>>THIS IS THE NIAAA DIRECTOR'S
REPORT.
I HAVE TO OPEN THE SESSION.
SORRY ABOUT THAT.
I WOULD LIKE TO WELCOME YOU TO
THE 164th MEETING OF THE
NATIONAL ADVISORY COUNCIL ON
ALCOHOL ABUSE AND ALCOHOLISM.
I'LL CALL ON EACH COUNCIL
MEMBER, BOTH ONLINE AND PRESENT
IN THE ROOM, AND IF YOU COULD
JUST SAY A WORD ABOUT YOURSELF,
WHERE YOU'RE FROM, AND YOUR
MAJOR INTEREST.
SO NANCY BARNETT?
MEANS?
>> HI, NANCY BARNETT, SCHOOL OF
PUBLIC HEALTH, BROWN UNIVERSITY,
ADOLESCENT INTERVENTION, SOCIAL
NETWORKS.
>> CHRISTINA CARPENTER.
>> I THINK THAT'S CHRISTOPHER,
IF THAT'S ME, I'M SORRY FOR
STEPPING IN.
SORRY I CAN'T BE WITH YOU TODAY.
>> CHRIS CARPENTER.
>> I'M CHRISTOPHER CARPENTER,
VANDERBILT UNIVERSITY,
INTERESTED IN PUBLIC POLICY AND
ADOLESCENTS.
>> I WAS LOOKING AT CHRISTINA
CHAMBERS, MIXED YOU UP.
CHRISTINA CHAMBERS?
>> THANKS, GEORGE.
TINA CHAMBERS, EPIDEMIOLOGIST,
PROFESSOR OF PEDIATRICS,
UNIVERSITY OF CALIFORNIA SAN
DIEGO, AND THE AREA I WORK IN IS
FETAL ALCOHOL SPECTRUM DISORDERS
AND PRENATAL ALCOHOL EXPOSURE.
>> AND NANCY GONZALEZ.
ALSO ON ZOOM.
>> HELLO.
SORRY I CAN'T BE THERE TODAY.
NANCY GONZALEZ, ARIZONA STATE
UNIVERSITY.
I STUDY -- PREVENTION SCIENTIST,
I STUDY HIGH RISK POPULATIONS,
PARTICULARLY LATINX POPULATIONS
AND OTHER UNDERREPRESENTED
GROUPS TO DESIGN PREVENTIVE
INTERVENTIONS FOR COMMUNITY
IMPLEMENTATION.
>> THANKS.
AND RHONDA JONES-WEBB.
>> YES, GOOD MORNING, I'M RHONDA
JONES-WEBB, PROFESSOR IN
DIVISION OF EPI AND COMMUNITY
HEALTH, UNIVERSITY OF MINNESOTA
SCHOOL OF PUBLIC HEALTH.
MY RESEARCH FOCUSES ON ALCOHOL
EPIDEMIOLOGY AND POLICY, FOR
SPECIAL EMPHASIS ON RAISED CLASS
AND NEIGHBORHOOD INFLUENCES.
>> BETH KING DAVIDSON.
>> DIRECT CARE PROVIDER,
SUBSTANCE USE DISORDERS, I'VE
BEEN DOING IT SINCE 1978, JUST
RECENTLY RETIRED FROM SUBURBAN
HOSPITAL, JOHNS HOPKINS, AS
DIRECTOR, CONTINUE A PRIVATE
PRACTICE.
>> THANKS.
DAVID KERRIKAN.
>> PROFESSOR IN DEPARTMENT OF
NEUROLOGY, INDIANA UNIVERSITY
SCHOOL OF MEDICINE AND DIRECTOR
OF THE ALCOHOL RESEARCH CENTER
THERE, MAJOR INTERESTS ARE IN
FUNCTIONAL IMAGING IN HUMANS OF
ALCOHOL USE DISORDER RISK.
>> AND CHARLES CHUCK LANG?
>> THANKS.
CHUCK LANG, PENN STATE COLLEGE
OF MEDICINE, INTERESTS IN
METABOLIC EFFECTS OF ALCOHOL ON
SKELETAL CARDIAC MUSCLE AND
DEVELOPMENT OF MYELOPATHY IN
THOSE TISSUES.
>> MARY LARIMER?
>> HI, MARY LARIMER, PROFESSOR
OF PSYCHIATRY AND BEHAVIORAL
SCIENCE AND PSYCHOLOGY
UNIVERSITY OF WASHINGTON,
DIRECTOR OF CENTER FOR STUDY OF
HEALTH AND RISK BEHAVIORS, AREAS
OF INTEREST ARE ETIOLOGY
PREVENTION AND TREATMENT OF
ALCOHOL USE DISORDERS AND
RELATED COMORBID CONDITIONS,
PRIMARY YOUNG ADEALTS,
ADOLESCENTS, COLLEGE STUDENTS.
>> MICHAEL LEWIS.
>> CITY UNIVERSITY OF NEW YORK,
HUNTER COLLEGE GRADUATE CENTER,
INTERESTED IN NEUROBEHAVIORAL
AND MOTIVATIONAL FACTORS
INVOLVED WITH ALCOHOL USE
DISORDER, AND EATING DISORDERS.
>> THANKS.
AND LAUREN NAGY ON ZOOM.
LAURA?
>> HI, YES, SORRY I CAN'T BE
THERE BUT I'M LAURA NAGY,
CLEVELAND CLINIC, DEPARTMENT OF
INFLAMMATION AND IMMUNITY,
INTERESTED IN THE ROLE OF INNATE
IMMUNE ACTIVITY IN ALCOHOL
ASSOCIATED LIVER DISEASE.
>> THANKS.
LAURA O'DELL.
>> UNIVERSITY OF TEXAS AT EL
PASO, PROFESSOR OF BEHAVIORAL
NEUROSCIENCE AND MY INTERESTS
ARE IN RODENT MODELS OF
SUBSTANCE USE DISORDER, WITH
PARTICULAR INTEREST IN
VULNERABLE POPULATIONS.
>> AND LAST BECAUSE HER LAST
NAME STARTS WITH A W, KATIE
WIKOWITZ.
>> PROFESSOR, DEPARTMENT OF
PSYCHOLOGY, DIRECTOR OF CENTER
ON ALCOHOL SUBSTANCE USE AND
ADDICTIONS, UNIVERSITY OF NEW
MEXICO, RESEARCH IS BROADLY ON
TREATMENT AND RECOVERY OF
ALCOHOL USE DISORDER.
>> THANKS, EVERYBODY.
GREAT TO SEE YOU ALL, ALL
COUNCIL MEMBERS HERE.
AND SO MANY OF YOU PRESENT IN
PERSON.
HOPEFULLY WE'LL HAVE SOME GOOD
DISCUSSIONS LATER ON.
YOU KNOW WHO I AM, DIRECTOR OF.
TRISH?
>> TRISH POWELL, DEPUTY
DIRECTOR, NIAAA.
>> AND THEN IS VICKIE ONLINE?
>> YES.
>> VICKIE?
>> GOOD MORNING, EVERYONE.
GOOD TO SEE YOU ALL.
VICKIE BUCKLEY, EXECUTIVE
OFFICER AND DEPUTY ETHICS
COUNSELOR FOR NIAAA.
>> I'LL HAVE THE DIRECTOR
INTRODUCE THEMSELVES AGAIN.
KATHY JUNG.
>> GOOD MORNING.
I WISH I COULD BE THERE WITH
YOU, KATHY JUNG, DIRECTOR OF THE
DIVISION OF METABOLISM AND
HEALTH EFFECTS, NIAAA.
>> ANTONIO.
>> HELLO, ANTONIO NORONHA,
DIRECTOR OF DIVISION OF
NEUROSCIENCE AND BEHAVIOR AT
NIAAA.
>> RALPH?
>> GOOD MORNING, DIVISION OF
EPIDEMIOLOGY, VETERAN RESEARCH
AT NIAA.
>> BRIDGET?
>> GOOD MORNING, BRIDGET
WILLIAMS-SIMMONS, ASSOCIATE
DIRECTOR FOR BASIC RESEARCH.
SORRY I COULDN'T BE THERE BUT
SOMEONE IN THE HOUSE HAS COVID.
GOOD TO BE HERE.
>> AND DAVID L,VINGER?
>> YES, I AM THE SCIENTIFIC
DIRECTOR OF THE DIVISION OF
INTRAMURAL CLINICAL AND
BIOLOGICAL RESEARCH, INTRAMURAL
PROGRAM AT NIAAA.
>> AND DAVID GOLDMAN, ARE YOU
ON, DAVID?
>> YES, I AM.
THANK YOU, GEORGE.
CLINICAL DIRECTOR NIAAA, ALSO ON
A COVID QUARANTINE.
SORRY THAT I CAN'T BE THERE.
>> PHILIPPE?
>> YES, PHILIPPEMARMILLOT,
DIRECTOR OF EXTRAMURAL
ACTIVITIES.
>> AND R.V.
>> R.V. SRINIVAS.
>> NOW IT'S TIME FOR MY
DIRECTOR'S REPORT.
IT'S NOT A LONG ONE THIS TIME,
AT LEAST I HOPE IT'S NOT.
AND IT'S A PLEASURE TO SEE
EVERYBODY HERE.
>> GEORGE, WE DID MISS RAY LITON
IN INTRODUCTIONS.
>> WE ALWAYS MISS SOMEBODY.
RAY, SORRY ABOUT THAT.
>> THAT'S OKAY, GEORGE.
RAY LITTON, DIRECTOR OF DIVISION
OF TREATMENT RECOVERY RESEARCH
AT NIAAA.
>> WHEN I MAKE THESE MISTAKES I
DON'T REALIZE PEOPLE THINK MAYBE
THEY HAVE BEEN FIRED IN THE
INTERIM.
YOU'RE STILL HERE, RAY, AND WE
LOVE YOU.
NOW TO THE DIRECTOR'S REPORT.
SO, WE START WITH SAD NEWS.
ANN SDREISSGUTH PASSED WITH A,
PROFESSOR IN DEPARTMENT OF
PSYCHIATRY AND BEHAVIORAL
SCIENCES AT UNIVERSITY OF
WASHINGTON SCHOOL OF MEDICINE,
BECAME THE FOUNDING DIRECTOR OF
THE SCHOOL'S FETAL ALCOHOL AND
DRUG UNIT, RENOWNED AS EXPERT ON
FETAL ALCOHOL SPECTRUM DISORDERS
AND CO-PUBLISHED FIRST STUDY
IDENTIFYING FETAL ALCOHOL
SYNDROME IN THE UNITED STATES,
AND ITS LINK TO MATERNAL ALCOHOL
CONSUMPTION IN PREGNANCY.
FOR 30 YEARS SHE LED THE
NIAAA-FUNDED LONGITUDINAL STUDY
ALCOHOL INTAKE DURING PREGNANCY,
OFFSPRING DEVELOPMENT,
QUOTE/UNQUOTE, THAT FOLLOWED
STUDY PARTICIPANTS FROM
CHILDHOOD INTO ADULTHOOD, TO
BETTER UNDERSTAND THE LONG-TERM
NEURAL DEVELOPMENTAL
CONSEQUENCES OF FETAL ALCOHOL
SPECTRUM DISORDER.
SHE WAS AN OUTSTANDING
SCIENTIST, ESTEEMED COLLEAGUE,
GENEROUS MENTOR.
SHE WILL BE SORELY MISSED, AND
I'M SURE THERE WILL BE SOME
CELEBRATIONS OF HER CAREER,
CERTAINLY AT RSA BECAUSE OF HER
SEMINAL CONTRIBUTIONS.
SOME INSTITUTE UPDATES, SOME OF
YOU, MANY ARE AWARE THAT TWO
SENIOR STAFF ANNOUNCEMENTS, DR.
DAVID LOVINGER IS NEW
SCIENTIFIC DIRECTOR, WAS ACTING
DIRECTOR FOR SOME TIME, PROVIDES
SCIENTIFIC PROGRAM AND
ADMINISTRATIVE LEADERSHIP.
ALSO RESPONSIBLE FOR PROMOTING
INCLUSIVE ENVIRONMENT THAT
VALUES DIVERSE PERSPECTIVES,
ENCOURAGES COLLABORATION,
FACILITATES INNOVATIVE RESEARCH,
AS I SAID WAS PREVIOUSLY NIAA'S
ACTING SCIENTIFIC DIRECTOR IN
ADDITION TO HIS NEW ROLE, HE
WILL CONTINUE TO DIRECT
LABORATORY FOR INTEGRATIVE
NEUROSCIENCE WHICH EXAMINES THE
ROLE OF PARTICULAR MOLECULES AND
IN THE NEURAL BIOLOGY OF ACUTE
ALCOHOL SEEKING BEHAVIOR, HE HAS
AN ACTIVE AND FORWARD-LOOKING
LABORATORY WITH MAIN SEMINAL
CONTRIBUTIONS SO I THINK THE
COMBINATION OF HIS OWN WORK AND
GUIDANCE OF THE IRP IS GOING TO
PUT US IN GOOD STEAD FOR THE
FUTURE.
MS.DAWN WAYMAN IS NIAAA'S NEW
SCIENTIFIC DIVERSITY OFFICER,
HELPING TO CATALYZE AND
COORDINATE NIAAA-SPECIFIC GOALS
AND RESOLVE CRITICAL ISSUES THAT
WILL ENHANCE DIVERSITY AND
EQUITY OF RESEARCH PROGRAMS.
MS.WAYMAN WAS PREVIOUSLY BRANCH
DIRECTOR FOR STRATEGIC DIVERSITY
AND INCLUSION IN NIH'S OFFICE OF
EQUITY, DIVERSITY, AND
INCLUSION.
WE'RE REALLY, REALLY HAPPY TO
HAVE DAWN WITH US.
I HOPE COUNCIL MEMBERS WILL
INTERACT WITH DAWN IN THE
FUTURE.
I KNOW SHE'S ALREADY REACHING
OUT TO NIAAA STAFF, LISTENING
AND WATCHING AND STARTING TO
INSTIGATE PROGRAMS THAT WE --
INTRODUCE PROGRAMS WE HOPE TO
INSTIGATE AND UTILIZE IN OUR
EFFORTS IN THIS AREA.
IT'S A REALLY HIGH PRIORITY AT
NIAAA AND I HOPE YOU ALL REALIZE
THAT IT IS.
THE BUDGET.
SO WE'RE CLOSING OUT FISCAL YEAR
2023 FOR WHICH NIAAA RECEIVED A
TOTAL OF ALMOST $600 MILLION,
INCLUDING $1.3 MILLION AIDS
TRANSFER.
THE BUDGET FOR 2024 IS NOT
FINALIZED.
I DIDN'T LET STAFF PUT VERBIAGE
ON HERE, PERHAPS I SHOULD,
BECAUSE THIS CAME UP AT THE
INSTITUTE DIRECTOR'S MEETING
THAT I PARTICIPATED IN ABOUT AN
HOUR AGO THIS MORNING.
THE OUTLOOK FOR 2024 IS NOT
GOOD.
ALL RIGHT.
THERE'S GOING TO BE, AT BEST, A
CONTINUING RESOLUTION.
EVEN IN THE CONTEXT OF THE
CONTINUING RESOLUTION, BECAUSE
OF PAY INCREASES, ALL KINDS OF
TAPS, ALL KINDS OF THINGS THAT
HAPPENED THAT WE HAVE TO DEAL
WITH ON A YEARLY BASIS, SOME ARE
JUST CONVERGING AT THIS GIVEN
TIME, THERE'S GOING TO BE SOME
BUDGET TIGHTENING.
AND WE'RE GOING TO BE WORKING
WITH OUR STAFF AT NIAAA TO SEE
HOW WE CAN, YOU KNOW, MITIGATE
SOME OF THIS BUT I JUST WANT YOU
AS COUNCIL MEMBERS TO GET THE
WORD OUT THERE, PRIORITIES HERE
AT NIAAA ARE GOING TO BE
EARLY-STAGE INVESTIGATORS AND
INVESTIGATORS AT RISK.
AND THAT COMES OFF THE TOP.
AND THAT'S WHAT LARRY TABAK,
ACTING DIRECTOR OF NIH, SAID
THIS MORNING ABOUT AN HOUR AGO,
HOUR-AND-A-HALF AGO.
THAT'S WHAT'S GOING TO COME OFF
THE TOP.
I JUST WANT YOU TO REALIZE THAT
THERE'S GOING TO BE CRUNCHES ON
THE REST.
YOU DO WHAT YOU WILL WITH THIS
INFORMATION BUT I THINK YOU
SHOULD GET BACK TO YOUR LOCAL
AREAS AND POINT OUT TO THEM
THAT, YOU KNOW, THERE'S GOING TO
BE NO -- WE SEE NO CAVALRY
RESCUE IN MARCH.
THAT'S THE FINAL WORD THAT LARRY
SAID.
YOU KNOW, WE JUST DON'T SEE IT.
AND SO JUST BEAR IN MIND.
I CAN'T GIVE YOU ANY CONCRETE
DECISIONS THAT WE'RE GOING TO
MAKE AS AN INSTITUTE AT THIS
POINT BUT WANT YOU TO REALIZE WE
KNOW, I WANT YOU TO KNOW, I'D
LIKE THE EXTRAMURAL COMMUNITY TO
KNOW THAT IT'S GOING TO BE A
TIGHT YEAR.
ALL RIGHT?
AND WE JUST DON'T SEE ANY
MIRACLES OUT THERE, IF YOU SEE A
MIRACLE THEN LET ME KNOW ABOUT
IT.
SO, A NUMBER OF FUNDING
OPPORTUNITIES, THESE WILL BE IN
YOUR WRITTEN REPORT, BUT THE
ALCOHOL RESEARCH CENTER PROGRAM,
THE PURPOSE OF THE ALCOHOL
RESEARCH CENTERS IS TO PROVIDE
LEADERSHIP CONDUCTING, FOSTERING
INTERDISCIPLINARY TOPICS,
LETTERS OF INTENT DUE OCTOBER
15.
IN THE CLOSED SESSION WE HAD A
NUMBER OF CENTERS THAT WERE UP
FOR RENEWAL.
WE HAVE P50s AND P60s, 60s
MUST INCLUDE DISSEMINATION CORE
TO INITIATE AND EXPAND COMMUNITY
EDUCATION RELATED TO ACTIVITIES
OF THE CENTER.
WE ALSO -- IT'S NOT ON THE SLIDE
BUT WE HAVE A PLAN FOR ENHANCING
DIVERSITY THAT MUST BE PUT FORTH
IN EACH CENTER WHEN THEY SEND IN
THEIR NEW APPLICATION TO RENEW
OR START A CENTER AND WE'RE
USING CENTERS AS EXAMPLE OF
HAVING THIS PEDP AS WE CALL IT
OUT THERE SO WE CAN SEE HOW IT
GETS REVIEWED, WHAT THE
STRUCTURES LOOK LIKE, AND HOW WE
CAN MAYBE INTEGRATE THESE KIND
OF PLANS MORE INTO THE -- ALL OF
OUR FUNDING OPPORTUNITIES IN THE
EXTRAMURAL WORLD.
AND SO THIS IS A MOVEMENT THAT'S
BEEN GOING ON, STARTED WITH THE
BRAIN INITIATIVE, MANY OF YOU
ARE AWARE.
WE MOVED IT TO THE CENTERS
PROGRAM.
WE'LL EVALUATE THAT WITH DAWN
AND OUR STAFF, AND THEN SEE
WHERE GO FROM THERE, JUST SO
YOU'RE AWARE OF IT.
ALCOHOL AND TREATMENT RECOVERY
RESEARCH, TO SUPPORT A BROAD
RANGE OF TOPICS, MEDICATION
DEVELOPMENT, BEHAVIORAL
THERAPIES, MECHANISMS, RECOVERY,
INNOVATIVE METHODS AND
TECHNOLOGIES, WE PUT OUT THIS
PAR AND THIS IS OBVIOUSLY THE
DIVISION OF TREATMENT AND
RECOVERY THAT THIS COMES FROM.
WE HAVE AN ALCOHOL HEALTH
SERVICES RESEARCH, ALSO PAR TO
SUPPORT RESEARCH ON CLOSING THE
TREATMENT GAP FOR INDIVIDUALS
WITH ALCOHOL USE DISORDER
INCLUDING ACCESS AND MAKING
TREATMENT MORE APPEALING,
REDUCING HEALTH DISPARITIES.
AGAIN, FROM DTR.
AND THEN ALCOHOL AND OTHER
SUBSTANCE USE RESEARCH EDUCATION
PROGRAMS FOR HEALTH
PROFESSIONALS, THIS IS TO
SUPPORT PROJECTS DESIGNED TO
ENGAGE HEALTH CARE PROFESSIONALS
IN EDUCATION AND RESEARCH ON
ALCOHOL USE DISORDER AND OTHER
SUBSTANCE USE DISORDERS.
AGAIN, FROM DTR.
AND THEN OUR HIV PROGRAM, HIV
PREVENTION AND ALCOHOL, THIS
SOLICITS APPLICATIONS TO EXPAND
THE HIV/AIDS PREVENTION TOOLKIT
AMONG ALCOHOL IMPACTED
POPULATIONS AND ASSOCIATED
BEHAVIORAL AND BIOLOGICAL RISKS
FOR HIV.
AND THEN WE HAVE ASKED FOR
ALCOHOL PHARMACOLOGY --
PHARMACOTHERAPY EVALUATION
PROGRAM, REQUEST FOR LETTERS OF
INTENT, AND PURPOSE OF THIS IS
TO HELP ADVANCE MEDICATIONS
DEVELOPMENT FOR ALCOHOL USE
DISORDER.
WE SUPPORT AN ALCOHOL
PHARMACOTHERAPY EVALUATION
PROGRAM.
THIS IS AN INTEGRATIVE PROGRAM
CONSISTING OF NIAA CLINICAL
INVESTIGATIONS GROUP, HUMAN
LABORATORY PROGRAM, NOW ALCOHOL
INTERACTION PROGRAM.
THE PROGRAM IS SEEKING LETTERS
OF INTEREST FOR PROMISING
MEDICATIONS FOR ALCOHOL USE
DISORDER, NOVEL COMPOUNDS AND
REPURPOSED MEDICATIONS, TO
EVALUATE SAFETY AND EFFICACY IN
PHASE 1 AND PHASE 2 CLINICAL
TRIALS.
CLINICAL TRIALS WILL BE
SUPPORTED BY AN NIAAA CONTRACT,
CONDUCTED BY ALCOHOL
PHARMACOTHERAPY EVALUATION
PROGRAM.
THIS IS NOT A GRANT.
YOU ACTUALLY GET SUPPORTED
DIRECTLY BY A CONTRACT
MECHANISM, IT IS RUN OUT OF DTR.
SO LETTERS ARE DUE SEPTEMBER 15.
MORE INFORMATION AND
INSTRUCTIONS FOR SUBMITTING A
LETTER OF INTEREST CAN BE FOUND
IN THE NOTICE, LISTED HERE, DAN
FALK IS OUR CONTACT.
WHAT'S PARTICULARLY NEW ABOUT
THIS IS WE'VE BEEN DOING HUMAN
LABORATORY STUDIES, WE'VE BEEN
DOING CLINICAL TRIALS.
BUT WE NOW ARE DOING ALCOHOL
INTERACTION STUDIES WHICH WOULD
HELP PEOPLE GET AN IND BECAUSE
YOU'RE NOT GOING TO BE ABLE TO
GET AN IND OUT OF THE FDA TO
TEST A COMPOUND IN HUMANS UNTIL
YOU DO A DRUG INTERACTION STUDY.
DID I GET THAT RIGHT, RAY?
>> YES.
THE IND AND ALSO DOING PHASE 1
STUDIES AND THE ALCOHOL
INTERACTION STUDIES WOULD
COMPLETE THE PHASE 1.
UNTIL YOU GET THE INDIAN -- IND
AND PHASE 1 STUDIES WE CAN'T
SUPPORT OUR PHASE 2 TRIALS.
>> YOU HEARD IT FROM THE MASTER.
ALSO, YOU KNOW, ANOTHER MAJOR
TOPIC AS I ALREADY MENTIONED IS
ADVANCING DIVERSITY, EQUITY,
INCLUSION, AND ACCESSIBILITY,
WE'RE PARTICIPATING IN SEVERAL
FUNDING OPPORTUNITIES TO ENHANCE
THE DIVERSITY OF THE RESEARCH
WORKFORCE ACROSS CAREER
SPECTRUM.
MORE INFORMATION ON THIS IS IN
THE DIRECTOR'S REPORT.
SOME THINGS WE'RE DOING, ADVANCE
PRE-DOCTORAL T32 TRAINING
PROGRAM TO PROMOTE DIVERSITY,
PREVENTIVE INTERVENTIONS, SIGNED
ON THE BRAIN INITIATIVE ADVANCED
POSTDOCTORAL CAREER TRANSITION
AWARD TO PROMOTE DIVERSITY.
THIS IS WHERE YOU MOVE FROM A
K99 TO R00, IT'S BEEN A VERY
SUCCESSFUL PROGRAM IN THE BRAIN
INITIATIVE.
ALSO THE NIH NEUROSCIENCE
DEVELOPMENT FOR ADVANCING THE
CAREERS OF DIVERSE WORKFORCE,
R25, AND RESEARCH SUPPLEMENTS TO
PROMOTE DIVERSITY IN
HEALTH-RELATED RESEARCH.
SO, PRETTY MUCH ANYTHING THAT
COMES THROUGH NIH IN THIS REGARD
THAT WE FEEL WOULD HELP OUR
EFFORTS IN DIVERSITY, EQUITY,
INCLUSION, AND ACCESSIBILITY WE
BASICALLY SIGN ON TO.
AND I THINK THIS IS -- I FEEL
LIKE WE'RE STARTING TO MAKE A
LITTLE BIT OF PROGRESS IN THIS
DOMAIN.
AND I STILL THINK WE HAVE A LONG
WAY TO GO.
A COUPLE OF RECENT NIAAA UPON
-- SPONSORED MEETING, ACCENT ON
PROMISING PROGRAMS.
THE WEBINAR WAS HELD JUNE 16,
HIGHLIGHTED THE IMANI PROGRAM
FOR BLACK AND LATINO
COMMUNITIES.
I BELIEVE THIS WEBINAR IS ONLINE
AND CAN BE WATCHED.
NIAAA AND NATIONAL CANCER
INSTITUTE CO-HOSTED POLICY
APPROACHES TO ALCOHOL AND CANCER
PREVENTION RESOURCES RESULTS AND
GAPS ON JULY 18 WHICH
HIGHLIGHTED NIAAA'S ALCOHOL
POLICY INFORMATION SYSTEM.
WHICH MANY OF YOU KNOW NOT ONLY
CHARTS POLICY CHANGES IN THE
STATES FOR ALCOHOL BUT ALSO FOR
MARIJUANA USE THAT WE PAY FOR.
AND NIAAA AND NATIONAL INSTITUTE
ON AGING HELD A WORKSHOP, ROLE
OF ALCOHOL MISUSE, ONSET AND
PROGRESSION OF ALZHEIMER'S
DISEASE AND RELATED DEMENTIAS ON
JULY 26 AND 27, WORKSHOP
FEATURED PRE-CLINICAL AND
CLINICAL RESEARCH ON HOW CHRONIC
HEAVY ALCOHOL EXPOSURE MAY
INTERSECT WITH PATHWAYS OF
DEVELOPING AND EXACERBATING
ALZHEIMER'S AND RELATED
DEMENTIAS.
THIS IS FOR ME A FASCINATING
AREA.
IT'S JUST BEGINNING BUT STAY
TUNED BECAUSE WE'RE STARTING TO
DO A GOOD BIT OF WORK IN
COLLABORATION WITH NATIONAL
INSTITUTE OF AGING ON THIS EXACT
TOPIC AND A LOT OF THIS WORK IS
BEING DONE IN DIVISION OF
NEUROBIOLOGY AND BEHAVIOR.
NEUROSCIENCE AND BEHAVIOR.
COMING UP IS OUR ANNUAL
NIDA-NIAAA MINI CONVENTION,
FRONTIERS IN ADDICTION RESEARCH
THAT HAS NOTHING TO DO WITH THE
FRONTIERS JOURNAL, JUST FOR THE
RECORD.
WE GOT THERE FIRST.
THIS HAS BEEN GOING ON NOW SINCE
CRAN DEVELOPED, WHICH AT LEAST
TEN YEARS, COLLABORATIVE
RESEARCH AT NIH, A SPECTACULARLY
GOOD MEETING.
WE'RE DOING IT ONLINE BECAUSE OF
CONFLICTS WITH THE BEGINNING OF
THIS SOCIETY FOR NEUROSCIENCE
MEETING AND HAVE BEEN DOING IT
ONLINE DURING THE PANDEMIC AND
IT WORKED SPECTACULARLY SO WE
EITHER DO IT ONLINE AND/OR
HYBRID IN THE FUTURE BECAUSE WE
GET SO MANY MORE PARTICIPANTS
LISTENING IN ON THESE SESSIONS,
WHEN WE HAVE A VIRTUAL COMPONENT
TO IT.
THE SCIENTIFIC SESSIONS THIS
YEAR WILL BE ALCOHOL AND
SUBSTANCE USE DISORDER IN THE
GLYMPHATIC SYSTEM, GLIAL CELLS
AND NEUROIMMUNE MECHANISMS,
USING NEUROSCIENCE TO INFORM
PREVENTION INTERVENTIONS FOR
SUBSTANCE USE.
JOHN MATIKHEK IS THE LEAD EVERY
YEAR AND DOES A SPECTACULAR JOB
MAKING SURE WE TALK A LITTLE BIT
ABOUT ALCOHOL, RIGHT, ANTONIO?
WE LOVE OUR COLLEAGUES AT NIDA.
BUT THEY HAVE MORE DRUGS THAN WE
DO.
SO SOMEHOW THE LAST VERSION OF
MY TALK DIDN'T GET IN HERE.
I'LL SKIP THIS AND MOVE TO
RESEARCH HIGHLIGHTS BECAUSE I
WANT TO EMPHASIZE THAT AT THE
END AND I'LL COME BACK TO THOSE
SLIDES.
SO, I PICKED OUT FIVE RESEARCH
HIGHLIGHTS.
ONE THING WE STARTED TO DO IS
NARROW DOWN RESEARCH HIGHLIGHTS
EACH ROUND.
ALSO TO PICK PEOPLE THAT WE
DON'T NORMALLY PICK AND TOPICS
THAT WE DON'T NORMALLY PICK, BUT
ALSO WHAT WE'RE TRYING TO DO IS
COME UP WITH A THEME.
THIS YEAR'S THEME IS BASICALLY
HUMAN STUDIES.
SO I'M NOT TALKING ABOUT RODENT
WORK, ANY MOUSE WORK, ANY FLY
WORK.
IT'S GOING TO BE ALL AS MY
THESIS ADVISOR USED TO SAY, THE
TWO-LEGGED RATS, RIGHT?
SO, THE FIRST ONE IS A STUDY
THAT SHOWED THAT WEB-BASED
SEXUAL VIOLENCE, ALCOHOL MISUSE,
AND BYSTANDER INTERVENTION
PROGRAM DELIVERED TO FIRST-YEAR
COLLEGE WOMEN REDUCED THEIR
EXPOSURE TO SEXUAL VIOLENCE.
THIS PARTICULAR STUDY SEXUAL
VIOLENCE TOWARD COLLEGE, THEY
OUTLINED TOWARD COLLEGE WOMEN, A
MAJOR PUBLIC HEALTH CONCERN,
ALCOHOL IS A KEY CONTRIBUTOR TO
SEXUAL VIOLENCE.
THIS STUDY AIMED TO DETERMINE
THE EFFICACY OF AN
INTERNET-BASED PREVENTION
INTERVENTION, WHICH I LOVE THAT
WORD, PREVENTION INTERVENTION,
CALLED REAL CONSENT.
DELIVERED TO FIRST-YEAR COLLEGE
WOMEN AND DESIGNED TO REDUCE
RISK FOR EXPOSURE TO SEXUAL
VIOLENCE.
IN REAL CONSENT, A FOUR
45-MINUTE MODULES THAT CONTAIN
TRAINING IN PROVEN BEHAVIORAL
CHANGE, TECHNIQUES, BUT ALSO
ENTERTAINMENT MEDIA EDUCATION
MEDIA.
THAT'S WHAT REAL CONSENT
CONSISTS OF.
AND IT WAS DELIVERED TO
FIRST-YEAR COLLEGE WOMEN, AND
DESIGNED TO REDUCE RISK FOR
EXPOSURE TO SEXUAL VIOLENCE.
I MIGHT ADD, THE PARTICIPANTS IN
THIS HAD ALREADY BEEN EXPOSED TO
SEXUAL VIOLENCE AT ONE TIME OR
ANOTHER.
SO THEY WERE -- THEY HAD
PREVIOUSLY BEEN EXPOSED.
PARTICIPANTS IN THE REAL CONSENT
GROUP EXPERIENCED LESS EXPOSURE
TO SEXUAL VIOLENCE, ENGAGED IN
MORE ALCOHOL PROTECTIVE
BEHAVIORS, LESS LIKELY TO BINGE
DRINK, MORE LIKELY TO ENGAGE IN
BYSTANDER BEHAVIOR THAN PLACEBO
GROUP.
YOU CAN SEE IN THE REAL CONSENT
TABLE HERE THAT IT WAS
STATISTICALLY SIGNIFICANT FOR A
DECREASE IN THE INCIDENCE RATE
RATIO WHICH IS THE INCIDENCE
RATE OVER, YOU KNOW, ONE ITEM
DIVIDED BY THE INCIDENCE RATE OF
THE SECOND ITEM, SO IT WOULD BE
THE CHANGE IN INCIDENCE, AND
THEN ALSO USING EITHER THE SOTS
OR THE COTS MODELS, AND IN BOTH
CASES IT WAS STATISTICALLY
SIGNIFICANT.
FOR THE POISSON REGRESSION AND
SOTS AND COTS, FOUND IS TO HAVE
SIGNIFICANT DECREASE IN LEVELS
OF EXPOSURE TO SEXUAL VIOLENCE
COMPARED TO THOSE IN THE CONTROL
CONDITIONS.
THIS WAS AT A SIX-MONTH
FOLLOW-UP.
SO IT WAS A SIX-MONTH FOLLOW-UP
FROM WHEN THEY WERE
PARTICIPATING IN REAL CONSENT
TRAINING, FOUR 45-MINUTE MOD
COMES.
THIS WAS A PROMISING
INTERVENTION THAT MAYBE COULD BE
SCALED UP ULTIMATELY TO HELP
INDIVIDUALS IN THIS REGARD.
I WANT TO EMPHASIZE SOMETHING WE
TRIED TO PUT INTO THIS
DESCRIPTION, BUT THIS IS A
PREVENTION INTERVENTION THAT
WILL HELP WOMEN BUT BY NO MEANS
IS THIS AN ARGUMENT THAT THE
FAULT LIES WITH THE WOMEN.
I WANT TO MAKE THAT POINT VERY
CLEAR TO EVERYBODY HERE, ALL
RIGHT?
THIS IS A UNIVERSAL PROBLEM WITH
YOUNG PEOPLE IN COLLEGE SETTINGS
BUT PRESUMABLY IN NON-COLLEGE
SETTINGS AS WELL.
ANOTHER PROGRAM THAT SEEMS TO
HAVE HAD SOME EFFICACY IN LOWER
SOME OF THE PATHOLOGY ASSOCIATED
WITH ALCOHOL IS THIS 24/7
SOBRIETY PROGRAM FOR INDIVIDUALS
ARRESTED FOR DRIVING WHILE
ALCOHOL IMPAIRED LOWERED THE
RISK OF MORTALITY.
SO, ALCOHOL DRIVING FATALITIES
ARE INCREASING.
I MEAN, IT'S HARD TO BELIEVE
BECAUSE THERE'S BEEN A STRAIGHT,
AS RALPH WILL TELL YOU, IT'S
BEEN A STRAIGHT LINE DOWN FOR
ABOUT 30 YEARS BUT IN THE LAST
COUPLE OF YEARS THERE'S BEEN AN
INCREASE, THE LAST YEAR IN 2020,
AN INCREASE WE LOST ALMOST
12,000 PEOPLE DRIVING UNDER THE
INFLUENCE AND IT WAS A 14%
INCREASE OVER THE PREVIOUS YEAR.
SO THE PANDEMIC SEEMS TO HAVE
TWEAKED THIS IN THE WRONG
DIRECTION AS WELL.
SO, ALCOHOL IMPAIRED DRIVING
FATALITIES ARE INCREASING, TO
HELP ADDRESS THIS PROBLEM THE
SOUTH DAKOTA 24/7 SOBRIETY
PROGRAM ORDERS DRIVING UNDER THE
INFLUENCE OFFENDERS TO ABSTAIN
FROM ALCOHOL AND PROVIDES
FREQUENT MONITORING WITH SWIFT,
CERTAIN, MODERATE PENALTIES FOR
VIOLATIONS.
THEY CALL THESE MODERATE
PENALTIES BUT THEY ARE ONE TO
TWO NIGHTS IN JAIL, MANY OF YOU
KNOW THAT, SO THEY ARE MODERATE
BUT I WOULD CALL ADEQUATELY
MODERATE, I'LL LEAN TOWARD THE
MORE HIGH SIDE OF MODERATE. MOD,
STARTING TIME TO MORTALITY
OUTCOMES, UP TO FIVE YEARS
FOLLOWING ARREST.
THE RESEARCHERS FOUND
SIGNIFICANT REDUCTIONS IN RISK
OF MORTALITY AMONG PROGRAM
PARTICIPANTS RELATIVE TO
NON-PARTICIPANTS, DEMONSTRATING
THAT 24/7 SOBRIETY PROGRAMS MAY
IMPROVE HEALTH OUTCOMES IN
ADDITION TO IMPROVING PUBLIC
SAFETY.
AND SURVIVAL PROBABILITIES
INDICATED HERE, PREDICTED
SURVIVAL FUNCTIONS FOR 24/7
PARTICIPANTS AND
NON-PARTICIPANTS ARE ILLUSTRATED
IN THE GRAPH HERE.
AT THE END OF THE FIVE-YEAR
FOLLOW-UP IT'S THE ACTUAL DATA
AND THEN PROJECTION DATA IS
SHOWN HERE FOR THE NEXT FIVE
YEARS.
AND SO IF YOU FOLLOW THESE
LINES, ACCORDINGLY, THERE IS AN
ESTIMATE OF 55% LOWER
PROBABILITY OF DEATH FOR 24/7
PARTIES WITHIN FIVE YEARS.
THIS IS PRETTY GOOD OUTCOME,
FROM MY PERSPECTIVE, AND YET
ANOTHER PROGRAM THAT SEEMS TO
HAVE PROMISE FOR REDUCING
MORTALITY ASSOCIATED WITH
ALCOHOL MISUSE.
NOW, WE DID GET A LITTLE BRAIN
IN THERE, ANTONIO.
IT TURNS OUT THAT TREATMENT WITH
FRONTAL DIRECT CURRENT
STIMULATION, TRANSDIRECT CURRENT
STIMULATION ACROSS THE FRONTAL
PART OF THE HEAD INCREASED ODDS
OF REMAINING ABSTINENT IN
INDIVIDUALS WITH ALCOHOL USE
DISORDER.
SO THEY INVESTIGATED
NON-INVASIVE NEUROMODULATION
TREATMENT DELIVERED DURING EARLY
ABSTINENCE.
VARIATIONS IN FUNCTIONAL
CONNECTIVITY BETWEEN CERTAIN
BRAIN NETWORKS HAS BEEN
ASSOCIATED WITH RISK OF RELAPSE
TO ALCOHOL MISUSE.
THIS STUDY INVESTIGATED EFFECTS
OF TRANSCRANIAL DIRECT CURRENT
STIMULATION, THIS IS NOT IN THE
BRAIN, OUTSIDE THE BRAIN,
STIMULATION USING TMS BASICALLY,
BRAIN-BASED NON-INVASIVE
TREATMENT, RELAPSE RATES DURING
EARLY ABSTINENCE.
AND THEY FOCUS ON FRONTAL
CORTEX, MOST OF YOU KNOW THAT
CONTROLS BOTH BASAL GANGLION,
THE AREA OF THE BRAIN THAT DAVID
LOVINGER STUDIES BUT ALSO
EXTENDED AMYGDALA, THE PART I
STUDY, TO CONTROL YOUR CRAVING
BUT ALSO NEGATIVE AFFECT THAT
COMES DURING ACUTE AND
PROTRACTED WITHDRAWAL FROM
ALCOHOL USE DISORDER.
SO CONTROLLING THIS CONNECTIVITY
CONTROLS IN SOME SENSE THE
REPTILE BRAIN.
I DON'T KNOW THAT REPTILES HAVE
MUCH OF A FRONTAL CORTEX,
LOVINGER KNOWS MORE ABOUT WHAT A
REPTILE HAS, BUT THEY DEFINITELY
HAVE A BASAL GANGLIA, WHEN THEY
CATCH THAT FLY THAT'S WHAT THEY
ARE USING.
THE LIZARD CATCHES THE FLY, AND
THEY HAVE EXTENDED AMYGDALA WHEN
THEY ARE -- YOU CAN SEE THEIR
MATING BEHAVIOR IS QUITE ACTIVE.
ALL RIGHT.
TREATMENT FOR FIVE DAYS COMPARED
TO SHAM CONDITION STRENGTHENED
CONNECTIVITY FROM THE LATERAL
DORSAL PREFRONTAL CORTEX TO
ADDICTION NETWORK SUPPORTING
INCENTIVE SALIENCE, THAT'S BASAL
GANGLIA, AND NEGATIVES
EMOTIONALITY, EXTENDED AMYGDALA,
INCREASE IN PRE-FRONT CORTEX,
INCREASED ODDS OF REMAIN
ABSTINENT FOR FOUR MONTHS, EVEN
MORE STRIKING.
THESE RESULTS SUPPORT THE
POTENTIAL UTILITY OF HARNESSING
THE BRAIN'S FUNCTIONAL
CONNECTIVITY TO SUPPORT BEHAVIOR
CHANGE.
IF YOU LOOK AT THE TOP GRAPH
RIGHT-HAND SIDE, FROM THE
PRE-FRONTAL CORTEX TO PRESUMABLY
BASAL GANGLIA, YOU CAN SEE
THERE'S A DIFFERENCE IN Z SCORE
WHICH IS THE NUMBER OF STANDARD
DEVIATIONS AWAY FROM THE MEAN,
PRETTY GOOD AND SIGNIFICANT
DIFFERENCE BETWEEN ABSTAINERS
AND RELAPSERS.
POST INTERVENTION.
SO, SEEMED TO HAVE AN EFFECT ON
CONNECTIVITY AND REMEMBER THAT
AS TRISH WAS POINTING OUT
CONNECTIVITY CAN BE INHIBITOR
INCREASE IN INHIBITION OR
INCREASE IN ACTIVATION.
WE DON'T KNOW WHAT THE NATURE OR
DIRECTION OF THAT CONNECTIVITY
IS.
IT JUST MEANS THERE'S MORE
CONNECTIVITY.
AND THEN THE BOTTOM SLIDE SHOWS
THAT THIS 50% DECREASE IN
RELAPSE PROBABILITY IN THOSE
THAT RECEIVE THE AC ACTIVE
DIRECT CURRENT STIMULATION, AND
I DIDN'T PUT IT IN BECAUSE I
LIMIT TO ONE SLIDE BUT FEMALES
ACTUALLY WERE DRIVING THIS
EFFECT.
IT WAS A MAJOR SEX DIFFERENCE
BETWEEN MALES AND FEMALES.
SO ANOTHER INTRIGUING PIECE TO
LOOK AT IF YOU LOOK AT THIS
PAPER YOURSELVES.
THIS IS A PILOT STUDY, THAT'S
THE LAST SENTENCE OF THE
SUMMARY, PROBIOTIC TREATMENT,
DECREASED LIVER INJURY, HEAVY
DRINKING IN MODERATE
ALCOHOL-ASSOCIATED HEPATITIS
PATIENTS.
I SHOULD HAVE MENTIONED WHERE
THESE PREVIOUS STUDIES WERE
DONE, THIS ONE IS ONE OF OUR
ALCOHOL RESEARCH CENTERS
DIRECTED BY CRAIG McCLAIN BUT
THE STUDY WAS DONE, IT'S ON THE
SLIDE, AND THAT'S HER NAME.
I DIDN'T GET THAT WRONG
ACTUALLY.
WE KNOW ALCOHOL CONSUMPTION
LEADS TO CHANGES IN GUT
MICROBIOTICS COMPOSITION AND
GROWTH, DYSBIOSIS, I CAN'T TELL
YOU HOW MANY PAPERS I'VE
PRESENTED AT COUNCIL
ILLUSTRATING THAT YOUR GUT GETS
REALLY OUT OF WHACK IF YOU DO A
LOT OF ALCOHOL.
AND THIS PARTICULAR STUDY THE
PROBIOTIC LACTOBACILLUS RANOSIS,
LGG FROM HENCEFORTH,
ADMINISTERED DAILY FOR SIX
MONTHS IN PATIENTS WITH HEAVY
DRINKING, MODERATE
ALCOHOL-ASSOCIATED HEPATITIS,
REDUCED LIVER INJURY AT ONE
MONTH AND SIGNIFICANTLY REDUCED
HEAVY DRINKING LEVELS AT SIX
MONTHS, WHICH IS A PRETTY
AMAZING FINDING.
THIS PILOT IS ONGOING AS I SAID
AND CONTINUES TO RECRUIT
PATIENTS.
SO THEY USED FOR LIVER DISEASE
SEVERITY MODEL FOR END STAGE
LIVER DESCRIES, MELD SCORE IN
PATIENTS RECEIVING LGG, OR
PLACEBO AT BASELINE.
AT ONE MONTH.
THEY EVALUATED AT ONE MONTH, THE
MELD SCORE.
THERE WAS DECREASE.
IT'S NOT HUGE BUT DEFINITELY
DECREASE IN THE MELD SCORE WITH
LGG.
AND THEN SIX MONTHS EVALUATION,
DRINKS PER WEEK IN PATIENTS,
REALLY DECREASED EVEN MORE
DRAMATICALLY IN THE LGG GROUP.
THERE WAS A DECREASE IN THE
PLACEBO GROUP AS YOU CAN SEE
FROM THIS SLIDE.
THE PROBIOTICS WAS ACTUALLY --
IT TOOK DEVIN TO FIND THIS IN
THE SUPPLEMENTARY MATERIAL.
I COULDN'T FIND IT IN THE PAPER,
BUT IT WAS TEN TO THE 9th CVU
UNITS, AND IN ONE CAPSULE, THOSE
ARE CALLED COLONY-FORMING UNITS.
I DIDN'T KNOW THIS ABOUT
PROBIOTICS.
I'VE ALWAYS BEEN ASKING CRAIG
McCLAIN TO TELL ME WHAT
PROBIOTIC I SHOULD TAKE, MAYBE
THERE'S A HINT IN THIS PAPER.
FINALLY, I WANT TO MENTION
SOMETHING WE'VE MENTIONED
BEFORE.
THIS IS A PAPER THAT KIND OF
CONFIRMS WHAT WE'VE BEEN PICKING
UP IN SMALL STUDIES.
AND THAT IS TELEHEALTH ADDICTION
TREATMENT UTILIZATION INCREASED
DURING THE COVID-19 PANDEMIC.
AND LOOKS LIKE IT'S LEER TO
STAY.
THIS STUDY INVESTIGATED IMPACT
OF COVID-19 TELEHEALTH POLICY
CHANGES ON ADDICTION TREATMENT
UTILIZATION AND POTENTIAL
DISPARITIES IN UTILIZATION.
THE INVESTIGATORS ANALYZED
ELECTRONIC HEALTH RECORDS AND
CLAIMS DATA FROM ADULTS WITH
SUBSTANCE MISUSE AND KAISER
PERMANENTE HEALTH CARE SYSTEM,
TELEHEALTH ADDICTION TREATMENT
UTILIZATION INCREASED DURING THE
EARLY PHASE OF THE PANDEMIC FOR
ALL SUBGROUPS WITHOUT ANY
VARIATION IN RACE/ETHNICITY OR
SOCIOECONOMIC STATUS, YOUNGER
ADULTS MAY HAVE BEEN FITTED MOST
FROM THE TRANSITION TO
TELEHEALTH.
IN THIS PARTICULAR STUDY, YOU
KNOW, THEY WERE LOOKING AT
BEFORE THE PANDEMIC WHICH WAS
YOU CAN SEE HERE ON THE GRAPH
WAS 2019, MOSTLY 2019, AND
DURING THE COVID-19 PANDEMIC IS
WHERE THE DATA IS SHOWN HERE,
2020, 19,000 PATIENTS BEFORE THE
PANDEMIC AND 17,000 PATIENTS
POST-PANDEMIC.
AND THE ODDS RATIO, PERCENT OF
PATIENTS, WENT UP DURING COVID
ONSET FOR OVERALL ENGAGEMENT IN
INITIATING TELEHEALTH, BUT ALSO
IN TELEHEALTH ENGAGEMENT IT
SELF, A HUGE INCREASE AS YOU CAN
SEE IN THE RIGHT-HAND PART OF
THIS PANEL.
SO, THEY ARGUE THE OVERALL
INCREASES SEEN IN ENGAGEMENT IN
HEALTH CARE FOR ALCOHOL USE
DISORDER IS DUE TO TELEHEALTH,
AND THEY ALSO CONCLUDED THAT
YOUNGER PATIENTS, AS I SAID,
WERE MORE LIKELY TO INITIATE
TREATMENT AND MAYBE TELEHEALTH
WAS MORE ATTRACTIVE TO THE
YOUNGER PEOPLE, AND THEN THERE
WERE INCREASES IN TELEHEALTH MAY
HAVE MITIGATED SOME POTENTIAL
DISPARITIES BY RACE AND
ETHNICITY.
NOW, MIND YOU, I SAY MAY
MITIGATE IT BUT THERE'S A HINT
THERE WHY NO DISPARITIES IN
UPTAKE.
I THOUGHT THIS WAS A COOL STUDY
AS WELL.
THAT'S MY HUMAN FOCUS TODAY.
IT'S MOSTLY TRANSLATIONAL, TO
THINGS THAT WE -- WHERE YOU CAN
SEE RESEARCH IS HAVING AN IMPACT
ON THE REAL WORLD, I HOPE.
AND I'VE TAKEN ON, STARTED
DURING THE PANDEMIC, BUT I
REALLY THINK IN ADDITION TO OUR
FOCUS ON DIVERSITY, EQUITY, AND
INCLUSION, AT THE INSTITUTE, I
THINK YOU'LL SEE ANOTHER FOCUS
I'VE BEEN DRIVING FROM MY
PERSPECTIVE AND OUR STAFF HAS
BEEN HELPING WITH, HOW DO WE GET
WHAT WE DO IN RESEARCH OUT TO
THE PUBLIC.
SO THAT'S MY MINI SPEECH TODAY.
YOU KNOW, I'M REALLY OBSESSED
WITH SCALING UP SOME OF THE
THINGS WHERE WE DO SEE
SUCCESSES, EVEN TINY STUDIES,
MIND YOU WE'RE NOT GOING TO BE
SCALING UP THIS PROBIOTIC YET OR
TMS YET BUT THE POTENTIAL IS
THERE.
SO THINK ABOUT THOSE KIND OF
ISSUES.
I THINK I CAN GO BACK.
I WANT TO END BY JUST REMINDING
YOU, BECAUSE MOST OF YOU COUNCIL
MEMBERS ARE WELL AWARE, MOST OF
THE STAFF WHO ARE LISTENING ARE
WELL AWARE BUT I USE THIS FOR
EVERY PRESS INTERVIEW.
I MENTION AS MANY OF THESE
RESOURCES, USUALLY ALL OF THEM,
IN VIRTUALLY EVERY PRESS
INTERVIEW I DO.
SO WE HAVE RETHINKING DRINKING,
A WEBSITE AND PRINT PUBLICATION
FOR GENERAL AUDIENCE TO HELP
INDIVIDUALS ASSESS THEIR
DRINKING HABITS AND FIND WAYS TO
MAKE A CHANGE.
WE HAVE COLLEGE-AIM, INFORMATION
ON PREVENTION APPROACHES FOUND
TO BE EFFECTIVE IN COLLEGE
ENVIRONMENTS.
IT WAS FAIRLY RECENTLY UPDATED.
WE HAVE THE ALCOHOL TREATMENT
NAVIGATOR HELPS INDIVIDUALS
UNDERSTAND TREATMENT OPTIONS,
AND SEARCH FOR NEARBY TREATMENT,
INCLUDING TELEHEALTH SERVICES,
INCLUDES PORTAL TO ASSIST HEALTH
CARE PROVIDERS MAKING REFERRALS
FOR THEIR PATIENTS, ALSO TELLS
YOU WHAT IS AN AUD AND WHAT IS A
SPECTRUM OF AUD AND SPECTRUM OF
AUD TREATMENTS.
THIS IS CRITICALALLY IMPORTANT.
FINALLY, THE HEALTHCARE
PROFESSIONAL CORE RESOURCE, WHAT
WE SAY IS WHAT EVERY HEALTHCARE
PROFESSIONAL SHOULD KNOW ABOUT
ALCOHOL, DESIGNED TO LEEP
ADDRESS COMMON BARRIERS TO OPT
MINIMUM HEALTH-RELATED HEALTH
CARE BY PROVIDING KNOWLEDGE TO
FILL GAPS IN ADDICTION INCLUDING
NEUROSCIENCE, EVIDENCE-BASED AUD
THERAPY AND MEDICATIONS AND
VARIED PATHS TO RECOVERY,
PROVIDES QUICK SCREENING TOOLS
TO ADDRESS TIME CONSTRAINTS
PROVIDING A PICTURE OF LEVELS AN
SYMPTOMS, CLARITY ABOUT WHAT
CONSTITUTES HEAVY DRINKING
ALCOHOL USE DISORDER SEVERITY
LEVELS AND RECOVERY TO BUILD
CONFIDENCE AND COLLABORATE ON
RECOVERY PLANS, PROVIDES STEPS
TO REDUCE STIGMA AND ENCOURAGE
GREATER PATIENT ACCEPTANCE FOR
ALCOHOL TREATMENT WHEN NEEDED.
IT'S NOT JUST FOR YOUR PRIMARY
CARE DOC.
IT COULD BE FOR ANYBODY IN THE
SPECTRUM, FROM, YOU KNOW,
NURSES, NURSE PRACTITIONERS,
PHARMACISTS, ALL THE WAY TO
BOARD CERTIFIED ADDICTION
MEDICINE SPECIALISTS, CLINICAL
PSYCHOLOGISTS IN BETWEEN BUT
COULD ALSO BE UTILIZED FOR
ANYTHING YOU DO IN THE ALCOHOL
FIELD TO INFORM EVEN STUDENTS
AND, YOU KNOW, GRADUATE STUDENTS
AND POSTDOCTORAL FELLOWS, WHAT
DO WE KNOW ABOUT ALCOHOL AND WHY
ARE WE DOING SOME THINGS WE'RE
DOING.
IT'S IN THE HEALTHCARE
PROFESSIONAL CORE RESOURCE.
I WANT TO GET TO MY THANK YOU
SLIDE.
I WANT TO THANK LAURA, DEVIN,
FOR PUTTING THESE SLIDES
TOGETHER, AND EVERYBODY WHO
HELPED WITH IT, PATRICIA POWELL,
TRISH POWELL, GREG ROA, AARON
WHITE, BRIDGET WILLIAMS-SIMMONS.
YOU MAY NOT REALIZE HOW MUCH
SCRUTINY THEY GET.
YOU WOULD BE SURPRISED THE
ERRORS WE FIND AND THE LITTLE
HOLES IN THE ARGUMENTS IN THE
PROCESS, AND WE HAVE TO REJECT A
FEW PAPERS EVERY ONCE IN A WHILE
BECAUSE THEY DIDN'T TELL US IN
THE ABSTRACT WHAT THEY REALLY
FOUND, AND THAT'S WHY I
MENTIONED THE SEX DIFFERENCES IN
THAT ONE PAPER BECAUSE IT WAS
KIND OF GLOSSED OVER.
WHEN YOU FINALLY READ IT YOU SEE
THE SEX DIFFERENCES.
IT'S A GOOD EXERCISE.
I'M TRYING TO FIGHT OFF
ALZHEIMER'S DISEASE, SO IT HELPS
ME KEEP MY COGNITIVE ABILITIES
STRAIGHT.
I'M NOT FIGHTING OFF ALZHEIMER'S
DISEASE, THAT WAS A JOKE, ALL
RIGHT?
I SHOULDN'T JOKE ABOUT IT, WHEN
YOU GET TO A CERTAIN AGE YOU
SHOULDN'T JOKE ABOUT STUFF LIKE
THAT, SPECIALLY NOW THAT THEY
ARE SCRUTINIZING OUR POLITICIANS
FOR THEIR -- EVERY TIME THEY
HAVE, YOU KNOW, A GAP IN THEIR
TAPE.
I FEEL SORRY FOR THEM.
OCCASIONALLY WHEN I'M TALKING I
HAVE A GAP IN MY TAPE BUT HAS
NOTHING TO DO WITH MY BRAIN THAT
I KNOW OF.
IT'S JUST I FORGET HOW TO
PRONOUNCE SOMEBODY'S NAME.
ALL RIGHT.
ANY QUESTIONS FROM ANYBODY WHILE
I'M UP HERE?
ANY COMMENTS?
LAURA?
>> I REALLY LIKE YOUR THOUGHTS
AND COMMENTS ABOUT REACHING OUT
TO THE PUBLIC.
AND I'VE HEARD YOU COMMENT ON
MEDICAL EDUCATION AND HOW LITTLE
MEDICAL EDUCATION THERE IS FOR
ALCOHOL AND DRUG USE.
I WONDER IF WE'VE MOVED THE
NEEDLE, WHAT ARE YOUR THOUGHTS
ON THAT.
>> WE MOVED THE NEEDLE IN THE
SENSE THE PROGRAM DONE BY ACAM,
AMERICAN COLLEGE OF ADDICTION
MEDICINE, AND I FORGET, THERE'S
ONE LETTER I LEFT OUT, AND THEY
ARE -- THEY HAVE A FELLOWSHIP
PROGRAM NOW FOR -- WHAT'S IT
CALLED, DAVID, WHEN YOU GET --
IT'S NOT CERTIFICATION.
WHAT'S IT CALLED WHEN YOU GET A
--
>> IT'S A CREDENTIALED TRAINING,
ACCREDITED TRAINING.
>> YEAH, AS A SPECIALTY IN
ADDICTION MEDICINE.
THERE'S A WORD FOR IT WHEN YOU
GET --
>> YEAH, SO ADDICTION MEDICINE
BOARDS, AND WE ACTUALLY HAVE TWO
PHYSICIANS WHO HAVE BEEN THROUGH
BOARDS INTRAMURALLY.
>> YOU GET BOARD -- YOU DON'T
CALL IT CERTIFIED.
>> IT IS BOARD CERTIFIED IN
ADDICTION MEDICINE.
>> THAT IS THE WORD, ALL RIGHT.
>> YES.
>> IT'S TAKEN OFF, LAURA.
SPECTACULARLY SUCCESSFUL.
THEY HAVE NOW GOT THIS BOARD
CERTIFICATION IN ALL STATES IN
THE UNION, AND IT'S JUST -- IT
WAS STARTED BY KEVIN KUNZ WHEN
HE WAS RUNNING IT, THEY
CONTINUED.
I PARTICIPATED, NORA
PARTICIPATES IN THE GRADUATION
CEREMONY, A LITTLE SPEECH EVERY
YEAR.
AND, YOU KNOW, SO THAT'S THE
GOOD NEWS.
THE BAD NEWS I'M NOT SURE THAT
WE'RE MAKING MUCH IMPACT IN
MEDICAL SCHOOLS YET, AND OTHER
FORMS OF TRAINING.
HOPEFULLY THE BOARD CERTIFIED
ADDICTION MEDICINE SPECIALISTS
WILL BE ABLE TO TRAIN RESIDENTS
AND DAVID GOLDMAN YOU MAY WANT
TO SPEAK THAT THAT, ASSUMING YOU
DO THAT IN THE CLINICAL CENTER,
MAYBE SAY A WORD OR TWO WHEN I
SHUT UP HERE.
WE STILL NEED TO GET SOME
EFFORTS INTO TRYING TO GET IT
INTO MEDICAL SCHOOL CURRICULUM.
YOU KNOW WE HAVE THIS CATCH 22.
SO, THE PEOPLE THAT WRITE THE
EXAMS FOR THE MEDICAL SCHOOL
CLAIM IT'S NOT IN THE
CURRICULUM, AND PEOPLE THAT
WRITE THE CURRICULUM SAY IT'S
NOT IN THE EXAMS.
BUT IT ALSO SHOULD BE IN
CLINICAL PSYCHOLOGY PROGRAMS,
FROM MY PERSPECTIVE.
SO, IT'S SOMETHING THAT'S ON MY
PRIORITY LIST FOR THIS YEAR TO
FOLLOW THROUGH.
WE'VE BEEN TALKING ABOUT IT AT
THE INSTITUTE, WHAT WE CAN DO.
I THINK WE CAN USE ELEMENTS OF
THE HEALTH CARE PROFESSIONAL
CORE RESOURCES LAUNCHING POINT.
BUT WE'VE GOT TO FIND A WAY TO
WEDGE IT INTO SOME OF THESE
PROGRAMS.
SOME SCHOOLS ARE ENLIGHTENED.
UNIVERSITY OF PENNSYLVANIA HAS
BEEN TEACHING FOR YEARS BECAUSE
CHUCK O'BRIEN PUT IT THERE, FOR
OTHERS IT'S NOT A HIGH PRIORITY
AREA.
GO AHEAD.
>> NIAAA HAS MADE A DENT WHEN IT
COMES TO SOME D.E.I.
INITIATIVES.
I'M CURIOUS WHAT KIND OF METRICS
HAVE BEEN DEVELOPED TO KIND OF
ASSESS PROGRESS.
>> SO, MY -- I DON'T HAVE ANY
METRICS ON DIRECT PROGRESS.
I JUST NOTICED AT A COUPLE
MEETINGS THAT I'VE BEEN GOING TO
THAT THE YOUNGER PEOPLE ARE MUCH
MORE DIVERSE THAN PREVIOUSLY.
AND WE'VE BEEN SUPPORTING A LOT
OF THESE INDIVIDUALS.
AND THEY ARE REALLY GETTING, I
DON'T KNOW, MICHAEL, LOUIS, YOU
GO TO THE SAME MEETINGS, AND
LAURA, I NOTICED UPTICK IN YOUNG
PEOPLE FROM DIVERSE BACKGROUNDS.
AND SO I THINK THERE'S SOME
POSITIVITY GOING ON THERE.
AND NOT JUST ATTENDING THE
MEETINGS, YOU KNOW, AND NOT
BEING INTERESTED, THESE ARE KIDS
THAT ARE REALLY CLEARLY
INTERESTED AND COME UP TO YOU
AND WANT TO TALK TO YOU ABOUT
CAREER OPPORTUNITIES.
SO THAT'S WHAT I PICK UP ON.
AS FAR AS METRICS, WE'RE GOING
TO GET THOSE METRICS.
THAT'S WHAT DAWN IS GOING TO BE
WORKING ON.
YOU KNOW, WE HAVE REGULAR
SURVEYS EVERY YEAR.
AND SO HOPEFULLY WE'LL BE ABLE
TO GET SOME OF THAT INFORMATION.
I MEAN, BEING A SMALL INSTITUTE,
SOMETIMES THE METRICS ARE, YOU
KNOW, IN NUMBERS ARE NOT
SUFFICIENT TO REALLY MAKE MUCH
OUT OF STATISTICAL SIGNIFICANCE.
KEEP ASKING THAT QUESTION.
IT'S REALLY IMPORTANT.
JUST SO YOU KNOW, GARY GIBBONS,
DIRECTOR OF HEART AND LUNG,
ASKED THE SAME QUESTION AT THE
INSTITUTE DIRECTOR'S MEETING
THIS MORNING.
COULD HE HAVE SOME HARD CORE
NUMBERS FOR HOW MANY PEOPLE ARE,
YOU KNOW, ASKED, YOU KNOW,
CONTACTING CYBILL FOR PROBLEMS
ASSOCIATED WITH INEQUITIES.
IT IS AN NIH-WIDE EFFORT GOING
ON, AND WE'RE GOING TO DO OUR
PART.
KATIE?
>> I WANTED TO GO BACK TO THE
RESOURCES AND THANK NIAAA FOR
PUTTING THEM TOGETHER.
ESPECIALLY WE JUST USED THE
COLLEGE AIM AT UNIVERSITY OF NEW
MEXICO TO EVALUATE OUR COLLEGE
LEVEL SUBSTANCE USE PREVENTION
PROGRAMMING.
THANK YOU, MARY, FOR THAT
RESOURCE.
EVERY TIME I TALK TO A REPORTER
I MENTION AT LEAST ONE OF THE
RESOURCES.
WE ALL CAN BE DOING THAT.
ONE THING WHEN YOU TALK TO A
REPORTER ABOUT, DAVID, YOUR
RESEARCH, COULD YOU MENTION
HEALTH CARE RESEARCH.
YOU'RE TIPALLY NOT A HUMAN
RESEARCHER BUT MAYBE COULD STILL
TALK ABOUT IT.
I'M CURIOUS IF NIAAA IS
COLLECTING DATA ON THE USAGE OF
THESE DIFFERENT TOOLS AND
WHETHER THAT COULD IDENTIFY
PLACES WHERE IT'S BEING USED
SUCCESSFULLY AND MAYBE LEARN
FROM THOSE PLACES OF KIND OF HOW
IT'S GETTING USED.
>> BRIDGET, YOU CHART SOME OF
THIS.
>> RIGHT.
SO WE'RE LIMITED IN THE AMOUNT
OF DATA THAT WE CAN COLLECT, FOR
EXAMPLE, WE CAN EASILY LOOK AT
THINGS LIKE WEBSITE METRICS, AS
FAR AS LIKE WHAT PAGES PEOPLE
ARE VISITING, WHAT DOWNLOADS
THEY ARE DOING.
SO WE CAN LOOK AT THOSE KINDS OF
DATA BUT WE AREN'T ABLE TO DO
ANYTHING LIKE LARGE SURVEYS TO
GET MORE MAYBE QUALITATIVE DATA
ON HOW PEOPLE ARE USING IT.
SO WE CAN GET SOME LIMITED DATA
BUT I THINK SOME OF THE THINGS
THAT ARE PROBABLY MORE OF
INTEREST LIKE WHAT YOU'RE ASKING
ABOUT, WE'RE SORT OF LIMITED IN
COLLECTING THAT KIND OF DATA.
>> OKAY.
SO ONE MORE AND WE'RE GOING TO
BREAK FOR LUNCH.
>> I WILL AGREE THAT THE -- WE
NEED THE METRICS BUT I AGREE
WE'RE MAKING PROGRESS IN THIS
AREA, SO IF WE CAN GET THE
METRICS AND GET THE WORD OUT,
THE BETTER.
>> ARE YOU PICKING UP THE SAME
THING I AM, THAT YOUNGER PEOPLE
ARE SEEMING MUCH MORE INTERESTED
IN THE CAREERS?
>> OH, YEAH, SPECIFIC ROLE OF
NIAAA IN THIS WOULD BE VERY
HELPFUL IN PLANNING AT OUR
LEVEL.
>> WE'RE ALSO SEEING A LOT MORE
WOMEN ENTERING SCIENCE, OUR
SCIENCE, THAN PREVIOUSLY.
SO, YOU KNOW, MY LABORATORY IS
AT NIDA BUT I TRAIN A HERD OF
POST BACCALAUREATE FELLOWS EVERY
YEAR IN THE CONTEXT OF MY LAB.
AND WE'VE SEEN A DEFINITE UPTICK
IN BOTH DIVERSITY, BUT ALSO IN
WOMEN APPLYING TO THE POST
BACCALAUREATE PROGRAM, WHICH I
ALSO SEE AS ENCOURAGING.
BUT AGAIN IT'S ONLY -- IT'S AN
N-of-1 THERE.
ALL RIGHT.
WE'RE GOING TO STOP FOR LUNCH,
RECONVENE AT 1:00 OR CLOSE TO
IT.
LUNCH IS GOING TO BE BROUGHT IN
HERE, IS THAT CORRECT, PHILIPPE?
>> IT'S OUTSIDE.
>> GRAB IT, COME BACK IN.
I'LL HAVE A LITTLE MEETING WITH
THE NEW HEAD OF FRIENDS OF NIAAA
IN MY OFFICE, AND THEN I'LL BE
HERE TO JOIN YOU FOR LUNCH AS
WELL.
THANKS, EVERYBODY.
>>IT'S A REAL PLEASURE TO
INTRODUCE OUR SPEAKER, ONE OF
OUR SPEAKERS TODAY, WE'LL HAVE
TWO.
AND DAVID IS THE DIRECTOR OF THE
INDIANA ALCOHOL RESEARCH CENTER
AND DIRECTOR OF THE
NEUROPSYCHOLOGY SECTION IN
DEPARTMENT OF NEUROLOGY AT
INDIANA UNIVERSITY SCHOOL OF
MEDICINE.
ALSO THE DEPARTMENT'S VICE CHAIR
FOR RESEARCH.
HIS EXPERTISE COMPRISES THE
IMAGING OF THE HUMAN BRAIN'S
REWARD SYSTEM AS WELL AS
MOTIVATED BEHAVIOR FOR NATURAL
REWARDS AND ALCOHOL.
THE LATTER OFTEN USING
PHARMACOKINETICALLY MODELED
INTERVENOUS ALCOHOL
ADMINISTRATION AND INFUSION,
INCLUDING VULNERABILITIES THAT
MAY PREDISPOSE PEOPLE USING
fMRI AND POSITRON EMISSION
TOMOGRAPHY, KNOWN AS PET.
MUCH RESEARCH ALSO EMPLOYS
ALCOHOL AND FOOD CUES
ADMINISTERED AS BOTH AROMAS AND
TASTES.
DR. KERIKEN'S RESEARCH IS
SYSTEMS OVER REWARD BEHAVIOR.
DAVID, LOOKING FORWARD TO YOUR
TALK.
MAYBE DAVID IS GOING TO GIVE
PAL'S TALK AND PAL WILL GIVE
DAVID'S TALK, A CHALLENGE FOR
PROMOTION TO FULL PROFESSORS TO
BOTH OF YOU.
THANKS VERY MUCH.
WE'RE COMFORTABLE WITH THIS
MATERIAL.
THANKS.
THANKS FOR THE COUNCIL AND DR.
KOOB FOR INVITING ME TO PRESENT
THE WORK THAT I DO.
THIS IS IN MY LABORATORY, BUT A
LOT OF WHAT WE DO IS SORT OF
TAKEN FROM THE ALCOHOL RESEARCH
CENTER AT INDIANA UNIVERSITY.
AND ITS LONG HISTORY NOW OF
EXAMINING THE HERITABLE
VULNERABILITIES AT LEVEL OF
BRAIN THAT LEAD TO ALCOHOL USE
DISORDER.
AS DR. KOOB MENTIONED THIS IS
KIND OF DIVIDED IN OUR LAB INTO
TWO BROAD CATEGORIES, THOSE
INVOLVING THE SUBCORTICAL REWARD
SYSTEM, MEDIAL FRONTAL SYSTEM
INVOLVED, AND SUBJECTIVE REWARD
VALUE, AS WELL AS REGIONS OF THE
EXECUTIVE CONTROL SYSTEM.
AND WHEN I TALK TO THE PUBLIC, I
LIKE TO USE THIS NOW PROBABLY
PRETTY DATED REFERENCE OF DR.
DOOLITTLE AND THE PUSH YOU/PULL
ME MYTHICAL ANIMAL, BECAUSE IN
ORDER FOR ADAPTIVE BEHAVIOR TO
WORK, BOTH FOR ALCOHOL AND DRUGS
BUT ALSO NATURAL REWARDS, YOU
NEED THIS INTENTION BETWEEN
THESE TWO SYSTEMS TO BE FINELY
REGULATED SO THE APPERTIVE
REWARD IS CONSTRAINED WHEN
NEEDED AND LOOSE AND REGULATED
APPROPRIATELY.
SO I WANT TO START BY TALKING
ABOUT REWARD SYSTEMS, PREFRONTAL
AND CORTICAL AREAS, HOW I GOT
STARTED.
I CAME WITH A DIFFERENT INTEREST
IN CHEMICAL SENSE, OLFACTION AND
GUSTATION, A LOT OF THE
IMAGENING WAS DONE WITH VISUAL
STIMULI THAT REMINDERS,
PAVOLVIAN STIMULI, WHAT'S A GOOD
STIMULUS, TASTE AND SMELL,
TAILOR THEM TO AN INDIVIDUAL'S
OWN HABITUALLY ENCOUNTERED
SMELLS AND FLAVORS FROM THE
ALCOHOL THEY USE,S THEY ARE THE
STIMULI THAT APPEAR PRIOR TO THE
RISE OF INTOXICATION.
FIRST FORAY WAS OLFACTION, THIS
IS THE COMPUTER CONTROLLED
OLFACTOMETER.
YOU CAN SEE THE TEST TUBES, WE
MIXED SUBJECTS OWN MOST USED TWO
MOST PREFERRED DRINKS WHEN
SEEKING TO BECOME INTOXICATE AND
COMPARED TO APPETITIVE CONTROLS
OF GRAPE AND CHOCOLATE, ONE
ASSOCIATED WITH INTOXICATION,
BOTH HAVING REWARD VALUE.
I WOULD ROLL THE CART ALONG THE
HIGHWAYS, A NEURORADIOLOGIST
CAME TO CALL ME STINKY KAREKEN,
ROLLING THE ODORANTS AROUND.
THIS IS THOSE WHO ARE FAMILY HIS
POSITIVE AND HEAVY DRINKERS AND
HEAVY DRINKERS WITH NO KNOWN
HISTORY.
THE STUDY WAS MORE COMPLICATED
BUT THE SIMPLE ASPECT WAS THAT
IN FACT THOSE WITH A FAMILY
HISTORY OF ALCOHOL USE DISORDER
DID HAVE MORE ACTIVATION OF
THESE MEDIAL PREFRONTAL AREAS
FROM THESE APPERTIVE AROMAS
COMPARED TO THOSE WITHOUT A
FAMILY HISTORY.
AND I WAS DISAPPOINTED WE DIDN'T
SEE MUCH STRIATAL ACTIVATION,
THIS LED US DOWN TO THE NEXT
STUDY USING POSITRON EMISSION
TOMOGRAPHY, IN HABITUAL BEER
DRINKERS.
WE WERE ABLE TO SQUEEZE IN A
SIZEABLE SAMPLE FOR PET WHICH IS
AN EXPENSIVE TECHNOLOGY.
THE IDEA BEHIND THIS FOR THOSE
WHO MAY NOT BE FAMILIAR WITH HOW
WE DO THIS, THIS ISN'T IN VIVO
VOLTOMETRY OR DIALYSIS BUT
LOOKING AT STRIATAL DOPAMINE
RELEASE IN HUMANS USING THIS
CARBON LABELED D2 D3 ANTAGONIST,
THE STORY BEHIND THIS PARTICULAR
RADIO TRACER IS THAT IT CAN BE
ENDOGENOUSLY DISPLACED,
DISPLACED BY ENDOGENOUS DOPAMINE
RELEASE.
IF YOU'RE IN A SITUATION IN
WHICH YOU APPETIVELY EXCITED AND
RELEASING DOME MEAN STRIATALLY,
LESS BIND OF TRACER, LESS
BINDING POTENTIAL.
WE DID THIS BY PROVOKING
DOPAMINE RELEASE USING EACH
SUBJECT'S OWN MOST USED BEER
PRIOR, WHEN SEEKING TO BECOME
INTOXICATED.
THIS IS WORK THAT WAS LED BY MY
POSTDOC AT THE TIME, BRANDON
OVERLAND, NOW HIS OWN
INVESTIGATOR IN PSYCHIATRY, AND
ASSISTED WITH CARMEN YODER IN
RADIOLOGY TO HANDLE THE PET END.
THIS SHOWS ONE SYRINGE LOADED
WITH BEER, ONE WITH GATORADE,
INTENSITY MATCHED CONTROL FOR
BAD AMERICAN BEER THAT DOESN'T
HAVE TOO MUCH FLAVOR, THESE WERE
HEAVY DRINKING INDIVIDUALS AS
YOU CAN SEE FROM CON
CONSUMPTION IN AUDIT.
THIS IS AN ML, SMALL AMOUNTS,
PER STIMULATION, 15 LITTLE
SQUIRTS OVER THE TIME AS TRACER
IS BEING TAKEN UP.
15 MLs OF BEER OVER 15
MINUTES, NOT PHARMACOLOGICALLY
SIGNIFICANT BUT PAVLOVIAN
STIMULUS OF BEER FLAVOR ALONE
WAS SUFFICIENT TO RELEASE
DOPAMINE LATERALLY, PAY
ATTENTION AND HOLD THAT IN MIND,
RIGHT VENTRAL STRIATUM IN HEAVY
DRINKERS.
IN THIS SITUATION THE
INTERESTING STORY IS THAT REALLY
THE EFFECT WAS DRIVEN LARGELY BY
THOSE WITH A FAMILY HISTORY OF
ALCOHOL USE DISORDER AS COMPARED
TO THOSE WHO HAD -- THIS IS
DEFINED BY AT LEAST ONE FIRST
DEGREE RELATIVE, SECOND THOSE
WITH ANY SECOND DEGREE BUT NO
FIRST DEGREE RELATIVES, AND
THOSE FAMILY HISTORY NEGATIVE
ARE THE OTHER TWO GROUPS.
SO, SUGGESTING AS THE fMRI
STUDY DID THAT FAMILY HISTORY
MAY BRING A SORT OF PRIMING OF
THE REWARD SYSTEM.
WE HAD A SMALL SUBCOMPONENT OF
THE SUBJECTS WHO ALSO HAD
fMRI.
IT IS CLOSELY MATCHED OF A
STIMULATION PARADIGM GETTING
BEER SCANS AND GATORADE SCANS.
HERE YOU SEE THERE'S RIGHT
LATIZED ACTIVITY, ALSO WHEN YOU
CORRELATE THE ACTIVATION SIGNAL
OF BEER GREATER THAN GATORADE,
HOW DOES THAT CORRELATE WITH
NUMBER OF BEERS WANTED IN
RESPONSE TO FLAVOR STIMULATION
THAT RISES AFTER PEOPLE GET THAT
SPRITZ, YOU SEE THIS SUBJECTIVE
REWARD AREA, SUBJECTIVE REWARD
VALUE AREA, MEDIAL PRE-FRONTAL
CORTEX.
THE BOLD ACTIVATION IS GREATER
WITH, ASCENDS WITH NUMBER OF
BEERS WANTED ACROSS THE
SUBJECTS.
SO, AGAIN, RIGHT LATERALIZED.
YOU'LL SEE THIS POP UP AGAIN.
SO IT WAS TOO HARD TO RESIST
GOING A LITTLE FURTHER WITH THIS
BECAUSE MOST HUMAN STUDIES GET
LIMITED TO THE SIMPLE SORT OF
PASSIVE STIMULATION IMAGES,
SMELLS, TASTE, THAT SORT OF
THING.
BUT THIS WAS OUR OPPORTUNITY TO
TAKE A HUMAN, PUT IT IN THE HOME
CAGE, GIVE IT A LEVER, AND
REALLY REPLICATE WHAT HAPPENS
WITH ALCOHOL SELF-ADMINISTRATION
WHICH I SAY IS SORT OF
COLLOQUIALLY REFERRED TO BY MOST
NORMAL PEOPLE AS DRINKING.
SO, BUT THIS WAS A CHANCE TO
DISASSOCIATE AND DISSECT THIS.
SO WHAT HAPPENS WHEN YOU DRINK?
SO, THERE'S SOME INSTRUMENTAL
BEHAVIOR INVOLVED, RIGHT?
I THINK THAT'S AN UNDEREXAMINED
ASPECT.
AND YOU HAVE TO REACH OUT, YOU
HAVE TO USE YOUR MOTOR SYSTEM
AND DO SOMETHING.
YOU HAVE TO DELIVER THE ALCOHOL
BUT AT LEAST TWO THINGS ARE
HAPPENING WITH THE ALCOHOL.
YOU HAVE THE FLAVOR,
SOMATOSENSORY ASPECTS, ALL OF
WHICH SERVE AS PAVLOVIAN AND
PHARMACOLOGIC.
WE WANTED TO DO OUR BEST AND
DIVIDE THIS OUT, GUSTOMETER
DELIVERED PAVLOVIAN ASPECT, THE
ALCOHOL WE USED COMPUTER
ADMINISTRATED INFUSION SYSTEM
DEVELOPED BY SEAN O'CONNOR AT
INDIANA UNIVERSITY AND NOW LED
BY MARTY PLUEKI, USING A
PHARMACOKINETIC MODEL TO MODEL
ALCOHOL ELIMINATION,
DISTRIBUTION, ELIMINATION,
PRECISELY TO CONTROL THE BRAIN
EXPOSURE WHICH IS MUCH HARDER TO
DO WITH ORAL CONSUMPTION AND
DURING IMAGING IT'S IMPOSSIBLE.
YOU CAN'T HAVE PEOPLE CONSUMING
ALCOHOL IN ANY MEANINGFUL WAY.
SO THIS IS WHAT THE STUDY LOOKED
LIKE.
WHAT WE HAD, WE WERE ABLE TO
GIVE THREE DIFFERENT PET SCANS,
WE HELD PEOPLE OVERNIGHT AT IU,
AND WE DID A SORT OF PARAMETRIC
COMBINATION OF FLAVORS AND
ETHANOL.
AND SUBJECTS SAW ON A SCREEN IN
FRONT OF THEM THESE BEER GLASSES
THAT WOULD SLOWLY SORT OF DRAIN
OF FLUID, EVERY TIME THEY
PRESSED THEY WERE INSTRUCTED TO
PRESS A BUTTON THAT WOULD
ADMINISTER THE FLAVOR.
SO THEY GOT THE SPRITZ OF BEER
AND AT THE SAME TIME WE HAD AN
ASCENDING CAREFULLY CONTROLLED
ASCENDING LIMB OF ALCOHOL
EXPOSURE IN THE BRAIN,
ADMINISTERED IV.
AND THEN CLAMPED AT 60
MILLIGRAMS PER CENT TO HOLD IT
STEADY SO THERE BE WOULD NO
VARIATION ACROSS PEOPLE.
THIS CORRESPONDED WITH AVERAGE
HEIGHT-WEIGHT MALE.
THESE WERE ALL MEN, FOR OTHER
REASONS THAT I WON'T GO INTO.
SO, OKAY.
GRANTED, THIS IS NOT THE FACULTY
LOUNGE HAVING ONE'S PREFERRED
COCKTAIL AFTER WORK BUT IT'S AS
CLOSE AS WE COULD GET INSIDE A
PET SCANNER.
SO, THE UPSHOT OF THIS IS BY
CONTROLLING FOR ETHANOL
EXPOSURE, LOOKING ONLY AT
CONDITIONED STIMULUS ALCOHOL
FLAVOR.
AGAIN DOPAMINE RELEASE IN THE
RIGHT VENTRAL STRIATUM.
BUT THEN WHEN YOU GO ACROSS AND
YOU CONTROL FOR THE FLAVOR, THE
NEUTRAL GATORADE, AND WE TOLD
SUBJECTS FOR ONE OF THESE SCANS
YOU'LL GET THE GATORADE IN THE
ALCOHOL, CONSIDERED IT SPIKED
GATORADE SO THEY WERE AWARE OF
WHAT THEY WERE GETTING.
YOU GET LEFT VENTRAL STRIATAL
RELEASE FROM THE ETHANOL.
IT'S WHEN YOU LOOK AT THE
NATURALISTIC CONDITION YOU WOULD
NORMALLY EXPERIENCE WITH
DRINKING WHEN THE CONDITIONED
STIMULUS MATCHES THE
PHARMACOLOGIC CONTENT OF THE
DRUG THEN YOU GET THE BILATERAL
RESPONSE AND DOPAMINE RELEASE.
OKAY.
SO I WANT TO STICK WITH THE
GUSTATORY MODALITY, TASTE
SPECIFIC.
YOU CAN'T DO THIS IN
ADOLESCENTS.
YOU CAN'T DO THIS IN RECOVERING
ALCOHOLICS OR THOSE WITH ALCOHOL
USE DISORDER BECAUSE YOU DON'T
WANT TO BE EXPOSING THESE
INDIVIDUALS TO THEIR ALCOHOL
FLAVORS FOR ETHICAL REASONS.
BUT THERE WAS THIS BODY OF
RESEARCH THAT WAS ATTRACTING ME
AT THE HUMAN LEVEL AND ANIMAL
LEVEL.
THERE ARE SOME HUMAN DATA,
ALEXEI TALKS ABOUT A SWEET
PREFERENCE, THOSE AT RISK FOR
ALCOHOL USE DISORDERS, BUT ALSO
THOSE RECOVERING FROM ALCOHOL
USE DISORDER, BUT ALL THE ANIMAL
RESEARCHERS IN THE ROOM WILL
RECOGNIZE THIS THING, WHICH IS
THAT RODENTS THAT ARE
SELECTIVELY BRED FOR ALCOHOL
PREFERENCE BRING ALONG A
CORRELATED TRAIT THEY LIKE
SWEETENED WATER AND STIMULI.
THESE ARE THE INDIANA P RATS,
WHO YOU CAN SEE, THIS IS THEIR
HOME CAGE DRINKING.
SO THEY ARE COMPARED TO WYSS
STARS, 20 MINUTES OVER 30-MINUTE
PERIODS, OUTDRINK THE WYSS STARS
AND ALCOHOL, BUT IT'S ALSO THE
CASE THAT THERE'S A
SIGNIFICANTLY GREATER INTAKE OF
SUCROSE OR SACCHARINE SOLUTIONS.
THESE ANIMALS ARE AVAILABLE AS
A SHARED RESOURCE AND
CORRESPONDING MICE.
WHAT HADN'T BEEN DONE IN HUMANS
LOOKING AT THE BRAIN RESPONSE TO
SUCROSE AND SWEET.
THIS IS HOT OFF THE PRESS.
JONATHAN ALESSY, LEAD AUTHOR,
MD/PHD STUDENT IN MY LAB.
WE PUBLISHED THIS ARTICLE IN
HIGH INTENSITY SWEET TASTE AS A
PREDICTOR OF SUBJECTIVE ALCOHOL
RESPONSES.
SO WE HAD A PRETTY RESPECTABLE
SAMPLE OF 140 INDIVIDUALS WHO
WERE MATCHED BAM H. 3W57 THE --
BALANCED IN FAMILY HISTORY AND
RECENT DRINKING.
CAME FOR fMRI TO GET EXPOSED
TO GUSTATORY STIMULATION, FAINT,
HARD TO TELL, AND A SWEET
SOLUTION CONCENTRATION SUCROSE,
SUCROSE PRIMARY, MONEY
SECONDARY.
AND THEN AFTER MRI A FEW DAYS
LATER AND TWO WEEKS LATER THE
SUBJECTS CAME AND ABOUT AN
INTRAVENOUS ALCOHOL
SELF-ADMINISTRATION SESSION.
AND THIS IS WHAT THIS LOOKS
LIKE.
YOU SAW THAT IN THE PREVIOUS PET
STUDY WE CLAMPED ALCOHOL
EXPOSURE TO KEEP IT CONSTANT
DURING IMAGING.
THIS IS OUTSIDE IMAGING IN A
HOSPITAL ROOM, AND THE SUBJECTS
STARTED WITH A BRIEF
STANDARDIZED PRIME SO THEY CAN
FIND OUT WHAT IT'S LIKE TO GET
ALCOHOL IV RAPIDLY TAKEN UP IN
ABOUT TEN MINUTES TO 30
MILLIGRAMS PERCENT, NOT A HIGH
EXPOSURE BUT PRETTY RAPID RATE
OF INCREASE OVER A SHORT PERIOD
OF TIME.
YOU DON'T NORMALLY DO THAT.
YOU DON'T NORMALLY EXPERIENCE
THAT WHEN DRINKING.
AND THEN THEY ARE SET LOOSE AT
30 MINUTES AFTER THEY REACH
AROUND 10 OR 15 TO DO WHAT THEY
WANT.
THIS IS JUST ONE SUBJECT WHO
GOES OFF AND SELF-ADMINISTERS AS
MUCH OR AS LITTLE UP TO A SAFETY
LIMIT OF 150 MILLIGRAMS PERCENT.
WHAT I WANT TO CONCENTRATE ON
BECAUSE OF THE VARIABILITY IS
THE PRIME.
AND WHAT WE'RE LOOKING AT HERE
IS SUBJECTIVE RESPONSES AT THE
PEAK OF PRIME COMPARED TO THE
BASELINE BEFORE INFUSION.
SO, FOR THIS, THE DEPENDENT
MEASURE IS A PRINCIPAL COMPONENT
OF FOUR VERY HIGHLY
INTERCORRELATED RESPONSES WHICH
ARE INTOXICATION, PERCEIVED
NUMBER OF DRINKS, WHICH SUBJECTS
ARE PRETTY GOOD AT, AT
PREDICTING OR ESTIMATING FROM
THE PRIME.
HOW MUCH THEY ENJOY IT AND THEIR
PERCEIVED STIMULATION.
SO, THE PRINCIPAL RESULTS, WHAT
YOU SEE IN BLUE IS THE BOLD
ACTIVATION OF THE BRAIN FROM THE
HIGH INTENSITY SUCROSE
STIMULATION.
WHERE'S MY CURSOR?
OKAY.
SO THE BLUE IS REGIONS OF THE
BRAIN THAT GET ACTIVATED FROM
HIGH INTENSITY SUCROSE, .85, YOU
SEE GUSTATORY REGIONS IN INSULA,
POSTERIORLY, INTENTIONAL
SALIENTS AREA MORE ANTERIORLY.
IN GREEN AND PINK, TWO DIFFERENT
STATISTICAL THRESHOLDS FOR
ILLUSTRATION PURPOSES, THIS IS
NOT THE ACTIVATION BUT THIS IS
THE CORRELATION BETWEEN THE
ACTIVATION TO SUCROSE AND THE
PERCEIVED ENJOYABLE INTOXICATION
THAT SUBJECTS EXPERIENCED FROM
THE ALCOHOL PRIME SEVERAL DAYS
TO TWO WEEKS LATER.
SO, THE ACTIVATION TO THE
SUCROSE IS PREDICTING SUBJECTS'
RESPONSE TO THE ALCOHOL.
YOU REMEMBER THAT WE ALSO DID A
MONETARY INCENTIVE DELAY
PARADIGM TO LOOK AT THE RESPONSE
TO ANTICIPATION AND RECEIPT OF
MONETARY REWARD.
THE SECONDARY REWARD.
AND WHAT YOU SEE IN BLUE HERE IS
THAT BOTH OF THESE PARADIGMS,
SUCROSE AND THE MONETARY
ACTIVATION, MONETARY
ANTICIPATION, BOTH ACTIVATE THE
INSULA.
OKAY?
BUT THE MONETARY REWARD EITHER
ANTICIPATION OR RECEIPT WAS
REALLY UNRELATED TO THE
ACTIVATION DESPITE THE FACT THEY
ARE BOTH ROBUST ACTIVATORS, IT'S
IN ANCILLARY AREAS THAT ARE
INVOLVED IN THIS INTENTIONAL
SALINE NETWORK THAT REFLECT
WHERE ACTIVATION UNDER SUCROSE
REFLECTS THE EXPERIENCE FROM
THIS ALCOHOL PRIME.
KEEPING IN MIND THAT AS ANDREA
KING AND OTHERS HAVE SHOWN, THAT
THIS SORT OF POSITIVE REWARDING
ASPECTS OF ALCOHOL ON THE RISING
LIMB ARE A RISK FACTOR FOR
FUTURE ALCOHOL USE DISORDER AND
FOR FUTURE BINGE DRINKING.
HERE WE HAVE PRIMARY REWARD
THAT'S SAFE AND USABLE IN ALL
KINDS OF SUBJECTS THAT MAY
REFLECT ATTUNING OF ONE'S BRAIN
IN SALIENCE REGIONS THAT MIGHT
INDICATE A RISK.
THE LAST THING I WANT TO TALK
ABOUT IS THIS EXECUTIVE CONTROL
SYSTEM.
I WISH THIS WERE A SIMPLER STUDY
TO TALK ABOUT, AS THE LAB CHIEF
SAYS WHY CAN'T YOU DISCOVER
ANYTHING THAT'S EASY TO TALK
ABOUT ON A TALK SHOW?
LET ME WALK YOU THROUGH MY
REASONING, AS WE DID THIS.
THE IDEA, THIS WAS ONE OF THOSE
TARGETS OF OPPORTUNITY THAT
REALLY WASN'T PLANNED BUT I
LOOKED AT THIS REPORT A NUMBER
OF YEARS AGO FROM ASHLEY
ACHINSON EXAMINING GO/NO GO
PARADIGM, MOST PEOPLE IN THE
ROOM ARE AWARE OF WHAT THIS IS
LIKE.
AND REPORTED THAT THERE'S
GREATER ACTIVATION IN FAMILY
HISTORY POSITIVE COMPARED TO
FAMILY HISTORY NEGATIVE.
BUT THE COMPLICATION HERE IN
THIS REPORT WAS YOU SEE THE
AREAS THAT ARE GREATER IN FAMILY
HISTORY POSITIVE UNDER BOTH
CONTROL BLOCK OF GOING AS WELL
AS THE BLOCK OF INTEREST OF
MOTOR INHIBITION OF GOING AND
NOT GOING, RESTRAINING ONE'S
RESPONSE.
SO THAT'S ONE COMPLICATION.
THE OTHER IS, THIS IS WHAT
REALLY STUCK OUT TO ME AND I
NOTICED IAN COALRAIN HAD
PUBLISHED AN INTERESTING
COMMENTARY ON THIS, BACK HERE IS
A PRIMARY NODE OF THE BRAIN'S
DEFAULT MODE NETWORK, A REGION
OF THE NEURAL NETWORK OF THE
BRAIN THAT BECOMES MORE
PROMINENT WHEN YOU ARE AT REST
AND LESS INVOLVED WITH COGNITIVE
CHALLENGES AND ACTIVE THINKING
AND DELIBERATION DEALING WITH
THE OUTSIDE WORLD.
AND ALL OF THE ACTIVATED AREAS,
ALMOST ALL, ARE NICE DEFAULT
MODE MAPS.
THE ASSERTION OR CONCLUSION
THOSE WOULD BE THE HISTORY OF
ALCOHOL USE DISORDER ACTIVATING
THE DEFAULT AREAS MORE INCLUDING
THIS SORT OF CHALLENGING AREA.
THAT DIDN'T QUITE MAKE SENSE TO
ME.
SO I WENT BACK THROUGH DATA WE
PREVIOUSLY PUBLISHED, USING A
STOP SIGNAL TASK, KIND OF
SIMILAR THAN THE GO/NO GO TASK
AND FOUND THE SAME THING.
THAT IN THIS POSTERIOR PROMINENT
NODE, PRE-DUNOUS, POSTERIOR
CINGULATE AREA, WE SAW THIS
GREATER ACTIVATION.
THAT WAS UNDERGO.
UNDER STOP IT BECAME MORE
PROMINENT.
WE HAD A BIGGER GO RESPONSE,
DIDN'T MAKE SENSE.
I THOUGHT YOU KNOW WHAT, I'LL
BET IT'S NOT GREATER ACTIVATION,
I'LL BET IT'S GREATER
DEACTIVATION IN THE FAMILY
HISTORY POSITIVE INDIVIDUALS.
THAT'S EXACTLY WHAT WAS GOING
ON.
SO THE FAMILY HISTORY NEGATIVE
INDIVIDUALS, WHAT THEY ARE DOING
IS SHOWING A MUCH GREATER
ALTERNATION IN DEFAULT MODE
NETWORK, ON AND OFF STATES IN
THIS NETWORK ARE GREATER.
THE APPARENT GREATER ACTIVATION
IS REALLY BECAUSE FAMILY HISTORY
POSITIVES ARE NOT CHANGING MUCH
AND THE FAMILY HISTORY NEGATIVES
ARE DROPPING LOW.
OKAY.
SO THAT'S WHAT LED TO THIS NEXT
STUDY WHICH WAS A MORE
DELIBERATE ATTEMPT TO LOOK AT
MAYBE NOT SO MUCH THE ASPECT OF
EXECUTIVE CONTROL AND INHIBITION
BUT MORE THE ALTERNATION, A LOT
OF WHAT GOES ON IN THIS TENSION,
REFLECTING, GOING BACK AND
FORTH.
WE STARTED A COLLABORATION WITH
JOAQUIN GONI, PURDUE UNIVERSITY,
WHO RUNS THE COMPLEXITY LAB AND
DOES INNOVATIVE GREAT WORK,
METRICS AND NETWORK ANALYSES,
NOW HE'S UP TO HIS NECK IN
ALCOHOL RESEARCH, WITH OUR
GROUP.
AND HE'S A GREAT GUY TO BE
WORKING WITH.
ENRICO WAS A POSTDOC IN HIS LAB
AT THE TIME.
WE WERE LESS INTERESTED IN
TALKING ABOUT SPECIFIC NODES OF
ACTIVATION AND MORE INTERESTED
IN THE DYNAMIC CONNECTIVITY AND
INTERRELATEDNESS OF THE WHOLE
BRAIN PARCELED INTO THESE SEVEN
CANONICAL NETWORKS.
THE WAY YOU PARCEL THE
INDIVIDUAL REGIONS AND THE WAY
YOU PARCEL THESE NETWORKS IS
EMPIRICALLY DETERMINED AND THERE
ARE OTHER WAYS OF DOING IT, YAO
HAS A 17 NETWORK PARCELLATION,
IT'S A QUESTION OF HOW MANY DATA
YOU CAN HANDLE AND STAND TO
INTERPRET.
AND THESE ARE THE -- NO MATTER
HOW YOU DO IT THESE TEND TO BE
ROUGH CANONICAL NETWORKS,
VISUAL, SOMATOMOTOR, DORSAL
ATTENTION, VENTRAL ATTENTION,
LIMBIC, FRONTOPARIETAL AND THESE
THAT I MENTIONED.
THIS STUDY WAS DIFFERENT.
WE DID IT IN TWO SCANS, ONE VERY
LONG SCAN.
FIRST THE TYPICAL RESTING
CONNECTIVITY SCAN THAT YOU SEE.
DIVIDED THE TWO 4-MINUTE EPICS,
SUBJECTS LAY PASSIVELY AND
LOOKED AT CROSS-HAIRS.
WE DID A LONG SCAN, SUBJECTS
PERFORMED THE STOP SIGNAL TASK
WHICH REQUIRES MAKING GO
RESPONSES AND THEN QUICKLY
WITHDRAWING ONE'S RESPONSE WHEN
YOU SEE A STOP SIGNAL, QUITE
DEMANDING.
VERY FRUSTRATING TO SUBJECTS.
AND THEN WHILE WE LET THE
SCANNER RUN WE TOLD THEM WITH
SOME WRITTEN INSTRUCTIONS, OKAY,
RELAX, STOP DOING THE TASK, JUST
GO AHEAD AND START RESTING.
AND WHAT WE'RE REALLY INTERESTED
IN IS THIS TRANSITION, DYNAMIC
TRANSITION.
AND DURING EACH OF THESE PERIODS
YOU CAN DERIVE THESE WHOLE BRAIN
CONNECTIVITY MATRICES, AND
ANALYZE THEM.
WHEN MOST PEOPLE DO THIS THEY
ARE LOOKING AT THE AVERAGE
CONNECTIVITY MATRICES, OKAY?
GROUP 1 AVERAGE, GROUP 2
AVERAGE, ET CETERA.
BUT THE INSIGHT THAT PROFESSOR
GONY HAD, YOU CAN DECOMPOSE
MATRICES.
MY VOICE HAS HIGH TONES, LOW
TONES, THROAT CONGESTION, YOU
CAN DECOMPOSE THOSE FREQUENCIES.
HE'S DOING THE SAME THING WITH
THESE MATRICES AND DECOMPOSING
THEM, EACH SUBJECT WILL HAVE A
LOADING INDICATING HOW MUCH OF
THE COMPONENT SUBCOMPONENT IS
PRESENT IN THAT PERSON, THE
FIRST COMPONENT TURNS OUT TO BE
THESE CANONICAL NETWORKS, THAT
WE ALL HAVE.
AND THEN YOU CAN GET OTHER
COMPONENTS.
THAT'S WHAT WE WERE INTERESTED
IN.
IN PARTICULAR INTERESTED IN
FINDING COMPONENTS THAT
DIFFERENTIATED THOSE WITH AND
WITHOUT A FAMILY HISTORY OF AUD.
AND WE TESTED 15 EMPIRICALLY
DETERMINED -- 15 COMPONENTS
ESTIMATED FROM EACH OF THESE
PERIODS AND TESTED THEM FOR WHAT
WOULD DIFFER ACROSS FAMILY
HISTORY.
AND ONLY ONE COMPONENT DID
DIFFERENTIATE BETWEEN THE FAMILY
HISTORY GROUPS AND IT APPEARED
SHORTLY AFTER THE TASK AS PEOPLE
WERE STOPPING THE TASK AND
SETTLING INTO THE REST.
WE CONFIRMED THIS WITH A MOVING
WINDOW ANALYSIS SHOWING THAT
WITHIN THE MINUTES HAVING
STOPPED THE TASK, THIS COMPONENT
EMERGES AND THEN GOES AWAY.
DOESN'T APPEAR IN THE FIRST
REST, DOESN'T APPEAR IN THE LAST
REST.
THIS IS SORT OF WHAT THIS
COMPONENT LOOKS LIKE.
IT TAKES A WHILE TO UNDERSTAND
ALL OF THE SUBTLETIES.
ONE THING THAT STUCK OUT TO ME
WAS THAT NORMALLY THESE
FRONTOPARIETAL AREAS INVOLVED IN
EXECUTIVE CONTROL ARE ANTE
RELATED TO DEFAULT NETWORK BUT
IN THIS COMPONENT THEY ARE A
LITTLE MORE POSITIVELY
COORELATED WITH EACH OTHER.
THERE'S SOME OTHER THINGS THAT
INVOLVE VISUAL AND SOMATOMOTOR
NETWORKS THAT WE TEND NOT TO
THINK MUCH ABOUT IN ALCOHOL USE
DISORDER PER SE.
AND YOU CAN PLOT THESE
COMPONENTS OVER THE BRAIN TO
FIND OUT PRECISELY WHERE THEY
ARE.
BOTH THOSE THAT ARE THE POSITIVE
FUNCTIONAL CORRELATIONS BETWEEN
THE REGIONS AND THOSE THAT ARE
THE NECK.
BUT THE INTERESTING THING ABOUT
THIS IS CONSISTENT WITH THE
PRIOR BOLD STOP SIGNAL
ACTIVATION DATA AND WHAT I THINK
WAS GOING WITH THE ACHESON
REPORT, THOSE WITH NO FAMILY
HISTORY OF ALCOHOL USE DISORDER
HAD GREATER LOADING OF THIS
COMPONENT.
OKAY.
THOSE WHO ARE FAMILY HISTORY
POSITIVE HAD MUCH LESS OF A
LOADING OF IT.
WHAT THIS SUGGESTS IS THAT AS
SUBJECTS ARE TRANSITIONING FROM
THIS ACTIVATED STATE AND
ENTERING A REST PERIOD, THERE'S
SOME FUNCTIONAL RECONFIGURATION,
TRANSIENT RECONFIGURATION THAT
HAPPENS INVOLVING, SEX IS
RELATED.
AS WELL AS MOTION ARTIFACTS,
PERFORMANCE, STOP SIGNAL
REACTION TIME, AUDIT, THE THERE
WERE DIFFERENCES IN DRINKING
BETWEEN THE TWO SAMPLES AS OFTEN
IS THE CASE WHEN YOU DON'T
CAREFULLY CONTROL BECAUSE THOSE
WITH FAMILY HISTORY TEND TO
DRINK MORE.
WHEN CONTROLLING FOR THAT YOU
STILL FIND THOSE WITHOUT A
FAMILY HISTORY HAVE MORE OF THIS
TRANSITIONAL RECONFIGURATION.
A SUBSAMPLE HAD DELAYED
DISCOUNTING TO MEASURE REWARD
AND PATIENTS AND THAT SUBSAMPLE
INTERESTINGLY A COUPLE OTHER
THINGS POPPED UP, DEPRESSIVE
SYMPTOMS ON THE CES INVENTORY,
BEING MALE, HAVING MORE NEGATIVE
AFFECT, HAVING LESS FUNCTIONAL
NETWORK RECONFIGURATION.
ALL THESE THINGS IN THE
ANTICIPATED DIRECTION.
SO THOSE WITHOUT A FAMILY
HISTORY RECONFIGURED HOW THE
BRAIN AREAS COMMUNICATED WHEN
CHANGING MENTAL STATES, AS I
MENTIONED ALREADY MEN MORE
NEGATIVE AFFECT, LESS DELAYED
GRATIFICATION, ALL RELATED IN
THE SAME DIRECTION.
AND SO THIS SORT OF ADDS TO THE
IDEA FAMILY HISTORY RELATED
BRAIN SIGNATURES MIGHT BE LESS
RELATED TO THE TASK AND WHAT YOU
THINK YOU'RE MEASURING, PERHAPS
MORE RELATED TO THE TRANSITIONS
THAT OCCUR BETWEEN EVENTS.
AND FLEXIBILITY REQUIRED TO GO
BACK AND FORTH.
SO THIS IS A DIRECTION THAT
WE'RE NOW PURSUING WITH DR. GUNY
AND HIS GROUP ON TWO NEW
PROJECTS LOOKING AT ALCOHOL USE
DISORDER DIAGNOSIS AS WELL AS
MUCH LARGER STUDY OF FAMILY
HISTORY RISK AND HOW THAT
RELATES TO COGNITIVE CAPACITY.
HOPEFULLY I CAN COME BACK AND
TELL YOU HOW THAT'S GOING.
THANKS TO MY GROUP AND TO THE
NIAAA FOR ITS SUPPORT.
THANK YOU.
>> THANK YOU, DAVID.
REALLY INTERESTING.
YOU GAVE ME FLASHBACKS TO A
DISCUSSION I HAD WITH ENOCH
CONVINCED THERE WAS A
RELATIONSHIP BETWEEN NEURAL
CONTROL OF EATING AND ALCOHOL,
MOTIVATION FOR EATING,
MOTIVATION FOR ALCOHOL.
I FOUND THAT FAMILY HISTORY
POSITIVE PIECE WITH THE SWEET
SOLUTION FASCINATING.
YOU'RE ALSO AWARE LORENZO GOT
INTO THE SEMI GLUETIDE STORY,
GLP-1 AGONIST DECREASE ALCOHOL.
I WONDERED, ANY LINK THERE WITH
THE GENETICS OF THAT PART AND
THEN I'LL STOP BUT THERE'S
OTHERS WHO MAY WANT TO ASK YOU
SOME QUICK QUESTIONS.
>> YEAH, WE HAVE -- WE DO HAVE
BLOOD SAMPLES, DRIED BLOOD
UNFORTUNATELY, FOR THESE
SUBJECTS.
WE HAVE HAD THEM GENOTYPED ON A
CHIP AND WE'VE SORT OF TAKEN A
PRELIMINARY LOOK AND NOT FIND
MUCH.
IT'S HARD WITH ONLY 140 SUBJECTS
ON THE GENETIC END.
BUT I KNOW DR. LEGY AND I TALK
FROM TIME TO TIME, I'M CONVINCED
THERE'S A BIGGER STORY IN THE
GUT-BRAIN CONNECTION THAN WE
PREVIOUSLY LATCHED ON TO, A LOT
TO BE EXPLORED BY THE VAGUS
NERVE.
>> ANY OTHER QUESTIONS, DAVE?
>> I ENJOYED THE TALK.
FASCINATING TO ACTUALLY THRILLED
TO KNOW THAT YOU'VE ALREADY DONE
THE GENOTYPING ARRAYS, AND
BECAUSE THE POLYGENIC SCORES FOR
ALCOHOL USE DISORDER RISK ARE
BECOMING INCREASINGLY
PREDICTIVE, AND THEN CAN GIVE
YOU THE ABILITY TO ACTUALLY
DEFINE WHO IN YOUR SAMPLE IS AT
GENETIC RISK AS OPPOSED TO
FAMILIAL RISK.
I WONDER IF YOU MIGHT COMMENT
THAT THOSE TWO TYPES OF RISK
MIGHT ACTUALLY BE DIFFERENT.
THANK YOU.
>> THAT'S REALLY IMPORTANT.
WE PRESUME -- I MEAN FAMILIAL
RISK IS AN AGGREGATE PROXY BUT
UNLESS YOU'RE LOOKING AT TWINS
REARED APART IT DOES BRING
ENVIRONMENT.
YOU CAN'T IGNORE THAT.
THAT'S PART OF IT.
CERTAINLY WE WOULD BE INTERESTED
AND MAYBE SHOULD CONSIDER
EXAMINING POLY GENETIC RISK
SCORES BEING PUBLISHED BY KOGA
AND OTHER INDIVIDUALS,
DETERMINING WHAT FRUIT MIGHT BE
BORNE THERE BUT SMALLER STUDIES,
SMALLER IN GENETICS WORD, IT CAN
BE HARD TO BRING THESE OUT.
AND HARDER WITH -- HARDER WHEN
YOU CONSIDER THAT THE DIFFERENT
ANCESTRIES THAT WE RECRUIT AS
WELL.
>> VERY VALID POINT.
POLYGENIC SCORES ARE NOT THAT
PREDICTIVE YET BUT THERE ARE
VERY LARGE SOURCE DATASETS FOR
COMPUTING POLYGENIC SCORES IN
YOUR DATASET, GETTING BETTER ALL
THE TIME.
IT'S GREAT THAT YOU WILL HAVE
THAT REALLY AS A RESOURCE FOR
THE FUTURE.
>> ANOTHER DAVE.
>> YEAH, THANKS.
REALLY GOOD TALK.
I WAS INTERESTED IN THAT LAST
PART, DIFFERENT NETWORKS.
IT GIVES US A LOT TO THINK
ABOUT.
ONE QUESTION, ARE THOSE AGAIN
REALLY CORTICAL NETWORKS BECAUSE
I --
>> YES.
>> WHAT SUBCORTICAL COMPONENTS
IF ANY ARE CONSIDERED.
>> YEAH, SO THERE ARE -- DEPENDS
HOW YOU PARCELLATE IT.
THERE WERE SOME SUBCORTICAL
AREAS THAT ARE THERE.
THERE'S AN ATLAS, TION ATLAS,
PARCELLATE NOT BY REGIONS WE
LEARNED IN BASIC ANATOMY BUT
MUCH MORE EMPIRICALLY DRIVEN BY
THEIR INHERENT MUTUAL
COMMUNICATION AND CONNECTIVITY
IT DIDN'T APPEAR MUCH IN THIS
TASK PARTICULARLY GIVEN THE
NATURE OF THE TASK NOT VERY
APPERTIVE TASK.
WE'LL TURN TO REFINING
SUBCORTICAL AREAS BUT THEY ARE
GROSS.
YOU WOULD BE LESS IMPRESSED BY
THE SUBCORTICAL PARSELATION.
>> THE FIRST QUESTION WAS FROM
DAVID GOLDMAN.
SECOND WAS FROM DAVID LOVINGER,
SO EVERYBODY KNOWS.
ONE MORE ONLINE OR IN PERSON.
ANYONE OUT THERE WITH ANOTHER
QUESTION FOR DAVID?
KATIE?
>> GREAT TALK.
IN THE LAST SLIDE I NOTICED A
LOT MORE HETEROGENEITY IN THE
FAMILY HISTORY POSITIVES.
>> YES.
>> AND SO I'M CURIOUS ABOUT
ANYTHING YOU'VE DONE
ANALYTICALLY TO ADDRESS THAT AND
THINK IT FITS INTO WITH A TOPIC
WE WERE HAVING A DISCUSSION
ABOUT AROUND HETEROGENEITY OF
AUD --
>> THINGS LIKE DRINKING?
>> NO, THE ACTUAL SLIDE YOU
SHOWED THERE WAS HETEROGENEITY
IN THE RESPONSES OF THE PEOPLE
IN THE FAMILY HISTORY POSITIVE
GROUP.
>> I'M SORRY, THIS IS THE
CONNECTIVITY STUDY?
>> I THINK SO, THE VERY LAST
SLIDE WITH THE FAMILY HISTORY
NEGATIVEs WAS HIGHER AND MORE
CONDENSE AND THEN THE FAMILY
HISTORY POSITIVE STRETCHED
ACROSS.
>> THAT WAS STATISTICAL LOADING.
>> YEAH, STATISTICAL LOADING IS
ALSO THERE'S A LOT OF
VARIABILITY IN THAT.
>> I DON'T RECALL SHOWING
VARIABILITY BUT I WILL SAY THAT
THAT PARTICULAR STUDY WAS A
TARGET OF OPPORTUNITY.
NORMALLY WHEN WE GO AND RECRUIT
PROSPECTIVELY WE DO OUR BEST
TO -- KNOWING THAT COMING FROM A
FAMILY WITH HISTORY OF ALCOHOL
USE DISORDER DOES BRING A LOT OF
THINGS WITH IT.
WE DO OUR BEST TO MATCH SUBJECTS
ON THOSE VARIABLES, AND IT WILL
BE THE CASE THAT THAT SAMPLE
THERE WE'RE EXPLORING THIS
INITIAL IDEA IS GOING TO BE A
LITTLE BIT MORE VARIABLE BOTH
WITHIN THE SAMPLES AS WELL AS
BETWEEN THEM.
THERE WAS A DRINKING DIFFERENCE
THERE, WE COULDN'T CONTROL THAT.
>> ALL RIGHT.
WE'RE GOING TO MOVE ON IN THE
INTEREST OF TIME.
DAVID IS COUNCIL, AND COUNCIL
MEMBERS ARE WELCOME TO INTERACT
WITH HIM AND THE REST OF THE
PEOPLE LISTENING IN.
I'M SURE HE WOULD BE HAPPY TO
ANSWER E-MAIL.
WE'RE GOING TO SET UP PAL AND
YOU'RE UP NEXT.
SO DR. PAL PACHER, HEAD OF
LABORATORY OF CARDIOVASCULAR
PHYSIOLOGY AND TISSUE INJURY,
NIAAA DIVISION OF INTRAMURAL
CLINICAL AND BIOLOGICAL
RESEARCH, THE IRP.
THE LABORATORY IDENTIFIED
OPPOSING REGULATORY ROLE OF
PERIPHERAL CANNABINOID 1,
CANNABINOID 2 RECEPTORS IN
CARDIOVASCULAR INFLAMMATION,
CARDIOMYOPATHIES, NEUROPATHY,
NEPHROOPATHY, STORY, AND
DIABETIC LAB COMPLICATIONS, AND
PATHWAY IN TISSUE INJURY, WORK
CONTRIBUTED TO OUR UNDERSTANDING
OF THE THERAPEUTIC POTENTIAL OF
PHYTO CANNABINOIDS AND NOVEL
THERAPEUTIC TARGETS RELATED TO
OXIDATIVE STRESSES, CELL-DEATH
PATHWAYS, RECENTLY WORK FOCUSED
ON DEVELOPMENT OF NOVEL
CANNABINOID 2 RECEPTOR AGONIST
AND ENDOCANNABINOID REGULATORS,
OTHER INTERESTS ELUCIDATING
BINGE AND CHRONIC ALCOHOL
CONSUMPTION AND INTERORGAN
COMMUNICATION IN CARDIOVASCULAR
DISEASE.
PAL IS SOMEONE I GO TO WHEN I
WANT TO KNOW ABOUT THE
ENDOCANNABINOID SYSTEM, ONE OF
THE MAIN PERSONS, OTHERS HAVE
BEEN WORKING ON IT INCLUDING
GEORGE KUNOS AND HE'S REALLY
DONE SOME ABSOLUTELY FASCINATING
WORK IN THE ENDOCANNABINOID
SYSTEM.
I WANT TO KNOW WHY KA NAB A DIOL
IS CALLED A PHYTO CANNABINOL BUT
I'LL LET DO YOU YOUR LECTURE.
>> THANK YOU FOR THE NICE
INTRODUCTION.
OUR LAB IS TRYING TO UNDERSTAND
THE INFLAMMATION, AND GEORGE
MENTIONED MOST OF OUR WORK WAS
FOCUSED ON THE ENDOCANNABINOID
SYSTEM AND STILL FOCUSED ON.
TODAY I WILL TALK ABOUT SOME
OTHER INTERESTING PROJECTS.
IT IS INCREASING RECOGNITION
PEOPLE ARE NOT DYING FROM LIVER
DISEASE BY ITSELF BUT DIEING
FROM CARDIOVASCULAR AND OTHER
COMPLICATIONS LIKE HEPATORENAL
CYST SYNDROME .
ONE OF THE EXAMPLES THAT I
SHOWED WAS A FEW YEARS AGO, A
STUDY WHICH MADE THE COVER OF
HEPATO, DESCRIBING MYOPATHY,
DEMONSTRATING INHIBITING
INFLAMMATION AND FIBROSIS IN
LIVER, IN THIS CASE CANNABINOID
2 RECEPTOR AGONIST, ALSO
IMPROVED CARDIAC FUNCTION.
AND THIS WAS NOTED.
THERE WAS HEPATORENAL SYNDROME
AND RECENTLY HAVE BEEN WORKING
ON UNDERSTANDING HOW CANNABINOID
RECEPTORS WORK.
BUT TODAY I WILL TALK ABOUT TWO
COMPLETELY DIFFERENT PROJECTS,
ONGOING SOME OVER TEN YEARS BUT
NOW CLOSE TO END.
SO ONE IS IDENTIFICATION OF
PCSK9, POTENTIAL BIOMARKER AND
THERAPEUTIC TARGET FOR
CARDIOVASCULAR AND LIVER AGING.
THIS IS A PERFECT EXAMPLE.
I DON'T KNOW -- OKAY.
THIS IS PERFECT EXAMPLE OF
IMPORTANCE OF LIVER AND HEART
COMMUNICATION.
AND ALSO TALK ABOUT
CARDIOVASCULAR EFFECT OF ALCOHOL
IN AGE.
SO WE'VE BEEN INTERESTED A LONG
TIME IN IN CARDIOVASCULAR
AGING, RISK FACTOR FOR METABOLIC
DISEASE, WHAT HAPPENS IN AGING
HEART.
THERE IS DECREASE THE HEART
RATE, PROLONGED REPOLARIZATION
AS A CONSEQUENCE OF IMPAIRMENT,
POTASSIUM CURRENT.
AGING PEOPLE MORE REASON TO (
INDISCERNIBLE) AND ENDOTHELIAL
DYSFUNCTION, THE RESULT IS
INCREASED CHOLESTEROL LEVEL AND
ATHEROSCLEROSIS.
YOU HAVE DIASTOLIC AND LATER
SYSTOLIC DYSFUNCTION, IN PART
VENTRICULAR ARTERIAL COUPLING,
DETERMINED BY THE STATE OF
ARTERY AND HEART, TALKED ABOUT
THIS LATER.
PROPOSED MECHANISM MITOCHONDRIAL
DYSFUNCTION, INCREASED OXIDATIVE
DNA INJURY, CELL DEATH,
DIMINISHED REGENERATIVE
CAPACITY.
CARDIOMYOCYTES CANNOT
REGENERATE, THE STEM CELL
RESEARCH FIELD IN THE HEART
SHOWS TEN YEARS AGO COMPLETELY
COLLAPSED.
IN LIVER THERE IS SOME REGION
BUT NOT IN THE HEART.
AND THEN REMODELING.
SO WHAT IS PCSK9, PROTEIN
CONVERTASE, ROLE IN CHOLESTEROL
METABOLISM.
IT BINDS TO THE LDLR RECEPTOR
AND CHOLESTEROL, BAD
CHOLESTEROL, THIS RECEPTOR IS
DEGRADED IN THE HEPATOCYTE.
IF YOU HAVE LESS RECEPTORS AND
THESE RECEPTORS DON'T BIND,
PCSK9 HIGHER, HIGHER CHOLESTEROL
LEVELS.
WHY WE'VE BEEN INTERESTED,
LEVELS WERE ELEVATED IN AGING
RATS AND ALSO IN THE HUMAN
STUDY, CONFIRMED THIS
OBSERVATION.
ALSO PCSK9 IS IMPORTANT PRENATAL
TARGET, ANTIBODIES IN CLINICAL
TRIALS, EXCEED THE BENEFICIAL
EFFECT IN DECREASING
CARDIOVASCULAR MORBIDITY AND
MORTALITY.
ALSO EFFECT IS UNEXPLAINED.
ALSO THERE WAS NOT MUCH KNOWN
ABOUT THE ROLE OF PCSK9 AND
CARDIOVASCULAR AGING.
FIRST EVENT TO DETERMINE WHAT IS
THE SOURCE OF THE PCSK9.
YOU SEE THIS IS THE DATA, IN THE
LIVER THERE'S PRETTY HIGH
LEVELS, 20 TO 40 TRANSCRIPT,
PRETTY HIGHLY EXPRESSED.
CONTRASTING THE HEART IT SHOWS
CAN ALSO BE RELEASED FROM THE
HEART, COULD NOT FIND ANY PCSK9
IN RATS, MICE, HUMANSES.
AS SEE THIS PATIENT
TRANSCRIPTOMICS FROM THE HEART,
AND THEN YOU SEE BASICALLY PCSK9
IS NOT IN THE HEART.
USE TROPONIN, CARDIOMYOCYTE
MARKER, YOU SEE IT EXPRESSED,
CARDIOMYOCYTES, DURING
MYOCARDIAL INFARCTION RELEASED
FROM ISCHEMIC AREA OF THE HEART.
SINGLE CELL TRANSCRIPTOMICS SHOW
CARDIOMYOCYTE FRACTION, SO
EXPRESS TROPONIN T, THE
EXPRESSION LEVEL OF PCSK9 IS
VIRTUALLY ZERO.
IT WAS EXPRESSED IN LIVER FIRST,
FOCUSED ON THE TRANSCRIPTOMIC
PROFILING OF AGING LIVER.
WE EXPECT GENES UP AND
DOWNREGULATED, ALSO SOME OF THE
GENES AS EXPECTED CONSIDERED
MITOCHONDRIAL DYSFUNCTION,
MITOCHONDRIAL COMPLEXIVITY, IN
PART MITOCHONDRIA STILL ONE OF
THE MOST (INDISCERNIBLE) OF
AGING, INCREASED OXIDATION,
DECREASE, ALSO INCREASED LIPID
ACCUMULATION, INCREASED
CHOLESTEROL LEVELS.
AND THERE WAS ALSO INFLAMMATION
IN THE LIVER OF AGING RATS.
AND METABOLIC PATHWAYS
(INDISCERNIBLE).
SO THEN WE VALIDATED OUR DATA
USING PUBLIC AVAILABLE RODENT,
AND WE DID USING THE NIH SUPER
COMPUTING RESOURCES, SO WE'VE
CREATED NETWORKS, IDENTIFIED
MORE THAN 2,000 GENES AND
200,000 LINKS, AND HE CREATED
NETWORKS, 14th CLUSTER WAS THE
MOST PROMINENT, WHAT WE FOUND IN
THIS GENES INVOLVED IN
CHOLESTEROL METABOLISM AND
BIOSYNTHESIS, UPREGULATED.
THEN WE FOCUSED ON THIS CLUSTER
AND THEN UPREGULATED, 29
DOWNREGULATED, COMPARED TO HUMAN
DATA.
THIS NUMBER IS SIGNIFICANTLY
DECREASED.
AND THE CENTRAL MOST CONNECTIVE
GENES, ONE OF THESE WAS ACTUALLY
PCSK9.
USING SINGLE CELL,
TRANSCRIPTOMICS, IN THE LIVER
PRIMARILY HEPATOCYTES,
PARTICULARLY TYPE 3, EVEN BASED
ON THIS THERE WAS SOME AGE
DEPENDENT, HEPATOCYTES MORE
SUBJECT, THE LEVELS WERE HIGH.
SO THEN WE SELECTED IN THE NIH
GTEx BASE SUBJECTS WERE MORE
THAN 65 YEARS.
AND DIVIDED THEM TO TWO GROUP.
THESE ARE HALF AGING SUBJECTS,
EXCLUDED ALL ADVANCED
(INDISCERNIBLE) METABOLIC
DISEASES, IN AS MUCH AS
POSSIBLE.
SO WE DIVIDED THEM TO LOW
EXPRESSING ROLE OF 25% AND HIGH
EXPRESSING, AND THEN WE FOUND
THAT IN THE HIGH EXPRESSING
GROUP THE CHANGES IN THE GENOME
WERE SIMILAR BETWEEN AGING AND
ANIMAL, SO THE RAT IS INCREASED,
DECREASED, SO THIS IS THE HIGH
AND LOW EXPRESSION.
THIS GENE EXPRESSION ASSOCIATED
WITH ENHANCED AGE-RELATED
PATHOPHYSIOLOGY.
THIS WAS EXCITING BUT STILL HAVE
TO PROVE THAT PCSK9 IS IMPORTANT
SO THEN ANIMAL STUDIES, SO WE
USED AGING FISCHER RATS, MORE
DEVELOPED BY AGING INSTITUTE,
BECAUSE THEY HAVE SIMILAR
CARDIOVASCULAR DYSFUNCTION, AND
ALSO DEVELOP ATHEROSCLEROSIS,
DIFFICULT TO TARGET AND VALIDATE
IN MOUSE MODEL, SO TREATED FOR
SIX WEEKS WITH MONOCLONAL
ANTIBODY AND PERFORMED VARIOUS
HEMODYNAMIC MEASUREMENTS AND
HUMAN SUBJECT WE STARTED 2000,
BUT LOOKING FOR YOUNG AND AGING
POPULATION, OLDER THAN 65 YEARS
OLD AND NEVER TREATED WITH LIPID
LOWERING DRUGS, NOT EASY TO FIND
IN EACH AGE GROUP.
WE MEASURED PCSK9 LEVELS AND TO
HAVE THE DETAILED HIGH
RESOLUTION RECORDING TO DO
TRACKING ANALYSIS, A MUCH
RELIABLE WAY BECAUSE LIKE
EJECTION FRACTION DEPENDING ON
LOADING ON CONDITIONS AND IT IS
NORMAL INCREASE IN VARIOUS FORMS
SO THIS SPECTRAL TRACKING IS
BASED ON THE FORCES IN THE
VENTRICLE.
WE FOUND IN BOTH RAT AND HUMAN
STUDIES THAT THE PCSK9 LEVELS
WERE INCREASED IN AGING AND THIS
CORRELATED POSITIVELY CAN
CARDIAC DYSFUNCTION, SYSTOLIC
AND DIASTOLIC.
THEN THE TARGET VALIDATION IN
OUR RAT STUDY, INCREASING AGING,
PCSK9 INHIBITION DECREASED IN
YOUNG AND AGING ANIMALS.
AND SERUM OXIDIZED CHOLESTEROL
WAS DECREASED BY PCSK9
INHIBITION.
SINCE WE HAVE LESS PCSK9, YOU
HAVE MORE LD RECEPTORS IN THE
LIVER WHICH CAN TAKE IN THE
CHOLESTEROL LEVEL SO THIS WAS
ALSO CONFIRMED, CONFIRMED THERE
WAS INCREASED PCSK9 LEVEL IN THE
AGING LIVER.
THEN IT WAS ALSO SURPRISING THAT
PCSK9 INHIBITION NOT ONLY MADE
THE PRIMARY ENDPOINT LIVER
INFLAMMATION AND DELIVER STATUS
IN AGING AND OXIDATIVE STRESS.
SO THEN ALSO SINCE WE ARE REALLY
INTERESTED IN INTERORGAN
COMMUNICATION, THERE ARE MORE
AND MORE CLINICAL RECORDED, MORE
SENSITIVE MEASURES OF CARDIAC
FUNCTION AND RESOLUTION,
CARDIOGRAPHY AND CT, THAT THE
LIVER FAT CONTENT CORRELATED
WITH LEFT VENTRICLE MOST AND
LIVER INFLAMMATORY SCORE
CORRELATED LEFT SERENITY --
LEFT VENTRICLE, SUGGESTING
IMPORTANT ROLE OF THE LIVER
WHICH MEDIATE CARDIOVASCULAR
FUNCTION IN AGING.
HALLMARKS OF AGING IN THE HEART,
I ALREADY SHOWED YOU,
MITOCHONDRIAL FUNCTION, YOU SEE
HERE LARGE NUMBER OF GENES
INVOLVED IN ASSEMBLY OF
MITOCHONDRIAL COMPLEXES,
DOWNREGULATED IN AGING TO YOUNG
ANIMALS AND VARIOUS PATHWAYS,
DIABETIC CARDIOMYOPATHY,
IMPROVED BY PCSK9 INHIBITION.
YOU SEE THE MITOCHONDRIA
COMPLEXES AND VARIOUS, LARGE
NUMBER OF PROTEINS INDICATED
WITH BLUE ARE DOWNREGULATED IN
CARDIOVASCULAR AGING, FUNCTION
OF CONSEQUENCE THE MITOCHONDRIA
COMPLEX ACTIVITIES WERE
DECREASED IN AGING, AND ONE AND
TWO COMPLEX ACTIVITY WAS BETTER
IN THE PCSK9.
THERE WAS ALSO INCREASED
OXIDATIVE STRESS IN AGING
HEARTS, YOU SEE THIS IS THE
LIPID OXIDATION AND NITRATIVE,
INFLAMMATORY PATHWAYS, INCREASED
IN AGING, CELL-DEATH PATHWAYS,
GENERATED BY PCSK9 INHIBITION.
ALSO ADVANTAGE OF THIS AGING
MODEL DEVELOPED, THAT YOU HAVE
SOME PHYSIOLOGICAL FIBER, YOU
HARDLY HAVE ANY FIBERS IN THE
HEART BUT HERE YOU HAVE ALSO
SOME MODELING, AND THIS WAS ALSO
IMPROVED BY PCSK9 INHIBITION AND
CARDIOMYOCYTE HYPERTROPHY, TWO
DIFFERENT STAINING FOR FIBROSIS,
RED, HERE YOU SEE IT BLUE.
THEN GOING TO THE LAST PART OF
THE FIRST PART OF MY TALK, WHAT
PCSK9 IS DOING INCREASING AGING
LIVES, LDL RECEPTOR, HIGHER LDL,
OXIDIZED LEVELS, AND THIS
OXIDIZE LDL CHOLESTEROL INDUCES
CARDIOMYOCYTE OXIDATIVE STRESS,
MITOCHONDRIA DYSFUNCTION, AND
THEN ACTIVATION OF VARIOUS
TRANSCRIPTIONAL FACTORS
INVOLVED, THEN ENDOTHELIAL CELL
ACTIVATION, THEN MONOCYTES
ATTACHED TO MACROPHAGES AND TAKE
UP, YOU HAVE THE INITIAL PROCESS
OF ATHEROSCLEROSIS.
AND PCSK9 INHIBITION BASICALLY
ATTENUATED THIS PROCESS, AND
MOST LIKELY THE PRIMARY TARGET
OF THIS WAS THE LIVER.
AND SO WHAT WE DISCOVERED IN
THIS STUDY THAT INCREASED AGE IS
ONE OF THE STRONGEST PREDICTORS
OF PCSK9 LEVELS, AND LEVELS
CORRELATE WITH CARDIOVASCULAR
DYSFUNCTION BOTH IN HUMANS AND
IN EXPERIMENTAL ANIMALS.
AND IT IS A PREDICTOR OF LEFT
VENTRICULAR DYSFUNCTION AND
PCSK9 NOT ONLY CARDIOVASCULAR
CHANGES, BUT ALSO SOME OF THE
CHANGES ASSOCIATED BY AGING, MAY
BE A BIOMARKER AND POTENTIAL
MARKER FOR CARDIAC FUNCTION.
THIS IS A VERY NICE EXAMPLE,
INTERORGAN, SYNTHESIZING THE
LIVER, NOT REALLY CARDIOMYOCYTES
SUPPORTED BY RECENT APPROVAL OF
ANOTHER DRUG TARGETING PCSK9
BECAUSE UNTIL NOW MOST OF THE
DRUGS WERE MONOCLONAL ANTIBODY
BUT THIS DRUG WAS JUST APPROVED
BY FDA A FEW WEEKS AGO, SO THIS
IS TARGETING THE PCSK9 SYNTHESIS
IN THE LIVER, IN CLINICAL TRIALS
PUBLISHED IN "LANCET," NEW
ENGLAND JOURNAL, AS EFFECTIVE AS
MONOCLONAL ANTIBODIES.
SO THEN GOING TO THE SECOND PART
OF MY TALK, IT IS KNOWN
EXCESSIVE ALCOHOL CONSUMPTION
CAN LEAD TO CARDIOMYOPATHY AND
VARIOUS EFFECTS IN THE
CARDIOVASCULAR SYSTEM.
HYPERTENSION, ARRHYTHMIAS, AND
NOW MORE AND MORE EVIDENCE IS
EMERGING THAT ALCOHOL CAN BE
RESPONSIBLE FOR THE SUDDEN
CARDIOVASCULAR DEATH IN PERSON
MOST LIKELY RELATED TO VARIOUS
ARRHYTHMIAS, ALSO IN PART
EXPLAIN ALSO THE INCREASING
(INDISCERNIBLE) AS GEORGE
REPORTED AT THE BEGINNING, LINK
NOT LINKED BUT COULD BE LINKED.
THE PURPOSE IS THE MYOCARDIAL
FUNCTION, MITOCHONDRIAL
DYSFUNCTION AGAIN FREE RADICAL
DAMAGE, INHIBITION OF CALCIUM,
DISRUPTION OF CELL MEMBRANES,
DECREASE OF PROTEIN SYNTHESIS
VERY IMPORTANT LARGELY
UNDERRATED, ALSO ONE OF THE MAIN
REASONS WHY PEOPLE WHO DRINK
ALCOHOL CHRONICALLY LOSE
SKELETAL MUSCLE.
WE WANTED TO FOCUS ON THE EFFECT
OF CHRONIC (INDISCERNIBLE) FOR
LOW DOSE 0.5%, FOR HIGH USED 5%,
THEY WERE THESE AGING RATS
DRINKING FOR HALF YEAR.
I WILL NOT TALK ABOUT THE LOW
DOSE BECAUSE WE COULD NOT SEE
ANY FUNCTIONAL CONSEQUENCES OF
THIS, I WILL FOCUS ABOUT THE 5%.
YOU SEE ALCOHOL LEVELS AROUND
100-MILLIGRAM, PER DECILITER.
I SHOWED YOU WITH AGING WE
MEASURED ACTIVITIES, COMPLEX
ACTIVITY WAS IMPAIRED IN YOUNG
ANIMALS DRINKING ALCOHOL FOR
HALF YEARS, AND IMPAIRED BY
AGING, AGING IS ALWAYS BLACK,
ALCOHOL IS ALWAYS RED.
SO COMPLEX 4 ACTIVITY IMPAIRED
ONLY IN AGING, SO IT IS ALSO
CHARACTERIZED BY EXPRESSION OF
ANGIOTENSIN 2 RECEPTOR, SAW
INCREASED, CONSEQUENCE OF
ALCOHOL USE, FURTHER INCREASING
AGING AND THIS IS VARIOUS
OXIDASE, ALCOHOL AND AGING, IF
YOU HAVE SUPEROXIDE TOGETHER YOU
HAVE (INDISCERNIBLE), INDUCING
INACTIVATION, SO THERE WAS ALSO
ENHANCED OXIDATIVE STRESS, LIPID
PARAOXIDATION IN AGING AND
ALCOHOL INDUCED OXIDATIVE
STRESS.
WE CHECKED RATES, MORE
PRONOUNCED IN AGING BY ITSELF,
IN AGING RATS CHRONICALLY
CONSUMING ALCOHOL.
SO THERE WAS SOME INFLAMMATION
BUT THIS WAS NOT DRAMATIC IN
AGING HEART.
SOME INFLAMMATORY
(INDISCERNIBLE) TNF ALPHA
ENHANCED MORE IN AGING ANIMALS.
AND ALSO INTERESTINGLY
MYOCARDIAL REMODELING, YOUNG
ANIMALS THERE WAS NO INCREASED
FIBROSIS BUT IN AGING ANIMALS
CHRONIC DRINKING ENHANDLESSED
MYOCARDIAL FIBROSIS.
THIS IS ONE MARKER OF
DYSFUNCTION, DIASTOLIC PRESSURE
IN RELATIONSHIP, YOU SEE NOT
INCREASED IN ALCOHOL IN YOUNG
ANIMALS BUT INCREASED IN AGING.
MORE DIASTOLIC STIFFNESS.
AND IT WAS MORE INCREASED IN
AGING AND ALCOHOL.
SO THEN CHRONIC ALCOHOL FEEDING
PROMOTED SERUM LIPID
ABNORMALITIES, SERUM CHOLESTEROL
TENDED TO INCREASE IN LOW DOSE,
TOTAL CHOLESTEROL, LDL
CHOLESTEROL NOT SHOWN BUT THAT
WAS SIGNIFICANTLY INCREASED.
ALCOHOL IN YOUNG ANIMALS AND
AGING AS EXPECTED BY ITSELF
INCREASED, AND THERE WAS MORE
IMPAIRED LIPID AND METABOLISM IN
AGING ANIMALS DRINKING.
SO WHAT HAPPENED IN THE
VASCULAR, WE MEASURED
ENDOTHELIAL FUNCTION,
RECONSTRUCTED VASCULAR, YOU GIVE
VARIOUS CONCENTRATIONS, AND
THERE'S RELAXATION, IT IS
DILATING, ENDOTHELIUM DEPENDENT
WAS RELAXATION, YOU SEE IN THE
YOUNG IT IS ALMOST 100%, AND
ALCOHOL INDUCES BY ITSELF
INCREASED, I MEAN DECREASE OF
RELAXATION, IN AGING FURTHER
IMPAIRED, FURTHER COMPARED WITH
ALCOHOL.
INCREASE OF TOTAL PERIPHERAL
RESISTANCE ALCOHOL BY ITSELF IN
YOUNG INCREASED TO CERTAIN
DEGREE INCREASED IN AGING AND
FURTHER INCREASE OF TOTAL
PERIPHERY RESISTANCE WAS SEEN.
CHRONIC ALCOHOL FEEDING ALSO
PROMOTED SYSTOLIC DYSFUNCTION SO
THIS HAPPENED, VARIOUS MARKERS
OF SYSTOLIC FUNCTIONS, THESE ARE
LOADING DEPENDENT IN THE LOWER
IMAGES.
SO IN THE YOUNG ANIMALS THIS
DYSFUNCTION WAS MORE MODERATE
BUT IN AGING BY ITSELF THERE WAS
INCREASED SYSTOLIC DYSFUNCTION,
AND IT WAS FURTHER DECREASED BY
ALCOHOL.
SO INTERESTINGLY, IN YOUNG
ANIMALS ALCOHOL DID NOT AFFECT
DISTOLIC FUNCTION, NO INCREASE
IN FIBROTIC REMODEL, HOWEVER IN
AGING ANIMALS WHERE DIASTOLIC
DYSFUNCTION, THERE WAS FURTHER
IMPAIRMENT OF DIASTOLIC
DYSFUNCTION, INCREASE FIBROTIC
REMODELING OF THE HEART.
THIS IS ANOTHER MARKER,
DIASTOLIC FUNCTION, THIS IS THE
DIASTOLIC PRESSURE IN
RELATIONSHIP WHICH IS IMPAIRED
BY AGING AND HIGHER
CONCENTRATION OF ALCOHOL IN
AGING ANIMALS.
AND THIS IS VERY IMPORTANT,
VENTRICULAR-ARTERIAL UNCOUPLING,
SO THIS IS WHICH GIVES YOU A
GOOD IMPRESSION OF STATE,
VASCULAR AND CARDIAC SYSTEM.
SO THIS IS ARTERY ELASTANCE.
IF YOU GO TO THE THEORY BELOW
NORMALLY THIS IS THE EFFICIENCY
OF THE TRANSMISSION OF THE
STROKE MODEL IN THE HEART DURING
THE CONTRACTION TO THE VASCULAR
SYSTEM.
YOU HAVE LOW CAPACITY DETERMINED
BY YOUR HEART AND ALSO
VASCULATURE, WITH CARDIOVASCULAR
AGING REVERSE CAPACITY IS
DECREASING, VASCULAR AND CARDIAC
SYSTEM IS GETTING UNCOUPLED.
WITH EXERCISE YOU CAN IMPROVE
THIS.
AND THIS IS IN HEART FAILURE
MORE UNCOUPLING OF THE SYSTEM.
ONE OF THE COMMON EFFECT
INCREASE -- I MEAN INCREASE
COUPLING, INCREASED DECOUPLING,
AND IN AGING EXPECTED INCREASED,
AND IT WAS FURTHER INCREASED SO
WHICH MEANS THAT IN THIS GROUP
REVERSE CAPACITY IS LARGELY
DECREASED, IF YOU HAVE LIKE
ARRHYTHMIAS OR SOMETHING LIKE A
SMALL INFARCTION, YOUR CAPACITY
TO COMPENSATE IS LARGELY
DECREASED, STRONG PREDICTOR OF
CARDIOVASCULAR MORTALITY.
SO THEN CONCLUDING SECOND PART,
CHRONIC ALCOHOL CONSUMPTION,
HIGHER DOSE IN YOUNG RATS
TRIGGERS MYOCARDIAL OXIDATIVE
STRESS, DYSFUNCTION, PREDOMINANT
SYSTOLIC DYSFUNCTION, NOT VERY
FOUND.
CHRONIC ETHANOL CONSUMPTION
INDUCES VENTRICULAR-ARTERIAL
UNCOUPLING, BOTH YOUNG AND
AGING, MORE PROMINENT IN AGING
ANIMALS, AGING BY ITSELF,
ALREADY IMPAIRED, AND CHRONIC
ETHANOL CONSUMPTION I TRIED TO
WALK YOU THROUGH CHARACTERISTIC
MARKERS OR HALLMARKS OF
CARDIOVASCULAR AGING, OF THESE
MARKERS.
IN OTHER WORDS, IT IS
ACCELERATING CARDIOVASCULAR
AGING.
COULD NOT SEE MUCH EFFECT OF
MODERATE ALCOHOL AND BASED ON
THIS CONSUMPTION OF ETHANOL
SHOULD BE AVOIDED IN AGING
POPULATION, AND IN PARTICULAR
SUBJECTS WITH CARDIOVASCULAR
DISEASE OR DIABETES BECAUSE IN
DIABETES YOU ALSO HAVE IMPAIRED
(INDISCERNIBLE).
I WOULD LIKE TO THANK PEOPLE IN
MY LAB, GEORGE K YOU CAN --
GEORGE KUNOS AND DAVE LOVINGER,
AND PCSK9 IS IMPORTANT IN
ALCOHOL DRINKING, COLLABORATIVE
STUDIES WITH THE COHORT,
INSTITUTE AND GEORGE KOOB AND
SOME RELATED TO THE
INFLAMMATION, HOPEFULLY
PUBLISHED SOON.
THANK YOU VERY MUCH.
>> THAT WAS GREAT.
IF ANY OF YOU NEED TO BE
CONVINCED THAT ALCOHOL CAUSES
PATHOLOGY, I THINK YOU JUST --
THE LAST SECTION HITS IT HOME.
GIVEN WE HEARD FROM FALK ABOUT
PCSK9 AND AGING, HAVE YOU EVER
THOUGHT OF LOOKING AT SOME OF
THESE TRANSGENIC ANIMALS THAT
ARE LIKE MODELS FOR ALZHEIMER'S
DISEASE TO SEE WHETHER THERE'S
ANY BRAIN CARDIOVASCULAR
INTERACTION?
IS IT POSSIBLE THAT THIS IS ALL
LINKED, AGING --
>> THIS IS VERY GOOD IDEA
BECAUSE IF YOU -- MANY PEOPLE DO
NOT REALIZE BUT ACTUALLY THE
BRAIN IS LARGELY COMPOSED OF
CHOLESTEROL AND WATER.
SO BASICALLY ALL NEURONS HAVE
LOTS OF CHOLESTEROL AND THEY
ALSO INVITE MATTER, 20% OF
CHOLESTEROL IN THE BODY IS IN
THE BRAIN.
AND BUT THE VERY INTERESTING
ASPECT, THERE'S MORE AND MORE
STUDIES SUGGESTING IN PART
CHOLESTEROL METABOLISM IN THE
BRAIN COULD BE RESPONSIBLE FOR
SOME OF THE NEURODEGENERATIVE
DISEASES BUT THE TRICKY PART IT
APPEARS THE BRAIN CHOLESTEROL
METABOLISM AND LIVER, PERIPHERY,
IS KIND OF SHIELDED BY
BLOOD-BRAIN BARRIER, CHOLESTEROL
PRODUCE IN THE LIVER, LDL
NORMALLY WOULD NOT GO TO THE
BRAIN BECAUSE IT IS INHIBITED
BLOOD-BRAIN BARRIER, THE BRAIN
FORMS CHOLESTEROL SYNTHESIS BUT
DEFINITELY UNDER PATHOLOGICAL
CONDITIONS THE BLOOD-BRAIN
BARRIER COULD BE DISRUPTED AND
ALCOHOL FROM STUDIES CAN ALSO
INTERRUPT THE BLOOD-BRAIN
BARRIER, TRANSIENTLY SO IT IS
NOT LIKE COMPLETELY, PROPORTION
TO ALCOHOL LEVELS, HIGH LEVELS
OF ALCOHOL CAN BE TRANSIENTLY
IMPAIRED FOR TEN MINUTES, JUST
AN EXAMPLE, BUT IN DIFFERENT
PATHOLOGY NEUROINFLAMMATORY
DISEASES, THIS IS A VERY
INTERESTING AREA, WE TRY TO
MOVE, THE CARDIOVASCULAR TO THE
(INDISCERNIBLE) WHICH IS
DIFFICULT CHANGE LIKE, FOR
EXAMPLE, PCSK9 IN THE HEART I
THINK I CONVINCED YOU IT IS NOT
IN THE HEART AT ALL BUT SOME
PEOPLE THINK (INDISCERNIBLE)
FROM THE HEART, COMPARED TO
TROPONIN, LESS IN THE HEART, IN
OTHER WORDS IT IS NOT THERE.
>> REMIND ME, MAYBE BY E-MAIL,
TO TELL YOU ABOUT NORA VOLKOW'S
FINDINGS WITH CHOLESTEROL IN THE
BRAIN AND HER IMAGING STUDIES
BECAUSE THERE'S SOME INDICATION
IT MAY BE INTERFERING WITH
MEASURES OF INFLAMMATION SHE'S
DOING WITH PET SCAN.
>> AND ALSO GOING BACK TO YOUR
QUESTION, THE HUMAN BRAIN ALSO
STARTED TO DEVELOP WHEN WE
STARTED TO EAT ACTUALLY MEAT.
AND THIS IS IN PART BECAUSE YOU
NEED CHOLESTEROL ALSO FOR THE
BRAIN, SO IT IS VERY IMPORTANT I
THINK.
>> CHUCK?
>> GREAT STUDIES.
SOMEBODY WORKS ON CARDIOVASCULAR
FUNCTION AND REALLY TAKEN IT TO
THE NEXT STEP.
SHOULD BE CONGRATULATED.
I MAY HAVE MISSED DETAILS IN THE
PCSK9 INHIBITOR STUDY.
THAT WAS IN ACUTE, THOSE ARE --
HOW LONG DID YOU GIVE THE
INHIBITOR TREATMENT?
>> ALMOST TWO MONTHS.
>> DOES THAT -- DOES THIS
SURPRISE YOU SO YOU GET AN AGING
INDUCED CARDIOVASCULAR
DYSFUNCTION, RIGHT?
THAT TAKES MONTHS, YEARS, TO
DEVELOP BECAUSE IT'S A TWO-YEAR
DIFFERENCE IN AGE, RIGHT?
AND THAT YOU CAN REVERSE THAT
LONG-TERM EFFECT IN DYSFUNCTION
BY A RELATIVELY ACUTE
ADMINISTRATION.
>> NO, ACTUALLY I WAS SURPRISED,
THE INITIAL --
>> SURPRISE IS --
>> THESE ARE NOT SURE AND WE
DESIGNED DIFFERENT STUDIES,
DIFFERENT DURATION, AND I HOPE
DON'T NEED TO GO FOR HALF YEAR
AND ONE YEAR, BUT THIS ALSO
SURPRISED ME , I WAS INITIALLY
SKEPTICAL, WE NEED TO BE REALLY
LUCKY, BUT IT WAS VERY, VERY
CLEAR CUT.
AND NOW ALL THE STUDIES COMING
OUT.
NOT ONLY MONOCLONAL ANTIBODIES,
NOW THERE'S ALSO PCSK9 INHIBITOR
WHICH STUDIES CAME OUT, AND ALSO
THERE ARE ALSO EFFECT OF PCSK9,
FOR EXAMPLE NOW A FEW MONTHS AGO
THE STUDY WAS PUBLISHED IN
JOURNAL OF AMERICAN CARDIOLOGY
THAT SUBJECTS WITH COVID WHO HAD
LIKE PCSK9 INHIBITOR TREATMENT
SURVIVED MUCH BETTER AND THEY
HAD DECREASED LUNG INFLAMMATION.
SO THERE IS DEFINITELY LOTS OF
THINGS ABOUT PCSK9 WHICH WE
STILL DON'T UNDERSTAND AND WE
DON'T UNDERSTAND WHAT PCSK9 BY
ITSELF IS DOING, IF NOT IN
CARDIOVASCULAR SYSTEM DOESN'T
MEAN IT'S DOING -- KIND OF
(INDISCERNIBLE) WHICH CAN
TRIGGER LOTS OF PROCESSES
VARIOUS CELL TYPES.
AND THERE IS ACTUALLY MORE AND
MORE EVIDENCE ON THAT BUT WE
STILL DON'T KNOW EXACTLY.
IN MY OPINION GOOD NEWS
REGARDING PCSK9 YOU HAVE
MONOCLONAL ANTIBODY AND
SYNTHESIS IN THE LIVER AND
CLINICAL EFFICIENCY IS PROGRESS,
THIS MAKES THE STORY MUCH MORE
EXCITING.
>> SO ONE QUICK QUESTION FROM
DAVID GOLDMAN.
CAN YOU DO A QUICK QUESTION?
>> YES, I CAN.
FIRST PCSK9 IS A HOT TOPIC AND
NIAAA AND CONGRATULATIONS, PAL.
WHAT I WANTED TO ASK YOU IS IF
YOUR SPATIAL TRANSCRIPTOMICS HAD
INDICATED THAT IN HEART THERE
ARE SPECIFIC TRANSCRIPTOMICS OF
PCSK9 OR THIS GENE NETWORK 14
THAT ARE HAPPENING IN PARTICULAR
CELLS WITHIN THE HEART.
THANK YOU.
IT'S GREAT TO SEE THE SPATIAL
TRANSCRIPTOMICS.
>> THANKS, DAVE.
WE ACTUALLY USED THE PUBLICLY
AVAILABLE DATABASE, BUT WE ALSO
USED VARIOUS OTHER METHODS
INCLUDING ELISA, TRANSCRIPTOMIC
DATA FROM RATS, ALSO CHECKED
MICE WE USED DIGITAL PCR
QUANTIFICATION AND THERE'S
PRACTICALLY NO PCSK9 IN THE
HEART, REMINISCENT FOR ME ON THE
STORY OF CB2 RECEPTOR IN THE
BRAIN AND NEURONS BUT AT LEAST
WE CANNOT FIND THIS.
>> THANK YOU.
>> PAL IS EASILY FINDABLE, IN
OUR IRP.
IF YOU HAVE QUESTIONS, I DO, BUT
FOR LATER.
I'M SURE HE'D BE HAPPY TO ANSWER
YOUR E-MAILS.
>> YES, THANK YOU VERY MUCH.
>> THANKS, PAL.
THAT WAS EXCELLENT.
AND DAVID, YOUR TALK WAS
EXCELLENT AS WELL.
AND NOW WE'RE GOING TO HEAR FROM
OUR NEW SCIENTIFIC DIVERSITY
OFFICER, DAWN WAYMAN.
SO I'VE ALREADY INTRODUCED HER
ON A SLIDE.
BUT I'LL REPEAT IT.
SHE'S LEADING OUR EFFORTS TO
FORMULATE, PLAN, EXECUTE,
EVALUATE AND DIVERSITY, EQUITY,
INCLUSION, AND ACCESSIBILITY,
OUR D. DEIA INITIATIVES,
GRADUATE OF BLOOMBERG SCHOOL OF
PUBLIC HEALTH, 14 YEARS AT NIH,
EXPERIENCE IN BOTH INTRAMURAL
AND EXTRAMURAL PROGRAMS, AND
JUST PRIOR TO JOINING US AT
NIAAA LED THE STRATEGIC
DIVERSITY AND INCLUSION BRANCH
OF OFFICE OF DIVERSITY, EQUITY,
AND INCLUSION.
DAWN DOESN'T KNOW IT YET BUT I'M
GOING TO ASK HER TO JOIN US AT
COUNCIL OFFICIALLY FROM
HENCEFORTH WITH THE REST OF THE
STAFF AND SHE'S GOING TO JUST
GIVE US A BRIEFING TODAY FOR A
FEW MINUTES, ABOUT WHAT SHE'S
THINKING ABOUT AND WHAT WE'RE
PLANNING ON DOING.
>> THANK YOU, DR. KOOB.
GOOD AFTERNOON TO EVERYONE.
I'M HAPPY TO SEE YOU AND GAD TO
BE ABLE TO -- GLAD TO SHARE THE
WORK WE'RE HOPING TO DO IN
DIVERSITY, EQUITY, INCLUSION,
AND ACCESSIBILITY HERE AT NIAAA.
MUCH OF WHAT WE'RE GOING TO TALK
ABOUT TODAY IS JUST INTRODUCTION
TO WHO I AM AND THEN AT THE END
WE'LL WRAP UP WITH SOME THOUGHTS
ABOUT WHERE THE NEXT SIX MONTHS
WILL TAKE US.
I SHOULD LET YOU KNOW IN ADVANCE
THIS IS I BELIEVE MY 11th WEEK
HERE.
SO IN 11 WEEKS YOU CAN DO
OBSERVING BUT IT TAKES A LITTLE
BIT MORE TIME THAN 11 WEEKS TO
ACTUALLY GET YOUR ROADMAP IN
PLACE SO YOU KNOW WHERE YOU ARE
AND WHERE IT IS THAT YOU ARE
TRYING TO GO.
JUST WANT TO GIVE THAT
DISCLAIMER SO WHEN WE GET TO THE
PLACE OF ASKING QUESTIONS YOU
ALREADY KNOW I'M 11 WEEKS IN.
SO A LITTLE BIT ABOUT ME.
AS DR. KOOB SHARED, I DID DO MY
GRADUATE WORK AT JOHNS HOPKINS
UNIVERSITY, BACKGROUND IN
INFECTIOUS DISEASE EPIDEMIOLOGY.
AT HOPKINS MY RESEARCH WAS
AROUND LOOKING AT COMMUNITY
LEVEL FACTORS, HOW THEY
INFLUENCE THE INDIVIDUAL'S RISK
FOR DISEASE.
I SHARE THAT BECAUSE IN ALL THE
WORK THAT I'VE DONE, I'VE ALWAYS
BEEN INTERESTED IN HOW POLICIES
AND PRACTICES AT COMMUNITY
LEVELS OR GROUP LEVELS IMPACT
OUTCOMES FOR INDIVIDUALS.
SO I LEFT HOPKINS, WAS
EPIDEMIOLOGIST FOR A LOCAL
HEALTH DEPARTMENT IN MARYLAND,
THEN CAME TO THE NIH AND WORKED
AT GENOME, AND LOOKED AT HOW
CLINICIANS MADE DECISIONS ABOUT
PATIENTS RELATED TO RACE, SO
TRYING TO UNDERSTAND IF RACE WAS
VIEWED AS A BIOLOGICAL FACTOR OR
SOCIAL FACTOR, IN CLINICAL
DECISION MAKING FOR PATIENTS.
CLINICIANS WERE BOTH PHYSICIANS
AND NURSES BECAUSE WE RECOGNIZE
THERE ARE MANY INDIVIDUALS WHO
PLAY A ROLE IN CARING FOR
PATIENTS.
FROM THERE MOVED INTO THE
EXTRAMURAL COMMUNITY.
ULTIMATELY LANDED IN A PROGRAM
HERE AT NIH THAT ALLOWED ME TO
TRANSITION FROM THE SCIENTIFIC
COMMUNITY TO NOW TAKING KIND OF
THE EPILENS INTO UNDERSTANDING
WORKFORCE PROBLEMS.
SO I'VE LEARNED A LOT ABOUT H.R.
AT THE FEDERAL LEVEL, WHICH I
BELIEVE IS REALLY IMPORTANT IN
TRYING TO ADDRESS ISSUES OF
INEQUITY IN THE WORKFORCE, AND
THEN GETTING INTO THE D. DEIA
SPACE LANDING AT NIAAA, LOOK AT
THIS SLIDE, IT'S NOT OUR
DIFFERENCES THAT DIVIDE US, IT'S
OUR INABILITY TO RECOGNIZE,
ACCEPT, AND CELEBRATE THOSE
DIFFERENCES.
I THINK THAT'S SO IMPORTANT.
IT'S THE FOUNDATION OF ALL THE
WORK I SEEK TO DO THAT I DON'T
TRY TO DIMINISH ALL THE
DIFFERENCES THAT WE BRING TO THE
TABLE, WE HAVE DIFFERENT LIVED
EXPERIENCES, WE HAVE DIFFERENT
EDUCATIONAL EXPERIENCES,
DIFFERENT RESEARCH INTERESTS, WE
HAVE A WHOLE LOT OF DIFFERENCES,
DIFFERENCE IN THE WAY WE THINK,
IN THE WAY WE PRESENT, IN JUST
HOW WE SHOW UP.
BUT THOSE DIFFERENCES DON'T MAKE
US INVALUABLE TO THE EXPERIENCE.
AND SO I WANT TO ENCOURAGE ALL
OF US IN THE WORK THAT WE DO
BOTH IN THE INSTITUTE LOOKING AT
INTRAMURAL AND THE NIAAA
WORKFORCE AS WELL AS OUR WORK IN
THE EXTRAMURAL COMMUNITY, I WANT
US TO LOOK AT HOW WE CAN
CELEBRATE AND ACCEPT AND
RECOGNIZE DIFFERENCES BECAUSE
WHEN WE RECOGNIZE THE
DIFFERENCES THAT'S WHEN WE'RE
ABLE TO DO THINGS TO ADDRESS THE
INEQUITIES THAT ARE CAUSED BY
DIFFERENCE.
ONE IMPORTANT QUESTION, WHY AIM
HERE AT NIAAA?
IT'S NOT JUST BECAUSE I WAS
OFFERED A JOB.
THAT WAS KEY FOR ME TO COME HERE
TO NIAAA.
BUT I'VE WORKED IN MANY I.C.s,
MAYBE NOT MANY, A FEW I.C.s.
MEDIUM SIZE ICs, O.D. AS A
WHOLE, WORKED AT SMALLER OFFICES
WITHIN THE NIH.
WHAT I KNOW IS THAT THE KEY TO
THIS WORK BEING SUCCESSFUL IS
LEADERSHIP TEAM THAT SUPPORTS
IT.
SO WHEN I WENT THROUGH THE
INTERVIEW PROCESS, IT BECAME
EVIDENT TO ME THAT THIS
LEADERSHIP TEAM SUPPORTED THE
WORK.
ONE QUESTION THAT I ASKED DURING
MY INTERVIEW WAS ARE WE ONLY
LOOKING AT NUMBERS?
BECAUSE IF WE'RE ONLY LOOKING AT
CHANGES IN NUMBERS, THEN WE MAY
NOT BE SUCCESSFUL IN DOING THIS
WORK.
I SAY THAT BECAUSE NUMBERS DON'T
CHANGE A WHOLE LOT.
BUT HOW WE THINK AND HOW WE FEEL
ABOUT THIS WORK CAN INFLUENCE
CULTURE AND CAN CHANGE WHETHER
OR NOT WE HAVE AN INCLUSIVE
ENVIRONMENT.
AND SO THE LEADERSHIP SUPPORTS
THE WORK.
THAT WAS KEY FOR ME COMING TO
JOIN THIS ORGANIZATION.
THE I.C. IS THE RIGHT SIZE.
THE NIH IS 17,000+ EMPLOYEES.
I WORKED IN THE NIH OFFICE OF
EQUITY, DIVERSITY, AND INCLUSION
AND I CAN TELL YOU THEY DO GREAT
WORK.
BUT IT'S HARD TO INFLUENCE
17,000 PEOPLE WHEN IT COMES TO
MAKING CHANGE.
NIAAA IS THE RIGHT SIZE.
IT'S SMALL ENOUGH THAT YOU CAN
KNOW EVERYTHING.
AND IN KNOWING EVERYBODY YOU CAN
UNDERSTAND NUANCES THAT NEED
LEADERSHIP ATTENTION TO ADDRESS
CHANGES.
I HAD AN OPPORTUNITY TO BECOME
AN INTERN HERE FOR A FEW MONTHS,
HAD A GREAT TIME.
I KNEW WHAT I WAS BEING TOLD IN
THE INTERVIEW WASN'T JUST GOOD
TALK BUT IT WAS ACTUALLY TRUTH
ABOUT THE ORGANIZATION.
LASTLY, THERE'S WORK TO BE DONE.
NOT TO SAY NIAAA IS IN A BAD
SPACE IN THE DEIA REALM, JUST
THAT THERE'S WORKING TO DONE.
I WOULD SAY THE SAME AT ANY
OTHER INSTITUTE OR ORGANIZATION,
THERE'S WORK TO BE DONE AND I'M
HERE BECAUSE I WANT TO BE A PART
OF DOING THE WORK.
SO WE'RE GUIDED BY THE
DEFINITIONS OF DIVERSITY,
EQUITY, INCLUSION, AND
ACCESSIBILITY THAT ARE OUTLINED
IN EXECUTIVE ORDER 14035 THAT
THE PRESIDENT RELEASED NOT LONG
AFTER HE TOOK OFFICE.
SO THESE DEFINITIONS I WON'T
READ THEM, BUT THESE ARE THE
DEFINITIONS THAT WILL GUIDE OUR
WORK, THE IMPORTANT THING I WANT
TO STRESS IS THAT ALL FOUR
ELEMENTS ARE IMPORTANT.
WE COULD BE A PLACE WITH GREAT
DIVERSITY BUT PEOPLE DON'T FEEL
LIKE THEY ARE A PART OF IT.
WE COULD THINK THAT WE'RE
INCLUDING PEOPLE BUT WE NEGLECT
ACCESSIBILITY.
SO EVERY ASPECT OF THIS EQUATION
IS IMPORTANT FOR US TO BE
SUCCESSFUL IN CREATING A CULTURE
BOTH INTERNALLY AND EXTERNALLY
THAT ALLOWS PEOPLE TO FEEL LIKE
THEY ARE A PART OF THE NIAAA
COMMUNITY AND THEY CAN BE
SUCCESSFUL WHILE FEELING
WELCOMED HERE.
AND SO AS I SAID, WE'RE JUST
GETTING STARTED.
THIS IS SIX MONTHS BUT I HOPE TO
BE HERE FOR A WHILE.
OVER THE NEXT SIX MONTHS WE KNOW
THERE'S SOME THINGS THAT WE NEED
TO DO.
YOU'LL SEE ON THE SCREEN FOUR
KEY AREAS THAT WE'RE FOCUSING
ON.
TODAY I'M REALLY JUST GOING TO
TALK ABOUT THE EXTERNAL
WORKFORCE AND FUTURE WORKFORCE
AND I'M GOING TO LEAVE TIME FOR
SOME QUESTIONS THAT YOU ALL MAY
HAVE TO BE ANSWERED.
BUT THESE ARE THE FOUR KEY AREAS
THAT WE WANT TO FOCUS ON,
INTERNAL WORKFORCE IS LOOKING AT
DEMOGRAPHIC DATA, WHO ARE WE,
WHAT IS OUR LEADERSHIP TEAM
LOOKING LIKE, WHAT ARE
OPPORTUNITIES THAT EXIST?
ONE GOAL IS TO DIVERSITY THE
LEADERSHIP TEAM BUT WE KNOW
PEOPLE LOVE NIAAA.
WHICH MEANS PEOPLE DON'T LEAVE.
SO WE MAY NOT BE ABLE TO CHANGE
WHAT OUR DEMOGRAPHICS LOOK LIKE
RIGHT AWAY.
BUT THAT DOES NOT MEAN THAT WE
DON'T DO THE WORK AND THAT'S WHY
WE'RE GOING TO TALK ABOUT
EXTERNAL WORKFORCE AND FUTURE
WORKFORCE BECAUSE THOSE WILL
INFLUENCE WHO OUR INTERNAL
WORKFORCE LOOKS LIKE IN THE NEXT
FIVE TO TEN YEARS.
LAST THING YOU SEE ON HERE IS
THE REEP AND MD-715.
YOU MAY HAVE HEARD OF THE NIH
UNITE INITIATIVE, ON OUR
WEBSITE, DEALING WITH RACIAL AND
ETHNIC INEQUITY.
OUT OF THAT CAME A CHARGE TO ALL
OF THE INSTITUTES AND CENTERS TO
CREATE A RACIAL AND ETHNIC
EQUITY PLAN, KNOWN AS THE REEP.
WE'RE REQUIRED TO UPDATE THIS
REPORT.
WE'RE REQUIRED TO REPORT THIS TO
OUR OFFICE OF EQUITY, DIVERSITY,
AND INCLUSION AS WELL AS OFFICE
OF THE SCIENTIFIC WORKFORCE
DIVERSITY.
SO WE'RE WORKING ON THAT, ALONG
WITH MD-715 WITH YOU YOU MAY NOT
HAVE HEARD ABOUT, THE FEDERAL
REPORTS REQUIRED FOR ALL FEDERAL
AGENCIES WITH MORE THAN 500
EMPLOYEES AND WE'RE REQUIRED TO
REPORT ABOUT OUR COMMITMENT TO
EQUAL EMPLOYMENT OPPORTUNITY.
SO I PUT THESE ON THE SLIDE
BECAUSE THESE ARE TWO REPORTING
MECHANISMS THAT HOLD US
ACCOUNTABLE FOR DOING WHAT IT IS
THAT WE SAY WE'RE DOING.
SO JUST TO DIG IN FOR A COUPLE
MINUTES, ON THE SIX MONTH PLAN,
FOCUSING JUST ON THE FUTURE
WORKFORCE, AND DEVELOPING
EXTRAMURAL WORKFORCE, THE FUTURE
FOCUSES ON COLLEGE STUDENTS,
NEXT GENERATION OF SCIENTISTS.
THE ONLY WAY WE CAN BUILD THAT
COMMUNITY IF WE ARE INTENTIONAL
IN BUILDING RELATIONSHIPS WITH
COLLEGES AND UNIVERSITIES.
ONE OF THE THINGS THAT I HAVE
CHALLENGED MYSELF AND CHALLENGED
OUR INSTITUTE TO DO IS THINK
BEYOND OUR COMFORT ZONE.
WE ALL HAVE COLLEAGUES IN
CERTAIN UNIVERSITIES THAT WE
TALK TO ALL THE TIME AND WE TALK
TO THEM ABOUT STUDENTS WHO MAY
BE INTERESTED IN INTERNSHIP
OPPORTUNITIES.
WE TALK ABOUT GRANT FUNDING
OPPORTUNITIES.
BUT WHAT ABOUT THE STUDENTS WHO
NO ONE REACHES OUT TO?
WHAT ABOUT THE STUDENTS WHO NO
ONE EVER CONSIDERS?
I WILL GIVE AN EXAMPLE.
THERE ARE HISTORICAL BLACK
COLLEGES IN UNIVERSITIES IN
MARYLAND, A LOT OF PEOPLE DON'T
KNOW THAT.
WHY?
ONE IS IN THE LOWER CORNER OF
MARYLAND'S EASTERN SHORE, IF YOU
DIDN'T KNOW UNIVERSITY OF
MARYLAND EASTERN SHORE EXISTED
IN PRINCESS ANNE YOU WOULD NEVER
GUESS BECAUSE IT'S HIDDEN, IT'S
NOT A PLACE PEOPLE TALK ABOUT
THE SCIENCE ABOUT.
THE OTHER ONE IS COPPIN STATE
UNIVERSITY, IN BALTIMORE CITY,
NORTH AVENUE, ONE OF THE MOST
CHALLENGING AREAS IN BALTIMORE
CITY.
NO ONE IS GOING TO COPPIN TO
RECRUIT STUDENTS FOR
INTERNSHIPS.
THAT'S NOT UNIQUE TO NIAAA.
THAT'S JUST BECAUSE OF THEIR
FATE, WHERE THEY SIT.
WHAT I WANT TO DO IS CHALLENGE
US TO THINK ABOUT THOSE STUDENTS
WHO ARE OVERLOOKED, THINK ABOUT
THOSE STUDENTS WHO MAY NOT HAVE
ACCESS TO A RESEARCH
INFRASTRUCTURE THAT WILL PREPARE
THEM TO GO TO GRADUATE SCHOOL,
PREPARE THEM TO GO TO MEDICAL
SCHOOL, PREPARE THEM TO BE THE
NEXT GENERATION OF RESEARCHERS,
WHO WILL SIT IN YOUR SEAT AS
COUNCIL MEMBERS, IN OUR LABS,
LEAD OUR ORGANIZATIONS.
AND SO I HAVE IN 11 WEEKS
STARTED BUILDING OUT THE
INFRASTRUCTURE FOR WHAT THAT
WILL LOOK LIKE AND I'M HAPPY TO
SHARE THAT WE'VE ALREADY BEGUN
TO HAVE CONTACT WITH A COUPLE OF
SCHOOLS.
WE'VE HAD SOME CONVERSATION WAS
JACKSON STATE UNIVERSITY, IN
JACKSON, MISSISSIPPI.
THANKS TO DR. POWELL MAKING A
CONNECTION.
WE'VE ALSO TALKED TO UP AND
COMING PROGRAM AT UNIVERSITY OF
MARYLAND EASTERN SHORE WHERE
THEY ARE BUILDING ACADEMIC
CENTER TO HELP STUDENTS FIND
INTERNSHIP OPPORTUNITIES.
IT MAY NOT YIELD ANYTHING.
BUT WHAT WE WILL BE ABLE TO SAY
IS THAT WE'VE MADE CONTACT.
WE'VE CREATED DIALOGUE THAT
ALLOWS STUDENTS TO KNOW ABOUT
OPPORTUNITIES THAT EXIST.
THE OTHER THING WE'D LIKE TO DO
WITH STUDENTS IS PROVIDE
LABORATORY VISITS, CAMPUS TOURS.
YOU CAN'T DREAM OF WHAT YOU CAN
BECOME IF YOU'VE NEVER SEEN IT.
YOU CAN'T DREAM OF WHAT YOU CAN
BECOME IF YOU'VE NEVER SEEN IT.
AND SO WE WANT TO BRING STUDENTS
HERE SO THEY CAN SEE WHAT LABS
DO HERE.
SO THAT THEY CAN SEE WHAT THE
NIH IS.
IT'S NOT JUST SOMETHING SOMEBODY
HEARD ABOUT ON TV DURING A
PANDEMIC.
BUT IT'S REAL.
AND WE HAVE A CLINICAL RESEARCH
CENTER THAT'S CHANGING PEOPLE'S
LIVES AND WE HAVE LABS THAT ARE
ACCESSIBLE TO ALL.
THE OTHER THING WE WANT TO TRY
AND DO IS A WEBINAR SERIES SO
THAT STUDENTS CAN ACTUALLY
INTERACT AND ENGAGE WITH
RESEARCHERS, ASK QUESTIONS, ASK
HOW DID YOU MAKE IT, HOW DID YOU
GET TO WHERE YOU ARE, WHAT
STEPS DO I NEED TO TAKE, IT'S
ABOUT MAKING OURSELVES AVAILABLE
SO STUDENTS WHO WILL BE THE NEXT
GENERATION OF SCIENTISTS CAN
BEGIN TO LAY THE GROUND WORK NOW
THAT WILL BE NECESSARY FOR THE
FUTURE THEY ARE HOPING TO BUILD.
SECOND AREA FOR OUR FUTURE WORK
IS DEVELOPING EXTRAMURAL
WORKFORCE.
WHAT WE KNOW IS THAT WE NEED TO
MAKE INTENTIONAL CONNECTIONS,
WHY?
BECAUSE IF PEOPLE ARE NOT
APPLYING FOR GRANTS, PEOPLE
CANNOT GET GRANTS.
AND SO WE NEED TO DIVERSIFY THE
APPLICANT POOL BECAUSE NO ONE'S
ASKING IN THIS D.E.I. SPACE FOR
US TO PRE-SELECT PEOPLE, TARGET
PEOPLE IN SELECTIONS.
AS A MATTER OF FACT, THE NIH
DOES NOT MAKE GRANT FUNDING
DECISIONS BASED ON RACE.
WE DON'T DO THAT.
BUT IF WE DON'T REACH
COMMUNITIES, IF WE DON'T REACH
SCIENTISTS, AND THEY DON'T
APPLY, THEY WILL NEVER GET A
GRANT.
AND SO WE NEED TO BE INTENTIONAL
IN BUILDING OUT RELATIONSHIPS,
MAKING CONNECTIONS, ONE OF THE
WAYS WE CAN DO IS THAT OFFERING
A GRANT APPLICATION WORKSHOP
SERIES.
SO FOR PEOPLE WHO HAVE NEVER
APPLIED, OR PEOPLE WHO APPLIED
AND DID NOT GET FUNDING, AND
FEEL DISCOURAGED, DON'T WANT TO
APPLY AGAIN, WE'RE HERE.
WE WANT TO HELP YOU MAKE IT
THROUGH THE PROCESS, DOESN'T
GUARANTEE YOU'LL GET A GRANT BUT
WE WANT TO MAKE THE OPPORTUNITY
ACCESSIBLE TO YOU.
LASTLY WE WANT TO ALSO INCLUDE
FACULTY WHO MAY BE IN
MINORITY-SERVING INSTITUTIONS,
GIVE THEM OPPORTUNITIES TO
PARTICIPATE IN WEBINARS AS WELL
SO THEY CAN ENGAGE IN COLLEGIAL
DIALOGUE AROUND THEIR RESEARCH
AND THEIR IDEAS CAN COME INTO
CONVERSATION WITH THE IDEAS OF
OTHERS.
SO THIS IS JUST A LITTLE SENSE
OF WHAT WE'RE TRYING TO DO.
I WOULD LOVE TO HEAR YOUR
THOUGHTS.
I DON'T HAVE MY E-MAIL ADDRESS
IN THE PRESENTATION BUT I'M
ACCESSIBLE.
I'LL BE AROUND.
I WOULD LOVE AND WELCOME YOUR
THOUGHTS, NOT ONLY WOULD I
WELCOME YOUR THOUGHTS, I WILL
WELCOME YOUR HELP IN SHARING OUR
MESSAGE IN THE COMMUNITIES THAT
YOU'RE PART OF BECAUSE YOU HAVE
ACCESS TO SOME STUDENTS AND SOME
FACULTY MEMBERS THAT I DON'T
HAVE ACCESS TO BUT THOSE ARE THE
PEOPLE WHO WE'RE TRYING TO
CONNECT WITH.
AND SO THANK YOU ALL FOR YOUR
TIME.
WE HAVE ABOUT A MINUTE LEFT.
I TRIED TO BE ON TIME.
I WANT TO OPEN FOR ANY QUESTIONS
OR DISCUSSION THAT YOU ALL WOULD
LIKE TO OFFER.
>> THANKS, DAWN.
THAT WAS PERFECT.
I WANT TO EMPHASIZE YOUR LAST
POINT, CONCRETE EXAMPLE OF WHY
WE NEED SOME OF THE EFFORT AND
ENERGY INTO SOME OF THE POINTS
THAT DAWN MADE IS APPLICANTS,
MINORITY APPLICANTS GET A SCORE
BACK.
IT'S A SCORE THAT ANY ON COUNCIL
WOULD SAY, WELL, THAT'S A COME
BACK IN SCORE, AND THEY GIVE UP.
THAT'S WHERE WE CAN APPLY A
LITTLE EXTRA ENERGY AND GET
PEOPLE TO COME IN WITH RENEWAL
OR REVISION.
SO, YOU KNOW, I MEAN THAT'S JUST
ONE.
THERE ARE LOTS OF LITTLE PIECES
LIKE THAT THAT WE'RE GOING TO
ACCUMULATE INFORMATION ON AND
HOPEFULLY THROUGH A WEBINAR
SERIES AND WORKSHOPS BE ABLE TO
MAKE SOME CHANGES.
ANY THOUGHTS?
>> YEAH, I WANT TO ECHO YOUR
COMMENT ABOUT IMPORTANCE OF
PERSONAL CONNECTIONS, AND I
REMEMBER EARLY IN MY CAREER
HAVING A CONNECTION WITH SOMEONE
AT NIAAA, JAN, WHO REALLY TOOK A
PERSONAL INTEREST AND REALLY
HELPED KIND OF CULTIVATE A
RELATIONSHIP.
THE OTHER IS THE ROLE THAT -- TO
LOOK INTO T32 TRAINING GRANTS, A
POOL OF PRE-DOCS AND POSTDOCS,
WHO MIGHT BE INTERESTED IN KIND
OF AN ACADEMIC OR RESEARCH
CAREER.
SO THAT'S ANOTHER GROUP YOU MAY
WANT TO THINK ABOUT.
>> THANK YOU.
>> WHAT AN EXCELLENT
PRESENTATION, ENERGY AND
ENTHUSIASM, AND I'M GLAD THAT
YOU'RE HERE.
MY QUESTION IS ABOUT THE
WORKFORCE GROUP THAT WAS STARTED
I BELIEVE WHEN I STARTED ON
COUNCIL, I'M CURIOUS IF THAT'S
STILL ACTIVE, IF WE'RE THINKING
ABOUT THAT?
AND MY SECOND POINT WHEN I ASK
QUESTIONS I END UP WITH MORE
WORK BUT ABSOLUTELY INVITE YOU
TO EL PASO WHERE WE HAVE 90%
HISPANIC STUDENTS AND HERE TO
SUPPORT YOU ANY WAY I CAN TO
MAKE SURE REPRESENTATION IS
THERE ALSO.
>> YOU STEPPED INTO THAT ONE,
LAURA, BECAUSE WE'RE GOING TO
REINNERVATE THE WORKING GROUP.
DAWN AND I AND TRISH AND BRIDGET
HAVE BEEN TALKING ABOUT THAT.
DAWN, DO YOU WANT TO RESPOND?
I DIDN'T GIVE YOUR TALK.
>> RIGHT.
SO, DEFINITELY.
EL PASO IS GREAT.
I WOULD LOVE TO COME OUT AND
CONNECT WITH YOUR STUDENTS.
AND ANY OTHER CONTACTS YOU HAVE.
WE CERTAINLY ARE NOT -- WE WANT
TO CAST THE NET WIDE WITH THE
HOPE OF DRAWING STUDENTS IN.
>> ANY OTHER COMMENTS OR
QUESTIONS, COMMENTS FOR DAWN?
I CAN JUST TELL YOU SHE'S ONLY
BEEN HERE 11 WEEKS BUT I FEEL
LIKE SHE'S BEEN HERE FOR A LONG
TIME.
WE'RE MOVING FORWARD.
AND I'M LOOKING FORWARD TO IT.
SOME EXCITING ADVENTURES IN THIS
DOMAIN.
THERE'S A REWARD OUTSIDE.
DAVID KARAKEN'S TERMS, ICE CREAM
IF YOU WANT IT.
DON'T WORRY ABOUT YOUR WEIGHT.
IT'S JUST A SMALL AMOUNT OF ICE
CREAM, ALL RIGHT?
WE'LL RECONVENE AT 3:00 AND CAN
YOU CONTINUE EATING YOUR ICE
CREAM WHILE WE RECONVENE, I
WILLS TON COUNCIL CLEARANCE IF
NEED BE.
WE'LL TAKE A TEN-MINUTE BREAK.
SO WHAT WE'RE GOING TO DO IS A
SERIES OF THREE CONCEPT
CLEARANCES, AND THE FIRST ONE IS
GOING TO BE BY ELIZABETH POWELL
FROM DIVISION OF NEUROSCIENCE
AND BEHAVIOR, TALKING ABOUT DATA
SCIENCE TOOLS FOR ALCOHOL
RESEARCH.
ELIZABETH, IT'S ALL YOURS.
>> THANK YOU.
GOOD AFTERNOON.
SO THIS CONCEPT WAS ORIGINALLY
PRESENTED IN 2018 AND NEEDS TO
BE RENEWED.
SO WHEN WE TALK ABOUT DATA,
WE'RE TALKING ABOUT THE ENTIRE
DATA LIFE CYCLE FROM
ACQUISITION, USE AND REUSE,
PRESERVATION OR DESTRUCTION, THE
LIFE PSYCH THAT WILL NOW IS
BEING COVERED BY THE NIH POLICY
DATA MANAGEMENT AND SHARING.
OVERARCHING OF THIS LIFE CYCLE
ARE ENVIRONMENTAL FACTORS
INCLUDING ETHICS, POLICY,
REGULATORY, STEWARDSHIP,
PLATFORM, AND DOMAIN.
SO I WANT TO DO A BRIEF REVIEW
OF WHAT HAS HAPPENED AT NIAAA IN
THE LAST FIVE YEARS.
WE HAVE HAD DEVELOPMENT OF SOME
NEW TOOLS, THROUGH THE SBIR
SPACE, CONTRACT MECHANISM, AND
WE HAVE TWO SMALL COMPANIES, ONE
HAS -- BOTH IN PHASE 2, JUST
STARTED WITH FACE -- PHASE 2,
ONE DOING ALGORITHMS FOR
IDENTIFICATION OF NEW GENES,
COLLABORATION WITH UNIVERSITY OF
TEXAS.
ANOTHER ONE IS PREDICTION OF
DRINKING PATTERNS, HUMAN
BEHAVIORAL DATA, COLLABORATION
WITH UNIVERSITY OF NEW MEXICO.
AND IN PHASE 2, FOR BOTH OF
THESE THEY ARE MOVING TO TOOL
KITS FOR ALCOHOL RESEARCHERS TO
BE ABLE TO USE THESE TOOLS.
PHASE 1 THEY MADE NEW ALGORITHMS
WHICH MEANS NEW MATH, REAL
RESEARCH, NOW WE NEED TO UTILIZE
THEM.
THEIR FINDINGS ARE PUBLISHED IN
PEER-REVIEWED PAPERS.
SECOND THING WE'VE ACCOMPLISHED
THERE'S BEEN 60% INCREASE IN
APPLICATIONS IN DATA SCIENCE,
THAT'S BASED ON SOME KEY WORD
SEARCHES IN OUR GRANTS DATABASE,
NOT JUST 60% IN APPLICATIONS BUT
60% INCREASE IN FUNDING, OVER
90% INCREASE IN FUNDING DOLLARS.
DATA POST EMBARGO, MAY BE OPEN
SOON.
WITHIN NIAAA AND NIH IN GENERAL
INCREASE IN DATA GOVERNANCE AND
USE, DATA ACCESS COMMITTEE NOW
REGULATING OUR DATASETS
INCLUDING COMBINE AND
(INDISCERNIBLE) AND NIH RELEASED
DATA MANAGEMENT AND SHARING
POLICY AND NIAAA I WILL SAY IS
READY AND WE WILL PROBABLY BE
RELEASING SOME AWARDS WITH THOSE
PLANS THAT WERE APPROVED TODAY.
AND THEN FINALLY FOR EDUCATION
AND IMPLEMENTATION THERE'S A
DATA SCIENCE WORKING GROUP FOR
NIAAA STAFF, THAT INCLUDES
PROGRAM REVIEW AND GRANTS
MANAGEMENT BUT ALSO POLICY AND
I.T.
SO THAT'S GOING ACROSS THE
ENTIRE EXTRAMURAL STAFF AND
INTRAMURAL WHEN IT'S APPROPRIATE
FOR INTRAMURAL TO JOIN US.
FINALLY WE ARE PARTICIPATING IN
WORKFORCE DEVELOPMENT
INITIATIVES, F AWARDS, SPECIFIC
T32s.
AND OVER ACROSS NIH AND IN THE
INTEREST OF TIME WE HAVE
PARTICIPATED IN THESE LARGE
STUDIES INCLUDING THE BRIDGE2AI,
MORE PARTICIPATION IN ABCD, ALL
OF US, AND WITH THE OFFICE OF
DATA SCIENCE STRATEGY WE
PARTICIPATE IN THEIR NOTICES OF
SUPPLEMENTS FOR FUNDED AWARDS,
AND IN REVIEWING THOSE
SUPPLEMENTS ON THE PROGRAMMATIC
LEVEL.
BUT WE STILL HAVE GAPS.
WE STILL DON'T KNOW HOW MUCH
DATA WE HAVE.
OR THE ACCESS TO IT.
WAYS TO BETTER HARMONIZE,
ALCOHOL IS A VERY COMMON WORD
AND SO WE'RE STRUGGLING WITH
COMMON DATA ELEMENTS AND HOW DO
YOU PULL OUT THE SCIENCE FROM
THE USE OF ALCOHOL IN ALL OF THE
TEXT.
DATA SHARING CAPABILITIES NIAAA
ASSESSING AND COMBINING AND NIH
ACTUALLY HAS AN ENTERPRISE
GITHUB, NIAAA WAS THE VERY FIRST
INSTITUTE TO SIGN ON.
WE'VE USED THAT AS A PLACE TO
DEPOSIT THE CODE AND JUPYTER
NOTEBOOKS FOR THOSE CONTRACTS.
AND THEN WE ARE COLLABORATING
ACROSS NIH BUT WITH WHOM AND
FINALLY WHAT'S OUR
REPRESENTATION IN THE DATA
SCIENCE COMMUNITY AND WORKFORCE
DEVELOPMENT AND THERE IS MORE
WORK ON ETHICS AND POLICY THAT
CAN BE DONE.
SO SOME FUTURE DIRECTIONS,
SIMILAR AS BEFORE, A LITTLE MORE
DETAILED, MORE FOCUSED, MORE
ANALYTICAL TOOLS, BETTER
HARMONIZATION, BETTER INTERFACES
THROUGHOUT THE OTHER
COMMUNITIES, AND WAYS TO COMBINE
THE DATA THAT WE HAVE NOW AND IN
SOME WAYS MAYBE PLAN BETTER FOR
THE EXPERIMENTS AND TYPE OF DATA
SO THAT WHEN WE WANT TO COMBINE
THEM IT'S SIMPLER AND WE CAN GET
BETTER ANSWERS.
AND YOU HAVE THESE FUTURE
DIRECTIONS SO AT THIS POINT I'LL
STOP AND TAKE ANY QUESTIONS.
>> SO ARE THERE ANY QUESTIONS
FOR ELIZABETH?
WE DO NEED ENDORSEMENT BY AT
LEAST ONE COUNCIL MEMBER OF THIS
CONCEPT.
ANYBODY WANTS TO VOLUNTEER?
>> SO MOVED.
>> I THINK YOU GET UNANIMOUS
ENDORSEMENT THERE.
EVERY ULTIMATELY C AND A-- EVERY
I.C. AND ACROSS THE BOARD, I'M
GRATEFUL FOR HER ENERGY AND
INSIGHTS INTO THIS CHALLENGE.
ANY OTHER COMMENTS OR THOUGHTS?
ANYBODY ONLINE OUT THERE HAVE
ANY COMMENTS? ?
WE'RE GOOD TO GO.
SHELICE IS ALSO IN THE DIVISION
OF NEUROSCIENCE AND BEHAVIOR,
TALKING ABOUT SLEEP DYSFUNCTION
AND ALCOHOL INDUCED
HYPERKATIFEIA.
THERE'S A WARM SPOT IN MY HEART
BECAUSE HE'S ACTUALLY TALKING
ABOUT HYPERKATIFEIA.
>> THANK YOU, DR. KOOB.
GOOD AFTERNOON, EVERYONE.
I'M REALLY EXCITED TO BE HERE.
THE TITLE OF THE PRESENTATION IS
SLEEP DYSFUNCTION AS A CORE
FEATURE AND INTERVENTION TARGET
IN ALCOHOL-INDUCED
HYPERKATIFEIA.
THE MAIN AIM OF THIS CONCEPT IS
TO EXPLORE THE INTRICACIES OF
HYPERKATIFEIA AND SLEEP AS WELL
AS ITS IMPLICATION FOR ALCOHOL
INDUCED HYPERKATIFEIA AND
RECOVERY.
SO LET ME FIRST DEFINE THE TERM
HYPERKATIFEIA.
IT CAME FROM A GREEK WORD WHICH
MEANS BEE GEEKS OF EMOTIONAL
STATE, PHYSIOLOGIC AND
PSYCHOLOGICAL SYMPTOMS INDUCED
BY WITHDRAWAL, ENCOMPASSES
HEIGHTENED EMOTIONAL DISTRESS
AND SENSITIVITY EXPERIENCED IF
WITH IN WITHDRAWAL PROCESS.
ONE CRUCIAL FEATURE IS DECEPTION
OF, EXCUSE ME, OF SLEEP PATTERNS
INDEED SLEEP DISRUPTION,
WITHDRAWAL SYSTEMS ASSOCIATED
WITH HYPERKATIFEIA.
THIS CONTRIBUTED FEELING OF
DISCOMFORT, DISSATISFACTION
EXPERIENCED BY THOSE UNDERGOING
ALCOHOL WITHDRAWAL.
WE SEE ALTERED SLEEP
ARCHITECTURE, SLANGS -- CHANGES
IN RECOMMEND AND NON-REM SLEEP,
SELF-AWARENESS, HEDONIC
FUNCTIONING.
INTENSIFYING NEGATIVE EMOTIONAL
STATES AND MOTIVATIONAL
CHALLENGES.
SO, IN THE CONTEXT OF ALCOHOL
WITHDRAWAL HYPERKATIFEIA SLEEP
DYSFUNCTION PLAYS A VERY
IMPORTANT SIGNIFICANT ROLE IN
AMPLIFYING EMOTIONAL DISTRESS.
THIS INTENSIFIES NEGATIVE
EMOTIONS AND SENSITIVITY AS WELL
AS PHYSICAL AND PSYCHOLOGICAL
PRESSES, AMPLIFYING ALLOSTATIC
LOAD, THE COST THE BODY MIGHT
PAY BY HOSTING ADVERSE OR
DELETERIOUS PSYCHOLOGICAL OR
PHYSICAL SITUATION, REPRESENTING
PRESENCE OF TOO MUCH OF THE
DEMAND ON THE OPERATION OF
REGULATORY SYSTEMS.
SO THIS OVERALL STRAIN ON THE
BODY IS DEVELOPING, HOW SLEEP
LINKS WITH EMOTIONS AND
WITHDRAWAL, CONNECTION WITH
POTENTIALLY GUIDE INTERVENTION
TO REDUCE DISTRESS, ENHANCE
COPING, IMPROVE RECOVERY
OUTCOMES.
SO THE PURPOSE OF THIS CONCEPT
IS TO DEVELOP INTERVENTIONS FOR
ENHANCED TREATMENT OUTCOMES
SPECIFICALLY EXAMINE SLEEP
DISTURBANCES, HYPERKATIFEIA AND
INTERACTION TO DEVELOP
INTERVENTIONS TARGETING SLEEP
DYSFUNCTION AND IMPROVING
TREATMENT OUTCOMES.
AND ALSO EXPLORE RELATIONSHIP
BETWEEN SLEEP DISTURBANCE AND
HYPERKATIFEIA DURING ALCOHOL
WITHDRAWAL, GAINING
COMPREHENSIVE UNDERSTANDING OF
HYPERKATIFEIA'S FEATURES AND ITS
CONNECTION WITH SLEEP
DISRUPTIONS.
ALSO DEVELOP PRECISE
INTERVENTIONS AIMED AT
MITIGATING SYMPTOMS, BOLSTERING
EMOTIONAL REGULATION, ENHANCING
OVERALL WELL-BEING THOSE
NAVIGATING HYPERKATIFEIA.
SO RESEARCH GOALS ARE CENTERED
AROUND CHARACTERIZING DISRUPTION
IN SLEEP STAGES, IMPACT ON
ALTERED SLEEP ARCHITECTURE,
MICRO AND MACRO ARCHITECTURES,
IDENTIFYING NEURONAL CIRCUIT
RESISTANCE, ENDOCRINE PATHWAYS,
CIRCUITS INVOLVED IN STRESS
DYSREGULATION AND MANIFESTATION
OF HYPERKATIFEIA, DEVELOP
SPECIFIC TARGETED INTERVENTIONS
SUCH AS DISRUPTION -- ADDRESSING
DISRUPTION IN SLEEP STAGES USING
BOTH PHARMACOLOGICAL AS WELL AS
NON-PHARMACOLOGICAL APPROACHES.
SO RESEARCH PLAN MAY INCLUDE
CROSS-SECTIONAL STUDIES TO
ASSESS SLEEP DISTURBSANCE AND
HYPERKATIFEIA SYMPTOMS,
OBJECTIVES MEASURES LIKE PSG,
EEG AND SUBJECTIVE ASSESSMENTS.
PET OR fMRI TO INVESTIGATE
NEURAL BIOLOGICAL CORRELATES OF
SLEEP DYSFUNCTION IN
HYPERKATIFEIA.
ALSO MOLECULAR APPROACHES TO
STUDY UNDERLYING NEUROBIOLOGY OF
SLEEP DISTURBANCE AND
HYPERKATIFEIA BY EXPLORING
PATHWAYS, GENETIC INFLUENCE AND
CIRCUIT LEVEL INTERACTIONS.
MAY INCLUDE LONG-TERM FOLLOW-UP
ASSESSMENT TO EXAMINE SUSTAINED
EFFECTS OF INTERVENTION ON SLEEP
OUTCOMES, HYPERKATIFEIA SYMPTOMS
AND ALCOHOL STATES, RATES IN
INDIVIDUALS WITH AUD.
SO JUSTIFICATION FOR THIS
CONCEPT LISTED HERE, ADDRESS A
LARGE SIGNIFICANT KNOWLEDGE GAP
IN THE FIELD.
REMAINS UNFUNDED AREA OF
RESEARCH HIGHLIGHTED IN ARTICLE
PUBLISHED IN 2022, ALSO HAVE
DONE MY OWN PORTFOLIO ANALYSIS,
THIS REMAINS UNFUNDED AREA OF
RESEARCH.
ALSO IT WOULD ADDRESS ROAM OF
SLEEP STAGES IN HYPERKATIFEIA
AND ALLOSTATIC LOAD, TO ENHANCE
WELL-BEING IN ALCOHOL-INDUCED
HYPERKATIFEIA CASES, ALSO WOULD
PROVIDE NEUROBIOLOGICAL INSIGHT,
UNCOVERING MECHANISMS AND
TARGETS FOR SYMPTOM RELIEF AND
TREATMENT ENHANCEMENT, OVERALL
IMPROVE STRESS REGULATION AND
EMOTIONAL WELL-BEING DURING
ALCOHOL WITHDRAWAL-INDUCED
HYPERKATIFEIA.
THANK YOU FOR YOUR ATTENTION.
I'M HAPPY TO ANSWER ANY QUELLS
YOU HAVE.
>> GO AHEAD, CHUCK.
>> SO WHEN I LISTEN TO THIS,
WHICH IS REALLY GREAT, IS THIS
PRIMARILY MEANT TO BE CLINICAL
STUDIES?
>> YES, MOST OF THE STUDIES WILL
BE IN HUMANS, YES.
>> AND IF THAT'S THE CASE I
WOUND WONDER IF THAT SHOULD BE
SPELLED OUT.
>> IT'S IN THE --
>> IS IT?
YEAH.
ONCE PEOPLE WHO DO PRE-CLINICAL
STUDIES TO THINK ABOUT HOW THEY
ARE GOING TO INTEGRATE INTO
THIS, AND BE A WASTE OF TIME.
>> SURE
>> I THINK IT SHOULD BE VERY
CLEAR THAT WHAT YOUR PRIMARY AIM
IS CLINICAL HUMAN STUDIES.
>> THANK YOU.
>> WHICH ALSO RAISES AN ISSUE
FOR US AS TO HAVING SOME INPUT
FROM DTR, BECAUSE THE TWO LEGGED
RATS ARE GOING TO BE THE LARGEST
CONTRIBUTORS TO THIS STUDY.
SO ANTONIO AND RAY, YOU MAY WANT
TO HAVE A LITTLE DISCUSSION
ABOUT THAT BECAUSE THIS HAS COME
UP IN PREVIOUS STUDIES, ACROSS,
BETWEEN THE TWO DIVISIONS.
I DON'T WANT TO SILO OUR
DIVISIONS.
I DON'T WANT TO BURDEN OUR
DIVISIONS WITH EXTRA WORK BUT
THE FACT IS THAT WHEN IT COMES
TO HUMAN STUDIES, THE EXPERTISE
LIE WAS DTR.
>> WE GAVE HIM A LOT OF
FEEDBACK, PROBABLY MORE THAN HE
WANTED, BUT THE BIG PROBLEM IS
ALWAYS THE HETEROGENEITY THAT
YOU SEE IN THIS POPULATION.
EVEN SLEEP DISORDERS.
SO WE HAVE TALKED.
AND HE WAS HAPPY WITH MY
COMMENTS.
>> AGREED.
>> MAYBE TOO MANY.
>> WE'VE BEEN INTERACTING OUR
DIVISION WITH HIM.
>> I HAVE ANOTHER QUESTION AS
WELL IF I MAY.
I SAW IT IN THE OVERVIEW BUT I
DIDN'T SEE IT IN THE SLIDES
HERE.
JUST ENSURING THAT BEHAVIORAL
INTERVENTIONS ARE ALSO PART OF
THE FOCUS HERE, NOT JUST
PHARMACOLOGICAL INTERVENTIONS.
>> YES, BOTH PHARMACOLOGICAL AND
NON-PHARMACOLOGICAL, YES,
ABSOLUTELY.
>> ENDORSEMENT FROM COUNCIL
MEMBER?
>> YES.
>> SEVERAL.
THANK YOU VERY MUCH.
>> THANK YOU.
>> ARE THERE QUESTIONS ONLINE
BEFORE YOU STEP OUT OF THE
PODIUM?
HANG ON.
THANK YOU, TRISH.
ANY QUESTIONS FROM ANYONE ONLINE
PLEASE?
ALL RIGHT.
>> THANK YOU.
>> KENDALL, ALL YOUR SKILLS THAT
YOU'VE ACQUIRED, ALL THE
CHALLENGES YOU FACE IN YOUR
CAREER MUST HAVE DONE LEVER
PRESSING AT SOME POINT NOW.
HAVE YOU NOT DONE THAT?
>> NO.
(INAUDIBLE).
>> WITH RATS, YEAH, THAT'S WHAT
I MEANT.
ALL RIGHT.
SO KENDALL BRYANT WORKS IN THE
OFFICE OF DIRECTOR, DIRECTOR OF
OUR HIV/AIDS PROGRAM AT NIAAA.
HE'S DONE A MAGNIFICENT JOB IN
HELPING END THE AIDS EPIDEMIC
BECAUSE OF ALCOHOL'S
CONTRIBUTION TO THE PATHOGENESIS
AND MAINTENANCE OF HIV, AND HE'S
NOW GOING TO TELL US ABOUT
COMPREHENSIVE ALCOHOL-HEARING
AIDS RESEARCH CENTERS THAT WE
SUPPORT.
YOU'LL STEP UP TO THE
MICROPHONE, KENDALL.
>> ALL RIGHT, GREAT.
THANK YOU.
I JUST GOT OFF THE TRAIL HERE.
JUST TO COME IN AND TALK TO YOU.
SO, THIS IS A COMPREHENSIVE
ALCOHOL HIV/AIDS RESEARCH
CENTER, P60 MECHANISM, DR. KOOB
TALKED ABOUT THIS AT THE
BEGINNING OF THE MEETING.
LARGELY, THE CENTERS'S BEEN WITH
US FOR 30 YEARS.
THIS IS CURRENTLY THE ONE CENTER
THAT WE'RE SUPPORTING, AT LSU, A
REISSUE OF THE LATEST CENTER
ANNOUNCEMENT.
BUT THERE ARE TWO AIDS PLANS
THAT ARE BASICALLY DRIVING THE
CENTER ACTIVITIES.
ONE IS THE NIH AIDS PLAN, BOTH
ARE OVER 150 150 PAGES.
THE OTHER IS FEDERAL
IMPLEMENTATION PLAN.
SO SHIFT IN THE CENTER IS ALONG
THESE LINES TOWARD
IMPLEMENTATION, THE STRUCTURE IS
PRESENTED AT THE BOTTOM HERE,
REALLY THE -- WE'RE GOING TO
FOCUS ON CROSS-CUTTING AREAS,
I'M NOT GOING TO GO INTO THEM.
I CAN HAVE A REFERENCE FOR YOU
LATER.
GO ON.
THE PURPOSE OF THIS NOFO IS TO
USE THE NIH COMPREHENSIVE
RESEARCH CENTER MECHANISM TO
SUPPORT RESEARCH CENTER GRANTS
TO CONDUCT A RANGE OF BASIC AND
BEHAVIORAL CROSS-CUTTING,
INTERVENTION, AND TRANSLATIONAL
RESEARCH IN THE ALCOHOL AND
HIV/AIDS AREA.
AND THE MAIN ISSUE HERE IS THAT
THE CENTERS OPERATE AS A SPECIAL
CENTER.
[ NO AUDIO ]
>> OKAY, CHARLES MILLIKEN, ARE
YOU ON?
>> I AM, DR. KOOB.
REALLY DON'T HAVE ANYTHING TO
REPORT ON THIS WEEK.
OR THIS MEETING.
>> I'M GLAD TO HEAR YOU.
I HAVEN'T SEEN YOU YET BECAUSE I
DON'T SEE A VIDEO BUT PLEASE
JOIN US IN THE FUTURE.
THERE YOU ARE.
YOU HAVE SOMETHING YOU WANT TO
REPORT ON, OKAY?
>> WILL DO.
>> THANK YOU.
>> THANKS FOR CHECKING IN.
APPRECIATE IT.
ALL RIGHT.
WHAT'S LEFT?
OH, BOB.
BOB HUEBNER, FORMER DIRECTOR OF
THE FRIENDS OF NIAAA.
HE'S TRANSITIONING, AND HE'S
GOING TO INTRODUCE THE NEW
DIRECTOR.
>> THAT'S CORRECT.
>> OF THE FRIENDS OF NIAAA.
>> THANK YOU VERY MUCH, GEORGE.
THANK YOU ALL FOR YOUR PATIENCE
AND ENDURANCE.
IT'S BEEN A LONG DAY, I KNOW.
AGAIN I'M BOB HUEBNER.
SPEAKING ON BEHALF OF THE
FRIENDS OF NIAAA, WHICH MOST OF
YOU KNOW IS A NON-PROFIT
ORGANIZATION THAT'S DEVOTED TO
PROMOTING THE EXCELLENT RESEARCH
SUPPORTED BY NIAAA.
AS GEORGE MENTIONED EARLIER, THE
IMPORTANCE OF GETTING THE WORD
OUT, FRIENDS OF NIAAA IS TOTALLY
AND COMPLETELY DEVOTED TO THAT
VERY IDEA.
OUR TARGET AUDIENCE IS OUR
MEMBERS OF CONGRESS, HEALTH AND
BEHAVIORAL HEALTH PROVIDERS, AND
THE GENERAL PUBLIC.
I WANT TO QUICKLY JUST SAY A
WORD OF THANKS TO DR. KOOB AND
HIS STAFF FOR PARTICIPATING IN
OUR WEBINARS AND BRIEFINGS OVER
THE PAST FEW YEARS.
AND FOR KEEPING US SO WELL
UPDATED ON WHAT'S GOING ON AT
THE INSTITUTE.
IT'S REALLY HELPED US TO DO OUR
JOB A LOT BETTER.
THERE ARE MANY GOOD THINGS TO
COME.
SPEAKING OF MANY GOOD THINGS TO
COME I'D LIKE TO INTRODUCE THE
NEW CHAIR OF FRIENDS OF NIAAA,
DR. BILL WISERIK, THE PRESIDENT
AND CEO OF THE PACIFIC INSTITUTE
FOR RESEARCH AND EVALUATION.
AND GRANTEE MANY TIMES OVER,
BRINGING SCIENTIFIC EXPERIENCE
AND KNOWLEDGE, AND A GREAT DEAL
OF EXPERTISE RUNNING NON-PROFIT
ORGANIZATIONS.
I THINK THE FRIENDS OF NIAAA HAS
A LOT OF GOOD THINGS TO LOOK
FORWARD WITH BILL AT THE HELM.
I'M HAND IT OVER TO BILL.
>> BEFORE YOU SAY ANYTHING,
BILL, LET'S GIVE BOB A BIG ROUND
OF APPLAUSE FOR -- HOW MANY
YEARS, BOB, THAT YOU'VE DONE
THIS?
FOUR YEARS OF OUTSTANDING
SUPPORT VIA FRIENDS OF NIAAA.
>> AND THANK YOU, GEORGE.
THAT LEADS INTO WHAT I WANT TO
SAY, THESE ARE BIG SHOES TO FILL
AND THIS IS -- I'M VERY HAPPY TO
TAKE THIS ROLE BUT IT'S NOT AN
EASY ROLE --
[ TECHNICAL ISSUES, PLEASE STAND BY]
MAY IS A LONG TIME AWAY.
>> IN THAT CASE I APPROVE OF THE
MINUTES.
>> THANK YOU.
>> 14th AND 15th?
>> 14th AND 15th.
I WILL DOUBLE CHECK AND SEND OUT
THE DETAILS.
>> OKAY.
SO COULD YOU LEAVE THAT SLIDE UP
FOR US?
SO, JEN JONES WANTED TO MENTION
HER SOCIETY FOR SOBER LIVER
SURVIVAL.
THE WEB LINK IS HERE.
SHE'S THE FOUNDER AND PURPOSE OF
HER SOCIETY IS THAT -- YOU HAVE
TO CUT THE PICTURES IF I'M GOING
TO READ THE SLIDES.
SO NO HUMAN DIAGNOSED WITH
ALCOHOL-RELATED LIVER DISEASE
HUFF TO WALK THIS COMPLEX
JOURNEY ALONE.
THE PURPOSE TO PROVIDE A SAFE
STAY SPACE TO EMPOWER PEOPLE TO
ACTIVATE THEIR AGENCY BY
DEVELOPING THEIR UNIQUE ALCOHOL
RECOVERY PATHWAY THROUGH PEER
GROUP AND MENTOR SUPPORT,
EDUCATION, EXTERNAL RESOURCES.
ADDITIONALLY, THROUGH THE
SUPPORT OF SOBER LIVER'S WHOLE
HEALTH ADVISORY COUNCIL, WE WILL
ACTIVELY ENSURE MEDICAL
PROVIDERS, HEALTH ASSOCIATIONS,
AND COMMUNITIES HAVE THE LATEST
ALCOHOL USE DISORDER AND ALCOHOL
ASSOCIATED LIVER DISEASE
INFORMATION ON EARLY DETECTION,
TREATMENT, AND PATIENT AND CARE
PARTNER SUPPORT OPTIONS.
SO THERE'S A VIDEO, YOU CAN SEE
THE LINK HERE ON YouTube.
WE'RE GOING TO INVITE THOROUGH
HAVE A LIAISON MEETING IN
SEPTEMBER WHERE SHE CAN SHOW THE
VIDEO.
WE'LL HAVE MORE TIME THERE.
DID YOU WANT TO SHOW THE VIDEO,
RV?
>> HI, I'M JENN JONES, FOUNDER
OF SOCIETY FOR SOBER LIVER
SURVIVAL.
I THANK DR. KOOB AND THE
COUNCIL TO DISCUSS WHY WE WANT
TO PARTNER WITH NIAAA TO DELIVER
BETTER HEALTH OUTCOMES FOR
INDIVIDUALS UP
ALCOHOL-ASSOCIATED DELIVER
DISEASE, ALD.
ONE MOMENT WHILE I BRING UP MY
PRESENTATION.
>> I WANT TO THANK NIAAA FOR
INTEGRATING TREATMENTS.
TODAY I WILL SHARE A MISSING
PIECE AS WELL AS CENTRAL PIECE
TO CONNECT TREATMENTS.
TO LEARN MORE ABOUT ME REFER TO
MY BIO.
THIS SUMMER THE CONFERENCE, IT
WAS ANNOUNCED NEW NOMENCLATURE
FOR FATTY LIVER DISEASE UPDATING
TO STAY STEATOTIC AND METABOLIC,
AND MASLD SAME JOURNEY,
CONDUCIVE TO COMBINING EFFORTS
WITH ADVOCATES AND SUPPORTING
PEOPLE WITH THESE CONDITIONS.
THERE ARE MANY TARGETED
ORGANIZATIONS FOR LIVER DISEASE,
THERE IS A MISSING PIECE.
I ADVOCATE FOR AND SUPPORT THEIR
IMPACTFUL WORK, IT IS ALSO A
PIECE MISSING IN PROGRAMMING AT
BOTH MAJOR LIVER ADVOCACY
ORGANIZATIONS.
AMERICAN FOUNDATION, LIVER
FOUNDATION, GLOBAL LIVER
INSTITUTE.
IT HAPPENS TO BE THE LIVER
DISEASE THAT KILLS THE MOST
PEOPLE IN THE U.S., NUMBER ONE
REASON FOR TRANSPLANTS.
IN PARTNERSHIP WITH THE FATTY
LIVER FOUNDATION, MENTORSHIP
WITH THE CEO OF THE AMERICAN
LIVER FOUNDATION MEDICAL
ADVISEMENT FROM DR. SHAH, MAYO
CLINIC CHAIR OF INTERNAL
MEDICINE AND DR. MELLINGER WITH
MICHIGAN MEDICINE ALCOHOL
IMPROVEMENT NETWORK CHAMPIONS
AND PATIENT PARTNERS LIKE BETH
LAYMAN, I FOUNDED SOBER LIVER IN
MARCH OF THIS YEAR TO SUPPORT
THIS HIGH MORTALITY GROWING
POPULATION.
WE MUST ACT NOW, THE PANDEMIC
HAS INCREASEED DEATHS AT AAN
ALARMING RATE.
OUR YOUNG WORKFORCE POPULATION
WILL HAVE UNFORESEEN ECONOMIC
IMPACTS.
AND AFFECTING WOMEN,
REPRODUCTIVE MEMBERS OF SOCIETY,
WHICH WILL LEAD TO GREATER FETAL
ALCOHOL SYNDROME, MOMS UNABLE TO
CARE FOR CHILDREN OR SEE THEM
GROW UP AND WOMEN WITH RESOURCES
TO HAVE CHILDREN DECIDING
AGAINST IT AS THEY CAN NOT STOP
DRINKING FOR NINE MONTHS.
MANY WELL RESOURCED INSTITUTIONS
ARE MOVING TO INTEGRATIVE MODEL
TREATING BOTH SIMULTANEOUSLY.
LIKE THE MICHIGAN ALCOHOL
IMPROVEMENT NETWORK, PEOPLE
DIAGNOSED WITH ALD MEET WITH A
HEPATOLOGIST, PSYCHIATRIST, AND
PSYCHOLOGIST IN ONE CLINIC WHILE
ENCOURAGING ATTENDING MUTUAL AID
SOCIETIES BUT THESE SOCIETIES
ARE FOR PEOPLE WITH AUD AND MANY
ARE NOT DIAGNOSED WITH ALD WHICH
CAN LEAD TO FEELINGS OF SHAME,
MORE SHAME, AND INCREASED
SELF-STIGMA FOR THE PERSON WITH
ALD.
WE MUST REDUCE STIGMAS
ASSOCIATED WITH ALD.
ALD STIGMA CAN BE COMBATED WITH
EMPATHY TO LEAD ACTION AGAINST
THIS STIGMATIZATION.
SOBER LIVER WILL BRIDGE
STRATEGIES CREATING A SPACE FOR
PEOPLE WITH BOTH AUD AND ALD.
WHEN I ALMOST DIED FROM LIVER
FAILURE IN 2018 I HAD 30% CHANCE
OF SURVIVING 30 DAYS.
DIAGNOSED WITH ALCOHOL INDUCED
HEPATITIS AND ALD.
I FELT ASHAMED THAT I HAD GOTTEN
MYSELF TO THIS POINT, BLAMING
MYSELF FOR LETTING THE SEVERE
INTIMATE PARTNER VIOLENCE I
SUFFERED LEAD ME DOWN THIS ROAD.
I WAS EMBARRASSED TO TALK WITH
MY FAMILY AND THOUGHT I MAY BE
BETTER OFF DEAD.
IF IT WASN'T FOR MY DOG I WOULD
HAVE GIVEN UP.
IF ONLY I HAD SOMEONE TO SHARE
FEELINGS WITH, CAME OUT ON THE
OTHER SIDE ALIVE AND WITH HOPE.
OUR GOAL IS TO BE THAT SOMEONE,
PROVIDING SOCIAL AND PEER
SUPPORT, CREATING BETTER HEALTH
OUTCOMES BY DISCOVERING THE
UNDERLYING WHY FOR DRINKING AND
FINDING SHORT- AND LONG-TERM
PURPOSES, REDUCING STIGMA AND
SHAME WHILE INCREASING
CONNECTION, AND BELONGING.
WE WILL ACCOMPLISH THIS MISSION
BY CREATING A SAFE SPACE TO
ENGAGE AND EMPOWER PEOPLE TO
ACTIVATE THEIR AGENCY BY
DEVELOPING THEIR UNIQUE ALCOHOL
RECOVERY PATHWAY THROUGH PEER
AND MENTOR SUPPORT, EDUCATION,
AND EXTERNAL RESOURCES.
ORIGINALLY SOBER LIVER WAS
SEEKING TO BECOME THE 501(C)3,
BUT BECAUSE OF THE NEW
NOMENCLATURE, I MET WITH
LEADERSHIP AT THE FATTY LIVER
FOUNDATION TO ACCELERATE SO WE
CAN BE MORE AGILE AND HELP
PEOPLE IN NEED OF SUPPORT.
WE'RE CURRENTLY WORKING ON AN
MOU FOR SOBER LIVER TO BECOME
RESTRICTED PROGRAM IN THE
ORGANIZATION AND WILL BE
ANNOUNCING THE STRUCTURE AND OF
IN UPCOMING PRESS RELEASE.
WHICH LEADS ME TO WHY SOBER
LIVER IS SEEKING YOUR HELP WITH
EVIDENCE INDICATING THIS CAN
IMPROVE HEALTH OUTCOMES AND NEED
TO SOLVE STIGMA AND SHAME
ASSOCIATED WITH ALD WE POSTULATE
INCLUDING SOBER LIVER IN THESE
INTEGRATIVE MODELS AND CLINICAL
TRIALS WILL IMPROVE HEALTH
OUTCOMES FOR PEOPLE WITH ALD.
TO ACCOMPLISH THESE GOALS WE'RE
SEEKING SUPPORT FOR OUR MISSION,
ALSO WANT TO BE INCLUDED IN
CLINICAL TRIALS TO PRODUCE
EVIDENCE-BASED CARE MODELS.
WHAT WOULD A GRANT DO FOR SOBER
LIVER?
IT WOULD PROVIDE SEAMLESS
TRANSFER OF SUPPORT FOR PATIENTS
PRE AND POST TRANSPLANT, SUPPORT
FOR THEIR TRANSPLANT THROUGH
MENTORS WHOSE LIVES HAVE BEEN
IMPACTED, PREVENT RELAPSE
THROUGH EVIDENCE-BASED SUPPORT
FOR UNIQUE RECOVERY PATHWAYS,
AND PROVIDE PATIENT NAVIGATION
TO ENSURE MEDICAL COMPLIANCE AND
TREATMENT ADHERENCE.
DR. JESSICA MELLINGER SAID PEER
SUPPORT IS SEVERELY LACKING, AND
MANY FIND THEMSELVES FEELING
ISOLATED AND ALONE, COPING NOT
ONLY WITH STIGMA OF ALCOHOL USE
DISORDER BUT ALSO WITH
CHALLENGES AND STIGMA OF HAVING
ALD.
HAVING ACCESS TO A PEER NETWORK
SUCH AS SOCIETY FOR SOBER LIVER
SURVIVAL FOR SUPPORT AND
GUIDANCE WHILE NAVIGATING OFTEN
COMPLEX AND BEWILDERING PROCESS
OF RECOVERING FROM ALCOHOL USE
DISORDERS WHILE COPING WITH
LIVER DISEASE WOULD BE
INVALUABLE TO OUR PATIENTS.
TOGETHER WE CAN INCREASE THE
NUMBER OF SOBER LIVER SURVIVORS.
MY CONTACT NUMBER IS BELOW.
AND I HAVE ENJOYED SHARING WITH
YOU TODAY AND PLEASE CONTACT ME
WITH ANY QUESTIONS.
THANK YOU SO MUCH FOR YOUR
SUPPORT.
I LOOK FORWARD TO WORKING WITH
YOU ALL SOON.
>> THANK YOU, JENN JONES.
YOU'RE ALSO WELCOME AS I SAID
EARLIER, IN THE LIAISON MEETING,
AND HEAR THIS AGAIN, LOOKS LIKE
A REALLY INTERESTING NON-PROFIT
THAT'S EMERGING AND WE HAVE AN
ACTIVE PROGRAM IN DMHE IN
EXPLORING HOW WE CAN DO JOINT
TREATMENT WITH
ALCOHOL-ASSOCIATED LIVER DISEASE
AND ALCOHOL USE DISORDER.
SO THIS IS AN ONGOING AREA OF
RESEARCH AND IMPLEMENTATION
SCIENCE.
HOPEFULLY DOWN THE LINE.
OKAY.
SO, WE HAVE -- IF WE STAY ON
TIME, ADJOURN AT 4:20 WE HAVE 10
MINUTES, IF YOU HAVE RESIDUAL
QUESTIONS.
YOU'VE BEEN ACTIVE TODAY.
WHAT ABOUT ONLINE INDIVIDUALS
WHO ARE COUNCIL MEMBERS?
DO ANY OF YOU HAVE ANY QUESTIONS
OR THOUGHTS OR COMMENTS ABOUT
COUNCIL THIS TIME, OTHER THAN
PROBLEMS WITH ZOOM?
>> [OFF MICROPHONE].
>> SO THERE'S NOBODY LEFT
ONLINE.
I'M SPEAKING TO THE VOID, IS
THAT YOU'RE TELLING ME, RV?
>> WE'RE HERE.
>> COMMENTS, QUESTIONS?
>> GREAT MEETING.
AND THIS IS MY FIRST TIME ALL
THE WAY THROUGH THE OPEN AND
CLOSED SESSION TOGETHER, AND SO
IT WAS GOOD TO PARTICIPATE.
>> OKAY, GREAT.
ANY OTHER COMMENTS FROM
INDIVIDUALS?
>> YEAH, THIS IS KITT CARPENTER
AT VANDERBILT.
PRESENTATIONS WERE EXCELLENT,
ESPECIALLY ENJOYED THE DEIA
PRESENTATION, I'LL BE JOINING
THE SCMRO WORKING GROUP ON
COUNCIL OF COUNCILS, HAPPY TO
WORK WITH DAWN AND OTHERS GOING
FORWARD, REALLY EXCITED ABOUT
THAT.
>> WHO ELSE HAVE WE MISSED
THAT'S A MEMBER?
LAURA NAGY, ANY THOUGHTS?
>> NOTHING TO ADD.
VERY INTERESTING MEETING AND
EVEN THOUGH WE MISSED A LITTLE
BIT OF IT I THINK WE GOT THE
FULL GIST.
IT WAS VERY INTERESTING.
THANK YOU.
>> ALL RIGHT.
THANK YOU, LAURA.
ANYBODY ELSE THAT I MISSED
FROM -- TINA CHAMBERS, ANYTHING
FROM YOU?
>> MEETING WAS FABULOUS, I'M
REALLY INTERESTED IN THE PCSK9
DISCUSSION, AND ROLE OF
CHOLESTEROL.
>> YEAH, IT'S A BURGEONING AREA
OF SIGNIFICANT INTEREST.
WE HAVE AT LEAST TWO RESEARCHERS
IN OUR ARP WORKING ON THIS, AND
-- WELL, THREE IF YOU COUNT NORA
VOLKOW, SO NORA VOLKOW, FALK AND
PAL PATCHER, SO THEY HAVE ALL
BEEN PUBLISHING IN EITHER PSCK 9
OR IN CHOLESTEROL WORK.
YOU MIGHT WANT TO CONTACT ANY OF
THEM BECAUSE I'M SURE THEY ARE
HAPPY TO SHARE SOME OF THEIR
PUBLICATIONS.
>> ABSOLUTELY.
A BIG INTEREST AREA IN
PREGNANCY.
>> I DIDN'T KNOW THAT PART.
>> YES.
>> OTHER COMMENTS FROM ANYONE
NOW?
I WANTED TO SINGLE OUT OUR
ONLINE INDIVIDUALS TO SEE IF
THEY HAD ANY FURTHER COMMENTS OR
THOUGHTS.
ANYONE IN THE ROOM HERE?
ANYTHING WE NEED TO PAY
ATTENTION TO?
MICHAEL, ANYTHING WE LEFT OUT.
>> REALLY INTERESTING MEETING.
LEARNED A LOT.
>> MARY?
ARE YOU HAPPY TO SEE HOW COLLEGE
AIM PROGRESSED OVER THESE YEARS?
>> YES, IT'S GREAT TO SEE THE
UPTAKE OF THAT AND THE IMPACT OF
IT WHEN WE TALK WITH CAMPUSES
AROUND THE COUNTRY, MOST OF THEM
ARE WELL AWARE OF IT AND IT'S
EXCITING TO SEE THAT BEING USED.
>> IT'S REALLY APPROPRIATE NOW
GIVEN WOMEN HAVE PASSED MEN IN
BINGE DRINKING IN SOME
POPULATIONS, COLLEGE AGE WOMEN.
I WISH THERE WAS A WAY WE COULD
BETTER ACCESS THE NON-COLLEGE
GROUP.
I MEAN, WE DO HAVE A NOSI OUT ON
THAT, DON'T WE, RAY?
I THINK WE DO.
>> RALPH.
>> RALPH, WHERE IS HE?
WE HAVE A NOSI OUT ON THAT,
DON'T WE?
YEAH.
LAURA O'DELL, ANY THOUGHTS.
>> YEAH, I LIKED THIS LAST
VIDEO, MADE ME WONDER HOW WE
CONNECT PEOPLE AND COMMUNITIES
WITH OPPORTUNITIES LIKE THIS.
I JUST WANT TO SAY THAT I REALLY
ENJOYED IT AND LEARNED ABOUT IT
AND WILL SHARE IT WITH OTHERS
BUT I WONDER IF WE'RE DOING
THAT IN A FORMAL WAY?
>> IT MIGHT BE NICE OF FRIENDS
OF NIAAA COULD ACCUMULATE SOME
OF THE -- A LISTING OF ALL THESE
NON-PROFITS ININVOLVED IN
TRANSLATION, SO TO SPEAK, OR --
AND OUR SCIENCE POLICY BRANCH.
MAYBE LAURA LEONARDY WILL WORK
WITH FRIENDS OF NIAAA, MAYBE
THERE WE CAN MAKE CONNECTIONS, I
TAKE YOUR POINT.
I IGNORED POOR DAVID AGAIN.
ANY THOUGHTS?
>> NO, JUST --
>> IS THERE TOO MANY DAVIDS.
>> IT WAS CONFUSION WITH THE
LUNCH.
NO, I JUST SENT OFF THE SOBER
LIVER TO THE HEPATOLOGIST THAT I
KNOW AT IU, AND I THINK THE
MISSING GAP IS HOW YOU MAKE THE
PHYSICIANS' OFFICES AWARE AND
HAVE MATERIAL THAT THEY CAN
PROVIDE TO PATIENTS.
>> KATIE, ANY FURTHER THOUGHTS?
>> I JUST WANT TO ACKNOWLEDGE
THE GREAT WORK BUT ALSO I WANT
TO CONTINUE TO SAY WE HAVE TO
KEEP FIGHTING STIGMA AND SO I
THINK WE'RE DOING A GOOD JOB OF
THAT BUT WE NEED TO DO IT MORE
AND SO ANYTHING THAT NIAAA CAN
DO TO CONTINUE TO COMBAT STIGMA
AND THE WORDS WE USE AND HOW WE
TALK ABOUT PEOPLE WITH
EXPERIENCES OF ALCOHOL-RELATED
HARM IS REALLY IMPORTANT.
I WANT TO GIVE A FINAL PLUG FOR
THAT.
>> YEAH.
I MEAN, I HAVE TO SAY THAT IT
CAN BE CHALLENGING AT TIMES
BECAUSE WHEN YOU START USING
SOME OLD SLIDES YOU HAVE TO
PURGE THEM AND, YOU KNOW, WE'VE
BEEN TRYING VERY HARD TO PURGE
ALL OF MY SLIDES.
BUT THEN YOU GET THE PROOFS OF
THE MANUSCRIPT YOU WROTE FOR
SOME BOOK FIVE YEARS AGO AND
THEY COME THROUGH AND YOU HAVE
TO REALLY PUT A LOT OF ENERGY
INTO CHANGING THE WORDING.
SO I HEAR YOU.
CHUCK, ANY FINAL THOUGHTS?
BETH?
>> I'D LIKE TO SAY I'M ON THE
OTHER SIDE.
I'M ON THE FRONT LINES.
I'M DEALING WITH PATIENTS EVERY
DAY, AND THE RESEARCH IS MIND
BLOWING FOR ME AND GIVES ME HOPE
AND I'M ALWAYS TRYING TO
TRANSLATE TO THE PATIENTS I'M
WORKING WITH, YOU KNOW,
ESPECIALLY THE SLEEP
DISTURBANCE, EXPLAINING WHAT'S
HAPPENING AND GIVING PEOPLE THE
TOOLS TO GET THROUGH THOSE HARD
TIMES WHERE THEY ARE VULNERABLE
TO RELAPSE.
I'D ALSO SAY THE SOBER LIVER
SURVIVAL SO IMPORTANT IN
TREATMENT CENTERS BECAUSE WHAT
HAPPENS IN TREATMENT CENTERS AND
OUTPATIENT PROGRAMS WHEN
SOMEBODY MAY BE ON THE
TRANSPLANT LIST, THEY DRINK,
THEY ARE OUT.
AND THEY ARE SO ALONE.
AND SO, YOU KNOW, JUST BEING
ABLE TO GET THIS INFORMATION OUT
AND, YOU KNOW, TALKING TO RAY
EARLIER, WHATEVER I CAN DO ON
THE TREATMENT END TO JUST KEEP
TRANSLATING THE SCIENCE, GET IT
OUT THERE, EVERY PRESENTATION,
GET THE RESOURCES OUT THERE AND
HELP PEOPLE UNDERSTAND WHAT IS
REALLY AT STAKE.
SO I THANK ALL OF YOU.
>> OKAY.
SO I THINK UNLESS THERE ARE ANY
OTHER COMMENTS OR THOUGHTS, I DO
APPRECIATE ALL OF YOUR THOUGHTS.
I'M GOING TO MENTION SOME TO
YOU, BETH, AFTERWARDS ABOUT
EXACTLY WHAT YOU WERE TALKING
ABOUT.
SO I THINK IT'S BEEN A GREAT
COUNCIL.
I DO APPRECIATE YOUR
INTERACTIONS THIS TIME.
YOU HAD A LOT OF QUESTIONS FOR
THE SPEAKERS AND CONCEPT
CLEARANCES, AND CLARIFICATIONS
AND THAT'S WHAT WE WANT YOU TO
DO.
I WANT TO URGE YOU IF YOU SEE A
GRANT COMING THROUGH THAT YOU
THINK IS REALLY HOT POTATOES AND
REALLY SOMETHING WE SHOULD PAY
ATTENTION TO, PLEASE LET US KNOW
BECAUSE AS WE LISTEN TO YOUR
ADVICE, SAME IF YOU THINK IT'S
REALLY OF LOW PRIORITY FOR A
NUMBER OF REASONS WE'D LIKE TO
KNOW THAT.
WE HE DON'T WANT -- WE DON'T
WANT TO FUND THINGS IN THE WRONG
DIRECTION IN THE SENSE OF
EXPERIMENTAL DESIGN WHERE THEY
HAVE TO DO PATCHES ON
EXPERIMENTAL DESIGN SO, YOU
KNOW, THINK ABOUT IT IN THOSE
TERMS.
DON'T GET CARRIED AWAY.
WE DON'T NEED 300 HOT POTATOES
AND DON'T NEED 300 LOW
PRIORITIES, BUT, YOU KNOW, THINK
ABOUT IT HARD BECAUSE
SOMETIMES -- I REMEMBER WHEN I
SERVED ON COUNCILS THERE WOULD
BE SOMETHING COME THROUGH, BACK
THEN FOR ME IT WAS
ENDOCANNABINOIDS, HARDLY ANY
WORK ON ENDOCANNABINOIDS.
I REMEMBER FLAGGING THOSE
GRANTS.
STILL TO THIS DAY I FEEL LIKE I
HAD A SMALL IMPACT IN GETTING
NIDA AND NIAAA INTERESTED BEFORE
ANYBODY COULD EVEN SPELL IT.
NOT SURE I CAN SPELL IT.
TWO Ns IN CANNABINOIDS, ALL
RIGHT.
SAFE TRIP BACK TO WHEREVER
YOU'RE GOING, AND WE'LL SEE YOU
NEXT TIME.
IN FEBRUARY.