WELCOME TO THE 207TH MEETING, THIS IS GOING TO BE PROBABLY THE BEST OF ALL EVER MEETINGS OF THE NINDS COUNCIL SO WE HAVE A PACKED AGENDA, SO I'M JUST GOING TO -- WE HAVE TWO MEMBERS WHO ARE JOINING US BY PHONE NEXT TWO DAYS NITA FARHOUNI, A NEW MOTHER. ARE YOU ON THE PHONE? CONGRATULATIONS. >> YES, I'M HERE. THANK YOU. >> SUPER. AND LARRY ABBOTT. >> I'M HERE. >> GREAT. AND ALAN BAUSBAUM IS NOT ABLE TO JOIN US TODAY BUT WILL BE HERE IN PERSON TOMORROW. I WOULD LIKE TO TAKE THIS OPPORTUNITY TO THANK SID HINES FOR SERVICE TO COUNCIL, OUR EXOFFICIO MEMBER FROM THE DEPARTMENT OF DEFENSE. AND HE -- SID AND I GO BACK A LONG WAY WORKING TO CLAIM THE TBI SPACE, HE'S BEEN A TREMENDOUS ASSET TO NIH AND NINDS. AND HE'S RETIRING FROM THE MILITARY. LOOKS LIKE HE MAYBE 23, 24. BUT ACTUAL FACT HE'S BEEN -- HE'S BEEN IN UNIFORM FOR 17 YEARS. REALLY APPRECIATE HIS SERVICE. [APPLAUSE] >> GREAT. WE SHOULD HAVE A NEW DOD REP ON BOARD IN MAY. AND AT THIS TIME I'M GOING TO HAND IT OVER TO BOB. NO I'M NOT. IT SAYS CLOSED SESSION BUT THAT'S NOT TRUE. >> HELLO. WELCOME TO THE OPEN SESSION. I HAVE HEARD THIS DRILLING GOING ON IN THE BUILDING BUT NO ONE CAN FIGURE OUT WHERE IT'S COMING FROM TO TELL THEM TO STOP BUT APPARENTLY IT'S IN LITTLE BURSTS SO IF YOU HEAR IT, DON'T WORRY, I SHOULD GO AWAY. THE MEETING IS OPEN TO THE PUBLIC VIDEO CAST FOURPOSTERTY. -- FOR, POSTERITY. WE'LL BE IN CLOSED SESSION TOMORROW STARTING 8:30 IN THE MORNING. SO THE OTHER THING THAT I DON'T WANT TO FORGET ABOUT IS AT THE END OF THE OPEN SESSION TODAY WE'LL TAKE A PICTURE OF COUNCIL. SO RUSH OUT THE DOOR. IT WILL BE PRETTY INCREDIBLE. I'M GOING TO DIVE IN. THE FIRST THING IS CONSIDERATION OF THE MINUTES OF OUR LAST MEETING WHICH WERE POSTED IN THE ECB. THEY'RE UNDER TAB 2. UNLESS YOU WANTED TO DISCUSS THEM, WE NEED A MOTION TO APPROVE OR DISAPPROVE THE MINUTES. THAT'S TO APPROVE I HOPE. I SHOULDN'T SAY I HOPE. SECOND. ALL IN FAVOR OF APPROVING THE MINUTES. THIS IS JUST A DRY RUN FOR -- OKAY. ALL OPPOSED. >> AYE. >> MINUTES APPROVED M. CONFIRMATION OF DATES, THIS IS UNDER TAB 1 DATES OF FUTURE COUNCILS. ONE OF THESE DATES IS CHANGED BECAUSE OF THE -- I BELIEVE THE INTERNATIONAL STROKE MEETING SO WE HAD TO CHANGE THE DATE OF THE FEBRUARY COUNCIL WHICH IS NOW FEBRUARY 3RD AND 4TH. AND I THINK THAT'S PRETTY MUCH IT FOR THAT. NEXT, ONCE A YEAR WE HAVE TO APPROVE WHAT ARE CALLED THE COUNCIL OPERATING PROCEDURES. WHICH ESSENTIALLY ARE THE RULES BY WHICH NINDS IS SUPPOSED TO ACT WITH ITS COUNCIL. THEY ARE UNDER TAB 3 IN YOUR NOTEBOOKS. PRETTY MUCH THE SAME AS ALWAYS. THE ONLY CHANGE INVOLVES CONCEPT CLEARANCE OF NEW INITIATIVES SO OUR GENERAL POLICY HAS BEEN AT NINDS THAT IF WE HAVE AN IDEA FOR AN INITIATIVE, MOST OF THESE IDEAS COME OUT OF WORKSHOPS, CONSULTING WITH THE PUBLIC, FEDERAL MANDATES, AND THE IDEA INVOLVES SET ASIDE MONEY, WE HAVE ALWAYS BROUGHT IT TO COUNCIL FOR CONCEPT CLEARANCE. MOST INSTITUTES, MANY INSTITUTES HAVE NOT DONE THAT BUT NOW THEY ALL WILL BECAUSE THERE'S NOW A NEW FEDERAL MANDATE THAT ALL INITIATIVES WHETHER THEY INVOLVE NONE, SET ASIDE MONEY OR NOT, HAVE TO GO TO COUNCIL. SO WE JUST CHANGED THE OPERATING PROCEDURES TO SAY THAT. I FORGET THE WORDS WE USE BUT IT'S NOW ALL INITIATIVES. DOESN'T MEAN WE HAVE TO DISCUSS EVERYONE BUT YOU DO NEED TO VOTE TO APPROVE THEM. YOU WILL SEE WHAT I MEAN LATER THIS AFTERNOON. NEXT IS A FEW WORDS ABOUT THE EXPEDITED PROCESS. SO THIS IS WHERE THREE DESIGNATED COUNCIL MEMBERS, SASAN INDIRA THIS YEAR, APPROVE THESE APPLICATIONS ACROSS THE ENTIRE COUNCIL, COUNCIL CAN WEIGH IN IF THEY WANT. THE GOAL IS TO GET AWARDS OUT THE DOOR SO PEOPLE GET PROJECTS STARTED SOONER. THIS PROCESS FOCUSES ON THINGS THAT ARE STRAIGHT FORWARD LIKE RO1s WITHIN THE PAY LINE WITH NO ISSUES, NO HUMAN SUBJECTS, ANIMAL SUBJECTS. I ALMOST SAID ANIMAL RIGHTS. ANIMAL SUBJECTS ISSUES. SO THIS ROUND I'M SUPPOSED TO REPORT THIS EVERY YEAR, EVERY ROUND, 140 APPLICATIONS WERE ELIGIBLE TO BE EXPEDITED. THOUGH GRANTS MANAGEMENT OUR GRANTS MANAGEMENT BRANCH IS WORKED UP ALMOST ALL OF THEM TO BE RELEASED AFTER COUNCIL, WE COULD ONLY ISSUE ABOUT 19 BECAUSE WE DIDN'T HAVE A BUDGET UNTIL RECENTLY. WE DIDN'T KNOW FOR SURE HOW MUCH WE COULD SPEND. BUT THE OTHER ONES ARE ALREADY TO GO OUT. AS I SAY, EVERY ROUND, THIS IS A TESTIMONY TO THE EXTREMELY HARD AND EFFICIENT WORK OF OUR (INDISCERNIBLE) AND OUR GRANTS MANAGE. BRANCH. YOU WILL BE HEARING MORE ABOUT TIA IN A FEW MINUTES FROM WALLER. -- WALTER. SO WE AT THIS POINT WE INTRODUCE NEW PEOPLE WHO HAVE COME TO THE INSTITUTE. IT WILL BE GOOD IF YOU COULD STAND UP WHILE BEING INTRODUCED. I'M GOING TO START BY INTRODUCING BOSHAN CHEN. RIGHT THERE. HE IS A NEW SRO, SCIENTIFIC REVIEW OFFICER IN ERNIE LYONS NINDS REVIEW BRANCH. HE GOT HIS Ph.D. IN BIOCHEMISTRY AND MOLECULAR BIOLOGY IN 2003 FROM RUTGERS WHERE HE STUDIED TRANSCRIPTIONAL REGULATION IN YEAST. HE DID A POST DOC WITH KATHERINE ROSCH IN NINDS INTRAMURAL WHERE HE INVESTIGATED GLUTAMATE RECEPTORS IN THE BRAIN. HE THEN MOVED ON TO THE MEDICAL COLLEGE OF GEORGIA IN 2010 AS ASSISTANT PROFESSOR AND EXAMINED MOLECULAR MECHANISMS UNDERLYING THE REGULATION OF GLUTAMATE RECEPTOR FUNCTION IN PLASTICITY AND NEURONAL SURVIVAL. BOSHUN WILL OVERSEE AMONG OTHERS THINGS REVIEWS OF BRAIN APPLICATIONS IN VARIOUS BASIC NEUROBIOLOGICAL APPLICATIONS WITHIN BRAINS. WELCOME ABOARD. GREAT TO HAVE YOU. NEXT I'M GOING TO PASS IT OVER TO LYNN, HEAD OF DIVISION OF NEUROSCIENCE WHO HAS TWO OR THREE PEOPLE TO INTRODUCE. >> WE HAVE THREE NEW STAFF MEMBERS IN THE DIVISION OF NEUROSCIENCE ALL IN THE REPAIR AND PLASTICITY CLUSTER. SO I WOULD LIKE TO INTRODUCE THEM, I'M GOING SLIGHTLY OUT OF ORDER, INTRODUCING THEM IN THE ORDER THEY ARRIVED. FIRST IS DR. REBECCA BURMAN OR BECKY BURMAN N. BECKY JOINS US FROM THE NATIONAL INSTITUTES OF MENTAL HEALTH INTRAMURAL PROGRAM. THERE SHE WAS A STAFF SCIENTIST IN THE SECTION OF COGNITIVE NEUROPHYSIOLOGY AND IMAGING. HER BACKGROUND INCLUDES ABAMP ALREADY'S DEGREE IN COGNITIVE NEUROSCIENCE FROM VASER AND DID A Ph.D. IN NEUROSCIENCE UNIVERSITY OF PITTSBURGH, POST DOC WORK AT NATIONAL EYE INSTITUTE. SO SHE'S A MULTI-NIH EXPERIENCED PERSON USING NEUROPHYSIOLOGICAL TECHNIQUES TOP MAP THAT WILL MIC CORTICAL ACTIVITY IN THE PRIMATE BRAIN. AT NIMH SHAW STUDIED CIRCUITS FOR PERCEPTION AND COGNITION AND WE ARE HAPPY TO HAVE HER ON BOARD IN EXTRAMURAL. SHE'S WORKING AS A PROGRAM ANALYST IN HEALTH PROGRAM SPECIALIST IN THE REPAIR PLASTICITY CLUSTER. SHE WILL BE STARTING OFF ASSISTING WITH THE TRAUMATIC BRAIN INJURY PORTFOLIO AND THE NINDS SOMATIC GENE ENGINEERING AWARDS. THANKS, BECKY. SECOND TO ARRIVE IN THE REPAIR AND PLASTICITY CLUSTER IS DR. LINDA BAMBRIK (PHONETIC) I'M THRILLED TO HAVE ON BOARD, PROGRAM DIRECTOR MANAGING THE SPINAL CORD INJURY PILE. SHE JOINED REPAIR AND PALACETITY IN NOVEMBER. SHE TRAINED IN NEUROSCIENCE RATS THE GOT HER Ph.D. AT UNIVERSITY OF ALBERTA IN BRITISH COLUMBIA. SHE STUDIED NEUROREGULATION OF MEMBRANE PROPERTIES. SHE THEN DID POST DOC WORK ON STUDY MILE NATION IN ASTROCYTES IN JOHNS HOPKINS AND JOINED UNIVERSITY OF MARYLAND DEPARTMENT OF PHYSIOLOGY. THERE SHE WAS DID RESEARCH PROGRAM THERE. AND THEN SHE MOVED ON TO GET SOME PROGRAMMING WRITING EXPERIENCE, SHE, WORKED AS A CONTRACTOR FIRST THEN AS A FED PROJECT MANAGER AT THE DEPARTMENT OF DEFENSE CONGRESSLY DIRECTED MEDICAL RESEARCH PROGRAM OR CDMRP. THERE SHE MANAGED THE SPINAL CORD INJURY RESEARCH PROGRAM, AND SHE OVERSAW A PROGRAM PRIORITIES OVERSEEING RECEIPT OF APPLICATIONS REVIEW AND AWARDS SPEARHEADING COORDINATION ACROSS THE FEDERAL AND PRIVATE FUNDERS, WORKED VERY HARD ACROSS THE AGENCIES TO WORK TOGETHER IN COORDINATE AND SPINAL CORD INJURY. SHE ALSO SUPPORTED PROGRAMS ON NEUROMUSCULAR INJURY AND REHABILITATION. SHE'LL MANAGE THE PORTFOLIO NOT ONLY FOR SPINAL CORD INJURY BUT PERIPHERAL NERVE INJURY AND REGENERATION. THANKS, LINDA. JOINING THE REPAIR AND PLASTICITY CLUSTER MOST RECENTLY, DR. KALINDA STOKES. SO SHE TRAINED IN NEUROSCIENCE AS WELL AT THE UNIVERSITY OF MASSACHUSETTS. THEN SHE DID POST DOC AT THE PRIMATE RESEARCH SENTENCER AT EMORY UNIVERSITY. FROM EMORY SHE DID MORE POST DOC WORK AT COLUMBIA AND INTERNATIONAL UNIVERSITY STUDYING NEUROTOXICITY AND NEURODEGENERATION IN NON-HUMAN PRIMATE MODELS. SO SHE WILL BE WORKING IN REPAIR AND PLASTICITY WITH THE NEURAL ENGINEERING PORTFOLIO AND ALSO PARTICIPATING IN THE CROSS DISCIPLINARY TEAMS OF THE BRAIN INITIATIVE. THANKS, KALIND. THAT'S IT. >> THANKS A LOT. OPERATOR: SHE REMINDED MED I NEED A MOTION TO APPROVE COUNCIL OPERATING PROCEDURES. SAME AS LAST YEAR EXCEPT THE BIT ABOUT INITIATIVE. SO I NEED A MOTION ABOUT COUNCIL OPERATING PROCEED SURE. DO WE HAVE A MOTION? AYE. >> SPEAKER5: CLAUDIA FROM DIVISION OF CLINICAL RESEARCH COULDN'T P HERE TODAY, CLAUDIA IS STANDING IN FOR HIM, UP ONE INTRODUCTION. >> I'M SITTING IN FOR HIM. AT THE DIVISION OF CLINICAL RESEARCH WE RECENTLY HIRED DR. JENNIFER (INAUDIBLE) WHO JOINED US AS A HEALTH PROGRAM SPECIALIST WORKING PRIMARILY IN THE EPIIC NET PROGRAM. SHE'S NOT HERE TODAY UNER FORTUNATELY BUT -- UNFORTUNATELY BUT REPRESENTING EPIIC NET AT A CONFERENCE. PRIOR TO NINDS SHE WAS A 2017 THROUGH 2019 AAAS SCIENCE AND TECHNOLOGY POLICY FELLOW AT THE NATIONAL SCIENCE FOUNDATION IN THE DIRECTOR OF ENGINEERING. HER PROFESSIONAL TRAINING IS DRUG DISCOVERY AND DEVELOPMENT. SHE RECEIVED HER BS IN BIOCHEMISTRY FROM RUSSELL SAGE COLLEGE. IN 2011 SHE COMPLETED HER Ph.D. IN MEDICINAL CHEMISTRY FROM THE UNIVERSITY OF CONNECTICUT WHERE SHE STUDIED TARGETED DESIGN OF ANTIBIOTICS AGAINST THE ENZYME DIHYDRO FOLATE REDUCTASE. SHE WENT TO BRANDIES UNIVERSITY AS A POST DOC FELLOW IN THE BIOCHEMISTRY DEPARTMENT STUDYING YEAST MODELS OF NEURODEGENERATIVE DISEASES. PRIOR TO HER AAAS FELLOWSHIP SHE WAS AT BENTLEY UNIVERSITY STUDYING SCIENTIFIC AND BUSINESS FACTORS AFFECTING DRUG DISCOVERY AND DEVELOPMENT AND SERVED AS AN ADJUNCT PROFESSOR. SO JENNIFER, IF YOU HAPPEN TO BE WATCHING ON VIDEO CAST, WELCOME. >> DIVISION OF TRANSLATIONAL RESEARCH. >> HI, EVERYONE. DELIGHTED TO WELCOME TWO NEW COLLEAGUES WITHIN THE DIVISION FIRST ME GANG (INDISCERNIBLE), LIKE TO WELCOME HER TO NINDS AS HEALTH PROGRAM SPECIALIST, SHE WILL BE PRIMARILY WORKING WITHIN THE DEVICE TEAM FOCUSED ON TRANS-NIH BRAIN RESEARCH PROJECTS. PRIOR TO JOINING US SHE WAS A POST DOC AT BAILOR COLLEGE OF MEDICINE, DEPARTMENT OF NEUROSURGERY WHERE HE WORKED ON NEUROIMAGING TECHNIQUES AND MODULATION FOCUSED ON DEEP BRAIN STIMULATION. PRIOR TO THAT SHE RECEIVED A BACHELOR'S DEGREE FROM EMORY AND Ph.D. FROM UNIVERSITY OF GEORGIA. WELCOME. NEXT PERSON IS MARIO (INDISCERNIBLE). MAYBE PARKING. HE ACTUALLY HAD A FULL DAY TRAINING TODAY SO HE WAS TRYING TO RUN OUT HERE TO JUST CATCH THIS BUT MAYBE HE'S STICK IN PARKING. HE JOINED US AS SCIENTIFIC PROJECT MANAGER WITHIN THE CREATE BIOTEAM. MARIO BRINGS OVER 25 YEARS OF EXPERIENCE IN TRANSLATIONAL RESEARCH VACCINE DEVELOPMENT AND THERAPEUTICS DEVELOPMENT. PRIOR TO NINDS HE WAS A SENIOR DIRECTOR AND HEAD OF NON-CLINICAL RESEARCH AT EMERGING BIOSOLUTIONS, A LOCAL COMPANY HERE PRETTY WELL KNOWN. HE HAS A BACHELOR'S DEGREE FROM NEW YORK MASTERS OF SCIENCE FROM MCMASTER AND A Ph.D. FROM DAVOSE UNIVERSITY. BACK TO YOU, BOB. >> ON A SAD NOTE, I'M GOING TO ANNOUNCE THAT AN IMPORTANT DEPARTURE COMING. DR. TIA DECOSTA IN THE BACK, SHE RUNS OUR GRANTS MANAGEMENT BRANCH AND SHE IS LEAVING THE INSTITUTE AT THE END OF THIS WEEK. SHE'S CHIEF GRANTS MANAGEMENT OFFICER, SHE'S BEEN WITH NINDS SINCE 1990 AND WAS ACTUALLY -- I'M SORRY, NINDS SINCE 2007, WORKED WITH NHLBI FOR ALMOST 17 YEARS BEFORE THAT. AND THE PEOPLE WHO DON'T KNOW WORKINGS OF NIH, TWO THINGS THAT ARE MOST IMPORTANT ARE REVIEW COMMITTEES THAT REVIEW THE GRANTS AND GLANCE MANAGEMENT PEOPLE WHO SEND THE MONEY OUT. EVERYTHING ELSE CAN GO AWAY AND NO ONE WOULD NOTICE. OUR GRANTS MANAGEMENT BRANCH HAS BEEN TREMENDOUS. SO TIA ACTUALLY RECEIVED AN AWARD FROM SECRETARY KATHLEEN SEBELIUS. WHEN PEOPLE LOOKED ACROSS NIH AT THE GRANTS MANAGEMENT OFFICES THAT WERE ABLE TO GET MONEY OUT FASTEST, THE NINDS FOLKS WON BY A LAND SLIDE. SO SHE VERY ACCOMPLISHED, SHE HAS A BACHELOR'S DEGREE UNIVERSITY OF SOUTH CAROLINA OR MASTERS FROM UNIVERSITY OF MARYLAND. SHE HAS Ph.D. IN PUBLIC POLICY AND ADMINISTRATION. AND SHE HAS REALLY BEEN A ROCK IN THE GRANTS MANAGEMENT FOR NINDS, WE WILL MISS YOU, TIA. [APPLAUSE] >> SO NOW IS TIME IF YOU ARE NOT IN THE GRANTS MANAGEMENT BRANCH OR REVIEW BRANCH YOU CAN LEAVE NOW. PAUL HAS INTRODUCTIONS. >> PAUL SCOTT. IS THAT CORRECT? >> GOOD AFTERNOON. I'M PAUL SCOTT, DIRECTOR OF THE OFFICE OF SCIENCE POLICY AND PLANNING AT NINDS AND I WANTED TO TAKE THIS OPPORTUNITY TO WELCOME JENNIE KIM, SHE JOINED AS AAAS AND SCIENCE TECHNOLOGY POLICY FELLOW. A PROGRAM THAT BRINGS SCIENTISTS AT WASHINGTON D.C. AND TO NIH TO LEARN MORE ABOUT POLICY FOR A YEAR OR TWO. SO SHE RECEIVED HER Ph.D. FROM MICHIGAN STATE UNIVERSITY, WHERE SHE WORKED ON HER WORK FOCUSED ON INTEGRATION OF NEURONS BORN DURING PUBERTY IN KNOWN CIRCUITS KNOWN TO REGULATE CIRCUIT BEHAVIOR IN MICE. SHE DID A PROGRAM AT NIMH INVESTIGATING SEX DIFFERENCES AN ANESTHESIA ON ADULT NEUROGENESIS USING A RAT MODEL. SO WITH THOSE SHE WORKED ON A NUMBER OF PROJECTS HELPING WITH OUR LEGISLATIVE AND CONGRESSIONAL ACTIVITIES AND BEEN INTEGRAL PART OF OUR HELPING WITH OUR INSTITUTE WIDE STRATEGIC PLANNING PROCESS. WELCOME, GENERALNY. -- JENNIE. >> INTROS. >> QUICKLY I WOULD LIKE TO INTRODUCE THE AAAS SCIENCE AND TECHNOLOGY POLICY FELLOW IN MY OFFICE. SHE -- I OVERSEE THE NEW OFFICE OF NEUROSCIENCE COMMUNICATIONS AND ENGAGEMENT YOU WILL HEAR MORE ABOUT LATER TODAY AND SHE IS WORKING ACROSS TWO BRANCHES BOTH SCIENTIFIC AND PUBLIC ENGAGEMENT BRANCH AND NEUROSCIENCE CONTENTS AND STRATEGY BRANCH, SHE EARNED Ph.D. IN MOLECULAR BIOPHYSICS UNIVERSITY OF PENNSYLVANIA AND DR. ERICA'S LAB STUDYING MOLECULAR MOTORS. BEFORE COMING TO HUNDRED DOLLARS SHE COMPLETE AD POST DOC DEVELOPING IPSC MODEL SYSTEMS TO STUDY NEUROLOGICAL DISORDERS AND SHE WAS ALSO ORGANIZING AND PARTICIPATING IN A NUMBER OF SCIENCE COMMUNICATION ACTIVITIES DURING THAT TIME. THANK YOU AND WELCOME, MARA. >> THANKS A LOT. I JUST SAY THE INTRODUCTIONS TODAY JUST CONCORDANT WITH A REALLY TREMENDOUS STAFF NINDS HAS BEEN ABLE TO RECRUITS. SO AS YOU WILL SEE FROM OUR REPORTS WE ARE REALLY BUSY AND WE'RE HAPPY TO BE BUSY. BUT IT'S REALLY THE STAFF THAT REALLY MAKES NINDS HUM. SO I'M GOING TO GO THROUGH A QUICK REPORT. I WANT TO ALSO INTRODUCE YOU'LL HEAR MORE ABOUT THIS IN MAY WHEN JOHN AND I BECOMES OFFICIAL FEDERAL EMPLOYEE AS DIRECTOR OF THE BRAIN INITIATIVE. IT'S REALLY JUST A MATTER OF TIME RIGHT NOW AND JOHN HAS BEEN HERE AND, STAND UP JOHN FOR A SECOND. JOHN HAS BEEN HERE WORKING AS A CONSULTANT AND WILL TAKE OVER THE BRAIN INITIATIVE JOB HOPE FULLY MID MARCH AND SO HE'S COMES FROM UNIVERSITY OF CALIFORNIA BERKELEY WHERE HE'S BEEN PROFESSOR OF NEUROBIOLOGY AND HE'S BEEN WORKING IN THE BRAIN INITIATIVE AS ONE OF THE MEMBERS OF THE BRAIN INITIATIVE CELL CENSUS STEERING COMMITTEE. AND HE'S REALLY THE PERFECT PERSON TO LEAD THE BRAIN INITIATIVE INTO THE SECOND HALF. HE'S A VERY QUICK LEARNER AND ALREADY LEARN WHEN YOU GIVE AN INTERVIEW TO THE JOURNALS THEY'RE GOING TO PICK THE HEADLINE EVEN THOUGH IT'S NOT WHAT YOU STRESSED OUT MOST. SO JOHN IS CLEARLY A BASIC SCIENTIST AND IS SEES THE BRAIN INITIATIVE AS A WAY TO REALLY MOVE OUR UNDERSTANDING OF BRAIN CIRCUITS FORWARD AND TO BRING THOSE ON TO -- INTO THE CLINIC. BUT THEY -- THE REPORT IS WHEN THEY DID THE INTERVIEW. IT'S A GREAT INTERVIEW. READ IT. BUT THEY JUMPED RIGHT ON THE HEADLINE TO THE END GOAL. AND SO JOHN WILL HAVE SOME EXPLAINING TO DO TO EVE MARTER. OKAY. SO THE MONEY. WE ALWAYS START OFF WITH EXPLAINING HOW THE BUDGET HAS UNFOLDEDDED. AND REALLY PLEASED TO SAY WE HAVE BEEN INCREDIBLY FORTUNATE THIS YEAR AGAIN TO GET ANOTHER INCREASE AND SO YOU CAN SEE HERE OVER TIME THE PERCENT INCREASE WE HAVE GOTTEN SINCE THE START IN 2016, AND THE 2020 APPROPRIATION GIVES US A 7.5% INCREASE AND CAVEATS ABOUT THAT I'M GOING TO EXPLAIN, SO THAT 7.5% INCREASE GIVES US A BUDGET OF $2.1 BILLION. IN FACT, OUR TOTAL BUDGET IS $2.446 BILLION, THAT DIFFERENCE IS DUE TO FUNDS THAT HAVE COME TO NINDS FOR A PARTICULAR PURPOSES. ONE IS THE HEAL INITIATIVE WHICH IS THE HELPING TO END ADDICTION LONG TERM INITIATIVE. NINDS IS THE RECIPIENT OF THE FUNDS THAT THEN GO OUT ACROSS NIH PARTICULARLY TO WORK IN THE AREA OF DEVELOPING NON-ADDICTIVE PAIN MANAGEMENT. WE ALSO RECEIVE FUNDS FROM THE 21 CENTURY CURES ACT FOR THE BRAIN INITIATIVE SO WHEN YOU COMBINE THESE OTHER SOURCES THAT GETS US TO $2.446 BILLION WHICH IS REALLY AN AMAZING RESPONSIBILITY BUT OPPORTUNITIES TO MOVE NEUROSCIENCE AND TREATMENT OF NEUROLOGICAL DISORDERS FORWARD. IN ADDITION, WE ALSO MANAGE ABOUT 10% OF THE FUNDS THAT HAVE GONE TO THE AGING INSTITUTE TO& DO RESEARCH TO REVERSE THE THE GROWING PROBLEM OF DEMENTIA IN OUR COUNTRY. AND THAT NOW IS AT -- IS TO THE POINT WHERE WE MANAGE ABOUT $205,000,000 A YEAR OF THE ALZHEIMER'S DISEASE RELATED DEMENTIA FUNDS THAT NIA RECEIVES. SO AGAIN, THIS IS PRETTY CLEAR IN TERMS OF THE FAITH OF THE CONGRESS HAS IN NINDS AND NIH AND ALSO TO THE AMOUNT OF WORK THAT OUR STAFF ARE DOING. SO APPRECIATE THE WORK THAT THE STAFF IS DOING. AND I JUST WANTED TO FOLKS ON THE TABLE TO GET THE MESSAGE BACK OUT THINGS GO UP AND DOWN. THIS IS A GOOD TIME. WE HAVE TO KIND OF PUT THE BAD TIMES BEHIND US AS LONG AS WE CAN, WE ARE IN A REALLY FORTUNATE SITUATION RIGHT NOW. AND MESSAGING THAT IS IMPORTANT. IN TERMS OF THE BUDGET, SO THIS IS A SLIDE THAT QUINN FROM FINANCE OFFICE MADE, BASICALLY THE POINT TO MAKE HERE IS THAT THE HASH LINES ARE FUNDS THAT ARE ALREADY OBLIGATED, THE SOLID COLORS INDICATE FUNDS THAT ARE AVAILABLE FOR NEW PROJECTS. AND SO THIS IS WHAT WE THINK WILL HAPPEN IN 2020. OF COURSE WHAT HAPPENS DEPENDS ON WHAT FOLKS SAY AROUND THIS TABLE. OUR PAY LINE IS THE 16TH PERCENTILE. YOU CAN SEE THAT MOST OF THE OUTYEARS GOING TO THE GRANTS, PAY LINE GRANTS PREVIOUSLY FUNDED, THERE'S A COMPONENT IN THE ORANGE THAT GOES TO TRANSLATIONAL NON-COMPETEK, THAT'S ONBLY -- COMPETING, OBLIGATING FUNDS, IN GREEN CLINICAL TRIAL NON-COMPETING, THE GRAYISH R-35, THE EIGHT YEAR GRANT WE WILL BE TALKING ABOUT AGAIN TOMORROW IN CLOSED SESSION. SO THOSE FUNDS WHICH IF THEY WERE RO1 FUNDS THEY COME BACK IN FIVE YEARS, THESE ARE OUT -- COMMITTED OUT FOR EIGHT YEARS. THEN YOU CAN SEE IN THE BLUE SOLID, PAY LINE GRANTS FOR NEW GRANTS WE WILL BE TALKING ABOUT AT THIS COUNCIL, THEN THE ORANGE, TRANSLATIONAL, THE GREEN THE CLINICAL TRIALS, THE GRAY THE R-35s AND THE YELLOW ARE THE OTHER GRANTS WHICH ARE THE RFAs, EARLY STAGE INVESTIGATORS ABOVE THE PAY LINE. HIGH PROGRAM PRIORITY GRANTS AND BRIDGE AWARDS. WE AT THIS INSTITUTE HAVE BEEN VERY COGNIZANT OF PARTICULARLY TRYING TO PRESERVE THE WORK FORCE PARTICULARLY LABS THAT ARE -- HAVE A GRANT IN THAT LOOKS REALLY GOOD BUT JUST MISSED THE PAY LINE. SO WE USE BRIDGING FUNDS AND WE USE HIGH PROGRAM PRIORITY MONEY TO FUND THOSE GRANTS, THE BRIDGE ARE BASICALLY ONE YEAR, THE HIGH PROGRAM PRIORITY GRANTS WILL BE FUNDED FOR THE DURATION OF THE GRANTS. THAT IS PROBABLY ABOUT -- WE PIT IN $20,000,000 A YEAR FOR -- PUT IN $20,000,000 A YEAR FOR THAT PURPOSE. WHAT WE HAVE ALSO DONE FOR TO HELP OUR BUDGETING PROCESS IS TO MULTI-YEAR FUND THE R21s. THEY ARE TWO YEAR GRANTS, INSTEAD OF SENDING OUT MONEY THE FIRST YEAR AND THE SECOND YEAR, WE SEND ALL THE MONEY OUT THE FIRST YEAR AND THAT PROTECTS US A LITTLE BIT BECAUSE WE DON'T INCUR THE OUTYEAR COSTS. THAT'S THE EXPLANATION WHERE THE MONEY GOES. AND THIS SHOWS OVER TIME WHERE THE MONEY HAS GONE AND WHERE WE ARE NOW, COMPARED TO WHERE WE WERE BEFORE. SO YOU CAN SEE WE HAVE A SUBSTANTIAL INCREASE IN FUNDS, AND THIS DOES NOT INCLUDE THE TABS AND STUFF THAT GOES INTRAMURAL SO THIS IS EXTRAMURAL FUNDING. AND SO THAT'S WHERE THE TRENDS ARE. THE CLINICAL TRIALS THIS YEAR WERE INCREASED BECAUSE MONEY THAT WAS AGREED TO FUND LAST YEAR WAS HELD OVER. WE DIDN'T FUND THINGS TO START OFF WITH. WE MAKE SURE THEY ARE RUNNING BEFORE WE GIVE THEM MONEY S THERE'S MORE MONEY THAT IS BUDGETED TO GO INTO CLINICAL TRIALS THIS YEAR. A LOT OF THAT MONEY IS ACTUALLY DECIDED UPON LAST YEAR. THE OTHER THING IS THAT THE AVERAGE COST OF AFTER GRANT, A COMPETING RPG PAY LINE GRANT IS INCREASED BY $100,000 BETWEEN FY 16 AND FY 19. SO THE NUMBER OF GRANTS WE WANT TO KEEP OUR EYE ON, PARTICULARLY AS WE GET INCREASED FUNDING, BUT THE COST OF THE GRANTS IS GOING UP. ONE OF THE REASONS FOR THIS WAS THAT THE MODULAR GRANTS WHICH USED TO BE 60% MODULAR AND 40% NON-MODULAR FLIPPED. SO NOW IT'S 40% MODULAR, 60% NON-MODULAR: THE MODULAR GRANTS ARE 250. WAY BACK BEFORE I CAME HERE, THE THERE ARE ADMINISTRATIVE CUTS TO BOTH THE NON-MODULAR AND MODULAR GRANTS. WE NOW FEEL THAT IT'S TIME THAT WE CAN GET RID OF THOSE ADMINISTRATIVE CUTS TO MODULAR GRANTS, THEY HAVE BEEN 250 FOR MANY YEARS, THEY ARE NOT THAT ATTRACTIVE ANY MORE, SEEN BY THE MOVEMENT AWAY FROM THEM. AND SO THIS YEAR WE ARE GOING TO REDUCE ADMINISTRATIVE CUT FROM 12.57 WHICH HAS BEEN GOING ON FOR YEARS DOWN TO 6 AND HOPEFULLY IF THE BUDGET HOLDS TIGHT WE WILL GET RID OF IT ALL TOGETHER NEXT YEAR. THE PAY LINE GIVEN OUR OUTYEAR COSTS REMAINS ABOUT 16 PERCENTILE. BOB MENTIONED THE IDEA WE WANT TO MAKE PUBLIC THE INITIATIVE TYPE THINGS WE ARE DOING. NOT QUITE INITIATIVE YET BUT I WANT TO LET FOLKS KNOW THAT WE ARE INTERESTED IN TRYING TO FIGURE OUT HOW TO DO MORE COLLABORATIVE RESEARCH GLOBALLY. WE BELIEVE NEUROSCIENCE IS A GLOBAL ACTIVITY, GREAT SCIENTISTS AROUND THE WORLD, AND FOR US TO FIGURE OUT HOW TO DO PROJECTS TOGETHER, WE THINK COULD BE IMPORTANT TO OUR SCIENCE. AND WE THINK IT WILL BE BETTER IF THE ATTORNEY COUNTRIES PAY FOR THE -- FOREIGN COUNTRIES PAY FOR THE COMPONENT IN THE FOREIGN COUNTRIES AND WE PAY FOR THE PART DONE IN THE US. SO THIS IS A PROJECT WE ARE PILOTING DISCUSSIONS. SO WE ARE BASICALLY WORKING THE DISCUSSION STAGE TO SEE IF WE CAN DO A MEMORANDUM OF UNDERSTANDING WITH THE EUROPEAN UNION WHO HAS A PROGRAM IN NEUROSCIENCE. THEY PICK ONE TOPIC EVERY YEAR, THEY HAVE THREE -- THEY HAVE TO HAVE PEOPLE FROM THREE DIFFERENT COUNTRIES ON A PROJECT. AND RIGHT NOW SINCE U.S. IS NOT PAYING THE U.S. PEOPLE CAN'T BE PART OF THE PROJECT AT LEAST GETTING MONEY FROM THEM, SOME OF THEM UNDERSTANDING WORKING ON THEM FOR FREE. IF WE DEVELOP AN MOU IN A SYSTEM IT WORKS VERY MUCH LIKE OUR REGULAR GRANT SYSTEM EXCEPT THE PART GETS DONE FOREIGN COUNTRY PAID BY FOREIGN COUNTRY. SO YOU WILL HEAR MORE ABOUT THIS IN MAY PARTICULARLY IF THINGS GO WELL IN THE NEGOTIATIONS. WE ARE EMBARKING ON A PROGRAM TO REALLY UNDERSTAND HOW WE CAN DO BETTER IN TERMS OF ELIMINATING OR DOING RESEARCH TO ELIMINATE HEALTH DISPARITIES. AND RICHARD BENSON, IS RICHARD HERE? IN THE BACK. HE WAS INTRODUCED LAST TIME HE LEADS THE OFFICE FOR GLOBAL HEALTH AND HEALTH DISPARITIES. AND HE'S GOING TO BE LEADING THE STRATEGIC PLANNING EFFORT TO GET AS MUCH INPUT FROM OUR COMMUNITY TO KIND OF DEVELOP A PROGRAM THAT WE CAN FEEL CONFIDENT IS GOING TO MAKE A DIFFERENCE IN THIS IMPORTANT SPACE. SO THERE WILL BE IN 2020 THERE WILL BE REVIEW OF THE STATE OF THE SCIENCE, THE PORTFOLIO ON NEUROLOGICAL DISPARITIES, THERE WILL BE A PUBLIC WORKSHOP THAT WILL IDENTIFY PRIORITIES AND GUIDE STRATEGIES AND OFTEN TIMES WE FEEL, YOU HAVE SEEN THIS, THAT THESE EFFORTS ARE REALLY HELPED BY THE INPUT OF COUNCIL THROUGH A WORKING GROUP. SO WE ARE REALLY INTERESTED IF THERE ARE PEOPLE AROUND THE TABLE WHO WANT TO BE PART OF SUCH A GROUP TO HELP RICHARD AND THE REST OF US AS WE PUT THIS TOGETHER. PLEASE LET US KNOW TODAY OR SEND US EMAILS. THIS IS A REMINDER, NINA SHORE CAN'T BE HERE TODAY BUT SHE IS LEADING THE STRATEGIC PLANNING EFFORT RATS NINDS AND THIS IS -- AT NINDS. THIS IS NOW IN FULL SWING. THERE ARE TEAMS WORKING ON DIFFERENT COMPONENTS THAT WOULD PUT TOGETHER A PRODUCT THAT HELPS NINDS HIT THESE FOUR GOALS THAT ARE PUT OUT BY ANY NINA. THERE WILL BE WEBINARS TO GET THE WORD OUT FROM THE COMMUNITY, THIS IS A PLAN THAT IS REALLY FOCUSED ON MAKING NINDS A MORE EFFICIENT MORE PRODUCTIVE ORGANIZATION AND WE ARE LOOKING FORWARD TO THE WORK OF THESE GROUPS. WE WILL KEEP YOU INFORMED WHEN THEY COME AND OF COURSE THIS ALL COMES TO THE COUNCIL WHEN THE DRAFTS ARE READY. PART OF THIS PROGRAM IS AT LEAST INSIDE TO ENSURE VIBRANT TALENTED DIVERSE NEUROSCIENCE WORK FORCE BOTH NINDS STAFF BUT ALSO IN THE EXTRAMURAL COMMUNITY. TO SUPPORT A WORK CULTURE FOR BIOMED MEDICAL RESEARCH IN NEUROSCIENCE COMMUNITY IS HEALTHY AND LEADS TO PRODUCTIVITY AND FULFILLING CAREERS. SO TODAY THE MAIN PART OF MY TALK IS GOING TO BE ABOUT THE THOUGHTS WE HAVE HAD ABOUT THE GENDER DISPARITIES AND THIS IS A MULTI-REALLY COMPLICATED ISSUE BUT WE PUT THIS PICTURE AND MICHELLE SAID THERE IS SOMETHING WRONG WITH THIS PICTURE, WE FIGURED OUT IT SHOULD BE HALF AND HALF. HALF BEING HELD BY THE WOMEN AND HALF BY THE MEN. BUT THAT'S NOT WHAT THE ISSUE -- WHAT'S HAPPENING NOW. I JUST PUT THIS ALTHOUGH THERE ARE LOTS OF REASONS WHY IT'S NOT HALF AND HALF, I CERTAINLY IN TALKING TO FOLKS BEEN STRUCK BY THIS PROBLEM DENNIS HAS BEEN QUOTED NO ONE SHOULD HAVE TO CHOOSE BETWEEN CARING FOR FAMILY MEMBER AND ADVANCING PROFESSIONALLY AND NO ONE SHOULD BE HINDERED IN THEIR RESEARCH BECAUSE THEY WELCOME A CHILD INTO THE WORLD. EQUITY AND EXCELLENCE GO HAND IN HAND. NOW, THAT BEING SAID, IT'S -- WE ARE NOT IN A SITUATION WHERE WE HAVE EQUITY. SO BUT AT THE TIME I THINK IS RIGHT TO PUT A PLAN TOGETHER THAT GETS US TO EQUITY. THAT'S EASIER SAID THAT DONE SO WE LIKE THE COUNCIL'S INPUT ON HOW WE SHOULD GO ABOUT DOING THIS. THIS SLIDE IS FROM NATIONAL SCIENCE FOUNDATION, AND IT'S NEUROSCIENCE CAREER STAGES SO NEUROSCIENCE AND WHAT IT DEMONSTRATES IS THE MALE TO FEMALE RATIOS AT DIFFERENT CAREER STAGES. THE IMPORTANT POINT TO NOTE NOW IS AT THE Ph.D. LEVEL THERE ARE MORE WOMEN THAN MEN. AT THE Ph.D. EARN LEVEL THERE'S MORE WOMEN THAN MEN. AT THE POST DOC LEVEL IT'S PRETTY CLOSE, BUT IT'S AROUND 46% WOMEN. THE ASSISTANT PROFESSOR LEVEL IT DROPS TO 44, THEN ASSOCIATE TO 39. PROFESSOR TO 26. OTHER FACULTY, WE UNDERSTAND, ARE LIKE INSTRUCTORS LECTURERS, THERE IT'S HEAVILY WOMEN IN THIS DATA AND RANKED NOT APPLICABLE, NOT SURE WHAT THOSE ARE, MAYBE ADMINISTRATIVE STAFF. BUT SO THIS IS THE NATIONAL SCIENCE FOUNDATION DATA, AND IT'S NOT POINT, IF WE WERE AT THIS POINT WE WOULD BE REALLY HAPPY BUT WE ARE NOT CLOSE SO WE WANT TO TALK ABOUT THAT. IF WE LOOK AT OUR DATA, THIS IS DATA NIH HAS, THAT'S RELATED TO NINDS RO1 APPLICANTS. SO WHAT YOU CAN SEE IS THAT THE THE NUDGE OF APPLICANTS AND NUMBER OF AWARDS ARE -- THEY GO UP AND DOWN FOR WOMEN, AND BUT THEY TEND TO HANG CLOSE TOGETHER. SO THE 30% IS THE FIVE YEAR AVERAGE FOR THE APPLICATIONS AND 25% IS THE FIVE YEAR AVERAGE FOR AWARDEES. IF YOU LOOK ALONG THE PIPELINE, THAT'S WHAT WE ARE GOING TO DO NOW. IF YOU LOOK AT PREDOCS, THE F 31ST, THESE ARE Ph.D. AND THERE IT DOES KIND OF GO WITH WHAT THE NSF DATA SHOWED WHICH IS A LITTLE MORE FEMALES THAN MALES. IF YOU GO NOW TO POST DOCS, SIMILAR TO WHAT NSF DATA SHOWED, THAT IS LOWER THE RATIO OF MALES TO FEMALES IS ABOUT THE SAME AS THE MALES BUT THE POST DOCS ARE A LITTLE LESS PERCENT MAKEUP OF FEMALES. IF YOU LOOK AT EARLY STAGE INVESTIGATORS SEEN HERE IN GREEN. THE SUCCESS RATES ARE IDENTICAL. THERE'S A SLOW GROWTH FROM ABOUT 29% IN 2015 TO ABOUT 39% IN 2019 THAT'S WHERE THE NIH IS AS WELL IN TERMS OF EARLY STAGE INVESTIGATORS. SO IF YOU LOOK AT THE ESTABLISHED INVESTIGATORS, THE NON-EARLY STAGE INVESTIGATORS, THE NUMBERS ARE NOT WHERE YOU WOULD WANT THEM TO BE. THEY ARE BELOW THE 30% LEVEL AND THERE ACTUALLY IS A DIFFERENCE IN THE SUCCESS RATE, FEMALES 18.5%, MALES 19.9%. THAT'S THE FIRST TIME WE HAVE SEEN THAT DISCREPANCY. BUT THAT IS KIND OF THE PICTURE THAT THE NUMBERS GIVE US. SO THE PIPELINE COMING IN IS VERY STRONG, AND THERE IS ATTRITION AS YOU MOVE ALONG THE PIPELINE. THAT IS THE THING WE HAVE TO THINK ABOUT WHAT CAN WE DO AND WHAT ARE THE PROBLEMS. IF YOU LOOK OVER TIME, THE OTHER THING YOU RECOGNIZE IS THAT IT'S NOT CHANGEING A LOT BETWEEN 1990 AND 2016, THERE'S SOME GROWTH IN PERCENTAGE OF FEMALES BUT AT THE RATE WE ARE GO, IT MAY TAKE 20, 30 YEARS TO GET IT TO WHERE YOU WOULD WANT IT TO BE. IF WE LOOK AT OUR OTHER PROGRAMS, SOME OF THEM ARE WORSE. SOME ARE THEM ARE A LITTLE BIT BETTER. AND PEOPLE WEREN'T HERE WHEN BEN BARRIS BASICALLY WENT ON A TEAR ABOUT HOW THE JAVOT'S NOMINEES THRIVES TIME ACHIEVEMENT AWARDS FROM NINDS WERE 90% MEN SO WE MADE A POLICY DECISION WE ARE NOT GOING TO LET THAT HAPPEN SO WE HAVE BEEN ABLE TO -- IF YOU LOOK AT THE JAVITS WE ARE NOW UP TO 35% WOMEN AND SOME YEARS 100% WOMEN. SO WE CAN MAKE CHANGES THE R 35 IS A PROGRAM THAT IS SOMETHING THAT IS A REAL SPECIAL PROGRAM HERE AT HUNDRED DOLLARS, AS I MENTIONED, FUNDS PEOPLE FOR EIGHT YEARS. WE NEED MORE WOMEN TO APPLY FOR THIS GRANT. 22% FOR THE FIVE YEARS AVERAGE. IT GOES UP AND DOWN BECAUSE NUMBERS AREN'T BIG H IT WAS 31% LAST YEAR, TOMORROW IT IS NOT CLOSE TO 31%. SO WE WANT TO THINK AND GET INPUT ON HOW WE CAN DO BETTER PARTICULARLY IN SOME OF THESE PARTICULAR AREAS. IN THE BRAIN INITIATIVE, THINGS HAVE BEEN REALLY TOUGH. THE BRAIN INITIATIVE, YOU CAN SEE HERE, THE FEMALE AWARDEES AND WE ALSO IN 2017, THROUGH MICHELLE JONES LONDON'S EFFORTS ABLE TO GET A K-9 9 AWARD FOR DIVERSITY, FOR BRAIN INITIATIVE RESEARCH, BECAUSE THE DATA WAS SO IMBALANCED IN TERMS OF WOMEN, THE LAWYERS ALLOWED US TO LIST WOMEN AS A DIVERSE GROUP IN THE DIVERSE GROUP. SO THE K-99 ROO IS A DIVERSITY AWARDS BUT WOMEN QUALIFY FOR THAT, YOU CAN SEE EACH YEAR WE GET GREAT TRAINEES. THEY ARE REALLY THE ONES THAT ARE ACCOUNTING FOR THE UPTICK IN THE BRAIN INITIATIVE PEOPLE WORK HARD AT OUTREACH GOING OUT TO MEETINGS. IF WE HAVE ANY BRAIN INITIATIVE EVENT, WE ALWAYS HAVE WOMEN SCIENTISTS IN THE -- IN FRONT AND CENTER. WE HAVE PULLED ALMOST EVERY TRICK IN THE BOOK THAT WE COULD BUT WE HAVEN'T MADE A LOT OF PROGRESS EXCEPT AT THE TRAINEE STAGE. THAT'S SOMETHING JOHN AND THE REST OF US WILL BE PUSHING IN THE FUTURE. BUT WE ARE LOOKING NOW FOR FOR HELP. MICHELLE JONES LONDON AND HER GROUP HAS DONE THE Y SURVEY, THE QUESTION IS WHY DID YOU DO WHAT YOU DO WITH YOUR CAREER. SO THAT'S -- THEY GOT INVITED 6,000 RESPONDENTS THESE ARE PEOPLE WHO GOT TRAINING AWARDS, RECEIVED 2,675 RESPONDENTS. AND IT'S A LOT OF WORK. STILL ANALYZING, I'M JUST GOING TO SHOW YOU A COUPLE OF THINGS. SO WE LOOKED AT THE GENDER DIFFERENCES IN THE Y SURVEY THESE ARE THINGS THAT CAME OUT THAT WAS STATISTICALLY SIGNIFICANT. THE CAVEAT IS THAT THE EFFECT SIZES ARE REALLY QUITE SMALL. THERE'S MEASURE OF EFFECT SIZE SMALL TO MODERATING NOTHING HAT A HIGH EFFECT SIZE. BUT WHEN YOU LOOK AT FOLKS IN -- WHO COME IN, THE MORE WOMEN ARE INTERESTED IN SCIENTIFIC NON-RESEARCH AND TEACHING FOCUS CAREERS, MORE MEN ARE INTERESTED IN ACADEMIC RESEARCH, NON-ACADEMIC RESEARCH AND NON-SCIENCE CAREERS. WOMEN ARE LESS INTERESTED IN ACADEMIC RESEARCH POSITIONS FROM THE BEGINNING. THE ASPECTS OF THE CAREERS ARE IMPORTANT, WHY IS THAT, WE DON'T KNOW EXACTLY BUT ONE MAY BE THE ASPECT OF CAREER IS IMPORTANT TO WOMEN DIFFER, IN MEN THEY VALUE HIGH AUTONOMY IN THEIR POSITIONS. THEY LOOK FOR AND WOMEN WORK LIFE BALANCE IS MORE AN ISSUE. THIS ONE IS INTERESTING, I WANT TO LOOK AT IT BUT THERE'S TWO WAYS OF READING THIS. FEWER WOMEN FEEL CONFIDENT IN POTENTIAL TO BE AN INDEPENDENT RESEARCHER THAN MEN. THE OTHER WAY TO READ IT IS MEN FEEL OVERCONFIDENT ABOUT THEIR POTENTIAL TO BE INDEPENDENT RESEARCHERS COMPARED TO THE WOMEN. I THINK BOTH OF THOSE THINGS ARE CAN BE TRUE PROBABLY ONE IS TRUE AND PROBABLY NOT THE FIRST ONE, PROBABLY THE SECOND ONE. THAT IS BUILT UP BY A LOT OF OTHER EVIDENCE OUT THERE THAT MEN TEND TO BE MORE BRAGGY AND SELF-CONFIDENT ABOUT THEIR SCIENCE WHETHER THE WORDS THEY USE IN THEIR RESEARCH, IN THEIR GRANTS, ALL KIND OF POINTS IN THAT WAY. OF THE -- A DISTURBING NATURE IS FEWER WOMEN FEEL POSITIVE ABOUT THEIR RELATION WITH THEIR PRIMARY TRAINING ADVISOR THAN MEN. SO I THINK ONE HAS TO DISSECT OUT WHY THAT IS. BUT THERE'S CLEARLY GENDER BIAS THAT COMES INTO PLAY AND MULTIPLE OTHER ISSUES THAT THE WOMEN WOULD HAVE TO DEAL WITH THEIR MENTORS MAY NOT BE SO ENTHUSIASTIC ABOUT. THEN MEN ARE ALSO GETTING MORE FIRST PEER REVIEWED PUBLICATIONS THAN WOMEN. AND THESE THINGS DIFFER AMONG THOSE WHO END UP IN RESEARCH POSITIONS AND THOSE WHO DON'T. SO THAT'S KIND OF THE DATA THAT WE HAVE SO FAR. THERE ARE SOME QUALITATIVE DATA WE COLLECTED. AND I MENTIONED THE QUOTE FROM DENNIS TORNEY BEFORE, BUT HERE ARE SOME OF THE THINGS IN HIGHLIGHT. SERIOUS CULTURAL PROBLEMS INVOLVING GENDER THAT NEED TO BE ADDRESSED IN SCIENCE COMMUNITY. THE REASON I CAN'T CONTINUE IN ACADEMIA IS BECAUSE I'M A MOTHER. THERE NEEDS TO BE BETTER MENTORSHIP FOR WOMEN WHO WANT TO PURSUE SERVICE AND HAVE A FAMILY. I HAVE SEEN GRADUATE STUDENTS AND POST DOCS WHO ARE DOING WELL FIRED WHEN THEY EITHER ANNOUNCE THEIR PREGNANCY OR THEIR PREGNANCY BECAME OBVIOUS. LITTLE TO NO SUPPORT FOR GRADUATE STUDENTS AND POST DOCS WHO WANTS THE START A FAMILY. MATERNITY LEAVE OPTIONS ARE INCREDIBLY POOR, MOST INSTITUTIONS DO NOT OFFER THE QUALITY CHILD CARE. AND BEING A WOMAN DID NOT MAKE ME LESS LIKELY TO BE AN INTELLIGENCE PRODUCTIVE SCIENTIST, FIXING BLATANT SEXISM WITH IMPLICIT BIAS IS NOT EASY. YOU CAN SEE FROM THESE QUOTE THAT PEOPLE HAVE BEEN -- HAVEN'T FELT AS THOUGH THEY HAVE BEEN BIASED AGAINST OR HURT IN TRYING TO PURSUE CAREERS. AND THAT'S SOMETHING THAT I DON'T THINK ANYBODY CAN FEEL GOOD ABOUT. QUESTION IS HOW TO FIX IT. WE PROBABLY TAKED ABOUT IN AT OTHER MEETINGS. BUT NOW WE ARE THINKING THAT THERE ARE A COUPLE OF THINGS NIH IS DOING, NONE OF THEM I DON'T THINK FIX THE PROBLEM ALL TOGETHER. BUT THE PROBLEM TO BE FIXED PROBABLY NEEDS MORE THAN NIH, IT NEEDS THE WHOLE COMMUNITY TO COME TOGETHER TO SOLVE THESE PROBLEMS. I THINK IN THE PAST WE HAD ONE THING HERE AND ONE THING THERE. I DON'T KNOW THAT IT MADE MUCH DIFFERENCE BUT WE HAVE A BUCKET OF THINGS, A BUNDLE OF PROGRAMS THAT WILL HELP WOMEN WHO ARE PASSIONATE ABOUT SCIENCE TO STAY IN SCIENCE ACADEMIC SCIENCE AS A CAREER. NOW, THERE'S CERTAINLY, IT'S NOT -- WE ARE NOT SAYING THAT IT'S BAD NOT TO, BUT FROM THE STANDPOINT THAT'S WHAT WE WANT, WE WANT PEOPLE TO COME INTO LABS AND RUN PROJECTSES. SO THESE ARE THE THINGS WE ARE TALKING ABOUT QUICKLY. SO THERE ARE NOW WE THINK PROGRAMS THAT WE -- WE HAVE PROGRAMS THAT WILL SUPPORT HIRING FROM COHORTS OF DIVERSE SCIENTISTS THAT INCLUDES WOMEN WHEN THE WOMEN ARE MINORITY, THAT'S THE BRAIN INITIATIVE K-9 9 I MENTIONED. WE HAVE BEEN ABLE TO WORK WITHIN NIH TO EXPAND THE TIME WINDOW OF ELIGIBILITY FOR ALL TRAINING GRANTS TO ACCOMMODATE CHILDBIRTH AND ADOPTION AND REMOVE ACTUAL PERCEIVED BARRIER IN TERMS OF THAT TIME OF GETTING IN BEFORE YOU ARE NOT ELIGIBLE FOR A TRAINING GRANT. WE DO REQUIRE A PLAN FOR CHILD CARE AND ALL NIH ACADEMIC CONFERENCES AND GRANT SUPPORT FOR MEETINGS IS AN ALLOWABLE EXPENSE FOR FEDERAL MONEY TO BE USED FORNA MUCH PURPOSE. FOR THAT PURPOSE TO THE GRANT PEOPLE. ADDITIONAL FUNDS TO PROVIDE TECHNICIAN RESEARCH SUPPORT TO POST DOCS OF INVESTIGATORS IS SOMETHING THAT IS HAPPENING AND THERE ARE TALK ABOUT THOSE COMING UP. MICHELLE WAS WORKING WITH HER GROUP ON A PRIOR TO HIRE COHORT DIVERSE FACULTY INTO NEUROSCIENCE PROGRAMS. AND DIVERSITY HERE IS GENDER ETHNIC SOCIO ECONOMIC AND GENDER AS WELL. THAT PROGRAM WAS RECENTLY PRESENTED AS ENTIRE NIH PROGRAM BY HANNAH VALENTINE AND GOT ENTHUSIASTIC MARKS FROM THE COUNCIL OF COUNCILS. SO LET'S TACONITE -- TALK ABOUT THOSE. THE POINT I WANT TO MAKE AND JOHN BURKLOW IS HERE AND YOU WILL HEAR FROM AMY ADAMS NEXT ABOUT COMMUNICATIONS THAT WE NEED TO MESSAGE THIS BETTER BECAUSE WE ARE FIGHTING UPSTREAM. SO THE EXTENSIONS POLICIES, EXTENSIONS FOR ONE YEAR FOR CHILDBIRTH WITHIN THE FOUR YEAR K-99 ELIGIBILITY WINDOW, THERE'S EX TENSION OF ONE YEAR FOR ESIs, ELIGIBILITY FOR CHILDREN WITHIN THE ESI PERIOD, THE NINDS HAD FOR A NUMBER OF YEARS AN F-32 POST DOC WHERE WE PROVIDE A 6 MONTH EXTENSIONS TO ENSURE THE FELLOWSHIP RESEARCH TRAINING CAN BE COMPLETED. TO FOLKS WHO HAVE NEW CHILDREN, AND THAT IS SOMETHING WE HAVE BEEN DOING HARDLY ANYBODY EVER CALLS US TO ASK FOR THIS. NOW SOME TRANS-NIH PROGRAMS THAT HAVE JUST COME OUT, THERE HAS BEEN A LONG TIME RESEARCH ELEMENTS TO PROMOTE REENTRY INTO BIOMEDICAL RESEARCH BEHAVIORAL CAREERS. I KNOW THERE ARE ACTUALLY IC DIRECTORS WHO LEFT SCIENCE FOR A WHILE, HAD THEIR FAMILIES AND THEN COME BACK. BUT AGAIN, NOT A VERY POPULAR MODE. SUPPORT FOR CONFERENCES IN SCIENTIFIC MEETING WE TAKED ABOUT. WHAT'S NEW IS ADMINISTRATIVE SUPPLEMENTS UP TO $50,000, ARE AVAILABLE NOW TO PROMOTE RESEARCH CONTINUES ANNUITY AND RETENTION OF NIH K AWARDEE RECIPIENTS. THIS WOULD APPLY TO WOMEN WHO HAVE KIDS DURING THEIR K AWARD AND THE SAME PROGRAM ALSO EXISTS NOW FOR PEOPLE WITH THEIR FIRST RO1 GRANT. SO THIS WOULD ALLOW FOLKS TO GET MONEY TO HIRE A TECH OR SOMEONE ELSE TO COME IN AND HELP DURING THIS PERIOD WHERE YOU ARE NOT ABLE TO BE AT THE BENCH THE SAME AMOUNT OF TIME IN THE PAST. THIS IS THE COHORT HIRING PLAN THAT HANNAH VALENTINE PUT TOGETHER FOR THE COMMON FUND. THIS IS PUT TOGETHER WITH A BUDGET, $240,000,000, THIS IS NOT SMALL CHANGE. AND THE GOAL IS TO HAVE UNIVERSITIES OR DEPARTMENTS, WE WOULD LIKE NEUROSCIENCE DEPARTMENTS TO HIRE A GROUP OF FOLKS FROM DIVERSE BACKGROUNDS SO THEY ARE NOT THE ONLY FEMALE IN THE DEPARTMENT. THE ONLY AFRICAN AMERICAN OR ONLY HISPANIC IN THE DEPARTMENT. WE THINK THAT WOULD BE MORE SUCCESSFUL FOR THEM. WE ALSO THINK THAT THE TRAINEES, IF THEY SEE A GROUP THAT LOOKS LIKE THEM AND CAME FROM WHERE THEY CAME FROM, THAT WILL BE SOMETHING THAT WILL REALLY BE IMPORTANT AND MOTIVATE THEM TO CONTINUE. WHAT WE TALKED ABOUT WITH GENDER IS MUCH MUCH WORSE FOR THE UNREPRESENTED -- UNDER-REPRESENTED MINORITIES. THIS WILL ALSO HAVE -- THEY WILL BE LOOKING AT DATA SO WE'LL HAVE A COORDINATION CENTER AND SO WE ARE REALLY EXCITED, MICHELLE DID A LOT OF WORK ON THIS AND EXCITED THE COMMON FUND LOOKS TO BE TAKING IT UP. NOW, SO WE ARE GOING TO TALK A LOT ABOUT MESSAGING AND COMMUNICATIONS TODAY. THIS IS A POINT TO MAKE THAT THERE'S BEEN A LOT OF PUBLICATIONS RECENTLY ABOUT THE LANGUAGE THAT COMES WITH SAY A JOB POSTING OR A TYPE OF A GRANT. AND ARE THESE -- ARE THERE THINGS THAT ARE -- THAT WE CAN DO DIFFERENTLY ON MESSAGING THAT WILL CHANGE THE GENDER IMBALANCE. THE NIH, IT IS NOT NINDS ALONE, ACROSS NIH MAYBE NOT ALL INSTITUTES BUT THEY ARE PUTTING ATTENTION NOW, THERE WAS AN RFI OUT NOW BECAUSE THE HIGH RISK HIGH REWARDS PROGRAMS ARE HAVING PROBLEM ATTRACTING WOMEN APPLICANTS. WHICH DON'T THINK THERE IS A DIRTH OF QUALIFIED WOMEN TO APPLY BUT THE QUESTION IS, IS THE MESSAGING WRONG? IS IT LIKE YOU HAVE TO BE REALLY STRONG AND BE ABLE TO RUN AND JUMP AND HURDLE TO GET THESE GRANTS. I PLAY THE PIANO, DOES THAT HELP? IT MAY BE THE MESSAGING IS ALSO IMPORTANT AS WE PUT DOWN -- PUT OUT THESE PROGRAMS, FOR US THE R-35 IS THE ONE WE ARE MOST CONCERNED ABOUT, IT'S A GREAT PROGRAM, WE NEED MORE WOMEN APPLICANTS AND IS IT A MESSAGE, RIGHT, IS IT SUPPOSED TO BE FOR PEOPLE WHO USE THOSE BIG WORDS. AND MAYBE THAT'S A GENDER BIAS. BUT SO WE REALLY WOULD LIKE SOME IDEAS HERE. LASTLY, I'M JUST GOING TO CLOSE BY SAYING THAT IF YOU HAVEN'T HEARD THESE PODCASTS, THESE ARE FANTASTIC. SO WE HAVE PUT TOGETHER A PODCAST CALLED BUILDING UP THE NERVE, THEY HAVE DIFFERENT PEOPLE INTERVIEW, IT'S ABOUT HOW NIH WORDS, HOW GRANTS ARE FUNDED. YOU THINK IT'S REALLY BORING BUT THEY ARE SO GOOD AT IT, IT'S EXCITING TO LISTEN. SO I ENCOURAGE YOU AND GET YOUR FOLKS TO LISTEN TO THESE. THEY ARE QUITE GOOD. HOPE THEY DON'T LEAVE AND START A BUSINESS DOING PODCASTS. THANKS. QUESTIONS? SUGGESTIONS? >> I HAVE CURIOUS ABOUT THE NEURON PROGRAM YOU MENTIONED. WILL THAT INCLUDE GREAT BRITAIN OR UK? >> THAT'S A GOOD QUESTION. AND WE ARE GOING TO STAFF A CALL NEXT WEEK TO SEE. I DON'T THINK THEY KNOW RIGHT NOW. BUT I THINK MAYBE BEARE THINKING THE SAME THING. IF THE BRITISH DROP OUT OF THE EUROPEAN UNION, THEN WHAT ABOUT US? NOW WE HAVE INTERNET, THE PLANES ARE NOT THAT BAD, YOU GET ACROSS, I THINK THAT COULD BE AN OPPORTUNITY FOR THE U.S. TO BUILD BRIDGES TO THE BRITISH SCIENTISTS. SO WE'LL TALK TO THE MRC FOLKS NEXT WEEK ABOUT THAT KAREN. >> CONGRATULATIONS TO THE WORK SHE'S DONE WITH THE WOMEN IN THE URM BUT AS IT RELATES TO THE WOMEN IN SCIENCE, AND YOU SHOWED THE Ph.D. DATA MD DATA ALSO SHOWS WOMEN HAVE BEEN ABOUT 50/50 IN THE PIPELINE FOR 20 YEARS. THE FACT THAT WHEN MICHELLE IS INTERVIEWING THEM WHEN DISPARITY SLAPPING AND THEY ARE NO LONGER BEING SUCCESSFUL IN ACADEMIC CAREERS BUT 20 YEARS PRIORITIZING SCIENTIFIC TRAINING AND THEY DO LOVE SCIENCE, SUGGESTS TO ME WE ARE SENDING THEM SOME SORT OF MESSAGE BETWEEN THE TIME THEY START MEDICAL OR GRADUATE SCHOOL AND THE TIME THEY GET INTO THEIR ACADEMIC PROFESSION. AND THAT'S WHAT I THINK WE HAVE TO UNDERSTAND WHAT IS THE MESSAGE WE ARE SENDING THAT MAKES THEM SAY I DON'T THINK I'M GOOD AT SCIENCE. I'M NOT CONFIDENT THAT I WILL GET A GRANT. THAT'S THE PIECE THAT I WOULD ASK THAT WE CONTINUE TO LOOK AT. >> I THINK YOU ARE RIGHT. THAT'S THE EXACT VULNERABLE SPOT. I THINK INDIRA WAS NEXT. >> HERE I AM, GOT IT. SORRY. I NOW FEEL CONFIDENT THAT I CAN USE THIS PROPERLY. I WAS ONE COMMENT AND ONE QUESTION. OR THE OTHER WAY AROUND. I WAS INTERESTED IN THE Y SURVEY OF COURSE AND IT SAID THAT FEWER WOMEN FEEL CONFIDENT IN THEIR POTENTIAL TO BE INDEPENDENT RESEARCHER BUT THERE WAS ALMOST NO DIFFERENCE AMONG THOSE? ACADEMIC RESEARCH POSITIONS SO THAT MEANS THOSE PEOPLE IN ACADEMIC RESEARCH POSITIONS WHEN THEY WERE EVALUATING ON SOME SCALE, HOW CONFIDENT ARE YOU,ING THIS CAME OUT SAYING THOSE WOMEN HAD CONFIDENCE IN THE ONES THAT GOT WENT OUT DIDN'T. BUT FOR THE MEN THEY WERE EQUALLY CONFIDENT WHETHER THEY WERE IN THE PROFESSION OR NOT. >> DUMB OR NOTMENT EXACTLY. >> VERY INTERESTING. SO THE GENERAL COMMENT, I WAS ALSO VERY INTERESTED IN ALL THE COMMENTS ABOUT HAVING CHILDREN AND SO -- OF THE 50% OF MY WOMEN TRAINEES HAVE HAD CHILDREN, ALL BUT ONE WHO LEFT MY LAB HAD CHILDREN AFTERWARDS, FOLLOWED ALL THEIR EXPERIENCES. AND I WILL SAY ONLY TWO ARE IN TENURE TRACK POSITIONS. WHAT WHICH I'M INTERESTED IN IS WHETHER THERE'S DISCUSSIONS ABILITY THE KIND OF SUPPORT THAT GOES NOT JUST TO THE INDIVIDUAL HAVING THE CHILD BUT TO THE ENVIRONMENT SUPPORTING THAT INDIVIDUAL HAVING THE CHILD SO THAT INCLUDES THE LABORATORIES BECAUSE THERE ARE INDIVIDUAL PIs WHO WANT TO BE SUPPORTIVE BUT THEY SEE THIS SUCCESSFUL YOUNG FEMALE TRAINEE WHO IS DOING THE GREAT PROJECT AND NOW WE ARE GOING TO GO THROUGH THE CHILDBIRTH AND THE AFTER PERIOD. HOW DOES THAT PI HELP THE TRAINEE BUT ALSO MAINTAIN RESEARCH PROGRAM ESPECIALLY IF IT'S A SMALLER LAB THAT CAN ABSORB LOSS OR HAS A HARD TIME ABSORBING THE LOSS OF 20% OF THEIR LABORATORY DURING THAT TIME. I THINK THAT INCLUDING THE VILLAGE THAT'S TRYING TO -- THAT'S LOCAL, IN THE SUPPORT WOULD BE REALLY IMPORTANT. I ALSO THINK THIS IS EXTREME BUT UNIVERSITIES THAT HAVE ON SITE CHILD CARE, THAT IS AVAILABLE TO THE TRAINEES AND YOUNG FACULTY MEMBERS, CAN THEY GET BETTER INDIRECTS THAN THE UNIVERSITIES THAT DON'T? I MEAN, IS THERE SOME WAY TO ENCOURAGE THE UNIVERSITIES TO MAKE THAT ENVIRONMENT AGAIN THE VILLAGE, WHERE THE TRAINEE IS? BECAUSE THE BUSINESS OF MANAGING CHILD CARE EVEN THOSE PEOPLE WHO WANT TO CONTINUE ON THE FIELD IS REALLY DIFFICULT, IT GOES BEYOND THE ABILITY OF JUST THE LABORATORY ENVIRONMENT TO SUPPORT THEM. >> RIGHT. SO COUPLE OF QUESTIONS HERE. YES S. WE THINK THAT ENCOURAGING MENTOR AT THIS PERIOD OF TIME IS ESSENTIAL. AND WE THINK THAT BECAUSE OF SOME OF THE THINGS YOU MENTIONED ABOUT THE WORK SLOWING DOWN, AND BLAH BLAH BLAH, NUMBER OF MENTORS ARE NOT ENCOURAGING. MENTOR WHO IS NEGATIVE ABOUT THE TRAINEE WHEN THEY ARE HAVING A KID, THAT IS PROBABLY GOING TO DRIVE SOMEBODY OUT. IN TERMS OF CHILD CARE, SO THERE WAS AN ADVISORY COMMITTEE DIRECTOR REPORT AND THAT WAS ON THIS TOPIC. THAT WAS ONE OF THE BIG ISSUES IS HOW DO YOU GET CHILD CARE? SO THEY MADE A RECOMMENDATION THAT NIH SHOULD PAY FOR CHILD CARE. SO FRANCIS IS LOOKING INTO THE LEGALITY OF THAT. BECAUSE I THINK THAT ALSO HAS COME TO THE TOP. MULTIPLE TIMES. WHY THAT IS SAW PROBLEM FOR THE WOMEN AND NOT THE MEN, A LOT OF PEOPLE ARE ANGRY THAT WE EVEN MENTION IN THAT TONE. EXCEPT IT PROBABLY IS REALITY. >> THERE'S A RELATED POINT, I'M SORRY TO GO ON, BUT OFTEN THERE ARE PLENTY OF VERY SUPPORTIVE MALE ADVISORS, I WANT TO START BY SAYING -- >> DOESN'T HAVE TO BE MALE. >> BUT THERE ARE OFTEN WOMEN WORKING FOR WOMEN. BECAUSE THERE'S THE WHOLE BUSINESS OF LUCKY TO HAVE SOMEBODY LIKE THEM SO IF YOU HAVE A SITUATION AND A YOUNG WOMAN ADVISOR SUPPORTING A YOUNG WOMAN TRAINEE OR MIDDLE AGE WOMAN ADVISOR, DOESN'T MATTER, AND THAT PERSON IS WILLING TO TAKE A HIT THAT DECREASEs THAT FEMALE PI PRODUCTIVITY AND HELP IT IS DROPPING OFF YOU ARE SEEING IN TERMS OF PROMOTION FROM ASSOCIATE TO FULL PROFESSOR, SO FORTH. I THINK THAT THE SUBSETS OF FACULTY WHO IS WILLING TO BE SUPPORTIVE THEY ARE ALSO WILLING TO TAKE THE HIT THEMSELVES, THAT PLAYS OUT AT A DIFFERENT LEVEL. >> I SEE. >> I THINK THAT IS REALLY THINKING ABOUT THE SECONDARY EFFECT AND I FEEL VERY CONFIDENT THIS IS THE CASE. >> I SHOULD MENTION INDIRA'S PROTOJADE GOT TEN YOUR MONDAY. . CLAUDIA. OKAY. AND DAVID. YEAH. YOU JUST HIT THE GUY WHO LOOKS LIKE HE'S THROWING UP. >> I JUST WANT TO GIVE COMMENT ABOUT CONFIDENCE. I THINK WE HAVE TO BE CAUTIOUS AROUND HOW THAT WORD IS USED. BECAUSE A TENDENCY WILL BE THAT WE SLIP INTO THE SPACE TO BELIEVE THAT CONFIDNCE IS -- THERE'S SOMETHING ABOUT THE WOMAN, SHE'S JUST NOT CONFIDENT ENOUGH WE HAVE TO WORK ON BUILDING CONFIDENCE. TWO DRIVERS THERE, STUDIES HAVE SHOWN SOME OF THE ASPECTS OF CONFIDENCE IS THE OVERCONFIDENT WOMAN FACES BACKLASH SO THERE'S A BIAS THAT DRIVES THAT; WE NEED TO RECOGNIZE THE ENVIRONMENTS WE ARE BALANCING THAT. THE SECTION IS SEROTYPE THREAT. THE REALITY A WOMAN IN AN ENVIRONMENT WHERE THERE MIGHT BE PERFORMING TO MATCH THE BIAS THERE. SO A WOMAN TAKING A MATH TEST IN A ROOM FULL OF MEN MAY FEEL AN EXCESS COGNITIVE EMOTIONAL BURDEN WHICH REDUCES HER PERFORMANCE. YOU HAVE HER TAKE THAT TEST WITHOUT MEN IN THE ROOM, HER PERFORMANCE GOES UP. SAME PERFORMANCE. SO THE CONCEPT OF HOW WE TACKLE NIH, OTHER AREAS OUR ENVIRONMENT STEREOTYPES IS DRIVEN AROUND INGRAINED BIASES SO OUR PROGRAMS ARE APPROPRIATE AND I APPLAUD THE MOVEMENT GOING FORWARD. BUT INCREASINGLY THE CONFIDENCE ONE WILL BE CONTINUE TO BE THE SOMETHING OF WHEN MUCH OF IT IS THE ENVIRONMENT. SO WE NEED TO HELP REALLY BALANCE THAT SO THAT OUR PROGRAMS ARE GOING AT THE HEART OF THE ISSUES WHICH ARE DRIVEN THROUGH PRESCRIPTIVE NORMATIVE BIASES THAT ARE MAKING A FUNDAMENTAL PIECE. SO AS WE LOOK FORWARD WE SHOULD BE THINKING ABOUT BALANCING THAT IN THE ENVIRONMENT CONDUCIVE TO A WOMAN TO SUCCEED. >> I THINK THAT'S SOMETHING THAT NIH CAN CERTAINLY ENCOURAGE. AS PARTS OF THE COHORT PROGRAM THE INSTITUTIONS HAVE TO DEAL WITH THE -- WHAT ARE WE GOING TO DEAL WITH THAT WILL CHANGE THE CULTURE? WHICH IS WHAT WE ARE GETTING AT. SO PART OF THAT COHORT HIRING IS THE HIRING. THE OTHER PART IS ACTUALLY CHANGING THE ENVIRONMENT FOR THE WHOLE INSTITUTION. SO WE THINK HOPEFULLY THEY WILL HAVE SOME IMPACT BUT IT CAN'T BE MORE THAN 20, 30 PLACES. REALLY HAVE HUNDREDS OF PLACES TO DEAL WITH. I THINK IF THE BALL GETS ROLLING, WE WILL BE IN BETTER SHAPE. DAVID. (OFF MIC) >> FOLLOWING ON, I THINK ALL THE COMMENTS YOU HEARD ARE EXACTLY THE PROBLEM, AND PUT ANOTHER VIEW OF IT THE VAST MAJORITY OF PEOPLE WE ARE TALKIN ABOUT DO NOT WORK FOR NIH AND OBVIOUSLY NONE OF THE PEOPLE ARE GETTING E -- EXTRAMURAL FUNDING SO THE ISSUE IS WHAT'S GOING ON AT THEIR RESEARCH CENTERS AND THEIR UNIVERSITIES. THIS GETS A LOT OF ATTENTION IN THE ACADEMIC WORLD BUT IT STRIKES ME THAT NIH PERHAPS SHOULD CONVENE WITH THOSE PARTS OF THE RESEARCH ENTERPRISE. ABOUT WHY THEIR POSITIONS ARE APPARENTLY CONSIDERED LESS APPEALING BY WOMEN THAN BY MEN. AND WOMEN ALL UP AND DOWN THE LINE IT SEEMS DROP OFF BECAUSE THEY DECIDE THIS IS NOT THE CAREER FOR ME. QUALITIED OF SCIENCE, IT'S THE ENVIRONMENT, IN WHICH THEY ARE LIVING. I DON'T KNOW HOW YOU COULD MAKE UNIVERSITY EFFORTS TO ADDRESS THAT. BE PART OF REVIEW CRITERIA OR SCORING CRITERIA OR MANDATORY ELEMENT OF APPLICATIONS IN INSTITUTIONAL SUPPORT. BUT I THINK THERE'S AN -- A LIMITED EXTENT TO WHICH NIH CAN DO SOMETHING ABOUT WHAT IT'S LIKE TO BE AN ASSISTANT PROFESSOR TRYING TO MAKE TENURE SOMEWHERE. BUT IT'S GOT TO FOCUS ATTENTION ON PEOPLE WHO MAKE DECISIONS. SOME MIGHT BE OPAQUE AND BIASED AN SUBJECTSTIVE PROCESSES AND EVALUATION APPROACHES BUT ENCOURAGE TRYING TO REACH OUT AND BUILD IT ACROSS NOT JUST FROM NIH BUT REALLY FROM THE PLACES WHERE THESE PEOPLE WORK. >> LAST QUESTION BUT I WANT TO SAY THIS WAS INTENDED TO BE AN INTRODUCTION TO THIS TOPIC AND WE ACTUALLY WANTED TO DIG DEEPER IN IT MAYBE INTO IT IN MAY OR IF NECESSARY SEPTEMBER COUNCIL. >> THREE VERY QUICK COMMENTS. I TOTALLY AGREE WITH CLAUDIA ON THE ISSUE OF CONFIDENCE, THERE IS NOTHING THAT INCREASES CONFIDENCE BETTER THAN SUCCESS. SO IF YOU REALLY ARE SUCCESSFUL AND CONFIDENT, THERE'S NO PROBLEM WITH THAT. SO WE HAVE TO CONCENTRATE ON INCREASING THE SUCCESS RATES EARLY SO THAT PEOPLE ARE NOT DISCOURAGED. MAYBE THE ADDING OR EXTENDING THE WINDOW FOR FIRST INVESTIGATORS, FIRST INVESTIGATORS NOW HAVE THE WINDOW AT WHICH THEY ARE GETTING A HIGHER FUNDING RATES. IF YOU ADDED WOMAN TO THAT AND EXTEND IT FURTHER IT WILL BE ABLE TO ALLOW WOMAN TO HAVE WIDER PROPORION TO TAKE ADVANTAGE OF THIS HIGHER FUNDING RATE AND IT CAN REALLY HELP IN THIS REGARD. IT'S A LITTLE BIT DIFFERENT THAN TELLK THEM I'M GOING TO -- TELLING THEM I'M GOING TO GIVE YOU A RESEARCH SENT OR ADDED RESOURCE. THIS IS ABOUT SECURING THE R GRANT IN THE FIRST PLACE. WHEN THEY DONE SECURE IT THEY LOSE CONFIDENCE AND DROP OUT. THE LAST POINT I WANTED TO MAKE IS ABOUT THE R 35. I THINK BY THE TIME A WOMAN IS ELIGIBLE FOR R 35 THEY ARE ALREADY IN THE GAME. THEY HAVE MULTIPLE RO 1s OR HISTORY OF RO1 FUNDING. WE NEED TO INTERVENE AT THE K LEVEL, WONDERING IF THERE IS NOT AN OPPORTUNITY TO RESURRECT THE MID CAREER K GRANTS WHEREBY PEOPLE CANNOT JUST REENTER BY RETRAINING BUT FOR A CLINICIAN WHO MADE HER DECISION NOT TO COMPETE FOR R FUNDING AND TO BE A NEUROLOGIST OR NEUROSURGEON FOR TEN YEARS, WHY NOT RETRAIN AND THE K MECHANISM LIKE WE HAVE THE K 25s OR 24s WHERE YOU ARE ABLE TO NOW REENTER BY RETRAINING AND BEING ABLE TO COME IN, DIFFERENT POINT IN YOUR CAREER THAN WHAT WE HAVE STRUCTURED SO FAR. >> THANKS. JUST TO QUICKLY ALL GOOD POINTS TO ADDRESS THE SECOND ONE, ADVISORY COMMITTEE TO FRANCIS COLLINS RECOMMENDED EXTENDING THE EARLY STAGE INVESTIGATORS SCORE FOR A COUPLE OF YEARS BUT THERE'S ALSO A COMMITTEE NINDS IS REPRESENTATIVE ON WHERE IF SOMEONE WANTS AN EXTENSION OF THAT WINDOW, FOR REASONS LIKE CHILDBIRTH OR CHILD CARE, WHATEVER, THE COMMITTEE DECIDES WHETHER TO GIVE THAT EXTENSIONS, THEY USUALLY DO. >> WE ARE MAKING THEM BACK. THE IDEA IS TO OPEN IT UP. >> IT'S FOR MEN AND WOMEN. BUT I THINK WHAT HE IS SAYING IS IT SHOULD BE AUTOMATIC FOR WOMEN. BUT LET'S MOVE ON. I THINK WALTER, WE ARE ALREADY HALF AN HOUR LATE. >> FOR PEOPLE CONTINUE THINKING ABOUT THIS, AND AS YOU KNOW, MICHELLE AND HER TEAM ALWAYS LOOKING FOR INPUT. MAYBE A GROUP THAT GETS TOGETHER THAT TRIES TO PLAN, FOLLOW HOW WE ARE DOING WOULD BE GREAT. SO NOW IT'S A GREAT PLEASURE TO INTRODUCE JOHN BURKLOW, THE ASSOCIATE DIRECT FOR FOR COMMUNICATIONS AND PUBLIC LIAISON AT NIH AND INVOLVED IN THE COMMUNICATION STRATEGIC PLAN THERE. TALKING ABOUT MESSAGING. THERE'S NO BETTER PERSON. HE'S A CUBS FAN. >> THANK YOU, WALTER, GOOD AFTERNOON, EVERYONE. I REALIZE WE ARE RUNNING HALF HOUR BEHIND SO I'LL SPEAK QUICKLY. APPRECIATE THE OPPORTUNITY TO TALK WITH YOU TODAY, TALK ABOUT WHO WE ARE, WHAT WE DO, HOW DO WE WORK TOGETHER AS A COMMUNITY. COMMUNICATION COMMUNITY. AND SINCE ONE OF MY PRIMARY RESPONSIBILITIES IS TO SUPPORT THE NIH DIRECTOR COMMUNICATIONS, I WILL GIVE YOU MULTIPLE EXAMPLES OF HOW. DR. COLLINS USES COMMUNICATIONS TO ADVANCE THE MISSION OF NIH. JUST TO GO THROUGH SOME OF THE THINGS WE DO, WE WORK WITH HUNDRED DOLLARS, WE WORK WITH ALISSA AND AMY EVERY DAY PLUS TEN OFFICES EACH HAS ITS OWN COMMUNICATION OFFICE. WE HAVE TO CLEAR PRESS RELEASES, PRESS INTERVIEWS, CAMPAIGNS, WHAT HAVE YOU. AND THEN WE ARE THE LIAISON WITH HHS. THEY HAVE THEIR OFFICE OF PUBLIC AFFAIRS AND THEY CLEAR WHAT WE SEND THEM. THAT'S A EUPHEMISM, YOU CAN SAY APPROVE BUT MOST TIME IT'S FYI AND MOVES QUICKLY. WE ALSO COORDINATE WITH OTHER AGENCIES AS NEEDED. BUT WE ARE TALKING TO REPORTERS, EDITORS PRODUCERS, OUTSIDE GROUPS EVERY DAY. WE MANAGE THE NIH HOME PAGE, LEAD THE WEB COMMUNITY ALSO DEVELOP AND IMPLEMENT STRATEGIC COMMUNICATIONS. FOR BIG ANNOUNCEMENT WE PIT TOGETHER STRATEGIC COMMUNICATIONS PLAN. IT'S A VERY ORDERLY ROLLER OR WE TRY TO MAKE IT ORDERLY. WE COMMUNICATE SCIENCE, I PUT NIH COMMUNICATION BECAUSE NOT ONLY ARE WE REACHING OUT WITH SCIENCE, WE ARE TALKING VARIOUS INITIATIVES THAT COME OUT OF NIH AND I WILL COVER THAT MORE LATER. WE HAVE FREEDOM OF INFORMATION IN OUR OFFICE, SOCIAL MEDIA, VISITORS, SPECIAL INQUERIES. PUBLIC INQUIRIES SPECIAL EVENTS, VIP EVENTS AND SPANISH LANGUAGE. WE HAVE MANY AUDIENCES AND WE TRY TO KEEP THEM IN MIND WHEN WE ARE COMMUNICATING OR WE FOCUS COMMUNICATIONS DEPENDING ON THE CONTENTS. THE KEY MESSAGE CONCEPTSES NOW PROBABLY THINK OF COURSE YOU ARE DOING THIS, YOU ARE NOT TELLING ME ANYTHING NEW. THE VALUE OF INVESTING IN MEDICAL VERGE THE PROFESSION WE ARE MAKING THE IMPACT THIS RESEARCH HAS ON PEOPLE'S HEALTH, THE ECONOMIC IMPACT OF NIH RESEARCH. THAT HASN'T ALWAYS BEEN THE CASE. WHEN PEOPLE SAY WHAT JOBS DO YOU GENERATE OR ECONOMIC RETURN ON INVESTMENT SO TO SPEAK DOES NIH HAVE. WE WILL GIVE ANSWERS TO THOSE WHO ASK. THEN ALSO TALK ABOUT THE IMPORTANCE OF BASIC CLINICAL AND TRANSLATIONAL RESEARCH. THE LAST ONE, THE FOOTPRINT OR IMPACT OF NIH, IT'S NOT JUST A PLACE IN BETHESDA, THIS IS A CONTINUAL COMMUNICATION CHALLENGE. EVEN AFTER ALL THESE YEARS, PEOPLE STILL COME UP TO DR. COLLINS AND SAY HOW DO YOU SPEND THAT MONEY? OVER IN BETHESDA, HOW DO YOU SPEND THAT? THEY DON'T REALIZE MOST MONEY IS GOING OUTSIDE. SO THAT IS AN IMPORTANT MESSAGE ESPECIALLY WHEN YOU ARE TALKING TO POLICY MAKERS AND OTHERS WHO MAY HAVE AN INTEREST IN WHAT'S HAPPENING IN THEIR STATE. OR DISTRICT. WE ARE IN THE NEWS ALL THE TIME. IT MAY NOT ALWAYS SAY NIH, MAY NOT SAY NINDS. QUITE OFTEN IT'S A GRANTEE INSTITUTION. THAT IS IN THE STORY. BUT WE ARE IN RADIO TV WEB, THE WHOLE NINE YARDS ALL THE TIME. WE MAKE A CONSTANT EFFORT TO STAY IN THE NEWS AND TO REACH OUT AND WORK WITH REPORTERS JUST TO GIVE YOU A SENSE OF THINGS WE GET ABOUT 7,000 PRESS QUERIES THROUGH OUR OFFICE, WE PROCESS INTERVIEWS COMING FROM THOSE QUERIES AND DR. COLLINS ALONE HAS DONE ABOUT A HUNDRED PRESS THE INTERVIEWS IN THE LAST YEAR JUST TO -- NOT TO JUMP AHEAD TOO MUCH BUT I WILL TALK CORONA REQUIRES BRIEFLY. BUT A LITTLE PERSPECTIVE HOW BUSY FOR DR. FAUCI, YOU RECOGNIZE DR. FAUCI'S NAME I'M SURE. SINCE JANUARY 19TH HE'S DONE OVER 100 INTERVIEWS. IN THE LAST TWO WEEKS. SO AND WE PROCESS AND MANAGE 350 PRESS RELEASES SOME COMING FROM OUR OFFICE BUT MOST FROM THE INSTITUTE AND CENTERS. I WANT TO POINT OUT NINDS DOES VERY WELL SECOND ONLY TO DR. FAUCI'S INSTITUTE. WHICH IS REALLY HARD TO COMPETE BECAUSE AS YOU CAN IMAGINE NUMBER OF PRESS RELEASES. AND I KNOW IT'S PROXY MEASURE BUT IT GIVES AN INDICATION OF -- IT'S A VERY ACTIVE OFFICE. O SOCIAL MEDIA, ALMOST A MILLION ON TWITTER. WE HAVE AN NIH TWITTER ACCOUNT, DR. COLLINS HAS HIS OWN TWITTER ACCOUNT. AND WALTER HAS HIS, I KNOW. AND DR. COLLINS IS NOW ALMOST 117,000 FOLLOWERS. WHEN WE DO A TWITTER CHAT THEY GET A LOT OF ATTENTION, AVERAGE 70,000,000 IMPRESSIONS. THIS NIH IN YOUR STATE GOES BACK TO WHAT I WAS TALKING ABOUT BEFORE, TRYING TO EDUCATE PEOPLE THAT IT'S NOT JUST A PLACE IN BETHESDA, THAT THERE IS NIH ACTIVITY, NIH SUPPORT. IN ALL THE STATES. AND WHAT'S GOING ON. WHAT RESEARCH IS GOING ON THERE. AS WELL AS AS WELL AS FACEBOOK AND INSTAGRAM. FOR DR. COLLINS, HE USES THE HOST OF METHODS AND TOOLS TO COMMUNICATE. I WILL GO THROUGH ALL OF THESE DIFFERENT EXAMPLES. SINCE BEING DIRECTOR HE'S GIVEN WELL OVER A THOUSAND PRESENTATIONS. GAVE ABOUT 130 LAST YEAR. AND HE KEEPS INCREASING THE NUMBER OF VIDEOS HE WILL SEND IF HE CAN'T BE THERE PERSONALLY. WE TRY TO LIMIT THOSE BECAUSE THEY ARE VERY LABOR INTENSIVE FOR HIM BUT HE IS DOING THEM MORE AND MORE TRYING TO EXPAND HIS REACH. HE'S ALSO PUBLISHING ALL THE TIME IN POPULAR JOURNALS PERIODICALS OR SCIENCE JOURNALS THIS CAME OUT LAST FALL IN TIME. ALSO ACTIVE AS I MENTION ON SOCIAL MEDIA. AND WE HAVE DONE EVERYTHING FROM ON VIDEO TO I DON'T KNOW IF YOU SAW A FEW YEARS AGO HE SANG THE NATIONAL ANTHEM. AT THE NATS PARK. THAT WAS ON PECISCOPE AT THE TIME. WHAT I ENJOY IS HE IS GAME TO DO A LOT OF THINGS I KNOW HE'S PUTTING HIMSELF OUT THERE BUT HE'S HAPPY TO EXPAND THE REACH. HE HAS ACTIVE BLOG. HE BLOGS TWICE A WEEK. HE USES ITS REALLY FOR WHAT HE CONSIDERS COOL SCIENCE. HE DOESN'T USE ITS AS BULLY PULPIT. HE WILL FOCUS ON IMPORTANT ISSUES PERTAINING TO NIH BUT QUITE OFTEN IT'S ABOUT THE SCIENCE. I WANT TO MENTION ONE SPECIAL INITIATIVE WE HAVE, I'M SURE YOU HEARD ABOUT BEFORE BECAUSE NINDS IS VERY INVOLVED IN IT. THE SOUND HEALTH INITIATIVE. WE AWARDED $20,000,000 OR OVER FIVE YEARS THIS FALL FOR THE INITIATIVE. THIS CAME FROM MEETING RENEE FLEMING. SOPRANO OPERA STAR, MEETING HER AT A DINNER, ONE THING LED TO ANOTHER AND BOB FINKELSTEIN IS VERY INVOLVED IN THIS, HE KNOWS THE WHOLE STORY BUT IT'S BEEN NOT ONLY FUN BUT IT'S BEEN INTERESTING AND OPENING US UP TO A WHOLE NEW SET OF AUDIENCES. DOWN THERE THEY DID A WHEN HE WAS WITH NPR ROBERT SEIGEL AN INTERVIEW A COUPLE OF YEARS AGO NOW, WITH DAVID WHERE SHE WENT INTO FMRI HERSELF AND SANG WHILE THEY DID IT TO SEE WHAT PHYSIOLOGICAL EFFECTS THAT HAD ON HER. SO THIS CONTINUES. WITH NOT ONLY THE RESEARCH BUT WE HOPE TO HAVE EVENTS FROM TIME TO TIME. WE HAVE ALSO HAS A NUMBER OF VIPs COME, WHY DO YOU HAVE ALL THESE FOLKS COMING HERE? I WOULD SAY TWOFOLD, ONE, IT'S OF INTEREST TO THE NIH AUDIENCE BUT ALSO IT ENCOURAGES ADVOCATES FOR BIOMEDICAL RESEARCH AND NIH WHO HAD EVERYBODY FROM BILL GATES, BARBARA STREISAND, THE DALI LLAMA. THE UPPER RIGHT IS NOT ONLY DO WE HAVE VIP EVENTS WE HAVE EVENTS SUCH AS THE COMBINED FEDERAL CAMPAIGN DR. COLLINS ENCOURAGES US TO HAVE EVENTS SO IF YOU CAN'T TELL THAT'S DR. KOROSHETZ CANCELING WHICH I THINK MIGHT HAVE BEEN MORE MEMORABLE DANCING WHICH MIGHT HAVE BEEN MORE MEMORABLE THAN ANY OTHER VIP EVENT WE HAVE EVER HAD. FRANCIS HAS HIS OWN BAND OF COURSE SO HE'S OUT AND ABOUT PLAYING AND HE GOT COVERED RECENTLY IN BETHESDA MAGAZINE AS A SCIENTIST IN HIS BAND THERE. OTHER INITIATIVES, YOU KNOW ABOUT HEAL, NINDS IS VERY INVOLVED IN HEAL AND THE ANNOUNCEMENT THIS FALL OF ALMOST A BILLION DOLLARS. WE ARE VERY INVOLVED IN THAT. OPTIMIZE NIH WAS SOMETHING THAT HHS ASKED US TO DO ASK ALL AGENCIES TO DO. WE TOO LONG THE LEAD TRYING TO STREAMLINE OPERATIONS IN VARIOUS AREAS LIKE FOIA AND HR AND OTHER AREAS. COMMUNICATING MORE INTERNALLY BUT ALSO EXTERNALLY ABOUT IT. ANTI-SEXUAL HARASSMENT OR ANTI-HARASSMENT IN GENERAL, WE HAVE BEEN VERY INVOLVED IN THAT AS WELCOMING UP WITH EDUCATION AND ALSO WORKING WITH DR. DR. VALENTINE ON A SURVEY OR DISTRIBUTING AND ENCOURAGING PEOPLE TO TAKE A CLIMATE SURVEY. INCLUDE FOR DOWN'S SYNDROME, ALL OF US YOU HAVE HEARD ABOUT TRYING TO GET A MILLION PEOPLE INTO THE ALL OF US RESEARCH PLATFORM, BRAIN I KNOW YOU ARE FAMILIAR WITH THE BRAIN INITIATIVE. DISTINGUISHED SCHOLARS DR. VALENTINE IS LEADING THAT EFFORT WITH DR. COUPLINGS TO ENCOURAGE INCLUSION AND DIVERSITY IN THE INTRAMURAL PROGRAM. AT NIH. I MENTION CORONA VIRUS THAT'S BEEN CONSUMING NINDS T ALLERGY INFECTIOUS DISEASE, DR. FAUCI OBVIOUSLY AND DR. COLLINS TALKED ABOUT IT WHEN HE JUST DID A YAHOO FINANCE INTERVIEW YESTERDAY THAT'S GOING TO BE STREAMED TOMORROW AND 80% OF THE QUESTIONS ARE ABOUT THE CORONA VIRUS. WE WORK WITH DR. FAUCI STAFF AND WHITE HOUSE STAFF, ON MAKING SURE AND ALSO CDC. SO WE ARE WORKING WITH OTHER AGENCIES AS WELL. TO MAKE SURE WE ARE ALL COORDINATED, I PUT DOWN IN THE LOWER CORNER THE MESSAGE FROM THE NIH DIRECTOR WE ARE ALSO COMMUNICATING WITH STAFF ABOUT CORONA VIRUS AND WE ARE TRYING TO MAKE SURE THEY ARE KEPT UP TO DATE ABOUT WHAT WE ARE DOING AND WHAT THEY CAN DO. WE HAVE A RANGE OF PRODUCTS THAT COME OUT OF OUR OFFICE. NOW, OUR WEBSITE AS I MENTIONED, IS VERY ACTIVE, IT'S JUST NOT OUR WEBSITE, IT'S CULMINATION OF ALL THE DIFFERENT WEBSITES ACROSS NIH. VERY WELL USED ACROSS ALL THE INSTITUTION AND CENTERS, BUT YOU HAVE 600 PUBLIC FACING SITES SO QUITE LARGE, MORE THAN 4500 SOCIAL MEDIA ACCOUNTS. WE CONVENE GROUPS FROM ACROSS NIH TO WORK ON POLICY AND OTHER DIRECTIONS WE ARE GOING IN. THE ONLINE WORLD. WE ALSO DO A WELLNESS TOOL KIT. I GO THROUGH THESE FAIRLY QUICKLY TO GIVE YOU A SENSE, THE NIH RESEARCH MATTERS IS TAKING RESEARCH FROM ACROSS NIH AND PUTTING IT INTO ALMOST A BLOG FORM THAT GOES UP ACROSS WHOEVER WANTS TO SUBSCRIBE TO IT. A MONTHLY NEWS LETTER THAT TAKES NIH INFORMATION AND MAKE IT MORE CONSUMER FRIENDLY. WE STILL MAKE IT IN PRINT BECAUSE SOME AUDIENCES DON'T HAVE ACCESS TO ONLINE RESOURCES. SO WE STILL DISTRIBUTE THEM ESPECIALLY THROUGH CLINICS AND HOSPITALS. WE ARE ALSO IN CHARGE OF THE NIH RECORD WHICH IS OUR NEWS LETTER, OUR NIH NEWS LETTER WE PUT OUT EVERY TWO WEEKS. AS I MENTIONED BEFORE, WE ALSO HAVE A SPANISH LANGUAGE WEBSITE. AGAIN, COUNTING ON THE CONTENT FROM NINDS AND OTHER INSTITUTES AND CENTERS TO PUT IT IN ONE PLACE WHERE PEOPLE CAN HAVE ACCESS TO IT. AND IF YOU ARE LOOKING FOR IMAGES, WE HAVE AN IMAGE GALLERY, SOMETIMES YOU NEED PHOTO OR IMAGE TO LET YOU KNOW THAT THAT EXISTS AS WELL ALL UP ON OUR HOME PAGE. I WANT TO PUT THIS UP HERE, EVERYONE -- PEOPLE SAY WHY DON'T YOU WORK OUT A TELEVISION SHOW? ABOUT NIH? AND IN FACT, WE DID. YOU CAN SEE THE DATE. I DON'T KNOW HOW MANY SEEING THIS SHOW IT WAS ON FOR ALMOST A FEW SEASON. AT THE TIME THIS IS A TRUE STORY, FOLKS AT CDC TOLD THE WASHINGTON POST BECAUSE IF YOU WATCH THE SHOW, I DON'T KNOW, ANYBODY REMEMBER THIS SHOW? ONLY 16 YEARS AGO. IF YOU WATCHED IT YOU START THINKING IT'S ALL ABOUT THE CDC THOUGH THEY CALLED IT NIH. CDC REQUIRES THE WASHINGTON POST THAT I WRANGLED THE DEAL WITH NBC TO TAKE IT FROM CDC AND MAKE IT NIH. I SAID THAT'S ALL TRUE. BECAUSE I HAVE THAT KIND OF PULL IN HOLLYWOOD. BUT IT WAS FUNNY, ITENTED UP BEING A FRONT PAGE STORY IN THE WASHINGTON POST, IT WAS A CDC DRAW MA STARRING THE NIH. IT WAS ALL ABOUT HOW WE STOLE THIS. BUT AS THE SERIES WENT ON AND PEOPLE WATCHED IT, CDC WAS LESS INCLINED TO SAY THAT'S US. KIND OF A MOMENT IN TIME SO TO SPEAK. SO WE DON'T HAVE ANYTHING ELSE ON NETWORK TELEVISION BUT WE DO HAVE, IT'S STILL UP FOR ON DEMAND, WE WORKED WITH THE DISCOVERY CHANNEL ON A DOCUMENTARY ABOUT THE CLINICAL CENTER HERE AND ABOUT CLINICAL RESEARCH. IT'S CALLED FIRST IN HUMAN. WE STARTED TALKING TO THEM IN I WOULD SAY JANUARY OF 2015. SO IT AIRED IN AUGUST OF 2017. WE HAD CAMERA CREWS, THREE SETS OF CAMERA CREWS EMBEDDED IN THE HOSPITAL FOR A YEAR. AND SO IT WAS A TREMENDOUS LIFT FOR THE CLINICAL CENTER AND DOCTORS NURSES AND THE PATIENTS. THE PATIENTS ABOVE ALL REALLY HAD TO AGREE TO PARTICIPATE IN THIS. THE RESULT WAS EXTREMELY MOVING -- IT IS REAL LIFE DRAMA BUT ALSO IT EDUCATES SOMEONE NOT FAMILIAR WITH HOW DOES CLINICAL RESEARCH WORK ESPECIALLY AT THE CUTTING EDGE. WE DID MAKE THE MOST OF IT AS WE COULD. DOWN HERE YOU HAVE LAMAR ALEXANDER AN TOM COLE AND OTHERS, WE HAD A SCREENING NEAR THE HILL THAT IT WAS WAY TO EDUCATE MEMBERS AND THEIR STAFF ABOUT WHAT NIH IS ALL ABOUT. THE CLINICAL CENTER USES CLIPS FROM THIS EVEN IN THEIR RECRUITMENT TO EDUCATE PEOPLE WHAT IT'S LIKE TO WORK HERE. I'M HOPING IF THIS WORKS THAT YOU WILL BE ABLE TO SEE A CLIP. WE WORK WITH 60 MINUTES FOR I WOULD SAY ABOUT A YEAR TO PUT TOGETHER A PROGRAM THAT AIREDDED IN MARCH AND REAIRED IN DECEMBER. AT TREATMENT FOR SICKLE CELL DISEASE. SO I MENTIONED THE LENGTHS OF TIME BECAUSE SOMETIMES THEY POP UP IN SOMETHING IS FIVE MINUTES LONG OR 30 SECONDS LONG, HOW HARD IS THAT, IT'S ONLY 30 SECONDS, JUST TO GIVE YOU A SENSE HOW MUCH GOES INTO PUTTING SOMETHING LIKE THIS TOGETHER. >> MOVE, SWITCH ARMS AND MOVE. >> REMEMBER, JENELL USED TO STRUGGLE TO WALK UP A FLIGHT OF STAIRS AND A FALL LIKE THIS WOULD HAVE LANDED HER IN THE HOSPITAL. >> BOOM. YEAH. GOOD JOB, YOU DID IT. BAM. >> WHAT WAS GOING THROUGH YOUR HEAD AS YOU WERE WATCHING HER BEING THROWN DOWN TO THE MAT? >> I WAS JUST SAYING THANK YOU LORD. THANK YOU FOR MEDICAL SCIENCE. AND THANK YOU FOR GIVING HER A NEW LIFE. >> NEW LIFE INDEED. >> SO JOHN IS AN M.D. WHO IS THE HOST OR THE CORRESPONDENTS FOR THIS PIECE. WE JUST SENT HIM A NEW BATCH OF IDEAS TO CONSIDER FOR OTHER PROGRAMS. WE TRY TO ESTABLISH AND MAINTAIN RELATIONSHIPS WITH REPORTERS PRODUCERS, AND SO THEY THINK OF US WHEN THEY ARE TRYING TO TELL A STORY. THIS WAS A VERY -- I FORGET HOW MANY MINUTES IT RAN BUT IT WAS A FULL SEGMENT ON 60 MINUTES. LAST NIGHT RIGHT BEFORE THE STATE OF THE UNION YOU MAY HAVE BEEN WATCHING PBS AND YOU MAY HAVE SEEN FINDING YOUR ROOTS. THEY PROFILED DR. VARMUS, FORMER NIH DIRECTOR FORMER NCI DIRECTOR AND SHIRLEY JACKSON PRESIDENT OF OUR PI AND DR. COLLINS. THIS IS ALSO YOU CAN GET THIS RIGHT OFF THEIR WEBSITE ADS WELL. THEY ARE STREAMING THIS. WE STARTED FREQUENTING WITH THEM IN 2016. THIS GIVES YOU ANOTHER IDEA. BUT IT IS A WAY TO I SAY HUMANIZE IT SOUNDS LIKE THE PERSON IS NOT HUMAN BUT IT WARMS UP PEOPLE REALLY SHOWS THAT SCIENTISTS ARE -- HAVE INTERESTING LIVES, BACKGROUNDS AND I ENCOURAGE YOU TO LOOK IT UP. AND TO SEE. THE NEXT THING THAT'S COMING, I DON'T HAVE A SLIDE FOR IS THIS APRIL THERE WILL BE A KEN BURNS DOCUMENTARY ON THE BOOK "THE GENE" AND DR. COLLINS AND OTHERS ACROSS NIH PARTICIPATED IN THAT DOCUMENTARY. BUT THAT SHOULD BE COMING OUT IN APRIL. TO GIVE YOU A SENSE OF WHO WE ARE AGAIN AND HOW WE WORK TOGETHER, HOW BETRY TO MAKE CONNECTIONS, WE ARE ALWAYS THINKING OKAY IF WE ARE DOING SOMETHING HERE IT WILL AFFECT PEOPLE HERE ON CAMPUS, EFFECT THE EXTRAMURAL COMMUNITY, PUBLIC PATIENTS, MEMBERS OF CONGRESS, STAKEHOLDER ORGANIZATIONS ADVOCACY ORGANIZATIONS, REALLY TRY TO SEE AS A CONSTELLATION AND HOW WE ARE REACHING OUT. ALSO I THINK OF IT AS FUEL. THERE'S NEVER ENOUGH. YOU DID THE NBC THING, 16 YEARS AGO NOBODY REMEMBERS IT, YOU GOT TO KEEP COMING UP WITH NEW WAYS OF BRINGING SCIENCE TO THE PUBLIC AND INTERESTING WAYS AND IN WAYS THAT THEY WILL GET BEHIND AND SAY YEAH WE SUPPORT THAT. WITH THAT, I'LL OPEN UP FOR QUESTIONS. >> IT WAS REALLY INTERESTING, WONDERING IF WE CAN FUSE CONCEPTS IN THE AFTERNOON AND YOU CAN START TO TAKE A ROLE NOT JUST IN DISSEMINATING THE FASCINATING AND ENERGETIC LEVELS OF DISCOVERY SCIENCE, BUT SOME OF THE INTERESTING TRACKS PEOPLE HAVE TAKEN TO TRAIN TO BECOME A SCIENCE. WE SEE THERE'S AN UNEXPLAINED GAP IN DIVERSE PEOPLE AS THEY TRY TO ACHIEVE THE ASSOCIATE PROFESSOR LEVEL. IT MIGHT BE INTERESTING TO FEATURE PEOPLE WHO HAVE DONE IT IN TRADITIONAL AND NON-TRADITIONAL WAYS. AND ALSO PUMP THE PUBLIC UP ON THE EXCITEMENT OF BECOMING A SCIENTIST SO WE CAN PRIME THE PUMP. >> THAT'S A GREAT IDEA. WE HAVE TAKEN DIFFERENT RUNS AT DIFFERENT TIMES IN DIFFERENT WAYS BUT I CERTAINLY THINK THE TIME IS TO REALLY INTENSIVE OUR EFFORTS. >> THERE WAS FUNNY COVER ON THE ROLLING STONE ON ROCK STARS OF SCIENCE A WHILE BACK TEN YEARS AND I KNEW CHARACTERS ON THAT COVER, IT DID A LOT OF -- AND THEY EVEN PUT IT UP IN AIRPORTS. SO IT REALLY HAD QUITE A DISPROPORTIONATESLY LARGE IMPACT ON PUBLIC CONCEPTION OF WHAT A SCIENTIST PHENOTYPE IS. >> MAYOR COLMER, BEHIND THAT WITH THE JEFFREY BEAN FOUNDATION, THEY HAD GREAT PHOTOS, FRANCIS WAS IN THERE, DR. FAUCI AND OTHERS. IT DID HAVE QUITE A BIT OF IMPACT, FRANCIS MADE A MUSIC VIDEO WITH JOE PERIONCE. GOT THAT OUT. AGAIN AS A WHILE AGO WE HAVE TO BRING IT BACK AND LOOK AT DIFFERENT WAYS SO I AGREE WITH YOU. >> ANYBODY ELSE? THANKS A LOT. >> THANK YOU. >> THANKS A LOT, JOHN. [APPLAUSE] >> WE'RE GOING TO STICK WITH OUR COMMUNICATIONS THEME AND ASK AMY BONNNY ADAMS TO COME UP. AMY IS DIRECTOR OF NEUROSCIENCE COMMUNICATIONS AN ENGAGEMENT OTHERWISE KNOWN AS NCAE, PREVIOUSLY DIRECTOR OF SCIENTIFIC LIAISON HERE AT NINDS. BEFORE THAT WAS DIRECTOR OF OFFICE OF SCIENCE POLICY ANALYSIS OF THE DENTAL INSTITUTE, BEFORE THAT AAAS FELLOW AND TECHNOLOGY FELLOW FOR DR. ZERHOUNI AND WAS SPECIAL ASSISTANT TO HIM. SHE GOT Ph.D. FROM CELL BIOLOGY FROM YALE. SHE GOT HER BS IN BIOLOGY FROM MIT. SO ALISSA GALLAGHER AND AMY ARE A TEAM. SHE'S DEPUTY DIRECTOR OF ONCE AND THE COMMUNICATION DIRECTOR FOR NINDS. SHE BEGAN HER NIH CAREER TEN YEARS AGO AS FELLOW AND NCI HEALTH COMMUNICATION INTERNSHIP PARTNERSHIP. SHE GOT HER NPH FROM THE UNIVERSITY OF TENNESSEE AND BS IN NEUROSCIENCE FROM WASHINGTON STATE UNIVERSITY. LUCKY TO HAVE PROS RUNNING ON COMMUNICATION SHOPS NOW. AMY WILL TALK ABOUT WHAT WE ARE DOING AND THE THEME OF MESSAGING THE VALUE OF SCIENCE AND TRYING TO SOLVE SOME PROBLEMS. AMY. >> GREAT. THANK YOU SO MUCH FOR THAT KIND INTRODUCTION, WALTER. I REALLY APPRECIATED JOHN'S OVERVIEW OF THE COMMUNICATION EFFORTS HIS OFFICE RUNS SO INCREDIBLY WELL ON BEHALF OF NIH. I DO WANT TO TAKE A MOMENT AND JUST SHARE OUR OFFICE DOES ACTIVITIES THAT ARE OUTSIDE THE BOUNDS OF MOST TRADITIONAL COMMUNICATION OFFICE ACROSS NIH. INTERESTING TO GET YOUR REACTION TO OUR INVESTMENT IN THOSE TYPES OF ACTIVITIES AS WELL. BOTH ALISSA AND I ARE DELIGHTED TO BE HERE TODAY TO TALK TO YOU ABOUT OUR NEW COMMUNICATION STRUCTURE. BECAUSE IT'S AN OPPORTUNITY TO TALK TO YOU ABOUT THE DIFFERENT THINGS WE ARE TRYING TO DO ON BEHALF OF THE INSTITUTE BUT ALSO LISTEN AND LEARN AND GET YOUR THOUGHTS HOW WE CAN DO THINGS BETTER. SO I CAME TO NINDS AS WALTER DESCRIBED A FEW YEARS AGO TO FORM THE OFFICE OF SCIENTIFIC LIAISON WITH THE CHARGE TO COMMUNICATE BETTER WITH THE SCIENTIFIC COMMUNITY AND ALSO TO COMMUNICATE AND COORDINATE THE ACTIVITIES OF THE NIH BRAIN INITIATIVE. THE OFFICE OF SCIENTIFIC LIAISON WAS DESIGNED TO COMPLIMENT OFFICE OF COMMUNICATION AND PUBLIC LIAISON WHICH DID OUTREACH TO PUBLIC INCLUDING PATIENTS AND CAREGIVERS, AND THE MEDIA. OVER THE PAST YEAR ALISSA AND I WORKED TOGETHER TO COMBINE THESE TWO OFFICES AND TO A SINGLE OFFICE OF NEUROSCIENCE COMMUNICATION AND ENGAGEMENT. ONCE. WE LIKE TO SAY THAT'S BECAUSE WE DO IT RIGHT THE FIRST TIME. YOU CAN SEE OUR MISSION HERE, AND OUR OFFICE IS DEVOTE -- DIVIDED INTO FIVE TEAMS THAT WORK TOGETHER SEAMLESSLY ACROSS DIVISIONS ALL THE TIME. IN DIFFERENT AREAS. I JUST WANT TO ACKNOWLEDGE LEADERSHIP THERE THAT HELPED US SO MUCH IN THIS TRANSITION OVER THE PAST YEAR. INCLUDING (INAUDIBLE) WHO OVERSEES PUBLIC HEALTH INFORMATION GROUP. MARGO WARREN MEDIA RELATIONS GROUP, DR. RAMOS AND DR. SAMANTHA WHITE WHO RECEIVES SCIENTIFIC AND PUBLIC ENGAGEMENT GROUP, WE ARE RECRUITING DIGITAL COMMUNICATIONS CHIEF SO ANYONE INTERESTED PLEASE LET ME KNOW. WE ARE REALLY LUCKY HERE AT NINDS OUR LEADERSHIP BELIEVES THAT COMMUNICATION IS NOT AN AFTER THOUGHT, IT'S CRITICALLY IMPORTANT PIECE OF OUR MISSION. WE REALLY BELIEVE SCIENCE ISN'T DONE UNTIL COMMUNICATED OTHERWISE IT'S JUST GATHERING DUST ON A SHELF. SO THIS IS OUR WHOLE ONCE TEAM HERE, I WANT TO ACKNOWLEDGE THEM AND THIS TALENTED WONDERFUL GROUP OF COLLEAGUES ALL BELIEVE SCIENCE ISN'T DONE UNTIL COMMUNICATED. AS WE LOOK AI HEAD, ANOTHER EXAMPLE HOW COMMITTED OUR LEADERSHIP IS TO COMMUNICATION, IS THAT AS WALTER MENTIONED IN HIS REMARKS, COMMUNICATION IS ONE OF THE FOUR STRATEGIC GOALS IN OUR NEW STRATEGIC PLANNING PROCESS. ALISSA IS WORKING CLOSE WITH SARA DODD SON, OFFICE OF SCIENCE POLICY AND PLANNING TO LEAD A TASK FORCE REALLY O FOCUSED ON DOING A FULL LANDSCAPE ANALYSIS TO LOOK AT ALL OF OUR COMMUNICATION ACTIVITIES BOTH ACROSS BOTH INTRAMURAL AND EXTRAMURAL PROGRAMS. TO HAVE A SENSE OF GAPS, WHAT ARE THE OPPORTUNITIES, AND HOW CAN WE COMMUNICATE ACROSS AN OUTSIDE BETTER. WE HAVE A LOT OF AUDIENCES TO COMMUNICATE TO. THIS IS JUST AN INITIAL OVERVIEW OF THOSE TARGET AUDIENCES. ONCE YOU START LOOKING AT THESE YOU REALIZE IN FACT THEY IN FACT ARE OFTEN SUBGROUPED. FOR EXAMPLE, THE GENERAL PUBLIC CAN BE DIVIDED IN TO HIGH SCHOOL STUDENTS AND STEM EDUCATORS AMONG OTHERS. RESEARCHERS CAN BE DIVIDED OVER LONG CAREER STAGES OR TO OUR EARLIER DISCUSSION, ACROSS DIFFERENT DEMOGRAPHIC GROUPS. SO WE ARE LOOKING FORWARD TO THINKING CAREFULLY ABOUT HOW WE TRY TO REACH ALL OF THESE DIFFERENT GROUPS WHO ALL HAVE DIFFERENT NEEDS AND WANT DIFFERENT THINGS FROM US. AND WHOM WE NEED DIFFERENT THINGS FROM IN TURN. ONE OF THE THINGS WE ARE GOING TO BE TALKING THROUGH THROUGHOUT THE COURSE OF OUR PRESENTATION ARE OUR DIFFERENT COMMUNICATION CHANNELS PRODUCTS AND PARTNERSHIPS. THERE ARE A SLEW OF THEM. BUT I WANT TO TAKE A MOMENT AND ACKNOWLEDGE IT TAKES A VILLAGE, OUR JOB IS TO COORDINATE THESE COMMUNICATION MATERIALS TO PROVIDE SUPPORT WHEREVER WE CAN TO DO REALLY GOOD JOB PROVIDING GOOD PLATFORMS AND SUPPORT FOR PEOPLE TO COMMUNICATE. THE SUBJECT MATTER EXPERTS ARE THE PEOPLE HERE H THE ROOM ON THE OUTSIDE BOTH THE RESEARCHERS IN THE INTRAMURAL PROGRAM, THE PROGRAM STAFF, THE REVIEW STAFF, POLICY STAFF, ET CETERA. WE REALLY VALUE OUR PARTNERSHIP WITH THEM TO GET COMMUNICATION MATERIALS OUT. AND THAT MAKES OUR WHOLE SYSTEM WORK SO MUCH BETTER BECAUSE THOSE ARE THE PEOPLE THAT NOT ONLY HAVE THE DEPTH OF KNOWLEDGE ABOUT THEIR SPECIFIC CONTENT AREA, BUT UNDERSTAND THEIR AUDIENCES AND THEIR NEEDS. I WANT TO TAKE A MINUTE AND GIVE A FEW SHOUT OUTS TO RECENT SUCCESSES IN THIS SPACE. DR. ADAM HARTMAN JUST CAME OUT LAST WEEK WITH A NEW WEBINAR SERIES ON PEDIATRIC NEUROLOGISTS AND AS WALTER MENTIONED WE HAVE A FANTASTIC NEW PODCAST SERIES, RUN BY OUR OPEN OFFICE BUILDING UP THE NERVE AND I THINK THE CURRENT EPISODE IS FOCUSED ON THE COUNCIL MEETING ITSELF AND WHAT IT MEANS TO YOU SO WE ENCOURAGE EVERYBODY TO PLEASE ENGAGE WIT. -- WITH IT. I ALSO WANTS TO TAKE A MINUTE AND JUST ORIENT YOU TO HOW WE COMMUNICATE SCIENCE. THE TRADITIONAL MODEL FOR COMMUNICATING SCIENCE IS WHAT WE CALL THE DEFICIT MODEL. THERE IS AN EXPERT WHO HAS INFORMATION AND THEN THERE IS AN AUDIENCE WHO DOESN'T HAVE THAT INFORMATION, THE ONLY WAY YOU CAN BRIDGE THAT GAP IS FOR THE EXPERT TO TALK LOUDLY, REPEATEDLY ABOUT THEIR AREA OF EXPERTISE UNTIL THE AUDIENCE ABSORBS IT MUST HAVE HAD TO CHANGE THEIR ATTITUDE BELIEFS AND BEHAVIORS. SOMETIMES THAT IS THE ONLY WAY YOU CAN SHARE INFORMATION BUT IT IS NOT ALWAYS THE BEST WAY AND RESEARCH HAS DEMONSTRATED THAT. SO WHAT OUR OFFICE REALLY WANTS TO DO ESPECIALLY MOVING FORWARD NOW THAT WE EXIST AS A COLLECTIVE UNIT, IS TO EMBRACE NEW MODELS WHERE YOU ACTUALLY ENGAGE WITH MEMBERS OF THE COMMUNITY AROUND SCIENTIFIC TOPICS. WE ARE A SMALL PERCENTAGE OF THE OVERALL NINDS RESEARCH INVESTMENT AND IT'S GOOD TO KEEP IN MIND OUR LITTLE SLICE OF THE PIE SUPPORTS COMMUNICATION EFFORTS OF OUR GRANTEES PROGRAM STAFF AND INTRAMURAL INVESTIGATORS WHO ARE USED TO HAVING THEIR OWN PRESS OFFICES AT THEIR ACADEMIC INSTITUTIONS BEFORE THEY COME HERE. AND NOW WE ARE IT FOR THEM. BUT I THINK WE ARE SMALL BUT MIGHTY. WE DO A LOT WITH WHAT WE HAVE. AND SO WE WILL BE TALKING THROUGH WITH YOU ACROSS THE COURSE OF OUR PRESENTATION HOW WE INVEST THESE FUNDS. WE SUPPORT OUR TREMENDOUS TEAM, WE ALSO SUPPORT WEB OPERATIONS BOTH FOR INSTITUTE WEBSITES AND NUMBER OF TRANS-NIH WEBSITES THAT WE RUN. YOU WILL HEAR ABOUT THOSE. THEN NEXT ALISSA WILL TALK TO YOU ABOUT OUR WORK IN PUBLIC INQUIRIES AND PUBLIC HEALTHCAL PAINS. HEALTH CAMPAIGNS. WE HAVE TIME FOR DISCUSSION I HOPE STILL AT THE END OF THIS PRESENTATION AND WE HAVE SOME QUESTIONS SPRINKLED IN ALONG THE PRESENTATION, OPPORTUNITIES FOR YOU TO GIVE US INPUT ON SPECIFIC POINTS. OUR OVER ARCHING QUESTION IS ONE WE WANTED TO SHARE AT THIS POINT, HOW DO WE ENGAGE WITH ALL OUR PARTNERS MORE EFFECTIVELY? AS WE WALK THROUGH THIS PRESENTATION WE ENCOURAGE YOU TO THINK ABOUT NEW IDEAS AND STRATEGIES HOW WE CAN SHARE NINDS RESEARCH WITH OUR VARIOUS STAKEHOLDERS. SO THAT I'M GOING TO TURN IT OVER TO ALISSA. >> THANKS, AMY. AS YOU HEARD FROM JOHN, NEWS IS A REALLY IMPORTANT WAY THE PUBLIC HEARS ABOUT THE LATEST IN SCIENTIFIC RESEARCH. OUR PRESS TEAM WORKS WITH TRUSTED JOURNALISTS AND REPORTERS TO REACH PUBLIC AND RESEARCHERS THROUGH POPULAR AND TRADE PRESS, JOHN SHARED EXAMPLES WHERE NIH IS MAKING NEWS. WE GET TIPS ON NEWSWORTHY RESEARCH FROM MANY SOURCES INCLUDING PROGRAM DIRECTORS AND STAFF, GRANTEES, MANUSCRIPTS THROUGH THE CLEARANCE PROCESS AND JOURNAL SCANNING AND ALERTS OUR PRESS TEAM DOES REGALISM SO WE USE A NUMBER OF STRATEGIES, BOTH REACTIVE AND PROACTIVE TO SHARE RESEARCH IN OUR MESSAGES. ONE VERY IMPORTANT PART OF OUR MEDIA STRATEGY INCLUDES PREPARING OUR SPOKES PEOPLE TO TALK WITH REPORTSERS. SO OUR PRESS TEAM WORKS CLOSELY WITH SPOKES PEOPLE TO CRAFT CONCISE AND COMPELLING MESSAGES AND TO HELP ANTICIPATE WHAT THE TOUGH QUESTIONS MIGHT BE. WE OFFER HALF OR FULL DAY MEDIA TRAINING SESSIONS WHERE WE BRING EXPERTS ON THE OTHER SIDE ASKING THE TOUGH QUESTIONS THEMSELVES AS REPORTERS IN THE FIELD. THIS IS ESPECIALLY EFFECTIVE WHEN WE ENCOUNTER SENSITIVE TOPICS OR ISSUES BECAUSE IT ALLOWS OUR SPOKES PEOPLE TO DEVELOP AND TEST MESSAGES ON CAMERA IN PRACTICE SESSIONS SO AMY IS GOING TO SHARE AN EXAMPLE OF THIS IN A LITTLE BIT WHERE IT WORKED REALLY WELL LAST YEAR. WHEN WE TALK ABOUT ENGAGING WITH THE PRESS, LIKE JOHN MENTION OUR GOAL IS TO BUILD POSITIVE PRODUCTIVE RELATIONSHIPS WHETHER RESPONDING TO REPORTER ON DEADLINE, PITCHING A STORY OR FACILITATING A PRESS BRIEFING. THE PAST YEAR OUR PRESS TEAM CLEARED 130 INTERVIEWS, BOTH INTERVIEWS FOR PRINT, THEY WERE ON CAMERA LIVE OR PRE-RECORDED. AS WELL AS BACKGROUND IN FACT O AND FACT CHECKING REQUESTS FROM REPORTERS. AS YOU CAN IMAGINE QUICK RESPONSES ARE KEY FOR REPORTERS ON DEADLINE. SO WHILE THIS IS THE MOST REACTIVE PART OF THE JOB, IT'S THE START OF THE RELATIONSHIP BUILDING PROCESS, WE WANT REPORTERS TO KNOW THEY CAN COME TO US FOR TRUSTED AND TIMELY INFORMATION AND CONNECT THEM WITH OUR EXPERTS HERE AROUND THE ROOM. GETTING INTO THE MORE PROACTIVE REALM, APPRECIATE JOHN NOTING WE ARE THE RUNNER UP AT NIH SECOND ONLY TO NIAID WHICH IS A BIG DEAL, AT LEAST TO US. IN 2019 WE ISSUED 31 PRESS RELEASES WITH TOPICS FROM STROKE DEMENTIA AND TRAUMATIC BRAIN INJURE TO HEAL AND BRAIN AWARD ANNOUNCEMENTS TO STORY HOW THE BRAIN PROCESSES MUSIC AND SPEECH. WE COVER BOTH OUR OWN INTRAMURAL SCIENCE AND WE PARTNER WITH UNIVERSITY PRESS OFFICES TO PROMOTE THE EXTRAMURAL SCIENCE THAT WE FUND. PEER REVIEW JOURNAL PUBLICATION IS THE GOLD STANDARD FOR OUR REELINGSES. SO OUR PRESS -- RELEASES SO OUR PRESS TEAM THOUGH WE PUBLISH 31 RELEASES WE REVIEW HUNDREDS OF PAPERS A YEAR, WHETHER SOMETHING MAKES THE CUT FOR RELEASE DEPENDS ON SEVERAL FACTORS. THE FIRST WE ASK, IS IT NEWSWORTHY, PICKED UP BY THE MEDIA. WE ALSO ASK OURSELF WHETHER THE SCIENCE IS TRANSLATABLE, SOMETIMES SCIENCE IS TOO TECHNICAL FOR US TO COVER IN THIS FORM. IS IT COOL -- IS THERE A BASIC SCIENCE FINDING INVOLVED, IS THERE A HUMAN INTEREST COMPONENT, DOES IT HAVE POTENTIAL TO IMPACT CLINICAL PRACTICE OR PUBLIC HEALTH NOW OR FUTURE AND WHAT DOES THAT LOOK LIKE. THE OTHER QUESTION WE ASK, DID WE HEAR ABOUT STUDY IN TIME. WE STRUGGLE WITH RECEIVING ADVANCE NOTICE ON THESE PAPERS SO IF WE GET NOTICE THE NIGHT BEFORE A PAPER IS ABOUT TO COME OUT ONLINE IN A JOURNAL THERE'S NOT MUCH WE CAN DO. AS JOHN MENTIONED IN DEVELOPING THE RELEASES WE HAVE TO TAKE THEM THROUGH EXTENSIVE REVIEW PROCESS AND THEN THE CLEARANCE PROCESS THAT GOES ALL THE WAY UP THROUGH THE DEPARTMENT FOR FINAL APPROVAL. SO PITCHING STORIES IS ANOTHER PROACTIVE WAY TO SHARE RESEARCH AND SOMETHING OUR PRESS TEAM DOES REALLY WELL, THIS GOES BACK TO RELATIONSHIP BUILDING. ARE WE COMFORTABLE PICKING UP THE PHONE SHARING A STORY WITH JOHN HAMILTON OR ANOTHER REPORTER WHEN SOMETHING COOL AND EXCITING IS COMING OUT THAT WE WOULD LIKE TO GET OUT THERE. IN FACT, THE ANSWER IS YES. THE ASSOCIATED PRESS PUBLISHED A STORY THIS JANUARY THAT WE PISHED LAST SUMMER SO BACK TO KIND OF THAT LONG LEAD TIME WORKING WITH REPORTERS AND PRODUCERS TO DEVELOP THE STORIES BEFORE THEY MAKE IT TO THE AIRWAVES. WE TOLD FOR THIS PARTICULAR CASE, WE TOLD LAUREN AN AP REPORTER WHO COVERS SCIENCE AND IS VERY INTERESTED IN NIH, ABOUT INTENSIVE ONE OF A KIND INTRAMURAL STUDY ON MECFS AT THE CLINICAL CENTER ON THE NIH CAMPUS. LAUREN WAS IN FACT INTERESTED, SO OUR OFFICE WORKED CLOSELY WITH THE RESEARCH TEAM AND CLINICAL CENTER COMMUNICATIONS OFFICE, TO IDENTIFY PARTICIPANT IN THIS STUDY WILLING TO BE FEATURED IN THIS STORY WHICH WAS ONE OF HER REQUIREMENTS THAT HUMAN INTEREST PIECE OF IT. LAUREN AND CREW SPENT MANY DAYS AT THE CLINICAL CENTER FILMING THE VARIOUS PROCEDURES AND TESTS AND SPEAKING WITH DR. KOROSHETZ AND MEMBERS OF THE STUDY TEAM. AND AFTER MONTHS OF WORK THE STORY AND VIDEO POSTED TO THE AP SITE ON JANUARY 8. WAS ALSO PICKED UP BY SEVERAL HIGH PROFILE MEDIA OUTLETS INCLUDING THE NEW YORK TIMES, THE WASHINGTON POST, AND THE USA TODAY. THE ARTICLE BROUGHT ATTENTION TO NIH INTRAMURAL PROGRAM AND HELPED RAISE AWARENESS ABOUT ME/CFS. WE DON'T HOST PRESS BRIEFINGS OFTEN BUT FIND IT TO BE EFFECTIVE MECHANISM IN SOME CASES AND LAST YEAR'S ADRD SUMMIT, WE THOUGHT IT WAS REALLY EFFECTIVE FOR TWO REASONS. THE FIRST REASON IT WAS TIED TO A NEW VIEW OF DEMENTIA, THAT'S UNKNOWN TO MANY REPORTERS THAT -- I'M SORRY, NEW DEMENTIA. THAT THERE ARE VARIOUS TYPES OF DEMENTIAS THAT PRESENT WITH DIFFERENT SYMPTOMS. THIS IS A MESSAGE THAT WE WORKING CLOSELY WITH PROGRAM STAFF FELT WE WANTED TO GET OUT THERE AND THE SECOND REASON IT WAS EFFECTIVE IS BECAUSE WE HOSTED THE BRIEFING IN CONJUNCTION WITH THE SCIENTIFIC WORKSHOP WHERE ALL EXPERTSES WERE GATHER SOD THEY CAN GET BACKGROUND INFORMATION ASK QUESTIONS, AND GET QUOTE FROM RESEARCHERS WITHOUT DOING TOO MUCH LEGWORK. SO THIS BRIEFING RESULTED IN AN NPL SEGMENT ON MORNING EDITION, A NEW YORK TIMES STORY ON COVER OF SCIENCE TUESDAY, AND A STORY BY LAUREN NERGARD AT THE AP. IN ADDITION TO TOPIC BASED BRIEFINGS ALSO THE NIH DIRECTOR PRESS BRIEFING EVERY YEAR AND PARTICIPATE IN NIH WIDE BRIEFING FOR NEWS RELEVENCE TO OUR PORTFOLIO. SO SWITCHING GEARS, EDUCATING THE PUBLIC ABOUT OUR RESEARCH POSITION AND NEUROLOGICAL DISORDERS IN OUR PORTFOLIO IS MANDATEDDED BY CONGRESS BUT WE ALSO FEEL STRONGLY SHARING THIS INFORMATION WITH OUR STAKEHOLDERS IS IMPORTANT. NOT ONLY ARE WE EMPOWERING PEOPLE WITH THE KNOWLEDGE WE HAVE GAINED THROUGH RESEARCH BUT WE ARE SHARING HOPE THAT OUR CURRENT RESEARCH WILL ONE DAY IMPROVE HEALTH AND LEAD TO EXCUSER FOR THESE DEBILITATING DISORDERS. MANY OF YOU HAVE HEARD DR. COLLINS REFER TO NIH ADS THE NATIONAL INSTITUTES OF HOPE. AND HERE AT NINDS WE HAVE A VARIETY OF WAYS TO SHARE THIS MESSAGE OF HOPE AND OF PROGRESS. WE DO THIS THROUGH OUR PUBLIC EDUCATION CAMPAIGNS, ONE CURRENTLY MANAGES TWO SIGNATURE CAMPAIGN FORS THE INSTITUTE. MANY OF YOU ARE FAMILIAR WITH OUR NO STROKE CAMPAIGN WHICH STARTED MORE THAN 20 YEARS AGO AFTER NINDS RESEARCH LED TO THE FIRST TREATMENT FOR ACUTE STROKE WHICH IS TPA. AND SINCE THAT TIME THOUSANDS OF PEOPLE HAVE RECEIVED TREATMENT AND THERE'S A NETWORK OF STROKE CENTERS ACROSS THE COUNTRY WE PARTNERED WITH OUR OFFICE OF SCIENCE POLICY AND PLANNING, TO HIGHLIGHT THE TPA STORY ON THE CONTRIBUTIONS TO APPROVED THERAPY SECTION OF OUR WEBSITE. WHEN THERE'S A THERAPY OR DRUG APPROVED OFTEN TIMES THE STORY ABOUT RESEARCH IS LOST, SO THIS IS WHERE WE TELL THAT STORY USING AN INTERACTIVE TIME LINE. THE CAMPAIGN LAUNCHED IN 2016 NOW ALSO IN PARTNERSHIP WITH OSPP BEING REFRESHED WITH STRONGER EVIDENCE WITH THE CONNECTION BETWEEN HIGH BLOOD PRESSURE AND DEMENTIA. WE ARE ALSO EXPLORING NEW STRATEGIES AND NON-TRADITIONAL PARTNERSHIPS TO DISSEMINATE CAMPAIGN MESSAGES AND MATERIALS WHICH ARE TARGETED TO BOTH PUBLIC AND HEALTHCARE PROVIDERS. JUST A BIT ABOUT THE 2016 CAMPAIGN RESULTS, WE REACH A TOTAL OF 56,000,000 PEOPLE WITH THE MINE YOUR RISKS PSA, PRINT ADS RADIO SPOTS AND PAID SOCIAL MEDIA. FOR THAT CAMPAIGN WE SPENT ABOUT $120,000 SO BREAKING DOWN WE WERE ABLE TO REACH 469 PEOPLE FOR EVERY DOLLAR SPENT WHICH WE THINK IS MONEY WELL SPENT BECAUSE AS YOU KNOW EITHER WORKED ON LARGE SCALE PUBLIC HEALTH CAMPAIGN ESPECIALLY IF PARTNERING WITH A LARGE AD AGENCY LIKE THE AD COUNCIL, THESE CAMPAIGNS RUN UPWARDS OF A MILLION OR MORE DOLLARS. WE WERE PLEASED WITH THOSE RESULTS. AS A RESULT OF THE FACEBOOK ADS VISITS TO MIND YOUR RISK WEBSITES WHERE ALL MATERIALS MESSAGES INCREASED BY 2000 PERCENT SO WE LOOK FORWARD TO SHARING MORE WITH YOU DURING THE SECOND PHASE OF THIS CAMPAIGN. OUR MIGRAINER APP LAUNCH LAST YEAR, WE WORKED CLOSE WITH STAFF TO DEVELOP THE APP BECAUSE NINDS SUPPORTED RESEARCH SUGGESTS BEHAVIORAL MANAGEMENT TECHNIQUES HELP KIDS CONTROL THEIR HEADACHES AND WE WERE HEARING THERE WERE NOT A LOT OF TOOLS KIDS COULD USE TO DO THIS. SO WE DECIDED TO METED THE TEENS WHERE THEY LIVE WHICH IS ON THEIR PHONE SO WE DEVELOPED AN APP TO HELP THEM TAKE CONTROL OF THEIR MIGRAINES. WE PROMOTED AND DEMOED IT BUT LAST YEAR'S AMERICAN ACADEMY OF PEDIATRICS MEETING AND WE RECEIVED REALLY ENTHUSIASTIC FEEDBACK FROM THE HEALTHCARE PROVIDERS AT THAT CONFERENCE. SO FAR IT'S BEEN DOWNLOADED OVER 6,000 TIMES. AND IN ADDITION TO OUR SOCIAL MEDIA PROMOTION WHICH IS ONGOING WE CREATED POST CARDS THAT WILL BE SENT TO PEDIATRICIAN AND NEUROLOY OFFICES AND WE ARE CONTINUING TO LOOK FOR CREATIVE WAYS TO DISSEMINATE THIS APP TO TEENS PARENTS AND PROVIDERS. THROUGH OUR EXHIBITS PROGRAM ONCE COORDINATES AND STAFF SEVERAL NATIONAL MEETINGS EVERY YEAR, HERE IS A LIST OF CONFERENCES THAT WE ATTENDED IN 2019. ATTEND DANCE AT THESE MEETINGS RANGES FROM 3,000 TO 27,000 REGISTRANTS AT SFN. AUDIENCES INCLUDE MANY FROM THE ONES AMY MENTIONED EARLIER, CLINICIAN SCIENTISTS STUDENTS, GRANTEES AND TRAINEES AND ADVOCACY GROUP REPRESENTATIVES TO NAME A FEW. THESE MEETINGS PROVIDE A VENUE TO PROMOTE EFFORTS AND PROGRAMS TO OFFER OUTREACH AND ALSO REACH OUT TO INDIVIDUALS WHO MAY NOT INITIALLY THINK OF NINDS OR NIH WHEN PLANNING TRAINING AND CAREER DECISIONS. ATTENDANCE ALSO ALLOW US TO PROMOTE AND DISTRIBUTE HEALTH EDUCATION MATERIALS, EVEN IN THIS DIGITAL AGE WE FIND OUR PRINT PUBLICATIONS ARE IN HIGH DEMAND ESPECIALLY CERTAIN SETTINGS LIKE DOCTORS OFFICES,& HOSPITAL LIBRARIES AND RESOURCE ROOMS, CLASSROOMS OR HEALTH FARES. OLDER ADULTS PREFER PRINT MATERIAS TO ONLINE INFORMATION SO WE MAINTAIN A COLLECTION OF BOOKLETS AND BROCHURES THAT CAN BE ORDERED FOR FREE ON OUR WEBSITES. IN 2019 OUR CLEARINGHOUSE DISTRIBUTED NEARLY 284,000 PRINTED BROCHURES. THOUSANDS MORE WERE DOWNLOADED ELECTRONICALLY. AS YOU CAN SEE BY THE WORD CLOUD STROKE WAS AT THE TOP OF THE LIST WITH FIVE STROKE TITLES TOPPING OVER 10,000 REQUESTS PER YEAR. AND THE NIH STROKE SCALE ON THE END WHICH HEALTHCARE PROVIDERS THROUGHOUT THE WORLD USE TO OBJECTIVELY QUANTIFY A PERSON'S IMPAIRMENT FROM STROKE, IS FAR AWAY THE MOST POPULAR NINDS PUBLICATION AND MAYBE THE SINGLE MOST REQUESTED OF ALL NIH PUBLICATIONS. OUR CALL CENTER WHICH IS ALSO PARTS OF THE CLEARINGHOUSE CONTRACT THE SERVICE IS POPULAR DESPITE INFORMATION THAT CAN BE FOUND ON OUR WEBSITE BUT IT ISN'T ALL THAT SURPRISING, PEOPLE WANT TO TALK TO A LIVE PERSON ESPECIALLY IF THEY HAVE BEEN GIVEN A DIAGNOSIS OR FAMILY MEMBER IS GIVEN DIAGNOSIS OF NEUROLOGICAL DISORDER THEY MAY NOT BE FAMILIAR WITH AND THEY HAVE A LOT OF QUESTIONS AND THEY DON'T KNOW WHERE TO TURN FOR TRUSTED INFORMATION. THAT'S WHERE WE COME IN. THE PAST YEAR OUR CALL CENTER STAFF WHO ARE FLUENT IN ENGLISH AND SPANISH RESPONDED TO 8,000 PUBLIC INQUIRIES. A LITTLE MORE THAN HALF OF THOSE CAME FROM CALLS TO OUR TOLL FREE HOTLINE AND THE REST BY EMAIL AND LETTERS. YOU CAN SEE FROM THIS WORD CLOUT THE BREADTH OF THE TOPICS WE FIELD QUESTIONS ON. IN ADDITION TO OUR CALL CENTER OUR OFFICE RECEIVES AN RESPONDS TO HUNDRED HEARSAY OF CALLS AN EMAILS EACH YEAR AND WE WORK WITH OSPP TO RESPOND TO MORE THAN HUNDRED CONTROLLED CORRESPONDENTS ASSIGNMENTS, THESE ARE THE RESPONSES TO CONGRESS AND INDIVIDUALS WHO WRITE TO DR. COLLINS OR OTHER NIH LEADERS, WHITE HOUSE OR HHS REGARDING NEUROLOGIC DISORDERS, RELATED TOPICS. WE RECEIVE MANY THANK YOU EMAILS AND LETTERS FROM GRATEFUL PATIENTS AND FAMILY MEMBERS AND DURING A GOOD WEEK WE RECEIVE SEVERAL WHICH I FILE AWAY INTO MY KUDOS FOLDER FOR A RAINY DAY. THE RESPONSES THAT WE SEND OUT ON BEHALF OF THE INSTITUTE ARE CAREFULLY CRAFTED THOUGHTFUL AND FULL OF HELPFUL RESOURCES AND LINKS SO I JUST PULLED TOGETHER A FEW OF THEM FOR YOU TO SEE. NICE COMPLIMENTS AND THE LAST ONE I PARTICULARLY WAS PARTICULARLY HEART WARMING FROM A WOMAN SEEKING HELP REGARDING CHRONIC PAIN DUE TO NEURAL GEEIA, SHE SAYS I'M GRATEFUL FOR THE DETAILED INFO AND IMPRESSED BY TIME AND EFFORT EXPENDED AS WELL AS INTEREST IN ADDRESSING MY INQUIRY. TO BE VERY HONEST I DIDN'T THINK MY INQUIRY WOULD RESULT IN A RESPONSE SO I HAVE TO EXPRESS KUDOS TO YOU AND YOUR ORGANIZATION. SO ON THAT HAPPY NOTE I WILL HAND IT BACK OVER TO AMY AND SHE WILL CONTINUE ON WITH DIGITAL AND SOCIAL MEDIA STRATEGY. >> THANK YOU SO MUCH, ALISSA. SO AS SHE MENTIONED IN TERMS OF THE MYBRAIN APP WE HAVE TO GO TO PEOPLE WHERE THEY ARE. INCREASINGLY PEOPLE ARE TURNING TOWARDS SOCIAL MEDIA FOR INFORMATION INCLUDING HEALTH INFORMATION. IN 2019 ABOUT 70% OF U.S. ADULTS USE SOCIAL MEDIA. AND 90% U.S. ADULTS OLDER THAN 50 USE IT TO SHARE A SEARCH FOR HEALTH INFORMATION. SO TO THAT END HERE AT NINDS WE MANAGE A SUITE OF DIFFERENT SOCIAL MEDIA CHANNELS THAT WE USE TO DISSEMINATE DIFFERENT TYPES OF INFORMATION TO DIFFERENT TYPES OF AUDIENCE AND ALSO WE CAN THROUGH THIS METHOD ENGAGE, THEY CAN RESPOND, THEY CAN LIKE OUR TWEETS, DISSEMINATE THEM MORE AND ASK FOLLOW-UP QUESTIONS. MOST RECENTLY WE HAVE A FACEBOOK ACCOUNT ALSO AND MOST RECENTLY WE JUST ESTABLISHED A LINKED IN PAGE THAT'S BRAND NEW BUT ENCOURAGE YOU ALL TO PLEASE JOIN US ON IT. THE CONTENT IS UPDATED DAILY ACROSS OUR SOCIAL MEDIA CHANNELS AND WE ALSO JOIN SOCIAL MEDIA INITIATIVES ACROSS NIH DEPARTMENT IN THE WHOLE GOVERNMENT. WE ALSO USE SOME OF THESE CHANNELS TO PROMOTED SPECIFIC HIGH PRIORITY EVENTS FOR THE INSTITUTE. FOR EXAMPLE, STROKE AWARENESS MONTH, IN 2018 WE HAD A BRAIN FOR LIFE TWITTER CHAT FOCUSED ON STROKE AWARENESS MONTH WITH OVER 45,000,000 CUMULATIVE IMPRESSIONS. AND WE GOT THE HASH TAG TRENDING WORLDWIDE WHICH WAS FUN BUT MOSTLY IT WAS EXCITING BECAUSE THAT WAS REALLY AN OPPORTUNITY TO SHARE INFORMATION WITH A REALLY WIDE RANGE OF PEOPLE THAT MIGHT NOT OTHERWISE THINK TO COME TO THE NINDS FOR THIS TYPE OF INFORMATION. MOST RECENTLY WE HAD A FACEBOOK LIVE EVENT FEATURING SURVIVORS AND EXPERTS SHARING INFORMATION ON STROKE AND IMPACT ON THEM AND RESOURCES HELPFUL FOR THEM. THIS WAS VIEWED OVER 60,000 TIMES PARTICULARLY AMONG MIDDLE AGED WOMEN. SO IN ADDITION TO SOCIAL MEDIA, WE USE OUR WEBSITES AS DIGITAL PLATFORMS TO REALLY SHARE WIDE RANGE OF INFORMATION FOR THE INSTITUTE. WE MANAGED 12 PUBLIC FACING WEBSITES RIGHT NOW, SOME ON BEHALF OF THE INSTITUTE, BUT MANY ON BEHALF OF THE ENTIRE AGENCY. REPRESENTING TRANS-NIH INITIATIVES SUCH AS THE BRAIN INITIATIVE, THE BLUEPRINT, COORDINATING COMMITTEES FOR PAIN AND MUSCULAR DYSTROPHY, AND MANY OTHERS. A FEW OF THEM ARE HERE AND THIS IS OUR NINDS HOME PAGE WHERE WE GET OVER 81,000,000 VIEWS A YEAR. I HAD WORKED VERY HARD -- BACK JUST A SECOND. I WANT TO TAKE A MOMENT AND SAY THAT IN THE YEARS THAT I HAVE BEEN HERE I WORKED HEAR TO MODERNIZE OUR DIGITAL PRESENCE, OVER THE LAST FEW YEARS WE HAVE REDESIGNED UPDATED EVERY ONE OF THESE WEBSITES FROM SCRATCH, MOVED TO A MUCH MORE MODERN CONTENT MANAGEMENT SYSTEM. AND HELPED THEM CONNECT TO EACH OTHER BETTER SO WE CAN SHARE INFORMATION THROUGH THESE PLATFORMS MORE SEAMLESSLY. ONE OF THE THINGS TO BEAR IN MIND IS THAT AS PEOPLE HAVE BEEN INCREASINGLY LEVERAGING THE INTERNET THEY ARE TURNING IT INTO A DR. GOOGLE AND USING IT TO FIND HEALTH INFORMATION. WE ARE ADAPTING TO THAT NEED AND WE PRODUCE REVIEW AND EDIT WITH THE HELP OF OUR FANTASTIC STAFF HERE AT NINDS ALMOST 300 DIFFERENT ONLINE PUBLIC INFORMATION PAGES ABOUT DIFFERENT NEUROLOGICAL DISORDERS. MANY OF THESE DISORDER PATIENTS ARE ALSO AVAILABLE ON OUR SPANISH LANGUAGE SITE AND IT'S IMPORTANT FOR PEOPLE TO REALIZE THIS IS THE INFORMATION THAT THE PUBLIC, THE TAXPAYER THAT FUNDS ALL OF OUR RESEARCH IS LOOKING FOR. THE TOP 50 PAGES, PROBABLY MORE WHICH JUST STOP LOOKING AFTER THE TOP 50, FOR OUR WEBSITE ARE ALL DISORDER OF PAGES OR PATIENT INFORMATION PAGES. THE TOP TEN OF THEM ARE LISTED HERE AND WHAT IS ALWAYS FASCINATING TO ME IS THEY DON'T ALWAYS CORRESPOND WITH THE LARGEST AREAS OF OUR RESEARCH INVESTMENT. WE ALSO LOOK CAREFULLY AND TRACK AT THE TERMS PEOPLE USE WHEN THEY COME TO OUR WEBSITE TO -- FOR SEARCHING TO SEE WHAT IS THE INFORMATION THEY ARE LOOKING FOR ONCE LEARN ABOUT THAT NINDS AND COME TO OUR WEBSITE. AND THOSE STILL ARE ALL DISORDER INFORMATION. WITH MULTIPLE SCLEROSIS BEING TOP IN 2019. IN ORDER TO FIGURE HOW WE CAN BETTER MEET THE NEED WE ARE CONDUCTING A EXTENSIVE USABILITY TESTING TO REDESIGN THIS AREA OF WEBSITES SO WE CAN SHARE THE MOST HELPFUL INFORMATION IN THE MOST HELPFUL WAY. THIS RAISES THE FIRST QUESTION THAT I HOPE TO GET A LITTLE BIT OF FEEDBACK FOR IN THE MIDDLE OF THE PRESENTATION, WHICH IS WE KNOW FROM A LOT OF USER TESTING AND OTHER FEEDBACK THAT WHAT IS HELPFUL FOR THE PUBLIC IS TO COME TO US FOR HEALTH INFORMATION BECAUSE WE ARE VIEWED UNBIASED AND FACTUAL. HOWEVER, WE ARE AWARE THERE ARE OTHER HEALTH INFORMATION WEBSITES THAT EXIST THAT ARE EXTREMELY POPULAR. I WILL SAY IT TURNS OUT MANY OF THEM LEVERAGE THE INFORMATION ON OUR PAGES FOR THEIR SITES WHICH IS FINE. THAT'S A GREAT WAY TO DISSEMINATE THE SAME CONTENT BUT THE UNIQUE ROLE IS RESEARCH WE CONDUCT AND SUPPORT. IT IS DIFFICULT TO CONNECT THAT INFORMATION TO THOSE DISORDER PAGES IN A WAY THAT IS MEANINGFUL FOR USERS OF THOSE PAGES. ALL THESE ARE TESTING WE HAVE DONE HAS INDICATED THEY ARE ACTIVELY ANNOYED EVERY TIME WE TRY TO ADD ADDITIONAL INFORMATION ABOUT THE RESEARCH WE ARE CONDUCTING. THEY ARE IN THE DOCTOR'S OFFICE JUST DIAGNOSED NOT WHAT THEY WANT TO HEAR RIGHT THEN, MAYBE LATER. SO HOW CAN WE DO A BETTER JOB? HOW CAN WE COUPLE THE DISSEMINATION OF THIS HEALTH EDUCATION CONTENT THAT PEOPLE ARE LOOKING FOR? WITH AN UNDERSTANDING CRITICALLY IMPORTANT ROLE NINDS AND OUR RESEARCHERS ARE PLAYING AND TRYING TO UNDERSTAND THESE DISORDERS, PREVENT THESE DISORDERS AND TREAT THESE DISORDERS. ANYONE HAVE ANY THOUGHTS? I WELCOME THEM NOW OR LATER. YES, PLEASE. >> FROM THAT PERSPECTIVE I CAN TOTALLY UNDERSTAND PATIENT PERSPECTIVE WHEN TRYING TO FIND INFORMATION ON MAYBE WHO THEY GO TO TO GET A DIAGNOSIS, WHAT IS THIS, DO I HAVE IT OR NOT. RESEARCH MAY NOT BE THE TOP OF THEIR BRAIN AT THAT POINT IN TIME BUT YOU MAY CONSIDER PATIENT INTERVIEWS OF PEOPLE WHO HAVE BEEN AT THE CLINICAL CENTER. WHO ARE PARTICIPATED IN RESEARCH THAT HAVE THAT CONDITION BECAUSE THEY MAY BE MORE LIKELY TO WATCH SHORT CLIPS THAW WANT TO KNOW WHAT WILL HELP THEM AT THAT POINT NOT TEN YEARS DOWN THE ROAD BUT IF YOU BRING THROUGH A PATIENT PERSPECTIVE AND PATIENT VOICE IT MAYBE MORE WELCOMED TO THEM VERSUS HERE IS A RESEARCH STUDY OR WHAT NINDS DOES. >> ABSOLUTELY, THAT'S GREAT. THANK YOU. >> I WONDER WHAT WOULD BE AN EFFICIENT WAY TO CROSS LINK OR COORDINATE WITH OTHER INFORMATION SAY GUIDELINES STATEMENTS DONE BY OTHER ORGANIZATIONS LIKE AMERICAN HEART OR STROKE AND SO FORTH WHERE MANY PEOPLE WHO DEVELOP THESE GUIDELINES ARE NIH FUNDED INVESTIGATORS THAT THEY REFER TO THAT. AND ALSO THE OTHER STATEMENTS BY PATIENT SUPPORT GROUPS THAT OFTEN HAVE OFTEN VIN INFORMATION BY NIH SUPPORTED SCIENTISTS. HOW CAN YOU IMPROVE THE ACCESS TO PATIENTS? >> RIGHT. I THINK WE WORK CLOSELY WITH MANY OTHER PROFESSIONAL SOCIETIES AND SCIENTIFIC SOCIETIES, AAN IS AN EXAMPLE. THEY WORK WITH US TO HELP US MAKE SURE OUR INFORMATION IS ACCURATE AND IN TURN THEY USE CONTENT ON OUR SITE TO HELP FURTHER EXPAND OUTREACH. BUT HOW CAN WE BUILD ON THOSE SUCCESSES? TO SOMETHING MORE MEANINGFUL? MAYBE WE CAN EXPLORE POTENTIALLY HOW TO DO THAT. THE QUESTION IS HOW IS THAT GOING TO HELP THOSE USERS UNDERSTAND WHAT NINDS CONTRIBUTES. RIGHT? AND IT'S AN ONGOING QUESTION. I THINK IT'S ONE WE ARE GOING TO CONTINUE TO BE CONTINUING AT DIFFERENT AUDIENCES WITH. YES, PLEASE. >> WE RUN INTO THIS A LOT IN A CLINICAL DEPARTMENT WHERE THE MEDICAL CARE END WANTS TO FUNNEL PATIENTS. SO THEIR COMMUNICATIONS ARE AROUND WHAT YOU MENTIONED WHERE THEY HAVE CLINICALLY PRESENT PRACTICALITY KINDS OF THINGS OR INNOVATIONS ARE FOCUSED AND ITERATIVE CLINICAL IMPROVEMENTS, WHEREAS IN THE RESEARCH SIDE OF THE DEPARTMENT DISCOVERY BASED. LESS CONNECTED TO CLINICAL CARE. SO WE WRESTLE WITH THIS A BIT, ONE WAY TO DO IT IS UNFORTUNATELY LABOR INTENSIVE BUT TO HAVE THE CLINICAL SITE AND THEN SAY SOMETHING LIKE WHERE THE GAPS IN CARE. WHAT ARE GAPS IN OUR TREATMENT OF THIS DISEASE, SOMETHING THAT STILL GRABS PATIENT BUT HIGHLIGHT WHAT IS IS MISSING AND WHAT IS NINDS DOING TO FILL THOSE GAPS. YOU MIGHT PUT SPECIFIC ASPECTS OF THE RESEARCH PORTFOLIO SO YOU CAN STILL GRAB THE HEART OF THE INITIAL INTERNET QUERY BUT INFORM THE READER WHAT'S -- WHAT REALLY IS MISSING, THAT'S NOT PRESENT IN SOME OF THE MD ALERTS AND OTHER THINGS THEY CAN GET -- THE PRACTICAL CLINICAL OBSERVATION. >> GREAT IDEA. YOU ARE RIGHT. WE HAVE A MORE GENERIC, WHAT IS THE RESEARCH BEING DONE NOW KIND OF TITLE. SO I THINK THAT THAT'S REALLY GREAT IDEA. THANK YOU. YES. >> I WAS A LITTLE BIT SURPRISED THAT I DIDN'T SEE STEM CELL CLINICS FEATURED ANYWHERE HERE. WONDER HOW MANY INQUIRIES YOU HAVE ALONG THOSE LINES AND WHAT DO YOU DO WITH THEM, HOW DO YOU DEAL WITH THAT? RESEARCH INFORMATION ABOUT STEM CELLS, ABOUT WHAT WE DO, THE GUIDELINES THAT HAVE BEEN DEVELOPED, AND WE DON'T GET VERY MANY QUERIES IN THAT SPACE ON OUR SITE. NOW, I DON'T KNOW IF THEY HAPPEN TO BE -- WE POINT AT THE END OF A LOT OF OUR CONTENT TO THE NIH CENTRAL SITE TO COVER THIS TOPIC. THERE IS A LOT OF URGE TOWARDS BEING CONSISTN 'T IN OUR MESSAGING ACROSS THE INSTITUTES IN THIS SPACE SO IT COULD BE GETTING REDIRECTED THERE BUT IT IS TRUE, IT IS NOT ONE OF THE THINGS THAT RISES UP TO US THAT OFTEN WE ALSO DON'T GET A LOT OF PUBLIC INQUERIES IN THAT SPACE WHICH IS JUST REALLY INTERESTING, IT'S TRUE ONCE -- NOW THAT YOU MENTION IT. THANK YOU. I'M GOING TO DEEP MOVING FORWARD. ONCE YOU GET PAST DISORDER AND PATIENT INFORMATION THOUGH YOU DO FIND THAT THIS MOST POPULAR PAGES ON OUR WEBSITE DEAL WITH FUNDING INFORMATION IN SOME WAY OR ANOTHER. AND I JUST WANT TO LET YOU KNOW WE HAVE WORKED REALLY CLOSELY WITH STAFF HERE, WITH STAFF ACROSS NIH, AND THROUGH REGULAR USER TESTING AT THE SOCIETY FOR NEUROSCIENCE MEETING TO FIND WAYS TO MAKE INFORMATION EASIER TO FIND. TO MAKE IT EASIER TO FIND FUNDING OPPORTUNITIES, EASIER TO FIND CLINICAL TRIAL INFORMATION, EASIER TO FIND INFORMATION ABOUT OUR HIGH PRIORITY PROGRAMS FOR EXAMPLE TRAINING CAREER DEVELOPMENT. IT STILL NEEDS WORK SO THIS IS AN AREA WE ARE ACTIVELY WORKING ON AND ONE THAT WE HEAR CONSTANTLY IS IMPORTANT TO THE RESEARCH COMMUNITY. WE ALSO ARE TRYING HARD TO BECOME MORE TRANSPARENT TO THE PUBLIC AND TO THE RESEARCH COMMUNITY AND SO ONE OF THE NEW THINGS THAT WE HAVE DONE IS TO OFFER OPPORTUNITIES EXPLORE NIH FUNDING SO WE ARE PROVIDING A GRAPH TO SHOW RESEARCH INVESTMENT AND OUTCOMETS REWARD RATE SUCCESS RATE AND PAY LINE, ET CETERA. THAT WILL HOPEFULLY BE ALSO SOMETHING THAT WILL HELP RESEARCH COMMUNITY FEEL LIKE WE WANT THEM TO UNDERSTAND WHAT WE ARE DOING AND HOW WE ARE DOING IT AND NOT JUST RECEIVE THAT OUTPUT OF OUR DECISIONS. JOHN BURKLOW DID A TREMENDOUS JOB TALKING ABOUT THE WIDE RANGE OF WAYS THAT THEY SUPPORT DR. COLLINS MESSAGING. AND AS THEY POINTED OUT, BALL TEAR IS WILLING EVEN TO GO UP ON STAGE AND DANCE. HE IS ALSO GAME FOR MANY, MANY THINGS. BUT I HAVE TO CONFESS, I'M THANKFUL HE DOES NOT HAVE A BAND. WE DO SUPPORT BOTH WALTER AND NINA SHORE AS DEPUTY DIRECTOR FOR PERSONAL COMMUNICATION EFFORTS. INCLUDING HELPING THEM DEVELOP PRESENTATIONS, DIRECTORS MESSAGES, BLOG POSTS FOR DIFFERENT AUDIENCES, WE ALSO HELP MANAGE WALTER'S TWITTER ACCOUNT WHICH IS RAPIDLY INCREASING IN NUMBER OF FOLLOWERS, ONE DAY WE WILL GET TO THE LEVEL OF FRANCIS COLLINS. BUT WE ENCOURAGE YOU TO SUBSCRIBE TO WALTER'S DIRECTORS MESSAGE AND FOLLOW HIM ON TWITTER. WE TRY HARD TO ADDRESS IMPORTANT ISSUES FACING THE INSTITUTE IN THESE VENUES. AND IT'S NOT ALWAYS CLEAR THAT WE ARE HAVING THE REACH WITH THESE MESSAGES THAT WE HOPE. SO THAT IS SOMETHING AS WE MOVE FORWARD IF ANYONE HAS ANY IDEA HOW WE CAN ENHANCE OUTREACH, WE WOULD WELCOME THEM. WE ALSO CAN USE DIGITAL PLATFORMS TO SPARK A DIALOGUE WITH THE RESEARCH COMMUNITY, TO THAT I WANT TO PROVIDE A QUICK EXAMPLE, MANY OF YOU MIGHT RECALL A NUMBER OF YEARS AGO WE DID RESEARCH AND ANALYSIS AND IT DEMONSTRATED -- IT DEMONSTRATED THAT YOU CAN SEE ON THE TOP GRAPH, THAT THE BLUE LINE WHICH REPRESENTED OUR BASIC RESEARCH, MOST FUNDAMENTAL BASIC RESEARCH FOCUSED ON THE FUNCTION OF NORMAL HUMAN BRAIN, WAS RAPIDLY DECREASING AND MAYBE HEADING TOWARDS EXTINCTION. WHICH PRESENTEDDED THAT DATA TO COUNCIL IN OPEN SESSION AS PART OF EFFORT TO ENGAGE WITH COMMUNITY AND THE ADVICE THEY GAVE AND ADDITIONAL ANALYSES WE DID REVEALEDDED THAT THE ISSUE WAS IN FACT THE APPLICATION NUMBER WAS DECREASING. INVESTIGATORS WERE SUBMITTING FEWER APPLICATIONS IN THIS FUNDAMENTAL AREA OF RESEARCH. WHICH SUGGESTED THAT THERE WAS PERCEPTION PERHAPS THE INSTITUTE WAS NOT INTERESTED IN THAT AREA OF RESEARCH WHICH WAS THE OPPOSITE OF THE TRUTH. THE INSTITUTE BUZZ FULLY AND -- WAS FULLY AND REMAINS FULLY COMMITTED TO BASIC RESEARCH AND TRULY BELIEVES IS THE ENGINE OF DISCOVERY. HOW COULD WE COMBATED THIS MISPERCEPTION? WE LAUNCHED OUR FIRST BLOG POST EVER, WHERE WE PRESENTED ALL OF OUR ANALYSES AND TOOK COMMENTS FROM THE PUBLIC AND TRIED TO& EXPLAIN WITH WE WERE HORRIFIED BY THIS PHENOMENON AND WE REALLY WANTED TO CHANGE THIS TREND. WE ALSO PUBLISHED A NUMBER OF HIGH PROFILE PERSPECTIVES YOU CAN SEE THERE. SO THAT WE COULD TRY TO REACH ADDITIONAL AUDIENCES WITH THIS POINT. WE LEVERAGED THE BRAIN INITIATIVE AND ITS COMMITMENT TO DEVELOPING NEW TOOLS AND TECHNOLOGIES LOOKING TO UNDERSTAND HOW NORMAL HUMAN BRAIN FUNCTIONS WHICH IS ALL FUNDAMENTAL BASIC RESEARCH SPACE. WE WORKED ACROSS NIH TO CONVERT A LOT OF THIS INPUT INTO ACTION. THIS INCLUDED WORKING WITH ALL THE IC DIRECTORS AND FRANCIS COLLINS TO COME OUT WITH EDITORIAL AND SCIENCE AFFIRMING IMPORTANCE OF BASIC RESEARCH AND CHANGING THE PUBLIC HEALTH RELEVANT STATEMENT FOR NIH TO AFFIRM THE IMPORTANCE OF BASIC RESEARCH AND RELEVANCE TO THE NIH MISSION. WE ALSO HERE AT NIH RELEASED PA& WITH SET ASIDE FUNDS FOCUSED ON SUPPORTING FUNDAMENTAL BASIC RESEARCH APPLICATIONS THAT MISSED THE PAY LINE. THAT HAS BEEN SUCCESSFUL AND BEEN REISSUED AND I THINK LATER TOMORROW YOU WILL BE APPROVING THAT PAY PLAN. I'M HAPPY TO SAY THAT THE RESULT OF ALL THESE EFFORTS WERE WE WERE AT VERY LEAST ON THE BLUE LINE STEM IF NOT ENTIRELY REVERSE THIS TREND. SO WE -- THIS IS AREA OF CONTINUED PRIORITY, WE ARE CONTINUING TO TRY TO GET OUT TO THE COMMUNITY. WE ALSO ARE CONNECTING WITH NON-PROFIT ORGANIZATION AND PATIENT GROUPS THAT ARE SO INVESTED IN NINDS SUCCEEDING IN OUR MISSION N. THERE IS A HUGE NUMBER OF DISORDERS THAT FALL WITHIN THE NINDS UMBRELLA MISSION. AND WE MAINTAIN RELATIONSHIPS WITH OVER 300 DIFFERENT RELEVANT ORGANIZATIONS. TO FOSTER COLLABORATIONS AND PARTNERSHIPS ACROSS THEM, AND TO HELP ADVANCE OUR MISSION. WE COLLABORATE AND PARTNER ON PUBLIC CAMPAIGNS WITHIN MEETINGS AND WORKSHOPS AT A NUMBER OF THE MEETINGS WHERE WE HAVE BOOTHS WHICH ALISSA DESCRIBED. WE ALSO WORK VERY HARD TO MEET WITH THEM IN A NUMBER OF DIFFERENT VENUES. WE HELP TO SUPPORT A NUMBER OF ONE ON ONE MEETINGS WITH PROGRAM STAFF AND LEADERSHIP. WE MAINTAIN THE BRAIN ATTACK COALITION, A GROUP TO CUTSED ON COMBATING ACUTE STROKE. WE ALSO NINDS NON-PROFIT FORUM. SO THE NON-PROFIT FORUM IS A FANTASTIC MEETING, ACTUALLY WALTER COMMITTED TO IT AND SAYS HIS FAVORITE MEETING OF THE YEAR. WHERE IT BRINGS TOGETHER NON-PROFIT ORGANIZATIONS TO NETWORK AND ENGAGE WITH NINDS STAFF. LAST YEAR WE HAD OVER 50 PATIENT ORGANIZATIONS REPRESENTED. THE MEETING TOPICS COVER A WIDE VARIETY OF ISSUES THAT THE GROUPS THEMSELVES HAS -- HAVE INDICATED TO US ARE IMPORTANT TO THEM. WE HAVE AN ORGANIZING COMMITTEE COMPRISED OF PATIENT ORGANIZATIONS TO THAT POINT. THE FORMAT OF THIS MEETING INCLUDES IN ADDITION TO PANEL DISCUSSIONS, BREAK OUT SESSIONS, SUCCESS STORIES, THERE IS A POSTER SESSION, ACTUALLY, AND THERE'S ALSO A LOT OF OPPORTUNITIES FOR THE PARTICIPANTS TO MEET WITH NINDS PROGRAM STAFF, I HAVE TO SAY THAT IS ABSOLUTELY THEIR FAVORITE PART OF THE MEETING. WE ALSO ARE WORKING HARD TO CONNECT IN PERSON THROUGH THESE SORTS OF METHODS WITH DIFFERENT TYPES OF RESEARCH COMMUNITIES. A LOT OF THAT EFFORT FOR OUR OFFICE IS STILL INVESTEDDED IN THE BRAIN INITIATIVE. WE ARE VERY EXCITED TO PARTNER WITH THE NEW BRAIN DIRECTOR NOW HE'S COME ON BOARD. WE HAVE RESPONSIBILITY TO MANAGE AND COORDINATE COMMUNICATION WITH NIH AND BETWEEN NIH AND OTHER FEDERAL AND NON-FEDERAL PARTICIPANTS IN THE NIH BRAIN INITIATIVE, THE U.S. BRAIN INITIATIVE. TO THAT END WE HAVE ORGANIZED A GROUP CALLED THE BRAIN INITIATIVE ALLIANCE, WHICH IS ASSEMBLY OF THESE PARTICIPANTS THAT ARE COMMITTED TO SHARING COMMUNICATION AND OPPORTUNITIES ACROSS THE BRAIN INITIATIVE. TOGETHER WE HAVE CREATED AND LAUNCHED A STAND ALONE WEBSITE, FOCUSED ON THE ENTIRETY OF THE U.S. BRAIN INITIATIVE WHICH WE MANAGE AND WHICH INCLUDES NOT ONLY SUCCESS STORIES ADVANCES AND RESOURCES EMERGED ACROSS THESE DIFFERENT GROUPS WITHIN THE BRAIN INITIATIVE SPACE BUT ALSO BRINGS TOGETHER FUNDING OPPORTUNITIES ACROSS THE DIFFERENT ORGANIZATIONS. SO WE HOPE THE RESEARCH COMMUNITY CAN COME TO THIS ONE STOP SHOP TO LOOK FOR RESEARCH OPPORTUNITIES FOR BRAIN RESEARCH. WE DEVELOP CONTENT FOR THIS SITE WHICH INCLUDES HIGHLIGHTING SPECIFICALLY WOMEN AND UNDER-REPRESENTED MINORITY AWAR DEES WITHIN THE BRAIN INITIATIVE AND SUCCESS TO ONE OF THE POINTS BROUGHT UP EARLIER, WE AGREE WE WANT TO DO MORE WORK TO EMPHASIZE YOU DON'T HAVE TO LOOK LIKE THE STEREO TYPICAL SCIENTIST TO BE SUCCESSFUL IN ANY AREA, INCLUDING BRAIN. BUT WE ARE SAD TO REPORT DESPITE YEARS OF THESE REALLY CONCERTED EFFORTS ON OUR PART, WE HAVEN'T BEEN ABLE TO MOVE THAT NEEDLE. SO THIS IS AN AREA WE CONTINUE TO WORK ON REALLY HARD. WE ALSO MANAGE -- HELP THE BIA MANAGE SOCIAL MEDIA BOTH FACEBOOK AND TWITTER. AND WE ALSO PARTICIPATE IN THE INTERNATIONAL BRAIN INITIATIVE WHERE WE INTERSECT WITH OTHER EMERGING BRAIN INITIATIVES ACROSS THE WORLD. WE BRING RESEARCHERS AND STAKEHOLDERS TOGETHER ON BEHALF OF BRAIN, A NUMBER OF SYMPOSIA CONFERENCES AND WORKSHOPS, THE MULTI-COUNCIL WORKING GROUP AND INNER ETHICS WORKING GROUPS WHICH FEED INTO THIS COUNCIL AND PROVIDE INPUT ON ACTIVITIES FOR THE BRAIN INITIATIVE. WE HELP TO COORDINATE WORKSHOPS AND INCLUDING THOSE RELATED TO THE RECENT ACD BRAIN STRATEGIC PLANNING EFFORTS WHERE WE PROVIDE ALL SUPPORT FOR THAT STRATEGIC PLANNING EFFORT INCLUDING THREE WORKSHOPS AND TWO TOWN HALLS. THEN THROUGH THE BRAIN INITIATIVE ALLIANCE, WE HAVE HAD AN ANNUAL SATELLITE EVENT AT SFN WHICH IS A GREAT SOCIAL NETWORKING OPPORTUNITY, WE PROVIDE A LITTLE SCIENCE BUT MOSTLY AN OPPORTUNITY FOR BRAIN RESEARCHERS TO CONNECT WITH EACH OTHER. AND TO SHARE THE TOOLS THAT THEY ARE CREATING AND THE HOPES THAT WE CAN HELP JUMP START DISSEMINATING THOSE TOOLS. FINALLY, WE HOLD AN ANNUAL BRAIN INVESTIGATORS MEETING, THIS COMING YEAR WE ANTICIPATE THERE WILL BE OVER 1700 REGISTRANTS FOR THAT MEETING. AND I WANT TO EMPHASIZE THAT AT THE MEETINGS WE ARE TRYING TO ENCOURAGE THE INVESTIGATORS THEMSELVES TO EMBRACE THE IMPORTANCE OF COMMUNICATING THEIR SCIENCE. SO WE HOLD WORK AS LONG AS DURING THE MEETING TO HELP THEM UNDERSTAND HOW TO SPEAK TO THE PRESS, WE PROVIDE MEDIA TRAINING, WE HELP THEM WITH ADVICE ON HOW TO LEVERAGE SOCIAL MEDIA TO DISSEMINATE THEIR RESEARCH. WE PROVIDE SOCIAL MEDIA WHILE WE DO PHONE AND VIDEO CONTESTS SO THAT WE HAVE DIFFERENT MATERIAL TO SHARE. AND WE PROVIDE EXTENSIVE NETWORKING OPPORTUNITIES. IT'S A REALLY FABULOUS MEETING AND I ENCOURAGE PEOPLE TO COME. BUT THE RESEARCH COMMUNITY IS BUSY. AND THEY DON'T REALLY WANT TO ENGAGE WITH US UNTIL THEY WANT ONE SPECIFIC PIECE OF INFORMATION AND THEN THEY WILL COME AND LOOK FORWARD AND GOING TO GO AWAY AGAIN. SO WE WOULD WELCOME ADDITIONAL IDEAS HOW WE CAN REACH RESEARCH COMMUNITY MORE EFFECTIVELY. ARE THERE OTHER WAYS WE CAN GO TO WHERE THEY ARE, ARE THERE OTHER PLATFORMS WE CAN USE OR TYPES OF MATERIAL WE CAN PROVIDE THAT WOULD BE HELPFUL. I'M GOING TO LET EVERYONE THINK ABOUT THAT A WHILE AND COME TO THAT AT THE END. SO SPEAKING OF BRAIN, THE BRAIN ACD NEUROSCIENCE NEUROETHICS REPORTS, BOTH CITED A RECENT NATIONAL ACADEMIES REPORT EMPHASIZING THE IMPORTANCE OF ENHANCED COMMUNITY SCIENCE LITERACY. AND ENCOURAGE BROAD ENGAGEMENT IN SCIENCE AND SPECIFICALLY SUGGESTED OFFERING OPPORTUNITIES TO MORE USE FROM DIVERSE SOCIO ECONOMIC BACKGROUNDS TO ENGAGE WITH BRAIN SCIENCE. I WANT TO SAY IN OUR OFFICE WE ARE PASSIONATELY COMMITTED TO THIS AS BEING AN IMPORTANT GOAL. SO WE ARE CURRENTLY SUPPORTING A LOT OF EFFORTS FOR STAFF ACROSS NINDS WHO ARE ALL PASSIONATELY COMMITTEDDED TO THIS. IT IS REMARKABLE, THE DEGREE TO WHICH PEOPLE ARE WILLING TO VOLUNTEER TIME AND HE WANT TO THIS GOAL. WHERE WE HAVE PARTNERSHIPS WITH LOCAL LIBRARIES REACHING COMMITTEE MEMBERS, WE HAVE ANNUAL EVENTS INCLUDING BRAIN AWARENESS WEEK AND USA SCIENCE ENGINEERING FESTIVAL SCOUT DAYS WHERE WE HAVE THE OPPORTUNITIES TO SHARE WITH KIDS THAT DON'T KNOW THAT MUCH ABOUT SCIENCE AND CERTAINLY NOT NEUROSCIENCE. WHY IT'S SO EXCITING TO STUDY THE BRAIN. AND WE HAVE A RICH AND GROWING PORTFOLIO OF EDUCATIONAL RESOURCES THAT WE ARE REALLY EXCITED ABOUT. SO >> EXCUSE ME, AMY. WE HAVE A SPEAKER WHO CAME OVER HERE TO TALK SO COULD WE PAUSE THIS AND PICK IT UP WHEN SHE'S DONE? SEEMS LIKE A GOOD PLACE TO PAUSE. WHY DON'T WE TAKE -- UNLESS THERE'S ANY QUESTIONS RIGHT NOW, WHY DON'T WE TAKE ABOUT A FIVE MINUTE BREAK. AND THEN WE'LL PROBABLY TAKE ANOTHER ONE IN AN HOUR OR SO. IT IS A PLEASURE TO INTRODUCE OUR NEXT SPEAKER, DR. HELENE LANGEVIN, DIRECTOR OF NATIONAL NATIONAL COMPLIMENTARY AND INTEGRATED HEALTH. APPOINTED IN 2018, PRIOR TO THAT SHE WAS OSHA CLINIC INTEGRATIVE MEDICINE BRIGHAM AND WELL'S HOSPITAL HARVARD MEDICAL SCHOOL, PROFESSOR RESIDENCE OF MEDICINE HARVARD SINCE 2012. HER RESEARCH INTERESTS CENTER AROUND CONNECTIVE TISSUE AND CHRONIC MUSCULOSKELETAL PAIN. ONE OF MY FAVORITE TOPICS AND MECHANISMS OF ACUPUNCTURE, MANUAL MOVEMENT BASED THERAPIES. HER RECENT WORK IS ON EFFECTS OF STRETCHING AND INFLAMMATION RESOLUTION MECHANISMS IN CONNECTIVE TISSUE. M.D. CAME FROM MCGILL, POST DOC FELLOWSHIP IN NEUROCHEMISTRY AT THE MRC CAMBRIDGE, AND RESIDENCY IN INTERNAL MEDICINE AND FELLOWSHIP ENDOCRINOLOGY METABOLISM AT HOPKINS. HELENE, THANK YOU FOR COMING. INTERESTED TO HERE WHERE YOU ARE TAKING THE INSTITUTE AND HOW WE CAN BEST COLLABORATE. >> THANK YOU SO MUCH. IT'S A PLEASURE TO BE HERE. I'M DELIGHTEDDED TO SPEAK WITH YOU, TO YOU ABOUT THE STRATEGIC PRIORITIES FOR THEM WE ARE DEVELOPING AS PART OF OUR NEXT STRATEGIC PLAN. AND NCCIH IS NOW 20 YEARS OLD AND I HAVE BEEN HERE A YEAR SO IT'S REALLY GREAT TIMING. AND I'M GOING TO BE FOCUSING ON PAIN TODAY. FOR A COUPLE OF REASONS, FIRST IT'S A VERY ONE OUR BIG AREAS OF PRIORITIES AS NCCIH BUT ALSO I WANT TO HIGHLIGHT AND ILLUSTRATE MANY FRUITFUL COLLABORATIONS THAT WE HAVE HAD WITH NINDS BOTH IN OUR INTRAMURAL PROGRAMS AS WELL AS EXTRAMURAL. OUR ENTIRE INTRAMURAL PROGRAM IS FOCUSED ON PAIN RESEARCH BOTH ON FOR EXAMPLE MCKNOW SENSORY MECHANISMS BASIC RESEARCH THE AMYGDALA IN PAIN AMPLIFICATION AND SUPPRESSION BUT ALSO SOME MORE CLINICAL RESEARCH ON INTERPLAY OF EMOTION AND EXPECTANCY ON PAIN. FOR EXTRAMURAL SIDE, 52% OF OUR PORTFOLIO IS DEVOTED TO PAIN OR NEUROSCIENCE RESEARCH. SO IT'S A VERY BIG COMPONENT OF WHAT WE DO. WE ALSO PARTICIPATE IN SEVERAL PROGRAMS BOTH TRANS-NIH AND ALSO ACROSS AGENCIES FOR EXAMPLE THE NIH DODVA PAIN MANAGEMENT LABORATORY THAT LOOKS AT PAIN MANAGEMENT IN A NON-PHARMACOLOGICAL TREATMENTS FOR PAIN IN THE MILITARY. THE HEAL INITIATIVE, THE BRAIN INITIATIVE, NEUROSCIENCE BLUEPRINT, WE HAVE A LOT OF ACTIVITIES WHERE WE COLLABORATE A LOT ACROSS IN THIS FIELD. SO THE REASON WHY PAIN IS SUCH A PRIORITY AT NCCIH IS BECAUSE THE TOP FOUR REASONS PEOPLE REPORT TO USE COMPLIMENTARY INTERVENTION IS BACK PAIN NECK PAIN JOINT PAIN AND OTHER MUSCULO SKELETAL PAIN. SO IN MANY OF THESE INTERVENTIONS FALL INTO A BROAD CATEGORY WE CALL MIND AND BODY PRACTICE. WHAT DOES THAT MEAN? THERE ARE PRACTICES FOR EXAMPLE, MINDFULNESS BASED MEDICATION OR COGNITIVE BEHAVIOR THERAPY, HYPNOSIS, RELAXATION TECHNIQUES THAT ARE -- WHEN WE THINK OF THE THERAPEUTIC INPUT OF THESE PRACTICES THE PRIMARILY PSYCHOLOGICAL OR MENTAL. AND THEN YOU HAVE OTHER THERAPIES THAT ARE MORE BODY BASED WHERE THE PRIMARY INPUT LIKE MASSAGE CHIROPRACTIC CARE, ACUPUNCTURE IS PHYSICAL, OF COURSE HAS AN EFFECT ON THE NERVOUS SYSTEM. AND THEN THERE'S PRACTICES LIKE YOGA AND TAI CHI WHERE THE PRIMARY INPUT IS BOTH. THERE'S A PSYCHOLOGICAL COMPONENT BUT ALSO A PHYSICAL COMPONENT OF THESE TECHNIQUES. BUT IN GENERAL, MIND AND BODY PRACTICES, MANY OF THEM INSPIRED BY EASTERN PHILOSOPHY AND PRACTICE, THAT TEND TO EMPHASIZE CONNECTIONS BETWEEN THE MIND AND THE BODY. AND OF COURSE THE PRACTICE OF MEDICATION IS VERY ANCIENT IN CHINATY BET, INDIA, ET CETERA BUT IT REALLY IN THE 1960s THAT I HAVE A PICTURE IN THE MIDDLE OF HERB BENSON AT HARVARD STUDYING MONKS MEDITATING AND THEY WERE ABLE TO LOWER BLOOD PRESSURE WHILE MEDITATING. AND HE WAS A CARDIOLOGIST AND REALLY GOT INTRIGUED BY THIS. THEN I COULDN'T RESIST SHOWING THIS WONDERFUL PICTURE HERE OF THE DALI LAMA SPEAKING TO MY PREDECESSOR JESSIE BRIGGS AND WALTER AND DR. COLLINS, I WISH I HAD BEEN THERE. SO INTERRECEPTION IS A PART OF NEUROSCIENCE BEGINNING TO REALLY DIVE INTO THIS BRAIN BODY CONNECTION. WHAT IS INTERCEPTION? IT'S DEFINED AS PROCESS BY WHICH THE BODY SENSES, INTERPRETS INTEGRATE AND REGULATES SIGNALS FROM WITHIN ITSELF. THIS IS AN AREA THAT'S REALLY NOT A NEW AREA BUT AN AREA THAT WE CERTAINLY US AT NCCIH ARE FOCUSING ON AND NCCIH LED A NEUROSCIENCE BLUEPRINT WORKSHOP ON THIS TOPIC, THIS WAS ABSOLUTELY A FASCINATING WORKSHOP AND REALLY HIGHLIGHTED HOW MUCH WE NEED TO LEARN ABOUT HOW OUR BRAIN AND OUR NERVOUS SYSTEM COMMUNICATES WITH OUR INTERNAL BODY. THE WAY WE DEFINE THIS IS REALLY INTERCEPTIONS IS DEFINED AS SIGNALS NOT FROM THE OUTSIDE WORLD, NOT EXCLUDE VISION OR HEARING, AND THERE ARE SENSATIONS DEEP TO THE SKIN. SO BUN AREA THAT IS PARTICULARLY UNDERDEVELOPED IN THE FIELD OF INTERRECEPTION IS THE INTERFACE BETWEEN THE MUSCULO SKELETAL SYSTEM AND THE NERVOUS SYSTEM. WHY IS THAT? WHEN WE THINK ABOUT SENSORY INPUT FROM DEEP TISSUE, DEEP TO THE SKIN, WE USUALLY THINK OF THIS AS PROPRIA SENTENCE YOU MOVE UP OR DOWN AND FEEL THE JOINT MOVING IN WHICHEVER DIRECTION THEIR PROPRIOCEPTION IS INTACT. BUT THE SENSORY NEURONS THAT MEDIATE THE PROPRIA CEPTIVE SIGNAL START IN MUSCLE SPINDLES, THEY START IN GOLGI TEN TON ORGANS, START IN JOINT CAPSULE CORPUSCLES. BUT THESE ARE KIND OF THESE ARE THE WHAT WE KNOW ABOUT OR MECHANISMS BY WHICH THE BODY FOR EXAMPLE KNOWS POSITION IN SPACE, AND SORT OF MOVES AROUND, HOWEVER I INVITE YOU TO CONSIDER THE TYPE OF SENSORY INPUT THAT YOU FEEL I ENCOURAGE THIS NOW, GRAB YOUR FOREARM AND TWIST IT AND WHAT DO YOU FEEL WHEN YOU DO THAT? THESE ARE NOT SENSATIONS FROM JOINTS. THESE ARE SENSATIONS THAT YOU GET FROM DEEP TISSUES, SUBCUTANEOUS OR THE FACIE TISSUES THAT SURROUND MUSCLES AND BONES, AND THESE ARE NOT SENSATIONS WE KNOW A LOT ABOUT. WHAT MEDIATES THESE SENSATIONS? THERE ARE SIMILAR SENSATIONS THAT YOU GET WHEN YOU STRETCH. YOGA OR PLAIN STRETCHING. WHEN YOU MOVE YOUR LIMBS, A LITTLE OUTSIDE RANGE OF MOTION YOU GET SENSORY INPUT WHEN -- FROM YOUR JOINTS WHEN DOING THAT BUT I WOULD ARGUE YOU ARE ALSO GETTING SENSORY INPUT FROM YOUR PLAIN OLD CONNECTIVE TISSUE. WE KNOW FACIE, WHEN I TALK FACIE, THESE ARE CONNECTIVE TISSUE ENVELOPES THAT SEPARATE THE MUSCLES, SURROUND THE MISLESS AND GO INSIDE, THE MUSCLE AROUND MUSCLE FAST CAN BELIEVES, ET CETERA, WE KNOW TISSUES ARE INNERVATED BY ABUNDANT SENSORY NERVE ENDINGS. WE ALSO KNOW DORSAL HORN NEURONS RECEIVE INPUT FROM THE FACIE AND THE FIELD GREATLY INCREASES WHEN THE FACSA IS INFLAMED. WHAT THE EQUIVALENT OF ALLODYNIA IN DEEP TISSUE? WE DON'T KNOW. WE ALSO DON'T KNOW HOW THE SENSORY INPUT FROM CONNECTIVE TISSUE CHANGES WHEN THE CONNECTIVE TISSUE BECOMES STIFF. ONE OF THE REASONS CONNECTIVE TISSUE CAN BECOME STIFF IS WHEN THERE'S CHRONIC INFLAMMATION IN THERE BECAUSE THEIR END RESULT OF CHRONIC INFLAMMATION IS FIBROSIS, SCARRING, ADHESIONS, TISSUES THAT IS UNDERGOING A FIBROTIC REACTION IN RESPONSE TO THE ONGOING INFLAMMATION. SO THERE'S BEEN A LONG STANDING DEBATE ABOUT WHETHER CHRONIC PAINFUL CONDITIONS LIKE TENDONITIS ARE ACTUALLY INFLAMMATORY. I WILL SHOW YOU, THIS IS A VERY IMPORTANT STUDY FROM MARY BARB GROUP AT TEMPLE UNIVERSITY PUBLISHED SOME YEARS AGO IT USED A RAT REPETITIVE MOTION MODEL. IN THIS MODEL RATS HAVE TO PULL A LEVER REPETITIVELY USING INCREASING AMOUNTS OF FORCE TO GET A REWARD. AND WHEN THIS -- WHEN THESE RATS WERE TRAINED TO DO THIS, AFTER SIX WEEKS WHEN YOU LOOK AT THEIR CONNECTIVE TISSUE, SHOWED CLEAR EVIDENCE OF CHRONIC INFLAMMATION. THERE WAS MACROPHAGE INFILTRATION IN THE CONNECTIVE TISSUES WHILE SUBCUTANEOUS TISSUE AND ALSO TISSUE AROUND THE TENDONS, AND INCREASED INFLAMMATORY MEDIATORS IN TNF ALPHA, SO THESE TISSUES HAD EVIDENCE OF ONGOING CHRONIC INFLAMMATION. WHEN THIS REPETITIVE MOTION MODEL CONTINUED 12 WEEKS RATS STARTED TO DEVELOP EVIDENCE OF FIBROSIS. YOU HAD INCREASE DOLL GENERAL DEPOSITION, SUBORDER MISSION BUT ALSO AROUND THE NERVES, THIS SHOWS AROUND THE MEDIA NERVE THERE'S COLLAGEN DEPOSITION. WHEN YOU LOOK AT AMOUNT OF COLLAGEN THAT WAS -- CAN YOU SEE MY POINTER? I GUESS YOU CAN'T. DO I HAVE A POINTER? SO THERE WAS INCREASE COLLAGEN STAINING, MACROPHAGE INFILTRATION AND ALSO SOME DEGRADED MYLOABRASIVE PROTEINS SUGGESTING THERE WAS PERHAPS ONGOING NERVE DAMAGE GOING ON DURING THIS PROCESS. SO AS WE PROGRESSED THE RANTS CONTINUED CONTRACTING THEIR MUSCLES THOUGH THE CONNECTIVE TISSUE SURROUNDING THEM WERE CHRONICALLY INFLAMED AND STIFF. INVESTIGATORS WANTED TO TEST IF GENTLE MOBILIZATION OF TISSUES COULD PREVENT THIS FROM HAPPENING. SO THEY RANDOMIZED THE RATS TO RECEIVE A DAILY MASSAGE VERSUS HANDLING WITHOUT MASSAGE. THIS HAS TO BE SEEN TO BE BELIEVED SO I'M GOING TO SHOW YOU A MOVIE OF THIS RAT GETTING THE MASSAGE. THE INVESTIGATOR IS HANDLING THE ANIMALS, YOU CAN SEE GENTLY THE RAT IS VERY RELAXED AND THERE IS AGENTED L MOVEMENT -- I MEAN MANIPULATION OF THE TISSUES TO TRY TO MOBILIZE TO TRY TO LOOSEN UP LIKE WHAT HAPPENS IF YOU GO AND GET A MASSAGE. YOU CAN SEE HERE ON THE RIGHT THAT THE SOLID CIRCLES ARE THE RATS MASSAGED. OVER THE COURSE OF EXPERIMENT THEY WERE ABLE TO COMPLETELY SUCCESSFULLY COMPLETE MORE REACHES OVER THE COURSE OF THE EXPERIMENTS WHERE THE NON- MASSAGE RATS COULDN'T THEIR PERFORMANCE STAYED FLAT OVER THE COURSE OF 12 WEEKS. WHEN YOU LOOK AT FIBROSIS THEY FOUND MASSAGES ARE RATS WERE CLOSE TO NORMAL IN TERMS OF HOW MUCH COLLAGEN DEPOSITION THEY HAD. SO I WANT TO SHOW YOU Z THIS IS REALLY REMARKABLE HOW YOU SIGH HOW THERE ARE STRETCHING THE ANIMAL AT THE SAME TIME ASTHMA ANYPLACE LATING TISSUES. YOU CAN SEE THIS RAT DOESN'T MIND THIS AT ALL. SO INTERESTINGLY, THEN THEY LOOK AT THE OTHER OUTCOMES, FIBROSIS AROUND THE MEDIAN NERVE, NAY HAD MYLYNN BASIC PROTEIN AND THE COLLAGEN EXPRESSION THIS IS CD 68 MACROPHAGES, THOSE ARE ALL CLOSE TO NORMAL. SO MASSAGE PREVENTED THE DEVELOPMENT OF THIS CHRONIC INFLAMMATION AND PRESERVED THE NERVE. IN MY PREVIOUS LAB AT BRIGHAM WOMEN'S HOSPITAL I HAD THE OPPORTUNITY TO COLLABORATE WITH DR. CHARLIE WHOSE GROUP WORKS ON THIS INFLAMMATION RESOLUTION MECHANISM. THESE ARE MOLECULES THAT ARE DERIVEDED FROM DIETARY O MEGA THREE FATTY ACIDS THAT HELP TERMINATE NATURAL ENDOGENOUS MECHANISM THAT TERMINATE INFLAMMATION WE SHOW DAILY STRETCHING FOR TEN MINUTES OF THESE ANIMALS, WE INDUCE THE WHOLE ANIMAL TO STRETCH BY INDUCING THEM TO GRAB TO SOMETHING AND STRETCH THEIR WHOLE BODY, PROMOTED RESOLUTION OF INFLAMMATION. IMPORTANTLY THE AMOUNT OF STRETCHING NEEDED TO OBTAIN THIS EFFECT IS QUITE SMALL. AND THIS MAKES SENSE BECAUSE EXCESSIVE STRETCHING CAN DAMAGE TISSUE. NOW, THIS SUGGESTS THAT BOTH EXTERNALLY APPLIED FORCES, DID YOU RECOLLECT MASSAGE AND MUSCLE CONTRACTIONS BY BODY MOVEMENTS PRODUCE BENEFICIAL EFFECTS. WE NIGHED TO UNDERSTAND VERY IMPORTANTLY -- WE NEED TO UNDERSTAND THE AMOUNT, THE DOSE, THE AMOUNT OF FORCE, DIRECTION, DURATION, ET CETERA, NEEDED TO OBTAIN THERAPEUTIC BENEFITS. ANOTHER VERY IMPORTANT COMPONENT OF THIS IS TO UNDERSTAND EFFECT OF THE STIFFNESS ON THE FORCE APPLIED. BECAUSE THIS COULD PLAY A VERY IMPORTANT ROLE IN THE EFFECT OF THE FORCE MEANING HOW STIFF THE TISSUE IS. THE REASON FOR THAT IS BECAUSE WHEN WE THINK OF ME DA KNOW SENSITIVE ION CHANNELS OR MEMBER KNOW SENSITIVE HE WILLN'TS OF BODY, WE THINK OF THESE AS TRANSDUCERS OF FORCE. BUT WE DON'T KNOW IF THESE CHANNELS ARE TRULY SENSITIVE TO FORCE THAT'S NOT TRIVIAL. IF THEY ARE INDEED SENSITIVE TO DEFAMATION, IF YOU TRY TO STRETCH A STIFF RUBBER BAND COMPARED TO LESS STIFF, THE STIFF RUBBER BAND DEFORMS LESS SO THE SAME FORCE PRODUCES LESS DEFORMATIONS SO IN THE CASE OF ION CHANNEL IF YOU HAVE INCREASE STIFFNESS OF EXTRA CELLULAR MATRIX, MEMBER BRAIN OR INTRACELLULAR CYTOSKELETON, YOU COULD GET IN A SITUATION WHERE THE SAME FORCE WOULD CAUSE LESS WE DON'T ACTUALLY KNOW THIS. THIS IS IMPORTANT BECAUSE NATURE FIBROSIS FOR EXAMPLE OR ALTERING LIPID COMPOSITION OF THE MEMBRANE, COULD HAVE AN EFFECT ON THIS. SO THIS IS REALLY AN AREA IN NEED OF MORE RESEARCH. THIS TOPIC WAS DISCUSSED AT ANOTHER RECENT NCCIH LED WORKSHOP ON THE NEUROCIRCUITRY OF FORCE BASED MANIPULATION. THIS WAS A FASCINATING WORKSHOP THAT BROUGHT TOGETHER CLINICS, BIOMEDICAL ENGINEERS, NEUROSCIENTISTS AND REALLY FASCINATING DISCUSSIONS. ANOTHER THING THAT ONE THING THAT WAS EXTENSIVELY DISCUSSED AT THE WORKSHOP WAS THE PSYCHOLOGICAL AND CONTEXTUAL EFFECTS OF THESE TREATMENTS IN ADDITION TO THEIR BIOMECHANICAL EFFECTS. WHEN FORCE IS APPLIED BY A PERSON, A PRACTITIONER NOT ONLY DOES PERSON APPLYING FORCE TO TISSUE BUT ALSO THEY ARE INTERACTING WITH THE PATIENT. AND THEY ARE PROVIDING A SOCIAL CONTEXT. PROVIDING CONTEXTUAL EFFECTS THAT MAY EFFECT THE PATIENT BEHAVIOR. THE PATIENT MAY FEEL LESS AFRAID TO MOVE BECAUSE OF INTERACTIONS WITH PRACTITIONER. THESE COMPONENTS, THESE PSYCHOLOGICAL COMPONENTS OF THESE TREATMENTS ARE VERY IMPORTANT. AND WE OFTEN PUT THEM IN CATEGORY OF PLACEBO EFFECTS BUT IT IS WORTH UNDERSTANDING HOW THEY HAPPEN. NOW, THE WORKSHOP ALSO HIGHLIGHTED THE NEED FOR BETTER IMAGING METHODS TO OBJECTIVELY MEASURE STRUCTURAL ABNORMALITY IT IS OF MYOFASCIAL TISSUE, LAGGING FAR BEHIND OUR UNDERSTANDING OF IMAGING OF BONE OR CARTILAGE OR INTERVERTEBRAL DISCS SO THE HEAL IS GOING TO FUND A FUTURE WORKSHOP PLANNED FOR LATE SUMMER, EARLY FALL, TO REALLY DEVELOP A -- GET A SENSE OF THE NEEDS FOR NEW METHODS AND BETTER METHODS TO QUANTIFY WHAT WE CALL MYOFASCIAL TISSUE. WHEN WE SAY THAT WE MEAN MUSCLES AND CONNECTIVE TISSUE TOGETHER BECAUSE YOU CAN'T OPERATE THEM ESPECIALLY DOING IMAGING. SO TECHNIQUES FOR EXAMPLE LIKE ILLUSTRATED HERE ULTRASOUND, ELASEOGRAPHY OR MR TECHNIQUES THAT NOT ONLY LOOK STRUCTURALLY BUT ALSO FUNCTIONALLY, AS THEY MOVE AROUND. NOW, THESE INTERDISCIPLINARY EFFORTS ILLUSTRATE HOW MIND AND BODY PRACTICES CAN HELP US BREAK DOWN SOME OF THE SILOS THAT WE HAVE IN PAIN RESEARCH AND THINK ABOUT MUSCULO SKELETAL PAIN ESPECIALLY AS A BACK AND FORTH CONVERSATION BETWEEN THE NERVOUS SYSTEM AND THE REST OF THE BODY. BECAUSE WE HAVE A LOT OF RESEARCH IN NEUROSCIENCE FIELD, IN PHYSICAL THERAPY, BEHAVIOR, ORTHOPEDICS IS CONCERNED WITH STRUCTURAL REMODELING AND INFLAMMATION FIELD. SO IT'S REALLY IMPORTANT THAT WE TIE THESE TOGETHER AND COME TO A BETTER UNDERSTANDING OF PAIN AS A WHOLE. ACUPUNCTURE IS ANOTHER EXAMPLE OF A TREATMENT WHERE WE KNOW QUITE A BIT ABOUT BOTH THE LOCAL EFFECT OF ACUPUNCTURE AND PSYCHOLOGICAL EFFECTS OF A FORCE APPLIED TO THE TISSUE. IMPORTANTLY, IMPORTANT TO REALIZE DID YOU RECOLLECT ACUPUNCTURE TREATMENT, NEEDLES ARE NOT SIMPLY INSERTED, BUT THEY ARE MANIPULATED. IT IS ROTATED OR MOVED UP AND DOWN, AND THIS REALLY CREATES A MECHANICAL COUPLING BETWEEN NEEDLE AND TISSUE HERE IN THE ULTRASOUND PICTURE WHERE WHEN YOU START TWISTING THE NEEDLE THE COLLAGEN WINDS AROUND THE NEEDLE LIKE SPAGHETTI AROUND A FORK. ONCE YOU DO THAT, EVERY MOVEMENT OF THE NEEDLE PULSE AND PUSHES ON THE CONNECTIVE TISSUE. IN MY LAB WE DO THIS, WE HAVE BEEN DOING THIS FOR 20 YEARS, WE THINK OF ACUPUNCTURE NEEDLES AS MICROMANIPULATORS. WE CAN MOVE FASCIA AROUND. WHEN THIS HAPPENS THE PATIENT FEELS SOMETHING, THEY FEEL A SENSATION OF PULLING THAT'S NOT VERY DISSIMILAR FROM THE SENSATION TWISTING YOUR FOREARM, IT FEELS LIKE THAT. IT FEELS LIKE TISSUE BEING MOVED AROUND IN AN UNHABITUAL DIRECTION. THE PRACTITIONER ALSO FEELS SOMETHING, LIKE SOMETHING WHEN YOU GO FISHING, A FISH BITES ON THE LINE. SO WE KNOW THE INTERACTION OF NEEDLE WITH CONNECTIVE TISSUE SPORT FOR THERAPEUTIC AFFECT IF YOU INJECT COLLAGENASE BEFORE YOU TWIST YOU DON'T GET ANAL JESUSSIC EFFECT. WE HAVE EVIDENCE ACUPUNCTURE MODULATE PAIN LOCALLY AT SITE OF NEEDLE. AFTER THE NEEDLES ARE INSERTED, TYPICALLY LEFT IN PLACE FOR 20 MINUTES, 20 TO 30 MINUTES. DURING THAT TIME THERE'S RESPONSE OF CONNECTIVE TISSUE FIBROBLAST AROUND THE NEEDLE, THEY EXPAND, REMODEL CYTOSKELETON AND RELEASE ATP. AND THIS IS NOT PAN INJURY RESPONSE, IT'S BECAUSE THIS IS A SUSTAINED RELEASE OF ATP THAT GOES ON FOR ABOUT 30 TO 60 MINUTES. THIS IS IS LINKED TO CYTOSKELETAL RESPONSE YOU CAN BLOCK WITH INHIBITORS WITH KINASE IN THIS EXAMPLE. WE ALSO KNOW THAT PURE SENSORY MODULATION OCCURS DURING ACUPUNCTURE, ILLUSTRATED NICELY THIS EXPERIMENT IN LAB AT ROCHESTER WHERE THEY DID AN EXPERIMENT WHERE THEY INDUCED INFLAMMATION OF THE PAW AND DID MANUAL ACUPUNCTURE AT THE KNEE. THE EFFECT OF ACUPUNCTURE IN TERMS OF REDUCING THESE SENSATION MECHANICAL STIMULATED PAIN AND ALSO THERMAL TESTS WAS COMPLETELY ABOLISHED IN THE PRESENCE IN ANIMALS THAT HAD ADEN SCENE A 1 KNOCK OUT. THIS SUGGESTS THAT PERIPHERALLY THERE'S EFFECT OF ACUPUNCTURE ON SENSORY MODULATION. INTERESTINGLY, CAFFEINE, WHICH CAN BLOCK ADEN SEEN RECEPTORS DECREASE ACUPUNCTURE IN RATS ADMINISTERED IN DRINKING WATER AND DIRECTLY INJECTED TO THE TISSUES. SO THIS IS INTRIGUING BECAUSE WHEN YOU THINK CLINICAL TRIALS OF ACUPUNCTURE HOW OFTEN DO THESE OCCUR IN NON-CAFFEINATED SUBJECTS? PROBABLY ARGUE NEVER. SO IN ADDITION THERE IS LONG STANDING EVIDENCE THAT ACUPUNCTURE NEEDLING INFLUENCES ACTIVITY OF BRAIN REGIONS THAT RESPONSIBLE FOR THE EMOTIONAL COMPONENTS OF PAIN PREFRONTAL CORTEX, CINGULATE, AMYGDALA, ET CETERA, AND INSULA, IN ADDITION TO SOMATO SENSORY CORTICAL AREAS. INTERESTINGLY, THESE SAME AREAS ARE ALSO CAN BE AFFECTED DURING MEDICATION. -- MEDITATION. SO THEY MAY ALSO BE INVOLVED IN INTERCEPTIVE PROCESSING THAT MAYBE RELEVANT TO BOTH OF THESE TREATMENTS. WHAT ABOUT THE CLINICAL EFFECT OF ACUPUNCTURE? THIS IS SOMETHING THAT HAS BEEN A SUBJECT OF A LOT OF DEBATE FOR A LONG TIME BECAUSE WE DID A LOT OF CLINICAL TRIALS, I WOULD SAY IN FROM 1980s TO RECENTLY THAT SHOW NOT A BIG DIFFERENCE BETWEEN REAL ACUPUNCTURE AND A SHAM OR STIMULATED ACUPUNCTURE WHERE YOU -- IT DID NOT -- INSERT NEEDLESS BUT YOU BASICALLY POKE THE SURFACE OF THE SKIN WITHOUT PENETRATING THE SKIN. RECENTLY THERE WAS A BIG META ANALYSIS WHERE STUDIES WERE COMBINED TOGETHER IN AN INDIVIDUAL PATIENT META ANALYSIS , WHERE THERE WERE 8,000 SUBJECTS. WHEN THE DATA COMBINED TOGETHER, YOU CAN SEE THAT THERE IS A STATISTICALLY SIGNIFICANT EFFECT THAT COMES OUT BUT THE EFFECT SIZE COMPARE TO USUAL CARE IS APPROXIMATELY .5 A MODERATE EFFECT SIZE. WHEN YOU COMPARE TO SHAM, IT IS .25. YOU WOULD ARGUE THAT'S NOT BIG EFFECT SIZE AND IT ISN'T. IT'S A SMALL EFFECT SIZE BUT IT'S VERY COMPARABLE TO MOST ANALGESICS EXCEPT OPIATES; IT'S DEFINITELY SOMETHING THAT IS WHERE THE EFFECT OF THE NEEDLES THEMSELVES CLEARLY ACUPUNCTURE HAS A LARGE PLACEBO EFFECT LIKE DRUGS, BUT IT ALSO HAS AN EFFECT THAT IS SPECIFIC TO THE NEEDLING. AN INTERESTING SUB ANALYSIS OF THIS META ANALYSIS, WHEN THEY LOOKED AT PATIENTS WHO HAD MUSCULO SKELETAL SHOULDER PAIN MEANING SHOULDERS AND UP, SHOULDERS AND NECK, IT WAS INTERESTING THAT THE EFFECT SIZE NOW WAS UP TO .5, COMPARED WITH SHAM. SO THIS IS INTERESTING AND WE DON'T REALLY UNDERSTAND WHY ACUPUNCTURE MIGHT BE MORE EFFECTIVE FOR UPPER BODY THAN LOWER BODY PAIN, WE DON'T KNOW. ACUPUNCTURE IS INCLUDED IN THE MOST RECENT 2017 CLINICAL GUIDELINES FOR THE INITIAL TREATMENT OF CHRONIC LOW BACK PAIN. ALONG WITH OTHER NON-PHARMACOLOGICAL TREATMENTS INCLUDING PHYSICAL THERAPY, HOWEVER, THESE CLINICAL GUIDELINES ARE NOT CONSISTENTLY APPLIED. AND MANY PATIENTS CONTINUE TO BE PRESCRIBED OPIATES INSURANCE COVERAGE FOR NON-PHARMACOLOGICAL TREATMENT IS OFTEN LACKING. SO FOR THIS REASON NCCIH IS LEADING A PROGRAM WITHIN THE HEAL INITIATIVE CALLED PRISM OR PRAGMATIC IMPLEMENTATION STUDIES FOR THE MANAGEMENT OF PAIN TO REDUCE OPIOID PRESCRIBING. THIS SUPPORTS MULTIPLE PRAGMATIC TRIALS, PRAGMATIC, MEANS CLINICAL TRIALS NOT SHAM CONTROLLED. THESE ARE TRIALS WE COMPARE TO USUAL CARE, BUT THEY ARE MEANT TO INVESTIGATE THE EFFECTS OF TREATMENTS ALREADY BEEN DEMONSTRATED TO BE SUPERIOR TO SHAM IN A CONTROL SETTING, BUT TO SEE WHETHER IN THE CONTEXT OF A HEALTHCARE SYSTEM WHETHER THESE TECHNIQUES CAN BE IMPLEMENTED AND WHETHER THEY ARE EFFECTIVE COMPARED TO USUAL CARE. AND IF THEY BENEFIT PATIENTS AND ALSO IF THEIR ARE COST EFFECTIVE. THESE TRIALS INCLUDE A TRIAL OF ACUPUNCTURE FOR CHRONIC LOW BACK PAIN IN OLDER ADULTS AND THAT IN COLLABORATION FOR CENTER FOR MEDICARE AND MEDICAID SERVICES. AND THE RESULTS OF THIS STUDY WAS ORIGINALLY INTENDED TO ENFORCE THE CMS COVERAGE DECISIONS THOUGH CNS COUPLE OF WEEKS AGO APPROVED THE COVERAGE PENDING THE RESULTS OF THE STUDY. SO PATIENTS NOW UNDER MEDICARE WILL BE COVERED FOR ACUPUNCTURE. THE PRAGMATIC TRIALS FUNDED IN HEAL ARE GOING TO BENEFIT GREATLY FROM THE EXTENSIVE EXPERTISE OF THE HEALTHCARE SYSTEMS RESEARCH LABORATORY, NCCIH LEADS WITHIN NIA. AND THIS FUNDS PRAGMATIC TRIALS IN REAL WORLD SETTINGS ONCE AN INTERVENTION IS DEMONSTRATED TO BE EFFECTIVE IN MORE NARROWLY DEFINED EXPLANATORY TRIALS.& THE GOAL OF THESE TRIALS IS TO EXPAND THE CLINICAL APPLICABILITY AND GENERALIZABILITY OF THE FINDINGS WITHOUT SACRIFICING THE RIGOR. WE ARE ACCUMULATING A LOT OF EXPERTISE WITHIN THE HEALTHCARE SYSTEMS LABORATORY HOW TO CONDUCT THESE TRIALS IN A RIGOROUS MANNER. THIS IS A FIELD THAT'S EVOLVING RAPIDLY, AS WE UNDERSTAND MORE AND MORE IMPORTANCE OF UNDERSTANDING HOW TO IMPLEMENT THESE TREATMENTS TO MAKE SURE PATIENTS ACTUALLY BENEFIT FROM THEM. SO IN THIS CASE OF ACAI PUNCTURE THE GOAL IS NOT THE SEE IF ACUPUNCTURE EFFECTS ARE GREATER THAN PLACEBO BUT TEST WHETHER ACUPUNCTURE IF EMBEDDEDDED IN A HEALTHCARE SETTING IS BENEFITING THE PATIENTS. NOW, ANOTHER NCCIH STRATEGIC PRIORITY IS NATURAL PRODUCTS WHICH ARE USED IN A LARGE SEGMENT OF THE POPULATION, OFTEN WITHOUT EVIDENCE OF BENEFIT. WE ARE PARTICULARLY INTERESTED IN NATURAL PRODUCTS FOR PAIN, AND LAST YEAR NCCIH ORGANIZED A WORKSHOP ON THIS TOPIC THAT LED TO A COORDINATED INITIATIVE AND COLLABORATION WITH NINDS AT N CATS AND NCI. THE GOAL OF THIS INITIATIVE IS TO BUILD A DEVELOPMENT PIPELINE OF NATURAL PRODUCTS FOR PAIN, STARTING WITH MINING EXISTING ELECTRONIC DATABASES AND REPOSITORIES AND PERFORMING HIGH THROUGH PUT SCREENING FOR POTENTIAL ANALGESIC ACTIVITY. WE ARE LEVERAGING THE FUNDS FROM FOR THE HEAL INITIATIVE FOR THIS. ANOTHER INCREASING AREA OF RECENT INTEREST IS OF COURTS CANNABINOIDS WITH THE -- WHICH THE GENERAL PUBLIC IS USING EXTENSIVELY ESPECIALLY CBD, TO SELF-MEDICATE FOR A VARIETY OF AILMENTS ESPECIALLY PAIN. AND THESE PRODUCTS ARE PROLIFERATING AT A RAPID PACE AND THAT IS WELL AHEAD OF THE SCIENCE. SO IT'S REALLY URGENT WE BETTER UNDERSTAND NOT ONLY POTENTIAL BENEFITS OF THESE COMPOUNDS BUT POTENTIAL HARMS INCLUDING ESPECIALLY INTERACTION WITH OTHER DRUGS. SO IN 2019 NCCIH FUNDED NINE GRANTS IN THIS SPACE TO LOOK AT THE POTENTIAL ANALGESIC EFFECTS OF CANNABINOIDS AND NIGH NOR -- THIS YEAR AS I MENTION NCCIH IS LAUNCHING THE STRATEGIC PLANNING PROCESS FOR 2001 TO 2026. AS PART OF THIS PROCESS WE ARE REEXAMINING HOW NATURAL PRODUCTS AND MIND AND BODY PRACTICE, FIT WITHIN THE DOMAINS OF DIETARY PSYCHOLOGICAL AND PHYSICAL TREATMENT AS WELL AS PARTIAL OVERLAPS WITH OTHER FIELDS. SUCH APPROXIMATE PHARMACOLOGICAL DRUGS AN DEVICES. IMPORTANTLY, THERE SEEMS TO BE A BLURRING OF LINES INCREASINGLY BETWEEN WHAT WE CALL CONVENTIONAL AND WHAT WE CALL COMPLIMENTARY AND WE FEEL THAT THIS IS A GOOD THING. THERE'S A CROSS FERTILIZATION. FOR EXAMPLE, INCREASING NUMBERS OF PHYSICAL THERAPY PROGRAMS ARE INCORPORATING MASSAGE FOR EXAMPLE TECHNIQUES AND SPINAL MANIPULATION AND CROSS FERTILIZE WITH COMPLIMENTARY THERAPIES. SAME WITH IN THE FIELD OF PSYCHOLOGY, COGNITIVE BEHAVIORAL THERAPY IS INCREASINGLY INCORPORATING RELAXATION TECHNIQUES, MINDFULNESS BASED RELAXATION TECHNIQUES. SO THESE ARE GRADUALLY INTEGRATING INTO MAINSTREAM HEALTHCARE. SO WE THINK THAT THIS SHARING OF IDEAS IS ALL WHAT INTEGRATIVE HEALTH IS ABOUT. WE LOOK FORWARD OF COURSE TO CONTINUING OUR FRUITFUL COLLABORATION WITH OUR COLLEAGUES AT NINDS AND ACROSS NIH ON THIS. SO I'M JUST SHARING SOME INFORMATION ABOUT THE STAGES THAT WE ARE GOING TO GO THROUGH WITH OUR STRATEGIC PLAN STARTING WITH WEBINARS TOWN HALL MEETING AT THE INTERNATIONAL CONFERENCE ON INTEGRATIVE MEDICINE AN HEALTH IN APRIL AND REQUEST FOR INFORMATION THAT'S COMING OUT SOON. THANK YOU, VERY MUCH. [APPLAUSE] >> THANKS VERY MUCH, ANY QUESTIONS? >> MINOR QUESTION, YOU TALKED ABOUT INTERESTING WORKSHOPS. WILL THOSE -- ANY PUBLICATIONS, ARE THOSE AVAILABLE ON YOUR WEBSITE OR ARE THOSE DISTRIBUTED TO US IN SOME WAY TO WAIVE ACCESS TO THINGS WE MADE REFERENCE TO? >> THE NEUROSCIENCE BLUEPRINT WORKSHOP IS A PAPER CURRENTLY IN PREPARATION THAT WILL BE HOPEFULLY COMING OUT RELATIVELY SOON. THE FORCE MANIPULATION WORKSHOP, WE ARE GOING TO HAVE A WORKSHOP SUMMARY OF THAT. THE MYOFASCIAL WORKSHO HASN'T HAPPENED YET. CERTAINLY THE BLUEPRINT WORKSHOP IS ARCHIVED ONLINE SO YOU CAN WATCH IT. >> JUST BASED ON PREVIOUS EXPERIENCE, A LOT OF THINGS YOU TALK ABOUT I SEE IN LIKE SPORTS MEDICINE, DO YOU HAVE A LOT OF OVERLAP WITH THAT? >> YES, SPORTS MEDICINE, I MEAN, THIS IS A VERY -- IS A VERY IMPORTANT QUESTION, SAME THING LIFESTYLE MEDICINE IS ANOTHER& FIELD THAT HAS A LOT -- THAT DEALS A LOT WITH THIS. THE EFFECT OF PHYSICAL ACTIVITY FOR EXAMPLE. SPORTS MEDICINE IS -- THERE'S A LOT OF OVERLAP WITH FOE ZYINDUSTRY AND PHYSICAL THERAPY. AND A LOT OF -- FOE ZYTRY IN THAT FOUR PART DIAGRAM, THERE HAVE MORE -- THEIR INTEREST IS MORE EFFECT OF THE TYPE OF MOVEMENT THAT YOU DO, AND HOW THAT INFLUENCES THE TISSUES AND HOW TO KEEP TISSUES HEALTHY. SO IT IS A BIG AND IMPORTANT PIECE OF THIS. >> THANK YOU, SUPER INTERESTING PRESENTATION, THANK YOU FOR THE WORK THAT YOU ARE DOING. THE QUESTION I HAVE INVOLVES AROUND RESEARCH STANDARDS. SO AS YOU KNOW ONE OF THE DIFFICULT PIECES OF TRYING TO COMPARE AND CONTRAST DIFFERENT STUDIES WITHIN THIS AREA, IS THAT THERE ARE NOT STANDARDS. THERE IS A META ANALYSIS ON EXERCISE THERAPY THAT INCLUDED 15 DIFFERENT TYPES OF MODALITIES. THIS IS AN ISSUE ON THE RESEARCH SIDE AS WELL AS GOING ON IN THE REAL WORLD CLINICAL SIDE WHAT TYPE OF MASSAGE, FOR HOW LONG, WITH WHOM, HOW MANY MONTHS BEFORE I DECIDE OR MOVE TO A DIFFERENT ONE. SO MY QUESTION IS, IN TERMS ON THE RESEARCH SIDE, ARE YOU DOING ANY WORK IN THE RESEARCH COMMUNITY TO AT LEAST STANDARDIZE OR MEAN OR DEFINE WHAT WE MEAN BY DIFFERENT TYPES OF COMPLIMENTARY AND ALTERNATIVE STRATEGIES SO WE CAN COMPARE AND CONTRAST BIGGER META ANALYSIS? >> EXCELLENT QUESTION, BIG PART OF THE CONVERSATION AT THE FORCE MANIPULATION WORKSHOP THIS IS REALLY BEEN ADDRESSED IN SOME EXTENT IN THE CHIROPRACTIC LITERATURE, THEY HAVE DONE A FAIR AMOUNT TO MEASURE THEM, TO MEASURE THE LOADS APPLIED DURING THESE TREATMENTS TO POLITICALIZE, MANUALIZE THE TREATMENT PROTOCOL SO THAT DIFFERENT PEOPLE CAN PERFORM THE SAME WAY. THERE IS A LOT OF WORK IN -- DONE IN THE ACUPUNCTURE FIELD AS WELL. IT IS A BIT OF A BALANCE. BECAUSE A LOT OF THESE TREATMENTS ONE OF THE THINGS THAT IS VERY APPARENT TO TREATMENT IS INDIVIDUALIZATION, NOT EVERYBODY WILL GET TREATMENT IN NEEDLESS INSERTED AT THE SAME PLACE. DEPENDING ON WHAT THEIR SYMPTOMS ARE. SO THERE'S KIND OF THIS BALANCE BETWEEN WANTING TO STANDARDIZE AND BE SURE WE HAVE REPRODUCIBLE INTERVENTIONS AND ALSO RESPECT WHAT WE KALE THE ECOLOGICAL VALIDITY OF THE TREATMENT. CREATING MANUALIZED TREATMENT PROTOCOLS THAT DESCRIBE RANGE OF INTERVENTIONS BEYOND WHICH DEFINES THE BOUNDARIES FOR EXAMPLE THAT SOMEBODY MIGHT HAVE IN TERMS OF FLEXIBILITY TO PERFORM A TREATMENT IS A BIT OF COMPROMISE, THERE'S MORE WORK TO BE DONE IN THIS AREA. >> THANKS SO MUCH, HELENE FOR COMING. KEN. >> THANK YOU VERY MUCH FOR YOUR PRESENTATION. IT WAS GREAT TO SEE THE SCIENCE AND THE INTERRECEPTION AND PAIN. THE QUESTION I HAVE THOUGH, ARE -- DOES YOUR INSTITUTE LOOK AT OTHER TRADITION ALLOTYPES OF MEDICINE, I'M THINKING ABOUT NOW TRADITIONAL CHINESE MEDICINE OR MEDICINE OUT OF INDIA, A LOT OF THE TIME WE SEE THOSE THINGS, YOU GET THEM AT GNC, THINGS LIKE THAT, THERE IS NOT LOT OF SCIENCE BEHIND THAT. IT WORK IN SOME, NOT IN OTHERS. THE QUESTION IS, IF WE CAN GET TO THE SCIENCE AND UNDERSTAND SCIENCE BEHIND THOSE WE CAN END IN A PLACE WHERE WE UNDERSTAND WHAT THE ACTIVE INGREDIENTS ARE FROM THAT COULD LEAD US BACK TO TRUE DRUG TARGETS FOR ETHICAL DRUGS. >> GOOD QUESTION. WE HAVE HAD SOME ONGOING CONVERSATIONS, WE HAD A DELEGATION FROM INDIA THAT CAME AND WE DISCUSSED THAT. THEY ARE DOING RESEARCH IN INDIA ON THIS. WE THINK THAT THIS IS AN IMPORTANT AREA OF RESEARCH, IT HAS TO BE DONE CAREFULLY, ESPECIALLY WHEN YOU ARE DEALING WITH PRODUCTS, WE NEED TO KNOW, IT'S VERY IMPORTANT NATURAL PRODUCTS ARE DEALT WITH IN A WAY THAT IS AGAIN STANDARDIZED. SAME WITH TRADITIONAL CHINESE MEDICINE. A BIG COMPONENT IS HERBS THAT ARE GIVEN IN COMBINATION, IN FORMULAS. SO IT GETS VERY COMPLEX. IF YOU ARE STUDYING NOT JUST ONE INGREDIENT BUT MIXTURE OF INGREDIENTS. THERE'S INTERESTING DATA STARTING TO COME OUT THAT ACTUALLY MAY BE SYNERGISTIC COMPONENTS WITHIN PLANT. THAT ACTUALLY WORK TOGETHER TO PRODUCE EFFECTS THAT DON'T OCCUR WHEN THE INGREDIENTS ARE GIVEN SEPARATELY. SO THIS IS AN AREA WE ARE STARTING TO LOOK AT AS PART OF OUR NATURAL PRODUCTS AREA. OF RESEARCH. GOOD TO LOOK AT IT. >> JUST REMINDER ASPIRIN IS A NATURAL PRODUCT. >> EXACTLY. SO MANY OTHER DRUGS STARTED FROM NATURAL PRODUCTS. IT IS VERY IMPORTANT WE LOOK AT THE NOT ONLY LIBRARIES AND REPOSITORIES ALREADY EXIST BUT THE KNOWLEDGE ABOUT THESE DRUGS THAT THESE PRODUCTS THAT IS IN CULTURE, FOR EXAMPLE, WE REALLY HAVE AN ETHNO BOTANY TO COLLECT KNOWLEDGE ABOUT THESE PLANTS BEFORE THE PLANTS DISAPPEAR OR THE KNOWLEDGE DISAPPEARS. BECAUSE A LOT ARE TRANSMITTED ORALLY AND SOME ARE BEING LOST. >> THANKS VERY MUCH, APPRECIATE IT. [APPLAUSE] >> WHY DON'T WE LET AMY FINISH. >> DO YOU WANT TO TALK ABOUT NEUROETHICS NOW? >> THEN WE'LL TAKE A BRIEF BREAK BEFORE CONCEPT CLEARANCE. >> JUST TO PREFACE, THE BRAIN INITIATIVE TRIGGERED A LOT OF INTERESTING NEUROETHICS. EXPLAIN WHY THE TIE IN. IT'S BEEN DWIGHT PRODUCTIVE. IT BRINGS UP THE QUESTION OF WHAT ABOUT THE REST OF NEUROSCIENCE. AMY? >> THANK YOU SO MUCH. I APPRECIATE EVERYBODY'S PATIENTS BEARING WITH ME AS I'M BACK AGAIN. I'M GOING TO TALK A LITTLE BIT NOW ABOUT THE WORK THAT OUR OFFICE DOES OVERSEEING THE NEUROETHICS PORTFOLIO AND ALSO NOT JUST MANAGING THE RESEARCH AND THINKING ABOUT OVERSEEING -- HELPING US OVERSEE THE INTEGRATION OF NEUROETHICAL CONSIDERATIONS INTO THE BRAIN INITIATIVE BUT ALSO THINKING ABOUT HOW DO WE COMMUNICATE THESE REALLY NUANCED POTENTIALLY CONTROVERSIAL ISSUES TO OUR STAKEHOLDERS AND COMBAT MEDIA SENSATIONALISM AT THE SAME TIME. THESE ARE REALLY IMPORTANT QUESTIONS EVEN THOUGH THEY ARE TRICKY. SO WE DON'T WANT TO AVOID THEM, WE WANT TO FIGURE OUT A WAY TO HANDLE THEM WITH CARE. SO I WANT TO ACKNOWLEDGE DR. KARA RAMOS WHO DIRECT IT IS NINDS NEUROETHIC PROGRAM AND IS ONE OUR BRANCH CHIEFS. SHE HAS A GREAT QUOTE THAT CUTTING EDGE NEUROSCIENCE DESERVES CUTTING EDGE ETHICS. SO THE NIH BRAIN INITIATIVE IN NEUROETHICS HAS A REALLY PRAGMATIC AND PRO ACTIVE STRATEGY FOR DEALING WITH EMERGING ISSUES AND MAKES A PRIORITY TO WORK WITH RESEARCHERS TO NAVIGATE ISSUES THEY ENCOUNTER AS THEY OPEN FRONTIERS WITH SCIENCE. SHE ALSO SERVES AS PROGRAM DIRECTOR THAT CO-LEADS THE TRANS-NIH BRAIN NEUROETHICS PROJECT TEAM OVERSEEING THE ETHICS RESEARCH PORTFOLIO WITHIN THE BRAIN INITIATIVE. AND WORKS VERY CAREFULLY WITHIN NUMBER OF DIFFERENT PROFESSIONAL SOCIETIES, WE PUBLISH A NUMBER OF ARTICLES IN THIS SPACE, INCLUDING BOOK CHAPTERS THAT HAVE BEEN CO-AUTHORED WITH WALTER AND OTHERS. THERE'S A LOT OF EFFORT TO DISSEMINATE INFORMATION ABOUT NEUROETHICS AT A VARIETY OF DIFFERENT CONFERENCES. SO SHE SPEAKS BROADLY INCLUDING UNCONVENTIONAL ISSUES LIKE SOUTH BY SOUTHWEST. TRYING TO ENGAGE A WIDE SPECTRUM OF AUDIENCES IN THESE IMPORTANT CONVERSATIONS. WE MANAGE THE BRAIN NEUROETHICS WORKING GROUP WITH OUTSIDE EXPERTS NEUROETHICISTS AND NEUROSCIENTISTS WHO PROVIDE EXPERT INPUT UNDER ETHICS AND ENSURE CONSIDERATIONS ARE FULLY INTEGRATED INTO BRAIN. THE NEUROETHIC WORKING GROUP ALSO HOLDS REGULAR TOPICAL WORKSHOPS WE SUPPORT NEW AND UNRESOLVED ETHICAL ISSUES IN BRAIN SO JUST FOR INSTANCE WE HAD ON RESEARCH WITH HUMAN NEURAL TISSUE AND BRAIN ORGANOIDS. THESE MEETINGS BRING TOGETHER NEUROSCIENTISTS WITH EMPHASIS PHILOSOPHERS WE HAD A THEOLOGIAN AT THIS MEETING. WE ARE TRYING TO FOSTER CONSTRUCTIVE DIALOGUE ACROSS A WIDE RANGE OF AUDIENCE SO WE SOLVE THE PROBLEMS TOGETHER. TOGETHER WE HOPE EFFORTS ARE TO ESTABLISH A SHARED VISION FOR ETHICAL CONDUCT OF HUMAN NEUROSCIENCE RESEARCHING NOT JUST IN BRAIN. NEUROSCIENCE NEUROETHICS WORKING GROUP WITH KARA ALSO DEVELOPED A SET OF GUIDING PRINCIPLES WE PUBLISHED LAST YEAR IN THE -- A LITTLE OVER A YEAR AGO IN JOURNAL OF NEUROSCIENCE, THESE GUIDING PRINCIPLES FRAME AND NAVIGATE ETHICAL QUESTIONS BRAIN RESEARCH PROMPTS AMONG RESEARCHERS AND ALSO HOPE WILL INFORM A PUBLIC DIALOGUE AMONG HIGHLY INTERDISCIPLINARY GROUP OF STAKEHOLDERS THAT INCLUDE INVESTIGATORS AND CLINICIANS BUT LEGAL SCHOLARS PHILOSOPHERS, IRBs, RESEARCH PARTICIPANTS, PATIENTS AND THE BROAD PUBLIC. WE WANT PEOPLE TALKING DESIGN AND CONDUCT OF RESEARCH, IMPLICATIONS FOR ADVANCES AND UNDERSTANDING HOW THE HUMAN BRAIN WORKS AND RISKS AND BENEFITS FOR INTERVENTIONS IN THE BRAIN SO TO WALTER'S POINT THESE ISSUES ARE CERTAINLY HEIGHTENED WITHIN THE BRAIN INITIATIVE BUT NOT ONLY THERE. THEY APPLY TO BROADER NEUROSCIENCE PORTFOLIO. SO ONE QUESTION IS HOW CAN AND SHOULD WE EXPAND UPON THIS EFFORT. I DON'T KNOW IF ANYBODY WANTS TO -- SO I'M GOING TO EASIER TO THINK ABOUT IN CONTEXT OF AN EXAMPLE, I'M GOING TO CLOSE FINALLY WITH AN EXAMPLE HOW TO BRING TOGETHER MANY COMPONENTS ACROSS THE OFFICE THAT WE TALKED TO YOU ABOUT TODAY, IN THE SERVICE OF THE SCIENTIFIC ENTERPRISE. SO THIS IS TALKING ABOUT BRAIN ACTS AS A CASE STUDY. ATTENTIVE PROGRAM STAFF ALERTED US TO THE UNEXPECTEDLY RAPID PROGRESS ONE OF THE BRAIN PROJECTS WAS MAKING DEVELOPING A SYSTEM CALLED BRAIN X, DELIVERING AN ARTIFICIAL BLOOD SUPPLY TO POSTMORTEM PIG BRAINS; THE RESEARCHERS OBSERVED WHEN IT WAS INTRODUCED TO PIG BRAINS FOUR HOURS AFTER CELL DEATH IT PRESERVED ANATOMICAL INTEGRITY AND RESTORED CIRCULATORY METABOLIC AND CELLULAR FUNCTIONS, AMAZING AND IMPRESSIVE. AND WE WERE REALLY EXCITED ABOUT THE POSSIBILITIES THAT LARGE INTACT MAMMALIAN BRAIN COULD PROVIDE, THIS OFFERS UNPARALLELED OPPORTUNITIES TO STUDY BRAIN CIRCUITRY, EXPERIMENTAL ACCESS LIKE NEVER BEFORE IN A BRAIN, HOWEVER, THE RESEARCH ABSOLUTELY RAISED A NUMBER OF IMPORTANT NEUROETHICAL CONCERNS. HOW CAN WE BE SURE WHICH ARE NOT RESTORING SOME FORM OF CONSCIOUSNESS. IT ALSO RAISES QUESTIONS OF THE DEFINITION OF CELL DEATH. THIS WAS AN EXAMPLE WHERE THE RESEARCHER WAS VERY OPEN TO WORKING WITH US AND SO THEY ENGAGED WITH NEUROETHICS WORKING GROUP, PROVIDE AD CLOSED PROGRAM MA TICK CONSULTATION TO THINK THROUGH HOW TO MOVE THIS RESEARCH FORWARD IN A WAY THAT WAS ETHICAL AND RESPONSIBLE AND TAKING ALL THESE CONSIDERINGS INTO ACCOUNT. WE HELD A NUMBER OF WORKSHOPS TO GET EXPERT INPUT INTO THIS AREA AND THE CONSENSUS THAT EMERGED WAS THAT BECAUSE THERE WAS NO EVIDENCE OF GLOBAL ELECTRICAL ACTIVITY IT SEEMED LIKELY THERE WAS NO COGNITION OR POTENTIAL FOR CONSCIOUSNESS. THERE WERE THINGS RESEARCHERS ADDED TO THEIR -- OR CONSIDERED ADDING TO THEIR EXPERIMENTAL DESIGN TO ENSURE THAT THAT STAYED THE CASE. SO WHAT WAS THE OUTCOME OF THIS? THIS ENGAGEMENT WITH THE RESEARCHERS, WITH THE NEUROETHICISTS, WITH OUR SCIENTIFIC PROGRAM STAFF, AND OUR WHOLE MEDIA TEAM REALLY HELPED US TO FIND A WAY TO TALK ABOUT THE STORY TO THE PUBLIC IN WAY THAT WAS INFORMATIVE BUT NOT SENSATIONALIST. SO ALTHOUGH THIS ADVANCE PREPARATION WAS KEY, WE THINK TO MAKING THE ANNOUNCEMENT A SUCCESS SO WE RECOMMENDED AND ARRANGED PROFESSIONAL MEDIA TRAINING. FOR BOTH NEUROSCIENTISTS AND THE NEUROETHICISTS WHO SERVED AS SPOKES PEOPLE ON THIS TOPIC. WE ISSUED A PRESS RELEASE AND HOST AD MEDIA BRIEFING, WHICH ALLOWED REPORTERS TO EXPLORE ETHICAL IMPLICATIONS OF RESEARCH AND WHAT WAS EXCITING IS THAT THE STORIES THAT CAME OUT, THERE WERE 50 THAT DAY, I HAVE NEVER HAD MY PHONE EXPLODE LIKE THAT AND HAVE IT BE SOMETHING I REALLY KNEW ABOUT. WERE REASONABLY FAIR BALANCED AN ACCURATE. WE HAD SOME SENSATIONAL TITLES LIKE FRANKENSWINE WHICH WERE UNFORTUNATE BUT I WILL SAY THAT OVERALL, WE REALLY FELT THAT THIS STRATEGY OF PROACTIVELY ENGAGING AND LEADING WITH THE SCIENCE WAS A SUCCESSFUL ONE. I'M HAPPY TO SAY THE INVESTIGATOR WHO WORKS CLOSELY WITH US WAS NAMED ONE OF NATURE'S TEN PEOPLE WHO MATTERED IN SCIENCE IN 2019 AND THE WRITE UP FEATURED HIS COMMITMENT TO ENSHIRING HIS RESEARCH WASTH -- ENSURING THE RESEARCH WAS ETHICAL. THAT WAS GOOD AND IMPORTANT. SO WITH THAT I WILL CLOSE. AND ASK MORE BROADLY HOW WE CAN ENGAGE WITH ALL OUR PARTNERS MORE EFFECTIVELY AND WHAT OUR OTHER THINGS WE CAN DO. TO DO OUR JOB BETTER. >> JUST ONE QUESTION, AS WE CONDUCT OR BEFORE ALLOWED TO CONDUCT RESEARCH WE DO A LOT OF ETHICAL TRAINING BUT IT'S USUALLY FOCUSED ON THE RESEARCH ITSELF, NOT HOW WE ETHICALLY TREAT OTHER PEOPLE WITH WHOM WE ARE RESEARCHING WITH. DOES YOUR SCOPE OF THIS COVER BOTH? OR IS IT JUST THE RESEARCH ITSELF? >> I MEAN, IT ALSO INCLUDE ENGAGING WITH RESEARCH PARTICIPANTS IF THAT IS WHAT YOU MEAN OR DO YOU MEAN WITH COLLABORATORS? Q. I MEAN THINGS ABOUT JUST KIND OF BASIC THINGS LIKE TREATING PEOPLE FAIRLY, DECIDING WHO IS SENIOR AUTHOR. FROM THE THOSE TYPES OF ISSUES. IN MY CAREER I HAVE BEEN ASKED TO CONDUCT A COUPLE OFVATIONS AND SOME OF THE THINGS WE TALKED ABOUT TODAY A LOT OF PEOPLE LEAVE RESEARCH BECAUSE THEY ARE NOT BECOME TREATED FAIRLY OR ETHICALLY. THIS KIND OF ALL TIESES IN ABOUT WHAT WE HAVE BEEN TALKING ABOUT TODAY. -- TIES IN TO WHAT WE WERE TALKING ABOUT TODAY. DO WE HAVE PROGRAMS THAT TEACH PEOPLE HOW TO CONDUCT RESEARCH BEFORE RESEARCH IS ACTUALLY CONDUCTED? IN A FAIR MANNER? HOW WE MENTOR PEOPLE, THOSE TYPES OF CURRICULUM. >> I KNOW WHEN I WAS IN GRAD SCHOOL I HAD TO TAKE AS PART OF OUR GRADUATE TRAINING PROGRAM, A RESEARCH ETHICS CLASS WHICH DID TALK ABOUT HOW YOU MANAGE CO-UTHORSHIP AND STUFF LIKE THAT. THOSE CURRICULA ARE NOT SOMETHING THAT OUR OFFICE IS INVOLVED WITH, AND THIS NEUROETHICS PROGRAM IS FOCUSED MORE SPECIFICALLY ON QUESTIONS THAT ARE EMERGING AT THEIR RESEARCH INTERFACE BUT I COMPLETELY AGREE WITH YOU, THOSE CONSIDERATIONS ARE CRITICALLY IMPORTANT AS WE MOVE FORWARD, AND PROBABLY UNDERSCORE OUR ABILITY TO REALLY FORM EFFECTIVE TEAMS, ANOTHER IMPORTANT PRIORITY FOR THE BRAIN INITIATIVE. >> GOOD POINT. I THINK THIS IS SOMETHING -- I DON'T THINK WE TOUCHED UPON BUT I THINK IT MAYBE IMPORTANT. I REMEMBER, SOMEBODY BEING CHALLENGED ABOUT WHY THE -- THEY SAID I MADE SOME IMPORTANT PHONE CALLS. >> AMY, COULD I -- OR WALTER COULD I WEIGH IN FROM THE PHONE? >> YES. >> SO FIRST, I WANT TO SAY I HAVE BEEN INVOLVED IN A LOT OF NEUROETHICS EFFORTS AND I THINK AMY AND KARA AND OTHERS HAVE BEEN DOING A REALLY TREMENDOUS JOB, IT'S BEEN A PLEASURE TO SEE HOW CENTRAL THEY HAVE MADE NEUROETHICS AND ETHICS AS PART OF BRAIN AND MORE GENERALLY TRYING TO THINK THOUGHTFULLY HOW TO ENGAGE THE COMMUNITY. I THINK ONE QUESTION FOR GOING FORWARD OR ONE RESPONSE TO AMY ON QUESTIONS HOW WE MIGHT MOVE THINGS FORWARD, KIND OF GOES TO THE LAST QUESTION WHICH IS, A GOOD BIT OF THE WORK THAT HAS BEEN DONE IS TRYING TO IDENTIFY SOME OF THE SPACES IN WHICH FOR EXAMPLE THE ETHICS CONSULT MIGHT BE USEFUL OR PROACTIVELY IDENTIFY WAYS TO ENGAGE NEUROSCIENTISTS OR OTHERS WHO ARE ENGAGED IN RESEARCH. IT SEEMSES LIKE ON THAT EFFORT, TRYING TO FIGURE OUT WHAT THE QUESTIONS ARE OR WHERE PEOPLE REALLY WOULD BENEFIT FROM GREATER TRAINING, GREATER FOCUS ON EFFORTS SO VIRTUE ETHICS IS WHAT I WOULD PUT CATEGORY OF HOW WE THINK ABOUT SENIOR AUTHORS AND HOW WE THINK ABOUT CONDUCT WITH RESPECT TO ONE ANOTHER, NOT SOMETHING THAT'S BEEN PART OF NEUROETHICS, PART OF TRADITIONAL BIOETHICS BUT IT HASN'T -- I THINK INTEGRATING IT INTO SOME OF THESE EFFORTS WOULD MAKE SENSE TO THINK ABOUT IT HOLISTICALLY, WHAT ARE THE WAYS IN WHICH WE CAN BETTER ENGAGE ETHICS AND HAVE IT BE PART OF THE CULTURE FROM THE GET GO IN EACH OF THESE DIFFERENT PROJECTS. HOW WE CAN START TO UNDERSTAND WHAT THE NEEDS ARE, WHAT THE QUESTIONS ARE, THAT ARE BEING ASKED BY SCIENTISTS. AND BETTER PARTNERS WITH THEM TO HELP ADDRESS THOSE ISSUES EARLIER ON. Z >> VERY HELPFUL, I THINK THAT'S RIGHT. >> ONE THING I LIKE ABOUT YOUR DESCRIPTION THIS LAST PART OF NEUROETHICS, GAVE THE SENSE THE INVESTIGATOR AND GROUPS WORKING WITH THAT INVESTIGATOR WERE ALLIED. I THINK THAT THAT'S SUCH A FUNDAMENTAL ASPECT OF ALL THE GOOD PARTS ABOUT COMPLIANCE THAT MANY INVESTIGATORS ARE INTERESTED IN BUT WHEN PEOPLE THAT ARE ENFORCING COMPLIANCE ARE SEEN ADVERSARIAL RATHER THAN HELPERS THAT'S WHEN MANY PROBLEMS ARISE. WHAT YOU DESCRIBE WAS VERY BEAUTIFUL AND ENCOURAGING BECAUSE SEEMED LIKE THE PEOPLE INVOLVED IN NEUROETHICS WERE TEAMING WITH INVESTIGATORS SAYING WE RECOGNIZE THIS WORK BUT HOW WE DEAL WITH IT, LET IS HELP YOU. I THINK THAT THAT COMMUNICATING TO THE SCIENTIST THAT PEOPLE WITH EXPERTISE AND NEUROETHICS ARE ALIES RATHER THAN ADVERSARIES HELPS BECAUSE SCIENTISTINGS CARRY THOSE ETHICS BUT FEEL THREATENED BECAUSE OF THE WAY THINGS ARE PRESENTED. SO I WANT TO POINT THAT OUT AND GIVE VOICE TO THAT. BUT SOUNDS LIKE THAT WAS A GREAT EXAMPLE. >> THANK YOU, YEAH. I 100 PERCENT AGREE WITH THAT. WE TRY VERY HARD TO AVOID THE REFLEXIVE SENSE THAT NEUROETHICS IS A POLICE GROUP THAT IS GOING TO COME IN AND STOP THE RESEARCH. OUR GOAL IS TO FIND A WAY FOR THE RESEARCH TO MOVE FORWARD BUT ETHICALLY. THAT IS ACTUALLY ALMOST ALWAYS THE INVESTIGATORS GOAL AS WELL. SO I THINK ACTUALLY IF WE CAN FIND WAYS TO COMMUNICATE THAT MORE EFFECTIVELY TO THE RESEARCHERS THAT WE ARE FROM THE GOVERNMENT AND WE ARE HERE TO HELP YOU, I THINK TO NITA'S POINT WE WILL GET THAT INTEGRATION WITH NEUROETHICS AT AN EARLIER POINT IN THE RESEARCH PROJECT WHICH HELPS EVERYBODY. >> CAN I JUMP IN ON THAT AGAIN, WHICH IS ONE PART OF THAT I THINK IS TRYING TO FIND A WAY TO MOVE PAST THE IDEA THAT ETHICS IS ABOUT COMPLIANCE. BECAUSE TRADITIONALLY I THINK THAT A LOT OF ETHICS HAS BEEN SEEN AS A SET OF CHECK BOXES OR GUARD RAILS THAT ARE PUT ON RESEARCH RATHER THAN HELPING SCIENTISTS TO BE ABLE TO HAVE THE RESPONSIBLE PROGRESS OF THEIR RESEARCH FOR THE BRAIN X PROJECT, EARLY ON RECOGNIZE THERE WERE BIG ETHICAL QUESTIONS THAT WERE RAISED, NOT FROM A TRADITIONAL CHECKING THE BOXES ONE MIGHT NEED TO GO THROUGH TO GET PAST IRB OR MEET QUESTIONS BUT BIGGER PHILOSOPHICAL QUESTIONS RAISED THAT COULD RAISE QUESTIONS ABOUT WHETHER AND HOW RESEARCH SHOULD PROGRESS AND REACTION OF THE PUBLIC MIGHT BE TO IT. AND HOW WE OUGHT TO THINK ABOUT IT ADS A SOCIETY. HELPING SCIENTISTS RECOGNIZE NEUROETHICISTS WANT TO PARTNER THOSE BIG QUESTIONS TO BE EMBEDDED PART OF THE RESEARCH TO HELP ASK AND ADDRESS AND HELP GUIDE RESEARCH IN WAYS ENABLING COULD BE USEFUL BUT I THINK THE STARTING PLACE IS TRYING TO MOVE FROM PERCEPTION OF COMPLIANCE AND TOWARD IDEA OF PARTNERSHIP AND HELPING ENSURE GOOD SCIENCE IS RESPONSIBLE SCIENCE. >> KEN IS NEXT. >> TWO THINGS, I WANT TO TAKE A MOMENT JUST TO POINT OUT THAT -- TO DR. HANS'S QUESTION, NINDS HAS SPONSORED THE NEUROSCIENCE SCHOLARS PROGRAM RUN BY SOCIETY FOR NEUROSCIENCE FOR OVER 30 YEARS. AS PARTS OF THE PROGRAM ALL SCHOLARS VERSUS TO TAKE A PROGRAM OF CONFERENCE SPORE RESPONSIBLE RESEARCH, THAT PROGRAM I THINK I AM LOOKING AT DR. KLINE, YOUR FORMER PRESIDENT OF SOCIETY FOR NEUROSCIENCE, IT'S ALMOST A FULL DAY OF RESPONSIBLE CONDUCT AND RESEARCH ADDRESSES BOTH PEOPLE AND THE SCIENCE. SO I WANT TO TRY TO MAKE -- TAKE A STAB AT THIS QUESTION. SO FIRST AMY, THANK YOU FOR THE PRESENTATION. IN ORDER TO TRY TO ADDRESS THIS QUESTION, I HAD TO ASK MYSELF ANOTHER QUESTION. THAT IS, WHO ARE YOUR PARTNERS AND WHAT IS ENGAGEMENT IN YOUR OFFICE MEAN? THE WAY I SEE NINDS IS THAT IT IS PROBABLY THE PREMIER FUNDER OF NEUROSCIENCE IN THE WORLD. AND THE WORK THAT IT FUNDS, THE BASIC SCIENCE AS WELL AS THE APPLIED SCIENCE, TRANSLATIONAL SCIENCE, THE CLINICAL SCIENCE, IS SOMETIMES GROUND BREAKING. BUT IT'S SOMETIMES BEYOND THE EFFORT OF ANY ONE INVESTIGATOR OR ANY ONE INSTITUTE. OR ANY ONE ASSOCIATION OR ANY ONE FOUNDATION. AND SOMETIMES IN THE FIELD OF NEUROSCIENCE BEYOND ANY ONE PHARMACEUTICAL COMPANY. ONE WAY TO ENGAGE PARTNERS MAYBE TO LOOK AT SOME OF THE RESEARCH WHETHER BASIC SCIENCE OR BEYOND THAT'S AT THAT CRITICAL POINT OF GETTING TO A BREAK THROUGH AND BRINGING THEM TOGETHER TO DISCUSS THOSE SPECIFIC TOPICS. HOW DO WE GET THERE IN THIS SPECIFIC AREA. IT GOES BEYOND THE CONCEPT OF A WORKSHOP, BEYOND CONCEPT OF A FORUM, IT MAY BE MORE IN THE PUBLIC PARTNER, PRIVATE PARTNER PUBLIC PARTNERSHIP, SOMETHING LIKE THIS BUT YOUR OFFICE CAN SERVE AS AN INSTIGATOR INITIATOR TO PRECIPITATE THINKING THAT NEEDS THE RIGHT CRITICAL MASS OF PEOPLE AND IT CAN BE DONE IN A VERY CARE FRIDAY CRAFTED THE CUSTOMIZED WAY COMING OFF THE WORK THAT NINDS IS FUNDING. >> IT WOULD BE A CATALYST OF POTENTIALLY FACILITATES THOSE CONVERSATIONS IN A CONSTRUCTIVE WAY. THAT WOULD BE GREAT. THANK YOU. >> IS THERE ANOTHER PERSON WITH HAND UP? >> DR. ADAMS, GREAT PRESENTATION. REALLY ENJOY WHAT YOU ARE DOING. THE REASON I'M TRYING TO ADDRESS THE QUESTIN ABOUT PARTNERING EFFECTIVELY. I THINK IT'S A CULTURE CHANGE TRYING TO GET PEOPLE TO THINK ABOUT ETHICS NOT AS SOMETHING YOU ARE TRYING TO SECURITY BUT SOMETHING YOU ARE EM BRATSING THAT'S PART OF THE RERESEARCH YOU ARE DOING AND NOT SOMETHING YOU HAVE TO ADDRESS OR GETTING PEOPLE TO THINK ABOUT ETHICS IN THAT WAY IS KEY OF ENGAGING PEOPLE AND KEEPING THEM ENGAGES. SO STARTS WITH ETHICAL CONDUCT CREATING RESEARCH AND IF YOU WANT PEOPLE TO INTERACT FREELY AS OPPOSED TO I BETTER DO IT OR I'M HAULMIERED, THAT'S HOW YOU DEVELOP IT AND START EARLY ON. WHILE EDUCATION IS PART OF IT, IT MAY BE THAT NIH HAS TO ALSO HAVE SOME TYPE OF CARROT AND STICK IN REGARDS TO WHAT ARE THE ETHICAL STANDARD, I RECENTLY USED SOMETHING NINDS AND NIH HAD AS A POLICY, AS SOMETHING TO SHAPE IN MY ORGANIZATION, RECOMMENDATION, SO IT IS NOT JUST SOMETHING IF I WANTED TO GRANT -- A GRANT FROM THE NIH I HAVE TO DO BUT SOMETHING THAT SHOULD BE DONE IN RESEARCH PERIOD. >> THANK YOU. >> THAT MIGHT BE A GOOD -- I'M SORRY, CLAUDIA. >> ARE YOU FAMILIAR WITH THE NATIONAL ACADEMY OF SCIENCE AND ENTERTAINMENT EXCHANGE. IN AN EFFORT TO BRING SCIENTISTS WITH PEOPLE FROM WRITERS PRODUCERS, MAINSTREAM TV, I ASK BECAUSE IT RELATES TO PUBLIC INFORMING THE PUBLIC ABOUT WHAT THE NINDS IS DOING AND COVERAGE OF CONDITIONS. LIKE IT OR NOT MAJORITY OF PUBLIC IS NOT READING THE TYPES OF THINGS YOU HIGHLIGHTED HERE.& WORK IS PHENOMENAL. THEY ARE GETTING HEALTH INFORMATION FROM PRIME TIME TELEVISION OR MAINSTREAM TV. I'M AWARE -- I'M FAMILIAR WITH THE DOWN SIDES OF THAT, IN TERMS OF SCIENTISTS DON'T WANT TO BE ASSOCIATED WITH THAT IN CASE THE STORY LINE GOES BAD OR NIH MIGHT NOT WANT TO BE ASSOCIATED BUT THE LAST CASE EXAMPLE YOU GAVE, IT DOES PROVIDE A NICE ILLUSTRATION HOW IF YOU ARE PROACTIVE AND YOU CAN TELL THE RIGHT STORY AND CONNECT THEM, IT REALLY INCREASE IT IS CHANCES THAT THESE STORIES ARE BEING TOLD APPROPRIATELY IN MAINSTREAM MEDIA. IT'S THE WAY MOST PEOPLE ARE LEARNING, REGULAR PEOPLE IN THE UNITED STATES ARE LEARNING ABOUT HEALTH AND MEDICINE. >> THAT IS A GREAT SUGGESTION. THANK YOU SO MUCH. >> OKAY. WE ARE GOING TO TAKE ANOTHER BRIEF BREAK BEFORE WE LAUNCH INTO CONCEPT CLEARANCE WHICH IS MAJOR TOPIC TO CLEAR THE PALATE. I'M GETTING THE SENSE THERE ARE PEOPLE GETTING UP BECAUSE THERE'S ANOTHER TALK NOW. YOU WANT TO GO? OKAY. YOU GO. >> ALL RIGHT. THANKS A LOT, AMY. LET'S GIVE AMY A HAND. [APPLAUSE] AND ALISSA. SO IF YOU NOTICE THEY HAD THEIR BEST SLIDES THIS IS ACTUALLY A THEME THAT'S RUNNING THROUGH MULTIPLE OTHER PRESENTATIONS TODAY AND SO NOW WE'RE GOING TO ASK DR. SHAI SILBERBERG, DIRECTOR FOR RESEARCH QUALITY AT NINDS, A NEW OFFICE SET UP IN -- UNDER BOB. THE IDEA HERE IS THAT WE ARE INVESTING $2.4 BILLION INTO NEUROSCIENCE RESEARCH AND HOW DO WE KNOW IT'S ANY GOOD? HOW DO WE KNOW THE QUALITY IS THERE? IF YOU ASK THOSE QUESTIONS SOMETIMES THE ANSWER ARE NOT WHAT YOU WANTEDDED TO HERE HEAR. BUT I DON'T THINK YOU CAN STOP THERE, AT NINDS WE WILL INVEST THE MONEY AND WE HAVE TO INVEST IN BRINGING THE QUALITY TO THE HIGHEST LEVEL WE CAN. THAT IS WHAT SHAI TOOK TO HEART. INSTIGATED HIMSELF AND GOT ACTIVE SO WE CREATED THIRD DEGREE OFFICE TO ELEVATE QUALITY OF NINDS FUNDED RESEARCH. THAT'S EASIER SAID THAN DONE AND SHAI WILL TELL US WHY. >> THANKS, WALTER, GOOD AFTERNOON TO ALL OF YOU. WHAT I WANT TO DO TODAY IS TO GIVE A BRIEF BACKGROUND ON THE ISSUES SURROUNDING RIGOR AND TRANSPARENCY IN PRE-CLINICAL RESEARCH. THEN TELL YOU ACTIONS THAT NINDS HAS TAKEN AND PROPOSE FUTURE ACTIVITIES BEFORE I BEGIN. I WANT TO SAY THAT NONE OF THE ACCOMPLISHMENTS THAT NINDS DID DURING THIS TIME WOULD HAVE BEEN POSSIBLE WITHOUT THE GUIDANCE AND SUPPORT OF WALTER KOROSHETZ STORY LANDIS AND BOB FINKELSTEIN. NINDS INTEREST RIGOR AN TRANSPARENCY TOOK A TURN 12 YEARS AGO. SOME OF YOU MIGHT ASK, WHY DID IT TAKE SO LONG. BUT IN ACTUAL FACT, THIS WAS RELATIVELY EARLY IN THE AWAKENING OF THE RIGOR AND TRANSPARENCY ACROSS BIOMEDICAL SCIENCES. TO ILLUSTRATE THIS POINT I WILL GIVE AN EXAMPLE FROM THE STROKE COMMUNITY. WHICH WAS IN THE FOREFRONT OF THIS AWAKENING. SO IN 1999, THE STROKE COMMUNITY, HELD A MEETING TO DISCUSS WHY SO MANY PRE-CLINICAL ANIMALS STUDIES PROMISING TREATMENT IN ANIMAL STUDIES FAILED IN HUMAN CLINICAL TRIALS. IT'S INTERESTING TO READ THE REPORT THAT CAME OUT OF THIS MEETING, BECAUSE THEY STILL DID NOT ZERO IN ON THE POSSIBILITY THAT THERE ARE ISSUES WITH THE QUALITY OF THE PRE-CLINICAL DATA. THEY DID RECOMMEND HOWEVER, PRE-CLINICAL ANIMAL STUDIES SHOULD PERHAPS USE THE SAME STANDARD ADS HUMAN CLINICAL TRIALS BUT THAT WAS THE LEVEL OF COMPREHENSION OF THE ISSUES. BUT JUST TWO YEARS LATER A SYSTEMATIC REVIEW WAS PUBLISHED ON ANIMAL MODELS OF EXPERIMENTAL FOCAL CEREBRAL ISCHEMIA, IN THIS SYSTEMATIC REVIEW, THEY SAID THAT THERE IS A PRE-CLINICAL ANIMAL MODELS ARE POOR QUALITY AND THEY SPECIFICALLY POINTED OUT RANDOMIZATION AN FORMS OF BLINDING BECAUSE THESE HAVE BEEN SHOWN IN HUMAN CLINICAL TRIALS TO BE RISK OF BIAS PARAMETERS IF THEY ARE NOT PRACTICED. IT'S IMPORTANT TO SAY THEY ASSUMED, THIS IS MY INTERPRETATION. THEY ASSUMED THAT IF AT THIS TIME'S NOT REPORTED MEANS IT WASN'T DONE BUT THEY DIDN'T SUBSTANTIATE THAT POINT. THEY DID DRAW ATTENTION TO THE RISK OF BIAS IN PRE-CLINICAL ANIMAL STUDIES. A GROUP IN ED DIDN'TBURO HEADED BY THE STROKE NEUROLOGIST MALCOLM MCLOUD TOOK SOME MA TICK REVIEWS OF PRE-CLINICAL ANIMAL STUDIES TO A COMPLETELY NEW LEVEL. AND THIS IS RESULTS HERE SHOWN IN THIS FIGURE ARE FROM EVALUATIONS THEY DID IN ANIMAL STUDIES RELATED TO THE DIFFERENT INTERVENTIONS IN STROKE MODELS, AND AS YOU CAN SIGH THEY LOOK AT RANDOMIZATION TWO FORMS OF BLINDING, AND SAMPLE SYCES CALCULATION T. AND OVERALL REPORTING WAS LOW TO NON-EXISTENT WHEN YOU LOOK AT THE SAMPLE SIZE CALCULATION. THIS OBVIOUSLY JUST SAYS THAT PEOPLE DID NOT REPORT. IS THERE EVIDENCE IF YOU DON'T REPORT YOU ACTUALLY DON'T PRACTICE? THERE IS SUCH EVIDENCE, IT IS INDIRECT BUT VERY INTERESTING. AND THIS DATA COMES FROM A FEW SOURCES BUT PERHAPS THE FIRST MOST PRONOUNCED WAS FROM THIS STUDY HERE ON THE IMMUNOSUPPRESSIVE DRUG FK 506 IN EXPERIMENTAL STROKE, THERE WERE 29 STUDIES, AND I HAVE PUT A HASH TAG ON WHERE THE GREEN BARS YOU CAN SEE WHICH STUDY I REFER TO. SO WHAT THEY DID IN THE STUDY, THEY GAVE A QUALITY SCORE TO EACH ONE OF THE 29 STUDIES IN FK 506. IF YOU REPORT RANDOMIZATION YOU GET A POINT. REPORT ON ALLOCATION CONCEALMENT YOU GOT A POINT. YOU REPORT ON SAMPLE SIZE CALCULATION YOU GOT A POINT. SO ON SO FORTH AND YOU CAN ACCUMULATE UP TO TEN POINTS AND THAT WAS CALLED THE QUALITY THAT IS SHORN ON X AXIS YOU CAN SEE NONE OF THE STUDIES GOT ALL TEN POINTS. THE Y AXIS PLOTS EFFICACY OF DRUG REPORTED IN EACH ONE OF THESE STUDIES. IT'S QUITE OBVIOUS THE FEWER PARAMETERS REPORTED, THE GREATER THEIR PARENT EFFICACY OF THE DRUG SUGGESTING LACK OF REPORTING IS ASSOCIATED WITH LACK OF PRACTICE, AND THAT LACK OF PRACTICE CAN LEAD TO UNCONSCIOUS BIAS. THIS IS FAR FROM BEING UNIQUE TO THE STROKE FIELD, NOT UNIQUE TO NEUROSCIENCE, IT'S SHOWN BROADLY TO APPLY TO BIOMEDICAL SCIENCES, THE QUESTION IS WHY? WHAT IS GOING ON? THERE ARE MANY REASONS THAT HAVE BEEN PUT FORWARD, PERHAPS THE MOST OBVIOUS AND PROMINENT IS THIS VICIOUS CYCLE. IF YOU DON'T PUBLISH A LOT AND PREFERENTIALLY IN HIGH PROFILE JOURNALS WHICH REQUIRE TO BE NOVEL INNOVATIVE SIGNIFICANT YOU ARE NOT GOING TO GET THE NEXT ROUND OF FUNDING SO YOU WON'T GO AROUND THE THIS CYCLE AGAIN, YOU WON'T GET PROMOTED, TENURE, TO PUT BREAD ON YOUR TABLE. SO THIS CYCLE ON AVERAGE IS ONLY FOUR YEARS. YOU CAN IMAGINE WHAT PRESSURE YOU KNOW, AS SCIENTISTS WHAT PRESSURE THERE IS, TO PUBLISH, THAT CAN LEAD TO RUSH STUDIESES THAT PERHAPS COULD HAVE BENEFITEDED FROM A COUPLE MORE CONTROLS, BENEFITED PERHAPS FROM LARGER SAMPLE SIDESES. OR COUPLE MORE EXPERIMENTS THAT ARE DESIGNED TO DISPROVE THAT PROCESS NOT TO PROVE IT RIGHT. SO TAKING ALL THIS DATA I SHOW AND LOTS OF OTHERS AND TAKING THIS VICIOUS CYCLE INTO CONSIDERATION, NINDS TOOK HOLISTIC VIEW OF THE WHOLE PROBLEM. THERE'S CLEAR EVIDENCE FOR LACK OF TRANSPARENCY IN REPORTING, THERE'S SOME EVIDENCE THERE'S DEFICIENCY IN EXPERIMENTAL PROCEDURES THAT LEAD TO RISK OF BIAS. WHICH MIGHT BE DRIVEN TO SOME EXTENT BY PERVERSE INCENTIVES THAT YOU HAVE TO PUBLISH A LOT, ET CETERA, ET CETERA. SO WE SAID THE FOLLOWING. TRANSPARENCY WE COULD PROBABLY IMPROVE BY CHANGING THE REVIEW OF MANUSCRIPTS OF GRANTS, DEFICIENCY IN EXPERIMENTAL PROCEDURES, WE HAVE TO IMPROVE EDUCATION, AND INCREASE AWARENESS, AND PERVERSE INCENTIVES IS A MORE DIFFICULT NUT TO CRACK BECAUSE IT REQUIRES A CHANGE IN CULTURE. THE VERY FIRST THING NINDS DID IS TO CHANGE REVIEW OF THE CLINICAL TRIALS THAT ARE REVIEWED WITHIN NINDS. SO WHAT WE DID WAS WE NOTICED THAT MOST APPLICATIONS FOCUS PRIMARILY ON THE DESIGN OF THE CLINICAL TRIAL WITH VERY LITTLE ATTENTION GIVEN TO THE QUALITY OR RIGOR OF THE SUPPORTING DATA. SIMILARLY A REVIEW THAT'S ALSO WHAT HAPPENED, A REVIEW PANEL FOCUSED ON DESIGN OF A CLINICAL TRIAL AND LARGELY IGNORED WHETHER THIS TRIAL SHOULD GO FORWARD IN THE FIRST PLACE BASED ON HOW STRONG THE PRELIMINARY DATA IS. SO WHAT NINDS DID IS TO ASSIGN THREE REVIEWERS TO SPECIFICALLY LOOK AT THE RIGOR OF THE KEY SUPPORTING DATA, THAT WAS THE FIRST THING THAT WAS DISCUSSED AT STUDY SECTION AND ONLY AFTER THAT THEY MOVE ON TO DISCUSS THE DESIGN OF THE CLINICAL TRIAL. I WANT TO SAY HERE, THAT THE SUCCESS OF THE CHANGE WOULD NOT HAVE BEEN POSSIBLE WITHOUT SEAN (INDISCERNIBLE) IS A SCIENTIFIC REVIEW OFFICER FOR CLINICAL TRIAL STUDY SECTION AND HER COMMITMENT AND ABILITY TO CHANGE THE BEHAVIOR OF THE STUDY SECTION WHICH IS FAR FROM EASY, IS LAUDABLE. WE CHANGE THE BEHAVIOR IN ONE STUDY SECTION, THAT'S CERTAINLY NOT GOING TO MOVE THE NEEDLE. AT THE TIME WE THOUGHT THAT THE CHANCES WE WILL BE ABLE TO CONVINCE NIH TO CHANGE THE REVIEW, SCIENTIFIC REVIEW WHICH IS WHERE MOST GRANTS GET REVIEWED IS UNLIKELY OR MAYBE EVEN IMPOSSIBLE SO WE PUT IT ASIDE AND DECIDED TO FOCUS ON JOURNALS. TO THIS END WE ORGANIZED A WORKSHOP IN 2012 WITH JOURNAL EDITORS, REPRESENTING FUNDING ORGANIZATIONS INVESTIGATORS AND REVIEWERS FROM OUR STUDY SECTIONS AT NINDS. HERE I WANT TO MENTION -- JOHN PORTER WHO HELPED ORGANIZE AND RUN THIS WORKSHOP. THIS WAS A FASCINATING WORKSHOP, THE FIRST DAY CAN BE SUMMARIZED IN TWO WORDS. FINGER POINTING. EACH GROUP SAID IT'S NOTS THEIR FAULT, IT'S ALL THE RESPONSIBILITY OF THE OTHERS AND THIS WENT ON THROUGHOUT THE DAY. SOMETHING HAPPENED OVERNIGHT. I DON'T KNOW WHAT IT WAS. JUST SOMETHING CLICKED. ON THE NEXT MORNING EVERYONE AGREED THAT WE ALL SHARE RESPONSIBILITY AND WITH THE END OF THE MEETING THEY AGREED ON A KEY MINIMUM OF SET OF PROGRAM TERSE ANY STUDY THAT REPORTS ANIMAL STUDIES NEEDS TO REPORT. THEY ARE SUMMARIZED IN THIS PAPER, SHOWN HERE, THEY WERE RANDOMIZATION BLINDING SAMPLE SYCESSEST MAKES, AND HANDLING OF ALL DATA WHICH INCLUDED A LOT OF THINGS BUT WHAT E A REALLY FLOATED TO THE TOP WAS INCLUSION EXCLUSION CRITERIA, THE FOUR PARAMETERS ARE RISK OF BIAS PARAMETERS. THESE DAYS IT'S INTERESTING SEVERAL PEOPLE NOW REFER TO THESE FOUR ITEMS ADS THE LANDIS FOUR, NOT SURE I'M COMFORTABLE WITH THAT DEFINITION FOR REASONS I DON'T UNDERSTAND THIS PAPER HAD A HUGE IMPACT. AND TO ILLUSTRATE THAT, WITHIN SIX MONTHS NATURE PUBLISHING GROUP MADE CHANGES TO REVIEW PROCESS, THEY INTRODUCED FOUR CHANGES, THEY LIFTED THE RESTRICTIONS OF THE LENGTH OF THE METHODS, AS YOU KNOW THERE'S STILL JOURNALS THAT RESTRICT THE LENGTH OF METHODS. THEY ADDED AROUND EXTENSIVE CHECKLIST WHICH HIGHLIGHTED THE LANDIS FOUR AND OTHER PARAMETERS WHERE INVESTIGATORS HAVE TO NOT ONLY STATE IF THEY DID OR DIDN'T DO IT BUT ALSO WHERE IT STATED IN THE PAPER. NOT UNCOMMON TO SEE PAPERS TO SAY THIS STUDY WAS NOT BLINDED OR RANDOMIZED. FINE AS LONG AS READER KNOWS HOW STUDY WAS CONDUCTED. THEY HIDE BY STATISTICIANS TO HELP REVIEWSERS AND EDITORS AND PROID VIEWED A PLACE WHERE LOAD RAW DATA BEHIND FIGURES IF THEY PLEASE. WITHIN A MONTH AFTER THE PAPER CAME OUT, NIH PUT TOGETHER A WORKING GROUP TO DISCUSS THESE ISSUES. A YEAR LATER NIH ANNOUNCED THEY HAVE PLANS TO ENHANCE REPRODUCIBILITY AND THEY DID A NUMBER OF THINGS. I'M GOING TO FOCUS ON WHAT I BELIEVE IS THE MAIN ONE. THAT IS CHANGING OR ENHANCING PEER REVIEW. I'LL COME BACK TO THIS IN A MOMENT. I WANT TO INTRODUCE THE OFFICE BECAUSE THIS IS MORE OR LESS THE TIME THE OFFICE WAS FORMALLY CREATED. IT IS A SMALL OFFICE, BASICALLY CONSISTS OF MYSELF AND DEVIN CRAWFORD, RECENTLY PROMOTED TO BE PROGRAM MANAGER. SHE IS ABSOLUTELY EXCEPTIONAL, A HUGE ASSET TO NINDS. THE OFFICE ALSO HAD THE BENEFIT OF THIS GREAT NINDS RIGOR WORKING GROUP, MADE UP OFFS STAFF WHO ARE PASSIONATE ABOUT RIGOR AND TRANSPARENCY AND PROVIDE GUIDANCE AND ADVICE ON THE ACTIVITIES OF THE OFFICE. OBVIOUSLY I CAN'T GO OVER EVERYTHING THAT THE OFFICE DOES, I'LL GIVE YOU EXAMPLES FROM EVALUATIONS INITIATIVES AND OUTREACH. THIS BRINGS ME BACK TO THE NIH ENHANCEMENT OF GRANT REVIEW. WE FOCUS ON NUMBER ONE, PREMISE. IT WAS INTENDED TO BE RIGOR OF THE KEY SUPPORTING DATA. BUT IT WAS CALLED PREMISE. AND IT WAS CLEAR VERY EARLY ON WHEN THIS ROLLED OUT THAT APPLICANTS REVIEWERS, SCIENTIFIC REVIEW OFFICERS DON'T UNDERSTAND WHAT NIH MEANS BY SCIENTIFIC PREMISE, THEY ASSUME HYPOTHESIS OR THE SIGNIFICANCE OF THE STUDY AND IT DIDN'T LOOK GOOD. HOW TO CONVINCE NIH THAT THIS NEEDS TO BE CHANGED? THAT IS NOT SIMPLE. WHAT WE DID IS WE DECIDED TO EVALUATE THE GRANTS SUBMITTED A YEAR AFTER CRITERIA WERE ROLLED OUT. AND WE LOOKED AT ALL THE RO1s THAT CAME IN THAT WERE AT THE A ZERO STAGE AND SCORED 25% OR BETTER. THERE WERE 84 SUCH GRANTS. READ THESE APPLICATIONS, AND THE SUMMARY STATEMENTS TO LOOK FOR NOT ONLY SCIENTIFIC PREMISE BUT A WHOLE RANGE OF OTHER PARAMETERS, EACH GRANT WAS REVIEWED BY TWO EVALUATORS AND IF THERE WAS INCONSISTENCIES, IT WAS GAITED -- ADJUDICATED BY A COMMITTEE OF FIVE. WE ESTIMATE THIS ACTIVITY WAS AROUND 450 PERSON HOURS. THAT'S SERIOUS INVESTMENT IN TIME. I WON'T SHOW RESULTS JUST SAY THAT I THINK IT WAS A GREAT INVESTMENT IN TIME BECAUSE AS OF JANUARY 2019 NIH CHANGED THE REVIEW CRITERIA. NUMBER ONE IS CALLED RIGOR OF THE PRIOR RESEARCH, IT SPEAKS ABOUT KEY SUPPORT FOR THE APPLICATION. AND TIME WILL TELL WHETHER THIS TOOK ROOT AND REVIEWERS AND APPLICANTS FOLLOW BUT THIS IS A GOOD CHANGE. I GAVE YOU EXAMPLES OF HOW ACTIVITIES OF NIH INFLUENCED REVIEW OF GRANTS AND REVIEW OF MANUSCRIPT. THERE'S ONE OAR PLACE WHERE THERE CAN BE A HUGE BENEFIT TO INCREASING TRANSPARENCY AND THAT'S SCIENTIFIC MEETINGS. I DON'T KNOW ABOUT YOU BUT WHEN I GO TO SCIENTIFIC -- SFN OR OTHER MEETINGS, I SIT THERE AND I ASK MYSELF WHAT SHOULD I REMEMBER FROM THIS? WHAT SHOULD I TAKE HOME? I DON'T KNOW BECAUSE ALMOST NEVER INFORMATION IS GIVEN ABOUT THE HOW EXPERIMENTS WERE DONE, SO I HAVE NO WAY OF JUDGING WHETHER IT'S WORTH REMEMBERING OR NOT. SO I SAID IS THERE A SIMPLE WAY WE CAN PERHAPS IMPROVE ON THAT? AND TO THIS END WE ORGANIZED A ROUND TABLE WITH REPRESENTATIVES FROM DIFFERENT ORGANIZATIONS. WE HAD THE SOCIETY FOR NEUROSCIENCE, WE HAD FASEB, COLD SPRING HARBOR AND KEYSTONE, AND THEY HAVE DISCUSSIONS AND COME UP WITH SUGGESTIONS HOW WE CAN IMPROVE TRANSPARENCY AT MEETINGS AND HOW TO PILOT. THE RECOMMENDATIONS WERE SUMMARIZED IN THIS COMMENTARY THAT WAS PUBLISHED IN 2017. I WON'T GO OVER ALL THE RECOMMENDATIONS, I WANT TO HIGHLIGHT A COUPLE OF THEM. SO TYPICALLY WHEN YOU LOOK -- LISTEN TO A TALK OR LOOK AT POSTER YOU WILL SEE HISTOGRAMS LIKE THIS WHERE THEY HAVE GOT ERROR BARS ABLE TO FIND, NO IDEA IF THEY ERROR STANDARD DEVIATION, NO IDEA WHAT THE SAMPLE SIZE WAS AND YOU JUST HAVE TO LOOK AT THE STARS THAT THEY PUT ON IT AND SAY IF THEY -- WHAT THE RESULTS MEAN. BUT EASY TO FIX BECAUSE YOU HAVE TO PLOT THE RAW DATA AND THEN YOU GET A SENSE HOW THE DATA IS SPREAD. YOU CAN PUT NUMBER OF WHAT THE SAMPLE SIZE WAS AND DON'T SPEND ANY TIME ON IT, JUST DO IT, IT DOESN'T TAKE UP MORE SPACE, DOESN'T TAKE UP MORE TIME. YOU JUST PLOT IN WAY PEOPLE APPRECIATE THE DATA BETTER. MORE IMPORTANTLY FROM MY BIASED PERSPECTIVE IS WE RECOMMENDED TO INCORPORATE SYMBOLS OR WHAT WE CALL RIGOR E MOW INJURIES FIGURES. AN EXAMPLE HERE THIS EXPERIMENT WAS RANDOMIZED BLINDED AND IS PART OF CONFIRMATORY STUDY, THIS WOULDN'T TAKE TIME FROM THE SPEAKER ANY MORE SPACE ON THE POSTER, AND IT WOULD HAVE ENRICHED THE DATA PROVIDED IN THE FIGURE. SOFA SECOND IS PILOTING THIS IDEA IN THEIR SUMMER MEETINGS. THE PROBLEM IS THAT IT'S DONE ON A VOLUNTARY BASIS. WE STILL DON'T HAVE ENOUGH INFORMATION TO SAY WHETHER THIS IS REALLY GOING TO WORK OR NOT NOT, ANECDOTALLY AT UC DAVIS THEY USE THIS AS POSTER DAY AND STUDENTS LOVE IT. TIME WILL TELL IF THIS WILL CATCH ON. I HOPE IT WILL SOME DAY. SO WE DISCUSSED TRANSPARENCY, WHAT ABOUT THE OTHER TWO CATEGORIES? AS FAR AS AWARENESS GOES, JUST TO MAKE THE POINT IN THE LAST FIVE YEARS WE GAVE MORE THAN 80 PRESENTATIONS ON THE TOPIC OF RIGOR AND TRANSPARENCY. JUST TO GIVE AN EXAMPLE IN THE LAST YEAR AMONG ALL THE TALKS WAS ONE AT THE NATIONAL COUNCIL OF UNIVERSITY RESEARCH ADMINISTRATORS. AT A WORKSHOP RUN BY NATIONAL ACADEMY OF SCIENCES AND AT RETREAT OF THE NEUROSURGEON RESEARCH CAREER DEVELOPMENT PROGRAM. IN ADDITION, THE OFTEN IN THIS IS INVOLVED IN AN ADVISORY CAPACITY IN A RANGE OF ACTIVITIES, WHICH ENRICH OUR UNDERSTANDING AND ENRICH CHANGES IN NEUROSCIENCE IN GENERAL. I'M GOING TO POINT OUT TWO. I'M NOW ON THE EUROPEAN QUALITY AND PRE-CLINICAL DATA CONSORTIUM, VERY INTERESTING INITIATIVE, IT'S A COLLABORATION BETWEEN PHARMA AND ACADEMIA TO SEE HOW TO IMPROVE PREDICTIVE VALUE OF PRE-CLINICAL STUDIES, FAR IS SHARING WITH ACADEMIA TO ANALYZE, VERY INTERESTING INITIATIVE FUNDED BID THE >> MS. UHER: MEAN COMMISSION. DEVIN SERVES ON ADVISOR FOR RESEARCHING TRANSPARENCY, ALSO AN INTERNATIONAL ORGANIZATION. WHAT ABOUT FORMAL TRAINING IN -- WHAT ABOUT TRAINING IN GENERAL. JOHN UNITE US, VERY WELL KNOWN IN THE FIELD, PUBLISHED A PAPER WHY MOST STUDIES ARE FALSE, CAME OUT IN 2005; GOT A LOT OF ATTENTION. HE WROTE LITTLE EVIDENCE EXISTS ABOUT RESEARCH TRAINING LABORATORY SCIENTIST IT IS WAY STUDIES ARE REPORTED SUGGESTS SIGN TEST AREN'T AWARE THE METHOD LOGICAL APPROACHES WITHOUT RIGOR. OBVIOUSLY THAT'S NOT TRUE ACROSS THE BOARD, THERE'S MANY OUTSTANDING MENTORS OUT THERE, AND NINDS FELT THESE MENTORS SHOULD BE RECOGNIZED IN SOME WAY. SO NINDS ESTABLISHED AN AWARD, IT'S NAMED AFTER STORY LANDIS. IT'S GETTING A LOT OF ATTENTION IN ITS THIRD YEAR NOW. AT LEAST I THINK IT'S A HERE I HAVE TO MENTION MICHELLE JONES LONDON AND STEVE CORN, WHO IS -- TENACITY AND RELENTILSNESS LED TO THIS AWARD GOING FORWARD. WHAT ABOUT FORMAL TRAINING? WE DID A SURVEY OF ALL THE INSTITUTIONS THAT HAVE A TRAINING GRANT FUNDED BID AT LEAST ONE TRAINING GRANT FUNDED BY NINDS. THERE ARE 41 SUCH/THAT WAS IN MAY IN MAY 2018. OUT OF 41 INSTITUTIONS, 37 RESPONDED AND AS YOU CAN SEE THE VAST MAJORITY OF THEM PROVIDE ALMOST NO TRAINING IN THE PRINCIPLES OF RIGOROUS RESEARCH. ONLY FIVE REPORTED HAVING A COURSE AND EVEN THAT ONE COURSE ONLY PARTIALLY COVERED ALL THE ISSUES RELATED TO THE PRINCIPLES OF RIGOROUS RESEARCH. GIVEN THAT THERE'S SO MUCH MATERIAL ONLINE, WHY IS THIS THE CASE? WE THOUGHT THIS IS PROBABLY BECAUSE ENERGY BARRIER FOR CREATING A COURSE FROM SCRATCH IS VERY HIGH BECAUSE YOU HAVE TO HAVE THE MOTIVATION, THE KNOWLEDGE, THE TIME THE RESOURCES TO DO THAT. SO WE THOUGHT WHAT IF THERE WAS A FREE EDUCATIONAL PLATFORM? THAT WAS COMPREHENSIVE, MODULAR ADAPTABLE UPGRADEABLE AND EVERYONE COULD USE IT READILY AND PUT A COURSE TOGETHER THAT FITS THEIR OWN NEEDS. THIS RESOURCE USED AT BENCH, CLASSROOM OR DURING MENTORING? WOULDN'T THAT ENHANCE THE PROBABILITY THAT MORE PEOPLE WILL BE TRAINED IN PRINCIPLES OF RIGOROUS RESEARCH? SO TO DISCUSS THESE ISSUES WE ORGANIZE RECOGNIZE THE WORKSHOP JUST OVER A YEAR AGO. IT INCLUDED NEUROSCIENTISTS AN TRAINEES, SCHOLARS OF EDUCATION, AND SCIENCE COMMUNICATION AND EDUCATIONAL PLATFORM DEVELOPERS, A RANGE OF PEOPLE WITH HIGHLY INTERESTING AND IF YOU LOOK CLOSELY, YOU CAN SEE THAT INDIRA PLAYED AN ACTIVE ROLE IN THIS WORK SHOP. FROM THESE DISCUSSIONS, THE MAIN CONCLUSIONS WERE IF WE PUT TOGETHER AN EDUCATIONAL PLATFORM THAT HAS TO TARGET ALL THE CAREER STAGES, THAT IF WE DON'T CHANGE THE CULTURE, JUST HAVING AN EDUCATIONAL PLATFORM WILL HAVE PROBABLY A LIMITED IMPACT. AND ACADEMIC INSTITUTIONS NEED TO PLAY A PROACTIVE ROLE IN CHANGING THE CULTURE. TO PUT ALL THIS TOGETHER, THE MAIN RECOMMENDATION THAT CAME OUT IN THE DISCUSSIONS WAS THAT WHEN PERHAPS ONE NEEDS TO ESTABLISH COMMUNITIES OF CHAMPIONS, RIGOR CHAMPIONS WITHIN AND ACROSS INSTITUTIONS THAT WILL CHANGE THE CULTURE, SHARE RESOURCES, AND SUPPORT BETTER TRAINING IN ALL ACADEMIC LEVELS. OBVIOUSLY CHANGING THE CULTURE MEANS CHANGING CULTURE GLOBALLY. NOT JUST NEUROSCIENCE OR U.S., SO IT'S BEYOND THE SCOPE OF NINDS. AND THEREFORE OBVIOUSLY WE CANNOT TAKE THIS UPON OURSELVES. BUT WE CAN SEE THE PROCESS. SO WHAT WE DID IS WE ESTABLISHED A WEBSITE WHERE PEOPLE CAN SELF-IDENTIFY AS RIGOR CHAMPIONS AND THE IDEA OF THIS IS NOW THEY CAN FIND PEOPLE WITHIN THEIR SAME INSTITUTION THEY DIDN'T KNOW ARE ALSO CARE ABOUT THE SAME ISSUES AND THEY CAN FORM THESE LOCAL NETWORKS AND DEVISE WAYS TO IMPROVE THE TRAINING AND RIGOR, CHANGING AND CULTURE OF HOW INVESTIGATORS ARE EVALUATED WITHIN THEIR INSTITUTION, FORM CONNECTIONS REGIONALLY, NATIONALLY AND EVENTUALLY HOPEFULLY GLOBALLY. THIS IS -- WE HAVE THIS ON OUR WEBSITE BUT IT'S NOT YET BEEN WIDELY ADVERTISED. A PAPER THAT SUM RIDESES THE WORKSHOP HOPEFULLY WILL BE COMING OUT SOON AND HOPEFULLY THAT WILL ATTRACT A LOT OF ATTENTION TO THIS SITE. HOW DO WE ENVISION THIS MIGHT LOOK LIKE? IT WILL BE MADE UP OF A RANGE OF MODULES, RELATED TO THE PRINCIPLES OF RIGOROUS RESEARCH, FOR EXAMPLE MODULE ON CONTROLS, MODULE ON RANDOMIZATION, A MODULE ON SAMPLING BIAS, SO FORTH. EACH ONE OF THESE MODULES COULD HAVE ONE OR MORE OF THESE ELEMENTS BUILT INTO IT. THAT IS THE IDEA. THE THOUGHT IS THESE MODULES WILL BE DEVELOPED BY THE SCIENTIFIC COMMUNITY. THAT'S KEY. AND THE MODULES, SCIENTIFIC CONTENT OF THESE MODULES WILL BE DEVELOPED BY THE SCIENTIFIC COMMUNITY, HOWEVER THE ACTUAL PRODUCTION WILL BE CENTRALIZED. THE IDEA BEHIND THAT IS TO ASSURE A HARMONIZATION. SO THERE WILL BE A COORDINATING CENTER, THAT DEVELOPS THE ACTUAL PLATFORM, COORDINATES AMONG THE MODULES, HARMONIZES THE DATA, MANAGES THE DATA, WORKS HAND IN HAND WITH THE MODULE DEVELOPERS, TO EVALUATE THE CONTENT AS IT'S BEING RELEASED. THEY WILL ALSO HOUSE RESOURCES TO PRODUCE THE MODULES. SO TEACHING AND LEARNING EXPERTISE, TO MAKE SURE THAT WE ARE USING THE BEST POSSIBLE METHODS OF GETTING INFORMATION ACROSS, THE ABILITY TO CREATE INTERACTIVE MEDIA, AND VIDEO PRODUCTION. AS FAR AS A TIME LINE HOW SOMETHING LIKE THIS MIGHT WORK, THE FIRST THING HAS TO BE DECIDING ON THE MODULES, AS I SAID THIS HAS TO BE DONE BY THE SCIENTIFIC COMMUNITY. WE ENVISION -- WE HAVE PUT TOGETHER A LIST OF POTENTIAL MODULES. THIS COULD BE SHARED WITH THE SCIENTIFIC COMMUNITY TO GET FEEDBACK TO GET SUGGESTIONS, HOW TO MODIFY IMPROVE OR ADD THE NEXT STEP WOULD BE TO SELECT A COORDINATING CENTER. ONCE THE COORDINATING CENTER IS IN PLACE, GRANTS CAN GO OUT TO -- FOR THE DEVELOPMENT OF SPECIFIC MODULES FOR PRINCIPLES OF RIGOROUS RESEARCH. IN THE FINAL STEP, IT WILL BE THE CREATION HARMONIZATION AN EVALUATION AND REFINEMENT OF EDUCATIONAL PLATFORM. I HIGHLIGHTED EVALUATION BECAUSE THIS IS GOING TO BE KEY. IT'S HIGHLY IMPORTANT TO TEST EVERY SINGLE MODULE THAT COMES OUT TO SEE WHAT'S EFFECTIVE AND WHAT IS NOT TO LEARN FROM IT AND TO IMPROVE IT. IF THIS ALL WORKS PROBABLY IN FIVE YEARS ONE COULD HAVE AN EFFECTIVE PLATFORM PUT TOGETHER. SO IF WE JUST LOOK AT THIS FROM A PICTURE POINT OF VIEW, ONCE A COORDINATING CENTER AND MODULES ARE IN PLACE, WHAT WOULD HAPPEN, THE WAY WE SEE THIS IS THE COORDINATING CENTER WOULD PROBABLY BE ADVISED BY ONE OR MORE STEERING COMMITTEE BECAUSE IT HAS MANY MOVING PARTS IN IT, THE MODULES AS I SAID BEFORE, AND THE COORDINATING CENTER WILL WORK HAND IN HAND TO DEVELOP AND EVALUATE THE MODULES. I MENTIONED THE COMMUNITIES OF CHAMPIONS, WE THINK THAT THESE LIKELY WILL BE -- BEFORE THAT, THE MODULES WILL WILL INTERACT AMONG THEMSELVES, NAP AN ANNUAL MEETING THIS WILL SERVE TO LEARN FROM EXPERIENCE OF OTHERS AND ESTABLISH COLLABORATIONS. I MENTIONED THAT COMMUNITY ALSO IDENTIFY THEMSELVESLESS, WE THINK THEY WILL PROBABLY BE MANY OF THOSE WHO WANT TO DEVELOP SOME OF THESE MODULES. THEREFORE WE SEE THE CHAMPIONS GETTING INVOLVED IN THE DEVELOPMENT OF THE EDUCATIONAL PLATFORM AND THOSE INVOLVED CAN ALSO PARTICIPATE IN THESE ANNUAL MEETINGS AND CONTRIBUTE TO THE DEVELOPMENT OF THIS PLATFORM. WITH THAT I WOULD LIKE TO THANK YOU FOR YOUR ATTENTION. AND WE GREATLY APPRECIATE THOUGHTS, IDEAS AND COMMENTS YOU MIGHT HAVE ON THIS PROPOSAL. >> A COUPLE OF IDEAS, I THINK I CAN ALMOST SEE SOMETHING EMERGEDED FROM THE SIMILAR TO CT TRAINING OR HIPAA TRAINING THAT WE TAKE BEFORE WE EVER PARTICIPATE IN HUMAN SUBJECTS RESEARCH. SO THE SAME IS TRUE FOR FUNDAMENTAL RESEARCH WITH ANY GRANT YOU HAVE TO SIGN OFF YOU HAVE HAD TRAINING AND CERTIFICATION AND RIGOROUS STANDARDS, I THINK IF WE DEVELOP IT WILL WORK WELL. THE SECOND IDEA, A LOT OF THE RUSH TO PUBLISH IS NOT JUST GET CREDIT TENURE, IT'S USUALLY TO REGISTER DISCOVERY. MANY WAYS IF YOU TRY TO GO DISCOVERY REGISTRY OUT, IT'S BUREAUCRATIC SO YOU RUSH TO GET AN ARTICLE OUT THERE. SO YOU CREDIT DISCOVERY, IF THERE CAN BE AN INTERIM AND DISCOVERY AND REPOSITORY SOMEHOW , PENDING OUTCOME IT CAN SOLVE A LOT. TENURE COMMITTEES ARE ALLOWING NOW PEOPLE WHOSE PAY SORE NOT QUITE READY TO PUT IT OUT THERE, AND GET SOME PARTIAL CREDIT FOR IT RATHER THAN RUSHING IT TO PUBLICATION AT THE LOWER IMPACT >> VERY GOOD POINT. THERE'S SOMETHING LIKE THAT RIGHT NOW, THAT'S BY ARCHIVE. SO YOU CAN PUT OUT SOMETHING THAT'S NOT QUITE READY FOR PRIME TIME BUT YOU AT LEAST YOU STAKE YOUR PLACE IN HISTORY. >> THE HANDS I HAVE SEEN ARE EILEEN, THEN AARON. >> IF I DID SOMETHING WRONG HERE. OOPS. I WAS JUMPING AHEAD TO HOW YOU MAKE SURE IT GETS APPLIED AND THINKING ABOUT WE HAVE BEEN TALKING A LITTLE BIT ABOUT VERY CURSORY LEVEL AS WE ARE LOOKING HOW WE FUND GRANTS AT AES AS AN EXAMPLE. HOW YOU GET BUY IN TO MAKE THAT EXPECTATION OF HAVING BEEN THROUGH THAT TRAINING. OR DEMONSTRATING APPLICATION OF PRINCIPLES STRONGLY ACROSS THE ENTIRE OR AS MUCH AS POSSIBLE ACROSS THE FUNDING COMMUNITY. >> SO I THINK THAT'S PART OF ALSO CHANGING THE CULTURE, AND THEREFORE INSTITUTIONS HAVE TO BUY INTO THIS. BUT I THINK I DON'T SEE REASONS WHY THIS WOULDN'T HAPPEN. I THINK THE REASON WE NOT SEEING IT HAPPEN, BECAUSE THEY JUST DON'T HAVE SOMETHING LIKE THAT, THEY CAN ACTUALLY EASILY ASSIGN SOMEONE OR SOMEONE WOULD HAPPILY WANT TO TEACH A COURSE LIKE THAT. THIS COULD BE USED IN THE LAB YOU ARE DOING AN EXPERIMENT AND SAYING I WOULD LIKE TO RANDOMIZE THIS EXPERIMENT BUT NOT QUITE SURE HOW IS THE BEST WAY TO DO IT SO YOU CLICK A BUTTON AND YOU GET THE ADVICE YOU WANT. ONE ON ONE MENTORING, YOU CAN BE IN LAB MEETINGS WHERE THIS COMES UP DISCUSSING A PROJECT, WHATEVER, SO IT'S OBVIOUSLY GOING TO TAKE TIME BUT I -- IF I HAD TO GUESS WHAT MEANS SUCCESS IN A PROGRAM LIKE THIS, OBVIOUSLY A SIGNIFICANT INCREASE IN NUMBER OF INSTITUTIONS THAT PROVIDE COURSES IN RIGOROUS RESEARCH, BUT ABOVE ALL, BESIDES SEEING A CHANGE IN THE RIGOR OF THE STUDIES THAT ARE COMING OUT T IN THE RIGOR OF GRANT APPLICATIONS, AND PERHAPS PRESENTATIONS AT SCIENTIFIC MEETINGS. >> AARON. >> HAVE YOU ANALYZED SOME OF THE PAPERS THAT HAVE BEEN COMING OUT RECENTLY AFTER IMPLEMENTATION OF JOURNALS OF REPORTING CHECKLISTS AND THINGS AND DO YOU THINK THAT'S IMPROVED THE QUALITY OF THE DESIGN OR NOT? >> SO GREAT QUESTION. I DIDN'T DO THAT ANALYSIS BUT IT'S BEEN DONE CAREFULLY. IT'S PUBLISHED. WHAT THEY DID IS LOOK AT NATURE PUBLISHING GROUP BEFORE AND AFTER. AND COMPARED IT TO JOURNALS THAT DON'T HAVE A SIMILAR CHECKLIST. IT IS EXTREMELY INTERESTING. FIRST THERE'S TWO PAPERS. THERE'S DEFINITELY A SIGNIFICANT UPTICK AFTER THESE CHECKLISTS CAME OUT. WHAT'S INTERESTING IF YOU LOOK AT ALL THE LANDI S FOUR, THEN IT ONLY WENT TO 16%. IN ORDER TO HAVE ALL FOUR. OKAY? BUT IT WENT UP FROM ZERO TO 16% SO IT'S WENT UP INFINITELY. INDIVIDUALLY THEY WENT UP 70 Z 08% BUT GET ALL FOUR DIDN'T HAPPEN MUCH. SO THEY DO HAVE IMPACT, THEY CAN HAVE IMPACT UNDER TWO CONDITIONS FROM WHAT THE LITERATURE SHOWS. ONE, THE CHECKLIST HAS TO BE CONCISE, TWO, GOT TO BE ENFORCED. THERE'S A GREAT STUDY WITH PLUS ONE. WHERE THEY ENDORSE ARRIVED GUIDELINES, I DON'T KNOW IF YOU ARE FAMILIAR, GUIDELINES FOR DOING STUDIES. EXTENSIVE AND CONTAIN IMPORTANT ITEMS AND NON-IMPORTANT ITEMS, MORE THAN A THOUSAND JOURNALS BOUGHT INTO THIS, WE ENDORSE GUIDELINES. NO CHANGE IN PRACTICE, A TOO LONG, BE, NO ONE ENFORCED IT. THAT'S BEING DEMONSTRATED SO YES, THERE'S CHECKLISTS, CAN WORK, IF THEY ARE TO THE POINT. >> ONE ANECDOTAL, IT MIGHT BE USEFUL TO INTEGRATE THE CHECKLIST EARLIER ON. MY LABORATORY IF WE SUBMIT A PAPER TO ONE NATURE PUBLISHING JOURNALS AN EDITOR WILL WRITE BACK AND SAY WE LIKE TO SEND THIS FOR REVIEW BUT YOU NEED TO HAVE THIS CHECKLIST, PLACE SEND THIS BACK IN 24 HOURS. THEN SO THAT'S NOT REALLY THE PURPOSE OF THE CHECKLIST. WHEREAS IF WE HAD THAT BEFORE WE DESIGN THE EXPERIMENT, IT MIGHT BE MORE IMPACTFUL. >> SO I TOOK -- TAKE A LONG VIEW ON THIS. AT LEAST WHAT NATURE PUBLISHING GROUP DID IS JUST A TRANSPARENCY CHECKLIST. THEY DON'T TELL YOU IF YOU DIDN'T RANDOMIZE OR BLIND YOUR PAPER IS DEAD. YOU CAN SEE LOTS OF PAPERS THAT DIDN'T DO IT AND STILL GET PUBLISHED. BUT OUR RESEARCH IS PSYCH WHETHER I CAN. SO MAYBE THE FIRST TIME YOU SUBMIT YOU SAY OH MY GOD, I DIDN'T KNOW I NEEDED THIS. NEXT TIME YOU DESIGN YOUR STUDY DIFFERENTLY, WAIT A MINUTE, I'LL PAY ATTENTION TO THESE ITEMS BECAUSE I KNOW I'LL BE ASKED AND MAYBE THERE'S A REASON WHY I'M ASKED TO DO THEM. >> SEEMS TO BE THE EXPERIENCE, AT LEAST IN MY GROUP FOR SUBSEQUENT STUDIES. >> THAT'S FANTASTIC. I THINK WE'LL SEE -- INTERESTING STUDY, OVER TIME WE WILL SEE LESS PAPERS SAY WE DIDN'T DO IT AND SEE MORE SAY THAT WE DID IT. >> THIS WAS LISTED AS A STAND ALONE AGENDA ITEM BUT WE WANTED TO GO INTO IT DEEPLY, SHAI GAVE BACKGROUND BUT WHAT SHAI IS PROPOSING IS AN INITIATIVE, THE INITIATIVE IS ESTABLISHING THIS EDUCATIONAL PLATFORM SO THIS IS REALLY ALSO CONCEPT CLEARANCE FOR THAT IDEA. ANY OTHER QUESTIONS? IF NOT ISLE ASK FOR A MOTION. >> MY FIRST PART OF THE QUESTION, IS THIS BEING DONE THROUGH BASICALLY STANDARD GRANT MECHANISM OR U MECHANISM? THAT LEADS TO A REAL PART OF MY QUESTION WHICH IS HUE DOES -- HOW DOES YOUR OFFICE AND NINDS OVERSEE AND MAKE SURE THIS PROJECT COMES OUT THE WAY THAT NIH NEEDS IT TO COME OUT? >> THAT IS SAW FANTASTIC QUESTION. WHAT WE ENVISION IS THIS IS GOING TO BE A A COOPERATIVE AGREEMENT, NOT A CONTRACT BECAUSE A CONTRACT YOU CAN'T CHANGE BUT A COOPERATIVE AGREEMENT WILL BE INVOLVED BUT WE ALSO HAVE TO EXPECT AS THIS EVOLVES, THINGS WILL HAVE TO CHANGE, ADDITION MODULES ADDED AS NEW TECHNOLOGIES COME OUT MAYBE TO INCORPORATE THEM. SO IT WILL BE A COOPERATIVE AGREEMENT, AND THERE WILL BE VERY STRONG OVERSIGHT ON THE DEVELOPMENT. >> I THINK WHAT HE IS SAYING IS THE COORDINATING CENTER WHICH HARMONIZE AND HELP PRODUCE THE FINAL MODULES WOULD BE COOPERATIVE AGREEMENT. THIS IS MORE COMMUNITY EFFORT SO DEFINITION OF COOPERATIVE AGREEMENT IS NIH CAN PLAY UP TO A 49% ROLE. IN OTHER WORDS DOMINANT FORCE IS COMMUNITY. IT MUST COME FROM THE IMMUNITY TO BE ACCEPTED BY THE COMMUNITY. >> I JUST WANTED TO COMMENT FOLLOWING UP FROM WHAT KEN MENTIONED BEFORE. SO THE SOCIETY FOR NEUROSCIENCE HAD BEEN VERY ACTIVELY INVOLVED IN THOSE COURSES ON BASICALLY INTERACTIONS AND RESEARCH ALSO ADDRESSING YOUR COMMENT. ETHICAL INTERACTIONS. THEY HAVE BEEN QUITE INVOLVED IN DEVELOPING WORKSHOPS THAT WOULD ADDRESS THESESH ISSUES SHAI HAS BEEN TALKED ABOUT NOW FOR MANY YEARS. SO NOT SUPER EVERY INVOLVED, WALTER YOU MAY KNOW THE SOCIETY FOR NEUROSCIENCE IS INVOLVED, AS YOU ALSO KNOW, VERY EFFECTIVE AT RUNNING WORKSHOPS AND DISSEMINATING INFORMATION IN WEBSITES AND ALL THAT STUFF. >> YOU WANT TO MENTION SFN PROJECT ONGOING? >> WE FUNDING A ONGOING PROJECT NOW WITH THE SOCIETY FOR NEUROSCIENCE. DIDN'T FUND BUT IT WAS RECENT FUNDED AS WELL IN THE LAST CYCLE. AND WE MOST DEFINITELY REACH OUT TO SOCIETIES, AND TO THE SCIENTIFIC COMMUNITY AS A WHOLE TO GET INVOLVED. WE BELIEVE WHEN WE CALL CREATION OF MODULES NOT SURPRISED SOCIETY FOR NEUROSCIENCE WILL NOT SAY WE WANT TO DEVELOP THIS AND THIS AND THIS MODULE. OR INVOLVED IN DEVELOPMENT OF THESE PARTICULAR MODULE. >> TRYING TO THINK OF THE LONG GAME HERE. TWO THINGS, ONE WE STARTED THE CONVERSATION BY TELLING YOU HOW THE CONGRESS HAS TRUSTED NIH THAT COULD ALL GO AWAY, IF THAT I BELIEVE QUALITY RESEARCH IS NOT YOU HAVE TO SNUFF. THIS IS A TREMENDOUS THREAT TO EVERYTHING WE DO. LET ALONE THE FACT THAT SLOPPY STUFF GOES ON. I'M TAKEN BACK. I GUESS NOT THIS ONE HERE BUT IN MEDICINE, WE HAVE BEEN THROUGH THIS SO WHEN WE TRAIN, THE DOCTOR DID WHAT HE WANTED, NO ONE TOLD HIM WHAT TO DO. NOTHING HAPPENED. AND GREAT DOCTORS, EVERYTHING WORKED OUT FINE BUT IN THE 80s PEOPLE STARTED TO COLLECT DATA WHAT WAS HAPPENING AND IT WASN'T AS GOOD AS EVERYBODY THOUGHT. THE NEXT THING THAT HAPPENED IS PEOPLE CAME IN WITH CHECKLISTS AND TURNED OUT, THIS WAS EVEN IN MY SHOP WHERE WE THOUGHT WE WERE GREAT. AND WE COLLECTED DATA AND WE FOUND OUT OUR PNEUMONIA RATES IN STROKE PATIENTS WERE HIGHER THAN OTHER HOSPITALS INVOLVED IN QUALITY IMPROVEMENT PROGRAM. WE HAD TO CHANGE THE POLICY CHECK SWALLOWING BEFORE YOU FEED THE PATIENT PATIENT. SOON ADS YOU DID THAT THE RATES WENT DOWN. THAT TOOK OFF IN MEDICINE. THE QUALITY IMPROVEMENT IS EVERYWHERE IN MEDICINE, YET IN SCIENCE, THERE'S NOTHING LIKE -- THIS IS JUST BEGINNING. SO YOU DON'T WANT TO HAVE AS MENTIONED WITH ETHICS, YOU DON'T WANT IT TO BE POLICEMEN BUT INTEGRATE FOLKS WHO CAN LOOK AT THE QUALITY OF THE RESEARCH WITH THE INVESTIGATORS, SEEMS TO BE A WIN WIN FOR EVERYONE. BUT THE DEPARTMENTS BASICALLY HAVE TO MAKE THE INVESTMENT THAT THEY'RE GOING TO EXAMINE THE QUALITY OF THE RESEARCH THEY ARE PUTTING OUT. IS ANY DEPARTMENTS YOU HEAR OF EVER THINK IN THOSE KIND OF TERMS? OR IS IT STILL WHAT THE INVESTIGATOR -- LET THE INVESTIGATOR DO WHAT THEY WANT, SEE WHO GETS PUBLISHED? >> WE STARTED TO SEE FEASIBILITY ASSESSMENTS REQUIRED AT THE DEPARTMENT LEVEL OUR INSTITUTION BUT JUST STABILITY PIECE NOT QUALITY OF THE DESIGN. >> COULDN'T THE NIH AS GRANTING AGENCY REQUIRE THAT THE GRANTEES HAVE TO COMPLY WITH THE RIGOROUS -- EVEN JUST THE TRANSPARENCY EMOGI, I THINK THE PACKAGE WOULD BE GREAT BUT NIH IS IN A POSITION TO ENFORCE. >> THE WAY NIH DOES THAT, WE HAVE TO BE CAREFUL ABOUT APPEARING TOO HEAVY HANDED BUT WHAT WE DO, IT'S NOW REVIEW CRITERIA RIGOR. IT'S SCORED. SO THIS IS AN INDIRECT WAY OF REQUIRING IT. >> YOU COULD REQUIRE IN PUBLICATION RESEARCH. ALL THE PAPERS NOW ARE LINKED TO THE GRANTS -- >> I'LL LET SHAI TALK ABOUT THAT. >> FIRST WHAT IS AMAZING TO ME, REVIEWERS ARE ONLY REQUIRED TO REVIEW WHAT'S INNER THE APPLICATION. NOT REQUIREDDED TO READ ANY OTHER MATERIAL IF THEY DON'T WANT TO. WHICH IS AN ISSUE, IF YOU WANT TO JUDGE RIGOR YOU HAVE TOW DONNA. BUT I THINK THAT -- YOU HAVE TO DO THAT. BUT THE CHANGE CALLED SCIENTIFIC PREMISE, NOW RIGOR, KEY SUPPORTING DATA IS THE MOST IMPORTANT CHANGE NIH MADE. REASON BEING, IF AN INVESTIGATOR HAS TO DISCUSS THE RIGOR OF THEIR PRIOR WORK OR SOMEONE ELSE PRIOR WORK, BEGIN BEING USED TO JUSTIFY FOUR OR FIVE YEARS OF FUNDING THEY WILL THINK MAYBE I NEED TO DO THIS IN A DIFFERENT WAY SO I'LL GET MY NEXT ROUND OF FUNDING. SO I WILL HAVE THE GREATEST LONG TERM IMPACT. AS FAR AS NIH FORCING THINGS, IT'S HIGHLY UNLIKELY. REVIEW IS DONE BY PIERCE. SO IT'S UP TO PIERCE TO ADHERES TO THESE GUIDELINES AT NIH PUTS FORWARD. BUT IT CAN'T BE ENFORCED IN A SENSE. BUT IF I MAY, TWO COMMENTS. ONE IS THAT IF AN INVESTIGATOR IS A VERY RIGOROUS SCIENTIST, IT IS OFTEN VERY DIFFICULT FOR THOSE INVESTIGATORS TO COMPREHEND WHAT WE ARE TALKING ABOUT. PROBABLY TRUE AROUND THE TABLE. WHAT DO YOU MEAN, PEOPLE DON'T USE CONTROLS? WHAT ARE YOU TALKING ABOUT? BUT I ALWAYS SAY THINK OF THE JOURNAL CLUBS THAT YOU HAVE. HOW MANY PAPERS SURVIVE A JOURNAL CLUB? THEY GET TRASHED LEFT RIGHT AND CENTER SO THERE'S A LOT NOT BEING DONE THE WAY IT SHOULD. NOT EVERYTHING BUT A LOT IS NOT BEING DONE. THE OTHER POINT TO MAKE, IF ONE WANTS TO MAKE CHANGE, YOU CAN'T JUST TELL PEOPLE THIS IS WHAT YOU NEED TO DO. UNFORTUNATELY THAT'S HOW THINGS ARE FOR THE MOST PART, BLIND RANDOMIZE. YOU HAVE TO TEACH WHY. IF YOU GET ACROSS THE WHY AND PEOPLE UNDERSTAND THAT WE ARE SUBJECT TO UNCONSCIOUS BIASES AND CAN EASILY BE FOOLED BY OURSELVES THEN ONE CAN GET BUY IN. >> SO I THINK THIS TERM RIGOR AND THE WAY IT'S BEING USED HERE, IT'S BEING USEDDED IN TWO WAYS. WHAT YOU JUST SAID SHAI IS REFERRING TO RIGOR AS THE QUALITY AND REPRODUCIBILITY OF THE WORK THAT HAS BEEN DONE PRIOR TO THE GRANT PROPOSAL BEING WRITTEN. WHEREAS I THINK WHAT OTHER PEOPLE CARRY GOSH IS WHAT IS IN MY EXPERIMENTAL DESIGN, AM I DOING THIS UNDER A BLIND MANNER DO I HAVE THE PROPER POWER ANALYSIS? I THINK HAYS -- THAT IS CONFUSING TO PEOPLE WRITING GRANTS, WE FEEL LIKE WE CAN BE RESPONSIBLE FOR RESEARCH PLAN AND THE DESIGN AND THE WORK DONE IN OUR LAB BUT NOT RESPONSIBLE FOR THE PRIOR WORK. SO THAT -- UNLESS WE DID IT BUT THAT ALSO PUTS US IN A SITUATION WHERE NOW YOU ARE WRITING GRANTS SAYING PRIOR WORK NOT DONE IN A RIGOROUS MANNER SO I NEED TO GO BACK, REPRODUCE THAT PRIOR WORK AND DEMONSTRATE IT'S CORRECT. YOU WRITE THAT INTO A GRANT YOU'LL NEVER GET THE FUNDING SO I FEEL LIKE THERE'S A LOT OF CATCH 22 WRITTEN IN HERE. THE OTHER COMMENT TO MAKE IS I FEEL LIKE GOING FORWARD THESE CHECKLISTS, ARE NOT GOING TO WORK EFFECTIVELY OR FAST ENOUGH. THE MOST EFFECTIVE WAY TO ACCOMPLISH THE GOALS WE ARE TALKING ABOUT IS THROUGH EDUCATION AND WORK SHOTS, MAKING SURE PEOPLE UNDERSTAND THE COMPONENTS OF PROPER EXPERIMENTAL DESIGN, RATHER THAN AFTER THE FACT SAYING GEE YOU DIDN'T MEET CRITERIA, NATURE COMMUNICATIONS CHECKLIST. I FEEL LIKE THIS IS NOT REALLY BEING APPROACHED IN THE MOST EFFECTIVE LOGICAL MANNER. >> TO RESPOND TO YOUR FIRST COMMENT, AS YOU CAN SEE HERE I PUT BACK UP THERE ARE FOUR ELEMENTS IN WHAT NIH PUT FORWARD. FIRST WAS RIGOR OF THE SUPPORTING DATA THE OTHER IS RIGOR OF THE PROPOSED RESEARCH NEW IS WHAT YOU REFERRED TO. NIH IN ITS WISDOM SAID YOU DON'T HAVE TO HAVE ALL YOUR DUCKS IN A ROW AS FAR AS RIGOR OF THE SUPPORTING DATA. IT HAS TO BE STRONG ENOUGH TO SAY YOU'RE NOT JUST -- THERE IS NOT HOUSE OF CARDS BUT IF THERE IS A STUDY DONE ON SMALL SAMPLE SIZE, YOU CAN SAY AIM 1A THIS ONE THING I WILL REPEAT THIS ONE EXPERIMENT TO SEE WHETHER INDEED IT SUPPORTS THE WORKING HYPOTHESIS. THAT'S SPECIFICALLY IN THE INSTRUCTIONS NOW TO APPLICANTS THAT THEY -- IT DOESN'T HAVE TO BE PERFECT BUT YOU HAVE TO POINT OUT WHAT ISN'T PERFECT AND WHAT YOU'RE GOING TO DO ABOUT IT. CHECKLISTS ACTUALLY WALTER BROUGHT UP CHECKLISTS BUT WE DIDN'T SPEAK OF THAT HERE. WE ARE TALKING ABOUT EXACTLY WHAT YOU SAID. EDUCATIONAL PLATFORM. PRINCIPLES OF RIGOROUS RESEARCH, HOW BEST TO TEACH PEOPLE TO CHANGE MINDS, INCREASE AWARENESS. AND WE HOPE THIS WILL LEAD TO MORE QUALITY RESEARCH. >> AN EXTREME EXAMPLE OF THE FIRST CRITERION, IF YOU ARE WRITING A GRANT APPLICATION TO LOOK AT THE TARGETS OF A PROTEIN KINASE, IF THE PREVIOUS WORK SHOWING THAT IT'S A PROTEIN KINASE IS JUST ININCREDIBLY SLOPPY, ONE SHOULD ARGUE THAT THAT SHOULD EFFECT REVIEW OF YOUR GRANT APPLICATION. I THINK THAT'S -- BUT ANYWAY, SO WHAT HE'S PROPOSING HERE IS SORT OF WHAT YOU ARE SAYING, EDUCATIONAL APPROACH. ANY OTHER COMMENTS BEFORE WE VOTE ON THIS CONCEPT? AARON. >> I DON'T KNOW IF THIS IS APROPOS WHAT YOU HAVE BEEN SAYING BUT WONDER IF IN THESE TYPES OF PRESENTATIONS IF IT MIGHT BE USEFUL TO LEAD WITH ALL THE GREAT DISCOVERIES IN NEUROSCIENCE THAT LED TO THERAPIES AND ESPECIALLY NEURODEGENERATIVE DISEASE, I THINK THERE WILL BE TREATMENTS THIS DECADE THAT COME FROM BASIC RESEARCH. THAT IS MORE REASON WHY WE HAVE THE SACRED OBLIGATION TO HAVE RIGOROUS RESEARCH BECAUSE WE ARE CLOSE TO THERAPIES THAT WILL TRANSLATE INTO THE CLINIC. SO I THINK RATHER THAN SOMETHING THAT'S OMINOUS MAYBE SOMETHING STARTING IN A MORE POSITIVE NOTE WHERE WE HAVE HAD BREAK THROUGHS IN THE LABORATORY TRANSLATING AND SORT OF HAVE A MORE RESPONSIBILITY TO PROCEED IN A RIGOROUS WAY. , JUST A COMMENT. >> INDIRA. >> IN THE PROCESS OF DOING THIS IT WILL BE INTERESTING TO TIE TOGETHER MANY THINGS THAT WERE TALKED ABOUT TODAY RANGING FROM PEOPLE LACKING CONFIDENCE IN THAT LINE GOING ON IN RESEARCH AND SOME NOT WANTING TO APPLY FOR HIGH RISK HIGH GAIN WHATEVER ENDEAVORS. WHEN WIN IS INTERESTED IN THAT ELEMENT OF RISK IN DOING SURPRISING THINGS, ONE BECOMES LESS ENTHUSIASTIC ABOUT ANYTHING THAT FEELS CONSTRAINING TO A FORMULA AND MY CHECKLIST IS CREEPY IN THAT REGARD. THE REALLY HARD PART I'M ENTHUSIASTIC ABOUT RIGOROUS RESEARCH. BUT I'M ALSO ENTHUSIASTIC ABOUT MAKING IT POSSIBLE FOR PEOPLE TO DO THE HIGH RISK EXPLORATORY WORK THAT IS POSSIBLE. I THINK THE REAL CHALLENGE WILL BE FINDING A WAY TO INCORPORATE ALL APPROPRIATE METHOD LOGICAL CONSTRAINTS WHILE MAKING IT POSSIBLE FOR PEOPLE TO INDULGE IN FLIGHTS OF FANCY THAT GIVE RISE TO CREATIVITY. THAT IS A SELLING POINT THAT GOES TO COMMUNICATIONS AND MARKETING COMPONENT HOW DO YOU MAKE PEOPLE PERCEIVE THE CONFORMING TO CERTAIN PRINCIPLES OF RIGOR ETHICS WHATEVER YOU WANT TO CALL -- ALL THESE ELEMENTS, NOT WHATEVER YOU WANT TO CALL, ALL OF THEM. AND MAKE IT POSSIBLE FOR THEM NOT TO FEEL CONSTRAINED THEY DON'T DARE TRY SOMETHING NEW. NOT SAYING ANYTHING NEGATIVE BUT THAT IS THE CALCULATION THAT IS GOING ON UNCONSCIOUSLY SUB CONSCIOUSLY IN PEOPLE'S HEADS WHEN FACED WITH A SET OF CRITERIA THEY ARE SUPPOSED TO FULFILL. >> I AGREE, TO MAKE THIS CLEAR IF YOU LOOK AT THE LANDIS PAPER THERE IS A SECTION COMPARING HYPOTHESIS GENERATING TYPE TESTING, THE DIFFERENCES, THE DIFFERENCES. OBVIOUSLY YOU HAVE TO ROOM FOR TRYING NEW THINGS. SO ON. THE ISSUE STARTS IN REPORTING. IF THOSE EXPERIMENTS ARE REPORTED ADS CONFIRMATORY STUDIES T THAT'S WITH RESPECT WE RUN INTO PROBLEMS. IF YOU REPORT, THIS WAS EXPLORATORY, WE DID THREE ANIMALS WE TRIED THIS, WE DIDN'T BLIND WE DIDN'T RANDOMIZE WE PURPOSEFULLY DIDN'T DO IT, MAKES SENSE YOU WOULDN'T DO IT. AND YOU CAN LOOK TO SEE WHAT YOU GOT, YOU GOT SOMETHING INTERESTING, IF YOU REPORT THAT WAY, THAT'S FINE. LOOK WHAT WHICH FOUND WE HYPOTHESIS THAT IS GOING TO HAPPEN LOOK WHAT WE FOUND THAT'S WHERE WE RUN INTO PROBLEMS BUT ABSOLUTELY, CREATIVITY,ERROR EXPLORATION AND DOING THE FUN THINGS WE DO IN THE LAB HAVE TO CONTINUE. >> CLAUDIA. (OFF MIC) >> IS YOUR MICROPHONE ON? >> I'M SUPPORTIVE OF THE EDUCATION MODULES BUT I THINK AS YOU ALLUDED TO THE ISSUE WILL BE TO EXECUTE AND HAVE IMPACT. AND I GUESS THE QUESTION I HAVE IF YOU TRY TO CREATE THIS CULTURE WHERE RIGOR BECOMES A PRIORITY WE HAVE TO INCENTIVIZE IT OR REWARD IT ON SOME LEVEL. RIGHT NOW OUR PROMOTION COMMITTEE'S REWARD ON VOLUME, H FACTORS WHICH ARE NUMBERS OF CITATIONS AND ATTEMPT WORD ON IMPACT BUT DON'T GIVE RIGOR SCORES PER SE AND NOT CHALLENGED TO LOOK CAREFULLY AT THE QUALITY OF THAT SCIENCE. SO ONE RAISES THE POSSIBILITY HOW YOU CAN PARTNER AND BEGIN IN THE SAME WAY WE HAVE IN THE CLINIC QUALITY SCORE YOUR BRONZE, GOLD WHATEVER SOUNDS HARSH BUT OTHER HAND MIGHT BE SOME WAY TOO INTERVENE THAT PROCESS OF PROMOTION. NOT NOT JUST ONCE, YOU HAVE BEEN EDUCATESSED, AND YOU DON'T IMPLEMENT THAT IN THE COURSE OF YOUR CAREER. >> ABSOLUTELY RIGHT. WHAT IS ENCOURAGING IN MY OPINION IS WE ARE STARTING TO SEE MOVEMENT IN THAT DIRECTION. IT'S DIFFERENT INSTITUTIONS IN DIFFERENT DEPARTMENTS. BUT THINGS ARE HAPPENING. AND WE ARE HOPING THE COMMUNITIES OF CHAMPIONS WILL BE THE ONES, THE MOVEMENT THAT WILL CONVINCE INSTITUTIONS THEY NEED TO CHANGE. AS FAR AS NINDS GOES FOR EXAMPLE, ANY INSTITUTION THAT GETS A TRAINING GRANT FROM NINDS IS REQUIRED TO HAVE A COURSE IN PRINCIPLES IN RIGOROUS RESEARCH, REQUIRED TO TEACH THAT. YOU ARE PROBABLY FAMILIAR WITH DORA, THIS MOVEMENT TO SHIFT FROM NUMBER OF PAPERS AND WHERE THEY PUBLISH. TO TAKE INTO CONSIDERATION OTHER ACTIVITIES OF INVESTIGATORS. THERE IS A WHOLE INSTITUTE IN BERLIN THAT MADE SIGNIFICANT CHANGES HOW THEY EVALUATE INVESTIGATORS JOHN HOPKINS IS EXPERIMENTING IN WAYS TO DO THIS IN A VERY INTERESTING WAY, FOR EXAMPLE, ONE OF THE THINGS THEY PILOT IS THAT IN ORDER TO HAVE ACCESS TO THE GRADUATE STUDENTS YOU HAVE TO DEMONSTRATE YOU ARE A RIGOROUS SCIENTIST, HOW? I DON'T KNOW BUT IT'S ONE OF THE THINGS. >> LAST QUICK QUESTION FROM ME THEN I WILL CALL THE QUESTION HERE. >> THERE CANNOT BE ANY GREATER REWARD MECHANISM THAN THE FUNDING. SO TO TIE IT TO FUNDING WHETHER REVIEW STAGE OR LATER BEFORE YOU AWARD THE GRANT Z YOU HAVE TO HAVE THE PERSON SIGN ON TO THESE CRITERIA. BECOMES PART OF THE CULTURE. >> WHAT IS BEING PROPOSE SECOND DEGREE A CONCEPT, ALL DETAILS NOT FLESHED OUT, THERE'S GOING TO BE MANY MORE DISCUSSIONS AND CONSULTATIONS WITH THE COMMUNITY AND PROBABLY COUNCIL BUT THE QUESTION IS, ARE YOU OKAY WITH THIS CONCEPT GOING FORWARD? WOULD BE GOOD UNLESS THERE'S PRESSING QUESTIONS THAT HAVE A MOTION YEAH OR NAY ABOUT THAT. (OFF MIC) >> OKAY. SECOND? ALL IN FAVOR OF THIS? >> AYE. >> THAT'S EVERYONE. >> YES FROM ME TOO. >> THANKS. I FORGET ABOUT THE PHONE OFTEN. OKAY. SO WE HAVE ONE OTHER INITIATIVE THAT'S GOING TO BE DISCUSSED FOR CONCEPT CLEARANCE. IT'S TO ESTABLISH AN NINDS TRANSLATIONAL NETWORK FOR RARE DISEASES. I THINK THAT -- ARE YOU -- >> SO THIS IS SOMETHING THAT WE HAVE BEEN THINKING ABOUT FOR A LONG TIME. NUMBER OF WORKSHOPS HAVE OCCURRED, IT'S ALL AROUND THE QUESTION OF WHERE SHOULD NINDS GO IN THE SCIENCE OF INTRODUCING GENE THERAPY INTO -- FOR THIS CASE ULTRA RARE DISORDERS. SO PEOPLE PROBABLY KNOW THAT THERE HAS BEEN SOME SUCCESS WITH INNOCENCE AND GENE THERAPY PARTICULARLY SPINAL MUSCULAR ATROPHY, THAT'S ONE OF THE RARE NEUROLOGIC DISORDERS THAT WE ARE IN OUR PORTFOLIO BUT WE HAVE MAYBE 200 OTHERS. SO WE ARE REALLY THINKING HARD ABOUT HOW AND WHAT WE SHOULD BE DOING IN THIS SPACE. SO WE HAVE HAD A NUMBER OF WORKSHOPS AND SO THE INITIATIVE YOU WILL BE HEARING FROM TODAY IS KIND OF BEGINNING OF TRYING TO UNDERSTAND HOW WE CAN MOVE FORWARD. THE PROBLEMS ARE THAT WITH FARM LOGICAL THERAPY THE IP IS IN THE MOLECULE. GENE THERAPY THERE IS NO IP IN THE SEQUENCE SO IT'S ALL A MATTER OF DEVELOPING A DELIVERY VECTOR. SO THE IP IS TIED UP THERE BUT THERE ARE DELIVERY VECTORS THAT COULD BE USED AND THE PROCESS OF MOVING A THERAPY INTO PATIENTS AND GENE THERAPY COULD OCCUR OVER PERIOD OF MONTHS OPPOSED TO DECADES. FOR THE ULTRA RARE DISORDERS, THE QUESTION COMES WHICH ONES ARE GOING TO GET ATTENTION CERTAINLY INDUSTRY IS NOT GOING TO PAY ATTENTION TO A CERTAIN LEVEL OF DISORDERS BECAUSE OF LOW PREVALENCE OR INCIDENCE. SO WE THINK THAT LOOKING INTO THE ULTRA RARE DISORDERS, IS KIND OF WHERE OUR SWEET SPOT WOULD BE. AND THERE WOULD BE A HEALTH IMPACT BUT ALSO A SCIENCE IMPACT. SO AFTER THESE MULTIPLE DIFFERENT WORKSHOPS, THIS IS NINA SHORE HAS BEEN THE ONE WHO HAS BEEN LEADING THIS BUT SHE'S NOT HERE SO I'M TAKING HER PLACE AND INTRODUCING CHRIS FROM THE DIVISION OF TRANSLATIONAL RESEARCH WORKING WITH A LOT OF THE PEOPLE AT NINDS. JILL MORRIS SPECIFICALLY, ON TRYING TO COME UP WITH A PLAN GOING FORWARD. THIS IS THE FIRST SHOTS OUT OF THE BOW. CHRIS. >> THANK YOU FOR THAT INTRODUCTION. IT'S A PRIVILEGE FOR ME TO PRESENT THIS CONCEPT PROPOSAL TO YOU FOR CONSIDERATION TO GO FORWARD. THE TITLE IS TO ESTABLISH NINDS GENE TARGETED THERAPEUTICS DEVELOPMENT NETWORK FOR ULTRA RARE NEUROLOGICAL DISEASES. THAT'S QUITE A MOUTHFUL. FOR A TITLE. AND RIGHT FROM THE START I WANT TO EMPHASIZE THREE WORDS IN THIS TITLE. THE FIRST IS GENE TARGETED, IT'S A FAIRLY LARGE BROAD TERM. WHAT WE -- ITS INTENTION WHAT WE MEAN BY THAT IS TO INCLUDE MODALITIES SUCH AS NUCLEOTIDES, THERE'S DIFFERENT TYPES OF OLIGONUCLEOTIDES SHOWING PROMISE AS THERAPEUTICS FOR NEUROLOGICAL DISEASE. GENE THERAPY AND GENOME EDITING. THE SECOND WORD IS THE WORD NETWORK. WHAT WE PROPOSE HERE IS TO TO ESTABLISH A NETWORK OPPOSED TO FOR EXAMPLE STANDARD PROGRAM WHERE YOU HAVE INDIVIDUAL PROJECTS COMING IN AND OUT. I WILL GO DEEPER INTO NETWORK AND WHY IT'S THE RIGHT APPROACH FOR THESE CHALLENGING DISEASES. THE THIRD WORD IS ULTRA RARE, IT MEANS THAT ALREADY, OUR FOCUS GROUP HERE IS TO ULTRA RARE, THESE ARE THE DISEASES WITH VERY FEW SMALL PATIENT POPULATION, MAYBE AS SMALL AS ONE, ONE PERSON WITH A KNOWN MUTATION AN KNOWN DISEASE. I WANT TO CREATE BACKGROUND CONTEXT TO THIS. MANY DISEASES WITHIN THE MISSION OF NINDS ARE AMENABLE TO INDIVIDUALIZED THERAPY APPROACHES AND BY THE NATURE OF ULTRA RARE DISEASES, THESE DISEASES ARE AMENABLE TO INDIVIDUALIZED MEDICINE THERAPY APPROACH. PER MILLION, AND THE SOBER REALITY, IF YOU PULL THESE DISEASES TOGETHER YOU END UP WITH A 30,000,000 IN THE U.S. ALONE. EXCITING THINGS ARE HAPPENING WITH REGARD TO TECHNOLOGY, FROM A DIAGNOSTIC PERSPECTIVE ADVANCES WITH EXOME SEQUENCING AND WE HAVE ABILITY TO IDENTIFY THESE MUTATIONS AND LINK THEM TO A SPECIFIC PHENOTYPE AND DISEASE. THERE ARE THINGS HAPPENING IN FIELD OF TREATMENTS AND WE ARE THINKING ABOUT RECENT FDA APPROVALS FOR OLIGONUCLEOTIDE THERAPIES. SO SIT'S AN EXCITING TIME TO BE IN THIS SPACE, THESE DISEASES ARE RAPID DISEASE PROGRESSION AND RAPID THERAPY DEVELOPMENT, THESE ARE DEVASTATING DISEASES, OFTEN FATAL AND YOU NEED TO RESPOND QUICKLY AFTER DIAGNOSIS. INNOVATIVE REGULATORY ENVIRONMENT, THIS IS ANOTHER GOOD THING PLAYING TO OUR FAVOR. WE HAVE A FAVORABLE REGULATORY ENVIRONMENT, FDA HAS DONE WORK IN THIS AREA TO ANTICIPATE WHAT WILL BE NEEDED WHEN THESE TECHNOLOGIES BECOME AVAILABLE AND START ENTERING THE CLINIC. THERE IS ONE SPECIFIC CASE STUDY I WOULD LIKE TO HIGHLIGHT, AND I THINK IT WILL BE VERY HELPFUL TO ILLUSTRATE TO YOU WHAT IT IS WE HAVE IN MIND HERE. I'M SURE YOU MAY HAVE HEARD ABOUT THIS, GOT ATTENTION IN THE MEDIA. IT IS A LITTLE GIRL DIAGNOSED WITH A RARE FORM OF DISEASE, SHE& WAS REFERRED TO BOSTON CHILDREN'S HOSPITAL, THERE WAS A TEAM OF PEOPLE THAT WAS FORMED AND THEY STARTED VERY QUICKLY AFTER DIAGNOSIS TO START LOOKING INTO THE POSSIBILITY OF DEVELOPING ANTI-SENSE NUCLEOTIDE THERAPY APPROACH FOR THIS PARTICULAR PERSON. SHE WAS THE ONLY PERSON KNOWN WITH THIS PARTICULAR MUTATION, IT WAS AN EXCELLENT EXAMPLE OF TAILORED OR CUSTOMIZED THERAPY APPROACH, PART OF THE TIME LINE PART OF PUBLICATION, SHE WAS DIAGNOSED END OF 2016, REFERRED TO BOSTON'S CHILDREN EARLY 2017. THE MUTATION WAS IDENTIFIED EARLY 2017 AND SHORTLY AFTER THAT, TO INVESTIGATE WHERE THEY COULD COUPLE OF MONTHS LATER GOING THROUGH SOME PRE-CLINICAL WORK INTERACTION WITH FDA, THEY FILED AN IND AND STARTED FIRST IN HUMAN CLINICAL TRIAL. SO WHAT IS REALLY IMPRESSIVE HERE IS HOW QUICK THEY RESPOND. TIME IS OF ESSENCE HERE, SHORT TIME LINE OF DEVELOPMENT BEFORE THEY WENT INTO THE CLINICAL TRIAL. I WANT TO EMPHASIZE I WANT TO EMPHASIZE THE TIME LINE, I FEEL THIS IS A CRITICAL ASPECT TO THIS STORY. IF YOU LOOK AT THE TIME LINE, I THINK YOU CAN IDENTIFY THERE WAS A PLANNING PHASE AFTER DIAGNOSIS AND AFTER IDENTIFICATION MUTATION, SHORT PERIOD OF TIME BUT MUST HAVE BEEN INTENSE SIGNIFICANT PERIOD OF TIME. WITH A PLAN OUT WHAT EXACTLY THE APPROACH WOULD BE. THEY ENTERED THE THERAPEUTIC DEVELOPMENT PHASE, PRE-CLINICAL PHASE, ENDING IN COMPASSIONATE USE IND SUBMISSION AND STARTED THE FIRST IN HUMAN CLINICAL TRIAL. SO THE QUESTION HERE, HOW CAN WE REPRODUCE THIS? AND APPLY THE SAME KIND OF APPROACH YOU ENTER A PLANNING PHASE MAKING SURE YOU UNDERSTAND THE DYNAMICS OF DISEASE, MUTATION, YOU ENTER THERAPEUTIC DEVELOPMENT PHASE AND ENTER INTO A CLINICAL TRIAL. WITH THIS IN MIND, WE PROPOSE THE ESTABLISHMENT OF THIS GENE TARGETED THERAPEUTICS DEVELOPMENT NETWORK AND MISSION OF THIS NETWORK WOULD BE TO THE FUNDING, FOR THE SCIENTIFIC COMMUNITY TO DEVELOP THESE GENE TARGETED THERAPIES FROM BENCH TO BEDSIDE. ULTRA RARE DISEASES. SO WHAT WE PROPOSE AT VERY HIGH LEVEL, HIGH LEVEL ORGANIZATION NETWORK STRUCTURE, WOULD BE BY ADAPTING THE SAME APPROACH, PLANNING THERAPY DEVELOPMENT AND CLINICAL TRIAL COMPONENT, AND OVERWARRER. ING STRUCTURE PROVIDE SCIENTIFIC -- OVER OVERARCHING STRUCTURE, IT WILL COME POSE A BOARD OF NINDS STAFF AS WELL AS EXPERTISE TO MANAGE THE ENTIRE NETWORK, IT WILL ALSO INCLUDE AN ETHICS COMPONENT WHICH WE FEEL IS FRONT AND CENTER TO THIS WHOLE EFFORT AND WILL BE INCLUDEDDED IN THIS BOARD. SECOND ASPECT TO THIS OVERARCHING MANAGEMENT STRUCTURE WILL BE CENTRALIZED DATA MANAGEMENT SYSTEM. WE SEE THIS AS KIND OF THE SHORT TERM AND LONG TERM MEMORY OF THE ORGANIZATION. WHERE THEY ACCUMULATE DATA, MAKE IT AVAILABLE TO PROJECTS COMING IN, AND CAN ADAPT FROM OTHER SYSTEMS INTO THIS SYSTEM TO MAKE IT AVAILABLE FOR GRANTEES. WE SEE THIS AS A TWO STEP PROCESS WHERE PERSON WILL -- APPLICANT WILL SUBMIT AN APPLICATION, A VERY PRELIMINARY APPLICATION AND IT WILL -- I WOULD IMAGINE IT WILL INCLUDE A SCIENTIFIC PREMISE ABOUT PARTICULAR DISEASE, MUTATION, AND WHY THEY THINK ONE OF THESE MODALITIES WOULD BE AMENABLE TO THERAPY. WE COULD MAKE CONSULTANTS OR EXPERTS AVAILABLE TO THE APPLICANT. THERE WILL BE A SECOND APPLICATION WHICH WILL BE FAR MORE DETAILED, IT WILL GO THROUGH SCIENTIFIC PEER REVIEW, IF SUCCESSFUL, IT WILL THEN ENTER THERAPEUTIC DEVELOPMENT PHASE, AT THIS POINT IN TIME WE CAN MAKE AVAILABLE DIFFERENT CONTRACT RESOURCE IF THE GRAM TEE DOESN'T HAVE THAT AVAILABLE. IT WILL BE A MILESTONE DRIVEN PROCESS THROUGH THE THERAPEUTIC DEVELOPMENT PROCESS., THEY WILL GO THROUGH NORMAL REGULATORY INTERACTIONS INCLUDING PRE-IND AND IND MEETINGS. IF SUCCESSFUL IT WILL CULMINATE IS IN IND SUBMISSION WITH START OF FIRST IN HUMAN CLINICAL TRIAL. IF THE GRANTEE, IF THE SIDE IS NOT GRANTEE SIDE WE COULD MAKE CLINICAL SIDE AVAILABLE ADS PART OF A CONTRACT. WE ESTIMATE THAT FROM BUDGET PERSPECTIVE 40, WORTH OF PLANNING PHASE AND FOUR TO $8,000,000 PER PROJECT FOR COMPLETION OF THE STUDY. LOOKING AT EXPECTED OUTCOMES TIMELY DELIVERY OF DISCOVERY THE ACADEMIC LAB TO CLINIC AND STANDARDIZATION AND HARMONIZATION OF BEST PRACTICES. THIS IS THE FINAL SLIDE. I WANT TO ACKNOWLEDGE THE CONTRIBUTION OF SEVERAL PEOPLE. IT WAS A TEAM EFFORT. TO GET HERE AND WILL BE A TEAM EFFORT TO MOVE THIS FORWARD. >> THANK YOU. >> THANKS, CHRIS. BRING KIRK BACK TO THE TABLE AND RECENTLY CAME BACK FROM SABBATICAL HE WILL TRANSITION A LITTLE BIT TO HELP US WITH EXTRAMURAL PROJECT. MAYBE MORE THAN A LITTLE BIT. QUESTION. >> THIS LOOKS REALLY INTERESTING. CEMENTS LIKE A GREAT AND WELL CONSIDERED SYSTEM. I MAD A MINOR COMMENT THAT ONE OF THE LIMITATION SOMEBODY OUTSIDE THE FIELD INVOLVED IN OTHER ASPECTS OF FDA INTERACTION MIGHT BE RAPID APPROVAL OF EACH INDIVIDUAL PRESUMABLY SEQUENCE THERAPEUTIC, MIGHT BE USEFUL TO HAVE A TIGHT INTERFACE WITH THE FDA, BACKBONE APPROVAL IS ALL NECESSARY. FARM AND TOX WOULD DRIVE MOST OF THESE TO THE GROUND IN TIME AND COST BUT IF YOU HAVE THE AV BACKBONE OR PARTICULAR OTHER DELIVERY SYSTEMS BLANKET APPROVAL YOU CAN MOVE FASTER THAT MAY TAKE THE HALF OF THIS EFFORT WITH THE FDA TO MOVE IT FORWARD. FROM WE TRY TO CONSOLIDATE EXPERTISE TO LEARN FROM PAST EXPERIENCE TO FUTURE PROJECTS. AND TRY TO HEAR HARMONIZE MANY ASPECT IT IS RATE LIMITING STEP IS NOT MANUFACTURING. FOR EXAMPLE WHEN IT COMES TO -- IT MAYBE THE FARM TOX AND EXPERTISE AROUND WHAT IS NEXT TO GET FROM THE CONCEPT TO IND. >> ON THE GENE THERAPY SPACE WE HAD DISCUSSIONS WITH THE FDA NOT JUST US BUT NIH IN GENERAL. AND THEY ARE HUNGRY TO DO WHAT HE SAID. BECAUSE THEY ARE ALSO GETTING HIT WITH ULTRA RARE CONDITIONS. SO THEY WANT A GENERIC SOLUTION, MAY NOT BE THE CADILLAC IP FOR IAV 26 BUT IT WOULD BE AAV 9 USED, YOU PLUG IN THE NEW GENE AND DO TOXICITY RELATED TO THAT BUT NOT GO THROUGH THE WHOLE PROCESS. AS YOU WOULD IF YOU WERE TRYING SOME NEW VECTOR. COMPANIES TO GET IP SPACE IS WHAT THEY'RE GOING TO HAVE TO DO. >> FOLLOW-UP TO WHAT TOM WAS RAISING, WHY LIMIT TO ULTRA RARE, THERE MAYBE A BENEFIT STAYING WITH RARE DISEASE, SOME OF THESE VECTORS WILL HAVE BROADER APPLICATIONS. YOU DEVELOP A VECTOR, WITH ENDOTHELIAL TARGET, IT CAN THEN SOLVE SEVERAL PROBLEMS OF AUTOEDSOMAL DOMINANT GENE DEFICIENT DISEASES. SO I THINK ALMOST DISCOURAGES THAT APPROACH, THERE'S NO NEED TO RESEARCH OURSELVES. >> AGREE THIS APPROACH IS TRANSFERABLE TO OTHER DISEASES, THINKING HERE IS JUST THAT WITH THE ULTRA RARE DISEASES COMMUNITY LIKE WALTER SUGGEST, IT'S VERY UNLIKELY THAT YOU HAVE INDUSTRY COMMITMENT TO SUPPORT THESE TECHNOLOGIES. SOUGHT WE WANT TO SERVE COMMUNITIES WHERE THERE IS NO HOPE OF THERAPEUTIC DEVELOPMENT. >> NOT MUTUALLY EXCLUSIVE THOUGH. >> MAYBE CHRIS YOU CAN MENTION, IT GETS COMPLICATED. SO THE PROPOSAL WE PUT IN FRONT OF YOU IS THE ULTRA RARE PIECE. WE ARE ALSO PLANNING TO TRY TO GO TO BLUEPRINT ALL NEUROSCIENCE EFFORTS TO BASICALLY BUILD A PROGRAM FORAGING THERAPY THAT MIMICS WHAT WE HAVE FOR SMALL MOLECULES. THAT WOULDN'T HAVE A LIMITATION. BUT THE NETWORK WE THOUGHT WOULD BE BEST TO START WITH ULTRA RARE CLINICIANS AND PEOPLE DOING THE TREATMENT, THAT THEY WOULD THEY HAVE UNIQUE ISSUES TO DEAL WITH. ALONE, HARDER THAN THEY DID ADS A GROUP. >> DO YOU WANT TO TALK ANYTHING? >> TO REITERATE THAT Z I THINK THIS IS A GREAT PROGRAM. IT DOES THE SAME APPROACH DOES HAVE APPLICATIONS OF COURSE TO A RANGE OF DIFFERENT DISEASES BUT THE ULTRA RARE DISEASE PRESENT PARTICULAR CHALLENGES WHICH YOU MIGHT THINK OF AS PROBLEMS WITH RIGOR ADS WE TALKED IN THE LAST PRESENTATION. WHEN YOU HAVE ONE PATIENT OR SMALL NUMBER OF PATIENTS HARDED TO DO CONTROLLED STUDY, HARD TO GO THROUGH STANDARD PRE-CLINICAL FARM TOX PACKAGE NEEDED FOR DISEASES THAT HAVE -- THAT ARE MORE COMMON. SO HOW DO YOU DEAL WITH ISSUES OF SAFETY, AND EFFICACY. IMPORTANTLY HOW DO YOU PAY FOR IT? THERE'S BEEN A LOT OF DISCUSSION, I THINK COMPANIES LIKE IONIS THERE'S INTEREST IN THIS. AND SUPPORT FOR IT. BUT GETTING IT PAID FOR IS A CHALLENGE. KEEPING THE PEOPLE AT THE COMPANY EMPLOYED WHILE DOING THIS IS A CHALLENGE. SO THERE'S A LOT OF DISCUSSION GOING ON NOT JUST IN OUR INSTITUTE BUT OTHER -- ELSEWHERE AT THE NIH, N CATS AND GENOME INSTITUTE BOTH INTRAMURAL AND EXTRAMURAL, CARSON OVER THERE HAS BEEN INVOLVED IN THIS RESEARCH BOTH WITH RARE AND ULTRA RARE DISEASES. AND THERE'S BEEN WORKING WITH N CATS. THERE IS AN IMPORTANT NEED HERE WITH NEUROLOGIC DISEASE AND NINDS TO GET INVOLVED AND MEET THE NEED T AS A SCIENTIFIC EFFORT TO GET MOST OUT OF THESE EXPERIMENTS OF NATURE THEY PRESENTING PATIENTS PRESENT BUT ALSO TO BE TRUE TO OUR MISSION OF FROM DUTIESING THE BURDEN OF DISEASE, NEUROLOGIC DISEASE. >> ALSO THERE'S THE ISSUE THERE'S FEW OF THESE PATIENTS YOU WILL LIKELY TREAT ALL THE PATIENTS AS PART OF THE CLINICAL TRIAL. SO YOU CAN MAKE A HUGE IMPACT THAT WAY. >> SO THERE ARE SOME DISEASES LICKETY BURL SCLEROSIS THAT IS NOT ULTRA RARE BUT TWO-THIRDS OF THE MUTATIONS ARE DE NOVO. IF YOU LOOK FROM A GENETIC POINT OF VIEW, THERE ARE MANY PEOPLE WITH TSC WHO ARE THE ONLY PERSON WITH THEIR MUTATION. OR THERE IS A HANDFUL, WHILE YOU HAVE A DISEASE PHENE TIP CLIP SIMILAR, IT AFFECTS ONE IN 6,000. THAT WOULDN'T MEET YOUR CRITERIA AT THE GENETIC LEVEL SO HOW ARE YOU DEFINING THIS THE DISEASE IN THAT CASE, THE ULTRA RARE, THE GENETIC APPROACH YOU ARE TRYING TO TREAT? >> I THINK THE GENETICS PLAY A BIG ROLE HERE. SO BIG DECISION POINT ENTERING THE NETWORK THAT PLANNING PHASE WOULD BE UNDERSTANDING EXACTLY MUTATION, THE DISEASE, AND INTERVENE AS A THERAPY. THAT'S WHERE THAT DETERMINATION NEED TO BE MADE EARLY ON BEFORE WE START INTO ANY THERAPY -- DEVELOPMENT PLAN. >> AARON. >> WORKING WITH OR BEING INDEPENDENT OF THE EFFORTS BOSTON CHILDREN'S HOSPITAL LIKE YOU MENTIONED OR THIS NEW FOUNDATION IONIS IS SUPPORTING. IT SEEMS ONE WAY NINDS HAS IMPACT GIVEN EFFORTS WHAT MIGHT BE TO FOCUS ON THE AAV VECTOR MANUFACTURING AND TOX AND THINGS LIKE THAT WHEREAS ASA APPROACHES SEEM TO BE THOSE TWO I MENTION LIKE CHILDREN'S HOSPITAL AND I'M THE -- FOUNDATION. >> I DON'T THINK THIS IS IN COMPETITION WITH ANYTHING, IN FACT, THE OPPOSITE, IT'S BOUND TO SYNERGIZE WELL WITH OTHER INITIATIVES LIKE THIS. AND THAT CENTRALIZED ITEM MANAGEMENT SYSTEM I REFER TO, COULD UTILIZE THESE OTHER EFFORTS AND WE CAN SHARE OUR EXPERIENCES WITH THEM AT THE SAME TIME. THERE ARE SO MANY DISEASES, THIS IS IS NOT THE TIME TO STAKE OUT -- TO HAVE TURF BATTED LES. THIS IS THE TIME TO COLLABORATE AND WORK TOGETHER. >> SEEMS LIKE IONIS IS ONE COMPANY, THEY ARE QUITE GOOD AT MAKING ANTI-SENSE OLIGOKNEW THREE OWE TIDES. -- OLIGONUCLEOTIDES. THERE MIGHT BE ADVANTAGE OF FOCUSING ON ONE MODALITY. WONDER IF SPREADING AN EFFORT TO MULTIPLE MODALITIES MIGHT BE RISKY. >> THAT'S THE CONSIDERATION. BUT WHAT I WOULD EXPECT TO SEE IS THAT IT WILL PROBABLY START WITH MOSTLY ON THE OLIGONUCLEOTIDE SIDE AND AFTER SHOWING THATTOLOGY GO NUCLEOTIDE APPROACH WITH SPECIFIC MUTATION OF DISEASE IS EFFICACIOUS, THAT BECOMES JUSTIFICATION TO START THINKING ABOUT PERHAPS AAV APPROACH. SO -- >> THAT WOULDN'T BE THE APPROACH I PERSONALLY DO BUT I CAN SEE A RUSH STARTING OLIGONUCLEOTIDES FIRST. >> THAT'S WHAT WE SAW WITH SMA. >> I THINK THE DEMAND HERE THE GREAT. THERE ARE HUNDREDS MAYBE THOUSANDS OF DISEASES AND PARTICULARLY LOOK AT PARTICULAR MUTATIONS TO TARGET, THERE'S A LOT OF DEMAND OUT THERE, I THINK IN LAUREN IT'S NON-PROFIT THAT SPUN OFF FROM IONIS AND THERE'S SUPPORT FOR THAT. AND BOSTON CHILDREN'S FOR SURE. THEY ONLY TAKE A SMALL MARKET OF THE POTENTIAL DEMAND, COVER A SMALL PART OF POTENTIAL DEMAND. YOUR POINT ABOUT FOCUSING ON SOME ASPECT OF IT AND SOME PARTICULAR THERAPEUTIC MODALITY IS A REASONABLE ONE. YEARS FROM NOW WE MIGHT LOOK BACK AT OLIGONUCLEOTIDES IS A PHASE IN DEVELOPMENT OF GENE TARGETED TREATMENT AND MORE DEFINITIVE AV MEDIATED OR GENE APPROACHES MAY SUPPLANT IT IN TIME. BUT NOW IT HAS POTENTIAL AND I THINK IT'S WELL WORTH PURSUING. I THINK NINDS COULD ADD TO THAT. >> ESPECIALLY IF THERE A WAY OF NOT REINVENTING WHAT CHILDREN'S IS DOING AND SEEING THEY CAN USE EXPERTISE TO DESIGN THESE BUT MAYBE NINDS COULD DO SOME MIDDLE AREA OR SPEED THE TOX TESTING, SOMETHING TO EXPAND IT >> TO PLAY IN OUR ROLE HERE. >> ANY OTHER QUESTIONS? OKAY. WE NEED A MOTION. THIS IS CONCEPT CLEARANCE, WE NEED A MOTION. YAY OR NAY. SECOND. ALL IN FAVOR. >> A. -- AYE. >> YES. >> I THINK THAT WAS EVERYBODY. >> YOU HAVE AN ABSTENTION, RARE DISEASE THERAPEUTIC UNIT SO I VIEW THIS AS CONFLICT OF INTEREST FOR MYSELF SO PLEASE RECORD ONE ABSTENTION. >> ONE ABSTENTION. YOU VOTED. OKAY. THE VERY LAST THING WHICH HOPEFULLY CAN SOMEBODY PUT MY SLIDE UP. SO THERE ARE TWO -- AS I SAID CONCEPT CLEARANCE WE DON'T HAVE TO TELL YOU EVERYTHING BUT WE DON'T NECESSARILY HAVE TO GIVE IN DEPTH PRESENTATIONS. THE FIRST WHO ARE THE ONE WE HAVE BEEN TALKING ABOUT IN DEPTH THE NEXT TWO ARE RENEWALS OF EXISTING INITIATIVES. WE WEREN'T PLANNING ON DISCUSSING THEM, WE CAN IF YOU HAVE QUESTIONS. BUT THEY ARE BOTH RENEWALS OF WHAT WE VIEW SUCCESSFUL INITIATIVES AND THEY COME FROM DEDICATED FUNDING STREAMS UNLIKE THESE OTHER THINGS. SO THE FIRST ONE WE'LL USE THE BRAIN INITIATIVE WE'LL USE BRAIN MONEY, IT DOESN'T FEET WITH NINDS INVESTIGATOR INITIATED POOL, THE SECOND USES THE MONEY THAT'S DEDICATED TO COUNTER-TERRORISM THROUGH THE COUNTER ACT MOVEMENT. THESE ARE SEPARATE FUNDING STREAMS. WHAT WE WOULD LIKE TO DO IS RENEW BOTH THOSE FUNDING ANNOUNCEMENTS, AND IF YOU WANT TO DISCUSS THEM WE CAN GET THE PROGRAM DIRECTOR TO DO THAT. DOES ANYBODY WANT TO HEAR MORE ABOUT EITHER OF THOSE? IT'S OKAY IF YOU DO. THEN IF NOT, I WOULD LIKE A MOTION FOR EXAMPLE TO EITHER APPROVE OR DISAPPROVE BOTH OF THOSE. IF I DON'T -- I CAN DO THIS ONE BY ONE BUT TRYING TO SAVE TIME HERE. SO IS THERE A MOTION TO APPROVE OR DISAPPROVE -- OKAY. THANK YOU. ALL IN FAVOR OF THE BLAH BLAH BLAH. OKAY. THIS TIME I THINK WE HAVE UNANIMITY. THANKS A LOT. SO WE ARE TAKING A PICTURE RIGHT OUTSIDE OVER THERE. AND DINNER IS AT WHAT TIME, 7 P.M.? I HAVE WRITTEN IT'S AT 7. 6:30, 7, KELLY TELLS ME, AT THE USUAL PLACE.