GOOD MORNING, EVERYONE.
I'VE BEEN INSTRUCTED TO USE THIS
GAVEL TO OPEN THE MEETING, AND
THIS IS THE 168TH MEETING OF THE
NATIONAL ADVISORY EYE COUNCIL.
IT'S GREAT TO SEE EVERYBODY HERE
IN BETHESDA.
AND I'M MICHAEL CHIANG, DIRECTOR
OF THE NATIONAL EYE INSTITUTE.
AND AS IS CUSS TO M CUSTOMARY, A
REALLY GOOD MEETING HERE TODAY,
WE'LL GO AROUND THE TABLE AND
HAVE EVERYONE INTRODUCE
THEMSELVES.
BEFORE WE START TO DO THIS, I
JUST WANT TO SAY THAT WE HAVE
TWO GUEST SPEAKERS HERE TODAY,
AND I WANT TO BRIEFLY INTRODUCE
THEM.
ONE OF THEM IS DR. VINIT MAHAJN
FROM STANFORD UNIVERSITY.
HE'S DONE SOME REALLY, REALLY
IMPRESSIVE STUFF, DOING SOME
RELIMB PRE SIEVEREALLY IMPRESSIO
WE'LL FORMALLY INTRODUCE HIM
AFTERWARDS, WELCOME, VINU.
THE SECOND PERSON IS NOT HERE
YET.
AND I WANT TO GIVE YOU A HEADS
UP THAT THE SECOND GUEST SPEAKER
THAT WE HAVE HERE IS GOING TO BE
DR. AFROUZ ANDERSON, PROGRAM
OFFICER FROM NIBIB, NATIONAL
INSTITUTE OF BIOMEDICAL IMAGING
AND BIOENGINEERING WHO WILL BE
HERE, AND THE TWO OF THEM ARE
GOING TO HAVE A REALLY
INTERESTING SESSION.
BUT WITH THAT, LET'S GO AROUND
THE TABLE.
WE'RE GOING TO START WITH THE
THREE OF US.
AGAIN, MICHAEL CHIANG, DIRECTOR,
NATIONAL EYE INSTITUTE.
>> GOOD MORNING, EVERYBODY.
I'M THE DEPUTY DIRECTOR OF THE
NATIONAL EYE INSTITUTE.
>> HI, I'M CATHY ANDERSON,
DIRECTOR OF THE DIVISION OF
EXTRAMURAL ACTIVITIES AT NEI,
AND THE EXECUTIVE SECRETARY FOR
THE ADVISORY EYE COUNCIL.
>> REZA, COULD WE START WITH YOU
AND GO AROUND THE TABLE, PLEASE?
>> GOOD MORNING, EVERYONE.
REZA DANA DR. BOSTON.
HEAD OF CORNEA.
THANK YOU.
>> GOOD MORNING, EVERYONE.
MARIA GRANT FROM UNIVERSITY OF
ALABAMA, DEPARTMENT OF
OPHTHALMOLOGY, VISUAL SCIENCE.
THANK YOU.
>>
>> THANK YOU.
I'M JANI LEHRER-STEIN FROM
SAN FRANCISCO.
MICHAEL TOLD ME LAST NIGHT I'M
OFFICIALLY THE PUBLIC PERSON ON
THIS COUNCIL, SO THANK YOU FOR
GIVING ME THE TITLE FINALLY.
>> HI, I'M PRADEEP RAMULU, JOHNS
HOPKINS INSTITUTE, DIRECT THE
GLAUCOMA DIVISION THERE.
>> GOOD MORNING, EVERYONE.
VICTOR PEREZ FROM UNIVERSITY OF
MIAMI, DIRECTOR OF CORNEA
RESEARCH AND PROFESSOR OF
OPHTHALMOLOGY.
THANK YOU.
>> HI, I'M DON MUTTI, OHIO STATE
UNIVERSITY DEPARTMENT OF
OPTOMETRY.
>> TIRIN MOORE, STANFORD
UNIVERSITY, DEPARTMENT OF
NEUROBIOLOGY.
>> HI, GOOD MORNING.
I'M MAUREEN MAGUIRE, PROFESSOR
EMERITUS FROM UNIVERSITY OF
PENNSYLVANIA, THE JADE CENTER
FOR HEALTH RESEARCH.
>> THANK YOU, EVERYONE.
TODAY WE DON'T HAVE ANY
DEPARTING OR NEW MEMBERS.
THERE'S A SLATE THAT'S GOING TO
BEGIN COMING IN, BUT IT'S MAKING
ITS WAY THROUGH THE DEPARTMENT
OF HEALTH AND HUMAN SERVICES
CLEARANCE PROCESS SO WE'LL HAVE
THOSE HOPEFULLY COMING UP AT THE
NEXT MEETING.
BUT WITH THIS, LET ME TURN OVER
TO CATHY, YOU AND YOUR TEAM HAS
ALWAYS DONE A GREAT JOB SETTING
UP THE LOGISTICS OF THIS MEETING
AND THE HYBRID PART OF THE
MEETING WITH EVERYBODY WHO'S ON
ZOOM AND ON THE VIDEOCAST, AND I
WANT TO JUST GIVE A SHOUT OUT TO
YOUR GROUP.
AND CAN WE TURN TO YOU TO MAKE
YOUR INTRODUCTORY REMARKS?
>> THANK YOU, MIKE, AND THANK
YOU, EVERYONE, FOR COMING HERE
TODAY IN PERSON AND VIRTUALLY.
I ALSO WANT TO WELCOME THE NEI
ADVOCACY COMMUNITY, THOSE WHO
ARE HERE IN PERSON AND THOSE WHO
ARE WATCHING ON THE VIDEOCAST.
OUR COLLEAGUES FROM THE CENTER
FOR SCIENTIFIC REVIEW WHO DO THE
MAJORITY OF OUR GRANT
APPLICATION REVIEWS, OUR INVITED
SPEAKERS, AND MEMBERS OF THE
PUBLIC WHO ARE WATCHING
VIRTUALLY.
I'LL ALSO ECHO MIKE'S THANKS AND
ACKNOWLEDGE OUR NEWEST STAFF
MEMBER FOR ALL THEIR EFFORTS TO
MAKE SURE THIS MEETING HAPPENS
AND HAPPENS SMOOTHLY.
THEY COORDINATE ALL THE
LOGISTICS, ALL THE TECHNOLOGY,
ALL THE PREP FOR THE MATERIALS
BEFOREHAND AND ON-SITE
LOGISTICS, SO THEY ARE
ABSOLUTELY ESSENTIAL TO THIS
PROCESS.
I ALSO WANT TO GIVE A SHOUT OUT
TO BOTH LESLIE EARL AND NATHAN
BROWN AGAIN FOR THEIR EXTENSIVE
EFFORTS TO MAKE THE MEETING
MATERIALS COMPLIANT AND
ACCESSIBLE FOR ALL OF OUR
COUNCILMEMBERS.
SO I'M JUST GOING TO GO OVER A
COUPLE REMINDERS FOR BEST
MEETING PRACTICES AND ZOOM
ETIQUETTE.
SO WHETHER YOU'RE IN THE ROOM O.
ON ZOOM, PLEASE IDENTIFY
YOURSELF WITH YOUR FULL NAME
EACH TIME YOU SPEAK.
IF YOU'RE ON ZOOM, PLEASE PUT
YOUR FULL NAME IN YOUR ZOOM
WINDOW SO WE CAN CAPTURE ALL
PARTICIPANTS ACCURATELY FOR OUR
MEETING MINUTES.
IF YOU'RE ON ZOOM, PLEASE HAVE
YOUR VIDEOS OFF DURING THE
MEETING UNLESS YOU'RE A
COUNCILMEMBER, MAUREEN, AND
REMEMBER TO MUTE YOURSELF UNLESS
YOU ARE PRESENTING OR SPEAKING.
IF YOU HAVE A QUESTION, YOU WILL
NEED TO TURN ON YOUR VIDEO AND
USE THE RAISE HAND FUNCTION AND
INTRODUCE YOURSELF.
PLEASE DO NOT USE THE CHAT BOX
IN ZOOM.
WE CAN'T SEE THAT IN THE ROOM
AND THE PEOPLE VIEWING ON THE
VIDEOCAST CAN'T SEE IT EITHER SO
WE CAN'T CAPTURE THAT FOR OUR
MINUTES.
IF YOU'RE IN THE ROOM PLEASE USE
YOUR MICROPHONE EACH TIME YOU
SPEAK AND, AGAIN, INTRODUCE
YOURSELF.
WHEN YOU'RE SPEAKING, THIS IS
HARD BECAUSE I'M NOT -- WHEN
YOU'RE SPEAKING TRY TO LOOK AT
THE CAMERA IN THE MIDDLE OF THE
ROOM, NOT YOURSELF ON THE VIDEO.
AND IF YOU'RE HERE IN PERSON,
COUNCILMEMBERS DON'T NEED TO DO
THIS BUT THE REST OF THE PEOPLE
IN THE ROOM, PLEASE REMEMBER TO
SIGN IN WITH BRONTE.
YOU'LL NEED TO DO THAT FOR BOTH
OPEN AND CLOSED SESSION.
AS ALWAYS, I'M REQUIRED TO
REMIND COUNCILMEMBERS THAT A A S
SPECIAL GOVERNMENT EMPLOYEES YOU
MAY NOT ENGAGE IN ANY LOBBYING
ACTIVITIES TODAY WHILE YOU'RE
RECEIVING PAY FROM THE FEDERAL
GOVERNMENT AND DURING YOUR
SPONSORED TRAVEL.
FUTURE COUNCIL MEETINGS.
THE DATES FOR FUTURE COUNCIL
MEETINGS ARE LISTED ON THE OPEN
SESSION AGENDA AND ON OUR
WEBSITE.
THE 2026 DATES HAVE BEEN ADDED
SINCE OUR LAST MEETING.
SO PLEASE MARK YOUR CALENDARS
AND LET ME KNOW IF YOU HAVE ANY
CONFLICTS.
OUR NEXT MEETING IS SCHEDULED
FOR FRIDAY, OCTOBER 11, 2024.
AND AS DR. CHIANG MENTIONED, WE
DO HOPE TO HAVE OUR NEXT SLATE
OF MEMBERS ONBOARDED BY THEM SO
WE HAVE A FULL ROSTER.
OKAY.
THE MINUTES OF THE FEBRUARY 2024
COUNCIL MEETING WERE MADE
AVAILABLE TO YOU IN THE
ELECTRONIC COUNCIL BOOK FOR YOUR
REVIEW.
WOULD ANYONE LIKE TO DISCUSS THE
FEBRUARY MEETING MINUTES?
OKAY.
IF NOT, MAY I HAVE A MOTION TO
APPROVE?
THANK YOU, VICTOR.
SECOND, MARIA, THANK YOU.
ALL IN FAVOR OF APPROVING THE
FEBRUARY MEETING, PLEASE RAISE
YOUR HANDS.
IS THERE ANYONE OW OPPOSED?
GREAT, THANK YOU.
JUST A SLIGHT CHANGE ON THAT
TOPIC, GOING FORWARD, I'M GOING
TO EMAIL YOU THE DRAFT COUNCIL
MINUTES IN ADVANCE OF THE
MEETING AND ASK FOR YOUR
APPROVAL VIA EMAIL.
WE'RE NOW REQUIRED -- WELL,
WE'VE PROBABLY ALWAYS BEEN
REQUIRED BUT WE'RE NOW REQUIRED
TO GET THESE APPROVED AND
CERTIFIED 120 DAYS AFTER THE
MEETING, SO WE CAN'T ALWAYS MAKE
THAT DEADLINE IF WE WAIT UNTIL
THIS MEETING SO JUST BE ON THE
LOOKOUT FOR THAT.
SO WITH THAT, IF ANYBODY HAS ANY
QUESTIONS?
I'M GOING TO TURN IT BACK OVER
TO DR. CHIANG FOR HIS DIRECTOR'S
REMARKS.
>> KATHY, THANKS AGAIN TO
BASICALLY YOU AND THE CREW OF
NATHAN, LISA AND BRONTE.
I'M GOING TO WALK UP HERE WHERE
NATHAN IS STANDING.
NATHAN, THANK YOU AGAIN.
THIS IS ALWAYS -- THERE ARE OVER
700 PEOPLE WHO WORK AT THE
NATIONAL EYE INSTITUTE, AND THIS
IS ALWAYS A PRIVILEGE FOR ME TO
STAND UP HERE AND GIVE A REPORT
ON BEHALF OF ALL OF US.
SO I ALWAYS BEGIN BY SAYING THAT
WHAT WE TALK ABOUT, WHAT WE
DISCUSS HERE IN THE NEXT HOUR
AND A HALF IS JUST A SMALL
AMOUNT OF WHAT ACTUALLY HAPPENS
IN BETHESDA AND WHAT THE CREW,
PARTICULARLY IN THE BACK, IS
DOING.
AND WE'VE BEEN USING SOCIAL
MEDIA TO TRY TO DISSEMINATE ALL
THE NEWS AS IT COMES UP.
SO PLEASE CONSIDER FOLLOWING US
ON SOCIAL MEDIA.
THE TWITTER HANDLES ARE SHOWN
HERE.
NATEYEINSTITUTE AND NEIDIRECTOR.
SO THIS IS OUR 168TH EYE
INSTITUTE COUNCIL, AND I WANT TO
BEGIN JUST WITH SOME LEADERSHIP
AND STAFF UPDATES.
THE FIRST ONE IS THE FOGARTY
INTERNATIONAL CENTER IS THE
INSTITUTE AT THE NIH THAT
HANDLES INTERNATIONAL HEALTH,
GLOBAL HEALTH, GLOBAL RESEARCH.
AND ROGER GLASS WAS THE
LONG-TIME DIRECTOR OF THE
FOGARTY, AND THEN RETIRED A
COUPLE YEARS AGO, AND THEN PETER
KILMARX BECAME THE ACTING
DIRECTOR, WHO WAS ROGER'S
DEPUTY.
AND THEN WITHIN THE PAST MONTH
OR SO, KATHLEEN NEUZIL WAS
APPOINTED AS THE PERMANENT
DIRECTOR OF THE FOGARTY.
AND DR. NEUZIL IS AN INFECTIOUS
DISEASE SPECIALIST BY BACKGROUND
AND SHE DOES GLOBAL HEALTH.
SHE WAS FROM THE UNIVERSITY OF
MARYLAND, AND WAS A PROFESSOR IN
VACCINOLOGY, DIRECTOR OF THE
CENTER FOR VACCINE DEVELOPMENT
AND GLOBAL HEALTH AT THE MEDICAL
SCHOOL, AND ALSO CHIEF OF THE
DIVISION OF GEOGRAPHIC MEDICINE
THERE.
SHE'S BEEN A VACCINE POLICY
ADVISOR WITH THE WHO AND WITH
THE CDC AND JUST HAS A LOT OF
EXPERIENCE IN THIS AREA.
SO WE'VE HAD WE'VE HAD A LOT OF
TOUCH POINTS WITH THE FOGARTY
BECAUSE OF GLOBAL HEALTH IRK EUS
WE DO IN VISION, AND REALLY
EXCITED ABOUT KATHLEEN, I'M
STARTING TO GET TO KNOW HER.
THE SECOND ONE TO LET YOU KNOW
ABOUT IS JOSH GORDON.
HE'S BEEN THE DIRECTOR OF THE
NATIONAL INSTITUTE OF MENTAL
HEALTH FOR EIGHT YEARS NOW, AND
HE RECENTLY -- SO HE CAME FROM
COLUMBIA UNIVERSITY, AND THEN IS
GOING BACK TO CLEUM BEE A COLUMA
UNIVERSITY AS THE CHAIR OF
PSYCHIATRY AND THE CHIEF OF THE
NEW YORK STATE PSYCHIATRIC
INSTITUTE.
AND HE'S GOT SOME OTHER
ADMINISTRATIVE RESPONSIBILITIES
THERE.
JOSH HAS REALLY DONE A GREAT JOB
AT NIMH DURING A VERY BUSY TIME
FOR MENTAL HEALTH IN THIS
COUNTRY.
A COUPLE PERSONAL THINGS FOR HIM
IS THAT HE WAS AN MD/PH.D. FROM
THE UNIVERSITY OF CALIFORNIA
SAN FRANCISCO WHERE HE DID HIS
PH.D. IN MIKE STRYKER'S LAB, SO
WELL-KNOWN VISION RESEARCH GRO
GROUP.
WHEN YOU START AS AN INSTITUTE
DIRECTOR AT THE NIH YOU ARE
ASSIGNED A MENTOR AND JOSH WAS
MY MENTOR.
SO A CERTAIN PERCENTAGE OF WHAT
I KNOW HERE IS FROM JOSH.
SO YOU CAN BLAME HIM FOR ALL
THAT STUFF.
BUT BUT HE HAD HIS LAST INSTITUE
DIRECTOR'S MEETING TODAY, AND WE
WILL REALLY MISS JOSH.
WELCOMES OVER HERE, I JUST WANT
TO GIVE A SHOUT OUT TO BRONE.
I CAN'T SEE YOU, BUT CAN YOU
JUST -- OKAY, EVERYBODY ELSE C
CAN -- YEAH, JUST OFFICIALLY
WELCOME TO BRONTE.
THANKS FOR STEPPING OUT HERE.
SHE'S THE NEW OPERATIONS
COORDINATOR FOR THE DEA HERE.
THE LAST BULLET POINT HERE IS
EXTRAMURAL.
SO KATHY MENTIONED THAT SHE'S
THE DIRECTOR OF THE DIVISION OF
EXTRAMURAL ACTIVITIES AT THE
NEI.
AND YOU KNOW, WHICH BASICALLY
OVERSEES REVIEW AND GRANTS
MANAGEMENT, AND KATHY IS ALSO
THE ACTING DIRECTOR OF THE DESP,
THE DIVISION OF EXTRAMURAL --
BASICALLY OVERSEES THE PROGRAM
OFFICERS, AND YOU KNOW, I'VE
MADE THE COMMENT ON A PRE-CALL
EARLIER THIS WEEK THAT SOMETIMES
I FEEL LIKE I CAN SEE TOLUCA
THEE BECAUSE SHE'S IN 1 1/2
PLACES AT THE SAME TIME BECAUSE
SHE'S DOING THESE TWO POSITIONS,
BUT WE DO HAVE A SEARCH THAT'S
GOING ON FOR A PERMANENT DESP
DIRECTOR.
IT'S GOING REALLY WELL, AND WE
HOPE TO BE ABLE TO HAVE
SOMETHING TO ANNOUNCE ABOUT THAT
IN THE NOT TOO DISTANT FUTURE.
SO IN THE MEANTIME, SANGEETA
BHARGAVA IN THE BACK HAS BEEN
DOING THE ACTING DEPUTY POSITION
IN DESP, SO REALLY JUST
ACKNOWLEDGE WHAT KATHY AND
SANGEETA HAVE BEEN DOING OVER
THE PAST -- COMING ON TWO YEARS
NOW.
SOME AWARDS THAT I WANT TO MAKE
YOU AWARE OF, ONE OF THEM,
LARYSSA HURYN, WHO'S SHOWN ON
THE RIGHT HERE, I GUESS YOU
CAN'T SEE MY POINTER.
OKAY, HERE IT IS.
LARYSSA IS ONE OF THE STAFF
CLINICIANS IN OUR CLINICAL
CENTER, AND SHE'S A PEDIATRIC
OPHTHALMOLOGIST AND DOES
GENETICS BY BACKGROUND.
AND SHE RECEIVED THE AAPOS, THE
PEDIATRIC SOCIETY OUTSTANDING
EMERGING LEADER AWARD THIS
PAST -- A FEW MONTHS AGO.
AND I WAS REALLY EXCITED TO SEE
HER RECEIVE THAT AWARD.
CONGRATULATIONS TO LARYSSA.
EMILY CHEW.
AND ANAND SWAROOP.
EMILY RECEIVED THE ARVO
PROCTOMEDAL AND ANAND RECEIVED
THE ARVO FRIEDENWALD AWARD.
TWO BEAUTIFUL LECTURES, AND WE
HAD A RECEPTION THAT REALLY
HONORED THEM.
FOR AN INSTITUTION TO HAVE ONE
WINNER OF THESE AWARDS WOULD
HAVE BEEN A BIG DEAL BUT THEN TO
HAVE TWO OF THEM IN THE SAME
YEAR, WE THOUGHT WAS A REAL --
WAS REALLY EXCITING TO SEE.
SO CONGRATULATIONS TO AN
>> Dr. Anderson:
CONGRATAND ANDCONGRATULATIONS TR
THOSE.
THERE'S A COMMON FUND PROGRAM
THAT'S CALLED COMPLEMENT-ARIE.
IT'S BEING LED BY JONI RUDDER,
DIRECTOR OF NCATS AND RICK
WYCHICK, WHO'S THE DIRECTOR OF
NIEHS.
THE TERM IS A NEW APPROACH,
METHODS, NAMs, THEIR TERM IS
IN VITRO, INSILICO OR CHEMICAL,
OR COMPUTER BASED APPROACHES,
YOU KNOW, ORGANOIDS TO
ACCURATELY MODEL HUMAN BIOLOGY
AND COMPLEMENT OR POTENTIALLY IN
SOME CASES REPLACE TRADITIONAL
RESEARCH MODELS, ANIMAL MODEL,
ET CETERA.
THIS IS -- IT'S BEEN KICKING
OFF, AND ONE OF THE WAYS THEY
KICKED OFF IS WITH A CHALLENGE
COMPETITION.
SO THE IDEA WAS TO DEVELOP CROWD
SOURCED IDEAS, AND THEY HAD A
CHALLENGE COMPETITION.
SO THEY CHOSE 20 WINNERS, IF YOU
WILL.
HOW CAN THESE NAMs BE USED TO
CONDUCT BASIC RESEARCH, DISCOVER
DISEASE MECHANISMS, TRANSLATE
SCIENCE INTO PRACTICE, AND THOSE
20 WINNERS WERE ANNOUNCED A
MONTH OR SO AGO, AND ONE OF THE
WINNERS WAS RELEVANT TO THE
VISION FIELD.
SO THE TEAM HERE WAS LED BY
CARLOS RAMON PONCE FROM HARVARD
MEDICAL SCHOOL, AND THEIR
PROJECT WAS CALLED ATHENA-N,
ANALYZING THE HIDDEN ENCODING IN
ARTIFICIAL NEURAL NETWORKS.
THE IDEA HERE IS THAT THESE DEEP
NEURAL NETWORKS HAVE HAD
EXTRAORDINARY ACCURACY IN TERM
OF IMAGE RECOGNITION, BUT ONE OF
THE CHALLENGES IS THAT NOBODY
REALLY KNOWS WHAT'S UNDER THE
HOOD, HOW THESE ACTUALLY WORK
AND WHAT FACTORS THEY'RE LOOKING
AT.
AND SO WHAT THIS PROJECT PROPOSE
TODAY DO IS REALLY KIND OF
DEMYSTIFYING THESE MODELS BY
LOOKING UNDER THAT HOOD AND
THEY'RE USING VISUAL INFORMATION
PROCESSING AS A USE CASE FOR
THAT.
SO LOOK FORWARD TO SEEING WHAT
COMES OF THIS, BUT THE MORE
BROAD THINGS I WANT TO MAKE SURE
YOU KNOW IS THAT TO PEOPLE IN
THE VISION COMMUNITY WHO ARE
INTERESTED IN THESE NOVEL
MODELS, THERE'S BEEN A LOT OF
WORK IN ORGANOIDS AND COMPUTER
MODELS, AND JUST KEEP AN EYE OUT
FOR THIS COMPLEMENTARY COMMON
FUND PROJECT HERE.
SO THAT'S COMING UP.
I WANT TO GO THROUGH JUST A
COUPLE HIGHLIGHTS IN TERMS OF
RESEARCH.
AND ONE OF THEM INVOLVES -- SO
ONE INTRAMURAL PROJECT, ONE
EXTRAMURAL PROJECT.
AND THIS ONE INVOLVES GENE
ENVIRONMENT INTERACTION IN AMD
AND THE LEAD AUTHORS ARE
JAYSHREE ADVANI AND ANANDSWAROOP
FROM OUR INTRAMURAL PRAK AT NEI.
SO THE CHALLENGE HERE IS THAT
THERE'S A LOT OF GENES THAT HAVE
BEEN LINKED TO DEVELOPING AMD
BUT THE MECHANISM AND
CONTRIBUTIONS OF THESE GENES
REALLY ISN'T ALWAYS -- IT'S THAT
THING LIKE IN OUR STRATEGIC PLAN
FROM GENES TO DISEASE
MECHANISMS.
SO ANAND'S GROUP IS DOING A LOT
OF WORK IN THIS AREA AND HE'S
GOTTEN PARTICULARLY INTERESTED
IN GENE ENVIRONMENT
INTERACTIONS, BUT WHAT
THEY'VE -- WHAT THE GROUP DID IS
THEY LOOKED AT DNA METHYLATION
PROFILES, SO 160 DONOR RETINAS,
LOOKED AT THESE METHYLATION
PROFILES ALSO WITH COMEASURED
FACTORS, THINGS LIKE GENOTYPED
RNA SEQ DATA, 3D DNA STRUCTURE
DATA, AND FROM THAT, IDENTIFIEDT
GENES BASICALLY, WHERE DNA
METHYLATION AND GENE EXPRESSION
CHANGES SEEMED LIKELY TO MEDIATE
THE GENOTYPE EFFECT ON AMD
PROGRESSION AND DISEASE
PATHOLOGY.
SO WHAT DO WE TAKE FROM THIS?
ONE OF THEM, IT SEEMS LIKE THE
EPIGENETIC REGULATION OF THE
IMMUNE RESPONSE AND METABOLISM
MAY BE INVOLVED IN AMD PATHOLOGY
AND I THINK MORE BROADLY THAN
THAT, THIS OBVIOUSLY HELPS
PROVIDE A FRAMEWORK FOR UNDER
AND STING REGULATION OF AMD
PATHOLOGY BY THESE GENE
ENVIRONMENT INTERACTIONS IN THE
RETINA, AND REALLY HOPEFULLY
PROVIDE A PIPELINE FOR
UNDERSTANDING OTHER COMPLEX
DISEASES.
SO CONGRATULATIONS TO JAYSHREE
AND ANAND.
AND THE OTHER THING THAT I WANT
TO HIGHLIGHT HERE IS THE
BRILLIANCE STUDY.
THIS WAS ONLY MI MINIMALLY FUNDD
BY NEI AND REALLY FUNDED THROUGH
INDUSTRY, BUT OF COURSE THE
PIs ARE WELL-KNOWN TO THE NEI
COMMUNITY, AND THEY'VE BEEN IN
OUR GROUP FOR A LONG TIME.
ERIC PIERCE, MARK PENNESI AND
TOMAS ALEMAN.
BUT I THOUGHT IT WAS REALLY
TIMELY THAT THIS WAS PUBLISHED
IN THE NAND JOURNAL OF MEDICINE,
AND IT CAME OUT DURING ARVO.
BUT THE CHALLENGE IS THAT IS
THERE'S A LOT OF DIFFERENT TYP
TYPES -- ONE THAT'S CALLED BY
MUTATIONS IN THE CEP290 GENE.
AND SO THEIR APPROACH IS GENE
EDITING, CHR CRISPR, AND THIS
METHODOLOGY WAS DEVELOPED BY
EDITAS MEDICINE WHO WAS THE ONE
WHO FUNDED THE STUDY AND THEY'VE
GOT THIS SO CALLED EDIT-101
TREATMENT.
BUT BASICALLY THEIR GROUP, THIS
WAS A PHASE 1/PHASE 2 STUDY, 11
PEOPLE, AND THEY LOOKED AT
OUTCOMES LIKE VISUAL ACUITY,
DARK-ADAPTED FULL-FIELD STIMULUS
TESTING AND FUNCTIONAL
NAVIGATION, AND OF THE 14
PEOPLE, 11 OF THEM SHOWED
IMPROVEMENT IN AT LEAST ONE OF
THOSE OUTCOMES, SO THIS WAS
SIGNIFICANT OBVIOUSLY BECAUSE
THIS WAS THE FIRST IN VIVO
DEMONSTRATION IN PEOPLE OF
CRISPR BASED GENE THERAPY.
SO REALLY OBVIOUSLY VERY
EXCITING WORK.
SO WITH THAT, LET ME TELL YOU
ABOUT SOME OF THE THINGS THAT
HAVE BEEN HAPPENING HERE AT THE
NEI SINCE THE LAST COUNCIL
MEETING.
I WANT TO START WITH MISSION.
THAT OUR MISSION IS TO ELIMINATE
VISION LOSS AND IMPROVE QUALITY
OF LIFE THROUGH VISION RESEARCH.
I WANT TO ORGANIZE OUR REMARKS
BASED ON THE FOUR CORNERSTONES
OF THIS MISSION STATEMENT.
SO HOW DO WE ACHIEVE THIS?
WE PROVIDE LEADERSHIP IN FOUR
AREAS.
DRIVE INNOVATIVE RESEARCH,
FOSTER COLLABORATIONS, RECRUIT,
INSPIRE AND TRAIN TALENTED AND
DIVERSE PEOPLE TO STRENGTHEN THE
VISION WORKFORCE, AND THEN
EDUCATE PEOPLE ABOUT WHAT WE DO
AND WHY IT'S IMPORTANT.
SO I'LL GO THROUGH EACH OF THOSE
BULLET POINTS AND GIVE A COUPLE
EXAMPLES OF THINGS THAT HAVE
BEEN GOING ON HERE.
NUMBER ONE, DRIVE INNOVATIVE
RESEARCH.
NOW, I THINK ALL OF YOU KNOW
THAT REGENERATIVE MEDICINE HAS
BEEN SOMETHING THAT WE'VE BEEN
INTERESTED IN FOR A WHILE HERE
AT THE NEI, AND IN OUR STRATEGIC
PLANNING PROCESS, A THING THAT
CAME UP TO THE TOP IN TERMS OF
POTENTIAL OPPORTUNITIES WAS
EXTRACELLULAR VESICLES.
SO IN THE FALL OF 2023, WE HELD
A WORKSHOP TO LOOK AT
EXTRACELLULAR VESICLES.
NOW THE TWO PEOPLE WHO CHAIRED
THE WORKSHOP WERE ALYSSA WEAVER
AT VANDERBILT UNIVERSITY AND ALI
DJALILIAN AT UNIVERSITY OF
ILLINOIS-CHICAGO.
THE TWO PEOPLE AT NEI THAT
REALLY ORGANIZED THIS WERE --
DOWN AT THE BOTTOM YOU'LL SEE
ASHLEY FORTRESS AND HONGMAN
SONG.
THE TWO OF THEM DID A GREAT JOB
OF GETTING PEOPLE TOGETHER IN
THE COMMUNITY.
SOME OF THESE PEOPLE WERE VISION
PEOPLE, SOME WERE NOT IN THE
VISION COMMUNITY AT ALL.
SO THE GOAL OF THIS WORKSHOP WAS
BASICALLY TO IDENTIFY
OPPORTUNITIES IN THE AREA.
AND THERE'S A WHITE PAPER THAT'S
FORTHCOMING SO STAY TUNED FOR
THAT.
BUT ONE OF THE OTHER THINGS I
WANT TO LET YOU KNOW ABOUT IN
REGENERATIVE MEDICINE IS THAT
THE 21ST CENTURY CURES ACT HAD
FOUR SO-CALLED INNOVATION
PROJECTS.
ONE OF THEM WAS ALL-OF-US, ONE
WAS THE BO BIDEN CANCER
MOONSHOT, ONE WAS THE BRAIN
INITIATIVE AND THE FOURTH ONE
WAS THE RMI PD REGENERATIVE
MEDICINE INNOVATION PROJECT.
THIS REALLY LOOKED AT STEM CELL
APPROACHES TO DISEASE, AND IT
WAS DONE IN COLLABORATION WITH
THE FDA.
SO THIS IS NOW GOING BACK
SEVERAL -- I THE LAST OF THESE E
RMIP PROJECTS, THE LAST WAS
FUNDED I THINK IN 2021.
AND I DID WANT TO GIVE A CALL
OUT TO THOSE 20 PROJECTS THAT
WERE FUNDED, FIVE OF THEM
RELATED TO EYE DISEASE.
CORNEAL EYE DISEASE, GENE
EDITING, RP TRANSPLANTATION, DRY
AMD, CORNEAL REGENERATION.
SO I REALLY JUST ALWAYS THOUGHT
THAT WAS AN INDICATION OF HOW
MUCH OF A FOOTHOLD WE HAVE IN
THE VISION FIELD IN REGENERATIVE
MEDICINE.
BUT THE QUESTION OBVIOUSLY IS
WHAT'S NEXT.
SO WE'VE BEEN WORKING WITH
NIAMS, THE NATIONAL INSTITUTE OF
ARTHRITIS AND MUSCULOSKELETAL
DISEASE, BUT TO REALLY LOOK AT
THIS.
AND WE IN THIS CASE REALLY MEANS
SANTA TUMMINIA, YOU DON'T NEED
TO LOOK AT HER PICTURE, YOU CAN
SEE HER RIGHT HERE.
SANTA HAS BEEN DOING A LOT OF
WORK WITH HER COUNTERPART IN
NIAMS, WHO'S BOB CARTER, SHOWN
ON THE BOTTOM RIGHT OF THIS
SLIDE.
SO WHAT THEY'VE BEEN TALKING
ABOUT, THIS HAS BEEN GOING ON
FOR ABOUT A YEAR THAT THEY'VE
BEEN HAVING THESE CONVERSATIONS,
SO WHAT'S NEXT AFTER RMIP, AND
IS IT FEASIBLE TO CREATE A
PUBLIC PRIVATE PARTNERSHIP
INVOLVING CELL-BASED THERAPIES?
I HOPE ALL OF YOU KNOW THAT OVER
THE PAST ABOUT TWO, THREE YEARS
AGO, WE DID A LOT OF WORK IN
EVOLVE AGO PUBLIC-PRIVATE
PARTNERSHIP IN GENE THERAPY.
THE AMP BESPOKE GENE THERAPY
CONSORTIUM.
SO THE QUESTION IS COULD THERE
BE SOMETHING ANALOGOUS THAT WE
BUILD IN CELL-BASED THERAPIES.
BACK IN THE FALL, NOVEMBER OF
2023, WE HOSTED A WORKSHOP, NI
NIAMS AND THE FDA.
THE HOPE IS THAT WE'RE GOING TO
HAVE A RESEARCH PLAN THAT'S
COMING UP OVER THE NEXT FOUR TO
SIX MONTHS.
SO STAY TUNED FOR THIS.
AND THE POINT -- I JUST WANT TO
MAKE SURE THAT YOU KNOW THAT WE
ARE INTERESTED IN REGENERATIVE
MEDICINE AND TRYING TO FIGURE
OUT WHAT CAN WE DO NEXT IN THIS
AREA.
ANOTHER -- PROJECT I WANT TO
MAKE SURE YOU KNOW ABOUT IS
EYEGENE STAGE III.
YOU KNOW THAT WE TALKED ABOUT,
AT THE LAST -- AT THE LAST
COUNCIL MEETING, I TALKED ABOUT
A WORKSHOP THAT WE HAD INVOLVING
EYEGENE.
NOW THAT'S REALLY LED TO STAGE
THREE.
SO WE'RE STARTING TO RE-OPEN
ENROLLMENT AND A NEW DATA
COLLECTION PROTOCOL.
SO THIS DATA COLLECTION PROTOCOL
IS INTENDED TO FOCUS ON
CONDITIONS THAT ARE
UNDERREPRESENTED IN CURRENT
DATABASES.
SO THE GOAL OF EYEGENE STAGE III
IS NOT TO COMPETE WITH ANY OTHER
DATABASES THAT ARE OUT THERE IN
THIS, BUT WE TRY TO IDENTIFY
AREAS WHERE -- THE DISEASES THAT
AREN'T CURRENTLY REPRESENTED,
AND SO SOME OF THESE EXAMPLES
ARE SHOWN HERE ON THIS SLIDE.
ANIRIDIA, BEST DISEASE, CORNEAL
DYSTROPHIES AND OTHER
HYPOPIGMENTATION DISORDERS.
OCULOCUTANEOUS AND OCULAR
ALBINISM.
ONE OF THE GOALS OF THIS IS TO
INCREASE ACCESSIBILITY TO THE
PARTICIPANTS THEMSELVES.
IN OTHER WORDS, GET THEM
INVOLVED IN HELPING TO UPLOAD
THE DATA.
AND SO WE'RE STARTING TO PILOT
THINGS LIKE ELECTRONIC CONSENT
FORMS, MAILED DNA SALIVA KITS,
DNA COLLECTION KITS THROUGH
SALIVA, AND THE PEOPLE WHO ARE
REALLY LEADING THIS WORK ARE
SANTA, KERRY GOETZ WHO'S IN THE
BACK HERE, ERIKA NELSON AND
MELISSA REEVES.
THE OTHER THING THIS GROUP HAS
REALLY EXPLORED IS ADDING
IMAGING.
SO TO THE DATA COLLECTION
OBVIOUSLY WE'VE GOT CLINICAL
DATA, WE'VE GOT GENETIC DATA,
IMAGE DATA, AND THEY'VE HAD A
LOT OF CONVERSATIONS WITH, IN
PARTICULAR, VERILY, WITH A
PORTABLE CAMERA THAT THEY'VE
VELLEVDEVELOPED, SO STAY TUNED,
THERE'S A LOT OF WHAT I THINK IS
EXCITING WORK INVOLVING EYEGENE.
I WANT TO FOLLOW UP ON THIS
SLIDE ON AN NEI ACCESSIBILITY
INITIATIVE.
SO THIS HAS BEEN DISCUSSED,
SHERRY WIGS GAVE THE CONCEPT
CLEARANCE WITHIN THE PAST YEAR,
AND I WANT TO FOLLOW UP AND SAY
THAT THIS IS NOW ON THE STREET,
SO CHERI, WE LEARNED A LOT FROM
COUNCIL ABOUT THIS TOPIC OF
ACCESSIBILITY BY PEOPLE WITH
VISUAL DISABILITIES.
AND IN FACT, CHERI TOOK A LOT OF
INITIATIVE IN THIS, IN FACT, ONE
DAY SHE JUST SHOWED UP AND SAID
I CREATED THIS INITIATIVE.
THAT'S AWESOME, AND THAT'S HOW
IT PLAYED OUT TO ME.
AND SO I LOVE THAT.
AND -- BUT LET ME JUST SORT OF
REFRESH YOUR MEMORY ABOUT WHAT
THIS IS, BECAUSE I SEE I'M GOING
TO HAVE A COUPLE QUESTIONS FOR
THE COUNCIL ABOUT THIS.
SO THIS IS AN R61/R33 MECHANISM
AND THE TITLE IS NEI RESEARCH
FOR LOW VISION AND BLINDNESS
ACCESSIBILITY TOOLS.
SO THE AIM OF THIS IS TO DEVELOP
AND/OR IMPLEMENT ACCESSIBILITY
DEVICES AND INTERVENTIONS FOR
PEOPLE WITH VISUAL IMPAIRMENTS.
AND THE GOAL OF THIS IS TO BUILD
MULTIDISCIPLINARY TEAMS.
WE ALL KNOW -- OF COURSE
OPHTHALMOLOGISTS, OPTOMETRISTS,
REHABILITATION SPECIALISTS,
BEHAVIORAL SCIENCE, ERGONOMICS,
ENGINEERS, BUT THE ONE THING
THAT WE REALLY ALSO WANT TO
FOCUS ON IS INCLUDING PEOPLE
WITH LIVED EXPERIENCE IN VISUAL
DISABILITY.
REALLY -- YOU WANT TO USE THIS
TO ADDRESS REAL WORLD
CHALLENGES, AND REALLY BUILD
USER-CENTERED DESIGN EARLY IN
THE DEVELOPMENT OF THESE
PRODUCTS.
AND THIS ALSO NEEDS TO INCLUDE A
PLAN FOR DISSEMINATING THE TOOL
OR INTERVENTION.
SO AGAIN, THE RFA HAS BEEN
PUBLISHED ALREADY, AND THE
DEADLINE IS AUGUST 14TH, 2024,
AND 1 OF THE QUESTIONS THAT I'VE
HAD THAT CHERI AND I HAVE
DISCUSSED AT SOME LENGTH IS A
QUESTION THAT I WANT TO POSE TO
THE COUNCIL HERE, AND IT'S
THAT -- I THINK THAT EVERYBODY
TALKS ABOUT COMPUTING DEVICES,
YOU KNOW, THINGS TO HELP PEOPLE
WHO CAN'T SEE VERY WELL
NAVIGATE, AND THERE ARE
TELEVISION SHOWS THAT HAVE
THINGS LIKE THIS, AND IT REALLY
SEEMS TO CAPTIVATE PEOPLE'S
IMAGINATION.
BUT WE'VE NEVER HAD A VERY LARGE
PORTFOLIO IN VISION
REHABILITATION.
AND SO I THINK THERE'S A LOT OF
ENGINEERS AND PEOPLE WHO COULD
BE INTERESTED IN THIS TOPIC, AND
SO MY QUESTION IS HOW CAN WE
BEST DISSEMINATE THIS TO THE
ENTIRE COMMUNITY, AND WHAT CAN
WE DO TO STIMULATE INTEREST AND
AWARENESS IN THIS RFA, AND
REALLY THIS FIELD IN GENERAL.
SO LOVE YOUR THOUGHTS ABOUT
THIS.
MARIA.
>> YEAH, MALIA GRANT.
FROM A VERY SIMPLISTIC ASPECT,
MOST OF THE DEPARTMENTS OF
OPHTHALMOLOGY AND OPTOMETRY HAVE
LIKE A WEEKLY ADVERTISEMENT
FEATURING THEIR FACULTY, YOU
KNOW, LIKE AWARDS AND PAPERS, AT
LEAST OUR DEPARTMENT DOES, AND
IT'S ACTUALLY A REALLY GOOD
VENUE FOR GETTING INFORMATION
ABOUT GRANTS BECAUSE IT'S THE
ONE TIME WHERE THERE'S KIND OF
CENTRALIZED INFORMATION.
SO I JUST STILL THINK IT'S A
GREAT WAY TO TRY TO GET EACH OF
THE DEPARTMENTS WHO THEN, OF
COURSE, HAVE VISION RESEARCHERS,
AND ALSO OUTSIDE OF -- OUR
UNIVERSITY ALSO HAS A MAY MAIN D
OF LIKE ADVERTISING WHERE THE
DIFFERENT INSTITUTES ALSO
ADVERTISE FOR THE NIH.
THEY WANT TO KNOW BECAUSE THEY
WANT PEOPLE TO APPLY SO THEY
MAKE EVERY EFFORT TO GET THE
INFORMATION OUT ONCE THEY KNOW
IT.
SO I THINK IT'S JUST TAPPING
INTO THAT, THAT MIGHT BE
HELPFUL.
IT'S SIMPLE, BUT -- SO --
>> THANKS, ME A.
REZA?
>> REZA DANA, BOSTON.
I THINK THERE ARE TWO QUESTIONS.
ONE IS HOW DO YOU DISSEMINATE A
NEW TOOL OR INTERVENTION VERSUS
HOW DO YOU DISSEMINATE THE
INFORMATION ABOUT THE GRANT
MECHANISM.
THOSE ARE TWO DIFFERENT
QUESTIONS WITH DIFFERENT
ANSWERS.
IN REGARD TO THE TOOL
INTERVENTION, IT FENDS ON THE
RESOURCES THAT THE NEI IS
INTERESTED IN EXPENDING FOR
THAT, RIGHT?
SO YOU CAN USE MASS MARKETING
TOOLS OR YOU CAN HAVE MORE
FOCUSED DISSEMINATION OF THAT
INFORMATION THROUGH NON-PROFIT
ORGANIZATIONS THAT SERVE THE
RELEVANT COMMUNITY.
AND THERE ARE A NUMBER OF THOSE.
THAT'S PROBABLY THE LOWEST IN
TERMS OF EXPENSE AND THE HIGHEST
YIELD RELATIVE TO THE EXPENSE.
IN REGARDS TO THE GRANT
MECHANISMS, PROBABLY A VERY HIGH
YIELD EFFORT WOULD BE THROUGH
ARVO, AND POSSIBLY THE AAO, BOTH
THE OPHTHALMOLOGY ACADEMY AND
THE OPTOMETRIC ACADEMY HAVING A
SPECIAL SESSION ON THIS CAN
ATTRACT THE RELEVANT PARTIES WHO
ARE INTERESTED.
THANK YOU.
>> PRADEEP?
>> SO CHERI, THANK YOU FOR -
PUTTING OUT THIS RFA.
FIRST OF ALL I'LL SAY THAT
WITHIN THE LOW VISION COMMUNITY,
THERE'S ALREADY A LOT OF
INTEREST IN THIS, SO I'M IN THAT
COMMUNITY AND I'VE TALKED TO A
LOT OF PEOPLE AND EVERYBODY
WANTS TO PUT IN AN APPLICATION,
SO YOU'RE GOING TO GET
APPLICATIONS.
THE QUESTION IS, YOU KNOW, IS
THIS A RECURRING THING, LOIBS OY
THE DEADLINE IS SHORT SO YOU'RE
GOING TO GET PEOPLE WHO ALREADY
PROBABLY HAVE AN APPLICATION
THAT THEY'RE WORKING ON OR
SOMETHING THAT DIDN'T GET FUNDED
WHICH THEY'RE GOING TO RESUBMIT
OR SOMETHING ALONG THOSE NATURE,
AND OBVIOUSLY YOU WANT TO HAV
HAVE -- AGAIN AND COMING UP WITH
THESE TEAMS AND EVERYTHING ELSE
IS NOT SOMETHING YOU CAN DO IN A
MONTH OR TWO REALISTICALLY, SO I
THINK YOU PROBABLY WANT A LONGER
LAUNCH PAD TO GET SOME NEW
PEOPLE INTO THE FIELD TO DO THAT
KIND OF WORK.
I THINK IN TERMS OF BRINGING
MORE PEOPLE INTO THE FIELD, I
THINK, YOU KNOW, WE HAVE TO
BEING THINKING ABOUT, WELL, CAN
WE GET PEOPLE FROM
REHABILITATION SCIENCE AND
ENGINEERS AND OTHER PEOPLE WHO
MAY WORK COLLABORATIVELY WITH
SOMEBODY WHO HAS KNOWLEDGE OF
VISION BUT ISN'T NECESSARILY A
LOW VISION SPECIALIST.
AND SO I THINK THAT MAYBE IS
MORE OF A CHALLENGE AND I DON'T
KNOW THAT I HAVE AN ANSWER FOR
THAT, BUT I THINK TO REALLY GET
SOME NICE, INNOVATIVE WORK, IT
WOULD BE NICE TO BRING IN
ENGINEERS, INTERVENTIONAL
SPECIALISTS, PEOPLE WHO ARE
EXPERTS IN BEHAVIORAL CHANGE,
ARCHITECTS, THINGS LIKE THAT,
WHO COULD REALLY MOVE THIS IN
EXCITING NEW DIRECTIONS.
>> PRADEEP, THANK YOU.
AND IF I COULD JUST REFLECT ON
THAT A LITTLE BIT.
WHEN I SEARCHED ON THIS TOPIC A
COUPLE -- MAYBE A YEAR OR TWO
AGO, WHEN I STARTED TO HAVE
THESE CONVERSATIONS WITH CHERI,
ONE OF THE -- I'M EMBARRASSED TO
SAY ONE OF THE FIRST THINGS I
DID WAS GOOGLE SEARCH, AND THE
FIRST -- AND ONE OF THE MAIN
THINGS THAT POPS UP IS A
NAVIGATION TOOL FROM MICROSOFT
AS I RECALL AND IT WAS FROM
2015.
IT WAS PRETTY GOOD.
BUT I WONDERED THE SAME THING,
PRADEEP, THAT YOU'RE WONDERING,
HOW CAN WE TAP IN TO SOME OF THE
EXPERTISE THAT'S REALLY OUT
THERE THAT'S NOT -- THAT MAY NOT
BE IN OUR COMMUNITY.
THINK THE OTHER ISSUE, THERE WAS
A WHO REPORT ON ACCESSIBILITY --
ON DISABILITY A YEAR OR SO AGO
AND IT CITED A FEW EXAMPLES.
ONE OF THEM WAS THE WHEELCHAIR
AND ONE WAS THE HEARING AID.
AS ACCESSIBILITY TOOLS.
SO I'VE BEEN WONDERING WHAT IS
OUR EQUIVALENT OF THE HEARING
AILD OR WHEELCHAIR?
IS IT A PAIR OF GLASSES, IS IT A
WHITE CANE OR SOMETHING THAT WE
HAVEN'T INVENTED YET?
THOSE ARE SOME OF THE REAL
REASONS THAT I ASKED WHAT I WAS
ASKING.
ANY OTHER COMMENTS ABOUT THIS?
JANI, I SEE YOUR HAND.
>> THANK YOU.
THIS IS JANI LEHRER-STEIN.
FIRST OF ALL, HUGE THANKS TO
CHERI.
YOU KNOW I'M A HUGE FAN OF SHER
OSTEOARTHRITIS FOR THE WAY THAT
SHE IMPLEMENTS THE MISSION OF
THIS COUNCIL IN TERMS OF QUALITY
OF LIFE FOR PEOPLE WHO ARE BLIND
OR LOW VISION.
I AM SOMEONE WHO IS DEPENDENT ON
THE EQUIVALENT TO THE HEARING
AND AID WHEELCHAIR.
HE'S SITTING UNDER THE TABLE
RIGHT NOW.
YOU ALL FIND HIM TO BE VERY
FRIENDLY AND ADORABLE, BUT THE
FACT OF THE MATTER IS, HE HAS NO
THUMBS SO HE CANNOT DRIVE, AND
HE'S NOT GREAT ON MODERN DEVICES
LIKE IPHONES AND THE INTERNET.
SO THERE HAS BEEN A TREMENDOUS
INCREASE BOTH IN TERMS OF NEW
PRODUCT, THERE ARE SIGNIFICANT
IMPROVEMENTS, BOTH IN TERMS OF
NAVIGATION, BUT ALSO IN
ACCESSIBILITY OF DOCUMENTS,
HANDLING CURRENCY, VIRTUALLY
EVERYTHING, INCLUDING ACCESS TO
TELEVISION THROUGH THE 21ST
VIDEO COMMUNICATIONS ACT, BUT
THERE IS A HUGE GAP FOR THOSE OF
YOUS WHO ARE CONSUMERS BECAUSE
MOST OF THE REHABILITATIVE WORK
IS DONE BY NON-PROFITS, A HUGE
AMOUNT OF THAT IS DONE BY
LIGHTHOUSE FOR THE BLIND AND
THEY ARE EXPERTS AT IT BUT THERE
ARE MANY MORE PEOPLE WHO HAVE
DIFFICULTY ACCESSING THOSE
PROGRAMS OR BECOME FRUSTRATED
WITH THE PROGRAMS BECAUSE IN
SOME INSTANCES, YOU'RE JUST
MATCHED WITH THE NEXT VOLUNTEER
WHO IS ABLE TO GIVE YOU TIME AND
ATTENTION.
MOST RECENTLY, MICROSOFT AS YOU
MENTIONED HAS CREATED SOME
AMAZING PRODUCTS INCLUDING
SOMETHING THAT WILL READ THOSE
POWERPOINTS THAT I KEEP HEARING
ABOUT AT THESE MEETINGS BUT
CANNOT EASILY ACCESS, AND SO I
WOULD SUGGEST PERHAPS LOOKING AT
THOSE PUBLIC-PRIVATE
PARTNERSHIPS AND MAYBE EVEN A
CHALLENGE OR A HACKATHON TO GET
THE ENGINEERS FROM THE -- TO PAY
FOR PLAY SEGMENTS OF THE
COMMUNITY WHO ARE ALREADY REALLY
WORKING HARD ON THIS ISSUE.
>> JANI, THANK YOU VERY MUCH.
THAT'S SOMETHING THAT WE CAN
DEFINITELY TAKE BACK AND THINK
ABOUT.
SO OTHER COMMENTS ABOUT THIS?
THIS HAS BEEN VERY HELPFUL.
FOR US.
FOR ME.
THANK YOU.
THIS IS ANOTHER TOPIC I WANT TO
TALK ABOUT, OCULOMICS, AT THE
LAST COUNCIL MEETING WE WERE NOT
ABLE TO ANNOUNCE THIS, BUT NOW
WE CAN ANNOUNCE IT AND IT'S, IN
FACT, AFTER THE FACT.
BECAUSE THE APPLICATIONS WERE
ALREADY DUE.
IN IS A VERY FAST-MOVING
INITIATIVE.
LET ME TELL YOU THE BACKGROUND
ABOUT THIS AND WHAT IS
HAPPENING.
IT'S SOMETHING WE'RE VERY
EXCITED ABOUT.
AND IN FACT, IT RELATES TO WHAT
WE'RE HAVING IN THIS SPECIAL
SESSION TODAY WITH VINU AND
AFROUZ.
OCULOMICS AND IMAGING.
SO NUMBER ONE, WHAT IS THE
COMMON FUND AND WHERE DO COMMON
FUND PROJECTS COME FROM?
SO I THINK MOST OF YOU KNOW,
COMMON FUND IS A CENTRAL NIH
MECHANISM THROUGH THE OFFICE OF
THE DIRECTOR, AND COMMON FUND
PROJECTS ARE TYPICALLY FIVE TO
10-YEAR REALLY LARGE BIG-SCOPE
PROJECTS.
THEY GET SELECTED BASICALLY
BECAUSE PEOPLE NOMINATE THEM,
BUILD TEAMS, NOMINATE THEM, AND
THEY GO THROUGH A VOTING
PROCESS.
A SMALL PERCENTAGE OF THE ONES
THAT ARE NOMINATED -- THAT ARE
PROPOSED END UP GETTING PICKED
FOR FUNDING.
THE VENTURE INITIATIVE HERE,
THIS COMMON FUND VENTURE
INITIATIVE IS A SMALLER COMMON
FUND PROGRAM THAT WAS JUST BEGUN
THIS PAST YEAR.
SO THESE ARE THREE-YEAR SMALLER
FUNDING-TYPE THINGS, ROUGHLY
THREE-YEAR, $15 MILLION
PROJECTS.
SO WHEN THIS WAS ANNOUNCED, ONE
OF OUR PROGRAM OFFICERS, TONY
GOVER, WHO'S IN THE BACK,
BASICALLY GOT WITH SOME PROGRAM
OFFICERS IN OTHER INSTITUTES,
AND THEY WERE BASICALLY NIBIB,
NINDS, SO BIOMEDICAL IMAGING,
NEUROSCIENCE, NHLBI, HEART LUNG,
AND NIA, AGING.
AND THEY BASICALLY BRAINSTORMED
ABOUT PROPOSALS AND TONY PUT
THIS TOGETHER.
AND IT GOT PICKED ACTUALLY.
AND SO THE GOAL OF THIS IS TO
DEVELOP NOVEL NONINVASIVE OCULAR
IMAGING TECHNOLOGIES AS WELL AS
MACHINE LEARNING ALGORITHMS TO
BASICALLY TRY TO BUILD BETTER
TOOLS FOR IDENTIFYING BIOMARKERS
FOR SYSTEMIC DISEASE.
THE REASON THIS IS EXCITING IS
THAT THERE'S BEEN SO MUCH
RESEARCH IN THE PAST FEW YEARS
IN OCULOMICS WHERE THE EYE IS
THE WINDOW TO THE BODY, IT SEEMS
LIKE IT'S REALLY BECOMING AN
ACTUAL THING.
THE STUDIES -- I'D CALL THEM
PILOT STUDIES ARE SHOWING THAT
YOU CAN DIAGNOSE AND PREDICT
SYSTEMIC DISEASE, IN SOME CASES
APPARENTLY QUITE ACCURATELY AND
MUCH EARLIER THAN CLINICIANS CAN
DO IT.
AND OF COURSE THE QUESTION IS
GOING TO BE, CAN THIS GENERALIZE
BEYOND THE PAPERS THAT ARE BEING
PUBLISHED.
SO WHAT WAS WRITTEN UP HERE IS,
WELL, SOME OF THE GOALS ARE,
WELL, DEVELOPING TOOLS THAT HAVE
BETTER RESOLUTION, BETTER IMAGE
DEPTH, TO LOOK AT FUNCTIONAL
MEASUREMENTS, THINGS LIKE BLOOD
FLOW, TO LOOK AT SUBSTANCE
IDENTIFICATION, WATER VERSUS
PROTEIN VERSUS LIPID.
AND SO THIS PARTICULAR
ANNOUNCEMENT WAS $1.6 MILLION
TOTAL COSTS PER YEAR UP TO THREE
YEARS WITH THREE PROJECTS BEING
FUNDED.
SO IT WAS ANNOUNCED SOMETIME --
I THINK, TONY, I THINK IT WAS
ANNOUNCED IN MARCH OR SOMETHING
AND THE DEADLINES WERE LATE MAY.
SO THEY'RE STARTING TO --
THEY'VE RECEIVED ALL OF THEM.
I THINK THE DEADLINE WAS JUST A
FEW WEEKS AGO.
SO THE REVIEW PROCESS IS GOING
TO BE STARTING AND IT WILL BE A
PRETTY RAPIDLY EVOLVING, SO WE
WERE REALLY EXCITED ABOUT THIS.
TONY AND THIS CREW, AFROUZ WHO'S
GOING TO BE COMING IN LATER WAS
ALSO ONE OF THE PEOPLE WHO WORK
ON THIS, AND IN FACT TONY LAST
NIGHT -- AFROUZ CAME OUT TO
DINNER, SHE GAVE THE IMPRESSION
THAT THIS HAS BEEN QUITE A BIT
OF WORK OVER THE PAST COUPLE
MONTHS.
SO GREAT WORK ON THIS, TONY.
IT'S A LOT OF WORK IN A SHORT
AMOUNT OF TIME.
SO EXCITED ABOUT THIS, AND WE'LL
HEAR MORE ABOUT IT WITH AFROUZ
AND VINU TODAY.
ANOTHER UPDATE ON THE BRIDGE2AI
COMMON FUND PROJECT.
SO THIS WAS A MAJOR PROJECT AND
YOU'VE ALL HEARD ABOUT THIS AND
I'M JUST GOING TO FOCUS ON
WHAT'S NEW INSTEAD OF WHAT YOU
ALREADY KNOW, BUT THIS WAS A
$130 MILLION PROJECT OVER FOUR
YEARS FOR PHASE ONE OF
BRIDGE2AI.
AND JAMES GAU IS THE ONE WHO --
THIS HAS SUCKED OUT ALL OF
JAMES' ENERGY OVER THE PAST FEW
YEARS AS OUR PROGRAM OFFICER.
BUT ONE OF THE FOUR TEAMS THAT
WAS FUNDED WITH THIS
$130 MILLION DATA COLLECTION
PROJECT IS FROM THE UNIVERSITY
OF WISCONSIN -- UNIVERSITY OF
WASHINGTON.
AARON LE AND CECILIA LEE.
BASICALLY THEIR PROJECT IS TO
GATHER DATA FROM 4,000 PEOPLE
WITH DIABETES.
SO ALL THESE DIFFERENT STAGES OF
DIABETES, AND YOU CAN HAVE
DISEASE PROGRESSION WHERE A
DISEASE GETS WORSE, AND YOU CAN
HAVE THE OPPOSITE OF DISEASE
PROGRESSION IS GOING FROM
DISEASE TO HEALTH.
AND THE TERM FOR THAT IS SLEW
SALUTOGENESIS.
SO ONE OF THE AIMS OF THIS
PROJECT IS TO COLLECT DATA FROM
ALL SORTS OF DIFFERENT TYPES, TO
LOOK AT THAT PROGRESSION OF
SOLUTOGENESIS CYCLE THROUGH AI
THROUGH MULTIMODAL AI.
SO WHAT'S NEW IN THIS PROJECT IS
THAT THE BRIDGE2AI GROUPS WERE
IN BETHESDA ABOUT A MONTH AGO TO
HAVE AN OPEN HOUSE AND THEY'VE
RELEASED THE FIRST DATASETS FROM
THIS PROJECT.
SO THE GOAL IS 4,000
PARTICIPANTS, AND THE FIRST DATA
DATASETS INCLUDE 204 PEOPLE.
THIS IS TERABYTES OF DATA.
I DON'T REMEMBER EXACTLY HOW
MUCH, BUT IT NOW PUBLICLY
AVAILABLE.
IF YOU GO TO THIS WEBSITE,
AIREADY.ORG, YOU CAN GET ACCESS
TO IT.
THERE ARE SOME FORMS THAT YOU
HAVE TO SIGN AND AGREE TO, BUT
OUR HOPE IS REALLY THAT WE CAN
USE THIS TO BUILD A COMMUNITY OF
PEOPLE WHO EXPLORES THESE
DATASETS IN A TON OF DETAIL,
DETERMINES TRUTH BASED ON --
IT'S A LITTLE BIT OF -- SOME OF
IT'S A LITTLE BIT OF
METHODOLOGY, SOME OF IT'S GOING
TO BE WHAT WE CAN DO TO LEARN
ABOUT DISEASE, SO REALLY EXCITED
ABOUT THIS THAT STUFF IS
ACTUALLY HAPPENING.
AND JAMES, GREAT JOB WORKING
WITH THE BRIDGE2AI CREW TO GET
US TO THIS STAGE.
AND SO I JUST ALSO WANT TO GIVE
A CALLOUT, THERE'S 5ICs THAT
CHAIR THE BRIDGE2AI PROJECT.
WE'RE ONE OF THEM, AND BRUCE
TRAWM BERG, WHO'S THE DIRECTOR
OF NIBIB, IS ONE OF THE OTHER
ONES.
SO ANYWAY, THE FIVE OF US ARE ON
STAGE HERE FROM THE EVENT ABOUT
A YEAR AGO AT BRIDGE2AI.
SO THIS IS A BIG WIN FOR THE
VISION COMMUNITY.
THERE'S ANOTHER COMMON FUND
PROJECT THAT I WANT TO LET YOU
KNOW ABOUT CALLED CLINICAL
RESEARCH IN PRIMARY CARE.
THE -- GOSH, I'M SORRY, THE
VERSION OF MY SLIDES THAT HAD A
PICTURE ON THIS -- MUST HAVE
UPLOADED WITHOUT THAT SLIDE.
BUT I'LL TALK YOU THROUGH IT.
THIS IS SOMETHING THAT'S BEEN A
BIG SIGNATURE INITIATIVE OF
MONICA BERTAGNOLLI'S AND IT BEEN
IN THE PLANNING FOR ALMOST A
YEAR NOW.
SO AGAIN, THE TOPIC IS ACTUALLY
CARE FOR HEALTH.
OKAY.
BUT THAT TOPIC WAS UNVEILED
YESTERDAY IN A PRESS RELEASE.
AND THERE'S AN EDITORIAL IN
SCIENCE THAT WAS PUBLISHED
YESTERDAY CALLED BASICALLY
CLINICAL RESEARCH IN
COMMUNITIES, AND IT WAS AUTHORED
BY MONICA.
AND SO THIS IS LITERALLY LIKE
HOT OFF THE PRESS.
BUT THE PROBLEM THAT THIS IS
ADDRESSING IS THAT THE HEALTH OF
THE U.S. POPULATION IS
DECLINING, AND IT'S NOT REALLY
THAT GOOD COMPARED TO WHERE WE
ARE SOCIOECONOMICALLY AS A
WHOLE.
SO YOU'VE ALL SEEN THE
STATISTICS, AND MONICA HAS BEEN
TALKING ABOUT THIS, ROB CALIFF
FROM FDA HAS BEEN TALKING ABOUT
THIS.
THAT THE U.S. LIFE EXPECTANCY
COMPARED TO OTHER COUNTRIES
AROUND THE WORLD OF SIMILAR
SOCIOECONOMIC STATUS IS NOT
GOOD.
IN FACT, IT'S ONE OF THE LOWEST.
LOWESTAGE OUR PEEEST AMONG OUR .
THAT APPLIES TO THINGS LIKE
INFANT MORTALITY, OTHER MEASURES
OF HEALTH, AND THIS GOT WORSE
DURING THE PANDEMIC, AND THIS
DECLINE IS THE STEEPEST AMONG
THE MEDICALLY UNDERSERVED GROUPS
IN THE U.S.
SO A LOT OF THIS RELATES TO
HEALTH DISPARITIES.
AND WHEN YOU COMPARE THAT TO THE
AMOUNT OF MONEY THAT WE SPEND ON
HEALTHCARE AND RESEARCH, THERE'S
A BIT OF A DISCONNECT THERE.
SO THAT'S THE PURPOSE OF THIS
FIRST BULLET POINT.
HEALTH OF THE U.S. POPULATION IS
DECLINING, ESPECIALLY IN
UNDERSERVED POPULATIONS.
SO THE GOAL OF THIS PROJECT,
CARE FOR HEALTH, IS TO ESTABLISH
A PRIMARY CARE-FOCUSED NETWORK
THAT INTEGRATES RESEARCH INTO
THE ROUTINE CLINICAL CARE
PROCESS, PARTICULARLY WITHIN
COMMUNITIES THAT ARE
UNDERREPRESENTED IN CLINICAL
RESEARCH.
AND THERE'S A FOCUS HERE ON
RURAL COMMUNITIES, AS WELL AS
UNDERSERVED URBAN COMMUNITIES.
ONE OF THE PURPOSES OF THIS IS
TO CREATE A FOUNDATION FOR
SUSTAINED ENGAGEMENT WITH THOSE
COMMUNITIES.
THE GOAL OF THIS IS NOT TO HAVE
PEOPLE DOING RESEARCH IN THE
BACKGROUND, BUT REALLY INTEGRATE
THE COMMUNITIES THEMSELVES WITH
THE RESEARCH THAT'S HAPPENING.
THIS NETWORK IS INTENDED TO BE
DISEASE-AGNOSTIC.
AND SO THE IDEA IS THAT IT COULD
APPLY TO ANY OF THE INSTITUTES
AT THE NIH.
THERE WAS A ROA ANNOUNCED A FEW
WEEKS AGO, AND THE LINK IS ON
THE WEBPAGE BUT THE IDEA IS THAT
THE INITIAL PROJECT SELECTED
WILL BE TO EXPAND EXISTING
STUDIES.
TO RAMP UP QUICKLY.
TO EXPAND THEM INTO AREAS THAT
ARE UNDERREPRESENTED IN CLINICAL
RESEARCH.
AND SO THE BUDGET NUMBERS ARE
ROUGHLY -- DURING THE FIRST
YEAR, IT'S GOING TO BE
$30 MILLION, AND THERE'S GOING
TO BE ANTICIPATED RAMP-UP EVERY
YEAR AS THIS PROJECT BUILDS.
SO AGAIN, THERE IS AN EDITORIAL
IN SCIENCE THAT WAS PUBLISHED
YESTERDAY ABOUT THIS.
SO MY QUESTION FOR THE COUNCIL
ABOUT THIS IS THAT MY
OBSERVATION IS THAT SOMETIMES
WHEN WE TALK ABOUT COLLABORATION
WITH PRIMARY CARE, IF YOU TALK
TO OPHTHALMOLOGISTS AND
OPTOMETRISTS, OUR EYES GLAZE
OVER, YOU KNOW, BECAUSE I'LL
HEAR THINGS LIKE, WELL, THEY'VE
GOT TO BRING THEM TO THE EYE
CLINIC.
WE HAVE SPECIALIZED EQUIPMENT IN
THE EYE CLINIC AND PATIENTS HAVE
TO COME TO US, YOU KNOW, NOT
GOING TO THEM.
AND THIS HAPPENS ALL THE TIME IN
TERMS OF DOING INPATIENT
CONSULTS AT THE BEDSIDE, YOU
KNOW, IT JUST DOESN'T -- PEOPLE
DON'T LIKE TO DO THAT.
AND I THINK THERE'S A DEEPER
QUELL WHICH IS IN THE WORLD NOW,
THERE'S A TREND MOVING LOCALLY,
AND THAT CAN MEAN, YOU KNOW,
PEOPLE WILL SHOP ONLINE INSTEAD
OF GOING TO THE MALL, ET CETERA,
AND HOW DO WE MAKE SURE THAT THE
VISION FIELD DOESN'T GET LEFT
BEHIND IN THIS, AND HOW CAN WE
BETTER CONNECT EYE CARE AND
PRIMARY CARE, NOT ONLY FOR
INITIATIVES LIKE THIS, BUT A
LITTLE BIT MORE BROADLY.
AND SO I WOULD LOVE YOUR
THOUGHTS ABOUT THIS.
THIS IS SOMETHING THAT I'VE BEEN
TRYING TO THINK THROUGH.
>> VICTOR PEREZ, UNIVERSITY OF
MIAMI.
MICHAEL, I THINK IT'S ABOUT
EDUCATION AND REACHING OUT TO
THE PRIMARY CARE FIELD.
AS YOU MENTIONED WHEN WE'RE
TRAINING, YEAH, WE WANT PATIENTS
TO COME TO US, AND THE DOCTORS
TOO.
SO I THINK REACHING OUT TO THE
PRIMARY CARE COMMUNITY AND
PERHAPS GIVING MORE EDUCATION
ABOUT EYE, YOU CAN UNDERSTAND
MANY PHYSICIANS ARE AFRAID OF
THE EYE ACTUALLY, OH, I DON'T
TOUCH THE EYE.
SO I THINK A VERY PROACTIVE
APPROACH TOWARDS EDUCATION OF
THE PRIMARY CARE COMMUNITY WOULD
BE VERY HELPFUL.
MAYBE, YOU KNOW, START WITH LOW
HANGING FRUITS DISEASES, LIKE
YOU WERE SAYING, DIABETES, ET
CETERA, THAT THEY CAN IDENTIFY
OR COMMON THINGS THEY SEE,
HYPERTENSION, AND USE THAT AS A
PLATFORM TO HAVE THEM IDENTIFY
WHAT WE CAN DO.
AND YOUR POINT IS VERY WELL
TAKEN.
NOW THAT YOU'RE TAKING THIS
INITIATIVE ON IMAGING, ET
CETERA, THAT'S THE DIRECT
IMPLICATION, YOU PUT THOSE
MACHINES WHERE THEY SHOULD BE,
AND EDUCATE THEM THAT THEY CAN
BE USED IN A FRIENDLY USER
MANNER THAT WON'T DISRUPT THEIR
PRACTICE OR THEIR FLOW BECAUSE
THEY'RE SEEING PATIENTS TOO.
>> THANK YOU.
I SEA RAY SEE REZA, THEN VINU.
>> THANK YOU.
REZA DANA, BOSTON.
I AGREE WITH YOU, VICTOR, VERY
MUCH ABOUT EDUCATION.
IT ALSO GOOD TO KEEP IN MIND
THAT THERE'S ONLY A VERY SMALL
NUMBER OF MEDICAL SCHOOLS THAT
HAVE ANY REQUIRED OPHTHALMOLOGY
CURRICULUM.
THOSE NUMBERS ARE DWINDLING AS
MORE AND MORE OTHER TOPICS ARE
BEING ADDED TO THE CURRICULUM.
THERE'S A COMPETITION SO WHAT TO
GET ON, THEREFORE, WE'RE SEEING
GRADUATION OF PHYSICIANS WHO
KNOW IN SOME WAYS RELATIVELY
LESS ABOUT OPHTHALMIC DISORDERS
THAN PERHAPS THEIR PEERS DID A
GENERATION OR TWO AGO.
SO I THINK EFFORTS TO TRY TO
DISSEMINATE THAT KNOWLEDGE AND
ALSO NOT FOCUS EXCLUSIVELY ON
DIABETIC RETINOPATHY, I THINK
ALL PHYSICIANS KNOW, YES,
DIABETES HITS THE EYE, BUT, YOU
KNOW, THERE'S MORE TO IT, AND
THAT KNOWLEDGE HAS BEEN
INCORPORATED INTO MANY
ELECTRONIC MEDICAL RECORD
SYSTEMS SO THAT JUST LIKE
VACCINATION PROMPTS COME UP, A
PATIENT'S VISITS ALSO GET
FLAGGED IF THEY'RE DIABETIC OR
PREDIABETIC, WHETHER THEY'VE HAD
AN EYE EXAM, THAT'S ALL GOOD BUT
THERE'S OBVIOUSLY MORE ABOUT
SYSTEMIC DISEASES AND EYE
DISEASE THAN JUST DIABETES.
THANK YOU.
>> VINIT MAHAJAN, STANFORD
UNIVERSITY.
I THINK OUR PRIMARY CARE
PHYSICIANS HAVE A MILLION THINGS
TO DO IN A SHORT VISIT, SO IT IS
QUITE CHALLENGING.
WHAT'S AMAZING IS THAT EVEN IN
WELL-SERVED COMMUNITIES WITH
WELL-INSURED PATIENTS, THEY MISS
THEIR DIABETES EXAMS AND
DIABETES REFERRALS.
AT STANFORD, WE'VE HAD SOME
SUCCESS DEPLOYING CAMERAS TO A
VARIETY OF PRIMARY CARE CLINICS
ACROSS NORTHERN CALIFORNIA.
THE ORIGINAL CONCERN WAS THAT
OPHTHALMOLOGISTS MIGHT LOSE
THESE PATIENTS THAT THEY WON'T
EVER COME SEE AN EYE DOCTOR, BUT
WHAT WE'VE FOUND IS USING AN
A.I. PROCEDURE AND INTEGRATING
THAT WITH HUMAN EVALUATION OF
THE IMAGES, WE'VE BEEN ABLE TO
SCREEN A LOT MORE PATIENT AND
ACTUALLY GET PATIENTS TO COME IN
TO SEE US AS A REFERRAL, BUT THE
PATIENTS THAT DON'T NECESSARILY
NEED TO COME IN TO AN
OPHTHALMOLOGIST ARE NOT CLOGGING
UP THE CLINIC.
I THINK AS THE IMAGING OUTCOMES
GO BEYOND DIABETES, THE ABILITY
TO LOOK AT HYPERTENSION AND
DIFFERENT SYSTEMIC DISEASES,
THAT THERE'S LOTS OF
OPPORTUNITIES JUST BY TAKING OUR
STRENGTH IN IMAGING AND MAKING
THAT REALLY EASILY ACCESSIBLE IN
A PRIMARY CARE CLINIC.
>> VINU, THANKS.
PRADEEP?
>> THE WAY I SEE THIS PROPOSAL,
IT'S NOT NECESSARILY TO -- IS TO
GET PRIMARY CARE DOCTORS TO BE
MORE ENGAGED IN OPHTHALMOLOGY.
BUT IT'S TO KIND OF CREATE A
RESEARCH CONNECTION BETWEEN THE
TWO.
BUT I THINK THAT ARE CREATING A
RESEARCH CONNECTION BETWEEN THE
TWO, IF WE DEVELOP MACHINES AND
ALGORITHMS THAT CAN -- THAT ARE
SCREENED FOR HYPERTENSION OR
INCIDENT DIABETIC RETINOPATHY OR
OTHER DISEASES AND MAKE STRONGER
CONNECTIONS BETWEEN THE EYE AND
SYSTEMIC HEALTH, I THINK THOSE
CONNECTIONS WILL NATURALLY
HAPPEN.
THEY WON'T HAPPEN IN ONE OR TWO
YEARS BULL IT MIGHT BE IN THE
TIME FRAME OF ONE TO TWO
DECADES.
I REALLY LIKE THE IDEA.
I WAS LOOKING AT THE WEBSITE
THAT YOU PUT UP THERE, MICHAEL.
AND YOU KNOW, HOW DO YOU GET
PEOPLE TO UNDERSTAND WHAT THESE
CLINICS ARE, WHO THEY'RE
TESTING, WHAT KIND OF DATA THEY
WOULD HAVE ON PATIENTS.
BECAUSE PRESUMABLY IF YOU PUT IN
AN OCT OR OCTA OR, YOU KNOW, A
LASER SPECKLE DEVICE OR
SOMETHING OF THAT NATURE IN
THESE CLINICS, WHAT DO YOU TIE
THAT TO?
WHAT IS THE CONNECTION WITH
REGARDS TO THEIR SYSTEMIC HEALTH
AND SYSTEMIC WELL-BEING, AND ARE
THEY GOING TO HAVE A VERY WELL
CATALOGED SET OF SYSTEMIC HEALTH
MEASURES THAT YOU CAN BUILD UPON
TO DO YOUR RESEARCH.
THEN HOW IS THAT GOING TO WORK
OUT FROM A LOGISTIC STANDPOINT?
BUT I LOVE THE IDEA.
>> DON, THEN MARIA.
>> MY THOUGHT ON THIS WAS NOT SO
MUCH ABOUT TECHNOLOGY OR
RESEARCH PROPOSAL, BUT I WAS
THINKING ABOUT HOW DO YOU
IMPROVE SERVICE TO THE
UNDERSERVED AND ONE ASPECT OF IT
IS MAYBE NOT TECHNOLOGY BUT
PEOPLE, AND THINKING ABOUT HOW
OUR RECENT GRADUATE CLINICIANS,
YOU KNOW, WHERE DO YOU CHOOSE TO
PRACTICE.
AND MANY WILL AVOID -- WHY ARE
THESE AREAS UNDERSERVED?
BECAUSE PRACTITIONERS DON'T WANT
TO LOCATE IN THOSE AREAS, AND
ASKING THIS QUESTION TO RECENT
GRADUATES, WHAT MIGHT MOTIVATE
YOU TO BE MORE INCLINED TOWARDS
SOMETHING THAT'S PERHAPS GEARED
TOWARD SERVICE TO THE
UNDERSERVED, AND LOAN
FORGIVENESS WAS THEIR NUMBER ONE
ANSWER, IF THERE WAS SOME
INCENTIVE TO ENGAGE IN A MORE
PUBLIC SERVICE ORIENTED CAREER,
MAYBE EARLY IN THEIR CAREER,
THERE USED TO BE QUITE A DRIVE
TO THINK ABOUT THE PEACE CORPS
OR VOLUNTEERS FOR AMERICA.
I'M NOT SURE THAT THAT AWARENESS
IS ON THE MINDS OF YOUNG PEOPLE
AS IT MAYBE ONCE WAS.
SO THAT'S ONE THOUGHT ABOUT
IMPROVING SERVICE TO THE
UNDERSERVED, IS MOTIVATING MORE
CLINICIANS TO WANT TO PRACTICE
IN THOSE AREAS.
>> DON, THANKS.
MARIA?
>> YEAH, EVERYBODY'S MADE --
MARIA GRANT.
EVERYBODY'S MADE GREAT POINTS,
AND IT'S HARD TO ADD SOMETHING
TO IT, BUT WHAT CAME TO MY MIND
WHEN YOU MENTIONED IT WAS THE
FACT THAT EVEN WITHIN ACADEMIC
COMMUNITIES, PULMONOLOGISTS,
CARDIOLOGIST, HEMATOLOGISTS
DON'T APPRECIATE HOW IMPORTANT
THE EYE CAN BE FOR A VISION INTO
THEIR DISEASES.
AND I DON'T -- WITH TIME BEING
AN ENEMY TO EVERYONE, EEFER ONEE
IN PRACTICE HAS TO GO THROUGH
PATIENTS SO QUICKLY, NO ONE SEES
IT AS A PRIORITY.
SO THE DIAGNOSIS OF PULMONARY
HYPERTENSION CAN OCCUR SO MUCH
EARLIER IF YOU LOOK AT THE
RETINA, THE SAME THING WITH
SICKLE DISEASE, YOU'RE GOING TO
ANTICIPATE A CRISIS,
HYPERTENSIVE RETINOPATHY.
ALL THESE THINGS COULD BE MADE
EASIER FOR THE PATIENT AS WELL
AS THE PHYSICIAN, BUT THE
PRIORITY ISN'T THERE.
IT'S LIKE TRYING TO DO A
CLINICAL STUDY WITH
PULMONOLOGISTS, WHICH WE'VE
TRIED, CARDIOLOGISTS, IT'S VERY,
VERY DIFFICULT UNLESS YOU HAVE
SOMEONE RECEPTIVE AT THE OTHER
END THAT WILL TAKE TIME IN THEIR
CLINIC TO HELP EVALUATE THOSE
PATIENTS, ET CETERA.
SO I THINK THE ISSUE IS ALSO
MAKING THE DATA THAT SHOWS THAT
THE RETINA IS A WINDOW TO
SYSTEMIC DISEASE MORE OF A
MAINSTREAM RATHER THAN JUST SORT
OF AN AFTERTHOUGHT TO GET -- TO
ENGAGE LIKE-MINDED PHYSICIAN
SCIENTISTS LIKE OUR ACADEMIC
COMMUNITY STILL ISN'T ON BOARD.
SO I THINK THAT'S SOMETHING THAT
REALLY -- WE NEED TO EDUCATE THE
PATIENTS, BUT ALSO TO MAKE THE
DATA EASIER FOR OTHER
COMMUNITIES, YOU KNOW, TO SEE,
BUT THE PULMONOLOGIST,
HEMATOLOGIST, CARDIOLOGIST, AND
I KNOW YOU GO -- MICHAEL, YOU
BROUGHT INTO THE IRCH
INSTITUTIONS AND YOU TALK ABOUT
ALL THE PROGRAMS AND THE GRANTS
AND WHAT NEI IS DOING, BUT
SOMETIMES JUST MAKING -- YOU GET
PEOPLE'S ATTENTION AND JUST ALSO
TALKING ABOUT THE ACTUAL STUDIES
THAT SUPPORT THE VALIDITY OF
THIS IS LIKE, OKAY, MAYBE IF
THEY'RE AWARE OF IT, THEY MAY
TAKE IT MORE SERIOUSLY.
THEN THE OTHER THING WITH REGARD
TO COMMUNITIES, I THINK THERE'S
A LOT OF STATE INITIATIVES.
I HATE TO KEEP TALKING ABOUT
ALABAMA BUT I KNOW ABOUT THAT
FOR SURE, WHERE THEY'RE TRYING
TO IDENTIFY PATIENTS EARLIER SO
THAT THEY CAN TREAT HYPERTENSIVE
RETINOPATHY EARLIER, TREAT D.R.,
ET CETERA, BUT THEY'RE NOT --
MAYBE PARTNERING WITH THEM
BECAUSE THEY'RE NOT VERY
EFFECTIVE.
PATIENTS ARE STILL COMING IN THE
EYE CLINICS WITH REALLY ADVANCED
DISEASE.
THEY HAVE NO PRIMARY CARE
DOCTOR, THEY HAVE NO -- OF
COURSE THEN THEY DON'T HAVE A
DIABETOLOGIST, THEY DON'T EVEN
HAVE A PRIMARY CARE DOCTOR.
SO I THINK THERE'S A BIG GAP IN
AVAILABILITY.
THERE'S A LOT OF PATIENTS THAT
ARE JUST NOT BEING TREATED, AND
THAT'S A HUGE,, BIGGER PROBLEM
THAN WHAT WE CAN CERTAINLY DEAL
WITH TODAY, BUT I THINK
CAPTURING THAT POPULATION
THROUGH EDUCATION MAY BE HELPFUL
AS WELL.
>> THANK YOU VERY MUCH.
SO APPRECIATE ALL THESE COMME
COMMENTS.
I THINK THAT AS I LISTEN TO
THIS, I THINK THERE'S A LOT OF
INTERPLAY BETWEEN THE SCIENCE,
WHAT YOU CAN DIAGNOSE WITH
SOMETHING IN THE PRIMARY CARE
SETTING, A LOT OF THESE COMMENTS
HAVE FOCUSED ON TECHNOLOGY, AND
ALSO ON THE POLICY.
IN OTHER WORDS, RIGHT NOW THERE
ARE GUIDELINES IN EVERY
OPHTHALMOLOGY AND OPTOMETRIC
SOCIETY THAT PEOPLE NEED TO HAVE
AN EYE EXAM ONCE A YEAR USUALLY,
OR ONCE EVERY TWO YEARS, ONCE
YOU'RE ABOVE A CERTAIN AGE.
AND IF YOU GET YOUR SCREENING --
IF YOU GET YOUR THING IN THE
PRIMARY CARE AND YOU STILL NEED
TO SEE AN EYE DOCTOR ONCE A
YEAR, IS THAT REALLY SAVING THE
SYSTEM MONEY, AND DO WE NEED TO
RE-ADJUST THE POLICY AND THE
PAYMENT AND ALL THIS.
SO I FEEL LIKE THIS IS A
COMPLICATED ISSUE THAT INVOLVES
A LOT OF DIFFERENT AREAS.
BUT THESE COMMENTS ARE REALLY
USEFUL.
THANK YOU.
THE NEXT BULLET POINT IN THAT
MISSION, FOSTER COLLABORATIONS.
AND I JUST WANT TO HIGHLIGHT A
FEW THINGS HERE.
NUMBER ONE, SYNTHETIC DATA.
YOU KNOW, AMBER REID AND KERRY
GOETZ HAVE BEEN WORKING ON A
SYNTHETIC DATA RESOURCE.
SYNTHEA IS A RESOURCE THAT
GENERATES SYNTHETIC DATA, THAT
HE DO A LOT OF GOVERNMENT
CONTRACTING, AND THEY'VE NOW
CREATED A FREELY ACCESSIBLE --
THEY'VE CREATED A FREELY SICIAL
TOOL, IF YOU GO TO THIS WEBSITE,
AND WHY WOULD YOU WANT SYNTHETIC
ELECTRONIC HEALTH RECORD DATA?
ONE OF THE APPLICATIONS FOR THIS
IS IF THERE WERE PEOPLE, FOR
EXAMPLE, TRYING TO TEST NEW
ELECTRONIC HEALTH RECORD
INTERFACES OR SYSTEMS OR
INTEROPERABILITY, CONNECTING
DEVICES AND SYSTEMS, ONE OF THE
COMPLAINTS THAT WE ALWAYS HEAR
IS, WELL, THEY HAVE NO EHL DATA
TO USE.
IT IMPOSSIBLE TO GET BECAUSE YOU
HAVE TO IF THROUGH ALL THESE
PRIVACY AGREEMENTS, SO THAT WAS
THE MAIN MOTIVATOR FOR THIS
TOOL.
BASICALLY SOMETHING FOR
DEVELOPERS TO USE.
NOW, I ONCE WORKED WITH A PH.D.
STUDENT IN MY OWN ACADEMIC LIFE
WHO GENERATED SYNTHETIC DATA AND
WE USE THAT SYNTHETIC DATA TO
TRAIN A.I. SYSTEMS, AND IT
WORKED ACTUALLY VERY, VERY WELL.
RIGHT NOW, THAT'S NOT THE INTENT
OF THIS.
THIS IS REALLY INTENDED FOR
DEVELOPERS.
BUT WE'VE BEEN REALLY EXCITED
ABOUT THIS AND REALLY GREAT JOB
TO KERRY AND TO AMBER IN TERMS
OF DOING THIS.
THE OTHER THING I WANT TO LET
YOU KNOW ABOUT IS FOLLOW-UP.
WE HAD TALKED ABOUT THIS
INITIATIVE TOGETHER WITH THE ONC
AND WITH THE FDA AND WITH US ON
IMAGE DEVICE INTEROPERABILITY,
AND THAT WE REALLY HAVE BEEN
TRYING TO PUSH ADOPTION OF
STANDARDS BY THE VENDOR
COMMUNITY AND IMAGING DEVICES.
THIS HASN'T HAPPENED FOR 20
YEARS.
AND IT REALLY HASN'T MOVED THAT
MUCH.
AND ACTUALLY HONESTLY UNTIL
RECENTLY.
AND COMPARED TO THE RADIOLOGY
FIELD, WHERE EVERY DEVICE HAS
ADOPTED THESE COMMON STANDARDS
FOR DECADES AN THEY'RE
PLUG-AND-PLAY BECAUSE OF THAT.
SO NOW, AS OF MAY THIRD, 2024,
THERE'S NOW A GUIDE NOTICE
BASICALLY SAYING THAT NEI
STRONGLY ENCOURAGES USE OF THESE
COMMON FORMATS, LIKE DICOMM IN
CLINICAL RESEARCH AND ALSO IN
NON-CLINICAL RESEARCH INVOLVING
IMAGES.
SO THE OTHER WAY TO PUT THIS IS
THAT ANYBODY WHO DOES RESEARCH
INVOLVING IMAGING DEVICES NEEDS
TO READ THIS GUIDE NOTICE.
IT WAS EFFECTIVE AS OF THE DATE
IT WAS PUBLISHED. SO WHAT THIS
MEANS IS, IF YOU SUBMIT A GRANT
AND IF THAT GRANT SCORES FIRST
PERCENTILE, AND IF IT INVOLVES A
DEVICE THAT USES IMAGING, AND
TESTIMONY YOU GET A LETTER
SAYING GRANT IS NOT BEING
FUNDED, DON'T COMPLAIN TO ME,
DON'T COMPLAIN TO YOUR PROGRAM
OFFICER, TALK TO YOUR VENDOR WHO
BUILDS THAT DEVICE AND SAY YOU
NEED TO MAKE IT COMPATIBLE WITH
STANDARDS LIKE DICOM OR USE A
DIFFERENT DEVICE.
SO THIS FIELD HAS NOT MOVED
SUBSTANTIVELY IN A LONG TIME.
THIS IS REALLY -- I HAVE TO SAY
THAT SO FAR, THE VENDOR
COMMUNITY HAS BEEN REALLY
SUPPORTIVE OF THIS IN A WAY THAT
I'VE FELT EXCITED ABOUT.
BUT I THINK THAT WE'VE REALLY --
IN FACT, KERRY AND I JUST WERE
ON A CONFERENCE CALL WITH THE
ONC, THE OFFICE OF NATIONAL
COORDINATOR, JUST A FEW DAYS AGO
ABOUT THIS, BUT I THINK THIS IS
HOW WE'RE GOING TO DO THE BEST
RESEARCH AND HOW WE'RE GOING TO
TAKE THE BEST CARE OF PATIENTS,
LIKE IN THE FUTURE.
SO REALLY EXCITED ABOUT THIS.
YES, PRADEEP.
>> SYNTHETIC DATA SOUNDS REALLY
EXCITING.
YOU KNOW, I CAN SEE A LOT OF
CLINICAL APPLICATIONS FOR IT.
AND YOU KNOW, KIND OF INTERNAL
SYSTEM BUILDING AT AN EYE
INSTITUTE OR SOMETHING OF THAT
NATURE, BUT THEN HOW DO YOU SEE
IT BEING USED FROM A RESEARCH
CAPACITY?
DO YOU HAVE A VISION OR ARE
THOSE SYNTHETIC THAT MIGHT BE
USEFUL FOR RESEARCHERS IN
PARTICULAR?
>> PRADEEP, I THINK THIS IS A
VERY EXCITING QUESTION, AND
THERE'S A TODAY VERSION AND A
FUTURE VERSION FOR IT.
YOU KNOW, ONE OF THE WAYS
THAT -- LIKE I MENTIONED ONE
EXAMPLE OF HOW WE USE SYNTHETIC
DATA TODAY, WHICH IS -- THIS
HAPPENS TO BE RETINAL IMAGES,
THERE'S A LOT OF CONCERN ABOUT
PRIVACY, AND IS A RETINAL IMAGE
DE-IDENTIFIED OR NOT, IN FACT,
DIFFERENT INSTITUTIONS HAVE
DIFFERENT POLICIES ABOUT THAT
QUESTION.
MAYBE SOMEDAY IN THE FUTURE,
SYNTHETIC DATA CAN BE A WAY TO
ADDRESS THAT.
IN PARTICULAR CASE, THE USE CASE
WAS REALLY MEANT TO BE FOR
PEOPLE WHO ARE DEVELOPING
SYSTEMS WHO MAY NOT OTHERWISE
HAVE ACCESS TO REAL EHR DATA OR
WHO HLD TAKE SO LONG TO GET
ACCESS THAT IT WAS IMPRACTICAL
AND YOU DON'T REALLY NEED DATA
THAT MAKES SENSE WHERE THE IMAGE
AND THE EHR DATA MATCH, SO
THAT'S REALLY THE BIG DRIVER FOR
IT.
AND KERRY, DO YOU HAVE ANYTHING
THAT YOU'D LIKE TO ADD TO WHAT I
JUST SAID HERE?
SO THE QUESTION IS, APPLICATION
OF THIS.
>> HELLO, KERRY GOETZ, NEI.
SO SYNTHEA IS NOT EVEN JUST
EYE-RELATED INFORMATION.
WE ADDED A MODULE, THIS INCLUDES
A DIABETIC MODULE AND A LOT OF
PRIMARY CARE SYNTHETIC
INFORMATION TOO, SO IT COULD
POTENTIALLY BE USED FOR RESEARCH
IN THE FUTURE.
WHAT WE ARE TRYING TO DO NOW IS
ACTUALLY KIND OF VET WITH
SUBJECT MATTER EXPERTS HOW WELL
THE SYNTHETIC GENERATED
INFORMATION ACTUALLY LOOKS REAL.
SO WE HAVE A LITTLE BIT OF
VALIDATION TO GO YET BEFORE I
THINK IT COULD BE REALLY USEFUL
FOR STUDIES.
BUT IN ADDITION TO THE SYNTHETIC
CLINICAL INFORMATION, WE ALSO
HAVE SYNTHETIC IMAGES, OCT AND
COLOR FUNDUS, THAT WE'RE ADDING
TO THIS TOO, SO TRYING TO ALSO
CREATE A USE CASE FOR RESEARCH
AND DEVELOPMENT OF TOOLS FOR
BRIDGING THAT IMAGING TO EHR
LINKAGE.
BUT YEAH, WHO KNOWS WHAT THE
FUTURE HOLDS.
IT'S ABOUT KIND OF GENERATING
MORE DATA AND VALIDATING IT OVER
TIME, BUT IT'S BASED ON HEUR IS
TICS THAT ARE WORKED OFF OF
CLINICAL CARE.
>> KERRY, THANKS, AND THANKS FOR
YOUR WORK IN THE AREA.
QUALITY OF LIFE IS ONE THING I
WANT TO TALK ABOUT IN THIS
SLIDE.
THIS IS A BIG PART OF OUR -- IN
FACT, IT'S IN OUR MISSION
STATEMENT, ELIMINATE VISION
LOSS, IMPROVE QUALITY OF LIFE.
THE CHALLENGE IS WE DON'T HAVE A
REALLY GOOD WAY TO MEASURE AND
QUANTIFY QUALITY OF LIFE AND
THAT'S WHAT THESE INITIATIVES
ARE ALL ABOUT.
JIMMY LE, CHERI W IGG S, EMILY
CHEW HAVE BEEN DOING A LOT OF
WORK, AND SO THE BACKGROUND HERE
IS THAT THE NEI, VFQ25 IS THE
SINGLE MOST COMMON INSTRUMENT
FOR DOING THIS.
IT WAS DEVELOPED IN THE 90s,
AND SOME OF THE LIMITATIONS COME
OUT THAT, NUMBER ONE, IT ASKS
ABOUT SOME THINGS THAT PEOPLE
DON'T AS MUCH NOW, LIKE READING
NEWSPAPERS, AND IT'S ALSO NOT
BEEN ACCEPTED FOR FDA
DECISION-MAKING, REGULATORY
DECISION-MAKING.
SO ON SEPTEMBER 29TH, 2023,
THERE WAS A WORKSHOP THAT WE
HOSTED IN THE SPIRIT OF
FOSTERING COLLABORATIONS WITH
THE FDA AND WITH PCORI.
THE PATIENT-CENTERED OUTCOMES
RESEARCH INSTITUTE, AND THAT
WORKSHOP WAS REALLY, REALLY
HEAVILY ATTENDED.
IT WAS LIKE HUNDREDS OF PEOPLE.
THERE'S A WHITE PAPER THAT'S
COMING OUT FROM IT.
AND AT ARVO, THIS -- LAST MONTH,
THERE WAS A FOLLOW-UP MEETING
WITH LARGELY -- WITH OUR PEOPLE,
WITH THE NEI, WITH THE FDA
PEOPLE, AND WITH SOME PEOPLE
FROM THE COMMUNITY.
AND I KNOW PRADEEP WAS IN THE
ROOM AT THAT TIME, AND OBVIOUSLY
JIMMY AND CHERI WERE IN THE
ROOM, AND SO I'M EXCITED ABOUT
WHAT'S GOING TO COME OUT OF
THIS, BUT DO ANY OF YOU WANT
TO -- LIKE PRADEEP, GINNY,
ANYTHINJIMMY,ANYTHING YOU WANT D
SAYING THAT THIS OCCURRED?
>> MAYBE JIMMY SHOULD TALK, BUT
THERE'S PROBABLY A LOT OF PEOPLE
AND DIFFERENT PEOPLE MAY HAVE
DIFFERENT OPINIONS ABOUT WHAT
THE NEXT GENERATION OF QUALITY
OF LIFE TOOLS SHOULD LOOK LIKE.
I MEAN, THERE WERE A FEW PEOPLE
WHO MENTIONED THAT IF THERE WAS
A DISEASE AGNOSTIC TOOL THAT
USED COMPUTER-ADAPTIVE TESTING
AND TESTED MULTIPLE DIFFERENT
DOMAINS AND HAD, YOU KNOW, A
DATABASE BACKBONE THAT WAS RUN
BY THE NEI THAT EVERYBODY COULD
COME ON AND USE, THAT WOULD BE A
DREAM.
IS THAT SOMETHING THAT'S
REALISTIC?
YES.
DOES IT REQUIRE SOME RESOURCES?
YES.
BUT, YOU KNOW, I THINK THERE'S A
LOT OF STAKEHOLDERS AND I DON'T
WANT TO SPEAK FOR EVERYBODY
BECAUSE DIFFERENT PEOPLE MAY SAY
DIFFERENT THINGS, SO MAYBE,
JIMMY, YOU WANT TO COMMENT ALSO?
>> HI, EVERYONE.
THIS IS JIMMY LE FROM THE
NATIONAL EYE INSTITUTE.
IT IS A WORK IN PROGRESS RIGHT
NOW.
WE'RE PLANNING OUT THINKING
THROUGH WHAT THE NEXT STEPS
SHOULD AND COULD BE, BUT I THINK
THE MESSAGE IS CLEAR, IS THAT
IT'S IMPORTANT TO HEAR HOW
PEOPLE THINK ABOUT, HOW PEOPLE
EXPERIENCE THEIR CONDITION,
THEIR DISEASES, AND IT'S
IMPORTANT THAT WE CAPTURE THIS
INFORMATION ACCURATELY IN A WAY
THAT MINIMIZES BURDEN FOR
PROVIDERS BUT ALSO FOR PATIENTS
WHO ARE LIVING WITH THE DISEASE
OR CONDITION.
SO PLEASE STAY TUNED.
>> JIMMY, THANKS TO YOU AND
CHERI, I KNOW EMILY HAS ALSO
DONE A TON OF WORK IN THIS AND
WE'RE EXCITED ABOUT THIS.
I WANTED TO -- MAY WAS HEALTHY
VISION MONTH, AND I WANTED JUST
TO LET YOU KNOW ABOUT A PROGRAM
THAT HAPPENED CALLED REFRAME
YOUR VISION.
THIS WAS LED BY MARIA ZACARIAS
PICTURED IN THE BOTTOM RIGHT
HERE, AND IT WAS BASICALLY A
SOCIAL MEDIA EDUCATIONAL
CAMPAIGN THAT FOCUSED ON THE
RELATIONSHIP BETWEEN VISION AND
MENTAL HEALTH.
AND TRY TO BRING ATTENTION TO
RESOURCES INVOLVING VISION
REHABILITATION AND MENTAL HEALTH
RESOURCES.
AND WE DID THIS IN COLLABORATION
WITH THE U.S. SURGEON GENERAL,
VIVEK MURTHY, AND WITH CHRISTINE
HA, WHO IS AN AWARD-WINNING
BLIND CHEF.
SHE WON A SHOW CALLED MASTERCHEF
A FEW YEARS AGO, AND IT WAS
REALLY -- REALLY NEAT TO GET TO
KNOW HER A LITTLE BIT AS AN -
EVENT LAST YEAR, ALL THEIR
ORGANIZATIONS REALLY, YOU KNOW,
THEIR ORGANIZATIONS TO REALLY
PROMOTE THIS LAST MONTH.
SO THE NASEM MYOPIA STUDY.
SO YOU KNOW WE AT NEI
CO-SPONSORED THIS STUDY ALONG
WITH A NUMBER OF OTHER
ORGANIZATIONS THAT ARE SHOWN IN
THE BOTTOM OF THIS SLIDE,
AMERICAN ACADEMY OF OPTOMETRY,
AMERICAN OPTOMETRIC ASSOCIATION,
WAR BWARBY PARKER AND OTHERS.
THIS IS BEING CHAIRED BY KEVIN
FRICK AT HOPKINS AND TERRY YOUNG
AT THE UNIVERSITY OF WISCONSIN.
AND IT MEANT TO BE A CONSENSUS
STUDY WITH THE GOAL OF ASSESSING
OUR CURRENT MECHANISTIC
UNDERSTANDING OF MYOPIA, AND
PROPOSING A RESEARCH AGENDA.
THIS IS -- THERE'S BEEN A LOT OF
WORK INVOLVING GENETICS, A LOT
OF WORK INVOLVING ENVIRONMENT
BUT EVEN THE EXPERTS DON'T
REALLY AGREE ON WHAT THE FACTORS
ARE.
AND SO I THINK MEANWHILE, THE
PREVALENCE IS RISING.
AND SO WHAT WE'VE BEEN HEARING
IS THAT THERE'S GOING TO BE A
FINAL REPORT THAT'S FORTHCOMING
BY THE END OF THE YEAR, AND
WE'RE REALLY LOOKING FORWARD TO
THIS.
IN THE MEANTIME AT THE NEI WHAT
WE'VE BEEN TRYING TO DO IS BUILD
A GROUP OF PEOPLE THAT'S
INTERESTED IN MYOPIA.
AT THE ARVO MEETING, YOU KNOW,
LAST MONTH, WE HOSTED -- WE WAS
REALLY JOHN PRAKASH, KAPIL AND
SHELDON MILLER.
WHAT I HEARD WAS SOME PEOPLE
SAID THEY PICKED UP COVID FROM
THE ARVO MEETING AND THEY GOT IT
DURING THIS BECAUSE THEY WERE
SIT ON TOP OF EACH OTHER.
BUT THE -- WHAT WE'VE BEEN
HOPING TO DO IS TO PLAN A
FOLLOW-UP MEETING AT THE NIH
CAMPUS BECAUSE OF THIS INTEREST
THAT'S BEEN GENERATED.
STAY TUNED.
A COUPLE THINGS IN TERMS OF
COLLABORATIONS.
SMALL BUSINESS.
PAEK LEE HAS BEEN ALL OVER THIS.
HE AND TONY RUN THE SMALL
BUSINESS PORTFOLIO HERE AMONG
OTHER THINGS THAT ARE NEW FOR
US.
ONE OF THEM IS THAT SBIR
COOPERATIVE AGREEMENT FOR EARLY
STAGE CLINICAL TRIALS WITH
GREATER THAN MINIMAL RISK.
THIS IS TYPICALLY PHASE 1/PHASE
2 TWIELS TRIELS AND BUDGETS UP
2 TRIALS AND BUDGETS UP TO
$1 MILLION TOTAL COSTS A YEAR,
THIS IS A U COOPERATIVE GRANT
MECHANISM.
THE OTHER THING THAT PAEK HAS
GOTTEN US SIGNED ON TO IS A
SMALL BUSINESS TRANSITION GRANT
FOR NEW ENTREPRENEURS.
THIS IS FOCUS OND
ENTREPRENEURSHIP.
THIS IS A CLASSIC SBI, STTR
GRANT MECHANISM AND IT'S MEANT
FOR EARLY CAREER SCIENTISTS WHO
ARE TRANSITIONING TO INTEREST IN
ENTREPRENEURSHIP, AND THE IDEA
IS THAT IT SUPPORTS THEIR
ENTREPRENEURIAL DEVELOPMENT AS
WELL AS COU CONDUCTING THE ACTUL
RESEARCH.
SO YOU'VE GOT TO HAVE A MENTOR,
THERE'S GOT TO BE AN
ENTREPRENEURSHIP TRAINING
COMPONENT, YOU KNOW, FOR THE PI,
AND IT'S A PHASED MECHANISM, SO
PHASE ONE IS A BUDGET OF ABOUT
$300,000.
PHASE TWO I THINK IS ABOUT
$2 MILLION BUDGET.
BUT THERE'S A TECHNICAL
ASSISTANCE WEBINAR NEXT WEEK,
AND AGAIN, IT'S A SERIES OF
ROTATING DEADLINES AND SO IF
YOU'RE INTERESTED IN THIS, TALK
TO PAEK.
I WANT TO LET YOU KNOW ABOUT
INTRAMURAL CARD COLLABORATION.
THIS IS AGAIN IN THE EYE AS A
WINDOW TO THE BODY.
AND THERE ARE A COUPLE PEOPLE AT
NEI IN OUR INTRAMURAL PROGRAM
WHO ARE REALLY FIRED UP ABOUT
THIS.
KAPIL BARTI, SCIENTIFIC
DIRECTOR, AND HE'S GOTTEN PEOPLE
INVOLVED, JOHNNY TAM -- SO WHAT
IS CARD?
IT'S THE CENTER FOR ALZHEIMER'S
AND RELATED DEMENTIAS AND IT'S
LED BY THE NATIONAL INSTITUTE OF
AGING AND ALSO BY NINDS,
NEUROLOGICAL DISEASES AND
STROKE, AND THERE'S A CARD
CLINIC AT THE CLINICAL CENTER,
AND BASICALLY WE'VE GOT SOME
SPACE IN IT NOW THAT WE'RE
HOPING TO MOVE INTO.
AND WHAT WE'D LIKE TO DO REALLY
WITH THESE CARD PATIENTS IS TO
DO THINGS LIKE DEEP RETINAL
PHENOTYPING, IMAGING, FUNCTIONAL
TESTING, CENTRAL VISUAL PATHWAY
TESTING, INDUCE PLEUR PLURIPOTM
CELL GENERATION FROM THESE
PEOPLE TO REALLY TRY TO
UNDERSTAND CAN THE VISUAL SYSTEM
GIVE US INFORMATION TO HELP WITH
THINGS LIKE RISK ASSESSMENT,
DIAGNOSIS, AND PROGNOSIS OF
DEMENTIAS AND CAN WE LEARN ABOUT
PATHOPHYSICIANOLOGY FROM EYE AND
BRAIN AND BRAIN TO EYE, SO BOTH
DIRECTIONS.
SO A FEW OTHER SLIDES HERE.
NEI, NIBIB AND AL ALL-OF-US, WEE
TALKED FOR SEVERAL YEARS NOW IN
TERMS OF WHAT WE CAN DO
TOGETHER, AND WITHIN THE PAST
YEE JOSH DENNY WAS OUT HERE FROM
THE ALL-OF-US PROJECT, WE HAD A
WORKSHOP LAST YEAR ON THIS.
IN THE STAGES HERE, WE GO FROM
CONCEPT DEVELOPMENT TO
IDENTIFIED REQUIREMENTS AND
COMING UP WITH SPECIFIC
PROTOCOLS TO ACTUALLY LAUNCHING.
AND WE'RE -- EVEN THOUGH WE'VE
DONE A TON OF WORK, WE'RE STILL
KIND OF RELATIVELY IN THE
BEGINNING ABOUT THIS, BUT KERRY
GOETZ IS GOING TO BE PRESENTING
TO THE ALL-OF-US CEO AZ BRAIN'SN
TRUST OVER THE SUMMER ABOUT
THIS.
A LOT OF PEOPLE HAVE BEEN
INVOLVED WITH THIS PROJECT FROM
IN.
EI.
KERRY, EMILY, SOME FOLKS FROM
THE CLINICAL CENTER AND OTHERS.
IN TERMS OF CAREER DEVELOPMENT,
I WANT TO BE GETTING CLOSE TO
THE END HERE.
NIRAJ AGARWAL, WHO WAS THE BRAIN
CHILD OF THIS R38 PROGRAM, AND
HE GAVE A CONCEPT CLEARANCE ON
THIS WITHIN THE PAST YEAR, AND
WANTED TO LET YOU KNOW THAT THIS
IS NOW LIVE, AND WE HAD THE
FIRST GROUP OF APPLICANT IN
MARCH 2024.
SO AS A REMINDER, THIS PROGRAM
SUPPORT ONE TO TWO RESEARCH
YEARS FOR RESIDENTS, THINGS LIKE
SALARY SUPPORT, RESEARCH
EXPENSES.
IT'S GIVEN TO DEPARTMENTS.
AND MY HOPE WAS TO ATTRACT THE
TOP -- I THINK THE TOP STUDENTS
KNOW THAT THERE ARE FEW FIELDS
OUT THERE THAT ARE KNOWN TO BE
FRIENDLY TO
CLINICIAN-SCIENTISTS.
AND I REALLY AM HOPING TO MAKE
SURE THAT WE CAN SHOW THAT THE
VISION FIELD IS ONE OF THOSE
FIELDS.
AND HOPEFULLY IT'S GOING TO BE
THINGS LIKE THIS THAT SEND
SIGNALS LIKE THAT TO THE FIELD.
THE ONLY INSTITUTES NOW THAT
HAVE THIS MECHANISM ARE NCI,
NIAID AND NIA, WHICH I THINK ARE
SOME OF THE VISION -- SOME OF
THE CLINICIAN-SCIENTIST-FRIENDLY
FIELDS.
SO EXCITED ABOUT THAT.
AND THE OTHER THING IS THIS
COUNCIL OF VISION EDITORS
FELLOWSHIP PROGRAM.
SO WHAT'S THIS?
A FEW TIMES A YEAR, I WORK WITH
THE EDITORS IN CHIEF OF SOME OF
THE MAJOR VISION JOURNALS.
WE TALK ABOUT WHAT CAN WE DO TO
ADVANCE THE FIELD TOGETHER.
AND FOR US, OUR INTEREST IS
CREATING CAREER DEVELOPMENT
OPPORTUNITIES FOR YOUNGER
FACULTY.
FOR THE JOURNALS, THEY WANT TO
BUILD A PIPELINE FOR REVIEWERS
AND FUTURE EDITORIAL BOARD
MEMBERS, AND SO WHAT CAME OUT OF
THIS IS A PROGRAM WHERE WE WILL
TAKE JUNIOR PEOPLE, K GRANT
AWARDEES, AND BASICALLY GET THEM
TO APPLY AND MATCH THEM WITH
JOURNALS AS MENTORED JUNIOR
EDITORIAL BOARD MEMBERS.
SO A COUPLE MONTHS AGO, WE HAD
THIS MATCH PROCESS AND SELECTED
14 PEOPLE FROM AROUND THE
COUNTRY, AND SO THIS IS
SOMETHING -- I HOPE IN TERMS OF
FOSTERING CAREER DEVELOPMENT
THAT'S REALLY GOING TO HELP OUT.
NIRAJ AGARWAL AND ED CLAYTON
HAVE DONE A LOT OF WORK WITH
THIS.
I'M JUST GOING TO GO THROUGH
SOME OF THESE.
YOU KNOW, QUICKLY AS I KNOW
WE'RE GETTING SHORT ON TIME.
IN TERMS OF WORKFORCE DIVERSITY,
THERE IS A DEIA MENTORSHIP
SUPPLEMENT THAT'S RUN THROUGH
NIH CENTRALLY WHERE IF YOU ARE A
P.I. WHO'S KNOWN AS AN
OUTSTANDING MENTOR WITH A
COMMITMENT TO DI DEIA, THERE ARE
ADMINISTRATIVE SUPPLEMENTS THAT
ARE AVAILABLE THROUGH NIH.
WE HAVE A SUMMER INTERNSHIP FOR
STUDENTS FROM BACKGROUNDS THAT
ARE UNDERREPRESENTED IN
RESEARCH, AND CAESAR PEREZ
GONZALEZ IS THE PERSON WHO RUNS
THAT AND DOES A REALLY GOOD JOB
WITH IT, AND FOR THE PAST THREE
YEARS, WE HAVE HAD A HIGH SCHOOL
VIDEO CONTEST FOR STUDENTS WHERE
THEY SUBMIT VIDEOS THAT ARE
ABOUT SCIENCE, MEDICINE,
HOPEFULLY ABOUT THE EYE.
IT'S CALLED EYE ON THE FUTURE.
AND THERE'S A $2,000 CASH PRIZE.
WE BRING THE WINNERS TO BETHESDA
FOR A DAY TO MEET PEOPLE, YOU
KNOW, TOUR THE CAMPUS, AND HAVE
PANELS, AND THEY'LL DO THINGS
LIKE DISSECT ANIMAL EYES, SO
THAT'S BEEN REALLY A LOT OF FUN.
THIS YEAR, LARRY TABAK, THE NIH
PRINCIPAL DEPUTY DIRECTOR, IS
GOING TO COME OUT AS ONE OF THE
SPEAKERS FOR THE KIDS, AND SO
NIRAJ AND ED HAVE DONE A REALLY
GOOD JOB WITH THESE TRAINING
PROGRAMS AND MARIA ZACARIAS IS
THE PERSON WHO'S RUNNING EYE ON
THE FUTURE.
THIS YEAR AT ARVO, NEERAJ AND ED
TOGETHER WITH PARTNERS AT RPB,
RESEARCH TO PREVENT BLINDNESS,
POSTED A K AWARDEE SYMPOSIUM.
FOR PEOPLE WHO HAVE K GRANTS OR
RPB CAREER DEVELOPMENT AWARDS
WHERE THERE WERE KEYNOTE TALKS,
ROUNDTABLES, PANEL DISCUSSIONS
FOR THEM.
AND I THOUGHT THIS WAS GREAT.
WE HAD GUEST SPEAKERS, NISHA
CHARIA FROM UCSF, TERRY YOUNG,
RAJ RAO, VIVIAN LEE AND JAJ RAO.
PEOPLE WHO WERE -- YOUNGER FOLKS
WHO WERE THERE TOLD ME THAT THIS
WAS REALLY, REALLY VALUABLE FOR
THEM.
ONE OF THE REASONS WE WANT TO DO
THIS IS I AWARDED A K AWARDEE
SYMPOSIUM IN 2005.
AND THAT'S WHERE I MET VINU.
DESPITE THAT, I THOUGHT IT WAS
VERY VALUABLE.
AND IN FACT, WE HAVEN'T HAD THIS
SINCE 2005, SO NNRAJ, ED AND THE
GROUP -- RPB, THERE WERE A LOT
OF OTHER PEOPLE THERE, DID A
REALLY AWESOME JOB WITH THIS.
I JUST WANT TO SAY THAT WE HAD
SOME -- THERE'S A GROUP OF
PEOPLE THAT I MEET WITH
REGULARLY.
AND IT'S LEADERSHIP IN SOME OF
THE VISION-RELEVANT COMMUNITIES.
AAO, AMERICAN ACADEMY OF OP TOM
OPTOMETRY, ARVO, NAEVR/AEVR.
DAN IS THE -- ARVO AND HOFLAND.
ONE OF THE THINGS WE'VE BEEN
TALKING ABOUT RECENTLY HAS BEEN
MESSAGING.
HOW CAN WE DRAW PEOPLE INTO THE
FIELD?
I WILL TALK A LITTLE BIT MORE
ABOUT THIS IN THE OPEN SESSION.
AND LASTLY, I JUST WANT TO SAY
IN TERMS OF EDUCATING PEOPLE
ABOUT WHAT WE DO AND WHY IT'S
IMPORTANT, I WANT TO MAKE SURE
THAT YOU KNOW ABOUT RESOURCES
THAT WE HAVE AVAILABLE.
THE DIVISION OF INTRAMURAL
RESEARCH AT THE NEI HAS A
WORKSHOP -- HAS A SEMINAR SERIES
THAT'S REALLY GOOD.
THIS QR CODE TAKES YOU TO THAT.
DATA SCIENCE HAS AN EMERGING
SEMINAR SERIES THAT'S BEEN
REALLY GOOD WITH THE ONE SO FAR.
AMBER AND KERRY HAVE PUT THAT
TOGETHER.
HERE'S A QR CODE.
THIS QR CODE TAKES YOU TO A
WEBSITE THAT HAS ALL THE NEI
GRANT OPPORTUNITIES SUMMARIZED.
IF YOU WANT TO REGISTER FOR THE
NEI EXTRAMURAL RESEARCH
NEWSLETTER, HERE'S THE QR CODE,
AND OF COURSE THERE'S SOCIAL
MEDIA.
SO WITH THAT, LET ME TRANSITION
TO KAREN COLBERT, CAN WE BRING
YOU UP TO TALK ABOUT BUDGET?
I KNOW THERE'S A LOT OF -- THIS
IS -- A LOT OF STUFF HAS BEEN
HAPPENING.
SO KAREN, THANK YOU FOR DOING
THIS.
KAREN IS OUR NEI BUDGET OFFICER,
AND SHE DOES AN AWESOME JOB WITH
THIS.
>> GOOD MORNING, EVERYONE.
AGAIN, I'M KAREN COLBERT, THE N
NEI BUDGET OFFICER.
I'M PLEASED TO BE HERE WITH YOU
TODAY TO PROVIDE THE BUDGET
UPDATE.
I'M GOING TO START WITH A BRIEF
RECAP OF THE CURRENT FISCAL YEAR
AND THEN I'LL SHARE WHAT WE
EXPECT FOR THE NEW FISCAL YEAR
2025 THAT STARTS ON OCTOBER 1.
THIS FISCAL YEAR, 2024, NEI DID
NOT RECEIVE A BUDGET INCREASE.
MOST OF THE NEI -- PARDON ME --
MOST OF THE NIH INSTITUTES AND
CENTERS WERE HELD FLAT, WITH THE
FY 2023 ENACTED LEVELS.
THIS FLAT BUDGET IS A RELATIVE
CUT BECAUSE THE COST OF DOING
BUSINESS HAS INCREASED, AND DUE
TO INFLATION AND OTHER FACTORS,
THE COST TO MAINTAIN OUR
INFRASTRUCTURE HAVE ALSO BEEN --
BECAUSE A CORPORATION'S PROCESS
IS FILLED WITH UNCERTAINTY, WE
PLAN IN ANTICIPATION OF THESE
PERIODS OF FLAT OR REDUCED
BUDGETS.
WE REVIEW OUR COMMITMENTS IN ALL
AREAS, LOOKING FOR WAYS TO
REDUCE WHERE WE CAN WHILE
PRIORITIZING TRAINING AND EARLY
CAREER INVESTIGATORS.
PROVIDED HERE IS A SNAPSHOT OF
NEI'S PROPOSED SPENDING FOR THE
YEAR.
THIS PLAN INVESTS $742 MILLION
OR 83% OF THE TOTAL BUDGET INTO
EXTRAMURAL RESEARCH.
$111 MILLION OR 12% OF THE
BUDGET INTO INTRAMURAL RESEARCH,
AND $43 MILLION OR 5% INTO
RESEARCH SUPPORT.
AT THE NIH LEVEL, THERE WAS A
$300 MILLION INCREASE FOR THE
FISCAL YEAR.
WHEN YOU EXAIRL THAT TO OTHER
AGENCIES THAT TOOK A CUT, IT'S
CERTAINLY A WIN BUT DID NOT COME
WITHOUT SOME CHALLENGES.
THE BILL DID NOT RESTORE A
$378 MILLION REDUCTION IN 21ST
CRECENTURY CURES ACT FUNDING ACS
NCI, NINDS, MENTAL HEALTH AND
THE NIH OD.
SETTING CURES ASIDE, THE
INCREASES ACROSS SOME INSTITUTES
AND CENTERS, AND A DECREASE IN
THE NIH COMMON FUND PROVIDED A
NET INCREASE OF $300 MILLION FOR
NIH.
LOOKING AH AHEAD TO FISCAL YEARR
2025.
THERE'S NO WAY TO SAY RIGHT NOW
HOW WELL THE NIH BUDGET WILL DO
IN THE APPROPRIATIONS PROCESS.
THIS IS AN ELECTION YEAR WHICH
ALWAYS HAS AN IMPACT ON THE
BUDGET PROCESS.
SO WE KNOW IT'S NOT LIKELY THAT
CONGRESS WILL NOT PASS
APPROPRIATIONS BEFORE THE NEW
FISCAL YEAR STARTS ON
OCTOBER 1ST.
WE FULLY EXPECT TO START THE
YEAR UNDER CONTINUING
RESOLUTIONS, AN THOSE WILL
PROBABLY FLOW THROUGH AFTER THE
ELECTIONS IN NOVEMBER.
CONTINUING RESOLUTIONS DO AVOID
COSTLY AND DIFFICULT GOVERNMENT
SHUTDOWN, BUT THEY CAN ALSO
DELAY SOME FUNDING DECISIONS.
BECAUSE UNDER CONTINUING
RESOLUTIONS, FUNDS ARE DIVVIED
OUT BASED ON THE NUMBER OF DAYS
IN THE CR BILL.
SO WE DON'T GET OUR ENTIRE
BUDGET RIGHT AWAY.
THTHE PRESIDENT'S BUDGET REQUEST
FOR 2025 ASKS FOR $898 MILLION,
THAT'S $2.8 MILLION INCREASE
OVER THE -- FOR REASONS THAT I
MENTIONED BEFORE BECAUSE OF
INFLATION AND BECAUSE OF THE
COST OF DOING BUSINESS
INCREASING.
HERE'S A SNAPSHOT OF THE NEI
BUDGET AS IT'S PUBLISHED IN THE
2025 PRESIDENT'S BUDGET REQUEST.
IT'S BUILT USING POLICY GUIDANCE
FROM BOTH THE NIH AND DEPARTMENT
OF HEALTH AND HUMAN SERVICES.
THIS PLAN KEEPS THE FUNDING
LEVELS FOR EACH ACTIVITY AT
RELATIVELY THE SAME PERCENTAGE
AS THE CURRENT FISCAL YEAR.
THE PLAN INVESTS APPROXIMATELY
$740 MILLION OF THE NEI TOTAL IN
EXTRAMURAL RESEARCH.
AGAIN, WE USE THESE AMOUNTS FOR
PLANNING PURPOSES UNTIL MORE
INFORMATION IS MADE AVAILABLE AS
CONGRESS WORKS THROUGH THE
APPROPRIATIONS PROCESS.
HERE WE HAVE A FEDERAL BUDGET
PROCESS TIME LIME.
TITLE THREE OF THE CONGRESSIONAL
BUDGET ACT ESTABLISHES A
SPECIFIC TIMETABLE FOR THE
CONGRESSIONAL BUDGET PROCESS.
THE OPEN SECRET IS THAT CONGRESS
CONTROLS THE PROCESS TO THINGS
MOVE ALONG AS THEY CHOOSE.
THERE ARE NO KNOWN PENALTIES FOR
NOT FOLLOWING THIS TIMELINE.
IN AN IDEAL YEAR, THOUGH, THE
HOUSE WOULD HAVE COMPLETED AK
SHUNL ON ALL APPROPRIATIONS
BILLS BY THE END OF JUNE.
SO WE KNOW THAT'S NOT GOING TO
HAPPEN.
AND SO THIS JUST SPEAKS TO THE
PROCESS BEING BEHIND SCHEDULE
AND WITHOUT SOMETHING
EXTRAORDINARILY UNEXPECTED
HAPPENING, WE AGAIN ARE MOST
ASSURED TO NOT HAVE AN
APPROPRIATION BY OCTOBER 1ST.
MOVING ON TO RECENT HOUSE AND
SENATE ACTIVITY.
KAY GRANGER, REPUBLICAN FROM
TEXAS, ANNOUNCED IN MARCH THAT
SHE WAS STEPPING DOWN AS THE
CHAIR OF THE HOUSE FULL
APPROPRIATIONS COMMITTEE.
THE CHAIR IS NOW TOM COLE,
REPUBLICAN FROM OKLAHOMA.
TOM COLE HAS HISTORICALLY BEEN
SUPPORTIVE OF NIH, SO WE HOPE
THAT'S A GOOD SIGN FOR THE
BUDGET PROCESS.
JUST AFTER TAKING OVER THE
CHAIRMAN'S POSITION, HE RELEASED
THE MARKUP SCHEDULE FOR FISCAL
YEAR 2025 APPROPRIATIONS BILL.
THE SUBCOMMITTEE MARKUP FOR THE
LABOR HHS EDUCATION BILL IS
SCHEDULED FOR THURSDAY,
JUNE 27TH.
THE FULL COMMITTEE MARKUP FOR
THE LABOR HHS BILL WAS SCHEDULED
FOR WEDNESDAY, JULY 10TH.
THERE IS NO EXPECTATION OF A
HOUSE APPROPRIATIONS
SUBCOMMITTEE HEARING FOR NIH,
HOWEVER, THE SENATE JUST HELD
THEIR HEARING ON MARCH 23RD.
THANKFULLY THERE WERE NO LAND
MINES DURING THAT HEARING.
OVERALL, IT WAS A VERY POSITIVE
DISCUSSION, AND APPARENTLY
BIPARTISAN SUPPORT FOR NIH.
THIS IS MY FINAL SLIDE.
THESE ARE HIGHLIGHTS OF SEVERAL
AREAS THAT WERE RAISED AS A
PRIORITY DURING THE SENATE
HEARING.
THIS ISN'T ALL-H1N1 INCLUSIVE
BUT JUST SOME OF THE
CONVERSATIONS THAT HAPPENED.
THE NEED FOR CONTINUED
INVESTMENTS TO DEVELOP BETTER
DIAGNOSTICS, IMPROVE TREATMENT
AND PRECISION CARE FOR PATIENTS,
INCLUDING TARGETED INVESTMENTS
FOR RESEARCH ON WOMEN'S HEALTH
AND CUTTING THE CANCER DEATH
RATE, LIMITING THE SPREAD OF
BIRD FLU.
THE IMPORTANCE OF RESTORING 21ST
CENTURY CURES FUNDING,
REIGNITING CANCER MOONSHOT.
INVESTMENT IN THE NEXT
GENERATION OF RESEARCHERS,
DEVELOPING TREATMENTS FOR LONG
COVID, ALZHEIMER'S RESEARCH AND
OTHER DEMENTIA-RELATED RESEARCH,
SUBSTANCE USE AND THE OPIOID
EPIDEMIC, MENTAL HEALTH
RESEARCH, RURAL HEALTH RESEARCH,
AND USING ARTIFICIAL
INTELLIGENCE AND MACHINE
LEARNING FOR GATHERING
INFORMATION.
SO I'LL STOP HERE.
THE LIST GOES ON, BUT I'LL
ANSWER ANY QUESTIONS NOW THAT
YOU MIGHT HAVE.
>> QUESTION, THE INTRAMURAL TO
EXTRAMURAL EXPENDITURES, ON THE
BUDGET, IS THAT SET FROM YEAR TO
YEAR?
AND IF IT'S NOT, HOW MUCH
VARIANCE DO YOU GET FROM YEAR TO
YEAR?
>> SURE.
OUR HISTORICAL TRENDS HAVE BEEN
PRPRETTY CONSISTENT.
OUR TRAIN MURAL PROGRAM IS ABOUT
12% OF THE TOTAL NEI BUDGET SO
THAT'S WHAT WE'VE SEEN OVER
TIME.
OF COURSE EACH YEAR IS UNIQUE
AND DIFFERENT, AND SO WE DO OUR
BEST TO MAINTAIN THE FUNDING
BECAUSE WE HAVE ONGOING
COMMITMENTS THAT WE HAVE TO
ADDRESS.
>> AND IF YOU WERE TO LOOK AT
THE NUMBER OF LABORATORIES
AND/OR PIs AS SUPPORTED BY
INTRAMURAL COMPARED TO
EXTRAMURAL, HOW DO THESE
COMPARE?
>> I'D ACTUALLY HAVE TO TURN
THAT QUESTION OVER TO NEI
LEADERSHIP.
>> REZA, THAT'S A GOOD QUESTION.
THE NUMBER OF INTRAMURAL
INVESTIGATORS IS OBVIOUSLY
SMALLER.
WE HAVE ABOUT 300 PEOPLE WHO
WORK IN BETHESDA HERE.
ROUGHLY 20-SOME LABS AND SIX
CORE FACILITIES.
>> THANK YOU.
>> THANK YOU VERY MUCH.
>> KAREN, THANK YOU VERY MUCH.
WE NORMALLY HAVE DISCUSSION
BUILT IN OVER HERE, BUT GIVEN
THE TIME, AND CAN YOU TELL THAT
WE RUSHED A LITTLE BIT THROUGH
SOME OF THE FINAL SLIDES HERE,
BECAUSE WE HAD A LOT TO DISCUSS
THAT WAS EMBEDDED WITHIN THE
ACTUAL DIRECTOR'S REPORT.
I REALLY APPRECIATE ALL THE
COMMENTS AND SUGGESTIONS THAT
YOU'VE MADE HERE, AND I HOPE IT
COMES ACROSS THAT MANY OF THE
COMMENTS THAT YOU HAVE MADE OVER
THE FEW YEARS HAVE MADE THEIR
WAY INTO THINGS THAT WE'VE DONE
HERE.
WE'LL HAVE 45 MINUTES FOR
GENERAL DISCUSSION LATER, AND MY
GUESS IS THAT WE WON'T BE
HURTING FOR TOPICS TO DISCUSS,
BUT IF WE ARE, I HAVE A COUPLE
PROMPTS.
BUT WITH THIS, LET ME -- KATHY,
IS THERE ANYTHING ELSE WE NEED
TO DO OR CAN WE MOVE TO A BREAK?
>> NO, WE CAN MOVE TO A BREAK.
AND YEAH, SORRY TO CUT THE
DISCUSSION SHORT, BUT I'M A BIG
FAN OF KEEPING TO BREAKS IN OUR
SCHEDULE, AND AS MIKE MENTIONED,
WE DO HAVE A LOT OF TIME AT THE
END FOR GENERAL DISCUSSION TOO.
>> THANK YOU.
LET'S START AT 10:30.
SO VINU AND AFROUZ WILL BE ON STAGE.
AS YOU CAN TELL, WE'RE REALLY
EXCITED ABOUT THE TWO SPEAKERS
THAT WE HAVE.
THE THEME IS BASICALLY
TRANSLATIONAL OPPORTUNITIES FOR
MULTI-OMIC RESEARCH IN VISION.
AND LET ME JUST INTRODUCE THE
TWO SPEAKERS RIGHT NOW, AND THEN
WE'LL HAVE THEM JUST SPEAK,
AFROUZ, YOU'LL COME UP WITH VINU
FINISHES AND THEN YOU CAN COME
BACK HERE AND WE'LL HAVE
DISCUSSION AROUND THE TABLE.
SO VINIT MAHAJAN IS AN MD/PH.D.,
AND HE TRAINED IN THE UCLA EYE
STAR PROGRAM, ACADEMICALLY
ORIENTED, AND HE'S BEEN A REAL
SUPERSTAR.
INITIALLY STARTED OUT AT
UNIVERSITY OF IOWA, AND THEN NOW
WORKS AT STANFORD, AND REALLY
CREATIVE, WORKS ALONG A LOT OF
DIFFERENT AREAS INCLUDING WHAT
HE'LL BE TALKING ABOUT TODAY,
MULTI-OMICS THROUGH LIQUID
BIOPSY.
AND AFROUZ ANDERSON IS A PROGRAM
OFFICER IN NIBIB THAT WE'VE
GOTTEN TO KNOW REALLY WELL OVER
THE PAST FEW YEARS, AND AFROUZ
IS AWESOME.
HER BACKGROUND IS IN
ENGINEERING, IN BIOMEDICAL
ENGINEERING AND IS TRAINED
INITIALLY AT UC DAVIS AND HAS
DONE A LOT OF WORK BOTH AS A
RESEARCHER AND PROGRAM OFFICER
AT NIBIB AND HAS GOTTEN TO
BECOME FRIENDS WITH US THROUGH
SOME INITIATIVES THAT WE'VE
WORKED ON TOGETHER, AND AFROUZ
WILL TALK MORE ABOUT IMAGING
BOTH FROM A TECHNICAL
PERSPECTIVE AND ALSO FROM
APPLICATIONS AND COLLABORATION
PERSPECTIVE, AND OUT OF THIS
WILL COME UP WHAT CAN WE ALL DO
TO ADVANCE THE FIELD.
SO WITH THAT, I HAVE NEW,
WELCOME, AND THEUP FOR BEING
HERE.
THANK YOU FOR BEING
HERE.
>> IT'S NICE TO SEE MIKE AND
SINCE WE'VE LAST MET IN 2005 AT
THAT K MEETING, IT LOOKS LIKE
YOU'VE DONE PRETTY WELL.
SO I'M GLAD - I DIDN'T BRING YOU
DOWN.
THAT WAS A VERY NICE
INTRODUCTION, IF YOU COULD SEND
THAT TO MY WIFE, I THINK SHE'LL
BE SHOCKED THAT ANYBODY SAIDS
WAY A SUPERSTAR OR VERY
PARTICULARLY CREATIVE, BUT THANK
YOU.
IT'S GREAT TO BE HERE AT THE
COUNCIL MEETING.
I'M GOING TO TALK TO YOU ABOUT
TEM POLE, WHICH IS A MULTI-OMIC
APPROACH LOOKING AT DISEASE
MECHANISMS IN LIVING HUMANS.
I'M COMING FROM STANFORD, I'VE
BEEN HERE TO THE NIH NOW A
COUPLE TIMES VERY RECENTLY AND
IT GREAT TO BE BACK HERE IN
FRONT OF THIS GROUP.
I'D LIKE TO ACKNOWLEDGE THE
PEOPLE WHO DID THE WORK.
JULIAN WOLF IN PARTICULAR WHO'S
A POSTDOC NOW BACK IN GERMANY
DOING HIS VITRIOL RETINAL
SURGERY AND SOO HYEON, AND OVER
THE MANY, MANY YEARS OUR FUNDING
HAS ALMOST ENTIRELY COME FROM
THE NIH SO I'M VERY GRATEFUL FOR
THAT.
I DIRECT A PROGRAM CALLED THE
MOLECULAR SURGERY PROGRAM, AND
THIS IS A REALLY HIGH TIME IN
RETINA AND IN EYE DISEASE AND
THIS IS FROM A REVIEW I WROTE
WITH MY FRIEND STEEFL STEVE SANN
JCI, AND I TELL PEOPLE, WE CAN
DELIVER ANY MOLECULE ANYWHERE IN
AND AROUND THE EYE, AND WE DON'T
OPERATE ON ORGANS OR TISSUES, WE
ACTUALLY OPERATE ON CELLS.
I WAS FORTUNATE TO BE A SURGEON
ON THE FIRST RP65 1ST HUMAN
FDA -- WE CAN DELIVER A 41 GAUGE
NEEDLE INTO THE SUBRETINAL
SPACE, PRECISELY DELIVER A FEW
HUNDRED MICRO LITERS OF GREEN
THERAPY VECTOR TO TREAT THE RPE
CELLS.
AND ON A DAILY BASIS NOW, GIVING
TENS OF THOUSANDS OF INJECTIONS,
OPHTHALMOLOGISTS INJECT PROTEIN
ANTIBODIES INTO THE EYE, WHICH
HAS HAD A STUNNING EFFECT ON
PATIENTS, AN IN WET MACULAR
DEGENERATION.
WE'RE ABLE TO INJECT ALL SORTS
OF THERAPEUTICS, I TELL MY
FRIENDS IN THE DRUG DEVELOPMENT
INDUSTRY, WHATEVER THEY'VE DONE
IN THEIR PETRI DISH WILL WORK IN
THE EYE.
THEY DON'T HAVE TO WORRY ABOUT
KIDNEY AND LIVER TOXICITY AND
THINGS LIKE THAT.
WE'RE VERY GOOD AT INJECTING
THINGS BUT WE DON'T TAKE THIS
OPPORTUNITY TO ACTUALLY REMOVE
FLUID FROM THE EYE.
SO IN MEDICINE, IF YOU GO TO THE
E.R., YOU HAVE CHEST PAIN, TO
FIGURE OUT WAS IT THE BURRITO
THAT YOU ATE YESTERDAY OR ARE
YOU ACTUALLY HAVING A MYOCARDIAL
INFARCTION, THEY DO NOT DRAW
BLOOD AND GENOME SEQUENCE YOU,
LOOK AT YOUR GWAS RISK FACTORS.
THEY ACTUALLY DRAW BLOOD AND
THEY LOOK AT PROTEINS.
IN THIS CASE, THEY LOOK FOR TRI
TROPONIN, AND IF YOU SEE THAT
PROTEIN FLOATING IN THE BLOOD,
YOU KNOW THERE'S BEEN DAMAGE TO
THE HEAR.
I THINK IN OPHTHALMOLOGY,
THERE'S AN INCREDIBLE
OPPORTUNITY TO IDENTIFY PROTEINS
IN THE INDIVIDUAL PATIENTS THAT
ARE SPECIFICALLY REFLECTING
THEIR STAGE OF DISEASE AND THE
ACTIVITY OF DISEASE, AND IF WE
COULD IDENTIFY THE TROPONINS FOR
EYE DISEASE, THEN WE COULD DO A
BETTER JOB WITH DIAGNOSIS,
CHOOSING DRUG THERAPY, DESIGNING
OUR CLINICAL TRIALS AND
OPTIMIZING OUR SURGICAL THERAPY,
SO I'M GOING TO TELL YOU A
RECENT STORY, A COUPLE RECENT
STORIES OF HOW WE'RE TAKING THIS
APPROACH.
NOW, I ALSO LECTURE THE MEDICAL
STUDENTS AND THE
NON-OPHTHALMOLOGISTS AND
NON-VISION SCIENTISTS AND SO I
ASK THEM WHAT'S THE MOST COMMON
SURGERY ON PLANET EARTH.
IT CATARACT SURGERY, IN THE
U.S., WE DO CLOSE TO 4 MILLION
CATARACT SURGERIES EACH YEAR,
WE'RE IN THE EYE BUT ALMOST ANY
OF THE FLUID WE REMOVE
IMMEDIATELY GET THROWN OUT.
WHAT I'VE DONE OVER THE YEARS IS
DEVELOP WHAT WE CALL THE MOBILE
OPERATING ROOM LAB INTERFACE,
THE MORLI.
IF YOU KNOW THE O.R. NURSES,
THEIR JOB IS TO GET THE PATIENT
IN AND OUT SAFELY, BUT WE
FIGURED IF WE TOOK A LITTLE LAB
BENCH AND WE PUT WHEELS ON IT
AND IT WAS A CART, THAT WAS OKAY
IN THE OPERATING ROOM.
EVERYONE LOVES WHEELING CARTS IN
AND OUT OF THE O.R.
WHAT WE HAVE IS A MINI LAB BENCH
THAT WOULD HAVE EVERYTHING WOULD
YOU HAVE IN THE LAB, BASICALLY A
COMPUTER, DRY ICE, CENTRIFUGES,
SO BASICALLY BRINGING THE LAB
DIRECTLY INTO THE OPERATING ROOM
SO THAT WHEN WE REMOVE FLUIDS
FLUID, INSTEAD OF USING THE
1800s TECHNOLOGY OF FORMALIN,
WE REMOVE FLUID AND IMMEDIATELY
SNAP FREEZE IT ON DRY ICE, IT'S
PUT IN CRYOBILE, BA BARCODED,
BANKED AND THEN WE HAVE A VERY
FRESH SPECIMEN THAT CAN BE USED
FOR MANY OF THE AMAZING
MOLECULAR TECHNOLOGIES THAT WE
NOW HAVE AVAILABLE TO US.
SO I ALWAYS TELL PEOPLE THE
LIMIT IN VISION SCIENCE IS NOT
THE SCIENCE, IT'S HAVING DRY ICE
IN THE O.R.
SO OUR FIRST QUESTION I'D LIKE
TO ADDRESS IS, HOW CAN WE
IDENTIFY PROTEIN AND CELL
RESPONSES IN LIVING HUMANS?
AND I'M GOING TO TALK ABOUT A
RECENT PUBLICATION THAT WE HAD
IN CELL.
AND THE ME TH METHOD THAT WE HAE
DEVELOPED IS CALLED TEMPO, WHICH
ASSISTANTS FOR TRACING THE
EXPRESSION OF MULTIPLE PROTEIN
ORIGINS.
THE MULTIPLE PROTEINS IS THE
PROTEOMICS, AND THE ORIGINS ARE
THE CELLS, AND IN OUR COVER
IMAGE HERE, THIS LITTLE CARTOON
BASICALLY EXPLAINS THE NEXT 20
SLIDES THAT I HAVE.
WE CAN MEASURE THOUSANDS OF
PROTEINS, AND THEN USING SINGLE
CELL RNA SEQ MAPS, WE CAN FIGURE
OUT WHERE THOSE PROTEINS CAME
FROM.
IF WE SEE A YELLOW PROTEIN, WE
KNOW THAT IT CAME FROM A YELLOW
CELL.
SO THIS IS OR PIPELINE.
SO I WAS REALLY PROUD THAT WE
GOT A PICTURE OF AN EYE SURGEON
IN THE OPERATING ROOM IN CELL.
WE SNUCK THAT IMAGE IN.
AND WE'RE COLLECTING AQUEOUS
FLUID HERE.
AND FROM ONLY 50 MICRO LITERS OF
EYE FLUID, WE APPLY THAT TO A
DNA APTAMER ARRAY THAT CAN
MEASURE UP TO -- CLOSE TO 8,000
AND NOW 11,000 PROTEINS, AND I
WAS TOTALLY SHOCKED TO SEE THAT
OUR SINGLE AQUEOUS FLUID SAMPLE,
WE CAN MEASURE CLOSE TO 6,000
DIFFERENT PROTEINS.
AND DO THAT QUITE ROBUSTLY.
WE'VE BEEN DOING VITREOUS
PROTEOMICS, BUT THE AQUEOUS
PROTEIN CONCENTRATION IS 400
TIMES LESS THAN THE BLOOD, AND
OF COURSE THE VOLUME IS VERY
SMALL, SO THAT'S BEEN A REAL
TECHNICAL CHALLENGE.
BUT THIS DNA APTAMER PLATFORM,
LIKE I SAID, 6,000 PROTEINS IN
THAT CLEAR FLUID OF AQUEOUS.
WE THEN TOOK THOSE PROTEINS AND
APPLIED TO THE VARIOUS SINGLE
CELL SEQUENCING MAPS THAT TELL
US WHICH GENES ARE MADE IN WHICH
SPECIFIC CELLS, AND THEN AS
CONTROL, WE USE SPLEEN AS A
NEGATIVE CONTROL, BUT WE ALSO
COMPARED TO BLOOD AND LIVER, AND
INTEGRATED THAT DATA.
IN THIS FIRST HEAT MAP, I'LL
SHOW YOU SOMETHING THAT'S
AMAZING AND BLEW THINGS AWAY
FROM ME.
ACROSS THE TOP ARE INDIVIDUAL
CELL TYPES, AND ON THE Y AXIS
ARE CLOSE TO OVER A THOUSAND,
2,000 PROTEINS.
THESE ORANGE STRIPES THAT YOU
SEE ARE MULTIPLE PROTEINS THAT
CAN ONLY COME FROM A SINGLE CELL
TYPE.
SO FOR EXAMPLE, IN AMICRIN
CELLS, WE CAN FIND 200 PROTEINS
THAT ARE ONLY MADE BY THOSE
CELLS.
WE FOUND A HUNDRED PROTEINS FOR
GANGLION CELLS, OVER 50 PROTEINS
FOR CONES AND SHOW ON.
THIS IS SHOWN IN CARTOON FORM.
SO SOMEHOW, THESE PROTEINS IN A
NORMAL EYE, WERE LEAKING OUT OF
THE CELLS, AND MANAGED TO
SURVIVE ALL THROUGH THE VITREOUS
AND FLOAT THEIR WAY INTO THE
AQUEOUS AND IN THAT 50 MICRO
LITER SAMPLE, WE COULD MEASURE
THEM.
AND IF YOU'VE DONE
IMMUNOHISTOCHEMISTRY AND
PATHOLOGY, YOU KNOW WE'RE
TYPICALLY LOOKING AT ONE OR TWO
PROTEINS ON OUR CELLS, BUT THIS
IS REMARKABLE THAT WE CAN SEE
OVER 50 PROTEINS THAT TARGET OR
ARE TELLING US A SINK EL CELL IS
THERE, WHICH GIVES US GREAT
STATISTICAL POWER.
THE FIRST DISEASE WE LOOKED AT
WAS RETINITIS PIGMENTOSA.
WE ALL KNOW THAT THIS IS A ROD
PHOTORECEPTOR DISEASE AND I'M
SHOWING SOME OF THE CLINICAL
TYPICAL IMAGES IN THE OCT IMAGE,
YOU CAN SEE THAT THIS IS A
PATIENT WHERE WE'VE LOST THOSE
ROD CELLS, BUT MUCH OF THE
OTHER -- REST OF THE RETINA
APPEARS INTACT.
AND SURE ENOUGH WHEN WE LOOK AT
THE PROTEIN, THE BIGGEST
FRACTIONAL DECREASE OF PROTEINS
WAS, IN FACT, IN THE ROD CELLS,
THE NEXT ONE WAS THE CONES AND
SO ON.
AND THEN YOU CAN SEE FOR
INDIVIDUAL CELLS, CAN YOU SEE
THOSE INDIVIDUAL PROTEINS AND
HOW THEY CHANGE IN PATIENTS.
SO THIS IS A MOLECULAR
FINGERPRINT OF THE CELLS IN AN
INDIVIDUAL PATIENT EYE AND
ACTUALLY SEEING WHICH OF THE
CELLS MARKERS ARE ACTUALLY
CHANGING AND GOING AWAY, AND WE
CAN DO THIS FOR MANY DIFFERENT
CELL TYPES USING THE VASCULAR
CELLS, THE RPE CELLS AND SO
FORTH.
THE NEXT THING WE LOOKED AT WAS
DIABETIC RETINOPATHY.
WHICH COMES IN TWO STAGES.
AN EARLY STAGE WHERE WE'RE
SHOWING THE CLINICAL IMAGES HERE
WHERE YOU GET THESE LITTLE MICRO
ANEURYSMS IN THE BLOOD VESSELS
AND THEN A LATER STAGE THAT'S
MORE SEVERE, WE CALL IT THE
PROLIFERATIVE, BECAUSE THERE'S
ACTUALLY BLOOD VESSEL GROWTH AND
LEAKAGE FROM THOSE BLOOD
VESSELS.
WHEN WE APPLIED THE TEMPO METHOD
HERE TO THE PROTEINS IN OUR
DIABETIC PATIENTS, WE CERTAINLY
SAW A NUMBER OF LIVER PROTEINS,
PRESUMABLY BECAUSE THOSE BLOOD
VESSELS ARE NOW LEAKING AND
LIVER PROTEINS ARE GETTING INTO
THE EYE.
AND WE LOOKED AT SORT OF THE HOT
TOPIC IN DIABETIC RETINOPATHY
WHICH ARE ANGIOGENIC PROTEINS,
WE GIVE OUR PATIENTS ANTI-VEGF
THERAPY TO CONTROL THE BLEEDING
AND EDEMA.
WE LOOKED AT 60 DIFFERENT
PROTEINS THAT ARE ANGIOGENIC
PROTEINS.
30 OF THEM ARE EXPRESSED IN THE
EARLY STAGE, AND ANOTHER 30 ARE
UNIQUELY EXPRESSED IN THE LATE
STAGE.
OF THOSE, SORT OF THE TOP 10
ANGIOGENIC PROTEINS WE SAW IN
THE EARLIER STAGE, WE FIND SOME
OF THE TYPICAL PLAYERS LIKE
VEG-F, BUT WHAT WE CAN DO WITH
TEMPO IS WE CAN SEE WHICH ARE
THE MAIN ANGIOGENIC PROTEINS WE
SEE DRIVING DISEASE AND WHICH
CELLS ARE THEY COMING FROM.
NOT SURPRISINGLY IN THE EARLY
STAGE, WE SEE THE ENDOTHELIAL
CELLS ARE THE BIG CONTRIBUTORS.
BUT IN THE LATE STAGES, ONE OF
THE SURPRISES WAS THAT SOME OF
THE MAIN PROTEINS ARE ACTUALLY
COMING FROM MACROPHAGES.
MACROPHAGES GENERATING
ANGIOGENIC SIGNALS.
IF YOU LOOK DEEP, DEEP INTO THE
PUBMED LITERATURE DATABASE, EULG
FIND A FEW PAPERS TALKING ABOUT
MACROPHAGES ENTERING THE
DIABETIC EYE, BUT HERE WE HAVE
OAFD IN OUR LIVING PATIENTS
THAT, IN FACT, MACROPHAGES ARE
MAKING A SIGNIFICANT
CONTRIBUTION TO THE ANGIOGENIC
DRIVE IN PROLIFERATIVE DIABETIC
RETINOPATHY.
NOW, WE HAVE ALL SORTS OF
PATIENTS THAT COME FOR CATARACT
SURGERY, AND WE CONSIDERED OUR
PARKINSON'S PATIENTS.
AND SO AS OPHTHALMOLOGISTS, WE
ALL KNOW THAT THE BRAIN IS AN
EXTENSION OF THE EYE.
THEY BOTH HAVE NEURONAL CELLS,
AND THEY SHARE SIMILAR PROTEIN
EXPRESSION PATTERNS.
BUT IN PARKINSON'S DISEASE, IT'S
AN INCREDIBLE CHALLENGE TO
DIAGNOSE PATIENTS, AND FOR ANY
KIND OF CLINICAL TRIAL, TO KNOW
THAT YOUR DRUG IS REACHING ITS
PROTEIN TARGET AND AK PLESHING G
ITS TASK.
SO IN OUR PARKINSON'S PATIENT,
WE LOOKED AT JUST UNDER 20
DIFFERENT PROTEINS THAT OUR
PARKINSON'S COMMUNITY IS LOOKING
AT UNDER 20 PROTEINS THAT
THEY'RE PARTICULARLY INTERESTED,
AND WHAT WE FOUND IS THAT NINE
OF THE PROTEINS, SOME OF THE HOT
PROTEINS IN PARKINSON'S DISEASE,
WE CAN ACTUALLY PICK UP IN THE
AQUEOUS AND THEY'RE
OVEREXPRESSED IN THE PARKINSON'S
PATIENTS.
WE CAN ALSO BEGIN AGAIN USING
TEMPO TO SEE WHERE ARE THOSE
PROTEINS COMING FROM THAT ARE
HAVING A SIGNIFICANT CHANGE, AND
AGAIN, HERE THEY LAND ON THE
GANGLION CELLS, AND CERTAINLY
FROM THE IMAGING STUDIES IN
PARKINSON'S DISEASE, WE'VE SEEN
THINNING OF THE GANGLION CELLS
NERVE FIBER LAYER, SO IT
CORRELATES WITH OUR IMAGING
FINDINGS.
BUT MANY OF THE CONCEPTS THAT
MIKE HAD TALKED ABOUT EARLIER,
SEEING HOW DOES EYE HEALTH TELL
US ABOUT OTHER DISEASES, I THINK
WE CAN ACTUALLY GET INSIGHT,
MOLECULAR INSIGHT INTO VERY
SPECIFIC NEUROLOGICAL DISEASES.
THE NEXT THING THAT WE LOOKED AT
WAS -- USING AI MODELS TO
PREDICT AGING.
AND SO AGING IS A REALLY HOT
TOPIC RIGHT NOW, AND SO WE'VE
LEARNED THAT OUR CHRONOLOGICAL
AGE CAN BE DIFFERENT THAN OUR
BIOLOGICAL AGE.
I KNOW MY BIOLOGICAL AGE IS MUCH
HIGHER THAN MICRON LOGICAL AGE
BECAUSE I DON'T EAT A LOT OF
SALAD, I DON'T SLEEP WELL, AND I
DON'T LIKE TO EXERCISE.
SO I HAVE NOT HAD MY BLOOD DRAWN
TO HAVE THE DNA METHYLATION
PATTERNS MEASURED BECAUSE I'M
SURE I'M PROBABLY LIKE 70 OR 80.
BUT WE ALL KNOW OUR PATIENTS AND
PEOPLE THAT SEEM REALLY HEALTHY
BUT IT'S ONLY THEIR EYES THAT
AREN'T FUNCTIONING WELL OR THEIR
BRAINS AREN'T FUNCTIONING WELL
OR THEY'RE MENTALLY VERY SHARP
BUT PHYSICALLY THEY CAN'T MOVE.
SO IT WOULD SEEM THAT DIFFERENT
ORGANS AGE AT DIFFERENT RATES.
AND IN THE EYE, WE CAN'T PLUCK
OUT THE TISSUE, BIOPSY THE
TISSUE AND LOOK AT DNA
METHYLATION PATTERNS, BUT WITH
ALL OF OUR PROTEOMIC DATA, WE
WANTED TO KNOW, COULD WE
ACTUALLY GENERATE A CLOCK?
SO AGAIN, WE TOOK OUR AQUEOUS
BIOPSIES, OUR PROTEOMICS, USED
VARIOUS MACHINE LEARNING
ALGORITHMS AND DEVELOPED A
PROTEOMIC CLOCK AND I'LL SHOW A
LITTLE BIT OF DATA, AND THEN
WITH TEMPO, WE COULD ACTUALLY GO
A STEP FURTHER AND LOOK AT CELL
LEVEL AGING AND CELL LEVEL
CLOCKS.
SO HERE IN PANEL A, WE TOOK 46
PATIENTS THAT ARE OTHERWISE
HEALTHY EXCEPT FOR THEIR
CATARACTS.
AND IN THE GREEN LINE HERE, WE
CAN SEE A NUMBER OF PROTEINS
THAT SEEM TO CORRELATE WITH AGE.
WE HAVE A 19-PATIENT VALIDATION
COHORT, AND WE FOUND IF WE
MEASURED 21 PROTEINS, THE
EXPRESSION LEVEL OF THOSE
21 PROTEINS IN YOUR A AQUEOUS,
WE'RE PRETTY GOOD AT PREDICTING
YOUR BIRTHDAY.
THEN WHAT WE DID WHICH I THINK
IS REALLY INTERESTING HERE IN
PANEL C IS WE TOOK OUR PATIENTS
WITH A VARIETY OF EYE DISEASES,
INCLUDING DIABETES, RETINITIS
PIGMENTOSA AND UVEITIS, YOU CAN
SEE ALL THESE COLORED DOTS ARE
MUCH HIGHER AND OFF THE SCALE OF
THE GREEN LINE, SO WHAT WE
FOUND, FLSKT, IS THAT SOME OF
OUR PATIENTS WITH PROLIFERATIVE
DIABETIC RETINOPATHY, EVEN
THOUGH THEY WERE 50 YEARS OF
AGE, THEY HAD AN EYE THAT WAS
MEASURING LIKE IT WAS 80 YEARS
OLD.
PATIENTS WITH RETINITIS
PIGMENTOSA AND PATIENTS WITH
UVEITIS ALSO SHOWING EVIDENCE
THAT THE BIOLOGICAL AGE WAS
HIGHER THAN THE THEIR
CHRONOLOGICAL AGE.
AND THIS IS GRAPHED OVER HERE.
NOW, IN THE BLOOD AGING THAT WE
DO, YOU'RE TOLD IF YOU EAT THE
SALAD AND GO RUNNING AND STUFF,
THAT YOU CAN REVERSE YOUR
BIOLOGICAL AGE.
IN THESE PATIENTS HERE, IN OUR
DIABETICS, WE HAVE CONTROLLED
THEIR BLEEDING, WE HAVE
CONTROLLED THEIR SWELLING, IN
OUR UVEITIS PATIENTS WE HAVE
CONTROLLED THEIR INFLAMMATION,
SO CLINICALLY WE THOUGHT THEY
WERE STABLE, BUT THEY STILL
SHOWED EVIDENCE OF ADVANCED
AGING IN THE ORGAN.
AND I THINK WHAT THIS TELLS US,
THAT IN THE EYE, THERE MAY BE AN
OPPORTUNITY TO TAKE ADVANTAGE OF
THE DIFFERENT ANTI-AGING
THERAPIES THAT ARE BEING
DEVELOPED BECAUSE THIS LOOKS
LIKE IT'S A SEPARATE PATHWAY
THAN THE TYPICAL DISEASE PATHWAY
THAT WE THINK ABOUT WHEN WE
THINK ABOUT DIABETES, RP AND
UVEITIS.
AND IT MAY BE AN OPPORTUNITY FOR
US TO CONTINUE TREATING OUR
PATIENTS THERE.
WITH TEMPO, WHERE WE COULD NOW
ASSIGN SPECIFIC PROTEINS TO
SPECIFIC CELLS, WE COULD KIND OF
SEE WHERE THESE 21 MOLECULES
WERE COMING FROM, AND WHICH
CELLS SEEMED TO BE DRIVING IT.
IN THIS PANEL, IT LOOKS LIKE
LOTS OF ENDOTHELIAL CELLS AND
ACROSS BIOLOGICAL AGING, YOU'LL
FIND THAT BLOOD VESSELS ARE ONE
OF THE KEY CELLS IN AGING.
BUT WE ALSO PICKED UP
HIALOCYTES, THIS MYSTERIOUS
IMMUNE CELL THAT'S IN OUR
VITREOUS, AND WE ALSO PICKED UP
PROTEINS COMING FROM HEPATOCYTES
AND SO SYSTEMIC PROTEINS COMING
REALLY FROM ANOTHER ORGAN
CONTRIBUTING -- THAT MAKE THEIR
WAY INTO THE EYE AT LEAST
CONTRIBUTING TO THIS AGING
PANEL.
IN MODELS THAT LOOKED AT
VASCULAR CELL AGING, IMMUNE CELL
AGING AND NOW RETINAL CELL
AGING, WE COULD SEE WHICH CELL
TYPES WERE CONTRIBUTING THE
MOST.
IN THE CASE OF IMMUNE AGING, IT
WAS THE B CELLS AND THE HYALO
DIDHYALOCYTES.
INTERESTINGLY FOR RETINAL CELL
AGING MODELS IT WAS THE BIPOLAR
CELLS AND ROD CELLS.
SO I THINK THERE'S A LOT OF
OPPORTUNITY TO PLAY WITH
PROTEOMICS, AGING CLOCKS IN
SPECIFIC DISEASES AND REALLY
UNDERSTAND THE SPECIFIC CELLS,
AND WH WHEN I WAS HERE AT THE NA
FEW WEEKS AGO, WAS TALKING ABOUT
TEMPO FOR CANCER.
SO I'M GOING TO SWITCH DISEASES
NOW AND TALK ABOUT SOMETHING
THAT REALLY LOOKS AT EYE CANCER
BUT I BELIEVE WILL HAVE AN
IMPACT ON LOOKING AT CANCERS IN
OTHER PARTS OF THE BODY.
AND I'LL JUST SPEND A FEW
MINUTES ON THIS.
SO UVEAL MELANOMA IS OUR MOST
COMMON INTRAOCULAR TUMOR THAT WE
KNOW.
SOME AMAZING WORK HAS NOW
ALLOWED OUR PATIENTS, AT LEAST
IN THE U.S., WHERE WE DO A FINE
NEEDLE BIOPSY AND THEY GET
GENOTYPED FOR DIFFERENT CANCER
DRIVER MUTATIONS.
BUT THE CHALLENGE IS, THERE'S A
LOT OF TUMOR HETEROGENEITY.
THAT GENE EXPRESSION PROFILE IS
RIGHT MOST OF THE TIME BUT NOT
IN EVERY SINGLE PATIENT.
AFTER WE IRRADIATE THE TUMOR,
YOU CAN'T CONTINUALLY FOLLOW THE
PATIENT, AND THEN SOMETIMES WE
SEE SOMETHING THAT'S PIGMENTED
BUT WE DON'T KNOW IF IT'S A
CANCER OR NOT.
AND CERTAINLY CANCER IS
INTERESTED IN LIQUID BIOPSIES,
WHERE MOST OF THE EFFORT IS AT
GENE SEQUENCING, LOOKING FOR
RARE TUMOR DNA, BUT WE'RE USING
OUR AQUEOUS HUMOR LIQUID BIOPSY
AND PROTEOMICS TO LOOK AT THIS
CANCER AND I'LL SHOW SOME OF
THOSE IMAGES.
THIS HEAT MAP, WHEN IT CAME OUT,
WAS AMAZING TO ME.
AND AGAIN, WE'RE USING THE
PROTEOMICS, MATCHING TO SINGLE
CELL SEQUENCING MAPS OF UVEAL
MELANOMA, AND THESE BRIGHT LINES
THAT YOU'RE SEEING DOWN HERE ARE
HUNDREDS OF PROTEINSING THAT IN
THE CARTOON FORM IS A LITTLE
EASIER TO LOOK AT.
THERE WAS 160 PROTEINS THAT CAN
ONLY COME FROM A TUMOR CELL, 38
THAT ONLY COME FROM TUMOR
MACROPHAGES, NOT REGULAR
MACROPHAGES, AND 40 PROTEINS
THAT COME FROM TUMOR T CELLS.
AND SO WITH A LIQUID BIOPSY,
EVEN IF YOU'VE NEVER, EVER SEEN
THE PATIENT, YOU WOULD
IMMEDIATELY RECOGNIZE THAT THERE
IS A TUMOR CELL IN THE EYE, AND
THOSE PROTEINS COULD NOT COME
FROM ANY OTHER CELL TYPE.
AND THE RESOLUTION IS SO STRONG,
WE CAN ACTUALLY SEE TUMOR
MACROPHAGES AND ACTUAL TUMOR T
CELLS IN THAT TISSUE WITHOUT
EVER HAVING TOUCHED THE TUMOR,
WITHOUT EVER HAVING TAKEN A
TISSUE BIOPSY AND PUTTING IT ON
A SLIDE FOR A PATHOLOGIST.
WE LOOKED AT OUR WHOLE
PROTEOMICS TO SEE IF THAT WOULD
HELP US CLASSIFY THE TUMORS, AND
JUST LIKE GENE EXPRESSION
PROFILING, WE FOUND THREE GROUPS
THAT WE CALL PROTEIN EXPRESSION
PROFILING OR PEP.
THESE THREE CATEGORIES HERE THAT
WE COULD DIVIDE THEM, AND IF YOU
WERE IN THIS PEP 3 GROUP WITH A
VERY SPECIFIC PROTEIN EXPRESSION
PROFILE, THAT WAS PREDICTIVE OF
SHORTER SURVIVAL TIME.
THIS PEP 3 GROUP WAS MOSTLY
INDICATIVE OF LARGE TUMORS, AND
MOST OF THE TIME CORRELATED WITH
THE GENE EXPRESSION PROFILING
PATTERN AND THE SIZE OF THE
TUMOR AND OTHER MARKERS, BUT IT
WAS SLIGHTLY DIFFERENT.
WE THINK THIS IS A POTENTIAL
ADD-ON HOLISTIC VIEW OF THE
TUMOR THAT WOULD HELP CLINICIANS
CLASSIFY THE TUMOR.
BUT NOW WE HAVE LOTS OF
MOLECULAR DATA THAT GOES BEYOND
SINGLE DRIVER M MUTATIONS, AND E
BEGAN LOOKING AT A DIAGNOSTIC
PANEL, AND SO ON THE LEFT HERE,
WE SHOW A NEVUS JUST LIKE ON
YOUR SKIN, YOU HAVE A NEVI, IT'S
BENIGN, CAN YOU DISTINGUISH THAT
FROM A TUMOR?
SO IN THE GRAPH, WE DEVELOPED A
DIAGNOSTIC PANEL AND THIS IS A
NORMAL EYE.
OUR NEVUS HERE IN THE GREEN IS
VERY CLOSE TO THE NORMAL, AND
THEN OUR UVEAL MELANOMA EYES ARE
WAY OVER HERE IN TERMS OF THE
DIAGNOSTIC PANEL.
AND INTERESTINGLY, WHAT WE'RE
SHOWING HERE IN THE MIDDLE IS A
BIG PIGMENTED LESION INSIDE THE
EYE THAT THE PATIENT EE LEKKED O
HAVE THEIR EYE REMOVED.
IT TURNED OUT TO BE A BENIGN
LESION, IT WASN'T A CANCER, AND
IN AT LEAST TWO OF THOSE CASES,
OUR DIAGNOSTIC PANEL FROM
AQUEOUS, JUST AQUEOUS, COULD
DISTINGUISH BETWEEN THE BENIGN
AND BETWEEN A MALIGNANT
MELANOMA.
SO WE THINK IN SOME OF THESE
INTERMEDIATE LESIONS, AN AQUEOUS
BIOPSY WITH A PROTEIN PROFILING
COULD BE VERY VALUABLE.
AND THERE'S THE POTENTIAL,
AGAIN, TO FOLLOW SOME OF THESELY
LESIONS, WHERE SOMETHING COMES
IN, THE PHYSICIAN IS NOT EXACTLY
CERTAIN, BUT IS WORRIED ABOUT AN
INTERMEDIATE LESION AND WOULD
LIKE TO FOLLOW THAT PATIENT.
THE OTHER INTERESTING THING IS
THAT BECAUSE OF THE DEPTH OF
MOLECULAR DATA, WE CAN SEE
ACTUAL IMMUNE CHECKPOINTS.
SO THERE'S A POPULAR IMMUNE
CHECKPOINT INHIBITOR PD-1, USED
IN UVEAL MELANOMA, IT DIDN'T
WORK.
WHEN WE ACTUALLY LOOK AT THE
PROTEIN PROFILING, WE DON'T SEE
ANY PD-1 BUT WE SEE OTHER KINDS
OF IMMUNE CHECKPOINT INHIBITORS
AT SPECIFIC STAGES OF THE TUMOR,
SO ONE COULD MAKE A RATIONAL
DECISION ABOUT WHAT THERAPEUTIC
TO GIVE IN AN INDIVIDUAL PATIENT
OR A RATIONAL DECISION ON WHICH
PATIENTS TO PUT IN A TRIAL FOR
THESE SPECIFIC IMMUNE CHECKPOINT
INHIBITORS.
JUST BRIEFLY HERE, THE OTHER
THING WE COULD DO WITH OUR
PROTEOMICS IS WE COULD ACTUALLY
DO PHOSPHOPROTEOMICS, LOOK FOR
PHOSPHORYLATED PEPTIDES AND
ACTUALLY PUT TOGETHER WHOLE
SIGNALING PATHWAYS.
THE TYPICAL THING YOU WOULD DO
IN A PEE TRE DISH IN A
LABORATORY, BUT NOW WE CAN DO
ACTUALLY IN OUR OWN PATIENTS.
WHEN I WAS A RESIDENT, WE WERE
TAKING EVERY SINGLE SKIN
MELANOMA DRUG, GIVING TO UVEAL
MELANOMA PATIENTS AND IT WOULD
ALWAYS FAIL.
THE ONLY THING SEEMINGLY THAT
SKIN AND UVEAL MELANOMA HAD IN
COMMON WAS THE WORD MELANOMA.
THEY WERE PIGMENTED.
WELL, WITH THESE PROTEIN
BIOMARKERS, WHAT WE DID IS WE
LOOKED AT A BANK OF CANCER
EXPRESSION PROFILING, AND WHAT
WE FIND IS THAT OUR UVEAL
MELANOMA IS ACTUALLY QUITE -- IS
A LOT CLOSER TO HEPATOCELLULAR
CANCER, BRAIN GLEE YOE GLIOMA.
WHEN ONCOLOGISTS ARE TRYING TO
CHOOSE OTHER DRUGS TO GIVE THEIR
PATIENTS, IT WOULD MAKE SENSE TO
CHOOSE FROM DRUGS THAT HAVE BEEN
APPROVED FOR HEPATOCELLULAR OR
PANCREATIC CANCER.
YOU CAN SEE THE HEAT MAP UP HERE
FOR THESE MARKERS.
THEN WAY, WAY AT THE BOTTOM WITH
THESE BLUE DOTS IS SKIN
MELANOMA.
IT LOOKS LIKE ONE OF THE
FURTHEST RELATED ANSWERS.
SO THIS KIND OF GAVE US THE
RATIONALE FOR THINKING ABOUT
WHAT ARE WE DOING IN CLINICAL
TRIALS?
AND UVEAL MELANOMA HAS AT LEAST
29 CLINICAL TRIALS THAT HAVE
FAILED.
SO WE LOOKED AT THEIR DRUG
TARGETS, THE DRUGS AND PROTEIN
TARGETS THEY WERE GOING AFTER,
THEN WE LOOKED AT OUR PATIENTS,
AND YOU CAN SEE HERE IN RED,
THESE ARE ALL THE TRIALS THAT
UNEQUIVOCALLY FAILED.
THERE ARE VERY FEW PATIENTS
ACTUALLY EXPRESSING THOSE DRUG
TARGETS.
WHY WOULD WE EVER GIVE A PATIENT
A DRUG WHEN THEY DON'T EVEN HAVE
THE DRUG TARGET?
AND IN SOME OF THE INSTANCES
WHERE IT LOOKS LIKE SOME OF THE
PATIENTS HAVE THE DRUG TARGETS,
EACH COLUMN HERE IS A PATIENT,
IT'S QUITE HETEROGENEOUS.
AND SO WHEN WE ENROLL UVEAL
MELANOMA PATIENTS, WE'RE NOT
REALLY LOOKING DO THEY HAVE A
SPECIFIC DRUG TARGET THAT WE'RE
TRYING TO TREAT THEM WITH, AND
WE'RE PROBABLY ENROLLING LOTS OF
PATIENTS OR A VERY MIXED
POPULATION BASED ONLY ON OUR
CLINICAL DEFINITION.
OF THOSE
PATIENTS.
SO WE TOOK THIS INFORMATION AND
THEN WE LOOKED AT THE NIH'S 169
APPROVED CANCER DRUGS, WE SEL
SELECTED 12 THAT HAVE NOT BEEN
USED IN UVEAL MELANOMA AND WE
LOOKED AT OUR PATIENTS TO SEE
WHETHER THOSE TARGETS WERE
EXPRESSED, AND YOU CAN SEE SOME
OF THESE PROTEIN TARGETS ARE
REALLY HIGH IN THE PEP
3 PATIENTS, WHEREAS SOME OF THEM
ARE QUITE LOW IN THE PEP 2 AND
PEP 1 PATIENTS.
NOW, WHAT'S REALLY COOL ABOUT
PROTEOMICS AT THIS DEPTH OF DATA
IS YOU DON'T JUST LOOK AT THE
PROTEIN TARGET.
YOU CAN LOOK AT THE ENTIRE
PROTEIN PATHWAY.
AND SO FOR THIS PI3 KINASE
PATHWAY, WE DON'T ONLY SEE THE
PI3 KINASE PROTEIN, BUT WE CAN
ACTUALLY SEE 109 OF THE 350
PROTEINS ASSOCIATED WITH THE
PATHWAY.
GIVING YOU A LOT MORE CONFIDENCE
THAT THIS WOULD MAKE A
REASONABLE DRUG TARGET.
AND THE PROTEOSOME PATHWAY, WE
ONLY SEE A PATHWAY ACTIVATED IN
THE PEP 3 CATEGORY BUT NOT IN
THE OTHER TWO.
WHAT WE DID THEN WAS TAKE UVEAL
MELANOMA CELL LINES, WHICH IS
THE USUAL WAY PEOPLE TEST DRUGS.
THE WE PROTEOMICALLY PROFILE
THESE TWO CELL LINES,
RECATEGORIZE THEM IN PEP
1 THROUGH PEP 3 WHERE THE CELL
LINES ACTUALLY MATCH WHAT WE SEE
IN HUMANS AND THEN BEGAN TESTING
A BUNCH OF DRUGS THAT WE
PREDICTED MIGHT WORK BETTER IN
THE PEP 3 COMPARED TO THE PEP
1 AND OVERALL, THAT'S WHAT WE
SAW.
SO THIS IS A VERY RATIONAL
APPROACH TO CHOOSING DRUGS,
TESTING THEM IN CELLS WHERE THE
CELL PROFILING MATCHES WHAT WE
SEE IN HUMANS, AND THEN TAKING A
PRECISION HEALTH APPROACH TO
ACTUALLY DECIDING WHICH PATIENTS
THEY GO INTO.
SO I'D LIKE TO WRAP UP NOW.
I THINK TEMPO IS REALLY
INTERESTING, COMBINING
PROTEOMICS WITH SINGLE CELL
SEQUENCING DATA.
WE'RE LOOKING AT AMD, GLAUCOMA,
UVEITIS.
IF I KNEW THERE WERE SO MANY
CORNEA PEOPLE HERE TODAY, I
WOULD HAVE ALSO PUT THE CORNEA
LISTED THERE, SO I'VE GOT SOME
OF OUR CORNEA COLLEAGUES
INTERESTED.
AND THEN MY COLLEAGUES ARE
TRYING TO APPLY THIS OUTSIDE THE
EYE NOW.
PARTICULARLY LOOKING AT
INFLAMMATORY BOWEL DISEASE, LOOK
AT REPRODUCTIVE ORGAN AGING AND
MENOPAUSE, NEUROLOGICAL DISEASE
AND OTHER CANCERS.
AND I'M TRYING TO ENCOURAGE
INDUSTRY TO INCLUDE THIS IN
THEIR ENROLLMENT OF PATIENTS FOR
THE VARIETY OF MOLECULAR
THERAPEUTICS.
SO WE'D NEVER GIVE A GENE
THERAPY TO A PATIENT THAT DIDN'T
HAVE THE GENE MUTATION, WE NEVER
PUT THEM IN A TRIAL, BUT WE DO
GIVE LOTS OF MOLECULAR
THERAPEUTIC DRUGS TO PATIENTS
WHERE WE'VE NEVER EVEN LOOKED
WHERE THAT PATIENT HAS THE DRUG
TARGET.
I THINK THERE'S AN OPPORTUNITY
FOR THE EYE INSTITUTE, THE NIH,
TO SUPPORT A MULTICENTER EYE
FLUID COLLECTION.
WHAT WE REALLY WANT TO DO IS
SCALE UP, LOOK AT OUR DIFFERENT
POPULATIONS, THE DIFFERENT
ETHNIC POPULATIONS, AND WHAT
WE'RE NEXT DOING WITH THIS IS
MULTIMODAL AI.
SO AI, MACHINE ALGORITHMS,
REALLY QUITE AMAZING, BUT WE'RE
NOW COMBINING PROTEOMICS WITH
THE IMAGING THAT WE HAVE IN AI
MODELS, AND WHAT WE'VE SEEN IS
THAT COMBINING DIFFERENT MODES
OF CLINICAL INFORMATION, EVEN
THE EHR, THE ELECTRONIC HEALTH
RECORD, WITH ACTUAL BIOLOGICAL
PROTEOMIC INFORMATION, CAN
REALLY STRENGTHEN THE PREDICTIVE
VALUE OF ALL OF THOSE MODES.
SO I'D LIKE TO THANK EVERYBODY,
AND THESE ARE ALL OUR PEOPLE IN
THE LAB, COLLABORATORS,
RESIDENTS, SURGEONS AND OTHER
FACULTY WHO'VE CONTRIBUTED.
SO THANK YOU VERY MUCH.
>> VINU, REALLY GREAT JOB.
WE'VE GOT A DISCUSSION AT THE
END AFTER BOTH OF YOU TALK, BUT
LET'S TAKE A FEW QUESTIONS RIGHT
NOW THAT ARE VINU-SPECIFIC.
SO REZA AND MARIA.
>> BEAUTIFUL TALK.
REZA DANA.
I JUST WANT TO COMMENT, IT'S
INTERESTING YOUR COMMENT ABOUT
MACROPHAGES IN DR.
>> YES.
>> WE'VE BEEN CONSISTENTLY FOR
DECADES SAYING MACROPHAGES ARE
THE CHIEF SOURCE OF PRO
ANGIOGENIC MOLECULES AND THE
DISORDERS THAT YOU'VE BEEN
LOOKING AT.
BUT AGAIN, OUR FIELD IS SMALLER,
AND PERHAPS IT DOESN'T GET THE
ATTENTION THAT IT DESERVES.
BUT THERE'S A PAPER IN JCI WE
WROTE LITERALLY IN 2004, I'LL
SHARE THAT WITH YOU.
IT REALLY CAPTURES WHAT THE
MACROPHAGE DOES IN REGARD TO
BOTH EXPRESSION OF LIGANDS AND
RECEPTORS TO DRIVE THAT PROCESS.
THANK YOU.
>> GREAT.
GREAT.
>> GREAT TALK.
THANK YOU.
I HAVE A QUESTION.
YOU SAID THAT IN THE PATIENTS
THAT YOU TREATED THEIR OCULAR
DISEASE AND YOU SAW A
IMPROVEMENT FROM AN OCULAR
PERSPECTIVE BUT YET YOU DIDN'T
SEE A CHANGE IN THEIR AGING, I
THINK THEIR AGING CLOCK, IF I
UNDERSTOOD THAT CORRECTLY?
>> YES.
YEAH.
>> AND THE QUESTION I HAVE IS,
HAVE YOU SAMPLED THE BLOOD ON
THESE PATIENTS AT THE SAME TIME?
IT SEEMS LIKE IT WOULD BE A
WONDERFUL SOURCE OF INFORMATION.
>> MOST OF THE WORK ORIGINALLY
WE'VE BEEN SAMPLING FLUID AROUND
THE EYE WITH THE IDEA THAT THIS
IS AN ENRICHED FLUID SOURCE
BECAUSE IT'S VERY LOCAL AND
CLOSE, AND AS AN
OPHTHALMOLOGIST, THE BLOOD
USUALLY ISN'T THAT IMPORTANT.
WE HAVEN'T LOOKED AT AGING
CLOCKS IN THE BODY AS SORT OF A
COMPARATIVE CONTROL.
SO THAT'S AN INTERESTING
QUESTION.
OUR GENERAL SENSE IS THAT THE
EYEBALL IS THE REALLY RICH PLACE
AND THINGS GET DILUTED OUT INTO
THE BLOOD, BUT THAT'S A
SEQUENTIAL STEP, AND CERTAINLY
OUR CANCER COLLEAGUES ARE
INTERESTED.
IN THAT.
>> IT MIGHT HELP DISTINGUISH
WHAT IS DIFFERENT AND THAT IT
MAY BE A SYSTEMIC CONTRIBUTION
TO THE EYE DISEASE THAT KEEPS
GETTING NEGLECTED IS KIND OF THE
POINT I WAS TRYING TO MAKE.
>> YES, YEAH, YEAH.
AND WHAT WE HAVE DONE IS THAT
THESE PROTEOMIC BIOMARKERS FOR
THE CLOCK AND THE EYE ARE NOT
REFLECTED IN THE BLOOD PER SE.
SO THAT THOUGHT IS TOTALLY
DIFFERENT.
>> YOUR B CELLS KEEP COMING UP
IN YOUR PANELS.
>> YEAH.
>> WHAT DO YOU MAKE OF THAT?
THEY'RE NOT USUALLY AS MUCH
APPRECIATED.
>> I THINK CLINICALLY, WHEN WE
WERE TALKING LAST EVENING, WE
THINK ABOUT UVEITIS, WE LIKE TO
PHYSICALLY SEE CELLS AND I LOVE
TO SHOW OFF OUR IMAGES, WE DON'T
ACTUALLY COUNT LEUKOCYTES IN THE
EYE, BUT THERE'S LOTS OF WHAT WE
WOULD SAY IS SUBCLINICAL
INFLAMMATION, SOMETIMES WHERE WE
DON'T SEE THE CLASSICAL FEATURES
OF THAT.
I WAS TOLD THE EYE IS IMMUNE
PRIVILEGE BUT IT'S NOT IMMUNE
ZERO, AND SO I THINK THESE
DIFFERENT CELLS MAY HAVE
CONTRIBUTIONS THAT WE TYPICALLY
DON'T CLINICALLY CHARACTERIZE OR
THINK ABOUT.
OR LIKE THE MACROPHAGES WHICH I
HAVE BEEN SNOOPING AROUND, I
WOULD GUESS, BUT IN GENERAL --
IT'S COMING UP AS A HOTTER TOPIC
NOW IN RETINA.
>> LET TAKE ONE MORE AND IT
LOOKS LIKE VICTOR.
>> GREAT TALK.
TWO POINTS.
ANY IDEA OR PLANS OR DO YOU HAVE
ANY DATA ON THE PEDIATRIC
AQUEOUS FLUID?
>> WE'VE COLLECTED A LITTLE BIT,
BUT AS YOU CAN IMAGINE, THE
PEDIATRIC FLUID IS A LOT MORE
COMPLICATED.
WE'VE COLLECTED SOME UVEITIS
SAMPLES WHEN THEY'RE GETTING IN
THE EUA.
BUT WE DON'T HAVE A COMPARATIVE
CONTROL LIKE WE DO FOR SORT OF
GENERAL CATARACT SURGERY WITH
THE KIDS, SO WE HAVEN'T GONE
HEAVILY INTO THAT BUT FOR SOME
OF THE UVEITIS CASES WE'VE
COLLECTED.
>> AND SECOND, IT'S INTERESTING,
THE MELANOMA HISTORY.
DO YOU THINK IN THE --
ENVIRONMENT CHANGES THE GENE
PROFILES OF THESE PHENOMENA?
COMING FROM MIAMI, WE DO SEE A
LOT OF -- THEY BEHAVE
DIFFERENTLY, FACT THEY ARE
PROBABLY MORE SIMILAR TO
ISCHEMIC MELANOMA.
>> I THINK THOSE ARE GREAT
QUESTIONS THAT WE DON'T KNOW THE
ANSWERS BECAUSE WE HAVEN'T
PROFILED THEM.
I THINK PROFILING THEM IN LIVING
HUMANS IS IMPORTANT, FREQUENTLY
IN OUR PATHOLOGY, WE'RE ONLY
LOOKING AT THE TUMOR ITSELF, NOT
THE SURROUNDING TISSUE THAT WE
CALL NORMAL, SO I THINK THAT'S
AN IMPORTANT OPPORTUNITY.
>> VINU, THANK YOU VERY MUCH.
LET'S SWITCH OVER TO -- WE'LL
TAKE MORE QUESTIONS DURING THE
DISCUSSION AT THE END.
THANK YOU.
>> GOOD MORNING, AND THANK YOU
FOR HAVING ME.
MY NAME IS AFROUZ ANDERSON,
PROGRAM DIRECTOR AT NIBIB, AND
TODAY I'M HERE TO TALK ABOUT
INTEGRATION OF THE BIOMEDICAL
IMAGING WITH MULTI-OMICS
ANALYSIS BASED ON AI FOR THE
DIAGNOSIS OF THE OCULAR AND
SYSTEMIC DISEASES.
SO AT NIBIB, WE'RE THE
ENGINEERING AND IMPANELING
TECHNOLOGY INSTITUTE.
WE'RE VERY PROUD OF THAT.
WE TAKE CARE OF A LOT OF EARLY
STAGE TECHNOLOGY DEVELOPMENT AND
WE LOVE OUR TECHNOLOGY SO MUCH
THAT WE LOVE TO SHARE THEM WITH
OUR FRIENDS IN DIFFERENT ICs
TO BE USABLE FOR THEIR SPECIFIC
DISEASES.
IN TERMS OF PARTNERSHIP AND
COLLABORATION, AT NIBIB, WE ARE
ABOUT 14% OF THE NIH BUDGET THAT
GOES TO OUR BAY O BIOENGINEERIN-
NOW THAT WE HAVE AN AMAZING
DR. BERTAGNOLLI AS OUR DIRECTOR,
THAT REALLY CARES ABOUT THE
BIOIMAGING AND BIOLOGICAL
TECHNOLOGIES TOWARD
UNDERSTANDING THE DISEASES.
SO TOWARD THAT END, WE HAVE A
LOT OF DIFFERENT FOCUSES, WE
HAVE FIVE MAIN AREA OF THE FOCUS
SPANNING FROM BIOENGINEERING TO
BIOIMAGING.
THIS INCLUDES THE THERAPEUTIC
SYSTEMS, IMAGING TECHNOLOGY,
VARIETY OF OPTICAL ALTERED
SOUND, MRI, AS WELL AS
ENGINEERED BIOLOGY SYSTEM, THESE
ARE CELLULAR TISSUE CHIPS AND SO
ON, AS WELL AS SENSOR AND POINT
OF CARE TECHNOLOGY, AND SORT OF
THE GLUE TO ALL THESE
TECHNOLOGIES IS DATA SCIENCE,
MODELING AND COMPUTATION.
THIS IS ANOTHER AREA OF THE
FOCUS THAT WE HAVE TO WORK WITH
THIS IMAGING TECHNOLOGY.
AS YOU MIGHT IMAGINE, WE HAVE A
LOT OF DATA COMING FROM EACH OF
THESE CORE AREAS, SO THERE'S A
NEED FOR DATA SCIENCE AND
MODELING.
WE ARE NOT
DISEASE-SPECIFIC-FOCUSED, WE ARE
NOT NECESSARILY
HYPOTHESIS-DRIVEN EITHER.
WE LOOK AT A LOT OF TECHNOLOGY
DEVELOPMENT TO UNDERSTAND AND
PREVENT DISEASES, TO PERSONALIZE
DIAGNOSIS AND TREATMENT IN ORDER
TO BE ABLE TO EXTEND THE
HEALTHSPAN AND REDUCE COST
TOWARD ALLOWING BARRIER TO
ACCESS AND THEN DRIVE THE
INNOVATION AND ENTREPRENEURSHIP
AND PARTNERSHIP.
SO FOCUSING ON THE DATA AND SORT
OF IMAGING TECHNOLOGY HERE, WE
HAVE A UNIQUE RELEVANCE IN AI
AND IMAGING AT NIBIB.
OUR PORTFOLIO SPANS -- AND
IMAGING TECHNOLOGIES REQUIRE
COMPUTATION AND MODELING FOR
DATA SCIENCE, FOR IMAGE
FORMATION, FOR IMAGE EVALUATION,
SO WE CAN USE AI AS A TECHNOLOGY
TO UNDERSTAND THESE SORTS OF
INFORMATION.
WE KNOW A LOT OF IMAGING
TECHNOLOGY HAVE SOURCE AND
DETECTOR.
WE HAVE SIGNAL AND NOISE PROBLEM
THAT IS ALWAYS A LIMITING FACTOR
FOR US, SO AI AND -- TECHNOLOGY
CAN BE USED FOR BETTER
SIGNAL-TO-NOISE RATIO.
VERY LARGE DATASET FOR TRAINING
AND DEVELOPMENT OF AI AND ANIMAL
MODEL, BOTH SUPERVISED AND
UNSUPERVISED SO OPTIMIZE THE
INVISIBLE INFORMATION THAT WE
CAN GET FROM THE IMAGING DATA.
AND BE ABLE TO EXPLAIN THE
RELEVANT -- THE CLINICAL
RELEVANCE OF THESE IMAGING.
AND ANOTHER AREA THAT WE FOCUS
ON A LOT IS WHAT IS THE GROUND
TRUTH THAT YOU'RE LOOKING AT.
SO IF YOU ARE LOOKING AT THE
IMAGING AND AI GROWTH AT NIH
OVER THE PAST FIVE YEARS, IT'S
INTERESTING TO SEE THAT IMAGING
TECHNOLOGY HAS HAD A STEADY
GROWTH SINCE 2019, AND THEN
LOOKING AT A CROSS-SECTION OF
THE AI AND IMAGING, LOOKING AT
THE CROSS-SECTION OF THE AI AND
IMAGING, YOU CAN SEE THAT THERE
HAS BEEN A 3.7 TIMES GROWTH OVER
THE PAST FIVE YEARS SHOWING THAT
INCREDIBLE GROWTH THAT YOU'RE
SEEING IN TERMS OF ENABLING THE
IMAGING TECHNOLOGY THROUGH THE
A.I.
IF YOU LOOKED AT THE FUNDING
THAT WE -- THAT NIH GOES TOWARDS
AI AND IMAGING INTERSECTION
VERSUS THE FUNDING THAT GOES
TOWARD THE APPROPRIATE BUDGET,
YOU CAN SEE A LOT OF INSTITUTES
ARE INVOLVED.
YOU CAN SEE THE DISEASE
SPECIFICITY OF THESE AI AND
IMAGING TECHNOLOGY FOR EXAMPLE
HUMAN HEALTH, MENTAL HEALTH,
BRAIN IMAGING, HEART LUNG BLOOD
INSTITUTE, AGING AND CANCER, AND
NIBIB AS A DISEASE AGNOSTIC,
YOU'RE REALLY HAVING A LARGE
FOCUS ON AI AND IMAGING COMPARED
TO OTHER INSTITUTES JUST BECAUSE
WE ARE LOOKING AT THE EARLIEST
STATE TECHNOLOGY DEVELOPMENT.
AND LOOKING AT THE SORT OF THE
MARKET SIDE FROM THE FDA POINT
OF VIEW, IS THAT IF YOU LOOK AT
THE GROWTH OF THE AI AND ML
ENABLED DEVICE THAT ARE CLEARED
BY FDA, YOU CAN SEE AGAIN THAT
GROWTH IN THE GRAPH SINCE 2014
WITH 76% OF THESE APPLICATION
FOCUSING ON RADIOLOGY AND
IMAGING TECHNOLOGIES, AND IF YOU
LOOK AT THE GRAPH ON THE RIGHT
SIDE THAT SHOWS A GLOBAL MARKET
GROWTH ESTIMATING IN 2029, THERE
WOULD BE 148 BILLION U.S.
DOLLARS TOWARDS THE GLOBAL
MARKET OF AI AND ML ALGORITHM
TOWARD THE HEALTHCARE MARKET.
SO I HOPE I'M CONVINCING YOU
DEFINITELY AND EVERYONE HERE IS
ALREADY CONVINCED THAT AI AND
IMAGING PLAYS AN IMPORTANT ROLE
IN TERMS OF IMPACTING THE
HEALTHCARE MARKET.
THE REST OF MY TALK IS GOING TO
FOCUS ON THREE MAJOR AREAS.
FIRST SOME OF THE DATA
REPOSITORY FOR AI ALGORITHM
DEVELOPMENT, OPT MY AIZATION AND
VALIDATION FOR IMAGING, AS WELL
AS BRIEFLY I WILL TOUCH ON THE
IMAGING STANDARD AND THEN
FOCUSING ON SOME OF THE EXAMPLE
OF INNOVATIVE ALGORITHM AND
ADVANCED IMAGING TECH TOWARD
OPHTHALMOLOGY.
SO ONE OF THE BIGGEST STRUCTURE
IN TERMS OF IMAGING AND AI AND
MAJOR SOURCES HAS BEEN MEDICAL
IMAGING AND DATA RESOURCE
CENTER.
THIS IS A MULTI-INSTITUTIONAL
COLLABORATIVE INITIATIVE DRIVEN
BY THE MEDICAL IMAGING COMMUNITY
IN ORDER TO BE ABLE TO
ACCELERATE THE DEVELOPMENT AND
REAL WORLD ASSESSMENT OF AI
PERFORMANCE AND CLINICAL
DEPLOYMENT.
ORIGINALLY MIDRC -- THE PI FOR
MIDRC, DR. GIGER, HAS DONE A
GREAT JOB IN ORDER TORE CONNECT
THE PROFESSIONAL SOCIETYINGS TO
BRING TO THE MIDRC AND I WILL
TOUCH ON WHY THIS IS SUCH AN
IMPORTANT DEAL.
THE GOAL OF THE MIDRC HERE IS TO
CREATE OPEN DISCOVERY DATA
COMMON WHERE YOU CAN DO
CREATION, TESTING, TATA
CONNECTIVITY AND QUALITY
ASSURANCE AS WELL AS ADDITION OF
THE CAP ABILITIES OF MACHINE
INTELLIGENCE AND COMPUTATION
TOWARD A VERY CLINICALLY
RELEVANT ALGORITHM AND
SOFTWARES.
AI READINESS IS NOT AN EASY
TASK.
YOU HAVE TO HAVE DATA CURATION
TO CREATE THIS USABLE DATA AND
MAKING YOUR DATA USEFUL FOR WHAT
YOU NEED.
TO TOWARD THAT END, MIDRC HAS
DONE SUCH A GREAT JOB IN
CREATING A PIPELINE THAT CAN
HELP YOU WITH CREATING USABLE
DATA.
THIS INCLUDES IDENTIFICATION,
CURE RANGE OF MOTION, QUALITY
CONTROL, ANNOTATION AND
HARMONIZATION.
WE HAVE PUBLIC FACING DATA
THAT'S AI/ML READY TOWARDS THE
TRUSTWORTHY AI CREATING FAIR AND
SEARCHABLE DATA.
IN ORDER TO VALIDATE PERFORMANCE
OF THE ALGORITHM THAT ARE BEING
DEVELOPED AND TO ACCELERATE FD
FDA -- DEPLOYABILITY OF THESE
ALGORITHM TOWARD THE CLINICAL
USE.
SO THERE HAS BEEN A SIGNIFICANT
PROGRESS IN THAT SENSE.
SINCE THE BEGINNING WE HAVE HAD
310 IMAGING STUDIES THAT HAVE
BEEN SUBMITTED TO MIDRC AND OUT
OF THOSE, AS THEY GO THROUGH THE
PIPE LAUNCH, THERE HAVE BEEN
165,000 STUDIES HAS BEEN
RELEASED AS WELL AS DEVELOPMENT
OF THE 30 UNIQUE ALGORITHMS.
AND THIS IS OUR AMAZING MIDRC
TEAM THAT UNFORTUNATELY WERE NOT
ABLE TO BE HERE, BRAD BROWER,
KRIS KANDARPA AND RUISDE SA, FOR
TRANSLATION OF THE AI ALGORITHM
TO THE CLINICAL PRACTICE.
SO ANOTHER NEXT STEP IS IF
YOU'RE TRYING TO GET YOUR
TRUSTWORTHY AI AND TRYING TO
REALLY CREATE A GOOD A.I. TOOL
YOU NEED TO UNDERSTAND THE BIAS
AND DIVERSITY OF THE DATA.
THIS BIAS CAN COME FROM MANY
DIFFERENT SOURCES, SOME OF IT IN
TERMS OF MODEL EVALUATION, MODEL
DEPLOYMENT, DATA COLLECTION,
DATA PREPARATION, AND SO TO THAT
END, MIDRC HAS CREATED A BIAS
AWARENESS TOOL, WHICH IS
ESSENTIAL FOR STANDARDIZATION
AND VALIDATION OF THE MULTISITE
AND MULTI-PLATFORM DATA.
FDA HAS ALSO PUBLISHED --
FORMALIZED AS A REGULATORY TOOL
FOR CLINICAL RELEVANCE HERE.
IT'S IMPORTANT TO MENTION THAT
IT'S VERY EASY TO FALL INTO THE
TRAP OF THE LARGE LANGUAGE
MODEL.
SO THE VERY IMPORTANT NEED I
WANT TO HIGHLIGHT HERE IS THE
NEED FOR DOMAIN-SPECIFIC
KNOWLEDGE IN TERMS OF CURE RANGE
OF MOTION ATIONOF THIS DATA.
IN TERMS OF COVID, WE BROUGHT A
LOT OF DIFFERENT SOCIETIES
TOGETHER TO WORK SO WE CAN
UNDERSTAND HOW THE DATA -- WHAT
ARE SET UP FOR THIS CURATION
WHAT ARE THE PATHWAY THAT WE
NEED TO CREATE FOR THE SPECIFIC
NEED IN TERMS OF THE CLINICAL
RELEVANCE.
SO I WANT TO HIGHLIGHT HERE,
THERE'S A VERY BIG PLACE FOR THE
PARTNERSHIP FROM A DIFFERENT
DOMAIN, BOTH FROM THE PUBLIC AND
PRIVATE ENTITY IN ORDER TO
REALLY CREATE A TRUSTWORTHY AI.
SO WE NEED TO ALL WORK TOGETHER
TOWARD THAT AND I THINK THIS IS
THE MESSAGE I WANT TO GET ACROSS
HERE.
IN TERMS OF CONTRIBUTING TO
NATIONAL AI INFRASTRUCTURE, DUE
TO THE EXECUTIVE ORDER TO BUILD
THE NATIONAL RESEARCH
INFRASTRUCTURE AND BO DEN THE
ACCESS AND RESOURCES TO RESEARCH
AND DEVELOPMENT IN AI, NIH HAS
PARTICIPATED IN NAIRR, THE
NATIONAL RESEARCH RESOURCE PILOT
IN 2024 TO DEPLOY THE RESOURCES
TO THE EARLY USERS.
WE ARE ALSO PART OF THE ARPA-H
BIOMEDICAL DATA FABRIC TOOLBOX.
THIS IS A NATIONAL
INFRASTRUCTURE FOR INGESTION OF
THE DATA, CURATION, DISCOVERY
AND VISUALIZATION OF THE
TRUSTWORTHY AI IN HEALTHCARE.
SO IFTS IT'S AN INTEGRAL PART T
FABRIC TOOL AND I THINK THAT
EXAMPLE HERE IS SHOWING THE
EXCELLENT OPPORTUNITY THAT, FOR
EXAMPLE, NIBIB, NEI AND EVEN
ALL-OF-US TOGETHER, I THINK SOME
OF IT, MICHAEL ALREADY ALLUDED
TO, TO BE ABLE TO INTEGRATE
OPHTHALMOLOGY DATA INTO THE
NATIONAL AI AND CREATING THE EYE
RELEVANT RESOURCES AND
POSSIBILITY EXTENSION OF THE
RESOURCES THAT WE HAVE TOWARD
THE OCULAR DATA AND INCLUSION OF
THE OCULAR-RELATED DATA INTO
THIS INFRASTRUCTURE.
SO THIS IS SOMETHING I WOULD
URGE EVERYONE TO TAKE A LOOK
INTO.
SO TO HAVE THE RELIABLE AI, WE
ALSO NEED RELIABLE AND USABLE
IMAGING DATA, AND TO THAT
EXTENT, WE HAVE TAKEN MULTI-SORT
OF PRONG APPROACH IN TERMS OF
STANDARDS, WE'RE GOING TO
HIGHLIGHT SOME OF OUR RECENT
ACTIVITIES THAT WE HAVE DONE IN
THAT SPACE TO CREATE A
REPRODUCIBLE AND QUANTIFIABLE
MEDICAL IMAGING DEVICES,
PHANTOMS PLAY AN ESSENTIAL ROLE
IN THIS TOPIC, SO WE HAVE
CREATED A NIST/NIBIB PHANTOM
LIBRARY.
A LOT OF THIS HAS BEEN IN TERMS
OF BIOMARKER DISCOVERY WITH THE
COLLABORATION IN NIST, AND THIS
IS A MULTI-EFFORT BETWEEN THE
FDA, NIST, NSF, AND NIH.
WE ALSO HAVE A FUNDING
OPPORTUNITY TO SUPPORT
OPTIMIZATION, COLLABORATION AND
CURATION OF THE IMAGING PHANTOMS
TOWARD THE USABLE IMAGING DATA.
THE DUE DATE WILL BE AUGUST 1ST,
2024.
AND WE'RE ALSO FOCUSING A LOT ON
COLLABORATIVE MULTI-SECTOR
EFFORT, THIS IS WHERE IN
PARTNERSHIP WITH NSF AND FDA WE
ARE TRYING TO CREATE A
MULTI-STRUCTURE EFFORT TO BRING
THE GOVERNMENT, UNIVERSITIES AND
INDUSTRY TOGETHER TO FOCUS ON
USABLE IMAGING DATA AND PHANTOM,
IN THIS CASE, OPTICAL MEDICAL
IMAGING DEVICES.
SO MOVING ON TO SOME OF OUR
ACTIVITIES IN TERMS OF PORTFOLIO
IN THE INTERSECTION OF THE AI
IMAGING AND OPHTHALMOLOGY, ONE
OF THE EXAMPLES THAT I'VE
PROVIDED HERE IS BY P.I.
DR. MILAN SANCA.
AS YOU CAN SEE IT'S BEING
SUPPORTED BY BOTH -- THIS IS FOR
DEVELOPMENT OF THE ALGORITHM
WHICH IS HYBRID, BOTH DEEP
LEARNING AND OPTICAL GRAPH
SEARCH METHOD FOR THE OCT DATA
FOR AUTOMATIC LAYER SEGMENTATION
TO EXTRACT THE CLINICAL AND
MEANINGFUL IMAGES OF THE RETINA,
AND TOWARD UNDERSTANDING THE
PATHOPHYSIOLOGY, AND BE ABLE TO
IMPROVE DIAGNOSTIC AND
MANAGEMENT OF THE DISEASES THAT,
FOR EXAMPLE, IN THIS CASE AS AN
EXAMPLE I'M SHOWING HERE IS THE
OPTIC NERVE.
SO THE IMAGE ON THE LEFT IS
SHOWING THE LAYER SEGMENTATION
AND 3D VISUALIZATION OF THE
RETINAL LAYER ON THE OPERATIVE
NERVE HEAD AND ON THE RIGHT IS
THE FIRST EVER 3D SEGMENTATION
OF THE HUMAN CHOROIDAL
VASCULATURE, THIS HAS ALREADY
BEEN USED IN SOME OF THE FDA
LABEL PRODUCT.
ANOTHER EXAMPLE THAT TAKES A
LITTLE BIT OF CURRENT IMAGING
TECHNOLOGY THAT CAN BE USED TO
GO BEYOND JUST EYE-SPECIFIC
DISEASES HAS BEEN IN THE
INTERSECTION OF AI AND IMAGING
AND OCT ANGIOGRAPHY.
THIS IS DONE BY OUR P41 CENTER,
WE HAVE THIS CENTER FOCUSING ON
RESEARCH DEVELOPMENT AND
DISSEMINATION OF THE
TECHNOLOGIES.
THIS SPECIFIC CENTER IS THE
CENTER FOR BIOMEDICAL OCT
RESEARCH AND DR. BRETT BOUMA.
AS PART OF THE CENTER, THEY'RE
FOCUSING ON NEW AND IMPROVED
METHODS OF THE OCT ANGIOGRAPHY
TO VISUALIZE THE DIFFUSING
CORRELATION OF THE RETINA WHICH
IS CORRELATIVE OF THE
INTRACELLULAR TRANSPORT
ACTIVITY.
THIS IS VERY EARLIEST STAGE BUT
WHAT THEY'RE LOOKING AT
SENSITIVITY TO -- IN THIS CASE
ALZHEIMER'S DISEASE AFFECTING
THE INTRACELLULAR EXPORT AND
TRANS CELLULAR TRAFFICKING.
IT'S SHOWING THE CROSS-SECTION
OF THE RETINAL LAYER AND THE
BOTTOM ONE ARE UNFAZED PROFILE,
BUT THE TAKE-HOME MESSAGE HERE
IS USING THIS METHOD, YOU CAN GO
AHEAD AND SORT OF DIFFERENTIATE
THE FIBER-RICH LAYER SUCH AS
THOSE IN LIKE A DARK RED, SUCH
AS -- VERSUS THE CELL-RICH LAYER
SUCH AS THE GCL, INL AND ONL.
BUT YOU CAN SEE EXAMPLES OF THE
TECHNOLOGIES THAT WE'RE WORKING
ON TOWARD THAT.
SO ANOTHER ASPECT IS AI
TRANSLATION TO CLINIC AND HOME.
THIS IS ANOTHER PART THAT WE
REALLY NEED TO FOCUS ON, AND
THIS IS AN EXAMPLE OF THE
CO-FUNDING FROM NEI, NCATS,
NIMHD, NIBIB AND IDS WITH THE
OFFICE OF THE DIRECTOR TOWARD
THE FDA CLEARED AI TECHNOLOGY
THAT CAN BE USED IN DIFFERENT
OCT TECHNOLOGY, IT IS THE FIRST
AND ONLY FDA CLEARED AI
TECHNOLOGY FOR AUTONOMOUS
DETECTION OF BOTH MORE THAN MILD
AND VISION THREATENING DIABETIC
RETINOPATHY, USING DIFFERENT
CAMERA MODELS AND ANOTHER
MANUFACTURER.
ANOTHER EXAMPLE IS SCANLY HOME
OCT, DE NOVO DEVICE CLASSIFIED
FOR AI-ENABLED OCT HOME
SCREENING DEVICES.
SO THIS IS SELF SET UP BY THE
PATIENT AND SELF OPERATED AP THE
DATA WILL BE REMOTE ACCESS THAT
CAN BE ACCESSIBLE BY PHYSICIAN
TO VISUALIZE THE HYPERREFLECTIVE
SPACES, WHICH IS AN IMPORTANT
BIOMARKER IN TERMS OF
NEUROVASCULAR AMD MANAGEMENT.
THIS IS VERY IMPORTANT BECAUSE
IT ALLOWS FOR -- SOMETIMES YOU
NEED MORE DATA FROM THE PATIENT
TO UNDERSTAND THE PROGRESSION OF
THE DEEDS SO THAT CAN HELP A LOT
SUCH HOME DEVICES CAN HELP A LOT
TOWARD THAT GOAL.
SO THE MA PART THAT I'M REALLY
EXCITED ABOUT, PERSONALLY I'M
EXCITED ABOUT AND I THINK OUR
INSTITUTE IS ALSO VERY EXCITED
ABOUT AND THAT'S WHY WE'RE HERE,
IS LOOKING INTO THE EYE AS A
PORTAL TO LOOK AT SYSTEMIC
HEALTH DISEASES.
IN TERMS OF TECHNOLOGICAL
ADVANCEMENT, WE'RE GETTING
THERE.
IT'S VERY FAST.
WE'RE HAVING THE OPTICAL IMAGING
TECHNOLOGY NON-INVAI CIVIL CAN
LOOK AT THE HIGHER DEPTH, AT THE
MULTI-SCALE SO WE CAN GO FROM
THE MACKO SCALE ALL THE WAY TO
NANOSCALE, WE CAN LOOK AT A
SINGLE CELL IMAGING RIGHT NOW,
AND ADVANCEMENT OF THE
OPTICAL -- AND THE NANOOPTIC,
THESE ARE EXAMPLES THAT I'M
PROVIDING, SO OPTICS, WE CAN
MAKE THE -- SMALLER AND SMALLER
TO ALLOW THE MULTIMODAL IMAGING
WHERE YOU CAN GET SO MANY
DIFFERENT OPTICAL BIOMARKERS,
FOR EXAMPLE, IN ONE SINGLE
SNAPSHOT.
AND HOPEFULLY WE CAN USE THIS TO
CREATE A LONGITUDAL DATA.
WE WANT TO GO THROUGH THE
MULTI-DIMENSIONAL DATA.
WE DON'T WANT TO JUST LOOK AT
FUNCTIONAL IMAGING.
-- STRUCTURAL IMAGING.
WE NEED TO HAVE THIS CAPABILITY
TO LOOK AT BOTH STRUCTURAL AND
FUNCTIONAL INFORMATION, AND
THINK ABOUT THE DATA IN TERMS OF
THE DISEASE -- SYSTEMIC DISEASES
SPECIFIC.
I KNOW A LOT OF CURRENT RESEARCH
THAT IS BEING DONE, WE CAN SEE
SOME IN TERMS OF SHOWING
FEASIBILITY OF THESE STUDIES IN
ALZHEIMER'S DISEASE, SOME OF
THEM CARDIOVASCULAR DISEASE,
SOME IN DIABETES.
BUT I THINK WE CAN ALSO LOOK AT
THE MORE COMPLEX DISEASES.
I THINK VINU MENTIONED SOME OF
THESE PROBLEMS THAT CAN IMPACT
THE DIFFERENT ORGAN, SO IN THIS
CASE, SYSTEMIC DISEASES THAT
HAVE COMPLEXITY IN TERMS OF
IMPACTING DIFFERENT ORGAN AT THE
SAME TIME, THESE ARE AUTOIMMUNE
DISEASES AND AUTOINFLAMMATORY
DISEASES, AND I'M NOT TALKING
ABOUT JUST LOOKING AT THE DRY
EYE, BUT ALSO LOOKING AT THE
PREDICTIVE BIOMARKER FROM
GENOMICS, FROM IMAGING, AND
HAVING A STRUCTURE LIKE AN AI TO
EXTRACT THE CLIPICALLY AND
DISEASE-RELATED BIOMARKER FROM
THIS MULTI-DIMENSIONAL DATA, FOR
EXAMPLE, AS MIDRC HAS THE
CAPABILITY TO DO THAT.
AND WE CAN TOTALLY USE THESE
SOURCES PREDICTION AND I BROUGHT
UP THE AUTOIMMUNE DISEASE
BECAUSE THIS IS AN IMPORTANT
TOPIC I RECENTLY HAD HE OFFICE
OF AUTOIMMUNE DISEASE RESEARCH
AT ORWH, AND I THINK THIS IS A
GREAT OPPORTUNITY TO WORK
TOGETHER TOWARD UNDERSTANDING
THESE COMPLEX DISEASES.
AGAIN AS I'M SAYING, IT'S
CREATING PARTNERSHIP, SO ONE
EXAMPLE OF THE PARTNERSHIP WE
HAVE RECENTLY DONE WITH NEI AND
OD IS THE OCULAR MAKE COMMENT
FUND VENTURE THAT HAS ALREADY
HAPPENED AND WE ARE LOOKING AT
THE INCOMING APPLICATION, BUT
THIS IS AN AMAZING OPPORTUNITY
BECAUSE THE CALL HAS BEEN -- HAS
ASKED FOR USING THE NEW
TECHNOLOGIES AND TOOLS BOTH FROM
THE AI AND IMAGING PERSPECTIVE
TO LOOK AT THE MULTIDIMENSIONAL
BIOMARKER OF THE SYSTEMIC
DISEASE FROM THE OCULAR IMAGING
AND OPHTHALMOLOGY POINT OF VIEW.
SO IN SUMMARY, AI AND IMAGING I
THINK WE ALL KNOW AND I HOPE
THAT I MADE THE CASE THAT
THEY'RE HAVING A RAPID GROWTH AT
NIH IN THE OVERALL HEALTHCARE
MARKET.
WE HAVE SEEN PROLIFERATION OF AI
TOOLS, NEW TECHNOLOGIES AND FDA
ALGORITHMS IN THE PAST FIVE
YEARS AND WE HAVE SEEN THE
RADIOLOGY-LED FDA GROWTH SO THE
QUESTION WE HAVE, DO YOU THINK
AND HOPEFULLY WE CAN SEE OR WILL
WE SEE THE GLOBAL AI GROWTH IN
TERMS OF OCULAR IMAGING?
THAT WOULD BE GREAT TO SEE,
BECAUSE I THINK OCULAR IMAGING,
ESPECIALLY NONINVASIVE AND AS
THE TECHNOLOGIES ARE GETTING
BETTER IN TERMS OF LABEL-FREE
PREDICTION AND LEGAL FREE
IMAGING AND MORE AT THE POINT OF
CARE, WE SHOULD BE ABLE TO GET
THERE.
OBVIOUSLY THERE ARE GOING TO BE
MAJOR CHALLENGING.
SOME OF THEM ARE ACCESS TO THE
LARGE AND USABLE DATASET, HAVING
A DATA AND -- TAKING CARE OF THE
DATA AND ALGORITHM BIAS AND ABLE
TO UNDERSTAND THEM, BEING ABLE
TO CREATE TRUSTWORTHY AND
EXPLAINABLE AI AND
STANDARDIZATION OF THE OUT COME
MEASURES AS WELL AS THE
REGULATORY CLEARANCE, CLINICAL
ADAPTATION AND AS I MENTIONED
GOING BEYOND SPECIFIC EYE
DISEASE, THESE ARE SOME OF THE
CHALLENGES WE WANT TO LOOK INTO.
THE GOOD NEWS IS WE HAVE A
SOLUTION.
WE ARE TECHNOLOGY-DRIVEN, AND
ONCE THE ENGINEERS KNOW WHAT ARE
THE NEED, WE CAN GO AHEAD AND
WORK TOGETHER.
SO I THINK EXPANDING THE
ENGINEERING AND MEDICINE
PARTNERSHIP BECOMES VERY
IMPORTANT IN TERMS OF OCULAR
IMAGING TECHNOLOGY TOWARD
SYSTEMIC DISEASE, AND TEC
TECH-DRIVEN IMAGING TECHNOLOGY,
OUR ULTIMATE USE CASE.
SO WE CAN USE THE MIDRC-LIKE
DATA REPOSITORY, WHO HAVE
EXPANDED BEYOND ONE DISEASE AND
ONE SPECIFIC DISEASE, INCLUSION
OF THE OCULAR DATA IN THESE
MODELS AND VALIDATE THE
ALGORITHM.
WE REALLY NEED DIFFERENT
SOCIETIES TO GET TOGETHER, WE
NEED TO WORK TOGETHER, ALL OF
US, NEI, WE SHOULD WORK TOGETHER
TO REALLY PUSH THIS FORWARD
BECAUSE THESE INVESTMENTS ARE
VERY IMPORTANT BECAUSE WE HAVE A
NEW TECH, WE WANT TO INVEST IN
THE NEW TECHNOLOGY DEVELOPMENT
EPT BRE NEWERSHIP AND CLINICAL
TRANSLATION AS WELL AS THE
TRAINING, AND THIS IS WHERE WE
CAN CREATE THIS SORT OF
PARTNERSHIP.
I HAVE SOME EXAMPLE HERE IN
TERMS OF OCULOMIBG, AI THROUGH
THE OFFICE OF DATA SCIENCE,
ODSS.
WITH THAT, I HOPE THAT WE CAN
WORK TOGETHER TO BRING THIS TO
THE NEXT STEP AND BE ABLE TO USE
THE EYE AS A WINDOW TO THE
SYSTEMIC DISEASES.
SOME OF THE MOST COMPLEX
DISEASES.
I KNOW IT'S A LOT OF WORK BUT I
THINK IF WE BRING THE GOVERNMENT
AND INDUSTRY AND SOCIETIES
TOGETHER AS WE HAVE SHOWN IN THE
MIDRC EXAMPLE, WE WOULD BE ABLE
TO MOVE THIS FORWARD.
THANK YOU, AND I WILL TAKE ANY
QUESTIONS YOU MIGHT HAVE.
>> AFROUZ, THANK YOU.
SO QUESTIONS SPECIFIC TO AFROUZ
HERE, COMMENTS?
I HA
>> I HAVE A GENERAL QUESTION.
IS OPHTHALMOLOGY THE BEST IN AI
IMAGING?
>> I THINK IT IS.
>> I MEAN, I ALWAYS LECTURE
THAT, THAT THEY LEAD, BUT IS
IT -- I MEAN, WE SEE LOTS OF
STUFF FROM RADIOLOGY, CHESS CHET
COMPLAISX-RAYS AND THINGS LIKE T
THAT'S A CULTURE THAT'S
EXCLUSIVELY IMAGING PER SE.
BUT JUST CURIOUS, YOU TALK
INTERACTING, WHERE ARE YOUR
BIGGEST INTERACTIONS RIGHT NOW?
>> OKAY, SO IN TERMS OF MY
BACKGROUND IS OPTICAL IMAGING
AND SPECTROSCOPY, AND I KNOW
THAT THERE ARE A LOT OF DEVICES
DESIGNED IN TERMS OF JUST
IMAGING THAT IS HAPPENING IN
THAT NATURE.
THERE ARE TECHNOLOGIES THAT ARE
BEING DEVELOPED INTO POINT OF
CARE ASSAYS THAT FOR EXAMPLE CAN
LOOK AT THE PROTEOMIC AND
GENOMIC DATA AS WELL AS THE
IMAGING DATA.
SO I THINK THE FIRST STEP IS TO
HAVE AND LOOK AT THE
MULTI-DIMENSIONAL DATA.
MAYBE INCLUSION OF THE OTHER
DATA TO FIRST UNDERSTAND WHAT
ARE THESE BIOMARKERS THAT WE ARE
SEEING IN TERMS OF LIKE
OCULOMIBG DATA, AND ONCE WE HAVE
A MODEL TO PREDICT THIS RISK OF
DISEASE, WE MIGHT NOT NEED ALL
OF THE IMAGING DATA TOGETHER, WE
CAN JUST FOCUS ON ONE AND SAY IF
WE SEE LET'S SAY FIVE DIFFERENT
OBSTETRICAL BIOMARK NER TERMS OF
ELASTICITY, IN TERMS OF
COLLAGEN, CHANGE OF THICKNESS,
FUNCTIONAL, LOOK INTO
MITOCHONDRIAL -- AND CHANGE THE
CELL ENVIRONMENT THAT YOU CAN
GET, YOU CAN SAY AS WE CORRELATE
THAT WITH THE PROTEOMIC AND
GENOMIC, NOW WE KNOW WHAT
TOTALLY MAKES SENSE IN CONTEXT
OF THIS CERTAIN DISEASE.
SO I BELIEVE PERSONALLY THAT I
CAN PRODUCE THAT DATA, BUT WE
NEED A LOT OF INFORMATION SUCH
AS EHR AT THE BEGINNING, AT
LEAST, AND YOU NEED A LOT OF
INFORMATION IN TERMS OF GENOMIC
AND -- TO ACTUALLY HAVE A GOOD
PREDICTIVE MODEL.
>> AFUSE, I HA
>> AFUSE VICTOR, I'M SORRY IF IT
YOU OFF.
AS HAVING THE FIRST FDA-APPROVED
AUTONOMOUS AI SYSTEM, WHICH YOU
SORTED HIGHLIGHTED THERE, BUT
YOU ALSO SHOWED THIS SLIDE OF
THE NUMBER OF CURRENT
FDA-APPROVED AI SYSTEMS IN 2024
AND RADIOLOGY IS NUMBER ONE BY A
PRETTY WIDE MARGIN.
AND AS I REMEMBER, I THINK WE'RE
NUMBER SIX.
WHICH DIDN'T MAKE IT ON TO YOUR
SLIDE BECAUSE I THINK IT ONLY
COVERED FOUR THINGS.
AND THE WAY THAT I SOMETIMES
LOOK AT IT IS THAT WE STARTED
OUT EARLY PRETTY FAST OUT OF THE
GATES, AND NOW RADIOLOGY HAS
DONE A LOT MORE IN THE PAST FIVE
YEARS.
AND DO YOU HAVE A SENSE OF WHAT
IS HAPPENING OR WHAT CAN WE BE
DOING, WHAT ARE THEY DOING THAT
WE'RE NOT DOING IN THAT
COMMUNITY?
>> I WISH CHRIS WAS HERE BECAUSE
HE COULD ANSWER THAT WAY BETTER
THAN I'M GOING TO DO.
I THINK CONNECTION WITH THE
SOCIETIES AND BRINGING SOCIETIES
INTO THE PICTURE IS A GREAT
OPPORTUNITY.
YOU WANT TO HAVE A
COMMUNITY-DRIVEN APPROACH AND
THAT'S WHERE YOU WENT.
I THINK A LOT OF TIME WHAT
HAPPENS IS IN TECHNOLOGY-DRIVEN,
LIKE FOR EXAMPLE, LIKE LET'S SAY
OPTICAL IMAGING, WE ALL WORK IN
OUR OWN SILOS, WE ARE NOT REALLY
CONNECTED TO PHYSICIANS AND WE
ARE NOT REALLY CONNECTED TO
MEDICAL PRACTITIONER TO FULLY
UNDERSTAND WHAT ARE THE NEEDS.
SO WE HAVE THE TECHNOLOGY, BUT
WE DON'T KNOW WHERE THAT'S
GOING.
AND ALSO CREATION OF THE
STANDARD.
SO I THINK BRINGING THE
SOCIETIES TOGETHER TO WORK ON A
SPECIFIC STANDARD NEEDED FOR
WHAT NEEDS TO BE DONE OR LOOKED
AT, ALONG WITH THE PARTNERSHIP,
WITH THE MEDICINE AND
TECHNOLOGIES, I THINK THAT IS
GOING TO BE VERY, VERY USEFUL.
>> AFROUZ -- REZA, PLEASE.
>> REZA DANA, BOSTON.
I'M NOT AN AI SPECIALIST, BUT I
DO THINK ABOUT ANALYZING DATA
ALL THE TIME, AND I THINK
PERHAPS TO STATE THE OBVIOUS,
ONE OF THE CRITICAL ASPECTS OF
ANY AI SYSTEM WILL BE ACCESS TO
LARGE AMOUNTS OF RELIABLE
NORMATIVE DATA.
SO THAT'S THE REAL CHALLENGE,
BECAUSE LIKE IN OPHTHALMOLOGICAL
STUDIES, WE OFTEN, LET'S SEE,
LET'S SAY WE DO A LIQUID BIOPSY
AND YOU LOOK AT THE PATIENT
HAVING CATARACT SURGERY WITH OR
WITHOUT, LET'S SAY, DIABETIC RET
NOP THEEL OR SOME TUMOR OR XYZ,
BUT IN FACT EVEN WHEN YOU LOOK
AT THE CATARACT PATIENT, THEY'RE
NOT ENTIRELY NORMAL.
THERE ARE MULTIPLE THINGS THAT
ARE NOT NORMAL ABOUT THEM.
ARE THERE WAYS OF EXTRACTING
THAT DATA US JUST LOOKING AT THE
DELTA.
BUT I THINK TO THE EXTENT THAT
FOR EXAMPLE THERE WERE A LOT OF
AI SYSTEMS BEING APLAYED TO
PATHOLOGY AS WELL.
IN GENERAL RADIOLOGY, THE
GENERAL PROPORTION OF NEGATIVES
TO DISEASE SAMPLES IS HIGHER
THAN, LET SAY, OCTs IN
OPHTHALMOLOGY OR FUNDUS
PHOTOGRAPHS IN OPHTHALMOLOGY.
OR CORNEA PHOTOGRAPHS IN
OPHTHALMOLOGY.
SO WE TEND TO MOSTLY IMAGE
CLEARCUT DISEASE PLUS MANY OTHER
FIELDS HAVE A LOT MORE
INFORMATION ON NON-DISEASE
SUBJECTS.
SO I THINK WE NEED TO THINK
ABOUT THAT AS WELL TO REALLY
SHARPEN OUR DIAGNOSTIC ACUMEN.
>> REZA, THANK YOU.
AND I'VE OFTEN WONDERED, IS THAT
AN OPPORTUNITY FOR PARTNERSHIP
WITH OPTOMETRY OR PRIMARY CARE
WHO MAY BE SEEING SOME MORE
NORMALS.
AND LET'S -- LET ME SUGGEST WE
TAKE ONE MORE THAT'S
AFROUZ-SPECIFIC.
MAUREEN, I SEE YOUR HAPPENED UP
HAND UP INZOOM.
>> YES, THANK YOU VERY MUCH.
EARLIER THIS MORNING, WE WERE
TALKING ABOUT THE CHALLENGES OF
GETTING EYE CARE INTO PRIMARY
CARE, AND I'M WONDERING HOW FAR
OFF DO YOU THINK WE ARE PERHAPS
FROM A PRIMARY CARE POSITION
WHILE THEY'RE OR THERRING A O TA
LIPID PANEL, GETTING A BATTERY
OF TESTS DONE WITH ONE MACHINE
THAT WOULD GIVE US INFORMATION
ON NOT ONLY OCULAR DISEASE BUT
SYSTEMIC CONDITIONS.
ARE WE 10 YEARS AWAY, 50?
>> SOME OF IT IS OUT OF MY HAND
TO PREDICT.
DEPENDS ON THE, YOU KNOW,
REGULAR TRI APPROVAL, SO ON, SO
FORTH, BUT IN TERMS OF
TECHNOLOGY DEVELOPMENT, I THINK
WE ARE -- MY GUESS IS FIVE YEARS
AWAY.
WE ARE NOT THAT FAR AWAY IN
TERMS OF TECHNOLOGY DEVELOPMENT.
NOW THERE'S A SIDE OF THE
TECHNOLOGY DEVELOPMENT AND THE
SIDE OF, LIKE, GETTING IT
ACTUALLY TO CLINICAL APPROVAL,
LET'S SAY ADD ANOTHER FIVE
YEARS, SO MY ESTIMATE, MY
OPTIMISTIC ESTIMATE IS ABOUT 10
YEARS AS YOU MENTIONED.
AND I'M VERY HOPEFUL BECAUSE WE
ARE ALREADY HAVING THE
TECHNOLOGIES, AGAIN, AT THE
POIND OF CPOINT OF CARE, THEY CT
DIFFERENT BIOMARKERS, ASSAYS
THAT CAN BE USED.
A LOT OF -- AND I KNOW THIS IS A
TOPIC THAT DOESN'T BE BROUGHT UP
A LOT, BUT QUANTUM TECHNOLOGIES
AND QUANTUM SENSING IS REALLY
CLOSE TO LOOKING AT THIS ASSAY
THAT CAN DETECT THE MOLECULE AND
PROTEINS AT A SINK EL CELL LEVEL
AND AT THE POINT OF CARE.
SO THESE ARE THE EXCITING
OPPORTUNITIES THAT WE HAVE, AND
AGAIN THE PARTNERSHIP AND
UNDERSTANDING WHAT ARE THE
NEEDS, HOW CAN WE USE THIS
TECHNOLOGY TOWARD THIS BIG NEED
THAT ENGINEERS ARE NOT AWARE OF,
I THINK THAT'S A VERY IMPORTANT
AREA THAT I THINK WE NEED TO
FOCUS ON.
>> AFROUZ, THANK YOU VERY MUCH.
[APPLAUSE]
WE HAVE UNTIL THE TOP OF THE
HOUR FOR A DISCUSSION THAT
REALLY FOCUSES ON WHAT VINU AND
AFROUZ SAID SYNTHETICALLY.
AND I MEAN, MY GUESS IS THAT --
IT LOOKS TO ME LIKE A COUPLE OF
YOU ARE CHOMPING AT THE BIT TO
PUSH THE BUTTON, BUT -- WHICH IS
FANTASTIC.
BUT LET ME JUST SUGGEST THAT IF
I CAN SUMMARIZE WHAT I HEARD,
THERE'S MULTIMODAL AI LARGELY
FOCUSED ON PROTEOMIC DATA, AND
WE HEARD ABOUT IMAGE-BASED DATA,
AND AI AND OTHER STUFF.
SO OBVIOUSLY ONE TOPIC I WOULD
LOVE TO HEAR YOUR THOUGHTS ABOUT
IS WHAT'S AT THE INTERSECTION OF
THESE TWO AREAS.
ANOTHER THING THAT I HEARD IS
GETTING THE BEST PEOPLE
INTERESTED IN THIS AREA.
AFROUZ, ONE OF THE LAST THINGS
YOU SAID.
ANOTHER THING THAT I HEARD IS
GETTING THE BEST TRAINING DATA
IN THERE AND ONE THING REZA
MENTIONED IS DEEMED EXAMPLES AS
WELL AS MORE NORMAL EXAMPLE EXS
REPRESENTING THE WHOLE SPECTRUM.
ANOTHER ISSUE WAS THE REGULATORY
ISSUE, LIKE HOW DO WE GET -- GO
FROM RESEARCH INTO THE REAL
WORLD APPLICATION, AND SOMETHING
THAT SOUNDS LIKE YOU'RE DOING
REALLY WELL IN YOUR COMMUNITY.
I'LL JUST GIVE ONE ANECDOTE, IS
THAT BACK WHEN I WAS AN
ACADEMIC, WE WORKED ON AN AI
PROJECT FOR A PEDIATRIC EYE
DISEASE, AND TOOK TO THE FDA
AFTER WORKING ON IT FOR, YOU
KNOW, QUITE A FEW YEARS.
AND ONE OF THE THINGS THEY SAID
IS, OH, IT WOULD HAVE BEEN GREAT
IF YOU TALKED TO US EARLIER.
WE COULD HAVE ADVISED ON HOW TO
DESIGN YOUR STUDY.
FROM OUR PERSPECTIVE, I WANT TO
MAKE SURE THAT WE CAN CONNECT
THOSE DOTS EARLY SO WE DON'T
HAVE WASTED EFFORT, QUOTE -- ON
DESIGNING STUDIES THAT DON'T
MEET REGULATORY CORRECT DESIGN.
AND SO I WOULD BE -- ANY OF
THOSE TOPICS, I THINK WHAT CAN
WE BE DOING TO ADVANCE THE
COMMUNITY MORE RAPIDLY, MORE
EFFICIENTLY, AND JUST WHAT ARE
THESE OPPORTUNITIES.
SO JUST WITH THAT, THOSE ARE
SOME OF MY THOUGHTS.
BUT PLEASE, ANY COMMENTS OR
QUESTIONS THAT PEOPLE HAVE.
>> I'LL MAKE A COMMENT
SPECIFICALLY WHAT YOU JUST
RAISED, MIKE.
ONE THING THAT'S BEEN
INTERESTING SINCE I'VE BEEN AT
STANFORD ARE SPECIFIC FUNDING
MECHANISMS THAT REQUIRE TWO
FACULTY FROM DIFFERENT
DEPARTMENTS.
WITH THE SPECIFIC INTENTION OF
BRINGING TWO DIFFERENT
APPROACHES OR TWO DIFFERENT
PEOPLE WHERE THE MASHUP IS
PRETTY INTERESTING, BUT THERE'S
THAT SPECIFIC REQUIREMENT THAT
THERE'S TWO TECHNOLOGIES COMING
TOGETHER, AND THAT'S BEEN
SUCCESSFUL AT BRINGING -- WE
TALKED ABOUT MULTI-OMICS AND
DIFFERENT KINDS OF THINGS
TOGETHER OR BRINGING CLINICIANS
AND SCIENTISTS TOGETHER OR
BRINGING DIFFERENT DEPARTMENTS
TOGETHER.
>> VINU, THANK YOU.
>> WHEN I WAS LISTENING TO THE
CONVERSATION, THE FIRST THING I
THOUGHT OF IS WITH THE
DEVELOPMENT OF THE MULTI-OMICS,
IS WHERE IS THE
HYPOTHESIS-DRIVEN RESEARCH
GOING?
AND ARE WE TRAINING YOUNG
SCIENTISTS TO STILL HAVE A
HYPOTHESIS BEFORE THEY EMBARK ON
THEIR OMICS STUDY?
AND A CASE IN POINT, I'M SURE
WE'VE ALL HAD EXPERIENCE OF
REVIEWING PAPERS THAT FELL RIGHT
IN THE CATEGORY THAT YOU WERE
TALKING ABOUT, MIKE, WHERE
THE -- THE COHORTS THAT WERE
BEING EXAMINED WERE TOTALLY
INCORRECT, BECAUSE THE
STATISTICIANS AND THE
BIOINFORMATICS AND ALL THE FOLKS
THAT DID ALL THIS BEAUTIFUL AND
COMPLEX ANALYSIS DIDN'T
UNDERSTAND THE BIOLOGY.
THEY DIDN'T HAVE THE BIOLOGIST
DRIVING THAT FIRST STEP.
AND SO I JUST -- I THOUGHT IT'S
AN INTERESTING POINT FOR US TO
COME HOME TO, WE'RE STILL -- THE
QUESTION STILL -- IT NEEDS TO
HAVE A HYPOTHESIS, EVEN AS
COMPLEX, YOU KNOW -- I JUST HOPE
WE CONTINUE TO FUND
HYPOTHESIS-DRIVEN RESEARCH
THROUGH THE OMICS ERA.
>> MARIA, THANK YOU.
>> A FEW COMMENTS AND A
QUESTION.
TO THIS POINT, I THINK THAT IT'S
VERY IMPORTANT THAT MECHANISMS
ARE USED TO ENHANCE THESE CLAB
COLLABORATIONS.
THE CONSORTIUM MECHANISM HAS
BEEN REALLY GOOD WITHIN THE EYE
INSTITUTE.
YOU KNOW, PERHAPS YOU CAN CREATE
A CONSORTIUM APPROACH BEYOND THE
EYE INSTITUTE.
EYE INSTITUTE -- CONSIDERING
THAT'S THE DIRECTION WE'RE GOING
IN.
WITH THE CONSORTIUM, WE'VE BEEN
PARTICIPATING, REALLY FORCED US
TO HAVE COMMUNICATION WITH OTHER
GROUPS, OTHER THOUGHTS AND
THINKING OUTSIDE THE BOX, SO
MAYBE EXPAND THAT BEYOND THE --
AND SECOND, I WAS VERY EXCITED
WITH THE AUTOIMMUNE PROGRAM.
AS YOU KNOW -- HAS A VERY STRONG
HISTORY -- AND OF COURSE THAT
COULD BE A GREAT COLLABORATION
WITH YOUR PROGRAM.
CAN YOU EXPAND IT A LITTLE BIT
MORE, YOUR PLANS OF APPROACHING
WITH IMMUNE DISEASES?
>> I DON'T THINK I CAN JUST
ALONE APPROACH IT.
I THINK THIS IS SOMEWHERE THAT
WE NEED TO SIT DOWN TOGETHER AND
APPROACH IT AS A GROUP.
BUT THAT'S EVEN HARDER THAN
DISEASES THAT ARE ALREADY KNOWN,
BECAUSE THE PROBLEM WITH
AUTOIMMUNE DISEASE IS, FIRST WE
DON'T UNDERSTAND WHICH ORGANS
ARE BEING IMPACTED EARLY ON, AND
TWO, THE COMPLEXITY OF THIS
DISEASE FOR EACH INDIVIDUAL IS
VERY DIFFERENT.
SO YOU HAVE TO HAVE A COMPLETELY
MULTIDIMENSIONAL DATA.
YOU HAD THAT PROAT KNOW MIX.
THE STUDY THAT YOU MENTIONED
ABOUT THE CHRONOLOGICAL AGE
VERSUS LIKE DISEASES OF THE
ORGAN, AND YOU HAVE TO COMBINE
ALL THIS DATA TOGETHER.
THIS IS WHERE IT SHOULD BEGIN.
I DON'T THINK YOU SHOULD BEGIN
BY JUST SAYING, LIKE -- AND WE
HAVE TO LOOK AT THE EHR DATA.
RIGHT NOW, FOR EXAMPLE, FOR
LUPUS STUDIES, THE DOCTOR GOES
AND THEY LOOK AT -- IT'S NOT IN
MY OPINION THAT QUANTITATIVE.
YOU ASK PATIENT DO YOU HAVE THIS
AND IF YOU, FOR EXAMPLE, CHECK
CERTAIN NUMBERS OF THOSE DISEASE
MANIFESTATION, THEN WOULD YOU
SAY, OKAY, YOU PROBABLY HAVE
THIS AUTOIMMUNE DISEASE OR NOT.
SO I THINK IT'S SO UNKNOWN AND
COMPLEX THAT WE NEED TO START
FROM VERY BEGINNING AND I THINK
TO SOME OF THE POINT THAT
DR. GRANT BROUGHT UP IS THAT WE
REALLY NEED TO LOOK AT THE
HYPOTHESIS-DRIVEN AS WELL TO
FULLY UNDERSTAND AND BE ABLE TO
EVEN LEAVE THESE BIASES IN THE
DATA THAT WE HAVE, BECAUSE THE
MORE COMPLEX DISEASE, THE MORE
LIKELY BIASES YOU ARE GOING TO
HAVE, SO I THINK WE NEED TO
START BRINGING
MULTI-INSTITUTIONAL AND
MULTIAGENCY PARTNERSHIP AND
BRINGING, FOR EXAMPLE, ORWH INTO
THIS AND SOME SORT OF CONSORTIUM
TO START FOCUSING ON THAT.
>> THANK YOU.
>> OTHER COMMENTS OR QUESTIONS
EITHER FOR US OR FOR VINU AND
AFROUZ?
>> I JUST HAD A QUESTION, I
THINK IT APPLIES A LITTLE BIT TO
BOTH.
WHEN YOU'RE THINKING OF A
PATIENT, ESPECIALLY AN AGED
PATIENT YOU'RE GOING TO COME IN
TO DO A PROCEDURE ON, THERE'S
THE PLETHORA OF DRUGS THAT
THEY'RE ON, AND THE LACK OF SIN
RG ASSYNERGY AMONG THE PHYSICIA,
EVEN THE PHARMACIST IS THE ONLY
ONE THAT KNOWS ABOUT DRUG-DRUG
INTERACTIONS.
SO THE QUESTION I HAD WITH
REGARD TO TRYING ELIMINATE THE
BIAS OR ELIMINATED CONFOUNDERS
OF DRUG-DRUG INTERACTIONS, HOW
DETAILED A H HISTORY AND HOW MUH
INFORMATION ARE YOU REALLY
OBTAINING?
BECAUSE YOU DON'T WHAT TO HAVE
DATA THAT IS MORE CONFUSING, AND
TYPICALLY THE AVERAGE
80-YEAR-OLD OR 70-YEAR-OLD
PATIENT IS ON LIKE 10 TO 15
DRUGS AND SUPPLEMENTS, SO IF YOU
ADD THEM ALL TOGETHER.
SO THE DRUGS, THE NUTRACEUTICS,
THE THING FAMILY MEMBER SAID
THIS IS GOING TO HELP YOUR
ARTHRITIS, HOW DO YOU PURIFY,
CLEAN UP YOUR DATA SO THAT
YOU'RE GETTING REAL DAY TALL AND
NOT ALL THIS OTHER STUFF THAT
COULD BE COMPLICATING YOUR --
SOME OF YOUR HOT TOPIC PROTEINS
THAT YOU WERE LOOKING AT?
>> WELL, ONE WAY SPEAKING AS A
NON-OMICS PERSON, YOU CAN STILL
APPROACH THIS IS THAT THANKFULLY
MOST OF US HAVE TWO EYES, AND
ALSO, VERY OFTEN, EVEN IN
CHRONIC DISEASE, THERE'S A VERY
SIGNIFICANT ASYMMETRY BETWEEN
THE TWO EYES.
SO IF YOU'RE ABLE TO GET
ANALYZED FROM BOTH EYES, IMAGES,
WHATEVER IT IS THAT YOU MEASURE
IN THE LIQUID BIOPSY, FROM BOTH
EYES, THEN YOU'RE BASICALLY
LARGELY RIDDING NAVIGATING
AROUND THOSE CONFOUNDERS WHICH
ARE VERY, VERY CRITICAL AND VERY
IMPORTANT.
SO IT NOT ONLY DRUGS.
IT JUST A VARIETY OF GENETIC
FACTORS THAT IMPACT PEOPLE'S
HEALTH, NUTRITION, ENVIRONMENT,
TOXIN EXPOSURE, ET CETERA, ET
CETERA.
BUT AGAIN, IF THERE'S ASYMMETRY,
YOU CAN APPLY THE SAME APPROACH
ALSO TO TREATMENT AS WELL,
NON-OMICS ANALYTICS, IF YOU
WILL, JUST THERAPEUTIC
RESPONSES.
RIGHT?
>> TO ANSWER YOUR QUESTION ABOUT
CON FOUNDERS, MY COLLEAGUES WHO
DO LOTS OF EHR DATA ANALYSIS AND
APPLY AI ALGORITHMS, THEY WOULD
SAY JUST GIVE ME ALL THE DATA.
AND I THINK WHEN WE TRY TO
RATIONALLY APPROACH
DISTINGUISHING CERTAIN FEATURES
OR PUTTING THEM IN COLUMNS,
THAT'S WHEN WE -- IT BECOMES A
VERY DIFFICULT THOUGHT PROBLEM
TO PICK APART SPECIFIC
COMPONENTS.
IN AI, THEY JUST ASK FOR ALL THE
DATA AND THEY WILL LET THEIR
ALGORITHMS, THE STATISTICAL
TESTS, WEED THROUGH EVERYTHING.
AND THE AI, THE WAY I VIEW IT, I
THINK YOU'VE GOT TO SLIDE,
SPHRITS A STATISTICAL TEST THAT
EXPOSES PATTERNS THAT YOU
WOULDN'T SEE BY CONVENTIONAL
STATISTICAL TESTING OR YOU
COULDN'T PICK OUT YOURSELF.
I'M ALWAYS STRUCK BY ONE OF THE
EARLY THINGS THAT THE AI IMAGING
OF A FUNDUS WAS THAT I CAN TELL
THE DIFFERENCE TWOAN THAT MALE
AND FEMALE.
I WAS LIKE, WAIT A MINUTE,
OPHTHALMOLOGISTS HAVE BEEN
LOOKING AT THE FUNDUS OF HUMANS
FOREVER AND NOBODY EVER COULD
DISTINGUISH A MALE AND FEMALE.
SO PATTERNS EMERGE.
SO USUALLY THEY JUST WANT MORE
DATA, AND THEY CAN SIFT THROUGH
THE NOISE.
>> WHAT IS A GOOD NUMBER ON A
COHORT OF PATIENTS THAT YOU'RE
TALKING ABOUT HERE?
YOU DID A LOT OF PATIENTS, THE
AQUEOUS -- THE LIQUID BRIEPS,
THE COHORT THAT YOU'VE EXAMINED
FOR A LONG PERIOD OF TIME, BUT
IF YOU'RE READING THE LITERATURE
AS A NON-AI PERSON AND YOU HAVE
A COHORT THAT IS 9,000 VERSUS A
COHORT THAT IS 900, WHAT IS THE
MINIMUM?
CAN YOU SHED SOME LIGHT ON SOME
OF THAT?
THAT WOULD BE REALLY HELPFUL.
>> SO I'M NOT THE EXPERT ON THE
AI ALGORITHM, BUT WHAT I'VE
LEARNED IS THAT IT USED TO BE
THOUSANDS, THEY WOULD HAVE
THOUSANDS OF PATIENTS AND THAT
WAS -- YOU HAD TO START THERE.
OURS WAS A RELATIVELY WIMPY
DATASET.
WE HAVE LIKE A COUPLE HUNDRED
PATIENTS BECAUSE IT'S A LOT OF
WORK TO GET THE FLUID OUT OF THE
EYE AND SO OUR R -- WHAT I'VE
BEEN RECENTLY TOLD IS THAT THE
NUMBER OF SAMPLES REQUIRED BASED
ON THE NEWER AI ALGORITHMS HAS
BEEN REDUCED AND REDUCED, SO
THEY'RE NOW COMBINING OUR AI
PROTEOMICS OF ONLY A FEW HUNDRED
PATIENTS WITH AN EHR THAT'S
THOUSANDS OF PATIENTS.
I DIDN'T THINK THAT WOULD BE
ENOUGH, BUT THERE ARE WAYS TO
ADDRESS -- THE NUMBER IS GETTING
LOWER AND LOWER, MY
UNDERSTANDING.
>> YEAH, AND IN TERMS OF DATA
YOU WERE MENTIONING, THIS IS
SOMETHING THAT, FOR EXAMPLE,
MIDRC IS TAKING VERY SERIOUSLY.
BEING CONNECTED TO THAT DOMAIN
IS SPECIFIC BECAUSE IT'S NOT
JUST THE -- BECAUSE YOU WANT TO
MODEL IT BETTER.
BUT THEN TO REDUCE THAT BIAS IN
TERMS OF DATA COLLECTION, WHAT
IS GOOD DATA, WHAT IS NOT, WHAT
ARE THE BA BACKGROUNDS?
SO NOT ONLY DO WE DO ANNOTATION
OF THESE DATA BUT WE START
CURATING THEM BASED ON THE INPUT
FROM THE DOMAIN-SPECIFIC LIKE I
SAY OPHTHALMOLOGIST.
WE NEED TO HAVE THAT IF WE TRULY
WANT TO CREATE -- DONE A
WONDERFUL JOB OF BRINGING THIS
SOCIETY TOGETHER TO SAY NO, YOU
MAILT -- BECAUSE OF THIS FOR
EXAMPLE BACKGROUND INFORMATION,
I DON'T THINK WE SHOULD LIKE,
FOR EXAMPLE, PUT THESE IMAGES IN
THIS CERTAIN CATEGORY OR NOT.
>> MARIA GRANT.
THERE'S ALWAYS A VALIDATION
COHORT, AND SO WHAT CRITERIA, N
OTHER N, OTHER THAN IT JUST A
SECOND INDEPENDENT COHORT, ARE
THERE OTHER FEATURES THAT
PEOPLE -- THAT YOU THINK ARE
IMPORTANT IN CONTRACT, LIKE WHEN
YOU'YOU'RE REVIEWING A PAPER THT
HAS THAT SECOND COHORT, WHAT
WOULD YOU CONSIDER BECAUSE
THERE'S SO MANY VARIABLES HERE.
>> SO I THINK THE INDEPENDENT
COHORT IS JUST AS IMPORTANT AND
DATA SIGN PACIFIC ISLANDERS WILL
USE A SECRETARY DATASET.
WE WERE -- SO YOU MAY DO
SOMETHING AT YOUR INDIVIDUAL
INSTITUTION, AND THEN YOU CAN
FLIP OUT TO WHATEVER IS
PUBLISHED OR FREE.
DATA REAL ANALYSIS, WE DO A LOT
OF THAT.
SO FOR OUR PROTEOMIC DATASET,
FOR EXAMPLE, WE'LL LOOK AT OTHER
PUBLISHED STUDIES THAT ARE DONE
IN DIFFERENT PATIENTS, EVEN
PROTEOMIC PLATFORMS AND IF WE
SEE ANY OF THOSE PROTEINS
REPLICATED, IT'S A VERY, VERY
STRONG INDICATION.
PEOPLE USE THE NIH PUBLIC
DATABASES FOR THE AMD IMAGES,
AND SO I THINK THAT'S PART AND
PARCEL OF THE WORKFLOW.
>> I ACTUALLY HAVE A QUESTION
BUT ANY OTHER COMMENTS OR
QUESTIONS FROM PEOPLE?
I HAVE A QUESTION FOR REALLY
AFROUZ OR VINU OR HOPEFULLY
BOTH.
I'M THINKING IN TERMS OF -- I
HEARD A BUNCH OF THINGS HERE IN
TERMS OF HOW TO ADVANCE THE
FIELD.
WHAT I'M REALLY WONDERING ABOUT
IS HOW TO BEST ADVANCE THE FIELD
AND WHAT WE CAN BE DOING OR WHAT
WE CAN BE DOING TOGETHER TO
ADVANCE THE FIELD.
AND YOU KNOW, ARE THERE THINGS
LIKE -- VICTOR MENTIONED THE
WORD CONSORTIA.
ARE THERE THINGS THAT -- WHAT
WOULD AN IDEAL PROGRAM LOOK
LIKE, KIND OF IN GENERAL TERMS
TO BEST ADVANCE WHAT WE'RE
DOING?
WOULD IT LOOK LIKE INDIVIDUAL --
I'M THINKING BEYOND INDIVIDUAL
R01s, WHICH PEOPLE CAN ALWAYS
DO.
ARE THERE THINGS THAT WE CAN BE
DOING TO BEST ADVANCE AND WHO
WOULD THE PARTNERS BE, WHAT
WOULD IT LOOK LIKE, SO I WOULD
LOVE BOTH OF YOUR THOUGHTS KIND
OF IN BROAD TERMS ABOUT THAT.
>> I THINK THERE ARE DIFFERENT
WAYS WE CAN DO THAT.
I THINK I LIKE THE IDEA OF THE
CONSORTIA A LOT.
YOU CAN TOTALLY BRING THE
PARTNERS TOGETHER, WE CAN HAVE
THE SUPPORT FOR MULTIAGENCY.
SOME OF THESE STUDIES MIGHT BE
BEYOND JUST SUPPORTING IN TERMS
OF R01, MAYBE FOCUSING ON THE
CENTER AND RESOURCE CENTERS.
THOSE ARE BIG AND THEY CONNECT
THE MULTI-INSTITUTION FROM THE
DIFFERENT BACKGROUND BECAUSE
THERE ARE DIFFERENT NEEDS EVEN
ACROSS THE UNITED STATES IN
TERMS OF DIFFERENT DISEASES AND
DIFFERENT STATES HAVE DIFFERENT
PROBLEMS, SO I THINK CREATING
THOSE SORT OF -- WE HAVE --
CENTERS FOR EXAMPLE AND THEY
HAVE DONE A GREAT JOB, SO WE
HAVE THESE CENTERS THAT NOT ONLY
THEY SUPPORT OUR RADX APPLICANTS
IN TERMS OF REGULATORY APPROVAL,
THEY HELP THEM WITH THE CLINICAL
VARIATION OF STUDIES, THEY HELP
THEM GO THROUGH THE STUDY
DESIGN, THEY HELP THEM THROUGH
MAKING THE DEVICE AND BRINGING
TO THE MARKET.
SO I THINK CREATING SOMETHING IN
THAT SENSE THAT THEY'RE
CENTER-BASED AND CAN LOOK TO
SORT OF THE -- MODEL TO CONNECT
DIFFERENT INSTITUTES TOGETHER TO
TAKE CARE OF THE DIFFERENT
PHASES AS WE GO THROUGH, I THINK
THAT WOULD BE VERY IMPORTANT AND
USEFUL.
>> I THINK WE NOW HAVE FAIRLY
COMPLEX TEAMS OF PEOPLE REQUIRED
TO PUT TOGETHER THESE STORIES,
RANGING FROM THE SCIENTISTS, THE
BENCH SCIENTIST TO THE SURGEON,
AND THEN TO THE DATA SCIENTIST.
AND BRINGING THOSE STAKEHOLDERS
TOGETHER IN SOME KIND OF GROUP
AS A CONSORTIA FOR SOME KIND OF
COLLABORATIVE GROUP SO THAT THE
TECHNOLOGIES ARE EXPANDED OUT,
BUT ALL THE STAKEHOLDERS HAVE
SOME INPUT, AND REALLY WOULD
MAKE A BIG DIFFERENCE INSTEAD OF
ALWAYS GROWING IT IN A SINGLE
R01, A SINGLE TEAM AT A SINGLE
INSTITUTION.
>> THESE ARE GREAT IDEAS.
>> I KNEW THIS WAS GOING TO BE
FABULOUS.
YOU KNOW, YOU BOTH REALLY DID
BEAUTIFULLY.
THANK YOU VERY MUCH.
VINU, AFROUZ, GREAT DISCUSSION.
LOOK FORWARD TO HOPEFULLY
CONTINUING SOME OF IT OVER
LUNCH.
SO FIRST OF ALL, THANK YOU.
[APPLAUSE]
>> THANK YOU.
THIS WAS TERRIFIC.
REALLY APPRECIATE IT.
BEFORE WE BREAK FOR LUNCH, AND
OUR PIZZA, I BELIEVE, IS HERE,
SO PROBABLY GETTING COLD, WE'RE
GOING TO HAVE AN UPDATE FROM DRN
MULTI-COUNCIL WORK GROUP, WHICH
MET A COUPLE WEEKS AGO, IN MAY,
I BELIEVE.
SO THANKS.
>> THE FOOD IS ALREADY HERE SO
I'LL DO THIS QUICKLY.
YEAH, SO THE BRAIN INITIATIVE
MULTI-COUNCIL WORKING GROUP
MEETING WAS JUST HELD.
AND -- BACK IN MID MAY, AND
DURING THE MEETING, THE DIRECTOR
AND I BEGAN FIRST BY
ACKNOWLEDGING ALL THE KEY STAFF
MEMBERS AND CONTRIBUTORS, BOTH
AT THE DIRECTOR'S OFFICE AS WELL
AS EACH OF THE ASSOCIATE
INSTITUTES AND THOSE WHO LEAD
THE MAJOR TEAMS.
THEN, THE DIRECTOR THEN PROVIDED
A BRIEF OVERVIEW OF THE STATUS
OF THE BUDGET, WHICH WE'VE HEARD
A FEW THINGS ABOUT.
SO THE BRAIN INITIATIVE HAS
ENJOYED ROBUST FUNDING SINCE
2014, WHEN IT STARTED.
AND ITS TOTAL BUDGET FOR FISCAL
YEAR '23 WAS AT ITS APEX.
AND THIS OCCURRED DESPITE A
SUBSTANTIAL REDUCTION IN THE
BRAIN INITIATIVE BASE BUDGET TO
ABOUT HALF OF ITS FY -- HALF ITS
BUDGET THE PREVIOUS YEAR.
AND THAT INCREASE WAS DUE TO A
LARGE BUT TEMPORARY INCREASE IN
THE PORTION OF THE BUDGET
DERIVED FROM THE CURES ACT.
UNFORTUNATELY, THAT TEMPORARY
INCREASE IN SUPPORT FROM THE
CURES ACT WAS REDUCED BACK
TOWARD ITS PREVIOUS YEAR'S
LEVELS FOR THE CURRENT YEAR, AND
SO AS MANY FOLKS HAVE ALREADY
HEARD, THE PRAIN INITIATIVE
SUBRAIN INITIATIVESUSTAINED A PT
SETBACK THIS BUDGET YEAR.
SPECIFICALLY THE REDUCTION OF
ABOUT $280 MILLION.
NEVERTHELESS, THE DIRECTOR
STRESSED THAT THE INITIATIVE
PLANS TO CONTINUE TO BE A GOOD
SHEPPARD, A GOOD STEWARD OF THE
FUNDS THAT CONGRESS HAS
ENTRUSTED IT WITH AND TO FUND
THE BEST SCIENCE, THE BEST
EXISTING SCIENCE.
THERE WAS ALSO HOPE, OF COURSE,
IN THE NEXT YEAR OR TWO THAT
THERE WILL BE AT LEAST SOME
RESTORATION OF FUNDS TO ALLOW
THE INITIATIVE TO GET BACK ON
TRACK SINCE IT HAS BEEN DOING
VERY WELL.
IN SPITE OF THE SUBSTANTIAL
REDUCTION IN AVAILABLE FUNDS FOR
THE CURRENT YEAR, THE WAY THAT
THE BRAIN INITIATIVE MANAGES ITS
FUNDS, IT'S ABLE TO COVER ALL
THE OUTYEAR COMMITMENTS WITH
ONLY SLIGHT ADJUSTMENTS, SO
ABOUT 10% DECREASED ON THE
OUTYEAR COSTS FOR MOST FORT
PROJECT BUT NOT ALL OF THE
PROJECTS.
THIS WAS DESCRIBED IN AN
ANNOUNCEMENT BACK IN APRIL.
MANY OF YOU MAY HAVE READ IT.
AND LAST THE REDUCTION ALSO
MEANS -- IN THIS BUDGET ALSO
MEANS THAT BRAIN WILL NEED TO
SEVERELY REDUCE THE NUMBER OF
AWARDS MADE THIS AND LIKELY NEXT
YEAR.
IN ADDITION, BRAIN HAS BEEN
CANCELING SOME OF THE NOFOs IN
PARTICULAR AREAS OF THE BRAIN
INITIATIVE AS -- YEAH, IT'S A
BIT OF A DOWNER.
OKAY.
SO THEN THE DIRECTOR NEXT
SHIFTED INTO SLIGHTLY MORE
POSITIVE NEWS BY WRECK NEEDING
SOME RECENT HONORS AND AWARDS
RECEIVED BY INVESTIGATORS WHO
HAVE BEEN INVOLVED IN BRAIN
INITIATIVE PROJECTS.
THIS INCLUDES LARRY ADDBUT AND
SAM -- AND -- WHO RECEIVED THE
BRAIN PRIZE.
HE ALSO RECOGNIZED BRAIN
INITIATIVE INVESTIGATORS WHO ARE
NEWLY ENACTED MEMBERS OF THE
AMERICAN ACADEMY, NATIONAL
ACADEMY OF SCIENCE.
THERE ARE QUITE A FEW.
NECK THE DIRECTOR SUMMARIZED
SOME OF THE RECENT BRAIN
INITIATIVE EVENTS, AND THESE
EVENTS INCLUDE A RECENT REQUEST
OF THE BRAIN INITIATIVE TO THE
10ICs FOR THEIR PERSPECTIVES
ON THE IMPACT OF THE BRAIN
INITIATIVE ON THEIR ICs'
INITIATIVES.
THUS FAR, THERE HAVE BEEN A FEW
ARTICLES PUBLISHED THAT HAVE
BEEN PROVIDED WITH MORE TO COME.
THEY'VE ALL -- THE FIRST TWO ARE
VERY KIND OF INSPIRING AND
ENCOURAGING THE IMPACT THE
BRAIN HAS HAD ON THE MISSION OF
THE ICs.
AS ALWAYS, BRAIN HOLDS WORKSHOPS
AND THE DIRECTOR HIGHLIGHTED A
RECENT WORKSHOP ON ADVANCING
HUMAN NEUROSCIENCE THROUGH
NEURAL STIMULATION AND
RECORDING.
THAT WAS HELD AT THE END OF MAY.
AND IN ADDITION TO THE
WORKSHOPS, THERE'S ALSO THE
UPCOMING TENTH ANNUAL BRAIN
INITIATIVE CONFERENCE, WHICH
WILL BE HELD IN JUNE.
IT'S A HYBRID FORMAT, AND OF
COURSE THE PURPOSE IS TO
CONTINUE TO BUILDED BRAIN
COMMUNITY AND TO PROVIDE A FORUM
FOR DISCUSSING ALL THE EXCITING
DEVELOPMENTS AND NEW DIRECTIONS
AND COLLABORATIONS.
THE DIRECTOR PROVIDED SOME
UPDATES ON BRAIN AWARDS
INCLUDING THE DISTRIBUTION OF
BRAIN FUNDED INVESTIGATORS
ACROSS THE U.S. AND ACROSS --
WHICH SO FAR IT'S 30 OF 50
STATES, PRETTY DECENT OVER THE
YEARS.
WE ALSO DISCUSSED SOME OF THE
CHALLENGES OF DIVERSIFYING A
POOL OF FUNDED BRAIN
INVESTIGATORS AND SCHOLARS AND
DESCRIBED THE CURRENT PLANS AND
INITIATIVES AIMED AT ADDRESSING
THOSE CHALLENGES.
FOLLOWING THE UPDATE DISCUSSIONS
AND QUESTIONS AFTER THAT UPDATE,
WE'RE NATURALLY FOCUSED ON HOW
THE BRAIN INITIATIVE PLANS TO
HANDLE THE SUBSTANTIAL DECREASE
IN ITS BUDGET, FOR EXAMPLE, HOW
IT PLANS TO CONTINUE TO SUPPORT
TRAINING, WHICH PROJECTS AND
PRIORITIES SHOULD BE EMPHASIZED
FOR THE INITIATIVE, SO THAT WAS
A MAJOR SOURCE OF DISCUSSION.
ANY CASE FOR MORE DETAILS ON THE
UPDATES, I ENCOURAGE YOU TO VIEW
THE POSTED RECORDING OF THE
MEETING AND THAT'S PROBABLY
ENOUGH.
WE CAN GO EAT.
>> THANK YOU.
AND I WILL SEND A LINK TO THE
MULTI-COUNCIL WORK GROUP MEETING
IF YOU'RE INTERESTED IN SEEING
IT.
AND THANKS FOR ENDING ON A MORE
POSITIVE NOTE ABOUT THAT.
OKAY.
SO WE ARE AT LUNCHTIME.
WE'RE GOING TO HAVE LUNCH WHERE
WE USUALLY DO UP ON THE THIRD
FLOOR, BUT IF DUSTIN HAS A
MINUTE, I WOULD LOVE TO GET A
PICTURE OF US ALL BEFORE YOU DO
THE BIO BREAK AND THEN WE CAN
HEAD UP TO LUNCH.
SO WE'LL JUST MEET OUT,
COUNCILMEMBERS AND OUR SPEAKERS
AND LEADERSHIP WILL MEET OUT IN
THE LOBBY AND WE'LL SNAP A QUICK
PICTURE FOR THIS MEETING, AND
THEN WE'LL BE BACK FOR -- WE'LL
BE BACK AT 1:00 AND WE'LL STILL
BE IN THE OPEN SESSION. THANKS.
SEE YOU LATER, MAUREEN.
I HOPE EVERYBODY ENJOYED THEIR
LUNCH.
PLEASE GO AHEAD AND TAKE YOUR
SEAT.
WE ARE STILL IN THE OPEN
SESSION.
AND WE HAVE A LITTLE BIT MORE
BUSINESS TO DO.
GREAT.
THANKS.
OKAY.
SO FOR THE REMAINDER OF THE OPEN
SESSION, WE HAVE TWO CONCEPT
CLEARANCES TO PRESENT TO YOU FOR
YOUR CONSIDERATION.
JUST A REMINDER AS WE BRING
CONCEPTS THAT WE'VE DEVELOPED
FOR POTENTIAL FUNDING
INITIATIVES, AND WE BRING THEM
TO YOU TO GET YOUR INPUT AND TO
GET YOUR APPROVAL OR NOT TO MOVE
FORWARD WITH DEVELOPING THE
INITIATIVE.
SO WE LOOK FORWARD TO YOUR
FEEDBACK.
THE FIRST CONCEPT IS GOING TO BE
PRESENTED BY DR. SANGEETA
BHARGAVA.
>> THANK YOU.
GOOD AFTERNOON, EVERYONE.
MY NAME IS SANGEETA BHARGAVA,
AND I'M GOING TO BE PRESENTING
THE FIRST CONCEPT TODAY, WHICH
IS THE NEI NEW INNOVATOR AWARD.
BEFORE I MOVE MY SLIDES TO THE
NEXT ONE, I DO WANT TO THANK MY
TRAINING COLLEAGUES, WHO HELPED
ME A LOT IN THIS CONCEPT AND
THINKING ABOUT IT VERY CLEARLY.
SO TODAY'S TALK IN THE
DIRECTOR'S AWARD, DR. CHIANG
POINTED OUT IN THE NEI STRATEGIC
PLAN, ONE OF THE CORNERS WE HAVE
IS RECRUIT, INSPIRE AND TRAIN A
TALENTED AND A DIVERSE NEW
GENERATION OF INDIVIDUALS TO
EXPAND AND STRENGTHEN THE VISION
WORKFORCE.
THE GOAL OF THIS CONCEPT IS TO
SUPPORT POSTDOCTORAL AS WELL AS
OTHER CANDIDATES IN
NON-INDEPENDENT POSITIONS OR
NEWLY INDEPENDENT EARLY STAGE
INVESTIGATORS THAT SHOW
EXCEPTIONAL CREATIVITY, WHO
PROPOSE NOVEL, ORIGINAL AND
INSIGHTFUL RESEARCH CONCEPTS
WITH THE POTENTIAL TO PRODUCE A
MAJOR IMPACT, TEST SCIENTIFIC
PARADIGMS, OR ADVANCE KEY
CONCEPTS ON TACKLING SOME OF THE
IMPORTANT PROBLEMS RELATED TO
THE NEI.
THE RATIONALE FOR THIS CONCEPT
CAME FROM TWO OBSERVATIONS.
THE FIRST ONE WAS THAT WE'VE
BEEN MONITORING THE PERCENTAGE
CHANGE OF F32 SUBMISSION FOR THE
LAST FIVE YEARS.
AND ON MY RIGHT -- ON THE
RIGHT-HAND SIDE OF THIS IS A
LINE GRAPH WHICH IS DESCRIBING
THE PERCENTAGE CHANGE IN THE F3O
PRESENT.
THAT'S '24.
, THE X AXIS IS DENOTING THE
YEARS THAT YOU CAN SEE HERE, AND
THE Y AXIS DENOTES THE
PERCENTAGE FROM ZERO TO 140.
WHAT WE DID SEE IN THE LAST FIVE
YEARS, THAT THERE WAS A DRAMATIC
DROP IN THE F32 SUBMISSIONS.
THIS IS FROM 2019 TO 2024, MORE
THAN 50% DROP OUT.
WHEN WE COMPARED THIS TREND WITH
OUR OTHER SISTER AGENCIES AND
THESE WERE NIDCD, WHICH IS THE
DEAFNESS AND COMMUNICATIONS
DISORDER, THE NINDS, WHICH IS
THE NATIONAL INSTITUTE OF
NEUROLOGY AND STROKE, AND AS
WELL AS THE NATIONAL INSTITUTE
OF MENTAL HEALTH, WE FOUND A
SIMILAR TREND THAT THERE WAS A
PERCENTAGE DECREASE IN THE
F32 SUBMISSIONS.
THE SECOND OBSERVATION WAS
AROUND 2022, THERE WAS AN
ADVISORY COMMITTEE THAT WAS SET
UP TO REENVISION THE NIH
SUPPORTED POSTDOCTORAL TRAINING,
AND THE WORKING GROUP CHARGE WAS
TO EXPLORE THE POSTDOCTORAL
TRAINING SYSTEM, IDENTIFY AND
UNDERSTAND THE CRITICAL FACTORS
AND ISSUES THAT WERE RELATING TO
ITS DECLINE OF POSTDOCTORAL
FELLOWS, AND AT THE SAME TIME,
PROVIDE US WITH RECOMMENDATIONS
TO ADDRESS THOSE FACTORS.
SO LAST YEAR IN LATE 2023, THE
ADVISORY COMMITTEE DID PROVIDE
US WITH SIX RECOMMENDATIONS.
THE RECOMMENDATIONS WERE BASED
ON IMPROVING THE POSTDOCTORAL
EXPERIENCE FOR THE POSTDOCTORAL
SCHOLARS AS WELL AS FOR THE
BROADER BIOMEDICAL ECOSYSTEM.
AND I'M GOING TO GO THROUGH EACH
ONE OF THESE RECOMMENDATIONS, SO
BEAR WITH ME, PLEASE.
THE RECOMMENDATION ONE WAS TO
INCREASE PAY AND BENEFITS FOR
ALL NIH-SUPPORTED POSTDOCTORAL
SCHOLARS.
THAT WAS THE TOP PRIORITY AND AS
ALL OF YOU KNOW, THE HIV HAS
IMPLEMENTED THAT.
RECOMMENDATION TWO, CREATE AND
EXPAND MECHANISMS TO SUPPORT THE
FULL TALENT OF POSTDOCTORAL
SCHOLARS.
RECOMMENDATION THREE, FACILITATE
THE TRANSITION OF POSTDOCTORAL
SCHOLARS INTO THE NEXT CAREER
STAGE, INCLUDING ROLES BEYOND
ACADEMIC FACULTY.
RECOMMENDATION FOUR, PROMOTE
TRAINING AND PROFESSIONAL
DEVELOPMENT OF POSTDOCTORAL
SCHOLARS AND THEIR MENTORS.
RECOMMENDATION FIVE, SUPPORT
SAFE AND DIVERSE PERSPECTIVES
AND RESEARCH ENVIRONMENTS WITHIN
INSTITUTIONAL RESEARCH PROGRAMS.
AND THE LAST RECOMMENDATION WAS
TO IMPROVE MEANS TO MEASURE AND
SHARE POSTDOCTORAL SCHOLARS AND
CAREER PROGRESSIONS.
SO INCORPORATING ALL THE
RECOMMENDATIONS THAT WERE
PROVIDED BY THE ADVISORY
COMMITTEE TO THE DIRECTOR
WORKING GROUP, THIS NEW CONCEPT,
WHICH IS THE NEI NEW INNOVATOR
PROGRAM, HAS TWO FOCUSES, BOTH
PROGRAM AS WELL AS THE
PERSON-FOCUSED.
SO WE HAVE THE FOLLOWING
OBJECTIVES.
ONE IS THAT THIS PROGRAM WILL BE
AVAILABLE TO BOTH U.S. AND
NON-U.S. CITIZENS IN U.S.-BASED
INS TUESDAYS.
THE APPLICANTS FOR THIS AWARD
MUST HAVE A RESEARCH OR A
CLINICAL DOCTORATE OR BOTH.
THE APPLICANTS WILL BE
ENCOURAGED TO EMPHASIZE
INNOVATION AND CREATIVITY.
THE REVIEW PROCESS WILL BE
DIFFERENT FROM THAT OF THE USUAL
R01, WHERE IT WILL BE -- THE
EMPHASIS WILL BE ON THE
INDIVIDUAL'S CREATIVITY, THE
INNOVATIVENESS OF THE RESEARCH
APPROACHES, AND THE POTENTIAL OF
THE PROJECT, WHAT ITS
SIGNIFICANT IMPACT WOULD BE ON
THE NEI MISSION.
LASTLY, THE APPLICANTS PROPOSING
UNEXPECTED CONVERGENCE OF
DISCIPLINES, NEW SCIENTIFIC
DIRECTIONS, WILL BE ENCOURAGED,
AND INDIVIDUALS FROM DIVERSE
BACKGROUNDS IN ANY TOPIC
RELEVANT TO THE MISSION OF THE
NEI WILL BE ENCOURAGED.
SO JUST ULTIMATELY THE AIM IS TO
FACILITATE THE MOVEMENT OF
TALENTED POSTDOCTORAL SCHOLARS
AND CANDIDATES IN
NON-INDEPENDENT POSITIONS INTO
MORE INDEPENDENT POSITIONS, AND
TO SUPPORT TALENTED NEW
INVESTIGATORS AT THE SAME TIME.
AND WITH THAT, I'M HAPPY TO TAKE
ANY QUESTIONS AND THANK YOU FOR
YOUR ATTENTION.
>> THANK YOU, SANGEETA.
SO I WENT AHEAD AND ASSIGNED A
COUPLE OF DISCUSSANTS FOR THIS
JUST TO KICK OFF THE DISCUSSION,
BUT WE ALSO WANT TO HEAR
EVERYBODY'S INPUT ON THIS.
WE HAVE ABOUT 10 MINUTES FOR
THIS.
SO I'M GOING TO -- FOR THIS ONE,
I ASSIGNED DRS. DANA AND MOORE,
SO LET ME START WITH DR. DANA.
>> THANK YOU.
THANK YOU FOR THE PRESENTATION,
REZA DANA FROM BOSTON.
THE DROP IN POSTDOCTORAL
SCHOLARS IS INDEED PRECIPITOUS.
THAT IS ALARMING BUT CERTAINLY
NOT SURPRISING.
AND THERE ARE MANY REASONS FOR
THIS.
THIS IS CERTAINLY A
MULTIFACTORIAL PROBLEM.
WE ALL KNOW THE CHALLENGES FACED
BY P.I.s, AND I THINK
POSTDOCTORAL SCHOLARS SEE THAT.
HISTORICALLY, WHEN THE FEDERAL
SITUATION BECAME PROBLEMATIC,
INDUSTRY WAS ABLE TO STEP IN,
AND I THINK IN THE LAST FEW
YEARS, WE KNOW THAT'S FINANCING
OF NEW TECHNOLOGIES, ESPECIALLY
IN THE OPT T OPHTHALMIC AREA HAN
VERY PROBLEMATIC AND, THEREFORE,
RATHER BLEAK FOR BOTH P.I.s AS
WELL AS POSTDOCS WHO ARE
CONSIDERING CAREERS IN THE
FIELD.
SO OF COURSE ANY MEASURE THAT
WILL HAVE A MEANINGFUL IMPACT ON
THIS DECLINE SHOULD BE SUPPOR
SUPPORTED, HOWEVER, WE NEED TO
PUT THIS IN CONTEXT AND FIND
OUT, FOR EXAMPLE, HOW MANY OF
THESE ARE BEING CONTEMPLATED TO
BE FUNDED?
IF THE NUMBERS ARE NOT
SUFFICIENT, THIS WILL
ESSENTIALLY BECOME A PRIC PRIZET
WILL LOOK GOOD ON SOMEONE'S CV
BUT DOUBTFUL THAT IT WILL IMPACT
AT ALL THE TREND.
THAT'S WHAT WE'RE SEEING RIGHT
NOW.
SO I THINK THE NUMBERS OF THESE
AWARDS SHOULD BE CONSIDERED.
I PERSONALLY WOULD RATHER SEE
MORE OF THESE WITH LESS, IF YOU
WILL, DOLLAR AMOUNTS PER AWARD
AS OPPOSED TO A LARGE CHUNK THAT
WILL BE, AGAIN, VERY PRESTIGIOUS
FOR THE RECIPIENT BUT NOT
PARTICULARLY MEANINGFUL FOR THE
FIELD AND FOR THE COMMUNITY.
THESE MEASURES, AGAIN, DEPENDING
ON WHAT THEY ARE, CAN BE
SELF-LIMITING IN THE EFFECT THAT
THEY HAVE, BUT I THINK ALL
THINGS CONSIDERED, I THINK IT'S
A GOOD IDEA.
ONE QUESTION THAT I HAVE IN
ADDITION TO THE NUMBER THAT
YOU'RE CONTEMPLATING IS, WHAT
OTHER INSTITUTES AT THE NIH HAVE
SIMILAR MECHANISMS?
I'M ASSUMING THAT YOU'RE
MODELING THIS AFTER
ALREADY-EXISTING PROGRAMS.
THANK YOU.
>> THANK YOU, REZA, FOR THAT
QUESTION.
SO THERE IS A COMMON FUND THAT
HAS A SIMILAR MODEL, AND THEY
HAD STARTED IN 2014, SO THERE IS
10 YEARS DATA OF THAT.
BUT MORE RECENTLY, NIAID HAS
THEIR OWN DP2 PROGRAM, AND THEY
STARTED IN 2019, AND THEY HAVE
JUST REISSUED THEIR -- AGAIN,
THEIR FUNDING OPPORTUNITY, AND
THEY HAVE HAD VERY GOOD SUCCESS
IN BRINGING POSTDOCTORAL FELLOWS
INTO MORE INDEPENDENT POSITIONS,
AS WELL AS THE NEW EARLY STAGE
INVESTIGATORS GETTING THESE
AWARDS AND GOING ON TO GETTING
THEIR SUBSEQUENT R01s OR
R21s, WHATEVER THEY NEED, SO
THEY'VE HAD VERY GOOD SUCCESS.
AND THERE ARE SOME LESSONS
LEARNED FROM THAT INSTITUTE THAT
I HAVE BEEN TALKING WITH THEM.
SO IT'S BEEN VERY ENCOURAGING
ACTUALLY TO SEE THAT.
>> AND APPROXIMATELY HOW MANY OF
THESE AWARDS DO YOU ANTICIPATE
COMING FROM THE NEI?
>> SO IT ALL DEPENDS, A, ON THE
BUDGET AS YOU KNOW FOR
EVERYTHING.
IT ALSO DEPENDS ON THE
MERITORIOUS APPLICATIONS, BUT
OUR INTENT IS TO SUPPORT AS MANY
AS MERITORIOUS APPLICATIONS AS
WE CAN.
>> THANK YOU.
>> I GUESS I'M SO STRUCK BY THE
NUMBERS THAT YOU SHOWED, F32s.
IS THERE MORE INFORMATION ON THE
BASIS OF THAT OR -- BECAUSE IF
IT'S ACROSS INSTITUTES, WHAT WAS
DRIVING -- WHAT'S DRIVING THAT
OR WHAT DO WE THINK IS DRIVING
THAT?
>> WELL, WHEN YOU LOOK AT THE
ADVISORY COMMITTEE REPORT, THERE
WERE MULTIPLE FACTORS.
I THINK ONE OF THEM THAT REALLY
CAME OUT WAS THE SALARY.
THE SECOND ONE, YOU KNOW, WAS
COVID EPIDEMIC, THAT WAS ANOTHER
FACTOR THAT CAME OUT, BUT THERE
WERE MULTIPLE THINGS THAT CAME
OUT, AND ALSO THE SALARY WAS ONE
OF THE BIG THINGS FOR MAKING THE
POSTDOCS GOING TO INDUSTRY MORE
THAN GOING INTO MORE INDEPENDENT
ACADEMIC PLACES.
ALSO, YOU KNOW, A LOT OF
INSTITUTIONS TRYING TO HOLD ON
TO POSTDOCTORAL -- NOT GIVING
THE POSTDOCTORAL NAME BUT HAVING
SOME DIFFERENT NAMES WHICH ARE
RATHER NON-INDEPENDENT, I THINK
WAS ANOTHER FACTOR THAT CAME
OUT.
SO THERE WERE MULTIPLE FACTORS
THAT CAME OUT INTO THAT REPORT
THAT LED TO THESE
RECOMMENDATIONS.
>> I SEE.
I GUESS FOR THE NEW INNOVATOR
AWARD, I NOTICE IT SAYS BOTH
U.S. AND NON-U.S. CITIZENS.
>> YES.
>> AM I WRONG THAT THAT'S A
NOVELTY?
>> YES.
>> OKAY.
THAT'S -- OKAY.
>> I MEAN, I THINK BECAUSE THE
POSTDOCTORALS -- I THINK THERE
WAS FOR BOTH U.S. AND NON-U.S.
CITIZENS, YES, TO BE -- BUT THE
INSTITUTION THAT CAN APPLY WOULD
BE A U.S.-BASED INSTITUTION.
>> RIGHT.
>> THE APPLICANTS CAN BE U.S.
CITIZENS OR NON-U.S. CITIZENS.
>> OKAY.
MAYBE I'VE JUST FORGOTTEN, BUT
REMIND ME, FOR THE TRADITIONAL
F32s, YOU HAVE TO BE A U.S.
CITIZEN?
>> SORRY?
>> FOR THE F32s, YOU HAVE TO
BE A CITIZEN OR RESIDENT FOR THE
F32?
>> FOR THE F32, I'M GOING TO
ASK --
>> FOR THE POSTDOCTORAL
FELLOWSHIPS, THE F32, YOU DO
NEED TO BE A U.S. CITIZEN.
>> RIGHT, SO HENCE MY QUESTION.
SO FOR THIS MECHANISM, THE FACT
THAT YOU DON'T HAVE TO BE A U.S.
CITIZEN IS PRETTY REMARKABLE AND
NOVEL.
>> YES.
>> SO THAT WAS --
>> AND THIS IS A RESEARCH GRANT.
IT'S NOT A FELLOWSHIP GRANT.
>> GOT IT.
GOT IT.
BUT -- OKAY.
NO, THAT'S CLEVER.
THINK IT CLEVER.
>> KEEP GOING.
IT'S FINE.
>> YEAH, I THINK IT'S CLEVER.
BUT JUST, YOU KNOW, WELL, ONE, I
THINK IT'S A GOOD IDEA, AND TWO,
I JUST WONDERED IF IT WAS
DIFFICULT TO DO THAT, BECAUSE
FOR THESE EARLY STAGE THINGS, IT
IS -- YOU'RE A RESEARCHER BUT
ALSO THERE'S A TRAINING
COMPONENT TOO AND YOU'RE
STILL -- YOU'RE YOUNG.
ANYWAY, THAT'S ALL.
I THINK IT'S A GREAT IDEA.
IT POPPED OUT AT ME.
IT WASN'T REALLY A QUESTION
THERE, I GUESS.
I MISSED THE ANSWER TO THE
QUESTION ABOUT HOW MANY -- OR --
DO YOU EXPECT TO FUND?
>> HOW MANY?
AS I JUST ANSWERED REZA, YOU
KNOW, IT DEPENDS ON HOW MANY WE
GET, AND I HOPE OUR THING WOULD
BE TO DO AS MANY AS MERITORIOUS
APPLICATIONS WE CAN FUND.
>> I'M GOING TO ADD TO THAT,
MAYBE I CAN CLARIFY AND THEN
WE'RE GOING TO CALL ON MAUREEN,
I THINK -- WELL, UNLESS TIRIN'S
NOT FINISHED.
SO WE'RE NOT -- MAYBE THIS IS
MORE -- THERE'S NOT A SETASIDE
FOR THESE, SO WE'RE NOT
ADVANCING THAT WE CAN ONLY FUND
FOUR OF THESE, SO IF, YOU KNOW,
MANY, MANY COME IN AND MANY GET
REALLY WELL SCORED, THEN, YOU
KNOW, WE'LL PRIORITIZE THEM JUST
AS WE DO OTHER EARLY STAGE
INVESTIGATORS.
SO I THINK GETTING TO YOUR
POINT, REZA, IF WE ONLY FUND ONE
OR TWO OF THESE, WE'RE NOT
REALLY DOING ANYTHING S BUT I
WANTED TO BE SURE YOU UNDERSTAND
THAT WE'RE NOT EVADING THE
ANSWER.
YOU KNOW, IT REALLY DOES DEPEND
WHAT WE GET, AND, YOU KNOW,
WE'RE NOT LIMITED IN WHICH ONES
WE CAN SELECT.
I MEAN, WE'RE LIMITED BY OUR
BUDGET BUT --
>> SO JUST, REZA, TO YOUR
QUESTION AND TO TIRIN'S, IT'S
GOING TO BE MORE ON A PAR, IT'S
NOT LIKE AN RFA WHERE WE KEEP
ASIDE MONEY FOR IT.
SO IT DEPENDS ON HOW MANY WE
GET.
AND THE OTHER INSTITUTIONS HAVE
BEEN VERY LUCKY TO GET MANY
APPLICANTS.
SO I HOPE THAT'S THE CASE FOR US
TOO.
>> HI, MAUREEN MAGUIRE.
I LIKE VERY MUCH THE
RECOMMENDATIONS FOR THE
IMPROVING THE OVERALL POSTDOC
EXPERIENCE.
AND WITH THE LARGE DECREASE IN
THE NUMBER OF POSTDOC POSITIONS,
HAS THIS BEEN REFLECTED IN ANY
WAY IN THAT THERE ARE NOT
SUFFICIENT NUMBERS OF PEOPLE
COMING OUT OF PROGRAMS, BEING --
OR ARE THERE JOBS THAT ARE NOT
BEING FILLED BECAUSE OF
SHORTAGE, OR DID WE HAVE TOO
MANY POSTDOCS BEFORE?
>> INTERESTING QUESTION,
MAUREEN.
WHEN I LOOKED INTO THE REPORT,
ONE OF THE THINGS THEY SAID,
THAT THE NUMBER OF GRADUATE
STUDENTS HAD BEEN INCREASING BUT
THE NUMBER OF POSTDOCS HAD BEEN
DECREASING, WHAT THEY HAVE BEEN
OBSERVING FOR THE LAST FIVE
YEARS.
SO THERE WAS -- THEY DIDN'T
DIRECT TO WHETHER THERE WERE
LESS POSITIONS AT ALL.
IT WAS THE NUMBER OF
POSTDOCTORAL STUDENTS
DRAMATICALLY DECREASING AND A
LOT OF STUDENTS MOVING INTO
DIFFERENT ARENAS INSTEAD OF
GOING TO THE POSTDOCTORAL ROUTE.
>> REZA, IT LOOKS LIKE YOU HAVE
A COMMENT ON THIS AND VICTOR I
KNOW YOU HAVE YOUR HAND UP.
>> WELL, I THINK THERE'S A THIRD
OPTION, MAUREEN, AND THAT IS,
CONSIDERING THAT AS WE HEARD PF
AND WE'VE HEARD MANY TIMES, OUR
BUDGETS AS P.I.s FOR THE NIH
HAVE BEEN KEPT CONSTANT AND,
THEREFORE, AS COMPARED TO, LET'S
SAY, 10 YEARS AGO, WHERE, YOU
KNOW, 30, 40% REALLY -- IN REAL
DOLLARS, AND AT THE SAME TIME,
MANY OF US, LET'S SAY IN BOSTON
IN THE HARVEST SYSTEM, POSTDOC
SALARIES WHICH WERE LAGGING
BEHIND ARE NOW ACTUALLY AHEAD OF
THE NIH REQUIREMENTS, SO THEY'VE
GONE UP ABOUT -- THEY'VE ALMOST
DOUBLED FOR US, SO IF YOU JUST
BASE IT ON THAT, IT'S NOT THAT
THERE WERE TOO MANY OR TOO FEW.
IT'S A MATTER OF HOW MANY YOU
CAN ACTUALLY SUPPORT IF YOUR
TOTAL RESEARCH BUDGET IS HELD
CONSTANT, IT'S NOT GOING DOWN,
AND THE POSTDOC SALARIES HAVE
GONE UP CONSIDERABLY WHERE YOU
JUST CAN'T SUPPORT AS MANY.
THAT CERTAINLY IMPACTS THE
NUMBER OF POSTDOCS COMING IN
ALSO.
>> BUT WERE OR ARE THE PEOPLE
COMING OUT OF POSTDOCS HAVING A
GOOD JOB MARKET, IN OTHER WORDS
ARE THERE JOBS OUT THERE FOR
THEM AT THE LEVEL OF TRAINING
THEY HAVE RECEIVED OR ARE THEY
HAVING TO DO SOME OTHER THINGS?
THAT WAS MY QUESTION.
IT WAS MORE OF THE DEMAND SIDE.
>> I DON'T KNOW THE ANSWER,
MAUREEN, FRANKLY.
>> THANK YOU.
>> TIRIN, YOU HAD A COMMENT?
>> VICTOR PEREZ, MIAMI.
SANGEETA, THANK YOU FOR THE
PRESENTATION.
I THINK IT'S A GREAT PROGRAM,
ONE THAT WE SHOULD SUPPORT,
INCREASE POSTDOCTORAL SUPPORT.
WHEN YOU READ THE TITLE, NEI
INNOVATOR AWARD, IT'S HARD TO
GET A GOOD IMPRESSION OF WHAT
EXACTLY THE I A WARD IS.
THE AWARD IS IN THE
DESCRIPTION, AND YOU MENTIONED
THAT THE REVIEW PROCESS IS GOING
TO BE DIFFERENT.
CAN YOU EXPAND ON THAT?
>> YES, SO WHEN WE HAVE LOOKED
AT THE OTHER SIMILAR KIND OF
AWARDS, THE REVIEW HAS BEEN MORE
ON WHAT THE IDEA IS AND WHAT THE
APPROACH YOU'RE GOING TO BE
USING.
THE AMOUNT OF DATA THAT USUALLY
A REGULAR R01 OR R21 ASKS IS NOT
THERE, UNLESS YOU HAVE SOMETHING
THAT'S UNPUBLISHED AND YOU WANT
TO SHOW THAT IS GOING TO BE
THERE.
SO THE REVIEW CRITERIA FOR SOME
OF THESE -- OR SUCH APPLICATIONS
IS QUITE DIFFERENT FROM THE
REGULAR R01, AND IT IS WHAT IS
THE IDEA, IS IT REALLY CREATIVE,
THE EMPHASIS IS ON THAT.
IT IS ALSO THERE'S AN EMPHASIS
ON THE PERSON, THE POSTDOCTORAL
FELLOW, WHAT WORK THEY'RE DOING,
HOW IS THIS WORK DIFFERENT
FROM -- YOU KNOW, ARE THEY
REALLY BRINGING SOMETHING NEW,
INNOVATIVE TO THE BANK TO THE T
THE SAME WORK THE LAB HAS BEEN
DOING?
SO IT'S COMPLETELY -- IT'S ON
THE PERSON AT THE SAME TIME, IT
IS NOT UNLIKE HOW MUCH DATA DO
YOU HAVE, HOW MUCH PUBLICATIONS,
ET CETERA.
>> THANK YOU.
I GET IT.
>> DOES THAT MAKE IT --
>> YEAH.
>> SORRY.
>> ONE QUESTION REALLY QUICK.
>> YES.
>> WOULD IT BE A REQUIREMENT OF
HOW LONG THE POSTDOCTORAL FELLOW
IS -- I MEAN HOW LONG HE'S BEEN
INVOLVED AS A FELLOW?
>> SINCE THIS IS GOING TO BE
OPEN TO EARLY STAGE INVESTIG
INVESTIGATORS, THEY WILL HAVE TO
MAKE THE SAME TIME FRAME SO
WITHIN 10 YEARS OF THE
TERMINAL DEGREE, I THINK THAT'S
WHAT --
>> THANK YOU.
>> I'D IMAGINE, GIVEN IT'S
INTENDED FOR NON-INDEPENDENT OR
INDEPENDENT INVESTIGATORS, IT
GOING TO BE HARD TO EVALUATE
THEM, RIGHT, BECAUSE YOU'VE GOT
PEOPLE WHO ARE, YOU KNOW -- I
MEAN, EVEN TO THE PREVIOUS
QUESTION, OBVIOUSLY SOMEONE WHO
IS AN INDEPENDENT, A NEWLY
INDEPENDENT INVESTIGATOR, IT'S
GOING TO BE EASIER TO SORT OF
FIRST OF ALL THEY HAVE MORE
EXPERIENCE.
>> SURE.
>> SO THEY'RE GOING TO RISE TO
THE TOP.
IT'S KIND OF LIKE TRYING TO HIRE
A FACULTY WHO'S OPEN RANK
FACULTY, IT'S VERY DIFFICULT TO
DO OFTEN.
SO HOW ARE YOU GOING TO HANDLE
THAT?
I CAN IMAGINE YOU CAN SORT OF
JUST DECIDE THAT YOU'RE GOING TO
PICK SOME -- YOU'RE GOING TO
ACHIEVE SOME RANGE OF
EXPERIENCE -- OF INDEPENDENCE IN
THE AWARDEES?
IS THAT THE IDEA OR -- YOU CAN
JUST SEE WHATEVER HAPPENS OR --
>> WELL, IT DEPENDS ON WHAT KIND
OF, A, APPLICANTS WE'RE GOING TO
GET, BUT YOU KNOW, TO ANSWER
YOUR QUESTION, THERE WILL BE
SOME POSTDOCS AND THERE WILL BE
SOME EARLY STAGE INVESTIGATORS,
AND OF COURSE, YOU KNOW, ONE HAS
MORE EXPERIENCE THAN THE OTHER,
AND MAYBE WE'LL HAVE TO PILE
THEM DIFFERENTLY AND EVALUATE
TWO DIFFERENT PILES.
THAT'S SOMETHING WE WOULD HAVE
TO DISCUSS MORE ABOUT IN TERMS
OF WHEN WE ARE CRAFTING THE
FUNDING OPPORTUNITY AND TALKING
TO THE REVIEWER -- TO OUR REVIEW
GROUP PEOPLE.
BUT ALL GREAT POINTS, YOU KNOW,
BRINGING OUT THE DIFFERENCES.
>> BECAUSE TO COMPOUND THINGS,
THE NEWLY APPOINTED -- NEW
INVESTIGATORS WILL HAVE JUST
GOTTEN THE JOB.
>> YES.
>> SO THEY'VE BEEN TO THE DANCE,
THEY'VE TAKEN ALL THE -- THEY'VE
DONE THE RIGHT APPS, THEIR ACT
IS REALLY POLISHED COMPARED TO
THE POSTDOCS.
SO IT'S GOING TO BE HARD TO
EVALUATE THEM THE SAME THING,
THAT'S ALL.
AND JUST BACK TO THE EARLIER
POINT ABOUT THE NON-U.S.
CITIZENS, SO THAT MEANS THAT --
AM I WRONG, THOUGH, THAT THIS
IS -- CAN THEY ONLY CASE IN
WHICH -- OH.
>> SO FOR -- NO, FOR R01s,
REGULAR RPGs, NON-U.S.
INVESTIGATORS, EVEN IF THEY'RE A
FOREIGN INSTITUTION CAN APPLY.
AND ALSO, THESE ARE LIKE SIMILAR
TO THE PIONEER AWARD, WHICH ARE
DP1s FOR MORE SENIOR
INVESTIGATORS, AND ALSO THE
INNOVATOR AWARDS THAT ARE
NIH-WIDE, WHICH ARE ALSO OPEN TO
NON-U.S.
SO WE DIDN'T INVENT THIS COOL
THING.
>> OF COURSE, BUT FOR THOSE
OTHER AWARDS, YOU CAN'T BE A
POSTDOC.
WHICH IS A TRAINEE.
>> THAT'S CORRECT.
EXCEPT FOR K99s.
YOU CAN BE A NON-U.S. CITIZEN.
CAN WE TAKE ONE MORE AND THEN --
>> ONE LAST COMMENT IS REGARDING
THE NAME OF THIS AWARD.
LIKE BEFORE I READ THE
DESCRIPTION AND I SAW NEI
INNOVATOR, IT SOUNDS AGAIN LIKE
THEY'RE A HIGH LEVEL.
WOULD YOU CONSIDER MAYBE HAVING
IT BE LIKE NEI EARLY
INVESTIGATOR OR EARLY CAREER
INNOVATOR AWARD?
THAT WILL MAKE IT CLEARER TO
PEOPLE WHO ARE NOT VERY FAMILIAR
WITH THE NIH SYSTEM AND WHO ARE
REVIEWING CDs NOT TO BE MISLED
BY THIS TITLE?
IT'S A RECOMMENDATION.
>> I WANTED TO SAY THAT THIS IS
QUITE ANALOGOUS TO K99 BECAUSE
NON-U.S. CITIZENS ARE ALLOWED TO
APPLY AND THIS WILL COMPLEMENT
FOR THOSE K99 APPLICANTS WHICH
MISSED THE DEADLINE OF FOUR
YEARS WINDOW.
SO I GET SO MANY CALLS, ED AND I
BOTH, THAT THEY MISSED THE
DEADLINE, IS THERE ANYTHING ELSE
FOR THEM, SO THIS WILL BE VERY,
VERY COMPLEMENTARY FOR THOSE
APPLICANTS WHO MISSED THE
DEADLINE TO APPLY K99, THEY CAN
COME BACK AS A DP2 APPLICANT.
>> THANKS.
OKAY.
IF THERE ARE NO FURTHER BURNING
QUESTIONS.
THEN CAN I HAVE A MOTION TO
APPROVE THIS CONCEPT FOR
POTENTIAL DEVELOPMENT AS A
FUNDING INITIATIVE?
THANK YOU.
A SECOND?
THANK YOU.
ALL THOSE IN FAVOR?
IS THERE ANYONE OPPOSED?
OKAY, GREAT.
THANKS SO MUCH.
AND THAT WAS GREAT FEEDBACK, AND
OBVIOUSLY WE CAN CLARIFY SOME OF
THESE WHEN WE DEVELOP IT.
THE SECOND CONCEPT THAT WE'RE
GOING TO PRESENT TO YOU TODAY IS
GOING TO BE PRESENTED BY
DR. JIMMY LE, SO I'M GOING TO
TURN IT OVER TO JIMMY.
>> HI, EVERYONE.
MY NAME IS JIMMY LEI, HERE AT
THE NATIONAL EYE INSTITUTE, AND
I AM BRINGING TO YOU A NEW
CONCEPT FOR A NEW INITIATIVE
THAT WE HAVE PUT TOGETHER.
AND THE CONCEPT BUILT ON LESSONS
LEARNED FROM OUR STRATEGIC
PLANNING EFFORTS, AS WELL AS A
WORKSHOP WE HOSTED IN 2023 WITH
NIMHD OFTEN VISION HEALTH
EQUITY.
THE MESSAGE AT THE WORKSHOP WAS
PRETTY CLEAR.
IT'S THAT WE NEED TO MEET
COMMUNITIES WHERE THEY'RE AT.
LISTEN TO COMMUNITY MEMBERS,
DESIGN RESEARCH PROGRAMS THAT
ADDRESS WHAT THE COMMUNITY TELLS
US IS IMPORTANT.
SO THE GOAL OF THIS CONCEPT IS
TO ADVANCE VISION HEALTH EQUITY
BY SUPPORTING COMMUNITY ENGAGED
RESEARCH ON MULTILEVEL
INTERVENTIONS THAT
SIMULTANEOUSLY ADDRESS VISION
HEALTH CONDITIONS AND SOCIAL
DETERMINANTS OF HEALTH.
WHICH INCLUDES THE BROADER SETS
OF NON-MEDICAL FACTORS SHAPING
CONDITIONS OF DAILY LIFE SUCH AS
HOUSING, TRANSPORTATION,
EDUCATION, EMPLOYMENT, AND SO
ON.
SO ANOTHER WAY OF SAYING THIS IS
THAT WE'RE ENVISIONING IN AN
INITIATIVE THAT SUPPORTS
RESEARCHERS WHO ARE SUPPORTING
RESEARCH THAT PRIORITIZES
POPULATIONS WHO EXPERIENCE
HEALTH DISPARITIES, WHO HAVE OR
CONTINUES TO BE ADVERSELY
DISADVANTAGED IN A WAY THAT
AFFECTS THEIR HEALTH OUTCOMES.
RESEARCH THAT FOCUSES ON
MULTILEVEL INTERVENTIONS
INVOLVING PARTNERSHIPS WITH
SCIENTISTS WITHIN AND OUTSIDE OF
THE VISION COMMUNITY TO DESIGN
INTERVENTIONS THAT TARGET
VARIOUS LEVELS OF INFLUENCE ON
HEALTH, INDIVIDUAL FACTORS,
COMMUNITY FACTORS, POLICY
FACTORS, SO ON.
AND RESEARCH THAT DEMONSTRATES
MEANINGFUL ENGAGEMENT WITH
COMMUNITY PARTNERS.
THROUGHOUT THE ENTIRE RESEARCH
PROCESS, TO ENSURE THAT THE
INTERVENTIONS UNDER
INVESTIGATION ARE RESPONSIVE TO
THE NEEDS OF THE COMMUNITY AND
ABLE TO ACHIEVE SUSTAINABLE
IMPROVEMENTS ONCE THE RESEARCH
PERIOD ENDS.
MY NEXT SLIDE OUTLINES THE
RATIONALE.
FIRST, VISION HEALTH EQUITY
RESEARCH IS AN IMPORTANT NEI
STRATEGIC PRIORITY.
THE COVID PANDEMIC AND OTHER
CURRENT EVENTS HAVE BROUGHT TO
THE FOREFRONT THE IMPACT OF
INEQUITIES IN THE PREVENTION AND
TREATMENT AND MANAGEMENT OF
DISEASES AMONG HEALTH DISPARITY
POPULATIONS, AND THIS REALITY
REALLY UNDERSCORES A NEED TO
BROADEN THE PARTICIPATION OF
UNDERREPRESENTED GROUPS IN ALL
STAGES OF RESEARCH.
THE NEI STRATEGIC PLAN THUS
DEDICATES AN ENTIRE CHAPTER TO
HEALTH EQUITY, HEALTH
DISPARITIES AND PUBLIC HEALTH.
SECOND, AS I MENTIONED, LAST
YEAR NEI AND NIMHD CO-HOSTED THE
FIRST WORKSHOP ON VISION HEALTH
EQUITY AT NIH AND THE WORKSHOP
ARRIVED AT VERY IMPORTANT
THEMES.
IN PARTICULAR OF NOTE, THE FACT
THAT VISION HEALTH DISPARITIES
ARE ADDRESSABLE.
VISION HEALTH EQUITY RESEARCH IS
BEST DRIVEN BY THE COMMUNITY,
AND THE VISION FIELD IS READY TO
LEAD LARGE SCALE PROJECTS
ADDRESSING HEALTH EQUITY.
AS EVIDENCED BY THE DISCUSSION
EARLIER THIS MORNING ON HOW
TECHNOLOGY -- DOING RESEARCH ON
NOT ONLY TECHNOLOGY BUT ALSO ON
PEOPLE, AND THIRD, COMMUNITY
ENGAGED SCIENCE WILL NOT
NECESSARILY -- WHILE NOT
NECESSARILY NEW TO NIH, IS A GAP
IN NEI'S CURRENT RESEARCH
PORTFOLIO.
AS A MOTIVATING EXAMPLE, ONE
EXAMPLE THAT DR. MEGAN COLLINS,
A PEDIATRIC OPHTHALMOLOGIST WHO
WAS A PARTICIPANT AT THE
WORKSHOP I MENTIONED, BROUGHT UP
IS THE CONCEPT OF REFRACTIVE --
UNCORRECTED REFRACTIVE ERROR AND
VISION SCHEENING.
SCREENING.
SO ON THIS SLIDE I HAVE THREE
BOXES TEE PICTURING THREE STEPS
OF A POTENTIAL PROCESS.
BOX ONE IS LABELED VISION
SCREENING WITH THE EXAMPLE OF
SCHOOLS.
BOX TWO IS LABELED EYE EXAM,
EXAMPLE IN THE COMMUNITY, AND
THREE IS BETTER OUTCOMES, FOR
EXAMPLE, GLASSES.
EACH STEP IS DMOAC CONNECTED BYA
QUESTION MARK INDICATING
UNCERTAINTY.
SO RESEARCH THAT NEI FUNDS
CONTINUES TO DOCUMENT IS
DISPARITIES N UNITED STATES,
BETWEEN GEOGRAPHY, DEMOGRAPHICS,
BUT WHAT ARE WE GOING TO DO
ABOUT IT?
ONE THOUGHT THAT OFTEN COMES TO
MIND INCLUDING AT THE WORKSHOP
IS HOW VISION SCREENING COULD
ADDRESS THIS.
THE LOGIC OF SCREENING LOOKS
PRETTY STRAIGHTFORWARD.
YOU GO OUT, YOU IDENTIFIED A
CONDITION EARLY, SAY AMONG
SCHOOL AGED CHILDREN, INTERVENE
SWIFTLY, AND PREVENT FURTHER
PROGRESSION.
IN REALITY, HOWEVER, SUCCESS OF
VISION SCREENING PROGRAMS IS
OFTEN AFFECTED BY DIFFERENT
FACTORS, INCLUDING INEQUITIES IN
ACCESS, INCONSISTENCIES IN
FOLLOW-UP CARE AFTER SCREENING,
VARIATIONS IN THE QUALITY OF
CARE PROVIDED ONCE A VISION --
IS DETECTED BY SCREENING, AND
PARTICIPANTS MENTIONED HOW
SCREENING CAN CREATE A FALSE
SENSE OF SECURITY FOR EXAMPLE BY
MISTAKING -- THUS INADVERTENTLY
EXACERBATING THE DISPARITIES IN
UNCORRECTED REFRACTION ERROR, SO
WHAT HAPPENS AFTER SCREENING
MATTERS A LOT.
AND TACKLING AND TAKING
REFRACTIVE ERRORS AND SCREENING
CHALLENGES REQUIRES INTERVENING
AT MULTIPLE LEVELS, SO IN THIS
CASE, 40 INTERVENING AT AN
INDIVIDUAL LEVEL AT BEHAVIOR AND
BIOLOGY TO INTERVENING AT AN
INDIVIDUAL LEVEL, SCHOOL
POLICIES, ACCESS TO EYE EXAM
SERVICES, COMMUNICATIONS WITH
PARENTS AND GUARDIANS.
MAYBE IT'S NECESSARY TO ENGAGE
WITH COMMUNITY AND HEAR WHAT
WORKS AND WHAT DOESN'T WORK TO
BUILD THAT TRUST WITH FAMILIES
AND PARENTS TO CLARIFY
MISUNDERSTANDINGS.
MAYBE WE NEED TO RECRUIT
PARENTS, TEACHERS AND GUARDIANS
AS PART OF THE RESEARCH TEAM, OR
MAYBE IF SCHOOLS ARE NOT THE
BEST VENUE, WHAT ELSE MIGHT BE
OPTIONS?
CAN RESEARCHERS TEAM UP WITH
COMMUNITY CENTERS, CHURCHES,
AFTER-SCHOOL PROGRAMS? SO
INTERVENTION HERE IS MORE THAN
JUST SCREENING.
IT'S MULTILEVEL.
IT'S ABOUT CORRECTING REFRACTIVE
ERROR AND ENSURING OVERALL
WELL-BEING OF AN INDIVIDUAL
THROUGHOUT THEIR LIFE COURSE.
REFRACTIVE ERROR AND SCREENING
IS JUST ONE BROAD EXAMPLE, AND I
WANT TO BE CLEAR THAT THIS IS
NOT A SCREENING INITIATIVE, PER
SE.
WE ENVISIONED THAT THIS
INITIATIVE WOULD PROVIDE MANY
OTHER OPPORTUNITIES TO ENGAGE
COMMUNITY PARTNERS, FOR EXAMPLE,
HOW MIGHT MOBILE HEALTH INCREASE
ACCESS TO VISION HEALTH SERVICES
IN RURAL SETTINGS?
IN WHAT WAYS COULD COLLABORATION
WITH FAITH-BASED ORGANIZATIONS
OR OTHER BUSINESSES OR SERVICES
COULD EXPAND THE DELIVERY OF
VISION HEALTH INTERVENTIONS?
HOW COULD CULTURALLY INFORMED
HEALTH PROMOTION STRATEGIES
IMPROVE VISION HEALTH LITERACY?
HOW MIGHT PEER SUPPORT PROGRAMS
AND NAVIGATORS CONNECT PATIENTS
TO RESOURCES AND OTHER VISION
SERVICES?
WHAT WAYS COULD AI ENHANCE
DETECTION AND REFERRAL PROCESSES
IN LOW RESOURCE SETTINGS?
SO I WOULD LIKE TO END THIS
CONCEPT CLEARANCE PRESENTATION
BY RECAPPING THE OBJECTIVES AND
SCOPE.
WE WOULD VERY MUCH APPRECIATE
COUNCIL'S FEEDBACK ON THIS
INITIATIVE THAT WOULD SUPPORT
RESEARCH PROGRAMS THAT WILL
CATALYZE, DEVELOP AND EVALUATE
COMMUNITY ENGAGED MULTILEVEL
INTERVENTIONS THAT ADDRESS
HEALTH DISPARITIES TO ADVANCE
VISION HEALTH EQUITY, RESEARCH
THAT REQUIRES EVIDENCE OF
MEANINGFUL COMMUNITY ENGAGEMENT,
FOR EXAMPLE, COMMUNITY PARTNERS
HOLDING KEY ROLES IN THE PROJECT
AS COINVESTIGATORS OR MPIs,
AND RESEARCH INVOLVES
TRANSDISCIPLINARY COLLABORATIONS
WITH SCIENTISTS AND OTHER
RESEARCHERS OUTSIDE THE VISION
FIELD, HEALTH SERVICES, HEALTH
DISPARITIES RESEARCH, EDUCATION,
BEHAVIORAL SCIENCE, SOCIAL
SCIENCES.
BEFORE I CLOSE WITH THE
DISCUSSION, I WANT TO AGAIN
ACKNOWLEDGE MY COLLABORATORS AND
THANK NIMHD FOR THEIR HELP WITH
THEIR WORKSHOP.
I WAS ORIGINALLY GOING TO CLOSE
WITH A QUOTE FROM
DR. BERTAGNOLLI ABOUT HOW
PATIENTS ARE OUR PARTNERS IN
RESEARCH, BUT I THINK
DR. ANDERSON GAVE US SOMETHING
TO THINK ABOUT THIS MORNING,
WHEN THE COMMUNITY IS INVOLVED,
WE ALL WIN.
SO ANY COMMENTS YOU HAVE WOULD
BE VERY MUCH APPRECIATED.
OTHER EXAMPLES FROM YOUR
SPECIALTY THAT COULD BENEFIT
FROM COMMUNITY ENGAGEMENT?
DO YOU HAVE EXAMPLES FROM OTHER
FIELDS THAT YOU WOULD LIKE TO
SHARE?
THANK YOU IN ADVANCE FOR YOUR
TIME, ATTENTION AND DISCUSSION.
>> THANKS, JIMMY.
SO THE ASSIGNED DISCUSSANTS FOR
THIS ARE JANI AND MARIA, AND
THEN OF COURSE WE'D LIKE TO HEAR
FROM OTHERS.
SO GO AHEAD -- OH, I TURNED ON
YOUR --
>> I WANT TO START BY REALLY
THANKING YOU FOR A FANTASTIC
PRESENTATION AND A GREAT
CONCEPT.
AS YOU ALL HAVE HEARD EARLIER
TODAY, I AM NOT THE SCIENTIFIC
COMMUNITY BUT MY BACKGROUND IS
IN LAW AND DISABILITY POLICY.
SO I WAS PARTICULARLY ENTRANCED
WITH YOUR ENDING WHERE YOU
PRETTY MUCH PRESENTED THE MANTRA
OF THE DISABILITY COMMUNITY, AND
THAT IS THAT IF YOU INCREASE
ACCESS AND INCLUSION FOR PEOPLE
WITH DISABILITIES, YOU IMPROVE
THE QUALITY OF LIFE FOR US ALL.
SO I WOULD BE REMISS IN NOT
THANKING ALL OF YOU, BOTH FOR
CREATING AND BRINGING THIS
FORWARD.
AND ALSO ACKNOWLEDGING THE
INCREDIBLE WORK BY THOSE AROUND
THIS TABLE AND THE COMMUNITY IN
SCIENCE, IN THE UNITED STATES
AND AROUND THE WORLD IN
RELENTLESSLY SEEKING TREATMENT
AND CURES FOR BLINDING AND OTHER
DISEASES, THE PHYSICIANS WHO SO
COMPASSIONATELY CARE FOR US.
AND I ALSO WANT TO CALL OUT
KATHY AND NATHAN, WHO HAVE MADE
IT THEIR PERSONAL MISSION TO
MAKE SURE THAT EVERY POWERPOINT
ON THIS SLIDE IS ACCESSIBLE TO
SOMEONE WHO IS UNABLE TO SEE IT.
AND IT HAS BEEN REALLY
INSTRUCTIVE, I THINK, TO ALL OF
US.
I WANT TO FOCUS JUST ON TWO
THINGS, TWO STATEMENTS THAT I
THINK ARE REALLY TELLING ABOUT
THIS.
POTENTIAL CONCEPT.
THIS CONCEPT OF COMMUNITY
ENGAGED SCIENCE, AND VISION
HEALTH EQUITY.
SO LET START WITH EQUITY SINCE
WE'RE TALKING ABOUT ACCESS
INCLUSION, IMPROVING THE LIVES
OF EVERYBODY.
THE MARGINALIZED GROUPS THAT YOU
HAVE IDENTIFIED ARE SIGNIFICANT
AND THEY ARE ALL ALSO HEALTH
DISPARITIES IDENTIFIED BY NIH,
AND I THINK IT IS IMPORTANT ALSO
TO POINT OUT THAT DISABILITY WAS
ADDED AS A HEALTH DISPARITY NO
LESS THAN THREE MONTHS AGO BY
EXECUTIVE ORDER FROM PRESIDENT
BIDEN.
SO THIS IS VERY MUCH AT THE
FRONTIER OF THE INCLUSION
DISCUSSION, AND IT'S VERY TIMELY
IN TERMS OF THE WAY OUR CULTURE
AND SOCIETY ARE DEVELOPING.
IT'S ALSO CLEAR FROM OUR
MORNING'S DISCUSSION THAT THIS
FITS WITHIN TWO IF NOT ALL FOUR
OF THE PILLARS THAT SUSTAIN THE
MISSION OF THIS COUNCIL, AND
THAT WHEN WE ACKNOWLEDGE THAT
OUR WORK IS TO INVESTIGATE AND
DEVELOP TREATMENTS AND CURES, WE
ALSO ACKNOWLEDGE THE WHOLE LIFE
OF THE PERSON AND THE WAY THEY
FIT INTO SOCIETY, AND LET'S JUST
BE PERFECTLY CLEAR, IF YOU ARE
BLIND OR LOW VISION, YOU ARE
MORE AT RISK OF ISOLATION AND
DEPENDENCE THAN SOMEONE WHO IS
NOT.
SO CREATING AN ATMOSPHERE FOR
COLLABORATIVE WORK THAT WILL
ENABLE US TO THEN TRANSLATE THE
BENEFITS OF THE RESEARCH INTO
ACTUAL MEANS BY WHICH DISABLED
AND OTHER PEOPLE CAN LIVE HAS
TREMENDOUS VALUE AND APPEAL, AT
LEAST TO ME.
THE IDEA OF COMMUNITY ENGAGED
RESEARCH AS WE ALL KNOW IS NOT
NEW BUT ALSO SOMETHING SPOKEN TO
ELOQUENTLY IN THE PRESENTATIONS
THIS MORNING IN TERMS OF
COLLABORATION AND OVERLAP IN
INTERSECTION WITH THE VERY MANY
SEGMENTS OF SOCIETY THAT SINCE
THE PANDEMIC HAVE REALLY COME
TOGETHER.
THERE IS NO LONGER ANY SUCH
THING AS JUST A PROBLEM FOR ONE
PERSON.
AND SO IN EXTENDING OUT INTO THE
COMMUNITY AND ENGAGING,
PARTICULARLY SINCE THE DOBBS
DECISION, IN COMMUNITY WHERE
HEALTHCARE IS FINDING A
DIFFICULT WAY FORWARD, AND SO
MAY BE LESS AVAILABLE OR
RESTRICTED IN CERTAIN WAYS, WE
CAN REALLY HELP ADVANCE THE
CAUSE OF THE ENTIRE NATION BY
DOING OUR BEST TO ELEVATE THE
STANDARD FOR COMMUNITY
INCLUSION.
SO I CONGRATULATION YOU, I
WHOLEHEARTEDLY SUPPORT YOUR
PROGRAM.
THANK YOU SO MUCH.
>> THANK YOU.
>> THAT'S HARD TO FOLLOW.
I THINK SHE NAILED IT.
I REALLY DON'T HAVE ANYTHING
ELSE TO ADD.
I THINK IT'S WONDERFUL, AND
THANK YOU, IT'S AN EXCELLENT
PROGRAM, 100% MY SUPPORT AS
WELL.
>> WE APPRECIATE COUNCIL'S
FEEDBACK.
DR. DANA?
>> HOW CAN ONE NOT SUPPORT SUCH
AN INITIATIVE, RIGHT?
SERIOUSLY.
I MEAN, I'M NOT SAYING IT TONGUE
IN CHEEK.
SO WONDERFUL.
HOWEVER, HOWEVER, AGAIN, IF THIS
IS NOT DONE AT A SCALE, THAT'S
GOING TO REALLY HAVE A
MEANINGFUL IMPACT, AGAIN, IT
WILL BE A NICE SYMBOLIC GESTURE
AND NOT MUCH BEYOND THAT.
SO THERE ARE TWO WAYS OF DEALING
WITH THAT SITUATION AT A TIME OF
LIMITED RESOURCES.
EITHER YOU HAVE TO ENSURE THAT
THE SCALE AND THE SCOPE OF THIS
BUDGET IS LARGE ENOUGH, AT LEAST
AT CERTAIN LOCALES, TO SEE
WHETHER YOU HAVE AN EFFECT, OR
IF YOU CAN'T, THEN YOU REALLY
HAVE TO RESTRICT WHERE YOU APPLY
THIS PROGRAM, AND THEN SEE IF
THERE ARE ANY MEASURABLE
EFFECTS.
THAT WAY, YOU'LL HAVE KIND OF A
QUASI CONTROL WOULD SITUATION,
RIGHT?
YOU WILL COMPARE TO OTHER PLACES
WHERE THERE HAS NOT BEEN THIS
INTERVENTION.
THANK YOU.
>> WE'RE DEFINITELY GOING TO
TAKE THAT FEEDBACK INTO
CONSIDERATION AND MAKE THIS AS
FOCUSED AS POSSIBLE BUT AS LARGE
AS FEASIBLE.
THANK YOU, EVERYONE.
>> OKAY.
GREAT.
THANK YOU FOR YOUR INPUT AND
KIND WORDS.
AND DANA, THANK YOU FOR YOUR
SUGGESTIONS.
WE MADE A NOTE OF THOSE.
SO MAY I HAVE A MOTION TO
APPROVE THIS CONCEPT?
THANK YOU.
A SECOND?
THANK YOU.
ALL IN FAVOR?
GREAT.
OKAY.
SO THE MOTION PASSES.
THANK YOU.
OKAY.
AT THIS POINT, WE ARE RUNNING A
LITTLE BIT BEHIND, BUT WE STILL
HAVE TIME FOR OUR GENERAL
DISCUSSION.
SO I'M JUST GOING TO OPEN THE
FLOOR FOR QUESTIONS ABOUT
ANYTHING THAT YOU HEARD THIS
MORNING OR ANYTHING ELSE YOU
WOULD LIKE TO RAISE WITH COUNCIL
OR WITH DR. CHIANG, NOT WITH ME.
[LAUGHTER]
>> OKAY, NOT WITH KATHY.
THIS IS MARIA GRANT.
I HAVE A QUESTION.
COULD YOU CLARIFY THE F38?
I AM CONFUSED ABOUT ITS ROLE IN
THE F38, DID I HEAR THAT
CORRECTLY?
R38 RATHER, SORRY.
GETTING MY LETTERS AND MY
NUMBERS CONFUSED.
OKAY.
>> MARIA, IT'S MIKE.
THE R38 IS A GRANT PROGRAM TO
FUND DEPARTMENTS, GROUPS, TO
SUPPORT CLINICAL RESIDENTS TO DO
RESEARCH YEARS.
SO FOR EXAMPLE, IF A TYPICAL
RESIDENCY WERE, SAY, FOUR YEARS,
THIS WOULD BE A FIVE-YEAR OR
SIX-YEAR RESEARCH-ORIENTED
RESIDENCY, AND THE R38 PROGRAM
FUNDS THE COMPONENT THAT'S
DEDICATED TO RESEARCH.
AND SO THE IDEA IS TO CREATE
PROGRAMS THAT HAVE A
RESEARCH-ORIENTED COHORT.
BEYOND THAT, AND THERE ARE THREE
THAT I'M AWARE OF OTHER
INSTITUTES AT NIH THAT IMPLEMENT
THIS RIGHT NOW.
CANCER, NIAID AND AGING.
AND SO WE, I BELIEVE, ARE THE
FOURTH ONE.
NEERAJ IS REALLY THE ONE THAT
HAS SHEPHERDED THIS, AND IF
THERE'S ANYTHING ELSE YOU'D ADD
TO THAT, DON'T FEEL COMPELLED TO
BUT I SEE YOU WALKING UP.
>> I WAS JUST GOING TO SAY, I
THINK MAYBE YOUR QUESTION -- AND
MAYBE I'M JUST ASSUMING, BUT THE
R38 IS AN INSTITUTIONAL AWARD.
SO AN INSTITUTION APPLIES FOR
IT, AND THEN SUPPORT DIFFERENT
PEOPLE, AND I THINK THE F32,
WHICH YOU -- IT'S AN INDIVIDUAL
FELLOWSHIP AWARD.
>> THANK YOU.
I HAVE A FOLLOW-UP ON THAT.
THERE SEEMS TO BE A CURRENT
PROBLEM WITH THE OPHTHALMOLOGY
MEDICAL STUDENTS THAT WANT TO GO
INTO OPHTHALMOLOGY, AND THEN
THEY DON'T GET ACCEPTED AND --
INTO RESIDENCY PROGRAM, AND THEY
HAVE A GAP YEAR.
AND THIS SEEMS TO BE EVERY YEAR
WORSE AND WORSE.
AND I THINK -- IT'S A
SUGGESTION, IT'S A WONDERFUL
OPPORTUNITY TO CA CAPTURE PHYSIN
NOOSE SCIENCE AT A TIME WHERE
THEY CAN REALLY FOCUS BEFORE
THEY -- AND, IF IT COULD BE KIND
OF HYBRIDDED INTO THE R38
SOMEHOW, YOU KNOW WHAT I MEAN,
SO IF THEY EVER ACTUALLY DID
EVENTUALLY GET INTO AN
OPHTHALMOLOGY PROGRAM, THEY
COULD POTENTIALLY CONTINUE SOME
ASPECT OF RESEARCH, THAT WOULD
GIVE SOMEONE TWO YEARS, YOU
KNOW, OF RESEARCH EXPERIENCE
WHICH I THINK MIGHT HELP
ENCOURAGE THEM TO MAINTAIN
THROUGHOUT THEIR CAREER AN
INTEREST IN RESEARCH.
AND IT'S A SERIOUS PROBLEM, I
THINK, HAVING THESE STUDENTS WHO
WANT TO MAKE THE MOST OF THEIR
EXPERIENCE AND IF -- I DON'T
KNOW HOW IT COULD HAPPEN BECAUSE
IT'S USUALLY KIND OF SHORT
NOTICE, THEY APPLY TO 70-PLUS
PROGRAMS AND THEN THEY DECIDE
WHEN THEY DON'T WANT TO -- YOU
KNOW WHAT I MEAN, TO THEN APPLY
FOR A GAP -- IT'S NOT A GAP
YEAR, IT'S A POSTDOC YEAR KIND
OF EXPERIENCE.
SO I JUST THOUGHT -- I DIDN'T
KNOW IF ANYONE HAD THOUGHTS
ABOUT HOW WE COULD BETTER SERVE
THAT REALLY CRITICAL GROUP OF
INDIVIDUALS.
>> MARIA, THANK YOU FOR RAISING
THAT ISSUE.
MIKE AGAIN.
I'D LIKE TO OPEN THIS UP TO THE
GROUP.
I THINK ONE OF THE QUESTIONS
THAT I'VE OFTEN WONDERED IS TH
THAT -- SO A COUPLE QUESTIONS.
ONE OF THEM, A COMMON SCENARIO I
SEE IS THAT THERE'S A MEDICAL
STUDENT WHO WANTS TO TAKE TIME
OFF TO DO RESEARCH, AND THERE'S
NOT OFTEN AN EASY FUNDING
MECHANISM FOR THAT.
OFTEN THE TYPICAL SCENARIO IS
THAT THEY WANT TO -- AND HERE,
MAYBE THIS IS A CYNICAL VIEW,
THEY WANT TO STRENGTHEN THEIR
APPLICATION SO THEY CAN BE
COMPETITIVE TO MATCH INTO A GOOD
PROGRAM, YOU KNOW, REGARDLESS OF
WHAT YEAR THEY COME IN AND DO
IT.
THAT'S ONE COMMON SCENARIO I
SEE.
ANOTHER COMMON SCENARIO THAT WE
SEE IS THAT WE WANT TO GET
PEOPLE INTERESTED IN THE FIELD
AND PASSIONATE ABOUT WANTING TO
DO THIS FOR THEIR CAREER AS
CLINICIAN-SCIENTISTS.
ONE QUESTION THAT I'VE BEEN
WONDERING, AND I'D LOVE YOUR
THOUGHTS ABOUT MARIA'S QUESTION
AND ALSO WHAT I'M GOING TO SAY
IS, WE ALL SEE A LOT OF
SUPERSTARS WHO HAVE CVs 12
PAGES LONG AS THIRD-YEAR MEDICAL
STUDENTS, AND THEN WE SEE PEOPLE
LIKE ALL OF YOU ON THE COUNCIL
WHO ARE SUPERSTARS IN THEIR
FIELD, AND WHAT IS THE PERSON --
WHO DO WE NEED TO REACH TO TRAIN
TO BECOME A SUPERSTAR?
IS IT THAT ONE WHO WAS GROOMED
SINCE THEY WERE 18 YEARS OLD OR
IS IT SOMEBODY WHO GETS INSPIRED
BY SOMETHING AND WHAT CAN WE BE
DOING BETTER TO INSPIRE PEOPLE
TO REALLY DO -- SO THOSE ARE
SOME OF -- MARIA, I THINK YOU
ASKED AN IMPORTANT QUESTION.
THESE ARE SOME OF MY FOLLOW-UP
THOUGHTS.
REZA.
>> I'VE TRAINED MANY OF THESE
CANDIDATES OVER THE YEARS, MANY,
AND HAVE MANY PEOPLE IN MY
LABORATORY APPLY FOR
OPHTHALMOLOGY RESIDENCY.
I DON'T THINK IT'S A CYNICAL
INTERPRETATION, MIKE, IT PART OF
REALITY.
TODAY, TO GO TO MEDICAL SCHOOL
OR LAW SCHOOL OR ANY
PROFESSIONAL SCHOOL, YOU HAVE TO
DO SOMETHING.
IT'S VERY DIFFICULT TO GO
STRAIGHT OUT OF COLLEGE AND GO
TO GRADUATE SCHOOL.
AT LEAST TO A PROFESSIONAL
SCHOOL.
SO YOU KNOW, IS THAT CYNICAL?
NO, THAT'S JUST HOW THE SYSTEM
WORKS.
IT'S MORE COMPETITIVE AND THAT'S
HOW THEY WANT TO DIFFERENTIATE
THEMSELVES.
DURING MEDICAL SCHOOL, THEY DO
RESEARCH TO GET INTO GOOD
RESIDENCIES.
THEN IF THEY'RE ON INTERNATIONAL
MEDICAL GRANT, THEY WANT TO DO
RESEARCH TO ALSO SPRUCE UP THEIR
CV TO BE ABLE TO GET INTO
RESIDENCY, SAME PHENOMENON.
IT'S EVEN MORE COMPETITIVE FOR
THEM.
BUT I THINK THAT'S IMPORTANT
BECAUSE IN THAT CASE, YES,
THEY'RE INTERESTED IN RESEARCH,
BUT THE MAJORITY OF THEM ARE NOT
REALLY THAT INTERESTED IN
RESEARCH.
THEY WANT TO GET INTO A GOOD
CLINICAL SPOT FOR THEIR TRAIN
TRAINING.
HOWEVER, I CAN TELL YOU THAT FOR
SURE, 90, 95% OF THE INCOMING
RESIDENTS WHO COME TO OUR
PROGRAM ALL CLAIM THAT THEY ARE
COMMITTED FOR LIFELONG SERIOUS
COMMITMENTS FOR RESEARCH AND
SCHOLARSHIP AND, IN FACT, WHEN
YOU LOOK AT WHAT THEY END UP
DOING REALLY CRITICALLY, MAYBE,
MAYBE 30, 40% END UP GOING TO
TRULY ACADEMIC POSITIONS, THE
REST GET A JOB, IT COULD BE AN
ACADEMIC, QUOTE-UNQUOTE, --
THEY'RE NOT REALLY DOING
RESEARCH, SOME EVEN GO KNEE
PRIVATE PRACTICE.
NOTHING WRONG WITH THAT BUT IT'S
NOT WHAT THEY CLAIMED THEY
WANTED TO DO.
SO I DON'T THINK THEY'RE BEING
MISLEADING OR TRICKING.
YO, YOUKNOW, THE PANELS.
I JUST THINK IT'S LIFE WHERE WE
ALL HAVE PLANS AND SOMETIMES IT
PANS OUT, SOMETIMES IT DOESN'T.
IT'S A COMPLEX WORLD, THERE ARE
MANY REASONS DURING RESIDENCY,
UNDER ECONOMIC, PERSONAL REASONS
AND OTHER REASONS WHY PEOPLE
DON'T END UP DOING WHAT THEY
CLAIM THEY WANT TO DO IN THE
FUTURE.
THEREFORE, HAVING SEEN ALL THAT,
MY RECOMMENDATION TODAY IS THAT
OUR JOB IS TO CREATE
OPPORTUNITIES FOR PEOPLE.
WE CREATE OPPORTUNITIES, WE
TRAIN THEM, AND THEN THEY WILL
ESSENTIALLY EXPRESS WHAT THEY
WANT TO DO BY THEIR ACTIONS AND
BY THEIR FEET.
WE CAN'T IDENTIFY IN ADVANCE,
I'VE BEEN BURNED HAVING TRIED
THAT.
I'VE HAD AMAZING POSTDOCS,
AMAZING, AMAZING, AND THEY GO TO
SOMETHING TOTALLY DIFFERENT AND
THEY'RE NOT INTERESTED IN
ACADEMICS, AND VICE VERSA.
I'VE HAD PEOPLE WHO ARE AT BIG
RISK, I TAING THEM ON AND THEY
TURN INTO AMAZING SCHOLARS AND
THEY TAKE GREAT ACADEMIC
POSITIONS AND THEY REALLY PUSH
SCIENCE FORWARD.
SO I'VE SEEN BOTH SIDES, AND I
DON'T THINK THERE'S A PARTICULAR
FORMULA.
THAT'S MY OPINION.
THANK YOU.
>> VICTOR PEREZ.
I THINK THAT STUDENT THAT CANNOT
GET INTO RESIDENCY, I MEAN
THAT'S A NORMAL PATH, AND I
THINK IT'S GOING TO BE UP TO THE
INDIVIDUAL TO MAKE TO THAT
LEVEL.
SO I THINK THIS MECHANISM OF
FUNDING THE R38 IS PERFECT.
BECAUSE BASICALLY WHAT YOU'RE
DOING IS YOU'RE GIVING THE
OPPORTUNITY FOR THESE THAT
INDIVIDUALS THAT REALLY WANT TO
DO IT AND CAN YOU IDENTIFY
THROUGH YOUR COMMITTEE, THIS IS
NOT A POSITION TO GET A STUDENT
OF OPHTHALMOLOGY.
THIS IS A POSITION THAT WILL
IDENTIFY THAT POTENTIAL
PHYSICIAN SCIENTIST TO GIVE THE
OPPORTUNITY, TRAIN THEM, GIVE
THEM SUPPORT, AND IT WILL EVOLVE
INTO THAT POTENTIAL PERSON TO
BECOME A CLINICIAN-SCIENTIST.
SO I THINK THIS MECHANISM IS
PERFECT FOR THAT, AND CLEARLY,
NEEDS TO STICK TO THE RULES AND
NOT BE ABUSED.
>> ARE SO SOME OF US AT THIS
TABLE HAVE PUT IN FOR THIS GRANT
AND WE DON'T KNOW WHAT'S
HAPPENED YET, BUT WHEN WE WERE
DEBATING WHETHER WE SHOULD PUT
IN OR NOT, YOU KNOW, ONE THING
THAT CAME UP WAS THAT A LOT OF
THE PEOPLE THAT WE WERE
RECRUITING TO OUR FACULTY WERE
PEOPLE WHO HAD BEEN THROUGH THIS
TYPE OF PROGRAM SOMEWHERE ELSE.
AND WE SAID, OH, WELL, NOT THAT
WE NECESSARILY WANT TO -- IT'S
LIKE MAYBE WE SHOULD BE
PRODUCING SOME OF THESE TWO,
BECAUSE IF WE REALLY WANT TO
RECRUIT THOSE PEOPLE, THERE
EITHER NEEDS TO BE MORE OF THOSE
PEOPLE ALL TOGETHER, SO ACTUALLY
THAT IS WHAT CHANGED MY THINKING
OR CONVINCED ME THAT IT WAS A
GOOD PROGRAM WHEN KIND OF OUR
HEAD OF OUR RETINA DEPARTMENT
SAID THAT.
>> THANK YOU TO ALL OF YOU.
ANY OTHER COMMENTS OR QUESTIONS
YOU FEEL WE CAN DISCUSS IN AN
OPEN FORUM HERE?
>> MAUREEN?
>> I HAVE A QUESTION WHICH MAY
SEEM SMALL WHILE WE'RE
RECONSIDERING HOW TO DELIVER EYE
CARE TO MANY UNDERSERVED
POPULATIONS AND HOW WE CREATE
THE BEST MANPOWER, BUT ONE OF
THE THINGS THAT CAME UP THIS
MORNING DURING MICHAEL'S REPORT
WAS THE TRAINING PROGRAM BEING
SPONSORED BY THE JOURNALS IN
OPHTHALMOLOGY FOR THE K AWARDEES
OR SELECTION OF THE K AWARDEES
TO HELP THEM BE GOOD REVIEWERS
AND GET INVOLVED IN THE
EDITORIAL PROCESS, AND I THINK
IT MIGHT BE A VERY GOOD IDEA TO
EXTEND THAT TO BIOSTATISTICIANS,
PERHAPS THOSE THAT ARE RECEIVING
FUNDING THROUGH THE CORE GRANTS.
THERE'S A SEVERE SHORTAGE OF
BIOSTATISTICIANS WHO REVIEW FOR
THE JOURNALS.
I PROBABLY GET TWO OR THREE
INVITATIONS A DAY, NOT BECAUSE
I'M ALL THAT POPULAR, BUT I
THINK THE POOL IS SO SMALL.
SO THIS MIGHT BE AN IDEA OF THE
K AWARD IDEA TRANSFERRED OVER
TO, PERHAPS, BIOSTATISTICIANS IN
THE CORE GRANTS.
>> MAUREEN, THANK YOU VERY MUCH.
YOU KNOW, AS YOU CAN IMAGINE,
THIS IS SOMEWHAT OF AN
EXPERIMENT, YOU KNOW, THAT WE'RE
DOING, AND THE QUESTION IS, IT'S
BASICALLY A PILOT.
A CERTAIN NUMBER OF JOURNALS
AROUND THE TABLE, A CERTAIN
SELECT POOL RIGHT NOW WHICH IS
CURRENTLY THE K POOL AND ONE OF
OUR QUESTIONS IS, WHAT COU
COULD/SHOULD WE BE DOING TO
EXPAND AND HOW?
SO THANK YOU FOR THAT
SUGGESTION.
OTHER COMMENTS, QUESTIONS?
DON -- I SEE DON, THEN PARDEEP.
>> DON MUTTI.
I WAS WONDERING IF I COULD GET A
CLARIFICATION ON THE -- WE'RE
GOING TO CALL IT THE EARLY STAGE
INNOVATOR AWARD, I AS THIS WILL
COME OUT, PEOPLE WILL WANT TO
KNOW ABOUT ITS IMPLEMENTATION.
CAN YOU HELP ME UNDERSTAND THE
THINKING OF AN APPLICANT, HOW
THEY WOULD DECIDE AM I GOING FOR
THIS BECAUSE I SHOULD VIEW IT AS
SORT OF A PRER01 VERSUS SHOULD I
CAST MY LOT AS A NEW
INVESTIGATOR AS AN R01, I MEAN,
AM I PUTTING MYSELF IN A
POSITION OF AN EITHER/OR, AM I
LOCKING MYSELF OUT OF ONE FOR A
PERIOD OF TIME WHILE IT'S
REVIEWED?
HELP ME NAVIGATE, WHAT IS THE
APPLICANT THOUGHT PROCESS GOING
TO BE AS THEY TRY TO FIGURE OUT
WHAT SHOULD I APPLY FOR?
>> OKAY.
SO IF IT IS NOT A LOT OF DATA,
THEN I THINK IT WILL BE THIS
ROUTE TO GO FOR -- IT'S A NEW
CONCEPT, NEW NOVELTY, GO WITH
THIS ROUTE.
IF THERE ARE TWO IDEAS THE
PERSON HAS, TWO DIFFERENT IDEAS,
ONE WITH A LOT OF DATA AND ONE
WITH NOT SO MUCH DATA BUT A
REALLY CLEVER PARADIGM SHIFTING,
YOU COULD GO FOR BOTH.
BECAUSE THE NIH DOES PERMIT YOU
TO HAVE TWO APPLICATIONS OF
DIFFERENT SCIENCE, NOT THE SAME
SCIENCE BEING PUT IN AT THE SAME
TIME.
SO IT REALLY BOILS DOWN TO WHAT
THE APPLICANT QUESTION IS AT
THAT TIME, WHAT AMOUNT OF DATA
THEY HAVE, WHAT THE NOVELTY IS
TO GO EITHER FOR AN R01, R21,
YOU KNOW, THIS NEW DP2 1 THAT WE
ARE THINKING OF, OR ANYTHING
ELSE.
>> SO IT'S SORT OF AN
APPLICATION BASED ON ME AND MY
IDEA VERSUS MATERIALS THAT ANY
OTHER APPLICANT MIGHT THINK IS
ADEQUATE FOR A A TRADITIONAL
R01 APPLICATION?
>> YEAH.
>> I WAS WONDERING IF MAYBE YOU
HAD SOME -- OBVIOUSLY ENCOURAGE
EARLY STAGE INVESTIGATORS IS THE
GOAL.
ABOUT BANG FOR THE BUCK FROM
THIS SORT OF PROGRAM VERSUS OUR
EARLY STAGE INVESTIGATORS
GETTING A FAIR SHAKE DURING
GRANT REVIEWS GIVEN THAT YOU
DON'T HAVE THE REPUTATION OF A
SENIOR PERSON, YOU MAY NOT HAVE
AS MUCH PRELIMINARY DATA AS
ANOTHER APPLICATION, AND YES,
YOU KNOW, EVERYBODY ON THE
REVIEW PANEL CAN SEE THAT, BUT
ARE THEY REALLY GETTING A FAIR
SHAKE?
ARE THEY GETTING SORT OF THE
CONSIDERATION THAT EARLY STAGE
INVESTIGATORS MAYBE SHOULD GET?
>> I'M GOING TO LET BRIAN TALK.
HE'S MUCH BETTER IN TALKING
ABOUT THIS PART.
GO AHEAD, BRIAN.
>> THANKS.
DON'T BUILD ME UP TOO MUCH.
THANKS.
SO I'M BRIAN HOESCHEL, CHIEF OF
THE REVIEW BRANCH AT NEI.
WE DON'T REVIEW R01s BUT PAUL
THE THOSE REVIEWED AT CSR AND
THE EARLY APPLICATION ARE
CLUSTERED TOGETHER SO A POSITIVE
REVIEW, WE'RE DOING ALL THE ESI
APPLICATIONS, EVERYONE GETS KIND
OF FREE AM KATEED, GIVING SOME
LEEWAY FOR PRELIMINARY DATA PUBL
KAI REVIEWING THEM IN THE
CONTEXT OF WHERE THEY ARE.
SO THAT WOULD BE FOR THE R01 ESI
APPLICATIONS.
>> ARE THEY THEN SCORED TOGETHER
LIKE ON THEIR OWN PERCENTILES OR
ARE THEY -- IS CONSIDERATION
GIVEN TO A DIFFERENT PERCENTILE
OF, SAY, SCALING COMPARED TO THE
BULK OF THE REST OF THE
APPLICATIONS?
>> SO THE PERCENTILE FOAS FOR
THE STUDY SECTION, SO IN THAT
SENSE, THEY ARE ON THE SAME
PERCENTILE BASIS AS THAT STUDY
SECTION BUT IN THE SECOND LEVEL
REVIEW WHEN THE FUNDING
DECISIONS ARE MADE, THAT IS
TAKEN INTO ACCOUNT, CORRECT ME
IF I'M WRONG, BUT THE EARLY
STAGE INVESTIGATOR APPLICATIONS
ARE TAKEN INTO ACCOUNT WHEN
THOSE DECISIONS ARE MADE.
>> YEAH, THIS IS ACTUALLY IN OUR
FUNDING POLICY BUT -- HAVE BEEN
ENCOURAGED TO PRIORITIZE EARLY
STAGE INVESTIGATORS, SO THAT CAN
COME IN THE FORM OF D YOU KNOW,
THEY GET A 5 PERCENTILE BUMP AND
DIFFERENT INSTITUTES DO IT A
DIFFERENT WAYS BUT THAT IS
SOMETHING WE PAY A LOT OF
ATTENTION TO WHEN WE'RE
PRIORITIZING UP ANY DECISIONS.
>> SO I THINK AS ILL STATED BY Y
ALL THESE PROPOSALS COMING OUT,
THE SCIENCE THAT'S BEING DONE AT
THE NEI IS CHANGING.
SO IT'S NOT WHAT MAY HAVE BEEN
DONE DEN 10 YEARS AGO OR MAYBE
EVEN FIVE YEARS AGO.
SO AS I SEE YOUNG INVESTIGATORS
PUTTING IN APPLICATIONS ON
ARTIFICIAL INTEL JEBS OR ON BIG
DATA OR ON HEALTH INEQUITY, THEY
KEEP ON ASKING ME O WELL, WHERE
SHOULD I SUBMIT THIS?
THEY LOOK AT THE REVIEW SECTIONS
AND SEE PE1 AND PE2 AND THEY'RE
COMPLETELY INAPPROPRIATE FOR
THEM.
SO I DON'T KNOW WHAT GUIDANCE OR
HOW WE CAN MARKET TO PEOPLE
THAT, YOU KNOW -- AND I KNOW
THAT THE NIH DOES A VERY
THOROUGH JOB OF MAKING SURE THAT
THERE ARE REVIEWERS WHO HAVE
EXPERTISE IN THE FIELD WHO
REALLY KNOW WHAT THEY'RE DOING,
THEY MAKE SURE THAT IT'S GOING
TO REVIEW PROPERLY, BUT IT
DEFINITELY IS CREATING SOME
ANXIETY FOR PEOPLE WHO ARE
WORKING IN ALL THE AREAS THAT
YOU'RE KIND OF TALKING ABOUT,
SOME OF THEM MIGHT HAVE EVEN
MENTIONED, LIKE COMMUNITY HEALTH
SCREENING, EVALUATING, HOW DO
YOU USE PRIMARY CARE CLINICS FOR
EVALUATION OF THE EYE AND RELATE
THAT TO HEALTH OUTCOMES.
THIS IS NOT THE STUFF THAT WE
EVEN HAVE ANY -- THAT MOST
PEOPLE, EVENLY I HAVE NO IDEA
WHERE THIS STUFF GETS REVIEWED.
AND HOW DO WE MESSAGE THAT, OH,
NO, WE HAVE THE EXPERTISE AND
YOU'RE GOING TO GET A FAIR
REVIEW.
>> THESE ARE ALL GREAT
QUESTIONS.
I'M GOING TO START ON THIS,
BECAUSE I THINK YOUR QUESTION
TOUCHED ON A FUEL DIFFERENT
AREAS, AND I'M GOING TO TALK TO
SOME OF THEM AND I THINK I'LL
PASS TO KATHY TO TALK ABOUT SOME
OF THEM AS WELL, AND I CAN
ENVISION THIS AREA WHERE WE MAY
WANT TO INVOKE OTHER PEOPLE
LIKE, FOR EXAMPLE, BRIAN WHO
PROBABLY JUST SAT DOWN.
BUT ONE OF THE THINGS YOU
MENTIONED IS THAT NEI, I THINK
YOU SAID THE SCIENCE IS
CHANGING, AND I THINK THE WAY WE
DO SCIENCE NOW IS CHANGING
COMPARED TO THE IT WAS EVEN WHEN
ALL OF US IN THIS ROOM GREW UP
DOING SCIENCE, THE WORLD IS JUST
CHANGING AND THE FIELD IS
CHANGING.
AND I VIEW ONE OF OUR JOBS AS
NEI, ONE OF THE MOST IMPORTANT
JOBS, IS WHAT CAN WE DO TO
STIMULATE THE SCIENCE THAT'S
BEST GOING TO POSITION US TO
ACHIEVE OUR MISSION MOVING
FORWARD.
AND SO, YOU KNOW, OF COURSE THAT
MEANS WE'RE GOING TO HAVE TO
EVOLVE AS A FIELD, AS THE WORLD
EVOLVES, AND -- BUT THAT DOES
NOT MEAN THAT WE DO NOT CARE
ABOUT SCIENCE THAT WAS DONE WHEN
WE WERE ALL GROWING UP.
YOU CAN'T HAVE ONE WITHOUT THE
OTHER.
AND THESE ARE PROBABLY OBVIOUS
BUT I JUST WANT TO SAY THAT WILL
OUT LOUD.
AND I THINK WHAT IT MEANS IS
WE'RE GOING TO HAVE TO FIGURE
OUT HOW TO EVOLVE, AND ONE OF
THE -- THERE WERE A COUPLE
THINGS YOU TOUCHED ON AS FAR AS
GRANT REVIEW, AND ONE OF THEM IS
FINDING THE RIGHT REVIEWERS, YOU
KNOW, ONE OF THEM IS WHERE TO
SUBMIT, LIKE WHAT INSTITUTE TO
SUBMIT TO.
ANOTHER IS WHAT STUDY SECTION TO
TRY TO SUGGEST.
ANOTHER ONE IS DO THE STUDY
SECTIONS HAVE THE RIGHT
EXPERTISE NOW, AND NUMBER FOUR
THAT I HEARD IS WHERE -- HOW DO
WE FIND THE MOST APPROPRIATE
REVIEWERS IN A WORLD THAT'S
CHANGING RAPIDLY WHERE THERE MAY
NOT BE A TON OF PEOPLE WITH
EXPERTISE.
BUT KATHY, I KNOW YOU AND THE
CREW HAVE THOUGHT ABOUT THESE
MORE THAN I HAVE SO LET ME TURN
TO YOU TO ADDRESS SOME OF THESE
LATTER ISSUES WITH REVIEW.
>> I DON'T KNOW IF I THOUGHT
ABOUT THEM MORE.
I'LL ADDRESS A COUPLE OF ISSUES.
I CAN ALSO TURN IT BACK -- I CAN
PUT BRIAN BACK ON THE SPOT.
BUT I WANT TO CLARIFY A COUPLE
OF THINGS AND THESE ARE KIND OF
MORE MUNDANE, BUT IN TERMS OF
FOR NEI-ISSUED INITIATIVES, SO
ONES THAT HAVE COME THROUGH HERE
BEFORE, ONE YOU'LL HEAR ABOUT
THIS -- WELL, NOT THIS
AFTERNOON, BUT ANY APPLICATIONS
THAT ARE REVIEWED BY NEI STAFF
SROs, SO THEY PUT TOGETHER A
ONE-TIME PANEL, BASED ON WHAT
THEY GOT, AND THEY PICK ALL THE
REVIEWERS, IT'S NOT A STANDING
SECTION, SO THEY CAN BE VERY
MANY CAREFUL IN MAPPING THE
RIGHT EXPERTISE.
SO THOSE ARE THE KIND OF WHEN
YOU SUBMIT THROUGH AN RFA OR
INITIATIVE, YOU DON'T REQUEST A
STUDY SECTION BECAUSE IT COMES
IN-HOUSE.
SO WE CAN MAKE SURE WE HAVE THE
APPROPRIATE REVIEWERS LINED UP
FOR THOSE.
THAT'S TRUE FOR THE OTHER, THERE
ARE A LOT OF STANDING NOTICE OF
FUNDING OPPORTUNITIES THAT ARE
NAI SPECIFIC, THE CLINICAL
TRIALS AND ALL THAT, HIS GROUP
TAKES CARE OF THAT, SO ABOUT THE
SCIENCES CHANGING, SO THE
SCIENCE IS CHANGING BUT EVEN CSR
STUDY SECTIONS, THEIR FOCUS ON
THEIR MEMBERSHIP CHANGED AND
THEY HAVE ACTUALLY A FAIRLY
ELABORATE PROCESS TO CHANGE THE
MAKEUP OF THEIR STUDY SECTIONS,
CREATE NEW STUDY SECTIONS AND
HAD TO DO THIS ONGOING REVIEW.
SO THE STUDY SECTIONS WERE IN
EXISTENCE WHEN I STARTED AS A
PROGRAM OFFICER ABOUT 40 YEARS
AGO.
VERY FEW OF THEM EXIST OR THEY
DON'T EXIST IN THAT, YOU KNOW,
THEY DON'T LOOK THE SAME.
SO THEY UNDERSTAND THAT AND
THEY'RE NOT STAGNANT, EVEN
THOUGH SOMETIMES IT SEEMS LIKE
THAT, BUT THEY'RE NOT.
SO THOSE ARE KIND OF THE TWO
THINGS THAT I WAS GOING TO SAY.
I DON'T KNOW IF, BRIAN, YOU WANT
TO ADD ANYTHING TO THAT?
GL THIS IS BRIAN HOESHUL.
IF YOU ARE APPLYING TO STUDY
SECTION, R01, R21, THERE ARE
TOLLS ON THE CSR WEBSITE WHERE
YOU CAN ENTER YOUR ABSTRACT AND
SPECIFIC AIMS, IT WILL FIND YOU
SORT OF THE BEST MATCH FOR THOSE
STUDY SECTIONS.
YOU CAN LOOK AT ROSTERS TO SEE
WHAT'S APPROPRIATE, THEY'LL SHOW
THE STANDING STUDY SECTIONS AS
WELL AS A RECENT -- ADD THAT.
TALKING TO PROGRAM OFFICERS IS A
REALLY GOOD RESOURCE.
THEY TALK AMONGST THEMSELVES AND
I THINK THERE'S SORT OF THIS
STIGMA, THE FEELING OF, WELL,
YOU APPLY -- ESPECIALLY THE
FIRST TIME YOU APPLY, I GET
ASSIGNED A PROGRAM, THEN I TALK
TO THEM.
I'M SURE ME COLLEAGUES HERE
WOULD ADPREE, IF YOU COULD TALK
TO THEM BEFORE YOU APPLY, THEY
CAN REALLY GIVE YOU THAT KIND OF
ADVICE BASED ON THEIR
EXPERIENCE.
>> GREAT.
>> CAN I JUST ADD SOMETHING TO
THAT?
SORRY.
SO BEFORE COMING TO NEI, I DID
WORK AT CSR, SO I'M JUST GOING
TO PUT ON THAT HAT AND TELL YOU
A COUPLE OF THINGS.
NUMBER ONE, FOR ANY APPLICATION
THAT COMES -- THAT GOES TO CSR,
YOU CAN DO THREE STUDY SECTIONS
IF NOT MORE.
AND THE WAY TO REALLY NAVIGATE
THAT IS ACTUALLY TO PROVIDE SOME
SORT OF EXPERTISE ON YOUR COVER
LETTER, WHAT NOW THEY HAVE IS A
NEW FORM, YOU SAY I WANT X, Y
AND Z PER TEASE.
NO NAMES, IF YOU PUT IN NAMES I
ASSURE YOU CSR IS NOT GOING TO
CALL THEM.
BUT PUT IN WHAT EXPERTISE YOU
ARE LOOKING OUT FOR.
THAT IS GOING TO BE VERY
HELPFUL, AND AS KATHY AND BOTH
BRIAN ALLUDED THAT THERE ARE
MULTIPLE CHANGES THAT ARE TAKING
PLACE AT CSR, SO THEY GO BY
CLUSTERS, THEY KEEP CHANGING THE
SCIENCE.
GO BACK TO THE STUDY SECTIONS
AND SEE WHO THE REVIEWERS WERE,
BECAUSE THEY DO HAVE STANDING
STUDY SECTION ROSTERS FOR THE
LAST THREE ROUNDS.
SO THAT'S VERY HELPFUL TO KNOW,
SO ARE THESE THE PEERS YOU WANT
TO KNOW?
IF THOSE ARE SOME OF THE FEA
FEARS -- YOU CAN REQUEST WHAT
OTHER EXPERTISE YOU KNOW AND THE
SRO WILL TAKE THAT INTO
CONSIDERATION.
SO THESE ARE SOME OF THE TOOLS
THAT YOU CAN USE IF YOUR
APPLICATION IS GOING TO CSR.
>> ONE MORE THING.
WHEN YOU WRITE YOUR ABSTRACT,
THERE IS YOU SUBMIT YOUR
ABSTRACT IN THAT MATCH MAKER AND
IT WILL TELL YOU WHAT THE
PROBABLE STUDY SECTION AND ALL
THOSE THINGS SO THAT'S VERY
HELPFUL, I THINK.
>> THANK YOU, SANGEETA,
>> RIGHT NOW WE ARE AT TIME.
AND I WANT TO JUST ASK, IS THERE
ANY QUICK THING THAT ANYBODY
ELSE WANTS TO BRING UP HERE?
I WANT TO THANK ALL OF YOU FOR
YOUR ENGAGEMENT HERE.
THIS IS -- OVER THE PAST FEW
YEARS, AGAIN, I MADE THIS POINT
EARLIER, I HOPE IT COMES ACROSS
THAT WE REALLY DO LISTEN TO WHAT
YOU SAY HERE, AND I HOPE IT
COMES ACROSS, SOME OF THE THINGS
THAT, YOU KNOW, COME UP ON THE
PODIUM HERE ARE DIRECTLY IN
RESPONSE TO THINGS THAT YOU'VE
HEARD FROM HERE.
I WANT TO THANK OUR STAFF HERE
WHO'S -- AS YOU ALL KNOW ARE THE
ONES WHO DO THE REAL WORK.
SANGEETA AND JIMMY PRESENTED TWO
REALLY NICE IDEAS, AND THANKS TO
THE COUNCIL FOR YOUR COMMENTS ON
THOSE, AND SANGEETA AND JIMMY, I
KNOW IT TOOK A LOT OF
INITIATIVE, AS HAVE MANY OTHERS
TO COME UP WITH IDEAS THAT YOU
WILL END UP HEARING ABOUT IN THE
FUTURE.
SO WITH THAT, I'M GOING TO CLOSE
HERE.
FOR THOSE STAYING FOR THE CLOSED
SESSION, WE'RE GOING TO TAKE A
15-MINUTE BREAK AND ACTUALLY
WE'RE GOING TO PICK UP AT 2:30.
OTHERWISE, THIS SESSION IS
ADJOURNED.
THANK YOU.