WELCOME TO THE OPEN SESSION OF THE 141st NATIONAL ADVISORY COUNCIL ON AGING. I'M GOING TO TURN NOW -- OVER TO RICHARD HODES THE DIRECTOR OF NIA. >> THANK YOU, KEN AND WELCOME EVERYONE BACK TO THE PUBLIC SESSION OF OUR ADVISORY COUNCIL. NEXT SLIDE, PLEASE. NEXT SLIDE PLEASE. 7. >> I'LL BEGIN WITH AS USUAL AN UPDATE OF OUR BUDGET PROCESS AND WHERE WE STAND AS WELL AS SOME COMINGS AND GOING OF CRITICAL STAFF AND SOME OF OUR RECENT NOTABLE EVENTS AND THEN OPEN IT UP TO USEFUL DISCUSSION FOR YOU. SO THE NEXT SLIDE, PLEASE. THIS IS A SUMMARY OF WHERE WE ARE FOR BUDGETS AND WHEN WE LAST MET IN THE SPRING WE KNEW ABOUT THIS YEAR'S BUDGET AND NOW IN THE PROCESS OF WORKING TOWARDS A 2021 BUDGET. THERE IS NO DRAFT BILL RELEASED THIS TIME FROM THE SENATE FROM THE HOUSE. THERE WAS A BILL THAT INCLUDED A $5.5 BILLION INCREASE FOR NIH ABOVE THE FUNDING LEVEL FOR THIS CURRENT YEAR. HOWEVER, NOTABLY OF THAT $5.05 BILLIONAIRELY ALL WAS DESIGNATED FOR COVID RELATED EMERGENCY ACTS. THIS IS A HOUSE BILL THAT DOES NOT HAVE ANY STATUS AS OF YET. NIA HAD AN FY20 ENACTED LEVEL OF $3.54 BILLION. IT WAS MODEST AMOUNT. AND THEN $228 MILLION FOR COVID RELATED EMERGENCY FUNDING. SO THIS IS INITIAL ACTION FROM THE HOUSE. NOTHING FROM THE SENATE. QUITE IMPOSSIBLE THAT WE'LL HAVE A BUDGET BEFORE THE END OF THE FISCAL YEAR SEPTEMBER 30th AND ALL OF YOU ARE PROBABLY TRACKING IN THE NEWS THAT WE WON'T SHUT DOWN THE GOVERNMENT WE'LL HAVE A CONTINUING RESOLUTION PERHAPS THROUGH THE END OF DECEMBER AS BEING REPORTED. ANY RESOLUTIONS ARE CONVENTIONALLY AT THE LEVEL OF THE PRIOR YEAR SO THAT WOULD MEAN FOR FY20 FLAT LEVELS. SO THE NIH HAS BEEN CONGRESSIONALLY REQUIRED TO SUBMIT ALZHEIMER'S BUDGET. SO WE'RE DOING THAT FOR FY22. THE BYPASS BUDGET THAT WAS RELEASED IN JULY. JUST TO WALK YOU THROUGH THIS. THIS IS THE LEGISLATION THAT ESTABLISHED THE ESTABLISHED THE REQUIREMENT. SO NIH IS REQUIRED TO SUBMIT TO CONGRESS EACH YEAR THROUGH 2025 A BUDGET WHICH SUMMARIZES THE INCREASE IN FUNDING FOR ALZHEIMER'S AND DEMENTIA RELATED RESEARCH TO MEET THE NATIONAL PLAN. THIS IS THE PROCESS SO WE BEGIN WITH INPUT FOR THE FY22 BY OF PASS BUDGET IN MEETINGS INCLUDING THE SUMMITS THAT ARE HELD ANNUALLY. THIS WORK GOES INTO THE DEVELOPMENT OF COMPREHENSIVE MILESTONES, NIH STAFF AND BASED ON SUM IT AND INPUTS TO DEVELOP PRIORITIES. THERE IS A COST THAT ADDS UP TO THE FINAL BUDGET ESTIMATE. SO THIS IS NOT A TOP DOWN OUT OF THE BLUE NUMBER. THIS IS A NUMBER DERIVED FROM NEEDS FOR SPECIFIC INITIATIVES TRANSLATED INTO MILESTONES. THE RESEARCH CATEGORIES ARE USED TO PROVIDE THE FRAMEWORK. AND THIS IS A SUMMARY -- I HOPE YOU CAN ALL SEE THE FULL SCREENINGS AND DON'T HAVE LITTLE BLACK BOXES OF PARTICIPANTS IN THE WAY BUT TO READ THROUGHth PROFESSIONAL JUDGMENT WOULD LEAD TO A TOTAL AS SHOWN HERE SOME OF THE ITEMS IN EACH OF THE CATEGORIES ILLUSTRATED WHICH LEAD TO NEW ADAR RESEARCH A TOTAL OF $434 MILLION. NOW THE NEXT LINE EXPRESSES THE FACT THAT FOR SOME OF THE RESEARCH PROJECTS THAT BEGAN IN PRIOR YEARS AND HAVE TERMINATED WE CAN CALCULATE AS BEST ESTIMATE ONLY HOW MUCH FUNDING IS RELEASED FROM THE SUCCESSFUL TERMINATION OF THOSE PROGRAMS AND IS THEREFORE USED TO OFFSET THE $434 MILLION TOTAL NEED. THAT IS A $145 MILLION. THE REQUEST FOR $289 MILLION ABOVE CURRENT LEVEL WHICH WOULD TAKE -- NEXT SLIDE PLEASE. THIS DISTRIBUTION OF FUNDS IS THE PERCENT IN EACH OF THESE AREAS. SO AGAIN THIS REITERATES A TOTAL FOR $434 MILLION OF NEW FUNDING REDUCED BY $145 MILLION FOR FUNDS THAT BECAME AVAILABLE AS PROJECTED. THIS IS ALL PROJECTION BECAUSE THIS IS 2022. ABOVE CURRENT FUNDING LEVEL AND THAT CAVEATS IS IMPORTANT AS WE LOOK AT THE NEXT SLIDE. BECAUSE THE PRESIDENT'S BUDGET PROPOSED FOR FY21 CALLS FOR A SUBSTANTIAL DECREASE IN FUNDING ACROSS ALL OF NIH BUT NOTABLY FOR ALZHEIMER'S DISEASE. IN THE AMOUNT OF $254 MILLION. OUR REQUEST FOR $289 MILLION ABOVE CURRENT FUNDING LEVELS WOULD NEED TO BE ADDED TO COMPENSATE FOR THE PROPOSED DECREASE IN THE PRESIDENT'S BUDGET WHICH PERHAPS FOR BOTTOM LINE NUMBER PROPOSAL FOR TOTAL FUNDING OF SOME $3.1 BILLION. SO THIS BUDGET WENT FORWARD AND BECAME PUBLIC IN JULY PRESENTED AT THE NATIONAL ADVISORY, NATIONAL ALZHEIMER'S ACT COUNCIL. IT WAS COMMUNICATED TO CONGRESS AT THE TIME. IN ADDITION TO THE BUDGET NUMBERS THERE IS A NARRATIVE WHICH IS A PROGRESS REPORT THAT ATTEMPTS TO BALANCE DEMONSTRATION OF PROGRESS MADE AND ACCOMPLISHMENTS WITH THE UNDERSTANDING OF THE GAPS AND NEEDS AND PRIORITIES FOR FUTURE RESEARCH AND FOR THOSE OF YOU WHO MAY NOT HAVE HAD AN OPPORTUNITY I COMMEND YOU TO READ THROUGH THIS. IT'S A THOUGHTFUL PROCESS OF A LOT OF WORK THAT GOES INTO THIS. AND FOR TRACKING IMPLEMENTATION WE DO THIS TRANSPARENTLY IN THE CREATION OF THE BUDGET AND TRACKING AND OFFER YOU THE SITES WHICH YOU CAN CONTINUE TO LOOK AT AWARDS UNDER THE CATEGORIES AND THAT FIRST AS WELL AS WEB BASED TOOLS FOR TRACKING INITIATIVES IN THE CONTEXT OF EACH OF OUR MILESTONES. SO WHAT IS VERY MUCH ON THE MINDS OF ALL OF US NOW WITH COVID OF 19 AND UPDATES. ACROSS ALL OF NIH THERE ARE A NUMBER OF NOTICES OF SPECIAL INTEREST THAT ARE GENERATED IN RESPONSE TO THE CO-INDIVIDUAL 19 CRISIS. THIS IS TO EMPHASIZE THE GOAL OF EXPEDITING REVIEW OF APPLICATIONS FOR FUNDS TO ASSIST COVID RESEARCH. THIS IS DIFFERENT ABOUT THE COST OF INTERRUPTION RESEARCH. A FULL NIH LIST IS LOCATED AT THE LINK PROVIDED HERE. THE NIA HIGHLIGHTS THE NEED FOR RESEARCH IN A VARIETY OF AREAS THAT ARE CRITICAL TO THE MISSION IN PARTICULAR. MANY OF YOU HAVE PROBABLY ALREADY SEEN THEM. SO SOME UPDATES. SOME IMPORTANT ACTIVITIES ACROSS NIH. THE APPOINTMENT OF JOSH DENNY AS THE CEO OF ALL OF US RESEARCH PROGRAM. HE HAS EXPERIENCE IN DIE OH -- AT VANDERBILT AND HAS BEEN INVOLVED WITH US FROM THE BEGINNING BUT NOW COMES ON TO DIRECT WITH HIS EXPERTISE. ALREADY TAKING A GREAT STEP TOWARDS LEADERSHIP OF ALL OF US. NOT SURPRISINGLY PERHAPS THE PRIORITY FOR ALL OF US IN THE SHORT MID-TERM FUTURE HAS BECOME COVID-19. SO THE USE OF ALL OF US AND IT'S GROWING ENROLLMENT HAS BEEN DIRECTED AS ONE OF ITS MANY BUT NOW A PRIMARY PRIORITY TOWARDS TRACKING AND IMPLEMENTATION OF MEASUREMENTS DIRECTED AT THE COVID-19 PANDEMIC. JOHN NY WHO WAS APPOINTED IN JANUARY AND CAME ON FULL-TIME AS DIRECTOR OF THE BRAIN INITIATIVE. HE BRINGS PERMANENT LEADERSHIP AFTER A HIATUS IN WHICH THE SEARCH WAS BEING CARRIED OUT. THE NOTABLE EFFORTS IN THE LEAD OF WALTER -- AND NOW WITH JOHN NGAI TAKING OVER FULL-TIME THERE THERE IS A GREATER OPPORTUNITY FOR PROACTIVE LEADERSHIP. AND A NEW INSTITUTE DIRECTOR APPOINTED. RICK. RICK HAS BEEN AT NIH SINCE 2011 BUT BECAME IN JUNE 7th THE DIRECTOR OF NIHS. SO WE WELCOME HIM. THERE ARE A NUMBER OF RECENT ANNOUNCEMENT WITH APPOINTMENTS TO COME AT NIH DIRECTORS. DESPITE THE IMPEDIMENTS WE'VE BEEN ABLE TO RECRUIT OUTSTANDING PEOPLE INTO VACANCIES. SOME OF YOU MAY RECOGNIZE THIS PERSON. RAY BERNARD HAS BEEN IDENTIFIED AS THE ACTING CHIEF OFFICER FOR SCIENTIFIC WORKFORCE DIVERSITY FOLLOWING THE RETIREMENT OF ANNA WHO HAS BEEN IN THAT POSITION FOR A LONG TIME. MANY OF US HAVE INTERACTED WITH HER FOR A LONG TIME. 50% OF HER TIME WILL BE SPENT IN THIS ACTING CAPACITY. 50% AS NIA'S DEPUTY DIRECTOR WHICH WILL ADD TO MORE THAN 100% OF HER TIME. THIS IS A GREAT TRIBUTE OF MARIE'S LEADERSHIP SKILLS AND REFLECTS ON HER ALSO SECONDLY ON US HERE AT NIA AND WE'RE DELIGHTED TO BE ABLE TO HELP. SHE WILL BE A DYNAMIC FORCE FOR THE OFFICE WHICH IN THESE TIMES HAVE TAKEN ON SPECIAL PRIORITY. NEXT SLIDE, PLEASE. FOR NIA UPDATES WE USUALLY HAVE THE OPPORTUNITY AT THIS TIME TO ASK TO BE SEEN TO STAND UP AND BE RECOGNIZED AND HAVE BRIEF CONVERSATIONS OF INTRODUCTION OF THOSE WHO HAVE JOINED SINCE THE LAST COUNCIL SESSION. HERE WE'RE POSTING BY NAMES THE PROFESSIONAL STAFF HIRED SINCE JANUARY. YOU'LL SEE THE NUMBERS INDICATED HERE. SOME OF THESE YOU'LL ALREADY HAVE HAD A CHANCE TO INTERACT WITH. WE OF CONGRATULATE ALL OF THESE PEOPLE. WELCOME THEM REMOTELY AND WHOLEHEARTEDLY AS IF THEY WERE HERE IN PERSON. VERY TALENTED PEOPLE. AGAIN A TRIBUTE TO THE FACT THAT EVEN DURING THE SHUT DOWN OF IN PERSON ACTIVITIES THESE ARE PEOPLE WHO MADE THE COMMITMENT AND JOINED NIA AND WE'RE EXCITED TO HAVE THEM ON A VERY OUTSTANDING AND EXCEPTIONAL TEAM. WELCOME ALL AND WE LOOK FORWARD TO A TIME WHEN WE CAN HAVE MORE PERSONAL INTRODUCTIONS. SO SOME METRICS FOR YOU. SINCE THE JANUARY 2020 -- BEGINNING OF THIS CALENDAR YEAR THEREOF WAS A LOT OF PRESS OUTREACH. 44 HIGHLIGHTS. 10 ANNOUNCEMENTS. THERE HAVE BEEN A NUMBER OF CONGRESSIONAL BRIEFINGS. 10 BRIEFINGS. NEARLY ALL OF THEM OCCURRING AFTER THE SHUT DOWN SO HAPPENING REMOTELY BUT STILL CONTINUING THE OPPORTUNITY FOR US TO INTERACT WITH POLICY MAKERS. RELEASED AND I HOPE YOU WILL HAVE SEEN THE STRATEGIC DIRECTION'S PLAN. THIS IS PUT OUT EVERY FIVE-YEARS AND UPDATED. THIS IS A POINT OF REFERENCE THAT WE USE AND LOOKING AT PRIORITIES ACROSS ALL OF OUR RESEARCH OVER TIME. THE GENERAL GOALS SHOWN HERE AND UNDERSTANDING THE DYNAMICS OF AGING AND SUPPORTINing the over-all research. A LOT OF WORK BY STAFF REFLECTING THE INPUT FROM MANY OF YOU IN THE COMMUNITY. THE NEXT ALZHEIMER'S RESEARCH SUMMIT IS GOING TO BE APRIL 19-20, 2021 AND WE'VE MADE THE DECISION TO CONDUCT THIS VIRTUALLY. IT'S TOO DIFFICULT TO PLAN FOR INPERSON MEETING AND THEN BE PREPARED TO CHANGE THAT AND PIVOT. REMEMBER THIS IS A LARGE NUMBER OF PEOPLE SEVERAL HUNDRED PEOPLE COMING FROM ACROSS THE WORLD. I HOPE IT WERE OTHERWISE BUT THE LIKELIHOOD OF PEOPLE TRAVELING GLOBALLY TO SIT IN ONE PLACE IN HIGH DENSITY DOES NOT SEEM LIKE A JUSTIFIED SPECULATION AT THIS POINT SO THIS WILL BE A VIRTUAL MEETING. AND THESE ARE THE LINKS THAT WE SHARE ALL THE TIME. A WAY IN WHICH WE HOPE YOU CAN KEEP UP-TO-DATE. AND LET ME THEN END THE SLIDE PRESENTATION AND OPEN -- OPEN US UP FOR DISCUSSION. >> QUESTIONS FOR DR. HODES. COUNCIL MEMBERS YOU CAN SIMPLY UNMUTE YOUR PHONE. ALL OTHER MEMBERS ON THE CALL IF YOU PLEASE USE THE CHAT BOX AND WE CAN RELAY YOUR QUESTIONS TO DR. HODES. COUNCIL MEMBERS? >> YOU CAN ALL FEEL FREE AT ANY POINT DURING THE MEETING IF NOT AT THIS MINUTE IF THINGS COME TO MIND I WILL BE HERE. >> I HAVE ONE THING I WANT TO SAY WHICH IS CONGRATULATIONSES TO MARIE. WELL DESERVED AND I'M SURE GOING TO DO A GREAT JOB AT BOTH OF YOUR 100% JOBS. >> I'M SURE MARIE WILL AGREE WITH YOU THERE. >> -- THANK YOU. >> ALL RIGHT. IF THERE IS NO OTHER QUESTIONS AT THIS TIME JUST AGAIN FOR FUTURE MEETINGS TO ANNOUNCE THAT OUR JANUARY MEETING IS JANUARY 12-13, 2021. THIS MEETING WILL BE VIRTUAL. VIA ZOOM AS THIS ONE HAS BEEN TOO. SO WE'VE MADE THAT DECISION ALREADY TO MAKE NEXT COUNCIL MEETING ALSO VIRTUAL. I ALSO WOULD LIKE TO CONSIDER -- OF THE MINUTES FROM OUR MAY COUNCIL MEETING. THIS MEETING WAS FROM MAY AND THE MINUTES ARE POSTED IN THE ELECTRONIC COUNCIL BOOK. MAY I HAVE A MOTION TO APPROVE THE MEETING MINUTES? >> APPROVE. >> ANY DESCENT. ANY CORRECTIONS? ALL RIGHT. NOT HEARING ANY. THANK YOU FOR APPROVING THE MINUTES FROM THE LAST MEETING. OUR NEXT ITEM ON OUR AGENDA IS TO HEAR A REPORT FROM THE TASK FORCE ON MINORITY -- AGING. FROM DR. TAYLOR HARDEN AND DR. DAVID BENNETT. AND DR. PATRICIA JONES FROM NIA. I'LL TURN IT OVER TO THEM. >> I SENT DIANE SOME SLIDES. >> ALL RIGHT. ONE SECOND. >> OKAY. I WILL SUMMARIZE THE TASK FORCE MEETING YESTERDAY. IT WAS A BRIEF MEETING SO THIS WILL BE A BRIEF SUMMARY. THE NEXT SLIDE. SO HERE ARE THE TWO OUTGOING COCHAIRS. NEXT SLIDE. AND HERE WAS THE AGENDA. AND THERE IS SOMETHING WRONG ON MY SIDE HERE. SO WE HAD A ONE HOUR MEETING AND MARIE GAVE AN UPDATE ON THE INCLUSION AND THEN PATRICIA GAVE AN UPDATE ON THE BUTLER WILLIAMS SCHOLAR'S PROGRAM. FIRST WE'LL SUMMARIZE MARIE'S PRESENTATION. FOR THOSE OF YOU WHO HAVE BEEN ON COUNCIL THIS IS THE TIME LINE OF THE VARIOUS ITERATIONS OF THE INCLUSION POLICIES. IT STARTED BACK IN 1986 AND IT WAS LAST REVISED IN 2016: THE 20th CENTURY CARES ACT WHICH INCLUDED ADDITIONAL REQUIREMENTS ON AGE PARTICIPANTS ON TRIALS. THIS COVERS BOTH THE BEGINNING OF LIFE AND THE END OF LIFE AND FOR THIS MEETING I'M JUST GOING TO FOCUS ON THE OLDER BOOKS. SO THERE WAS A STUDY THAT LOOKED AT THE AGE OF PARTICIPANTS IN TRIALS. AND HERE YOU CAN SEE THE TOP 10 DISEASES THAT CAUSE HOSPITALIZATIONS AND/OR AFFECT DISABILITY ADJUSTED LIFE YEAR AND YOU CAN SEE THE MEAN AGE OF PARTICIPANTS IN THESE -- VARIOUS TRIALS RANGE IN THE LOW 50s FOR STROKE AND LOWER FOR LUNG CANCER AND UP INTO THE 60s FOR PROSTATE CANCER. YOU CAN SEE THE DEVIATIONS THERE. SO THERE ARE SOME OLDER PEOPLE BUT THE MEAN AGES ARE CERTAINLY QUITE YOUNG FOR THESE DISEASES. THERE SHOULD BE MORE INFORMATION ON THIS SLIDE. CAN YOU ADVANCE AND SEE IF IT SHOWS UP. SO FOR THIS DISEASE OF AGING OVER A QUARTER OF THE STUDIES ARBITRARY UPPER AGE LIMIT. WE TALKED YESTERDAY A LITTLE BIT ABOUT THE FACT THAT SOMETIMES IRBs GET SKITTISH ABOUT CERTAIN AGE GROUPS BEING IN TRIALS WHICH IS SOMETHING THAT WE'LL HAVE TO ADDRESS IF THE DISEASES AFFECT PEOPLE ABOVE THOSE AGES WE NEED TO FIGURE OUT A WAY TO GET THOSE PEOPLE INTO CLINICAL TRIALS BECAUSE IF THE DRUGS ARE APPROVED THEY ARE GOING TO GET THE DRUGS AND THEN OTHER CONDITIONS SUCH AS COMORBIDITY THOSE ARE NUANCED SINCE THOSE COULD HAVE -- COULD PUT THOSE PEOPLE AT ADVERSE HIGHER RISK OF ADVERSE EVENT. ON THE OTHER HAND THESE PEOPLE GET THE DRUG ANY WAYS AND THEN YOU DON'T FIGURE OUT WHAT IS GOING ON UNTIL LONG-TERM PHASE FOUR TRIALS WHEN SOME LOW EVENTS BEGIN TO ACCUMULATE POSSIBLY RELATED TO THIS. AND THEN INCLUSION ACROSS THE LIFE-SPAN AND THE GOALS WERE TO SHARE EVIDENCE WITH THE SPIRIT OF THE POLICY, OPEN SCIENTIFIC DISCUSSION. AND TO SHARE RESOURCES TO FACILITATE INCLUSION ACROSS THE LIFE-SPAN. AND HERE ARE SOME EVIDENCE BASED STRATEGIES FOR MAXIMIZING DIVERSITY AND REPRESENTATIVE AND STUDIES INVOLVING OLDER ADULTS. SO RESULTS CANNOT ALWAYS BE EXTRAPOLATED TO POPULATIONS THAT WERE NOT INCLUDED. I'LL TAKE THAT ONE STEP FURTHER. THEY CANNOT BE EXTRAPOLATED. DEVELOPING A PLAN FOR ININTENTIONALLY INCLUDED POPULATION AND FUNCTIONAL STATUS AMONG OLDER PEOPLE AND THE NEED FOR TRAINING AND AGING RESEARCH, FLEXIBLE STUDY PROTOCOLS IN PATIENTS WITH OUTCOMES AND MORE CLINICAL TRIALS AND REAL EVIDENCE THAT THESE WORK AND THEN TOOLS AND RESOURCES. SO I'LL SWITCH DOWN TO PA PATRICIA'S PRESENTATION ON THE 2020 BUTLER WILLIAMS SCHOLAR PROGRAM. THERE WERE A RECORD NUMBER OF APPLICATIONS RECEIVED. THEY SELECTED 55. AN INCREASE OVER PRIOR YEARS. IN 40% OF THESE PEOPLE CAME FROM TRADITIONALLY UNDER REPRESENTED MINORITIES. EVEN THOUGH 55 IS HIGHER THAN USUAL GIVEN THE RECORD NUMBER OF APPLICATIONS THE SECH ANNES -- ACCEPTANCE RATE WAS LOW. IT WAS REMOTE. THERE WAS SOME CHANGES IN THE PROGRAM AND IT WAS TWO AND A HALF DAYS INSTEAD OF FIVE DAYS. INCORPORATED ADDITIONAL RESOURCES TO ENHANCE NETWORKING. GROUP COHESION AND KNOWLEDGE INTEGRATION. SO THERE WAS A SURVEY AFTERWARDS. THERE WERE 43 OF THE 55 PARTICIPANTS RESPONDED. AND THE PROGRAM GUIDE GOT HIGH MARKS IN A NUMBER OF AREAS. QUALITY OF SCIENTIFIC PRESENTATIONS. THE QUALITY OF THE NIA PRESENTATION. THE FORMAT. CREATIVE NETWORKING OPPORTUNITIES. PROGRAM STAFF INTERACTIONS. PROPOSAL WRITEINGS. REVIEWS SPECIFIC AIMS. THERE ARE ALSO SOME AREAS RECOMMENDED FOR IMPROVEMENT. THE PARTICIPANTS WANTED MORE STRUCTURE FOR THE MIX AND MINGLE NETWORKING PROCESSES. WANTED TO OFFER INFORMAL NETWORKING OPPORTUNITIES. AND ADDITIONAL BREAKS THROUGHOUT THE DAY TO ACCOMMODATE ADULT LEARNER NEEDS. SO SUMMARY OF THE KEY TAKE AWAY POINTS. FREQUENT BREAKS. GROUP ACTIVITIES. MAINTAIN THE SIZE OF 55. CONSIDER OFFERING MORE CYCLES PER YEAR. I THINK IT WOULD BE GREAT IF WE COULD -- GET MORE PEOPLE IN. I'M NOT FOCUSED SO MUCH ON AN ACCEPTANCE RATE AS I AM ON NOT LEAVING GOOD CANDIDATES OUTSIDE SO WE NEED TO FIGURE OUT A WAY TO GET ALL OF THE REALLY MOST EXCELLENT CANDIDATES THAT APPLY INTO THE PROGRAM AND SO I WOULD CERTAINLY HOPE THAT YOU WOULD THINK ABOUT WAYS OF EXPANDING. AND FOCUS ON BUILDING LONG-TERM SENSE OF -- -- SOME OF VISION AND TANGIBLE TARGETS. ESTABLISH NEW PARTNERSHIPS THAT CAN REACH SCHOLARS. ENGAGE WITH NIA AND NIH AND OTHERS REGARDING EFFECTIVE STRATEGIES THAT CAN BE EXPLAINED AND ENHANCE AWARENESS AMONG OTHERS. EXPLORE OPPORTUNITIES TO ENHANCE DIVERSE SCHOLARS AND SERVING IN LEADERSHIP ROLES IN SCIENTIFIC MEETINGS. INCREASE THE AWARENESS OF COMMUNITY AND TRADITIONAL AND NONTRADITIONAL RESEARCH PARTNERS OF NIA RESOURCE PARTNERS. OKAY. SO THERE WERE A COUPLE OF THINGS I WANT TO ADD HERE. WHAT HAPPENED TO MY MOUSE? SO WE HAVE A FEW RECOMMENDATIONS FROM ME AND TAYLOR. SO THIS SUCCESS RATE WAS QUITE LOW AS I MENTIONED FOR THE BUTLER WILLIAMS SCHOLARSHIP OF PROGRAMS. AGAIN IT'S NOT JUST THE SUCCESS RATE BUT IN THE MAKING SURE THAT WE CAPTURE ALL OF THE HIGH QUALITY CANDIDATES. ENHANCED GUIDANCE FOR THE CRITERIA TO REFLECT EXPECTATION FOR MENTORING. WE'VE ASKED FOR A REPORT ON SUCCESS OF VARIOUS DIVERSITY SUPPLEMENT PROGRAMS. SO WE KNOW HOW MANY ARE GIVEN BUT WE DON'T KNOW A LOT ABOUT WHAT HAPPENED TO THESE PEOPLE AND THEN WE HOPE TO SEE IN JANUARY OR HOPE YOU'LL SEE IN JANUARY MORE INFORMATION ON THE NIA TRACKING TOOL FROM THE DOCTORS TO FIND OUT MORE GRAN -- ABOUT WHAT PEOPLE GET INTO THEIR STUDIES. I THINK THAT IS, ALL OF THESE THINGS ARE REALLY IMPORTANT BUT I WANT TO PARTICULARLY NOTE THAT UNDERSTANDING AND FIGURING OUT HOW TO GET INVESTIGATORS TO GET DIVERSITY, WE'RE NOT GOING TO MAKE EVERYBODY HEALTH DISPARITY AND HEALTH EQUITY RESEARCHERS. THAT IS NOT THE POINT. THE POINT IS TO MAKE SURE THAT PEOPLE ENGAGE THE COMMUNITIES AROUND THEM. AND AT LEAST ENROLL IN RELATION TO THE DIVERSITY AND THEIR AREA. AND FOR INVESTIGATORS THAT DON'T DO THAT OR CAN'T DO IT OR ARE NOT SURE HOW TO DO IT THEY NEED TO LEARN HOW TO DO IT AND TO DO THAT THEY NEED TO ENGAGE WITH THOSE DIVERSE COMMUNITIES. THEY NEED TO LEARN ABOUT THE DIVERSE COMMUNITIES. THEY NEED TO HAVE A DIALOGUE WITH THOSE DIVERSE COMMUNITIES. AND THESE ARE THE KIND OF DIALOGUES WE NEED TO SEE AROUND THE COUNTRY AT TIMES LIKE THIS AND THIS IS A WAY THAT NIA CAN HELP THE ACADEMIC COMMUNITY AS A WHOLE BE LEADERS IN THE AREA. SO THIS IS MY LAST MEETING. AND TAYLOR'S LAST MEETING. SO WE WANT TO THANK YOU FOR THE OPPORTUNITY TO PARTICIPATE IN THE TASK FORCE. IT HAS BEEN QUITE REWARDING FOR ME. AND I SUSPECT FOR TAYLOR. AS WELL. AND THEN I WANT TO WELCOME CLIFF ROSEN AND KEITH WHIF FIELD WHO IN JANUARY WILL BE THE NEW COCHAIRS. ACTUALLY STARTING TOMORROW. OR MAYBE AT 1:00 TODAY. OR 11:00 WHERE EVER KEITH IS. WE'LL NEED TO WORK WITH PATRICIA GREAT TO PLAN THE PROGRAM FOR JANUARY. THANK YOU VERY MUCH FOR THE OPPORTUNITY. AND LET ME KNOW IF THERE ARE ANY QUESTIONS. >> QUESTIONS FOR DAVID AND TAYLOR. >> IS TAYLOR ON? >> I AM. THANK YOU. >> HI, TAYLOR. DO YOU WANT TO SAY -- >> HI. SUPER GREAT JOB. >> I JUST WANT TO SAY GOOD MORNING AND THANK YOU FOR THE GOOD REPORT. >> AND I'D LIKE TO REITERATE AND THANK YOU BOTH FOR BEING CHAIRS OF THE TASK FORCE AND ALL THAT WAS COMPLETED AND DONE AND FORWARD THINKING IN THIS AREA DURING YOUR LEADERSHIP AND WE AT NIA THANK YOU VERY MUCH FOR ALL OF THE WORK THAT WAS DONE. >> OKAY. LET'S SEE. JUST IN THE CHAT ALSO MONICA ALSO REITERATES HER THANKS TO DAVID AND TAYLOR. YOU'VE MADE A BIG DIFFERENCE. HEARING NO QUESTIONS THANK YOU VERY MUCH AGAIN DAVID, TAYLOR. AND WE'LL MOVE ON TO OUR NEXT AGENDA ITEM. AGAIN, THE NEXT WE WILL BE HEARING FROM DR. STEPHEN KRITCHEVSKY. HE WILL GIVE A SUMMARY OF THE CONCEPTS THAT WERE DISCUSSED YESTERDAY AND FOR NIA. I'LL TURN IT OVER TO STEVE. >> THANK YOU. I'M NOT GOING TO -- SO FIRST OF ALL THE WORKING GROUP ON THE PROGRAM HAD A VERY FULL MEETING. WE HAD 1 15 -- CONCEPTS TO CONSIDER. WE APPROVED 14 OF THOSE AND ONE OF THOSE IS PENDING SOME CLARIFICATION AND WILL BE VOTED ON BY THE COUNCIL PENDING THE CONSIDERATION OF THE ADDITIONAL INFORMATION. I'M GOING TO ASK THE PRIMARY REVIEWERS OF THE CONCEPTS TO PROVIDE A VERY BRIEF SUMMARY OF WHAT THE CONCEPT ENTAILED AND ANY HIGHLIGHTS OF THE WORKING GROUP DISCUSSION. BEFORE I'M NOT GOING TO DO THAT FOR ALL OF THEM. THERE WERE SEVERAL OF THESE OF CONCEPTS THAT WERE BASICALLY APPROVED WITH VERY LITTLE DISCUSSION AND SINCE THEY ARE GOING TO BE POSTED ON THE NIA WEBSITE AND THE LINK WAS SHOWN BY DR. HODES AND HIS COMMENTS PEOPLE CAN FEEL FREE TO LOOK AT THEM AT THEIR LEISURE AND THERE ARE GOING TO BE SOME SUBSTANTIVE CHANGES BASED ON THE WORKING GROUP DELIBERATIONS. THEY CAN GO AHEAD. I'M GOING TO READ THOSE OFF RIGHT NOW. THE ENTREPRENEURSHIP AND INNOVATION TRAINING PROGRAM ENRICH WAS APPROVED WITH ENTHUSIASM. NI A CAREER ACADEMIC AWARD WAS APPROVED. ADVANCING DIVERSITY THROUGH UNDERGRADUATE EDUCATION WAS APPROVED WITH LITTLE DISCUSSION AND THE EARLY PHASE CLINICAL TRIALS OF NOVEL INTERVENTIONS TO PREVENT DELAY AND TREAT AGING RELATED CONDITIONS YOU ALL -- THE PROPOSAL WAS ALSO APPROVED WITH LITTLE DISCUSSION. SO WE'LL TAKE THIS FROM THE TOP OF THE LIST THEN. IN THE FIRST WERE TWO CONCEPTS FROM DIVISION OF AGING BIOLOGY. THE FIRST WAS EARLY STAGE INVESTIGATIVE RESEARCH USING NONHUMAN PRIMATE MODELS AND DR. ROSEN WAS THE PRIMARY REVIEWER. CLIFF, WOULD YOU SAY A FEW WORDS ABOUT THAT. >> YES. SO THIS WAS A PROGRAM THAT WAS INITIALLY DEVELOPED OUT OF A SPECIAL REPORT FROM NIH. THE EXPERT PANEL FORUM ON CHALLENGES ON ASSESSING NONHUMAN RESOURCES FOR BIOMEDICAL RESEARCH. IT WAS AN OPPORTUNITY TO OFFER TWO YEARS OF SUPPORT TO EARLY STAGE INVESTIGATORS WHO WERE ASSOCIATED WITH THE PRIMATE RESEARCH CENTER AS AN OPPORTUNITY TO JUMP-START THEIR CAREER. IT'S AN R-21 MECHANISM AND THE DISCUSSION CENTERED ON BOTH THE FUNDING SITUATION FOR AN R-21 WHICH IS QUITE MODEST AT $245,000 AND ALSO THE DISCUSSION WITH HOW BEST TO GET YOUNG INVESTIGATORS INTO RESEARCH ON PRIMATES AND WHETHER OR NOT THE R-21 WAS THE MOST DEFINITIVE OR APPROPRIATE MECHANISM SO WE DISCUSSED THIS. AND ALTHOUGH THERE IS AN OPPORTUNITY AND IT' IT IS -- AN NIH INITIATIVE SO NIA IS TAKING THE LEADED AND OTHERS WILL SIGN ON. THERE ARE FUTURE PLANS FOR OFFERING UP K OPPORTUNITIES FOR YOUNG INVESTIGATORS. ALSO DURING THE DISCUSSION IT WAS NOTED THAT ASSOCIATION WITH THE PRIMATE RESEARCH CENTER ITSELF MAY NOT BE THE MOST RELEVANT WAY TO BRING IN YOUNG INVESTIGATORS SO THAT MAY BE MODIFIED A BIT. SO IT WAS APPROVED BUT THERE WERE SOME CAVEATS. IT WILL BE CONTINUED TO BE DISCUSSED. >> WONDERFUL. THANK YOU. IF PEOPLE HAVE SOMETHING TO ASK THE REVIEWER IF YOU WOULD PUT THAT IN THE CHAT BOX OR Q&A AND THEN WE CAN ORGANIZE THOSE IN THE FLOW OF THE REPORT. NEXT IS OS GROW IMMUNOLOGY AND AGING. >> THANKS, STEVE. THIS IS A CONCEPT THAT AIMS TO FOSTER INVESTIGATION INTO AN EMERGING FIELD KNOWN AS OSTEO IMMUNOLOGY. THIS FIELD IS RELATIVELY NEW AND MOST OF THE INFORMATION THAT HAS BEEN GARNERED TO DATE HAS BEEN FROM WORK DONE IN RELATIVELY YOUNG INDIVIDUALS AND RODENT MODELS. SO TO ENCOURAGE THE EXPANSION OF THIS FIELD TO HAVE GREATER RELEVANCE IN AGING BIOLOGY A PRIOR -- RFA FUNDED A FEW PILOT PROJECTS WITH A MODEST BUDGET TO TEST WHETHER UNIQUE INSIGHTS WOULD BE GAINED THROUGH THE USE OF AGE MODELS. A WORK SHOT THAT WAS HELD IN 2018 STRONGLY SUPPORTED THE IDEA THAT THERE IS IN FACT REAL BENEFIT AND THAT ADDING THE FOCUS ON AGING PARTICULARLY INCENTIVIZING THE ASSESSMENT OF AGING AFFECTS IN THE FIELD WOULD BE OF STRONG IMPORTANCE TO THE FIELD. SO THE CURRENT CONCEPT WILL FURTHER ENCOURAGE THE AREA OF AGING BIOLOGY BY SOLICITING R-1 LEVEL APPLICATIONS. THE DISCUSSION SUGGESTEDDED THE ADDITION OF A FEW MORE INCLUDING CALLING OUT POTENTIAL ROLE OF INFLAMMATION IN THE MICROBIUM. THERE WAS ALSO DISCUSSION ABOUT USE OF A MULTI-PI MECHANISM FOR THIS AND SUGGESTION TO ALLOW FOR AN I'M OLOGIST AND A BONE -- SO AT THE END OF THE DISCUSSION THERE WAS STRONG SUPPORT OF THIS CONCEPT. >> OKAY. THANK YOU. NEXT ON THE LIST IS COPIOUS CAPITALIZING ON PRIOR INVESTMENTS AND ANIMAL STUDIES AND I WAS THE PRIMARY VIEWER ON. THIS PROPOSED AN R61/R33 PHASED MILESTONE THROUGH A MECHANISM TO PROMOTE THE DEVELOPMENT AND STRENGTH IN THE INFRASTRUCTURE FOR AGING RELEVANT BEHAVIORAL AGING. THE REPOSITORIES OF EXISTING ANIMAL HEALTH. AND THE CONCEPT INCLUDED A CALL FOR IMPROVING METHODS OF BEHAVIORAL AND SOCIAL AND PHYSICAL ASSESSMENTS IN ANIMAL STUDIES PARTICULARLY FOCUSING ON ADDING VALUE I THINK TO EXPERIMENTAL MODELS THAT ARE DEVELOPED FROM MORE OF A BIO BIOMEDICAL PERSPECTIVE AND TO ANALYZE THE ASSOCIATION BETWEEN BEHAVIORAL AND SOCIAL PROCESSES AND HEALTH MEASURES THROUGH THE LIFE COURSE. PART OF THE CONCEPT INVOLVED THE CREATION OF CENTRALIZED DATA REPOSITORY AND TOOLS FOR EMERGING AND HARMONIZING AND EXPANSION OF NATURAL HISTORY STUDIES IN AGING POPULATIONS IN WILD ANIMALS. THERE WAS ENTHUSIASM FOR THE IDEA OF BLENDING THE BIOBEHAVIORAL AND LIFE COURSE ASPECTS OF THE CONCEPT WITH ONGOING OPPORTUNITIES AND A GREAT DEAL OF ANIMAL RESEARCH THAT IS GOING ON BOTH IN EXPERIMENTAL MODELS AND IN NATIONAL HISTORY STUDIES IN WILD ANIMALS. THIS IS CONSISTENT WITH FEEDBACK FROM THE RECENT REVIEW OF BEHAVIORAL AND SOCIAL RESEARCH SUGGESTING THAT THIS WOULD BE AN AVENUE FOR RESEARCH IN REVIEW IT WAS -- THE DISCUSSION THOUGHT THAT ALL THREE OF THE AIMS WERE PROBABLY A BRIDGE TOO FAR AND DIDN'T BLEND VERY NATURALLY AND SUGGESTED THAT THE DEVELOPMENT OF THE BIOREPOSITORY AND TOOLS FOR HARMONIZATION BE CONSIDERED IN SOME OTHER MECHANISM AND FOCUS THIS ONE ON THE DEVELOPMENT OF NEW METHODOLOGIES AND THE TESTING OF THEM IN HYPOTHESIS DRIVEN WAYS IN THE STRUCTURE OF THE R61 AND R33. SO IT PASSED AND THAT WAS THE NATURE OF THE 10 OR OF THE DISCUSSION. THE NEXT WAS THE MECHANISM FOR USED RESEARCH TO PREVENT AD AND ADRD AND DR. WHITFIELD WAS THE PRIMARY VIEWER. >> THANK YOU, STEVE. SO THIS WAS TO -- A CONCEPT THAT PROPOSED TO USE R61 OR R33 AND R01 TO SOLICIT RESEARCH -- OF NEW AND ONGOING AND RECENTLY COMPLETED EARLY TO LATE STAGE TRIALS. RELEVANT TO THE PREVENTION OF AD AND RD. PREVIOUS RESEARCH HAS BEEN DONE TRYING TO LOOK AT SOME OF THE THINGS THAT ADDRESSED HEAR ANC BUT THIS A FAR MORE IN-DEPTH CONCEPT, APPROACH TO TRYING TO IDENTIFY WHAT THE INDIVIDUAL FACTORS THAT CONTRIBUTE TO VARIABILITY AND OUTCOMES MIGHT LOOK LIKE. THE DISCUSSION OF THIS WAS AROUND A COUPLE OF THINGS BUT THE PIECE THAT I REMEMBER THE MOST WAS THERE MIGHT BE A WAY TO HAVE A COORDINATING CENTER ACROSS STUDIES BECAUSE THERE MIGHT BE SO MUCH INDIVIDUAL VARIABILITY OR EVEN CONCERN ABOUT THE SIZE OF SOME OF THE CLINICAL TRIALS BEING DONE THAT TO BE ABLE TO LOOK AT IN A MEANINGFUL WAY THOSE INDIVIDUAL PSYCHOLOGICAL AND SOCIAL FACTORS THAT ADDRESSED HEAR -- -- ADHERENCE MIGHT BE LOOKED AT IN A MORE STRATEGIC MANNER. >> THERE WAS A COMMENT FROM OTHER COUNCIL MEMBERS ABOUT MAKING SURE THAT THE POPULATIONS MOST AT RISK BE A FOCUS OF THIS. BE EXPLICITLY CALLED OUT IN THIS MECHANISM AS A TARGET. >> GOOD POINT. >> ALL RIGHT. THE NEXT IS MID-LIFE IN THE UNITED STATES MINUS RENEWAL AND DR. WIER WAS THE PRIMARY. >> YES. MID-LIFE IN THE UNITED STATES BEGAN IN THE MID-90s AS THE FOUNDATION STUDY -- IT CAME TO NIA FOR FOLLOW-UP ON THAT COHORT AND IT HAS SINCE ADDED SOME SAMPLES AS WELL. IT HAS BEEN ACTUALLY PRODUCTIVE IN ITS NICHE AREA OF PSYCHOLOGICAL INFLUENCES ON HEALTH AND COGNITION. IT'S INNOVATIVE BENEFITING OTHER NIA STUDIES AND IT'S BEEN A MODEL FOR DATA SHARING FROM THIS TYPE OF RESEARCH. THE CONCEPT WE WERE ASKED TO REVIEW IS NOT THE ENTIRE MIDUS STUDY BUT TO TECHNICAL MODIFICATIONS GOING FORWARD. IT WAS CONVERTED TO U19 COOPERATIVE AGREEMENT AND MONITORING COMMITTEE WAS CREATED TO INTERFACE BETWEEN THE INVESTIGATORS AND NIA PROGRAM. THAT COMMITTEE HAS RECOMMENDED AN INTENSIFICATION OF THE ASSESSMENT INTERVALS. TO A THREE-YEAR -- AND TO MAKE THAT WORK A FIVE-YEAR STUDY PERIOD IS AWKWARD SO THEY ARE RECOMMENDING A SIX YEAR STUDY PERIOD FOR THE RENEWAL AND IN ADDITION TWO OF THE PROJECTS WITHIN THIS U19 ARE STRONGLY FOCUSED ON ADAR RESEARCH AND THE RECOMMENDATION IS THAT THOSE COME IN SEPARATELY SO THAT THE CONTRIBUTION OF THE PROJECT CAN BE ACCOUNTED FOR MORE CLEARLY. AND THEN FINALLY THEY RECOMMEND THAT SPECIAL REVIEW PANEL BE COMPOSED TO REVIEW BOTH SIMULTANEOUSLY BOTH TO APPRECIATE THE COMPLEXITY OF THE PROJECTS AND TO LOOK AT THEIR OVERLAP BECAUSE THEY ARE USING THE SAME HUMAN SUBJECT PANEL. THE MAIN SUGGESTION FROM THE DISCUSSION WAS THAT THIS STUDY PAY GREATER ATTENTION TO THE DIVERSITY OF ITS SAMPLE AND ITS REPRESENTATION OF THOSE GROUPS IN THE STUDY AND OTHERWISE IT WAS APPROVED. >> THANK YOU. YOU ALSO WERE THE PRIMARY ON THE NEXT NETWORKS TO DEVELOP BEHAVIORAL AND SOCIAL RESEARCH IN AGING. >> YES. STARTING IN 2009NIA BEGAN TO USE THE R24 MECHANISM TO FUND RESEARCH NETWORKS. DBSR HAS CREATED 16 SUCH NETWORKS OVER THAT TIME INTERVAL. OF THOSE FIVE HAVE BEEN TERMINATED. CONCLUDED THEIR WORK. ANOTHER FIVE ARE IN THE FIRST FUNDING CYCLE OF THEIR EXISTENCE. TWO ARE IN A RENEWAL AND THERE ARE FOUR PROPOSED HERE FOR RENEWAL AND THOSE ARE ON MID-LIFE REVERSIBILITY, HARMONIZATION OF HEALTH AND RETIREMENT STUDIES AROUND THE WORLD. THE USE OF BIOMARKERS AND DECISION NEURO SCIENCE. .R24 MECHANISM WAS STRONGLY PRAISED IN THE RECENT REVIEW OF DBSR AND IT WAS RECOMMENDED THAT THEY EXTEND IT TO SOME NEW AREAS AND SO IN ADDITION TO THE FOUR NEW AREAS FOR NETWORKS WHICH INCLUDE INNOVATION AND LONGITUDINAL STUDIES, DEMENTIA CARE AT HOME AND COMMUNITY BASED SERVICES. WORKFORCE AND EDUCATION IN ADRD. I FOUND ALL OF THESE TO BE WORTHWHILE. EACH OF THEM CONNECTS TO MILESTONE GOALS AND TO SPECIFIC RECOMMENDATIONS OF THE REVIEW. AND THE TRACK RECORD OF THESE NETWORKS WHICH BRING TOGETHER RESEARCHERS FROM DIFFERENT DISCIPLINES WITH A FOCUS ON INTEGRATING JUNIOR AND SENIOR RESEARCHERS SO THAT THERE IS A LEARNING AND MENTORING COMPONENT. I FIND AN EXTREMELY COMPELLING INNOVATIVE MECHANISM. SO THIS ONE ALSO WAS APPROVED BY COUNCIL. >> WONDERFUL. THANK YOU. NEXT ON THE LIST IS SHORT COURSES ON INTERDISCIPLINARY BEHAVIORAL AND SOCIAL SCIENCE RESEARCH AND EDGING AND THIS IS ALSO DR. WHEN IT FIELD. >> THANK YOU. >> THIS CONCEPT WOULD USE AN R24 MECHANISM TO ADDRESS THE NEED FOR SHORT COURSES TO TRAIN A WORKFORCE TO MEET THE NEEDS OF ASPIRING, NEW AND EVEN EXPERIENCED RESEARCHERS. THE FOA WOULD TARGET SIX AREAS FOR THE SOR. INCLUDING GENOMICS FOR SOCIAL SCIENTIST. REPRODUCIBILITY IN SOCIAL AND BEHAVIORAL SCIENCES. CROSS NATIONA-- ANDAPPLICATIONS OF MACHINE LEARNING TO SOCIAL SCIENCE RESEARCH ON AGING. SO IT WAS THOUGHT IN GENERAL THIS WAS A GOOD IDEA. IT COULD PROVIDE FOR SOME WONDERFUL TRAINING FOR PEOPLE WHO ARE COMING THROUGH THE PIPELINE BOTH AT THE UNDERGRADUATE AND GRADUATE AND EVEN PROFESSIONAL LEVELS. THE OUTPUT COULD BE USED FOR SCHOLARS AT BASICALLY ANY POINT AND PERHAPS BE ABLE TO FOSTER MORE INTERDISCIPLINARY RESEARCH. IT WAS NOTED THAT THE CONCEPT PAPER IN SOME WAY WAS MISSING SOME OF THE DETAILS ON HOW THE COURSES MIGHT BE OFFERED IN THE WORLD THAT WE LIVE IN TODAY. REMOTE LEARNING IS VERY COMMON. I KNOW ONE OF OUR MEMBERS ON THIS CALL IS DOING HER TEACHING OF HER SON ON HER FIRST DAY OF SCHOOL. IT MIGHT BE A USEFUL WAY IN THE FUTURE TO SHARE SOME OF THE INFORMATION AND KNOWLEDGE. IT WAS ALSO SUGGESTED THAT THERE MIGHT BE AN INDIVIDUAL COMPONENT ON MINORITY AGING OR THE INCLUSION OF RACE AND ETHNICITY AS FACTORS TO BE INCLUDED SHOULD BE SOMETHING TO BE CONSIDERED THAT IS THIS GOES FORWARD BUT THERE WAS IN GENERAL SUPPORT FOR THIS PARTICULAR MECHANISM. >> GREAT. THANK YOU. WE'RE GOING TO SKIP ON DOWN TO THE DN LIST BECAUSE THE ONES INTERVENING WERE APPROVED WITH VERY LITTLE COMMENT AND WILL BE AVAILABLE ON THE WEBSITE. THE FIRST IS ADRD CLINICAL TRIAL SHORT COURSE. AND DR. RYAN MAN. >> THANK YOU, STEVE. THIS CONCEPT WOULD USE THE R25 GRANT MECHANISM. IT WOULD CREATE A FUNDING OPPORTUNITY ANNOUNCEMENT TO ENCOURAGE APPLICATIONS TO REQUEST SUPPORT FOR THE EVALUATION OF LESS THAN 12 WEEK COURSES FOR GRADUATE STUDENTS, MEDICAL STUDENTS, POSTDOCTORAL FELLOWS AND/OR JUNIOR FACULTY AND PLACE A SPECIAL EMPHASIS ON DIVERSE BACKGROUNDS. COUNCIL ENTHUSIASTICALLY APPROVED THIS CONCEPT FOR A NUMBER OF THE REASONS THAT PROGRAM STAFF HAD OUTLINED INCLUDING THE GROWING NUMBER AND IMPORTANCE OF A D AND ADRD CLINICAL TRIALS. THE SPECIALIZED SKILL SET THAT WAS NEEDED TO CONDUCT AND LEAD THESE TRIALS WITH THE NECESSARY SKILL SET TO CONDUCT AND LEAD THESE TRIALS. THE PARTICULAR NEED TO SUPPORT THE DEVELOPMENT OF CLINICAL TRIAL FROM DIVERSE BACKGROUNDS AND TO FURTHER DEVELOP MECHANISMS TO INCLUDE UNDER REPRESENTED GROUPS IN CULTURALLY SENSITIVE IN MORE EFFECTIVE WAYS THAN WE DO TODAY AND THE CONCEPT'S RESPONSIVENESS TO A 2018 NIH SUMIC RECOMMENDATIONS. IT WAS THOUGHT THAT THIS WOULD PROVIDE A COST EFFECTIVE WAY -- SUPPORT THE NEXT GENERATION OF CLINICAL TRIAL RESEARCHERS IN THE FIELD AND INCREASE THE NUMBER OF TRIALIST AND ADVANCE THE CLINICAL TRIALS THEMSELVES. WHILE THE CONCEPT WAS ENTHUSIASTICALLY APPROVED COUNCIL HAS ASKED PROGRAM STAFF TO CONSIDER ADDITIONAL WAYS TO HAVE YOU ABORT THE RESEARCH CAREER DEVELOPMENT OF CLINICAL TRIALS RESEARCHERS FROM UNDER REPRESENTATIVE MINORITY GROUPS GIVEN THE IMPORTANT NEED AND THE ADDITIONAL EFFORTS TO BE SUCCESSFUL. >> THANK YOU. GREAT. THE NEXT IS ALZHEIMER'S DISEASE SEQUENCING PROJECT FOLLOW-UP STUDY 2.0. THE DIVERSE POPULATION INITIATIVE. THIS IS A CONCEPT THAT WAS -- THE FINAL VOTE IS BEING DEFERRED PENDING ADDITIONAL INFORMATION. I THINK IT WOULD BE VALUABLE FOR PEOPLE TO HEAR WHAT IT'S ABOUT AND WHAT ADDITIONAL INFORMATION IS BEING SOUGHT AND DR. HOLTZ MAN IS THE PRIMARY ON THIS. THE IDEA IS THERE HAS BEEN A LOT OF NEW INFORMATION ASCERTAINED ABOUT DIFFERENT GENES THAT AFFECT ALZHEIMER'S DISEASE RISK AND MOST OF THAT INFORMATION HAS COME FROM SEQUENCING OF INDIVIDUALS OF CAUCASIAN OR EUROPEAN DECENT. IN ORDER TO FOR EXAMPLE THE CURRENT ALZHEIMER'S SEQUENCING PROJECT HAS DONE A WHOLE GENOME SEQUENCING ON 50,000 PEOPLE. IN ORDER TO SORT OUT DIFFERENCES IN THE GENETICS THAT ARE -- OTHER POPULATIONS IT LOOKS LIKE YOU NEED TO SEQUENCE 18,500 PEOPLE OF PARTICULAR DIFFERENT BACKGROUNDS. THE ADSP HAS SEQUENCED ABOUT 2500 HISPANIC AND BEFORE 6700 AFRICAN-AMERICANS. SO NOT ENOUGH SEE CONSEQUENCING HAS BEEN DONE ON THOSE AND SOME OTHER POPULATIONS IN ORDER TO SORT OUT WHAT OTHER GENETIC CHANGES MIGHT BE OCCURRING THAT LEAD TO ALTERED RISK SO THE IDEA IS TO SEQUENCE ABOUT 25,000 ADDITIONAL WHOLE GENOMES FROM PEOPLE OF DIFFERENT BACKGROUNDS IN ORDER TO GET THOSE NUMBERS HIGHER SO THAT INCLUDED POPULATIONS SUCH AS MENTIONED HISPANICS, AFRICAN-AMERICANS AND ALSO ASIANS. NATIVE AMERICANS. AS WELL. SO WE WERE POSITIVE ABOUT THIS BUT WE WANTED SOME CLARIFICATION ABOUT EXACTLY HOW THE NUMBERS HOW THE ULTIMATE NUMBERS ARE BEING DETERMINED THAT NEED TO BE SEQUENCED SO WE'LL GET MORE INFORMATION ABOUT THAT AND VOTE ON IT SOON. >> THANK YOU. DAVID IS ALSO THE PRIMARY REVIEWER ON THE NEXT CONCEPT. >> YES. SO THE ISSUE HERE IS THAT THERE ARE SEVERAL INTERESTING FEATURES OF NEURO DEGENERATIVE DISEASES SUCH THAT SPECIFIC BRAIN REGIONS AND CIRCUITS ARE AFFECTED. SO-CALLED SELECTIVE VULNERABILITY. AND TO UNDERSTAND THE MECHANISMS THAT UNDERLIE THAT THE IDEA WOULD BE TO UTILIZE MODELS THAT DEVELOP DIFFERENT ASPECTS OF AD PATHOLOGY TO STUDY THE CIRCUITS THAT ARE BEING AFFECTED OVER TIME IN THESE MODELS USING SOME OF THE TECHNIQUES THAT ARE CURRENTLY BEING UTILIZED IN BY THE CONNECT NOME PROJECT THAT HAVE BEEN ABLE TO REVEAL HOW DIFFERENT CIRCUITS ARE CONNECTED IN THE RODENT BRAIN. ALSO TO UTILIZE THE STUDY OF CIRCUITS THAT ARE SUSCEPTIBLE. AND TO MAKE THAT DATA PUBLICLY AVAILABLE TO LEARN ABOUT THE MECHANISMS THAT LEAD TO DEGENERATION. IN GENERAL WE APPROVED THE CONCEPT WITH SOME CAVEATS. WE AGREED THAT THE PREMISE IS IMPORTANT TO MAP OUT CIRCUITS THAT ARE VULNERABLE BUT WE DID RECOMMEND THAT FOA BE FOR A COMPREHENSIVE CHARACTERIZATION -- AND OTHER POTENTIAL AD RELATED CHANGES IN CIRCUITS AND THE REASON IS THAT THE MOUSE MODELS THAT DEVELOP, THEY ARE NOT REALLY NOW MOUSE MODELS OF AD THEY ARE MODELS THAT -- PATHOLOGY. WHAT THEY ARE ABLE TO PROVIDE A STUDY OF. IN ADDITION THERE IS A LOT OF INFORMATION THAT HAD BEEN COMING FROM HUMAN BRAINS SUCH AS SINGLE CELL SEQUENCING ABOUT PARTICULAR CELL TYPES THAT MIGHT BE VULNERABLE. WE THOUGHT IT WOULD BE IMPORTANT TO MAKE SURE THEY ARE INTEGRATING DATA FROM HUMAN BRAIN SAMPLES WHICH OF WHICH IS ALREADY AVAILABLE BUT SOME MIGHT NEED TO BE ACQUIRED SO WITH THOSE MODIFICATIONS WE APPROVED THE CONCEPT AND WE ALSO RECOMMENDED THAT THIS WAS ORIGINALLY FOR RO1 MECHANISMS. WE BELIEVE THAT WAS OKAY BUT TO CONSIDER ADDING ALSO A UO1 MECHANISM AS WELL. >> GREAT. THANK YOU. NEXT ON THE LIST IS NEW APPROACHES TO THE STUDY OF DYNAMICS OF NEURO AGAIN US AND BRAIN AGING IN AD. >> THANK YOU. THIS IS A CONCEPT THAT AIMS TO ATTRACT PROJECTS TO DEVELOP NEW TOOLS AND TECHNOLOGIES AS WELL AS NEW MECHANISMS INCITES TO THE DEGREE TO WHICH NEURO GENESIS PERSIST IN HUMANS WITH ADVANCING AGE AND ALSO IN THE CONTEXT OF ALZHEIMER'S DISEASE AND RELATED DEMENTIAS. THE CONCEPT SEEKS TO EXPLORE WHETHER EFFORTS TO PROMOTE OR ENHANCE NEURO GENESIS PARTICULARLY WITHIN THE ADULT HEM OH CAMPUS. THE CONCEPT WAS ENTHUSIASTICALLY RECEIVED BY THE COUNCIL WHICH BASICALLY HAD TWO RECOMMENDATIONS WHICH WERE BOTH ACCEPTED BY PROGRAM. THE FIRST WAS SINCE THIS CONCEPT SEEKS TO SOLICIT APPLICATIONS THAT ARE TECHNOLOGY DEVELOPMENT AS WELL AS A HYBRID THAT EXPLICITLY DELINEATING THAT THEY WOULD BE RESPONSIVE WOULD BE USEFUL TO BOTH THE APPLICANTS AND THE REVIEWERS. THE SECOND WAS TO ENSURE THAT ADRD IS PROMINENTLY INDICATED AS AN AREA OF INTEREST WITHIN THIS CONCEPT. OVER-ALL IT WAS FELT THAT THE SCOPE WOULD BE APPROPRIATE TO ADVANCE THE FIELD AND PARTICULARLY WOULD BE IMPACTFUL IN DEVELOPING NEW MODALITIESES FOR INVESTIGATING CRUCIAL QUESTIONS IN THE FIELD AND HELPING TO RESOLVE SOME OF THE EXISTING PERSISTENT CONTROVERSIES AS WELL. SO THE CONCEPT WAS THERE WAS CONCURRENCE TO ENDORSE THE CONCEPT FROM THE COUNCIL. >> THANK YOU. THE FINAL THAT WE'LL HEAR ABOUT IS THE NIA FELLOWSHIP AND CAREER DEVELOPMENT AWARDS TO PROMOTE DIVERSITY IN RESEARCH FOR AD/ADRD AND DR. MANLEY IS THE PRIMARY. >> THANKS. SO THIS CONCEPT IS TO SET ASIDE RESOURCES AND SPECIALIZED REVIEW FOR FELLOWSHIP AND CAREER DEVELOPMENT AWARDS FOR TRAINEES FROM THE UNDER REPRESENTED GROUPS IN SCIENCE AND MEDICINE. THE ACTUAL PROPOSAL SAID UNDER REPRESENTED MINORITY BACKGROUNDS. AND THESE TRAINEES AND AWARDEES WOULD BE AT THE PREDOC, POSTDOC AND JUNIOR FACULTY LEVEL AND FOR PEOPLE WHOSE RESEARCH FOCUSES ON DATA SCIENCE AND DRUG DISCOVERY DISCIPLINES. THESE ARE PEOPLE WHO WOULD BE TRAINED TO PARTICIPATE AND TO LEAD CROSS DISCIPLINARY TEAM SCIENCE PROGRAMS AND TO FOCUS ON USE OF PRECISION MEDICINE APPROACHES TO AD AND ADRD TREATMENT AND PREVENTION. THE COUNCIL CLEARANCE WAS F31 AND F32 AND KOA1 AWARDS. THAT WAS DEFINED AS DATA SCIENCE, DIGITAL TECHNOLOGIES AND DRUG DISCOVERY FOR APPLICATION TO DIFFERENT TYPES OF AD AND ADRD RESEARCH. ANY KIND OF AD AND ADRD RESEARCH COULD COUNT THERE INCLUDING POPULATION STUDIES, BEHAVIORAL AND SOCIAL RESEARCH AND ALSO OF DIAGNOSTICS AND DRUG DEVELOPMENT. JUST TO QUICKLY GIVE YOU SOME EXAMPLES OF THE TYPES OF SCIENCE THAT WERE LISTED IN THE CONCEPT CLEARANCE THAT COULD BE A FOCUS OF THESE AWARDS. MULTI--- APPROACHES TO TARGET AND DISCOVERY OF PRECLINICAL DEVELOPMENT OF NEW SMALL MOLECULES IN BIOLOGICS FOR ALZHEIMER'S DISEASE. -- AND IDENTIFICATION OF FUNCTIONAL AD AND ADRD BIOMARKERS AND ALSO ANALYSIS OF TIME INTENSIVE BEHAVIORAL PREDICTS OF NCI AND DEMENTIA. THERE WAS A LOT OF EXCITEMENT IN THE COUNCIL FOR THIS PROPOSAL. A LOT OF ENTHUSIASM BECAUSE THERE ARE NO CURRENT TRAINING PROGRAMS FOR AD AND ADRD TRANSLATIONAL RESEARCH THAT ARE SPECIFIC FOR PEOPLE WHO ARE UNDER REPRESENTED IN SCIENCE AND MEDICINE. THERE IS A LOT OF DEMAND FOR THESE PEOPLE WITH THESE SKILLS. THERE IS A WEALTH OF DATA NOW INCLUDING THE EXCELLENT CONSORTIUM AND ADSP MODEL AD AND ALSO THE TREAT AD CENTERS. THESE DATA SOURCES ALSO INCLUDE DATA FROM DIVERSE PEOPLE, DIVERSE POPULATIONS AND ALSO WE KNOW THAT THE EXPERTISE IN THESE DISCIPLINES AND TRADITIONAL AND EMERGING DRUG DISCOVERY ARE TYPICALLY LACKING AMONG ACADEMIC INVESTIGATORS. SO THE COUNCIL IN DISCUSSING IT SUGGESTED FIRST THAT A K99 MECHANISM BE INCLUDED BECAUSE IT'S REALLY THE PIPELINE FOR INVESTIGATORS WHO ARE UNDER REPRESENTED IS GROWING AND IS GETTING STRONGER BUT THE FALL OFF IS BETWEEN THAT POSTDOC STAGE AND THE FACULTY LEVEL AND SO K99 IS A GREAT MECHANISM FOR HELPING WITH THAT TRANSITION FOR MINORITY INVESTIGATORS. THE COUNCIL ALSO COMMENTED THAT WITHIN THE CONCEPT PROPOSAL IT COULD BE IMPROVED WITH MENTION OF ONGOING SUPPORT FOR CAREER DEVELOPMENT, MENTORSHIP FOR RESEARCH, DEVELOPING AND REFINING SKILLS FOR GRANT WRITING AND APPLYING FOR TENURE. AND ALSO THE NIDDK HAS A NETWORK OF MINORITY HEALTH RESEARCH INVESTIGATORS THAT WAS ESTABLISHED IN 2002 AND THAT WAS MENTIONED AS A SPECIFIC POTENTIAL TEMPLATE FOR THIS CONCEPT. AND IT WAS APPROVED. >> GREAT. I THINK YOU ADDRESSED THE QUESTION. >> I THINK I DID. SO WE HAD A QUESTION FROM MIA LOWDEN WHO ASKED IS THERE A FOCUS ON PARTICULAR GROUPS AND THE QUESTION I THINK WAS WHETHER -- WHO ARE THE TRAINEES WHO ARE BEING TARGETED? THE TRAINEES WHO ARE BEING FOCUSED ON ARE PEOPLE WHO ARE AS THE PROPOSAL READS FROM UNDER REPRESENTED MINORITY BACKGROUNDS. THE WAY THAT I DESCRIBE THAT ARE PEOPLE THAT ARE TRADITIONALLY UNDER REPRESENTED IN SCIENCE AND MEDICINE. >> GREAT. THANK YOU. SO THAT CONCLUDES THE SUMMARIES THAT WE'RE GOING TO HEAR. JUST A COUPLE OF THOUGHTS. IT CAME -- IN SEVERAL SITUATIONS IT CAME UP AND WAS POINTED OUT THAT IN THE REVIEW OF BSR THE NUMBER ONE PRIORITY WAS A BETTER UNDERSTANDING OF HEALTH DISPARITIES ESPECIALLY WITH RESPECT TO ALZHEIMER'S -- WITH RESPECT TO ALZHEIMER'S DISEASE AND OTHER ASPECTS OF AGING AND HEALTH AND A FAIR AMOUNT OF DISCUSSION WAS MAKING SURE THAT THAT TARGET THAT PRIORITY WAS REPRESENTED WELL IN THE CONCEPT PROPOSALS THAT WE LOOKED AT. ANOTHER ISSUE THAT WAS RAISED IN SEVERAL SITUATIONS AND WE HAD A VERY RICH GROUP OF CAREER DEVELOPMENT ORIENTED CONCEPT CLEARANCES WAS THE IDEA THAT ESPECIALLY FOR THE EDUCATIONAL COMPONENTS THAT EDUCATION ON ITS OWN IS NECESSARY BUT PERHAPS NOT SUFFICIENT TO PROPEL CAREERS FORWARD AND FINDING WAYS TO EMBED MENTORING AND SERVICE AFTER THE SALE KINDS OF THINGS TO PROMOTE NETWORKING AND DEVELOPMENT GUIDANCE FOR FACULTY COMING THROUGH THOSE PROGRAMS. IT'S PROBABLY SOMETHING TO BE THOUGHT ABOUT IN A PURPOSEFUL WAY. SO I DON'T SEE ANY OTHER QUESTIONS COMING THROUGH THE Q&A Q&A. SO WITH THAT I WILL SAY I HAVE FOUND -- I'VE BEEN THE CHAIR OF THIS GROUP FOR THIS PAST CYCLE AND IT'S BEEN A VERY STRANGE EXPERIENCE. JANUARY HAD VERY FEW VERY LITTLE BUSINESS AND THEN MAY WAS A ZOOM EMERGENCY KIND OF SITUATION. AND THIS IS ALSO YET A THIRD FORMAT. BUT THROUGH IT ALL I'VE BEEN TREMENDOUSLY -- IT'S A FASCINATING THING BUT ALSO JUST WANTED TO ACKNOWLEDGE THE THOUGHTFULNESS OF MY COLLEAGUES ON COUNCIL AND HOW MUCH THOUGHT AND DELIBERATION THEY'VE PUT IN TO THEIR CONSIDERATIONS OF THESE AND THE AGING COMMUNITY IS MUCH BETTER OFF FOR THEIR INPUT. AND SO WITH THAT I WILL TURN IT BACK TO DR. SANTORA. >> THANK YOU, STEVE AND I ALSO WANT TO SEND MY THANKS TO YOU ESPECIALLY AS THE CHAIR OF OUR WORKING GROUP ON PROGRAM AND ALSO TO COUNCIL MEMBERS FOR ALL OF THEIR THOUGHTFUL CRITIQUES OF THESE CONCEPTS THAT ARE GOING OUT TO OUR NIA APPLICANTS. SO LET'S SEE. OUR NEXT -- I'M GOING TO TURN THIS NOW OVER TO DR. HODES. DERRICK, IF YOU CAN ALLOW DR. HODES TO PLEASE SHARE HIS SCREEN. >> BEFORE WE HAVE A CHANCE TO SPEAK WITH AND HEAR FROM COUNCIL MEMBERS I THOUGHT WE NEEDED TO PAY THE GREATEST HOMAGE TO SOMEONE WE'VE LOST RECENTLY. JAMES JACKSON. MANY OF YOU KNOW HIM. DON'T NEED INTRODUCTION TO HIS HISTORY AND CONTRIBUTIONS. JAMES WAS AN EXTRAORDINARY RESEARCHER AND LEADER A BRILLIANT AND EMPATHETIC PERSON ABOVE ALL JUST A WONDERFUL, WONDERFUL HUMAN BEING. HE WAS ON OUR COUNCIL. HE WAS ON OUR BOARD OF SCIENTIFIC COUNSELORS. HE SERVED ON THE ADVISORY COUNCIL. THE DIRECTOR. HE WAS ALWAYS WILLING TO SERVE WHEN HIS SERVICE WAS REQUESTED. HE JUST HAD A UNIQUE TALENT FOR UNDERSTANDING PEOPLE. TAKING COMPLEX SITUATIONS AND RECOGNIZING AND HONESTLY RESPECTING PEOPLE AND ALL OF THEIR VARIED PERSPECTIVES AND TRANSLATING THAT INTO THE MOST PRODUCTIVE OUTCOMES. I CERTAINLY WELCOME THE OPPORTUNITY FOR ANY OF YOU WHO KNEW HIM TO SAY SIMILAR WORDS BUT I DIDN'T WANT THE TIME TO PASS WITHOUT RECOGNIZING JUST A VERY, VERY SPECIAL HUMAN BEING TO WHOM WE IN THE GENERAL RESEARCH ACADEMIC COMMUNITIES OWE SUCH A GREAT DEAL. >> RICHARD IF I MIGHT. THIS IS KEITH WHEN I -- KEITH. I WANTED TO SAY SOME THINGS. WHAT HE HAS DONE FOR THE FIELD. I KNOW FOR ME WHEN I WAS ASSISTANT PROFESSOR AT PENN STATE UNIVERSITY MEETING HIM WAS LIKE MEETING SOMEBODY WHO WAS 10 FEET TALL AND HAD BEEN THE PERSON THE KIND OF STAKE A FLAG IN THE RESEARCH. AND WAS AN INCREDIBLE INFLUENCE THROUGH ALL OF THE YEARS I'VE BEEN IN THE FIELD AS BEING SOMEONE WHO WAS ALWAYS THERE FOR YOU NO MATTER HOW BUSY HE WAS. NO MATTER WHERE YOU WENT SOMEBODY KNEW JAMES JACKSON. HE IS GOING TO BE GREATLY LOST AT A PROFESSIONAL AND PERSONAL LEVEL. >> THANK YOU, KEITH. >> RICHARD, CAN I SAY SOMETHING? JAMES IS ONE OF THOSE REMARKABLE PEOPLE WHO ANYBODY WHO KNEW HIM YOU THOUGHT YOU WERE HIS BEST FRIEND. HE HAD AN ABILITY TO CONNECT TO PEOPLE AND RELATE TO PEOPLE AND CARE ABOUT PEOPLE AND SO MANY PEOPLE OF ALL DIFFERENT TYPES. AND THE OTHER THING I WANT TO TESTIFY TO AS A COLLEAGUE, HE OBVIOUSLY MENTORED PEOPLE IN ALL OF THESE FORMAL WAYS THAT WE FUND AND REVIEW AND CARE ABOUT. BUT HE MENTORED PEOPLE IN WONDERFULLY INFORMAL WAYS AS WELL. I BENEFITED FROM THAT. I WAS NOT HIS STUDENT. I WAS NOT A POSTDOC. I DIDN'T WORK IN MYS -- HIS LAB BUT HE TAUGHT ME A LOT ABOUT WHAT WE DO. YES. HE IS GOING TO BE GREATLY MISSED. >> I'LL ALSO CHIME IN. JAMES WAS -- A A -- REMARKABLE MAN. HE WAS AN ADVISER FOR VARIOUS PROGRAMS THAT WE HAD. AND WAS A GREAT ADVISER AND MENTOR. ON DISPARITIES AND HEALTH EQUITY FOR ME AND MY STAFF. AND IT WAS ONE OF THOSE MEETINGS WHERE YOU JUST REALLY LOOK FORWARD TO HAVING HIM COME AND SITTING WITH HIM AND LEARNING FROM HIM. AND WHEN I HEARD HE HAD PASSED IT WAS JUST AWFUL. HE WAS TRULY A GIANT IN THE FIELD. >> CAN I SAY SOMETHING? >> PLEASE. >> I AM ONE OF THOSE PEOPLE WHO WAS INFORMALLY MENTORED BY JAMES. A LOT OF -- HE -- A LOT OF KEEFE A -- LOT OF KEY POINTS, HE CHANGED THE WAY I THOUGHT BEFORE THINGS AND I'M VERY THANKFUL FOR THAT. AND ALTHOUGH WE DON'T ALWAYS KNOW EXACTLY ALL THE DETAILS OF WHAT GOES ON AT COUNCIL I KNOW THAT HE WAS PIVOTAL IN SOME ROLE IN THE SEED OR THE BEGINNING OF THE RESOURCE CENTERS FOR MINORITY AGING RESEARCH PROGRAM. AND THAT IS ONE OF THE MOST I THINK SUCCESSFUL PROGRAMS AND TRAINING MORE AND DIVERSIFYING THE WORKFORCE AND IN AGING RESEARCH AT NIA WITHIN NIA SO I'M INSPIRED BY THAT AS A NEW COUNCILMEMBER THAT COUNCIL MEMBERS CAN REALLY MAKE A CHANGE AND IN THE DIRECTION OF THE FIELD. SO THANK YOU, JAMES FOR THAT. >> THIS IS TAYLOR. AND I'D LIKE TO JUST SHARE THAT WHEN I HEARD OF JAMES' PASSING I THOUGHT ABOUT CONCENTRIC CIRCLES OF CONCERN. AND BY THAT I MEAN HE TOUCHED SO MANY AND AS WE REFLECT ON HIS LIFE HIS CAREER AND CONTRIBUTION CONTRIBUTIONS YOU'RE ABSOLUTELY RIGHT. HE WAS A STRONG ADVOCATE AND ONE OF THE FOUNDING CENTERS IN THE RESOURCE CENTERS AND BY CONCENTRIC CIRCLES IT'S HARD TO THINK ABOUT JAMES WITHOUT THINKING ABOUT OTHER COLLEAGUES LIKE SAID STAHL. STRONG ADVOCATES INDEED FOR SCIENCE THAT HE CARED ABOUT. AND INDIVIDUALS ACROSS THE NATION AND INTERNATIONALLY. WHEN I WAS IN THE POSITION AS ASSISTANT TO THE DIRECTOR OF SPECIAL POPULATIONS JAMES WAS THE CHAIR OF THE TASK FORCE ON MINORITY AGING RESEARCH AND THE SLIGHT SMILE THAT YOU ARE SEEING IN THE PICTURES PRESENTED BEFORE YOU IS CERTAINLY A KEY TO THAT PERSONALITY. QUICK WITT. QUICK THINKING AND QUICK TO ACTION AND TO INSPIRE OTHERS TO ACTION. SO I THINK HIS IMPRINT HIS CONTRIBUTIONS TO THE PROFESSION WILL ALLOW HIS VISION FOR MINORITY AGING RESEARCH TO LIVE ON AND ON AND ON AND WE CERTAINLY DO HONOR AND REFLECT AND THANK HIS FAMILY FOR SHARING HIM WITH US. >> THANK YOU ALL OF YOU. I THINK WHAT WE'RE SAYING IN COMMON IS THAT JAMES WAS SUCH AN OVERWHELMING PERSON FOR GOOD IN ALL OF OUR LIVES THAT IT'S SIMPLY HARD TO IMAGINE THE WORLD WITHOUT HIM AND WE DON'T HAVE TO BECAUSE AS WE'VE BEEN SAYING AND HEARING HIS LEGACY LIVES ON. HIS FACE, HIS VOICE AND WE MISS HIM SORELY. AND I THINK NEXT IS TO HAVE AN OPPORTUNITY TO EXPRESS APPRECIATION AND GIVE THOSE OF YOU WHO FOLLOWED JAMES ON OUR COUNCIL TO MAKE SOME COMMENTS AND WORDS HERE IN YOUR LAST SESSION OF OUR COUNCIL. SO USUALLY OF COURSE WE HAVE THE CHANCE TO RECOGNIZE YOU. HAVE YOU STAND UP AND FOR WHAT IT'S WORTH YOU GET A HANDSHAKE AND A HUG AND A PRICELESS CERTIFICATE FROM THE FEDERAL GOVERNMENT. WE'LL HAVE TO THINK OF A WAY TO REPLACE THAT. BUT FOR NOW I INVITE EACH OF YOU TO SAY SOME WORDS AND REFLECT ON WHAT YOUR TIME HERE HAS BEEN. WE CAN START WITH DAVID. I'LL BEGIN BY THANKING YOU DAVID WITH HOW ACTIVE YOU'VE BEEN. AS YOU'VE BEEN A POWER IN RESEARCH AND IN POLICY. OUTSPOKEN WITH YOUR IDEAS. THE ONLY PROBLEM IS YOU COLLABORATE WITH SO MANY PEOPLE YOU'RE OFTEN IN CONFLICT BUT THAT ASIDE I CAN'T FIND A CRITICISM TO MAKE SO THANK YOU FOR THE TIME YOU SPENT AND INVITE YOU TO SHARE SOME WORDS WITH US. >> RICHARD, I CAN'T BELIEVE IT'S BEEN FOUR YEARS. ON THE ONE HAND IT FEELS LIKE JUST YESTERDAY THAT I GOT AN INSIGHT IN PERSON TRAINING FROM ROBIN. ON THE OTHER HAND IT'S OF SEEMS LIKE FOUR YEARS SINCE MARCH THIS YEAR. SO I WANT TO THANK YOU FOR THE INVITATION TO JOIN THIS GROUP AND LEARN FROM YOU AND ROBIN AND KEN FOR THE LEADERSHIP OF THIS MEETING AND I REALLY FEEL LUCKY. IT WAS -- IT IS AND WILL BE A WONDERFUL TIME IN THE HISTORY OF NIA TO BE ON COUNCIL. WHEN I DO THE THOUGHT EXPERIENCE OF THE ANGUISH PEOPLE WERE GOING THROUGH BEFORE I JOINED WHEN THE PAY LINES WERE SO LOW AND NOW WITH THE STEADY OF INFLUX OF DOLLARS YEAR AFTER YEAR TO FUND THINGS THAT I'VE NEVER SEEN IN OVER THREE DECADES OF BEING FUNDED BY NIA. I'LL REQUEST WITH YOU THE PROGRAM STAFF THAT HAVE JOINED THIS EFFORT, EVERY COUNCIL MEETING AND MEET NEW PEOPLE THAT ARE JOINING ON TO THE NIA AND THEY ARE ALTER. A LOT OF YOUNG PEOPLE BECAUSE THEY ARE GOING TO CARRY THIS ON. AND THEN ALL OF YOUR DEDICATION TO RESEARCH. I'M IMPRESSED WITH THE OUT OF BOX THINKING. WE PLEAD TO GET PEOPLE FROM OUTSIDE WITH NEW IDEAS TO KIND OF REFRESH AND CHALLENGE SOME OF THE THINKING THAT GOES ON IN FIELDS WHICH CAN BECOME DOGMA VERY QUICKLY. AND I'M REALLY IMPRESSED WITH MY COLLEAGUES ON COUNCIL. I HAVE LEARNED SO MUCH FROM ALL OF YOU. THIS WAS ON THE SHORT LIST OF MEETINGS TO WHICH I ALWAYS LOOK FORWARD AND DESPITE THE GOVERNMENT PAPERWORK AND THE COUNCIL HOMEWORK AND THE IN OPPORTUNE TIMING OF THIS PARTICULAR MEETING SINCE I HAVE A P30 DUE TO RESEARCH IN A COUPLE OF DAYS I'M GOING TO MISS THIS MEETING AND MISS ALL OF YOU. SO, ITS AN HONOR TO HAVE SERVED WITH ALL OF YOU AND THANK YOU FOR THE OPPORTUNITY. KEEP UP THE GOOD WORK AND I LOOK FORWARD TO SHARING SPACE WITH ALL OF YOU SOME TIME ON THE OTHER SIDE OF THIS PANDEMIC. THANK YOU. >> THANK YOU, DAVID. TAYLOR HARDEN. I'VE HAD THE GREAT PLEASURE OF WORKING WITH TAYLOR. THEY WERE WONDERFUL TIMES. SHE EXPANDED BEYOND NIA AND WENT OUT TO SERVE ABLY IN THE COMMUNITY AND WE WERE ABLE TO CONVINCE HER TO COME BACK AND WITH THE EXPERIENCE OF BOTH THE KNOWLEDGE FROM THE INSIDE OF NIA AND A WONDERFUL PERSPECTIVE OF THE OUTSIDE WORLD WITH WHOM WE INTERACT SHE HAS COME BACK AND SERVED ABLEBLY. TAYLOPLEASE LET US KNOW IF YOU'VE GOT SOME WORDS YOU WOULD LIKE TO SHARE. AND UNMUTE, PLEASE. >> SO ANXIOUS TO GET IT OUT AND THEN FORGETTING TO UNMUTE. AS THE OLD I HADIAN GOES ALL THINGS AND IN THIS CASE ALL GOOD THINGS MUST COME TO AN END. I WILL CERTAINLY TREASURER MY EXPERIENCES HERE ON COUNCIL. AND I WILL MISS EACH OF YOU AND YOUR INTELLECTUAL CURIOSITY AND YOUR ABILITY TO STRONGLY EXPRESS SCIENTIFIC CONDITION AND TO ADVOCATE FOR THE SCIENCE THAT WE ALL SO VERY MUCH TREASURER. I WANT TO SAY THANK YOU TO THE LEADERSHIP ESPECIALLY TO RICHARD AND I WILL RETURN TO THE NIA TO COLLECT MY HUG. TO DR. BERNARD THE SAME TO YOU. HUGGING YOU FROM AFAR AND CONGRATULATIONS TO YOU AND TO ALL NIA STAFF. PAST AND PRESENT. I WILL MISS YOU. AND IN MISSING YOU IT'S HARD FOR ME NOT TO THINK ABOUT CURRENT LEADERSHIP AND MISS THE OPPORTUNITY TO SAY THAT I KNOW THAT I STAND ON THE SHOULDERS OF MANY THAT HAVE GONE BEFORE THAT HAVE MADE TERRIFIC CONTRIBUTIONS TO THE NIA AND TO THE SCIENCE OF AGING AND I'M THINKING TODAY ABOUT MY BEING HERE BECAUSE OF. AN EARLY MENTOR DR. MIRIAM KELTY. DR. FOX. ROBIN WHO HELPED WITH MY ORIENTATION WHEN I FIRST JOINED BACK IN THE '90s. DR. HAGA. DR. HADLY WHO IS AN INSPIRATION. DR. SIERRA. AND REFLECTING TO THOSE WHO HAVE GONE ON I'VE LEARNED A LOT OF LESSONS. SOME THAT I SHOULD NOT HAVE LEARNED FROM DR. SESSION MAN. VERY CREATIVE AND DR. WARNER EACH TAUGHT ME IMPORTANT LESSONS AND I RECOGNIZE THAT WE STAND ON THE SHOULDRS OF THOSE INDIVIDUALS. A SPECIAL THANK YOU TO DAVID FOR JOINING ME TO SHEPHERD THE TASK FORCE ON MINORITY AGING RESEARCH. A SPECIAL THANK YOU TO DR. LOCKET. DR. LOWDEN AND DR. SENAGA AND A SPECIAL THANK YOU TO OUR ASSISTANT ANDREA GRIFFIN MAN. WE WOULD NOT BE WHERE WE ARE TODAY AND LOOK SO IMPRESSIVE WITHOUT YOUR SUPPORT. I ENJOYED OUR ACCOMPLISHMENTS IN TERMS OF THE 2019 REVIEW. AND ALWAYS THE ADVOCACY FOR THE SCHOLAR'S PROGRAM. IT'S A GREAT JOY AND WONDERFUL COMPLIMENT TO WELCOME TO COUNCIL THOSE WHO HAVE BEEN RECOMMENDED OVER TIME AND TO WELCOME THEM TO THIS MEMBERSHIP IN THIS BODY. AGAIN, I HAVE TO THINK ABOUT ME BEING THE FOURTH I BELIEVE ASKED TO SERVE ON THE NATIONAL ADVISORY COMMITTEE SO I WILL GIVE A NOD TO DR. KITTY WHO WAS THE FIRST NURSE. DR. MARY HARPER WHO WAS A MENTOR AND WHO HAS PASSED ON. AND DR. JENNY HANSON. A NOD NOW TO YOU TERRI AS THE 5th NURSE I BELIEVE TO SERVE ON COUNCIL. I LEAVE TODAY WITH DEEP GRATITUDE AND THANK YOU YOU ABUNDANTLY FOR THE EXPERIENCES. THANK YOU. >> THANK YOU, TAYLOR AND DAVID, THANK YOU, HAVE BEEN IMPRESSED ALWAYS BY YOUR SCHOLARSHIP -- YOUR ABILITY TO BE CRITICAL ABOUT SCIENCE. MAYBE THAT IS NOT SO SURPRISING KNOWING YOU AND YOUR WORK OVER THE YEARS BUT IN ADDITION THANKFUL FOR THE DEPTH OF THOUGHT YOU PUT INTO EVALUATION RAISING QUESTIONS ABOUT THE WAY THAT WE DO THINGS. THE WAY TO BEST ADVANCE SCIENCE. DISCUSSIONS WITH YOUR OWN IDEAS AT THE FOREFRONT AND ALWAYS ABLE TO TAKE THOSE AND RESPOND TO THE GROUP. YOU'VE BEEN A WONDERFUL PLAYER ON THE TEAM. ONE OF THE LEADERS ON THE TEAM. YOU'VE SHINED. AND WE'LL MISS YOUR SERVICE ON COUNCIL BUT LOOK FORWARD TO CONTINUING INTERACTIONS WITH YOU AS A MEMBER OF THE NIA FAMILY. THANK YOU. >> THANK YOU SO MUCH, RICHARD. I WANT TO THANK YOU FOR ASKING ME TO BE ON THE NIA COUNCIL. AVENUE I HAVE LEARNED SO MUCH DURING THE LAST FOUR YEARS. IT'S BEEN, I REMEMBER ACTUALLY FIRST I THINK I FIRST MET YOU IN 1995 AS I WAS FIRST IN THE CLASS OF -- SCHOLARS AND YOU WERE IN YOUR CURRENT ROLE AND IT WAS A GREAT EVOLUTION OF SEEING WHAT IS HAPPENING AT THE NIA. IT'S' MAGAZIN -- AMAZING WHAT HAS HAPPENED FOR AGING AND ALZHEIMER'S DISEASE RELATED RESEARCH. SO, IT'S REWARDING TO BE INVOLVED IN COUNCIL. I PARTICULARLY WANT TO THANK ALL OF THE NIA STAFF BECAUSE I REALIZE HOW SERIOUS THEY ARE ABOUT WHAT THEY ARE DOING AND HOW HARD THEY WORK AND ARE SO DEVOTED TO THE GOALS OF THE NIA AND I THINK SIMILARLY IT WAS IMPRESSIVE TO SEE THE MEMBERS OF COUNCIL TAKE THEIR JOBS SO SERIOUSLY AND TRY THEIR BEST TO DO WHAT THEY THOUGHT WAS RIGHT AND IT'S BEEN A WONDERFUL EXPERIENCE AND THAT IS THE MAIN THING I WANT TO SAY. THANKS SO MUCH. >> THANK YOU, DAVID AND STEVE KRITCHEVSKY. YOU'VE BEEN A MARVELOUS MEMBER OF THE AGING RESEARCH COMMUNITY. ONE OF THE RARITIES IN YOUR ABILITY TO UNDERSTAND THE BASIC SCIENCE AND ITS TRANSLATION AND YOUR WORK CHAIRING THE WORKING GROUP ON PROGRAM. A VERY SPECIAL GROUP THAT HAS PUT IN EXTRAORDINARY EFFORT TO MAKE THINGS WORK TO ASSIMILATE THE INPUT THAT COMES FROM MULTIPLE MEMBERS OF COUNCIL AROUND CONCEPT CLEARANCES AROUND PROGRAM REVIEWS. YOU'VE BEEN A LEADER ON THE COUNCIL AND WE THANK YOU FOR IT AND LOOK FORWARD TO YOUR COMMENTS AND THEN TO OUR CONTINUE RELATIONSHIP. STEVE. >> WE NEED TRAINING IN UNMUTING I THINK STILL. >> THANK YOU. ANY WAY WELL -- AND THOSE ARE MY THOUGHTS. THESE FOUR YEARS HAVE JUST FLOWN BY AND I WANT TO ECHO THE SENTIMENTS OF MY GRATITUDE FOR BEING ABLE TO PARTICIPATE IN THIS AND ALSO HOW MUCH I'VE LEARNED FROM NIA STAFF AND FROM MY COLLEAGUES ON COUNCIL. I HAVE A THREE SORT OF REFLECTIONS, ONE IN ADDITION TO THE GREAT GROWTH IN THE RESEARCH PORTFOLIO THAT HAS COME WITH THE EXPANSION OF THE NIA BUDGET AND THE GREAT INVESTMENTS IN ALZHEIMER'S DISEASE. THESE PAST FOUR YEARS HAVE BEEN MARKED BY A CONVERGENT SCIENCE WHERE THE CONCERNS OF EACH DIVISION ARE CONVERGING IN CROSS DIVISION ALL OF KINDS OF CONSIDERATIONS. WE SAW SOME OF THOSE IN THE CONCEPT PROPOSALS. WE'RE LOOKING AT SOCIAL FACTORS IN BEHAVIORAL FACTORS IN THE LIFE COURSE OF EXPERIMENTAL MODELS OF AGING TRYING TO APPLY BIOLOGY OF AGING CONCEPTS TO BOTH PREVENTION OF AGE RELATED DISEASE INCLUDING ALZHEIMER'S DISEASE. THIS IS A REAL DIFFERENCE. THIS IS A REAL CHANGE IN THE WAY PEOPLE ARE THINKING ABOUT SCIENCE AND ABOUT AGING FROM CERTAINLY WHEN I GOT INTO THE FIELD AND CERTAINLY EVEN THOUGH I THINK OVER THE LAST FOUR OR FIVE YEARS AND CERTAINLY THE LAST FOUR YEARS ON COUNCIL INCREDIBLY EXCITING TO BE PART OF THAT. I LIKE TO PRESENT OUR WORK TO AUDIENCES OF OLDER ADULTS HERE IN WINSTON, SALEM AND OTHER PLACES BECAUSE I KNOW THAT A LOT OF US GET LOST OR I CERTAINLY DO IN THE DAY-TO-DAY ASPECTS OF RESEARCH AND MANAGING A RESEARCH PROGRAM AND WHEN I TALK TO OLDER PEOPLE HERE IN WINSTON SALEM I GET INVIGORATED BECAUSE IT'S CLEAR TO ME HOW MUCH THEY WANT US TO WIN. HOW MUCH THEY WANT OUR RESEARCH TO BE SUCCESSFUL. AND I FIND THAT INCREDIBLY LIFTING AND ENERGIZING AND I JUST WANT TO SAY I SEE THAT SAME PASSION IN NIA STAFF. THEY REALLY WANT THE RESEARCH TO WORK. IT'S REALLY IMPORTANT TO EVERYBODY. AND CERTAINLY THE PASSION OF MY FELLOW COUNCIL MEMBERS ALSO REFLECTS THAT. AND THE LAST IMAGE I HAVE IS A GAME OF OPERATION. I DON'T KNOW IF YOU REMEMBER THAT GAME. BUT YOU HAVE IT'S A GAME FOR KIDS WHERE THEY HAVE LITTLE BITS OF BODY PARTS AND THEY HAVE TO USE AN ELECTRONIC TWEEZERS TO GET THE BODY PART OUT WITHOUT SHOCKING ANYTHING. I ALSO SEE THAT AS A CHALLENGE FOR THE NIA BECAUSE THEY ARE TRYING TO CURE THE PATIENT AND WORK AROUND THE RULES OF REGULATIONS AND NOT GET SHOCKED TRYING TO GET THAT BODY PART OUT AND YOU GUYS DO A GREAT JOB OF WORKING WITHIN AN ARRAY OF CONSTRAINTS THAT I DON'T THINK I COULD MASTER AND STILL MOVE THINGS. MY HAT IS OFF TO ALL OF YOU. A GREAT APPRECIATION TO THE TREMENDOUS TALENT OF MY COLLEAGUES ON COUNCIL. THANK YOU. >> THANK YOU, STEVE. SUE PERSON CHIPESCHIN. IT'S BEEN A GREAT ASSET TO HAVE HER SERVING ON OUR COUNCIL AND YOU'RE BRINGING THAT PERSPECTIVE. ALL OF YOU REMARKABLE IN YOUR OWN FIELDS PROVE TO BE EVEN MORE REMARKABLE IN THE BROAD CONTEXT OF OUR COUNCIL. AND SUE WITH HER OUTSTANDING SKILLS IN COMMUNICATION AND RELATING AGING AND RESEARCH TO THE PUBLIC BUT ALSO A FULL-FLEDGED MEMBER OF OUR REVIEW GROUP AND LOOKING AT CONCEPTS. SHE HAS A PERSPECTIVE THAT ALLOWS HER TO UNDERSTAND THE SCIENCE AND PUT IT INTO CONTEXT IN A WAY THAT SERVES THE PUBLIC THAT WE ALL ULTIMATELY WANT TO ADDRESS. SO FOR SHARING THAT SPECIAL SKILL WE THANK YOU. I TRUST YOUR ADVOCACY WILL WELL CONTINUE. AND NOW FOR ALL OF YOU IN ADDITION TO WHAT WE LEARN AND GAIN BY HAVING YOU ON COUNCIL ALL OF YOU ONCE YOU'RE FINISHED WITH YOUR TERMS WE HOPE WE'LL CONTINUE TO BE EFFECTIVE AMBASSADORS IN MANY RESPECTS. AMBASSADORS FOR THE IMPORTANCE OF AGING RESEARCH AND THE RESEARCH COMMUNITY SO THAT PEOPLE ESPECIALLY EARLY IN THEIR CAREER WILL UNDERSTAND THAT THE INSTITUTE IS HERE TO RECEIVE AND LISTEN AND HELP AND SUPPORT THEM. THERE SHOULD BE NO BARRIERS OR ADVOCACIES BETWEEN THOSE. SUE, ESPECIALLY YOU. SOME WORDS, PLEASE. >> THANK YOU, RICHARD. THAT WAS VERY SWEET AND I APPRECIATE IT AND VERY MUCH APPRECIATE THE RELATIONSHIPS THAT WE HAVE WITH YOU AND MARIE AND I AM NOT A RESEARCHER BUT I AM A GROUPY OF RESEARCHERS. SO, ITS BEEN AN ABSOLUTE PLEASURE TO SERVE WITH ALL OF YOU. I'VE LEARNED A LOT. I HAVE GREAT ADMIRATION FOR YOU AND I HOPE I'LL STAY IN TOUCH WITH MANY OF YOU. I DID WANT TO SHOUT OUT ALSO TO CAREER STAFF. I KNOW SOME OTHER FOLKS DID AS WELL. IT'S MORE IMPORTANT THAN EVER THERE ARE A LOT OF ATTACKS GOING ON AGAINST RESEARCH AND I KNOW MORALE CAN BE AFFECTED BY THAT AND JUST WANT TO SAY THAT YOUR NEEDED MORE THAN EVER. THAT RESEARCH IS WHAT IS GOING TO GET US OUT OF COVID. AND THE RESEARCH PARTICULARLY THAT YOU'RE DOING FOCUSING ON OLDER ADULTS WITH THEIR DISPROPORTIONATE IMPACT ON COVID ON ALZHEIMER'S AND A VARIETY OF CHRONIC CONDITIONS OF AGING IS MORE IMPORTANT THAN EVER. I HOPE THAT YOU STAY. AND CONTINUE TO DO THE WORK THAT YOU'RE DOING. IF YOU HEAR OF THINGS THAT NEED TO BE LOOKED AT THAT ARE SORT OF OUTSIDE YOUR PURVIEW IN TERMS OF ADVOCACY THAT IS WHAT WE'RE HERE FOR SO PLEASE REACH OUT. ONE THING THAT I WANTED TO SAY TO THE COUNCIL MEMBERS THAT I FIND REALLY VALUABLE IS PLEASE VISIT ALL OF THE DIFFERENT DIVISIONS. MANY OF YOU HAVE SPECIALTY AREAS IN ALZHEIMER'S OR AGING BIOLOGY OR BEHAVIORAL AND SOCIAL SCIENCE BUT PLEASE MAKE A POINT AT LEAST ONCE DURING THAT ONE HOUR TIME PERIOD TO VISIT OTHER DIVISIONS BECAUSE WE SHOULD BE ADVOCATES FOR ALL OF THE DIVISIONS AT NIA AND AMBASSADORS FOR THE ENTIRETY OF THE AGENCY. AND THEN THE LAST THING I JUST WANTED TO SAY BECAUSE I'M ADVOCATE IS I HOPE THAT THE NATIONAL INSTITUTE OFF AGING WILL TAKE A LEADERSHIP ROLE IN THE AREA OF HEALTH ECONOMICS AND QUALITY ADJUSTED LIFE YEARS. THEY ARE BECOMING MORE AND MORE IMPORTANT IN THE COVERAGE OF REIMBURSEMENT NOT JUST FOR DRUGS BUT FOR ALL ASPECTS OF MEDICAL PRODUCTS AND HEALTH SERVICES AND THEY DISCRIMINATE AGAINST OLD WE WERE PEOPLE AGAINST PEOPLE OF COLOR AGAINST PEOPLE WITH DISABILITIES AND I FEEL LIKE COVID HAS REVEALED SO MUCH OF THINGS THAT HAVE BEEN LYING UNDER THE SURFACE. HEALTH ECONOMICS IS A STRUCTURAL ISSUE. IT'S BORING. WE TEND TO JUST LET IT KEEP GOING ON THE WAY IT'S ALWAYS GOING ON BUT WE HAVE CHANGED SO MANY THINGS LITERALLY ALMOST OVERNIGHT AND WE NEED YOU GUYS UNTIL HEALTH ECONOMICS TO WORK WITH THE QUARRY TO TRY TO LOOK AT OTHER WAYS TO FIGURE OUT THE VALUE OF HEALTH SERVICES, HEALTH PRODUCTS. BECAUSE EVERYBODY IS WORTH SOMETHING. YOU DON'T GET TO THE END OF LIFE AND HAVE FOLKS SAY TOO BAD. THE WAY THAT WE EMBRACE EQUALITY INCREASINGLY -- EVEN BY CONGRESS IN H 3, AND RECENTLY BY THE ADMINISTRATION IN WANTING TO TAKE ON REFERENCE PRICING. THIS IS A HUGE ISSUE AND IT'S NOT GOING TO GO AWAY ANY TIME SOON AND NIA SHOULD TAKE A LEADERSHIP ROLE WITH THE QUARRY IN FINDING AN ALTERNATIVE. THANK YOU SO MUCH FOR CHOOSING ME TO SERVE. IT WAS AN HONOR AND I WILL DEFINITELY STAY IN TOUCH. >> THANK YOU, SUE. THANK YOU TO ALL OF YOU. LET ME SAY TO DAVID AND JENNIFER, OUR QUOTE NEW MEMBERS WE HAD THE GOOD FORTUNE OF HAVING YOU PRIOR TO YOUR APPOINTMENT FOR A MEETING, WE WILL HAVE A MORE FORMAL OPPORTUNITY TO HAVE YOU RECOGNIZED. SOME OF YOU WILL REMEMBER GOING TO A DI DINNER TOGETHER. THE SPIRIT AND THE CLOSENESS I THINK HAS SURVIVED THROUGHOUT THE VIRTUAL POSITION UPON US. SO I THANK YOU AND WE'LL TURN IT BACK TO KEN THEN FOR MOVING ON THROUGH OUR AGENDA. >> YES. ALSO I WOULD LIKE TO EXTEND MY THANKS AS IT WAS INTERESTING TO HEAR HOW EVERYONE WAS REMINISCING ABOUT THE LAST FOUR YEARS. BUT FOR ME IT'S BEEN THE LAST TWO COUNCILS. SO YOU'RE STILL NEW MEMBERS TO ME BUT I WANT TO THANK YOU FOR YOUR SUPPORT AND YOUR ADVOCACY AND ADVICE TO THE NATIONAL INSTITUTE ON AGING. SO OUR NEXT POINT IN OUR AGENDA IS WE WILL BE NOW HAVING TWO SPEAKERS AND I WILL TURN IT BACK TO RICHARD TO INTRODUCE OUR FIRST SPEAKER DR. ELISEO J. PƒREZ-STABLE. >> YES. ELISEO. MANY OF YOU KNOW WAS SUPPORTED BY -- HE WAS ONE OF THE REAL LEADERS IN THE PROGRAM THAT YOU REFERRED TO. HE WAS SUCH A NOTABLE LEADER IN AGING RESEARCH THAT MANY OF YOU WILL REMEMBER THAT HE SERVED ON OUR COUNCIL. AND FROM THERE HE MOVED AT NIH COMING BACK TO BE THE DIRECTOR OF THE NATIONAL INSTITUTED ON MINORITY AND WILL HEALTH DISPARITIES. WE'VE HAD REREMARKABLY CLOSE RELATIONSHIP. OVER THE PAST YEARS AND ESPECIALLY DURING THESE TIMES OF COVID AND CRISIS I'VE HAD THE OPPORTUNITY OF SERVING WITH HIM, SERVING AND CHAIRING AND COCHAIRING. THE E-MAIL VOLUME AND THE ZOOM VOLUME HAS BEEN EXTRAORDINARY. HE ALMOST ROSE TO THE LEVEL OF MARIE BERNARD IN THE NUMBER OF HITS AS REFLECTED IN THE OUTLOOK PRIORITY WHAT POPS UP WHEN YOU OPEN UP AN E-MAIL. I'VE PROFITED ENORMOUSLY AND ENJOYED THE OPPORTUNITY. AND I'M DELIGHTED THAT HE WAS ABLE AND WILLING TO JOIN US AND SPEAK TO YOU. ELISEO, WELCOME. >> THANK YOU SO MUCH. RICHARD. IT IS MY PRIVILEGE AND PLEASURE TO BE HERE TO PRESENT TO YOU TODAY AND HOPEFULLY ANSWER ANY QUESTIONS YOU MAY HAVE. A LOT OF WHAT I DID, IT'S BEEN FIVE YEARS SINCE I WAS THE DIRECTOR. I LEARNED A LOT BY BEING ON THE COUNCIL AND SEEING HOW RICHARD AND MARIE CONDUCTED THEIR WORK AND IF IT WAS NOT FOR THAT EXPERIENCE I WOULD HAVE NEVER SERIOUSLY CONSIDERED MOVING TO NIH TO BE AN INSTITUTE DIRECTOR. AND ALSO WANT TO ACKNOWLEDGE JAMES JACKSON'S PRESENCE. HE WAS A COLLEAGUE A FELLOW PI OF THE PROGRAM. I WAS ALSO PRIVILEGED TO LEARN FROM HIM AND REALLY WILL MISS HIM AND ADMIRE ALL THAT HE DID FOR THE FIELD OVER HIS MANY YEARS OF CONTRIBUTIONS. SO I'M GOING TO NOT FOCUS TOO MUCH ON SPECIFIC CHALLENGES EVEN THOUGH THIS WAS MY TITLE. EMPHASIZE SOME OF THE MANY ACTIVITIES WE'VE BEEN WORKING ON IN THE LAST SIX MONTHS. I'LL START WITH THE DEFINITION. THESE ARE RACIAL ETHNIC MINORITIES OR PEOPLE OF ANY COLOR. UNDERSERVED. RURAL RESIDENTS AND THEN SEXUAL GENDER MINORITIES THAT WE DECLARED AFTER A LONG PROCESS AT NIH. WE CONSIDER A HEALTH DISPARITY TO BE I'LL HEALTH OUTCOME THAT IS WORSE THAN A REFERENCED GROUP. NOT EVERY DIFFERENCE IS A HEALTH DISPARITY. WE HAVE ALSO EMBRACE THE NOTION THAT SOCIAL DISADVANTAGE IN THESE POPULATIONS WITH HEALTH DISPARITIES IS IT'S DERIVED IN PART FROM BEING SUBJECT TO DISCRIMINATION AND BEING UNDERSERVED IN WILL HEALTH CARE AND THAT IS TRUE FOR ALL OF THOSE GROUPS. THIS IS AN ILLUSTRATION OF PROGRESS AND DISPARITIES. ALONG THIS ACCESS WE SEE MORTALITY -- BETWEEN WHITES AND BLACKS. THE TOP LINES ARE MORTALITY FOR PEOPLE OVER THE AGE OF 65 AND AS YOU CAN SEE THE LINES SORT OF BLEND TOGETHER AS OF 2008. MORE OF THIS DIFFERENCE MAY BE DUE TO THE ADVANTAGE OF WOMEN, AFRICAN-AMERICAN WOMEN. THE FACT THAT THE MORTALITY DIFFERENCE PRESENT AS RECENTLY AS 1999 HAS BEEN ELIMINATED. YES WE CAN MAKE PROGRESS IN THESE AREAS. OTHER PROBLEMS REMAIN AND NOT SHOWN IN THE SLIDE IS THE FACT THAT LATINO, HISPANIC POPULATIONS HAVE A LOWER MORTALITY COMPARED TO WHITES. THE CORRELATION OF SOCIOECONOMIC STATUS WITH HEALTH IS VERY ROBUST. ON THE SAME LEVEL AS SMOKING CIGARETTES OR EXTREME LEVELS OF BMI. IF YOUR HOUSEHOLD INCOME. FOUR IS UNDER $25,000 A YEAR WHICH IS ROUGHLY POVERTY LEVEL YOU'RE MORE LIKELY TO DIE FROM ANY CAUSE. THREE TIMES MORE LIKELY TO DIE FROM ANY CAUSE COMPARED TO A HOUSEHOLD OF 115,000 A YEAR. AND OUR MEDIAN INCOME IN THE U.S. PRIOR TO THE SHOCK OF THE COVID PANDEMIC WAS ABOUT $62,000. YET I DO BELIEVE THAT MANY INVESTIGATORS OF FAIL TO ASCERTAIN THIS. CERTAINLY NOT AT NIA BUT IN MANY OTHER SETTINGS AND IN CLINICAL MEDICINE THIS IS ALSO LACKING. STAFF INSPIRED BY WHEN I ARRIVED FIVE YEARS AGO I TALKED ABOUT THE RESEARCH FRAMEWORK THAT WE DEVELOPED WITH CARL HILL AND MARIE BERNARD AND ANOTHER ONE OF OUR COUNCIL MEMBERS, NORMAN KAPLAN AND THEY WORKED AND DEVELOPED THIS FRAMEWORK THAT WE NOW USE AS A GUIDE FOR RESEARCH. JUST TO REFLECT THE COMPLEXITY OF THE LEVELS OF INFLUENCE AND THE DOMAINS OF INFLUENCE RELATED TO INTERPERSONAL COMMUNITY AND SO SITE TALL ISSUES. AND WE ENCOURAGE OUR INVESTIGATORS TO REFER TO IT AND THINK IN TERMS OF MULTIPLE LEVELS WHEN THEY CAN. OUR FUNDING IS MODEST. FISCAL YEAR 20 IS $335 MILLION. WE DIFFER FROM MANY ICs IN TWO IMPORTANT WAYS. FIRST WE HAVE A -- INTERMURAL PROGRAM. THE AVERAGE -- IS ABOUT 10%. AND WE ARE BY FAR THE LOWEST PROPORTIONATELY. ALTHOUGH THAT HAS MADE HUGE PROGRESS IN THE LAST THREE YEARS. ABOUT 45% OF OUR BUDGET IS ALLOCATED TO RO1 TYPE RESEARCH PROJECT APPLICATIONS. AGAIN THIS IS CONSIDERABLY LOWER THAN THE AVERAGE INSTITUTE AS WE HAVE A SUBSTANTIAL PROPORTION OF OUR PORTFOLIO ALLOCATED TO CENTERS. THE RESEARCH CENTER FOR MINORITY BUT ALSO FOR EXCELLENCE. AND THE ENDOWMENT PROGRAM AND WE'VE PLAYED A MAJOR PART IN THE LOAN REPAYMENT PROGRAM. THESE ARE 18 INSTITUTIONS THAT ARE MINORITY SERVING. MANY ARE HBCUs. THE ELIGIBILITY CRITERIA INCLUDE A CAP OF $50 MILLION PER YEAR. THAT IS THE MAIN ELIGIBILITY CRITERIA. THAT AND COMMITMENT TO TRAINING AND SERVING UNDER REPRESENTED INDIVIDUALS IN SCIENCE AS DEFINED BY THE NATIONAL SCIENCE FOUNDATION AND JUST TO REFER TO YOU WHEN COLLABORATIONS CAN BE FACILITATED WE ARE SUPPORTIVE OF THAT. WE HAVE HAD A NUMBER OF FUNDING OPPORTUNITY ANNOUNCEMENTS AS A WAY TO STIMULATE OUR RO1 APPLICANTS. WHEN I ARRIVED WE HAD ESSENTIALLY VERY FEW INVESTIGATOR INITIATIVE APPLICATIONS. SO STAFF DEVELOPED A NUMBER OF FUNDING OPPORTUNITY ANNOUNCEMENTS. THESE ARE NOT SET ASIDE. IN ORDER TO STIMULATE THE FIELD. I FELT THAT EXTRAMURAL WORLD HAD A LOT OF HEALTH DISPARITY AND WE WERE NOT SEEING THOSE APPLICANTS. THEY WERE GOING TO OTHER INSTITUTES DEPENDING ON THE TOPIC. YOU CAN GET A FLAVOR HERE OF WHAT WE'VE HAD. SOME OF THEM HAVE BEEN VERY SUCCESSFUL. WE HAVE FUNDED ABOUT 20RO1s THERE. OTHERS HAVE BEEN LESS SUCCESSFUL. WHERE WITH WE WERE OBLITERATED BY THE HEAL PROGRAM. WE HAVE THREE THAT WERE CLEARED BY OUR COUNCIL HAVING NET MANIFESTED AS FUNDING OPPORTUNITY ANNOUNCEMENTS. POST DISASTER IMPACTS OFF HEALTH AND HEALTH CARE AND PARTICULARLY LOOKING AT HEALTH CARE PART OF IT. AND MANAGEMENT OF DIABETES IN TERMS OF HEALTH DISPARITY POPULATIONS AND STRUCTURAL RACISM AND DISCRIMINATION WHICH WE JUST CLEARED ON OUR COUNCIL LAST FRIDAY. WE'VE ALSO FUNDED SEVERAL SUPPLEMENTS TO FOCUS ON RURAL HEALTH DISPARITIES IN RESPONSE MOTIVATE MORE INTEREST. THESE ARE MEANT AS RESEARCH HUBS TO SEE WHAT COULD BE DONE. AND WE'LL SEE HOW THIS PROGRAM THESE WERE JUST FUNDED IN THE LAST COUPLE OF MONTHS. SO SOME OF THE ISSUES AROUND AGING WE LOOKED AT WITH OUR PORTFOLIO. WE NEED TO GROUP SEVERAL YEARS TOGETHER TO GET ANY SENSE OF DATA BECAUSE OUR TOTAL END IS SMALL. BUT YOU CAN SEE ABOUT 11% OF OUR FUNDING BUDGET IS ALLOCATED TO WHAT WOULD BE CONSIDERED AGING TOPICS. AND A MAJORITY IS IN THE FORM OF RO1s WHICH IS WHAT MY INTENT IN HAVING REDIRECTED THE FUNDING AFTER 2015. MOST OF THE PROJECTS ARE -- INCLUDE LARGE POPULATIONS OR POPULATIONS OF AFRICAN-AMERICANS AND LATINOS ALTHOUGH IT IS SPREAD TO OTHER MINORITIES AS WELL. 3 WE HAVE GREATLY BENEFITED FROM THE NIA ALZHEIMER'S DISEASE SUPPLEMENTS TO NONARD GRANTS. WE'VE ENCOURAGED OUR COMMUNITY TO APPLY AND NIA HAS BEEN GENEROUSLY SUPPORTIVE OF THESE. HOPEFULLY WE'LL WORK TOGETHER TO SEE WHAT THE EVALUATIONS IN TERMS OF OUTCOMES. 7 ARE ANY OF THESE SUPPLEMENTAL APPLICATIONS LEADING TO AD-ADRD APPLICATIONS LATER. ONE OF OUR RESEARCH CENTERS IS FOCUSED ON AMERICAN INDIANS. CAREGIVING FOR LATINO DEMENTIA PATIENTS. RACIAL INEQUALITY AND THE CUMULATIVE STRESSORS. THESE ARE JUST EXAMPLES. I WILL POINT OUT THAT MY TIME AT UCSF AND ONE OF OUR SCHOLARS WHO'S NOW SUCCESSFUL -- PUBLISHED ON THE RATES OF DIMENSION YA AND SURVIVAL AFTER USING THE KAISER DATABASE. THIS IS STILL AN AREA THAT I THINK WOULD BENEFIT FROM ADDITIONAL STUDY PARTICULARLY AMONG THE GROUPS THAT ARE NOT WHITE OR AFRICAN-AMERICAN WHERE THE DIFFERENCES ARE NOT AS CLEAR AS WE WOULD LIKE TO BE ABLE TO UNDERSTAND. SO SWITCHING TO COVID WE PUBLISHED A VIEWPOINT IN MAY THAT REALLY HIGHLIGHTED THE EMERGING CONCERNS AT THE TIME ABOUT THIS BURDEN ON RACIAL AND ETHNIC MINORITY POPULATIONS. I WILL BE HONEST IN FEBRUARY AS THE PANDEMIC BEGAN TO BECOME A REALITY FOR US. I HAD NO REASON TO BELIEVE THAT THIS WOULD PROVOKE THIS LEVEL OF DISPARITY. THE FLU PANDEMIC IN 1918-1921 DID NOT NECESSARILY HAVE THIS IMPACT. WE DID NOT SEE DIFFERENCE, MORTALITY FROM A SIGNIFICANT AMOUNT. AND SO THERE WAS NO BACKGROUND TO SEE WHAT HAPPENED. BUT THE IMPACT NOT ONLY THAT WAS EMERGING IN APRIL AND EARLY MAY HAS NOT ONLY BEEN REINFORCED WITH DATA SINCE THEN BUT IT REALLY AS BAD AS IT SOUNDED WITH OVER 50% OF ALL CASES OCCURRING IN LATINOS AND AFRICAN-AMERICANS IN PART DUE TO THE KIND OF EMPLOYMENT AND THE CROWDING IN COMMUNITIES AND HOUSING. AS MUCH AS THE INITIAL FLURRY OF INTEREST IN WELL IT'S MORE COMORBIDITY PARTICULARLY HYPERTENSION, DIABETES AND EXTREMO -- OBESITY. IN ADDITION OF COURSE TO AGE THAT YOU ARE ALL FAMILIAR WITH. IN RESPONSE TO THIS -- THIS WORKED VERY WELL WITH OUR N NIH WIDE EFFORTS TO LEAD INITIATIVES AND WITH A SCIENCE RESPONSE TO THE PANDEMIC. A COUPLE OF HALF DAY TWO MINUTE PRESENTATIONS ON BRAINSTORMING FOR IDEAS ON SCIENCE AND ALTHOUGH INITIALLY I THOUGHT WELL IT'S PRECLINICAL SMALL MOLECULES. VACCINE DEVELOPMENT, CLINICAL TRIAL SET UP. BUT QUICKLY REALIZED THAT THE SOCIAL BEHAVIORAL AND ECONOMIC CONSEQUENCES WERE SUBSTANTIAL AND ENDED UP IN A CONSORTIUM ALLIANCE WITH NATIONAL INSTITUTE ON AGING AND NATIONAL INSTITUTE ON MENTAL HEALTH AND OTHER ICs WHO CONTRIBUTE. WE HAVE PARTNERED AND WE'VE RECEIVED FUNDS FROM THE OFFICE OF THE DIRECTOR FOR START UP AND WE WERE SUCCESSFUL IN APPROVING OVER 50 SUPPLEMENTS TO EXISTING GRANTS IN ADDITION TO THOSE THAT WERE FUNDED AND OF COURSE NIA FUNDED MANY. SO WE'RE VERY PLEASED WITH THE OUTCOME AND WE PLAN TO CONTINUE THIS COLLABORATION. MORE RECENTLY PART OF THE SUPPLEMENTAL APPROPRIATIONS GIVEN TO NIH IN APRIL DR. COLLINS ALLOCATED $500 MILLION OVER FOUR YEARS FOR RAPID ACCELERATION OF DIAGNOSTICS FOR UNDERSERVED POPULATIONS. THE INITIAL SUPPORT WAS TO WORK ON DEVELOPING NEW TECHNOLOGY AND WE THOUGHT WE WOULD COMPETE WITH GETTING FUNDING FOR THESE ISSUES BUT INSTEAD WE WERE CHARGED WITHSTANDING UP A WHOLE PROGRAM LARGER IN SOME WAYS THAN MY OWN INSTITUTE TO TRY AND UNDERSTAND THE FACTORS ASSOCIATED WITH DISPARITIES IN COVID-19 MORBIDITY AND MORTALITY CENTRALIZED ON THE THEME OF TESTING SINCE THAT IS WHAT THE APPROPRIATED FUNDS WERE FOR. WE'RE IN THE PROCESS OF PRESENTING OUR FUNDING PROGRAM TO NIH LEADERSHIP. WE WILL BE FUNDING UP TO 60 SITES AS SUPPLEMENTAL AWARDS FOR CONDUCTING THIS WORK ON UNDERSERVED AND VULNERABLE POPULATIONS. MOST AFFECTED BY THESE INFECTION RATES. WE HAVE BEEN VERY PLEASED WITH THE INITIAL RESPONSE. RICHARD IS VERY MUCH COCHAIRING THIS WITH ME. WE'RE ALSO WILL BE FUNDING A DATA COLLECTION CENTER THAT ARE WILL BE HOUSED TO FUNCTION BOTH AS A COORDINATING CENTER, A DATA REGISTRY, A CONSULTANT AND SUPPORTIVE COMMUNITY ENGAGEMENT AND TESTING TECHNOLOGY SO WE LOOK FORWARD TO THIS PROGRAM. SEEING THE LIGHT OF DAY SHORTLY. THE STRATEGIES I ALREADY ELUDED TO REALLY TESTING SORT OF EFFECTIVENESS OF INTERVENTIONS TO REDUCE DISPARITIES. WE HAVE WANT TO EXPAND CAPACITY TO TEST BROADLY. BE NIMBLE IN ADAPTING TO THE TECHNOLOGIES. WE'RE OPEN TO A VARIETY OF POINT OF CARE TESTING INCLUDING AS THEY BECOME MORE AVAILABLE LESS INVASIVE TEST SUCH AS SALIVA OR NASAL SWABS. THE MITIGATION STRATEGIES AND BEHAVIORAL ISSUES ARE NOT GOING TO GO AWAY EVEN WITH A SOMEWHAT EFFECTIVE VACCINE. THERE IS ALSO IMPORTANT TO THINK ABOUT THE FUTURE OF DISTRIBUTION AND EVALUATION OF THE VACCINES AND POTENTIAL AMBULATORY THEY THERAPEUTIC CANDIDATES. AND THE OPPORTUNITY TO DEPLOY THESE POINT OF CARE TESTS. WHICH LED US THEN TO THE NEXT PROGRAM THAT WE WERE THRUST IN TO COCHAIRING. THIS TIME WITH THE NATIONAL HEART LUNG BLOOD INSTITUTE. SO GARY AND I WERE CONVENED BY DR. COLLINS ON JULY 4th TO BE EXACT TO TRY AND HAVE A PLAN OR DEVELOP A PLAN TO DEAL WITH THE POTENTIAL LACK OF DIVERSITY IN INCLUSION OF PARTICIPANTS IN THE VACCINE TRIALS THAT WERE BEING ROLLED OUT AT THE TIME. CURRENTLY WE HAVE TWO THAT ARE CLOSING IN ON FINALIZING THE RECRUITMENT. THIS IS THE MOW DERN A AND FIES A TRIALS. -- REGARDLESS THE REAL CONCERN AT NIH LEADERSHIP WAS THAT THE COMPANIES WERE NOT GOING TO HAVE AN EYE ON DIVERSITY OF PARTICIPANTS EVEN THOUGH 50% OF THE AFFECTED INDIVIDUALS CASES IN THE UNITED STATES WERE EITHER AFRICAN-AMERICAN OR LATINO. SO WE EMBRACING THIS CHARGE WITH THE IDEA THAT COMMUNITY ENGAGEMENT WAS THE FOCUS. WE CREATED THIS PROGRAM COMMUNITY ENGAGEMENT AND RESEARCH ALLIANCE. THE MAIN INITIAL EFFORT IS TO ADDRESS THE MISINFORMATION IN COMMUNITIES OF COLOR AND MORE BROADLY. IT HAS UNFORTUNATELY PERMEATED OUR SOCIETY TO TRY AND BUILD AND SOLIDIFY AN UNDERSTANDING OF A TRUST IN SCIENCE. ACKNOWLEDGING THAT MISTRUST IN GOVERNMENT ARE GOING TO BE A MORE CHALLENGING ONE TO OVERCOME IN THE SHORT-TERM AND THEN ACCELERATE THE UP TICKER OF THESE POTENTIAL BENEFICIAL TREATMENTS IN THE APPROACH TO CONTROL THE COVID-19 PANDEMIC IN THESE COMMUNITIES. WE'RE PROPOSING TO ACCELERATE INCLUSION. WORKING CLOSELY WITH THE NETWORK THAT HAS BEEN SET UP BY THE NATIONAL INSTITUTE ON ALLERGIES AND INFECTIOUS DISEASES. WE'RE TARGETING ELEVEN STATES AND ABOUT TO FINALIZE SETTING THESE UP. ALL BEING DONE WITH CLOSE PARTNERSHIP WITH US. AVENUE INCLUDE A CONSORTIUM OF NOT ONLY ACADEMIC INSTITUTIONS AND OTHER FEDERAL PARTNERS BUT ALSO NUMEROUS COMMUNITY BASED ORGANIZATIONS BOTH LOCAL AS WELL AS NATIONAL. TURNING TO A MORE SCIENTIFIC TOPIC ONE OF THE THINGS THAT I'VE BEEN ENCOURAGED WITH IS THE IMPORTANCE THAT HAS BEEN EMPHASIZED ON THE COMMON CURRENCY OF STUDYING THE SOCIAL DETERMINANTS OF HEALTH AND LINKED IS THE IMPORTANCE OF STANDARDIZED MEASURES. THIS IS AN ISSUE THAT I RAISED WITH OUR STAFF. WE DEVELOPED PHOENIX PROCESS IN ORDER TO EVALUATE EXISTING MEASURES OF SOCIAL DETERMINANTS OF HEALTH. WE CONVENED AN EXPERT COMMITTEE. THEY DID THEIR WORK OVER THE COURSE OF ABOUT A YEAR PLUS. WE HAVE ALSO CONVENED AN NHY COMMITTEE THAT INFORMED THIS WORK AND NEXT SLIDE WE WERE ABLE TO CREATE A WEB A WEBSITE ON THE PHOENIX TOOLBOX THAT WAS LAUNCHED ON MAY 11th OF THIS YEAR WHERE WE GROUPED TOGETHER WHAT WE'RE CALLING CORE OR BASIC SOCIAL DETERMINANTS OF HEALTH MEASURES ON INDIVIDUAL FACTORS THAT YOU ARE FAMILIAR WITH WHETHER IT'S DEMOGRAPHICS SOCIAL ARE SOCIOECONOMIC STATUS, RACE AND ETHNICITY AND OCCUPATION. AND MANY OTHERS. MANY HAVE EXISTED AND WE TRIED TO GROUP THEM TOGETHER IN ONE SITE AND ENCOURAGED OUR INVESTIGATORS TO USE THESE MEASURES IN EVALUATING THESE VARIABLES BUT ALSO ADDED A SERIES OF NEW CONSTRUCT EXEMPTION THAT WERE VETTED BY THE EXPERT COMMITTEE. AND BEGAN TO CREATE SOME ASPECT OF LOOKING AT STANDARDIZED MEASURES OF SOCIAL STRUCTURAL DETERMINANTS OF HEALTH. THIS IS A PARTIAL LIST. OFTEN WE END UP USING CRAN CENSUS. BUT THESE OTHER FACTORS ARE IMPORTANT WE DON'T HAVE THE ANSWER FOR THEM YET. THERE IS MUCH WORK TO BE DONE IN EVALUATING THESE FOR EXAMPLE THERE WAS NO REAL MEASURE OF GREEN SPACE AND SAFE SIDEWALKS AND ACCESS TO BROADBAND NOW SEEMS LIKE A NO-BRAINER NOW. BUT YET AGAIN THESE -- ARE A SOURCE OF DISPARITY THAT HAS NOT BEEN PROPERLY INCORPORATED. I MENTIONED SOMETHING ABOUT DIVERSITY IN THE WORKFORCE. ENCOURAGED TO HEAR THE CONCEPT IS THAT WE'RE BEING APPROVED. I WANT TO PUT A SPECIAL PLUG IN FOR THE LOAN RELY PAYMENT PROGRAM. THIS WAS GENERATED IN PART BY CONGRESS. THERE HAS BEEN A SIGNIFICANT RESPONSIBILITY FOR IT UNTIL THIS YEAR. WHEN NOW ALL NIH INSTITUTES ARE ELIGIBLE TO FUND LOAN REPAYMENT PROGRAMS. AS YOU CAN SEE IN OUR EVALUATION OF OUR OWN PROGRAM OVER THE COURSE OF ABOUT 10 YEARS FOR WHICH WE HAD REASONABLE DATA PRIOR TO 2005 WE DID NOT. ROUGHLY A SIMILAR NUMBER OF SUCCESSFUL AND UNSUCCESSFUL APPLICANTS AND 60% WERE FROM UNDER REPRESENTED MINORITIES WHICH IS REMARKABLE. WHAT GETS ATTRACTED WHEN YOU DO THIS KIND OF THING AND THEN THE MOST IMPORTANT ASPECT AND THERE ARE OTHER DATA TO SUPPORT THAT LOAN REPAYMENT RECIPIENTS ARE MORE LIKELY TO STAY. COMPARED TO THOSE WHO DID NOT RECEIVE THE AWARD. SO IN MANY WAYS I SEE THE LOAN REPAYMENT PROGRAM AS AN INTERVENTION THAT DOES PROMOTE THE DIVERSITY AND THERE IS EVIDENCE FROM OTHER RESEARCH INTERNATIONALLY ESPECIALLY CASH ASSISTANCE PROGRAMS, INCOME TAX CREDIT THAT THIS WORKS. AND SO THIS IS ONE OF THE APPROACHES TO INNOVATION -- INNOVATIVE APPROACHES THAT WE HAVE TO CONSIDER. OUR SUCCESS RATES FOR OUR GRANTEES ARE LISTED BELOW. EACH IC HAS BEEN ASKED TO SELF-REFLECT ON THIS. WE HAVE BEGIN HAD TO GROUP DATA OVER THE COURSE OF FOUR YEARS TO MAKE MEANINGFUL -- GET MEANINGFUL INFORMATION BUT LIKE NIA WHICH HAS NO FUNDING GAP BETWEEN WHITE AND BLACK. YOU CAN SEE OUR GAP IS VERY SMALL AND IN FACT HISPANIC, LATINOS HAVE A GREATER AWARD RATE. I LOVE THIS PICTURE. THIS WAS A PRODUCT OF OUR 2020 HEALTH DISPARITIES HEALTH INSTITUTE WHICH WAS VIRTUAL. WE WERE ABLE TO INVITE AND ACCEPT 66 OF OUR APPLICANTS. WE HAVE ABOUT 200 OR SO -- 220 APPLICANTS. WE USUALLY SUPPORT 50 SLOTS. WE'RE NOT AS GENEROUS AS BUTLER WILLIAMS. WE SUPPORT THEM WITH TRAVEL SUPPORT BUT NOT FULL BOARD. REGARDLESS WE WERE ABLE TO DO A SLIGHTLY SHORTER. WE HAD 20% REDUCTION IN ACTIVITIES AND WE WERE PLEASED WITH THE OUTCOMES. I WAS INSPIRED BY THE EXPERIENCE I HAD WITH BUTLER WILLIAMS AT NIA. THIS IS JUST A DESCRIPTION OF WHAT WE DO. THE MOCK GRANT SESSION HAS ALWAYS BEEN THE MOST FAVORABLEBLY REVIEWED AND LEARNING EXPERIENCE AND WE'VE SWITCHED TO USING REAL GRANTS WITH PERMISSION AND THOSE HAVE BEEN MUCH APPRECIATED BY THE SCHOLARS. THE NETWORKING OPTIONS ARE GREAT NOT ONLY WITH NIH STAFF BUT ALSO AMONG THEMSELVES AND I COULD SEE WITH THE ZOOM FORMAT THE CHATS THAT WENT ON DURING PRESENTATION I WAS ABLE TO LISTEN TO ABOUT THREE QUARTERS OF THE INVITED SCIENTISTS WHO PRESENTED IT WAS QUITE AMAZING. WE HAVE HAD 270 PARTICIPANTS IN THE FIRST FIVE YEARS. AGAIN ABOUT 60% ARE UNDER REPRESENTED MINORITIES AND WE WILL BE EMBARKING ON A NEW EVALUATION OF THIS PROGRAM SOON. AND JUST TO SHARE A COUPLE OF SNIPPETS OF RESEARCH THAT WE'VE FUNDED. THIS IS A PROJECT THAT LOOKED AT WHAT THE EFFECT OF INCREASING STATE MINIMUM WAGE WOULD BE ON SUICIDE RATES. AND BETWEEN 1990 AND 2015 FOUND THAT A DOLLAR INCREASE IN MINIMUM WAGE WAS ASSOCIATED WITH A SUBSTANTIAL DECREASE IN SUICIDE RATE AMONG YOUNGER ADULTS 18-64 WITH A HIGH SCHOOL EDUCATION OR LESS. AGAIN LOOKING AT SOCIO ECONOMIC DISPARITIES. THIS IS A MORE RECENT STUDY USING THE AREA OF DEPRIVATION TO EXAMINE NEIGHBORHOOD DISADVANTAGE AND OBESITY IN THE STATE OF MISSOURI AND BMI OVER 30 WAS MORE PREVALENT IN DISADVANTAGED NEIGHBORHOODS THAN ONE WOULD PREDICT AND SUPPORT THE NEED FOR PREVENTIVE RESOURCES. I THINK THIS IS THE KIND OF INFORMATION THAT HELPS INFORM POLICY AND POTENTIAL INTERVENTIONS TO DECREASE DISPARITIES. AND IN THIS WORK I THINK WAS OUT OF A GROUP IN OREGON HEALTH SCIENCES LOOKING AT THE MANDATORY MEDICARE BUNDLE PAYMENT WITH JOINT REPLACEMENT OUTCOME IN HOSPITALS WITH DISADVANTAGED PATIENTS. HOW THEY EVALUATED AND COMPARED HOSPITALS BUT THEY LOOKED AT HOSPITALS WITH HIGH DUAL MEDICARE MEDICAID ELIGIBLE PATIENTS AS YOU KNOW TEND TO BE MORE VULNERABLE AND HAVE HIGHER RATES OF COMPLICATIONS AND WORSE DISPARITIES -- HAVE HIGHER RATES OF INFECTION. AND THESE ARE SERVING PATIENTS WHO ARE UNDERWENT JOINT REPLACE REPLACEMENT IN 2015-2017. AND IN RELATED ANALYSIS THERE IS THE INDICATION THAT THESE KINDS OF POLICIES MAY ACTUALLY DISADVANTAGE THESE HOSPITALS THAT SERVE HIGH DUAL POPULATIONS AND THAT MORE OF THEM ARE LIKELY TO BE NOT ELIGIBLE FOR INSENSITIVE AND MORE LIKELY TO BE PENALIZED FOR NOT MEETING THE REQUIREMENTS OF THE PROGRAMS. AND FINALLY THIS STUDY THAT WAS HIGHLIGHTED IN ONE OF THE BLOGS LOOKING AT DIAGNOSIS IN STAGE ONE AND TWO OF BREAST CANCER WHICH IS IMMINENTLY CURABLE AT THAT LEVEL. ONCE YOU REACH STAGE THREE IT IS -- THERE ARE MANY THERAPIES THAT CAN LEAD TO CHRONIC DISEASE WITH BREAST CANCER. AVERAGE AGE IS YOUNGER THAN THE MAIN TARGET. MOST HAD INSURANCE BUT A SIGNIFIGANT NUMBER HAD MEDICAID. EVEN WITH THAT CATEGORIZATION AND THEIR DIVERSITY OF THE SAMPLE. THIS IS FROM MEDICARE LINK DATA WHICH IS A SOURCE OF IMPORTANT RESEARCH QUESTIONS TO BE ADDRESSED. THE RISK OF PRESENTING WITH STAGE THREE WAS SUBSTANTIALLY HIGHER IN THOSE WITH MEDICAID OR UNINSURED STATUS. 20% VERSUS 11% AND AFTER YOU WILL OF THESE FISCAL ADJUSTMENTS FOR DIFFERENT FACTORS AVAILABLE IN THE SIERRA MEDICARE LINKED DATA THIS LACK OF INSURANCE EXPLAINED ABOUT HALF OF THE DISPARITY. SO THIS KIND OF ANALYSIS IS HELPFUL IN POINTING OUT WHAT THE DIFFERENT FACTORS THAT LEAD TO WHY THERE MIGHT BE HIGHER MORTALITY FOR EXAMPLE IN BREAST CANCER AMONG AMERICAN AFRICAN WOMEN AND THE LATE PRESENTATION THAT WE CAN FIX WITH BETTER ACCESS TO HEALTH CARE. AND JUST PUT IN A QUICK PLUG FOR AMERICAN JOURNAL OF PUBLIC HEALTH SPECIAL ISSUE THAT WE PUBLISHED A YEAR AND A HALF AGO. IN JANUARY OF 2019. THESE WERE A SERIES OF ESSAYS THAT WERE COLLABORATIONS OF NUMEROUS NIH STAFF AS WELL AS SCIENTISTS FOCUSING ON 30 RESEARCH STRATEGIES AND METHODS TO ADVANCE THE FIELD OF MINORITY HEALTH ALABAMA HEALTH -- HEALTH ALABAM HEALTH DISPARITIES. THANK YOU VERY MUCH FOR YOUR ATTENTION AND I'M HAPPY TO ANSWER ANY QUESTIONS. >> THANK YOU. THAT WAS FANTASTIC. WE'VE GOT TIME FOR QUESTIONS. >> I HAVE A COUPLE OF QUESTIONS AND COMMENTS. THAT WAS AN IMPRESSIVE PRESENTATION AND I'M PARTICULARLY STRUCK BY THE SUCCESS OF THE LOAN REPAYMENT PROGRAM. I'D LIKE TO KNOW WHAT THE PLANS ARE FOR INCREASING THE SUPPORT FOR THAT PROGRAM. IT'S CLEARLY A MAJOR SUCCESS AND IT LOOKS LIKE THE FUNDING RATES OR THE SUCCESS RATES OF THE APPLICANTS COULD BE IMPROVED OR COULD BE HIGHER. AND MORE FELLOWS OR MORE APPLICANTS COULD BE SUPPORTED. THERE IS CLEARLY AN IMPACT OF THAT FUNDING ON THEIR LIVES AND ON SCIENCE. THE OTHER OVER-ALL COMMENT I HAVE IS GIVEN, IT'S BECOME FOR MANY OF US WHO ARE HEALTH DISPARITIES RESEARCHERS BEFORE COVID THE OVER-ALL BUDGET OF THE NIMHD WAS ALREADY CHALLENGING. GIVEN WHAT WE'RE ALL AWARE OF IN COVID DISPARITIES IS A PRIORITY FOR THIS COUNTRY AND IT'S NOT A TAKE FROM ONE GROUP AND GIVE TO ANOTHER KIND OF QUESTION. THE ISSUE IS WHETHER THE DISPARITIES THAT WERE -- HAVE BEEN HIGHLIGHTED THROUGH COVID ARE GOING TO BE A PRIORITY FOR RESEARCH. AND I'M WONDERING SO WHAT ARE THE STRATEGIES AND I KNOW AS DIRECTOR THIS MAY NOT BE IN YOUR PURVIEW BUT WHAT ARE THE STRATEGIES TO INCREASE THE OVER-ALL LEVEL OF SUPPORT FOR THE INSTITUTE FOR HEALTH DISPARITIES. >> THANK YOU, JENNIFER FOR THOSE TWO ITEMS. THE LOAN REPAYMENT PROGRAM IS IN 21st CENTURY CURES WAS RAISE THE CAP TO $50,000. THAT WAS A BIG CHANGE. CONGRESSIONALLY MANDATED. WE AT NIMHD HAVE CARRIED A DISPROPORTIONATE NUMBER OF APPLICANTS. ANY ANY. -- WE WOULD FUND BETWEEN 80-110 APPLICANTS A YEAR. FORTUNATELY THE OFFICE HAS NOW CREATED AND FACILITATED FOR ALL TO FUND THESE. AND ALSO CLINICAL RESEARCH WAS OPENED UP. SO NOW I HAVE NOT SEEN THE ANALYSIS RESULTS FOR FISCAL YEAR 2020 IT'S TOO EARLY. WE FUNDED A SLIGHTLY FEWER NUMBER. WE ALLOCATED THE SAME EXACT BUDGET. WE HAD FEWER APPLICANTS. WE HAD ABOUT HALF THE NUMBER OF APPLICANTS. BECAUSE A LOT OF THEM WERE GOING TO THEIR SPECIFIC INSTITUTE. WHERE THEIR LIKELIHOOD OF SUCCESS WAS GOING TO GO UP. ONE OF THE DIRECTORS SAID HOW COME THEY HAVE THE LOWEST RATE AND WE WERE FUNDING 20%-22%. I THINK THAT IS MOVING IN THE RIGHT DIRECTION. I MADE THIS PITCH TO THE OTHER DIRECTORS THAT THIS IS A PROGRAM THAT SEEMS TO HAVE WORKED. WE NEED TO WRITE UP OUR EXPERIENCE SO THAT THE WORLD KNOWS. THAT CASH ASSISTANCE SEEMS TO BE EFFECTIVE IN OTHER ARENAS SO WHY NOT IN RESEARCH. MY OWN STAFF SCIENTIST HAS BENEFITED FROM LOAN RELY PAYMENTS SINCE I BROUGHT HIM TO NIH. ANOTHER QUESTION IS A BIGGER ONE. OF COURSE I'M NOT IN A POSITION TO ADVOCATE FOR ANYTHING BUT I DO WANT TO EMPHASIZE THAT MINORITY HEALTH DISPARITIES RESEARCH AT NIMHD. -- ONE COULD SEE I REALLY WORKED HARD TO DIFFERENTIATE WHAT I WOULD CALL SCIENCE IN MINORITY HEALTH AND HEALTH DISPARITIES AS OPPOSED TO INCLUSION AND DIVERSITY OF PROGRAMS AND WE ARE ABLE TO SEPARATE THOSE BUCKETS IF YOU WISH INTO MORE DISCREET CATEGORIES ALTHOUGH SOMETIMES THEY DO BLEND WITH EACH OTHER AND THERE ARE MANY DISCUSSIONS ABOUT THINGS THAT I THINK OKAY -- WE CAN GO ON. THE TOTAL BUDGET THAT IS OFFICIALLY ALLOCATED IS SIGNIFICANT. IT'S UPWARDS OF $3.5 BILLION. THAT IS PER RCDC CATEGORIES. THERE IS I THINK INTEREST IN SEEING HOW MORE CAN BE DONE. AND TO LOOK SPECIFICALLY AT NIMHD TO DO THAT WE WILL HELP PROMOTE IDEAS BUT I THINK AN AREA IN THE NEAR FUTURE YOU'LL SEE SOME TRACTION COMING OUT OF THE NIH LEADERSHIP. I WOULD SAY THAT WHEN I FIRST GOT TO MY FIRST YEAR OF MAKING FUNDING DECISIONS WE WERE FUNDING GRANTS SCORING IN THE HIGH 30s. RO1 GRANTS BECAUSE WE WERE NOT ABLE -- ONCE I STARTED SHIFTING THE CENTER TO INVESTIGATOR INITIATED GRANTS WE DIDN'T HAVE THE VOLUME OF QUALITY APPLICATIONS THAT WERE GETTING THROUGH REVIEW. NOW WE HAVE ONE OF THE LOWEST FUNDING AWARD RATES OF ANY INSTITUTE. AND IN AN ANALYSIS INTERNALLY WE DISPROPORTIONATELY HAD -- MINORITY SCIENTISTS AND SMALLER INSTITUTES HAVE VERY LOW FUNDING RATES. SO I DO THINK THAT THERE IS INTEREST IN ADDRESSING THIS INTERNALLY SO I'LL LEAVE IT AT THAT. >> THANK YOU. OTHER QUESTIONS? CERTAINLY ADD THAT THE PARTNERSHIP OF NIA AND NIMHD HAS BEEN FRUITFUL AND A CHANCE TO WORK AND CONTINUE WORKING CLOSELY WITH ELISEO WHO HE NOTED HAD A LOT IN COMMON. THANK YOU FOR THE CHANCE TO WORK WITH YOU. >> THANK YOU SO MUCH, RICHARD AND I'M SURE WE WILL BE MEETING AT LEAST TWICE MORE THIS WEEK. >> ABSOLUTELY. >> GOOD LUCK WITH THE REST OF YOUR COUNCIL. IT WAS GREAT TO BE PART OF IT TODAY. >> NOW ONE ADDITIONAL POINT BEFORE WE TURN IT OVER TO OUR NEXT AGENDA ITEM. I SPOKE TO YOU ABOUT THE RESPONSIBILITY EVEN AS YOU LEAVE COUNCIL FOR CONTINUE TO BE AMBASSADORS. YOUR ABILITY TO HELP WITH REVIEW. REVIEW OF APPLICATIONS AND PEER REVIEW. YOU CAN DO THAT IN AN AD HOCK CAPACITY. YOU CAN DO THAT IN ANY CAPACITY WHEN YOU'RE OFF COUNCIL. FOR BETTER OR WORSE -- TO GIVE YOU A BREAK. PLEASE YOU ALL KNOW YOU CAN SEE HOW IMPORTANT PEER REVIEW IS. WE'LL CALL UPON YOU AND ENCOURAGE YOU TO PLAY A ROLE. YOU'RE THE MOST INFORMED ABOUT OUR PROGRAMS. PEER REVIEW IS AS IMPORTANT AS FUNDING. ALL RIGHT. THEN AND I KNOW YOU WILL ALL TAKE THAT VERY SERIOUSLY. OUR NEXT ITEMS COUNCIL GUEST SPEAKER. WE HAVE THE PRIVILEGE OF HEARING FROM DR. MONICA DRISCOLL. I DON'T KNOW IF WE HAVE AN INTRODUCTION. >> YES. >> IT'S MY PLEASURE TO INTRODUCE MONICA WHO'S KNOWN TO YOU FOR HER EXTRAORDINARY CAREER AND SERVICE ON COUNCIL AND AS RICHARD MENTIONED MANY SECTIONS -- MONICA RECEIVED HER PhD FROM HARVARD UNIVERSITY AND THEN WENT ON TO COMPLETE TRAINING -- AT COLUMBIA UNIVERSITY AND CURRENTLY IS A DISTINGUISHED PROFESSOR AT RUTGERS. AND HER RESEARCH FOCUSES AS WE'LL HEAR MORE ABOUT TODAY AND I'M REALLY DELIGHTED THAT WE HAVE TODAY -- THE BASIC BIOLOGY OF AGING AND UTILIZING CL AGAIN. SHE HAS BEEN A LEADER IN THE FIELD AND AN INNOVATOR. TO UNDERSTAND NOT ONLY NORMAL PROCESS OF AGING BUT ALSO CHALLENGES THAT ARE RELATED TO DEGENERATION PARTICULARLY NEURO DEGENERATION AND SHE HAS MORE RECENTLY DISCOVERED AND WE'LL PROBABLY HEAR MORE ABOUT THIS WHICH APPEARS TO PLAY AN IMPORTANT ROLE IN NEURO PROTECTION -- AS CL AGAINST AGES AND OF COURSE IT'S OF GREAT RELEVANCE TO THE DISEASE. THANK YOU VERY MUCH, MONICA FOR AGREEING TO TALK TO US AND PLEASE TAKE IT FROM HERE. >> THANK YOU SO VERY MUCH. HOPEFULLY YOU CAN HEAR ALL RIGHT. SO THANK YOU SO MUCH FOR THE OPPORTUNITY TO PRESENT SOME OF OUR WORK. IT'S REALLY A GREAT GROUP TO HAVE INTERACTED WITH. THIS IS THRILLING. I'M INVOLVED IN VERY BASIC RESEARCH AND IF WE CONSIDER REALLY FROM THE MOLECULAR TO THE CELCELLULAR TO ORGANISM LEVEL -- IT CAN BE CONSIDERED THROUGH ROBUST -- INTO FAILURE. OUR INTEREST LIKE MANY RESEARCHERS IN THE BIOLOGY OF AGING AND NEURO SCIENCE IS TO UNDERSTAND WHAT ARE THE MECHANISMS THAT MAINTAIN FUNCTIONALITY AND HOW DO THEY FAIL AND WHAT CAN WE DO TO PUSH THIS FORWARD SO THAT YOU HAVE A MORE ROBUST HEALTHY FUNCTION FOR A LONGER PART OF THE LIFETIME. AND SO IN OUR LAB WE CONSIDER SEVERAL -- WE LOOK AT THIS FROM SEVERAL DIFFERENT ANGLES. WE HAVE A PROJECT ON EXERCISE THAT IS SUPPORTED BY A PROGRAM OFFICER DAN WILLIAMS AND WE HAVE ANOTHER PROJECT THAT IS -- AN INTERVENTION TESTING PROGRAM SUPPORTED BY PROGRAM MEMBERS MAXWELL AND RON KOHANS KICK AND WE CONSIDER ENVIRONMENT INCLUDING DIET, GENES AND EVEN -- IMPACT ON HOW HEALTHY ORGANISMS AND CELLS CAN AGE WE HAVE A PARTICULAR FOCUS ON NEURONS AND THIS WORK HAS BEEN SUPPORTED BY INTERACTIONS WITH PROGRAM OFFICER BRAD WISE. SO I JUST WANT TO GIVE A SHOUT OUT TO NIA FOR ITS VERY STRONG SUPPORT OF BASIC RESEARCH. AS WE ALL KNOW THE MAJOR CHALLENGES FOR AN AGING NEURON. THERE ARE TWO REALLY BIG PROBLEMS. ONE IS PROTEIN AGGREGATION. WHICH ESSENTIALLY UNDERLIES EVERY NEURO DEGENERATIVE DISEASE THAT WE KNOW OF AND SECONDLY MITOCHONDIRAL DYSFUNCTION. SO MITOCHONDIRAL HEALTH IS ABSOLUTELY CRITICAL FOR NEURONS. AND SO TO KEEP THINGS CLEAN AND UNDERGOING -- SOME OF US DEVOTE A LOT OF EFFORT TO THIS HOMEOSTASIS. THERE AR -- ARE MECHANISMS AND ON THE MITOCHONDIRAL SIDE THERE ARE DEDICATED EFFORTS TO RECOGNIZE -- AND DEGRADE THEM THROUGH A SPECIALIZED PROCESS CALLED MITOFGY. NOW IN ADDITION TO THAT OUR PROBLEM GOT WORSE BECAUSE ALL OF THESE MECHANISMS ARE INTERNAL MECHANISMS IT'S BECOME CLEAR IN RECENT HISTORY THAT THESE AGGREGATES CAN ACTUALLY SPREAD TO PROMOTE PATHOGENESIS. SO YOU CAN GET A CRISIS IN ONE NEURON THROWING OUT AGGREGATING PROTEIN AND NOW IT GOES INTO ANOTHER NEURON AND THE SUPPORT. NOW OF COURSE BECAUSE THIS UNDERLIES PATHOGENESIS WE WANT TO KNOW WHY IS THIS HAPPENING? HOW AND WHAT ARE THE CONSEQUENCES FOR THE NEURON. THESE ARE REALLY CHALLENGING QUESTIONS TO ADDRESS IF YOU'RE LOOKING IN A A HIGHER ORGANISM AND WE'RE ALL INTERESTED IN WHAT HAPPENS IN HUMANS SO WE TURNED TO MODEL ORGANISMS AND I WANTED TO INTRODUCE THE WONDERFUL WORM. AND SO THIS IS A SIMPLE ANIMAL 959 CELLS. 302 NEURONS. WE KNOW HOW EVERY ONE OF THOSE NEURONS CONNECTS. KEY FEATURES ARE THAT THE ANIMAL IS TRANSPARENT SO WE CAN LOOK INSIDE THE ANIMAL AND THERE ARE VERY STRONG GENETICS. WE CAN INTRODUCE GENES AND TAKE THEM AWAY AND ASK SPECIFIC QUESTIONS ABOUT THE FUNCTIONS OF GENES AND WE CAN MAKE TRANCE AGAIN IT ANIMALS AND THIS ANIMAL LIVERS ABOUT THREE WEEKS. AND SO, ITS FANTASTIC SO WE CAN LOOK AT THAT. THE REASON THAT WE CAN KIND OF GET AWAY WITH THIS OR WE TAKE ADVANTAGE OF THESE EXPERIMENTAL ADVANTAGES AND DISSECT THESE MECHANISMS QUICKLY AND UNDERSTAND THE FUNDAMENTAL BIOLOGY AND WE TOTALLY BELIEVE THAT THE WORM IS A SMALL PERSON AND THE BASIC LESSONS THAT WE'VE LEARNED ACTUALLY HOLDS TRUE AND LET US GET INSIGHT INTO ASKING MORE SPECIFIC QUESTIONS IN THE HIGHER ORGANISMS. THERE ARE 302 NEURONS BUT ACTUALLY I'M GOING TO TELL YOU ABOUT ONE. BUT THIS IS A SET OF SIX TOUCH REE RECEPTORS. ONE IS THAT AS LABELED THEY ARE SUPER EASY TO SEE IN THE ANIMAL AND TWO -- THEY ARE MECHANOSENSORY. WITH OUR SOPHISTICATED A SAY OF AN EYELASH HAIR THAT IS ATTACHED TO A TOOTHPICK AND YOU CAN TOUCH THE ANIMAL AND IT WILL MOVE BACKWARDS. THAT IS THEIR FUNCTIONALITY. WE'VE BEEN INTERESTED IN WHAT HAPPENS TO THESE OVER THE LIFETIME OF THE ANIMAL. SO WE TRAIN A LOT OF UNDER GRADUATES IN EARLY SCIENCE AND THIS IS AN OBSERVATION ABSOLUTELY AMAZING OBSERVATION BY -- AND HIS JOB WAS TO LOOK AT AGING NEURONS AND HE NOTICED SOMETHING SUPER IMPORTANT AND TO REALLY DOCUMENT IT HE MADE THIS MOVIE. AND SO WHAT YOU'RE LOOKING AT ACTUALLY IS A NEURON IN THE CONTEXT OF A LIVING ANIMAL. HERE IS THE PROCESS AND HERE IS KIND OF -- THE CELL BODY. WHAT IS KEY IS THAT IT IS EXPRESSING WHAT TURNED OUT TO BE A NASTY M CHERRY -- THIS NEURON -- TAKES CONCENTRATES THIS M CHERRY AND THROWS IT OUT IN A COLOSSAL SIZE -- AND SO THIS EXTRUSION OF THE M CHERRY TAKES PLACE AS THIS MAJOR BUDDING OUT PROCESS AND WHEN IT LEAVES IT TAKES THE -- PLASMA MEMBRANE. WHAT IS OBVIOUS IS WHEN IN THE VERY FINAL STAGE OF MAKING -- THIS IS THERE IS A CONNECTION IN THE CELL BODY AND THIS LARGE EXTRUSION. AND THIS STRUCTURE STRUCTURE IS ANALOGOUS . 8 AND WE KNOW FROM THE WORM YOU CAN TRANSFER AGGREGATES, CALCIUM THROUGH THIS. BUT THE MAJORITY OF THE MATERIAL IS EXTRUDED IN THIS BIG BUDDING OUT EVENT. SO I WANT TO TELL YOU A LOT ABOUT THESE THINGS T. THREE THINGS FAST THAT THEY ARE NOT. THE FIRST IS THAT THEY ARE NOT RELATED TO -- EXOPHONES. 7 EXOPHERS ARE ABOUT 100 TIMES THICKER. IT'S NOT A CELL DIVISION. ALTHOUGH IT LOOKS LIKE IT COULD BE. SO WE ALWAYS HAVE THE NUCLEUS NEVER GOES INTO THIS. AND THEN FINALLY AND I HOPE YOU CAN SEE THIS TO MAKE A LONG STORY SHORT EVEN THOUGH I TOLD YOU THAT WE WATCHED THIS WITH THIS NASTY M CHERRY YOU CAN FIND MORE KIND WAYS TO LABEL NEURONS SO FOR EXAMPLE BY DYE FILLING. IN THE ABSENCE OF MAKING TOXIC TRANCE GENES. HOW DO YOU TELL WHAT WAS TRASH AND NOT. WHAT CELL MACHINERY IS NEEDED TO RECOGNIZE THIS TRASH. WHAT IS THE TRIGGER? HOW DO YOU DECIDE WHEN TO DO IT AND WHY. WHAT IS THE FATE OF THE NEURON FOR MAKING THIS DRAMATIC EXIT. AND THEN WHAT IS THE FATE OF THE EXTRUDED MATERIAL AND THESE QUESTIONS RELATE TO PROBLEMS TO QUESTIONS THAT ARE PERTINENT TO A MILLION BIOLOGY ABOUT AGGREGATE TRANSFER -- AT THE FUNDAMENTAL LEVEL. SO WHAT GETS THROWN OUT? I TOLD YOU ALREADY THE NASTY M CHERRY GETS THROWN OUT. BUT LET ME TELL YOU A LITTLE BIT ABOUT A MORE POSSIBLY FAMILIAR TOXIC -- THAT EXPRESS SHORT POLLY Qs THAT ARE NOT TOXIC. AND THAT COMPROMISES NEURAL FUNCTION SO WHEN WE DO THAT AND TAG IT HERE IS A TYPICAL LOOK YOU HAVE AN AGGREGATE AND A SOMA. HERE IS ONE BEGINNING TO FORM AND YOU CAN SEE THAT THE -- ALL OF THE VISIBLE POLLY Qs SEEM TO BE GOING IN TO THIS DOMAIN AND HERE IS A MORE MATURE ONE. ALL OF THE POLLY Q THAT WE CAN SEE IS IN THERE AND AS THIS PROCESS IS REASONABLY EFFECTIVE PROBABLY TO OUR EYE ABOUT HALF OF THE EVENTS TAKE AWAY ALL OF THE POLLY Q. THIS SUGGEST TO US THAT THERE IS SOME SORT OF TRASH KIND OF STIMULUS FOR THROWING THINGS OUT. NOW THOSE EXOFFICERS ARE HUGE -- THE EXOPHERS -- WE MADE A TAG FOR THAT. IT CAN THROW OUT ROUGH ER. ONE OTHER THING THAT IT CAN THROW OUT IS MITOCHONDIRAL. IN THIS SLIDE WHAT IS LABEL IS MITOCHONDIRAL MIGHT THERE ARE PLUMPED MITOCHONDIRAL OR IN THAT ONE -- IN THIS ONE EVEN NETWORKED MITOCHONDRIA CAN MEET. WHAT IS THE QUALITY? ARE THEY DAMAGED OR NOT? WE'RE WORKING ON THIS. BUT BASICALLY I'LL TELL YOU ONE FUN GENETIC EXPERIMENT THAT IS SO NICE AND CLEAN SO WE'RE EXCITED ABOUT IT. IT GOES WITH TWO WAYS THAT YOU CAN DAMAGE MITOCHONDRIA IF YOU WANT. ONE IS TO INCREASE THE AMOUNT OF SUPER OXIDE. EXFOR. -- THATHERE ARE FOUR OF THESE. TWO OF THEM WORK IN THE CITO CLASSISM AND TWO OF THEM ARE EXPRESSED IN THE MITOCHONDRIA. AND SO WE CAN TAKE THESE OUT. IN EITHER COMPARTMENT AND WHEN WE DO WHAT WE THINK HAPPENS IS THE SUPER OXIDE LEVELS GO UP SO THE QUESTION IS WHAT HAPPENS? AND WHAT HAPPENS IS SUPER DRAMATIC AND WHILE THERE IS A LOW LEVEL OF BASELINE EXOPHERS. AND IF YOU LOOK AT AND MESSED UP THE SITE IT DOESN'T CARE. IT DOESN'T THROW AWAY MORE MITOCHONDRIA BUT IF YOU HAVE TAKEN AWAY THE DEFENSE AND JACKED UP IT UP -- YOU MAKE A WHOOPING NUMBER. I FEEL LIKE I'M GOING FAST. THAT WAS A SELF-TIMER. 7 SO WHAT THIS SAYS TO US IS ELEVATED MITOCHONDIRAL SUPER OXIDE. IT ALSO SUGGEST THAT MITOCHONDRIA COULD BE INDUCE A SIGNAL AND CALLING BOTH OF THESE THINGS ARE A LITTLE BIT TRICKY SO ONE OTHER THING ABOUT THE CARGO IS THAT THE OFFENSIVE PROTEINS APPEAR TO BE SELECTIVELY THROWN OUT. YOU DON'T NECESSARILY THROW EVERYTHING. SO HERE IS A NICE STUDY WHERE HE CO-EXPRESSED THIS NASTY M CHERRY WITH NICE SOLUBLE GREEN FLUORESCENT PROTEIN. HERE IS ANNEX FOR AND YOU CAN -- HERE IS AN EXFOR IN TERMS OF CARGO -- THEY SEEM TO BE PREFERENTIALLY INCLUDED AND WE GET THE IDEA THAT THIS IS A MECHANISM MAYBE A NEW MECHANISM WHERE YOU'RE GETTING CLOSE TO THE EDGE. IT'S AN OPTION TO THROW OUT YOUR TRASH. SO WE WANT TO KNOW WHAT CELL MACHINERY ACCOMPLISHES THIS AND WE DO THIS PRIMARILY BY GENETICALLY DISRUPTING CERTAIN GENES AND WE'RE REALLY CURIOUS HOW THESE THINGS CONTRIBUTE TO BUDDING EXTRUSION AND TRASH COLLECTION. I'M GOING TO TELL YOU QUICKLY THE PUNCH LINE. IF YOU INJECT A POLLYQ PROTEIN IT WILL START TO DISPERSE BUT BECOME COLLECTED AND BECOME, MAKE A PERRY NUCLEAR FOCUS THAT IS ASSOCIATED. THERE ARE TRASH. THERE ARE ADAPTER PROTEINS THAT CARRY THESE THINGS. THERE IS A -- MOTOR AND THEN THESE FILLMENTS SURROUNDING THESE THINGS. TO MAKE A LONG STORY SHORT I WANT TO TELL YOU SOME OTHER THINGS. THAT MANY GENES THAT ARE INVOLVED IN EFFICIENT EXFOR PRODUCTION ARE SO THIS IS PRETTY COOL. 7 THAT TRASH MAY BE COLLECTED IN THE SAME WAY. SO THERE ARE -- THERE ARE TRIGGERS THAT INCREASE EXOPHOR BY ACCIDENT. THESE ARE THREE OF THEM. YOU CAN TAKE AWAY FOOD FOR SIX HOURS AND YOU MAKE A LOT MORE EXOPHORS. SO ZERO. YOU CAN INTRODUCE -- STRESS AND YOU CAN INTRODUCE OXIDATIVE STRETCH AND I'M SHOWING INCREASING OXIDATIVE STRESS TO MAKE THE POINT THAT YOU CAN ACTUALLY GO TOO FAR. SO THERE ARE VERY SPECIFIC ENVIRONMENTAL STRESSORS THAT MARKETLY INCREASE THE NUMBER OF EXOPHORS SO BASICALLY TO SUMMARIZE THIS IDEA AGAIN NORMALLY CELL -- STATION US TAKES CARE OF THINGS. YOU ARE NOT PERMITTED TO TAKE AN EXOFOR LATER. WE'VE IDENTIFIED A PATH. AND THEN THERE IS A PATHWAY THAT SEEMS TO BE REQUIRED FOR TELLING THE NEURON TO MAKE MORE. ALL OF THIS IS HAPPENING OUTSIDE OF THE NEURON SO, ITS RESPONDING TO ITS ENVIRONMENT. INSULIN SIGNALING. LOCAL INSULIN SIGNALING ALSO MAKES -- SO I JUST WANT TO TELL YOU TWO PUNCH LINES QUICKLY AS TIME IS LIMITED. IS THIS A GOOD THING? IT'S A HORRIBLE LOOKING THING. THIS IS HUGE. THIS NEURON HAS LOST HALF OF ITSELF. SO THE QUESTION IS CAN THIS BE A GOOD THING? IT ACTUALLY SEEMS LIKE IT CAN BE. SO AS I TOLD YOU ONLY GARBAGE CAN BE THROWN AWAY. THE NEURONS DON'T DIE AND IN FACT IF YOU JUST TEST THAT TOUCH FUNCTIONALITY THE NEURONS WORK FINE AND IN FACT YOU CAN DO THINGS WITH THE POLLYQ AGAIN AND I'M NOT GOING TO GO INTO THE DETAILS -- AND THE TOUCH DECLINES IN THESE POLLYQ -- POLYQ. THAT IS LIKE LOOKING OVER THE WHOLE LIFE. IF EVERYTHING IS GOOD IF WE HAVE NOT STRESSED THE ANIMALS IN THEIR CUSHY LAB LIFE THOSE NEURONS DON'T DIE. IT DOESN'T MATTER IF YOU MAKE AN EXOFOR OR NOT. AND THIS IS DATA THAT WE JUST GENERATED. SO THIS -- CAN BE GOOD AND NO STRESS BUT IT CAN BE BAD IF CONTINUED WITH HIGH STRESS. I'M NOT GOING TO HAVE TIME TO TELL YOU ABOUT WHAT HAPPENS TO THE EXTREATED EXOPHERS. IT'S SUPER INTERESTING. THE NEURON HAS TO BECAUSE OF THE ANATOMY OF THE WORM IT HAS TO HAND OFF THIS GARBAGE TO A HYPER DERMAL CELL. AND THIS IS IN THE CONTEXT OF A HYPO DERMIS BUT IT GETS BROKEN UP AND WE KNOW THIS GOES INTO THE -- NETWORK OF THAT SURROUNDING HYPO DERMAL CELL SO, ITS TRYING HARD TO DEGRADE AND WE CALL THIS STARRY NIGHT AND I'M NOT GOING TO TELL YOU THE DETAILS BUT WE KNOW THAT -- AGGREGATES CAN INTEGRATE IT AND THE NASTY M CHERRY IS IT REALLY GETTING DEGRADED? THE ANSWER IS NO AND WE KNOW THAT BECAUSE THERE ARE OTHER CELLS IN THE WORM WHOSE JOB IS TO TAKE THAT MATERIAL THAT IS EXTRUDED INTO THIS BODY FLUID AND ALTHOUGH THE NEURONS CANNOT GET TO THAT THE HYPO DERMIS CAN ACTUALLY DO THAT AND IF YOU LOOK LATER AT WHAT HAPPENS TO THE RED MATERIAL THAT CAME FROM THE NEURON IT ENDS UP IN THE REMOTE CELLS. SO THERE IS A PROCESS WHERE A NEURON THROWS OUT GARBAGE. THE GLEA TRIES TO DO WHAT IT CAN AND IF NOT THE HYPER -- THROWS IT OUT AGAIN AND GOES INTO THE LONG-TERM TRASH. SO BASICALLY I WANT TO POINT OUT THAT WHAT WE THINK -- WHAT WE HOPE IS THAT THE FUNDAMENTAL BIOLOGY OF THIS PROCESS WILL INFORM ON WHAT CAN HAPPEN AS NEURONS PASS OUT AGGREGATES AND ALTHOUGH I'M NOT -- THERE ARE ACTUALLY EXAMPLES THAT LOOK VERY SIMILAR. ONE IS THIS TRANCE CELLULAR DEGRADATION AND THERE IS ANOTHER PAPER. THERE IS AN EXCITING PAPER BY THIS GROUP IN SPAIN AND YOU WOULD NEVER THINK THIS IS EXOPHERS BUT THE PROCESS LOOKS VERY MUCH LIKE CARDIO MY CITES. CAN EXTRUDE MITOCHONDRIA. SO THAT PAPER IS COMING OUT OCTOBER 1st AND WE'RE TALKING TO EACH OTHER TO MAKE THAT CONNECTION BETWEEN WORMS AND MAMMALS. I TRIED TO MENTION PEOPLE AS WE WENT THROUGH BUT ALSO MY COLLEAGUE WHO SHARES SOME MONEY -- SO I'LL STOP THERE AND HAPPY TO TAKE QUESTIONS OR STAY ON IF PEOPLE WANT TO TALK MORE BUT I APOLOGIZE IT'S AFTER 1:00. 7. >> THANK YOU, MONICA. QUESTIONS FOR DR. DRISCOLL? PLEASE USE THE CHAT ALSO. AND COUNCIL MEMBERS JUST PRESS ON MUTE. >> MONICA, THAT WAS REALLY NICE. HOW MANY GENES IN THE C AN ELEGANCE GENOME AND OF THOSE JONES HOW MANY -- ARE IN HUMAN. >> LET'S SAY ON THE ORDER OF LIKE 18,000 GENES -- SO CELYCANGS -- WHERE YOU DRAW THE LINE ON WHAT IS A REAL HOMO LOG OR NOT IS A MATTER OF DISCUSSION. BUT IN GENERAL THERE ARE 70% OF -- GENES LOOK TO HAVE AT LEAST REASONABLE HOMO LOGS. >> MONICA THIS IS ALLISON HERE. I WAS WONDERING IF YOU HAD LOOKED AT THE ALS ASSOCIATED MUTATIONS IN YOUR FUNCTIONAL A SAYS TO SEE IF THOSE MUTATIONS HAD ANY IMPACT. >> THAT IS A GREAT SUGGESTION AND OUR COLLEAGUE ANN HART OF BROWN HAS A GREAT COLLECTION WHERE SHE HAS MADE SINGLE COPY AND WE'VE STARTED A PROJECT ON THIS AND HER GRADUATE STUDENT LEFT AND WE HAVE NOT DONE THOSE EXPERIMENTS YET BUT IT'S A VERY INTERESTING QUESTION. >> I WAS INTERESTED IN THE PAPERS THAT ARE COMING OUT IN THE SOUTH BECAUSE WHEN YOU THINK ABOUT THE INVOLVEMENT OF ALZHEIMER'S DISEASE -- >> RIGHT. SO WE'RE REALLY EXCITED AND STRUCK BY THE PARALLELS AND IT WOULD BE SOMETHING IS THAT THE PAPER IS IMMUNOLOGY AND SOME ACTUALLY MY GRADUATE STUDENTS -- IT WAS SUCH A COOL CONNECTION. SO TO SPEAK TO THE BASIC BIOLOGY I THINK ACTUALLY A NUMBER OF DIFFERENT CELL TYPES HAVE THE CAPACITY TO EXPEL IN THESE DRAMATIC EVENTS THINGS THAT THEY DON'T REALLY CARE FOR. AND THOSE EXPULSIONS INFLUENCE BOTH THE SENDING CELL AND THE RECEIVING CELL AND THAT FUNDAMENTAL BIOLOGY IS NOT UNDERSTOOD BY I SUSPECT ACTUALLY SUPER IMPORTANT. >> MONICA, THIS IS CLIFF. GREAT TALK. WHAT ABOUT -- IT'S AWFULLY BIG. CAN IT BE INSIDE THESE EXOPHERS. >> THAT IS A GREAT QUESTION. AND WE HAVE NOT REALLY DONE THAT EXPERIMENT. WE HAVE A MODEL AND IT JUST WAS NOT BEHAVING SUPER WELL. OUR SUSPICION WAS THAT THE GFP TAG WAS MESSING IT UP. ACTUALLY REALLY LOW EXPRESSION. AND SO WE HAVEN'T DONE THAT SPECIFIC EXPERIMENT. WE'VE LOOKED AT A BETA 1-42. THAT CAN INCREASE THE NUMBER OF EXOPHERS AND THEN WE TRIED SOME OTHER THINGS THAT HAVE THESE WEIRD -- TENDENCY TO AGGREGATE AND THOSE ALSO INCREASE THE NUMBER OF EXOPHERS. >> ANY OTHER QUESTIONS FOR MONICA? ALL RIGHT. MONICA, I JUST WANT TO THANK YOU VERY MUCH FOR A TERRIFIC TALK. VERY COMPREHENSIVE AND GAVE US A GREAT OVERVIEW OF YOUR WORK. AND THANK YOU VERY MUCH. >> THANK YOU SO MUCH FORGIVING ME THE CHANCE TO SHARE WITH YOU GUYS. AND THANKS AGAIN TO THE NIA FOR ALL OF THEIR SUPPORT. >> ALL RIGHT. THEN. SO THAT CONCLUDES OUR AGENDA FOR TODAY. THIS THEN ENDS THE 141st NATIONAL ADVISORY COUNCIL ON AGING. I'M OFFICIALLY ADJOURNING OUR MEETING AND I WANT TO THANK OUR COUNCIL MEMBERS AND OUR STAFF FOR ALL OF THEIR HARD WORK AND LOOK FORWARD TO WORKING WITH YOU AGAIN IN JANUARY. RICHARD, ANY FINAL COMMENTS. >> I WOULD ALSO LIKE TO THANK MONICA AND ONE OF THE ADVANTAGES WE'RE NOT LIMITED TO A BOX LUNCH AND A RUN TO THE AIRPORT. SO THERE ARE SOME OF ADVANTAGES. BUT THANK YOU ALL FOR MAKING IT A MOST PRODUCTIVE OCCASION. WE'VE GOT SOME ACTION ITEMS WE AGREED UPON. WE'LL BE NEGOTIATING AND DISCUSSING OVER THE NEXT WEEKS AND MONTH. STAY SAFE AND STAY HEALTHY. >> GOOD-BYE, EVERYBODY. >> THANK YOU.