1 00:00:05,760 --> 00:00:08,280 I'M DR. JULIE PANEPINTO AT THE 2 00:00:08,280 --> 00:00:09,480 NHLBI. 3 00:00:09,480 --> 00:00:15,040 IT'S MY PLEASURE TO OPEN THE 4 00:00:15,040 --> 00:00:18,320 2022 NHLBI AND OASH SYMPOSIUM. 5 00:00:18,320 --> 00:00:19,520 THE PLANNING AND ORGANIZING OF 6 00:00:19,520 --> 00:00:21,160 THIS HAS BEEN SIGNIFICANT AND I 7 00:00:21,160 --> 00:00:22,680 WANT TO EXTEND MY THANKS AND 8 00:00:22,680 --> 00:00:26,240 APPRECIATION TO THE CO-CHAIRS OF 9 00:00:26,240 --> 00:00:27,320 THE SYMPOSIUM, DOCTORS CUSTER 10 00:00:27,320 --> 00:00:28,720 AND ROUBINIAN, AND TO THE 11 00:00:28,720 --> 00:00:34,600 PROGRAM STAFF FROM OASH AND 12 00:00:34,600 --> 00:00:36,280 NHLBI FOR THEIR HARD WORK. 13 00:00:36,280 --> 00:00:37,320 IT'S WONDERFUL TO NOW HAVE ALL 14 00:00:37,320 --> 00:00:38,720 OF YOU JOINED WITH US TODAY TO 15 00:00:38,720 --> 00:00:41,000 BEGIN THE WORK OF IDENTIFYING 16 00:00:41,000 --> 00:00:45,640 RESEARCH PRIORITIES RELEVANT TO 17 00:00:45,640 --> 00:00:46,280 BLOOD TRANSFUSION MEDICINE. 18 00:00:46,280 --> 00:00:48,840 FOCUSED ON THESE THREE AREAS OF 19 00:00:48,840 --> 00:00:49,320 IMPORTANCE. 20 00:00:49,320 --> 00:00:50,320 INCREASING AND DIVERSIFYING THE 21 00:00:50,320 --> 00:00:51,880 POOL, IDENTIFYING WHICH BLOOD 22 00:00:51,880 --> 00:00:53,360 PRODUCTS FROM WHICH DONORS WOULD 23 00:00:53,360 --> 00:00:56,520 BEST MATCH THE NEEDS OF SPECIFIC 24 00:00:56,520 --> 00:00:57,160 RECIPIENT POPULATIONS, AND 25 00:00:57,160 --> 00:01:00,520 HELPING ENSURE SAFE AND 26 00:01:00,520 --> 00:01:01,240 EFFECTIVE TRANSFUSION 27 00:01:01,240 --> 00:01:01,520 STRATEGIES. 28 00:01:01,520 --> 00:01:02,720 TODAY WE'RE FORTUNATE AND 29 00:01:02,720 --> 00:01:05,280 HONORED TO HAVE ADMIRAL RACHEL 30 00:01:05,280 --> 00:01:07,800 LEVINE WHO SERVES AS 17th 31 00:01:07,800 --> 00:01:09,920 ASSISTANT SECRETARY FOR HEALTH, 32 00:01:09,920 --> 00:01:10,640 UNITED STATES DEPARTMENT OF 33 00:01:10,640 --> 00:01:11,440 HEALTH AND HUMAN SERVICES, AND 34 00:01:11,440 --> 00:01:14,800 HEAD OF THE U.S. PUBLIC HEALTH 35 00:01:14,800 --> 00:01:16,000 SERVICE COMMISSIONED CORPS, 36 00:01:16,000 --> 00:01:17,080 PROVIDE OPENING REMARKS BY 37 00:01:17,080 --> 00:01:19,040 VIDEOCAST FOR THE STATE OF THE 38 00:01:19,040 --> 00:01:23,320 SCIENCE AND TRANSFUSION MEDICINE 39 00:01:23,320 --> 00:01:29,560 SYMPOSIUM. 40 00:01:29,560 --> 00:01:34,080 ADMIRAL LEVINE IS A STRONG 41 00:01:34,080 --> 00:01:36,240 ADVOCATE, WORKING TO HELP OUR 42 00:01:36,240 --> 00:01:37,280 NATION OVERCOME THE COVID-19 43 00:01:37,280 --> 00:01:39,800 PANDEMIC AND BUILD A STRONGER 44 00:01:39,800 --> 00:01:41,480 FOUNDATION FOR HEALTHIER FUTURE. 45 00:01:41,480 --> 00:01:43,360 ONE IN WHICH EVERY AMERICAN CAN 46 00:01:43,360 --> 00:01:46,080 ATTAIN THEIR FULL HEALTH 47 00:01:46,080 --> 00:01:46,560 POTENTIAL. 48 00:01:46,560 --> 00:01:48,600 ADMIRAL LEVINE'S CAREER FIRST AS 49 00:01:48,600 --> 00:01:51,000 A PHYSICIAN IN ACADEMIC MEDICINE 50 00:01:51,000 --> 00:01:51,840 FOCUSED ON INTERSECTION BETWEEN 51 00:01:51,840 --> 00:01:54,640 HEALTH AND PHYSICAL HEALTH 52 00:01:54,640 --> 00:01:55,800 TREATING CHILDREN, ADOLESCENTS, 53 00:01:55,800 --> 00:01:58,000 YOUNG ADULTS, THEN AS 54 00:01:58,000 --> 00:01:59,120 PENNSYLVANIA'S PHYSICIAN 55 00:01:59,120 --> 00:02:00,560 GENERAL, LATER AS PENNSYLVANIA'S 56 00:02:00,560 --> 00:02:03,960 SECRETARY OF HEALTH, SHE 57 00:02:03,960 --> 00:02:04,720 ADDRESSED COVID-19, OPIOID 58 00:02:04,720 --> 00:02:06,680 CRISIS, BEHAVIORAL HEALTH, OTHER 59 00:02:06,680 --> 00:02:08,360 PUBLIC HEALTH CHALLENGES. 60 00:02:08,360 --> 00:02:11,440 HERE ARE DR. LEVINE'S OPENING 61 00:02:11,440 --> 00:02:14,520 REMARKS. 62 00:02:14,520 --> 00:02:19,920 63 00:02:19,920 --> 00:02:20,680 >> THANK YOU, DR. PANEPINTO. 64 00:02:20,680 --> 00:02:21,800 GOOD MORNING. 65 00:02:21,800 --> 00:02:23,600 FIRST I WOULD LIKE TO THANK YOU 66 00:02:23,600 --> 00:02:26,440 FOR YOUR INVITATION TODAY TO 67 00:02:26,440 --> 00:02:28,600 ADDRESS THIS VERY EXCITING 68 00:02:28,600 --> 00:02:30,680 SYMPOSIUM. 69 00:02:30,680 --> 00:02:31,680 AS THE UNITED STATES DEPARTMENT 70 00:02:31,680 --> 00:02:37,120 OF HEALTH AND HUMAN SERVICES 71 00:02:37,120 --> 00:02:41,440 BLOOD SAFETY DIRECTOR -- OF THE 72 00:02:41,440 --> 00:02:42,640 BLOOD, ORGAN SENIOR EXECUTIVE 73 00:02:42,640 --> 00:02:44,400 COUNCIL I REMAIN ENGAGED IN 74 00:02:44,400 --> 00:02:46,000 ISSUES AFFECTING THE BLOOD 75 00:02:46,000 --> 00:02:47,240 SUPPLY AND AM DEEPLY INTERESTED 76 00:02:47,240 --> 00:02:49,400 IN WAYS TO IMPROVE OUTCOMES FOR 77 00:02:49,400 --> 00:02:51,720 PATIENTS WHO REQUIRE BLOOD AND 78 00:02:51,720 --> 00:02:53,360 BLOOD PRODUCTS. 79 00:02:53,360 --> 00:02:54,360 BEYOND MY CURRENT ROLES, I 80 00:02:54,360 --> 00:02:59,280 ADDRESS YOU TODAY AS A PHYSICIAN 81 00:02:59,280 --> 00:03:01,480 AND PEDIATRICIAN, HAVING SEEN 82 00:03:01,480 --> 00:03:03,680 THE ROLE BLOOD CAN MAKE IN 83 00:03:03,680 --> 00:03:08,560 PATIENTS WHO EXPERIENCED TRAUMA, 84 00:03:08,560 --> 00:03:09,440 CANCER, HEMORRHAGE, 85 00:03:09,440 --> 00:03:10,320 HEMOGLOBINOPATHIES AND OTHER 86 00:03:10,320 --> 00:03:11,640 CONDITIONS, IT IS LIFE SAVING. 87 00:03:11,640 --> 00:03:13,600 THERE ARE SO MANY INTERESTING 88 00:03:13,600 --> 00:03:15,560 PROJECTS THAT DESERVE YOUR 89 00:03:15,560 --> 00:03:16,720 ATTENTION AND PRIORITIZATION. 90 00:03:16,720 --> 00:03:19,680 FROM WAYS TO ENSURE A DIVERSE 91 00:03:19,680 --> 00:03:21,520 AND ROBUST BLOOD DONOR 92 00:03:21,520 --> 00:03:23,680 POPULATION TO EVALUATING THE 93 00:03:23,680 --> 00:03:24,840 TRANSFUSION AND TRANSMISSION 94 00:03:24,840 --> 00:03:26,880 POTENTIAL OF EMERGING 95 00:03:26,880 --> 00:03:32,200 INCORPORATE FECKS, -- 96 00:03:32,200 --> 00:03:33,840 INFECTION, TO IMPLEMENTING 97 00:03:33,840 --> 00:03:35,600 TRANSFUSION PRECISION MEDICINE 98 00:03:35,600 --> 00:03:36,800 APPROACHES, TO REDUCING HEALTH 99 00:03:36,800 --> 00:03:38,560 DISPARITIES IN PEOPLE WHO NEED 100 00:03:38,560 --> 00:03:38,880 TRANSFUSIONS. 101 00:03:38,880 --> 00:03:40,320 REMEMBER, WHAT MAY BE AN IDEA 102 00:03:40,320 --> 00:03:44,560 TODAY COULD BE A TRANSFORMATIVE 103 00:03:44,560 --> 00:03:45,040 INTERVENTION TOMORROW. 104 00:03:45,040 --> 00:03:46,640 IT'S MORE IMPORTANT THAN EVER TO 105 00:03:46,640 --> 00:03:50,440 INVEST IN WAYS TO DRIVE RESEARCH 106 00:03:50,440 --> 00:03:51,600 TO IMPROVE OUTCOMES FOR PATIENTS 107 00:03:51,600 --> 00:03:56,120 WE CARE FOR SPECIAL ESPECIALLY 108 00:03:56,120 --> 00:03:57,520 WHEN SUPPLIES ARE NOT 109 00:03:57,520 --> 00:03:58,280 GUARANTEED. 110 00:03:58,280 --> 00:03:59,800 I KNOW THAT NOT EVERYONE WHO 111 00:03:59,800 --> 00:04:02,000 WOULD LIKE TO DONATE BLOOD IS 112 00:04:02,000 --> 00:04:03,400 ELIGIBLE TO DONATE. 113 00:04:03,400 --> 00:04:05,200 I RECOGNIZE THE HISTORY 114 00:04:05,200 --> 00:04:07,040 ASSOCIATED WITH RESTRICTIONS ON 115 00:04:07,040 --> 00:04:08,800 BLOOD DONATION, AND I NEED TO 116 00:04:08,800 --> 00:04:12,080 USE SCIENCE AND EVIDENCE TO MOVE 117 00:04:12,080 --> 00:04:13,240 FORWARD. 118 00:04:13,240 --> 00:04:15,040 UP UNTIL THIS SUMMER, DAYS OF 119 00:04:15,040 --> 00:04:18,400 BLOOD SUPPLY ON HAND FOR MOST OF 120 00:04:18,400 --> 00:04:21,360 THE COVID-19 PANDEMIC WAS VERY 121 00:04:21,360 --> 00:04:21,520 LOW. 122 00:04:21,520 --> 00:04:22,400 VOLUNTARY BLOOD DONATION HAS 123 00:04:22,400 --> 00:04:24,600 BEEN ON THE DECLINE FOR THE PAST 124 00:04:24,600 --> 00:04:25,680 DECADE ACTUALLY. 125 00:04:25,680 --> 00:04:28,160 AS YOU ALL KNOW, COMPOUNDING THE 126 00:04:28,160 --> 00:04:30,520 PROBLEM, THE COVID-19 PANDEMIC 127 00:04:30,520 --> 00:04:32,000 BROUGHT TO FORE EXTRAORDINARY 128 00:04:32,000 --> 00:04:33,640 CHANCE, THE COLLECTION AND 129 00:04:33,640 --> 00:04:36,400 UTILIZATION OF BLOOD AND BLOOD 130 00:04:36,400 --> 00:04:37,080 PRODUCTS. 131 00:04:37,080 --> 00:04:38,440 TO ENCOURAGE BLOOD AND PLASMA 132 00:04:38,440 --> 00:04:40,640 DONATION EARLIER THIS MONTH MY 133 00:04:40,640 --> 00:04:42,440 OFFICE, OFFICE OF THE ASSISTANT 134 00:04:42,440 --> 00:04:44,280 SECRETARY FOR HEALTH, LAUNCHED 135 00:04:44,280 --> 00:04:47,520 THE NATIONAL BLOOD AND PLASMA 136 00:04:47,520 --> 00:04:50,200 DONATION AWARENESS CAMPAIGN. 137 00:04:50,200 --> 00:04:55,640 IN MARCH 2020 CONGRESS PASSED 138 00:04:55,640 --> 00:04:57,160 THE CORONAVIRUS ACT, THE CARES 139 00:04:57,160 --> 00:04:58,640 ACT, TO PROVIDE COVID-19 140 00:04:58,640 --> 00:05:01,480 PANDEMIC RELIEF TO MILLIONS OF 141 00:05:01,480 --> 00:05:03,760 AMERICANS, INCLUDED IN THAT 142 00:05:03,760 --> 00:05:05,120 IMPORTANT LEGISLATION IS THE 143 00:05:05,120 --> 00:05:07,760 NATIONAL BLOOD AND PLASMA 144 00:05:07,760 --> 00:05:08,520 AWARENESS CAMPAIGN DESIGNED TO 145 00:05:08,520 --> 00:05:10,480 ADDRESS THE DECLINES IN BLOOD 146 00:05:10,480 --> 00:05:12,880 AND PLASMA DONATION WITNESSED 147 00:05:12,880 --> 00:05:14,360 DURING THE EARLY WEEKS AND 148 00:05:14,360 --> 00:05:15,480 MONTHS OF THE PANDEMIC. 149 00:05:15,480 --> 00:05:18,040 NOW, WHILE THERE IS NO DOUBT 150 00:05:18,040 --> 00:05:20,760 THAT THE COVID-19 PANDEMIC 151 00:05:20,760 --> 00:05:21,640 CAUSED IMMENSE DISRUPTION, THE 152 00:05:21,640 --> 00:05:24,640 CHALLENGES THAT WE FACE TODAY 153 00:05:24,640 --> 00:05:25,600 ARE NOT FROM COVID-19 ALONE. 154 00:05:25,600 --> 00:05:28,320 THAT IS WHY IT IS CRITICAL THAT 155 00:05:28,320 --> 00:05:30,760 THE CAMPAIGN SOUGHT TO ADDRESS 156 00:05:30,760 --> 00:05:33,160 BOTH IMMEDIATE AND LONG-TERM 157 00:05:33,160 --> 00:05:35,560 NEEDS, RELATED TO DONATION, 158 00:05:35,560 --> 00:05:38,200 INCLUDING DONOR EDUCATION AND 159 00:05:38,200 --> 00:05:39,600 DONOR OUTREACH. 160 00:05:39,600 --> 00:05:41,320 IMPORTANTLY, THIS CAMPAIGN ALSO 161 00:05:41,320 --> 00:05:43,480 PROVIDES AN OPPORTUNITY TO REACH 162 00:05:43,480 --> 00:05:44,400 UNDERSERVED COMMUNITIES, BECAUSE 163 00:05:44,400 --> 00:05:46,240 WE KNOW PATIENTS WHO RECEIVE 164 00:05:46,240 --> 00:05:49,320 BLOOD FROM DONORS OF SIMILAR 165 00:05:49,320 --> 00:05:50,840 RACIAL BACKGROUNDS EXPERIENCE 166 00:05:50,840 --> 00:05:53,040 BETTER OUTCOMES. 167 00:05:53,040 --> 00:05:56,720 IN IT, WE HIGHLIGHT HEATHER, A 168 00:05:56,720 --> 00:06:03,960 BLACK WOMAN BATTLING SICKLE 169 00:06:03,960 --> 00:06:08,160 CELL DISEASE AND AIRABELLE, IN 170 00:06:08,160 --> 00:06:08,520 NEED OF PLASMA. 171 00:06:08,520 --> 00:06:13,200 INCLUDING DIVERSITY, EQUITY, AND 172 00:06:13,200 --> 00:06:14,720 INCLUSION INTO THIS SYMPOSIUM'S 173 00:06:14,720 --> 00:06:17,320 RESEARCH PRIORITIES. 174 00:06:17,320 --> 00:06:18,440 I'M CONFIDENT EXPERTS WILL 175 00:06:18,440 --> 00:06:19,240 PROVIDE INSIGHTFUL INFORMATION 176 00:06:19,240 --> 00:06:21,640 AND HELP GUIDE A FRUITFUL 177 00:06:21,640 --> 00:06:22,600 DISCUSSION OF THE RESEARCH 178 00:06:22,600 --> 00:06:24,480 PRIORITIES THAT WILL HELP ENSURE 179 00:06:24,480 --> 00:06:26,680 THE SAFETY AND AVAILABILITY OF 180 00:06:26,680 --> 00:06:29,280 THE BLOOD SUPPLY AS WELL AS THE 181 00:06:29,280 --> 00:06:31,720 SAFETY AND EFFECTIVENESS OF 182 00:06:31,720 --> 00:06:32,200 TRANSFUSION THERAPIES. 183 00:06:32,200 --> 00:06:34,240 I LOOK FORWARD TO THE FUTURE OF 184 00:06:34,240 --> 00:06:35,560 TRANSFUSION MEDICINE AND THE 185 00:06:35,560 --> 00:06:37,760 ADVANCEMENTS THAT CAN BE MADE 186 00:06:37,760 --> 00:06:40,040 POSSIBLE BY THE DECISIONS MADE 187 00:06:40,040 --> 00:06:40,600 TODAY. 188 00:06:40,600 --> 00:06:42,560 I WILL NOW TURN TO THE CHAIRS OF 189 00:06:42,560 --> 00:06:44,280 THE SYMPOSIUM AND WISH YOU THE 190 00:06:44,280 --> 00:06:46,120 BEST OF LUCK IN YOUR CONTINUED 191 00:06:46,120 --> 00:06:46,480 RESEARCH. 192 00:06:46,480 --> 00:06:48,440 THANK YOU. 193 00:06:48,440 --> 00:06:54,480 194 00:06:54,480 --> 00:07:00,560 195 00:07:00,560 --> 00:07:01,560 >> ALL RIGHT. 196 00:07:01,560 --> 00:07:02,080 THANK YOU. 197 00:07:02,080 --> 00:07:04,960 WELCOME AND THANK YOU FOR 198 00:07:04,960 --> 00:07:06,400 PARTICIPATING IN THE 2022 STATE 199 00:07:06,400 --> 00:07:08,720 OF THE SCIENCE AND TRANSFUSION 200 00:07:08,720 --> 00:07:09,400 MEDICINE SYMPOSIUM. 201 00:07:09,400 --> 00:07:13,120 WE WOULD LIKE TO THANK ADMIRAL 202 00:07:13,120 --> 00:07:18,920 LEVINE AND DR. PANEPINTO FOR THE 203 00:07:18,920 --> 00:07:19,360 OPENING STATEMENTS. 204 00:07:19,360 --> 00:07:21,480 THANK YOU FOR TAKING TIME TO 205 00:07:21,480 --> 00:07:22,360 OPEN THIS SYMPOSIUM. 206 00:07:22,360 --> 00:07:26,120 NEXT I WOULD LIKE TO THANK THE 207 00:07:26,120 --> 00:07:27,720 NATIONAL HEART, LUNG AND BLOOD 208 00:07:27,720 --> 00:07:29,440 INSTITUTE DIVISION OF BLOOD 209 00:07:29,440 --> 00:07:32,200 RESOURCE, BLOOD EPIDEMIOLOGY AND 210 00:07:32,200 --> 00:07:32,840 CLINICAL THERAPEUTICS BRANCH AND 211 00:07:32,840 --> 00:07:33,760 DEPARTMENT OF HEALTH AND HUMAN 212 00:07:33,760 --> 00:07:34,960 SERVICES, OFFICE FOR ASSISTANT 213 00:07:34,960 --> 00:07:36,080 SECRETARY FOR HEALTH, FOR BEING 214 00:07:36,080 --> 00:07:43,240 ASKED TO SERVE AS CO-CHAIR ALONG 215 00:07:43,240 --> 00:07:48,840 WITH DR. ROUBINIAN, THANK YOU TO 216 00:07:48,840 --> 00:07:51,400 DR. GLEN, HALU, XI R, 217 00:07:51,400 --> 00:07:52,600 MR. BERGER, AND DR. MARTIN, A 218 00:07:52,600 --> 00:07:53,600 MEMBER OF THE ORGANIZING 219 00:07:53,600 --> 00:07:55,200 COMMITTEE FOR STATE OF THE 220 00:07:55,200 --> 00:07:56,200 SCIENCE AND TRANSFUSION 221 00:07:56,200 --> 00:07:56,840 MEDICINE. 222 00:07:56,840 --> 00:07:58,200 IT'S BEEN A LONG PROCESS TO GET 223 00:07:58,200 --> 00:08:00,240 TO THE OPENING OF THIS SYMPOSIUM 224 00:08:00,240 --> 00:08:02,680 AND THE ACTIVITIES OF THE NAGS 225 00:08:02,680 --> 00:08:05,000 TWO DAYS, FIRST PLANNED TO BE 226 00:08:05,000 --> 00:08:08,120 HELD ON THE NIH CAMPUS IN 227 00:08:08,120 --> 00:08:09,920 BETHESDA IN 2020. 228 00:08:09,920 --> 00:08:11,760 STARTING IN 2019, THE ORGANIZING 229 00:08:11,760 --> 00:08:13,600 COMMITTEE BEGAN THE PROCESS OF 230 00:08:13,600 --> 00:08:17,160 DEFINING THE SYMPOSIUM AREAS OF 231 00:08:17,160 --> 00:08:19,320 FOCUS AND EXPECTED RESULTS. 232 00:08:19,320 --> 00:08:20,560 THIS BEGAN WITH IDENTIFYING SIX 233 00:08:20,560 --> 00:08:22,920 THEMES OR TOPICS OF RELEVANCE TO 234 00:08:22,920 --> 00:08:24,800 TRANSFUSION MEDICINE BY THE 235 00:08:24,800 --> 00:08:25,880 ORGANIZING COMMITTEE INCLUDING A 236 00:08:25,880 --> 00:08:28,200 DEBATE AS TO WHETHER WE ACHIEVED 237 00:08:28,200 --> 00:08:29,600 THE OVERALL OBJECTIVES OF 238 00:08:29,600 --> 00:08:33,080 DEFINING RESEARCH THEMES BY 239 00:08:33,080 --> 00:08:35,320 WHICH TO ORGANIZE THE SYMPOSIUM. 240 00:08:35,320 --> 00:08:37,240 I BELIEVE WE HAVE. 241 00:08:37,240 --> 00:08:38,880 THAT WAS JUST TRULY THE 242 00:08:38,880 --> 00:08:39,680 BEGINNING. 243 00:08:39,680 --> 00:08:40,960 IDENTIFICATION OF THE LEADERS OF 244 00:08:40,960 --> 00:08:43,360 EACH OF THOSE TEAMS AND TOPICS, 245 00:08:43,360 --> 00:08:44,760 THE FORMATION OF WORKING GROUPS, 246 00:08:44,760 --> 00:08:46,840 TO GUIDE US THROUGH THINKING 247 00:08:46,840 --> 00:08:48,640 THROUGH THE RESEARCH PRIORITIES 248 00:08:48,640 --> 00:08:50,760 AND DEFINING PRIORITIES WAS THE 249 00:08:50,760 --> 00:08:52,200 NEXT MOST IMPORTANT STEP. 250 00:08:52,200 --> 00:08:53,920 WE THEN HIT PAUSE FOR TWO YEARS, 251 00:08:53,920 --> 00:09:00,080 ALMOST TWO YEARS, AS WE ALL 252 00:09:00,080 --> 00:09:00,440 NOW. 253 00:09:00,440 --> 00:09:02,640 NOW LATE IN 2021, WE ESSENTIALLY 254 00:09:02,640 --> 00:09:05,880 RECONVENED AND ASKED THOSE 255 00:09:05,880 --> 00:09:08,000 WORKING GROUP CHAIRS TO DEVELOP 256 00:09:08,000 --> 00:09:09,160 WORKING GROUPS ULTIMATELY GOING 257 00:09:09,160 --> 00:09:11,000 TO DEFINE RESEARCH PRIORITIES 258 00:09:11,000 --> 00:09:12,080 PRESENTED TODAY AND TOMORROW. 259 00:09:12,080 --> 00:09:14,320 EACH OF THE WORKING GROUPS HAS 260 00:09:14,320 --> 00:09:18,920 SIX TO EIGHT MONTHS TO DISCUSS 261 00:09:18,920 --> 00:09:20,040 THEIR RESEARCH PRIORITIES AND 262 00:09:20,040 --> 00:09:22,320 DEFINE THEM, THAT WILL BE 263 00:09:22,320 --> 00:09:23,120 PRESENTED TODAY. 264 00:09:23,120 --> 00:09:26,240 THE WORKING GROUP MEMBERS ARE AN 265 00:09:26,240 --> 00:09:27,960 IMPRESSIVE CROSS-SECTION OF 266 00:09:27,960 --> 00:09:28,840 REALLY DIVERSE RESEARCH 267 00:09:28,840 --> 00:09:30,360 EXPERTISE THAT I THINK ARE GOING 268 00:09:30,360 --> 00:09:32,360 TO BE CRITICAL FOR US AS WE 269 00:09:32,360 --> 00:09:34,400 REALLY EXPAND OUR THOUGHTS ABOUT 270 00:09:34,400 --> 00:09:36,400 WHAT ARE THE RESEARCH PRIORITIES 271 00:09:36,400 --> 00:09:39,840 IN BLOOD-RELATED RESEARCH IN THE 272 00:09:39,840 --> 00:09:40,400 U.S. 273 00:09:40,400 --> 00:09:41,080 ALSO, OF COURSE, HAVING 274 00:09:41,080 --> 00:09:42,120 SYMPOSIUM IS JUST THE FIRST 275 00:09:42,120 --> 00:09:43,360 STEP. 276 00:09:43,360 --> 00:09:46,640 WE WILL HAVE THE PROCESS FOR 277 00:09:46,640 --> 00:09:47,960 FORMALIZING THESE PRIORITIES 278 00:09:47,960 --> 00:09:48,880 THROUGH PUBLICATIONS. 279 00:09:48,880 --> 00:09:52,560 BUT FOR NOW, THE NEXT STEP IS 280 00:09:52,560 --> 00:09:57,440 FOR ME TO INTRODUCE MY CO-CHAIR, 281 00:09:57,440 --> 00:10:02,960 DR. NAREG ROUBINIAN TO LEAD US 282 00:10:02,960 --> 00:10:04,640 THROUGH HOUSEKEEPING. 283 00:10:04,640 --> 00:10:04,880 WELCOME. 284 00:10:04,880 --> 00:10:10,360 >> THANK YOU, BRIAN, FOR THE 285 00:10:10,360 --> 00:10:10,680 INTRODUCTION. 286 00:10:10,680 --> 00:10:12,840 I'M NAREG ROUBINIAN, AND I'M 287 00:10:12,840 --> 00:10:14,320 PLEASED TO WELCOME EVERY ONE. 288 00:10:14,320 --> 00:10:16,240 IT'S BEEN AN HONOR TO WORK WITH 289 00:10:16,240 --> 00:10:18,440 THE ORGANIZING COMMITTEE AND 290 00:10:18,440 --> 00:10:19,920 WONDERFUL COLLEAGUES CO-CHAIRING 291 00:10:19,920 --> 00:10:21,040 AND PARTICIPATING IN THE SIX 292 00:10:21,040 --> 00:10:23,280 WORKING GROUPS. 293 00:10:23,280 --> 00:10:24,800 AND WE'RE LOOKING FORWARD TO 294 00:10:24,800 --> 00:10:25,720 SHARING THE DRAFT RESEARCH 295 00:10:25,720 --> 00:10:27,240 PRIORITIES AND HEARING AND 296 00:10:27,240 --> 00:10:30,320 DISCUSSING YOUR COMMENTS AND 297 00:10:30,320 --> 00:10:31,560 QUESTIONS. 298 00:10:31,560 --> 00:10:33,880 TODAY YOU'LL HEAR PRESENTATIONS 299 00:10:33,880 --> 00:10:34,640 OF RESEARCH PRIORITIES FROM 300 00:10:34,640 --> 00:10:37,040 THREE OF THE SIX WORKING GROUPS, 301 00:10:37,040 --> 00:10:40,360 INCLUDING FOCUS ON BLOOD DONORS 302 00:10:40,360 --> 00:10:42,840 AND BLOOD SUPPLY, OPTIMIZING 303 00:10:42,840 --> 00:10:46,520 TRANSFUSION OUTCOMES, AND 304 00:10:46,520 --> 00:10:48,080 EMERGING INFECTIONS. 305 00:10:48,080 --> 00:10:49,520 KEY COMPONENT IS DIRECT 306 00:10:49,520 --> 00:10:50,280 ENGAGEMENT WITH SCIENTIFIC 307 00:10:50,280 --> 00:10:52,400 COMMUNITY, IN ORDER TO FURTHER 308 00:10:52,400 --> 00:10:54,600 REFINE RESEARCH PRIORITIES AND 309 00:10:54,600 --> 00:10:56,960 INCORPORATE YOUR PERSPECTIVES IN 310 00:10:56,960 --> 00:10:58,320 THIS PRIORITIZATION PROCESS. 311 00:10:58,320 --> 00:11:00,160 IT IS WORTH NOTING THAT THE 312 00:11:00,160 --> 00:11:00,880 SYMPOSIUM IS BEING RECORDED, 313 00:11:00,880 --> 00:11:02,760 YOU'LL HAVE THE OPPORTUNITY TO 314 00:11:02,760 --> 00:11:04,040 REVIEW THESE PRESENTATIONS AND 315 00:11:04,040 --> 00:11:05,320 DISCUSSIONS, AND WE ASK THAT 316 00:11:05,320 --> 00:11:07,960 DURING THE PRESENTATIONS THAT 317 00:11:07,960 --> 00:11:09,360 YOUR MICROPHONES REMAIN MUTED. 318 00:11:09,360 --> 00:11:11,240 WE DO ASK THAT YOU USE THE ZOOM 319 00:11:11,240 --> 00:11:13,080 CHAT BOX TO ASK QUESTIONS OR 320 00:11:13,080 --> 00:11:16,000 MAKE COMMENTS DURING THE 321 00:11:16,000 --> 00:11:16,640 PRESENTATIONS. 322 00:11:16,640 --> 00:11:19,120 THESE QUESTIONS AND COMMENTS 323 00:11:19,120 --> 00:11:20,680 HAVE BEEN COLLATED AND SHARED 324 00:11:20,680 --> 00:11:23,600 FOR DISCUSSION DURING SUBSEQUENT 325 00:11:23,600 --> 00:11:24,080 BREAKOUT SESSIONS. 326 00:11:24,080 --> 00:11:25,000 FOLLOWING THE PRESENTATIONS BY 327 00:11:25,000 --> 00:11:26,560 THE THREE WORKING GROUPS TODAY, 328 00:11:26,560 --> 00:11:28,080 WE'LL HAVE A LUNCH BREAK, ASK 329 00:11:28,080 --> 00:11:29,520 YOU TO RETURN TO PARTICIPATE IN 330 00:11:29,520 --> 00:11:33,760 ONE OF THE THREE SIMULTANEOUSLY 331 00:11:33,760 --> 00:11:34,440 OCCURRING WORKING GROUP BREAKOUT 332 00:11:34,440 --> 00:11:35,520 SESSIONS, AND YOU WILL AGAIN 333 00:11:35,520 --> 00:11:37,160 HAVE THE OPPORTUNITY TO USE THE 334 00:11:37,160 --> 00:11:39,160 CHAT BOX TO ASK QUESTIONS, MAKE 335 00:11:39,160 --> 00:11:40,240 COMMENTS, RAISE YOUR HAND 336 00:11:40,240 --> 00:11:42,280 THROUGH THE ZOOM PORTAL, TO BE 337 00:11:42,280 --> 00:11:44,320 CALLED ON TO SPEAK. 338 00:11:44,320 --> 00:11:45,280 THE WORKING GROUP CO-CHAIRS WILL 339 00:11:45,280 --> 00:11:48,200 ADDRESS THE COMMENTS AND CALL ON 340 00:11:48,200 --> 00:11:50,440 ATTENDEES WHO RAISED THEIR 341 00:11:50,440 --> 00:11:51,040 HANDS. 342 00:11:51,040 --> 00:11:53,240 WE'RE ALSO PLEASED TO HAVE THREE 343 00:11:53,240 --> 00:11:55,040 KEYNOTE SPEAKERS WHO WILL IS 344 00:11:55,040 --> 00:11:56,080 SHARE PERSPECTIVES ON THE STATE 345 00:11:56,080 --> 00:11:58,760 OF THE SCIENCE IN TRANSFUSION 346 00:11:58,760 --> 00:12:00,840 MEDICINE. 347 00:12:00,840 --> 00:12:03,720 IT'S MY PRIVILEGE TO INTRODUCE 348 00:12:03,720 --> 00:12:05,720 DR. STEPHEN SPITALNIK, A 349 00:12:05,720 --> 00:12:07,160 PROFESSOR OF PATHOLOGY AND CELL 350 00:12:07,160 --> 00:12:09,320 BIOLOGY, VICE CHAIR OF 351 00:12:09,320 --> 00:12:10,600 LABORATORY MEDICINE, COLUMBIA 352 00:12:10,600 --> 00:12:12,920 UNIVERSITY, RECOGNIZED FOR 353 00:12:12,920 --> 00:12:14,400 OUTSTANDING LEADERSHIP, 354 00:12:14,400 --> 00:12:18,360 RESEARCH, MENTOR SHIP IN 355 00:12:18,360 --> 00:12:20,840 TRANSFUSION MEDICINE, A LEADER 356 00:12:20,840 --> 00:12:22,480 IN CELL BIOLOGY. 357 00:12:22,480 --> 00:12:24,040 DR. SPITALNIK HAS HEALTH 358 00:12:24,040 --> 00:12:25,280 NUMEROUS COMMITTEE AND 359 00:12:25,280 --> 00:12:29,080 LEADERSHIP POSITIONS, INCLUDING 360 00:12:29,080 --> 00:12:29,720 STUDY SECTIONS, CO-CHAIRING THE 361 00:12:29,720 --> 00:12:32,680 MOST RECENT STATE OF THE SCIENCE 362 00:12:32,680 --> 00:12:34,400 IN TRANSFUSION MEDICINE 363 00:12:34,400 --> 00:12:34,800 SYMPOSIUM IN 2015. 364 00:12:34,800 --> 00:12:38,320 DR. SPITALNIK, I WELCOME YOU. 365 00:12:38,320 --> 00:12:46,360 366 00:12:46,360 --> 00:12:46,760 367 00:12:46,760 --> 00:12:48,360 >> THANK YOU FOR INVITING ME TO 368 00:12:48,360 --> 00:12:51,000 SPEAK TO YOU TODAY, IT'S A 369 00:12:51,000 --> 00:12:54,200 PLEASURE AND HONOR TO DO SO AND 370 00:12:54,200 --> 00:12:56,600 I APPRECIATE IT. 371 00:12:56,600 --> 00:12:58,640 SO, I THOUGHT -- I TURNED 70 372 00:12:58,640 --> 00:13:00,200 YEARS OLD THIS YEAR, I'VE BEEN 373 00:13:00,200 --> 00:13:03,720 AT MULTIPLE STATE OF THE SCIENCE 374 00:13:03,720 --> 00:13:05,080 SYMPOSIUM IN THE PAST AND 375 00:13:05,080 --> 00:13:07,760 THOUGHT I WOULD GIVE YOU SOME 376 00:13:07,760 --> 00:13:09,480 REFLECTIONS ON THE PAST AND SOME 377 00:13:09,480 --> 00:13:10,640 THOUGHTS ON THE FUTURE. 378 00:13:10,640 --> 00:13:12,400 THIS IS NOT RELATED TO MY WORK 379 00:13:12,400 --> 00:13:14,920 BUT IT IS SORT OF MY PERSPECTIVE 380 00:13:14,920 --> 00:13:17,080 ON TRANSFUSION MEDICINE AS A 381 00:13:17,080 --> 00:13:17,440 WHOLE. 382 00:13:17,440 --> 00:13:18,480 NEXT SLIDE PLEASE. 383 00:13:18,480 --> 00:13:19,480 SO, THESE ARE MY DISCLOSURES. 384 00:13:19,480 --> 00:13:20,840 I DON'T THINK THAT ANY OF THEM 385 00:13:20,840 --> 00:13:22,040 ARE REEL VICE-PRESIDENT TO WHAT 386 00:13:22,040 --> 00:13:23,680 I'M GOING TO TALK TO YOU ABOUT 387 00:13:23,680 --> 00:13:24,760 TODAY. 388 00:13:24,760 --> 00:13:25,000 THANKS. 389 00:13:25,000 --> 00:13:26,360 NEXT SLIDE PLEASE. 390 00:13:26,360 --> 00:13:29,720 SO, I THINK WE'RE AMONGST 391 00:13:29,720 --> 00:13:32,520 OURSELVES IN THE TRANSFUSION 392 00:13:32,520 --> 00:13:35,320 MEDICINE COMMUNITY AND CAN BE 393 00:13:35,320 --> 00:13:36,920 HONEST WHICH IS WE'RE 394 00:13:36,920 --> 00:13:38,360 CONTROLLING INDIVIDUALS. 395 00:13:38,360 --> 00:13:40,120 WE HAVE SOPs FOR EVERYTHING, 396 00:13:40,120 --> 00:13:42,240 EVEN SOPs ON HOW TO WRITE AN 397 00:13:42,240 --> 00:13:42,400 SOP. 398 00:13:42,400 --> 00:13:44,880 I THINK IF WE WERE BEING HONEST 399 00:13:44,880 --> 00:13:46,520 WITH OURSELVES, WE WOULD ADMIT 400 00:13:46,520 --> 00:13:49,680 THAT WE WOULD LIKE TO MANIPULATE 401 00:13:49,680 --> 00:13:51,400 THE COMPOSITION OF BLOOD WITH 402 00:13:51,400 --> 00:13:54,360 COMPLETE CONTROL AND WITHOUT ANY 403 00:13:54,360 --> 00:13:56,200 ADVERSE CONSEQUENCES. 404 00:13:56,200 --> 00:13:57,600 OF COURSE, THAT'S NOT POSSIBLE, 405 00:13:57,600 --> 00:13:59,920 AT LEAST NOT POSSIBLE NOW, BUT I 406 00:13:59,920 --> 00:14:04,640 REALLY THINK THAT'S WHO WE ARE. 407 00:14:04,640 --> 00:14:05,640 NEXT SLIDE PLEASE. 408 00:14:05,640 --> 00:14:06,200 NEXT SLIDE PLEASE. 409 00:14:06,200 --> 00:14:06,640 THANK YOU. 410 00:14:06,640 --> 00:14:10,040 HOW DO WE DO THIS? 411 00:14:10,040 --> 00:14:12,400 WE DO THIS BY TRANSFUSING 412 00:14:12,400 --> 00:14:14,280 PRODUCTS, CLASSICAL PRODUCTS, WE 413 00:14:14,280 --> 00:14:17,240 DO THIS BY INFUSING PURIFIED OR 414 00:14:17,240 --> 00:14:19,280 RECOMBINANT PROTEINS, CAN 415 00:14:19,280 --> 00:14:21,360 PRESCRIBE DRUGS TO MANIPULATE 416 00:14:21,360 --> 00:14:22,600 THE BLOOD, CIRCULATING BLOOD, 417 00:14:22,600 --> 00:14:24,800 AND WE ALSO DO THIS INTERESTING 418 00:14:24,800 --> 00:14:26,960 THING OF APHERESIS WHERE WE CAN 419 00:14:26,960 --> 00:14:30,280 REMOVE, IF YOU WILL, EVIL HUMORS 420 00:14:30,280 --> 00:14:32,800 AND REPLACE THEM WITH GOOD 421 00:14:32,800 --> 00:14:36,800 HUMORS, WHETHER CELLS OR SOLUTES 422 00:14:36,800 --> 00:14:37,600 IN THE PLASMA. 423 00:14:37,600 --> 00:14:39,760 AS AN EXAMPLE OF WHAT WE WOULD 424 00:14:39,760 --> 00:14:41,880 LIKE TO DO IS WE WOULD LIKE TO 425 00:14:41,880 --> 00:14:43,560 TRANSFUSE ANY UNIT OF BLOOD 426 00:14:43,560 --> 00:14:46,280 CELLS OFF THE SHELF AND GIVE IT 427 00:14:46,280 --> 00:14:49,120 INTO ANY RECIPIENT, AND DO THIS 428 00:14:49,120 --> 00:14:51,080 BY ACHIEVING WHATEVER OUR 429 00:14:51,080 --> 00:14:54,200 DESIRED EFFECT IS, LIKE 430 00:14:54,200 --> 00:14:55,600 NORMALIZING HEMOGLOBIN OR 431 00:14:55,600 --> 00:14:57,760 HEMATOCRIT AND WITHOUT ANY 432 00:14:57,760 --> 00:14:59,360 ADVERSE CONSEQUENCES, NO 433 00:14:59,360 --> 00:15:00,760 TRANSFUSION REACTIONS, NO 434 00:15:00,760 --> 00:15:01,360 TRANSFUSION TRANSMITTED 435 00:15:01,360 --> 00:15:02,240 DISEASES, ET CETERA. 436 00:15:02,240 --> 00:15:04,520 AGAIN, I DON'T THINK THIS IS 437 00:15:04,520 --> 00:15:06,040 POSSIBLE YET BUT I THINK WE'RE 438 00:15:06,040 --> 00:15:08,440 GETTING CLOSER AND CERTAINLY MY 439 00:15:08,440 --> 00:15:09,200 PERSPECTIVE OVER THE LAST 40 440 00:15:09,200 --> 00:15:11,240 YEARS OR SO IN THIS FIELD IS 441 00:15:11,240 --> 00:15:13,720 THAT WE'RE GETTING A LOT CLOSER. 442 00:15:13,720 --> 00:15:14,920 NEXT SLIDE PLEASE. 443 00:15:14,920 --> 00:15:18,440 SO, I WOULD ARGUE THAT ONE OF 444 00:15:18,440 --> 00:15:20,640 THE CENTRAL THESIS OF THIS, IF 445 00:15:20,640 --> 00:15:22,400 WE'RE GOING TO MANIPULATE 446 00:15:22,400 --> 00:15:23,600 COMPOSITION OF BLOOD, FOR WHAT 447 00:15:23,600 --> 00:15:25,520 WE CONSIDER TO BE CLASSICAL 448 00:15:25,520 --> 00:15:26,840 BLOOD PRODUCTS THAT WE SHOULD 449 00:15:26,840 --> 00:15:29,800 THINK OF THEM AS 450 00:15:29,800 --> 00:15:30,320 PHARMACEUTICALS. 451 00:15:30,320 --> 00:15:31,000 NEXT SLIDE PLEASE. 452 00:15:31,000 --> 00:15:35,000 AND SO THE GOAL WOULD BE TO 453 00:15:35,000 --> 00:15:37,720 CHANGE OR EVOLVE A COMPLEX 454 00:15:37,720 --> 00:15:40,600 BIOLOGICAL PRODUCT INTO A PURE 455 00:15:40,600 --> 00:15:42,360 DRUG. 456 00:15:42,360 --> 00:15:43,400 NEXT SLIDE. 457 00:15:43,400 --> 00:15:46,720 SO, THE CLASSICAL EXAMPLE I USE, 458 00:15:46,720 --> 00:15:48,800 I GET HEADACHES OFTEN, A FORMER 459 00:15:48,800 --> 00:15:51,800 HEAD OF TRANSFUSION MEDICINE AND 460 00:15:51,800 --> 00:15:52,680 LABORATORY MEDICINE, IS IF YOU 461 00:15:52,680 --> 00:15:54,800 BREW YOURSELF A CUP OF WHITE 462 00:15:54,800 --> 00:15:56,480 WILLOW BARK TEA, ON THE LEFT, 463 00:15:56,480 --> 00:15:58,360 YOUR HEADACHE WILL CERTAINLY GO 464 00:15:58,360 --> 00:15:58,720 AWAY. 465 00:15:58,720 --> 00:16:00,120 THE MEDICAL MODEL, HOWEVER, IS 466 00:16:00,120 --> 00:16:03,640 TO FIGURE OUT WHAT IS THE ACTIVE 467 00:16:03,640 --> 00:16:05,520 INGREDIENT OR INGREDIENTS IN 468 00:16:05,520 --> 00:16:07,440 WHITE WILLOW BARK TEA, AND THEN 469 00:16:07,440 --> 00:16:10,040 MAKE THAT INTO A DRUG LIKE ON 470 00:16:10,040 --> 00:16:11,680 THE RIGHT, WHICH IS ASPIRIN, 471 00:16:11,680 --> 00:16:14,080 WHICH THEN YOU CAN CONTROL THE 472 00:16:14,080 --> 00:16:15,480 DOSAGE AND PURITY AND THINGS 473 00:16:15,480 --> 00:16:16,280 LIKE THAT. 474 00:16:16,280 --> 00:16:21,520 IN FACT, NEXT SLIDE PLEASE, THE 475 00:16:21,520 --> 00:16:23,920 FDA HAS DEFINED THEIR MEDICAL 476 00:16:23,920 --> 00:16:25,720 MODEL OF A PHARMACEUTICAL THAT 477 00:16:25,720 --> 00:16:26,680 INCLUDES THINGS LIKE WE WOULD 478 00:16:26,680 --> 00:16:28,640 ALL THINK ABOUT, WHAT ARE THE 479 00:16:28,640 --> 00:16:29,760 ACTIVE INGREDIENTS, HOW PURE ARE 480 00:16:29,760 --> 00:16:31,800 THEY, WHAT ARE THE OTHER THINGS 481 00:16:31,800 --> 00:16:33,320 THAT ARE IN THERE, HOW LONG CAN 482 00:16:33,320 --> 00:16:34,880 YOU KEEP IT ON THE SHELF, WHAT 483 00:16:34,880 --> 00:16:37,320 DOSE SHOULD YOU USE, HOW SHOULD 484 00:16:37,320 --> 00:16:40,000 YOU ADMINISTER IT, WHAT ARE THE 485 00:16:40,000 --> 00:16:40,600 INDICATIONS, ADVERSE OUTCOMES, 486 00:16:40,600 --> 00:16:42,080 ET CETERA, ET CETERA. 487 00:16:42,080 --> 00:16:43,680 SO, I THINK THIS MAKES A LOT OF 488 00:16:43,680 --> 00:16:46,280 SENSE WHEN YOU THINK IN THE 489 00:16:46,280 --> 00:16:47,720 CONTEXT OF ASPIRIN OR WHATEVER, 490 00:16:47,720 --> 00:16:49,200 WHAT OTHER TYPE OF THERAPEUTIC 491 00:16:49,200 --> 00:16:53,880 DRUG YOU MIGHT THINK OF. 492 00:16:53,880 --> 00:16:54,880 NEXT SLIDE PLEASE. 493 00:16:54,880 --> 00:16:56,400 HOWEVER, IN THE CONTEXT OF BLOOD 494 00:16:56,400 --> 00:16:57,880 PRODUCTS, I THINK IT ACTUALLY 495 00:16:57,880 --> 00:16:59,360 MAKES A LOT OF SENSE. 496 00:16:59,360 --> 00:17:00,480 NEXT SLIDE PLEASE. 497 00:17:00,480 --> 00:17:04,440 I WOULD ARGUE THAT ALL OF THESE 498 00:17:04,440 --> 00:17:06,160 DEFINITIONS OF A MEDICAL MODEL 499 00:17:06,160 --> 00:17:08,200 OF A PHARMACEUTICAL ARE RELEVANT 500 00:17:08,200 --> 00:17:09,360 TO BLOOD PRODUCTS. 501 00:17:09,360 --> 00:17:11,760 IF YOU'RE GOING TO GIVE, YOU 502 00:17:11,760 --> 00:17:13,200 KNOW, A UNIT OF FRESH FROZEN 503 00:17:13,200 --> 00:17:14,360 PLASMA, WHAT ARE YOU GIVING? 504 00:17:14,360 --> 00:17:16,040 WHAT IS THE ACTIVE INGREDIENT? 505 00:17:16,040 --> 00:17:17,040 HOW PURE IS IT? 506 00:17:17,040 --> 00:17:19,000 WHAT ELSE IS IN THERE? 507 00:17:19,000 --> 00:17:21,200 HOW LONG IS IT STABLE? 508 00:17:21,200 --> 00:17:23,400 HOW MUCH SHOULD YOU GIVE? 509 00:17:23,400 --> 00:17:26,360 WHAT IS THE INDICATION, CLINICAL 510 00:17:26,360 --> 00:17:27,560 EFFECTIVENESS, ADVERSE OUTCOMES. 511 00:17:27,560 --> 00:17:29,440 ALL THESE THINGS RELATE TO THE 512 00:17:29,440 --> 00:17:30,880 WAY WE PRACTICE TRANSFUSION 513 00:17:30,880 --> 00:17:32,080 MEDICINE AND THINK ABOUT HOW TO 514 00:17:32,080 --> 00:17:34,600 IMPROVE THE PRACTICE OF 515 00:17:34,600 --> 00:17:35,680 TRANSFUSION MEDICINE. 516 00:17:35,680 --> 00:17:36,840 NEXT SLIDE PLEASE. 517 00:17:36,840 --> 00:17:39,720 AND IN FACT, I WOULD ARGUE THAT 518 00:17:39,720 --> 00:17:42,840 WE'VE SUCCEEDED, AT LEAST IN 519 00:17:42,840 --> 00:17:44,280 SOME REGARD, IN THIS APPROACH. 520 00:17:44,280 --> 00:17:47,520 AND THE CLASSICAL EXAMPLE I 521 00:17:47,520 --> 00:17:49,360 WOULD USE IS TREATING PATIENTS 522 00:17:49,360 --> 00:17:50,040 WITH HEMOPHILIA A. 523 00:17:50,040 --> 00:17:53,120 WHEN I WAS A RESIDENT IN THE 524 00:17:53,120 --> 00:17:56,560 1970s, IF WE HAD A PATIENT 525 00:17:56,560 --> 00:17:59,760 WITH HEMOPHILIA, ADMITTED WITH A 526 00:17:59,760 --> 00:18:01,960 HEME ARTHROSIS, TREATMENT WOULD 527 00:18:01,960 --> 00:18:03,160 INCLUDE CRYOPRECIPITATE, ON THE 528 00:18:03,160 --> 00:18:05,400 LEFT, WHICH HAS ALL THE ISSUES 529 00:18:05,400 --> 00:18:08,560 AND PROBLEMS OF A COMPLEX 530 00:18:08,560 --> 00:18:09,400 BIOLOGICAL PRODUCT, BUT NOW 531 00:18:09,400 --> 00:18:17,520 TODAY IF A PATIENT WAS ADMITTED 532 00:18:17,520 --> 00:18:18,320 WE GIVE RECOMBINANT FACTOR A 533 00:18:18,320 --> 00:18:20,680 WHERE WE KNOW WHAT WE'RE GOING, 534 00:18:20,680 --> 00:18:22,480 EXACTLY THE DOSE AND HOW PURE 535 00:18:22,480 --> 00:18:24,600 AND EXACTLY WHAT INGREDIENTS 536 00:18:24,600 --> 00:18:25,360 ARE. 537 00:18:25,360 --> 00:18:26,160 NEXT SLIDE PLEASE. 538 00:18:26,160 --> 00:18:27,600 HOWEVER, THIS IS MORE 539 00:18:27,600 --> 00:18:29,000 COMPLICATED TO DO IN SOMETHING 540 00:18:29,000 --> 00:18:31,400 LIKE A RED BLOOD CELL UNIT, TO 541 00:18:31,400 --> 00:18:33,840 MAKE THAT INTO A PURE DRUG. 542 00:18:33,840 --> 00:18:35,640 NEXT SLIDE PLEASE. 543 00:18:35,640 --> 00:18:37,080 HOWEVER, WITH THE ADVENT OF, IF 544 00:18:37,080 --> 00:18:38,080 YOU WILL, BLOOD FARMING, THERE 545 00:18:38,080 --> 00:18:41,600 ARE A LOT OF GROUPS THAT ARE 546 00:18:41,600 --> 00:18:43,800 WORKING ON EITHER MAKING HUMAN 547 00:18:43,800 --> 00:18:48,000 RED BLOOD CELLS FROM STEM CELLS 548 00:18:48,000 --> 00:18:53,360 IN VITRO OR MAKING VESICLES THAT 549 00:18:53,360 --> 00:18:56,400 CONTAIN PURE HEMOGLOBIN OR 550 00:18:56,400 --> 00:18:57,280 CELL-FREE HEMOGLOBIN, NONE HAVE 551 00:18:57,280 --> 00:18:59,600 COME TO THE STATUS OF BEING USED 552 00:18:59,600 --> 00:19:02,080 CLINICALLY BUT PERHAPS IN THE 553 00:19:02,080 --> 00:19:03,840 NEXT NUMBER OF YEARS THIS WILL 554 00:19:03,840 --> 00:19:05,040 HAPPEN, WE WILL SEE. 555 00:19:05,040 --> 00:19:06,000 NEXT SLIDE PLEASE. 556 00:19:06,000 --> 00:19:09,480 SO, I WOULD LIKE TO SWITCH TO 557 00:19:09,480 --> 00:19:13,680 WHY WE'RE HERE TODAY WHICH IS TO 558 00:19:13,680 --> 00:19:15,080 MAKE TRANSFUSION MEDICINE 559 00:19:15,080 --> 00:19:15,760 BETTER, MAKE TRANSFUSIONS SAFER, 560 00:19:15,760 --> 00:19:17,960 COME UP WITH NEW WAYS OF 561 00:19:17,960 --> 00:19:22,200 TREATING PATIENTS. 562 00:19:22,200 --> 00:19:25,360 AND I'LL START WITH BISMARK, 563 00:19:25,360 --> 00:19:28,120 FELT TO BE A CONSUMMATE 564 00:19:28,120 --> 00:19:30,080 POLITICIAN WHO HELPED UNIFY 565 00:19:30,080 --> 00:19:31,400 GERMANY INTO A SINGLE COUNTRY IN 566 00:19:31,400 --> 00:19:32,280 THE 19th CENTURY. 567 00:19:32,280 --> 00:19:34,400 NEXT SLIDE PLEASE. 568 00:19:34,400 --> 00:19:36,520 AND ONE OF HIS STATEMENTS, AS 569 00:19:36,520 --> 00:19:37,640 THE CONSUMMATE POLITICIAN, IS 570 00:19:37,640 --> 00:19:40,920 THAT POLITICS IS THE ART OF THE 571 00:19:40,920 --> 00:19:41,440 POSSIBLE. 572 00:19:41,440 --> 00:19:42,040 NEXT SLIDE PLEASE. 573 00:19:42,040 --> 00:19:43,800 HOWEVER, HE DIDN'T SAY THAT. 574 00:19:43,800 --> 00:19:45,040 HE SAID THIS. 575 00:19:45,040 --> 00:19:46,280 BUT SINCE I DON'T SPEAK GERMAN 576 00:19:46,280 --> 00:19:48,600 I'M NOT GOING TO MAKE AN ATTEMPT 577 00:19:48,600 --> 00:19:51,320 TO READ THIS TO YOU. 578 00:19:51,320 --> 00:19:52,520 RATHER, NEXT SLIDE, I'LL REMIND 579 00:19:52,520 --> 00:19:55,160 YOU OF THE ENGLISH TRANSLATION, 580 00:19:55,160 --> 00:19:57,760 THAT POLITICS IS THE ART OF THE 581 00:19:57,760 --> 00:19:58,400 POSSIBLE. 582 00:19:58,400 --> 00:20:00,680 NEXT SLIDE PLEASE. 583 00:20:00,680 --> 00:20:02,560 THEN SIR PETER MEDAWAR WHO WON A 584 00:20:02,560 --> 00:20:05,040 NOBEL PRIZE FOR WORK IN 585 00:20:05,040 --> 00:20:06,960 IMMUNOLOGY TOOK THIS TO ANOTHER 586 00:20:06,960 --> 00:20:07,320 STEP. 587 00:20:07,320 --> 00:20:08,640 NEXT SLIDE PLEASE. 588 00:20:08,640 --> 00:20:12,120 HE SAID THAT SCIENCE IS THE ART 589 00:20:12,120 --> 00:20:15,840 OF THE SOLUBLE. 590 00:20:15,840 --> 00:20:18,160 IN AMERICA WE MIGHT SAY ART OF 591 00:20:18,160 --> 00:20:19,160 THE SOLVABLE. 592 00:20:19,160 --> 00:20:20,400 IF YOU CAN'T SOLVE A SCIENTIFIC 593 00:20:20,400 --> 00:20:22,320 PROBLEM, YOU CAN'T DO SCIENCE. 594 00:20:22,320 --> 00:20:24,760 YOU CAN COME TO YOUR OWN 595 00:20:24,760 --> 00:20:26,080 DECISIONS AS TO WHAT EXAMPLES 596 00:20:26,080 --> 00:20:28,240 YOU WOULD USE FOR THAT. 597 00:20:28,240 --> 00:20:30,000 NEXT SLIDE PLEASE. 598 00:20:30,000 --> 00:20:31,520 I THINK FOR TODAY, SINCE WE'RE 599 00:20:31,520 --> 00:20:33,520 TALKING ABOUT THE NIH AND FUTURE 600 00:20:33,520 --> 00:20:34,720 OF NIH FUNDING, I WOULD ARGUE 601 00:20:34,720 --> 00:20:36,560 THAT SCIENCE IS THE ART OF THE 602 00:20:36,560 --> 00:20:37,360 FUNDABLE. 603 00:20:37,360 --> 00:20:40,560 EVEN IF YOU HAVE A PROBLEM THAT 604 00:20:40,560 --> 00:20:41,360 IS SOLVABLE, IF YOU'RE NOT 605 00:20:41,360 --> 00:20:43,480 FUNDED THEN YOU CAN'T SOLVE IT. 606 00:20:43,480 --> 00:20:44,000 NEXT SLIDE PLEASE. 607 00:20:44,000 --> 00:20:46,600 I WOULD MAKE THE SIMPLE EQUATION 608 00:20:46,600 --> 00:20:50,320 OF NO DOLLARS, NO SCIENCE. 609 00:20:50,320 --> 00:20:51,280 NEXT SLIDE PLEASE. 610 00:20:51,280 --> 00:20:53,120 SO, WHERE DO THESE DOLLARS COME 611 00:20:53,120 --> 00:20:56,800 FROM TO DO SCIENCE? 612 00:20:56,800 --> 00:20:59,000 NEXT SLIDE PLEASE. 613 00:20:59,000 --> 00:21:01,080 I DON'T HAVE CONFLICTS WITH ANY 614 00:21:01,080 --> 00:21:02,200 OF THE ORGANIZATIONS I'VE LISTED 615 00:21:02,200 --> 00:21:05,560 HERE BUT THE MONEY CAN COME FROM 616 00:21:05,560 --> 00:21:06,560 INDUSTRY, WHICH TYPICALLY FUNDS, 617 00:21:06,560 --> 00:21:09,040 IF YOU WILL, IN-HOUSE SCIENCE 618 00:21:09,040 --> 00:21:10,640 ALTHOUGH SOME COMPANIES ALSO 619 00:21:10,640 --> 00:21:12,600 HAVE GRANT PROGRAMS. 620 00:21:12,600 --> 00:21:13,800 IT CAN COME FROM PRIVATE 621 00:21:13,800 --> 00:21:14,040 CHARITIES. 622 00:21:14,040 --> 00:21:16,400 MY FAVORITE IS THE FIRST ONE, 623 00:21:16,400 --> 00:21:17,680 NATIONAL BLOOD FOUNDATION, PART 624 00:21:17,680 --> 00:21:18,840 OF THE ABB. 625 00:21:18,840 --> 00:21:19,760 OR IT CAN COME FROM GOVERNMENT. 626 00:21:19,760 --> 00:21:21,880 IN THE UNITED STATES, THAT WOULD 627 00:21:21,880 --> 00:21:24,520 BE THE NIH, DARPA, THINGS LIKE 628 00:21:24,520 --> 00:21:24,880 THAT. 629 00:21:24,880 --> 00:21:25,880 NEXT SLIDE PLEASE. 630 00:21:25,880 --> 00:21:29,080 THERE HAVE BEEN TIMES IN MY OWN 631 00:21:29,080 --> 00:21:32,080 CAREER WHERE I WAS DEPRESSED AT 632 00:21:32,080 --> 00:21:33,720 THE ABILITY TO ATTRACT FUNDING 633 00:21:33,720 --> 00:21:35,480 TO DO SCIENCE. 634 00:21:35,480 --> 00:21:37,400 AND EVEN CONSIDERED THE 635 00:21:37,400 --> 00:21:39,480 POSSIBILITY OF HAVING A BAKE 636 00:21:39,480 --> 00:21:42,240 SALE IN THE LOBBY OF OUR 637 00:21:42,240 --> 00:21:42,720 RESEARCH BUILDING, BUT 638 00:21:42,720 --> 00:21:44,200 FORTUNATELY NEVER HAD TO GO THAT 639 00:21:44,200 --> 00:21:47,240 FAR ALTHOUGH WE GOT CLOSE. 640 00:21:47,240 --> 00:21:48,320 NEXT SLIDE PLEASE. 641 00:21:48,320 --> 00:21:50,800 WHO IS THE LARGEST SUPPORTER OF 642 00:21:50,800 --> 00:21:53,840 MEDICAL RESEARCH IN THE UNITED 643 00:21:53,840 --> 00:21:54,400 STATES? 644 00:21:54,400 --> 00:21:57,000 NEXT SLIDE. 645 00:21:57,000 --> 00:21:57,640 SOME PEOPLE THINK IT'S BILL AND 646 00:21:57,640 --> 00:21:59,880 MELINDA GATES, AND THEY HAVE 647 00:21:59,880 --> 00:22:01,840 BEEN INCREDIBLY GENEROUS WITH 648 00:22:01,840 --> 00:22:03,480 THEIR FOUNDATION, WHICH PROVIDES 649 00:22:03,480 --> 00:22:05,160 HUNDREDS OF MILLIONS OF DOLLARS 650 00:22:05,160 --> 00:22:06,400 ANNUALLY FOR RESEARCH. 651 00:22:06,400 --> 00:22:07,080 NEXT SLIDE PLEASE. 652 00:22:07,080 --> 00:22:09,480 BUT THEY ARE NOT THE BIGGEST 653 00:22:09,480 --> 00:22:11,480 SUPPORTER OF RESEARCH IN THE 654 00:22:11,480 --> 00:22:12,360 UNITED STATES. 655 00:22:12,360 --> 00:22:13,840 THIS X UNFORTUNATELY RELATES TO 656 00:22:13,840 --> 00:22:16,480 THEIR NOT EVEN BEING MARRIED 657 00:22:16,480 --> 00:22:19,400 ANYMORE, WHICH IS SAD BUT THAT'S 658 00:22:19,400 --> 00:22:20,040 LIFE. 659 00:22:20,040 --> 00:22:20,360 NEXT SLIDE. 660 00:22:20,360 --> 00:22:22,960 SO, THEN IF IT'S NOT THE GATES 661 00:22:22,960 --> 00:22:24,440 FOUNDATION OR SOME OTHER PRIVATE 662 00:22:24,440 --> 00:22:26,040 FOUNDATION WHO IS IT? 663 00:22:26,040 --> 00:22:27,080 NEXT SLIDE PLEASE. 664 00:22:27,080 --> 00:22:33,080 I WOULD ARGUE IT'S ALL OF YOU. 665 00:22:33,080 --> 00:22:34,640 ALL OF THE PEOPLE IN THE UNITED 666 00:22:34,640 --> 00:22:35,560 STATES. 667 00:22:35,560 --> 00:22:41,520 THE U.S. TAXPAYER IS THE BIGGEST 668 00:22:41,520 --> 00:22:42,560 SUPPORTER IN THE UNITED STATES. 669 00:22:42,560 --> 00:22:46,360 HOW DO WE DO THIS? 670 00:22:46,360 --> 00:22:49,160 BY PAYING OUR TAXES. 671 00:22:49,160 --> 00:22:50,360 IT'S DONE THROUGH THE NIH. 672 00:22:50,360 --> 00:22:52,480 THIS IS A PICTURE OF THE CAMPUS 673 00:22:52,480 --> 00:22:53,280 IN BETHESDA, THE INTRAMURAL 674 00:22:53,280 --> 00:22:54,800 PROGRAM, IF YOU WILL. 675 00:22:54,800 --> 00:22:56,480 NEXT SLIDE PLEASE. 676 00:22:56,480 --> 00:22:57,720 BUT FOR THE PURPOSES OF TODAY 677 00:22:57,720 --> 00:23:00,040 AND FOR MOST OF THE PEOPLE IN 678 00:23:00,040 --> 00:23:01,640 THE AUDIENCE, WE'RE MOST 679 00:23:01,640 --> 00:23:02,840 CONCERNED WITH THE EXTRAMURAL 680 00:23:02,840 --> 00:23:06,280 PROGRAM, HOW DOES THE NIH FUND 681 00:23:06,280 --> 00:23:09,000 BIOMEDICAL RESEARCH OUTSIDE OF 682 00:23:09,000 --> 00:23:09,280 BETHESDA? 683 00:23:09,280 --> 00:23:10,880 NEXT SLIDE PLEASE. 684 00:23:10,880 --> 00:23:14,120 SO THE WAY NIH DOES THIS IS BY 685 00:23:14,120 --> 00:23:14,520 PROVIDING GRANTS. 686 00:23:14,520 --> 00:23:17,360 AND AS I'M SURE YOU'RE ALL 687 00:23:17,360 --> 00:23:19,520 AWARE, GETTING AN NIH GRANT IS 688 00:23:19,520 --> 00:23:20,000 VERY DIFFICULT. 689 00:23:20,000 --> 00:23:21,880 THERE'S A HIGH BAR THAT NEEDS TO 690 00:23:21,880 --> 00:23:24,920 BE JUMPED OVER IN ORDER TO GET 691 00:23:24,920 --> 00:23:25,280 FUNDED. 692 00:23:25,280 --> 00:23:26,720 AND THE WAY THESE DECISIONS ARE 693 00:23:26,720 --> 00:23:29,400 MADE OR THE FIRST STEP IN MAKING 694 00:23:29,400 --> 00:23:31,560 THESE DECISIONS IS PEER REVIEW 695 00:23:31,560 --> 00:23:33,280 BY STUDY SECTION. 696 00:23:33,280 --> 00:23:35,040 AND YOU SHOULD REMEMBER, PLEASE, 697 00:23:35,040 --> 00:23:38,040 THAT PEER REVIEW IS A HUMAN 698 00:23:38,040 --> 00:23:39,080 CONSTRUCT. 699 00:23:39,080 --> 00:23:40,480 IT'S PERFORMED BY HUMANS. 700 00:23:40,480 --> 00:23:41,840 AND THEREFORE AS YOU MIGHT 701 00:23:41,840 --> 00:23:43,080 IMAGINE, EVEN THOUGH PART OF 702 00:23:43,080 --> 00:23:46,280 EVERY NIH GRANT YOU NEED TO DEAL 703 00:23:46,280 --> 00:23:48,320 WITH THE CONCEPTS OF RIGOR AND 704 00:23:48,320 --> 00:23:50,320 REPRODUCIBILITY, AND IF YOU 705 00:23:50,320 --> 00:23:53,080 WILL, THE ROBUSTNESS OF THE 706 00:23:53,080 --> 00:23:54,160 RESEARCH YOU'RE PROPOSING I 707 00:23:54,160 --> 00:23:55,800 WOULD ARGUE FROM YEARS OF 708 00:23:55,800 --> 00:23:57,360 EXPERIENCE THAT THE PEER REVIEW 709 00:23:57,360 --> 00:24:02,080 PROGRAM IS NOT A HIGHLY ROBUST 710 00:24:02,080 --> 00:24:03,160 PROGRAM, PARTICULARLY AT THE -- 711 00:24:03,160 --> 00:24:06,520 IN THE MIDDLE, AT THE NIH 712 00:24:06,520 --> 00:24:07,840 FUNDING CUTOFF. 713 00:24:07,840 --> 00:24:10,080 SO, FOR PROPOSALS THAT ARE 714 00:24:10,080 --> 00:24:11,560 FANTASTIC, I THINK ROBUSTNESS IS 715 00:24:11,560 --> 00:24:12,880 TERRIFIC. 716 00:24:12,880 --> 00:24:13,720 FOR PROPOSAL THAT ARE REALLY 717 00:24:13,720 --> 00:24:16,080 PRETTY BAD, I THINK THE 718 00:24:16,080 --> 00:24:18,000 ROBUSTNESS IS TERRIFIC. 719 00:24:18,000 --> 00:24:22,720 BUT IN THE MIDDLE, IT'S NOT SO 720 00:24:22,720 --> 00:24:25,040 CLEAR TO ME THAT THE REVIEW IS 721 00:24:25,040 --> 00:24:25,720 ROBUST. 722 00:24:25,720 --> 00:24:27,080 EVERYBODY DOES THEIR BEST, BUT 723 00:24:27,080 --> 00:24:29,200 IT IS A HUMAN CONSTRUCT AND 724 00:24:29,200 --> 00:24:30,360 HUMAN JUDGMENT IS REQUIRED. 725 00:24:30,360 --> 00:24:32,800 SO I THINK THERE'S A STATEMENT 726 00:24:32,800 --> 00:24:34,120 FROM WINSTON CHURCHILL THAT'S 727 00:24:34,120 --> 00:24:36,680 RELEVANT TO THIS, WHICH IS, HE 728 00:24:36,680 --> 00:24:38,400 SAID THAT DEMOCRACY IS THE WORST 729 00:24:38,400 --> 00:24:39,880 FORM OF GOVERNMENT, EXCEPT FOR 730 00:24:39,880 --> 00:24:42,040 ALL OTHERS THAT HAVE BEEN TRIED. 731 00:24:42,040 --> 00:24:42,920 NEXT SLIDE PLEASE. 732 00:24:42,920 --> 00:24:45,240 AND I WOULD ARGUE THAT NIH PEER 733 00:24:45,240 --> 00:24:48,440 REVIEW IS THE WORST FORM OF 734 00:24:48,440 --> 00:24:49,280 PROPOSAL EVALUATION, EXCEPT FOR 735 00:24:49,280 --> 00:24:51,040 ALL OTHERS THAT HAVE BEEN TRIED. 736 00:24:51,040 --> 00:24:52,680 AND SO I THINK THIS IS THE BEST 737 00:24:52,680 --> 00:24:54,360 WE CAN DO AT THE MOMENT. 738 00:24:54,360 --> 00:24:57,360 I THINK IT WORKS EXTREMELY WELL. 739 00:24:57,360 --> 00:24:59,560 BUT IT CAN BE, I'M AWARE, 740 00:24:59,560 --> 00:25:01,600 FRUSTRATING FOR YOU AND IT HAS 741 00:25:01,600 --> 00:25:03,560 BEEN ALSO VERY FRUSTRATING ON 742 00:25:03,560 --> 00:25:06,360 OCCASION FOR ME. 743 00:25:06,360 --> 00:25:09,800 NEXT SLIDE PLEASE. 744 00:25:09,800 --> 00:25:12,440 SO, TODAY AND TOMORROW DURING 745 00:25:12,440 --> 00:25:14,160 THIS STATE OF THE SCIENCE 746 00:25:14,160 --> 00:25:15,760 SYMPOSIUM AS IN PRIOR STATE OF 747 00:25:15,760 --> 00:25:18,120 THE SCIENCE SYMPOSIA, THIS IS AN 748 00:25:18,120 --> 00:25:21,400 INCREDIBLE OPPORTUNITY FOR ALL 749 00:25:21,400 --> 00:25:21,600 OF US. 750 00:25:21,600 --> 00:25:23,760 THE NIH LEADERSHIP AT THE 751 00:25:23,760 --> 00:25:25,480 HIGHEST LEVEL WANTS TO HEAR WHAT 752 00:25:25,480 --> 00:25:26,400 WE HAVE TO SAY. 753 00:25:26,400 --> 00:25:29,400 THEY WOULD LIKE TO KNOW WHAT OUR 754 00:25:29,400 --> 00:25:31,840 OPINIONS ARE REGARDING WHAT ARE 755 00:25:31,840 --> 00:25:33,360 THE BEST OR MOST IMPORTANT 756 00:25:33,360 --> 00:25:36,200 THINGS THAT THEY SHOULD FOCUS 757 00:25:36,200 --> 00:25:39,200 THEIR GRANT PROGRAMS ON FOR 758 00:25:39,200 --> 00:25:41,000 ARGUMENT'S SAKE FOR THE NEXT 759 00:25:41,000 --> 00:25:42,960 FIVE TO SEVEN YEARS, AN 760 00:25:42,960 --> 00:25:44,400 INCREDIBLE OPPORTUNITY FOR US TO 761 00:25:44,400 --> 00:25:45,960 GIVE OUR OPINION AND IT'S 762 00:25:45,960 --> 00:25:47,040 INCREDIBLY IMPORTANT FOR THE 763 00:25:47,040 --> 00:25:49,760 FUTURE OF OUR FIELD BECAUSE WE 764 00:25:49,760 --> 00:25:51,880 HELP -- WE DON'T DIRECT IT BUT 765 00:25:51,880 --> 00:25:54,840 WE HELP THE NIH DECIDE WHERE 766 00:25:54,840 --> 00:25:56,520 FUNDING SHOULD BE DIRECTED. 767 00:25:56,520 --> 00:25:58,320 NEXT SLIDE PLEASE. 768 00:25:58,320 --> 00:26:01,640 SO, WHAT ARE OUR HISTORICAL 769 00:26:01,640 --> 00:26:02,320 ANTECEDENTS FOR THIS? 770 00:26:02,320 --> 00:26:03,240 NEXT SLIDE PLEASE. 771 00:26:03,240 --> 00:26:07,320 SO, I WOULD LIKE TO GIVE YOU MY 772 00:26:07,320 --> 00:26:10,080 PERSONAL OPINION ON WHAT THE TOP 773 00:26:10,080 --> 00:26:13,000 TEN ADVANCES HAVE BEEN IN 774 00:26:13,000 --> 00:26:16,040 TRANSFUSION MEDICINE SINCE 1978. 775 00:26:16,040 --> 00:26:16,640 WHY DID I PICK 1978? 776 00:26:16,640 --> 00:26:19,520 BECAUSE THAT WAS THE YEAR I 777 00:26:19,520 --> 00:26:21,680 STARTED MY RESIDENCY IN ANATOMIC 778 00:26:21,680 --> 00:26:22,280 AND CLINICAL PATHOLOGY. 779 00:26:22,280 --> 00:26:24,720 AND WHY DID I PICK TOP TEN? 780 00:26:24,720 --> 00:26:26,360 BECAUSE, WELL, THAT'S HOW WE 781 00:26:26,360 --> 00:26:27,880 OFTEN THINK ABOUT THIS IS, THE 782 00:26:27,880 --> 00:26:32,920 TOP THEN THIS, THE TOP TEN THAT. 783 00:26:32,920 --> 00:26:33,920 NEXT SLIDE PLEASE. 784 00:26:33,920 --> 00:26:34,840 I COULDN'T LIMIT TO TEN, EVEN 785 00:26:34,840 --> 00:26:35,360 THOUGH I TRIED. 786 00:26:35,360 --> 00:26:36,040 NEXT SLIDE PLEASE. 787 00:26:36,040 --> 00:26:38,480 SO I WOULD LIKE TO PROVIDE MY 788 00:26:38,480 --> 00:26:40,840 OPINION ON WHAT THE TOP TWELVE 789 00:26:40,840 --> 00:26:42,880 ADVANCES HAVE BEEN SINCE I 790 00:26:42,880 --> 00:26:44,600 STARTED RESIDENCY TRAINING IN 791 00:26:44,600 --> 00:26:45,280 THE LATE 1970s. 792 00:26:45,280 --> 00:26:46,640 NEXT SLIDE PLEASE. 793 00:26:46,640 --> 00:26:48,400 THESE ARE THE FIRST SIX. 794 00:26:48,400 --> 00:26:50,080 I DON'T THINK THERE'S GOING TO 795 00:26:50,080 --> 00:26:52,320 BE OF ARGUMENT WITH THE GROUP AS 796 00:26:52,320 --> 00:26:57,000 TO WHETHER THESE RISE TO THE 797 00:26:57,000 --> 00:27:04,280 OCCASION, FIRST FOUR PCR, HCV, 798 00:27:04,280 --> 00:27:07,520 HBV, RECOGNIZED BY NOBEL PRIZES, 799 00:27:07,520 --> 00:27:10,600 THE DISCOVERY OF HBV WAS 800 00:27:10,600 --> 00:27:11,920 RECOGNIZED BY NOBEL PRIZE. 801 00:27:11,920 --> 00:27:12,920 THAT'S GREAT. 802 00:27:12,920 --> 00:27:14,520 THE RESULT OF THAT PARTICULARLY 803 00:27:14,520 --> 00:27:15,960 FOR TRANSFUSION MEDICINE HAS 804 00:27:15,960 --> 00:27:21,880 BEEN ABILITY TO SCREEN THE BLOOD 805 00:27:21,880 --> 00:27:22,840 SUPPLY WHICH IS USEFUL. 806 00:27:22,840 --> 00:27:26,320 WHEN I WAS A RESIDENT, HIV/AIDS 807 00:27:26,320 --> 00:27:28,560 PANDEMIC STARTED, WE HAD NO IDEA 808 00:27:28,560 --> 00:27:29,960 FIRST OF ALL WHETHER IT WAS EVEN 809 00:27:29,960 --> 00:27:32,920 A VIRUS BUT EVEN AFTER THAT WAS 810 00:27:32,920 --> 00:27:34,200 IT TRANSMISSIBLE BY BLOOD, AND 811 00:27:34,200 --> 00:27:36,880 IF SO HOW COULD YOU SCREEN OUT 812 00:27:36,880 --> 00:27:39,160 THE UNITS? 813 00:27:39,160 --> 00:27:41,880 AND ALSO I REMEMBER THAT IN THE 814 00:27:41,880 --> 00:27:43,960 1970s, ABOUT 10% OF THE BLOOD 815 00:27:43,960 --> 00:27:45,320 SUPPLY WAS CONTAMINATED WITH 816 00:27:45,320 --> 00:27:51,280 WHAT WAS THEN CALLED NON-A, 817 00:27:51,280 --> 00:27:53,080 NON-B HEPATITIS, NO WAY OF 818 00:27:53,080 --> 00:27:54,040 IDENTIFYING WHICH UNITS WERE 819 00:27:54,040 --> 00:27:55,040 INFECTIOUS OR NOT. 820 00:27:55,040 --> 00:27:56,400 THIS HAS BEEN A TREMENDOUS 821 00:27:56,400 --> 00:27:58,240 ANSWER I WOULD ARGUE IN TERMS OF 822 00:27:58,240 --> 00:27:59,720 THE SAFETY OF THE BLOOD SUPPLY. 823 00:27:59,720 --> 00:28:01,840 I CAN ALSO TELL YOU THAT IN 824 00:28:01,840 --> 00:28:03,600 1978, THE ONLY BLOOD GROUP 825 00:28:03,600 --> 00:28:06,040 ANTIGENS THAT WE HAD ANY IDEA 826 00:28:06,040 --> 00:28:13,920 WHAT THEIR STRUCTURES WERE, WERE 827 00:28:13,920 --> 00:28:15,040 THE CARBOHYDRATE, ET CETERA, AND 828 00:28:15,040 --> 00:28:16,920 DIDN'T KNOW THE GENES THAT 829 00:28:16,920 --> 00:28:18,160 ENCODED THOSE BLOOD GROUP 830 00:28:18,160 --> 00:28:19,720 ANTIGENS AND HAD NO IDEA WHAT 831 00:28:19,720 --> 00:28:22,160 ANY OF THE PROTEIN BLOOD GROUP 832 00:28:22,160 --> 00:28:24,200 ANTIGENS WERE. 833 00:28:24,200 --> 00:28:28,720 IT'S REMARKABLE NOW 40 YEARS 834 00:28:28,720 --> 00:28:30,200 LATER, 44 YEARS LATER, THAT 835 00:28:30,200 --> 00:28:31,000 REALLY WE KNOW EVERYTHING ABOUT 836 00:28:31,000 --> 00:28:33,280 ALL THE GENES AND STRUCTURES 837 00:28:33,280 --> 00:28:34,440 WITH RARE EXCEPTIONS IN THE 838 00:28:34,440 --> 00:28:34,760 BLOOD GROUPS. 839 00:28:34,760 --> 00:28:37,800 I THINK THIS IS A MAJOR ADVANCE. 840 00:28:37,800 --> 00:28:38,560 NEXT SLIDE. 841 00:28:38,560 --> 00:28:40,280 WE MIGHT HAVE MORE ARGUMENTS 842 00:28:40,280 --> 00:28:41,920 AMONG THE GROUP AS TO WHETHER 843 00:28:41,920 --> 00:28:45,240 THESE ARE THE SICK YOU WOULD 844 00:28:45,240 --> 00:28:46,560 CHOOSE -- SIX YOU WOULD CHOOSE 845 00:28:46,560 --> 00:28:48,640 BUT THESE ARE MY OPINION. 846 00:28:48,640 --> 00:28:55,040 USE OF RECOMBINANT GROWTH 847 00:28:55,040 --> 00:28:57,040 FACTORS LIKE ERYTHROPOETIN, 848 00:28:57,040 --> 00:28:59,040 APHERESIS PARTICULARLY FOR 849 00:28:59,040 --> 00:29:00,960 COLLECTING CELLS LIKE PERIPHERAL 850 00:29:00,960 --> 00:29:02,080 BLOOD, HEMATOPOIETIC STEM CELLS, 851 00:29:02,080 --> 00:29:04,360 LYMPHOCYTES, ET CETERA. 852 00:29:04,360 --> 00:29:05,120 ABILITY TO MANIPULATE THE 853 00:29:05,120 --> 00:29:08,440 GENETICS OF EITHER THE CELLS WE 854 00:29:08,440 --> 00:29:14,320 COLLECT OR PATIENTS THAT NEED TO 855 00:29:14,320 --> 00:29:18,760 BE GENETICICALLY MODIFIED, 856 00:29:18,760 --> 00:29:21,520 VARIOUS IMMUNOSUPPRESSION 857 00:29:21,520 --> 00:29:31,920 METHODS STARTING WITH 858 00:29:37,800 --> 00:29:38,240 LEUKOREDUCTION. 859 00:29:38,240 --> 00:29:43,440 HOW ARE WE DOING? 860 00:29:43,440 --> 00:29:44,440 THAT'S MY OPINION FROM 40 YEARS, 861 00:29:44,440 --> 00:29:47,640 WHAT'S MY OPINION FROM THE LAST 862 00:29:47,640 --> 00:29:48,880 STATE OF THE SCIENCE SYMPOSIUM 863 00:29:48,880 --> 00:29:49,120 IN 2015? 864 00:29:49,120 --> 00:29:51,080 NEXT SLIDE PLEASE. 865 00:29:51,080 --> 00:29:58,360 SO, AT THE END OF THE SYMPOSIUM 866 00:29:58,360 --> 00:30:01,280 THESE WERE SOME MAJOR POINTS, 867 00:30:01,280 --> 00:30:02,800 QUESTIONS INCLUDE WHAT'S IN THE 868 00:30:02,800 --> 00:30:03,360 BAG? 869 00:30:03,360 --> 00:30:04,800 ARE OUR TRANSFUSION TRIGGERS 870 00:30:04,800 --> 00:30:05,200 RELEVANT? 871 00:30:05,200 --> 00:30:07,200 HOW DO WE KNOW IF WHAT WE'RE 872 00:30:07,200 --> 00:30:08,200 DOING ACTUALLY WORKS? 873 00:30:08,200 --> 00:30:10,920 HOW CAN WE MAKE BETTER AND SAFER 874 00:30:10,920 --> 00:30:12,440 PRODUCTS? 875 00:30:12,440 --> 00:30:14,320 HOW CAN WE PROTECT OUR DONORS 876 00:30:14,320 --> 00:30:15,640 BETTER BECAUSE THESE ARE 877 00:30:15,640 --> 00:30:18,320 PRIMARILY THE VAST MAJORITY ARE 878 00:30:18,320 --> 00:30:19,760 VOLUNTEER DONORS WHO DONATE 879 00:30:19,760 --> 00:30:23,520 THEIR TIME AND THEIR BLOOD TO 880 00:30:23,520 --> 00:30:24,920 OUR PURPOSE. 881 00:30:24,920 --> 00:30:26,760 AND ALSO AS SOME OF MY 882 00:30:26,760 --> 00:30:28,320 PEDIATRICIAN FRIENDS WILL 883 00:30:28,320 --> 00:30:29,800 CONTINUE TO REMIND ME THAT 884 00:30:29,800 --> 00:30:32,960 CHILDREN ARE NOT SMALL ADULTS, 885 00:30:32,960 --> 00:30:34,640 NEONATES ARE NOT SMALL CHILDREN. 886 00:30:34,640 --> 00:30:35,840 NEXT SLIDE PLEASE. 887 00:30:35,840 --> 00:30:38,200 SO, IN ORDER TO DO THIS WE ALSO 888 00:30:38,200 --> 00:30:40,400 FELT THERE WERE THINGS WE 889 00:30:40,400 --> 00:30:41,560 NEEDED, THE GROUP FELT THERE 890 00:30:41,560 --> 00:30:43,280 WERE THINGS WE NEEDED. 891 00:30:43,280 --> 00:30:45,360 SO WE NEEDED MORE ROBUST 892 00:30:45,360 --> 00:30:47,400 DATABASES, WE NEEDED MORE 893 00:30:47,400 --> 00:30:48,760 MECHANISTICALLY ORIENTED 894 00:30:48,760 --> 00:30:49,240 RESEARCH. 895 00:30:49,240 --> 00:30:50,920 WE NEEDED TO EDUCATE EACH OTHER, 896 00:30:50,920 --> 00:30:52,640 AND OTHER HEALTH CARE PROVIDERS, 897 00:30:52,640 --> 00:30:55,400 AND ALSO THE LAY PUBLIC. 898 00:30:55,400 --> 00:31:05,760 WE NEEDED A BETTER OF 899 00:31:06,400 --> 00:31:07,960 HEMOSTASIS AND IMPROVE TRAINING 900 00:31:07,960 --> 00:31:10,680 IN TRANSFUSION MEDICINE, THE 901 00:31:10,680 --> 00:31:12,240 TASKS WE SET SEVEN YEARS AGO. 902 00:31:12,240 --> 00:31:12,920 NEXT SLIDE PLEASE. 903 00:31:12,920 --> 00:31:14,320 SO I THINK WE DID WELL. 904 00:31:14,320 --> 00:31:15,560 I THINK IF YOU LOOK AT THE 905 00:31:15,560 --> 00:31:16,960 NUMBERS OF PAPERS THAT HAVE BEEN 906 00:31:16,960 --> 00:31:18,120 PUBLISHED OVER THE LAST SEVEN 907 00:31:18,120 --> 00:31:20,240 YEARS, HOW MANY OF THEM HAVE 908 00:31:20,240 --> 00:31:21,520 ADDRESSED THESE KINDS OF ISSUES 909 00:31:21,520 --> 00:31:23,520 AND THE AMOUNT OF COLLABORATIVE 910 00:31:23,520 --> 00:31:26,480 RESEARCH THAT'S BEEN DONE AND 911 00:31:26,480 --> 00:31:28,920 QUALITY OF THE TALKS AT OUR 912 00:31:28,920 --> 00:31:29,760 NATIONAL AND INTERNATIONAL 913 00:31:29,760 --> 00:31:31,960 MEETINGS, I THINK THE FIELD AS A 914 00:31:31,960 --> 00:31:32,560 WHOLE HAS MADE SIGNIFICANT 915 00:31:32,560 --> 00:31:33,600 ADVANCES OVER THE LAST SEVEN 916 00:31:33,600 --> 00:31:36,960 YEARS AND I THINK THE NIH 917 00:31:36,960 --> 00:31:38,520 FUNDING AND SUPPORT FOR 918 00:31:38,520 --> 00:31:40,320 TRANSFUSION MEDICINE HAS PLAYED 919 00:31:40,320 --> 00:31:41,880 A MAJOR ROLE IN THAT. 920 00:31:41,880 --> 00:31:43,040 HOWEVER, I WOULD ARGUE THAT NONE 921 00:31:43,040 --> 00:31:46,080 OF WHAT I'VE SEEN FROM THE LAST 922 00:31:46,080 --> 00:31:47,720 SEVEN YEARS WOULD FIT THE BILL, 923 00:31:47,720 --> 00:31:49,560 IF YOU WERE GIVING THIS TALK 40 924 00:31:49,560 --> 00:31:50,880 YEARS FROM NOW. 925 00:31:50,880 --> 00:31:54,320 SO, WHAT ARE WE GOING TO DO AS A 926 00:31:54,320 --> 00:31:55,640 FIELD TO MAKE SIGNIFICANT 927 00:31:55,640 --> 00:31:56,960 ADVANCES OVER THE NEXT 40 YEARS 928 00:31:56,960 --> 00:31:58,720 TO MATCH WHAT WAS DONE OVER THE 929 00:31:58,720 --> 00:31:59,480 LAST 40 YEARS? 930 00:31:59,480 --> 00:32:02,040 AND I THINK ONE OF THEM IS TO 931 00:32:02,040 --> 00:32:03,880 HAVE MEETINGS LIKE THIS TO TALK 932 00:32:03,880 --> 00:32:05,720 TO EACH OTHER, ENCOURAGE AND 933 00:32:05,720 --> 00:32:07,560 STIMULATE EACH OTHER, AND THEN I 934 00:32:07,560 --> 00:32:10,000 THINK WE NEED TO AIM HIGH IN 935 00:32:10,000 --> 00:32:12,640 TERMS OF WHAT WE FOCUS ON. 936 00:32:12,640 --> 00:32:16,560 NEXT SLIDE PLEASE. 937 00:32:16,560 --> 00:32:18,120 SO, I BELIEVE, AND I BET THAT 938 00:32:18,120 --> 00:32:20,520 ALL OF YOU BELIEVE, THAT THE 939 00:32:20,520 --> 00:32:22,120 MAJOR WAY OF MAKING SUCH 940 00:32:22,120 --> 00:32:24,160 ADVANCES IS BY DOING RESEARCH. 941 00:32:24,160 --> 00:32:26,880 AND THERE ARE MULTIPLE TYPES OF 942 00:32:26,880 --> 00:32:27,240 RESEARCH. 943 00:32:27,240 --> 00:32:31,880 THERE'S BASIC, IF YOU WILL, 944 00:32:31,880 --> 00:32:33,240 MECHANISTIC BENCH RESEARCH, 945 00:32:33,240 --> 00:32:34,680 CLINICAL OR PATIENT-FACING 946 00:32:34,680 --> 00:32:35,840 RESEARCH, THERE'S TRANSLATIONAL 947 00:32:35,840 --> 00:32:37,800 RESEARCH BRINGING THINGS FROM 948 00:32:37,800 --> 00:32:39,080 THE BENCH TO BEDSIDE. 949 00:32:39,080 --> 00:32:40,760 THERE'S PUBLIC HEALTH RESEARCH 950 00:32:40,760 --> 00:32:43,320 WHICH IS REALLY VERY IMPORTANT 951 00:32:43,320 --> 00:32:44,920 DURING THE COVID PANDEMIC, AND I 952 00:32:44,920 --> 00:32:47,560 FORGOT TO LIST THEM BUT YOU 953 00:32:47,560 --> 00:32:50,400 COULD ALSO CONSIDER RESEARCH IN 954 00:32:50,400 --> 00:32:52,040 EDUCATION, EDUCATIONAL RESEARCH, 955 00:32:52,040 --> 00:32:53,520 AND IMPLEMENTATION RESEARCH AS 956 00:32:53,520 --> 00:32:55,240 DIFFERENT TYPES OF RESEARCH 957 00:32:55,240 --> 00:32:56,000 APPROACHES. 958 00:32:56,000 --> 00:32:57,600 AND I'M OFTEN ASKED, WELL, 959 00:32:57,600 --> 00:32:59,720 WHAT'S THE MOST OR BEST WAY OF 960 00:32:59,720 --> 00:33:02,040 DOING RESEARCH, WHAT IS THE BEST 961 00:33:02,040 --> 00:33:02,400 RESEARCH? 962 00:33:02,400 --> 00:33:06,280 AND I WILL ANSWER THAT WITH A 963 00:33:06,280 --> 00:33:07,280 METAPHOR. 964 00:33:07,280 --> 00:33:09,600 NEXT SLIDE PLEASE. 965 00:33:09,600 --> 00:33:14,400 THIS IS DUKE ELLINGTON, AN 966 00:33:14,400 --> 00:33:16,640 AMAZING PIANIST, ORCHESTRA 967 00:33:16,640 --> 00:33:19,160 LEADER, COMPOSER, ADVOCATE, ET 968 00:33:19,160 --> 00:33:19,360 CETERA. 969 00:33:19,360 --> 00:33:20,880 NEXT SLIDE PLEASE. 970 00:33:20,880 --> 00:33:24,480 AND HE WAS ASKED IN A SNIDE WAY, 971 00:33:24,480 --> 00:33:25,560 WHICH WAS INAPPROPRIATE BUT 972 00:33:25,560 --> 00:33:27,680 OKAY, WHICH IS BETTER, CLASSICAL 973 00:33:27,680 --> 00:33:28,400 MUSIC OR JAZZ? 974 00:33:28,400 --> 00:33:31,360 SINCE HE MADE MOST OF HIS CAREER 975 00:33:31,360 --> 00:33:34,440 IN THE REALM, IF, WILL YOU, OF 976 00:33:34,440 --> 00:33:36,840 JAZZ IT WAS A SNIDE QUESTION 977 00:33:36,840 --> 00:33:38,480 TRYING TO IMPLY HIS MUSIC WASN'T 978 00:33:38,480 --> 00:33:40,280 AS GOOD AS CLASSICAL MUSIC. 979 00:33:40,280 --> 00:33:43,280 HE GAVE A WONDERFUL ANSWER. 980 00:33:43,280 --> 00:33:44,320 NEXT SLIDE. 981 00:33:44,320 --> 00:33:44,840 NEXT SLIDE. 982 00:33:44,840 --> 00:33:45,600 THANK YOU. 983 00:33:45,600 --> 00:33:48,120 THAT THERE'S SIMPLY TWO KINDS OF 984 00:33:48,120 --> 00:33:48,320 MUSIC. 985 00:33:48,320 --> 00:33:50,160 THERE'S GOOD MUSIC, AND THERE'S 986 00:33:50,160 --> 00:33:51,520 THE OTHER KIND. 987 00:33:51,520 --> 00:33:52,840 AND THAT'S THE ANSWER I GIVE. 988 00:33:52,840 --> 00:33:55,440 I THINK WE SHOULD GIVE WHEN 989 00:33:55,440 --> 00:34:02,760 PEOPLE ASK US ABOUT RESEARCH. 990 00:34:02,760 --> 00:34:03,800 NEXT SLIDE PLEASE. 991 00:34:03,800 --> 00:34:06,560 THAT THERE'S SIMPLY TWO KINDS OF 992 00:34:06,560 --> 00:34:06,880 RESEARCH. 993 00:34:06,880 --> 00:34:08,240 THERE'S GOOD RESEARCH, AND 994 00:34:08,240 --> 00:34:15,680 THERE'S THE OTHER KIND. 995 00:34:15,680 --> 00:34:16,720 NEXT SLIDE PLEASE. 996 00:34:16,720 --> 00:34:19,600 AND SO I WOULD ARGUE THAT NONE 997 00:34:19,600 --> 00:34:21,320 OF THESE APPROACHES IS BETTER 998 00:34:21,320 --> 00:34:22,440 THAN THE OTHER. 999 00:34:22,440 --> 00:34:25,080 IT'S HOW ARE THESE APPROACHES 1000 00:34:25,080 --> 00:34:26,280 APPLIED, AND WHAT ARE THE 1001 00:34:26,280 --> 00:34:27,120 QUESTIONS BEING ASKED THAT ARE 1002 00:34:27,120 --> 00:34:29,160 BEING TRIED TO ANSWER. 1003 00:34:29,160 --> 00:34:34,160 THAT REALLY MATTER. 1004 00:34:34,160 --> 00:34:35,240 NEXT SLIDE PLEASE. 1005 00:34:35,240 --> 00:34:37,360 SO IF THAT'S SO, WHO IS GOING TO 1006 00:34:37,360 --> 00:34:40,000 DO THIS RESEARCH IN ANY OF THESE 1007 00:34:40,000 --> 00:34:40,840 DIFFERENT AXES OF RESEARCH, IF 1008 00:34:40,840 --> 00:34:42,120 YOU WILL. 1009 00:34:42,120 --> 00:34:43,800 NEXT SLIDE PLEASE. 1010 00:34:43,800 --> 00:34:45,360 WELL, I WOULD ARGUE, AS MANY OF 1011 00:34:45,360 --> 00:34:47,640 YOU KNOW I'M BLUNT AND 1012 00:34:47,640 --> 00:34:50,360 OUTSPOKEN, I BELIEVE THAT 1013 00:34:50,360 --> 00:34:51,360 SERIOUS RESEARCH TRAINING IS 1014 00:34:51,360 --> 00:34:51,720 REQUIRED. 1015 00:34:51,720 --> 00:34:53,760 I DON'T CARE HOW YOU DO IT, 1016 00:34:53,760 --> 00:34:56,360 WHETHER A POSTDOC OR TWO 1017 00:34:56,360 --> 00:34:58,240 POSTDOCS OR GET TRAINED ON THE 1018 00:34:58,240 --> 00:35:00,120 JOB OR SOMETHING, BUT YOU REALLY 1019 00:35:00,120 --> 00:35:02,600 NEED TO SPEND THE TIME AND THE 1020 00:35:02,600 --> 00:35:04,720 ENERGY TO GET SERIOUS TRAINING 1021 00:35:04,720 --> 00:35:05,920 TO DO SIGNIFICANT RESEARCH, AND 1022 00:35:05,920 --> 00:35:09,080 I WOULD ARGUE THAT A ONE-YEAR 1023 00:35:09,080 --> 00:35:10,200 CLINICAL FELLOWSHIP IN 1024 00:35:10,200 --> 00:35:12,080 TRANSFUSION MEDICINE FOLLOWING A 1025 00:35:12,080 --> 00:35:13,840 RESIDENCY TRAINING IN PATHOLOGY, 1026 00:35:13,840 --> 00:35:15,240 INTERNAL MEDICINE, WHATEVER, IS 1027 00:35:15,240 --> 00:35:18,000 NOT SUFFICIENT TO BE ABLE TO DO 1028 00:35:18,000 --> 00:35:18,560 GOOD RESEARCH. 1029 00:35:18,560 --> 00:35:21,360 YOU NEED TO DO MORE THAN THAT, 1030 00:35:21,360 --> 00:35:24,080 AND THAT SIMPLY HAVING A BOARD 1031 00:35:24,080 --> 00:35:26,400 CERTIFICATION IN PATHOLOGY 1032 00:35:26,400 --> 00:35:26,960 MEDICINE, PEDIATRICS, 1033 00:35:26,960 --> 00:35:32,080 TRANSFUSION MEDICINE IS NOT THE 1034 00:35:32,080 --> 00:35:33,160 SAME AS HAVING RESEARCH 1035 00:35:33,160 --> 00:35:33,760 EXPERTISE. 1036 00:35:33,760 --> 00:35:35,720 I WOULD URGE YOU, THE PEOPLE YOU 1037 00:35:35,720 --> 00:35:36,440 TRAIN AND INFLUENCE, TO 1038 00:35:36,440 --> 00:35:38,320 INFLUENCE THEM TO GET SERIOUS 1039 00:35:38,320 --> 00:35:41,880 RESEARCH TRAINING. 1040 00:35:41,880 --> 00:35:42,400 NEXT SLIDE PLEASE. 1041 00:35:42,400 --> 00:35:44,360 AND SO WHO IS GOING TO DO IT? 1042 00:35:44,360 --> 00:35:45,960 WE NEED ALL THESE PEOPLE. 1043 00:35:45,960 --> 00:35:47,960 IT'S NOT JUST PHYSICIANS, NOT 1044 00:35:47,960 --> 00:35:49,040 JUST SCIENTISTS. 1045 00:35:49,040 --> 00:35:51,880 ANYBODY WHO HAS WRITTEN OR 1046 00:35:51,880 --> 00:35:53,680 OBTAINED AN NIH GRANT REALIZES 1047 00:35:53,680 --> 00:35:54,720 YOU NEED ADMINISTRATIVE STAFF 1048 00:35:54,720 --> 00:35:55,800 AND BUSINESS PEOPLE TO HELP YOU 1049 00:35:55,800 --> 00:35:57,080 THROUGH THE PROCESS. 1050 00:35:57,080 --> 00:35:59,320 SO I THINK WE NEED ALL OF THESE 1051 00:35:59,320 --> 00:36:00,800 DIFFERENT TYPES OF INDIVIDUALS. 1052 00:36:00,800 --> 00:36:02,800 WE NEED TO ATTRACT ALL OF THESE 1053 00:36:02,800 --> 00:36:03,440 TYPES OF INDIVIDUALS. 1054 00:36:03,440 --> 00:36:06,440 I THINK WE NEED TO ENGAGE ALL OF 1055 00:36:06,440 --> 00:36:08,440 THESE TYPES OF INDIVIDUALS, IF 1056 00:36:08,440 --> 00:36:11,160 WE'RE GOING TO MAKE MAJOR TOP 1057 00:36:11,160 --> 00:36:16,400 TEN CONTRIBUTIONS OVER THE NEXT 1058 00:36:16,400 --> 00:36:16,720 40 YEARS. 1059 00:36:16,720 --> 00:36:18,120 I'D LIKE TO GIVE YOU -- I'M 1060 00:36:18,120 --> 00:36:20,000 GETTING CLOSE TO THE END, I'D 1061 00:36:20,000 --> 00:36:23,920 LIKE TO GIVE SOME THOUGHTS ABOUT 1062 00:36:23,920 --> 00:36:27,320 COVID AND THE LAST THREE YEARS. 1063 00:36:27,320 --> 00:36:30,320 IF YOU'RE NOT SPEAKING, PLEASE 1064 00:36:30,320 --> 00:36:32,680 MUTE YOURSELF. 1065 00:36:32,680 --> 00:36:34,320 NEXT SLIDE PLEASE. 1066 00:36:34,320 --> 00:36:35,680 SO, THERE'S GOOD NEWS. 1067 00:36:35,680 --> 00:36:37,360 I THINK REALLY AMAZING NEWS OF 1068 00:36:37,360 --> 00:36:38,800 HAVING LIVED THROUGH THE LAST 2 1069 00:36:38,800 --> 00:36:40,360 1/2 YEARS. 1070 00:36:40,360 --> 00:36:43,400 ONE OF WHICH WAS INCREDIBLE TO 1071 00:36:43,400 --> 00:36:46,200 ME HOW EVERYONE, I MEAN EVERYONE 1072 00:36:46,200 --> 00:36:48,000 IN SCIENCE AND MEDICINING, 1073 00:36:48,000 --> 00:36:49,000 REORIENTED THEIR ATTENTION AND 1074 00:36:49,000 --> 00:36:50,720 SKILL SETS FROM WHATEVER THEY 1075 00:36:50,720 --> 00:36:53,040 WERE DOING TO FOCUS ON COVID-19. 1076 00:36:53,040 --> 00:36:55,680 THAT WAS INCREDIBLE TO ME. 1077 00:36:55,680 --> 00:36:58,240 I ALSO THINK THAT THINGS 1078 00:36:58,240 --> 00:37:00,280 HAPPENED INCREDIBLY FAST, AND 1079 00:37:00,280 --> 00:37:03,440 THERE WAS WONDERFUL SHARING, 1080 00:37:03,440 --> 00:37:04,120 COOPERATION, INCREDIBLE 1081 00:37:04,120 --> 00:37:05,520 PRODUCTIVITY, THE NUMBERS OF 1082 00:37:05,520 --> 00:37:08,000 PAPERS PUBLISHED PER MINUTE WAS 1083 00:37:08,000 --> 00:37:08,840 AMAZING. 1084 00:37:08,840 --> 00:37:10,960 AND AT LEAST FOR ME THERE WERE 1085 00:37:10,960 --> 00:37:12,840 UNIMAGINED ACCOMPLISHMENTS. 1086 00:37:12,840 --> 00:37:15,720 I NEVER EXPECTED THAT A VACCINE 1087 00:37:15,720 --> 00:37:16,920 WOULD BE AVAILABLE, PROTECTIVE 1088 00:37:16,920 --> 00:37:19,000 VACCINE WOULD BE AVAILABLE FOR 1089 00:37:19,000 --> 00:37:21,840 COVID WITHIN A YEAR OF THE 1090 00:37:21,840 --> 00:37:23,520 IDENTIFICATION OF THE ORGANISM. 1091 00:37:23,520 --> 00:37:25,320 IT'S AMAZING TO ME. 1092 00:37:25,320 --> 00:37:27,240 THAT WAS GREAT, AND IT'S ONE OF 1093 00:37:27,240 --> 00:37:29,400 THE RELATIVELY FEW THINGS THAT 1094 00:37:29,400 --> 00:37:31,480 GIVES ME HOPE FOR HUMANITY IN 1095 00:37:31,480 --> 00:37:33,800 THESE VERY DIFFICULT AND CHAOTIC 1096 00:37:33,800 --> 00:37:34,000 TIMES. 1097 00:37:34,000 --> 00:37:35,040 NEXT SLIDE PLEASE. 1098 00:37:35,040 --> 00:37:37,400 HOWEVER, I THINK THERE'S SOME 1099 00:37:37,400 --> 00:37:39,160 BAD NEWS ALSO, AT LEAST IN MY 1100 00:37:39,160 --> 00:37:40,520 OPINION. 1101 00:37:40,520 --> 00:37:48,760 I'M GOING TO USE CCP AS MY 1102 00:37:48,760 --> 00:37:49,640 EXAMPLE. 1103 00:37:49,640 --> 00:37:51,400 I'M ALSO -- I WAS ALSO INVOLVED, 1104 00:37:51,400 --> 00:37:53,880 I'M ALSO AT FAULT FOR SOME OF 1105 00:37:53,880 --> 00:37:54,120 THIS. 1106 00:37:54,120 --> 00:37:57,200 I THINK IF YOU LOOK BACK, IF 1107 00:37:57,200 --> 00:37:58,560 WE'RE SELF-CRITICAL, IT WAS A 1108 00:37:58,560 --> 00:37:59,440 LACK OF COORDINATION. 1109 00:37:59,440 --> 00:38:01,400 EVERYBODY WAS DOING GREAT 1110 00:38:01,400 --> 00:38:01,960 THINGS. 1111 00:38:01,960 --> 00:38:02,840 EVERYBODY GOT ENGAGED, WAS 1112 00:38:02,840 --> 00:38:03,200 INVOLVED. 1113 00:38:03,200 --> 00:38:05,040 BUT THERE WAS REALLY A LACK OF 1114 00:38:05,040 --> 00:38:05,840 COORDINATION. 1115 00:38:05,840 --> 00:38:07,680 I THINK THERE WAS A LOT OF POOR 1116 00:38:07,680 --> 00:38:08,680 DECISION MAKING. 1117 00:38:08,680 --> 00:38:09,840 AGAIN, ON MY PART, IN ADDITION 1118 00:38:09,840 --> 00:38:10,680 TO OTHERS. 1119 00:38:10,680 --> 00:38:13,440 I THINK THERE WAS A LOT OF POOR 1120 00:38:13,440 --> 00:38:16,440 SCIENCE, MUCH OF WHICH ALSO GOT 1121 00:38:16,440 --> 00:38:17,320 PUBLISHED. 1122 00:38:17,320 --> 00:38:17,720 NEXT SLIDE PLEASE. 1123 00:38:17,720 --> 00:38:19,640 AND SO I WOULD LIKE TO PROPOSE 1124 00:38:19,640 --> 00:38:21,160 TO THE NIH, ALTHOUGH IT'S OUT OF 1125 00:38:21,160 --> 00:38:25,480 THE SCOPE OF THIS MEETING, ONE 1126 00:38:25,480 --> 00:38:25,880 POSSIBLE SOLUTION. 1127 00:38:25,880 --> 00:38:26,880 NEXT SLIDE PLEASE. 1128 00:38:26,880 --> 00:38:28,560 ONE THING I THINK IS DONE 1129 00:38:28,560 --> 00:38:30,800 INCREDIBLY WELL OVER THE LAST 1130 00:38:30,800 --> 00:38:35,800 20+ YEARS IS THE NIH-FUNDED REDS 1131 00:38:35,800 --> 00:38:36,640 PROGRAM, INCREDIBLY SUCCESSFUL, 1132 00:38:36,640 --> 00:38:38,200 I'VE GOTTEN TO KNOW IT MORE UP 1133 00:38:38,200 --> 00:38:40,400 CLOSE AND PERSONAL OVER THE LAST 1134 00:38:40,400 --> 00:38:42,320 COUPLE YEARS AS NEW YORK CITY 1135 00:38:42,320 --> 00:38:43,520 HAS BECOME ONE OF THE HUBS. 1136 00:38:43,520 --> 00:38:44,760 NEXT SLIDE PLEASE. 1137 00:38:44,760 --> 00:38:46,720 IT'S A HIGHLY PRODUCTIVE 1138 00:38:46,720 --> 00:38:47,800 PROGRAM. 1139 00:38:47,800 --> 00:38:49,240 I THINK IT WONDERFUL FOSTERS 1140 00:38:49,240 --> 00:38:50,600 TRAINING AND COLLABORATION. 1141 00:38:50,600 --> 00:38:51,600 THE WHOLE IS GREATER THAN THE 1142 00:38:51,600 --> 00:38:53,280 SUM OF THE PARTS AS THE GROUP 1143 00:38:53,280 --> 00:38:56,000 WORKS TOGETHER TO TRY TO DO EVEN 1144 00:38:56,000 --> 00:38:56,680 BETTER THINGS THAN ANY ONE 1145 00:38:56,680 --> 00:38:58,360 PERSON IN THE GROUP COULD THINK 1146 00:38:58,360 --> 00:38:59,920 OF ON THEIR OWN. 1147 00:38:59,920 --> 00:39:02,400 AND I THINK IT ALSO RAPIDLY CAN 1148 00:39:02,400 --> 00:39:05,760 REORIENT ITSELF TO DEAL WITH 1149 00:39:05,760 --> 00:39:07,240 IMMINENT THREATS, WHETHER ZIKA 1150 00:39:07,240 --> 00:39:10,040 OR EVEN COVID, THE THE GROUP CAN 1151 00:39:10,040 --> 00:39:12,360 REORIENTS ITSELF AND APPLY ITS 1152 00:39:12,360 --> 00:39:14,760 STRENGTHS AND RESOURCES TO 1153 00:39:14,760 --> 00:39:18,480 WHATEVER THE IMMINENT THREAT IS. 1154 00:39:18,480 --> 00:39:19,920 HOWEVER, ONE OF THE PROBLEMS IN 1155 00:39:19,920 --> 00:39:25,080 MY VIEW, THE WAY IT IS 1156 00:39:25,080 --> 00:39:26,360 CONSTITUTED, IT'S LIMITED TO 1157 00:39:26,360 --> 00:39:27,280 ONLY OBSERVATIONAL STUDIES 1158 00:39:27,280 --> 00:39:28,600 INCLUDING DURING COVID, COULD 1159 00:39:28,600 --> 00:39:29,920 ONLY DO OBSERVATIONAL STUDIES. 1160 00:39:29,920 --> 00:39:30,840 NEXT SLIDE PLEASE. 1161 00:39:30,840 --> 00:39:32,920 I REALLY THINK WHAT WE NEED, WE 1162 00:39:32,920 --> 00:39:35,600 HAD SOMETHING LIKE THIS A 1163 00:39:35,600 --> 00:39:37,520 NEWBORN OF YEARS, I WAS ONE OF 1164 00:39:37,520 --> 00:39:38,680 THE SEVERE CRITICS OF THE 1165 00:39:38,680 --> 00:39:42,760 PROGRAM I MUST ADMIT, I THINK WE 1166 00:39:42,760 --> 00:39:45,480 NEED ANALOGOUS PROGRAM FOR 1167 00:39:45,480 --> 00:39:46,480 PROSPECTIVE STUDIES, SHOULD BE 1168 00:39:46,480 --> 00:39:48,560 NIH FUNDED AND GIVEN MY 1169 00:39:48,560 --> 00:39:49,320 EXPERIENCE WITH COVID AND THE 1170 00:39:49,320 --> 00:39:51,440 WONDERFUL WORK AROUND THE WORLD 1171 00:39:51,440 --> 00:39:52,480 AND WONDERFUL COLLABORATION 1172 00:39:52,480 --> 00:39:53,920 AROUND THE WORLD, I THINK IT 1173 00:39:53,920 --> 00:39:55,240 NEEDS TO BE INTERNATIONAL IN 1174 00:39:55,240 --> 00:39:55,520 SCOPE. 1175 00:39:55,520 --> 00:39:57,680 I THINK IT NEEDS TO FUND PEOPLE 1176 00:39:57,680 --> 00:39:59,400 AROUND THE WORLD. 1177 00:39:59,400 --> 00:40:00,840 REDS HAS AN INTERNATIONAL PART 1178 00:40:00,840 --> 00:40:04,600 OF ITS PROGRAM NOW TOO. 1179 00:40:04,600 --> 00:40:05,160 IT CAN INCLUDE TRAINING IN 1180 00:40:05,160 --> 00:40:09,680 RANDOMIZED CONTROLLED TRIALS, 1181 00:40:09,680 --> 00:40:10,720 WHICH HAS UNIQUE ISSUES, COULD 1182 00:40:10,720 --> 00:40:12,400 HAVE A SINGLE IRB TO FOSTER 1183 00:40:12,400 --> 00:40:13,080 RESEARCH AND THINGS LIKE THAT. 1184 00:40:13,080 --> 00:40:17,040 NEXT SLIDE PLEASE. 1185 00:40:17,040 --> 00:40:18,280 SO FINALLY, IN CONCLUSION, I'D 1186 00:40:18,280 --> 00:40:19,680 LIKE TO MAKE ACKNOWLEDGMENTS. 1187 00:40:19,680 --> 00:40:21,320 I'VE BEEN ASSOCIATED ONE WAY OR 1188 00:40:21,320 --> 00:40:24,920 THE OTHER WITH THE NIH SINCE 1189 00:40:24,920 --> 00:40:27,520 1983 WHEN I ARRIVED ON THE 1190 00:40:27,520 --> 00:40:29,320 INTRAMURAL BETHESDA CAMPUS TO BE 1191 00:40:29,320 --> 00:40:37,760 A MEDICAL STAFF FELLOW IN WHAT 1192 00:40:37,760 --> 00:40:40,240 WAS NIADDK, MEANTORY WAS VIC 1193 00:40:40,240 --> 00:40:42,640 GINSBERG, NO LONGER WITH US. 1194 00:40:42,640 --> 00:40:43,960 I'VE BEEN FORTUNATE MYSELF AND 1195 00:40:43,960 --> 00:40:46,600 COLLEAGUES TO BE FUNDED 1196 00:40:46,600 --> 00:40:47,440 PRIMARILY BY NHLBI AND CURRENT 1197 00:40:47,440 --> 00:40:52,480 PEOPLE WHO I WOULD LIKE TO 1198 00:40:52,480 --> 00:41:02,960 THANK, INCREDIBLE, SIMONE AND 1199 00:41:05,360 --> 00:41:09,120 TRACI, LISBETH AND SHIMIAN. 1200 00:41:09,120 --> 00:41:11,200 GRANT PROPOSALS GET REVIEWED 1201 00:41:11,200 --> 00:41:12,080 THROUGH CENTER FOR SCIENTIFIC 1202 00:41:12,080 --> 00:41:12,600 REVIEW. 1203 00:41:12,600 --> 00:41:14,400 FOR THE FIRST TIME EVER STARTING 1204 00:41:14,400 --> 00:41:15,520 A COUPLE YEARS AGO THERE'S 1205 00:41:15,520 --> 00:41:20,760 TRANSFUSION IN THE NAME OF A 1206 00:41:20,760 --> 00:41:25,000 STUDY SECTION, HTBT STUDY 1207 00:41:25,000 --> 00:41:27,440 SECTION, I'M FORTUNATE ENOUGH TO 1208 00:41:27,440 --> 00:41:29,720 BE A STANDING MEMBER, AI-PING 1209 00:41:29,720 --> 00:41:33,440 AND KATHERINE ARE THE DIRECTORS, 1210 00:41:33,440 --> 00:41:35,360 YOU CAN BLAME ME IF YOU DON'T 1211 00:41:35,360 --> 00:41:36,720 FEEL YOUR GRANTS WERE REVIEWED 1212 00:41:36,720 --> 00:41:38,840 BUT WE DO THE BEST WE CAN AND 1213 00:41:38,840 --> 00:41:42,800 PLEASE REMEMBER THIS IS A HUMAN 1214 00:41:42,800 --> 00:41:44,960 CONSTRUCT. 1215 00:41:44,960 --> 00:41:46,520 NEXT SLIDE PLEASE. 1216 00:41:46,520 --> 00:41:48,560 FINALLY, ROZ IS A CONTRIBUTOR TO 1217 00:41:48,560 --> 00:41:51,600 THE NEW YORKER, I'VE BEEN 1218 00:41:51,600 --> 00:41:52,880 ENJOYING HER CARTOONS MY WHOLE 1219 00:41:52,880 --> 00:41:53,800 ADULT LIFE. 1220 00:41:53,800 --> 00:41:55,800 THIS JUST RECENTLY CAME OUT. 1221 00:41:55,800 --> 00:41:57,720 I THINK IT'S QUITE RELEVANT TO 1222 00:41:57,720 --> 00:41:59,480 US, QUITE RELEVANT TO TODAY. 1223 00:41:59,480 --> 00:42:01,120 THESE ARE THE FREQUENTLY ASKED 1224 00:42:01,120 --> 00:42:03,640 QUESTIONS OF LIFE. 1225 00:42:03,640 --> 00:42:05,880 NEXT SLIDE PLEASE. 1226 00:42:05,880 --> 00:42:08,640 NEXT SLIDE PLEASE. 1227 00:42:08,640 --> 00:42:10,640 SO WHEN YOUR NEW RESIDENTS AND 1228 00:42:10,640 --> 00:42:13,400 FELLOWS STARTED IN JULY 1229 00:42:13,400 --> 00:42:14,640 QUESTIONS THEY WERE, WHAT THE 1230 00:42:14,640 --> 00:42:15,120 HELL'S GOING ON? 1231 00:42:15,120 --> 00:42:21,400 I DON'T KNOW WHAT I'M DOING? 1232 00:42:21,400 --> 00:42:23,960 THEY WOULD ASK WHY ME, AND AS 1233 00:42:23,960 --> 00:42:25,000 THEY ARE ATTENDINGS YOU MIGHT 1234 00:42:25,000 --> 00:42:25,960 HAVE HAD THESE QUESTIONS ABOUT 1235 00:42:25,960 --> 00:42:28,480 THEM, WHICH IS WHERE DID YOU GET 1236 00:42:28,480 --> 00:42:32,360 THAT IDEA, WHO DO YOU THINK 1237 00:42:32,360 --> 00:42:32,960 YOU'RE KIDDING? 1238 00:42:32,960 --> 00:42:34,160 A QUESTION I ASK A LOT. 1239 00:42:34,160 --> 00:42:37,440 WHEN YOU GET TO MY AGE, NEXT 1240 00:42:37,440 --> 00:42:39,760 SLIDE, ONE OF THE QUESTIONS THAT 1241 00:42:39,760 --> 00:42:41,320 WILL INEVITABLY COME UP, IS THIS 1242 00:42:41,320 --> 00:42:42,160 ALL THERE IS? 1243 00:42:42,160 --> 00:42:46,760 AND I WOULD LIKE TO ANSWER THAT 1244 00:42:46,760 --> 00:42:47,520 QUESTION AFFIRMATIVELY, THAT'S 1245 00:42:47,520 --> 00:42:48,320 NOT TRUE. 1246 00:42:48,320 --> 00:42:49,560 NEXT SLIDE PLEASE. 1247 00:42:49,560 --> 00:42:51,360 THAT WE STILL HAVE A LOT OF WORK 1248 00:42:51,360 --> 00:42:52,400 TO DO. 1249 00:42:52,400 --> 00:42:54,000 IT'S GOING TO REQUIRE ALL OF US 1250 00:42:54,000 --> 00:42:55,880 TO PARTICIPATE IN SOME ROLE, 1251 00:42:55,880 --> 00:42:59,280 WHETHER THAT'S BY DOING, OR 1252 00:42:59,280 --> 00:43:00,920 MENTORING, OR CRITIQUING, OR 1253 00:43:00,920 --> 00:43:02,080 EDITING OR WHATEVER, THERE'S 1254 00:43:02,080 --> 00:43:04,720 STILL A LOT FOR ALL OF US TO DO, 1255 00:43:04,720 --> 00:43:06,320 EVEN SOMEONE CLOSER TO THE END 1256 00:43:06,320 --> 00:43:08,280 OF HIS CAREER THAN THE 1257 00:43:08,280 --> 00:43:10,320 BEGINNING. 1258 00:43:10,320 --> 00:43:11,040 NEXT SLIDE PLEASE. 1259 00:43:11,040 --> 00:43:14,080 AND THIS IS JOHN GORMAN, NOW 91 1260 00:43:14,080 --> 00:43:15,920 YEARS OLD. 1261 00:43:15,920 --> 00:43:20,480 ONE OF THE INVENTORS OF HR 1262 00:43:20,480 --> 00:43:21,360 IMMUNE GLOBULIN, I'M HONORED TO 1263 00:43:21,360 --> 00:43:24,840 SAY IS A FRIEND, AT 91 MORE 1264 00:43:24,840 --> 00:43:26,160 ENERGY, IDEAS, MORE CREATIVITY 1265 00:43:26,160 --> 00:43:27,240 THAN ANYONE I KNOW, CERTAINLY 1266 00:43:27,240 --> 00:43:27,800 ME. 1267 00:43:27,800 --> 00:43:29,120 AND I FEEL EVERY DAY HE'S 1268 00:43:29,120 --> 00:43:30,360 LOOKING OVER MY SHOULDER ASKING 1269 00:43:30,360 --> 00:43:32,960 ME WHAT I DID TODAY. 1270 00:43:32,960 --> 00:43:34,720 SO, MAY HE LOOK OVER YOUR 1271 00:43:34,720 --> 00:43:35,040 SHOULDER TOO. 1272 00:43:35,040 --> 00:43:37,520 THANK YOU VERY MUCH FOR THIS 1273 00:43:37,520 --> 00:43:38,040 OPPORTUNITY. 1274 00:43:38,040 --> 00:43:40,360 THANK YOU. 1275 00:43:40,360 --> 00:43:46,320 1276 00:43:46,320 --> 00:43:49,000 1277 00:43:49,000 --> 00:43:50,720 >> THANK YOU SO MUCH, DR. 1278 00:43:50,720 --> 00:43:51,720 SPITALNIK, FOR THE OPENING 1279 00:43:51,720 --> 00:43:53,120 COMMENTS AND REALLY HELPING US 1280 00:43:53,120 --> 00:43:55,080 THINK NOT ONLY ABOUT WHERE WE 1281 00:43:55,080 --> 00:43:56,600 ARE BUT WHERE WE'RE GOING AND 1282 00:43:56,600 --> 00:43:58,600 HOW WE HAVE TO GET THERE 1283 00:43:58,600 --> 00:43:59,200 TOGETHER. 1284 00:43:59,200 --> 00:44:00,480 TRULY APPRECIATE THAT OVERVIEW 1285 00:44:00,480 --> 00:44:02,080 BECAUSE IT'S A BEAUTIFUL 1286 00:44:02,080 --> 00:44:04,000 INTRODUCTION TO NOW REALLY WHAT 1287 00:44:04,000 --> 00:44:05,840 ARE THOSE PRIORITIES THAT THE 1288 00:44:05,840 --> 00:44:07,160 WORKING GROUPS HAVE DEVELOPED, 1289 00:44:07,160 --> 00:44:09,640 AND THAT OPPORTUNITY FOR ALL OF 1290 00:44:09,640 --> 00:44:11,840 THE PARTICIPANTS TO JOIN US AND 1291 00:44:11,840 --> 00:44:14,800 COMMENT ON THOSE PRIORITIES AND 1292 00:44:14,800 --> 00:44:16,720 ALSO FURTHER DEVELOP PRIORITIES. 1293 00:44:16,720 --> 00:44:18,440 WE'LL MOVE INTO THE GENERAL 1294 00:44:18,440 --> 00:44:19,480 SESSION FOR THAT OVERALL PROGRAM 1295 00:44:19,480 --> 00:44:22,400 FOR THE STATE OF THE SCIENCE AND 1296 00:44:22,400 --> 00:44:25,440 WE'LL BEGIN WITH DOCTORS BRYANT 1297 00:44:25,440 --> 00:44:26,360 AND SAYERS. 1298 00:44:26,360 --> 00:44:30,080 AND THEY WILL PRESENT TO US THE 1299 00:44:30,080 --> 00:44:31,320 WORKING GROUP PRIORITIES DEFINED 1300 00:44:31,320 --> 00:44:34,320 FOR BLOOD DONORS AND THE SUPPLY, 1301 00:44:34,320 --> 00:44:35,720 DIVERSIFYING WHILE MAINTAINING 1302 00:44:35,720 --> 00:44:39,600 THE DONOR POOL, DONOR SELECTION, 1303 00:44:39,600 --> 00:44:40,200 OPTIMIZING BLOOD AVAILABILITY 1304 00:44:40,200 --> 00:44:40,760 AND SAFETY. 1305 00:44:40,760 --> 00:44:43,080 I WILL HAND IT OVER TO DR. 1306 00:44:43,080 --> 00:44:44,040 BRYANT RIGHT NOW. 1307 00:44:44,040 --> 00:44:46,240 BEFORE I DO, I WILL JUST SAY 1308 00:44:46,240 --> 00:44:50,760 THAT I'M NOT GIVING A DETAILED 1309 00:44:50,760 --> 00:44:52,000 INTRODUCTION. 1310 00:44:52,000 --> 00:44:54,320 ALL THE BIOS FOR WORKING GROUP 1311 00:44:54,320 --> 00:44:56,520 CHAIRS ARE PROVIDED IN A 1312 00:44:56,520 --> 00:44:57,720 PAMPHLET LATER SO YOU'LL HAVE 1313 00:44:57,720 --> 00:44:59,120 MORE INFORMATION. 1314 00:44:59,120 --> 00:45:01,520 I DON'T WANT TO SHORT SHRIFT BUT 1315 00:45:01,520 --> 00:45:02,960 LET YOU KNOW DETAILS WILL BE 1316 00:45:02,960 --> 00:45:04,760 AVAILABLE FOR REVIEW. 1317 00:45:04,760 --> 00:45:08,600 I'LL TURN IT OVER TO DR. BRYANT, 1318 00:45:08,600 --> 00:45:11,720 PLEASE. 1319 00:45:11,720 --> 00:45:17,120 1320 00:45:17,120 --> 00:45:18,840 >> CAN EVERYONE SEE MY SLIDES? 1321 00:45:18,840 --> 00:45:20,320 >> WE CAN SEE YOUR SLIDES AND 1322 00:45:20,320 --> 00:45:22,320 NOW HEAR YOU. 1323 00:45:22,320 --> 00:45:23,240 THANK YOU. 1324 00:45:23,240 --> 00:45:23,800 >> EXCELLENT. 1325 00:45:23,800 --> 00:45:25,840 THANK YOU. 1326 00:45:25,840 --> 00:45:27,040 THANK YOU FOR THE INTRODUCTION, 1327 00:45:27,040 --> 00:45:28,320 BRIAN. 1328 00:45:28,320 --> 00:45:32,000 I'D LIKE TO THANK THE NHLBI, 1329 00:45:32,000 --> 00:45:34,480 OASH, AND THE CHAIRS FOR THEIR 1330 00:45:34,480 --> 00:45:36,360 HARD WORK AND DEDICATION 1331 00:45:36,360 --> 00:45:38,560 ORGANIZING THIS SYMPOSIUM. 1332 00:45:38,560 --> 00:45:41,080 I'M BARBARA BRYANT, WITH MERLYN 1333 00:45:41,080 --> 00:45:43,200 SAYERS WE'RE THE CO-CHAIRS OF 1334 00:45:43,200 --> 00:45:45,640 WORKING GROUP NUMBER 1. 1335 00:45:45,640 --> 00:45:47,320 WORKING GROUP NUMBER 1, FOCUSED 1336 00:45:47,320 --> 00:45:50,800 ON IMPORTANT TOPIC, BLOOD DONORS 1337 00:45:50,800 --> 00:45:55,080 AND THE BLOOD SUPPLY, 1338 00:45:55,080 --> 00:45:56,400 DIVERSIFYING WHILE MAINTAINING 1339 00:45:56,400 --> 00:45:58,680 THE DONOR POOL, DONOR SELECTION, 1340 00:45:58,680 --> 00:45:59,480 OPTIMIZING BLOOD AVAILABILITY 1341 00:45:59,480 --> 00:46:00,200 AND SAFETY. 1342 00:46:00,200 --> 00:46:02,760 SO AS WE HEARD THIS MORNING, 1343 00:46:02,760 --> 00:46:05,080 FROM ADMIRAL LEVINE, IN THE U.S. 1344 00:46:05,080 --> 00:46:07,040 ABOUT 62% OF THE POPULATION IS 1345 00:46:07,040 --> 00:46:09,520 ELIGIBLE TO DONATE BLOOD. 1346 00:46:09,520 --> 00:46:11,640 THAT'S ABOUT 205 MILLION 1347 00:46:11,640 --> 00:46:11,960 INDIVIDUALS. 1348 00:46:11,960 --> 00:46:14,800 BUT ONLY 3% OF THE U.S. 1349 00:46:14,800 --> 00:46:16,800 POPULATION DONATES BLOOD EACH 1350 00:46:16,800 --> 00:46:17,160 YEAR. 1351 00:46:17,160 --> 00:46:19,680 SO, OF ALL THE WHOLE BLOOD AND 1352 00:46:19,680 --> 00:46:21,680 APHERESIS RED CELL DONATIONS, 1353 00:46:21,680 --> 00:46:24,040 LESS THAN 20% COME FROM RACIAL 1354 00:46:24,040 --> 00:46:26,680 OR ETHNIC MINORITY DONORS. 1355 00:46:26,680 --> 00:46:29,080 AND FROM 2017 TO 2019 THERE WAS 1356 00:46:29,080 --> 00:46:34,080 A 15% DECREASE IN DONATION FROM 1357 00:46:34,080 --> 00:46:36,600 INDIVIDUALS IN THE 19 TO 24 YEAR 1358 00:46:36,600 --> 00:46:38,120 AGE RANGE. 1359 00:46:38,120 --> 00:46:39,320 WE KNOW WE NEED MORE 1360 00:46:39,320 --> 00:46:40,560 PARTICIPATION FROM DIVERSE AND 1361 00:46:40,560 --> 00:46:43,240 YOUNGER DONORS TO SUPPORT THE 1362 00:46:43,240 --> 00:46:43,960 NATION'S BLOOD TRANSFUSION NEEDS 1363 00:46:43,960 --> 00:46:46,760 TODAY AND ESPECIALLY IN THE 1364 00:46:46,760 --> 00:46:47,400 FUTURE. 1365 00:46:47,400 --> 00:46:48,600 AND PAST AND CURRENT INITIATIVES 1366 00:46:48,600 --> 00:46:51,440 TO ADDRESS THESE ISSUES HAVE NOT 1367 00:46:51,440 --> 00:46:53,040 RESULTED IN DEPENDABLE SOLUTIONS 1368 00:46:53,040 --> 00:46:55,680 THAT WILL ENSURE ADEQUACY, 1369 00:46:55,680 --> 00:46:57,280 SUSTAINABILITY, AND DIVERSITY OF 1370 00:46:57,280 --> 00:46:58,000 THE BLOOD SUPPLY. 1371 00:46:58,000 --> 00:47:00,320 IN THE PAST YEAR WE'VE ALL DEALT 1372 00:47:00,320 --> 00:47:01,320 WITH TREMENDOUS CHALLENGES 1373 00:47:01,320 --> 00:47:04,360 FACING THE BLOOD SUPPLY. 1374 00:47:04,360 --> 00:47:05,560 MANY TIMES BLOOD INVENTORIES 1375 00:47:05,560 --> 00:47:07,840 DROP TO LESS THAN 24-HOUR SUPPLY 1376 00:47:07,840 --> 00:47:10,080 LEVEL FORCING MANY HOSPITALS TO 1377 00:47:10,080 --> 00:47:12,320 TRIAGE BLOOD PRODUCTS, LOWER 1378 00:47:12,320 --> 00:47:13,680 THRESHOLD FOR TRANSFUSION, IN 1379 00:47:13,680 --> 00:47:16,040 SOME CASES SURGERIES WERE 1380 00:47:16,040 --> 00:47:22,840 CANCELED, POSTPONED, THERE WERE 1381 00:47:22,840 --> 00:47:25,040 REPORTS OF NOT ENOUGH BLOOD FOR 1382 00:47:25,040 --> 00:47:25,440 PATIENTS. 1383 00:47:25,440 --> 00:47:27,840 MANY SUGGESTED IT'S TIME TO STEP 1384 00:47:27,840 --> 00:47:31,080 OUTSIDE AND DEVELOP INNOVATIVE 1385 00:47:31,080 --> 00:47:32,080 APPROACHES FOR DIVERSIFYING AND 1386 00:47:32,080 --> 00:47:33,160 SUSTAINING THE BLOOD SUPPLY. 1387 00:47:33,160 --> 00:47:36,080 IF WE DO WHAT WE'VE BEEN DOING 1388 00:47:36,080 --> 00:47:41,760 WE'LL MOST LIKELY GET THE SAME 1389 00:47:41,760 --> 00:47:42,320 RESULT. 1390 00:47:42,320 --> 00:47:44,920 SO, AFTER REVIEWING THE 1391 00:47:44,920 --> 00:47:46,600 LITERATURE AND RECENT AND PAST 1392 00:47:46,600 --> 00:47:48,440 LITERATURE, SPEAKING TO THOUGHT 1393 00:47:48,440 --> 00:47:49,240 LEADERS AND CHANGE LEADERS 1394 00:47:49,240 --> 00:47:51,160 ACROSS THE UNITED STATES AND 1395 00:47:51,160 --> 00:47:52,800 GLOBALLY, MERLYN AND I PUT 1396 00:47:52,800 --> 00:47:54,600 TOGETHER A DYNAMIC GROUP OF 1397 00:47:54,600 --> 00:47:57,400 INDIVIDUALS FOR WORKING GROUP 1398 00:47:57,400 --> 00:48:00,440 NUMBER 1. 1399 00:48:00,440 --> 00:48:02,680 THE MEMBERS INCLUDE MEDICAL 1400 00:48:02,680 --> 00:48:05,320 DIRECTORS, NURSES, EDUCATORS, 1401 00:48:05,320 --> 00:48:08,480 MARKETING AND COMMUNICATION 1402 00:48:08,480 --> 00:48:09,960 SPECIALISTS, BIOMEDICAL 1403 00:48:09,960 --> 00:48:10,680 PARTNERSHIP MANAGERS, PSYCHOLOGY 1404 00:48:10,680 --> 00:48:12,680 PROFESSOR ALREADY WELL KNOWN IN 1405 00:48:12,680 --> 00:48:16,680 THE FIELD, APPLIED MEDICAL 1406 00:48:16,680 --> 00:48:17,640 ANTHROPOLOGIST, APPLIED 1407 00:48:17,640 --> 00:48:18,960 MATHEMATICIAN WHO SPECIALIZES IN 1408 00:48:18,960 --> 00:48:22,200 ALGORITHMS AND A.I. FOR 1409 00:48:22,200 --> 00:48:23,160 DETERMINING BEHAVIORS AND 1410 00:48:23,160 --> 00:48:25,320 DECISION MAKING, TRANSFUSION 1411 00:48:25,320 --> 00:48:27,720 MEDICINE FELLOW, AND A COMMUNITY 1412 00:48:27,720 --> 00:48:29,040 REPRESENTATIVE OR STAKEHOLDER 1413 00:48:29,040 --> 00:48:31,200 WHO IS A STRONG ADVOCATE FOR 1414 00:48:31,200 --> 00:48:34,920 SUPPORTING BLOOD DONATION FROM 1415 00:48:34,920 --> 00:48:36,280 UNDERREPRESENTED COMMUNITIES. 1416 00:48:36,280 --> 00:48:37,840 THE SLIDES FOR THIS PRESENTATION 1417 00:48:37,840 --> 00:48:41,320 WERE PREPARED BY EVERYONE IN 1418 00:48:41,320 --> 00:48:42,880 THIS WORKING GROUP. 1419 00:48:42,880 --> 00:48:46,280 SO, THESE ARE THE FIVE DRAFTS 1420 00:48:46,280 --> 00:48:48,000 RESEARCH PRIORITIES WE 1421 00:48:48,000 --> 00:48:49,000 IDENTIFIED. 1422 00:48:49,000 --> 00:48:50,560 NUMBER 1, MOTIVATORS AND 1423 00:48:50,560 --> 00:48:53,640 BARRIERS TO BLOOD DONATION. 1424 00:48:53,640 --> 00:48:56,640 NUMBER 2, DONOR EXPERIENCE AND 1425 00:48:56,640 --> 00:49:00,640 SUBSEQUENT DONOR BEHAVIOR. 1426 00:49:00,640 --> 00:49:03,360 NUMBER 3, INCENTIVES, DONOR 1427 00:49:03,360 --> 00:49:06,600 APPRECIATION AND COMPENSATION. 1428 00:49:06,600 --> 00:49:07,920 NUMBER 4, OPTIMIZING 1429 00:49:07,920 --> 00:49:10,760 COMMUNICATIONS WITH DONORS AND 1430 00:49:10,760 --> 00:49:11,880 POTENTIAL DONORS. 1431 00:49:11,880 --> 00:49:13,120 NUMBER 5, INNOVATIVE AND 1432 00:49:13,120 --> 00:49:16,920 INCLUSIVE USES OF INFORMATION 1433 00:49:16,920 --> 00:49:19,880 AND COMMUNICATION TECHNOLOGY. 1434 00:49:19,880 --> 00:49:22,880 SO FOR THE FIRST DRAFT PRIORITY, 1435 00:49:22,880 --> 00:49:24,040 MOTIVATORS AND BARRIERS, WHAT 1436 00:49:24,040 --> 00:49:27,520 ARE THE MOTIVATORS AND BARRIERS 1437 00:49:27,520 --> 00:49:30,080 TO INITIAL AND REPEAT BLOOD 1438 00:49:30,080 --> 00:49:30,760 DONATION, PARTICULARLY AMONG 1439 00:49:30,760 --> 00:49:31,920 YOUNGER INDIVIDUALS AND PEOPLE 1440 00:49:31,920 --> 00:49:33,800 OF DIVERSE BACKGROUNDS WHO ARE 1441 00:49:33,800 --> 00:49:35,440 CURRENTLY UNDERREPRESENTED IN 1442 00:49:35,440 --> 00:49:36,600 THE DONOR POOL? 1443 00:49:36,600 --> 00:49:39,920 THE PROBLEM IS IN THE U.S. WE'RE 1444 00:49:39,920 --> 00:49:41,480 FACED WITH ONGOING CHALLENGES 1445 00:49:41,480 --> 00:49:42,400 RELATED TO RECRUITMENT AND 1446 00:49:42,400 --> 00:49:45,720 RETENTION OF A NEW GENERATION OF 1447 00:49:45,720 --> 00:49:52,760 DONORS. 1448 00:49:52,760 --> 00:49:53,520 AND PARTICULARLY NOTEWORTHY 1449 00:49:53,520 --> 00:49:53,920 UNDERREPRESENTATION. 1450 00:49:53,920 --> 00:49:55,920 WHY IS THIS AN ISSUE? 1451 00:49:55,920 --> 00:49:58,120 THERE IS A SIZEABLE LITERATURE 1452 00:49:58,120 --> 00:50:01,360 ON BLOOD DONOR MOTIVATION, MAJOR 1453 00:50:01,360 --> 00:50:03,240 DEMOGRAPHIC, TECHNOLOGICAL AND 1454 00:50:03,240 --> 00:50:04,080 SOCIETAL CHANGES HAVE TAKEN 1455 00:50:04,080 --> 00:50:06,040 PLACE SINCE THE WORK WAS 1456 00:50:06,040 --> 00:50:08,040 PUBLISHED AND POTENTIAL IMPACT 1457 00:50:08,040 --> 00:50:08,960 OF CHANCE ON DONOR RECRUITMENT 1458 00:50:08,960 --> 00:50:14,840 AND RETENTION ARE NOT WELL 1459 00:50:14,840 --> 00:50:15,520 UNDERSTOOD. 1460 00:50:15,520 --> 00:50:16,280 DO BARRIERS REMAIN RELEVANT? 1461 00:50:16,280 --> 00:50:17,880 DO THEY HAVE THE SAME MEANING 1462 00:50:17,880 --> 00:50:18,840 TODAY AS IN THE PAST? 1463 00:50:18,840 --> 00:50:21,080 IN THE PAST IT SEEMED THE 1464 00:50:21,080 --> 00:50:22,480 MOTIVATORS WERE ALTRUISM, SAVE A 1465 00:50:22,480 --> 00:50:24,080 LIFE, NOW WE'RE FINDING MORE 1466 00:50:24,080 --> 00:50:25,440 THAT IT'S BENEVOLENCE AND THE 1467 00:50:25,440 --> 00:50:27,160 MESSAGE OF SAVE A LIFE IS A 1468 00:50:27,160 --> 00:50:30,320 TURNOFF TO A LOT OF DONORS. 1469 00:50:30,320 --> 00:50:31,920 ALSO WHAT ROLE DOES SOCIALIST 1470 00:50:31,920 --> 00:50:36,160 THEME PLAY IN THE MOTIVATION? 1471 00:50:36,160 --> 00:50:38,360 AS FAR AS BARRIERS, DID WE GET 1472 00:50:38,360 --> 00:50:42,360 TOLD IT'S CONVENIENT, THE TIME, 1473 00:50:42,360 --> 00:50:45,040 I HAVE ADMIT AT NIH OUR DONORS 1474 00:50:45,040 --> 00:50:46,640 HAVE TO GET THROUGH THE 1475 00:50:46,640 --> 00:50:48,680 PERIMETER, GO THROUGH HAVING THE 1476 00:50:48,680 --> 00:50:50,080 CAR SCREENED AND PARK, WAIT IN 1477 00:50:50,080 --> 00:50:52,240 LINE TO GET IN THE BUILDING 1478 00:50:52,240 --> 00:50:53,720 BEFORE THEY CAN GET SCREENED 1479 00:50:53,720 --> 00:50:58,320 AGAIN TO GET TO THE DONOR ROOM. 1480 00:50:58,320 --> 00:51:00,920 SO HOW DO THESE BARRIERS, 1481 00:51:00,920 --> 00:51:01,760 CONVENIENCE, FEAR, NEGATIVE 1482 00:51:01,760 --> 00:51:03,200 EXPERIENCES, REALLY IMPACT OUR 1483 00:51:03,200 --> 00:51:03,840 DONORS? 1484 00:51:03,840 --> 00:51:06,360 AND WHAT ARE THESE MOTIVATIONS 1485 00:51:06,360 --> 00:51:08,800 AND BARRIERS ACROSS SEX AND 1486 00:51:08,800 --> 00:51:13,360 GENDER, GENERATIONS, RACE, 1487 00:51:13,360 --> 00:51:14,040 ETHNICITY, AND GEOGRAPHY? 1488 00:51:14,040 --> 00:51:16,520 AS THE U.S. BECOMES MORE 1489 00:51:16,520 --> 00:51:18,080 DIVERSE, BLOOD DONOR MOTIVATION 1490 00:51:18,080 --> 00:51:20,040 MUST BE PURSUED IN A RANGE OF 1491 00:51:20,040 --> 00:51:20,440 COMMUNITIES. 1492 00:51:20,440 --> 00:51:22,080 PEOPLE OF COLOR, RELIGIOUS 1493 00:51:22,080 --> 00:51:22,880 MINORITIES, RECENT IMMIGRANT 1494 00:51:22,880 --> 00:51:25,520 GROUPS, ANDS HOW CAN WE 1495 00:51:25,520 --> 00:51:27,040 ENCOURAGE AND SUSTAIN DONORS AND 1496 00:51:27,040 --> 00:51:30,680 ENGAGE THOSE WHO NEVER 1497 00:51:30,680 --> 00:51:31,640 DONATEDs FROM DIFFERENT 1498 00:51:31,640 --> 00:51:32,640 COMMUNITIES? 1499 00:51:32,640 --> 00:51:35,840 SO, WHAT IS THE PROPOSED 1500 00:51:35,840 --> 00:51:37,880 APPROACH TO THIS RESEARCH? 1501 00:51:37,880 --> 00:51:43,560 NEEDED STUDIES WILL RANGE FROM 1502 00:51:43,560 --> 00:51:44,960 OBSERVATIONAL, QUALITATIVE, 1503 00:51:44,960 --> 00:51:45,560 MIX-METHOD DESIGNS, RANDOM 1504 00:51:45,560 --> 00:51:46,920 CLINICAL TRIALS INTENDED TO 1505 00:51:46,920 --> 00:51:50,760 EVALUATE NEW APPROACHES TO 1506 00:51:50,760 --> 00:51:52,160 RECRUITMENT AND RETENTION. 1507 00:51:52,160 --> 00:51:54,120 HOW FEASIBLE ARE THESE? 1508 00:51:54,120 --> 00:51:56,360 WHAT ARE THE BARRIERS? 1509 00:51:56,360 --> 00:51:56,920 METHODOLOGICAL APPROACHES 1510 00:51:56,920 --> 00:51:59,200 REQUIRED TO PRODUCE THIS 1511 00:51:59,200 --> 00:52:00,720 EVIDENCE DO NOT PRESENT UNDUE 1512 00:52:00,720 --> 00:52:02,880 CHALLENGE, WITH MANY EXISTING 1513 00:52:02,880 --> 00:52:04,360 EXAMPLES OF OBSERVATIONAL, 1514 00:52:04,360 --> 00:52:07,280 SURVEY, AND RANDOMIZED TRIALS 1515 00:52:07,280 --> 00:52:08,920 WITH BLOOD DONORS. 1516 00:52:08,920 --> 00:52:11,920 SO HOWEVER THESE STUDIES MUST BE 1517 00:52:11,920 --> 00:52:12,720 CONSIDERED NESTED, INTERACTING 1518 00:52:12,720 --> 00:52:15,480 INFLUENCES ON DONATION AND 1519 00:52:15,480 --> 00:52:16,960 BEHAVIOR OVER TIME INCLUDING 1520 00:52:16,960 --> 00:52:17,960 INDIVIDUAL RELATIONSHIP 1521 00:52:17,960 --> 00:52:19,000 ORGANIZATIONAL AND SOCIETAL 1522 00:52:19,000 --> 00:52:19,600 FACTORS. 1523 00:52:19,600 --> 00:52:22,320 SO, IN THIS DIAGRAM YOU SEE THE 1524 00:52:22,320 --> 00:52:24,160 INDIVIDUAL INFLUENCES SUCH AS 1525 00:52:24,160 --> 00:52:33,880 ALTRUISM, BENEVOLENCE, 1526 00:52:33,880 --> 00:52:35,880 VASOVAGAL, FAMILY, PEER, ONLINE 1527 00:52:35,880 --> 00:52:38,600 SOCIAL NETWORKS WHICH, AGAIN, IS 1528 00:52:38,600 --> 00:52:41,640 NESTED WITHIN ORGANIZATIONAL 1529 00:52:41,640 --> 00:52:43,520 INFLUENCES, ACCESS TO DONATION, 1530 00:52:43,520 --> 00:52:44,800 OPPORTUNITIES, CULTURALLY 1531 00:52:44,800 --> 00:52:48,800 TAILORED COMMUNICATION, AND 1532 00:52:48,800 --> 00:52:52,800 INCENTIVES, AND THEN SOCIETY'S 1533 00:52:52,800 --> 00:52:53,720 INFLUENCE, TRUST, ACCESS, 1534 00:52:53,720 --> 00:52:58,360 TREATMENT BASED ON RACE, 1535 00:52:58,360 --> 00:52:59,640 ETHNICITY, SEXUAL ORIENTATION. 1536 00:52:59,640 --> 00:53:00,240 COMMUNITY-BASED PARTICIPATORY 1537 00:53:00,240 --> 00:53:02,440 RESEARCH WILL BE PARTICULARLY 1538 00:53:02,440 --> 00:53:03,040 VALUABLE IN ASSURING ACCURATE 1539 00:53:03,040 --> 00:53:05,760 CONSIDERATION OF ALL THESE 1540 00:53:05,760 --> 00:53:12,280 FACTORS AND NESTED INFLUENCES ON 1541 00:53:12,280 --> 00:53:14,320 DONATION BEHAVIOR. 1542 00:53:14,320 --> 00:53:15,720 DRAFT PRIORITY NUMBER 2, DONOR 1543 00:53:15,720 --> 00:53:16,040 EXPERIENCE. 1544 00:53:16,040 --> 00:53:17,440 THE QUESTION IS WHAT IS THE 1545 00:53:17,440 --> 00:53:19,120 DONOR'S EXPERIENCE FROM THE 1546 00:53:19,120 --> 00:53:19,960 DONOR PERSPECTIVE? 1547 00:53:19,960 --> 00:53:22,960 HOW DOES IT VARY AND HOW DOES IT 1548 00:53:22,960 --> 00:53:25,680 RELATE TO SUBSEQUENT DONOR 1549 00:53:25,680 --> 00:53:26,440 BEHAVIOR? 1550 00:53:26,440 --> 00:53:28,600 THE PROBLEM IS, BLOOD DONATION 1551 00:53:28,600 --> 00:53:30,480 EXPERIENCES APPEAR TO INFLUENCE 1552 00:53:30,480 --> 00:53:32,400 SUBSEQUENT DONATION PRACTICES. 1553 00:53:32,400 --> 00:53:35,680 BUT MOST ASPECTS OF THIS 1554 00:53:35,680 --> 00:53:40,440 EXPERIENCE OUTSIDE OF TH ADVERSE 1555 00:53:40,440 --> 00:53:41,840 REACTIONS RECEIVED LITTLE 1556 00:53:41,840 --> 00:53:42,280 ATTENTION. 1557 00:53:42,280 --> 00:53:43,520 IT IS OPERATIONALIZED BY 1558 00:53:43,520 --> 00:53:44,680 RESEARCHERS RATHER THAN DEFINED 1559 00:53:44,680 --> 00:53:47,080 OR EXPLORED WITH THE RESEARCH 1560 00:53:47,080 --> 00:53:47,960 PARTICIPANTS. 1561 00:53:47,960 --> 00:53:49,760 THE IMPACT OF DONOR DIVERSITY IS 1562 00:53:49,760 --> 00:53:52,760 RARELY ADDRESSED IN THESE 1563 00:53:52,760 --> 00:53:53,760 STUDIES AS WELL. 1564 00:53:53,760 --> 00:53:56,720 SO WHY IS THIS AN ISSUE? 1565 00:53:56,720 --> 00:53:58,240 DONOR RECRUITMENT AND RETENTION 1566 00:53:58,240 --> 00:54:01,280 EFFORTS COULD BE CUSTOMIZED TO 1567 00:54:01,280 --> 00:54:03,240 BE MORE EFFECTIVE WITH IN DEPTH 1568 00:54:03,240 --> 00:54:05,720 AND AWARE UNDERSTANDING OF DONOR 1569 00:54:05,720 --> 00:54:06,080 EXPERIENCE. 1570 00:54:06,080 --> 00:54:09,000 FOR INSTANCE, WHAT ARE THE 1571 00:54:09,000 --> 00:54:10,320 DONOR'S PERCEPTIONS, WHAT DO 1572 00:54:10,320 --> 00:54:12,960 THEY UNDERSTAND ABOUT 1573 00:54:12,960 --> 00:54:13,800 ELIGIBILITY CRITERIA AND 1574 00:54:13,800 --> 00:54:15,640 DEFERRAL AND RECENT CHANGES TO 1575 00:54:15,640 --> 00:54:17,280 SOME CRITERIA. 1576 00:54:17,280 --> 00:54:18,320 DO THEY UNDERSTAND THE SCREENING 1577 00:54:18,320 --> 00:54:19,600 QUESTIONS AND WHY THEY ANSWER 1578 00:54:19,600 --> 00:54:21,760 THE WAY THEY DO? 1579 00:54:21,760 --> 00:54:23,920 HOW DOES THIS PERCEPTION 1580 00:54:23,920 --> 00:54:27,040 MOTIVATE OR DETER DONATION 1581 00:54:27,040 --> 00:54:27,400 BEHAVIOR? 1582 00:54:27,400 --> 00:54:29,120 AND WE MEAN THAT OUR 1583 00:54:29,120 --> 00:54:30,680 UNDERSTANDING OF THE DONOR 1584 00:54:30,680 --> 00:54:33,040 EXPERIENCE NEEDS TO INCORPORATE 1585 00:54:33,040 --> 00:54:33,960 ELEMENTS LIKE DEMOGRAPHIC 1586 00:54:33,960 --> 00:54:36,200 DIVERSITY, TYPE OF DONATION THEY 1587 00:54:36,200 --> 00:54:39,200 ARE ABOUT TO MAKE, DONOR CAREER 1588 00:54:39,200 --> 00:54:41,400 STAGE AND FREQUENCY, GEOGRAPHY, 1589 00:54:41,400 --> 00:54:44,640 DONATION LOCATION, AND OTHER 1590 00:54:44,640 --> 00:54:49,480 INTERACTING FACTORS. 1591 00:54:49,480 --> 00:54:50,480 INDIVIDUAL PERCEPTIONS 1592 00:54:50,480 --> 00:54:51,480 OBJECTIVELY SIMILAR EXPERIENCES 1593 00:54:51,480 --> 00:54:53,120 OFTEN VARY, AND BLOOD DONATION 1594 00:54:53,120 --> 00:54:54,920 IS LIKELY NO EXCEPTION. 1595 00:54:54,920 --> 00:54:57,000 WE NEED TO SAMPLE DIVERSE 1596 00:54:57,000 --> 00:54:59,800 DONORS, RACE AND ETHNICITY, 1597 00:54:59,800 --> 00:55:00,560 GENDER, AGE, NOVICE EXPERIENCE 1598 00:55:00,560 --> 00:55:04,200 AND THAT WILL HELP ENABLE US TO 1599 00:55:04,200 --> 00:55:06,040 EXAMINE THIS VARIATION, FROM THE 1600 00:55:06,040 --> 00:55:07,600 DONOR PERSPECTIVE DO THEY FEEL 1601 00:55:07,600 --> 00:55:08,880 WELCOME OR VALUED WHEN THEY COME 1602 00:55:08,880 --> 00:55:10,080 TO THE CENTER WHEN DEALING WITH 1603 00:55:10,080 --> 00:55:12,600 THE FRONT LINE STAFF? 1604 00:55:12,600 --> 00:55:13,800 ARE TIME COMMITMENTS BEING 1605 00:55:13,800 --> 00:55:14,200 UPHELD? 1606 00:55:14,200 --> 00:55:15,520 AND FOR THE FRONT LINE STAFF 1607 00:55:15,520 --> 00:55:17,080 THAT DEALS WITH THESE DONORS DAY 1608 00:55:17,080 --> 00:55:20,560 IN AND DAY OUT ARE THERE FACTORS 1609 00:55:20,560 --> 00:55:22,200 AND INFLUENCES THAT LEAVE THEY 1610 00:55:22,200 --> 00:55:23,920 WILL WELL OR ILL EQUIPPED TO 1611 00:55:23,920 --> 00:55:27,120 PROVIDE THE EXPERIENCE THE DONOR 1612 00:55:27,120 --> 00:55:29,880 WANTS AND EXPECTS? GIVEN THE 1613 00:55:29,880 --> 00:55:30,480 COALS OF BOLSTERING 1614 00:55:30,480 --> 00:55:31,920 SUSTAINABILITY OF THE BLOOD 1615 00:55:31,920 --> 00:55:34,440 SUPPLY AND ADVANCING HEALTH 1616 00:55:34,440 --> 00:55:35,040 EQUITY, RESEARCH MUST INCLUDE 1617 00:55:35,040 --> 00:55:38,600 PER SPECK PERSPECTIVES AND 1618 00:55:38,600 --> 00:55:45,400 PEOPLE OF COLOR. 1619 00:55:45,400 --> 00:55:46,600 MORE MAXIMUM IMPACT RESEARCH 1620 00:55:46,600 --> 00:55:48,480 SHOULD EXAMINE RELATIONSHIP 1621 00:55:48,480 --> 00:55:49,040 BETWEEN DONOR EXPERIENCE, 1622 00:55:49,040 --> 00:55:55,120 REPORTED BEHAVIOR. 1623 00:55:55,120 --> 00:56:00,520 PROPOSED RESEARCH APPROACH IS 1624 00:56:00,520 --> 00:56:03,320 LIKE A RESEARCH TRAJECTORY THAT 1625 00:56:03,320 --> 00:56:05,960 STARTS WITH RESEARCH AND MOVES 1626 00:56:05,960 --> 00:56:08,000 TO MIXED METHOD AND HYPOTHESIS 1627 00:56:08,000 --> 00:56:10,640 TESTING, THEN INTO 1628 00:56:10,640 --> 00:56:11,360 EVIDENCE-BASED INTERVENTIONS, 1629 00:56:11,360 --> 00:56:13,000 AND TESTING WITH EVENTUALLY 1630 00:56:13,000 --> 00:56:14,400 GETTING TO TRANSLATIONAL 1631 00:56:14,400 --> 00:56:18,320 RESEARCH PUTTING THESE EFFECTIVE 1632 00:56:18,320 --> 00:56:19,680 INTERVENTIONS INTO PLACE. 1633 00:56:19,680 --> 00:56:21,640 IT'S IMPORTANT TO ENGAGE WITH 1634 00:56:21,640 --> 00:56:22,160 UNDEREXPLORED POTENTIAL 1635 00:56:22,160 --> 00:56:25,320 INFLUENCES ON THE DONOR 1636 00:56:25,320 --> 00:56:25,760 EXPERIENCE. 1637 00:56:25,760 --> 00:56:26,480 EMOTIONS, SOCIAL FACTORS, 1638 00:56:26,480 --> 00:56:28,760 EVERYDAY LIFE EXPERIENCE OUTSIDE 1639 00:56:28,760 --> 00:56:31,520 OF DONATIONS. 1640 00:56:31,520 --> 00:56:33,000 CULTURAL DYNAMICS, INEQUALITY, 1641 00:56:33,000 --> 00:56:36,720 DONOR CENTER ENVIRONMENT. 1642 00:56:36,720 --> 00:56:37,960 APPROPRIATE STUDY DESIGNS WILL 1643 00:56:37,960 --> 00:56:40,520 VARY DEPENDING WHAT STAGE OF THE 1644 00:56:40,520 --> 00:56:45,360 RESEARCH TRAJECTORY THAT YOU'RE 1645 00:56:45,360 --> 00:56:46,360 IN. 1646 00:56:46,360 --> 00:56:48,320 WHAT IS FEASIBILITY AND 1647 00:56:48,320 --> 00:56:48,920 BARRIERS? 1648 00:56:48,920 --> 00:56:50,600 WELL, RESEARCH METHODS AND TOOLS 1649 00:56:50,600 --> 00:56:55,200 ESSENTIAL TO ADDRESS QUESTIONS 1650 00:56:55,200 --> 00:56:58,280 ARE WIDELY ACCESSIBLE, 1651 00:56:58,280 --> 00:56:58,880 MULTI-METHOD, THEORY-INFORMED 1652 00:56:58,880 --> 00:57:01,520 LONGITUDINAL APPROACHES. 1653 00:57:01,520 --> 00:57:02,520 THERE ARE CHALLENGES, POTENTIAL 1654 00:57:02,520 --> 00:57:13,040 LOW LOGISTIC PARTNERING WITH 1655 00:57:14,240 --> 00:57:15,360 BLOOD ORGANIZATIONS, ALSO 1656 00:57:15,360 --> 00:57:16,640 ANALYTICAL CHALLENGE, COMPLEXITY 1657 00:57:16,640 --> 00:57:19,240 OF HUMAN EXPERIENCE, IDENTIFYING 1658 00:57:19,240 --> 00:57:20,480 MULTIPLE INFLUENCES AND 1659 00:57:20,480 --> 00:57:22,360 UNDERSTANDING INTERACTION WHICH 1660 00:57:22,360 --> 00:57:25,320 MAY DIFFER ACROSS PARTICIPANTS 1661 00:57:25,320 --> 00:57:27,440 AND DONORS. 1662 00:57:27,440 --> 00:57:28,080 EVENTUALLY, MULTI-SITE TRIALS OF 1663 00:57:28,080 --> 00:57:30,320 POSSIBLE INTERVENTIONS WILL BE 1664 00:57:30,320 --> 00:57:31,560 NEEDED AS GEOGRAPHY, REGION IN 1665 00:57:31,560 --> 00:57:33,840 THE UNITED STATES MAY INFLUENCE 1666 00:57:33,840 --> 00:57:37,760 DONOR'S PERSPECTIVE AND THEIR 1667 00:57:37,760 --> 00:57:38,360 BEHAVIOR. 1668 00:57:38,360 --> 00:57:38,960 TRANSLATING EFFECTIVE 1669 00:57:38,960 --> 00:57:41,000 INTERVENTIONS INTO PRACTICE MAY 1670 00:57:41,000 --> 00:57:43,400 ALSO PROVE CHALLENGING AS BLOOD 1671 00:57:43,400 --> 00:57:48,360 COLLECTION ORGANIZATIONS FACE 1672 00:57:48,360 --> 00:57:49,360 MANY CONSTRAINTS. 1673 00:57:49,360 --> 00:57:51,280 DRAFT PRIORITY NUMBER 3, 1674 00:57:51,280 --> 00:57:54,320 INCENTIVES AND COMPENSATION. 1675 00:57:54,320 --> 00:57:56,560 SO WHAT INCENTIVE STRATEGIES 1676 00:57:56,560 --> 00:57:59,440 MOST EFFECTIVELY DRIVE BLOOD 1677 00:57:59,440 --> 00:58:00,440 DONATION? 1678 00:58:00,440 --> 00:58:03,040 FOR VARIOUS TYPES OF DONORS, HOW 1679 00:58:03,040 --> 00:58:04,960 WOULD OFFERING COMPENSATION FOR 1680 00:58:04,960 --> 00:58:06,640 BLOOD IMPACT DONOR BEHAVIOR IN 1681 00:58:06,640 --> 00:58:07,760 THE BLOOD SUPPLY? 1682 00:58:07,760 --> 00:58:10,880 THE PROBLEM IN THE UNITED STATES 1683 00:58:10,880 --> 00:58:21,360 THE BLOOD SYSTEM IS BASED ON 1684 00:58:22,400 --> 00:58:23,640 VOLUNTARY DONORS, OFFERING 1685 00:58:23,640 --> 00:58:26,160 INCENTIVES HAVE NOT STABILIZED 1686 00:58:26,160 --> 00:58:27,400 INVENTORIES UP TO NOW. 1687 00:58:27,400 --> 00:58:29,040 WHY IS THIS AN ISSUE? 1688 00:58:29,040 --> 00:58:30,680 THERE'S A NEED TO UNDERSTAND 1689 00:58:30,680 --> 00:58:35,360 CURRENT IMPLEMENTATION AND 1690 00:58:35,360 --> 00:58:38,360 IMPACT OF INCENTIVIZATION, 1691 00:58:38,360 --> 00:58:40,160 RESEARCH MAY IMPROVE THE 1692 00:58:40,160 --> 00:58:43,080 STABILITY AND EFFICIENCY OF THE 1693 00:58:43,080 --> 00:58:45,280 BLOOD SYSTEM. 1694 00:58:45,280 --> 00:58:47,840 WHAT IS THE PROPOSED RESEARCH? 1695 00:58:47,840 --> 00:58:48,880 RESEARCH ON INCENTIVE STRATEGIES 1696 00:58:48,880 --> 00:58:51,600 AND THEIR IMPACT WILL REQUIRE 1697 00:58:51,600 --> 00:58:56,040 MULTI-PHASED TRAJECTORY WITH 1698 00:58:56,040 --> 00:58:56,880 FORMATIVE RESEARCH, 1699 00:58:56,880 --> 00:58:57,760 HYPOTHESIS-TESTING AND STUDIES. 1700 00:58:57,760 --> 00:59:00,240 QUESTIONS ARE TO FIND OUT WHAT 1701 00:59:00,240 --> 00:59:01,400 DO DONORS UNDERSTAND AS 1702 00:59:01,400 --> 00:59:04,240 INCENTIVES AND WHAT ARE 1703 00:59:04,240 --> 00:59:06,320 PREFERENCES? 1704 00:59:06,320 --> 00:59:10,360 WHEN WE THINK OF INCENTIVE IT 1705 00:59:10,360 --> 00:59:15,640 COULD BE T-SHIRTS, MUST BE, 1706 00:59:15,640 --> 00:59:20,200 SWEATSHIRTS, OR TIME OFF, 1707 00:59:20,200 --> 00:59:21,600 RAFFLES, POSSIBLY AND INCLUDING 1708 00:59:21,600 --> 00:59:22,400 MONEY. 1709 00:59:22,400 --> 00:59:29,760 WE NEED TO EXAMINE ROLE OF 1710 00:59:29,760 --> 00:59:30,360 INCENTIVES ACCOUNTING FOR 1711 00:59:30,360 --> 00:59:31,520 PRESENTING BARRIERS. 1712 00:59:31,520 --> 00:59:33,960 AS FAR AS MOTIVATORS GO, DO 1713 00:59:33,960 --> 00:59:34,880 INCENTIVES DRIVE BEHAVIOR? 1714 00:59:34,880 --> 00:59:36,520 THERE ARE MANY COUNTRIES THAT DO 1715 00:59:36,520 --> 00:59:38,600 NOT GIVE INCENTIVES AND DON'T 1716 00:59:38,600 --> 00:59:40,040 HAVE TROUBLE RECRUITING DONORS 1717 00:59:40,040 --> 00:59:41,800 BUT IN THE UNITED STATES DOES IT 1718 00:59:41,800 --> 00:59:42,480 DRIVE BEHAVIOR? 1719 00:59:42,480 --> 00:59:44,440 WILL IT HELP WITH GOAL OF 1720 00:59:44,440 --> 00:59:45,840 RECRUITING THE YOUNGER AND MORE 1721 00:59:45,840 --> 00:59:47,600 DIVERSE DONOR? 1722 00:59:47,600 --> 00:59:51,120 AND THE BARRIERS ARE, WELL, 1723 00:59:51,120 --> 00:59:52,920 WOULD OTHERS NOT WANT 1724 00:59:52,920 --> 00:59:55,400 COMPENSATION, WOULD IT BE A 1725 00:59:55,400 --> 00:59:57,040 BUSINESS TRANSACTION? 1726 00:59:57,040 --> 00:59:59,160 SO WE NEED TO HAVE ANALYSIS DONE 1727 00:59:59,160 --> 01:00:00,800 ON THE IMPACT AND MULTIPLE 1728 01:00:00,800 --> 01:00:04,440 FACTORS SUCH AS RACE, ETHNICITY, 1729 01:00:04,440 --> 01:00:05,120 GENDER, AGE, GEOGRAPHY, DONATION 1730 01:00:05,120 --> 01:00:07,720 FREQUENCY AND HOW THAT PLAYS 1731 01:00:07,720 --> 01:00:09,400 INTO INCENTIVE STRATEGIES. 1732 01:00:09,400 --> 01:00:11,720 AND STUDIES MUST BE LONGITUDINAL 1733 01:00:11,720 --> 01:00:14,040 TO DOCUMENT CHANGES IN DONOR 1734 01:00:14,040 --> 01:00:14,880 ATTITUDE, BEHAVIOR AND 1735 01:00:14,880 --> 01:00:16,240 EXPECTATION OVER TIME, AS WELL 1736 01:00:16,240 --> 01:00:21,920 AS IMPACT OF THESE STRATEGIES ON 1737 01:00:21,920 --> 01:00:24,480 BLOOD CENTERS AND SUPPLY. 1738 01:00:24,480 --> 01:00:25,160 IN CONTINUING WITH PROPOSED 1739 01:00:25,160 --> 01:00:28,160 APPROACHES WE NEED TO EVALUATE 1740 01:00:28,160 --> 01:00:29,440 IMPACT OF INTRODUCING A 1741 01:00:29,440 --> 01:00:30,920 COMPENSATED BLOOD COLLECTION IN 1742 01:00:30,920 --> 01:00:32,920 TERMS OF BLOOD SAFETY, 1743 01:00:32,920 --> 01:00:36,360 AVAILABILITY, MOTIVATION TO GIVE 1744 01:00:36,360 --> 01:00:38,600 OR CONTRIBUTE AND COST 1745 01:00:38,600 --> 01:00:39,120 STRUCTURE. 1746 01:00:39,120 --> 01:00:43,600 I HAVE TO SAY WORKING GROUP 1 1747 01:00:43,600 --> 01:00:52,640 SPENT CONSIDERABLE AMOUNT OF 1748 01:00:52,640 --> 01:00:53,600 TIME TO DETERMINE WORDING. 1749 01:00:53,600 --> 01:00:55,280 MAYBE IT SHOULD BE VENDOR, 1750 01:00:55,280 --> 01:00:57,200 BECAUSE THEY ARE NOT A DONOR 1751 01:00:57,200 --> 01:00:59,160 BECAUSE THEY ARE GETTING PAID, 1752 01:00:59,160 --> 01:01:02,000 OR JUST CONTRIBUTOR? 1753 01:01:02,000 --> 01:01:05,320 AND ALSO FROM THE BLOOD CENTER 1754 01:01:05,320 --> 01:01:05,920 STANDPOINT, INDUSTRY STANDPOINT, 1755 01:01:05,920 --> 01:01:08,320 IF WE ARE GOING TO PAY DONORS TO 1756 01:01:08,320 --> 01:01:10,760 DONATE BLOOD WILL THE COST OF A 1757 01:01:10,760 --> 01:01:12,280 PAID DONOR MODEL BE PASSED TO 1758 01:01:12,280 --> 01:01:13,200 THE HOSPITALS? 1759 01:01:13,200 --> 01:01:15,120 WILL THIS SET UP A COST WAR 1760 01:01:15,120 --> 01:01:16,160 BETWEEN BLOOD CENTERS WHERE YOU 1761 01:01:16,160 --> 01:01:18,400 CAN GET PAID A CERTAIN AMOUNT AT 1762 01:01:18,400 --> 01:01:19,360 ONE BLOOD CENTER, DOWN THE 1763 01:01:19,360 --> 01:01:21,240 STREET FURTHER THEY WILL PAY YOU 1764 01:01:21,240 --> 01:01:26,160 A LITTLE BIT MORE FOR THE SAME 1765 01:01:26,160 --> 01:01:30,480 PRODUCT THAT YOU'RE DONATING. 1766 01:01:30,480 --> 01:01:31,920 AGAIN, WE NEED TO INVESTIGATE 1767 01:01:31,920 --> 01:01:33,640 HOW THIS IMPACT MIGHT DEPEND ON 1768 01:01:33,640 --> 01:01:35,840 WHAT PRODUCTS, WHAT COULD BE 1769 01:01:35,840 --> 01:01:36,440 INCLUDED FOR COMPENSATION, HOW 1770 01:01:36,440 --> 01:01:38,320 MUCH AND WHAT TYPE OF 1771 01:01:38,320 --> 01:01:39,040 COMPENSATION IS OFFERED. 1772 01:01:39,040 --> 01:01:41,240 SO ARE WE GOING TO COMPENSATE 1773 01:01:41,240 --> 01:01:43,160 FOR PLATELETS OR PLASMA OR RED 1774 01:01:43,160 --> 01:01:44,280 CELLS? 1775 01:01:44,280 --> 01:01:45,720 AND WILL OUR DONORS UNDERSTAND 1776 01:01:45,720 --> 01:01:49,120 WHY SOME GET PAID MONEY, SOME 1777 01:01:49,120 --> 01:01:49,680 DON'T? 1778 01:01:49,680 --> 01:01:50,880 DOES IT CHANGE DONATION 1779 01:01:50,880 --> 01:01:51,400 PRACTICES? 1780 01:01:51,400 --> 01:01:55,200 WILL EVERYBODY SWITCH TO 1781 01:01:55,200 --> 01:01:56,160 WHATEVER PRODUCT, WHERE THEY GET 1782 01:01:56,160 --> 01:01:56,360 PAID? 1783 01:01:56,360 --> 01:01:57,560 HOW MUCH MONEY IS ENOUGH TO 1784 01:01:57,560 --> 01:02:01,520 AGAIN COMPENSATE? 1785 01:02:01,520 --> 01:02:02,720 ARE YOU COMPENSATING FOR TIME? 1786 01:02:02,720 --> 01:02:06,120 IS IT THE MINIMUM WAGE, WHAT ARE 1787 01:02:06,120 --> 01:02:10,280 WE LOOKING AT HERE? 1788 01:02:10,280 --> 01:02:16,600 ALSO HOW DONOR IDENTITY MIGHT 1789 01:02:16,600 --> 01:02:16,960 EVOLVE. 1790 01:02:16,960 --> 01:02:19,520 THE IMPACT OF BECOMING A PAID 1791 01:02:19,520 --> 01:02:20,240 DONOR MAY CHANGE THAT. 1792 01:02:20,240 --> 01:02:23,520 DOES IT HAVE A POSITIVE OR 1793 01:02:23,520 --> 01:02:25,000 NEGATIVE SPIN? 1794 01:02:25,000 --> 01:02:26,880 IT'S POSSIBLE THAT WE MAY OFFEND 1795 01:02:26,880 --> 01:02:28,720 OR POSSIBLY LOSE LOYAL BLOOD 1796 01:02:28,720 --> 01:02:31,240 DONORS WHO WERE NEVER PAID IN 1797 01:02:31,240 --> 01:02:32,800 THE PAST, NOW INSULTED THAT THEY 1798 01:02:32,800 --> 01:02:34,280 COULD HAVE BEEN DOING IT FOR 1799 01:02:34,280 --> 01:02:36,720 MONEY AND DON'T UNDERSTAND THE 1800 01:02:36,720 --> 01:02:40,120 TRANSITION TO A COMPENSATED 1801 01:02:40,120 --> 01:02:40,600 MODEL. 1802 01:02:40,600 --> 01:02:41,760 BECAUSE COMPENSATED COLLECTION 1803 01:02:41,760 --> 01:02:43,600 OF CERTAIN COMPONENTS OCCURS IN 1804 01:02:43,600 --> 01:02:54,160 THE U.S., RESEARCH THAT EXPLORES 1805 01:02:56,400 --> 01:02:57,000 NON-REMUNERATED, OVERALL 1806 01:02:57,000 --> 01:02:59,120 COMPARISONS WITH PLASMA INDUSTRY 1807 01:02:59,120 --> 01:03:00,120 MAY BE INSTRUCTIVE. 1808 01:03:00,120 --> 01:03:02,720 WHAT ARE THE FEASIBILITY AND 1809 01:03:02,720 --> 01:03:04,200 BARRIERS? 1810 01:03:04,200 --> 01:03:07,600 AS LONG AS THE REPORTED 1811 01:03:07,600 --> 01:03:10,280 PREFERENCE CAN CAN BE LINKED TO 1812 01:03:10,280 --> 01:03:13,160 BEHAVIOR IT CAN BE PERFORM WITH 1813 01:03:13,160 --> 01:03:16,120 SURVEYS, INTERVIEWS, FOCUS 1814 01:03:16,120 --> 01:03:18,120 GROUPS, EXPERIMENTAL DESIGNS. 1815 01:03:18,120 --> 01:03:18,920 EFFECTS OF OFFERING FINANCIAL 1816 01:03:18,920 --> 01:03:21,480 COMPENSATION FOR BLOOD ARE 1817 01:03:21,480 --> 01:03:22,280 UNKNOWN. 1818 01:03:22,280 --> 01:03:23,080 AND ANY EVENTUAL INTERVENTION 1819 01:03:23,080 --> 01:03:25,440 STUDY SHOULD BE CONDUCTED IN 1820 01:03:25,440 --> 01:03:27,800 MULTIPLE LOCATIONS, TO PROVIDE 1821 01:03:27,800 --> 01:03:29,200 CONTEXT TO THE IMPACT. 1822 01:03:29,200 --> 01:03:31,040 FURTHER, THIS RESEARCH WILL NEED 1823 01:03:31,040 --> 01:03:34,120 TO BE LONGITUDINAL TO DOCUMENT 1824 01:03:34,120 --> 01:03:35,640 DISRUPTION OF THE CURRENT 1825 01:03:35,640 --> 01:03:37,520 UNREMUNERATED MODEL AND 1826 01:03:37,520 --> 01:03:40,040 CONSEQUENCES DRIVEN BY 1827 01:03:40,040 --> 01:03:42,080 ADJUSTMENTS TO IT. 1828 01:03:42,080 --> 01:03:45,440 NOW, DRAFT PRIORITY NUMBER 4, 1829 01:03:45,440 --> 01:03:46,480 MESSAGING AND CHANNELED, THE 1830 01:03:46,480 --> 01:03:48,240 QUESTION IS, IN TERMS OF 1831 01:03:48,240 --> 01:03:50,200 COMMUNICATING WITH DIVERSE BLOOD 1832 01:03:50,200 --> 01:03:51,680 DONORS AND POTENTIAL DONORS, 1833 01:03:51,680 --> 01:03:53,680 WHAT ARE THE CHARACTERISTICS TO 1834 01:03:53,680 --> 01:03:55,360 WHICH MESSAGES SHOULD BE 1835 01:03:55,360 --> 01:03:57,360 TAILORED, WHAT CONTENT IS MOST 1836 01:03:57,360 --> 01:03:59,000 RESONANT, WHICH CHANNELS AND 1837 01:03:59,000 --> 01:04:01,040 MODALITIES ARE MOST EFFECTIVE 1838 01:04:01,040 --> 01:04:04,120 AND HOW CAN EFFECTIVENESS BE 1839 01:04:04,120 --> 01:04:04,560 MARRIED? 1840 01:04:04,560 --> 01:04:07,320 THE PROBLEM IS IN AN AGE OF 1841 01:04:07,320 --> 01:04:10,440 EXTENSIVE DATA INFORMED TARGET 1842 01:04:10,440 --> 01:04:14,080 MARKETING, THE PRESUMPTION IS 1843 01:04:14,080 --> 01:04:15,080 THAT RELEVANCE AND 1844 01:04:15,080 --> 01:04:16,680 PERSUASIVENESS CAN BE ENCHANCED 1845 01:04:16,680 --> 01:04:18,040 THROUGH TAILORING YET THERE'S 1846 01:04:18,040 --> 01:04:22,160 LITTLE RESEARCH ON SUCH EFFORTS 1847 01:04:22,160 --> 01:04:23,720 FOR BLOOD DONATION IN THE U.S. 1848 01:04:23,720 --> 01:04:24,000 ENVIRONMENT. 1849 01:04:24,000 --> 01:04:28,760 SO WHY IS THIS AN ISSUE? 1850 01:04:28,760 --> 01:04:29,840 COMMUNICATION CHANNELS, 1851 01:04:29,840 --> 01:04:33,440 EFFECTIVE MESSAGING, TECHNOLOGY 1852 01:04:33,440 --> 01:04:35,200 CHANGES OCCUR SO RAPIDLY, 1853 01:04:35,200 --> 01:04:36,880 CENTERS MAY NOT MAXIMIZE USE OF 1854 01:04:36,880 --> 01:04:37,800 DOLLARS AND OPPORTUNITIES, 1855 01:04:37,800 --> 01:04:39,320 IMPACTING THEIR ABILITY TO REACH 1856 01:04:39,320 --> 01:04:41,440 NEW AND EXISTING BLOOD DONORS TO 1857 01:04:41,440 --> 01:04:44,160 ENSURE ADEQUATE BLOOD SUPPLY FOR 1858 01:04:44,160 --> 01:04:44,320 ALL. 1859 01:04:44,320 --> 01:04:46,800 STUDIES ARE NEEDED TO ASCERTAIN 1860 01:04:46,800 --> 01:04:49,760 HOW TO TAILOR AND DELIVER THIS 1861 01:04:49,760 --> 01:04:50,960 COMMUNICATION ACROSS DIVERSE 1862 01:04:50,960 --> 01:04:53,520 SUBPOPULATIONS OF PATIENTS, I'M 1863 01:04:53,520 --> 01:04:54,640 SORRY, DONORS, HARNESSING POWER 1864 01:04:54,640 --> 01:04:57,200 TO DRIVE BLOOD DONATION MAY HELP 1865 01:04:57,200 --> 01:05:00,120 ENSURE SUFFICIENCY OF BLOOD 1866 01:05:00,120 --> 01:05:00,480 SUPPLY. 1867 01:05:00,480 --> 01:05:03,960 WHAT WOULD BE THE PROPOSED 1868 01:05:03,960 --> 01:05:04,600 APPROACH? 1869 01:05:04,600 --> 01:05:08,200 BASIC RESEARCH IS NECESSARY TO 1870 01:05:08,200 --> 01:05:08,680 DETERMINE APPROPRIATE 1871 01:05:08,680 --> 01:05:11,080 SEGMENTATION PRACTICES FOR 1872 01:05:11,080 --> 01:05:12,640 POTENTIAL DONORS. 1873 01:05:12,640 --> 01:05:20,280 SO EVIDENCE SUGGESTS THAT 1874 01:05:20,280 --> 01:05:21,520 RACIAL, ETHNIC, GEOGRAPHIC AND 1875 01:05:21,520 --> 01:05:22,720 DONATION PRODUCT BASED GROUPS 1876 01:05:22,720 --> 01:05:24,960 MIGHT BE RELEVANT BUT TARGETING 1877 01:05:24,960 --> 01:05:28,760 MIGHT BE EQUALLY OR MORE 1878 01:05:28,760 --> 01:05:29,480 EFFECTIVE. 1879 01:05:29,480 --> 01:05:30,920 NEED TO DETERMINE WHAT CONTENT 1880 01:05:30,920 --> 01:05:31,880 RESONATES FOR EACH GROUP. 1881 01:05:31,880 --> 01:05:35,320 IN OTHER WORDS, IS IT A POSITIVE 1882 01:05:35,320 --> 01:05:36,480 MESSAGE THAT WE'VE USED LIKE 1883 01:05:36,480 --> 01:05:40,080 SAVE A LIFE OR IS IT A REALISTIC 1884 01:05:40,080 --> 01:05:41,640 MESSAGE, WE HAVE HORRIBLE BLOOD 1885 01:05:41,640 --> 01:05:42,640 SHORTAGE, NOT ENOUGH BLOOD TO 1886 01:05:42,640 --> 01:05:45,920 TAKE CARE OF PATIENTS, SURGERIES 1887 01:05:45,920 --> 01:05:47,480 CANCELED, WHICH CONTENT 1888 01:05:47,480 --> 01:05:49,440 RESONATES FOR EACH GROUP? 1889 01:05:49,440 --> 01:05:51,240 EFFECTIVENESS IS LINKED TO DONOR 1890 01:05:51,240 --> 01:05:52,440 MOTIVATION, THIS TYPE OF 1891 01:05:52,440 --> 01:05:55,280 RESEARCH SHOULD SEEK TO EXPLAIN 1892 01:05:55,280 --> 01:05:57,720 NOT ONLY WHAT WORKS BUT WHY IT 1893 01:05:57,720 --> 01:05:58,080 WORKS. 1894 01:05:58,080 --> 01:05:59,880 AND EVALUATE THE IMPACT OF 1895 01:05:59,880 --> 01:06:01,520 DIFFERENT DELIVERY CHANNELS FOR 1896 01:06:01,520 --> 01:06:02,120 THESE MESSAGES. 1897 01:06:02,120 --> 01:06:04,320 THE INTENT IS YOU WANT TO MAKE 1898 01:06:04,320 --> 01:06:08,160 SURE THE MESSAGING INCREASES 1899 01:06:08,160 --> 01:06:08,760 VISIBILITY, RELATABILITY, 1900 01:06:08,760 --> 01:06:09,640 COMPREHENSION AROUND THE NEED 1901 01:06:09,640 --> 01:06:14,640 FOR DONATION AND WILL MOVE 1902 01:06:14,640 --> 01:06:15,760 DONORS TOWARD WILLINGNESS TO 1903 01:06:15,760 --> 01:06:16,160 DONATE. 1904 01:06:16,160 --> 01:06:19,400 YOU HAVE TO WATCH POSITIVE 1905 01:06:19,400 --> 01:06:23,240 VERSUS OVERDOING IT. 1906 01:06:23,240 --> 01:06:30,320 I LIKE IT THE STORY ABOUT HARVEY 1907 01:06:30,320 --> 01:06:30,760 ALTER. 1908 01:06:30,760 --> 01:06:32,640 WE GET CALLS ABOUT OUR CAR 1909 01:06:32,640 --> 01:06:35,320 WARRANTY ON OUR NIH PHONES. 1910 01:06:35,320 --> 01:06:37,520 WHEN HE GOT HIS PHONE CALL ABOUT 1911 01:06:37,520 --> 01:06:39,360 WINNING THE NOBEL PRIZE HE 1912 01:06:39,360 --> 01:06:41,160 DIDN'T ANSWER UNTIL THE THIRD 1913 01:06:41,160 --> 01:06:42,360 CALL BECAUSE HE KNEW IT WAS 1914 01:06:42,360 --> 01:06:44,960 SOMETHING ABOUT A CAR WARRANTY. 1915 01:06:44,960 --> 01:06:46,080 IT WAS 4:00 IN THE MORNING BUT 1916 01:06:46,080 --> 01:06:47,440 HE DID NOT ANSWER UNTIL THE 1917 01:06:47,440 --> 01:06:49,040 THIRD PHONE CALL. 1918 01:06:49,040 --> 01:06:51,680 YOU DON'T WANT WITH THESE 1919 01:06:51,680 --> 01:06:53,360 IMPACTED DELIVERY CHANNELS TO 1920 01:06:53,360 --> 01:06:56,040 ENDS UP WITH NUMBNESS. 1921 01:06:56,040 --> 01:06:58,800 YOU WANT TO MOVE DONORS TOWARD 1922 01:06:58,800 --> 01:06:59,680 DONATION. 1923 01:06:59,680 --> 01:07:03,680 TRADITIONAL AND DIGITAL 1924 01:07:03,680 --> 01:07:12,240 CHANNELINGS ARE USED. 1925 01:07:12,240 --> 01:07:13,200 CHANNELS ARE POSSIBLE, WE HAVE 1926 01:07:13,200 --> 01:07:15,720 TO UNDERSTAND THE BEST MARKETING 1927 01:07:15,720 --> 01:07:17,200 CHANNELS FOR EACH GENERATION, 1928 01:07:17,200 --> 01:07:21,400 ETHNICITY, GENDER, AND TAKE INTO 1929 01:07:21,400 --> 01:07:23,800 ACCOUNT DIGITAL, THOSE WHO 1930 01:07:23,800 --> 01:07:25,360 ALWAYS HAD TECHNOLOGY, THOSE 1931 01:07:25,360 --> 01:07:26,760 THAT ARE IMMIGRANTS, NOT SO MUCH 1932 01:07:26,760 --> 01:07:29,840 UP ON THE TECHNOLOGY BUT WE'RE 1933 01:07:29,840 --> 01:07:31,200 TRYING REAL HARD. 1934 01:07:31,200 --> 01:07:33,440 SO THE USE OF NEW COMMUNICATION 1935 01:07:33,440 --> 01:07:36,280 TECHNOLOGY SHOULD ALSO BE 1936 01:07:36,280 --> 01:07:36,640 INVESTIGATED. 1937 01:07:36,640 --> 01:07:37,520 AND MEASURING EFFECTIVENESS OF 1938 01:07:37,520 --> 01:07:39,600 MARKETING CAN BE A CHALLENGE. 1939 01:07:39,600 --> 01:07:41,640 THEREFORE STUDIES NEED TO BE 1940 01:07:41,640 --> 01:07:45,280 CAREFULLY DESIGNED SO YOU'RE 1941 01:07:45,280 --> 01:07:47,520 ABLE TO PARSE OUT IMPACT 1942 01:07:47,520 --> 01:07:50,360 CONTENT, MODE, AND STRATEGIES. 1943 01:07:50,360 --> 01:07:52,080 IDEALLY ASSESSMENT WILL LINK 1944 01:07:52,080 --> 01:07:54,280 OUTREACH TO DONATION, AS WELL AS 1945 01:07:54,280 --> 01:07:56,520 CAPTURING THE MEANINGFUL EFFECTS 1946 01:07:56,520 --> 01:07:59,840 OF THOSE ATTEMPTS THAT FALL 1947 01:07:59,840 --> 01:08:00,680 SHORT OF DONATION. 1948 01:08:00,680 --> 01:08:06,080 WHAT IS THE FEASIBILITY AND 1949 01:08:06,080 --> 01:08:08,040 BARRIERS? 1950 01:08:08,040 --> 01:08:11,520 TESTING MESSAGES AND CHANNELS IN 1951 01:08:11,520 --> 01:08:12,600 CONTROLLED/LAB ENVIRONMENTS IS 1952 01:08:12,600 --> 01:08:12,920 FEASIBLE. 1953 01:08:12,920 --> 01:08:14,200 HOWEVER, WHEN YOU START LOOKING 1954 01:08:14,200 --> 01:08:16,760 AT REAL WORLD STUDIES YOU MAY 1955 01:08:16,760 --> 01:08:18,040 ENCOUNTER TWO MAIN CHALLENGES 1956 01:08:18,040 --> 01:08:19,840 DUE TO EXTERNAL FACTORS THAT MAY 1957 01:08:19,840 --> 01:08:21,200 THREATEN VALIDITY OF THE 1958 01:08:21,200 --> 01:08:22,360 RESEARCH FINDINGS. 1959 01:08:22,360 --> 01:08:24,520 FIRST OFF, CHANGES IN 1960 01:08:24,520 --> 01:08:25,680 ENVIRONMENT DURING THE STUDY, IN 1961 01:08:25,680 --> 01:08:28,120 OTHER WORDS UPDATES TO 1962 01:08:28,120 --> 01:08:29,840 ALGORITHMS, CHANGES IN SOCIAL 1963 01:08:29,840 --> 01:08:32,400 MEDIA PLATFORMS, SHIFTING LAWS 1964 01:08:32,400 --> 01:08:33,680 AND PRIVACY POLICIES. 1965 01:08:33,680 --> 01:08:36,920 OR PARTICIPANTS MAY OPT TO 1966 01:08:36,920 --> 01:08:37,800 DONATE BLOOD DRIVEN BY 1967 01:08:37,800 --> 01:08:39,920 INFLUENCES OUTSIDE OF THE STUDY. 1968 01:08:39,920 --> 01:08:41,560 A NATIONAL PLEA FOR BLOOD, IN 1969 01:08:41,560 --> 01:08:42,480 OTHER WORDS. 1970 01:08:42,480 --> 01:08:44,160 THE FEASIBILITY OF THE RESEARCH 1971 01:08:44,160 --> 01:08:48,000 MAY BE IMPACTED BY CURRENTLY 1972 01:08:48,000 --> 01:08:49,000 LIMITED TECHNOLOGICAL 1973 01:08:49,000 --> 01:08:50,880 CAPABILITIES OF MANY U.S. BLOOD 1974 01:08:50,880 --> 01:08:51,440 CENTERS. 1975 01:08:51,440 --> 01:08:53,320 MANY BLOOD CENTERS LACK 1976 01:08:53,320 --> 01:08:57,040 AUTOMATED ABILITY TO CONNECT 1977 01:08:57,040 --> 01:08:57,760 SPECIFIC COMMUNICATIONS, 1978 01:08:57,760 --> 01:08:59,520 STRATEGIES TO DONATIONS DUE TO 1979 01:08:59,520 --> 01:09:02,360 LACK OF SYSTEM INTEGRATION. 1980 01:09:02,360 --> 01:09:06,400 IN OTHER WORDS, MARKETING 1981 01:09:06,400 --> 01:09:07,240 DEPLOYMENT PLATFORMS. 1982 01:09:07,240 --> 01:09:09,600 OR NATURE OF SOCIAL MEDIA, MOST 1983 01:09:09,600 --> 01:09:11,640 PEOPLE USE HANDLES, THERE HAS TO 1984 01:09:11,640 --> 01:09:12,880 BE A WAY TO PULL HANDLES IN 1985 01:09:12,880 --> 01:09:14,920 BECAUSE IT MAY NOT BE A LEGAL 1986 01:09:14,920 --> 01:09:16,760 NAME. 1987 01:09:16,760 --> 01:09:22,720 CENTERS MAY STRUGGLE TO MEASURE 1988 01:09:22,720 --> 01:09:24,600 EFFECTIVENESS, TECHNOLOGY AND 1989 01:09:24,600 --> 01:09:27,280 EXPERTISE MAY EXIST EXTERNALLY. 1990 01:09:27,280 --> 01:09:31,360 NOW DRAFT PRIORITY NUMBER 5, 1991 01:09:31,360 --> 01:09:32,480 INFORMATION/COMMUNICATION 1992 01:09:32,480 --> 01:09:33,000 TECHNOLOGY. 1993 01:09:33,000 --> 01:09:36,400 THE QUESTION IS, WHAT ROLE DO 1994 01:09:36,400 --> 01:09:38,360 INFORMATION AND COMMUNICATION 1995 01:09:38,360 --> 01:09:40,200 TECHNOLOGIESES, KNOWN AS ICTs, 1996 01:09:40,200 --> 01:09:42,760 PLAY IN RAISING AWARENESS ABOUT 1997 01:09:42,760 --> 01:09:43,840 BLOOD DONATION AND RECRUITMENT 1998 01:09:43,840 --> 01:09:46,120 AND RETENTION OF BLOOD DONORS? 1999 01:09:46,120 --> 01:09:48,560 HOW CAN BLOOD COLLECTION 2000 01:09:48,560 --> 01:09:51,400 ORGANIZATIONS USE ICTs AND 2001 01:09:51,400 --> 01:09:53,680 INNOVATIVE AND INCLUSIVE WAYS? 2002 01:09:53,680 --> 01:09:56,440 THE PROBLEM IS MODERN ICTs 2003 01:09:56,440 --> 01:09:58,080 PRESENT MANY OPPORTUNITIES FOR 2004 01:09:58,080 --> 01:09:59,400 BLOOD DONATION ORGANIZATIONS TO 2005 01:09:59,400 --> 01:10:01,640 IMPROVE ENGAGEMENT WITH DONORS 2006 01:10:01,640 --> 01:10:03,960 AND POTENTIAL DONORS BUT OFTEN 2007 01:10:03,960 --> 01:10:07,280 ICTs ARE UNDERUTILIZED, NOT 2008 01:10:07,280 --> 01:10:08,480 WELL LEVERAGED. 2009 01:10:08,480 --> 01:10:12,560 WHY IS THIS AN ISSUE? 2010 01:10:12,560 --> 01:10:17,560 ICTs ARE EVERYWHERE AWAY. 2011 01:10:17,560 --> 01:10:20,680 MOST OF US CARRY OUR MOBILE 2012 01:10:20,680 --> 01:10:22,480 PHONE OR PHONES, WEARABLES, 2013 01:10:22,480 --> 01:10:26,080 REALTIME GEO LOCATION. 2014 01:10:26,080 --> 01:10:27,120 AUTOMATION, ARTIFICIAL 2015 01:10:27,120 --> 01:10:27,920 INTELLIGENCE, MACHINE LEARNING. 2016 01:10:27,920 --> 01:10:28,840 AUTOMATION HAS BEEN CREDITED 2017 01:10:28,840 --> 01:10:34,160 WITH ON ONE HAND MINIMIZING 2018 01:10:34,160 --> 01:10:37,200 HUMAN INTERACTION WHICH SOME 2019 01:10:37,200 --> 01:10:39,200 DONORS CAN ENJOY BUT CAN RAISE 2020 01:10:39,200 --> 01:10:40,960 INTERACTION THROUGH PERSONAL 2021 01:10:40,960 --> 01:10:42,680 CONNECTIONS ON SOCIAL MEDIA. 2022 01:10:42,680 --> 01:10:45,680 SO, THERE ARE MANY OPPORTUNITIES 2023 01:10:45,680 --> 01:10:46,840 FOR BLOOD COLLECTION 2024 01:10:46,840 --> 01:10:47,440 ORGANIZATIONS. 2025 01:10:47,440 --> 01:10:49,800 ICTs CAN BE USED FOR DONOR 2026 01:10:49,800 --> 01:10:51,760 ENGAGEMENT AND RECRUITMENT, 2027 01:10:51,760 --> 01:10:53,640 COORDINATION AND EDUCATION. 2028 01:10:53,640 --> 01:10:55,840 EDUCATION FOR NEW DONORS CAN 2029 01:10:55,840 --> 01:10:57,400 ADDRESS FEAR, KNOWLEDGE, ACCESS, 2030 01:10:57,400 --> 01:11:00,720 ANY OTHER INFORMATION THEY MAY 2031 01:11:00,720 --> 01:11:01,960 NEED. 2032 01:11:01,960 --> 01:11:03,040 EDUCATION FOR SEASONED DONORS 2033 01:11:03,040 --> 01:11:07,760 COULD ADDRESS CONVENIENCE, 2034 01:11:07,760 --> 01:11:09,880 PROMOTION OF DONOR IDENTITY AND 2035 01:11:09,880 --> 01:11:14,240 CONNECTION WITH OTHER DONORS. 2036 01:11:14,240 --> 01:11:16,600 ICTs COULD BE USED FOR 2037 01:11:16,600 --> 01:11:17,440 ESPECIALLY SMALLER DONOR CENTERS 2038 01:11:17,440 --> 01:11:19,800 THAT DON'T HAVE A DEDICATED 2039 01:11:19,800 --> 01:11:21,360 MARKETING AND RECRUITMENT TEAM, 2040 01:11:21,360 --> 01:11:23,840 COULD AID WITH THIS INFORMATION. 2041 01:11:23,840 --> 01:11:26,560 AND ICTs COULD ESTABLISH THE 2042 01:11:26,560 --> 01:11:30,880 BEST PRACTICES FOR STAFFING 2043 01:11:30,880 --> 01:11:32,280 DONOR CENTERS. 2044 01:11:32,280 --> 01:11:33,800 ALSO OPPORTUNITY TO ASSESS DIE 2045 01:11:33,800 --> 01:11:40,760 VEERS -- DIVERSE DONORS. 2046 01:11:40,760 --> 01:11:43,320 WHAT IS THE PROPOSED APPROACH? 2047 01:11:43,320 --> 01:11:45,960 WHAT ROLES DO ICTs PLAY IN 2048 01:11:45,960 --> 01:11:48,800 DONOR RECRUITMENT AND 2049 01:11:48,800 --> 01:11:50,280 COORDINATION? 2050 01:11:50,280 --> 01:11:53,040 HOW DO DONORS USE ICTS, WHEN 2051 01:11:53,040 --> 01:11:57,840 DOES THE CLIP EQUAL A DONATION? 2052 01:11:57,840 --> 01:12:00,840 HOW DO BLOOD DONOR COLLECTION 2053 01:12:00,840 --> 01:12:02,800 ORGANIZATIONS USE ICTs AND USE 2054 01:12:02,800 --> 01:12:06,080 THEM BETTER? 2055 01:12:06,080 --> 01:12:07,160 AND DO ICTs FACILITATE 2056 01:12:07,160 --> 01:12:10,000 DONATION OR CREATE BARRIERS TO 2057 01:12:10,000 --> 01:12:10,280 DONATION? 2058 01:12:10,280 --> 01:12:12,560 AND THESE BARRIERS WOULD BE DUE 2059 01:12:12,560 --> 01:12:14,840 TO DISPARITIES IN ACCESS, USE OF 2060 01:12:14,840 --> 01:12:15,360 ICTs. 2061 01:12:15,360 --> 01:12:17,160 THIS TYPE OF RESEARCH WOULD NEED 2062 01:12:17,160 --> 01:12:18,720 TO BE CONDUCTED IN DIVERSE 2063 01:12:18,720 --> 01:12:21,400 COMMUNITIES, PEOPLE OF COLOR, 2064 01:12:21,400 --> 01:12:23,000 YOUNGER AND OLDER DONORS, 2065 01:12:23,000 --> 01:12:24,120 NON-ENGLISH SPEAKERS, PEOPLE 2066 01:12:24,120 --> 01:12:25,160 LIVING WITH DISABILITIES WHICH 2067 01:12:25,160 --> 01:12:30,480 IS ONE GROUP THAT HAS NOT BEEN 2068 01:12:30,480 --> 01:12:31,040 INVESTIGATED. 2069 01:12:31,040 --> 01:12:33,000 ALSO, TO DEVELOP INNOVATIVE USE 2070 01:12:33,000 --> 01:12:35,560 FOR ICTs FOR RECRUITMENT AND 2071 01:12:35,560 --> 01:12:37,400 COORDINATION, THIS WOULD BE 2072 01:12:37,400 --> 01:12:39,720 GREAT TO LEVERAGE GROUP 2073 01:12:39,720 --> 01:12:44,920 COLLECTIVE CONSCIOUSNESS, SUCH 2074 01:12:44,920 --> 01:12:47,520 AS TWITTER AND ECHO CHAMBERS, 2075 01:12:47,520 --> 01:12:50,200 AND ALSO ROLE OF INFLUENCERS, 2076 01:12:50,200 --> 01:12:51,080 NETWORK, CONNECTION TO PEOPLE 2077 01:12:51,080 --> 01:12:52,480 MORE INFLUENTIAL THAN 2078 01:12:52,480 --> 01:12:55,400 INDIVIDUALS THEMSELVES MAY PLAY 2079 01:12:55,400 --> 01:12:56,600 A ROLE IN ICTs. 2080 01:12:56,600 --> 01:12:58,000 ALSO METHODS FROM OTHER FIELDS 2081 01:12:58,000 --> 01:13:03,120 WILL BE VERY USEFUL AND HELPFUL 2082 01:13:03,120 --> 01:13:06,000 AS WE START PROPOSING RESEARCH 2083 01:13:06,000 --> 01:13:07,040 IN OUR FIELD. 2084 01:13:07,040 --> 01:13:09,120 WHAT ARE THE FEASIBILITY AND 2085 01:13:09,120 --> 01:13:09,720 BARRIERS? 2086 01:13:09,720 --> 01:13:13,320 SO, THE METHODS FOR STUDYING 2087 01:13:13,320 --> 01:13:17,920 ICTs HAVE BEEN DEVELOPED OVER 2088 01:13:17,920 --> 01:13:19,600 MANY DECADES, SOCIOLOGY, 2089 01:13:19,600 --> 01:13:25,800 PSYCHOLOGY, ANTHROPOLOGY, 2090 01:13:25,800 --> 01:13:27,400 MARKETING, MEDIA STUDIES, 2091 01:13:27,400 --> 01:13:30,840 HUMAN-COMPUTER INTERACTION. 2092 01:13:30,840 --> 01:13:33,000 MODERN ICTs RAISE NOVEL RISK. 2093 01:13:33,000 --> 01:13:35,800 YOU HAVE ISSUE OF DONOR PRIVACY, 2094 01:13:35,800 --> 01:13:38,160 NEW ICTs GATHER FAR MORE 2095 01:13:38,160 --> 01:13:39,400 PERSONAL DATA THAN EARLIER 2096 01:13:39,400 --> 01:13:39,960 ICTs. 2097 01:13:39,960 --> 01:13:41,080 THE DATA CREATES A GREAT 2098 01:13:41,080 --> 01:13:43,360 OPPORTUNITY TO DEVELOP NEW DONOR 2099 01:13:43,360 --> 01:13:44,600 ENGAGEMENT STRATEGIES BUT ALSO 2100 01:13:44,600 --> 01:13:46,880 POSES RISK TO THE DONOR FOR 2101 01:13:46,880 --> 01:13:48,160 PRIVACY AN TRUST. 2102 01:13:48,160 --> 01:13:51,000 AND HOW WILL DONORS FEEL ABOUT 2103 01:13:51,000 --> 01:13:51,720 SURVEILLANCE? 2104 01:13:51,720 --> 01:13:54,280 THE POSITIVE AND NEGATIVES. 2105 01:13:54,280 --> 01:13:56,640 WE'VE ALL FELT THIS. 2106 01:13:56,640 --> 01:13:57,480 AMAZON, FACEBOOK, EVERY TIME I 2107 01:13:57,480 --> 01:13:58,800 LOG ON IT KNOWS WHAT IT IS I 2108 01:13:58,800 --> 01:14:01,400 NEED TO ORDER BEFORE I EVEN 2109 01:14:01,400 --> 01:14:04,120 THOUGHT OF IT. 2110 01:14:04,120 --> 01:14:08,240 AND ALSO ICTs RUN ON 2111 01:14:08,240 --> 01:14:08,760 ALGORITHMS. 2112 01:14:08,760 --> 01:14:09,880 THERE ARE BUILT-IN BIASES. 2113 01:14:09,880 --> 01:14:11,760 MAYBE NEWER ONES WILL HAVE THOSE 2114 01:14:11,760 --> 01:14:13,160 ELIMINATED BUT WE HAVE TO TAKE 2115 01:14:13,160 --> 01:14:14,280 THIS INTO ACCOUNT AND THERE'S A 2116 01:14:14,280 --> 01:14:16,280 NEED TO TRY TO REMOVE THESE 2117 01:14:16,280 --> 01:14:19,960 BIASES TO BEST SERVE THE DONORS. 2118 01:14:19,960 --> 01:14:22,720 AND THEN FINALLY HERE ABILITY TO 2119 01:14:22,720 --> 01:14:24,240 DISPEL DISINFORMATION BUT THERE 2120 01:14:24,240 --> 01:14:27,120 IS A POTENTIAL TO SPREAD 2121 01:14:27,120 --> 01:14:28,160 MISINFORMATION WITH ICTs, SO 2122 01:14:28,160 --> 01:14:31,920 THOSE ARE SOME OF THE CONCERNS 2123 01:14:31,920 --> 01:14:33,600 AND RISKS. 2124 01:14:33,600 --> 01:14:38,320 IN SUMMARY, DRAFT RESEARCH 2125 01:14:38,320 --> 01:14:42,240 PRIORITIES FOR WORKING GROUP 1 2126 01:14:42,240 --> 01:14:44,120 ARE MOTIVATORS AND BARRIERS, 2127 01:14:44,120 --> 01:14:45,360 DONOR EXPERIENCE, INCENTIVES AND 2128 01:14:45,360 --> 01:14:47,280 DOANORY APPRECIATION AND 2129 01:14:47,280 --> 01:14:48,920 COMPENSATION FOR BLOOD DONORS, 2130 01:14:48,920 --> 01:14:51,320 OPTIMIZING COMMUNICATION WITH 2131 01:14:51,320 --> 01:14:52,480 DONORS AND POTENTIAL DONORS, 2132 01:14:52,480 --> 01:14:55,520 INNOVATIVE AND INCLUSIVE USE OF 2133 01:14:55,520 --> 01:14:57,160 INFORMATION AND COMMUNICATION 2134 01:14:57,160 --> 01:14:57,480 TECHNOLOGY. 2135 01:14:57,480 --> 01:14:58,520 SO I'D LIKE TO THANK YOU FOR 2136 01:14:58,520 --> 01:14:59,640 YOUR ATTENTION. 2137 01:14:59,640 --> 01:15:01,320 WE LOOK FORWARD TO INPUT AND 2138 01:15:01,320 --> 01:15:03,760 SUGGESTIONS AS WE DISCUSS THESE 2139 01:15:03,760 --> 01:15:04,720 DRAFT RESEARCH PRIORITIES 2140 01:15:04,720 --> 01:15:06,520 FURTHER DURING THE BREAKOUT 2141 01:15:06,520 --> 01:15:08,400 SESSION THIS AFTERNOON. 2142 01:15:08,400 --> 01:15:14,320 THANK YOU VERY MUCH. 2143 01:15:14,320 --> 01:15:19,840 2144 01:15:19,840 --> 01:15:22,000 >> THANK YOU, DR. BRYANT, FOR 2145 01:15:22,000 --> 01:15:23,440 THAT EXCELLENT PRESENTATION. 2146 01:15:23,440 --> 01:15:28,360 I'D LIKE TO REMIND ATTENDEES TO 2147 01:15:28,360 --> 01:15:31,520 USE THE CHAT BOX TO MAKE 2148 01:15:31,520 --> 01:15:32,520 COMMENTS, WORKING GROUP 2149 01:15:32,520 --> 01:15:35,600 CO-CHAIRS WILL RESPOND DURING 2150 01:15:35,600 --> 01:15:39,320 THE BREAKOUT SESSION. 2151 01:15:39,320 --> 01:15:49,200 I'M PLEASED TO INTRODUCE DR. 2152 01:15:49,200 --> 01:15:53,120 TRIULZI AND JOSEPHSON, 2153 01:15:53,120 --> 01:15:57,600 OPTIMIZING TRANSFUSION, 2154 01:15:57,600 --> 01:15:58,320 OUTCOMES. 2155 01:15:58,320 --> 01:16:04,400 DR. TRIULZI IS IS UNIVERSITY OF 2156 01:16:04,400 --> 01:16:06,000 PITTSBURGH, EXPERTISE IN 2157 01:16:06,000 --> 01:16:08,960 TRANSFUSION AND CLINICAL TRIALS, 2158 01:16:08,960 --> 01:16:12,200 HELD NUMEROUS LEADERSHIP 2159 01:16:12,200 --> 01:16:14,360 POSITIONS IN PARTNERSHIP WITH 2160 01:16:14,360 --> 01:16:15,040 DR. SPITALNIK CO-CHAIRED THE 2161 01:16:15,040 --> 01:16:18,840 MOST RECENT STATE OF SCIENCE IN 2162 01:16:18,840 --> 01:16:19,440 TRANSFUSION MEDICINE SYMPOSIUM 2163 01:16:19,440 --> 01:16:20,120 IN 2015. 2164 01:16:20,120 --> 01:16:23,840 IT'S MY PLEASURE TO WELCOME DR. 2165 01:16:23,840 --> 01:16:25,600 CASSANDRA JOSEPHSON, DIRECTOR 2166 01:16:25,600 --> 01:16:27,680 FOR HEMATOLOGY ONCOLOGY AND 2167 01:16:27,680 --> 01:16:28,520 MEDICAL DIRECTOR OF TRANSFUSION 2168 01:16:28,520 --> 01:16:33,360 MEDICINE JOHNS HOPKINS AL 2169 01:16:33,360 --> 01:16:35,560 CHILDREN'S HOSPITAL, IN FLORIDA, 2170 01:16:35,560 --> 01:16:39,160 INVOLVED IN MEDICAL EDUCATION, 2171 01:16:39,160 --> 01:16:46,120 CLINICAL RESEARCH, LEADERSHIP 2172 01:16:46,120 --> 01:16:47,720 POSITIONS, WE WELCOME DR. 2173 01:16:47,720 --> 01:16:50,280 JOSEPHSON TO PRESENT RESEARCH 2174 01:16:50,280 --> 01:16:52,920 PRIORITIES FOR THE WORKING 2175 01:16:52,920 --> 01:16:53,160 GROUP. 2176 01:16:53,160 --> 01:16:54,720 >> THANK YOU, NAREG. 2177 01:16:54,720 --> 01:16:57,440 I'D LIKE TO THANK THE ORGANIZERS 2178 01:16:57,440 --> 01:17:00,840 FOR INVITING DR. TRIULZI AND 2179 01:17:00,840 --> 01:17:04,520 MYSELF TO CO-CHAIR THIS VERY 2180 01:17:04,520 --> 01:17:07,480 TALL ORDER TO FILL GROUP, 2181 01:17:07,480 --> 01:17:09,800 OPTIMIZING TRANSFUSION OUTCOMES 2182 01:17:09,800 --> 01:17:11,120 FOR RECIPIENTS, CLINICAL 2183 01:17:11,120 --> 01:17:14,360 RESEARCH, RCTs, PRAGMATIC 2184 01:17:14,360 --> 01:17:17,520 TRIALS, PATIENT BLOOD 2185 01:17:17,520 --> 01:17:18,840 MANAGEMENT, OBSERVATIONAL 2186 01:17:18,840 --> 01:17:19,200 EPIDEMIOLOGY. 2187 01:17:19,200 --> 01:17:23,000 I HAD TO ENLIST QUITE A FEW 2188 01:17:23,000 --> 01:17:24,360 PEOPLE, ONE OF WHICH WAS NOT 2189 01:17:24,360 --> 01:17:27,240 WRITTEN ON THIS SLIDE BUT WAS A 2190 01:17:27,240 --> 01:17:29,960 KEY MEMBER AND HELPED DR. 2191 01:17:29,960 --> 01:17:34,840 TRIULZI AND I CONSTITUTE THESE 2192 01:17:34,840 --> 01:17:35,720 DIFFERENT SUBGROUP MEMBERS, 2193 01:17:35,720 --> 01:17:38,040 NANCY AND HER CLINICAL EXPERTISE 2194 01:17:38,040 --> 01:17:41,800 AND CLINICAL RESEARCH EXPERT 2195 01:17:41,800 --> 01:17:42,080 DESIGN. 2196 01:17:42,080 --> 01:17:45,680 WE HAD TO FILL THESE SUBGROUPS 2197 01:17:45,680 --> 01:17:49,400 WITH EXPERTS AND WE TRIED TO GET 2198 01:17:49,400 --> 01:17:58,320 REPRESENTATION FROM TRANSFUSION 2199 01:17:58,320 --> 01:18:05,400 MEDICINE, ADULT AND PED HEM-ONC, 2200 01:18:05,400 --> 01:18:07,440 NEONATOLOGY, COMMUNITY LEADERS, 2201 01:18:07,440 --> 01:18:09,640 FAMILIES, MOMS, WE TRIED TO RUN 2202 01:18:09,640 --> 01:18:12,080 THE SPECTRUM SO WE COULD ADDRESS 2203 01:18:12,080 --> 01:18:15,200 EVERYTHING THAT WAS ASKED OF US. 2204 01:18:15,200 --> 01:18:16,560 WE HAD THESE SUBGROUPS CREATED 2205 01:18:16,560 --> 01:18:20,120 THAT FIRST WE THOUGHT WOULD 2206 01:18:20,120 --> 01:18:24,200 REPRESENT THE DIFFERENT 2207 01:18:24,200 --> 01:18:30,160 PRODUCTS, AND THEN AS WE 2208 01:18:30,160 --> 01:18:31,760 BROUGHT THE GROUP TOGETHER WE 2209 01:18:31,760 --> 01:18:35,320 NEEDED TO MANAGE ACUTE BLEEDING, 2210 01:18:35,320 --> 01:18:37,520 ENCOMPASSING THOSE PRODUCTS. 2211 01:18:37,520 --> 01:18:43,680 WE ALL QUICKLY DESIGNED FOR 2212 01:18:43,680 --> 01:18:43,920 SUBGROUP. 2213 01:18:43,920 --> 01:18:44,440 NEXT SLIDE. 2214 01:18:44,440 --> 01:18:46,680 WE THOUGHT WE WERE GOING TO HAVE 2215 01:18:46,680 --> 01:18:48,160 MANY GREAT IDEAS COME TO THE 2216 01:18:48,160 --> 01:18:50,280 FOREFRONT AND HOW WERE WE GOING 2217 01:18:50,280 --> 01:18:52,840 TO PRIORITIZE THOSE SO WE TRIED 2218 01:18:52,840 --> 01:18:58,520 IN A SCIENTIFIC WAY TO FIND A 2219 01:18:58,520 --> 01:18:59,360 PRIORITIZATION METHODOLOGY THAT 2220 01:18:59,360 --> 01:19:03,920 WE COULD EMPLOY. 2221 01:19:03,920 --> 01:19:05,440 AND THE CHILDREN'S HEALTH 2222 01:19:05,440 --> 01:19:07,400 NUTRITION RESEARCH INITIATIVE 2223 01:19:07,400 --> 01:19:12,800 HAD ACTUALLY VALIDATED A WAY TO 2224 01:19:12,800 --> 01:19:15,960 PUT PRIORITIES INTO ORDER AND IT 2225 01:19:15,960 --> 01:19:17,360 WAS SIMON AND MARY ANN TO 2226 01:19:17,360 --> 01:19:19,160 BROUGHT THIS TO OUR ATTENTION. 2227 01:19:19,160 --> 01:19:20,640 NEXT SLIDE PLEASE. 2228 01:19:20,640 --> 01:19:24,960 SO WHAT WE DID IS WE AS A GROUP 2229 01:19:24,960 --> 01:19:26,520 WERE SURVEYED AND WE LOOKED AT 2230 01:19:26,520 --> 01:19:28,560 THE TEN CRITERIA THAT THEY PUT 2231 01:19:28,560 --> 01:19:30,520 OUT AND SELECTED THE TOP -- 2232 01:19:30,520 --> 01:19:33,160 SORRY, 20 PUT OUT AND SELECTED 2233 01:19:33,160 --> 01:19:35,760 THE TOP 10 AS A GROUP. 2234 01:19:35,760 --> 01:19:39,440 YOU CAN SEE WHAT REPRESENTATION 2235 01:19:39,440 --> 01:19:42,240 IS HERE, ANSWERABILITY TO 2236 01:19:42,240 --> 01:19:43,080 FEASIBILITY, WE JUST FELT LIKE 2237 01:19:43,080 --> 01:19:46,400 WE WERE GOING TO NEED SOME KIND 2238 01:19:46,400 --> 01:19:48,120 OF OBJECTIVE WAY TO DECIDE WITH 2239 01:19:48,120 --> 01:19:56,280 ALL OF THE PRIORITIES THAT WOULD 2240 01:19:56,280 --> 01:19:57,640 COME TO THE FOREFRONT. 2241 01:19:57,640 --> 01:20:00,520 YOU CAN SEE PROPOSAL BY THE 2242 01:20:00,520 --> 01:20:03,000 COMMITTEE, SO WE EMPLOYED THOSE 2243 01:20:03,000 --> 01:20:05,400 CRITERIA, AND THE TOP FIVE WERE 2244 01:20:05,400 --> 01:20:11,680 RED BLOOD CELL, ACUTE ANEMIA 2245 01:20:11,680 --> 01:20:21,480 MEASURES, PROPHYLACTIC PLATELET 2246 01:20:21,480 --> 01:20:22,320 TRANSFUSION, NON-HEMOSTATICS, 2247 01:20:22,320 --> 01:20:30,160 CHRONIC TRANSFUSION, BLEEDING 2248 01:20:30,160 --> 01:20:38,160 MANAGEMENT, NEXT FIVE STILL 2249 01:20:38,160 --> 01:20:39,040 IMPORTANT, NISHOT, COMPARING, 2250 01:20:39,040 --> 01:20:40,360 IMPLEMENTATION, AND COMPARING 2251 01:20:40,360 --> 01:20:42,360 PLASMA PRODUCTS. 2252 01:20:42,360 --> 01:20:44,400 NEXT SLIDE PLEASE. 2253 01:20:44,400 --> 01:20:46,800 PRIORITY NUMBER 1 WAS ANEMIA 2254 01:20:46,800 --> 01:20:48,240 MEASURES AND RED CELL 2255 01:20:48,240 --> 01:20:49,760 TRANSFUSION MAKING, WHAT ARE THE 2256 01:20:49,760 --> 01:20:51,600 OPTIMAL MEANS OF RED CELL 2257 01:20:51,600 --> 01:20:53,520 TRANSFUSION DECISION MAKING IN 2258 01:20:53,520 --> 01:20:54,880 THE SETTING OF ACUTE ILLNESS, 2259 01:20:54,880 --> 01:20:59,000 AND WE KNOW DURING ACUTE ILLNESS 2260 01:20:59,000 --> 01:21:00,600 RED CELL TRANSFUSION IS 2261 01:21:00,600 --> 01:21:06,320 INDICATED TO IMPROVE DELIVERY OR 2262 01:21:06,320 --> 01:21:08,800 RELIEVE BURDENS OF COMPENSATORY 2263 01:21:08,800 --> 01:21:12,680 ELEMENTS OF O2 DELIVERY SYSTEM. 2264 01:21:12,680 --> 01:21:16,000 WE'VE BEEN KIND OF PUT INTO A 2265 01:21:16,000 --> 01:21:17,920 BOX WITH LOOKING AT TRANSFUSION 2266 01:21:17,920 --> 01:21:20,120 TRIGGERS AND RESTRICTIVE RED 2267 01:21:20,120 --> 01:21:22,720 CELL TRANSFUSION STUDIES 2268 01:21:22,720 --> 01:21:27,640 FOCUSING ON ONE 2269 01:21:27,640 --> 01:21:28,280 ONE-SIZE-FITS-ALL OPTION, AND 2270 01:21:28,280 --> 01:21:30,360 LESS THAN 7 GRAMS PER DECILITER 2271 01:21:30,360 --> 01:21:33,360 HAVE BEEN OUR TRIGGER CHOICE BUT 2272 01:21:33,360 --> 01:21:34,840 WE KNOW THIS ONE DIMENSIONAL WAY 2273 01:21:34,840 --> 01:21:38,160 OF CHOOSING DOESN'T ACCOUNT FOR 2274 01:21:38,160 --> 01:21:38,720 VARIATION IN INDIVIDUAL 2275 01:21:38,720 --> 01:21:40,120 PHYSIOLOGY, AND SOME PATIENTS 2276 01:21:40,120 --> 01:21:42,440 MAY HAVE MORE PHYSIOLOGIC 2277 01:21:42,440 --> 01:21:44,320 RESERVE AND TOLERATE LOWER 2278 01:21:44,320 --> 01:21:46,480 LEVELS, OTHERS HAVE LESS 2279 01:21:46,480 --> 01:21:50,200 PHYSIOLOGIC RESERVE AND REQUIRE 2280 01:21:50,200 --> 01:21:50,600 HIGHER LEVELS. 2281 01:21:50,600 --> 01:21:52,440 AS A DISCIPLINE, OUR ABILITY TO 2282 01:21:52,440 --> 01:21:53,640 IMPROVE PATIENT OUTCOMES HAS 2283 01:21:53,640 --> 01:21:55,640 BEEN LIMITED BY THESE TYPE OF 2284 01:21:55,640 --> 01:21:56,600 STUDY DESIGNS. 2285 01:21:56,600 --> 01:21:58,880 SO THERE'S A NEED FOR 2286 01:21:58,880 --> 01:22:00,240 PERSONALIZED APPROACH BASED ON 2287 01:22:00,240 --> 01:22:03,160 NEW MEASURES OF OXYGEN DELIVERY 2288 01:22:03,160 --> 01:22:04,480 SYSTEMS, HOMEOSTASIS THAT 2289 01:22:04,480 --> 01:22:06,640 CORRELATES WITH CLINICAL 2290 01:22:06,640 --> 01:22:06,880 OUTCOMES. 2291 01:22:06,880 --> 01:22:07,320 NEXT SLIDE PLEASE. 2292 01:22:07,320 --> 01:22:11,680 SO WHAT IS THE ISSUE HERE? 2293 01:22:11,680 --> 01:22:14,320 CURRENT TRANSFUSION DECISION 2294 01:22:14,320 --> 01:22:16,280 MAKING IS ALWAYS BASED ON 2295 01:22:16,280 --> 01:22:22,960 HEMOGLOBIN CONCENTRATION AND 2296 01:22:22,960 --> 01:22:26,160 DOESN'T CONSIDER INTENSITY, AND 2297 01:22:26,160 --> 01:22:30,640 OTHER FACTORS INDEPENDENT OF 2298 01:22:30,640 --> 01:22:32,280 SEVERITY, THIS VARIES WIDELY 2299 01:22:32,280 --> 01:22:38,400 ACROSS AND WITHIN INDIVIDUALS 2300 01:22:38,400 --> 01:22:40,800 DUE TO CO-MORBIDITIES. 2301 01:22:40,800 --> 01:22:41,880 THERE'S LACK OF TRANSFUSION 2302 01:22:41,880 --> 01:22:45,080 MAKING DECISION STRUCTURE FOR 2303 01:22:45,080 --> 01:22:47,160 US, INDIVIDUALS FOR WHOM 2304 01:22:47,160 --> 01:22:51,080 PERMISSIVE ANEMIA IS UNSAFE SUCH 2305 01:22:51,080 --> 01:22:54,160 AS COMPENSATION IS UNSUSTAINABLE 2306 01:22:54,160 --> 01:22:56,200 AT ANY ABNORMAL HEMOGLOBIN, IN 2307 01:22:56,200 --> 01:22:58,080 SUCH PATIENTS WHERE GUIDELINES 2308 01:22:58,080 --> 01:22:59,920 GUIDE TRANSFUSION TIMING AND 2309 01:22:59,920 --> 01:23:00,800 AMOUNT. 2310 01:23:00,800 --> 01:23:05,360 RESULT IS BOTH OVERAND UNDER 2311 01:23:05,360 --> 01:23:08,400 UNDERTRANSFUSION AND RISK OF 2312 01:23:08,400 --> 01:23:09,320 ORGAN FAILURE. 2313 01:23:09,320 --> 01:23:11,760 UNDERTRANSFUSION ABOVE THIS 2314 01:23:11,760 --> 01:23:19,240 THRESHOLD OF 7, TRANSFUSION 2315 01:23:19,240 --> 01:23:22,120 RISKS UNDER 7, WE NEED NEW AND 2316 01:23:22,120 --> 01:23:24,400 BETTER MEASURES RATHER THAN 2317 01:23:24,400 --> 01:23:29,080 HEMOGLOBIN TO GUIDE OUR DECISION 2318 01:23:29,080 --> 01:23:30,240 MAKING TO IMPROVE OUTCOMES. 2319 01:23:30,240 --> 01:23:32,600 WHY IS THIS AN ISSUE? 2320 01:23:32,600 --> 01:23:35,720 WHAT IS THE PROPOSED APPROACH? 2321 01:23:35,720 --> 01:23:38,040 TRANSFUSION DECISION MAKING 2322 01:23:38,040 --> 01:23:39,280 REQUIRES IMPROVED 2323 01:23:39,280 --> 01:23:44,280 UNDERSTANDINGS, OF SUSTAINABLE 2324 01:23:44,280 --> 01:23:45,680 PHYSIOLOGIC COMPENSATION, ANEMIA 2325 01:23:45,680 --> 01:23:47,200 TOLERANCE, ABILITY TO IDENTIFY 2326 01:23:47,200 --> 01:23:50,920 SPECIFIC VITAL ORGANS AT RISK 2327 01:23:50,920 --> 01:23:58,120 FOR ISCHEMIA, WHEN GLOBAL 02 2328 01:23:58,120 --> 01:24:00,080 DELIVERY HOMEOSTASIS IS 2329 01:24:00,080 --> 01:24:00,360 MAINTAINED. 2330 01:24:00,360 --> 01:24:01,760 A PERSONALIZED APPROACH NEEDS TO 2331 01:24:01,760 --> 01:24:03,400 BE USED AND IS NOT ONLY GOING TO 2332 01:24:03,400 --> 01:24:07,080 BE BASED ON THE SEVERITY OF THE 2333 01:24:07,080 --> 01:24:10,040 ANEMIA BUT INTENSITY AND 2334 01:24:10,040 --> 01:24:11,800 SUSTAINABILITY TO COMPENSATE. 2335 01:24:11,800 --> 01:24:13,840 SO DIFFERENCES IN NATIVE AND 2336 01:24:13,840 --> 01:24:18,480 DONOR RED CELL PHYSIOLOGY AS 2337 01:24:18,480 --> 01:24:26,480 WELL AS TRANSFUSION 2338 01:24:26,480 --> 01:24:27,000 TRANSFUSION. 2339 01:24:27,000 --> 01:24:28,760 REQUIRES PERSONALIZED INDICATORS 2340 01:24:28,760 --> 01:24:29,840 OF COMPENSATION, CANDIDATES FOR 2341 01:24:29,840 --> 01:24:34,360 THIS COULD BE FOR GLOBAL OR 2342 01:24:34,360 --> 01:24:36,960 VITAL ORGANS SPECIFICALLY SO 2343 01:24:36,960 --> 01:24:40,200 BEDSIDE VO2, O2 CONSUMPTION 2344 01:24:40,200 --> 01:24:45,440 MEASURES, USE OF NOVEL 2345 01:24:45,440 --> 01:24:47,320 BIOMARKERS, INJECTABLE REPORTER 2346 01:24:47,320 --> 01:24:48,680 MOLECULES REFLECTING TISSUE 2347 01:24:48,680 --> 01:24:52,280 LEVELS, BIOCHEMICAL CUES OF 2348 01:24:52,280 --> 01:24:52,960 DELIVERY. 2349 01:24:52,960 --> 01:24:57,160 THERE NEED TO BE NOVEL 2350 01:24:57,160 --> 01:25:00,360 MONITORING DEVICES, 2351 01:25:00,360 --> 01:25:02,360 COMPUTATIONALLY DERIVED METRICS. 2352 01:25:02,360 --> 01:25:05,080 NEXT SLIDE PLEASE. 2353 01:25:05,080 --> 01:25:07,080 FEASIBILITY AND BARRIERS ARE 2354 01:25:07,080 --> 01:25:09,320 QUITE SUBSTANTIAL HERE BECAUSE 2355 01:25:09,320 --> 01:25:14,320 WE DON'T HAVE MUCH TO SUPPORT 2356 01:25:14,320 --> 01:25:15,160 DATA-WISE USE OF PHYSIOLOGIC 2357 01:25:15,160 --> 01:25:19,040 STRATEGIES AND SEEMS TO BE NO 2358 01:25:19,040 --> 01:25:21,880 CONSENSUS ON GOALS TARGETED. 2359 01:25:21,880 --> 01:25:23,280 SOME CANDIDATE METHODS EXIST AND 2360 01:25:23,280 --> 01:25:24,760 CAN BE STUDIED IN CLINICAL 2361 01:25:24,760 --> 01:25:30,560 SETTING SUCH AS WITH NIRS, 2362 01:25:30,560 --> 01:25:32,640 BEDSIDE VO2, BLOOD BIOMARKERS, 2363 01:25:32,640 --> 01:25:34,840 COMPUTED METRICS FROM 2364 01:25:34,840 --> 01:25:39,000 PHYSIOLOGIC DATA STREAMS, HEART 2365 01:25:39,000 --> 01:25:40,200 RATE, VARIABILITY INDEXING, 2366 01:25:40,200 --> 01:25:41,760 NOVEL DEVICE DEVELOPMENT 2367 01:25:41,760 --> 01:25:44,000 REQUIRES SUSTAINABILITY 2368 01:25:44,000 --> 01:25:45,600 STABILITY OF DELIVERY, GUIDING 2369 01:25:45,600 --> 01:25:51,680 THE TIMING, AMOUNT, RESPONSE TO 2370 01:25:51,680 --> 01:25:52,080 TRANSFUSION. 2371 01:25:52,080 --> 01:25:56,800 TRANSFUSION DECISION MAKING 2372 01:25:56,800 --> 01:25:59,120 DEVELOPMENT MAY BE FACILITATED 2373 01:25:59,120 --> 01:26:00,920 VIA BAYESIAN MODELING, 2374 01:26:00,920 --> 01:26:02,840 APPLICATION OF DYNAMICS, 2375 01:26:02,840 --> 01:26:04,560 DEVELOPMENT OF EHR EMBEDDED 2376 01:26:04,560 --> 01:26:08,200 COMPUTERIZED TOOLS AND THIS IS 2377 01:26:08,200 --> 01:26:08,960 POSSIBLY WITH REALTIME 2378 01:26:08,960 --> 01:26:13,040 ARTIFICIAL INTELLIGENCE AND 2379 01:26:13,040 --> 01:26:16,800 MACHINE LEARNING APPLICATIONS, 2380 01:26:16,800 --> 01:26:18,320 MEASURED TO REPORT GLOBAL HOMEO 2381 01:26:18,320 --> 01:26:28,480 TASTE IS. -- HOMEOSTASIS. 2382 01:26:28,480 --> 01:26:29,160 PROPHYLACTIC PLATELET 2383 01:26:29,160 --> 01:26:33,080 TRANSFUSION, WHAT IS THE OPTIMAL 2384 01:26:33,080 --> 01:26:34,520 USE IN CLINICAL SETTING? 2385 01:26:34,520 --> 01:26:39,720 WE'RE LOOKING AT CRITICAL 2386 01:26:39,720 --> 01:26:41,800 ILLNESS, SURGERY, EXTRACORPOREAL 2387 01:26:41,800 --> 01:26:42,720 SUPPORT, PATIENTS ON 2388 01:26:42,720 --> 01:26:46,360 ANTIPLATELET THERAPIES, HOW DO 2389 01:26:46,360 --> 01:26:49,920 DONOR CHARACTERISTICS SUCH AS 2390 01:26:49,920 --> 01:26:53,160 PRODUCT STORAGE, ABO 2391 01:26:53,160 --> 01:26:54,600 COMPATIBILITY AND PHYSIOLOGY, 2392 01:26:54,600 --> 01:26:56,240 RISK STRATIFICATION INFLUENCE 2393 01:26:56,240 --> 01:26:56,920 THIS OPTIMAL USE. 2394 01:26:56,920 --> 01:26:58,720 I THINK EVERYBODY IN THIS 2395 01:26:58,720 --> 01:27:01,440 AUDIENCE IS AWARE WE'VE LOOKED 2396 01:27:01,440 --> 01:27:04,560 AT UP AND DOWN PROPHYLACTIC 2397 01:27:04,560 --> 01:27:05,560 PLATELET TRANSFUSION IN 2398 01:27:05,560 --> 01:27:08,840 MALIGNANCIES BUT HAVEN'T DEFINED 2399 01:27:08,840 --> 01:27:10,320 IT IN OTHER REALM. 2400 01:27:10,320 --> 01:27:14,880 THIS IS A MAJOR SOURCE OF LACK 2401 01:27:14,880 --> 01:27:17,560 OF GUIDANCE FOR TRANSFUSING 2402 01:27:17,560 --> 01:27:17,840 PATIENTS. 2403 01:27:17,840 --> 01:27:18,480 NEXT SLIDE PLEASE. 2404 01:27:18,480 --> 01:27:20,720 SO WHAT IS THE ISSUE? 2405 01:27:20,720 --> 01:27:24,520 THE ISSUE IS THERE'S NO EVIDENCE 2406 01:27:24,520 --> 01:27:26,400 IN ADULT AND PEDS, VERY LITTLE 2407 01:27:26,400 --> 01:27:29,040 IN SETTING OF CRITICAL ILLNESS, 2408 01:27:29,040 --> 01:27:31,440 NEED FOR SURGERY, AND 2409 01:27:31,440 --> 01:27:34,120 NON-HEMATOLOGIC MALIGNANCIES SO 2410 01:27:34,120 --> 01:27:38,720 WHEN WE SHOULD USE PROPHYLACTIC 2411 01:27:38,720 --> 01:27:40,400 PLATELET TRANSFUSION. 2412 01:27:40,400 --> 01:27:41,600 THERE'S RISK OF USING PLATELETS 2413 01:27:41,600 --> 01:27:43,200 AND NOT UNDERSTANDING WHAT THEIR 2414 01:27:43,200 --> 01:27:44,760 BENEFITS ARE AND WE KNOW 2415 01:27:44,760 --> 01:27:46,120 PLATELET COUNT DOES NOT 2416 01:27:46,120 --> 01:27:50,360 CORRELATE WITH BLEEDING RISK. 2417 01:27:50,360 --> 01:27:52,160 USING THAT ONE DIMENSIONAL 2418 01:27:52,160 --> 01:27:53,840 TRIGGER IS PROBABLY INCORRECT. 2419 01:27:53,840 --> 01:27:56,160 THE USE OF PLATELET COUNT TO 2420 01:27:56,160 --> 01:27:57,280 MAKE TRANSFUSION DECISIONS 2421 01:27:57,280 --> 01:27:59,600 DOESN'T ACCOUNT FOR ADDITIONAL 2422 01:27:59,600 --> 01:28:00,560 DONOR AND RECIPIENT 2423 01:28:00,560 --> 01:28:01,600 CHARACTERISTICS THAT MAY BE 2424 01:28:01,600 --> 01:28:03,520 RELEVANT FOR DETERMINING RISK OF 2425 01:28:03,520 --> 01:28:06,920 BLEEDING OR RISKS ASSOCIATED 2426 01:28:06,920 --> 01:28:10,000 WITH TRANSFUSION OF PLATELET 2427 01:28:10,000 --> 01:28:10,280 COMPONENTS. 2428 01:28:10,280 --> 01:28:12,040 I MENTIONED DONOR FACTORS. 2429 01:28:12,040 --> 01:28:13,200 THERE ARE RECIPIENT FACTORS, 2430 01:28:13,200 --> 01:28:14,600 THAT'S WHY THESE DIFFERENT 2431 01:28:14,600 --> 01:28:19,480 RECIPIENT POPULATIONS NEED TO BE 2432 01:28:19,480 --> 01:28:20,120 LOOKED AT INDIVIDUALLY, 2433 01:28:20,120 --> 01:28:21,120 COMORBIDITIES, PLATELET 2434 01:28:21,120 --> 01:28:21,640 FUNCTION, LOCATION OF THE 2435 01:28:21,640 --> 01:28:25,040 POTENTIAL BLEED AND TYPE OF 2436 01:28:25,040 --> 01:28:26,080 INTERVENTION WHERE SUPPORT HAS 2437 01:28:26,080 --> 01:28:28,800 TO BE CONSIDERED WHEN GIVING A 2438 01:28:28,800 --> 01:28:31,800 PLATELET TRANSFUSION. 2439 01:28:31,800 --> 01:28:33,800 GLOBAL MEASURES OF HOMEOSTASIS 2440 01:28:33,800 --> 01:28:37,320 MAY ALLOW FOR RISK 2441 01:28:37,320 --> 01:28:39,440 STRATIFICATION INCLUDING TAKING 2442 01:28:39,440 --> 01:28:48,320 ANTIPLATELET MEDICATION OR 2443 01:28:48,320 --> 01:28:49,520 EXTRACOREPOREAL CIRCUIT. 2444 01:28:49,520 --> 01:28:53,440 WE NEED MORE RESEARCH TO ADDRESS 2445 01:28:53,440 --> 01:28:54,160 THE QUESTIONS. 2446 01:28:54,160 --> 01:28:54,760 RANDOMIZED CONTROLLED TRIALS 2447 01:28:54,760 --> 01:28:57,960 NEED TO BE PUT IN PLACE, TRIAL 2448 01:28:57,960 --> 01:29:01,200 DESIGN NEEDS TO BE CALLED UPON 2449 01:29:01,200 --> 01:29:01,800 BECAUSE SOME POPULATIONS ARE 2450 01:29:01,800 --> 01:29:05,040 MUCH SMALLER AND TO BE ABLE TO 2451 01:29:05,040 --> 01:29:06,840 CREATE TRANSFUSION GUIDELINES WE 2452 01:29:06,840 --> 01:29:13,800 NEED TO BE ABLE TO STUDY THESE 2453 01:29:13,800 --> 01:29:15,760 SMALLER PATIENT POPULATIONS. 2454 01:29:15,760 --> 01:29:17,080 ANIMAL MODELS AND TRANSLATIONAL 2455 01:29:17,080 --> 01:29:21,400 STUDIES TO DEFINE DONOR AND 2456 01:29:21,400 --> 01:29:25,400 RECIPIENT CHARACTERISTICS FOR 2457 01:29:25,400 --> 01:29:26,280 PROPHYLACTIC PLATELET 2458 01:29:26,280 --> 01:29:29,040 TRANSFUSION ARE NECESSARY, 2459 01:29:29,040 --> 01:29:33,560 ADDITIONAL MEASURES NEED TO BE 2460 01:29:33,560 --> 01:29:37,200 ASSESSED. 2461 01:29:37,200 --> 01:29:39,040 SYSTEMS BIOLOGY STUDIES AND 2462 01:29:39,040 --> 01:29:40,320 LEVERAGING ANALYTIC APPROACHES 2463 01:29:40,320 --> 01:29:41,480 SUCH AS AUTOMATED ARTIFICIAL 2464 01:29:41,480 --> 01:29:42,440 INTELLIGENCE MODELING PLATFORMS 2465 01:29:42,440 --> 01:29:44,240 WILL BE NEEDED TO BE ABLE TO 2466 01:29:44,240 --> 01:29:45,360 INTEGRATE ALL THAT DATA. 2467 01:29:45,360 --> 01:29:49,480 NEXT SLIDE PLEASE. 2468 01:29:49,480 --> 01:29:49,880 2469 01:29:49,880 --> 01:29:50,800 SO FEASIBILITY AND BARRIERS 2470 01:29:50,800 --> 01:29:53,680 IT IS FEASIBLE TO DO SOME 2471 01:29:53,680 --> 01:29:59,200 STUDIES, MORE CREATIVE TO COME 2472 01:29:59,200 --> 01:30:03,360 UP IN THESE SPECIAL POPULATIONS. 2473 01:30:03,360 --> 01:30:05,360 STUDIES LINKING PRE-CLINICAL 2474 01:30:05,360 --> 01:30:07,400 DATA AND METADATA MAY HELP YIELD 2475 01:30:07,400 --> 01:30:09,240 NEW INSIGHTS INTO THIS ISSUE 2476 01:30:09,240 --> 01:30:10,480 WITHOUT STUDYING THOUSANDS OF 2477 01:30:10,480 --> 01:30:17,080 PATIENTS SUCH AS WERE NEEDED IN 2478 01:30:17,080 --> 01:30:18,240 TRADITIONAL TRIALS. 2479 01:30:18,240 --> 01:30:20,440 IT MAY BE DIFFICULT TO ENROLL 2480 01:30:20,440 --> 01:30:21,640 ENOUGH SO POWERING LARGER 2481 01:30:21,640 --> 01:30:23,480 STUDIES MAY BECOME AN ISSUE AND 2482 01:30:23,480 --> 01:30:25,080 THAT TRANSLATES TO MORE 2483 01:30:25,080 --> 01:30:25,880 EXPENSIVE STUDIES THAT MAY NEED 2484 01:30:25,880 --> 01:30:28,680 TO GO ON BEYOND FIVE YEARS. 2485 01:30:28,680 --> 01:30:34,640 ADAPTIVE TRIAL DESIGN STRATEGIES 2486 01:30:34,640 --> 01:30:39,160 COULD BE HELPFUL HERE. 2487 01:30:39,160 --> 01:30:42,120 NUMBER 3, TRANSFUSION, WHAT ARE 2488 01:30:42,120 --> 01:30:44,760 EFFECTS ON HEMOSTATIC AND 2489 01:30:44,760 --> 01:30:47,360 NON-HEMOSTATIC PROCESSES SUCH AS 2490 01:30:47,360 --> 01:30:48,920 IMMUNE FUNCTION, INFLAMMATION, 2491 01:30:48,920 --> 01:30:50,800 ANGIOGENESIS AND MECHANISMS THAT 2492 01:30:50,800 --> 01:30:52,800 MEDIATE IN RECIPIENTS OF 2493 01:30:52,800 --> 01:30:54,840 DIFFERENT AGES GOING FROM 2494 01:30:54,840 --> 01:30:57,600 EXTREMELY PRE-TERM INFANTS TO 2495 01:30:57,600 --> 01:30:58,680 OLDER ADULTS, WITH VARIABLE 2496 01:30:58,680 --> 01:31:02,440 UNDERLYING CONDITIONS SUCH AS 2497 01:31:02,440 --> 01:31:09,200 CRITICAL ILLNESS, 2498 01:31:09,200 --> 01:31:09,840 IMMUNOCOMPROMISED, HAVING 2499 01:31:09,840 --> 01:31:10,280 CANCER. 2500 01:31:10,280 --> 01:31:12,880 WE NEED TO ANSWER WHAT IS GOING 2501 01:31:12,880 --> 01:31:21,560 ON IN SOME TRIALS ESPECIALLY THE 2502 01:31:21,560 --> 01:31:23,600 ONE IN NEONATES, DYING OR MORE 2503 01:31:23,600 --> 01:31:28,240 SICK WITH MORE PLATELETS GIVEN 2504 01:31:28,240 --> 01:31:29,040 FOR HEMOSTATIC REASONS, 2505 01:31:29,040 --> 01:31:31,680 MECHANISMS LEADING TO INCREASES 2506 01:31:31,680 --> 01:31:36,120 IN MORBIDITY AND MORTALITY IN 2507 01:31:36,120 --> 01:31:37,520 SELECT PATIENT PLATELET 2508 01:31:37,520 --> 01:31:39,040 TRANSFUSION RECIPIENTS SEEM TO 2509 01:31:39,040 --> 01:31:43,160 BE RELATED TO OFF TARGET OR 2510 01:31:43,160 --> 01:31:44,160 NON-HEMOSTATIC EFFECTS, VITAL TO 2511 01:31:44,160 --> 01:31:46,160 UNDERSTAND WHETHER AND HOW THEY 2512 01:31:46,160 --> 01:31:48,080 ARE MODULATED BY DIFFERENT 2513 01:31:48,080 --> 01:31:50,320 PRODUCT TREATMENT CONDITIONS 2514 01:31:50,320 --> 01:31:51,680 CRITICALLY IS IMPORTANT TO 2515 01:31:51,680 --> 01:31:53,160 APPRAISE RISK/BENEFIT RATIO OF 2516 01:31:53,160 --> 01:31:55,880 PLATELETS AND OTHER PRODUCTS 2517 01:31:55,880 --> 01:32:06,400 SUCH AS PLASMA TRANSFUSION IN 2518 01:32:07,960 --> 01:32:15,720 PATIENT POPULATIONS. 2519 01:32:15,720 --> 01:32:18,040 ARE THESE OFF-TARGET REASONS -- 2520 01:32:18,040 --> 01:32:19,960 PLATELETS ARE CRITICAL 2521 01:32:19,960 --> 01:32:24,880 REGULATORS OF NON-HEMOSTATIC 2522 01:32:24,880 --> 01:32:27,800 PROCESSES PARTICULARLY IN INNATE 2523 01:32:27,800 --> 01:32:29,800 REALM, INFLAMMATION, 2524 01:32:29,800 --> 01:32:30,120 ANGIOGENESIS. 2525 01:32:30,120 --> 01:32:33,040 MAJORITY OF GENES IN PLATELETS 2526 01:32:33,040 --> 01:32:38,200 REGULATE IMMUNE PROCESS RATHER 2527 01:32:38,200 --> 01:32:39,800 THAN HEMOSTASIS. 2528 01:32:39,800 --> 01:32:42,080 THERE ARE FUNCTIONS IN ADDITION 2529 01:32:42,080 --> 01:32:43,040 TO HEMOSTATIC FUNCTIONS 2530 01:32:43,040 --> 01:32:45,320 PLATELETS INTERACT WITH IMMUNE 2531 01:32:45,320 --> 01:32:56,040 AND VASCULAR CELLS DIRECTLY AND 2532 01:32:56,040 --> 01:32:58,280 INDIRECTLY, SO IT'S SO IMPORTANT 2533 01:32:58,280 --> 01:33:02,320 TO HAVE ANIMAL MODEL DESIGNS TO 2534 01:33:02,320 --> 01:33:04,800 EVALUATE THE NON-HEMOSTATICS 2535 01:33:04,800 --> 01:33:07,920 FUNCTIONS IN INFECTION, 2536 01:33:07,920 --> 01:33:08,560 TRANSPLANTATION, CANCER, 2537 01:33:08,560 --> 01:33:09,160 RETINOPATHY, PLATELETS ENHANCE 2538 01:33:09,160 --> 01:33:11,760 THE DISEASE IN SOME CASES, 2539 01:33:11,760 --> 01:33:12,640 ATTENUATE IN OTHERS, DEPENDING 2540 01:33:12,640 --> 01:33:17,680 ON THE SPECIFIC MODEL BEING 2541 01:33:17,680 --> 01:33:17,880 USED. 2542 01:33:17,880 --> 01:33:19,320 NEXT SLIDE PLEASE. 2543 01:33:19,320 --> 01:33:24,680 SO WHAT IS THE PROPOSED 2544 01:33:24,680 --> 01:33:24,960 APPROACH? 2545 01:33:24,960 --> 01:33:26,400 TRANSLATIONAL STUDIES NEED TO 2546 01:33:26,400 --> 01:33:29,520 LOOK AT PATIENT POPULATION AND 2547 01:33:29,520 --> 01:33:30,800 CONDITIONS, BIOBANKING AND 2548 01:33:30,800 --> 01:33:32,600 ADDRESSING RESEARCH QUESTIONS 2549 01:33:32,600 --> 01:33:34,800 COULD BE INCORPORATED. 2550 01:33:34,800 --> 01:33:38,560 STATE-OF-THE-ART TECHNOLOGY SUCH 2551 01:33:38,560 --> 01:33:45,080 AS SINGLE CELL RNAseq TO BE 2552 01:33:45,080 --> 01:33:47,840 IMPLEMENTED TO CHARACTERIZE 2553 01:33:47,840 --> 01:33:50,520 MOLECULAR EFFECTS. 2554 01:33:50,520 --> 01:33:51,160 GIVEN CURRENT TRENDS, IT'S GOING 2555 01:33:51,160 --> 01:33:54,480 TO BE A LOT MORE DIFFICULT, SO 2556 01:33:54,480 --> 01:33:56,640 HUMAN STUDIES WILL NEED TO BE 2557 01:33:56,640 --> 01:33:59,960 REQUIRED TO BE MULTI-CENTER IN 2558 01:33:59,960 --> 01:34:01,120 APPROACH. 2559 01:34:01,120 --> 01:34:03,040 NEXT SLIDE PLEASE. 2560 01:34:03,040 --> 01:34:04,160 FEASIBILITY AND BARRIERS 2561 01:34:04,160 --> 01:34:05,560 ADDRESSING THIS COMPLEX QUESTION 2562 01:34:05,560 --> 01:34:09,560 IS GOING TO REQUIRE COMBINATION 2563 01:34:09,560 --> 01:34:12,320 OF STUDIES USING SYSTEM BIOLOGY 2564 01:34:12,320 --> 01:34:13,920 APPROACH AND INCORPORATING 2565 01:34:13,920 --> 01:34:23,280 ANIMAL MODELS OF DISEASE AND THE 2566 01:34:23,280 --> 01:34:27,200 STUDIES IN HUMANS. 2567 01:34:27,200 --> 01:34:28,640 PUBLISHED WORKS SUGGEST EFFECTS 2568 01:34:28,640 --> 01:34:31,960 ARE DIFFERENT BASED ON 2569 01:34:31,960 --> 01:34:33,760 DEVELOPMENTAL STAGE, CRITICAL TO 2570 01:34:33,760 --> 01:34:38,360 UNDERSTAND EVEN PRE-TERM VERSUS 2571 01:34:38,360 --> 01:34:46,360 TERM NEONATES VERSUS CHILDREN 2572 01:34:46,360 --> 01:34:49,480 VERSUS ADULTS. 2573 01:34:49,480 --> 01:34:51,640 NEXT SLIDE PLEASE. 2574 01:34:51,640 --> 01:34:54,680 NUMBER 4, RED CELL THERAPY, WHAT 2575 01:34:54,680 --> 01:34:57,680 ARE OPTIMAL TRANSFUSION 2576 01:34:57,680 --> 01:34:59,200 STRATEGIES FOR OUTPATIENTS 2577 01:34:59,200 --> 01:35:04,360 REQUIRING TRANSFUSION THERAPY? 2578 01:35:04,360 --> 01:35:06,160 RED CELL TRANSFUSION STUDIES, 2579 01:35:06,160 --> 01:35:10,520 NEARLY 30% OF TRANSFUSIONS OCCUR 2580 01:35:10,520 --> 01:35:12,560 OUTSIDE THE OUTPATIENT SETTING. 2581 01:35:12,560 --> 01:35:18,360 WE CAN'T APPLY WHAT'S LEARNED IN 2582 01:35:18,360 --> 01:35:19,680 THE HOSPITAL TO OUTPATIENTS, 2583 01:35:19,680 --> 01:35:22,160 TRANSFUSION NEEDS ARE OVER AND 2584 01:35:22,160 --> 01:35:23,400 EXTENDED PERIOD. 2585 01:35:23,400 --> 01:35:26,760 CLINICAL STUDIES ARE NEEDED TO 2586 01:35:26,760 --> 01:35:27,560 DEFINE OPTIMAL TRANSFUSION 2587 01:35:27,560 --> 01:35:28,760 DECISION MAKING STRATEGIES AND 2588 01:35:28,760 --> 01:35:31,240 WE LACK CONDITION OR 2589 01:35:31,240 --> 01:35:40,760 PATIENT-SPECIFIC METRICS FOR 2590 01:35:40,760 --> 01:35:42,320 LOOKING AT HEMATOPOIESIS. 2591 01:35:42,320 --> 01:35:43,640 NEXT SLIDE PLEASE. 2592 01:35:43,640 --> 01:35:44,800 WHAT IS THE ISSUE? 2593 01:35:44,800 --> 01:35:46,560 I ALREADY EXPLAINED IT BUT THERE 2594 01:35:46,560 --> 01:35:49,000 ARE DIFFERENT GROUPS OF PATIENTS 2595 01:35:49,000 --> 01:35:51,440 THAT REQUIRE RED CELL 2596 01:35:51,440 --> 01:35:52,600 TRANSFUSION CHRONICALLY IN 2597 01:35:52,600 --> 01:35:53,040 OUTPATIENT SETTING. 2598 01:35:53,040 --> 01:35:55,760 SICKLE CELL DISEASE COMES TO 2599 01:35:55,760 --> 01:36:00,160 MIND, BUT ALSO QUALITY OF LIFE 2600 01:36:00,160 --> 01:36:01,000 BENEFITS, PERFORMANCE STATUS 2601 01:36:01,000 --> 01:36:03,920 SUCH AS MDS ARE IMPORTANT. 2602 01:36:03,920 --> 01:36:10,200 PROLONGED TRANSFUSION IS 2603 01:36:10,200 --> 01:36:12,560 ASSOCIATED WITH RISK. 2604 01:36:12,560 --> 01:36:13,760 SIGNIFICANT RESOURCES ARE 2605 01:36:13,760 --> 01:36:15,960 REQUIRED TO MEET NEEDS OF 2606 01:36:15,960 --> 01:36:17,560 DEPENDENT PATIENTS. 2607 01:36:17,560 --> 01:36:22,040 WE LOOK AT RED CELL ANTIBODY 2608 01:36:22,040 --> 01:36:23,360 IDENTIFICATION WORKUPS HERE, RED 2609 01:36:23,360 --> 01:36:25,640 CELL ANTIGEN MATCHING FOR MORE 2610 01:36:25,640 --> 01:36:28,240 FREQUENT UNITS, AND SICKLE CELL 2611 01:36:28,240 --> 01:36:30,480 DISEASE DESK FOR PATIENTS WITH 2612 01:36:30,480 --> 01:36:33,120 SICKLE CELLS, MAKING SURE 2613 01:36:33,120 --> 01:36:35,280 THERE'S NOT SICKLE CELLS IN 2614 01:36:35,280 --> 01:36:38,600 TRANSFUSED UNITS, LACK OF RCT 2615 01:36:38,600 --> 01:36:43,560 DEFINING OPTIMAL DECISION 2616 01:36:43,560 --> 01:36:44,840 MAKING STRATEGIES IN OUTPATIENT 2617 01:36:44,840 --> 01:36:45,240 SETTING. 2618 01:36:45,240 --> 01:36:47,200 WHAT'S THE PROPOSED APPROACH? 2619 01:36:47,200 --> 01:36:50,120 LOOKING AT RCTs TO DEFINE 2620 01:36:50,120 --> 01:36:52,800 OPTIMAL TRANSFUSION SUPPORT FOR 2621 01:36:52,800 --> 01:36:54,440 DISTINCT POPULATIONS REQUIRING 2622 01:36:54,440 --> 01:36:56,640 THERAPY TO EVALUATE AND 2623 01:36:56,640 --> 01:36:58,720 IMPLEMENT NATIONAL REGISTRIES TO 2624 01:36:58,720 --> 01:36:59,520 DOCUMENT TRANSFUSION 2625 01:36:59,520 --> 01:37:07,880 INFORMATION, INCLUDING RED CELL 2626 01:37:07,880 --> 01:37:09,560 IMMUNIZATION, GENOTYPE, 2627 01:37:09,560 --> 01:37:14,160 PHENOTYPE, STUDIES TO DEIMPACT 2628 01:37:14,160 --> 01:37:17,120 IMPACT OF COMMON COMPLICATIONS. 2629 01:37:17,120 --> 01:37:22,480 STUDIES TO DEFINE FUNDAMENTAL 2630 01:37:22,480 --> 01:37:24,320 RISK FACTORS. 2631 01:37:24,320 --> 01:37:25,840 AND THEN CLINICAL AND 2632 01:37:25,840 --> 01:37:27,240 PRE-CLINICAL TRANSLATIONAL 2633 01:37:27,240 --> 01:37:28,000 INVESTIGATION INCLUDING KEY 2634 01:37:28,000 --> 01:37:29,920 DONOR CHARACTERISTICS TO DEFINE 2635 01:37:29,920 --> 01:37:32,040 FACTORS THAT INFLUENCE SURVIVAL 2636 01:37:32,040 --> 01:37:35,400 OF TRANSFUSED RED CELLS THERE BY 2637 01:37:35,400 --> 01:37:37,920 REDUCING ALLOGENEIC EXPOSURE AND 2638 01:37:37,920 --> 01:37:39,240 CONSEQUENCES AS WELL AS 2639 01:37:39,240 --> 01:37:40,200 EFFECTIVE TRANSFUSION UPON 2640 01:37:40,200 --> 01:37:50,760 GENESIS AND CLEARANCE OF NATIVE 2641 01:37:51,840 --> 01:37:52,600 CELLS. 2642 01:37:52,600 --> 01:37:53,280 FEASIBILITY/BARRIERS, LARGE 2643 01:37:53,280 --> 01:37:54,440 NUMBER OF TRANSFUSE THE 2644 01:37:54,440 --> 01:37:58,360 OUTPATIENTS LIKE I SAID NEARLY 2645 01:37:58,360 --> 01:37:59,880 30%, NATIONAL DATABASES AND 2646 01:37:59,880 --> 01:38:01,440 REGISTRIES, ADVANCING ABILITY TO 2647 01:38:01,440 --> 01:38:04,240 PERFORM RED CELL GENESIS, 2648 01:38:04,240 --> 01:38:06,280 RECOVERY AND SURVIVAL STUDDIES, 2649 01:38:06,280 --> 01:38:11,040 GOING TOOL OF BIOTIN LABELING, 2650 01:38:11,040 --> 01:38:15,520 AND GOALS AND ENDPOINTS WILL 2651 01:38:15,520 --> 01:38:16,520 DELIVER BY POPULATION, AND 2652 01:38:16,520 --> 01:38:22,800 LOOKING AT QUALITY OF LIFE 2653 01:38:22,800 --> 01:38:26,360 MEASURES AND PHYSIOLOGIC 2654 01:38:26,360 --> 01:38:26,920 CAPACITY. 2655 01:38:26,920 --> 01:38:30,080 NEXT SLIDE PLEASE. 2656 01:38:30,080 --> 01:38:30,600 BLEEDING MANAGEMENT WITH 2657 01:38:30,600 --> 01:38:31,600 MULTIPLE COMPONENTS, THE 2658 01:38:31,600 --> 01:38:34,400 QUESTION HERE IS WHICH BLOOD 2659 01:38:34,400 --> 01:38:40,280 PRODUCTS, WHOLE OR COMPONENT 2660 01:38:40,280 --> 01:38:41,360 ALONE OR COMBINATION, 2661 01:38:41,360 --> 01:38:42,360 INTRAVENOUS, TOPICAL, 2662 01:38:42,360 --> 01:38:44,280 HEMOSTATICS, ARE MOST EFFECTIVE 2663 01:38:44,280 --> 01:38:46,880 AND SAFE TO TREAT BLEEDING IN 2664 01:38:46,880 --> 01:38:48,920 THE PRE-HOSPITAL AND HOSPITAL 2665 01:38:48,920 --> 01:38:50,240 SETTING INCLUDING DIFFERENT 2666 01:38:50,240 --> 01:38:52,120 CONDITIONS ASSOCIATED WITH 2667 01:38:52,120 --> 01:38:55,200 BLEEDING SUCH AS INTRACRANIAL, 2668 01:38:55,200 --> 01:38:57,800 G.I., SURGICAL, TRAUMA, ALSO 2669 01:38:57,800 --> 01:39:01,160 TAKING INTO CONSIDERATION 2670 01:39:01,160 --> 01:39:04,600 CLINICAL AND COST EFFECTIVENESS 2671 01:39:04,600 --> 01:39:05,600 OUTCOMES, STUDYING COMBINATIONS 2672 01:39:05,600 --> 01:39:07,040 TO OPTIMIZE OUTCOMES. 2673 01:39:07,040 --> 01:39:09,400 INSTEAD OF COMPARING ONE TO 2674 01:39:09,400 --> 01:39:11,800 ANOTHER WE ARE ABLE TO COMPARE 2675 01:39:11,800 --> 01:39:13,960 COMBINATION WE WOULD USE REALLY 2676 01:39:13,960 --> 01:39:17,280 IN REAL WORLD SITUATION TO TREAT 2677 01:39:17,280 --> 01:39:22,640 TRAUMA IN DESIGNING STUDIES THAT 2678 01:39:22,640 --> 01:39:23,960 WAY. 2679 01:39:23,960 --> 01:39:26,960 WHY IS IT AN ISSUE? 2680 01:39:26,960 --> 01:39:31,280 MORBIDITY AND MORTALITY IS HIGH, 2681 01:39:31,280 --> 01:39:33,000 24%, 50%, MORTALITY IN TRAUMA 2682 01:39:33,000 --> 01:39:39,400 AND ABOVE 60% FOR CHILDREN WITH 2683 01:39:39,400 --> 01:39:40,520 MEDICAL ETIOLOGY OF BLEEDING, 2684 01:39:40,520 --> 01:39:41,960 NOT MANY TRIALS CAN INFORM BEST 2685 01:39:41,960 --> 01:39:43,280 PRACTICE SO WE NEED TO CREATE 2686 01:39:43,280 --> 01:39:45,280 THEM IN THE FUTURE. 2687 01:39:45,280 --> 01:39:47,640 RELATIVE TO ALL OTHER CONDITIONS 2688 01:39:47,640 --> 01:39:48,400 THAT REQUIRE TRANSFUSION 2689 01:39:48,400 --> 01:39:50,080 PATIENTS WITH SEVERE BLEEDING 2690 01:39:50,080 --> 01:39:51,920 FROM ALL CAUSES HAVE THE WORST 2691 01:39:51,920 --> 01:39:53,240 OUTCOMES WITH HIGHEST POTENTIAL 2692 01:39:53,240 --> 01:39:54,320 FOR IMPROVEMENT IN OUTCOMES 2693 01:39:54,320 --> 01:39:56,640 SINCE THE RATE OF PREVENTIBLE 2694 01:39:56,640 --> 01:39:59,320 DEATH FROM BLEEDING IS HIGH. 2695 01:39:59,320 --> 01:40:02,360 IT'S ESTIMATED THAT FROM TRAUMA 2696 01:40:02,360 --> 01:40:03,920 ALONE THERE'S 30,000 PREVENTIBLE 2697 01:40:03,920 --> 01:40:13,200 DEATHING PER YEAR IN THE U.S.ING 2698 01:40:13,200 --> 01:40:14,800 SO RESEARCH ON STRATEGIES AND 2699 01:40:14,800 --> 01:40:17,040 BLEEDING PATIENTS SHOULD RECEIVE 2700 01:40:17,040 --> 01:40:19,600 HIGHEST PRIORITY ACCORDING TO 2701 01:40:19,600 --> 01:40:20,560 THIS GROUP. 2702 01:40:20,560 --> 01:40:22,200 AND SINCE THERE'S THE MOST TO 2703 01:40:22,200 --> 01:40:25,120 GAIN IN THIS POPULATION. 2704 01:40:25,120 --> 01:40:27,000 MULTIOMICS ANALYSES HAVE BEEN 2705 01:40:27,000 --> 01:40:30,360 ABLE TO IDENTIFY DISTINCT 2706 01:40:30,360 --> 01:40:32,400 BIOLOGIC RESPONSES AND THEY ARE 2707 01:40:32,400 --> 01:40:34,360 PREDICTIVE OF WHICH COHORT WILL 2708 01:40:34,360 --> 01:40:36,200 HAVE IMPROVED SURVIVAL WITH 2709 01:40:36,200 --> 01:40:37,960 CERTAIN THERAPIES. 2710 01:40:37,960 --> 01:40:40,800 USING PRECISION TRANSFUSION 2711 01:40:40,800 --> 01:40:41,360 MEDICINE THERAPY. 2712 01:40:41,360 --> 01:40:42,920 FOR EXAMPLE, PRE-HOSPITAL PLASMA 2713 01:40:42,920 --> 01:40:45,560 IMPROVED SURVIVAL IN PATIENTS 2714 01:40:45,560 --> 01:40:47,520 WITH PRO-INFLAMMATORY ENDOTYPE 2715 01:40:47,520 --> 01:40:50,760 WITH TRAUMATIC BRAIN INJURY. 2716 01:40:50,760 --> 01:40:52,720 NEXT SLIDE PLEASE. 2717 01:40:52,720 --> 01:40:55,160 WHAT IS THE PROPOSED APPROACH? 2718 01:40:55,160 --> 01:40:56,400 ADAPTIVE TRIAL DESIGN THAT 2719 01:40:56,400 --> 01:40:59,040 INCLUDE PLATFORM TRIALS COULD BE 2720 01:40:59,040 --> 01:41:04,560 CONSIDERED TO FACILITATE THE 2721 01:41:04,560 --> 01:41:05,840 STUDY OF COMBINATIONS AND 2722 01:41:05,840 --> 01:41:07,200 INCLUDE OTHER DESIGNS. 2723 01:41:07,200 --> 01:41:08,480 ALL OF THOSE PLATFORM TRIALS 2724 01:41:08,480 --> 01:41:11,120 COULD INCLUDE WHAT IS BELOW, FOR 2725 01:41:11,120 --> 01:41:12,240 INSTANCE COMPARING INDICATIONS 2726 01:41:12,240 --> 01:41:18,760 FOR PRODUCTS SUCH AS GOAL 2727 01:41:18,760 --> 01:41:20,960 DIRECTED THERAPIES, VISCOELASTIC 2728 01:41:20,960 --> 01:41:21,800 TESTING, MICROFLUIDIC FLOW-BASED 2729 01:41:21,800 --> 01:41:25,080 ASSAYS, COMPARING HOW BLOOD 2730 01:41:25,080 --> 01:41:26,160 COMPONENTS MANUFACTURING METHODS 2731 01:41:26,160 --> 01:41:28,440 AFFECT EFFICACY AND SAFETY, USE 2732 01:41:28,440 --> 01:41:33,440 FOR BLEEDING SUCH AS ROOM 2733 01:41:33,440 --> 01:41:36,040 TEMPERATURE, USE OF HEMOSTATIC 2734 01:41:36,040 --> 01:41:38,520 AGENTS, BIOLOGIC DATA REGARDING 2735 01:41:38,520 --> 01:41:42,760 OXYGEN DELIVERY, IMMUNE FUNCTION 2736 01:41:42,760 --> 01:41:44,960 TO ALLOW FOR USING MULTIOMIC 2737 01:41:44,960 --> 01:41:47,320 PLATFORMS FOR RESPONSE TO 2738 01:41:47,320 --> 01:41:49,160 BLEEDING AND BIOLOGIC RESPONSE 2739 01:41:49,160 --> 01:41:52,160 TO THERAPEUTIC MODALITIES, USE 2740 01:41:52,160 --> 01:41:53,640 OF IMPLEMENTATION SCIENCE, TO 2741 01:41:53,640 --> 01:41:55,560 LOOK AT IMPROVING BLEEDING IN 2742 01:41:55,560 --> 01:41:56,680 THESE PATIENTS, AND FINALLY 2743 01:41:56,680 --> 01:42:00,280 METHODS TO ALLOW FOR EXAMINING 2744 01:42:00,280 --> 01:42:02,200 THE GENERATION AND ACCURACY OF 2745 01:42:02,200 --> 01:42:03,880 BLEEDING SCORES THAT PREDICT USE 2746 01:42:03,880 --> 01:42:05,160 AND CORRELATE WITH CLINICAL 2747 01:42:05,160 --> 01:42:09,120 OUTCOMES THAT ARE ALSO FEASIBLE 2748 01:42:09,120 --> 01:42:13,400 AND REPRODUCIBLE. 2749 01:42:13,400 --> 01:42:16,160 NEXT SLIDE PLEASE. 2750 01:42:16,160 --> 01:42:17,280 THERE ARE ISSUES BUT MOSTLY 2751 01:42:17,280 --> 01:42:21,320 TRIALS IN BLEEDING PATIENTS HAVE 2752 01:42:21,320 --> 01:42:23,320 BEEN SUCCESSFULLY PERFORMED 2753 01:42:23,320 --> 01:42:24,080 RECENTLY, PRE-HOSPITAL, WITH 2754 01:42:24,080 --> 01:42:26,320 EXCEPTION FOR INFORMED CONSENT 2755 01:42:26,320 --> 01:42:28,760 AND PLATFORM TRIALS WHERE 2756 01:42:28,760 --> 01:42:31,040 BASIS -- MANY WERE BASED OFF 2757 01:42:31,040 --> 01:42:32,680 WHAT WAS DONE DURING COVID-19 2758 01:42:32,680 --> 01:42:33,040 TRIALS. 2759 01:42:33,040 --> 01:42:41,880 IT'S FEASIBLE TO INCORPORATE 2760 01:42:41,880 --> 01:42:47,040 PLATFORM TRIALS THAT REQUIRE 2761 01:42:47,040 --> 01:42:51,760 EFIC BASED ON ETHICAL 2762 01:42:51,760 --> 01:42:53,480 PRINCIPLES. 2763 01:42:53,480 --> 01:42:55,560 SO AS I MENTIONED THERE WERE 2764 01:42:55,560 --> 01:42:58,120 FIVE MORE TRIALS THAT REALLY 2765 01:42:58,120 --> 01:43:00,120 WERE GIVEN MUCH, MUCH THOUGHT 2766 01:43:00,120 --> 01:43:01,360 AND CONSIDERATION AND CAN BE 2767 01:43:01,360 --> 01:43:02,920 DISCUSSED IN THE BREAKOUT 2768 01:43:02,920 --> 01:43:03,640 SESSION AS WELL. 2769 01:43:03,640 --> 01:43:08,040 AND THEY WERE LOOKING AT RED 2770 01:43:08,040 --> 01:43:18,520 BLOOD CELL NISHOTS, RISK AND 2771 01:43:21,000 --> 01:43:28,800 OPTIMAL APPROACHES, 2772 01:43:28,800 --> 01:43:30,160 CRYOPRECIPITATE VERSUS 2773 01:43:30,160 --> 01:43:34,400 FIBRINOGEN CONCENTRATE, AND 2774 01:43:34,400 --> 01:43:38,000 CRYOPRECIPITATE VERSUS PLASMA, 2775 01:43:38,000 --> 01:43:41,480 HOW CAN WE PATIENTS WHO REQUIRE 2776 01:43:41,480 --> 01:43:43,480 PLASMA TRANSFUSION OR FIBRINOGEN 2777 01:43:43,480 --> 01:43:45,080 REPLACEMENT, THERE'S STEWARDSHIP 2778 01:43:45,080 --> 01:43:47,080 AND IMPLEMENTATION SCIENCE, 2779 01:43:47,080 --> 01:43:51,760 STRATEGIES TO OPTIMIZE BLOOD 2780 01:43:51,760 --> 01:43:58,080 PRODUCT STEWARDSHIP TO EVALUATE 2781 01:43:58,080 --> 01:44:00,560 AND DISSEMINATE AND COMPARING 2782 01:44:00,560 --> 01:44:02,720 PRODUCTS, IS ONE SUPERIOR, 2783 01:44:02,720 --> 01:44:03,960 TREATMENT OF NON-BLEEDING 2784 01:44:03,960 --> 01:44:05,280 PATIENTS PRIOR TO INVASIVE 2785 01:44:05,280 --> 01:44:06,480 PROCEDURES OR BLEEDING PATIENTS 2786 01:44:06,480 --> 01:44:09,440 IN TERMS OF EFFICACY, SAFETY, 2787 01:44:09,440 --> 01:44:12,040 LOGISTICS, OR SPECIFIC PATIENT 2788 01:44:12,040 --> 01:44:13,800 POPULATIONS. 2789 01:44:13,800 --> 01:44:15,440 NEXT SLIDE PLEASE. 2790 01:44:15,440 --> 01:44:18,320 >> TWO-MINUTE WARNING. 2791 01:44:18,320 --> 01:44:22,040 >> THESE ARE THE PRIORITY 2792 01:44:22,040 --> 01:44:22,720 SUMMARY, PRIORITIES SUMMARIZED, 2793 01:44:22,720 --> 01:44:25,040 AND YOU CAN GO BACK TO SEE SLIDE 2794 01:44:25,040 --> 01:44:27,920 27 TO GO FLEW SOME DETAILS OR 2795 01:44:27,920 --> 01:44:29,440 BACK TO WHAT YOU'VE BEEN 2796 01:44:29,440 --> 01:44:33,680 SUPPLIED TO READ PRIOR TO THIS. 2797 01:44:33,680 --> 01:44:36,240 NEXT SLIDE PLEASE. 2798 01:44:36,240 --> 01:44:38,800 AND LAST BUT NOT LEAST, WE CAN 2799 01:44:38,800 --> 01:44:40,880 RELEASE THESE FROM THE SLIDES, I 2800 01:44:40,880 --> 01:44:42,760 DON'T THINK THIS WAS INCLUDED 2801 01:44:42,760 --> 01:44:44,600 WHEN YOU GOT YOUR INFORMATION 2802 01:44:44,600 --> 01:44:45,360 PRIOR TO THE STATE OF THE 2803 01:44:45,360 --> 01:44:51,240 SCIENCE BUT THIS IS HOW WE WENT 2804 01:44:51,240 --> 01:44:52,760 THROUGH AND RATED EACH PRIORITY 2805 01:44:52,760 --> 01:44:57,320 AND CAME TO OUR TOP FIVE AND OUR 2806 01:44:57,320 --> 01:44:58,960 SECOND FIVE. 2807 01:44:58,960 --> 01:45:03,360 SO WITH THAT, I THANK YOU FOR 2808 01:45:03,360 --> 01:45:04,160 YOUR ATTENTION AND WE'LL 2809 01:45:04,160 --> 01:45:06,560 ENTERTAIN QUESTIONS IN THE CHAT 2810 01:45:06,560 --> 01:45:16,440 BOX DURING THE BREAKOUT SESSION. 2811 01:45:16,440 --> 01:45:17,120 THANK YOU. 2812 01:45:17,120 --> 01:45:19,000 >> THANK YOU, DR. JOSEPHSON. 2813 01:45:19,000 --> 01:45:21,840 AN AMAZING AMOUNT OF MATERIAL TO 2814 01:45:21,840 --> 01:45:23,880 COVER IN JUST UNDER 30 MINUTES, 2815 01:45:23,880 --> 01:45:27,640 VERY MUCH APPRECIATED AND LOTS 2816 01:45:27,640 --> 01:45:28,440 OF POINTS FOR DISCUSSION. 2817 01:45:28,440 --> 01:45:31,840 FOR NOW WE WILL MOVE ON TO OUR 2818 01:45:31,840 --> 01:45:33,440 NEXT WORKING GROUP, EMERGING 2819 01:45:33,440 --> 01:45:35,400 INFECTIONS, IMPACT ON BLOOD 2820 01:45:35,400 --> 01:45:38,160 SCIENCE, THE SUPPLY, SAFETY, AND 2821 01:45:38,160 --> 01:45:39,320 PUBLIC HEALTH. 2822 01:45:39,320 --> 01:45:44,280 CHAIRS ARE DR. EVAN BLOCH AND 2823 01:45:44,280 --> 01:45:45,080 LOUIS KATZ. 2824 01:45:45,080 --> 01:45:48,400 DR. BLOCH IS LEADING US THROUGH 2825 01:45:48,400 --> 01:45:58,320 THE CONTENT TODAY. 2826 01:45:58,320 --> 01:45:58,960 >> OKAY. 2827 01:45:58,960 --> 01:46:06,160 FIRST, SINCERE THANKS TO NHLBI, 2828 01:46:06,160 --> 01:46:08,440 ORGANIZING COMMITTEE, BRIAN AND 2829 01:46:08,440 --> 01:46:08,680 NAREG. 2830 01:46:08,680 --> 01:46:11,880 OUR FOCUS IS EMERGING INFECTION. 2831 01:46:11,880 --> 01:46:14,800 A CONCEPT PRESENTED BY MYSELF 2832 01:46:14,800 --> 01:46:16,440 AND MY CO-MODERATOR, DR. LOUIS 2833 01:46:16,440 --> 01:46:18,160 KATZ, IS CREDITED COULD THE 2834 01:46:18,160 --> 01:46:20,000 EFFORT OF THE MEMBERS OF THE 2835 01:46:20,000 --> 01:46:20,600 WORKING GROUP ACKNOWLEDGED AT 2836 01:46:20,600 --> 01:46:21,200 THE END. 2837 01:46:21,200 --> 01:46:25,000 AS WE GO THROUGH THE SLIDES, THE 2838 01:46:25,000 --> 01:46:26,200 PRIORITIES ARE NOT NUMBERED SO 2839 01:46:26,200 --> 01:46:29,200 DIFFERENT FROM THE PRIOR TWO 2840 01:46:29,200 --> 01:46:29,680 PRESENTATIONS. 2841 01:46:29,680 --> 01:46:31,000 THIS WAS INTENTIONAL. 2842 01:46:31,000 --> 01:46:33,080 WE EACH HAVE OUR BIASES AND 2843 01:46:33,080 --> 01:46:34,720 PREFERENCES, SO WE'VE LEFT THE 2844 01:46:34,720 --> 01:46:36,520 FINAL RANKING TO THE BREAKOUT 2845 01:46:36,520 --> 01:46:39,320 SESSION, WE DO KNOW WHAT THE 2846 01:46:39,320 --> 01:46:40,800 INDIVIDUAL MEMBERS, WHAT THEY 2847 01:46:40,800 --> 01:46:46,360 WOULD LIKE TO SEE. 2848 01:46:46,360 --> 01:46:50,200 NEXT SLIDE PLEASE. 2849 01:46:50,200 --> 01:46:54,800 SO, A WORD ABOUT EMERGING 2850 01:46:54,800 --> 01:46:56,240 INFECTIOUS DISEASES, ENCOUNTERED 2851 01:46:56,240 --> 01:46:57,320 MUCH MORE FREQUENTLY THAN 2852 01:46:57,320 --> 01:46:58,440 APPRECIATED, WE CAN LOOK AT THE 2853 01:46:58,440 --> 01:47:01,440 PAST TWO YEARS JUST TO GET A 2854 01:47:01,440 --> 01:47:03,320 FINE APPRECIATION FOR THE IMPACT 2855 01:47:03,320 --> 01:47:04,200 OF EMERGING INFECTIOUS DISEASES, 2856 01:47:04,200 --> 01:47:06,680 WE'RE IN THE MIDST OF AN 2857 01:47:06,680 --> 01:47:10,240 HISTORIC COVID-19 PANDEMIC AS 2858 01:47:10,240 --> 01:47:13,040 WELL AS MONKEYPOX PANDEMIC, OR 2859 01:47:13,040 --> 01:47:14,320 CRISIS OF INTERNATIONAL CONCERN, 2860 01:47:14,320 --> 01:47:16,560 DEPENDING HOW YOU WANT TO PHRASE 2861 01:47:16,560 --> 01:47:17,840 IT. 2862 01:47:17,840 --> 01:47:18,400 MULTIPLE AND DIVERSE 2863 01:47:18,400 --> 01:47:22,360 CONTRIBUTING FACTORS WHY THERE 2864 01:47:22,360 --> 01:47:25,400 IS INCREASED ESCALATION IN 2865 01:47:25,400 --> 01:47:27,520 EIDs, AND THEY ARE BOTH DIRECT 2866 01:47:27,520 --> 01:47:30,760 AS INDIRECT EFFECTS ON THE BLOOD 2867 01:47:30,760 --> 01:47:32,560 SUPPLY INDEPENDENT OF WHETHER A 2868 01:47:32,560 --> 01:47:33,960 GIVEN PATHOGEN IS ULTIMATELY 2869 01:47:33,960 --> 01:47:37,000 DEEMED TO BE TRANSFUSION 2870 01:47:37,000 --> 01:47:37,960 TRANSMISSIBLE. 2871 01:47:37,960 --> 01:47:39,200 NEXT SLIDE PLEASE. 2872 01:47:39,200 --> 01:47:43,680 SO, FIRST PRIORITY WHICH I'LL BE 2873 01:47:43,680 --> 01:47:45,960 DISCUSSING IS LEVERAGE DONOR 2874 01:47:45,960 --> 01:47:47,960 POPULATION TO STUDY EPIDEMIOLOGY 2875 01:47:47,960 --> 01:47:56,800 AND PATHOGENESIS OF TTIs AND 2876 01:47:56,800 --> 01:48:07,240 EIDs TO OPT MICE USE OF 2877 01:48:07,240 --> 01:48:07,640 POPULATION. 2878 01:48:07,640 --> 01:48:10,320 BLOOD DONORS OFFER OPPORTUNITIES 2879 01:48:10,320 --> 01:48:12,280 FOR STUDY OF INFECTIOUS DISEASE. 2880 01:48:12,280 --> 01:48:13,000 NEXT SLIDE PLEASE. 2881 01:48:13,000 --> 01:48:15,040 WHY IS THIS AN ISSUE? 2882 01:48:15,040 --> 01:48:16,920 WELL, IT'S NOT REALLY AN ISSUE. 2883 01:48:16,920 --> 01:48:19,640 IT'S AN OPPORTUNITY. 2884 01:48:19,640 --> 01:48:20,600 BLOOD DONORS ARE LARGE 2885 01:48:20,600 --> 01:48:22,800 DEMOGRAPHICALLY DIVERSE SUBSETS 2886 01:48:22,800 --> 01:48:25,840 OF THE GENERAL POPULATION. 2887 01:48:25,840 --> 01:48:27,160 THEY ARE GENERATING 2888 01:48:27,160 --> 01:48:31,560 CROSS-SECTIONAL AS WELL AS 2889 01:48:31,560 --> 01:48:32,960 LONGITUDINAL SAMPLES, LEVERAGED 2890 01:48:32,960 --> 01:48:39,400 FOR RESEARCH. 2891 01:48:39,400 --> 01:48:41,440 THE DATA AFFORD INSIGHT INTO 2892 01:48:41,440 --> 01:48:42,120 TRANSFUSION TRANSMITTED 2893 01:48:42,120 --> 01:48:45,200 INFECTION AND EMERGING 2894 01:48:45,200 --> 01:48:46,480 INFECTION. 2895 01:48:46,480 --> 01:48:47,960 THERE'S NUMEROUS EXAMPLES WHERE 2896 01:48:47,960 --> 01:48:52,840 DATA HAVE BEEN USED SUCCESSFULLY 2897 01:48:52,840 --> 01:48:54,320 TO ADVANCE OUR UNDERSTANDING OF 2898 01:48:54,320 --> 01:48:59,360 VARIETY OF INFECTIOUS DISEASES. 2899 01:48:59,360 --> 01:49:03,440 SEMINAL WORK ON HEPATITIS THAT 2900 01:49:03,440 --> 01:49:05,880 ARE WIDE REACHING, THOSE 2901 01:49:05,880 --> 01:49:07,880 FINDINGS WERE WIDE REACHING, 2902 01:49:07,880 --> 01:49:09,080 ADVANCING UNDERSTANDING OF 2903 01:49:09,080 --> 01:49:12,200 HEPATITIS B AS WELL AS HEPATITIS 2904 01:49:12,200 --> 01:49:14,240 C AND INTERVENTIONS THAT WE KNOW 2905 01:49:14,240 --> 01:49:17,760 IS ROUTINE IN BLOOD BANKING 2906 01:49:17,760 --> 01:49:19,640 ATTRIBUTED TO SOME OF THAT WORK. 2907 01:49:19,640 --> 01:49:21,560 LONGITUDINAL STUDY OF HIV 2908 01:49:21,560 --> 01:49:23,560 INFECTED DONORS AND RECIPIENTS 2909 01:49:23,560 --> 01:49:26,840 HAS INFORMED THE VIRAL AND 2910 01:49:26,840 --> 01:49:28,000 IMMUNOLOGICAL DYNAMICS DURING 2911 01:49:28,000 --> 01:49:29,680 ACUTE AND EARLY INFECTION. 2912 01:49:29,680 --> 01:49:31,960 SO THAT'S BEEN USED, 2913 01:49:31,960 --> 01:49:33,400 INCORPORATED INTO DIFFERENT 2914 01:49:33,400 --> 01:49:35,520 STAGING SYSTEMS. 2915 01:49:35,520 --> 01:49:39,560 IT'S YIELDED NOVEL CONCEPTS 2916 01:49:39,560 --> 01:49:42,800 SURROUNDING TRANSMITTED AND 2917 01:49:42,800 --> 01:49:44,360 FOUNDER VIRUSES. 2918 01:49:44,360 --> 01:49:47,640 WHAT'S THE PROPOSED APPROACH? 2919 01:49:47,640 --> 01:49:49,440 REALLY TO EXTEND EPIDEMIOLOGICAL 2920 01:49:49,440 --> 01:49:51,280 AND PATHOGENESIS RESEARCH IN 2921 01:49:51,280 --> 01:49:53,880 DONORS TO OTHER AGENTS. 2922 01:49:53,880 --> 01:49:58,320 IT'S ALREADY BEEN UNDERTAKEN FOR 2923 01:49:58,320 --> 01:50:02,720 A VARIETY OF PATHOGENS, HTLV, 2924 01:50:02,720 --> 01:50:09,760 ARBOVIRUS, PARASITES, AND FOR 2925 01:50:09,760 --> 01:50:11,720 EMERGING OUTBREAKS COMBINING TO 2926 01:50:11,720 --> 01:50:12,960 PROVIDE ESTIMATES OF POPULATION 2927 01:50:12,960 --> 01:50:15,640 INFECTIOUS RATES. 2928 01:50:15,640 --> 01:50:17,840 ALSO TO CONDUCT DONOR FOLLOW-UP 2929 01:50:17,840 --> 01:50:21,040 STUDIES WHERE WE CAN EXAMINE 2930 01:50:21,040 --> 01:50:22,320 IMMUNE RESPONSE DYNAMICS, 2931 01:50:22,320 --> 01:50:28,600 CORRELATE THOSE FINDINGS WERE 2932 01:50:28,600 --> 01:50:29,320 SYMPTOMS, AGAIN EXAMPLE OF 2933 01:50:29,320 --> 01:50:33,440 RECENT, YOU KNOW, RECENT EXAMPLE 2934 01:50:33,440 --> 01:50:37,640 WHERE THIS HAS BEEN UNDERTAKEN 2935 01:50:37,640 --> 01:50:40,960 SUCCESSFULLY DONOR SURVEILLANCE 2936 01:50:40,960 --> 01:50:42,800 STUDIES OF SARS-COV-2, YIELDED 2937 01:50:42,800 --> 01:50:45,600 ESTIMATES OF BURDEN OF 2938 01:50:45,600 --> 01:50:48,400 INFECTION, VACCINATION RATES, 2939 01:50:48,400 --> 01:50:49,760 COMPARED WITH CLINICAL CASE 2940 01:50:49,760 --> 01:50:52,560 RATES ENABLE ESTIMATES OF 2941 01:50:52,560 --> 01:50:54,120 INFECTION INCLUDING VACCINE 2942 01:50:54,120 --> 01:50:54,640 BREAKTHROUGH, REINFECTION, 2943 01:50:54,640 --> 01:50:58,280 DISEASE PENETRANCE. 2944 01:50:58,280 --> 01:51:00,280 NEXT SLIDE PLEASE. 2945 01:51:00,280 --> 01:51:03,600 WHAT'S THE FEASIBILITY OF 2946 01:51:03,600 --> 01:51:04,560 BARRIERS? 2947 01:51:04,560 --> 01:51:06,600 FEASIBLE, WE DISCUSSED A FEW 2948 01:51:06,600 --> 01:51:09,400 HIGH YIELD CONTRIBUTIONS, BUT 2949 01:51:09,400 --> 01:51:12,040 THE CHALLENGES RELATE TO 2950 01:51:12,040 --> 01:51:12,800 ESTABLISHING SUSTAINABILITY, 2951 01:51:12,800 --> 01:51:15,680 SUSTAIN ANALYSIS ITEMS FOR 2952 01:51:15,680 --> 01:51:17,720 REPOSITORIES AND RESEARCH 2953 01:51:17,720 --> 01:51:19,040 PROGRAMS, THE APPROACH HAS BEEN 2954 01:51:19,040 --> 01:51:22,840 BASED ON AD HOC PROPOSALS AND 2955 01:51:22,840 --> 01:51:26,480 SHORT-TERM FUNDING STREAMS. 2956 01:51:26,480 --> 01:51:30,520 HIGH PRIORITY ACTIVITIES INCLUDE 2957 01:51:30,520 --> 01:51:31,880 REALLY BUILDING SUSTAINABLE 2958 01:51:31,880 --> 01:51:34,480 CAPACITY, IDEALLY NEAR REAL TIME 2959 01:51:34,480 --> 01:51:36,960 RESPONSE TO POTENTIAL EID, ONE 2960 01:51:36,960 --> 01:51:40,520 NEEDS SYSTEMS TO CAPTURE 2961 01:51:40,520 --> 01:51:41,640 DONATION SAMPLES, CHARACTERIZE 2962 01:51:41,640 --> 01:51:42,560 MOLECULAR AND SEROLOGICAL 2963 01:51:42,560 --> 01:51:46,160 MARKERS TO ESTABLISH INCIDENCE 2964 01:51:46,160 --> 01:51:47,920 AND PREVALENCE OF INFECTION, 2965 01:51:47,920 --> 01:51:49,560 LONGITUDINAL FOLLOW-UP OF DONORS 2966 01:51:49,560 --> 01:51:54,200 FOR NATURAL HISTORY, AND 2967 01:51:54,200 --> 01:51:55,800 PATHOGENESIS STUDIES, SAMPLES 2968 01:51:55,800 --> 01:51:56,760 CAPTURE POST-DONATION 2969 01:51:56,760 --> 01:52:00,040 INFORMATION AND REPEAT DONOR 2970 01:52:00,040 --> 01:52:01,440 COHORT REPOSITORIES AND SUPPORTS 2971 01:52:01,440 --> 01:52:03,720 EFFORTS WHICH ARE ALREADY 2972 01:52:03,720 --> 01:52:06,080 UNDERWAY SO AGAIN GOING BACK TO 2973 01:52:06,080 --> 01:52:07,680 SARS-COV-2, THERE'S A LOT WHICH 2974 01:52:07,680 --> 01:52:10,320 CAN BE DONE WITH EPIDEMIOLOGY 2975 01:52:10,320 --> 01:52:11,520 AND PATHOGENESIS RESEARCH, AND 2976 01:52:11,520 --> 01:52:14,240 AS WELL AS ADVANCING THINGS TO 2977 01:52:14,240 --> 01:52:18,400 RAPID RESPONSES TO NEW EIDs 2978 01:52:18,400 --> 01:52:21,040 BASED ON TARGETING INVESTIGATION 2979 01:52:21,040 --> 01:52:22,680 OF DIFFERENT REPOSITORIES. 2980 01:52:22,680 --> 01:52:24,520 TO CONTINUE MOLECULAR 2981 01:52:24,520 --> 01:52:28,600 SURVEILLANCE OF INCIDENCE 2982 01:52:28,600 --> 01:52:30,000 INFECTION USING EXTANT 2983 01:52:30,000 --> 01:52:40,480 MECHANISMS SUCH AS REDS AND 2984 01:52:44,280 --> 01:52:44,680 TTIMS. 2985 01:52:44,680 --> 01:52:46,920 QUESTION IS HOW CAN PATHOGEN 2986 01:52:46,920 --> 01:52:49,280 REDUCTION OR PR BE INTEGRATED 2987 01:52:49,280 --> 01:52:50,440 INTO ROUTINE BLOOD TRANSFUSION 2988 01:52:50,440 --> 01:52:57,400 OPERATIONS TO OPTIMIZE BLOOD 2989 01:52:57,400 --> 01:52:59,720 SAFETY WHILE PRESERVING POTENCY? 2990 01:52:59,720 --> 01:53:04,800 CONVENTIONAL PARADIGM OF TEST 2991 01:53:04,800 --> 01:53:07,520 DEVELOPMENT IS SUBOPTIMAL, WHEN 2992 01:53:07,520 --> 01:53:08,400 CONTENDING WITH EMERGING, 2993 01:53:08,400 --> 01:53:12,240 REEMERGING, NOVEL PATHOGENS. 2994 01:53:12,240 --> 01:53:14,320 NEXT SLIDE PLEASE. 2995 01:53:14,320 --> 01:53:18,560 IT'S LOOKING AT A REACTIVE 2996 01:53:18,560 --> 01:53:21,040 VERSUS PRO-ACTIVE RESPONSE, THE 2997 01:53:21,040 --> 01:53:25,760 CONVENTIONAL PARADIGM OF TEST 2998 01:53:25,760 --> 01:53:32,600 DEVELOPMENT IS REACTIVE, A PIECE 2999 01:53:32,600 --> 01:53:34,840 VIEWED AS PRO-ACTIVE, INCLUDING 3000 01:53:34,840 --> 01:53:39,640 PATHOGENS WHICH SCREENING IS 3001 01:53:39,640 --> 01:53:41,760 ROUTINE, MAJOR TTIs, AGENTS 3002 01:53:41,760 --> 01:53:42,720 KNOWN TO BE TRANSMISSIBLE BUT 3003 01:53:42,720 --> 01:53:44,200 SCREENING IS NOT AVAILABLE FOR 3004 01:53:44,200 --> 01:53:47,680 ONE REASON OR ANOTHER. 3005 01:53:47,680 --> 01:53:50,160 WITH RESPECT TO TESTING, WHICH 3006 01:53:50,160 --> 01:53:51,720 IS THE CURRENT PARADIGM, THE 3007 01:53:51,720 --> 01:53:56,400 PACE OF TEST DEVELOPMENT IS 3008 01:53:56,400 --> 01:53:57,040 UNMATCHED. 3009 01:53:57,040 --> 01:53:58,520 THERE ARE REGULATORY AND 3010 01:53:58,520 --> 01:54:01,560 ADMINISTRATIVE BARRIERS TO TEST 3011 01:54:01,560 --> 01:54:02,520 DEVELOPMENT, QUALIFICATION 3012 01:54:02,520 --> 01:54:03,200 IMPLEMENTATION. 3013 01:54:03,200 --> 01:54:04,720 WE LOVE TO BLAME REGULATORS BUT 3014 01:54:04,720 --> 01:54:09,000 SOME OF THAT IS INHERENT TO A 3015 01:54:09,000 --> 01:54:10,320 NEW PATHOGEN. 3016 01:54:10,320 --> 01:54:12,200 THESE THINGS TAKE TIME. 3017 01:54:12,200 --> 01:54:14,840 DURING THAT TIME OF TEST 3018 01:54:14,840 --> 01:54:15,920 DEVELOPMENT, TRANSFUSION 3019 01:54:15,920 --> 01:54:18,320 TRANSMISSION, IS POTENTIALLY 3020 01:54:18,320 --> 01:54:20,080 GOING UNINTERRUPTED. 3021 01:54:20,080 --> 01:54:23,960 SO P.R. OFFERS A PRO-ACTIVE 3022 01:54:23,960 --> 01:54:25,640 STRATEGY, AVOIDS INTERVENTION. 3023 01:54:25,640 --> 01:54:28,840 ANCILLARY BENEFITS AS WELL, ONE 3024 01:54:28,840 --> 01:54:30,880 COULD EXTEND PRODUCT SHELF LIFE, 3025 01:54:30,880 --> 01:54:33,160 WHICH WOULD REDUCE WASTE AND 3026 01:54:33,160 --> 01:54:35,120 PRESERVE SAFETY, IF YOU THINK 3027 01:54:35,120 --> 01:54:36,920 ABOUT BACTERIAL CONTAMINATION 3028 01:54:36,920 --> 01:54:37,600 AND PLATELETS. 3029 01:54:37,600 --> 01:54:41,000 KIND OF MY NEXT STATEMENT IS 3030 01:54:41,000 --> 01:54:43,520 IRONIC, COULD DEFRAY COST OF 3031 01:54:43,520 --> 01:54:45,440 INFECTIOUS TESTING, WHICH IS 3032 01:54:45,440 --> 01:54:46,440 PLACING STRAIN ON TRANSFUSION 3033 01:54:46,440 --> 01:54:48,440 SERVICES AND I'LL GET TO THAT IN 3034 01:54:48,440 --> 01:54:50,280 A SUBSEQUENT SLIDE. 3035 01:54:50,280 --> 01:54:52,520 AND P.R. COULD REPLACE 3036 01:54:52,520 --> 01:54:53,280 IRRADIATION OF SELECTIVE 3037 01:54:53,280 --> 01:54:55,400 TECHNOLOGIES HAVE BEEN SHOWN TO 3038 01:54:55,400 --> 01:54:59,520 BE EFFECTIVE IN PREVENTING 3039 01:54:59,520 --> 01:55:00,320 TRANSFUSION-ASSOCIATED 3040 01:55:00,320 --> 01:55:00,880 GRAFT-VERSUS-HOST DISEASE. 3041 01:55:00,880 --> 01:55:02,920 NEXT SLIDE PLEASE. 3042 01:55:02,920 --> 01:55:05,560 THE PROPOSED APPROACH BROADLY IS 3043 01:55:05,560 --> 01:55:08,040 RESEARCH TO ADVANCE PR BY 3044 01:55:08,040 --> 01:55:09,360 REFINING CURRENT METHODS, AS 3045 01:55:09,360 --> 01:55:11,440 WELL AS DEVELOPING NEW 3046 01:55:11,440 --> 01:55:12,440 TECHNOLOGIES, SPECIFICALLY FOR 3047 01:55:12,440 --> 01:55:15,600 WHOLE BLOOD AND RED CELLS. 3048 01:55:15,600 --> 01:55:18,800 AND THERE ARE MECHANISMS TO DO 3049 01:55:18,800 --> 01:55:24,600 THIS, COULD SHALL ACCOMPLISHED 3050 01:55:24,600 --> 01:55:26,160 THROUGH INDUSTRY PARTNERSHIPS, 3051 01:55:26,160 --> 01:55:28,400 SPECIFICALLY SBIR FUNDING, AND 3052 01:55:28,400 --> 01:55:30,440 INDEPENDENCE ASSESSMENTS OF 3053 01:55:30,440 --> 01:55:32,400 RISKS AND COST/BENEFITS OF 3054 01:55:32,400 --> 01:55:34,360 IMPLEMENTATION OF P.R. 3055 01:55:34,360 --> 01:55:37,040 NEXT SLIDE PLEASE. 3056 01:55:37,040 --> 01:55:38,080 SO FEASIBILITY OR BARRIERS, 3057 01:55:38,080 --> 01:55:40,120 MAJOR BARRIER AT THE MOMENT IS 3058 01:55:40,120 --> 01:55:41,720 THAT THERE'S NO APPROVED 3059 01:55:41,720 --> 01:55:43,560 TECHNOLOGIES FOR TREATMENT OF 3060 01:55:43,560 --> 01:55:47,160 WHOLE BALLOONED RED CELLS IN THE 3061 01:55:47,160 --> 01:55:49,600 U.S. 3062 01:55:49,600 --> 01:55:51,680 RED CELLS ARE MOST COMMONLY 3063 01:55:51,680 --> 01:55:54,200 TRANSFUSED, THAT BARS UNIVERSAL 3064 01:55:54,200 --> 01:56:04,720 ADOPTION OF P.R. AT THE MOMENT. 3065 01:56:06,320 --> 01:56:07,640 AS COMPARED TO UNTREATED 3066 01:56:07,640 --> 01:56:10,960 PRODUCTS, P.R. IS HIGH COST AND 3067 01:56:10,960 --> 01:56:13,120 THE PREVIOUS SLIDE SAID IT COULD 3068 01:56:13,120 --> 01:56:16,240 DEFRAY COST, BUT AT THE MOMENT 3069 01:56:16,240 --> 01:56:18,920 IMPLEMENTATION IS VIEWED AS 3070 01:56:18,920 --> 01:56:20,600 INCREMENTAL COST, SO 3071 01:56:20,600 --> 01:56:22,160 IMPLEMENTATION MIGHT BE VIEWED 3072 01:56:22,160 --> 01:56:23,840 MORE FAVORABLY IF P.R. 3073 01:56:23,840 --> 01:56:25,880 TECHNOLOGIES WERE ALLOWED TO 3074 01:56:25,880 --> 01:56:26,640 REPLACE COMPETING INTERVENTIONS 3075 01:56:26,640 --> 01:56:29,600 BUT THAT REALLY NEEDS TO BE 3076 01:56:29,600 --> 01:56:31,440 UNDERSTOOD MORE HOW THAT COULD 3077 01:56:31,440 --> 01:56:33,040 BE INTEGRATED BETTER. 3078 01:56:33,040 --> 01:56:34,640 THERE'S ALSO UNCERTAINTY ABOUT 3079 01:56:34,640 --> 01:56:37,560 THE LONG-TERM SAFETY EFFECTS OF 3080 01:56:37,560 --> 01:56:39,240 SELECTIVE TECHNOLOGIES. 3081 01:56:39,240 --> 01:56:41,760 NEXT SLIDE PLEASE. 3082 01:56:41,760 --> 01:56:43,720 THE THIRD PRIORITY IS A 3083 01:56:43,720 --> 01:56:46,360 FRAMEWORK FOR RAPID OR RIGOROUS 3084 01:56:46,360 --> 01:56:47,920 INTRODUCTION OF PASSIVE ANTIBODY 3085 01:56:47,920 --> 01:56:48,840 BASED THERAPIES. 3086 01:56:48,840 --> 01:56:50,720 SPECIFICALLY HOW CAN BLOOD 3087 01:56:50,720 --> 01:56:55,000 PRODUCTS AND DERIVATIVES SUCH AS 3088 01:56:55,000 --> 01:56:56,680 CONVALESCENT PLASMA BE PRODUCED 3089 01:56:56,680 --> 01:57:00,800 FOR EMERGING INFECTIOUS 3090 01:57:00,800 --> 01:57:03,840 DISEASES, SO DESPITE WIDESPREAD 3091 01:57:03,840 --> 01:57:06,480 USE OF THERAPIES DURING THE 3092 01:57:06,480 --> 01:57:08,440 COVID-19 PANDEMIC, THERE'S 3093 01:57:08,440 --> 01:57:10,320 REALLY NUMEROUS QUESTIONS THAT 3094 01:57:10,320 --> 01:57:10,800 REMAIN. 3095 01:57:10,800 --> 01:57:13,280 EVERYTHING FROM MECHANISM OF 3096 01:57:13,280 --> 01:57:15,440 ACTION, OPTIMAL DOSAGE, CLINICAL 3097 01:57:15,440 --> 01:57:15,840 USE. 3098 01:57:15,840 --> 01:57:16,440 NEXT SLIDE PLEASE. 3099 01:57:16,440 --> 01:57:24,240 SO WHY IS IT AN ISSUE? 3100 01:57:24,240 --> 01:57:26,320 WHAT IS CONVALESCENT PLASMA? 3101 01:57:26,320 --> 01:57:28,200 IT'S COLLECTED FROM INDIVIDUALS 3102 01:57:28,200 --> 01:57:31,560 WHO RECOVERED FROM A GIVEN 3103 01:57:31,560 --> 01:57:33,240 INFECTION, VACCINATED AND 3104 01:57:33,240 --> 01:57:36,760 DEVELOPED ANTIBODIES AGAINST A 3105 01:57:36,760 --> 01:57:38,120 PATHOGEN OF INTEREST. 3106 01:57:38,120 --> 01:57:41,560 IT'S AN ATTRACTIVE THERAPY FOR 3107 01:57:41,560 --> 01:57:42,640 USE AGAINST EIDs, PARTICULARLY 3108 01:57:42,640 --> 01:57:45,680 EARLY IN AN OUTBREAK WHEN 3109 01:57:45,680 --> 01:57:47,560 PREVENTIVE STRATEGIES SUCH AS 3110 01:57:47,560 --> 01:57:51,840 VACCINES OR TREATMENTS SUCH AS 3111 01:57:51,840 --> 01:57:53,360 DIRECT ACTING ANTI-VIRALS, 3112 01:57:53,360 --> 01:57:54,160 MONOCLONALS, UNLIKELY TO BE 3113 01:57:54,160 --> 01:57:54,680 AVAILABLE. 3114 01:57:54,680 --> 01:57:58,320 THERE ARE OTHER EXAMPLES OF 3115 01:57:58,320 --> 01:57:59,920 PASSIVE ANTIBODY BASED 3116 01:57:59,920 --> 01:58:03,320 THERAPIES, HUMANER IMMUNE 3117 01:58:03,320 --> 01:58:04,080 GLOBULIN, MONOCLONAL ANTIBODIES, 3118 01:58:04,080 --> 01:58:05,920 SLOW TO BE MANUFACTURED, MAY NOT 3119 01:58:05,920 --> 01:58:08,440 KEEP PACE WITH VIRAL EVOLUTION, 3120 01:58:08,440 --> 01:58:12,960 AS WAS THE CASE CAN SARS-COV-2, 3121 01:58:12,960 --> 01:58:17,520 EMERGENCE OF VARIANTS ANDS 3122 01:58:17,520 --> 01:58:22,560 SUBVARIANTS RENDERING AGENTS 3123 01:58:22,560 --> 01:58:23,920 INEFFECTIVE. 3124 01:58:23,920 --> 01:58:33,720 CP MAY BE LESS VULNERABLE. 3125 01:58:33,720 --> 01:58:34,920 PRIOR TO THE COVID-19, ONE CATCH 3126 01:58:34,920 --> 01:58:39,080 IS THAT A LOT OF FAVORABLE 3127 01:58:39,080 --> 01:58:41,840 REPORTS ARE GLEANED AND 3128 01:58:41,840 --> 01:58:42,320 CONTROLLED OBSERVATIONAL 3129 01:58:42,320 --> 01:58:45,040 STUDIES, HOST OF LIMITATIONS. 3130 01:58:45,040 --> 01:58:47,480 WE'VE LEARNED A LOT DURING 3131 01:58:47,480 --> 01:58:48,840 COVID. 3132 01:58:48,840 --> 01:58:50,040 WE KNOW THAT CONVALESCENT PLASMA 3133 01:58:50,040 --> 01:58:52,320 SEEMS TO BE SAFETY, COMPARABLE 3134 01:58:52,320 --> 01:58:54,520 RISKS TO OTHER PLASMA PRODUCTS, 3135 01:58:54,520 --> 01:59:03,400 AND EFFICACY IS PREDICATED ON 3136 01:59:03,400 --> 01:59:05,400 HIGH-TITER ANTIBODIES. 3137 01:59:05,400 --> 01:59:06,640 PROPOSED APPROACH BROADLY WE 3138 01:59:06,640 --> 01:59:08,200 NEED RESEARCH TO GUIDE RATIONAL 3139 01:59:08,200 --> 01:59:10,200 PRACTICE, SO THIS IS JUST A LIST 3140 01:59:10,200 --> 01:59:12,560 OF SOME OF THE EXAMPLES OF 3141 01:59:12,560 --> 01:59:14,640 STUDIES THAT ARE WITHIN THAT 3142 01:59:14,640 --> 01:59:16,040 SCOPE. 3143 01:59:16,040 --> 01:59:17,080 SO DETERMINATION OF EFFICACY, 3144 01:59:17,080 --> 01:59:20,960 SELECTED HIGH RISK PATIENT 3145 01:59:20,960 --> 01:59:21,680 POPULATIONS. 3146 01:59:21,680 --> 01:59:22,840 INCLUDING IMMUNOCOMPROMISED, 3147 01:59:22,840 --> 01:59:25,000 OPTIMIZATION OF CONVALESCENT 3148 01:59:25,000 --> 01:59:26,440 PLASMA USE, PRODUCT 3149 01:59:26,440 --> 01:59:27,280 QUALIFICATION, DOSING, 3150 01:59:27,280 --> 01:59:30,680 INDICATION, NOT JUST FOR 3151 01:59:30,680 --> 01:59:33,000 SARS-COV-2 BUT OTHER PATHOGENS, 3152 01:59:33,000 --> 01:59:35,400 DEVELOPMENTS OF OPERATIONAL 3153 01:59:35,400 --> 01:59:37,040 STRATEGIES TO DEPLOY 3154 01:59:37,040 --> 01:59:40,440 CONVALESCENT PLASMA EARLY AND 3155 01:59:40,440 --> 01:59:44,160 RAPIDLY, RISK ASSESSMENT OF CP 3156 01:59:44,160 --> 01:59:46,320 IN LOW- AND MIDDLE-INCOME 3157 01:59:46,320 --> 01:59:47,920 COUNTRIES WHERE TRANSMISSIBLE 3158 01:59:47,920 --> 01:59:48,960 INFECTION MAY OUTWEIGH BENEFIT 3159 01:59:48,960 --> 01:59:51,160 OF CP AND COULD BE A ROLE FOR 3160 01:59:51,160 --> 01:59:54,360 PATHOGEN REDUCTION AND A HOST OF 3161 01:59:54,360 --> 01:59:57,440 BASIC SCIENCE QUESTIONS RELATING 3162 01:59:57,440 --> 01:59:58,280 TO UNDERSTANDING MECHANISM OF 3163 01:59:58,280 --> 02:00:00,920 ACTION AND DEVELOPMENT OF OTHER 3164 02:00:00,920 --> 02:00:01,840 PASSIVE ANTIBODY-BASED 3165 02:00:01,840 --> 02:00:02,320 THERAPIES. 3166 02:00:02,320 --> 02:00:04,560 NEXT SLIDE PLEASE. 3167 02:00:04,560 --> 02:00:06,240 SO IN TERMS OF BARRIERS, 3168 02:00:06,240 --> 02:00:08,240 FEASIBILITY SO THAT THERE'S -- I 3169 02:00:08,240 --> 02:00:11,960 SEE THIS AS A REAL OPPORTUNITY, 3170 02:00:11,960 --> 02:00:16,400 EVIDENCED BY THE COVID-19 3171 02:00:16,400 --> 02:00:17,520 PANDEMIC, MULTI-DISCIPLINARY AND 3172 02:00:17,520 --> 02:00:19,920 INTERDISCIPLINARY COLLABORATION 3173 02:00:19,920 --> 02:00:21,680 AND RESEARCH, REFLECTING ON 3174 02:00:21,680 --> 02:00:23,560 COVID-19, CHALLENGES RELATED TO 3175 02:00:23,560 --> 02:00:25,760 LACK OF HARMONIZATION AND THIS 3176 02:00:25,760 --> 02:00:27,640 WAS HIGHLIGHTED SPECIFICALLY BY 3177 02:00:27,640 --> 02:00:32,520 DR. SPITALNIK IN HIS KEYNOTE 3178 02:00:32,520 --> 02:00:36,160 CONTRIBUTING TO DUPLICATION OF 3179 02:00:36,160 --> 02:00:37,240 EFFORTS, STUDY OF SUBPOPULATION, 3180 02:00:37,240 --> 02:00:40,560 NEGLECT OF OTHERS. 3181 02:00:40,560 --> 02:00:42,600 AND EFFICACY OF CONVALESCENT 3182 02:00:42,600 --> 02:00:43,360 PLASMA, HYPER IMMUNE GLOBULIN, 3183 02:00:43,360 --> 02:00:46,080 MAY BE SPECIFIC TO A PATHOGENRY 3184 02:00:46,080 --> 02:00:50,160 INTRODUCES A RANGE OF CHALLENGES 3185 02:00:50,160 --> 02:00:53,560 SUCH AS THERE ARE MANY 3186 02:00:53,560 --> 02:00:55,040 PATHOGENS, EACH DERIVATIVE 3187 02:00:55,040 --> 02:01:05,280 TARGETING A GIVEN PATHOGEN, AND 3188 02:01:05,280 --> 02:01:07,840 THERE'S ALSO POTENTIAL FOR 3189 02:01:07,840 --> 02:01:12,560 EVOLUTION OF PATHOGEN, MUTATION, 3190 02:01:12,560 --> 02:01:13,000 VARIANTS. 3191 02:01:13,000 --> 02:01:15,800 LASTLY, RESEARCH OF DERIVATIVES 3192 02:01:15,800 --> 02:01:17,600 IS COMPLEX. 3193 02:01:17,600 --> 02:01:19,920 SO, MASSIVE NUMBERS OF CASES MAY 3194 02:01:19,920 --> 02:01:23,960 BE NEEDED TO JUSTIFY INVESTMENT 3195 02:01:23,960 --> 02:01:26,640 FOR NEW AGENT. 3196 02:01:26,640 --> 02:01:28,520 THERE COULD BE VALUE IN STORE, 3197 02:01:28,520 --> 02:01:31,080 WHAT WE LEARNED FROM ONE AGENT 3198 02:01:31,080 --> 02:01:33,000 COULD BE APPLIED TO REEMERGENCE 3199 02:01:33,000 --> 02:01:36,640 BUT RESOURCES ARE NEEDED TO 3200 02:01:36,640 --> 02:01:38,080 SUPPORT INCENTIVIZED COLLECTION. 3201 02:01:38,080 --> 02:01:42,960 I'LL HAND OVER TO DR. KATZ FOR 3202 02:01:42,960 --> 02:01:44,720 THE OTHER THREE. 3203 02:01:44,720 --> 02:01:46,280 >> THANKS, EVAN. 3204 02:01:46,280 --> 02:01:48,280 I HOPE OUR SEVERE THUNDERSTORMS 3205 02:01:48,280 --> 02:01:52,400 HERE DON'T DEGRADE THE AUDIO. 3206 02:01:52,400 --> 02:01:54,360 OUR WORK GROUP WAS FOUNDED ON 3207 02:01:54,360 --> 02:01:56,760 THE RECOGNITION THAT THERE ARE A 3208 02:01:56,760 --> 02:01:58,280 LOT OF POTENTIAL PATHOGENS 3209 02:01:58,280 --> 02:01:59,840 EMERGING, OR ARE THE POTENTIAL 3210 02:01:59,840 --> 02:02:04,000 TO DO SO, BOTH AS TTIs FOR 3211 02:02:04,000 --> 02:02:06,840 PATHOGENS IN THE GENERAL 3212 02:02:06,840 --> 02:02:07,280 POPULATION. 3213 02:02:07,280 --> 02:02:12,120 SO RISK ASSESSMENT ASKS WHAT 3214 02:02:12,120 --> 02:02:13,160 SYSTEMS WILL ALLOW COLLECTION 3215 02:02:13,160 --> 02:02:15,400 CONTEMPORANEOUS RISK FACTOR DATA 3216 02:02:15,400 --> 02:02:17,440 FROM BLOOD DONOR SURVEILLANCE 3217 02:02:17,440 --> 02:02:19,160 COHORTS AND HOW REPRESENTATIVE 3218 02:02:19,160 --> 02:02:21,520 OF THE GENERAL POPULATION THOSE 3219 02:02:21,520 --> 02:02:23,280 COHORTS MIGHT BE, WHAT 3220 02:02:23,280 --> 02:02:24,720 ADJUSTMENTS STATISTICALLY NEED 3221 02:02:24,720 --> 02:02:30,840 TO BE MADE TO ASSURE GENERALIZED 3222 02:02:30,840 --> 02:02:32,920 ABILITY. 3223 02:02:32,920 --> 02:02:34,400 NEXT. 3224 02:02:34,400 --> 02:02:35,880 EARLY IDENTIFICATION OF 3225 02:02:35,880 --> 02:02:39,560 POTENTIAL TTI MAY FACILITATE 3226 02:02:39,560 --> 02:02:40,800 ANALYSIS AND INTERVENTION, WE'RE 3227 02:02:40,800 --> 02:02:43,320 VERY REACTIVE AND TIME IS OF THE 3228 02:02:43,320 --> 02:02:44,600 ESSENCE IN THAT CIRCUMSTANCE. 3229 02:02:44,600 --> 02:02:48,000 THERE MAY BE AN OPPORTUNITY TO 3230 02:02:48,000 --> 02:02:51,720 OPTIMIZE AND PRIORITIZE OUR 3231 02:02:51,720 --> 02:02:52,400 PROCESSES IN COLLECTION 3232 02:02:52,400 --> 02:02:54,720 FACILITIES TO IDENTIFY THOSE 3233 02:02:54,720 --> 02:02:56,560 EIDs THAT MAY BE IMPORTANT AND 3234 02:02:56,560 --> 02:03:03,480 SUPPLEMENT AS WELL IN A PUBLIC 3235 02:03:03,480 --> 02:03:05,760 HEALTH MODE NON-DONOR 3236 02:03:05,760 --> 02:03:07,680 SURVEILLANCE EFFORTS. 3237 02:03:07,680 --> 02:03:08,160 NEXT. 3238 02:03:08,160 --> 02:03:09,440 THE PROPOSED APPROACH IS TO 3239 02:03:09,440 --> 02:03:12,680 DEVELOP AND ENHANCE ABILITY TO 3240 02:03:12,680 --> 02:03:14,840 EXTRACT USEFUL INFORMATION FROM 3241 02:03:14,840 --> 02:03:16,280 AVAILABLE OPERATIONAL DATA FROM 3242 02:03:16,280 --> 02:03:19,440 OUR VERY DIVERSE POPULATION OF 3243 02:03:19,440 --> 02:03:21,280 DONORS. 3244 02:03:21,280 --> 02:03:22,720 THESE INCLUDE STANDARD 3245 02:03:22,720 --> 02:03:23,840 DEMOGRAPHICS, DONOR HISTORY, 3246 02:03:23,840 --> 02:03:27,560 ELEMENTS INCLUDING WHAT WE 3247 02:03:27,560 --> 02:03:31,000 ALWAYS COLLECT AND ADDITION OF 3248 02:03:31,000 --> 02:03:32,280 SPECIALIZED NEW ELEMENTS, 3249 02:03:32,280 --> 02:03:33,760 APPROPRIATE ADJUSTMENTS ALLOWING 3250 02:03:33,760 --> 02:03:38,800 COMPARISON TO THE GENERAL 3251 02:03:38,800 --> 02:03:40,800 POPULATION, ESPECIALLY PROCESS 3252 02:03:40,800 --> 02:03:43,040 AND I.T. ENHANCEMENT COMPATIBLE 3253 02:03:43,040 --> 02:03:45,920 WITH RAPID TURNAROUND FOR NEWLY 3254 02:03:45,920 --> 02:03:49,200 RECOGNIZED POTENTIAL THREATS IN 3255 02:03:49,200 --> 02:03:50,440 GMP ENVIRONMENT. 3256 02:03:50,440 --> 02:03:51,520 FEASIBILITY AND BARRIERS INCLUDE 3257 02:03:51,520 --> 02:03:56,520 NEED TO MOVE VERY RAPIDLY IN OUR 3258 02:03:56,520 --> 02:03:59,720 HIGHLY REGULATED ENVIRONMENT, 3259 02:03:59,720 --> 02:04:01,840 AND THIS IS OPERATIONAL, 3260 02:04:01,840 --> 02:04:04,280 AFFECTED BY I.T. INFRASTRUCTURE, 3261 02:04:04,280 --> 02:04:08,600 QUITE DIVERSE IN THE U.S., AND 3262 02:04:08,600 --> 02:04:09,440 CONSIDERATIONS OF RESEARCH 3263 02:04:09,440 --> 02:04:11,560 ETHICS THAT MUST BE DEALT WITH. 3264 02:04:11,560 --> 02:04:14,840 WE NEED TO DEVELOP AND MAINTAIN 3265 02:04:14,840 --> 02:04:17,280 COLLABORATIVE RELATIONSHIPS WITH 3266 02:04:17,280 --> 02:04:19,680 OTHER SECTORS ESPECIALLY PUBLIC 3267 02:04:19,680 --> 02:04:21,960 HEALTH AND FIELD INVESTIGATORS 3268 02:04:21,960 --> 02:04:24,520 IN ORDER TO MAXIMIZE RELEVANCE 3269 02:04:24,520 --> 02:04:26,120 OF PROPOSED DATA COLLECTION AND 3270 02:04:26,120 --> 02:04:27,120 ITS TIMELINESS. 3271 02:04:27,120 --> 02:04:33,440 AND WE NEED AGAIN TO HAVE MODELS 3272 02:04:33,440 --> 02:04:34,680 TO MAXIMIZE GENERALIZABILITY TO 3273 02:04:34,680 --> 02:04:40,360 DONOR DATA TO THE POPULATION IN 3274 02:04:40,360 --> 02:04:42,000 GENERAL TO THE DEGREE WE'RE IN A 3275 02:04:42,000 --> 02:04:44,160 PUBLIC HEALTH FOCUS. 3276 02:04:44,160 --> 02:04:44,360 NEXT. 3277 02:04:44,360 --> 02:04:46,640 ENHANCED DONOR TESTING, OF 3278 02:04:46,640 --> 02:04:48,840 COURSE DONOR TESTING HAS BEEN 3279 02:04:48,840 --> 02:04:50,880 CENTRAL TO OUR RESPONSES TO 3280 02:04:50,880 --> 02:04:52,240 EMERGING INFECTIONS, THE 3281 02:04:52,240 --> 02:04:56,360 QUESTION IS HOW CAN WE ENHANCE 3282 02:04:56,360 --> 02:04:58,520 AND EXPAND THAT BOTH WITH 3283 02:04:58,520 --> 02:05:02,840 RESPECT TO PERFORMANCE 3284 02:05:02,840 --> 02:05:04,000 CHARACTERISTICS AND EFFICIENCY 3285 02:05:04,000 --> 02:05:07,160 TO BE ADAPTED BLOOD DONORS IN 3286 02:05:07,160 --> 02:05:09,640 EVENT OF EMERGING INFECTION AND 3287 02:05:09,640 --> 02:05:15,480 EVALUATE RISK TO BLOOD SUPPLY. 3288 02:05:15,480 --> 02:05:17,840 DETECTING-- EARLY DETECTION CAN 3289 02:05:17,840 --> 02:05:22,320 SUPPORT PUBLIC HEALTH EFFORTS. 3290 02:05:22,320 --> 02:05:28,720 THIS IS ENHANCED BY MULTIPLEX 3291 02:05:28,720 --> 02:05:30,960 PLATFORMS WHICH WILL NEED TO BE 3292 02:05:30,960 --> 02:05:33,440 EXPANDED PERHAPS MADE PRO-ACTIVE 3293 02:05:33,440 --> 02:05:35,560 TO EVALUATE AND IDENTIFY 3294 02:05:35,560 --> 02:05:38,520 POTENTIAL EID THREATS. 3295 02:05:38,520 --> 02:05:39,960 WE NEED FORMALIZED NATIONALIZE 3296 02:05:39,960 --> 02:05:43,320 AND GLOBAL NETWORKS TO USE 3297 02:05:43,320 --> 02:05:45,600 CONTEMPORARY TESTING PLATFORMS, 3298 02:05:45,600 --> 02:05:48,160 OPERATIONAL AND RESEARCH, FOR 3299 02:05:48,160 --> 02:05:51,440 SENSITIVE SURVEILLANCE THAN THE 3300 02:05:51,440 --> 02:05:53,280 CURRENT INFORMAL HORIZON 3301 02:05:53,280 --> 02:05:56,200 SCANNING USED NOW TO RECOGNIZE 3302 02:05:56,200 --> 02:05:58,440 POTENTIAL THREATS BEFORE THEY 3303 02:05:58,440 --> 02:06:00,200 CAUSED RECOGNIZED CLINICAL 3304 02:06:00,200 --> 02:06:03,920 ILLNESS VIA TRANSFUSION AND TO 3305 02:06:03,920 --> 02:06:04,600 RESPOND PROACTIVELY. 3306 02:06:04,600 --> 02:06:05,280 NEXT. 3307 02:06:05,280 --> 02:06:06,880 THERE ARE A LARGE NUMBER OF 3308 02:06:06,880 --> 02:06:09,120 VIRAL AND OTHER AGENTS THAT ARE 3309 02:06:09,120 --> 02:06:11,360 BEING RECOGNIZED AS HUMAN 3310 02:06:11,360 --> 02:06:12,440 PATHOGENS, AS YOU SAW ON OUR 3311 02:06:12,440 --> 02:06:14,320 FIRST SLIDE. 3312 02:06:14,320 --> 02:06:18,040 MANY HAVE THE POTENTIAL FOR 3313 02:06:18,040 --> 02:06:19,800 TRANSFUSION TRANSMISSION THAT 3314 02:06:19,800 --> 02:06:21,560 DEMAND IMPROVED SURVEILLANCE. 3315 02:06:21,560 --> 02:06:25,320 CURRENT SURVEILLANCE IS LARGELY 3316 02:06:25,320 --> 02:06:27,200 AN INFORMAL ACTIVITY, 3317 02:06:27,200 --> 02:06:29,800 ESSENTIALLY BASED ON VOLUNTEER 3318 02:06:29,800 --> 02:06:31,960 HORIZON SCANNING BY TRANSFUSION 3319 02:06:31,960 --> 02:06:34,040 MEDICINE EXPERTS AND/OR 3320 02:06:34,040 --> 02:06:35,560 RECOGNIZED INFECTION -- 3321 02:06:35,560 --> 02:06:38,320 RECOGNITION THAT INFECTION WITH 3322 02:06:38,320 --> 02:06:40,800 A NOVEL PATHOGEN MAY HAVE BEEN 3323 02:06:40,800 --> 02:06:42,320 TEMPORALLY ASSOCIATED WITH 3324 02:06:42,320 --> 02:06:43,320 TRANSFUSION BY BEDSIDE 3325 02:06:43,320 --> 02:06:47,400 CLINICIANS NOT FOCUSED ON OUR 3326 02:06:47,400 --> 02:06:47,640 ISSUES. 3327 02:06:47,640 --> 02:06:49,440 FORMAL GLOBAL COMMUNICATION AND 3328 02:06:49,440 --> 02:06:51,880 RESEARCH NETWORKS FOCUSED ON 3329 02:06:51,880 --> 02:06:55,000 NOVEL TTIs ARE REALLY NOT 3330 02:06:55,000 --> 02:06:57,600 AVAILABLE AT THIS POINT. 3331 02:06:57,600 --> 02:06:59,840 SUCH NETWORKS WITH AC STOWS 3332 02:06:59,840 --> 02:07:00,840 FLEXIBLE STATE-OF-THE-ART IN 3333 02:07:00,840 --> 02:07:03,840 VITRO TESTING COULD SUPPORT 3334 02:07:03,840 --> 02:07:07,760 EARLY RECOGNITION, NOT JUST OF 3335 02:07:07,760 --> 02:07:10,960 POTENTIAL EIDs BUT IN OUR 3336 02:07:10,960 --> 02:07:13,600 SPECIFIC FOCUS THOSE THAT MIGHT 3337 02:07:13,600 --> 02:07:15,720 BE TRANSFUSION TRANSMITTED. 3338 02:07:15,720 --> 02:07:18,200 THE PROPOSED APPROACH TO 3339 02:07:18,200 --> 02:07:19,720 LEVERAGE NOVEL TESTING METHODS 3340 02:07:19,720 --> 02:07:23,720 AND PLATFORMS TO STUDY DONOR 3341 02:07:23,720 --> 02:07:24,760 POPULATIONS. 3342 02:07:24,760 --> 02:07:28,680 THE ENHANCED METHODS INCLUDE 3343 02:07:28,680 --> 02:07:30,680 HIGHLY MULTIPLEX NUCLEIC AND 3344 02:07:30,680 --> 02:07:34,600 SEROLOGIC PLATFORMS APPLIED TO 3345 02:07:34,600 --> 02:07:37,480 EXISTING DONOR REPOSITORY, RAPID 3346 02:07:37,480 --> 02:07:39,560 HIGH-THROUGHPUT METAGENOMIC AND 3347 02:07:39,560 --> 02:07:41,520 SEQUENCING PLATFORMS, TO USE AT 3348 02:07:41,520 --> 02:07:45,720 NEED, AND A FOCUS ON ZOONOTIC 3349 02:07:45,720 --> 02:07:48,080 AND VECTOR-BORNE THREATS. 3350 02:07:48,080 --> 02:07:52,480 WE NEED BROADLY REPRESENTATIVE 3351 02:07:52,480 --> 02:07:53,360 GLOBAL GEOGRAPHICALLY DIVERSE 3352 02:07:53,360 --> 02:07:54,800 NETWORKS EARLY WITH ACTIVITY 3353 02:07:54,800 --> 02:07:56,760 STUDIES IN BLOOD AND COMPONENTS 3354 02:07:56,760 --> 02:08:00,840 THAT ARE NOT GENERALLY PERFORMED 3355 02:08:00,840 --> 02:08:04,080 AT THIS POINT, APPROPRIATE 3356 02:08:04,080 --> 02:08:05,400 CONFIRMATORY ALGORITHMS, 3357 02:08:05,400 --> 02:08:07,480 CONCEIVABLY TIME LIMITED ROLLING 3358 02:08:07,480 --> 02:08:09,240 REPOSITORIES THAT CAN BE 3359 02:08:09,240 --> 02:08:12,080 INTERROGATED IN THE NEAR REAL 3360 02:08:12,080 --> 02:08:15,080 TIME IN RESPONSE TO THE 3361 02:08:15,080 --> 02:08:18,360 EMERGENCE OF NEW PATHOGENS. 3362 02:08:18,360 --> 02:08:19,520 NEXT. 3363 02:08:19,520 --> 02:08:22,320 NEXT SLIDE PLEASE. 3364 02:08:22,320 --> 02:08:24,160 THERE WE GO. 3365 02:08:24,160 --> 02:08:25,560 FEASIBILITY AND BARRIERS, WE 3366 02:08:25,560 --> 02:08:29,040 ALREADY HAVE INDUSTRY AND BLOOD 3367 02:08:29,040 --> 02:08:30,360 COMMUNITY COLLABORATION. 3368 02:08:30,360 --> 02:08:31,840 INTERNATIONAL COLLABORATIONS, 3369 02:08:31,840 --> 02:08:35,520 FOR EXAMPLE, REDS, ARE ALREADY 3370 02:08:35,520 --> 02:08:36,320 SUCCESSFUL IN APPLYING 3371 02:08:36,320 --> 02:08:36,920 STATE-OF-THE-ART TEST METHODS 3372 02:08:36,920 --> 02:08:38,680 BUT ARE SOME WHAT REACTIVE. 3373 02:08:38,680 --> 02:08:41,160 THIS HAS BEEN THE EXCEPTION. 3374 02:08:41,160 --> 02:08:44,360 THE NEED TO INTEGRATE OUR DONOR 3375 02:08:44,360 --> 02:08:46,880 CONCERNS WITH FRONT LINE 3376 02:08:46,880 --> 02:08:50,280 SURVEILLANCE IS CRITICAL AND 3377 02:08:50,280 --> 02:08:52,160 SUSTAINABILITY IS PROBLEMATIC IN 3378 02:08:52,160 --> 02:08:54,920 THE FACE OF OTHER U.S. AND 3379 02:08:54,920 --> 02:09:00,320 INTERNATIONAL FUNDING 3380 02:09:00,320 --> 02:09:01,160 PRIORITIES. 3381 02:09:01,160 --> 02:09:01,360 NEXT. 3382 02:09:01,360 --> 02:09:03,920 OUR NEXT PRIORITY WAS 3383 02:09:03,920 --> 02:09:06,360 SURVEILLANCE AND HORIZON 3384 02:09:06,360 --> 02:09:07,440 SCANNING FOR EMERGING INFECTIOUS 3385 02:09:07,440 --> 02:09:09,080 DISEASES, THE QUESTION IS HOW TO 3386 02:09:09,080 --> 02:09:12,560 OPTIMIZE USE OF BLOOD DONOR 3387 02:09:12,560 --> 02:09:15,520 POPULATIONS TO ADVANCE 3388 02:09:15,520 --> 02:09:16,200 EPIDEMIOLOGIC AND SURVEILLANCE 3389 02:09:16,200 --> 02:09:18,080 PATHOGENESIS RESEARCH OF 3390 02:09:18,080 --> 02:09:18,600 ESTABLISHED AND EMERGING 3391 02:09:18,600 --> 02:09:20,840 INFECTIONS INCLUDING THOSE THAT 3392 02:09:20,840 --> 02:09:23,680 MAY BE TRANSFUSION 3393 02:09:23,680 --> 02:09:24,240 TRANSMISSIBLE. 3394 02:09:24,240 --> 02:09:25,840 AABB AND OTHERS GENERATED SOME 3395 02:09:25,840 --> 02:09:26,160 TOOLS. 3396 02:09:26,160 --> 02:09:31,080 FOR EXAMPLE, AABB HAS LISTED 3397 02:09:31,080 --> 02:09:34,520 AGENTS THAT MAY BE TRANSFUSION 3398 02:09:34,520 --> 02:09:38,280 TRANSMITTED BASED ON VOLUNTARY 3399 02:09:38,280 --> 02:09:40,160 AND REALLY UNSYSTEMIC 3400 02:09:40,160 --> 02:09:42,320 ACTIVITIES. 3401 02:09:42,320 --> 02:09:44,000 SYSTEMATIC ACTIVITIES. 3402 02:09:44,000 --> 02:09:47,960 THE EUROPEAN UPFRONT RISK 3403 02:09:47,960 --> 02:09:49,960 ASSESSMENT TOOL CAN QUANTIFY 3404 02:09:49,960 --> 02:09:52,680 RISK, BASED ON A PRIORI 3405 02:09:52,680 --> 02:09:56,480 ASSUMPTION ABOUT EPIDEMIOLOGY 3406 02:09:56,480 --> 02:09:59,200 AND PATHOGENESIS, AND ON EXPERT 3407 02:09:59,200 --> 02:10:00,440 OPINION WHICH MIGHT BE 3408 02:10:00,440 --> 02:10:04,480 CHARACTERIZED AS WELL AS 3409 02:10:04,480 --> 02:10:05,520 SPECULATION. 3410 02:10:05,520 --> 02:10:05,720 NEXT. 3411 02:10:05,720 --> 02:10:08,320 SO, THE ISSUE IS PREDICTING 3412 02:10:08,320 --> 02:10:14,200 EMERGENCE OF A NOVEL PATHOGEN, 3413 02:10:14,200 --> 02:10:18,200 WHICH IS INHERENTLY CHALLENGING, 3414 02:10:18,200 --> 02:10:20,920 BLOOD DONOR SCREENING MAY BE 3415 02:10:20,920 --> 02:10:21,560 SUFFICIENTLY TIMELY TO PREVENT 3416 02:10:21,560 --> 02:10:23,720 EARLY SPREAD IN THE DONOR BASE 3417 02:10:23,720 --> 02:10:25,200 AND SUBSEQUENTLY TO TRANSFUSION 3418 02:10:25,200 --> 02:10:28,440 RECIPIENTS AND THERE'S NO 3419 02:10:28,440 --> 02:10:30,360 ESTABLISHED PRO-ACTIVE APPROACH 3420 02:10:30,360 --> 02:10:32,080 TO RECOGNIZING AND PROJECTING 3421 02:10:32,080 --> 02:10:33,920 THE IMPACT OF EMERGING 3422 02:10:33,920 --> 02:10:35,160 INFECTIOUS DISEASES ON BLOOD 3423 02:10:35,160 --> 02:10:39,600 SAFETY AND AVAILABILITY. 3424 02:10:39,600 --> 02:10:40,160 NEXT. 3425 02:10:40,160 --> 02:10:42,160 PROPOSED APPROACH IS DEVELOPMENT 3426 02:10:42,160 --> 02:10:44,560 OF PROGRAMS TO FOSTER EARLY 3427 02:10:44,560 --> 02:10:47,480 RECOGNITION BY OUR COMMUNITY OF 3428 02:10:47,480 --> 02:10:50,240 A NEW EMERGING INFECTION, 3429 02:10:50,240 --> 02:10:51,680 FOLLOWED BY SYSTEMATIC 3430 02:10:51,680 --> 02:10:56,520 ASSESSMENT OF ITS POTENTIAL FOR 3431 02:10:56,520 --> 02:10:57,920 TRANSFUSION TRANSMISSION, TO 3432 02:10:57,920 --> 02:10:58,920 ENABLE RAPID RESPONSE. 3433 02:10:58,920 --> 02:11:05,520 WHAT IS THE EVIDENCE OF 3434 02:11:05,520 --> 02:11:07,240 TRANSFUSION TRANSMISSIBILITY AND 3435 02:11:07,240 --> 02:11:08,920 RISK INCLUDING OUR STAFF, WHAT 3436 02:11:08,920 --> 02:11:12,080 IS DONOR INCIDENCE AND IMPACT, 3437 02:11:12,080 --> 02:11:16,800 WHAT ARE THE -- WHAT IS 3438 02:11:16,800 --> 02:11:18,360 APPROPRIATE DONOR SCREENING 3439 02:11:18,360 --> 02:11:20,000 OPTION INCLUDING RISK SCREENING, 3440 02:11:20,000 --> 02:11:26,440 IN VITRO TESTING, PATHOGEN 3441 02:11:26,440 --> 02:11:28,160 REDUCTION IMPLEMENTATION. 3442 02:11:28,160 --> 02:11:28,920 NEXT. 3443 02:11:28,920 --> 02:11:31,560 THE PROPOSED APPROACH IS TO LOOK 3444 02:11:31,560 --> 02:11:34,280 AT RECENT EXPERIENCE INCLUDING 3445 02:11:34,280 --> 02:11:38,320 WEST NILE, CHAGAS, ZIKA, 3446 02:11:38,320 --> 02:11:39,560 CHIKUNGUNYA, COVID, NOW 3447 02:11:39,560 --> 02:11:46,360 MONKEYPOX, AS THAT EXPERIENCE 3448 02:11:46,360 --> 02:11:46,760 DEVELOPS. 3449 02:11:46,760 --> 02:11:48,960 REFINEMENT OF EUFRAT-LIKE TOOLS, 3450 02:11:48,960 --> 02:11:50,000 WHERE ASSUMPTION ARE USED, 3451 02:11:50,000 --> 02:11:53,280 SUPPORT FOR RAPID RESPONSE 3452 02:11:53,280 --> 02:11:55,680 TESTING PLATFORMS, AND TO 3453 02:11:55,680 --> 02:11:57,560 INCENTIVIZE INCLUSION OF DONOR 3454 02:11:57,560 --> 02:12:00,760 SAMPLE IN INITIAL STUDIES OF 3455 02:12:00,760 --> 02:12:03,200 EMERGING PATHOGENS BY 3456 02:12:03,200 --> 02:12:05,840 ESTABLISHING FORMAL AND 3457 02:12:05,840 --> 02:12:07,720 SUSTAINABLE COLLABORATIONS OF 3458 02:12:07,720 --> 02:12:17,120 FIELD INVESTIGATORS WITH GLOBAL 3459 02:12:17,120 --> 02:12:18,360 BLOOD COMMUNITY. 3460 02:12:18,360 --> 02:12:19,960 INTERNATIONAL COLLABORATIONS, 3461 02:12:19,960 --> 02:12:22,920 FOR EXAMPLE REDS, ALREADY 3462 02:12:22,920 --> 02:12:24,880 SUCCESSFUL AS PREVIOUSLY STATED 3463 02:12:24,880 --> 02:12:26,000 IF STILL REACTIVE. 3464 02:12:26,000 --> 02:12:28,960 WHILE SUCH INDUSTRY AND BLOOD 3465 02:12:28,960 --> 02:12:31,040 COMMUNITY COLLABORATION IS 3466 02:12:31,040 --> 02:12:33,520 ALREADY COMMON, BROAD ROUTINE 3467 02:12:33,520 --> 02:12:35,760 FIELD RESEARCH BLOOD COMMUNITY 3468 02:12:35,760 --> 02:12:37,920 COOPERATION IS LESS SO, 3469 02:12:37,920 --> 02:12:39,920 ESPECIALLY IN THE AREAS MOST OF 3470 02:12:39,920 --> 02:12:44,080 INTEREST FOR EMERGENCE OF NOVEL 3471 02:12:44,080 --> 02:12:45,120 PATHOGENS. 3472 02:12:45,120 --> 02:12:45,640 SUSTAINABILITY AGAIN IS 3473 02:12:45,640 --> 02:12:47,520 PROBLEMATIC, IN THE FACE OF 3474 02:12:47,520 --> 02:12:50,880 OTHER FUNDING PRIORITIES. 3475 02:12:50,880 --> 02:12:51,160 NEXT. 3476 02:12:51,160 --> 02:12:53,600 THIS IS OUR PRIORITY SUMMARY 3477 02:12:53,600 --> 02:12:56,880 THAT EVAN AND I HAVE GONE 3478 02:12:56,880 --> 02:12:58,080 THROUGH FOR THE BREAKOUT 3479 02:12:58,080 --> 02:12:58,320 SESSION. 3480 02:12:58,320 --> 02:13:00,560 WHILE WE HAVE IDEAS ABOUT THE 3481 02:13:00,560 --> 02:13:04,280 RANKINGS, WE HAVE CHOSEN NOT TO 3482 02:13:04,280 --> 02:13:06,320 BIAS THE BREAKOUT SESSION BY 3483 02:13:06,320 --> 02:13:08,640 LISTING THEM NOW. 3484 02:13:08,640 --> 02:13:09,160 NEXT SLIDE. 3485 02:13:09,160 --> 02:13:13,600 I WANT TO ACKNOWLEDGE THE 3486 02:13:13,600 --> 02:13:15,320 EMERGING INFECTIONS WORK GROUP 3487 02:13:15,320 --> 02:13:17,880 LISTED HERE AND AGAIN TO THANK 3488 02:13:17,880 --> 02:13:20,840 THE ORGANIZERS FOR ASKING US TO 3489 02:13:20,840 --> 02:13:21,560 PARTICIPATE. 3490 02:13:21,560 --> 02:13:22,880 I BELIEVE THAT IS OUR LAST 3491 02:13:22,880 --> 02:13:25,000 SLIDE. 3492 02:13:25,000 --> 02:13:32,920 3493 02:13:32,920 --> 02:13:40,320 BACK TO YOU, BRIAN AND NAREG. 3494 02:13:40,320 --> 02:13:41,480 >> THANK YOU, DOCTORS BLOCH AND 3495 02:13:41,480 --> 02:13:42,320 KATZ. 3496 02:13:42,320 --> 02:13:45,640 AGAIN, TO ALL THE SPEAKERS FOR 3497 02:13:45,640 --> 02:13:47,160 THEIR PRESENTATIONS AS PART OF 3498 02:13:47,160 --> 02:13:48,960 THE MORNING'S GENERAL SESSION. 3499 02:13:48,960 --> 02:13:53,200 WE'VE COME TO OUR BREAK FOR 3500 02:13:53,200 --> 02:13:53,600 LUNCH. 3501 02:13:53,600 --> 02:13:54,240 >>HELLO, EVERYBODY. 3502 02:13:54,240 --> 02:13:55,320 I KNOW WE'RE COMING TOGETHER 3503 02:13:55,320 --> 02:13:57,880 AFTER HAVING BEEN IN THE 3504 02:13:57,880 --> 02:13:59,560 BREAKOUT ROOMS. 3505 02:13:59,560 --> 02:14:00,680 THANK YOU, EVERYBODY, FOR GOING 3506 02:14:00,680 --> 02:14:06,040 TO THOSE BREAKOUT ROOMS AND FOR 3507 02:14:06,040 --> 02:14:07,160 THE DIALOGUE THAT WE HAD OVER 3508 02:14:07,160 --> 02:14:08,880 THE LAST HOUR. 3509 02:14:08,880 --> 02:14:10,560 FOR THE OTHER TWO ROOMS IT WAS 3510 02:14:10,560 --> 02:14:12,800 INTERESTING, FOR DONOR AND 3511 02:14:12,800 --> 02:14:13,800 SUPPLY GROUP REALLY IMPORTANT 3512 02:14:13,800 --> 02:14:15,160 CONVERSATION BUILDING ON WHAT 3513 02:14:15,160 --> 02:14:18,200 WAS PRESENTED THIS MORNING BY 3514 02:14:18,200 --> 02:14:19,920 DR. BRYANT, AN OPPORTUNITY TO 3515 02:14:19,920 --> 02:14:20,520 REFLECT. 3516 02:14:20,520 --> 02:14:22,360 OF COURSE, THEY HAVE THE 3517 02:14:22,360 --> 02:14:23,800 DISTINCT DISBENEFIT OF NOW 3518 02:14:23,800 --> 02:14:25,880 HAVING TO REPORT BACK TO THE 3519 02:14:25,880 --> 02:14:27,720 LARGER GROUP WHAT WAS DISCUSSED 3520 02:14:27,720 --> 02:14:31,640 OVER THE LAST HOUR, SO I BELIEVE 3521 02:14:31,640 --> 02:14:34,160 THAT THEY WILL DO THAT, EACH 3522 02:14:34,160 --> 02:14:35,360 GROUP HAS UP TO 20 MINUTES TO 3523 02:14:35,360 --> 02:14:38,200 TALK ABOUT WHAT THEY HEARD IN 3524 02:14:38,200 --> 02:14:39,960 TERMS OF FEEDBACK OF THE DEFINED 3525 02:14:39,960 --> 02:14:41,720 RESEARCH PRIORITIES AND THE NEXT 3526 02:14:41,720 --> 02:14:42,280 STEPS. 3527 02:14:42,280 --> 02:14:45,200 I DID NOTICE ACTUALLY ON OUR 3528 02:14:45,200 --> 02:14:48,000 AGENDA IT SAYS CONCLUDING 3529 02:14:48,000 --> 02:14:48,440 REMARKS, OR CONCLUDING 3530 02:14:48,440 --> 02:14:49,720 STATEMENTS, THAT'S MORE THAN A 3531 02:14:49,720 --> 02:14:50,640 BIT UNFAIR. 3532 02:14:50,640 --> 02:14:52,520 IT'S REPORTING BACK AND IT'S THE 3533 02:14:52,520 --> 02:14:53,840 BEGINNING OF A CONVERSATION 3534 02:14:53,840 --> 02:14:56,640 RATHER THAN THE CONCLUSION OF A 3535 02:14:56,640 --> 02:14:58,280 CONVERSATION BUT NONETHELESS IT 3536 02:14:58,280 --> 02:15:00,480 IS AN OPPORTUNITY FOR YOU ALL TO 3537 02:15:00,480 --> 02:15:01,840 HEAR IN THE LARGER MEETING ON 3538 02:15:01,840 --> 02:15:05,720 THE STATE OF THE SCIENCE WHAT 3539 02:15:05,720 --> 02:15:06,520 WAS DISCUSSED. 3540 02:15:06,520 --> 02:15:08,560 WE'LL BELIEVE WITH DR. BRYANT, 3541 02:15:08,560 --> 02:15:10,800 ALSO REPORTING BACK TO US FROM 3542 02:15:10,800 --> 02:15:15,480 THE FIRST WORKING GROUP. 3543 02:15:15,480 --> 02:15:16,680 THANK YOU. 3544 02:15:16,680 --> 02:15:19,120 >> THANKS, BRIAN. 3545 02:15:19,120 --> 02:15:20,080 BRIAN HELPED COORDINATE CALLING 3546 02:15:20,080 --> 02:15:21,480 ON PEOPLE AND KEEPING TRACK. 3547 02:15:21,480 --> 02:15:23,160 WE DIDN'T GET THROUGH ALL THE 3548 02:15:23,160 --> 02:15:25,200 COMMENTS IN THE CHAT BOX BUT GOT 3549 02:15:25,200 --> 02:15:27,080 THROUGH SOME VERY IMPORTANT 3550 02:15:27,080 --> 02:15:27,560 ONES. 3551 02:15:27,560 --> 02:15:29,880 I'D LIKE TO SAY THANK YOU TO THE 3552 02:15:29,880 --> 02:15:31,200 THOUGHTFUL CONTRIBUTIONS FROM 3553 02:15:31,200 --> 02:15:33,520 THE BREAKOUT PARTICIPANTS. 3554 02:15:33,520 --> 02:15:34,880 GREAT GROUP OF PEOPLE, ALL OF US 3555 02:15:34,880 --> 02:15:38,040 IN ONE ROOM EVEN THOUGH IT WAS 3556 02:15:38,040 --> 02:15:38,680 VIRTUAL. 3557 02:15:38,680 --> 02:15:39,040 GREAT FEEDBACK. 3558 02:15:39,040 --> 02:15:40,480 THIS IS STUFF WE'LL CONSIDER AS 3559 02:15:40,480 --> 02:15:42,560 WE LOOK AT THE PRIORITIES THAT 3560 02:15:42,560 --> 02:15:44,600 WE'VE PUT TOGETHER, THE DRAFT 3561 02:15:44,600 --> 02:15:45,160 PRIORITIES. 3562 02:15:45,160 --> 02:15:47,240 SO, JUST TO SUMMARIZE A LITTLE 3563 02:15:47,240 --> 02:15:48,880 BIT, I THINK ONE OF THE FIRST 3564 02:15:48,880 --> 02:15:52,040 THINGS THAT CAME UP WAS BUILDING 3565 02:15:52,040 --> 02:15:53,680 OF RESEARCH PARTNERSHIPS, AND 3566 02:15:53,680 --> 02:15:55,160 CHALLENGE THAT THERE IS BECAUSE 3567 02:15:55,160 --> 02:15:57,440 THIS ISN'T JUST THE REGULAR 3568 02:15:57,440 --> 02:15:58,320 TRANSFUSION MEDICINE ROLE. 3569 02:15:58,320 --> 02:16:00,480 THIS IS LOOKING AT FOLKS THAT 3570 02:16:00,480 --> 02:16:07,080 ARE DOING THE PSYCHOLOGICAL 3571 02:16:07,080 --> 02:16:07,760 WORK, ANALYSIS, ANTHROPOLOGISTS, 3572 02:16:07,760 --> 02:16:08,800 MATHEMATICIANS, HOW DO YOU BRING 3573 02:16:08,800 --> 02:16:10,320 THESE PEOPLE IN AND ATTRACT THEM 3574 02:16:10,320 --> 02:16:11,920 TO WANT TO DO TRANSFUSION 3575 02:16:11,920 --> 02:16:12,960 MEDICINE WORK. 3576 02:16:12,960 --> 02:16:15,360 IT'S A BLENDING OF ACADEMIC AND 3577 02:16:15,360 --> 02:16:15,720 BLOOD CENTERS. 3578 02:16:15,720 --> 02:16:18,400 AND THIS IS SOMETHING THAT WE 3579 02:16:18,400 --> 02:16:19,840 HAVEN'T SEEN BEING DONE 3580 02:16:19,840 --> 02:16:20,360 STRONGLY. 3581 02:16:20,360 --> 02:16:21,760 SURE, THERE'S BEEN PEOPLE IN THE 3582 02:16:21,760 --> 02:16:22,600 GROUP SUCCESSFUL DOING IT, BUT 3583 02:16:22,600 --> 02:16:25,000 THIS IS SOMETHING WE'LL HAVE TO 3584 02:16:25,000 --> 02:16:27,880 MAKE SURE THAT WE OPEN THE DOORS 3585 02:16:27,880 --> 02:16:30,880 IN BOTH DIRECTIONS TO WORK 3586 02:16:30,880 --> 02:16:31,240 TOGETHER. 3587 02:16:31,240 --> 02:16:32,000 ALSO, COMMUNITY-BASED RESEARCH 3588 02:16:32,000 --> 02:16:33,480 WAS SOMETHING BROUGHT UP THAT 3589 02:16:33,480 --> 02:16:36,280 CONTINUES TO BE VERY IMPORTANT 3590 02:16:36,280 --> 02:16:38,680 THAT IS INTEGRAL IN WHAT WE'LL 3591 02:16:38,680 --> 02:16:41,400 BE DOING. 3592 02:16:41,400 --> 02:16:42,080 RESEARCHERS WITH TRUST ALREADY 3593 02:16:42,080 --> 02:16:43,040 DEVELOPED, MY NOTES, SOMETIMES 3594 02:16:43,040 --> 02:16:44,240 THEY DON'T MAKE ALL THE SENSE IN 3595 02:16:44,240 --> 02:16:45,040 THE WORLD. 3596 02:16:45,040 --> 02:16:46,600 THOSE RESEARCHERS THAT HAVE DONE 3597 02:16:46,600 --> 02:16:47,720 THIS HAVE DEVELOPED TRUST WITHIN 3598 02:16:47,720 --> 02:16:50,000 THE BLOOD BANKING COMMUNITY AND 3599 02:16:50,000 --> 02:16:51,800 VICE VERSA AND WILL BE GREAT 3600 02:16:51,800 --> 02:16:53,640 LEADERS AS WE MOVE FORWARD. 3601 02:16:53,640 --> 02:16:54,840 HOW DO WE GET COLLEGES AND 3602 02:16:54,840 --> 02:16:57,840 UNIVERSITIES TO LOOK AT THE FACT 3603 02:16:57,840 --> 02:16:58,920 THAT THEY COULD PARTNER WITH US 3604 02:16:58,920 --> 02:17:00,240 TO DO THESE THINGS. 3605 02:17:00,240 --> 02:17:00,640 LET'S SEE. 3606 02:17:00,640 --> 02:17:01,840 ONE OF THE OTHER CONCERNS IS 3607 02:17:01,840 --> 02:17:04,840 THAT WHEN WE GO OUT FOR FUNDING, 3608 02:17:04,840 --> 02:17:08,200 THAT HOW DO WE GET -- LET ME SEE 3609 02:17:08,200 --> 02:17:09,880 MY OTHER NOTES, HOW DO WE GET 3610 02:17:09,880 --> 02:17:11,840 PEOPLE ON THE COMMITTEES TO 3611 02:17:11,840 --> 02:17:13,800 UNDERSTAND THE IMPORTANCE OF 3612 02:17:13,800 --> 02:17:16,320 THESE OTHER FOLKS THAT MAYBE 3613 02:17:16,320 --> 02:17:18,960 AREN'T YOUR TYPICALLY PEOPLE 3614 02:17:18,960 --> 02:17:19,920 PUTTING THROUGH FOR TRANSFUSION 3615 02:17:19,920 --> 02:17:22,520 MEDICINE RESEARCH MONEY. 3616 02:17:22,520 --> 02:17:25,080 THAT THE PSYCHOLOGISTS AND THE 3617 02:17:25,080 --> 02:17:27,000 SOCIOLOGISTS, ALL THAT. 3618 02:17:27,000 --> 02:17:28,840 THIS IS IMPORTANT, POSSIBLY 3619 02:17:28,840 --> 02:17:30,200 PEOPLE THAT ARE FROM THE 3620 02:17:30,200 --> 02:17:31,840 ACADEMIC SHOULD BE PART OF THESE 3621 02:17:31,840 --> 02:17:33,840 GROUPS THAT ARE GIVING OUT THE 3622 02:17:33,840 --> 02:17:35,520 FUNDING. 3623 02:17:35,520 --> 02:17:37,840 THAT WILL BE IMPORTANT. 3624 02:17:37,840 --> 02:17:39,640 NEXT BIG TOPIC WAS A LOT OF 3625 02:17:39,640 --> 02:17:42,160 DISCUSSION ABOUT BLOOD DONATION 3626 02:17:42,160 --> 02:17:44,200 AND PLASMA DONATION, COMPARING 3627 02:17:44,200 --> 02:17:45,840 MOTIVATION AND BEHAVIORS AND 3628 02:17:45,840 --> 02:17:47,480 CONSTRAINTS OF BOTH GROUPS. 3629 02:17:47,480 --> 02:17:49,600 I DON'T KNOW IF WE'RE MORE ALIKE 3630 02:17:49,600 --> 02:17:51,240 OR MORE DIFFERENT. 3631 02:17:51,240 --> 02:17:54,640 WE FREQUENTLY SEE OURSELVES AS 3632 02:17:54,640 --> 02:17:56,280 COMPETITORS, MAYBE THAT'S NOT 3633 02:17:56,280 --> 02:17:57,840 EXACTLY RIGHT BUT WE DON'T KNOW 3634 02:17:57,840 --> 02:17:59,160 FOR SURE. 3635 02:17:59,160 --> 02:18:01,000 MANY DONORS IN THE PLASMA CENTER 3636 02:18:01,000 --> 02:18:03,520 RELY ON THE MONEY THEY ARE 3637 02:18:03,520 --> 02:18:04,640 GETTING TO SUPPORT THEMSELVES, 3638 02:18:04,640 --> 02:18:05,800 TO FEED THEMSELVES. 3639 02:18:05,800 --> 02:18:08,440 IT'S A HEALTH EQUITY ISSUE. 3640 02:18:08,440 --> 02:18:10,760 HOW DOES THIS PLAY INTO GETTING, 3641 02:18:10,760 --> 02:18:14,360 YOU KNOW -- PLAY INTO BLOOD 3642 02:18:14,360 --> 02:18:15,080 DONATION? 3643 02:18:15,080 --> 02:18:18,320 IS THERE A ROLE FOR PAYING 3644 02:18:18,320 --> 02:18:20,200 DONORS FOR THE SAME REASON? 3645 02:18:20,200 --> 02:18:21,840 ARE THEY DIFFERENT? 3646 02:18:21,840 --> 02:18:23,760 ARE THEY SIMILAR? 3647 02:18:23,760 --> 02:18:24,760 THEY MAY BE MOTIVATED MORE THAN 3648 02:18:24,760 --> 02:18:26,440 WE THINK. 3649 02:18:26,440 --> 02:18:28,520 ANOTHER ISSUE THAT CAME UP, I'M 3650 02:18:28,520 --> 02:18:30,280 GOING TO JUMP OVER, SOME 3651 02:18:30,280 --> 02:18:33,440 BARRIERS THAT WE SAW WERE 3652 02:18:33,440 --> 02:18:34,880 BARRIERS OF LOCATION. 3653 02:18:34,880 --> 02:18:36,960 SOMETIMES THE LOCATIONS OF OUR 3654 02:18:36,960 --> 02:18:37,680 BLOOD CENTERS AREN'T EXACTLY IN 3655 02:18:37,680 --> 02:18:38,800 THE LOCATIONS THAT YOU WANT THEM 3656 02:18:38,800 --> 02:18:44,040 TO BE IF YOU'RE TRYING TO 3657 02:18:44,040 --> 02:18:44,560 RECRUIT UNDERREPRESENTED 3658 02:18:44,560 --> 02:18:44,840 MINORITIES. 3659 02:18:44,840 --> 02:18:46,160 AND SO, THERE'S AN INEQUITY IN 3660 02:18:46,160 --> 02:18:47,800 BURDEN THERE FOR DONOR TO GET 3661 02:18:47,800 --> 02:18:53,520 DOWN TO A BLOOD CENTER. 3662 02:18:53,520 --> 02:19:02,920 3663 02:19:02,920 --> 02:19:11,320 ONE SECOND, BARBARA. 3664 02:19:11,320 --> 02:19:12,120 >> ONE SECOND, BARBARA. 3665 02:19:12,120 --> 02:19:13,320 WE LOST YOU. 3666 02:19:13,320 --> 02:19:16,560 CAN YOU HEAR US? 3667 02:19:16,560 --> 02:19:20,480 3668 02:19:20,480 --> 02:19:24,040 >> BARBARA, WE CAN'T HEAR YOU 3669 02:19:24,040 --> 02:19:24,440 ANYMORE. 3670 02:19:24,440 --> 02:19:25,360 >> UNFORTUNATELY BARBARA, I 3671 02:19:25,360 --> 02:19:33,800 DON'T KNOW, WE CANNOT HEAR YOU. 3672 02:19:33,800 --> 02:19:36,040 3673 02:19:36,040 --> 02:19:46,080 3674 02:19:49,080 --> 02:19:49,800 3675 02:19:49,800 --> 02:19:59,600 >> WE CANNOT HEAR YOU. 3676 02:19:59,600 --> 02:20:00,960 3677 02:20:00,960 --> 02:20:03,520 >> CAN YOU HEAR ME NOW? 3678 02:20:03,520 --> 02:20:03,960 >> YES. 3679 02:20:03,960 --> 02:20:04,320 >> YES. 3680 02:20:04,320 --> 02:20:06,600 >> HOW MUCH OF THAT DID Y'ALL 3681 02:20:06,600 --> 02:20:06,800 MISS? 3682 02:20:06,800 --> 02:20:07,840 THE WHOLE THING? 3683 02:20:07,840 --> 02:20:11,000 >> THE LAST MINUTE OR TWO. 3684 02:20:11,000 --> 02:20:12,040 >> OKAY, GOOD. 3685 02:20:12,040 --> 02:20:13,440 I STARTED THIS THING, I'VE BEEN 3686 02:20:13,440 --> 02:20:15,440 ON THE PHONE. 3687 02:20:15,440 --> 02:20:17,040 THE NIH PHONE MUST HAVE 3688 02:20:17,040 --> 02:20:18,600 DISCONNECTED AFTER SO MANY 3689 02:20:18,600 --> 02:20:18,880 HOURS. 3690 02:20:18,880 --> 02:20:22,320 WHERE DID I LAST LEAVE OFF? 3691 02:20:22,320 --> 02:20:25,800 DID I GET TO BLOOD DONATION OF 3692 02:20:25,800 --> 02:20:26,040 PLASMA? 3693 02:20:26,040 --> 02:20:27,720 MERLYN, DID I GET THROUGH MOST 3694 02:20:27,720 --> 02:20:29,120 OF THAT? 3695 02:20:29,120 --> 02:20:32,040 I CAN'T HEAR YOU. 3696 02:20:32,040 --> 02:20:35,400 3697 02:20:35,400 --> 02:20:37,720 >> YES, YOU DID, BARBARA. 3698 02:20:37,720 --> 02:20:44,240 >> I'D LOVE TO HEAR IT AGAIN. 3699 02:20:44,240 --> 02:20:46,480 >> SO, WE'RE COMPARING 3700 02:20:46,480 --> 02:20:48,240 MOTIVATION BETWEEN BLOOD DONORS 3701 02:20:48,240 --> 02:20:51,160 AND PLASMA DONORS AND 3702 02:20:51,160 --> 02:20:54,200 CONSTRAINTS, A LOT OF TIMES 3703 02:20:54,200 --> 02:20:56,360 PLASMA DONORS NEED THE MONEY TO 3704 02:20:56,360 --> 02:20:57,960 FEED THEIR HOUSEHOLDS, IT'S A 3705 02:20:57,960 --> 02:20:59,640 HEALTH EQUITY TYPE ISSUE. 3706 02:20:59,640 --> 02:21:00,520 BUT OTHERWISE, ARE THEY 3707 02:21:00,520 --> 02:21:01,800 DIFFERENT OR SAME? 3708 02:21:01,800 --> 02:21:03,040 WHAT ARE THE MOTIVATIONS? 3709 02:21:03,040 --> 02:21:04,600 WE DON'T KNOW BECAUSE WE HAVEN'T 3710 02:21:04,600 --> 02:21:05,800 ASKED THE QUESTION. 3711 02:21:05,800 --> 02:21:08,760 AND THEN FOR THE METHODS GROUP, 3712 02:21:08,760 --> 02:21:10,400 SEVERAL TIMES FOCUS GROUPS CAME 3713 02:21:10,400 --> 02:21:11,120 UP. 3714 02:21:11,120 --> 02:21:12,040 WE NEED PROBABLY MORE FOCUS 3715 02:21:12,040 --> 02:21:13,720 GROUPS, AS WE LOOK AT DONORS 3716 02:21:13,720 --> 02:21:16,400 ASKING THEM WHY DO YOU DONATE AS 3717 02:21:16,400 --> 02:21:20,760 OPPOSED TO NON-DONORS WHY HAVE 3718 02:21:20,760 --> 02:21:22,320 YOU NEVER DONATE OR STOP? 3719 02:21:22,320 --> 02:21:25,320 THERE NEEDS TO BE MORE TALKING 3720 02:21:25,320 --> 02:21:26,360 AND ENGAGING. ONLINE RESEARCH, 3721 02:21:26,360 --> 02:21:29,840 FOLKS COMMENTED ABOUT THAT. 3722 02:21:29,840 --> 02:21:31,640 I'M NOT SURE, TOTALLY UNDERSTAND 3723 02:21:31,640 --> 02:21:33,040 ALL THE ASPECTS OF THIS ANALYSIS 3724 02:21:33,040 --> 02:21:34,680 THAT THEY WOULD BE ABLE TO DO 3725 02:21:34,680 --> 02:21:36,400 WITH THAT. 3726 02:21:36,400 --> 02:21:40,440 ONE OF THE CHALLENGES ALSO 3727 02:21:40,440 --> 02:21:41,600 DEALT -- BARRIERS DEALT WITH 3728 02:21:41,600 --> 02:21:41,960 LOCATIONS. 3729 02:21:41,960 --> 02:21:43,480 WE HAVE OUR BRICK AND MORTAR 3730 02:21:43,480 --> 02:21:46,120 CENTERS NOT IN AREAS WHERE 3731 02:21:46,120 --> 02:21:46,600 THERE'S UNDERREPRESENTED 3732 02:21:46,600 --> 02:21:49,320 MINORITIES, AND THIS IS AN 3733 02:21:49,320 --> 02:21:50,920 INEQUITABLE BURDEN FOR THOSE 3734 02:21:50,920 --> 02:21:52,040 DONORS. 3735 02:21:52,040 --> 02:21:54,160 ALSO WITH MOBILES, IT'S HARD TO 3736 02:21:54,160 --> 02:21:54,760 PREDICT. 3737 02:21:54,760 --> 02:21:55,360 YOU'RE NOT ALWAYS PREDICTING 3738 02:21:55,360 --> 02:21:56,800 WHERE THEY ARE GOING TO BE. 3739 02:21:56,800 --> 02:21:59,520 THAT'S SOMETHING THAT NEEDS TO 3740 02:21:59,520 --> 02:22:01,240 BE LOOKED AT. 3741 02:22:01,240 --> 02:22:03,160 WE TALKED QUITE A BIT ABOUT 3742 02:22:03,160 --> 02:22:03,680 STUDENTS. 3743 02:22:03,680 --> 02:22:06,440 HIGH SCHOOL STUDENTS THAT WE 3744 02:22:06,440 --> 02:22:07,840 HOPED THAT BEING BLOOD DONORS 3745 02:22:07,840 --> 02:22:09,200 THROUGH THE HIGH SCHOOL YEARS 3746 02:22:09,200 --> 02:22:11,480 THAT WOULD CONTINUE TO BE DONORS 3747 02:22:11,480 --> 02:22:14,280 DURING COLLEGE AND BEYOND BUT 3748 02:22:14,280 --> 02:22:16,080 LOOKS THAT'S NOT COMING TO BE 3749 02:22:16,080 --> 02:22:16,520 TRUE. 3750 02:22:16,520 --> 02:22:18,080 WHY DO THESE DONORS NO LONGER 3751 02:22:18,080 --> 02:22:20,480 THINK THEY DON'T HAVE THE DONOR 3752 02:22:20,480 --> 02:22:20,880 IDENTITY? 3753 02:22:20,880 --> 02:22:22,160 IT WAS THERE IN HIGH SCHOOL, NOT 3754 02:22:22,160 --> 02:22:23,600 SO MUCH IN COLLEGE AND BEYOND. 3755 02:22:23,600 --> 02:22:26,480 WHAT CAN WE DO, HOW CAN WE 3756 02:22:26,480 --> 02:22:30,040 CAPTURE THOSE AND RETAIN THOSE 3757 02:22:30,040 --> 02:22:31,520 DONORS? 3758 02:22:31,520 --> 02:22:33,480 MORE DISCUSSION ABOUT IMMIGRANT 3759 02:22:33,480 --> 02:22:34,320 POPULATIONS, TAILORING OR 3760 02:22:34,320 --> 02:22:37,000 MESSAGE TO THOSE GROUPS OF 3761 02:22:37,000 --> 02:22:37,320 PEOPLE. 3762 02:22:37,320 --> 02:22:39,840 THAT'S VERY IMPORTANT. 3763 02:22:39,840 --> 02:22:42,960 AND LET'S SEE HERE. 3764 02:22:42,960 --> 02:22:43,360 RESEARCH FUNDING. 3765 02:22:43,360 --> 02:22:45,240 OH, I THINK I MENTIONED THAT 3766 02:22:45,240 --> 02:22:46,400 EARLIER, RESEARCH FUNDING WHEN 3767 02:22:46,400 --> 02:22:48,040 WE START GETTING TOGETHER PEOPLE 3768 02:22:48,040 --> 02:22:51,440 TO REVIEW, THERE WILL BE PEOPLE 3769 02:22:51,440 --> 02:22:53,280 THAT UNDERSTAND THE NEED FOR 3770 02:22:53,280 --> 02:22:55,240 COLLABORATIONS WITH PEOPLE THAT 3771 02:22:55,240 --> 02:22:56,720 ARE OUTSIDE THE TRANSFUSION 3772 02:22:56,720 --> 02:22:58,160 MEDICINE WORLD TO HELP US TAKE A 3773 02:22:58,160 --> 02:23:00,320 LOOK AT WHAT WE'VE GOT GOING ON. 3774 02:23:00,320 --> 02:23:02,800 ALL IN ALL, A BUNCH OF 3775 02:23:02,800 --> 02:23:04,360 THOUGHTFUL CONTRIBUTIONS FROM 3776 02:23:04,360 --> 02:23:04,720 EVERYBODY THERE. 3777 02:23:04,720 --> 02:23:06,120 THE GOOD THING, I DON'T THINK WE 3778 02:23:06,120 --> 02:23:09,800 MISSED ANYTHING IN OUR LIST OF 3779 02:23:09,800 --> 02:23:10,080 PRIORITIES. 3780 02:23:10,080 --> 02:23:12,360 THERE WAS A DISCUSSION, A POINT 3781 02:23:12,360 --> 02:23:14,520 MADE MAYBE PRIORITY 4 WHICH WAS 3782 02:23:14,520 --> 02:23:16,400 MESSAGING AND CHANNELS COULD BE 3783 02:23:16,400 --> 02:23:18,760 COMBINED WITH INNOVATIVE AND 3784 02:23:18,760 --> 02:23:19,800 INCLUSIVE USES AND INFORMATION 3785 02:23:19,800 --> 02:23:20,840 THAT WAS PRIORITY 5 SO WE'LL 3786 02:23:20,840 --> 02:23:25,440 TAKE A LOOK AT THAT AND CONSIDER 3787 02:23:25,440 --> 02:23:25,800 IT. 3788 02:23:25,800 --> 02:23:27,600 SO, MERLYN, DID I MISS ANYTHING 3789 02:23:27,600 --> 02:23:28,360 ELSE? 3790 02:23:28,360 --> 02:23:30,440 >> NO, I THINK THAT'S IT, 3791 02:23:30,440 --> 02:23:31,160 BARBARA. 3792 02:23:31,160 --> 02:23:31,960 >> OKAY. 3793 02:23:31,960 --> 02:23:32,200 ALL RIGHT. 3794 02:23:32,200 --> 02:23:36,880 WELL, THANK YOU VERY MUCH. 3795 02:23:36,880 --> 02:23:37,800 THANKS, BRIAN. 3796 02:23:37,800 --> 02:23:39,000 >> THANK YOU VERY MUCH, BARBARA 3797 02:23:39,000 --> 02:23:39,600 AND MERLYN. 3798 02:23:39,600 --> 02:23:41,800 THERE WAS QUITE AN EXTENSIVE 3799 02:23:41,800 --> 02:23:44,040 CHAT DISCUSSION TOO ASSOCIATED 3800 02:23:44,040 --> 02:23:45,440 THAT WE HAVE CAPTURED, THAT THE 3801 02:23:45,440 --> 02:23:47,760 WORKING GROUP WILL BE ABLE TO 3802 02:23:47,760 --> 02:23:48,520 BUILD OFF OF. 3803 02:23:48,520 --> 02:23:50,160 SO I WANT TO ACKNOWLEDGE 3804 02:23:50,160 --> 02:23:51,760 EVERYBODY WHO DID PROVIDE THOSE 3805 02:23:51,760 --> 02:23:52,320 COMMENTS. 3806 02:23:52,320 --> 02:23:55,120 THEY WILL NOT BE IGNORED IN ANY 3807 02:23:55,120 --> 02:23:55,480 WAY. 3808 02:23:55,480 --> 02:23:56,160 ALL RIGHT. 3809 02:23:56,160 --> 02:23:59,440 NEXT IS FOR US TO MOVE TO THE 3810 02:23:59,440 --> 02:24:01,440 NEXT WORKING GROUP, OPTIMIZING 3811 02:24:01,440 --> 02:24:07,960 TRANSFUSION OUTCOMES. 3812 02:24:07,960 --> 02:24:08,080 3813 02:24:08,080 --> 02:24:08,840 >> HELLO. 3814 02:24:08,840 --> 02:24:12,400 I'M GOING TO BE YOUR SUMMARIZER. 3815 02:24:12,400 --> 02:24:14,800 AND THEN DARRELL IS GOING TO 3816 02:24:14,800 --> 02:24:16,840 JOIN IN, IF I MISS ANYTHING OR 3817 02:24:16,840 --> 02:24:18,600 AT LEAST DON'T CAPTURE 3818 02:24:18,600 --> 02:24:19,040 SOMETHING. 3819 02:24:19,040 --> 02:24:21,720 THERE WAS GREAT DISCUSSION IN 3820 02:24:21,720 --> 02:24:24,280 THIS GROUP, LOTS OF TOPICS TO 3821 02:24:24,280 --> 02:24:25,440 DISCUSS, BUT I JUST WANTED TO 3822 02:24:25,440 --> 02:24:27,320 GIVE EVERYBODY KIND OF A 3823 02:24:27,320 --> 02:24:28,800 REMINDER OF WHAT OUR TOPICS 3824 02:24:28,800 --> 02:24:31,920 WERE, JUST TO RUN IT DOWN AGAIN. 3825 02:24:31,920 --> 02:24:33,760 SO, THERE WERE TEN. 3826 02:24:33,760 --> 02:24:36,200 FIRST WAS RED CELL ACUTE ANEMIA 3827 02:24:36,200 --> 02:24:41,600 MEASURES, SECOND WAS 3828 02:24:41,600 --> 02:24:42,200 PROPHYLACTIC TRANSFUSION, 3829 02:24:42,200 --> 02:24:43,440 NON-HEMOSTATIC FUNCTION, THE 3830 02:24:43,440 --> 02:24:44,960 IMMUNE SYSTEM. 3831 02:24:44,960 --> 02:24:47,000 RED CELL CHRONIC TRANSFUSION, 3832 02:24:47,000 --> 02:24:47,440 BLEEDING MANAGEMENT. 3833 02:24:47,440 --> 02:24:52,840 AND THEN THE OTHER FIVE WERE RED 3834 02:24:52,840 --> 02:25:03,280 CELL NISHOTS, FIBROGEN, 3835 02:25:08,520 --> 02:25:09,160 GUIDELINES, IMPLEMENT SCIENCE 3836 02:25:09,160 --> 02:25:10,240 AND COMPARING PRODUCTS. 3837 02:25:10,240 --> 02:25:11,360 WE HAD PEOPLE COMMENT WITH 3838 02:25:11,360 --> 02:25:14,920 SYNTHESIS OF WHAT WAS DISCUSSED. 3839 02:25:14,920 --> 02:25:17,720 ACTUALLY, IT WAS VERY NICE 3840 02:25:17,720 --> 02:25:18,720 BECAUSE THERE WERE THEMATIC 3841 02:25:18,720 --> 02:25:19,920 THINGS FOR EVERYTHING THAT CAME 3842 02:25:19,920 --> 02:25:21,600 OUT THAT WERE THE SAME KINDS OF 3843 02:25:21,600 --> 02:25:23,440 THEMES THAT CAME OUT WHEN WE 3844 02:25:23,440 --> 02:25:24,640 WERE HAVING OUR COMMITTEE 3845 02:25:24,640 --> 02:25:26,360 MEETINGS OVER THE LAST SEVERAL 3846 02:25:26,360 --> 02:25:30,080 MONTHS AND OUR SUBGROUP 3847 02:25:30,080 --> 02:25:31,080 MEETINGS. 3848 02:25:31,080 --> 02:25:33,680 AND I THINK THAT IF WE THINK 3849 02:25:33,680 --> 02:25:37,920 ABOUT THIS GOING ACROSS THE 3850 02:25:37,920 --> 02:25:40,280 DIFFERENT SUBGROUPS, REALLY THE 3851 02:25:40,280 --> 02:25:42,360 PLATELET COUNT AND HEMOGLOBIN 3852 02:25:42,360 --> 02:25:44,280 SEEM TO HAVE LOST THEIR MEANING 3853 02:25:44,280 --> 02:25:46,040 AND WE'VE LOST OUR WAY IN THE 3854 02:25:46,040 --> 02:25:49,040 SENSE OF USING THOSE AS A 3855 02:25:49,040 --> 02:25:51,000 TRANSFUSION TRIGGER. 3856 02:25:51,000 --> 02:25:53,600 AND SO, IN SOME WAYS WE'VE 3857 02:25:53,600 --> 02:25:54,720 OUTGROWN THEM. 3858 02:25:54,720 --> 02:25:55,800 WE'VE STUDIED THEM AND THEY HAVE 3859 02:25:55,800 --> 02:25:58,840 TRAPPED US IN A WAY THAT WE 3860 02:25:58,840 --> 02:26:00,760 REALLY CAN'T -- IT'S LIMITED US 3861 02:26:00,760 --> 02:26:02,680 TO LOOK BETTER AT PATIENT 3862 02:26:02,680 --> 02:26:03,160 OUTCOMES. 3863 02:26:03,160 --> 02:26:04,760 SO THE THOUGHT PROCESS WAS THAT 3864 02:26:04,760 --> 02:26:07,280 WE NEEDED TO HAVE A FUTURE WHERE 3865 02:26:07,280 --> 02:26:09,520 WE DEVELOP OTHER THINGS THAT ARE 3866 02:26:09,520 --> 02:26:11,560 GOING TO HELP US WITH 3867 02:26:11,560 --> 02:26:12,440 INDICATIONS OR OUTCOMES OF 3868 02:26:12,440 --> 02:26:13,520 TRANSFUSION. 3869 02:26:13,520 --> 02:26:15,200 THEY ARE NO LONGER IDEAL. 3870 02:26:15,200 --> 02:26:18,040 THAT WAS A HUGE SUMMARY 3871 02:26:18,040 --> 02:26:18,360 STATEMENT. 3872 02:26:18,360 --> 02:26:21,840 I WOULD SAY THAT WHAT WE DO NEXT 3873 02:26:21,840 --> 02:26:25,000 IN BOTH THE BLEEDING SPACE AND 3874 02:26:25,000 --> 02:26:27,320 IN THE OXYGEN CARRYING CAPACITY 3875 02:26:27,320 --> 02:26:29,720 OR TISSUE OXYGENATION SPACE HAS 3876 02:26:29,720 --> 02:26:32,640 TO DO WITH DEVELOPING BETTER 3877 02:26:32,640 --> 02:26:34,440 MEASURES EITHER USING HEMOGLOBIN 3878 02:26:34,440 --> 02:26:36,880 IN CONJUNCTION WITH NIRS OR 3879 02:26:36,880 --> 02:26:42,880 OTHERS MEASURES IN THE ICU, 3880 02:26:42,880 --> 02:26:43,520 DIFFERENT MONITORING TECHNIQUES, 3881 02:26:43,520 --> 02:26:46,240 TO COME UP WITH A BETTER WAY 3882 02:26:46,240 --> 02:26:47,280 FUNCTIONALLY TO ASSESS OUTCOMES 3883 02:26:47,280 --> 02:26:52,240 AND SO IN THE OXYGENATION, 3884 02:26:52,240 --> 02:26:53,320 TISSUE OXYGENATION SPACE, 3885 02:26:53,320 --> 02:26:54,880 INCORPORATING ALSO WHAT PATIENTS 3886 02:26:54,880 --> 02:26:57,640 ARE EXPERIENCING INTO THAT 3887 02:26:57,640 --> 02:26:57,880 OUTCOME. 3888 02:26:57,880 --> 02:26:58,600 SO, VERY FUNCTIONAL. 3889 02:26:58,600 --> 02:27:00,120 ALL THE WAY TO ASKING THE 3890 02:27:00,120 --> 02:27:04,520 PATIENT, NOT JUST WHAT WE CAN 3891 02:27:04,520 --> 02:27:09,200 MEASURE WITH NEW MEASURING 3892 02:27:09,200 --> 02:27:09,800 TECHNIQUES. 3893 02:27:09,800 --> 02:27:16,120 WITH PLATELETS AND RED CELLS, 3894 02:27:16,120 --> 02:27:18,000 GLOBAL WAYS TO MEASURE, TOO 3895 02:27:18,000 --> 02:27:20,480 LIMITED WITH PTT AND PT AND INR, 3896 02:27:20,480 --> 02:27:22,240 WE'VE BEEN TALKING ABOUT THIS 3897 02:27:22,240 --> 02:27:25,120 FOR A LONG TIME, PLASMA 3898 02:27:25,120 --> 02:27:25,960 PRODUCTS, SO REALLY 3899 02:27:25,960 --> 02:27:27,920 CONCENTRATING AND MOVING TO THE 3900 02:27:27,920 --> 02:27:29,440 NEXT DIRECTION OF DEVELOPING 3901 02:27:29,440 --> 02:27:34,600 WAYS TO STUDY THIS IN A MORE 3902 02:27:34,600 --> 02:27:35,360 PRECISION-BASED MEDICINE WAY. 3903 02:27:35,360 --> 02:27:37,800 HOW DID THIS ALL COME ABOUT? 3904 02:27:37,800 --> 02:27:39,440 ALL THE SCIENCE HAS LED US TO 3905 02:27:39,440 --> 02:27:41,520 UNDERSTAND THAT WHAT'S IN THE 3906 02:27:41,520 --> 02:27:44,440 PLATELET BAG AND WHAT'S IN THE 3907 02:27:44,440 --> 02:27:45,760 RED CELL BAG IS MUCH MORE 3908 02:27:45,760 --> 02:27:47,960 SOPHISTICATED THAN WE EVER 3909 02:27:47,960 --> 02:27:48,280 THOUGHT. 3910 02:27:48,280 --> 02:27:50,120 AND SO, PLATELETS AND RED CELLS 3911 02:27:50,120 --> 02:27:51,720 SEEM TO HAVE OTHER FUNCTIONS 3912 02:27:51,720 --> 02:27:55,000 WHICH HAVE BEEN DEFINED IN A LOT 3913 02:27:55,000 --> 02:27:57,600 OF DIFFERENT WAYS, AND ISN'T 3914 02:27:57,600 --> 02:27:58,360 JUST FOR PLATELETS FOR 3915 02:27:58,360 --> 02:28:00,640 HEMOSTASIS AND RED CELLS FOR 3916 02:28:00,640 --> 02:28:01,960 OXYGEN-CARRYING CAPACITY, THAT 3917 02:28:01,960 --> 02:28:06,160 THERE MAY BE IMMUNOLOGIC 3918 02:28:06,160 --> 02:28:07,440 FUNCTIONS, ANGIOGENIC FUNCTIONS, 3919 02:28:07,440 --> 02:28:09,760 FLOW CAPACITY, AND WE NEED TO 3920 02:28:09,760 --> 02:28:10,760 STOP LOOKING ONE DIMENSIONALLY 3921 02:28:10,760 --> 02:28:14,840 AND LOOK MORE BROADLY. 3922 02:28:14,840 --> 02:28:16,400 THE ENDOTHELIUM AS AN ORGAN 3923 02:28:16,400 --> 02:28:17,760 NEEDS TO BE STUDIED IN 3924 02:28:17,760 --> 02:28:22,240 RELATIONSHIP TO THIS, LEADING TO 3925 02:28:22,240 --> 02:28:23,040 COMMENTS ABOUT EXTRACORPOREAL 3926 02:28:23,040 --> 02:28:24,600 CIRCUITS, HOW DO WE UNDERSTAND 3927 02:28:24,600 --> 02:28:26,720 THAT IN EVERYTHING IN THAT 3928 02:28:26,720 --> 02:28:29,360 MILIEU AND WE NEED TO GET MORE 3929 02:28:29,360 --> 02:28:35,400 SOPHISTICATED IN THAT AREA. 3930 02:28:35,400 --> 02:28:37,640 THERE WERE ALSO IDEAS THROUGH 3931 02:28:37,640 --> 02:28:38,600 THE LIFESPAN RECIPIENTS REACTING 3932 02:28:38,600 --> 02:28:41,960 IN DIFFERENTIAL WAY TO RED CELL 3933 02:28:41,960 --> 02:28:43,440 TRANSFUSION, PLATELETS, AND 3934 02:28:43,440 --> 02:28:47,440 PLASMA AND THE VOLUME, DOSE, 3935 02:28:47,440 --> 02:28:50,040 RATE AROUND WHAT POTENCY OR 3936 02:28:50,040 --> 02:28:52,640 PRODUCTS DO FOR DIFFERENT 3937 02:28:52,640 --> 02:28:53,440 POPULATIONS IS IMPORTANT. 3938 02:28:53,440 --> 02:28:54,080 DIVERSITY, EQUITY, AND INCLUSION 3939 02:28:54,080 --> 02:28:56,280 NEEDS TO BE CONSIDERED WHEN IT 3940 02:28:56,280 --> 02:28:57,680 COMES TO RECIPIENTS, WHO ARE THE 3941 02:28:57,680 --> 02:29:00,720 PATIENTS THAT ARE BEING 3942 02:29:00,720 --> 02:29:02,760 TRANSFUSED ON A REGULAR BASIS, 3943 02:29:02,760 --> 02:29:09,200 AND PEOPLE WITH HEMOGLOBIN BE 3944 02:29:09,200 --> 02:29:09,720 O N -- HEMOGLOBINOPATHIES, 3945 02:29:09,720 --> 02:29:10,800 DIFFERENCES BETWEEN MEN AND 3946 02:29:10,800 --> 02:29:13,400 WOMEN, AND STUDIES POINTING 3947 02:29:13,400 --> 02:29:15,280 TOWARD THAT DIRECTION, PROBABLY 3948 02:29:15,280 --> 02:29:15,800 DIFFERENTIAL RESPONSES FOR 3949 02:29:15,800 --> 02:29:18,440 DIFFERENT PRODUCTS AS WELL. 3950 02:29:18,440 --> 02:29:19,960 THAT WAS DISCUSSED, AND BROUGHT 3951 02:29:19,960 --> 02:29:23,280 OUT TO BE IMPORTANT. 3952 02:29:23,280 --> 02:29:25,880 FINALLY WHAT IS THE EFFICACY OF 3953 02:29:25,880 --> 02:29:27,880 TRANSFUSION VERSUS THE SAFETY 3954 02:29:27,880 --> 02:29:29,320 PROFILE OF TRANSFUSIONS? 3955 02:29:29,320 --> 02:29:30,800 WHEN ARE WE TOO MUCH ONE SIDE OR 3956 02:29:30,800 --> 02:29:31,600 THE OTHER? 3957 02:29:31,600 --> 02:29:35,160 HOW ARE WE GOING TO INCORPORATE 3958 02:29:35,160 --> 02:29:36,480 THAT INTO TRANSFUSION STUDIES 3959 02:29:36,480 --> 02:29:38,360 THAT HAVE TO DO WITH WOMEN, HAVE 3960 02:29:38,360 --> 02:29:41,520 TO DO WITH TRAUMA VICTIMS, ARE 3961 02:29:41,520 --> 02:29:42,880 WE BEING TOO CONSERVATIVE WHERE 3962 02:29:42,880 --> 02:29:45,360 WE DON'T GIVE CERTAIN THINGS 3963 02:29:45,360 --> 02:29:46,400 BECAUSE WE'RE WORRIED, BUT SOME 3964 02:29:46,400 --> 02:29:48,000 OF THAT ALL STEMS FROM THE FACT 3965 02:29:48,000 --> 02:29:49,000 WE DON'T UNDERSTAND WHAT IS 3966 02:29:49,000 --> 02:29:51,480 GOING TO BE THE ACTUAL BENEFIT. 3967 02:29:51,480 --> 02:29:53,360 AND I THINK COMING TO A PLACE OF 3968 02:29:53,360 --> 02:29:54,160 STUDYING THOSE THINGS TOGETHER 3969 02:29:54,160 --> 02:29:57,200 IS GOING TO BE IMPORTANT TO THE 3970 02:29:57,200 --> 02:30:00,680 FUTURE OF HOW WE ADDRESS MANY OF 3971 02:30:00,680 --> 02:30:04,320 THE AREAS THAT WERE IDENTIFIED 3972 02:30:04,320 --> 02:30:05,840 BY THIS SUBGROUP OF THE STATE OF 3973 02:30:05,840 --> 02:30:07,000 THE SCIENCE. 3974 02:30:07,000 --> 02:30:09,440 WITH THAT I'LL LET YOU, DARRELL, 3975 02:30:09,440 --> 02:30:11,480 FILL IN OTHER PARTS YOU THINK I 3976 02:30:11,480 --> 02:30:11,880 MISSED. 3977 02:30:11,880 --> 02:30:14,680 >> YEAH, I THINK YOU COVERED IT 3978 02:30:14,680 --> 02:30:15,040 WELL. 3979 02:30:15,040 --> 02:30:15,960 I'LL EMPHASIZE ALMOST EACH 3980 02:30:15,960 --> 02:30:20,400 GROUP, WHETHER IT WAS PLATELETS 3981 02:30:20,400 --> 02:30:24,800 OR PLASMA OR RED CELLS, 3982 02:30:24,800 --> 02:30:27,720 DEFINITELY WANTED NHLBI TO 3983 02:30:27,720 --> 02:30:29,680 CONSIDER THE DONOR 3984 02:30:29,680 --> 02:30:31,240 CHARACTERISTICS THAT COULD 3985 02:30:31,240 --> 02:30:34,240 RESULT IN VARIABLE EFFICACY OF 3986 02:30:34,240 --> 02:30:36,520 THE PRODUCT ITSELF. 3987 02:30:36,520 --> 02:30:39,120 THOSE DONOR CHARACTERISTICS MAY 3988 02:30:39,120 --> 02:30:43,080 BE DONOR SEX, IT MAY BE DONOR 3989 02:30:43,080 --> 02:30:46,760 SMOKING STATUS, IT MAY BE DONOR 3990 02:30:46,760 --> 02:30:49,680 HEMOGLOBIN OR PLATELET CONTENT. 3991 02:30:49,680 --> 02:30:52,200 WE'RE LEARNING ABOUT THESE DONOR 3992 02:30:52,200 --> 02:30:53,040 AND COMPONENT CHARACTERISTICS 3993 02:30:53,040 --> 02:30:55,360 THAT MIGHT BE RELATED TO 3994 02:30:55,360 --> 02:30:56,120 OUTCOME. 3995 02:30:56,120 --> 02:30:58,880 SOME MAY BE NOT NECESSARILY 3996 02:30:58,880 --> 02:31:00,400 DONOR BUT MANUFACTURING STEPS, 3997 02:31:00,400 --> 02:31:02,680 OR TECHNIQUES SUCH AS COLD STORE 3998 02:31:02,680 --> 02:31:05,560 PLATELETS VERSUS ROOM 3999 02:31:05,560 --> 02:31:06,720 TEMPERATURE PLATELETS. 4000 02:31:06,720 --> 02:31:08,840 WE TALKED ABOUT P.I. RED CELLS 4001 02:31:08,840 --> 02:31:10,520 VERSUS NON-P.I. RED CELLS. 4002 02:31:10,520 --> 02:31:16,160 AND SO P.I. PLATELETS VERSUS 4003 02:31:16,160 --> 02:31:16,960 NON-P.I. PLATELETS. 4004 02:31:16,960 --> 02:31:20,480 SO, ALONG THE ENTIRE CONTINUUM 4005 02:31:20,480 --> 02:31:23,240 OF DONOR CHARACTERISTICS, 4006 02:31:23,240 --> 02:31:23,760 COMPONENT MANUFACTURING 4007 02:31:23,760 --> 02:31:25,960 CHARACTERISTICS TO WHAT IS THE 4008 02:31:25,960 --> 02:31:28,120 APPROPRIATE INDICATION WHICH WE 4009 02:31:28,120 --> 02:31:31,160 NOW KNOW IS -- WE'RE BEYOND JUST 4010 02:31:31,160 --> 02:31:32,240 HEMOGLOBIN OR PLATELET COUNT, 4011 02:31:32,240 --> 02:31:35,520 AND THEN WHAT ARE THE OUTCOMES 4012 02:31:35,520 --> 02:31:37,600 TO MEASURE. 4013 02:31:37,600 --> 02:31:39,720 SO, IT REALLY WAS AMAZING THE 4014 02:31:39,720 --> 02:31:40,640 CONSISTENCY OF THE COMMENTS 4015 02:31:40,640 --> 02:31:43,440 ACROSS THE DIFFERENT TYPES OF 4016 02:31:43,440 --> 02:31:44,320 BLOOD PRODUCTS. 4017 02:31:44,320 --> 02:31:46,600 AND ALTHOUGH IT WAS NOT IN OUR 4018 02:31:46,600 --> 02:31:48,480 TOP FIVE THAT WE PRESENTED, WE 4019 02:31:48,480 --> 02:31:54,360 SPENT QUITE A BIT OF TIME ON 4020 02:31:54,360 --> 02:31:55,800 NON-INFECTIOUS HAZARDS OF 4021 02:31:55,800 --> 02:31:56,800 TRANSFUSIONS AS CASSANDRA 4022 02:31:56,800 --> 02:31:58,520 MENTIONED SO ULTIMATELY WE CAN 4023 02:31:58,520 --> 02:32:02,240 UNDERSTAND RISK/BENEFIT PROFILE 4024 02:32:02,240 --> 02:32:03,640 OF AN INTERVENTION. 4025 02:32:03,640 --> 02:32:04,720 >> WE'RE GOING TO INCLUDE THAT 4026 02:32:04,720 --> 02:32:06,640 JUST TO MAKE SURE, DARRELL, 4027 02:32:06,640 --> 02:32:07,640 EVERYBODY HEARS THIS LOUD AND 4028 02:32:07,640 --> 02:32:09,160 CLEAR, JUST BECAUSE WE ALL CAME 4029 02:32:09,160 --> 02:32:11,080 UP WITH THOSE TOP FIVE AND WE 4030 02:32:11,080 --> 02:32:13,320 REALLY TRIED HARD TO BE ABLE TO 4031 02:32:13,320 --> 02:32:15,080 HAVE THOSE TO PRESENT, WE'RE 4032 02:32:15,080 --> 02:32:17,120 GOING TO BE DEVELOPING A 4033 02:32:17,120 --> 02:32:17,880 MANUSCRIPT THAT WILL COME FROM, 4034 02:32:17,880 --> 02:32:19,320 YOU KNOW, THE STATE OF THE 4035 02:32:19,320 --> 02:32:22,040 SCIENCE AND MAYBE EVEN EACH ONE 4036 02:32:22,040 --> 02:32:24,160 OF THESE GROUPS. 4037 02:32:24,160 --> 02:32:25,800 AND EVENTUALLY, WE'LL BE ABLE TO 4038 02:32:25,800 --> 02:32:27,960 INCORPORATE WHAT OTHER PEOPLE 4039 02:32:27,960 --> 02:32:31,240 HAVE SAID AND HOW WE PUT THIS 4040 02:32:31,240 --> 02:32:32,160 TOGETHER, BECAUSE IT'S REALLY 4041 02:32:32,160 --> 02:32:34,640 IMPORTANT TO BE ABLE TO 4042 02:32:34,640 --> 02:32:35,800 INTEGRATE ALL OF EVERYBODY'S 4043 02:32:35,800 --> 02:32:40,120 COMMENTS INTO THIS BECAUSE THEY 4044 02:32:40,120 --> 02:32:41,800 ALL ARE MEANINGFUL AND TO SOME 4045 02:32:41,800 --> 02:32:43,640 EXTENT ALL OF US ARE EXPERTS IN 4046 02:32:43,640 --> 02:32:44,480 THIS FIELD. 4047 02:32:44,480 --> 02:32:48,280 SO WE WANT ALL OF OUR THOUGHTS 4048 02:32:48,280 --> 02:32:49,640 TO BE INCORPORATED. 4049 02:32:49,640 --> 02:32:52,480 >> VERY MUCH THE PERSONALIZED 4050 02:32:52,480 --> 02:32:53,440 MEDICINE APPROACH TO GENERALIZED 4051 02:32:53,440 --> 02:32:55,760 CLINICAL CARE CAME THROUGH LOUD 4052 02:32:55,760 --> 02:32:59,280 AND CLEAR FROM THIS GROUP, WHICH 4053 02:32:59,280 --> 02:33:01,000 WAS EQUALLY REPRESENTED BY 4054 02:33:01,000 --> 02:33:05,840 TRANSFUSION MEDICINE PHYSICIANS 4055 02:33:05,840 --> 02:33:07,000 AND CLINICIANS, INTENTIONALLY. 4056 02:33:07,000 --> 02:33:08,240 WE REALIZE THAT TO BE 4057 02:33:08,240 --> 02:33:11,320 PERSONALIZED IN OUR APPROACH TO 4058 02:33:11,320 --> 02:33:14,160 TRANSFUSION, WE HAVE TO EVOLVE 4059 02:33:14,160 --> 02:33:17,160 BEYOND AN HEMOGLOBIN, PLATELET 4060 02:33:17,160 --> 02:33:19,800 COUNT, PTINR TO DO THAT AND 4061 02:33:19,800 --> 02:33:21,000 HELPING TO IMPROVE PATIENT 4062 02:33:21,000 --> 02:33:21,400 OUTCOMES. 4063 02:33:21,400 --> 02:33:23,160 THAT'S WHAT I WOULD SAY IS 4064 02:33:23,160 --> 02:33:24,160 REALLY THE OVERARCHING TEAM THAT 4065 02:33:24,160 --> 02:33:31,040 CAME OUT FROM THIS DISCUSSION. 4066 02:33:31,040 --> 02:33:32,000 >> I AGREE. 4067 02:33:32,000 --> 02:33:32,960 ARE WE SUPPOSED TO TAKE 4068 02:33:32,960 --> 02:33:33,360 QUESTIONS? 4069 02:33:33,360 --> 02:33:35,400 I SEE A HAND UP. 4070 02:33:35,400 --> 02:33:37,640 I DON'T KNOW HOW THIS IS 4071 02:33:37,640 --> 02:33:39,360 SUPPOSED TO GO. 4072 02:33:39,360 --> 02:33:40,440 >> WE DO HAVE TIME, ACCORDING TO 4073 02:33:40,440 --> 02:33:41,120 THE SCHEDULE. 4074 02:33:41,120 --> 02:33:42,640 >> YEAH, WE DO HAVE TIME. 4075 02:33:42,640 --> 02:33:44,760 SO WITH THAT IN MIND ACTUALLY I 4076 02:33:44,760 --> 02:33:47,800 THINK IT WOULD BE JUST FINE. 4077 02:33:47,800 --> 02:33:48,880 >> I'M COOL WITH THAT. 4078 02:33:48,880 --> 02:33:56,520 >> JULIE, DO YOU WANT TO ASK? 4079 02:33:56,520 --> 02:33:56,640 4080 02:33:56,640 --> 02:33:58,720 >> THANK YOU VERY MUCH. 4081 02:33:58,720 --> 02:34:04,560 IT WAS GREAT PARTICIPATING IN 4082 02:34:04,560 --> 02:34:10,280 THIS GROUP DISCUSSION. 4083 02:34:10,280 --> 02:34:14,120 I'M COMING FROM PERSPECTIVE OF 4084 02:34:14,120 --> 02:34:14,840 (INAUDIBLE) AND SICKLE CELL 4085 02:34:14,840 --> 02:34:19,160 DISEASE AND THE THIRD ASPECT IS 4086 02:34:19,160 --> 02:34:19,720 WORKING FROM AFRICA. 4087 02:34:19,720 --> 02:34:21,960 I THINK TOWARDS THE END OF THE 4088 02:34:21,960 --> 02:34:24,000 DISCUSSION IN OUR WORKING GROUP 4089 02:34:24,000 --> 02:34:26,760 THERE WAS A COMMENT ABOUT THE 4090 02:34:26,760 --> 02:34:29,200 ISSUE ABOUT DIVERSITY AND 4091 02:34:29,200 --> 02:34:29,440 EQUITY. 4092 02:34:29,440 --> 02:34:31,840 NOT JUST FROM PERSPECTIVE OF 4093 02:34:31,840 --> 02:34:34,160 DONORS BUT PERSPECTIVE OF 4094 02:34:34,160 --> 02:34:34,600 SCIENTISTS. 4095 02:34:34,600 --> 02:34:36,960 ONE OF THE THINGS THAT I WANTED 4096 02:34:36,960 --> 02:34:38,840 TO MAKE A COMMENT WAS 4097 02:34:38,840 --> 02:34:40,560 SPECIFICALLY FOR SICKLE CELL 4098 02:34:40,560 --> 02:34:42,920 DISEASE, WE HAVE A SITUATION 4099 02:34:42,920 --> 02:34:45,480 WHERE WE HAVE PATIENTS WITH A 4100 02:34:45,480 --> 02:34:49,040 HEMOGLOBIN LESS THAN 5 GRAMS PER 4101 02:34:49,040 --> 02:34:51,880 DECILITER, 5% COME TO THE 4102 02:34:51,880 --> 02:34:56,160 CLINIC, 20% OF THE HOSPITALIZED 4103 02:34:56,160 --> 02:34:57,080 PATIENTS HAVE HEMOGLOBIN LESS 4104 02:34:57,080 --> 02:34:57,520 THAN 5. 4105 02:34:57,520 --> 02:34:59,680 IN THIS ISSUE THE ISSUE IS THEY 4106 02:34:59,680 --> 02:35:02,480 NEED BLOOD AND THERE'S 4107 02:35:02,480 --> 02:35:04,920 INADEQUATE BLOOD AND THERE ARE 4108 02:35:04,920 --> 02:35:07,400 CONSEQUENCE ABOUT CONSEQUENCES 4109 02:35:07,400 --> 02:35:11,000 OF SEVERE ANEMIA ON SICKLE CELL 4110 02:35:11,000 --> 02:35:11,560 DISEASE. 4111 02:35:11,560 --> 02:35:13,960 AND WHEN YOU HAVE TOO MUCH 4112 02:35:13,960 --> 02:35:16,360 BLOOD, WE'VE HAVE HAD INSTANCES 4113 02:35:16,360 --> 02:35:18,800 WITH INDIVIDUALS OR PARTICULARLY 4114 02:35:18,800 --> 02:35:23,080 CHILDREN WHO HAVE BEEN 4115 02:35:23,080 --> 02:35:28,360 TRANSFUSED AND HAD UNFORTUNATELY 4116 02:35:28,360 --> 02:35:28,840 POSTERIOR REVERSIBLE 4117 02:35:28,840 --> 02:35:29,360 (INDISCERNIBLE) SYNDROME, 4118 02:35:29,360 --> 02:35:32,000 REVERSIBLE, THEY WERE ABLE TO 4119 02:35:32,000 --> 02:35:33,200 RECOVER FROM THE NEUROLOGICAL 4120 02:35:33,200 --> 02:35:35,480 COMPLICATIONS SO THESE ARE TWO 4121 02:35:35,480 --> 02:35:38,960 INSTANCES, I THINK THIS WAS 4122 02:35:38,960 --> 02:35:40,320 DISCUSSED, TOO MUCH AND I THINK 4123 02:35:40,320 --> 02:35:41,600 SOMEBODY ELSE TALKED ABOUT THE 4124 02:35:41,600 --> 02:35:45,760 RATE WHERE YOU MAY BE 4125 02:35:45,760 --> 02:35:47,200 TRANSFUSING TOO FAST. 4126 02:35:47,200 --> 02:35:49,160 THE THIRD -- AND THESE ARE AREAS 4127 02:35:49,160 --> 02:35:51,120 FROM A CLINICAL PERSPECTIVE THAT 4128 02:35:51,120 --> 02:35:52,000 I THINK ARE IMPORTANT RESEARCH 4129 02:35:52,000 --> 02:35:53,640 QUESTIONS THAT NEED TO BE 4130 02:35:53,640 --> 02:35:54,200 ANSWERED. 4131 02:35:54,200 --> 02:35:55,280 AGAIN, SOMETHING THAT WAS 4132 02:35:55,280 --> 02:36:00,520 RAISED, THAT THERE'S A GAP IN 4133 02:36:00,520 --> 02:36:04,360 CLINICAL SCIENCE, REALLY ABOUT 4134 02:36:04,360 --> 02:36:04,960 THERAPEUTIC BLOOD TRANSFUSION, 4135 02:36:04,960 --> 02:36:07,000 WHETHER IT'S IN ACUTE OR CHRONIC 4136 02:36:07,000 --> 02:36:07,880 FACE. 4137 02:36:07,880 --> 02:36:10,120 I'M BIAS BECAUSE MY PERSPECTIVE 4138 02:36:10,120 --> 02:36:12,240 IS LOOKING FROM PERSPECTIVE OF 4139 02:36:12,240 --> 02:36:14,000 SICKLE CELL AND OF AFRICA. 4140 02:36:14,000 --> 02:36:15,400 OVER TO YOU. 4141 02:36:15,400 --> 02:36:16,120 THANK YOU. 4142 02:36:16,120 --> 02:36:17,640 >> JULIE, THAT WAS AWESOME. 4143 02:36:17,640 --> 02:36:18,920 WHAT A GREAT SUMMARY OF AN 4144 02:36:18,920 --> 02:36:21,560 ASPECT OF WHAT WE TALKED ABOUT 4145 02:36:21,560 --> 02:36:25,360 WHICH BROUGHT IN DIFFERENT 4146 02:36:25,360 --> 02:36:25,800 THINGS. 4147 02:36:25,800 --> 02:36:28,360 DEFINITELY DIVERSITY OF THE 4148 02:36:28,360 --> 02:36:28,920 PHYSICIANS AND INVESTIGATORS 4149 02:36:28,920 --> 02:36:29,480 REPRESENTED HERE, THAT WAS 4150 02:36:29,480 --> 02:36:30,080 BROUGHT UP. 4151 02:36:30,080 --> 02:36:31,840 THAT IS A VERY IMPORTANT ASPECT 4152 02:36:31,840 --> 02:36:33,080 OF THINGS. 4153 02:36:33,080 --> 02:36:34,480 SO I'M REALLY GLAD YOU'RE 4154 02:36:34,480 --> 02:36:36,680 SPEAKING UP FOR WHERE YOU'RE 4155 02:36:36,680 --> 02:36:38,880 PARTICIPATING FROM BECAUSE IT 4156 02:36:38,880 --> 02:36:41,080 DEFINITELY PRESENTS SIMILAR 4157 02:36:41,080 --> 02:36:43,160 ISSUES BUT SOME OTHER, YOU KNOW, 4158 02:36:43,160 --> 02:36:44,920 BIG DIFFERENCES IN AVAILABILITY 4159 02:36:44,920 --> 02:36:48,480 OF RESOURCES AND THEN HOW DO YOU 4160 02:36:48,480 --> 02:36:50,080 MANAGE THAT AND MANAGE THOSE 4161 02:36:50,080 --> 02:36:52,360 POTENTIAL CONSEQUENCES. 4162 02:36:52,360 --> 02:36:54,200 WE DID TALK A LOT ABOUT TACO, 4163 02:36:54,200 --> 02:36:57,440 THIS IS NOT TACO IN CHILDREN BUT 4164 02:36:57,440 --> 02:36:59,400 TACO ALL OVER BEING, YOU KNOW, 4165 02:36:59,400 --> 02:37:03,320 ONE OF THE NUMBER ONE 4166 02:37:03,320 --> 02:37:03,920 TRANSFUSION REACTION MORBIDITY 4167 02:37:03,920 --> 02:37:05,840 AND MORTALITY THINGS IN THE U.S. 4168 02:37:05,840 --> 02:37:06,440 AS WELL. 4169 02:37:06,440 --> 02:37:07,960 I THINK THAT WE SORT OF WRITE IT 4170 02:37:07,960 --> 02:37:08,480 OFF. 4171 02:37:08,480 --> 02:37:09,800 WE THINK IT'S OVERLOAD. 4172 02:37:09,800 --> 02:37:11,600 BUT THERE ARE MANY CIRCUMSTANCES 4173 02:37:11,600 --> 02:37:13,280 OF THE PATIENT THAT WE NEED TO 4174 02:37:13,280 --> 02:37:16,280 TAKE INTO ACCOUNT LIKE A VERY 4175 02:37:16,280 --> 02:37:18,520 LOW HEMOGLOBIN AND HOW MUCH WE 4176 02:37:18,520 --> 02:37:19,800 TRANSFUSE, HOW FAST, HOW MUCH 4177 02:37:19,800 --> 02:37:21,480 ARE WE DOING IT WITH AND NOW 4178 02:37:21,480 --> 02:37:23,200 THAT WE UNDERSTAND THERE'S 4179 02:37:23,200 --> 02:37:24,520 DIFFERENCES IN RED CELLS HOW 4180 02:37:24,520 --> 02:37:27,360 LONG HAS THAT BEEN BLOOD STORED, 4181 02:37:27,360 --> 02:37:29,120 ARE THERE DIFFERENCES IN THE 4182 02:37:29,120 --> 02:37:30,280 BIOLOGIC CHARACTERISTICS FROM 4183 02:37:30,280 --> 02:37:33,560 DONOR TO DONOR, IS THAT IN 4184 02:37:33,560 --> 02:37:33,800 EFFECT? 4185 02:37:33,800 --> 02:37:37,640 THAT BRINGS OUT AN ENTIRE OTHER 4186 02:37:37,640 --> 02:37:40,520 ASPECT OF RED CELL TRANSFUSION 4187 02:37:40,520 --> 02:37:42,240 WE NEED TO CONCENTRATE ON. 4188 02:37:42,240 --> 02:37:44,080 I'M SUPER HAPPY YOU BROUGHT THAT 4189 02:37:44,080 --> 02:37:45,040 UP. 4190 02:37:45,040 --> 02:37:46,720 AND LIKE I SAID, LIKE DARRELL 4191 02:37:46,720 --> 02:37:48,160 SAID, THERE WERE A LOT OF 4192 02:37:48,160 --> 02:37:49,520 COMMENTS THAT CAME INTO THE 4193 02:37:49,520 --> 02:37:51,000 CHAT, AND THIS IS AN ONGOING 4194 02:37:51,000 --> 02:37:52,400 DISCUSSION AND WE WANT TO 4195 02:37:52,400 --> 02:37:53,520 INCORPORATE WHAT OTHER PEOPLE 4196 02:37:53,520 --> 02:37:56,880 THINK ARE IMPORTANT QUESTIONS TO 4197 02:37:56,880 --> 02:37:57,640 BE ANSWERED. 4198 02:37:57,640 --> 02:37:59,600 AND SO I JUST WANT TO SAY THANK 4199 02:37:59,600 --> 02:38:03,120 YOU, JULIE, FOR SAYING ALL OF 4200 02:38:03,120 --> 02:38:05,760 THAT. 4201 02:38:05,760 --> 02:38:06,080 QUENTIN? 4202 02:38:06,080 --> 02:38:07,920 >> A VERY GENERAL QUESTION 4203 02:38:07,920 --> 02:38:10,880 FOLLOWING ON JULIE'S POINT, 4204 02:38:10,880 --> 02:38:12,520 WORKING IN AFRICA, WHERE I AM 4205 02:38:12,520 --> 02:38:16,320 FROM MYSELF. 4206 02:38:16,320 --> 02:38:17,440 I KNOW THE REDS PROGRAM ENTER 4207 02:38:17,440 --> 02:38:19,480 NATIONAL BUT WHAT IS THE SCOPE 4208 02:38:19,480 --> 02:38:22,120 OF THE INITIATIVE TO EXPAND MORE 4209 02:38:22,120 --> 02:38:24,000 BROADLY AND HAVE INITIATIVES 4210 02:38:24,000 --> 02:38:24,640 WITH DOMAINS LIKE AFRICA AND 4211 02:38:24,640 --> 02:38:26,600 OTHER PARTS OF THE WORLD? 4212 02:38:26,600 --> 02:38:28,800 THERE'S AN ENORMOUS AMOUNT OF 4213 02:38:28,800 --> 02:38:30,960 COLLABORATIVE OPPORTUNITY AND 4214 02:38:30,960 --> 02:38:37,480 THINGS WE CAN LEARN BY THESE 4215 02:38:37,480 --> 02:38:37,920 CROSS-COLLABORATIVE 4216 02:38:37,920 --> 02:38:38,240 OPPORTUNITIES. 4217 02:38:38,240 --> 02:38:41,200 SOMEONE COULD ELUCIDATE, THAT 4218 02:38:41,200 --> 02:38:43,400 COULD UNEARTH THE BEGINNING, 4219 02:38:43,400 --> 02:38:45,760 U.S.-CENTRIC, BUT I'M CURIOUS IF 4220 02:38:45,760 --> 02:38:49,080 ANYONE CAN ANSWER THAT. 4221 02:38:49,080 --> 02:38:51,400 >> I DON'T KNOW IF NHLBI WANTS 4222 02:38:51,400 --> 02:38:53,280 TO TAKE THAT OR OUR CALL WAS TO 4223 02:38:53,280 --> 02:38:54,800 PUT SCIENCE -- WHAT ARE 4224 02:38:54,800 --> 02:38:55,760 SCIENTIFIC QUESTIONS, THAT'S WHY 4225 02:38:55,760 --> 02:38:57,640 THIS IS VERY IMPORTANT, WHAT 4226 02:38:57,640 --> 02:38:58,840 EVERYBODY'S BRINGING BUT THE 4227 02:38:58,840 --> 02:39:00,840 MECHANISM AND HOW IT GETS DONE, 4228 02:39:00,840 --> 02:39:03,560 I DON'T BELIEVE HAS TO BE 4229 02:39:03,560 --> 02:39:05,840 LIMITED TO THE UNITED STATES BUT 4230 02:39:05,840 --> 02:39:11,240 I'M GOING TO LET THE NHLBI OR 4231 02:39:11,240 --> 02:39:12,920 BRIAN AND NARIG ANSWER. 4232 02:39:12,920 --> 02:39:14,880 >> THIS IS SIMONE. 4233 02:39:14,880 --> 02:39:16,920 YES, OF COURSE, INTERNATIONAL 4234 02:39:16,920 --> 02:39:18,440 COLLABORATIONS, AS WE ALL KNOW, 4235 02:39:18,440 --> 02:39:21,600 ARE EXTREMELY IMPORTANT. 4236 02:39:21,600 --> 02:39:25,800 SO, WE CERTAINLY, YOU KNOW, AS 4237 02:39:25,800 --> 02:39:28,560 WE GO FORWARD THE GOAL OF THIS 4238 02:39:28,560 --> 02:39:29,880 PARTICULAR EFFORT WAS FIRST OF 4239 02:39:29,880 --> 02:39:33,360 ALL TO INVITE EVERYONE TO 4240 02:39:33,360 --> 02:39:37,280 PARTICIPATE AND COME UP WITH 4241 02:39:37,280 --> 02:39:38,720 SCIENTIFIC RESEARCH PRIORITIES. 4242 02:39:38,720 --> 02:39:39,800 SO, YOU KNOW, THAT'S HOPEFULLY 4243 02:39:39,800 --> 02:39:40,640 WHAT WE'RE DOING. 4244 02:39:40,640 --> 02:39:43,200 BUT THERE IS NO DOUBT THAT OF 4245 02:39:43,200 --> 02:39:47,600 COURSE INTERNATIONAL 4246 02:39:47,600 --> 02:39:49,920 COLLABORATIONS ARE REALLY 4247 02:39:49,920 --> 02:39:50,640 IMPORTANT. 4248 02:39:50,640 --> 02:39:51,640 >> THANK YOU, SIMONE. 4249 02:39:51,640 --> 02:39:53,080 DOES ANYBODY ELSE HAVE 4250 02:39:53,080 --> 02:39:54,320 QUESTIONS? 4251 02:39:54,320 --> 02:40:00,280 ABOUT WHAT WE PUT UP? 4252 02:40:00,280 --> 02:40:00,480 4253 02:40:00,480 --> 02:40:01,680 OR OTHER QUESTIONS THAT OTHER 4254 02:40:01,680 --> 02:40:03,560 PEOPLE WANT TO ANSWER? 4255 02:40:03,560 --> 02:40:05,520 >> I'M GOING TO TAKE SOME 4256 02:40:05,520 --> 02:40:05,800 PREROGATIVE. 4257 02:40:05,800 --> 02:40:07,960 I WOULD LIKE TO MAKE SURE THE 4258 02:40:07,960 --> 02:40:09,480 EMERGING INFECTIOUS GROUP HAS A 4259 02:40:09,480 --> 02:40:13,400 CHANCE TO CONVEY, AND IF THERE 4260 02:40:13,400 --> 02:40:14,160 ARE FURTHER THOUGHTS, PLEASE 4261 02:40:14,160 --> 02:40:15,720 ENTER THEM IN THE CHAT BOX. 4262 02:40:15,720 --> 02:40:16,960 YOU DON'T NECESSARILY HAVE TO GO 4263 02:40:16,960 --> 02:40:19,640 OFF MUTE TO MAKE SURE YOU'RE 4264 02:40:19,640 --> 02:40:21,280 CONVEYING ANY IMPORTANT POINT. 4265 02:40:21,280 --> 02:40:22,160 PLEASE DO DO THAT. 4266 02:40:22,160 --> 02:40:23,680 IT'S VERY IMPORTANT. 4267 02:40:23,680 --> 02:40:25,040 THAT'S ANOTHER SOURCE TO PROVIDE 4268 02:40:25,040 --> 02:40:25,240 INPUT. 4269 02:40:25,240 --> 02:40:30,480 FOR NOW I WANT TO GIVE EMERGING 4270 02:40:30,480 --> 02:40:31,560 INFECTIONS, EMERGING AGENTS 4271 02:40:31,560 --> 02:40:33,000 GROUP A CHANCE TO SUMMARIZE 4272 02:40:33,000 --> 02:40:34,720 THEIR BREAKOUT SESSION. 4273 02:40:34,720 --> 02:40:37,680 >> THANK YOU, EVERYBODY. 4274 02:40:37,680 --> 02:40:39,800 THANKS. 4275 02:40:39,800 --> 02:40:41,840 4276 02:40:41,840 --> 02:40:44,360 >> SO THAT'S US. 4277 02:40:44,360 --> 02:40:49,800 CAN I SHARE SLIDES? 4278 02:40:49,800 --> 02:40:55,560 4279 02:40:55,560 --> 02:40:58,640 ONE SECOND. 4280 02:40:58,640 --> 02:41:02,760 NO PRESSURE WHATSOEVER. 4281 02:41:02,760 --> 02:41:03,200 OKAY. 4282 02:41:03,200 --> 02:41:04,240 SO, THANKS VERY MUCH. 4283 02:41:04,240 --> 02:41:06,480 I'M GOING TO PRESENT THE 4284 02:41:06,480 --> 02:41:11,120 FINDINGS FROM OUR BREAKOUT 4285 02:41:11,120 --> 02:41:12,400 SESSIONS, EMERGING INFECTIONS. 4286 02:41:12,400 --> 02:41:15,760 SO THE FIRST THING WE ACTUALLY 4287 02:41:15,760 --> 02:41:19,360 SUCCESSFULLY MANAGED TO RANK OR 4288 02:41:19,360 --> 02:41:22,360 RERANK THE PRIORITIES. 4289 02:41:22,360 --> 02:41:24,600 THE WAY THIS IS COMING OUT WE'VE 4290 02:41:24,600 --> 02:41:25,760 BEEN LEFT WITH FIVE RATHER THAN 4291 02:41:25,760 --> 02:41:29,200 FIVE PLUS ONE AS WHAT WE HAD 4292 02:41:29,200 --> 02:41:30,640 BEFORE. 4293 02:41:30,640 --> 02:41:32,080 PRIORITY 1 SURVEILLANCE HORIZON 4294 02:41:32,080 --> 02:41:34,240 SCANNING AND RISK ASSESSMENTS 4295 02:41:34,240 --> 02:41:38,000 FOR EID. 4296 02:41:38,000 --> 02:41:41,280 TWO IS LEVERAGING DONOR 4297 02:41:41,280 --> 02:41:42,480 POPULATIONS. 4298 02:41:42,480 --> 02:41:44,160 THREE IS PATHOGEN REDUCTION OF 4299 02:41:44,160 --> 02:41:45,480 BLOOD PRODUCTS. 4300 02:41:45,480 --> 02:41:47,120 FOUR ENHANCED DONOR TESTING. 4301 02:41:47,120 --> 02:41:49,800 FIVE, APPLICATION OF BLOOD 4302 02:41:49,800 --> 02:41:52,160 DERIVATIVES TO TREAT INFECTIOUS 4303 02:41:52,160 --> 02:41:53,800 DISEASES, ALL ORIGINAL LISTS 4304 02:41:53,800 --> 02:41:56,400 WERE CONSOLIDATED AND MADE IT 4305 02:41:56,400 --> 02:41:56,680 IN. 4306 02:41:56,680 --> 02:41:59,360 PRIORITIES 1 AND 2 WERE CLEARLY 4307 02:41:59,360 --> 02:42:01,560 IDENTIFIED AS FRONTRUNNERS WITH 4308 02:42:01,560 --> 02:42:03,840 RESPECT TO IMPORTANCE. 4309 02:42:03,840 --> 02:42:05,440 ALL THE PRIORITIES WERE DEEMED 4310 02:42:05,440 --> 02:42:06,440 TO BE IMPORTANT, INDEPENDENT OF 4311 02:42:06,440 --> 02:42:09,000 SOURCE OF FUNDING. 4312 02:42:09,000 --> 02:42:11,080 THERE WAS SOME DEBATE WOULD THIS 4313 02:42:11,080 --> 02:42:12,640 BE SOMETHING WHICH NHLBI WAS 4314 02:42:12,640 --> 02:42:15,080 WILLING TO FUND. 4315 02:42:15,080 --> 02:42:16,720 THAT WAS STILL DEEMED TO BE 4316 02:42:16,720 --> 02:42:17,800 IMPORTANT. 4317 02:42:17,800 --> 02:42:19,880 AS I MENTIONED SURVEILLANCE, 4318 02:42:19,880 --> 02:42:22,320 HORIZON SCANNING, RISK 4319 02:42:22,320 --> 02:42:24,480 ASSESSMENT WERE ULTIMATELY 4320 02:42:24,480 --> 02:42:26,040 COMBINED WHICH MADE SENSE. 4321 02:42:26,040 --> 02:42:29,560 WITH RESPECT TO PRIORITY 1, WE 4322 02:42:29,560 --> 02:42:31,000 ALREADY UNDERTAKE SURVEILLANCE 4323 02:42:31,000 --> 02:42:32,440 SCANNING AND RISK ASSESSMENT. 4324 02:42:32,440 --> 02:42:35,200 THE CATCH BEING THAT IT'S NOT 4325 02:42:35,200 --> 02:42:36,080 NECESSARILY PRO-ACTIVE OR 4326 02:42:36,080 --> 02:42:37,720 SUFFICIENTLY RIGOROUS FOR WHAT 4327 02:42:37,720 --> 02:42:38,720 IS NEEDED. 4328 02:42:38,720 --> 02:42:42,240 SO SOME OF THOSE SUBPOINTS, 4329 02:42:42,240 --> 02:42:43,720 CERTAINLY A NEED FOR 4330 02:42:43,720 --> 02:42:44,720 INTERNATIONAL COLLABORATION, 4331 02:42:44,720 --> 02:42:46,840 PARTICULARLY IN LESS RESOURCE 4332 02:42:46,840 --> 02:42:48,120 COUNTRIES GIVEN PROXIMITY TO THE 4333 02:42:48,120 --> 02:42:52,400 SOURCE OF OUR BREAKS IN EMERGING 4334 02:42:52,400 --> 02:42:55,920 INFECTIOUS DISEASES, SO THOSE 4335 02:42:55,920 --> 02:42:57,440 COLLABORATIONS SHOULD FUEL 4336 02:42:57,440 --> 02:42:59,040 IMPORTATION OF SAMPLES, ALSO 4337 02:42:59,040 --> 02:43:01,640 NEEDS TO BE DEVELOPMENT OF 4338 02:43:01,640 --> 02:43:04,640 ASSAYS FOR LOW-RESOURCE 4339 02:43:04,640 --> 02:43:05,640 SETTINGS, PARTICULARLY VALUABLE 4340 02:43:05,640 --> 02:43:10,000 FOR HAVING THINGS LIKE LAMP OR 4341 02:43:10,000 --> 02:43:14,120 MOLECULAR ASSAYS FOR FIELD WORK, 4342 02:43:14,120 --> 02:43:15,200 FOR LOW RESOURCE PLACES. 4343 02:43:15,200 --> 02:43:21,800 THERE'S A NEED FOR SCALEUP OF 4344 02:43:21,800 --> 02:43:22,440 SURVEILLANCE, INTERFACING -- I 4345 02:43:22,440 --> 02:43:24,880 DON'T KNOW WHAT THIS MEANS, 4346 02:43:24,880 --> 02:43:27,400 APPROPRIATE DONOR SAMPLES EARLY 4347 02:43:27,400 --> 02:43:29,760 ON, NEED FOR INFECTIVITY 4348 02:43:29,760 --> 02:43:30,560 STUDIES. 4349 02:43:30,560 --> 02:43:32,520 ALSO, INTEGRATION OF BLOOD DONOR 4350 02:43:32,520 --> 02:43:35,160 COHORTS INTO KIND OF OTHER 4351 02:43:35,160 --> 02:43:36,000 SURVEILLANCE EFFORTS, THAT'S 4352 02:43:36,000 --> 02:43:39,280 OUTSIDE OF THE BLOOD COMMUNITY. 4353 02:43:39,280 --> 02:43:47,680 AND IN STRENGTHENING POST 4354 02:43:47,680 --> 02:43:50,480 DONATION INFORMATION REPORTING 4355 02:43:50,480 --> 02:43:52,320 SYSTEMS AND PROCESS CAPTURE. 4356 02:43:52,320 --> 02:43:54,280 THERE'S RISK ASSESSMENT, NEED 4357 02:43:54,280 --> 02:43:56,520 ONGOING RISK ASSESSMENT WITH 4358 02:43:56,520 --> 02:43:59,520 ABILITY TO PIVOT ACCORDINGLY SO 4359 02:43:59,520 --> 02:44:01,920 WE NEED TO DETERMINE A 4360 02:44:01,920 --> 02:44:03,280 NO-BRAINER TERMINATION OF 4361 02:44:03,280 --> 02:44:03,680 TRANSFUSION RISK. 4362 02:44:03,680 --> 02:44:14,200 IT TAKES TIME TO DEMONSTRATE. 4363 02:44:15,320 --> 02:44:17,800 AN EMPHASIS, REQUEST FOR ANIMAL 4364 02:44:17,800 --> 02:44:21,800 MODELS, WHERE -- WHICH CAN BE 4365 02:44:21,800 --> 02:44:24,040 USEFUL IN DETERMINING MINIMUM 4366 02:44:24,040 --> 02:44:25,480 INFECTIOUS DOING AND 4367 02:44:25,480 --> 02:44:26,400 UNDERSTANDING PARAMETERS, SO 4368 02:44:26,400 --> 02:44:32,520 LOOKING AT THE -- UNDERSTANDING 4369 02:44:32,520 --> 02:44:34,920 THE ECLIPSE PHASE VERSUS 4370 02:44:34,920 --> 02:44:37,120 ANTIBODY FACE, IMPACT OF 4371 02:44:37,120 --> 02:44:39,360 SEROCONVERSION ON INFECTIVITY 4372 02:44:39,360 --> 02:44:40,600 AND LOOKING AT ALGORITHMS. 4373 02:44:40,600 --> 02:44:44,320 THERE WAS A POINT BLOOD 4374 02:44:44,320 --> 02:44:45,320 TRANSFUSION IS BEING A 4375 02:44:45,320 --> 02:44:46,480 RELATIVELY MINOR CONTRIBUTOR TO 4376 02:44:46,480 --> 02:44:49,040 INCIDENCE OF INFECTION AT LEAST 4377 02:44:49,040 --> 02:44:51,840 IN HIGH-INCOME COUNTRIES IN A 4378 02:44:51,840 --> 02:44:53,720 POST-HIV ERA. 4379 02:44:53,720 --> 02:45:01,400 THEY MAY NOT HOLD TRUE FOR 4380 02:45:01,400 --> 02:45:04,600 FUTURE EIDs, NOT IN LOW- AND 4381 02:45:04,600 --> 02:45:06,120 MIDDLE-INCOME COUNTRIES TODAY. 4382 02:45:06,120 --> 02:45:09,720 LOOKS AT VIABILITY OR ASSESSING 4383 02:45:09,720 --> 02:45:12,360 VIABILITY OF INDIVIDUALIZED RISK 4384 02:45:12,360 --> 02:45:14,120 ASSESSMENTS AND DEFERRAL, SO 4385 02:45:14,120 --> 02:45:16,320 LOOKING AT DEFERRALS DUE TO 4386 02:45:16,320 --> 02:45:19,280 INFECTIOUS RISK, HOW THIS MAY 4387 02:45:19,280 --> 02:45:20,600 IMPACT DONORS, WILLINGNESS TO 4388 02:45:20,600 --> 02:45:25,360 DONATE IN THE FUTURE, ONE 4389 02:45:25,360 --> 02:45:29,800 EXAMPLE BEING MSM. 4390 02:45:29,800 --> 02:45:33,680 A NEED FOR EDUCATION OF 4391 02:45:33,680 --> 02:45:35,400 CLINICIANS IN VULNERABLE 4392 02:45:35,400 --> 02:45:36,320 POPULATIONS SUCH AS 4393 02:45:36,320 --> 02:45:37,800 IMMUNOSUPPRESSED. 4394 02:45:37,800 --> 02:45:38,840 A SUGGESTION TO CONDUCT 4395 02:45:38,840 --> 02:45:45,320 PRO-ACTIVE RESEARCH SUCH AS 4396 02:45:45,320 --> 02:45:49,240 STUDY OF THE VIROME AND AN 4397 02:45:49,240 --> 02:45:55,600 INTERESTING ERA, PARAMETERS OF 4398 02:45:55,600 --> 02:45:56,720 TOLERABLE RISK, CANADIANS CAME 4399 02:45:56,720 --> 02:45:59,240 UP WITH A NICE FRAMEWORK, BUT 4400 02:45:59,240 --> 02:46:02,840 FORMALIZING A PROCESS WHICH MAY 4401 02:46:02,840 --> 02:46:07,440 BE APPLICABLE IN THE U.S. 4402 02:46:07,440 --> 02:46:11,920 SO, PRIORITY 2 IS LEVERAGING 4403 02:46:11,920 --> 02:46:18,880 DONOR POPULATIONS TO STUDY EPI 4404 02:46:18,880 --> 02:46:20,760 AND PATHOGENESIS, TRYING TO 4405 02:46:20,760 --> 02:46:21,840 UNDERSTAND TO WHAT EXTENT THEY 4406 02:46:21,840 --> 02:46:24,080 ARE REPRESENTATIVE OF THE 4407 02:46:24,080 --> 02:46:26,920 GENERAL POPULATION AND DEVISING 4408 02:46:26,920 --> 02:46:28,360 WAYS TO ADJUST ACCORDING THIS. 4409 02:46:28,360 --> 02:46:30,640 THIS IS LESS OF CONCERN WITH 4410 02:46:30,640 --> 02:46:33,080 NOVEL AGENTS, BUT IF WE ALREADY 4411 02:46:33,080 --> 02:46:36,240 SCREEN FOR AGENT, MAY BE LEFT 4412 02:46:36,240 --> 02:46:39,680 WITH A HIGHLY BIASED CONCLUSION. 4413 02:46:39,680 --> 02:46:43,040 THERE'S A POINT EPIDEMIOLOGY AND 4414 02:46:43,040 --> 02:46:47,720 PATHOGENESIS MAY BE DIFFERENT BY 4415 02:46:47,720 --> 02:46:48,720 LOCATION, ASSAYS DIFFERENT 4416 02:46:48,720 --> 02:46:51,360 AROUND THE WORLD, HOW THAT 4417 02:46:51,360 --> 02:46:52,360 IMPACTS INTERPRETATION. 4418 02:46:52,360 --> 02:46:54,200 REALLY AN IMPORTANT POINT WHICH 4419 02:46:54,200 --> 02:46:58,440 WAS RAISED AND NEEDS TO BE 4420 02:46:58,440 --> 02:47:00,760 INCORPORATED, ESTABLISHMENT AND 4421 02:47:00,760 --> 02:47:01,320 MAINTENANCE OF REPOSITORIES, 4422 02:47:01,320 --> 02:47:05,440 SEEMS TO BE A RETICENCE TO FUND 4423 02:47:05,440 --> 02:47:06,680 DEVELOPMENT AND MAINTENANCE OF 4424 02:47:06,680 --> 02:47:12,800 REPOSITORIES THAT ENABLE THE 4425 02:47:12,800 --> 02:47:14,480 RESEARCH THAT'S BEING PROPOSED, 4426 02:47:14,480 --> 02:47:16,880 ROLLING REPOSITORIES IN SELECTED 4427 02:47:16,880 --> 02:47:18,520 SETTINGS, THE EXAMPLE OF BRAZIL 4428 02:47:18,520 --> 02:47:19,920 WHERE THEY MAINTAIN SAMPLES FOR 4429 02:47:19,920 --> 02:47:21,200 SIX MONTHS. 4430 02:47:21,200 --> 02:47:24,280 THERE WAS ALSO THE POINT THAT IT 4431 02:47:24,280 --> 02:47:27,440 MIGHT BE BEST TO EMPHASIZE 4432 02:47:27,440 --> 02:47:29,440 REPEAT DONORS OR HIGH-YIELD 4433 02:47:29,440 --> 02:47:31,200 DONOR SUBSETS THAT, YOU KNOW, 4434 02:47:31,200 --> 02:47:36,120 WHICH ARE MORE LIKELY TO PROVIDE 4435 02:47:36,120 --> 02:47:36,600 EPIDEMIOLOGICALLY 4436 02:47:36,600 --> 02:47:38,760 CROSS-SECTIONAL SAMPLES WERE NOT 4437 02:47:38,760 --> 02:47:40,000 FEASIBLE BUT REPEAT DONORS 4438 02:47:40,000 --> 02:47:42,640 FLAGGING A SUBSET OF DONORS AND 4439 02:47:42,640 --> 02:47:44,000 HOLDING THOSE SAMPLES FOR TWO TO 4440 02:47:44,000 --> 02:47:47,400 THREE YEARS MAY BE VALUABLE. 4441 02:47:47,400 --> 02:47:51,600 INFRASTRUCTURE IS A KEY 4442 02:47:51,600 --> 02:47:53,000 CHALLENGE THAT NEEDS TO BE 4443 02:47:53,000 --> 02:47:58,000 SPECIFIC, AND THERE WAS CONCERN 4444 02:47:58,000 --> 02:48:00,680 OF OVERLAP WITH NIAID OR CDC IN 4445 02:48:00,680 --> 02:48:01,800 THIS REGARD. 4446 02:48:01,800 --> 02:48:04,280 THIRD IS PATHOGEN REDUCTION OF 4447 02:48:04,280 --> 02:48:08,200 BLOOD PRODUCTS. 4448 02:48:08,200 --> 02:48:10,440 AN IMPORTANT POINT, THIS MAY 4449 02:48:10,440 --> 02:48:11,440 EVOLVE INTO HOMELAND SECURITY 4450 02:48:11,440 --> 02:48:15,720 ISSUE TO THE DEGREE THE BLOOD 4451 02:48:15,720 --> 02:48:21,080 SUPPLY WOULD BE THREATENED, NEXT 4452 02:48:21,080 --> 02:48:23,880 EID COULD BE HIGHLY TRANSFUSION 4453 02:48:23,880 --> 02:48:25,440 TRANSMISSIBLE, AND LOOK AT 4454 02:48:25,440 --> 02:48:27,720 PATHOGEN REDUCTION ON OTHER 4455 02:48:27,720 --> 02:48:32,000 ASPECTS OF PLATELET FUNCTION AS 4456 02:48:32,000 --> 02:48:34,160 IMPORTANT AS HEMOSTASIS, LIKE 4457 02:48:34,160 --> 02:48:34,720 IMMUNOMODULATION. 4458 02:48:34,720 --> 02:48:37,400 ALSO A RISK/BENEFIT OF P.R. IN 4459 02:48:37,400 --> 02:48:39,040 LOW AND MIDDLE INCOME COUNTRIES, 4460 02:48:39,040 --> 02:48:42,000 THAT'S NOT THE SAME AS 4461 02:48:42,000 --> 02:48:43,160 HIGH-INCOME COUNTRIES, SAME 4462 02:48:43,160 --> 02:48:45,560 THRESHOLD MAY NOT NECESSARILY 4463 02:48:45,560 --> 02:48:48,960 APPLY WHEN ONE IS DEALING WITH 4464 02:48:48,960 --> 02:48:51,320 HIGH INCIDENCE OF INFECTION, LOW 4465 02:48:51,320 --> 02:48:55,520 UPTAKE OF MOLECULAR METHODS AND 4466 02:48:55,520 --> 02:48:56,720 SUBOPTIMAL SEROLOGY. 4467 02:48:56,720 --> 02:49:01,000 RED CELL AND WHOLE BLOOD 4468 02:49:01,000 --> 02:49:02,200 TECHNOLOGIES ARE IN DEVELOPMENT, 4469 02:49:02,200 --> 02:49:03,200 THERE ARE EXPECTATIONS WITH 4470 02:49:03,200 --> 02:49:04,640 THINGS COMING THROUGH IN THE 4471 02:49:04,640 --> 02:49:06,240 NEXT YEAR OR TWO. 4472 02:49:06,240 --> 02:49:07,600 WITH ABILITY TO PRODUCE 4473 02:49:07,600 --> 02:49:12,040 COMPONENTS, IN THE CASE OF WHOLE 4474 02:49:12,040 --> 02:49:12,480 BLOOD. 4475 02:49:12,480 --> 02:49:13,600 ONE QUESTION RAISED TO WHAT 4476 02:49:13,600 --> 02:49:16,840 EXTENT IS THIS A RESEARCH VERSUS 4477 02:49:16,840 --> 02:49:20,440 COMMERCIAL ENDEAVOR? 4478 02:49:20,440 --> 02:49:20,920 ALSO RAISED, POTENTIAL 4479 02:49:20,920 --> 02:49:22,680 COLLABORATION BETWEEN NHLBI AND 4480 02:49:22,680 --> 02:49:26,360 BARDA, GIVEN BARDA IS FOLKED ON 4481 02:49:26,360 --> 02:49:28,280 PANDEMIC PREPAREDNESS WITH 4482 02:49:28,280 --> 02:49:29,800 FUNDING OPPORTUNITIES. 4483 02:49:29,800 --> 02:49:33,400 FOUR IS ENHANCED DONOR TESTING. 4484 02:49:33,400 --> 02:49:34,920 SO, DISCUSSED AVAILABILITY OF 4485 02:49:34,920 --> 02:49:36,760 MULTIPLEXED AND NEXT GENERATION 4486 02:49:36,760 --> 02:49:39,360 SEQUENCING METHODS. 4487 02:49:39,360 --> 02:49:40,560 DISCUSSED SPEED AND SCALABILITY 4488 02:49:40,560 --> 02:49:43,920 OF DEPLOYMENT THAT WOULD 4489 02:49:43,920 --> 02:49:45,520 IDENTIFY AGENTS NOT NECESSARILY 4490 02:49:45,520 --> 02:49:48,720 RELEVANT AND IMPACT TO DONORS, 4491 02:49:48,720 --> 02:49:50,600 WITH RESPECT TO GENERATING 4492 02:49:50,600 --> 02:49:53,000 INFORMATION, DONORS NEED TO BE 4493 02:49:53,000 --> 02:49:54,360 NOTIFIED ABOUT RESULTS, NOT 4494 02:49:54,360 --> 02:49:55,520 NECESSARILY ACTIONABLE. 4495 02:49:55,520 --> 02:49:57,080 TALKS ABOUT BUILDING ASSAY 4496 02:49:57,080 --> 02:50:00,720 PROTOTYPES AND SYSTEMS TO SCALE 4497 02:50:00,720 --> 02:50:01,800 AGAINST EIDs. 4498 02:50:01,800 --> 02:50:04,120 OBVIOUSLY NEEDS TO BE 4499 02:50:04,120 --> 02:50:04,720 RESTRICTIONS, TARGET SEQUENCES 4500 02:50:04,720 --> 02:50:08,440 TO AGENTS THAT ARE RELEVANT, IF 4501 02:50:08,440 --> 02:50:09,320 THIS IS OPERATIONALLY 4502 02:50:09,320 --> 02:50:11,680 INTEGRATED, AND HOW TO INTERPRET 4503 02:50:11,680 --> 02:50:11,960 FINDINGS. 4504 02:50:11,960 --> 02:50:14,480 AND THEN HOW DOES TESTING AND 4505 02:50:14,480 --> 02:50:15,560 RESEARCH CONTRIBUTE TO 4506 02:50:15,560 --> 02:50:22,040 OPERATIONAL DECISION MAKING, AND 4507 02:50:22,040 --> 02:50:24,280 BALANCE OF SEROLOGY. 4508 02:50:24,280 --> 02:50:27,040 PRIORITY 5, BLOOD DIFFERENCE 4509 02:50:27,040 --> 02:50:28,440 SUCH AS CONVALESCENT PLASMA TO 4510 02:50:28,440 --> 02:50:31,680 TREAT INFECTIOUS DISEASES, A FUN 4511 02:50:31,680 --> 02:50:33,080 DISCUSSION, LOTS OF HEATED 4512 02:50:33,080 --> 02:50:33,320 DEBATE. 4513 02:50:33,320 --> 02:50:35,040 I DON'T KNOW IF IT'S CONSENSUS 4514 02:50:35,040 --> 02:50:37,800 BUT I'LL SAY IT ANYWAY. 4515 02:50:37,800 --> 02:50:39,920 SEEMS IMPORTANT TO UNDERSTAND 4516 02:50:39,920 --> 02:50:43,160 THE HETEROGENEITY OF OUTPUT OF 4517 02:50:43,160 --> 02:50:45,960 CONVALESCENT PLASMA, LOOKING AT 4518 02:50:45,960 --> 02:50:47,840 CYTOKINES, ANIMAL MODELS, ET 4519 02:50:47,840 --> 02:50:49,240 CETERA. 4520 02:50:49,240 --> 02:50:51,200 AND SPECIFICALLY WHY WERE THERE 4521 02:50:51,200 --> 02:50:56,400 DISPARATE FINDINGS OF SIMILAR 4522 02:50:56,400 --> 02:50:57,880 TRIALS IN COVID-19. 4523 02:50:57,880 --> 02:51:00,040 THERE'S A HESITANCY TO ACCEPT 4524 02:51:00,040 --> 02:51:01,800 MODEL SYSTEMS IN TRANSFUSE 4525 02:51:01,800 --> 02:51:03,080 MEDICINE IN GENERAL FOR DECISION 4526 02:51:03,080 --> 02:51:04,280 MAKING. 4527 02:51:04,280 --> 02:51:05,280 FOR EXAMPLE, TO UNDERSTAND 4528 02:51:05,280 --> 02:51:08,080 RISK/BENEFITS OF A GIVEN 4529 02:51:08,080 --> 02:51:08,760 PRODUCT. 4530 02:51:08,760 --> 02:51:10,520 THERE IS, YOU KNOW, I THINK THIS 4531 02:51:10,520 --> 02:51:13,560 REALLY IS A RICH AREA TO STUDY, 4532 02:51:13,560 --> 02:51:14,920 SPECIFICALLY IN SELECTED HIGH 4533 02:51:14,920 --> 02:51:17,280 RISK POPULATIONS SUCH AS 4534 02:51:17,280 --> 02:51:20,040 IMMUNOSUPPRESSED, BUT THERE ARE 4535 02:51:20,040 --> 02:51:21,400 NOTABLE CHALLENGES SURROUNDING 4536 02:51:21,400 --> 02:51:23,360 HOW TO DEVELOP A PROGRAM OR 4537 02:51:23,360 --> 02:51:26,080 RESEARCH STUDY IN THE ABSENCE OF 4538 02:51:26,080 --> 02:51:26,840 A PATHOGEN. 4539 02:51:26,840 --> 02:51:30,040 AND THAT IS I THINK IT. 4540 02:51:30,040 --> 02:51:37,040 THANKS VERY MUCH. 4541 02:51:37,040 --> 02:51:37,160 4542 02:51:37,160 --> 02:51:39,560 THE END. 4543 02:51:39,560 --> 02:51:42,040 4544 02:51:42,040 --> 02:51:43,240 >> THAT WAS FANTASTIC. 4545 02:51:43,240 --> 02:51:49,720 THANK YOU TO ALL OF THE WORKING 4546 02:51:49,720 --> 02:51:51,160 GROUP CO-CHAIRS AND GROUP 4547 02:51:51,160 --> 02:51:53,000 MEMBERS FOR EFFORT IN 4548 02:51:53,000 --> 02:51:54,320 IDENTIFYING AND PRIORITIZING 4549 02:51:54,320 --> 02:51:56,960 RESEARCH PRIORITIES AS WELL AS 4550 02:51:56,960 --> 02:51:57,840 LEADING THE BREAKOUT DISCUSSION 4551 02:51:57,840 --> 02:52:02,600 WHICH THE ONE I ATTENDED I 4552 02:52:02,600 --> 02:52:03,920 CONCUR WAS EXCELLENT, IN ITS 4553 02:52:03,920 --> 02:52:05,360 SUMMARY FOR YOUR RESPECTIVE 4554 02:52:05,360 --> 02:52:06,320 WORKING GROUPS TODAY. 4555 02:52:06,320 --> 02:52:08,640 I ALSO WANT TO THANK ALL OF YOU 4556 02:52:08,640 --> 02:52:10,680 IN ATTENDANCE FOR YOUR ATTENTION 4557 02:52:10,680 --> 02:52:11,680 AND PARTICIPATION. 4558 02:52:11,680 --> 02:52:14,960 I FOR ONE AM GLAD TO KNOW THE 4559 02:52:14,960 --> 02:52:16,560 OTHER GREATOUT SESSIONS ARE 4560 02:52:16,560 --> 02:52:19,800 RECORDED AND CAN BE REVIEWED BY 4561 02:52:19,800 --> 02:52:21,520 US IN THE FUTURE. 4562 02:52:21,520 --> 02:52:25,800 I ALSO IN ADDITION TO YOUR 4563 02:52:25,800 --> 02:52:27,120 COMMUNICATIONS WITH US, WE DO 4564 02:52:27,120 --> 02:52:29,320 PLAN TO PROVIDE YOU WITH AN 4565 02:52:29,320 --> 02:52:31,680 NHLBI E-MAIL ADDRESS TO SHARE 4566 02:52:31,680 --> 02:52:34,240 ADDITIONAL COMMENTS OR 4567 02:52:34,240 --> 02:52:34,600 QUESTIONS. 4568 02:52:34,600 --> 02:52:37,080 I DO HOPE THAT MANY OF YOU WILL 4569 02:52:37,080 --> 02:52:42,040 BE ABLE TO RECONVENE WITH US 4570 02:52:42,040 --> 02:52:42,800 TOMORROW, HEARING FROM THREE 4571 02:52:42,800 --> 02:52:49,920 MORE STATE OF THE SCIENCE AND 4572 02:52:49,920 --> 02:52:55,480 TRANSFUSION MEDICINE WORKING 4573 02:52:55,480 --> 02:52:56,520 GROUPS, INCLUDES MECHANISTIC 4574 02:52:56,520 --> 02:52:58,400 TRANSFUSION, THAT METHODS IN 4575 02:52:58,400 --> 02:53:01,800 TRANSFUSION SCIENCE, DONOR AND 4576 02:53:01,800 --> 02:53:02,400 RECIPIENT HEALTH DISPARITIES. 4577 02:53:02,400 --> 02:53:05,000 THANK YOU AGAIN. 4578 02:53:05,000 --> 02:53:06,000 LOOK FORWARD TO RECONVENING 4579 02:53:06,000 --> 02:53:07,080 AGAIN TOMORROW MORNING, 10 A.M. 4580 02:53:07,080 --> 00:00:00,000 EASTERN TIME.