>>IT'S MY PRIVILEGE TO OPEN
THIS 164th MEETING OF THE
NATIONAL EYE COUNCIL AND FOR
SOMEONE WHO STARTED MY CAREER
DOING TELEHEALTH AND TRYING TO
MOVE THAT IT WOULD BE OKAY TO BE
AT A DISTANCE VERSUS IN-PERSON,
I REALLY THINK ONE THING WE'VE
LEARNED FROM THE PANDEMIC IS IT
IS NICE TO BE TOGETHER.
AND REALLY HAVE APPRECIATED
THAT.
I HOPE IT'S BEEN GOOD FOR
EVERYBODY.
I WANT TO START WITH WELCOMES
BUT THERE'S VIRTUAL MEETINGS AND
HYBRID MEETING HARDER TO PUT
TOGETHER AND CATHY AND NATHAN
AND LAV LATIFAH HAVE DONE A TON
OF WORK AND A WANT TO GIVE THEM
A SHOUT OUT FOR GETTING
EVERYTHING TOGETHER.
THE OTHER THING I WANT TO DO IS
PARTICULARLY WELCOME A FEW
GUESTS AND NEW COUNCIL MEMBERS.
THE TWO GUEST SPEAKERS WE HAVE I
JUST WANT TO INTRODUCE NOW IN
CASE EVERYBODY HASN'T MET THEM.
ONE IS DOUG RHEE A GLAUCOMA
SPECIALIST.
HE WAS A FELLOW AT THE NEI AND
THEN WORKED AT HARVARD AND NOW
THE CHAIR OF OPHTHALMOLOGY AT
CASE WESTERN AND THE SESSION
LATER WILL BE LED BY THEM AND WE
HAVE ANN COLEMAN A GLAUCOMA
SPECIALIST AND EPIDEMIOLOGIST
AND HAS DONE A LOT OF GREAT WORK
AT THE INTERFACE OF
OPHTHALMOLOGY AND PUBLIC HEALTH
AND BAZ BECOME THE CHAIR OF
OPHTHALMOLOGY AND THE CHAIR OF
THE UCLA STEIN INSTITUTE.
THANK YOU FOR BEING HERE AND
WELCOME.
WE HAVE TWO NEW COUNCIL MEMBERS
WHO HAVE BEEN HERE BEFORE.
I KNOW THEY WERE OFFICIALLY
INTRODUCED OR ADDED TO THE
COUNCIL WITHIN THE PAST MONDAY
ONE IS JENNIE LEHRER-STEIN AND
HAS HAD AN IMPRESSIVE CAREER.
SHE'S A BLOGGER AND HAS BEEN ON
THE COUNCILS OF THE AMERICAN
FOUNDATION OF THE BLIND,
FOUNDATION FIGHTING BLINDNESS.
SHE'S BEEN ON NATIONAL ACADEMY
OF SCIENCE PANEL FOR DISABILITY
RIGHTS AND IS A LECTURER AND
BLOGGER AND PARTICIPATED IN
POLITICAL CAMPAIGNS AS AN
ADVISER FROM THE LOCAL LEVEL UP
TO THE NATIONAL PRESIDENTIAL
LEVEL.
SO WE'LL TALK A LITTLE BIT MORE
ABOUT THIS BUT VERY GLAD TO HAVE
YOU HERE ON THIS COUNCIL.
AND VICTOR PEREZ IS FROM DUKE
UNIVERSITY AND PEOPLE FROM THE
VISION COMMITTEE KNOW VICTOR
WELL FOR HIS WORK IN OCULAR
IMMUNOLOGY AND WITH THE ANTERIOR
SEGMENT AND HE'S HAD A
DISTINGUISHED CAREER PLACES LIKE
DUKE, BASTON PALMER AND WILL
CONTRIBUTE A LOT OF EXPERTISE TO
HE'S AREAS AND HAS DONE A LOT OF
REALLY NICE WORK TRYING TO
INTRODUCE STUDENTS FROM
DISADVANTAGED BACKGROUNDS.
IT'S GREAT TO HAVE YOU HERE.
WAN KE GO AROUND AND DO A ROUND
OF INTRODUCTIONS.
WE'LL SKIP THE PEOPLE WE
INTRODUCED NOW.
>>I'M RENU KOWLURU.
MY FOCUS IS ON EPIGENETICS AND
MITOCHONDRIAL DYSFUNCTION AND
GLAD TO BE HERE IN PERSON TODAY.
>>I'M MAUREEN MAGUIRE I'M
RETIRED AND HAVE BEEN INVOLVED
IN MULTI-CENTER CLINICAL
RESEARCH AND MAINLY CLINICAL
TRIALS THROUGHOUT MY CAREER AND
MAINLY IN RETINA BUT HOPPED
AROUND TO THE CORNEA AND OTHER
PARTS OF THE EYE AS WELL.
>>I'M TELLER.
I'M A LOCAL OPTOMETRIST INVOLVED
WITH PRIMARY EYE CARE AND
KERATOKONIS AND PLEASED TO BE
HERE ON MY LAST COUNCIL MEETING.
THANKS.
>>WELCOME.
I'M
>>I'M MARY ELIZABETH HARTNETT
AND PROFESSOR OF OPHTHALMOLOGY
AT STANFORD.
>>I'M TOM GARDNER AND WORK ON
DIABETIC RETINOPATHY.
>>I'M FROM MIAMI UNIVERSITY
KN
KNOXBURG, OHIO AND THIS WILL BE
MY LAST COUNCIL MEETING.
THANK YOU.
>>I'M JAMES COUGHLAN IN SAN
FRANCISCO AND STUDY PEOPLE WITH
VISION IMPAIRMENTS AND USE
CAMERAS TO UNDERSTAND THE
PHYSICAL ENVIRONMENT AROUND THE
PERSON.
THANK YOU.
>>I'M TERESA BORRAS.
I RECENTLY RETIRED FROM UNC.
MY INTEREST IS GLAUCOMA.
I AM INVOLVED IN RESEARCH OF
MECHANISM OF THAT CONTROL OF THE
OCULAR PRESSURE ESPECIALLY WITH
GENE THERAPY AND GLAD TO SEE
EVERYBODY.
>>THANK YOU TO ALL OF YOU.
THERE ARE TWO COUNCIL MEMBERS
WHO COULDN'T BE HERE IN PERSON.
WE'RE LOOKING AT ONE OF THEM IN
THE ROOM ON THE ZOOM CALL.
REZA DANA AND THE SECOND IS
TIRIN MOORE FROM STANFORD, IS A
NEUROBIOLOGIST AND REZA, IT'S
GOOD TO SEE YOU VIRTUALLY.
MAY WE ASK YOU TO INTRODUCE
YOURSELF?
>>SURE.
GOOD MORNING.
I'M SORRY NOT TO BE THERE WITH
YOU IN PERSON.
I'M HERE WITH THE FLU AND A
DAUGHTER WITH COVID SO APOLOGIZE
NOT BEING THERE WITH YOU.
I'M A PROFESSOR AND SENIOR
SCIENTIST THE HARVARD HEAD OF
CORNEA AND PROFESSOR OF
IMMUNOLOGY AT HARVARD MEDICAL
SCHOOL.
MY PRINCIPLE CLAIM TO FAME IS MY
OFFICE WAS DOUG RHEE'S NEIGHBOR
AND WAS A MENTOR TO VICTOR SO
IT'S GOOD TO SEE MY FRIENDS
THERE.
LOOK FORWARD TO THIS MEETING.
THANK YOU.
>>THANK YOU FOR BEING PATIENT
WITH THE HOPEFULLY LAST GLITCH
OF DAY AND THANK YOU FOR MAKING
THE TRIP AND WELCOME TO JANNIE
AND VICTORY AND A WARM WELCOME
TO THE STAFF AND ADVOCACY
COMMUNITY AND STAFF FROM STAND
UP FOR SCIENTIFIC REVIEW AS WELL
AS MEMBERS OF THE PUBLIC
WATCHING ON THE VIDEOCAST OR
PARTICIPATING VIRTUALLY.
FINALLY, I NEED TO THANK I KNOW
WE CAN'T THANK THEM ENOUGH,
NATHAN LATIFAH FOR ALL THEIR
EFFORTS TO COORDINATE THE
LOGISTICS AND PREPARATION FOR
THIS HYBRID MEETING.
THEY DID AN AMAZING AMOUNT OF
WORK AND WE COULD NOT BE DOING
THIS IF NOT FOR THEM.
THANK YOU TO YOU BOTH.
NATHAN, LATIFAH, I APPRECIATE
IT.
SO I'M GOING TO GO OVER -- THE
IS AN IN PERSON AND ENVIRONMENT
MEETING AND THIS IS A HYBRID
MEETING.
AS ALWAYS PLEASE IDENTIFY
YOURSELF WITH THE FULL NAME EACH
TIME YOU SPEAK.
IF YOU'RE ON ZOOM, PLEASE
INDICATE YOUR FULL NAME AND YOUR
ZOOM WINDOW SO WE CAN CAPTURE
ALL PARTICIPANTS ACCURATELY FOR
OUR RECORDS.
SINCE WE HAVE INDIVIDUALS BOTH
IN THE ROOM AND ON ZOOM,
REMEMBER TO USE YOUR MICROPHONE
EACH TIME YOU SPEAK, IT'S EASIER
FOR THE PEOPLE ON ZOOM TO HEAR
YOU.
IF YOU'RE IN THE ROOM DON'T LOG
ON TO ZOOM.
I SEE NOBODY HAS DONE THAT SO
THAT'S GOOD.
IT CAUSES A LOT OF ISSUES AND IF
YOU'RE IN THE ROOM LOOK AT THE
CAMERA IN THE MIDDLE OF THE ROOM
AND THE TENDENCY IS TO LOOK AT
THE SCREEN BUT THE CAMERA
FOCUSES ON YOU.
IF YOU'RE ON ZOOM, PLEASE HAVE
YOUR VIDEOS OFF DURING THE
MEETING UNLESS HAVE YOU A
QUESTION OR WANT TO PARTICIPATE
IN THE MEETING THEN PLEASE TURN
YOUR VIDEO ON AND RAISE YOUR
HAND OTHERWISE WE WON'T BE ABLE
TO HE SEE YOUR HAND RAISED.
I'M GOING ASK PEOPLE ON ZOOM NOT
TO CHOOSE THE CHAT BOX.
PEOPLE WHO ARE VIEWING THIS VIA
THE VIDEOCAST AND ALSO US IN THE
ROOM HAVE A HARD TIME AND WE
CAN'T SEE YOUR COMMENTS.
SINCE THIS IS A PUBLIC SESSION
I'M GOING ASK YOU NOT TO USE THE
CHAT BOX.
AS ALWAYS I'LL REMIND YOU THIS
SAY PUBLIC SESSION AND IT'S
BEING RECORDED AND IT WILL BE
STORED ON THE NIH WEBSITE
FOREVER.
FINALLY, AGAIN, COMMON REMINDER
I WANT TO REMIND COUNCIL MEMBERS
A SPECIAL GOVERNMENT EMPLOYEES
MAY NOT ENGAGE IN ANY LOBBYING
ACTIVITIES TODAY, THE DAY OF THE
MEETING WHILE YOU'RE RECEIVING
PAY FROM THE GOVERNMENT.
SO THANK YOU FOR THAT NOTE THERE
WAS A CHANGE THE OCTOBER 2024
MEETING HAS BEEN RESCHEDULED TO
OCTOBER 11 TO AVOID A CONFLICT
WITH A MAJOR MEETING.
AND THEN OUR NEXT MEETING IS
SCHEDULED FOR JUNE 16 OF THIS
YEAR.
ANY QUESTIONS ABOUT ANY OF THAT?
I HAVE TWO BITS OF BUSINESS
BEFORE WE GET ON WITH THE HEART
OF THE MEETING.
SO THE MINUTES OF THE OCTOBER
2023 MEETING WERE MADE AVAILABLE
TO YOU IN THE ELECTRONIC COUNCIL
BOOK.
WOULD ANYBODY LIKE TO DISCUSS
THE MEETINGS OR HAVE QUESTIONS
ABOUT THEM OR THE MINUTES?
IF NOT, MAY I HAVE A MOTION TO
APPROVE?
THANK YOU.
MAY I HAVE A SECOND?
>>SECOND.
THANK YOU.
ALL IN FAVOR OF APPROVING THE
OCTOBER MINUTE MEETINGS, PLEASE
RAISE YOUR HANDS.
IS THERE ANYONE OPPOSED?
THANK YOU.
THE MOTION TO APPROVE PASSES.
AND MY LAST BIT OF BUSINESS WE
DO THIS ONCE A YEAR IN JANUARY.
WE ARE REQUIRED TO REVIEW THE
NEI ADVISORY COUNCIL OPERATING
PROCEDURES WHICH OUTLINES
COUNCIL'S ROLE IN THE NEI GRANT
APPLICATION.
THE UPDATED PROCEDURES WERE
POSTED IN THE ELECTRONIC COUNCIL
BOOK FOR YOU TO REVIEW AND THERE
WERE NO SUBSTANTIVE CHANGES MADE
TO THE 2023 GENERAL OPERATING
PROCEDURES.
DOES ANYONE HAVE ANY QUESTIONS
OR COMMENTS ON THE OPERATING
PROCEDURES?
I KNOW IT'S FASCINATING READING
SO IF YOU HAVEN'T READ THEM,
PLEASE DO.
MAY I HAVE A MOTION TO ACCEPT?
THANK YOU, BEN.
MAY I HAVE A SECOND?
THANK YOU.
ALL IN FAVOR, PLEASE RAISE YOUR
HANDS.
ALL OPPOSED?
THE MOTION PASSES.
THANK YOU SO MUCH I'LL TURN IT
BACK TO DR. CHIANG.
I FORGOT TO MENTION, EVERYBODY
IF YOU HAVEN'T SIGNED IN, PLEASE
SIGN IN.
WE NEED TO KEEP TRACK OF WHO'S
HERE.
THERE'S COFFEE AND SOME SNACKS
OUT IN THE HALLWAY RIGHT HERE SO
FEEL FREE TO HELP YOURSELF TO >
THE ME TO DELIVER THIS REPORT ON
BEHALF OF THE NEI KERATOCONUS
AND WITHIN THE TIME WE HAVE HERE
I THINK WE HAVE SLOTTED UNTIL
10:30, WE CAN'T POSSIBLY TALK
ABOUT EVERYTHING THAT'S GOING ON
SO I'VE BEEN USING THIS TO TROLL
FOR SOCIAL MEDIA FOLLOWERS
BECAUSE WHAT WE'VE REALLY BEEN
TRYING TO DO AND MARIA
ZACHARIAS' GROUP HAS BEEN GOOD
IDENTIFYING THINGS AND GETTING
THINGS ON SOCIAL MEDIA.
WHAT ARE WE DOING OF INTEREST TO
THE COMMUNITY.
WHAT GRANT OPPORTUNITIES ARE
THERE.
I REALLY DON'T WANT PEOPLE WHO
DON'T APPLY TO THINGS BECAUSE
THEY DIDN'T KNOW ABOUT THEM
BEFORE THE DEADLINE.
SO THOSE ARE THE TWO TWITTER
HANDLES FOR THOSE WHO ARE STILL
ON TWITTER.
SO WITH THAT, THIS IS THE SLIDE
WE HAD PREPARED OFFICIALLY
WELCOMES BOTH JANNIE AND VICTOR.
ON THE LEFT IS A PICTURE OF
JANNIE AND ON THE RIGHT A
PICTURE OF VICTOR PEREZ.
ANOTHER WELCOME TO YOU
OFFICIALLY TO THE COUNCIL.
CATHY ALLUDED TO THIS AND WE
HAVE A COUNCIL MEMBER NOW WITH A
VISUAL IMPAIRMENT AND HAVEN'T
HAD THAT FOR A LONG TIME AND I
THINK AT THE NATIONAL EYE
INSTITUTE IF WE DON'T ADVOCATE
OR PUSH THIS WE REALLY HAVE TO
BE THE ONES TO LEAD THE
COMMUNITY IN THIS AREA.
IT'S INTERESTING, MY DAUGHTER
RECENTLY FOR VARIOUS REASONS HAD
BEEN LEARNING ABOUT
ACCESSIBILITY, WEB ACCESSIBILITY
AND WHAT SHE LEARNED IS THAT THE
NIH IS ONE OF THE VERY TOP
ORGANIZATIONS IN TERMS OF
PUTTING OUT ACCESSIBLE ITEMS.
ON THE OTHER HAND, ONE OF THE
THINGS WE LEARNED AND CATHY HAS
TAUGHT ME ABOUT IN TERMS OF
RECENTLY WE STILL HAVE A LITTLE
BIT OF WORK TO DO IN TERMS OF
MAKING OUR THINGS ACCESSIBLE.
AND THIS HAS BECOME A BIG DEAL
AT NIH FOR REASONS I'LL TALK
ABOUT TOWARDS THE ENDS OF THE
REMARK AND IMPORTANT FOR NEI TO
DO AND IMPORTANT FOR US TO LEAD
NIH IN TERMS OF DOING THIS.
A COUPLE THINGS, AS CATHY
MENTIONED, STATE YOUR FIRST AND
LAST NAME BEFORE YOU TAKE THE
FLOOR.
VERBALLY SUMMARIZE THE WRITTEN
CONTENT ON POWER POINT
CONVERSATIONS AND WHEN HAVE YOU
PHOTOS, GRAPHS, DESCRIBE THEM
VERBALLY.
IF YOU HAVE CHARTS, WILL
DESCRIBE THEM AND THE GRAPH
THOSE RO1 GRANTS WENT UP 3%.
ONE POINT THAT'S COME OUT OF
THIS IS THESE ARE ON THE SLIDE
BECAUSE THEY'RE ACCESSIBLE
MEETING PRACTICES BUT THEY'RE
GOOD OVER ALL AND MAKE IT
CLEARER FOR EVERYBODY.
SO AND WITH THAT, JANNIE, MAY I
ASK YOU, IS THERE ANYTHING YOU'D
LIKE TO SAY TO COMPLIMENT WHAT
WE SAID HERE?
>>I'D LIKE TO THANK EVERYONE
FOR THEIR PATIENCE AS WE ENTER
THE NEW PHASE ULTRA
ACCESSIBILITY.
IT'S SOMETHING MANDATED IN
SECTION 508 OF THE
REHABILITATION ACT AND THAT IS
COMPLETELY OUT OF DATE BY THE
TIME IT WAS PASSED AND THE
EFFORTS TO GO ABOVE AND BEYOND
ARE GREATLY APPRECIATED AND YOUR
EFFORTS HAVE BEEN FANTASTIC.
MY THANKS TO THE STAFF FOR THE
WORK IN MAKE MATERIALS DIGITALLY
ACCEPTABLE IN TERMS OF
ACCESSIBILITY FOR DIGITAL ACCESS
AND I LOOK FORWARD TO ENGAGING
WITH AND FORGIVE ME IF I
INTERRUPT YOU AND ASK YOU TO
STATE YOUR NAME IF YOU FORGOT
WHICH IS A NATURAL RESPONSE.
THANK YOU FOR THE EFFORTS.
>>THANKS FOR THOSE REMARKS AND
BEING ON OUR COUNCIL.
I'M GOING TO GO THROUGH A SET OF
SLIDES HERE TALKING ABOUT PEOPLE
AND ACCOMPLISHMENTS.
THE FIRST SLIDE DECK, A FEW OF
YOU ALLUDED TO THE REMARK THIS
IS YOUR LAST MEETING.
ON THE TOP OF THE SLIDES IS A
PHOT YO OF KATIA FROM MIAMI
UNIVERSITY OF OHIO WHO DOES WORK
IN REGENERATIVE MEDICINE
PARTICULARLY WITH THE RETINA AND
LENS.
AND THE SECOND PHOTOGRAPH IS
EMMY HARTNETT NOW AT STANFORD
UNIVERSITY AFTER HAVING WORKED
AT UTAH AND DID PEDIATRIC RETINA
WORK.
AND THE LAST PERSON IS PEN
TELLER IN THE D.C. AREA WHO HAS
BEEN VALUABLE AND WHAT DO REAL
WORLD DOCTORS NEED.
AND SO I HAVE TO SAY I'VE
APPRECIATED THE THREE OF YOU.
THE THREE OF YOU WERE HERE AS I
WAS STARTING THIS I FELT LIKE I
DREW IN THE POSITION WITH THE
THREE OF YOU AND WE DID THINGS
LIKE THE MISSION STATEMENT AND
THE STRATEGY PLAN AND I
APPRECIATED YOUR EFFORTS AT A
DIFFICULT TIME OVER ALL JUST
TRANSITIONING THROUGH THE
PANDEMIC.
AND TOWARDS THE END TOWARDS THE
CONCEPT CLEARANCES WE'LL INVITE
YOU TO SAY A FEW REMARKS BUT FOR
NOW, THANKS TO THE THREE OF YOU.
THIS SLIDE SHOWS NEI STAFF
UPDATES.
WE'VE HAD ACTIVITY.
THE PICTURE ATOP IS MELANIE
REAGAN APPOINTED AS THE
EXECUTIVE OFFICER.
IT'S BASICALLY OUR CHIEF
OPERATING OFFICER AT NEI AND HAS
BEEN DOING THIS A YEAR AND A
HALF AND WE RECENTLY APPOINTED
HER AS THE PERMANENT EXECUTIVE
OFFICER.
AND SHE'S DONE A GREAT JOB.
THE NEXT PHOTOGRAPH SHOWS A
PICTURE OF RICH KRAUZLIS AND HAS
BEEN APPOINTED THE CHIEF OF THE
LSR, LABORATORY OF SENSORY
RESEARCH.
LSR AT NEI HAS HAD A RICH
HISTORY.
IT WAS BOB WERTZ AND FRED MILES
HE DID HIS POSTDOC WITH AND
RETIRED AFTER BRUCE COMMING AND
BECAME A WORLD FAMOUS RESEARCHER
IN THAT SETTING AND CAME BACK 10
YEARS AGO AND HAS BEEN ACTING
FOR ABOUT ALMOST TWO YEARS AND
WAS RECENTLY APPOINTED AS THE
PERMANENT CHIEF OF THAT LAB.
THE NEXT PHOTO IS BEN SOLOMON AS
THE NEI CLINICAL DIRECTOR.
THANK YOU TO BEN FOR DOING THAT.
MARYANNE IS A PROGRAM OFFICER
WHO RETIRED RECENTLY.
SHE OVERSAW A LOT OF GRANTS
PARTICULARLY IN THE CLINICAL
RESEARCH AREA AND SHE WAS
ACTUALLY ONE OF THE FIRST ON THE
PROJECTS I WAS INVOLVED WITH THE
ROTP PROJECT.
WE'RE GOING MISS MARYANNE.
SHE'S COMING BACK PART-TIME AS A
CONTRACTOR WHILE WE WORK ON
RECRUITING A REPLACEMENT.
SO JUST A WORD TO OUR PEOPLE,
THANKS FOR THE RETIREMENTS AND
FOR THE NEW POSITIONS HERE.
TWO UPDATES ON ACTIVE SEARCHS.
THERE'S TWO OTHER BIG SEARCHS WE
HAVE NOW.
THE SCIENTIFIC DIRECTOR AND THE
CLINICAL DIRECTOR.
THE SCIENTIFIC DIRECTOR SEARCH
IS GETTING CLOSE TO ITS
CONCLUSION.
WE'VE DONE MULTIPLE ROUNDS OF
VIEWS AND WE'LL HAVE AN
ANNOUNCEMENT FORTHCOMING.
THIS IS SOMETHING THAT WE'RE
EXCITED ABOUT.
THE CLINICAL DIRECTOR WE HAVE
PROGRESS AND VISITS COMING UP.
THIS PART IS GOING TO BE
EXCITING FOR US.
MORE COMING UP MOPEFULLY
ANNOUNCEMENTS BY THE TIME THE
COUNCIL MEETS.
A FEW UPDATES ON NIH LEADERSHIP
AND THE PICTURE HERE IS HUGH
AUCHNCLOSS AND DR. FAUCI RETIRED
AND HUGH HAS BEEN THE DEPUTY
DIRECTOR AT NIAID SINCE 2006 SO
IS FAMILIAR WITH THE POSITION
AND ANY OF YOU THAT KNOW
MASSACHUSETTS POLITICS MAY KNOW
HIM AND NINA SCHLOR OVERSEES THE
INSTITUTES AND HAS BEEN AT NIH
FIVE YEARS NOW.
SHE HAS HAD A VERY DISTINGUISHED
CAREER BEFORE THAT.
SHE'S A PEDIATRIC NEUROOLOGIST
BY BACKGROUND AND HER RECENT
POSITION WAS THE SCIENTIFIC
DIRECTOR AT THE NEUROLOGICAL
INSTITUTE.
BEFORE THAT SHE WAS AT THE
UNIVERSITY OF PITTSBURGH WHERE
SHE WAS DEAN FOR RESEARCH
UNIVERSITY WIDE AND WAS AT THE
UNIVERSITY OF RODCHESTER CHAIR
OF PEDIATRICS FOR YEARS.
ON THE LEFT SIDE IS MONICA
BERTONELLI AND CAME FROM THE
HARVARD SYSTEM.
NEXT TO MONICA IS A PICTURE OF
JO
JONI RUTTER AND BOTTOM ROW THE
FIRST IS OF ROGER GLASS WHO
RECENTLY RETIRED AS THE DIRECTOR
OF THE FOGARTY INTERNATIONAL
START AND IT'S THE INSTITUTE
THAT OVERSEES INTERNATIONAL
COLLABORATIONS.
AND ROGER WAS -- WE HAD A GOOD
RELATIONSHIP WITH ROGER.
HE SUPPORTED A LOT OF WORK WE DO
INVOLVING FOR EXAMPLE TRAINING
INTERNATIONAL FELLOWS IN EYE
DISEASE.
AND ROGER RETIRED AND HIS
POSITION HAS BEEN TAKEN BY PETER
KILMARX AND ON THE BOTTOM IS EYE
PICTURE OF JOHN GALLIN RETIRING
IN MARCH AS THE ASSOCIATE
DIRECTOR FOR CLINICAL RESEARCH
AND CHIEF SCIENTIFIC OFFICER AT
THE NIH CLINICAL.
A LOT OF CHANGE AT NIH OVER ALL.
NOW, THE NEXT SET OF SLIDES,
WHAT I WANT TO DO IS TALK ABOUT
PEOPLE AND PROJECTS THAT CAUGHT
OUR ATTENTION.
THERE'S A LITTLE BIT OF
EXTRAMURAL AND INTRAMURAL WORK
WE WANT TO HIGHLIGHT.
THE SLIDE SHOWS NATIONAL ACADEMY
OF SCIENCE AWARDEES.
THERE ARE TWO OF THEM.
THE TOP PHOTOGRAPH IS HONGKUI
ZENG THE DIRECTOR OF THE ALLEN
INSTITUTE FOR BRAIN SCIENCE IN
SEATTLE.
SHE RECEIVE THE 2023 PRADEL
RESEARCH AWARD FOR A MIDCAREER
RESEARCHER.
SHE AND THE CREW HAVE DONE
GROUNDBREAKING WORK IN WHAT IN
MAMMALIAN MOUSE MODELS AND DONE
WORK IN OPEN SCIENCE.
AND QUESTIONS LIKE HOW DO THE
DIFFERENT NEURONAL TYPES WORK
TOGETHER TO PROFESSION VISUAL
AND THE NEXT IS TIM BUSCHMAN HAS
DONE WORK ON NEURAL MECHANISMS
OF THINGS LIKE COGNITIVE
CONTROL, ATTENTION AND WORKING
MEMORY.
SO PROUD OF THESE TWO NEI
GRANTEES.
AND THIS IS A GRANTEE THAT
CAUGHT OUR ATTENTION.
THIS IS FROM UCLA AND DID WORK
INVOLVING ZIKA VIRUS AND MANY
KNOW IT HAS AFFECTS ON THE
DEVELOPING RETINA AND IN THE
BRAIN INFANT BRAIN AND THEY
LOOKED AT THE HIPPO PATHWAY
WHICH CONTROLS ORGAN GROWTH AND
HAS A RELATIONSHIP WITH CANCER
AND FOUND THAT HATHAWAY HAS
VIRUS FIGHTING EFFECTS AND BY
LOOKING AT SOME TISSUE CULTURE
TYPE STUDIES AND LOOKING AT THE
PATHWAYS INVOLVED WHAT THEY
FOUND IS THAT VERTIVORFIN HAS A
ROLE IN STOPPING SARS COV2.
THERE'S SO MUCH WORK WE DO THAT
HAS IMPACT WHAT YOU
TRADITIONALLY CALL VISION.
AND THIS WORK CAME FROM A
RESEARCHER IN THE INTRAMURAL
CENTER WHO DOES AMAZING WORK
INVOLVING STEM CELLS AND
TOGETHER THE HEAD OF THE NCATS
3-D TISSUE BIOPRINTING
LABORATORY AND THE TITLE IS 3-D
EYE PRINTING MODELS OF DISEASE.
WHAT THIS GROUP HAS DONE IS THEY
TOOK PARASITES AND THREE TYPES
ON A HYDROGEL AND PRINTED THEM
ON A BIODEGRADABLE SCAFFOLD AND
I THOUGHT IT WAS SCIENCE FICTION
WHEN I STARTED TO READ ABOUT
THIS AND WITHIN DAYS THE CELLS
MATURED INTO A CAPILLARY NETWORK
AND CELLS WITHIN DAYS CEDED TO
THE OTHER SIDE OF THE SCAFFOLD
AND WHEN THEY DID GENETIC
TESTING THE PRINTED TISSUE
LOOKED AND BEHAVED LIKE NATIVE
RETINAL BARRIER AND STRESSED THE
IMMUNOLOGICALLY AND FOUND THE
TISSUE COULD EVENTUALLY SHOW
CHARACTERISTICS OF A DRY AMD AND
PROGRESS TO LATE AMD AND THE
EXCIT
EXCITING THING IS THIS COULD BE
USED TO STUDY THE DISEASE AND SO
NICE WORK DONE AT THE CENTER
DONE COLLABORATIVELY.
THIS IS CALLED ONE SMALL
HANDSHAKE FOR NEURONS.
IT'S WORKING LOOKING AT
ORGANOIDS.
THERE ARE TWO PHOTOGRAPHS HERE
THAT BASICALLY SHOW ORGANOIDS
MAKING SYNAPTIC CONNECTIONS.
THE FIRST SET OF WORK IS DONE BY
AN NEI GRANTEE AT THE UNIVERSITY
OF WISCONSIN.
I FIRST MET HIM AT A K AWARD
SYMPOSIUM IN BETHESDA IN 2005.
VICTOR WERE YOU THERE BY CHANCE?
I THOUGHT I REMEMBERED YOU THERE
AS WELL.
SO WE HAVEN'T HAD ONE OF THOSE
SINCE THEN.
AND THEY BROKE THE ORGANOIDS AA
PART AND FOUND THEY CAN FORM
WITH OTHER RETINAL CELLS.
AND AND A RESEARCHER AT UCSD SHE
RECEIVED THE NIH NEW INNOVATOR
AWARD.
AND WE THOUGHT THESE WERE REALLY
INTERESTING BECAUSE THEY'RE TWO
RELATED STORIES ABOUT ORGANOIDS
MAKING SYNAPTIC CONNECTIONS.
WHAT I WANT TO DO IN THE NEXT
SET OF SLIDES IS TALK ABOUT A
FEW OF THE PROGRAMS THAT WE'VE
GOTTEN THAT WE'RE SORT OF
CREATING.
WE TALKED ABOUT -- WE'VE BEEN
TRYING TO TALK ABOUT OUR MISSION
STATEMENT, ELIMINATE VISION LIFE
AND IMPROVE QUALITY OF LIFE
THROUGH VISION RESEARCH.
AND THESE PROGRAMS TAKE US
TOWARDS THAT MISSION AND THIS IS
ONE EXAMPLE THAT'S LED BY THE
BOTTOM RIGHT IS A PHOTO OF LISA
NEWHOLD.
THIS PROGRAM IS BASICALLY IT'S
AN R21 MECHANISM.
THE FUNDING ANNOUNCEMENT IS
BASICALLY TRYING TO ENCOURAGE
GRANT APPLICATIONS DIRECTED
TOWARDS CREATING THESE NEXT
GENERATION HUMAN SELL DERIVED
MICROPHYSIOLOGICAL SYSTEMS.
THESE MAY BE THINGS LIKE
ORGANOIDS OR TISSUE CHIPS BUT
THE IDEA IS THAT WE'D LIKE FOR
THEM TO BE ABLE TO REPRESENT
ORGAN FUNCTION.
REPLICATE CENTRAL CENTRAL
NERVOUS SYSTEM DISEASES AND
HUMAN BRAIN, SPINAL CORD AND WE
WOULD LIKE TO ENABLE STUDIES OF
DEVELOPMENT FUNCTION, AGING IN
HEALTHY STAGE OR IN DISEASE
STATES AND THE GOAL IS TO BE
HIGH RISK, HIGH REWARD AND NOT
BE PRELIMINARY DATA FOR THOSE
THAT ARE THERE'S A COMPANION RO1
MECHANISM BUT IS GOING TO BE
ACTIVE THE NEXT THREE YEARS AND
THE FIRST CYCLE IS COMING UP NOW
AND SOMETHING WE'RE EXCITE
ABOUT.
THANKS TO LISA FOR WORK IN THIS
AREA.
THIS IS NEI CREATED THIS IN
COLLABORATION WITH FOUR OTHER
INSTITUTES.
THE NEXT SLIDE TALKS ABOUT THE
BRAIN INITIATIVE.
I THINK ALMOST ALL OF YOU KNOW
THE BRAIN INITIATIVE THIS CAME
FROM THE 21st CENTURIES CURES
ACT.
THIS IS OBAMA ERA AND ON THAT
TIME THERE'S BEEN ON THE ORDER
OF BILLIONS OF FUNDING FROM THE
BRAIN INITIATIVE MEANT TO STUDY
THINGS LIKE CIRCUITRY WIRING OF
THE BRAIN.
WHAT THIS CHART DISPLAYS IS A
PIE CHART AND THE POINT OF THIS
IS THAT OF THE FY22 BRAIN
INITIATIVE AWARDS THE NEW AWARDS
TOTAL $350 MILLION.
ONE OF THE SLICES OF THE PIE
CHART SHOWS 18% WENT TO VISION
RESEARCH.
THE OTHER SHOWS 26% NON-EYE
RESEARCH AND IT WAS REGULATED TO
THE PORTFOLIO MAKING THE POINT
THAT VISION RESEARCH IS A BIG
PART OF THIS RESEARCH OVER ALL.
THAT'S WHAT WE'RE EXCITED ABOUT.
THE NEXT SLIDE TALKS ABOUT THE
AN TEARIOR -- ANTERIOR SEGMENT
INITIATIVE AND WE TALKED ABOUT
IT A LONG TIME AND WE'RE GETTING
MORE AND MORE OF THESE
INITIATIVES FUNDED.
THIS INITIATIVE DEALS WITH
NEURAL CIRCUITRY OF THE SEGMENT
AND THE ROLE IN OCULAR PAIN AND
DRY EYE.
WE RECENTLY FUNDED A CONSORTIUM
OF EIGHT GROUPS.
IT'S GOING TO BE FIVE YEARS
TOTAL OVER $50 MILLION AND THE
QUESTIONS HERE ARE WHAT ARE THE
NEURAL PATHWAYS.
THE CIRCUITRY RESPONSIBLE FOR
THINGS LIKE DRY EYE PAIN, REFLUX
TEARING, PHOTOPHOBIA.
THESE GROUPS WE FUNDED ARE
LOOKING AT THE MORPH OWE LOGICAL
AND MOLECULAR, FUNCTIONAL
SPECIFICS AND WE'RE EXCITED
ABOUT THIS.
THERE'S GROUPS FROM OREGON,
ARIZONA, HARVARD, MIAMI,
UNIVERSITY OF PENNSYLVANIA, UCLA
AND DUKE AND VICTOR I KNOW
YOU'RE HEADING ONE OF THESE
CONSORTIA.
WE'RE EXCITED ABOUT WAS AN
INITIAL KICKOFF MEETING
HOPEFULLY TRYING TO FIND WAYS TO
WORK TOGETHER TO CREATE MODELS
FOR COLLABORATIVE RESEARCH FOR
THE WHOLE IS BIGGER THAN THE SUM
OF THE PARTS.
VERY HAPPY AND EXCITED ABOUT
THIS.
IMPLEMENTATION RESEARCH.
THIS SLIDE DISCUSSES THAT YOU'LL
REMEMBER FROM OUR LAST MEETING
WE HAD A SESSION ON
DISSEMINATION AND
IMPLEMENTATION.
TWO GREAT TALKS.
ONE WAS INTEREST NORTHWESTERN
UNIVERSITY AND ONE FROM JENNY
SUNG FROM HARVARD AND TALKED
ABOUT DISSEMINATION AND
IMPLEMENTATION AS IT RELATES TO
VISION RESEARCH.
IN FOLLOW-UP TO THAT THE BOTTOM
SHOWS A PICTURE OF JIMMY LEI AND
THOUGHT WHAT COULD WE BE DOING
WITH D & I AND SIGNED ON TO THE
DISSEMINATION, IMPLEMENTATION
RESEARCH AND HEALTH AND WE'RE
INTERESTED IN GETTING
APPLICATIONS RELATED TO
PROMOTING, ADAPTING, SUSTAINING
EVIDENCE-BASED INTERVENTIONS AND
PRACTICES TO PREVENT AND TREAT
EYE-RELATED DISEASE.
THIS COULD INCLUDE TELEAND
SUPPORT AND PROJECTS THAT
INCORPORATE SOCIAL DETERMINATES
OF HEALTH AND COMMUNITY-BASED
RESEARCH.
THIS IS GOING TO BE ACTIVE A FEW
YEARS NOW AND THE NEXT CYCLE IS
COMING UP SOON BUT THIS IS NOT
GOING AWAY.
I WANT TO TAKE A BREAK AND
LISTEN INSTEAD OF TALKING TO THE
COUNCIL MEMBERS BECAUSE WE
TALKED ABOUT THIS LAST TIME.
I WOULD LOVE YOUR ADVISE ON THE
CLINICAL BASED INTERVENTION OR
PRACTICE MAY BE IDEAL FOR
IMPLEMENTATION PROJECTS.
>>MAUREEN MAGUIRE.
WE'VE BEEN SUCCESSFUL ON
STRATEGIES BUT WITH A LARGE
SEGMENT OF THE POPULATION THAT
DON'T TAKE ADVANTAGE.
IF WE CAN HAVE DIFFERENT
APPROACHES TO GET THE PEOPLE NOT
TAKING ADVANTAGE OF THE ADVANCES
WE HAVE INTO TREATMENT AND CARE
I THINK THAT'D BE WORTHWHILE.
>>THANKS.
ARE THERE COMMENTS ABOUT THAT.
>>EMMY HARTNETT.
THERE ARE SO MANY THINGS IN
PUBLIC HEALTH WE KNOW HAVE
VALUE, VERSE, DIET, VARIOUS
THINGS LIKE THIS BUT IT MAY BE
THERE ARE BARRIERS WHY PEOPLE
HAVE DIFFICULTY IN THE DAY TO
DAY LIVING TO BE ABLE TO
IMPLEMENT THIS.
UNDERSTANDING THE PRAYER YEARS
AND MOTIVATION -- BARRIERS AND
MOTIVATION MAY HELP IMPLEMENT
THIS INTO GOOD HEALTH.
IS
>>IT BRINGS US BACK TO RACIAL
DISPARITY IS SOMETHING WE NEED
TO ADDRESS.
RENU.
>>WE TALKED ABOUT ADVANCES IN
SCIENCE BUT IF THEY DON'T MAKE
IT TO THE PEOPLE WHO NEED IT
MOST IT'S NOT THAT AMAZING.
THIS NEXT SLIDE TALKS ABOUT THE
NEXT GENERATION OF VISION
RESEARCHERS.
MARTHA FLANDERS IS THE
PHOTOGRAPH IN THE BOTTOM RIGHT.
SHE HAS BASICALLY WORKED TO GET
US INVOLVED WITH WHAT'S CALLED
THE TRAILBLAZER AWARD FOR NEW
AND EARLY STAGE INVESTIGATORS.
THIS IS AN R21 MECHANISM.
IT'S DONE WITH THE NATIONAL
INSTITUTE OF AGING AND BIOIM
BIOIMING -- BIOIMAGING AND
BRINGING NEW PEOPLE INTO THE
VISION RESEARCH COMMUNITY.
THIS IS MEANT TO BE A BROAD AREA
OF SCIENCE.
ENGINEERING AND PHYSICAL SCIENCE
AS APPLIED TO VISION RESEARCH.
THIS IS SOMETHING I'M
PARTICULARLY EXCITED ABOUT BUT I
WANT TO ASK THE COUNCIL AGAIN,
THERE'S TWO THINGS THAT PREMISE
THE AWARD BRINGING NEW AND EARLY
STAGE INVESTIGATORS INTO THIS
AND HOW TO MAKE THEM AWARE AND
THE OTHER THING IS HOW DO WE
BROADEN THE OUTREACH TO OTHER
FIELDS?
WE'D LOVE TO GO TO THE
ENGINEERING AND SCIENTIFIC
COMMUNITY AND FIND THESE PEOPLE
BUT OFTEN IT'S TWO DIFFERENT
WORLDS.
DO YOU HAVE ADVICE IN TERMS OF
HOW WE KCAN CAN BETTER DO THESE
THINGS?
>>KATIA.
MAYBE WORKSHOPS INVITING OUTSIDE
INVESTIGATORS AND ENGINEERING
AND OPTICS THAT ARE MOSTLY IN
THE PHYSICAL SCIENCES IN
CONFERENCES OR WORKSHOPS THAT
ARE NEI SPONSORED.
THAT COULD BE ONE WAY.
>>I'D LIKE TO SECOND THAT THE
GLAUCOMA FOUNDATION HAVE SMALL
WORKSHOPS OF ABOUT 40 PEOPLE IN
WHICH THEY INVITE PEOPLE OUTSIDE
THE FIELD AND THEY WERE VERY
PRODUCT IVE THE IDEA OF SMALL
WORKSHOPS LIKE 30 OR 40 PEOPLE
ONCE THEY'RE OUTSIDE BUT SOMEHOW
RELATED THAT WOULD BE GREAT.
>>VICTOR PEREZ, AND HAVE
PHYSICAL SCIENCE MEETINGS WHERE
WE GO AND HAVE THE PRESENCE
THERE NOT ONLY TO PRESENT THE
CONCEPT AND GET TO KNOW THE
PLAYERS IN THE FIELD.
>>THANK YOU.
>>REZA DANA HERE, BOSTON.
I WAS JUST THINKING EXACTLY
THAT, VICTORY.
THERE ARE EXCELLENT SCIENTIFIC
MEETINGS THAT ARE PHENOMENAL FOR
INTRODUCING NEW INVESTIGATORS TO
NEW TECHNOLOGIES, NEW
DISCIPLINES.
THE FACT IS THAT WHETHER YOU'RE
IN CELL BIOLOGY, IMMUNOLOGY,
GENOMICS, WHAT HAVE YOU, SOME OF
THE BEST INVESTIGATORS, PEOPLE
ARE OUTSIDE OF THE WORLD VISION
SCIENCE AND OPHTHALMOLOGY AND GO
KEYSTONE CONFERENCES AND
CONFERENCES NOT OPHTHALMOLOGY
FOCUSSED.
THERE'S MANY JUNIOR FACULTY OR
POSTDOCS WHO CAN BENEFIT
SIGNIFICANTLY FROM GOING TO
THESE CONFERENCES AND GOING TO
THE CONFERENCES OVER FOUR OR
FIVE DAYS AND THE EXPENSES CAN
SOMETIMES BE QUITE DIFFICULT FOR
THE MENTOR TO COVER.
AND GOING TO MANY KEYSTONE
CONFERENCES IN MY YOUNGER DAYS
HELPED BRING CONCEPTS INTO THE
FIELD OF VISION SCIENCE.
PERHAPS THE NEI CAN SEE OF A
PROGRAM OF SELECTING INDIVIDUALS
THAT GO TO NON-NEI OR NIH
SPONSORED PROGRAMS WHERE THESE
YOUNG INVESTIGATORS CAN LEARN
NEW THINGS.
>>MAUREEN MAGUIRE.
I APPRECIATE THE SUGGESTIONS
MADE PREVIOUSLY BUT IN TERMS OF
SOMETHING THAT MAY BE
INEXPENSIVE TO DO WOULD BE TO
SEND OUT MODULES TO LEADERS OF
GRANTS WHERE THERE'S A LARGE
VISION COMMUNITY THAT INTERSECTS
WITH THE OTHER PARTS OF THE
UNIVERSITY.
AND THAT HAS A MODULE SAYING
THESE ARE THE FUNDING MECHANISMS
THAT MAY BE AVAILABLE AS WELL
SOMETHING LIKE YOU'VE BEEN DOING
THIS MORNING WHICH IS SHOWING
SOME EXAMPLES OF HOW THERE'S
BEEN SYNERGY BY BRINGING IN
OTHER SCIENTIFIC RELATED
DISCIPLINES BUT HAVING THEM WORK
TOGETHER.
THOSE EXAMPLES MAY MOTIVATE
OTHERS.
>>EMMY DEF
>>EMMY HARTNETT.
MANY INSTITUTIONS HAVE MENTORS
THAT WORK WITH SCIENTISTS TO
HELP WITH GRANT WRITING AND IT
WOULD BE GREAT TO LET THEM KNOW
TO SPREAD THE WORD SO THAT THEY
MAY BE ABLE TO EXTEND AND HAVE
THEIR MENTEES REACH OUT TO OTHER
PEOPLE AND BRING TOGETHER GROUPS
THAT WAY.
>>ONE THING THAT'S RESONATED
WITH ME IS THERE'S METHODOLOGY
AND APPLICATION AND THERE'S
GREAT METHODOLOGY THAT OCCURS.
WHAT WE'D LIKE TO DO BASICALLY
IS FIND THE BEST METHODOLOGIST
AND SOLVE PROBLEMS BY DEVELOPING
NOVEL METHODOLOGY THAT CAN BE
APPLIED TOWARDS SOLVING DISEASE.
THAT'S WHAT SOME OF THESE
EXAMPLES DID.
I'VE BEEN WONDERING TO FOLLOW ON
SOME OF THESE COMMENTS -- ARE
THERE THINGS WE CAN DO AND I
THINK IT'S AWESOME TO GO TO
MEETINGS LIKE GRC AND ARE THERE
THINGS WE CAN DO TO PUT THINGS
ABOUT VISION OUT THERE TO PEOPLE
WHO HAVE EXPERTISE AND IT'S
EXCITING TO TAKE YOUR
METHODOLOGY INTO THIS FIELD.
I'M NOT SURE IF YOU'RE AWARE OF
THINGS LIKE THAT.
SPECIFICALLY MEANT TO ENTICE
PEOPLE WHO ARE EXPERTISE IN SOME
TYPE OF METHODOLOGY SAYING MAYBE
I DON'T WANT TO WORK FOR PFIZER
OR GOOGLE OR SOMETHING.
OR WHAT I WANT TO DO IS CURE
BLINDNESS AND WE LEARN FROM
THESE THINGS WHAT THE VISUAL
SYSTEM IS ABOUT.
ARE ANY OF YOU FAMILIAR WITH
THINGS LIKE THAT THAT ARE
DIGESTIBLE AND QUICK AND SIMPLE?
THERE'S SO MANY WAYS THAT HAVE
GROWN FIELDS.
IS THERE ANYTHING IN THE VISION
SYSTEM YOU'RE AWARE OF?
>>EMMY HARTNETT.
THE RYAN INSTITUTE FOR MACULAR
RESEARCH INVITE PEOPLE AND
SOMETIMES HAVE SPEAKERS THAT ARE
OUTSIDE OF OPHTHALMOLOGY THAT
DESCRIBE NEW TECHNIQUES.
>>AND WE CAN USE PREVENT
BLINDNESS AMERICA AND REACH OUT
TO OTHERS FIELD AS WELL.
THEY MAY HAVE MORE WAYS TO TAP.
>>I'M NOT AWARE OF ANY SIMPLE
PROCESS FOR THAT IN RESPONSE TO
YOUR QUESTION BUT I THINK IN
FACT THE TRUE BENEFIT IS HAVING
PEOPLE IN THE VISION COMMUNITY
GOING TO A CONFERENCE WHERE THE
PURPOSE IS INTENTIONALLY NOT
VISION.
THAT'S WHERE A LOT OF THE
ADVANCES ARE HAPPENING.
WHEN YOU THINK OF LEARNING NEW
CONCEPTS AND ALSO NETWORKING
WITH PEOPLE WHO ARE ON EDITORIAL
BOARDS OF TOP-LINE MEDICAL
JOURNALS OFTEN THEY'RE NOT IN
THE VISION COMMUNITY.
IT'S IMPORTANT TO MEET PEOPLE IN
DOMAINS NOT VISION-ORIENTED.
THAT'S THE VALUE THERE.
AND THROUGH SUPPORT PERHAPS THE
NEI COULD WORK WITH KEYSTONE OR
OTHER CONFERENCES TO HAVE A
SMALL SLIVER OF THE PROGRAM AND
THAT COULD BE FURTHER EXPLORED.
>>AND THIS IS MORE TOWARDS
METHODOLOGY OR TECHNIQUES.
AND THERE'S NO EXTRA MONEY
INVOLVED HERE.
MAYBE JUST LEARN FROM OTHER
VISION FIELDS.
>>GREAT.
VERY USEFUL.
THIS NEXT SET OF SLIDES TALKS
ABOUT ACD WORKING GROUP ON
DIVERSITY.
THE ACD IS THE ADVISORY COUNCIL
TO THE NIH DIRECTOR.
AND THERE WAS A SUBGROUP ON
INDIVIDUALS WITH DISABILITIES
THAT HAS GOTTEN A LOT OF
PUBLICITY WITHIN NIH AND
NATIONALLY OVER THE PAST COUPLE
MONTHS.
AND THIS GROUP WAS HEADED BY
THREE FOLKS AT THE BOTTOM HERE
WHO MANY KNOW FROM THE VISION
COMMUNITY AND THERE'S BEEN
RESEARCH ON HEALTH DISABILITIES
AND UNIVERSITY OF RODCHESTER
DOES WORK ON HEARING
DISABILITIES.
THIS REPORT HAD A NUMBER OF
FINDINGS AND RECOMMENDATIONS.
ON THIS SLIDE IS SOME OF THE
FINDINGS OVER 20% OF THE
U.S. ADULT POPULATION HAS
DISABILITIES AND THAT'S THE
SINGLE LARGEST AND FASTEST
GROWING MINORITY POPULATION IN
THE COUNTRY.
THE GROUP IS PROFOUNDLY UNDER
REPRESENTED IN THE BIO MEDICAL
AND BEHAVIORAL RESEARCH
WORKFORCE.
UNDER REPRESENTED IN NIH FUNDING
AND THERE ARE FEW PUBLICLY
AVAILABLE DATA ON DISABILITY
PREVALENCE AT NIH.
SO THOSE ARE THE FACTS, IF YOU
WILL.
AND THERE ARE RECOMMENDATIONS
FROM THIS WORKING GROUP.
THERE ARE A SERIES OF THEM.
NINE TOTAL.
NUMBER ONE IS TO UPDATE THE NIH
MISSION STATEMENT.
TWO IS ESTABLISH THE NIH OFFICE
OF DISABILITY RESEARCH AND THREE
IS ESTABLISH NIH DISABILITY,
ACCESS COORDINATING COMMITTEE
AND FOUR DEVELOP AN INTERNAL NIH
WIDE EFFORT TO ADDRESS
STRUCTURAL ABLISM AND PROMOTE
DISABILITY INCLUSION BY
FOSTERING SUPPORT FOR PERSONS
WITH DISABILITIES WITHIN THE NIH
CULTURE AND ADVANCING INCLUSION
AND ANTIABLISM THROUGH TRAINING
COMMUNICATIONS AND POLICIES.
.
FIVE, REVIEW POLICY, CULTURE AND
STRUCTURE TO IDENTIFY
OPPORTUNITIES TO PROMOTE
DISABILITY INCLUSION IN THE
NIH-FUNDED RESEARCH WORKFORCE.
SIX IS TO EFFORTS TO INCLUDE
PERSPECTIVES OF PERSONS WITH
DISABILITIES.
SEVEN, CONDUCT RESEARCH ON
DISABILITY HEALTH AND HEALTH
CARE DISPARITY AND EQUITY BY
COLLECTING DATA ABOUT THIS AND
SUPPORTING INCLUSION OF DISABLED
PEOPLE AS RESEARCH PARTICIPANTS.
I WOULD LOVE YOUR THOUGHTS ABOUT
THIS SPECIFICALLY.
I KNOW A FEW OF YOU WILL HAVE
THOUGHTS.
I KNOW, JAMES, FOR EXAMPLE, YOU
WORK IN THIS AREA.
AND ARE THERE EXEMPLARS IN THE
COMMUNITY WE SHOULD LOOK AT AND
THINGS NEI SHOULD BE DOING TO
ADDRESS ABLISM.
LET ME STOP THERE AND WOULD LOVE
YOUR REACTIONS ABOUT THIS.
I WANT TO THANK YOU FOR THE
FOCUS.
I KNOW I'M A BIT A FISH OUT OF
WATER AS A PERSON WITH
EXPERIENCE WITH VISION
IMPAIRMENT.
I'M NEARLY TOTALLY BLIND AND
PART OF THE WORK I'VE DONE
OUTSIDE OF THIS ORGANIZATION HAS
BEEN TO DELVE INTO WHAT IS
COMMONLY REFERRED TO AS DEI,
DIVERSITY, EQUITY, INCLUSION AND
ACCESSIBILITY IT'S BEEN A
CORPORATE AND INSTITUTIONAL
MANTRA, IF YOU WILL.
SO FAR IT'S LACKED INCLUDING
PEOPLE WITH DISABILITIES.
A RECENT STUDY CONDUCTED BY
RUTGERS UNIVERSITY THAT FOCUSES
IN ON THE ISSUE CONCLUDED LESS
THAN 4% OF ALL DEI ORGANIZE D
INQUIRIES INCLUDES THESE AND THE
FACT NIH HAS COME THIS FAR, THIS
FAST IS INCREDIBLE.
ONE OF THE ELEMENTS DISCUSSED
PRETTY FAR DOWN THE LIST IS DATA
COLLECTION.
THIS IS AN AREA IN WHICH THE
DISABILITY COMMUNITY WHICH
CONSISTS OF 63 MILLION PLUS
AMERICANS AND A BILLION MORE
AROUND THE WORLD REALLY HAVE
FOUND TO BE A BARRIER IN TERMS
OF WORKING TOWARDS ANY KIND OF
EQUITY OR INCLUSION.
SO I WOULD ACTUALLY ELEVATE THAT
DATA COLLECTION RECOMMENDATION
TO NEAR TO THE TOP OF THE LIST
BECAUSE IF WE DON'T HAVE THE
INFORMATION WE'LL NEVER ACHIEVE
THE EQUITY.
FOR THE FIRST ORGANIZATION
COMPOSED OF SCIENTISTS WHO
RELENTLESSLY SEEK THE CURES AND
PHYSICIANS WHO TAKE CARE OF
PEOPLE LIKE ME AND MILLIONS OF
FAMILIES WHO DEAL WITH THE
IMPACT OF THESE KINDS OF
DISEASES TO BE THE STANDARD
BARRIER IN TERMS OF
UNDERSTANDING DIVERSITY MUST
INCLUDE PEOPLE WITH DISABILITIES
AND THAT EQUITY WILL NEVER EVER
BE ACHIEVED WITHOUT FULL
INCLUSION.
IF THERE IS A WAY TO PUBLICIZE
THIS TO THE OTHER MANY
ORGANIZATIONS INCLUDING MANY
ACADEMIC INSTITUTIONS INCLUDING
INSTITUTIONS LIKE HARVARD WHO
SPEND MILLIONS IT COULD BE AN
OPPORTUNITY TO COLLABORATE AND
INCLUDE PEOPLE WITH DISABILITIES
GOING FORWARD.
>>THANK YOU, JANNIE.
>>THIS IS JAMES COUGHLAN.
I WAS AMAZED BY THE STATISTIC IN
THE PREVIOUS SLIDE IT WAS LIKE
34 OUT OF A 1,000 SUPPLEMENTS.
IT AS A WONDERFUL PROGRAM.
I'VE RECRUITED SOMEONE WITH THIS
PROGRAM.
I WANT TO SEE THE WORD GET OUT
MORE AND IT'S A RECRUITING TOOL
I THINK UNDER APPRECIATED.
THANKS FOR HAVING THAT.
>>DO YOU HAVE ADVICE ABOUT
HELPING NAVIGATE.
>>15 YEARS AGO IT WAS
CONSIDERED QUITE OBSCURE AND ONE
THING THAT'S HEARTENING IS
ACCESSIBILITY IS EXPANDING BY
LEAPS AND BOUNDS AND PEOPLE
THOUGHT IF YOU COULD IGNORE IT
FIVE YEARS AGO, YOU CAN'T
ANYMORE AND YOUNG PEOPLE ARE
EXPECTING IT IN SETTINGS WHERE
THEY NEVER USED TO.
IT'S GETTING EASIER TO PROMOTE
THIS RESEARCH AS SOMEONE
INTERESTING.
IT'S CHICKEN OR EGG OBVIOUSLY
THE FEWER PEOPLE YOU HAVE WITH
DISABILITIES WORKING IN RESEARCH
AND THE LESS OF A MOLT IT MAY
APPEAR TO BE FOR PEOPLE WITH
DISABILITIES.
I DON'T HAVE ANY EASY ANSWER FOR
YOU BUT BASICALLY HAVING THE
PATIENCE TO LOOK FOR AND WIDE TO
SEE WHEN YOU'RE HIRING FOR
INSTANCE I HAVE A COLLEAGUE
WHO'S BLIND WHO WAS INSISTENT WE
HIRE A PROGRAMMER BLIND AS WELL.
THE SEARCH WAS ACTUALLY PRETTY
LONG AND TOOK A WHILE BUT IT WAS
A WONDERFUL FIT.
I'M THINKING ABOUT THIS MORE AS
WE SIT HERE AND IF I HAVE OTHER
IDEAS I'LL LET YOU KNOW.
>>WE'RE GETTING CLOSE TO THE
END OF MY SLIDES.
THIS IS AN UPDATE ABOUT THE
OFFICE OF DATA SCIENCE AND
HEALTH INFORMATICS RUN BY --
THERE'S THREE PHOTOGRAPHS AND
THE PHOTOGRAPH NEXT TO HER IS
FROM OREGON DOING A SABBATICAL
AS A SCHOLAR WITH HER AND HER
GROUP AND AMBER HAS DONE A LOT
OF WORK WITH THIS GROUP.
IT'S A PROJECT CONCEPT.
ON THE ALL OF US PROJECT IS A
PROJECT IT'S PART OF THE U.K.
BIO BANK AND THE GOAL IS TO TAKE
A MILLION PARTICIPANTS FROM AS
DIVERSE BACKGROUND AS POSSIBLE
AND CHARACTERIZE THEM
LONGITUDINALLY AND VERY DEEPLY.
THERE'S VERY LITTLE OCULAR DATA
IN THE DATA SET AND THE PREMISE
OF THESE DISCUSSIONS WE'VE BEEN
HAVING WITH THE ALL OF US GROUP
HAVE BEEN -- THAT ACCESS TO
RETINAL AND OCULAR IMAGING IF
THEY'RE LINKED WITH ELECTRONIC
HEALTH RECORD DATA CAN
ENORMOUSLY EXPAND THE BREADTH OF
STUDIES WITH THE DATA SET.
AND ONE OF THE OTHER THINGS
THERE'S A VERY BIG OPHTHALMIC
INVESTIGATOR COMMUNITY WITH
EXPERTISE AND CAN TAKE ADVANTAGE
OF THIS.
THERE'S OCULAR DATA INCLUDING
THE DATA SET.
THE FIRST PUBLICATION USING THE
DATA SET WAS DONE BY AN
OPHTHALMOLOGIST AND THERE WAS AN
EARLY STUDY FROM STANFORD.
THEY WERE BOTH INVOLVING
GLAUCOMA.
THE PROPOSAL IS TO PLACE RETINAL
CAMERAS IN THE ALL OF US
REGIONAL CENTERS WITH THE GOAL
OF RECRUITING APPROXIMATELY
50,000 PEOPLE AND GETTING
LONGITUDINAL IMAGES IN THEM.
AND TO EXPLORE THIS, CARRIE AND
HER CREW HAVE WORKED ON
BIOENGINEERING TO PUT TOGETHER A
WORKSHOP BEFORE ARVO.
TO LOOK AT WHAT ARE THE
SCIENTIFIC OPPORTUNITIES AND
INCLUDING OCULAR IMAGES IN THE
"ALL OF US" DATA SET AND WHAT
THIS ARE THE DATA NEEDS AND
ANALYTIC TOOLS.
THIS IS SOMETHING WE'RE EXCITED
ABOUT.
THE REST ARE AS WELL.
SO IN TERMS OF PUBLIC HEALTH AND
DISPARITIES, THIS IS GOING TO
PICK UP ON THE PREVIOUS
DISCUSSION.
WE TALKED ABOUT HOME COVID TESTS
NOT BEING VERY ACCESSIBLE
BECAUSE PEOPLE WHO DON'T SEE
WELL CAN'T READ THE INSTRUCTIONS
AND CAN'T SEE THE PINK LINE.
AND SOME HAVE GOTTEN INVOLVED
WITH THE RAD X GROUP.
AT THE BOTTOM IS A PICTURE OF
THEM AND WHAT'S COME OUT SO FAR
HAS BEEN A SET OF BEST PRACTICES
OF DESIGN FOR ACCESSIBLE HOME
COVID TESTS.
MORE TO COME AND THE OTHER THING
I WANT TO HIGHLIGHT IS HAVE
GOTTEN INTERESTED IN THE
QUESTION OF WHY ARE SO MANY
PEOPLE GOING BLIND IN THIS
COUNTRY FROM PREVENTIBLE AND
TREATABLE DISEASE EVEN IN 2023?
JIMMY LEI -- THERE'S BEEN
SEVERAL PEOPLE INVOLVED IN THESE
MEETINGS AND JIMMY GOT STUCK
BEING THE ONE LEADING THEM
TOGETHER WITH NIMHD THE NATIONAL
INSTITUTE OF MINORITY HEALTH AND
HEALTH DISPARITIES AND THEY'VE
BEEN A GREAT GROUP TO WORK WITH
ON THIS.
THEY'RE ORGANIZING A WORKSHOP ON
VISION HEALTH EQUITY APRIL 11
HERE IN BETHESDA.
WE'RE ABLE TO GET TWO GREAT
CO-CHAIRS.
STEVEN McCLEOD AND AARON KOBETZ
FROM THE UNIVERSITY OF MIAMI.
SHE'S SOMEONE WHO I MET THERE'S
WAYS TO GET DIVERSE PEOPLE
INVOLVED IN THESE STUDIES.
THE PURPOSE OF THE WORKSHOP IS
TO GOING TO BE TO IDENTIFY AREAS
WHERE WE CAN BE DEVELOPING
PROJECTS TO NARROW THE GAPS.
WITH THAT KAREN WAS GOING TO
GIVE AN UPDATE ON THE BUDGET?
GOOD TO HEAR YOU.
>>I'M KAREN HOLEBERT AND WILL
PROVIDE THE BUDGET UPDATE.
-- KAREN COLBERT.
I DIDN'T WANT TO ASSUME EVERYONE
KNOWS HOW THE PROCESS WORKS AND
THERE'S FORMULATION AND THE
PRESIDENT'S BUDGET, ACTION BY
CONGRESS, AND EXECUTION OF
ENACTED BUDGETS.
THE BUDGET PROCESS IS COMPLEX
AND ADDRESSES MATTERS FACING THE
COUNTRY.
THE GOAL OF THE PARTY OF THE
MAJORITY IN CONGRESS AND WHO
SITS IN THE WHITE HOUSE AND THE
RELATIONSHIP BETWEEN THE WHITE
HOUSE AND CONGRESS.
I'LL ADDRESS WHAT HAPPENS DURING
THE PROCESS AND THE ROLE OF
CONGRESS AND OTHER FEDERAL
STAKEHOLDERS.
OVER THE DECADES THE BUDGET
PROCESS HAS GONE FROM TIMING
THAT WAS PRETTY PREDICTABLE
REFLECTING REGULAR ORDER TO
TIMING THAT IS QUITE
UNPREDICTABLE.
THERE'S IN STEPS IN THE PROCESS
AND THAT CAN CAUSE DELAYS IN OUR
RECEIVING A BUDGET.
I'LL START WITH THE FORMULATION
OF THE PRESIDENT'S BUDGET.
INCLUDING YEARS WHEN THERE'S A
TRANSITION BETWEEN
ADMINISTRATIONS, GENERAL BUDGET
AND GUIDELINES ARE ESTABLISHED
BY SPRING BY THE PRESIDENT AND
THE OMB, THE PRESIDENT'S BUDGET
OFFICE WORKS WITH FEDERAL
AGENCIES TO DETERMINE SPECIFIC
POLICY AND PLANNING LEVELS TO
GUIDE PREPARATION OF BUDGET
REQUEST.
DURING FORMULATION THE OFFICIALS
IN THE EXECUTIVE OFFICE OF THE
PRESIDENT EXCHANGE INFORMATION
AFFECTING POLICY DECISIONS WITH
THE SECRETARIES OF THE
DEPARTMENTS AND HEADS OF OTHER
GOVERNMENT AGENCIES.
DECISIONS IN REFLECTED BUDGETS
INCLUDING FOR THE ONE OF THE
YEAR IN PROGRESS INFLUENCE
DECISION THE FORTHCOMING BUDGET.
AGENCIES SUBMIT BUDGET REQUESTS
TO OMB .
IN SEPTEMBER THE FINAL STAGES OF
PRODUCING THE FINAL BUDGET
DOCUMENT WOULD BEGIN.
THE LAW GOVERNING THE
PRESIDENT'S BUDGET REQUIRES IT
BE RELEASED ON OR AFTER THE
FIRST MONDAY IN JANUARY BUT NOT
LATER THAN THE FIRST MONDAY OF
FEBRUARY OF EACH YEAR.
THIS TIME LINE GIVES CONGRESS
EIGHT MONTHS TO ACT ON THE
BUDGET BEFORE THE NEW FISCAL
YEAR BEGINS.
WHEN A PRESIDENTIAL TRANSITION
TAKES PLACE, HOWEVER, THE TIME
LINE FOR THE BUDGET RELEASE IS
EXTENDED TO ALLOW THE NEW
ADMINISTRATION TO TAKE OFFICE
AND FORMULATE ITS OWN BUDGET
POLICY.
CONGRESS CONSIDERS THE ABUDGET
AND MODIFIES, OR APPROVES
PORTIONS AND CAN ADD PROGRAMS
NOT REQUESTED BY THE PRESIDENT.
THROUGH THE PROCESS OF ADOPTING
A PLANNING DOCUMENT CALLED THE
BUDGET RESOLUTION, CONGRESS
AGREZ ON TARGETS FOR TOTAL
SPENDING AND RECEIPTS, THE SIZE
OF THE DEFICIT OR SURPLUS AND
DEBT LIMIT.
THE BUDGET RESOLUTION PROVIDES
THE FRAMEWORK BY WHICH
INDIVIDUAL CONGRESSIONAL
COMMITTEES PREPARE BILLS AND
LEGISLATION.
IN A SEPARATE PROCESS PRIOR TO
MAKING APPROPRIATIONS, CONGRESS
USUALLY ENACTS LEGISLATION THAT
AUTHORIZES THE APPROPRIATION OF
FUNDS TO CARRY OUT PROGRAMS AND
IN SOME CASES LIMITS THE AMOUNT
THAT COULD BE APPROPRIATED FOR
CERTAIN PROGRAMS.
CONGRESS BEGINS SHORTLY AFTER
RECEIVING THE BUDGET REQUEST AND
THEN DECIDES ON BUDGET TARGETS
BEFORE STARTING ACTION ON
INDIVIDUAL APPROPRIATIONS.
STANDING COMMITTEES IN THE HOUSE
AND SENATE RECOMMEND BUDGET
LEVELS IN EACH BODY.
THE HOUSE AND SENATE BUDGET
COMMITTEES THEN EACH DEVELOP A
REPORT AND EACH BODY THEN
CONSIDERS A CONCURRENT
RESOLUTION ON THE BUDGET.
THE ESTABLISHED TIME LINE CALLED
FOR THE HOUSE AND SENATE TO
RESOLVE DIFFERENCES BETWEEN
THEIR RESPECTIVE VERSIONS OF THE
BUDGET RESOLUTION AND ADOPT A
SINGLE BUDGET RESOLUTION BY
APRIL 15 OF EACH YEAR.
OUR ROLE IS THE EXECUTION OF
FUNDS PROVIDED BY CONGRESS
FEDERAL AGENCIES ARE NOT ALLOWED
TO SPEND MORE THAN THE AMOUNT
CONGRESS HAS APPROPRIATED AND
FUNDS MAY ONLY BE USED FOR THE
PURPOSE OF SPECIFIED IN LAW.
THE ANTI-DEFICIENCY PREVENTS
THEM FROM ACTING IN LESS THAN
APPROPRIATION UNLESS BY LAW.
DURING THE BUDGET EXECUTION
PHASE AGENCIES MAY NEED MORE
FUNDING THAN THE CONGRESS HAS
APPROPRIATED FOR THE PHYSICAL
YEAR DUE TO UNANTICIPATED
CIRCUMSTANCES.
AN EXAMPLE WOULD BE A NATURAL
DISASTER OR OTHER EVENTS WITH
SIGNIFICANT FINANCIAL
IMPLICATIONS LIKE THE COVID
EPIDEMIC.
UNDER THOSE CIRCUMSTANCES,
CONGRESS CAN ENACT SUPPLEMENTAL
APPROPRIATIONS AS WELL, THE
PRESIDENT THROUGH OMB CAN REDUCE
A PREVIOUSLY ENACTED
APPROPRIATION THROUGH RESCISSION
OR CANCELLATION OF FUNDS.
WE'VE SEEN THOSE PROCESSES PLAY
OUT MANY TIMES OVER THE YEARS
WHERE THE ACTUAL APPROPRIATION
BY CONGRESS IS NOT THE FULL
AMOUNT WE HAVE AVAILABLE TO
OPERATE WITH.
THIS THOSE THE BUDGET CALENDAR
AS IT WOULD PLAY OUT FROM THE
RELEASE OF THE PRESIDENT'S
BUDGET BY THE FIRST MONDAY IN
FEBRUARY THROUGH FINALIZING
APPROPRIATIONS AT THE BEGINNING
OF THE NEXT PHYSICAL YEAR
OCTOBER 1.
AFTER RELEASE OF THE PRESIDENT'S
BUDGET, CONGRESS STARTS THEIR
WORK TO DEVELOP AND REPORT
BUDGET ESTIMATES, COMPLETE
BUDGET RESOLUTION, CONSIDERATION
OF ANNUAL APPROPRIATIONS BILLS,
COMPLETING RECONCILIATION AND
PROVIDING APPROPRIATIONS BEFORE
THE START OF THE NEW FISCAL YEAR
OCTOBER 1.
CONGRESS ONLY PROVIDED NIH WITH
THE BUDGET ONCE IN THE LAST TWO
DECADES.
NOW BRINGING YOUR ATTENTION TO
THIS CURRENT FISCAL YEAR.
WE RECEIVED AN OMNIBUS DAYS
BEFORE CONTINUING RESOLUTION
ALLOWING US TO OPERATE SET TO
EXPIRE DECEMBER 3, 2022.
AN OMNIBUS BILL PACKAGES
MULTIPLE APPROPRIATIONS BILLS
TOO ONE LARGER SINGLE BILL SO
IT'S EASIER TO PASS.
THIS PROVIDES CONTEXT FOR THE
FY2023 BUDGET INCREASE BY
SHOWING IT ALONGSIDE THE
INCREASES THAT NEI HAS RECEIVED
FROM FY2016 AND FORWARD.
WE'VE SEEN MODEST INCREASES EACH
YEAR.
MOST RECENTLY A 3.8% OR INCREASE
THIS FISCAL YEAR AND 3.4%
INCREASE FY2022 WITH THE
SMALLEST RECENT INCREASE IN 2021
AT 1.4%.
I TYPICALLY LIKE TO SHOW HOW
MUCH WE WILL INCREASE THE
PORTFOLIO AND INTRAMURAL
RESEARCH AND MANAGEMENT AND
SUPPORT.
HOWEVER, WE'RE NOT ALLOWED TO
SHOW A PLAN UNTIL THE
INFORMATION IS SUBMITTED TO
CONGRESS AND NIH, THE DEPARTMENT
OF HEALTH AND HUMAN SERVICES AND
OMB ARE WORKING THROUGH THE
PROCESS OF GATHERING AND VETTING
THAT INFORMATION FOR SUBMISSION
TO CONGRESS.
SO I'LL BE ABLE TO SHARE MORE
INFORMATION WHEN WE NEXT MEET.
THIS THOSE A COMPARISON
ALONGSIDE THE INCREASE RECEIVED
BY NIH.
NIH IN TOTAL RECEIVED A 5.6%
INCREASE ABOVE 2022
APPROPRIATION AND NEI RECEIVED
AN INCREASE ABOVE THE FY22
PERCENTAGE.
THE DIFFERENCE IS DUE TO FUNDS
TARGETED BY CONGRESS TO SPECIFIC
PROGRAMS AT THE NIH.
THIS THOSE TARGETED INCREASES
FROM CONGRESS.
MENTAL HEALTH TREATMENT, IMPACT
OF COVID-19, INVESTMENT OF A FLU
VACCINE, ENVIRONMENTAL HEALTH,
HEALTH DISPARITIES, PAIN AND
OPIOIDS RESEARCH, ALZHEIMER'S
DISEASE AND RELATED DEMENTIAS
AND CANCER RESEARCH.
ALZHEIMER'S AND CANCER RESEARCH
CONTINUE TO RECEIVE THE MOST
SIGNIFICANT INCREASES FROM
CONGRESS WITH ALZHEIMERS
RECEIVING $226 MILLION THIS YEAR
IN ADDITION TO THE CURES ACT
MONEY FOR CANCER MOON SO THE
THERE WAS AN INCREASE TO
PRIORITIZE COMPETING GRANTS AND
SUSTAIN COMMITMENT TO CONTINUING
GRANTS.
WE ALREADY KNOW RELEASE OF THE
REQUEST TO THE PRESIDENT'S
BUDGET IS DELAYED.
IN FACT IT'S NOT EXPECTED BEFORE
MARCH.
IDEALLY THE BUDGET RELEASE IS
TIMED TO COINCIDE WITH THE
PRESIDENT'S STATE OF THE UNION
ADDRESS.
THAT WILL HAPPEN THIS COMING
TUESDAY, FEBRUARY 7.
BECAUSE THERE'S NO PRESIDENT'S
BUDGET RELEASED YET WE'LL BE
LISTENING CLOSELY TO THE SPEECH
WITH PRIORITIES OR ANYTHING THAT
SUGGESTS POTENTIAL BUDGET POLICY
FOR FY2024.
BY WAY OF POTENTIAL
CONGRESSIONAL ACTIVITY, THERE
ARE ALREADY MURMURING WE MAY SEE
A MORE CONTENTIOUS PROCESS.
THERE'S THE ONGOING BATTLE ABOUT
RAISING THE DEBT LIMIT.
THE PRESIDENT HAD THE FIRST IN
PERSON MEETING THIS WEEK WITH
THE NEW SPEAKER OF THE HOUSE TO
DISCUSS THE TOPIC.
THERE WERE NO BREAKS THROUGH.
REPUBLICANS ARE PUSHING FOR
SPENDING CUT WHILE THE PRESIDENT
ISN'T BUDGING ON THE DEBT LIMIT
A
AND THERE ARE REPORTS
REPUBLICANS WANT TO TAKE 2020
APPROPRIATIONS BACK TO FY22
LEVELS AND THERE ARE SOME
DEMOCRATS RESPONDING WITH HOW
DISASTROUS THE CUTS WOULD BE.
THERE'S NOTHING TO INDICATE CUTS
OF THIS MAGNITUDE WILL
MATERIALS.
IT WOULD BE MORE OF A SERIOUS
CONCERN IF AND WHEN NIH GETS
FORMAL REQUEST TO EXPLAIN HOW IT
WOULD MANAGE THE DRASTIC CUTS.
TO DATE THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES HAS BEEN
QUIET WE'LL SEE HOW THE PROCESS
PLAYS OUT.
AT THE END OF THE DAY, BOTH
CHAMBERS, THE HOUSE AND SENATE
WOULD HAVE TO AGREE ON CUTS.
A FULL YEAR CONTINUING
RESOLUTION AND HOLDING FUNDING
AT THE FY2023 LEVEL IS WITHIN
THE REALM OF POSSIBLE.
FINALLY, HERE I'M SHARING THE
HEALTH APPROPRIATIONS LABOR
HEALTH AND HUMAN SERVICES
EDUCATION SUBCOMMITTEE ROSTER
RELEASED LAST WEEK.
KAY GRANGER IS THE CHAIR WOMAN
AND EXPRESSED DOING AWAY WITH
RUNAWAY SPENDING ON WASHINGTON
AND VOWED TO PASS CONSERVATIVE
APPROPRIATIONS BILLS.
AND THERE'S SIMILAR
PERSPECTIVES.
WHAT THIS MEAN FOR NIH AND NEI
IS TO BE DETERMINED BUT WE COULD
HAVE A VERY LEAN YEAR COMING
NEXT YEAR.
THAT'S ALL I HAVE FOR A BUDGET
UPDATE FOR TODAY.
THANK YOU FOR YOUR TIME AND I'LL
TAKE ANY QUESTIONS.
>>I'VE BEEN TOLD MY HAIR IS
MORE GRAY THAN WHEN I STARTED
THIS JOB.
ONE OF THE REASONS IS WHAT KAREN
JUST TALKED ABOUT HERE.
IF NOT FOR KAREN, IT WOULD BE
WORSE AND SHE'S VERY CALM.
THANK YOU VERY MUCH.
>>YOU'RE VERY WELCOME.
>>CATHY, I THINK WE'LL STOP
HERE AND HAVE AN OPEN DISCUSSION
PERIOD TOWARD THE END AND A WANT
TO PLANT SOME QUESTIONS AND FEEL
FREE TO RAISE ANYTHING YOU WANT
BUT I'D BE INTERESTED IN OTHER
COMMENTS OR SUGGESTIONS YOU HAVE
ABOUT THINGS YOU DIDN'T GET TO
STAY AND BLUE SKY INITIATIVES
FOR 2023 AND WHAT CAN WE DO
BETTER TO MEET OUR MISSION.
WHAT CAN WE DO BETTER TO MEET
THE NEEDS OF THE VISION
COMMUNITY AND I'VE HAD PEOPLE
TELLING ME THEY HAVE TROUBLE
FINDING WHAT THEY WANT AND
KNOWING WHAT WE'RE ALL ABOUT AND
LASTLY SUGGESTIONS FOR FUTURE
COUNCIL MEETINGS AND FOCUS ON
TOPICS LIKE DEI AND DATA SCIENCE
AND DATA SHARING AND PORTFOLIOS.
DISSEMINATION AND EM --
IMPLEMENTATION AND ANY FINAL
QUESTIONS BEFORE WE TAKE A
BREAK?
>>THANK YOU.
>>IF THERE ARE NO BURNING
QUESTIONS NOW WE'LL HAVE TIME
LATER AND WE'LL GET BACK ON
TRACK THOUGH WE'RE NOT DOING
TERRIBLY WITH TIME.
LET'S TAKE A NO MORE THAN
15-MINUTE BREAK SO IF YOU CAN BE
BACK AT 11:00 a.m.
WE'LL START THE NEXT SESSION AND
A REMINDER IF PEOPLE HAVEN'T
SIGNED IN PLEASE DO THAT SO WE
KNOW WHO'S IN THE ROOM.
THANK YOU.
>>LET'S GET STARTED WITH THE
NEXT SESSION BECAUSE I WANT TO
MAKE SURE WE'RE ON TIME.
CATHY IS MAKING SURE WE'RE ON
TIME.
HOUMAM HAS BEEN THE BRAINS
BEHIND THIS AND RUNS PORTFOLIOS
AND HE'S DONE OCULAR MOTILITY
OVER THE YEARS, NEUROSCIENCE BUT
ONE OF THE THINGS HE'S
RESPONSIBLE FOR IS THE LENS
PORTFOLIO.
ONE OF THE THINGS THAT HAS
STRUCK ME IS LENS IS ONE OF OUR
SMALLEST PORTFOLIOS FOR EYE
DOCTORS IT'S ONE THING EVERY
PERSON GETS AND WE'LL HAVE A
CATARACT OR REFRACTIVE PROBLEM
IN OUR LIVES IF WE LIVE LONG
ENOUGH.
THE QUESTION IS WHAT SHOULD OUR
PORTFOLIO LOOK LIKE AND THAT'S
THE SPIRIT AND AN WILL SPEAK AND
AFTER THEY SPEAK WOLE HAVE A FEW
MOMENTS FOR QUESTION AND THEN
HAVE A DISCUSSION EACH OF THE
THREE FINISHING TOGETHER.
HOUMAM DO YOU WANT TO BEGIN T
THIS.
THANK YOU NEW WORE IN
COORDINATING THIS AND RUNNING
THE PORTFOLIO.
>>GOOD MORNING.
I HOPE IT LEAVE YOU WITH ONE
PREMISE AND ONE PROMISE.
THE PREMISE THERE'S A BUYER
BETWEEN BASIC SCIENCE FINDING
AND PATIENT CARE.
THE PROPOSITION, CONCILIANCE IS
NEEDED.
LET'S TRAVEL BACK IN TIME.
JULY, 1844, CHARLES DARWIN
FINISHED EVOLUTION BY NATURAL
SELECTION.
HE NEXT RELATED TO HIS WIFE,
EMMA, I WRITE THIS IN CASE OF MY
SUDDEN DEATH AS MY MOST SOLEMN
AND LAST REQUEST YOU DEVOTE 400
POUNDS TO THE PUBLICATION.
SHE QUESTIONS HOW IT COULD
EXPLAIN A STRUCTURE AS COMPLEX
AS THE EYE FINDING THE
EXPLANATION UNCONVINCING CHARLES
DARWIN SET ASIDE THE ASSAY AND
WAITED TO WRITE AND IN HIS BOOK
HE WROTE THE EYE WITH ALL THE
CONTRIVANCES FORMED BY NATURAL
SELECTION SEEMS I CONFESS ABSURD
IN THE HIGHEST DEGREE.
FAST FORWARD OVER 150 YEARS
LATER THE BEAUTY OF THE EYE HAS
NOT DIMINISHED.
WHETHER YOU LOOK FOR COMPLEXITY
OR SIMPLICITY, THE EYE HAS IT.
IF YOU'RE INTO COMPLEXITY, TAKE
THE RETINA.
FIVE TYPES OF NEURONS, MULTIPLE
SUPPORT CELLS, BLOOD VESSELS,
IMMUNE CELLS AND THAT'S JUST THE
ANATOMICAL LEVEL AND THE LENS,
EPITHELIAL CELLS AT THE FRONT
AND FIBROUS CELLS IN THE REST.
NO NERVES, NO BLOOD VESSELS OR
NUCLEI.
IN ORDER TO MAXIMIZE THE
REFRACTIVE POWER OF THE LENS
EVOLUTION BY NATURAL GIVES THE
LENS THE HIGHEST LEVEL OF
PROTEIN CONCENTRATION AND TOOK
AWAY PRACTICALLY EVERYTHING
ELSE.
EVEN ORGANELLES IN THE CORE
FIBER CELLS THAT MAY SCATTER
LIGHT GONE AND NO TRANSLATION
AND TRANSCRIPTION.
IF THE SIMPLE STRUCTURE IS
RESPONSIBLE FOR AN INCREDIBLE
LEVEL OF MISERY GLOBALLY, 20
MILLION ARE BILATERALLY AFFECTED
BY CATARACT.
IT'S THE NUMBER ONE REASON
WORLDWIDE AND THERE'S
CONSIDERABLE SURGERIES AT A HIGH
HEALTH COST.
CATARACT HAS HIGH PUBLIC HEALTH
SIGNIFICANCE.
IT'S WORSE BECAUSE CATARACT HAS
A TWIN, PRESBYOPIA AND LIKE A
LENS THAT IS CLOUDY IS NO GOOD,
A LENS THAT CANNOT FOCUS IS NO
GOOD EITHER.
PRESBYOPIA IS PRACTICALLY
UNIVERSAL.
ESSENTIALLY EVERY ADULT OVER 50
HAS IT.
THESE NUMBERS ARE SOBERING BUT
HOW DID YOU DEAL WITH THE
DILEMMA LARGE NUMBERS GO FROM
THE ASTOUNDING TO THE
INCOMPREHENSIBLE.
WE HAVE TWO OUTSTANDING SPEAKERS
TO HELP BETTER UNDERSTAND AND
APPRECIATE THE BURDEN OF
CATARACT.
WHETHER IT'S ACCESS TO CARE,
DISPARITIES OF HEALTH,
PREVALENCE OF CATARACT THESE ARE
COMPLICATED ISSUES INTEGRAL TO
THE MISSION OF THE NIH AND
LOOKING FORWARD TO TODAY'S TALKS
AND THANK THE SPEAKERS IN
ADVANCE FOR TAKING THE TIME TO
BE HERE.
NEI HAS A LONG STANDING PROGRAM
AND SUPPORT RESEARCH IN
UNDERSTANDING THE PATH YO
PHYSIOLOGY OF THESE.
MOST THE SUPPORTED PROJECTS
INVOLVE BASIC SCIENCE
INVESTIGATORS TO ADVANCE FUTURE
CLINICAL APPLICATIONS.
THERE'S MULT WALL WAYS TO
DESCRIBE THE PROJECT SUPPORTED
OVER OVER THE YEARS.
HERE'S ONE WAY.
THE TOPICS CAN BE DIVIDED INTO
DEVELOPMENT, HOMEOSTASIS AND
OXIDATIVE DAMAGE.
I NAMED SOME.
A PROGRAM UPDATE WOULD TYPICALLY
PROVIDE EXAMPLES OF EACH OF
THESE THEMES AND THERE'S A LOT
OF EXCITING STORIES THAT WE
COULD TALK ABOUT.
IN THE INTEREST OF TIME WE TALK
ABOUT SOME OF THESE STORIES BUT
WE USE THEM TO ILLUSTRATE A KEY
BARRIER IN MOVING BASIC SCIENCE
FINDINGS INTO CLINICAL LEADS.
IMPORTANTLY, THIS NOT ONLY
AFFECTS THE CATARACT PROGRAM BUT
OTHER AREAS TOO.
OVER THE YEARS OF BEING THE LENS
AND CATARACT PROGRAM, I HAVE
BEEN COLLECTING SOME OF THE KEY
TERMS THAT COME UP TO UNDERSTAND
LENS BIOLOGY.
HERE'S A LIST WITH SOME TERMS.
WE CAN DOUBLE THE LIST.
THERE'S A PART OF THE PUZZLE AND
THE KEY IS UNDERSTANDING AND
MANY HAVE BEEN PROPOSED.
THERE'S MANY EXAMPLES TO
ILLUSTRATE THE BARRIER.
LET'S TAKE THESE PARTICULAR
EXAMPLES.
THE OXIDATIVE DAMAGE AND IT'S
IMPORTANT TO POINT OUT THESE ARE
EXAMPLES AND NOT UNIQUE.
TAKE THE STORY OF REVERSING
CATARACTS.
A FEW YEARS AGO PAPERS CAME OUT.
THE FIRST IN NATURE AND A COUPLE
MONTHS LATER A CAN'T REPORT CAME
OUT.
BOTH PAPERS HIT UPON THE
LANOSTEROL.
BOTH ABLE TO REVERSE CATARACT IN
VIVO.
THIS PRESENTS A WAY THIS IS A
WAY TO REMOVE CATARACTS.
ONE, BIOLOGICAL PLAUSIBILITY.
THEY'RE PROTEINS THAT PREVENT
AGGREGATION OF OTHER PROTEINS.
UPON AGING, THIS ABILITY
DIMINISHES AND YOU'LL FIND
PROTEINS AGGREGATING AND FORMING
LIGHT SCATTERING AGGREGATES,
CAPACITY FOR CATARACT.
FASCINATINGLY IT TURNS OUT THE
MOLECULE IS ABLE TO FIT NICELY
BETWEEN THE ALPHA A AND ALPHA B
CHRISSAL -- CRYSTALLINE.
AND YOU HAVE HIGH CLINICAL
SIGNIFICANCE, WIDE UTILITY,
BIOLOGICAL PLAUSIBILITY AND THE
FACT THE TWO FINDINGS ARE
INDEPENDENT SO YOU HAVE
INDEPENDENT CONFIRMATION.
NO WONDER THIS HAS BEEN CALLED A
NEW DAWN FOR CATARACTS.
UNFORTUNATELY THE PAPER CAME
OUT.
THEY TESTED THE LENOSTER OL AND
FOUND IT FAILED FOR CATARACTED
AND TESTED THE PROTEIN REPORTED
IN THE SCIENCE PAPER AND FOUND
IT FAILED TOO.
AND THIS CAME OFF THE OTHER
REPORT WHERE THEY FOUND THE SAME
FAILURE.
WHAT'S GOING ON?
MAYBE THE NEW STATEMENT IS THE
SAME AS THE OLD?
NOT SO FAST.
FOLLOWING THE TWO NEGATIVE
REPORTS FOUR PUBLICATIONS FOUND
POSITIVE FINDINGS CONSISTENT
WITH NATURE AND SCIENCE PAPERS.
THEY USED DIFFERENT MODELS.
CLEARLY THESE ARE CONFUSING SETS
OF RESULTS.
AS THE AUTHOR SAID IF YOU'RE NOT
CONFUSED, YOU'RE NOT PAYING
ATTENTION.
THIS IS NOT ABOUT THE MOUSE OR
RAT OR CELL LINE.
IT'S ABOUT US.
IT'S ABOUT ANSWERING AN
IMPORTANT CLINICAL QUESTION, CAN
WE REVERSE CATARACTS WITHOUT
SURGERY IN THE FORM OF AN
OXISOXY
ST
STEROL COMPOUND?
MAYBE, MAYBE NOT.
THIS IS SIGNIFICANT IN TERMS OF
MOVING BASIC SCIENCE FINDINGS
INTO CLINICAL INSIGHTS.
THE CHALLENGES IS BROADER.
YOU HAVE HIGH CLINICAL
SIGNIFICANCE, WIDE UTILITY AND A
NUMBER OF REPORTS, CONFIRMATORY
REPORTS AND OXIDATIVE DAMAGE HAS
BEEN A POWERFUL EXPLANATION USED
FOR ALL SORTS OF HUMAN DISEASE
IN TISSUES BEYOND THE EYE AND
BEYOND AT RACKET.
IT PROVIDES A WAY TO TREAT
DISEASE.
YOU LOWER THE OXIDATIVE STRESS
OR INCREASE THE OXIDATIVE
INTAKE.
THERE'S I NICE CAUSE/EFFECT
LINK.
SO WHAT'S THE PROBLEM?
THIS PAPER TALKS ABOUT THE MYTH
OF ANTIOXIDANTS AND THEY LOOKED
AT THE POPULAR ANTIOXIDANT AND
FOUND THAT THERE'S NO EVIDENCE
IT REVERSES NOR PREVENTION.
WHAT'S GOING ON?
MAYBE IT'S SOMETHING SPECIFIC.
LET'S TAKE A BROADER LOOK.
THERE'S A SECOND COCHRAN REVIEW
WHERE THEY LOOKED AT ANTIOXIDANT
SUPPLEMENTATION FOR SLOWING
PROGRESSION OF AGE-RELATED
CATARACT.
AND THE AUTHORS FOUND THE SAME
FAILURE.
IN FACT THEY CONCLUDED WE DO NOT
RECOMMEND FURTHER STUDIES TO
EXAMINE THE ROLE OF ANTIOXIDANTS
IN AGE-RELATED CATARACT.
THE STUDY HAS BEEN CONFIRMED BY
NEWER FINDINGS.
HERE'S ONE FROM THE ANTIOXIDANTS
FOR PREVENTION AND THEY FOUND
FAILURE AND CONCLUDE THE RISK OF
COUNTERACT BETWEEN THE VITAMIN
GROUP AND PLACEBO NO DIFFERENT.
THIS CHALLENGE IS BEYOND THE
KNACK FOR VITAMINS.
THERE'S FLAVONOIDS AND CAROTENES
AND OTHERS EACH WITH A MOUNTAIN
OF PUBLICATIONS WITH POTENTIAL
EFFICACY AND ALSO A NUMBER OF
DISCREPANCIES AND LOOKING AT THE
DIFFERENT OMICS APPROACHES FOR
READOUTS OF CELL FUNCTION AND
DYSFUNCTION.
IN SOME THERE'S A CATARACT OF
INFORMATION AND FRAGMENTATION.
WHILE THERE'S INFORMATION ON
CELL BIOLOGY THERE'S LESS
UNDERSTANDING.
IT'S SEEN BEYOND OXIDATIVE
DAMAGE.
HERE'S A LIST OF OPPORTUNITIES
BECKONING US TO FURTHER DEVELOP
WHETHER IT'S THE CRYSTALLINES
FUNCTION AND THE ROLE OF THE
STRUCTURE IN DEVELOPMENT OF
CATARACT AND A NUMBER OF OTHER
AREAS.
THIS IS A SIGNIFICANT CHALLENGE
AND AT THE SAME TIME PRESENTS AN
OPPORTUNITY.
WHAT KIND OF OPPORTUNITY?
HOW CAN WE RECONCILE THE
FINDINGS IN THE LITERATURE AND
THE MODELS BEING USED IN ORDER
TO BETTER ACQUISITION SCIENCE
AND OPTIMIZE PATIENT BENEFIT?
THIS IS WHERE CONSILIENCE COMES
IN.
IN THE BOOK WE'RE PRESENTED WITH
THIS CONCEPT OF CONSILIENCE.
AND A JUMPING TOGETHER OF
KNOWLEDGE WITH LINKING OF FACTS
TO CREATE A COMMON GROUND WORK
OF EXPLANATION.
THIS IS NOT ABOUT YOUR TYPICAL
HYPOTHESIS DRIVEN -- YOU CAN
ENVISION A FUNDING OPPORTUNITY
WHERE IT ENABLES PEOPLE
OBSERVING DIFFERENT FINDINGS AND
DISCREPANT FINDINGS USING MODELS
TO WORK TOGETHER TO DISSOLVE THE
DIFFERENCES WITHOUT SOLELY
RELYING ON HYPOTHESIS DRIVEN.
ALL THAT'S NEEDED IS A CHILDLIKE
SENSE OF WONDER.
AND BE PREPARED TO GIVE UP EVERY
PRECONCEIVED NOTION AND FOLLOW
TO WHERE THIS NATURE LEADS YOU
OR YOU SHALL LEARN NOTHING.
RIGOR AND REPRODUCIBILITY HAVE
BEEN ON NIH AGENDA AND IT WILL
INVOLVE ENHANCED RIGOR AND
REPRODUCIBILITY AND INVOLVES
CONSILIENCE.
IT'S ABOUT REDUCING COMPLEXITY.
IT'S ABOUT DEALING WITH
CONTRADICTORY FINDINGS.
REDUCING INFORMATION OVERLOAD.
THE FRAGMENTATION WE SEE,
DIFFERENT SILOS IN TERMS OF
BASIC SCIENCE VERSUS CLINICAL
APPLICATIONS.
AND ABIDING WHILE THE PROBLEM
FOR EVERY WHICH THERE'S
SOMETHING SIMPLE, NEAT AND
WRONG.
THE CHALLENGES ARE IMMENSE.
A LOT NEEDS TO BE DONE BUT WE
NEED TO SEE LESS OF THIS.
HERE'S THE RECENT PUBLICATION
WHERE THE AUTHORS TALK ABOUT
INDIVIDUALIZED CHEMO THERAPY FOR
CONGENITAL CAT RABLTHS.
-- CATARACT.
I OPENED WITH THE BEAUTY OF THE
EYE AND THE BEAUTY OF THE LENS.
HISTORIANS TELL US THAT BEFORE A
PROCEDURE CALLED POUCHING WAS
USED.
ESSENTIALLY YOU SHOVE THE
CATARACT TO A LENS ASIDE.
THAT LASTED FOR THOUSANDS OF
YEARS UNTIL 1010 WHEN AN
ASPIRATED THE LENS SIMPLY BY
SUCTION.
THAT WAS THE YEAR 1010.
1,010 YEARS LATER WE'RE STILL
ASPIRATING THE LENS.
A LOT OF ADVANTAGES TOOK PLACE
BUT IT'S A HUMBLING REMINDER
CATARACT IS WHAT IT'S ALWAYS
BEEN.
SUCCESS IS IT NOT FINAL.
FAILURE IS NOT FATAL.
IT'S THE COURAGE TO CONTINUE
THAT COUNTS.
THANK YOU FOR YOUR TIME.
>>THANK YOU.
QUESTIONS FOR HOUMAM.
>>WONDERFUL TALK ABOUT THE
EVENTS.
ID NEEDS TO BE MENTION ED
STRONGER LENS PROGRAM AND THEY
KNOW THAT.
>>THANK YOU.
>>YOUR PORTRAYAL OF THE LENS OF
TO BE A MODEL SYSTEM TO ASPIRATE
PUTTING IT TOGETHER IS WORTH
INCREASING THE PROGRAM INTERNAL,
EXTERNAL RESEARCH.
THANK YOU VERY MUCH.
>>HOUMAM, THANK YOU VERY MUCH.
>>I THINK WE APPRECIATE THE
BURDEN OF BLINDNESS FROM
CATARACT AND WE'LL HEAR FROM
ANNE COLEMAN.
AND THERE'S BEEN WORK BY HUGH
TAYLOR AND OTHERS I REMEMBER AS
A MEDICAL STUDENT IN BALTIMORE
ISSUE IS LEARNING ABOUT DISEASE
AND THE CURE.
THE CURE IS THE RELATIVELY
SIMPLE PROCEDURE OF CATARACT
SURGERY AND THE COST AND EXPENSE
TO SOCIETY HAS COME DOWN
CONSIDERABLY OVER THE YEARS.
REIMBURSEMENTS HAVE GONE FROM
HUNDREDS OF DOLLARS TO
THOUSANDS.
THE OVER ALL CHARGE I THINK THE
$4,000 RANGE IS EQUIVALENT FOR
WHAT INSURANCE PAYS FOR GLAUCOMA
MEDS AND DRY EYE MEDS OVER THE
YEAR.
ALL THESE COST ABOUT $500, $600
A MONTH AND THE QUESTION IS NOT
ONLY SCIENTIFIC BUT SOCIO
ECONOMIC ONE.
WE NEED TO FIGURE OUT A SOLUTION
NOTE ONLY ADDRESSES ACCESS TO
HEALTH CARE AND BLINDNESS TO
CATARACT BUT HOW DO WE CHANGE
THE EQUATION.
SAY WE HAD A MAGIC DRUG OR DROP
OR WHAT HAVE YOU, ORG OR TOPICAL
OR WHAT HAVE YOU THAT COULD
PREVENT OR STOP THE PROGRESSION
OF LENS DISEASE.
IT WILL HAVE TO BE SUCH THAT
THERE WOULD BE LESS THAN
CATARACT PROCEDURE.
WE NEED TO THINK ABOUT THE
ECONOMIC ASPECT.
NOT THE USUAL GAP BETWEEN
SCIENCE AND CLINICAL
TRANSLATION.
IN CONTRAST WHEN WE THINK OF
DEGENERATIVE DECISION IT'S A
DIFFERENT ECONOMIC CALCULUS.
>>YOUR PRESENTS DO A LOT TO
MOTIVATE THE TALKS COMING UP.
THANK YOU VERY MUCH.
WE'LL TRANSITION TO DOUG AND
THEN ANNE.
>>THE FOR THE OPPORTUNITY TO
PRESENT THE CLINICAL UNMET
NEEDS.
I'M DOUG RHEE FROM OHIO CASE
WESTERN UNIVERSITY.
THANK YOU FOR THE ASSISTANCE
WITH THE AUDIO VISUAL.
THESE ARE MY DISCLOSURES.
I WANTED TO DISPLAY THEM FOR
EVERYONE.
I HAVE RESEARCH FUNDING AND SOME
AD HOC CONSULTING I DO WITH SOME
CORPORATIONS.
AS FAR AS AN OVERVIEW IN
CATARACT PRACTICE.
IT'S NOT A DISEASE BUT AN AGING
PRACTICE.
CATARACT SURGERY IS ONE OF THE
MOST SUCCESSFUL AND SAFEST
PROCEDURES IN MEDICINE ALIGNING
FOR VISUAL RESTORATION FOR WHAT
WOULD BE THE MOST COMMON CAUSE
OF BLINDNESS IN THE UNITED
STATES.
IN FACT CATARACT SURGERY IS
LISTED AS ONE OF THE SCIENCES IN
MEDICINE'S MOST DISTINGUISHED OR
MOST IMPACTFUL INNOVATIONS IN
MODERN HISTORY.
WITH THAT SAID SHOULD I STOP THE
TALK NOW?
WHAT ELSE IS NEEDED?
WHAT ARE OUR UNMET NEEDS?
PREVENTING CATARACT FORMATION OR
REVERSING ITS PROCESS.
THERE ARE A WONDERFUL CADRE OF
LABORATORY SCIENTISTS HOUMAM
WENT OVER AND WE LEAVE IT TO THE
LABORATORY SCIENCE.
MY VIEW OF THIS IS GOING TO BE
PRIMARILY FROM A CLINICAL ONE.
WE'D LIKE TO BETTER UNDERSTAND
ACCOMMODATION AND PRESBYOPIA.
THAT WILL PROBABLY ALSO COME
FROM LABORATORY SCIENTISTS.
WHEN WE LOOK AT MODIFYING THE
PROCEDURE AND INSTRUMENTATION,
BEST INSTRUMENTATION, BETTER
TUBING, THAT'S PROBABLY GOING TO
COME FROM INDUSTRY.
AS FAR AS BETTER INTRAOCULAR
LENS IMPLANT CAN MAKE A
SIGNIFICANT ADVANCE.
THAT PRIMARILY PROBABLY GOING TO
COME FROM INDUSTRY.
WHAT ARE THE UNMET CLINICAL
NEEDS WE CAN ADDRESS?
ONE, REDUCING COMPLICATIONS OR
NEGATIVE SEQUELAE OF THE SURGERY
AND INFECTION AND YOU'LL SEE
FROM LATER SLIDES THAT'S ONE OF
THE PRIMARY MOTIVATORS FOR WHAT
WE DO.
REDUCING POST OCULAR EDEMA AND
CAN ADDRESS DISPARITIES IN
CATARACT CARE.
I'LL SAVE COMMENTS FOR THAT FOR
DR. COLEMAN.
WE WANT TO BECAUSE THIS IS SUCH
A COMMONLY PERFORMED PROCEDURE,
I THINK WE HAVE TO THINK ABOUT
ENHANCING SUSTAINABILITY IN
MULTIPLE WAYS.
DR. DANA MENTIONED ECONOMIC
SUSTAINABILITY AND THERE'S
MULTIPLE ASPECTS.
I LISTED THREE DISTINCT POINTS.
THE REALITY IS THIS VEN DIAGRAM
WHERE YOU HAVE OVERLAP INTERESTS
IN ENHANCING ACCESS AND
SUSTAINABILITY.
ONE OF THE COMMON AREAS IS
REDUCING THE EFFORTS.
I WANT TO FIRST TALK ABOUT
SUSTAINABILITY.
IN 2013 THE U.S. HEALTH
SECRETARY WAS RESPONSIBLE FOR
10% OF THE GREENHOUSE GAS
EMISSIONS FROM THE UNITED
STATES.
IF U.S. HEALTH CARE WERE A
COUNTRY, IT WOULD BE THE FIFTH
LARGEST CONTRIBUTOR TO CARBON
EMISSIONS IN THE WORLD.
BETWEEN 2010 AND 2018,
U.S. HEALTH CARE GREENHOUSE GAS
EMISSIONS HAVE ONLY RISEN BY 6%.
OPERATING ROOMS PRODUCED 30% OF
A FACILITY'S TOTAL WASTE.
THAT INCLUDES FOOD, OFFICE
SUPPLIES.
IF YOU LOOK AT MEDICALLY
REGULATED WASTE THE ORs PRODUCE
TWO-THIRDS OF THAT.
IF YOU LOOK AT CATARACT SURGERY
THE MOST COMMONLY PERFORMED IN
2019, 29 MILLION CATARACT
SURGERIES WERE PERFORMED
GLOBALLY AND 4. 2 MILLION IN THE
U.S. AND BY 205015 MILLION
PEOPLE WILL HAVE CATARACT IN THE
UNITED STATES.
WHEN WE LOOK AT THE AMOUNT OF
O.R. WASTE KEEP IN MIND CATARACT
SURGERY IS PERFORMED PRIMARILY
IN ASCs NOT IN MAJOR HOSPITAL
FACILITIES BUT AMBULATORY
CENTER.
THIS STUDY WAS DONE IN ENGLAND
WHEN THEY LOOKED AT THE MAJORITY
OF GREENHOUSE GAS, 53.8% GO TO
PROCUREMENT.
THAT GOES TO UNUSED MEDICATIONS,
THE DISPOSABLES.
THE SINGLE-USE TUBING
INSTRUMENTS AND AGAIN THE
MEDICATIONS.
IN TRYING TO QUANTIFY THE
POTENTIAL AFFECT OF UNUSED
PHARMACEUTICALS IN CATARACT
SURGERY, THIS TEAM LOOKED AND
FOUND ROUGHLY APPROXIMATELY
BETWEEN FOUR SITES IN THE
U.S. AND FOUND BETWEEN 2000 TO
7,000 KILOGRAMS OF CO2 PER MONTH
WERE GENERATE THE BY THEIR
FACILITIES.
LOOKING AT JUST UNUSED
MEDICATIONS WE'RE MANDATED TO
DISPOSE OF IT WAS $148 PER
CATARACT SURGERY UNUSED.
DR. DANA MENTIONED THE DECLINING
REIMBURSEMENT BUT THE COST STILL
MAIN SIGNIFICANT AND I CAT
CREATE A GREATER ACCESS ISSUE
AND IF YOU MULTIPLY IT BY THE
CATARACTS PER YEAR IT'S $628
MILLION A YEAR AND THE
U.S. SPENDS $6.8 MILLION ON
CATARACT SURGERY ALONE?
WHY ARE WE SPENDING SO MUCH?
THERE'S MULTIPLE FACTORS BUT
SOME IS MANDATING SINGLE USE OF
PHARMACEUTICALS AND WHAT ARE
CALLED DISPOSABLES.
SINGLE USE TUBING
INSTRUMENTATION AND OTHER THINGS
REQUIRED.
THE REGULATIONS MANDATING THESE
ARE NOT EVIDENCE BASED.
THEY'RE DESIGNED TO REDUCE THE
RISK OF ENDOPHTHALMITIS.
AND IN INDIA THEY INSTITUTED
WESTERN O.R. PROTOCOLS.
THEY HAD ONLY ONE PATIENT IN THE
O.R. AT A TIME.
THEY CHANGE GOWNS AND GLOVES
BETWEEN CASES.
AND THEY LOOKED BACK IN A
RETROSPECTIVE STUDY AND USING
THE ARAVIND PROTOCOL AND THEY
FOUND NO DIFFERENCE IN THE
RUPTURE OR ENDOPHTHALMITIS
RATES.
IF YOU LOOK AT ACCESS TO HEALTH
CARE WHAT CAUSES DISPARITIES I
THINK WE'VE ALL NOTICED ISSUES
WITH SUPPLY CHAIN.
THE FIVE BARRIERS AT LEAST THIS
ARTICLE IDENTIFIED BUT THERE'S
COMMONALITY AND INSUFFICIENT
INSURANCE AND STAFF SHORTAGING,
STIGMA AND BIAS AMONGST THE
MEDICAL COMMUNITY.
TRANSPORTATION AND WORK-RELATED
BARRIERS AND PATIENT-RELATED
BARRIERS.
I'LL LOBBY FOR YOU THOUGH WE'RE
NOT SUPPOSED TO BUT
INTELLECTUALLY AND INSUFFICIENCY
IN COVERAGE AND AFFORDABILITY
AND TRANSPORTATION ARE KEY
BARRIERS.
THERE ARE DIFFERENCES IN
BLINDNESS RATES BETWEEN AFRICAN
AMERICAN AND NATIVE AND EUROPEAN
ANCESTRY AND GEOGRAPHIC
DIFFERENCES BETWEEN URBAN AND
RURAL SETTINGS.
COST IS OFTEN THE TOP BARRIER IN
ANY SURVEY.
I PICKED THIS PAPER AND LANGUAGE
AND FINANCIAL BARRIERS COMPETE
ACCESS AND COST IS IMPORTANT.
LET ME TALK ABOUT REDUCING
ENDOPHTHALMITIS.
IN A RETROSPECTIVE REGISTRY
STUDY THE ARAVIND'S OWN REGISTRY
OF 10 REGIONAL SMALLER HOSPITALS
THAT MAKE UP THEIR SYSTEM
LOOKING AT OVER 2,000 SURGERIES
AND A FOURTH GENERATION FLUORO
QUINOLONE TO PREVENT THE
OPHTHALMITIS AND FOR THE
MECHANICAL MEANS OF REMOVING THE
CATARACT.
AND IN THE COHORT STUDY
INTERROGATING THE IRIS DATABASE
THERE'S AN AUTHOR WE'LL FIND
FAMILIAR LOOKING AT 5.4 MILLION
PATIENTS FOR PROCEDURES BETWEEN
2013 AND 2017 FOUND THE RATE TO
BE 0.4%.
CONSEQUENCES ARE SIGNIFICANT AND
44% STILL ACHIEVE 20/40 VISION
OR BETTER.
THE CONSEQUENCES OF
ENDOPHTHALMITIS ARE SIGNIFICANT.
WHY DON'T WE USE THIS IN THE
UNITED STATES?
THIS IS THE MOST RECENT SURVEY
AND IN 2021 OF ASCRS MEMBER
RESPONDENSS -- RESPONDENTS, 66%
WERE USING MOXIFLOXACIN AND
THEY'RE CONCERNED ABOUT THE
LIABILITY ISSUE OF A STERILE
INFLAMMATION OF COMPOUNDED
PRODUCTS AND OFF-LABEL USE.
IN 2014, GOING BACK ALMOST A
DECADE NOW THE SAME SURVEY
STATED 84% STATED THEY WOULD USE
INTRACAMERAL MOXIFLOXACIN AND
WE'RE POSITIONED FOR EQUIPOISE
WITH A PRODUCTIVE STUDY.
SHOULD WE THROW OUR HANDS UP AND
NOT DO ANYTHING?
ABSOLUTELY NOT.
THIS IS EYE CARE THIS IS THE
NATIONAL INSTITUTE WE CAN CHANGE
THE WORLD.
WE NEED EVIDENCE TO COMBAT
EMINENCE.
WITHIN THE REALM OF
SUSTAINABILITY AND DECREASING
COSTS OF HEALTH CARE IN ORDER TO
EQUALIZE AND MINIMIZE HEALTH
CARE DISPARITIES WE CAN LOOK AT
EQUIPMENT BEFORE AND AFTER
SURGERY AND DO COMPARATIVE
COHORT AND REGISTRY TRIALS
COMPARING OUTCOMES OF MULTI-USE
VERSUS SINGLE USE.
PARTICULARLY BECAUSE SINGLE USE
WAS A MODERN REGULATION MEANING
RECENTLY AND I BELIEVE THESE CAN
HELP EQUALIZE DISPARITIES.
THERE WAS A STUDY OF
PREOPERATIVE MEDICAL TESTING.
IT WAS ROUTINE PATIENTS GOT AN
AN EXTENSIVE EVALUATION.
AFTER THIS MOST HAS BEEN
ABANDONED SAVING TIME,
INTERVENTION AND COST.
AND HAVING EXHAUSTED ALL
REGULATORY METHODS GETTING
APPROVED A RANDOMIZED CONTROL
TRIAL IS NEEDED NOT ONLY TO GET
AN FDA PRODUCT BUT TO CONVINCE
THE REMAINING 48% OF OUR
COLLEAGUES THIS IS THE BEST WAY
FOR THE STUDY AND IT'S SUPERIOR
TO TOPICAL MOXIFLOXACIN AND IT'S
GENERALLY CONSIDERED THE
STANDARD CARE FOR
ENDOPHTHALMITIS PREVENTION.
I WON'T GO IN THE DETAILS OF THE
TIME-SLATED DESIGN BUT IT'S A
PERSPECTIVE RANDOMIZED PLACEBO
CONTROL TRIAL WHERE YOU COMPARE
THOSE WHO JUST GOT THE TOPICAL
VERSUS ONLY THE INTERCAMERAL
MOXIFLOXACIN.
DAUNTINGLY 74,000 PATIENTS WOULD
BE REQUIRED WHICH IS WHY THE
STUDY HASN'T BEEN DONE BEFORE.
THE CONCEPT OF PERFORMING THE
STUDY HAS BEEN CONCEPTUALIZED
FOR DECADES BUT THE COST AND
SCOPE HAVE BEEN PROHIBITED FOR A
SING AT ORGANIZATION OR COMPANY
TO COMPLETE.
WE'VE GOTTEN A CON -- CONSORTIUM
TOGETHER AND WE HAVE AN AUDITING
AND RESOURCE TEAM CALLED SMART
AND THE PHARMACY COORDINATING
SYSTEM AND DESIGN A TRIAL AND
PROTOCOL CODIFIED WITH A 56-PAGE
SPA.
THE PROJECT WAS PASSED THE
INITIAL REVIEW OF THE V.A. BY
DR. WONG TO GO IN THE PLANNING
PHASE.
DURING THAT TIME WE ALSO DID
WHAT WE CALL MOXI-TOXY STUDY TO
MAKE SURE THE DOSE OF
MOXIFLOXACIN WOULD NOT BE BAD
FOR THE ENDO THELIUM.
AND WE VERIFIED THE BENEFIT FOR
THE INTRACAMERAL MOXI AND WE
HARMONIZED THE REVIEW PROCESS.
IT DID NOT PASS FINAL REVIEW.
THE CONCERN WAS AT THE TIME WE
DID NOT HAVE YET A
PHARMACEUTICAL COMPANY OR
PARTNER AND THE COST BURDEN.
MAJOR CONCERN WE HAVE TWO LOIs
TO COOPERATE AND THE PROTOCOL
WAS REVISED AND TOLL SHARE IN
THE COST BURDEN OF THE STUDY.
DESPITE THE GREAT EFFICACY AND
SAFETY OF CATARACT THERE REMAINS
A SIGNIFICANT UNMET NEED TO
ADDRESS ACCESS TO CATARACT
SURGERY AND DISPARITIES FOR CARE
AND THE NEED TO ADDRESS
SUSTAINABLE.
THERE'S POTENTIAL TO PARTNER
WITH KEY STAKEHOLDERS TO ADDRESS
THE UNMET NEEDS.
THANK YOU.
>>THANK YOUVIC.
QUESTIONS FOR DOUG?
>>WHO IMPOSES THE REGULATIONS
THAT ARE CURRENT STATUS QUO?
>>I BELIEVE OSHA.
>>MAUREEN MAGUIRE.
WHY HAS A COMPANY NOT BEEN
INTERESTED IN SUPPLYING THE
INTRACAMERAL MOXIFLOXACIN WITH
12 MILLION SURGERIES A YEAR YOU
DON'T NEED A HIGH PROFIT FOR A
PROFITABLE BOTTOM LINE.
>>THEY HAVE TO DO THIS STUDY
THAT'S BEEN THE MAIN BARRIER.
>>THAT WAS TERRIFIC.
EMMA HARTNETT.
AFTER THE CLINICAL TRIAL AND IF
YOU KNOW THE INTRACAMERAL
MOXIFLOXACIN IS SUPERIOR WHAT
EFFORTS ARE NEEDED TO CHANGE
WHAT THE RULES ARE NOW?
>>I BELIEVE ONCE WE HAVE THE
EVIDENCE TO MAKE ONE
RECOMMENDATION ONE WAY OR THE
OTHER THEN IT'S JUST A MATTER OF
ENGAGEMENT.
RESPECTRY AGENCIES OR AT LEAST
FOR OUR COLLEAGUES, ENGAGEMENT
AT THE EDUCATIONAL STANDPOINT.
FOR THINGS LIKE THAT I'M HIGHLY
CONFIDENT OUR PROFESSIONAL
SOCIETIES WOULD DO AN EXCELLENT
JOB DOING THAT AS THEY
TRADITIONALLY HAVE DONE.
>>
>>VICTOR PEREZ.
NICE TALK.
THINKING OUT LOUD AND BEING IN
INDIA AND LATIN AMERICA WHERE
THEY DO CATARACT SURGERY WITH
CERTAIN INSTRUMENTS OR
INJECTIONS, ETCETERA WE DON'T
SEE THIS INCREDIBLE AMOUNT.
PERHAPS YOUR TIME MAY CREATE A
SAFETY BED AND I THINK LIABILITY
IS A HUGE PROBLEM IN THE UNITED
STATES.
HOW CAN YOU ADDRESS THAT?
I THINK A LOT OF OUR LIABILITY
COMES FROM WHETHER YOU FOLLOW
THE STANDARD OF CARE OR NOT AND
WHETHER THERE'S BEEN A
DEVIATION.
THE COMMUNITY STANDARD WHICH IS
IMMENSE BASED DICTATES AND WE
NEED CHANGES TO CHANGE THINGS OR
SUPPORT THEM.
>>HEY, REZA.
>>WHY HAS INDUSTRY NOT CHECKED
IN AND TECHNOLOGIES WHETHER
PHARMA OR DEVICES THAT RELATE TO
COMMONLY PERFORMED PROCEDURES IN
OR ARE PART OF WHAT WE CALL
BUNDLED PAYMENTS.
THE CONCEPT OF CATARACT SURGERY
WHICH INCLUDES EVERYTHING FROM
THE ELEMENTS OF THE TUBING AND
DRAPES ARE ALL BUNDLED INTO ONE
COST WHERE SURGICAL COSTS ARE
PAID FOR BY MEDICARE OR ANOTHER
CARRIER.
BECAUSE OF THAT BUNDLE THE
MARGINS THAT COMPANIES CAN MAKE
VERY LIMITED.
UNLESS DOUG AND THE OTHERS DO
STUDIES THAT SHOW SIGNIFICANT A
SIGNIFICANT ADVANTAGE TO THEIR
HYPOTHESIS ADMINISTRATION
INTRACAMERALLY WILL LEAD TO
COMPLICATION.
THE COST WILL HAVE TO BE BUNDLED
AND THEREFORE BECOME IMPROBABLE.
SO INVESTORS TYPICALLY SHY AWAY
FROM THOSE ENTRIES AND IF THEY
MAKE AN AGREEMENT WITH A
SURGICAL SITE THEY'RE WILLING TO
PROVIDE THEY CAN'T GET IT
THROUGH AT THE COST.
AS COSTS GO UP IT WILL FORCE
CONSTRICTION OF AVAILABILITY OF
THE MOST COMMONLY PERFORMED AND
WOULD WORSEN DISPARITIES FOR
CATARACT CARE.
>>THANK YOU FOR YOUR TALK.
AND FOR THE QUESTIONS AFTER
THAT.
TO ME THE QUESTIONS HIGHLIGHT
IT'S IMPORTANT TO THINK ABOUT
OUR WORK WITHIN A BROADER
SOCIETAL CONTEXT.
YOU MENTIONED THINGS LIKE
ENVIRONMENT, SUSTAINABILITY,
COST EFFECTIVENESS AND
FEASIBILITY AND WHAT I'M TAKING
FROM THIS THERE ARE THINGS WE
SHOULD BE THINKING ABOUT IN
TERMS OF THE OUTPUT SHOULDN'T
JUST BE A RESEARCH PAPER THAT
GOES TO OPHTHALMOLOGY MAYBE WE
HAVE TO LOOK AT THESE OTHER
THINGS.
LET ME SUGGEST WE MOVE OVER AND
SWITCH TO ANNE BECAUSE I THINK
IT WILL BE A PERFECT SEGUE TO
WHAT SHE'S TALKING ABOUT.
>>I WANTED TO THANK YOU FOR
HAVING ME HERE TO SPEAK AND I
THINK YOU'LL SEE FROM MY
PRESENTATION A LOT OF PEOPLE
HOUMAM AND DOUG AND MEMBERS OF
THE COUNCIL HAVE ALL REFERRED TO
THE IMPORTANCE OF HEALTH
DISPARITIES IN FUTURE RESEARCH.
I DID WANT TO POINT OUT THE
NATIONAL EYE INSTITUTE HAS BEEN
ON THE FOREFRONT OF FUNDING
POPULATION HEALTH STUDIES.
YOU'LL SEE AS I GO THROUGH THE
STATUS AND KNOWLEDGE OF CATARACT
AND CATARACT SURGERY WE WOULDN'T
BE WHERE WE ARE WITHOUT THE
NATIONAL EYE INSTITUTE AND THE
FUNDING AND THIS COUNCIL AND OUR
PRIOR COUNCILS.
I JUST WANTED TO THANK EVERYBODY
AND THE PROJECT OFFICERS AND THE
WHOLE ORGANIZATION FOR
EVERYTHING YOU'VE DONE TO MAKE A
DIFFERENCE IN THE HEALTH CARE
NOT JUST FOR THE UNITED STATES
BUT FOR THE WORLD.
I DON'T KNOW IF YOU GET THANKS
TOO OFTEN BUT WANT TO THANK YOU
FOR THAT BECAUSE IT'S VIT YAL.
TO DESCRIBE WHAT'S ON THE SLIDE,
TO THE LEFT IS A PICTURE OF THE
CAMPUS OF OPHTHALMOLOGY FOR
UCLA.
FOR THE JULE STEIN EYE
INSTITUTE AND WE HAVE THREE
BUILDINGS.
WE'VE BEEN AFFILIATED WITH THE
DOHENY EYE INSTITUTE THE
AFFILIATION WAS SIGNED IN 2013.
THEY HAD A NEW BUILDING THEY
PURCHASED IN PASADENA WHERE WE
HAVE TWO FLOORS OF RESEARCH AND
ONE FLOOR CLINICAL AND WE'LL
ALSO BE BUILDING AN AMBULATORY
SURGERY CENTER.
BUT WHERE I COME FROM JUST TO
HAVE AN IDEA OF WHAT'S HAPPENING
AT UCLA.
IN TERMS OF POPULATION HEALTH
AND CATARACT I WAS ASKED TO
FOCUS ON GAPS AND OPPORTUNITIES
AND FINANCIAL DISCLOSURE.
WAS RECENTLY A CONSULTANT FOR
THE ALCON INSTITUTE FOR STUDIES
ON GLAUCOMA AND TO REMIND YOU
WHAT EVERYBODY'S BEEN TALKING
ABOUT CATARACTS IS COMMON IN THE
UNITED STATES AND YOU DON'T HEAR
PEOPLE IN THE STREET COMPLAINING
BECAUSE WE HAVE A SURGERY.
WE DO CONSIDER IT TREATABLE BUT
IT DOES CAUSE AGE-RELATED VISION
LOSS AND YOU'LL SEE IN THE TALK
THERE'S A CATARACT BURDEN IN THE
UNITED STATES.
A LOT OF TIMES WE TALKED ABOUT
THE CATARACT BURDEN IN
DEVELOPING WORLD BUT WE ALSO
HAVE IT IN THE DEVELOPED WORLD.
AND MORE THAN HALF OF AMERICANS
GREATER THAN 80 ARE LIVING WITH
CATARACTS AND THIS IS ASSOCIATED
WITH INCREASE MORBIDITY AND
MORTALITY ASSOCIATED WITH THAT.
IN ADDITION WE HAVE DONE
POPULATION-BASED STUDIES TO
SAMPLES FROM THE POPULATION AND
WE FIGURED IT OUT IN THE UNITED
STATES AND DEVELOPING WORLD WHEN
YOU LOOK AT THE UNITED STATES
IT'S VERY INTERESTING BUT IT
REALLY RANGES WHAT IS THE
PREVALENCE OF CATARACT IT'S 2.8%
TO 27.1% IN THE BALTIMORE
NURSING HOME RESIDENCE STUDY IN
THE LATE '80s I WAS ASKED TO
MENTION CATARACT SURGERY IS
EXTREMELY EFFECTIVE AND A LOT OF
TIMES THERE'S POLICIES LIKE
LET'S TAKE OUT THE CATARACT IN
ONE EYE.
IF YOU DO SURGERY IN ONE EYE DO
YOU NEED TO DO IT IN THE SECOND
EYE AND IT HELPS RESTORE
BINOCULAR VISION.
THIS MAKES A DIFFERENCE IN THE
QUALITY-ADJUSTED LIFE YEARS YOU
GET A GAIN OF 1.6 YEARS FOR THE
FIRST EYE SURGERY AND DOUBLES
2.8 FOR BILATERAL SURGERY.
AND YOU HAVE A 50% REDUCTION
AFTER THE SECOND EYE SURGERY.
IT'S WORTH IT TO TAKE OUT THE
SECOND CATARACT.
WE HAVE DONE STUDIES
POPULATION-BASED AND THIS WAS A
WHILE AGO BACK IN THE BALTIMORE
EYE SURVEY ONCE AGAIN IN THE
LATE 80s AND EARLY 90s.
THE CATARACT PREVALENCE IN THE
BLACK POPULATION WAS 15.9 PER
THOUSAND AND THAT WAS GREATER
THAN IN THE WHITE POPULATION 9.1
PER 1,000.
WE ALSO FOUND WITH SHEILA WEST
IN THE EVALUATION PROJECT BLACK
PARTICIPANT FOUR TIMES MORE
LIKELY TO HAVE CORTICOCATARACTS
THEN THE WHITE PARTICIPANTS AND
THE WHITE PARTICIPANTS WERE TWO
TIMES MORE LIKELY TO HAVE
CATARACT SURGERY COMPARED TO
BLACK PARTICIPANTS.
AGAIN THIS WAS BACK IN THE '90s.
AT THAT POINT WE WERE FINDING
THERE WAS A DIFFERENCE IN THE
PREVALENCES AND THERE WAS A BIG
DIFFERENCE IN ACCESS.
PEOPLE STARTED WORKING ON IT A
LITTLE BIT.
ONE OF THE ISSUES YOU'LL SEE IS
A LOT OF OUR RESEARCH HAS
STOPPED.
WHY IS THAT?
YOU HAVE TO HAVE MONEY AND
RESOURCES BECAUSE THAT'S WHY ME
INVESTIGATORS GO.
WOULD WERE FINDING THE PROBLEM
BACK IN THE '90s AND I THOUGHT
THAT WAS A WELL RESEARCHED AREA
BUT FOR WHATEVER REASON THE
RESEARCH DIDN'T BLOSSOM AS YOU
WOULD HAVE THOUGHT.
WE DIDN'T SOLVE THE PROBLEM.
HERE WE ARE, 30 YEARS LATER
STILL WITH A REAL ISSUE AND
CATARACT BURDEN IN DIFFERENT
ETHNIC AND RACIAL GROUPS AND IN
THE LATINO WE FOUND A
DISCREPANCY AND HISPANICS WERE
AT HIGHER RISK THAN HAVING
CATARACTS THAN BLACKS AND WHITES
WERE AT 2.5%.
IN THE LOS ANGELES LATINA EYE
STUDY LATINO ADULTS HAD A LARGE
UNMET NEED FOR CATARACT SURGERY
THE STUDIES JUST COME IN AND
THEY'RE AL.
THE STUDY MAY REFER A PATIENT
FOR CATARACT SURGERY BUT THERE'S
REAL NO FOLLOW-UP WHETHER THEY
GET IT.
SO MISSED OPPORTUNITY IN TERMS
OF LOOKING AT ACCESS AND THOSE
BARRIERS.
RISK FACTORS FOR NOT HAVING
CATARACT SURGERY WAS BEING
UNINSURED.
WAS THERE A 2.7 ODDS RATIO AND
REPORTING BARRIERS TO ACCESS,
2.41.
THIS IS IN LOS ANGELES.
YOU DO HAVE THE EYE INSTITUTE
AND ON THATMOLOGISTS.
-- OPHTHALMOLOGISTS AND IN TERMS
OF CHINESE-AMERICAN EYE STUDY IN
MON
MONTEREY PARK AND THERE WAS THE
AFRICAN AMERICAN IN THE BARBADOS
EYE STUDY.
THERE'S A DISPARITY FOR THE
PREVALENCE OF CATARACT AND
CATARACT SURGERY.
A AND THERE'S ONE THING IN
TERMS OF A COMMON TERMINOLOGY.
WHAT CAN BE VISUALLY SIGNIFICANT
TO ONE PRACTITIONER CAN BE TO
ANOTHER IN INVESTIGATORS IT'S
IMPORTANT TO SEE WHETHER THE
STUDY IS GENERALIZED TO THE PAR
GET POPULATION AND HOW
TRANSPORTABLE THEY HAVE TO A
TOTALLY DIFFERENT POPULATION.
POPULATION BASED STUDIES ARE
QUITE COSTLY.
THEY'RE ALSO LOGISTIC
CHALLENGES.
WHEN A LOT OF THE STUDIES WERE
DONE IT WAS DONE BY CENSUS
TRACKS.
YOU WENT TO HOMES AND TO
APARTMENT BUILDINGS.
WHAT ABOUT PEOPLE HOUSING
INSECURED.
THEY'RE ALSO IN OUR
NEIGHBORHOODS NOW.
THOSE INDIVIDUALS ARE NOT CAUGHT
IN STUDIES LIKE THIS.
IN ADDITION THE REASON THE
BALTIMORE NURSING HOME STUDY WAS
DONE, IF YOU HAVE A NURSING HOME
IN THAT RACKET WILL YOU COUNT
IT?
IS THAT REPRESENT OF WHAT YOU'RE
FINDING OUT IN THE COMMUNITY?
SO LOOKING AT THE NATIONAL
HEALTH AND NUTRITION EXAMINE
SURVEY AND N HANES.
AS THE BEEN A SURVEY DEVE DONE
WORK WITH AT UCLA AND HAS GREAT
DATA.
THE LAST TIME CATARACT WAS
ASSESSED WAS DONE BY AN EYE
EXAMINATION IN 1971 TO '72.
THAT MADE -- THAT MADE IT DONE
BY 91 RESIDENTS WERE LOOKING AT
ALL THE PATIENTS AND EVALUATING
THE CATARACTS.
AFTER THAT TIME THEY DIDN'T HAVE
IT BY EXAMINE FOR CATARACTS.
THEY FOUND BLACK PARTICIPANTS
WERE 1.31 MORE TIMES LIKELY TO
HAVE CATARACT THAN THE WHITE
COUNTERPARTS AND RURAL
PARTICIPANTS WERE MORE LIKELY
AND THIS WAS BACK IN THE '70s.
THE DATA REALLY HASN'T CHANGED.
IN TERMS OF THE N HANES.
HAVE BEEN DOING SELF-REPORT AND
BLACK REPRESENTS WERE LESS
LIKELY TO HAVE RECEIVED CATARACT
SURGERY BY SELF-REPORT AND FOR
NON-HISPANIC WHITES IT WAS 19.3%
FOR NON-HISPANIC BLACKS WAS
16.4% AND FOR MEXICAN AMERICANS
WAS 20.5%.
THESE WERE STATISTICALLY
SIGNIFICANT DIFFERENCES.
WHEN YOU LOOK LATER IN '94 TO
2005 TO 2008, THE PREVALENCE WAS
AS LISTED.
IT ACTUALLY DECREASED.
ALL OF A SUDDEN WE HAVE A
PREVALENCE OF LESS CATARACT
SURGERY BY SELF-REPORT IN THE.
FOR ALL THE ETHNIC RACIAL
GROUPS.
I THINK THERE'S A GREAT
INITIATIVE AND A SUGGESTION IS
LOOKING AT THE NHANES AND THEY
WERE SELECTED TO REPRESENT THE
ENTIRE U.S. POPULATION.
THEY DO DO OVER SAMPLING NOW.
IN THE PAST THEY DIDN'T.
THEY OVER SAMPLED RESULTS 60 AND
OLDER, BLACKS, HISPANICS AND
LOW-INCOME AND NON-HISPANIC
WHITES AND OTHER ADULTS.
THE LAST YEAR WAS IN 2005 AND
2008 AND THAT WAS VISUAL
FUNCTIONING, SERVICE UTILIZATION
IN TERMS OF CATARACT SURGERY AND
HIGH HEALTH CONDITIONS WHICH THE
INDIVIDUALS SELF-REPORT.
THEY HAD EYE EXAM VISUALS AND
LOOKED FOR GLAUCOMA AND DIABETIC
REP -- RETINOPATHY.
THAT WAS IN THE '70s.
NHANES HAS INFRASTRUCTURE FOR
EXAMINES AND THEY HAVE HEALTH
DATA AND EDUCATION, INCOME,
EMPLOYMENT FOOD INSECURITY AND
HOUSING.
I'M NOT SURE THEY HAVE
DISABILITY DATA BUT I THINK IT'S
A GOOD POINT AND NEEDS TO BE
INCLUDED IN OUR ANALYSIS WHEN
WE'RE LOOKING AT DISPARITIES.
THEY DO SAMPLING OF MEDICALLY
UNDER SERVED INCOMES AND
MINORITIZED GROUPS AND ONE OF
THE THINGS IS THEY'RE NOT JUST
LOOKING AT EYES.
THEY'RE LOOKING AT ALL OF HEALTH
AND IT'S A RICH DATA SET IN
TERMS OF THE ABILITY TO ASK
UNIQUE QUESTIONS AND GET
ANSWERS.
THERE'S THE POSSIBILITY OF
INNOVATING WITH THE MOBILE
HEALTH TECHNOLOGY I'LL BRING UP
LATER.
THAT'S AN OPPORTUNITY TO
CONSIDER FOR THE NATIONAL EYE
INSTITUTE.
THERE'S FEMALE SEX, LOWER
INCOME, LOWER EDUCATIONAL
ATTAINMENT, INTELLECTUAL
DISABILITY AND RESIDENT OF
NURSING HOME FACILITIES.
AND OTHERS HAVEN'T BEEN
ADDRESSED.
ANOTHER DATA SOURCE MENTIONED IS
THE NIH "ALL OF US" RESEARCH
PROGRAM.
THIS IS TO BUILD HEALTH SURVEYS
AND PHYSICAL MEASUREMENTS AND
BIO SPECIMENS AND MORE AND IT'S
A VERY EXCITING DATABASE.
AND IT IS OPEN TO THE PUBLIC TO
USE AND CAN LOOK AT DIFFERENT
RISK FACTORS INTERACTING AND THE
EFFECT MODELS AND ONE OF THE
NICE THINGS ABOUT THE DATA SET
IS YOU CAN START LOOKING NOT
JUST AS A RISK FACTOR IN
ISOLATION.
LOOK AT THE COMBINED EFFECT OF
RISK FACTORS BECAUSE WE DON'T
JUST ALL LIVE IN A CERTAIN TYPE
OF WORLD.
THE WORLD HAS IN INTERACTIONS
WITH DIFFERENT RISK FACTORS IN
THE WORLD WE LIVE IN.
IT'S NICE YOU CAN LOOK THAT THE.
I DO THINK ADDING THE IMAGING
DATA WOULD BE GREAT WITH THE
"ALL OF US".
IT IS KIND OF A CONVENIENCE
SAMPLE AND THERE WILL BE A LARGE
PROPORTION THAT WON'T DO THAT
FOR PRIVACY ISSUES FOR ONE.
ARE YOU GOING TO ALLOW YOUR
RETINAL IMAGE TO A DATA SET TO
IDENTIFY AS THEY DID IN THE
TERMINATOR MOVIE.
PEOPLE MAY BE HESITANT.
NOT EVERYBODY BUT SOME PEOPLE.
HOW WILL WE REACH THE HOUSING
INSECURED INDIVIDUALS OR
INDIVIDUALS THAT AREN'T AWARE
THERE IS THIS OPPORTUNITY OR
HAVE ACCESS TO THE INTERNET
WHICH WE ALL TAKE FOR GRANTED.
IN ADDITION I THINK WE HAVE THE
DATA AND THE NATIONAL ACADEMY OF
SCIENCES AND MEDICINE CAPTURING
SOCIAL DETERMINATES OF HEALTH IN
THE ELECTRONIC HEALTH RECORDS
AND STARTED TO SEE THAT THE
VENDORS ARE STARTING TO CAPTURE
SOCIAL DETERMINATES AND THEY HAD
HISTORY FREELDZ BUT STILL ONLY
12%.
NOT EVEN 20%.
REEMPHASIZING WE HAVE HIDDEN
POPULATIONS NOT JUST AROUND THE
WORLD BUT IN THE UNITED STATES
AND OUR TRADITIONAL SAMPLING
METHODS AND POPULATION-BASED
STUDIES, THE CLAIMS DATA WORK
WITH MEDICARE, ELECTRONIC DATA
ANALYSIS WITH HOW MUCH ULTRA
VIOLATE RADIATION ARE PEOPLE
EXPOSED TO AND AMBIENT AIR FOR
PEOPLE FACING THAT WITH HOUSING
INSECURITY.
SOME OPTIONS ARE TWO
PHOTOGRAPHS.
ONE SHOWING A SMARTPHONE WITH A
LENS TO LOOK AT THE EYE AND
ANOTHER OF THE EYE WITH THE
CATARACT AND THERE HAS BEEN A
STUDY LOOKING AT MOBILE HEALTH
TO INCREASE SCREENING FOR DAT
RACKETS AND THIS IS A STUDY OF
78 SAN FRANCISCO BAY AREA
NURSING SKILLED RESIDENTS USING
SMARTPHONE BASED APPLICATION AND
OPHTHALMIC SYSTEM AND FOUND
CATARACT IN 51% OF PARTICIPANTS.
AND HAVING THE OPHTHALMOLOGIST
IMPROVED THE DIAGNOSIS IN 42% OF
THE EYES.
THAT MADE AN IMPACT IN TERMS OF
69% OF THE PATIENTS WHETHER OR
NOT THEY WERE REFERRED FOR
CATARACT SURGERY OR WHERE THEY
WERE REFERRED.
AND IT'S FEASIBLE AND SCALE AND
AND AN OPPORTUNITY.
THERE WAS AN INSTITUTE FOUNDED
IN 2017 TO PROVIDE SUBSPECIALTY
CARE TO CENTRAL AFRICA
REGARDLESS OF THE ABILITY TO PAY
AND THEY DON'T HAVE ENOUGH
OPHTHALMOLOGISTS IN THE COUNTRY
AND ARE LOOKING FOR SOLUTIONS TO
IMPROVE THE ABILITY OF
APPRECIATES TO GET TO THE CENTER
S AND THEY'RE DOING SCREENING
FOR DIABETIC RETINOPATHY AND
CATARACT AND TWO OTHERS
AFFECTING BLINDNESS AND VISUAL
IMPAIRNESS RATES AND THERE'S THE
SAME DISPARITIES CATARACTS DO.
WE SEE DECREASED CATARACT
SURGERY IN THE BLACK RACE,
LATINO ETHNICITY, LOW-INCOME
RURAL RESIDENCE AND LOWER
EDUCATIONAL ATTAINMENT.
WHEN WE LOOKED AT CATARACT
SURGERY ACCESS USING THE
CALIFORNIA MEDICARE DATABASE IN
2017 WE FOUND BENEFICIARIES IN
CALIFORNIA AND RURAL REGIONS HAD
TO TRAVEL 12.7 MILES MORE FOR
CATARACT SURGERY AND WERE LESS
LIKELY TO GET CATARACT SURGERY.
THERE'S A BARRIER IN THE RURAL
COMMUNITIES IN THE UNITED STATES
IN CALIFORNIA AND COMPLEX
CATARACT SURGERY WAS MORE LIKELY
IN BLACKS, ASIANS, ODDS RATIO
1.5 AND IN HISPANICS 1.42
COMPARED TO NON-HISPANIC WHITE
PATIENTS.
MEN WERE MORE LIKELY TO HAVE
COMPLEX CATARACT SURGERY THAN
WOMEN AND PATIENTS GREATER THAN
80 YEARS OLD THAN PATIENTS 65 TO
69.
AS PEOPLE GET OLDER THE SURGERY
GETS MORE COMPLEX AND WE KNOW
THAT AS CLINICIANS BUT IT'S NOW
SHOWING IN STUDIES.
WE HAVE LOOKED AT THIS WITH THE
CLAIMS DATA AND ELECTRONIC
HEALTH RECORD DETE AND ONE OF
THE ISSUES IS THERE'S MANY
DIAGNOSTIC CODES TO DEFINE
CATARACT.
THAT HELPS THE CLINICIAN BUT
DOESN'T NECESSARY HELP WITH THE
RESEARCH.
YOU WANT TO INCLUDE ALL THE
CODES AND GO INTO THE DETAILS
ABOUT THAT.
IT'S IMPORTANT THOSE CODES ARE
USED RELIABLY.
THAT BECOMES ANOTHER ISSUE.
THEN THE SELECTION BIAS OF NOT
HAVING ACCESS TO HEALTH CARE TO
EVEN BEING IN THE ELECTRONIC
MEDICAL RECORD AND NO
EXAMINATION OR VISUAL ACUITY OR
PRESSURE WE'RE CURIOUS ABOUT AS
HEALTH CARE PROVIDERS.
TO BRIEFLY GO OVER WE'RE
STARTING TO USE IN EPIDEMIOLOGY
AND CONCEPTUAL MODELS IT'S
DIFFICULT WE'RE NOT ALL
INFLUENCED BY ONE RISK FACTOR.
AND IT'S NOT THE ONLY RISK
FACTOR FROM BEING A CATARACT.
IT MAY BE WHERE THE POLLUTION
RATES ARE HIGHER IN LOS ANGELES
AND SO EVERYBODY IN L.A.'S AT
INCREASED RISK ESPECIALLY NEAR A
FREEWAY.
IN LOOKING AT THAT WITH THE
CONCEPTUAL MODEL FOR THE
NATIONAL ACADEMY OF MEDICINE AND
I APOLOGIZE THE FIGURE IS QUITE
BUSY BUT IT'S IN THE SLIDE DECK
SLIDE 27 AND IT'S GOING OVER
IT'S COMPLICATED IN TERMS OF
WHEN YOU'RE TRYING TO
CONCEPTUALIZE IMPROVING EYE AND
HEALTH CARE IN THE UNITED STATES
AND IN THE DEVELOPING WORLD.
BECAUSE YOU HAVE NOT JUST THE
INNATE INDIVIDUAL TRAITS SUCH AS
AGE, SEX AND RATION AND BIOLOGY
FACTORS BUT ACCESS TO CARE AND
QUALITY OF CARE AND THE
INDIVIDUAL BEHAVIOR AND YOU HAVE
YOUR SOCIAL DETERMINATES OF
HEALTH.
THEY'RE ACTING AS ON EACH OTHER.
NEED TO BE ABLE TO CONTROL FOR
THESE THINGS TO MOVE THE NEEDLE.
THIS DIAGRAM IS FROM THE
NATIONAL ACADEMY OF SCIENCES
ENGINEERING AND MEDICINE BOOK
MAKING EYE HEALTH A POPULATION
HEALTH IMPERATIVE.
WE SPENT TIME IN THAT COMMITTEE
ON DESIGNING THIS.
YOU CAN ANALYZE THE HEALTH CARE
PROVIDERS.
ARE DISPARITIES CAUSED BY
STRUCTURAL INEQUITIES AT THE
PATIENT SHARING NETWORKS OF EYE
CARE PROVIDERS?
ONE OF THE THINGS THEY'RE
FINDING IN EPIDEMIOLOGY IS
MINORITIZED GROUP MAY BE CARED
FOR BY INSULAR UNDER RESOURCED
NETWORKS AND THE NETWORKS AREN'T
AS GREAT AS OTHER GROUPED SO IS
THERE A WAY TO IMPACT THAT AND
ONE IS USING MEDICARE
ADMINISTRATIVE CLAIMS DATA.
ANOTHER IS THEIR DISPARITIES IN
TERMS OF INSTITUTIONS.
A LOT OF US LIKE TO THINK HEALTH
CARE IS EQUIVALENT ACROSS
INSTITUTIONS AND WHAT WE'RE
FINDING OUT FOR SYSTEMIC
DISEASES AND EYE CARE
MINORITIZED GROUP MAY BE MORE
LIKELY TO SEEK SOLUTIONS FROM
LOWER QUALITY METRICS.
THOSE INSTITUTIONS MAY BE CLOSER
TO WHERE THEY LIVE AND HAVE
ACCESS.
HOW DO YOU STUDY THE INSTITUTION
SINCE THAT COULD BE MAKING A
DIFFERENCE IN TERMS OF HEALTH
CARE DISPARITIES AND ONE WAY IS
USING MEDICARE DATA TO LOOK AT
THE ADVERSE OUTCOME RATE BY
INSTITUTION.
AND EVALUATING THE TOP TEN AND
BOTTOM PERCENT TO SEE IF THERE'S
A DIFFERENCE.
AND ONE OF THE ISSUES WE HAVE IS
RAISE AND ETHNICITY CAN'T BE
INTERVENED UPON.
WE NEED TO CHANGE SOCIETY AND
THE FACTORS THAT ARE LEADING TO
THE DIFFICULTIES IN THE UNITED
STATES AND TO RACISM.
THAT'S ONE OF THE ISSUES HOW WE
STUDY RACISM AND END IT TO MAKE
A BIG DIFFERENCE IN HEALTH CARE
DISPARITIES BECAUSE WITHOUT
DOING THAT WE WON'T NECESSARILY
MAKE THE CHANGE WE NEED TO IN
THIS COUNTRY AND ELIMINATE
HEALTH CARE DESPAIRS FOR THOSE
INDIVIDUALS.
THERE'S A NEW METHOD CALLED THE
CAUSAL MEDIATION ANALYSIS AND
TAKE EXPOSURE SUCH AS RACE AND
ETHNICITY WILL NOT CHANGE BY
SOCIETY TAN STANDARDS RIGHT NOW
AND ASSOCIATED WITH INCREASE
RISK FOR CATARACT AND LESS AND
CAN ALLOW FOR ANALYSIS OF DOWN
STREAM MEDIATORS RESPONSIBLE FOR
PART OF THE EXPOSURE AFFECT AND
MODIFIABLE TARGETS SUCH AS SOCIO
ECONOMIC DISPARITIES.
IN ADDITION, ONE OF THE THINGS
IN EPIDEMIOLOGY THEY'RE DOING IS
TO HELP DIRECTED ACYCLIC GRAPHS
AND THIS IS FOR GLAUCOMA
SURGERY.
I THANK MY DOCTORAL STUDENT WHO
HELPED ME WITH THIS
PRESENTATION.
HE'S LOOKING AT GLAUCOMA SURGERY
AND ONE THING IS YOU COULD HAVE
CATARACT SURGERY AND THEN LOOK
AT CATARACT SURGERY
COMPLICATIONS IN TERMS OF
SEVERITY AND ARE THERE NETWORK
CHARACTERISTICS IN TERMS OF HOW
THEY GET TO THE SURGEON, SEX AND
AGE AND LOOKING AT INSURANCE
STATUS WITH SOCIO ECONOMIC
STATUS AND THEN YOU HAVE THE
HISTORICAL FACTORS OF RACISM AND
HAVING A PLACE HOLDER FOR THAT
TO START TO TACKLE IT IN THIS
COUNTRY.
THAT'S A NEW APPROACH IN
EPIDEMIOLOGY THEY'RE HOPING WILL
ENABLE US TO TEASE UP THE
FACTORS.
INSTEAD OF LOOKING AT IT LIKE
THE '70 AND '90s WE CAN START
INTERVENING TO MAKE A
DIFFERENCE.
AND WE LIKE THE RANDOMIZED
CLINICAL TRIALS.
THAT'S WHAT WE PREFER BUT THEY
CAN BE EXPENSIVE AND UNETHICAL
BECAUSE SOMETIMES YOU CAN'T
RANDOMIZE INDIVIDUALS TO CERTAIN
TREATMENTS OR NOT AND TAKE A
WHILE.
SO HOW DO YOU RANDOMIZE
INDIVIDUAL TO CATARACT SURGERY
AND NONE LOOKING AT REDUCING THE
RISK OF FALLS AND FRACTURE AND
DEMENTIA.
THERE'S THE TARGET TRIAL
EMULATION AND YOU USE
OBSERVATIONAL DATA THAT CAN BE
USED TO ASK SIMILAR QUESTIONS BY
EMULATING A TARGET TRIAL AND WHY
THE ELECTRONIC MEDICAL RECORDS
AND THE HUGE DATA SETS ARE
IMPORTANT BECAUSE THEY MAY ALLOW
US TO GO IN AND SEE WHAT'S
HAPPENING BUT IF YOU THINK BACK
TO WHAT I SAID ORIGINALLY, WE
HAVE HIDDEN POPULATIONS NOT IN
THE DATA SETS.
WE HAVE TO GET PEOPLE ACCESS TO
THEN REALLY TRY TO FILL THE
SCIENTIFIC GAPS.
THERE'S ALSO MORE ABOUT
ENVIRONMENTAL RISK FACTORS.
AND UNDERSTANDING HOW THESE
EXPOSURES AT DIFFERENT PERIODS
OF LIFE MAY IMPACT THE
DEVELOPMENT OF CATARACTS.
DO YOU HAVE INTENSE SUN EXPOSURE
AS A CHILD?
THAT'S HARD TO LOOK AT.
OR IS IT WHEN YOUR IN YOUR 60s
OR EXACTLY WHAT IS IT PEOPLE CAN
START MODIFYING AND DOING
THROUGHOUT THEIR LIFE TIME AND
THAT'S LIFE COURSE EPIDEMIOLOGY
HOW DIFFERENT EXPOSURES THROUGH
LIFE WOULD AFFECT CATARACT AND
WHAT INTERVENTIONS WE CAN DO AND
LOOK AT BOTH COHORTS POTENTIALLY
USING ELECTRONIC HEALTH RECORD
DATA PROVIDING INFORMATION
ESPECIALLY IF WE'RE ABLE TO GET
THE HIDDEN POPULATIONS INTO
THEM.
I WANTED TO THANK YOU FOR HAVING
ME HERE TODAY.
THIS IS JUST A PICTURE OF THE
GLAUCOMA SPECIALISTS AT UK WHO
ALSO DO CATARACTS.
>>ANNE, THANK YOU VERY MUCH.
THIS IS MICHAEL CHIANG AND I
WANT TO OPEN IT UP TO QUESTIONS
SPECIFICALLY TARGETED TO THIS
RIGHT NOW.
>>ENVIRONMENTAL FACTORS AND
RADIATION ALL IMPACT THE
INCIDENT OF CATARACT.
AND THEY CAN BE PASSED TO THE
NEXT GENERATION.
WE ARE MAKING DISCOVERIES OF
HIGHER CATARACTS.
>>POSSIBLY.
IT CAN BE RATHER SOBERING.
THE ISSUE IS THAT'S WHY ACCESS
IS SO IMPORTANT.
WE DON'T NECESSARILY UTILIZE IT.
ONE THING BROUGHT UP IS IT'S
GETTING REIMBURSEMENT FOR
CATARACT SURGERY IS LESS.
ONE OF THE QUESTIONS IS HAS IT
GOTTEN TOO LOW.
THAT'S A QUESTION FOR POLICY
MAKERS.
ONE OF THE THINGS YOU SEE IS YOU
SEE PREMIUM LENSES AND
COLLEAGUES DOING FANCY
TECHNIQUES YET WE HAVE A RISING
CATARACT BURDEN IN THE UNITED
STATES.
PEOPLE TEND TO FOLLOW THE MONEY,
UNFORTUNATELY BUT THAT'S HOW IT
IS BECAUSE YOU NEED THE CAPITAL
AND RESOURCES.
THAT TREATMENT WE HAVE WE'RE NOT
NECESSARILY EFFECTIVELY USING IT
IN THE UNITED STATES.
IN INDIA THEY'RE MAKING GREAT
STRIDES WITH THEIR CATARACT
BUR
BURDEN BETTER THAN THE UNITED
STATES AND I DON'T THINK WE
THINK WE HAVE A BURDEN.
WE DON'T THINK PEOPLE HAVE
PROBLEMS WITH CATARACTS.
THAT'S SOMETHING HOPEFULLY THE
FEDERAL GOVERNMENT STARTS TO
REALIZE.
>>THIS IS EMMY HARTNETT.
THAT WAS A FABULOUS TALK.
I HAVE SO MY QUESTION EXTENDS
BEYOND SURGERY AND AS A
PEDIATRIC RETINA SPECIALIST I'M
INTERESTED IN IN THE DISPARITIES
FOR CHILDREN AND INFANTS AND
WHETHER OR NOT THEY CAN GET
ACCESS TO CARE AND THERE'S SO
MANY BURDENS BECAUSE IT INVOLVE
THE WHOLE FAMILY.
IF ONE WERE TO BEGIN TO SORT
THAT OUT, MANY OF THE CHILDREN
THAT HAVE PROBLEMS ARE ON
MEDICAID.
WOULD IT BE LOOKING AT MEDICAID
VERSUS COMMERCIAL INSURANCES OR
JUST EVEN TO UNDERSTAND LIKE
WHEN YOU BROUGHT UP STUDY
NETWORKS AS A WAY TO BETTER
DEFINE WHAT THE PROBLEM IS
>>NOW YOU'RE IN CALIFORNIA
YOU'LL FIND WE HAVE MEDICAL AND
SPECIAL INSURANCE FOR CHILDREN.
WHEN A CHILD IS DIAGNOSED WITH A
DISORDER IN CALIFORNIA THE
FAMILIES LEAVE THEIR COMMERCIAL
INSURANCE AND GO FOR THE SPECIAL
INSURANCE FROM CALIFORNIA
BECAUSE IT'S JUST SO EXPENSIVE.
EVEN FOR COMMERCIAL INSURANCE.
THAT WOULD BE A DATA SET YOU CAN
POTENTIALLY GET AND START TO
SEE.
THE BIGGEST ISSUE THOUGH IS I
KNOW BECAUSE I'M AT UCLA AND DO
PEDIATRIC GLAUCOMA BUT DO THEY
KNOW THAT AT OTHER CENTERS
AROUND LOS ANGELES?
THAT I DON'T KNOW.
THAT'S ONE THING YOU FIND IN
PUBLIC HEALTH RESEARCH AS WE
HAVE FRAGMENTATION WITH OUR
KNOWLEDGE SO DOES SOCIETY.
IT BECOMES FRUSTRATING BECAUSE
YOU HAVE SEGMENTS OF THE
POPULATION THAT DOESN'T KNOW
WHAT'S AVAILABLE TO THEM AND
THAT'S TRUE OF CHILDREN.
>>I HAVE A QUESTION THAT MIGHT
BE DIRECTED TOWARDS YOU OR DOUG
AND USE IT TO KICK OFF A
DISCUSSION ABOUT ANY OTHER STOCK
MARKET COMMENTS OR QUESTIONS
PEOPLE HAVE.
ANNE, YOU CITED DATA ABOUT
PREVALENCE DATA OF CATARACTS
THAT SHOWED A 10X DIFFERENCE IN
WHO HAS IT.
I THINK ONE OF THE CHALLENGES
CATARACT IS A SPECTRUM OF
FINDING AND AT SOME POINT WE
HAVE TO DECIDE IF YOU HAVE IT
AND DOCTORS HAVE TO DECIDE IF
THEY WANT TO DO SURGERY.
EPIDEMIOLOGISTS CHECK THE BOX IN
THE PERCENT OF HAVING IT.
HOW IMPORTANT OF A PROBLEM IS IT
TO STANDARDIZE AND HOW WOULD
THAT BE DONE?
IS THERE A QUANTITATIVE TEST FOR
DETERMINING IF YOU HAVE QUOTE,
CATARACT?
>>I'M NOT SURE IF ANYONE'S
LOOKING AT THE CLASSIFICATION
PART AND I KNOW THERE'S SOME BUT
IN OUR CLINICS WE'RE NOT DOING
THAT.
IT'S VERY SUBJECT TO THE
CLINICIAN AND THAT'S WHAT
AFFECTS THE ELECTRONIC MEDICAL
RECORD.
IT'S QUITE A SUBJECTIVE
CLASSIFICATION.
>>AGREE -- THIS IS DOUG RHEE,
THE DEFINITION IS AN ISSUE AND
ONE FOR DATABASE QUERY AS YOU
POINTED OUT VISUALLY SIGNIFICANT
ADDS DEFINED BY MEDICARE.
WE CAN START TO LEAPFROG OFF
EXIST
EXISTING LACK OF
STANDARDIZATION.
>>THANK YOU, DOUG.
THANK YOU, ANNE.
REZA YOU HAVE YOUR HAND UP.
>>THAT WAS AN INCREDIBLE
PRESENTATION.
AT BRIGHAM THEY HAD A SYSTEM
USED EXTENSIVELY IN CATARACT
RESEARCH AND RETIRED A DECADE
AGO AND WE HEARD THAT SYSTEM IS
NOT REALLY USED THAT MUCH
ANYMORE BECAUSE IT'S LABOR
INTENSIVE.
IF I MAY GO BACK TO DOUG'S
PRESENTATION, DID YOU SAY $6.8
BILLION IS THE TOTALITY TO THE
COST TO THE U.S. SYSTEM OF
CATARACT SURGERY.
I WAS SURPRISED OF THAT BECAUSE
I THOUGHT IT'D BE MORE.
THINKING OF THE PHARMACO
PRESCRIBED THERAPIES WE HAVE $15
BILLION PLUS FOR GRAW --
GLAUCOMA AND SO IT'S REMARKABLE
THE CATARACT IS SOMETHING WE ALL
GET EVENTUALLY AND AT SOME POINT
IT BECOMES VISUALLY SIGNIFICANT.
THE FACT THAT OUR SOCIETY IS
DEALING WITH IT NOT
COMPREHENSIVELY AS WE JUST HEARD
BUT $6.8 BILLION IS NOT THAT
HIGH AND BRINGS US BACK TO THE
FACT WE NEED TO EXTEND SERVICES
AND IT'S A PUBLIC HEALTH ISSUE
FOR SURE AND THE FACT WE'LL
THINK ABOUT NON-SURGICAL
APPROACH IT HAS TO BE SOMETHING
THAT FITS THE ECONOMIC MODEL
IT'S EASY TO GET IN THE BILLIONS
IN OUR COUNTRY.
THE DRY EYE MARKET ITSELF IS
SEVERAL BILLION.
WE NEED TO THINK ABOUT SOLUTIONS
THAT MAKE ECONOMIC SENSE TO US
AS WELL.
THANK YOU.
>>THANK YOU.
KATIA.
>>THIS WAS VERY INFORMATIVE AND
A FANTASTIC TALK.
MOST THE DATA OR WHAT YOU'RE
TRYING TO REACH WITH THE
INITIATIVES AND EFFORTS ARE
USING AN ESTABLISHMENT OF THE
INSURANCE COMPANY'S MEDICARE,
ETCETERA.
HOW DO YOU REACH TO THE
COMMUNITIES THAT ARE IN THE
RURAL LOCATIONS THAT ARE NOT
REALLY PART OF THAT WORK.
>>FOR THE RURAL COMMUNITY I
HAVE ANOTHER MASTERS CANDIDATE
AT UCLA WHOSE MOTHER IS A
MIGRANT FARM WORKER AND VERY
INTERESTED IN THAT.
SHE KNEW OF DIFFERENT COMMUNITY
GROUPS IN BAKERSFIELD WHICH IS
WHERE IN CALIFORNIA HAVE THE
FARMING COMMUNITIES AND MIGRANTS
AND WE WERE ABLE IT DO A LOT OF
SCREENING.
A LOT'S BEEN DONE AND ACADEMIC
CENTERS ARE LIKE IVORY TOWERS.
WE SIT THERE WE HAVE IDEAS BUT
WE HAVE TO GET THE COMMUNITY
INVOLVED AND THAT'S COMMUNITY
ENGAGEMENT AND ALSO TRUE FOR THE
HOUSING INSECURE.
WE HAVE A VAN WE SEND OUT TO
THEM BECAUSE THEY'RE NOT GOING
TO COME TO US I THINK IT'S
RETHINKING THE MODEL AND SOME
PEOPLE HAD BEEN ENUMERATED AND
YOU KNEW HOW MANY PEOPLE WERE IN
THE HOUSE AND HAD A GOOD
DENOMINATOR.
ONCE YOU WORK WITH THE HIDDEN
POPULATIONS, HOW MANY MIGRANT
WORKERS ARE THERE IN
BAKERSFIELD?
I DON'T KNOW.
IS THERE A DATABASE OF THEM?
ARE THEY SUPPOSED TO BE IN THE
COUNTRY?
WILL WE EVER FIND OUT THE TRUE
DENOMINATOR.
YOU HAVE TO USE STATISTICAL
METHODS AND ASSUMPTIONS FOR THE
ANAL
ANALOGIES.
YOU HAVE TO INCLUDE THEM IN THE
MEDICAL RECORD AND ARE THERE
LIMITS ON WHO COULD BE INCLUDED
AND IF THEY HAVE INSURANCE AND
SAYING WE'LL EVALUATE YOU BUT
WE'RE NOT WRITING DOWN YOUR
IDENTITY.
WE HAVE YOUR IDENTITY HIDDEN
WITH THE NUMBER BECAUSE IF THE
RULES IN THE UNITED STATES
CHANGE AND AFFECT CALIFORNIA
THEY DON'T WANT TO BE DEPORTED
BECAUSE DATA COULD BE SEARCHED.
>>AND MAYBE REACHING OUT TO
CHURCHES.
THEY'RE A GOOD WAY TO REACH OUT
TO THE POPULATION.
>>WE DO A LOT OF FAITH BASED
AND WE'RE DOING THAT WITH
GLAUCOMA IN MICHIGAN AND THE
NATIONAL HEALTH EDUCATION
PROGRAM WERE DOING FAITH-BASED
REACH OUT TO REACH THE BLACK AND
LATINO POPULATION FOR EDUCATION.
THAT COULD ALSO BE A WAY WITH
THE STUDIES.
>>LET'S TAKE ONE LAST COMMENT
AND WE'LL WRAP UP.
>>I WANT TO GO BACK TO BEN
TELLER TO GOING BACK TO USING
DROPS TO TREAT CATARACTS.
HOW FAR IN THE FUTURE ARE WE
LOOKING?
IT WILL CHANGE EVERYTHING IT
WILL CHANGE THE DISPARITY OF
EVERYTHING.
IS THIS IN OUR LIFE TERM?
HOW FAR ARE WE LOOKING AT THIS?
>>THAT'S PART OF THE CHALLENGE
AND IT'S PART OF THE DIFFICULTY
OF ANSWERING THIS AND I HOPE TO
HAVE A BETTER ANSWER THAN NOW
AND YOU FIND THE SPECTRUM OF
DIFFERENT REPORTS AND THIS IS
NOT JUST FOR EYE DROPS FOR THE
CATARACTS BUT I THINK IT'S A
BROADER ISSUE AND I THINK THAT'S
A NEED WHERE HOPEFULLY PEOPLE IN
THE FIELD STUDYING THE DIFFICULT
PROBLEMS, AND THEY ARE, CAN SIT
TOGETHER AND WORK TOGETHER TO
TRY TO COME UP WITH SOME
COHESIVENESS AN CONSILIENCE
TALKED ABOUT.
>>HOUMAM AND THANK YOU FOR THE
QUESTION.
I WANT TO THANK ANNE AND DOUG
ONE LAST TIME TO COMING TO
BETHESDA TO SPEAK ON THE TOPIC.
THERE'S A LOT OF OPPORTUNITIES
FOR COLLABORATION WHICH IS WHAT
WE TALKED ABOUT EARLIER ON AND
MAYBE COMMUNITIES WILL BE LIKE
NIEHS ENVIRONMENTAL SCIENCES AND
THEY'RE INTERESTED IN THE
EXPOSOME AND THAT COULD TIE INTO
SOME AREAS OF SUSTAINABILITY.
LET ME THANK BOTH OF YOU ONCE
MORE.
CATHY, MAY I TURN FOR
LOGISTICALLY WHAT WE'LL DO.
>>THANK YOU.
THAT WAS GREAT.
WE'RE LITTLE BEHIND TIME BUT
THAT'S OKAY.
WE'LL BREAK FOR LUNCH.
LUNCH IS GOING TO BE SERVED
UPSTAIRS IN OUR OFFICE SUITES ON
THE THIRD FLOOR.
BEFORE THAT BECAUSE WE HAVEN'T
DONE THIS IN TWO AND A HALF,
THREE YEARS WE WANT A GROUP
PHOTO WITH COUNCIL MEMBERS AND
LEADERSHIP AND WITH OUR SPAERPS.
BEFORE WE GATHER LET'S GATHER
OUT IN THE LOBBY AND WE'LL GET
TOGETHER AND WE'LL PHOTOSHOP
REZA IN.
WE'LL PLAN TO BE BACK AT 1:15 NO
LATER THAN 1:15 FOR LUNCH FOR
THE SECOND PART OF THE OPEN
SESSION.
FOR THIS PART ONE OF THE DOWN
SIDES OF BEING IN PERSON WE HAVE
LUNCH AND ALL TALK TO EACH OTHER
BUT THANKS TO CATHY FOR
ORGANIZING THIS AND ROUNDING US
UP.
WE HAVE CONCEPT CLEARANCES ONE
OF OUR PROGRAM OFFICERS WHO
ACTUALLY WORKS ACROSS IN
PORTFOLIOS AND ONE OF THE BIG
THINGS HE DOES IS TECH TRANSFER.
THAT'S WHAT WE'LL TALK ABOUT
HERE.
>>GOOD AFTERNOON.
I'M TONY GOVER AT THE NATIONAL
EYE INSTITUTE.
I'M SEEKING COUNCIL'S
CONCURRENCE FOR ISSUING THE NEI
TRANSLATIONAL PROGRAM IN
THERAPEUTICS AND UTILIZING THE
R61 AND R23 ACTIVITY CODES.
THE PURPOSE OF OUR TRANSLATIONAL
RESEARCH PROGRAM IS TO ENCOURAGE
INVESTIGATORS TO PURSUE
TRANSLATIONAL ACTIVITIES TO
ADVANCE THE DEVELOPMENT OF
BIOLOGICAL AND PHARMACEUTICAL
DEVICE AND/OR COMBINATION
THERAPIES FOR DISEASE OR
DISORDER OF THE VISUAL SYSTEM.
THIS PROGRAM AND MECHANISM WAS
DESIGN TO SUPPORT PRODUCT
DEVELOPMENT EFFORTS WE TYPICALLY
WOULDN'T SUPPORT WITH OUR NORMAL
R01 TYPE MECHANISMS.
THE GOAL OF THE TRANSLATIONAL
RESEARCH PROGRAM IS TO SUPPORT
RESEARCH THAT WOULD ENABLE
SUCCESSFUL SUBMISSIONS OF IND OR
IDE AT THE END OF THE PERIOD OF
PERFORMANCE OF THESE AWARDS AS I
SAID THE TRANSLATIONAL RESEARCH
PROGRAM WILL UTILIZE AN R21, R33
ACTIVITY CODE.
THIS IS A BIPHASIC MILESTONE
MECHANISM CONSISTING OF AN
INITIAL R61 EXPLORATORY PHASE
AND R33 DEVELOPMENTAL SPACE.
THE EXPLORATORY PHASE WILL
SUPPORT PRODUCTS BACKED BY
SUBSTANTIAL DATA BUT NOT
ADVANCED TO THE LEVEL OF
CLINICAL TRANSLATION.
THE R61 ACTIVITY WOULD SUPPORT
REFINEMENT OF DEVICE DESIGN AND
COMPOUNDS AND ADMINISTRATION FOR
CERTAIN DRUGS AND ANY OTHER
RESEARCH THAT WOULD SUPPORT
FUTURE R33 DEVELOPMENT WORK.
THE SATISFACTORY COMPLETION WILL
BE DETERMINED BY NEI TO
DETERMINE IF A PROJECT IS
ELIGIBLE TO TRANSITION FROM THE
R61 EXPLORATORY FACE AND THE
DEVELOPMENT PHASE WILL SUPPORT
RESEARCH OR SPECIFIC FOR
SPECIFIC S AT THE LAST-STAGE AND
SUPPORT THINGS SUCH AS GNP
MANUFACTURING FOR IND STUDIES
AND SAFETY STUDIES, PHARMACOLOGY
AND TOXICOLOGY STUDIES.
ANY RESEARCH THAT WOULD SUPPORT
SUBMISSION OF AN IND OR IDE TO
THE FDA.
WE THINK THE R61, R33 SUPPORT
YOUR EFFORTS INCLUDING THINGS
LIKE OUR SMALL BUSINESS PROGRAM
THAT SUPPORTS OF COURSE SMALL
BUSINESS PRODUCT DEVELOPMENT
ACTIVITIES AGAIN FOR ANY DISEASE
OR DISORDER OF THE VISUAL SYSTEM
AND INCLUDES THE TRANS-NIH
BLUEPRINT PROGRAMS.
THEY SUPPORT PRODUCT DEVELOPMENT
IN THE AREA OF NEUROSCIENCE.
UNDER BLUEPRINT THERE'S A MED
TECH PROGRAM WHICH SUPPORTS
MEDICAL DEVICE PRODUCT
DEVELOPMENT BUT SPECIFICALLY FOR
THE DEVICES THAT REQUIRE DE NOVO
OR REGULATORY PATHWAY.
THEN THERE'S THE THERAPEUTICS
FOR BIOLOGICS AND SEPARATE
PROGRAM FOR SMALL MOLECULAR
DRUGS.
ALL THE BLUEPRINT PROGRAMS
REQUIRE THE PRODUCT BE RELATED
TO NEUROSCIENCE.
OUR R61, R33 TRANSLATIONAL
RESEARCH PROGRAM CAN SUPPORT
PRODUCTS THAT ARE FOCUSSED ON
ANY DISEASE OR DISORDER OF THE
SERVICE SYSTEM.
IT MAY SUPPORT ACADEMICS, NOT
FOR PROFITS, SMALL BUSINESS AND
ALL FOR PROFIT ORGANIZATIONS AND
AGAIN WILL SUPPORT THE
DEVELOPMENT OF BIOLOGICS AND ANY
CLASS OF DEVICE AND COMBINATION
THERAPIES CURRENT BLUEPRINT
PROGRAMS DO NOT SUPPORT.
WITH THAT I'M HAPPY TO TAKE
QUESTIONS ABOUT THE CONCEPT AND
HAPPY TO HEAR FROM DISCUSSANTS
ON THE CONCEPT.
>>THANK YOU.
WE HAD ASSIGNED INITIAL
DISCUSSIONS DR. DANA AND THEN WE
CAN OPEN IT UP FOR DISCUSSION
AND VOTE.
>>THAT WITH US A NICE
PRESENTATION.
I'M VERY ENTHUSIASTIC ABOUT
THIS.
I THINK IT'S A GOOD MOVE.
I LIKE THE CHECKPOINT IN
BETWEEN.
I HAVE A FEW MINOR CONCERNS.
I DON'T KNOW WHETHER IT'S A
CONCERN VIABLE CONCERN OR NOT
SOME CAN DISCOURAGE IT TO THE
YOUNG SCIENTISTS WITH NEW IDEAS.
AND CAN EXCLUDE YOUNG
INVESTIGATORS AND WOULD REQUIRE
COLLABORATION FROM IT WOULD BE
NICE TO ENCOURAGE THIS AND ON A
LARGER SET OF PEOPLE WORKING ON
THE P.I. AND MORE INSTITUTIONS
IS HOW I FEEL AND OF COURSE I
HAVE AN SBIR QUESTION.
SO I'LL LEAVE IT THERE.
>>I'LL ADDRESS THE FIRST
QUESTION.
WE HAVE OTHER MECHANISMS THAT
NEW INVESTIGATORS CAN APPLY TO,
R21, R01.
THE GOAL OF THE PROGRAM IS TO
GET A PRODUCT ON THE MARKET.
TO DO THAT AND HAVE A SUCCESS
RATE AND RETURN ON INVESTMENT WE
HAVE TO HAVE PROJECTS THAT HAVE
A GOOD TRACK RECORD AND DE
RISKED BEFORE FUNDING IT AND
THERE'S NEWER MECHANISMS I THINK
INVESTIGATORS CAN APPLY TO.
WE AGREE MULTI-DISCIPLINARY
TEAMS WOULD BE REQUIRED FOR THE
MECHANISM.
I DON'T THINK THERE'S ANY --
THERE'S FEWER ORGANIZATION WOULD
HAVE THE PROPER EXPERTISE AND
EXPERIENCE TO GET A PRODUCT FROM
THE EARLY PRELIMINARY DATA TO AN
IND OR IDE THAT WILL REQUIRE
MULTI DISCIPLINARY TEAM.
>>VERY NICE, VERY EXCITING.
>>CAN I REMIND PEOPLE TO STATE
THEIR NAME FIRST.
SORRY, I MEANT TO DO THAT
EARLIER.
>>DO YOU FORESEE THE R66 ALSO
USED TO DEVELOP OR IMPROVE A NEW
ASSET BASED ON THE ORIGINAL
COMPOUNDING YOU MAY HAVE?
>>NO, THIS IS MORE FOR PRODUCTS
OUT ON THE STREET.
UNLESS YOU NEED A NEW ASSAY THAT
WOULD BE REQUIRED FOR THE FDA
THEN YES, BUT OTHERWISE WE DON'T
WANT NEW MODELS OR ASSAYS.
WE WANT TO DO THE WORK TO GET
YOU THE --
>>IMPROVING THE MOLECULE FOR
EXAMPLE YOU ALREADY HAVE AND
TAKE IT TO A DIFFERENT LEVEL.
>>THERE'S PRODUCT OPTIMIZATION.
THAT WOULD BE FINE.
>>CAN YOU EXPLAIN MORE HOW THE
INTELLECTUAL PROPERTY AND THINGS
LIKE THAT WOULD BE HANDLED?
>>THIS IS AN IMPORTANT FACTOR
BECAUSE WE WANT A PRODUCT ON THE
MARKET SO IT'S IMPORTANT SO WITH
OUR OTHER MECHANISMS, SBIR, THE
I.T. STAYS WITH THE SPONSOR.
>>DR. DANA.
>>THANK YOU.
CREATE.
-- GREAT PRESENTATION.
I'M ENTHUSIASTIC ABOUT THE
PROGRAM.
WE ALL KNOW NIH IN GENERAL NEI
AS WELL HAS DONE MORE AND BETTER
IN REGARDS TO INCREMENTAL
DISCOVERY RESEARCH AND
TRANSLATIONAL SO ANY STEP WE CAN
TAKE THAT HELP THE TRANSLATIONAL
DEVELOPMENT OF NEW TECHNOLOGIES
IS A POSITIVE ONE.
I THINK THERE'S A GREAT PROGRAM.
I LOVE THE FACT IT'S TIER ED AN
INVESTING IN THE R61 AND
FOLLOWED THROUGH THE R33.
THERE'S TWO QUESTIONS THAT I
HAVE.
ONE IS IN REGARDS TO THE STUDY
SECTION COMPOSITION.
IT'S GOING TO BE VERY TRICKY.
WE KNOW STUDY SECTION DO THE
BEST ARE COMPRISED OF SCIENTISTS
PRIMARILY BASIC SCIENTISTS IN
THE STUDY SECTIONS.
AND MOST OF THESE INDIVIDUALS AS
GREAT AS THEY ARE IN THEIR
DISTINCT FIELD ARE NOT REALLY
QUALIFIED FOR TRANSLATIONAL
TECHNOLOGIES AND REQUIRE A
DIFFERENT SKILL SET IN MANY
CASES HOW WILL THAT NEED TO BE
DONE BECAUSE IT NEEDS TO BE DONE
IN THE CAREFUL FASHION OTHERWISE
THE PROPOSALS CAN'T BE ASSESSED
PROPERLY.
QUESTION ONE.
SECONDLY, IN REGARDS TO THE SBIR
INITIATIVES WILL SOME ENTITIES
BE LICENSED FROM THE ACADEMIC
LABS TO A NEW CODE THAT WILL
APPLY FOR A NEW NCCR OR ARE YOU
ENVISIONING SOME OTHER KIND OF
RELATIONSHIP BETWEEN THE TWO
PROGRAMS OR ARE THEY TOTALLY
INDEPENDENT AND YOU DON'T NEED
TO WORRY ABOUT THAT AT THIS
POINT.
YOU JUST WANT TO PUSH THINGS
FORWARD AND THINGS WILL WORK
THEMSELVES OUT AT SOME STAGE.
>>THANK YOU FOR THE QUESTIONS.
>>THE REVIEW WILL BE DONE
IN-HOUSE.
WE'LL HAVE THE APPROPRIATE
REGULATORY EXPERTS, INDUSTRY
EXPERTS AND CLINICIANS AND
SCIENTISTS.
THAT'S A VERY IMPORTANT POINT.
WE'LL HAVE THE APPROPRIATE
REVIEW TO ME IN PLACE FOR THAT.
THE ROUTE A SPECIFIC PRODUCT
TAKES IS REALLY DEPENDENT ON A
LOT OF THINGS, WHO THE SPONSOR
IS, THE MATURITY OF THE PRODUCT
AT THE END OF THIS AWARD IS A
COMPANY OR ACADEMIC HAS AN IDE
OR IND THEY CAN GO DIRECTLY TO
CLINICAL TRIALS UTILIZING
ANOTHER MECHANISM AND THEY'RE
BOTH TO ACADEMICS AND FOR-PROFIT
ORGANIZATIONS.
IF THEY WANT TO SUPPORT THE
CLINICAL TRIALS THAT'S FINE AS
LONG AS THE PRODUCT GETS TO
MARKET.
WE ENVISION IT CAN GO THE OTHER
WAY AS WELL.
SBIR PROJECTS CAN SUBMIT TO THIS
PROGRAM SO THEY MAKE THE FINAL
STAGES OF THAT REGULATORY
PATHWAY AND GET THE IND OR IDE.
DID THAT ANSWER YOUR QUESTION?
>>I'M MORE SATISFIED WITH THE
SECOND.
I'M NOT CLEAR ON THE FIRST ONE.
YOU SAID YOU WILL FORM THE STUDY
SECTI
SECTIONS WITH YOUR IN-HOUSE
SCIENTIFIC RESOURCES YOU HAVE?
LIKE INTRAMURAL SCIENTISTS
OUTSIDE NEI ON THE STUDY
SECTIONS?
>>THE REVIEW GROUP WILL BE
EXTERNAL SCIENTISTS AND EXPERTS.
I MEANT INTERNAL AS IN WE HAVE A
GROUP THAT RUNS STUDY SECTIONS.
>>WE WOULD HAVE OUR EXTERNAL
REGULATORY EXPERTS.
>>THANK YOU SO MUCH, TONY.
GREAT PROGRAM.
>>ONE MORE QUESTION AND THEN
WE'LL NEED TO MOVE ON.
>>SO WITH THE R61 DO YOU HAVE
TO HAVE ALREADY IP?
>>DOES THE PRODUCT HAVE TO HAVE
IP?
>>YEAH.
>>I DON'T WANT TO GET THE
SPECIFICS OF WHAT THE FOA MAY
LOOK LIKE BUT I WOULD SAY
THERE'S NO LEGAL REQUIREMENT TO
HAVE AN IP.
>>I'M GETTING NERVOUS ABOUT
TIME.
THIS IS A CONCEPT CLEARANCE
WE'RE CONSIDERING DEVELOPING
INTO A FUNDING OPPORTUNITY
ANNOUNCEMENT SO KE -- WE NEED
YOU TO VOTE SO CAN I HAVE A
MOTION IT APPROVE THE CONCEPT?
THANK YOU.
CAN I HAVE A SECOND?
THANK YOU.
ALL IN FAVOR PLEASE RAISE YOUR
HANDS.
IS THERE ANYBODY OPPOSED?
GREAT.
THANK YOU.
MOTION PASSES.
THANK YOU, TONY.
OUR NEXT CONCEPT CLEARANCE IS
GOING TO BE PRESENTED BY
NEERAJNEE
NEERAJAGE
NEERAJ AGRAWAL AND WILL PRESENT
CONCEPT TO RENEWEERAJAGE
NEERAJ AGRAWAL AND WILL PRESENT
CONCEPT TO RENEWERAJAGE
NEERAJ AGRAWAL AND WILL PRESENT
CONCEPT TO RENEWJAGE
NEERAJ AGRAWAL AND WILL PRESENT
CONCEPT TO RENEWAGE
NEERAJ AGRAWAL AND WILL PRESENT
CONCEPT TO RENEW
NEERAJ AGRAWAL AND WILL PRESENT
CONCEPT TO RENEW THE K12
PHYSICIAN AWARD.
OVER TO NEERAJ.
>>GOOD AFTERNOON.
THANK YOU AND I'M SO HAPPY TO BE
HERE IN PERSON AND IT'S NICE TO
SEE YOU ALL IN ONE PLACE.
I'M HERE FOR THE RE-ISSUANCE OF
THE INSTITUTIONAL MENTORED
PHYSICIAN SCIENTIST AWARD K12 IN
CLINICAL TRIAL OPTIONAL MOST MAY
KNOW THE GOAL OF THE FUNDING
OPPORTUNITY ANNOUNCEMENT IS TO
ENCOURAGE INSTITUTIONS TO
PROPOSE CREATIVE AND INNOVATIVE
INSTITUTIONAL RESEARCH AND
DEVELOPMENT PROGRAMS WHICH
PREPARE THE CLINICALLY TRAINED
INDEPENDENT SCIENTISTS FOR
CARRIERS THE OBJECTIVE IS TO
INCREASE THE NUMBER OF CLINICIAN
SCIENTISTS TRAINED IN
TRADITIONAL RESEARCH AND PROMOTE
THEIR CAREER DEVELOPMENT AS
RESEARCHERS IN ACADEMIA.
CLINICIAN SCIENTISTS FROM NEI
K12 PROGRAMS ARE EXPECTED TO
APPLY FOR A K08 OR O23 AND THE
R01.
THE THIRD IS THE PROPOSED CAREER
DEVELOPMENT PROGRAM MAY
COMPLEMENT OTHER ONGOING
RESEARCH TRAINING AND CAREER
DEVELOPMENT PROGRAMS AND THE
APPLICANT INSTITUTION MUST BE
DISTINCT FROM THE OTHER PROGRAMS
CURRENTLY RECEIVING FEDERAL
SUPPORT.
THIS FOA ALLOWS APPOINTMENT OF
SCHOLARS WITH STUDIES TO AN
EXISTING TRIAL PROPOSING TO GAIN
RESEARCH EXPERIENCE IN A
CLINICAL TRIAL LED BY ANOTHER
INVESTIGATOR AS PART OF THEIR
CAREER DEVELOPMENT.
SO THIS IS THE PORTFOLIO
OVERVIEW.
NEI CURRENTLY SUPPORTS 10 K12
PROGRAMS AND EACH HAVE TWO
SCHOLARS EACH EXCEPT FOR USC AND
OREGON ONLY HAVE ONE SCHOLAR
EACH.
HERE'S THE DATA ANALYSIS HOW
SUCCESSFUL IS THIS PROGRAM?
AS I MENTIONED, WE HAVE 10
PROGRAMS SUPPORTED BY K12.
HARVARD, HOPKINS, PENN, UIC,
MICHIGAN, UCSD AND SAN FRANCISCO
AND USF AND STANFORD.
IN THE MIDDLE COLUMN YOU SEE THE
SCHOLARS SUPPORTED AND THE DATA
WAS TAKEN FROM THE LAST PROGRESS
REPORT ON THE LAST SUBMISSIONS
OF THE GRANT APPLICATION.
FOR EXAMPLE, HARVARD APPOINTED
14 SCHOLARS AND THEY WERE ABLE
TO GET THEIR K08 OR K23 OR R21.
IT'S A PRETTY SUCCESSFUL PROGRAM
AND THEY'RE ABLE TO CONVERT.
IT'S A CASE HOPKINS 6 OF 10 AND
UIC, 5 OF 12 AND MICHIGAN AND WE
HAVE THE PROGRAM DIRECTOR OF
MICHIGAN 7 OF 8 AND UCSD, 4 OF 4
AND ORE OREGON AND 2 OF 3 AND
STANFORD WE JUST STARTED THIS
YEAR.
THE DATA SAYS IT'S A SUCCESSFUL
PROGRAM.
WE WILL BE HAPPY TO RE-ISSUE THE
K12.
DR. BORRAS IS A DISCUSSANT AND
I'M HAPPY TO HAVE YOUR
QUESTIONS.
THANK YOU.
>>THIS IS A PROGRAM I WAS
EXCITED ABOUT BECAUSE I'VE BEEN
WORKING WITH K12 AWARDEES AND
ALSO I'VE BEEN WORKING WITH
DUKE'S PROGRAMS INTERESTED IN
RESEARCH FOR A YEAR AND THE
DIFFERENCE THAT MAKES IN THE WAY
THEY EXAMINE THE PATIENTS TO DO
THAT.
I DON'T HAVE NEGATIVE THINGS TO
STAY.
ONE QUESTION IS WHAT IS THE
PERCENT OF THE K12 THEY GET AN
R01 LATER AND GET ESTABLISHED AS
RESEARCH INVESTIGATORS.
>>THE QUESTION IS HOW MANY K12
POINTEES ARE ABLE TO GET THEIR
INDIVIDUAL R.
THE DATA WAS ONE WE LOOKED INTO
IT WHEN IT COMES TO THE RENEWAL.
IF YOU REMEMBER LAST COUNCIL I
PRESENTED MY DATA ON K08 AND K23
AND THE PERCENTAGE IS HIGH 50%
TO 55% ARE ABLE TO CONVERT WHICH
IS A REFLECTION OF K12 TO K08.
>>THE DATA YOU PRESENTED TODAY
WAS THE CONVERSION TO R01?
>>NO, K08 TO K23.
>>TODAY WHEN YOU SAID 100% OF
MICHIGAN THOSE ARE FROM THE
APPLICATION THEY GOT THE AWARD
THE PERCENT OF PERSONS THAT GOT
THE AWARD FROM THE NUMBER OF
APPLICANTS.
>>YES.
>>OKAY.
>>THANK YOU.
>>TOM GARDNER.
THANK YOU VERY MUCH.
SEVERAL OF US IN THE ROOM ARE
THE BENEFICIARIES OF THE K
PROGRAMS AND THIS PROVIDES AN
IMPORTANT NICHE IN IT'S A UNIQUE
OPPORTUNITY FOR YOUNG FISSION
WHO'S DON'T HAVE MUCH AND WANT
TO DO THE RIGHT RESEARCH BUT
NEED TRAINING.
THEY HAVEN'T HAD A Ph.D. AND CAN
ALMOST START FROM THE GROUND UP
AND BE SUCCESSFUL AND BECOME
INDEPENDENT TO THEIR OWN K AND
RO1.
IT'S IMPORTANT TO RECOGNIZE THIS
COMPLEMENTS THE K08, K23 PROGRAM
VERY MUCH IT'S THE SEEDING
GROUND FOR SUBSEQUENT RO1s.
I THINK THE PROGRAM ABLE TO
CAPTURE A POPULATION OF PEOPLE
THAT DIDN'T KNOW THEY WANTED TO
BE INVESTIGATORS UNTIL THEY CAME
TO THE IDEA LATE IN THE CLINICAL
TRAINING.
WITHOUT THIS THEY'D PROBABLY BE
LOST.
THERE'S NO MANY OTHERS IN
OPHTHALMOLOGY FROM FOUNDATIONS
AND THINGS LIKE THAT.
THIS PLAYS AN IMPORTANT ROLE
THOUGH I'M NO LONGER A P.I. AND
NOT CONFLICTED.
>>THANK YOU.
>>REZA, DO YOU HAVE TO SAY
ANYTHING?
>>THANK YOU SO MUCH.
OF THE 14, 12 ARE HERE AND 11
RECEIVED K FUNDING.
EVERYONE WAS FINISHED EXCEPT FOR
ONE RECEIVED RO1 FUNDING AND
MADE THE DIFFERENCE.
DR. MICHAEL CHIANG MENTIONED AT
THE BEGINNING OF THE DAY THE
CLINICIAN SCIENTIST PROGRAM AND
I CAN THINK OF MANY WHO HAVE
BEEN RECIPIENTS OF THIS SINCE
THE PROGRAM WAS LAUNCHED AT THE
NEI.
WE CAME WITH HOPKINS AND PENN
AND WE STRONGLY ENDORSE IT.
THE FUNDING HAS CONTRACTED
SOMEWHAT.
WE USED TO GET FIVE YEARS OF
FUNDING AND USED TO HAVE UP TO
THREE PEOPLE AT A GIVEN TIME IN
A PROGRAM NOW IT'S UP TO TWO AND
FEWER YEARS.
IT'S BECOME MORE OF A STEPPING
TONE TO AN INDIVIDUAL KAY
OPPOSED TO AN RO1 GRANT AND HOPE
IT MEETS YOUR SUPPORT.
THANK YOU.
>>THE PROGRAM IS AMAZING.
OTHER COUNTRIES ENVY THE PROGRAM
AND THANK YOU FOR YOUR
CONTRIBUTION.
SOME PROGRAMS ARE MORE
SUCCESSFUL TO CONVERT TO A K23.
DO YOU HAVE AN INSTINCT WHY SOME
ARE MORE SUCCESSFUL THAN OTHERS?
>>THE DATA IS THERE.
I THINK THEY'RE ALL SUCCESSFUL
IF YOU HAVE 60% CONVERSION THEY
MAY TAKE LONGER TIME.
I DIDN'T CALL INDIVIDUAL
DIRECTORS BUT I WENT THROUGH THE
APPLICATIONS AND DUG THE DATA
OUT AND STANFORD WE STARTED AND
ONE MOVED TO HOPKINS AND SOME
LEFT THE PROGRAM.
THE DATA IS THERE.
I HAVE NO PROBLEMS.
>>THERE'S HOW LONG THE PROGRAM
HAS BEEN IN EXISTENCE.
SOME OF THE ONES TOWARDS THE
BOTTOM OF THE LIST THAT DIDN'T
LOOK QUITE AS SUCCESSFUL IS
BECAUSE THEY HAVEN'T BEEN AROUND
SLONG.
-- AS LONG AS THEY HAVE MORE
TRAINEES APPLY FOR Ks
PRESUMABLY.
>>THEY USED TO HAVE K12.
>>I WANTED TO RECOGNIZE THE
SUCCESS OF THE PROGRAM IS IN
DIRECT PROPORTION TO DR
DR. AGGERWAHL'S ROLE AND HELPS
THE P.I.s UNDERSTAND WHAT THE
CRITERIA ARE AND HELPS THE
SCHOLARS AND EVERYTHING.
IT'S NOT JUST THE PROGRAM.
>>IF I MAY ADD THIS PROGRAM
BENEFITS THE CLINICIAN
SCIENTISTS AND THE Ph.D.s.
IT'S REALLY NICE TO HAVE IN YOUR
LAB A CLINICIAN BECAUSE IT'S
BOTH WAYS FOR THE CLINICIAN AND
FOR THE Ph.D.s ALSO BENEFIT.
>>THIS IS A GREAT DISCUSSION.
THANK YOU.
ARE THERE ANY MORE COMMENTS
BEFORE WE TAKE A VOTE?
IF NOT MAY I HAVE A MOTION TO
APPROVE THE CONCEPT FOR THE
RENEWAL OF THE K12?
MAY I HAVE A SECOND?
THE DISCUSSION WAS A LITTLE
AMBIGUOUS.
ALL IN FAVOR OF APPROVING THE
RE-ISSUE?
ANYONE OPPOSED?
THANK YOU.
NOW WE DO HAVE THREE COUNCIL
MEMBERS WHO THIS WILL BE THEIR
LAST MEETING AND WE WANTED TO
GIVE THEM AN OPPORTUNITY TO FEW
REMARKS ABOUT THEIR TIME ON
COUNCIL AND ANY OTHER FEEDBACK
THEY WANTED TO SHARE WITH US.
I FIRST WANT TO EXTEND MY THANKS
TO THEM FOR THEIR SERVICE AND
ACTIVE ENGAGEMENT IN COUNCIL.
WE REALLY APPRECIATE IT.
LETS START WITH DR. DEL
RIO-TSONIS.
>>IT'S BEEN AN ENRICHING
EXPERIENCE WORKING WITH THE PAST
AND CURRENT COUNCIL MEMBERS.
IT'S BEEN A PLEASURE AND WITH
NEI STAFF.
IT'S IN THE MIDDLE A MORPHING
COUNCIL IN MANY INSTANCES
BECAUSE NOT ONLY BECAUSE OF THE
CHANGING COUNCIL MEMBERS BUT I
THINK THE NEI HAS UNDER GONE
CHANGE.
WHEN I WAS RECRUITED I HAD
FANTASTIC TALKS BUT SAD I DIDN'T
GET TO MEET HIM BUT HAD A
PLEASURE TO WORK WITH ANNE
RUNNING THE COUNCIL FOR THE
FIRST PART OF MY TENURE AND NOW
I HAD THE PLEASURE TO WORK WITH
YOU.
THANK YOU.
IT'S BEEN A PLEASURE.
ALSO MY FIRST MEETING HERE WAS
WHEN THE NEI DIRECTOR AND SPAN
THE PROCESS AND THANK YOU FOR
BEING IN BETWEEN DRIVING THE
INITIATIVES WE STARTED AND OF
COURSE MIKE THAT'S COME IN WITH
STRONG INITIATIVES FOR THAT.
I ALSO HAD THE PLEASURE TO WORK
WITH MIKE SIMONS.
I WAS SAD WHEN HE PASSED AWAY.
HE WAS THE GLUE OF THE COUNCIL.
HE WAS A GIFT.
HE KNEW THE INS AND OUTS AND
KNEW THE COUNCIL.
I ALSO WANT TO COMMEND THE NEI
AND COUNCIL FOR BEING INCLUSIVE
AND THE DIVERSITY AND INCLUSION
THAT'S BEEN OBVIOUS IN THE
COMPOSITION OF THE COUNCIL AND
INITIATIVES AND EFFORTS FOR THE
INCLUSION OF SEX AND MINORITIES
AND SMALLER INSTITUTIONS LIKE
MINE BASIC SCIENCE AND USING
MODEL ORGANISMS TO ASK
QUESTIONS.
I HOPE THE INITIATIVES CONTINUE
TO ENRICH THE COUNCIL AND NEI.
ONE OF THE EFFORTS INITIATED
HERE AND I WAS VERY HAPPY AND,
WELL, WAS FORTUNATE TO WORK
TOGETHER WITH THE NEI STRATEGY
PLANNING AND WAS AN ENRICHING
EXPERIENCE AS WELL.
I THANK SHEPPA AND THE PROGRAM
OFFICERS I HAD THE PLEASURE TO
WORK WITH WHILE AT COUNCIL.
I THINK ONE OF THE LAST THINGS I
WANT TO SAY IS A PRODUCT FROM
THE NIH STRATEGIC PLANNING WAS
THE OFFICE OF REGENERATED
MEDICINE AND I AM SAD TO SEE
THAT GO AND HOPE IT'S NOT A
PERMANENT CHANGE AND THINK OF
THE STRUCTURE AND THE PROGRAMS
BASED ON REGENERATIVE MEDICINE
RESEARCH.
THAT'S ONE OF THE THINGS I
THOUGHT WOULD BE IMPORTANT TO
BRING UP AND THE OTHER IS TO
CONTINUE DIVERSITY AND ANIMAL
MODELS AND BASIC RESEARCH WHICH
DRIVES THE TRANSLATIONAL
RESEARCH.
I APPRECIATE THE OPPORTUNITY TO
BE PART OF THE PANEL AND THANK
YOU FOR HAVING A LIVE SESSION.
THANK YOU.
REGENERATIVE MEDICINE WON'T GO
AWAY HERE THANK YOU.
>>BEFORE WE GET TO THE NEXT WE
HAVE NICE CERTIFICATES FOR YOU.
>>NEXT WE WOULD LOVE TO HEAR
FROM DR. HARTNETT.
>>IT'S BEEN AN HONOR TO
PARTICIPATE AND SERVE AND IT'S
BEEN A LOT OF FUN.
WE ALL BELIEVE IN SCIENCE AND I
WAS HAPPY TO SERVE TO BE PART OF
THIS GROUP THAT COMMUNICATES TO
THE PUBLIC WITH THE IMPORTANCE
OF SCIENCE AND ADVISES HOW WE
BEST MEET OUR MISSION AND HOPE
IT WILL INCREASE FINANCIAL
SUPPORT FOR SCIENCE AS WELL.
IT WAS MUCH MORE.
I APPRECIATE THE OPPORTUNITY TO
WORK WITH EVERYONE HERE SO IN
TELL GENT AND COMMITTED AND
CREATIVE SCIENTISTS AND STAFF
AND TO LEARN ABOUT THEIR SCIENCE
WORK.
AND THE PROGRAM OFFICERS AND
DIRECTORS.
IT'S BEEN SO TREMENDOUS AND I
LEARNED ABOUT THE EXTRAMURAL AND
INTRAMURAL PROGRAM FROM OUR
MEETINGS.
AND WORKING WITH PAUL AND MIKE
CHIANG WHO I ALWAYS ADMIRED AND
HAD GREAT RESPECT FOR AND YOUR
CREATIVITY AND THANK YOU FOR
YOUR LEADERSHIP AND COLLEGIALITY
AND THE STAFF HAS BEEN
TERRIFICALLY HELP FFUL I
APPRECIATE THE CREDENTIALING AND
ETHICS AND FINANCIAL FORM AND
TRAVEL, THANK YOU.
A SPECIAL THANKS TO SANTA AND TO
ANNIE AND NOW CATHY.
THANK YOU VERY MUCH.
I'VE LEARNED ABOUT SCIENCE AND
HOW IT'S RECEIVED FROM THE
SCIENTIFIC COMMUNITY AND WHILE
SERVING AS ACTING DIRECTOR OF
THE EXTRAMURAL PROGRAM.
THANK YOU.
IT'S BEEN A GREAT HONOR AND
ENRICHING TO PARTICIPATE IN THE
NEW STRATEGY PLAN AND I'VE
APPRECIATED THAT.
BEING PART OF THE VISION AND NIH
GOAL HAS BEEN SPECIAL AND MY
HOPE IS NEI WILL CONTINUE
SUPPORTING THE EMERGING AREAS OF
SCIENCE WITH BIG DATA AND THE
MECHANISTIC WORK OF THE
INDIVIDUAL INVESTIGATE OR
INITIATED SCIENCE WHILE NOT
COMPROMISING SCIENCE.
THERE'S SO MANY WAYS TO GET
CONSILIENCE, I THINK THAT'S THE
WORD, WE HAVE TO FIGURE OUT HOW
TO COME TOGETHER.
WE HAVE TO BE INCLUSIVE OF THE
SCIENCE TO ALL APPROACHES.
I HOPE IT CONTINUES AND WE HAVE
THE FUNDING.
THANK YOU.
>>THANK YOU VERY MUCH, EMMY.
WE CAN TAKE PHOTOS AT THE BREAK.
>>IT WILL BE VERY SHORT.
>>WE KNEW EACH OTHER
PROFESSIONALLY AND I'VE ENJOYED
HAVING YOU HERE.
THANK YOU.
>>NEXT WE'LL HEAR FROM DR. BEN
TELLER.
>>THANKS, GUYS.
IT'S BEEN AN INTERESTING AND
ENLIGHTENING COUNCIL I THINK
FOUR YEARS AND WHEN ANNIE CALLED
ME UP FIRST AND ASKED ME TO BE
ON THE COUNCIL I'M LIKE WHAT IS
THIS?
I HAVE NO IDEA WHAT I'M DOING
HERE.
AFTER SEEING IMPROVING THE EYE
CARE IN THE FOREFRONT OF THE
WORLD HAS BEEN AMAZING.
AND I'VE TALKED TO MIKE ABOUT
THIS IS TOO MUCH, I CAN'T DO
CLINICAL PRACTICE AND SERVE AT
THE SAME TIME BUT I'M GLAD I
STUCK WITH.
IT'S BEEN SO AMAZING LEARNING.
I'VE LEARNED SO MUCH HERE.
I HOPE TO SPREAD KNOWLEDGE TO
SOME COLLEAGUES WHO HAVE NO IDEA
THIS SIFTS HERE.
THANKING MIKE AND KATHLEEN,
JIMMY FOR PICKING FOR ALL THE
PROJECTS THAT WERE VERY
ENLIGHTENING AND STIMULATING.
THE ONBOARDING PROCESS COULD BE
COULD BE A BIT EASIER.
IT TAKES ME LONGER TO FILL OUT
THE PASS WORDS THAN THE REPORTS.
AND FOR SOMEONE LIKE MYSELF THAT
DOESN'T HAVE A LOT OF EXPERIENCE
IN CLINICAL RESEARCH HAVING A
MENTOR WILL HELP KNOW WHAT TO
EXPECT.
MAYBE SOME OUTREACH TO STUDENTS,
EX TERNS SO THEY KNOW WHAT'S
GOING ON WITH THE GREAT WORK YOU
GUYS ARE DOING HERE.
I'LL CONTINUE TO SUPPORT THE EYE
COUNCIL ANY WAY I CAN AND SEE
AND THE PROJECTS AND EVERYTHING
YOU GUYS DO IS SO IMPRESSIVE.
I'M HONORED TO BE PART OF THE
COUNCIL AND THANK YOU FOR
INCLUDING ME.
>>BEN, THANK YOU FOR THE
REMARKS AND BOTH ELUDED TO BEING
THE ODD PERSON OUT AND THOSE
PERSPECTIVES ARE IMPORTANT
BECAUSE WE NEED ON HOW WE DO AND
HOW THE SCIENCE MATTERS TO
DOCTORS IN THE REAL WORLD SO
THANK YOU FOR THAT PERSPECTIVE.
>>THANK YOU FOR SERVICE.
THAT'S THE END OF THE OPEN
SESSION.
UNFORTUNATE WE RAN OUT OF TIME
FOR GENERAL DISCUSSION.
THE REASON WE'RE PRESSED IS SOME
PEOPLE HAVE SOME FLIGHTS TO
CATCH BUT ALSO BECAUSE WE HAVE
TO BEING OUT OF THIS ROOM BY
5:00.
SO WE'RE GOING TO NEED TO MOVE
ON AND HAVE A NUMBER OF THINGS
TO COVER IN THE CLOSED SESSION.
THANK YOU, EVERYBODY.
IT WAS A GREAT SESSION.
I APPRECIATE YOUR PATIENCE WITH
TO THE CHAOS.
THAT ENDS THE CLOSED SESSION AND
WE'LL TAKE A 10-MINUTE BREAK AND
COME BACK AND START -- BEFORE
BEFORE YOU GO, KATHY, I WANT TO
GIVE A SHOUT OUT TO YOU AND
NATHAN AND LATIFAH AS YOU CAN
TELL FROM THE MORNING.
WE HEARD SOME STUFF BEHIND THE
SCENES BUT WHAT I HEARD WAS THE
TIP OF THE ICEBERG SO THANK YOU
VERY MUCH.