>>WELCOME TO THE 230th
MEETING OF THE NATIONAL ADVISORY
DENTAL AND CRANIOFACIAL RESEARCH
COUNCIL.
I'M LYNN KING, DIRECTOR OF THE
DIVISION OF EXTRAMURAL ACTIVITY,
EXECUTIVE SECRETARY OF THE NIDCR
COUNCIL, I'M GOING TO BEGIN WITH
A FEW INFORMATIONAL PROCEDURE
ITEMS.
TODAY'S PROCEEDINGS ARE BEING
CONDUCTED VIA ZOOM WITH
ACCOMPANYING VIDEOCAST FOR
VIEWING BY THE GENERAL PUBLIC.
WE'LL NOT BE TAKING QUESTIONS OR
COMMENTS FROM THE PUBLIC DURING
THE WEBCAST BUT WELCOME
QUESTIONS OR COMMENTS UNTIL JUNE
1, SUBMITTED TO A SPECIAL NIDCR
E-MAIL BOX THAT WILL BE
DISPLAYED AT THE END OF THIS
SESSION.
WE ASK THE COUNCIL MEMBERS AND
STAFF TO PLEASE MAKE SURE THAT
YOUR MICROPHONES ARE SET ON MUTE
AND YOUR VIDEO CAMERAS ARE OFF
UNLESS YOU'RE SPEAKING.
WHEN SPEAKING AT ANY TIME,
PLEASE IDENTIFY YOURSELF SO WE
KNOW WHO IT IS WHO IS SPEAKING
AND TO ENSURE ACCURACY OF OUR
RECORDS.
IF ANYONE PARTICIPATING IN THE
ZOOM VIDEOCAST NEEDS TECHNICAL I
A SIS TANS, THE NIDCR I.T. TEAM
TIM AND KEVIN WILL BE AVAILABLE
TO ASSIST YOU.
THEIR CONTACT INFORMATION IS IN
THE CHAT BOX.
NOW WE'LL HEAR FROM THE DIRECTOR
OF NIDCR, DR. RENA D'SOUZA.
>> GOOD MORNING, I'M HAPPY TO
SEE YOU PARTICIPATE IN THE
230th COUNCIL, SEEMS TO GET
BETTER FOR ME OVER TIME.
I WANT TO START OFF BY SAYING
WHAT WE EXPERIENCED IN THE PAST
WEEK UNLEASHING OF ANOTHER
HORRIFIC AND RACIALLY MOTIVATED
SHOOTING TO INNOCENT CIVILIANS
IN BUFFALO, NEW YORK, JENNIFER
AND I JUST SENT OUT A MESSAGE
THAT I WANT TO READ.
WE REALLY WROTE TO EXTEND THE
SUPPORT AND COMFORT TO OUR
AFRICAN AMERICAN COLLEAGUES FOR
WHOM THE BURDEN OF SOCIETAL
INJUSTICE REMAINS ONEROUS AND
BECOMES HEAVIER WITH EVERY
ADDITIONAL INCIDENT.
KNOW THAT NIDCR IS FIERCELY
COMMITTED TO A COMMUNITY THAT
EMBRACES ALL, IRRESPECTIVE OF
RACE, RELIGION, GENDER IDENTITY.
WE'RINTENTIONAL TO IMPROVING,
BELONGING IS OUR RESPONSE TO
COMBAT SYSTEMIC INJUSTICE THAT
IS MANIFESTED ITSELF IN OUR
COMMUNITY OVER TIME.
PLEASE JOIN US IN KNOWING THAT
YOU DO NOT STAND ALONE AS WE
WORK TOWARDS THE REALIZE AGO
THAT AFTER ALL THERE IS ONLY ONE
RACE, THE HUMAN RACE.
WE ALSO WEAR AT NIDCR AND I'M
SURE IN YOUR VARIOUS
INSTITUTIONS, STAFF THAT
SUFFERED PERSONAL LOSSES, MAY
EACH OF YOU FIND SOLACE AS YOU
GRIEVE THIS LOSS.
WE'RE AWARE OF THE SURGE OF
MANY PEOPLE NOT FEELING QUITE
WELL, TAKE CARE AND STAY HOME
AND BE WATCHFUL.
I END THAT SYMPATHY AND RESOLVE
TOWARDS BUILDING A BETTER
TOMORROW.
THAT'S MY OPENING STATEMENT TO
YOU, COUNCIL MEMBERS, AND THOSE
ATTENDING.
ON A SAD MIXED FEELING NOTE I
WANT TO SAY FAREWELL AND THANK
YOU TO FOUR OUTSTANDING COUNCIL
MEMBERS WHO DEDICATED THEIR TIME
AND EFFORTS TO MOVING NIDCR
FORWARD IN YOUR TERM ON COUNCIL,
KATHY, DAVID, CLARK AND JOEL,
I'LL MESS YOU BECAUSE YOU
WELCOMED ME SO WARMLY AS I
STARTED MY FIRST JOURNEY HERE
WITH YOU.
PLEASE DO STAY IN TOUCH.
WE INTEND TO ENGAGE YOU AS WE
ADVANCE NIDCR INTO A NEW ERA OF
SUCCESS.
WE HAVE NEWCOMERS ON BOARD THAT
WOULD BE INTRODUCED AT NEXT
COUNCIL WHICH WOULD BE IN
SEPTEMBER.
LIKELY TO BE VIRTUAL.
THRILLED TO WELCOME A SENIOR
MEMBER ON THE STAFF HEADING
RESEARCH TRAINING AND CAREER
DEVELOPMENT BRANCH, WHO COMES
WITH A WEALTH OF EXPERIENCE IN
NIGMS, WHO FORGED AVENUES OF
DIVERSE PIPELINES, SO ANISSA,
WELCOME ON BOARD.
WE LOOK FORWARD TO YOUR
LEADERSHIP IN THAT BRANCH.
YOU TAKE OVER FOR LYNN KING WHO
LEFT A GREAT LEGACY AND YOU HAVE
GREAT STAFF IN LESLIE FRIEDEN
WHO WILL ASSIST YOU TO ACHIEVE
ALL THAT YOU DREAM ABOUT FOR
NIDCR AND FOR US.
THANK YOU AND WELCOME.
NOW, IT'S A VERY SPECIAL
MEETING, SPECIAL IN MANY WAYS.
WE HAVE A GREAT PANEL OF
SPEAKERS WHO WILL SHARE THEIR
EXPERIENCES AND EXPERTISE WITH
US.
TOP ON THAT LIST IS LARRY TABAK.
I WAS THINKING OF THE TIME OF
TRANSITION FOR OUR SOCIETY,
CULTURE, THE COUNTRY, THE WORLD,
AND NIH WE'RE NOT EXCLUDED FROM
THIS TIME OF CHANGE, SOUL
SEARCHING AND REFORM, NO BETTER
PERSON THAN LARRY WHO WOULD GIVE
A TRUE SENSE FOR NIH IS TODAY
AND WHERE IT'S HEADING IN THE
FUTURE.
FOR ME HE'S BEEN INDISPENSABLE
TO MY CAREER AND LIFE.
WONDERFUL FOR OUR PROFESSION, NO
DOUBT ABOUT THAT, ONE OF A KIND
IN THE WAY HE ACTUALLY CHANNELS
HIS SON'S MUSICAL TALENT, HE
SAYS HE HAS NONE, IN A
SELF-DEPRECATING WAY MAKES US
LAUGH, A ONE OF A FIND SCIENTIST
IN BIOCHEMISTRY, FUNCTION, ALL
WHICH LAID THE FRAMEWORK FOR
DIAGNOSTICS.
LARRY HAS DISTINGUISHED HIMSELF
AS A LEADER ON OUR CAMPUS AND IN
MORE WAYS THAN I CAN POSSIBLY
DESCRIBE.
HE HAS KEPT US SAFE AND STABLE
THROUGH THIS TIME, THE TIME
PRECEDING THE PANDEMIC, DURING
THE PANDEMIC, AND SURELY MAKING
SURE THAT WE ARE WELL POSITIONED
FOR THE FUTURE.
WE OWE HIM AN IMMEASURABLE
AMOUNT OF GRATITUDE AND
APPRECIATION FOR IN HIS HUMBLE
WAY FOR ELEVATING THE ORAL
HEALTH PROFESSION, FOR STANDING
BY US THROUGH ALL OF THESE
WONDERFUL ADVENTURES THAT HE'S
HAD, AND IT'S JUST A PRIVILEGE
TO HAVE HAD THE OPPORTUNITY TO
WORK WITH LARRY AND TO BE KIND
OF JUST LOOKING UP AT HIM IN THE
WAY HE ADMINISTERS WITH SUCH
SAVVY AND SUCH GRACE.
LARRY, IF YOU'RE HERE, PLEASE
TAKE OVER AND I'LL DO ONE MORE
THING, WHICH IS TO SAY AT THE
END OF OUR OPEN SESSION, TOWARDS
THE END, WE'LL HAVE TWO
WONDERFUL SPEAKERS, SUSAN IS AN
EXPERT IN DATA SCIENCE TALKING
ABOUT THE NIH'S PLANS AND NIKI
MOUTSOPOULOS, WHOSE WORK I WILL
BRIEFLY MENTION, FORGING NEW
PATHS IN UNDERSTANDING OF
INFORMATION AND IN MUCOSAL
IMMUNITY AND PERIODONTAL
DISEASE.
LARRY, WELCOME AND THANK YOU FOR
TAKING THE TIME TO BE WITH US.
IF YOU'RE NOT QUITE THERE, LET
ME GET OUT OF HERE, SORRY.
WE STILL HAVE 8 MINUTES.
IS HE ON?
>> RENA, I CAN TAKE THIS FEW
MINUTES TO DO THE FIRST ORDER OF
BUSINESS.
>> THAT WOULD BE NICE.
>> YEAH, THE APPROVAL OF THE
MINUTES.
THE MINUTES FROM THE JANUARY
2022 MEETING WERE MADE AVAILABLE
TO COUNCIL MEMBERS FOR REVIEW.
AT THIS POINT WE ASK FOR
COMMENTS OR CORRECTIONS TO THE
MINUTES THAT ANYONE WOULD LIKE
TO RAISE.
IF THERE ARE NO COMMENTS OR
QUESTIONS, WOULD A MEMBER OF
COUNCIL LIKE TO MAKE A MOTION TO
APPROVE THE MINUTES?
>> I'LL MOVE.
IS THERE SOMEONE TO SECOND THAT
MOTION?
>> SECOND.
HAL EBERTINO.
>> ALL IN FAVOR?
>> AYE.
>> ANY OPPOSED?
OKAY.
SO WE'VE COMPLETED THAT ACTION.
AND THE NEXT ON THE AGENDA IS
DR. TABAK.
WHO SHOULD BE JOINING US IN A
FEW MINUTES.
>> MY TALK IS TO REFRESH, FOR
THOSE WHO READ THE MINUTES IT'S
RECORDED THERE, THAT WE DO WANT
TO TAKE ADVANTAGE EVEN MORE SO
THAN IN THE PAST OF THE GREAT
PRIVILEGE AND RESOURCES WE HAVE
AMONGST OUR COUNCIL MEMBERS, TO
BE ABLE TO UTILIZE THE EXPERTISE
AND COUNCIL AND BRING THE VOICE
OF THE EXTRAMURAL COMMUNITY INTO
OUR PLANNING AND PROCESS AND
STRATEGIC THINKING.
IT'S GOING TO BE CRITICAL FOR
NIDCR.
TODAY WOULD BE LAUNCHING INTO
THE WORKING GROUP FORMAT WHERE
WE'VE BEEN VERY SELECTIVE AND
DISCREET IN PICKING WHO FOCUS
AREAS FROM A LONG LIST, AND ONE
OF THEM IS DATA SCIENCE, AS WE
WOULD EXPECT, TO LOOK AT WAYS IN
WHICH NIDCR CAN CAPTURE ITS
RESOURCES AS THEY STAND TODAY,
AND EXPAND THEM TO THE ADVANTAGE
OF OUR PATIENTS AND OUR
COMMUNITIES AND CLINICIANS AND
OUR EDUCATORS.
AND YOU CAN THINK OF SOMETHING
TO BE TALKED ABOUT FOR A LONG
TIME, INTEGRATION OF COMBINED
HEALTH RECORDS IS ONE ASPECT.
BUT YOU CAN GO ALL THE WAY INTO
ARTIFICIAL INTELLIGENCE AND
MACHINE LEARNING TOOLS THAT NOW
ARE REALLY TRULY AVAILABLE TO US
AS SCHOOLS INVEST IN DIGITAL
TECHNOLOGY, SO THAT WE CAN
ACTUALLY USE IT FOR TO
IMPROVE -- FOR THE GOOD OF
SOCIETY, THE GOOD OF ALL, THAT
WE CAN TRACK DOWN HEALTH
DISPARITIES THROUGH MODEL
SYSTEMS WOULD BE TRUE ADVANTAGES
FOR THE FUTURE.
WE'RE GOING TO HAVE A TEAM OF
EXPERTS, STRUCTURED PROCESS THAT
NIH PRESCRIBES HOW A WORKING
GROUP MUST FUNCTION WITH MEMBERS
OF COUNCIL AS WELL AS THOSE
RECRUITED FROM THE EXTRAMURAL
COMMUNITY WHO ARE THOUGHT
LEADERS AND EXPERTS.
THEY WILL SPEND TIME IN THIS
CASE PROBABLY ABOUT A YEAR,
PERHAPS GIVING US UPDATES OF
PROGRESS REPORTS, AS WE PROGRESS
THROUGH COUNCIL THROUGH THE
YEAR, AND THEN COME BACK WITH A
DISCRETE SET OF RECOMMENDATIONS.
SO WE BALANCE THAT INITIATIVE,
WHICH IS VERY EMERGING AND
VISIONARY IN MANY WAYS BUT WITH
REALISTIC CONTEXT OF WHAT
RESOURCES ARE NEED AND HOW WE
CAN PROGRESS EXTRAMURALLY AND
EXTRAMURALLY.
THE OTHER QUESTION THAT IS VERY
CRITICAL IS FOR US TO TAKE A
GOOD LOOK AT HOW WE'RE TRAINING
OUR WORKFORCE, OF CLINICIAN
SCHOLARS/SCIENTISTS, FOR THE
FUTURE, ARE WE TAPPING INTO
RESOURCES, IS IT TIME TO LOOK AT
THE RETURN OF INVESTMENT, LOOK
AT OUR Ks AND Fs AND ANY
OTHER WAY WE CAN ENRICH THAT
WORKFORCE FOR THE FUTURE.
THE TIME HAS COME TO TRANSLATE.
THOSE ARE THE TWO WORKING
GROUPS, THE SECOND ONE IS GOING
TO BE LED BY DANA GRAVES AT THE
UNIVERSITY OF PENNSYLVANIA, HE
WILL FOLLOW THE SAME PROTOCOL
AND DELIVER FOR US A SET OF VERY
DISCRETE FORWARD-LOOKING
INITIATIVES THAT WE CAN
HIGHLIGHT 75th ANNIVERSARY
CELEBRATION WITH NEXT YEAR.
WITH THAT, IS LARRY ON BOARD?
NOT AS YET.
SO HE IS -- OKAY, THREE MORE
MINUTES.
>> HERE.
>> OH, HERE'S LARRY.
YOU MISSED ALL THE GOOD THINGS I
SAID ABOUT YOU.
>> GOOD, I'M GLAD.
NO, THANKS.
GOOD MORNING, EVERYBODY.
SO, I DON'T KNOW IF YOU ALL WANT
TO DRIVE MY SLIDES OR IF YOU
PREFER THAT I SHARE MY SCREEN,
WHAT'S BEST FOR YOU?
>> I THINK IT'S BEST THAT YOU DO
IT YOURSELF, LARRY.
>> OKAY.
JUST GIVE ME A MOMENT TO
NAVIGATE THAT.
NO MATTER HOW MANY TIMES I DO
IT, I NEVER GET IT RIGHT THE
FIRST TIME.
OKAY.
>> SHARE SCREEN, YEAH.
>> WELL, SO NOW YOU'RE SEEING
PRESENTER MODE.
DID THAT NOW WORK?
>> IT'S SHOWING UP AS A TINY
SCREEN ON MY LEFT.
HAVE YOU PRESSED SHARE SCREEN,
LARRY?
>> YEAH, OF COURSE.
SOMETIMES YOU HAVE TO STOP
SHARING AND RESHARE.
LET'S TRY THAT TRICK.
LET'S SEE IF THAT WORKED.
>> FOR THOSE THAT JOINED LATE
THERE'S NO BETTER PERSON TO GIVE
THIS.
WHAT LARRY WILL TALK ABOUT IS
NOT -- I MADE SURE I WOULDN'T
COVER THE TOPICS OF COVID AND
BUDGETS AND THINGS LIKE THAT
BECAUSE LARRY WILL TOUCH ON
THOSE.
>> MAYBE.
OKAY.
DID THAT WORK?
>> NO.
KEVIN, CAN YOU TROUBLESHOOT?
>> EVERYTHING SHOULD BE GOOD
NOW.
>> IT'S NOW OKAY?
>> GREAT.
>> AH, WONDERFUL.
WELL, THANK YOU.
I APOLOGIZE FOR NOT BEING ABLE
TO DO THIS IN A FACILE WAY.
SO GOOD MORNING, EVERYBODY.
GOOD TO BE HOME AGAIN AND WE'LL
COVER TOPICS THAT ARE LISTED
HERE THIS MORNING.
SO IT'S GOING TO BE A RAPID
SERIES OF COMMENTS.
LET'S BEGIN WITH LEADERSHIP
CHANGES.
AS I THINK YOU ALL KNOW, FRANCIS
COLLINS STEPPED DOWN AS NIH
DIRECTOR TOWARDS THE END OF
DECEMBER OF LAST YEAR.
AND IT WAS INTERESTING, NOBODY
REALLY NOTICED THAT I HAD TAKEN
OVER AS ACTING DIRECTOR UNTIL
THIS ARTICLE APPEARED IN THE
SYRACUSE NEWSPAPER.
IT WAS ALSO IN THE BUFFALO
NEWSPAPER, ABOUT THIS FORMER
UPSTATE NEW YORK DENTIST WHO
TOOK OVER NIH.
BUT OF COURSE THE PUNCHLINE IS
THAT I BECAME DR. FAUCI'S BOSS.
THIS IS WHAT ATTRACTED ALL THE
ATTENTION.
AND SO WE ALL GOT A GOOD CHUCKLE
OUT OF THIS ONE.
ALL KIDDING ASIDE, THERE HAVE
BEEN A SERIES OF LEADERSHIP
CHANGES DURING THIS TRANSITIONAL
PERIOD I WANT TO DRAW YOUR
ATTENTION TO.
THE FIRST IS THAT I ASSUME THE
ROLE OF DIRECTOR, DR. TARA
SCHWETZ HAS MOVE INTO THE NIH
PRINCIPAL DEPUTY DIRECTOR ROLE.
ADDITIONALLY, COURTNEY AKLIN HAS
NOW TAKEN TARA'S PLACE AS ACTING
ASSOCIATE DEPUTY DIRECTOR FOR
NIH.
FINALLY LYRIC JORGENSON IS
ACTING DIRECTOR OF OFFICE OF
SCIENCE POLICY.
WE'RE REALLY, REALLY LUCKY TO
HAVE SUCH TALENTED LEADERS STEP
UP AND TAKE ON THESE ACTING
ROLES DURING THIS TIME OF
TRANSITION.
AND I AM EXTREMELY GRATEFUL TO
THEM FOR ALL THE WORK THEY ARE
DOING.
IN THESE THREE WOMEN YOU'RE
SEEING THE REAL FUTURE OF NIH
LEADERSHIP.
SO REALLY VERY PROUD TO HAVE
THEM ON BOARD DURING THIS
TRANSITION TIME.
OKAY.
SO FUNDING TRENDS, WHICH IS
USUALLY WHAT COUNCILS ARE
PARTICULARLY INTERESTED IN.
SO, THIS CHART DISPLAYS THE NIH
FUNDING FROM 1990 THROUGH 2023.
AND THIS IS NORMALIZED TO
$2,019, USING INFLATIONARY INDEX
THAT WE REFER TO AS THE
BIOMEDICAL RESEARCH AND PRICE
INDEX, IT'S KNOWN AS BRDPI.
AS YOU CAN SEE, BEGINNING IN
2014, 2015, NIH HAS REALLY
ENJOYED SUSTAINED GROWTH, THE
RESULT OF BIPARTISAN SUPPORT
FROM THE CONGRESS, AND THIS
GROWTH IS KEEPING PACE WITH
BRDPI, AND THE HOPE IS GOING
FORWARD THAT WE SEE THIS
SUSTAINED IN YEARS TO COME.
SOME OF YOU MAY KNOW THAT
YESTERDAY WE HAD OUR SENATE
APPROPRIATIONS HEARING.
AND CHAIR MURRAY AND RANKING
MEMBER BLUNT BOTH EXPRESSED HOPE
THAT NIH WOULD CONTINUE ON THIS
PATHWAY OF GROWTH, BOTH THE
CHAIR MURRAY AND THE RANKING
MEMBER BLUNT HAVE BEEN
EXTRAORDINARILY STALWART IN
THEIR SUPPORT NIH.
SADLY, THIS LIKELY WAS THE LAST
HEARING FOR NIH THAT MR. BLUNT
WILL APPEAR AT, AS HE ANNOUNCED
HIS RETIREMENT FROM THE SENATE
AT THE CLOSE OF THE SESSION.
BUT PRESUMABLY SENATOR MURRAY
WILL CONTINUE HER GOOD WORK IN
THIS SPACE, TOGETHER WITH
WHOMEVER SUCCEEDS MR. BLUNT.
NOW, IF YOU LOOK AT THE 21
BUDGET AT A HIGH LEVEL, IN THE
DIFFERENT BUCKETS THAT WE
SUPPORT, OVERWHELMINGLY OUR
RESOURCES ARE DIRECTED TO
RESEARCH PROJECT GRANTS, WITH A
MUCH SMALLER AMOUNT TO OTHER
CATEGORIES SUCH AS RESEARCH
CENTERS AND TRAINING.
THE INTRAMURAL RESEARCH PROGRAM
IS ROUGHLY 10 TO 11% OF THE
OVERALL BUDGET, AND THE
SBIR/STTR, THE SMALL BUSINESS
PROGRAM CONGRESSIONALLY MANDATED
AT $1.2 BILLION, IN 2021.
WHAT IS NOT DISPLAYED IN ANY OF
THE PRECEDING TWO CHARTS ARE THE
EMERGENCY SUPPLEMENTAL FUNDS FOR
COVID-19 THAT THE CONGRESS HAS
GENEROUSLY SUPPORTED US WITH,
AND THESE ARE DISPLAYED HERE
JUST TO SERVE AS A REMINDER OF
THE ADDITIONAL RESOURCES THAT
NIH HAS BEEN ABLE TO MOBILIZE TO
THE COVID RESPONSE WHICH I'LL
COVER IN A LITTLE BIT MORE
DETAIL IN A MOMENT.
MOST OF THE RESOURCES
UNDERSTANDABLY WENT TO NIAID,
BUT SOME RESOURCES WENT TO OTHER
ENTITIES AROUND NIH.
THE WORK IN THE OFFICE OF THE
DIRECTOR WAS REDISTRIBUTED TO
SUPPORT ASPECTS OF THE SO-CALLED
RADx PROGRAM, WHICH I'LL TOUCH
UPON IN A BIT.
BUT THIS IS MOSTLY RELATED TO
RECOVER FUNDS, WHICH WE'LL BE
INVOLVED WITH, WHICH IS A LONG
STUDY ON LONG COVID, AND THEN
ALSO TO THE COMMON FUND WHICH
ALSO BECAME ENGAGED IN SOME OF
THE SUPPLEMENTAL WORK.
NOW, THE 22 APPROPRIATIONS AS
YOU KNOW WE RECENTLY RECEIVED IN
THE FORM OF AN OMNIBUS, GENERAL
INCREASE FOR INSTITUTES AND
CENTERS 3.4%, OVERALL 5.2%
INCREASE OVER FISCAL YEAR 21
WHICH WAS QUITE REMARKABLE GIVEN
THE LANDSCAPE, SPECIFIC
INCREASES ARE OUTLINED HERE.
AND THESE INCLUDE SIGNIFICANT
INCREASE FOR ALZHEIMER'S DISEASE
RESEARCH, FOR CANCER, OPIOIDS,
THE BRAIN INITIATIVE, AND THE
HEALTH DISPARITIES RESEARCH.
THE PRESIDENT'S BUDGET WHICH WE
WERE DEFENDING YESTERDAY IN THE
SENATE AND PREVIOUS WEEK IN THE
HOUSE INCLUDES $16.3 BILLION
INCREASE, BUT OF THAT,
$12.05 BILLION ARE MANDATORY
RELATED TO PANDEMIC
PREPAREDNESS.
SO THAT'S REALLY A SEPARATE
BUCKET OF MONEY.
AND THEN $4 BILLION DIRECTED TO
ARPA-H, AND THEN THE REMAINING
INCREASES ARE DISPLAYED.
WE'VE ASKED FOR VERY LARGE
INCREASE IN HEALTH DISPARITIES
RESEARCH FOR NEW RESOURCES
RELATED TO CLIMATE CHANGE AND
NUTRITION SCIENCE.
A LOT HAS BEEN MADE ABOUT THE
BUDGET NUMBERS IN FISCAL YEAR 23
REQUEST BY THE ADMINISTRATION,
VERSUS THE FISCAL YEAR 22
OMNIBUS, OUR CURRENT FISCAL
YEAR.
AND AS I EXPLAINED YESTERDAY IN
THE SENATE AND PRECEDING WEEK IN
THE HOUSE, THE SEEMINGLY MODEST
BUDGET INCREASE INDEED IN SOME
INSTANCES DISPLAYED FOR
INSTITUTES AND CENTERS A
DECREASE IS REALLY THE RESULT OF
TIMING ARTIFACT.
THE ADMINISTRATION NEEDED TO PUT
ITS BUDGET TOGETHER BASED UPON A
BASELINE THAT WAS AVAILABLE AT
THE TIME, AND AT THE TIME THE
BUDGET WAS PUT TOGETHER THE ONLY
BASELINE AVAILABLE WAS THE
CONTINUING RESOLUTION.
WE WERE VERY FORTUNATE THAT THE
CONGRESS WENT WELL BEYOND THE
CONTINUING RESOLUTION IN
PROVIDING US WITH AN INCREASE
THIS PHYSICAL FISCAL YEAR IN
THE OMNIBUS AND THEREFORE MUCH
OF THE INCREASE PROPOSED IN THE
23 BUDGET WAS, IF YOU WILL,
CONSUMED BY THE INCREASE THE
OMNIBUS ALREADY PROVIDED.
SO ON RELATIVE TERMS IT LOOKS
LIKE THERE'S A DECREASE RATHER
THAN ANY INCREASE GOING FORWARD.
AS THE SECRETARY OF HHS
INDICATED, AND AS I INDICATED
LAST WEEK AND YESTERDAY, TO THE
HOUSE AND SENATE RESPECTIVELY,
WE LOOK FORWARD TO WORKING WITH
THE CONGRESS AS THE 23 BUDGET
PLAYS OUT, AND THEY MADE IT
CLEAR IN BOTH HOUSES THAT THEIR
EXPECTATION IS THAT WE SHOULD,
YOU KNOW, RECEIVE AN INCREASE
HOPEFULLY IN LINE WITH THE TYPES
OF INCREASES THAT WE'VE BEEN
RECEIVING IN THE PAST GOING
FORWARD.
SO PLEASE STAY TUNED.
THERE'S STILL QUITE A BIT TO DO
WITH THE 23 BUDGET BEFORE WE
KNOW WHAT THE FINAL RESULT WILL
BE.
SO, NOW I'D LIKE TO GIVE YOU A
QUICK UPDATE ON THE COVID
RESPONSE, AND I'LL GO THROUGH
THIS RATHER RAPIDLY JUST TO GIVE
SOME OF THE HIGHLIGHTS.
THE PUBLIC/PRIVATE PARTNERSHIP
KNOWN AS ACTIV WAS LAUNCHED IN
APRIL OF 2020, WITH THE MISSION
OF DEVELOPING A COORDINATED
RESPONSE TO SPEED TREATMENT AND
VACCINE OPTIONS.
THE PARTNERSHIPS ARE DISPLAYED
IN THE LOWER PART OF THIS SLIDE,
AND AS YOU CAN SEE 20 INDUSTRY
LEADERS, STAKEHOLDER GROUPS FROM
ALL ACROSS THE UNITED STATES
GOVERNMENT AND FOUR NOT FOR
PROFITS AND A SHOUT OUT TO THE
FOUNDATION FOR NIH, I CANNOT SAY
ENOUGH FOR HOW IMPORTANT THAT
PARTNERSHIP HAS BEEN FOR US.
THE NET RESULT HAS BEEN
DOCUMENTED MANY, MANY, MANY
TIMES, HAS BEEN AN IMPRESSIVE
ARRAY, UNPRECEDENTED TIMELINES
FOR VACCINES AS WELL AS THE
ANTI-VIRALS.
THIS IS JUST A REALLY BRIEF
SUMMARY OF THE STATUS OF THE
CURRENT AGENTS THAT HAVE BEEN
TESTED IN THE VARIOUS ARMS OF
THE ACTIV EFFORT.
THE SECOND COLUMN CEASED
ENROLLMENT LISTS THOSE THINGS
THAT HAVE BEEN STOPPED EITHER
DUE TO LOW CLINICAL VALUE OR TO
FUTILITY, ON THE FAR RIGHT
EVERYTHING WITH COMPLETED
ENROLLINGMENT IS DISPLAYED.
AWAITING RESULTS, SOME WORK IS
NOT YET REMOVED IN THE ACTIV 2
PROTEASE INHIBITOR FROM SHENOGI,
ADDITIONAL AGENTS IN 2/2B ARE
AWAITING RESULTS.
ACTIVE 3 DID NOT REACH ENDPOINT
BUT SHOWED EFFECT ON ALL CAUSE
MORTALITY WHICH WILL BE FOLLOWED
UP ON.
AND THEN SIMILARLY, THE WORK
WITH HEPARIN, WHICH SHOWS TO BE
QUITE USEFUL IN CERTAIN CLINICAL
SITUATIONS.
TOGETHER WITH OTHER EFFORTS IN
THE VARIOUS ACTIV 4 TRIALS.
FINALLY WE'RE WAITING FOR
TOPLINE DATA ON VARIOUS ACTIV 5
AND ACTIV 6 EFFORTS.
THE LATTER PRAGMATIC TRIALS, LOW
TOUCH DONE MOSTLY BY MAIL AND
VIRTUALLY, WE'RE WAITING ON THE
IVERMECTIN READOUT, AND
FLUTICASONE, FLUVOXAMINE
AWAITING ENROLLMENT.
I'M OFTEN ASKED HAS THIS BEEN A
SUCCESS BECAUSE ONLY A FEW
THINGS CAME OUT TO SHOW EFFICACY
AND SO FORTH.
THE ANSWER IS THIS IS AN
UNPARALLELED SUCCESS BECAUSE WE
DO HAVE A SERIES OF APPROACHES
THAT CAN BE USED IN DIFFERENT
STAGES OF THE DISEASE, BUT
EQUALLY IMPORTANTLY WE'VE
LEARNED WHAT DOESN'T WORK, AND
THAT'S SO VERY, VERY USEFUL.
AND I HOPE PEOPLE KEEP THAT IN
MIND BECAUSE AS YOU PARSE
THROUGH THIS IN AN EMERGENCY
CIRCUMSTANCE, KNOWING WHAT
DOESN'T WORK IS EQUALLY
IMPORTANT TO WHAT DOES.
NOW, AS YOU ALL KNOW,
INDIVIDUALS WHO ARE INFECTED
WITH COVID, A PERCENTAGE OF
PEOPLE DO GO ON WITH SO-CALLED
LONG COVID, AND WE HAVE LAUNCHED
A RATHER COMPREHENSIVE
INITIATIVE KNOWN AS RECOVER TO
REALLY IMPROVE OUR UNDERSTANDING
OF AND OUR ABILITY TO PREDICT
AND TREAT AND HOPEFULLY PREVENT
LONG COVID.
THE SCIENTIFIC AIMS ARE
ELABORATED HERE.
AND REALLY WE'RE STILL NOT
EXACTLY SURE WHAT WE ARE DEALING
WITH IN THE SENSE THAT THE
PRESENTATION COVERS SO MANY
DIFFERENT ORGAN SYSTEMS OF THE
BODY.
AND SO THE FIRST AIM
UNDERSTANDABLY IS TO REALLY
UNDERSTAND THAT CLINICAL
SPECTRUM IN BIOLOGY UNDERLYING
RECOVERY OVER TIME, WE WANTED TO
FIND RISK FACTORS, WE WANT TO
STUDY PATHOGENESIS, AND
ULTIMATELY TO IDENTIFY THE
INTERVENTIONS.
THE GUIDING PRINCIPLES ARE
SUMMARIZED HERE.
THIS IS A COLLABORATION AMONG
PATIENTS AND CAREGIVERS,
SCIENTIFIC COMMUNITY, COMMUNITY
AND FEDERAL PARTNERS, PRIVATE
SECTOR, AND OF COURSE CLINICAL
GROUPS.
IF ALL OF THE DIFFERENT GROUPS
DON'T WORK TOGETHER, WE WILL NOT
BE SUCCESSFUL IN ACHIEVING OUR
GOALS.
THE GUIDING PRINCIPLES, PATIENT
CENTRIC, NATIONAL SCALE TO
ENSURE INCLUSIVE AND DIVERSE
PARTICIPATION, WE'RE USING
UNIFORM PLATFORMS ACROSS ALL OF
THE EFFORTS.
AND WE'RE GOING TO HAVE TO ADAPT
BECAUSE AS THE VIRUS, YOU KNOW,
ADAPTS, WE HAVE TO ADAPT.
AND SO THIS WILL BE AN ADAPTIVE
APPROACH, AS THE SCIENCE
CONTINUES TO EVOLVE.
ANOTHER ACTIVE EFFORT
TRACK RESISTANCE TO CORONAVIRUS,
MONITORING GLOBAL EMERGENCE AND
CIRCULATION OF SARS-COV-2
MUTATIONS, AND WHAT'S TAKELY
VALUABLE -- PARTICULARLY
VALUABLE, WHETHER THE AVAILABLE
INTERVENTIONS ARE STILL
EFFICACIOUS WITH THE MUTATED
FORMS, AND THIS DATABASE IS
CONSTANTLY BEING UPDATED AND
INDUSTRY, ACADEMIA, AND USG FEED
INTO THIS.
WHICH LEADS TO A RATHER
COMPREHENSIVE DATASET THAT HAS
PROVEN TO BE VERY HELPFUL.
AND THEN FINALLY, NIH, NIAID IN
THE LEAD, HAVE A SERIES OF
EXPERTS, A U.S. PANEL, DEVELOPED
TREATMENT GUIDELINES FOR
COVID-19.
THESE ARE EVER EVOLVING.
STARTED IN 2020, AND THERE HAVE
BEEN 51 UPDATES.
AS YOU CAN SEE, ALMOST 36
MILLION PAGE VIEWS.
SO, THIS SITE IS LOOKED AT VERY
CAREFULLY, AND HAS REALLY GUIDED
CLINICIANS THROUGHOUT THE NATION
IN APPROACH TO TREATING, AND
THIS WILL CONTINUE TO BE UPDATED
AS IT EVOLVES.
THE STATUS OF THE NIH CAMPUS, I
HOPE THIS IS REDUNDANT TO WHAT
DR. D'SOUZA SHARED, I APOLOGIZE,
BASICALLY TRENDS IN VIRAL CASE
LOADS AMONG OUR STAFF MIRROR THE
REST OF THE COUNTRY.
OVER THE PAST MONTH OR SO THINGS
ARE TICKING UPWARDS AGAIN.
ALL STAFF HAVE RETURNED TO THE
PHYSICAL WORKPLACE IN SOME
CAPACITY, BUT WE REALLY DO HAVE
AN EXPANSION OF WORKPLACE
FLEXIBILITIES.
OUR OWN STAFF ARE ENGAGED IN
VOLUNTARY TESTING PROGRAMS,
EITHER ASYMPTOMATIC OR
SYMPTOMATIC.
THIS HAS BEEN SUPPLEMENTED WITH
PROCUREMENT OF HOME ANTIGEN
TESTS FOR STAFF, THIS WAS BEFORE
THE FEDERAL GOVERNMENT WAS ABLE
TO PROVIDE THIS BROADLY.
BUT OUR STAFF HAVE BEEN ABLE TO
USE THE ANTIGEN TESTS AS WELL AS
AN ADJUNCT.
WE'RE NOW AT MEDIUM, SO ANY I
HAVES TOSH -- VISITOR HAS TO
ATTEST TO VACCINATION OR SHOW
RECENT NEGATIVE TEST.
STARTING NEXT MONTH, BSCs AND
COUNCILS WILL BE ALLOWED TO USE
HYBRID FORMATS.
IF WE GO TO HIGH WE'LL REVISIT
THAT AND SADLY THE TRENDS ARE IN
THAT DIRECTION.
BUT WE ARE AT LEAST FOR THE
MOMENT CONSIDERING HYBRID
FORMATS AS BEING POSSIBLE.
I DO KNOW MANY COUNCILS HAVE
DETERMINED THAT THEY ARE JUST
GOING TO REMAIN WITH THE VIRTUAL
FORMAT.
SO NOW I'D LIKE TO SHIFT GEARS
AND HAVE A LITTLE FUN.
WHENEVER I TALK ABOUT SCIENCE,
THAT'S FUN.
AND SO I WANTED TO TALK ABOUT
SOME HIGHLIGHTS FROM NIDCR.
AND THESE ARE VERY HIGH LEVEL
AND VERY LIMITED IN SCOPE.
OBVIOUSLY MANY HOURS COULD BE
SPENT ON TALKING ABOUT THIS, BUT
THE TIME ALLOTTED DOESN'T PERMIT
IT.
SO, WHAT I'D LIKE TO HIGHLIGHT
AMONG THE MANY, MANY, MANY, MANY
THINGS GOING ON EXTRAMURALLY, AT
NIDCR, IS THE NIDCR ROLE IN NIH
HEAL INITIATIVE, ADDRESSING THE
OPIOID USE CRISIS IN THIS
NATION.
I'M SURE YOU ALL KNOW THAT WE
HAVE A HORRIBLE PRICE TO PAY
WITH THE OPIOID USE CRISIS WHICH
HAS BEEN NOW EXACERBATED BOTH BY
THE PANDEMIC AND BY THE INFLUX
OF SYNTHETIC OPIOIDS LIKE
FENTANYL WHICH ARE SO VERY,
VERY, VERY DEADLY.
NIDCR IS PLAYING AN IMPORTANT
ROLE IN THIS.
AS YOU CAN SEE, LOWER PORTION OF
THE SLIDE, DR. D'SOUZA WORKED
TOGETHER -- WORKS TOGETHER WITH
DR. REBECCA BAKER, DIRECTOR OF
THE HEAL INITIATIVE, AND THEY
PARTICIPATED THROUGH A Q&A AND
UNDERSCORING NIDCR'S COMMITMENT
TO THIS VERY, VERY IMPORTANT
INITIATIVE.
AND AS YOU CAN SEE, THE OVERALL
APPROACH IS TO BOTH IMPROVE
PREVENTION AND TREATMENT FOR
OPIOID MISUSE, OPIOID USE
DISORDER, BUT ALSO TO COME UP
WITH NEW WAYS OF ENHANCING PAIN
MANAGEMENT WITHOUT THE USE OF
OPIOIDS.
SO, SPECIFICALLY, NIDCR IS
ENGAGED IN TWO VERY IMPORTANT
INITIATIVES.
THE FIRST ON MYOFASCIAL PAIN.
AND AS YOU CAN SEE, THIS IS
BEING SUPPORTED BROADLY ACROSS
NIH.
BUT TO HIGHLIGHT THE FUNDING
OPPORTUNITY ANNOUNCEMENT WILL
INCREASE KNOWLEDGE ABOUT OTHER
IMPORTANT PAIN CONDITIONS,
INVOLVING MYOFASCIAL TISSUES
INCLUDING TEMPOROMANDIBULAR
DISORDERS AS WELL AS CHRONIC
NECK AND SHOULDER PAIN AND
HEADACHE.
THIS IS A VERY IMPORTANT AREA,
RIPE FOR DISCOVERY.
AND WE'RE DELIGHTED THAT NIDCR
IS TAKING LEADERSHIP IN THIS
ASPECT.
SIMILARLY, A HEAL INITIATIVE
RESTORING JOINT HEALTH AND
FUNCTION TO REDUCE PAIN, THIS IS
A CONSORTIUM WHICH, AGAIN, IS
PRIORITIZING BOTH
TEMPOROMANDIBULAR JOINTS AND
KNEE JOINTS.
ONE OR BOTH OF THESE JOINTS NEED
TO BE A FOCUS.
THIS IS, AGAIN, AN INITIATIVE
WHICH IS BEING DRIVEN BY A
NUMBER OF INSTITUTES AND CENTERS
BUT OF COURSE INCLUDING NIDCR.
SO, I REALLY WANT TO THANK THE
NIDCR STAFF WHO ENGAGED IN THESE
AND OF COURSE DR. D'SOUZA FOR
HER LEADERSHIP.
SO, NOW, SIMILARLY I COULD GO ON
AND ON AND ON AND ON ABOUT THE
INTRAMURAL PROGRAM, AND AS I
THINK YOU KNOW THERE ARE 26
INVESTIGATOR LABS, FIVE RESEARCH
FOCI, A VERY STRONG COMMITMENT
WITH DR. D'SOUZA JOINING NIDCR
ON TRANSLATION, THERE ARE SEVEN
P.I.s.
OF THE MANY EXAMPLES I COULD
PICK FROM WITHIN THE INTRAMURAL
PROGRAM THIS IS A PAPER, AN
INVESTIGATOR IN THE INTRAMURAL
PROGRAM, MARK HOON, HE'S
INTERESTED IN ITCH.
YOU MIGHT THINK, WELL, THAT'S AN
ODD THING, BUT, YOU KNOW, WHAT
MIGHT BE A NUISANCE FOR SOME
DISEASES AND CONDITIONS SUCH AS
PSORIASIS, ATOPIC DERMATITIS,
THIS IS A VERY SIGNIFICANT
ISSUE.
AND WHAT TSENG AND HOON GOOD
DEMONSTRATED, ONCOSTATIN M IS
ABLE TO MODULATE THE ITCH
RESPONSE AND SO IF YOU CAN
AMELIORATE SIGNALING ON THE
ONCOSTATIN PATHWAY YOU'RE
ACTUALLY ABLE TO REDUCE THE NEED
FOR ITCH, AND THEY HAVE
CONSTRUCTED A MOUSE MODEL.
AND AS YOU CAN SEE, BY REDUCING
THE SIGNALING THAT'S IN THE
LOWER CURVE IN THE RED, YOU CAN
REDUCE THE AMOUNT OF ITCH.
THIS IS GOING TO LEAD NO DOUBT
TO THERAPEUTIC OPTIONS GOING
FORWARD FOR SOME OF THESE VERY
SEVERE DERMATOLOGICAL
CONDITIONS.
NEXT IS A BIT OF AN INDULGENCE
SO PLEASE FORGIVE ME, BUT I'M
SHOWING IT MORE TO HIGHLIGHT
SOMETHING ABOUT THE INTRAMURAL
PROGRAM.
SO, THIS IS A COLLABORATION
WHICH STARTED WITH OUR
INTERESTS, WHEN I SAY OUR, I
MEAN MY INTEREST, DR. KELLY TEN
HAGEN AND DR. NADINE SAMARA'S
INTEREST THOUSAND GLYCOPROTEINS
ARE DECORATED WITH A CERTAIN
CLASS OF SUGAR, O-GLYCANS, ALL
ABOUT HOW YOU MAKE A PROPER
MUCIN AND -- AND OTHER
SECRETIONS COATING MUCOSAL
SURFACES.
CAN COLLEAGUES FROM UNIVERSITY
MEDICAL CENTER IN THE
NETHERLANDS, KELLY, NADINE AND I
HAVE BEEN LOOKING AT HOW ONE OF
THOSE ENZYMES THAT INITIATES
O-GLYCOSYLATION ARE INVOLVED IN
OVERALL ENERGY HOMEOSTASIS, SO
TURNS OUT, CHART TO THE TOP
LEFT, SHOWS THE ASSOCIATIONS
BETWEEN GENE VARIANTS AND GALNT2
GENE RELATED TOED ON POSITIVITY
AND BMI IN HUMANS.
AND IF YOU CAN MAKE OUT THE
DATA, THIS IS ALL COMING OUT OF
THE STUDY IN THE U.K., THE
BIOBANK STUDY IN THE U.K., IN
INDIVIDUALS WHO DO NOT HAVE A
FULLY FUNCTIONAL GALNT2 YOU HAVE
DECREASE IN LEG FAT PERCENTAGE,
DECREASE IN BODY FAT PERCENTAGE,
SO FORTH.
A NULL MOUSE FOR THE SAME GENE
CREATED IN MICE A NUMBER OF
YEARS AGO, THESE MICE, WE SHOW
EXAMPLES OF THIS, EXHIBIT
SIMILAR DECREASED ADIPOSITY
SIMILAR CHANGES IN THEIR BMI, IF
YOU WILL.
AND SO AS YOU DISSECT DOWN IN
TERMS OF THE METABOLIC
UNDERPINNINGS OF THIS, IT'S DUE
TO INSULIN SIGNALING AND LOCAL
EFFECTS APPEAR TO BE MEDIATED
FOR INSULIN RECEPTOR
GLYCOSYLATION.
WHAT'S MOST REMARKABLE ABOUT
THIS STUDY IS THAT IT'S BEEN
GOING ON FOR ABOUT NINE YEARS,
AND IT UNDERSCORES DIFFERENCE IN
THE INTRAMURAL VERSUS EXTRAMURAL
PROGRAM.
THIS IS ONE OF THE ADVANTAGES OF
THE INTRAMURAL PROGRAM IS YOU
CAN SUSTAIN STUDIES OVER VERY,
VERY LONG PERIOD OF TIME.
IT TOOK TIME FOR SCIENCE TO
CATCH UP FOR US TO GET TO THIS
POINT.
CHRISTY FROM THE UMCG WAS THE
LEAD SHORE AND DID JUST A
REMARKABLE JOB.
SHE AND HER COLLEAGUES IN THE
NETHERLANDS SHOULD BE
CONGRATULATED, BUT ALSO GREAT
THANKS TO KELLY'S GROUP AND TO
NADINE'S GROUP AS WELL FOR ALL
OF THEIR CONTRIBUTIONS.
SO, NOW LET ME TURN TO THE TOPIC
OF DIVERSITY, EQUITY, AND
INCLUSION AND ACCESSIBILITY IN
THE ACTIVITIES.
I HAVE TO SAY THE TRAGIC
INCOMPREHENSIBLE EVENTS THAT
OCCURRED IN BUFFALO REALLY
UNDERSCORE THE NEED FOR NIH TO
REDOUBLE OUR EFFORTS IN THIS
SPACE.
SOME OF YOU KNOW I WAS AT THE
UNIVERSITY OF BUFFALO FOR NINE
YEARS, HOWEVER HORRIBLE THESE
TYPES OF EVENTS ARE AROUND THE
COUNTRY, WHEN IT OCCURS IN A
PLACE THAT YOU KNOW, IT HAS EVEN
A GREATER IMPACT.
IT'S REALLY QUITE REMARKABLE.
GOVERNMENT-WIDE, WE ARE WORKING
TO ADVANCE DEIA IN THE FEDERAL
WORKFORCE, IN RESPONSE TO OUR
NEED TO IMPLEMENT EXECUTIVE
ORDER 14035.
AND WE'VE RECEIVED REPORT
LANGUAGE, WHICH REQUIRES US TO
DEVELOP A STRATEGIC PLAN TO
INCLUDE SHORT- AND LONG-TERM
GOALS TO ADJUST RACIAL, ETHNIC,
GENDER DISPARITIES AT NIH AND
IDENTIFY AND ADDRESS BARRIERS IN
ACCESS TO NIH FUNDING BY
INVESTIGATORS WHO ARE STUDYING
HEALTH DISPARITIES.
WE ACTUALLY WERE WELL AHEAD OF
THIS EXECUTIVE ORDER, AND WELL
AHEAD OF THE REPORT LANGUAGE,
AND HAD BEEN DOING QUITE A BIT
OF WORK ALREADY.
THIS IS OUR FRAMEWORK FOR THE
OVERALL DEIA STRATEGIC PLAN.
THE OBJECTIVES ARE LISTED ON THE
LEFT.
AN INVENTORY ON THE RIGHT, WHICH
OF COURSE FEEDS IN TO OUR
ABILITY TO AMPLIFY UPON THE
FRAMEWORK, AND MUCH OF THE
INITIAL DATA WAS COLLECTED
THROUGH OUR UNITE INITIATIVE, IN
PARTICULAR THE U COMMITTEE, WITH
EDI'S EFFORTS FROM THE MD-715
REPORT.
THE UNITE INITIATIVE IS A
BOTTOM-UP EFFORT, FIVE WORK
STREAMS THAT ARE SUMMARIZED
HERE.
AND AS YOU CAN SEE, IT INCLUDES
LISTENING TO STAKEHOLDER
EXPERIENCE, DEVELOPING NEW
APPROACHES AND NEW OPPORTUNITIES
FOR RESEARCH IN HEALTH
DISPARITIES, MINORITY HEALTH AND
HEALTH EQUITY.
HOW CAN WE IMPROVE THE CULTURE
HERE AT NIH, HOW DO WE INCREASE
TRANSPARENCY, ACCOUNTABILITY,
ACROSS BOTH INTERNAL AND
EXTERNAL STAKEHOLDERS AND
FINALLY WHAT DO WE DO IN THE
EXTRAMURAL RESEARCH ECOSYSTEM.
THIS IS SOMETHING I'M VERY PROUD
OF TO HAVE HELPED INITIATE AND,
AGAIN, BOTTOM UP HUNDREDS OF
VOLUNTEERS ACROSS THE INSTITUTES
AND CENTERS, NIDCR OF COURSE
REPRESENTED IN THIS EFFORT.
DR. D'SOUZA IS HERSELF ON ONE OF
THE COMMITTEES.
SO THE SO-CALLED I COMMITTEE HAS
RELEASED REQUEST FOR
INFORMATION, AND THE IDEA IS TO
SEE IF WE SHOULD OFFER PRIZES
FOR INSTITUTIONAL EXCELLENCE IN
THIS SPACE TO ENABLE
ACKNOWLEDGMENT OF THESE EFFORTS.
WE ARE SEEKING BROAD INPUT.
THE RFI LINK IS DISPLAYED HERE.
RESPONSES ARE DUE BY JULY 28.
AND WE DO HOPE THAT PEOPLE WILL
ENGAGE IN THIS EFFORT AS WE TRY
AND COLLECT AS MANY GREAT IDEAS
AS POSSIBLE.
NOW, AGAIN, I WOULD NEED
TREMENDOUS AMOUNT OF TIME TO GO
THROUGH THE MANY, MANY EFFORTS
THE NIDCR IS DOING, BUT THESE
ARE JUST VERY HIGH LEVEL
EXAMPLES, NOT EXCLUSIVE BUT
ILLUSTRATIVE.
AWARDS TO ENHANCE DIVERSITY ARE
LISTED, A PARTNERSHIP WITH THE
AADR ON MENTORING AND INCLUSION,
AND THEN OF COURSE NIDCR HAS A
FORMALLY ESTABLISHED EQUITY,
DIVERSITY AND INCLUSION PLAN AS
A GUIDING PRINCIPLE IN
EVERYTHING THAT THEY DO.
ANTI-HARASSMENT, CONGRESS
STRENGTHENED OUR ABILITY TO
ADDRESS HARASSMENT THROUGH
CONSOLIDATED ACT, AND UNIVERSE
FER UNIVERSITIES ARE OBLIGATED
TO TELL US IF PEOPLE HAVE BEEN
IDENTIFIED EITHER THOSE WHO ARE
P.I.s OR KEY PERSONNEL, IF
THEY HAVE BEEN REMOVED FROM
POSITIONS OR DISCIPLINED DUE TO
HARASSMENT, BULLYING,
RETALIATION, HOSTILE WORKING
CONDITIONS, AND SO THIS IS
SOMETHING THAT WE'VE BEEN
WORKING HARD AT OVER THE LAST
FIVE YEARS TO ENSURE SAFE
WORKPLACE BUT NOW THIS IS NO
LONGER A NEGOTIATION WITH
INSTITUTIONS, APPLICANT
ORGANIZATIONS.
THIS IS NOW A REQUIREMENT OF THE
LAW.
AND SO WE NOW HAVE THE AUTHORITY
TO REQUIRE INSTITUTIONS TO
REPORT HARASSMENT-RELATED
PERSONNEL CHANGES ON GRANTS.
WE'RE VERY GRATEFUL TO THE
CONGRESS FOR PROVIDING US WITH
THIS ADDITIONAL SET OF TOOLS.
AND FINALLY, TO SAY A LITTLE BIT
ABOUT ARPA-H, THE ADVANCED
RESEARCH PROJECTS AGENCY FOR
HELP, THE OMNIBUS APPROPRIATED
$1 BILLION TO ESTABLISH THIS NEW
ENTITY WITHIN THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES.
THE SECRETARY TRANSFERRED ARPA-H
TO NIH.
AND THE FUNDS TO NIH.
BUT DETERMINED THAT THE
INDIVIDUAL WHO IS ULTIMATELY
REPORTED AS INAUGURAL DIRECTOR
OF ARPA-H WILL REPORT TO THE
SECRETARY.
THIS WILL BE A PRESIDENTIAL
APPOINTEE.
AND THIS INDIVIDUAL WILL HAVE
FULL AUTHORITY FOR ALL THE
ADMINISTRATION AND OPERATIONS.
THE SECRETARY AND I THINK
INTERIM DIRECTOR IS PROBABLY NOT
ACCURATE, BUT WILL LIKELY BE
REPORTED SOME OPERATIONAL STAFF
TO HELP US PROVIDE
ADMINISTRATIVE AND OPERATIONAL
SUPPORT AS WE SORT OF BUILD THE
WIRING AND SO FORTH,
ADMINISTRATIVELY, AWAITING THE
INAUGURAL DIRECTOR WHICH, AGAIN,
IS A PRESIDENTIAL APPOINTMENT.
TODAY THE ENERGY AND COMMERCE
COMMITTEE MARKS UP ITS BILL,
WHICH AT LEAST FROM INITIAL WORD
THAT I'VE RECEIVED MAY SEEK TO
MOVE ARPA-H OUTSIDE OF NIH BACK
INTO HHS, SO STAY TUNED.
WE'LL HAVE TO WAIT TO SEE HOW
THIS ALL PLAYS OUT.
REGARDLESS OF HOW IT PLAYS OUT,
NIH STANDS READY TO PROVIDE
WHATEVER EFFORT WE CAN TO HELP
STAND UP THE ORGANIZATION
ADMINISTRATIVELY, FROM A
PRACTICAL STANDPOINT WE WANT TO
BE ABLE TO USE ALL THE EQUITIES
WE HAVE AVAILABLE TO ENSURE A
RAPID AND SUCCESSFUL STANDUP OF
THIS NEW AGENCY.
WITH THAT, AND WITH APOLOGIES
FOR RACING THROUGH, I THANK YOU
FOR LISTENING.
I'LL STOP SHARING MY SLIDES, I
HOPE.
OF COURSE IF THERE ARE COMMENTS
OR QUESTIONS I'D BE DELIGHTED TO
ANSWER THOSE.
SO THANK YOU.
OKAY.
I ASSUME I'VE STOPPED SHARING MY
SLIDES, RIGHT?
OKAY, GOOD.
>> THANK YOU VERY MUCH, LARRY,
FOR THE GREAT OVERVIEW.
I OPEN THE FLOOR FOR ANY
QUESTIONS FROM COUNCIL AND
NIDCR.
I DON'T SEE ANYTHING IN THE
THAT'S PRESSING.
THERE MAY BE SOME FROM OUR --
>> I'VE ANESTHETIZED EVERYBODY.
I WASN'T SO GOOD AT THIS WHEN I
WAS PRACTICING.
>> I'VE ALREADY DESCRIBED YOUR
BIO, AS LIVING VICARIOUSLY
THROUGH YOUR MUSICAL SON AND
YOU'VE BECOME A FANTASTIC
STANDUP COMIC, WE LOOK FORWARD
TO BEING ENTERTAINED.
>> I WAS A STANDUP COMIC LONG
BEFORE THIS.
>> ANY QUESTIONS FROM THE
AUDIENCE?
OBVIOUSLY WHAT I'VE HEARD MOST
OFTEN IS WHAT ABOUT THE NEW
DIRECTOR.
I KNOW THERE ARE RUMORS FLOATING
AROUND, LARRY.
>> THE NEW DIRECTOR?
OH, YES, THAT.
THANKS, RENA.
OF COURSE, AS YOU KNOW, THIS IS
A SENATE CONFIRMED PRESIDENTIAL
APPOINTEE, THE WAY IT WORKS IS
THE PRESIDENT WILL NEED TO
ANNOUNCE HIS CHOICE OF NOMINEE
FOR THE NEXT PERMANENT DIRECTOR
OF NIH.
THAT NOMINATION GOES TO THE
SENATE FOR THEIR CONSIDERATION.
THE NOMINEE WILL HAVE TO MEET
WITH MEMBERS OF THE SUBCOMMITTEE
THAT WILL REPORT OUT ON THE
NOMINATION.
AND THEN ULTIMATELY IT GOES TO
THE FULL SENATE.
THE CALCULUS OF COURSE IS THAT
THE CONGRESS DOES GO INTO RECESS
TOWARDS EARLY AUGUST.
AND WHEN THEY RETURN IN THE
FALL, AS YOU KNOW, THIS IS AN
ELECTION YEAR.
AND SO THE HOPE OF COURSE IS
THAT THEY WILL HAVE A NOMINEE
CONFIRMED BEFORE RECESS OCCURS.
BUT AS OF THIS MORNING WE DO NOT
YET HAVE A NOMINEE, AND BY THE
WAY, AS FAR AS MY INSIGHT, I
WILL READ ABOUT IT IN THE
"WASHINGTON POST" ALONG WITH
EVERYBODY ELSE.
SO BECAUSE AS THE ACTING
DIRECTOR, I'M ACTUALLY REMOVED
FROM ANY OF THE, YOU KNOW,
ENGAGEMENT IN THIS.
AND, YOU KNOW, APPROPRIATELY SO.
SO, WE'LL SEE WHAT THE TIMING
IS.
IN THE MEANTIME, AS I TRY TO
REASSURE BOTH THE HOUSE AND THE
SENATE, AS THE ACTING DIRECTOR
WE'RE MOVING FORWARD ON THE
MANY, MANY THINGS THAT NIH NEEDS
TO DO.
AND AMONG THOSE THINGS IS WE'RE
PREPARING MATERIALS, MUCH
CONDENSED FROM WHAT THEY USED TO
BE, BUT MATERIALS FOR ANY
TRANSITION THAT WILL OCCUR.
SO THAT WE CAN GET THE NEW
PERMANENT NIH DIRECTOR UP AND
RUNNING AS RAPIDLY AS POSSIBLE.
WHEN YOU SEE STUFF IN THE
NEWSPAPER, THAT'S WHAT IT IS.
IT'S STUFF.
AND THERE'S REALLY NO WAY OF
KNOWING WHETHER IT'S TRUE AND
TRIAL BALLOONS ARE BEING FLOATED
OR IF IT'S FALSE AND PEOPLE ARE
JUST MAKING THINGS UP.
OR EVERYTHING IN BETWEEN.
THE OLD WISDOM OF WASHINGTON IS
IF SOMEBODY TELLS YOU THEY KNOW
SOMETHING, THEY DON'T.
IF SOMEBODY TELLS YOU THEY DON'T
KNOW SOMETHING, THEY DO.
SO THERE YOU GO.
>> ABSOLUTELY.
LARRY, I DO HAVE AN OVERARCHING
QUESTION, AND I KNOW THAT YOU
WOULD HAVE SOMEBODY WISE TO
INFORM US ABOUT.
YOU KNOW, WE AT NIDCR ARE CAUGHT
IN A VIRTUAL CYCLE WHERE WE PAY
ATTENTION TO TRENDS IN OUR
EDUCATIONAL SECTOR AS WELL AS
OUR PRACTICING FRONTS, AND YOU
KNOW WHAT THOSE ARE WELL
REFLECTED IN THE REPORT ON ORAL
HEALTH STATUS OF AMERICA.
AS I TRAVEL AROUND, I'VE GAUGED
THERE ARE SCHOOLS THAT
EXPERIENCED GREAT DIFFICULTY
BECAUSE OF REVENUE STREAMS BEING
NARROWED THROUGH THE PANDEMIC.
ADMINISTRATIVE PRIORITIES, NEW
SCHOOLS POPPING UP, NOW 70 ON
THE MAP, MANY BEING PROPRIETARY
SCHOOLS.
WHAT ADVICE WOULD YOU GIVE US AT
NIDCR BOTH, FOR KNOWLEDGE
CREATION AND TAKE IT SERIOUSLY,
WHAT COULD YOU INFORM US ABOUT
AS WE FACE THESE CHALLENGES?
>> WELL, THEY ARE INDEED
CHALLENGES, RENA.
NIDCR UNDERGIRDS THE PROFESSION
OF DENTISTRY, AND SO IT IS
INCUMBENT UPON NIDCR AND NIH AS
A WHOLE OF COURSE TO BE
SUPPORTIVE OF ANY PROFESSIONAL
SCHOOL IN DENTISTRY.
THE HOPE BEING THAT ALL THESE
SCHOOLS WILL FIND THEIR NICHE
AND WILL SUPPORT SCHOLARLY
ACTIVITY.
ABSENT THAT, AND I'VE LIKENED
THE PROFESSION OF DENTISTRY AND
THE TRIALS AND TRIBULATIONS TO
EYE CARE, SO FORGIVE ME, I'LL GO
THROUGH THAT FOR A MOMENT.
YOU KNOW, WE LIKE TO THINK OF
OURSELVES AS OPHTHALMOLOGISTS,
PHYSICIANS OF THE MOUTHS.
MANY ARE MORE LIKE OPTOMETRISTS,
YOU KNOW, DELIVERING
HIGH-QUALITY CARE, BUT NOT AT
THE LEVEL OF, YOU KNOW, THE
OPHTHALMOLOGIST, SAY.
IF WE'RE NOT CAREFUL WE'RE GOING
TO BECOME OPTICIANS.
AND I FEAR THAT SOME, NOT ALL,
BUT SOME OF THESE SO-CALLED
NEWER PROPRIETARY SCHOOLS FALL
OR COULD FALL IN THAT BUCKET.
TO BE A PROFESSION, YOU NEED
STRONG INQUIRY.
YOU NEED STRONG EXPLORATION.
AND THAT CAN COME IN MANY, MANY,
MANY FORMS.
YOU CAN MAKE KNOCKOUT MICE OR
YOU CAN DO SURVEYS OF PROVIDER
EXPERIENCE.
I MEAN, EVERYTHING IN BETWEEN.
BUT YOU'VE GOT TO ENGAGE IN
SCHOLARLY ACTIVITY.
AND I -- AND SO THE CHALLENGE,
RENA, AND THE CHALLENGE TO ALL
OF MY COLLEAGUES AT NIDCR, AND
TO ALL OF YOU ON THE COUNCIL, IS
MAKE AVAILABLE THE OPPORTUNITIES
THAT ALL SCHOOLS OF DENTISTRY
ARE ABLE TO EMBRACE BECAUSE
SHUNNING THEM WON'T WORK.
AND BUT ENABLING WON'T EITHER.
SO I THINK WE'VE GOT TO STRIKE
THAT BALANCE.
AND I HOPE THAT, YOU KNOW, IF
I'VE UPSET SOME FOLKS OUT THERE,
YOU KNOW, WHO ARE INVOLVED WITH
SOME OF THESE SO-CALLED
PROPRIETARY SCHOOLS, IT'S A
WAKEUP CALL TO YOU.
HONESTLY.
AND SO I DO HOPE YOU WILL FIND A
WAY FOR YOUR FACULTY AND FIND A
WAY FOR YOUR STUDENTS TO ENGAGE
IN SCHOLARLY INQUIRY.
YOU KNOW, AT WHATEVER LEVEL IT
IS.
>> WE DO HAVE OPPORTUNITIES
COMING FORTH AND THERE IS A HAND
RAISED.
RAUL?
>> THANK YOU VERY MUCH, DR.
TABAK.
IMPRESSIVE TO SEE THE PROGRESS
THAT THE NIH OVERALL HAS MADE,
OF COURSE THE NIDCR IN THE AREA
OF DIVERSITY AND KUDOS TO YOU
ALL ON THAT.
I HAVE A SPECIFIC QUESTION IN
THAT REGARD.
DO YOU NOT THINK THE 2019 NEEDS
TO BE UPDATED?
THE 2019 NIH NOTICE MAKES NO
MENTION, SILENT ON THE LGBTQ
COMMUNITY IN REGARDS TO
DIVERSITY AND WOULD IT NOT BE
TIMELY FOR THE NIH TO TAKE THAT
ON?
>> YEAH, THANK YOU.
YEAH, WE'VE BEEN DISCUSSING THE
TIMING.
LGBTQI GROUPS OF COURSE ARE PART
OF THE DIVERSITY GROUP THAT
NIMHD AND THE REST OF NIH
RECOGNIZES, APPROPRIATELY SO.
AND AS YOU MAY KNOW, AS PART OF
THIS YEAR'S PRESIDENTIAL BUDGET,
WE'VE REQUESTED RESOURCES FOR A
SMALL CENTER WITHIN THE OFFICE
OF THE DIRECTOR, AND THE SEXUAL
AND GENDER MINORITY RESEARCH
OFFICE TO SPECIFICALLY ENHANCE
OUR ABILITY AND THE RESEARCH
COMMUNITY TO TAKE ADVANTAGE OF
THE RECENT REPORT ON DESCRIPTORS
AND SO FORTH IN THIS SPACE, AND
YOU'RE CORRECT FOR POINTING THAT
OUT.
THAT IS ONE ADDITIONAL THING WE
COULD ADD, SO I APPRECIATE THAT
YOU MENTIONED THAT.
>> THANKS, LARRY.
AND ANOTHER HAND UP.
>> YES, THANKS FOR A GREAT
OVERVIEW.
MY COMMENT OR QUESTION HAS TO DO
WITH COVID.
SO WHAT WE SEE AND WHAT YOU'VE
SHOWN US IS THAT THERE ARE THESE
NEW IMMUNOMODULATORY AGENTS THAT
HAVEN'T BEEN USED PREVIOUSLY IN
THE CONTEXT OF VIRAL INFECTIONS,
WE'RE SEEING REALLY A NEW
MEANING OF WHAT SYSTEMIC
DISEASES OR SYSTEMIC ILLNESS IS
IN THE CONTEXT OF COVID.
>> I'VE LOST HER.
HAVE I LOST YOU ALL?
NO?
>> NO.
>> BUT I LOST JENNIFER.
I'VE LOST RENA.
OH MY.
THEY MUST BE IN BUILDING 31.
AH, THEY DIDN'T PAY THE BILL.
THAT'S WHAT IT IS, OKAY.
>> BUILDING 30 IS STILL WORKING.
>> AS IS BUILDING 1, LET THE
RECORD SHOW.
[LAUGHTER]
OH MY.
WELL, I'M NOT QUITE SURE WHAT
JENNIFER HAD TO SAY.
>> HOPEFULLY WE'LL BE ABLE TO
REJOIN.
>> I'M SURE THEY ARE FRANTICALLY
TRYING TO GET THIS THING SET
BACK UP AGAIN.
WE'VE LOST JENNIFER AND RENA.
I'LL HANG OUT UNTIL THEY SHOW
UP.
>> DOES ANYBODY ELSE HAVE A
QUESTION FOR DR. TABAK WHILE
WE'RE WAITING?
NICE TO SEE YOU, LARRY.
>> YEAH.
>> WELL, I WAS REMISS.
IT IS REALLY NICE TO SEE A
NUMBER OF COLLEAGUES THAT I
HAVEN'T SEEN IN A WHILE.
GOOD TO SEE YOU ALL.
>> I DON'T SEE --
>> LARRY, TELL US MORE ABOUT
ARPA-H.
YOU HAD IT ON YOUR SLIDE BUT I
THINK IT'S SOMETHING THAT MANY
WANT TO HEAR ABOUT.
>> YEAH.
SO, THIS IS PATTERNED AFTER
DARPA, WHICH HAS ONLY ONE
CLIENT, THE DEFENSE DEPARTMENT.
AND THEY HAVE HAD A SERIES OF
SUCCESSES INCLUDING THE
INTERNET, AT LEAST WHAT BECAME
THE INTERNET.
AND IT'S A DIFFERENT WAY OF
IDENTIFYING SCIENTIFIC
OPPORTUNITIES AND IT IS A
DIFFERENT WAY OF SUPPORTING
THOSE SCIENTIFIC OPPORTUNITIES.
IT'S MUCH MORE GOAL ORIENTED,
MUCH MORE DELIVERY OF A
PLATFORM.
DELIVERY OF A PRODUCT.
DOESN'T DO A LOT OF BASIC
SCIENCE UNLESS BASIC SCIENCE
NEEDS TO BE INVENTED.
I DON'T MEAN TO BE HYPERBOLIC.
I MEANS IT TAKES ON VERY, VERY,
VERY HIGH RISK EFFORTS SO YOU
NEED TO DEVELOP NEW MATH TO
FIGURE SOMETHING OUT, YOU
DEVELOP THE NEW MATH.
AND SO FORTH.
BASED UPON THE DARPA MODEL FOR
DEFENSE AND IARPA, WHICH IS USED
IN THE INTELLIGENCE COMMUNITY,
AND ARPA-E IN THE ENERGY FIELD
THE ADMINISTRATION FELT STRONGLY
THAT HEALTH COULD ALSO USE THIS
APPROACH.
THE APPROACH IS VERY DIFFERENT
THAN NIH'S.
THE DIRECTOR OF THE ORGANIZATION
RECRUITS A SERIES OF PROJECT
MANAGERS, WHO ARE HIRED ON THE
BASIS OF THE IDEAS THEY BRING TO
THE TABLE ABOUT NEW THINGS, NEW
EXCITING RISKY THINGS.
THE PROGRAM, THESE PROJECT
MANAGERS ARE EMPOWERED TO MAKE
MANY DECISIONS IN TERMS OF WHO
IS SUPPORTED.
WE DO NOT -- THEY DO NOT USE THE
PEER REVIEW SYSTEM, THE REVIEW
IS DONE INTERNALLY BY FEDERAL
EMPLOYEES.
THERE ARE VERY STRICT
MILESTONE-DRIVEN ACTIVITIES, AND
YOU FAIL EARLY AND RAPIDLY.
SO YOU WOULD NOT BE DOING A
NINE-YEAR PROJECT IS THE ONE I
DESCRIBED KELLY, NADINE AND MY
GROUP AND THE GROUP IN THE
NETHERLAND.
YOU FAIL QUICKLY.
IF IT'S NOT GOING TO GO, IT'S
NOT GOING TO GO.
THE CLOSEST WE HAVE TO THIS AT
NIH IS OUR USE OF OTHER
TRANSACTION AUTHORITIES WHICH
SOME INSTITUTES AND CENTERS USE
AND WE USE IN THE OFFICE OF THE
DIRECTOR.
BUT NOT USING TRADITIONAL PEER
REVIEW SYSTEM, BEING ABLE TO MIX
AND MATCH YOUR RESEARCH TEAM.
SO IF YOU PUT OUT AN
ANNOUNCEMENT FOR -- I'M MAKING
IT UP NOW, TISSUE ENGINEERING OF
THE CRANIOFACIAL COMPLEX, AND
YOU GET IN TEN APPLICATIONS,
YOU'LL LIKE WHAT MATT HOFFMAN IS
DOING IN THE FIRST APPLICATION,
YOU LIKE WHAT RAUL GARCIA IS
DOING IN THE SECOND, ET CETERA.
AND YOU MIX AND MATCH THE TEAM.
AND YOU'RE NOT OBLIGATED TO TAKE
ANY TEAM INTACT BUT YOU BUILD
YOUR OWN TEAM.
AND SO IT IS A VERY, VERY
DIFFERENT APPROACH TO SOLVING
PROBLEMS BASICALLY.
NOW, THE ORGANIZATION IS TO
SOLVE PROBLEMS FOR MOLECULES TO
SOCIETAL.
WHICH IS A HEAVY LIFT.
AND EQUITY HAS TO BE BUILT INTO
EVERYTHING THEY DO.
IF YOU MAKE SOME APPROACH WHICH
NOBODY CAN AFFORD, THEN WE'VE
LOST THE BATTLE.
WE'VE NOT ACCOMPLISHED ANYTHING.
AND SO IT'S A COMPLETELY NEW WAY
OF LOOKING AT THINGS, AND MANY
FEEL THAT THIS WOULD BE AN
OUTSTANDING ADDITION TO WHAT
NIH -- WHAT THE NIH APPROACH IS,
WHICH OBVIOUSLY USES TRADITIONAL
PEER REVIEW, IS THERE MORE FOR
THE LONG TERM, SUPPORTS THE
BASIC SCIENCE, MUCH OF WHICH
THEN ORGANIZATIONS LIKE DARPA
TURN INTO DELIVERABLES AND SO
FORTH.
SO I SEE JENNIFER HAS REJOINED.
WE'RE TALKING ABOUT ARPA-H.
I HOPE EVERYTHING HAS BEEN
PLUGGED BACK IN.
I DON'T SEE RENA YET.
>> WE HAVE NO INTERNET HERE AT
NIDCR.
I'M ON THE PHONE.
>> OKAY.
>> BUT HOPING TO GET BACK ON.
>> ALL RIGHT.
>> SORRY FOR THE DISRUPTION.
WE DO HAVE SOME TIME FOR
JENNIFER'S QUESTION.
>> DID YOU HEAR THE END OF THE
QUESTION?
>> NO, UNFORTUNATELY NOT,
JENNIFER.
I HEARD THE FACT THAT BY
EXPLORING THE USE OF IMMUNE
MODULATORS AND VIRAL DISEASE
WE'VE ENTERED AND THEN YOU CUT
OFF.
>> WELL, SO LEARNED SO MUCH,
RIGHT?
WE'VE GOT IN ADDITION TO USING
IMMUNOMODULATORS WHICH WE'VE NOT
USED BEFORE WE'VE GOT A NEW
DEFINITION WHAT SYSTEMIC ILLNESS
IS IN THE CONTEXT OF THIS LONG
COVID.
AND WE'RE DOING SCIENCE A
DIFFERENT WAY.
WHAT DO YOU THINK THIS MEANS FOR
THE WAY THAT WE SHOULD APPROACH
SCIENCE HERE AT NIDCR?
AND ACROSS OUR DIFFERENT
LABORATORIES.
>> YEAH, WELL, ACROSS AND AMONG
ARE THE KEY STATEMENTS.
SCIENCE IS A TEAM SPORT.
AND HONESTLY, I THOROUGHLY
APPRECIATE THE CREATIVITY OF
INDIVIDUAL SCIENTISTS.
BUT WHEN YOU GET TWO AND THREE
AND FIVE CREATIVE SCIENTISTS
TOGETHER, IT'S EVEN THAT MUCH
BETTER.
EVERYTHING WE KNOW ABOUT TEAMS,
SCIENCE OF TEAMS, UNDERSCORES
THE FACT DIVERSE TEAMS DO BETTER
WORK.
I DON'T KNOW WHY ANYBODY IS
SURPRISED BY THAT, BUT IT'S BEEN
PROVEN OVER AND OVER AGAIN.
AND SO AS A FUNDING AGENCY, WE
HAVE TO DO A BETTER JOB OF
ENABLING PEOPLE TO TEAM,
ENABLING PEOPLE TO FIND EACH
OTHER, BECAUSE THAT'S OFTEN THE
BIGGEST CHALLENGE IS KNOWING
THAT THERE'S SOMEBODY ON THE
OTHER SIDE OF THE CAMPUS OR IN
ANOTHER STATE OR ANOTHER COUNTRY
THAT IS DOING SOMETHING THAT
WOULD BE SO VERY COMPLEMENTARY
TO WHAT YOU'RE TRYING TO DO.
SO, I WOULD HOPE GOING FORWARD,
YOU KNOW, WE EMPOWER NEWER
INVESTIGATORS SOONER, FIGURE OUT
HOW TO ENCOURAGE MORE TEAMING,
NOT LESS, AND FRANKLY, YOU KNOW,
REALLY INCENTIVIZE THIS NOTION
THAT THE WHOLE GROUP SHOULD BE
REWARDED.
IT'S STILL THE CASE I FEAR THAT
ACADEMIC ORGANIZATIONS INCLUDING
THE NIH INTRAMURAL PROGRAM,
QUITE FRANKLY, SO I'M NOT SAYING
THAT NIH HAS SOLVED THIS YET.
YOU KNOW, IF YOU'RE THE FIRST
AUTHOR, GREAT.
IF YOU'RE THE LAST AUTHOR,
GREAT.
IF YOU'RE SOMEWHERE IN BETWEEN,
STILL MANY AN ACADEMIC
ORGANIZATION, INCLUDING NIH, YOU
KNOW, SORT OF QUESTION, WELL,
WHAT DOES THAT MEAN IN TERMS OF
YOUR CONTRIBUTION?
WE'VE GOT TO GET OVER THAT.
FOR SCIENCE TO MOVE FORWARD THE
ET AL. NEED TO BE RECOGNIZED FOR
THE VALUE OF WHAT THEY ARE
DOING.
OFTEN, I'M SURE MANY OF YOU HAVE
THIS EXPERIENCE, IT'S THE
CLINICIAN SCIENTIST IN THE
MIDDLE, AND THEY SORT OF GET
SHORT CHANGED IN THE CREDIT BUT
WITHOUT THEIR INSIGHT, WITHOUT
THEIR UNDERSTANDING OF THE
CLINICAL NUANCES OF WHAT IS
BEING DEALT WITH, THE WORK
DOESN'T HAPPEN.
SO, ALL GLORY TO THE FIRST
AUTHOR, ALL GLORY TO THE
SO-CALLED SENIOR AUTHOR IN
BIOMEDICAL RESEARCH, BUT WE'VE
GOT TO FIGURE OUT A BETTER
REWARD SYSTEM BECAUSE AT THE END
OF THE DAY THAT'S WHAT DRIVES SO
MUCH OF THIS.
AND SO I HOPE NIDCR WILL DO
EXPERIMENTS IN THIS SPACE, NIH
AS A WHOLE IS DOING EXPERIMENTS
IN THIS SPACE.
BUT I THINK THAT'S WHAT THE
PANDEMIC HAS TAUGHT US IS IT'S
GOT TO BE A TEAM SPORT.
IT REALLY DOES.
>> A MAJOR CULTURE SHIFT.
BUT AN IMPORTANT ONE.
>> NO QUESTION.
AND I KNOW MATT, YOU WORK HARD
AT THIS IN THE INTRAMURAL
PROGRAM.
I MEAN, I STAY PERIPHERAL
BECAUSE I HAVE THIS DAY JOB, BUT
I SEE IT IN MY TRAINEES, I SEE
IT IN THE FOLKS IN MY OWN LITTLE
GROUP.
THIS IS SOMETHING THAT MATT
DRIVES VERY HARD.
AND I KNOW JANICE DRIVES VERY
HARD IN THE CLINICAL SIDE,
CLINICAL CENTER.
I KNOW THE NIDCR LEADERSHIP IS
DEEPLY ENGAGED IN THIS APPROACH.
WELL, I'M GOING TO HAVE TO JUMP
OFF.
I HOPE YOU FIND A WAY FOR RENA
TO JOIN.
>> THANK YOU VERY, VERY MUCH,
DR. TABAK.
>> I REALLY APPRECIATE BEING
ABLE TO BE HERE.
AND HOPE THE REST OF YOUR
COUNCIL GOES A LITTLE BIT MORE
SMOOTHLY.
BUT REALLY NICE.
AND I WILL DO ONE ADDITIONAL, AS
I'M LEAVING, ONE ADDITIONAL IRP
ADVERTISEMENT.
WHEN I WAS ORIGINALLY ASKED TO
DO THIS, I THOUGHT, GREAT, I'M
GOING TO TALK ABOUT NIKI
MOUTSOPOULOS'S WORK.
AND THEN I LEARNED SHE'S GOING
TO BE SPEAKING.
INSTEAD OF ME BUTCHERING HER
ELEGANT WORK YOU GET TO HEAR IT
DIRECTLY FROM NIKI.
I HOPE YOU ENJOY IT BECAUSE IT'S
REALLY GREAT.
THANKS, EVERYBODY.
>> THANKS, LARRY.
>> TAKE CARE.
>> THANK YOU.
THANK YOU FOR THE INVITATION TO
PRESENT, AN HONOR AND PRIVILEGE
TO SHARE A BIT OF OVERVIEW OF
OUR RESEARCH PROGRAM AND
HIGHLIGHT ONE OF THE STUDIES
THAT HAS BEEN RECENTLY DEVELOPED
IN THE LAB THAT WE'RE EXCITED
ABOUT.
FIRST, IN WAY OF INTRODUCTION,
WHAT WE'RE INTERESTED IN IS
BARRIER IMMUNITY AT A
FUNDAMENTAL LEVEL.
BARRIERS ARE THE PARTS OF THE
MAMMALIAN HOST SUCH AS SKIN,
ORAL AND INTESTINAL MUCOSA, THE
LUNG, EXPOSED TO THE OUTSIDE
ENVIRONMENT.
SO ALL OF THESE SURFACES HAVE TO
PROTECT THIS, HAVE TISSUE
INTEGRITY.
BUT AT THE SAME TIME THEY HAVE
TO COMBAT PATHOGENIC VIRUS AND
BACTERIA AND ALSO TOLERATE
INNOCUOUS AGENTS.
AS WE TRY TO UNDERSTAND
PHYSIOLOGY AND TISSUE IMMUNITY
AT THESE SITES A LOT OF THE
QUESTIONS THAT ARE IMPORTANT FOR
BARRIER IMMUNITY IN GENERAL ARE
VERY MUCH SHARED THROUGHOUT ALL
OF THE SURFACES.
FUNDAMENTAL QUESTION WE'VE BEEN
THINKING ABOUT ARE HOW IS TISSUE
INTEGRITY MAINTAINED, PROTECT
FROM PATHOGENS CONFERRED, HOW DO
YOU PROTECT BUT NOT OVERINFLAME
AND TOLERATE INAC WOWS ELEMENTS?
HOWEVER, THE QUESTIONS ARE VERY
MUCH SHARED, THE ANSWER AS
PEOPLE HAVE BEEN TRYING TO
UNDERSTAND BARRIER IMMUNITY FOR
A NUMBER OF DECADES NOW, THE
ANSWERS BECOME VERY TISSUE
SPECIFIC.
IT BECOMES EVIDENT THAT EACH
TISSUE IS VERY SPECIAL.
ITS EXPOSURES ARE SPECIAL.
FOR EXAMPLE, THE SKIN IS EXPOSED
TO SUNLIGHT.
VIRUSES THAT ARE AIRBORNE WILL
COME INTO THE LUNGS, PRIMARILY.
GAS TOE INTESTINAL TRACT WILL
COME IN CON CONTACT WITH FOOD,
SO EXPOSURES ARE DIFFERENT.
WITH DISEASE, MANY ARE VERY
TISSUE SPECIFIC.
SO, IT BECOMES IMPORTANT FOR ALL
OF US TO THINK OF TISSUE
IMMUNITY IN A VERY SPECIFIC WAY.
AND SITE SPECIFIC WAY.
THE SITE THAT IS OF INTEREST TO
US IS THE ORAL MUCOSA.
THIS IS AN ILLUSTRATION THAT
COMES FROM A REVIEW THAT SARAH
AND I HAD PUT TOGETHER A COUPLE
YEARS AGO.
TO ILLUSTRATE THAT THE ORAL
MUCOSA IS A VERY SPECIAL SITE,
OBVIOUSLY PREVENTIVE, RELEVANT
FOR MANY DENTISTS CLINICALLY
RELEVANT BUT BEYOND THAT, I WANT
TO ADVOCATE THAT IT'S A VERY
IMPORTANT SITE TO THINK ABOUT,
THE AREA WHERE THE
GASTROINTESTINAL AND RESPIRATORY
TRACT COMES INTO CONTACT WITH
OUTSIDE FOR THE FIRST TIME.
FOR EXAMPLE, AS WE BREATHE,
AIRBORNE PARTICLES AND ALLERGENS
WILL COME THROUGH THE NOSE AND
MOUTH BEFORE GOING INTO THE
LUNGS.
A LOT OF THE COMMENSAL
MICROBIOTA AS THEY TRAFFIC INTO
THE LUNGS AND GASTROINTESTINAL
TRACT PASS THROUGH THE MOUTH.
OF COURSE FOOD AND DIGESTION IS
GOING TO START AT THE ORAL
MUCOSA.
AND SO WHAT OUR LAB IS
INTERESTED IN UNDERSTANDING IS
HOW THE LOCAL IMMUNE SYSTEM IS
GOING TO BALANCE ALL OF THESE
ENVIRONMENTAL EXPOSURES AND KEEP
TISSUE INTEGRITY AND KEEP TISSUE
FUNCTIONALITY AND MAINTAIN
HEALTH.
WE ALSO WANT TO UNDERSTAND HOW
SOME OF THESE EXPOSURES COULD
BECOME IMBALANCED AND LEAD TO
DISEASE.
WHILE WE'VE BEEN PARTNERING OVER
THE YEARS WITH MANY AT THE NIH
HOSPITALS THAT ARE INTERESTED IN
BIODIVERSE ORAL DISEASE, THE
DISEASE OF INTEREST THAT OUR LAB
HAS BEEN FOCUSING ON FOR YEARS
NOW, PER -- PERIODONTAL
DISEASE.
I APPRECIATE I DON'T NEED TO DO
AN INTRODUCTION ON PERIDONTITIS
BUT OBVIOUSLY IT'S A PREVALENT
DISEASE, MILD AND MODERATE
FORMS, WIDESPREAD THROUGH THE
POPULATION, IN SEVERE FORMS,
THAT WILL CAUSE MORBIDITY, THAT
WILL LEAD TO SURGICAL
INTERVENTION OFTEN, AND THAT ARE
ALSO CONNECTED TO VERY
SIGNIFICANT HEALTH COSTS, IT'S
STILL SEEN 8% OF THE GENERAL
POPULATION.
WE THINK OF A TRIGGER,
INFLAMMATORY DISEASE.
WE KNOW BY THE WORK OF MANY IN
OUR FIELD THAT FOR SUSCEPTIBLE
INDIVIDUALS DYSBIOTIC MICROBIOME
WILL COLONIZE THE TOOTH, END UP
STIMULATING INFLAMMATORY
RESPONSE IN THE MUCOSA, THIS
RESPONSE WILL BECOME DESTRUCTIVE
IN NOT ONLY DESTROYING MUCOSAL
TISSUES BUT SUPPORTING BONE,
LEADING TO LOSS OF SUPPORT AND
EVENTUALLY TO LOSS OF TEETH WHEN
THIS IS VERY SEVERE.
AND SO WHILE WE UNDERSTAND A LOT
OF THESE GENERAL PRINCIPLES, WE
DON'T FULLY HAVE A TACKLE ON
PATHOGENESIS MECHANISMS BEST TO
TARGET FOR THIS DISEASE.
BEFORE STARTING MANY OF THE
QUESTIONS, I WANT TO FIRST POSE
BECAUSE THIS IS ALSO A COUNCIL
MEETING, A MORE EXISTENTIAL
QUESTION, THE QUESTION OF WHY
SHOULD WE BE STUDYING, WHAT IS
THE REASON FOR US TO CONTINUE
STUDYING PERIODONTAL DISEASE,
ISN'T THIS A DISEASE THAT COULD
JUST BE PREVENTIBLE, PREVENTIBLE
BY INCREASING ACCESS OF CARE,
INCREASING ORAL HYGIENE, SO I
WANT TO KIND OF PITCH TO YOU
THIS IDEA THAT WE DO HAVE TO DO
A LOT ON THE PUBLIC HEALTH AND
ACCESSIBILITY TO CARE ARENA, IN
THE CONTROL, IN THE ARENA OF
SMOKING CESSATION INTERVENTIONS,
IMPORTANT FOR PERIODONTAL
DISEASE SUSCEPTIBILITY.
WHEN YOU PROVIDE OPTICAL CARE
YOU WILL REDUCE DISEASE BURDEN
IN THE GENERAL COMMUNITY.
HOWEVER, THIS DOES NOT ABROGATE
DISEASE.
THE PROPORTION OF PEOPLE THAT
ARE SUSCEPTIBLE TO PERIODONTITIS
DOES NOT DRASTICALLY CHANGE.
WE STILL HAVE PATIENTS WITH
SEVERE DISEASE, WITH NEED
SURGICAL INTERVENTION,
RECALCITRANT TO TREATMENT.
EVEN IN THE PRESENCE OF OPTIMAL
CARE THE WAY WE'VE BEEN
PROVIDING CARE THERE'S MORE FOR
US TO UNDERSTAND.
SO ONE OF THE QUESTIONS THAT OUR
GROUP IS VERY INTERESTED IN IS
UNDERSTANDING THE DISEASES
SUSCEPTIBLE, WERE ARE
INDIVIDUALS SUSCEPTIBLE TO
SEVERE FORMS, THIS IS A
POLYGENIC DISEASE ALSO
ASSOCIATED WITH ENVIRONMENTAL
EXPOSURES.
WE KNOW THAT THERE'S A LOT OF
TARGETED THERAPIES FOR
PERIODONTITIS, WHILE WE HAVE
WAYS OF REMOVING THE MICRO
BIOFILM, SURGICAL INTERVENTION
TO CREATE A HEALTHY ENVIRONMENT
AROUND THE DENTITION.
WE DON'T HAVE A TARGETED WAY TO
EITHER TARGET SPECIFIC
MICROBIOTA THAT MIGHT BE
IMPORTANT OR SPECIFIC
INFLAMMATORY PATHWAYS.
THERE'S ALSO A LOT OF QUESTIONS
THAT REMAIN REGARDING
ASSOCIATION OF PERIODONTITIS
WITH SYSTEMIC DISEASES.
FROM THE STANDPOINT OF
FUNDAMENTAL BIOLOGY,
UNDERSTANDING PERIODONTAL
DISEASE ONE CAN ARGUE IS ALSO A
FANTASTIC NICHE TO ADVANCE OUR
UNDERSTANDING OF HOST-MICROBIOME
BIOLOGY.
SO, WHATEVER THESE QUESTIONS AND
THOUGHTS ARE NOT UNIQUE TO OUR
PROGRAM ARE VERY MUCH SHARED
THROUGHOUT THE COMMUNITY.
BUT WHAT WE'VE TRIED TO DO
THROUGH UNIQUE LENS AT THE NIH
IS THE WAY WE'VE TRIED IN THE
LAST ALMOST DECADE NOW TO TACKLE
THIS QUESTION.
AND WE'VE DONE THIS VERY MUCH
FROM THE LENS OF THE HOST AND
THE LENS OF THE GENETIC DISEASE.
SO, AS YOU ALL WILL APPRECIATE
THE NIH HAS A FANTASTIC CLINICAL
RESEARCH HOSPITAL, THE LARGEST
RESEARCH HOSPITAL IN THE WORLD,
THAT IS VERY MUCH FOCUSED ON
RARE DISEASE.
AND SO HERE A COURSE OF PATIENTS
CAN RARE GENETIC DISORDERS ARE
BROUGHT TOGETHER SO WE CAN
UNDERSTAND THEIR DISEASES AND
TRY TO TARGET THEM, LOOKING AT
COHORTS ALL TOGETHER AT ONCE.
ESPECIALLY BECAUSE MANY OF THESE
DISEASES ARE NOT VERY WELL
UNDERSTOOD, AND IT'S VERY HARD
FOR MANY PATIENTS TO GET CARE IN
THE COMMUNITY.
EVALUATING PATIENTS WITH SINGLE
GENE DEFICIENCIES PROVIDES A WAY
ALSO A WINDOW INTO HUMAN
BIOLOGY.
WHILE WE LOOK AT THE GENOTYPES
AND GENETIC, SPECIFIC GENETIC
DEFECTS, WE CAN LING THEM OFTEN
TO PARTICULAR PHENOTYPES AND
THIS CAN TELL US HOW SPECIFIC
GENOME-RELATED PATHWAY COULD BE
INFLUENCING HUMAN BIOLOGY.
AND SO THIS IS DONE BY MANY OF
US AT THE NIH CENTER, DEPENDING
ON THE DISEASE OF INTEREST, AND
THIS IS THE WAY THAT WE'VE BEEN
TRYING TO APPROACH OUR
UNDERSTANDING INTO GENETIC
SUSCEPTIBILITY, STARTING WITH
MAMMALIAN GENE DISEASES,
PHENOTYPING TO LINK GENOTYPE
WITH PHENOTYPE OF SEVERE EARLY
ONSET PERIODONTITIS, WORK WITH
SAMPLES FROM THE MICROBIOME AND
TISSUE SIDE AND SYSTEMIC
IMMUNITY SIDE TO START
UNDERSTANDING IMMUNE
RESPONSIVENESS IN THESE
PATIENTS.
WHEN APPLICABLE WE MOVE INTO
ANIMAL MODELS, PARTICULARLY WHEN
WE HAVE AN ANIMAL MODEL THAT
WILL PHENOCOPY A DISEASE, AND
THEN THE MODELS BECOME A PLACE
WHERE WE CAN EXPAND THE
CONNECTIVE UNDERSTANDING, AND WE
CAN ALSO PERFORM PRE-CLINICAL
TARGETING WHEN POSSIBLE.
NOW, OUR INTENT IS THREE-FOLD
BUT I'M SHOWING ONE HERE.
A LOT OF THE RARE DISEASE THAT
WE SEE WHEN WE HAVE GENETIC
DISRUPTION LEAD TO SIGNIFICANT
CLINICAL PHENOTYPES SO WE WANT
TO TRY TO MOVE INTO HUMAN
INTERVENTION AT LEAST IN THE
RARE DISEASE ARENA, AND THE NIH
IS AN IDEAL PLACE TO DO SO.
BUT AT THE SAME TIME, WE WANT TO
FURTHER MECHANISTIC
UNDERSTANDING OF ORAL MUCOSAL
IMMUNITY AND MUCOSAL BIOLOGY.
AND IF POSSIBLE, BE ABLE TO
EDUCATE OUR UNDERSTANDING OF
SYSTEMIC DISEASES TO SEE HOW
UNDERSTANDING THESE GENETIC
FORMS OF DISEASE CAN TRANSLATE
INTO SOME LEVEL OF UNDERSTANDING
OF COMMON FORMS OF DISEASE.
AND SO THROUGH THE YEARS TO OUR
STUDY PARTICULARLY IN GENETIC
IMMUNODEFICIENCIES WE VERY MUCH
FOCUSED ON SPECIFIC IMMUNE
PATHWAYS WHICH I'M CALLING HERE
THE Th17 NEUTROPHIL AXIS.
I WILL BE SUPERFICIAL IN MY
DESCRIPTION FOR THE PURPOSE OF
THIS TALK, OF THE BASIC
IMMUNOLOGY HERE BUT I'M HAPPY TO
ANSWER FURTHER QUESTIONS.
WE'VE BEEN FOCUSING ON THESE
HELPER T CELLS, Th17, CD4
POSITIVE CELLS THAT SECRETE
IL-17.
NEUTROPHILS ARE THE MOST
ABUNDANT IN THE CIRCULATION,
THESE ARE OUR PRINCIPAL INNATE
IMMUNE CELLS THAT WILL RUN TO
THE SITE OF INFECTION AND
INFLAMMATION AND THEY HAVE A
PRINCIPAL ROLE IN ANTIMICROBIAL
DEFENSE.
NEUTROPHILS WILL TRY TO COMBAT
INFECTION EITHER BY EATING UP
BACTERIA, BY SECRETING ENZYMES
OR SECRETING THEIR DNA CONTENTS
THAT WILL TRAP LARGER MICROBES
AND SECRETE THEIR ENZYMES AT THE
SAME TIME.
THE PARADIGM IN IMMUNOLOGY FOR
MANY YEARS, WHEN YOU DON'T
HAVE -- WE HAVE ISSUES WITH
NEUTROPHIL ABUNDANCE, OR
RECRUITMENT, YOU END UP WITH
INFECTION.
WHEN YOU HAVE TOO MANY
NEUTROPHILS YOU WILL END UP WITH
INFLAMMATION.
FOR THE WORK OF OUR GROUP AND
OTHERS AT THE NIH AND
EXTRAMURALLY WE'VE CHALLENGED
PARADIGM TO INCLUDE IN THE
ABSENCE OF NEUTROPHILS YOU END
UP WITH SETTINGS OF INFLAMMATION
BUT I WON'T TALK ABOUT THIS
TODAY.
IN Th17 NEUTROPHIL BIOLOGY OUR
LAB AS WORKED A LOT, THERE'S A
NUMBER OF PEOPLE HERE, PAPERS
AND PEOPLE HERE I WILL NOT
PRESENT TODAY BUT I WANTED TO
KIND OF DO A SMALL SHOUT OUT TO
SAY THAT WE'VE BEEN VERY
INTERESTED IN FUNDAMENTAL Th17
BIOLOGY, A LOT OF EARLY
UNDERSTANDING OF IL-17 AND
Th17 CAME FROM THE WORK OF
SARAH GAFFEN, PARTICULARLY
FUNGAL IMMUNOLOGY.
WE'VE EXPANDED INTO PERIODONTAL
IMMUNITY.
EVEN THE SAME CYTOKINE WITH
DIFFERENT LOCATION IN THE MOUTH
CAN HAVE DIVERSE FACTIONS.
RECENTLY WE'VE WORKED VERY MUCH
ON AN EFFORT TO CREATE A SINGLE
CELL ATLAS FOR THE ORAL MUCOSA.
AND I WON'T HAVE TIME
UNFORTUNATELY TO SPEAK OF ANY OF
THIS WORK TODAY.
IN THE SETTING OF GENETIC
IMMUNODEFICIENCY WE WORKED BOTH
ON PATIENTS THAT HAVE ISSUES
WITH NEUTROPHIL DEFICIENCIES AS
WELL AS NEUTROPHIL OVERABUNDANCE
AND IT'S BECOME EVIDENT TO US
THE BALANCE OF NEUTROPHILS
BECOMES VERY IMPORTANT FOR
NEUTROPHIL -- FOR HOMEOSTASIS.
SO OUR WORK IN NEUTROPHIL
DEFICIENCIES HAS BEEN
PARTICULARLY FOCUSED ON RARE
DISEASE CALLED LEUKOCYTE
ADHESION DEFICIENCY IN
COLLABORATION WITH NIAID AND
EXTRAMURALLY WITH GEORGE, AND I
WON'T HAVE TIME TO PRESENT ANY
OF THIS WORK TODAY.
I DECIDED FOR THE PURPOSE IT'S
OF MY TALK TODAY TO JUST FOCUS
ON ONLY ONE TOPIC, AND ON THE
STUDY THAT HAS BEEN A
COLLABORATIVE STUDY BETWEEN OUR
LAB AND THAT OF THE NIH, AND LED
BY A TALENTED POSTDOCTORAL
FELLOW, SILVA, CO-MENTORED
BETWEEN THE TWO LABS.
I WANT TO HIGHLIGHT THE FACT
THESE STUDIES THAT ARE BEDSIDE
TO BENCH AND BACK START FROM
GENETIC IMMUNE DEFICIENCY GOING
TO THE LAB WITH INTENT OF MOVING
INTO THE CLINIC, HIGHLY
COLLABORATIVE AS LARRY TABAK
JUST INTRODUCED TO US THESE
BIGGER QUESTIONS REALLY
NECESSITATE WORK FROM MANY
FIELDS, MANY PEOPLE, IN ORDER TO
BE PUSHED FORWARD.
AND BECAUSE THIS CAN BE UNIQUELY
DONE AT THE NIH CLINICAL CENTER
I THOUGHT IT WOULD BE MORE
RELEVANT FOR ME TO PRESENT THIS
WORK TO YOU TODAY.
AND SO THE DISEASE THAT WE
FOCUSED ON HERE PLASMINOGEN
DEFICIENCY, THE FORM OF THE
ENZYME PLASMID, PATIENTS WITH
END UP WITH REDUCED ENZYMATIC
ACTIVITY.
AND CLINICAL PHENOTYPE-WISE THEY
WILL HAVE WIDESPREAD MUCOSAL
IMMUNOPATHOLOGY.
THEY HAVE LESIONS IN THEIR
CONJUNCTIVA, GUT, LUNG, VAGINA,
AND MOUTH.
AND SO FOR THE DENTIST AND NOT
DENTISTS IN THE ROOM I HAVE HERE
AN X-RAY OF A 15-YEAR-OLD
PATIENT, PATIENT WITH
PLASMINOGEN DEFICIENCIES
ASSOCIATINGED PERIODONTITIS.
THIRD MOLARS ARE NOT OUT.
DENTITION, PRETTY MUCH OF
MAJORITY OF BONE HAS BEEN LOST.
THIS IS A VERY SEVERE CASE.
THESE ARE THE KIND OF CASES THAT
WE HAVE BEEN SEEING AT THE NIH
HOSPITAL ASSOCIATED GENETIC
IMMUNODEFICIENCY.
SO THOMAS A NUMBER OF YEARS AGO
CAME TO ME, HE'S HAD THE
INTEREST IN PROTEASE, WORKED ON
PLASMINOGEN AS AN ENZYME FOR
MANY YEARS WITH THE IDEA THAT
THIS IS AN AREA WHERE WE HAVE
COMBINED INTEREST AND WE CAN
KIND OF PUT OUR BRAINS TOGETHER
AND OUR EFFORTS TOGETHER TO TRY
TO UNDERSTAND THE ROLE IN
MUCOSAL IMMUNOLOGY.
JUST A COUPLE MORE WORDS ABOUT
PLASMINOGEN AND ITS FUNCTION.
IT NEEDS TO BE ACTIVATED INTO
PLASMIN TO DEGRADE FIBRIN, THE
MAIN COMPONENT RELEASED FROM THE
VASCULATURE TO CREATE CLOTS,
NOT JUST RELEED WHEN BROKEN BUT
WHEN INFLAMED.
WE NEED FIBRIN FOR HEMOSTASIS,
BUT WE ALSO NEED FIBRIN TO BE
REMOVED IN A TIMELY FASHION TO
ALLOW FOR TISSUE REPAIR.
AND SO THAT'S THE ROLE OF
PLASMID, IT COMMENTS IN AND
DEGRADES FIBRIN AFTER THE CLOT
IS FORMED.
AND SO IN THE ABSENCE OF PLASMID
WHAT WILL HAPPEN IS THAT FIBRIN
WILL PERSIST IN THE WOUND, IN
TISSUES, IN A WAY THAT WILL
CREATE A CHRONIC INFLAMMATORY
TYPE OF CONDITION.
NOW, WE WERE VERY FORTUNATE WE
HAD A FANTASTIC MOUSE MODEL TO
WORK WITH.
THIS IS A MOUSE THAT THOMAS HAD
MADE TWO DECADES AGO,
PLASMINOGEN KNOCKOUT MOUSE, THIS
MOUSE TRULY HAD MANY FEATURES
THAT COPY HUMAN BEINGS,
SPONTANEOUS IMMUNOPATHOLOGY IN
MUCOSAL SITE, CONJUNCTIVITIS,
SPONTANEOUS PERIODONTAL DISEASE.
BECAUSE THIS WAS REALLY A GREAT
MODEL, THIS GAVE US THE
OPPORTUNITY TO ASK THE QUESTION
HOW DOES PLASMINOGEN DEFICIENCY
LEAD TO MUCOSAL PATHOLOGY AND WE
STARTED LOOKING AT THIS THROUGH
THE AREA OF ORAL MUCOSAL
IMMUNOPATHOLOGY, PERIODONTITIS
FIRST.
FIRST TO DESCRIBE TO YOU OR SHOW
DATA THAT LAKMALI HAD ON
PERIODONTITIS HERE SHE SHOWS
MICRO CT SCAN OF A KNOCKOUT
MOUSE VERSUS WILDTYPE LATER MATE
CONTROL, IN THE WILD TYPE AT 24
WEEKS WHERE THIS IS TAKEN, YOU
SEE WHERE THE LEVEL OF BONE IS
AS OPPOSED TO IN THE PLASMINOGEN
KNOCKOUT THE BONE IS
SIGNIFICANTLY REDUCED AND
RECEDED, BETTER TO BE SHOWN WITH
THE MAGNIFICATION AT EARLY
WEEKS, 11 TO 12 WEEKS WE HAVE
SIGNIFICANT BONE LOSS AND THIS
BECOMES A LOT MORE SIGNIFICANT
WITH AGE.
IMPORTANTLY THIS IS A
SPONTANEOUS PHENOTYPE AS I
MENTIONED.
WE DON'T ELICIT PERIODONTAL
DISEASE, THIS SPONTANEOUSLY
OCCURS.
WHEN LAKMALI LOOKED AT MUCOSAL
TISSUES, DEPOSITS ARE CONSISTENT
WITH FIBRIN POSITION,
DISORGANIZATION OF THE TISSUE,
SWELLING, AND INFLAMMATORY
INFILTRATION.
THE QUESTION BECOMES IS THIS
ACCUMULATION OF FIBRIN?
AND SO THE SIMPLE GENETIC WAY TO
ANSWER THIS QUESTION WAS TO
CROSS THE PLASMINOGEN KNOCKOUT
MOUSE, IF WE REMOVE FIBER DO WE
RESCUE DISEASE?
INDEED YOU'LL SEE THIS IN THE
MICROCT SCAN, ALSO QUANTITY FIND
THIS IS COMPLETELY ARRESTED.
THE QUESTION IS HOW DOES FIBRIN
MEDIATE THESE LESIONS OF
IMMUNOPATHOLOGY?
AND SO THE NUMBER OF ASSAYS
CHARACTERIZING INFLAMMATORY
LESIONS OF PERIODONTITIS I WON'T
TIRE YOU WITH THE DETAILS OF
DATA.
THIS IS ALREADY PUBLISHED.
SHE'S DONE FLOW CYTOMETRY OF
IMMUNE CELL POPULATION, RNA,
TRANSCRIPTOMIC ANALYSIS, WITH
ALL OF THESE ASSAYS COLLECTIVELY
SHOWING AND ALSO DEMONSTRATED
HERE IN HISTOLOGY IS FIBRIN
DEPOSITION IN TISSUE, SPECIFIC
ANTIBODY FOR FIBRINOGEN, A
SPECIFIC ANTIBODY FOR
NEUTROPHILS.
NEUTROPHILS ARE ACCUMULATING ON
TOP OF FIBRIN BUT ALSO
SURROUNDING THE FIBRIN DEPOSITS.
AND SO THE NEXT QUESTION BECOMES
CAN THIS FIBRIN -- IS THERE A
FIBRIN-NEUTROPHIL INTERACTION
THAT PLAYS A ROLE IN THIS
PATHOLOGY?
THIS BECOMES RELEVANT BECAUSE OF
PRIOR KNOWLEDGE THAT WE HAD FROM
THE LITERATURE.
FIBRIN HAS A CRYPTIC DOMAIN THAT
BINDS CD11B, A MARKER, A
RECEPTOR SEEN IN ALL MYELOID
CELLS INCLUDING NEUTROPHILS.
THIS DOMAIN THAT'S BEEN
CHARACTERIZED IN FIBRIN IS
PRESENT IN FIBRIN ONLY WHEN
FIBRIN IS LAID DOWN IN CLOTS OR
TISSUE, WHEN IN CIRCULATION THIS
IS NOT SHOWN AS OPPOSED TO
CROSS-LINKED IN A TISSUE IT
BECOMES EXPOSED.
THE FANTASTIC TOOL WE HAD HERE
IS A COLLABORATOR HAD CREATED
KNOCK-IN MOUSE FOR FIBRIN, AT
THIS SPECIFIC SITE.
WHAT HE DID, CREATED A MUTATION
WHERE FIBRIN IS INTACT, CAN FORM
CLOTS, IT'S ACCUMULATED
NORMALLY, BUT THERE IS NO
BINDING SITE FOR CD11B.
WE THOUGHT WHAT WE COULD DO HERE
IS WE COULD CROSS PLASMINOGEN
KNOCKOUT, WON'T BIND MYELOID
CELLS INCLUDING NEUTROPHILS.
IF YOU TAKE JUST THE BINDING OF
NEUTROPHILS AWAY CAN YOU RESCUE
DISEASE?
THIS WAS AN IMPORTANT EXPERIMENT
FOR US.
AND SO WE WERE THRILLED WHEN
LAKMALI HAD THE DATA THAT SHOWS
ABSOLUTE RESCUE.
ABOVE AND BEYOND WHAT WE HAD
EVER HOPED FOR.
PLASMINOGEN HAS SIGNIFICANT BONE
LOSS, WHEN YOU CROSS TO THE
GAMMA, IT BRINGS IT LOWER THAN
WILD TYPE.
FOR THOSE WORKING ON PERIODONTAL
DISEASE IN ANIMAL MODELS WE KNOW
WITH AGE, THIS IS 24 WEEKS, MICE
WILL END UP HAVING LOW LEVEL OF
BONE LOSS.
IT SEEMS THAT ABROGATING THIS
BINDING SITE FOR NEUTROPHILS
RESCUES EVEN IN AGE-DEPENDENT
PERIODONTAL MODEL INDICATING
THIS BINDING SITE COULD HAVE
ROLES INTO COMMON FORMS OF
PERIODONTAL DISEASE.
THE CONTROL HERE IS THAT WITHIN
THIS MOUSE MODEL WHEN WE LOOK IN
THE TISSUE WE SEE FIBRIN IS
PRETTY MUCH AT THE SAME LEVEL
ACCUMULATED AND NEUTROPHIL
ACCUMULATED WITH PLASMINOGEN
KNOCKOUT WHICH MEANS THAT, TO
US, THIS MEANT THAT IT LOOKS
LIKE YOU NEED INTERACTION
THROUGH FIB GAMMA.
IF FIBER AND NEUTROPHILS ARE
THERE BUT YOU DON'T HAVE
BINDING, YOU DON'T HAVE DISEASE.
WE WERE THRILLED WHEN A PAPER
CAME OUT, A NICE COMMENTARY ON
IT.
THE AUTHORS OF THE COMMENTARY
DID MENTION THIS, THAT UP TO NOW
WE'VE BEEN THINKING OF
NEUTROPHIL ACCUMULATION AS A
SURROGATE FOR IMMUNOPATHOLOGY
AND THIS WORK IS OPENING THIS
IDEA THAT NEUTROPHILS ALONE WENT
LEAD TO NEUROPATHOLOGY, YOU NEED
A LOCAL TISSUE TRIGGER TO
STIMULATE THEM INTO MEDIATING A
PROBLEM.
NOW, LAKMALI WANTED TO TRY TO
UNDERSTAND WHAT HAPPENED WHEN
NEUTROPHILS BIND, IT TOOK HER A
HUGE EFFORT TO CREATE THIS IN
VITRO ASSAY AND HAVE IT BE
CONSISTENTLY REPRODUCIBLE.
SO WHAT SHE DID IS THAT SHE
CREATED IN VITRO PLATES, WHERE
SHE WOULD LAY DOWN AND CROSS
FIBRIN FROM A WILDTYPE MOUSE OR
FIB GAMMA MOUSE AND WOULD PLATE
NEUTROPHILS WITH HUMAN AND MOUSE
NEUTROPHILS AND ARE COMPARABLE
RESULTS.
AND SHE LOOKED AT WHAT HAPPENED
IN THIS IN VITRO SETTING.
SHE SAW THE BINDING SITE IS
IMPORTANT FOR ADHESION SO WHEN
YOU DON'T HAVE -- WHEN YOU HAVE
THE MUTATED FIBRIN NEUTROPHILS
WON'T STICK AS MUCH.
ALSO WHEN SHE DID DIFFERENT
LEVELS OF STIMULATION SHE SAW
THE ACTIVATION OF NEUTROPHILS IS
GREATLY ENHANCED BECAUSE OF FIT
GAMMA.
WHEN YOU DON'T HAVE FIB GAMMA
YOU HAVE REDUCED ACTIVATION,
LOSS PRODUCTION.
IN THE INTEREST OF TIME FOR THIS
SESSION I'M NOT SHOWING A LOT OF
DATA AS I SAID THIS IS ALSO
PUBLISHED, BUT I THOUGHT I WOULD
SHARE WITH YOU A FASCINATING, IN
MY OPINION, VIDEO OF SOME ASSAYS
THAT LAKMALI PUT TOGETHER AND
THE LEFT-HAND SIDE YOU HAVE THE
WILDTYPE FIBRIN, ON THE
RIGHT-HAND SIDE THE KNOCK-IN
FIBRIN.
AND SHE GOT TOGETHER WITH A VERY
TALENTED STAFF SCIENTIST FROM
OUR CORE FACILITY, ANDREW DOYLE,
TO FIGURE OUT THESE ASSIST AND
TO IMAGE AND QUANTIFY.
THEY ARE STAINING CELLS,
NEUTROPHILS THROUGH THE NUCLEAR
STAIN.
CELLS BECOME GREEN WHEN THEIR
MEMBRANE ARE STARTING TO DIE,
RED WHEN NETOSING, AN EXPLOSION
OF THE CELLS.
THE CELLS START TO EXPLODE AND
THIS EXPLOSION MOLD IS MORE
COMMON ON THE LEFT-HAND SIDE
VERSUS RIGHT-HAND SIDE, WE'VE
QUANTIFIED OVER TIME AND HAVE
DATA FOR THAT BUT IT'S OBVIOUSLY
VISIBLE EVEN I THINK BY THE
NAKED EYE HERE.
THE LAST QUESTION LAKMALI WANTED
TO ASK, YES, WE HAVE INCREASED
ACTIVATION AND NETOSIS, IS THIS
ACTIVATION AND NETOSIS WHAT WILL
DRIVE PERIODONTAL
IMMUNOPATHOLOGY?
DIFFERENT TYPES OF MODELS, TO
INHIBIT NETOSIS AN WHEN SHE
INHIBITS IN THE KNOCKOUT MOUSE
WILL REDUCE IMMUNOPATHOLOGY,
DOESN'T RESCUE THE T IT WAY
WHEN SHE ABROGATES FIB GAMMA
BINDING, AN IMPORTANT PATHWAY
BUT NOT THE WHOLE STORY HOW FIB
GAMMA SEEMS TO MEDIATE
IMMUNOPATHOLOGY SO THERE'S MORE
FOR US TO UNDERSTAND IN THAT
ARENA FOR SURE.
THE WAY -- WE ARE VERY EXCITED
ABOUT THIS WHEN IT COMES TO
PLASMINOGEN DEFICIENCY
ASSOCIATED PERIODONTITIS BUT WE
WERE ALSO EXCITED AS WE'RE
THINKING AS A BROADER CONCEPT IN
BIOLOGY, THE WAY WE'VE BEEN
THINKING ABOUT THIS IS THAT
FIBRIN NEEDS TO COME OUT OF THE
VASCULATURE DURING A WOUND.
AND TO FORM A CLOT.
AND IT HAS A BINDING SITE FOR
NEUTROPHILS BECAUSE WITHIN A
CLOT THEY NEED TO BE RETAINED
AND ACTIVATED IN ORDER TO
MEDIATE ANTIMICROBIAL DEFENSE.
SO WE THINK OF THIS FIB GAMMA
NEUTROPHIL BINDING AS
POTENTIALLY A VERY IMPORTANT
PATHWAY FOR WOUND CLEARANCE AND
WOUND HEALING.
AND EVENTUALLY, AS THE WOUND IS
CLEARED, THEN FIBRIN CAN BE
REMOVED BY PLASMINOGEN AND
COMPLETE WOUND HEALING CAN
OCCUR.
HOWEVER, IF YOU DON'T HAVE
PLASMINOGEN, WHEN THIS
ACCUMULATION OF FIBRIN PERSISTS,
NEUTROPHIL ACTIVATIONS PERSISTS,
AND THEN YOU DON'T -- YOU HAVE
CHRONIC INFLAMMATION AND YOU
DON'T HAVE WOUND HEALING.
IN MANY WAYS WE THINK OF THE
PERIODONTAL TISSUES OF
CONTINUOUSLY STIMULATED
ENVIRONMENT THAT NEED WOUND
HEALING AND BECOMES IMPAIRED
WHEN YOU DON'T HAVE
FIBRINOLYSIS.
WE SUSPECT THIS COULD BE
IMPORTANT IN WOUND HEALING,
WANTED TO THINK ABOUT THE
CONTEXT OF COMMON FORMS OF
PERIODONTITIS.
AND SO THE REASON THIS MADE
SENSE FOR US TO THINK OF IN THE
CONTEXT OF COMMON FORMS OF
PERIODONTITIS WE ALREADY KNEW BY
WORK OF MANY BEFORE US IN THE
FIELD THAT ESPECIALLY IN THE
YOUNGER ADULT KIND OF SETTINGS
OF PERIODONTITIS, NEUTROPHILS
ARE A DOMINANT CELL TYPE.
THIS IDEA NEUTROPHILS PLAY AN
IMPORTANT ROLE IN PERIODONTITIS
WE WERE NOT THE FIRST TO
INTRODUCE BUT DISTHIS DIS-- BUT
THIS IS DATA FROM OUR LAB BY
FLOW CYTOMETRY AND HISTOLOGY.
WE ALSO SEE THAT NEUTROPHILS ARE
IN AREAS CONSISTENT WITH FIBRIN.
THOSE OF US THAT WORK WITH THESE
PATIENTS CLINICALLY KNOW
BLEEDING, VASCULAR LEAKAGE, EVEN
SEVERE BLEEDING IS A HALLMARK OF
PERIODONTITIS.
AS WE WERE PUTTING OUR DATA
TOGETHER, A GROUP FROM GERMANY
PUBLISHED A LARGE GWAS STUDY OFY
ON WHAT WAS THEN CALLED
AGGRESSIVE PERIODONTITIS.
THEY SHOWED THE GENE VARIANT
THAT HAD A VARIATION MORE
SIGNIFICANTLY ASSOCIATED WITH
AGGRESSIVE FORMS OF
PERIODONTITIS WAS INDEED
PLASMINOGEN.
THIS WAS EXCITING TO US.
WE GOT TOGETHER WITH A COLLEAGUE
IN FRANCE, WHO WORKS ON GENOMIC
DATASETS, AND IN ORAL DISEASES,
AND HE HAD BEEN WORKING ON GWAS
STUDY OF PERIODONTITIS IN THE
U.S. AND WE THOUGHT WE ALREADY
HAVE SEEN THIS FASCINATING DATA
FROM THE GERMAN GROUP, CAN WE
LOOK AT THE DATA FROM THE U.S.
POPULATION AND SEE IF WE FIND
SOMETHING SIMILAR.
FROM THE U.S. POPULATION THE
SEVERE PERIODONTITIS SUBGROUP
WAS NOT A LARGE -- DIDN'T HAVE A
LARGE NUMBER SO WE WEREN'T TO DO
GWAS LEVEL ANALYSIS, WE HAD TO
DO A TARGETED GENE LOOKUP.
WHEN KIMON DID THIS EVALUATION
WHAT HE FOUND THERE IS
SIGNIFICANT ASSOCIATION BETWEEN
SNPs IN THE PLASMINOGEN REGION
WITH SEVERE FORMS OF PERIODONTAL
DISEASE AND ASSOCIATED WITH
YOUNGER ADULTS CONSISTENT WITH
DATA FROM THE GERMAN GROUP.
THIS IS JUST AN ASSOCIATION, IT
DOESN'T PROVE CAUSALITY AT THIS
POINT BUT OPENS THE DOOR THAT
PLASMINOGEN VARIATION COULD BE
PLAYING A ROLE THROUGH FIBRIN IN
SOME FORMS OF COMMON
PERIODONTITIS.
THE WAY WE'VE BEEN WANTING TO
LOOK IN THIS, IN THE FUTURE, IS
THAT WHEN WE START WITH
MENDELIAN DISEASE WE FIND
PATHWAYS THAT INDEED SEEM TO BE
IMPORTANT IN PERIODONTAL
STABILITY AND IMMUNOPATHOLOGY.
WHILE WE HAVE WAYS TO TRY TO
UNDERSTAND MECHANISMS FOR THOSE
DISEASES WE WANT TO TAKE IT A
STEP FURTHER AND POTENTIALLY
LOOK INTO THE COMMON DISEASES
AND SEE IF THIS COULD DESCRIBE
AT LEAST A SUBPOPULATION OF
PATIENTS WITH PERIODONTITIS, A
LOT OF INFLAMMATORY DISEASE,
ARTHRITIS, IMMUNE DISEASES, DO
END UP HAVING SOME
SPECIFICATION, THEY HAVE
CLINICAL PHENOTYPES THAT ARE
SHARED BUT THE GENETIC
SUSCEPTIBILITY AND PATHWAYS MAY
NOT BE SHARED BY ALL AND
TARGETED TREATMENTS MAY NOT WORK
IN THE SAME UNTIL WE UNDERSTAND
THE PATHOPHYSIOLOGY INVOLVED IN
THE SUBGROUPS.
AND SO I WILL LEAVE YOU WITH
THIS IDEA THAT WHAT I'M HOPING
THIS WORK FROM LAKMALI HAS
ATTEMPTED TO DO, WE HOPE CAN
MOVE FORWARD IS THAT WE WANT TO
TAKE A UNIQUE LENS AT THE NIH
WITH GENETIC IMMUNODEFICIENCY TO
UNDERSTAND HUMAN BIOLOGY AS
RELATES TO ORAL IMMUNITY AND
PERIODONTAL IMMUNOPATHOLOGY, TRY
TO FOCUS ON GENETIC DISEASE AND
TRY TO HELP PATIENTS THAT HAVE
DISEASES THAT ARE HARD TO MANAGE
ELSEWHERE, BUT ALSO OPEN THE
WINDOW INTO UNDERSTANDING
POTENTIALLY COMMON FORMS OF
PERIODONTITIS.
IT'S BEEN MY GROUP IN THE LAST
DECADE, A GROUP OF VERY TALENTED
DEVOTED FANTASTIC PEOPLE, I
TALKED ABOUT LAKMALI'S WORK THE
MOST TODAY BUT I'M SORRY I
COULDN'T MENTION EVERYBODY'S
WORK.
AND IT'S A DIVERSE GROUP OF
INDIVIDUALS FROM ALL PARTS OF
THE WORLD WITH CLINICAL AND
BASIC BACKGROUNDS AND I REALLY
HAVE BEEN PRIVILEGED TO BE
MENTORING AND WORKING WITH THEM
OVER THE YEARS.
BUT OF COURSE THIS WORK DOESN'T
HAPPEN FROM ONE LAB.
IT COMES TOGETHER WITH
COLLABORATIONS FROM THE NIH
HOSPITAL, INTRAMURAL PROGRAM, A
LOT OF EXTRAMURAL COLLABORATORS,
OF COURSE GENEROUS SUPPORT FROM
LEADERSHIP.
THANK YOU VERY MUCH FOR YOUR
ATTENTION.
>> THANK YOU VERY MUCH, NIKI.
OH, RENA.
>> WE'RE BACK.
ANY QUESTIONS FROM COUNCIL OR
PARTICIPANTS?
WHAT A WONDERFUL PRESENTATION.
WHAT A WONDERFUL JOURNEY YOU
WERE ON, NIKI.
SO HAPPY AND PROUD OF WHERE
YOU'VE COME IN UNRAVELING
UNDERLYING MOLECULAR QUESTION.
WOULD YOU NOT SUSPECT A
MULTI-GENIC CONTRIBUTION TO THIS
COMPLEX DISEASE?
>> YES, SO, YES, THAT MAKES IT A
LOT MORE COMPLICATED.
HOWEVER, IF WE DO END UP HAVING
SUBCATEGORIES OF PATIENTS WHERE
WE CAN ZERO IN, ON A GENE
VARIATION THAT COULD BE
PRIMARILY IMPORTANT, THAT COULD
ALSO UNTIE YOUR HANDS A LITTLE
BIT.
>> YES.
>> THE OTHER PART IS AS WE THINK
OF COMBINED KIND OF PATHWAYS
THAT WILL FEED INTO A PROBLEM,
IF WE CAN GET NODES THAT ARE THE
MOST IMPORTANT TO TARGET.
I DEFINITELY DON'T HAVE MOST OF
THE ANSWERS.
>> THANK YOU.
JACQUES?
>> TERRIFIC PRESENTATION, GREAT
WORK.
A QUESTION IN TERMS OF ANY
THOUGHTS YOU MIGHT HAVE IN TERMS
OF TARGETING LOCALLY THE
PLASMINOGEN PATHWAY IN PATIENTS
WITH PERIODONTAL DISEASE.
>> YES, I'LL TELL YOU TWO OR
THREE THINGS.
WHEN I I GAVE A SIMILAR TALK
WITH SOME OTHER PARTS, NIH
AUDIENCE, SO ONE LOCAL
PLASMINOGEN WOULD BE MORE FIBRIN
ACCUMULATION RATHER THAN
PLASMINOGEN THINKING OF
DEFICIENCY, WANT SOMETHING THAT
LEADS TO FIBRINOLYSIS.
WE'RE INTERESTED IN FIBRIN SHOWN
TO PLAY A ROLE IN BRAIN KIND OF
MICROGLIAL ACTIVATION, IN THE
SETTING OF BRAIN INJURY, WHEN
THE BRAIN BARRIER IS BREACHED IT
ACCUMULATES AND SEEMS TO BE
AFFECTING OF IMMUNITY IN THE
BRAIN SO THE PERSON THAT'S BEEN
WORKING ON THAT HAS COME UP WITH
THE FIB GAMMA BINDING ANTIBODY.
AND THEY ARE TRYING TO MOVE THAT
THROUGH, IT HASN'T GONE INTO
PRE-CLINICAL PHASE, WE WANT TO
TRY THAT IN PERIODONTAL MODELS.
NOW, LOCAL VERSUS SYSTEMIC
THERE'S GOING TO BE INTERESTING,
ONE THING, YEAH, SO WE'RE
THINKING ALONG THOSE LINES BUT
IDEALLY WE WOULD WANT TO
SUBSTRATIFY PATIENTS THAT HAVE
PLASMINOGEN VARIATIONS AND SEE
WHETHER VARIATIONS EVEN HAVE A
FUNCTIONAL OUTCOME SO AT THIS
POINT FOR THE GENERAL POPULATION
WE DON'T EVEN KNOW IF SNPs
HAVE AN OUTCOME IN REDUCE THE
PLASMINOGEN AND THAT'S WHAT WE
WANT TO COME TOGETHER WITH MANY
IN THE EXTRAMURAL COMMUNITY TO
THINK ABOUT AND THEN MOVE INTO
THINKING OF TARGETING.
>> THANK YOU, NIKI.
MATT HAS A QUESTION.
>> I WAS INTERESTED IN THE
MICROBIOME COMPONENT.
IS THERE ANY INTERACTION WITH
SPECIFIC PERIODONTAL PATHOGENS
WITH EITHER OF THE NEUTROPHIL OR
FIBRIN?
>> SO, WHAT I WILL TELL YOU IN
GERM-FREE MICE WE DON'T HAVE
FIBRIN ACCUMULATION SO WE
KNOW -- THE FACT THAT ALL OF THE
DOMINANT PHENOTYPE OF MUCOSAL
SUGGESTS THAT SOMETHING THAT IS
IN THE MUSE CO-A MICROBIOME,
PLASMINOGEN MICE GERM FREE AND
SAW THAT THEY HAVE REDUCED
FIBRIN ACCUMULATION WHETHER THAT
LEADS TO LEAKAGE I CAN'T TELL
YOU.
THERE IS DATA TO SUPPORT FIBRIN
MESHES BECOME STICKY FOR
PARTICULAR MICROBES, IF THEY ARE
AROUND TOO LONG WHETHER THAT
PERPETUATES -- THERE'S A LOT TO
BE ANSWERED.
AND SO SOME OF THESE QUESTIONS
LAKMALI HAS GOTTEN A K99 FROM
AND WE'RE VERY PROUD SO SOME
QUESTIONS SHE WILL BE TAKING
WITH HER, A BUNCH OF QUESTIONS
FOR HER TO BE LOOKING AT.
>> WONDERFUL.
I THINK --
>> I HAVE A QUESTION.
>> KATHY, YES.
>> I WAS WONDERING IN TERMS OF
THINKING ABOUT MECHANISMS
WONDERFUL TALK, BY THE WAY.
DO THESE PATIENTS HAVE PAIN?
DO YOU EVER ASSESS PAIN?
AND DOES THAT CORRELATE WITH ANY
KIND OF -- THE LEVEL OF THE
CONDITION.
>> PERIODONTITIS IS NOT
ASSOCIATED WITH PAIN.
PATIENTS COME TO A DENTIST
VOLUNTARILY BECAUSE OF PAIN SO
MANY TIMES PATIENTS WITH
PERIODONTITIS GO UNCHECKED
BECAUSE UNTIL BLEEDING IS A
SYMPTOM, SWELLING, PEOPLE TEND
TO IGNORE THAT, PAIN IS NOT A
DOMINANT PHENOTYPE OR CLINICAL
SIGN FOR PERIODONTITIS UNLESS
YOU GET AN ABSCESS.
WE SEE PATIENTS LATE SOMETIMES
BECAUSE OF THAT.
I DON'T KNOW IF THAT ANSWERS
YOUR QUESTION.
>> I ASKED BECAUSE THE
PLASMINOGEN PATHWAY IN GENERAL
IS IMPORTANT IN SENSORY NEURONS
AS WELL AND SO THERE MIGHT BE A
WAY TO STRATIFY.
>> WITH A PATIENT WITH
PLASMINOGEN I CANNOT ANSWER THAT
QUESTION.
I WAS ANSWERING IN GENERAL FOR
PERIODONTITIS BUT I HAVEN'T SEEN
THAT REPORTED.
WE'VE ONLY SEEN ONE OF THESE
PATIENTS AT NIH.
>> THANK YOU.
>> PERIPHERAL CENTRAL
CONNECTIONS.
WELL, THANK YOU, NIKI, FOR THE
TIME AND SHARING YOUR KNOWLEDGE
AND PROGRESS WITH US.
THANK YOU.
>> THANK YOU FOR HAVING ME.
>> LOVELY DOING THAT.
FOLKS, DOES ANYONE NEED A
BIO-BREAK, A QUICK ONE, COFFEE,
ANYTHING LIKE THAT?
WE WERE NOT A SUBJECT OF CYBER
ATTACK.
INTERNET CAPABILITY SIMPLY WAS
NOT EXISTENT IN THE ENTIRE
BUILDING 31.
NOW IT'S RESTORED.
WE SHOULD BE BACK ON SCHEDULE.
SHOULD I LAUNCH STRAIGHT INTO MY
--
>> WE CAN DO A 5-MINUTE BREAK.
>> HOW DID LARRY -- WE WERE
KICKED OUT, HE WAS IN THE MIDST
OF Q&A.
DID HE TALK ABOUT ANYTHING ELSE?
WAS IT -- I LEFT OFF WHEN THE OF
HE WAS TALKING ABOUT THE NEW
DIRECTOR.
WAS IT ARPA-H?
>> ARPA RELATED, ARPA I AND ARPA
E.
>> GREAT.
WE SHOULD BE BACK IN FIVE
MINUTES.
>> FIVE MINUTES AND WE'LL THEN
HAVE YOUR DIRECTOR'S REPORT.
>> PLEASE DO COME BACK.
THANKS.
>> FROM NIKI'S TALK WE'VE
LEARNED TO UNDERSTAND MOLECULAR
PATHOGENESIS OF THE DISEASE THAT
IS REALLY A PUBLIC HEALTH
CONCERN, HUGE BURDEN ON SOCIETY,
UNDERSTANDING SYSTEMS APPROACH
IS VALUABLE.
THAT IS A THEME THAT'S GOING TO
RESONATE THROUGH THIS TALK, I
THINK LARRY EMPHASIZED TO THE
DEVELOPMENT OF ARPA-H AND ALL
THE OTHER ALPHABET MODELS THAT
THE AGE OF INTEGRATION OF
CONNECTING THE DOTS IS UPON US.
AND WE NO LONGER CAN STAY
ISOLATED IN ECOSYSTEMS THAT
DON'T CONNECT.
I'VE BEEN IMMERSED IN THAT KIND
OF THINKING SINCE LAST COUNCIL,
SO THIS IS GOING TO REFLECT
THAT.
WE'VE APPROACHING OUR 75th
YEAR, WE HAVE A PLANNING
COMMITTEE OF HISTORIANS AND
EMPLOYEES, THERE'S A PLAN ISSUED
OUT IN SEPTEMBER SO EVERYONE IS
INVOLVED.
WE PLAN TO CELEBRATE IN WHAT I
CONSIDER SCIENTIFIC FOCUS AND
FOCUS ON THE TRAINEES OF THE
FUTURE.
CELEBRATING WITH NIAID AND NHLBI
AND PLAN TO HAVE A JOINT
SYMPOSIUM ON THE SCIENCE THAT
CONNECTS US.
HOWEVER, I THINK WHEN YOU ARE AT
THIS POINT AND THINKING ABOUT
THE CELEBRATION OF THE LEGACY
AND HISTORY, YOU HAVE TO BE
THINKING OF THE NEXT 25 YEARS.
AND YOU HAVE TO BE THINKING
WHERE SHOULD WE BE 25 YEARS FROM
NOW AS OUR VISION IS EXACTLY THE
SAME AS THE REASON HEAR TRUMAN
SIGNED US INTO EXISTENCE 74
YEARS AGO -- HARRY TRUMAN.
BE PART OF THIS PROCESS.
BE THE VISIONARY YOU ARE AND
SEND US IDEAS AND STAY ENGAGED.
WE DID CROSS THE 500 MILLION
MARK, IT'S A GOOD SIGN FOR WHAT
COMES NEXT.
WE'RE GRATEFUL FOR THE EXTRA $16
MILLION PLUS THAT WE'LL STEWARD.
THERE'S SO MUCH WORK BEHIND THE
SCENES, TO MAKE SURE WE KEEP THE
BALANCE BETWEEN NEW GRANTS AND
RENEWALS, WE LOOK AT THOSE WHO
HAVE ENDURED HARDSHIP IN COVID,
CREATING BALANCE BETWEEN
TRAINING AND CAREER DEVELOPMENT
SO WE'RE BEING RESPONSIBLE
STEWARDS OF THE PIPELINE FOR THE
FUTURE.
WE SHOULD EXPECT THAT PIECE OF
THE PIE TO INCREASE BUT IT IS
GOING TO BE AT THE EXPENSE OF
THE RPGs.
WE ARE KEEN ON CREATING THE
BALANCE OF EARLY-STAGE
INVESTIGATORS, IT'S A COMMITMENT
NIH-WIDE, TARGET OF 1100 EARLY
STAGE INVESTIGATORS FUNDED EVERY
YEAR.
WE MAKE SURE OR PORTFOLIO IS
BALANCED IN TERMS OF RESEARCH
INTEREST, WHO ARE GRANTEES,
RACE, ETHNIC, GENDER,
PROJECT-WISE, DISABILITY-WISE,
EVERYTHING IS BROUGHT INTO PLAY
AS WE LOOK AT OUR GRANTEE TALK.
I WANT YOU TO NOTE THAT.
THIS IS THE BALANCE AS IT EXISTS
TODAY AS WE KEEP A HEALTHY
PAYLINE, WORKING HARD TO
MAINTAIN THAT THROUGH FISCAL
YEAR 2023.
I WANT TO SHARE A TALK I'M
GIVING TOMORROW, IT'S A UNIQUE
OPPORTUNITY TO BE GRANTED 30
MINUTES WHERE I TALK TO FELLOW
AND STUDENT CENTER DIRECTORS.
I ASKED LARRY FOR THIS TIME.
THE FOCUS WAS TO HIGHLIGHT CALLS
TO ACTION BASED ON WHAT THE
REPORT INDICATED.
THERE'S ALSO I THINK A PLATFORM
BY WHICH I CAN ANNOUNCE WHO WE
ARE, IMPORTANT FOR US TO BE AT
THE TABLE FOR THE LARGE
INITIATIVE AND BE CONTRIBUTING
TO HEALTH PROGRESS OF HEALTH IN
GENERAL.
SO I THOUGHT I WOULD SIMPLY
SHARE WITH YOU, IT'S A DRY RUN
IN A WAY WHAT I WILL BE
PRESENTING TOMORROW.
WE IN THE PROFESSION NO MATTER
WHAT WE DO AMAZING PARADIGMS FOR
ORGANOGENESIS, SKULL, FACE,
TEETH, ET CETERA, PALATE,
MEASURES OF HOW GENES COORDINATE
ACTIVITY TO CREATE THIS
BEAUTIFUL FORM THAT IDENTIFIES
EACH ONE OF US AS UNIQUE HUMAN
BEINGS.
WE HAVE TONGUE, TASTE BUDS, YOU
KNOW THE SYSTEMS, TO ME OFFER
PARADIGMS FOR THE REST OF
BIOLOGY, MAMMALIAN.
BEYOND THAT COMES IMPORTANCE OF
THE ORAL CAVITY AS AF PORT O
ENTRY TO COMMON RISK FACTORS
THAT PREDISPOSE TO THREATEN
SYSTEMIC DISEASES,
CARDIOVASCULAR, METABOLIC
SYNDROME, DIABETES.
IT'S THROUGH THE ORAL CAVITY
THAT NUTRITION PASSES THROUGH,
E-CIGARETTES AND TOBACCO AND
ALCOHOL HAVE RUN THEIR TOLL ON
MUCOSA AND TISSUES AND OF COURSE
DRUGS AND ADDICTION.
WE CAN VIEW ORAL CAVITY
MANIFESTING SYSTEMIC DISEASE, WE
CAN MONITOR COMPLIANCE AND
HEALING AND TREATMENT PROTOCOLS,
ABSOLUTELY SO.
AND THAT DETERMINANTS OF HEALTH,
THERE'S NO OTHER SYSTEM WHERE WE
CAN SEE THEM AND OF AFFECT THE
STATUS OF ORAL HEALTH.
I'LL SHOW YOU OF THAT TO YOU.
WE HAVE TO BE PROUD TO BE AT THE
ABLE.
ORAL HEALTH WAS EMPHASIZED,
CONNECTIONS WERE BROUGHT TO THE
ATTENTION OF OUR NATION OVER 20
YEARS AGO BY SURGEON GENERAL
SATCHER.
FOCUSING ON NEED TO REPLICATE
AND BUILD SCIENCE BASE, INCREASE
DIVERSITY AS WE INCREASE
PARTNERSHIPS WITH OTHER
ORGANIZATIONS AND SCIENTIFIC
ENTITIES.
AND SO THE QUESTION I ASKED EACH
OF YOU TO REFLECT, BECAUSE SOME
OF HAVE BEEN AROUND FOR THESE 20
YEARS, WHAT PROGRESS WE'VE MADE
IN EACH OF THESE FRONTS.
WHILE THIS IS DEVELOPING OVER
THE LAST 20 YEARS, THE TRENDS
AND ATTENTION TO ORAL HEALTH AND
ITS CONNECTION WORLD HEALTH
ORGANIZATION DID PUT IT ON THE
MAP.
THERE'S A RESOLUTION PASSED ORAL
HEALTH IS ESSENTIAL FOR OVERALL
HEALTH, THAT ORAL HEALTH CARE
SHOULD BE PART OF UNIVERSAL
HEALTH COVERAGE.
AND THAT IS TAKING ON ITS OWN
MOMENTUM, SELLING INFORMATION
AND LEADING EFFORTS ACROSS THE
GLOBE.
THANK YOU.
"THE LANCET" HAS PRIORITIZED
ORAL HEALTH, SO NICE WHEN
SOMEONE OUTSIDE OUR FIELD TAKES
THIS ON, CAME UP WITH A 2019
SERIES THAT AGAIN STRESSED THE
FOLLOWING.
NOW THEY HAVE AUTHORIZED A
COMMISSION RELEASED I THINK
PASSED 2020 MOST LIKELY NEXT
YEAR, AUTHORIZED IN 2020,
TARGETED FOR RELEASE IN 2022-23.
IT HIGHLIGHTS AGAIN THE
IMPORTANCE, SO WHAT HAPPENS FOR
US IN THE U.S. WAS THIS GIFT THE
CURRENT SURGEON GENERAL COULD
NOT TAKE ON AT THE TIME HE
ASSUMED THE OFFICE FOR MANY,
MANY NATIONAL CRISES CRITICAL
REASONS.
SO NIH SHEPHERDED THIS THROUGH
AND THIS REPORT ITSELF STANDS AS
A CONTRIBUTION TO "THE LANCET"
COMMISSION.
AND AGAIN I SAY THANK YOU TO
THOSE WHO LED THIS REPORT, WHO
WROTE SECTIONS, A WIDE GROUP OF
CONTRIBUTORS, TO OUR OFFICE OF
COMMUNICATION AND HEALTH
EDUCATION, THAT WAS LED BY J.D.
JESS VENTURA, GRATEFUL FOR
LEADERSHIP AND MANAGEMENT.
THE BURDEN UPON ON US, WHAT DO
WE DO WITH THAT DATA?
PERSPECTIVE ARTICLES IN "LANCET"
AND NEW ENGLAND JOURNAL OF
MEDICINE.
THE REPORT IS 700 PAGES LONG, AN
EXECUTIVE SUMMARY IS 25 PAGES
LONG.
WE DECIDED TO TARGET PIECES OF A
CROSS-CUTTING THEME ACROSS THE
REPORT BASED ON LIFESPAN ALONE,
TO DIFFERENT SEGMENTS OF OUR
ORAL HEALTH PROFESSION,
CLINICIANS, JADA HIGHLIGHTS
THEIR ROLE.
NEED TO REVISE CURRICULUM, CALL
FOR ACTION EXISTS, WE KNEW WHAT
WE DIDN'T HAVE DURING THE
PANDEMIC AND WHAT NEEDS TO
CHANGE, OF COURSE LED BY LORI,
THE JDR ARTICLE TALKS ABOUT THE
SCIENCE AND TECHNOLOGY AT OUR
FINGERTIPS THAT WASN'T ABLE 20
YEARS AGO TO MOVE THE NEEDLE
FORWARD.
THESE PUBLICATIONS ON THE RIGHT
WILL BE RELEASED 25th OF MAY,
NEXT WEEK.
YOU CAN SEE THE DISSEMINATION
HAS BEEN WIDE.
WE'VE HAD GOOD COVERAGE, MANY
ORGANIZATIONS STEPPING UP TO
TAKE OWNERSHIP OF THE REPORT
BECAUSE THAT'S WHAT NIDCR WANTS
SO WE CAN HE CAN TO US ON THE
SCIENCE NEEDED TO MOVE FUNDS
FORWARD.
THIS TO ME WAS WHAT I THINK WAS
THE KEY MESSAGE FROM THE REPORT
THAT PEOPLE IN THE U.S.
POPULATION, SELECT POPULATION,
DISADVANTAGED.
THEY ARE.
EXPERIENCE ORAL HEALTH
DIFFERENTLY.
AND WE HAVE TO ASK THE QUESTION
AS TO WHY IN 20 YEARS THAT
HASN'T CHANGED.
WE NEED TO CONVERT WHAT WE DO
INTO WHAT WE -- WHAT WE KNOW
INTO WHAT WE ACTUALLY DO.
IF YOU LOOK IT THE LEFT COLUMN
THESE ARE THINGS UNDOUBTEDLY
HAVE TRANSFORMED THE PAST TWO
DECADES, DEMOGRAPHICS HAVE
CHANGED, WE MOVED INTO A VERY
POWERFUL DIGITAL ERA AND HENCE
DATA SCIENCE OPPORTUNITY EXISTS.
DELIVERY OF SERVICES,
DELIVERABLES, DIAGNOSTICS HAVE
ALL RADICALLY CHANGED.
DISEASE TRENDS EVOLVING, WE HAVE
HIV, OROPHARYNGEAL CANCERS, BUT
WE HAVE BARRIERS, THE PANDEMIC
BROUGHT THEM TO LIGHT, THAT
PREVENTS US FROM DELIVERING
SOMETHING THAT WOULD BENEFIT
ALL.
THOSE ARE THE ACTUAL STATISTICS.
MANY RANKING AS THE MOST COMMON
IN MANKIND.
THERE ARE OTHER BURDENS THAT
SOCIETY THAT AFFECT OUR SOCIETY
AND PUBLIC HEALTH.
THIS IS SEARCH NOT NEW STUFF.
IT'S THINGS THAT WE'VE SOMEHOW
HAVE TO INTEGRATE INTO THE
RESEARCH WE PERFORM AND TO
PROGRAMS WE HAVE RESPONSIBLY
FOR.
IT DOES INVOLVE POLICY REFORM,
EDUCATIONAL SYSTEMS, NIDCR CAN
DO THAT, WE CAN SUPPORT OR
CREATE EVIDENCE THAT CAN GUIDE
SUCH REFORM.
I WANT TO GIVE AN EXAMPLE OF A
DISEASE, THE REASON WE WERE
CREATED, YOUNG MEN COULD THE NO
BE RECRUITED TO WAR BECAUSE THEY
HAD MOUTHS DEVASTATED BY CARIES,
BEFORE FLUORIDE WAS INTRODUCED.
YOU CAN SEE WHEN A CHILD SETS
UP, THIS HAPPENING, NURSING
BOTTLE CARIES, IMPAIRMENT OF
FUNCTION, CHILDREN HAVE TO BE
TREATED UNDER ANESTHESIA AND
JUST THEN FACE A LIFETIME OF
DISEASE, IF NOT CORRECTED AND
MITIGATED.
WE ALSO HAVE VERY DISTURBING
TRENDS IN THE TRIBAL NATIONS
WHERE WE HAVE A VERY HIGH
PERCENTAGE OF DECAY, THREE TO
FIVE YEAR OLDS RAVAGED WITH
PAIN, IN THIS SCHOOL ADULTS
RUNNING TO THE E.R. SEEKING HELP
FROM THE E.R. MOST OFTEN
PALLIATIVE, OFTENTIMES
PRESCRIBED MEDICATION THAT THEY
SOMETIMES GET ADDICTED TO.
IT'S A VICIOUS CYCLE.
AND THIS EXAMPLE OF TRIBAL
NATIONS IS REFLECTED IN ALL OUR
DISADVANTAGED AND MINORITY
POPULATIONS.
THERE'S NEED TO PAY ATTENTION TO
INTERSECTION AREAS WITH
DIFFERENT LENSES, FROM WHAT WE
USED BEFORE.
THAT IN FACT DURING THE PANDEMIC
AS MY COLLEAGUE WHO DIRECTS THE
NATIONAL INSTITUTE OF DRUG ABUSE
WILL SAY ON MANY PLATFORMS THE
NUMBER OF SUBSTANCE USE
DISORDERS HAS RISEN ALMOST
FOUR-FOLD DURING THE PANDEMIC.
WE HAVE DRUGS LIKE OPIOIDS NOW
CONTAMINATED WITH FENTANYL, AND
METH, AND THAT IN FACT
OPIOID-RELATED SUICIDE ARE ON
THE INCREASE ESPECIALLY IN
TEENAGERS.
WE HAVE THE NEED TO CORRECT
MENTAL HEALTH AND ORAL HEALTH
WITH SUBSTANCE USE DISORDERS AND
THOSE INTERSECTION AREAS THAT WE
AS RESEARCHERS AND ORAL HEALTH
PROFESSIONALS CAN CONNECT DOTS
ACROSS THESE ECOSYSTEMS, IT'S
CRITICAL FOR OUR SOCIETY.
THIS IS ALSO NOT A NEW CONCEPT
FOR US TO BE THINKING IN THE WAY
WE APPROACH DISEASE, THAT WE'RE
NOT LOOKING AT ONE RESTORATION,
BUT WE LOOK AT THE SITUATION
THAT SURROUNDS THE PARTICULAR
PATIENT, THAT FAMILY INFLUENCES
WHAT IS IN THE REFRIGERATOR AT
HOME, WHAT KIDS ARE EATING IN
SCHOOL, COMMUNITY LEVEL
INFLUENCES PLAY INTO HOLISTIC
APPROACH ON HEALTH.
AND I LOVE THIS SLIDE BECAUSE IT
TELLS US THAT NIDCR CAN'T BE
JUST IN THAT RESEARCH SPECTRUM.
DOMINO EFFECT HERE, I COULD HAVE
FILLED UP EACH BOWL BALL.
WE HAVE TO PAY ATTENTION TO
WHAT'S HAPPENING IN THE PRIVATE
SECTOR AND EDUCATIONAL WORLD.
I ASKED LARRY THAT QUESTION,
EACH OF US ARE MUTUALLY
DEPENDENT.
ONE SIDE SUCCEEDS, BENEFITS THE
RESEARCH WORLD, RIGHT?
MUTUALLY REINFORCING TO PREPARE
AN ENTIRE SYSTEM.
THAT IS THE PRINCIPLE THAT WE
ARE OF OUR STAFF, P.I.s AT
NIH, JANICE LEE AND HER ENDEAVOR
WITH OFFICE OF CLINICAL RESEARCH
OFFICE AND BUILDING 10 IS
FOCUSED ON.
THAT DIVERSITY, EQUITY, AND
INCLUSION AND ACCESSIBILITY
REMAIN INTERTWINING THEMES.
THERE IS A BIAS ORAL HEALTH IS
NOT AS CRITICAL, WE ONLY THINK
OF TEETH AND WHITENING, PART OF
OUR PROFESSION THEMSELVES DO NOT
PRIORITIZE THE IMPORTANCE OF
RESEARCH AND KNOWLEDGE BASES.
WE HAVE PEER REVIEW SYSTEMS NOT
NECESSARILY AWARE OF OR
FAVORABLE FOR ADVANCEMENT OF
ORAL HEALTH SCIENCES.
IT'S A DIFFICULT ONE TO ADDRESS
BUT WHAT WE NEED TO MAKE SURE
HAPPENS IS CONSTANTLY FEED A
ROBUST PIPELINE OF REVIEWERS TO
LOOK AT GRANTS FROM THE ORAL
HEALTH SCIENCES.
THERE ARE ANECDOTAL REFERENCES,
AND SOMETIMES WITH BIRTH OF BEST
PRACTICES, AND THE REST YOU KNOW
ABOUT.
SO ONE OF THE SOLUTIONS TO HAVE
A STRATEGIC PLAN THAT
ENCOMPASSES THIS THINKING, AND
SO IN A DISEASE AGNOSTIC WAY WE
DECIDED THAT THE OVERALL
EMPHASIS SHOULD BE ON
TRANSLATION.
AND I KNOW LARRY STRESSED THAT
IN DIFFERENT WAYS, THAT WE HAVE
TO MATCH THE NEEDS OF
POPULATIONS, DEMOGRAPHICS
SLOWSLY IN SYNC, LOOK AT WHAT
WE'RE DOING WELL.
AND REPEAT THOSE BEST PRACTICES
AND LOOK AT PROGRAMS THROUGH
WHICH THE RETURN OF INVESTMENT
IS NOT THAT ROBUST.
IN FACT WE JUST HAVE ONE PIE WE
NEED TO BALANCE OUT VERY
RESPONSIBLY FOR THE FUTURE.
WE HAVE STRICT CORE VALUES THAT
GUIDE OUR THINKING.
SO JUST TO REFRESH, AGAIN ON THE
LEFT IT PUTS THE PATIENT IN THE
CENTER, EMPHASIZES THAT ALL
ASPECTS OF RESEARCH IS
IMPORTANT.
THAT THE TRANSLATIONAL SPECTRUM
HAS THE PATIENT IN FIND OF MIND
SO USE-DRIVEN RESEARCH DOESN'T
TAKE OVER CURIOSITY-DRIVEN.
WE SHOULD NEVER THINK THAT WAY
BUT IN A WAY THINKING ALL THE
TIME ABOUT RELEVANCE TO WHAT THE
APPLICATION MIGHT BE, EVEN IF IT
IS DOWNSTREAM.
AND WE LOOK AT THE SYSTEMIC ORAL
HEALTH CONSEQUENCES NOW WITH A
REAL SENSE OF WHAT IS THE
UNDERLYING CONNECTION, WHAT ARE
THE MECHANISMS, HOW DO WE
PERSONALIZE AND CONSIDER THE
UNIQUE MAKEUP OF INDIVIDUALS,
HOW DO WE TRANSLATE TO CHAIRSIDE
AND COMMUNITIES, IMPLEMENTATION
SCIENCES THAT WE HAVE A ROBUST
BUT ROOM TO GROW IN THAT AREA AS
WE DIVERSIFY OUR NEW GENERATION
AND EXPAND OUR PARTNERSHIPS.
YOU SEE THEY ARE TAKING THAT
SERIOUSLY.
WE HAVE THESE STATISTICS NOTHING
THAT SHOULD ALARM YOU.
NIDCR HAS PORTFOLIO GRANTEES, IT
LOOKS PRETTY DISCOURAGING BUT WE
HAVE A PLAN OF ACTION TO REALLY,
REALLY MAKE A DIFFERENCE.
YOU CAN SEE FROM THE WORKFORCE
ITSELF OF INDIVIDUALS OUT IN THE
PRACTICING SECTOR THAT WE ARE
NOT ACCESSING ALL THE
POPULATIONS IN NEED.
LARRY MENTIONED UNITE.
FROM THERE CAME THE UMBRELLA
PROGRAM THAT OVERARCHING THEME.
I REMEMBER IN ONE OF MY FIRST
COUNCIL MEETINGS MENTIONING THE
PUBLIC/PRIVATE PARTNERSHIP.
WE THOUGHT DIFFERENT CONVERGING
FRONTS THAT WE CANNOT DO IT BY
FOCUSING ON THE BIOMEDICAL
RESEARCH PIPELINE DEVELOPMENT
ITSELF.
WE HAVE TO PARTNER WITH
ORGANIZATIONS LIKE ADA, NDA,
ADEA, DEANS, WHO MADE A
DIFFERENCE, THOUGHT LEADERS, ET
CETERA, PLUS INDUSTRY PARTNERS.
AND JENNIFER WEBSTER CYRIAQUE IS
COMMITTED TO THIS EFFORT.
IT'S NOT AN EASY ONE, DRAWING
THE TEAM TOGETHER SO WE HAVE A
ROAD MAP AND CAN MOVE FORWARD.
I WANT TO SAY JENNIFER WAS
REALLY BEHIND A LOT OF THE
"HEAL" INTERACTIONS WE'VE HAD
WITH "HEAL," LARRY MENTIONED ME
BUT JENNIFER IS THE ONE WHO SITS
THROUGH THE MEETINGS AND HAS
MADE A REAL DIFFERENCE PUTTING
ORAL HEALTH IN THE FOREFRONT OF
THINKING WITH "HEAL."
AND PAIN MANAGEMENT.
WE HAVE TWO AMAZING PROGRAMS, WE
TRAIN FELLOWS.
HERE IS THE CLINICAL RESEARCH
FELLOWSHIP DEVELOPED FROM THE
WORK JIM MELVIN DID ON THE
FOUNDATIONS, DEVELOPED INTO A
NATIONALLY RECOGNIZED PROGRAM.
THESE SCHOLARS FIND VERY, VERY
GOOD FACULTY POSITIONS AND
REALLY FORGING PATHS IN CLINICAL
RESEARCH METHODOLOGY AND
TREATMENT FOR PATIENTS IN A
VARIETY OF CONDITIONS AND MANY
INSTITUTIONS AROUND THE COUNTRY.
THIS IS THE DEADLINE FOR THIS,
TYPICALLY TAKING SIX FELLOWS A
YEAR, SIX GENERAL, I THINK THEY
TAKE TWO TO THREE A YEAR, AND
YOU HAVE TO OBVIOUSLY HAVE A DDS
OR DDS Ph.D.
WE'VE REINSTATED THE FELLOWS
PROGRAM, WE'VE ADDED SOMETHING
UNIQUE, TO HAVE THESE TRAINEES
GET THROUGH THE DENTAL PUBLIC
HEALTH CERTIFICATION AND
CURRICULUM AS PRESCRIBED AND GET
INTO TWO YEARS OF FOCUSED
RESEARCH EXPERIENCE IN A LAB
EPIDEMIOLOGY AT NCI, EXAMPLE,
NIA, NATIONAL INSTITUTE OF
AGING, INTERESTING ON
CORRELATION WITH COGNITIVE
DECLINE.
I HOPE THAT IT PROVIDES US WITH
KNOWLEDGE CREATORS FOR THIS
FIELD, THAT WOULD THEN GO OUT
INTO THE COUNTRY AND BE THOUGHT
LEADERS AS WELL AS IT CAN BE
MODEL FOR OTHER PROGRAMS TO
FOLLOW IF POSSIBLE IN CAMPUSES
AROUND THE COUNTRY.
VERY PLEASED AGAIN TO HAVE A
VERY STRONG TEAM, BELINDA HOUSER
WHO WORKS WITH MATT HOFFMAN IN
INTRAMURAL HAS BEEN ACTIVE IN
GUIDING INTRAMURAL RESEARCH
EXPERIENCES FOR SCHOLARS, SHE'S
VERY WELL CONNECTED WITH
UNIVERSITY OF MARYLAND AND
HOWARD AND HAS GOT PIPELINE
PROGRAMS COMING IN, SUMMER OR
LONGER PROGRAMS THAT SOMETIMES
LAST A YEAR OR TWO.
LYNN KING HAS MOVED UP, TO BE
DIRECTOR, TO TAKE HER POSITION
IS ANISSA BROWN WHO I INTRODUCED
EARLIER ON.
AND THANKS TO LESLIE FRIEDEN,
WHO YOU APPRECIATE BECAUSE
LESLIE PUTS HER HEART AND SOUL
INTO INDIVIDUAL MENTORING AND
SUPPORT FOR ALL OF ON TRAINEES.
HOW ARE WE DOING?
YOU CAN SEE IN THE PINK BOXES
THE PROGRAMS THAT INTRAMURAL
OFFERS.
WE HAVE OTHER MEANS BY WHICH AN
INTRAMURAL TRAINEE CAN SEEK A
PERMANENT POSITION, EVERYTHING
IS BLUE WE OFFER TO THE
EXTRAMURAL COMMUNITY.
MANY KNOW WE'VE PAID A LOT OF
ATTENTION TO LEAKS IN THE
PIPELINE AND HAVE BRIDGE GRANTS
TO ASSIST PRE-DOCTORAL, DOCTORAL
TRANSITION, POSTDOCTORAL TO
FACULTY TRANSITION.
NOW, WHAT IS ACTUALLY
DRAMATICALLY INCREASED OVER THE
LAST YEAR AS WE LOOKED AT THESE
MECHANISMS, THE AMOUNT OF
OPPORTUNITY AVAILABLE FOR
DIVERSITY, EQUITY DEVELOPMENT.
YOU CAN SEE THESE ARE NOT OUR
PROGRAMS.
WE HAVE DOVETAILED, LATCHED MANY
TO INFRASTRUCTURE OF PROGRAMS
ALREADY EXISTING LIKE CEPA THAT
LOOKS AT K-12, CONDITIONING,
TALKING TO STUDENTS ABOUT
IMRTANCE OF BIOMEDICALRESEARCH,H
COMPONENT WILL ONLY HELP US
DEVELOP THAT PIPELINE.
WHEN WE LAUNCH THE DEIA
INITIATIVE IT WILL COME TOGETHER
VERY WELL.
I CAN'T GO THROUGH EACH BACKUP
THE POWERPOINT IS AVAILABLE FOR
YOUR REFERENCE AS WE FINISH.
VERY PLEASED AT THIS TRIAL GRANT
WE FUNDED, THEY PUT A LOT OF
WORK INTO THIS.
TEN TRAINEES A YEAR FROM
UNDERREPRESENTED BACKGROUND,
EARLY STAGE INDIVIDUALS,
HANDS-ON EXPERIENCED MENTORS,
YOU CAN SEE JACK AND FRANCISCO
AND OTHERS THAT ARE STALWARTS IN
OUR FIELD.
THE GOOD NEWS LOOK AT THE
SUCCESS RATES OF THE PROGRAM.
YOU CAN SEE FIVE INDIVIDUALS,
ELEVEN ACTUALLY, THAT WERE
FUNDED, SUCCESSFUL IN COMING UP
WITH A COMPETITIVE GRANT
APPLICATION, VERY ENCOURAGING
TREND FOR US TO BE LOOKING AT
AND MAYBE EXPLORING IN TERMS OF
EXPANSION.
ANOTHER SOLUTION OR STRATEGY TO
MAKE SURE WE HAVE LEADERSHIP
TEAM IN PLACE THAT REFLECTS THE
DIVERSITY OF OUR RESEARCH
PORTFOLIO AND OUR INTERESTS SO
JENNIFER HIT THE GROUND RUNNING.
I WOULD LOVE FOR YOU TO
CO-MODERATE WITH ME, PLANE IN
SEPTEMBER, SHE'S VERY KEEN ON
DEVELOPING A HEALTH DISPARITIES
RESEARCH PORTFOLIO, DEVELOPS
DIVERSITY INITIATIVES, WITH HER
OWN LAB IN NIAID WITH JEFF GOLD
AND HIS GROUP EXPLORING VIRAL
PATHOGENESIS AGAIN ALONG WITH
HEALTH DISPARITIES RESEARCH.
RENEE JOSKOW COMES WITH A WEALTH
OF EXPERIENCE WITH FEDERAL
AGENCIES UNDERSTANDING HOW
AGENCIES WORK, SHE HEADED ORAL
HEALTH DIVISION, HERE TO
ACTUALLY STRIKE UP AND DEVELOP
FROM SCRATCH NOVEL COLLABORATION
2000 IS TRANSFEDERAL AGENCIES.
YOU KNOW FROM THOSE DIAGRAMS I
SHOWED THAT WE CAN DO THINGS
APART FROM HRSA OR CDC AND CMS,
YOU KNOW, DEFINITELY
COLLABORATING ON WIN-WIN
INITIATIVES IS GOING TO BE WHERE
WE MOVE.
VERY HAPPY TO SAY THE PROGRAM IS
ROBUST, LARRY TALKED ABOUT SO I
WON'T SAY MUCH MORE, BUT WHAT
MATT HAS DONE IS TO CREATE SENSE
OF COMMUNITY AMONGST
INVESTIGATORS, TRAINEES, STAFF,
VERY HAPPY ENVIRONMENT AND HIS
EFFORT TO DIVERSITY IS
COMMENDABLE.
NOW WE HAVE SEVEN PRINCIPAL
INVESTIGATORS WHO ARE APPOINTED
IN THE DIVISION OF INTRAMURAL
RESEARCH BUT WORK IN
COLLABORATION WITH THE CLINICAL
CENTER.
LOADS OF EXAMPLES OF PARADIGM
SHIFTING WORK.
THE WORK IS PARADIGM SHIFTING,
MOVING TOWARDS IDENTIFYING ONE
NEUROMODULATOR, CDK5, WOULD
ALLEVIATE PAIN, A POSSIBLE
NON-OPIOID ALTERNATIVE FOR PAIN
MANAGEMENT, TIMELY.
IT INVOLVES MANY YEARS OF HARD
WORK THAT ASHOK HAS DONE IN THE
FIELD OF NEUROSCIENCE.
YOU HEARD FROM NIKI, I WAS GOING
TO INTRODUCE HER.
THE REASON, WE LOOKED AT PAIN
PORTFOLIO IN PERIODONTAL BIOLOGY
AND WE FIND THAT IT IS NOT AS
ROBUST AS COULD BE.
WE CONSIDERED ALL THE MANY
STUDIES THAT HAVE BEEN SPONSORED
ON REGENERATING, IT'S NOT THAT
EVERYTHING HAS TO SUCCEED FOR US
TO FEEL GOOD, IT'S THE FACT HOW
MUCH DO WE UNDERSTAND OF THE
SYSTEMS APPROACH OF THE DEEP
PHENOTYPING, STRATIFICATION
BASED ON UNDERLYING MOLECULAR
EVENTS.
I THINK WHAT NIKI IS MOVING THE
THEME FORWARD IS THAT CONCEPT
THAT NEEDS TO BE UNDERSTOOD.
ROBUST EXTRAMURAL PROGRAM IS
DIVERSE AND THE CHALLENGE HERE,
THIS IS THE CHALLENGE, ARE WE
CONNECTING THE DOTS?
IF WE WORK IN THE AREA OF CARIES
AND FOCUS ON EARLY INTERVENTION
STRATEGY, ARE WE CONNECTING THAT
TO THE MICROBIOME THAT SOMEONE
ELSE IS WORKING ON OR PRO
BIOTICS.
WE'VE BEEN SEEKING TO DEVELOP
SYSTEMS APPROACHES THAT TAKE
SOMETHING FROM START TO FINISH,
IN A GIVEN COMMUNITY.
I JUST GOT BACK FROM THE
UNIVERSITY OF TEXAS IN SAN
ANTONIO, SO IMPRESSED WITH THEIR
QUIET UNDERSTATED BUT STRONG
RESEARCH PORTFOLIO.
I'M NOT FAVORING ONE INSTITUTE,
JUST SOMETHING I PICKED UP,
STRENGTHS, OPPORTUNITIES, THAT
HUGE HISPANIC POPULATION IN
SOUTH TEXAS, THAT COULD BE
FOLLOWED FROM EARLY CHILDHOOD TO
ROOT CARIES, TO THE VERY AGE, IS
AVAILABLE FOR US TO EXPLORE
USING A MULTI-DISCIPLINARY
APPROACH.
A WONDERFUL EXAMPLE.
THIS IS A WONDERFUL ARTICLE.
IT SPEAKS TO THE CROSS-CUTTING
THEME WE COULD UNDERSTAND FUNDED
RESEARCH ACROSS THE BODY.
I WANTED TO HIGHLIGHT THIS
PARTICULARLY.
HOW DO WE WORK WITH P.I.s SUCH
THAT THEY MOVE INTO THE NEW ERA
OF TRANSLATION, MAKING
DIFFERENCE TO OUR PATIENTS.
WE HAVE AS YOU KNOW THE HUB
BASED IN ALABAMA, THE
REGENERATIVE MEDICINE CONSORTIA
IN THE WEST COAST AND NORTHEAST
AND MICHIGAN.
WE HAVE FACEBASE IN CALIFORNIA,
SOON TO COME TEMPORO
TEMPOROMANDIBULAR JOINT
DYSFUNCTION.
IF YOU LOOK AT THIS, ONE WOULD
ASK, I'M BEING DIRECT HERE, HOW
MUCH IS THE PBRN, IS THERE AN
OPPORTUNITY FOR PBRN TO EXPAND
INTO COMMUNITY HEALTH INTEREST
AREAS THAT HAVE PUBLIC HEALTH
CONCERN?
COULD WE LEVERAGE FROM EXISTING
PLATFORMS THAT THE PANDEMIC
FIELD, FOR EXAMPLE BOTTOM LEFT,
AN INFRASTRUCTURE THAT CAME FROM
THE NEEDS FROM US UNDERSTANDING
DEFICIENCIES AS A COUNTRY, THAT
WE DIDN'T HAVE COMMUNITY
ENGAGEMENT AS ITS BEST.
WE HAD NOT FORGED RELATIONSHIP
WAS COMMUNITY LEADERS, SCIENCE
COMMUNICATION WAS LACKING, HENCE
THAT UNDERSTANDING OF TESTING
AND INFECTIOUS DISEASES AND
VACCINES OBVIOUSLY CAME A HUGE
PROBLEM.
NOW THESE CONNECTIONS WITH THIS
RELIGIOUS LEADERS, FAITH-BASED
SCHOOL BOARDS, LOCAL MAYORS AND
GOVERNMENTS ARE IN PLACE IN MANY
PARTS OF THE COUNTRY AND THE
PLAN IS COULD WE LEVERAGE FROM
THESE PLATFORMS, THAT OFFERS AT
LEAST 450,000 PATIENTS, DIVERSE
BACKGROUNDS AND RECORDS TO HAVE
THE PBRN TAKE PART IN.
OF COURSE THE LARGER CONCEPT OF
DIABETES, OBESITY, ALZHEIMER'S,
ALL OF WHICH WOULD GAIN FROM
ORAL HEALTH INTERVENTION I WOULD
SAY.
SO THE PLAN IS, THE CHARGES
LET'S THINK ABOUT THE FUTURE AS
WE CAPITALIZE ON THESE WONDERFUL
INITIATIVES THAT WE'VE INVESTED
IN.
AND IN THAT SAME LIGHT AND IN
ALMOST IN THE CONTEXT OF WHAT I
ASKED LARRY ABOUT DENTAL SCHOOL
AND INVESTING, TAKING A NEW LOOK
AT WHAT IS BEST SCIENCE, IT'S
NOT ALWAYS AT THE BENCH, RIGHT?
WE USED TO THINK THAT WAY IN
REDUCTIONIST APPROACH BUT WE'VE
GOT TO THINK OF EXPANDING THE
WORKFORCE, ENGAGING CLINICIANS
TO THE FULLEST.
THE BEST WAY TO START THAT CAN
ONLY BENEFIT THE NATIONAL PBRN
TO CREATE THAT CULTURE WITH THE
DENTAL SCHOOL ENVIRONMENT, THAT
OFFERS A SAFETY NET TO PROBABLY
THE MOST DIVERSE OF ALL PATIENT
POPULATIONS THAT EXIST IN THE
COUNTRY.
BOTH DISEASE-WISE, RACE, ETHNIC,
SPECIAL NEEDS PATIENTS, WE HAVE
IT IN DENTAL SCHOOL SETTING,
GETTING BACK INVOLVED WHO ARE
TYPICALLY MANNING CLINICAL FOLD,
LEVERAGING FROM PROGRAMS COULD
ENGAGE IN CREATING NEW KNOWLEDGE
STUDENTS EXPERIENCE IN TREATING
PATIENTS.
THAT RFA SOON TO BE RELEASED, WE
HAVE A WEBINAR DESCRIBING IT IN
GREAT DETAIL.
AND SO IT WILL BE OPEN TO
QUESTION AND ANSWERS, OUR SENSE
IS THE INTEREST IS VERY HIGH.
IT WILL OPERATE AS A PLANNING
PHASE AND THEN GO INTO
IMPLEMENTATION PHASE BUT IT'S
INTENDED TO BE A TRANSFORMATIVE
MECHANISM.
AND NO DOUBT THERE WILL BE
GLITCHES BUT WE ARE GOING TO AS
BEST AS POSSIBLE MITIGATE THESE.
WE HAVE THROUGH GREAT SUCCESS IN
THE DOC PROGRAM, TO HAVE MORE
FDA APPROVAL STAGES, YOU CAN SEE
THAT'S ACTUALLY HAPPENING.
I'VE CHALLENGED THIS GROUP TO
USE THE SYSTEMS APPROACH.
SIMILAR TO WHAT NIKI HAS SET US
ON, THAT PATH.
SO THAT WITH THAT UNDERSTANDING
WE CAN COME UP WITH EFFECTIVE
TECHNOLOGIES AT THE RIGHT TIME
FOR THE RIGHT PATIENTS.
USING THAT KIND OF APPROACH IS
IMPORTANT AS WE THINK OF THE
STAGE SPECIFICITY OF SUCH
DISEASE.
THAT WOULD BE THE CHALLENGE.
AND YOU CAN SEE FROM
INSTITUTIONS TO TISSUES AND TO
TECHNOLOGIES THAT HAS BEEN QUITE
DIVERSE AND TRANSLATIONAL.
IT'S A WONDERFUL PATH TO BE ON.
I'M PLEASED WITH SAFE SPACE AND
AMOUNT OF REPOSITORY DATA WE
HAVE.
THE QUESTION IS HOW DO WE MAKE
IT USEFUL TO CLINICIAN WHO IS
HAVE -- CLINICIAN WHO IS HAVE A
HARD TIME WITH SUBTLETIES, COULD
WE USE A.I. MACHINE LEARNING
TOOLS, CONNECT THIS DATABASE,
INTO A LARGER REPOSITORY SO WE
CAN CONNECT BOTH SINGLE GENE
DISORDERS AND SYNDROMIC
CONDITIONS TO THE BENEFIT OF
PATIENTS.
THIS IS ONE OF THE INTEGRATED
SERVICES THAT THIS PARTICULAR
PROGRAM OFFERS CURRENTLY.
AND THE QUESTION IS CAN WE MAKE
IT INTEROPERABLE TO WHAT NIH IS
SOON TO OFFER AS OPEN ACCESS
CLOUD-BASED PLATFORM
TECHNOLOGIES, SAME EXISTS
WITHOUT DIR THAT HAS MANY
DATASETS THAT NEED TO BE MERGED
INTO THESE OPEN ACCESS PLAT
FORMS.
THIS IS EXAMPLES WHAT WE'RE
MAKING PROGRESS, AMP-AIM, AN
UNPRECEDENTED PARTNERSHIP
BETWEEN INDUSTRY, GOVERNMENT
WHICH WAS NIH, FDA, AND
ACADEMICS, TOE THE -- TO THE
TABLE TO SOLVE PROBLEMS OF
COMPLEX DISEASES, ALZHEIMER'S,
DIABETES.
PROGRESS MADE IN AUTOIMMUNE
DOMAIN WAS WHAT ENCOURAGED
FRANCIS COLLINS AND LARRY TO
CONSIDER SJOGREN'S AS PART OF
THIS.
WE WERE VERY INVOLVED, ONE OF
THE FIRST GIFTS WHEN I ARRIVED
IN OCTOBER OF 2020, LOOKING AT
WHAT WE HAD CURRENTLY, HUGE
REPOSITORY, 4,000 PATIENTS WITH
SAMPLES AND CONNECT THE DOTS AS
BEST WE CAN, THAT WILL BE AS YOU
CAN SEE A MULTI-INSTITUTIONAL
EFFORT BASED AT UCSF, A
PARTNERSHIP, AND INTRAMURAL
PROGRAM WITH 35-YEAR HISTORY
CONTRIBUTING TO THE
UNDERSTANDING OF SALIVA, ITS
BIOLOGY AND REGENERATION, AND
GENE THERAPY TO ACTUALLY
OVERCOME RADIATION DAMAGE, IN
PHASE 2 RIGHT NOW.
THIS IS AN EXAMPLE OF THE
PHASES, DISASSOCIATED,
DESEGREGATING THE DISEASE AT
EVERY STAGE, ASSOCIATING THE
PHENOTYPE AND PUTTING IT ALL
BACK TOGETHER WITH THE HOPE
THERE WOULD BE THERAPIES FOR
EACH STAGE OF SJOGREN'S
DEVELOPMENT.
NEEDLESS TO SAY EMERGENT ISSUES
AND TRENDS ARE VERY MUCH WHAT
NIDCR IS PREPARED TO APPROACH IN
A NIMBLE FACTION, YOUNG MALES
WERE MORE AFFECTED NOW, COULD
NOT BE -- IT WAS NOT PREDICTED
WHEN WE STARTED WITH THE VACCINE
THAT WE WERE THINKING TEENAGE
GIRLS WERE ONES TO BE
VACCINATED.
TURNS OUT THAT YOUNG MEN ARE
JUST AS PRONE.
I THINK THE RATIO IS SIX TIMES
MORE NOW THAN FEMALES, I
BELIEVE.
WE BROUGHT TOGETHER A THINK TANK
THAT NED SHARPLESS AND I KICKED
OFF, HE'S NO LONGER DIRECTOR, HE
DID STEP DOWN AS NCI DIRECTOR SO
WE SHOULD HAVE A NEW
PRESIDENTIAL APPOINTEE.
BUT VERY, VERY COMMITTED TO THIS
AREA, THAT WAS HIS CLINICAL AREA
OF INTEREST.
AND LOOK TO SEE, AGAIN, IN A
SYSTEMS APPROACH LET'S NOT HAVE
PREVENTION KIND OF GROUP WORKING
ON ONE END OF THE COUNTRY AND
SOMEONE BE LOOKING AT
PRE-DIAGNOSTICS OR BIOLOGIC
MARKERS IN ANOTHER END, AND
UNNECESSARY TALKING TO EACH
OTHER, LET'S COME TOGETHER IN A
SYSTEMS-WIDE APPROACH, SUCH THAT
WE ACTUALLY CAN REALLY DETECT
THIS DISEASE EARLY, PUT AN
EMPHASIS ON PREVENTION, AND COME
UP WITH TREATMENTS THAT ARE IN
FACT EFFECTIVE.
THIS IS ANOTHER IDEA THAT LARRY
DID EXPAND ON SO I WON'T TALK
ABOUT IT, TWO INITIATIVES THAT
NIDCR WAS AT THE TABLE FOR,
MYOFASCIAL, I WANT TO THANK
HELENE LANGEVIN, AND WHO ALSO
ACTUALLY SPEARHEADED THE REJOIN
INITIATIVE.
LARRY DIDN'T SAY THEY IS NOT A
SYSTEMS APPROACH.
IT'S A VERY DIRECT WAY OF
ANALYZING THE NEURAL OR
INNOVATION OF THE
TEMPOROMANDIBULAR JOINT COMPARED
TO KNEE JOINT, LOOKING AT
SIMILARITIES SO WE HAVE A SENSE
OF WHAT INNOVATION IS, PROBABLY
WOULD GIVE US PREDICTION FOR HOW
DISEASE PROGRESSES.
YOU CAN SEE THERE ARE TWO
IMPORTANT PAPERS IN THIS AREA
THAT HIGHLIGHT THE IMPORTANCE OF
THIS CONNECTION.
SO VERY SOON THERE IS GOING TO
BE THIS CONSORTIUM AGREEMENT
MOST LIKELY HUB AND SPOKE MODEL,
DECONSTRUCT AND RECONSTRUCT
TMJ -- TMD, SUCH THAT WE BRING
RELIEF FROM PATIENTS, A
DEBILITATING CHRISTIANS THAT --
CONDITION THAT WILL OF -- IT
FITS INTO THE PAIN REALM AND WE
INTEND TO LEVERAGE THROUGH
"HEAL" SO WE PRESENT THE
PORTFOLIO TO OUR LEGISLATORS FOR
CONSIDERATION, THAT THIS IS
IMPORTANT.
AND YOU CAN SEE JUST LOOKING AT
WHAT WE HAVE IN FRONT OF US, IN
TERMS OF PAIN, THERE'S A LOT
MORE PROGRESS THAT IS NEEDED,
MUCH GREATER INVESTMENT, ALL THE
KINDS OF PAIN.
WE I THINK MIGHT HAVE THE BEST
BIOLOGICAL MODELS, WE ALSO HAVE
THE MOST CHALLENGING SYSTEM TO
CONSIDER, RIGHT?
A TOOTH THAT IS COMPLETELY
ENCASED BY THE HARDEST TISSUE IN
MAMMALIAN SYSTEMS, MRI IMAGING
TECHNOLOGY ALSO, COULD IT HELP
US DICTATE TREATMENT, REVERSIBLE
VERSUS IRREVERSE ABLE, MITIGATE
PAIN, PREVENT PULP FROM
NECROSING AND START THE SPIRAL
OF ROOT CANAL THERAPY, CROWN,
PROBABLY LEADING TO IMPLANT IN
THE END.
THERE'S A CYCLE THAT NEEDS TO BE
BROKEN.
PAIN IN CHILDREN WITH
CRANIOFACIAL DISORDERS, OPIOIDS
AND CONSEQUENCES, ORAL CANCER
PREVENTION AND PAIN,
RECONSTRUCTION AFTER ORAL
CANCER, ALL OF WHICH I THINK
WE'RE GOING TO PUT TOGETHER IN A
PORTFOLIO TO MAKE AVAILABLE TO
FUNDING SOURCES.
SO WHEN I TOOK A STEP BACK AND
JENNIFER HELPED WITH THIS SLIDE
WE THINK IN ORDER FOR ORAL
HEALTH TO BE AVAILABLE FOR ALL
IT DOES TAKE ALL OF US.
I DON'T MEAN JUST THE PRECISION
MEDICINE INITIATIVE, IT'S REALLY
ALL OF US.
IN T AREA AS I WILL PREVENT
TOMORROW WE NEED TO BE AT THE
TABLE.
IT'S MUCH MORE DIFFICULT TO
RETROFIT.
WE WANT TO BE PRO-ACTIVE AND
MAKE SURE THERE'S AN
UNDERSTANDING THAT IF ORAL
HEALTH IS INCLUDED, THAT OVERALL
HEALTH OUTCOMES ARE GOING TO
IMPROVE.
AND THAT WE DO HAVE A RIGHT.
WE ARE CONNECTED THROUGH THE
REST OF THE BODY.
THAT'S GOING TO BE MADE VERY
CLEAR AND VERY INVITATIONAL
MANNER SO WE MAKE CONNECTIONS
FOR BENEFIT OF PEOPLE WE SERVE.
AGAIN, WE FACE THAT NEXT 25
YEARS, WE WERE CREATED BECAUSE
OF DENTAL CARIES.
75 YEARS LATER WE STILL HAVE IT
AS A SOCIETAL THREAT, SYMBOLIC
OF A LARGER PROBLEM NIDCR SHOULD
BE AWARE OF AND PART OF THAT
CHANGE THAT IS TO COME.
WE IDENTIFY PROBLEMS THROUGH THE
REPORT.
WE HAVE A PLAN, A STRATEGIC PLAN
CAME OUT INDEPENDENTLY OF THE
REPORT BUT ABOUT THE SAME TIME.
I THINK IF WE CONNECT THOSE DOTS
AND WE REALLY ARE, BECAUSE OUR
LEADERS ARE ACCOUNTABLE,
EVALUATIONS OCCUR, AS MINE WILL
BE BY THE DIRECTOR OF NIH THAT
WE MOVE THE NEEDLE BECAUSE WE
HAVE ADDRESSED THE PRIORITIES
THAT WE COLLECTIVELY AS A
COMMUNITY DECIDED ON.
IF WE DID THAT I THINK
COLLECTING RESULTS, LOOKING AT
SYSTEMS APPROACHES, WAYS TO DO
THINGS BETTER, THERE WILL BE A
RESULT THAT WILL IMPROVE ORAL
HEALTH FOR ALL.
OH, HOW DID THAT HAPPEN?
SIGNIFIES THE WAY I WAS
THINKING, LOTS OF ACTIVITY, I
MUST THANK THOSE WHO INVITED US.
AND WHO EXTENDED SUCH WARMTH AND
HOSPITALITY MAKING EACH VISIT
SPECIAL.
FOR ME THE ONLY WAY I CAN HAVE A
FINGER ON THE PULSE IS SITTING
IN FRONT OF TRAINEES, DEANS,
HIRED ADMINISTRATORS, FEELING
CHANGE THAT IS OCCURRING RIGHT
NOW.
I BRING THAT DATA BACK TO OUR
PROGRAM AND WE CONSIDER IDEAS
AND ISSUES THAT ARISE, AND ACT
ON THEM AND YOU CAN SEE ON THE
FAR RIGHT STRENGTHENING
RELATIONSHIPS WITH OUR TAKE
HOLDERS IS STRONG RIGHT NOW.
IT'S VERY ACTIVE RIGHT NOW.
JENNIFER IS ALSO PARTICIPATING.
SO HAS RENEE IN DISPERSING NEWS
OR DISSEMINATING NEWS ON THE
REPORT AND ACTIVITIES.
I THANK THEM BOTH.
GREAT PARTNERS TO HAVE.
HERE ARE FUNDING OPPORTUNITIES,
FIRST BEING A RENEWAL OF THE
K12.
CLINICIAN SCIENTIST IN THE
MAKING CAN GET BALANCE AND
QUALITY OF LIFE AND CONSIDER A
Ph.D. ALONG WITH DENTAL
SPECIALTY OR JUST Ph.D. ALONE.
THAT'S AN OPPORTUNITY AS IS THE
SUPPLEMENT, VERY IMPORTANT FOR
US IN DENTAL SCHOOLS TO BE
THINKING OF WAYS TO BE
COMPETITIVE FOR LARGER FUNDS.
WE HAVE TWO RFAs OUT NOW THAT
CLEARLY MENTIONED HERE, THAT YOU
CAN LOOK UP.
AND BOTH ADDRESS IMPORTANT
INTERSECTION AREAS AND SCREENING
FACIAL DISORDERS.
ONE CONCEPT CLEARANCE WILL BE
PRESENTED BY DENA FISCHER, FROM
AN FDA ALERT FOCUSED ON
BUPRENORPHINE, INCLUDES THE
SPECTRUM OF OPIOIDS AND
PREEXISTING DRUG USE CONDITIONS
THAT COMPROMISE SALIVARY FLOW
AND MAKE PATIENTS FOR
SUSCEPTIBLE.
I WILL END WITH A QUICK
RUN-THROUGH WHAT THE WORKING
GROUPS ARE GOING TO ACCOMPLISH
FOR US, THE VOICE OF THE
EXTRAMURAL COMMUNITY.
YOUR THOUGHTS, YOUR IDEAS, AND
YOU'RE GOING TO MAKE A
COLLABORATION SO YOU'RE NOT JUST
WORKING ON YOUR OWN.
THERE WILL BE STAFF SUPPORT AND
INSIGHTS PROVIDED BY PROGRAM
STAFF AND SO THE FIRST ONE ON
DATA SCIENCE IS REALLY A
NO-BRAINER, WE HAVE THINK ABOUT
WAYS REALISTICALLY WE HAVE OPEN
UP OUR FIELD BY CONNECTING THE
DOTS.
OR FOR THE BENEFIT OF PATIENTS
AND OUR COMMUNITIES.
THE GAPS REALLY EXISTING RIGHT
NOW, WE DON'T HAVE THAT KIND OF
COALESCING THAT'S OCCURRING.
WE DON'T REALLY KNOW ALL THAT'S
AVAILABLE.
I EVEN INCLUDE THERE THE DIGITAL
TECHNOLOGY DATA THAT SOME
SCHOOLS INVESTED IN RIGHT NOW.
AND SOME WHO ARE REALLY ACTUALLY
LOOKING AT THE WISDOM INTERFACE
BETWEEN EPPIC AND AXIOM, THAT WE
DO HAVE THE OPPORTUNITY TO
CREATE THAT UNIFIED HEALTH
RECORD, WE'RE LOOKING AT THAT.
DIRECTED ALSO TO IDENTIFY HEALTH
DISPARITIES, AND INEQUALITY IS
DATA DRIVEN SO WE HAVE A MEANS
BY WHICH WE CAN OVERCOME IT FOR
US.
SO WE DON'T PRODUCE 20 YEARS
FROM NOW THE SAME DATA THAT
WE'RE LOOKING AT TODAY.
THIS IS WHAT THE WORKING GROUP
IS CHARGED TO DO.
IN CLOSED SESSION WE'LL BE
TALKING MUCH MORE IN DEPTH AT
HOW THIS CAN UNFOLD FOR US OVER
THE YEAR.
WE'VE IDENTIFIED THOUGHT
LEADERS, ANYONE LISTENING TODAY
THAT FEELS THIS IS YOUR AREA OF
PASSION AND INTEREST, THE DOOR
IS OPEN FOR YOU TO WRITE TO LYNN
KING AND, OR AXEL, EITHER ONE,
AND LET THEM KNOW OF THE
COMMITMENT.
IT WILL BE VIRTUALLY MOSTLY
UNLESS AN ON-SITE VISIT IS
POSSIBLE.
THESE ARE THE AREAS.
YOU CAN SEE A COUPLE OF THEM.
DANA GRAVES PICKED UP THIS
CAUSE, SOMETHING DEAR TO HIS
PROFESSIONAL INTEREST AND
PASSION.
TO TAKE UP THE CHARGE OF LOOKING
WITH A NEW SET OF LENSES YOU A
TO HOW BEST TO TRAIN SCIENTISTS
FOR THE FUTURE.
CLINICIAN SCIENTISTS WOULD HAVE
MAXIMUM SKILL SET TO BRIDGE THE
GAP.
YOU CAN SEE THERE ARE DETRACTORS
AND CHALLENGERS, IT'S DIFFICULT
WHEN SCIENCE AND TECHNOLOGY IS
MOVING SO FAST.
WE'VE GOT VERY COMMITTED THOUGHT
LEADERS IN THE FIELD.
CURRENT PROGRAM DIRECTORS,
TRAINING PROGRAM DIRECTORS, K
AND F MENTORS, AND MENTEES, WILL
BE AT THE TABLE.
AND I THINK THE IDEA THAT 55% OF
NIDCR'S BUDGET IS OUTSIDE DENTAL
SCHOOLS, IT WILL TAKE TIME,
SCIENCE MATTERS.
WHAT IS IMPORTANT, 55% OF
FUNDEES THAT GET MONEY FROM
TRAINEES, POSTDOCS, GRADUATE
STUDENTS, WE WANT TO MAKE SURE
THEY ARE EMBRACED THAT OUR
COMMUNITY MOVES THEM SO THEY
STAY TRUE TO WHAT THEIR Ph.D.
PROJECT WAS OR INTEREST AREA IS
AND THAT'S HOW WE CAN DIVERSE IF
I-- DIVERSIFY THE PIPELINE.
ALL ASPECTS TRAINING AND CAREER
DEVELOPMENT LOOK AT DATA THAT
WOULD BACK IT UP, EACH STEP OF
THE WAY SO WE MAKE A NEW FUTURE.
WHAT'S EXCITING IS THAT AS WE
TALKED ABOUT OUR PLANS FOR
CELEBRATING THE DIAMOND JUBILEE
YEAR WHAT CAME UP AS THE
FLAGSHIP EVENT, SIGNIFIES THE
FUTURE, THE TRAINEES ACROSS OUR
PROGRAM AND MENTORS ON CAMPUS TO
SHOWCASE RESEARCH WITH
INTRAMURAL TRAINEES AS WELL AND
MAKE THAT A SPECIAL CELEBRATION
OF WHO WE ARE AND WHAT WE'RE
COMMITTED TO FOR THE FUTURE.
SO, NOTHING COULD BE POSSIBLE
WITHOUT THE AMAZING GROUP OF
STAFF, DEDICATED, TALENTED,
COMMITTED, CARING,
COMPASSIONATE, MAKES EVERY DAY
TRULY AN HONOR AND PRIVILEGE.
DOESN'T MATTER IF YOU'RE VIRTUAL
OR ON-SITE, IT'S A THRILL.
I ECHO JENNIFER'S SENTIMENTS AND
LEADERSHIP TEAM.
THANK YOU FOR LISTENING.
STAY CONNECTED, OPEN TO
QUESTIONS AND COMMENTS YOU MIGHT
HAVE.
I PICKED THIS UP FROM GOOGLE,
IT'S GOT A FACE ON THE RIGHT
SIDE OF THE QUESTION MARK, I
THOUGHT THAT WAS APT.
ANY QUESTIONS?
BEFORE I INTRODUCE SUSAN
GREGURICK.
SURELY THERE'S SOME.
AXEL PUTS OUT A CALL IF YOU'RE
INTERESTED IN PARTICIPATING,
DATA SCIENCE WORK GROUP LET HIM
KNOW.
HE'S PUT DOWN HIS E-MAIL
ADDRESS.
THANK YOU, AXEL.
DOES ANYONE HAVE QUESTIONS?
I'D BE HAPPY TO ANSWER.
NOW?
HOW'S THAT FOR STIMULATING
DISCUSSION.
WELL, WITH THAT I WILL JUST WANT
TO SAY IS IT TIME FOR LUNCH OR
MOVE TO SUSAN?
>> WE MOVE TO SUSAN.
>> A THRILL TO INTRODUCE YOU.
SUSAN HAS INTERACTED WITH OUR
EXECUTIVE STAFF TO GIVE A SENSE
FOR THAT FIELD OF DATA SCIENCE,
WHAT DOES IT INVOLVE, WHAT DOES
IT INCLUDE AND WHAT DOES IT NOT
INCLUDE?
LOTS OF TERMINOLOGY, LOTS OF
HUGE AMOUNT OF TECHNOLOGY,
SOMETIMES DIFFICULT TO WRAP YOUR
HEAD AROUND.
SO WE THOUGHT WHY NOT HAVE SUSAN
WHO IS VERY GENEROUS WITH HER
TIME AND HER KNOWLEDGE TO SHARE
THIS WITH US.
SUSAN, I THANK YOU FOR YOUR
COMMITMENT.
ALL THAT YOU DO AT NIH AND ALL
THAT YOU'RE DOING TO MAKE DATA
SCIENCE REALITY FOR OUR
INSTITUTES AND FOR NIH IN
GENERAL.
THANK YOU.
>> THANK YOU SO MUCH, DR.
D'SOUZA.
CAN YOU HEAR ME OKAY?
>> YES.
>> AWESOME.
SUCH A PLEASURE TO BE HERE AND I
KNOW THAT I MIGHT BE CUTTING
INTO YOUR LUNCH TIME.
CAN YOU LET ME KNOW IF YOU'D
LIKE ME TO SHORTEN SO THAT YOU
WILL HAVE ADEQUATE TIME FOR
LUNCH?
>> NO, I DON'T THINK SO.
I THINK WE CAN GRAB WHATEVER WE
HAVE AROUND US AND NOT
COMPROMISE ON YOUR PRESENTATION
AT ALL.
PLEASE.
THERE'S PEOPLE IN DIFFERENT TIME
ZONES, SOME COULD BE EATING
BREAKFAST, WHO KNOWS.
>> IT'S A NEW WORLD VIRTUALLY,
DOING OUR WORK BY ZOOM FOR THE
MOST PART, ALL OUR COUNCIL
MEETINGS.
THANK YOU AGAIN FOR INVITING ME
TO THE COUNCIL MEETING.
I'M JUST THRILLED TO BE ABLE TO
TELL YOU ABOUT WHAT WE'RE DOING
AT NIH TO CONNECT OUR DATA,
ENHANCE SOFTWARE, AND TO CREATE
A DIGITAL DATA HEALTH ECOSYSTEM.
NEXT SLIDE IS A HIGHLIGHT OF THE
NIH STRATEGIC PLAN FOR DATA
SCIENCE.
THIS IS THE NORTH STAR FROM MY
OFFICE.
REALLY HELPS ARTICULATE OUR
GOALS AND DATA SCIENCE
STRATEGICAL FOR THE NIH.
YOU CAN SEE THEM LISTED HERE
SUPPORTING COMMON
INFRASTRUCTURE, LEVERAGING
INDUSTRY RESOURCES AND ADOPTING
AND ADAPTING TECHNOLOGIES TO OUR
FIELDS.
ENHANCING BIOMEDICAL DATA
SCIENCE RESEARCH WORKFORCE AS
DR. D'SOUZA SAID.
THIS IS AN IMPORTANT COMPONENT
OF WHAT WE DO AT NIH AND IN DATA
SCIENCE, ALSO AN IMPORTANT
COMPONENT.
ENHANCING OUR ABILITY TO SHARE
DATA, ACCESS DATA, CREATE
INTEROPERABILITY IN ACCORDANCE
WITH LAWS AND REQUIREMENTS.
IMPORTANTLY, WITH COMMUNITY
INPUT AND YOUR INPUT DEVELOPING
AND PROMOTING AND REFINING
STANDARDS, STANDARDIZED
VOCABULARIES, ELEMENTS, MODELS,
ONTOLOGIES, CREATING ABILITY TO
ENABLE FAIR DATA.
THESE ARE SOME HIGHLIGHTS FROM
THE STRATEGIC PLAN.
NEXT SLIDE TELLS MORE ABOUT MY
OFFICE.
WE'RE IN THE OFFICE OF THE
DIRECTOR IN DPCPSI, KNOWN MOSTLY
FOR THE COMMON FUND BUT ACROSS
DPCPSI OUR OFFICES PLAY
LEADERSHIP ROLES IN COORDINATING
AND FOR ME ON THE STRATEGIC PLAN
FOR DATA SCIENCE.
WE HELP DEVELOP AND IMPLEMENT
VISION FOR ECOSYSTEM, PROMOTE
DATA SCIENCE THROUGH WORKFORCE
DEVELOPMENT.
AND BUILDING STRATEGIC
PARTNERSHIPS ACROSS NIH WITH
OTHER FEDERAL AGENCIES SUCH AS
NSF AND DEPARTMENT OF ENERGY TO
HELP DEVELOP AND DISSEMINATE
TECHNOLOGIES AND METHODS.
NEXT IS THE SAME BUT ILLUSTRATED
IN TERMS OF ACTIONABLE ITEMS
THAT WE'RE WORKING ON AT NIH.
I CAN'T ITEM YOU -- TELL YOU
ABOUT ALL, I'LL HIGHLIGHT A FEW
TODAY.
IF YOU'RE INTERESTED OUR WEBSITE
LISTS EVERYTHING WE'RE DOING TO
INSTANTIATE AND IMPLEMENT
STRATEGIC PLAN.
NEXT SLIDE IS A WAY TO CAPTURE
THE FACT THAT THIS IS REALLY AN
ALL OF NIH ACTIVITY.
WE WORK WITH OVER 23 INSTITUTES
AND CENTERS AND OFFICES, MORE
THAN 190 NIH STAFF CONTRIBUTING
ON WORKING GROUPS ON
IMPLEMENTING FUNDING
ANNOUNCEMENTS, SUPPLEMENTAL
ANNOUNCEMENTS, CONTRACTS,
OTAs, OTHER ACTIVITIES SUCH AS
TRAINING ACTIVITIES TO CATALYZE
DATA SCIENCE ACROSS NIH.
THIS IS THE STORY I'M TELLING
YOU, THE STORY OF ALL THE WORK
WE DO TOGETHER.
NEXT SLIDE.
JUST AN OVERVIEW OF WHAT I WILL
TALK TODAY, AGAIN I CAN'T TALK
TO EVERYTHING BUT I PICKED OUT A
FEW AREAS THAT I THOUGHT WOULD
BE MOST IMPORTANT AND IMPACTFUL
FOR THIS COMMUNITY.
I CAN ANSWER QUESTIONS ON
ANYTHING THAT MAY BE OF
INTEREST.
BY SHARING MIKE LAUER'S SLIDES
AND HOW WE'RE SUPPORTING THE
MANAGEMENT SHARING POLICY TO
FAIR DATA AND TRUST
REPOSITORIES, PARTNERSHIPS WITH
CLOUD SERVICE PROVIDERS, WITH
NSF AND OTHER PROGRAMS.
I WANT TO HIGHLIGHT RESOURCES,
INTERSECTION WITH DENTAL
RESOURCES AND CLOSE ON THE DATA
SCHOLARS IF THERE'S TIME.
NEXT SLIDE.
IT'S SOMETHING I'M FAIRLY
CERTAIN YOU'VE HEARD ABOUT AND
THINKING ABOUT, ACROSS NIH WE'RE
THINKING ABOUT THIS.
IT'S FINAL NIH POLICY FOR DATA
MANAGEMENT SHARING.
THIS POLICY WILL GO INTO EFFECT
ON JANUARY 25 OF 2023.
IT WILL REQUIRE RESEARCHERS TO
PLAN FOR HOW YOU WILL MANAGE AND
SHARE YOUR SCIENTIFIC DATA
THROUGH THE SUBMISSION OF YOUR
DATA AND MANAGEMENT SHARING
PLAN.
AT THE TIME OF APPLICATION YOUR
PLAN WILL OUTLINE HOW YOU PLAN
TO MANAGE AN SHARE YOUR DATA
WITH ACCOMPANYING METADATA,
TAKING INTO ACCOUNT POTENTIAL
RESTRICTIONS ON SHARING DATA.
IT'S PART OF YOUR BUDGET
JUSTIFICATION SECTION FOR YOUR
EXTRAMURAL AWARDS.
IF YOU CLICK YOU'LL SEE SOME OF
THE CAVEATS FOR THIS PLAN.
THIS WILL APPLY TO ALL RESEARCH,
FUNDED THROUGH GRANT, CONTRACT,
OTA, OR WHETHER YOU'RE AN
INTRAMURAL RESEARCHER.
ACTIVITIES THAT ARE EXCLUDED OF
COURSE ARE THOSE THAT DO NOT
GENERATE SCIENTIFIC DATA
INCLUDING OUR TRAINING GRANTS,
DEVELOPMENT AWARDS,
NON-SCIENTIFIC ACTIVITIES.
NEXT SLIDE IS A FEW NOTES FROM
DR. LAUER, WHAT WE HOPE TO DO IS
IMPART WITH YOU THE CONCEPT ALL
THE DATA SHOULD BE MANAGED IN
OUR RESEARCH ENTERPRISE.
THAT DOESN'T NECESSARILY MEAN
ALL DATA WILL BE SHARED BUT
SHOULD ALL BE MANAGED,
ARTICULATING WHICH WAYS ARE YOU
GENERATING SCIENTIFIC DATA, HOW
WOULD YOU PLAN ON SHARING THAT
DATA?
WHAT WE DON'T ANTICIPATE YOU
SHARING IS YOUR LABORATORY
NOTEBOOKS, PRELIMINARY ANALYSIS,
CASE REPORTS, PHYSICAL OBJECTS.
WE HOPE YOU'LL SHARE YOUR DATA
NO LATER THAN THE TIME OF
PUBLICATION OF THE SCIENTIFIC
FINDING OR AT THE END OF YOUR
AWARD.
THE NEXT SLIDE ARE SOME
CONSIDERATIONS FOR ELEMENTS OF
DATA MANAGEMENT SHARING PLAN
INCLUDING TYPE OF DATA THAT
YOU'LL BE SHARING AND
PRESERVING, RELATED TOOLS OR
SOFTWARE ANALYSIS CODE NEEDED TO
ACCESS DATA, STANDARDS THAT
APPLY.
I WANT TO HIGHLIGHT
SCIENTIFICALLY METADATA THAT
CREATES BETTER WAY TO FIND AND
USE DATA OF YOUR RESEARCH.
FACTORS THAT AFFECT DATA ACCESS
AND WHICH DATA WOULD FALL UNDER
CONTROL OF ACCESS REQUIREMENT
SUCH AS FOR EXAMPLE GENOMICS
DATA OR IMAGING DATA THAT
CONTAIN IDENTIFIABLE ELEMENTS.
YOU'LL WANT TO TALK ABOUT THE
PRESERVATION OF DATA, REPOSITORY
THAT YOU'RE GOING TO BE USING TO
SHARE THE DATA.
AND OVERALL DATA MANAGEMENT PLAN
AND WHO WILL MANAGE THE DATA.
NEXT SLIDE IS JUST A NOTE ON THE
ALLOWABLE COST THAT YOU CAN
REQUEST IN YOUR BUDGET TO CURATE
THE DATA, DEVELOP SUPPORTING
DOCUMENTATION, PRESERVING AND
SHAKER DATA THROUGH REPOSITORIES
IS ANOTHER ALLOWABLE COST.
NOT INCLUDED WOULD BE
INFRASTRUCTURE COST.
I WANT TO POINT YOU TO A NEW
WEBSITE, SHARING.NIH.GOV TELLING
YOU APPROACHES, HOW TO SELECT A
REPOSITORY AND THEN A NUMBER OF
NIH AFFILIATED REPOSITORIES THAT
DO SUPPORT DATA SHARING.
THIS IS JUST A QUICK HIGHLIGHT
AND OVERVIEW OF A MUCH LONGER
PRESENTATION ON THE DATA
MANAGEMENT SHARING POLICY.
NEXT SLIDE WILL START WAYS IN
WHICH WE THROUGH THE OFFICE OF
DATA STRATEGY ARE SUPPORTING
CAPABILITIES TO MAKE DATA MORE
FAIR, FINDABLE, ACCESSIBLE, AND
REASONABLE, A.I. READY.
FOR THE PAST TWO YEARS WE'VE
BEEN SUPPORTING SUPPLEMENTS TO
EXISTING NIH AWARDS, FOR NIH
RESEARCHERS TO BRING IN
EXPERTISE IN DATA MANAGEMENT,
ARTIFICIAL INTELLIGENCE, MACHINE
LEARNING, COMPUTER SCIENCE, TO
SUPPORT THE ABILITY TO TAKE
ALREADY EXISTING NIH DATA AND
CREATE A.I. READY CAPABILITIES
FOR THE DATA SUCH AS COMPUTABLE
METADATA, IMPUTING METADATA THAT
DOESN'T HAVE METADATA, TIME
SERIES, ADDITIONS FOR DATA, NEXT
SLIDE A PARTNERSHIP WITH THE
DENTAL INSTITUTE.
YOU'LL HEAR MORE IN A MOMENT
ABOUT FACEBASE.
ONE OF OUR SUPPLEMENTS FOR A.I.
READINESS DATA WAS TO DR.
CASTLEMAN FOR FACEBASE.
IT'S A REPOSITIVE TEAR TO SHARE
DATA GENERATED FROM THE DENTAL
RESEARCH COMMUNITY.
THIS SUPPLEMENTS STREAMLINES
CURATION AND ABILITY TO CURATE
AND IMPROVE METADATA,
DESCRIPTIVE ELEMENTS,
MAINTAINING RESTRICTION ON DATA
HANDLING.
I WANT TO POINT TO AN ARTICLE
THAT IS IN ARCHIVE SYSTEM CALLED
SHARING BEGINS AT HOME, AN
ARTICLE WRITTEN BY DR. DEMPSEY,
FOSTER, FRAZIER, CASTLEMAN,
RESONATING WITH THE POLICY.
DATA SHARING REMAINS QUITE LOW.
WHAT WE HOPE TO HAVE AND WHAT
THIS ARTICLE IS WAYS RESEARCHERS
CAN AT THE TIME OF THE INCEPTION
OF THE EXPERIMENT CREATE FAIR
DATA, THIS IS REALLY A
PARTNERSHIP BETWEEN RESEARCH
COMMUNITY AND REPOSITORY
COMMUNITY AND OF COURSE THE
FUNDERS WITH THE SAME GOAL TO
CREATE DATA THAT'S FAIR AT
INCEPTION OF RESEARCH PROJECT
AND NOT AT THE END OF THE
RESEARCH PROJECT.
THIS IS SUPPORTED BY OUR DATA
MANAGEMENT SHARING POLICY.
SO THE ARTICLE AND SIMILAR
ARTICLES ARE WORTH CONSIDERING
AND READING.
NEXT SLIDE TELLS YOU A LITTLE
BIT ABOUT THE FACT THAT DATA
SHARING IS NO ONE-SIZE-FITS-ALL
SOLUTION.
THERE'S GOING TO BE MANY WAYS
RESEARCHERS WOULD LIKE TO SHARE
DATA.
I'D LIKE TO TALK ABOUT EACH ONE
OF THESE OPTIONS.
BUT AS A FIRST START WE DO
STRONGLY ENCOURAGE RESEARCHERS
TO SHARE THEIR DATA IN AN OPEN
ACCESS DATA SHARING REPOSITORY.
YOU CAN SEE THEM ON THE
WEBSITES.
THESE ARE RESEARCH REPOSITORIES
SUPPORTED BY COMMUNITIES.
YOU'LL HEAR ABOUT FACEBASE,
SUPPORTED BY NIH AND ALIGNS WITH
THE MISSION, IN THIS CASE THE
DENTAL INSTITUTE.
THERE ARE OTHER OPTIONS, I'LL
TELL YOU ABOUT PubMed, A NEW
INITIATIVE TO SUPPORT GENERAL
REPOSITORIES AND BRIEFLY ABOUT
OUR PARTNERSHIP WITH GOOGLE,
AWS, MICROSOFT AZURE.
NEXT SLIDE TELLS ABOUT THE WORK
THAT NLM HAS BEEN DOING TO ALLOW
RESEARCHERS TO SHARE THEIR DATA
TO SUPPLEMENTAL MATERIALS TO
THEIR ARTICLES IN PubMed
CENTRAL, SHARED ON THE AWS OPEN
DATA PLATFORM, YOU CAN SEE A
LINK AT THE BOTTOM.
ALL THAT DATA IS AVAILABLE, IT'S
ABOUT 4 MILLION TO 7 MILLION
TEXTS, YOU CAN SEARCH AND FIND
DATA THROUGH THE OPEN DATA
PLATFORM.
THE NEXT SLIDE TELLS YOU ABOUT
SUPPORTING NIH DATA
REPOSITORIES.
THERE ARE A VARIETY OF DIFFERENT
REPOSITORIES OF SIZES AND
COMPLEXITIES, LEVELS OF
MATURITY.
ONE GOAL IS TO HELP REPOSITORIES
ALONG THE MATURITY LANDSCAPE.
EACH REPOSITORY BRINGS VALUE TO
THE RESEARCH AREA, BUT OF COURSE
WE NEED TO GROW REPOSITORIES SO
THEY DO REACH A LEVEL OF
MATURITY AND SOME OF THIS WILL
BE ALIGNING WITH THE FAIR
PRINCIPLES AND ALSO TRUST
PRINCIPLES OF TRANSPARENCY,
RESPONSIBILITY OF USE, THINKING
ABOUT THE REPOSITORY AS A USER
FOLKSED REPOSITORY, ENHANCING
TECHNOLOGY, BOTH FAIR AND TRUST
PRINCIPLES ALIGN WITH OST
DESIRED CHARACTERISTICS FOR DATA
REPOSITORIES, LINKED ON THE DATA
MANAGEMENT SHARING POLICY.
WE WANT TO INSTANTIATE
INSTANTIATE REPOSITORIES, THE
NEXT SLIDE IS WORK WE'VE BEEN
DOING OVER THE PAST TWO YEARS TO
SUPPORT EXISTING REPOSITORIES
SUCH AS FACEBASE AND OTHERS TO
ALIGN WITH THE OSTP PRINCIPLES
TO INSTANTIATE FAIR DATA AS
YOU'VE HEARD FROM DR.
CASTLEMAN'S WORK ON CREATING
BETTER YOU'RATION TOOL FOR
METADATA AN TRUST PRINCIPLES AND
TO HELP EVALUATE USAGE, UTILITY,
IMPACT.
NEXT CLICK.
WE'VE BEEN PROVIDING FUNDING FOR
REPOSITORIES OF ALL SIZES AND
STAGES.
TO INCREASE TRUSTWORTHINESS AND
FAIRNESS.
NEXT CLICK.
ONE MORE.
WE'VE AWARDED NOW 17 AWARDS, TWO
FROM IDeA STATES, WE SUPPORT
INTRAMURAL REPOSITORIES WITH THE
SAME PRINCIPLES, I WANT TO
HIGHLIGHT NEXT SLIDE ONE OF THE
AREAS THAT WE HAVE BEEN
SUPPORTING THIS FACEBASE, A PLUG
FOR YOUR COMMUNITY'S DATA
REPOSITORY.
HOLDING DATA NOT ONLY ON NORMAL
BUT ABNORMAL CRANIOFACIAL AND
DENTAL DEVELOPMENT IN HUMAN AND
ANIMAL MODELS, HAS OVER A
THOUSAND DATASETS, AND 200
PUBLICATIONS, ASSOCIATED
PUBLICATIONS, SOMETHING WE
ARTICULATED EARLY ON, LINKING
DATA IN THE PUBLICATIONS TO THE
REPOSITORY SO RESEARCHESSERS CAN
FIND AND USE THE DATA.
IT ALSO HAS ANALYTIC
CAPABILITIES.
EMPOWERS SCIENTISTS TO THINK
ABOUT BEST PRACTICES FOR DATA
SHARING AND DATA CITATION.
AND HELPING REALLY PRODUCE THAT
COMMUNITY OF DATA REUSE AND
REPRODUCIBILITY, I HOPE YOU IF
YOU HAVEN'T EXPLORED IT YOU'LL
HAVE THE OPPORTUNITY TO DO SO.
THERE'S MORE OPPORTUNITIES TO
CONNECT TO INTEROPERABILITY WITH
OTHERS ACTIVITIES WE'RE
SUPPORTING AT NIH INCLUDING ALL
OF US AND OUR CLINICAL AND
GENOMICS DATA REPOSITORIES.
WE HAVE PROGRAMS THAT SUPPORT
DATA REPOSITORIES AND KNOWLEDGE
BASES AS RESOURCES SO THESE
ACTIVITIES DO NOT NEED TO COME
IN THROUGH THE R01 GRANTING
MECHANISM WHICH IS NOT ALIGNED
TO A DATA REPOSITORY OF
KNOWLEDGE BASE BUT RATHER WILL
SUPPORT THESE PROGRAMS WITH A
SPECIAL EMPHASIS REVIEW PANEL TO
FILM A GAP IN NIH MISSION I.C.
TO ENCOURAGE ADOPTION OF GOOD
DATA MANAGEMENT PRACTICES.
AND TO ENGAGE RESEARCH COMMUNITY
IN TRAINING ON FAIR DATA AND
CREATING DATA THAT'S FAIR AT THE
BEGINNING OF THE EXPERIMENT AS
WELL AS ENABLING GREATER REUSE
OF DATA.
OF COURSE THINKING ABOUT DATA
GOVERNANCE IN TERMS OF LIFE
CYCLE APPROACH.
THE NEXT CLICK, AWARDS IN THE
PAST TWO YEARS.
SOME ARE FAMILIAR, BIOPORTAL,
UNIPROT.
LOOK AT PARS, REISSUED IN 2023,
SLIGHT MODIFICATIONS,
PARTITIONING A FUNDING
ANNOUNCEMENT TO EARLY STAGE
REPOSITORIES, AND TO
REPOSITORIES THAT ARE FAIRLY
MATURE SUCH AS UNIPROT FOR
EXAMPLE.
I HOPE YOU'LL FOLLOW US ON OUR
JOURNEY AS WE SUPPORT DATA
REPOSITORIES AND KNOWLEDGE
BASES, ALIGNING WITH WHAT'S
HAPPENING IN EUROPE, IN THE
GLOBAL DATA COALITION.
NEXT SLIDE.
IT ILLUSTRATES WORK WE'RE DOING
WITH THE GENERALIST
REPOSITORIES.
RESEARCHERS MAY CHOOSE TO SHARE
DATA IN PUBMED CENTRAL.
OR MAY CHOOSE A COMMUNITY-DRIVEN
REPOSITORY SUCH AS FACEBASE OR
OTHERS.
WE'VE INITIATED A NEW PROGRAM,
GENERALIST REPOSITORY ECOSYSTEM,
CHARACTERISTICS CONSISTENT
METADATA, FOR EXAMPLE, SO THAT
WE CAN BETTER DISCOVER AND FIND
AND REUSE NIH-SUPPORTED DATA,
CONDUCTING OUTREACH AND ENGAGING
RESEARCH COMMUNITY TO ENCOURAGE
SECONDARY REUSE OF DATA, THIS
KICKED OFF IN EARLY JANUARY.
WE'RE A FEW MONTHS IN BUT I HOPE
YOU'LL WORK WITH US AS WE WORK
WITH OUR GENERALIST REPOSITORIES
TO CREATE A BETTER AND MORE
SUSTAINABLE DATA ECOSYSTEM
ACROSS OUR REPOSITORIES
ENHANCING FAIR DATA AND DATA
SHARING.
SOME THOUGHT QUESTIONS FOR THE
COMMUNITY WAYS TO
RETROSPECTIVELY AND PROACTIVELY
ENHANCE FAIR DATA, FAIR AT
CREATION OF EXPERIMENT AND
THINKING ABOUT WAYS IN WHICH WE
CAN SHARE DATA THROUGHOUT ITS
LIFE CYCLE.
IMPROVING, FOR EXAMPLE, THE WAYS
IN WHICH WE CAN CAPTURE METADATA
AND EXTRACT IT TO ALLOW FOR
GREATER DISCOVERABILITY.
CONNECTING REPOSITORIES AS WELL
AS WAYS TO BETTER STORE AND
MANAGE AND INTEGRATE DIVERSE
DATASETS, JUST SOME THOUGHTS, US
A WORK WITH YOUR GROUP YOU'LL
CONSIDER SOME OF THESE.
I'LL TALK BRIEFLY ON THE NEXT
SLIDE ABOUT OUR PARTNERSHIP WITH
GOOGLE, AWS, MICROSOFT AZURE,
STRIDES PARTNERSHIP, TO PROVIDE
RESEARCHERS ABILITY TO STORE AND
ANALYZE IN A CLOUD ENVIRONMENT
WITH ACCESS TO PROFESSIONAL
SERVICES, POTENTIAL
COLLABORATIONS.
YOU'LL SEE A SNAPSHOT, THIS
MIGHT BE FROM EARLY MAY.
WE STORED OVER -- NOW OVER 170
PETABYTES OF DATA ON OUR THREE
CLOUD SERVICE PROVIDERS,
MANAGING AND ACCESSING AND
COMPUTING THIS AMOUNT OF DATA IS
A GRAND CHALLENGE.
WE'VE TRAINED OVER 4,000 PEOPLE,
AND WORKED WITH OVER 700
PROGRAMS AND PROJECTS IN OUR
STRIDES PROGRAM.
WE UNDERSTAND UTILIZING THE
CLOUD IS A HEAVY LIFT AND
RESEARCHERS NEED A SANDBOX TO
EXPLORE THE CLOUD, THE WAYS YOU
CAN CONFIGURE THE ARCHITECTURE
OF CLOUD PROVIDERS, AND
POTENTIALLY SUPPLEMENT THROUGH
EXISTING TRAINING.
NEXT SLIDE TELLS YOU ABOUT A
PROGRAM WE LAUNCHED IN APRIL,
ALLOWS RESEARCHERS TO TRY THE
CLOUD BEFORE YOU COMMIT, YOU CAN
UPLOAD YOUR DATA, UPLOAD YOUR
TOOLS OR APPLICATIONS, OR USE
SOME OF THOSE THAT ARE ALREADY
IN THE CLOUD LAB TO EXPLORE THE
FIELD, THE ENVIRONMENT, WE ALSO
PROVIDE TRAINING, TRAINING COULD
BE IN JUPYTER NOTEBOOK BOOKS, WE
HAVE A NUMBER OF ANALYTIC
CAPABILITIES ALREADY.
FOR EXAMPLE, GWAS ANALYSIS,
MEDICAL IMAGING ANALYSIS.
CAN EXPERIMENT WITH DIFFERENT
CLOUD SOLUTIONS, TRY ONE OR ALL,
BENCHMARK WITH A HIGH-THROUGHPUT
WORKFLOW CAN BENCHMARK TOOLS AND
CONFIGURATIONS, OPTIMIZE YOUR
WORK.
I HOPE AS WE ROLL THIS OUT TO
THE EXTRAMURAL COMMUNITY IT'S
NOW BEING TESTED IN INTRAMURAL
COMMUNITY, YOU'LL ENGAGE WITH US
AS OUR AIM IS TO REALLY PROVIDE
YOU WITH MANY DIFFERENT TYPES OF
SOLUTIONS FOR DATA STORAGE
MANAGEMENT AND COMPUTE TO FIT
YOUR RESEARCH NEEDS.
NEXT SLIDE, I WANT TO SPEND A
SHORT AMOUNT OF TIME TO DISCUSS
THE WORK WE'RE DOING TO IMPROVE
OUR SOFTWARE CAPABILITIES, PART
OF OUR DATA ECOSYSTEM.
NEXT SLIDE IS OUR PARTNERSHIP
WITH NATIONAL SCIENCE
FOUNDATION.
THE GOAL IS TO BRING IN COMPUTER
SCIENTISTS AND ENGINEERS INTO
THE BIOMEDICAL WORKSPACE, SINCE
I DON'T HAVE A LOT OF TIME I
WANT TO HIGHLIGHT ONE AWARD FROM
THIS PROGRAM RECENTLY, DR. RONG
WANG FROM ILLINOIS INSTITUTE OF
TECHNOLOGY, HE'S DEVELOPING A
FAIRLY RAPID AND USER PRESENTLY
LOW COST POINT OF CARE DEVICE IN
THE DENTIST OFFICE OR AT HOME TO
INTEGRATE AND ANALYZE DIFFERENT
TYPES OF DATA THAT UNDERLIE
DENTAL AND ORAL CARE.
THIS IS ONE EXAMPLE OF THE MANY
DIFFERENT R01s THAT IS
SUPPORTED BY ALL OUR INSTITUTES
AND CENTERS.
I HOPE YOU'LL CONSIDER THIS IF
YOU'RE INTERESTED IN COMPUTERS,
INTEGRATION OF COMPUTER SCIENCE,
DENTAL HEALTH RESEARCH.
IMPLICATIONS ARE MANAGED BY NSF
FOR REVIEW AND ONCE REVIEWED THE
APPLICATIONS ARE BROUGHT TO NIH
FOR FUNDING.
THE NEXT SLIDE TELLS YOU ABOUT
THE WORK THAT WE'RE DOING TO
ENHANCE EXISTING NIH SOFTWARE
AND TOOLS TO PROMOTE SOFTWARE
ENGINEERING, TO ESTABLISH
COLLABORATIONS BETWEEN
RESEARCHERS WHO ALREADY ARE
FUNDED BY NIH, AND THOSE WHO
WOULD LIKE TO BRING ON COMPUTER
SCIENTISTS AND SOFTWARE
ENGINEERS INTO THE PROGRAMS AND
R01s.
IN ORDER TO MAKE TOOLS
SUSTAINABLE, TO, FOR EXAMPLE,
ENABLE MULTI-CLOUD COMPUTING,
HYBRID COMPUTING, INCLUDE REUSE
OF SOFTWARE YOU HAVE DEVELOPED
ALREADY SO THE NEXT SLIDE IS
JUST AN EXAMPLE OF SOME OF THE
TYPES OF RECENT AWARDS THAT
WE'VE BEEN MAKING, I WANT TO
HIGHLIGHT THE AWARD BY DR.
EMONDI FROM BOSTON UNIVERSITY,
CANDIDATE DRIVER ANALYSIS, WHAT
HE'S GOING TO BE DOING, TO
OPTIMIZE AND CONTAINERIZE WORK
SO IT BECOMES MORE USER FRIENDLY
AND OPEN SOURCE.
IT'S WORKING AT PICKING
MULTIOMICS DATASETS FROM HEAD
AND NECK CANCER TO IMPROVE THE
ANALYSIS CAPABILITY OF THOSE
DATASETS.
I THINK THIS IS SOMETHING THAT
IF YOU'RE INTERESTED IN PLEASE
DO LOOK FOR THE SUPPLEMENTS,
WE'RE ALWAYS ENGAGING THE
COMMUNITY TO ENHANCE THE
SOFTWARE PRACTICES OF THE WORK
THAT WE'RE DOING.
THE NEXT SLIDE IS JUST A QUICK
THOUGHT ON WHERE WE'RE THINKING
OF GOING IN TERMS OF EXPLAINING
PARADIGMS FOR LOCOED
PERFORMANCE, EDGE COMPUTING AS
WELL AS HUMAN SOFTWARE
AUGMENTATION.
I WANT TO SPEND A MOMENT AND
NEXT FEW SLIDES TO TALK ABOUT
SOME ACTIVITIES, BUT I NEED TO
TELL YOU ABOUT THE WORK WE'RE
DOING GENERALLY IN ELECTRONIC
HEALTH CARE RECORD DATA FOR
RESEARCH.
I'M SURE YOU'RE FAMILIAR WITH
THE STATE OF THE ART OF
ELECTRONIC HEALTH RECORDS, AND
RICH AMOUNT OF DATA THAT ONE CAN
GET FROM THESE RECORDS THAT
BASICALLY DESCRIBE ENCOUNTERS
PATIENTS HAVE WITH OUR HEALTH
CARE PROVIDER SYSTEMS.
THEY ARE OFTEN DIVERSE DATA, LAB
DATA, IMAGING DATA, BUT THESE
RECORDS ARE DEVELOPED FOR
BILLING AND HEALTH CARE
PRACTICES, NOT FOR RESEARCH.
SO CREATING A WORLD IN WHICH
ELECTRONIC HEALTH CARE DATA CAN
BE USED FOR RESEARCH PURPOSES IS
SOMETHING NOT JUST OUR OFFICE
BUT MANY I.C.s HAVE BEEN
WORKING ON.
NEXT SLIDE.
IT TALKS ABOUT WAYS WE'RE
UTILIZING THE FHIR STANDARDS
WHICH HAVE BEEN DEVELOPED TO
HARMONIZE ACROSS VENDORS LIKE
EPPIC TO ENHANCE DATA SHAKER AND
INTEROPERABILITY TO ENABLE
RESEARCHERS TO MAP DIFFERENT
ELECTRONIC SYSTEMS ON ONE
STANDARD, SOMETHING WE'VE BEEN
DOING DURING COVID TIMES.
WORKING TO MAKE SURE WE CAN
SHARE DATA BROADLY AND SUPPORT
SECONDARY REUSE OF THIS DATA.
THIS IS TAKING QUITE A BIT OF
TRAINING.
I'LL TELL YOU IN THE NEXT SLIDE
A FEW ACTIVITIES WE'VE BEEN
DOING TO SUPPORT FHIR.
INCLUDING SMART ON FHIR APP SO
RESEARCHERS CAN DOWNLOAD DATA,
FOR EXAMPLE UNDERSTANDING
CHRONIC CONDITIONS, THE EMERGE
NETWORK LOOKING AT NAPPING
GENOMICS AND PHENOTYPIC DATA
INTO ELECTRONIC HEALTH CARE
RECORD DATA FEAR A FHIR-BASED
SCHEMA AND APIs TO STANDARDIZE
DATA, ACROSS LARGE COHORT
STUDIES BY MAPPING THOSE INTO A
FHIR STANDARDS.
ENCOURAGING RESEARCHERS TO USE
FHIR IN CLINICAL DATA
ACTIVITIES.
AND THEN OF COURSE TO USE FHIR
AS RESOURCES FOR TRANSLATIONAL
NETWORKS, JUST A FEW OF THE
PROGRAMS THAT NIH HAS BEEN
WORKING ON TO ENHANCE THE USE OF
CLINICAL RECORDS, USING FHIR
STANDARDS, BUT THERE'S QUITE A
BIT OF TRAINING THAT NEEDS TO
HAPPEN SO THE NEXT SLIDE WILL
TELL YOU ABOUT THE TRAINING
WE'VE BEEN DOING SINCE DECEMBER.
OF 2021.
SO GO TO THE NEXT SLIDE.
WE'VE BEEN WORKING ACROSS NIH
AND CLINICAL CENTER AND OUR
INSTITUTIONS TO PROVIDE TAILORED
TRAINING TO NIH RESEARCHERS ON
FHIR, AND USING FHIR WITH
DIFFERENT PROGRAMS SUCH AS R OR
PYTHON.
WE'RE NOW LOOKING TO MOVE
TRAINING ON FHIR TO EXTRAMURAL
COMMUNITY, DEMONSTRATING HOW YOU
CAN EXTRACT HEALTH CARE DATA,
USING FHIR STANDARDS FOR THE
PURPOSES OF RESEARCH, WE PROVIDE
TRAINING ON MITRE AND WILL
PROVIDE TRAINING ON COMPLEX
EXERCISES THAT YOU MAY HAVE FOR
RESEARCH QUESTIONS, ALL THIS
TRAINING IS ALSO WITH A HANDS-ON
EXPERIENCE.
SO THIS IS SOMETHING TO LOOK
FORWARD TO.
NEXT SLIDE IS THOUGHTS.
THERE'S BEEN GOOD MOVEMENT
RECENTLY IN HL7 AND FHIR,
INTEGRATING ELECTRONIC MEDICAL
RECORDS AND DENTAL RECORDS SO
IT'S WORTH LOOKING AT THE DENTAL
DATA EXCHANGE IN HL7.
I CAN PUT THE LINK IN THE ZOOM
CHAT.
I THINK THERE'S GOOD
OPPORTUNITIES TO INTEGRATE
ELECTRONIC HEALTH CARE RECORD
AND DENTAL RECORD FOR A MUCH
MORE HOLISTIC VIEW OF THE
PATIENT'S HEALTH AND DISEASE
PROGRESSION.
SO I HOPE THIS IS SOMETHING THAT
AS YOU'RE WORKING THROUGH
WORKING GROUPS YOU'LL THINK
ABOUT WAYS TO LEVERAGE HEALTH
CARE SYSTEM DATA WITH DENTAL
RECORD DATA FOR GREATER RESEARCH
PURPOSES.
AND THE NEXT SLIDE IS JUST A
QUICK PLUG, I KNOW TIME IS
SHORT.
ABOUT OUR DATA AND TECHNOLOGY
ADVANCEMENT NATIONAL DATA
SCHOLARS PROGRAM.
IT'S A ONE OR TWO YEAR
SABBATICAL, RESEARCHERS COME
FROM ACADEMIA, FROM INDUSTRY,
THEY ALSO COME FROM OTHER
FEDERAL AGENCIES, AND FROM
NON-PROFITS TO WORK ON
CHALLENGING PROBLEMS, AND THIS
YEAR WE'LL BE LOOKING AT I
HEALTH DATA INTEROPERABORITY,
DATA F PANDEMICS, VERY
IMPORTANT RIGHT NOW.
CHALLENGING NEW AREAS AND
WEARABLES FOR PREDICTING
CLINICAL OUTCOMES, I'M SURE
THERE'S INTEGRATION BASED WITH
DENTAL SPACE, MULTI-MODAL CANCER
DATA AND ACCELERATED
PARTNERSHIPS.
THE APPLICATIONS ARE DUE MAY 27.
BUT WE RUN THIS EVERY YEAR, IF
THIS IS NOT THE YEAR FOR YOU.
LAST SLIDE FOR TODAY IS JUST A
PLUG THAT EACH MONTH ON THE
SECOND FRIDAY OF THE MONTH WE
HIGHLIGHT A DIFFERENT I.C. AND
THEIR DATA SCIENCE CAPABILITIES
INCLUDING FUNDING ANNOUNCEMENTS
AND PROGRAMS, NOT TOO LONG AGO
WE HIGHLIGHTED THE DENTAL AND
CRANIOINSTITUTE, DR. YANG CHAI
TELLING US MORE, INCLUDING A
VIDEO DEMONSTRATING WORK
FACEBASE IS DOING.
WITH THAT, I WANT TO THANK ALL
OF MY COLLEAGUES AND THE FOLKS
ACROSS NIH WHO WORK WITH US TO
DEVELOP AN ENHANCED CLOUD DATA
INTEGRATING DATA AND CLOUD
PLATFORMS, ACTIONING A.I.,
ARTIFICIAL INTELLIGENCE, AND
MACHINE LEARNING WHICH I DIDN'T
TALK ABOUT TODAY, BUILDING A
STRONG DIVERSE DATA SCIENCE
WORKFORCE.
I'M HAPPY TO TAKE QUESTIONS IF
THERE'S TIME.
I CAN ALWAYS BE REACHED AT
ANYTIME.
THANK YOU SO MUCH FOR THE
INVITATION AND CHANCE TO TALK
TODAY.
>> THANK YOU, SUSAN.
THAT SAID, FOLKS SHOULD KNOW
THAT THE CREATION OF THIS IDEA,
CONCEPT, HAS GROWN FROM THE
BRAIN, THE DIRECTOR OF OFFICE OF
INFORMATION TECHNOLOGY.
I WANT TO ACKNOWLEDGE JOHN.
THERE YOU ARE.
>> HELLO.
>> YES, THANK YOU FOR YOUR
VISION AND FOR YOUR LEADERSHIP
BECAUSE I KNOW YOU SPENT
COUNTLESS HOURS TO DEVELOP THIS
INTO A CONCEPT THE WORKING GROUP
CAN TAKE FORTH.
>> CERTAINLY.
IT WAS MY PLEASURE.
DR. GREGURICK, THANK YOU FOR
YOUR TIME.
>> WE'LL BE ATTACHED TO YOU FOR
QUITE A WHILE NOW.
>> ABSOLUTELY.
>> ANY QUESTIONS?
I HAVE A GLOBAL QUESTION, HOW
ARE OTHER COUNTRIES DOING?
THE U.K. FOR EXAMPLE SEEMS TO BE
A LITTLE BIT FORGING AHEAD WITH
SOME OF THIS DATABASES.
IS THAT RIGHT?
>> THEY ARE.
WITHIN THE EUROPEAN UNION,
THERE'S THE ELIXIR PROGRAM THAT
HAS MAIN DRIVERS IN BIOMEDICAL
RESEARCH IN LIFE SCIENCE,
CLIMATE AND THE ENVIRONMENT, AND
THEIR WORK IS NOT TOO DISSIMILAR
FROM WORK WE DO.
THEY RUN ON A DISTRIBUTED HUB
AND SPOKE MODEL, WHERE THERE ARE
ELIXIR HUBS, AND THEY ARE MAKING
GREAT HEADWAY IN ITEMS OF
INTEGRATING ACROSS THEIR DATA
SPOKES TO ENABLE FAIR DATA
SHARING.
THEY HAVE A LOT OF REALLY
WORTHWHILE DATA, CREATING PLANS
WORTH LOOKING AT AS WELL AS DATA
HARMONIZATION.
SO I THINK THERE'S BEEN SOME
REALLY GOOD PROGRESS WITH
ELIXIR.
NOW ELIXIR IS ALSO EXPANDING TO
OTHER COUNTRIES BEYOND THE
EUROPEAN UNION, AND WE CONNECT
WITH THEM THROUGH SOME OF OUR
INTEROPERABILITY ACTIVITIES.
>> OBVIOUSLY THEY HAVE A
NATIONAL HEALTH SYSTEM, HEALTH
CARE SYSTEM, SO THAT MUST HELP
IN TERMS OF PATIENT RECORDS AND
SYSTEMIC CONNECTIONS AS WELL,
RIGHT?
I WOULD IMAGINE.
>> I THINK IT DOES.
THEY DO HAVE SOME DATA SHARING
REQUIREMENTS THAT MIGHT BE A
LITTLE BIT HIGHER BAR THAN SOME
OF THE WORK THAT WE DO HERE BUT
INDEED THEIR HARMONIZATION OF
ELECTRONIC HEALTH CARE RECORDS
IS QUITE MORE ADVANCED THAN WHAT
WE DO, ALTHOUGH FHIR IS AN
INCREDIBLY GOOD TOOL HERE.
BUT THEIR NATIONAL HEALTH CARE
SYSTEM DOES ALLOW FOR GREATER
HARMONIZATION.
>> YES.
AXEL, I KNOW YOU PROBABLY HAVE
QUITE AN INTEREST AND ALSO SOME
SKILLS IN THIS AREA.
DO YOU HAVE ANYTHING TO BRING
UP?
>> SO, FIRST OF ALL, THANK YOU.
THIS WAS A GREAT PRESENTATION
WITH A LOT OF INTERESTING
THOUGHTS AND BACKGROUND FOR OUR
DATA SCIENCE WORKING GROUP.
SOMETHING THAT WE WILL DO IN THE
NEXT FEW WEEKS IS GET TOGETHER
AND THINK ABOUT THE EXACT CHARGE
FOR THIS WORKING GROUP, THE
GOALS, AND THEN OBVIOUSLY
CONSIDERING THE COMPLEXITY OF
ALL OF THIS, ALSO HAVE TO THINK
ABOUT BOUNDARIES OF WHAT WE'RE
TRYING TO ACCOMPLISH HERE.
AND I ASSUME WE CAN PROBABLY
ALSO GET A COPY OF THESE SLIDES
TO LOOK AT IN DETAIL AND TALK
THROUGH
>> YES.
>> I PUT IT IN THE CHAT EARLIER,
WE'RE STILL LOOKING FOR PEOPLE
WHO WANT TO PARTICIPATE IN THIS
WORKING GROUP, SO WHOEVER IS
INTERESTED SHOULD PLEASE GET IN
CONTACT, GET IN TOUCH WITH ME OR
I GUESS LYNN OR LIU WANG, WE'LL
PUT THIS TOGETHER.
SOMETHING THAT WAS CLEAR FROM
THE PRESENTATION JUST NOW IS HOW
MANY AREAS OF NIDCR'S WORK THIS
POTENTIALLY TOUCHES, ALL THE WAY
FROM THE BASIC SCIENCE AND
ACTUAL DATA SCIENCE EFFORTS LIKE
MAKING DATA ACCESSIBLE AND SO ON
BUT ALSO LIKE POTENTIALLY
EXTENDING ALL THE WAY INTO
CLINICAL PRACTICE.
SO, WITH THAT IN MIND I WOULD
HOPE THAT WE WILL HAVE A DIVERSE
REPRESENTATION FROM DIFFERENT
ASPECTS OF NIDCR'S WORK, NOT
JUST PEOPLE WHO HAVE INHERENT
INTEREST IN BIOINFORMATICS OR
ARE KNOWLEDGEABLE BUT ALSO
PEOPLE WHO FEEL LIKE THERE COULD
BE WAYS TO LEVERAGE DATA SCIENCE
IN THEIR RESPECTIVE FIELD.
SO WITH THAT IN MIND I WOULD
ENCOURAGE PEOPLE WHO FEEL LIKE
THEY ARE NOT PERHAPS -- NOT
SUPER KNOWLEDGEABLE IN DATA
SCIENCE PER SE TO CONSIDER
PARTICIPATING IN THE WORKING
GROUP SO WE CAN UNDERSTAND WHAT
THE NEEDS ARE, AND THEN THINK
ABOUT HOW COULD THIS TRANSLATE
INTO ACTIONS OR RECOMMENDATIONS
THAT THE WORKING GROUP MIGHT
MAKE.
>> YES.
AND JUST SO YOU KNOW, A REAL
THOUGHT LEADER IN THE FIELD OF
DENTAL DATA SCIENCE WAS
RECOMMENDED BY PATTI BRENNAN,
HEAD OF NATIONAL LIBRARY OF
MEDICINE, WE'LL MAKE SURE WE DO
OF DO THAT DILIGENCE TO GIVE YOU
A LIST OF POSSIBILITIES.
YOU HAVE YOUR HAND UP.
THANK YOU FOR WORKING ON THIS AS
WELL.
>> THANK YOU.
THANK YOU, RENA.
I'LL LOWER MY HAND BEFORE I
TALK.
SUSAN, THANKS FOR THE WONDERFUL
TALK.
I ALWAYS TELL MY COLLEAGUES, I
AFTER MANY SEMINARS THAT I
ATTEND, THE SEMINARS OFFERED BY
YOUR OFFICE OTHERWISE I WILL
ALWAYS TRY MY BEST TO ATTEND
BECAUSE I ALWAYS LEARN SO MUCH
AND I HAVE THE FULL FRONT OF
DATA SCIENCE.
THANK YOU FOR THAT.
MY QUESTION REALLY HAS TO DO
WITH WHAT DO WE ANTICIPATE IN
THE ARENA OF DATA SCIENCE WHEN
SCIENCE AND TECHNOLOGIES
CONTINUE TO ADVANCE RAPIDLY, SO
WE WILL CONTINUE TO HAVE THE
EXPLOSION OF BIG DATA, IN
MULTI-DIMENSIONS, AND AT THE
SAME TIME WE WILL HAVE NEW AND
FOR SURE NEW TECHNOLOGY
PLATFORMS THAT WILL PRODUCE NEW
DATA TYPES THAT WE MIGHT NOT BE
ABLE EVEN TO ANTICIPATE AT THIS
POINT.
THAT IS WHEN DISRUPTION OF
TECHNOLOGY, YOU KNOW, REALLY
COMES INTO THE REAL WORLD, IN
OUR INVESTIGATORS' RESEARCH.
I'M JUST WONDERING ABOUT WHAT
MAY BE CONSIDERED AS VERY
COMPREHENSIVE AND COMPLETE
DATASETS, IN LET'S SAY FIVE
YEARS, BE REGARDED AS
INCOMPLETE, YOU KNOW, AS NOT
COMPREHENSIVE ENOUGH, SO IN THAT
REGARD I HAVE BEEN WONDERING A
LOT ABOUT WHAT COULD BE DONE TO
REALLY -- TOWARDS THE
DEVELOPMENT OF MORE ADVANCED
DATA ANALYTICS THAT CAN HANDLE
WHAT MAY BE VIEWED AS COMPLETE
DATASET OR INCOMPLETE DATASET,
THIS IS REALLY, YOU KNOW,
SOMETHING I WONDER A LOT IN
TERMS OF WHAT FUTURE --
>> CAN YOU ADDRESS THAT PLEASE?
>> ABSOLUTELY.
SO GLAD YOU ASKED THAT.
FIRST, THE STRATEGIC PLAN FOR
DATA SCIENCE WHICH I HIGHLIGHTED
IS 2018 TO 2022, YOU CAN IMAGINE
WE'VE BEEN STARTING THE INITIAL
PROCESS FOR THE STRATEGIC PLAN
FOR DATA SCIENCE FOR 2023 TO
2028.
FIVE-YEAR PLAN.
AND SOME OF THE THINGS WE'LL BE
LOOKING AT DO START TO ADDRESS
WHAT YOU'RE SPEAKING OF, DR.
WANG, IN TERMS OF LOOKING AT
DATA AS THE PRIMARY
INFRASTRUCTURE SO THERE'S A LOT
GOING ON IN INDUSTRY AROUND THE
CONCEPT OF DATA MESH OR
HARMONIZING DATA INFRASTRUCTURE
SO THAT IT IS INTERCONNECTED IN
WAYS THAT MAKE SENSE FOR THE
DATA.
AND THIS WILL BE SOMETHING THAT
YOU'LL SEE, BUT ALSO IN
IMPROVING OUR DATA COMPUTATION
AND ALGORITHMS, THIS COULD
INCLUDE COMPUTING ACROSS, ALSO
CREATING A.I. AND ETHICAL
FRAMEWORKS AS WELL AS
UNDERSTANDING COMPLETENESS OF
DATA BY UTILIZING A.I.
OFTENTIMES WE HAVE TO THINK
ABOUT A.I. EITHER AS A FEDERATED
LEARNING OR AS ITERATIVE MODEL
FOR LEARNING SO YOU'LL SEE A LOT
MORE IN TERMS OF A.I.
INFRASTRUCTURE AND INTEGRATION
OF A.I. ETHICS BIAS
TRANSPARENCY, AS WELL AS NEW
IDEAS AND SOCIAL DETERMINANTS OF
HEALTH AND REAL WORLD DATA WHICH
DOES ADD AN ADDITIONAL COMPONENT
AND I THINK THERE'S PROBABLY
SOME VERY INTERESTING IDEAS OF
INTEGRATING DENTAL DATA
TOGETHER, SOMETHING I'M NOT SURE
THE EXTENT HAPPENING NOW BUT
COULD BE AN IMPORTANT COMPONENT
IN FIVE YEARS BUT UNDERSTANDING
THE COMPLETENESS OF THE DATA
WHICH IS WHAT YOU'RE SPEAKING
OF, COMPUTING ON DATA THAT'S AT
THE PETABYTE SCALE, TWO GRAND
CHALLENGES THAT I SEE GOING
AHEAD COULD BE OF GREAT INTEREST
TO OUR SCIENTIFIC COMMUNITY AND
TO THE SCIENTIFIC COMMUNITY WRIT
LARGE FUNDED BY NSF AND
DEPARTMENT OF ENERGY.
>> A FOLLOW-UP QUESTION, IS
THERE TIME?
>> THIS IS SUCH A WORTHY
DISCUSSION, I THINK WE HAVE
TIME, RIGHT, LYNN?
2:00 IS WHEN DENA COMES ON.
>> WE HAVE TIME FOR ANOTHER
QUESTION.
>> AND WHAT YOU'RE SAYING IS SO
RELEVANT AND APPLIES TO BEST
PRACTICES, IF YOU'RE A SURGEON
AND DECIDED TO INTERVENE FOR
CORRECTION LATER THAN MOST
PRESCRIBED AND HAVE THIS DATA
THAT SAYS DOING MUCH BETTER
BECAUSE OF INTERVENTION, THE
CHILD DID WELL, HOW DO YOU GET
THAT ACROSS, HOW DOES ONE HANDLE
MISINFORMATION AND
MISINTERPRETATION OF DATA?
ALL OF THOSE QUESTIONS ARE GOING
TO BE REALLY CONFOUNDING FOR US.
>> THANK YOU.
CLARK?
>> FOR THE RESEARCH COMMUNITY, I
WANT TO UNDERSTAND NUANCES, MANY
TIMES WE WILL COLLECT FOR
INSTANCE A RANGE OF DIFFERENT
DATASETS COMING OFF BIOSAMPLES
BUT THE REPOSITORY OF THE
BIOSAMPLES, THE DATA YOU'RE
GETTING IS ONLY AS GOOD AS
MEASUREMENT TECHNIQUES THAT WERE
DONE BY THAT INVESTIGATOR,
THAT'S THE DATA BEING SHARED IN
THESE DATASETS, IS THERE
THOUGHTS HOW TO COMMUNICATE WITH
THE INVESTIGATIVE COMMUNITY AS
TO HOW TO MAKE THE ORIGINAL
BIOSPECIMEN AVAILABLE FOR
TECHNIQUES OR REPLICATION OF
MEASUREMENT APPROACHES?
AND HAS THAT BEEN THOUGHT ABOUT
OR HOW TO COMMUNICATE THAT, OR
NOT, WITH THE RESEARCH
COMMUNITY?
THAT'S ALL.
THANK YOU.
EXCELLENT PRESENTATION.
>> THANK YOU.
THANK YOU SO MUCH, DR. STANFORD.
THAT'S A GREAT QUESTION.
I HAVE SEEN IT EMERGING BOTH
THROUGH NCBI AND THE WORK THAT
WE'RE DOING IN COLLECTING
GENOMICS DATA AND ALSO
BIOSPECIMEN DATA, LINKING THOSE
DATA IN THE GENOMICS SPHERE WITH
THE ACTUAL REPOSITORY SAMPLES.
THIS IS CERTAINLY PLAYING OUT
ALSO IN OUR COVID WORK,
ESPECIALLY IN OUR RECOVER, WHERE
WE FUNDED CLINICAL SCIENCE CORE
FOR THE CLINICAL STUDIES,
BIODATA REPOSITORY CORE FOR
SAMPLES, AND DATA RESOURCE CORE,
ALL THREE LINK TOGETHER, LINK
SAMPLES WITH THE DATA, WITH THE
CLINICAL STUDIES.
I THINK THAT HOPEFULLY WE'LL SEE
THIS EMERGING AS A COMPONENT
THAT'S MUCH MORE INSTANTIATED
HERE AT NIH BECAUSE YOU'RE
RIGHT, THE SAMPLES HOLD ALSO
FUTURE ANALYSIS CAPABILITIES,
AND IT'S A PERFECT EXAMPLE OF
MICROARRAY DATA THAT'S NOW BEEN
REPLACED WITH RNAseq, HAVING
THOSE ORIGINAL SAMPLES ENABLES
YOU TO GO BACK TO BETTER AND
MORE IN DEPTH TECHNOLOGY.
>> YES.
AND JENNIFER MENTIONED THAT
WE'VE DISCUSSED QUITE
EXTENSIVELY THE IMPORTANCE OF
STANDARDIZING DATA SELECTION
ACROSS NIDCR STUDIES.
THAT ITSELF IS A GOING TO BE --
YEAH.
AXEL, YOU WANT TO SAY SOMETHING?
>> I HAD THE EXACT SAME THOUGHT
JENNIFER PUT IN THERE.
AND JUST WANTED TO ADD TO THE
POINT WHICH IS MADE WHICH IS
THAT, YOU KNOW, YES, THE DATA IS
ONLY AS GOOD AS THE MEASUREMENTS
THAT YOU MAKE, THE TECHNIQUE,
BUT WHEN YOU THINK ABOUT USING
THIS IN DATA SCIENCE APPLICATION
THERE'S ANOTHER IMPORTANT
COMPONENT WHICH IS THAT EVEN THE
MOST ACCURATE MEASUREMENTS,
HIGHEST QUALITY DATA, IS FAIRLY
USELESS IF YOU DON'T HAVE
STANDARDS, AND IT'S IMPORTANT TO
STANDARDIZE DATA.
FOR DATA MAN REALLY PROCESSED IN
THE PAST, DON'T EVEN EXIST, SO
WHEN WE THINK ABOUT MICROARRAYS,
IT TOOK A LONG TIME TO EVEN COME
UP WITH AN AGREED UPON SET OF
METADATA STANDARDS FOR THESE
KINDS OF EXPERIMENTS, THE
COMMUNITY AGREED ON, REQUIRED
FOR DEPOSITING THAT DATA.
I'VE BEEN INVOLVED IN FACEBASE
FOR THE LAST DECADE OR SO AND WE
SEES THE SAME THING, MANY KINDS
OF DATA IN THERE THAT ARE
ONE-OFF FROM -- THEY ARE NOT
STANDARD SEQUENCE DATA, THESE
ARE DATA TYPES THAT ARE NOVEL
AND NO DATA STANDARD EXISTS.
I WOULD HOPE THAT AS PART OF OUR
DATA SCIENCE WORKING GROUP THAT
WILL BE AN IMPORTANT COMPONENT
TO THINK ABOUT WAYS HOW NIDCR
CAN POTENTIALLY PLAY A ROLE IN
DEFINING DATA STANDARDS AND IN
PARTICULAR BECAUSE I ASSUME
THERE ARE MANY DATA TYPES THAT
ARE VERY SPECIFIC TO THE KIND OF
RESEARCH THAT IS DONE BY NIDCR,
NOT BY ANY OF THE OTHER I.C.s.
AND WHERE NO SUCH DATA STANDARDS
EXIST.
SO I THINK THIS SHOULD PROBABLY
BE AN IMPORTANT PART OF THE
CHARGE OF THIS WORKING GROUP TO,
AT LEAST PROVIDE A FRAMEWORK HOW
WE MIGHT GET TO THE POINT OF
HAVING SUCH STANDARDS.
>> ABSOLUTELY.
>> LU, DO YOU WANT TO PICK UP?
>> I WILL.
QUICKLY.
THANK YOU, RENA.
SUSAN, THE NEXT QUESTION HAS TO
DO WITH WHAT I UNDERSTAND TO BE
THE SITUATION WITH THE MAJOR
CLOUD PLATFORM VENDORS.
AND, YOU KNOW, WE HEAR FROM OUR
INVESTIGATORS THAT THE VENDORS
DON'T, YOU KNOW, COLLABORATE
THAT WELL.
SO THERE'S A REALISTIC SITUATION
THAT WE AS PROGRAM STAFF HAVE TO
FACE WHEN WE TRY TO FACILITATE
OUR INVESTIGATORS AS TO, YOU
KNOW, WHAT TO CHOOSE THROUGH OUR
STRIDES INITIATIVE.
AND COULD YOU PLEASE OFFER ANY
INSIGHT ON THE FUTURE USAGE OF
THESE MAJOR CLOUD PLATFORMS
THROUGH THE STRIDES PROGRAM?
>> ABSOLUTELY, SOMETHING OF
GREAT INTEREST TO MYSELF, ALSO
TO ANDREA NORRIS, OUR CHIEF
INFORMATION OFFICER.
MY COLLEAGUES AT CIT AND STRIDES
PROGRAM, AND THE INSTITUTES AS
WELL, CREATING CAPABILITIES TO
STORE DATA ON ONE OR TWO CLOUDS
AND THEN ALLOW THAT DATA TO BE
FOUND ON A THIRD OR DIFFERENT
CLOUD, THROUGH BASICALLY A VERY
FACILE METADATA SEARCH
CAPABILITY, HAVING THAT DATA
INDEX, COMPUTED ON IN THE CLOUD.
THERE ARE SOME WORKS WE NEED TO
DO, SOME PAIN POINTS YOU HEAR
ABOUT ARE EGRESS CHARGES MOVING
FROM DIFFERENT CLOUD VENDORS
OCCURRING EGRESS CHARGES SO
ENABLING WAYS IN WHICH WE CAN
SHARE DATA ACROSS CLOUDS OR
COMPUTE ON THE DATA, WHILE STILL
MAINTAINING NECESSARY SECURITY
BOUNDARIES PARTICULARLY FOR
CONTROLLED ACCESS DATA IS
SOMETHING THAT WE WILL BE
ADDRESSING IN THE COMING YEARS
AND I THINK IS VERY IMPORTANT
FOR RESEARCH COMMUNITY AS WELL
AS ENABLING COMPUTING ACROSS
DIFFERENT ENVIRONMENTS.
RESEARCHERS DO USE HIGH
PERFORMANCE COMPUTING, AND
THERE'S A LOT OF WORK AT NIH,
DEPARTMENT OF ENERGY, NSF ON
HYBRID COMMUNITY, YOU'LL SEE IT
IN THE FEDERAL SPACE AS WELL,
NEW DISCUSSION ON HYBRID
COMPUTING ENVIRONMENTS AS A WAY
FORWARD.
>> LIKE MANY WOULD IDENTIFY IF
YOU'RE LIKE ME, HAVEN'T PUT YOUR
WEDDING PICTURES IN AN ALBUM
FROM 42 YEARS AGO, WHERE YOU
BEGIN, YOU'VE GOT PILES OF
PHOTOS.
WHAT YOU NEED TO DO IS START
PUTTING WHAT YOU HAVE CURRENTLY,
AND ORGANIZE THAT.
I'M THINKING FOR NEW
INITIATIVES, TMJ, SHÖGREN'S IS
LOOKING AT STANDARDIZATION, WE
HAVE TO MAKE SURE THAT OUR NEW
INITIATIVES WE'RE INVESTING IN,
IT'S ACROSS THE BOARD, WOULD TRY
FROM GROUND ZERO TO ESTABLISH
THESE, RIGHT?
I'M HOPING THOSE RESOURCES ARE
AVAILABLE.
>> I WANT TO RESONATE ON A
COMMENT THAT AXEL PUT IN THE
CHAT, WHICH IS REALLY WHAT WE
HAVE TO THINK ABOUT THE METADATA
AND STANDARDS REALLY THE TIME OF
THE EXPERIMENT IS BEING STOOD
UP.
IT'S SO MUCH HARDER TO THINK
ABOUT THIS WHEN THE EXPERIMENT
IS DONE AND PUBLISHED AND THEN
YOU WANT TO SHARE THE DATA.
IT'S VERY HARD FOR THE COMMUNITY
TO ACTUALLY HARMONIZE ON DATA
AFTER THE FACT AND PEOPLE SPEND
A LOT OF TIME ON THIS PROCESS.
>> I COMPLETELY AGREE.
YOU NEED TO KNOW ABOUT IT BEFORE
YOU EVEN DO THE EXPERIMENT WHAT
KIND OF METADATA YOU WILL NEED.
BASED ON MY OBSERVATION, CAN BE
DIFFICULT TO ACCOMPLISH THAT
SEEMINGLY SIMPLE TASK OF GETTING
PEOPLE TO AGREE ON METADATA
STANDARDS BECAUSE IT'S
POLITICAL, EVERYBODY HAS THEIR
OWN PREFERRED WAY THAT THEY HAVE
BEEN PUSHING PUBLICATIONS IN THE
PAST, THIS IS REALLY WHERE
FUNDING AGENCIES THAT HAVE AN
OPPORTUNITY TO DEFINE
REQUIREMENT TO ESSENTIALLY FORCE
THAT KIND OF COMMUNITY AGREEMENT
THAT MIGHT NOT HAPPEN OTHERWISE.
>> ABSOLUTELY.
THANK YOU, SUSAN.
JOHN, I WANT TO GIVE YOU A
CHANCE TO SAY SOMETHING.
ANYTHING?
>> THANKS, DR. D'SOUZA.
I'M IN AGREEMENT WITH THE
CHALLENGES HERE.
I SEE DATA FROM A VERY AGNOSTIC
PERSPECTIVE.
MY BACKGROUND ISN'T EXPLICITLY
SCIENTIFIC DATA BUT ALL KIND OF
DATA, FOR 40 YEARS NOW.
AND SO I SEE HEALTHY DATA
ECOSYSTEM AS WE IMAGINE IT IN
THE FUTURE IS GOING TO INVOLVE
STARTING LOW AND SLOW, IN TERMS
OF CATEGORIZATION, AND BUILDING
UPON LAYERS OF MATURITY AND THE
KINDS OF METADATA THAT WE
COLLECT.
AS WE'RE APPROACHING OUR DATA
SHARING AND MANAGEMENT PLAN
REQUIREMENTS, AND CALENDAR YEAR
23, IT'S ACTUALLY A NICE
OPPORTUNITY TO START
ESTABLISHING LOW-LEVEL COMMON
DATA ELEMENTS FOR ACROSS OUR
EXTRAMURAL RESEARCH PROGRAM, AND
OUR INTRAMURAL RESEARCH PROGRAM.
AND SO I THINK WE'LL SEE SORT OF
A LAYERING APPROACH TO ADDRESS
THIS PARTICULAR CHALLENGE BUT
IT'S GOING TO BE EXCITING,
THERE'S MANY OPPORTUNITIES
THERE.
LOOK FORWARD TO WORKING WITH
EVERYBODY ON THAT.
>> LYNN, WOULD YOU TAKE OVER
NOW?
I WANT TO THANK SUSAN AGAIN FOR
YOUR GENEROUS SHARING OF
KNOWLEDGE AND TIME.
>> THANK YOU.
>> VERY USEFUL.
>> WE HAVE ONE LAST ITEM ON THE
AGENDA FOR THE OPEN SESSION.
IF WE WANT TO PROCEED WITH THAT.
WE HAVE A CONCEPT CLEARANCE THAT
IS -- WE'RE REQUIRED TO DOCUMENT
THE CLEARANCE OF CONCEPTS TOKING
PRESENTED FOR THE PURPOSE
PRESENTING PURPOSE, SCOPE,
OBJECTIVES IN A PUBLIC FORUM
SUCH AS COUNCIL MEETING AND
GIVING COUNSEL MEMBERS THE
OPPORTUNITY AND PUBLIC AN
OPPORTUNITY TO COMMENT.
A PRESENTATION BY STAFF,
FOLLOWED BY VOTE FOR APPROVAL OF
THE CONCEPT.
BASIS OF DEVELOPING A FUTURE
FUNDING OPPORTUNITY
ANNOUNCEMENT.
DR. DENA FISCHER IS WITH US
TODAY, CHIEF OF THE CENTER FOR
CLINICAL RESEARCH, SHE WILL
PRESENT THE CONCEPT AND COUNCIL
MEMBERS ARE DOCTORS EBOTINO AND
STRONG WHO WILL LEAD THE
DISCUSSION.
>> THANK YOU, EVERYONE.
I THINK WE'VE HAD A REALLY LONG
TIME WITHOUT A BREAK SO THANKS
FOR HANGING IN THERE.
IT WILL BE JUST A FEW MORE
MINUTES.
SO TODAY GOOD AFTERNOON AND GOOD
MORNING TO THOSE ON THE WEST
COAST, I'LL BE PRESENTING THE
CONCEPT, WHICH IS BEING
SUBMITTED THROUGH THE HEAL
INITIATIVE, TITLED ORAL
COMPLICATIONS ARISING FROM
PHARMACOTHERAPIES TO TREAT
OPIOID USE DISORDER.
I'LL TAKE THE NEXT SLIDE.
SO, WE'VE HEARD ACTUALLY TODAY
FROM DOCTORS TABAK AND D'SOUZA
ABOUT NIDCR'S ROLE WITH THE HEAL
INITIATIVE, TO MAYBE OFFER A
BRIEF SUMMARY, HELPING TO END
ADDICTION LONG TERM, THE HEAL
INITIATIVE IS A TRANS-NIH
INITIATIVE, WITH PRIMARY GOALS
TO IMPROVE, PREVENTION AND
TREATMENT STRATEGIES FOR OPIOID
MISUSE AND ADDICTION, AND TO
ENHANCE PAIN MANAGEMENT.
SO, AS WE'VE HEARD TODAY, NIDCR
HAS BEEN AND CONTINUES TO BE
ACTIVE PARTICIPANT IN THE HEAL
INITIATIVE, SINCE INCEPTION IN
2018 BECAUSE WE HAVE A
SIGNIFICANT INTEREST IN PAIN
RESEARCH FROM PREVENTION TO
DIAGNOSIS AND TREATMENT OF ACUTE
AND CHRONIC ORAL FACIAL PAIN
CONDITIONS AND UNDERSTANDING
BIOLOGICAL MECHANISMS OF PAIN
PATHWAYS.
SO, THE CONCEPT I'M PRESENTING
TODAY HAS BEEN SUBMITTED TO AND
ACTUALLY HAS BEEN
ENTHUSIASTICALLY SUPPORTED BY
THE HEAL INITIATIVE, SO IF THE
CONCEPT IS APPROVED BY YOU, OUR
COUNCIL MEMBERS THEN THE FUNDS
WOULD BE PROVIDED BY THE HEAL
INITIATIVE.
NEXT SLIDE.
DR. D'SOUZA PAINTED A HIGH LEVEL
BACKGROUND PICTURE AS WELL, IN
HER TALK EARLIER TODAY, BUT JUST
TO OFFER A LITTLE MORE DETAIL,
THERE ARE THREE DRUGS THAT HAVE
BEEN FDA APPROVED TO TREAT
OPIOID DEPENDENCE.
BUPRENORPHINE, METHADONE,
NALOXONE.
AND IN GENERAL DUE TO THE OPIOID
EPIDEMIC, THERE HAVE BEEN
EFFORTS TO MAKE TREATMENT FOR
OPIOID DEPENDENCOR ACCESSIBLE.
SO SPECIFICALLY BUPRENORPHINE
PRESCRIBING HAS INCREASED
RECENTLY, IN RECENT YEARS,
PARTLY DUE TO THE DRUG
FORMULATION WHICH IS AVAILABLE
AS AN ORAL, DISSOLVABLE,
SUBLINGUAL OR BUCCAL FILM OR
TABLET.
AND RECENTLY EARLIER THIS YEAR
JANUARY OF THIS YEAR, AN FDA
DRUG SAFETY COMMUNICATION REPORT
INDICATED ORAL COMPLICATIONS
ARISING FROM BUPRENORPHINE
FORMULATIONS DISSOLVED IN THE
MOUTH SO THERE HAVE BEEN A
VARIETY OF COMPLICATIONS THAT
HAVE BEEN REPORTED THROUGH THIS
FDA COMMUNICATION, RANGING FROM
DENTAL -- FROM CARIES, ABSCESS,
TOOTH EROSION, TOOTH LOST, MOST
REPORTED TO THE FDA ADVERSE
EVENT RECORDING SYSTEM DATABASE.
AND THAT SUGGESTED THEY WERE
REPORTED BY INDIVIDUALS
RECEIVING BUPRENORPHINE TO TREAT
OPIOID USE DISORDER.
NEXT SLIDE.
SO, ALTHOUGH THERE ARE THESE
REPORTED ORAL COMPLICATIONS THAT
WE CAN IMAGINE, OR MORE THAN
IMAGINE, WE CAN I'M SURE AGREE
THAT THE BENEFITS OF
PHARMACOTHERAPIES TO TREAT
OUDs OUTWEIGH RISKS.
SO, AS A RESULT, CONSEQUENTLY
THE GOALS OF THIS INITIATIVE ARE
TO UNDERSTAND THE BIOLOGY,
NATURAL HISTORY, DIRECTIONALITY
OF ORAL COMPLICATIONS ASSOCIATED
WITH PHARMACOTHERAPIES TO TREAT
OUDs, AND TO ADDRESS ACCESS TO
CARE AND OTHER CHALLENGES THAT
MAY CONTRIBUTE TO DENTAL AND
ORAL DISEASE IN PEOPLE WITH OUD.
NEXT SLIDE.
THANK YOU.
OKAY.
SO, THERE ARE NUMEROUS, WE DON'T
HAVE A LOT OF TIME TO SPEAK TO
THE FDA COMMUNICATION, SO TO
ADDRESS THE NUMEROUS GAPS WE
HAVE ABOUT MECHANISM AND
CLINICAL COURSE OF DISEASE
DEVELOPMENT IN PEOPLE RECEIVING
PHARMACOTHERAPIES TO TREAT OUD,
THIS INITIATIVE IS RATHER BROAD,
WILL SUPPORT BROAD RESEARCH
AREAS INCLUDING BASIC SCIENCE
RESEARCH TO UNDERSTAND THE
ENVIRONMENT, INCLUDING THE ROLE
OF MICROBIAL FLORA, SALIVARY
PROTECTIVE FACTORS, ALSO
BUFFERING CAPACITY DURING ORAL
FARM -- PHARMACOTHERAPY USE FOR
OUD, CLINICAL RESEARCH IS NEEDED
SUCH AS EXTENT OF DE NOVO ORAL
DISEASE DEVELOPMENT, PREEXISTING
ORAL DISEASE PROGRESSION.
NEXT SLIDE.
AREAS INCLUDE COMPONENTS OF
DELIVERY PRODUCT ON TWO
STRUCTURES AND TISSUES,
IDENTIFYING DIRECT AND INDIRECT
CHANGES IN ORAL CAVITY
PARAMETERS, AND INTERACTION OF
THE MICROBIOME WITH HOST
PROTECTIVE FACTORS IN PRESENCE
OF PHARMACOTHERAPIES FOR OUD.
RESEARCH TO CHARACTERIZE
CLINICAL COURSE, PREEXISTING
ORAL DISEASE PROGRESSION, AND
RESEARCH TO ASSESS OR ADDRESS
ACCESS TO CARE, AND QUALITY OF
CARE CHALLENGES AND HOW OUD
TREATMENT MAY IMPACT DENTAL CARE
UTILIZATION, AND ALSO EXTENT TO
WHICH INTERACTION WITH MEDICAL
COLLEAGUES CAN SUPPORT
CONTINUITY OF MEDICAL AND ORAL
CARE NEEDS.
SO WITH THAT, AS DR. KING
MENTIONED, THERE ARE TWO COUNCIL
DISCUSSANTS.
AND I BELIEVE DR. EBETINO IS
GOING TO START THE DISCUSSION.
>> WOULD YOU LIKE TO BEGIN?
>> SURE.
I THINK DR. STRONG HAD A MORE
COMPLETE --
>> OKAY.
EITHER ONE.
WE CAN SWITCH.
>> I JUST HAD A COUPLE QUICK
COMMENTS I REALLY SUPPORT THE
FUNDAMENTAL RESEARCH HERE AND
BECAUSE THERE'S SO MUCH TO LEARN
AND ALSO HAD THE OPPORTUNITY TO
SPEAK WITH PRESCRIBER IN THIS
AREA AND SEE THE TRAINING
MATERIALS THAT HAVE BEEN
AVAILABLE, THERE'S QUITE A LACK
OF SENSITIVITY TO THE PROBLEMS
ORALLY, WITH THE USE OF THESE
DRUGS BY THE PRESCRIBERS.
SO GO AHEAD, DR. STROM.
>> NO PROBLEM.
VERY KIND TO SAY I'LL HAVE MORE
COMPLETE COMMENTS BUT REGARDLESS
IN THE INTEREST OF GETTING TO
THE BREAK, THE PAIRING IS GOOD
THIS TIME AROUND, I'M A
CLINICIAN.
FULL-TIME CLINICIAN.
YOU HAVE A RESEARCHER, SOMEBODY
IN THE ECONOMICS PRODUCTION
INDUSTRY, WE HAVE OUR
DISCUSSIONS THAT WERE REALLY
WONDERFUL, THE FACT THAT WEIGH
WEI CAME TO THE SAME CONCLUSION
IS EDIFYING FOR THE WHOLE
CONCEPT.
WE BOTH AGREED QUITE READILY ON
THE IMPORTANCE OF THE CONCEPT.
A COUPLE COMMENTS, WE BOTH
THOUGHT IT WAS REALLY QUITE
COOL, LET'S SAY, WE'RE LOOKING
AT THE MICROBIOME, EXPANDING
FROM WHAT'S THE IMPACT OF A
DRUG, MEDICATION, THE pH VALUE
OF SALIVA, WITH SALIVARY
TESTING, UNDERSTANDING THE
MICROBIOME, IT'S IMPORTANT THIS
IS EXPANDED AS IT IS TO INCLUDE
THOSE AREAS.
SECONDLY, AS YOU MENTIONED, THE
PHYSICIAN COMMUNITY, YOU KNOW,
THERE'S PRECIOUS LITTLE
INTERFACE WITH THE PHYSICIAN
COMMUNITY, MOST PHYSICIANS DO
NOT DO ANYTHING MORE THAN THE
BACK OF THE THROAT, SO THAT
EDUCATION AND COLLABORATION WITH
THE PHYSICIAN COMMUNITY IS
ESSENTIAL, IN MY MIND, FOR THIS
TO -- FOR THE BENCH RESEARCH TO
BEAR FRUIT, TO HELP PEOPLE OUT.
THE ONLY SUGGESTION I WOULD HAVE
MAYBE IS THAT WE FOCUS ON THOSE
INSURANCE COMPANIES AND THIRD
PARTY PAYERS WITH THE RECORDS TO
BE ABLE TO LOOK BACK AND SAY,
HOW IS THIS GOING TO WORK, HOW
DID THIS WORK OUT FOR US BY
SEEING IF UTILIZATION RATE HAS
GONE UP OR DOWN, THOSE TYPES OF
THINGS.
THAT'S MY COMMENTS.
WE BOTH TOTALLY SUPPORT THE
CONCEPT.
THANK YOU FOR YOUR WORK, DENA.
>> DO ANY COUNCIL MEMBERS HAVE
ANY QUESTIONS OR COMMENTS?
ANYTHING ELSE TO ADD?
BEFORE WE TAKE A VOTE ON THE
CONCEPT.
>> I JUST WONDERED HOW -- WHAT
DATA THE FDA IS ACTUALLY GETTING
REAL TIME, IN THIS CASE ON
BUPRENORPHINE, THAT CAUSED THEM
TO ISSUE THE ALERT.
AND HOW BEST WE CAN BE INFORMED
ABOUT THAT.
I GUESS SORT OF LOOKING UP THEIR
WEBSITE, BUT IS THERE ANY OTHER
WAY, DOES ANYONE KNOW ABOUT
REALTIME STUDIES ONGOING?
BASICALLY SAYING THAT PARTICULAR
ALERT DOES NOT WELL JUSTIFY, IT
WASN'T VALID, BUT THAT'S ONLY
SECONDHAND AND ANECDOTAL.
>> I THINK THIS WAS KIND OF A
SUMMARY OF COMPLAINTS FROM
INDIVIDUAL PATIENTS AND
PRACTITIONERS TO SHARE THAT THIS
WAS AN UNTOWARD EFFECT THAT THEY
THOUGHT WAS DIRECTLY ASSOCIATED
WITH USE OF BUPRENORPHINE.
>> YEAH.
SO I THINK JUST TO -- MY
UNDERSTANDING, CERTAINLY NOT A
COMPLETE UNDERSTANDING, BUT MY
UNDERSTANDING IS THAT FOR THE
MOST PART THIS IS DATA THAT WAS
REPORTED THROUGH THIS ADVERSE
EVENT REPORTING SYSTEM, SO IT
WOULD -- ONE WOULD IMAGINE IT'S
REPORTED AS DR. WEBSTER CYRIAQUE
MENTIONED BY PATIENTS, THOSE
TAKING BUPRENORPHINE AS WELL AS
PROVIDERS WHO MIGHT BE SEEING
THESE ORAL COMPLICATIONS OR
MAYBE HEARING ABOUT THEM FROM
THEIR PATIENTS.
I DO BELIEVE THEY MIGHT HAVE
ALSO INCORPORATED THE LITTLE
BIT OF DATA TO CASE SERIES, TO
CASE SERIES WRITTEN BY THE SAME
SET OF AUTHORS SO PERHAPS THE
SAME PATIENT POPULATION FROM A
NUMBER OF YEARS AGO.
FROM I THINK 2013 AND 2014.
SO THAT WOULD BE WHERE THE DATA
IS COMING FROM BUT I DON'T HAVE
DIRECT ACCESS TO IT.
WHICH I THINK WE NEED TO DO SOME
RESEARCH TO BETTER UNDERSTAND
WHAT IT IS THAT THE FDA HAD
REPORTED.
>> ARE THERE ANY OTHER QUESTIONS
OR COMMENTS?
P.
>> ONE LAST COMMENT, MY LAST
MEETING, THANK YOU, THE CONCEPT
CLEARANCE PART FOR THE BOARD
MEMBERS, PANEL MEMBERS, NEWER,
THIS IS THE BEST PARTHE
WHOLE MEETING, YOU GET TO DELVE
INTO SOMETHING, GET TO KNOW
STAFF AND IT'S BEEN WONDERFUL
FOR ME TO PARTICIPATE.
THANK YOU VERY MUCH FOR ASKING
ME, ONE FINAL TIME.
>> THANK YOU, JOEL.
THANK YOU FOR THE LOVELY MESSAGE
YOU YOU WROTE IN THE CHAT.
WE'LL MISS YOU, BUT YOU'RE NOT
TOO FAR OFF.
WE CAN REACH YOU, YEAH.
>> I HAVE TO ADD A THANK YOU TO
DR. STROM.
OVER THE YEARS, DR. STROM, YOU
HAVE BEEN A COUNCIL REVIEWER FOR
MULTIPLE CONCEPTS I BROUGHT
FORWARD, I'VE JUST ENJOYED OUR
CONVERSATIONS AND THANK YOU FOR
ALL OF YOUR INPUT OVER THE
YEARS.
>> THANKS.
THANK YOU.
>> THANK YOU FOR YOUR COUNCIL
CONTRIBUTIONS.
>> WOULD A MEMBER OF COUNCIL
LIKE TO MAKE A MOTION FOR
RECOMMENDATION TO APPROVE THIS
CONCEPT?
>> SO MOVED.
>> I'LL SECOND.
>> ALL IN FAVOR?
>> AYE.
>> ANY OPPOSED?
OKAY.
WE HAVE NOW REACHED THE END OF
THE OPEN SESSION.
AND I'D LIKE TO REMIND EVERYONE
YOU CAN SUBMIT COMMENTS OR
QUESTIONS ABOUT THE
PRESENTATIONS IN OPEN SESSION
TODAY TO THE MAILBOX THAT WE'LL
POST ON OUR FINAL SLIDE, UNTIL
JUNE 1, 2022.
AND I WILL NOW TURN THE MEETING
BACK OVER TO DR. D'SOUZA FOR
CLOSING COMMENTS.
>> I KNOW IT WAS AN ATYPICAL
SESSION BUT WAS ENRICHED WITH
THE INFORMATION LARRY TABAK
PROVIDED, CONTEXT OF THE FUTURE,
BRINGING IN THEMES OF SCIENCE.
I DIDN'T LISTEN BECAUSE WE WERE
INTERRUPTED WITH INTERNET
DIFFICULTIES BUT IT'S THE SAME
THING AS CONNECTING THE DOTS AND
THINKING SYSTEMS APPROACHES,
WHERE YOU NEED
MULTI-DISCIPLINARY THINKING.
SO I WANT TO SAY THANK YOU FOR
LISTENING IN.
WE'RE ENDING VERY MUCH ON TIME,
SO DESPITE THOSE HARDSHIPS, I
WANT TO STAY CONNECTED.
WE HAVE DIFFERENT FORUMS.
SUCCESSFUL ATTRACTING AN
AUDIENCE WHO IS INTERESTED IN
THE STRATEGIC PLAN ITSELF, IT
WAS A WEBINAR, ORGANIZED BY
JENNIFER WEBSTER CYRIAQUE
AVAILABLE FOR YOUR VIEWING.
IT DOES GO DEEP INTO WHAT WE
PLAN TO DO FOR THE FUTURE.
WE HAVE ANOTHER ONE COMING UP IN
JUNE.
BUT IT WILL BE MOST LIKELY JULY,
PERHAPS EVEN AUGUST, WE'RE
TRYING TO SPACE IT OUT, ACTUALLY
TAKING THE REPORT INTO ACTION,
BY LOOKING AT HOW BEST WE CAN
COME TOGETHER TO REINFORCE
PREVENTION, PREVENTIVE RESEARCH,
PREVENTIVE INTERVENTIONS, ET
CETERA.
THOUGHTS, A LOT OF BEHAVIORAL
CONDITIONING, AND IT WILL
INVOLVE ALL MAJOR STAKEHOLDER
ORGANIZATIONS, THEIR ROLE IN OUR
PROFESSION.
WITH THAT, THERE WILL BE
REMINDERS.
THANK YOU FOR JOINING.
IF YOU MISSED ANY PORTION IT
WILL BE AVAILABLE ON THE WEBCAST
RECORDING.
THANK YOU AGAIN.
BE SAFE AND BE WELL.
ENJOY THE SUMMER.
WE WILL MOST LIKELY BE VIRTUAL
IN SEPTEMBER SO PREPARE FOR
THAT.
IF THINGS CHANGE, IT MIGHT BE
HYBRID BUT WE'RE LEANING TOWARDS
VIRTUAL, RIGHT, LYNN?
MORE LIKELY?
>> YES, YES, MORE LIKELY
VIRTUAL.
>> THANK YOU VERY MUCH.
THANK YOU TO OUR SPEAKERS, TO
NIKI, AND SUSAN, AND ALL THOSE
WHO SUPPORTED THEIR FINDINGS AND
RESEARCH IN THE AREAS OF DATA
SCIENCE AS WELL.
THANK YOU.
TAKE CARE.
WE SHALL NOW GO INTO CLOSED
SESSION.