1 00:00:07,236 --> 00:00:09,705 >> I WOULD LIKE TO WELCOME 2 00:00:09,705 --> 00:00:16,512 EVERYONE TO THE 165th 3 00:00:16,512 --> 00:00:21,584 MEETING -- 66th MEETING OF THE 4 00:00:21,584 --> 00:00:22,752 NATIONALITY ADVISORY COUNCIL ON 5 00:00:22,752 --> 00:00:28,357 ALCOHOL ABUSE AND ALCOHOLISM. 6 00:00:28,357 --> 00:00:29,925 I'LL LET PHILIPPE GIVE 7 00:00:29,925 --> 00:00:39,869 INSTRUCTIONS AFTER WE DO THE 8 00:00:39,869 --> 00:00:40,202 INTRODUCTIONS. 9 00:00:40,202 --> 00:00:42,304 I'M GOING TO CALL ON YOU AND 10 00:00:42,304 --> 00:00:46,008 MAYBE SAY YOUR NAME AND WHERE 11 00:00:46,008 --> 00:00:50,880 YOU'RE FROM AND YOUR -- MAYBE 12 00:00:50,880 --> 00:00:52,414 ONE SENTENCE ABOUT WHAT YOU WORK 13 00:00:52,414 --> 00:00:53,282 ON. 14 00:00:53,282 --> 00:00:53,849 ALL RIGHT? 15 00:00:53,849 --> 00:00:57,920 SO, I'M GOING TO START WITH 16 00:00:57,920 --> 00:00:59,789 ZOOM, NANCY BARNETT. 17 00:00:59,789 --> 00:01:00,756 >> HELLO, NANCY BARNETT FROM THE 18 00:01:00,756 --> 00:01:04,126 SCHOOL OF PUBLIC HEALTH AT BROWN 19 00:01:04,126 --> 00:01:04,693 UNIVERSITY. 20 00:01:04,693 --> 00:01:07,730 I STUDY ALCOHOL USE IN YOUNG 21 00:01:07,730 --> 00:01:10,733 PEOPLE FROM THE PERSPECTIVE OF 22 00:01:10,733 --> 00:01:12,968 SOCIAL INFLUENCE AND SOCIAL 23 00:01:12,968 --> 00:01:16,038 NETWORK ANALYSIS AND BY STANDARD 24 00:01:16,038 --> 00:01:17,740 INTERVENTION I ALSO STUDY 25 00:01:17,740 --> 00:01:21,076 ALCOHOL SENSORS AND THEIR 26 00:01:21,076 --> 00:01:23,946 VALIDITY, WEARABLE ALCOHOL 27 00:01:23,946 --> 00:01:24,647 BIOSENSORS. 28 00:01:24,647 --> 00:01:34,990 >> THANKS, NANCY. 29 00:01:44,133 --> 00:01:45,968 AND CAMERON. 30 00:01:45,968 --> 00:01:46,836 >> [ GARBLED AUDIO ]. 31 00:01:46,836 --> 00:01:49,371 >> WE'LL HEAR HIM IF FRET, JOHNS 32 00:01:49,371 --> 00:01:49,605 HOPKINS. 33 00:01:49,605 --> 00:01:50,472 >> TINA CHAMBERS, UNIVERSITY OF 34 00:01:50,472 --> 00:01:52,241 CALIFORNIA, SAN DIEGO, 35 00:01:52,241 --> 00:01:54,610 DEPARTMENT OF PEDIATRICS, AND I 36 00:01:54,610 --> 00:01:56,178 STUDY PRENATAL EXPOSURE TO 37 00:01:56,178 --> 00:01:57,112 ALCOHOL AND HEALTH OUTCOMES FOR 38 00:01:57,112 --> 00:02:01,951 THE MOTHER AND THE BABY. 39 00:02:01,951 --> 00:02:04,220 >> OKAY. 40 00:02:04,220 --> 00:02:05,254 THANK YOU, TINA. 41 00:02:05,254 --> 00:02:10,492 WESTLEY CLARK CAN'T BE HERE, NOR 42 00:02:10,492 --> 00:02:13,395 NANCY GONZALEZ, SO HAIDEN 43 00:02:13,395 --> 00:02:14,897 HUSKAMP. 44 00:02:14,897 --> 00:02:17,967 >> HAIDEN HUSKAMP FROM HARVARD 45 00:02:17,967 --> 00:02:23,772 MEDICAL SCHOOL, HEALTH 46 00:02:23,772 --> 00:02:27,042 ECONOMIST, UTILIZATION OF CARE, 47 00:02:27,042 --> 00:02:28,143 INCLUDING OUTCOMES. 48 00:02:28,143 --> 00:02:34,884 >> THANKS, WELCOME TO OUR 49 00:02:34,884 --> 00:02:35,117 COUNCIL. 50 00:02:35,117 --> 00:02:36,652 RHONDA JONES-WEBB. 51 00:02:36,652 --> 00:02:39,889 >> GOOD MORNING, RHONDA 52 00:02:39,889 --> 00:02:40,856 JONES-WEBB, PROFESSOR IN 53 00:02:40,856 --> 00:02:42,124 DIVISION OF EPI AND COMMUNITY 54 00:02:42,124 --> 00:02:44,994 HEALTH, SCHOOL OF PUBLIC HEALTH, 55 00:02:44,994 --> 00:02:47,863 AND MY RESEARCH FOCUSES ON 56 00:02:47,863 --> 00:02:49,265 ALCOHOL EPIDEMIOLOGY AND POLICY 57 00:02:49,265 --> 00:02:53,636 WITH A SPECIAL FOCUS ON RACE, 58 00:02:53,636 --> 00:02:55,704 CLASS, AND NEIGHBORHOOD 59 00:02:55,704 --> 00:02:56,572 INFLUENCES. 60 00:02:56,572 --> 00:02:59,108 >> THANKS, RHONDA. 61 00:02:59,108 --> 00:03:00,910 AND DAVID KAREKEN. 62 00:03:00,910 --> 00:03:02,678 >> DAVID KAREKEN, PROFESSOR AND 63 00:03:02,678 --> 00:03:05,581 VICE CHAIR FOR RESEARCH AT 64 00:03:05,581 --> 00:03:06,248 DEPARTMENT OF NEUROLOGY, INDIANA 65 00:03:06,248 --> 00:03:08,951 UNIVERSITY SCHOOL OF MEDICINE, 66 00:03:08,951 --> 00:03:10,252 ALSO DIRECTOR OF THE INDIANA 67 00:03:10,252 --> 00:03:11,687 UNIVERSITY ALCOHOL RESEARCH 68 00:03:11,687 --> 00:03:13,689 CENTER AND MY OWN RESEARCH 69 00:03:13,689 --> 00:03:16,191 CENTERS ON HUMAN BRAIN IMAGING 70 00:03:16,191 --> 00:03:22,064 AND ALCOHOL USE DISORDER RISK. 71 00:03:22,064 --> 00:03:27,670 >> THANKS, DAVID. 72 00:03:27,670 --> 00:03:32,308 AND FRANCES LEVIN? 73 00:03:32,308 --> 00:03:34,276 >> ADDICTION PSYCHIATRIST, CHIEF 74 00:03:34,276 --> 00:03:37,246 OF THE SUBSTANCE USE DISORDER 75 00:03:37,246 --> 00:03:42,584 COLUMBIA UNIVERSITY NEW YORK 76 00:03:42,584 --> 00:03:43,986 STATE PSYCHIATRIC INSTITUTES, 77 00:03:43,986 --> 00:03:44,753 FOCUSING ON INTERVENTIONS FOR 78 00:03:44,753 --> 00:03:48,390 INDIVIDUALS WITH A RANGE OF 79 00:03:48,390 --> 00:03:50,359 SUBSTANCE USE DISORDERS, 80 00:03:50,359 --> 00:03:54,163 COCAINE, MARIJUANA, OPIATES, AND 81 00:03:54,163 --> 00:03:55,664 ALCOHOL, AND PARTICULAR EMPHASIS 82 00:03:55,664 --> 00:03:57,766 ON PSYCHIATRIC COMORBIDITY WITH 83 00:03:57,766 --> 00:03:59,335 PARTICULARLY WE'VE DONE WORK IN 84 00:03:59,335 --> 00:04:02,838 THE AREA OF ADULT AND ADOLESCENT 85 00:04:02,838 --> 00:04:05,574 ADHD AND SUBSTANCE USE 86 00:04:05,574 --> 00:04:06,108 DISORDERS. 87 00:04:06,108 --> 00:04:07,209 >> THANKS, FRANCES. 88 00:04:07,209 --> 00:04:10,412 WELCOME TO OUR COUNCIL. 89 00:04:10,412 --> 00:04:11,847 MICHAEL LEWIS? 90 00:04:11,847 --> 00:04:13,849 YES, HELLO, EVERYONE. 91 00:04:13,849 --> 00:04:16,085 MICHAEL LEWIS, AND I'M 92 00:04:16,085 --> 00:04:18,387 PROFESSOR, DEPARTMENT OF 93 00:04:18,387 --> 00:04:20,923 PSYCHOLOGY AT HUNTER COLLEGE, 94 00:04:20,923 --> 00:04:21,557 GRADUATE CENTER, CITY UNIVERSITY 95 00:04:21,557 --> 00:04:22,224 OF NEW YORK. 96 00:04:22,224 --> 00:04:24,793 AND I'M INTERESTED IN LOTS OF 97 00:04:24,793 --> 00:04:30,933 DIMENSIONS OF ALCOHOL BUT 98 00:04:30,933 --> 00:04:32,901 ESPECIALLY INTERESTED IN 99 00:04:32,901 --> 00:04:33,736 MOTIVATIONAL, AND CHEMICAL 100 00:04:33,736 --> 00:04:34,703 INTERVENTIONS OF ALCOHOL ABUSE 101 00:04:34,703 --> 00:04:41,877 AND GLAD TO BE HERE. 102 00:04:41,877 --> 00:04:43,345 >> THANKS, MICHAEL. 103 00:04:43,345 --> 00:04:46,915 DAYNE MAYFIELD. 104 00:04:46,915 --> 00:04:49,918 >> DAYNE MAYFIELD, DEPARTMENT OF 105 00:04:49,918 --> 00:04:50,586 NEUROBIOLOGY, WAGGONER CENTER, 106 00:04:50,586 --> 00:04:54,523 UNIVERSITY OF TEXAS AT AUSTIN, 107 00:04:54,523 --> 00:04:57,159 MY WORK UTILIZES BOTH HUMAN 108 00:04:57,159 --> 00:05:02,498 POSTMORTEM BRAIN AND ANIMAL 109 00:05:02,498 --> 00:05:05,134 MODELS, AND WITH FOCUS GENETIC 110 00:05:05,134 --> 00:05:09,438 APPROACHES TO IDENTIFY TARGETS 111 00:05:09,438 --> 00:05:13,776 FOR THERAPEUTIC DEVELOPMENT. 112 00:05:13,776 --> 00:05:14,109 >> WELCOME. 113 00:05:14,109 --> 00:05:15,878 KATIE WITKIEWITZ? 114 00:05:15,878 --> 00:05:17,112 >> GOOD MORNING, KATIE 115 00:05:17,112 --> 00:05:17,646 WITKIEWITZ, DISTINGUISHED 116 00:05:17,646 --> 00:05:18,180 PROFESSOR OF PSYCHOLOGY 117 00:05:18,180 --> 00:05:19,081 UNIVERSITY OF NEW MEXICO AND 118 00:05:19,081 --> 00:05:21,150 DIRECTOR OF THE CENTER ON 119 00:05:21,150 --> 00:05:23,652 ALCOHOL SUBSTANCE USE AND 120 00:05:23,652 --> 00:05:25,054 ADDICTION, AND RESEARCH BROADLY 121 00:05:25,054 --> 00:05:28,123 BEHAVIORAL TREATMENTS, PRECISION 122 00:05:28,123 --> 00:05:29,858 MEDICINE, AND RECOVERY. 123 00:05:29,858 --> 00:05:30,526 >> THANKS, EVERYBODY. 124 00:05:30,526 --> 00:05:34,229 SO I'M JUST GOING TO INTRODUCE 125 00:05:34,229 --> 00:05:38,200 SENIOR STAFF, I'LL LET THEM 126 00:05:38,200 --> 00:05:39,535 INTRODUCE THEMSELVES AND WE'LL 127 00:05:39,535 --> 00:05:43,405 GO FROM MYSELF TO MY RIGHT. 128 00:05:43,405 --> 00:05:46,542 I'M OBVIOUSLY YOU KNOW ME, 129 00:05:46,542 --> 00:05:52,114 DIRECTOR OF NIAAA, SO TRISH? 130 00:05:52,114 --> 00:05:54,049 >> GOOD MORNING 131 00:05:54,049 --> 00:05:56,652 DEPUTY DIRECTOR NIAAA. 132 00:05:56,652 --> 00:05:57,519 >> GOOD MORNING, KATHY YOUNG, 133 00:05:57,519 --> 00:05:59,488 DIRECTOR OF THE DIVISION OF 134 00:05:59,488 --> 00:06:00,189 METABOLISM AND HEALTH EFFECTS, 135 00:06:00,189 --> 00:06:01,790 THAT'S THE DIVISION THAT LOOKS 136 00:06:01,790 --> 00:06:04,993 AT THE EFFECTS OF ALCOHOL ON 137 00:06:04,993 --> 00:06:06,762 ORGAN DAMAGE. 138 00:06:06,762 --> 00:06:08,230 >> HELLO, BRIDGE IT WILLIAMSON, 139 00:06:08,230 --> 00:06:09,565 DIRECTOR OF OFFICE OF SCIENCE 140 00:06:09,565 --> 00:06:11,834 POLICY COMMUNICATIONS AND 141 00:06:11,834 --> 00:06:15,070 ASSOCIATE DIRECTOR FOR BASIC 142 00:06:15,070 --> 00:06:16,839 RESEARCH NIAAA. 143 00:06:16,839 --> 00:06:19,208 >> HI, DAVID GOLDMAN, CLINICAL 144 00:06:19,208 --> 00:06:29,718 DIRECTOR, CHIEF OF THE LAB OF 145 00:06:33,422 --> 00:06:33,689 NEUROGENETICS. 146 00:06:33,689 --> 00:06:35,090 >> RAY LITTEN, DIVISION OF 147 00:06:35,090 --> 00:06:38,060 TREATMENT AND RECOVERY. 148 00:06:38,060 --> 00:06:40,229 >> HELLO, I'M ANTONIO, AND I'M 149 00:06:40,229 --> 00:06:45,467 THE DIRECTOR OF THE DIVISION OF 150 00:06:45,467 --> 00:06:48,437 NEUROSCIENCE AND BEHAVIOR. 151 00:06:48,437 --> 00:06:50,739 >> DAVID GOLDMAN, COULD YOU 152 00:06:50,739 --> 00:06:53,275 SHARE YOUR MICROPHONE AND LET 153 00:06:53,275 --> 00:07:01,383 DAWN INTRODUCE HERSELF? 154 00:07:01,383 --> 00:07:05,354 >> HELLO, DAWN WAYMAN, 155 00:07:05,354 --> 00:07:06,221 SCIENTIFIC DIVERSITY OFFICER AT 156 00:07:06,221 --> 00:07:06,421 NIAA. 157 00:07:06,421 --> 00:07:07,689 >> DID YOU MISS ANYBODY? 158 00:07:07,689 --> 00:07:10,192 MOST OF YOU KNOW THE STAFF. 159 00:07:10,192 --> 00:07:14,496 IF YOU DON'T, YOU CAN 160 00:07:14,496 --> 00:07:18,734 CERTAINLY -- OH, YEAH, SORRY. 161 00:07:18,734 --> 00:07:29,178 >> PHILIPPE MARMMILLOT. 162 00:07:32,080 --> 00:07:34,850 >> AND VICKIE, SORRY ABOUT THAT. 163 00:07:34,850 --> 00:07:36,718 >> VICKIE BUCKLEY, NIAA 164 00:07:36,718 --> 00:07:38,320 EXECUTIVE OFFICER AND DEPUTY 165 00:07:38,320 --> 00:07:40,289 ETHICS COUNSELOR. 166 00:07:40,289 --> 00:07:42,491 NICE TO SEE EVERYONE. 167 00:07:42,491 --> 00:07:44,326 >> I'M GLAD MY STAFF SPEAKS UP 168 00:07:44,326 --> 00:07:46,562 BECAUSE I'M ALWAYS DOING THIS. 169 00:07:46,562 --> 00:07:47,663 SO, YOU KNOW. 170 00:07:47,663 --> 00:07:50,365 >> ONE MORE PERSON, GEORGE. 171 00:07:50,365 --> 00:07:52,367 >> ONE MORE PERSON, WHO IS THAT? 172 00:07:52,367 --> 00:07:54,102 >> BOB FREEMAN. 173 00:07:54,102 --> 00:07:58,273 >> BOB FREEMAN, DEPUTY CHEF, EPI 174 00:07:58,273 --> 00:07:59,675 AND PREVENTION. 175 00:07:59,675 --> 00:08:00,776 >> BOB'S HERE BECAUSE RALPH 176 00:08:00,776 --> 00:08:04,413 WASN'T ABLE TO MAKE IT TO THIS 177 00:08:04,413 --> 00:08:04,713 MEETING. 178 00:08:04,713 --> 00:08:09,985 THANKS, BOB, FOR STEPPING IN. 179 00:08:09,985 --> 00:08:12,654 ALL RIGHT. 180 00:08:12,654 --> 00:08:17,859 SO I'M SUPPOSED TO DO A 181 00:08:17,859 --> 00:08:18,760 DIRECTOR'S REPORT. 182 00:08:18,760 --> 00:08:22,898 IT'S TIME FOR THE KOOB JOURNAL 183 00:08:22,898 --> 00:08:33,008 CLUB. 184 00:09:07,576 --> 00:09:09,344 CAN EVERYBODY SEE THIS, ONLINE 185 00:09:09,344 --> 00:09:12,714 AND LIVE? 186 00:09:12,714 --> 00:09:17,953 ALL RIGHT. 187 00:09:17,953 --> 00:09:25,127 SO, I'M GOING TO BE -- NOT 188 00:09:25,127 --> 00:09:35,270 MOVING. 189 00:09:37,606 --> 00:09:41,576 I'M GOING TO BE DOING THAT 190 00:09:41,576 --> 00:09:43,412 INSTITUTE AND NIH UPDATES. 191 00:09:43,412 --> 00:09:44,446 OKAY. 192 00:09:44,446 --> 00:09:46,815 WE'RE GOOD. 193 00:09:46,815 --> 00:09:47,049 THANKS. 194 00:09:47,049 --> 00:09:53,121 SO FIRST THING, SAD NEWS FOR US 195 00:09:53,121 --> 00:09:56,191 AT NIAAA, DALE HERELD PASSED 196 00:09:56,191 --> 00:09:58,827 AWAY, HE WAS AN MD/PHD THAT 197 00:09:58,827 --> 00:10:01,563 SERVED WITH US FOR MANY YEARS. 198 00:10:01,563 --> 00:10:03,465 HE SERVED AS HEALTH SCIENTIST 199 00:10:03,465 --> 00:10:05,967 ADMINISTRATOR IN DIVISION OF 200 00:10:05,967 --> 00:10:07,969 METABOLISM AND HEALTH EFFECTS 201 00:10:07,969 --> 00:10:11,239 FROM 2008 UNTIL HIS RETIREMENT 202 00:10:11,239 --> 00:10:14,176 IN 2019, MANAGED THE FETAL 203 00:10:14,176 --> 00:10:15,177 ALCOHOL SPECTRUM DISORDERS 204 00:10:15,177 --> 00:10:18,447 RESEARCH PORTFOLIO AND THEN WAS 205 00:10:18,447 --> 00:10:20,882 NIAAA PROJECT SCIENTIST FOR 206 00:10:20,882 --> 00:10:24,653 PRENATAL ALCOHOL SIDS, AND 207 00:10:24,653 --> 00:10:26,455 STILLBIRTH RESEARCH, WHICH IS 208 00:10:26,455 --> 00:10:33,562 THE PASS NETWORK, AND 209 00:10:33,562 --> 00:10:35,897 COLLABORATIVE INITIATIVE ON 210 00:10:35,897 --> 00:10:41,002 CIFASD, RESEARCH CONSORTIUM ON 211 00:10:41,002 --> 00:10:42,504 COLLABORATION ON FASD 212 00:10:42,504 --> 00:10:43,939 PREVALENCE, CoFASP. 213 00:10:43,939 --> 00:10:47,909 HE REPRESENTED NIAA ON MANY 214 00:10:47,909 --> 00:10:49,411 NIH-WIDE COMMITTEES AND 215 00:10:49,411 --> 00:10:53,382 PROJECTS, A BELOVED MEMBER OF 216 00:10:53,382 --> 00:10:54,549 THE NIAAA FAMILY, COUNTED 217 00:10:54,549 --> 00:10:58,353 YOURSELF LUCKY TO HAVE KNOWN 218 00:10:58,353 --> 00:11:00,355 HIM, WITNESSED HIS KINDNESS OR 219 00:11:00,355 --> 00:11:01,857 TOUCH OF HIS QUICK-WITTED HUMAN, 220 00:11:01,857 --> 00:11:04,226 WILL BE DEEPLY MISSED BY HIS 221 00:11:04,226 --> 00:11:05,694 FAMILY, FRIENDS, NIAAA 222 00:11:05,694 --> 00:11:05,994 COLLEAGUES. 223 00:11:05,994 --> 00:11:16,505 SO WE LOST ONE OF OUR FORMER 224 00:11:16,705 --> 00:11:23,145 REALLY DYNAMIC STAFF. 225 00:11:23,145 --> 00:11:27,482 WE HAD A CONGRESSIONAL BRIEFING 226 00:11:27,482 --> 00:11:30,452 JUST ABOUT THE TIME THEY WERE 227 00:11:30,452 --> 00:11:34,389 VOTING ON THE BUDGET, AND SO IT 228 00:11:34,389 --> 00:11:41,263 WAS REALLY QUITE NICE THAT 229 00:11:41,263 --> 00:11:42,497 REPRESENTATIVE PAUL TONKO CAME 230 00:11:42,497 --> 00:11:44,666 AND GAVE A FEW REMARKS AT THE 231 00:11:44,666 --> 00:11:46,468 BEGINNING OF OUR CONGRESSIONAL 232 00:11:46,468 --> 00:11:47,102 BRIEFING. 233 00:11:47,102 --> 00:11:48,970 WE DO THESE ON A REGULAR BASIS 234 00:11:48,970 --> 00:11:51,006 IN COLLABORATION WITH THE 235 00:11:51,006 --> 00:11:53,008 FRIENDS OF NIAAA, THE AMERICAN 236 00:11:53,008 --> 00:11:53,775 PSYCHOLOGICAL ASSOCIATION, AND 237 00:11:53,775 --> 00:11:56,077 CONGRESSIONAL ADDICTION 238 00:11:56,077 --> 00:11:57,646 TREATMENT AND RECOVERY CAUCUS. 239 00:11:57,646 --> 00:12:00,248 IT'S USUALLY MOSTLY FOR STAFF 240 00:12:00,248 --> 00:12:01,750 BUT OCCASIONALLY A CONGRESSMAN 241 00:12:01,750 --> 00:12:05,187 SHOWS UP, AND THAT'S GOOD TOO. 242 00:12:05,187 --> 00:12:07,589 SO THIS ONE WAS ENTITLED 243 00:12:07,589 --> 00:12:08,557 PREVENTING ALCOHOL MISUSE, 244 00:12:08,557 --> 00:12:12,060 RESEARCH TO IMPROVE AND SAVE 245 00:12:12,060 --> 00:12:15,630 LIVES, IT FEATURED, AS I SAID, 246 00:12:15,630 --> 00:12:18,133 PAULTONKO AND DR. WILLIAM 247 00:12:18,133 --> 00:12:20,702 WIECZOREK, CHAIR OF FRIENDS OF 248 00:12:20,702 --> 00:12:23,972 NIAAA, AND OVERVIEW OF THE NEEDS 249 00:12:23,972 --> 00:12:25,307 AND OPPORTUNITIES IN PREVENTION 250 00:12:25,307 --> 00:12:29,444 RESEARCH, THREE SPEAKERS GAVE 251 00:12:29,444 --> 00:12:30,946 EXCELLENT TALKS, DR. PASCALL, 252 00:12:30,946 --> 00:12:32,481 LIVINGSTON AND LEWIS AND 253 00:12:32,481 --> 00:12:34,216 DISCUSSED RESEARCH ON INDIVIDUAL 254 00:12:34,216 --> 00:12:35,550 AND ENVIRONMENTAL APPROACHES FOR 255 00:12:35,550 --> 00:12:36,551 ALCOHOL MISUSE PREVENTION. 256 00:12:36,551 --> 00:12:37,752 I ENJOYED IT VERY MUCH. 257 00:12:37,752 --> 00:12:42,090 I THINK THE STAFF DID AS WELL. 258 00:12:42,090 --> 00:12:48,930 AND THEN A BUDGET PASSED RIGHT 259 00:12:48,930 --> 00:12:49,164 AFTER. 260 00:12:49,164 --> 00:12:50,799 WITH TONKO RUNNING OUT THE DOOR 261 00:12:50,799 --> 00:12:52,601 TO VOTE, I GATHER. 262 00:12:52,601 --> 00:12:54,536 ANYWAY, SPEAKING OF THE BUDGET, 263 00:12:54,536 --> 00:12:57,005 ON MARCH 23 PRESIDENT BIDEN 264 00:12:57,005 --> 00:13:00,141 SIGNED THE FURTHER CONSOLIDATED 265 00:13:00,141 --> 00:13:04,045 APPROPRIATIONS ACT OF 2024. 266 00:13:04,045 --> 00:13:08,850 NIH RECEIVED $47.2 BILLION, .8% 267 00:13:08,850 --> 00:13:10,385 DECREASE BELOW FISCAL 2023 268 00:13:10,385 --> 00:13:13,688 ENACTED LEVEL. 269 00:13:13,688 --> 00:13:15,957 WE RECEIVED $595.3 MILLION FOR 270 00:13:15,957 --> 00:13:17,726 FISCAL YEAR 2024, THE SAME 271 00:13:17,726 --> 00:13:20,662 AMOUNT APPROPRIATED IN FISCAL 272 00:13:20,662 --> 00:13:21,763 YEAR 2023. 273 00:13:21,763 --> 00:13:24,032 TO BE HONEST, WE'RE PRETTY 274 00:13:24,032 --> 00:13:27,369 GRATEFUL THAT THAT'S WHAT THE 275 00:13:27,369 --> 00:13:28,837 BUDGET WAS, IN THE CURRENT 276 00:13:28,837 --> 00:13:29,304 CLIMATE. 277 00:13:29,304 --> 00:13:32,541 AS PART OF THIS ABILITY, NIH 278 00:13:32,541 --> 00:13:36,278 WILL INCREASE ANNUAL PAY 4% FOR 279 00:13:36,278 --> 00:13:38,413 PRE-DOCTORAL TRAINEES, 8% FOR 280 00:13:38,413 --> 00:13:39,548 POSTDOCTORAL SCHOLARS REPORTED 281 00:13:39,548 --> 00:13:43,652 BY THE RUTH L. KIRSCHSTEIN 282 00:13:43,652 --> 00:13:45,086 NATIONAL RESEARCH SERVICE 283 00:13:45,086 --> 00:13:45,587 AWARDS. 284 00:13:45,587 --> 00:13:49,090 ELIGIBLE PARTICIPANTS WILL ALSO 285 00:13:49,090 --> 00:13:51,092 RECEIVE $500 INCREASES IN 286 00:13:51,092 --> 00:13:53,395 SUBSIDIES FOR CHILD CARE, WHICH 287 00:13:53,395 --> 00:13:56,398 RANGE NOW FROM $2500 TO $3,000, 288 00:13:56,398 --> 00:14:00,402 AND ADDITIONAL $200 FOR 289 00:14:00,402 --> 00:14:01,469 TRAINING-RELATED EXPENSES. 290 00:14:01,469 --> 00:14:04,406 SO OUR BUDGET IS WHAT OUR BUDGET 291 00:14:04,406 --> 00:14:04,773 IS. 292 00:14:04,773 --> 00:14:06,942 I JUST, YOU KNOW, PUT IT IN 293 00:14:06,942 --> 00:14:11,646 TERMS THAT WE LIVE WITH, WE HAVE 294 00:14:11,646 --> 00:14:13,248 A PRETTY HIGH TURN THIS YEAR, 295 00:14:13,248 --> 00:14:16,051 FUNDED A LOT OF GRANTS LAST YEAR 296 00:14:16,051 --> 00:14:17,852 WITH OUR BUDGET INCREASE, AND 297 00:14:17,852 --> 00:14:23,658 NOW WE'RE PAYING THEM AS 298 00:14:23,658 --> 00:14:25,560 NON-COMPETING RENEWALS. 299 00:14:25,560 --> 00:14:30,265 BUT OTHER THAN THAT WE'RE GOING 300 00:14:30,265 --> 00:14:31,933 TO CONTINUE TO CONTINUE. 301 00:14:31,933 --> 00:14:35,837 AND I'M PLEASED TO ANNOUNCE DR. 302 00:14:35,837 --> 00:14:41,109 PHILIPPE MARMILLOT HAS BEEN 303 00:14:41,109 --> 00:14:43,111 SELECTED AS NIAAA NEW DIRECTOR 304 00:14:43,111 --> 00:14:44,913 OF OFFICE OF EXTRAMURAL 305 00:14:44,913 --> 00:14:48,750 ACTIVITIES, HE SERVED AS ACTING 306 00:14:48,750 --> 00:14:50,218 DIRECTOR PRIOR TO APPOINTMENT. 307 00:14:50,218 --> 00:14:54,055 HE WILL PROVIDE OVERSIGHT OVER 308 00:14:54,055 --> 00:14:57,792 NIAAA'S GRANTS MANAGEMENT, PEER 309 00:14:57,792 --> 00:14:58,627 REVIEW, COMMITTEE MANAGEMENT 310 00:14:58,627 --> 00:14:59,694 ACTIVITIES, INCLUDING EXECUTIVE 311 00:14:59,694 --> 00:15:01,529 SECRETARY OF THE NIAAA ADVISORY 312 00:15:01,529 --> 00:15:02,964 COUNCIL, WHICH HE'S OBVIOUSLY 313 00:15:02,964 --> 00:15:05,834 DOING TODAY. 314 00:15:05,834 --> 00:15:09,270 HE WILL SERVE ALSO AS REFERRAL 315 00:15:09,270 --> 00:15:10,605 OFFICER AND RESEARCH INTEGRITY 316 00:15:10,605 --> 00:15:14,776 OFFICER FOR INSTITUTE. 317 00:15:14,776 --> 00:15:17,879 DR. MARMILLOT JOINT NIAAA IN 318 00:15:17,879 --> 00:15:21,683 2007 AS A SCIENTIFIC REVIEW 319 00:15:21,683 --> 00:15:21,950 OFFICERS. 320 00:15:21,950 --> 00:15:23,151 SO, WE'RE PLEASED PHILIPPE WAS 321 00:15:23,151 --> 00:15:30,291 WILLING TO TAKE THIS ON, AND HE 322 00:15:30,291 --> 00:15:33,061 MANAGED TO SURVIVE BEING AN 323 00:15:33,061 --> 00:15:38,967 ACTING DIRECTOR FOR I THINK 324 00:15:38,967 --> 00:15:43,972 ABOUT A YEAR, AND SO I HOPE YOU 325 00:15:43,972 --> 00:15:46,207 WILL WELCOME PHILIPPE TO HIS NEW 326 00:15:46,207 --> 00:15:48,410 JOB AND BE PATIENT WITH US ALL. 327 00:15:48,410 --> 00:15:50,045 AS IT TURNS OUT THIS IS A REALLY 328 00:15:50,045 --> 00:15:51,312 TOUGH JOB BECAUSE YOU HAVE TO 329 00:15:51,312 --> 00:15:53,114 MONITOR ALL THE CHANGES THAT ARE 330 00:15:53,114 --> 00:15:56,151 COMING FROM BUILDING 1, AND 331 00:15:56,151 --> 00:15:57,285 INTEGRATE THEM WITH ALL THE 332 00:15:57,285 --> 00:16:00,889 CHANGES WE WANT TO EFFECT FROM 333 00:16:00,889 --> 00:16:03,625 OUR END. 334 00:16:03,625 --> 00:16:06,261 KEEP THAT IN MIND. 335 00:16:06,261 --> 00:16:08,430 I WANTED TO ALSO HIGHLIGHT A NEW 336 00:16:08,430 --> 00:16:10,665 COMMON FUND PROGRAM TO SUPPORT 337 00:16:10,665 --> 00:16:13,268 CLINICAL RESEARCH IN PRIMARY 338 00:16:13,268 --> 00:16:14,436 CARE SETTINGS. 339 00:16:14,436 --> 00:16:16,705 THIS IS THE -- ONE OF THE 340 00:16:16,705 --> 00:16:19,074 PROGRAMS THAT OUR NEW DIRECTOR, 341 00:16:19,074 --> 00:16:21,042 DR. MONICA BERTAGNOLLI, IS 342 00:16:21,042 --> 00:16:23,445 REALLY, REALLY, REALLY EXCITED 343 00:16:23,445 --> 00:16:27,749 ABOUT HEALTH ABOUT. 344 00:16:27,749 --> 00:16:30,585 THE HEALTH IS DECLINING, 345 00:16:30,585 --> 00:16:33,054 STEEPEST AMONG UNDERSERVED AND 346 00:16:33,054 --> 00:16:33,855 UNDERREPRESENTED POPULATIONS. 347 00:16:33,855 --> 00:16:36,624 NIH SEEKS TO IMPROVE HEALTH 348 00:16:36,624 --> 00:16:39,327 OUTCOMES IN RESEARCH, EQUITY, BY 349 00:16:39,327 --> 00:16:41,262 ESTABLISHING A PRIMARY CARE 350 00:16:41,262 --> 00:16:42,530 FOCUSED CLINICAL RESEARCH 351 00:16:42,530 --> 00:16:47,435 NETWORK THAT IS DISEASE 352 00:16:47,435 --> 00:16:51,806 AGNOSTIC, FACILITATING CLINICAL 353 00:16:51,806 --> 00:16:53,374 RESEARCH IN MISSION AREAS, 354 00:16:53,374 --> 00:16:54,175 INTEGRATED RESEARCH WITH 355 00:16:54,175 --> 00:16:56,945 CLINICAL CARE IN REAL WORLD 356 00:16:56,945 --> 00:16:59,748 SETTINGS CREATING FOUNDATION FOR 357 00:16:59,748 --> 00:17:01,216 SUSTAINED ENGAGEMENT WITH 358 00:17:01,216 --> 00:17:02,016 COMMUNITIES UNDERREPRESENTED IN 359 00:17:02,016 --> 00:17:04,552 CLINICAL RESEARCH. 360 00:17:04,552 --> 00:17:06,521 THERE'S A TIMELINE HERE OF 361 00:17:06,521 --> 00:17:07,088 GATHERING FEEDBACK AND 362 00:17:07,088 --> 00:17:08,923 INFORMATION, WHICH IS WHAT WE'RE 363 00:17:08,923 --> 00:17:11,860 DOING CURRENTLY, AND A QUICK 364 00:17:11,860 --> 00:17:13,862 LAUNCH SOMETIME IN 2024 ACTUALLY 365 00:17:13,862 --> 00:17:17,665 I BELIEVE IT'S GOING TO BE JUNE 366 00:17:17,665 --> 00:17:19,534 7, SO IT'S REALLY QUICK. 367 00:17:19,534 --> 00:17:23,705 AND THEN TO EXPAND IT IN 2025 368 00:17:23,705 --> 00:17:27,242 AND BEYOND. 369 00:17:27,242 --> 00:17:29,377 NIH ANTICIPATES PROVIDING $5 370 00:17:29,377 --> 00:17:33,114 MILLION IN FISCAL YEAR 2024 AND 371 00:17:33,114 --> 00:17:35,216 $25 MILLION IN 2025 FOR THE 372 00:17:35,216 --> 00:17:36,551 COMMON FUND PROGRAM. 373 00:17:36,551 --> 00:17:37,619 FOLLOWING THE INITIAL FUNDING 374 00:17:37,619 --> 00:17:43,558 THE BUDGET IS PROJECTED TO 375 00:17:43,558 --> 00:17:44,926 INCREASE TO 50 TO 100 MILLION 376 00:17:44,926 --> 00:17:51,166 PER YEAR AFTER ASSESSING 377 00:17:51,166 --> 00:17:52,734 FEASIBILITY AND BUDGET 378 00:17:52,734 --> 00:17:53,134 REQUIREMENTS. 379 00:17:53,134 --> 00:17:53,935 IT'S AN INNOVATIVE IDEA. 380 00:17:53,935 --> 00:17:56,404 THE PART FOR ME THAT'S REALLY 381 00:17:56,404 --> 00:17:57,372 IMPORTANT IS IN REAL WORLD 382 00:17:57,372 --> 00:17:59,941 SETTINGS AND THE FACT THAT IF WE 383 00:17:59,941 --> 00:18:02,477 CAN -- IF THEY CAN PULL THIS 384 00:18:02,477 --> 00:18:05,180 OFF, PRIMARY CARE SETTINGS WILL 385 00:18:05,180 --> 00:18:07,148 BECOME A SOURCE OF CLINICAL 386 00:18:07,148 --> 00:18:07,448 STUDY. 387 00:18:07,448 --> 00:18:10,552 AND IT'S NOT GOING TO BE JUST 388 00:18:10,552 --> 00:18:13,655 TESTING THE LATEST ASPIRIN ON 389 00:18:13,655 --> 00:18:13,988 PATIENTS. 390 00:18:13,988 --> 00:18:16,691 IT WILL BE CLINICAL STUDIES THAT 391 00:18:16,691 --> 00:18:19,994 INVOLVE EVERYTHING FROM 392 00:18:19,994 --> 00:18:22,096 PREVENTION, INTERVENTIONS, TO 393 00:18:22,096 --> 00:18:25,867 NEW BEHAVIORAL TREATMENTS TO NEW 394 00:18:25,867 --> 00:18:27,402 TELEHEALTH SO THAT 395 00:18:27,402 --> 00:18:29,170 OPPORTUNITIES, SO I REALLY THINK 396 00:18:29,170 --> 00:18:32,307 THAT I'M EXCITED ABOUT IT AND I 397 00:18:32,307 --> 00:18:34,375 HOPE IT WILL PAY OFF WITH US, 398 00:18:34,375 --> 00:18:37,345 AND WHEN WE HAVE OUR DISCUSSION 399 00:18:37,345 --> 00:18:39,147 LATER TODAY ABOUT SOME OF THE 400 00:18:39,147 --> 00:18:42,116 THINGS I LISTED, YOU THINK ABOUT 401 00:18:42,116 --> 00:18:44,919 THIS IN CONTEXT OF ALCOHOL USE 402 00:18:44,919 --> 00:18:48,056 DISORDER AS FIFTH VITAL SIGN. 403 00:18:48,056 --> 00:18:49,724 I WANTED TO ALSO UPDATE YOU ON 404 00:18:49,724 --> 00:18:53,328 THE WHITE HOUSE INITIATIVE ON 405 00:18:53,328 --> 00:18:54,462 WOMEN'S HEALTH RESEARCH. 406 00:18:54,462 --> 00:18:56,231 NOVEMBER 2023 THE WHITE HOUSE 407 00:18:56,231 --> 00:18:58,466 ANNOUNCED A NEW INITIATIVE TO 408 00:18:58,466 --> 00:19:00,301 GALVANIZE FEDERAL GOVERNMENT TO 409 00:19:00,301 --> 00:19:01,469 CLOSE RESEARCH GAPS AND IMPROVE 410 00:19:01,469 --> 00:19:03,972 WOMEN'S HEALTH, PART OF THIS 411 00:19:03,972 --> 00:19:05,573 INITIATIVE MARCH 18 PRESIDENT 412 00:19:05,573 --> 00:19:06,674 BIDEN ANNOUNCED EXECUTIVE ORDER 413 00:19:06,674 --> 00:19:10,178 FOCUSED ON THE FOLLOWING KEY 414 00:19:10,178 --> 00:19:10,411 AREAS. 415 00:19:10,411 --> 00:19:12,547 PRIORITIZING INVESTMENTS IN 416 00:19:12,547 --> 00:19:13,681 WOMEN'S HEALTH RESEARCH, 417 00:19:13,681 --> 00:19:17,252 STIMULATING NEW RESEARCH ON 418 00:19:17,252 --> 00:19:19,420 WOMEN'S MID-LIFE HEALTH, 419 00:19:19,420 --> 00:19:20,588 DEVELOPING AND STRENGTHENING 420 00:19:20,588 --> 00:19:21,723 RESEARCH AND DATA STANDARDS 421 00:19:21,723 --> 00:19:28,696 THANE HANS -- THAT ENHANCE 422 00:19:28,696 --> 00:19:30,632 WOMEN'S HEALTH, ASSESSING NEEDS 423 00:19:30,632 --> 00:19:31,966 IN RESEARCH, INTEGRATING HEALTH 424 00:19:31,966 --> 00:19:37,105 ACROSS THE FEDERAL RESEARCH 425 00:19:37,105 --> 00:19:37,639 PORTFOLIO. 426 00:19:37,639 --> 00:19:40,909 WE-- THERE ARE A NUMBER OF NEW 427 00:19:40,909 --> 00:19:42,744 NOSIs OUT ON WOMEN'S HEALTH 428 00:19:42,744 --> 00:19:44,279 RESEARCH SO IN COORDINATION WITH 429 00:19:44,279 --> 00:19:48,816 THE WHITE HOUSE INITIATIVE ON 430 00:19:48,816 --> 00:19:50,218 WOMEN'S HEALTH RESEARCH NIH 431 00:19:50,218 --> 00:19:53,221 ISSUED A NOSI TO HIGHLIGHT OUR 432 00:19:53,221 --> 00:19:54,622 INTEREST IN APPLICATIONS FOCUSED 433 00:19:54,622 --> 00:20:01,262 ON DISEASES AND HEALTH 434 00:20:01,262 --> 00:20:02,797 CONDITIONS THAT AFFECT WOMEN AND 435 00:20:02,797 --> 00:20:03,965 ARE FEMALE SPECIFIC. 436 00:20:03,965 --> 00:20:06,868 ALL NIH INSTITUTES AND CENTERS 437 00:20:06,868 --> 00:20:07,869 ARE PARTICIPATING. 438 00:20:07,869 --> 00:20:09,570 OUR SPECIFIC AREAS OF INTEREST 439 00:20:09,570 --> 00:20:11,506 THAT WE SET UP ARE RESEARCH 440 00:20:11,506 --> 00:20:13,107 FOCUSED ON MENTAL HEALTH OF 441 00:20:13,107 --> 00:20:15,009 WOMEN INCLUDING ALCOHOL AND 442 00:20:15,009 --> 00:20:16,044 OTHER SUBSTANCE USE DISORDERS, 443 00:20:16,044 --> 00:20:19,747 RESEARCH ON HEALTH ISSUES THAT 444 00:20:19,747 --> 00:20:21,582 AFFECT YOUNG WOMEN, INCLUDING 445 00:20:21,582 --> 00:20:22,951 ETIOLOGY, PREVENTION, AND 446 00:20:22,951 --> 00:20:26,220 TREATMENT OF ALCOHOL MISUSE, AND 447 00:20:26,220 --> 00:20:28,389 NOTE ALCOHOL MISUSE AMONG 448 00:20:28,389 --> 00:20:29,891 CERTAIN SUBPOPULATIONS, YOUNG 449 00:20:29,891 --> 00:20:32,160 WOMEN IN PARTICULAR, INCREASE 450 00:20:32,160 --> 00:20:33,027 AND EXCEEDS MALE COUNTERPARTS 451 00:20:33,027 --> 00:20:37,198 FOR THE FIRST TIME AND INCREASES 452 00:20:37,198 --> 00:20:38,666 WOMEN'S RISK FOR ALCOHOL-RELATED 453 00:20:38,666 --> 00:20:39,500 POTENTIAL APPROACHESSOLOGY IN 454 00:20:39,500 --> 00:20:41,336 ALL AGE GROUPS COMPARED TO YOUNG 455 00:20:41,336 --> 00:20:41,703 MEN. 456 00:20:41,703 --> 00:20:43,504 WHEN I TALK AT CRAN TOMORROW, 457 00:20:43,504 --> 00:20:45,873 OUR JOINT MEETING WITH NIDA AND 458 00:20:45,873 --> 00:20:47,275 NCI, I'LL PROBABLY SHOW A SLIDE 459 00:20:47,275 --> 00:20:49,043 ON THIS ISSUE. 460 00:20:49,043 --> 00:20:51,079 AND IN RESEARCH TO UNDERSTAND 461 00:20:51,079 --> 00:20:53,648 THE MECHANISMS THROUGH WHICH 462 00:20:53,648 --> 00:20:54,415 ENVIRONMENTAL FACTORS INFLUENCE 463 00:20:54,415 --> 00:20:58,553 RESILIENCE AND DISEASE AMONG 464 00:20:58,553 --> 00:20:59,821 WOMEN ACROSS THE LIFESPAN. 465 00:20:59,821 --> 00:21:01,789 ONE OF OUR BIG FUNDING 466 00:21:01,789 --> 00:21:02,991 OPPORTUNITIES THAT WE'RE REALLY 467 00:21:02,991 --> 00:21:05,426 PROUD OF IS THE MODEL CONTINUUMS 468 00:21:05,426 --> 00:21:07,795 OF CARE INITIATIVE TO ADVANCE 469 00:21:07,795 --> 00:21:09,864 HEALTH EQUITY AND END HEALTH 470 00:21:09,864 --> 00:21:15,169 DISPARITIES AMONG WOMEN AND 471 00:21:15,169 --> 00:21:16,337 GIRLS IN RACIAL, ETHNIC, 472 00:21:16,337 --> 00:21:18,773 MINORITY COMMUNITIES, THIS WILL 473 00:21:18,773 --> 00:21:20,875 SUPPORT THE PLANNING PHASE OF 474 00:21:20,875 --> 00:21:24,579 THE MODELS OF CONTINUUM OF CARE, 475 00:21:24,579 --> 00:21:26,981 GOAL REDUCE PREVALENCE AND 476 00:21:26,981 --> 00:21:29,117 IMPACT OF MULTI-MORBIDITY AMONG 477 00:21:29,117 --> 00:21:30,385 RACIAL, ETHNIC MINORITY WOMEN 478 00:21:30,385 --> 00:21:31,886 AND GIRLS OF REPRODUCTIVE AGE 479 00:21:31,886 --> 00:21:36,591 WHO ARE AT RISK OF AND LIVING 480 00:21:36,591 --> 00:21:38,559 WITH MENTAL HEALTH DISORDERS, 481 00:21:38,559 --> 00:21:40,828 SUBSTANCE USE DISORDERS, COMMON 482 00:21:40,828 --> 00:21:42,864 OCCURRING PHYSICAL CONDITIONS. 483 00:21:42,864 --> 00:21:44,332 USING IMPLEMENTATION AND 484 00:21:44,332 --> 00:21:45,099 DISSEMINATION SCIENCE, THE 485 00:21:45,099 --> 00:21:47,235 INITIATIVE PROPOSES A CONTINUUM 486 00:21:47,235 --> 00:21:49,971 OF CARE APPROACH THAT INTEGRATES 487 00:21:49,971 --> 00:21:51,506 PREVENTIVE HEALTH SERVICES, 488 00:21:51,506 --> 00:21:54,075 PRIMARY CARE, BEHAVIORAL HEALTH, 489 00:21:54,075 --> 00:22:02,116 INTEGRATIVE CARE, CARDIO PULL 490 00:22:02,116 --> 00:22:02,784 CARDIOPULMONARY, ENDOCRINE, 491 00:22:02,784 --> 00:22:06,120 ANYONE WANTING TO HELP PROMOTE 492 00:22:06,120 --> 00:22:07,488 THIS AS AMBASSADORS, CONTACT 493 00:22:07,488 --> 00:22:09,357 DEIDRA ROACH, WORKING ON THIS 494 00:22:09,357 --> 00:22:10,992 NOW FOR SEVERAL YEARS BUT WE'RE 495 00:22:10,992 --> 00:22:13,161 OFF AND RUNNING AT THIS POINT. 496 00:22:13,161 --> 00:22:16,130 WE ALSO HAVE NOTICES OF INTEREST 497 00:22:16,130 --> 00:22:19,434 TO PUBLISH A FUNDING 498 00:22:19,434 --> 00:22:20,968 OPPORTUNITY, NOTICE OF INTENT TO 499 00:22:20,968 --> 00:22:23,738 PUBLISH FUNDING OPPORTUNITY FOR 500 00:22:23,738 --> 00:22:28,643 SPECIALIZED ALCOHOL RESEARCH 501 00:22:28,643 --> 00:22:30,711 CENTERS, P50, AND COMPREHENSIVE 502 00:22:30,711 --> 00:22:32,547 P 60s, OVERARCHING GOAL OF THE 503 00:22:32,547 --> 00:22:34,649 FORTHCOMING NIAAA NOTICES OF 504 00:22:34,649 --> 00:22:37,151 FUNDING OPPORTUNITIES TO SUPPORT 505 00:22:37,151 --> 00:22:38,586 A BROAD-BASED ALCOHOL RESEARCH 506 00:22:38,586 --> 00:22:41,689 CENTERS PROGRAM TO FOSTER AND 507 00:22:41,689 --> 00:22:42,890 CONDUCT INTERDISCIPLINARY 508 00:22:42,890 --> 00:22:43,791 COLLABORATIVE RESEARCH ON 509 00:22:43,791 --> 00:22:46,561 ALCOHOL USE DISORDER, ALCOHOL 510 00:22:46,561 --> 00:22:48,996 MISUSE, AND ALCOHOL-RELATED 511 00:22:48,996 --> 00:22:51,299 PROBLEMS AND OTHER 512 00:22:51,299 --> 00:22:53,801 HEALTH-RELATED CONSEQUENCES 513 00:22:53,801 --> 00:22:56,537 ACROSS THE LIFESPAN. 514 00:22:56,537 --> 00:23:00,708 P60 INVOLVES A PUBLIC COMPONENT, 515 00:23:00,708 --> 00:23:08,282 INTERACTION WITH THE COMMUNITY. 516 00:23:08,282 --> 00:23:12,253 WE'VE HAD THIS CENTERS PROGRAM 517 00:23:12,253 --> 00:23:14,889 SINCE 1977, BECAUSE I WAS PART 518 00:23:14,889 --> 00:23:16,390 OF THE ORIGINAL SUBMISSION FROM 519 00:23:16,390 --> 00:23:18,259 WHAT AT THE TIME WAS OUR 520 00:23:18,259 --> 00:23:22,797 LABORATORY AT THE SALK INSTITUTE 521 00:23:22,797 --> 00:23:24,365 LED BY FLOYD BLOOM, YOU COULD 522 00:23:24,365 --> 00:23:25,700 WELL ASK WHY IT'S STILL AROUND, 523 00:23:25,700 --> 00:23:29,070 AND THE REASON IS BECAUSE I FEEL 524 00:23:29,070 --> 00:23:31,572 THE CENTER'S PROGRAM PROVIDES A 525 00:23:31,572 --> 00:23:34,709 SEED AND GIVEN LOCALE AND GIVEN 526 00:23:34,709 --> 00:23:36,077 DOMAIN OF FUNCTION, OR 527 00:23:36,077 --> 00:23:39,147 DYSFUNCTION, IF THE CASE MAY BE, 528 00:23:39,147 --> 00:23:41,048 AND SO BECAUSE WE STARTED IN 529 00:23:41,048 --> 00:23:43,184 1977 WITH THE BUDGET OF $2 530 00:23:43,184 --> 00:23:44,785 MILLION TOTAL COST, AND STILL 531 00:23:44,785 --> 00:23:49,090 HAVE A BUDGET OF $2 MILLION IN 532 00:23:49,090 --> 00:23:52,226 TOTAL COST IN 2024, WHICH IS 47 533 00:23:52,226 --> 00:23:55,196 YEARS LATER, SOMETHING LIKE 534 00:23:55,196 --> 00:24:00,034 THAT, IF I'VE ADDED CORRECTLY, 535 00:24:00,034 --> 00:24:02,503 AND SO, YOU KNOW, WE'VE -- THE 536 00:24:02,503 --> 00:24:04,906 ONE CHANGE I'VE MADE SINCE I 537 00:24:04,906 --> 00:24:08,476 BECAME DIRECTOR IS TO FOCUS EACH 538 00:24:08,476 --> 00:24:11,112 CENTER ON A GIVEN DOMAIN OF 539 00:24:11,112 --> 00:24:14,882 ACTIVITY, COULD BE MICROBIOME, 540 00:24:14,882 --> 00:24:16,918 CENTRAL NERVOUS SYSTEM, CRAVING, 541 00:24:16,918 --> 00:24:20,388 COULD BE SOME PART OF 542 00:24:20,388 --> 00:24:21,189 INTERVENTION PREVENTION. 543 00:24:21,189 --> 00:24:22,657 SO, YOU KNOW, WE STILL HAVE OURS 544 00:24:22,657 --> 00:24:24,859 CENTERS PROGRAM AND I INTEND TO 545 00:24:24,859 --> 00:24:27,662 KEEP DOING IT IN THIS FASHION. 546 00:24:27,662 --> 00:24:30,131 WE HAVE A REQUEST FOR 547 00:24:30,131 --> 00:24:31,899 INFORMATION ON INNOVATIVE 548 00:24:31,899 --> 00:24:32,400 NON-INVASIVE BIOSENSING 549 00:24:32,400 --> 00:24:34,202 TECHNOLOGIES WITH HIGH ACCURACY 550 00:24:34,202 --> 00:24:35,937 AND HIGH RESOLUTION DETECTION OF 551 00:24:35,937 --> 00:24:37,238 BLOOD ALCOHOL LEVELS. 552 00:24:37,238 --> 00:24:39,273 SO, WE DID THIS ONE IN 553 00:24:39,273 --> 00:24:41,375 COLLABORATION WITH NATIONAL 554 00:24:41,375 --> 00:24:43,678 INSTITUTE OF BIOMEDICAL IMAGING 555 00:24:43,678 --> 00:24:44,845 AND BIOENGINEERING, WE'RE 556 00:24:44,845 --> 00:24:47,281 SEEKING INFORMATION AND SOUGHT 557 00:24:47,281 --> 00:24:49,217 INFORMATION ON CUTTING-EDGE 558 00:24:49,217 --> 00:24:49,884 BIOSENSING TECHNOLOGIES TO 559 00:24:49,884 --> 00:24:58,059 ACCELERATE DEVELOPMENT OF A 560 00:24:58,059 --> 00:24:59,227 NON-INVASIVE INCONSPICUOUS 561 00:24:59,227 --> 00:25:00,828 ALCOHOL BIOSENSORS THAT DETECTS 562 00:25:00,828 --> 00:25:01,729 CONCENTRATION WAS HIGH ACCURACY 563 00:25:01,729 --> 00:25:03,497 IN REAL TIME. 564 00:25:03,497 --> 00:25:04,699 NANCY BARNETT IS STILL WORKING 565 00:25:04,699 --> 00:25:07,335 WITH THE CURRENT ONES OUT THERE, 566 00:25:07,335 --> 00:25:11,372 BUT WE WERE -- WE FOCUSED THIS 567 00:25:11,372 --> 00:25:15,710 PARTICULAR RFI ON INFRARED 568 00:25:15,710 --> 00:25:17,478 TECHNOLOGY AND WE'LL SEE WHAT 569 00:25:17,478 --> 00:25:18,346 COMES IN. 570 00:25:18,346 --> 00:25:21,148 AND THEN WE ARE ADVANCING 571 00:25:21,148 --> 00:25:23,551 DIVERSITY, EQUITY, INCLUSION, 572 00:25:23,551 --> 00:25:25,653 AND ACCESSIBILITY IN RESEARCH BY 573 00:25:25,653 --> 00:25:27,588 PARTICIPATING IN MULTIPLE 574 00:25:27,588 --> 00:25:28,623 FUNDING OPPORTUNITIES TO 575 00:25:28,623 --> 00:25:32,126 INCREASE RESEARCH ON HEALTH 576 00:25:32,126 --> 00:25:32,727 DISPARITIES. 577 00:25:32,727 --> 00:25:33,794 ONE IS TRANSFORMATIVE RESEARCH 578 00:25:33,794 --> 00:25:35,096 TO ADDRESS HEALTH DISPARITIES 579 00:25:35,096 --> 00:25:37,231 AND ADVANCE HEALTH EQUITY, WHICH 580 00:25:37,231 --> 00:25:41,535 IS A U01 CLINICAL TRIAL OPTIONAL 581 00:25:41,535 --> 00:25:46,307 AND NIH BLUEPRINT IN BRAIN 582 00:25:46,307 --> 00:25:48,309 INITIATIVE, ADVANCEMENT IN 583 00:25:48,309 --> 00:25:52,013 NEUROSCIENCE AWARD KNOWN AS 584 00:25:52,013 --> 00:25:53,147 F99/K00, CLINICAL TRIALS NOT 585 00:25:53,147 --> 00:25:56,117 ALLOWED, THIS IS REALLY AN 586 00:25:56,117 --> 00:25:57,485 EXCELLENT PROGRAM. 587 00:25:57,485 --> 00:25:58,786 IT'S REALLY BEEN SUCCESSFUL AND 588 00:25:58,786 --> 00:26:01,789 FOR ANY OF YOU INTERESTED IN 589 00:26:01,789 --> 00:26:04,959 THIS, TAKE A LOOK AT IT ON THE 590 00:26:04,959 --> 00:26:05,893 BRAIN WEBSITE. 591 00:26:05,893 --> 00:26:07,862 AS MANY OF YOU KNOW, THE BRAIN 592 00:26:07,862 --> 00:26:10,331 HAS STEPPED FORWARD IN A NUMBER 593 00:26:10,331 --> 00:26:12,833 OF AREAS IN DIVERSITY, AND WE 594 00:26:12,833 --> 00:26:18,172 TRY TO FOLLOW IN LOCK-STEP AT 595 00:26:18,172 --> 00:26:19,006 NIAAA. 596 00:26:19,006 --> 00:26:21,175 AND REQUEST FOR INFORMATION WAS 597 00:26:21,175 --> 00:26:22,376 IMPROVING RESEARCH FRAMEWORKS TO 598 00:26:22,376 --> 00:26:24,412 ENABLE RIGOROUS STUDY OF THE 599 00:26:24,412 --> 00:26:27,081 EFFECTS OF RACISM ON BRAIN AND 600 00:26:27,081 --> 00:26:34,822 BEHAVIORAL HEALTH ACROSS THE 601 00:26:34,822 --> 00:26:36,157 LIFESPAN. 602 00:26:36,157 --> 00:26:38,959 WE JOINED NIMH, NIDA, NIMHD, 603 00:26:38,959 --> 00:26:40,761 ACKNOWLEDGING KNOWLEDGE GAPS AND 604 00:26:40,761 --> 00:26:44,365 INTACT OF STRUCTURAL RACISM ON 605 00:26:44,365 --> 00:26:46,667 BRAIN, COGNITIVE AND BEHAVIORAL 606 00:26:46,667 --> 00:26:49,170 FUNCTION ACROSS THE LIFESPAN AND 607 00:26:49,170 --> 00:26:50,171 ROLE OF STRUCTURAL SYSTEMIC 608 00:26:50,171 --> 00:26:52,273 RACISM ON THE CONDUCT OF BRAIN 609 00:26:52,273 --> 00:26:52,973 AND BEHAVIORAL RESEARCH. 610 00:26:52,973 --> 00:26:54,675 SO THESE ARE OUT THERE. 611 00:26:54,675 --> 00:26:59,347 AND I'M PROUD TO TELL YOU THAT 612 00:26:59,347 --> 00:27:03,651 THE NEW NIAAA STRATEGIC PLAN 613 00:27:03,651 --> 00:27:05,286 FISCAL YEARS 2024-2028 ADVANCING 614 00:27:05,286 --> 00:27:06,821 ALCOHOL RESEARCH TO PROMOTE 615 00:27:06,821 --> 00:27:08,656 WHOLE PERSON HEALTH AND 616 00:27:08,656 --> 00:27:13,260 WELL-BEING, IS NOW LIVE ON THE 617 00:27:13,260 --> 00:27:14,161 NIAAA WEBSITE. 618 00:27:14,161 --> 00:27:21,202 AND I THINK BRIDGET 619 00:27:21,202 --> 00:27:22,002 WILLIAMS-SIMMONS AND HER TEAM 620 00:27:22,002 --> 00:27:23,304 DESERVE A ROUND OF APPLAUSE FOR 621 00:27:23,304 --> 00:27:24,071 THIS ONE. 622 00:27:24,071 --> 00:27:28,175 THIS WAS A LOT OF WORK. 623 00:27:28,175 --> 00:27:35,516 SO THE PLAN CHARTS A COURSE FOR 624 00:27:35,516 --> 00:27:37,251 RESEARCH OVER THE NEXT FIVE 625 00:27:37,251 --> 00:27:39,253 YEARS, A LIVING DOCUMENT, WE 626 00:27:39,253 --> 00:27:42,390 WELCOME YOUR FEEDBACK. 627 00:27:42,390 --> 00:27:44,892 THANK YOU TO ALL NIAAA STAFF WHO 628 00:27:44,892 --> 00:27:46,527 CONTRIBUTED TO THE STRATEGIC 629 00:27:46,527 --> 00:27:48,629 PLAN CONTENT AND REVIEW, SPECIAL 630 00:27:48,629 --> 00:27:56,404 THANKS TO THE STRATEGIC PLAN 631 00:27:56,404 --> 00:27:57,671 TEAM. 632 00:27:57,671 --> 00:28:03,210 THAT'S KARA, LAURA, LAURA, 633 00:28:03,210 --> 00:28:04,178 BRIDGIT, AND RACHEL. 634 00:28:04,178 --> 00:28:06,680 I CALL THIS THE FUTURE IS NOW 635 00:28:06,680 --> 00:28:07,181 SLIDE. 636 00:28:07,181 --> 00:28:12,720 THE PLAN SEEKS TO ADVANCE MANY 637 00:28:12,720 --> 00:28:15,456 LONG HELD TRAINING PRIORITIES, 638 00:28:15,456 --> 00:28:17,591 BUT I'M GOING TO HIGHLIGHT KEY 639 00:28:17,591 --> 00:28:23,230 AREAS AND THEY GO AS FOLLOWING. 640 00:28:23,230 --> 00:28:23,831 DIVERSITY, EQUITY, INCLUSION, 641 00:28:23,831 --> 00:28:27,034 AND ACCESSIBILITY IN THE ALCOHOL 642 00:28:27,034 --> 00:28:28,436 RESEARCH ENTERPRISE, WOMEN'S 643 00:28:28,436 --> 00:28:29,603 HEALTH RESEARCH, WHOLE PERSON 644 00:28:29,603 --> 00:28:32,840 HEALTH AND INTEGRATED HEALTH 645 00:28:32,840 --> 00:28:33,374 APPROACHES, DATA SCIENCE, 646 00:28:33,374 --> 00:28:35,476 ARTIFICIAL INTELLIGENCE AND DATA 647 00:28:35,476 --> 00:28:38,412 MANAGEMENT, TRANSLATION AND BACK 648 00:28:38,412 --> 00:28:38,913 TRANSLATION OF RESEARCH 649 00:28:38,913 --> 00:28:39,547 FINDINGS, SOCIAL DETERMINANTS OF 650 00:28:39,547 --> 00:28:42,750 HEALTH IN THE CONTEXT OF RISK 651 00:28:42,750 --> 00:28:44,852 AND RESILIENCE, SOCIAL MEDIA 652 00:28:44,852 --> 00:28:46,320 IMPACT ON ALCOHOL-RELATED 653 00:28:46,320 --> 00:28:47,188 BEHAVIORS AND OUTCOMES, AND 654 00:28:47,188 --> 00:28:50,157 SOCIAL MEDIA AS A TOOL FOR 655 00:28:50,157 --> 00:28:51,058 INNOVATING INTERVENTIONS. 656 00:28:51,058 --> 00:28:52,460 BRIDGIT, YOU'RE GOING TO GIVE A 657 00:28:52,460 --> 00:28:53,527 BRIEF TALK ABOUT THIS? 658 00:28:53,527 --> 00:28:54,728 NO, YOU'RE NOT? 659 00:28:54,728 --> 00:28:58,432 I JUST DID IT? 660 00:28:58,432 --> 00:28:59,834 OH, ALL RIGHT. 661 00:28:59,834 --> 00:29:00,568 ALL RIGHT. 662 00:29:00,568 --> 00:29:07,141 HOW DID YOU GET OUT OF THAT, 663 00:29:07,141 --> 00:29:07,475 BRIDGIT? 664 00:29:07,475 --> 00:29:07,975 SO WHAT'S AHEAD? 665 00:29:07,975 --> 00:29:13,547 WE HAVE A PUBLIC MEETING OF THE 666 00:29:13,547 --> 00:29:14,248 INTERAGENCY COORDINATING 667 00:29:14,248 --> 00:29:18,419 COMMITTEE ON MAY 9, THIS WEEK, 668 00:29:18,419 --> 00:29:21,255 AND THE ICCFASD FOSTERS IMPROVED 669 00:29:21,255 --> 00:29:22,590 COMMUNICATION, COOPERATION, 670 00:29:22,590 --> 00:29:23,591 COLLABORATION AMONG DISCIPLINES 671 00:29:23,591 --> 00:29:25,125 AND FEDERAL AGENCIES THAT 672 00:29:25,125 --> 00:29:27,561 ADDRESS ISSUES RELATED TO 673 00:29:27,561 --> 00:29:28,729 PRENATAL ALCOHOL EXPOSURE. 674 00:29:28,729 --> 00:29:31,999 IT WILL BE HERE IN PERSON, AND 675 00:29:31,999 --> 00:29:33,734 ALSO ACCESSIBLE ONLINE BY 676 00:29:33,734 --> 00:29:34,134 VIDEOCAST. 677 00:29:34,134 --> 00:29:36,904 AND I MIGHT ADD JUST AS AN 678 00:29:36,904 --> 00:29:39,907 ASIDE, WE'RE DOING A LOT OF 679 00:29:39,907 --> 00:29:42,376 THESE HYBRID OR AT LEAST BEING 680 00:29:42,376 --> 00:29:45,212 AVAILABLE ONLINE BY VIDEOCAST IN 681 00:29:45,212 --> 00:29:48,716 OUR MEETINGS, EVEN OUR 682 00:29:48,716 --> 00:29:50,184 SEMINARRERS IS. 683 00:29:50,184 --> 00:29:52,686 MORE AND MORE PEOPLE ARE 684 00:29:52,686 --> 00:29:56,323 ATTENDING THESE EVENTS LIVE BUT 685 00:29:56,323 --> 00:29:58,292 IT DOES ALLOW FOR WHOLE HERDS OF 686 00:29:58,292 --> 00:29:59,793 REASONS FOR PEOPLE WHO CAN'T 687 00:29:59,793 --> 00:30:01,262 MAKE IT LIVE TO ACCESS THESE 688 00:30:01,262 --> 00:30:04,031 MEETINGS, SO I FIND IT VERY 689 00:30:04,031 --> 00:30:04,565 VALUABLE. 690 00:30:04,565 --> 00:30:06,634 I MEAN, WHEN I GO TO WHEREVER 691 00:30:06,634 --> 00:30:09,703 AND DO A GRAND ROUNDS, THERE'S 692 00:30:09,703 --> 00:30:12,106 SOMETIMES 40, 60 PEOPLE IN THE 693 00:30:12,106 --> 00:30:15,042 ROOM, AND MAYBE 100 OR MORE WHO 694 00:30:15,042 --> 00:30:16,477 ARE ONLINE LISTENING TO THE 695 00:30:16,477 --> 00:30:17,678 GRAND ROUNDS. 696 00:30:17,678 --> 00:30:20,414 I MEAN, IT'S THE WAY THINGS ARE 697 00:30:20,414 --> 00:30:22,516 BEING DONE THESE DAYS AND I'M 698 00:30:22,516 --> 00:30:24,451 ASSUMING YOU ALL EXPERIENCE IT 699 00:30:24,451 --> 00:30:25,152 AS WELL. 700 00:30:25,152 --> 00:30:27,555 ALL RIGHT. 701 00:30:27,555 --> 00:30:30,124 NOW WE ENTER THE KOOB JOURNAL 702 00:30:30,124 --> 00:30:30,324 CLUB. 703 00:30:30,324 --> 00:30:32,860 I ALWAYS PICK WITH THE HELP OF 704 00:30:32,860 --> 00:30:34,929 STAFF, THE DIVISION DIRECTORS 705 00:30:34,929 --> 00:30:36,830 AND ALL THEIR STAFF FEED ME 706 00:30:36,830 --> 00:30:42,670 ARTICLES THEY THINK ARE QUITE 707 00:30:42,670 --> 00:30:44,939 SALIENT FROM THE PREVIOUS FEW 708 00:30:44,939 --> 00:30:47,374 MONTHS. 709 00:30:47,374 --> 00:30:49,109 AND I'VE BEEN TRYING TO PICK A 710 00:30:49,109 --> 00:30:49,476 THEME. 711 00:30:49,476 --> 00:30:53,080 TODAY'S THEME IS HUMAN STUDIES 712 00:30:53,080 --> 00:30:55,583 OF ALCOHOL MISUSE AS A 713 00:30:55,583 --> 00:30:56,483 WHOLE-BODY DISORDER. 714 00:30:56,483 --> 00:30:59,153 SO THE FIRST ONE I'M GOING TO 715 00:30:59,153 --> 00:31:00,187 HIGHLIGHT IS ACTUALLY A CLINICAL 716 00:31:00,187 --> 00:31:04,692 TRIAL THAT WAS RUN BY THE 717 00:31:04,692 --> 00:31:06,026 ALCOHOL HEPATITIS NETWORK THAT 718 00:31:06,026 --> 00:31:12,967 WE FUND AS A U MECHANISM. 719 00:31:12,967 --> 00:31:17,771 SO, AS MANY OF YOU KNOW, SEVERE 720 00:31:17,771 --> 00:31:19,340 ALCOHOL-ASSOCIATED HEPATITIS IS 721 00:31:19,340 --> 00:31:24,678 ASSOCIATED WITH HIGH SHORT-TERM 722 00:31:24,678 --> 00:31:25,279 MORTALITY. 723 00:31:25,279 --> 00:31:27,748 SO, PREDNISONE IS STANDARD OF 724 00:31:27,748 --> 00:31:30,784 CARE FOR TREATING SEVERE 725 00:31:30,784 --> 00:31:31,385 ALCOHOL-ASSOCIATED HEPATITIS, 726 00:31:31,385 --> 00:31:35,255 AND THERE WERE A NUMBER OF 727 00:31:35,255 --> 00:31:37,791 STUDIES PRE-CLINICALLY THAT 728 00:31:37,791 --> 00:31:39,126 SHOWED THAT ELEVATING 729 00:31:39,126 --> 00:31:41,829 CIRCULATING CYTOKINE LEVELS, LOW 730 00:31:41,829 --> 00:31:43,163 ZINC LEVELS, DISRUPTED GUT 731 00:31:43,163 --> 00:31:46,333 MUCOSAL BARRIER ARE OBSERVED IN 732 00:31:46,333 --> 00:31:48,636 PATIENTS WITH SEVERE 733 00:31:48,636 --> 00:31:49,236 ALCOHOL-ASSOCIATED HEPATITIS, 734 00:31:49,236 --> 00:31:53,974 AND IN ANIMAL MODELS, SO BOTH 735 00:31:53,974 --> 00:31:56,677 CLINICAL AND PRE-CLINICAL 736 00:31:56,677 --> 00:32:01,882 STUDIES. 737 00:32:01,882 --> 00:32:03,317 IN PREVIOUS STUDIES, ANAKINRA, 738 00:32:03,317 --> 00:32:07,121 DID I GET IT RIGHT, KATHY? 739 00:32:07,121 --> 00:32:10,758 ANAKINRA, WHICH IS AN IL-1 740 00:32:10,758 --> 00:32:11,725 RECEPTOR ANTAGONIST WITH 741 00:32:11,725 --> 00:32:12,359 ANTI-INFLAMMATORY PROPERTIES, 742 00:32:12,359 --> 00:32:17,631 WAS ASSOCIATED WITH REDUCTION IN 743 00:32:17,631 --> 00:32:19,066 ALCOHOL-INDUCED HEPATIC KETOSIS, 744 00:32:19,066 --> 00:32:21,602 PARTICULARLY IN PRE-CLINICAL 745 00:32:21,602 --> 00:32:22,736 MODEL OF ALCOHOL-ASSOCIATED 746 00:32:22,736 --> 00:32:23,303 HEPATITIS. 747 00:32:23,303 --> 00:32:30,177 BUT ALSO IN PATIENTS WITH SEVERE 748 00:32:30,177 --> 00:32:31,445 ALCOHOL-ASSOCIATED HEPATITIS. 749 00:32:31,445 --> 00:32:34,415 THEY ADDED ZINC BECAUSE IT SEEMS 750 00:32:34,415 --> 00:32:35,783 TO FACILITATE GUT INTEGRITY, AND 751 00:32:35,783 --> 00:32:39,753 SO THIS WAS A DOUBLE BLIND 752 00:32:39,753 --> 00:32:41,855 PLACEBO CONTROLLED PHASE 2 753 00:32:41,855 --> 00:32:44,792 TRIAL, AND IT WAS CONDUCTED TO 754 00:32:44,792 --> 00:32:49,897 COMPARE STANDARD OF CARE OF 755 00:32:49,897 --> 00:32:51,031 PREDNISONE WITH THIS ANAKINRA 756 00:32:51,031 --> 00:32:52,266 AND ZINC. 757 00:32:52,266 --> 00:32:55,102 WHICH I'M GOING TO CALL FROM NOW 758 00:32:55,102 --> 00:32:58,072 ON, BECAUSE I CAN'T PRONOUNCE 759 00:32:58,072 --> 00:33:02,843 IT, AS AN IL-1 ANTAGONIST AND 760 00:33:02,843 --> 00:33:03,043 ZINC. 761 00:33:03,043 --> 00:33:04,511 SO, THE RANDOMIZED TRIAL WAS 762 00:33:04,511 --> 00:33:07,681 STOPPED EARLY AFTER A 763 00:33:07,681 --> 00:33:08,549 PRE-SPECIFIED INTERIM ANALYSIS 764 00:33:08,549 --> 00:33:10,517 SHOWED PREDNISONE WHICH WAS 765 00:33:10,517 --> 00:33:14,221 SUPPOSED TO BE THE CONTROL WAS 766 00:33:14,221 --> 00:33:16,323 ASSOCIATED WITH HIGHER 90-DAY 767 00:33:16,323 --> 00:33:22,162 OVERALL SURVIVAL, 90% VERSUS 768 00:33:22,162 --> 00:33:25,065 70%, AND TRANSPLANT-FREE 769 00:33:25,065 --> 00:33:27,034 SURVIVAL 88 VERSUS 64% COMPARED 770 00:33:27,034 --> 00:33:29,303 TO IL-1 ANTAGONIST AND ZINC. 771 00:33:29,303 --> 00:33:31,505 YOU COULD WELL ASK, HOW DID THIS 772 00:33:31,505 --> 00:33:32,306 COME ABOUT? 773 00:33:32,306 --> 00:33:35,843 WELL, THEY DID AN INTERIM 774 00:33:35,843 --> 00:33:41,148 ANALYSIS WHEN THEY HAD HALF OF 775 00:33:41,148 --> 00:33:44,151 THE -- IT WAS PRE-SPECIFIED WHEN 776 00:33:44,151 --> 00:33:48,155 50% OF THE PATIENTS COMPLETED 777 00:33:48,155 --> 00:33:49,556 THE DESIGNATED FOLLOW-UP, THEN 778 00:33:49,556 --> 00:33:51,058 THEY STOPPED THE TRIAL BECAUSE 779 00:33:51,058 --> 00:33:55,662 THEY HAD BEEN DOING WHAT THEY 780 00:33:55,662 --> 00:33:58,065 CALL ALLELE 7-DAY STOP, SO 781 00:33:58,065 --> 00:34:01,168 ALLELE SCORE IS BASICALLY 782 00:34:01,168 --> 00:34:04,505 MEASURING YOUR BILIRUBIN LEVELS, 783 00:34:04,505 --> 00:34:05,239 AND BILIRUBIN IS INVOLVED, 784 00:34:05,239 --> 00:34:07,541 YOU'RE GOING TO BE AMAZED WHAT 785 00:34:07,541 --> 00:34:09,643 I'VE LEARNED. 786 00:34:09,643 --> 00:34:12,346 BILIRUBIN IS INVOLVED IN THE 787 00:34:12,346 --> 00:34:14,681 DESTRUCTION OF -- RESULTS FROM 788 00:34:14,681 --> 00:34:16,383 DESTRUCTION OF BLOOD VESSELS AND 789 00:34:16,383 --> 00:34:18,152 ABNORMAL BLOOD CELLS, SO WHEN 790 00:34:18,152 --> 00:34:20,788 THERE'S AN INCREASE IN BILIRUBIN 791 00:34:20,788 --> 00:34:23,423 IT CAN LEAD TO JAUNDICE AND YOU 792 00:34:23,423 --> 00:34:26,493 TURN KIND OF YELLOW, AND SO WHEN 793 00:34:26,493 --> 00:34:29,429 HAVE YOU ALLELE SCORE .45, 794 00:34:29,429 --> 00:34:33,567 GREATER THAN .45, THEY STOP THE 795 00:34:33,567 --> 00:34:34,001 TREATMENT. 796 00:34:34,001 --> 00:34:35,369 AND WHY IS THIS IMPORTANT? 797 00:34:35,369 --> 00:34:37,604 WELL, WHEN YOU LOOK AT THESE 798 00:34:37,604 --> 00:34:39,540 CURVES YOU SEE PREDNISONE WAS 799 00:34:39,540 --> 00:34:44,077 WORKING AT 90% LEVEL, IF YOU GO 800 00:34:44,077 --> 00:34:48,048 OUT EVEN 180 DAYS PREDNISONE HAD 801 00:34:48,048 --> 00:34:51,985 AN 81% SURVIVAL RATE, WHERE THE 802 00:34:51,985 --> 00:34:54,054 IL-1 ANTAGONIST HAD LESS THAN 803 00:34:54,054 --> 00:34:55,122 70% SURVIVAL RATE. 804 00:34:55,122 --> 00:35:01,395 THE REAL TAKEHOME MESSAGE FROM 805 00:35:01,395 --> 00:35:05,098 THIS IS THAT TAILORS THE 806 00:35:05,098 --> 00:35:06,767 DURATION OF GLUCOCORTICOID 807 00:35:06,767 --> 00:35:09,269 THERAPY USING DAY 7 ALLELE SCORE 808 00:35:09,269 --> 00:35:11,605 MAY BE EFFECTIVE STRATEGY FOR 809 00:35:11,605 --> 00:35:14,508 PROMOTING 90-DAY SURVIVAL IN 810 00:35:14,508 --> 00:35:17,077 INDIVIDUALS WITH SEVERE ALCOHOL 811 00:35:17,077 --> 00:35:17,411 HEPATITIS. 812 00:35:17,411 --> 00:35:18,679 AND I THINK THIS IS IMPORTANT 813 00:35:18,679 --> 00:35:21,248 BECAUSE IT MAY MEAN THAT LESS 814 00:35:21,248 --> 00:35:24,551 PREDNISONE IS BETTER THAN MORE, 815 00:35:24,551 --> 00:35:26,887 CHRONIC ADMINISTRATION OF 816 00:35:26,887 --> 00:35:34,094 PREDNISONE IS BACKFIRING IN THE 817 00:35:34,094 --> 00:35:34,962 TREATMENT OF SEVERE 818 00:35:34,962 --> 00:35:35,596 ALCOHOL-ASSOCIATED HEPATITIS. 819 00:35:35,596 --> 00:35:38,866 IT WAS A NEGATIVE TRIAL AND IT'S 820 00:35:38,866 --> 00:35:41,001 A VERY DIFFICULT PAPER TO 821 00:35:41,001 --> 00:35:44,204 DISSECT BECAUSE IF YOU THINK THE 822 00:35:44,204 --> 00:35:50,043 NEUROBIOLOGISTS LIKE ACRONYMS, 823 00:35:50,043 --> 00:35:51,144 TRY THE LIVER DOCS. 824 00:35:51,144 --> 00:35:53,280 BUT I THINK IT'S IMPORTANT, AN 825 00:35:53,280 --> 00:35:53,847 IMPORTANT OBSERVATION. 826 00:35:53,847 --> 00:35:57,150 I'LL FOLLOW WITH THE SECOND 827 00:35:57,150 --> 00:35:59,086 STUDY, WHICH IS IN A SENSE A 828 00:35:59,086 --> 00:36:01,655 COUSIN OF THE FIRST STUDY, IN A 829 00:36:01,655 --> 00:36:03,156 DIFFERENT WAY. 830 00:36:03,156 --> 00:36:04,925 THE N HERE IS VERY SMALL, WHEN 831 00:36:04,925 --> 00:36:07,594 WE GET DOWN TO THE FINAL 832 00:36:07,594 --> 00:36:10,130 ANALYSIS, THIS WAS A STUDY BY -- 833 00:36:10,130 --> 00:36:12,733 WELL, I DID MENTION THAT THERE 834 00:36:12,733 --> 00:36:17,170 WAS THE STUDY WAS FROM THE -- 835 00:36:17,170 --> 00:36:18,672 PREVIOUS STUDY FROM ALCOHOL 836 00:36:18,672 --> 00:36:25,946 NETWORK, THIS IS HARDETY CENTER, 837 00:36:25,946 --> 00:36:26,680 UNIVERSITY OF LOUISVILLE, ANDREW 838 00:36:26,680 --> 00:36:27,614 STOKES IS PART OF THIS. 839 00:36:27,614 --> 00:36:29,716 THESE ARE THE PEOPLE I 840 00:36:29,716 --> 00:36:30,417 RECOGNIZE. 841 00:36:30,417 --> 00:36:32,119 IN ANY EVENT, THIS STUDY SHOWED 842 00:36:32,119 --> 00:36:35,589 CHANGES IN LIVER PROTEINS THAT 843 00:36:35,589 --> 00:36:38,859 WERE ASSOCIATED WITH 844 00:36:38,859 --> 00:36:39,960 GLUCOCORTICOID RESPONSIVENESS, 845 00:36:39,960 --> 00:36:40,560 MORTALITY, ALCOHOL-ASSOCIATED 846 00:36:40,560 --> 00:36:43,430 HEPATITIS, APPROXIMATELY 40% OF 847 00:36:43,430 --> 00:36:45,666 PATIENTS WITH ALCOHOL-ASSOCIATED 848 00:36:45,666 --> 00:36:47,601 HEPATITIS DO NOT RESPOND TO 849 00:36:47,601 --> 00:36:48,702 GLUCOCORTICOIDS. 850 00:36:48,702 --> 00:36:50,470 I SHOWED YOU 90% RESPONDED. 851 00:36:50,470 --> 00:36:52,873 IN THIS PARTICULAR STUDY THE 852 00:36:52,873 --> 00:36:54,908 RESEARCHERS ANALYZED PROTEOMES 853 00:36:54,908 --> 00:36:57,177 FROM SAMPLES FROM PATIENTS WITH 854 00:36:57,177 --> 00:36:57,844 ALCOHOL-ASSOCIATED HEPATITIS 855 00:36:57,844 --> 00:37:01,515 BEFORE TREATMENT IN TWO GROUPS. 856 00:37:01,515 --> 00:37:04,117 ALCOHOL-ASSOCIATED HEPATITIS 857 00:37:04,117 --> 00:37:08,188 SUBJECTS WHO RESPONDED TO 858 00:37:08,188 --> 00:37:09,623 GLUCOCORTICOIDS, AND 859 00:37:09,623 --> 00:37:10,057 NON-RESPONDERS. 860 00:37:10,057 --> 00:37:12,359 THE NON-RESPONDERS, THIS IS 861 00:37:12,359 --> 00:37:14,227 IMPORTANT, THE NON-RESPONDERS 862 00:37:14,227 --> 00:37:17,931 WERE DIVIDED INTO SURVIVORS FOR 863 00:37:17,931 --> 00:37:20,233 24 WEEKS, AND NON-SURVIVORS, A 864 00:37:20,233 --> 00:37:23,870 SMALL N BUT FIRST OF ALL THEY 865 00:37:23,870 --> 00:37:25,138 FOUND SEVERAL POTENTIAL 866 00:37:25,138 --> 00:37:26,039 GLUCOCORTICOID MECHANISMS 867 00:37:26,039 --> 00:37:28,642 CONTRIBUTED TO LACK OF RESPONSE 868 00:37:28,642 --> 00:37:32,012 TO THE STEROIDS. 869 00:37:32,012 --> 00:37:34,448 AND, YOU KNOW, THAT WAS ONE MAIN 870 00:37:34,448 --> 00:37:35,949 FINDING IN THE STUDY. 871 00:37:35,949 --> 00:37:40,654 BUT WHEN THEY DID AN ANALYSIS OF 872 00:37:40,654 --> 00:37:43,090 THE DIFFERENTIALLY EXPRESSED 873 00:37:43,090 --> 00:37:44,291 PROTEINS IN TREATMENT, 874 00:37:44,291 --> 00:37:48,295 NON-RESPONDERS WHO SURVIVED 24 875 00:37:48,295 --> 00:37:51,531 WEEKS RELATIVE TO NON-SURVIVORS 876 00:37:51,531 --> 00:37:53,400 REVEALED SEVERAL PROTEIN 877 00:37:53,400 --> 00:37:54,501 EXPRESSION CHANGES, INCLUDING 878 00:37:54,501 --> 00:37:56,970 INCREASED LEVELS OF THE ACUTE 879 00:37:56,970 --> 00:38:01,241 PHASE PROTEIN, ELEVATED 880 00:38:01,241 --> 00:38:02,442 COAGULATION FACTORS, AND REDUCED 881 00:38:02,442 --> 00:38:05,812 MASS CELL MARKERS. 882 00:38:05,812 --> 00:38:09,182 BASICALLY DID LIVER BIOPSIES, 883 00:38:09,182 --> 00:38:12,552 AND THEY WERE ABLE TO MEASURE IN 884 00:38:12,552 --> 00:38:18,258 THE LIVER THESE DIFFERENT 885 00:38:18,258 --> 00:38:20,527 PROTEINS BY LC/MS, LIQUID 886 00:38:20,527 --> 00:38:31,071 CHROMATOGRAPHY MASS SPEC TROUGH 887 00:38:39,579 --> 00:38:47,187 SCOPEY, YOU CAN SEE DECREASE IN 888 00:38:47,187 --> 00:38:47,654 NON-SURVIVORS. 889 00:38:47,654 --> 00:38:51,324 AND FROM THE SURVIVORS. 890 00:38:51,324 --> 00:38:57,097 AND THIS IS -- THESE APP 891 00:38:57,097 --> 00:38:58,799 PROTEINS ARE BASICALLY 892 00:38:58,799 --> 00:39:00,700 ANTI-INFLAMMATORY SO YOU'RE 893 00:39:00,700 --> 00:39:01,601 LOSING SOME ANTI-INFLAMMATORY 894 00:39:01,601 --> 00:39:03,236 PROTECTION IN THE LIVER. 895 00:39:03,236 --> 00:39:05,772 AND THEN ON THE CONVERSELY THE 896 00:39:05,772 --> 00:39:10,177 MAST CELL MARKERS ARE INCREASED, 897 00:39:10,177 --> 00:39:12,813 MAST CELLS ARE ASSOCIATED WITH 898 00:39:12,813 --> 00:39:14,948 RELEASE OF CYTOKINES, THE BAD 899 00:39:14,948 --> 00:39:15,148 GUYS. 900 00:39:15,148 --> 00:39:17,350 YOU LOSE GOOD GUYS AND GAIN BAD 901 00:39:17,350 --> 00:39:19,419 GUISE IN THE NON-SURVIVORS. 902 00:39:19,419 --> 00:39:21,054 THIS STUDY IDENTIFIED POTENTIAL 903 00:39:21,054 --> 00:39:23,290 MECHANISMS CONTRIBUTING TO LACK 904 00:39:23,290 --> 00:39:25,392 OF STEROID RESPONSES, IN ALCOHOL 905 00:39:25,392 --> 00:39:28,028 HEPATITIS AND APPROACHING 906 00:39:28,028 --> 00:39:29,896 LANDSCAPE THAT MAY INFLUENCE 907 00:39:29,896 --> 00:39:31,231 ALCOHOL HEPATITIS NON-RESPONSE 908 00:39:31,231 --> 00:39:32,165 MORTALITY. 909 00:39:32,165 --> 00:39:34,768 SO I'M SORRY TO REGALE YOU WITH 910 00:39:34,768 --> 00:39:36,503 TWO PAPERS OF PEOPLE DYING FROM 911 00:39:36,503 --> 00:39:38,205 LIVER DISEASE BUT THE FACT IS 912 00:39:38,205 --> 00:39:39,072 WE'RE GETTING CLOSER TO BEING 913 00:39:39,072 --> 00:39:41,041 ABLE TO IDENTIFY AT LEAST WITH 914 00:39:41,041 --> 00:39:42,509 STANDARD OF CARE WHO IS GOING TO 915 00:39:42,509 --> 00:39:45,345 RESPOND, WHO IS NOT GOING TO 916 00:39:45,345 --> 00:39:48,014 RESPOND, AND MAYBE EVEN A NOVEL 917 00:39:48,014 --> 00:39:50,016 WAY OF PROVIDING STANDARD OF 918 00:39:50,016 --> 00:39:52,853 CARE FROM A NEGATIVE STUDY AT 919 00:39:52,853 --> 00:39:55,789 NIAAA. 920 00:39:55,789 --> 00:40:00,894 SO FOOD FOR THOUGHT. 921 00:40:00,894 --> 00:40:02,662 ANOTHER STEROID PAPER THAT I 922 00:40:02,662 --> 00:40:03,697 FOUND QUITE INTRIGUING FOR A 923 00:40:03,697 --> 00:40:05,398 NUMBER OF REASONS, ONE IS WHICH 924 00:40:05,398 --> 00:40:06,666 I'VE ACTUALLY WORKED IN THIS 925 00:40:06,666 --> 00:40:09,436 AREA, BUT THIS ONE FOUND OUR 926 00:40:09,436 --> 00:40:11,771 CORTISOL MARKER THAT WAS HIGHER 927 00:40:11,771 --> 00:40:13,073 IN STRESS-RELATED BRAIN REGIONS 928 00:40:13,073 --> 00:40:15,575 IN INDIVIDUALS WITH ALCOHOL USE 929 00:40:15,575 --> 00:40:15,942 DISORDER. 930 00:40:15,942 --> 00:40:19,279 SO, CHRONIC ALCOHOL USE IS 931 00:40:19,279 --> 00:40:26,153 ASSOCIATED WITH DYSREGULATED 932 00:40:26,153 --> 00:40:28,989 HYPO FLAMMIC PULMONARY THY TEAR 933 00:40:28,989 --> 00:40:29,256 STRESS. 934 00:40:29,256 --> 00:40:33,660 THERE'S ELEVATED TONIC LEVELS OF 935 00:40:33,660 --> 00:40:37,264 CORTISOL IN HUMANS, WE KNOW 936 00:40:37,264 --> 00:40:39,799 THERE'S BLUNTED RESPONSE BECAUSE 937 00:40:39,799 --> 00:40:43,703 OF FEEDBACK TO THE PITUITARY 938 00:40:43,703 --> 00:40:45,772 ADRENAL RESPONSE, BLUNT HPA 939 00:40:45,772 --> 00:40:47,174 ACCESS FROM FURTHER RESPONDING. 940 00:40:47,174 --> 00:40:50,076 THERE'S A SENSITIZATION AT THE 941 00:40:50,076 --> 00:40:51,478 SAME TIME, INCREASE IN 942 00:40:51,478 --> 00:40:53,547 GLUCOCORTICOID RECEPTORS IN THE 943 00:40:53,547 --> 00:40:55,348 BRAIN, AND PARTICULARLY IN THE 944 00:40:55,348 --> 00:41:00,053 AREAS OF THE BRAIN THAT DRIVER 945 00:41:00,053 --> 00:41:02,489 RELEASING FACTOR, A STRESS 946 00:41:02,489 --> 00:41:05,659 NEUROPEPTIDE. 947 00:41:05,659 --> 00:41:07,460 RESEARCHERS IN THIS STUDY, YALE 948 00:41:07,460 --> 00:41:13,300 UNIVERSITY, AND McGEE AND 949 00:41:13,300 --> 00:41:14,901 COSGROVE GROUPS. 950 00:41:14,901 --> 00:41:18,004 USED RADIOTRACER AND PET BRAIN 951 00:41:18,004 --> 00:41:23,743 IMAGING TO MEASURE LEVELS OF 11 952 00:41:23,743 --> 00:41:26,046 BETA HYDROXY STEROID 953 00:41:26,046 --> 00:41:29,683 DEHYDROGENASE TYPE 1, CORTISOL 954 00:41:29,683 --> 00:41:40,093 EGENERATING ENZYME, THIS 955 00:41:40,860 --> 00:41:41,261 CONVERTS CORTISONE, 956 00:41:41,261 --> 00:41:42,729 KORTECOSTERONE, HUMANS DON'T 957 00:41:42,729 --> 00:41:47,634 RESPOND AS WELL AS CORTISOL. 958 00:41:47,634 --> 00:41:51,404 AND CORTECOSTERONE, IF YOU WORK 959 00:41:51,404 --> 00:42:00,146 YOUR WAY BACK, IS DERIVED FROM 960 00:42:00,146 --> 00:42:00,447 CHOLESTEROL. 961 00:42:00,447 --> 00:42:03,850 FINDINGS INDICATE THAT THOSE 962 00:42:03,850 --> 00:42:07,454 WITH AUD HAD HIGHER BRAIN 963 00:42:07,454 --> 00:42:10,991 AVAILABILITY OF THIS ENZYME IN 964 00:42:10,991 --> 00:42:13,827 PREFRONTAL AND LIMBIC REGIONS 965 00:42:13,827 --> 00:42:16,129 COMPARED TO UNAFFECTED 966 00:42:16,129 --> 00:42:17,597 INDIVIDUALS. 967 00:42:17,597 --> 00:42:21,468 IN ADDITION, HIGHER ENZYME 968 00:42:21,468 --> 00:42:22,869 AVAILABILITY WAS ASSOCIATED WITH 969 00:42:22,869 --> 00:42:27,240 DRINKS PER WEEK, QUANTITY PER 970 00:42:27,240 --> 00:42:30,877 EPISODE AND AUD SEVERITY. 971 00:42:30,877 --> 00:42:31,978 CENTRAL NERVOUS SYSTEM 972 00:42:31,978 --> 00:42:34,114 GLUCOCORTICOID ACTIVITY IS 973 00:42:34,114 --> 00:42:36,950 INCREASED IN INDIVIDUALS WITH 974 00:42:36,950 --> 00:42:44,491 AUD IN ADDITION TO 975 00:42:44,491 --> 00:42:46,826 DYSREGULATION, AND PROVIDE 976 00:42:46,826 --> 00:42:47,594 INSIGHT IN DYSFUNCTION 977 00:42:47,594 --> 00:42:48,662 ASSOCIATED WITH AUD. 978 00:42:48,662 --> 00:42:50,997 THE BRAIN REGIONS WHERE THEY SAW 979 00:42:50,997 --> 00:42:53,466 THESE, RED IS AUD HERE, THESE 980 00:42:53,466 --> 00:42:57,537 INCREASES WERE ALL THE ONES I, 981 00:42:57,537 --> 00:43:01,841 YOU KNOW, LOVE BEST AND 982 00:43:01,841 --> 00:43:03,143 INCLUDING AMYGDALA AND 983 00:43:03,143 --> 00:43:05,145 ACCUMBENS -- I'M SORRY, ANTERIOR 984 00:43:05,145 --> 00:43:09,783 CINGULATE, I WANT YOU TO KNOW 985 00:43:09,783 --> 00:43:10,984 VENTRAL MEDIAL PRE-FRONT CORTEX 986 00:43:10,984 --> 00:43:13,720 CONTROLS STRESS RESPONSE IN THE 987 00:43:13,720 --> 00:43:15,689 AMYGDALA, OFTEN A DAMP OTHER 988 00:43:15,689 --> 00:43:18,425 STRESS RESPONSE, OFTEN A REGION 989 00:43:18,425 --> 00:43:19,459 ALSO COMPROMISED IN 990 00:43:19,459 --> 00:43:20,060 POSTTRAUMATIC STRESS DISORDER, 991 00:43:20,060 --> 00:43:22,896 JUST FOR THE RECORD. 992 00:43:22,896 --> 00:43:24,564 SO, ANOTHER INTRIGUING STUDY 993 00:43:24,564 --> 00:43:25,699 ABOUT CORTISOL, AND I THOUGHT 994 00:43:25,699 --> 00:43:28,168 THE THREE OF THESE TOGETHER WERE 995 00:43:28,168 --> 00:43:33,039 PRETTY COMPELLING STORY FOR 996 00:43:33,039 --> 00:43:34,274 TODAY. 997 00:43:34,274 --> 00:43:36,476 AND THEN THIS ONE IS TO REMIND 998 00:43:36,476 --> 00:43:39,913 US THAT WE DO HAVE THREE 999 00:43:39,913 --> 00:43:41,348 FDA-APPROVED MEDICATIONS FOR 1000 00:43:41,348 --> 00:43:43,083 TREATMENT OF ALCOHOL USE 1001 00:43:43,083 --> 00:43:43,483 DISORDER. 1002 00:43:43,483 --> 00:43:44,517 THEY ARE EFFECTIVE. 1003 00:43:44,517 --> 00:43:48,455 AND AS MANY OF YOU HEARD ME SAY 1004 00:43:48,455 --> 00:43:58,965 BEFORE, THEY ARE AS ON AS IF 1005 00:44:01,334 --> 00:44:05,305 EFFECTIVE FOR ANY DISORDER. 1006 00:44:05,305 --> 00:44:06,339 RESEARCHERS INVESTIGATED 1007 00:44:06,339 --> 00:44:09,209 POSSIBLE MOLECULAR MECHANISMS 1008 00:44:09,209 --> 00:44:11,211 ASSOCIATED WITH ALCOHOL CRAVING, 1009 00:44:11,211 --> 00:44:14,114 AND THEY SUPERIMPOSED IN THIS 1010 00:44:14,114 --> 00:44:22,522 STUDY AS A KIND OF VALIDATION, 1011 00:44:22,522 --> 00:44:26,226 ANTI-CRAVING ALCOHOL USE 1012 00:44:26,226 --> 00:44:27,694 DISORDER, USED iPSC ASTROCYTE 1013 00:44:27,694 --> 00:44:33,433 CELL MODEL WITH RNA SEQUENCING. 1014 00:44:33,433 --> 00:44:37,203 SO, iPSCs ARE INDUCED 1015 00:44:37,203 --> 00:44:39,105 PLURIPOTENT STEM CELLS, THEY GOT 1016 00:44:39,105 --> 00:44:44,010 THE CELLS THEY TOOK FROM THE 1017 00:44:44,010 --> 00:44:48,415 BLOOD, PERIPHERAL BLOOD MONO 1018 00:44:48,415 --> 00:44:49,549 NUCLEAR CELLS, AND LET DAVID 1019 00:44:49,549 --> 00:44:51,017 GOLDMAN EXPLAIN THIS TO YOU IN 1020 00:44:51,017 --> 00:44:53,386 MORE DETAIL BUT CONVERTED THEM 1021 00:44:53,386 --> 00:44:57,323 TO ASTROCYTES USING IN VITRO 1022 00:44:57,323 --> 00:45:00,093 PROCEDURE. 1023 00:45:00,093 --> 00:45:04,063 AND THEN THEY MEASURED THESE 1024 00:45:04,063 --> 00:45:05,832 TRANSCRIPTION FACTOR INTERFERON 1025 00:45:05,832 --> 00:45:07,767 REGULATORY FACTOR. 1026 00:45:07,767 --> 00:45:09,068 IT ACTIVATES INTERFERONS ALPHA 1027 00:45:09,068 --> 00:45:09,969 AND BETA. 1028 00:45:09,969 --> 00:45:12,739 IT RESPONDS TO VIRAL INFECTION. 1029 00:45:12,739 --> 00:45:14,908 AND IT'S ACTIVATED BY TOLL LIKE 1030 00:45:14,908 --> 00:45:16,910 RECEPTORS WHICH MEANS IT'S A KEY 1031 00:45:16,910 --> 00:45:19,946 PART OF THE INNATE IMMUNE 1032 00:45:19,946 --> 00:45:20,180 SYSTEM. 1033 00:45:20,180 --> 00:45:22,248 SO, ACTIVATION OF THIS 1034 00:45:22,248 --> 00:45:28,087 TRANSCRIPTION FACTOR WAS 1035 00:45:28,087 --> 00:45:29,289 ASSOCIATED WITH ALCOHOL-INDUCED 1036 00:45:29,289 --> 00:45:34,861 -- WHAT'S IT CALLED? 1037 00:45:34,861 --> 00:45:35,428 E.R. STRESS. 1038 00:45:35,428 --> 00:45:41,401 I'M BLOCKENING ON E.R. 1039 00:45:41,401 --> 00:45:42,335 1040 00:45:42,335 --> 00:45:44,337 ENDOPLASMIC RETICULAR STRESS. 1041 00:45:44,337 --> 00:45:48,174 IT'S A MOLECULAR KIND OF STRESS 1042 00:45:48,174 --> 00:45:49,342 RESPONSE INTRACELLULARLY, AND 1043 00:45:49,342 --> 00:45:53,046 WHICH COULD BE ATTENUATED WITH 1044 00:45:53,046 --> 00:45:53,680 ANTI-CRAVING MEDICATION. 1045 00:45:53,680 --> 00:46:00,787 SO, IF YOU LOOK IN THE SLIDES 1046 00:46:00,787 --> 00:46:01,921 YOU SEE NALTREXONE INTERACTS 1047 00:46:01,921 --> 00:46:03,723 WITH THIS E.R. STRESS, THE 1048 00:46:03,723 --> 00:46:05,291 ALCOHOL CAUSES E.R. STRESS AND 1049 00:46:05,291 --> 00:46:10,797 YOU'LL SEE FROM THE SLIDES BELOW 1050 00:46:10,797 --> 00:46:15,435 THAT SINCE THEY HAVE TWO 1051 00:46:15,435 --> 00:46:16,636 DIFFERENT MECHANISMS OF ACTION 1052 00:46:16,636 --> 00:46:19,506 REDUCE EXPRESSION OF THE E.R. 1053 00:46:19,506 --> 00:46:21,774 STRESS. 1054 00:46:21,774 --> 00:46:22,141 LEFT-HAND PANEL. 1055 00:46:22,141 --> 00:46:26,112 AND ALCOHOL INDUCED IRF 3 1056 00:46:26,112 --> 00:46:27,780 BINDING TO GENES WAS DECREASED 1057 00:46:27,780 --> 00:46:36,923 IN PRESENCE OF THESE TWO 1058 00:46:36,923 --> 00:46:37,223 MEDICATIONS. 1059 00:46:37,223 --> 00:46:38,224 ALTOGETHER ACTIVATION OF 1060 00:46:38,224 --> 00:46:40,393 TRANSCRIPTION FACTOR IRF 3 WAS 1061 00:46:40,393 --> 00:46:41,160 ASSOCIATED WITH ALCOHOL INDUCED 1062 00:46:41,160 --> 00:46:44,030 E.R. STRESS WHICH COULD BE 1063 00:46:44,030 --> 00:46:46,666 ATTENUATED BY THE ANTI-CRAVING 1064 00:46:46,666 --> 00:46:47,133 MEDICATION. 1065 00:46:47,133 --> 00:46:49,435 IRF 3 REGULATION OF GENES 1066 00:46:49,435 --> 00:46:51,137 ASSOCIATED WITH ALCOHOL CRAVING 1067 00:46:51,137 --> 00:46:54,207 WERE IMMUNE RELATED PATHWAYS AS 1068 00:46:54,207 --> 00:46:56,342 I DESCRIBED, SUGGESTING POSSIBLE 1069 00:46:56,342 --> 00:46:58,378 RELATIONSHIP BETWEEN CRAVING AND 1070 00:46:58,378 --> 00:46:59,679 INFLAMMATION, SUGGESTING E.R. 1071 00:46:59,679 --> 00:47:02,448 STRESS ATTENUATION MIGHT BE A 1072 00:47:02,448 --> 00:47:03,850 TARGET FOR ANTI-CRAVING 1073 00:47:03,850 --> 00:47:04,551 MEDICATION. 1074 00:47:04,551 --> 00:47:06,553 MIGHT BE A SCREEN POSSIBLY FOR 1075 00:47:06,553 --> 00:47:07,820 SOME MEDICATIONS, WE DON'T KNOW 1076 00:47:07,820 --> 00:47:08,621 YET. 1077 00:47:08,621 --> 00:47:16,796 THIS IS FROM THE MAYO CLINIC, 1078 00:47:16,796 --> 00:47:23,102 DR. HO AND THE WEINSTHIBOUM 1079 00:47:23,102 --> 00:47:30,376 TEAM. 1080 00:47:30,376 --> 00:47:34,480 USING iPSC SELLS, SMALL N, AND 1081 00:47:34,480 --> 00:47:35,448 DOES SUGGEST THE POSSIBILITY 1082 00:47:35,448 --> 00:47:39,686 THAT WE WILL BE ABLE TO DO 1083 00:47:39,686 --> 00:47:41,087 SOMETHING, I KNOW RAY HAS ALWAYS 1084 00:47:41,087 --> 00:47:43,456 WANTED TO DO, WHICH IS HAVE A 1085 00:47:43,456 --> 00:47:44,557 MOLECULAR SCREEN FOR MEDICATIONS 1086 00:47:44,557 --> 00:47:48,661 THAT MIGHT ACTUALLY WORK. 1087 00:47:48,661 --> 00:47:50,196 SO, ONWARD AND UPWARD. 1088 00:47:50,196 --> 00:47:54,567 AND FINALLY, I'M GOING TO END ON 1089 00:47:54,567 --> 00:47:55,568 A LESS INTENSE MOLECULAR STUDY 1090 00:47:55,568 --> 00:48:05,211 WHICH IS ABOUT THE SOBER CURIOUS 1091 00:48:05,211 --> 00:48:09,616 PARTICIPATION, AND KNOWN AS 1092 00:48:09,616 --> 00:48:11,618 TACK, DRY JANUARY, SOBER 1093 00:48:11,618 --> 00:48:12,018 OCTOBER. 1094 00:48:12,018 --> 00:48:13,353 PARTICIPATION IN THE TWO 1095 00:48:13,353 --> 00:48:14,520 ACTIVITIES CORRELATED WITH 1096 00:48:14,520 --> 00:48:15,488 GREATER SUBSTANCE USE TREATMENT, 1097 00:48:15,488 --> 00:48:19,192 AND WITH MORE MOTIVATION TO QUIT 1098 00:48:19,192 --> 00:48:21,995 ALCOHOL IN EMERGING ADULTS. 1099 00:48:21,995 --> 00:48:22,962 SO RESEARCHERS EXAMINED 1100 00:48:22,962 --> 00:48:24,764 FAMILIARITY WITH THE SOBER 1101 00:48:24,764 --> 00:48:27,800 CURIOUS MOVEMENT AND 1102 00:48:27,800 --> 00:48:29,869 PARTICIPATION IN TEMPORARY 1103 00:48:29,869 --> 00:48:31,237 ALCOHOL ABSTINENCE CHALLENGES IN 1104 00:48:31,237 --> 00:48:33,840 U.S. EMERGING ADULTS. 1105 00:48:33,840 --> 00:48:36,142 THESE WHY YOUNG ADULTS 18-29. 1106 00:48:36,142 --> 00:48:37,610 THOSE WHO PARTICIPATED IN THE 1107 00:48:37,610 --> 00:48:39,579 CHALLENGES OR WERE AWARE OF 1108 00:48:39,579 --> 00:48:41,381 SOBER CURIOUS WERE MORE LIKELY 1109 00:48:41,381 --> 00:48:45,585 TO REPORT HEAVY DRINKING IN THE 1110 00:48:45,585 --> 00:48:46,252 PAST MONTH, HIGHER AUDIT-C 1111 00:48:46,252 --> 00:48:50,123 SCORES CIRCLED IN RED HERE, AND 1112 00:48:50,123 --> 00:48:51,090 GREATER PREVALENCE OF PAST 1113 00:48:51,090 --> 00:48:52,392 CANNABIS USE AND GREAT HE BE 1114 00:48:52,392 --> 00:48:55,428 NUMBER OF PAST YEAR ALCOHOL AND 1115 00:48:55,428 --> 00:48:56,863 CANNABIS CONSEQUENCES, COMPARED 1116 00:48:56,863 --> 00:48:58,765 TO THOSE WITHOUT AWARENESS. 1117 00:48:58,765 --> 00:49:03,436 SO, FIRST THING HERE IS BEING 1118 00:49:03,436 --> 00:49:06,205 AWARE OF THAT YOU MIGHT HAVE A 1119 00:49:06,205 --> 00:49:07,573 PROBLEM, INCREASED THE 1120 00:49:07,573 --> 00:49:09,175 LIKELIHOOD YOU WOULD PARTICIPATE 1121 00:49:09,175 --> 00:49:10,810 IN THESE TWO MOVEMENTS. 1122 00:49:10,810 --> 00:49:12,578 I CALL THEM MOVEMENTS. 1123 00:49:12,578 --> 00:49:15,682 HOWEVER, THOSE WHO WERE AWARE OF 1124 00:49:15,682 --> 00:49:17,483 SOBER CURIOUS OR THE CHALLENGES 1125 00:49:17,483 --> 00:49:20,319 WERE ALSO MORE LIKELY TO RECEIVE 1126 00:49:20,319 --> 00:49:21,387 PAST-YEAR SUBSTANCE USE 1127 00:49:21,387 --> 00:49:23,356 TREATMENT AND WERE NOR MOTIVATED 1128 00:49:23,356 --> 00:49:25,291 TO QUIT BOTH ALCOHOL AND 1129 00:49:25,291 --> 00:49:25,625 CANNABIS. 1130 00:49:25,625 --> 00:49:27,894 AND PART OF THIS IS ILLUSTRATED 1131 00:49:27,894 --> 00:49:30,663 IN THE BOTTOM ORANGE CIRCLES, 1132 00:49:30,663 --> 00:49:34,067 WHICH SHOW IF THEY PARTICIPATED 1133 00:49:34,067 --> 00:49:38,905 THEY HAD A 33% LIKELIHOOD OF 1134 00:49:38,905 --> 00:49:39,605 PARTICIPATING IN TREATMENT AND 1135 00:49:39,605 --> 00:49:45,278 IF THEY WERE IN A CHALLENGE THE 1136 00:49:45,278 --> 00:49:48,381 SAME, 18 TO 6%, THE OTHER WAS 1137 00:49:48,381 --> 00:49:56,489 33% TO 8%. 1138 00:49:56,489 --> 00:49:58,491 SO, YOU KNOW, THIS SUGGESTS THAT 1139 00:49:58,491 --> 00:50:01,160 SOMETHING THAT WE'VE BEEN 1140 00:50:01,160 --> 00:50:04,831 OBSERVING WHICH IS MORE INTEREST 1141 00:50:04,831 --> 00:50:08,034 IN DRY JANUARY AND THE SOBER 1142 00:50:08,034 --> 00:50:09,535 CURIOUS MOVEMENT, PARTICULARLY 1143 00:50:09,535 --> 00:50:10,770 IN YOUNGER GROUPS OF INDIVIDUALS 1144 00:50:10,770 --> 00:50:12,071 IN THE UNITED STATES. 1145 00:50:12,071 --> 00:50:16,209 SO I HOPE THIS STIMULATES MORE 1146 00:50:16,209 --> 00:50:17,243 STUDY OF THIS KIND. 1147 00:50:17,243 --> 00:50:18,578 I MEAN ONE OF THE THINGS I'D 1148 00:50:18,578 --> 00:50:21,214 LIKE TO KNOW IS WHETHER WE 1149 00:50:21,214 --> 00:50:22,782 REALLY DO HAVE A METRIC OF THE 1150 00:50:22,782 --> 00:50:25,885 FACT THAT MORE PEOPLE ARE 1151 00:50:25,885 --> 00:50:26,385 PARTICIPATING. 1152 00:50:26,385 --> 00:50:29,922 BUT I THINK IT AS -- ONE THING 1153 00:50:29,922 --> 00:50:33,559 THEY WROTE IN THE PAPER AS A 1154 00:50:33,559 --> 00:50:37,096 CONCLUSION, IT PROVIDES A 1155 00:50:37,096 --> 00:50:40,700 DENORMALIZATION OF DRINKING AND 1156 00:50:40,700 --> 00:50:42,468 THESE PROGRAMS PROVIDE 1157 00:50:42,468 --> 00:50:43,102 NORMALIZATION OF NON-DRINKING, 1158 00:50:43,102 --> 00:50:45,505 MANY OF YOU HEARD ME SAY BEFORE, 1159 00:50:45,505 --> 00:50:48,608 YOU KNOW, WE'VE GOT TO GET RID 1160 00:50:48,608 --> 00:50:51,511 OF STIGMA, BUT THERE'S STIGMA 1161 00:50:51,511 --> 00:50:53,146 ALSO IN NOT DRINKING. 1162 00:50:53,146 --> 00:50:54,180 IT'S VERY PREVALENT. 1163 00:50:54,180 --> 00:50:57,150 AND SO, YOU KNOW, NEVER HOLD A 1164 00:50:57,150 --> 00:51:00,653 RECEPTION OR PARTY WHERE A 1165 00:51:00,653 --> 00:51:01,587 NON-ALCOHOL-CONTAINING BEVERAGE 1166 00:51:01,587 --> 00:51:05,191 IS NOT AVAILABLE. 1167 00:51:05,191 --> 00:51:06,058 DOUBLE NEGATIVE. 1168 00:51:06,058 --> 00:51:08,528 AND THEN I WANT TO END AND I 1169 00:51:08,528 --> 00:51:11,898 HOPE I'M NOT OVER, HOW AM I 1170 00:51:11,898 --> 00:51:12,265 DOING, PHILIPPE? 1171 00:51:12,265 --> 00:51:13,566 AM I OKAY? 1172 00:51:13,566 --> 00:51:14,200 OKAY. 1173 00:51:14,200 --> 00:51:17,537 SO, I WANT TO REMIND YOU ABOUT 1174 00:51:17,537 --> 00:51:18,337 OUR RESOURCES. 1175 00:51:18,337 --> 00:51:23,176 WE HAD A WONDERFUL MEETING WITH 1176 00:51:23,176 --> 00:51:24,710 THE -- ABOUT INTEGRATED CARE OF 1177 00:51:24,710 --> 00:51:26,412 ALCOHOL USE DISORDER AND ALCOHOL 1178 00:51:26,412 --> 00:51:27,814 ASSOCIATED LIVER DISEASE. 1179 00:51:27,814 --> 00:51:29,749 BUT I WAS UNDER THE DISTINCT 1180 00:51:29,749 --> 00:51:30,683 IMPRESSION THAT MANY OF THE 1181 00:51:30,683 --> 00:51:35,221 PEOPLE AT THAT WONDERFUL MEETING 1182 00:51:35,221 --> 00:51:37,123 HAD LITTLE KNOWLEDGE OF OUR 1183 00:51:37,123 --> 00:51:37,790 ACTUAL RESOURCES. 1184 00:51:37,790 --> 00:51:39,525 SO, AGAIN, I'M GOING TO CHARGE 1185 00:51:39,525 --> 00:51:42,128 YOU AS COUNCIL MEMBERS TO BE 1186 00:51:42,128 --> 00:51:43,830 AMBASSADORS AND TAKE THIS BACK 1187 00:51:43,830 --> 00:51:46,866 TO YOUR HOME TURFS AND MAKE THEM 1188 00:51:46,866 --> 00:51:48,801 AMBASSADORS FOR EVERYTHING WE 1189 00:51:48,801 --> 00:51:49,168 HAVE AVAILABLE. 1190 00:51:49,168 --> 00:51:50,937 WE REALLY ARE NOT GETTING THE 1191 00:51:50,937 --> 00:51:53,606 WORD OUT. 1192 00:51:53,606 --> 00:51:55,074 I'M SORRY, BUT WE'RE NOT. 1193 00:51:55,074 --> 00:51:56,776 THERE WAS ONE CHAP AT THE 1194 00:51:56,776 --> 00:51:58,744 MEETING WHO I SAT NEXT TO, I 1195 00:51:58,744 --> 00:52:00,146 WON'T SAY WHERE HE WORKED FOR, 1196 00:52:00,146 --> 00:52:01,914 BUT IT WAS ONE OF THE BIG HEALTH 1197 00:52:01,914 --> 00:52:05,885 SERVICES IN THE UNITED STATES, 1198 00:52:05,885 --> 00:52:10,656 HE NEVER HEARD OF ACAMPROSATE. 1199 00:52:10,656 --> 00:52:14,026 THE ONLY DRUG HE KNEW ABOUT WAS 1200 00:52:14,026 --> 00:52:14,894 NALTREXONE. 1201 00:52:14,894 --> 00:52:19,398 WE HAVE A WEB RESOURCE, NIAAA 1202 00:52:19,398 --> 00:52:22,568 FOR MIDDLE SCHOOL, INTERACTIVE 1203 00:52:22,568 --> 00:52:25,271 ACTIVITIES FOR PARENTS, 1204 00:52:25,271 --> 00:52:27,306 CAREGIVERS, TEACHERS TO 1205 00:52:27,306 --> 00:52:29,108 REINFORCE MESSAGES ABOUT PEER 1206 00:52:29,108 --> 00:52:31,110 PRESSURE AND UNDERAGE DRINKING. 1207 00:52:31,110 --> 00:52:33,379 ANOTHER WEB RESOURCE NIAAA FOR 1208 00:52:33,379 --> 00:52:34,647 TEENS, RESEARCH-BASED ONLINE 1209 00:52:34,647 --> 00:52:36,282 RESEARCH FOR TEENS, HIGHLIGHTING 1210 00:52:36,282 --> 00:52:37,850 HOW ALCOHOL AFFECTS YOUR HEALTH, 1211 00:52:37,850 --> 00:52:39,085 WARNING SIGNS AND SYMPTOMS, 1212 00:52:39,085 --> 00:52:41,821 WHERE TO GET HELP FOR 1213 00:52:41,821 --> 00:52:43,956 ALCOHOL-RELATED PROBLEMS. 1214 00:52:43,956 --> 00:52:44,991 WE HAVE RETHINKING DRINKING, I 1215 00:52:44,991 --> 00:52:47,960 WON'T EXPLAIN THAT. 1216 00:52:47,960 --> 00:52:49,562 YOU KNOW ABOUT COLLEGE-AIM. 1217 00:52:49,562 --> 00:52:50,897 WE HAVE ALCOHOL TREATMENT 1218 00:52:50,897 --> 00:52:52,265 NAVIGATOR, YOU KNOW ABOUT THAT. 1219 00:52:52,265 --> 00:52:55,534 AND WE HAVE THE HEALTHCARE 1220 00:52:55,534 --> 00:52:57,737 PROFESSIONAL CORE RESOURCE. 1221 00:52:57,737 --> 00:53:00,673 AND, YOU KNOW, THIS IS THE ONE 1222 00:53:00,673 --> 00:53:03,142 THAT I THINK IS NOT ONLY USED 1223 00:53:03,142 --> 00:53:03,876 FOR HEALTH CARE PROFESSIONALS, 1224 00:53:03,876 --> 00:53:09,015 AND I MEAN THE WHOLE GAMUT OF 1225 00:53:09,015 --> 00:53:12,618 HEALTH CARE PROFESSIONALS FROM, 1226 00:53:12,618 --> 00:53:15,221 YOU KNOW, PHARMACISTS TO 1227 00:53:15,221 --> 00:53:18,724 PHYSICIAN ASSISTANTS TO NURSE 1228 00:53:18,724 --> 00:53:20,559 PRACTITIONERS TO, YOU KNOW, 1229 00:53:20,559 --> 00:53:21,928 CLINICAL PSYCHOLOGISTS, TO 1230 00:53:21,928 --> 00:53:23,863 PRIMARY CARE DOCS, WHAT WE AIMED 1231 00:53:23,863 --> 00:53:25,498 AT, TO BOARD CERTIFIED ADDICTION 1232 00:53:25,498 --> 00:53:25,965 MEDICINE SPECIALISTS. 1233 00:53:25,965 --> 00:53:29,835 I DON'T THINK WE CAN PROMOTE 1234 00:53:29,835 --> 00:53:31,470 THIS RESOURCE LESS. 1235 00:53:31,470 --> 00:53:32,972 I MEAN, ANYONE WHO IS INTERESTED 1236 00:53:32,972 --> 00:53:35,074 IN ALCOHOL IS GOING TO FIND 1237 00:53:35,074 --> 00:53:39,312 THINGS IN THIS RESOURCE THAT'S 1238 00:53:39,312 --> 00:53:40,046 VALUABLE. 1239 00:53:40,046 --> 00:53:42,315 SO, THAT'S IT. 1240 00:53:42,315 --> 00:53:43,516 THANK YOU. 1241 00:53:43,516 --> 00:53:49,255 AND THANKS A LOT TO LAURA AND 1242 00:53:49,255 --> 00:53:56,495 DEAF INAND TRISH AND BRIDGET AND 1243 00:53:56,495 --> 00:54:00,499 VAN VAN FOR THE SLIDES. 1244 00:54:00,499 --> 00:54:01,801 I TORTURE THEM BEFORE COUNCIL, 1245 00:54:01,801 --> 00:54:03,436 AND IT TAKES A VILLAGE. 1246 00:54:03,436 --> 00:54:08,607 SO THANKS VERY MUCH. 1247 00:54:08,607 --> 00:54:09,542 >> IF THERE'S ANY QUESTIONS, HOW 1248 00:54:09,542 --> 00:54:14,313 MUCH TIME DO WE HAVE, PHILIPPE? 1249 00:54:14,313 --> 00:54:16,449 1250 00:54:16,449 --> 00:54:17,550 ANYBODY HAVE QUESTIONS OR 1251 00:54:17,550 --> 00:54:17,950 COMMENTS? 1252 00:54:17,950 --> 00:54:19,719 I'M HAPPY TO TAKE THEM NOW. 1253 00:54:19,719 --> 00:54:21,287 WE'RE GOING TO HAVE A BIG 1254 00:54:21,287 --> 00:54:25,024 DISCUSSION LATER BUT FEEL FREE. 1255 00:54:25,024 --> 00:54:25,524 IS THERE ANYTHING -- 1256 00:54:25,524 --> 00:54:26,859 >> MAYBE THIS WILL COME UP IN 1257 00:54:26,859 --> 00:54:30,696 TERMS OF THE STRATEGIC PLANNING, 1258 00:54:30,696 --> 00:54:33,799 ONE PRIORITY AREA WAS 1259 00:54:33,799 --> 00:54:34,767 TRANSLATION AND BACK-TRANSLATION 1260 00:54:34,767 --> 00:54:35,334 AND RESEARCH FINDINGS. 1261 00:54:35,334 --> 00:54:37,870 CAN YOU SAY A LITTLE BIT MORE 1262 00:54:37,870 --> 00:54:44,110 ABOUT WHAT THAT MEANS? 1263 00:54:44,110 --> 00:54:46,045 >> YEAH, SO TRANSLATION, I 1264 00:54:46,045 --> 00:54:47,713 THINK, YOU KNOW, WOULD BE THE 1265 00:54:47,713 --> 00:54:52,918 CLASSIC WAY IS THAT YOU HAVE A 1266 00:54:52,918 --> 00:54:54,553 PRE-CLINICAL OBSERVATION LIKE 1267 00:54:54,553 --> 00:54:56,222 THAT IL-1 ANTAGONIST BLOCKS SOME 1268 00:54:56,222 --> 00:55:00,159 OF THE SIGNS OF KETOSIS IN THE 1269 00:55:00,159 --> 00:55:02,828 LIVER, AND YOU MOVE IT TO A 1270 00:55:02,828 --> 00:55:04,497 PHASE 1 CLINICAL TRIAL TO SEE 1271 00:55:04,497 --> 00:55:06,065 WHETHER, YOU KNOW, IT CAUSES ANY 1272 00:55:06,065 --> 00:55:07,967 PROBLEMS AND THEN YOU MOVE IT 1273 00:55:07,967 --> 00:55:11,170 INTO THE PHASE 2 CLINICAL TRIAL. 1274 00:55:11,170 --> 00:55:13,439 THAT'S FORWARD TRANSLATION. 1275 00:55:13,439 --> 00:55:16,942 BACK TRANSLATION WOULD BE THAT 1276 00:55:16,942 --> 00:55:17,710 YOU DISCOVER PREDNISONE GIVEN 1277 00:55:17,710 --> 00:55:19,879 FOR SHORT PERIOD OF TIME WORKS 1278 00:55:19,879 --> 00:55:20,846 BETTER THAN PREDNISONE FOR A 1279 00:55:20,846 --> 00:55:22,615 LONG PERIOD OF TIME IN HUMANS. 1280 00:55:22,615 --> 00:55:24,417 LIKE I SHOWED YOU IN SLIDE 1. 1281 00:55:24,417 --> 00:55:27,286 AND THEN YOU ARE GO BACK TO THE 1282 00:55:27,286 --> 00:55:28,554 RESEARCH, PRE-CLINICAL PEOPLE, 1283 00:55:28,554 --> 00:55:30,656 AND SAY, SHOW ME WHAT'S CHANGING 1284 00:55:30,656 --> 00:55:34,226 IN ONE WEEK OF TREATMENT OF 1285 00:55:34,226 --> 00:55:39,198 PREDNISONE THROUGH A RODENT OR 1286 00:55:39,198 --> 00:55:41,867 PRIMATE, OR A MONTH-LONG 1287 00:55:41,867 --> 00:55:42,735 TREATMENT OF PREDNISONE. 1288 00:55:42,735 --> 00:55:46,005 BACK TRANSLATION IS A WAY OF 1289 00:55:46,005 --> 00:55:46,972 GENERATING NEW INFORMATION BY 1290 00:55:46,972 --> 00:55:50,176 GOING BACK TO THE PRE-CLINICAL 1291 00:55:50,176 --> 00:55:50,476 SIDE. 1292 00:55:50,476 --> 00:55:54,346 AND I WAS AT A TRANSLATIONAL 1293 00:55:54,346 --> 00:55:57,216 NEUROSCIENCE THINK TANK WITH 1294 00:55:57,216 --> 00:55:59,085 THREE, FOUR OTHER NIH DIRECTORS 1295 00:55:59,085 --> 00:56:01,020 TWO WEEKS AGO. 1296 00:56:01,020 --> 00:56:02,955 AND THEY WERE FOCUSED ON MENTAL 1297 00:56:02,955 --> 00:56:09,628 ILLNESS IN GENERAL WITH MOSTLY 1298 00:56:09,628 --> 00:56:11,831 BIPOLAR AND AUTISM AND 1299 00:56:11,831 --> 00:56:13,132 PARKINSON'S DISEASE BUT SOME 1300 00:56:13,132 --> 00:56:14,533 PRINCIPLES HELD UP. 1301 00:56:14,533 --> 00:56:16,001 ONE THING COMING OUT OF THE 1302 00:56:16,001 --> 00:56:17,736 BRAIN INITIATIVE, AND I PROBABLY 1303 00:56:17,736 --> 00:56:23,042 CAN'T EXPLAIN THIS AS WELL AS 1304 00:56:23,042 --> 00:56:24,944 SHANGHAI, BUT THEY HAVE BEEN 1305 00:56:24,944 --> 00:56:26,412 ABLE THROUGH CELL CENSUS PROGRAM 1306 00:56:26,412 --> 00:56:28,681 IDENTIFY EVERY CELL AS UNIQUE 1307 00:56:28,681 --> 00:56:29,648 MOLECULAR ENTITY, EVERY 1308 00:56:29,648 --> 00:56:33,519 DIFFERENT CELL IN THE BRAIN OF A 1309 00:56:33,519 --> 00:56:33,786 MOUSE. 1310 00:56:33,786 --> 00:56:34,753 AND THE ALLEN BRAIN INSTITUTE 1311 00:56:34,753 --> 00:56:35,621 NOW IS TAKING THAT INFORMATION 1312 00:56:35,621 --> 00:56:39,291 AND THEY ARE GOING TO BE ABLE TO 1313 00:56:39,291 --> 00:56:40,359 EVENTUALLY IDENTIFY ALL OF THE 1314 00:56:40,359 --> 00:56:41,393 GENES THAT ARE INVOLVED. 1315 00:56:41,393 --> 00:56:43,462 AND THEN YOU'RE GOING TO BE ABLE 1316 00:56:43,462 --> 00:56:45,998 TO FIND SOME GENE IN HUMANS AND 1317 00:56:45,998 --> 00:56:49,568 BACK TRANSLATE IT TO THE MOUSE, 1318 00:56:49,568 --> 00:56:51,971 AND SEE WHAT NETWORKS ARE 1319 00:56:51,971 --> 00:56:53,339 AFFECTED, GENE NETWORKS, BUT 1320 00:56:53,339 --> 00:56:54,073 EVEN NEURAL NETWORKS. 1321 00:56:54,073 --> 00:57:02,348 DID I GET THAT RIGHT, DAVID? 1322 00:57:02,348 --> 00:57:05,251 IS THAT REASONABLY ACCURATE 1323 00:57:05,251 --> 00:57:05,751 EXPLANATION? 1324 00:57:05,751 --> 00:57:06,819 >> NOW WITH SPATIAL 1325 00:57:06,819 --> 00:57:09,555 TRANSCRIPTOMICS THAT IS LETTING 1326 00:57:09,555 --> 00:57:11,190 YOU NOT ONLY SINGLE CELL 1327 00:57:11,190 --> 00:57:13,559 SEQUENCE BUT SEE EXACTLY WHERE 1328 00:57:13,559 --> 00:57:19,965 EACH OF THOSE CELLS SITS IN THE 1329 00:57:19,965 --> 00:57:20,566 STRUCTURE. 1330 00:57:20,566 --> 00:57:21,800 >> THIS CAME OUT OF SITTING FOR 1331 00:57:21,800 --> 00:57:24,503 FOUR DAYS WITH A BUNCH OF THINK 1332 00:57:24,503 --> 00:57:25,804 PEOPLING ABOUT TRANSLATION 1333 00:57:25,804 --> 00:57:26,372 NEUROSCIENCE. 1334 00:57:26,372 --> 00:57:28,674 THE OTHER WAS BIOMARKERS. 1335 00:57:28,674 --> 00:57:29,175 DUH. 1336 00:57:29,175 --> 00:57:30,476 SO, YOU KNOW, EVERYBODY HAD 1337 00:57:30,476 --> 00:57:32,144 BIOMARKERS RIGHT AT THE TOP OF 1338 00:57:32,144 --> 00:57:33,045 THE LIST. 1339 00:57:33,045 --> 00:57:35,047 EVEN BIOMARKERS CAN BE 1340 00:57:35,047 --> 00:57:37,616 BACK-TRANSLATED TO FIND OUT WHAT 1341 00:57:37,616 --> 00:57:43,222 IT IS, WHAT WAS THE ONE I 1342 00:57:43,222 --> 00:57:47,459 IDENTIFIED TODAY? 1343 00:57:47,459 --> 00:57:48,694 WELL, ENDOPLASMIC RETICULAR 1344 00:57:48,694 --> 00:57:50,863 STRESS WAS IN HUMAN iPSC 1345 00:57:50,863 --> 00:57:51,130 CELLS. 1346 00:57:51,130 --> 00:57:52,831 BASIC RESEARCHERS CAN GO BACK 1347 00:57:52,831 --> 00:57:58,170 AND FIND OUT WHAT IS THE PATHWAY 1348 00:57:58,170 --> 00:57:59,138 THAT ULTIMATELY ENDS UP DRIVING 1349 00:57:59,138 --> 00:58:02,141 ALCOHOL USE DISORDER IN A 1350 00:58:02,141 --> 00:58:02,675 RODENT. 1351 00:58:02,675 --> 00:58:04,543 BUT, YOU KNOW, IT'S A VERY GOOD 1352 00:58:04,543 --> 00:58:04,810 QUESTION. 1353 00:58:04,810 --> 00:58:06,245 THANKS FOR ASKING IT. 1354 00:58:06,245 --> 00:58:09,381 YOU KNOW, I'VE BEEN A PROPONENT 1355 00:58:09,381 --> 00:58:13,018 OF BACK-TRANSLATION FOR YEARS. 1356 00:58:13,018 --> 00:58:14,787 BUT IT IS NOT THAT WELL EMBRACED 1357 00:58:14,787 --> 00:58:17,790 BUT I THINK IT CAN BE NOW. 1358 00:58:17,790 --> 00:58:19,124 ESPECIALLY WITH WHAT WE'RE 1359 00:58:19,124 --> 00:58:20,593 LEARNING IN NEUROSCIENCE. 1360 00:58:20,593 --> 00:58:21,860 YOU MAY WONDER WHY DO WE SPEND 1361 00:58:21,860 --> 00:58:24,129 ALL THIS MONEY IN NEUROSCIENCE? 1362 00:58:24,129 --> 00:58:26,565 HOPEFULLY SOME DAY IT'S GOING TO 1363 00:58:26,565 --> 00:58:28,367 PAY OFF WITH IDENTIFYING NOVEL 1364 00:58:28,367 --> 00:58:29,501 TREATMENTS AND NOVEL TREATMENTS 1365 00:58:29,501 --> 00:58:32,471 THAT CAN BE NOT ONLY MEDICATIONS 1366 00:58:32,471 --> 00:58:36,008 BUT EVEN BEHAVIORAL TREATMENTS 1367 00:58:36,008 --> 00:58:36,875 AND INTERVENTIONS. 1368 00:58:36,875 --> 00:58:38,510 ANY OTHER THOUGHTS OR QUESTIONS? 1369 00:58:38,510 --> 00:58:44,450 THAT WAS A REALLY GOOD QUESTION, 1370 00:58:44,450 --> 00:58:44,683 RHONDA. 1371 00:58:44,683 --> 00:58:45,484 THANK YOU. 1372 00:58:45,484 --> 00:58:45,818 ANYTHING ELSE? 1373 00:58:45,818 --> 00:58:49,054 ALL RIGHT. 1374 00:58:49,054 --> 00:58:50,356 WE'LL CARRY ON. 1375 00:58:50,356 --> 00:58:52,891 AND USUALLY I RUN OVER SO I'M 1376 00:58:52,891 --> 00:58:56,595 FEELING GOOD TODAY. 1377 00:58:56,595 --> 00:59:01,567 1378 00:59:01,567 --> 00:59:11,610 1379 00:59:28,560 --> 00:59:34,667 WE MAY GET AN EARLY BREAK FOR 1380 00:59:34,667 --> 00:59:35,000 LUNCH. 1381 00:59:35,000 --> 00:59:36,268 AFTER LUNCH DAVID GOLDMAN WILL 1382 00:59:36,268 --> 00:59:38,070 GIVE THE TALK, OUR CLINICAL 1383 00:59:38,070 --> 00:59:40,105 DIRECTOR, REALLY LOOKING FORWARD 1384 00:59:40,105 --> 00:59:41,040 TO THAT. 1385 00:59:41,040 --> 00:59:45,077 AND SHOULD BE A LOT OF FUN. 1386 00:59:45,077 --> 00:59:47,613 SO, ANY DISCUSSION ABOUT 1387 00:59:47,613 --> 00:59:47,880 ANYTHING? 1388 00:59:47,880 --> 00:59:50,516 KATIE, AS I SAID, WAS VERY BRAVE 1389 00:59:50,516 --> 00:59:52,451 BEING THE FIRST PERSON IN A 1390 00:59:52,451 --> 00:59:55,654 NUMBER OF YEARS TO RAISE A HIGH 1391 00:59:55,654 --> 00:59:55,921 PRIORITY. 1392 00:59:55,921 --> 00:59:58,357 PLEASE FEEL FREE TO DO THIS. 1393 00:59:58,357 --> 01:00:02,027 WHEN I WAS ON NIDA STUDY 1394 01:00:02,027 --> 01:00:03,062 SECTION, NOT STUDY SECTION, 1395 01:00:03,062 --> 01:00:05,931 COUNCIL, YEARS AND YEARS AGO, 1396 01:00:05,931 --> 01:00:06,932 WAS WHEN THE ENDOCANNABINOID 1397 01:00:06,932 --> 01:00:09,134 WORK WAS COMING OUT. 1398 01:00:09,134 --> 01:00:10,703 I HIGHLIGHTED A NUMBER OF THOSE 1399 01:00:10,703 --> 01:00:12,971 GRANTS IN THE EARLY DAYS. 1400 01:00:12,971 --> 01:00:15,507 AND I FEEL, I MEAN, YOU KNOW, 1401 01:00:15,507 --> 01:00:17,109 I'M A LITTLE NARCISSISTIC SO I 1402 01:00:17,109 --> 01:00:19,478 FEEL THOUGH THAT I REALLY 1403 01:00:19,478 --> 01:00:20,713 ACTUALLY HELPED MOVE THE FIELD 1404 01:00:20,713 --> 01:00:23,549 FORWARD A LITTLE BIT BECAUSE IT 1405 01:00:23,549 --> 01:00:25,851 STARTED, YOU KNOW, A PROGRAM 1406 01:00:25,851 --> 01:00:28,354 THAT HAS BEEN VERY RICH, AND WE 1407 01:00:28,354 --> 01:00:33,525 HAVE A HUGE PROGRAM ON 1408 01:00:33,525 --> 01:00:37,696 ENDOCANNABINOIDS IN OUR 1409 01:00:37,696 --> 01:00:39,965 INTRAMURAL PROGRAM AND EVEN 1410 01:00:39,965 --> 01:00:40,632 EXTRAMURALLY. 1411 01:00:40,632 --> 01:00:41,467 QUESTIONS, COMMENTS? 1412 01:00:41,467 --> 01:00:41,667 TINA? 1413 01:00:41,667 --> 01:00:43,335 >> I'M INTERESTED IN LEARNING 1414 01:00:43,335 --> 01:00:45,838 MORE ABOUT THIS COMMON FUND 1415 01:00:45,838 --> 01:00:48,407 PRIMARY CARE NETWORK. 1416 01:00:48,407 --> 01:00:49,975 I THINK THAT HAS TREMENDOUS 1417 01:00:49,975 --> 01:00:53,045 POTENTIAL FOR PEDIATRIC AND 1418 01:00:53,045 --> 01:00:54,713 OB/GYN BEING PRIMARY CARE 1419 01:00:54,713 --> 01:00:57,149 ABILITY TO BE ABLE TO TEST 1420 01:00:57,149 --> 01:00:58,717 INTERVENTIONS AND SO ON. 1421 01:00:58,717 --> 01:01:00,519 YOU MENTIONED THAT IT WOULD 1422 01:01:00,519 --> 01:01:01,720 START SMALL AND EXPAND. 1423 01:01:01,720 --> 01:01:06,225 CAN YOU EXPAND ON OR MAYBE 1424 01:01:06,225 --> 01:01:07,726 INFORMATION ISN'T AVAILABLE YET 1425 01:01:07,726 --> 01:01:09,428 BUT HOW BIG WOULD THE NETWORK BE 1426 01:01:09,428 --> 01:01:11,397 AND WOULD THIS BE A BASIS 1427 01:01:11,397 --> 01:01:13,198 WHEREBY RFAs WOULD COME OUT 1428 01:01:13,198 --> 01:01:14,500 FROM DIFFERENT INSTITUTES TO USE 1429 01:01:14,500 --> 01:01:17,903 THE NETWORK AS A PLATFORM? 1430 01:01:17,903 --> 01:01:20,038 >> YEAH, I THINK YOU NAILED IT 1431 01:01:20,038 --> 01:01:21,039 WITH YOUR LAST SENTENCE. 1432 01:01:21,039 --> 01:01:23,709 I'M GUESSING THAT'S HOW IT'S 1433 01:01:23,709 --> 01:01:25,811 GOING TO BE FORMULATED 1434 01:01:25,811 --> 01:01:26,412 EVENTUALLY. 1435 01:01:26,412 --> 01:01:26,712 EVENTUALLY. 1436 01:01:26,712 --> 01:01:30,482 BUT I BELIEVE THEY ARE PLANNING 1437 01:01:30,482 --> 01:01:32,651 TO HAVE THREE SITES THAT THEY 1438 01:01:32,651 --> 01:01:33,719 HAVE ALREADY IDENTIFIED AND THAT 1439 01:01:33,719 --> 01:01:35,687 WILL BE ANNOUNCED I THINK ON 1440 01:01:35,687 --> 01:01:36,288 JUNE 7. 1441 01:01:36,288 --> 01:01:38,457 BUT I DON'T KNOW WHAT THOSE 1442 01:01:38,457 --> 01:01:39,324 SITES ARE. 1443 01:01:39,324 --> 01:01:42,327 AND I'M GUESSING IT'S GOING TO 1444 01:01:42,327 --> 01:01:44,763 BE MORE RELATED TO PROBABLY 1445 01:01:44,763 --> 01:01:45,831 PHYSICAL AILMENTS TO START WITH, 1446 01:01:45,831 --> 01:01:49,168 HEART DISEASE OR SOMETHING LIKE 1447 01:01:49,168 --> 01:01:50,636 THAT, OR ENDOCRINE. 1448 01:01:50,636 --> 01:01:53,272 BUT, YOU KNOW, I THINK AN 1449 01:01:53,272 --> 01:01:55,374 OPPORTUNITY FOR US TO FOLD IN 1450 01:01:55,374 --> 01:01:59,511 MINIMUM, YOU KNOW, MY FAVORITE, 1451 01:01:59,511 --> 01:02:00,446 THE AUDIT-C. 1452 01:02:00,446 --> 01:02:03,415 AND MANY OF YOU KNOW DAVID 1453 01:02:03,415 --> 01:02:05,684 GOLDMAN INSTITUTED THAT AT THE 1454 01:02:05,684 --> 01:02:06,418 CLINICAL CENTER. 1455 01:02:06,418 --> 01:02:08,487 SO IT IS DONE WITH EVERY PATIENT 1456 01:02:08,487 --> 01:02:11,156 NOW THAT INTAKES IN THE CLINICAL 1457 01:02:11,156 --> 01:02:11,590 CENTER. 1458 01:02:11,590 --> 01:02:15,994 OUR CLINICAL CENTER BUILDING 1. 1459 01:02:15,994 --> 01:02:17,062 SO, BUILDING 10. 1460 01:02:17,062 --> 01:02:17,863 MONICA WOULD NOT WANT THE 1461 01:02:17,863 --> 01:02:20,132 CLINICAL CENTER TO BE IN 1462 01:02:20,132 --> 01:02:22,501 BUILDING 1. 1463 01:02:22,501 --> 01:02:23,469 BUILDING 10. 1464 01:02:23,469 --> 01:02:25,070 SO, I DON'T KNOW MUCH MORE. 1465 01:02:25,070 --> 01:02:27,372 YOU KNOW, I HOPE THAT THERE WILL 1466 01:02:27,372 --> 01:02:28,707 BE EQUAL PLAY FOR THE MENTAL 1467 01:02:28,707 --> 01:02:33,212 DISORDERS AS WELL AS PHYSICAL 1468 01:02:33,212 --> 01:02:33,479 DISORDERS. 1469 01:02:33,479 --> 01:02:34,813 AND, YOU KNOW, HOW MANAGEABLE 1470 01:02:34,813 --> 01:02:37,149 IT'S GOING TO BE, I DON'T KNOW. 1471 01:02:37,149 --> 01:02:39,785 BUT I'VE ALWAYS FELT, YOU KNOW, 1472 01:02:39,785 --> 01:02:41,854 I CALL IT FREE RANGING CHICKEN 1473 01:02:41,854 --> 01:02:49,628 KIND OF APPROACH TO DOING 1474 01:02:49,628 --> 01:02:51,096 RESEARCH. 1475 01:02:51,096 --> 01:02:52,264 I OVERHEARD VENTURE CAPITALISTS 1476 01:02:52,264 --> 01:02:53,899 AND SOME OF THE PHARMACEUTICAL 1477 01:02:53,899 --> 01:02:56,635 INDUSTRY PEOPLE THAT WERE AT 1478 01:02:56,635 --> 01:03:02,441 THIS TRANSLATIONAL NEUROSCIENCE 1479 01:03:02,441 --> 01:03:03,509 COMPLAINING ABOUT PROFESSIONAL 1480 01:03:03,509 --> 01:03:04,009 PARTICIPANTS IN STUDIES. 1481 01:03:04,009 --> 01:03:05,978 IN OTHER WORDS, THEY JUST GO 1482 01:03:05,978 --> 01:03:07,212 FROM STUDY TO STUDY. 1483 01:03:07,212 --> 01:03:13,619 DAVID, MAYBE YOU COULD 1484 01:03:13,619 --> 01:03:13,986 ELABORATE. 1485 01:03:13,986 --> 01:03:20,158 APPARENTLY IT'S A PAIN NOW, THEY 1486 01:03:20,158 --> 01:03:21,994 MANAGE TO CONVINCE PEOPLE THEY 1487 01:03:21,994 --> 01:03:23,996 ARE DEPRESSED AND HAVE AN 1488 01:03:23,996 --> 01:03:25,430 ANXIETY DISORDER AND THEY GO TO 1489 01:03:25,430 --> 01:03:26,064 THE NEXT TRIAL. 1490 01:03:26,064 --> 01:03:27,833 I THINK THAT'S HOW IT WORKS. 1491 01:03:27,833 --> 01:03:30,903 DAVID, DO YOU WANT TO -- 1492 01:03:30,903 --> 01:03:32,871 >> YEAH, I THINK SPECIALLY 1493 01:03:32,871 --> 01:03:33,772 UNIVERSITY ENVIRONMENTS, A LARGE 1494 01:03:33,772 --> 01:03:40,979 PART OF THE PROBLEM IS YOU GET 1495 01:03:40,979 --> 01:03:42,681 HIGHLY NON-REPRESENTATIVE VERY 1496 01:03:42,681 --> 01:03:45,751 OVEREDUCATED INDIVIDUALS 1497 01:03:45,751 --> 01:03:46,351 INHERENTLY INTELLECTUALLY 1498 01:03:46,351 --> 01:03:47,019 INTERESTED IN RESEARCH, NOT 1499 01:03:47,019 --> 01:03:50,889 REPRESENTATIVE OF THE GENERAL 1500 01:03:50,889 --> 01:03:51,189 POPULATION. 1501 01:03:51,189 --> 01:03:52,824 SOME SOCIODEMOGRAPHIC FACTORS 1502 01:03:52,824 --> 01:03:54,793 THAT CONTRIBUTE TO LOWER QUALITY 1503 01:03:54,793 --> 01:03:57,362 OF HEALTH, SO I THINK I GUESS 1504 01:03:57,362 --> 01:04:00,098 WHAT'S EXCITING TO ME IS IF YOU 1505 01:04:00,098 --> 01:04:04,836 CAN -- IF THIS DOES COME OUT OF 1506 01:04:04,836 --> 01:04:08,440 PRIMARY CARE CLINICS, ESPECIALLY 1507 01:04:08,440 --> 01:04:10,842 IN PERHAPS NON-UNIVERSITY 1508 01:04:10,842 --> 01:04:11,843 ENVIRONMENTS, OR URBAN 1509 01:04:11,843 --> 01:04:12,411 ENVIRONMENTS, RURAL 1510 01:04:12,411 --> 01:04:13,612 ENVIRONMENTS, MAYBE THERE'S A 1511 01:04:13,612 --> 01:04:15,681 CHANCE TO OVERCOME SOME OF THAT. 1512 01:04:15,681 --> 01:04:18,450 SO I THINK THAT'S A VERY 1513 01:04:18,450 --> 01:04:19,251 EXCITING INITIATIVE. 1514 01:04:19,251 --> 01:04:21,186 >> AND THEN ONE MORE THING FROM 1515 01:04:21,186 --> 01:04:22,854 THE DISCUSSIONS, TINA, THAT THEY 1516 01:04:22,854 --> 01:04:23,555 ARE TALKING ABOUT ELECTRONIC 1517 01:04:23,555 --> 01:04:24,156 HEALTH RECORDS HERE. 1518 01:04:24,156 --> 01:04:27,359 SO THAT'S GOING TO BE THE 1519 01:04:27,359 --> 01:04:27,960 METRIC. 1520 01:04:27,960 --> 01:04:30,495 AND THAT HAS SOME LIMITATIONS, 1521 01:04:30,495 --> 01:04:32,998 BUT THEY CAN ALSO BE IMPROVED. 1522 01:04:32,998 --> 01:04:35,801 AND WE'LL TALK ABOUT THAT LATER 1523 01:04:35,801 --> 01:04:39,371 TODAY BUT THAT'S ANOTHER BEE IN 1524 01:04:39,371 --> 01:04:42,808 MY BONNET, COMMON DATA ELEMENTS. 1525 01:04:42,808 --> 01:04:43,475 KATIE? 1526 01:04:43,475 --> 01:04:45,611 >> JUST TO FOLLOW UP, I AGREE 1527 01:04:45,611 --> 01:04:49,615 THIS IS AN IMPORTANT PROGRAM BUT 1528 01:04:49,615 --> 01:04:54,820 I'M CURIOUS WORKING WITH 1529 01:04:54,820 --> 01:04:57,155 COMMUNITY CLINICS, FQHCS, STAFF 1530 01:04:57,155 --> 01:04:58,323 ARE EXTREMELY TAPPED, CURIOUS IF 1531 01:04:58,323 --> 01:05:00,592 NIH AS PART OF THE PROGRAMS 1532 01:05:00,592 --> 01:05:02,361 MIGHT HAVE THE ABILITY TO INVEST 1533 01:05:02,361 --> 01:05:03,795 IN THESE PROGRAMS AS WELL, AS 1534 01:05:03,795 --> 01:05:05,397 FAR AS LIKE IF WE'RE GOING TO DO 1535 01:05:05,397 --> 01:05:07,165 RESEARCH IN THE PROGRAM THAT WE 1536 01:05:07,165 --> 01:05:09,501 CAN PAY STAFF TIME, WE CAN PRAY 1537 01:05:09,501 --> 01:05:12,204 PROVIDER TIME, BECAUSE IN OUR 1538 01:05:12,204 --> 01:05:13,972 EXPERIENCE THAT'S BEEN A REAL 1539 01:05:13,972 --> 01:05:17,376 BARRIER TO DOING WORK WITHIN 1540 01:05:17,376 --> 01:05:19,845 THESE -- SPECIAL RURAL PRIMARY 1541 01:05:19,845 --> 01:05:21,046 CARE SETTINGS. 1542 01:05:21,046 --> 01:05:25,017 >> YEAH, GOOD POINT, DULY NOTED. 1543 01:05:25,017 --> 01:05:27,285 I'LL PROBABLY RAISE THE ISSUE IF 1544 01:05:27,285 --> 01:05:28,954 NOT RAISED BY SOMEONE ELSE WHEN 1545 01:05:28,954 --> 01:05:31,356 IT IS LAUNCHED IN JUNE, AND AS 1546 01:05:31,356 --> 01:05:33,625 WE START MOVING INTO LATER 1547 01:05:33,625 --> 01:05:35,293 PHASES IT MAY TURN OUT TO BE 1548 01:05:35,293 --> 01:05:36,395 MORE EXPENSIVE THAN ANYONE 1549 01:05:36,395 --> 01:05:39,931 ANTICIPATES BUT I DO THINK IT'S 1550 01:05:39,931 --> 01:05:45,704 ALSO, YOU KNOW, A POTENTIAL FOR 1551 01:05:45,704 --> 01:05:47,639 RICH WINDOW ON DIVERSITY ISSUES 1552 01:05:47,639 --> 01:05:52,711 ACROSS THE BOARD, RURAL, CITY, 1553 01:05:52,711 --> 01:05:53,211 RACIAL, CULTURAL GROUPS. 1554 01:05:53,211 --> 01:05:56,381 AND, YOU KNOW, THINGS ARE GOING 1555 01:05:56,381 --> 01:05:59,518 TO HAVE TO PROBABLY BE MODIFIED, 1556 01:05:59,518 --> 01:06:02,521 SCALES THAT ARE DONE FOR WHITE 1557 01:06:02,521 --> 01:06:11,296 ANGLO SAXONS MAY HAVE TO BE 1558 01:06:11,296 --> 01:06:13,265 MODIFIED FOR OTHER CULTURAL 1559 01:06:13,265 --> 01:06:13,498 GROUPS. 1560 01:06:13,498 --> 01:06:14,066 EVERYTHING MAY CHANGE. 1561 01:06:14,066 --> 01:06:16,101 IF IT'S AN ENGINE FOR THAT KIND 1562 01:06:16,101 --> 01:06:17,102 OF CHANGE I THINK IT'S GOING TO 1563 01:06:17,102 --> 01:06:18,070 BE GOOD. 1564 01:06:18,070 --> 01:06:18,904 OTHER THOUGHTS? 1565 01:06:18,904 --> 01:06:19,171 ANYBODY? 1566 01:06:19,171 --> 01:06:22,307 HOW ARE WE DOING ON TIME? 1567 01:06:22,307 --> 01:06:24,509 >> I WANT TO FOLLOW UP WITH 1568 01:06:24,509 --> 01:06:25,143 KATIE SAID. 1569 01:06:25,143 --> 01:06:26,745 I THINK COMMUNITY ENGAGEMENT 1570 01:06:26,745 --> 01:06:29,581 PIECE ALREADY CRITICAL TO THIS 1571 01:06:29,581 --> 01:06:30,849 SUCCESS. 1572 01:06:30,849 --> 01:06:33,485 >> YEAH, AND THAT'S A NEW THRUST 1573 01:06:33,485 --> 01:06:34,720 AT NIH. 1574 01:06:34,720 --> 01:06:38,590 ALMOST ALL THE INSTITUTES, 1575 01:06:38,590 --> 01:06:39,224 INCLUDING OURSELVES, WITH MCCI, 1576 01:06:39,224 --> 01:06:41,593 BUT THIS IS THE INVOLVEMENT OF 1577 01:06:41,593 --> 01:06:42,828 COMMUNITY, THE HEAL INITIATIVE 1578 01:06:42,828 --> 01:06:46,131 HAS BEEN WORKING HARD TO INVOLVE 1579 01:06:46,131 --> 01:06:51,136 COMMUNITY IN THEIR OPIOID 1580 01:06:51,136 --> 01:06:52,170 INTERVENTIONS, AND THEY ARE 1581 01:06:52,170 --> 01:06:54,372 GETTING THE ENGAGEMENT. 1582 01:06:54,372 --> 01:06:56,074 YOU KNOW, FINDING WHAT'S 1583 01:06:56,074 --> 01:06:57,008 SUCCESSFUL, WHAT'S NOT 1584 01:06:57,008 --> 01:06:58,844 SUCCESSFUL IS A CHALLENGE. 1585 01:06:58,844 --> 01:07:02,881 BUT THEY ARE AT LEAST DOING IT. 1586 01:07:02,881 --> 01:07:03,715 THERE'S FUNDS BEING SPENT IN THE 1587 01:07:03,715 --> 01:07:04,683 CONTEXT OF THE HEAL INITIATIVE 1588 01:07:04,683 --> 01:07:06,785 ON THIS. 1589 01:07:06,785 --> 01:07:10,088 AND I KNOW NIH, LBI, THE HEART 1590 01:07:10,088 --> 01:07:12,324 INSTITUTE HAS BEEN DOING THIS AS 1591 01:07:12,324 --> 01:07:12,524 WELL. 1592 01:07:12,524 --> 01:07:14,059 SO I'M SURE -- AND NIDA IS BIG 1593 01:07:14,059 --> 01:07:15,827 IN IT BECAUSE THEY ARE RUNNING 1594 01:07:15,827 --> 01:07:17,529 THAT PART OF THE HEAL INITIATIVE 1595 01:07:17,529 --> 01:07:18,797 AT THIS POINT. 1596 01:07:18,797 --> 01:07:20,632 BUT I BELIEVE NINDS IS DOING IT 1597 01:07:20,632 --> 01:07:23,034 AS WELL IN THE CONTEXT OF PAIN. 1598 01:07:23,034 --> 01:07:28,974 SO ... IS THAT CORRECT, MARK? 1599 01:07:28,974 --> 01:07:30,475 ARE YOU HERE? 1600 01:07:30,475 --> 01:07:32,744 >> YEAH, WE HAVE SOME OF THE 1601 01:07:32,744 --> 01:07:34,312 "HEAL" MONEY, THAT'S CORRECT. 1602 01:07:34,312 --> 01:07:35,614 WE'LL FOCUS ON COMMUNITY 1603 01:07:35,614 --> 01:07:36,414 ENGAGEMENT. 1604 01:07:36,414 --> 01:07:37,516 >> OKAY. 1605 01:07:37,516 --> 01:07:39,851 ALL RIGHT, GOOD. 1606 01:07:39,851 --> 01:07:40,919 I DIDN'T IMAGINE IT. 1607 01:07:40,919 --> 01:07:48,260 ANYTHING ELSE? 1608 01:07:48,260 --> 01:07:49,194 1609 01:07:49,194 --> 01:07:52,430 WELL, OVER LUNCH TIME TALK TO 1610 01:07:52,430 --> 01:07:53,231 YOUR FELLOW COUNCIL MEMBERS, AND 1611 01:07:53,231 --> 01:07:55,167 THINK ABOUT THINGS YOU WANT TO 1612 01:07:55,167 --> 01:07:56,034 TALK ABOUT. 1613 01:07:56,034 --> 01:08:00,906 I MEAN, WE'RE OPEN FOR BUSINESS. 1614 01:08:00,906 --> 01:08:01,540 WE GOT THROUGH THE STRATEGIC 1615 01:08:01,540 --> 01:08:02,140 PLAN. 1616 01:08:02,140 --> 01:08:04,442 WE GOT THROUGH THE BUDGET ISSUE. 1617 01:08:04,442 --> 01:08:06,278 IT COULD HAVE BEEN WORSE. 1618 01:08:06,278 --> 01:08:07,546 COULD HAVE BEEN BETTER, BUT 1619 01:08:07,546 --> 01:08:11,449 COULD HAVE BEEN WORSE. 1620 01:08:11,449 --> 01:08:13,385 AND, YOU KNOW, WE'RE ANXIOUS TO 1621 01:08:13,385 --> 01:08:16,288 MEET SOME OF THE GOALS THAT YOU 1622 01:08:16,288 --> 01:08:17,823 SAW IN THAT SLIDE FOR OUR 1623 01:08:17,823 --> 01:08:19,624 STRATEGIC PLAN. 1624 01:08:19,624 --> 01:08:21,159 SO START THINKING ABOUT WAYS, 1625 01:08:21,159 --> 01:08:22,494 FROM YOUR PERSPECTIVES, THAT WE 1626 01:08:22,494 --> 01:08:24,462 COULD START DOING THAT. 1627 01:08:24,462 --> 01:08:27,566 THAT'S THE CHALLENGE. 1628 01:08:27,566 --> 01:08:27,833 ALL RIGHT. 1629 01:08:27,833 --> 01:08:29,000 SO, PHILIPPE, DO YOU WANTS TO 1630 01:08:29,000 --> 01:08:31,469 SAY ANY WORDS ABOUT HOW PEOPLE 1631 01:08:31,469 --> 01:08:33,405 GET LUNCH? 1632 01:08:33,405 --> 01:08:33,939 >> SURE. 1633 01:08:33,939 --> 01:08:36,441 THERE'S A CAFETERIA ON THE FIRST 1634 01:08:36,441 --> 01:08:43,148 FLOOR, IN THIS BUILDING AREA. 1635 01:08:43,148 --> 01:08:47,719 AND THAT'S YOUR CHANCE FOR 1636 01:08:47,719 --> 01:08:48,653 LUNCH. 1637 01:08:48,653 --> 01:08:52,157 IT'S ON -- IT'S A FEW BUILDINGS 1638 01:08:52,157 --> 01:08:53,358 DOWN THE PATH. 1639 01:08:53,358 --> 01:08:55,293 >> DOES ANYBODY KNOW WHAT 1640 01:08:55,293 --> 01:08:59,731 BUILDINGS, CAN FIND IT? 1641 01:08:59,731 --> 01:09:01,233 >> SURE. 1642 01:09:01,233 --> 01:09:11,409 HOLD ON. 1643 01:09:13,245 --> 01:09:15,113 >> IS THERE SOMEBODY FROM NIAAA 1644 01:09:15,113 --> 01:09:18,383 THAT COULD LEAD EVERYONE DOWN 1645 01:09:18,383 --> 01:09:20,785 TOWARD THIS? 1646 01:09:20,785 --> 01:09:21,052 >> YES. 1647 01:09:21,052 --> 01:09:26,925 >> CAN YOU LEAD THEM, PHILIPPE? 1648 01:09:26,925 --> 01:09:29,561 >> I CAN, NOT A PROBLEM. 1649 01:09:29,561 --> 01:09:35,233 >> YOU'RE DESIGNATED LEADER. 1650 01:09:35,233 --> 01:09:35,700 FOLLOW PHILIPPE LIKE 1651 01:09:35,700 --> 01:09:38,069 KINDERGARTEN, WE'LL TAKE CARE OF 1652 01:09:38,069 --> 01:09:39,604 EVERYBODY. 1653 01:09:39,604 --> 01:09:46,645 HAVE A ROPE. 1654 01:09:46,645 --> 01:09:47,183 >> 6610 IN CASE YOU CAN'T FIND PHILIPPE. 1655 01:09:52,552 --> 01:09:55,288 >> WE'LL RECONVENE THE OPEN 1656 01:09:55,288 --> 01:09:58,391 SESSION OF THE 166th MEETING 1657 01:09:58,391 --> 01:09:59,960 OF THE NATIONAL ADVISORY COUNCIL 1658 01:09:59,960 --> 01:10:10,203 FOR ALCOHOL ABUSE AND 1659 01:10:10,203 --> 01:10:10,604 ALCOHOLISM. 1660 01:10:10,604 --> 01:10:12,973 >> OKAY, EVERYONE. 1661 01:10:12,973 --> 01:10:21,982 DID YOU SAY 1:15 ONLINE? 1662 01:10:21,982 --> 01:10:22,215 >> YES. 1663 01:10:22,215 --> 01:10:30,323 >> ALL RIGHT. 1664 01:10:30,323 --> 01:10:36,329 SO, ANDREW CAMERON, ARE YOU ON? 1665 01:10:36,329 --> 01:10:37,330 >> I AM. 1666 01:10:37,330 --> 01:10:39,099 THANK YOU FOR HAVING ME. 1667 01:10:39,099 --> 01:10:41,034 >> COULD YOU INTRODUCE YOURSELF? 1668 01:10:41,034 --> 01:10:45,472 EVERYBODY GOT TO INTRODUCE 1669 01:10:45,472 --> 01:10:49,676 THEMSELVES, NAME, RANK, SERIAL 1670 01:10:49,676 --> 01:10:50,844 NUMBER. 1671 01:10:50,844 --> 01:10:51,144 KIDDING. 1672 01:10:51,144 --> 01:10:53,613 >> ANDREW CAMERON, I'M A LIVER 1673 01:10:53,613 --> 01:10:56,216 TRANSPLANT SURGEON UP AT JOHNS 1674 01:10:56,216 --> 01:10:57,784 HOPKINS, INTERESTED IN SEVERE 1675 01:10:57,784 --> 01:11:01,388 ALCOHOLIC HEPATITIS AND USE OF 1676 01:11:01,388 --> 01:11:03,056 LIVER TRANSPLANTATION FOR THAT 1677 01:11:03,056 --> 01:11:03,423 CONDITION. 1678 01:11:03,423 --> 01:11:05,158 THANKS AGAIN FOR HAVING ME 1679 01:11:05,158 --> 01:11:05,525 INCLUDED. 1680 01:11:05,525 --> 01:11:06,393 >> THANKS, ANDREW. 1681 01:11:06,393 --> 01:11:09,429 THANKS FOR JOINING US. 1682 01:11:09,429 --> 01:11:11,364 I KNOW YOU PROBABLY HAVE AN EVEN 1683 01:11:11,364 --> 01:11:16,803 BUSIER SCHEDULE THAN I DO. 1684 01:11:16,803 --> 01:11:21,775 >> HAPPY TO BE HERE. 1685 01:11:21,775 --> 01:11:22,542 >> ALL RIGHT. 1686 01:11:22,542 --> 01:11:25,979 SO, NEXT ON OUR LIST IS, AS I 1687 01:11:25,979 --> 01:11:28,048 PREVIEWED EARLIER, WE'LL HAVE A 1688 01:11:28,048 --> 01:11:30,350 PRESENTATION BY DR. DAVID 1689 01:11:30,350 --> 01:11:30,884 GOLDMAN. 1690 01:11:30,884 --> 01:11:32,219 AND I'M GOING TO INTRODUCE HIM 1691 01:11:32,219 --> 01:11:34,788 AND TELL YOU A LITTLE BIT ABOUT 1692 01:11:34,788 --> 01:11:35,188 DAVID. 1693 01:11:35,188 --> 01:11:38,491 BUT THE TITLE OF HIS TALK IS 1694 01:11:38,491 --> 01:11:40,293 GENOMIC MEDICINE OF ALCOHOL USE 1695 01:11:40,293 --> 01:11:42,629 DISORDER, WHY ONLY SOME DRINKERS 1696 01:11:42,629 --> 01:11:44,297 DEVELOP ALCOHOL USE DISORDER AND 1697 01:11:44,297 --> 01:11:46,666 ONLY SOME HEAVY DRINKERS DEVELOP 1698 01:11:46,666 --> 01:11:47,601 LIVER DISEASE. 1699 01:11:47,601 --> 01:11:51,271 SO, DAVID IS CHIEF OF THE 1700 01:11:51,271 --> 01:11:53,607 LABORATORY OF NEUROGENETICS, 1701 01:11:53,607 --> 01:11:56,409 CLINICAL DIRECTOR AT NIAAA, 1702 01:11:56,409 --> 01:11:57,244 GRADUATED FROM YALE UNIVERSITY, 1703 01:11:57,244 --> 01:12:00,180 UNIVERSITY OF TEXAS MEDICAL 1704 01:12:00,180 --> 01:12:04,251 BRANCH IN GALVESTON, CAME TO NIH 1705 01:12:04,251 --> 01:12:05,719 FIRST ON A THREE-MONTH 1706 01:12:05,719 --> 01:12:07,320 EXTERNSHIP AS A SENIOR MEDICAL 1707 01:12:07,320 --> 01:12:11,591 STUDENT, A YEAR LATER IN 1979 1708 01:12:11,591 --> 01:12:14,227 JOINED NIH, AND HAS BEEN HERE 1709 01:12:14,227 --> 01:12:18,031 EVER SINCE, BOTH IN NIMH AND IN 1710 01:12:18,031 --> 01:12:18,331 NIAAA. 1711 01:12:18,331 --> 01:12:21,434 HE HAS TAKEN ON SEVERAL 1712 01:12:21,434 --> 01:12:24,137 ADMINISTRATIVE ROLES FOR EXAMPLE 1713 01:12:24,137 --> 01:12:30,143 CHAIRING NIAAA IRB FOR A DECADE, 1714 01:12:30,143 --> 01:12:31,778 HELPING SHEPHERD MERGER WITH 1715 01:12:31,778 --> 01:12:34,748 OTHER INSTITUTES FOUNDED AND 1716 01:12:34,748 --> 01:12:36,716 CHAIRED BY NIAAA/NIDA, 1717 01:12:36,716 --> 01:12:37,917 SCIENTIFIC REVIEW COMMITTEE, 1718 01:12:37,917 --> 01:12:40,654 FOUNDED THE NIAAA OFFICE OF 1719 01:12:40,654 --> 01:12:41,821 CLINICAL DIRECTOR, WHEN HE 1720 01:12:41,821 --> 01:12:43,556 BECAME CLINICAL DIRECTOR. 1721 01:12:43,556 --> 01:12:46,026 HE HAS FOCUSED ON IDENTIFYING 1722 01:12:46,026 --> 01:12:48,161 GENES THAT INFLUENCE VULNERABLE 1723 01:12:48,161 --> 01:12:51,865 TO ALCOHOL USE DISORDER, AND 1724 01:12:51,865 --> 01:12:52,799 OTHER PSYCHIATRIC DISEASES, 1725 01:12:52,799 --> 01:12:53,967 INCLUDING IN FOUNDER POPULATIONS 1726 01:12:53,967 --> 01:12:55,669 SUCH AS NATIVE AMERICAN TRIBES 1727 01:12:55,669 --> 01:12:57,470 AND FINLAND. 1728 01:12:57,470 --> 01:13:00,307 HIS LABORATORY USES COMBINATION 1729 01:13:00,307 --> 01:13:02,142 OF GENOMIC INTERMEDIATE 1730 01:13:02,142 --> 01:13:03,276 PHENOTYPE AND FUNCTIONAL GENETIC 1731 01:13:03,276 --> 01:13:10,116 METHODS TO IDENTIFY FUNCTIONAL 1732 01:13:10,116 --> 01:13:11,551 VARIANTS THAT CAUSALLY INFLUENCE 1733 01:13:11,551 --> 01:13:14,487 VULNERABILITY TO PSYCHIATRIC 1734 01:13:14,487 --> 01:13:16,856 DIAGNOSES. 1735 01:13:16,856 --> 01:13:21,194 THESE METHOD OVER 500 PAPERS 1736 01:13:21,194 --> 01:13:24,631 INCLUDING FIRST IMAGING GENETIC 1737 01:13:24,631 --> 01:13:26,666 STUDIES, IDENTIFYING LOCI OF 1738 01:13:26,666 --> 01:13:28,401 MODULATED RISK DISORDERS AMONG 1739 01:13:28,401 --> 01:13:31,871 THE MOST HIGHLY CITED IN 1740 01:13:31,871 --> 01:13:33,473 PSYCHIATRIC GENETICS, DISCOVERED 1741 01:13:33,473 --> 01:13:35,642 INHERITED GENE VARIATIONS THAT 1742 01:13:35,642 --> 01:13:39,679 INFLUENCE VULNERABILITY, AND 1743 01:13:39,679 --> 01:13:40,980 TRACED EFFECTS THESE VARIATIONS 1744 01:13:40,980 --> 01:13:42,248 FROM MOLECULAR LEVEL TO COMPLEX 1745 01:13:42,248 --> 01:13:44,684 BEHAVIORS IN HUMAN RESEARCH 1746 01:13:44,684 --> 01:13:46,653 STUDIES AND MODEL ORGANISMS. 1747 01:13:46,653 --> 01:13:49,522 AMONG HIS AWARDS, DR. GOLDMAN 1748 01:13:49,522 --> 01:13:52,292 WON DISTINGUISHED RESEARCHER AND 1749 01:13:52,292 --> 01:13:55,095 MENTORING AWARDS, RESEARCH 1750 01:13:55,095 --> 01:13:57,964 SOCIETY ON ALCOHOLISM, 1751 01:13:57,964 --> 01:13:58,865 OUTSTANDING RESEARCHER JAMES 1752 01:13:58,865 --> 01:14:00,467 ISAACSON RESEARCHER AWARD OF THE 1753 01:14:00,467 --> 01:14:02,502 INTERNATIONAL SOCIETY FOR 1754 01:14:02,502 --> 01:14:04,571 BIOLOGICAL RESEARCH ON 1755 01:14:04,571 --> 01:14:06,840 ALCOHOLISM, AND MULTIPLE NIH 1756 01:14:06,840 --> 01:14:09,843 DIRECTORS AWARDS. 1757 01:14:09,843 --> 01:14:12,212 HE WROTE OUR GENES, OUR CHOICES, 1758 01:14:12,212 --> 01:14:15,615 WHICH IS A BOOK, AND IT WON THE 1759 01:14:15,615 --> 01:14:16,583 BRITISH MEDICAL ASSOCIATION TOP 1760 01:14:16,583 --> 01:14:21,788 PRIZE AND IS IN ITS SECOND 1761 01:14:21,788 --> 01:14:22,088 EDITION. 1762 01:14:22,088 --> 01:14:27,093 HIS CURRENT BOOK IS ABOUT THE 1763 01:14:27,093 --> 01:14:29,629 NATURE OF LIFE, "IMMORTAL." 1764 01:14:29,629 --> 01:14:38,471 DAVID, IT'S ALL YOURS. 1765 01:14:38,471 --> 01:14:45,979 1766 01:14:45,979 --> 01:14:48,915 >> THANKS FOR YOUR HELP. 1767 01:14:48,915 --> 01:14:57,457 1768 01:14:57,457 --> 01:15:00,427 1769 01:15:00,427 --> 01:15:00,927 OKAY. 1770 01:15:00,927 --> 01:15:02,762 IS EVERYTHING WORKING? 1771 01:15:02,762 --> 01:15:02,962 RIGHT. 1772 01:15:02,962 --> 01:15:05,198 SO I'M GOING TO TRY TO USE THE 1773 01:15:05,198 --> 01:15:05,498 POINTER. 1774 01:15:05,498 --> 01:15:07,100 I THINK THAT I CAN TELL IF THE 1775 01:15:07,100 --> 01:15:08,535 POINTER IS ON. 1776 01:15:08,535 --> 01:15:12,172 SO FIRST I WANT TO THANK ALL THE 1777 01:15:12,172 --> 01:15:13,940 MEMBERS OF THE COUNCIL. 1778 01:15:13,940 --> 01:15:15,508 WAS VERY HAPPY TO SEE ANDREW 1779 01:15:15,508 --> 01:15:16,943 CAMERON JOINED US THIS 1780 01:15:16,943 --> 01:15:17,477 AFTERNOON. 1781 01:15:17,477 --> 01:15:22,482 PART OF THIS TALK WILL BE ABOUT 1782 01:15:22,482 --> 01:15:24,117 ALCOHOL-ASSOCIATED HEPATITIS AND 1783 01:15:24,117 --> 01:15:27,887 LIVER DISEASE, AND ALL THE REST 1784 01:15:27,887 --> 01:15:30,290 OF YOUR SAGE ADVICE FOR TAKING 1785 01:15:30,290 --> 01:15:35,895 THE TIME TO CONTRIBUTE NIAAA. 1786 01:15:35,895 --> 01:15:44,137 THIS IS NOT ADVANCING YET. 1787 01:15:44,137 --> 01:15:45,905 THERE IT IS. 1788 01:15:45,905 --> 01:15:48,708 SO, ALCOHOL USE DISORDER IS A 1789 01:15:48,708 --> 01:15:50,310 GENE BY ENVIRONMENT INTERACTION. 1790 01:15:50,310 --> 01:15:59,118 IT'S CONTINGENT ON EXPOSURE AND 1791 01:15:59,118 --> 01:16:03,590 CONTINGENT ON SOCIAL CONTEXT. 1792 01:16:03,590 --> 01:16:06,993 UNRECOGNIZED ASPECT IS 1793 01:16:06,993 --> 01:16:08,194 CORRELATION BETWEEN GENE AND 1794 01:16:08,194 --> 01:16:09,128 ENVIRONMENT WHICH SO OFTEN 1795 01:16:09,128 --> 01:16:10,263 HAPPENS WITH ALCOHOL USE 1796 01:16:10,263 --> 01:16:13,933 DISORDER. 1797 01:16:13,933 --> 01:16:17,203 THIS IS BOTH PASSIVE, THE THEME 1798 01:16:17,203 --> 01:16:18,605 ONE SHOULD CHOOSE ONE'S PARENTS 1799 01:16:18,605 --> 01:16:20,139 WISELY BECAUSE YOUR PARENTS ARE 1800 01:16:20,139 --> 01:16:22,041 GOING TO NOT ONLY PASS ON THEIR 1801 01:16:22,041 --> 01:16:25,044 GENES TO YOU BUT ALSO EXPOSE YOU 1802 01:16:25,044 --> 01:16:26,579 TO THEIR BEHAVIORS. 1803 01:16:26,579 --> 01:16:28,948 THE THINGS THAT WE EVOKE IN OUR 1804 01:16:28,948 --> 01:16:30,383 ENVIRONMENT, OR THE THINGS THAT 1805 01:16:30,383 --> 01:16:31,751 WE TRIGGER, AND OF COURSE THE 1806 01:16:31,751 --> 01:16:35,855 THINGS THAT WE CHOOSE AND 1807 01:16:35,855 --> 01:16:36,523 CREATE. 1808 01:16:36,523 --> 01:16:39,993 SO, THE HERITABILITY OF 1809 01:16:39,993 --> 01:16:41,594 ADDICTIVE DISORDERS ENCOMPASSES 1810 01:16:41,594 --> 01:16:42,262 ALCOHOL USE DISORDER. 1811 01:16:42,262 --> 01:16:44,497 YOU CAN SEE THAT IT'S PRETTY 1812 01:16:44,497 --> 01:16:49,802 MUCH RIGHT IN THE MIDDLE HERE, 1813 01:16:49,802 --> 01:16:51,004 HERITABILITY OF 50%, THIS 1814 01:16:51,004 --> 01:16:53,072 DOESN'T MEAN THAT IT'S 50% 1815 01:16:53,072 --> 01:16:53,706 ENVIRONMENTAL. 1816 01:16:53,706 --> 01:16:56,376 IT MEANS THAT WE CAN MEASURE 1817 01:16:56,376 --> 01:16:58,044 THAT THE HERITABILITY IS 50%. 1818 01:16:58,044 --> 01:17:00,880 SO THAT'S THE MEASURED COMPONENT 1819 01:17:00,880 --> 01:17:02,549 AND IT'S A GENETIC COMPONENT, 1820 01:17:02,549 --> 01:17:05,251 IT'S DUE TO NOT EPIGENETIC 1821 01:17:05,251 --> 01:17:06,319 FACTORS, OR ENVIRONMENTAL 1822 01:17:06,319 --> 01:17:10,690 FACTORS, BUT TO ACTUAL GENETIC 1823 01:17:10,690 --> 01:17:11,958 VARIANTS INHERITED FROM PARENT 1824 01:17:11,958 --> 01:17:14,260 TO CHILD THAT TEND TO BE SHARED 1825 01:17:14,260 --> 01:17:17,797 AMONGST PEOPLE WHO ARE RELATED. 1826 01:17:17,797 --> 01:17:22,302 BUT IN ADDITION TO WHAT IS 1827 01:17:22,302 --> 01:17:24,003 INHERITED, MUCH IS ACQUIRED, IN 1828 01:17:24,003 --> 01:17:26,139 THE ADDITIONS. 1829 01:17:26,139 --> 01:17:31,177 AND THIS IS THE KOOB CYCLE OF 1830 01:17:31,177 --> 01:17:32,779 ADDICTION, WHICH WAS ORIGINALLY 1831 01:17:32,779 --> 01:17:35,815 PROPOSED BY GEORGE BUT THEN WAS 1832 01:17:35,815 --> 01:17:37,817 ACTUALLY SCORCHED TO BE 1833 01:17:37,817 --> 01:17:40,053 VALIDATED WITHIN THE INTRAMURAL 1834 01:17:40,053 --> 01:17:40,587 DATA STATE, SUBSEQUENTLY 1835 01:17:40,587 --> 01:17:42,155 REPLICATED ALSO. 1836 01:17:42,155 --> 01:17:48,895 YOU SEE SOME PAPERS THERE, KWAKO 1837 01:17:48,895 --> 01:17:57,437 ET AL., AND THOSE DIMENSIONS ARE 1838 01:17:57,437 --> 01:17:58,137 PREOCCUPATION, BINGES 1839 01:17:58,137 --> 01:17:58,605 INTOXICATION, 1840 01:17:58,605 --> 01:18:00,106 WITHDRAWAL/NEGATIVE AFFECT. 1841 01:18:00,106 --> 01:18:03,977 NOT ONLY DO THESE TEND TO HAPPEN 1842 01:18:03,977 --> 01:18:05,211 DURING THE COURSE OF ADDICTION 1843 01:18:05,211 --> 01:18:07,013 BUT PEOPLE START OFF ALREADY 1844 01:18:07,013 --> 01:18:08,881 WITH VARIATION IN THESE 1845 01:18:08,881 --> 01:18:09,649 DIMENSIONS. 1846 01:18:09,649 --> 01:18:15,722 THEY START WITH VARIATIONS IN 1847 01:18:15,722 --> 01:18:17,023 NEGATIVE AFFECT, NEGATIVE 1848 01:18:17,023 --> 01:18:18,725 EMOTIONALITY, ANXIETY AND 1849 01:18:18,725 --> 01:18:19,692 DEPRESSION BEING HERITABLE. 1850 01:18:19,692 --> 01:18:20,660 THEY START WITH DIFFERENCES IN 1851 01:18:20,660 --> 01:18:23,129 EXECUTIVE FUNCTION AND START 1852 01:18:23,129 --> 01:18:24,597 WITH DIFFERENCES IN SALIENCE. 1853 01:18:24,597 --> 01:18:27,800 THESE DIFFERENCES ARE THEN 1854 01:18:27,800 --> 01:18:29,335 AMPLIFIED BY ADDICTION. 1855 01:18:29,335 --> 01:18:32,271 AND A TERRIBLE THING ABOUT THE 1856 01:18:32,271 --> 01:18:36,743 ADDICTIONS IS THAT ALTHOUGH 1857 01:18:36,743 --> 01:18:37,777 PEOPLE START OFF BEING 1858 01:18:37,777 --> 01:18:39,512 VULNERABLE IN SO MANY DIFFERENT 1859 01:18:39,512 --> 01:18:42,281 WAYS, THAT THERE ARE THESE FINAL 1860 01:18:42,281 --> 01:18:43,383 COMMON PATHWAYS OF ADDICTIONS. 1861 01:18:43,383 --> 01:18:46,185 SO THEY ROB PEOPLE OF THEIR 1862 01:18:46,185 --> 01:18:46,552 INDIVIDUALITY. 1863 01:18:46,552 --> 01:18:50,590 THERE'S A DIFFERENCE IN 1864 01:18:50,590 --> 01:18:52,392 RESPONSE, BUT ON THE OTHER HAND 1865 01:18:52,392 --> 01:18:55,695 THERE'S A SAMENESS TO PEOPLE 1866 01:18:55,695 --> 01:18:57,530 WITH ADDICTIONS. 1867 01:18:57,530 --> 01:19:00,867 SO, WE MIGHT THINK FROM THESE 1868 01:19:00,867 --> 01:19:04,070 INTERMEDIATE PHENOTYPES THAT WE 1869 01:19:04,070 --> 01:19:06,039 DISCUSSED, FROM GENE BY 1870 01:19:06,039 --> 01:19:08,508 ENVIRONMENT INTERACTION BEING SO 1871 01:19:08,508 --> 01:19:11,411 IMPORTANT IN AUD THAT GENE BY 1872 01:19:11,411 --> 01:19:15,648 ENVIRONMENT INTERACTION STUDIES 1873 01:19:15,648 --> 01:19:16,182 AND INTERMEDIATE PHENOTYPE 1874 01:19:16,182 --> 01:19:20,453 STORIES WOULD BE THE WAY FORWARD 1875 01:19:20,453 --> 01:19:23,623 AND WE USED TO THINK SO BECAUSE 1876 01:19:23,623 --> 01:19:25,458 OF LARGE GWAS STUDIES. 1877 01:19:25,458 --> 01:19:27,326 THIS IS WHERE THINGS WERE 10 1878 01:19:27,326 --> 01:19:28,594 YEARS AGO. 1879 01:19:28,594 --> 01:19:34,267 WE HAD GENES SUCH AS THESE, 1880 01:19:34,267 --> 01:19:38,471 FKBP5, IN THE ULTRA SHORT 1881 01:19:38,471 --> 01:19:40,973 FEEDBACK LOOP TO INHIBIT 1882 01:19:40,973 --> 01:19:45,445 CORTISOL RESPONSE, OR MAOA, NPY, 1883 01:19:45,445 --> 01:19:48,247 ONE COULD VERY POWERFULLY SHOW 1884 01:19:48,247 --> 01:19:49,882 GENE BY ENVIRONMENT 1885 01:19:49,882 --> 01:19:50,349 INTERACTIONS. 1886 01:19:50,349 --> 01:19:52,885 AND THERE'S A VAST LITERATURE 1887 01:19:52,885 --> 01:19:55,888 AND A LOT OF CONTROVERSY. 1888 01:19:55,888 --> 01:19:58,091 THE FIELD HAS MOVED ON, IF YOU 1889 01:19:58,091 --> 01:20:00,226 WILL, HERE IS ANOTHER GENE BY 1890 01:20:00,226 --> 01:20:01,461 ENVIRONMENT INTERACTION. 1891 01:20:01,461 --> 01:20:07,233 THIS IS FROM OUR GROUP WHERE WE 1892 01:20:07,233 --> 01:20:11,971 SHOW PEOPLE WITH A FUNCTIONAL 1893 01:20:11,971 --> 01:20:13,673 OXIDASE A POLYMORPHISM ARE 1894 01:20:13,673 --> 01:20:15,208 LIKELY TO HAVE AGGRESSIVE 1895 01:20:15,208 --> 01:20:16,809 BEHAVIOR OR DISCONTROL IF THEY 1896 01:20:16,809 --> 01:20:19,378 HAVE HIGH EXPOSURES TO 1897 01:20:19,378 --> 01:20:19,712 TESTOSTERONE. 1898 01:20:19,712 --> 01:20:21,347 WHICH MALES -- MANY MALES DO, 1899 01:20:21,347 --> 01:20:22,949 AND FEMALES DON'T. 1900 01:20:22,949 --> 01:20:27,887 SO, YOU SEE ON THE LEFT THAT 1901 01:20:27,887 --> 01:20:29,622 THERE'S THIS RELATIONSHIP 1902 01:20:29,622 --> 01:20:31,457 BETWEEN TESTOSTERONE LEVEL AND 1903 01:20:31,457 --> 01:20:32,325 BROWN/GOODWIN LIFETIME 1904 01:20:32,325 --> 01:20:33,025 AGGRESSION SCORE. 1905 01:20:33,025 --> 01:20:36,963 ON THE RIGHT PEOPLE WITH THE 1906 01:20:36,963 --> 01:20:39,031 OTHER MAO GENOTYPE, NO 1907 01:20:39,031 --> 01:20:39,699 RELATIONSHIP. 1908 01:20:39,699 --> 01:20:44,537 SO THERE WE WERE WITH MAOA, AND 1909 01:20:44,537 --> 01:20:49,242 WE WERE WITH NEUROPEPTIDE Y, 1910 01:20:49,242 --> 01:20:53,446 WITH A POWERFUL RELATIONSHIP 1911 01:20:53,446 --> 01:20:55,214 BETWEEN NEUROPEPTIDE Y GENOTYPE 1912 01:20:55,214 --> 01:20:58,050 AND MFRI ACTIVATION OF THE BRAIN 1913 01:20:58,050 --> 01:21:06,425 BEING PREDICTED BY FUNCTIONAL 1914 01:21:06,425 --> 01:21:06,692 DIPLOTYPE. 1915 01:21:06,692 --> 01:21:08,861 A STRONG EFFECT ON THE 1916 01:21:08,861 --> 01:21:09,495 PHENOTYPE, ON MOLECULES. 1917 01:21:09,495 --> 01:21:12,899 ON THE OTHER HAND WEAK EFFECTS 1918 01:21:12,899 --> 01:21:15,635 JUST LIKE MOST OTHER GENOTYPES 1919 01:21:15,635 --> 01:21:17,236 ON THE FINAL BEHAVIOR, THE 1920 01:21:17,236 --> 01:21:19,305 BEHAVIOR OF ANXIETY. 1921 01:21:19,305 --> 01:21:23,442 YOU MIGHT THINK THIS WOULD BE 1922 01:21:23,442 --> 01:21:25,545 THE WAY FORWARD. 1923 01:21:25,545 --> 01:21:28,815 BUT IT'S -- AND I'M GOING TO 1924 01:21:28,815 --> 01:21:30,283 SKIP THIS, BUT IT'S, AGAIN -- I 1925 01:21:30,283 --> 01:21:32,552 DON'T KNOW IF I'LL SKIP IT BUT 1926 01:21:32,552 --> 01:21:37,390 THIS IS A DISCOVERY OF THE STOP 1927 01:21:37,390 --> 01:21:40,827 CODON WHICH HAS A ROLE IN 1928 01:21:40,827 --> 01:21:41,861 EXTERNALIZING BEHAVIOR. 1929 01:21:41,861 --> 01:21:45,364 I'M GOING TO MOVE TO THEN WHAT 1930 01:21:45,364 --> 01:21:49,468 IS GENOME WIDE ASSOCIATION? 1931 01:21:49,468 --> 01:21:50,636 GENOME WIDE ASSOCIATION IS WHAT 1932 01:21:50,636 --> 01:21:58,678 I THINK TOOK OVER OUR FIELD, IT 1933 01:21:58,678 --> 01:22:04,250 IS ALLELE BASED, MILLIONS OF 1934 01:22:04,250 --> 01:22:05,451 ADDITIONAL SNPs, 1935 01:22:05,451 --> 01:22:07,653 BIOINFORMATICALLY IMPUTED SO ONE 1936 01:22:07,653 --> 01:22:08,721 GENERATES A MANHATTAN PLOT, YOU 1937 01:22:08,721 --> 01:22:12,458 SEE ON THE LEFT, WHERE YOU HAVE 1938 01:22:12,458 --> 01:22:13,826 A GENOME WIDE THRESHOLD AND 1939 01:22:13,826 --> 01:22:16,262 CERTAIN LOCI THAT RISE ABOVE 1940 01:22:16,262 --> 01:22:16,629 THAT THRESHOLD. 1941 01:22:16,629 --> 01:22:19,498 AND ON THE OTHER HAND WE HAVE 1942 01:22:19,498 --> 01:22:22,068 THE MANHATTAN CARTOON BY WELL 1943 01:22:22,068 --> 01:22:23,269 KNOWN AMERICAN ARTIST THERE ON 1944 01:22:23,269 --> 01:22:25,371 THE RIGHT SIDE. 1945 01:22:25,371 --> 01:22:27,874 JUST TO SHOW YOU WHY THEY CALL 1946 01:22:27,874 --> 01:22:28,875 IT MANHATTAN PLOT. 1947 01:22:28,875 --> 01:22:32,912 I'M NOT SURE ABOUT THE WORD 1948 01:22:32,912 --> 01:22:33,145 "PLOT." 1949 01:22:33,145 --> 01:22:33,880 MAYBE WE SHOULD BE CAREFUL ABOUT 1950 01:22:33,880 --> 01:22:40,720 THE USE OF THAT WORD IN THIS 1951 01:22:40,720 --> 01:22:41,087 CONTEXT. 1952 01:22:41,087 --> 01:22:43,289 WHAT DOES GWAS FOR ALCOHOL USE 1953 01:22:43,289 --> 01:22:44,857 DISORDER TELL US? 1954 01:22:44,857 --> 01:22:47,059 WELL, IT BRINGS US BACK TO OLD 1955 01:22:47,059 --> 01:22:49,962 TERRITORY FROM THE CANDIDATE 1956 01:22:49,962 --> 01:22:52,632 GENE ERA, ALSO TO NEW TERRITORY. 1957 01:22:52,632 --> 01:22:57,603 THERE ARE 281 GWAS LISTINGS FOR 1958 01:22:57,603 --> 01:23:02,308 AUD, TODAY, IN THE GWAS CATALOG, 1959 01:23:02,308 --> 01:23:05,444 OVER A THOUSAND FOR DRINKING 1960 01:23:05,444 --> 01:23:08,814 INCLUDING CLASSICS WHERE YOU SEE 1961 01:23:08,814 --> 01:23:12,785 THE P-VALUE IS 10 TO THE MINUS 1962 01:23:12,785 --> 01:23:13,052 4740. 1963 01:23:13,052 --> 01:23:14,620 WHICH MEANS THAT WHEN WHEN WE'RE 1964 01:23:14,620 --> 01:23:15,621 CERTAIN OF THAT, WE'RE NOT 1965 01:23:15,621 --> 01:23:22,929 LIVING IN SOME KIND OF ELABORATE 1966 01:23:22,929 --> 01:23:26,832 SIMULATION, AND THERE'S ADH1B, 1967 01:23:26,832 --> 01:23:28,000 HIGHLY SIGNIFICANT BUT, AGAIN, 1968 01:23:28,000 --> 01:23:30,336 EXERTS LARGE EFFECT ON 1969 01:23:30,336 --> 01:23:31,837 PHENOTYPE. 1970 01:23:31,837 --> 01:23:33,906 NOW, MOST GWAS FINDINGS DO NOT 1971 01:23:33,906 --> 01:23:35,508 EXHORT LARGE EFFECTS ON 1972 01:23:35,508 --> 01:23:36,042 PHENOTYPES. 1973 01:23:36,042 --> 01:23:37,243 THEY ARE CONDUCTED IN THESE, AS 1974 01:23:37,243 --> 01:23:39,946 YOU'LL SEE, IN THESE EXTREMELY 1975 01:23:39,946 --> 01:23:41,314 LARGE DATASETS, THE ADVANTAGE OF 1976 01:23:41,314 --> 01:23:44,951 THAT IS THAT VERY SMALL EFFECTS 1977 01:23:44,951 --> 01:23:47,019 CAN BE DETECTED AS A LARGE 1978 01:23:47,019 --> 01:23:47,687 DATASET. 1979 01:23:47,687 --> 01:23:50,056 THE DISADVANTAGE IS THAT THE 1980 01:23:50,056 --> 01:23:51,724 VARIANTS IMPLICATED, THE GENES 1981 01:23:51,724 --> 01:23:53,960 IMPLICATED, ARE OF VERY SMALL 1982 01:23:53,960 --> 01:23:55,161 EFFECT AGAINST THOSE PHENOTYPES. 1983 01:23:55,161 --> 01:23:58,965 BUT THESE ARE SOME OF THE NEW 1984 01:23:58,965 --> 01:24:00,666 PATHWAYS THAT HAVE BEEN 1985 01:24:00,666 --> 01:24:10,142 IMPLICATED BY GWAS OF AUD, 1986 01:24:10,142 --> 01:24:17,450 ETHYL-C3, ION TRANCE PORTER. 1987 01:24:17,450 --> 01:24:19,051 FGF CO-RECEPTOR, GLUCOKINASE 1988 01:24:19,051 --> 01:24:21,087 RECEPTOR, ALL OF THESE THEN 1989 01:24:21,087 --> 01:24:24,423 REPRESENT A NEW TERRITORY FOR 1990 01:24:24,423 --> 01:24:25,124 FUNCTIONAL STUDIES. 1991 01:24:25,124 --> 01:24:27,059 SO, HERE THIS BIG GWAS OF 1992 01:24:27,059 --> 01:24:29,261 ALCOHOL USE DISORDER, YOU SEE 1993 01:24:29,261 --> 01:24:31,330 THE MANHATTAN PLOT, AND YOU SEE 1994 01:24:31,330 --> 01:24:34,867 THERE'S A WHOLE CLUSTER OF HITS 1995 01:24:34,867 --> 01:24:43,075 WHICH ALL REPRESENT THE ALCOHOL 1996 01:24:43,075 --> 01:24:45,044 DEADROGENESE CLUSTER IN THE 1997 01:24:45,044 --> 01:24:45,277 MIDDLE. 1998 01:24:45,277 --> 01:24:47,413 OLD FAVORITES ALSO ON THIS MAP 1999 01:24:47,413 --> 01:24:51,384 INCLUDING SOMEWHERE ON THEIR IS 2000 01:24:51,384 --> 01:24:54,086 DRD2, THERE'S FTO, WHICH IS A 2001 01:24:54,086 --> 01:24:57,023 GENE THAT'S INVOLVED IN OBESITY 2002 01:24:57,023 --> 01:24:59,692 AND METABOLIC SYNDROME. 2003 01:24:59,692 --> 01:25:02,261 THERE ARE A LOT OF VERY SENSIBLE 2004 01:25:02,261 --> 01:25:05,097 FINDINGS, AS WELL AS FINDINGS 2005 01:25:05,097 --> 01:25:11,037 WHICH ARE NOT WELL UNDERSTOOD. 2006 01:25:11,037 --> 01:25:14,540 BUT THEN IT WENT TO BIGGER GWAS. 2007 01:25:14,540 --> 01:25:20,546 YOU SEE THIS BIGGER GWAS IS OVER 2008 01:25:20,546 --> 01:25:21,680 400,000 PEOPLE. 2009 01:25:21,680 --> 01:25:24,650 AND ONE FINDS NOT ONLY LOCI THAT 2010 01:25:24,650 --> 01:25:27,086 WOULD HAVE BEEN SUBTHRESHOLD, IF 2011 01:25:27,086 --> 01:25:30,089 YOU ONLY STUDIED 200,000 PEOPLE 2012 01:25:30,089 --> 01:25:32,725 BUT ALSO POSSIBLE WITH POLYGENIC 2013 01:25:32,725 --> 01:25:34,693 SCORES TO LOOK AT OVERLAP 2014 01:25:34,693 --> 01:25:36,295 BETWEEN THE WELCOME FOR ALCOHOL 2015 01:25:36,295 --> 01:25:38,130 USE DISORDER AND RISK FOR OTHER 2016 01:25:38,130 --> 01:25:39,031 BEHAVIORAL TRAITS. 2017 01:25:39,031 --> 01:25:41,467 SO YOU SEE MANY OTHER TRAITS 2018 01:25:41,467 --> 01:25:48,541 THAT ARE LISTED HERE IN THIS 2019 01:25:48,541 --> 01:25:49,542 PAPER, CHANCELLOR AND GELLER, 2020 01:25:49,542 --> 01:25:51,710 THAT GROUP. 2021 01:25:51,710 --> 01:25:53,512 IT'S WORKING AGAIN. 2022 01:25:53,512 --> 01:25:56,449 AND YOU SEE THAT SOME TRAITS ARE 2023 01:25:56,449 --> 01:25:57,950 POSSIBLY ASSOCIATED WITH AUD AT 2024 01:25:57,950 --> 01:26:00,753 THE GENETIC LEVEL, AND THEN SOME 2025 01:26:00,753 --> 01:26:01,554 ARE ACTUALLY NEGATIVELY 2026 01:26:01,554 --> 01:26:01,854 ASSOCIATED. 2027 01:26:01,854 --> 01:26:05,458 AND SOME OF THE ONES THAT ARE 2028 01:26:05,458 --> 01:26:06,926 POSITIVELY ASSOCIATED ARE QUITE 2029 01:26:06,926 --> 01:26:10,729 SENSIBLE, TRAITS LIKE RISK 2030 01:26:10,729 --> 01:26:15,234 TAKING, TRAITS LIKE ANXIETY, THE 2031 01:26:15,234 --> 01:26:15,668 DEPRESSIVE SYMPTOMS, 2032 01:26:15,668 --> 01:26:16,535 SCHIZOPHRENIA. 2033 01:26:16,535 --> 01:26:18,137 ON THE OTHER HAND, THERE ARE 2034 01:26:18,137 --> 01:26:26,011 TRAITS WHICH ARE NEGATIVELILY 2035 01:26:26,011 --> 01:26:27,346 CORRELATED, AGE, NUMBER OF 2036 01:26:27,346 --> 01:26:29,582 OFFSPRING IN A FAMILY, AGE OF 2037 01:26:29,582 --> 01:26:30,983 FIRST BIRTH, ET CETERA. 2038 01:26:30,983 --> 01:26:32,685 WE'LL TOUCH UPON THAT A LITTLE 2039 01:26:32,685 --> 01:26:34,019 BIT MORE. 2040 01:26:34,019 --> 01:26:40,693 THIS IS AGAIN THE CLASSIC STORY 2041 01:26:40,693 --> 01:26:46,332 OF THE ALDAHYDE AND ALCOHOL 2042 01:26:46,332 --> 01:26:47,800 POLYMORPHISMS THAT WE NEED TO 2043 01:26:47,800 --> 01:26:49,368 IDENTIFY FUNCTIONAL LOCI. 2044 01:26:49,368 --> 01:26:51,670 WE KNOW FUNCTIONAL LOCI OF BOTH 2045 01:26:51,670 --> 01:26:57,343 OF THESE GENES LEAD TO ENHANCE 2046 01:26:57,343 --> 01:26:59,645 THE ACETALDEHYDE LEVELS AFTER 2047 01:26:59,645 --> 01:27:02,047 DRINKING, PRODUCING THE FLUSHING 2048 01:27:02,047 --> 01:27:02,815 RESPONSE WHICH IS PROTECTIVE, ON 2049 01:27:02,815 --> 01:27:09,255 THE OTHER HAND IF PEOPLE DRINK 2050 01:27:09,255 --> 01:27:11,557 NEVERTHELESS RISK OF BREAST AND 2051 01:27:11,557 --> 01:27:15,261 UPPER G.I. CANCER ARE ELEVATED. 2052 01:27:15,261 --> 01:27:17,296 GOOD NEWS/BAD NEWS SITUATION. 2053 01:27:17,296 --> 01:27:20,900 THE WORST NEWS PEOPLE WHO 2054 01:27:20,900 --> 01:27:22,034 EXHIBIT THIS ALCOHOL INDUCED 2055 01:27:22,034 --> 01:27:24,170 FLUSHING ARE NOW A LOT MORE 2056 01:27:24,170 --> 01:27:26,338 LIKELY TO TAKE ANTIHISTAMINE 2057 01:27:26,338 --> 01:27:27,606 DRUGS, AND THE ANTIHISTAMINES 2058 01:27:27,606 --> 01:27:28,641 WHEREAS THEY BLOCK THE FLUSHING 2059 01:27:28,641 --> 01:27:30,910 THEY DO NOT BLOCK THE 2060 01:27:30,910 --> 01:27:31,343 GENOTOXICITY. 2061 01:27:31,343 --> 01:27:34,947 THIS IS A MAJOR PUBLIC HEALTH 2062 01:27:34,947 --> 01:27:39,618 PROBLEM TODAY. 2063 01:27:39,618 --> 01:27:41,253 SO WHAT IS CONSEQUENT TO THE 2064 01:27:41,253 --> 01:27:43,422 ALCOHOL EXPOSURE AT THE 2065 01:27:43,422 --> 01:27:46,592 EPIGENETIC LEVEL? 2066 01:27:46,592 --> 01:27:47,927 WELL, THERE'S AN INVESTIGATOR AT 2067 01:27:47,927 --> 01:27:50,162 NIAAA DOING A SERIES OF STUDIES, 2068 01:27:50,162 --> 01:27:56,068 MOST WITH US SINCE WE'VE BEEN 2069 01:27:56,068 --> 01:27:58,370 DOING THE METHYL ARRAYS IN MY 2070 01:27:58,370 --> 01:27:59,972 LAB. 2071 01:27:59,972 --> 01:28:02,007 WE FOUND THAT IF ONE DRINKS 2072 01:28:02,007 --> 01:28:05,411 HEAVILY, AND IF ONE IS STRESSED, 2073 01:28:05,411 --> 01:28:06,879 EPIGENETIC AGING IS ACTUALLY 2074 01:28:06,879 --> 01:28:07,613 ACCELERATED. 2075 01:28:07,613 --> 01:28:11,050 SO YOU SEE THE ACCELERATION OF 2076 01:28:11,050 --> 01:28:12,451 EPIGENETIC AGE IS ON THE ORDER 2077 01:28:12,451 --> 01:28:15,020 OF TWO YEARS FOR THE EARLY LIFE 2078 01:28:15,020 --> 01:28:17,823 STRESS, AND TWO YEARS FOR THE 2079 01:28:17,823 --> 01:28:21,460 HEAVY DRINKING, AND IT'S 2080 01:28:21,460 --> 01:28:23,562 APPROXIMATELY ADDITIVE. 2081 01:28:23,562 --> 01:28:25,231 THIS WAS RECENTLY PUBLISHED , 2082 01:28:25,231 --> 01:28:34,807 THE LEAD AUTHOR AT THE TOP. 2083 01:28:34,807 --> 01:28:35,874 THERE'S MOLECULAR IMPRINT OF 2084 01:28:35,874 --> 01:28:38,010 ALCOHOL ON THE GENOME. 2085 01:28:38,010 --> 01:28:40,145 YET THAT'S NOT WHY ALCOHOL USE 2086 01:28:40,145 --> 01:28:41,647 DISORDER IS HERITABLE. 2087 01:28:41,647 --> 01:28:43,916 BECAUSE THE HERITABILITY IS NOT 2088 01:28:43,916 --> 01:28:49,555 DUE TO EPIGENETIC VARIATIONS BUT 2089 01:28:49,555 --> 01:28:51,123 DUE TO GENETIC VARIATIONS 2090 01:28:51,123 --> 01:28:53,826 BETWEEN RELATED INDIVIDUALS. 2091 01:28:53,826 --> 01:28:57,329 NOW I TURN TO THE QUESTION OF 2092 01:28:57,329 --> 01:29:01,734 WHY ONLY SOME DRINKERS WILL 2093 01:29:01,734 --> 01:29:03,636 DEVELOP LIVER DISEASE. 2094 01:29:03,636 --> 01:29:05,337 AND TO POINT OUT FIRST OF ALL 2095 01:29:05,337 --> 01:29:09,508 ABOUT 90% OF HEAVY DRINKERS WILL 2096 01:29:09,508 --> 01:29:10,843 DEVELOP ALCOHOL FATTY LIVER 2097 01:29:10,843 --> 01:29:13,779 DISEASE BUT AS KATHY COULD TELL 2098 01:29:13,779 --> 01:29:19,585 US 10 TO 35% PROGRESS TO AH, 20% 2099 01:29:19,585 --> 01:29:20,819 TO ALCOHOL CIRRHOSIS. 2100 01:29:20,819 --> 01:29:26,325 YOU SEE THE HISTOLOGY OF THOSE 2101 01:29:26,325 --> 01:29:29,962 DISEASES, NOTING THE LYMPHOCYTIC 2102 01:29:29,962 --> 01:29:30,829 INFILTRATION IN ALCOHOL 2103 01:29:30,829 --> 01:29:32,898 CIRRHOSIS, WHICH DOES 2104 01:29:32,898 --> 01:29:40,839 DISTINGUISH IT HISTOLOGICALLY 2105 01:29:40,839 --> 01:29:42,975 FROM -- I'M SORRY, LYMPHOCYTIC 2106 01:29:42,975 --> 01:29:44,009 INFILTRATION DISTINGUISHED FROM 2107 01:29:44,009 --> 01:29:45,244 ALCOHOL CIRRHOSIS. 2108 01:29:45,244 --> 01:29:46,645 WE'VE CONTRIBUTED TO SEVERAL 2109 01:29:46,645 --> 01:29:49,181 GENOMIC CONSORTIA WHICH ARE 2110 01:29:49,181 --> 01:29:50,849 STUDYING ALCOHOL LIVER DISEASE, 2111 01:29:50,849 --> 01:29:54,219 AND DONE THAT VIA THE NIAAA 2112 01:29:54,219 --> 01:29:55,754 INTRAMURAL DATASET. 2113 01:29:55,754 --> 01:29:58,257 ALL SUBJECTS THAT ARE STUDIED ON 2114 01:29:58,257 --> 01:30:00,159 OUR UNIT, AND YOU SHOULD 2115 01:30:00,159 --> 01:30:02,561 ENCOURAGE PEOPLE TO GET 2116 01:30:02,561 --> 01:30:03,862 REEVALUATION AND CARE, AT THE 2117 01:30:03,862 --> 01:30:06,899 NIH CLINICAL CENTER THEY CAN GO 2118 01:30:06,899 --> 01:30:10,869 TO THE NIAAA WEBSITE AND JOIN 2119 01:30:10,869 --> 01:30:14,940 THE STUDY BUTTON, AND BY THAT 2120 01:30:14,940 --> 01:30:18,043 GET FIVE WEEKS OF FREE INPATIENT 2121 01:30:18,043 --> 01:30:21,447 EVALUATION CLINICAL CARE. 2122 01:30:21,447 --> 01:30:28,520 THIS POPULATION IS FIRST OF ALL 2123 01:30:28,520 --> 01:30:30,656 SCREENED WITH PSYCHIATRIC 2124 01:30:30,656 --> 01:30:32,958 INTERVIEWING AND PSYCHOLOGICAL 2125 01:30:32,958 --> 01:30:33,659 ASSESSMENTS. 2126 01:30:33,659 --> 01:30:36,428 THEY ALL ARE GENOMICALLY 2127 01:30:36,428 --> 01:30:39,198 ANALYZED, ACTUALLY IN MY LAB 2128 01:30:39,198 --> 01:30:47,272 EXOME SEQUENCED, METHYLOMES ARE 2129 01:30:47,272 --> 01:30:52,478 DONE, SNP ARRAYS WITH DOING, 2130 01:30:52,478 --> 01:30:54,413 INCREASINGLY DOING TRANSCRIPTOME 2131 01:30:54,413 --> 01:30:55,981 ANALYSIS WITH CLIP RATTER OF 2132 01:30:55,981 --> 01:31:02,554 DANE MAYFIELD, LAWYERING 2133 01:31:02,554 --> 01:31:03,155 FERGUSON. 2134 01:31:03,155 --> 01:31:07,025 WE ARE DEPOSITING OUR DATA INTO 2135 01:31:07,025 --> 01:31:12,064 THE NIAAA DATA ARCHIVE AND 2136 01:31:12,064 --> 01:31:17,169 dbGAP, INTO THE NIH CLINICAL 2137 01:31:17,169 --> 01:31:18,070 CENTER SYSTEM, BTRIS. 2138 01:31:18,070 --> 01:31:20,672 AND SO WHAT HAPPENS IN THESE 2139 01:31:20,672 --> 01:31:21,540 COLLABORATIVE GENOMIC STUDIES IS 2140 01:31:21,540 --> 01:31:25,744 FIRST OF ALL WE CAN FIND LOCI 2141 01:31:25,744 --> 01:31:26,879 FOR ALCOHOL CIRRHOSIS AND AS 2142 01:31:26,879 --> 01:31:29,681 I'LL SHOW YOU FOR ALCOHOL 2143 01:31:29,681 --> 01:31:30,315 HEPATITIS. 2144 01:31:30,315 --> 01:31:34,553 AND SO HERE IS THE GWAS OF 2145 01:31:34,553 --> 01:31:37,389 ALCOHOL CIRRHOSIS DONE IN 2146 01:31:37,389 --> 01:31:40,592 COLLABORATION WITH GENOME ALK, 2147 01:31:40,592 --> 01:31:42,361 WHERE WE PROVIDED MOST OF THE 2148 01:31:42,361 --> 01:31:43,929 NON-ALD HEAVY CONTROLS FOR THIS 2149 01:31:43,929 --> 01:31:46,098 STUDY, AND YOU SEE THERE'S 2150 01:31:46,098 --> 01:31:49,735 SEVERAL LOCI THAT WERE DETECTED 2151 01:31:49,735 --> 01:31:51,637 IN THIS STUDY, ACTUALLY HAVE 2152 01:31:51,637 --> 01:31:53,906 LARGE EFFECT SIZES AND WHICH ARE 2153 01:31:53,906 --> 01:31:55,374 INVOLVED IN LIPID DROPLET 2154 01:31:55,374 --> 01:31:55,641 FORMATION. 2155 01:31:55,641 --> 01:31:56,742 AND THOSE ARE AT THE TOP THERE. 2156 01:31:56,742 --> 01:32:01,814 THERE'S THE P.I. OF THAT STUDY, 2157 01:32:01,814 --> 01:32:04,817 DEVANSIH SETH, AND I'LL SHOW YOU 2158 01:32:04,817 --> 01:32:08,287 LATER INSPIRED BY THIS STUDY, 2159 01:32:08,287 --> 01:32:13,859 INDICATING THERE WERE HEPATOCYTE 2160 01:32:13,859 --> 01:32:16,295 INTRINSIC GENES LIKE PNPLA3, WE 2161 01:32:16,295 --> 01:32:23,936 PROCEEDED TO MAKE INDUCED 2162 01:32:23,936 --> 01:32:24,937 HEPATOCYTE-LIKE CELLS FROM 2163 01:32:24,937 --> 01:32:28,373 iPSCs OF CIRRHOSIS PATIENTS. 2164 01:32:28,373 --> 01:32:31,310 IF YOU EXPOSE THE IHLCs TO 2165 01:32:31,310 --> 01:32:34,847 ALCOHOL THERE'S A MASSIVE 2166 01:32:34,847 --> 01:32:36,782 INDUCTION OF PNPLA3, THE TOP 2167 01:32:36,782 --> 01:32:44,790 GWAS HIT IN ALCOHOL CIRRHOSIS, 2168 01:32:44,790 --> 01:32:46,325 AND THAT'S BANI MUKHOPADHYAY'S 2169 01:32:46,325 --> 01:32:46,592 WORK. 2170 01:32:46,592 --> 01:32:50,329 ILLUSED TO BE IF YOU WANTED TO 2171 01:32:50,329 --> 01:32:51,997 ADVANCE THE SLIDES YOU HAD TO 2172 01:32:51,997 --> 01:32:53,699 HIT THE BUTTON ON THE KEYBOARD. 2173 01:32:53,699 --> 01:32:57,836 WE'VE GOT PAST THAT NOW. 2174 01:32:57,836 --> 01:33:01,640 SO, ACTUALLY I WAS FASCINATED 2175 01:33:01,640 --> 01:33:04,643 GEORGE PRESENTED TWO PAPERS AT 2176 01:33:04,643 --> 01:33:06,178 HIS JOURNAL CLUB ON ALCOHOL 2177 01:33:06,178 --> 01:33:07,579 HEPATITIS, WHICH IS UNIQUE AND 2178 01:33:07,579 --> 01:33:08,714 CLINICALLY PERILOUS DISEASE. 2179 01:33:08,714 --> 01:33:12,885 WHAT HE SHOWED US WAS THAT IF 2180 01:33:12,885 --> 01:33:16,121 YOU USED A DIFFERENT PREDNISONE 2181 01:33:16,121 --> 01:33:17,189 REGIMEN, THAT SURVIVAL OUT TO 2182 01:33:17,189 --> 01:33:19,758 THREE MONTHS MIGHT BE QUITE 2183 01:33:19,758 --> 01:33:20,025 HIGH. 2184 01:33:20,025 --> 01:33:21,460 IT LOOKED LIKE IT WAS WELL OVER 2185 01:33:21,460 --> 01:33:23,095 95%. 2186 01:33:23,095 --> 01:33:25,864 ON THE OTHER HAND, ALCOHOL 2187 01:33:25,864 --> 01:33:31,870 HEPATITIS PATIENTS ARE VERY 2188 01:33:31,870 --> 01:33:34,907 LIKELY TO DIE, IN MONTH THREE. 2189 01:33:34,907 --> 01:33:37,109 DAVE LOVINGER WAS LOOKING IT UP, 2190 01:33:37,109 --> 01:33:38,510 MORTALITY WAS SOMETHING LIKE 30% 2191 01:33:38,510 --> 01:33:41,246 IN THE PAPER THAT HE FOUND. 2192 01:33:41,246 --> 01:33:44,383 AND IN SHORT TIME INTERVALS. 2193 01:33:44,383 --> 01:33:47,286 AND SO IT IS A DIFFERENT 2194 01:33:47,286 --> 01:33:48,353 CHALLENGE THAN ALCOHOL 2195 01:33:48,353 --> 01:33:49,154 CIRRHOSIS. 2196 01:33:49,154 --> 01:33:52,925 IT'S MARKED BY INFLAMMATION OF 2197 01:33:52,925 --> 01:33:55,093 THE LIVER WITH T CELLS AND MANY 2198 01:33:55,093 --> 01:34:03,902 OTHER CELLS INVADING THE LIVER, 2199 01:34:03,902 --> 01:34:10,475 ACUTE PHASE REACTANTS IN THE 2200 01:34:10,475 --> 01:34:11,877 SERUM, ABDOMINAL PAIN, NAUSEA, 2201 01:34:11,877 --> 01:34:18,784 FEVER, JAUNDICE. 2202 01:34:18,784 --> 01:34:20,786 NEVER APPROACHED BEFORE IN GWAS. 2203 01:34:20,786 --> 01:34:24,690 THE PATIENTS DO TEND TO DIE. 2204 01:34:24,690 --> 01:34:28,627 AND THEN THE LARGE SAMPLES OF 2205 01:34:28,627 --> 01:34:29,628 WELL CHARACTERIZED PATIENTS 2206 01:34:29,628 --> 01:34:31,997 WEREN'T AVAILABLE. 2207 01:34:31,997 --> 01:34:34,399 SO ANOTHER LARGE CONSORTIUM THAT 2208 01:34:34,399 --> 01:34:37,469 NIAAA STUDIED WAS THIS 2209 01:34:37,469 --> 01:34:40,672 CONSORTIUM, WITH THE P.I. LAURA 2210 01:34:40,672 --> 01:34:46,478 NAGY TOP RIGHT, ALCOHOL GENOMICS 2211 01:34:46,478 --> 01:34:47,079 CONSORTIUM. 2212 01:34:47,079 --> 01:34:49,014 1735 HEAVY ALCOHOL DRINKERS WERE 2213 01:34:49,014 --> 01:34:49,247 STUDIED. 2214 01:34:49,247 --> 01:34:53,452 YOU SEE THAT ABOUT HALF OF THEM 2215 01:34:53,452 --> 01:34:55,420 HAD ALCOHOL HEPATITIS, THE 2216 01:34:55,420 --> 01:34:57,222 REMAINDER WERE HEAVY DRINKING 2217 01:34:57,222 --> 01:34:59,057 CONTROLS, ALCOHOL LIVER DISEASE, 2218 01:34:59,057 --> 01:35:00,726 THESE CONTROLS WERE MAINLY FROM 2219 01:35:00,726 --> 01:35:01,860 OUR INTRAMURAL PROGRAM. 2220 01:35:01,860 --> 01:35:04,663 THEY WERE ALL VERY DEEPLY 2221 01:35:04,663 --> 01:35:06,198 CLINICALLY PHENOTYPED. 2222 01:35:06,198 --> 01:35:09,668 SO, TO ANALYZE THESE GENOMICALLY 2223 01:35:09,668 --> 01:35:13,372 WE SEQUENCED THE EXOME, ABOUT 58 2224 01:35:13,372 --> 01:35:15,407 MEGABASES OF DNA. 2225 01:35:15,407 --> 01:35:19,778 VERY HIGH LEVELS OF ACCURACY AND 2226 01:35:19,778 --> 01:35:23,048 COMPLETION. 2227 01:35:23,048 --> 01:35:23,582 THE YIELD, SOMETHING LIKE 2228 01:35:23,582 --> 01:35:27,152 45,000, 50,000 GENETIC VARIANTS 2229 01:35:27,152 --> 01:35:28,787 PER PERSON, WITHIN THAT 58 2230 01:35:28,787 --> 01:35:30,188 MEGABASE TARGET, IT'S THOSE 2231 01:35:30,188 --> 01:35:31,923 GENETIC VARIANTS THAT ARE AT 2232 01:35:31,923 --> 01:35:36,528 GENES THAT ARE ACTUALLY THE 2233 01:35:36,528 --> 01:35:37,329 SUBJECT OF THIS STUDY. 2234 01:35:37,329 --> 01:35:39,865 LET'S SEE IF I PRESS THE RIGHT 2235 01:35:39,865 --> 01:35:40,165 BUTTON. 2236 01:35:40,165 --> 01:35:41,266 AH, I DID IT. 2237 01:35:41,266 --> 01:35:44,102 HERE IS THE RESULT, AND THE 2238 01:35:44,102 --> 01:35:46,171 MANHATTAN PLOT. 2239 01:35:46,171 --> 01:35:49,274 AND WITH THE PREVIOUSLY KNOWN 2240 01:35:49,274 --> 01:35:59,818 LIVER DISEASE GENE, AND TWO NEW 2241 01:36:01,019 --> 01:36:02,287 ONES, INCLUDING TOX4. 2242 01:36:02,287 --> 01:36:03,889 I'M NOT GOING TO EMPHASIZE 2243 01:36:03,889 --> 01:36:06,591 ANYTHING EXCEPT FOR LARGE ODDS 2244 01:36:06,591 --> 01:36:06,892 RATIOS. 2245 01:36:06,892 --> 01:36:09,394 SO IN CONTRAST TO THE USUAL GWAS 2246 01:36:09,394 --> 01:36:10,762 FINDINGS, THESE ARE GENES OF 2247 01:36:10,762 --> 01:36:19,871 LARGE EFFECT WITH ODDS RATIOS OF 2248 01:36:19,871 --> 01:36:27,879 1.73, FOR PNPLA3, 1.7 FOR 2249 01:36:27,879 --> 01:36:30,282 ICOSGL, AND ULTIMATELY POINT 2250 01:36:30,282 --> 01:36:32,617 CLINICALLY TO HOME IN ON 2251 01:36:32,617 --> 01:36:33,452 FUNCTIONAL LOCI. 2252 01:36:33,452 --> 01:36:35,454 WHAT ABOUT THE POLYGENIC 2253 01:36:35,454 --> 01:36:38,056 COMPONENT OF ALCOHOL HEPATITIS? 2254 01:36:38,056 --> 01:36:41,059 WELL, THE WAY THAT WAS 2255 01:36:41,059 --> 01:36:43,795 INVESTIGATED WAS THAT WE RANK 2256 01:36:43,795 --> 01:36:45,564 ORDERED ALL GENES, STUDIED IN 2257 01:36:45,564 --> 01:36:48,500 OUR EXOME SEQUENCING BY 2258 01:36:48,500 --> 01:36:51,970 P-VALUES, SO THAT WOULD BE ONE 2259 01:36:51,970 --> 01:36:54,439 TO 16,700 OR WHATEVER IT IS 2260 01:36:54,439 --> 01:36:54,873 P-VALUES. 2261 01:36:54,873 --> 01:36:56,441 RANK ORDERING ALL THESE 2262 01:36:56,441 --> 01:36:56,708 P-VALUES. 2263 01:36:56,708 --> 01:36:59,377 AND THEN TOOK THOSE P-VALUES 2264 01:36:59,377 --> 01:37:01,246 AGAINST CERTAIN FAMILIES OF 2265 01:37:01,246 --> 01:37:05,684 GENES WHICH HAD BEEN PREVIOUSLY 2266 01:37:05,684 --> 01:37:06,251 IDENTIFIED, OBJECTIVELY 2267 01:37:06,251 --> 01:37:07,552 IDENTIFIED, EITHER BECAUSE THEY 2268 01:37:07,552 --> 01:37:09,755 WERE THE TOP GWAS HITS FOR A 2269 01:37:09,755 --> 01:37:11,790 CERTAIN PHENOTYPE OR BECAUSE 2270 01:37:11,790 --> 01:37:15,527 THEY WERE ONE OF THE WIKI 2271 01:37:15,527 --> 01:37:16,461 PATHWAYS FOR PHYSIOLOGICAL 2272 01:37:16,461 --> 01:37:18,730 PATHWAY, AND SO WHAT THAT LET US 2273 01:37:18,730 --> 01:37:22,901 DO WAS TO SEE THAT THE GENES 2274 01:37:22,901 --> 01:37:24,136 THAT ARE IMPLICATED WERE -- I'M 2275 01:37:24,136 --> 01:37:25,771 TRYING TO FIGURE THIS OUT, 2276 01:37:25,771 --> 01:37:27,906 LOOKING AT TWO DIFFERENT PLACES. 2277 01:37:27,906 --> 01:37:30,442 THAT IF YOU LOOK AT GENES THAT 2278 01:37:30,442 --> 01:37:32,577 ARE INVOLVED IN ALCOHOL USE 2279 01:37:32,577 --> 01:37:34,746 DISORDER OR OF A HEAVY DRINKING, 2280 01:37:34,746 --> 01:37:36,248 THERE'S ONLY A WEAK SIGNAL FOR 2281 01:37:36,248 --> 01:37:38,283 THESE GENES TO BE INVOLVED IN 2282 01:37:38,283 --> 01:37:39,885 ALCOHOL HEPATITIS. 2283 01:37:39,885 --> 01:37:41,887 AS TIME GOES ON, ALCOHOL 2284 01:37:41,887 --> 01:37:43,355 HEPATITIS GWAS STUDIES GET 2285 01:37:43,355 --> 01:37:45,190 LARGER AND LARGER, THEN THE ROLE 2286 01:37:45,190 --> 01:37:47,092 OF SUCH GENES WOULD OF COURSE BE 2287 01:37:47,092 --> 01:37:49,795 DETECTABLE BUT THEIR EFFECT 2288 01:37:49,795 --> 01:37:51,429 SIZES NOT LARGER. 2289 01:37:51,429 --> 01:37:54,633 ON THE OTHER HAND, THERE WERE 2290 01:37:54,633 --> 01:37:56,168 NEW PATHWAYS INCLUDING VITAMIN D 2291 01:37:56,168 --> 01:38:02,107 PATHWAY, PROBABLY AT THE TOP 2292 01:38:02,107 --> 01:38:02,307 RIGHT. 2293 01:38:02,307 --> 01:38:04,609 SHOWED ENORMOUS ENRICHMENT. 2294 01:38:04,609 --> 01:38:08,814 AND FURTHERMORE THIS MASTER 2295 01:38:08,814 --> 01:38:12,851 REGULATORY PATHWAY FOR LIPID 2296 01:38:12,851 --> 01:38:13,585 SYNTHESIS, SREBP, STRONGLY 2297 01:38:13,585 --> 01:38:17,622 IMPLICATED, AND THE WAY THESE 2298 01:38:17,622 --> 01:38:20,225 P-VALUES ARE DETERMINED IS 2299 01:38:20,225 --> 01:38:24,296 EMPIRICALLY, HAVING THE -- FIRST 2300 01:38:24,296 --> 01:38:26,431 OF ALL, YOU JUST RUN A RANDOM 2301 01:38:26,431 --> 01:38:30,335 LIST OF 96 GENES OR 225 GENES 2302 01:38:30,335 --> 01:38:35,807 AGAINST ALL THE P-VALUES FROM 2303 01:38:35,807 --> 01:38:38,944 THE EXOME SEQUENCING AND SEE 2304 01:38:38,944 --> 01:38:42,147 WHAT CONSTITUTES SIGNIFICANT 2305 01:38:42,147 --> 01:38:43,982 ENRICHMENT VERSUS RANDOM 2306 01:38:43,982 --> 01:38:44,316 ENRICHMENT. 2307 01:38:44,316 --> 01:38:48,053 AND SO NOW I'M GOING TO MOVE TO 2308 01:38:48,053 --> 01:38:50,822 OUR iPSC PAPER. 2309 01:38:50,822 --> 01:38:55,627 SO, THIS JUST CAME OUT IN NATURE 2310 01:38:55,627 --> 01:38:57,462 COMMUNICATIONS, AND REMINISCENTS 2311 01:38:57,462 --> 01:38:58,330 OF THE WINSELBOMB PAPER 2312 01:38:58,330 --> 01:38:59,898 PRESENTED THIS MORNING. 2313 01:38:59,898 --> 01:39:03,535 WHAT WE'VE DONE IS TO DERIVE 2314 01:39:03,535 --> 01:39:07,973 FROM PATIENTS THE iPSCs MADE 2315 01:39:07,973 --> 01:39:10,842 FROM PERIPHERAL BLOOD, POSITIVE 2316 01:39:10,842 --> 01:39:15,080 T CELLS, CRYOPRESERVED, BY THE 2317 01:39:15,080 --> 01:39:25,624 WAY, AND TRANSFORMED USING THE 4 2318 01:39:27,292 --> 01:39:30,695 YAMANAKA, USING A PROTOCOL BY 2319 01:39:30,695 --> 01:39:32,998 SOMEBODY NAMED TAKEDA, SO WHAT 2320 01:39:32,998 --> 01:39:35,901 THAT DOES IS TO -- IT ALLOWS US 2321 01:39:35,901 --> 01:39:38,770 TO LOOK FOR INTRINSIC 2322 01:39:38,770 --> 01:39:42,040 DIFFERENCES IN THOSE IHLCs 2323 01:39:42,040 --> 01:39:44,376 FROM THE ALCOHOL CIRRHOSIS 2324 01:39:44,376 --> 01:39:45,677 PATIENTS, ALSO LETS US TEST 2325 01:39:45,677 --> 01:39:49,147 DRUGS THAT MIGHT BE EFFICACIOUS 2326 01:39:49,147 --> 01:39:49,915 IN PREVENTING OUTCOMES. 2327 01:39:49,915 --> 01:39:51,950 FIRST OF ALL HERE IS HOW YOU 2328 01:39:51,950 --> 01:39:53,184 MAKE THEM. 2329 01:39:53,184 --> 01:39:54,619 IT'S DONE IN STAGES. 2330 01:39:54,619 --> 01:40:00,725 AND YOU SEE IT TAKES ABOUT THREE 2331 01:40:00,725 --> 01:40:04,296 MONTHS BEFORE ONE HAS IHLCs 2332 01:40:04,296 --> 01:40:04,729 PRODUCED. 2333 01:40:04,729 --> 01:40:06,298 iPSCs TAKE ABOUT A MONTH TO 2334 01:40:06,298 --> 01:40:06,765 MAKE. 2335 01:40:06,765 --> 01:40:13,104 YOU SEE THE PROCESS BY WHICH 2336 01:40:13,104 --> 01:40:15,473 IHLCs ARE MADE, CHANGING FROM 2337 01:40:15,473 --> 01:40:17,609 DAY 5 COLONIES, LUMPS OF CELLS, 2338 01:40:17,609 --> 01:40:21,980 UNTIL FINALLY WHEN YOU HAVE 2339 01:40:21,980 --> 01:40:31,022 IHLCs, YOU HAVE NICE CUBOIDAL 2340 01:40:31,022 --> 01:40:32,924 HEPATOCYTE-LIKE CELLS. 2341 01:40:32,924 --> 01:40:34,726 THIS IS SHOWING PLURIPOTENCY 2342 01:40:34,726 --> 01:40:39,030 MARKER, AND ON THE RIGHT 2343 01:40:39,030 --> 01:40:46,104 COMPARING THE PATIENT AND 2344 01:40:46,104 --> 01:40:47,839 CONTROL IHLCs, TWO MARKERS, 2345 01:40:47,839 --> 01:40:50,942 THAT INDICATE MATURITY OF 2346 01:40:50,942 --> 01:40:53,345 HEPATOCYTES. 2347 01:40:53,345 --> 01:40:55,180 THESE MARKERS ARE HNF 4, 2348 01:40:55,180 --> 01:41:00,318 ALBIONS, PROTEINS THAT 2349 01:41:00,318 --> 01:41:01,820 HEPATOCYTES EXPRESS IN ABUNDANCE 2350 01:41:01,820 --> 01:41:03,621 INDUCED WHEN YOU DIFFERENTIATE 2351 01:41:03,621 --> 01:41:05,590 CELLS INTO IHLCs. 2352 01:41:05,590 --> 01:41:06,658 I'M NOT SHOWING BUT GREAT 2353 01:41:06,658 --> 01:41:08,860 STRENGTH OF THIS CELL MODEL IS 2354 01:41:08,860 --> 01:41:11,896 THAT THESE CELLS ARE ABOUT 95% 2355 01:41:11,896 --> 01:41:22,374 PURE, SO 95% HEPATOCYTE-LIKE 2356 01:41:22,974 --> 01:41:23,308 CELLS. 2357 01:41:23,308 --> 01:41:26,478 AND CORRELATION ACROSS MANY 2358 01:41:26,478 --> 01:41:29,881 THOUSANDS OF TRANSCRIPTS, R 2359 01:41:29,881 --> 01:41:30,815 SQUARED OF .95 REGARDLESS OF 2360 01:41:30,815 --> 01:41:32,050 CONDITION OR INDIVIDUAL. 2361 01:41:32,050 --> 01:41:34,853 THERE'S A LOT OF VARIATION WHICH 2362 01:41:34,853 --> 01:41:37,188 IS CAUSED OR ATTRIBUTABLE 2363 01:41:37,188 --> 01:41:39,391 ACTUALLY TO THE DIAGNOSIS BUT ON 2364 01:41:39,391 --> 01:41:41,826 THE OTHER HAND IT'S -- THESE 2365 01:41:41,826 --> 01:41:43,128 CELLS ARE MORE ALIKE JUST LIKE 2366 01:41:43,128 --> 01:41:49,934 PEOPLE ARE MORE ALIKE THAN THAT 2367 01:41:49,934 --> 01:41:52,270 THEY ARE DIFFERENT. 2368 01:41:52,270 --> 01:41:57,108 SO THIS IS SHOWING THE 2369 01:41:57,108 --> 01:41:59,878 DIFFERENCE IN LIPOGENESIS AND 2370 01:41:59,878 --> 01:42:02,480 NUMBER OF LIQUID DROPLETS IN THE 2371 01:42:02,480 --> 01:42:03,148 IHLCs. 2372 01:42:03,148 --> 01:42:05,283 YOU CAN'T SEE THE IMAGES VERY 2373 01:42:05,283 --> 01:42:07,485 WELL SO WE'LL LOOK AT THE BAR 2374 01:42:07,485 --> 01:42:07,986 GRAPHS. 2375 01:42:07,986 --> 01:42:12,457 WHAT YOU SEE WITH RED BARS IS 2376 01:42:12,457 --> 01:42:19,664 THAT MOSTLY THE LIPID STAINS, 2377 01:42:19,664 --> 01:42:23,268 RED LIPID STAINING, AND THERE'S 2378 01:42:23,268 --> 01:42:28,506 ANOTHER ONE, ADIPO GREEN, 2379 01:42:28,506 --> 01:42:31,943 MASSIVELY INCREASED IN THE AC 2380 01:42:31,943 --> 01:42:33,244 IHLCs VERSUS CONTROL IHLCs. 2381 01:42:33,244 --> 01:42:34,546 THIS IS JUST BASELINE. 2382 01:42:34,546 --> 01:42:37,215 WHERE MIGHT THAT BE? 2383 01:42:37,215 --> 01:42:37,749 WELL, THERE'S A METABOLIC 2384 01:42:37,749 --> 01:42:39,317 DIFFERENCE, WHAT YOU CAN DO IS 2385 01:42:39,317 --> 01:42:45,890 TAKE THESE CELLS, PUT THEM IN 2386 01:42:45,890 --> 01:42:46,791 THE SEAHORSE INSTRUMENT, 2387 01:42:46,791 --> 01:42:50,528 BIZARRELY ENOUGH, WHICH ENABLES 2388 01:42:50,528 --> 01:42:50,995 YOU TO MEASURE OXYGEN 2389 01:42:50,995 --> 01:42:52,263 CONSUMPTION RATE OF THE CELLS, 2390 01:42:52,263 --> 01:42:54,899 YOU MEASURE THAT RATE AFTER 2391 01:42:54,899 --> 01:42:57,469 GIVING DIFFERENT COMPOUNDS THAT 2392 01:42:57,469 --> 01:42:59,170 BLOCK DIFFERENT COMPONENTS OF 2393 01:42:59,170 --> 01:43:00,105 THE RESPIRATORY TRANSPORT CHAIN. 2394 01:43:00,105 --> 01:43:06,744 AND WHAT YOU SEE IS THAT THE 2395 01:43:06,744 --> 01:43:12,350 BASAL RESPIRATORY, SPARE 2396 01:43:12,350 --> 01:43:13,952 CAPACITY, MAXIMAL RESPIRATORY OF 2397 01:43:13,952 --> 01:43:17,455 THE RED ALCOHOL CIRRHOSIS 2398 01:43:17,455 --> 01:43:21,426 IHLCs ARE ALL LOWER, WHEREAS 2399 01:43:21,426 --> 01:43:26,197 THE NOT MITOCHONDRIAL 2400 01:43:26,197 --> 01:43:27,632 RESPIRATION, A FRACTION OF THE 2401 01:43:27,632 --> 01:43:30,768 CELLS, YOU SEE ON THE LEFT HERE 2402 01:43:30,768 --> 01:43:35,140 IT'S ONLY A SMALL PART OF THE 2403 01:43:35,140 --> 01:43:37,509 TOTAL RESPIRATION OF THE CELL, 2404 01:43:37,509 --> 01:43:39,344 THAT RESPIRATION IS NOT 2405 01:43:39,344 --> 01:43:44,149 DIFFERENT IN THE CONTROLS VERSUS 2406 01:43:44,149 --> 01:43:45,750 ALCOHOL CIRRHOSIS CELLS. 2407 01:43:45,750 --> 01:43:46,885 IT'S FASCINATING YOU TAKE THE 2408 01:43:46,885 --> 01:43:49,587 CELLS OUT OF A PERSON, CULTURE 2409 01:43:49,587 --> 01:43:52,657 THEM IN VITRO, THEY HAVE NOT 2410 01:43:52,657 --> 01:43:54,025 BEEN EXPOSED TO ANYTHING THAT 2411 01:43:54,025 --> 01:43:59,397 THE PERSON IS EXPOSED TO FOR 2412 01:43:59,397 --> 01:43:59,731 MONTHS. 2413 01:43:59,731 --> 01:44:01,933 DEDIFFERENTIATED WIPING OUT MUCH 2414 01:44:01,933 --> 01:44:03,101 OF EPIGENETIC MEMORY YET STILL 2415 01:44:03,101 --> 01:44:06,671 KNOW IN SOME WAY THAT THEY NEED 2416 01:44:06,671 --> 01:44:09,507 TO BE METABOLICALLY ABNORMAL. 2417 01:44:09,507 --> 01:44:14,412 HERE IS THE LOWER MITOCHONDRIAL 2418 01:44:14,412 --> 01:44:15,780 RESPIRATION AC IHLCs, FOR TIME 2419 01:44:15,780 --> 01:44:18,983 I'M GOING TO SKIP THIS BUT YOU 2420 01:44:18,983 --> 01:44:22,520 CAN SEE THE RED ONES, RED BARS, 2421 01:44:22,520 --> 01:44:24,889 ARE ALWAYS LOWER. 2422 01:44:24,889 --> 01:44:27,792 SO HERE IS THEN THE WAY THAT 2423 01:44:27,792 --> 01:44:38,036 HE'S CELLS WITH UTILIZE FATTY 2424 01:44:38,036 --> 01:44:39,704 ACIDS AND GLUTEMANE AS 2425 01:44:39,704 --> 01:44:41,239 SUBSTRATES. 2426 01:44:41,239 --> 01:44:49,113 ON THE TOP TREATED WITH ETOMOXIR 2427 01:44:49,113 --> 01:44:51,616 WE'RE SEEING THAT THEY UTILIZE 2428 01:44:51,616 --> 01:44:53,484 THE ALTERNATIVE FATTY ACIDS LESS 2429 01:44:53,484 --> 01:44:54,352 WELL. 2430 01:44:54,352 --> 01:45:02,727 AND ON THE BOTTOM TREATED WITH 2431 01:45:02,727 --> 01:45:04,329 BPTES, UTILIZING LESS WELL. 2432 01:45:04,329 --> 01:45:08,066 SO WE NATURALLY HAVE DONE 2433 01:45:08,066 --> 01:45:11,336 TRANSCRIPTOMICS ON THESE CELLS. 2434 01:45:11,336 --> 01:45:13,504 INSTEAD OF JUST LOOKING AT 2435 01:45:13,504 --> 01:45:18,109 THINGS THAT YOU KNOW, YOU'RE 2436 01:45:18,109 --> 01:45:19,444 OBJECTIVELY INVESTIGATING WHAT 2437 01:45:19,444 --> 01:45:23,715 PATHWAYS ARE DISTURBED, WHAT 2438 01:45:23,715 --> 01:45:25,183 MIGHT BE NORMAL, IN THESE 2439 01:45:25,183 --> 01:45:25,917 ALCOHOL CIRRHOSIS CELLS. 2440 01:45:25,917 --> 01:45:28,486 WHAT YOU SEE IS THE 2441 01:45:28,486 --> 01:45:36,761 DOWNREGULATED PATHWAYS, THIS IS 2442 01:45:36,761 --> 01:45:42,867 THE TOP PATHWAYS, INCLUDE 2443 01:45:42,867 --> 01:45:46,504 GLUCONEOGENESIS, OXIDATIVE 2444 01:45:46,504 --> 01:45:47,005 PHOSPHORYLATION, WHAT'S 2445 01:45:47,005 --> 01:45:50,108 UPREGULATED IS APOPTOSIS, DNA 2446 01:45:50,108 --> 01:45:51,476 DAMAGE, MAPK SIGNALING, I 2447 01:45:51,476 --> 01:45:53,645 WOULDN'T DOUBT E.R. STRESS IS 2448 01:45:53,645 --> 01:45:56,247 ALSO UPREGULATED IN THESE CELLS. 2449 01:45:56,247 --> 01:45:59,083 I'M GOING TO SKIPS THIS PROPOSED 2450 01:45:59,083 --> 01:45:59,684 MECHANISM. 2451 01:45:59,684 --> 01:46:00,618 PHILIPPE, I THINK A DIFFERENT 2452 01:46:00,618 --> 01:46:02,487 VERSION OF THE SLIDES ENDED UP 2453 01:46:02,487 --> 01:46:03,988 GETTING USED HERE. 2454 01:46:03,988 --> 01:46:08,559 AND GO TO THE POTENTIAL USE OF 2455 01:46:08,559 --> 01:46:10,895 CELLS, OF THESE CELLS IN DRUG 2456 01:46:10,895 --> 01:46:11,229 SCREENING. 2457 01:46:11,229 --> 01:46:14,365 ONE OF THE THINGS WE DID WAS TO 2458 01:46:14,365 --> 01:46:17,435 LOOK AT THE POTENTIAL EFFECT OF 2459 01:46:17,435 --> 01:46:22,573 ON THE HEALTH OF THESE CELLS, 2460 01:46:22,573 --> 01:46:24,842 ARAMKOL IS DRUG USED IN A 2461 01:46:24,842 --> 01:46:28,313 COLLABORATOR OF OURS, AND IN 2462 01:46:28,313 --> 01:46:33,151 PHASE 2B TRIAL, YOU SEE THE 2463 01:46:33,151 --> 01:46:35,620 RESULTS A RUN GOT, WHERE ARAMKOL 2464 01:46:35,620 --> 01:46:39,023 IS RESOLVING AT THE TIME WHAT 2465 01:46:39,023 --> 01:46:44,262 WAS CALLED NASH, NOW CALLED 2466 01:46:44,262 --> 01:46:45,096 MASH, METABOLIC ASSOCIATED 2467 01:46:45,096 --> 01:46:49,167 HEPATITIS, AND THAT THERE'S 2468 01:46:49,167 --> 01:46:53,871 STRONG EVIDENCE THAT ARAMKOL IS 2469 01:46:53,871 --> 01:46:56,174 GOOD FOR LIVER DISEASE, SO HERE 2470 01:46:56,174 --> 01:47:01,446 WE TREATED THESE ALCOHOL 2471 01:47:01,446 --> 01:47:08,086 CIRRHOSIS IHLCs WITH ARAMCOL, 2472 01:47:08,086 --> 01:47:11,222 IMPROVED PERFORMANCE, BASAL 2473 01:47:11,222 --> 01:47:12,457 RESPIRATION, MAXIMAL 2474 01:47:12,457 --> 01:47:14,158 RESPIRATION, SPARE RESPIRATORY 2475 01:47:14,158 --> 01:47:17,195 CAPACITY AND ATP PRODUCTION ARE 2476 01:47:17,195 --> 01:47:17,795 ALL IMPROVED. 2477 01:47:17,795 --> 01:47:23,601 I'D LIKE TO JUST SUMMARIZE NOW. 2478 01:47:23,601 --> 01:47:25,470 ALCOHOL USE DISORDER OVERLAPS 2479 01:47:25,470 --> 01:47:27,638 WITH OTHER SUBSTANCE USE 2480 01:47:27,638 --> 01:47:31,275 DISORDERS AND PSYCHIATRIC 2481 01:47:31,275 --> 01:47:32,810 DISEASES, INHERITANCE AND 2482 01:47:32,810 --> 01:47:34,779 MECHANISMS, A CLASSIC GENE BY 2483 01:47:34,779 --> 01:47:36,147 ENVIRONMENT INTERACTION 2484 01:47:36,147 --> 01:47:36,814 DISORDER. 2485 01:47:36,814 --> 01:47:40,518 GENE EFFECTS ARE STRONG OTHER 2486 01:47:40,518 --> 01:47:42,286 MOLECULES IMMEDIATE PROCESS BUT 2487 01:47:42,286 --> 01:47:44,222 VERY LARGE GWAS ON CRUDE 2488 01:47:44,222 --> 01:47:45,590 PHENOTYPES DETECT KNOWN GENES IN 2489 01:47:45,590 --> 01:47:47,225 MANY MORE OF SMALL EFFECT, 2490 01:47:47,225 --> 01:47:48,059 LARGELY UNKNOWN. 2491 01:47:48,059 --> 01:47:50,228 THE REASON IS THAT THE GWAS 2492 01:47:50,228 --> 01:47:52,497 STUDIES ARE JUST SO LARGE THAT 2493 01:47:52,497 --> 01:47:55,500 THEY HAVE POWER TO DETECT 2494 01:47:55,500 --> 01:47:56,534 MINUSCULE EFFECT, AND VERY LARGE 2495 01:47:56,534 --> 01:47:58,436 NUMBER OF THEM. 2496 01:47:58,436 --> 01:47:59,604 SO ALCOHOL HAS POWERFUL 2497 01:47:59,604 --> 01:48:03,408 EPIGENETIC EFFECTS THAT ARE NOT, 2498 01:48:03,408 --> 01:48:05,009 HOWEVER, INVOLVED IN THE 2499 01:48:05,009 --> 01:48:07,245 HERITABILITY OF ALCOHOL USE 2500 01:48:07,245 --> 01:48:08,312 DISORDER. 2501 01:48:08,312 --> 01:48:11,616 GENES ALTERING RISK OF AUD, 2502 01:48:11,616 --> 01:48:14,752 ALCOHOL ASSOCIATED CIRRHOSIS AND 2503 01:48:14,752 --> 01:48:15,353 HEPATITIS ARE OVERLAPPING, BUT 2504 01:48:15,353 --> 01:48:15,853 THEY ARE DISTINCT. 2505 01:48:15,853 --> 01:48:20,758 WE KNOW IN VITRO THAT THERE'S AN 2506 01:48:20,758 --> 01:48:22,160 INTRINSIC METABOLIC ABILITY OF 2507 01:48:22,160 --> 01:48:25,963 HEPATOCYTES DERIVED FROM AC 2508 01:48:25,963 --> 01:48:27,899 PATIENTS, IT APPEARS CONSERVED, 2509 01:48:27,899 --> 01:48:28,800 AND POTENTIAL MODEL FOR TESTING 2510 01:48:28,800 --> 01:48:31,002 EFFECTS OF NEW DRUGS. 2511 01:48:31,002 --> 01:48:33,471 SO I WANT TO THANK YOU FOR YOUR 2512 01:48:33,471 --> 01:48:34,939 ATTENTION. 2513 01:48:34,939 --> 01:48:41,646 AND GIVE SPECIAL THANKS TO THE 2514 01:48:41,646 --> 01:48:46,350 ALCOHOL CIRRHOSIS GENOME 2515 01:48:46,350 --> 01:48:47,985 CONSORTIUM, DEVANSHI AND TIM, 2516 01:48:47,985 --> 01:48:54,926 AND THE ALCOHOL HEPATITIS 2517 01:48:54,926 --> 01:48:55,493 GENOMICS CONSORTIUM, 2518 01:48:55,493 --> 01:48:56,360 PARTICULARLY SOMEONE IN MY LAB 2519 01:48:56,360 --> 01:49:05,803 WHO HAS WRITTEN A PAPER AND 2520 01:49:05,803 --> 01:49:08,172 COLIN HODGKINSON, AND BANI IS 2521 01:49:08,172 --> 01:49:09,807 RIGHT NOW IN PORTUGAL PRESENTING 2522 01:49:09,807 --> 01:49:12,009 THIS WORK. 2523 01:49:12,009 --> 01:49:14,812 AND SHE WAS RECENTLY KEYSTONE 2524 01:49:14,812 --> 01:49:15,980 MEETING DOING THE SAME. 2525 01:49:15,980 --> 01:49:23,621 AND THEN FOR THE EPIGENETIC 2526 01:49:23,621 --> 01:49:28,993 STUDIES, FALK LOHOFF AND JEESUN 2527 01:49:28,993 --> 01:49:29,560 JUNG. 2528 01:49:29,560 --> 01:49:29,861 THANK YOU. 2529 01:49:29,861 --> 01:49:31,596 >> I'LL LEAD OFF WITH A 2530 01:49:31,596 --> 01:49:32,363 QUESTION. 2531 01:49:32,363 --> 01:49:33,664 DAVID, COULD YOU USE THE SAME 2532 01:49:33,664 --> 01:49:38,302 TECHNIQUE THAT YOU USED FOR THE 2533 01:49:38,302 --> 01:49:41,439 LIPID DYSFUNCTION IN THE LIVER 2534 01:49:41,439 --> 01:49:43,841 WITH iPSCs FOR ONE OF THOSE 2535 01:49:43,841 --> 01:49:46,644 GENES THAT'S NOT SO HIGHLY 2536 01:49:46,644 --> 01:49:47,812 REPRESENTED IN THE GWAS STUDY? 2537 01:49:47,812 --> 01:49:49,881 IN OTHER WORDS, DOESN'T HAVE THE 2538 01:49:49,881 --> 01:49:51,415 HIGH, WHATEVER IT IS, MANHATTAN 2539 01:49:51,415 --> 01:49:54,385 SCORE, WHAT'S THE WORD FOR THAT? 2540 01:49:54,385 --> 01:49:57,722 BUT ANYWAY, IS THERE -- I MEAN, 2541 01:49:57,722 --> 01:50:01,459 DO YOU NEED TO -- DO YOU HAVE A 2542 01:50:01,459 --> 01:50:03,895 MUCH HIGHER SIGNAL BEFORE YOU 2543 01:50:03,895 --> 01:50:05,196 WOULD EMBARK ON iPSCs? 2544 01:50:05,196 --> 01:50:09,433 HOW DO WE GO FORWARD WITH THE 2545 01:50:09,433 --> 01:50:11,736 GWAS ON THE AUD? 2546 01:50:11,736 --> 01:50:16,207 >> YES, IT'S A WONDERFUL 2547 01:50:16,207 --> 01:50:17,441 QUESTION. 2548 01:50:17,441 --> 01:50:20,945 THE SUGGESTION FROM JOSH GORDON 2549 01:50:20,945 --> 01:50:23,147 WHO ABLY LED NIMH FOR MANY YEARS 2550 01:50:23,147 --> 01:50:24,448 HAS BEEN THAT THE ONLY GENES 2551 01:50:24,448 --> 01:50:26,717 THAT REALLY SHOULD BE FOLLOWED 2552 01:50:26,717 --> 01:50:31,289 UP ON ARE ONES THAT HAVE, YOU 2553 01:50:31,289 --> 01:50:32,056 KNOW, SIGNALS, THERE ARE 2554 01:50:32,056 --> 01:50:33,958 MULTIPLE WAYS TO GET A 2555 01:50:33,958 --> 01:50:36,761 SIGNIFICANT SIGNAL, NOT JUST 2556 01:50:36,761 --> 01:50:43,634 GWAS STUDY, ALSO TRANSCRIPTOME 2557 01:50:43,634 --> 01:50:45,002 OR EPIGENETIC-WIDE ASSOCIATION 2558 01:50:45,002 --> 01:50:45,236 STUDIES. 2559 01:50:45,236 --> 01:50:46,604 THERE ARE WAYS, JOSH RESPONDED 2560 01:50:46,604 --> 01:50:48,272 AT A MEETING FIVE YEARS AGO, 2561 01:50:48,272 --> 01:50:52,577 THAT ONE COULD GET A GENOME WIDE 2562 01:50:52,577 --> 01:50:53,010 SIGNIFICANT SIGNAL. 2563 01:50:53,010 --> 01:50:55,446 THE QUESTION IS SHOULD YOU 2564 01:50:55,446 --> 01:50:57,515 FOLLOW UP ON SUCH LOCI? 2565 01:50:57,515 --> 01:51:00,551 AND THE REASON NOT TO IS THAT 2566 01:51:00,551 --> 01:51:02,987 THE END GAME IS THAT THE VARIANT 2567 01:51:02,987 --> 01:51:04,789 THAT YOU'RE FOLLOWING UP ON 2568 01:51:04,789 --> 01:51:06,290 MIGHT NOT BE VERY STRONG. 2569 01:51:06,290 --> 01:51:08,759 BUT THE REASON TO DO IT IS THAT 2570 01:51:08,759 --> 01:51:11,028 NOT ONLY DO YOU HAVE A SIGNAL 2571 01:51:11,028 --> 01:51:11,796 THAT PARTICULAR GENE IS 2572 01:51:11,796 --> 01:51:13,397 IMPORTANT BUT MIGHT HAVE A 2573 01:51:13,397 --> 01:51:14,899 SIGNAL THAT A PATHWAY IS 2574 01:51:14,899 --> 01:51:15,700 IMPORTANT, A NEW PATHWAY. 2575 01:51:15,700 --> 01:51:19,103 THERE ARE MANY WAYS TO TARGET 2576 01:51:19,103 --> 01:51:20,438 SUCH PATHWAYS MOLECULARLY. 2577 01:51:20,438 --> 01:51:24,275 YOU MIGHT DO THAT WITH ANTISENSE 2578 01:51:24,275 --> 01:51:26,544 RNA, IN A KNOCKOUT ANIMAL, WHERE 2579 01:51:26,544 --> 01:51:28,479 THE GENE IS KNOCKED OUT. 2580 01:51:28,479 --> 01:51:33,517 YOU MIGHT DO IT AS WE ARE DOING 2581 01:51:33,517 --> 01:51:37,421 BY GENE EDITING INTO iPSCs, 2582 01:51:37,421 --> 01:51:43,828 PARTICULAR VARIANTS. 2583 01:51:43,828 --> 01:51:46,697 THERE'S ALSO NOW, SHOWING 2584 01:51:46,697 --> 01:51:48,099 POSSIBILITY OF TARGETING THE 2585 01:51:48,099 --> 01:51:50,668 EPIGENETIC CONTROL OF GENES. 2586 01:51:50,668 --> 01:51:53,738 SO, I THINK THE ANSWER, GEORGE, 2587 01:51:53,738 --> 01:51:57,942 IS YES, THAT THE SIGNALS THAT 2588 01:51:57,942 --> 01:51:58,809 ARE EVEN SUBTHRESHOLD IF 2589 01:51:58,809 --> 01:52:01,312 POINTING TO PATHWAYS AND IF THEY 2590 01:52:01,312 --> 01:52:05,349 ARE COHERENT WITH OTHER GENES, 2591 01:52:05,349 --> 01:52:06,450 IF THAT GENE HAS OTHER GENES 2592 01:52:06,450 --> 01:52:07,952 THAT ARE FRIENDS OF IT AND THAT 2593 01:52:07,952 --> 01:52:11,589 ARE DOING THE SAME THING, THAT 2594 01:52:11,589 --> 01:52:14,925 THEN YOU HAVE -- YOU HAVE A 2595 01:52:14,925 --> 01:52:23,167 NOVEL PATHWAY TO STUDY. 2596 01:52:23,167 --> 01:52:24,068 >> DAVE, GO AHEAD. 2597 01:52:24,068 --> 01:52:27,238 >> YEAH, I WAS REALLY AMAZED TO 2598 01:52:27,238 --> 01:52:28,205 SEE EFFECTS ON METABOLISM, SO 2599 01:52:28,205 --> 01:52:32,843 THAT GOT ME THINKING ABOUT 2600 01:52:32,843 --> 01:52:33,210 NEURONS. 2601 01:52:33,210 --> 01:52:35,279 ARE THERE COMPARABLE DATA FROM 2602 01:52:35,279 --> 01:52:35,546 NEURONS? 2603 01:52:35,546 --> 01:52:37,081 AND THIS REMINDS ME A LOT OF 2604 01:52:37,081 --> 01:52:38,482 SOME OF THE OTHER NEURONAL 2605 01:52:38,482 --> 01:52:39,917 DISORDERS WHERE MITOCHONDRIA 2606 01:52:39,917 --> 01:52:42,787 BECOME A MORE AND MORE PART OF 2607 01:52:42,787 --> 01:52:43,120 THE PICTURE. 2608 01:52:43,120 --> 01:52:47,258 AND SO WITH ALCOHOL HAVE YOU -- 2609 01:52:47,258 --> 01:52:49,260 AUD, HAVE YOU SEEN THIS, OR 2610 01:52:49,260 --> 01:52:51,195 ANYONE SEEN THIS SORT OF 2611 01:52:51,195 --> 01:52:51,796 DISORDER IN NEURONS? 2612 01:52:51,796 --> 01:52:55,199 >> YEAH, SO WE HAVE A WHOLE 2613 01:52:55,199 --> 01:52:57,668 OTHER SERIES OF STUDIES, 2614 01:52:57,668 --> 01:52:59,837 COLLABORATIVE WITH NIMH, WITH 2615 01:52:59,837 --> 01:53:06,544 PETER SCHMIDT ON OVARIAN STEROID 2616 01:53:06,544 --> 01:53:11,582 TRIGGERED -- AND WE'RE STUDYING 2617 01:53:11,582 --> 01:53:12,383 NEURONS DIFFERENTIATED FROM 2618 01:53:12,383 --> 01:53:14,585 iPSC, AND FASCINATING THING 2619 01:53:14,585 --> 01:53:19,790 ABOUT THESE OVARIAN STEROID 2620 01:53:19,790 --> 01:53:21,459 TRIGGERED MOOD DISORDERS THE 2621 01:53:21,459 --> 01:53:24,261 WOMEN WHO HAVE NORMAL LEVELS BUT 2622 01:53:24,261 --> 01:53:25,763 DIFFERENCE IN CELLULAR RESPONSE 2623 01:53:25,763 --> 01:53:30,367 MUCH AS DIFFERENCE IN RESPONSE 2624 01:53:30,367 --> 01:53:33,437 TO ALCOHOL IN PEOPLE HIGH OR LOW 2625 01:53:33,437 --> 01:53:39,677 RESPONDERS IS NOT DUE PRIMARILY 2626 01:53:39,677 --> 01:53:42,179 TO MA METABOLISM BUT 2627 01:53:42,179 --> 01:53:43,114 PHARMACODYNAMIC RESPONSE. 2628 01:53:43,114 --> 01:53:47,585 WE'VE BEEN ABLE IN THOSE LCL 2629 01:53:47,585 --> 01:53:49,653 STUDIES AND ALSO MAKING SOME 2630 01:53:49,653 --> 01:53:52,823 NEURONAL TYPES TO SEE THESE 2631 01:53:52,823 --> 01:53:53,424 DIFFERENTIAL EFFECTS OF 2632 01:53:53,424 --> 01:53:57,995 RESPONSE, WE HAVE A SERIES OF 2633 01:53:57,995 --> 01:54:03,167 PAPERS ON ENTITIES LIKE 2634 01:54:03,167 --> 01:54:05,436 PRE-MENSTRUAL DYSPHORIC 2635 01:54:05,436 --> 01:54:06,504 DISORDER, DEPRESSION. 2636 01:54:06,504 --> 01:54:08,539 THE LIMITATION, SEEN IN SOME OF 2637 01:54:08,539 --> 01:54:11,876 FRED GAUGE'S WORK ON 2638 01:54:11,876 --> 01:54:12,543 SCHIZOPHRENIA, ON NEURONS, IS 2639 01:54:12,543 --> 01:54:16,380 THAT IF YOU DON'T HAVE A MODEL 2640 01:54:16,380 --> 01:54:19,049 WHERE YOU CAN CONSISTENTLY 2641 01:54:19,049 --> 01:54:21,986 PRODUCE THE CELLULAR -- THE SAME 2642 01:54:21,986 --> 01:54:25,189 CELLULAR -- A LOT OF NOISE, YOU 2643 01:54:25,189 --> 01:54:28,826 HAVE THE POSSIBILITY THAT YOUR 2644 01:54:28,826 --> 01:54:31,395 CELLS FROM YOUR CASES JUST HAVE 2645 01:54:31,395 --> 01:54:32,530 DIFFERENTIATED IN DIFFERENT WAY 2646 01:54:32,530 --> 01:54:34,298 THAN THE CELLS FROM YOUR 2647 01:54:34,298 --> 01:54:38,135 CONTROLS, SO YOU'RE NOT THE 2648 01:54:38,135 --> 01:54:39,236 FIRST PLACE COMPARING DIFFERENT 2649 01:54:39,236 --> 01:54:44,542 APPLES TO OTHER TYPES OF APPLES 2650 01:54:44,542 --> 01:54:45,743 BUT COMPARING APPLES TO ORANGES, 2651 01:54:45,743 --> 01:54:47,444 AND THAT YOU CAN SEE IF YOU HAVE 2652 01:54:47,444 --> 01:54:49,513 A DIFFERENT PERCENTAGE OF CELL 2653 01:54:49,513 --> 01:54:52,483 TYPES, IN THAT WHICH YOU STUDY. 2654 01:54:52,483 --> 01:54:54,585 IT'S VERY IMPORTANT THAT THE 2655 01:54:54,585 --> 01:54:56,854 IHLC WORK, AS WE'VE SHOWN BY 2656 01:54:56,854 --> 01:55:00,124 ANALYTIC CELL SORTING, YOU END 2657 01:55:00,124 --> 01:55:01,158 UP WITH 95% HEPATOCYTE-LIKE 2658 01:55:01,158 --> 01:55:03,661 CELLS AND THEY ARE FAIRLY 2659 01:55:03,661 --> 01:55:06,730 CONSISTENT IN THEIR LEVEL, 2660 01:55:06,730 --> 01:55:09,567 LEVELS OF GENE EXPRESSION. 2661 01:55:09,567 --> 01:55:13,470 IT'S UNKNOWN HOW POWERFUL THAT 2662 01:55:13,470 --> 01:55:16,707 STUDIES OF NEURONS ARE GOING TO 2663 01:55:16,707 --> 01:55:17,341 BE. 2664 01:55:17,341 --> 01:55:19,977 THE LIMITATION OF STUDIES OF 2665 01:55:19,977 --> 01:55:21,779 NEURONS IS THAT HEPATOCYTE 2666 01:55:21,779 --> 01:55:22,980 EXISTS NOT IN THE ABSENCE OF 2667 01:55:22,980 --> 01:55:25,216 INTERACTION WITH OTHER CELLS. 2668 01:55:25,216 --> 01:55:25,983 IT'S INTERACTING WITH OTHER 2669 01:55:25,983 --> 01:55:28,752 CELLS, IN VERY IMPORTANT WAYS. 2670 01:55:28,752 --> 01:55:31,155 BUT AS COMPARED TO A NEURON IT'S 2671 01:55:31,155 --> 01:55:34,458 DOING NOTHING. 2672 01:55:34,458 --> 01:55:38,395 SO, A NEURON MAY BE SYNAPSING 2673 01:55:38,395 --> 01:55:39,830 WITH 50 OR 100 OR WHATEVER 2674 01:55:39,830 --> 01:55:43,901 NUMBER OF CELLS, AND IF YOU'VE 2675 01:55:43,901 --> 01:55:47,304 EVER LOOKED AT THE NEUROPILE OF 2676 01:55:47,304 --> 01:55:49,340 DOPAMINE NEURON, RECENTLY IN A 2677 01:55:49,340 --> 01:55:50,941 SEMINAR, IT'S JUST AMAZING 2678 01:55:50,941 --> 01:55:55,779 BECAUSE YOU HAVE THIS ABSOLUTELY 2679 01:55:55,779 --> 01:55:57,681 TANGLED MASS OF WHATEVER THEY 2680 01:55:57,681 --> 01:55:58,983 ARE, DENDRITES OR AXONS, 2681 01:55:58,983 --> 01:55:59,383 WHATEVER. 2682 01:55:59,383 --> 01:56:03,387 SO, YOU KNOW, I THINK THAT THE 2683 01:56:03,387 --> 01:56:05,589 FACT THAT WITH NEURONS THAT THE 2684 01:56:05,589 --> 01:56:07,524 ISSUES OF GEOMETRY AND 2685 01:56:07,524 --> 01:56:09,660 INTERACTION IS SO MUCH MORE 2686 01:56:09,660 --> 01:56:11,562 IMPORTANT MAY MEAN THAT IT'S 2687 01:56:11,562 --> 01:56:14,565 GOING TO BE MORE DIFFICULT TO 2688 01:56:14,565 --> 01:56:18,235 APPLY THESE -- YOU KNOW, APPLY 2689 01:56:18,235 --> 01:56:21,405 THIS IN VITRO MODEL TO NEURONS, 2690 01:56:21,405 --> 01:56:22,406 AND WE'VE ALSO SEEN THAT IN THE 2691 01:56:22,406 --> 01:56:24,608 SENSE IF YOU LOOK AT DIFFERENT 2692 01:56:24,608 --> 01:56:26,110 PARTS OF THE PLATE, WHERE YOU 2693 01:56:26,110 --> 01:56:29,613 HAVE NEURONS FROM ONE PERSON IN 2694 01:56:29,613 --> 01:56:31,682 ONE PART OF THE CULTURE DISH 2695 01:56:31,682 --> 01:56:32,816 NEURONS ARE DOING ONE THING AND 2696 01:56:32,816 --> 01:56:35,319 OVER THERE THEY ARE DOING 2697 01:56:35,319 --> 01:56:36,520 SOMETHING A LITTLE BIT 2698 01:56:36,520 --> 01:56:38,989 DIFFERENT. 2699 01:56:38,989 --> 01:56:43,627 SO MAKING THIS WORK FOR NEURONS 2700 01:56:43,627 --> 01:56:44,495 HAS DIFFERENT SORT OF CHALLENGE 2701 01:56:44,495 --> 01:56:47,898 THAN FOR SOME OTHER TYPES OF 2702 01:56:47,898 --> 01:56:49,099 CELLS. 2703 01:56:49,099 --> 01:56:51,602 >> THANK YOU FOR THAT WONDERFUL 2704 01:56:51,602 --> 01:56:52,803 RICH TALK. 2705 01:56:52,803 --> 01:56:57,441 I WAS WONDERING IF YOU COULD 2706 01:56:57,441 --> 01:57:00,311 COMMENT FURTHER ON GENOMIC 2707 01:57:00,311 --> 01:57:01,245 VERSUS EPIGENETIC CHANGES IN ANY 2708 01:57:01,245 --> 01:57:02,713 OF THE RESEARCH YOU TALKED 2709 01:57:02,713 --> 01:57:03,180 ABOUT. 2710 01:57:03,180 --> 01:57:04,448 >> YEAH, THANKS A LOT. 2711 01:57:04,448 --> 01:57:08,419 IT'S A LOT OF CONFUSION ABOUT 2712 01:57:08,419 --> 01:57:11,422 GENOMIC -- GENETIC VERSUS 2713 01:57:11,422 --> 01:57:11,722 EPIGENETIC. 2714 01:57:11,722 --> 01:57:14,959 PART IS BECAUSE WHEN CONRAD 2715 01:57:14,959 --> 01:57:16,360 WARRINGTON COINED THE WORD 2716 01:57:16,360 --> 01:57:19,463 EPIGENETIC, WHICH HE DID TO 2717 01:57:19,463 --> 01:57:22,199 EXPLAIN HOW CELLS DIFFERENTIATE 2718 01:57:22,199 --> 01:57:24,134 FROM PRIMORDIAL GERM CELL HE 2719 01:57:24,134 --> 01:57:26,870 USED THE TERM EPIGENETIC, ABOVE 2720 01:57:26,870 --> 01:57:28,105 GENETIC SO PEOPLE SOMETIMES 2721 01:57:28,105 --> 01:57:30,407 THINK THAT EPIGENETIC IS NOT A 2722 01:57:30,407 --> 01:57:32,142 CHANGE IN DNA BUT OF COURSE 2723 01:57:32,142 --> 01:57:33,677 THERE ARE MANY EPIGENETIC 2724 01:57:33,677 --> 01:57:38,282 CHANGES WHICH DIRECTLY ARE 2725 01:57:38,282 --> 01:57:42,853 CHANGES IN DNA, DNA METHYLATION, 2726 01:57:42,853 --> 01:57:44,288 TELOMERE SHORTENING IS CHANGE IN 2727 01:57:44,288 --> 01:57:44,488 DNA. 2728 01:57:44,488 --> 01:57:46,724 EPIGENETIC CHANGE IS A CHANGE 2729 01:57:46,724 --> 01:57:47,925 THAT'S READILY REVERSIBLE. 2730 01:57:47,925 --> 01:57:49,960 WHEREAS A AGAINST CHANGE IS VERY 2731 01:57:49,960 --> 01:57:51,295 DIFFICULT TO REVERSE, ESPECIALLY 2732 01:57:51,295 --> 01:57:55,532 IF IT'S A POINT SUBSTITUTION, 2733 01:57:55,532 --> 01:57:56,200 REVERSING -- GENETIC CHANGES 2734 01:57:56,200 --> 01:58:03,874 OCCUR ON ORDER IF THEY ARE NOT 2735 01:58:03,874 --> 01:58:06,076 SHORT CHAIN REMEET POLY MORPH 2736 01:58:06,076 --> 01:58:08,579 ITS ONE TIMES 10 TO THE MINUS 8, 2737 01:58:08,579 --> 01:58:11,181 EPIGENETIC CHANGES ARE HAPPENING 2738 01:58:11,181 --> 01:58:11,615 EVERY MOMENT. 2739 01:58:11,615 --> 01:58:13,851 I THINK VIRTUE OF EPIGENETIC 2740 01:58:13,851 --> 01:58:19,223 WORK IS IT LETS US CAPTURE 2741 01:58:19,223 --> 01:58:20,524 EFFECTS OF EXPOSURES, IN A 2742 01:58:20,524 --> 01:58:21,258 DRAMATIC WAY. 2743 01:58:21,258 --> 01:58:23,427 YOU CAN SEE A PERSON HAS BEEN 2744 01:58:23,427 --> 01:58:25,963 EXPOSED TO ALCOHOL OR TO 2745 01:58:25,963 --> 01:58:27,431 NICOTINE OR TO STRESS, AND NOT 2746 01:58:27,431 --> 01:58:29,767 ONLY THAT THEY HAVE BEEN 2747 01:58:29,767 --> 01:58:31,368 EXPOSED, THE RESPONSE TO THE 2748 01:58:31,368 --> 01:58:37,074 EXPOSURE, ALL THE TIME WE ARE -- 2749 01:58:37,074 --> 01:58:38,075 INFORMATION ON CHILDHOOD TRAUMA, 2750 01:58:38,075 --> 01:58:39,343 CHILDHOOD NEGLECT, BUT MAYBE 2751 01:58:39,343 --> 01:58:41,879 YOU'RE GLAD YOUR DOG DIED OR NOT 2752 01:58:41,879 --> 01:58:43,647 AS UPSET AS THE PERSON REALLY 2753 01:58:43,647 --> 01:58:48,085 ATTACHED TO THAT DOG WAS. 2754 01:58:48,085 --> 01:58:50,087 THE SAME EFFECT HAS VERY 2755 01:58:50,087 --> 01:58:50,621 DIFFERENT SIGNIFICANCE FOR 2756 01:58:50,621 --> 01:58:51,889 DIFFERENT PEOPLE. 2757 01:58:51,889 --> 01:58:55,059 AND PART OF THE DIFFERENCE IN 2758 01:58:55,059 --> 01:58:57,361 RESPONSE CAN BE THE RESILIENCE 2759 01:58:57,361 --> 01:58:58,796 OR VULNERABILITY OF THE 2760 01:58:58,796 --> 01:59:00,697 INDIVIDUAL ALSO. 2761 01:59:00,697 --> 01:59:03,133 IT'S THE SAME EXPOSURE, WITH THE 2762 01:59:03,133 --> 01:59:04,902 SAME PSYCHOLOGICAL MEANING, CAN 2763 01:59:04,902 --> 01:59:06,570 HAVE A VERY DIFFERENT 2764 01:59:06,570 --> 01:59:07,671 PHYSIOLOGIC RESPONSE IN TWO 2765 01:59:07,671 --> 01:59:08,172 DIFFERENT PEOPLE. 2766 01:59:08,172 --> 01:59:12,076 SO I THINK THE EPIGENETIC 2767 01:59:12,076 --> 01:59:17,915 REVOLUTION WHICH IS ENABLED BY 2768 01:59:17,915 --> 01:59:22,853 THE 850,000 FEATURE EPIC ARRAYS 2769 01:59:22,853 --> 01:59:25,656 WHICH MEANS CpG SITE AND MAYBE 2770 01:59:25,656 --> 01:59:27,491 CpG METHYLATION TAKE US INTO A 2771 01:59:27,491 --> 01:59:30,394 NEW ERA OF EPIGENETIC WORK. 2772 01:59:30,394 --> 01:59:31,495 THAT'S A STANDARD PRODUCT. 2773 01:59:31,495 --> 01:59:34,164 IT ALSO IS -- THE STRENGTH OF IT 2774 01:59:34,164 --> 01:59:37,301 IS IS THAT LIKE WITH ANYTHING 2775 01:59:37,301 --> 01:59:41,972 GENOMIC, IT LETS US PUT THE DATA 2776 01:59:41,972 --> 01:59:44,241 AGAINST A COMMON RUBRIC, AGAINST 2777 01:59:44,241 --> 01:59:46,743 THE GENOME. 2778 01:59:46,743 --> 01:59:49,880 SO THIS IS THE CpG METHYLATION 2779 01:59:49,880 --> 01:59:51,982 SITE, AND OF COURSE WHO LOOKS AT 2780 01:59:51,982 --> 01:59:55,419 THAT SITE CAN TALK ABOUT THE 2781 01:59:55,419 --> 01:59:56,420 SAME SITE. 2782 01:59:56,420 --> 02:00:05,062 AND VERY OFTEN MEASURED WITH THE 2783 02:00:05,062 --> 02:00:07,097 SAME PRODUCT. 2784 02:00:07,097 --> 02:00:09,433 >> HAVE YOU CONSIDERED SOME OF 2785 02:00:09,433 --> 02:00:12,102 THE TREATMENT RAMIFICATIONS OF 2786 02:00:12,102 --> 02:00:13,504 EPIGENETICS VERSUS GENETIC 2787 02:00:13,504 --> 02:00:13,804 COMPONENT? 2788 02:00:13,804 --> 02:00:16,106 >> YEAH, VERY GOOD QUESTION. 2789 02:00:16,106 --> 02:00:18,408 IT'S NOT -- IT'S NOT FULLY KNOWN 2790 02:00:18,408 --> 02:00:20,043 TO WHAT EXTENT EPIGENETIC 2791 02:00:20,043 --> 02:00:20,777 CHANGES ARE REVERSIBLE. 2792 02:00:20,777 --> 02:00:22,980 WE KNOW THAT YOU CAN MAKE 2793 02:00:22,980 --> 02:00:28,452 MATTERS WORSE, BUT CAN YOU MAKE 2794 02:00:28,452 --> 02:00:30,988 MATTERS BETTER? 2795 02:00:30,988 --> 02:00:32,055 AND VERY LIKELY REVERSIBLE 2796 02:00:32,055 --> 02:00:33,924 BECAUSE THERE ARE READERS, 2797 02:00:33,924 --> 02:00:39,196 WRITERS, AND ERASERS FOR ALL OF 2798 02:00:39,196 --> 02:00:41,265 THESE EPIGENETIC MARKS. 2799 02:00:41,265 --> 02:00:44,001 AND TELOMERE SHORTENING ITSELF 2800 02:00:44,001 --> 02:00:50,374 IS, YOU KNOW, REVERSED BY 2801 02:00:50,374 --> 02:00:51,875 TELOMEREASE, WHICH BUILDS BACK 2802 02:00:51,875 --> 02:00:52,376 TELOMERES. 2803 02:00:52,376 --> 02:00:53,810 IT'S NOT KNOWN BECAUSE 2804 02:00:53,810 --> 02:00:55,145 LONGITUDINAL STUDIES HAVE NOT 2805 02:00:55,145 --> 02:00:59,116 REALLY BEEN DONE TO WHAT EXTENT 2806 02:00:59,116 --> 02:01:04,321 THESE EPIGENETIC CHANGES CAN BE 2807 02:01:04,321 --> 02:01:11,228 REVERSED, OR POTENTIALLY TO STOP 2808 02:01:11,228 --> 02:01:11,929 THEM FROM WORSENING. 2809 02:01:11,929 --> 02:01:13,096 >> THANK YOU. 2810 02:01:13,096 --> 02:01:13,964 >> YOU'RE WELCOME, MICHAEL. 2811 02:01:13,964 --> 02:01:15,966 >> ANY OTHER QUESTIONS? 2812 02:01:15,966 --> 02:01:16,300 >> GO AHEAD. 2813 02:01:16,300 --> 02:01:17,968 >> DAVID, YEAH, THIS IS -- YOU 2814 02:01:17,968 --> 02:01:20,103 USED THE WORD EPIC STUDIES, THIS 2815 02:01:20,103 --> 02:01:21,438 IS REALLY AN EPIC STUDY, I 2816 02:01:21,438 --> 02:01:23,874 CONGRATULATE YOU FOR THAT. 2817 02:01:23,874 --> 02:01:24,975 IT'S REALLY WONDERFUL. 2818 02:01:24,975 --> 02:01:27,077 I WANT TO FOLLOW UP A LITTLE BIT 2819 02:01:27,077 --> 02:01:29,580 ON THE QUESTION ABOUT TREATMENT 2820 02:01:29,580 --> 02:01:31,982 OPTIONS, AND IN THINKING ABOUT 2821 02:01:31,982 --> 02:01:33,317 THIS, THIS HAS BEEN 50 YEARS 2822 02:01:33,317 --> 02:01:35,385 WE'VE BEEN WAITING FOR SOMEBODY 2823 02:01:35,385 --> 02:01:38,255 TO START PUTTING TOGETHER THE 2824 02:01:38,255 --> 02:01:40,691 GENOMICS OF ALCOHOL USE 2825 02:01:40,691 --> 02:01:41,525 DISORDER, ALCOHOL LIVER DISEASE, 2826 02:01:41,525 --> 02:01:42,726 AND YOU'RE GETTING THERE. 2827 02:01:42,726 --> 02:01:45,829 THAT'S WHAT I LIKE TO SAY. 2828 02:01:45,829 --> 02:01:49,166 AND I THINK THAT -- CAN YOU PUT 2829 02:01:49,166 --> 02:01:51,602 YOUR FINGER ON HOW MANY FACTORS 2830 02:01:51,602 --> 02:01:54,371 DO YOU NEED, CAN YOU SAY IF WE 2831 02:01:54,371 --> 02:01:57,774 FIND A PERSON WHO HAS TWO OF THE 2832 02:01:57,774 --> 02:01:59,042 FACTORS, THEIR LIKELIHOOD IS 2833 02:01:59,042 --> 02:02:00,477 MUCH HIGHER, THEY HAVE THREE 2834 02:02:00,477 --> 02:02:02,346 EVEN HIGHER AGAIN, AND IF YOU 2835 02:02:02,346 --> 02:02:06,850 THEN INTERVENE WITH TWO OUT OF 2836 02:02:06,850 --> 02:02:08,819 THE THREE MAYBE THAT'S A 2837 02:02:08,819 --> 02:02:09,853 TREATMENT STRATEGY. 2838 02:02:09,853 --> 02:02:14,791 I THINK YOUR TOOL, IHSCs, IS 2839 02:02:14,791 --> 02:02:18,895 WONDERFUL, IF WE'RE LOOKING AT 2840 02:02:18,895 --> 02:02:20,430 BOTH INHIBITORS AND ACTIVATES OR 2841 02:02:20,430 --> 02:02:23,133 OF VARIOUS GENES YOU HAVE TO SEE 2842 02:02:23,133 --> 02:02:25,936 WHETHER YOU CAN GO THROUGH SOME 2843 02:02:25,936 --> 02:02:29,039 LARGE SCALE SCREENING OF DRUGS 2844 02:02:29,039 --> 02:02:33,377 TO TRY AND ELEVATE OR INHIBIT 2845 02:02:33,377 --> 02:02:35,779 THE PARTICULAR PROTEIN THAT IS 2846 02:02:35,779 --> 02:02:36,747 CAUSING THE EFFECT. 2847 02:02:36,747 --> 02:02:38,148 ALL OF THAT GOES TO SAY THAT 2848 02:02:38,148 --> 02:02:39,316 WE'RE GETTING THERE. 2849 02:02:39,316 --> 02:02:40,517 WE'RE GETTING CLOSE AND WE CAN 2850 02:02:40,517 --> 02:02:43,053 ALWAYS ASK THE QUESTION HOW DO 2851 02:02:43,053 --> 02:02:47,224 WE TREAT IT. 2852 02:02:47,224 --> 02:02:48,325 >> THE MILLION DOLLAR QUESTION. 2853 02:02:48,325 --> 02:02:51,862 I FORGET WHAT THE BUDGET IS, 2854 02:02:51,862 --> 02:02:52,529 $550 MILLION QUESTION. 2855 02:02:52,529 --> 02:02:53,964 >> WE NEED MORE. 2856 02:02:53,964 --> 02:02:57,668 >> THE THING IS THAT THERE ARE 2857 02:02:57,668 --> 02:02:59,036 MANY PHENOTYPES INCLUDING AUD 2858 02:02:59,036 --> 02:03:00,203 AND LIVER DISEASE, WHICH ARE THE 2859 02:03:00,203 --> 02:03:04,041 PRODUCT OF A LARGE NUMBER OF 2860 02:03:04,041 --> 02:03:08,679 GENES AND A PRODUCT OF MULTIPLE 2861 02:03:08,679 --> 02:03:09,913 PATHWAYS OF THE DOESN'T MEAN 2862 02:03:09,913 --> 02:03:10,814 MULTIPLE PATHWAYS HAVE TO BE 2863 02:03:10,814 --> 02:03:13,750 ADDRESSED IN THERAPY. 2864 02:03:13,750 --> 02:03:17,921 IT CAN BE SUFFICIENT TO ADDRESS 2865 02:03:17,921 --> 02:03:22,492 A KEY CHECKPOINT OR BOTTLENECK. 2866 02:03:22,492 --> 02:03:26,596 THAT'S A LESSON. 2867 02:03:26,596 --> 02:03:28,565 THAT'S APPLICABLE FOR AUD. 2868 02:03:28,565 --> 02:03:30,801 NOW, YOU MIGHT -- IF YOU HAVE A 2869 02:03:30,801 --> 02:03:36,640 PROBLEM WITH THE APPENDIX, TAKE 2870 02:03:36,640 --> 02:03:37,274 IT OUT. 2871 02:03:37,274 --> 02:03:38,175 YOU DON'T HAVE TO KNOW 2872 02:03:38,175 --> 02:03:39,710 EVERYTHING ABOUT THE BIOLOGY OF 2873 02:03:39,710 --> 02:03:44,414 THE APPENDIX, OR ALL THE GENES 2874 02:03:44,414 --> 02:03:48,785 INVOLVED IN THE VULNERABILITY, 2875 02:03:48,785 --> 02:03:49,920 ALL THE PATHWAYS, ET CETERA. 2876 02:03:49,920 --> 02:03:50,787 JUST TAKE IT OUT. 2877 02:03:50,787 --> 02:03:53,724 THERE ARE A LOT OF DISEASES THAT 2878 02:03:53,724 --> 02:03:58,528 ARE ACTUALLY TREATABLE THAT WAY. 2879 02:03:58,528 --> 02:03:59,162 MOST GENETIC DISEASES 2880 02:03:59,162 --> 02:04:02,132 SUCCESSFULLY TREATED HAVE NOT 2881 02:04:02,132 --> 02:04:04,868 BEEN TREATED BY ADDRESSING THE 2882 02:04:04,868 --> 02:04:06,536 PRIMARY GENE THAT IS DISTURBED 2883 02:04:06,536 --> 02:04:07,404 TO CREATE THE VULNERABILITY IN 2884 02:04:07,404 --> 02:04:09,539 THE FIRST PLACE. 2885 02:04:09,539 --> 02:04:11,308 THEY HAVE BEEN ADDRESSED SOME 2886 02:04:11,308 --> 02:04:13,076 OTHER WAY. 2887 02:04:13,076 --> 02:04:13,443 SOME OTHER WAY. 2888 02:04:13,443 --> 02:04:14,478 AND SO THAT'S SOMETHING THAT I 2889 02:04:14,478 --> 02:04:17,247 THINK THAT WE SHOULD TAKE TO 2890 02:04:17,247 --> 02:04:17,447 HEART. 2891 02:04:17,447 --> 02:04:20,283 WE WANT THE GENETICS TO TELL US 2892 02:04:20,283 --> 02:04:21,351 ABOUT PATHWAYS. 2893 02:04:21,351 --> 02:04:22,886 AND ABOUT MECHANISMS. 2894 02:04:22,886 --> 02:04:25,889 BUT WE CAN'T ALLOW OURSELVES TO 2895 02:04:25,889 --> 02:04:30,660 GET HYPNOTIZED BY THE IDEA THAT 2896 02:04:30,660 --> 02:04:33,930 WE GOT TO TARGET THIS GENE, FIX 2897 02:04:33,930 --> 02:04:34,531 THAT GLITCH. 2898 02:04:34,531 --> 02:04:37,134 WE NEED THAT FIRST, WHATEVER 2899 02:04:37,134 --> 02:04:37,434 THAT TAKES. 2900 02:04:37,434 --> 02:04:40,237 >> THANK YOU. 2901 02:04:40,237 --> 02:04:43,140 >> THANK YOU, DAVID, FOR A 2902 02:04:43,140 --> 02:04:45,976 REALLY WONDERFUL TALK. 2903 02:04:45,976 --> 02:04:48,345 AND STIMULATING A LOT OF 2904 02:04:48,345 --> 02:04:48,612 INTEREST. 2905 02:04:48,612 --> 02:04:51,481 DAVID IS GENEROUS SO IF ANYONE 2906 02:04:51,481 --> 02:04:53,150 HAS QUESTIONS I'M SURE HE'LL BE 2907 02:04:53,150 --> 02:04:56,787 HAPPY TO ANSWER YOUR E-MAILS AND 2908 02:04:56,787 --> 02:04:59,022 GIVE YOU REFERENCES. 2909 02:04:59,022 --> 02:05:00,390 BUT WE SHOULD PROBABLY MOVE ON 2910 02:05:00,390 --> 02:05:03,627 AT THIS POINT. 2911 02:05:03,627 --> 02:05:07,130 SO, NEXT SPEAKER IS JOAN 2912 02:05:07,130 --> 02:05:08,064 ROMAINE, HEALTH SPECIALIST IN 2913 02:05:08,064 --> 02:05:10,834 THE DIVISION OF TREATMENT AND 2914 02:05:10,834 --> 02:05:12,903 RECOVERY, TREATMENT HEALTH 2915 02:05:12,903 --> 02:05:15,839 SERVICES AND RECOVERY BRANCH, 2916 02:05:15,839 --> 02:05:19,109 SHE'LL PRESENT ON NIAAA'S 2917 02:05:19,109 --> 02:05:21,144 PARTICIPATION IN THE DHHS CENTER 2918 02:05:21,144 --> 02:05:24,247 FOR FAITH-BASED AND NEIGHBORHOOD 2919 02:05:24,247 --> 02:05:26,383 PARTNERSHIPS, MATERNAL OUTCOMES 2920 02:05:26,383 --> 02:05:30,253 MATTERS TOUR, THE ACRONYM IS 2921 02:05:30,253 --> 02:05:31,021 APPROPRIATELY MOMS, M-O-M-S. 2922 02:05:31,021 --> 02:05:34,891 I WANT TO SAY A FEW OTHER THINGS 2923 02:05:34,891 --> 02:05:36,726 ABOUT JOAN. 2924 02:05:36,726 --> 02:05:38,862 JOAN IS -- I MENTIONED DEIDRA 2925 02:05:38,862 --> 02:05:40,797 ROACH EARLIER TODAY BUT JOAN IS 2926 02:05:40,797 --> 02:05:43,567 ALSO CONTRIBUTING MASSIVELY TO 2927 02:05:43,567 --> 02:05:45,435 OUR WOMEN'S HEALTH INITIATIVES 2928 02:05:45,435 --> 02:05:47,771 AT NIAAA. 2929 02:05:47,771 --> 02:05:49,840 AND SHE'S ALSO THE FOUNDER WITH 2930 02:05:49,840 --> 02:05:52,876 OTHERS OF THE RELIGION AND 2931 02:05:52,876 --> 02:05:55,979 SPIRITUALITY INTEREST GROUP, 2932 02:05:55,979 --> 02:05:58,582 WHICH HAS TAKEN OFF AT NIH, AND 2933 02:05:58,582 --> 02:06:01,117 NOW EXTENDS ACROSS ALL OF NIH. 2934 02:06:01,117 --> 02:06:02,552 AND WE'RE PROUD OF JOAN'S 2935 02:06:02,552 --> 02:06:04,654 EFFORTS IN THESE AREAS. 2936 02:06:04,654 --> 02:06:06,256 BECAUSE IT -- AS DAVID POINTED 2937 02:06:06,256 --> 02:06:08,758 OUT, WE'RE TALKING ABOUT THE 2938 02:06:08,758 --> 02:06:10,927 WHOLE BODY, WHEN WE TALK ABOUT 2939 02:06:10,927 --> 02:06:12,796 ALCOHOL USE DISORDER. 2940 02:06:12,796 --> 02:06:13,663 THE WHOLE BODY INCLUDES THE 2941 02:06:13,663 --> 02:06:16,666 ENVIRONMENT THE BODY IS LOCATED 2942 02:06:16,666 --> 02:06:16,900 IN. 2943 02:06:16,900 --> 02:06:22,939 SO, I WILL TURN IT OVER TO YOU, 2944 02:06:22,939 --> 02:06:24,908 JOAN, JUST TO MENTION THE MOMS 2945 02:06:24,908 --> 02:06:27,043 TOUR, A TWO-YEAR COMMUNITY BABY 2946 02:06:27,043 --> 02:06:28,979 SHOWER TOUR TARGETING 36 CITIES 2947 02:06:28,979 --> 02:06:31,114 ACROSS THE UNITED STATES, 2948 02:06:31,114 --> 02:06:33,416 REACHING UP TO 25,000 EXPECTANT 2949 02:06:33,416 --> 02:06:35,719 MOTHERS IN COMMUNITIES WITH HIGH 2950 02:06:35,719 --> 02:06:39,623 MATERNAL MORTALITY AND MORBIDITY 2951 02:06:39,623 --> 02:06:42,959 RATES. 2952 02:06:42,959 --> 02:06:46,162 IT'S ALL YOURS, JOAN. 2953 02:06:46,162 --> 02:06:46,997 >> I'M JOAN REMAIN. 2954 02:06:46,997 --> 02:06:47,998 IT'S AN HONOR AND PRIVILEGE TO 2955 02:06:47,998 --> 02:06:50,967 BE HERE TODAY TO TELL YOU ABOUT 2956 02:06:50,967 --> 02:06:53,670 A REALLY IMPORTANT AND EXCITING 2957 02:06:53,670 --> 02:06:56,940 INITIATIVE THAT'S FUNDED BY THE 2958 02:06:56,940 --> 02:06:57,541 DEPARTMENT OF HEALTH AND HUMAN 2959 02:06:57,541 --> 02:06:59,809 SERVICES, CENTER FOR FAITH BASED 2960 02:06:59,809 --> 02:07:02,345 AND NEIGHBORHOOD PARTNERSHIPS, 2961 02:07:02,345 --> 02:07:06,249 AS DR. KOOB SAID THE NAME IS THE 2962 02:07:06,249 --> 02:07:08,151 MATERNAL OUTCOMES MATTER, OR 2963 02:07:08,151 --> 02:07:08,952 MOMS TOUR. 2964 02:07:08,952 --> 02:07:10,320 AND I'M JUST REALLY HONORED TO 2965 02:07:10,320 --> 02:07:11,755 GET TO SPEAK WITH YOU ABOUT IT. 2966 02:07:11,755 --> 02:07:13,523 THE WAY I'M GOING TO FRAME MY 2967 02:07:13,523 --> 02:07:15,825 TIME WITH YOU TODAY IS BASICALLY 2968 02:07:15,825 --> 02:07:16,893 TO FOCUS ON THREE POINTS. 2969 02:07:16,893 --> 02:07:18,628 FIRST I'M GOING TO TELL YOU WHAT 2970 02:07:18,628 --> 02:07:19,663 THE MOMS TOUR IS. 2971 02:07:19,663 --> 02:07:22,165 THEN I'M GOING TO TELL YOU AND 2972 02:07:22,165 --> 02:07:23,533 SHARE WHAT NIAAA IS DOING. 2973 02:07:23,533 --> 02:07:25,635 THEN I'M GOING TO EMPHASIZE WHY 2974 02:07:25,635 --> 02:07:27,170 THIS IS IMPORTANT AND HOW WE 2975 02:07:27,170 --> 02:07:29,039 THINK THIS FURTHERS OUR GOALS, 2976 02:07:29,039 --> 02:07:30,340 PARTICULARLY RELATED TO WOMEN 2977 02:07:30,340 --> 02:07:33,843 AND GIRLS AND HEALTH 2978 02:07:33,843 --> 02:07:34,945 DISPARITIES. 2979 02:07:34,945 --> 02:07:35,679 SO BEFORE I BEGIN, FIRST 2980 02:07:35,679 --> 02:07:37,213 QUESTION, HOW MANY OF YOU HAVE 2981 02:07:37,213 --> 02:07:39,215 GONE TO A BABY SHOWER? 2982 02:07:39,215 --> 02:07:40,283 SHOW OF HANDS. 2983 02:07:40,283 --> 02:07:41,685 DON'T BE BASHFUL. 2984 02:07:41,685 --> 02:07:43,019 GREAT, THERE'S MEN AND WOMEN. 2985 02:07:43,019 --> 02:07:43,787 I LOVE THAT! 2986 02:07:43,787 --> 02:07:45,288 SO YOU HAVE AN IDEA OF WHAT 2987 02:07:45,288 --> 02:07:47,390 TAKES PLACE AT A BABY SHOWER, 2988 02:07:47,390 --> 02:07:47,724 RIGHT? 2989 02:07:47,724 --> 02:07:51,227 THEY ARE FUN, THERE'S GAMES, 2990 02:07:51,227 --> 02:07:52,896 FOOD, PRIZES, PRESENTS, AND IT'S 2991 02:07:52,896 --> 02:07:57,834 FOCUSED ON THE PREGNANT WOMAN, 2992 02:07:57,834 --> 02:07:58,034 RIGHT? 2993 02:07:58,034 --> 02:07:59,135 SECOND QUESTION HOW MANY OF YOU 2994 02:07:59,135 --> 02:08:03,640 HAVE GONE TO OR HEARD OF A MOMS 2995 02:08:03,640 --> 02:08:08,511 TOUR BABY SHOWER? 2996 02:08:08,511 --> 02:08:11,448 YAY! 2997 02:08:11,448 --> 02:08:12,816 THANK YOU, MY ESTEEMED 2998 02:08:12,816 --> 02:08:19,189 COLLEAGUES WHO PARTICIPATED IN 2999 02:08:19,189 --> 02:08:20,323 CALVETTON, MARYLAND. 3000 02:08:20,323 --> 02:08:22,659 THE ACRONYM STANDS FOR MATERNAL 3001 02:08:22,659 --> 02:08:23,660 OUTCOMES MATTERS SHOWER. 3002 02:08:23,660 --> 02:08:26,863 AND THIS IS A TWO-YEAR COMMUNITY 3003 02:08:26,863 --> 02:08:29,199 BABY SHOWER TOUR THAT STARTED 3004 02:08:29,199 --> 02:08:32,202 LAST YEAR KICKING OFF IN AUGUST 3005 02:08:32,202 --> 02:08:33,003 IN DETROIT, MICHIGAN. 3006 02:08:33,003 --> 02:08:36,973 AND IT'S GOING TO END THIS YEAR 3007 02:08:36,973 --> 02:08:40,243 ON NOVEMBER 23 IN PUERTO RICO. 3008 02:08:40,243 --> 02:08:41,678 IT'S TARGETING 36 CITIES ACROSS 3009 02:08:41,678 --> 02:08:44,814 AMERICA, WITH THE GOAL OF 3010 02:08:44,814 --> 02:08:46,983 REACHING UP TO 25,000 EXPECTANT 3011 02:08:46,983 --> 02:08:48,818 MOTHERS, IN COMMUNITIES WITH 3012 02:08:48,818 --> 02:08:50,020 HIGH MATERNAL MORTALITY AND 3013 02:08:50,020 --> 02:08:50,887 MORBIDITY RATES. 3014 02:08:50,887 --> 02:08:53,156 I'M NOT GOING TO READ THROUGH 3015 02:08:53,156 --> 02:08:54,891 ALL THE DIFFERENT PARTNERS THAT 3016 02:08:54,891 --> 02:08:58,962 ARE INVOLVED HERE BUT I SHARED 3017 02:08:58,962 --> 02:09:00,764 LOGOS OF SOME MAJOR PARTNERS SO 3018 02:09:00,764 --> 02:09:04,267 YOU CAN SEE THE COLLABORATION OF 3019 02:09:04,267 --> 02:09:06,970 BOTH FAITH GROUPS AND ACADEMIC 3020 02:09:06,970 --> 02:09:09,639 GROUPS AND NON-PROFITS AND 3021 02:09:09,639 --> 02:09:11,041 HEALTH SERVICE PROVIDERS. 3022 02:09:11,041 --> 02:09:12,676 AND ALSO FEDERAL GOVERNMENT. 3023 02:09:12,676 --> 02:09:15,412 I WILL POINT OUT THAT NIAAA IS 3024 02:09:15,412 --> 02:09:17,514 THE ONLY NIH INSTITUTE 3025 02:09:17,514 --> 02:09:19,015 PARTICIPATING IN THIS 3026 02:09:19,015 --> 02:09:19,315 INITIATIVE. 3027 02:09:19,315 --> 02:09:21,985 SO, WHAT DOES THIS INITIATIVE 3028 02:09:21,985 --> 02:09:22,218 DO? 3029 02:09:22,218 --> 02:09:24,254 IT BRINGS TOGETHER A MATRIX OF 3030 02:09:24,254 --> 02:09:25,488 PROFESSIONALS TO ADDRESS THE 3031 02:09:25,488 --> 02:09:25,722 PROBLEM. 3032 02:09:25,722 --> 02:09:27,357 I'LL TALK MORE ABOUT SPECIFIC 3033 02:09:27,357 --> 02:09:29,159 LIVE WHO THOSE PROFESSIONALS 3034 02:09:29,159 --> 02:09:29,325 ARE. 3035 02:09:29,325 --> 02:09:31,628 AND IT EDUCATES AND EMPOWERS 3036 02:09:31,628 --> 02:09:35,331 EXPECTANT MOMS AND NEW MOMS AND 3037 02:09:35,331 --> 02:09:37,867 DADS ON THIS ISSUE. 3038 02:09:37,867 --> 02:09:39,269 AND PERHAPS MOST IMPORTANTLY IT 3039 02:09:39,269 --> 02:09:40,804 LINKS THESE WOMEN TO SERVICES 3040 02:09:40,804 --> 02:09:41,604 AND SUPPORTS. 3041 02:09:41,604 --> 02:09:43,873 THIS IS NOT JUST TALKING ABOUT 3042 02:09:43,873 --> 02:09:44,174 THE PROBLEM. 3043 02:09:44,174 --> 02:09:46,509 THIS IS REALLY GOING TO WHERE 3044 02:09:46,509 --> 02:09:47,377 THE WOMEN ARE, MEETING THEM 3045 02:09:47,377 --> 02:09:49,279 WHERE THEY ARE AT AND LINKING 3046 02:09:49,279 --> 02:09:50,447 THEM TO SERVICES. 3047 02:09:50,447 --> 02:09:53,249 I'LL GIVE YOU SOME EXAMPLES OF 3048 02:09:53,249 --> 02:09:54,517 WHAT THOSE SERVICES ARE. 3049 02:09:54,517 --> 02:09:56,152 THE GOAL IS TO MAKE THE UNITED 3050 02:09:56,152 --> 02:09:58,555 STATES ONE OF THE SAFEST 3051 02:09:58,555 --> 02:10:01,057 COUNTRIES FOR WOMEN TO GIVE 3052 02:10:01,057 --> 02:10:02,125 BIRTH. 3053 02:10:02,125 --> 02:10:03,827 AND THIS MATERNAL HEALTH FOCUS 3054 02:10:03,827 --> 02:10:06,429 WE'VE ALREADY HEARD IS A 3055 02:10:06,429 --> 02:10:07,630 PRIORITY FOR THIS 3056 02:10:07,630 --> 02:10:08,231 ADMINISTRATION. 3057 02:10:08,231 --> 02:10:10,800 AND IT'S TO REDUCE UNACCEPTABLY 3058 02:10:10,800 --> 02:10:13,970 HIGH MATERNAL MORTALITY AND 3059 02:10:13,970 --> 02:10:15,939 MORBIDITY RATES IN THE UNITED 3060 02:10:15,939 --> 02:10:17,273 STATES ESPECIALLY AMONG BLACK 3061 02:10:17,273 --> 02:10:18,441 AND AMERICAN INDIAN AND ALASKA 3062 02:10:18,441 --> 02:10:20,210 NATIVE MOMS. 3063 02:10:20,210 --> 02:10:22,178 LOOK AT THIS STATISTIC HERE. 3064 02:10:22,178 --> 02:10:27,317 BLACK WOMEN ARE THREE TIMES MORE 3065 02:10:27,317 --> 02:10:29,219 LIKELY AND AMERICAN INDIAN 3066 02:10:29,219 --> 02:10:30,286 ALASKA NATIVE WOMEN TWO TIMES 3067 02:10:30,286 --> 02:10:33,256 MORE LIKELY TO DIE FROM 3068 02:10:33,256 --> 02:10:34,858 PREGNANCY-RELATED CAUSES THAN 3069 02:10:34,858 --> 02:10:35,959 WHITE WOMEN. 3070 02:10:35,959 --> 02:10:40,363 AND OVER 80% OF THOSE DEATHS ARE 3071 02:10:40,363 --> 02:10:42,031 PREVENTIBLE. 3072 02:10:42,031 --> 02:10:43,833 SO LET'S GET INTO IT. 3073 02:10:43,833 --> 02:10:45,802 ON THE RIGHT YOU'LL SEE A 3074 02:10:45,802 --> 02:10:47,604 DEPICTION, I COULDN'T FIT THE 3075 02:10:47,604 --> 02:10:48,738 WHOLE SCREEN SHOT SO IT'S THE 3076 02:10:48,738 --> 02:10:50,874 TOP OF THE WEBSITE AND THEN THE 3077 02:10:50,874 --> 02:10:52,909 BOTTOM JUST TO SHOW YOU. 3078 02:10:52,909 --> 02:10:54,844 AND WHO IS INVOLVED IN THESE 3079 02:10:54,844 --> 02:10:55,178 EVENTS? 3080 02:10:55,178 --> 02:10:56,746 THE BEST WAY TO DESCRIBE 3081 02:10:56,746 --> 02:10:58,314 IMAGINING THE EVENT IS SAY 3082 02:10:58,314 --> 02:11:00,250 YOU'RE AT A SCIENTIFIC 3083 02:11:00,250 --> 02:11:01,785 CONFERENCE, YOU GO TO THE 3084 02:11:01,785 --> 02:11:03,386 EXHIBIT HALL, ALL THESE TABLES 3085 02:11:03,386 --> 02:11:04,888 OF BOOTHS AROUND THE ROOM. 3086 02:11:04,888 --> 02:11:07,490 PERHAPS IN THE CENTER OF THAT 3087 02:11:07,490 --> 02:11:09,826 EXHIBIT HALL THERE'S TABLES OR 3088 02:11:09,826 --> 02:11:10,693 CHAIRS DECORATED WITH BABY 3089 02:11:10,693 --> 02:11:11,694 SHOWER THEMES. 3090 02:11:11,694 --> 02:11:13,863 AND THERE'S AN AREA FOR A PANEL 3091 02:11:13,863 --> 02:11:18,401 OF SPEAKERS TO DO EDUCATIONAL 3092 02:11:18,401 --> 02:11:19,469 PANELS FOR THE WOMEN. 3093 02:11:19,469 --> 02:11:22,739 AT EACH OF THESE EVENTS 3094 02:11:22,739 --> 02:11:24,207 PARTICIPANTS ARE MOMS AND DAD, 3095 02:11:24,207 --> 02:11:25,008 SOMETIMES THEIR KIDS. 3096 02:11:25,008 --> 02:11:26,176 THEY ARE REGISTER FOR THE EVENT 3097 02:11:26,176 --> 02:11:28,645 OR WALK IN FROM THE STREET. 3098 02:11:28,645 --> 02:11:30,180 THERE ARE VOLUNTEERS FROM THE 3099 02:11:30,180 --> 02:11:31,781 LOCAL COMMUNITIES THAT ENSURE 3100 02:11:31,781 --> 02:11:32,715 EVERYTHING GOES SMOOTHLY DURING 3101 02:11:32,715 --> 02:11:34,284 THE EVENT. 3102 02:11:34,284 --> 02:11:34,884 AND THERE'S HUNDREDS OF 3103 02:11:34,884 --> 02:11:36,853 PARTICIPANTS WHO GO TO THESE 3104 02:11:36,853 --> 02:11:39,189 EVENTS, FOR EXAMPLE THE EVENT 3105 02:11:39,189 --> 02:11:41,457 HELD IN BOSTON HAD OVER 300 3106 02:11:41,457 --> 02:11:42,125 PEOPLE ATTEND. 3107 02:11:42,125 --> 02:11:45,061 EVENTS WE'VE GONE TO IN MARYLAND 3108 02:11:45,061 --> 02:11:46,596 HAVE PROBABLY TWO OR THREE 3109 02:11:46,596 --> 02:11:50,266 HUNDRED PEOPLE ATTEND AS WELL. 3110 02:11:50,266 --> 02:11:54,003 DR. DEIDRA ROACH AND I JUST GOT 3111 02:11:54,003 --> 02:11:56,206 BACK FROM WILMINGTON EVENT 3112 02:11:56,206 --> 02:11:58,741 SATURDAY, UPWARDS OF 200 PEOPLE. 3113 02:11:58,741 --> 02:12:00,243 THERE ARE ALSO PANELISTS. 3114 02:12:00,243 --> 02:12:04,747 THESE ARE THE HEALTH CARE 3115 02:12:04,747 --> 02:12:05,081 PROFESSIONALS. 3116 02:12:05,081 --> 02:12:06,449 OB/GYNs, MIDWIVES, DOULAS, 3117 02:12:06,449 --> 02:12:07,317 WOMEN WITH LIVED EXPERIENCES, 3118 02:12:07,317 --> 02:12:08,918 THERE ARE MENTAL HEALTH 3119 02:12:08,918 --> 02:12:10,720 THERAPISTS THERE AND THEY ARE 3120 02:12:10,720 --> 02:12:12,121 TALKING WITH THE AUDIENCE. 3121 02:12:12,121 --> 02:12:14,691 EDUCATING THEM ON HOW TO 3122 02:12:14,691 --> 02:12:17,727 ADVOCATE FOR THEMSELVES, GIVING 3123 02:12:17,727 --> 02:12:18,628 THEM INFORMATION, FOR EXAMPLE, 3124 02:12:18,628 --> 02:12:20,196 ON BLACK BIRTHING BILL OF 3125 02:12:20,196 --> 02:12:22,098 RIGHTS, TEACHES WOMEN THEY HAVE 3126 02:12:22,098 --> 02:12:23,933 A SAY IN THEIR MEDICAL CARE. 3127 02:12:23,933 --> 02:12:25,869 THEY CAN FIRE A DOCTOR THAT 3128 02:12:25,869 --> 02:12:29,005 ISN'T LISTENING TO THEM OR 3129 02:12:29,005 --> 02:12:30,807 RESPECTING THEM. 3130 02:12:30,807 --> 02:12:32,809 IT'S REALLY, REALLY JUST A 3131 02:12:32,809 --> 02:12:34,043 WONDERFUL THING TO SEE. 3132 02:12:34,043 --> 02:12:36,446 THERE ARE EXHIBITORS SUCH AS 3133 02:12:36,446 --> 02:12:41,784 NIAAA BOOTH, AND THEY ALSO HAVE 3134 02:12:41,784 --> 02:12:43,887 POP-UP CLINICS, IN CALVERTON, 3135 02:12:43,887 --> 02:12:46,189 MARYLAND, FOR EXAMPLE DOING 3136 02:12:46,189 --> 02:12:48,625 SONOGRAMS AND VACCINATIONS ON 3137 02:12:48,625 --> 02:12:50,693 SITE AT THE CHURCH. 3138 02:12:50,693 --> 02:12:51,995 AND THERE'S ALSO WHAT'S 3139 02:12:51,995 --> 02:12:53,396 WONDERFUL TO ADDRESS THIS 3140 02:12:53,396 --> 02:12:56,566 PROBLEM IS THEY HAVE FINANCIAL 3141 02:12:56,566 --> 02:12:59,636 SUPPORT TO REGISTER AND TRAIN 3142 02:12:59,636 --> 02:13:01,204 BLACK DOULAS FROM THE COMMUNITY, 3143 02:13:01,204 --> 02:13:02,839 AND WILL STAY VESTED IN THE 3144 02:13:02,839 --> 02:13:06,042 COMMUNITY AND HELP THOSE WOMEN 3145 02:13:06,042 --> 02:13:10,780 THROUGH THE BIRTHING PROCESS. 3146 02:13:10,780 --> 02:13:13,650 THE MOM'S LOUNGE, DAD'S DEN AND 3147 02:13:13,650 --> 02:13:15,952 KIDS CORNER, THE MOMS WITH BE 3148 02:13:15,952 --> 02:13:17,720 WITH WOMEN, DADS WITH OTHER MEN 3149 02:13:17,720 --> 02:13:19,923 AND TALK ABOUT THEIR ANXIETY OR 3150 02:13:19,923 --> 02:13:21,958 QUESTIONS ABOUT BEING A DAD, AND 3151 02:13:21,958 --> 02:13:23,860 THEN VOLUNTEERS IN ANOTHER ROOM 3152 02:13:23,860 --> 02:13:25,728 WITH KIDS READING BOOKS TO THEM, 3153 02:13:25,728 --> 02:13:28,998 DOING ARTS AND CRAFTS SO MOM AND 3154 02:13:28,998 --> 02:13:30,867 DAD WITH ATTEND TO THE LEARNING. 3155 02:13:30,867 --> 02:13:32,702 JUST LIKE REGULAR BABY SHOWER, 3156 02:13:32,702 --> 02:13:35,471 THEY GET A NICE FREE LUNCH, 3157 02:13:35,471 --> 02:13:40,677 THERE'S MUSIC, THERE'S GAMES, 3158 02:13:40,677 --> 02:13:44,614 THERE'S RAFFLES, A FUN GREAT 3159 02:13:44,614 --> 02:13:45,915 EVENT, SERVING THOSE AT GREATEST 3160 02:13:45,915 --> 02:13:46,316 RISK. 3161 02:13:46,316 --> 02:13:48,351 THIS IS JUST TO GIVE A SCHEDULE 3162 02:13:48,351 --> 02:13:50,486 OF WHERE THE EVENTS HAVE TAKEN 3163 02:13:50,486 --> 02:13:51,854 PLACE OVER THE LAST YEAR AND 3164 02:13:51,854 --> 02:13:53,056 WHERE THEY ARE GOING TO BE 3165 02:13:53,056 --> 02:13:53,990 COMING UP. 3166 02:13:53,990 --> 02:13:55,091 I WOULD ENCOURAGE YOU IF YOU CAN 3167 02:13:55,091 --> 02:13:58,461 TO GO TO ONE OF THESE EVENTS, IF 3168 02:13:58,461 --> 02:13:59,862 IT'S NEAR YOU. 3169 02:13:59,862 --> 02:14:00,730 HAPPY TO PROVIDE MORE 3170 02:14:00,730 --> 02:14:01,397 INFORMATION. 3171 02:14:01,397 --> 02:14:03,366 CAN YOU GO TO THE WEBSITE AND 3172 02:14:03,366 --> 02:14:07,904 REGISTER OR JUST WALK IN. 3173 02:14:07,904 --> 02:14:10,106 I KNOW THIS IS A BUSY SLIDE BUT 3174 02:14:10,106 --> 02:14:12,108 I WANTED TO KIND OF JUST FOCUS 3175 02:14:12,108 --> 02:14:14,544 ON THE AGENDA, EACH OF THESE 3176 02:14:14,544 --> 02:14:16,713 EVENTS HAS BEEN BASICALLY THE 3177 02:14:16,713 --> 02:14:19,215 SAME FORMAT. 3178 02:14:19,215 --> 02:14:22,251 THEY GO FROM ELEVEN TO TWO, FOUR 3179 02:14:22,251 --> 02:14:23,486 KEY COMPONENTS, ALL HAVE 3180 02:14:23,486 --> 02:14:25,989 EXHIBITORS, ALL HAVE A PRESS 3181 02:14:25,989 --> 02:14:28,191 CONFERENCE, ALL HAVE TWO 3182 02:14:28,191 --> 02:14:29,092 EDUCATIONAL PANELS, ONE FOR 3183 02:14:29,092 --> 02:14:31,227 MATERNAL AND MENTAL HEALTH, ONE 3184 02:14:31,227 --> 02:14:31,761 FOR MATERNAL OUTCOMES. 3185 02:14:31,761 --> 02:14:33,629 SO THE TYPES OF THINGS THEY ARE 3186 02:14:33,629 --> 02:14:37,633 TALKING WITH THE WOMEN ABOUT ARE 3187 02:14:37,633 --> 02:14:41,070 THINGS LIKE DEPRESSION, THINGS 3188 02:14:41,070 --> 02:14:44,307 LIKE HYPERTENSION, THINGS LIKE 3189 02:14:44,307 --> 02:14:45,641 PREECLAMPSIA, THINGS LIKE ALL 3190 02:14:45,641 --> 02:14:46,909 KINDS OF THINGS, GETTING 3191 02:14:46,909 --> 02:14:51,748 YOURSELF A DOULA, GETTING A 3192 02:14:51,748 --> 02:14:51,981 MIDWIFE. 3193 02:14:51,981 --> 02:14:55,051 AND THERE'S A LOT OF POLITICAL 3194 02:14:55,051 --> 02:14:56,285 INVOLVEMENT AS WELL, DIFFERENT 3195 02:14:56,285 --> 02:14:57,120 CONGRESSIONAL REPRESENTATIVES, 3196 02:14:57,120 --> 02:14:58,287 DIFFERENT STATE AND LOCAL 3197 02:14:58,287 --> 02:15:00,123 REPRESENTATIVES ARE THERE. 3198 02:15:00,123 --> 02:15:02,158 AND THE PRESS CONFERENCE IS TO 3199 02:15:02,158 --> 02:15:04,427 GET AWARENESS OUT ABOUT THIS 3200 02:15:04,427 --> 02:15:07,697 ISSUE AND TO EDUCATE EVEN THE 3201 02:15:07,697 --> 02:15:10,366 LARGER COMMUNITY FOR THOSE THAT 3202 02:15:10,366 --> 02:15:11,667 ARE NOT THERE. 3203 02:15:11,667 --> 02:15:15,104 SO WHAT IS NIAAA DOING? 3204 02:15:15,104 --> 02:15:16,672 WELL, BASICALLY DR. DEIDRA ROACH 3205 02:15:16,672 --> 02:15:18,508 AND I ARE SEARCHING ON THE 3206 02:15:18,508 --> 02:15:19,709 EXECUTIVE PLANNING COMMITTEE OF 3207 02:15:19,709 --> 02:15:20,510 THESE EVENTS. 3208 02:15:20,510 --> 02:15:21,978 THAT MEANS WE SIT ON AS MANY 3209 02:15:21,978 --> 02:15:24,347 CALLS AS WE CAN AND THERE CAN BE 3210 02:15:24,347 --> 02:15:26,049 UP TO SIX CALLS A WEEK, FOR 3211 02:15:26,049 --> 02:15:29,819 THESE EVENTS TO GIVE INPUT ON 3212 02:15:29,819 --> 02:15:31,821 MAKING SURE THEY ARE GETTING 3213 02:15:31,821 --> 02:15:33,589 PANELISTS, MAKING SURE THEY ARE 3214 02:15:33,589 --> 02:15:35,992 THINKING OF DIFFERENT PEOPLE TO 3215 02:15:35,992 --> 02:15:37,894 HAVE AS EXHIBITORS AT THESE 3216 02:15:37,894 --> 02:15:38,394 EVENTS. 3217 02:15:38,394 --> 02:15:41,397 WE ARE BRINGING THE BOOTH TO 3218 02:15:41,397 --> 02:15:44,233 SOME OF THESE EVENTS, AND WHEN 3219 02:15:44,233 --> 02:15:45,401 WE'RE AT THOSE EVENTS WE'VE BEEN 3220 02:15:45,401 --> 02:15:47,670 TO TWO OF THEM SO FAR, WE'RE 3221 02:15:47,670 --> 02:15:49,272 TALKING WITH THE ATTENDEES. 3222 02:15:49,272 --> 02:15:52,475 WE'RE GIVING OUT OUR MATERIALS. 3223 02:15:52,475 --> 02:15:54,911 WE HAVE NIAAA ALCOHOL TREATMENT 3224 02:15:54,911 --> 02:15:57,580 NAVIGATOR IPAD THERE AND PEOPLE 3225 02:15:57,580 --> 02:15:59,482 HOW TO USE IT AND IDENTIFY WHERE 3226 02:15:59,482 --> 02:16:01,217 TO FIND TREATMENT. 3227 02:16:01,217 --> 02:16:02,752 OFTEN WE'LL HEAR FROM MOMS, YOU 3228 02:16:02,752 --> 02:16:04,420 KNOW, I DON'T DRINK, BUT MY 3229 02:16:04,420 --> 02:16:04,987 UNCLE DOES. 3230 02:16:04,987 --> 02:16:07,156 OR, YOU KNOW, I DON'T NEED THIS, 3231 02:16:07,156 --> 02:16:09,292 BUT MY HUSBAND DOES. 3232 02:16:09,292 --> 02:16:10,793 OR MY BOYFRIEND DOES. 3233 02:16:10,793 --> 02:16:13,696 AND SO WE'RE GIVING OUT OUR 3234 02:16:13,696 --> 02:16:16,666 INFORMATION WITH OUR RESOURCES 3235 02:16:16,666 --> 02:16:18,501 AND OUR RESEARCH FINDINGS. 3236 02:16:18,501 --> 02:16:19,836 WHEN WE'RE NOT ATTENDING THE 3237 02:16:19,836 --> 02:16:23,739 EVENTS, WHAT WE ARE DOING IS 3238 02:16:23,739 --> 02:16:24,740 INCLUDING NIAAA INFORMATION ON A 3239 02:16:24,740 --> 02:16:26,609 RESOURCE LIST THAT EVERY SINGLE 3240 02:16:26,609 --> 02:16:26,976 ATTENDEE GETS. 3241 02:16:26,976 --> 02:16:29,879 SO IT WILL TALK ABOUT OUR 3242 02:16:29,879 --> 02:16:30,980 INSTITUTE, WILL GIVE INFORMATION 3243 02:16:30,980 --> 02:16:33,716 FOR OUR WEBSITE, INFORMATION TO 3244 02:16:33,716 --> 02:16:34,484 E-MAIL, INFORMATION TO CALL, 3245 02:16:34,484 --> 02:16:36,452 INFORMATION FOR ALL OF OUR 3246 02:16:36,452 --> 02:16:36,786 SOCIAL MEDIA. 3247 02:16:36,786 --> 02:16:39,155 SO THAT YOU KNOW WHERE THEY CAN 3248 02:16:39,155 --> 02:16:39,956 GET THIS INFORMATION. 3249 02:16:39,956 --> 02:16:42,158 AND THEN ALSO WE'RE HELPING TO 3250 02:16:42,158 --> 02:16:44,460 PROMOTE THE EVENT, USING OUR 3251 02:16:44,460 --> 02:16:47,463 COMMUNICATION TO HELP PUSH OUT 3252 02:16:47,463 --> 02:16:50,166 THE REGISTRATION FLYERS FOR 3253 02:16:50,166 --> 02:16:52,602 THESE EVENTS AND CREATE 3254 02:16:52,602 --> 02:16:53,669 AWARENESS FOR THEM. 3255 02:16:53,669 --> 02:16:56,405 THIS IS JUST TO SHOW SOME 3256 02:16:56,405 --> 02:16:58,808 EXAMPLES OF THE TYPES OF THINGS 3257 02:16:58,808 --> 02:17:02,645 WE'RE DISTRIBUTING AT THESE 3258 02:17:02,645 --> 02:17:04,013 EVENTS. 3259 02:17:04,013 --> 02:17:07,116 IN ENGLISH AND SPANISH, I'VE 3260 02:17:07,116 --> 02:17:10,686 ONLY INCLUDED THE ENGLISH HERE. 3261 02:17:10,686 --> 02:17:10,987 LASTLY, WHY. 3262 02:17:10,987 --> 02:17:12,021 WHY IS THIS IMPORTANT AND HOW 3263 02:17:12,021 --> 02:17:13,289 DOES THIS FURTHER OUR GOALS 3264 02:17:13,289 --> 02:17:14,357 PARTICULARLY RELATED TO WOMEN 3265 02:17:14,357 --> 02:17:15,992 AND GIRLS AND HEALTH 3266 02:17:15,992 --> 02:17:16,392 DISPARITIES. 3267 02:17:16,392 --> 02:17:17,660 I THINK IT'S OBVIOUS, YOU KNOW, 3268 02:17:17,660 --> 02:17:20,129 THIS EXTENDS THE REACH OF WHAT 3269 02:17:20,129 --> 02:17:22,265 WE'RE DOING TO MINORITY WOMEN 3270 02:17:22,265 --> 02:17:24,167 AND DADS AND CHILDREN IN 3271 02:17:24,167 --> 02:17:27,170 COMMUNITIES WHERE THEY LIVE, 3272 02:17:27,170 --> 02:17:28,004 WHERE THERE'S HEALTH 3273 02:17:28,004 --> 02:17:28,938 DISPARITIES, AND, YOU KNOW, 3274 02:17:28,938 --> 02:17:31,040 WHERE THEY MIGHT NOT OTHERWISE 3275 02:17:31,040 --> 02:17:32,742 BE GETTING THIS INFORMATION. 3276 02:17:32,742 --> 02:17:35,144 IT GENERATES PUBLICITY AND 3277 02:17:35,144 --> 02:17:36,145 CREATES AWARENESS FOR NIAAA AND 3278 02:17:36,145 --> 02:17:37,280 OUR WORK. 3279 02:17:37,280 --> 02:17:39,482 IT PROMOTES OUR RESEARCH 3280 02:17:39,482 --> 02:17:39,749 FINDINGS. 3281 02:17:39,749 --> 02:17:43,452 IT IMPROVES ACCESS TO OUR 3282 02:17:43,452 --> 02:17:43,920 INFORMATION. 3283 02:17:43,920 --> 02:17:44,921 WE'RE ALSO SHOWING FOR EXAMPLE 3284 02:17:44,921 --> 02:17:47,323 THE DELAWARE SITE I HAD MY 3285 02:17:47,323 --> 02:17:53,095 LAPTOP SHOWING THE HEALTH CARE 3286 02:17:53,095 --> 02:17:53,930 PROVIDERS THERE THE CORE 3287 02:17:53,930 --> 02:17:57,166 RESOURCE BECAUSE THERE ARE 3288 02:17:57,166 --> 02:17:57,767 DOULAS, NURSES, MIDWIVES THERE 3289 02:17:57,767 --> 02:17:58,801 THAT DON'T KNOW ABOUT THIS. 3290 02:17:58,801 --> 02:18:01,337 I WAS GOING THROUGH IT WITH 3291 02:18:01,337 --> 02:18:01,637 THEM. 3292 02:18:01,637 --> 02:18:03,606 IT ALSO FOSTERS RELATIONSHIP 3293 02:18:03,606 --> 02:18:04,840 BUILDING AND GOODWILL AMONG 3294 02:18:04,840 --> 02:18:06,876 OTHER PARTNERS, THESE ARE WITH 3295 02:18:06,876 --> 02:18:08,244 OUR OTHER EXECUTIVE PLANNING 3296 02:18:08,244 --> 02:18:09,979 COMMITTEE MEMBERS, COMMUNITY 3297 02:18:09,979 --> 02:18:11,414 GROUPS AND MEMBERS, THE OTHER 3298 02:18:11,414 --> 02:18:12,215 EXHIBITORS, THE OTHER 3299 02:18:12,215 --> 02:18:13,883 VOLUNTEERS. 3300 02:18:13,883 --> 02:18:14,717 I WAS JUST MENTIONING THAT 3301 02:18:14,717 --> 02:18:16,118 HAVING BEEN THERE ON SATURDAY, 3302 02:18:16,118 --> 02:18:20,556 WE HAD TWO PEOPLE FROM THE 3303 02:18:20,556 --> 02:18:21,457 WILMINGTON DEPARTMENT AND REC, 3304 02:18:21,457 --> 02:18:24,327 TELL US WE'RE HAVING ANOTHER 3305 02:18:24,327 --> 02:18:25,261 EVENT IN AUGUST, WE WANT YOU TO 3306 02:18:25,261 --> 02:18:27,096 COME BACK WITH YOUR NIAAA BOOTH. 3307 02:18:27,096 --> 02:18:33,236 I THINK THESE ARE JUST 3308 02:18:33,236 --> 02:18:33,636 WONDERFUL. 3309 02:18:33,636 --> 02:18:35,471 THIS NEXT SLIDE I WANTED TO 3310 02:18:35,471 --> 02:18:38,107 SHARE BECAUSE THESE ARE FLYERS, 3311 02:18:38,107 --> 02:18:39,742 WHAT GETS SENT OUT TO INVITE 3312 02:18:39,742 --> 02:18:41,444 PEOPLE TO REGISTER. 3313 02:18:41,444 --> 02:18:44,547 WHAT REALLY, REALLY IMPRESSES ME 3314 02:18:44,547 --> 02:18:46,782 ABOUT THIS INITIATIVE IS THAT 3315 02:18:46,782 --> 02:18:47,883 THEY REALLY COMMUNICATE TO THE 3316 02:18:47,883 --> 02:18:49,318 AUDIENCES THEY ARE TRYING TO 3317 02:18:49,318 --> 02:18:49,585 REACH. 3318 02:18:49,585 --> 02:18:51,954 FOR EXAMPLE, WHEN THEY WENT TO 3319 02:18:51,954 --> 02:18:54,056 BOSTON THERE WAS A LARGE HAITIAN 3320 02:18:54,056 --> 02:18:55,324 CREOLE POPULATION. 3321 02:18:55,324 --> 02:18:56,892 IN ADDITION TO ENGLISH AND 3322 02:18:56,892 --> 02:19:04,900 SPANISH THEY HAD EVERYTHING 3323 02:19:04,900 --> 02:19:07,970 TRANSLATED IN HAITIAN CREOLE. 3324 02:19:07,970 --> 02:19:09,672 YOU CAN SEE RESOURCES AND PRIZES 3325 02:19:09,672 --> 02:19:11,607 WOMEN GET, LIKE A BABY SHOWER. 3326 02:19:11,607 --> 02:19:13,609 THEY HAVE TO VISIT EACH BOOTH, 3327 02:19:13,609 --> 02:19:14,910 GET IT CHECKED OFF, GET PRIZEs 3328 02:19:14,910 --> 02:19:15,811 AT THE END. 3329 02:19:15,811 --> 02:19:24,654 THEY ARE GETTING CAR SEATS, BOPY 3330 02:19:24,654 --> 02:19:25,454 PILLOWS, STROLLERS, DIAPERS, 3331 02:19:25,454 --> 02:19:25,955 WIPES, PRACTICAL THINGS. 3332 02:19:25,955 --> 02:19:29,458 I'D LIKE TO THANK MY ESTEEMED 3333 02:19:29,458 --> 02:19:30,893 COLLEAGUES LISTED HERE AND SHOWN 3334 02:19:30,893 --> 02:19:31,627 HERE WHO VOLUNTEERED THEIR 3335 02:19:31,627 --> 02:19:34,130 SATURDAY TO COME OUT FOR THE 3336 02:19:34,130 --> 02:19:35,097 CALVERTON, MARYLAND, EVENT. 3337 02:19:35,097 --> 02:19:37,500 I'M SURE THEY COULD ALSO SHARE 3338 02:19:37,500 --> 02:19:38,801 THEIR EXPERIENCES OF HOW THIS 3339 02:19:38,801 --> 02:19:41,437 WAS BUT YOU CAN SEE IT WAS IN A 3340 02:19:41,437 --> 02:19:41,704 BALLROOM. 3341 02:19:41,704 --> 02:19:43,873 WE WERE ON THE PERIMETER OF THE 3342 02:19:43,873 --> 02:19:44,440 BALLROOM. 3343 02:19:44,440 --> 02:19:46,676 THAT'S WHERE THE EVENT TOOK 3344 02:19:46,676 --> 02:19:47,376 PLACE. 3345 02:19:47,376 --> 02:19:48,311 HERE ARE SOME ADDITIONAL PHOTOS 3346 02:19:48,311 --> 02:19:49,111 OF THAT EVENT. 3347 02:19:49,111 --> 02:19:51,981 YOU CAN SEE THE PANELISTS UP 3348 02:19:51,981 --> 02:19:53,516 TOP, SPEAKING WITH THE AUDIENCE. 3349 02:19:53,516 --> 02:19:58,254 YOU CAN SEE SOME OF THE 3350 02:19:58,254 --> 02:20:00,456 ENGAGEMENTS, DR. ROACH SHOWING A 3351 02:20:00,456 --> 02:20:02,325 PARTICIPANT, A DAD, HOW TO USE 3352 02:20:02,325 --> 02:20:04,994 ALCOHOL TREATMENT NAVIGATOR 3353 02:20:04,994 --> 02:20:05,428 WEBSITE. 3354 02:20:05,428 --> 02:20:07,296 WE IDENTIFIED AT THE LAST MINUTE 3355 02:20:07,296 --> 02:20:09,465 WHEN A NEED CAME UP AN EXPERT 3356 02:20:09,465 --> 02:20:12,001 SPEAKER FROM HOPKINS, A NURSE 3357 02:20:12,001 --> 02:20:13,569 MIDWIFE, WHO SPOKE ON THE PANEL 3358 02:20:13,569 --> 02:20:15,504 FOR THIS EVENT. 3359 02:20:15,504 --> 02:20:18,941 AND FINALLY IN SUMMARY THESE ARE 3360 02:20:18,941 --> 02:20:20,810 REALLY IMPORTANT AND IMPACTFUL 3361 02:20:20,810 --> 02:20:22,745 EVENTS THAT ARE TARGETING A HIGH 3362 02:20:22,745 --> 02:20:24,580 PRIORITY AREA FOR THIS 3363 02:20:24,580 --> 02:20:24,947 ADMINISTRATION. 3364 02:20:24,947 --> 02:20:27,650 AND OUR ABILITY IS REALLY 3365 02:20:27,650 --> 02:20:27,883 UNIQUE. 3366 02:20:27,883 --> 02:20:29,185 OUR ABILITY TO PARTICIPATE IN 3367 02:20:29,185 --> 02:20:31,053 THESE, AS I MENTIONED, WE'RE THE 3368 02:20:31,053 --> 02:20:37,626 ONLY NIH INSTITUTES 3369 02:20:37,626 --> 02:20:38,761 PARTICIPATING, BASED ON PRIOR 3370 02:20:38,761 --> 02:20:39,695 RELATIONSHIP WITH DR. ENGLISH 3371 02:20:39,695 --> 02:20:48,237 AND THAT OFFICE. 3372 02:20:48,237 --> 02:20:49,739 INEXPENSIVE, STAFF TIME, AND 3373 02:20:49,739 --> 02:20:52,208 PARTNERING WITH DEPARTMENT OF 3374 02:20:52,208 --> 02:20:53,209 HEALTH AND HUMAN SERVICES WITH 3375 02:20:53,209 --> 02:20:55,144 APPROVAL FROM THE WHITE HOUSE. 3376 02:20:55,144 --> 02:20:56,979 OUR INVOLVEMENT ALLOWS US TO 3377 02:20:56,979 --> 02:20:58,981 EXPAND OUR AWARENESS AND 3378 02:20:58,981 --> 02:21:00,850 EDUCATION AND OUTREACH 3379 02:21:00,850 --> 02:21:02,051 ACTIVITIES, TO HIGH PRIORITY 3380 02:21:02,051 --> 02:21:05,454 POPULATION AND THESE ARE IN 3381 02:21:05,454 --> 02:21:08,758 URBAN AND RURAL SITES ADDRESSING 3382 02:21:08,758 --> 02:21:11,026 HEALTH DISPARITIES AND MATERNAL 3383 02:21:11,026 --> 02:21:15,164 MORBIDITY AND MORTALITY PROBLEM. 3384 02:21:15,164 --> 02:21:16,031 PARTICULARLY IN MINORITY 3385 02:21:16,031 --> 02:21:17,333 AUDIENCES, AND ONE OF THE KEY 3386 02:21:17,333 --> 02:21:18,434 MESSAGES WE TRIED TO GET TO THE 3387 02:21:18,434 --> 02:21:19,335 WOMEN WHEN WE HAVE THEIR 3388 02:21:19,335 --> 02:21:22,371 ATTENTION AT THE TABLE IS THAT 3389 02:21:22,371 --> 02:21:24,940 THERE'S NO SAFE LEVEL OF ALCOHOL 3390 02:21:24,940 --> 02:21:26,142 FOR WHEN YOU'RE PREGNANT. 3391 02:21:26,142 --> 02:21:29,645 WE ONLY HAVE A FEW SECONDS. 3392 02:21:29,645 --> 02:21:33,482 AND THEN THIS JUST ALLOWS US TO 3393 02:21:33,482 --> 02:21:36,385 SHARE OUR IMPORTANT RESOURCES 3394 02:21:36,385 --> 02:21:39,422 WITH, YOU KNOW, HUNDREDS, 3395 02:21:39,422 --> 02:21:40,356 HUNDREDS OF PEOPLE. 3396 02:21:40,356 --> 02:21:42,491 I WOULD LIKE TO THANK THE 3397 02:21:42,491 --> 02:21:43,759 INDIVIDUALS LISTED HERE WHO HAVE 3398 02:21:43,759 --> 02:21:46,929 BEEN A GREAT SUPPORT TO THIS 3399 02:21:46,929 --> 02:21:50,866 PROGRAM AND/OR HAVE PARTICIPATED 3400 02:21:50,866 --> 02:21:53,169 IN THIS INITIATIVE. 3401 02:21:53,169 --> 02:21:54,570 AND LASTLY JUST A PARTING 3402 02:21:54,570 --> 02:21:58,874 THOUGHT OF MY OWN, WHEN I WAS AT 3403 02:21:58,874 --> 02:22:00,743 THE CALVERTON, MARYLAND, EVENT, 3404 02:22:00,743 --> 02:22:02,778 IN THE BALLROOM I SAW IT FILLED 3405 02:22:02,778 --> 02:22:05,448 WITH BLACK AND BROWN WOMEN. 3406 02:22:05,448 --> 02:22:07,283 AND IT REMINDED ME TO 30 YEARS 3407 02:22:07,283 --> 02:22:14,023 AGO WHEN I WAS A PEACE CORPS 3408 02:22:14,023 --> 02:22:16,692 VOLUNTEER IN GABON. 3409 02:22:16,692 --> 02:22:20,262 I'LL SPARE YOU THE FRENCH 3410 02:22:20,262 --> 02:22:20,729 PRONUNCIATION. 3411 02:22:20,729 --> 02:22:22,531 THERE'S A PROVERB WHEN WORKING 3412 02:22:22,531 --> 02:22:24,233 IN WOMEN IN DEVELOPMENT IN 3413 02:22:24,233 --> 02:22:25,334 AFRICA, NOT A PROVERB, JUST A 3414 02:22:25,334 --> 02:22:25,835 PHRASE. 3415 02:22:25,835 --> 02:22:28,304 IT IS TO TEACH A WOMAN IS TO 3416 02:22:28,304 --> 02:22:29,939 EDUCATE A NATION. 3417 02:22:29,939 --> 02:22:31,140 AND THIS IS REALLY WHAT I FELT 3418 02:22:31,140 --> 02:22:33,442 WHEN I SAW ALL THOSE WOMEN IN 3419 02:22:33,442 --> 02:22:36,312 THAT BALLROOM. 3420 02:22:36,312 --> 02:22:44,487 THANK YOU. 3421 02:22:44,487 --> 02:22:48,657 3422 02:22:48,657 --> 02:22:49,792 3423 02:22:49,792 --> 02:22:50,960 [SPEAKING FRENCH]. 3424 02:22:50,960 --> 02:22:51,360 >> MERCI. 3425 02:22:51,360 --> 02:22:53,462 >> JOAN, THAT WAS GREAT. 3426 02:22:53,462 --> 02:22:54,630 SERIOUSLY, I WANT EVERYBODY TO 3427 02:22:54,630 --> 02:22:58,934 KNOW HERE THAT THIS WAS A 3428 02:22:58,934 --> 02:23:00,369 PROGRAM THAT CAME UP FROM THE 3429 02:23:00,369 --> 02:23:04,440 PROGRAM OFFICERS, THIS CAME FROM 3430 02:23:04,440 --> 02:23:07,209 JOAN AND D.E.I.DRA, CERTAINLY 3431 02:23:07,209 --> 02:23:10,880 NOT MY IDEA, AND I THINK IT'S A 3432 02:23:10,880 --> 02:23:11,247 WONDERFUL IDEA. 3433 02:23:11,247 --> 02:23:13,015 AND WE'RE ALWAYS TALKING ABOUT 3434 02:23:13,015 --> 02:23:15,351 HOW TO SCALE UP SOME OF THESE 3435 02:23:15,351 --> 02:23:15,618 THINGS. 3436 02:23:15,618 --> 02:23:19,788 AND I MEAN, JOAN, DO YOU HAVE 3437 02:23:19,788 --> 02:23:23,125 ANY THOUGHTS ON HOW WE COULD 3438 02:23:23,125 --> 02:23:25,427 CONNECT THIS, YOU KNOW, SHOULD 3439 02:23:25,427 --> 02:23:26,362 WE PRESENT TO OUR ALCOHOL 3440 02:23:26,362 --> 02:23:29,098 CENTERS ACROSS THE NATION? 3441 02:23:29,098 --> 02:23:30,833 I MEAN, YOU KNOW, ANY THOUGHTS 3442 02:23:30,833 --> 02:23:35,037 YOU HAVE ON HOW WE COULD 3443 02:23:35,037 --> 02:23:36,238 ACTUALLY GET MORE ENGAGEMENT 3444 02:23:36,238 --> 02:23:40,242 FROM OUR ALCOHOL COMMUNITY? 3445 02:23:40,242 --> 02:23:42,244 WHAT ABOUT RFAs, SHOULD -- I'M 3446 02:23:42,244 --> 02:23:46,916 HAPPY TO PUT SLIDES IN MY TALK 3447 02:23:46,916 --> 02:23:48,050 THIS YEAR, ALTHOUGH LAURA 3448 02:23:48,050 --> 02:23:49,251 LEONARDI MIGHT KILL ME BECAUSE 3449 02:23:49,251 --> 02:23:50,352 WE'RE STARTING TO PACK THINGS IN 3450 02:23:50,352 --> 02:23:50,619 THERE. 3451 02:23:50,619 --> 02:23:52,488 WHAT DO YOU THINK? 3452 02:23:52,488 --> 02:23:53,689 >> I THINK IT WOULD BE 3453 02:23:53,689 --> 02:23:55,524 WONDERFUL. 3454 02:23:55,524 --> 02:23:57,192 OBVIOUSLY NOW THE INITIATIVE 3455 02:23:57,192 --> 02:23:58,060 GOES UNTIL NOVEMBER 23. 3456 02:23:58,060 --> 02:24:02,331 I SAID 36 CITIES AND SHOWED 35. 3457 02:24:02,331 --> 02:24:03,866 THAT'S BECAUSE WE'RE CURRENTLY 3458 02:24:03,866 --> 02:24:04,733 DISCUSSING ADDING ANOTHER SITE 3459 02:24:04,733 --> 02:24:07,536 WHICH I DON'T HAVE THAT INFO 3460 02:24:07,536 --> 02:24:07,937 YET. 3461 02:24:07,937 --> 02:24:09,572 I I DON'T KNOW IF WE'LL GET 3462 02:24:09,572 --> 02:24:10,973 FUNDING TO CONTINUE BUT IF 3463 02:24:10,973 --> 02:24:13,542 THERE'S ANYTHING WE CAN DO WHILE 3464 02:24:13,542 --> 02:24:16,478 IT'S STILL HAPPENING, THERE ARE 3465 02:24:16,478 --> 02:24:17,813 OTHER SHOWERS, THAT WOULD BE 3466 02:24:17,813 --> 02:24:18,080 WONDERFUL. 3467 02:24:18,080 --> 02:24:21,116 ANYTHING WE CAN DO TO GET THE 3468 02:24:21,116 --> 02:24:22,184 WORD OUT THERE WOULD BE 3469 02:24:22,184 --> 02:24:22,518 WONDERFUL. 3470 02:24:22,518 --> 02:24:24,019 ONE OF THE THINGS I KEEP 3471 02:24:24,019 --> 02:24:25,821 THINKING OF HOW CAN WE MAXIMIZE 3472 02:24:25,821 --> 02:24:27,856 THE UTILITY OF THESE EVENTS FOR 3473 02:24:27,856 --> 02:24:28,958 OTHER THINGS LIKE WE WERE 3474 02:24:28,958 --> 02:24:31,560 TALKING ABOUT COULD WE HAVE 3475 02:24:31,560 --> 02:24:33,562 SOMEONE DOING SCREENING AND 3476 02:24:33,562 --> 02:24:35,064 BRIEF INTERVENTION REFERRAL TO 3477 02:24:35,064 --> 02:24:36,732 TREATMENT THERE? 3478 02:24:36,732 --> 02:24:38,934 COULD WE HAVE INFORMATION ABOUT 3479 02:24:38,934 --> 02:24:39,768 CLINICAL TRIALS THERE? 3480 02:24:39,768 --> 02:24:40,669 AND PARTICIPATION. 3481 02:24:40,669 --> 02:24:42,871 I JUST THINK THESE ARE A 3482 02:24:42,871 --> 02:24:46,408 WONDERFUL VEHICLE FOR US TO 3483 02:24:46,408 --> 02:24:47,142 REACH REALLY IMPORTANT AUDIENCE 3484 02:24:47,142 --> 02:24:55,351 AND WE SHOULD TRY TO MAXIMIZE, 3485 02:24:55,351 --> 02:24:57,319 YOU KNOW, THE OPPORTUNITY. 3486 02:24:57,319 --> 02:24:58,554 >> A LOT OF QUESTIONS, 3487 02:24:58,554 --> 02:25:00,255 CLARIFICATION, WHO IS FUNDING 3488 02:25:00,255 --> 02:25:00,589 THIS? 3489 02:25:00,589 --> 02:25:02,891 IS HHS AND WHAT DEPARTMENT? 3490 02:25:02,891 --> 02:25:05,060 >> YOU SAW THE PARTNERS LISTED 3491 02:25:05,060 --> 02:25:05,561 THERE. 3492 02:25:05,561 --> 02:25:06,028 IT'S A LOT. 3493 02:25:06,028 --> 02:25:10,432 SOME OF THESE ARE ACTUALLY 3494 02:25:10,432 --> 02:25:13,002 RELIGIOUS GROUPS. 3495 02:25:13,002 --> 02:25:16,872 LIKE WORLD VISION AND LATTER DAY 3496 02:25:16,872 --> 02:25:17,673 SAINTS. 3497 02:25:17,673 --> 02:25:18,807 JUST SERVE ORGANIZATION IS 3498 02:25:18,807 --> 02:25:20,209 ANOTHER -- I BELIEVE IT'S A 3499 02:25:20,209 --> 02:25:20,843 RELIGIOUS ORGANIZATION BUT THEY 3500 02:25:20,843 --> 02:25:23,145 ARE RECRUITING ALL OF THE 3501 02:25:23,145 --> 02:25:24,780 VOLUNTEERS FOR, YOU KNOW, ALL 3502 02:25:24,780 --> 02:25:26,015 THE SHOWERS ACROSS THE COUNTRY. 3503 02:25:26,015 --> 02:25:30,452 THAT'S THE PART THEY ARE DOING. 3504 02:25:30,452 --> 02:25:31,487 THERE'S ALSO DIFFERENT NGOs 3505 02:25:31,487 --> 02:25:32,354 AND LOCAL GROUPS. 3506 02:25:32,354 --> 02:25:34,757 I COULDN'T LIST THEM ALL. 3507 02:25:34,757 --> 02:25:38,093 IT DOES VARY BY LOCATIONS THAT 3508 02:25:38,093 --> 02:25:42,898 ALSO PROVIDE SUPPORT. 3509 02:25:42,898 --> 02:25:43,198 >> DAVID? 3510 02:25:43,198 --> 02:25:44,900 >> YEAH, JUST ACTUALLY ON A 3511 02:25:44,900 --> 02:25:47,436 RELATED NOTE, OBVIOUSLY THERE'S 3512 02:25:47,436 --> 02:25:49,271 A LOT TO BE GAINED AT AN 3513 02:25:49,271 --> 02:25:50,839 IN-PERSON EVENT LIKE THIS BUT 3514 02:25:50,839 --> 02:25:55,477 SINCE IT IS LIMITED IN CITIES I 3515 02:25:55,477 --> 02:25:58,247 WONDER IS THERE AN ADAPTABLE 3516 02:25:58,247 --> 02:25:59,248 VERSION THAT COULD HAPPEN 3517 02:25:59,248 --> 02:26:00,315 REMOTELY SO CHURCH GROUPS ACROSS 3518 02:26:00,315 --> 02:26:03,552 THE COUNTRY AT ONE GIVEN TIME 3519 02:26:03,552 --> 02:26:04,720 MIGHT BE EXPOSED TO THE 3520 02:26:04,720 --> 02:26:05,521 EDUCATIONAL COMPOUNDS OF IT? 3521 02:26:05,521 --> 02:26:07,956 >> IT'S A GREAT IDEA. 3522 02:26:07,956 --> 02:26:13,662 WE CAN BRING IT UP TO REVEREND 3523 02:26:13,662 --> 02:26:15,397 ENGLISH AND HER TEAM. 3524 02:26:15,397 --> 02:26:19,368 MAYBE IT'S RECORDING PANEL 3525 02:26:19,368 --> 02:26:20,602 DISCUSSIONS AND DOING VIRTUAL 3526 02:26:20,602 --> 02:26:20,936 BABY SHOWERS. 3527 02:26:20,936 --> 02:26:22,871 GREAT IDEA, THANK YOU. 3528 02:26:22,871 --> 02:26:24,506 >> ALONG THE SAME LINES, JOAN, 3529 02:26:24,506 --> 02:26:25,374 THAT WAS FANTASTIC. 3530 02:26:25,374 --> 02:26:25,941 >> THANK YOU. 3531 02:26:25,941 --> 02:26:28,510 >> THAT YOU'VE DONE THAT. 3532 02:26:28,510 --> 02:26:31,013 JUST AMAZING. 3533 02:26:31,013 --> 02:26:32,748 I CAN ENVISION WHENCE YOU LEAVE 3534 02:26:32,748 --> 02:26:36,185 THEY ARE THINKING, WELL, OKAY, 3535 02:26:36,185 --> 02:26:37,252 200 OTHER PREGNANT WOMEN WOULD 3536 02:26:37,252 --> 02:26:38,921 LIKE TO COME NEXT WEEK AND DO 3537 02:26:38,921 --> 02:26:43,759 THE SAME THING. 3538 02:26:43,759 --> 02:26:45,127 WONDERING WHEN YOU IDENTIFY A 3539 02:26:45,127 --> 02:26:45,961 CITY AND FIND PARTNERS IN THE 3540 02:26:45,961 --> 02:26:47,763 CITY TO HELP YOU PUT THIS ON 3541 02:26:47,763 --> 02:26:49,331 COULD YOU KIND OF PACKAGE THAT 3542 02:26:49,331 --> 02:26:51,533 TO SAY, OKAY, YOU GUYS CARRY 3543 02:26:51,533 --> 02:26:52,201 THIS FORWARD? 3544 02:26:52,201 --> 02:26:53,202 AND DO IT? 3545 02:26:53,202 --> 02:26:55,037 YOU KNOW, EVERY THREE MONTHS, 3546 02:26:55,037 --> 02:26:56,238 EVERY SIX MONTHS, WHATEVER. 3547 02:26:56,238 --> 02:26:59,108 SO THAT YOU COULD MAYBE EXTEND 3548 02:26:59,108 --> 02:27:01,443 YOUR REACH BEYOND YOUR TOUR? 3549 02:27:01,443 --> 02:27:02,845 >> I THINK THAT'S A WONDERFUL 3550 02:27:02,845 --> 02:27:05,481 IDEA AS WELL. 3551 02:27:05,481 --> 02:27:08,250 I WILL SAY, YOU KNOW, SO 3552 02:27:08,250 --> 02:27:09,451 BASICALLY THE INITIATIVE ITSELF 3553 02:27:09,451 --> 02:27:13,155 HAD ALREADY BEEN WRITTEN BY 3554 02:27:13,155 --> 02:27:14,356 REVEREND DR. Q ENGLISH. 3555 02:27:14,356 --> 02:27:16,759 WHEN I LEARNED FROM HER SHE WAS 3556 02:27:16,759 --> 02:27:17,826 WAITING FOR DEPARTMENTAL AND 3557 02:27:17,826 --> 02:27:18,961 WHITE HOUSE APPROVAL. 3558 02:27:18,961 --> 02:27:21,130 SO WE WEREN'T REALLY IN ON THAT 3559 02:27:21,130 --> 02:27:21,997 STAGE OF IT. 3560 02:27:21,997 --> 02:27:24,733 WE JOINED THE EXECUTIVE PLANNING 3561 02:27:24,733 --> 02:27:25,868 COMMITTEE AFTER THAT. 3562 02:27:25,868 --> 02:27:29,338 BUT I THINK THAT'S A GREAT IDEA 3563 02:27:29,338 --> 02:27:32,174 AND ONE OF THE THINGS DEIDRE AND 3564 02:27:32,174 --> 02:27:34,476 I AS AN EXAMPLE THIS PAST 3565 02:27:34,476 --> 02:27:35,878 SATURDAY IN WILMINGTON, WHEN WE 3566 02:27:35,878 --> 02:27:36,445 GIVE INFORMATION TO PEOPLE 3567 02:27:36,445 --> 02:27:37,579 BECAUSE WE HAVE THAT CAPTIVE 3568 02:27:37,579 --> 02:27:39,815 AUDIENCE THEY HAVE TO GET OUR 3569 02:27:39,815 --> 02:27:40,716 SIGNATURE ON THEIR BINGO CARD 3570 02:27:40,716 --> 02:27:42,985 BEFORE THEY GET THEIR PRIZES. 3571 02:27:42,985 --> 02:27:45,554 WE TRY TO SAY, YOU KNOW, PLEASE 3572 02:27:45,554 --> 02:27:47,356 BE AN AMBASSADOR FOR THIS 3573 02:27:47,356 --> 02:27:49,458 INFORMATION IN YOUR COMMUNITY 3574 02:27:49,458 --> 02:27:51,760 WITH YOUR FAMILY, ET CETERA. 3575 02:27:51,760 --> 02:27:56,131 SO WE'RE TRYING TO EXTEND IT 3576 02:27:56,131 --> 02:27:58,300 THAT WAY, AND YEAH, HAVING 3577 02:27:58,300 --> 02:27:58,667 FURTHER INROADS. 3578 02:27:58,667 --> 02:28:01,904 THERE'S A LOT OF I WOULD SAY 3579 02:28:01,904 --> 02:28:03,071 POLITICAL SUPPORT FOR THIS. 3580 02:28:03,071 --> 02:28:05,374 AND SO, YOU KNOW, THOSE PEOPLE 3581 02:28:05,374 --> 02:28:08,610 ARE DOING THAT KIND OF WORK AT 3582 02:28:08,610 --> 02:28:16,051 THAT LEVEL IN DIFFERENT STATES 3583 02:28:16,051 --> 02:28:17,352 AND LOCALITIES. 3584 02:28:17,352 --> 02:28:19,955 >> IT'S JUST A FANTASTIC 3585 02:28:19,955 --> 02:28:21,857 PROJECT, VERY IMPRESSED. 3586 02:28:21,857 --> 02:28:24,526 AND I REALLY SEE NIAAA THAT'S AN 3587 02:28:24,526 --> 02:28:27,796 IMPORTANT ROLE TO PLAY IN TERMS 3588 02:28:27,796 --> 02:28:34,536 OF JUST THAT NIAAA CARES DEEPLY 3589 02:28:34,536 --> 02:28:36,672 ABOUT THESE KINDS OF ISSUES OF 3590 02:28:36,672 --> 02:28:39,508 THE I WAS WONDERING -- THE 3591 02:28:39,508 --> 02:28:41,910 PROGRAM FOCUSES ON GIVING -- 3592 02:28:41,910 --> 02:28:43,145 HELPING WOMEN ADVOCATE FOR 3593 02:28:43,145 --> 02:28:43,612 THEMSELVES. 3594 02:28:43,612 --> 02:28:46,982 THAT'S ONE ASPECT, RIGHT? 3595 02:28:46,982 --> 02:28:48,951 I DO WONDER HOW WELL -- THE 3596 02:28:48,951 --> 02:28:53,155 OTHER SIDE IN TERMS OF THE 3597 02:28:53,155 --> 02:28:55,357 PROVIDER SIDE, RIGHT? 3598 02:28:55,357 --> 02:28:57,492 WHAT CAN NIAAA NIMHD DO TO 3599 02:28:57,492 --> 02:28:59,528 REALLY ALSO KIND OF HIGHLIGHT 3600 02:28:59,528 --> 02:29:03,198 THOSE KINDS OF FACTORS THAT 3601 02:29:03,198 --> 02:29:04,366 AFFECT MATERNAL HEALTH OUTCOMES 3602 02:29:04,366 --> 02:29:06,068 PARTICULARLY IN BLACK WOMEN, SO 3603 02:29:06,068 --> 02:29:10,405 PROVIDER BIAS, RIGHT? 3604 02:29:10,405 --> 02:29:10,672 >> YEAH. 3605 02:29:10,672 --> 02:29:14,509 >> A NUMBER OF DEATHS DUE TO 3606 02:29:14,509 --> 02:29:16,211 HYPERTENSION, HOW MUCH EDUCATION 3607 02:29:16,211 --> 02:29:17,646 DO PROVIDERS HAVE AROUND THAT 3608 02:29:17,646 --> 02:29:18,013 PARTICULAR LINK? 3609 02:29:18,013 --> 02:29:22,284 SO I DON'T KNOW IF THAT'S A ROLE 3610 02:29:22,284 --> 02:29:24,853 IN TERMS OF PARTNERSHIP ROLE, 3611 02:29:24,853 --> 02:29:26,655 NIMHD, BUT REALLY THINKING ALSO 3612 02:29:26,655 --> 02:29:28,357 ABOUT THOSE SYSTEMIC KINDS OF 3613 02:29:28,357 --> 02:29:32,461 FACTORS AS WELL THAT KIND OF 3614 02:29:32,461 --> 02:29:34,796 DEEPLY AFFECT MATERNAL OUTCOMES. 3615 02:29:34,796 --> 02:29:35,163 >> ABSOLUTELY. 3616 02:29:35,163 --> 02:29:38,166 I GRABBED -- I WENT AROUND ON 3617 02:29:38,166 --> 02:29:39,635 SATURDAY AND PULLED SOME 3618 02:29:39,635 --> 02:29:41,169 INFORMATION AND, YOU KNOW, JUST 3619 02:29:41,169 --> 02:29:44,306 RIGHT NEXT TO US ONE OF THE 3620 02:29:44,306 --> 02:29:45,741 BOOTHS HAD THE BLOOD PRESSURE 3621 02:29:45,741 --> 02:29:47,276 STUFF AND HYPERTENSION STUFF. 3622 02:29:47,276 --> 02:29:49,411 AND LINKING THEM TO SERVICES, 3623 02:29:49,411 --> 02:29:50,712 SOME OF THESE WOMEN, YOU KNOW, 3624 02:29:50,712 --> 02:29:51,780 THEY ARE DEPENDING ON THE 3625 02:29:51,780 --> 02:29:53,448 LOCATION EITHER GETTING SIGNED 3626 02:29:53,448 --> 02:29:55,350 UP FOR FEDERAL GOVERNMENT 3627 02:29:55,350 --> 02:29:56,818 SERVICES FOR FOOD ASSISTANCE OR 3628 02:29:56,818 --> 02:30:01,790 OTHER HEALTHY START IS THERE. 3629 02:30:01,790 --> 02:30:04,860 YOU KNOW, YOU SAW ACRONYMS FOR 3630 02:30:04,860 --> 02:30:06,028 OTHER FEDERAL AGENCIES, 3631 02:30:06,028 --> 02:30:07,829 ASSOCIATION FOR CHILDREN AND 3632 02:30:07,829 --> 02:30:09,231 FAMILIES, HRSA, SAMHSA, ET 3633 02:30:09,231 --> 02:30:11,633 CETERA. 3634 02:30:11,633 --> 02:30:15,537 SO THERE'S DEFINITELY PLUGGING 3635 02:30:15,537 --> 02:30:17,406 THEM INTO DIFFERENT SERVICES, 3636 02:30:17,406 --> 02:30:20,309 DEPENDING ON INCOME AND 3637 02:30:20,309 --> 02:30:23,011 EVERYTHING ELSE, BUT YOU'RE 3638 02:30:23,011 --> 02:30:25,147 RIGHT, LIKE PHYSICIANS AND 3639 02:30:25,147 --> 02:30:28,350 OTHERS ALSO NEED TO BE PART OF 3640 02:30:28,350 --> 02:30:30,953 THE SOLUTION. 3641 02:30:30,953 --> 02:30:31,853 I THINK . 3642 02:30:31,853 --> 02:30:32,988 >> OTHERWISE IT PUTS THE BURDEN 3643 02:30:32,988 --> 02:30:38,026 ON THE WOMEN SO PROVIDERS, THAT 3644 02:30:38,026 --> 02:30:38,760 EDUCATION AS WELL. 3645 02:30:38,760 --> 02:30:40,062 TO BE AROUND ALCOHOL USE AS 3646 02:30:40,062 --> 02:30:41,363 WELL. 3647 02:30:41,363 --> 02:30:41,630 >> YEAH. 3648 02:30:41,630 --> 02:30:43,265 THAT'S WHY I ALSO LOVED LIKE I 3649 02:30:43,265 --> 02:30:44,933 PICKED UP THIS, YOU KNOW, BLACK 3650 02:30:44,933 --> 02:30:47,202 BIRTHING BILL OF RIGHTS THAT THE 3651 02:30:47,202 --> 02:30:48,170 NATIONAL ASSOCIATION TO ADVANCE 3652 02:30:48,170 --> 02:30:50,472 BLACK BIRTH WAS THERE. 3653 02:30:50,472 --> 02:30:52,741 AND, YOU KNOW, WOMEN COULD GET 3654 02:30:52,741 --> 02:30:53,942 THOSE AND HAVE THIS WITH THEM 3655 02:30:53,942 --> 02:30:57,145 AND THE WOMEN ARE REALLY 3656 02:30:57,145 --> 02:30:58,480 ENCOURAGED TO CONSIDER, YOU 3657 02:30:58,480 --> 02:31:01,450 KNOW, HAVING A MIDWIFE, CONSIDER 3658 02:31:01,450 --> 02:31:03,285 USING A DOULA, ET CETERA. 3659 02:31:03,285 --> 02:31:04,786 SO THESE ARE THINGS THAT MAYBE 3660 02:31:04,786 --> 02:31:09,157 THEY DIDN'T EVEN KNOW WHY -- 3661 02:31:09,157 --> 02:31:10,425 WERE AVAILABLE TO THEM BEFORE. 3662 02:31:10,425 --> 02:31:13,028 I LOVE THEY ARE TRAINING AND 3663 02:31:13,028 --> 02:31:14,763 CERTIFYING DOULAS FROM THOSE 3664 02:31:14,763 --> 02:31:15,998 COMMUNITIES VESTED AND COMMITTED 3665 02:31:15,998 --> 02:31:17,466 TO THOSE COMMUNITIES AND WILL 3666 02:31:17,466 --> 02:31:18,367 STAY IN THOSE COMMUNITIES 3667 02:31:18,367 --> 02:31:19,534 WORKING WITH THOSE WOMEN AND 3668 02:31:19,534 --> 02:31:24,406 FAMILIES. 3669 02:31:24,406 --> 02:31:34,116 >> WE DO HAVE A HEALTH SERVICES 3670 02:31:34,116 --> 02:31:38,186 DIVISION, RIGHT? 3671 02:31:38,186 --> 02:31:39,988 >> YES, WE DO. 3672 02:31:39,988 --> 02:31:43,291 LAURA KWAKO IS IN THE BACK. 3673 02:31:43,291 --> 02:31:45,460 SHE'S OUR BRANCH CHIEF. 3674 02:31:45,460 --> 02:31:46,661 I'LL MENTION LAURA HAS DONE A 3675 02:31:46,661 --> 02:31:49,531 GREAT JOB OVER THE PAST COUPLE 3676 02:31:49,531 --> 02:31:51,233 YEARS OF ADVANCING HEALTH 3677 02:31:51,233 --> 02:31:51,867 SERVICES. 3678 02:31:51,867 --> 02:31:59,007 YOU KNOW, FUNDING SOME REALLY 3679 02:31:59,007 --> 02:32:00,242 IMPORTANT STUDIES ONE OF OUR 3680 02:32:00,242 --> 02:32:02,811 IMPORTANT MISSIONS IS TO GET 3681 02:32:02,811 --> 02:32:04,980 EVIDENCE-BASED TREATMENTS OUT TO 3682 02:32:04,980 --> 02:32:05,847 THE PUBLIC. 3683 02:32:05,847 --> 02:32:09,017 YOU KNOW, THAT SHOULD BE ONE OF 3684 02:32:09,017 --> 02:32:13,488 OUR TOP AREAS THAT WE SHOULD DO. 3685 02:32:13,488 --> 02:32:15,090 IT'S REALLY HARD WHEN YOU SEE 3686 02:32:15,090 --> 02:32:16,992 SOMEBODY YOU CARE ABOUT, THEY 3687 02:32:16,992 --> 02:32:22,931 ARE GETTING TREATMENT BUT IT'S 3688 02:32:22,931 --> 02:32:23,899 NOT STATE-OF-THE-ART TREATMENT. 3689 02:32:23,899 --> 02:32:24,566 THEY ARE NOT GETTING THE 3690 02:32:24,566 --> 02:32:25,734 TREATMENT THEY SHOULD BE 3691 02:32:25,734 --> 02:32:26,268 GETTING. 3692 02:32:26,268 --> 02:32:28,904 WHAT IS IT TO GET RESEARCH 3693 02:32:28,904 --> 02:32:30,772 EVIDENCE-BASED TREATMENT IS 3694 02:32:30,772 --> 02:32:32,774 NOBODY'S USING THEM? 3695 02:32:32,774 --> 02:32:35,377 AND SO THAT'S SOMETHING THAT'S 3696 02:32:35,377 --> 02:32:37,446 VERY IMPORTANT TO US AND WE NEED 3697 02:32:37,446 --> 02:32:39,714 TO GET OUT TO THE COMMUNITY. 3698 02:32:39,714 --> 02:32:42,951 IT'S GOING TO BE CHALLENGING TO 3699 02:32:42,951 --> 02:32:45,187 GET THIS OUT BECAUSE I DON'T 3700 02:32:45,187 --> 02:32:47,389 KNOW ANY OTHER COMPLEX DISEASE 3701 02:32:47,389 --> 02:32:49,424 THAT GETS LESS TREATMENT THAN 3702 02:32:49,424 --> 02:32:51,026 WITH ALCOHOL USE DISORDER. 3703 02:32:51,026 --> 02:32:53,228 SO WE HAVE A BIG CHALLENGE BUT 3704 02:32:53,228 --> 02:32:54,529 WE ARE MAKING PROGRESS. 3705 02:32:54,529 --> 02:32:57,132 AND IT DOES TAKE A VILLAGE. 3706 02:32:57,132 --> 02:32:59,768 ANY WAY THAT WE CAN GET THIS 3707 02:32:59,768 --> 02:33:02,437 INFORMATION OUT WE'RE GOING TO 3708 02:33:02,437 --> 02:33:06,842 DO IT. 3709 02:33:06,842 --> 02:33:07,109 >> OKAY. 3710 02:33:07,109 --> 02:33:07,909 THAT'S A GOOD SEGUE TO WHAT 3711 02:33:07,909 --> 02:33:10,512 WE'RE SUPPOSED TO BE DOING NEXT. 3712 02:33:10,512 --> 02:33:13,315 THANK YOU, AGAIN, JOAN. 3713 02:33:13,315 --> 02:33:18,854 3714 02:33:18,854 --> 02:33:20,155 IS EVERYBODY IF WE JUST CONTINUE 3715 02:33:20,155 --> 02:33:20,856 TO THE END? 3716 02:33:20,856 --> 02:33:26,795 WE DON'T HAVE THAT MUCH TO DO. 3717 02:33:26,795 --> 02:33:28,463 PHILIPPE WANTED TO KNOW WHETHER 3718 02:33:28,463 --> 02:33:29,764 WE NEEDED A SHORT BREAK BUT I 3719 02:33:29,764 --> 02:33:30,499 THINK WE'RE GOOD. 3720 02:33:30,499 --> 02:33:35,403 WHAT ARE WE DOING NEXT? 3721 02:33:35,403 --> 02:33:36,338 >> DISCUSSION. 3722 02:33:36,338 --> 02:33:37,973 >> IT'S MY DISCUSSION, YEAH. 3723 02:33:37,973 --> 02:33:42,611 THE FOCUS DISCUSSION. 3724 02:33:42,611 --> 02:33:44,546 SO I JUST THREW THESE OUT 3725 02:33:44,546 --> 02:33:45,480 LITERALLY, TRISH AND I WROTE 3726 02:33:45,480 --> 02:33:46,915 THESE IN LESS THAN THREE 3727 02:33:46,915 --> 02:33:48,283 MINUTES, THERE'S NOTHING CAST IN 3728 02:33:48,283 --> 02:33:49,851 STONE HERE, DIDN'T HAVE TO DO 3729 02:33:49,851 --> 02:33:50,752 ANY HOMEWORK. 3730 02:33:50,752 --> 02:33:53,021 IF YOU DID SOME HOMEWORK, THAT'S 3731 02:33:53,021 --> 02:33:53,288 FINE. 3732 02:33:53,288 --> 02:33:58,026 BUT I JUST WANTED TO HAVE SOME 3733 02:33:58,026 --> 02:33:59,794 TIME SET ASIDE AT COUNCIL FOR 3734 02:33:59,794 --> 02:34:01,062 ANYTHING THAT COMES TO YOUR 3735 02:34:01,062 --> 02:34:03,565 HEADS THAT YOU WANT TO TALK 3736 02:34:03,565 --> 02:34:03,932 ABOUT BASICALLY. 3737 02:34:03,932 --> 02:34:08,036 THEY ARE DOING THIS NOW AT THE 3738 02:34:08,036 --> 02:34:10,105 INSTITUTE DIRECTORS' MEETINGS, 3739 02:34:10,105 --> 02:34:12,641 SO MONICA GOT, OUR FEARLESS 3740 02:34:12,641 --> 02:34:13,608 LEADER, GOT UPSET BECAUSE 3741 02:34:13,608 --> 02:34:17,712 SOMEONE KEPT GOING ON AND ON AND 3742 02:34:17,712 --> 02:34:18,813 ON ABOUT VERY DETAILED 3743 02:34:18,813 --> 02:34:20,415 INFORMATION IN SLIDES, CUTTING 3744 02:34:20,415 --> 02:34:21,950 INTO OUR RAISE YOUR HAND AND SAY 3745 02:34:21,950 --> 02:34:25,654 WHATEVER YOU WANT SESSION AT THE 3746 02:34:25,654 --> 02:34:26,388 INSTITUTE DIRECTORS MEETING. 3747 02:34:26,388 --> 02:34:31,226 I WANT TO DO IT HERE TOO. 3748 02:34:31,226 --> 02:34:37,132 I HAD FOUR THINGS, ALCOHOL AS A 3749 02:34:37,132 --> 02:34:40,969 FIFTH VITAL SIGN, ALCOHOL 3750 02:34:40,969 --> 02:34:41,870 PATHOLOGY -- TRISH REMINDED ME 3751 02:34:41,870 --> 02:34:43,939 ALCOHOL IS FIFTH VITAL SIGN, NOT 3752 02:34:43,939 --> 02:34:45,006 ALCOHOL USE DISORDER. 3753 02:34:45,006 --> 02:34:45,874 WE OFTEN PUT ALCOHOL USE 3754 02:34:45,874 --> 02:34:47,175 DISORDER IN THERE BUT THERE'S A 3755 02:34:47,175 --> 02:34:49,678 LOT IN BETWEEN ALCOHOL AND 3756 02:34:49,678 --> 02:34:52,581 ALCOHOL USE DISORDER. 3757 02:34:52,581 --> 02:34:54,849 ALCOHOL PATHOLOGY AND TREATMENT, 3758 02:34:54,849 --> 02:34:55,250 SAME. 3759 02:34:55,250 --> 02:34:57,252 ALCOHOL AND WOMEN, AND ALCOHOL 3760 02:34:57,252 --> 02:34:59,187 AND AGING. 3761 02:34:59,187 --> 02:35:01,122 AND TOMORROW I WILL IN THE CRAN 3762 02:35:01,122 --> 02:35:04,092 TALK AT LEAST HAVE ONE SLIDE ON 3763 02:35:04,092 --> 02:35:05,293 ALCOHOL AND WOMEN, ALCOHOL AND 3764 02:35:05,293 --> 02:35:05,627 AGING. 3765 02:35:05,627 --> 02:35:07,596 I THINK YOU'RE ALL AWARE BUT 3766 02:35:07,596 --> 02:35:09,898 THERE WILL BE A SLIDE ON THIS 3767 02:35:09,898 --> 02:35:10,298 TOMORROW. 3768 02:35:10,298 --> 02:35:15,604 YOU'RE ALL AWARE WOMEN NOW IN 3769 02:35:15,604 --> 02:35:17,372 THE COLLEGE-AGE RANGE ARE BRINGE 3770 02:35:17,372 --> 02:35:18,340 DRINKING MORE THAN MEN, AND 3771 02:35:18,340 --> 02:35:20,108 DRINKING MORE THAN MEN FOR THE 3772 02:35:20,108 --> 02:35:23,545 FIRST TIME EVER. 3773 02:35:23,545 --> 02:35:24,112 CROSSOVER OCCURRED ABOUT -- 3774 02:35:24,112 --> 02:35:26,481 RIGHT AT THE BEGINNING OR PEAK 3775 02:35:26,481 --> 02:35:27,682 OF THE PANDEMIC. 3776 02:35:27,682 --> 02:35:29,317 THREE YEARS AGO, THREE OR FOUR 3777 02:35:29,317 --> 02:35:30,719 YEARS AGO. 3778 02:35:30,719 --> 02:35:36,658 AND THAT'S WHERE -- I MEAN THE 3779 02:35:36,658 --> 02:35:38,059 LINES WERE WEDY TO CROSS OVER 3780 02:35:38,059 --> 02:35:40,562 BUT THEY SEEM TO HAVE BEEN 3781 02:35:40,562 --> 02:35:41,896 ACCELERATED IN CROSSING OVER. 3782 02:35:41,896 --> 02:35:43,498 ONE OF THE BIGGEST ISSUES I 3783 02:35:43,498 --> 02:35:46,668 ALREADY RAISED TODAY, I'LL RAISE 3784 02:35:46,668 --> 02:35:48,003 THE FIRST PART, WHAT YOU HEARD 3785 02:35:48,003 --> 02:35:49,904 FROM JOAN. 3786 02:35:49,904 --> 02:35:52,374 I MEAN, PEOPLE DO NOT HAVE THE 3787 02:35:52,374 --> 02:35:54,209 INFORMATION THEY NEED TO MAKE 3788 02:35:54,209 --> 02:35:56,144 PROPER DECISIONS ABOUT THEIR USE 3789 02:35:56,144 --> 02:35:56,945 OF ALCOHOL. 3790 02:35:56,945 --> 02:35:59,347 IT'S JUST FLAT OUT A BIG 3791 02:35:59,347 --> 02:35:59,581 PROBLEM. 3792 02:35:59,581 --> 02:36:01,883 AND IT RANGES FROM EVERYTHING 3793 02:36:01,883 --> 02:36:04,886 FROM KNOWING WHAT THE DIETARY 3794 02:36:04,886 --> 02:36:08,690 GUIDELINES ARE, KNOWING WHAT A 3795 02:36:08,690 --> 02:36:10,025 STANDARD DRINK IS, TO KNOWING 3796 02:36:10,025 --> 02:36:11,192 THAT THERE ARE MEDICATIONS AND 3797 02:36:11,192 --> 02:36:12,661 BEHAVIORAL TREATMENTS THAT ARE 3798 02:36:12,661 --> 02:36:15,330 QUITE EFFECTIVE FOR TREATING 3799 02:36:15,330 --> 02:36:18,833 ALCOHOL USE DISORDER, MUCH LESS, 3800 02:36:18,833 --> 02:36:19,901 YOU KNOW, LIVER DISEASE, 3801 02:36:19,901 --> 02:36:22,370 PANCREATITIS, CANCER, THE WHOLE 3802 02:36:22,370 --> 02:36:23,038 NINE YARDS. 3803 02:36:23,038 --> 02:36:25,240 SO IT'S -- THE FIRST TOPIC, 3804 02:36:25,240 --> 02:36:29,110 ALCOHOL AS FIFTH VITAL SIGN, 3805 02:36:29,110 --> 02:36:30,845 SIMPLY, YOU KNOW, I'M SURE LAURA 3806 02:36:30,845 --> 02:36:32,914 AND RAYE WILL CORRECT ME ON THIS 3807 02:36:32,914 --> 02:36:35,183 BUT AT THE INTEGRATED ALCOHOL 3808 02:36:35,183 --> 02:36:37,919 USE DISORDER LIVER DISEASE 3809 02:36:37,919 --> 02:36:39,888 MEETING WE HAD, YOU KNOW, 3810 02:36:39,888 --> 02:36:41,356 SOMEBODY MENTIONED THEY COULD DO 3811 02:36:41,356 --> 02:36:43,758 A BRIEF INTERVENTION IN TWO 3812 02:36:43,758 --> 02:36:44,259 MINUTES. 3813 02:36:44,259 --> 02:36:47,128 YOU KNOW, IN THE DOCTOR'S 3814 02:36:47,128 --> 02:36:47,362 OFFICE. 3815 02:36:47,362 --> 02:36:49,431 WHEN I RAISED THESE KIND OF 3816 02:36:49,431 --> 02:36:51,566 ISSUES AT HOWARD UNIVERSITY A 3817 02:36:51,566 --> 02:36:55,337 MONTH OR SO AGO WHEN I GAVE A 3818 02:36:55,337 --> 02:36:58,073 TALK THERE, THE LADY, WHO IS A 3819 02:36:58,073 --> 02:37:00,942 DOCTOR, WHO WAS IN CHARGE OF 3820 02:37:00,942 --> 02:37:03,044 TRAINING PRIMARY CARE, YOU KNOW, 3821 02:37:03,044 --> 02:37:04,646 SO, YOU KNOW, WAS BASICALLY 3822 02:37:04,646 --> 02:37:08,550 THROWING UP HER HANDS IN FRONT 3823 02:37:08,550 --> 02:37:09,918 OF THE CHAIR OF PSYCHIATRY 3824 02:37:09,918 --> 02:37:11,519 SAYING WHERE ARE WE GOING TO 3825 02:37:11,519 --> 02:37:13,054 FIND THE TIME TO DO THIS IN 3826 02:37:13,054 --> 02:37:15,023 MEDICAL SCHOOL EDUCATION? 3827 02:37:15,023 --> 02:37:16,891 OR IN PRIMARY CARE DOCTOR'S 3828 02:37:16,891 --> 02:37:17,459 OFFICE? 3829 02:37:17,459 --> 02:37:19,427 AND, YOU KNOW, THAT'S A 3830 02:37:19,427 --> 02:37:21,863 CHALLENGE THAT WE'RE WORKING ON. 3831 02:37:21,863 --> 02:37:25,767 WE ARE STARTING TO WORK ON 3832 02:37:25,767 --> 02:37:26,868 TAKING THE HEALTHCARE 3833 02:37:26,868 --> 02:37:29,104 PROFESSIONAL CORE RESOURCE AND 3834 02:37:29,104 --> 02:37:30,305 MAKING A 30-MINUTE PRESENTATION 3835 02:37:30,305 --> 02:37:31,272 FOR MEDICAL SCHOOLS. 3836 02:37:31,272 --> 02:37:34,242 SO WE'RE WORKING ON THAT. 3837 02:37:34,242 --> 02:37:35,343 MANY NEXT COUNCIL WE'LL HAVE 3838 02:37:35,343 --> 02:37:36,811 SOMETHING TO TALK ABOUT. 3839 02:37:36,811 --> 02:37:41,216 WE STILL HAVE A BIGGER PROBLEM. 3840 02:37:41,216 --> 02:37:42,684 YOU KNOW, I WAS THINKING WHEN 3841 02:37:42,684 --> 02:37:43,985 JOAN WAS TALKING WE COULD USE 3842 02:37:43,985 --> 02:37:46,354 SOCIAL MEDIA TO GET THIS OUT 3843 02:37:46,354 --> 02:37:46,554 THERE. 3844 02:37:46,554 --> 02:37:49,124 BUT IT HAS -- YOU WOULD ALMOST 3845 02:37:49,124 --> 02:37:52,360 NEED A TEAM, JOAN, THAT WOULD GO 3846 02:37:52,360 --> 02:37:53,762 FROM CITY TO CITY IN THE UNITED 3847 02:37:53,762 --> 02:37:56,498 STATES AND DO WHAT WAS IT OBAMA 3848 02:37:56,498 --> 02:38:02,404 USED TO DO, LOCAL ORGANIZATIONS 3849 02:38:02,404 --> 02:38:04,172 OR COMMUNITY -- COMMUNITY -- 3850 02:38:04,172 --> 02:38:05,807 COMMUNITY ORGANIZING, YEAH, IT'S 3851 02:38:05,807 --> 02:38:06,975 A POLITICAL TERM. 3852 02:38:06,975 --> 02:38:08,576 LET'S TURN IT INTO A HEALTH 3853 02:38:08,576 --> 02:38:09,043 TERM. 3854 02:38:09,043 --> 02:38:10,712 WE COULD DO COMMUNITY 3855 02:38:10,712 --> 02:38:11,212 ORGANIZING. 3856 02:38:11,212 --> 02:38:14,482 BUT WHO IS GOING TO GIVE US THE 3857 02:38:14,482 --> 02:38:17,419 MONEY TO SEND A SWAT TEAM TO 3858 02:38:17,419 --> 02:38:18,620 EVERY CITY IN THE UNITED STATES, 3859 02:38:18,620 --> 02:38:22,490 TO DO COMMUNITY ORGANIZING? 3860 02:38:22,490 --> 02:38:24,058 THAT'S MY SOLILOQUY. 3861 02:38:24,058 --> 02:38:25,260 I'LL STOP THERE AND LET'S HEAR 3862 02:38:25,260 --> 02:38:29,030 FROM THE REST OF YOU. 3863 02:38:29,030 --> 02:38:29,397 KATIE? 3864 02:38:29,397 --> 02:38:30,031 >> YEAH, THANKS, GEORGE, FOR 3865 02:38:30,031 --> 02:38:32,333 HAVING THIS TIME FOR US. 3866 02:38:32,333 --> 02:38:36,070 I ALSO WANTED TO FOLLOW UP ON 3867 02:38:36,070 --> 02:38:38,473 THE MOMS TOUR, IT FEEDS INTO 3868 02:38:38,473 --> 02:38:38,873 THIS. 3869 02:38:38,873 --> 02:38:41,109 I THINK THERE'S A LOT OF 3870 02:38:41,109 --> 02:38:43,378 OPPORTUNITIES THAT WE DON'T TAP 3871 02:38:43,378 --> 02:38:45,980 INTO WITH RESPECT TO -- WE HAVE 3872 02:38:45,980 --> 02:38:47,415 UNIVERSITIES AROUND THE COUNTRY, 3873 02:38:47,415 --> 02:38:51,486 AROUND THE WORLD, THAT HAVE 3874 02:38:51,486 --> 02:38:52,353 UNDERGRADUATE, GRADUATE, HEALTH 3875 02:38:52,353 --> 02:38:53,021 PROFESSIONAL STUDENTS INTERESTED 3876 02:38:53,021 --> 02:38:54,456 IN BEING ENGAGED IN THEIR 3877 02:38:54,456 --> 02:38:55,123 COMMUNITIES. 3878 02:38:55,123 --> 02:38:57,459 AND MIGHT NOT HAVE THE TOOLS OR 3879 02:38:57,459 --> 02:38:59,661 RESOURCES TO BE ENGAGED. 3880 02:38:59,661 --> 02:39:01,396 AND I'M REALLY EXCITED THAT MOMS 3881 02:39:01,396 --> 02:39:03,698 TOUR IS COMING TO ALBUQUERQUE 3882 02:39:03,698 --> 02:39:04,933 AND WE WILL SIGN UP. 3883 02:39:04,933 --> 02:39:07,235 YOU CAN SIGN UP TO BE AN 3884 02:39:07,235 --> 02:39:09,671 EXHIBITOR FOR FREE, YOU CAN 3885 02:39:09,671 --> 02:39:10,205 VOLUNTEER. 3886 02:39:10,205 --> 02:39:11,806 THESE SEEM LIKE GREAT 3887 02:39:11,806 --> 02:39:14,442 OPPORTUNITIES THAT I WONDER IF A 3888 02:39:14,442 --> 02:39:16,311 SMALL INVESTMENT FROM NIAAA 3889 02:39:16,311 --> 02:39:19,047 WOULD BE CREATING A TRAINING 3890 02:39:19,047 --> 02:39:20,982 PROGRAM FOR NIAAA AMBASSADORS 3891 02:39:20,982 --> 02:39:22,817 THAT WOULD BE UNDERGRADUATE, 3892 02:39:22,817 --> 02:39:23,518 GRADUATE HEALTH PROFESSIONAL 3893 02:39:23,518 --> 02:39:25,019 STUDENTS ACROSS THE U.S., ACROSS 3894 02:39:25,019 --> 02:39:28,590 THE WORLD, WHO COULD GO TO 3895 02:39:28,590 --> 02:39:31,292 EVENTS LIKE THIS AND TABLE AND 3896 02:39:31,292 --> 02:39:31,893 BE EXHIBITORS AND VOLUNTEER. 3897 02:39:31,893 --> 02:39:33,394 A LOT OF PEOPLE WANT TO GIVE 3898 02:39:33,394 --> 02:39:33,895 BACK. 3899 02:39:33,895 --> 02:39:35,363 THEY JUST DON'T KNOW WHERE OR 3900 02:39:35,363 --> 02:39:36,564 HOW OR HAVE THE RESOURCES TO DO 3901 02:39:36,564 --> 02:39:36,865 SO. 3902 02:39:36,865 --> 02:39:39,000 MIGHT NOT HAVE THE TRAINING TO 3903 02:39:39,000 --> 02:39:39,667 DO SO. 3904 02:39:39,667 --> 02:39:41,803 SO CREATING A PROGRAM LIKE THAT 3905 02:39:41,803 --> 02:39:43,638 WHERE PEOPLE COULD GET, YOU 3906 02:39:43,638 --> 02:39:45,106 KNOW, THAT OPPORTUNITY, THOSE 3907 02:39:45,106 --> 02:39:46,274 OPPORTUNITIES, AND ALSO, YOU 3908 02:39:46,274 --> 02:39:47,709 KNOW, SOMETHING ON THEIR CV THEY 3909 02:39:47,709 --> 02:39:49,644 ARE ENGAGING WITH ONE OF THE 3910 02:39:49,644 --> 02:39:50,845 NATIONAL INSTITUTES OF THE 3911 02:39:50,845 --> 02:39:51,079 HEALTH. 3912 02:39:51,079 --> 02:39:53,715 I THINK THAT WOULD BE A WAY TO 3913 02:39:53,715 --> 02:39:57,719 MAY BE -- MAKE THE MONEY GO 3914 02:39:57,719 --> 02:40:01,055 FURTHER AND TRAIN THE NEXT 3915 02:40:01,055 --> 02:40:05,827 GENERATION, WHICH IS ALSO 3916 02:40:05,827 --> 02:40:07,128 IMPORTANT. 3917 02:40:07,128 --> 02:40:10,365 >> I LIKE THAT. 3918 02:40:10,365 --> 02:40:11,099 I TAUGHT UNDERGRADUATE AT UCSD 3919 02:40:11,099 --> 02:40:12,300 FOR 40 YEARS, YOU CAN DO THE 3920 02:40:12,300 --> 02:40:14,836 SAME THING IN MEDICAL SCHOOLS 3921 02:40:14,836 --> 02:40:16,204 FOR UNDERGRADUATES RIGHT DOWN 3922 02:40:16,204 --> 02:40:18,973 THE LINE. 3923 02:40:18,973 --> 02:40:20,208 YOU KNOW. 3924 02:40:20,208 --> 02:40:23,177 SOMEBODY COULD BANG IT INTO 3925 02:40:23,177 --> 02:40:24,045 THEIR NEUROSCIENCE COURSE OR 3926 02:40:24,045 --> 02:40:27,615 MENTAL HEALTH COURSE, PSYCHOLOGY 3927 02:40:27,615 --> 02:40:27,916 DEPARTMENT. 3928 02:40:27,916 --> 02:40:28,650 >> PRE-MED CURRICULUM, ALL 3929 02:40:28,650 --> 02:40:29,417 RIGHT? 3930 02:40:29,417 --> 02:40:31,085 YOU COULD ENCOURAGE THE 3931 02:40:31,085 --> 02:40:31,853 PRE-MEDS. 3932 02:40:31,853 --> 02:40:34,389 THAT'S A WAY OF GETTING THEM 3933 02:40:34,389 --> 02:40:42,797 EVEN FURTHER UPSTREAM. 3934 02:40:42,797 --> 02:40:46,534 3935 02:40:46,534 --> 02:40:49,537 3936 02:40:49,537 --> 02:40:51,806 >> TO ADD TO WHAT KATIE SAID, I 3937 02:40:51,806 --> 02:40:53,875 CAN TALK TO YOU OFFLINE, JOAN, 3938 02:40:53,875 --> 02:40:54,943 AN ISSUE IN PREGNANCY, THE 3939 02:40:54,943 --> 02:40:56,711 MESSAGE IS NO AMOUNT OF ALCOHOL 3940 02:40:56,711 --> 02:40:58,513 IS SAFE IN PREGNANCY BUT WHEN 3941 02:40:58,513 --> 02:40:59,781 YOU'RE TALKING TO PREGNANT WOMEN 3942 02:40:59,781 --> 02:41:01,349 MANY HAVE ALREADY CONSUMED 3943 02:41:01,349 --> 02:41:02,717 ALCOHOL. 3944 02:41:02,717 --> 02:41:05,019 IT'S A MORE NUANCED DISCUSSION. 3945 02:41:05,019 --> 02:41:06,788 WE HAVE TO GET THE INFORMATION 3946 02:41:06,788 --> 02:41:08,222 OUT THERE AND HAVE RESOURCES 3947 02:41:08,222 --> 02:41:09,757 THAT ALLOW THEM TO TALK TO 3948 02:41:09,757 --> 02:41:10,625 SOMEBODY ABOUT WHAT'S ALREADY 3949 02:41:10,625 --> 02:41:11,025 HAPPENED. 3950 02:41:11,025 --> 02:41:12,627 I THINK IT'S IMPORTANT TO 3951 02:41:12,627 --> 02:41:14,529 PARTNER WITH GROUPS THAT CAN 3952 02:41:14,529 --> 02:41:16,564 PROVIDE THAT KIND OF ONE-ON-ONE 3953 02:41:16,564 --> 02:41:18,933 NUANCED CONVERSATION AND I THINK 3954 02:41:18,933 --> 02:41:20,969 NIAAA COULD REALLY FACILITATE 3955 02:41:20,969 --> 02:41:23,271 THAT. 3956 02:41:23,271 --> 02:41:27,609 3957 02:41:27,609 --> 02:41:30,578 >> YEAH, JUST THAT THE TIME 3958 02:41:30,578 --> 02:41:34,382 ISSUE REALLY IS IMPORTANT. 3959 02:41:34,382 --> 02:41:37,251 I KNOW MOST OF THE PEOPLE IN MY 3960 02:41:37,251 --> 02:41:38,786 DEPARTMENT ARE PHYSICIANS AND IN 3961 02:41:38,786 --> 02:41:40,021 PRIMARY CARE I KNOW THAT JUST 3962 02:41:40,021 --> 02:41:41,122 THE APPRECIATE TO SEE HIGH 3963 02:41:41,122 --> 02:41:42,957 NUMBERS OF PATIENTS WITH 3964 02:41:42,957 --> 02:41:44,459 DROPPING REIMBURSEMENT AND DOING 3965 02:41:44,459 --> 02:41:46,527 IT VERY QUICKLY AND BEING 3966 02:41:46,527 --> 02:41:48,062 EXTREMELY FOCUSED ON THE PROBLEM 3967 02:41:48,062 --> 02:41:50,465 I THINK A LOT OF PEOPLE APPROACH 3968 02:41:50,465 --> 02:41:51,666 THOSE FOLKS AND SAY, HEY, CAN 3969 02:41:51,666 --> 02:41:54,502 YOU DO THIS, CAN YOU DO THAT? 3970 02:41:54,502 --> 02:41:55,770 THEIR ANSWER IS NO. 3971 02:41:55,770 --> 02:41:57,639 I'VE GOT ENOUGH TO DO AS IT IS. 3972 02:41:57,639 --> 02:42:01,109 SO I THINK THE KEY PROBABLY IS 3973 02:42:01,109 --> 02:42:03,044 FIGURING OUT HOW TO WORK IT IN 3974 02:42:03,044 --> 02:42:08,082 OUTSIDE OF THE PHYSICIAN. 3975 02:42:08,082 --> 02:42:10,251 AND WITH SOME OF THE SUPPORT 3976 02:42:10,251 --> 02:42:10,518 STAFF. 3977 02:42:10,518 --> 02:42:12,286 >> I DO THINK THEY HAVE THE TIME 3978 02:42:12,286 --> 02:42:13,988 TO DO IT. 3979 02:42:13,988 --> 02:42:15,123 WE OUTLINED THIS VERY CLEARLY IN 3980 02:42:15,123 --> 02:42:17,258 THE CORE RESOURCE BUT THE KEY IS 3981 02:42:17,258 --> 02:42:19,527 THAT THEY GOT TO WANT TO DO IT. 3982 02:42:19,527 --> 02:42:21,996 THAT WE HAVE TO SHOW THEM IT 3983 02:42:21,996 --> 02:42:24,532 WILL HELP THEIR PRACTICE. 3984 02:42:24,532 --> 02:42:26,234 IF SOMEBODY COMES IN WITH A HIGH 3985 02:42:26,234 --> 02:42:27,702 BLOOD PRESSURE AND STUFF, FOR 3986 02:42:27,702 --> 02:42:30,004 THEM TO KNOW WHETHER OR NOT THEY 3987 02:42:30,004 --> 02:42:32,607 HAVE BEEN DRINKING AND DO A 3988 02:42:32,607 --> 02:42:33,608 BRIEF INTERVENTION, THAT'S PART 3989 02:42:33,608 --> 02:42:35,109 OF THE THERAPY THEY ARE GIVING. 3990 02:42:35,109 --> 02:42:38,179 IF THEY DON'T ADDRESS THAT, MOST 3991 02:42:38,179 --> 02:42:40,214 AREN'T ADDRESSING THAT, YOU TRY 3992 02:42:40,214 --> 02:42:43,051 TO TREAT THE BLOOD PRESSURE BUT 3993 02:42:43,051 --> 02:42:45,086 THEY ARE STILL DRINKING, OR THE 3994 02:42:45,086 --> 02:42:46,087 LIVER DOCTORS. 3995 02:42:46,087 --> 02:42:48,956 YOU KNOW, WE'RE BEGINNING AT 3996 02:42:48,956 --> 02:42:50,992 LEAST THE RESEARCHERS AND LIVER 3997 02:42:50,992 --> 02:42:52,193 DOCTORS BEGINNING TO REALIZE, 3998 02:42:52,193 --> 02:42:53,795 HEY, WE NEED TO DO SOMETHING 3999 02:42:53,795 --> 02:42:54,729 ABOUT THEIR DRINKING TO REALLY 4000 02:42:54,729 --> 02:42:56,597 TREAT THE LIVER DISEASE. 4001 02:42:56,597 --> 02:42:58,800 SO IT'S REALLY IMPORTANT THAT 4002 02:42:58,800 --> 02:43:00,802 THEY -- THAT THIS IS GOING TO 4003 02:43:00,802 --> 02:43:01,135 BENEFIT THEM. 4004 02:43:01,135 --> 02:43:03,004 THIS IS NOT AN EXTRA LAYER FOR 4005 02:43:03,004 --> 02:43:05,973 THEM OR EXTRA WORK. 4006 02:43:05,973 --> 02:43:07,508 THIS IS SOMETHING THAT IS GOING 4007 02:43:07,508 --> 02:43:09,110 TO HELP THEM IN THEIR PRACTICE. 4008 02:43:09,110 --> 02:43:11,279 THAT'S THE MESSAGE WE HAVE TO 4009 02:43:11,279 --> 02:43:12,013 GET ACROSS. 4010 02:43:12,013 --> 02:43:13,948 >> YOU DON'T HAVE TO CONVINCE ME 4011 02:43:13,948 --> 02:43:15,917 BUT I THINK THE COMPETITION FOR 4012 02:43:15,917 --> 02:43:17,018 THEIR TIME AND ATTENTION IS 4013 02:43:17,018 --> 02:43:20,822 REALLY INTENSE AND I THINK IT 4014 02:43:20,822 --> 02:43:22,824 HAS TO -- YOU KNOW. 4015 02:43:22,824 --> 02:43:25,159 >> YEAH, I ALSO HAD A FOLLOW-UP 4016 02:43:25,159 --> 02:43:28,062 ON DAVID'S COMMENT WHICH IS THAT 4017 02:43:28,062 --> 02:43:32,633 WE FINALLY AFTER TWO YEARS GOT 4018 02:43:32,633 --> 02:43:33,568 THE AUDIT-C INTO THE ELECTRONIC 4019 02:43:33,568 --> 02:43:34,902 HEALTH RECORD. 4020 02:43:34,902 --> 02:43:36,070 AND NOW WE HAVE ONE YEAR 4021 02:43:36,070 --> 02:43:37,705 EXPERIENCE WITH IT. 4022 02:43:37,705 --> 02:43:39,240 SO THERE ARE OVER 500 NURSES 4023 02:43:39,240 --> 02:43:41,576 THAT HAD TO BE TRAINED IN DOING 4024 02:43:41,576 --> 02:43:43,578 THE AUDIT-C AND WE DID A 4025 02:43:43,578 --> 02:43:48,015 QUESTIONNAIRE AS TO HOW WELL IT 4026 02:43:48,015 --> 02:43:48,282 WORKED. 4027 02:43:48,282 --> 02:43:50,451 100% OF THESE 500 NURSES SAID 4028 02:43:50,451 --> 02:43:53,254 THAT IT WAS WORTHWHILE TO DO THE 4029 02:43:53,254 --> 02:43:53,621 AUDIT-C. 4030 02:43:53,621 --> 02:43:58,092 BY THE WAY, LAURA GOT THIS INTO 4031 02:43:58,092 --> 02:44:01,896 THE "ALL OF US" PHENOTYPING 4032 02:44:01,896 --> 02:44:08,202 QUESTIONNAIRE, SHE WAS 4033 02:44:08,202 --> 02:44:11,706 INSTRUMENTAL IN DOING THAT. 4034 02:44:11,706 --> 02:44:14,842 WE'VE DOUBLED THE NUMBER OF 4035 02:44:14,842 --> 02:44:17,011 ADDITION CONSOLE REFERRALS, 4036 02:44:17,011 --> 02:44:19,480 THERE HAVE BEEN PROBABLY -- 4037 02:44:19,480 --> 02:44:21,015 WE'RE STILL DEBATING PROCESSING 4038 02:44:21,015 --> 02:44:22,416 THE NUMBERS, WE DON'T WANT TO 4039 02:44:22,416 --> 02:44:25,419 COUNT PEOPLE TWICE BUT IT SEEMS 4040 02:44:25,419 --> 02:44:27,688 THERE WERE 70 OR 80 NIH CLINICAL 4041 02:44:27,688 --> 02:44:32,360 CENTER PATIENTS WHO WERE ABOVE 4042 02:44:32,360 --> 02:44:33,227 THE AUDIT-C THRESHOLD. 4043 02:44:33,227 --> 02:44:35,062 I THINK THAT SCORE IS ABOUT SIX. 4044 02:44:35,062 --> 02:44:38,166 THE KEY THING IS THAT IT'S 4045 02:44:38,166 --> 02:44:41,969 ADMINISTERED ON ADMISSION BY THE 4046 02:44:41,969 --> 02:44:44,472 NURSES, AND NOT BY A PHYSICIAN 4047 02:44:44,472 --> 02:44:45,773 OR A PHYSICIAN PRACTITIONER. 4048 02:44:45,773 --> 02:44:49,443 IT GOES RIGHT INTO THE 4049 02:44:49,443 --> 02:44:50,611 ELECTRONIC HEALTH RECORD. 4050 02:44:50,611 --> 02:44:52,847 >> YES, THAT'S GREAT. 4051 02:44:52,847 --> 02:44:53,614 CONCEPTUALLY HOW WOULD ALCOHOL 4052 02:44:53,614 --> 02:44:56,050 AS A FIFTH VITAL SIGN BE 4053 02:44:56,050 --> 02:45:00,354 SEPARATE AND DISTINCT FROM THE 4054 02:45:00,354 --> 02:45:00,721 AUDIT-C? 4055 02:45:00,721 --> 02:45:01,722 >> THAT'S IT. 4056 02:45:01,722 --> 02:45:04,625 IT'S THREE QUESTIONS, IT'S JUST 4057 02:45:04,625 --> 02:45:04,992 THREE QUESTIONS. 4058 02:45:04,992 --> 02:45:10,331 AND IT'S EXECUTED IN ABOUT TWO 4059 02:45:10,331 --> 02:45:10,565 MINUTES. 4060 02:45:10,565 --> 02:45:11,833 >> IT WOULDN'T NECESSARILY. 4061 02:45:11,833 --> 02:45:13,134 I'M VERY UNPOPULAR WITH MY 4062 02:45:13,134 --> 02:45:14,769 FELLOW I.C. DIRECTORS BECAUSE I 4063 02:45:14,769 --> 02:45:18,206 TRY TO GET THE AUDIT-C INTO 4064 02:45:18,206 --> 02:45:20,241 EVERY COHORT AT NIH. 4065 02:45:20,241 --> 02:45:21,742 SO THEY DON'T WANT TO HEAR IT 4066 02:45:21,742 --> 02:45:24,979 ANYMORE BUT DO PUT IT IN THERE. 4067 02:45:24,979 --> 02:45:27,782 I SO I THINK YOU ALL AS 4068 02:45:27,782 --> 02:45:30,952 RESEARCHERS COULD START LOOKING 4069 02:45:30,952 --> 02:45:34,288 AT -- EVEN AT HEART LUNG AND 4070 02:45:34,288 --> 02:45:35,990 NEUROLOGY, YOU MIGHT FIND ACTUAL 4071 02:45:35,990 --> 02:45:36,324 NUMBERS THERE. 4072 02:45:36,324 --> 02:45:37,859 YOU WERE LOOKING ON THE WEBSITE 4073 02:45:37,859 --> 02:45:39,627 OR QUERYING ONE OF THE PROGRAM 4074 02:45:39,627 --> 02:45:40,027 OFFICERS. 4075 02:45:40,027 --> 02:45:41,329 >> THE OTHER THING I'D LIKE TO 4076 02:45:41,329 --> 02:45:45,633 ADD IS WE RAN -- WE DID THE 4077 02:45:45,633 --> 02:45:47,268 RECEIVER OPERATING CURVE AGAINST 4078 02:45:47,268 --> 02:45:48,736 SEVEN OR EIGHT HUNDRED 4079 02:45:48,736 --> 02:45:50,905 INDIVIDUALS WHO WE STUDIED UNDER 4080 02:45:50,905 --> 02:45:52,273 OUR NATURAL HISTORY PROTOCOL. 4081 02:45:52,273 --> 02:45:56,410 AND SO IT'S A DATASET THAT'S 4082 02:45:56,410 --> 02:45:59,180 ABOUT 60% AUD AND 40% SOMETHING 4083 02:45:59,180 --> 02:45:59,513 ELSE. 4084 02:45:59,513 --> 02:46:05,419 THE AREA UNDER THE CURVE WAS 4085 02:46:05,419 --> 02:46:06,053 .95. 4086 02:46:06,053 --> 02:46:08,689 SO, JUST THESE THREE QUESTIONS 4087 02:46:08,689 --> 02:46:10,091 PRETTY RELIABLY TELL YOU WHETHER 4088 02:46:10,091 --> 02:46:14,061 SOMEBODY HAS AN ALCOHOL PROBLEM. 4089 02:46:14,061 --> 02:46:15,162 >> AND AS YOU KNOW, A LOT OF 4090 02:46:15,162 --> 02:46:16,797 TIMES YOU GO TO THE DOCTOR, FILL 4091 02:46:16,797 --> 02:46:18,466 OUT THESE FORMS AHEAD OF TIME. 4092 02:46:18,466 --> 02:46:19,867 THOSE COULD BE FILLED OUT AHEAD 4093 02:46:19,867 --> 02:46:21,702 OF TIME FOR THEM TO LOOK AT. 4094 02:46:21,702 --> 02:46:25,973 SO IT WOULDN'T TAKE ANY OF THEIR 4095 02:46:25,973 --> 02:46:26,173 TIME. 4096 02:46:26,173 --> 02:46:27,275 >> THE JUSTIFICATION FOR IT TO 4097 02:46:27,275 --> 02:46:28,876 BE A VITAL SIGN IS THE YIELD. 4098 02:46:28,876 --> 02:46:30,711 THERE ARE A LOT OF THINGS THAT 4099 02:46:30,711 --> 02:46:32,580 YOU GET ASKED ABOUT WHEN YOU GO 4100 02:46:32,580 --> 02:46:36,617 TO THE DOCTOR, THE ANSWER IS 4101 02:46:36,617 --> 02:46:37,518 ALWAYS NO. 4102 02:46:37,518 --> 02:46:39,420 AND SO HERE'S A QUESTIONNAIRE 4103 02:46:39,420 --> 02:46:41,722 WHERE THE ANSWER REALLY SHOULD 4104 02:46:41,722 --> 02:46:44,625 BE YES, QUITE OFTEN, GIVEN THAT 4105 02:46:44,625 --> 02:46:51,098 THE ONE-YEAR PREVALENCE OF AUD 4106 02:46:51,098 --> 02:46:54,602 IS ABOUT 10% SO VERY HIGH YIELD. 4107 02:46:54,602 --> 02:46:57,605 AS I THINK YOU JUST SAID, IT 4108 02:46:57,605 --> 02:46:58,539 AFFECTS EVERYTHING ELSE A 4109 02:46:58,539 --> 02:47:00,875 PHYSICIAN MIGHT BE WANTING TO 4110 02:47:00,875 --> 02:47:05,880 DO, DRUGS THEY ARE PRESCRIBING, 4111 02:47:05,880 --> 02:47:07,682 INTERPRETING LAB TEST RESULTS, 4112 02:47:07,682 --> 02:47:09,917 SYMPTOMS THE PATIENT IS 4113 02:47:09,917 --> 02:47:11,419 EXPERIENCING, EVERYTHING. 4114 02:47:11,419 --> 02:47:12,853 >> YOU KNOW, NORTHERN CALIFORNIA 4115 02:47:12,853 --> 02:47:15,289 HAS ALL THEIR PRIMARY CARE 4116 02:47:15,289 --> 02:47:16,424 PHYSICIANS, ABOUT 600, ACTUALLY 4117 02:47:16,424 --> 02:47:18,592 DOING THIS RIGHT NOW WHEN THEY 4118 02:47:18,592 --> 02:47:19,226 SEE IT. 4119 02:47:19,226 --> 02:47:21,195 YOU KNOW, THEY FIND OUT IF 4120 02:47:21,195 --> 02:47:22,530 THERE'S HEAVY DRINKING. 4121 02:47:22,530 --> 02:47:27,201 IN FACT RIGHT NOW THEY HAVE A 4122 02:47:27,201 --> 02:47:28,169 REGISTRY OF 1.1 MILLION PATIENTS 4123 02:47:28,169 --> 02:47:29,637 THAT HAD SOME PROBLEMATIC 4124 02:47:29,637 --> 02:47:30,571 DRINKING THAT THEY ACTUALLY 4125 02:47:30,571 --> 02:47:32,139 FOLLOW UP. 4126 02:47:32,139 --> 02:47:33,641 ACTUALLY HAVE A CONTRACT WITH 4127 02:47:33,641 --> 02:47:36,477 THAT WE'RE DOING ALL KINDS OF 4128 02:47:36,477 --> 02:47:37,611 ACKNOWLEDGE SIS, GETTING OUT 4129 02:47:37,611 --> 02:47:39,413 THREE OR FOUR PAPERS A YEAR NOW. 4130 02:47:39,413 --> 02:47:43,317 IT'S SUCH A RICH DATASET. 4131 02:47:43,317 --> 02:47:45,820 IT DID SHOW ORGANIZATION LIKE 4132 02:47:45,820 --> 02:47:47,021 KAISER, PRIMARY CARE PHYSICIANS 4133 02:47:47,021 --> 02:47:54,128 CAN DO THIS AND WORK IT IN TO 4134 02:47:54,128 --> 02:47:54,662 THEIR 15-MINUTE SCHEDULE 4135 02:47:54,662 --> 02:47:56,831 >> DO YOU FIND IN RESPONSE TO'D 4136 02:47:56,831 --> 02:47:58,632 AING AUDIT-C THERE'S AN 4137 02:47:58,632 --> 02:48:00,968 INCREASED RATE OF PRESCRIPTION 4138 02:48:00,968 --> 02:48:05,740 BY PRIMARY CARE PHYSICIANS OF 4139 02:48:05,740 --> 02:48:06,340 MEDICATIONS LIKE ACAMPROSATE? 4140 02:48:06,340 --> 02:48:08,242 >> I DON'T KNOW IT'S SO 4141 02:48:08,242 --> 02:48:11,712 DIFFICULT FOR PRIMARY CARE 4142 02:48:11,712 --> 02:48:16,150 PHYSICIANS TO SUBSCRIBE -- 4143 02:48:16,150 --> 02:48:17,418 PRESCRIBE MEDICATIONS, 4144 02:48:17,418 --> 02:48:18,486 FDA-APPROVED MEDICATION. 4145 02:48:18,486 --> 02:48:22,456 EVEN KAISER, PRIMARY CARE 4146 02:48:22,456 --> 02:48:26,494 PHYSICIANS, WERE RELUCTANT TO 4147 02:48:26,494 --> 02:48:27,628 GIVE, SAY NALTREXONE OR AL CAMP 4148 02:48:27,628 --> 02:48:38,039 ROW SAY -- ACAMPROSATE. 4149 02:48:40,508 --> 02:48:43,210 THEY WOULD EXPLAIN ABOUT GIVING 4150 02:48:43,210 --> 02:48:46,113 THE MEDICATIONS, STARTED PICKING 4151 02:48:46,113 --> 02:48:47,548 UP, STARTED PRESCRIBING FDA 4152 02:48:47,548 --> 02:48:48,449 MEDICATIONS, BY DOING THAT, AND 4153 02:48:48,449 --> 02:48:50,618 THEN I THINK THE PHYSICIANS GOT 4154 02:48:50,618 --> 02:48:51,318 MORE COMFORTABLE. 4155 02:48:51,318 --> 02:48:53,721 NOT QUITE SURE WHY THEY FEEL 4156 02:48:53,721 --> 02:48:55,923 UNCOMFORTABLE. 4157 02:48:55,923 --> 02:48:57,425 I DON'T KNOW IF THEY ARE 4158 02:48:57,425 --> 02:48:59,593 CONFUSING WITH BUPRENORPHINE 4159 02:48:59,593 --> 02:49:00,661 WHERE THEY HAVE TO BE ADDICTIVE 4160 02:49:00,661 --> 02:49:02,229 AND STUFF. 4161 02:49:02,229 --> 02:49:07,968 THESE ARE NOT ADDICTIVE. 4162 02:49:07,968 --> 02:49:09,170 >> GIVEN LIKE ANTIDEPRESSANTS. 4163 02:49:09,170 --> 02:49:15,342 >> DAVE KRAB AT IU DID A SURVEY 4164 02:49:15,342 --> 02:49:16,677 AT ESKENAZI HOSPITAL, PHYSICIANS 4165 02:49:16,677 --> 02:49:17,745 DON'T FEEL COMFORTABLE. 4166 02:49:17,745 --> 02:49:21,449 IGNORANCE WAS A LOT OF IT. 4167 02:49:21,449 --> 02:49:22,550 THEY ARE NOT COMFORTABLE WITH 4168 02:49:22,550 --> 02:49:24,518 THE DATABASE. 4169 02:49:24,518 --> 02:49:28,189 >> I HAVE TO TELL YOU, WHEN THEY 4170 02:49:28,189 --> 02:49:30,124 TAKE THESE DRUGS, ACAMPROSATE OR 4171 02:49:30,124 --> 02:49:31,959 NALTREXONE, AND THE PEOPLE THAT 4172 02:49:31,959 --> 02:49:33,427 DO RESPOND TO THESE AND THESE 4173 02:49:33,427 --> 02:49:35,262 ARE PEOPLE THAT HAVE BEEN 4174 02:49:35,262 --> 02:49:38,132 DRINKING 15, 20 YEARS, THEY NO 4175 02:49:38,132 --> 02:49:41,001 LONGER HAVE THE DESIRED URGE TO 4176 02:49:41,001 --> 02:49:41,535 DRINK ANYMORE, IT'S QUITE 4177 02:49:41,535 --> 02:49:45,072 REMARKABLE TO SEE SOMETHING LIKE 4178 02:49:45,072 --> 02:49:45,272 THAT. 4179 02:49:45,272 --> 02:49:47,842 AND THAT'S WHY IT'S KIND OF 4180 02:49:47,842 --> 02:49:48,843 HEARTBREAKING, MORE PEOPLE 4181 02:49:48,843 --> 02:49:50,111 AREN'T USING THIS. 4182 02:49:50,111 --> 02:49:51,912 THEY CAN BE HELPING SO MANY 4183 02:49:51,912 --> 02:49:54,515 PEOPLE IF MORE PEOPLE WERE USING 4184 02:49:54,515 --> 02:49:55,483 SOMETHING LIKE THIS. 4185 02:49:55,483 --> 02:49:58,119 >> I FEEL LIKE IT REMINDS ME OF 4186 02:49:58,119 --> 02:49:59,019 THE COLLABORATIVE CARE MODELS, 4187 02:49:59,019 --> 02:50:00,754 AND SORT OF FIGURING OUT WAYS TO 4188 02:50:00,754 --> 02:50:02,256 SUPPORT THE PRIMARY CARE 4189 02:50:02,256 --> 02:50:03,491 PHYSICIANS WHO AREN'T 4190 02:50:03,491 --> 02:50:04,925 COMFORTABLE DOING THIS, OR, YOU 4191 02:50:04,925 --> 02:50:06,293 KNOW, NEED SOME EXTRA SUPPORT 4192 02:50:06,293 --> 02:50:08,395 LIKE ADDING A PHARMACIST TO THE 4193 02:50:08,395 --> 02:50:09,964 TEAM OR ADDING AN ADDICTION 4194 02:50:09,964 --> 02:50:12,466 SPECIALIST TO THE TEAM OR 4195 02:50:12,466 --> 02:50:15,803 WHATEVER DIFFERENT CREATIVE WAYS 4196 02:50:15,803 --> 02:50:19,206 TO TRY TO SUPPORT THE PROVISION 4197 02:50:19,206 --> 02:50:20,641 FOR THE CLINICIANS WHO WANT TO 4198 02:50:20,641 --> 02:50:22,643 DO IT BUT AREN'T COMFORTABLE OR 4199 02:50:22,643 --> 02:50:27,014 FEEL THEY DON'T HAVE TIME. 4200 02:50:27,014 --> 02:50:30,084 >> BUT WE ALSO HAVE TO ADDRESS 4201 02:50:30,084 --> 02:50:30,784 THOSE SUPPORT PEOPLE. 4202 02:50:30,784 --> 02:50:32,520 SO ONE OF MY PROUDEST MOMENTS 4203 02:50:32,520 --> 02:50:35,122 WHEN I WAS TEACHING AT UCSD WAS 4204 02:50:35,122 --> 02:50:37,458 WHEN I WENT UP TO THE PHARMACY, 4205 02:50:37,458 --> 02:50:42,229 MY PHARMACY, TO PICK UP MY 4206 02:50:42,229 --> 02:50:45,099 OMEGA-3 OR WHATEVER IT WAS I 4207 02:50:45,099 --> 02:50:45,566 TAKE. 4208 02:50:45,566 --> 02:50:47,001 AND I WAS TEACHING IN THE 4209 02:50:47,001 --> 02:50:51,038 PHARMACY SCHOOL AS WELL AS IN 4210 02:50:51,038 --> 02:50:54,742 THE PSYCHOLOGY DEPARTMENT. 4211 02:50:54,742 --> 02:50:55,876 AND THE LADY, THE PHARMACIST, 4212 02:50:55,876 --> 02:50:57,611 HAD BEEN ONE OF OUR STUDENTS AND 4213 02:50:57,611 --> 02:50:59,380 SAID, OH, DR. KOOB, WE'RE SO 4214 02:50:59,380 --> 02:51:00,247 GLAD YOU'RE HERE. 4215 02:51:00,247 --> 02:51:01,649 WE HAVE A PATIENT WHO IS GOING 4216 02:51:01,649 --> 02:51:08,189 TO GO A VISITROL BUT ONLY WANTS 4217 02:51:08,189 --> 02:51:10,691 TO GO ON ONE COURSE. 4218 02:51:10,691 --> 02:51:12,760 CAN WE START ON ONE OR DOES IT 4219 02:51:12,760 --> 02:51:14,261 HAVE TO BE TWO I SAID TAKE 4220 02:51:14,261 --> 02:51:15,029 WHATEVER YOU CAN GET. 4221 02:51:15,029 --> 02:51:16,764 IT WAS INTERESTING TO ME THEY 4222 02:51:16,764 --> 02:51:17,698 ALSO NEED TRAINING. 4223 02:51:17,698 --> 02:51:21,035 YOU KNOW, WE HAVE TO START AT 4224 02:51:21,035 --> 02:51:26,574 EVERY LEVEL TO GET THIS 4225 02:51:26,574 --> 02:51:28,242 INFORMATION OUT. 4226 02:51:28,242 --> 02:51:29,810 IT'S-- YOU GUYS ARE STARTING TO 4227 02:51:29,810 --> 02:51:33,948 THINK OF CREATIVE IDEAS BUT I DO 4228 02:51:33,948 --> 02:51:35,716 THINK, YOU KNOW, WE NEED TO 4229 02:51:35,716 --> 02:51:37,651 SCALE UP A WHOLE VARIETY OF 4230 02:51:37,651 --> 02:51:37,851 AREAS. 4231 02:51:37,851 --> 02:51:43,857 WE'RE GOING TO BE MEETING WITH 4232 02:51:43,857 --> 02:51:45,359 SAMHSA SOON, I THINK. 4233 02:51:45,359 --> 02:51:46,193 WE'VE ALREADY BEGUN DISCUSSIONS 4234 02:51:46,193 --> 02:51:47,461 WITH THEM. 4235 02:51:47,461 --> 02:51:48,229 THEY HAVE SOME HUGE PROGRAMSER 4236 02:51:48,229 --> 02:51:52,766 THAT GOING TO BE PUTTING OUT 4237 02:51:52,766 --> 02:51:52,967 THERE. 4238 02:51:52,967 --> 02:51:56,737 BUT SAMHSA DOESN'T EVALUATE 4239 02:51:56,737 --> 02:51:57,204 THEIR PROGRAMS. 4240 02:51:57,204 --> 02:51:59,440 WE WANT TO GET ONE LEG IN TO BE 4241 02:51:59,440 --> 02:52:01,809 THE EVALUATION ARM FOR SAMHSA TO 4242 02:52:01,809 --> 02:52:06,046 FIND OUT WHETHER THIS IS IN THE 4243 02:52:06,046 --> 02:52:06,814 PREVENTION INTERVENTION DOMAIN, 4244 02:52:06,814 --> 02:52:10,084 TO FIND OUT WHETHER WE CAN 4245 02:52:10,084 --> 02:52:11,986 EVALUATE ONE OF THEIR BIG 4246 02:52:11,986 --> 02:52:16,590 PROGRAMS AND SEE WHETHER IT'S 4247 02:52:16,590 --> 02:52:18,325 ACTUALLY EFFECTIVE, YOU KNOW. 4248 02:52:18,325 --> 02:52:24,632 >> ONE OF THE APPROACHES IS AS 4249 02:52:24,632 --> 02:52:25,566 WE GET THESE INSTRUCTIONAL 4250 02:52:25,566 --> 02:52:28,335 CASSETTES THAT WE PUT THEM UP ON 4251 02:52:28,335 --> 02:52:31,272 OUR WEBSITE AND FOR IT TO BE A 4252 02:52:31,272 --> 02:52:33,707 MODULE THAT IS FAIRLY WELL -- 4253 02:52:33,707 --> 02:52:35,709 YOU KNOW, SELF-CONTAINED AND 4254 02:52:35,709 --> 02:52:38,279 THAT IS TARGETED TO A CERTAIN 4255 02:52:38,279 --> 02:52:39,613 CATEGORY OF INDIVIDUAL AND, FOR 4256 02:52:39,613 --> 02:52:44,885 EXAMPLE, WE WOULD BE GLAD TO 4257 02:52:44,885 --> 02:52:46,253 SUPPLY THE AUDIT-C TRAINING 4258 02:52:46,253 --> 02:52:49,556 MATERIALS, YOU KNOW, LIKE THEIR 4259 02:52:49,556 --> 02:52:49,923 VIDEOS. 4260 02:52:49,923 --> 02:52:53,193 THERE ARE EXPLANATIONS, THERE 4261 02:52:53,193 --> 02:52:54,528 ARE SLIDES. 4262 02:52:54,528 --> 02:52:56,630 BUT TO HAVE THIS MODULES OF 4263 02:52:56,630 --> 02:53:00,301 THESE THINGS THAT JUST 4264 02:53:00,301 --> 02:53:01,502 DIGESTIBLE BITS. 4265 02:53:01,502 --> 02:53:02,736 >> STILL TRYING TO GET RSA TO 4266 02:53:02,736 --> 02:53:06,540 NOTICE THAT WE HAVE A WEBSITE. 4267 02:53:06,540 --> 02:53:07,341 FRANCES, I UNDERSTAND ONLINE 4268 02:53:07,341 --> 02:53:08,909 THAT YOU HAVE A QUESTION. 4269 02:53:08,909 --> 02:53:11,345 I'M GOING TO ASK ANDREW IF HE'S 4270 02:53:11,345 --> 02:53:15,916 STILL THERE AND WHO ELSE IS 4271 02:53:15,916 --> 02:53:16,517 ONLINE? 4272 02:53:16,517 --> 02:53:16,717 NANCY. 4273 02:53:16,717 --> 02:53:18,619 I LEFT YOU OUT. 4274 02:53:18,619 --> 02:53:19,219 I APOLOGIZE. 4275 02:53:19,219 --> 02:53:19,687 FRANCES? 4276 02:53:19,687 --> 02:53:21,121 >> THANK YOU. 4277 02:53:21,121 --> 02:53:22,990 NO, I JUST WAS AGREEING AS 4278 02:53:22,990 --> 02:53:23,891 EVERYBODY WAS TALKING TODAY. 4279 02:53:23,891 --> 02:53:26,493 I'M SORRY I'M NOT THERE IN 4280 02:53:26,493 --> 02:53:27,161 PERSON. 4281 02:53:27,161 --> 02:53:29,263 YOU KNOW, I MEAN, AS A PHYSICIAN 4282 02:53:29,263 --> 02:53:32,800 I WILL TELL YOU THAT THE MESSAGE 4283 02:53:32,800 --> 02:53:33,634 ABOUT THAT THESE MEDICATIONS 4284 02:53:33,634 --> 02:53:36,970 WORK ARE JUST NOT OUT THERE. 4285 02:53:36,970 --> 02:53:37,838 AND THAT MOST PHYSICIANS JUST, 4286 02:53:37,838 --> 02:53:40,774 YOU KNOW, UNLESS THEY HAVE AN 4287 02:53:40,774 --> 02:53:42,042 EFFECT SIZE OF 1, FOR SOME 4288 02:53:42,042 --> 02:53:43,811 REASON WE EXPECT A LOT MORE OUT 4289 02:53:43,811 --> 02:53:45,379 OF THESE MEDICATIONS THAN OTHER 4290 02:53:45,379 --> 02:53:46,080 PSYCHIATRIC MEDICATIONS. 4291 02:53:46,080 --> 02:53:48,949 SO HOW TO GET THAT MESSAGE OUT 4292 02:53:48,949 --> 02:53:49,883 IS REALLY CRUCIAL. 4293 02:53:49,883 --> 02:53:53,821 I THINK WITH MEDICAL STUDENTS, 4294 02:53:53,821 --> 02:53:56,623 YOU HAVE A SHOT BECAUSE, YOU 4295 02:53:56,623 --> 02:54:00,828 KNOW, THEY ARE STILL NOT BIASED 4296 02:54:00,828 --> 02:54:04,064 AGAINST TREATING SUBSTANCE USE 4297 02:54:04,064 --> 02:54:05,265 DISORDERS. 4298 02:54:05,265 --> 02:54:06,734 THERE'S BEEN A REAL SEA CHANGE, 4299 02:54:06,734 --> 02:54:12,005 THEY WANT MORE ON SUBSTANCE USE 4300 02:54:12,005 --> 02:54:15,008 DISORDERS, PARTICULARLY OPIATE 4301 02:54:15,008 --> 02:54:16,677 USE DISBOARDS, DRAMATIC DEATHS 4302 02:54:16,677 --> 02:54:20,681 THAT HAVE BEEN NOTICED WITHOUT 4303 02:54:20,681 --> 02:54:21,648 UNDERSTANDING ALCOHOL ALSO LEADS 4304 02:54:21,648 --> 02:54:23,484 TO MORE DEATHS OVER TIME. 4305 02:54:23,484 --> 02:54:28,856 THE OTHER THING, I'M INVOLVED IN 4306 02:54:28,856 --> 02:54:31,358 THE PCSS MEDICATIONS FOR OPIOID 4307 02:54:31,358 --> 02:54:33,227 USE DISORDER, NOW THERE'S ONE 4308 02:54:33,227 --> 02:54:34,862 WITH SAMHSA ON ALCOHOL USE 4309 02:54:34,862 --> 02:54:37,765 DISORDER, PROBABLY WILL HAVE A 4310 02:54:37,765 --> 02:54:38,799 VERY WIDE AUDIENCE, PHYSICIANS 4311 02:54:38,799 --> 02:54:40,934 HOPEFULLY WILL PARTAKE OF IT. 4312 02:54:40,934 --> 02:54:43,670 WHEN YOU CAN GET SORT OF -- I 4313 02:54:43,670 --> 02:54:44,972 WON'T SAY A STICK BUT WHEN YOU 4314 02:54:44,972 --> 02:54:46,407 HAVE A STICK TO USE WITH 4315 02:54:46,407 --> 02:54:49,743 PHYSICIANS THEY DO CHANGE THEIR 4316 02:54:49,743 --> 02:54:52,713 BEHAVIORS, SO FOR EXAMPLE NOW IF 4317 02:54:52,713 --> 02:54:55,015 YOU WANT YOUR D.A. LICENSE AND 4318 02:54:55,015 --> 02:54:55,849 PRESCRIBE CONTROL SUBSTANCE YOU 4319 02:54:55,849 --> 02:54:59,420 HAVE TO LISTEN TO AN 8-HOUR 4320 02:54:59,420 --> 02:55:00,287 COURSE. 4321 02:55:00,287 --> 02:55:03,991 ON THE PCSS MOUD WEBSITE WE HAD 4322 02:55:03,991 --> 02:55:05,092 36,000 PHYSICIANS LAST MONTH 4323 02:55:05,092 --> 02:55:06,960 ATTEND OUR COURSE BECAUSE THEY 4324 02:55:06,960 --> 02:55:09,096 KNEW THEY NEEDED THAT FOR THEIR 4325 02:55:09,096 --> 02:55:09,363 LICENSURE. 4326 02:55:09,363 --> 02:55:11,865 I DON'T KNOW HOW YOU WOULD DO 4327 02:55:11,865 --> 02:55:15,335 THAT WITH GETTING PHYSICIANS TO 4328 02:55:15,335 --> 02:55:17,304 LISTEN ABOUT, YOU KNOW, 4329 02:55:17,304 --> 02:55:18,305 NON-CONTROLLED SUBSTANCES BUT I 4330 02:55:18,305 --> 02:55:21,074 THINK IT'S AN AUDIENCE TO TRY TO 4331 02:55:21,074 --> 02:55:24,678 GO AFTER THROUGH THE -- IF YOU 4332 02:55:24,678 --> 02:55:26,380 CAN COLLABORATE WITH SAMHSA, 4333 02:55:26,380 --> 02:55:27,714 THERE'S A LOT OF PRACTITIONERS 4334 02:55:27,714 --> 02:55:32,453 GOING TO THE WEBSITE. 4335 02:55:32,453 --> 02:55:34,721 PCSS MOUD HAD OVER 100,000 GO TO 4336 02:55:34,721 --> 02:55:35,923 THE WEBSITE AND WATCH WEBINARS 4337 02:55:35,923 --> 02:55:37,658 AND STUFF. 4338 02:55:37,658 --> 02:55:40,027 WITH THE PCSS AUD COMING OUT 4339 02:55:40,027 --> 02:55:42,396 ALCOHOL USE DISORDER THIS IS AN 4340 02:55:42,396 --> 02:55:42,796 OPTION. 4341 02:55:42,796 --> 02:55:43,664 BUT I THINK GRASS ROOTS 4342 02:55:43,664 --> 02:55:43,931 TRAINING. 4343 02:55:43,931 --> 02:55:45,966 AND THE OTHER THING I'D THROW IN 4344 02:55:45,966 --> 02:55:47,568 AS A PSYCHIATRIST, I THINK A LOT 4345 02:55:47,568 --> 02:55:49,703 OF THESE PATIENTS HAVE -- 4346 02:55:49,703 --> 02:55:50,737 PARTICULARLY WOMEN HAVE 4347 02:55:50,737 --> 02:55:52,239 PSYCHIATRIC CO-MORBIDITIES AND 4348 02:55:52,239 --> 02:55:55,375 WHEN HAVE YOU ADDITIONAL 4349 02:55:55,375 --> 02:55:55,976 PSYCHIATRIC COMORBIDITIES 4350 02:55:55,976 --> 02:55:58,345 DOCTORS, INTERNISTS GET MORE 4351 02:55:58,345 --> 02:55:59,413 NERVOUS ABOUT THE COMBINATION 4352 02:55:59,413 --> 02:56:00,848 AND WANTING TO REFER THEM RATHER 4353 02:56:00,848 --> 02:56:03,250 THAN TAKE IT ON. 4354 02:56:03,250 --> 02:56:03,984 HAVING BEHAVIORAL HEALTH 4355 02:56:03,984 --> 02:56:06,019 SPECIALISTS IN THE PRIMARY CARE 4356 02:56:06,019 --> 02:56:09,356 SETTINGS COULD HELP A LOT OR 4357 02:56:09,356 --> 02:56:10,257 FACILITATE THIS POPULATION 4358 02:56:10,257 --> 02:56:11,959 WHICH, YOU KNOW, CAN BE 4359 02:56:11,959 --> 02:56:14,294 COMPLICATED. 4360 02:56:14,294 --> 02:56:17,064 IT'S NOT JUST GIVING ACAMPROSATE 4361 02:56:17,064 --> 02:56:17,731 AND NALTREXONE. 4362 02:56:17,731 --> 02:56:20,267 THOSE ARE SOME OF MY THOUGHTS. 4363 02:56:20,267 --> 02:56:21,468 >> THANKS, FRANCES. 4364 02:56:21,468 --> 02:56:21,735 EXCELLENT. 4365 02:56:21,735 --> 02:56:22,569 NANCY BARNETT, DO YOU HAVE 4366 02:56:22,569 --> 02:56:23,971 ANYTHING YOU'D LIKE TO ADD TO 4367 02:56:23,971 --> 02:56:26,206 THIS OR START A NEW 4368 02:56:26,206 --> 02:56:28,509 CONVERSATION? 4369 02:56:28,509 --> 02:56:30,377 >> THANK YOU, GEORGE. 4370 02:56:30,377 --> 02:56:31,812 NO, I'M HERE LISTENING, BUT 4371 02:56:31,812 --> 02:56:33,814 DON'T HAVE ANY QUESTIONS TO ADD. 4372 02:56:33,814 --> 02:56:34,414 THANK YOU. 4373 02:56:34,414 --> 02:56:38,051 >> AND ANDREW, ARE YOU STILL ON? 4374 02:56:38,051 --> 02:56:40,487 >> SURE AM. 4375 02:56:40,487 --> 02:56:43,257 EXCELLENT DISCUSSION. 4376 02:56:43,257 --> 02:56:45,759 REALLY APPRECIATE DAVID'S 4377 02:56:45,759 --> 02:56:46,960 PRESENTATION. 4378 02:56:46,960 --> 02:56:48,762 THE QUESTION OF WHO GETS SICK 4379 02:56:48,762 --> 02:56:50,998 FROM ALCOHOL USE DISORDER 4380 02:56:50,998 --> 02:56:52,900 CLINICALLY, FROM SIMILAR AMOUNTS 4381 02:56:52,900 --> 02:56:54,835 OF ALCOHOL EXPOSURE IS AN AWFUL 4382 02:56:54,835 --> 02:56:55,769 INTERESTING ONE. 4383 02:56:55,769 --> 02:56:57,437 HE IS LOOKING AT LARGE 4384 02:56:57,437 --> 02:56:58,405 POPULATIONS AND MOVING FORWARD 4385 02:56:58,405 --> 02:57:00,173 TO TRY AND UNDERSTAND THAT 4386 02:57:00,173 --> 02:57:00,841 QUESTION. 4387 02:57:00,841 --> 02:57:01,975 WE'RE SORT OF TRYING TO REVERSE 4388 02:57:01,975 --> 02:57:02,709 ENGINEER IT. 4389 02:57:02,709 --> 02:57:05,279 WE'RE LOOKING AT PEOPLE WHO HAVE 4390 02:57:05,279 --> 02:57:06,380 TERRIBLE OUTCOMES FROM MAYBE 4391 02:57:06,380 --> 02:57:07,314 SIMILAR EXPOSURE TO ALCOHOL AS 4392 02:57:07,314 --> 02:57:09,116 OTHER PEOPLE THAT DIDN'T HAVE A 4393 02:57:09,116 --> 02:57:10,050 TERRIBLE OUTCOME. 4394 02:57:10,050 --> 02:57:11,685 WHEN WE EXPLANT THEIR LIVES 4395 02:57:11,685 --> 02:57:13,620 BECAUSE THEY NEED AN ENERGY LIFE 4396 02:57:13,620 --> 02:57:14,788 SAVING LIVER TRANSPLANT WE'RE 4397 02:57:14,788 --> 02:57:16,056 ABLE TO EXAMINE THAT LIVER TO 4398 02:57:16,056 --> 02:57:19,059 SEE IF THERE'S ANYTHING THAT 4399 02:57:19,059 --> 02:57:21,028 MAKES THEM DIFFERENT FROM OTHER 4400 02:57:21,028 --> 02:57:22,829 FOLKS THAT, FOR EXAMPLE, DIED 4401 02:57:22,829 --> 02:57:24,531 WITHOUT LIVER DISEASE. 4402 02:57:24,531 --> 02:57:26,733 AND WE'RE TRYING TO COME TO 4403 02:57:26,733 --> 02:57:29,169 SIMILAR UNDERSTANDINGS OF WHY 4404 02:57:29,169 --> 02:57:30,637 SOME PEOPLE GET HORRIBLY ILL 4405 02:57:30,637 --> 02:57:32,005 FROM ALCOHOL EXPOSURE, OTHERS 4406 02:57:32,005 --> 02:57:32,205 DON'T. 4407 02:57:32,205 --> 02:57:35,609 IT'S A VERY INTERESTING TOPIC. 4408 02:57:35,609 --> 02:57:40,814 GREAT SCIENCE BUT VERY IMPORTANT 4409 02:57:40,814 --> 02:57:41,648 CLINICAL TRANSLATION QUESTION, 4410 02:57:41,648 --> 02:57:43,684 VERY IMPORTANT TO OUR SICK 4411 02:57:43,684 --> 02:57:43,951 PATIENTS. 4412 02:57:43,951 --> 02:57:45,185 >> RHONDA, THAT'S ANOTHER 4413 02:57:45,185 --> 02:57:46,153 EXAMPLE OF BACK-TRANSLATION. 4414 02:57:46,153 --> 02:57:47,788 HE'S TAKING LIVES OUT OF PEOPLE 4415 02:57:47,788 --> 02:57:50,691 WHO ARE VERY, VERY SICK AND THEN 4416 02:57:50,691 --> 02:57:52,759 TRYING TO FIGURE OUT WHAT IS 4417 02:57:52,759 --> 02:57:56,930 DIFFERENT ABOUT THOSE LIVES THAT 4418 02:57:56,930 --> 02:57:57,931 COULD THEN FEED FORWARD TO HELP 4419 02:57:57,931 --> 02:58:01,101 PEOPLE NOT GET THAT SICK. 4420 02:58:01,101 --> 02:58:02,002 IT'S REALLY FASCINATING APPROACH 4421 02:58:02,002 --> 02:58:03,570 AND I REMEMBER WHEN YOU FIRST 4422 02:58:03,570 --> 02:58:06,239 CAME DOWN TO TALK ABOUT THAT. 4423 02:58:06,239 --> 02:58:11,445 THAT WAS, TO ME, ONE OF THE MORE 4424 02:58:11,445 --> 02:58:11,845 INTRIGUING PARTS. 4425 02:58:11,845 --> 02:58:14,014 >> I COULD ADD ONE POINT TO THE 4426 02:58:14,014 --> 02:58:14,514 LAST DISCUSSION? 4427 02:58:14,514 --> 02:58:16,483 IF YOU THINK ABOUT THE TREATMENT 4428 02:58:16,483 --> 02:58:18,251 CASCADE PEOPLE FALL OUT OF IT AS 4429 02:58:18,251 --> 02:58:19,486 LOTS OF POINTS. 4430 02:58:19,486 --> 02:58:21,688 SOME PEOPLE NEVER GET IDENTIFIED 4431 02:58:21,688 --> 02:58:23,190 IN PRIMARY CARE. 4432 02:58:23,190 --> 02:58:25,158 SOME PEOPLE GET IDENTIFIED AND 4433 02:58:25,158 --> 02:58:26,493 NEVER GET THE CONVERSATION WITH 4434 02:58:26,493 --> 02:58:27,394 THE CLINICIAN. 4435 02:58:27,394 --> 02:58:29,796 SOME GET CONVERSATION BUT NEVER 4436 02:58:29,796 --> 02:58:31,198 GET THE PRESCRIPTION WRITTEN FOR 4437 02:58:31,198 --> 02:58:31,398 THEM. 4438 02:58:31,398 --> 02:58:32,399 SOME GET THE PRESCRIPTION BUT 4439 02:58:32,399 --> 02:58:33,700 NEVER FILL IT. 4440 02:58:33,700 --> 02:58:35,302 AND THEN SOME PEOPLE GO AND FILL 4441 02:58:35,302 --> 02:58:38,238 IT BUT THEN THEY STOP TAKING IT. 4442 02:58:38,238 --> 02:58:40,807 SO WE REALLY NEED SUPPORT IN ALL 4443 02:58:40,807 --> 02:58:42,175 OF THOSE PIECES. 4444 02:58:42,175 --> 02:58:44,144 I THINK THE PATIENTS NEED 4445 02:58:44,144 --> 02:58:45,312 ADDITIONAL SUPPORT AND 4446 02:58:45,312 --> 02:58:45,579 EDUCATION. 4447 02:58:45,579 --> 02:58:46,947 I'M DOING WORK RIGHT NOW LOOKING 4448 02:58:46,947 --> 02:58:50,017 AT PEOPLE WHO GET A PRESCRIPTION 4449 02:58:50,017 --> 02:58:51,284 AND STOP, MEDIAN NUMBER OF DAYS 4450 02:58:51,284 --> 02:58:53,520 SUPPLY THEY GET BEFORE THEY STOP 4451 02:58:53,520 --> 02:58:53,920 IS 30. 4452 02:58:53,920 --> 02:58:55,689 SO LOTS OF PEOPLE ARE GETTING 4453 02:58:55,689 --> 02:58:56,957 ONE SCRIPT AND NEVER GOING BACK 4454 02:58:56,957 --> 02:58:59,026 AND YOU DON'T KNOW IF THEY TAKE 4455 02:58:59,026 --> 02:59:01,094 IT AND HAVE SIDE EFFECTS SO THEY 4456 02:59:01,094 --> 02:59:03,430 STOP, OR THEY NEVER ACTUALLY 4457 02:59:03,430 --> 02:59:04,831 TOOK IT ONCE THEY FILLED IT 4458 02:59:04,831 --> 02:59:06,099 BECAUSE THEY HAD SECOND THOUGHTS 4459 02:59:06,099 --> 02:59:07,634 OR NEEDED EXTRA SUPPORT IN SORT 4460 02:59:07,634 --> 02:59:09,336 OF GETTING THEM OVER THE HUMP. 4461 02:59:09,336 --> 02:59:11,638 THINKING ABOUT ALL OF THOSE 4462 02:59:11,638 --> 02:59:12,939 PIECES OF THE PROCESS IS 4463 02:59:12,939 --> 02:59:15,409 IMPORTANT WHEN WE'RE THINKING 4464 02:59:15,409 --> 02:59:17,511 ABOUT HOW TO IMPROVE 4465 02:59:17,511 --> 02:59:18,945 CONTINUATION ON MEDICATION 4466 02:59:18,945 --> 02:59:19,212 TREATMENT. 4467 02:59:19,212 --> 02:59:21,281 >> , YEAH YOU RAISE AN IMPORTANT 4468 02:59:21,281 --> 02:59:24,685 ISSUE THAT I'VE COME TO REALIZE 4469 02:59:24,685 --> 02:59:26,920 DONE SOMETIMES IN MORE SEVERE 4470 02:59:26,920 --> 02:59:28,822 MENTAL ILLNESSES, MANY ONE OF 4471 02:59:28,822 --> 02:59:31,058 YOU CLINICIANS CAN HELP ME OUT 4472 02:59:31,058 --> 02:59:32,693 WITH THE OFFICIAL WORD. 4473 02:59:32,693 --> 02:59:34,895 THERE ARE PEOPLE WHO GUIDE THE 4474 02:59:34,895 --> 02:59:36,530 PATIENT THROUGH THE DIFFERENT 4475 02:59:36,530 --> 02:59:37,664 PARTS OF THE MEDICAL SYSTEM. 4476 02:59:37,664 --> 02:59:40,233 THEY HAVE A NAME FOR THEM. 4477 02:59:40,233 --> 02:59:40,734 >> NAVIGATORS. 4478 02:59:40,734 --> 02:59:43,170 >> THANK YOU VERY MUCH. 4479 02:59:43,170 --> 02:59:44,271 YEAH, PATIENT NAVIGATOR. 4480 02:59:44,271 --> 02:59:47,407 MAYBE WE NEED TO HAVE SOMETHING 4481 02:59:47,407 --> 02:59:48,742 LIKE THAT FOR ADDICTION. 4482 02:59:48,742 --> 02:59:50,777 FRANCES, DO YOU HAVE PATIENT 4483 02:59:50,777 --> 02:59:53,046 NAVIGATORS FOR SEVERE ALCOHOL 4484 02:59:53,046 --> 02:59:53,447 USE DISORDER? 4485 02:59:53,447 --> 02:59:54,014 >> NO. 4486 02:59:54,014 --> 02:59:56,883 IT WOULD BE A GOOD IDEA. 4487 02:59:56,883 --> 02:59:59,920 YOU KNOW, THERE'S BEEN SEVERAL 4488 02:59:59,920 --> 03:00:01,121 MODELS WITH, YOU KNOW, STARTING 4489 03:00:01,121 --> 03:00:02,322 PEOPLE ON MEDICATION IN THE 4490 03:00:02,322 --> 03:00:03,557 EMERGENCY ROOM AND HAVING THAT 4491 03:00:03,557 --> 03:00:05,726 PERSON WORK WITH THEM TO GET 4492 03:00:05,726 --> 03:00:06,893 THEM INTO TREATMENT WHEN THEY 4493 03:00:06,893 --> 03:00:09,696 COME OUT OF THE -- WHEN THEY 4494 03:00:09,696 --> 03:00:11,498 LEAVE THE EMERGENCY ROOM BUT I 4495 03:00:11,498 --> 03:00:12,099 THINK THAT APPROACH WOULD BE, 4496 03:00:12,099 --> 03:00:14,000 YOU KNOW, WOULD BE GREAT. 4497 03:00:14,000 --> 03:00:16,136 I'M SURE THERE'S PROBABLY 4498 03:00:16,136 --> 03:00:18,405 RESEARCH ON THIS, BUT, YOU KNOW, 4499 03:00:18,405 --> 03:00:19,740 IN TERMS OF ALCOHOL, BUT, YOU 4500 03:00:19,740 --> 03:00:23,276 KNOW, THERE ARE SO MANY REASONS. 4501 03:00:23,276 --> 03:00:25,278 EVEN DRUGS THAT HAVE ABUSE 4502 03:00:25,278 --> 03:00:27,681 LIABILITY LIKE I TREAT PATIENTS 4503 03:00:27,681 --> 03:00:29,983 WITH ADHD, AND MANY TAKE THEIR 4504 03:00:29,983 --> 03:00:30,383 STIMULANTS. 4505 03:00:30,383 --> 03:00:31,918 EVERYONE IS WORRIED ABOUT MISUSE 4506 03:00:31,918 --> 03:00:33,553 OF STIMULANTS BUT A LOT OF KIDS, 4507 03:00:33,553 --> 03:00:34,755 YOUNG ADULTS DON'T WANT TO TAKE 4508 03:00:34,755 --> 03:00:36,490 THE MEDICATION. 4509 03:00:36,490 --> 03:00:37,557 EVEN WITH MEDICATIONS, WHEN 4510 03:00:37,557 --> 03:00:39,493 MEDICATION DOESN'T HAVE AN 4511 03:00:39,493 --> 03:00:41,027 EFFECT, OFTEN THE ABSENCE OF 4512 03:00:41,027 --> 03:00:42,429 EFFECT MAKES IT SO THEY DON'T 4513 03:00:42,429 --> 03:00:47,334 SEE THE UTILITY IN TAKING IT. 4514 03:00:47,334 --> 03:00:51,004 EXCEPT BUPRENORPHINE YOU'LL HAVE 4515 03:00:51,004 --> 03:00:53,106 WITHDRAWAL, EVEN THAT 50% STOP 4516 03:00:53,106 --> 03:00:54,908 TAKING BUPRENORPHINE. 4517 03:00:54,908 --> 03:01:00,013 HOW TO KEEP PEOPLE ADHERENT IS 4518 03:01:00,013 --> 03:01:01,982 AN ISSUE, TRUE WITH HYPERTENSION 4519 03:01:01,982 --> 03:01:05,418 MEDICATIONS, KEEPING THEM IN IT, 4520 03:01:05,418 --> 03:01:06,720 CASCADES JUST DESCRIBED, REALLY 4521 03:01:06,720 --> 03:01:09,456 TRUE ALONG MANY MEDICAL 4522 03:01:09,456 --> 03:01:13,960 ILLNESSES. 4523 03:01:13,960 --> 03:01:16,062 >> IT WAS SAID YEARS AGO 4524 03:01:16,062 --> 03:01:16,763 ADHERENCE TO MEDICATIONS FOR 4525 03:01:16,763 --> 03:01:18,265 BLOOD PRESSURE AND HEART DISEASE 4526 03:01:18,265 --> 03:01:21,501 WERE NO BETTER THAN ADHERENCE 4527 03:01:21,501 --> 03:01:22,636 FOR ADDICTION MEDICINES, BUT 4528 03:01:22,636 --> 03:01:27,674 THAT'S NOT SOLVING OUR PROBLEM. 4529 03:01:27,674 --> 03:01:29,643 DAYNE, ANY THOUGHTS ABOUT ANY 4530 03:01:29,643 --> 03:01:32,112 PART OF THIS? 4531 03:01:32,112 --> 03:01:34,848 YOU WORK WITH DEAD BRAINS. 4532 03:01:34,848 --> 03:01:36,149 >> MOST OF THE TIME. 4533 03:01:36,149 --> 03:01:39,085 YEAH, I THINK THIS WHOLE 4534 03:01:39,085 --> 03:01:41,188 DISCUSSION UTILIZATION OF 4535 03:01:41,188 --> 03:01:42,722 CLINICAL RECORDS IS CRITICAL FOR 4536 03:01:42,722 --> 03:01:44,624 A LOT OF MOLECULAR STUDIES WE 4537 03:01:44,624 --> 03:01:44,925 DO. 4538 03:01:44,925 --> 03:01:49,329 SO WE CAN CORRELATE TO CLINICAL 4539 03:01:49,329 --> 03:01:49,996 OUTCOMES AND DAVID'S 4540 03:01:49,996 --> 03:01:51,097 IMPLEMENTATION OF AUDIT IS A 4541 03:01:51,097 --> 03:01:52,265 GREAT WAY TO DO THAT. 4542 03:01:52,265 --> 03:01:55,535 ONE OF THE PROBLEMS THAT WE HAVE 4543 03:01:55,535 --> 03:01:57,671 THOUGH IS IT COMES DOWN TO THE 4544 03:01:57,671 --> 03:02:00,140 TERMS THAT WE'RE GOING TO USE, 4545 03:02:00,140 --> 03:02:01,975 COMMON DATA ELEMENTS, WHAT ARE 4546 03:02:01,975 --> 03:02:04,110 WE GOING -- WHEN WE GET OUR 4547 03:02:04,110 --> 03:02:06,580 TERMS FROM CLINICAL RECORDS, 4548 03:02:06,580 --> 03:02:08,281 THEY DON'T ALWAYS MEAN THE SAME 4549 03:02:08,281 --> 03:02:09,516 AS, YOU KNOW, THE RECORD FROM 4550 03:02:09,516 --> 03:02:10,016 ANOTHER PLACE. 4551 03:02:10,016 --> 03:02:14,955 SO ONE OF ONE OF OUR BIG 4552 03:02:14,955 --> 03:02:15,555 CHALLENGES IS COMING TO GRIPS 4553 03:02:15,555 --> 03:02:17,490 WITH THE TERMS WE'RE GOING TO 4554 03:02:17,490 --> 03:02:18,925 USE BECAUSE IF YOU HAVE TEN WAYS 4555 03:02:18,925 --> 03:02:20,527 TO SAY THE SAME THING, WE'RE 4556 03:02:20,527 --> 03:02:22,829 GOING TO HAVE TEN WAYS TO 4557 03:02:22,829 --> 03:02:25,432 CORRELATE A FINDING TO MOLECULAR 4558 03:02:25,432 --> 03:02:25,699 FINDINGS. 4559 03:02:25,699 --> 03:02:27,300 SO I THINK BUILT INTO ALL OF 4560 03:02:27,300 --> 03:02:31,271 THIS THERE NEEDS TO BE SOME WAY 4561 03:02:31,271 --> 03:02:34,774 TO COME UP WITH COMMON TERMS 4562 03:02:34,774 --> 03:02:37,844 THAT ARE DESCRIPTIVE AND 4563 03:02:37,844 --> 03:02:38,278 ACCURATE. 4564 03:02:38,278 --> 03:02:39,412 >> YEAH, GLAD YOU MENTIONED 4565 03:02:39,412 --> 03:02:39,980 THAT. 4566 03:02:39,980 --> 03:02:42,115 I WANTED TO SAY SOMETHING ABOUT 4567 03:02:42,115 --> 03:02:42,649 THAT. 4568 03:02:42,649 --> 03:02:44,618 THERE IS ALREADY EFFORTS IN THE 4569 03:02:44,618 --> 03:02:46,686 CLINICAL DOMAIN FOR COMMON DATA 4570 03:02:46,686 --> 03:02:48,722 ELEMENTS BUT IT IS SOMETHING 4571 03:02:48,722 --> 03:02:50,357 PAROCHIAL TO NIAAA THAT WE 4572 03:02:50,357 --> 03:02:56,963 PROBABLY SHOULD -- WE WILL BE 4573 03:02:56,963 --> 03:02:57,831 ADDRESSING. 4574 03:02:57,831 --> 03:03:00,767 AND I'M EVEN IN COMMON DATA 4575 03:03:00,767 --> 03:03:03,470 ELEMENTS FOR PRE-CLINICAL DATA, 4576 03:03:03,470 --> 03:03:14,014 AND I THINK THERE'S THIS -- KEEP 4577 03:03:14,214 --> 03:03:16,116 IING IN THE DARK, IN THE CAGE, 4578 03:03:16,116 --> 03:03:18,318 GETS ACCESS TO ALCOHOL IN THE 4579 03:03:18,318 --> 03:03:19,419 DARK, SOPHISTICATED BEHAVIOR 4580 03:03:19,419 --> 03:03:19,853 HERE. 4581 03:03:19,853 --> 03:03:21,021 BUT THEY DRINK A LOT. 4582 03:03:21,021 --> 03:03:22,055 WHEN YOU DO THAT. 4583 03:03:22,055 --> 03:03:25,525 IF YOU KEEP DOING IT THEY DRINK 4584 03:03:25,525 --> 03:03:30,030 EVEN MORE. 4585 03:03:30,030 --> 03:03:32,365 THESE MICROPHONES ARE GOING. 4586 03:03:32,365 --> 03:03:34,000 BUT ACTUALLY THE MICE WILL 4587 03:03:34,000 --> 03:03:44,411 ATTAIN A BLOOD ALCOHOL ABOVE -- 4588 03:03:44,411 --> 03:03:45,812 WITHIN TWO HOURS. 4589 03:03:45,812 --> 03:03:47,647 TALKING TO HOWARD BECKER LAST 4590 03:03:47,647 --> 03:03:50,583 WEEK, PRESIDENT OF OUR LATEST 4591 03:03:50,583 --> 03:03:51,685 YEAR, CLINICAL RESEARCHER, MUSC, 4592 03:03:51,685 --> 03:03:53,853 HE SAID EVERYBODY, GEORGE, IS 4593 03:03:53,853 --> 03:03:54,988 DOING IT DIFFERENTLY. 4594 03:03:54,988 --> 03:03:57,424 BUT CAN WE GET A METRIC, EVEN IF 4595 03:03:57,424 --> 03:03:58,658 THEY ARE DOING IT DIFFERENTLY, 4596 03:03:58,658 --> 03:04:00,293 YOU KNOW, LIKE A BLOOD 4597 03:04:00,293 --> 03:04:01,828 COLLABORATIVE LEVEL AFTER X 4598 03:04:01,828 --> 03:04:03,830 AMOUNT OF TIME THAT COULD BE 4599 03:04:03,830 --> 03:04:04,831 USED AS SOMETHING THAT WOULD 4600 03:04:04,831 --> 03:04:07,968 MAKE IT SO MUCH EASIER TO 4601 03:04:07,968 --> 03:04:09,035 FACILITATE THESE KIND OF 4602 03:04:09,035 --> 03:04:11,004 ANALYSES THAT WE CAN NOW DO. 4603 03:04:11,004 --> 03:04:13,540 SO, IT IS SOMETHING WE'LL BE 4604 03:04:13,540 --> 03:04:16,309 TALKING ABOUT, ELIZABETH POWELL 4605 03:04:16,309 --> 03:04:21,047 IS OUR -- NOT TRISH POWELL, 4606 03:04:21,047 --> 03:04:23,450 THERE'S ANOTHER POWELL IN DNB, 4607 03:04:23,450 --> 03:04:26,953 LEADING OUR DATA ANALYSIS AND 4608 03:04:26,953 --> 03:04:29,322 MANAGEMENT AND WE HAVE A TEAM 4609 03:04:29,322 --> 03:04:30,523 WORKING ON THIS. 4610 03:04:30,523 --> 03:04:32,759 WE'LL BE WORKING IN DOMAIN BUT 4611 03:04:32,759 --> 03:04:34,294 WE'LL NEED YOUR CREATIVE 4612 03:04:34,294 --> 03:04:39,599 THINKING ON HOW TO DO THIS. 4613 03:04:39,599 --> 03:04:41,935 THE MICROPHONES ARE FADING IN 4614 03:04:41,935 --> 03:04:42,836 AND OUT. 4615 03:04:42,836 --> 03:04:45,572 >> MAYBE I USED IT TOO MUCH. 4616 03:04:45,572 --> 03:04:46,506 I'M PARTICULARLY INTERESTED IN 4617 03:04:46,506 --> 03:04:49,642 WHAT WE CAN DO IN THE 4618 03:04:49,642 --> 03:04:52,178 PRE-CLINICAL DOMAIN. 4619 03:04:52,178 --> 03:04:53,646 SO DAVID OLDMAN, WE'RE 4620 03:04:53,646 --> 03:04:54,514 PARTICULARLY INTERESTED IN WHAT 4621 03:04:54,514 --> 03:04:56,149 WE NEED TO DO IN THE CLINICAL 4622 03:04:56,149 --> 03:04:59,119 DOMAIN TO MAKE LIFE EASIER FOR 4623 03:04:59,119 --> 03:05:00,220 THE KIND OF WORK YOU'RE DOING. 4624 03:05:00,220 --> 03:05:03,390 >> ONE OF THE THINGS THAT IS 4625 03:05:03,390 --> 03:05:06,926 HELPFUL IS THAT THE SORT OF 4626 03:05:06,926 --> 03:05:09,029 HARMONIZATION IS BEING DONE IN 4627 03:05:09,029 --> 03:05:10,964 THE NIAAA DATA ARCHIVE, WHEREAS 4628 03:05:10,964 --> 03:05:12,999 WHEN YOU -- AS YOU ENTER DATA 4629 03:05:12,999 --> 03:05:14,934 INTO THE ARCHIVE YOU WORK WITH 4630 03:05:14,934 --> 03:05:18,638 THIS TEAM TO TRY TO IDENTIFY AN 4631 03:05:18,638 --> 03:05:21,941 ALREADY EXISTING TERM. 4632 03:05:21,941 --> 03:05:24,844 IF YOU GO TO "ALL OF US," AS 4633 03:05:24,844 --> 03:05:27,981 WE'VE BEEN DOING FOR 4634 03:05:27,981 --> 03:05:31,251 IRON-RELATED TERMS YOU MIGHT 4635 03:05:31,251 --> 03:05:35,088 FIND EHR 20 OR EVEN TWO DOZEN 4636 03:05:35,088 --> 03:05:42,562 VERY SIMILAR TERMS FROM 4637 03:05:42,562 --> 03:05:44,597 TRANSFERRIN LEVEL, ON AND ON, A 4638 03:05:44,597 --> 03:05:45,832 HUGE PROBLEM TO FIGURE OUT HOW 4639 03:05:45,832 --> 03:05:48,134 TO COMBINE THE DATA. 4640 03:05:48,134 --> 03:05:50,236 IN THE INTRAMURAL SAMPLES 4641 03:05:50,236 --> 03:05:51,805 WE'VE -- I ADDRESSED THIS AT THE 4642 03:05:51,805 --> 03:05:53,406 BEGINNING BECAUSE AT THE 4643 03:05:53,406 --> 03:05:54,841 BEGINNING YOU HAVE EVERYBODY WHO 4644 03:05:54,841 --> 03:05:58,178 TAKES PART IN A NATURAL HISTORY 4645 03:05:58,178 --> 03:06:00,080 STUDY, BUT CERTAIN DATA ELEMENTS 4646 03:06:00,080 --> 03:06:01,848 THAT ARE COLLECTED IN COMMON 4647 03:06:01,848 --> 03:06:02,482 ACROSS EVERYBODY. 4648 03:06:02,482 --> 03:06:05,251 IT NEEDS TO BE DONE EITHER 4649 03:06:05,251 --> 03:06:06,252 INITIALLY WHERE SOMEBODY HAS TO 4650 03:06:06,252 --> 03:06:09,422 DO THE WORK LATER TO FIGURE OUT 4651 03:06:09,422 --> 03:06:11,591 AS YOU SAID HOW TO RATIONALIZE 4652 03:06:11,591 --> 03:06:13,359 AND HARMONIZE THESE ELEMENTS. 4653 03:06:13,359 --> 03:06:15,495 IF WE DON'T DO IT WE'RE NOT ABLE 4654 03:06:15,495 --> 03:06:23,403 TO TAKE ADVANTAGE OF POWER OF 4655 03:06:23,403 --> 03:06:24,237 THESE LARGE DATASETS. 4656 03:06:24,237 --> 03:06:26,906 >> WE HAVE A COUPLE MORE MINUTES 4657 03:06:26,906 --> 03:06:27,107 LEFT. 4658 03:06:27,107 --> 03:06:28,174 ANYTHING ELSE FROM ANYONE? 4659 03:06:28,174 --> 03:06:32,879 I THINK I MANAGED TO CALL ON 4660 03:06:32,879 --> 03:06:33,913 EVERYONE, OR EVERYONE 4661 03:06:33,913 --> 03:06:34,247 VOLUNTEERED. 4662 03:06:34,247 --> 03:06:35,315 WHO HAVE I MISSED? 4663 03:06:35,315 --> 03:06:37,250 OH, KATIE. 4664 03:06:37,250 --> 03:06:39,152 >> I'VE BEEN VERY VOCAL TODAY. 4665 03:06:39,152 --> 03:06:40,053 TWO COMMENTS. 4666 03:06:40,053 --> 03:06:44,224 ONE, DR. GOLDMAN PRESENTED GWAS 4667 03:06:44,224 --> 03:06:47,193 THAT RELIED ON THE V.A. DATA, 4668 03:06:47,193 --> 03:06:48,661 SINCE 2007. 4669 03:06:48,661 --> 03:06:52,432 SO I AGREE MORE PLACES WE CAN DO 4670 03:06:52,432 --> 03:06:54,868 GIVING THAT MEASURE. 4671 03:06:54,868 --> 03:06:56,870 I WANTED TO GO BACK TO SOMETHING 4672 03:06:56,870 --> 03:06:57,770 DR. LEVIN SAID ABOUT 4673 03:06:57,770 --> 03:06:58,071 COMORBIDITY. 4674 03:06:58,071 --> 03:06:59,906 I HAD A CHANCE THIS MORNING TO 4675 03:06:59,906 --> 03:07:01,040 LOOK BRIEFLY AT THE STRATEGIC 4676 03:07:01,040 --> 03:07:03,076 PLAN, THE NEW ONE. 4677 03:07:03,076 --> 03:07:05,378 I'M A LITTLE BIT SURPRISED TO 4678 03:07:05,378 --> 03:07:07,280 SEE LESS FOCUS ON COMORBIDITY IN 4679 03:07:07,280 --> 03:07:08,982 THE NEW STRATEGIC PLAN SO I'M A 4680 03:07:08,982 --> 03:07:10,416 LITTLE BIT WORRIED AND WONDERING 4681 03:07:10,416 --> 03:07:13,453 IF THAT'S NO LONGER A PRIORITY 4682 03:07:13,453 --> 03:07:16,156 AREA FOR NIAAA OR IF IT'S MAYBE 4683 03:07:16,156 --> 03:07:18,224 EMBEDDED WITH OF THROUGHOUT THE 4684 03:07:18,224 --> 03:07:21,961 STRATEGIC PLAN AND THAT'S WHY 4685 03:07:21,961 --> 03:07:24,731 I'M NOT SEEING IT BOLDED BUT I 4686 03:07:24,731 --> 03:07:28,101 WOULD LOVE TO HEAR IF ISSUES OF 4687 03:07:28,101 --> 03:07:30,403 COMORBIDITY, IT TIES INTO THE 4688 03:07:30,403 --> 03:07:33,072 TOPIC OF ALCOHOL IN WOMEN AS DR. 4689 03:07:33,072 --> 03:07:33,706 LEVIN MENTIONED, CURIOUS IF 4690 03:07:33,706 --> 03:07:35,608 THAT'S STILL A PRIORITY AREA. 4691 03:07:35,608 --> 03:07:38,778 >> IT'S A BURGEONING PRIORITY 4692 03:07:38,778 --> 03:07:39,145 AREA. 4693 03:07:39,145 --> 03:07:41,915 BUT I'LL LET -- I'LL PUT POOR 4694 03:07:41,915 --> 03:07:42,882 BRIDGIT ON THE SPOT. 4695 03:07:42,882 --> 03:07:44,250 >> I DON'T REMEMBER ALL THE 4696 03:07:44,250 --> 03:07:45,885 PLACES BECAUSE IT IS 4697 03:07:45,885 --> 03:07:46,186 DISTRIBUTED. 4698 03:07:46,186 --> 03:07:48,588 LIKE THERE'S A SECTION WE TALK 4699 03:07:48,588 --> 03:07:49,589 ABOUT IT IN WHOLE PERSON HEALTH. 4700 03:07:49,589 --> 03:07:50,857 IT IS SPREAD OUT. 4701 03:07:50,857 --> 03:07:52,859 SO IT HASN'T BEEN DEPRIORITIZED. 4702 03:07:52,859 --> 03:07:53,993 IT'S A VERY IMPORTANT AREA THAT 4703 03:07:53,993 --> 03:07:57,197 WE WANT TO CONTINUE TO FOCUS 4704 03:07:57,197 --> 03:07:58,731 ENERGY ON. 4705 03:07:58,731 --> 03:08:00,466 THAT'S THE THING I SHOULD POINT 4706 03:08:00,466 --> 03:08:00,700 OUT. 4707 03:08:00,700 --> 03:08:03,303 BECAUSE YOU MAY NOT SEE 4708 03:08:03,303 --> 03:08:04,904 SOMETHING SPECIFIC OR MAY NOT 4709 03:08:04,904 --> 03:08:06,206 SEE IT A LOT OF TIMES DOESN'T 4710 03:08:06,206 --> 03:08:07,540 NECESSARILY MEAN IT'S NOT A 4711 03:08:07,540 --> 03:08:08,975 PRIORITY FOR US. 4712 03:08:08,975 --> 03:08:10,610 THERE'S SO MANY THINGS WE HAVE 4713 03:08:10,610 --> 03:08:12,579 TO COVER BUT IT'S GOOD TO ALWAYS 4714 03:08:12,579 --> 03:08:13,012 CHECK. 4715 03:08:13,012 --> 03:08:14,647 >> THANK YOU. 4716 03:08:14,647 --> 03:08:16,449 >> TO THAT POINT, KATIE, WHEN I 4717 03:08:16,449 --> 03:08:20,920 WAS AT CPDD LAST YEAR, NOT THIS 4718 03:08:20,920 --> 03:08:26,626 YEAR, WE HAD A SYMPOSIUM ON 4719 03:08:26,626 --> 03:08:29,162 READDICTION, OR WHATEVER, 4720 03:08:29,162 --> 03:08:30,263 SOMETHING LIKE THAT. 4721 03:08:30,263 --> 03:08:31,998 IT CAME UP WITH A LOT OF 4722 03:08:31,998 --> 03:08:34,734 QUESTIONS FROM THE AUDIENCE. 4723 03:08:34,734 --> 03:08:39,272 THERE WAS REAL CONCERN THAT 4724 03:08:39,272 --> 03:08:40,473 HISTORICALLY WE EXCLUDE 4725 03:08:40,473 --> 03:08:43,443 COMORBIDITY AND TRY TO GET THESE 4726 03:08:43,443 --> 03:08:46,479 PURE AUDs IN STUDIES. 4727 03:08:46,479 --> 03:08:48,348 I DO THINK RAYE WILL TELL ME IT 4728 03:08:48,348 --> 03:08:49,949 COSTS A LOT MORE MONEY IF YOU 4729 03:08:49,949 --> 03:08:52,418 INCLUDE THEM BUT I DO THINK AT 4730 03:08:52,418 --> 03:08:55,488 SOME POINT MAYBE THE PRIMARY 4731 03:08:55,488 --> 03:08:57,457 CARE NETWORK THAT MONICA IS 4732 03:08:57,457 --> 03:08:58,791 THINKING OF, IF WE GET INTO IT, 4733 03:08:58,791 --> 03:09:00,994 IN THE MENTAL HEALTH WAY, THEN 4734 03:09:00,994 --> 03:09:02,762 MAYBE THAT'S GOING TO BE ONE OF 4735 03:09:02,762 --> 03:09:04,631 THE SOURCES FOR THIS INFORMATION 4736 03:09:04,631 --> 03:09:06,266 BECAUSE THERE WILL BE A LOT OF 4737 03:09:06,266 --> 03:09:06,666 PEOPLE PRESUMABLY. 4738 03:09:06,666 --> 03:09:07,800 BUT IT IS A CHALLENGE. 4739 03:09:07,800 --> 03:09:08,735 THAT'S A CHALLENGE. 4740 03:09:08,735 --> 03:09:12,405 BUT I DO THINK IT'S INCREDIBLY 4741 03:09:12,405 --> 03:09:13,339 IMPORTANT. 4742 03:09:13,339 --> 03:09:18,077 COMORBIDITY IS 20 TO 40% FOR 4743 03:09:18,077 --> 03:09:22,915 EFFECTIVE DISORDERS, ANXIETY 4744 03:09:22,915 --> 03:09:23,716 DISORDERS, PTSD, BIPOLAR, JUST 4745 03:09:23,716 --> 03:09:24,884 GO DOWN THE LINE. 4746 03:09:24,884 --> 03:09:27,253 >> KATIE, IT IS IN OUR 4747 03:09:27,253 --> 03:09:28,521 ANNOUNCEMENT FOR OUR DIVISION. 4748 03:09:28,521 --> 03:09:28,888 COMORBIDITY. 4749 03:09:28,888 --> 03:09:32,325 AND WE HAVE OVER THE YEARS 4750 03:09:32,325 --> 03:09:33,259 ACTUALLY DID FUND MOSTLY 4751 03:09:33,259 --> 03:09:34,193 MEDICATIONS WITH COMORBIDITY. 4752 03:09:34,193 --> 03:09:39,032 A LOT OF DEPRESSION, EVEN 4753 03:09:39,032 --> 03:09:40,133 BIPOLAR, SOME SCHIZOPHRENIA. 4754 03:09:40,133 --> 03:09:44,337 GENERALLY WHAT WE FOUND WAS THAT 4755 03:09:44,337 --> 03:09:46,939 IT IS HARDER FOR RESEARCHERS TO 4756 03:09:46,939 --> 03:09:47,740 RECRUIT COMORBIDITY. 4757 03:09:47,740 --> 03:09:50,243 I CAN'T TELL YOU THEY NEEDED 4758 03:09:50,243 --> 03:09:52,679 EXTRA TIME OR JUST NEVER GOT. 4759 03:09:52,679 --> 03:09:55,214 IT'S MORE DIFFICULT TO DO THAT. 4760 03:09:55,214 --> 03:09:56,182 IT IS IMPORTANT. 4761 03:09:56,182 --> 03:10:00,787 AND YOU KNOW WHEN WE WERE LIKE 4762 03:10:00,787 --> 03:10:02,088 DOING DEPRESSION, AND ALCOHOL, 4763 03:10:02,088 --> 03:10:03,890 PAST 20, 30 YEARS WE DID FUND 4764 03:10:03,890 --> 03:10:05,358 SOME STUDIES ON THAT. 4765 03:10:05,358 --> 03:10:07,393 AND WE WERE JUST WANTING TO 4766 03:10:07,393 --> 03:10:08,628 ANSWER SOME SIMPLE QUESTIONS 4767 03:10:08,628 --> 03:10:11,931 THAT IF YOU TREAT THE DEPRESSION 4768 03:10:11,931 --> 03:10:14,100 WILL THAT REDUCE DRINKING OR IF 4769 03:10:14,100 --> 03:10:15,268 YOU REDUCE DRINKING, AND IT 4770 03:10:15,268 --> 03:10:19,605 TURNED OUT TO BE COMPLEX, THAT'S 4771 03:10:19,605 --> 03:10:20,106 SURPRISING. 4772 03:10:20,106 --> 03:10:22,375 EVERYTHING IN ALCOHOL RELATED 4773 03:10:22,375 --> 03:10:23,476 SEEMS TO BE HETEROGENEITY, AND 4774 03:10:23,476 --> 03:10:24,077 JUST DEPEND. 4775 03:10:24,077 --> 03:10:26,179 I THINK WHAT WE ENDED UP SAYING 4776 03:10:26,179 --> 03:10:29,615 IS PROBABLY BEST TO TREAT BOTH. 4777 03:10:29,615 --> 03:10:32,085 PROBABLY THE SAFEST THING TO DO. 4778 03:10:32,085 --> 03:10:34,854 YES, WE ARE INTERESTED. 4779 03:10:34,854 --> 03:10:37,757 A LITTLE MORE CHALLENGING. 4780 03:10:37,757 --> 03:10:42,395 ALSO STUDIES WE'VE DONE SAY WITH 4781 03:10:42,395 --> 03:10:42,995 NALTREXONE, MAYBE ACAMPROSATE, 4782 03:10:42,995 --> 03:10:44,330 SEEMS TO WORK WELL TO REDUCE 4783 03:10:44,330 --> 03:10:47,467 DRINKING IF THEY ARE DEPRESSED 4784 03:10:47,467 --> 03:10:49,402 OR NOT DEPRESSED, EVEN 4785 03:10:49,402 --> 03:10:50,436 SCHIZOPHRENIA, THEY SEEM TO HAVE 4786 03:10:50,436 --> 03:10:51,971 THE SAME TYPE OF EFFECT. 4787 03:10:51,971 --> 03:10:53,473 WE DIDN'T REALLY SEE ANYTHING 4788 03:10:53,473 --> 03:10:55,541 DRAMATIC LIKE IT DOESN'T WORK IF 4789 03:10:55,541 --> 03:10:57,276 YOU'RE DEPRESS AND DRINKING, 4790 03:10:57,276 --> 03:10:59,779 STEAMS TO WORK ABOUT THE SAME. 4791 03:10:59,779 --> 03:11:02,482 BY-- SEEMS ABOUT THE SAME. 4792 03:11:02,482 --> 03:11:03,683 ANTIDEPRESSANTS ARE ABOUT THE 4793 03:11:03,683 --> 03:11:05,051 SAME TOO, DRINKING OR NOT 4794 03:11:05,051 --> 03:11:07,687 DRINKING, AT LEAST THAT I 4795 03:11:07,687 --> 03:11:13,726 EXPERIENCED FROM THE RESEARCH. 4796 03:11:13,726 --> 03:11:14,327 >> OKAY. 4797 03:11:14,327 --> 03:11:15,461 ONE LAST COMMENT, QUESTION, FROM 4798 03:11:15,461 --> 03:11:18,998 ANYBODY? 4799 03:11:18,998 --> 03:11:22,235 YOU GUYS ARE SO ON TIME TODAY. 4800 03:11:22,235 --> 03:11:24,237 IT'S EERIE. 4801 03:11:24,237 --> 03:11:26,038 ALL RIGHT. 4802 03:11:26,038 --> 03:11:27,039 IT IS 3:15. 4803 03:11:27,039 --> 03:11:28,975 AND WE'RE SUPPOSED TO HAVE 4804 03:11:28,975 --> 03:11:30,643 PUBLIC COMMENTS AND COUNCIL 4805 03:11:30,643 --> 03:11:30,943 DISCUSSION. 4806 03:11:30,943 --> 03:11:33,012 WE'VE HAD A LARGE AMOUNT OF 4807 03:11:33,012 --> 03:11:33,446 COUNCIL DISCUSSION. 4808 03:11:33,446 --> 03:11:41,220 DO WE HAVE ANYBODY FOR PUBLIC 4809 03:11:41,220 --> 03:11:41,454 COMMENT? 4810 03:11:41,454 --> 03:11:43,222 >> THERE WAS NO REQUEST, THERE 4811 03:11:43,222 --> 03:11:45,858 WAS SOMEONE REACHING OUT BUT 4812 03:11:45,858 --> 03:11:47,026 THERE WAS NO FOLLOW-UP. 4813 03:11:47,026 --> 03:11:54,000 THE PERSON WAS NOT INTERESTED IN 4814 03:11:54,000 --> 03:11:54,367 PARTICIPATING. 4815 03:11:54,367 --> 03:11:55,234 >> WHY DON'T YOU GO OVER THE 4816 03:11:55,234 --> 03:11:57,970 SCHEDULE FOR THE NEXT COUNCIL 4817 03:11:57,970 --> 03:11:59,605 MEETING, FOR TOMORROW. 4818 03:11:59,605 --> 03:12:00,740 >> THE NEXT MEETING? 4819 03:12:00,740 --> 03:12:03,443 YOU WANT ME TO GO THROUGH THE 4820 03:12:03,443 --> 03:12:04,310 MINUTES FIRST? 4821 03:12:04,310 --> 03:12:05,878 >> OH, YES, THE MINUTES. 4822 03:12:05,878 --> 03:12:08,548 DO ALL YOUR THINGS. 4823 03:12:08,548 --> 03:12:10,450 >> SURE, SURE. 4824 03:12:10,450 --> 03:12:11,951 SO, YEAH, I WANT TO MENTION THE 4825 03:12:11,951 --> 03:12:14,954 MINUTES OF THE LAST COUNCIL 4826 03:12:14,954 --> 03:12:21,928 MEETING WERE POSTED ON ECB FOR 4827 03:12:21,928 --> 03:12:25,398 THE 165th NCAA MEETING BACK IN 4828 03:12:25,398 --> 03:12:27,800 FEBRUARY. 4829 03:12:27,800 --> 03:12:33,039 AND ALSO THERE WAS THE STANDARD 4830 03:12:33,039 --> 03:12:34,207 OPERATING PROCEDURE WANTED TO 4831 03:12:34,207 --> 03:12:35,875 KNOW IF YOU HAVE COMMENTS, 4832 03:12:35,875 --> 03:12:37,844 QUESTIONS, ANY DISCUSSION 4833 03:12:37,844 --> 03:12:39,979 REGARDING THE TWO DOCUMENTS, WE 4834 03:12:39,979 --> 03:12:41,414 NEED TO HAVE APPROVAL FROM 4835 03:12:41,414 --> 03:12:45,585 COUNCIL FOR THESE TWO DOCUMENTS. 4836 03:12:45,585 --> 03:12:47,587 UNLESS THERE ARE ANY OTHER 4837 03:12:47,587 --> 03:12:49,755 QUESTIONS, ANY COMMENTS, OR I 4838 03:12:49,755 --> 03:12:52,158 WOULD LIKE TO ENTERTAIN A MOTION 4839 03:12:52,158 --> 03:12:55,261 FOR APPROVAL OF THE MINUTES OF 4840 03:12:55,261 --> 03:12:56,162 THE 165th -- 4841 03:12:56,162 --> 03:12:57,029 >> SO MOVED. 4842 03:12:57,029 --> 03:12:57,363 >> SO MOVED. 4843 03:12:57,363 --> 03:12:58,197 THANK YOU VERY MUCH. 4844 03:12:58,197 --> 03:13:08,040 AS WELL AS FOR THE SOPs. 4845 03:13:08,040 --> 03:13:13,179 AND SO IN FAVOR, THEN SO 4846 03:13:13,179 --> 03:13:13,613 OPPOSED? 4847 03:13:13,613 --> 03:13:14,814 ALL IN FAVOR? 4848 03:13:14,814 --> 03:13:18,084 THANK YOU VERY MUCH. 4849 03:13:18,084 --> 03:13:19,452 THE MOTION -- ABSTAIN. 4850 03:13:19,452 --> 03:13:20,853 AND THEREFORE THE MOTION 4851 03:13:20,853 --> 03:13:22,288 CARRIES. 4852 03:13:22,288 --> 03:13:25,424 THANK YOU VERY MUCH. 4853 03:13:25,424 --> 03:13:29,028 AND SINCE DR. KOOB MENTIONED 4854 03:13:29,028 --> 03:13:32,164 NEXT DATES FOR THE MEETINGS OF 4855 03:13:32,164 --> 03:13:34,767 THE NIAAA COUNCIL AS WELL AS 4856 03:13:34,767 --> 03:13:36,269 CRAN, SO YOU HAVE THE 4857 03:13:36,269 --> 03:13:40,273 INFORMATION, YOU CAN PUT IT ON 4858 03:13:40,273 --> 03:13:43,042 THE SCREEN REALLY QUICK. 4859 03:13:43,042 --> 03:13:49,081 4860 03:13:49,081 --> 03:13:59,125 4861 03:14:04,730 --> 03:14:08,467 2024 IT'S SEPTEMBER 12 FOR 4862 03:14:08,467 --> 03:14:09,335 NIAAA. 4863 03:14:09,335 --> 03:14:13,105 2025 FEBRUARY 6, MAY 13, 4864 03:14:13,105 --> 03:14:13,573 SEPTEMBER 4. 4865 03:14:13,573 --> 03:14:19,278 FOR 2026, IT WILL BE FEBRUARY 5, 4866 03:14:19,278 --> 03:14:23,816 MAY 5, AND SEPTEMBER 17 FOR 4867 03:14:23,816 --> 03:14:24,951 NIAAA COUNCIL. 4868 03:14:24,951 --> 03:14:27,420 FUTURE MEETING DATES OF CRAN 4869 03:14:27,420 --> 03:14:29,422 JOINT ADVISORY COUNCIL, NIAAA 4870 03:14:29,422 --> 03:14:34,760 AND NIDA AND NCI, 2025, MAY 7. 4871 03:14:34,760 --> 03:14:38,097 I MEAN IT WAS ACTUALLY -- I'M 4872 03:14:38,097 --> 03:14:42,001 SORRY, I'M CONFUSED HERE. 4873 03:14:42,001 --> 03:14:44,337 FOR THIS YEAR, TOMORROW, MAY 8, 4874 03:14:44,337 --> 03:14:45,071 FOR TOMORROW. 4875 03:14:45,071 --> 03:14:49,308 AND FOR 2025 IT WILL BE MAY 14. 4876 03:14:49,308 --> 03:14:50,977 AND FOR 2026, IT'S GOING TO BE 4877 03:14:50,977 --> 03:14:54,213 MAY 6. 4878 03:14:54,213 --> 03:14:55,481 >> AND WHAT DO PEOPLE NEED TO 4879 03:14:55,481 --> 03:14:56,949 KNOW ABOUT TOMORROW MORNING, 4880 03:14:56,949 --> 03:15:00,119 WHEN DO WE START? 4881 03:15:00,119 --> 03:15:04,223 >> SO TOMORROW MORNING THIS IS 4882 03:15:04,223 --> 03:15:05,091 THE 11th CRAN MEETING, 4883 03:15:05,091 --> 03:15:08,628 STARTING AT 10 A.M. HERE IN THIS 4884 03:15:08,628 --> 03:15:10,396 MEETING ROOM, IF YOU CAN COME A 4885 03:15:10,396 --> 03:15:12,398 FEW MINUTES, OR I THINK IT 4886 03:15:12,398 --> 03:15:14,600 WORKED PRETTY WELL THIS MORNING, 4887 03:15:14,600 --> 03:15:15,701 IF YOU COME WITHIN 20 MINUTES TO 4888 03:15:15,701 --> 03:15:20,239 30 MINUTES BEFORE THE MEETING 4889 03:15:20,239 --> 03:15:22,141 YOU HAVE TIME TO GET SETTLED, 4890 03:15:22,141 --> 03:15:23,609 GET COFFEE, MAKE SURE YOU HAVE 4891 03:15:23,609 --> 03:15:25,378 INTERNET CONNECTION. 4892 03:15:25,378 --> 03:15:26,646 THAT WILL BE HERE TOMORROW 4893 03:15:26,646 --> 03:15:29,215 MORNING. 4894 03:15:29,215 --> 03:15:32,218 >> IF YOU HAVEN'T BEEN AT A CRAN 4895 03:15:32,218 --> 03:15:38,357 MEETING, SO THE WAY WE DO IT 4896 03:15:38,357 --> 03:15:40,793 NORA AND I ALTERNATE. 4897 03:15:40,793 --> 03:15:41,894 I BELIEVE SHE'S THE HOST THIS 4898 03:15:41,894 --> 03:15:43,696 YEAR AND WILL START THE MEETING. 4899 03:15:43,696 --> 03:15:46,932 I END THE MEETING. 4900 03:15:46,932 --> 03:15:49,969 AND THEN SHE GIVES THE 4901 03:15:49,969 --> 03:15:51,137 DIRECTOR'S PRESENTATION OF 30 4902 03:15:51,137 --> 03:15:55,007 MINUTES, THEN I HAVE A 30-MINUTE 4903 03:15:55,007 --> 03:15:56,609 PRESENTATION. 4904 03:15:56,609 --> 03:16:00,680 AND THEN WE'LL HAVE ALSO NCI 4905 03:16:00,680 --> 03:16:01,113 UPDATE. 4906 03:16:01,113 --> 03:16:09,388 AND THEN WE HAVE AN HBCD STUDY 4907 03:16:09,388 --> 03:16:12,024 UPDATE, THAT'S HEALTHY BABY 4908 03:16:12,024 --> 03:16:13,726 COGNITIVE DEVELOPMENT STUDY. 4909 03:16:13,726 --> 03:16:17,196 DID I GET THAT RIGHT? 4910 03:16:17,196 --> 03:16:20,299 AND AN ABCD STUDY UPDATE FROM 4911 03:16:20,299 --> 03:16:22,001 GAYA DOWLING. 4912 03:16:22,001 --> 03:16:23,736 KATHY COLE DOING HBCD. 4913 03:16:23,736 --> 03:16:28,340 I FENCE YOU'LL FIND IT QUITE 4914 03:16:28,340 --> 03:16:28,974 INTERESTING. 4915 03:16:28,974 --> 03:16:29,642 PARTICULARLY ABCD, BECAUSE THOSE 4916 03:16:29,642 --> 03:16:33,245 INDIVIDUALS ARE NOW GETTING INTO 4917 03:16:33,245 --> 03:16:35,648 THE AREA OF THE AGE WHERE THEY 4918 03:16:35,648 --> 03:16:38,818 MAY START DOING DRUGS AND 4919 03:16:38,818 --> 03:16:44,323 DRINKING AND OTHER THINGS. 4920 03:16:44,323 --> 03:16:49,428 AND THEN WE HAVE A PRESENTATION 4921 03:16:49,428 --> 03:16:51,130 ABOUT THE START PROGRAM, 4922 03:16:51,130 --> 03:16:52,064 PREDICTING ADOLESCENT ALCOHOL -- 4923 03:16:52,064 --> 03:16:54,467 CAN YOU TAKE OVER FOR ME? 4924 03:16:54,467 --> 03:16:55,634 >> SURE, WE HAVE TWO 4925 03:16:55,634 --> 03:16:58,037 PRESENTATIONS OF PEOPLE WHO HAVE 4926 03:16:58,037 --> 03:17:00,106 BEEN USING ABC DATA, ONE IS THE 4927 03:17:00,106 --> 03:17:01,207 START PROGRAM OVERVIEW, 4928 03:17:01,207 --> 03:17:03,375 ADVANCING THE PREDICTION OF 4929 03:17:03,375 --> 03:17:06,078 ADOLESCENT ALCOHOL USE ONSET BY 4930 03:17:06,078 --> 03:17:07,713 DERIVING POLICY EXPOSURE ALCOHOL 4931 03:17:07,713 --> 03:17:10,516 RISK SCORES USING ABCD STUDY. 4932 03:17:10,516 --> 03:17:12,785 AND SECOND ONE IS RACIAL 4933 03:17:12,785 --> 03:17:17,289 INEQUITIES IN NEUROIMAGING 4934 03:17:17,289 --> 03:17:19,358 STUDIES IN ABCD. 4935 03:17:19,358 --> 03:17:20,893 YOU'LL HEAR A GENERAL OVERVIEW 4936 03:17:20,893 --> 03:17:22,261 AND TWO PROJECTS AND DATA FROM 4937 03:17:22,261 --> 03:17:24,897 IT. 4938 03:17:24,897 --> 03:17:25,197 >> THANKS. 4939 03:17:25,197 --> 03:17:28,100 THANKS, TRISH. 4940 03:17:28,100 --> 03:17:30,669 4941 03:17:30,669 --> 03:17:31,904 SO, THAT'S IT. 4942 03:17:31,904 --> 03:17:33,038 THE ROUNDTABLE DISCUSSION AND I 4943 03:17:33,038 --> 03:17:35,274 GET TO CLOSE US OUT. 4944 03:17:35,274 --> 03:17:36,876 SO IT SHOULD BE FUN. 4945 03:17:36,876 --> 03:17:38,377 I ALWAYS ENJOY THE CRAN MEETING 4946 03:17:38,377 --> 03:17:42,448 BECAUSE WE GET TO SEE OUR FELLOW 4947 03:17:42,448 --> 03:17:44,350 RESEARCHERS IN ADDICTION AND 4948 03:17:44,350 --> 03:17:45,184 THERE'S ALWAYS SOMETHING THEY 4949 03:17:45,184 --> 03:17:47,086 ARE DOING THAT WE WANT TO DO AND 4950 03:17:47,086 --> 03:17:48,187 PROBABLY THINGS WE'RE DOING THEY 4951 03:17:48,187 --> 03:17:50,389 WANT TO DO. 4952 03:17:50,389 --> 03:17:56,028 SO IT'S A GOOD 4953 03:17:56,028 --> 03:17:56,529 CROSS-FERTILIZATION. 4954 03:17:56,529 --> 03:17:57,530 ALL RIGHT. 4955 03:17:57,530 --> 03:18:01,500 ANYTHING ELSE FROM ANYONE ABOUT 4956 03:18:01,500 --> 03:18:02,401 ANYTHING? 4957 03:18:02,401 --> 03:18:03,536 HAPPY TO -- ANYBODY ONLINE WITH 4958 03:18:03,536 --> 03:18:06,405 ANY FURTHER COMMENTS? 4959 03:18:06,405 --> 03:18:08,808 4960 03:18:08,808 --> 03:18:09,175 ALL RIGHT. 4961 03:18:09,175 --> 03:18:10,643 WELL, THANK YOU ALL. 4962 03:18:10,643 --> 03:18:12,912 I THINK WE HAD SOME LIVELY 4963 03:18:12,912 --> 03:18:14,380 DISCUSSION AND A LOT OF 4964 03:18:14,380 --> 03:18:15,114 PARTICIPATION THIS TIME. 4965 03:18:15,114 --> 03:18:16,382 I THINK WE'RE GOING TO KEEP 4966 03:18:16,382 --> 03:18:20,686 DOING IT THIS WAY. 4967 03:18:20,686 --> 03:18:22,655 REMEMBER, IN GENERAL, WE HAVE 4968 03:18:22,655 --> 03:18:25,391 LIVE COUNCIL MEETINGS EXCEPT IN 4969 03:18:25,391 --> 03:18:26,959 JANUARY, FEBRUARY, WHEN WE DO 4970 03:18:26,959 --> 03:18:29,995 NOT HAVE LIVE COUNCIL MEETINGS. 4971 03:18:29,995 --> 03:18:33,833 WE HAVE -- WE'LL DO IT PROBABLY 4972 03:18:33,833 --> 03:18:35,668 VIRTUAL BECAUSE OF TRAVEL. 4973 03:18:35,668 --> 03:18:37,803 I JUST HAVE SEARING MEMORIES, 4974 03:18:37,803 --> 03:18:38,804 MAYBE CLIMATE CHANGE WILL CHANGE 4975 03:18:38,804 --> 03:18:39,972 THIS, BUT I HAVE LOTS OF 4976 03:18:39,972 --> 03:18:42,708 MEMORIES OF MOST OF OUR COUNCIL 4977 03:18:42,708 --> 03:18:45,411 MEMBERS BEING STUCK IN AIRPORTS 4978 03:18:45,411 --> 03:18:46,011 IN CHICAGO, INDIANAPOLIS, AND 4979 03:18:46,011 --> 03:18:47,913 ALL KIND OF OTHER PLACES. 4980 03:18:47,913 --> 03:18:49,748 DALLAS AND SO ON AND SO FORTH. 4981 03:18:49,748 --> 03:18:53,052 SO WE DO IT VIRTUALLY IN 4982 03:18:53,052 --> 03:18:53,986 FEBRUARY. 4983 03:18:53,986 --> 03:18:54,520 OKAY. 4984 03:18:54,520 --> 03:18:56,121 THANKS, EVERYBODY. 4985 03:18:56,121 --> 03:18:59,558 [END OF PROGRAM] 4986 03:18:59,558 --> 03:19:05,497 4987 03:19:05,497 --> 03:19:15,541