.
WE'VE HAD TO COME UP WITH A
DEFINITION FOR EARLY SJOGREN'S
DISEASE AS YOU KNOW THERE IS NO
ESTABLISH DEFINITION FOR EARLY
DISEASE.
WE PROPOSED TO DERIVE A
DEFINITION FROM INCLUSION
CRITERIA OFTEN USED BY INDUSTRY
PARTNERS FOR RECRUITMENT INTO
TRIALS.
THIS IS BASICALLY THE CRITERIA
WE ARE USING FOR THIS EARLY
DISEASE PROJECT.
NOW, REMEMBERING SJOGREN'S IS A
HETEROGENOUS DISEASE IT'S NOT
ONLY IMPORTANT TO HAVE POSITIVE
SJOGREN'S PARTICIPANTS AND
MAKING YOU ARE SURE THEY HAVE
SALIVARY GLANDS IF THEY HAVE A
FOCUS OR ONE OR MORE THEY'RE
MORE LIKELY TO FROM FIBROTIC
CHANGES IN THEIR GLANDS.
THE OTHER GROUP IS THE RO
NEGATIVE BECAUSE IT MAY REFLECT
LESS SEVERE AND POSSIBLY EARLIER
DISEASE AND AMONG THE CONTROLS,
WE WILL BE RECRUITING
SYMPTOMATIC AND HEALTHY
CONTROLS.
THE MAJORITY WILL BE IN OUR RO
POSITIVE SJOGREN'S PARTICIPANTS.
WE HAVE AVAILABLE PARTICIPANTS
FOR EVERY ONE OF THESE
CATEGORIES AND THE POSITIVE SUB
GROUP HAS TWO TIME POINTS AS
PART OF SICCA AND ONE WITH ONE
EXISTING VISIT ALL HAVE
AVAILABLE PLASMA AND SARIN AND
WILL BE AN OPPORTUNITY TO DO AN
ASSESSMENT AMONG THE PROJECT.
AND GIVING A SNAPSHOT OF THE
OPPORTUNITY FUND JENNIFER
REFERRED TO THE COLLABORATION
BETWEEN STAMP, THE SLE GROUP AT
NCU, SYMPTOMS BIOLOGY CORE AND
THE TRC AND IT'S TO EVALUATE
MOTHERS OF CHILDREN WITH
NEONATAL LUPUS TO PROVIDE
INSIGHT INTO THE PROTECTIVE AND
PERMISSIVE FACTORS OF SJOGREN'S
DISEASE.
THE MAIN QUESTION BEING WHAT ARE
THE CHARACTERISTIC OF SALIVARY
GLAND TISSUES IN ASYMPTOMATIC
INDIVIDUALS AND HAVE THE
REGISTRY OF THE NEONATAL LUPUS
AND HAVE AN IRB AND ARE ABOUT TO
FINISH THE COLLABORATION FOR THE
SALIVARY GLAND ULTRASOUND AND
START IN OCTOBER.
I'LL STOP SHARING MY SLIDE SO
BLAKE WARNER CAN COME ON.
THE ACKNOWLEDGEMENT SLIDE WILL
COME AT THE END WITH CHRIS'
TALK.
THANK YOU VERY MUCH.
>> THIS, CAROLINE FOR THE
INTRODUCTION AND THANK YOU FOR
COUNCIL FOR THE OPPORTUNITY TO
TALK TODAY.
I'M BLAKE WARNER A STADTMAN
TRACK INVESTIGATOR.
I'LL TALK ABOUT SPATIAL
RECONSTRUCTION OF SJOGREN'S
DISEASE.
IT IS SHARING?
TO SELECT THE MOST SPATIAL
PERFORMING PLATFORM WE CONDUCTED
PILOTS WITH THE READILY
AVAILABLE INSTRUMENTS THE XENIUM
GENOMICS AND COSMX PLATFORM.
THOUGH BOTH INSTRUMENTS
PERFORMED EQUALLY WELL AT THE
PER CELL LEVEL WITH SOME BETTER
CONSISTENCY WINNING OUT TO THE
XENIUM PLATFORM IT ALLOWS MORE
CELLS TO BE CAPTURED AND THE
COSMX WAS DIFFERENT IT WAS
IMPORTANT TO SELECT OTHER SINGLE
CELL PLATFORMS THAT MARRIED WELL
WITH THE XENIUM SPATIAL
PLATFORM.
THE TECHNOLOGY WE PLANNED TO USE
ACROSS STAMP USES FORMAL AND
FIXED EMBEDDED TISSUES AND A
SIMILAR STRATEGY TO USING PROBES
TO QUANTIFY GENE EXPRESSION IN
INDIVIDUAL CELLS.
THIS WILL BE FURTHER DETAILED BY
DR. CHRISTOPHER LESSARD AFTER MY
PRESENTATION.
AND IT USES TARGETS AND
AMPLIFICATION TO AMPLIFY THE
PRESENCE OF THAT TRANSCRIPT AND
FLUORESCENCE DETECTION AS
QUANTIFIED BY THE XENIUM
ANALYZER TO LOCALIZE INDIVIDUAL
TRANSCRIPTS AND CELLS ACROSS THE
TISSUES AND FOBs SELECTED ON
YOUR SLIDE.
HOWEVER THE FACT WE WERE ABLE TO
COLLECT THE DATA IS IS ONE
THING.
THE NEXT PART WAS COULD WE USING
THE AVAILABLE INFORMATION ABOUT
THE COMPOSITION OF THE GLANDS TO
ADEQUATELY PREDICT WHAT CELL
TYPES WERE PRESENT IN THE
SPATIAL CONTEXT.
SO WE USED OUR EXISTING
UNPUBLISHED AND PUBLISHED
THREE-PRIME SINGLE CELL
SEQUENCING DATA FROM THE MINOR
SALARY GLANDS AND TRANSFERRED
ANCHORS BETWEEN THE SINGLE CELL
AND THE SPATIAL TRANSCRIPTOMICS
WHICH MEANS WE TOOK THE CELL
I.D.s WE FOUND IN SINGLE CELL
SPACE AND APPLIED IT TO THE
SPATIAL FACE ACROSS THREE
DIFFERENT CUSTOM PANELS USING A
280 PLEX BREAST CANCER PANEL AND
PANEL CONDUCTED IN COLLABORATION
WITH AMP AIM AND THROUGH A
COLLABORATION BETWEEN AMP AIM
AND 10X GENOMICS WE WERE ONE OF
THE FIRST USERS TO USE THE 5K OR
PRIME GENOMICS PANEL.
WE ALSO UNDERSTOOD WE NEEDED TO
OPTIMIZE NOT ONLY WHICH PLATFORM
TO USE BUT THE BEST FORMAT FOR
ANALYZING THE GLANDS IN THE
STAMP PROGRAM.
SO ONE OF THE WAYS TO MAXIMIZE
THESE FRAMES AND DECREASE COST
AND DECREASE VARIABILITY ACROSS
THE MULTIPLE RUNGS WE PLANNED TO
CONSTRUCT MINOR SALIVARY GLAND
TISSUE MICRO ARRAY.
THIS IS WHAT WE CONSTRUCTED WITH
THE NCI THAT REPRESENTS 44 CORES
FROM 22 PATIENTS ON ONE SLIDE.
YOU CAN SEE EVEN AT THIS LEVEL
WHEN YOU DO THE LABEL TRANSFER
YOU CAN IDENTIFY THE CELL TYPES
YOU EXPECT TO FIND IN THE GLANDS
AND CAN ENUMERATE OR
CHARACTERIZE DIFFERENT AREAS OF
THE GLAND INCLUDING AS YOU'D
EXPECT TO SEE THE TERTIARY
LYMPHOID STRUCTURE NOT FOUND IN
THIS EXAMPLE OF A NON-SJOGREN'S
DISEASE PATIENT AND TO FURTHER
SHOWCASE THE XENIUM PANEL WE
PLANNED TO USE FOR THE DOWN
STREAM ANALYSES WE'RE GOING TO
DO IN STAMP AND THE MULTIPLE
DISEASE TEAMS, HERE WE USED THE
SAME APPROACH TO TRANSFER LABELS
TO THAT 5K.
THE AND WHETHER WE'RE USING A
480K AS LONG AS THERE'S MARKERS
IN THE DATA SET.
WE THEN TOOK THE MARKERS TOOK
THE PHENOTYPES PUTTING THEM IN
THE EXPLORER AND THIS IS
SOMETHING WHERE CLINICIANS OR
SCIENTISTS CAN DO THE JOB THAT
PATHOLOGISTS USED TO DO AT
HIGHER RESOLUTION AND SHOW
RELATIONSHIPS BETWEEN SPECIFIC
CELLS YOU MIGHT BE INTERESTED
AND HEAR THEM HIGHLIGHTING CD4 B
CELL INTERACT IN THE CELL AND
HIGHLIGHTS THE HETEROGENEITY
WITHIN THE EPITHELIAL
COMPARTMENT WHICH IS REMARKABLE
ONCE WE IDENTIFIED THE CELL TYPE
AND LOOK AT RELATIONSHIPS
BETWEEN CELL TYPE AND TISSUES
COLLECTED USING THE XENIUM TASK
FORCE AND LOOKING AT THE
MULTIPLEX IMAGING DATA A MACHINE
LEARNING DAIT FOR CELL TYPES AND
REGIONS OF THE TISSUES ENRICHED
FOR IMMUNE CELL TYPES AND YOU
CAN SEE THERE'S ENRICHMENT FOR T
AND B CELLS AND REGIONS JUST
ENRICHED FOR T CELLS.
YOU CAN USE OTHER THIRD-PARTY
APPLICATIONS APPLIED IN THE
SPATIAL CONTEXT TO THESE TO
UNDERSTAND THE COMPOSITION OF
THE NEIGHBORHOODS AND
NEIGHBORHOODS THAT ARE PUNIT
PUNITIVELY DRUGGABLE POTENTIALLY
AND CAN USE THIRD-PARTY
APPLICATIONS TO PREDICT DRUG
TARGETS AND CELLS THAT MAY BE
RESPONSIVE TO THE DRUGS.
I'M SHOWING THE SAME INFILTRATE
WITH THE TACIT PREDICTION OF
CELL TYPES.
AND THIS DRUG TO CELL PIPELINE
THAT DERIVED A SEMI SELECTED
JAK1 AND 3 AND WAS PREDICTED TO
BE USEFUL IN SJOGREN'S DISEASE
AND UNDER INVESTIGATION BY THE
TEAM AND NOT ONLY THAT CAN YOU
THEN TAKE THIS DATA AND LOOK AT
INDIVIDUAL CELL TYPES LIKELY TO
RESPOND AND WHY THIS IS
IMPORTANT IS IT WOULD ENABLE
TEMPORAL ANALYSIS OF THESE
IMMUNE IN FILL TRIAL THEED
BIASES TAKEN OVER TIME SUCH AS
FOLLOW-UP DATA AND THE OTHER
BENEFIT OF THE 5K XENIUM PANEL
IS IT'S NON DESTRUCTIVE AND
ALLOWS FOR WORK FLOW.
THIS WAS PIONEERED BY CALEB
MARLIN TO PERFORM SPATIAL
TRANSCRIPT OMICS AND STAIN THIS
AND CAPTURE WHAT IS USED FOR
DOWN STREAM A.I. BASED TISSUE
ALGORITHMS AND IMAGING CYTOMETRY
AND USE ANTIBODIES WITH MEDALS
AND THE METALS CAN BE CLEAVED
AND WAQUANTIFIED HERE ON THE SA
CELLS YOU CAN COMBINE GROUND
TRUTH WITH DISCOVERY.
AND HERE I'M SHOWING THE
EXAMPLE.
HERE WE HAVE SINGLE CELL
TRANSFER AND SEE THE HISTOLOGY
AND OVERLAID ON THE DATA SET AND
REGISTERED TO THAT DATA SET YOU
CAN PERFORM THE PROTEOMICS.
TRANSCRIPTOMIC I'D FINDS
CELLULAR NEIGHBORHOODS,
SIGNALLING AND DRUGGABLE NICHES
AND TISSUES USED TO PREDICT OR
MONITOR THERAPEUTIC RESPONSES IN
SITU AND MULTI-MODAL WORK FLOWS
ARE WITHIN REACH AND GROUND
TRUTH NEEDS DISCOVERY.
THE INVESTIGATIVE DIRECTION IS
ENABLED BY MATCHED SINGLE CELL
OMICS TECHNOLOGY DISCUSSED
FURTHER.
THANK YOU.
>> MY NAME IS CHRIS LESSARD A
PROFESSOR AT THE RESEARCH
FOUNDATION AND TELL YOU ABOUT
OUR STUDY ON SINGLE CELL
TECHNOLOGIES.
TO START OFF I WANT TO GIVE OVER
THE STATE OF WHERE WE'RE AT
SINCE THE NETWORK KICKED OFF.
BOTH GROUPS HERE ARE
DISAGGREGATED TISSUE FROM
SALIVARY GLANDS BUT WE'VE DONE
THIS AFTER THEY WERE TAKEN AND
WE NEEDED TO PILOT THAT OUT TO
MAKE SURE WE WEREN'T GOING TO
SEE ANYTHING DIFFERENT FROM
BEFORE IN THE FREEZING AND DYING
OF THE TISSUE AND IMPACT THE
DOWN STREAM AND UNDERSTAND HOW
WE SPENT TIME DEVELOPING A
PROTOCOL AS WELL AS MERGING THE
PROCESS.
THERE WAS A NEW CHEMISTRY
INTRIGUING TO US WITH SINGLE
CELL FLEX.
THIS ALLOWED US TO USE FIXED
SAMPLES AND DISEASE DESCRIBED
EARLIER.
WE GOT EARLY ACCESS TO A
PRE-RELEASED PROTOCOL.
IT CALLED FOR A 225 MICRON
SESSION TO BE USED.
THAT'S WAY TOO MUCH TISSUE FOR
THE USE IN AMP AIM FOR TISSUES
LIKE THE KIDNEY SAMPLES BEING
TAKEN IN NEEDLE BIOPSIES.
WE SPENT TO THE FIRST HALF OF
2023 MODIFYING THE PROTOCOL AND
ABLE TO USE 125 MICROON SESSION
AND CAPTURING THOUSANDS OF CELLS
PER SUBJECT.
THE WORK FLOW IS DESCRIBED HERE
WE DISAGGREGATE TISSUE ON THE
SYSTEM AND THEN THE SAMPLES ARE
THEN PROBED AND HYBRIDIZED IN AN
OVERNIGHT STEP AND UNIQUELY
LABELLED.
THE SEQUENCING CAPTURES MOLES
PRESENT IN THE CELL.
ONE OF THE BIGGEST BENEFITS
THAT'S HARD TO APPRECIATE NOT
ONLY CAN WE DO SINGLE CELL WORK
BUT CAN DO THE COMPLEX OF THE
EMBEDDED TISSUE AND DO OTHER
DOWN STREAM PLATFORMS.
THERE'S PROS AND CONS TO
DIFFERENT PLATFORMS AVAILABLE TO
DO SINGLE CELL TECHNOLOGIES.
SOME ARE FIXED TISSUE BEING USED
IN THE OTHER ASSAYS.
THESE ARE HOMOGENIZED ACROSS
SITES AND SURVIVORSHIP BIAS IS
AN EXTREME PROBLEM WITH THE
ASSAYS WE'LL TOUCH ON WHEN I
SHOW YOU DATA.
BY AND LARGE THE BIGGEST BENEFIT
IS YOU CAN USE THE XENIUM
PLATFORM AND THE SAME PROBES
BETWEEN TECHNOLOGY.
THERE'S ONLY 18,000 PROBES.
IT DOES NOT COVER THE ENTIRE
GENOME.
IT DOES NOT ALLOW FOR THE
REPERTOIRE OR SEQ ANALYSIS
TALKED ABOUT IN THE SPATIAL
CONTEXT.
SO BEFORE WE STARTED RECRUITING,
BLAKE WAS GENEROUS ENOUGH AT HIS
GROUP AND THE INTRAMURAL PROGRAM
TO COLLECT SAMPLES FROM HEALTHY
SUBJECTS TO CAPTURE ALL THE CRYO
PRESERVATION AND TISSUE WE NEED
TO PILOT THIS AS WELL AS
CAPTURING DATA TO DO THAT DIRECT
COMPARISON.
WE'LL TALK ABOUT THE DATA
BECAUSE IT WAS THE SAME AS THE
CRYO PRESERVED DATA I'LL TALK
ABOUT IN A MINUTE.
THIS SUMMARIZES THE INITIAL
PILOT AND WHERE THEY'RE
SEQUENCING BASED APPROACHES FROM
DIFFERENT ENDS OF THE RNA
MOLECULE.
BECAUSE THE APPROACH IS PROBE
BASED I THINK THE NETWORK WAS
CONCERNED ABOUT THE LOSS OF
GENES PER CELL AND SAW GOOD
AGREEMENT IF YOU LOOK APT THE
FEATURES OR GENES PER CELL I'M
SHOWING ON THE LEFT SIDE OF THE
SLIDE THEY'RE FAIRLY SIMILAR.
AND THIS IS AA WELL KNOWN
DIFFERENCE BETWEEN THE THREE
PRIME AND FIVE PRIME MORE GENES
PER CELL THOUGH NOT IDENTICAL
IT'S SIMILAR AND THE NET WORK
WAS EXCITED ABOUT THE RESULTS
AND THE TECHNOLOGY MOVING
FORWARD.
I THINK ONE OF THE MOST
INTERESTING FINDINGS WAS THE
FACT THAT WE DID SEE EXTREME
SURVIVORSHIP BIAS.
WE HAVE THREE COLORS AND GREEN
IS FIVE PRIME AND RED IS THREE
PRIME.
WHEN YOU LOOK AT PERCENT OF
CELLS ACROSS THE BOARD MOST
REGIONS OF THE GLAND THE CELLS
BEING COUNTED IN THE SINGLE CELL
APPROACH AND THERE'S OTHER
SUBSETS MAKE IDENTIFIED IN THE
WORK THEY ARE DIDN'T LOOK LIKE
THEY ARE CAPTURED AS WELL AND
THERE MIGHT BE TRANSLATABILITY
DIFFERENCE BETWEEN THE PROBES
AND TECHNOLOGIES WE NEED TO
EXPLORE FURTHER.
IT WASN'T ONLY THE EPITHELIAL
CELLS WE SEE MORE MACROPHAGES
AND PLASMA CELLS AND MORE
DENDRITIC CELLS AND B CELLS.
IT WAS NICE TO SEE WE'LL GET
BETTER REPRESENTATION OF THE
DIVERSE CELL TYPES WE COULD
EXPECT TO SEE IN THE
PATHOGENESIS OF SJOGREN'S
DISEASE AND WE FOCUSSED ON
POSITIVE SJOGREN'S AND WERE ABLE
TO TRANSFER LABELS FROM MAKE'S
ORIGINAL 90,000 K DATA SET AND
WERE ABLE TO FIND ALMOST ALL THE
CELL POPULATIONS ACROSS THE DATA
SET.
IMMUNE CELLS WERE HIGHLY
REPRESENTED IN THE SJOGREN'S
PATIENTS AND WE USED A LONG
KNOWN ALGORITHM THAT USES A.I.
DEVELOPED IN THE U.K. WHERE IT A
DEEP DATA SET TO BE ABLE TO
INTERROGATE THE DATA SET TO FIND
THE CELL TYPES.
AND AS YOU'D EXPECT WE'D WANT TO
TO SEE THE DOMINATION OF IMMUNE
CELLS IN THE SALIVARY GLANDS AND
HERE'S SHOWING SOME IMMUNE CELL
SUBSETS.
ONE OF THE BIGGEST INCREASES IN
NUMBER WE WERE ABLE TO IDENTIFY
WITH THE PLASMA CELLS AND SEE A
LARGE NUMBER OF THEM WE'RE ABLE
TO PULL OUT AND ALL THESE MAJOR
CELL TYPE POPULATIONS WE WERE
ABLE TO IDENTIFY INCLUDING SOME
THAT I THINK THAT ARE MORE
REFINED AND OTHERS THAT MAY BE
IMPORTANT THAT IMPACT
PHYSIOLOGY.
EXCITED ABOUT OUR ABILITY TO
CAPTURE IMMUNE CELLS SUBSETS IN
THE DATA WITHOUT HAVING ANTIBODY
TAGS FOR ANALYSIS.
IN WORKING WITH BLAKE WE DECIDED
TO DIVE DEEPER IN THE SINGLE
CELL NON-IMMUNE COMPARTMENTS AND
ANNOTATE THIS DATA TO GIVE
BETTER IDEA OF WHAT SUBSETS
WE'RE SEEING AND I WANT TO SAY
ONE OF THE BIGGEST ADVANTAGES OF
THE SINGLE CELL FLP IS HOW CLEAN
IT IS AND WE'VE SEEN
CONTAMINATION ACROSS CELL TYPES
AND DISTRACTION MAKING IT
DIFFICULT SHOWN IN THE DARK
CLOUD.
AND LIKE YOU'D EXPECT TO SEE
INCREASED INFLAMMATORY CELLS WE
EXPECT TO SEE MORE GLANDULAR
CELLS IN THE CONTROLS AND SEE
MORE.
WE TRIED TO DO A DIFFERENT
ANALYSIS AND WERE VERY
UNDERPOWERED.
NOTHING PATCHED THE THRESHOLD
BUT IT'S IMPORTANT TO LOOK AT
BECAUSE THERE ARE THINGS IN
SJOGREN'S DISEASE PATIENTS WE
EXPECT TO SEE.
I'M GOING TO HIGHLIGHT A FEW.
IT'S BUSY TO SEE BUT WE DO SEE
THE TYPE 1 INTERFERON SIGNALLING
SHOWING UP AS THE PATHWAY IN THE
IMMUNE CELL SUBSET AND GLANDULAR
CELLS AND DOWN REGULATION OF THE
ENZYME A WE KNOW FROM OTHER
PREVIOUS AMP WORK.
AND INCREASED K CELLS.
WE SEE A MIXED BACK IN AUTOPHAGY
AND SEE ALTERNATIVE ACTION
APPROACHES WITH THE MACRO
FATHERS AS WELL AS NEUTROPHIL
DEGRADATION SHOWING IMPORTANCE
IN B CELLS.
WE'RE EXCITED ABOUT THE INITIAL
RESULTS AND PLEASED MOVING
FORWARD IN THE EARLY DISEASE
PROJECT CAROLINE DESCRIBED AS
THE SINGLE CELL FFP WITH THE
SITES TO GET THE B CELL, C CELL
REPERTOIRE AND THE CELL TYPES IN
THE TISSUE AS WELL AS THE WORK
FLOW FOR THE PLATFORMS AND OTHER
TECHNOLOGIES THAT WE'LL BE USED
IN COMBINATION FOR THIS AND THE
NETWORK SELECTED TO DO THE WORK.
REALLY EXCITED ABOUT THAT.
I WANT TO THANK EVERYBODY IN MY
LAB AND COLLABORATORS THAT
PARTICIPATED AND THOSE FOR ALL
THEIR HARD WORK IN THIS AND THE
NETWORK BECAUSE WITHOUT THEM
THIS WOULDN'T BE GOING ANYWHERE
AND THE NET WORK PRIMARY
INVESTIGATORS FROM EACH SITE AND
THE FNI H WHO PRIMM MED -- WHO
BRIDGES TOGETHER THE STAFF AND
WITH THAT NEXT SARA McCOY WILL
TALK ABOUT HER LEADERSHIP
SCHOLARS PROGRAM.
>> HI, EVERYBODY.
EVERYBODY CAN SEE MY SCREEN
OKAY?
>> LOOKS GOOD.
>> IT'S AN HONOR TO BE HERE TO
SPEAK WITH YOU ABOUT THE AMP AIM
LEADERSHIP SCHOLARS PROGRAM PART
OF AMP AIM.
I'M SARA McCOY AT THE UNIVERSITY
OF WISCONSIN I RUN OUR SJOGREN'S
DISEASE CLINIC AND RUN A WET LAB
AND EXCITING TO TELL YOU ABOUT
THE PROGRAM.
WHAT WE'LL DO IS WE'LL TALK
ABOUT THE GAPS THE LSP WAS
DESIGN TO DISCUSS AND DISCUSS
THE LSP AND WHAT EXACTLY IT IS
AND THEN I'LL DIVE INTO AN
EXAMPLE WHICH IS OUR WORK IN AMP
AIM LSP DEPLOYMENT.
WHY DO WE HAVE THE AMP AIM LSP?
WELL, 80% OF FOLKS WITH AUTO
IMMUNE DISEASE ARE FEMALE.
AND SJOGREN'S DISEASE WHICH IS
MY PASSION AND AREA OF INTEREST
TO TRY TO UNDERSTAND HAS A 9-1
FEMALE TO MALE RATIO AND IN SOME
PUBLICATIONS AS HIGH AS 20-1.
REGARDLESS THE MOST
FEMALE-DOMINANT SYSTEMIC AUTO
IMMUNE DISEASE.
IF WE WANT TO UNDERSTAND THE
HEALTH DISPARITY AND WAYS TO
MITIGATE IT, WE NEED TO DEVELOP
A PROGRAM THAT PROMOTES
UNDERSTANDING THESE DIFFERENCES
AND THAT'S WHERE THE AMP AIM LSP
STEPS IN.
THE GOAL IS TO IMPROVE WOMEN'S
HEALTH WITH SCHOLARS WHO
SPECIALIZE IN WOMEN'S HEALTH
RELATED AUTO IMMUNE DISEASES.
IT'S TO ENHANCE SCHOLAR
LEADERSHIP RAND MENTORSHIP AND
ENCOURAGE SCIENCE AND LEVERAGE
THE AMP AIM RESOURCES AND
SYNERGIZE TO PROMOTE
LONGITUDINAL SCIENCE INITIATIVES
THAT HAVE LEGS THAT CAN LAST AND
LEAD TO IMPORTANT PATHOGENIC
INSIGHTS AND HOPEFULLY CURES FOR
DISEASE.
KNOW I'LL DIVE INTO MY AREA OF
INTEREST WITHIN THE FIELD.
I THINK STROMAL CELLS ARE REALLY
INTERESTING AND THIS PROJECT
FOCUSES ON SALIVARY GLAND
FIBROBLASTS A CELL TYPE.
THAT SAID WE DON'T KNOW THE
EFFECTS OF THE CHRONIC SALIVARY
GLAND INFLAMMATION AND THE
FIBROBLAST CHROMATIN AND
TRANSCRIPTOME AND WE STARTED THE
PROJECT AND FOCUS ON WHAT WE
DISCOVERED ABOUT THE
TRANSCRIPTOME SO FAR.
THE VERY FIRST THING I DID WHEN
WE US AWARDED WITH THIS AMP AIM
LSP IS TO SEEK OUT A REALLY
STRONG TEAM.
ONE OF THESE FACES IS GOING TO
BE FAMILIAR TO YOU, DR. BLAKE
WARNER WHO IS OUR NIDCR MENTOR
AND HE'S AN AMP AIM STAMP
MEMBER.
HE WORKS WITH MYSELF AND HE ALSO
HELPS RUN THE SYSTEMS BIOLOGY
CORE AND WE HAVE ALEX TSOI AIO
INFORMATICIAN AND HELP RUN THE
CORE.
I THOUGHT I BUILT A STRONG TEAM.
I'LL TALK LATER WHERE THE TEAM
CAN TAKE US POTENTIALLY IN THE
FUTURE.
OUR NEXT STEP WAS TO SAY LET'S
START ANSWERING THE QUESTIONS
PROPOSED.
I WAS FORTUNATE TO WORK WITH
DR. BLAKE WARNER AND SHARED THE
LARGEST SINGLE CELL SEQ DATA SET
OF SALIVARY GLANDS AND I'M FO
FOCUSSING ON THESE SAMPLE 15SSA
POSITIVE SJOGREN'S DISEASES AND
WE TALKED ABOUT THE DINKSS AND
PHENOTYPES -- DIFFERENCES AND
PHENOTYPES AND I WANT TO START
WITH A BROAD OVERVIEW OF WHAT WE
FOUND SO FAR.
HERE'S A MAP SHOWING THE GENES
BETWEEN THE SSA POSITIVE
SJOGREN'S DISEASE AND CONTROLS.
IF WE FOCUS IN ON THE FIBER ROW
BLAST POPULATIONS WHAT I THINK
IS INTERESTING IS THE AMOUNT OF
DIFFERENTIALLY EXPRESSED GENES
IS AKIN TO THAT OF MYELOID CELL
WITH A KNOWN ROLE IN SJOGREN'S
DISEASE PATHOGENESIS.
WHEN WE FOCUS ON THE MOST
DIFFERENTLY EXPRESSED GENES FIBE
-- FIBROBLASTS AS A CELL TYPE
OF INTEREST.
THE OTHER REASON WE FOUND THEM
COMPELLING IS THEY'RE EXPANDING.
HERE ON THE RIGHT SIDE YOU CAN
SEE FIBROBLASTS IN BROWN THE SSA
POSIT
POSITIVE SJOGREN'S DISEASE
PATIENTS AND NON-SJOGREN'S.
WE DON'T SEE AS MUCH IN THE
EPITHELIAL POPULATION AND
THERE'S CONTRACTION OF
EPITHELIAL CELLS IN SJOGREN'S
DISEASE.
SO GETTING MORE INTO THE FUN
STUFF.
WHAT IS DIFFERENT ABOUT THESE
FIBROBLASTS IN SJOGREN'S DISEASE
COMPARED TO NONE?
LET'S LEARN A LITTLE BIT ABOUT
IT.
THE RIBOSOMAL TRANSCRIPTS ARE UP
REGULATED IN SJOGREN'S COMPARED
TO CONTROLS AND TGF BETA
TRANSCRIPTS ARE DOWN REGULATED
COMPARED TO SJOGREN'S CONTROLS.
WE ALSO SEE A NICE TREND OF
INTERFERON TRANSCRIPTS
DR. WARNER MENTIONED AND WE
THINK THEY HAVE A ROLE.
AND I'M ALSO INTERESTED IN JAK
INHIBITORS AND THE FIBROBLASTS
ARE DOWN REGULATED TRANSCRIPTS
RELATED TO RP SIGNALLING.
AND FINALLY IN SYSTEMIC
DISEASES, HERE WE SEE IN OUR
SJOGREN'S FIBROBLASTS WE HAVE
INCREASED TRANSCRIPTS RELATED TO
THE COMPLIMENT SYSTEM.
WHAT'S NICE ABOUT SINGLE CELL
RNA SEQ DATA SET IS DISENTANGLE
THE FIBROBLAST SUB SETS.
WORKING WITH A STATISTICIAN AT
MICHIGAN WE STARTED
UNDERSTANDING WHAT THE SUB TYPE
ARE AND I WANT TO FOCUS ON THE
SUBSET OF FIBROBLASTS.
I THINK IT'S A NICE STORY TO
TELL BUT WE HAVE SO MANY TO TELL
FROM THE DATA SET.
WHAT IS DIFFERENT ABOUT THE
FIBROBLASTS?
SOMETHING SIMILAR HAS BEEN
DESCRIBED IN THE LITERATURE
RECENTLY.
THEY'VE BEEN LABELLED SOMETHING
CALLED IMMUNOFIBROBLASTS AT THE
MOST IMMUNE ACTIVE AND WHEN WE
FOCUS ON THE VOLCANO PLOT WE SEE
STRONGER INTERFERON RELATED
TRANSCRIPTS COMPARED TO THE
OTHER SUBSETS.
AND THERE ARE OTHER WAYS TO LOOK
RAT THAT TOO.
HERE ARE THE UPSTREAM
TRANSCRIPTIONAL REGULATORS AND
WE HAVE DIFFERENT CELL TYPE OF
INTEREST AND HERE WE CAN SEE
AGAIN THE FMO SUBTYPE ENRICHED
IN TRANSCRIPTION FACTORS RELATED
TO INTERFERONS INCLUDING IRF1
AND 7 AND 3 AND THE LIST GOES ON
BUT I DIDN'T WANT TO GO THROUGH
TOO MANY OF THAT.
AND THE OTHER THING WE CAN DO IS
LOOK AT THE TRANSCRIPTION FACTOR
NOT ONLY BY DISEASE STATE BUT BY
CELL TYPE.
HERE PITCHNK IS OUR CONTROL ANDU
CAN ONLY SEE THE GREEN BECAUSE
THIS TRANSCRIPTION FACTOR STAT 1
WIN THE INTERFERON SIGNATURE
WHAT YOU SEE CLEARLY IS FMO2 IS
THE ONLY SUBTYPE WITH
TRANSCRIPTION FACTOR EXPRESSION
AND NOT ONLY THAT BUT DISEASE
SPECIFIC IN OUR SJOGREN'S
PATIENTS.
I THINK THE PLOT NICELY
DEMONSTRATES WHEN WE'RE LOOKING
AT OUR FIBROBLAST SUBSETS WE SEE
NOT ONLY DISEASE STATE SPECIFIC
DIFFERENCES WHICH WE'D EXPECT
BUT CAN SEE CELL TYPE SPECIFIC
DIFFERENCES.
TO THE OTHER WAY IS TO LOOK AT
THE CELL-CELL COMMUNICATION AND
WHAT FIBROBLASTS AND FOCUS ON
THE UNIQUE INTERACTIONS WE SEE.
IN THIS IT'S FLIPPED, HIGHER
INTERACTION IS BLUE AND LOWER
INTERACTION IS RED.
AND THESE ARE INTERACTIONS
UNIQUE TO SJOGREN'S FIBROBLASTS
AND IF YOU LOOK AT THE TOP ROW
THOSE ARE THE FMO 2 FIBROBLASTS
AND THE OTHERS IN THE COLUMN
FIVE DOWN THERE'S SIMILARITIES
BETWEEN THE FIBROBLASTS SUB SETS
AND THE FMO2 FIBROBLASTS HAVE
HIGHER COMMUNICATION WITH THE
NEGATIVE CELLS WHICH ARE
PERIPHERALLY GENERATED CELLS
WITH A DIFFERENT PHENOTYPE AND
EFFICACY IN IMMUNOREGULATION.
I SAID OKAY, THE GOAL IS TO
BUILD A STRONG FOUNDATIONAL DATA
DEFINING THE PATHOGENESIS OF THE
FEMALE PREDOMINANT DISEASES.
AND TO FOSTER FUTURE WOMEN
HEALTH RESEARCH TO TRY TO REDUCE
THAT GAP PRESENT.
AND ANOTHER GOAL IS TO SUPPORT
BUILDING STRONG TEAMS AND
PROMOTE SUSTAINABILITY OF FUTURE
PROJECTS.
WITH THE FIBROBLASTS WORK WE'VE
DONE IS TO CORRELATING THEM TO
CLINICAL SYSTEMS AND PHENOTYPES
AND TRANSLATE TO OTHER DISEASES
AND TISSUES AND LUPUS AND
RHEUMATOID ARTHRITIS AND LINK IT
TO GWAS TO OUR UPCOMING E
EPIGENOMIC DATA TO IDENTIFY RISK
VARIANTS AND WITH THE LARGE DATA
SETS WHAT ABOUT OTHER STROMAL
CELLS?
THOSE CELLS ARE INTERESTING AND
I'D LOVE AN OPPORTUNITY TO
EXPLORE.
THESE ARE THE ACKNOWLEDGE MANIES
FOR THE AMP AIM LSP AND THANK
YOU TO EVERYONE FOR YOUR TIME
AND ATTENTION.
>> WONDERFUL.
THIS MINI SYMPOSIUM PROVIDED A
WONDERFUL EXAMPLE OF TEAM
SCIENCE BRIDGING TOGETHER
CLINICAL OUTCOMES, DATA,
EXPLORING DATA RE-USE AND THE
IMPORTANCE OF GETTING THE NEXT
GENERATION INVOLVED.
WE HAVE PERHAPS TIME FOR ONE
QUESTION AND THEN WE'LL MOVE TO
THE INITIATIVES.
THANKS TO ALL OF YOU FROM STAMP.
QUESTIONS FOR THE GROUP?
>> THANK YOU.
THAT WAS FASCINATING.
I HAVE A QUESTION FOR SARA.
THIL IS PAUL KREBSBACH FROM U
UCLA.
YOU SAID YOU LAD STORIES TO TELL
AND WITH THE TRANSCRIPTIONAL
RECTORS WHICH STORIES WILL YOU
HUNT DOWN FIRST AND DECIDE?
THERE'S SO MANY.
MAYBE YOUR LAB CAN HANDLE ALL OF
THEM BUT RIGHT NOW PROBABLY NOT.
>> JENNIFER KING IS AT UCLA AND
HAS A GREAT SJOGREN'S CLINIC AND
WE MEET REGULARLY.
I'M INTO TELLING SMALLER
STORIES.
WARE GOING TO FOCUS ON THE
FIBROBLASTS AND WE'VE GOT
NEGATIVE SUBJECTS AND WE
IDENTIFIED NEW TRANSCRIPTION
FACTORS AND HAVE AN IN VITRO
MODEL SYSTEM.
WE'RE WORKING ON A TWO-DAY
CULTURE BUT HAVE A 3-D CULTURE
SYSTEM AND KNOCKOUT
TRANSCRIPTION FACTORS AND SEE
HOW IT AFFECTS FIBROBLASTS'
BEHAVIOR IN THAT SETTING.
>> THANK YOU.
>> YES, THANK YOU.
I'LL LOOK FORWARD TO WATCHING
THIS GROW.
ALL RIGHT.
SO MOVING ON TO THE NEXT SESSION
WE'LL MOVE ON TO OUR CONCEPT
CLEARANCES.
WE ARE REQUIRED TO DOCUMENT THE
CLEARANCE OF CONCEPTS BY
PRESENTING THE PURPOSE, SCOPE
AND OBJECTIVES IN A PUBLIC FORUM
SUCH AS COUNCIL.
AND GETTING COUNCIL MEMBERS AND
THE PUBLIC AN OPPORTUNITY TO
COMMENT ON THE PROPOSED
CONCEPTS.
FOLLOWING THE PRESENTATION BY
NIDCR COUNCIL MEMBERS WILL LEAD
THE DISCUSSION FOLLOWED BY VOTE
FOR APPROVAL AS THE BASIS OF
DEVELOPING A FUTURE FUNDING
OPPORTUNITY SUCH AS REQUEST FOR
APPLICATIONS OR OTHER NOSIS OR
PARs NIH ISSUES.
WE'LL BEGIN WITH DR. DENA
FISCHER TO PRESENT THE FIRST
CONCEPT.
>> THANK YOU.
GOOD AFTERNOON, EVERYONE.
CAN YOU HEAR ME OKAY?
>> YES.
>> WONDERFUL.
THANK YOU FOR YOUR CONTINUED
ATTENTION DURING TODAY'S COUNCIL
MEETING.
I'M HERE SEEKING COUNCIL'S
CONCURRENCE FOR THIS CONCEPT
TITLED DENTAL PRIMARY CARE
PRACTICE-BASED RESEARCH NETWORK
TO SUPPORT RESEARCH IN CLINICAL
PRACTICES.
I'LL TAKE THE NEXT SLIDE.
SO THIS GOAL IS TO TRANSFORM AND
ADVANCE NIDCR SUPPORT OF
PRACTICE-BASED RESEARCH BY
ENDORSING A DENTAL PRIMARY CARE
BASED RESEARCH NETWORK OR PBRN
BUILDING ON THE KNOWLEDGE GAINED
AND LESSONS LEARNED FROM THE
PREVIOUS AND CURRENTLY FUNDED
NIDCR SUPPORTED PDRNs.
THE GOAL WILL BE ACCOMPLISHED BY
PROMOTING AN EFFICIENT AND AGILE
NETWORK FOCUSSED ON INTEGRATING
ORAL HEALTH CARE INTO WHOLE
PATIENT CARE OR OVERALL HEALTH
OR INFORMATION ON IMPORTANT ORAL
HEALTH PRACTICE IN PRACTICE
SETTINGS AND LOCATIONS.
SO THIS IS A GREAT TIME FOR ME
TO OFFER BACKGROUND ABOUT NIDCR
SUPPORT OF THE DENTAL
PRACTICE-BASED RESEARCH NETWORKS
AND YOU HEARD ABOUT THIS
THROUGHOUT THE DAY PARTICULARLY
FROM DR. WEBB-CYRIAQUE.
THE FIRST CYCLE OF FUNDING WAS
2005 TO 2012 WHEN NIDCR
SUPPORTED THREE REGIONAL DENTAL
PBRNs IN THREE DISTINCT AREAS IN
THE UNITED STATES.
THEY CONDUCTED RESEARCH STUDIES
AND ALSO THESE THREE SEPARATE
PBRNs ON STUDIES ACROSS THE
THREE REGIONAL NETWORKS.
THEN THE SECOND CYCLE TOOK PLACE
FROM 2012 TO 2019 AND DURING
THIS CYCLE OF FUNDING NIDCR
SUPPORTED ONE NATIONAL DENTAL
PBRN AND IT WAS CONFIGURED WITH
SIX REGIONAL HUBS OR INSTITUTIVE
SITES BY ONE AWARD.
IT ALSO SUPPORTED THE PBRN
RESEARCH STUDIES WITHIN THE
LARGER NETWORK.
OVER THE COURSE OF THE FUNDING
PERIOD THEY EXPANDED
PRACTITIONERS TO INVOLVE
PRACTITIONERS ACROSS THE UNITED
STATES.
IT BEGAN IN 2019 AND CONTINUE
THROUGH MAY 2026.
NIDCR IS SUPPORTING THE NETWORK
INFRASTRUCTURE THROUGH TWO
AWARDS.
ONE IS THE ADMINISTRATIVE AND
RESOURCE CENTER WHICH HAS SIX
REGIONAL NODE OR ADMINISTRATE IR
SITES AND ONE SPECIALTY
DENTISTRY NODE.
AND THAT CENTER IS PRIMARILY
RESPONSIBLE FOR RECRUITING AND
RETAINING PRACTITIONERS ACROSS
THE UNITED STATES ALL STATES IN
THE UNITED STATES AND THESE
PRACTITIONERS ARE PARTICIPATING
IN RESEARCH STUDIES BY
COLLECTING RESEARCH DATA ON
THEIR CONSENTING PATIENTS.
SO THEN THERE'S A NETWORK
COORDINATING CENTER WHICH
MAINTAINS A PRACTITIONER MEMBER
DATABASE.
AND STATISTICAL SUPPORT FOR
STUDIES CONDUCTED WITHIN THE
PBRN.
IN THE CURRENT STRUCTURE THE
RESEARCH STUDIES ARE FUNDED
THROUGH GRANT MECHANISMS.
THERE ARE OVER 8400 PRACTITIONER
MEMBERS OF AND A MEMBER PLAY NOT
NECESSARILY BE A PARTICIPATING
IN RESEARCH STUDIES.
8400 MEMBERS AND CLOSE TO 5700
OF THOSE HAVE PARTICIPATED IN
RESEARCH STUDIES.
COMBINED THEY HAVE ENROLLED OVER
75,000 PATIENTS AND CONTRIBUTED
DATA FROM OVER 790,000 PATIENT
HEALTH RECORDS.
FOR EACH OF THE THREE CYCLES FOR
STUDIES CONDUCTED IN THE
NATIONAL DENTAL PBRN HAVE BEEN
THOSE GENERATED FROM
PRACTITIONERS AND RESEARCHERS
PROPOSING TO CONDUCT RESEARCH
WITHIN THE INFRASTRUCTURE
OVERALL WE CAN SAY THE PRACTICE
BASED NETWORK IS A UNIQUE VENUE
IN WHICH TO CONDUCT RESEARCH IN
WHICH DENTAL PRACTITIONERS AND
PARTICIPANTS ARE ABLE TO ENROLL
PATIENTS.
EACH PRACTITIONER MAY ENROLL A
RELATIVELY SMALL NUMBER OF
PATIENT PARTICIPANTS BUT TAKEN
WITH A LARGE NUMBER
PARTICIPATING THE STUDY CAN
ENROLL LARGE NUMBERS
EFFICIENTLY.
TO ADDRESS PERCEIVED GAPS IN THE
PBRNs THE FUTURE DENTAL PRIMARY
CARE WILL EMPHASIZE TOPICS THAT
PROMOTE THE INTEGRATION OF ORAL
HEALTH CARE INTO MEDICAL CARE OR
WHOLE PERSON HEALTH.
THE FUTURE NETWORK WILL FORMAL
I'D CLINICAL SKILL TRAINING AND
MENTORING AND PROVIDE
OPPORTUNITIES FOR ENHANCE 789
FOR THOSE CONDUCTING AND/OR
PARTICIPATING IN RESEARCH
STUDIES.
AND THE FUTURE NETWORK WILL ALSO
EMPHASIZE RECRUITING
PRACTITIONERS WHO PRACTICE IN
RURAL AREAS AND/OR PRIMARILY
CARE FOR UNDER SERVED
POPULATIONS.
TO GIVE AN EXAMPLE OF TOPICS OF
INTEREST RESEARCH FOCUS ON
EVIDENCE TO SUPPORT SCREENING OF
MEDICAL CONDITIONS AND RISK
BEHAVIORS BY ORAL HEALTH
PROFESSIONALS AND APPROPRIATE
FOLLOW-UP FOR CARE.
SOME EXAMPLES MAY INCLUDE
COMPARING THE EFFECTIVENESS OF
DIFFERENT SCREENING APPROACHES
IN DENTAL CARE SETTINGS,
EVALUATED EFFORTS AMONG HEALTH
CARE PROFESSIONALS AND ENHANCE
SCREENING AND REFERRAL USING
VARIOUS FORM OF TECHNOLOGY AND
NEW INSTRUMENT ALGORITHMS OR
TECHNOLOGIES AND RESEARCH FOR
RATES OF APPROVAL FOLLOWING
SCREENING.
OTHER TOPICS ARE ORAL DISEASE
PREVENTION OR TREATMENT OUTCOME
THROUGH LONGITUDINAL STUDIES AND
INTEREST OF SPECIALTY
ORGANIZATIONS.
NEXT WE'LL MOVE ON TO HAVING OUR
FIRST COUNCIL REVIEWER PROVIDE
FEEDBACK AND THAT WOULD BE
DR. PIETRO.
>> THANK YOU, DR. FISCHER.
I'M SUPPORTIVE OF THE CONCEPT
AND MANY REASONS.
AS DR. FISCHER MENTIONED, NIDCR
HAS BEEN SUPPORTING THE PBRNs
SINCE 2005 AND HAVE BEEN VERY
SUCCESSFUL AND SOME INCLUDE LIKE
6,000 PRACTITIONERS ENROLLED
OVER 75,000 PATIENTS AND LOOKED
AT ALMOST 7 800,000 PATIENT
HEALTH RECORDS AND PRODUCED 225
PUBLICATIONS AND THERE'S 18
ADDITIONAL STUDIES ONGOING AND
EXPECTED TO BE COMPLETED IN THE
THIRD PHASE AND TRIALS AND
STUDIES AND STUDIES INVOLVING
COVID-19.
AND THOSE METRICS OF
PRODUCTIVITY AND THERE'S THE
IMPORTANCE OF PBRNs AND ENGAGE
RESEARCHERS AND THAT'S CRUCIAL
TO PROGRESS AND THEY ARE
FACILITATE THE TRANSLATION OF
RESEARCH FINDINGS INTO CLINICAL
PRACTICE.
WE KNOW DENTAL PBRNs CAN BE
PRODUCTIVE RESEARCH ENDEAVORS.
WE TO THE THEY CONTRIBUTE
SIGNIFICANTLY TO THE LANDSCAPE
OF PRIMARY CARE.
SO THAT ALONE WOULD BE ENOUGH TO
CONTINUE IT BUT THIS PARTICULAR
CONCEPT NOW HAS CHANGES THAT
MAKE IT EVEN MORE DESIRABLE AND
BETTER.
THE ADMINISTRATIVE STRUCTURE IS
GOING TO BE GENERALLY THE SAME
BECAUSE IT'S EFFECTIVE BUT THERE
ARE THREE SIGNIFICANT CHANGES
THAT HAVE BEEN INCORPORATED.
THE FIRST IS THE ADDITION OF THE
FORMAL CLINICAL RESEARCH SKILL
TRAINING AND THE MENTORING FOR
MEMBERS OF THE PBRN.
THAT'S VERY IMPORTANT AND IT
WILL BE VERY HELPFUL TO PROGRESS
OF THE PBRNs AND TOPICS OF
INTEGRATING ORAL HEALTH CARE TO
MEDICAL CARE.
IN MY OPINION THAT'S AN
OUTSTANDING DECISION AND ALIGNS
WITH WHAT WE HEARD ABOUT THE
RESEARCH PRIORITIES AND THE
FINAL CHANGE IS EXTREMELY
IMPORTANT ALSO THAT'S THE
EMPHASIS ON INCLUDING MORE
PRACTITIONERS AND THE UNDER
SERVED AND IN MY CURRENT PBRN MY
UNDERSTANDING IS THAT'S QUITE
SMALL AND THOSE THAT PLAY A ROLE
OR SERVING THE UNDER SERVED IS
ONLY ABOUT 5% AND GET THE LEVEL
TO 50%.
I THINK THIS IS AN OUTSTANDING
GOAL.
IT WILL ACCELERATE THE
SIGNIFICANCE OF THE RESEARCH
FINDINGS TO THOSE RURAL AND
UNDER SERVED POPULATIONS AND
THIS IDEA OF INCORPORATING MORE
ACTIVITY AMONG THE UNDER SERVED
AND RURAL POPULATIONS ALIGNS
WITH NIDCR PRIORITIES AND
CRITICAL NIH PRIORITIES.
SO OVER ALL I THINK THE PROPOSED
CONCEPT WILL IMPROVE ON
SOMETHING ALREADY SUCCESSFUL
WITH IMPROVED DISTRIBUTION OF
THE PRACTITIONERS TO THE RURAL
AND UNDER SERVED COMMUNITIES AND
THE FOCUS ON SCREENING MEDICAL
CONDITIONS OR ALIGNING WITH
MEDICAL CARE I THINK THE PBRNs
WILL BECOME MORE CRUCIAL TO
IMPROVING ORAL HEALTH AND FOSTER
THE INTERSECTION BETWEEN ORAL
AND SYSTEMIC HEALTH.
FOR ALL THOSE REASONS I'M VERY
SUPPORTIVE OF THIS.
>> THANK YOU.
WONDERFUL COMMENT AND THANKS
VERY MUCH FOR YOUR INPUT.
NOW WE CAN MOVE TO DR. DICKINSON
AND HEAR ABOUT ANY FEEDBACK
PERTAINING TO THIS CONCEPT.
I AGREE WITH EVERYTHING BRUTH
UP AS FAR AS WHY WE NEED TO
CONTINUE THE PROGRAM.
I KIND OF TOOK A NON-TRADITIONAL
LOOK AT THIS AND SO I WANTED TO
COMMENT ON A COUPLE THINGS.
THOSE IN THE CLINICAL PRACTICE
CONTINUE TO BE CHALLENGED BY THE
MULTIPLE CHOICES WE OFTEN HAVE
FACING US AS WE TEMPT TO PROVIDE
THE BEST POSSIBLE CARE TO OUR
PATIENTS.
FOR EXAMPLE SEVERAL YEARS AGO A
PATIENT WAS SENT TO DENTISTS TO
GET DIAGNOSIS AND TREATMENT PLAN
WITHOUT REGARDS TO COST AND
OTHER FACTORS.
SURPRISINGLY OR NOT THERE WAS A
WIDE VARIETY OF SUGGESTED
TREATMENT PLANS.
CERTAINLY THERE'S DIFFERENCES
WITH COST AND FACTORS ARE
INTRODUCED.
SO OFTEN DIFFERENT TREATMENT
PLANS ARE OFFERED TO THE
PATIENTS BASED ON THEIR
CIRCUMSTANCES.
HOWEVER OFTEN THE DECISION TO
TREAT A TOOTH OR NOT COMES IN
OFTEN AND IT'S IMPORTANT TO GAIN
EVIDENCE-BASED CARE ABOUT THE
FACTORS THAT CREATE THE DECISION
POINTS THAT ARE CRITICAL TO
MAKING SOUND DECISIONS ABOUT THE
CARE OF EACH INDIVIDUAL PATIENT.
IF THE GOAL IS TO TRANSLATE
RESEARCH FINDINGS INTO HELPING
THE PRACTITIONER MAKE THE
DECISIONS, THIS CONCEPT NEEDS TO
BE CONTINUED WITH THE BROADER
BASE NETWORK IT SUGGESTS.
THE BROADER-BASED APPROACH IS
ONE OF THE KEYS TO GAINING DATA
AND PROVIDING IMPORTANT CHANGES
IN CLINICAL TREATMENT CHOICES IN
A MORE SYSTEMIC MANNER,
BROADENING THE BASE OF INVOLVED
PRACTITIONERS AND RECRUITING
PRACTITIONERS IN RURAL AND UNDER
SERVED AREAS ARE OF BENEFIT TO
THE GOALS OF THE CONCEPT.
THE CHALLENGE OF FINDING
PRACTICES WHERE 50% OF THE
PATIENTS WHO RECEIVE BENEFITS
THROUGH MEDICAID MAY BE OF
CHALLENGE.
MOST PRACTICES ARE PEDIATRIC OR
POSSIBLY DENTAL SCHOOLS.
HOW WILL YOU DISSEMINATE AND SEE
IT'S IMPLEMENTED IN A DIFFERENT
METHOD USED CURRENTLY IN THE
PBRN NETWORK.
INCLUDING A WHOLE HEALTH
COMPONENT WOULD BE OF GREAT
BENEFIT TO THIS POPULATION.
MOST DENTAL PRACTITIONERS TAKE
BLOOD PRESSURE AND PULSE AND
TEMPERATURE.
THERE'S MORE THEY CAN DO
INCLUDING THE PULSE OXIMETER AND
BLOOD SUGAR OR A1C READING.
WE'RE CAPABLE IS OF DOING THIS
ON A REGULAR PARTICULARLY THOSE
WHO EXPERIENCE HEALTH YKT
INEQUITIES AND DON'T HAVE A PCP.
IT'S A BROAD BASED APPROACH WITH
SIGNIFICANT CHANGES TO THE PBRNs
WHICH EXIST.
I'M CONCERNED ABOUT THE WIDE
REACH ON MANY SUBJECTS ALL OF
WHICH HAVE COMPLEXITIES.
PERHAPS I'M FOCUSSING ON KEY
ISSUES THAT COULD BE BROADENED
IN THE FUTURE AND MIGHT BE OF
INTEREST.
I THINK ONE OF THE THINGS WE'RE
SEEING IN THE PROFESSION IS THE
USE OF A.I.
CURRENTLY THERE ARE FIVE
APPROVED A.I. SYSTEMS WHICH I
THINK WILL HAVE A GREAT IMPACT
ON THE PROFESSION OF DENTISTRY.
I SEE MORE EVIDENCE IN
EVIDENCE-BASED CARE GOING
FORWARD.
I THINK IT'S A GREAT CONCEPT AND
I CERTAINLY SUPPORT WHAT LOUISA
SAID AND ENCOURAGE YOU TO VOTE
POSITIVE FOR IT.
>> ARE THERE ANY OTHER COMMENTS
FROM COUNCIL MEMBERS BEFORE WE
MOVE TO VOTING?
>> THIS IS PAUL FROM UCLA.
MY INTENT IS NOT TO BE A STRONG
CONTRARIAN BUT RATHER TO SAY
AFTER ALMOST 20 YEARS AND A LOT
OF DOLLARS I'M WONDERING IF WHAT
KIND OF REAL ASSESSMENT NIDCR
HAS TAKEN TO LOOK AT THE SUCCESS
OF HOW THIS HAS GONE.
IT'S A LONG TIME.
THERE'S PLENTY OF TIME TO MAKE
THE RIGHT ASSESSMENTS.
YOU CAN COUNT HOW MANY PAPERS
PER DOLLAR OR YEAR.
HOW HAS IT -- WHAT'S THE IMPACT
OF IT SO FAR.
AND TRANSFORMATIONAL THINGS HOW
WE TREAT PATIENTS.
AND WHETHER THEY'RE IN A REAL OR
URBAN SETTING.
>> I'LL TRY TO RESPOND TO YOUR
QUESTION.
SO I WOULD OFFER THAT WITH EACH
CYCLE OF FUNDING NIDCR HAS
PERFORMED AN INDEPENDENT REVIEW
OR ASSESSMENT OR EVALUATION OF
THE CYCLE AND THERE MAY NOT BE A
LOT OF DETAIL BUT THE WAY I'D
VIEW THIS IS IN GENERAL AND IT'S
PROMOTED A MORE CONSERVATIVE
APPROACH TO ORAL HEALTH CARE AND
ON PARTICULAR TOPICS THAT HAVE
BEEN STUDIED IN THE NETWORK.
SO AS DR. DICKINSON HAS
MENTIONED THERE'S THE QUESTION
DO YOU TREAT OR NOT TREAT A
TOOTH OR TREAT OR NOT TREAT A
CONDITION.
HOW DO YOU BEST MANAGE IT?
TAKEN TOGETHER THE RESEARCH HAS
SHOWN ADVANTAGE TO CONSERVATIVE
CARE TO LESS INVASIVE TREATMENT
AND MARCHING IN A LESS INVASIVE
APPROACH.
I WOULD OFFER THAT WITHOUT
GETTING INTO A LOT OF SPECIFICS
ABOUT EACH PARTICULAR TOPIC.
I THINK THAT'S PRETTY PROFOUND
PERSONALLY.
>> I DON'T KNOW HOW MANY
DENTISTS ARE IN THE UNITED
STATES OR WORLD BUT HOW DO WE
THEN TAKE THE STATEMENT AND YOUR
FINDINGS THAT YOU JUST DISCUSSED
ABOUT MORE CONSERVATIVE
TREATMENT AND GET THAT TO ALL
THE DENTISTS AROUND THE COUNTRY?
THAT'S WHERE YOU'LL MAYBE THE
IMPACT.
>> I AGREE.
IT MAY BE A LARGER ISSUE BUT
CERTAINLY WE KNOW THIS BEGETS
PUBLICATIONS AN MANY HAVE BEEN
IN THOSE JOURNALS OF INTEREST TO
THE ORAL HEALTH COMMUNITIES SUCH
AS THE JOURNAL OF THE AMERICAN
DENTAL ASSOCIATION IN SOME CASES
PERHAPS WORK THAT HAS
CONTRIBUTED TO GUIDELINES WHICH
OF COURSE THE WORK OF GUIDELINE
DEVELOPMENT IS COMPLEX AND THAT
MIGHT SPEAK TO A LITTLE BIT MORE
DIRECTLY TO OFFERING CLINICAL
CARE BASED ON CERTAIN
GUIDELINES.
I THINK IN OTHER CASES IT MIGHT
BE BEST PRACTICES BASED UPON
THAT WHICH HAS BEEN IN THE ORAL
HEALTH LITERATURE.
AS DR. DICKINSON MENTIONED THERE
MAY BE OTHER WAYS TO DISSEMINATE
INFORMATION FROM THE PBRN TO THE
PRACTICING COMMUNITY.
CERTAINLY THAT'S SOMETHING THAT
CAN BE EXPLORED IN THE NEXT
CYCLE.
IT'S GOES BEYOND THE LITERATURE
PUB LUSHED THROUGH THE --
PUBLISHED IN THE PBRN AND
THROUGH ORAL HEALTH IN GENERAL.
>> I WANTED TO RESPOND HOW DO WE
DISSEMINATE INFORMATION.
I THINK WE HEARD EARLIER TODAY
ABOUT TRYING TO ENGAGE OUR
DENTAL STUDENTS AND
UNDERSTANDING HOW PBRN'S WORK
AND BACK TO YOU PAUL AS THE DEAN
AND THE STUDENTS BECOME ENGAGED
AND KNOW ABOUT THIS ACTIVITY THE
MORE THAT PAY ATTENTION TO WHAT
COMES FROM THE ACTIVITY.
WE CAN DO THAT AT OUR DENTAL
SCHOOLS AND MAKE SURE THE
STUDENTS ARE AWARE AND WE'RE ALL
TEACHING EVIDENCE-BASED
DENTISTRY IT'S JUST ANOTHER
ASPECT OF THAT TO PARTICIPATE IF
THEY CAN AND AT THE LEAST TO BE
AWARE OF THE SYSTEMS GOING ON
AND THE OUTCOMES.
>> VERY GOOD THANK YOU.
GREAT POINT.
WE HEARD ABOUT NIDCR'S OTHER
INITIATIVE WHERE PRACTICE-BASED
RESEARCH IS BEING CONDUCTED IN
DENTAL SCHOOL.
HOPEFULLY THERE'LL BE
DOVETAILING BETWEEN THE EFFORTS.
>> ARE WE READY TO VOTE ON THE
CONCEPT?
>> SO MOVED.
>> WOULD ANYONE LIKE TO SECOND?
>> I SECOND.
>> ALL IN FAVOR.
>> YES.
>> ANY OPPOSED?
ALL RIGHT.
THANK YOU VERY MUCH.
WE'LL MOVE ON TO THE NEXT
CONCEPT BY DR. ORLANDO LOPEZ.
>> GREETINGS AND GOOD AFTERNOON.
EVERYBODY HEAR ME OKAY?
>> CAN YOU TURN YOUR MONITOR ON?
>> THANK YOU FOR ALLOWING ME TO
SEEK COUNCIL'S CLEARANCE FOR THE
CONCEPT TO REVOLUTION I'D
DENTAL, ORAL AND CRANIOFACIAL
MEDICINE AND THIS IS FOR DIGITAL
TWINS AND ADVANCING INNOVATION
IN OPTIMIZING CLINICAL OUTCOME
IN DENTAL, ORAL AND CRANIOFACIAL
MEDICINE AND I SERVE AS THE
COORDINATOR FOR THE SMALL
BUSINESS PROGRAM DEVELOPED WITH
COLLEAGUES DR. WAN AND DR. OKI
WHO DIRECTS THE DATA SCIENCE
BIOLOGY AND BIO INFORMATICS
PROGRAM.
AND BY LEVERAGING DIGITAL TWINS
TECHNOLOGIES WE AIM TO
ACCELERATE CUTTING EDGE RESEARCH
TO PATIENT CARE AM KAPPLICATIOND
THEY'RE EXPECTED TO SERVE AS
POWERFUL TOOLS FOR PREDICTIVE
TESTING AND INNOVATION PUSHING
THE BOUNDARIES OF WHAT'S NOW
POSSIBLE IN DENTAL, ORAL AND
CRANIOFACIAL MEDICINE.
SECOND, WE LOOK TO TRANSFORMING
TREATMENTS.
IN DOING SO WE INTEND TO HAVE
DIGITAL TWIN TECHNOLOGIES TO
REPLICATE SCENARIOS TO INTEGRATE
WITH REAL TIME DATA AND
PREDICTIVE ANALYTICS AND IN
DOING THIS WE'LL HAVE A
CAPABILITY TO REVOLUTIONIZE
PLANNING MAKING IT MORE PRECISE
THAN EVER BEFORE.
THIRD, OPTIMIZING PATIENT
OUTCOMES BY TRADITIONAL METHODS
THROUGH INFORMATION WE SEEK TO
ENHANCE DIAGNOSTIC ACCURACY,
OPTIMIZE CARE DELIVERY AND
ENABLE CONTINUOUS PATIENT
SPECIFIC ADJUSTMENTS LEADING TO
IMPROVED EFFICIENCY AND
EFFECTIVENESS IN PATIENT
OUTCOMES.
IN TERMS OF BACKGROUND, IT IS
BROADLY ACCEPTED PRACTICES IN
ORAL, DENTAL AND CRANIOFACIAL
MEDICINE RELY ON GENERALIZED
APPROACHES AND CASES WHICH CAN
LEAD TO SUBOPTIMAL OUTCOMES AND
PATIENT EXPERIENCES.
THIS IS WHERE DIGITAL TWINS
OFFER A PARADIGM SHIFT AND BASED
NATIONAL ACADEMIES WITH A
DIGITAL TWIN CAN BE KEY DEFINED
AND UPDATED WITH DATA TO PREDICT
OUTCOME.
THIS TECHNOLOGY ALLOWS US TO
MODEL A PATIENT'S SPECIFIC
STRUCTURES AND CONDITIONS
PROVIDING LEVEL OF PRECISION
TRADITIONAL METHODS CANNOT
MATCH.
BY CAPTURING DIGITAL MODELS OF A
PATIENT'S ORAL ANATOMY AND
INTEGRATING THEM WITH REAL TIME
DATA WE CAN OPTIMIZE PLANNING
BEFORE IMPLEMENTATION.
THIS INTERACTION BETWEEN THE
VIRTUAL AND PHYSICAL MODELS
ENABLES ENHANCED TREATMENT OF
THE PATIENT'S TREATMENT AND
EFFECTIVENESS AND IMPROVE
PATIENT SATISFACTION IN THE
SHORT AND LONG TERM.
AND THE VIRTUAL MODELS REPLICATE
AN INDIVIDUAL'S HEALTH STATUS BY
INTEGRATING A WIDE RANGE OF DATA
SOURCES RANGING FROM MEDICAL
RECORDS, IMAGING DATA TO GENETIC
INFORMATION ON ENVIRONMENTAL
FACTORS AND THE MODELS NOT ONLY
ENABLE PERSONALIZED TREATMENT
PLAN BUT PREDICTIVE ANALYTICS
FOR THE DISEASE PROGRESSION AND
OPTIMIZATION OF HEALTH CARE
DELIVERY.
THERE'S A DYNAMIC INTERACTION
BETWEEN THE PHYSICAL AND VIRTUAL
MODEL.
IN THE CONTEXT OF CRANIOFACIAL
MEDICINE, THE EXAMPLE TA COMES
TO MIND IS DENTAL IMPLANT
OPTIMIZATION AND DIGITAL TWINS
CAN LOOK HOW TO IMPACT OUTCOMES
AND ALLOWING FOR FINE TUNING
BEFORE A PHYSICAL PROCEDURE IS
UNDERTAKEN.
A
AND AND THERE WERE DIFFICULTIES
IN DIAGNOSIS AND TREATMENT,
PLANNING FOR COMPLEX CONDITIONS
LIKE DISORDERS AND ORAL CANCERS
AND ISSUES RELATED TO DATA
PRIVACY, INFRASTRUCTURE AND
INTEROPERABILITY AND IT PRESENTS
OPPORTUNITIES AND BY ADDRESSING
THE GAP WE CAN UNDERSTAND OUR
COMPLEX PROCESSES, OPTIMIZE
TREATMENT PLANS AND ENHANCE
INTERVENTION ACROSS SPATIAL,
TEMPORAL AND BIOLOGIC SCALE.
AND CATALYZING INNOVATION AND
THE CYCLES OF DENTAL, ORAL AND
CRANIOFACIAL INNOVATIONS.
AND OPPORTUNITIES IN THE FIELD
ITSELF.
SO FIRST DENTAL, ORAL AND
CRANIOFACIAL TOOLS.
WE CAN USE DIGITAL TWINS TO
ACCELERATE APPROACHED AND
OPTIMIZING THE NEW INNOVATIONS.
THERE'S BROAD OPPORTUNITIES FOR
OPPORTUNITIES IN DIGITAL TWINS
INCLUDING OPTIMIZING
INTERVENTIONS AND TREATMENTS FOR
TEMPORAL MANDIBULAR DISORDERS
AND ORAL CANCERS AND DIGITAL
TWINS ALSO OFFER POTENTIAL TO
ENHANCE EARLY DETECTION
CAPABILITIES PARTICULARLY
ADDRESSING CONDITIONS SUCH AS
TEMPORAL MANDIBULAR DISORDERS
AND ORAL CANCERS.
THIRD, OPPORTUNITIES IN CLINICAL
WORK FLOW INTEGRATION INTO
ROUTINE DENTAL CARE AND TRAINING
IS CRUCIAL BUT OFFERING USER
FRIENDLY INTERFACES AN TRAINING
WE CAN ENSURE THE TECHNOLOGIES
ARE INTEGRATED INTO DAILY
PRACTICE.
FOURTH, LONG-TERM IMPACT
EVALUATION WILL BE ABLE TO HAVE
AN OPPORTUNITY TO ASSESS HOW
DIGITAL TWINS BASED APPROACHES
MAY IMPROVE TREATMENT POSITION,
EFFICIENCY, PATIENT SATISFACTION
AND CLINICAL OUTCOMES AND
COMMUNITY-BASED APPLICATIONS
WILL ALLOW US TO CUSTOMIZE
OUTCOMES.
INTEGRATION OF THE DIGITAL TWIN
TECHNOLOGIES TO DENTAL, ORAL,
CRANIOFACIAL MEDICINE IS NOT
ONLY A TECHNICAL ADVANCEMENT BUT
OFFERING A PARADIGM SHIFT AND
MOVE TO FUTURE CARE THAT'S MORE
PRECISE, PERSONALIZED AND
EFFECTIVE THAN EVER BEFORE.
I INVITE YOU TO JOIN ME IN
SUPPORTING THE INITIATIVE AND
TRANSFORM PATIENT CARE AND
OUTCOMES IN MEDICINE.
THANK YOU VERY MUCH FOR YOUR
CONSIDERATION.
THANK YOU.
>> THANK YOU, DR. LOPEZ FOR
SHARING THIS CUTTING EDGE
CONCEPT ON DIGITAL TWINS AND I
AM TRULY EXCITED TO SEE THIS
WORK BEING ADVANCED IN NIDCR.
OUT WAS ESTABLISHED IN
ENGINEERING A DIGITAL TWINS ON
MY CAR COULD BE BASED ON THE
ENGINE, THE MATERIALS, THE
FORCES APPLIED ON THOSE
COMPONENTS, COMBINED WITH REAL
TIME DATA PULLED IN FROM ALL THE
SENSORS IN YOUR VEHICLE.
AND YOU COULD USE IT TO SEE HOW
THAT ENGINE WOULD PERFORM IN
DIFFERENT CONDITIONS LIKE COLD
WEATHER WE DON'T GET IN
TENNESSEE OR USE IT TO PREDICT
WA PARTS OF THE ENGINE MIGHT
WEAR OUT FASTER.
IT SEEMS WE SHOULD BE ABLE TO
APPLY THE CONCEPTS IN ORAL
HEALTH CARE AND RESEARCH.
AS YOU'VE DESCRIBED IT'S PRETTY
NOVEL AND UNTESTED IN MEDICINE
SO FAR WHICH PRESENTS A FEW MORE
CHALLENGES.
THE DEFINITION AND OUR
UNDERSTANDING OF DIGITAL TWINS
IN HEALTH IS STILL INFLUX.
I THINK THE METHOD OF
IMPLEMENTING AND EVALUATING ARE
NOT CLEARLY ESTABLISHED.
SO I WOULD HAPPY TO SEE THE
EMPHASIS ON THE IMPORTANCE OF
WHY UP DATING BUT MAY BE HARDER
ATTAIN THE SCALES OF
AVAILABILITY AND IMPACT AND
COMMUNITY-BASED APPLICATIONS.
THE MAIN THING I'VE THOUGHT
ABOUT PATIENT DATA PRIVACY AND
CYBER SECURITY AND HAVE TO BE
CRITICAL COMPONENTS BECAUSE DATA
ABOUT MY CAR ENGINE IS NOT THE
SAME AS DATA ON MY HEALTH AND
THERE'S ALSO UNEXPLORED ONLY
CAL, LEGAL AND SOCIAL
IMPLICATIONS WE DON'T QUITE
UNDERSTAND YET.
BUT BASED ON YOUR PRESENTATION I
CAN TELL THESE THOUGHTS ARE ALSO
ON YOUR RADAR.
I DO WANT TO RECOGNIZE THAT THIS
CONCEPT APPEARS TO BUILD
DIRECTLY ON OPPORTUNITIES
OUTLINED BY THE DATA SCIENCE
STRATEGY WORKING GROUP THAT
WE'VE HEARD ABOUT IN PRIOR
COUNCIL.
THEY CHALLENGED US TO FIND NEW
METHODOLOGICAL APPROACHES AND
THOUGH THEY DIDN'T MENTION
DIGITAL TWINS SPECIFICALLY, THEY
DID AND I QUOTE SAY SIMULATION
METHODS CAN FACILITATE THE
ASSESSMENT OF NOVEL AND COMPLEX
INTERVENTIONS TO TACKLE ORAL
HEALTH INEQUALITIES INCLUDING
SCALABILITY, EFFECTIVENESS AND
LONG-TERM SUSTAINABILITY.
I THINK THAT IS WHAT THIS
CONCEPT IS TRULY AIMING FOR.
BECAUSE THESE APPROACHES ARE NEW
THE CONCEPT IS INHERENTLY MORE
RISKY BUT WILL CATALYZE
INNOVATION AND HAS THE POTENTIAL
TO HAVE A LASTING IMPACT IN OUR
RESEARCH FIELD.
I FULLY SUPPORT THE CONCEPT.
>> THANK YOU SO MUCH.
I APPRECIATE YOUR COMMENTS.
>> IT'S A BALANCE OF EXCITEMENT
AND LIMITATIONS.
THIS IS CUTTING EDGE.
VERY NEW EVEN IN THE MEDICAL
FIELD WITH ONCOLOGY AND
CARDIOLOGY IS WHERE DIGITAL
TWINS ARE A LITTLE BIT MORE
ADVANCED.
I DO SHARE SOME CHALLENGES AND
CONCERNS STEPH BROUGHT UP.
THE MAJOR ONE YOU KNOW IS THE
BIOLOG
BIOLOGICAL HETEROGENEITY OF
PATIENTS IS A CHALLENGE FOR
DIGITAL TWINS TECHNOLOGY AND
INTEGRATION.
YOU'RE TALKING ABOUT MULTISCALE
AND YOU HAVE MANY LAYERS OF DATA
AND WILL PROBABLY NEED HIGHER
RESOLUTION MODELS TO BE
INTEGRATED.
I THINK IN TERMS OF CONCEPT I
THINK I'M SUPPORTIVE.
THE KEY POINT IS HOW WE FRAME
THIS TO BE VERY SPECIFIC.
MAYBE STARTING WITH
METHODOLOGISTS IS ONE WAY TO
START SINCE IT'S A NEW
TECHNOLOGY.
ONE SUGGESTION IS ORAL CANCER
TMD IS GREAT BUT WHY NOT
INFECTIOUS DISEASES.
THE MICROBIOME DATA IS EASY TO
COLLECT AND ABUNDANT AND CAN BE
STRATIFIED TO THE PATIENT'S
HEALTH COULD BE ANOTHER
POTENTIAL APPLICATION FOR
DIGITAL TWINS TO INCLUDE
INFECTIOUS DISEASES AND
MICROBIOME DATA.
UME NOT SURE IF ORTHODONTIC
PLACEMENT OR IMPLANT PLACEMENT
ARE WELL ESTABLISHED.
WE'RE DOING DENTISTRY IN THAT
AREA.
MAYBE ORAL CANCER TMD FOR SURE
BUT INFECTIOUS DISEASES COULD BE
ANOTHER AREA THAT COULD BE
INTEGRATED.
OVER ALL I FULLY SUPPORT THIS
CONCEPT.
MAYBE JUST FRAMING WHERE THE
FOCUS ARE FOR THE CONCEPT.
THAT WOULD BE MY ONLY
SUGGESTION.
THANK YOU.
>> EXCELLENT THANK YOU VERY
MUCH.
VERY INSIGHTFUL AND SUGGESTIONS.
THIS WILL PROVIDE ADDITIONAL
CONTEXT TO SOME OF THE CONCERNS
AND LIMITATIONS STEMMING FROM
THE NATIONAL ACADEMIES REPORT
THAT CAME OUT EARLIER THERE'S
BEEN A SIGNIFICANT AND ONE
RECOMMENDATION WAS FOR
COALESCENCE OF THE DIFFERENT
FEDERAL AGENCIES TO COME
TOGETHER SEE THE INFRASTRUCTURE
BEING DEVELOPED.
PART OF DIGITAL TWINS FAST TRACT
ACTION COMMITTEE BUT ENCOMPASSES
ALL DIFFERENT KINDS OF FEDERAL
AGENCIES THAT WILL BE LOOKING AT
THE DIGITAL TWINS FOR MANY
DIFFERENT DOMAINS.
THAT'S COMING IN THE FUTURE
WHERE WE'RE TALKING ABOUT HOW TO
BEST ADDRESS THE CRITICAL
INFRASTRUCTURE NEEDS REGARDING
DATA AND PRIVACY SECURITY.
THERE'S SOME FRAME WORKS WE'LL
BE ABLE TO LEVERAGE IN THE
DISCUSSION AND DEVELOPMENT OF
THE TOOLS.
WELL TAKEN IN TERMS OF A LOT OF
THE CONCERNS AND LOOKING FORWARD
TO EXCITING IMPLEMENTATION OF
THESE IN THE FUTURE.
>> WE HAVE TIME FOR MAYBE ONE
MORE COMMENT.
IF NOT WE CAN GO TO THE VOTING.
WOULD A MEMBER OF COUNCIL LIKE
TO MOTION TO APPROVE THE
CONCEPT.
>> I MORE TO APPROVE THE
CONCEPT, STEPHANIE DUDDA.
>> WOULD SOMEONE LIKE TO SECOND.
>> I SECOND.
MICHELLE KOO.
>> ALL IN FAVOR.
THANK YOU.
ANY OPPOSED?
THANK YOU, ORLANDO.
WE'LL MOVE TO THE THIRD CONCEPT
PRESENTED BY DR. BACCAGLINI.
DR. DANA FISCHER AND I WOULD
LIKE TO SEEK COUNCIL CLEARANCE
FOR INTEGRATION OF MEDICALLY
NECESSARY PREVENTION TREATMENT
AND MONITORING OF ONCOLOGIC
RELATED DENTAL, ORAL AND
CRANIOFACIAL COMPLICATIONS.
THE GOAL IS TO PROMOTE RESEARCH
TO REDUCE DENTAL, ORAL AND
CRANIOFACIAL COMPLICATIONS
DURING AND AFTER CANCER
TREATMENT OF ANY SITE.
THE INITIATIVE HAS THE MEDICAL
CARE AN ORAL CARE.
TRANSLATIONAL RESEARCH WITH
CLINICAL APPLICATIONS AND
RESEARCH THAT MAY EXTEND TO THE
COMMUNITY LEVEL TO RESPOND TO
THE INITIATIVE.
AND CHANGES IN MEDICARE POLICY
TO REDUCE COVERAGE GAP LINKED TO
THE MEDICAL ONCOLOGY SERVICES.
TO PROVIDE SOME BACKGROUND,
ABOUT 40% OR TWO OF FIVE
AMERICANS WILL BE DIAGNOSED WITH
CANCER ADENOCYTES IN THEIR LIFE
TIME AND MOST WILL LIVE FIVE
YEARS OR LONGER.
OVER THE DECADE THE NUMBER IS
EXPECTED TO INCREASE TO NEARLY
23 MILLION AMERICANS.
COMPLICATIONS FROM TREATMENTS
MAY INCLUDE SPREAD OF
INFECTIONS, CRANIOFACIAL GROWTH
AND DENTAL GROWTH AND
OSTEONECROSIS AND PAIN AND
POORER NUTRITION AND DYSPHAGIA
AND FIBROSIS AND MUCOSITEIS.
THEY CAN INTERFERE WITH CARE
LEADING TO REDUCED CANCER
TREATMENT AND INCREASED RISK
SUCH AS RISK OF COMPLICATIONS.
DEF
AND IT MAY REQUIRE ADDITIONAL
INTERVENTIONS.
AND THE RESULT IS INCREASED
HEALTH CARE COST AND PATIENT
BURDEN.
AND LEAD TO HEALTH INEQUITIES.
THUS THERE'S A NEED TO REDUCE
COMPLICATIONS FROM MANAGEMENT
AND INTEGRATE NECESSARY CARE AND
DENTAL SERVICES ARE LINKED TO
THE CLINICAL SUCCESS OF MEDICAL
ONCOLOGY OF SERVICES AND THERE'S
A CRITICAL NEED OF COORDINATED
MEDICAL AND DENTAL CARE FOR
ONCOLOGY PATIENTS.
THE INITIATIVE PROMOTES RESEARCH
TO BUILD NEW EVIDENCE ALONGSIDE
IMPLEMENTATION OF NEW CMS
POLICIES AND GAPS AND THE
INITIATIVE RESPONDS TO THE 2024
HHS APPROPRIATION BILL WHICH
STATES DENTAL CARE IS INTEGRAL
TO THE MEDICAL MANAGEMENT OF
NUMEROUS DISEASES AND MEDICAL
CONDITIONS AND THE LACK OF
MEDICALLY NECESSARY ORAL HEALTH
CARE HEIGHTENED THE RISK OF
MEDICAL COMPLICATIONS.
THE COMMITTEE URGES NIH TO FUND
ADDITIONAL RESEARCH IN THE AREA
AND CONDUCT TRIALS TO DETERMINE
WHICH ORAL CARE INTERVENTIONS
ARE MOST EFFECTIVE FOR IMPROVING
MANAGEMENT AND REDUCING
MALIGNANT CANCERS IN EMERGENCY
ROOM DEPARTMENT ADMISSION RATES.
THIS IS ALSO ADDRESSING ONE OF
THE NIDCR PRIORITIES AS
DR. WEBB-CYRIAQUE MENTIONED THIS
MORNING.
EXAMPLES OF RESEARCH STATUS IN
RESPONSE TO THE INITIATIVE
INCLUDE COORDINATED MEDICAL AND
DENTAL APPROACHES TO PREVENT,
REDUCE COMPLICATIONS OF HIGH
RISK PATIENTS AND PROPOSE
STUDIES OF POORLY UNDERSTOOD
COMPLICATIONS SUCH AS THOSE AS
NOVEL TREATMENTS AND METHODS TO
IMPROVE CLINICAL WORK FLOWS OR
REDUCE BARRIERS TO REDUCE
PREVENTIVE MEASURES AND REDUCE
COMPLICATIONS.
ANALYSIS OF ELECTRONIC HEALTH
RECORD OR INTEGRATED DENTAL CARE
AND DATA AND MECHANISTIC STUDIES
COULD BE INCLUDED TO SUPPORT AND
ENRICH THE PROPOSED CLINICAL
STUDY.
AND TO COUNCIL MEMBERS DR. NOR
AND MORON-KON SEPSIAN AGREED TO
REVIEW THIS.
>> THE CONCEPT THAT WAS BROUGHT
FORWARD BY YOURSELF AND
DR. FISCHER IS TIMELY AND HIGHLY
IMPACTFUL.
AND RADIATION IN THE HEAD AND
NECK AREAS CAN LEAD TO CARIES
AND PERIODONTAL DISEASE AND
THERE'S MANY THERAPIES THAT CAN
CAUSE THIS IN THE PATIENTS.
RADIATION CAN INCREASE THE
CHANCE OF OSTEONECROSIS WHICH
CAN BE DEBILITATING UP TO FIVE
YEARS AFTER RADIATION.
WITH IMPROVEMENTS IN CANCER
TREATMENT THERE'S AN INCREASE IN
LIFE EXPECTANCY AND THEREFORE
THE MANAGEMENT OF DENTAL, ORAL
AND CRANIOFACIAL COMPLICATIONS
IS IMPACT AND POTENTIAL TO
PREVENT COMPLICATIONS AND MAY
LEAD TO NEW EVERYDAY THAT
DEMONSTRATE THE CRITICAL
IMPORTANCE OF INSURANCE FOR
DENTAL PROCEDURES TO THE OUTCOME
AND QUALITY OF LIFE OF PATIENTS
WITH CANCER.
I THINK YOU DID A WONDERFUL JOB
PUTTING THE CONCEPT TOGETHER AS
I SAID IS EXTREMELY SIGNIFICANT
TO ME.
I HAVE A COUPLE RECOMMENDATION
TO FOSTER DEVELOPMENT AND
EVALUATION OF THE EFFECTIVENESS
OF EDUCATIONAL PROGRAMS FOR
POST-CANCER TREATMENT PATIENTS
OF THE IMPORTANCE OF GOOD ORAL
HEALTH.
THIS IS ESPECIALLY SIGNIFICANT
BECAUSE PATIENTS HAVE MANY OTHER
WORE RID -- WORRIES AND ARE ORAL
HYGIENE MY IMPACT OVER ALL
QUALITY OF LIFE AND NUTRITION
FOR PATIENTS AND IT'S IMPORTANT
TO REMEMBER MANY PATIENTS COULD
BE MORE SUSCEPTIBLE TO
INFECTIONS DUE TO ANTI-CANCER
THERAPIES TO THE IMMUNE SYSTEM.
ANOTHER REASON WHERE PROGRAMS TO
STIMULATE AND INFORM ABOUT ORAL
HEALTH BECOME IMPORTANT.
MY OTHER SUGGESTION IS MINOR IS
TO AN EXISTING AREA OF INTEREST
AND THE FIFTH LISTED IN YOUR
LIST THE FIRST IN THE SECOND
SLIDE TO ADD RADIATION THERAPY
AND CONTROLLED RESEARCH STUDIES
TO TEST EFFECTIVENESS OF
DIFFERENT DENTAL CARE PROTOCOLS
PRIOR TO OR DURING CHEMOTHERAPY
OR RADIATION THERAPY TO IMPROVE
CLINICAL GUIDELINES.
I SAY THAT BECAUSE DEPENDING ON
THE TYPE OF TREATMENT OR CHEMO
OR A COMBINATION BUT BOTH HAVE
SIGNIFICANT IMPACTS ON ORAL
HEALTH.
THE POTENTIAL IMPACT AND
SIGNIFICANCE OF RESEARCH
STIMULATED BY THE CONCEPT ARE
TRULY EXCEPTIONAL.
THE CONCEPT IS TIMELY AS IT
ADDRESSES THE INCREASED NEED FOR
ORAL AND DENTAL CARE OF PATIENTS
WHO EN ABOUT -- WHO BENEFITTED
POST THERAPY AND I SUPPORT THE
CONCEPT WITHOUT ANY HESITATION.
THANK YOU.
>> I AGREE IT'S A TIMELY CONCEPT
AND HASN'T BEEN INVESTIGATED OR
EXPLORED IN THE PAST.
IT'S IMPORTANT AND I APPRECIATE
YOUR EFFORTS ON PUTTING
TOGETHER.
I HAVE A FEW COMMENTS AND
SUGGESTIONS.
THE FIRST ONE IS AS A BASIC
SCIENTIST I APPRECIATE WHEN WE
DEFINE A CONCEPT AND TALKING
ABOUT TRANSLATIONAL AND
CLINICAL.
I THINK IT WOULD BE GOOD TO
EMPHASIZE THIS IS GOING TO BE
SUPPORTING BASIC RESEARCH THAT
CAN PROVIDE NEW MECHANISTIC
INSIGHTS HOW TO IMPROVE DENTAL
TREATMENT.
AND WHEN WE SAY TRANSLATIONAL IT
CAN BE CLINICAL OR BASIC BUT
BASIC SHOULD BE INCORPORATED
HERE.
THE OTHER THING I THINK THAT'S
IMPORTANT WHERE YOU DESCRIBE
INTERESTS IS COMORBIDITY.
AND ONE OF THE IMPORTANT
COMORBIDITIES IS PAIN
MANAGEMENT.
MANY TIMES THE CANCER SURVIVORS
HAVE BEEN EXPOSED TO TREATMENT
AND SOME HAVE BEEN TAKEN OPIOIDS
AND BECAUSE OF CHRONIC OPIOID
TREATMENT CAN LEAD TO ANALGESIA
AND TOLERANCE AND INCORPORATED
AS A GOAL HOW YOU MANAGE PAIN
DURING COMPLICATIONS AFTER DOC
DEPENDING ON HOW THE HISTORY OF
THE PATIENT AND AGAIN THAT COULD
BE A PILOT WIN CLINICAL AND
BASIC RESEARCH.
THE OTHER COMORBIDITY THAT
SHOULD BE INCLUDED IS SOMETIMES
BECAUSE OF THE TREATMENT THESE
PATIENTS ARE TREATED SHOULD BE
STUDIED AND WHAT I'LL MENTION
ABOUT CONTROL AND STUDIES TO
TEST THE DIFFERENT PROTOCOLS
DURING OR PRIOR OR AFTER CHEMO
OR RADIO THERAPY.
IT SHOULD BE DONE WITH BASIC
STUDIES YOU CAN DO THIS WITH
DIFFERENT MODELS AND WOULD BE
GOOD TO UNDERSTAND THE BEST TIME
TO PROVIDE THAT TREATMENT.
ONE FINAL COMMENT I HAVE THAT IS
BIG PICTURE, I UNDERSTAND IT'S
SUPPORTED BY ONLY NIDCR.
IS THERE ANY REASON WHY NCI
CAN'T BE INVOLVED IN THIS?
YOU CAN HAVE RFAs BY TWO
INSTITUTES OR MORE AND MAY BE
ABLE TO BRING PEOPLE NOT IN THE
DENTAL FIELD AND WORKING IN
BIOLOGY AND COULD PROVIDE A
DIFFERENT POINT OF VIEW AND
EXPAND RESEARCH BUT IT'S MY LAST
POINT.
THANK YOU VERY MUCH.
>> THANK YOU, MORON-CONCEPCION
WE'RE PENDING THE APOSCONTACT W
NCI.
>> IT'S GREAT WHEN WE CAN BRING
IN A DIFFERENT PERSPECTIVE AND
THAT'S THE WAY TO FIND NEW
APPROACHES OF THERAPEUTIC
TARGETS.
THAT SOUNDS GOOD.
>> THANK YOU.
>> IS THERE ANY OTHER COMMENT?
IF NOT WOULD A MEMBER OF COUNCIL
LIKE TO MAKE I MOTION.
>> WOULD ANYONE LIKE TO SECOND.
>> SECOND, PAUL.
>> THANK YOU.
ALL IN FAVOR?
THANK YOU.
ANY OPPOSED?
THE NEXT CONCEPT ARE WE READY TO
MOVE ON?
WILL BE PRESENTED BY DR. IDA.
>> GOOD AFTERNOON.
UME THE DIRECTOR OF ORAL HEALTH
DISPARITIES AND INEQUITIES
PROGRAM IN THE DIVISION OF
EXTRAMURAL RESEARCH.
THE CONCEPT PROPOSAL I'M
PRESENTING FOR COUNCIL
CONCURRENCE IS COMMUNITY ENGAGED
RESEARCH TO ADVANCE ORAL HEALTH
INTERVENTION MODELS FOR
RACIAL/ETHNIC MINORITY HIV/AIDS
POPULATIONS.
THE GOAL IS TO SUPPORT
EFFECTIVENESS AND EQUITY OF
HIV/AIDS AND ORAL HEALTH
INTERVENTION MODEL FOR RACIAL
AND ETHNIC MINORITIES LIVING
WITH HIV/AIDS OR AT RISK FOR
ACQUIRING HIV IN THE UNITED
STATES.
AND WHILE NEW INFECTIONS HAVE
DECREASED IN RECENT YEARS,
NON-HISPANIC BLACK AND LATINO
PEOPLE ARE DISPROPORTIONATELY
AFFECTED BY HIV AS SHOWN IN THE
FIGURE SHOWING THE DISTRIBUTION
IN U.S. POPULATION BY RACE AND
ETHNICITY ON THE RIGHT AND HIV
INCIDENTS BY RACE AND ETHNICITY
ON THE LEFT.
SO NON-HISPANIC BLACK PEOPLE
ACCOUNTS FOR NEW HIV INFECTIONS
AND AMONG BLACK WOMEN WAS TEN
TIMES THAT OF NON-HISPANIC WHITE
WOMEN AND FOUR TIMES THAT OF
LATINO WOMEN IN 2021.
AMERICAN INDIAN AND ALASKAN
NATIVE PEOPLE REPRESENT A LOW
NUMBER BUT THE RATE OF NEW
DIAGNOSIS IS TWICE HIGHER OF
NON-HISPANIC WHITE PEOPLE.
CDC DATA USING THE CONTINUUM OF
HIV CARE FRAMEWORK INDICATE 87%
OF 1.2 MILLION PEOPLE ESTIMATED
TO LIVE WITH HIV IN THE UNITED
STATES IN 2022 WERE LIVING WITH
DIAGNOSED HIV.
THEY KNOW THE DIAGNOSIS.
AND 66% OF THEM WITH DIAGNOSED
HIV HAD AT LEAST ONE CD4 VIRAL
LOAD CARE AND 47% WERE RETAINED
IN CARE BY HAVING TWO OR MORE
VIRAL LOAD TEST RESULTS OF AT
LEAST THREE MONTHS APART AND 57%
HAD A VIRAL SUPPRESSION AND BY
LOOKING AT THE HIV CARE
CONTINUUM CARE DATA BY RACE AND
ETHNICITY THE HIV CARE RECEIVED
AND VIRAL SUPPRESSION WERE THE
LOWEST AMONG AMERICAN INDIAN AND
ALASKAN NATIVE PEOPLE AND THE
PREVALENCE OF RETENTION IN HIV
CARE WAS THE LOWEST AMONG NATIVE
HAWAIIANS AND MEN WHO HAVE SEX
WITH MEN WITH DIAGNOSED HIV
FEWER HISPANIC LATINO MEN AND
NATIVE HAWAIIAN OR OTHER PACIFIC
ISLANDER MEN RECEIVED HIV
MEDICAL CARE THAN OVER ALL MSM
POPULATION AND BLACK MEN HAVE
THE LOWEST IN THE MOST RECENT
LABORATORY TESTS.
SO THESE NATIONAL DATA INDICATE
THAT HIV DIAGNOSIS AND ACCESS
AND OUTCOME OF HIV CARE MAY BE
AFFECTED BY THE COMPLEX
INTERACTION BETWEEN INDIVIDUAL
RACE, ETHNICITY, OTHER SOCIAL
IDENTITIES AND SYSTEMS OF
INEQUALITY.
THERE'S SUBSTANTIAL DISPARITIES
IN DENTAL CARE ACCESS AND
OUTCOME BY RACE AND ETHNICITY AS
WELL AS WE ALL KNOW.
IT BEEN REPORTED UNMET DENTAL
CARE NEEDS ARE MORE THAN TWICE
PREVALENT AMONG PEOPLE LIVING
WITH HIV/AIDS.
AND THIS COULD BE BECAUSE OF THE
HEIGHTENED NEEDS AND RISK FOR
ORAL HEALTH PROBLEMS AMONG
PEOPLE LIVING WITH HIV OR AT
RISK OF ACQUIRING HIV.
COMPOUNDED BY HIV/AIDS RELATED
AND UNRELATED BARE YEARS TO
DENTAL CARE INCLUDING SOCIAL
DETERMINATES OF HEALTH, STIGMA,
BIAS, RACISM AND
DISCRIMINATIONS.
THIS RESPONDS TO THE INEQUITIES
IN THE BUDGET AND ALIGNS WITH
ORAL HEALTH DISPARITIES
INEQUITIES RESEARCH PROGRAM
FUTURE INITIATIVE ADAPTED AS
MENTIONED EARLIER TODAY.
THE POPULATION COMMUNITY OF
INTEREST FOR THIS INITIATIVE IS
RACIAL AND ETHNIC MINORITIES
LIVING WITH OR AT RISK OF HIV
AND THE POTENTIAL APPLICANTS
SHOULD PROPOSE STRATEGIES FOR
EQUITABLE PARTNERSHIPS AND
EXISTING COMMUNITY ENGAGEMENT TO
DETERMINE THE CAPACITY OF
MEANINGFUL CO-LEARNING WITH THE
TARGET COMMUNITY ON THE OPTIMAL
MODEL OF ORAL HEALTH AND HIV
CARE DELIVERY.
IN ADDITION TO SCIENTIFIC
PROPOSAL.
SO THE EXAMPLES OF AREAS OF THE
INITIATIVE INCLUDE BUT NOT
LIMITED TO STUDIES TO UNDERSTAND
MULTI-LEVEL BARRIERS AND
FACILITATORS FOR HIV/AIDS AND
ORAL HEALTH INTERVENTIONS BY
PAYING ATTENTION TO
INTERSECTIONALITY OR TEST
ACCEPTABILITY AND EFFECTIVENESS
OF NON-TRADITIONAL POINT OF
ENTRY FOR INTERVENTIONS RELATED
TO HIV/AIDS IN ORAL HEALTH
SCREENING AND COORDINATION OF
KNOWLEDGE AND SERVICES.
OR ADDRESS STRUCTURAL RACISM AND
SOCIAL DETERMINATES OF HEALTH
EFFECTS HIV/AIDS AND ORAL HEALTH
CARE ACCESS AND OUTCOMES AND
ASSESS COMMUNICATION AND
ENGAGEMENT STRATEGIES FOR
EQUITABLE UPTAKE OF
EVIDENCE-BASED INTERVENTION AND
SUSTAINABLE PRE VENTION FOR ORAL
AND DENTAL DISEASES OR ASSESS
THE SUPPORT INTEGRATION IN THE
PROGRAM SITES.
THANK YOU AND TWO REVIEWERS FOR
THE INITIATIVES ARE
DR. KREBSBACH AND DR. DICKINSON.
THANK YOU.
I LOOK FORWARD TO YOUR COMMENTS.
>> THANK YOU FOR PUTTING THAT
TOGETHER.
I THOUGHT IT WAS A VERY
DIFFICULT SOCIAL PROBLEM TO
ADDRESS AND I THINK YOU DID A
REALLY GREAT JOB AND THINK IT'S
EXTRAORDINARILY IMPORTANT.
THERE ARE SIGNIFICANT DATA
DISPARITIES WITH HIV/AIDS AND
ORAL HEALTH AMONG THESE RACIAL
AND ETHNIC MINORITIES.
I THINK IT'S REALLY IMPORTANT TO
WORK ON THE UNDER SERVED
POPULATIONS.
I THOUGHT IT WAS A COMPREHENSIVE
APPROACH WITH THE
COMMUNITY-ENGAGED RESEARCH.
IT'S IMPORTANT THAT WE PARTNER
WITH THE AFFECTED COMMUNITIES
TOO.
THEY DO HAVE CERTAIN STRUCTURAL
BARRIERS LIKE STIGMA AND RACISM
AND OTHER HEALTH INEQUITIES THAT
MAKES IT EVEN MORE COMPLEX FOR
THEM.
I LIKE THE ORAL SYSTEMIC
CONNECTION.
I THINK IN DENTISTRY WE'RE
TAKING A STRONG LOOK AT THAT AND
THIS CONTINUES THAT AND THIS
CONCEPT MOVING FORWARD WE
PROVIDE THAT HOLISTIC APPROACH
TO MANAGING THE CHRONIC DISEASES
WHEN YOU HAVE OTHER COMORBI
COMORBIDITIES AND IMPORTANT TO
THE SOCIAL DETERMINATES OF
HEALTH.
YOU PROBABLY DON'T WANT TO BE
REDUNDANT BUT I THOUGHT IT
SHOULD HAVE BEEN UP ON THE FIRST
PAGE THERE WHEN YOU TALKED ABOUT
RACISM AND ETHNICITY TOO.
THE SOCIAL DETERMINATES OF
HEALTH MAY BE MORE IMPORTANT
THAN JUST THE ETHNICITY OR
PROFILE AND YOU DID ADDRESS THAT
LATER ON IN THE SECOND PAGE OF
THE CONCEPT CLEARANCE.
I LIKE THE PARTNERSHIP WITH THE
LARGER COMMUNITY-BASED
ORGANIZATIONS LIKE THE RYAN
WHITE PROGRAM AND URBAN SETTINGS
HAVE HOSPITALS THAT TAKE THESE
PATIENTS AND THOSE WOULD BE GOOD
PARTNERS AS WELL.
I LIKE IT WAS LOOKING AT
DIVERSITY OF THE POPULATION AND
THE AGE CONSIDERATION.
I THOUGHT THOSE WERE ALL STRONG
AND POTENTIAL WEAKNESS SIDE I
THINK IT WAS VERY COMPREHENSIVE
AND THAT CERTAINLY IS A STRENGTH
BUT ALSO HAS POTENTIAL TO BE A
WEAKNESS AS WELL.
I THINK THAT PROBABLY FOR THE
NEXT PHASE TO CONSIDER HOW
COMPREHENSIVE YOU WANT IT WITH
THE APPLICATIONS TO HAVE THE
RIGHT STUDY SECTION MAKE UP TOO
TO REVIEW THOSE.
AS FAR AS SUSTAINABILITY, I
THINK EYE CRITICISM OF THE PBRN
ONES IS THE COMMUNITY-ENGAGED
RESEARCH IS TIME CONSUMING AND
RESOURCE INTENSIVE ONE NEEDS TO
KEEP AN EYE ON THAT.
THE POPULATIONS ARE SOMETIMES
DIFFICULT TO RECRUIT TO THESE
STUDY.
I THINK THAT'S GOING TO BE EYE
CHALLENGE GOING FORWARD AND WITH
THEP P BRNs WE NEED WELL
ESTABLISHED OUTCOME MEASURES SO
WHILE WE ARE DOING THIS
IMPORTANT RESEARCH WE HAVE THE
RIGHT OUTCOME MEASURES TO MAKE
DOES DECISIONS BUT THOUGHT IT
WAS A GOOD CONCEPT CLEARANCE AND
EXTRAORDINARY IMPORTANT TOPIC TO
CONTINUE TO LEARN MORE AND
CORRECT THESE INEQUITIES IN OUR
POPULATIONS.
>> THANK YOU VERY MUCH.
>> I GUESS IT'S ME NEXT.
IT'S HARD TO BELIEVE THIS
DECEMBER WELL REACH THE 40 YEAR
POINT OF AT WHICH TIME RYAN
WHITE OVERCAME THE DIAGNOSIS
WITH HIV.
AS A RESULT OF THAT THE CLOCK
WENT TO ZERO AND WE'D HAVE A
GENERATION.
AND BEGINNING IN 1990 WE MADE
STRIDES IN ADDRESSING NOT ONLY
THE INCIDENTS OF THE DISEASE BUT
THE TRAGIC FACT THAT WE SEE MANY
DISPARITIES ACROSS THE SPECTRUM
OF RACE, LOCATION, BELIEFS,
HEALTH DISPARITIES AND YET TODAY
THERE REMAINS THE GREATER
CHALLENGE OF BRINGING EQUALITY
TO POPULATIONS.
I BELIEVE WE'RE GETTING CLOSER
BUT WE STILL A MOUNTAIN OF
CHALLENGES.
YEAR AFTER YEAR WE CONTINUE TO
OBSERVE DISPARITIES IN VIRAL
SUPPRESSION AND POPULATIONS
FACING VIRAL SUPPRESSION.
THE CONCEPT WOULD ADDRESS THESE
DISPARITIES OF THE MOST
VULNERABLE WITH A TARGET
POPULATION IN RELEVANT
COMMUNITIES.
THESE ARE ALSO SCIENTIFIC
PROPOSALS.
IT ALSO DELIBERATELY ADDRESSES
THE INEQUALITY OF APPROPRIATE
CARE.
A KEY POINT IN MY OPINION TO BE
YOUR COMMENT OF PAYING ATTENTION
TO INTERSECTIONALITY.
THE MORE INEQUALITIES WE SEE THE
MORE BURDEN ON THE SCIENCE
COMMUNITY TO SEEK AND UNDERSTAND
THE MANY FACETS OF HOW A HIGHER
BURDEN AFFECT THE MENTAL WELL
BEING OF THESE POPULATIONS AND
IT'S NOT JUST A SIMPLE LINEAR
FACTOR RATHER ONE PLUS ONE
EQUALS THREE OR FOUR OR FIVE.
THE FAIRNESS AND EQUALITY.
STUDIES SEEM LIKE AT EVERY
CONCEPT OR ACTION WE CONTINUE TO
SEE THE SAME THINGS AND HOPE WE
CAN GIVE MORE ENERGY AS A DIRECT
RESULT OF CONTINUING TO SEE
HEALTH INEQUITIES WE SEE TODAY
HOW CAN WE ADDRESS THEM AND MAKE
SURE YOU USE ALL THE RESOURCES
OF THE RYAN WHITE ORGANIZATION
HAS AND THERE'S BEEN WORK IN ALL
THESE MANY MANY YEARS WITH THEIR
GOAL TRYING TO CREATE THE
GENERATION THAT'S FREE IN HIV.
OVER ALL THE CONCEPT IS GREAT
AND PAUL IDENTIFIED POSITIVE
THINGS ABOUT THE CONCEPT SO I
CERTAINLY ENCOURAGE YOU TO LOOK
FAVORABLY UPON THIS CONCEPT.
THANK YOU.
>> THANK YOU FOR YOUR REVIEW AND
IMPORTANT COMMENTS.
I TOOK NOTES AND WILL
INCORPORATE YOUR SUGGESTIONS.
>> ARE THERE ANY OTHER COMMENTS?
IF NOT WOULD A MEMBER LIKE TO
MOTION THE CONCEPT.
>> SO MOVED BY PAUL.
>> WOULD SOMEONE LIKE TO SECOND.
>> I'LL SECOND.
>> ALL IN FAVOR?
ANY OPPOSED?
THANK YOU.
WE'LL MOVE ON TO THE FINAL
CONCEPT BY TAMARA McNEALY.
>> GOOD AFTERNOON, EVERYONE.
I'M HERE TO SEEK COUNCIL'S
CONCURRENCE ON AN INITIATIVE
THAT ENTITLED MODULATING THE
MICROBIOME TOWARDS HEALTH.
HEALTHY ORAL MICROBIOME EXISTS
IN A STATE OF BALANCE.
THIS IMAGE REPRESENTS ALL THE
VARIOUS ASPECTS THAT ARE IN PLAY
WHEN WE TALK ABOUT THAT BALANCE.
IT'S NOT ONLY THE ORGANISMS
PRESENT BUT ALSO THOSE ORGANISMS
WITHIN A SPACE IN
GEOGRAPHY.
ONE A VARIABLE SHIFTS THE WHOLE
SYSTEM CAN BE AFFECTED.
WE KNOW ONCE PANEL GENIC ORG
MIXES SHIFT TOWARDS DYSBIOSIS
AND DISEASE IF IT CAN SHIFT TO
DISEASE WE CAN ASK HOW DO WE
SHIFT THE DISEASE MICROBIOME
BACK TOWARDS HEALTH.
IT'S TO FOCUS EFFORTS ON
UNDERSTANDING THE MICROBIOME AS
A COMMUNITY AND FOCUS ON
DEVELOPMENT OF MICROBIOME
DIRECTED THERAPIES FOR ORAL
DISEASE.
WE EXPECT THE OUTCOME AND
SUCCESSFUL PROJECTS WILL THEN
LEAD TO NOVEL OPTIONS THAT
MODULATE THE MICROBIOME
PROMOTING A RETURN TO OR
MAINTENANCE OF HEALTH WHILE
REDUCING THE RELIANCE ON
ANTIMICROBIALS AND ACHIEVING
IMPACT ONLY THE ORAL CAVITY
HEALTH.
THESE PLAY HAMAY HAVE POSITIVE
EFFECTS ON ORAL DISEASE.
RESEARCH IN THE ORAL MICROBIOME
FIELD HAS RESULTED IN THE WEALTH
OF DATA OF INDIVIDUAL ORGANISMS,
NEE
NICHES AND WE HAVE DATA IN
METABOLOMICS AND DATA ON THE
ORGANISMS PRESENT IN HEALTH AND
DISEASE SCENARIOS.
WE HAVE DATA FROM A VARIETY OF
IMAGING TECHNIQUES DEMONSTRATING
THE IMPORTANCE OF BIOGEOGRAPHY
AND SPATIAL STRUCTURE IN THE
MICROBIOME.
THOUGH OUR KNOWLEDGE OF
INTERPLAY HAS VASTLY IMPROVED
WITH ALL OF THIS INFORMATION,
THE TRANSLATION TO THERAPEUTICS
HAS SO FAR BEEN RATHER LIMITED.
WE HAVE A NEED TO HARNESS THE
DATA TO DEVELOP MORE ROBUST
PIPELINES FOR ORAL THERAPY.
YOU MIGHT ASK HOW DO WE KNOW
MODULATION OF THE MICROBIOME
WILL HELP?
WE CAN TAKE TWO EXAMPLES BECAUSE
WE KNOW AFTER AN INTENSIVE
PERIODONTAL TREATMENT IF YOU
MAIN TRAIN ORAL HYGIENE, HAVE
MORE FREQUENT DENTAL VISITS YOU
CAN PREVENT REOCCURRENCE.
YOU CAN MAINTAIN THAT HEALTHY
COMMUNITY.
WE ALSO KNOW THIS IS THE CASE
AFTER CARIES TREATMENT.
THIS SUGGESTS IT IS POSSIBLE TO
SHIFT THE MICROBIOME BACK TO
HOMEOSTASIS BUT WHAT IF WE CAN
DO IT IN A WAY THAT LEADS TO A
MORE STABLE, LONGER LASTING
MAINTENANCE WITHOUT ANTIBIOTICS
BECAUSE WE'RE PROVIDING SUPPORT
TO THE HEALTHY MICROBIOME?
MICROBIOME DIRECTED THERAPIES
HAVE BEEN AROUND FOR A WHILE AND
GAINED ATTENTION THROUGH WORK IN
THE GUT MICROBIOME FIELD.
PARTICULARLY WITH THE SUCCESSION
OF USING THE FECAL MICROBIOME
TRANSPLANT TO RESTORE A HEALTHY
GUT MICROBIOTA WITH C DIVI SILL
AND LED TO CURE RATE.
SINCE THEN A NUMBER OF THERAP
HAVE BEEN INVESTIGATED AND NOW
WE CAN CONSIDER THERE ARE
GENERALLY FOUR CATEGORIES.
DIET AND PROBIOTICS THAT TARGET
EXPANSION OF ORGANISM,
RECONSTITUTION WITH BACTERIAL
CONSORTIA, THE USE OF ENGINEERED
MICROBIOTA AND BIO ACTIVE
COMPOUNDS.
DEF WE LOOK AT HOW THE
MICROBIOTA SUPPORT, TOLERATE OR
REJECT EACH EITHER WITHIN THE
COMMUNITY ENVIRONMENT AND HOW TO
SELECT THOSE BEST FIT FOR
THERAPEUTIC USE.
MICROBIOTA DIRECTED
COMPLEMENTARY DIETS AND HOW THAT
RELATES TO DYSBIOSIS OF A
COMMUNITY AND TARGETING OF
PATHOGENIC SPECIES AND
COMPUTATIONAL APPROACHES TO
PREDICT, ANALYZE AND MONITOR HOW
COMMUNITIES TRANSITION BETWEEN
HEALTH AND DYSBIOSIS.
SMALL MOLECULE THERAPEUTICS AND
MEDIATORS AND INTEGRATION OF THE
OMICS-BASED APPROACHES
PARTICULARLY THE METABOLOMICS TO
HELP EXAMINE HOW ORAL
COMMUNITIES CHANGE FUNCTIONALLY
AND TAXONOMICLY OVER TIME TO
TARGET DEVELOPMENT FOR
MODULATION THERAPY.
SO SOME SPECIFIC COMBRARZ OF
INTEREST INCLUDE TARGETED PANEL
GEN ELIMINATION THERAPIES,
COMMENSAL DRIVEN MODULATION
STRATEGIES AND MECHANISMS
DRIVING THE COMMUNITY FROM
DYSBIOSIS TO HEALTH AND TARGETED
THERAPIES AFFECTING HOMEOSTASIS.
WE HOPE TO ENCOURAGE THE FIELD
TO BUILD UPON THE CURRENT WEALTH
OF DATA FROM THE ORAL AS WELL AS
FROM OTHER MICROBIOME FIELD AND
DEVELOP THERAPEUTIC OPTIONS
BASED ON UNDERSTANDING OF THE
MICROBIOME RELATIONSHIP AND
COMMUNITY FUNCTIONS.
THE OTHER ASPECT IS THAT WE
UNDERSTAND THE DEGREE OF
INTERINDIVIDUAL VARIABILITY OF
THE ORAL MICROBIOME DOES SUGGEST
A PERSONALIZED TARGETED AND
DEFINED APPROACH TO THERAPY MAY
OFFER GREATER CHANCES OF
THERAPEUTIC SUCCESS.
OUR TWO COUNCIL REVIEWERS THAT
AGREED TO ASSESS THIS INITIATIVE
OR CONCEPT ARE DR. NOR AND
DR. KOO.
THANK YOU.
>> I THINK DR. KOO IS GOING TO
GO FIRST.
>> THANK YOU.
VERY NICELY PUT TOGETHER.
OFF THE BAT I'M VERY
ENTHUSIASTIC ABOUT THE CONCEPT.
I THINK YOU PUT IT VERY WELL
TOGETHER THE REASONS AND I THINK
IT'S A NATURAL EVOLUTION OF THE
INITIATIVES IN THE MICROBIOME
AND RECENT NOSI ON THE
FUNCTIONAL MICROBIOME.
A NATURAL EVOLUTION TO TRY TO
FIND THERAPEUTIC APPROACHES TO
MODULATE.
I THINK SOME ENTHUSIASM WITH THE
HIGH IMPACT AND THERE'S ORAL AND
SYSTEMIC HEALTH COMPONENTS
ALLOWING COLLABORATION IN
CHECKING THE RIGHT BOXES.
I LIKE THE IDEA OF THE
CONSORTIA-BASED THERAPY.
I CHOSE TO BRING UP IF HE
CHALLENGES OF MODULATING THE
MICROBIOME ESPECIALLY ORAL
MICROBIOME AND CAN SUMMARIZE
MAYBE THREE REASONS WHY IT'S A
CHALLENGING APPROACH.
ONE IS IT'S HIGHLY DYNAMIC IN
NATURE.
THE MICROBIOTA IS THE MOST
DYNAMIC IN THE HUMAN BODY.
TWO THERE'S MEDICAL VARIATES AND
HOW THEY NEED TO BE ADJUSTED.
AND THE THIRD AND IT'S HARD TO
CHANGE THE MICROBIOTA ONCE
ESTABLISHED ESPECIALLY
NATURALLY.
SO THOSE ARE THE THREE REASONS I
THINK THERE'S CHALLENGES IN
TERMS OF MODULATE BEING THE
MICROBIOTA BUT TO ME IT BRINGS
OPPORTUNITIES AND INNOVATIVE
APPROACH TO MAKE CHANGES IN
MODULATING THE MICROBIOME.
IN TERMS OF SUGGESTIONS, THE KEY
POINTS YOU PUT TOGETHER THE
FOCUS AREAS ARE ALL GREAT AND I
THINK THOSE HAVE NO COMMENTS.
THOSE ARE EXCITING AND VERY
IMPORTANT BUT MAYBE IF I CAN
SUMMARIZE THREE AREAS THAT COULD
BE IMPROVED.
ONE, OMICS IS GREAT.
MULTI-OMICS AND I THINK OMICS
WITHOUT SPATIAL AND TEMPORAL
INFORMATION WILL BE LIMITED.
BY INTEGRATING THE SPATIAL
ASPECTS ARE CRITICAL AND WHAT WE
ARE LEARNING FROM THE FUNCTIONAL
MICROBIOME STUDY.
AND WHAT'S IMPORTANT FOR THE
CONCEPT IS TO CONSIDER THE HOST
FACTORS.
THE GENETICS AND DIET SHOULD BE
INCLUDED IN TERMS OF MODULATING
THE MICROBIAL.
THERE'S HOST MICROBE
INTERACTIONS WHEN YOU GO TO
COMPUTATIONAL APPROACHES.
THE HOST FACTORS NEED TO BE
THERE.
I LIKE YOU'RE LOOKING FOR NEW
MOLECULES AND EVEN NEW M
METABOLITES TO MODULATE IS COOL.
IN ADDITION TO PROVIDE THE DOSE
BIOLOGICS OR EVEN MOLECULES I
THINK THE KEY CHALLENGE IS HOW
DELIVER THEM AND HOW TO RETAIN
THOSE MOLECULES OR BIOLOGICS OR
MICROBIOME WITHIN THE COMMUNITY.
THE ORAL CAVITY IS DYNAMIC, YOU
DRINK ALL THE TIME AND EAT AND
SWALLOWING.
SO RETAINING THOSE BIOLOGICS IS
VERY IMPORTANT.
OVER ALL VERY SUPPORTIVE AND
ENTHUSIASTIC AND IT NEEDS TO BE
DONE BUT AS A SUGGESTION MAY BE
INTEGRATE THE SPATIAL TEMPORAL
INFORMATION AND SPATIAL IMAGING
AND THE HOST FACTORS AND
EMPHASIZE NOT ONLY THERAPEUTIC
DEVELOPMENT BUT ALSO DELIVERY
AND RETENTION OF THOSE AGENTS.
FINALLY ONE POINT THAT'S
IMPORTANT I KNOW YOU EMPHASIZED
THE MECHANISMS OF DYSBIOSIS AND
IT'S IMPORTANT TO DEVELOP
METHODS TO ASSESS THE MECHANISMS
IN THE ONLY THE MODELS BUT THE
ASSESS THE MECHANISMS.
THOSE ARE ALL SUGGESTIONS.
OVER ALL HIGHLY ENTHUSIASTIC AND
SUPPORTIVE OF THIS CONCEPT.
>> THANK YOU.
THOSE ARE ALL GREAT SUGGESTIONS.
I APPRECIATE YOU TAKING THE TIME
TO PROVIDE THOSE.
THANKS.
IS
>> I AGREE MICHEL AND SUMMARIZED
THE CONCEPT AND I THINK YOU DID
A TERRIFIC JOB PUTTING THE
CONCEPT TOGETHER.
AND ONE IMPORTANT DIRECTION I
THINK FOR THE NIDCR.
I HAVE SEEN OVER THE LAST 20, 30
YEARS LOTS OF DESCRIPTIVE
STUDIES AND CORRELATIONAL
STUDIES BETWEEN MICROBIOME AND
CERTAIN DISEASES.
IT'S REALLY TIME NOW TO MOVE THE
FIELD FORWARD BEYOND THE
DESCRIPTIVE AND CORRELATIONAL
STUDIES AND THINKING HOW TO
APPLY THE 23407KNOWLEDGE TO
THERAPIES.
AS I LOOK AT THE FIELD I CAN
COMPARE IT TO THE ONCOLOGY
FIELD.
WE USED TO USE NON-SPECIFIC
CHEMO THERAPIES AND MOVED TO
TARGETED THERAPIES FOR TREATMENT
AND PREVENTION OF CANCER.
IN THE ORAL CAVITY WE'RE USING
THERAPY AND OTHER THERAPIES IT'S
TIME TO MOVE IT FORWARD TOWARD
MORE PRECISION DENTISTRY AND
PRECISE TARGETED TREATMENTS.
I THINK THIS CONCEPT REALLY
FOSTERS THE FIELD INTO THE RIGHT
DIRECTION.
ONE COMMENT ALONG THESE LINES IS
WHEN WE THINK ABOUT MICROBIOME
AND ORAL CAVITY WE THINK OF
CARIES AND ORAL DON TAL DISEASE
AND THE LINK BETWEEN MICROBIOME
AND PHARYNGEAL CANCER IS
BECOMING MORE ESTABLISHED.
MICHEL DID A WONDERFUL JOB
GIVING YOU GOOD SUGGESTIONS.
I THINK THIS A TERRIFIC CONCEPT
AND HIGHLY IMPACTFUL AND TIMELY
RAND CONSEQUENTIAL AND I WANT TO
CONGRATULATE YOU ON PUTTING THIS
TOGETHER.
>> THANK YOU.
WE TALKED ABOUT THE INCLUSION OF
THE ORAL CANCER AS WELL.
>> ANY OTHER COMMENTS?
QUESTIONS?
IF NOT WOULD A MEMBER LIKE TO
MAKE A MOTION TO APPROVE THE
CONCEPT.
>> I MAKE THE MOTION.
>> I CAN SECOND IT.
>> ALL IN FAVOR?
ANY OPPOSED?
OKAY.
SO THAT CONCLUDES THE OPEN
SESSION.
SO THANK YOU VERY MUCH EVERYONE.
I JUST WOULD LIKE TO MAKE
COMMENTS BEFORE I INVITE CLOSING
COMMENTS FROM JENNIFER WE DO
HAVE AN UPCOMING MEETING IN
JANUARY 22, 2025.
WE'RE RUNNING A LITTLE LATE ON
TIME SO MAYBE WE CAN BEGIN THE
CLOSED SESSION AT 4:00 P.M. IF
THAT'S OKAY.
WE LOOK FORWARD TO YOUR
COMMENTS.
WE HAVE A SLIDE THAT SHOWS THE
E-MAIL ADDRESS WHERE YOU CAN
PROVIDE COMMENTS AFTER THE
MEETING AND THERE'S A NEW LINK
FOR THE CLOSED SESSION.
CHECK YOUR CALENDAR AND USE THE
ZOOM LINK FOR THE CLOSED
SESSION.
WITH THAT I'LL TURN IT OVER TO
JENNIFER OR HER FINAL COMMENTS.
>> THANK YOU, LYNN.
THANK YOU ALL FOR JOINING US
TODAY.
A SPECIAL THANKS TO ALL OF US
AND STAMP COLLEAGUES AND
CLINICAL SCIENTIST TRAINING AND
PROGRAM STAFF ON THE INNOVATIVE
INITIATIVES TOWARDS REACHING OUR
GOAL OF ORAL HEALTH AND OVERALL
WELL BEING FOR ALL THERE'S A LOT
TO DO.
WE NEED TO DO IT TOGETHER FROM
THE FOUNDATIONAL SCIENCE LEVEL
OUT TO THE POPULATION.
IN COLLABORATION WITH OTHER
INSTITUTES AND FEDERAL AGENCIES.
SO LET'S TOGETHER MAKE A
DIFFERENCE AND HAVE A WONDERFUL
REST OF THE DAY.
I'LL SEE YOU COUNCIL IN THE
CLOSED SESSION.
>> THE OPEN SESSION IS NOW
ADJOURNED.