WELCOME COUNCIL MEMBERS AND
GUESTS TO THE NATIONAL ADVISORY
AND DENTAL CRANIO FACIAL
RESEARCH COUNCIL.
FOR THE FIRST FEW HOUSEKEEPING
ITEMS WE WON'T TAKE QUESTIONS OR
COMMENTS FROM THE PUBLIC DURING
THE LIVE VIDEOCAST BUT WILL
ACCEPT QUESTIONS AND COMMENTS
UNTIL FEBRUARY 17TH IN THE
E-MAIL BOX WE WILL DISPLAY AT
THE END OF THE SESSION AND ASK
COUNCIL AND STAFF MAKE SURE
MICROPHONES ARE SET ON MUTE AND
VIDEO CAMERAS ARE OFF UNLESS YOU
ARE SPEAKING AND WHEN SPEAKING
PLEASE STATE YOUR NAME SO WE
KNOW WHO IS SPEAKING AND TO
ENSURE ACCURACY OF THE RECORDS.
IF IN ZOOM OUR IT TEAM WILL BE
AVAILABLE TO ASSIST YOU AND
THEIR CONTACT INFORMATION WILL
BE POSTED IN THE CHATS.
I WILL BEGIN WITH THE FIRST
ORDER OF BUSINESS BEFORE WE
BEGIN WITH THE DIRECTOR'S REPORT
AND FIRST ITEM OF BUSINESS IS
APPROVAL OF THE MINUTES FROM
PREVIOUS MEETING FROM SEPTEMBER
2ND 2022 MEETING WERE MADE
AVAILABLE FOR COUNCIL FOR
REVIEW. ARE THERE QUESTIONS OR
COMMENTS ON THE SEPTEMBER
COUNCIL MINUTES?
IF NOT WOULD A MEMBER OF COUNCIL
LIKE TO MAKE A MOTION TO APPROVE
THE MINUTES.
>>SO MOVED.
>>LEE, I THINK MAKE SURE YOU
UNMUTE YOUR PHONES OR UNMUTE
YOURSELF IF YOU ARE SPEAKING. I
SAW LEE AND WEN CHI. IS THAT
CORRECT FOR A SECOND?
>>I SECOND.
>>THANK YOU, HAL.
>>YEAH.
>>ALL IN FAVOR?
>>AYE.
>>ANY OPPOSED?
ALL RIGHT.
MOVING ON, THE OTHER ITEM OF
BUSINESS THAT HAPPENS EVERY
JANUARY MEETING IS THE ANNUAL
REVIEW OF THE COUNCIL OPERATING
PROCED
PROCEDURES.
THE TO MAKE RECOMMENDATIONS AND
REVISIONS WHERE APPROPRIATE AND
THIS YEAR I MADE TWO CHANGES TO
THE OPERATING PROCEDURES AND
FIRST CHANGE COMPLIES WITH THE
UPDATED NIH POLICY DESCRIBING OR
DESCRIBED IN NOTICE OF CHANGE TO
NIH'S POLICY ON SPECIAL COUNCIL
REVIEW OF RESEARCH APPLICATIONS
AND DESCRIBED IN THE IN THE IN
SEPTEMBER OF 2012, NIH ISSUED A
SPECIAL COUNCIL REVIEW POLICY
REQUIRING INSTITUTIONS AND
CENTER ADVISORY COUNCILS TO
PROVIDE ADDITIONAL REVIEW OF
GRANT AND COOPERATIVE AGREEMENT
APPLICATIONS FROM PRINCIPLE
INVESTIGATORS RECEIVING $1
MILLION IN DIRECT COSTS PER YEAR
TO DETERMINE IF ADDITIONAL FUNDS
SHOULD BE PROVIDED TO AN ALREADY
WELL-SUPPORTED INVESTIGATOR AND
ALIGNING WITH POLICY WITH NIH'S
UPDATED SUPPORT DISCLOSURE
REQUIREMENTS, UPDATED POLICY
REFLECTS THE DIRECT COSTS AND
INCLUSIVE OF DIRECT AND INDIRECT
COSTS PER YEAR FOR ALL ACTIVE
AWARDS IT THAT HAS BEEN CHANGED
FROM THE 1 MILLION DIRECT COSTS
TO 2 MILLION IN TOTAL COSTS AND
THIS POLICY DOESN'T REPRESENT A
CAP IN NIH FUNDING.
SECOND CHANGE IS FOUND IN
SECTION 2 OF REVIEW OF GRANT
APPLICATIONS. IT IS ONE OF THE
BULLETS THAT DESCRIBES THE
OPERATING PROCEDURES FOR THE
ELIGIBILITY OF UNDER THE PUBLIC
HEALTH SERVICE ACT.
THIS ONE IS THE PUBLIC HEALTH
SERVICE ACT REQUIRING GRANT
APPLICATIONS MAY BE FUNDED AFTER
BEING REVIEWED AND COUNCIL HAS
CONCURRED WITH RECOMMENDATIONS
OF THE SCIENTIFIC REVIEW GROUP.
AND THIS HAS BEEN CHANGED TO
INCLUDE COOPERATIVE AGREEMENTS
AND STATEMENT IS NOW THE PUBLIC
HEALTH SERVICE ACT REQUIRES
PUBLICATIONS FOR GRANTS AND
COOPERATIVE AGREEMENTS MAY BE
FUNDED ONLY AFTER IT HAS BEEN
REVIEWED BY COUNCIL. ANY
COUNCIL MEMBERS HAVE ANY
SUGGESTED CHANGED COMMENTS OR
QUESTIONS ON WHAT I HAVE FOR
PROPOSED CHANGES?
IF NO QUESTIONS OR COMMENTS
WOULD A MEMBER OF COUNCIL LIKE
TO MAKE A MOTION FOR THE
OPERATING PROCEDURES?
>>SO MOVED.
>>CHECK.
>>THANK YOU. WOULD ANYONE LIKE
TO SECOND THE MOTION?
>>I WILL SECOND, AMY.
>>THANK YOU, AMY. ALL IN
FAVOR?
>>AYE.
>>ANY OPPOSE THE?
OKAY. NOW, WELL, NOW IT IS TIME
FOR THE NEXT ITEM THAT IS DR.
ROOENA D'SOUZA WHO WILL PRESENT
THE DIRECTOR'S REPORT.
>>GREETINGS EVERYONE. HAPPY
2023 FOR COLLEAGUES MISERABLE IN
BOSTON ENSURE SPRING IS IN THE
AIR AND COMES WITH IT HOPE AND
PROMISE FOR THE FUTURE WE ARE IN
UNPRECEDENTED TIME IN SCIENCE
AND TECHNOLOGY IN THINKING IN
WAY THAT SOCIETY HAS EVOLVE THE
TO ACTUALLY MAKE A DIFFERENCE
AND WISH EACH ONE OF YOU WITH A
HEARTFELT GRATITUDE WITH SERVICE
ON COUNCIL AND TO THE INSTITUTE
AND TO ALL THOSE LISTENING.
VERY IMPORTANT PART OF OUR
COMMUNITY THAT WE WANT TO ENGAGE
YOU AND WELCOME YOU IN. NOW,
THERE ARE DIFFERENT WAYS WHICH
COUNCIL CAN RUN. WITH THE
ADVICE MY STAFF WILL TWEAK A
LITTLE BIT. I THINK THAT
ACTUALLY HAS EVOLVE THE THEME
ATTIC AREAS; RIGHT?
WE HAVE FOCUSED DISCUSSIONS ON
CLINICAL RESEARCH, ET CETERA, ET
CETERA.
I THINK FOR THIS PARTICULAR
COUNCIL THAT EMPHASIS WILL BE ON
PEOPLE AND THAT THEY ACTUALLY
MATTER THAT COULD BE A CONSTANT
THEME. BUT, THE WAY THAT OUR
SPEAKERS HAVE BEEN ORGANIZE THE
IN OUR TOPICS, IT WOULD REALLY
POINT TO THAT IMPORTANT VALUE
SYSTEM.
I'M ALSO EAGER TO SHARE THE
PLATFORM OF THE DIRECTOR'S
PODIUM, SO-TO-SPEAK AND TODAY
DELIGHTED TO HAVE JENNIFER
WEBSTER OUR DEPUTY DIRECTOR TO
GIVE PROGRESS SHE MADE IN ONE OF
HER PORTFOLIOS SHE MINISTERS AND
I HAVE BEEN MOTIVATED TO SHARE
AND DISSEMINATE INFORMATION THAT
COMES MANY I WAY IN DIFFERENT
WAYS; RIGHT?
IT IS EASY TO NOT HAVE A HANDLE
ON WHAT IS GOING ON. WE GET SO
CAUGHT UP IN OUR EGO SYSTEMS AND
WORLDS AND IS FIRST GOAL OF
TODAY AND MOVING TO NEW PROGRAMS
AND IMPERATIVES THAT NIH IS
IMPLEMENTING RIGHT NOW OF
CONCERN TO ALL OF US HERE, BOTH
PROGRAM STAFF AS WELL AS
GRANTEES AND TRAINEES AND QUICK
GLANCE AT MILESTONE ACHIEVEMENTS
AT NIDCR GOING THROUGH VARIOUS
KEY LEADERSHIP APPOINTMENTS AND
WORDS AND RECOGNITIONS MOVING
EXTRAMURAL FRONTIERS AND
RESEARCH AND DISCOVERY FORWARD
AND WHAT IS COMING AND ENDING
WITH AN OPTIMISTIC NOTE ABOUT 70
FIF NL CENTENNIAL DI-MONDAY
JUBILEE CELEBRATION BEGINNING IN
JUNE, THE 24TH OF THIS YEAR AND
CONTINUE FOR A YEAR. YOU WILL
SEE FOCUS THERE IS ON SCIENCE
AND ON PEOPLE AND ON ACTUALLY
MAKING SURE THAT WE HAVE A
SUSTAINABLY AND ROBUSTNESS IN
ALL WE DO FOR THE NEXT 25 YEARS
SUCH THAT WE MOVE THE NEEDLE FOR
HEALTH FOR ALL.
LEADERSHIP REMAINS STRONG WITH
LARRY TABAK AND WE ARE ON HELM
OF NEWS OF PRESIDENTIAL NOMINEE
THAT HASN'T COME YET AND LARRY'S
LEADERSHIP NOW IS ESCAPING US
VERY, VERY STEADY AND ON COURSE
CAN DECISIONS YOU WILL SEE THAT
MADE IMPORTANT PRIORITIES FOR
INSTITUTE IN GENERAL THROUGH TO
WELCOME RENAE ON TO THE
EXECUTIVE BOARD STAFF.
SHE IS THE NORMAL DIRECTOR OF
ARPAH. I WILL SPEND A LITTLE
TIME ON THE PROGRAM SHE WILL
ADMINISTER VERY, VERY HIGH-RISK
INNOVATIVE VENTURE FOR THE
GOVERNMENT, REALLY, FOR HHS AND
FOR NIH AND WILL TALK A LITTLE
MORE ABOUT THAT. IN TERMS OF
FUNDING NIH'S BUDGET HAS GROWN
STEADILY AND THAT IS ARROW
MECHANISM BUT WE HAVE GROWN
STEADILY OVER THE YEARS AND NIH
IN GENERAL RECEIVE THE MORE OF A
BUDGET THAT INCLUDES FUNDING
GOING TO ARPAH WHICH IS OVER A
LITTLE OVER A BILLION AND 19
INCREASE REPRESENTING ABOUT 3.8%
INCREASE THAT IS VERY, VERY G
GOOD.
OUR HOPE IS REMAINING
RESPONSIBLE STEWARDS OF THAT
FUNDING AND YOU CAN SEE MOST OR
MAJORITY OF THAT BUDGET GOES
TOWARDS THE EXTRAMURAL COMMUNITY
OF SUPPORTING GRANTEDS AT
INSTITUTIONS AND LABS, ET
CETERA.
WE SUPPORT INTRAMURAL AND
MANAGEMENT SYSTEM AND THAT RATIO
HAS REMAINED FAIRLY STEADY. YOU
SEE FROM THE PIE CHART
DISTRIBUTION OF EXTRAMURAL
FUNDING REMAINS FOCUSED ON
INDIVIDUAL AND INDEPENDENT
INVESTIGATOR INITIATED PROJECTS
AND WE HAVE SMALLER AMOUNTS
ALLOCATED TO TRAINING AND
CAREERS, ACCENTURES AND OTHERS
THAT INCLUDE THE USE AND R13S
AND 24S AND OF COURSE THE SMALL
BUSINESS AND TECHNOLOGY TRANSIT
PROGRAMS. YOU CAN LOOK AT ALL
OF THAT. ASK YOURSELF THE
QUESTION IF THAT IS A BALANCE TO
OUR PORTFOLIO.
NEED FOR US TO INVEST FURTHER IN
TRAINING AND CAREER DEVELOPMENT
IS HUGE. IT IS HUGE.
OPPORTUNITIES ARE HUGE. IN
ORDER TO DO THAT, THERE HAS TO
BE A COMPROMISE THAT PIE CHART
HAS TO REMAIN IN BALANCE. YOU
WILL SEE OVER THE NEXT FEW YEARS
A SHIFT TOWARDS MUCH MORE
INVESTMENT IN TRAINING AND
CAREER DEVELOPMENT THAN WE HAVE
NOW AND WE KEEP BALANCE BETWEEN
NONCOMPETING AND COMPETING
GRANTS.
FROM THE PURCHASING POWER
PERSPECTIVE YOU WILL SEE WE
HAVEN'T REALLY ACTUALLY LOWER
THAN WHAT WE HAD AVAILABLE IN
2020 AND PURCHASING POWER DUE TO
INFLATION COSTS, I GUESS, HAS
NOT BEEN ALIGNED WELL WITH OUR
ACTUAL APPROPRIATIONS OR
ALLOCATIONS.
SUCCESS RATE IN TERMS OF FUNDING
THIS YEAR CAME CLOSE TO NIH. WE
USED TO BE HIGHER BUT HAD TO
MAKE DECISIONS TO KEEP PORTFOLIO
IN BALANCE AND WE HAVE FUNDING
YOU CAN SEE VERY CLOSE TO -- A
LITTLE ABOVE THE 20TH
PERCENTILE. IT IS VERY
FAVORABLE. THE SPLIT THAT NIDCR
OR SUPPORT THAT NIDCR AFFORDS
DENTAL SCHOOLS WILL BE ON THE
RISE AND WE CURRENTLY HAVE 44%
OF TOTAL EXTRAMURAL BUDGET
INCLUDING RPGS AND TRAINING
GRANTS, ET CETERA. THEY ACCOUNT
FOR 44% OF THE BUDGET. WE
SHOULD SHIFT THAT OVER TO YET
AND YET BE CONSISTENT AND
PRINCIPLE IN SUPPORTING THE VERY
BEST SCIENCE AND TRAINING WILL
CONTINUE.
YOU KNOW, ON THE -- OVER THE
LAST FEW YEARS, MIKE LAUER
DIRECTING EXTRAMURAL RESEARCH
OFFICE FOR NIH DID A VERY, VERY
THOROUGH STUDY ON RETURN FOR
INVESTMENT FOR INDIVIDUAL
INVESTIGATORS IN THE EXTRAMURAL
WORLD AND GRANT NUMBERS AND
PRODUCTIVITY. IT WAS CLEAR THAT
THE MORE FUNDING ONE GIVES TO
VARIOUS ESTABLISHED
INVESTIGATORS, RETURNS ARE NOT
DIRECTLY PROPORTIONAL. THAT
OBVIOUSLY MAKES SENSE. SO,
INSTITUTES OTHER THAN OURS HAVE
STEADILY FOCUSED ON INCREASING
INVESTMENT IN EARLY STAGE
INVESTIGATORS NOT TO IN ANY WAY
TAKE AWAY FROM WELL-ESTABLISHED
LABS OR BEST SCIENCE OR ANY WAY
LIKE THAT BUT TO MAKE SURE THAT
THE BALANCE IS ACTUALLY MUCH
MORE DRIVEN TOWARDS OUR FUTURE
GENERATION OF RESEARCHERS.
WE HAD TARGETED 1100 FOR -- PER
YEAR. ACTUALLY, WE WENT WAY
ABOVE THAT. MANY INSTITUTES
TOOK THAT VERY SERIOUSLY AS DID
NIDCR. WE FUNDED A TOTAL OF 16
AND ACTUALLY HAVE A PUBLISHED
BROCHURE HIGHLIGHTING EARLY
STAGE INVESTIGATORS AS BEING
FUTURE INVESTMENTS AND OUR
FUTURE STARS.
VERY IMPORTANT FOR US TO NOTE
THAT THE EXTRAMURAL COMMUNITY TO
NOTE THAT ARE CHANGES IN THE
CRITERIA FOR EVALUATING GRANTS
OR CENTER FOR SCIENTIFIC REVIEW
UNDER REALLY OUTSTANDING
LEADERSHIP OF NONI BURNS WENT
THROUGH A VERY STRATEGIC
THINKING PROCESS TO LOOK
STRINGENTLY AT PEER REVIEW NOT
MEANING THAT ALL ISSUES OR
PROBLEMS WILL BE SOLVED BUT
TAKING STEPS IN THE RIGHT
DIRECTION IS IMPORTANT FOR NOW.
AND THE EMPHASIS IS NOW BEING
DIRECTED VERY CLEARLY TOWARDS
SUPPORTING THE STRONGEST
SCIENTIFICALLY IMPACTFUL
RESEARCH. AND TO -- IN ORDER TO
DO THAT, THEY HAVE TO EFOCUS
SOME CRITERIA THAT ARE
TRADITIONALLY USED AND TRY TO AS
BEST AS POSSIBLE MITIGATE
REPUTATIONAL BIAS.
THAT ALL OF US WHO HAVE BEEN ON
STUDY SECTION KNOW IT EXISTS AS
PART OF THE HUMAN PROCESS. WE
ARE TRYING OUR VERY BEST TO KIND
OF CONTROL FOR THAT. WHAT
QUESTIONS ARE ASKED WHAT SHOULD
IT BE DONE? SHOULD SCIENCE BE
DONE? THAT IS ON A FACTOR OF 1
AND IMPORTANCE OF ROOET SEARCH.
CAN IT BE DONE WELL AND WILL IT
BE DONE; RIGHT?
I WANT TO GO INTO JUST A LITTLE
MORE DETAIL AND TO URGE YOU TO
SEND IN YOUR RESPONSES AND STUDY
THAT STRATEGIC PLAN AND SEND
RESPONSES BY MARCH 10TH IF YOU
HAVE ADDITIONAL SUGGESTIONS. IN
TERMS OF SIGNIFICANCE ALL
CRITERIA 1, 2, 3, 4, 5 THAT ARE
ALL SCORED ARE REDUCED TO 3 AND
IMPORTANT OF THE RESEARCH IS
RIGOR AND FEASIBILITY AND
WHETHER EXPERTISE AND RESOURCES
ARE THERE. THAT LAST ELEMENT IS
NOT SCORED ANYMORE INVESTIGATORS
IN ENVIRONMENT COME INTO PLAY
BUT ARE NOT SCORED CRITERIA.
CURRENT REVIEW CRITERIA THAT
WERE -- THAT EFFECTS OVERALL
IMPACT SCORE WOULD PRETTY MUCH
STAY THE SAME. SO, IT -- SO, IN
THE AREAS OF HUMAN SUBJECTS AND
OF ALL COMPLIANCE ISSUES WITH
TIDBITS AND BIOHAZARDS AND
LOOKING AT RESPONSES TO PREVIOUS
CRITIQUES ALL THAT COULD BE
CONSIDERED AND EFFECT THE
OVERALL IMPACT SCORE BUT THEY
ARE NOT SCORED DIRECTLY.
FACTORS THAT ARE NOT ANY LONGER
GOING TO IMPACT OR INFLUENCE
FINAL SCORES ARE THE BIOLOGICAL
AND CHEMICAL RESOURCES AND
BUDGET AND PERIOD OF SUPPORT.
IT IS REALLY STREAMLINING THE
REVIEWER'S CRITERIA FOR
EVALUATING A GRANT AND DRAWING
MUCH ATTENTION TO THE
INVESTIGATOR AT HAND AND SCIENCE
BEING PROPOSED AND AT THE SAME
TIME YOU CAN DO THAT FOR
INDEPENDENT RESEARCHERS IF YOU
ARE NOT CHANGING AND LEVELING
THE PLAYING FIELD FOR OUR
TRAINEES OR RESEARCH TRAINEES
AND FOR THAT NRSA FELLOWSHIP
PEER REVIEW COMMITTEE CAME UP
WITH VERY, VERY POINTED CRITERIA
THAT WOULD -- THEY REALLY STEM
FROM THE OVERALL DATA-DRIVEN
FINDING THAT IF YOU CAME FROM A
SMALLER SCHOOL THAT IS NOT A
RESEARCH INTENSE SCHOOL OR
DOESN'T HAVE CRITICAL MASS AND
THAT YOUR CHANCES OF BEING OR
ENTERING BIOMEDICAL RESOURCE
THROUGH NIH ARE LAW IF YOU CAME
FROM A BIGGER SCHOOL AND WE HAVE
ALL EXPERIENCE THE THAT IN ONE
WAY OR ANOTHER AND OF COURSE
APPLICATION OF SENIOR SCIENCES
DO BETTER WITH SPONSORS IN
EARLIER CAREERS AND COMES UP AS
A CRITIQUE. THIS PERSON DOESN'T
HAVE MENTORING EXPERIENCE. ALL
THAT NOW WILL BE MODIFIED SUCH
THAT THE FOCUSES ON THE
POTENTIAL OF THE APPLICANT AND
STR INGRESTH OF THE SCIENCE AND
QUALITY OF THE TRAINING PLAN.
REVIEWERS WILL ALSO RECEIVE LESS
INFORMATION AND INFORMATION THAT
WILL CHANGE OUR -- IN THESE
CATEGORIES.
AND, OBVIOUSLY YOU CAN DELVE
INTO THAT IN FURTHER DEPTH. WE
WILL CERTAINLY BE AVAILABLE TO
ANSWER QUESTIONS IN THE PROGRAM
STAFF IN OFFICE OF DIVISION OF
RESEARCH AND BRANCH OF RESEARCH
TRAINING AND CAREER DEVELOPMENT
ARE AVAILABLE AND WANTED TO
BRIEFLY SWEEP INTO THIS VERY
IMPORTANT EFFORT ACROSS OUR
CAMPUS THAT IS DEFINITELY
INFLUENCING OUR EXTRAMURAL
CULTURE IN VARIOUS SCHOOLS AND
JENNIFER WEBSTER-CYRIAQUE WILL
HIGHLIGHT PROGRESS MADE IN THIS
PARTICULAR EFFORT RIGHT NOW.
VERY, VERY IMPORTANT IS THIS
PROGRAM THAT GOES INTO EFFECT
THAT IS ACTUALLY IMPERATIVE THAT
GOES INTO EFFECT TODAY.
SO, YOU KNOW, ODDLY ENOUGH IT IS
TODAY.
YOU CAN SEE THAT IN THIS GROWING
ANL OF SCIENCE AND TECHNOLOGY
THAT GENERATING, MANAGING, AND
ANALYZING HIGHLY SCALED AND
COMPLEX DATA WILL ALLOW US
ACTUALLY FAR BETTER INSIGHTS
INTO BIOLOGICAL SYSTEMS AND
SOCIETAL CHALLENGES AT A DEPTH
IT THAT IS PREVIOUSLY
UNIMAGINABLE AND WE ARE REALLY
EXCITED NEW NIH DATA MANAGEMENT
AND SHARING POLICIES EFFECTIVE
TODAY THAT ALL OF US PROGRAM
INVESTIGATORS ALL OF US WILL
REAP BENEFITS OF DATA SELLING
INCLUDING DISCOVERY OF
STRENGTHENING AND RIGOR BY
TACKLING ACTUALLY
REPRODUCIBILITY. WE WILL AS YOU
CAN SEE ON THE RIGHT WE WILL
MAKE IT A POINT TO ACTUALLY
PROVIDE RESOURCES AND LINKS TO
EASE INTO THE TRANSITION THAT
DOES APPLY TO NEWLY FUNDED
PROJECTS.
THERE WILL BE NO GRANDFATHERING
IN. THAT IS A BIT TOO COMPLEX.
NOW, YOU CAN SEE THAT THE
APPLICATIONS FOR NIDC ARE HUGE
AND WE WERE INNOVATIVE AND
CREATED 20 YEARS AGO TO CREATE
FACE-BASE REPOSITORY ON KRAISH
CRANIO FACIAL DEFORMITIES AND
THEY HAVE GONE THROUGH THREE
CYCLES OPENING OPPORTUNITY FOR
US TO CREATE COMMON DATA
ELEMENTS TO LOOK AT INFORMATION
THAT IN THE END THROUGH THIS
PLATFORM INFORMS CLINICIANS
ABOVE IMPORTANT DECISIONS
RELATED TO PATIENT CARE
DIAGNOSIS AND TREATMENT. YOU
CAN SEE HERE FROM THIS WONDERFUL
SLIDE PREPARED FOR ME BY LIU
WANG AND KATIE STEIN THIS
BANISHMENT PLATFORM WE ARE RIGHT
NOW IN THE SOUL-SEARCHING MODE
OF LOOKING AT ITS DEPTH,
BREADTH, AND PRACTICAL
APPLICATIONS OF TRANSLATABILITY
TO ALL DISEASES AND DISORDERS
THAT ARE IN OUR PORTFOLIO. WE
WILL USE OBVIOUSLY DATA
MANAGEMENT AND SHARING POLICIES
WITH FAIR AND TRUST PRINCIPLES
THAT WILL BE APPLIED. I WANT TO
SPEND A LITTLE MORE TIME THAN,
PERHAPS, THIS HAS ALLOWED ME OR
ALLOTTED ME TODAY TO ACTUALLY
FOCUS ON PRINCIPLES THAT ARE
GUIDING ARPAH. I WILL TELL YOU
WHY IN A MINUTE. THIS
INITIATIVE WAS PUT FORTH BY
PRESIDENT BIDEN DRAWING FROM
SUCCESS OF DARPA DEFENSE BUDGET
CREATING INNOVATIVE TECHNOLOGIES
AND GPS INTERNET ELECTRIC CARS,
ET CETERA AND MRNA VACCINES AND
I LIKE THIS QUOTE THAT SAID
PEOPLE JUST WONTDER IF WE COULD
ONLY TRY TO SOLVE THESE BIG BOLD
AUDACIOUS PROBLEMS AND WE ARE
ABOUT TO TRY IN A BIG WAY IS
WHAT HE SAID. ALLOWING US TO
EXPAND OUR THINKING NOW FROM OUR
OWN INDIVIDUAL RUN LABS,
PROJECTS AND PROGRAMS TO
THINKING BIGGER AND HOW WE IN
THE ORAL HEALTH SCIENCES CAN
MOVE THE NEEDLE.
NOW IT IS NOT THAT OUR FOCUSED
PROJECTS WILL GET ATTENTION OF
ARPAH BUT GUARANTEE PROGRESSES
MADE BY ARPAH'S HIGH-RISK
INITIATIVES WILL BENEFIT US
WITHOUT A DOUBT. YOU WILL SEE
WHY IT INVOLVES A HOLISTIC
APPROACH ENGAGING THOSE THAT
PERFORM WHICH IS YOU AND
ACADEMIC SECTOR AND CORPORATE
SECTOR AND CUSTOMERS AND THEIR
OPINION AND FOR US PROVIDERS AND
CARETAKERS AND STAKEHOLDERS
INCLUDING NIH THAT IS AN
ALL-ENCOMPASSING ENDEAVOR THAT
GROWS FROM CREATING THAT
CHALLENGE YOU CAN SOLVE THROUGH
TRADITIONAL ACTIVITY AND FIRST
THING IS THINKING OUTSIDE OF THE
BOX AND PROGRAM MANAGERS PLAY A
KEY ROLE IN GUIDING THIS TO
SOLUTION-BASED PLATFORM AND SEE
FOCUS AREAS ARE CREATING HEALTH
SCIENCES FUTURES EXPANDING WHAT
IS TECHNICALLY FEASIBLE. YOU
KNOW WE AS HUMAN BEINGS HAVE NO
BOUNDARIES TO WHAT WE CAN
CREATE; RIGHT?
ROBOTICS AND EVERYTHING IN THE
WORKS AND WHAT WE DO IS
SCALEABLE TO A LARGER PLATFORM
BENEFIT TO GENERAL SOCIETY
ABSOLUTELY THAT IS PROACTIVE
WITH THINKING WAEBD ACTUALLY
INVENT SYSTEMS THAT ARE HERETO
LAST THAT WILL NOT FALL BY THE
WAYSIDE GIVEN BUDGET ECONOMY
STRAINS OR EVEN POLITICAL
STRAINS.
SO, THE PROGRAM OFFICE THAT THEY
ARE LOOKING FOR HAVE TO HAVE
THESE CHARACTERISTICS.
I KNOW THAT I LOOKED AT THEM AND
SAID, WOW. PROBLEM SOLVER AND
DREAMER AND STATUS QUO
CHALLENGER AND TINKER OF THE
SAGE, THE ROOKIE. WHICH ARE
YOU? WHAT CAN YOU BECOME? ALL
QUESTIONS WE ASK OURSELVES.
AS THEY DELIBERATE THROUGH
ACTUALLY LAYING DOWN
INFRASTRUCTURE OF ARPAH THESE
ARE QUESTIONS WE WERE RAISED AND
REASON I BRING THIS UP IS EVEN
THOUGH ARPAH BE -- NO ONE WILL
HAVE A CENTRAL PLATFORM THAT
WILL BE VERY CROSS-CUTTING AND
WE HAVE PROJECTS IN MIND AND
TEAM WILL MEET WITH BRENE VERY
SHORTLY, THE DIRECTOR. THESE
ARE QUESTIONS THEY ASKED AND ARE
QUESTIONS WE SHOULD BE ASKING
OURSELVES ANYWAY, ALL THE TIME,
FOR ALL OF THE GRANTS ISSUED AND
FOR GRANTS PROJECTS AND GOALS
THAT WE EXECUTE. RIGHT? HOW
MUCH WILL IT TAKE AND COST AND
WHO CARES AND WHAT IS NEW ABOUT
OUR APPROACH? I WANTED THAT TO
KIND OF STICK WITH US FOR NOW AS
A THEME AND GIVING EXAMPLE MOON
SHOT INITIATIVE AGAIN BY
PRESIDENT BIDEN HAD THESE
VARIOUS WHAT THEY CALL NOTIONAL
INITIATIVES OF -- THESE ARE THE
HIGH -- HIGH-LEVEL GOALS THAT
THEY SEEK; RIGHT?
EXAMPLE OF WHERE ARPAH CAN MAKE
DIFFERENCE IS A EXAMPLE TO COME
UP WITH MACHINE LEARNING TOOLS
AND PATHOLOGY THAT IS DONE VERY
MUCH THE OLD-FASHIONED WAY
MANUALLY ON GLASS SLIDES MAKING
IT AVAILABLE TO PHYSICIANS
CLINICIANS RESEARCHERS AND
PATIENTS IT THAT IS NO. 4
PRIORITY.
NOW, I WILL GET BACK TO US,
NIDCR AND WHO WE ARE ABOUT. ALL
OF THESE ELEMENTS IT THAT MAKE
UP WHO WE ARE. IT IS IN FACT
ALL ABOUT PEOPLE FOR US.
SO, FOR ME, IN THAT REGARD
OUTREACHING AND VISITING SCHOOL
ROOZ HE MAINS THE BLESSING OF
THE JOB EVEN THOUGH IT IS
TEDIOUS AND TIRING SOMETIMES AND
I HAVE CHOSEN AND GAINED SO MUCH
IN TERMS OF UNDERSTANDING
CULTURES OF INDIVIDUAL
INSTITUTION MEETING WITH
TRAINEES AND FACULTY AND FROM
ALL OVER, TYPICALLY. I HAVE
ALSO MADE IT A POINTED REQUEST
TO MEET WITH THE HIRED
ADMINISTRATION AND CHANCELLORS
AND PRESIDENTS TO COMMUNICATE
IMPORTANCE OF SUPPORT FOR ALL
ORAL HEALTH SCIENCES AND
JENNIFER HAS JOINED ME DOING HER
OWN OUTREACH AS WELL AS RENÉ
JOSCO AND OTHER PROGRAM MEMBERS
AND WE BUILD MEANINGFUL
RELATIONSHIPS WITH STAKEHOLDERS
MEANING THAT IN TERMS OF JOINT
INITIATIVES LOOKING ACROSS THE
BOARD WITH IC DIRECTOR
COLLEAGUES AND WE HAVE GROWN THE
EXTENT OF TRANS NIH OR ACROSS
NIH INITIATIVES SIGNIFICANTLY IN
THE LAST YEAR AND YOU CAN SEE A
FEW EXAMPLES WHAT IS OUT THERE.
I WANT TO WELCOME ON BOARD
SHARON JACKSON DEPUTY CLINICAL
DIRECTOR WORKING WITH DIRECTOR
JANIS LEE BRINGING WEALTH OF
EXPERTISE TO PEDIATRICIAN YOU
CAN SEE WITH A VERY STRONG
INTEREST IN DISPARITY RESEARCH.
>>I DON'T KNOW HOW LONG THIS
WILL BE BUT PROBABLY. I MIGHT
GO THIS AFTERNOON.
SOMEONE IS TALKING ON MUTE.
SORRY.
-- WHO WILL BE A FAMILIAR FACE
TO OUR TRAINEES AND TO OUR
TRAINEES AND OUR GRANTS.
I WANT TO SAY AS A TRIPLE HEADER
HERE IS JENNIFER WHO I WANT TO
ACKNOWLEDGE HER 22 WAS A
MAGNIFICENT YEAR FOR HER SHE WAS
NAMED DISTINGUISHED SCIENTIST BY
IDR ELECTED TO NATIONAL ACADEMY
AND VICE PRESIDENT FOR AMERICAN
SOCIAL DENTAL ORAL CRANIO
FACIAL.
YOU HAVE BEEN PRICELESS AND
[INDISCERNIBLE] HONORS
INDIVIDUALS MAKING A DIFFERENCE
IN THE FIELD OF IMMUNOLOGY AND
IN NICKY'S CASE MUCOSAL
[INDISCERNIBLE] AND LIFETIME
SERVICE AWARD PRESTIGIOUS AWARD
FROM HEALTH AND HUMAN SERVICES
IN 2020 WE AWARDED RFAS IN THESE
AREAS THAT YOU CAN SEE NUMBERS
AND ACTIVITIES THAT WE CONTINUE
IN THAT MANNER LOOKING AT
2023RFAS HERE THAT COVER A RANGE
OF INFECTIOUS DISEASES HIV
CONGENITAL DISORDERS LOOKING AT
PAIN MANAGEMENT SUBSTANCE USE
DISORDERS AS WELL HARNESSING
TECHNOLOGIES FOR PROMOTION OF
ORAL HEALTH AND SAYING OPIOID
DRUG MISUSE AND FENTANYL CRISIS
IS A BURDEN FOR US ON THE
NATIONAL LEVEL IS A REAL
UNDERSTATEMENT TODAY IF YOU LOOK
AT ACTUAL DATA. WE WILL
CONTINUE AS YOU CAN SEE WITH
THESE VERY SPECIAL INITIATIVES
AND VERY PROUD WE COULD BRING
THAT FORTH AS SIGNATURE
INITIATIVES FOR T 7 /* THE 75TH
LOOKING AT LONGSTANDING ISSUES
WE WRESTLED WITH FOR YEARS AND
BRINGING COMMUNITIES TOGETHER IN
NATIONAL COLLABORATIVE APPROACH
TO CONNECT DOTS AND SHARE
RESOURCES AND KNOWLEDGE ACROSS
ALL FOR THE BENEFIT FOR THE
PATIENT AND THE COMMUNITY AND I
WANT TO HIGHLIGHT OUR REALLY
RESPONSE FROM YOU OUR EXTRAMURAL
COMMUNITY AND VERY ROBUST
RESPONSE THAT IS IN DENTAL
SCHOOLS IT THAT HAVE APPLIED FOR
THIS PARTICULAR INITIATIVE.
LOTS MORE NEWS WILL COME AS PEER
REVIEW PROGRESSES IN THE NEWS.
I THANK YOU FOR COMING AND
STEPPING UP TO THE PLATE AND
WANTING TO BELONG TO OUR
COMMUNITY. WE NEED CLINICAL
RESEARCHERS AND NEED
TRANSLATIONAL RESEARCHERS AS
WELL. CONCEPTS APPROVED BY
COUNCIL RANGE FROM MATERNAL
HEALTH AND CHILD HEALTH
INITIATIVE THAT THE NIH IS
SUPPORTED BY THE WHITE HOUSE,
ACTUALLY IN PROMOTING. WE HAVE
A STAKE IN THAT ALONG WITH
LOOKING AT HPV AND LOOKING AT,
AGAIN, A VERY DIAGNOSTICS WAYS
TO DISRUPT THE WAY WE THINK IN
THE ARPAH MODE AND APPLYING DATA
SCIENCE, OF COURSE. I'M VERY
EAGER TO HEAR FROM AXEL ON
WORKING GROUP'S PROGRESS IN THIS
AREA. WE CONTINUE WITH OUR
SPECIAL ANNOUNCEMENTS IT THAT
SIMPLY HIGHLIGHTS AREAS THAT WE
IDENTIFIED GAPS OR HOLES WE NEED
TO MOVE ALONG. WE CREATE THESE
ATTRACT AND CHEMOATTRACTANTS I
CALL THEM TO SOLICIT INPUT AND
ASK EACH OF YOU TO REALLY THINK
ABOUT WHO YOU ARE AROUND IN YOUR
UNIVERSITY SETTINGS.
MANY HAVE VERY ENRICHED
RESOURCES IN TERMS OF HUMAN
CAPITAL IN SCHOOLS OF HEALTH
PUBLIC HEALTH PHARMACY NURSING
AND ENGAGING THIS AND THIS
DEMANDS THAT AND IN PARTICULAR I
WANT TO HIGHLIGHT THAT WE BRING
TOGETHER BASIC AND CLINICAL
RESEARCHERS IN A TEAM APPROACH
TO LOOK AT PATHOPHYSIOLOGY AND
STRATIFICATION OF PAIN AND EARLY
DIAGNOSTICS AND HOW BEST TO MOVE
THE NEEDLE AND DENTAL PAIN
REMAINS A DIFFICULT PAIN TO
SOLVE OR TREAT AS WE KNOW.
TAKES THEMSELVES TEMPERO MAN
DIBULAR AND [INDISCERNIBLE] ET
CETERA AND CRANIO FACIAL AS
WELL. VERY PLEASED WITH THE
PROGRESS THAT IS MADE IN THE
MEET THE -- I WAS CALLED MINING
THE GAP MINE THE FUTURE PROGRAM
THAT WE HAVE SUPPORTED AADCR.
IF YOU CAN IMAGINE THIS AND
PINCH YOURSELF 60% OF THE FIRST
COHORT ACTUALLY FUNDED BY NIH
AND SECOND COHORT, 55%. THAT IS
A SIGNIFICANT SUCCESS RATE. WE
WILL URGE INDIVIDUALS TO STAY
CLOSE TO OUR PROGRAM OFFICERS TO
MAINTAIN THAT CONTINUUM OF
SCHOLARSHIP AND FUNDING AND NO
MATTER HOW DEMANDING YOUR LIFE
IS AS A FACULTY MEMBER, EITHER
IN A DENTAL OR MEDICAL SCHOOL.
QUICK GLANCE AT RESEARCH
ADVANCES THAT YOU CAN SEE HERE.
WE DISCOVERED THIS. THE SUPPORT
BY MCLEE YOED AND OWL AND
SUBSPECIES OF GIVEN MICROBE HAS
SITE SPECIFICITY AND THAT
DISTINCTIVE HABITAT AND
ECOSYSTEM CHARACTERISTICS
ATTRACTING ORGANISMS TO SPECIFIC
SITES THAT IS A NICE AND GOOD
WAY TO LOOK AT ORAL HYGIENE AND
TREATMENT STRATEGIES AND WE KNOW
THAT A FEW ACTUALLY USE
STEREOSTATIC BODY RADIATION THAT
IN FACT HAS AN ACTUALLY HUGE
BENEFIT FOR TARGETING PRIMARY
TUMORS THIS IS A PRACTICAL
IMPLEMENTATION PIECE OF WORK
THAT WILL IMPACT OUR CLINICAL
TRIALS RESEARCH IN AREA OF HEAD,
NECK, SQUEEMOUS CANCERS AND
NUMBERS AND DENTAL FEAR ANXIETY
HAVE REMAINED HIGH AMONGST BLACK
WOMEN FOR DIFFERENT REASONS THAT
REALLY SETS US UP LOOKING
CAREFULLY AT INCLUDING
POPULATIONS THAT ARE
DISADVANTAGED THAT COULD BE
BECAUSE OF THE FEAR AND ANXIETY
ELEMENT THAT COULD APPLY TO
OTHER POPULATIONS OF RISK AS
WELL AND [INDISCERNIBLE] THAT
OUR PROGRAM STAFF WAS ABLE TO
ORGANIZE A GROUP OF
[INDISCERNIBLE] OR HEALTH PORT
LEADERS COMING TOGETHER TO LOOK
AT THIS WHOLE AREA OF HOW DO WE
P MAKE IT BETTER FOR CHILDREN.
4 OUT OF 5 REMAIN WITH UNTREATED
DENTAL CARRIES. THIS IS A STUDY
THAT CAME TO US FROM AFRICA AND
BELIEVE IT WAS NAIROBI, I'M NOT
SURE. YOU CAN SEE SORRY IT WAS
NIGERIA. PARTICIPANTS WERE
COHORT OF HIV INFECTED AND THOSE
THAT ARE NOT AND CLEARLY IF YOU
ARE INFECTED WITH THIS VIRUS,
YOUR RISK FORWARD CARRIES
PREVALENCE OR GOES MUCH HIGHER
AN IMPORTANT DISCOVERY FOR US TO
TAKE NOTE OF AND ALSO OTHER
COMORBID INFECTIONS WE WITNESS
IN THE US THAT INFLUENCES
CARRIES AS YOU KNOW.
WE HAD THIS REALLY WONDERFUL
STUDY ALONG WITH ALL OTHER
INDIVIDUAL PROJECTS FUNDING IN
AREA OF TEMPOROMAN DIBULAR
DISFUNCTION YOU CAN DEVELOP
RESPONSES TO PAIN DEPENDING
WHERE YOU HAVE LOCI OF PAIN IN
YOUR BODY THAT RELATES AND
CORRELATES TO INFORMATION. SO,
THIS IS AN IMPORTANT DISCOVERY
AS WELL.
I WANT TO NOW MOVE ON TO GIVING
YOU A LITTLE BIT OF INFORMATION
WHERE WE ARE WITH THE 7 FIFTH
THAT FROM THE BEGINNING IS NOT
MEANT TO BE A SPLASHY ONE-TIME
EVENT BUT A SERIES SPREAD OUT
THROUGH THE YEAR IN KIND OF
EDIBLE VIGNETTE AND DRAWING
ATTENTION TO OUR SCIENCE AND
SCIENCE THAT PROPELLED US TO
WHERE WE ARE TODAY.
IT MEANS THAT WE ACKNOWLEDGE THE
HISTORY AND CAN'T IGNORE IT.
CLEARLY WITH THE INTENTION TO
FORECAST HOW THAT SCIENCE IS
BEING DONE TODAY AND HOW DOES IT
-- HOW DO WE AS A COMMUNITY
FORECAST THE NEXT 25 YEARS.
SO, WE START OFF WITH THESE
THINGS ON THE PERATIVE REAL
OCCURRING AS WE PLAN ALL OF THE
OTHER PROGRAMS AND WE START OFF
WITH SCIENTIFIC STRIDE SYMPOSIUM
AT ARCD GENERAL SESSION IN
PORTLAND MID MARCH HOPE YOU CAN
ATTEND IT WILL BE RECORDED BUT
HOPE YOU CAN ATTEND THIS
IMPORTANT MEETING. OTHER THINGS
WILL BE HAPPENING AND AT THAT
TIME WE WILL ACKNOWLEDGE
400 + CONTRIBUTORS TO ORAL
HEALTH AND AMERICAN REPORT AND
ARE WAITING FOR THAT OPPORTUNITY
TO DELIVER THIS IN PERSON AND WE
HAVE CERTIFICATES THAT ARE VERY
NICE ACKNOWLEDGMENT SYMBOLS.
THOSE THAT CAN'T ATTEND WILL
HAVE THEM MAILED TO THEM. WHAT
IS HAPPENING AT THAT SYMPOSIUM?
OPPORTUNITY HERE FROM HEALTH
[INDISCERNIBLE] AND IMPACTFUL
5-YEAR TERM WHEN INSTITUTE
CHANGED THEIR NAME AND LARRY
TAIBAC WE WILL HEAR FROM AND
THEIR TENURE INITIATIVES THEY
SUPPORTED SPEARHEADED AND
CHAMPIONED HOW DID THEY FEEL
ABOUT THEM AND SEE THEM TODAY
AND FORECAST INITIATIVES GOING
FORWARD AND WITH ME COMING IN AT
THE END JUST SHOWCASING OR
PROJECTING A VISION FROM MY
PERSPECTIVE IN THE NEXT 25 YEARS
THAT IS FOLLOWED BY INTRAMURAL
RESEARCHERS WHO WILL -- FOUR OR
FIVE OF THEM REALLY RESEMBLE A
SYMBOLIZE THE DIFFERENT FOCUS
AREAS OF THE INSTITUTE THAT I
WANT -- IT IS THE BEST WAY FOR
US TO ACTUALLY STRESS HOW
IMPORTANT OUR INTRAMURAL
RESEARCH PROGRAM IS ON OUR
CAMPUS AND HOW SOME OF THE
DISCOVERIES ACTUALLY CHAMPION
AND PROPELLED OTHER FIELDS
ACROSS NIH WHETHER MICROBIOME OR
STEM CELL WORK FROM
[INDISCERNIBLE] THERE ARE MANY
EXAMPLES THAT WE CAN SHARE WITH
THE COMMUNITY THAT WILL BE
FOLLOWED BY A GROUP OF
INVESTIGATORS THAT ARE ACTUALLY
PUBLISHING A VERY -- I WOULDN'T
CALL THEM PHYSICIAN PAPERS BUT
THEY ARE MORE LIKE REVIEWS IN A
JDR SPECIAL ISSUE OR ADVANCES IN
DEMORESEARCH AND WE HAVE I THINK
OUR FLAGSHIP EVENT THAT IS A
TRAINING SYMPOSIUM THAT NOW WILL
BE DONE TOTALLY VIRTUALLY
DRAWING TOGETHER ABOUT
400 + TRAINEES FROM ALL OVER OUR
COUNTRY INCLUDING THEIR MENTORS
AND TRAINING PROGRAM DIRECTORS
ASSOCIATE DEANS FOR RESEARCH AND
ANYONE ELSE AROUND CAMPUS THAT
CAN PARTICIPATE OR WELCOME TO.
IT IS THEIR WAY OF SENSING HOW
THEY BELONG TO THIS COMMUNITY
THAT WE CARE ABOUT DEEPLY. WE
DO HAVE -- THE NEXT SLIDE IS A
SAVE THE DATE THAT ONE I SHARED
MORE WITH YOU. WE FOLLOW THAT
UP WITH A SPECIAL SEMINAR
ATTRIBUTING TO FIBERS DISPLACING
WORK OF 25 YEARS AND ACTUALLY IT
PROCEEDS AND IT IS IN SEPTEMBER.
AND THEN CONTINUE ON TO KIND OF
ROUNDING UP THE YEAR WITH
CELEBRATIONS AND WITH A JOINT
SYMPOSIUM AND WITH FELLOW
INSTITUTES NIHLBI THAT WAS ALSO
FOUNDED IN THE SAME YEAR AS WE
WERE. THERE IS A LOT OF
CONNECTION THAT THE ORAL CAVITY
HAS WITH ALL THESE SYSTEMS AND
WE WILL HIGHLIGHT THE BEST
SCIENCE THERE. THE DATE TO NOTE
IS OCTOBER THE 10TH AND 11TH AND
A TWO-DAY VERY ENRICHED SETTING
THAT WILL BE -- WE HAVE
CONTRACTED AND WE HAVE MADE SURE
THAT EVERYTHING IS DONE IN THE
MOST MODERN OF ALL TECHNOLOGY
PLATFORMS THAT WE HAVE ONE OF
THE TWO NOBLISTS ARE
[INDISCERNIBLE] WHO RECEIVED
NOBEL PRIZE FOR MEDICINE IN 2022
AND FUNDED FOR 10 YEARS AND
JOULUS IS THE OTHER WHO WILL
COME IN LATER IN OUR PROGRAM AND
WILL BE IN OUR PROGRAM AND THAT
WILL BE NICE TO HEAR FROM HIM
HIS JOURNEY THROUGH SCIENCE AND
PROFESSIONALLY AND HIGHLIGHTS
FOR ME IN 2022 IS CONNECTING
WITH TONY FAUCI CONNECTED
THROUGH E-MAIL. HARD TO ENGAGE
WITH HIM IN PERSON. HE WAS SO
INVOLVED IN THE PANDEMIC AND WAS
AT THE WHITE HOUSE I GOT TO SEE
HIM BEFORE HE LEFT. THAT OFFICE
IS A MUSEUM OF AWARDS AND
RECOGNITIONS THAT IS
UNBELIEVABLE AND DIRECTORS CAME
TOGETHER WITH HIS LAB AND OWN
INSTITUTE COMMUNITY AND SMALL
AUDIENCE TO SAY OR TO BID HIM
FAREWELL. I WAS THERE ON THE
SECOND ROLE. I CAME LATER.
THAT WAS ONLY SEAT I HAD. I
LEARNED FROM TONY WELL PUBLICIZE
THE HIS PRINCIPLES ARE TO SERVE
OTHERS AND HE CAME IN WITH THAT
PASSION THAT WAS DEEP IN HIS
SOUL EARLY ON AS A PHYSICIAN.
HE BECAME DISCERNING AND
CRITICALLY ANALYTICAL, THAT IS
OBVIOUS. HE PAID A LOT OF
ATTENTION TO FITNESS AND
SELF-DISCIPLINE AND REMAINED
COMPASSIONATE AND UNFAILING IN
HIS EFFORTS AND, OF COURSE,
FILLED WITH LOVE. YOU HAVE TO
HAVE THAT GUIDING ALL THAT YOU
DO.
YOU SEE IT THAT HERE. HIS
LEADERSHIP TIP WAS TO MASTER ART
OF PRECISION OF THOUGHT AND
ECONOMY OF EXPRESSION, BOTH OF
WHICH I STRIVE TO ACHIEVE IN MY
DAILY LIFE AND EVEN HERE IN
COUNCIL. I WANTED TO SAY THANK
YOU TO TONY. IF I CAN REACH HIM
AND GET HIM TO COME TO US IN A
CELEBRATORY EVENT ESPECIALLY
THAT INVOLVING TRAINEES WOULD BE
WONDERFUL. WE ARE WORKING ON
THAT RIGHT NOW.
NOW, ONE OF THE TIPS THAT TONY
GAVE ME AS HE SAID, IT TOOK HIM
THREE YEARS TO ORGANIZE HIS
TEAM. HE SAID I FINALLY GOT THE
TEAM I WANTED.
I NOW -- THAT RESONATES WITH ME
VERY DEEPLY. I SAID, HOW DID
YOU DO THAT?
HE SAID, I WANT TO MAKE SURE
THAT EVERYONE WHO IS ON BOARD
ALIGNS AND RECOGNIZES AND VALUES
MY VISION AND MY MISSION AND MY
VALUES.
AND I WAS THINKING, HM. THIS IS
NOT ALL ABOUT YOU; RIGHT?
IT IS ABOUT THE TEAM. WHAT HE
MEANT IS I HAVE TO FIRST MAKE IT
CLEAR WHAT WE ARE ABOUT. IT
THEN PEOPLE WILL SIGN ON AND
SOME MIGHT DROP OFF AND JOIN
THIS EFFORT. IT IS CLEAR TOED
THAT MY VISION ALONG WITH
JENNIFER'S AND LEADERSHIP AT
NIDCR IS TO TAKE PROBLEMS THAT
CAME OUT FROM -- THAT WERE
IDENTIFIED IN THE REPORT THAT
WERE LEASED IN 2021 AND
RECOGNIZED SUCCESSES AND
ADVANCES WE MADE. IT WASN'T ALL
ABOUT IDENTIFYING PROBLEMS AND
COMING UP WITH SOLUTIONS AND THE
PLAN THAT WE HAVE IN OUR
STRATEGIC INITIATIVES CLEARLY
SPELLED OUT. WE ARE CONSTANTLY
EVALUATING AND FINE TUNING
MEASURING HOW WE ARE DOING AND
WE DON'T WAIT 5 YEARS DOWN THE
ROAD TO THINK ABOUT HOW DID WE
DO? WE DO IT IN REAL-TIME AND
HOPE ALL OF YOU LEARN MORE ABOUT
OUR ANALYSIS SUCH THAT WITH THAT
COMBINATION AND FORCE, IT
PROPELS US TO THE FUTURE IN SUCH
THAT THE OUTCOME IS VERY CLEAR
THAT WE WOULD IMPROVE ORAL
HEALTH NOT JUST FOR INDIVIDUALS
ABOUT YOU FOR ALL AND
COMMUNITIES AND POPULATIONS AT
ALL LEVELS BOTH IN THE US AND
GLOBALLY. THAT IS THE MISSION.
IT IS FIRM AND WELSTATED AND
UNFLAGGING AND WILL SUSTAIN US
FOR THE FUTURE AND I'M ACTUALLY
THRILLED WE HAVE TWO WONDERFUL
SPEAKERS AND NATALIA WHO I BRAG
IS ONE OF OUR OWN GRADUATES THAT
WAS ON JANIS LEE'S MENTORSHIP AS
A CLINICAL RESEARCH FELLOW WHO
IS INAUGURAL CHIEF DENTAL
OFFICER AT CENTERS FOR MEDICARE
AND MEDICAID AND HEAR ABOUT IF
PIVOTAL LEADERSHIP ROLES AND
DATA ON OPIOID SUBSTANCE USE
DISORDERS AND READING ABOUT YOU
SIMULATED MY THOUGHTS. YOU
DISCOVERED THAT SALIVA WAS IN
FACT A VERY IMPORTANT MEDIUM IN
CONNECTING ORAL AND GUT
MICROBIOME THAT I THOUGHT WOULD
BE OF GREAT INTEREST TO VIEWERS
AND LISTENERS AND THANK YOU FOR
BEING HERE AND TURN IT OVER TO
LYNNE OR ACTUALLY JENNIFER RIGHT
NOW. THAT MEANS I HAVE TO STOP
SHARING. JENNIFER? RIGHT ON
10:45. DO YOU HAVE YOUR --
>>ROOENA, WE HAVE TIME FOR A
FEW QUESTIONS FOR YOU.
>>YEAH. PLEASE DO.
>>IF THERE ARE ANY.
>>ANYONE?
>>QUESTIONS OR COMMENTS?
>>YEAH. ESPECIALLY ABOUT
REVIEW CRITERIA.
THAT IS A PRETTY BROAD-SWEEPING
CHANGE AND DAYS THAT WE HAD
LIMITED RO1S DOWN TO SMALLER
NUMBERS AND WE ARE CONSTANTLY
LOOKING TO IMPROVE THE PROCESS.
ANYONE? WEN CHI? I DON'T HAVE
TO POINT OR DRAG YOU ON BUT --
NO?
>>WELL.
>>IT WAS THAT CLEAR?
>>WELL, IF NO QUESTIONS OR
COMMENTS. IS THERE A QUESTION?
>>I HAVE A QUICK QUESTION.
THIS RELATES TO YOUR
PRESENTATION OR EARLIER PART OF
YOUR PRESENTATION.
>>RIGHT.
>>ABOUT THE INCREASE IN EARLY
STAGE INVESTIGATORS AWARDS THAT
ARE ACROSS NIH.
SAME IS TRUE FOR NIDCR.
SOMETHING THAT I THINK CAME UP
IN DISCUSSIONS ABOUT THIS IS THE
QUESTION ABOUT THE LONG-TERM
SUSTAINABILITY OF THIS; RIGHT?
IT IS GREAT THAT MORE EARLY
STAGE INVESTIGATORS GET AWARDED
BUT AT THE SAME TIME SAME
INVESTIGATORS WILL APPLY FOR
FOLLOWUP GRANTS AT SOME POINT;
RIGHT?
OVERALL FUNDING STAYS THE SAME.
YOU KNOW, DOES THAT ESSENTIALLY
KICK THE CAN DOWN THE ROAD AND
CREATES A BOOTLE NECK THEN?
I'M SURE THERE ARE DISCUSSIONS
ABOUT THIS. WHAT IS THE CURRENT
THINKING?
>>IT IS A VERY VALID PLATFORM
AND WAYS AND RISKS WITH BENEFITS
WE MUST SEEK THAT IT WEIGHS;
RIGHT?
THERE IS A GREAT AMOUNT OF
VARIETY OF RESPONSES AMONGST
INSTITUTES. IF YOU LOOK AT
NATIONAL INSTITUTES FOR GENERAL
MEDICAL SCIENCES AND THEY FOUND
BASIC SCIENCES THEY LIMIT RO
ONE'S INSTITUTE IF YOU COME UP
WITH IT GET 1% OR 2 THEY WON'T
CONSIDER IT AND WILL LOOK AT
OVERALL FUNDING HOW WARD HUES
AND FOUNDATIONAL MONEY TO DRAW
BACK CONCLUSION AND GOING BACK
FROM THAT I WOULDN'T CALL IT
EXTREME POSITION TO INSTITUTES
FAR MORE SAFEGUARDING OF CURRENT
PORT FOLIO AND LOOKED AT NEEDS
AND ERRORS AND DENTAL SCIENCE
PERIONTOLOGY THAT ADVANCE IN THE
MANNER THAT IS SIGNIFICANT. WE
WILL PUT IT THAT WAY. BE
LACKING CRITICAL MASS TRAINEES
AND YOU WOULD ADMIT LOOKING AT
DATA SCIENCE THAT WE NEED A
BREED OR GENERATION OF DATA
SCIENTISTS WHO HAVE AN ORAL
HEALTH BACKGROUND OR HEALTH
SCIENCES BACKGROUND, AT LEAST;
RIGHT?
WE ARE SHIFTING OUR PRIORITIES
WITH ESIS TO FOCUS ON TARGETED
NEEDS THAT WE HAVE. I THINK
THAT THE BALANCE WILL BE IN
CONTROLLING THE LARGER
INITIATIVES AND THE BIG
INVESTMENTS AND BEING ABLE TO
ALSO LOOK AT SENIOR
INVESTIGATORS THAT HAVE 4 OR 5
GRANTS AND KIND OF CREATE THE
VERY BEST EQUILIBRIUM TO KEEP
VERY BEST SCIENCE IN TACT WHILE
INVESTING IN THE FUTURE THAT IS
A TOUGH BALANCING ACT. I
APPRECIATE IT. WE WILL COUNT ON
YOUR ADVICE AND SUPPORT.
>>JACK HAS A QUESTION.
>>HI, JACK.
>>HI. THANK YOU, LYNN.
QUESTION IS REVIEWING CRITERIA
FOR NIH GRANTS AND TWO BRIEF
QUESTIONS. ONE IS WHAT IS THE
REAL PROBLEM THAT NEW CRITERIA
IS TRYING TO FIX OR ADDRESS?
IF YOU HAVE A PERSPECTIVE OF IN
TERMS OF A TIMELINE FOR
IMPLEMENTATION OF THE NEW
CRITERIA. THANK YOU.
>>YES. YES. AND I WILL
ACTUALLY TURN OVER THE TIMELINE
QUESTION TO LILLIAN AND LYNN.
THERE WAS A DEBATE WHEN IT WOULD
TAKE EFFECT AND WILL TELL YOU
BONES ARE VERY CLEAR. IF YOU
HAVE TO CREATE FOCUS ON SCIENCE
ALONE, THINGS LIKE INSTITUTIONS
AND ENVIRONMENTS BECOME
SECONDARY.
>>UH-HUH.
>>AND VERY OFTEN NOT ALLOWING
IT TO STAY THAT WAY CREATES A
KIND OF IMPLICIT BIAS AMONGST
REVIEWERS BELONGING TO A GREAT
UNIVERSITY LIKE MICHIGAN AND
ENCOURAGE A DIVERSE PIPELINE IN
EVERY WAY AND RESEARCH INTERESTS
AND BACKGROUNDS AND WE MIGHT BE
SKEWING TO THOSE WHO ARE ALREADY
PROVEN ENTITIES RATHER THAN
INVESTING TO THOSE WHO ARE
COMING INTO THE PIPELINE AND ARE
TWO MAJOR DRIVING FACTORS.
AND IT CAME AFTER VERY DEEP
REVIEW BY CSR.
WHEN I COME TO MICHIGAN NEXT
WEEK OR WEEK AFTER, I WILL DELVE
INTO IT AS A LITTLE MORE DEPTH
AND MEET WITH TRAINING OFFICERS
AS WELL.
>>THANK YOU.
>>WHAT IS THE SECOND ONE?
OKAY.
DID YOU HAVE ANOTHER QUESTION?
WAS THAT JUST --
>>JUST IN TERMS OF TIMELINE.
>>YEAH. LYNN, DO YOU REMEMBER?
>>JASMINE ARE YOU AWARE OF A
SPECIFIC TIMELINE, DR. CHER
RAZI.
>>THEY ARE NOW REQUESTING INPUT
FROM THE COMMUNITY AND AFTER
THEY RECEIVE INPUT FROM THE
COMMUNITY THEY WILL WORK OUT A
DETAILED TIMELINE.
>>THANK YOU.
>>YEAH.
>>THANK YOU.
>>I'M SURE IT WILL BE -- YOU
KNOW, IT TAKES IT A WHILE TO GET
THROUGH DIFFERENT STAGES OF
APPROVAL AND IT WILL BE AT LEAST
A YEAR OUT, I'M PREDICTING.
>>THANK YOU.
>>THANK YOU. PLEASURE TO HAVE
JENNIFER HERE TO SHARE THE
PODIUM. GO FOR IT.
>>WE CAN TURN IT OVER TO DR.
JENNIFER WEBSTER-CYRIAQUE.
>>THANK YOU ALL VERY MUCH FOR
THOSE VERY KIND WORDS, RENA. AS
YOU MAY REMEMBER, IN MARCH.
2021, JUST AFTER THE HORRIFIC
EVENTS ASSOCIATED WITH GEORGE
FLOYD, FRANCIS COLLINS THEN
LEADER OF NIH SHARED WITH THE
COMMUNITY THAT NIH'S EFFORTS TO
IMPROVE DIVERSITY WERE NOT
SUFFICIENT.
HE APOLOGIZED TO INDIVIDUALS WHO
WERE PART OF THE RESEARCH
ENTERPRISE AND WHO ENDURED
DISADVANTAGES ASSOCIATED WITH
STRUCTURAL RACISM. HE SHARED
THERE WOULD BE PLANS FOR NIH TO
DO THINGS DIFFERENTLY AND TO
CORRECT POLICIES HERE AT NIH
HARMING THE WORKFORCE AND
SCIENCE. AND TO STRUCTURAL
RACISM, THE FOCUS REALLY THERE
IS ON POLICIES, PRACTICES AND
NORMS THAT CAN PERPETUATE
INEQUITY. OKAY?
WHAT WAS STEP 1? REACHING OUT
TO THE COMMUNITY AND HEARING
FROM THEM INCLUDING PEOPLE FROM
ACADEMIA AND NIH AND HEALTHCARE
PROFESSIONALS, STUDENTS AND
PROFESSIONAL SOCIETIES AND
OTHERS AND ACROSS THE COMMUNITY,
HE CAME BACK WITH CONCERNS IN
FIVE AREAS: GRANTS, CAREER
PATHWAYS, WORKFORCE ITSELF AND
HEALTH DISPARITIES EQUITY
RESEARCH AND COMMUNITY
PARTNERSHIPS.
ACROSS AREAS OF CONCERN, THERE
WERE CROSS-CUTTING THEMES THAT
FOCUSED IN IMPLEMENTING DEI AND
MAINLY OPERATIONALIZED DEI
METRICS TO IMPROVE COMMUNICATION
AND OUTREACH AND TO ACKNOWLEDGE
IMPACT OF STRUCTURAL RACISM.
SO, STRATEGY WAS THREE FOLD TO
FOCUS IN THREE OBJECTIVES
ASSOCIATED WITH RESEARCH AREAS
THAT WERE A BASIC FOUNDATIONAL
SCIENCE AND IN DISEASE
PREVENTION AND HEALTH PROMOTION
AND TREATMENT INTERVENTION AND
CURES AND RESEARCH CAPACITY AND
WORKFORCE AND IN HOW WE DO THE
RESEARCH.
NOW, THE OTHER THING HERE WAS
THAT IT REALLY FOCUSED AND WAS
GREAT FOR CROSS-CUTTING THINGS
THAT HIT EVERY AREA OF DENTAL
RESEARCH INCLUDING MINORITY
HEALTH AND HEALTH DISPARITIES,
WOMEN'S HEALTH, PUBLIC HEALTH
CHALLENGES ACROSS THE LIFESPAN
AND COLLABORATIVE DATA SCIENCE
AND ALL THAT IS US. ONE PROGRAM
THAT HAS BEEN ENABLED THAT HAS
BEEN ENABLED IS REALLY LIKE JUST
THERE IS NEVER ANYTHING LIKE
THIS. WHERE THE COMMUNITY IS
ACTUALLY DRIVING THE RESEARCH.
AND THIS IS THE PROGRAM THAT
STANDS FOR COMMUNITY
PARTNERSHIPS TO ADVANCE SCIENCE
FOR SEW SIGH THAT IS COMPASS AND
IS COMMUNITY LED HEALTH
STRUCTURAL -- THAT LEVERAGES
PARTNERSHIPS ACROSS A BUNCH OF
SECTORS AND GRANTS ARE PHASED
WITH PLANNING PHASE AND
IMPLEMENTATION AND DISSEMINATION
PHASE AND THEY ARE 10 YEARS LONG
AND HAVE A VERY DIFFERENT REVIEW
CRITERIA. THIS IS SO NEW. THE
OTHER THING PUT INTO PLACE WAS
TO BUILD A SET OF COMMITTEES AND
OF FIVE COMMITTEES WHO HAVE
COORDINATED OBJECTIVES TO REALLY
FOCUSING IN ON RACIAL INEQUITY.
THIS IS UNIT YOU HEARD A LITTLE
ABOUT FROM RENA JUST A MOMENT
AGO. SO, ACTUALLY RENA IS PART
OF THE E COMMITTEE AND KELLY
HAIGEN WAS AN INTRAMURAL
SCIENTIST PART OF UNITE
COMMUNITY AND UNDERSTANDING
THROUGH STAKEHOLDERS THROUGH
LISTENING AND STANDS IN NEW
RESEARCH HEALTH DISPARITIES AREA
AND I IS FOCUSED ON INCLUSION
HERE AT NIH. T IS FOCUSING ON
TRANSPARENCY AND ACCOUNTABILITY
AND E IS PROMOTING DIVERSITY AND
INCLUSION IN EXTRAMURAL
RESEARCH.
OKAY?
SO, TODAY I WILL FOCUS ON FOUR
AREAS THAT ARE RELATED TO THIS
UMBRELLA TOPIC STARTING WITH
PROMOTING EQUITY IN INTERNAL NIH
WORKFORCE.
THE WAY THAT I HAVE LAID THIS
OUT. FIRST, I WILL SHARE WHAT
IS HAPPENING AT NIH AND WHAT WE
ARE DOING AT NIDCR. PROMOTING
EQUITY IN INTERNAL NIH
WORKFORCE, THERE HAS BEEN
ESTABLISHED AN NIHWIDE
ANTIRACISM COMMITTEE AND ALSO
THEY ARE WORKING TO ENHANCE
OUTREACH TO ENSURE THAT EVERYONE
HAS AN OPPORTUNITY TO APPLY.
AND ENSURE THAT THERE IS A BROAD
RANGE IN DIVERSITY OF
APPLICANTS.
OTHER THING IS DEVELOPMENT OF
INSTITUTE-LEVEL RACIAL AND
ETHNIC EQUITY PLANS.
OKAY?
DATA THAT WAS NEVER PUBLISHED
BEFORE HAS NOW BEEN PUBLISHED ON
DEMOGRAPHIC COMPOSITION AND
PROFILES OF NIH WORKFORCE THAT
WAS VERY IMPORTANT AND
ILLUMINATED. YOU COULD SEE
CERTAIN GROUPS WERE NOT ABLE TO
ASCEND TO LEADERSHIP AND
ESTABLISHED AND LOOKED REALLY AT
THE AWARDS AND THEY HAVE NOW
DEVELOPED A TASKFORCE TO
RECOMMEND CHANGES TO DIRECTORS
AWARDS AND ALSO REALLY HAVE
SPEARHEADED AN ART PROJECT THAT
IS CALLED INCLUSIVE WORKPLACE
RECOGNITION SO THAT YOU SEE
EVERYBODY. OKAY?
YOU CAN SEE HETEROGENEITY OF
PEOPLE HERE MAKING NIH WORK
VERSUS HOMOGENOUS IMAGES WE
RECEIVED BEFORE AND FINALLY TO
PROVIDE SKILL DEVELOPMENT AND
OPPORTUNITIES THEY ARE
DEVELOPING CAREER DEVELOPMENT
PROGRAM OPPORTUNITIES FOR THOSE
IN GRADES UP TO 11.
HERE IS A EXAMPLE OF SOME OF THE
ART WORK THAT IS BEING SHARED
ACROSS NIH TO BOLSTER CULTURE OF
INCLUSIVE EXCELLENCE. WE HAVE
HERE OUR OWN JIMMY DOUGH ACTING
EO HIGHLIGHTED WITHIN THIS
ARTWORK. UNITE I XHOO COMMITTEE
REACHED OUT ACROSS ALL ICS
DEVELOPING A REACH COMMUNITY
PRACTICE IT STANDS FOR RACIAL
AND EQUITY PLAN AND OUR RIC
DECIDED TO USE REEP AS A
FOUNDATION TO CREATE A MORE
COMPREHENSIVE PLAN FOR
BELONGING. WE WANTED TO REALLY
ATTACK ALL OF THE -ISMS AND
ENSURE EVERYONE BELONGED. WHY?
DIVERSITY ONLY ASKS WHO IS
THERE. OKAY? EQUITY ASKS,
WELL, WHY IS THIS PERSON NO THE
IN THE ROOM AND WHAT ARE THE
BARRIERS? IN COLLUSION ASKS,
WELL, BECAUSE EVERYBODY'S IDEA
HAS BEEN HEARD AND RESPECTED AND
UNDERSTOOD. BELONGING WHICH IS
WHAT WE ARE STRIVING FOR ASKS IS
EVERYONE FEELING VALUED THROUGH
CONNECTIONS THAT ARE POSITIVE
WITH OTHERS?
IS THIS A SPACE TO ACTUALLY
BRING YOUR AUTHENTIC SELF TO
WORK? THAT IS WHAT WE STRIVE
FOR HERE IN BUILDING AT NIDCR.
HERE, WE ARE REALLY WORKING
ACROSS SEVERAL ELEMENTS
ACCEPTING DIFFERENCES IN
CULTURAL APPRECIATION AND
FOSTERING TRANSPARENCY AND
STREAMLINING ACTUAL WORK THAT WE
DO, THE PROCESSES.
ENSURING THAT THERE IS IMPROVED
ACCESS TO LEADERSHIP AND WORKING
TOWARDS CAREER DEVELOPMENT AND
GROWTH. FINALLY, IMPROVING
COMMUNICATION AND INTERACTIONS
WITHIN AND OUTSIDE OF NIDCR.
SO, HOW ARE WE DOING THAT?
WE ARE NOW HAVING MONTHLY ALL
STAFF MEETINGS. WE ARE
PROMOTING ADDITIONAL STAFF
TRAINING AND DEVELOPMENT. WE
HAVE A CAREER DEVELOPMENT
PROGRAM THAT IS SPECIFIC TO
NIDCR. ALSO, A SUPERVISOR
TRAINING PROGRAM AT NIDCR THAT
IS BEING DEVELOPED AND WE HAVE A
DIGITAL TRANSFORMATION
INITIATIVE ALLOWING US TO GO
BACK AND LOOK AT EVERYTHING WE
DO AND DIGITIZE IT SO THAT WE
CAN PROVIDE OBJECTIVITY WITHIN
THE PROCESS AND TRANSPARENCY AND
ALSO BE ABLE TO DO THINGS MORE
EFFICIENTLY. WE WILL HAVE
VIRTUAL AND IN-PERSON CHATS WITH
LEADERSHIP AND DIVISION-BASED
CELEBRATIONS OF ALL OF OUR
SPECIAL EMPHASIS GROUPS HERE AT
NIH.
HERE IS A EXAMPLE OF THE LANDING
PAGE. THIS IS OUR WEBSITE AND
INTERNET SITE IT THAT HOUSES A
WEALTH OF INFORMATION ON
WELLNESS IT THAT IS CRITICAL ON
DIGITAL TRANSFORMATION
INITIATIVE I JUST SHARED WITH
YOU AND WE HAVE A LENDING
LIBRARY THAT IS DEI FOCUSED AND
PLAN IS HERE AS WELL AS ALL OF
THE SURVEY RESULTS FROM SURVEYS
WE ARE DOING SO THAT PEOPLE CAN
SEE AND ON INFORMATION ON THINGS
HAPPENING ELSEWHERE ON THE
CAMPUS. THE BRIDGE PROGRAM IS
CAREER DEVELOPMENT PROGRAM I
ELUDED TO AND HERE AT NIDCR WE
PROVIDE TOOLS AND NETWORK
OPPORTUNITIES SO STAFF COULD
ACHIEVE OWN CAR EAR GOALS AND
REALLY RAISE AWARENESS OF
INDIVIDUAL STRENGTHS.
BASED ON THAT TO ENSURE THAT WE
CAN ALSO BUILD FOUNDATIONAL
COMPETENCIES SO THEY CAN GROW IN
A WAY THAT THEY WOULD LIKE TO.
MENTORSHIP IS ALSO PROVIDED AND
FOR US AT NIDCR THIS GOES UP TO
GS-13. WE ACTUALLY START
TOMORROW. IT IS THE FIRST
SESSION.
I'M VERY EXCITED AND IT THIS IS
SOMETHING WE HAVE TO DO AS A
COMMUNITY. BELONGING HERE AT
NIDCR ENCOMPASSES ALL OF US AND
CHALLENGES ALL OF US HERE AND
REQUIRES ALL OF US. IT ALSO
REQUIRES ALL OF YOU WHO ARE IN
THE EXTRAMURAL COMMUNITY.
WE WANTED TO ENSURE THAT
EVERYONE HAD OPPORTUNITIES TO
PROVIDE INPUT AND ONE EXAMPLE IS
OUR NEW RESPECT INDIGNITY SOP
THAT EVERYBODY COULD WEIGH IN ON
AND IN A NUMBER OF SURVEYS IT
THAT OCCUR ALL THE TIME. WE CAN
KIND OF KEEP OUR FINGER ON THE
PULSE OF WHAT WE ARE DOING AND
WHETHER WE NEED TO MODIFY IT.
IS IT WORKING?
WE JUST HIRED OUR NIDCR CHIEF
DIVERSITY OFFICER DETAIL LEAD
JOY PASTEL THAT RENA ELUDED TO
EARLIER ON. SHE IS FACILITATING
BELONGING HERE AND IS WONDERFUL
TO HAVE HER. THE SECOND FOCUS
AREA IS PROMOTING EQUITY IN NIH
AND NIDCR-SUPPORTED ECOSYSTEM
THAT IS EXTRAMURAL. IN TRUTH,
IF WE ARE WORKING TO BECOME
FUNCTIONAL MULTICULTURAL
LEARNING ENVIRONMENTS THERE IS A
BODY OF EMPIRICAL INFORMATION TO
HELP GUIDE OWE US TO UTILIZE SO
WE CAN MOVE FORWARD IN AN
EVIDENCE-BASED WAY. HOW IS NIH
PROMOTING THIS EQUITY?
ONE, THEY LAUNCHED THE FIRST
PROGRAM THAT NIDCR IS SIGNED ON
TO AND STANDS FOR FACULTY
INSTITUTIONAL RECRUITMENT FOR
SUSTAINABLE TRANSFORMATION AND
GROUP HIRES THAT ALSO EXPANDED
THE SCIENCE EDUCATION
PARTNERSHIP AWARDS AND NIDCR IS
ALSO SIGNING ON FOR THAT. THEY
HAVE A PLAN AND SOLICITED PUBLIC
COMMENT AND HAVE FIRST SET OF
AWARDEES FOR INSTITUTIONAL
EXCELLENCE IN DEIA.
THEY HAVE CREATED SEVERAL OTHER
INITIATIVES TO SUPPORT
EXTRAMURAL DEIA EFFORTS AND ARE
EVEN SUPPORTING INSTITUTIONS TO
CONDUCT CLIMATE ASSESSMENTS AND
NEEDS ASSESSMENTS AND THAT KIND
OF STUFF WAS NOT HAPPENING FROM
NIH BEFORE. OKAY?
SO, WHAT DOES THE FRAMEWORK LOOK
LIKE FOR EXTRAMURAL?
AT THE CENTER IS EVAL YAITION IN
STAKEHOLDER ENGAGEMENT AND
ENSURING THAT IMMEDIATE ACTION
IS TAKEN AND ONE TO BE PROMOTING
EQUITY AT EXTRAMURAL
INSTITUTIONS IS IMPROVING
ENVIRONMENT IN CULTURE WHERE
CLIMATE ASSESSMENTS WILL OCCUR
AND WE HAVE TO PROMOTE EQUITY
HAD HERE AT NIH THROUGH POLICIES
AND PROCEDURES THAT WILL IMPACT
THE EXTRAMURAL COMMUNITY AND TO
ENSURE THAT THERE ARE CAREER
PATHWAYS IN TERMS OF GROWTH AND
THAT THERE IS RESOURCES AND
CAPACITY NOT ONLY AT MAJORITY
INSTITUTIONS BUT ALSO AT
MINORITY-SERVING INSTITUTIONS.
IF THERE ARE PROBLEMS LIKE
HARASSMENT AND DISCRIMINATION,
NIH WANTS TO KNOW ABOUT IT,
PARTICULARLY IF IT IS
CONTRIBUTING TO AN UNSAFE OR
HOSTILE WORK ENVIRONMENT
EFFECTING AN NIH-FUNDED PROJECT
AT A GRANTEE INSTITUTION THAT
INCLUDES SEXUAL HARASSMENT AND
RACIAL DISCRIMINATION.
WHAT YOU DO IS GO TO ERA AND YOU
CAN FILL THIS FORM OUT. SOMEONE
WILL BE BACK IN TOUCH WITH YOU.
THIS IS ABSOLUTELY PRIVACY THAT
IS AROUND THE REPORTING AND IS
AN OPPORTUNITY THAT DID NOT
EXIST BEFORE. IT HELPS TO LEVEL
THE PLAYING FIELD.
AGAIN, THE AWARD FOR
INSTITUTIONAL EXCELLENCE HAS
ACTUALLY -- IT WAS ACTUALLY
AWARDED IN THE NEXT DUE DATE
THAT IS COMING UP. IT IS JUST
LESS THAN A MONTH AWAY. IF YOU
FEEL THAT YOUR INSTITUTION IS
MOVING TOWARDS A TRANSFORMATIVE
CULTURE THAT HAS ACHIEVED
INCLUSIVE EXCELLENCE, PLEASE
FEEL FREE TO APPLY FEBRUARY
17TH. HERE AT NIH, WE ARE ALSO
PROMOTING EQUITY IN BIOMEDICAL
RESEARCH ECOSYSTEM. WE HAVE
POST DOCTORAL TRAINING
FELLOWSHIPS WITH INTRAMURAL.
ALSO, FOR POST BACCALAUREATE
TRAINING. THIS IS JASON THERE.
EXTRAMURALLY THERE IS AAODC
PROGRAM THEY ARE IN THE THIRD
COHORT THIS IS WHO COHORT IS AT
THIS TIME AND WE ARE WORKING
WITH FOUNDATION OF NATIONAL
INSTITUTES OF HEALTH TO BUILD
PUBLIC/PRIVATE PARTNERSHIPS TO
HELP IN A VERY MEANINGFUL WAY TO
PROMOTE ORAL HEALTH WORKFORCE
DIVERSITY AND REALLY BRINGING IN
THE VILLAGE TO HELP US SOLVE THE
PROBLEM. THE OTHER THING THAT
IS -- ONE OTHER THING TO MAKE
YOU AWARE OF IS THE PROGRAM
GENDER, WHICH GALVANIZES HEALTH
EQUITY THROUGH NOVEL AND DIVERSE
EDUCATIONAL RESOURCES FOCUSED ON
INFORMATION THAT IS AROUND SEX
AS A BIOLOGICAL VARIABLE AND
CURRICULA AND METHODS
DEVELOPMENT TO ADVANCE
UNDERSTANDING OF SEX AND GENDER
INFLUENCES ON HEALTH AND ORAL
HEALTH.
IF YOU ARE INTERESTED IN THAT,
YOU CAN REACH OUT TO ANISA, OUR
PROGRAM OFFICER.
WE ARE REALLY WORKING TOWARDS
PARTNERING AND REALLY THINKING
ABOUT THE FULL PATHWAY FROM
UNDERGRADS WHERE WE ARE LOOKING
INTO ONLINE OPPORTUNITIES TO
REACH OUT THROUGH THE COMMUNITY
AND TO LEVERAGE EXISTING STEM
PROGRAMS FOR UNDERGRAD AND LET
THEM KNOW ABOUT DENTISTRY TO DO
PUBLIC/PRIVATE PARTNERSHIPS WE
TALKED ABOUT AND PARTNERING WITH
OTHER ORGANIZATIONS LIKE IDEA
WHERE WE WORK ON AN ACADEMIC
CAREER TRACK WITH THEM AND IN
THE STUDENT DIVERSITY LEADERSHIP
PROGRAM.
FOR THOSE OF YOU WHO RENA JUST
SHARED ABOUT THE DENTAL
SCHOOL-BASED PBRN.
THIS WILL BE A SIGNIFICANT
OPPORTUNITY TO EXPOSE PEOPLE TO
RESEARCH AND BUILD THAT CULTURE.
SO, IF THERE ARE QUESTIONS ABOUT
RESEARCH TRAINING AND CAREER
DEVELOPMENT IT THAT IS BOTH IN
THE EXTRAMURAL COMMUNITY AND
ABOUT WHAT IS HAPPENING IN THE
INTRAMURAL OFFICE, FEEL FREE TO
REACH OUT TO ANISA BROWN AND TO
BELINDA HAUSER.
OUR THIRD FOCUS AREA IS
ELEVATING HEALTH DISPARITIES AND
MINORITY HEALTH RESEARCH BOTH AT
NIH AND HERE AT NIDCR.
NOW, STRUCTURAL RACISM CREATES
HEALTH INEQUITY.
THERE IS SOMETIMES CIRCUMSTANCES
THAT ARE BEYOND OUR CONTROL LIKE
WHERE WE GREW UP. WHERE WE
LIVE. AND OTHER SYSTEMIC ISSUES
THAT CAN PREVENT PEOPLE FROM
HAVING THE SAME PRIVILEGE AS
OTHERS.
AND REALLY PREDISPOSE THEM TO
DISEASE. OKAY?
SO, WHAT IS NIH DOING IN THIS
SPACE?
OKAY?
THEY ARE INCREASED FUNDING TO
THIS TYPE OF RESEARCH AND
RELEASE -- THEY ARE RELEASING
MORE AND MORE FOAS AND I WILL
SHOW YOU DATA IN A MOMENT. TO
IMPROVE NIH TRANSPARENCY AND
MOVE TOWARDS SUSTAINABILITY AND
AUTOMATED METHODS HAVE BEEN
DEVELOPED TO MORE PRECISELY
CHARACTERIZE, ANALYZE AND TRACK
THESE PORTFOLIOS AND THEY HAVE
EXPANDED MESH TERMS RELATED TO
SOCIAL DETERMINANTS OF HEALTH.
THERE IS ALSO THE PROGRAM THAT I
MENTIONED EARLIER ON.
NOW, LOOK AT HOW MANY FOAS THERE
ARE NOW OR WITH 2022, 115 THAT
ARE ACROSS NIH THAT ARE RELATED
TO HEALTH DISPARITIES VERSUS
ONLY 18 THAT ARE ABOUT FIVE
YEARS AGO.
PROUD TO SAY NIDCR IS A LEADER
IN THIS SPACE HAVING ORAL HEALTH
DISPARITY CENTERS BACK IN THE
90S.
OKAY?
THERE ARE CROSS-CUTTING
INITIATIVES.
THEY FOCUS ON REDUCING HEALTH
DISPARITY AND UNDERSTAND THE
ROLE OF SOCIAL DETERMINANTS AND
ENSURING YOU ARE ENGAGING IN THE
EFFECTIVE COMMUNITY AND
MULTILEVEL INTERVENTIONS AND
RECRUITMENT AND, YOU KNOW,
ENSURING THAT WHEN WE DO OUR
STUDIES THAT OUR STUDIES LOOK
LIKE THE EFFECTED POPULATION.
IT THAT MAY INCLUDE PEOPLE WHO
ARE EXPERIENCING HEALTH
DISPARITIES.
SOME EXAMPLES OF FOAS ARE THE
SUBSTANCE USE AND ADDICTION
OUTCOMES RFA. FOCUS ON HEAL AND
PREVENTION AND MANAGEMENT
CHRONIC PAIN PARTICULARLY IN
RURAL POPULATIONS AND LOOKING AT
EVIDENCE-BASED SCREENING AND
DIVERSE POPULATION AS CROSS THE
LIFESPAN. LOOKING AT
MISINFORMATION AND POPULATIONS
EXPERIENCING HEALTH DISPARITY
HIGHLIGHTING THOSE THAT I
BELIEVE ARE VERY RELEVANT TO OUR
COMMUNITY.
NOW, WHEN WE LOOK AT EQUALITY
AND EQUITY, WE CAN SEE VERY
CLEARLY THAT EQUALITY IS NOT
ENOUGH. WHY?
WE ARE DIFFERENT. OKAY?
WE -- THERE ARE BARRIERS THAT
ARE IN PLACE. IF WE ARE ALL
GETTING IN THE SAME, SOME OF US
ARE UNABLE TO SURPASS THE
BARRIER.
EQUITY MAKES A DIFFERENCE. WHAT
IS BEST IS NOT TO HAVE ANY
BARRIERS AT ALL. THAT IS WHAT
JUSTICE IS.
LET'S LOOK AT REALITY OVER HERE
ON THE LEFT. REALITY IS SOME OF
US HAVE WAY MORE THAN WHAT WE
NEED. OKAY?
SOME OF US HAVE JUST ENOUGH.
SOME OF US HAVE WAY LESS. IN
FACT, THERE IS SOCIAL AND
COMMERCIAL DETERMINANTS.
THIS IS AN IMAGE IT THAT I
BORROWED FROM THE NORTH CAROLINA
ORAL HEALTH COLLABORATIVE.
THOSE SOCIAL AND COMMERCIAL
DETERMINANTS CAN EVEN WORSEN
THIS DISPARITY DIGGING AN EVEN
DEEPER HOLE FOR THESE PEOPLE.
WE, ORAL HEALTH, WE NEED TO BE
MOVING ACROSS TO JUSTICE.
NOT ONLY HERE IN THE US BUT
ACROSS THE GLOBE. THE WORLD'S
MOST COMMON NONCONTAGIOUS
DISEASE IS TOOTH DECAY AND MORE
THAN 90% OF THE ENTIRE WORLD
POPULATION WILL SUCCUMB TO
DENTAL DISEASE LOOKING ACROSS
THE WORLD AT PEOPLE BETWEEN 65
AND 74, 35% OF THEM DON'T HAVE
TEAM AND IT THAT CAN HELP
SOMEONE'S QUALITY OF LIFE AND
LOOKING AT ORAL CANCER THIRD
MOST COMMON CANCER IF IN ASIA
AND 6TH MOST COMMON IN THE US.
WE KNOW THERE ARE DISPARITIES
WITH SIGNIFICANTLY HIGHER LEVELS
OF ORAL CANCER IN MEN AND IN
WOMEN. AGAIN, ORAL DISEASES ARE
THE MOST COMMON DISEASES THAT
ARE EFFECTING 3.5 BILLION PEOPLE
IN THIS WORLD. REMINDER HERE
THAT CLEFT LIP HAPPENS IN 1 IN
700 AND BURDEN OF ORAL DISEASE
MUCH OF IT PREVENTABLE, $500
BILLION. WE HAVE WORK TO DO.
OKAY?
IF WE LOOK IN CHILDREN AND IN
ADOLESCENCE, AND HERE IS DATA
FROM LONDON.
WHAT YOU SEE IS THE POORER KIDS
HAVE THEIR TEETH EXTRACTED FOUR
TIMES MORE FREQUENTLY THAN
CHILDREN WHO ARE LESS DEPRIVED
AND LOOKING HERE AT THE UNITED
STATES, WE SEE NON-HISPANIC
WHITE CHILDREN ARE ALREADY
GETTING CARRIES, 25%. AMERICAN,
INDIAN ANDAL ALASKA NATIVES 3
TIMES MORE LIKELY TO HAVE
CHILDREN CARRIES AND ADOLESCENCE
YOU SEE 2.5 TIMES HIGHER LEVELS
OF CARRIES IN NON-HISPANIC
BLACKS AND NON-HISPANIC WHITES
AND TWICE AS MANY CARIES IN
ADOLESCENTS THAT ARE POOR
COMPARED TO THOSE WHO ARE NOT.
WE HAVE WORK TO DO. OKAY?
NIDCR IS ELEVATING HEALTH
DISPARITIES AND MINORITY HEALTH
GROUP THROUGH MECHANISMS AND
SEVERAL PROJECTSLY SHARE WITH
YOU. JAIN IS LEADING AND
LOOKING AT ORAL HEALTH
CONDITIONS AMONG OLDER ADULTS
USING ALL OF US.
THERE IS A STUDY BY MARY M. WHO
IS LOOKING AT ORAL CLEFT TRIOS.
TAMARA IS USING DATA TO LOOK AT
ACCURACY OF EEHRS IN BIG MOUTH
REPOSITORY. WE ARE TALKING
ADVANTAGE OF ALL OF US, WHICH IS
GREAT. AGAIN, RENA ACTUALLY
SHOWED THIS ONE. OTHER WAYS
THAT NIDCR IS ELEVATING THROUGH
WORK BEING DONE DEMONSTRATING IN
60,000 US BLACK WOMEN
RELATIONSHIPS BETWEEN RACISM AND
DENTAL FEAR AND LOOKING AT ORAL
HYGIENE AND AUTISTIC VERSUS
NONAUTISTIC AND WOMEN'S HEALTH
ISSUE FOCUS ON OFFICE OF
RESEARCH ON WOMEN'S HEALTH AND
TALKED ABOUT ORAL HEALTH AND
ORAL HEALTH DISPARITIES AND
CHALLENGES IN THE WORKWORKFORCE
WITHIN AN ISSUE JUST RELEASED
LAST QUARTER. THERE WAS ORAL
HEALTH DISPARITIES THINK TANK
LED BY DR. HEROKO AIDA. WE ARE
IN THE MIDDLE OF IT SECOND HALF
DONE FEBRUARY 9TH AND INVOLVED
IN AGENCY AND CROSS-AGENCY
ACTIVITIES TOWARDS DIMINISHING
ORAL HEALTH DISPARITIES.
DOWN THE ROAD I WANTED TO SHARE
THERE IS AN NIH-LEVEL
DISCUSSION. WE HAVE BEGUN SOME
DISCUSSIONS HERE AROUND GRANT
REVIEW AND CONSIDERING DIVERSITY
EQUITY INCLUSION IN THE CONTEXT
OF THE PROJECTS BEING PROPOSED
AND REVIEWED. OKAY?
ONE OTHER THING WE ARE DOING AS
YOU ALL KNOW, WE ARE NOT -- OUR
FIELD HAS NOT HAD LARGE
MULTI-SITE CLINICAL TRIALS TO
GENERATE EVIDENCE WE IF NEED TO
BE ABLE TO MOVE THE FIELD
FORWARD.
ONE THING WE ARE DOING IS WE ARE
WORKING IN CONSULTATION WITH
SEVERAL GROUPS SO THAT WE CAN
OBTAIN MERGED MEDICAL DATA OR
MEDICAL DENTALE DATA THAT HAVE
SOCIAL DETERMINANTS INFORMATION.
WE ARE WORKING WITH REZDAK TO
OBTAIN INFORMATION TO DATA WITH
ALL STATES AND MEDICAL AND
DENTAL DATA THAT INCLUDES
FEDERALLY QUALIFIED HEALTH CARE
CENTERS AND WORKING WITH THE
WISCONSIN COLLABORATIVE
INCLUDING 35 HEALTH SYSTEMS IN
THE MIDWEST INCLUDING 150 DENTAL
PRACTICES AND 325 MEDICAL
CLINICS THAT HAVE INTEGRATED
DATA AND ULCHIN BASED IN
PORTLAND INCLUDING MORE THAN 6
MILLION PATIENTS COVERING 45
STATES CAPTURING SOCIAL
DETERMINANTS ACROSS THIS VERY
DIVERSE PAYER MIX AND WE ARE
HOPING BY PROVIDING TYPES OF
RESOURCES TO THE FIELD TO ASK
QUESTIONS THAT ARE INCLUDING
QUESTIONS THAT ARE AROUND ORAL
HEALTH DISPARITIES. WE WILL
THEN HAVE THE OPPORTUNITY TO
MOVE PRACTICE AND GUIDELINES IN
A WAY THAT WE HAVE NOT BEEN ABLE
TO DO BEFORE.
THE LAST FOCUS AREA IS IMPROVING
ACCURACY AND TRANSPARENCY OF
RACIAL AND ETHNIC EQUITY DATA.
WHAT IS HAPPENING HERE AT NIH IS
TO GET TOGETHER RECENT BASELINE
DATA THAT HAVE BEEN -- THERE WAS
AN RFI THAT WAS RELEASED.
THERE WERE OVER 1,000 RESPONSES.
THERE HAVE BEEN 14 LISTENING
SESSIONS WITH THE EXTRAMURAL
COMMUNITY. THIS WAS OVER IT
1300 ATTENDEES.
THE OTHER PIECE IS TO IMPROVE
TRANSPARENCY AND ACCOUNTABILITY.
TOWARDS THIS END, A PUBLIC
FACING DATA DASHBOARD THAT HAS
BEEN DEVELOPED THAT ANYONE CAN
ACCESS.
THERE IS A UNITE LINKED IN PAGE
AND ENDING STRUCTURAL RACISM WEB
SITE AND INTRANET SO THAT
EVERYONE CAN SEE WHERE WE ARE
AND WHERE WE ARE WITH THIS DATA.
WHAT WILL IT TAKE?
THIS IS JUST MY PERSPECTIVE TO
AMELIORATE ORAL HEALTH
DISPARITIES WE HAVE TO WORK
TOGETHER TOWARDS WORK EXPANSION
AND SCIENTIFIC EXCELLENCE
EMBRACING DIVERSE PEOPLE,
DIVERSE NEEDS AND DIVERSE
PERSPECTIVES AND WE HAVE TO
BUILD AN ENVIRONMENT AND
COMMUNITY AND FIELD AND OUR
FIELD THAT WILL ALL BELONG.
THIS IS SO CRITICAL AS WE
COLLECTIVELY STRIVE TO MEET OUR
MISSION OF ORAL HEALTH FOR ALL.
I WILL END THERE. THANKS FOR
YOUR ATTENTION AND HAPPY TO TAKE
ANY QUESTIONS.
>>WE HAVE 10 MINUTES OR SO FOR
QUESTIONS FOR DR.
WEBSTER-CYRIAQUE. SO, PLEASE.
>>I MUST HAVE BEEN CLEAR. I
HOPE SO.
>>RAUL.
>>HI. THANK YOU, DR.
WEBSTER-CYRIAQUE FOR FANTASTIC
PRESENTATION AND ENCOURAGING TO
SEE PROGRESS MADE BY NIH AND
NICDR IN THE LAST HANDFUL OF
YEARS IN PRESENTING THIS
CHALLENGING ISSUE OF RACE AND
RACISM IN REGARDS TO HEALTH
OUTCOMES AND IN REGARDS TO
HEALTH RESEARCH WORKFORCE AND
TREMENDOUS PROGRESS AND KUDOS TO
YOU AND YOUR TEAM AND WHAT YOU
ARE DOING AND PLEASE TOTD SEE
THE CONSIDERATION OF THE
IMPORTANCIN COLLUSION OF DIVERSE
COMMUNITIES AND RESEARCH PROJECT
AS WELL AS FOCUS OF ACTUAL
RESEARCH EFFORTS IN DEALING WITH
ISSUES OF RACE AND RACISM AND
PROJECT YOU MENTIONED INCLUDING
WORK BY COLLEAGUES AT BOSTON
HEALTH UNIVERSITY AND WOMEN'S
BLACK HISTORY AND LED BY BRENDA
HOOETON AND FANTASTIC PROGRESS
AND THANK YOU FOR THE
OPPORTUNITY TO SHARE IN THIS
WONDERFUL PROGRESS BEING MADE.
THANK YOU.
>>THANK YOU FOR THAT COMMENT.
MOST IMPORTANTLY, IT REALLY IS
NOT A NICHE THING. IT REALLY
TAKES OUR ENTIRE COMMUNITY TO
OPTIMIZE ORAL HEALTH FOR ALL OF
US.
SO, FOR THIS TO WORK, FOR THESE
THINGS THAT NIH IS DOING, IT
WILL REALLY TAKE BUY-IN FROM
EVERYBODY, BOTH IN THE
EXTRAMURAL SPACE AND INTRAMURAL.
>>YEAH. WE HEAR FROM THE
EXTRAMURAL FOLKS, YOU ON
COUNCIL, AS TO HOW THINGS ARE
MOVING FOR YOU IF IN TERMS OF
CULTURE CHANGES.
CHECKING BOXES DOESN'T ALWAYS
SOLVE THE PROBLEM. YOU CAN HIRE
-- ONLY PERSON WHO DOESN'T LOOK
LIKE THE OTHER PERSON INTO THE
COMMUNITY WHO DOESN'T FEEL
INCLUDED OR THAT SENSE OF
BELONGING. THERE IS MANY, MANY
ASPECTS FOR TRANSFORMING THAT
CULTURE MAINTAINING THE VALUE
FOR EVERY INDIVIDUAL AND WONDER
HOW YOU ARE DOG AND JACK IN
MICHIGAN HAS ALWAYS LED THE WAY
AND IN MANY WAYS AND LEE IN YOUR
INSTITUTION AND OF COURSE MORE
OF YOU FOR [INDISCERNIBLE] IN
THE BOSTON AREA AND JOEL AS
WELL.
>>YEAH. SO, I THINK THAT
ESTHER HERE HAS DONE A WONDERFUL
JOB IN MICHIGAN IN REALLY
FOSTERING DEI FOR MANY YEARS AND
THINK ONE OF THE KEY ASPECTS IS
RECRUITING EARLY IN TERMS OF
WORKFORCE.
SO, I WAS WONDERING, JENNIFER,
IF YOU COULD EXPAND A LITTLE BIT
ON EFFORTS FROM THE NIH AND
NIDCR ON EARLY RECRUITMENT OF
HIGH SCHOOL STUDENTS MAYBE OR
COLLEGE STUDENTS THAT ARE INTO
THE WORKFORCE AND WHAT ARE IDEAS
IN -- WHAT TYPE OF SUPPORT,
PERHAPS THAT WE CAN -- OR HOW
CAN WE BEST WORK TOGETHER TO
ACHIEVE THIS GOAL?
>>SO, THANK YOU FOR THAT. AT
THE HIGH SCHOOL LEVEL, ONE THING
WE HAVE REALLY THOUGHT HARD
ABOUT IS THERE ARE CERTAINLY
INDIVIDUAL -- INDIVIDUAL
OPPORTUNITIES TO GO TO THE HIGH
SCHOOLS AND PROVIDE EXPOSURES.
ONE THING WE HAVE BEEN DOING IS
WORKING WITH A COMPANY THAT IS
ACTUALLY HIGHLIGHTING ONE OF OUR
NIDCR RESEARCHERS, AMBER D'SOUZA
AND THIS COMPANY, WE ARE IN THE
MIDDLE OF IT THIS RIGHT NOW.
PROVIDES OPPORTUNITIES FOR
LESSON PLANS AND ANIMATIONS AND
PODCASTS FOR THE STUDENTS TO
QUESTION, I WOULD LIKE TO BE AN
X. YOU KNOW WHAT THEY DON'T
HAVE UP THERE, DENTAL, ANY
PLACE.
SO, WHAT WE ARE WORKING TOWARDS
IS A SITUATION WHERE WE CAN
HIGHLIGHT TRANSLATIONAL
RESEARCH, FOUNDATIONAL RESEARCH.
JUST GETTING STRAIGHT DENTAL AND
CLINICAL RESEARCH AND PROVIDE
THIS OPPORTUNITY FOR TEACHERS TO
UTILIZE THIS INFORMATION IN THE
CLASSROOM AND FOR STUDENTS TO
COME TO IT THEMSELVES.
NOW, IT HAS BEEN VERY, VERY
EFFECTIVE IN OTHER FIELDS WITH
THEM GETTING LIKE, YOU KNOW,
20,000 MEDIUM IMPRESSIONS A
MONTH AND WHAT HAVE YOU AND
FACEBOOK AND LIVENG THE IN AND
ALL THIS OTHER STUFF I'M
PERSONALLY NOT GOOD AT BUT
RECOGNIZE THAT, THAT IS HOW
FOLKS COMMUNITY AND OTHER THING
TO RECOGNIZE I THINK AND I'M
LEARNING IS THERE IS MANY, MANY
STEM EFFORTS. OKAY?
MANY STEM EFFORTS. WE NEED TO
INTERFACE WITH THOSE -- DO WE
HAVE TO START A DENTAL-SPECIFIC
PROGRAM?
SOME OF THOSE ARE FINE. OUR
REACH WILL BE SO MUCH BROADER IF
WE CAN GET TO THOSE STEM
PROGRAMS AND SAY CAN WE PROVIDE
A SESSION ON DENTAL; RIGHT?
>>THAT'S RIGHT.
>>CAN WE PROVIDE A SESSION ON
DENTAL? WE ARE WORKING NOW
ACROSS SOME OTHER INSTITUTES
HERE LIKE NIGMS IN HOPING THAT
WE CAN WORK, FOR INSTANCE, WITH
THE MARK PROGRAM AND THERE IS
[INDISCERNIBLE] WHICH IS NOT NIH
BUT THINK IT IS ASM. THEIR
SADNESS AND WHAT IS THE OTHER
ONE? THEIR SACKNESS IT THAT
TARNISHED CHICANO -- LET ME JUST
THINK. AMOCOMS. ANYWAY, LARGE
PROGRAMS WITH THOUSANDS OF
UNDERGRADS COMING IN WHO HAVE
SAID I WILL BE A SCIENTIST.
WELL, WHAT NEEDS TO HAPPEN IS
THEY NEED TO SAY, I WILL BE A
DENTAL SCIENTIST. I NEVER
THOUGHT ABOUT THAT BEFORE. WHAT
ARE WE DOING? WE ARE AT
MEETINGS AND AT BOOTHS AND SO
MANY BOOTHS AND SOMEBODY MIGHT
WALK BY AND MAYBE THEY WON'T.
IF WE ARE HIGHLIGHTED ON THE
PROGRAM AND WE HAVE THE STAGE
AND OPPORTUNITY TO SAY THIS IS
WHY THIS IS IMPORTANT FROM THE
EXTRAMURAL SIDE, IT WOULD BE
AWESOME. SO MANY OF US ARE
INVOLVED IN MEETINGS THAT ARE
NOT JUST DENTAL. I WON'T SAY
DENTAL. LOOK. YOU ARE A CANCER
GUY FOR INSTANCE. RIGHT? YOU
AT THE CANCER MEETING COULD TALK
ABOUT DENTAL RESEARCH AND
CANCER. WE CAN ALL TAKE UP THE
BANNER IN OUR VARIOUS -- IN OUR
VARIOUS FIELDS TO SAY WHY THIS
IS SOMETHING THAT YOU SHOULD
THINK ABOUT.
RIGHT?
>>UH-HUH.
>>I COULD DO THAT. NIDCR FUNDS
A WHOLE LOT OF VIROLOGY
RESEARCH. DOES THE VIROLOGY
COMMUNITY RECOGNIZE THIS IS THE
ORAL STUFF THAT IS ACTUALLY
DRIVING ALL OF THE DISCOVERIES?
NO.
SO, I THINK THAT IS ANOTHER
OPPORTUNITY FOR US IN TERMS OF
UNDERGRADS. THERE IS ALSO OTHER
PROGRAMS THAT ARE ALREADY
EXISTING. FOR INSTANCE
INCREASING DIVERSITY AND DENTAL
PROGRAM. THERE ARE PEOPLE WHO
WANT TO BE DENTISTS IN THE
UNDERGRAD ASDA PROGRAM OR
UNDERGRAD HISPANIC DENTAL
ASSOCIATION OR UNDERGRAD --
THESE ARE ALL OPPORTUNITIES FOR
US.
THEY ARE TO MAKE SURE WE ARE
ENGAGING THEM AND HAVING THEM
THINK ABOUT DENTISTRY. THAT IS
JUST NOT KNOWING. THAT IS MINE.
I DIDN'T REALLY THINK ABOUT
DENTISTRY UNTIL I WAS EXPOSED
LATER ON. IF WE AS A COMMUNITY
CAN WORK TOWARDS PROVIDING
ADDITIONAL EXPOSURES WHILE WE
HAVE OTHER HATS ON IS A VERY
GOOD WAY TO BRING THEM IN.
>>YEAH. THERE IS ALSO A
STRATEGIC WAY TO APPROACH IT
THAT WOULD SAY -- THAT IS
MULTIDIRECTIONAL. BECAUSE THERE
IS SOLE RELIANCE AND RESPONSIBLE
[INDISCERNIBLE] OF THE HEALTH
PROFESSION WE ARE THE ONLY
INSTITUTE THAT HAS THAT
RESPONSIBILITY OF THE
EDUCATIONAL AND CLINICAL SECTORS
THAT ARE BEING GUIDE THE TOWARDS
QUALITY DISCOVERIES.
I WOULD SAY RAUL, WHEN YOU WOULD
REMEMBER THE FIRST COUNCIL
MEETING WHEN I -- WHEN WE TALK
THE ABOUT THAT PUBLIC/PRIVATE
PARTNERSHIP.
>>WE TALKED ABOUT.
>>ALL ARE WORKING FROM VARIOUS
ECOSYSTEMS TO FERTILIZE THEIR
FIELDS BUT WE WOULD COME IN AND
DIRECT THAT TOWARDS BIOMEDICAL
RESEARCH. WE DO NEED THAT. WE
CAN'T HAVE 2.4% OF DENTISTS IN
THE COUNTRY AFRICAN-AMERICAN AND
ADMISSIONS INTO DENTAL SCHOOLS
LESS THAN 5% FOR ALL
UNDER-REPRESENTED GROUPS EXCEPT
ASIAN AMERICANS HISPANICS ARE
DOING A LITTLE BETTER INCLUDING
INVESTMENT CRITERIA AND
INVESTMENTS AND PARTNERSHIPS
WORKING TOGETHER WITH ALL THESE
STAKEHOLDERS.
>>YES. SHARING EXPERIENCE
PIPELINE IS VERY IMPORTANT. ON
OTHER HAND WHEN YOU LOOK AT SOME
ECOSYSTEM DENTAL SCHOOL WHETHER
HOWARD OR UNIVERSITY OF
MISSOURI, THEY HAVE ALREADY A
HUGE NUMBER OF, YOU KNOW,
MINORITY STUDENTS.
QUESTION IS OVERALL PERCENTAGES
ARE LOW. THERE IS LOT OF THE,
YOU KNOW, MINORITY STUDENTS
ALREADY IN THE SCHOOL. USUALLY
SCHOOLS MAY NOT HAVE A STRONG
PROGRAM AND SOLUTING NIH IS NOT
DEVELOPING MORE MECHANISM.
RECENTLY, YOU KNOW, FOR SIZE FOR
EXAMPLE APPLYING THIS RICH
APPLICATION AND THAT WOULD
DEMAND TO YOU YOU HAVE TO HAVE
YOU KNOW MINORITY PARTNER. WE
WRITE TO 10 DENTAL SCHOOLS AND
EVERY ONE OF THEM RESPONDS
POSITIVELY. THEY REALLY HELP US
TO TAKE A LOT. IF I WAS
WONDERING FROM NIDCR POINT OF
VIEW IF WE DEMAND ONE TYPE OF
RO1, YOU HAVE TO HAVE SOMEBODY,
YOU KNOW?
YOU CAN SOLVE DIVERSITY ISSUE
AND THAT WOULD BE GETTING MORE
PEOPLE IN DENTAL FIELD ALREADY.
THEY ARE PUSHING THEM GETTING
THEM TO ROOET SEARCH.
>>YEAH. I APPRECIATE THAT
COMMENT. ONE THING THAT IS
HAPPENING TOO IS THERE ARE
TARGETED INITIATIVES TO HELP
BUILD CAPACITY AT THOSE
INSTITUTIONS.
RIGHT NOW, THERE IS TWO, TWO FOR
DENTAL. AND IT THAT IS JUST --
THEY HAVE REALLY BEEN PROVIDING
MAJORITY OF DENTISTS THAT GO
INTO THE COMMUNITIES THAT IS
JUST NOT ENOUGH IN TERMS OF WHO
ARE DISEASES AND BURDEN OF
DISEASE AND THINK THAT AS
RESEARCH CAPACITY IMPROVES AND
AS WE WRITE TARGETED
MECHANISMSES AND BEING
THOUGHTFUL IN THAT WAY COULD
CERTAINLY HELP, I AGREE WITH
YOU. AND TO ENSURE THAT THOSE
FOLKS HAVE ALSO OPPORTUNITIES TO
DO RESEARCH. OFTEN TIMES THEIR
SCHOOLS MAY NOT HAVE OPTIMAL
INFRASTRUCTURE.
>>YEAH. I WAS FEELING MORE
[INDISCERNIBLE]. IF YOU LOOK AT
ADMISSION CRITERIA FOR SCHOOLS
IT THAT YOU SEE THAT HAVE LARGE
UNDER-REPRESENTED GROUPS,
RESEARCH IS NOT PART OF IT,
GUARANTEED. THEY MAY SAY IT IN
STATEMENT OR MENTIONED IN
INTERVIEW BUT IS CERTAINLY NOT
SELECTION CRITERIA THAT IS
COMMONLY USED BY DENTAL SCHOOLS.
>>I HATE TO INTERRUPT.
>>I KNOW.
>>WE CAN GET INTO THIS.
>>YEAH.
>>THIS IS A VERY RICH
DISCUSSION. UNFORTUNATELY, WE
HAVE TO MOVE ON TO THE NEXT
SPEAKER.
>>YEAH.
>>I THINK THIS IS SOMETHING WE
CAN CONTINUE IN A COUNCIL
DISCUSSION THIS AFTERNOON TO
RENA AND COUNCIL MEMBERS.
WE HAVE SOME TIME.
>>ABSOLUTELY.
>>NEXT SPEAKER WE HAVE IS FIRST
GUEST SPEAKER FOR TODAY. NIHOW
BONNET --
>>THANK YOU SO MUCH FOR THE
INVITATION. AND I WILL STOP MY
PRESENTATION.
SO, MY NAME IS NIHAL BONNET. I
WILL PRESENT TO YOU TODAY RECENT
WORK WE REPORTED SHOWING ANTERIC
VIRUSES NORRO VIRUS AND ROTO
VIRUS REPLICATE IN SALIVARY
GLANDS AND TRANSMIT THROUGH
SALIVA TO OTHER INDIVIDUALS AND
STARTING OUT BY ACKNOWLEDGING MY
LAB DID THIS WORK AND ALSO OUR
COLLABORATORS MATTHEW HOFFMAN
AND JH UREVENI WITHOUT WHOSE
GUIDANCE AND RESOURCES NONE OF
THIS WORK WOULD BE POSSIBLE AND
SHOUTOUT TO THEM AND THEIR LABS
FOR THIS WORK AND QUICK
INTRODUCTION TO YOU ABOUT MY LAB
AND I'M AT A LAB AND OVERALL
THEME OF LAB IS UNDERSTANDING
WHAT VIRUSES DO TO INFECT YOU
AND STRATEGIES THEY USE TO
INFECT YOU AND THIS WORK WE HAVE
BEEN USING MY LAB IS
MULTI-DISCIPLINARY AND WE USE
TOOLS AND INFORMATION FROM CELL
BIOLOGY AND VIROLOGY AND
IMMUNOLOGY AND PUBLIC HEALTH AND
ENVIRONMENTAL ENGINEERING. IN
MY LAB YOU HAVE REPRESENTATIVES
FROM AREAS WHO ARE WORKING AT
ANY GIVEN TIME IN A
COLLABORATIVE INTERDISCIPLINARY
MAN
MANNER.
LOOKING AT VIRAL STRATEGIES USE
THE FOR TRANSMISSION, WE LOOK AT
IT IN TWO LEVELS ONE IS
INTRACELLULAR FROM CELL TO CELL
HOW VIRUSES EGRESS AND WHAT THEY
HAVE TO DO TO SUCCESSFULLY
INFECT ANOTHER CELL AND
INTERORGANIZIS MAL WHAT
STRATEGIES AND VIRUSES ARE USE
TODAY TRANSMIT THEMSELVES
EFFICIENT IN POPULATION AND
TODAY'S TALK WILL FOCUS ON
LATTER. THE VIRUSES FOR THOSE
WHO MAY NOT BE FAMILIAR ARE RNA
VIRUSES INFECTING NOT ONLY
HUMANS BUT ANIMALS IN PARTICULAR
LIVESTOCK. COMBINED THESE THREE
VIRUSES ARE ANTERIC VIRUSES THAT
EFFECT GLOBALLY 1.5 BILLION
HUMANS PER YEAR AND PROPORTION
OF INFECTIONS ARE LARGE IS
REPRESENTED IN THIS BAR GRAPH OR
EXCUSE ME. THIS PIE GRAPH IN MY
POINTER AND NORRO VIRUS MAKES UP
MAJORITY OF INFECTIONS OF 750
MILLION PEOPLE A YEAR GET
INFECTED WITH NORRO VIRUS AND
THE REST IS SPLIT BETWEEN ROTA
VIRUS AND ASTO VIRUS AND THESE
ARE MORBIDITY ASSOCIATED WITH
ENTERIC DISEASE AND WITH YOUNG
CHILDREN AGE OF 5 AND ELDERLY
AND IN ADDITION THEY INCUR LOTS
OF ECONOMIC COSTS DUE TO
LIVESTOCK INFECTIONS AND PEOPLE
MISSING WORK BECAUSE OF
SIGNIFICANT DIARRHEA SYMPTOMS
ASSOCIATED WITH DISEASES.
THESE VIRUSES HAVE ALL BEEN
ASSUMED AND DEMONSTRATED TO
REPLICATE IN INTESTINES OF
HUMANS AND ANIMALS AND SHED INTO
FECES TRANSMITTED BY FECAL ORAL
ROUTE TO OTHER HOSTS VIA FECAL
CONTAMINATION OF HANDS AND WATER
AND PUBLIC HEALTH PRACTICES USED
ACROSS THE GLOBE LIMIT FECAL
ORAL ROUTE OF TRANSMISSION OF
THE VIRUSES.
IN MANY I LAB WE HAVE BEEN
STUDYING ANTERIC VIRUSES FOR
MANY YEARS.
MOSTLY THERE HAVE BEEN MOSTLY
EX-VIVO AND IN VIVO STUDIES AND
RECENTLY SWITCH THE TO ANIMAL
MODELS TO LOOK AT INFECTION AND
PATHOGEN ESIS AND TRANSMISSION
OF VIRUSES AND CURRENTLY MAIN
INFECTION MODEL USED FOR THESE
OR TO STUDY VIRUSES ACROSS THE
WORLD IS SUPPLING PUP ANIMAL
MODEL INFECTION. THIS IS VERY
YOUNG PUPS THAT ARE ABOUT 10
DAYS OLD OR LESS WHO HAVE
SUCKLING FROM THEIR MOTHER AND
ARE ORALLY INOCULATED WITH
ANTERIC VIRUSES THAT VIRUSES
DROPPED INTO MOUTH AND ANIMALS
SWALLOW VIRUSES AND PUT BACK ON
MOTHERS TO SUCKLE THEY ARE AT
VERY YOUNG AGE AND PRIMIARY
REASON WE USE THIS MODEL SYSTEM
IS PUPS HAVE VERY IMMATURE
IMMUNE AND DIGESTIVE SYSTEMS AND
ARE PRONE TO INFECTION MUCH LIKE
IN HUMANS VERY YOUNG IS
ESPECIALLY VULNERABLE TO THESE
INFECTIONS.
WHAT YOU SEE IS AFTER YOU DO
THIS EXPERIMENT AND INOCULATE
PUPS ORALLY WITH THE VIRUSES IS
WITHIN THREE DAYS YOU GET
MASSIVE INTESTINAL INFECTION
WITH THE VIRUSES ON LEFT IN THE
BLUE IS QUANTITY FICTION OF THE
VIRAL LOAD IN THE INTESTINE AND
ORAL INOCULATION AT TIME 0 AND
ON THE RIGHT IS INTESTINAL LODE
OF ROTA VIRUS AT INOCULATION AND
SHARP RISE IN VIRAL REPLICATION
AND LOAD IN THE ININDICATING
INFECTION. THIS INFECTION
EVENTUALLY CLEARS SO BOTH IN
NORRO VIRUS INOCULATED PUBS AND
ROTA VIRUS INOCULATED PUPS YOU
SEE AFTER 5 DAYS THIS VIRUS
DECREASES IN ANIMALS AND LOOKING
AT INTESTINES OF THE PUPS TO SEE
WHAT IS THERE IN ADDITION TO
VIRUS WE SEE A RISE IN
INTESTINAL SEC RECEIPTORY IGA
LOAD IN THE INTESTINE OF THE
PUPS SIGA IS IMPORTANT ANTIBODY
IT THAT IS IN THE PUPS AND IS
ABUNDANT IN SALIVA AND ROLE IS
TO HELP TO CLEAR INFECTIONS OR
BACTERIAL OR VIRAL INFECTIONS.
WE SEE CORRELATING WITH TIME OF
CLEARANCE OF INFECTION FROM PUPS
INTESTINES WE SEE A RAPID RISE
IN IGA LEVELS.
PUPS THAT I MENTIONED EARLIER
HAVE VERY IMMATURE IMMUNE
SYSTEMS.
THEY CAN'T MAKE THEIR OWN IGA
YET BECAUSE OF THEIR AGE. IGA
IT THAT WE SEE IN LUMIN OF THE
INTESTINES COMES FROM THE
MOTHER'S MILK. IF WE TAKE MILK
FROM MOTHERS BREASTFEEDING THE
PUPS WE SEE A SIMILAR RAPID RISE
IN MOTHER'S IGA LOAD IN HER MILK
IN RESPONSE TO HER PUP'S
INFECTION AND BLUE AND ORANGE
BARS HERE ARE SIMPLY JUST
QUANTITY FICTION OF THE MILK
FROM THE P MOTHERS WHO WERE
EITHER BREASTFEEDING THE NORRO
VIRUS INOCULATED PUPS IN BLUE OR
ROTA VIRUS INOCULATED PUPS IT
THAT ARE IN ORANGE.
NOW, THIS RAPID RISE OR RISE IN
HER ANTIBODY LOAD IN HER MILK
WAS VERY INTERESTING TO US.
THESE MOTHERS HAD NEVER SEEN A
ROTA VIRUS OR NORRO VIRUS BEFORE
THEY WERE 0 FOR THESE VIRUSES
THEMSELVES BUT RATE AT WHICH
THEY BUMPED UP IGA PRODUCTION IN
RELEASE INTO THEIR MILK WAS
SUPER FAST AS IF THEY HAD SEEN
IT BEFORE. THEY HAD NOT. WE
HAD TESTED THESE AND SOMEHOW
THEY WERE SENSING INFECTION IN
THEIR PUP IN RESPONSE.
>>[INDISCERNIBLE].
>>OKAY. OKAY. GOOD.
>>AND SO WE DECIDED TO SORT OF
DELVE INTO THIS AND TRY TO
UNDERSTAND WHAT COULD BE MAKING
THE MOTHER ENHANCE THE -- HER
IGA PRODUCTION TO HELP CLEAR THE
VIRUS FROM HER PUPS?
WE EXTRACTED MAMMARY GLANDS FROM
THE MOTHERS AND LOOKING INTO
THEM WE SAW VIRAL INFECTION WITH
VERY SAME VIRUSES.
NORA VIRUS IN THIS CASE AND IN
MILK DUCT EPITHELIAL CELLS AND
PLASMA CELLS AND WE SAW ROETA
VIRUS IN HER AND THIS WAS A
SURPRISE TO US. UP TO THIS
POINT ONLY INTESTINES WERE KNOWN
TO BE SITES OF REPLICATION AND
INFECTION IN THE VIRUSES AND
SEEING IN MOTHER'S MAMMARY
GLANDS AND VIRUSES AND IS
QUANTITY FICTION OF THE LEVEL OF
VIRUSES IN THE MOTHER'S MAMMARY
GLANDS INDICATING ITS VERY
SIGNIFICANT RISE. HOW DID THE
VIRUS GET TO THE MOM'S MAMMARY?
THIS WAS THE BIG QUESTION AND
VIRUS GETTING INTO MOM'S MAMMARY
WAS TRIGGERING IGA RESPONSE AND
LEADING TO IGA TO FLOW INTO HER
PUPS WITH BOUND 2 VIRUSES AS
WELL FROM HER MILK HELPING TO
CLEAR INFECTION.
SO WE WANTED TO FIRST RULE OUT
WHETHER THE VIRUS GOT TO THE
MOTHER'S BREAST THROUGH THE
CONVENTIONAL WAY MEANING WHAT IF
MOTHERS INGESTED SOME OF THE
FECAL MATTER OF PUPS THAT HAD
BEEN SICK AND GOT INFECTED IN
THEIR INTESTINE AND FROM THE
INTESTINE THE VIRUS TRANSFERRED
TO THE BREAST AND TO RAUL THIS
OUT WE DIDN'T EXPERIMENT BUT
DIRECTLY INOCULATED MOTHERS
ORALLY WITH VIRUSES AND LOOKED
TO SEE IF THERE WOULD BE
INFECTION IN THEIR MAMMARY
GLANDS ANSWER WAS NOW WHILE
INTESTINES WERE INFECTED MAMMARY
GLANDS WERE NOT INFECTED WITH
THIS VIRUS AND BREAST MILK IGA
LEVELS NO CHANGE IN BREAST MILK
IGA OR RAPPING UP IGA. IS IT
THROUGH SALIVA AND PUPS THAT ARE
INFECTED BE SENDING A VIRAL
SIGNAL OR ANOTHER SIGNAL FROM
THEIR SALIVA AS THEY ARE
BREADBREASTFEEDING IT THAT IS
TRANSFERRING VIRUS TO MOTHER'S
BREAST AND PROMPTING MOTHER TO
RAPIDLY MAKE SEC RECEIPTARY IGA
IN HIR MILK THIS DIDN'T KONL OUT
COMPLETELY OUT OF THE BLUE IN
HUMANS IT IS VERY CONTROVERSIAL
BUT IDEA WHEN HUMANS BREASTFEED
SIGNALS ARE SENT FROM BRAEFLT
FEEDING INFANT TO THE MOTHER'S
BREAST ALLOWING MOTHER TO MAKE A
RAPID IMMUNE RESPONSE TO
WHATEVER THE BABY IS SUFFERING
FROM OR WHATEVER THE INFECTION
IS.
AND IT THIS IS CONTROVERSIAL.
THERE IS REALLY GOOD DIRECT
EVIDENCE FOR THIS. IN VIRUSES
PEOPLE HAVE USED TO STUDY THIS
HAVE BEEN TYPICALLY RESPIRATORY
VIRUSES OF BABIES WHERE MOTHERS
SUDDENLY MAKE ANTIBODIES TO
RESPIRATORY VIRUS AND CAVEAT OF
EXPERIMENTS HAS BEEN BECAUSE IT
IS A RESPIRATORY VIRUS IT COULD
EASILY BE THAT THE MOTHER INHALE
THE PATHOGENS FROM THE BABY
BECAUSE IT IS A CLOSE CONTACT
SITUATION AS YOU BREASTFEED AND
THEREFORE MAKE ANTIBODIES AFTER
INHALING VIRUS HERSELF RATHER
THAN IT COMING FROM ACT OF
BREASTFEEDING INTO HER BREAST
AND PEOPLE HAVE LOOKED AT
ULTRASOUND STUDIES ON
BREASTFEEDING PROCESS AND IN
HUMANS THEY SEE IN MILK
INJECTION MILK PRESSURE
INCREASES THAT IS IN THIS MILK
DUCT HERE IN THE UPRISE AND MILK
FLOWS TOWARDS NIPPLES AND BABY'S
HOUSE OXYTOCIN WEARS OFF MILK
PRODUCTION DECREASES AND -- AND
IT HAS BEEN PROPOSE THE MILK
FLOW BACKWARDS WILL LIKELY BRING
TOGETHER WITH IT ANY SALIVA FROM
THE BABY'S MOUTH THAT IS IN THE
NIPPLE AREA. WITH THAT IN MIND
WE THOUGHT REASONABLE HYPOTHESIS
LET'S SEE IF ANY VIRUSES ARE IN
THE SALIVA OF THEM. WHEN WE
COLLECTED SALIVA FROM ANIMALS WE
INDEED COPIOUS AMOUNTS OF VIRUS
IN THE SALIVA OF THE ANIMALS
THAT HAD BEEN INOCULATED AND DID
A FOLLOW UP EXPERIMENT TO REALLY
TEST THIS IDEA OF SALIVA AND PO
POSSIBLY MILK SPREADING
INFECTION BETWEEN MOTHERS AND
PUPS BY TAKING TWO SETS OF
MOTHERS IN SEPARATE CAGES WHERE
ONE SET OF PUPS OF ONE MOTHER
WERE ORALLY INOCULATED WITH ROTO
VIRUS IN THIS CASE AND PUT BACK
ON TO THEIR MOTHERS AND 24 HOURS
LATER TWO MOTHERS WERE SWAPPED
AND THEN TWO DAYS LATER ALL
TISSUES WERE HARVESTED FROM BOTH
SETS OF PUPS AND BOTH SETS OF
MOTHERS AND WE SAW WIDESPREAD
DISSEMINATION OF THE VIRUSES
FROM BETWEEN BOTH MAMMARY GLANDS
OF BOTH MOTHERS TO INTESTINES OF
THE PUPS REALLY SUGGESTING
COMBINATION OF SALIVA AND MILK
COULD SPREAD ENTERIC VIRUSES
AMONG MOTHERS AND INFANTS. WHEN
WE SAW SALIVA OF THE PUPS WE
WANTED TO KNOW IF SALIVARY GLAND
WAS REPLICATING THE VIRUS AND --
INOCULATED WITH NORRO VIRUS ROTA
VIRUS AND LEVELS OF REPLICATION
OF EACH OF THE VIRUSS IN THE
SALIVARY GLANDS WAS ON PAR WITH
REPLICATION OBSERVED IN COLON
AND SMALL INTESTINE POUND FOR
POUND AND MOREOVER WHEN WE LOOK
THE AT REPLICATION OF THE MORE
PERSISTENT STRAINS OF NORRO
VIRUSES SUCH AS MMB3 WE FOUND
THEY WERE EQUALLY AS PERSISTENT
IN THE SALIVARY GLAND AS THEY
WERE IN THE COLON AND SIMILARLY
EQUALLY AS PERSISTENT BEING SHED
INTO THE SALIVA AS THEY WERE
INTO THE FECES. THEY WERE THREE
SEPARATE PERSISTED NORRO VIRUS
STRAINS.
LOOKING AT TISSUE IN THESE
ANIMALS NORRO VIRUSES
PERSISTENTLY REPLICATE -- ASTO
VIRUSES WE HAVE NOT STUDIED THIS
YET. FINALLY, FROM THE WORK, WE
STARTED TO THINK ABOUT HOW WE
COULD USE SALARY CELLS AND
ORGANOIDS TO GROW VIRUSES
EX-VIVO. THE NORRO VIRUSES AND
ROTA VIRUSES HAVE BEEN EXTREMELY
DIFFICULT TO GROW EX-VIVO. WE
USED MATT HOFFMAN'S GROUPS
DEVELOPED SPHEROID ORGANOID
SYSTEM TO SEE IF WE COULD GROW
NORRO VIRUS AND ROTA VIRUS AND
-- EX-VIVO IN ANYTHING OTHER
THAN HUMAN INTESTINAL
[INDISCERNIBLE] AND IDENTIFIED
HUMAN SALIVARY SELL LINE AND
TEAR CELL LINE THAT COULD
EFFICIENTLY REPLICATE HUMAN
NORRO VIRUS WITH ADVANTAGE THIS
IS A SIMPLE CELL CULTURE SYSTEM
EASY TO POPPOGATE AND IS QUITE
INEXPENSIVE. TAKE-HOME MESSAGES
FROM THE TALK ARE IT THAT
SALIVARY GLANDS ARE AN IMPORTANT
REPLICATION SITE FOR ENTERIC
VIRUSES NORRO VIRUS ASTO VIRUS
AND ROTA VIRUS AND THEY ARE
ENTERIC VIRUSES AND IT MAKES IT
REALLY INTERESTING THAT THESE
VIRUSES CAN ALSO BE FOUND IN
SALIVA AND REPLICATING SALIVARY
GLANDS AND SUCKLING INFECTED
INFANTDS THROUGH SALIVA BACKWASH
WE HAVE SHOWN CAN TRANSFER
ENTERIC VIRUSES TO MOTHER'S
MAMMARY GLANDS AND -- INFECTION,
THIS IS REALLY THE ENTERIC
VIRUSES OUR STUDIES GIVE MORE
CREDENCE TO THIS IDEA IN HUMANS
THAT THERE IS BACKWASH, SALIVARY
BACKWASH MIGHT SIGNAL TO THE
MOTHER AND FIRST TIME VIRUS HAS
BEEN USED THAT IS NOT
RESPIRATORY AND THUS IS IMMUNE
FROM SOME CAVEATS THAT WERE
AGAINST SALIVARY BACKWASH IDEA
AND FINALLY EX-VIVO SALIVARY
ORGANOIDS AND CELL LINES ARE
REALLY WE THINK THEY ARE REALLY
IMPORTANT AND WILL HELP A LOT OF
PEOPLE TO PROPAGATE ENTERIC
VIRUSES IN CULTURE AND USE THEM
ESPECIALLY CELL LINES USE THEM
FOR VACCINE DEVELOPMENT AND
ANTIVIRAL DEVELOPMENT AND NOW
FOR NORRO VIRUS THERE IS NO --
WE BELIEVE THEY WILL BE
IMPORTANT CULTURE SYSTEMS FOR
DEVELOPMENT OF THERAPEUTICS.
SO, I WANT TO LEAVE YOU WITH
OPEN QUESTIONS.
SO, WHAT ABOUT ENTERIC VIRUS
TRANSMISSION AMONG HUMANS?
SOMETHING THAT WE ARE FOCUSING
ON NOW AND ARE DOING EXPERIMENTS
WITH OVERSEAS GROUP THAT HAS
AUTOPSY SAMPLES FROM CHILDREN
AND SALIVARY GLANDS THAT HAVE
DIED FROM NORRO VIRUS AND I'M
HAPPY TO REPORT THAT JUST
YESTERDAY WE GOT DATA FROM THEM
SHOWING THEY ARE ACTUALLY
POSITIVE FOR NORRO VIRUS.
THERE IS ACTUALLY SALIVARY IN
THE HUMAN NORRO VIRUS ABTD
SALIVARY GLANDS OF CHILDREN WHO
HAVE PASSED AWAY FROM IT. THIS
IS REALLY IMPORTANT. MORE DATA
LIKE THIS WILL POTENTIALLY
REVISE PUBLIC HEALTH PRACTICES
THAT ARE BEING USED.
I JUST WANT TO THROW IT OUT
THERE THAT, NORRO VIRUS AND ROTA
VIRUS HAVE FREQUENTLY BEEN FOUND
IN SALIVA. IT HAS ALWAYS BEEN
CHALKED UP TO CONTAMINATION FROM
GUT VIA VOMITING AND RECENT
RESULTS WE GOT FROM HUMAN
SALIVARY GLANDS FROM AUTOPSY
PATIENTS HAVE REALLY SPECIAL
VALUE BECAUSE THEY ARE NOT
SALIVA DIAGNOSTIC BUT PER ACTUAL
TISSUE EVIDENCE OF VIRAL
REPLICATION TAKING PLACE AND
THIS IS SOMETHING THAT WE ARE
VERY INTERESTED IN FOLLOWING UP
ON AND WE HAVE PRELIMINARY
EVIDENCE THAT WE REPORTED WHERE
WE REMOVED PARTIALLY SALIVARY
GLANDS FROM MICE PRIOR TO
INOCULATING THEM WITH NORRO
VIRUS FINDING INTESTINAL INTECHS
CLEARED FASTER THIS IS NOT TOTAL
REMOVAL OF SALIVARY GLANDS BUT
SUBMANDIBULAR GLANDS TAKEN OUT
AND IN PINK HERE COURSE OF
INFECTION IN INTESTINE OF
ANIMALS WHERE SALIVARY GLAND HAS
BEEN REMOVED AND IN BLUE IS
COURSE OF INFECTION IN INTESTINE
WHERE SALIVARY GLAND IS IN TACT
WITH ANIMALS THERE IS A FASTER
DECREASE OF VIRAL LOAD FROM
INTESTINE AND WHEN SALIVARY
GLAND IS INFECTED AND ONE
SWALLOWS SALIVA. INFECTION
TRYING TO BE CLEARED FROM
INTESTINES SALIVA COMING DOWN
REPOPULATES GUT AND
REESTABLISHES INFECTION AND
CLEARS FASTER WHEN SALIVARY
GLAND IS EXTRACTED AND CAN THEY
BE SHED IN SALIVA ASIM TOMORROW
ATICALLY AND RABIES FOR INSTANCE
SALIVA COULD HAVE RABIES VIRUS
UP TO TWO WEEKS BEFORE ANY
CLINICAL SYSTEMS THAT APPEAR IN
THE INDIVIDUAL. IT WILL BE VERY
INTERESTING TO KNOW IF THERE ARE
VIRAL SHEDDING IN SALIVA BEFORE
ANY REAL DIARRHEA SYMPTOMS
APPEAR AND RELATE THE TO THIS
POTENTIALLY SALIVA COULD BE NICE
DIAGNOSTIC TOOL FOR ENTERIC
VIRUSES NOW BUT IS THROUGH FECAL
TESTING THAT IS LABORIOUS AND
NOT MANY PEOPLE WANT TO DO IT.
SALIVA COULD BE AN EASIER
DIAGNOSTIC TOOL.
I WANT TO END THERE AND TAKE
QUESTIONS YOU HAVE. THANKS SO
MUCH FOR YOUR TIME.
>>THANK YOU SO MUCH FOR YOUR
PRESENTATION AND ARE TWL ANY
QUESTIONS?
>>YEAH. VERY EXCITING.
AS YOU KNOW ONLY FDA-APPROVED
PRODUCT FOR SALIVA DIAGNOSTICS
PREVIOUSLY HAVE HIV TEST FROM
[INDISCERNIBLE] AND FROM RED X
PROGRAM NOW 20-SOME YOU KNOW
APPROVED PRODUCT FOR COVID-19
TEST. ALL THOSE TECHNOLOGY ARE
VARIABLE DETECTING VIRUSES
SALIVA AND TO DO THAT. THIS IS
BESIDES HPD, YOUR STUDY IS
ADDING MORE, YOU KNOW, THOSE
BIOMARKERS WHO HAVE IMMEDIATE
VALUE FOR SALIVA DIAGNOSTICS.
VERY EXCITING AND WE WILL REACH
OUT TO YOU MORE IN THE CHAT
ABOUT THAT.
>>THANKS SO MUCH.
>>JENNIFER.
>>THANKS FOR A GREAT TALK HAVE
YOU LOOKED AT ORAL MIKE CUESAL
RESPONSES AND THIS MIGHT BE
DIFFERENT AND CHALLENGE STUDY TO
THOSE PEOPLE MORE SUSCEPTIBLE TO
INFECTION BASED ON EXISTING
IMMUNITY? SFWL GREAT QUESTIONS
AND FIRST PART OF QUESTION IS WE
ARE ACTUALLY DOING THOSE
EXPERIMENTS RIGHT NOW AND ARE
LOOKING AT SALIVARY GLANDS AND
ANIMAL MODELS DOING IMMUNE
PROFILING OF CYTOKINE CHEMOKIND
PRODUCTION IMMUNE CELL
POPULATIONS AND ONE THING WE
NOTICED REALLY SURPRISING TO US
IF IN THE SAME ANIMAL WHERE
INFECTION IS TAKING PLACE. THE
INTESTINES JUST LOOK LIKE A
MESS.
SALIVARY GLANDS, YOU WOULD NOT
KNOW IF THERE WAS ANY INFECTION
IN THE SALIVARY GLANDS.
THERE IS MASSIVE INFECTION THERE
WHEN STAINING IT WITH VIRAL
MARKERS AND WOULD LIKE TO KNOW
WHAT IS IT THAT THE VIRUS IS
DOG?
HOW IS IT PLAYING WITH TOLLER
GENIC POTENTIAL IMMUNITY IN
SALIVARY GLAND TO BRING THIS
ABOUT. IT THAT IS WHAT WE ARE
LOOKING AT NOW. SORRY.
>>THAT IS GREAT. TWO QUICK
FOLLOW UPS ONE IN TERMS OF
IMMUNE RESPONSE ARE YOU LOOKING
AT SYSTEMIC ITGA AND WHAT IS
HAPPENING AT MUCOSAL
[INDISCERNIBLE].
>>ABSOLUTELY.
>>AND SALIVARY GLANDS ABLE TO
MAINTAIN THEMSELVES I WONDER
ABOUT LOOKING AT INNATE IMMUNE
RESPONSES AND ANTI-MICROBIAL
PEPTIDES THERE IN ABUNDANCE.
>>YES.
>>LOTS OF PROTECTION AGAINST
HIV PER-SE WITH SLIPPY AND BETA
DEFENSE SYSTEMS AND OTHERS AND
SO MUCH HAPPENS IN HERE WITH
REGARDS TO MANY TYPES OF VIRUSES
AND PEOPLE CAN MAINTAIN THEIR
MUCOSAL -- [NO AUDIO].
>>NORRO VIRUS INFECTION OR
OTHER ENTERIC INFECTION WOULD IT
CLEAR FASTER FOR THEM? I WOULD
PREDICT SO. I TRIED TO LOOK FOR
DATA IN THE LITERATURE AND
COULDN'T FIND ANY. SO PEOPLE
WHO HAVE -- YES? GO AHEAD.
>>GREAT QUESTION I'M SO EXCITED
ABOUT IT HAPPY TO TALK TO YOU
ABOUT IT AFTERWARDS AND ANOTHER
GROUP TO LOOK AT ARE PEOPLE WITH
HIV. I'M SURE THAT SOMEBODY IS
FOLLOWING NORRO VIRUS AND HIV;
RIGHT?
>>RIGHT.
>>THOSE FOLKS HAVE OFTEN
DIMINISHED SALIVARY GLAND
FUNCTION AND HAVE THIS SALIVARY
GLAND DISEASE LOOKS LIKE
[INDISCERNIBLE] BUT INFILTRATE
IS A LITTLE DIFFERENT AND GOOD
POPULATION AS WELL YOU MIGHT BE
ABLE TO LOOK BACK AT RETROSPECT.
>>YEAH. MIGHT BE MORE DATE AON
THAT BECAUSE OF HIV ASPECT.
>>ONE MORE QUESTION FROM JOEL
COLLIER.
>>GREAT TALK I ENJOY. WONDER
IS THERE ANYTHING I HAVE TWO
SMALL QUESTIONS. IS ANYTHING
SORT OF IMMUNOLOGICALLY UNIQUE
OR NOTICEABLE ABOUT THE QUALITY
OR QUANTITY OF THE IGA IT THAT
THE MOTHER PROVIDES THAT
REFLECTS THIS NEW ROUTE THAT YOU
HAVE FOUND?
>>THIS IGA IS NONSPECIFIC SEC
RECEIPTORY IGA. INITIALLY WE
WERE LIKE IT IS NONSPECIFIC BUT
ARE READING LITERATURE AND THERE
IS ACTUALLY NOT -- [NO AUDIO].
>>WE DON'T UNDERSTAND HOW IT IS
DOING IT. WE ARE LOOKING AT
LACTOFERIN AND OTHER THINGS IN
THE MILK THAT MIGHT BE BOOSTED
WE LOOKED AT IGA AND IGG AND IGM
BUT OTHER THINGS COULD BE
ACTUALLY INSTRUMENTAL IN
CLEARING THE INFECTION AND WE
ARE NOW DOING A MUCH MORE
COMPLETE ANALYSIS AND IN
ADDITION WE PROCURED HUMAN MILK
SAMPLES FROM PERU FROM MOTHERS
WHO HAVE BEEN BREASTFEEDING
NORRO VIRUS INFECTED INSF FANTS.
THERE IS A WHOLE COHORT OF
PATIENTS AND COLLABORATION OF
WOMEN IN JAPAN MONITORING THEM
OVER TWO YEARS DURING
BREASTFEEDING SOME HAVE GOTTEN
NORRO VIRUS DURING THIS TIME
COLLECTED BREAST MILK AND SALIVA
AND FECAL MATTER FROM INFANTS
AND LOOKING AT SAMPLES TO SEE
WHAT IS GOING UP AND FIRST IS
THERE VIRUS IN THE MILK AND WHAT
OTHER [INDISCERNIBLE] ARE GOING
UP.
>>THANK YOU.
>>IT THAT IS REALLY EXCITING.
TIME FOR LAST ONE OR MONTH OF
ON.
>>I WILL ANSWER VERY QUICKLY.
>>YOU MENTION THE VERY END OF
YOUR TALK THINKING ABOUT
VACCINES AND NEW ROUND SOMETHING
TO CONSIDER VACCINATING INFANT
TO RAZENATE WITH THE MOTHER TO
HAVE A BETTER RESPONSE WHAT
WOULD IT LOOK LIKE?
>>ABSOLUTELY. I'M THINKING
ABOUT THIS BARN ANY GRAHAM IS
DEVELOPING VACCINATING MOTHERS
SO ANTIBODIES COULD BE
TRANSFERRED TO THE BABIES AND
I'M THINKING THE SAME THING WITH
THE NORRO VIRUS IF THERE IS A
VACCINE THERE IS A WAY THAT
THESE ANTIBODIES COULD BE
TRANSFERRED TO THE BABIES
ESPECIALLY WHEN BABY IS SICK AND
NEEDS THE ANTIBODIES COULD
REALLY BOOST UP PRODUCTION.
YEAH.
>>EXCITING. THANKS.
>>VERY NICE. I WANT TO THANK
YOU. YOU ARE ON OUR LIST OF
INVITEES OR SPECIAL 75TH
SYMPOSIUM.
>>OKAY.
>>MOIR MORAL OF STORY IS PLEASE
READ CATALYST AND IF YOU FIND
ANYTHING INTERESTING BRING THEM
UP.
>>ABSOLUTELY.
>>I'M GLAD I DID.
>>THANK YOU. I WISH YOU A VERY
PRODUCTIVE DAY.
>>THANK YOU.
>>BYE.
>>THANK YOU FOR YOUR TIME.
>>OKAY. SO, OUR NEXT GUEST
SPEAKER IS DR. NATALIA CHALMERS
PRESENTING ON ORAL HEALTH IN
EVIDENCE AND DATA DRIVEN
APPROACH TO ACHIEVE BETTER
HEALTH EQUITY AND FISCAL
RESPONSIBILITY.
>>THANK YOU VERY MUCH FOR
HAVING ME AND THANK YOU FOR THE
COUNCIL FOR THIS INVITATION THAT
IS COMING HOME AND CLINICIAN AND
SCIENTIST IN ME IS SUPER EXCITED
AFTER THE LAST TALK.
WE CAN ALL RELATE AND ZOOM OUT A
LITTLE INTO THE PUBLIC HEALTH
SPHERE AND LOOK AT ORAL HEALTH
ACROSS THE LIFE SPAN AND HOW IT
IS ABOUT REALLY ACHIEVING HEALTH
EQUITY FISCAL RESPONSIBILITY AND
BETTER CLINICAL HEALTH OUTCOMES.
YOU HAVE BEEN SITTING BUT FEEL
FREE TO STRETCH.
I THINK IT WOULD BE GREAT TO
START BY LEVEL SETTING THE
INFORMATION ABOUT BENEFICIARIES
WE SERVE. SO, WE IN OUR
PROGRAMS AND IF IN MEDICAID
THESE ARE THE LATEST ENROLLMENT
NUMBERS THAT HAVE OVER 19
MILLION ENROLLEES AND 84 ON
MEDICAID AND 7 MILLION IN CHIP.
MEDICARE PROGRAM CLOSE TO 65
ENROLLEES AND 35 MILLION OF THEM
IN SECRET SERVICE AND 35 MILLION
IN MEDICARE ADVANTAGE AND CLOSE
TO 14.5 MILLION PEOPLE ACCESS
HEALTH COVERAGE THROUGH THE
MARKETPLACE. THIS IS TO LEVEL
SET 158 MILLION PEOPLE THAT ARE
EFFECTED BY THE CMS PROGRAMS AND
SHARING VISION AND STRATEGIC
PILLARS THAT GUIDE ALL OUR WORK.
THAT IS THAT CMS SERVES THE
PUBLIC AS A TRUSTED PARTNER AND
STEWARD DEDICATED TO ADVANCING
HEALTH EQUITY EXPANDING COVERAGE
AND IMPROVING HEALTH OUTCOMES
THESE ARE NOT IN RANDOM ORDER.
FIRST PILLAR HERE IS ADVANCING
HEALTH EQUITY ADDRESSING HEALTH
DISPARITIES UNDERLINING HEALTH
SYSTEM AND EXPANDING ACCESS AND
BUILDING ON AFFORDABLE KAIR ACT
EXPANDING ACCESS TO QUALITY
AFFORDABLE HEALTH CARE AND
ENGAGING WITH PARTNERS AND I
HEARD IN THE PREVIOUS REMARKS WE
-- IT WILL TAKE ALL OF US TO
ACHIEVE THESE GOALS.
THIS REALLY RESONATED. YOU
KNOW, DR. WEBSTER-CYRIAQUE
MENTION THE IT WILL REQUIRE
PARTNERSHIP AND, YOU KNOW, NEW
INITIATIVES IT THAT HAD NOT
EXISTED IF WE WERE TO CLOSE
THESE GAPS. AGAIN, THROUGH
POLICY MAKING PROCESS AND
IMPLEMENTATION STAYING CLOSELY
ENGAGED WITH PARTNERS AND
DRIVING INNOVATION WE HAVE
CENTERS FOR MEDICARE AND
MEDICAID INTERVENTION THAT
CHARTERED AMBITIOUS PLANS HOW TO
INNOVATE IN THE HEALTH CARE
SYSTEM AND HOW TO DEFINE
VALUE-BASED PERSON-CENTERED CARE
AND REMAINS FOR DEN TRYSTRY TO
DEFINE HOW TO BE PART OF THE
VALUE-BASED PROPOSITION. WHAT
IS VALUE-BASED DENTAL CARE?
THESE ARE QUESTIONS THAT I ASK
MYSELF AND I THINK VERY CLOSELY
OF HOW WE DEVELOP A
PERSON-CENTERED MODEL OF CARE
THAT IS VALUE BASED.
PROTECTING PROGRAM I HEARD
EARLIER MENTIONING WE ARE THE
RESPONSIBLE STEWARDS OF PUP LICK
FUNDS AND WITH THAT I TAKE IT
VERY SERIOUSLY. LAST ONE IS
FOSTERING EXCELLENCE IN OUR
PROGRAMS AND IN PROMOTING
EXCELLENCE WITH CMS. WE HEARD
THE TERM HEALTH EQUITY QUITE
OFTEN.
WE WILL COME TO THE SPACE WITH
OWN EXPERIENCES.
I WAS REALLY THRILLED THAT LAST
YEAR WE ACTUALLY DEFINE THE IT
AS PART OF OUR FIRST STRATEGIC
PLAN PILLAR.
THIS IS WHAT WE MEAN WHEN WE SAY
ACHIEVE HEALTH EQUITY. DEFINING
HEALTH EQUITY ATTAINMENT OF
HIGHEST LEVEL OF HEALTH FOR ALL
PEOPLE WHERE EVERYONE HAS A FAIR
AND JUST OPPORTUNITY TO OBTAIN
OPTIMAL HEALTH REGARDLESS OF
RACE, ETHNICITY, DISABILITY,
SEXUAL ORIENTATION GENDER
IDENTITY SOCIOECONOMIC STATUS
AND OTHER FACTORS AFFECTING
ACCESS TO HEALTH CARE AND
OUTCOMES AND ALL OF US IN THE
ORAL HEALTH RESEARCH FIELD KNOW
ALL THESE CAN BE BARRIERS
THROUGH ATTAINING ORAL HEALTH
SERVICES.
AS PART OF THE WORK, REALLY
EXCITING CMS LAUNCHING FRAMEWORK
FOR HEALTH EQUITY WITH 5
PRIORITIES WILL YOU HAVE ACCESS
TO THE LINKS AND ENCOURAGE YOU
TO LOOK AT ALL OF THEM. DATA IS
KEY EXPANDING COLLECTION
RECORDING AND ANALYSIS OF
STANDARDIZED DATA WE CAN CLOSE
GAPS IF NOT ABLE TO MEASURE GAPS
AND THAT IS REALLY AT THE HEART
OF ALL THIS. THINKING ABOUT
ACCESS AND WHERE THEY ARE IN OUR
PROGRAMS AND HOW TO ADDRESS
THESE INEQUITIES AND BUILDING
CAPACITY OF HEALTHCARE
ORGANIZATIONS AND WORKFORCE.
WAYS SO PLEASED TO HEAR EFFORTS
THAT ARE MAKING IN THIS SPACE
RELATED TO ORAL HEALTH ADVANCING
LANGUAGE ACCESS LITERACY. EVEN
IF YOU HAVE INFORMATION, PLEASE
IT IS OUT ON WEBSITE WHAT GOOD
IS IT IF PEOPLE CAN'T UNDERSTAND
IT OR IN A LANGUAGE THEY CANNOT
READ AND OF COURSE REALLY
THINKING ABOUT HOW DO YOU
INCREASE ALL FORMS OF
ACCESSIBILITY?
I THINK THESE CAN ALL BE
TRANSLATED AND PUT, YOU KNOW,
INTO THE ORAL HEALTH AND
ADVANCEMENTS THAT ARE MADE
THERE. WE ALSO RECOGNIZED THAT
A LOT OF THE WORK TOUCHES
MULTIPLE COMPONENTS, MEANING
THAT MEDICAID AND MEDICARE AND
DUAL OFFICE. SO, WE LAUNCH THE
THESE 12 CROSS-CUTTING
INITIATIVES AND ARE REALLY
THRILLED TO MOVE WORK ACROSS ALL
CENTER ROOEZLATED TO BEHAVIORAL
HEALTH ROLE HEALTH LACK OF
AFFORDABILITY MATERNITY CARE
BENEFIT EXPANSION WHERE HEALTH
WORK LIES AND NATIONAL HEALTH
STRATEGY DEFINING IT IN
HEALTHCARE AND IS IT ALIGN AND
ACROSS ALL CENTERS AND ELEVATING
STAKEHOLDER VOICES WE COMPLETED
A YEAR-LONG ENGAGEMENT WITH
HUMAN CENTERED DESIGN OR
MEDICAID BENEFICIARIES AND LOOK
FORWARD TO SHARING RESULTS WITH
YOU. IT THIS IS MY VISION FOR
ORAL HEALTH PROGRAM THAT IS TO
IMPROVE OUR BENEFICIARIES HEALTH
INTEGRATING ORAL HEALTH
TRANSFORMING SYSTEM TO ADVANCE
HEALTH EQUITY EXPANDING COVERAGE
AND IMPROVING OUTCOMES AND ARE
FUNDAMENTAL PRINCIPLES THAT ARE
KEY POINTING OUT THAT HAS TO BE
OUR FOCUS. SOME DISPARITIES
THAT HAVE PERSISTED FOR SO LONG
THEY ARE NOT JUST GOING TO, YOU
KNOW, DISAPPEAR. WE HAVE TO BE
INTENTIONAL AND THEY HAVE TO BE
EVIDENCE IN POWER AND DATA
DRIVEN. WHAT IS BEST EVIDENCE
OR DATA TO SUPPORT THESE
INITIATIVES AND THINKING ABOUT
INTEGRATION AND STAKEHOLDER
ENGAGEMENT AND OF COURSE
INNOVATION. I HAVE SAID THIS IN
THE BEGINNING.
REALLY WHEN I TALK ABOUT ORAL
HEALTH, FIRST, YOU WILL VERY
RARELY HEAR ME TALK ABOUT TEETH.
I WANT PEOPLE TO REALLY FOCUS ON
ORAL HEALTH ASPECT AND ORAL
HEALTH AND PART OF THAT AND HEAL
-- DEEP DISPARITIES AND
CONTINUOUS DISPARITIES IN ACCESS
TO CARE. IF YOU DON'T HAVE
ACCESS TO DENTAL CARE, YOU END
UP ACTUALLY COSTING THE HEALTH
CARE SYSTEM SUBSTANTIALLY AND
SEEKING CARE IN THE EMERGENCY
DEPARTMENT AND OPERATING REMOTE
TALKING ABOUT THIS AND FRANKLY
TO RECOGNIZE SHARED PATHWAY THAT
IS THE INFLAMMATION WITH ALL
CLINICAL OUTCOMES THAT ARE MAJOR
PLAYERS IN THE HEALTH CARE
SPACE. WE TALKED A LITTLE ABOUT
THIS. LET'S LOOK AT THIS. IN
THE DENTAL DELIVERY SYSTEM WE
HAVE WELESTABLISH THE PATIENTS
BEFORE COVID I WAS IN PRIVATE
PRACTICE. WE KNOW PATIENTS
SHOWING UP THERE FOR QUICK
CHECK-INS EVERY 6 MONTHS DOING
REALLY GREAT AND IT THOSE THAT
SHOW UP WITH PROBLEMS.
IF THEY DON'T HAVE ACCESS TO
DENTAL DELIVERY SYSTEM THEY END
UP BROADER HEALTH CARE SYSTEM
EMERGENCY DEPARTMENTS MAY BE
TRUE SINGLE EMERGENCY OR BACK
AGAIN IN 30 OR 60 DAYS.
ON AVERAGE EMERGENCY DEPARTMENT
VISIT COSTS $900.
YOU KNOW WHAT PEOPLE GET FOR
THAT?
ANTIBIOTIC PRESCRIPTION, OPIOID
PRESCRIPTION AND SOMETIMES
[INDISCERNIBLE] AND SOMETIMES
ALL THREE OF THEM. WE ARE
TREATING DENTAL CAVITIES AND
INFECTION WITH OPIOIDS AND
ANTIBIOTICS AND SOMETIMES THEY
HAVE TO BE ADMITTED AND ON
AVERAGE WHAT IS COST OF
IN-PATIENT ADMISSION?
I CAN MONITOR CHAT AND HEAR FROM
10 OR 15 OR 10 OR 20 OR 30 OR
$45,000 FOR SAVING SOMEONE WITH
A LIFE'S -- YOU KNOW,
THREATENING ANGINA CAUSE THE BY
A DENTAL ABSCESS. PEOPLE
CONTINUE TO DIE. IT THAT IS THE
OTHER UNSPOKEN THING THAT YOU --
YOU KNOW, SOMEHOW MORTALITY OF
ORAL INFECTION IS GONE.
SORRY, IT IS REALLY IMPORTANT TO
RECOGNIZE THAT SURGICAL CENTERS
ARE IMPORTANT FOR CHILDREN OR
ACCIDENTAL SERVICES FOR THOSE
WHO ARE PRECOOPERATETIVE FOR
ADULTS INTELLECTUAL AND
DEVELOPMENTAL DISABILITIES AND
SCHOOL IS AN IMPORTANT PLACE FOR
NOT ONLY LEARNING BUT NUTRITION
AND HEALTH SERVICES AND WHEN THE
PANDEMIC CLOSED MANY OF THEM
THAT WAS A BIG PROBLEM. ARENA
WE SOMEHOW ACCEPTED FOR SOME
PEOPLE ARENA AND ANNUAL CHARITY
EVENTS AND WAYS TO GET DENTAL
CARE. THESE ARE THREE THINGS
THAT IF WE DON'T SOLVE, THERE
WILL BEIN TEG [GROUP
PRESENTATION].
HEALTH INFORMATION TECHNOLOGY
DIVIDE IS HUGE. SYSTEMS DON'T
COMMUNICATE. MY QUESTION IS
WHAT AND HOW WE ARE ADDRESSING
TO SOLVE HEALTH INFORMATION
TECHNOLOGY DIVIDE IN A
MEANINGFUL WAY TO CLOSE LOOK
WITH AGNOSTIC CODING AND ACCEPT
IN A FEW OCCASIONS AND BIG
CHALLENGE BECAUSE WE DON'T HAVE
A SHARED LANGUAGE WITH MEDICINE
THAT PREVENT INTEGRATION AND
COORDINATION OF CARE NOT ONLY
SOLUTION BUT IS A HUGE BARRIER
AND MENTIONED CHARITY EVENTS
HAPPENING EVERY YEAR PEOPLE LINE
UP AT 4 O'CLOCK GET 1, TWO FOLD
WAITING UNTIL NEXT YEAR AND WAY
FOR ANY OF US TO GET ACCESS TO
DENTAL SERVICES AND YET THEY
STILL PERSIST. THIS IS THE
OTHER HUGE OPPORTUNITY THAT WHEN
YOU THINK ABOUT WHERE DOLLARS
AND INVESTMENTS GO IS PEOPLE IN
BEST CASE SCENARIOS MIGHT SPEND
TWO HOURS IN DENTAL CARE OFFICE
ACCESSING LATEST INNOVATION
DIAGNOSTIC AND EVERYTHING AND
TRUTH IS MAJORITY OF TIME IS
SPENT AT HOME MANAGING ORAL AND
DENTAL CONDITIONS AND WHAT ARE
INNOVATIONS AND CHALLENGES WE
FUND AND THINK ABOUT ADDRESSING
PEOPLE MANAGING ORAL HEALTH AT
HOME THAT IS REALLY IMPORTANT?
THIS IS THE REAL CHALLENGE THAT
I THINK IS WHERE, AGAIN, A
CRITICAL LOOK AND FUNDING AND
HOW WE ARE THINKING ABOUT EQUITY
THAT NEEDS TO BE TAKEN.
FOR LAST 16 YEARS, WE HAVE MADE
GREAT PROGRESS IN BLUE CHILDREN
LIVING BELOW FEDERAL POVERTY
LINES AND IN GREEN, ABOVE. WE
HAVE SEEN GAP BETWEEN CHILDREN
NOT IN POVERTY AND CHILDREN IN
POVERTY CLOSE.
THIS GAP HAS REMAINED AND
PERSISTED AND WHAT ARE EFFORTS
TO CLOSE GAPS MEANINGFULLY AND
INTENTIONALLY?
THERE HAS BEEN NO CHANGE IN
ADULTS AND GAP HAS WIDEN FOR
SENIORS AND 61% OF SENIORS NO
THE IN POVERTY ENJOYED THE BEST
ACCESS IN THE HEALTH CARE SYSTEM
TO DENTAL SERVICES WIDENING THE
GAB FOR THOSE IN POVERTY AND
WOULD SAY WHAT AN INVESTMENT
CHALLENGES AND OPPORTUNITIES TO
CLOSE GAPS INTENTIONALLY. HERE
IS THE CHALLENGE THAT EVEN FOR
CHILDREN COVERAGE IS NOT ISSUE
IN MEDICAID. IF YOU LOOK AT
MEDICAID BENEFICIARIES WITH
PREVENTIVE DENTAL SERVICE THIS
WAS COVID BUT BEFORE COVID YOU
HAVE HUGE GEOGRAPHICAL VARIATION
AND WHY IS IT IN SOME STATES 12
PRSZ OF KIDS GET TO DENTIST AND
OTHER STATES 60% GET COVERAGE
AND ADDRESSING TO REMOVE ACCESS
TO DENTAL CARE SERVICES? HERE,
DISPARITIES THAT I HAVE TALKED
ABOUT I WILL POINT EARS AND 2005
AND 12 YEARS IN-BETWEEN. GAPS
HAVE CLOSED. THEY ARE NOT GONE.
STILL, THEY PERSISTED FOR MANY
YEARS.
WE SHOULD NOT ACCEPT THIS AS
ACCEPTABLE AND AS WAS POINTED BY
DR. WEBSTER-CYRIAQUE WE SHOULD
HAVE INTENTIONAL PROGRAMS
CLOSING DISPARITIES IT THAT IS A
LITTLE BIT BETTER BUT WOULD SAY
STILL NOT GOOD ENOUGH. YOU WILL
SEE IN ADULTS AND SENIORS THAT
GAPS CAN GROW. FOR CHILDREN
MANY KNOW I'M A PEDIATRIC
DENTIST AND ROLE AND ACCESS AND
COVERAGE AND THIS PAPER IS
TELLING IF PARENT HAD DENTAL
VISIT COMPARED TO PARENT WITHOUT
DENTAL VISIT VERY FEW CHILDREN
OF PEOPLE WITH DENTAL VISITS
DON'T SEE THEM. LOTS MORE
CHILDREN PARENTS WITHOUT DENTAL
VISIT DON'T SEE DENTIST.
CHILDREN WON'T DRIVE THEMSELVES
TO DENTIST. MOM IS SOMETIMES
WORKING THREE JOBS AND TAKING
THREE HOURS TO GO TO DENTIST IS
ALSO NOT AN OPTION AND THINK
REALLY INTENTIONAL COMMUNICATION
STRATEGIES AND PARENTAL
INVOLVEMENT ARE KEY FOR
INCREASING ACCESS TO DENTAL
SERVICES FOR CHILDREN.
THIS IS THE GAP THAT I MENTIONED
TO YOU FOR ADULTS GOING FROM 12%
CLOSE TO 20. PERSISTENT,
SYSTEMIC, REQUIRED INTENTIONAL
SOLUTIONS AND WE WON'T ACHIEVE
AND CLOSE GAP BY JUST
DIVERSIFYING WORKFORCE. GREAT
WAY TO DO IT PEOPLE LOVE SEEING
A PROVIDER THAT LOOKS LIKE THEM
BUT WILL TAKE A LONG TIME AND
HAVE TO THINK OF INNOVATIVE
SOLUTIONS TO HELP CLOSE THESE
GAPS SOONER. RURAL AMERICA IS
NOT LIKE URBAN AMERICA.
SOLUTIONS AND CHALLENGES IN
RURAL AMERICA ARE SIGNIFICANT.
DISPARITIES EXISTING IN URBAN
AMERICAN ARE MORE PRONOUNCED AND
ADULTS AND CHILDREN AND WHERE
YOU LIVE MAKES A HUGE
DIFFERENCE. SOMETIMES RURAL
AMERICA DRIVE TO DENTIST IS 2
HOURS AND DRIVE TO EMERGENCY
DEPARTMENT IS ONE HOUR. WHERE
AM I GOING?
THIS IS RECOGNIZING WHERE PEOPLE
ARE UNDERSTANDING LIVED
EXPERIENCE AND RECOGNIZING WHAT
CHALLENGES ARE. REMEMBER GRAPH?
LOOK AT HUGE RACIAL DISPARITIES
SENIORS AND ACCESS TO 10 TAL
SERVICES.
WE LOOKED AT THESE MORE CLOSELY
AND THAT IS PUBLICLY AVAILABLE
NOW. OVERALL ABOUT 40% OF
SENIORS ACTS AS DENTAL CARE AND
HUGE DISPARITIES WHEN COMING TO
DUAL ELIGIBLES THOSE WHO ARE
MEDICAID AND MEDICARE. LOOK AT
HUGE RACIAL DISPARITIES EXISTING
FOR SENIORS LIVING IN COMMUNITY
AND I WILL TELL YOU WHAT THESE
ARE ON THE X AXIS IS. YOU KNOW
ON THIS SIDE THAT THEY DON'T
HAVE ACCESS TO DENTAL CARE.
HERE THEY HAVE THE BEST DENTAL
CARE. IT THIS IS INCOME. SO,
POVERTY IS A HUGE DRIVER OF LACK
OF ACCESS TO DENTAL SERVICES AND
HUGE RACIAL DISPARITIES. ONE
HAS TO BE VERY INTENTIONAL
RECOGNIZING.
WE WILL TAKE A STEP BACK AND PUT
DENTAL IN THE CONTEXT OF ALL OF
THE SPENDING IT THAT IS
HAPPENING IN THE HAD HEALTH CARE
SYSTEM. WE ARE ABOUT 4% OF
HEALTH CARE SPENDING THAT IS FOR
2016. PROPORTIONS ARE VERY
SIMILAR AND 4% OF HEALTH CARE
EXPENDITURES AND TWO THINGS
IMPORTANT, LOOK AT DENTAL
SERVICES IN CONNECTION TO
PRESCRIPTION DRUGS AND POINT OF
REFERENCE. REST OF HEALTHCARE
IS DRIVING A LOT OF THE
CHALLENGES AND OPPORTUNITIES I
WOULD SAY THIS IS ONE OF BIGGEST
CHALLENGES FOR DENTISTRY.
DENTAL IT IS 40 AND THIS
ADDRESSED ACCESS TO DENTAL
SERVICES WILL REMAIN A HUGE
CHALLENGE AND WAS GREAT TO HEAR
THAT NIH GOT 3 BILLION INCREASE
IN FUNDING AND NIDCR IS CLOSE TO
520 MILLION AND CONGRATULATIONS
THIS IS REALLY IMPORTANT. I
THOUGHT I WOULD SHARE WITH YOU
SPENDING IN PUBLIC PROGRAMS THAT
IS IN BILLIONS AND IN MEDICAID
PROGRAM IN 2021 WE SPENT $15
BILLION AND 4.7 BILLION IN
MEDICARE AND 2.5 BILLION IN --
THIS IS IN CHIP, TITLE IX. IF
YOU ADD THEM UP IT THIS IS EVERY
10 DAYS IS BASICALLY ANNUAL
BUDGET OF NIDCR. THIS IS REALLY
IMPORTANT TO JUST APPRECIATE THE
PUBLIC HEALTH SPENDING FOR
DENTAL SERVICES. IF YOU ADD
PUBLIC AND OUT OF POCKET AND
PRIVATE AND OUT OF POCKET WE ARE
AT $161.8 BILLION AND SEEMS FOR
THIS AMOUNT OF MONEY EVERYONE IN
THE US SHOULD HAVE ACCESS TO
GREAT DENTAL CARE. WE KNOW THAT
IS NOT TRUE. THE OTHER
CHALLENGE IS REALLY WE HAVE
THREE HEALTH CARE SYSTEMS PUBLIC
AND PRIVATE AND OUT OF POCKET
AND DENTAL PROBLEMS AND
SOLUTIONS WON'T BE SAME ACROSS
ALL OF THEM. TOP 5 PRIORITIES
MIGHT SHARE COMMONALITIES SUCH
AS DIABETES A PROBLEM
EVERYWHERE. RANKING OF ORAL
HEALTH IS 34 AND 47. YOU HAVE
TO SHRINK THE SCALE. IT JUST
DOESN'T FIT. BILLIONS OF
DOLLARS AND PRIVATE SPACE 11 AND
12 MUCH BETTER CONNECTED TO
CLINICAL OUTCOMES UP HERE. IN
AND OUT OF POCKET, 1 AND 2.
AGAIN, JUST TO THINK ABOUT WHERE
THESE BILLIONS OF DOLLARS ARE
GOING AND WHEN WE SAY THAT
PEOPLE WITH DIABETES ARE
IMPACTED AND POOR ORAL HEALTH
WITH IMPACT ON GLYCEMIC CONTROL
AND A1C AND OF ALL SENIORS 3%
HAVE DIABETES AND 97% HAVE OTHER
CONDITIONS AND 41% HAVE 5
COMORBIDITIES AND I CHALLENGE
STUDIES AND PORTFOLIOS AND
RESEMBLE REAL WORLD WHERE WE ARE
THINKING OF 5 CONDITIONS AND
MORE IN ORAL HEALTH THAT WILL
POORLY IMPACT ALL OF THEM. THEY
ARE VERY MUCH INTERCONNECTED
THAT IS TO LEVEL SET AND THINK
IT IS GREAT TO HAVE SINGLE
DISEASE MODEL THAT IS JUST NOT
REALITY OF THE PEOPLE WHO LIVE
IN THE US. THEN WHEN IT COMES
TO COST IT IS JUST IMPORTANT TO
RECOGNIZE THAT PEOPLE WHO HAVE
ONLY ONE CONDITION P MAKE UP 31%
OF ALL MEDICARE BENEFICIARIES
ARE CHEAP IN A SENSE THEY HAVE
SMALLER PROPORTION OF
EXPENDITURE AND MOST EXPENSIVE
ARE THOSE WITH 6 OR MORE
CONDITIONS AND MAKE UP CLOSE TO
54% OF ALL OF THE SPENDING.
THIS IS A COMPLEX CHART THAT IS
WORTH GOING THROUGH IT. IT IS
EYE-OPENING. THIS IS THE
CUMULATIVE PERCENTAGE OF THE
POPULATION. 0 TO 100.
THIS IS CUMULATIVE PERCENTAGE OF
EXPENDITURE 0 TO 100. THIS IS
ACTUAL DOLLARS AND WAY YOU WOULD
DO THIS HERE IS THAT 50% OF THE
PEOPLE USE 3% OF THE SPENDING.
OR IF YOU HAVE 100 PEOPLE AND
$100, 50 PEOPLE WOULD USE THREE
DOLLARS AND LAST FIVE PEOPLE WE
SEE USE $50.
1 PERSON WOULD USE $22 AND
NUMBERS ARE SLIGHTLY DIFFERENT
IN MEDICAID AND MEDICARE AND IT
HAD IS IN IMPORTANT CONTEXT
THINKING WHERE NEED IS AND HOW
YOU ADDRESS THAT. IF YOU LOOK
AT BOTTOM 50% OF SPENDERS, GUESS
WHAT?
THEY SPEND MOST ON DENTAL CARE.
32% OF ALL SPENDING GOES TO
DENTAL. WHEN YOU GET TO THE TOP
5 DENTAL DIMINISHES. 2.57. YOU
CAN FIND THIS. THIS IS A HUGE
OPPORTUNITY THAT IS TO BE
EXTREMELY CLEAR HOW POOR ORAL
HEALTH IMPACTS EMPLOYABILITY AND
WITH EMPLOYABILITY COMES PRIVATE
DENTAL INSURANCE AND COVERAGE
AND WE KNOW THIS AND THERE IS
GREAT FUNDING OF RESEARCH HOW
NO. 1 REASONS WHY CHILDREN MISS
DAYS IN SCHOOL IS FOR ORAL
HEALTH NOT LEARNING ABOUT MATH
AND ARE IN DENTAL PAIN. IT IS
ABSOLUTELY LINK THE TO SUBSTANCE
USE DISORDER THAT IS ALL CAUSE
MORTALITY PREDICTOR AND TOUCHING
ON MUCH BROADER CONVERSATION IN
HIGH PRIORITIES IN TERMS OF
SUBSTANCE USE DISORDER AND
ECONOMIC PROSPECT FOR PEOPLE.
THE CHALLENGE IS THAT NOT
EVERYBODY IS GOING TO SEE A
DENTIST. I THINK THIS IS WHERE
WE JUST NEED TO RECOGNIZE THIS.
NOT EVERYBODY WILL SEE A DENTIST
IN A YEAR. LOTS MORE PEOPLE
WILL ACTUALLY ONLY SEE A
PHYSICIAN. YES. THERE IS A
GREAT GROUP OF PEOPLE WHO WILL
SEE BOTH A DENTAL AND MEDICAL
PROVIDER. WE HAVE 65 MILLION
PEOPLE WHO SEE NEITHER. 28
MILLION HERE WHO SEE ONLY A
DENTIST I WOULD SAY IS A HUGE
OPPORTUNITY TO THINK ABOUT HPV
VACCINATION AND HIGH BLOOD
PRESSURE AND MONITORING AND ALL
THINGS WE KNOW THAT DENTISTS ARE
CAPABLE OF YOU KNOW
COMMUNICATING NOT ONLY FOR
HEALTH LITERACY BUT ACTUALLY
CONNECTING WITH THE HEALTH CARE
SYSTEM. THIS IS NOT TRUE ONLY
OVERALL BUT IF YOU LOOK AT
PRIVATE MEDICAL AND WITH DENTAL
INSURANCE AND EVEN IN THE PUBLIC
SPACE, YOU HAVE PEOPLE WHO ONLY
SEE THE DENTIST ONCE A YEAR. I
THINK, AGAIN, JUST A HUGE
OPPORTUNITY FOR DENTISTS TO
LEVERAGE THAT INTERACTION AND
POINT OF CARE. I KNOW WE ARE
CLOSE ON TIME. THIS IS I WOULD
SAY A HUGE OPPORTUNITY AND THIS
GROUP WILL APPRECIATE IT. YOU
UNDERSTAND THE INFLAMMATORY
CASCADES AND ALL MECHANISMS AND
IF YOU SHOW THIS TO PEOPLE THEY
WILL SAY THE THING ON THE RIGHT
IS TERRIBLE AND OOZING AND
INFECTION. THEY WILL LOOK AT
ONE ON THE LEFT AND SAY IT IS
TEETH. WHAT IS WRONG WITH THE
TEETH? THEY ARE WHITE TEETH.
INFECTION OF PERIDONE TAL
DISEASE HERE IS [INDISCERNIBLE]
WE HAVE TO FIND A COMMON
LANGUAGE THAT IS INFLAMMATION
AND TRANSLATE IT INTO HOW IF
THIS IS NOT OKAY THIS IS NOT
OKAY. IT IMPACTS CLINICAL
OUTCOMES.
WE KNOW AND, AGAIN, NIDCR HAS
FUNDED GREAT STUDIES THINKING
ABOUT THE CONNECTION BETWEEN
ASSOCIATED INFLAMMATORY
COMORBIDITIES AND DISSEMINATION
PATHWAYS AND FOR INGAL AND
DIJESTIVE JUST GREAT VALUE OF
SCIENCE THAT NEEDS TO BE
TRANSLATED INTO PRACTICE.
THIS IS A GREAT PAPER ON
ASSOCIATION BETWEEN MATERNAL
PERIDONE TAL DISEASE AND ADVERSE
PREGNANCY OUTCOMES. 10%
INCREASE LOW ODDS OF BIRTH
WEIGHT AND 34 SPONTANEOUS
ABORTION WE WON'T IMPROVE
MATERNAL HEALTH MOMS WALKING
WITH AGGRESSIVE OR CHRONIC
PERIDONE TAL DISEASE AND OVERALL
20% HIGHER RISK OF MATERNAL
COMPLICATIONS.
CHALLENGE HERE IN A MEDICAID
SPACE 36% OF WOMEN SEE A DENTIST
COMPARE THE TO 60 IN THE
COMMERCIAL. HUGE DISPARITIES.
FOR FIRST TIME WE REACHED A
MILESTONE LAST YEAR AND
CELEBRATED ALL 50 STATES FIRST
TIME IN MEDICAID PROGRAM AND
PROVIDE DENTAL COVERAGE FOR
MEDICAID IN PREGNANT WOMEN IS
PHENOMENAL COVERAGE NOT SAME IT
IS AN OPTIONAL BENEFIT BUT IS
REALLY FIRST STEP FORWARD IT
THAT RECOGNITION OF HOW
IMPORTANT ORAL HEALTH IS. I
WILL CLOSE WITH STUDY ON
EMERGENCY DEPARTMENT AND COVID
AND ALLOW ME TO GO A FEW SECONDS
OR MINUTES LATER. WE ARE AT
TIME FOR BREAK. YOU HAVE BEEN
VERY PATIENT AND THIS IS AN
OPPORTUNITY THAT EXISTS FROM
HEALTH INFORMATION TECHNOLOGY
AND ADDRESSING COST OF HEALTH
CARE. THIS IS ABOUT OPIOIDS AND
ABOUT ANTIBIOTICS. THIS IS
ABOUT DOLLARS.
WE -- DID YOU KNOW THAT POOR
ORAL HEALTH IS IN TOP 10 FIRST
LISTED DIAGNOSIS IN 2018?
THIS IS THE PROBLEM WITH ACCESS
TO DENTAL SERVICES.
PEOPLE STILL GO TO EMERGENCY
DEPARTMENT BECAUSE THEY CAN'T
FIND A DENTIST. YOU WILL HAVE
ACCESS TO FULL REPORT. I WILL
SHOW YOU A PICTURE OF SUMMARIES
AND WHY IT MATTERS. 2014
MEDICAID BECAME BIGGEST PAYER
FOR CONDITIONS AND GROUP MOST
IMPACTED WOMEN IN REPRODUCTIVE
AGE WOMEN 19 TO 34 IN MEN.
PROBLEM IS DENTAL PAIN IN
EMERGENCY DEPARTMENT IS ONE OF
TOP REASONS FOR OPIOID
PRESCRIBING. WE PLAY TAG WITH
KIDNEY STONES AND WE WILL NOT
ADDRESS OPIOID PROBLEM WITHOUT
ADDRESSING WHY PEOPLE SHOW UP TO
EMERGENCY DEPARTMENT WITH DENTAL
PAIN. THIS IS A MAP. IN SOME
STATES WE HAVE CLOSE TO 4% OF
ALL MEDICAID ADULTS SHOW UP TO
EMERGENCY DEPARTMENT WITH DENTAL
PAIN IT THAT IS MILLIONS OF
PEOPLE WHO DON'T HAVE ACCESS TO
DENTIST AND SHOW US IN THE
EMERGENCY DEPARTMENT. I WANTED
TO HIGHLIGHT WHAT DR. D'SOUZA
INDICATED IN THE BEGINNING.
NATIONAL ACADEMY OF SCIENCE AND
ENGINEERING AND MEDICINE LOOKED
CRITICALLY WHERE ARE CHALLENGES
IN OPIOID PREDESCRIBING IN FDA
AND PUBLISHED CONSENSUS REPORT
FRAMING OPIOID GUIDELINES FOR
ACUTE MAIN DEFINING SURGICAL AND
MEDICAL CONDITIONS DENTAL WAS IN
BOTH AND UNDER SURGICAL AND
THERMAL EXTRACTION AND MEDICAL
DENTAL PAIN NOT SURGICAL
EMERGENCY DEPARTMENT IS THE
PRIORITY CONDITIONS AND FOCUS
AREAS BRINGING WORK TO
PHENOMENAL SYSTEMATIC REVIEW AND
METAANALYSIS THAT BASICALLY SAYS
YOU DON'T NEED OPIOIDS HAS NOW
BEEN, YOU KNOW, QUANTIFIED FOR
MANY DIFFERENT WAYS OF MANAGING
PAIN AND ENCOURAGE YOU TO READ
THAT. I WILL CONCLUDE WITH
COVID THAT HAS DISRUPTED
EVERYTHING. WE CAN'T MOVE
FORWARD SETTING PRIORITIES IN
ACCESS IF IN DENTAL SERVICES
WITHOUT RECOGNIZING THIS. THIS
IS CYCLICAL NATURE OF THOSE IN
PRACTICE BUSY AUGUST OF GOING TO
DENTIST BEFORE SCHOOL. SLOW
SEPTEMBER IT THAT PEAKED IN
OCTOBER AND SLOW HOLIDAYS YOU
SEE IT REPEATED. COVID
DISRUPTED ALL THAT. WE ARE
STILL NOT UP TO LEVELS BEFORE
COVID AND WHAT DO WE DO WITH
FOREGOING CARE? CAVITIES AND
PERIDONE TAL DISEASE DOESN'T
WAIT WE PUBLISHED DATA FOR YOUR
REFERENCE THAT IS AT STATE LEVEL
ENROLLMENT GROWTHS. THIS IS
IMPACT. FOR SOME STATES GAP IS
CLOSE TO 40%. I WOULD JUST SAY
THAT WE HAVE ALSO SEEN
UNPRECEDENTED ENROLLMENT GROWTH.
MEDICAID PROGRAM HAS 20 MORE
MILLION PEOPLE WHO ARE IN THE
PROGRAM AND 30% GROWTH. YOU
KNOW, WE DID NOT INCREASE DENTAL
PROVIDERS BY 30% IN MEDICAID
PROGRAM PRESENTING HUGE
CHALLENGES THAT I THINK TO JUST
HIGHLIGHT A VERY IMPORTANT
LEGISLATIVE ACTION BY THE
CONSOLIDATED APROPRIATION ACT
THAT CONTINUES ENROLLMENT FOR
STATES WILL END ON MARCH 31ST.
ALL OF THE 20 MILLION PEOPLE
WILL NEED TO TRANSITION AND FIND
COVERAGE.
I WILL SUMMARIZE THAT OUR SYSTEM
CAPACITY DID NOT INCREASE AND
DENTAL OFFICES ACTUALLY COULD
SEE FEWER PATIENTS BECAUSE OF
NEW SAFETY PROTOCOLS VACCINES
AND VACCINATION AND WE HAVE A
HUGE INCREASE IN ENROLLMENT AND
WE HAVE WORKFORCE SHORTAGES AND
PROVIDER BURNOUT. PANDEMIC,
WHAT NEXT WAVE IS NEXT.
TELEHEALTH WAS PROMISING IN THE
BEGINNING WHERE WILL INTEGRATE
IN THE FUTURE OF DENTISTRY?
SCHOOLS WERE CLOSED FOR A WHILE
AND THEY ARE OPEN AND THIS ISSUE
FOR ONGOING CARE WILL BECOME
REALLY IMPORTANT AS PEOPLE
RETURN TO THE DENTIST AND YOU
ARE NOW SEEING LEVEL OF DISEASE
THAT WE HAVE NOT SEEN PRIOR TO
THE PANDEMIC AND THANKS AGAIN
FOR HAVING ME AND WELCOME A FEW
QUESTIONS AND APPRECIATE THE
PATIENCE.
>>QUESTIONS?
>>HI. RAUL GARCIA. WANTED TO
MAKE A COMMENT AND THANK YOU FOR
A THOROUGH AND ELOQUENT
PRESENTATION AND CHALLENGES IT
THAT EXIST AND THANKS FOR HER
SERVICE IN CMS AND ELEVATING THE
GAME IN REGARDS TO ORAL HEALTH
DATA GENERATION AND SHARING YOU
TALK ABOUT ISSUES AND PROBLEMS
AND CHALLENGES AND WE ARE AT
ADVISORY COUNCIL OF A RESEARCH
BASED INSTITUTE AT NIH. NOW,
HOW DOES RESEARCH EFFORT THAT IS
CLEARLY NEEDED TO ADDRESS MANY
CHALLENGES THAT YOU DESCRIBE GET
DONE BECAUSE YOU ARE TALKING
ABOUT HEALTH SERVICES RESEARCH
OF WHICH RELATIVELY MODEST
COMPONENT OF NIDCR'S BUDGET IS
DIRECTED TOWARDS IT THAT AREA
AND FEDERAL AGENCY AND REGENCY
AND QUALITY ARK THE ORGANIZATION
OF THIS IN A SENSE AND HOW DOES
NEED FOR YOUR WORK AND RESEARCH
IN YOUR AREA IMMEDIATE AND
RELEVANT TO PUBLIC HEALTH
IMPLICATIONS GET DONE WITH
NIDCR'S CURRENT PORTFOLIO AND
NEED CHANGES IN THAT FOCUS HOW
WOULD YOU ADVISE NICDR DIRECTOR
TO BEGIN RESEARCH AGENDA IN THIS
IMPORTANT AREA?
>>THANK YOU FOR YOUR COMMENTS.
RESTATING WHAT DR. WEST SAID WE
HAVE TO WORK ON THIS TOGETHER
AND WON'T ADDRESS THIS BY ONLY
FUNDING ONE PIECE OF SCIENCE.
AGAIN, IT IS VERY IMPORTANT AND
I LOVE BASIC SCIENCE AND PHD IN
MICROBIOLOGY AND SO EXCITED
ABOUT PREVIOUS RESEARCH BUT
POINT HERE IS TO WORK
COLLABORATIVELY TO ADDRESS SOME
OF THE CHALLENGES. IF WE DON'T
PAY ATTENTION TO HOW HEALTH CARE
IS FUNDED OR WHERE GAPS OR
OPPORTUNITIES ARE, YES. IT IS
ARC AND THEY COULD TAKE THE
LEAD. NIDCR I WOULD SAY IS
LEADER IN ORAL HAD HEALTH
RESEARCH AND UP TO THIS
LEADERSHIP TO DECIDE AND
ELEVATE. I WAS SO THRILLED TO
SEE SOME BIG DATA COMPONENTS AND
SEE CMS DATA AND THESE ARE A
STEP IN THE RIGHT DIRECTION.
BUTDY OF THIS WE HAVE A VERY
CLOSE COLLABORATION BETWEEN
FEDERAL PARTNERS NIDCR, FDA,
HRSA. WE COME TOGETHER AND ARE
THINKING WHAT IS ON HHS LEVEL
STRATEGIC PLAN LIKE WHAT ARE THE
PRIORITIES AND DATA AND
COLLABORATION ARE KEY. AGAIN,
NOT TO REDUPLICATE OR REPEAT
WHAT OTHER AGENCIES ARE DOG BUT
REALLY ELEVATE ALL OUR WORK. IF
NIDCR DEVELOPS EDUCATIONAL
MATERIALS ABOUT MATERIAL AND
MATERNAL HEALTH I CAN ELEVATE AT
STATE LEVEL HERE IS MORE
EVIDENCE. MORESO IT HAS BEEN A
BEAUTIFUL PARTNERSHIP TO ASK AND
SEEK GUIDANCE THINKING ABOUT NEW
POLICIES IN MEDICAID AND
MEDICARE AND ASKING INPUT FROM
NIDCR WHAT IS BEING FUNDED AND
WHERE ARE PRIORITIES AND HOW CAN
WE ELEVATE THIS? I WOULD SAY
THAT IS ONLY THE BEGINNING AND
I'M REALLY ACTUALLY EXCITED
ABOUT THE FUTURE THAT WOULD
ENCOURAGE COUNCIL TO THINK ABOUT
A PORTFOLIO. WE NEED BIG DATA.
WE -- I DON'T KNOW HOW MUCH HAS
BEEN FOCUSED ON HEALTH
INFORMATION TECHNOLOGY BUT THAT
DIVIDE IF WE DON'T ADDRESS IT IT
DOESN'T MATTER WHAT SCIENCE YOU
HAVE ABOUT HOW IMPORTANT ORAL
HEALTH IS IF PEOPLE CAN'T SEND
REFERRAL TO A DENTIST WHAT IS
GOOD? IT HAS TO REALLY COME
FROM SYSTEMS AND COMMUNICATION
IN ORDER TO ELEVATE SCIENCE
BEING DONE AND TO ME IS ABOUT
IMPLEMENTATION SCIENCE AND
THINKING ABOUT ALL QUALITY
IMPROVEMENT INITIATIVES THAT I
THINK THAT WE JUST KNOW ARE
CRITICAL IN HEALTH CARE. IF I
CAN PUT ONE CHALLENGE THAT IS
MORE FOR DENTAL BOARDS AND NIDCR
COULD HAVE A LEADERSHIP.
QUALITY IMPROVEMENT IS NOT
SOMETHING THAT DENTISTS LEARNED
AT ALL. THEY HAVE NEVER HEARD
THIS WORD COMING TO PRACTICE.
YOU KNOW, MAYBE SOME SCHOOLS
HAVE A QUALITY IMPROVEMENT
INITIATIVE BUT IS NOT PART OF
THE CURRICULUM. RESIDENTS AND
MEDICAL FELLOWS DO QUALITY
IMPROVEMENT IS PART OF THE
TRAINING. WE HAVE A HUGE
OPPORTUNITY HERE. MEASURE
DEVELOPMENT AND IMPLICATIONS AND
DENTISTS DON'T WANT TO BE
MEASURED. RIGHT?
HOW DO YOU START TO USE COMMON
LANGUAGE WITH REST OF HEALTH
CARE THAT WOULD BE HEALTH
SERVICES RESEARCH. A PILOT OR 2
OR SOMETHING TO MAKE IT PART OF
THE CULTURE. IT WILL TAKE TIME
BUT CONFIDENT WE WILL FIND
OPPORTUNITIES AND HAPPY TO TALK
MORE.
>>THANK YOU.
>>ANOTHER ANGLE I CAN ADD TO
YOUR WONDERFUL MATERIAL.
NATALIA. THAT DIRECTLY
ADDRESSES RAUL'S POINT THAT IS
IMPORTANT IS THAT TRADITIONALLY
AND FROM WHERE WE COME; RIGHT?
WE MOVE YOU AND I RAUL GREW UP
IN ACADEMIA AND WE WERE REWARDED
FOR REDUCTIONIST HYPOTHESISES
AND RESEARCH IN PUBLIC HEALTH OR
BASIC SCIENCE AND IS TIME NOW TO
CONNECT DOTS IN ECOSYSTEMS AND
LISTENING TO NATALIA FIRST THING
I WILL MAKE SURE IS NORA
DIRECTOR OF NATIONAL INSTITUTE
AND DRUG ABUSE GETS WITH YOU ON
EMERGENCY ROOM VISITS AND
TOGETHER WE CAN COME UP WITH A
VERY EFFECTIVE PROPOSAL TALKING
TO MELISSA RIDDLE WHO IS HERE
YOU NOTE WE HAVE EMPHASIZED THE
UPSTREAM HEALTH DETERMINANTS
INVOLVING BEHAVIORAL
CONDITIONING THROUGH LIFESPAN
COMMERCIAL AND INFLUENCES AND
WILL BE CONNECTING IT SUCH THAT
FUNDING RESEARCHERS LEADING
FIELD OF PREVENTION AND CARRIES
AND ARE BENEFITING FROM THAT AND
ARE WE GETTING THERE?
WE HAVE TO GET TO CONNECTING THE
DOTS PHASE, RAUL. IT CAN'T
HAPPEN OVERNIGHT. PEOPLE ARE SO
CONDITIONED TO DOING ECOSYSTEMS
AND DISPARITY CENTERS AND YOU
LET ONE OF THEM. YOU KNOW
SUCCESSES AND LIMITATIONS OF
THAT APPROACH AS WELL. SO, WE
WELCOME ANY -- ANY CHANCE OF
TURNING THE NEEDLE TOWARDS A
20-YEAR OF PROGRESS IN THIS
AREA. THANK YOU SO MUCH FOR
YOUR COMMENTS.
>>OKAY. SO, I THINK IT IS TIME
TO --
>>WAIT.
>>I THINK IT IS TIME TO TAKE
OUR BREAK.
>>SHE HAD A QUICK QUESTION AND
I'M HAPPY TO ANSWER IT.
>>SORRY. GO AHEAD.
>>SURE.
>>NATALIA.
>>IT IS ALL RIGHT. GREAT
PRESENTATION. IT IT IS SO GREAT
TO HAVE SOMEBODY LIKE YOU WHO IS
A SCIENTIST AND BASIC SCIENTIST
AND DATA SCIENTIST AT THIS
IMPORTANT POSITION. I AGREE
WITH YOU MORE DATA IS NEEDED.
IT IS KIND OF AMAZING TO SEE
EVEN ALL OF US AT NIH. IS ONLY
ONE OR TWO% OF PEOPLE HAVE ORAL
DATA AND AREA A LOT MORE NEEDS
TO BE IMPROVED AND I HAVE A
SPECIFIC QUESTION FOR YOU.
BASED ON DATA THAT YOU ALREADY
HAVE IS CLEAR TO MILLIONS OF
PEOPLE THAT ONLY SEE DENTISTS
AND IS JUST USING THAT NUMBER TO
IMPROVING OVERALL HEALTH COULD
BE VERY USEFUL AND THERE ARE
LOSS OF -- THIS IS VERY MUCH
BEGGING FOR SALIVA DIAGNOSTICS
YOU WON'T EXPECT DENTISTS TO DO
DIAGNOSTICS FOR OTHERS OR
DRAWING BLOOD AND QUESTION IS
NOT CMS WHOEVER IS COVERING
THOSE ACTIVITIES. YOU KNOW?
MAKING THEM A REALITY SO
DENTISTS CAN ACTUALLY
PARTICIPATE IN THE OVERALL
HEALTH DIAGNOSTICS.
>>YEAH. HAPPY TO CHAT MORE.
COVERAGE IS SOMETHING WE
OBVIOUSLY DO AND TAKE VERY
SERIOUSLY AND CONSIDER ALL
EVIDENCE ESPECIALLY RELATING TO
CLINICAL OUTCOMES AND WELCOME
ANY INFORMATION YOU CAN SHARE.
AND WHEN IT COMES TO MEDICAID,
DECISION LIES IN MEDICAID STATE
AGENCY AND HAPPY TO CONNECT FOR
FURTHER DISCUSSION AND COMPLEX
ISSUE NOT ONE-SIZE FITS ALL BUT
REALLY IMPORTANT.
>>YEAH.
>>THANK YOU VERY MUCH, NATALIA.
VERY USEFUL.
>>THANK YOU. THANK YOU FOR
HAVING ME.
>>THIS IS A BREAK FOR LUNCH.
>>WE HAVE A BREAK UNTIL 1 P.M.
EASTERN TIME.
>>JUST 1 P.M.. THAT IS JUST A
FEW MINUTES. OKAY. THANK YOU.
WE WILL BE BACK.
>>WE WILL BE BACK FOR THE
COUNCIL OF WORKING GROUP
UPDATES.
>> I WOULD
LIKE TO WELCOME EVERYONE BACK TO
THE COUNCIL MEETING AND NEXT ON
AGENDA UPDATES FROM TWO COUNCIL
MEETING GROUPS.
[INDISCERNIBLE] WILL PRESENT THE
FIRST UPDATES ON THE WORKING
GROUP.
I'M READY TO GO. YOU NEED TO
UNSHARE THE SCREEN AND NOT SURE
WHO IS SHARING RIGHT NOW.
>>I THINK I -- THERE WE GO.
>>I WILL SHARE MY SCREEN.
DOES MY SCREEN SHOW UP NOW?
>>YES.
>>YOUR SCREEN LOOKS GOOD.
>>I WILL GO. GOOD MORNING,
EVERYBODY. I GUESS GOOD
AFTERNOON FOR THE EASTERN HALF
OF THE COUNTRY AND I'M EXCITED
TO GIVE AN UPDATE ABOUT RECENT
WORK OF DATA SCIENCE STRATEGY
WORKING GROUP THAT IS ON BEHA OF
THE ENTIRE WORKING GROUP. AT
THE LAST COUNCIL MEETING, I
ALREADY GAVE AN OVERVIEW ABOUT
MOTIVATION BEHIND THE WORKING
GROUP. AS A BRIEF REMINDER OF
TH
THIS.
THIS IS DRIVEN BY NIDCR
STRATEGIC PLAN PUBLISHED IN
2021. I SHOWED LAST TIME WHEN
YOU LOOK AT THE STRATEGIC PLAN
AND ALL 5 MAJOR STRATEGIC
PRIORITIES YOU CAN FIND IN THIS
PLAN, DATA AND DATA SCIENCE AND
OPPORTUNITIES THAT COME ALONG
WITH IT ARE RELEVANT FOR EACH OF
THESE FIVE PRIORITIES.
THIS IS VERY CLEAR FROM THE
PLAN.
SO, IT HAS BEEN CALLED OUT. AT
THE SAME TIME, THERE IS
CURRENTLY NO EXPLICIT DATA
SCIENCE STRATEGY THAT NIDCR HAS.
AT LEAST NOT IN THE FORM OF THE
DOCUMENT.
THE WORKING GROUP HAS BEEN
REALLY CREATING TO HELP TO FILL
THIS GAP. AND TO THINK ABOUT A
MORE EXPLICIT DATA SCIENCE
STRATEGY FOR NIDCR THAT CAN BE
USED TO ADDRESS ALL THESE
PRIORITIES.
DATA SCIENCE STRATEGY WORKING
GROUP WAS CHARGED WITH THE
FOLLOWING.
OUR GOAL IS PROVIDING COUNCIL
AND EXTENSION AT NIDCR WITH
RECOMMENDATIONS THAT PROVIDE
FOUNTDATION FOR A WELL-INFORMED
AND WELL-REASONED DATA SCIENCE
STRATEGY THAT CAN HELP NIDCR TO
REALIZE FULL POTENTIAL OF DATA
SCIENCE AND IMPORTANTLY
REALIZING THIS POTENTIAL ACROSS
THE ENTIRE TRANSLATIONAL
SPECTRUM OF DENTAL, ORAL AND
CRANIO FACIAL RESEARCH AND HELP
TO REDUCE HEALTH DISPARITIES
IMPROVING OVERALL HEALTH AND
SPECIFIC OPPORTUNITIES THAT HAVE
BEEN CALLED OUT AND FIRST OF ALL
UNDERSTANDING THE DENTAL OR
CRANIO FACIAL DATA ECOSYSTEM AND
UNDERSTANDING THE STATUS QUO TO
MAKE MEANINGFUL RECOMMENDATIONS
ABOUT DIRECTIONS WHICH THIS HAS
TO BE INVOLVED MORE BROADLY AND
DATA SCIENCE METHOD
OPPORTUNITIES AND HOW WE CAN
LEVERAGE THEM.
THIRD ONE PRESENTS TO
INFORMATION AND EARLIER
HIGHLIGHTED CHALLENGES IN AREAS
OF HEALTH DISPARITIES AND
INEQUALITIES IN BOTH TERMS OF
ACCESS TO HEALTH CARE AS WELL AS
IN TRAINING EFFORTS FOR NEXT
GENERATION OF RESEARCH. HOW
DOES DATA AND DATA SCIENCE FIT
IN THERE?
WHAT DO WE NEED TO DO IN TERMS
OF TRAINING IN THESE AREAS?
THE APPROACH THAT OUR WORKING
GROUP CHOSE TO TAKE IS IDEA WHEN
LOOKING AT COMPOSITION OF IT, IT
IS TO MAKE SURE WE HAVE A
DIVERSITY OF EXPERTS FROM ACROSS
THE SPECTRUM, BROAD SCIENTIFIC
EXPERTISE AND IMPORTANTLY
COVERING THE ENTIRE
TRANSLATIONAL SPECTRUM FROM
BASIC TO HUMAN TO PATIENT TO
CLINICAL AND COMMUNITY SETTINGS.
WITH THE ULTIMATE GOAL TO
PROVIDE BOTH SHORT TERM AND
LONG-TERM RECOMMENDATIONS IT
THAT CAN GUIDE NIDCR'S
PRIORITIES.
THIS IS AN OVERVIEW OF WORKING
GROUP MEMBERS.
ON THE LEFT IS ACTUAL WORKING
GROUP MEMBERS.
YOU CAN SEE HERE FROM
AFFILIATIONS THAT ARE UNDER THE
NAMES THAT THESE ARE NOT JUST
UNIVERSITY RESEARCHERS AND IS A
WIDE RANGE OF ORGANIZATIONS THAT
ARE REPRESENTED. LOOKING AT
EXPERTISE, YOU CAN SEE THERE IT
COVERS THE ENTIRE SPECTRUM FROM
BASIC RESEARCH TO CLINICAL AND
COMMUNITY APPLICATION AND WE
WORK CLOSELY WITH NIDCR STAFF
WHO ARE ATTENDING SOME MEETINGS
TO STAIN THE LOOP AND ALSO TO
HELP US GUIDE THE DIRECTIONS OF
THE WORKING GROUP.
SO, IN REMAINING TIME THAT I
WOULD LIKE TO GIVE YOU A FEW
UPDATES ABOUT WHAT WE HAVE BEEN
DOING SINCE THE LAST COUNCIL
MEETING.
WE HAVE HAD REGULAR MEETINGS
SINCE SEPTEMBER. WE ARE
CURRENTLY MEETING TWICE PER
MONTH WITH THE ENTIRE GROUP.
THERE ARE ADDITIONAL MEETINGS.
FOR EXAMPLE, FROM OUR
SUB-COMMITTEE THAT IS SCHEDULED
AD HOC.
THE TWO ACTIVITIES THAT WE HAVE
SPENT MOST TIME ON IN THE LAST
FEW MONTHS IS, FIRST OF ALL, AN
ENVIRONMENTAL SCAN AND MAPPING
OF DOCD ECOSYSTEM TO UNDERSTAND
THE STATUS QUO AND UNDERSTAND
WHAT THE STARTING POINT FOR ANY
FUTURE STRATEGY MIGHT BE. THE
SECOND ONE IS DEVELOPING AN RFI
THAT CAN FURTHER INFORM THIS
STRATEGY. SO, I'M GOING TO GIVE
YOU MORE DETAIL ABOUT BOTH.
FIRST, THIS EFFORT.
ENVIRONMENTAL SCAN MAPPING AND
DOC DATA ECOSYSTEMS.
SO, JUST TO -- TO OFFER FOR A
GENERAL BACKGROUND. WHEN WE
TALK ABOUT THE DOC DATA
ECOSYSTEM, WHAT DO WE MEAN BY AN
ECOSYSTEM?
YOU SEE HERE A GENERAL
DEFINITION THAT IS OF DATA
ECOSYSTEMS TAKEN STRAIGHT FROM
WIKIPEDIA DEFINED AS COMPLEX
ENVIRONMENT OF CODEPENDENT
ACTORS AND NETWORKS CONTRIBUTING
TO DATA COLLECTION AND SOME ARE
IN VARIETY OF ENVIRONMENTS SOME
SHOWN HERE. WHEN WE THINK ABOUT
DOC RESEARCH. OUR THOUGHT WAS
THAT WE WANTED TO HAVE A
STARTING POINT TO CAPTURE ENTIRE
DATA ECOSYSTEM BY DEFINITION AND
SYSTEMS AND RESOURCES AND DATA
SYSTEMS AND DATABASIS AND SO ON
RELEVANT TO DOC RESEARCH AND
IMPORTANTLY DOING SO ACROSS THE
ENTIRE TRANSLATIONAL SPECTRUM.
NOW, TO TACKLE THIS. WE TOOK
ADVANTAGE OF THE FACT THAT AS I
POINTED OUT THAT THE GROUP
COVERS THE ENTIRE SPECTRUM. YOU
SEE HERE THIS MATRIX BROADLY
SHOWS EXPECTED EXPERTISE FROM
BASIC TO COMMUNITIES.
WE SPLIT THIS UP INTO THREE
SUBGROUPS WITH OVERLAPPING
EXPERTISE.
AS A STARTING POINT, WE
ATTEMPTED TO CAPTURE ALL
DATABASES AND REPOSITORY
RESOURCES AND DATA SYSTEMS USE
THE FROM DATA RESEARCHERS FROM
T0 TO T4 AND CAME TOGETHER AND
COMPILED ALL DATA AND HAD A LOOK
AT IT. I WILL PRESENT HERE IN
THE NEXT FEW SLIDES ARE SOME
INITIAL OBSERVATIONS THAT CAME
OUT OF THIS. I WANTED TO
HIGHLIGHT THAT THESE ARE FIRST
OF ALL PRELIMINARY FINDINGS AND
HAVEN'T RECEIVED RFI INFORMATION
YET. THAT MIGHT ADD FURTHER TO
THIS AND WANT TO POINT OWE
THOUGHT AT THIS POINT NONE OF
THESE ARE SPECIFIC
RECOMMENDATIONS.
THEY ARE OBSERVATIONS THAT WE
MADE ALONG THE WAY. BUT THAT WE
FEEL CONFIDENT ABOUT THAT WE
THOUGHT WOULD BE WORTH SHARING
THEM WITH COUNCIL AND NIDCR
LEADERSHIP AT THIS POINT.
THE FIRST OBSERVATION WE HAD IS
DODC ECOSYSTEM IS CHARACTERIZE
THE BY SUBSTANTIAL COMPLEXITY
AND HETEROGENEITY. WHEN WE
COMPILE THE ALL OF THE RESOURCES
I WON'T SHOW YOU BIG TABLES WE
HAD FOR THIS BUT SUMMARY FINDING
IS THAT WE IDENTIFIED AT LEAST
30 DIFFERENT RESOURCES AND
DATABASES AND DATA REPOSITORIES
THAT CONTAINED DATA COMMONLY
USED BY DOC COMMUNITY AND SOME
EXPLICITLY AND THEY FOCUSED ON
DOC DATA AND SOME MORE BROADLY
FOCUSING ON DATA AND CONTAINING
RELEVANT DATA.
AND DIRECTLY RELATED TO THIS,
THERE IS NO INTENTIONALLY
DESIGNED DOC DATA ECOSYSTEMS AND
MOST RESOURCES THAT EXIST GREW
ORGANICALLY AND ARE FUNDED
THROUGH VARIETY OF MECHANISMS
AND ARE HOSTED BY A NUMBER OF
ORGANIZATIONS. YOU KNOW, THIS
IS WHAT HAPPENED HISTORICALLY.
IT IS REFLECTED IN A CURRENT
LACK OF COHERENCE AND IN THE DOC
DATA ECOSYSTEM. WE ALSO
OBSERVED HETEROGENEITY THAT
MEANS WHEN WE LOOK AT DIFFERENT
REPOSITORIES FROM OUR INITIAL
ASSESSMENT, THEY ARE VERY
DIFFERENT IN TERMS OF FOR
EXAMPLE COMPLIANCE WITH FAIR
DATA STANDARDS OR USE OF COMMON
DATA STANDARDS BOTH THAT HAVE
MAJOR IMPLICATIONS FOR EVOLVING
THIS DATA ECOSYSTEM.
SECOND IMPORTANT FINDING IS
FUZZY BOUNDARIES.
SO, WHEN WE FOUND OUT ABOUT HOW
TO DEFINE THE DOC DATA
ECOSYSTEM, WE THOUGHT ABOUT WHAT
EXACTLY IS PART OF IT VERSUS
WHAT IS OUTSIDE OF IT?
SO, THIS IS SUMMARIZE THE HERE
ON THE LEFT.
WHEN WE LOOK AT DOC DATA
ECOSYSTEM, AS IT IS CURRENTLY IN
EXISTENCE, IT CONSISTS OF
EXPLICITLY DOC-FOCUSED DATA
SYSTEMS.
SOME OF THESE ARE FUNDED OUT OF
NIDCR. AN EXAMPLE OF THIS WOULD
BE FAITH-BASED THAT MOSTLY
COVERS T0T1 LEVEL AND THERE IS A
MUCH LARGER NUMBER OF GENERAL
SCIENTIFIC AND MEDICAL DATA
SYSTEMS CONTAINING RELEVANT DATA
THAT IS FREQUENTLY USE THE BY
RESEARCHERS AND CLINICIANS THAT
ARE DOING DOC-RELEVANT WORK OR
THAT ARE OFTEN NIDCR FUNDED AND
ARE MORE GENERAL SYSTEMS AND FOR
EXAMPLE IN BASIC SPACE GENERAL
MC OR GENOMIC DATA OR VARIOUS
CLINICAL SYSTEMS USE THE BY
CLINICAL RESEARCHERS.
NOW, THIS IS, AGAIN, NOT A
RECOMMENDATION BUT OBSERVATION.
THIS LACK OF CLEAR DELINEATION
BETWEEN THESE EXPLICITLY
DOC-FOCUSSED AND MORE PERIPHERAL
DATA SYSTEMS ARE INEVITABLE
BASED ON HOW THEY AROSE AND IS
NOT SOMETHING THAT IS
NECESSARILY A PROBLEM AND COULD
BE DESIRABLE FOR MANY PURPOSES
AND MANY OF THESE SHOULDN'T BE
GUIDED BY JUST THE INTERESTS OF
THE DOC COMMUNITY.
IT IS AN IMPORTANT OBSERVATION
THAT WE NEED TO CONSIDER WHEN WE
WANT TO MAKE RECOMMENDATIONS FOR
NIDCR STRATEGY DEVELOPMENT.
INTERFACES NEED TO BE DERIVED.
THIRD OBSERVATION IS LACK OF
CONNECTIVITY. IT RELATES
DIRECTLY TO WHAT I SAID BEFORE,
THE LACK OF HISTORICAL
COHERENCE. CURRENTLY DATA
SYSTEMS ARE SCATTERED. MANY OF
THE SYSTEMS ARE NOT CONNECTED
WITH EACH OTHER. TO BE VERY
CLEAR, IT IS NOT NECESSARY THAT
WE, YOU KNOW, GENERATE THIS ONE
SINGULAR SYSTEM IN WHICH
EVERYTHING IS CONNECTED WITH
EVERYTHING ELSE.
FOR EXAMPLE, FOR ACTIVITIES AT
EXTREME ENDS OF THE
TRANSLATIONAL SPECTRUM, THERE IS
-- THERE IS VERY DIFFERENT
COMMUNITIES TO USE THE SYSTEM
AND IS NOT NECESSARILY A NEED
FOR MUCH DIRECT INTEROPERABILITY
BUT ARE CERTAIN AREAS WHERE SUCH
CONNECTIVITY WOULD BE MORE
DESIRABLE. WHENEVER THAT
CONNECTIVITY IS DESIRABLE AND
WILL BE NOT LIKELY CALLED OUT TO
SOMETHING THAT SHOULD BE
INCREASED CHALLENGES SUCH AS
LACK OF COMMON DATA STANDARDS OR
METADATA STANDARDS ORONTOLOGIES
COULD BE A CHALLENGE FOR
CREATING THESE CONNECTIONS.
THE THIRD IS A LACK OF DEDICATED
RESOURCES.
HERE, RESOURCES IS NOT
NECESSARILY REFER THE TO
FUNDING. WHAT I MEAN HERE IS
DATA RESOURCES.
SOMETHING THAT WE OBSERVED
WITHIN OUR GROUP IS THAT FOR
MANY TYPES OF DATA, THERE ARE
CURRENTLY NO EXISTING SYSTEMS OR
REPOSITORIES IT THAT WOULD BE
READY TO ACCEPT THAT DATA.
NOW, MOST OF YOU WILL BE AWARE.
I THINK IT WAS PRESENTED HERE AT
COUNCIL BEFORE THAT -- THAT NIH
IS CURRENTLY STRENGTHENING THESE
ASPECTS OF DATA SHARING AND
STARTING THIS MONTH, OUR
PROPOSALS AND ALL NEW PROPOSALS
WILL HAVE TO CONTAIN DATA
MANAGEMENT PLAN AND NEW NIH DATA
MANAGEMENT AND SHARING POLICY
THAT URGES NIH FUNDED
RESEARCHERS TO MAKE SURE DATA IS
SHARED AND SOMETHING WE HEARD
FROM COMMITTEE MEMBERS.
ESPECIALLY THOSE IN HIGHER T
LEVELS IS THEY ARE WORKING ON
PROPOSALS.
THEY ARE ENCOURAGED TO SAY WHERE
THEY WILL DEPOSIT DATA. THERE
IS NO CURRENTLY EXISTING
REPOSITORY DATA TO ACCEPT DATA
SETS THAT IS INHERENT CONFLICT
BETWEEN WHAT PEOPLE WOULD LIKE
TO DO AND ARE ENCOURAGE THE TO
DO VERSUS WHAT INFRASTRUCTURE
EXI
EXISTS.
FINALLY, MY LAST PRELIMINARY
OBSERVATION IS THERE ARE HURDLES
FOR FAIR COMPLIANCE. WE HAVE
HEARD ABOUT FAIR IN THIS FORM
BEFORE. IT IS AN IDEA THAT ALL
DATA THAT IS GENERATED WITH
PUBLIC FUNDING AND TAXPAYER
DOLLARS SHOULD BE MADE AVAILABLE
FOR DOWNSTREAM USES FOR OTHER
RESEARCHERS DATA HAS TO BE
FIENTDABLE BY OTHERS ACCESSED
AND DOWNLOAD THE AND IN A FORMAT
TO INTERACT WITH THE DATA AND
WHERE DIFFERENT DATA TYPES COULD
BE INTEGRATED AND DATA NEEDS TO
BE SUFFICIENTLY DOCUMENTED AND
WAYS THAT MAKES IT REUSABLE AND
THESE SOUND GREAT AND ARE REALLY
HARD TO DO IN REALITY.
ONE OBSERVATION OUR GROUP HAS
MADE IS CURRENTLY WELL THIS IS
NOT JUST NIDCR BUT IS TRUE
ACROSS NIH AND THERE IS A LOT OF
FOCUS ON RESEARCH ASKING THE
COMMUNITY WHAT SHOULD BE
SUPPORTED PRIMARILY PEOPLE ARE
INTERESTED IN FUNDING RESEARCH
THAT HAS IN MANY CASES CREATED
EFFORTS FOR DEDICATED FUNDING TO
CREATING INFRASTRUCTURE THAT CAN
RESULT IN INFRASTRUCTURE GAPS
SUCH AS CERTAIN REPOSITORIES
JUST NOT EXISTING LIKE I SAID
AND IN CHALLENGES HOW DO YOU DO
CURERATION AND GOVERNANCE OF
DATA AT SCALE AND CREATING THIS
FOR DATA COMPLIANCE AND ONE
PARTICULAR CHANCE THAT WAS
POINTED OUT CURRENTLY MANY
REPOSITORIES THAT ARE OPERATED
INFORM LIMITED TERM FUND
INSTRUMENTS THAT COULD CREATE
INHERENT CONFLICTS WITH A
LONG-TERM COMMITMENT TO KEEPING
DATA FAIR AND KEEPING
REPOSITORIES UP TO DATE
MAINTENANCE OF DATA SO IT STAYS
FINDABLE AND ACCESSIBLE IN A
REALLY IMPORTANT CONSIDERATION.
PRELIMINARY FINDINGS WE WILL
TALK MORE ABOUT RFIS. WE HAVE
LOTS OF EXPERTISE ON GROUPS
ALREADY. WE STILL REALIZE AND
WE STILL ARE PROBABLY NOT
CAPTURING EVERYTHING.
WE WANTED TO REACH OUT TO THE
BROADER COMMUNITY FOR ADDITIONAL
INPUT AND WANTED TO UNDERSTAND
ACROSS TRANSLATIONAL SPECTRUM
WHAT REALLY ARE PEOPLE'S DATA
NEEDS AND IF THERE ARE
ADDITIONAL DATA TYPES
UNFORTUNATELY FOR REPOSITORY
NEEDS AND WHAT ARE GAPS AND
SHARING AND ACCESSING DATA AND
WHAT USE CASES PEOPLE HAVE.
UNDERSTANDING WHAT TYPES OF DATA
AND OUTPUTS THEY GENERATE OR
NEED TO ACCESS AND GOAL HERE WAS
TO MAKE THE SURVEY ACCESSIBLE
AND INCLUSIVE TO COVER THE
ENTIRE SPECTRUM.
MORE FROM A PRACTICAL
PERSPECTIVE TO ADOPTED FORMAT
THAT IS SUFFICIENTLY SUCCINCT
AND MANAGEABLE TO GET A LARGE
NUMBER OF RESPONSES.
TO GET THIS RFI OUT, WE FORMED A
SUB-COMMITTEE THAT YOU SEE HERE
SOME OF THE WORKING GROUP
MEMBERS AND WE ENLISTED CHRIS
WILLIAMS FAITH-BASED CONSULTANT
WITH THIS HELPING WITH LOGISTICS
OF PUTTING THIS TOGETHER AND
NIDCR STAFF THAT ARE INVOLVED
FOR HELPING US WITH GETTING THIS
INTO THE RIGHT FORMAT AND
DEVELOPING AND, YOU KNOW, AN
RFI-COMPATIBLE FORMAT FOR THIS
AND SUB-COMMITTEE IS CURRENTLY
MEETING WEEKLY TO DEVELOP THIS
RFI AND SURVEY THAT COMES ALONG
WITH IT TO COLLECT INPUT.
THE GOAL IS TO HAVE THE RFI AND
WE WILL PUT IT INTO THE PROCESS
FOR GETTING IT PUBLISHED BY THE
END OF JANUARY THAT SHOULD ALIGN
WITH PUBLISHING DATE FOR ACTUAL
RFI BY MARCH 13TH AN IMPORTANT
DATE THAT ALIGNS WITH AODCR
MEETING IN MARCH WHERE ATTENDEES
WILL BE PRIMARY DEMOGRAPHIC TO
GET INPUT FROM. SO, TO GET
RESPONSES FOR US AND WORKING
GROUPS THAT WILL BE ADVERTISE
THE WITH A USUAL NIH CHANNELS.
WE WILL ALSO ASK ALL OF OUR
WORKING GROUP MEMBERS THAT ARE
PRESENT AT THAT CONFERENCE TO
ADVERTISE IT THERE AND TO GET A
GOOD NUMBER OF RESPONSES.
SO, IN TERMS OF THE UPCOMING
WEEKS AND MONTHS FOR THE WORKING
GROUPS.
SO, ONE MAJOR FOCUS AREA NOW IS
TO GET RFI OUT AND GET INPUTS
AND HAVE ANOTHER LOOK AT THE
INPUTS AND INCORPORATE THAT INTO
OUR ANALYSIS IDENTIFYING
ADDITIONAL GAPS AND GETTING
IDEAS FOR OPPORTUNITIES TO
ADDRESS THEM.
THEN WITH RESPECT TO DOC DATA
ECOSYSTEM, WE CAN TAKE OUR
FINDINGS AND COME UP WITH A SET
OF HIGH-LEVEL RECOMMENDATIONS
FOR HOW TO EVOLVE DATA ECOSYSTEM
TO GO INTO OUR FINAL REPORT TO
COUNCIL.
THEN SOMETHING THAT WE HAVE NOT
REALLY SPENT A LOT OF TIME ON
BUT WE PLAN TO TACKLE IN THE
UPCOMING MONTHS IS THESE OTHER
OPPORTUNITIES AND SO FARTHER WE
HAVE TRIED TO UNDERSTAND WHAT IS
EVEN THERE AND UNDERSTANDING THE
COMMUNITY NEEDS.
SOMETHING THAT WE WILL FOCUS ON
MOVING FORWARD IS ALSO BROADLY
THINKING ABOUT DATA AND DATA
SCIENCE METHODS AND WHAT ARE THE
OPPORTUNITIES THERE THAT ARE
CURRENTLY NOT BEING FULLY
REALIZED.
AND THEN HOW DOES THIS RELATE TO
HEALTH DISPARITIES AND
INEQUALITIES AND RELATED TO BOTH
OF THESE HOW WE TRAIN THE NEXT
GENERATION OF DOC RESEARCHERS
AND HOW DO WE MAKE SURE TO BUILD
THE RIGHT KIND OF EXPERTISE INTO
NIDCR PORTFOLIO AND WHILE DOING
SO, HOW CAN THIS AT THE SAME
TIME HELP TO ADDRESS THESE
DISPARITIES AND INEQUALITIES?
WITH THAT, I THINK I'M AT TIME.
I HOPE THAT WE STILL HAVE TIME
FOR QUESTIONS OR A FEW.
>>THANK YOU, DR. BISSEL. ARE
THERE ANY QUESTIONS?
RENA?
>>YOU ARE ON MUTE.
>>YEAH. THANK YOU SO MUCH FOR
YOUR LEADERSHIP AND PERSEVERANCE
SPEAR HEADING THIS TOPIC WITH
THOUGHT LEADERS AND YOUR LISTING
OF 30 RESOURCES THAT WE
CURRENTLY HAVE DID YOU INCLUDE
IN CONSIDERATION INDUSTRY LARGE
CORPORATIONS THAT SEEM TO HAVE
INFRASTRUCTURE FROM BIG DATA
MANAGEMENT AND WHAT ABOUT
ORGANIZATIONS LIKE ADA AND
OTHERS? DO THEY HAVE ANY
SYSTEMS IN PLACE THAT WOULD BE
OF RELEVANCE TO DENTAL OR CRANE
YOE FACIAL RESEARCH?
>>ANSWERING THE FIRST QUESTION,
THE -- AND SOMETHING THAT WE
REALIZED PUTTING THIS TOGETHER
IS THAT OUR LIST IS LIKELY
INCOMPLETE AND IS -- IT CAN BE
HARD TO KNOW WHERE TO DRAW THE
LINE. AND WE HAVE LOOKED AT A
VARIETY OF DATA SYSTEMS.
AND SOME OF THEM ARE, YOU KNOW,
DIRECTLY NIDCR FUNDED AND SOME
ARE DATA SYSTEMS THAT ARE RUN BY
OTHER ORGANIZATIONS AND WE MIGHT
HAVE HAD A FEW THAT OUR INDUSTRY
AND WOULD HAVE MADE AN EXPLICIT
EFFORT TO CAPTURE ON THOSE ALSO
IN PART BECAUSE THERE ARE -- ONE
CHALLENGE IS SOME THAT ARE
CLOSED SYSTEMS IT THAT ARE NOT
PUBLICLY ACCESSIBLE AND YET
MIGHT CONTAIN A HIGHLY RELEVANT
DATA.
WE HAVE ALSO THOUGHT ABOUT WAYS
TO, YOU KNOW, BE EVEN MORE, YOU
KNOW, COMPREHENSIVE IN WHAT WE
CAN CONSIDER FROM A VARIETY OF
RESOURCES AND IT TURNS OUT THIS
IS A REALLY BIG CHALLENGE THAT
WE GET TO GET COMPREHENSIVE LIST
AND NOT SURE WE WILL EVEN HAVE A
COMPREHENSIVE LIST IN THE END.
SO, I THINK THAT -- IT WOULD BE
AN OR TAKE A CONCERTED EFFORT
THAT IS BEYOND SCOPE OF THE
WORKING GROUP TO THEN EVEN
SYSTEMATICALLY ASSESS FOR EVERY
SINGLE ONE OF THESE EXACTLY WHAT
DATA IS IN THERE AND THEY DO A
COMPREHENSIVE ASSESSMENT OF, YOU
KNOW, HOW FAIR IS THE DATA. AND
HOW EXACTLY IS IT CONNECTED?
THIS IS INITIALLY WHAT WE
THOUGHT WE MIGHT DO. IT IS VERY
COMPLEX.
>>YEAH.
>>I THINK IN THE -- IN -- FOR
OURSELVES IN THE WORKING GROUP,
CONCLUSION HAS BEEN THAT WE WILL
PRIMARILY USE THIS TO GET A
SENSE OF THE OVERALL LANDSCAPE.
WE CAN USE THAT FOR
RECOMMENDATION HOW THIS MIGHT
EVEN BE TACKLED MOVING FORWARD.
IT IS INCREDIBLY COMPLEX.
>>YES. THANK YOU.
>>ANY OTHER QUESTIONS?
>>YEAH. SO, THIS IS JACK.
AXEL, SUPER JOB. I WANT TO
REALLY COMPLEX YOU IN ALL OF THE
GROUP FOR THIS EFFORT. I THINK
IT IS COMING TOGETHER EXTREMELY
NICELY AND WANT TO CALL
ATTENTION OF YOURSELF AND
PERHAPS ALL OF THE ATTENDEES
HERE TO A SPECIAL ISSUE THAT JDR
JUST PUBLISHED IN OCTOBER ON
DATA DRIVEN ANALYTICS FOR HEALTH
CARE. THIS IS FOR
[INDISCERNIBLE] AND IN THIS
SPECIAL ISSUE THAT I THOUGHT WAS
TRULY OUTSTANDING THERE ARE
EXTREMELY EXCELLENT AUTHORS
THERE THAT COULD PERHAPS WE
COULD ENGAGE IN THIS
CONVERSATION AS WELL AS TERRIFIC
PAPERS THAT EXPLORE ISSUES OF
DATA ANALYTICS IN CONTEXT OF
DOC. I WOULD ENCOURAGE IF THIS
HAS NOT HAPPENED YET TO PERHAPS
LOOK INTO THIS SPECIAL ISSUE AS
AN ADDITIONAL SOURCE OF
INFORMATION FOR EXCELLENT WORK
YOU ARE DOING.
THANK YOU.
>>THANK YOU. WE WILL
DEFINITELY -- WE HAVE NOT LOOKED
AT THIS BUT WILL SHARE WITH
WORKING GROUP AND GUESS HOW WE
MIGHT USE THIS.
>>DO YOU HAVE A QUESTION?
>>YEAH. THANK YOU, LYNNE.
AXEL, THANKS FOR YOUR LEADERSHIP
AND WORK THAT YOUR GROUP HAS
PRODUCED TO GUIDE US ALONG THE
WAY.
MY QUESTION IS CAN YOU COMMENT
ON THE EXTENT THAT ISSUES
IDENTIFY BEING UNIQUE TO DOC OR
MORE BROADLY APPLICABLE TO OTHER
DOMAINS? IT WOULD HAVE
DOWNSTREAM IMPLICATIONS ON
RECOMMENDATIONS WHETHER NIDCR
ALONE SHOULD BE PRODUCING THE
SOLUTIONS OR THERE COULD BE
HIGHER [INDISCERNIBLE]
COORDINATION FOR BETTER
EFFICIENCY AND SYNERGIES.
>>WE SO FAR FOCUSED ON DOC DATA
ECOSYSTEM AND HAVE NOT ATTEMPTED
TO SYSTEMATICALLY COMPARE THIS
WITH CHALLENGES OTHER INSTITUTES
MIGHT HAVE. HOWEVER, I WOULD
ASSUME IT IS A MIX OF BOTH AND
THINK THERE ARE CHALLENGES THAT
ARE BROAD THAT MANY OTHER
INSTITUTES ENCOUNTER THAT MIGHT
BE NIHWIDE PROBLEMS AND EXAMPLE
OF THAT COULD BE HOW DO YOU FUND
REPOSITORIES WITH LONG-TERM
SUSTAINABILITY USING EXISTING
FUNDING INSTRUMENTS ARE PROBABLY
SOMETHING THAT MANY INSTITUTES
ARE THINKING ABOUT. THERE ARE
OTHERS THAT ARE PROBABLY MORE
DOC-SPECIFIC. FOR EXAMPLE WHEN
WE THINK ABOUT IT, DISPARITIES
ACCESS THAT WE HEARD ABOUT THIS
MORNING AND SOME ARE WE SAW SOME
ARE MORE PARTICULARLY PRONOUNCED
IN DOC SPACE.
ALSO WITH RESPECT TO DATA TYPES
WHERE OFTEN TIMES LIKE THE
DENTAL IS FOR EXAMPLE KEPT
SEPARATE FROM GENERAL MEDICAL IN
TERMS OF DATA SPACE.
IT IS A MIX OF BOTH. NOT SURE
HOW TO ANSWER YOUR QUESTION
ABOUT HOW -- LIKE IF THESE
SHOULD BE ADDRESSED PERHAPS
BETTER AT NIH LEVEL. WE ARE
JUST MAKING, YOU KNOW,
RECOMMENDATIONS TO NIDCR
COUNCIL. I THINK IT WOULD BE
GOOD THEN TO TAKE SOME OF THE
CONCLUSIONS AND RECOMMENDATIONS
AND THINK ABOUT WHICH OF THEM
SHOULD BE ADDRESSED AT NICDR
LEVEL AND SOME SHOULD BE
ELEVATED AND DISCUSSED WITH
OTHER INSTITUTES AND MAYBE JUST
HAVE A LOOK AT THEIR STRATEGIES
AND I SUSPECT THERE WILL BE SOME
ITEMS WITH SUBSTANTIAL OVERLAP
WITH OTHER INSTITUTES AND
CENTERS.
>>THANK YOU.
>>JENNIFER HAS A QUESTION.
>>YES. THIS IS A QUESTION
THINKING ABOUT THE PIG PICTURE.
I'M WONDERING ABOUT DOC DATA
FROM SAME INDIVIDUALS TO HAVE OR
ASK QUESTIONS AROUND SOCIAL
DETERMINANTS OF HEALTH OR
SYSTEMIC CONDITIONS AND LOOKING
AT DATA AS WELL TALKING ABOUT
DOC AS PART OF THE WHOLE PERSON
AND THINKING ABOUT WHAT THE
SPACE WOULD LOOK LIKE.
>>YES. AS I SAID BEFORE, IT
TURNS OUT THE WHOLE SPACE IS
EXTREMELY COMPLEX AND IS BEYOND
SCOPE OF WORKING GROUP TO THINK
SPECIFICALLY ABOUT INDIVIDUAL
DATA SYSTEMS AND VERY SPECIFIC
DATA TYPES AND GENERALLY
SPEAKING DATA THAT YOU DESCRIBED
ARE DEFINITELY PART OF TYPES OF
DATA THAT IS COMPREHENSIVE DATA
DOD SYSTEM SHOULD INCLUDE AND
IMPORTANTLY IN A PERFECT WORLD
WOULD BE COLLECTED IN A WAY THAT
IS HIGHLY INTEGRATABLE WITH
OTHER TYPES OF DATA; RIGHT?
IT DOESN'T LIVE IN SYSTEMS THAT
ARE IN ISOLATION AND ANSWER IS
DEFINITELY YES. FOR SPECIFIC
DATA TYPES, WE DON'T HAVE
EXPLICIT RECOMMENDATIONS AT THIS
POINT.
>>OKAY. THANK YOU.
>>THANK YOU VERY MUCH, AXEL.
IT WAS TERRIFIC UPDATES.
NEXT SPEAKER IS DANA GRACE CHAIR
OF HEALTH WORKFORCE WORKING
GROUP AND WILL PROVIDE AN UPDATE
ON THAT WORKING GROUP.
>>THANK YOU VERY MUCH. IS MY
PRESENTATION READY?
CAN YOU SEE MY PRESENTATION?
>>YES.
>>THANK YOU FOR GIVING ME AN
OPPORTUNITY. PLEASURE TO BE
HERE AND MEET EVERYONE VIRTUALLY
AND DISCUSS UP DATES ORAL HEALTH
RESEARCH WORKFORCE WORKING
GROUP. PROBLEM THAT THE GROUP
IS GOING TO ADDRESS IS DECLINE
IN DENTAL ORAL CRANIAL WORKFORCE
AND GOAL TO RECRUIT TRAINEES
INTO PROGRAMS RETAINING
RESEARCHERS AS WELL AS BUILDING
SKILLS OF THESE TRAINEES AND TO
INCREASE DIVERSITY AND SPECIAL
EMPHASIS ON CLINICIAN SCIENTISTS
AND WORKING GROUP MEMBERS, THERE
IS [INDISCERNIBLE] WHO IS
CO-CHAIR AND REPRESENTATIVES
FROM NIDCR ARE LYNN AND LISA
BROWN AND MOST MEMBERS ARE
CLINICIAN SCIENTISTS AND DUAL
DEGREE AND LOTS HAVE GONE
THROUGH TRAINING PROGRAMS WITH
QUITE A BIT OF EXPERIENCE
MENTORING OR LEADING PROGRAMS
THAT ARE DESIGNED FOR THAT
PURPOSE AND YOU WILL RECOGNIZE
MOST NAMES AND FACES OF PEOPLE
HE
HERE.
APPROACH WE HAVE TAKEN WE HAVE
SUBMITTED AN RFI THAT HAS BEEN
COMPLETED AND WILL GET FEEDBACK
FAIRLY SOON FROM THE RESULTS AND
THERE WAS A PRESENTATION BY LYNN
ON AN ANALYSIS ON CURRENT
PROGRAMS AND ANISSA BROWN GAVE
PRESENTATION ON DIVERSITY OF
PROGRAMS THAT CURRENTLY EXIST
AND THERE IS CURRENTLY
DISCUSSION ON THESE PROGRAMS AND
A NUMBER OF LISTENING SESSIONS
AND PANEL DISCUSSIONS HAVE BEEN
HELD WITH KEY STAKEHOLDERS.
LISTENING SESSIONS AND PANEL
DISCUSSIONS WERE PARTICULARLY
IMPORTANT.
THEY WERE HELD WITH FAST AND
CURRENT TRAINEES AND DENTAL
SCHOOL NICD TRAINING PROGRAMS
AND FOUNDATION AND NSF TRAINING
PROGRAM DIRECTORS AND NUMBER OF
ORAL HEALTH LEADERS AND WERE
SEVERAL KEY FIENTDINGS THAT WE
HAVE TAKEN FROM STAKEHOLDER
INPUT ONE IS NIDCR TRAINING
PROVIDES SUPPORT BUT BY ITSELF
IS NOT SUFFICIENT TO PROVIDE
COMPLETE INFRASTRUCTURE THAT A
TRAINING NEEDS AND AS A RESULT
IS A NEED FOR
NON-GOVERNMENTALMENTAL AND
PROFESSIONAL ORGANIZATIONS TO
ENHANCE RESEARCH TRAINING THAT
IS QUITE CLEAR THAT THE
ENVIRONMENT OF THE TRAINEE IS
CRITICAL TO THE SUCCESS. NIDCR
ALONE IS PROBABLY NOT ABLE TO
DELIVER THIS IN A COST-EFFECTIVE
WAY.
SO, SOME COMMENTS FROM TRAINEES
IS -- MIGHT BE AN OPEN
MICROPHONE AND TRAINEES FELT
THAT THE RESEARCH CULTURE IN
DENTAL SCHOOLS IS LACKING AND
THERE IS INSUFFICIENT NETWORKING
AND THEY DON'T HAVE FREQUENT
ENOUGH OPPORTUNITIES FOR
PEER-TO-PEER INTERACTIONS AT
LOCAL AND REGIONAL AND NATIONAL
LEVELS. A MAJOR ISSUE TRAINEES
ENCOUNTERED IS INSUFFICIENT
MENTORING PARTICULARLY IN
TRANSITION FROM RESEARCH TO
RESEARCH INDEPENDENCE AND MIGHT
HAVE MENTORING IN THE TRAINING
PROGRAM BUT ABRUPTLY ENDS AND
FEEL LIKE A 10 YEAR OLD CHILD
KICKED OUT OF THE HOME AND THEY
ARE LEFT TO FEND FOR THEMSELVES
AND PART OF THIS IS LACK OF
SUPPORT INFRASTRUCTURE THAT IS
NEEDED FOR SUCCESS. THIS LACK
OF INFRASTRUCTURE IS EVEN MORE
PRONOUNCED FOR INDIVIDUALS FROM
GROUPS THAT ARE
UNDER-REPRESENTED IN THE
BIOMEDICAL RESEARCH COMMUNITY.
SO, ONE OF THE QUESTIONS IS ARE
THERE SUFFICIENT INCENTIVES TO
FOSTER AND MAINTAIN MENTORING
RELATIONSHIPS?
THERE IS A NEED TO INCREASE
DIVERSITY AND INPUT WE RECEIVED
IS EARLY OUTREACH PROGRAMS WOULD
BE IMPORTANT TO ENHANCE
DIVERSITY AND PARTICULAR
ATTENTION NEEDS TO BE PAID TO
DEVELOPING DIVERSE ROLE MODELS.
THERE IS A NUMBER OF ISSUES
RELATED TO CAREER OPPORTUNITIES
IT THAT WERE BROUGHT UP. ONE IS
THAT THERE ARE TRAINEES THAT
FELT THERE WAS INSUFFICIENT
KNOWLEDGE ON THEIR RESEARCH
OPPORTUNITIES BESIDES A STANDARD
TENURE TRACT PATH AND ASPECT TO
THIS WAS ALTERNATIVE PATHWAYS TO
OTHER CAREER TYPES THAT THEY
COULD PURSUE THAT ARE OPAQUE.
THERE IS A LARGE GAP IN
OPPORTUNITY FOR TRAINEES FROM
RESEARCH INTENSIVE VERSUS LESS
RESEARCH INTENSIVE UNIVERSITIES
THAT WAS FELT TO CREATE AN
OBSTACLE OF -- FOR SOME AND THAT
THERE IS A SENSE THAT SOME
UNIVERSITIES PROVIDE
OPPORTUNITIES AND OTHERS DO NOT.
THAT CREATES AN UNLEVEL PLAYING
FIELD.
THERE IS ALSO A MAJOR ISSUE THAT
IS THE UNCERTAINTY THAT IS IN
ESTABLISHING A SUCCESSFUL
RESEARCH CAREER.
THIS UNCERTAINTY LEADS TO A
SENSE OF RISK. THEY FELT THAT
THE CAREER RISK FOR PURSUING A
RESEARCH CAREER LARGELY IS DUE
TO THIS UNCERTAINTY OUTWEIGHED
THE REWARDS AND WHEN THEY
THOUGHT ABOUT WHAT THEIR CAREERS
WOULD LOOK LIKE, THIS WAS A
MAJOR ISSUE.
OF COURSE, THERE WAS FINANCIAL
ISSUES THAT ARE PARTICULARLY THE
DEBT LOAN SCENARIO.
LYNN PRESENTED ANALYSIS OF
PROGRAMS THAT WERE CURRENT AND
WAS DISCUSSION FROM THIS FROM
DISCUSSION THERE WERE A COUPLE
THINGS BROUGHT FORTH AND
PARTICULARLY RELEVANT AND
GUIDING TOWARDS RECOMMENDSES
DOWN THE ROAD AND ONE IS
PREDOCTORAL DEGREE PROGRAMS WITH
VERY LOW RATES OF TRAINEES
ENTERING RESEARCH CAREERS AND IN
CONTRACT ENTERING TRAINING
PROGRAMS AT A LATER STAGE HAS A
MUCH HIGHER SUCCESS RATE.
ONE OF THE SURPRISING FINDINGS
WAS THAT POST DOCTORAL US AND
NON-US NATIONALS HAVE SIMILAR
RATES OF ENTRY INTO RESEARCH
CAREERS AND GRANT AWARDS AND
THEN FINALLY THERE IS A NEED FOR
A MORE GRANULAR ASSESSMENT OF
FACTORS THAT MAKE CERTAIN
TRAINING PROGRAMS SUCCESSFUL AS
WELL AS A MORE GRANULAR
ASSESSMENT OF WHAT TRAINEE
CHARACTERISTICS ARE NEEDED FOR A
SUCCESSFUL CAREER IN RESEARCH.
SO, THE NEXT STEPS FOR THE
COMMITTEE ARE TO IDENTIFY STEPS
TO PROMOTE A SUPPORTIVE RESEARCH
ENVIRONMENT AND IDENTIFY STEPS
TO FACILITATE AND ENHANCE AND
BROADEN SUCCESSFUL MENTORING.
BY BROADEN I MEAN REACHING OUT
TO AREAS NOT TYPICALLY PART OF
DENTAL RESEARCH SUCH AS
ENGINEERING AND BROADEN MAY ALSO
MEAN CROSS-INSTITUTIONAL
MENTORING TO HELP SCHOOLS TO
HAVE LESS RESEARCH
INFRASTRUCTURE. THERE IS A
NUMBER OF ASPECTS RELATED TO
MENTORING THAT ARE LIKELY TO BE
QUITE IMPORTANT.
THIS INCLUDES A MORE SUSTAINED
MENTORING. AS A STUDENT TRAINEE
TRANSITIONS TOWARDS
INDEPENTDIENT CAREER AND STILL
WILL HAVE OPPORTUNITIES OF
MENTORING.
TO IDENTIFY STEPS THAT CAN BE
TAKEN TO INCREASE BREADTH AND
QUALITY OF TRAINING AND THIS
INCLUDES TRANSLATIONAL SPECTRUM.
THERE IS A STRONG EMPHASIS ON
BASIC SCIENCE RESEARCH AND NEEDS
TO BE SOMEWHAT OF A TRANSITION
TO SUPPORTING TRAINING TOWARDS
CLINICAL RESEARCH CAREERS IT
THAT INCLUDES ENHANCING TRAINING
AND REGULATORY ASPECTS OF
RESEARCH.
AND OF PRODUCT DEVELOPMENT.
AND IN ADDITION, STEPS NEED TO
BE TAKEN TO ENHANCE DIVERSITY OF
TRAINEES AND DIVERSITY OF EARLY
CAREER RESEARCHERS.
ANOTHER THING THAT THE COMMITTEE
IS GOING TO FOCUS ON IS TO
IDENTIFY IDIOLOGIC FACTORS
ASSOCIATED WITH SUCCESS IN
PURSUING A RESEARCH CAREER.
LASTLY ILLUDING TO THE POINT
THAT WAS MADE EARLIER ABOUT
NIDCR NOT NECESSARILY DOING THIS
ALONE IS THE IDEA THAT
PARTNERSHIPS WITH NIDCR COULD BE
PARTICULARLY USEFUL IN REDUCING
SOME OF THE RISK OF CAREER
UNCERTAINTY AND IN TERMS OF
BROADENING KNOWLEDGE AVAILABLE
AND IDENTIFY MULTIPLE CAREER
PATHS AND PROVIDING A RICHER
CULTURE FOR STUDENTS WHO ARE OR
TRAINEES AND EARLY STAGE
RESEARCH CAREERS IN DOC.
SO SOME POTENTIAL PARTNERSHIPS
DISCUSSED AT THE MEETING ARE
INVOLVING NIDCR PARTNERSHIPS
WITH PROFESSIONAL ASSOCIATIONS
THAT INCLUDE DENTAL SPECIALTY
ORGANIZATIONS SUCH AS AAP
AMERICAN FAMILY OF PE
PERIDENTALONTOLOGY AND WITH IDER
AND WE HAVE IDENTIFIED OVER 100
PROFESSIONAL ORGANIZATIONS AND
COULD POTENTIALLY PARTNER WITH
DISCUSSED PARTNERSHIPS AND I
THINK IT IS CLEAR THAT DENTAL
SCHOOLS NEED TO PLAY A GREATER
ROLE ESPECIALLY IN THIS ISSUE OF
CAREER UNCERTAINTY PARTNERSHIPS
WITH DENTAL SCHOOLS MIGHT HELP
OVERCOME GAPS WITH TRAINEES IT
THAT EXPERIENCE AS THEY
TRANSITION TO INDEPENDENCE.
THEN LASTLY THERE IS A DESIRE BY
ORAL HEALTH INDUSTRY WITH
LEADERS THAT WE SPOKE TO.
GREATER PARTICIPATION IN
DEVELOPING DOC WORK AND RESEARCH
WORKFORCE THAT WOULD BENEFIT
THEM AS WELL AS TRAINEES AND TWL
ARE POTENTIAL PARTNERSHIPS THAT
WE WILL BE PURSUING.
SO, TO GIVE YOU A TIMELINE OF
WHAT HAS OCCURRED, AT THIS POINT
WE HAVE HAD INITIAL MEETINGS AND
HAD PRESENTATIONS FROM NIDCR ON
TYPES OF PROGRAMS THAT ARE
AVAILABLE AND ASSESSMENT OF THE
PROGRAMS AND METRICS USE THE TO
MEASURE SUCCESS. WE HAVE HAD
LISTENING SESSIONS IN PANEL
DISCUSSIONS WITH KEY
STAKEHOLDERS AND RFI HAS BEEN
SUBMITTED AND WILL BE GETTING
FEEDBACK ON THAT SOON ON THAT.
NIDCR HAS GIVEN A PRESENTATION
ON OUTCOMES.
SO, FOR THE FUTURE, AND IN THE
MEDIATE FUTURE, WE WILL DISCUSS
POTENTIAL PARTNERSHIPS WITH
NIDCR WITH GROUPS THAT I
MENTIONED THAT THESE ARE
PROFESSIONAL ASSOCIATIONS AND
DENTAL SCHOOLS AND THAT ARE
LEADERS IN ORAL HEALTH INDUSTRY
AND PHARMA. WORKING GROUPS WILL
THEN DISCUSS SOME OF -- THEY
WILL HAVE DISCUSSIONS ON
RECOMMENDATIONS AND SUBGROUPS
WILL BE FORMED TO TACKLE
DIFFERENT ASPECTS OF THE CHARGE
THAT WE HAVE.
WE HOPE BY END OF JULY TO HAVE
RECOMMENDATIONS TO COUNCIL.
WE EXPECT THAT SOME OF THE
RECOMMENDATIONS WILL INVOLVE
PARTNERSHIPS THAT WE HAVE BEEN
DISCUSSING.
SO, THANK YOU VERY MUCH.
I WOULD BE HAPPY TO TAKE ANY
QUESTIONS.
>>ARE THERE ANY QUESTIONS FOR
DR. GRAVES?
>>I THINK YOU ARE MUTED.
>>JUST MY HEAT FELT GRATITUDE
FOR STEERING AND IN A VERY
COMPLEX MILIEU; RIGHT? FACTORS
YOU BROUGHT UP WE HAVE HEARD OF
BEFORE. WE HAVE DEBATED AND
WRESTLED FOR SOLUTIONS. IT
REALLY TAKES A VILLAGE TO START
MOVING THE NEEDLE WITH ADMISSION
CRITERIA DEVELOPING PATHWAYS AND
PIPELINES, ET CETERA, ET CETERA.
WHEN YOU IN JULY YOU WOULD BE
HOPEFULLY PROVIDING
RECOMMENDATIONS FOR NIDCR
LEADERS TO CONSIDER SERIOUSLY
AND ALSO TO INCLUDE PARTNERSHIPS
WITH OTHER INSTITUTES. YOU
KNOW?
NIH HAS REALLY GOOD SUCCESS WITH
CERTAIN GROUPS OF PHYSICIAN
SCIENTISTS AND TRAINEES AND NOT
ALL BUT SOME AND PROGRAM IN
GENERAL SUFFERS FROM ABOUT THE
SAME THING AS WE DO.
I WOULD LIKE FOR YOU AND IT
WOULD BE NICE TO GET FEEDBACK
FOR YOU ON WHETHER THERE OUGHT
TO BE A UNIVERSAL CURRICULUM FOR
DDS COMBINED DUAL TRAINEES TO
CREATE MORE OR LESS A LEVEL
PLAYING FIELD TO MITIGATE
FACTORS OF LONGEVITY AND STRESS
AND HARDSHIP SEEMING TO PLAGUE
THAT PARTICULAR PROGRAM; RIGHT?
COMPARED TO THOSE DOING DDS AND
PHD AFTER. HOPEFULLY WHEN WE
ARE TOGETHER IN MARCH, WE CAN
SHARE IDEAS AND BELIEVE THERE IS
A BROADER GROUP OF FOLKS.
>>YES.
I THINK WE HAVE DISCUSSED MOST
OF THE ISSUES YOU BROUGHT UP. I
WILL RESPOND TO ONE OF THE
THINGS THAT IS HAVING A
UNIVERSAL CURRICULUM. THE
PROGRAM DIRECTORS EMPHASIZE THE
NEEDING LOCAL CONTROL. SO, I
JUST --
>>I KNOW. YEAH.
>>YOU KNOW, SO, IF YOU SPEAK TO
THE PROGRAM DIRECTORS, THAT IS
WHAT THEY FELT WAS CRITICAL AND
SPEAKING TO TRAINEES AND SOME
FEEDBACK THAT WE GOT WAS THAT
THE DENTAL SCHOOLS OF THE
PROGRAMS ARE NOT MEETING
COMMITMENTS THAT THEY HAVE MADE.
SO, YOU KNOW, WE HAVE HAD
DIFFERENT PERSPECTIVES IT THAT
EACH HAS BEEN SOMEWHAT
DIFFERENT.
>>IT WILL BE GOOD TO HEAR THAT
TOGETHER.
>>ONE LAST QUESTION. HOW WILL
YOU LINK TO PHARMA?
I MEAN, THAT COULD -- OR
PHARMAOR OTHER INDUSTRY THAT
COULD GENERATE SOME NICE
RESEARCH OPPORTUNITIES.
>>YEAH. SO, WE HAVE STARTED TO
EXPLORE THAT.
PHARMAHAS MENTIONED THINGS SUCH
AS PROVIDING OPPORTUNITIES FOR
SUMMER PROGRAMS AND FOR
INTERNSHIPS AND EXTERNSHIPS.
THEY HAVE ALSO DISCUSSED
CONTRIBUTING TO THE CULTURE.
TOWARDS GUIDANCE AND TOWARDS
ENTREPRENEURSHIP AND TOWARDS
TRAINING AND REGULATORY ASPECTS
OF DEVICE DEVELOPMENT AND
PRODUCT DEVELOPMENT. THERE IS A
NUMBER OF ISSUES THAT
PHARMACONSIDERS IMPORTANT. WE
WILL BE -- WHAT WE -- WHAT I DID
IS WE TOOK THE -- I THINK THE 20
LARGEST COMPANIES IN THAT SPACE.
WE HAVE INVITED THE ORAL HEALTH
LEADERS OF COMPANIES TO MEET
WITH US AT A DOCKER MEETING IN
PERSON AND VIRTUALLY. THERE ARE
REASONS THAT WE COULD RESPOND.
WE WILL ASK THEM WHAT TYPE OF
PARTNERSHIPS ARE YOU WILLING TO
DO?
AND WE ARE ASKING THE DENTAL
SCHOOLS: WHAT CAN YOU DO TO
PROVIDE GREATER CAREER CERTAINTY
AND TO -- TO ENHANCE TRAINING
ENVIRONMENTS SO THAT -- I MEAN,
THE EASIEST THING TO DO IS ASK
NIDCR TO THROW MORE MONEY AT THE
PROBLEM BUT WAS PRETTY MUCH THE
SECOND THING I WAS TOLD NOT TO
EXPECT TO TRY TO DO THIS IN A
WAY THAT WAS COST EFFECTIVE.
SO, I THINK THAT THE COMMITTEE
HAS SEEN THAT THERE DOES NEED TO
BE MORE INTERACTION FROM THE
PROFESSIONAL SOCIETIES.
ANOTHER INTERESTING COMPONENT OF
THIS IS THAT MOST OF THE
SOCIETIES HAVE FOUNDATIONS THAT
ARE DESIGNED TO FOSTER CAREER
DEVELOPMENT.
THAT MIGHT -- THAT REPRESENTS AN
AVENUE OF PARTNERSHIPS AND ARE
LOTS OF OPPORTUNITIES THERE THAT
ARE WORTH EXPLORING.
>>GREAT. THANK YOU.
>>THIS IS EXCELLENT. THANK YOU
FOR LEADING THIS GROUP AND
RESEARCH THAT IS AN IMPORTANT
WORK.
MY QUESTION HERE IS IDENTIFYING
GAP THAT YOU IDENTIFIED IN YOUR
GROUP AND BETWEEN RESEARCH
INTENSIVE AND NONINTENSIVE
DENTAL SCHOOLS THAT IS VERY REAL
AND THIS GAP IS INCREASING AS WE
SPE
SPEAK.
IS THERE OPPORTUNITY TO ENGAGE
WITH AKREDIZATION STANDARDS TO
STIPULATE RESEARCH CREDENTIALS
ON SCHOOLS AND THOUGHTS ON THAT?
>>STANDARD 6 IS PRETTY CLEAR
AND QUESTION IS WILL KODIA
ENFORCE STANDARD 6 TO ANYTHING
THAT IS BEYOND SYSTEMATIC
REVIEW?
YOU KNOW, I'M NOT SURE I HAVE
THE ANSWER TO THE QUESTION AND
AMERICAN DENTAL ASSOCIATION AND
OUTCOMES COME INTO PLAY.
PARTNERSHIPS WITH ORGANIZATIONS
CAN HAVE IMPACTS AND AS A
WORKING GROUP I WOULD BE GREATLY
OVERSTEPPING BALANCE TO SAY WE
COULD COME UP WITH A SOLUTION
WITH THAT AND WE DISCUSSED IT
WITH AMERICAN DENTAL ASSOCIATION
AND THINK THIS ISSUE WITH
PARTNERSHIP WILL BE IMPORTANT
AND IT HAS ALREADY STARTED. AM
I IN THE FUTURE AND LOOKS LIKE A
GREAT PROGRAM BUT IS NOT AN
ENTIRELY NOVEL CONCEPT BUT THINK
IT CAN BE ENHANCED AND CAN BE
EXPANDED TO BENEFIT DENTISTS AND
RESEARCHERS AND DOC AND
EVERYBODY INVOLVED.
>>THANK YOU.
>>>>THANK YOU VERY MUCH DANA.
THAT WAS GREAT AND GREATLY
APPRECIATE THE UPDATE AND
PRESENTATION. FOR THE NEXT, WE
CAN MOVE TO FINAL ITEM ON AGENDA
TODAY THAT IS ONE CONCEPT
CLEARANCE THAT WE ARE REQUIRED
TO DOCUMENT CLEARANCE OF
CONCEPTS BY PRESENTING THE
PURPOSE AND SCOPE AND OBJECTIVES
IN A PUBLIC FORUM SUCH AS
COUNCIL MEETINGS GIVING COUNCIL
MEMBERS AND PUBLIC AN
OPPORTUNITY TO COMMENT.
FOLLOWING PRESENTATION BY NIDCR
STAFF AND DESIGNATED COUNCIL
MEMBERS WILL LEAD DISCUSSION AND
FOLLOWED BY A VOTE FOR APPROVAL
OF THE CONCEPT AS A BASIS FOR
DEVELOPING FUTURE FUNDING
OPPORTUNITY ANNOUNCEMENTS AND
DR. LORENA THE PROGRAM OFFICER
FOR CLINICAL RESEARCH AND
EPIDEMIOLOGY PROGRAM WILL
PRESENT A CONCEPT ON TODAY'S
AGENDA AND COUNCIL MEMBERS DR.
AXEL VISCEL AND RAUL GARCIA
WILL LEAD THE DISCUSSION AND
TURNING IT TO LORENA.
I THINK IT WILL PRESENT YOUR
SLIDE.
>>THANK YOU. I'M A PROGRAM
OFFICER AT NICDR CENTER WHERE I
OVERSEE RESEARCH. NICDR
CLINICAL RESEARCH CENTER IS
DIRECTED BY DANA FISHER WHO WE
ARE EXCITED TO PRESENT YOU TO ON
BEHALF OF NICDR REQUEST OF
REISSUANCE OF FUNDING
OPPORTUNITY AND TITLE OF
[INDISCERNIBLE].
NEXT, PLEASE.
GOAL OF THE CONCEPT IS PROVIDING
INVESTIGATORS WITH SUPPORT
NECESSARY TO CONDUCT RESOURCE
INTENSIVE PROSPECTIVE VALIDATION
STUDIES MULTI-YEAR OPPORTUNITY
ENCOURAGES APPLICATIONS TO
UTILIZE U1 CORPORATE AGREEMENT
MECHANISM PROVIDING RESEARCH
SUPPORT FOR INVESTIGATORS UP TO
FIVE YEARS AND CURRENT FUNDING
OPPORTUNITY IS DUE TO EXPIRE IN
FOUR MONTHS AND WILL REQUEST
ISSUANCE.
NEXT, PLEASE.
PROVIDING BACKGROUND RESPONSE TO
FUNDING OPPORTUNITY SERIES THAT
WAS FIRST PUBLISHED FIVE YEARS
AGO WE RECEIVED 29 COMPETITIVE
GRANT APPLICATIONS AND 12
APPLICATIONS HAVE BEEN AWARDED
AND FUNDING APPLICATIONS FOUR
WERE SUBMITTED ABOUT I TEAMS
WITH MULTIPLE INVESTIGATORS AND
TWO WERE FROM NEW INVESTIGATORS
AND GRANTS SUPPORTED TWO
SUPPLEMENTS ALSO. MOST
APPLICANTS PROPOSED STUDIES
HIGHLY DIVERSE SAMPLE SCLEKSS
AND APPROACHES AND TYPES AND
DATA SPECIMEN COLLECTION
INCLUDED CLINICAL DATA
TRANSMEDICAL -- BIOSPECIMENS AND
PLASMA SLIDE TISSUE SPECIMENS
AND IMAGING AND MRIS AND LUNG OR
MICROBIOME DATA AND
INVESTIGATORS HAVE BEEN VERY
PRODUCTIVE AND RESEARCH STUDIES
CONDUCTING FUNDING OPPORTUNITY
AND 37 PUBLICATIONS AND MANY
RESULTS FROM INTENSIVE 5 YEAR
LONGITUDINAL STUDIES HAVE BEEN
PROCESSED AND THROUGH
PUBLICATIONS RESULTS HAVE BEEN
DISSEMINATED ON MICROBIOMES
FINDINGS AND METHODOLOGICAL
APPROACHES AND VALIDATION
STUDIES.
NEXT, PLEASE.
THE PLAN IS FOR THIS FUNDING
OPPORTUNITY TO CONTINUE TO
SUPPORT RESEARCH INTENSIVE
RESEARCH PROPOSALS -- IN LARGE
COHORTS AND THESE ARE
OPPORTUNITIES FOR DEVELOPING
PREDICTIVE -- THERE ARE
OPPORTUNITIES FOR DEVELOPING
PREDICTIVE TOOLS AND FOR
OPTIMIZING DISEASE PREVENTION
AND TREATMENT. ADDITIONALLY,
RESEARCH STUDIES MAY BE PROPOSED
FOR LONG-TERM FOLLOW UP OF
CLINICAL TRIAL PARTICIPANTS IN
PREVENTIVE OR THERAPEUTIC
INVENTION AND INITIAL TRIAL HAS
ENDED.
CURRENTLY THERE IS NO SPECIFIC
MECHANISM TO FOLLOW UP
PARTICIPANTS BEYOND CLOSEOUT AND
ADDITIONAL FOLLOW UP COULD BE
USED TO ASSESS LONG TERM EVENTS
SUSTAINED EFFECT OF INTERVENTION
OR COLLECTING ADDITIONAL DATA TO
CREATE COMBINED COHORTS TO
UNCOVER NEW KNOWLEDGE. THIS IS
ALSO A TIMELY OPPORTUNITY TO
LEVERAGE EXISTING BIOSPECIMENS
AND DATA AND OR EPIDEMIOLOGIC
COHORTS TO PROMOTE HIGH QUALITY
DATA SHARING CONSISTENT WITH
TODAY'S IMPLEMENTATION OF NIH
DATA MANAGEMENT AND SHARING
POLICY AND GENERATION OF
ADDITIONAL MULTIDIMENSIONAL DATA
USING NEW ANALYTIC METHOD AND
TECHNOLOGIES CONSISTENT WITH NEW
POLICY NICDR PARTICIPATES IN
ROBUST SHARING CURATED REUSABLE
DATA AND POPULATION EFFECTED BY
CONDITION IN THE STUDY AND
INVESTIGATORS WILL BE EXPECTED
TO PRODUCE AND SHARE HIGH
QUALITY PROTOCOLS AND DIGITAL
DATA AND METADATA ALIGNED WITH
FAIR AND JUST PRINCIPLES AND
NEXT, PLEASE.
THIS FUNTDING OPPORTUNITY HAS
DUAL FOCUS PERSPECTIVE COVER
STUDIES AND BIOMARKER STUDIES
AND BROAD RANGE OF CRANIOFICIAL
CONDITIONS AND MANY AWARDED
PROJECTS INVOLVING LARGE
LONGITUDINAL MULTICENTER STUDIES
WITH EXTENSIVE COLLECTION OF
DATA COLLECTION OF SPECIMENS AND
ANALYZE AND PRODUCE PUBLICATIONS
FROM VARIOUS DENTAL ORAL KRASH
YO FACIAL TOPICS AND MEDICAL
CONDITIONS AND SYNDROMES AND
SPEECH ABNORMALITIES AND ORAL
CANCER AND CYSTIC FIBROSIS AND
DENTAL [INDISCERNIBLE] AND CLEFT
PALETTE. NEXT, PLEASE.
ON BEHALF OF NICDR I WOULD LIKE
TO THANK YOU FOR ATTENTION AND
CONSIDERATION OF ISSUANCE OF
FUNDING OPPORTUNITIES AND I ALSO
WISH TO THANK DR. AXEL VISCEL
AND RAUL GARSIO FOR INPUT AND
WOULD LIKE TO PASS IT TO THEM
FOR ADDITIONAL THOUGHTS WOULD
YOU LIKE TO TAKE IT FROM HERE
DR. VISCEL?
>>YES. OKAY. SO, THANK YOU
FOR THE GREAT OVERVIEW. SO, I
WILL START BY SAYING THAT I'M
HIGHLY SUPPORTIVE OF THIS
CONCEPT AND THINK IT WILL PAVE
THE WAY FOR CONTINUED FOCUSED
EFFORTS ON DEVELOPMENT AND
VALIDATION OF BIOMARKERS AND
PROSPECTIVE OBSERVATIONAL
STUDIES.
MOST OF YOU KNOW THAT WELL
VALIDATED BIOMARKERS ARE
CRITICAL FOR IMPROVING DIAGNOSIS
AND TREATMENT AND SAME TIME CAN
BE DIFFICULT TO SUPPORT
DISCOVERY AND VALIDATIONAL
BIOMARKERS IN FUNDING MECHANISMS
FOCUSED ON HYPOTHESIS FOR
RESEARCH AND SAME IS TRUE FOR
POST [INDISCERNIBLE] PERSPECTIVE
STUDIES AND HEARD THIS PREVIOUS
FOA THAT HAS BEEN IN EXISTENCE
FOR SEVERAL YEARS AND IT HAS
BEEN AN IMPORTANT WAY TO ADDRESS
A GAP BY USING UO1 MECHANISMS
SPECIFICALLY SUPPORTING THESE
EFFORT AND WHEN YOU LOOK AT MORE
DETAIL THE CONCEPTS, YOU KNOW,
IT IS PRETTY EVIDENT THAT OVER
THE LAST FEW YEARS IT HAS BEEN
QUITE SUCCESSFUL AND PROPOSALS
COVER WIDE SPECTRUM OF
BIOMARKERS AND OBSERVATIONAL
DATA AND CLINICAL DATA FROM A
RANGE SAY YOU KNOW MASS
BIOSPECIMENS PLASMA AND SALIVA
AND MICROBIOME DATA AND
IMPRESSIVE LIST OF ALMOST 40
PUBLICATIONS HAVE RESULT THE
FROM THE RESEARCH SO FAR THAT I
THINK SPEAKS TO IMPACTS OF THIS
EFFORT AND BASED ON THIS VERY
SUCCESSFUL TRACK RECORD AND
RESEARCH THAT IS DONE THAT IT
WAS DONE UNDER PREVIOUS FOA AND
BASED ON CONTINUED NEED FOR
EXPANDING REPERTOIRE OF THESE
AVAILABLE WELL VALIDATED
BIOMARKERS AND PREDICTORS AND
SUPPORTIVE OF THIS CONCEPT AND
HIGHLY SUPPORTIVE OF CONTINUING
THIS FOA INTO FUTURE YEARS.
>>THANK YOU FOR THE
PRESENTATION AND TIME YOU GAVE
US EARLIER THIS MONTH TO GO OVER
THE CONCEPT.
AND TO ANSWER OUR QUESTIONS.
I HAVE NOTHING ELSE TO ADD TO
DR. VISEL'S ENTHUSIASTIC SUPPORT
OF THIS CONCEPT AND I TOO
ENDORSE MOVING ON WITH IT.
THANK YOU.
>>THANK YOU BOTH.
>>ANYBODY ELSE HAVE ANY
COMMENTS OR QUESTIONS ABOUT THIS
CONCEPT?
IF NO FURTHER COMMENTS OR
QUESTIONS WOULD A MEMBER OF
COUNCIL LIKE TO MAKE A MOTION
FOR RECOMMENDATION TO APPROVE
THIS CONCEPT?
>>SO MOVED [ROLL CALL] GARCIA.
>>WOULD ANYONE LIKE TO SECOND
THE MOTION?
>>SECONDED IT.
>>ALL IN FAVOR?
>>AYE.
>>ANY OPPOSED?
OKAY. WE ARE NOW AT THE END OF
THE OPEN SESSION. WE WILL POST
THE WEB -- THE URL OF THE
WEBSITE OR E-MAIL ADDRESS OR
POST THE E-MAIL ADDRESS WHERE
YOU CAN SUBMIT QUESTIONS TO US
ABOUT THE COUNCIL TODAY AND
COUNCIL MEETING TODAY BY
FEBRUARY 17TH.
AND WE ALSO HAVE A SLIDE THAT
WILL SHOW THE UPCOMING COUNCIL
MEETINGS.
THE MAY 16TH MEETING, 2023 WILL
BE A VIRTUAL MEETING. WE ARE
PLANNING FOR IN-PERSON MEETING
ON SEPTEMBER 13TH AT 2023 FOR
THE LATER COUNCIL IN THE FALL.
WITH THAT, I WOULD LIKE TO
INVITE DR. RENA D'SOUZA FOR
CLOSING COMMENTS FOR THE OPEN
SESSION.
>>YOU KNOW, I JUST GOT A
WONDERFUL COMPLEMENT FROM BRENDA
HCHLTD DIRECT TODAY ALL OF THE
STAFF SHE THOUGHT IT WAS ONE OF
THE NICEST AND MOST ILLUMINATING
OF ALL COUNCILS. WE CAN ONLY
STRIVE TO KEEP BRENDA IN THAT
MODE FOR A LONG TIME. I THANK
YOU ALL FOR YOUR PARTICIPATION.
YOU KNOW, WE SEEK ALWAYS BETTER
WAYS TO DO THINGS.
SO, THE DOOR IS OPEN FOR YOUR
SUGGESTIONS IN HOW TO MAKE THIS
MORE INTERACTIVE AND MORE
ENGAGING, PERHAPS, ON OUR END
AND ANYTHING LIKE THAT WOULD BE
MOST REALLY WELL COME. I THANK
YOU FOR ALL THOSE WHO HAVE SAT
THROUGH THIS MORNING AND IN THE
AFTERNOON AND THANK YOU FOR
LISTENING AND BEING PART OF OUR
COMMUNITY AND I LOOK FORWARD TO
THE CLOSED SESSION NOW IN A FEW
MINUTES AND THANK YOU AXEL AND
DANA AND CONCEPT CLEARANCE
OFFICERS. THANK YOU VERY MUCH.
>>COUNCIL MEMBERS WILL BE MOVED
TO THE CLOSED SESSION.
WE WILL HAVE A BRIEF MEETING
WITH COUNCIL MEMBERS SO STAFF
MAY RETURN AT 2:45.