>> WELCOME TO THE 198TH MEETING OF THE NINDS ADVISORY COUNCIL. ALL MEMBERS ARE SCHEDULED TO BE PRESENT EXCEPT DR. PERRIN WHO IS ON THE PHONE AND LARRY IS HERE. >> I'M HERE TOO. >> LARRY IS NOT HERE. LARRY WHO IS HOPEFULLY ON THE PHONE AS WELL. ON THE PHONE, CAN YOU GUYS TELL US IF YOU'RE HEAR OKAY? >> MARY IS HERE. >> STEVE. GOOD. >> WE'RE GOOD THANK YOU. >> ARE YOU OKAY? >> YES, I'M SAFE AND SOUND. >> OKAY. SO IT'S SOMEWHAT MIXED EMOTIONS, WE HAVE TO MENTION THIS IS ALAN WHEELERS LAST MEETING BEFORE RETIREMENT. HE'S BEEN SITTING AT THE TABLE IN THE NUMEROUS ROLES, MOST RECENTLY AS THE ACTING DEPUTY DIRECTOR OF NINDS AND JUST TO SAY HE STARTED HIS SCIENTIFIC CAREER AT YALE. HE STUDIED BIOPHYSICS AND BIOCHEMISTRY, Ph.D. IN BIOLOGY AD NICK SPITZER'S LAB ADS HIS FIRST GRAD STUDENT WHERE HE STUDIED EXCITABILITY IN XENOPUS, FELLOWSHIP AT UCSD, BECAME A RESEARCH FELLOW AND INSTRUCTOR OF HARVARD DEPARTMENT OF NEUROBIOLOGY. AND THAT'S ACTUALLY WHERE I MET HIM WHEN HE WAS THERE AND HE AND STORY AND JERRY FISHBACK WERE RUNNING THE DISEASE COURSE IN 1985. SO THAT WAS AN INTERESTING SUMMER, SAY THE LEAST. SOME SECRETS WILL REMAIN WITH ALAN AS HE LEAVES. SO ALAN'S CAREER, HE WEPT TO DEPARTMENT AT UNC, PHYSIOLOGY NEUROBIOLOGY, CAME TO NINDS, HIS CAREER AT NINDS SPANNED 19 IMPRESSIVE YEARS BEGINNING IN 1998 WHEN HE WAS REVIEWED AS A SCIENTIFIC REVIEW ADMINISTRATOR. IN 2002 HE WAS PROMOTED TO THE CHIEF OF THE SCIENTIFIC REVIEW BRANCH AND IN 11 BECAME DEPUTY DIRECTOR OF EXTRAMURAL RESEARCH. WORKING CLOSELY WITH BOB. DURING HIS TENURE AT NINDS HIS TEDCATION TO ENHANCING PEER REVIEW EARNED SEVERAL MER LET AWARD FROM NINDS AND NIH DIRECTOR. AMONG ACTIVITIES HE PLED PEER REVIEW AT NIH, SO ACROSS THE BOARD TREMENDOUS RESPECT FROM THE COMMUNITY. HIS COMMON SENSE SOLUTIONS AND LEADERSHIP REVOLUTIONIZED THE PEER REVIEW PROCESS. SO IF YOU HAVE ANY BEEF WITH THE PEER REVIEW PROCESS THERE IT IS. SINCE 2014 HE SEVENNED AS ACTING DEPUTY DIRECTOR OF NINDS AND ACTING DIRECTOR OF OFFICE OF TRANSLATIONAL RESEARCH AND PLAYED AN IMPORTANT ROLE GUIDING THE BRAIN INITIATIVE MULTI-COUNCIL WORKING GROUP. SO A SPECIAL BLEND OF SCIENTIFIC ACUMEN, MANAGEMENT SKILLS AND CONGENIAL PERSONALITY WHICH MAKES HIM A RARE ASSET AND WE'RE GOING TO MISS HIM TREMENDOUSLY. HE OFFERS INVALUABLE INSIGHT ON WHAT IS SCIENTIFICICALLY IMPORTANT TO DO AND IS EXTREMELY GOOD AT SUGGESTING TO US HOW TO MANEUVER THROUGH THE BUREAUCRACY OF NIH TO DO IT IN LEGAL WAYS ONLY AND HE CAN ALWAYS FIND THE RIGHT PEOPLE WHO ARE DELIGHTED TO HELP HIM ALONG THE WAY BECAUSE HE IS ALWAYS A GREAT HELP TO THEM. SO WE HAVE BEEN VERY LUCKY TO HAVE HIM FOR 19 YEARS, I HAVE BEEN PERSONALLY LUCKY TO HAVE HIM ADS MY DEPUTY, BOB IS ALSO HIS DEPUTY. AND I KNOW Y'ALL MISS HIS INFAMOUS QUIRKY JOKES COUNCIL FROM VERMONT BUT BE ASSURED HE'S GOING TO HAVE A GREAT SECOND CAREER HIKING THE WORLD AND WE'RE GOING TO MISS HIM AND WE'LL TRY TO CALL HIM BACK TO DO THINGS BUT MAY OR MAY NOT WORK. SO I HOPE Y'ALL JOIN ME IN CONGRATULATING ALAN ON AN IMPRESSIVE CAREER AND GREAT SERVICE. [APPLAUSE] >> OKAY. COUPLE OF OTHER THINGS, DR. AMIR TAMIZ, HE'S BEEN PART OF THE NINDS FAMILY SINCE 2012 AND IS NOW BEEN TAKING OVER AS NEW DIRECTOR OF THE DIVISION OF TRANSLATIONAL RESEARCH. AND HE BECAME DIRECTOR OF THE NIH NEUROTHERAPEUTICS BLUEPRINT NETWORK IN 2014 AND THAT'S A TRANS-NIH PROGRAM WITH 15 INSTITUTES INVOLVED AND PROVIDING GRANT FUNDING AND RESOURCES WITH SMALL MOLECULE DRUG DISCOVERY AND DEVELOPMENT WHICH IS DIRECTED HEAVILY OUT OF HIS OFFICE IN RDTR. HE ALSO FOUNDED AND LED THE NINDS IGNITE PROGRAM WHICH IS A SWEETER FUNDING PROGRAM DESIGNED TO FACILITATE THE EARLY STAGE THERAPEUTIC DEVELOPMENT, PRIOR TO JOINING NINDS HE SUCCESSFUL TENURE IN BIOTECH WHERE HE HELD SCIENTIFIC AND MANAGERIAL POSITIONS LEADING TRANSASIANAL EFFORTS IN SEVERAL DISEASE AREAS IN NEUROSCIENCE, ONCOLOGY, IMMUNOLOGY, HE EARNED HIS Ph.D. FROM UNIVERSITY OF OREGON WHERE HE STUDIED NMDA RECEPTOR ANTAGONIST AND THEN POST-DOC AT GEORGETOWN MEDICAL WHERE HE WORKED ON SEROTONIN DOPAMINE TRANSMITTER INHIBITORS. GLAD TO HAVE HIM ON BOARD, WE HAVE A GREAT TEAM AND TRANSLATIONAL RESEARCH GROUP AND THANKS TO ALAN FOR STEPPING IN AS RUNNING THE SHOW IN THE MEANTIME. NEXT I JUST WANTED TO INTRODUCE AGAIN CLINTON WRIGHT, WHO CAME ON AS OUR NEW DIRECTOR, DIVISION OF CLINICAL RESEARCH. VASCULAR STROKE NEUROLOGIST FROM THE UNIVERSITY OF MIAMI, HIS PUBLIC HEALTH SERVICES AND EVIDENCE LICK MCNIGHT CHAIR FOR LEARNING MEMORY AND AGING AND SERVED AS SCIENTIFIC DIRECTOR OF THE MCNIGHT BRAIN INSTITUTE AND CHIEF OF THE DIVISION OF COG I INTIVE DISORDERS BEGINNING IN 2008. THANKS TO RALPH FOR LETTING HIM LEAVE. HE EARNED HIS M.D. FROM COLUMBIA UNIVERSITY COLLEGE PHYSICIAN AND SURGEONS COMPLETED NEUROLOGY RESIDENCY AND STROKE FELLOWSHIP THERE. HE GOT MS IN EPIDEMIOLOGY FROM COLUMBIA AS WELL. ASSISTANT PROFESSOR COLUMBIA BEFORE MOVING TO THE UNIVERSITY OF MIAMI. HIS RESEARCH IS IDENTIFYING THE CAUSES, POTENTIAL TREATMENTS OF VASCULAR COGNITIVE IMPAIRMENT AND SO HE'S COME ON BOARD AND AGAIN, WE HAVE GREAT TEAM IN THE DIVISION OF CLINICAL RESEARCH NOW AND CLINTON STEPPED IN AND MOVED QUICKLY INTO THIS POSITION IN A VERY EFFECTIVE MANNER. REALLY GREAT TO HAVE HIM. THANKS TO CLAUDIA MOI, ACTING BCR DIRECTOR IN THE INTERIM, CLAUDIA HAS BEEN IN THE -- THAT DIVISION FOR A LONG TIME, THAT WAS ALL THE ROPES ALL THE INS AND OUTS AND NEVER HESITATES TO COME FORWARD AND DO WHAT'S BEST FOR THE INSTITUTE. SO THAT'S MY INTRODUCTION OF FOLKS. BOB DID YOU WANT TO -- OKAY. >> WE HAVE THREE HOURS OF INTRODUCTIONS TODAY. SO FIRST OF ALL, GOOD MORNING, GOOD TO SEE YOU AGAIN. I HAVE THAT IN MY NOTES. I WANT TO REMIND YOU FIRST OFF THAT WE VIDEOCAST COUNCIL AND WE ARCHIVE IT SO JUST KEEP THAT UNDER ADVISEMENT. TODAY'S MEETING IS OPEN TO THE PUBLIC IN ABOUT 2:30 WHEN WE GO TO CLOSED SESSION TO LOOK AT GRANT APPLICATIONS, AT THE BEGINNING OF THE CLOSED SESSION I WILL GO THROUGH THE USUAL RIG MA ROLE ABOUT THINGS YOU SHOULD AND SHOULDN'T DO, MOSTLY WHAT YOU SHOULDN'T DO. SO I WILL MOVE THROUGH THE BOILERPLATE HERE. CONSIDERATION OF THE MINUTES FOR OUR LAST MEETING, THESE ARE UNDER TAB 2 OF NOTEBOOK POSTED IN THE ELECTRONIC COUNCIL BOOK. UNLESS ANYONE WANTS AND IN DEPTH DATE CUSHION OF THE MINUTES I WILL PAUSE THERE. I WOULD NEED A MOTION TO APPROVE OR DISAPPROVE THEM. SECOND. ALL IN FAVOR OF APPROVING THE MINUTES. ALL OPPOSED? ABOUT TENSIONS? -- ABSTENTIONS? LARRY AND STEVE, ARE YOU OKAY WITH THE MINUTES? ARE YOU ON THE PHONE THERE, LARRY AND STEVE? >> YES. >> >> IT'S NOT FOREVER. SO -- I'M JUST GOING TO KEEP GOING. WE HAVE A SOLID MAJORITY OF 30 MINUTES. OKAY. SO ALSO UNDER TAB 1 OF NOTEBOOKS ARE DATES OF THE COUNCIL MEETINGS THROUGH 2018, I WON'T GO THROUGH THEM BUT IF YOU THINK YOU NEED TO MISS ONE OF THESE COUNCIL MEETINGS PLEASE TELL KELLY BAKER IN ADVANCE BECAUSE WE NEED TO PLAN THESE THINGS. BY THE WAY YOUR TERM OFFICIALLY ENDS JULY 31st OF THE YEAR NOTED NEXT TO YOUR NAME THAT'S WHY YOU STOP BEING A COUNCIL MEMBER UNLESS WE HAVE TO EXPAND BECAUSE THERE'S A FEDERAL FREEZE AND NEXT IS APPROVAL OF THE COUNCIL OPERATING PROCEDURES. WE'RE REQUIRED TO DO THIS ONCE A YEAR. THESE ARE THE GROUND RULES THAT GOVERN HOW WE INTERACT WITH COUNCIL. FOR EXAMPLE ONE OF THE THINGS IN THEM ARE WHAT ARE CALLED DELEGATED COUNCIL DELEGATED AUTHORITIES. THESE ARE THE THINGS THAT YOU ALLOW US TO DO WITHOUT COUNCIL APPROVAL LIKE ISSUING ADMINISTRATIVE SUPPLEMENTS UNDER A CERTAIN AMOUNT. THE ONLY INCREDIBLE CHANGE WE MADE TO THIS DOCUMENT IS THAT NOW WE'LL PRESENT THE INTRAMURAL PROGRAM IN MAY INSTEAD OF JANUARY. SO UNLESS YOU WANT TO DISCUSS COUNCIL OPERATING PROCEDURES, IF YOU HAVE QUESTIONS I'LL BE GLAD TO ANSWER THEM BUT MOTION TO APPROVE OR DISAPPROVE THEM. MOVE TO APPROVE. SECOND. ALL IN FAVOR. ALL OPPOSED. ABSTENTIONS. OKAY. NEXT A FEW WORDS ABOUT THE EXPEDITED REVIEW PROCESS WHICH I'M ALSO REQUIRED TO TALK TO YOU ABOUT. THIS IS THE PROCESS IN WHICH THREE DESIGNATED COUNCIL MEMBERS, TIM, BRUCE, WHO WAS THE OTHER PERSON? RALPH. I BELIEVE THOSE ARE THE THREE PEOPLE DESIGNATED TO DO THIS. SO THROW COUNCIL MEMBERS APPROVE A SUBSET OF APPLICATIONS FOR FUNDING BEFORE COUNCIL BEGINS. THIS ALLOWS INCREDIBLE GRANTS MANAGEMENT BRANCH TO BEGIN ISSUING AWARDS AHEAD OF USUAL SCHEDULE SO OBVIOUSLY THE PROJECTS CAN BE STARTED SOONER. IT FOCUSES ON RO1s WITHIN THE PAY LINE AND GRANTS WITH NO OBVIOUS ISSUES SO WE DON'T THINK THEY NEED TO BE DISCUSSED BY COUNCIL. THERE WERE 142 APPROXIMATELY CAUTIONS ELIGIBLE TO BE EXPEDITED INCLUDING 8-K APPLICATIONS CAREER APPLICATIONS. OF THESE 80 ARE ISSUED AND OTHERS KEYED UP AND READY TO GO AFTER COUNCIL. AS I SAY EVERY TIME, THIS IS A TESTIMONY TO THE HARD WORK OF OUR GRANTS MANAGEMENT BRANCH WHO DO A FANTASTIC JOB ISSUING AWARDS FASTER THAN ANY OTHER NIH INSTITUTE. SHE'S IN THE BACK IS HEAD OF OUR GRANTS MANAGEMENT BRANCH. FROM SO NOW I'LL LAUNCH INTO INTRODUCTIONS. I WILL GO QUICKLY SINCE WE HAVE SO MANY. THESE ARE SHORTER THAN THE USUAL. THE REASON WE HAVE SO MANY IS THAT WE HAVE A BUNCH OF STAFF WHO LEFT PRIMARILY TO MOVE UP IN THE WORLD. AND ALSO HIRED PEOPLE FOR THE BRAIN INITIATIVE AND COUPLE OF OTHER THINGS THAT WERE NEW AND REORGANIZATION OF THE EXTRAMURAL SO MORE THAN THE USUAL. SO IF EACH OF YOU CAN STAND UP WHEN I INTRODUCE YOU, THAT'S GOOD. SO FIRST IS ALISSA SCHAFER, A NEW PROGRAM ANALYST IN MY OFFICE UNDER ANNA TAYLOR'S SUPERVISION. YOU'LL HEAR FROM ANNA LATER: SHE GOT HER Ph.D. FROM USI SIXTH WORKING ON STEM CELL REPAIR BRAIN DAMAGE IN NEWBORN FERRETS. THEN BECAME A AAAS FELLOW AND ADVISOR FOR GLOBAL OUTREACH OFFICE OF DIRECTOR AT NCRR. DURING THE LAST FIVE YEARS SHE WORKED AT BIOMEDICAL FUNDING AGENCIES IN CANADA, DEVELOPING METRICS FOR MEASURING THE IMPACT OF GRANTS THESE AGENCIES AWARD. SO WHEREVER SHE IS, WELCOME. NEXT IS TINA MARIE LU. A NEW PROGRAM ANALYST IN -- THERE SHE IS IN STEVE CORN'S TRAINING TRAINING OFFSIS. BA IN MOLECULAR CELLULAR BIOLOGY AT BERKELEY AND Ph.D. IN PHYSIOLOGY AT JOHNS HOPKINS, SHE THEN DID POST-DOCTORAL WORK AT MONASH UNIVERSITY AND PUBLICATIONS ON DIFFERENT TOPICS INCLUDING MUCOSAL ION TRANSPORT, PAIN SIGNALING, ET CETERA, ET CETERA. SORRY I CAN'T READ THE WHOLE LIST HERE. SHE'S BEEN VERY ACTIVE IN TEACHING MENTORING AND ACADEMIC SERVICE. SO WELCOME. GREAT TO HAVE YOU. NEXT IS CARRIE ASHMON, JOINING REPAIR IN PLASTICITY CLUSTER, AS PROGRAM ANALYST SHE DID GRADUATE WORK AT ARIZONA STATE UNIVERSITY WORKING ON CORTICAL ELECTROPHYSIOLOGY AND NEUROPROSTHESES. AFTER THAT SHE GAME A POST-DOC AMOUNT PHOENIX CHILDREN'S HOSPITAL DEVELOPING ALGORITHMS AND SYSTEMS FOR MONITORING SUBJECTS WITH EPILEPSY AND TRAUMATIC BRAIN INJURY. I HOPE I GOT THAT RIGHT. LING WONG IS ANALYST IN THE GENETICS CLUSTER, BEFORE THAT AN AAAS FELLOW IN OFFICE OF SCIENTIFIC PLANNING POLICY IN PAUL IS IT'S OFFICE FOR A AREA. BACHELORS IN BIOLOGY FROM BROWN, Ph.D. IN UC DAVIS, POST-DOC IN D.C. WHERE SHE FOCUSED OWN MILLION TA HEALTH DISORDERS AND STUDIED TBI AT WALTER REED IN NATIONAL INPRED BY CENTER FOR EXCELLENCE. EMILY CAROFI. IF I MISPRONOUNCE, I APOLOGIZE. IS EMILY HERE? SHE'S REALLY GOOD. H'S MOVE ON. -- SHE'S GOOD. LET'S MOVE ON. SECOND ANALYST IN NEUROGENETICS CLUSTER, BA FROM AM HERSELF DID GRADUATE WORK AT THOMAS JEFFERSON PHILADELPHIA. SHE STUDIED ROLE OF ABNORMAL CLEAVAGE PRODUCT WITH GLUTAMATE TRANSPORTER AND ALS PROGRESSION. MOST RECENTLY DID A POST-DOC WITH CURT FISHBACK IN INTRAMURAL IMPROVING METHODS TO DIFFERENTIATE IPSCs TO MOTOR NEURONS AN STUDY IMPACT OF ASTROCYTES AND SMA PROGRESSION. SO WELCOME TO EMILY, WHEREVER YOU ARE. NEXT IS MARIAH, I HOPE TO PRONOUNCE IT RIGHT. BITMAN, NEW ANALYST IN THE CHANNELS CLUSTER WHO WILL DIVIDE BETWEEN BRAIN INITIATIVE AND VARIOUS CLUSTER RELATED PROGRAMS. SHE GOT HER BS IN MECHANICAL ENGINEER FROM UNIVERSITY OF MICHIGAN, Ph.D. IN BIOENGINEER FROM UNIVERSITY OF ILLINOIS. SHE DID GRADUATE RESEARCH AT THE REHAB INSTITUTE OF CHICAGO. THEN POST DOC AT THE UNIVERSITY OF WISCONSIN MADISON WHERE SHE CREATED MUSCULOSKELETAL MODELS TO EVALUATE THE EFFECTS OF CORRECTIVE SURGERIES FOR CHILDREN WITH CEREBRAL PALSY WHICH YOU WILL ALSO HEAR ABOUT SOON. SO WELCOME TOP MARIA. NEXT IS ANDREW BREEDEN. YOU HAVE TO COME OUT. NEXT IS ANDREW BREEDEN WHO WAS IN THE RESTROOM. ANOTHER NEW PROGRAM ANALYST IN THE CHANNELS CLUSTER, ANDREW WILL BE HELPING VICKIE WITH THE TRANS-NIH CHRONIC FATIGUE SYNDROME EFFORT. ALSO INVOLVED IN OTHER CLUSTER ACTIVITIES. GOT HIS UNDERGRADUATE IN PSYCHOLOGY FROM THE UNIVERSITY OF RICHMOND AND Ph.D. FROM GEORGETOWN IN NEUROSCIENCE, HIS GRADUATE WORK FOCUSED TON ROLE OF NEUROEPINEPHRINE AND EXECUTIVE FUNCTION AND NEURAL NETWORKS, IMMEDIATELY BEFORE COMING HERE HE WAS A PRESIDENTIAL MANAGEMENT FELLOW, DO SRI THIS RIGHT, AT THE U.S. CENSUS BUREAU. THAT SOUNDS INTERESTING. SO WELCOME, ANDREW. NEXT IS DEVIN CRAWFORD. THERE SHE IS. ANOTHER NEW ANALYST WHO IS GOING TO HAVE ALSO A SPLIT JOB, HALF HER TIME WORKING WITH SHY SILVERBERG WHO I WILL TALK ABOUT IN A MINUTE, WHO IS NOW OFFICIALLY THE NINDS POINT PERSON FOR PROMOTING RIGOR IN THE RESEARCH THAT WE FUND. FROM AND THE OTHER HALF OF THE TIME ANALYZING THE BRAIN INITIATIVE AND OUR POLICY AND PLANNING OFFICE. SHE GOT UNDERGRADUATE DEGREES IN BIOLOGY AND PSYCHOLOGY FROM CASE WESTERN AND Ph.D. IN NEUROSCIENCE FROM WASU. DID A POST-DOC AT UT SOUTH WESTERN, STUDIED THE MOLECULAR MECHANISMS OF SYNAPTIC PLASTICITY AND FAST ANTI-ACTING ANTI-DEPRESS SENT RESPONSES. WELCOME. I'M ALMOST DONE. JESSICA CORLEY. SHE IS HERE. YES. RECENTLY JOINED OUR COMMUNICATIONS OFFICE WHICH IS HEADED, MOST OF YOU KNOW BY MARION EMER. BEFORE THAT JESSICA WAS A HEALTH VOLUNTEER IN THE PIECE CORPS PEACE WE WERE IN BELIZE WORKING ON NON-COMMUNICABLE DISEASE PREVENTION AND CONTROL AMONG RURAL POPULATIONS STUDIED BIOLOGICAL SCIENCES IN SPANISH AT EAST CAROLINA UNIVERSITY SHE GOT HER BS, AS A TECHNICAL WRITER AND EDITOR IN MARION'S SHOP SHE'S GOING TO SERVE, IF I UNDERSTAND CORRECTLY AS THE INSTITUTE'S PUBLIC LIAISON OFFICER. AND ALSO WORK WITH THE TEAMS THAT HANDLE PUBLICATIONS AND SOCIAL MEDIA. I HOPE I HAVE THAT RIGHT. WELCOME, JESSICA. I HAVE TWO FINAL UPDATES THEN I'M DONE. MANY OF YOU ALREADY KNOW THE EMINENT SHY SILVERBERG, PLEASE STAND UP. YOU LOOK TIRED. SO NOT ONLY -- I THINK MOST OF YOU KNOW SHY, HE'S SPOKEN AT COUNCIL MULTIPLE TIMES NOT ONLY HAS HE BEEN A TERRIFIC PROGRAM DIRECTOR ION CHANNELS ET CETERA BUT HE'S ALSO AS WELL AS CONTINUING TO PUBLISH PAPERS LIKE IN NEURON AS AN INTRAMURAL INVESTIGATOR. BUT HE'S ALSO A PIONEER IN CALLING THE ATTENTION OF NIH AND COMMUNITY AT LARGE, THE IMPORTANCE OF PROMOTING RIGOR AND TRANSPARENCY IN THE RESEARCH THAT WE FUND. THIS WORD TRANSPARENCY IS A VERY INTERESTING ONE. HIS ROLE IN THIS CAPACITY EXPANDED SINCE HE REALLY STARTED DOING THIS, IN ABOUT 2012 IF I REMEMBER. AND TO ACKNOWLEDGE THE INCREASING IMPORTANCE -- RECOGNITION OF THE IMPORTANCE OF WHAT HE'S DOING, WE'VE ACTUALLY APPOINTED HIM TO A BRAND NEW POSITION THAT'S CALLED THE NINDS DIRECTOR OF RESEARCH QUALITY. HE'S THE QUALITY CONTROL GUY. I DON'T HAVE TIME TO DESCRIBE HIS ACCOMPLISH TESTIMONIES, THERE ARE A LOT -- ACCOMPLISHMENTS, SUFFICE IT TO SAY HE HE'S ALREADY HAD MAJOR IMPACT HOW EVALUATES RIGOR IN GRANT APPLICATIONS AND HOW DIFFERENT JOURNALS, NATURE, SCIENCE, ET CETERA, DO PEER REVIEW. SHY HAS SINGLE HANDEDLY SPEARHEADED WHAT BECAME A REAL MOVEMENT IN THIS AREA. JUST THIS PAST MONDAY HE DID A REALLY INTERESTING WORKSHOP WHERE HE BROUGHT THE HEAD HONCHOS TOGETHER FROM SFN, KEYSTONE, THE GORDON CONFERENCES, ET CETERA, TO DISCUSS HOW TO PROMOTE MORE TRANSPARENCY IN IN SCIENTIFIC PRESENTATIONS BE THEY TALK AND POSTERS, TO MAKE SURE THE INFORMATION IS THERE SO SOMEONE LOOKING OR LISTENING TO A TALK EVALUATE WHETHER IT'S GOOD OR NOT. SO WELCOME, SHY TO YOUR NEW POSITION. LAST AND MOST DEFINITELY NOT LEAST IS MICHELLE JONES LONDON. BACK THERE. AGAIN, MOST OF YOU KNOW MICHELLE. SHE SPOKE AT COUNCIL BEFORE SO AS PART OF THE RESTRUCTURING OF EXTRAMURAL, MICHELLE IS NOW THE CHIEF OF A NEW DIVERSITY OFFICE WHICH IS CALLED THE OFFICE OF PROGRAMS TO ENHANCE NEUROSCIENCE WORK FORCE DIVERSITY. IN THIS POSITION SHE'S GOING TO CONTINUE THE LEAD AND OVERSEE THE INSTITUTE DIVERSITY AND INCLUSION EFFORTS AND WILL ALSO CHAIR ACROSS CUTTING NINDS DIVERSITY WORKING GROUP. AS IN THE KISS OF SHY SHE HAS A LIST OF ACCOMPLISHMENT, SHE'S BEEN AROUND HERE 12 YEARS I BELIEVE BUT I DON'T HAVE TIME TO GO THROUGH BUT SHE'S COLLEGIATED MANY NETWORKS AND -- CREATED PARTNERSHIPS THAT PROMOTE DIVERSITY NOT ONLY THE EXTRAMURAL COMMUNITY BUT ALSO WITHIN NINDS. IN TERMS OF WHAT OUR STAFF DO AND THE PEOPLE WE HIRE. FOR EXAMPLE SHE'S LED THE NIH ENDURE PROGRAM WHICH IS HELPED 95 DIVERSE TRAINEES SUCCESSFULLY TRANSITION TO GRADUATE PROGRAMS, SHE'S PLAYED AN INCREDIBLY IMPORTANT ROLE IN THE SFN NEUROSCIENCE SCHOLARS PARTNERSHIP THAT HAS OVER 600 ALUMNI. AS I HAVE SAID MANY TIMES TO MY SHE WOULD OVER THE YEARS, WE'RE TRULY LUCKY TO HAVE YOU. THAT'S IT FOR ME. I'M GOING TO PASS IT ALONG TO ERNIE LIONS THE HEAD OF REVIEW BRANCH WHO WILL INTRODUCE A NEW SRO. >> GOOD MORNING, I WOULD LIKE TO INTRODUCE JIM KIM, WHO JOINED US AS NEW SRO. HE GOT HIS Ph.D. IN NEUROSCIENCE IN 2004, THE UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE. WORKING WITH BRADLEY ALGER, HE DID POST-DOC AT STANFORD UNIVERSITY AND IN 2010 HE WENT TO THE MEDICAL COLLEGE OF GEORGIA WHERE HE WAS ASSISTANT PROFESSOR, HE HAD AN RO1 FUNDED AND HE'S FOCUSED ON BASIC NEUROPHYSIOLOGY OF THE ENDOCANNABINOID SYSTEMS AND IS NOW JOINING US, WE'RE LOOKING FORWARD TO WORKING WITH JIMOC. >> THANKS, ERNIE. >> CLINTON, YOU'RE UP NEXT. >> LET ME JUST SAY IT'S A GREAT PLEASURE TO BE HERE AND I ONLY GLAD Y'ALL MADE IT AND FOR THOSE OF YOU WHO WERE HERE YESTERDAY YOU CAN UNDERSTAND WHY I MOVED HERE FROM MIAMI, THE WEATHER IS TERRIFIC. ANYWAY, I WOULD LIKE TO -- I WON'T TAKE MUCH TIME TO DO THIS BUT LIKE EVERYBODY IN DCR THAT'S HERE PLEASE STAND UP AND MAKE THEMSELVES SO JOANNA, SARA, OTHERS, JEREMY, PLEASE JUST STAND UP. SO THAT EVERYBODY CAN SEE WHO YOU ARE. SO THAT IF YOU HAVE OPPORTUNITIES DURING THE DAY YOU CAN APPROACH PEOPLE FROM DCR, THE DIVISION OF CLINICAL RESEARCH AND THAT'S IT. YOU CAN SIT DOWN. THEN -- YEAH. I HAVE A COUPLE OF GOODBYES. I WANTED TO MENTION THAT SALANA WAHI, WHO LED OUR DISPARITIES PROGRAM, VERY KNOWLEDGEABLE IN THAT AREA, HAS MOVED TO NIDDK TO RUN A PROGRAM, DISPARITIES PROGRAM THERE. SO WE'LL -- WE'RE SORRY TO MISS HER EXPERTISE. LOU AKINO WHO DID WORK FOR US AT CLINICALTRIALS.GOV AND DSB LIAISON WORK MOVED TO NCATS AND WE LOOK FORWARD TO CONTINUE COLLABORATIONS WITH NCATS. WE HAVE A COUPLE GOING ON RIGHT NOW, MORE IN THE PIPELINE. THEN I WANT TO INTRODUCE NEW STAFF. JEREMY BROWN WHO JUST JOINED US, HE'S DOING A DETAIL WITH US FROM NIGMS WHERE HE DIRECTS THE OFFICE OF EMERGENCY CARE RESEARCH. HE'S A BOARD CERTIFIED EMERGENCY DEPARTMENT PERSON AND HE'S GOING TO LEAD OUR SIREN NETWORK PROGRAM. SO WE'RE EXCITED TO HAVE HIM HERE. ELLEN ROSEBERG WHO IS ON THE PHONE AND WAS NOT ABLE TO BE HERE IN PERSON THIS MORNING BUT HOPEFULLY HERE LATER IS EMERGENCY AND TRAUMA NURSE AND SHE JOINED US ACTUALLY FROM NHLBI BUT BEEN AT NIH FOR QUITE SOME TIME, HAS TREMENDOUS CLINICAL EXPERIENCE AND WILL BE BRINGING A LOT TO OUR DIVISION IN SUPPORT OF CLINICAL WORK INCLUDING DSMB WORK AND OUR SOPs. THEN I WANT TO INTRODUCE CAROLINA, I DON'T KNOW WHERE SHE IS, BUT SHE JOINED THE UNIVERSITY OF MIAMI WHERE SHE WORKED FOR ME FOR FIVE YEARS AND RALPH TOOK ANOTHER HIT BUT HOPEFULLY THAT'S THE END. SO SHE -- (OFF MIC) >> RALPH WILL BE JOINING US. >> OH. SO YES. THOSE ARE MY INTRODUCTIONS. NOT SURE AMIR? >> GOOD MORNING, EVERYONE. SO JUST BRIEFLY DIVISION OF TRANSLATIONAL RESEARCH IS PLEASED TO WELCOME DR. CHUCK SAIWEN, TO HIS NEW ROLE AS A PROGRAM DIRECTOR FOR THE BLUEPRINT THERAPEUTICS NETWORK. CHUCK JOINED NINDS IN 2011 AS SCIENTIFIC PROJECT MANAGER AND HE'S BEEN AMAZING LEADING MANY PROJECTS AND ACTUALLY ONE OF HIS PROJECTS MADE IT TO PHASE 1 CLINICAL TRIALS JUST RECENTLY. PRIOR TO JOINING US HE SPENT ABOUT 20 YEARS AT BERENGER DIRECTOR OF MEDICINAL CHEMISTRY, RECEIVED HIS BACHELORS DEGREE IN CHEMISTRY FROM PROVIDENCE COLLEGE, MOVED TO SYRACUSE FOR A Ph.D. AND WORKED WITH EJ CORRY AT HARVARD. WELCOME, CHUCK. NEXT IS VICTORIA SMITH. DR. SMITH JOINED US AS A HEALTH PROGRAM SPECIALIST, SHE RECEIVED HER BS FROM UC IRVINE. AND DOCTORATE DEGREE WAS CLINICAL TRIALS PSYCHOLOGY FROM UNIVERSITY OF MARYLAND. SHE COMPLETED A CLINICAL RESIDENCY AT JOHNS HOPKINS AND AS A RECENTLY WAS AAAS FELLOW AT THE OFFICE OF THE DIRECTOR. WELCOME. THIRD PERSON IS DR. NATALIE TRAZINSKI. WELCOME. SHE JOINED US ALSO AS A HEALTH PROGRAM SPECIALIST. SHE DID HER UNDERGRADUATE WORK IN BIOLOGY AT CORNELL. SHE DID NEUROSCIENCE AT JOHNS HOPKINS ALSO LOCAL. STUDIED EXPERIENCED DEPENDENT PLASTICITY AND NEURAL MECHANISM OF ATTENTION. AFTER GRADUATE WORK SHE DID A POST-DOC AT MARYLAND AND WE ARE REALLY BLESSED TO HAVE ALL YOU GUYS HERE. WELCOME. >> I WANT TO ANNOUNCE THAT QUINN LEE, IS QUINN HERE? SO SHE'S BEEN SELECTED AFTER A SEARCH AS THE NINDS BUDGET OFFICER REPLACING KEN FRESHAUR. SHE JOINED NINDS AS BUDGET ANALYST IN THE INTRAMURAL PROGRAM IN 2002, IN 2008 SHE MOVED TO THE FINANCIAL MANAGEMENT BRANCH IN THE OD SO SHE HAS REALLY EXTENSIVE KNOWLEDGE OF THE BUDGET COMPONENTS OF THE NINDS PROGRAM. SHE'S BEEN ACTIVELY ENGAGED IN MANAGING THE FINANCES OF THE BLUEPRINT AND THE BRAIN INITIATIVE WHICH INVOLVES MULTIPLE DIFFERENT INSTITUTES, INCREDIBLY COMPLEX BUT BEEN REALLY GOOD AT THIS. SHE ALSO WORKED AS A BUDGET ANALYST FOR SAMSA, OFFICE OF RESEARCH SERVICES AT NIH AND SHE'S BEEN A MEASURE TO WORK WITH AND WE'RE LOOKING FORWARD TO HER KEEPING US OUT OF JAIL AS WE GO FORWARD. THANK YOU, QUINN. >> OKAY. UNLESS ANYBODY WANTS TO GET UP AND INTRODUCE THEMSELVES, I THINK WE'RE DONE. >> THANKS VERY MUCH. WE HAVE A REALLY BUSY MEETING TODAY AND WE HAVE LOTS OF REALLY IMPORTANT THINGS TO DISCUSS. AND I WANT TO GIVE FOLKS, AS I DO AT EACH MEETING A SENSE OF WHERE WE ARE. IN TERMS OF THE BUDGET AND WHAT'S GOING ON IN THE INSTITUTE AND SOME INSTANCES ABOUT WHAT'S GOING ON AT NIH IN GENERAL. SO OUR MAIN JOB IS TO BE GOOD STEWARDS OF THE TAXPAYERS INVESTMENT IN NEUROLOGICAL RESEARCH. AND SO YOU WANT TO UNDERSTAND, WE DO FOLLOW THE MONEY. AND THAT'S WHAT I'M GOING TO SHOW YOU RIGHT OFF THE BAT. SO IN THIS SLIDE WHERE YOU CAN SEE IS THE FUNDING THAT WE HAVE HAD OVER THE YEARS WITH THE DECREASE THAT OCCURRED DUE TO THE SEQUESTER IN 2013. AND THEN SLOWLY COMING BACK WITH INCREASE IN 16. THE CAVEAT HERE IS SYSTEM OF THIS INCREASE IS TARGETED TOWARD BRAIN INITIATIVE MONEY SO IT'S NOT AVAILABLE FOR ALL OF THE RESEARCH THAT WE DO. LOOKING FORWARD TO '17, REMEMBER FY 17 STARTED IN OCTOBER 1st SO WE'RE HALFWAY THROUGH THE YEAR PRETTY MUCH. THERE'S A VERY LOW EXPECTATION THAT WE'RE GOING TO HAVE A BUDGET ANY TIME SOON. SO THEREFORE, OUR PLAN IS TO OPERATE UNDER THE LIKELY CONDITIONS OF WHAT'S CALLED A CONTINUING RESOLUTION WHICH MEANS THAT WE GET THE SAME MONEY THIS YEAR WE GOT LAST YEAR. AND THAT IS SEEN HERE IN TERMS OF WHAT THE TOTAL NIH BUDGET, THE TOTAL CHANGES ARE OVER TIME. THE THING THE KNOW IS THAT NON-COMPETING GRANTS ARE AWARDED ABOUT 90% RATE DURING CR AND IF A BUDGET COMES THROUGH THEN THE GRANTS ARE PAID UP TO 100%. I'M GOING TO TALK TO YOU ABOUT WHY WE HAD TO MAKE THIS CHANGE, DROPPING OUR PAY LINE DOWN TO 12 PERCENTILE AND WE ALSO HAD TO CONTINUE WITH THESE ADMINISTRATIVE CUTS THAT WE HAVE BEEN USING OVER THE YEARS BUT WE ALSO INSTITUTED A 1% CUT IN -- 1% CUT. THE REASON FOR THAT IS HERE. SO IF YOU LOOK AT THE NUMBER OF APPLICATIONS, THE KEY THING IS THAT FROM 2010 TO WHERE WE ARE NOW, WE HAVE OVER 25%, SO 27, 28% INCREASE IN NUMBER OF APPLICATIONS. WE MADE THE PACK THE TRY TO KEEP OUR PAY LINE CONSTANT DURING THE THIS TIME OF INCREASED APPLICATIONS. WHICH IS LED TO THE FACT THAT WE HAVE MORE MONEY IN RPGs BUT WE HAVE LESS MONEY AVAILABLE FOR COMPETING GRANTS. SO SEEN HERE IS THE FUNDING THAT WE HAVE EACH YEAR. THIS IS THE PAY LINE, DROP TO 12 PERCENTILE. THESE ARE NON-COMPETING -- THIS IS WHERE MONEY IS ALREADY COMMITTED IN OUTYEARS SO YOU CAN SEE WE WENT FROM 766 MILLION IN OUTYEARS NOW IN THIS YEAR UP TO 880 MILLION IN OUTYEARS. THAT'S BECAUSE AS THOSE NEW GRANTS CAME IN WE STARTED PAYING THOSE, WE HAVE MORE MONEY IN OUTYEARS THAN WE HAD BEFORE. AND THE DOWN SIDE OF THAT IS YOU HAVE LESS MONEY FOR COMPETING GRANTS. THE DECREASE SUBSTANTIALLY FROM WHAT IT WAS LAST YEAR. IT'S BECAUSE OF THIS BIG INCREASE IN NON-COMPETING OUTYEAR COSTS. THE GOOD NEWS IS THAT SOME OF THIS INVESTMENT IN OUTYEARS OCCURS IN THIS TIME PERIOD RETURN BECAUSE AVERAGE LENGTH OF RETURNS IS FIVE YEARS SO THAT MONEY WILL START COMING BACK SO WE SHOULD HAVE A LITTLE BIT MORE MONEY FOR COMPETINGS AVAILABLE IN 18 AND AGAIN IN 19 AS THE OUTYEAR MONEY COMES BACK AVAILABLE AGAIN. THIS SHOWS EXACTLY WHERE THE FUNDING GOES, LOOK AT OUR OVERALL BUDGET, YOU CAN CONSIDER THE RO1 EQUIVALENTS, THE BRIDGES, THE PIONEER AWARDS, THE R-35s, IT'S ABOUT 61% OF OUR BUDGET. FROM THE OTHER THING TO MENTION, THE R-35 GRANTS ARE BEING PAID AS 17 MONEY. THE R 35 GRANTS ARE GIVEN TO PEOPLE WHO ARE COMING IN FOR RENEWAL OF AN RO1 AND THEY ELECT TO GO INTO THIS POOL WHERE THEY GET 7 -- UP TO 750,000 FOR EIGHT YEARS. ACTUAL FACT REMOVES THOSE PEOPLE FROM THE RO1 POOL SO THE PERCENTILE FOR RO1s IS SOMEWHAT HAS TO BE CAVEAT THERE THAT THE R 35 MONEY IS REALLY GOING FOR THE SAME PURPOSE, SAME PEOPLE, AND SO THAT AMOUNTS TO ONE AND A HALF PERCENTILE POINTS THOUGH RO1 IS DOWN 12 PERCENTILE, R-35 MONEY THAT'S ABOUT ONE AND A HALF PERCENTILE WORTH OF MONEY THAT GETS US BACK TO 13 1/2. FROM SO NOT AS BAD AS IT LOOKS BUT IT'S IMPORTANT TO MESSAGE THIS AS WE GO ALONG, IF THE R-35 CONTINUES WE HOPE AND MORE PEOPLE MOVE INTO THE R-35, THE RO1 PAY LINE SHOULD BE LOWER BECAUSE A LOT OF THE PEOPLE WHO WOULD HAVE SCORED VERY HIGHLY, THAT'S WHAT YOU REALLY NEED TO DO TO GET INTO THE R-35 POOL, THOSE ARE NOT IN THE RO1 POOL ANY MORE. SO THOUGHTS ABOUT HOW TO MESSAGE THAT AS WE GO ALONG ARE IMPORTANT. BUT AS A CONSEQUENCE, MOST OF THE OTHER THINGS THAT WE DO, WE HAVE REALLY TRIED TO HOLD PRETTY STEADY OR BASICALLY CUT IN TERMS OF BIG PROJECTS, TO TRY AND MAKE ROOM FOR THESE INVESTIGATORS INITIATED GRANTS. THIS GRAPH, THESE ARE INITIATIVES NINDS DOES OVER THE YEARS AN THOSE HAVE KIND OF DROPPED. IT'S BEEN MET BY MORE INVOLVEMENT WITH THE OTHER ICs, ONE THING THAT HAPPENS WHEN MONEY IS SHORT IS YOU LOOK TO SEE HOW YOU CAN LEVERAGE YOUR MONEY WITH SOMEONE ELSE'S MONEY. SO WE ARE DOING THAT, THAT'S WHAT THAT REPRESENTS, CERTAINLY THINGS LIKE BLUEPRINT FOR INSTANCE, THERE ARE REALLY MISSION-CENTRIC TO NINDS GRAMS WE GET INVOLVED WITH AND FUND WITH THE OTHER INSTITUTES. WHERE ABOUT A THIRD OF THE NEUROSCIENCE BUDGET TO MY POLICY BLUEPRINT IS REALLY GOOD PROJECTS WILL PAY A THIRD OF THE PROJECT OTHER INSTITUTES DO TWO-THIRDS, WE THINK THAT'S A WIN FOR US. THE CLINICAL TRIALS IS PRETTY FLAT, ADS YOU CAN SEE HERE. AND TRANSLATIONAL PROGRAM IS ACTUALLY GOING DOWN SUBSTANTIALLY BUT I THINK WE'RE SEEING AN UPTURN NOW AS PEOPLE UNDERSTAND THESE PROGRAMS BETTER, BIG INCREASE IS BRAIN AN BLUEPRINT, THAT'S ACTUALLY NEW FUNDS BECAUSE THE BRAIN MONEY IS ACTUALLY NEW MONEY THAT'S COME TO THE NINDS BASE. THAT'S KIND OF WHERE WE STAND. WE HAD TO DO THINGS THAT WE DON'T LIKE TO DO, SO WE USE EVERY YEAR TRY TO PULL GRANTS THAT MISSED A PAY LINE, HIGH PRIORITY PROJECTS AND PAY THEM. IT'S VERY DIFFICULT TO DO THAT NOW WITH THIS FINANCIAL SITUATION WE'RE IN NOW. CENTER GRANTS, INFRASTRUCTURE GRANTS, PROGRAM PROJECT GRANTS, BIG TICKET ITEMS ARE VERY MUCH MORE DIFFICULT TO FUND IN THIS KIND OF CLIMATE. SO WE REALLY DO NEED SOME KIND OF A SUBSTANTIAL STEADY INCREASE TO MANAGE THE SCIENCE IN A WAY THAT'S REASONABLE GOING FORWARD. PAY LINES AT THIS 12 PERCENTILE LEVEL, THEY ARE -- IT'S A CONVENTION, JIM KNOWS VERY WELL, STUDIED THIS, THAT 12 PERCENTILE GRANT, 11 PERCENTILE GRANT, 13%, 14, THEY'RE PRETTY MUCH THE SAME. YOU CAN'T SAY THEY'RE DIFFERENT. THE PAY LINE IS A CONVENTION THAT PEOPLE BUY INTO. IT'S A TRANSPARENT NUMBER, IT'S NOT BEHIND THE SCENES INFLUENCES BEHIND IT. IT'S A PERFECT SYSTEM, EVERYBODY KNOWS THAT, THOSE LEVEL OF FUNDING. THERE HAS BEEN IN TERMS OF LOOKING TO THE FUTURE, THERE HAVE BEEN A COUPLE OF BRIGHT SPOTS, LAST WEEK I WENT DOWN TO CAPITOL HILL EVENT, WITH ABOUT 25 CONGRESSMEN AND SENATORS. DR. COLLINS, TOM COLE FROM THE APPROPRIATIONS COMMITTEE, SENATOR BLOUNT FROM THE SENATE APPROPRIATIONS AND EVERYTHING THEY SAID WAS VERY PRONIH, EVERYTHING THEY SAID REALIZED THE FACT THAT A STEADY GROWTH IN THE NIH BUDGET AS WAS SEEN IN THE '90s IS WHAT YOU NEED. SO IF YOU LOOK AT THE NIH BUDGET OVER TIME, IT WAS INCREASING WITH THE GROSS DOMESTIC PRODUCT AT 3% OR 4% A YEAR AND THOSE AGES, AND THERE WAS A DOUBLING, THEN THERE'S A FLATTENING. IF WE HAD STAYED ON THAT CONSTANT GRADUAL INCREASE, DONELING FOLLOWED BY FLATTENING. SO WE WOULD LIKE TO PUSH FOR THAT CONSISTENT GROWTH LIKE YOU WOULD HAVE IN OTHER AREAS OF THE COUNTRY. CONGRESS -- THE PEOPLE WE TALK TO ARE VERY FAVORABLE TO THAT IDEA, THE QUESTION IS GOING TO BE WHEN THEY DO THE BUDGET WHERE THEY GET MONEY FROM TO DO WHAT THEY LIKE TO DO. THAT'S WHAT WE HAVE A BAY TO SEE. -- WAIT TO SEE. THE DIFFERENCE THIS YEAR IS THEY'RE CONFIDENT TO DO A BUDGET AT SOME POINT IN TIME, THERE'S NOT A BLOCK TO STOP THEM FROM DOING A BUDGET SO WE'LL HAVE TO WAIT AND SEE WHAT HAPPENS THERE. IT WAS THE 21st CENTURY CURES -- >> I HAVE A QUESTION. SO THERE IS THE UPTICK IN GRANT APPLICATIONS, IS THAT A ONE UP? DO YOU KNOW WHAT'S DRIVING THAT AND DO YOU EXPECT THAT TO BE SUSTAINED IN >> GOOD QUESTION. SO TWO THINGS HAPPENED. INITIALLY WHAT HAPPENED WAS THERE WAS THIS -- THERE WAS THE RULE THAT YOU COULD SUBMIT AN A 0 AND A-1 THEN YOU WERE DONE SO WHEN THAT RULE WENT AWAY AND YOU CAN SUBMIT AS MANY TIMES AS YOU WANT, THERE WAS DEFINITELY UPTICK. WE HAVE SEEN A FLATTENING BUT STILL GOING UP. FOR US WE EXPECT WE STILL WILL GET MORE APPLICATIONS, THE REASON WE EXPECT THAT IS BECAUSE IF YOU LOOK AT PEOPLE GOING INTO NEUROSCIENCE Ph.D. PROGRAMS THAT IS GOING UP EXPONENTIALLY. THAT'S NOT TRUE ABOUT OTHER AREAS OF SCIENCE BUT IT IS ABOUT NEUROSCIENCE. SO WE EXPECT, IT'S A DOUBLE EDGE SWORD. WE ARE ATTRACTING LARGE NUMBERS OF REALLY SMART PEOPLE, AND THAT'S A GREAT THING FOR US BECAUSE WE NEED THEM, THE PROBLEMS WE HAVE, REQUIRE THAT. THE OTHER SIDE OF THE SWORD IS THE FACT WE DON'T HAVE THE FUND TO SUPPORT THEM AND THIS IS A TIME IN WHICH IF WE HAD THE FUNDS WE'RE IN A REALLY SPECIAL SPOT BECAUSE WE HAVE THE MAN POWER, WE JUST NEED THE RESOURCES AND IF YOU LOOK AT WHERE NEUROSCIENCE IS GOING, IT'S EXPLODING SO JUST A MATTER HOW MUCH FUEL WE HAVE HOW FAR WE CAN GO. SO THAT'S KIND OF THE MESSAGE I WOULD LIKE TO GET OUT TO FOLKS TO THINK ABOUT. NOW, I WANT TO TALK A LITTLE BIT ABOUT THE 21st CENTURY CURES ACT, THAT WAS PASSED BY A PARTISAN -- YES. (OFF MIC) >> YOU MENTIONED DURING CONTINUING RESOLUTION GRANTS AWARDED AT 10% CUT THEN YOU SAID SHOULD YOU GET A BUDGET THAT IS RESCINDED AND GET THE PAYMENT. WHAT HAPPENS IF THERE IS NO BUDGET AND CONTINUING RESOLUTION IS WHAT YOU DEAL WITH ALL YEAR? SITUATION HAS BECOME THE NORM SO TO BE CAUTIOUS WE ISSUE AT 90% ON THE OUTSIDE CHANCE THE BUDGET DROP BY 10% FOR EXAMPLE. BUT THE CR, THEY WILL STILL GET REMAINDER, UNLESS WE GET -- IF IT IS BUDGET WHERE THEY CUT US, THEN -- >> IF THERE IS NO CUT AND NO -- THEN YOU PAY THAT, AT THE END OF THE FISCAL YEAR? >> QUINN, DO YOU KNOW WHEN THAT HAPPENS? (OFF MIC) >> SOUNDS LIKE YOU CUT 10% IS WHAT HE SAID, RIGHT? >> THAT'S A TRANS-NIH POLICY, THAT'S NOT SOMETHING ANYONE MADE UP. NO. >> OPERATIONALLY BECAUSE THOSE FUNDS FLOW, THE INSTITUTIONS, CREATE SOME MORE PAPERWORK BURDEN. >> THIS HAPPENED FOR THE LAST THREE OUT OF THE LAST FIVE YEARS. THE MOST LIKELY SCENARIO IS THE FUND WILL BE RESTORED. EXACT TIMING OF THAT, ONCE WE HAVE AN IDEA WHAT THE BUDGET IS, WHETHER IF IT'S -- ONCE WE KNOW IT'S FLAT THEN -- WALTER MENTIONS CUT OF 1%. >> THE CUT TO THE 1% OUTYEAR WE DID THIS YEAR, WILL GIVE MORE MONEY TO PUT INTO NEW GRANTS. WE WOULD LIKE TO DO IS LEVEL OFF A LOT OF THESE SWINGS UP AND DOWN. SO THAT'S -- SINCE WE HAVE SO MUCH MONEY IN OUTYEARS, THAT WAS WHAT WE COULD DO. BUT THOSE ARE THE KIND OF TOUGH THINGS -- GOOD THINGS WE'RE DOING BECAUSE WE'RE NOT IN A GOOD SPOT. SO I WANT TO TELL YOU ABOUT THE 21st CENTURY CURES ACT, BECAUSE IT WAS FOCUSED ON NIH AND THE FDA. THE GOOD NEWS IS THAT THERE WAS A LOT OF INTEREST ON THE HOUSE AND SENATE SIDE TO GET MORE MONEY TO THE FDA AND NIH. AND AS YOU WILL SEE, AGAIN THERE'S A DOUBLE EDGE SWORD TO THIS. THIS FUNDING INITIATIVE, BUT THERE'S POLICY INITIATIVES THAT WOULD BE OF INTEREST I THINK. ESTABLISH REVIEWEDS KEY PROGRAMS, IF YOU WANT TO READ A GOOD SUMMARY OF THE BILL IT'S HERE IN THIS LINK, THERE'S A NEXT GENERATION RESEARCH INITIATIVE. THIS IS BASED ON A FAIRLY STRONG PUSH BOTH IN THE SENATE AND THE HOUSE THAT THE AGE OF NIH INVESTIGATORS WHEN THEY BECOME INDEPENDENT IS JUST GOING UP AND UP AND UP AND START GOING BACK DOWN AGAIN. LOT OF PRESSURE ON CONGRESS, THIS INSTRUCT IT IS NIH STARTUP PGH AT THIS AND DIRECTOR SUITE THE TRY TO WORK ON MOVING THIS BAR DOWN. AS YOU KNOW, WE GIVE 10%, 10 PERCENTILE POINT ADVANTAGE TO EARLY STAGE INVESTIGATOR, THIS INSTITUTE TO TRY AND OFFER THIS PROBLEM AND BRING THE AGE OF THE INVESTIGATORS DOWN. A LOT OF OTHER INSTITUTES DON'T DO THAT, SOME ARE TWO OR THROW POINTS SO WE AND NHLBI ARE THE MOST AGGRESSIVE IN THIS SPACE. ESTABLISHES AN INNOVATION FUND. WE WILL TALK ABOUT THIS BUT IT HAS MONEY, THIS IS WHERE THE MONEY IS. FOR THE BRAIN INITIATIVE, PRECISION MEDICINE INITIATIVE AND CANCER MOON SHOT INITIATIVE. MOON SHOT INITIATIVE HAS A BLUE RIBBON PANEL WHICH OUTLINES THE AREAS WHICH TO PUT THIS MONEY WHERE IT STARTED DISCUSSION WITH THEM ON WORKING WITH THEM ON BRAIN TUMORS, PARTICULARLY THEY'RE INTERESTED IN MOON SHOT IMMUNOLOGICAL THERAPIES WHICH ARE NOW REALLY BEING STUDIED HEAVILY IN GLIOMAS AND PEDIATRIC BRAIN TUMORS AS WELL. PRECISION MEDICINE INITIATIVE IS ATTEMPT TO RECRUIT A MILLION PEOPLE ACROSS THE COUNTRY INTO A RESEARCH REPOSITORY WHERE MEDICAL RECORD DATA GENETIC DATA CAN BE STUDIED AND IF THIS GETS OFF THE GROUND THERE COULD BE TREMENDOUS IMPACT FOR OUR INSTITUTE AND OTHER DISEASE INSTITUTES. RIGHT NOW THE EMPHASIS IS ON GENERIC, LET'S GET A MILLION GENERIC PEOPLE UP, THEY WOULD RATHER NOT HAVE ONE GENERIC PERSON, AND EVERYBODY ELSE HAVING EPILEPSY NOT BE -- BUT THEY ARE NOW THINKING ABOUT HOW TO INTERROGATE THIS GROUP AS IT COMES IN TERMS OF NEUROLOGICAL COGNITIVE FUNCTION. SO EVEN AT THIS POINT WE STARTED WORKING WITH THEM TO TRY TO GET INFORMATION FROM FROM THIS GROUP. IN THE LOAN REPAYMENT PROGRAM CAP INCREASED FROM $35,000 TO $50,000 A YEAR. SO PEOPLE WHO I APPLY FOR LOAN REPAYMENT, THAT IS GOOD NEWS. ALSO INSTRUCT THE NIH TO GET INTO BUSINESS OF AWARDING PRIZE COMPETITIONS FOR RESEARCH THAT LEADS TO IMPROVED HEALTH OUTCOMES AND DISEASES THAT ARE BZ UNDERSTUDIED, WHO ARE -- MAJOR HEALTH IMPACT. SO WE DO HAVE PRIZE AUTHORITY, THAT'S SOMETHING THAT WE HAVEN'T HAD A LOT OF EXPERIENCE WITH IN THIS INSTITUTE. WE'LL SEE MAYBE AT NIH THIS WILL GROW MORE. OKAY. AT NIH THERE'S BEEN LANGUAGE THAT EXEMPTS NIH FROM THE PAPERWORK REDUCTION ACT THIS ALLOWS US TO DO SURVEYS THAT ARE INVOLVED IN RESEARCH. SO RESEARCH SURVEYS. SO WE HAVE RESEARCH SURVEY CALLED THE YES SURVEY, I WILL TALK ABOUT IN A SECOND. TRY TO GET INFORMATION FROM TRAINEES PARTICULARLY DIVERSE TRAINEES FROM DIVERSE BACKGROUNDS ON WHY THEY MADE THE CAREER DECISIONS THEY DID. AND THIS ACTUALLY PASSING THIS ACT ALLOWED US TO GET THE SURVEY OUT. WE ALSO HAVE SOME LOOSENING ON RESTRICTIONS TO TRAVELING TO CONFERENCES AND SCIENTIFIC CONFERENCES FOR NIH FOLKS WHICH IS INCREDIBLY HELPFUL AND ALSO SAVES MONEY. APPROVAL COME IN SO LATE WITH TRAVEL ARRANGEMENTS AND REGISTRATION FEES WILL HIRE THAT WE WERE PAYING THAN IF WE HAD DONE IT EARLIER AND DIDN'T HAVE TO COME THROUGH THIS LENGTHY APPROVAL PROCESS. THERE'S A LOT OF TALK AND LANGUAGE IN THE BILL TO HAVE THE GOVERNMENT LOOK AT ITS RESEARCH POLICIES. AND THERE WAS AN IOM STUDY, NATIONAL ACADEMY OF SCIENCES STUDY ON OPTIMIZING RESEARCH, IN THE 21st CENTURY THAT CONCENTRATED ON THE TREMENDOUS ADMINISTRATIVE BURDEN THAT RESEARCHERS HAVE. AND THIS LED TO SOME OF THIS LANGUAGE SO THERE'S GOING TO BE A LOOK ACROSS THE GOVERNMENT TO TRY TO DECREASE THE BURDEN OF THESE REGULATIONS TO TRY TO HARMONIZE THEM, WHY SHOULD EACH FEDERAL AGENCIES HAVE DIFFERENT STUDY OR ANIMAL STUDIES PROTOCOL REQUIREMENTS CONFLICT OF INTEREST REQUIREMENTS TO SOMEHOW IF YOU CAN HARMONIZE IT DO IT ONCE AND IT'S DONE, POTENTIALLY BE HELPFUL. SO WE WILL LOOK AND SEE HOW THIS WORKS. THERE ARE SOME CHANGES IN THE -- AND MORE EMPHASIS ON DATA ACCESS AND PRIVACY. AND EXEMPT CERTAIN GENOMIC INFORMATION FROM FOIA REQUEST, THAT'S ARE FREEDOM OF INFORMATION ACT REQUESTS, AND IT ALSO DIRECTS US TO ISSUE CERTIFICATES OF CONFIDENTIALITY, THROUGH ALL NIH RESEARCH COLLECTING PERSONAL INFORMATION DATA, SENSITIVITY DATA, PEOPLE ASKED FOR THEM, THESE ARE QUITE HELPFUL IN CASE THERE'S A LAWSUIT WHERE THEY WANT THE INFORMATION FROM THE RESEARCH RECORDS. YOU HAVE THE CERTIFICATE OF CONFIDENTIALITY, YOU'RE IN GOOD SHAPE IN TERMS OF THE -- CAN'T WITH OVERREACH INTO THESE RECORDS, IF YOU DIDN'T HAVE THIS THERE'S NOT A LOT THAT CAN STOP SUBPOENA RESEARCH RECORDS. SO THIS IS SOMETHING THAT WILL BE HELPFUL, IT'S UNUSUAL BUT IT DOES HAPPEN THAT THESE GET STUDY. THEY WILL ASK FOR A STRATEGIC PLAN FROM THE NIH AND THE INSTITUTES HAVE TO COORDINATE THE NIH STRATEGIC PLAN. THEY ALSO AS BOB MENTIONED WE HAVE BEEN OUT AT THE FOREFRONT IMPROVING QUALITY OF RESEARCH BUT THEY DIRECT THE NIH TO START WORKING GROUP TO RECOMMEND THE FORMAL POLICY TO ENHANCE RIGOR AND REPRODUCIBILITY, LOOK AT PRE-CLINICAL, EXPERIMENTAL DESIGN, STATISTICAL METHODS AND DATA SHARING SO THE THINGS WE'RE DOING, NINDS IS SOMETHING THAT ALL OF NIH IS GOING TO HAVE TO GET INVOLVED WITH. I CAN'T EMPHASIZE THE IMPORTANCE OF THE FACT THAT THIS IS IN THE BILL. WHAT THIS MEANS POLITICALLY CONGRESS IS AWARE OF THE FACT THERE'S LANGUAGE OUT THERE THAT PEOPLE CAN'T REPRODUCE DATA. THEY ARE EXTREMELY WORRIED THAT THE TAXPAYER MONEY IS NOT BECOME USED APPROPRIATELY AND IT'S BEING WASTED ON EXPERIMENTS THAT ARE NOT LEADING TO QUALITY SCIENCE. THAT I THINK IS THE GREATEST THREAT TO THE NIH BUDGETMENTS? THAT WILL TONE IT DOWN, THIS WILL BE -- SO I THINK THE WORK THAT SHY IS DOING AND BOB AND THE REST OF OUR FOLKS IS REALLY IN THE FOREFRONT. INCREDIBLY IMPORTANT PEOPLE AROUND THIS TABLE KIND OF TAKE THIS AWAY WITH THEM. BECAUSE WE CAN DO VERY LIMITED -- WHAT WE CAN DO IS QUITE LIMITED IN THIS SPACE. REALLY A CULTURE CHANGE, IT'S A TRAINING -- IT'S A CHANGE HOW WE TRAIN PEOPLE, AND AGAIN BRING THAT MESSAGE TO -- INSTITUTIONS CAN BE VERY HELPFUL. THE IC DIRECTORS, THEY ARE ASSIGNED NOW FIVE YEAR TERMS, THEY CAN BE RENEWED BUT THEY GET REVIEWED AND THEY CAN BE -- IT CAN BE RELIEVED THAT FIVE YEAR TIME POINT. THEY ARE AGAIN EMPHASIZING THE IC DIRECTOR RESPONSIBLE TO MAKE A FINAL IN FUNDING AWARDS. I CAN'T FIND ANYTHING WITHOUT YOUR AGREEMENT. BUT IF YOU AGREE, I'M STILL RESPONSIBLE FOR WHAT WE FUND. SO I MAY HAVE IN SOME -- I CAN'T MANAGE WHAT HAPPEN DECIDE NOT TO FUND SOMETHING AGREED UPON, I WILL NEVER FUND SOMETHING THAT YOU VOTED AGAINST. AND IF I WOULD ALSO SAY IF I EVER WAS IN THAT POSITION, I WOULD BASICALLY COMMUNICATE WITH YOU EXACTLY WHY. PUTTING THIS ON THE IC DIRECTOR SAYING YOU CAN'T SAY I HAVE A GOOD SCORE THAT'S WHY YOU FUNDED IT, IT'S NOT GOING TO FLY. WE HAVE TO BE RESPONSIBLE STEWARDS OF THE MONEY, THAT'S GOING TO BE UP TO THE DIRECTORS. THE OTHER PARTS OF THE ACT IS INTERESTING LANGUAGE TO THE FDA AND THE CDC AS WELL SETTING UP SURVEILLANCE SYSTEM FOR NEUROLOGIC DISORDERS, THE AMOUNT OF MONEY APPROPRIATE FOR THIS MAKES IT HARD TO DO ANYTHING IN DEPTH SO THEY KIND OF HAD ALL NEUROLOGIC SURVEILLANCE BUT NOT REALLY THE KINDS OF FUNDS YOU NEED TO DO THAT. SO WE HAVE TO SEE HOW THAT WORKS OUT. TURNS OUT, THE LEADERSHIP CHANGES SO AS YOU PROBABLY KNOW, THE DIRECTORS OF THE NIH AND THE NCI ARE POLITICAL APPOINTEES. THEY HAVE TO HAND IN THEIR RESIGNATION. AND WHEN THERE'S A TURN OVER IN THE EXECUTIVE BRANCH. THIS HAPPENED EVERY YEAR. EVERY TIME THERE HAS BEEN A CHANGE. IN THIS CASE DR. COLLINS HAS MADE IT PUBLIC KNOWLEDGE THAT HE WOULD BE VERY INTERESTED IN CONTINUING HIS WORK HERE AT THE NIH AND HEAVEN IF HE WASN'T DIRECTOR HIS PLAN IS TO GO BACK TO HIS LABORATORY IN GENETICS AND SO HE HANDS IN HIS RESIGNATION BUT THE RERESIGNATION WAS DENIED SO I SEN AN EMAIL SAYING WHAT'S THE MATTER YOU DON'T KNOW HOW TO RESIGN RIGHT? BUT THAT'S GOOD NEWS FOR US. SO WE'RE IN THIS LIMBO PERIOD RIGHT NOW BECAUSE WE DON'T KNOW IF THIS IS A TEMPORARY THING OR APPOINT HIM, AN ACTUAL FACT YOU WOULDN'T BE ABLE TO POINT SOMEBODY NIH DIRECTOR WITHOUT HAVING HHS DIRECTOR, WE DON'T HAVE THAT YET SO WE SUSPECT THAT THIS COULD BE JUST A MATTER OF THE PROCESS WORKING ITS WAY BUT WE'LL SEE WHAT HAPPENS. WE'RE IN LIMBO HERE. THERE WERE SOME LEADERSHIP CHANGES THAT CAME IN. BEFORE THE HIRING FREEZE. SO WE'RE IN A HIRING FREEZE NOW. DIANA BIANCI CAME FROM TUFTS FROM THE NATIONAL CHILD HEALTH AND DEVELOPMENT, PATRICIA BRANNON WILL TALK TO US SHORTLY TO THE NATIONAL LIBRARY OF MEDICINE, SHE IS EXPERT IN BIOINFORMATICS AND HAS TAKEN OVER A LOT OF THE DATA SCIENCE WORK FROM PHIL BORN WHO LEFT, HE WAS HEAD OF THE BIG DATA TO KNOWLEDGE PROJECT, HE LEFT TO THE UNIVERSITY OF VIRGINIA. SO THOSE ARE FAIRLY BIG CHANGES, PATTY WILL UNDERSTAND WHAT WE THINK IS GOING TO HAPPEN GOING DOWN THE ROAD. THE CLINICAL CENTER, NOT SURE PEOPLE OUTSIDE D.C. ARE AWARE OF THIS, BUT THE CLINICAL CENTER IS THE STATE OF SOMEWHAT TURMOIL. BECAUSE OF FINDINGS OF IRREGULARITIES IN PORTING INFORMATION, THERE'S NO PATIENT HARM THAT'S BEEN DISCOVERED BUT THE PROCESS OF REPORTING TO THE IRBs AND THE IRB TO THE FDA, THERE WERE CLICKS IN THAT, THERE WAS BOUND TO BE PARTICULATE MATTER IN MOUTHWASH SO IT'S COME UNDER A LOT OF SCRUTINY AND THERE HAVE BEEN CHANGES AT THE LEADERSHIP LEVEL SO THE MAIN BIG CHANGE THAT MADE GENERAL JAMES GILLMAN RETIRE IS MADE THE HOSPITAL CHIEF EXECUTIVE OFFICER, HE WAS PREVIOUSLY COMMANDER WALTER REED HOSPITAL TOWN AND ARMY HOSPITAL IN TEXAS AND ALASKA. SO HE HAS EXPERIENCE IN RUNNING HOSPITALS, HE HE'S ALSO COMMAND OF U.S. MATERIAL COMMAND A GROUP I WORK WITH CLOSELY, THEY HAVE RESEARCH FUNDING FOR TRAUMATIC BRAIN INJURY SO WE HAVE DEFINITELY TIES TO THAT GROUP. JOHN GALLEN PREVIOUSLY DIRECTOR OF THE CLINICAL CENTER IS TAKEN ON THE POSITION AS DIRECTOR CHIEF SCIENTIFIC OFFICER AND WILL BE WORKING TO BASICALLY WITH THEY ARE DOING NOW IS GOING IN TO THE DEPTHS OF THE ORGANIZATION AND CENTRALIZE DEVELOP POLICIES ACROSS ALL THE INSTITUTES. WHAT HAPPENED DIFFERENTLY IN NINDS COMPARED TO HOSPITALS, AT LEAST WHEN I WAS TRAINING THE DEPARTMENTS DID THEIR OWN THING AND NOBODY BARTERED THEM. OVER TIME THE HOSPITAL ADMINISTRATORS BEGAN TO SET DOWN RULES AND STANDARDIZATION AND THAT'S A PROCESS THAT NEVER REALLY HAPPENED AT THE CLINICAL CENTER BUT IS REALLY UNDERWAY NOW. WE TALKED ABOUT THESE FOLKS. ARMS OVER THE YEARS THAT I HAVE BEEN HERE AND WORKING WITH STORY AND I -- HE HAS BEEN SCIENTIFIC DIRECTOR OF THE INTRAMURAL PROGRAM, AND HE'S WANTING TO RETURN TO THE LAB FULL TIME. FOR THE LAST THREE YEARS. SO HE FIRST TRIED TO RESIGN WHEN STORY WAS HERE, STORY SAID IT'S NOT A GOOD TIME BUT DIDN'T TELL THEM WHAT SHE WAS UP TO. AND THEN WHEN I BECAME COLLECTOR HE TRIED TO RESIGN, I SAID NO, I NEED YOU, I CAN'T LET YOU RESIGN NOW. BUT I CAN JUST GO SO FAR WITH THAT. HE REALLY WANTS TO GET BACK TO THE SCIENCE. SO THERE IS A SEARCH COMMITTEE FORMED THAT PEOPLE OUT THERE ARE LOOKING FOR PEOPLE TO APPLY. THIS IS A TREMENDOUS JOB, WE HAVE GREAT SCIENTISTS, GREAT OPPORTUNITIES TO DO SUPERB STUFF HERE. IT'S A PLACE WHERE YOU DON'T HAVE TO WRITE GRANTS ALL THE TIME, WE CAN MOVE QUICKLY IN RESEARCH AREAS SO IT'S A VERY SPECIAL PLACE. SO WE'RE HOPEFUL TO GET SOMEBODY GOOD FOR THAT POSITION. AND SHY, BOB TALKED ABOUT SHY, SO WE'RE HAPPY TO HAVE SOMEBODY OUT IN THE FOREFRONT IN THIS AREA WHICH IS SO IMPORTANT. NEW DIVERSITY OFFICE, BOB MENTIONED WE HAVE NEW OFFICE CONCENTRATING ON HOW DO WE GET MORE DIVERSE WORK FORCE IN NEUROSCIENCE. AS WE MENTION BEFORE, WE PUT IN A LOT OF EFFORT, DOING GREAT THINGS GETTING TRAINEES IN AND WE HAVE TO KEEP FILLING THE PIPELINE AND WE HAVE TO EXAMINE WHAT THE LEAK IS BECAUSE DIVERSITY AT THE ASSISTANT PROFESSOR LEVEL, ASSOCIATE PROFESSOR LEVEL IS REALLY BEEN A TOUGH NEEDLE TO MOVE. I MENTION THE Y SURVEY, SOMETHING MICHELLE PUT TOGETHER, WE'LL SEND IT OUT TO OUR TRAINEES. ANYBODY WE FUND WE CAN SEND IT OUT TO, IF AS MUCHABLE ELSE WANTED TO SEND IT OUT FROM THEIR ORGANIZATION, FEEL FREE. WE CAN'T COLLECT IN THE GOVERNMENT INFORMATION ON PEOPLE EXCEPT FOR THE ONES WE FUND. BUT IT WOULD BE GREAT IF OTHER ORGANIZATIONS WE CAN ALWAYS COMBINE INFORMATION SOME FASHION. BUT WE WANT TO KNOW IS WHAT IS MAKING -- WHAT IS THE -- WHAT IS GOING ON TO MAKE DECISIONS IN THEIR SCIENCE CAREERS EITHER GO ACADEMIA, INDUSTRY, POLICY, TEACHING, JUST TRYING TO UNDERSTAND WHAT THAT IS. PARTICULARLY FROM PEOPLE FROM DIVERSE BACKGROUNDS, WHERE WE THINK IS A REAL PROBLEM FOR NEUROSCIENCE BECAUSE WE NEED THAT DIVERSITY AT THAT HIGHER LEVEL. IN ADDITION IT'S ALSO TRUE THAT YOU CAN DO AS MUCH AS YOU CAN FUNDING TRAINEES BUT IF THEY CAN'T -- IF THEY HAVE TROUBLE IDENTIFYING WITH THE PEOPLE AT HIGHER UP, IT WILL BE DIFFICULT FOR THEM TO SEE THE ROLE MODEL IS REALLY IMPORTANT FOR THEM TO SEE THEIR PATH. SO WE REALLY DO NEED TO MOVE DIVERSITY MORE STRONGLY. WE HAVE A NEW PROGRAM CAME OUT OF THE BLUEPRINT TO FUND DIVERSE SCHOLARS IN NEUROSCIENCE, THIS IS THE BLUEPRINT SO WITHIN -- YOU GET ONE TO TWO YEARS OF ONE TO TWO YEARS COMPLETING Ph.D. FUNDED AND FOUR YEARS SUPPORT POST-DOCTORAL TRAINING AND ANY DOMESTIC U.S. INSTITUTION. THIS IS HOPE WHAT WE CAN DO HERE I THINK IS TO PROVIDE SECURITY FOR FOLKS WHO ARE DOING WELL IN THEIR Ph.D. PROGRAM TO HAVE THE MONEY TO GO TO THE NEXT STEP, OFTENTIMES WE LOSE PEOPLE AT THOSE TRANSITION POINTS TRYING TO FILL IN THE TRANSITION POINTS LET PEOPLE KNOW ABOUT THAT. WE HAVE BEV DAVISSON AN BRUCE AND DAVID ALONG WITH PAST MEMBER HAVE HELPED US IN TERMS OF WORKING ON A PLAN FOR LEVERAGING THE UNIQUE STRENGTHS AFFORDED TO MINORITY SERVING INSTITUTIONS AND THOSE WITH A TRACK RECORD OF REPRESENTING UNDER-REPRESENTED MINORITY STUDENTS SO WE HAVE COLLEGES AND SOME UNIVERSITIES AROUND THE COUNTRY WITH VERY HIGH NUMBERS OF THE KIND OF PEOPLE THAT WE WOULD LIKE TO BRING INTO NEUROSCIENCE AND WHAT WE'RE TRYING TO DO NOW IS TO FIGURE OUT WHAT IS THE BEST MECHANISM FOR US TO GET THE MOST NUMBERS OF GOOD PEOPLE FROM THESE INSTITUTIONS, MANY WHICH DON'T HAVE PREMIER NEUROSCIENCE PROGRAMS BUT HOW DO WE GET THOSE PEOPLE INTERESTED IN NEUROSCIENCE AND MOVE THEM ON A PATHWAY THAT THEY WILL BE SUCCESSFUL. SO WE ARE STILL WORKING HOPEFULLY WILL COME IN MAY WITH A PLAN FOR PEOPLE TO THINK ABOUT BUT WE'RE HELPFUL IN THE TOP RECOMMENDATIONS ARE TO BASICALLY FOCUS ON THE TRAINEES, AS OPPOSED TO TRYING TO DEVELOP INSTITUTIONS INTO PRIMARY HIGH-LEVEL NEUROSCIENCE ISTITUTIONS AND FOCUS ON THE TRAINEES. NOT BE A ONE SIZE FITS ALL APPLICATION SO TRY TO FIGURE OUT WHAT'S THE RIGHT FOR COLLEGE FOLKS, WHAT'S RIGHT FOR PEOPLE IN THIS SPACE BETWEEN COLLEGE AND Ph.D. PROGRAMS, WHAT'S RIGHT FOR Ph.D. STUDENTS. NOT A ONE SIZE FITS ALL APPLICATION. AND TO LEVERAGE THE POWER OF NETWORKS AND COLLABORATIONS, BETWEEN NEUROSCIENCE HEAVY, NEUROSCIENCE LIGHT INSTITUTIONS, AS WELL AS AMONG THE MINORITY SERVING INSTITUTIONS THEMSELVES. SO GET BACK TO YOU IN MAY ON THAT. OTHER TRAINIG ANNOUNCEMENTS THAT ARE OUT NOW. SO WE HAVE THE NEW REVISED JOINT SPONSOR PROGRAM IN NEUROSCIENCE, THE T-32 PROGRAM. THIS WAS HEAVILY COMING OUT OF NIGMS. BUT NIGMS RELINQUISHED THAT TO US AND OTHER NEUROSCIENCE INSTITUTES SO STEVE AND NANCY DECEMBER MONDAY AND OTHER FOLKS REWROTE THIS AND WHAT THEY DID IS THINKING THIS QUESTION OF RIGOR AND QUALITY OF RESEARCH REALLY EMPHASIZED THAT IN THE T-32 PROGRAM. SO THAT'S OUR OPPORTUNITY TO INFLUENCE THE TRAINING TO GET A BETTER PRODUCT, OR BETTER QUALITY RESEARCH IS TO LEVERAGE INTO THESE T-32 PROGRAMS INTO INSTRUCTION AND TRAINING. WE HAVE THE NEW F-32 FOR POST-DOC TRAINING SO THIS IS AGAIN TRYING TO GET PEOPLE INTO A POST-DOC THAT LOOKS LIKE SOMETHING, A PROJECT THEY CAN TAKE ON FOR THEIR CAREER AND BECOME INDEPENDENT SO I MOVE THEM QUICKER TO INDEPENDENCE, SO YOU HAVE TO APPLY FOR THIS IN THE LAST YEARS OF YOUR DOCTORAL TRAINING OR FIRST YEAR OF YOUR POST-DOCTORAL TRAINING, THE FUNDING RESTRICTED TO THE FIRST THREE YEARS. WE'RE LOOKING TO PEOPLE WHO HAVE PROJECTS TO TAKE ON AS THEIR OWN AS THEY MOVE FORWARD. WE HAVE THE BOOK END TO THIS WHICH IS A KO 1 POST-DOCTORAL CAREER AND DEVELOPMENT. THE F-32 WAS EARLY STAGE POST DOC, THE LATEST STAGE, AND AGAIN IT'S PEOPLE TO COME IN WITH A PROJECT, IT'S REALLY SOMETHING WITH POTENTIAL TO TAKE OUT ADS INDEPENDENT PROJECT THEY CAN GET INDEPENDENT FUNDING ON. STILL TRYING TO FIGURE OUT HOW TO DO THIS MENTOR AWARD. WE CAN TALK ABOUT THAT OFFLINE. COUPLE OF THINGS ABOUT THE BRAIN INITIATIVE. THE BRAIN INITIATIVE HAS ABOUT $150 MILLION PUT IN THE BASE OF THE INSTITUTES FOR THE BRAIN INITIATIVE NOW. THAT WILL CONTINUE INTO THE FUTURE. 21st CENTURY CURES BILL DID PUT MONEY TO THE BRAIN INITIATIVE AND YOU WILL SEE THE GRAPH, IN THE NEXT SLIDE. IT'S A FUNNY LOOKING GRAPH IF U YOU'RE TRYING TO MANAGE FUNDING FOR RESEARCH. BUT GOOD NEWS IS IT BASICALLY GIVES ABOUT 1 1/2 BILLION DOLLARS OVER THE NEXT 12 YEARS TO REALLY KIND OF REALIZE THE FULL POTENTIAL OF THE BRAIN INITIATIVE. SO WE PEER THOSE THREE YEARS IN A PILOT PHASE, ENTERING THE PHASE NOW WITH TRYING TO GET THE INVESTIGATORS TO COME TOGETHER AND SAY FROM THESE PILOTS WHAT LOOKSES LIKE IF YOU LAUNCH SOMETHING THAT'S GOING TO BE VERY SPECIAL, SOMETHING WE COULDN'T DO WITHOUT THIS BRAIN INITIATIVE TYPE OF FUNDING. THAT'S WHERE WE ARE RIGHT NOW. WE HAVE A COUPLE OF THOSE. PUT OUR TOES IN THE WATER ABOUT BIG PROJECTS, THE ONE THAT LOOKS LIKE THE MOST AMBITIOUS BUT DOABLE CELL CENSUS OF THE MOUSE BRAIN WHICH IS 8.5 BILLION NEURONS COMPARED TO 85 BILLION NEURONS, THE HIGH THROUGH PUT TECHNIQUES, NOW TEAMS POSSIBLE WE MIGHT BE ABLE TO DO SOMETHING LIKE THAT TEAM BASE WHEN WE SPLIT BRAIN UP INTO PIECES, COORDINATED ACTIVITIES SO THE DATA COMPARED SO THAT WOULD BE A MAJOR ACHIEVEMENT WITH A LOT OF SPIN OFF ADVANTAGES FOR PHYSIOLOGY RESEARCH AND UNDERSTANDING BRAIN CIRCUITS. SO WE CAN TALK LATER HOW WE PLAN TO USE THIS, WHAT WE PLAN TO DO IS GET PERMISSION TO DO SOMETHING CALLED FULL FUNDING SO WE CAN FIND A GRANT IN THESE GOOD YEARS POTENTIAL THINK SO INSTEAD OF THEN TRYING TO DEVELOP PROGRAM FOR MONEY GOING OUT YEAR BY YEAR FROM THE BUDGET, HAVE SOME GRANTS THAT WE FUND THE WHOLE THING FROM THE BEGINNING, COMMIT THAT MONEY THAT WILL HELP US SMOOTH OUT THESE UPS AND DOWNS. WE HAD TREMENDOUS RESEARCH GOING ON, TREMENDOUS NUMBER OF REALLY GOOD TOOLS COMING OUT OF THE BRAIN INITIATIVE, WE HAVE AS MANY ENGINEERS FUNDED AS NEUROSCIENTISTS IN 2016 SO THE IDEA WAS TO DEVELOP TOOLS TO IDENTIFY CIRCUITS, LOTS OF REALLY HIGH LEVEL PUBLICATIONS HAVE COME OUT OF BRAIN INITIATIVE FUNDING AND REALLY INTERESTING TOOL, HARD TO PICK ONE BUT THIS IS AN INTERESTING ONE WHERE IT ALLOWS YOU TO RECORD ELECTRICAL ACTIVITY AND ALSO EITHER TURN ON OR TURN OFF WITHOUT -- WITH LASER LIGHT, PARTICULAR NEURONAL CELL TYPES THAT HAD THIS OPTO GENETIC PROBE INTRODUCED INTO THE MOUSE. SO NOW YOU CAN STIMULATE AND RECORD SIMULTANEOUSLY OR INHIBIT SIMULTANEOUSLY IN THE BRAIN WITH THIS TINY ELECTRODE. LOTS OF OTHER REALLY AMAZING TYPE OF PRODUCTS THAT PEOPLE ARE WORKING ON. WE HAVE NOW THROUGH THE HARD WORK OF AMY ADAMS, I PUT TOGETHER A BRAIN INITIATIVE ALLIANCE, PARTNERSHIP FOR PUBLIC AND PRIVATE FOUNDATIONS IN THE BRAIN INITIATIVE, WE NOW HAVE A NEW WEBSITE WHICH IS WE HAVE OUR WEBSITE WHICH IS IT'S QUITE GOOD BUT IT'S MADE FOR SCIENTISTS TO UNDERSTAND THE FUNDING. THIS IS MORE FOR PUBLIC. SO TO GET PEOPLE TO UNDERSTAND THE BRAIN INITIATIVE MAY NOT BE INVOLVED IN THE SCIENCE BUT IT'S HIGH LEVEL AND I ENCOURAGE YOU TO TAKE A LOOK AT IT AND TRY AND PUBLICIZE IT. WE TRY TO HAVE AT THAT WEBSITE ALL THE FUNDING INITIATIVES, ALL THE DIFFERENT GROUPS THAT ARE INVOLVED IN THE BRAIN INITIATIVE SO IT'S KIND OF ONE STOP SHOPPING FOR FUNDING WHAT'S GOING ON. AMY PUT TOGETHER A NEW NINDS WEBSITE AND AGAIN ENCOURAGE PEOPLE THE LOOK AT IT, GIVE US FEEDBACK WHAT YOU THINK ABOUT IT T. WEBSITES ARE JUST OFTENTIMES COBWEBS THAT YOU GO IN AND SAY I'M GOING TO GOOGLE, FORGET THIS, I'M GOING BACK TO GOOGLE. AMY HAS DONE A REALLY GOOD JOB TRYING TO ORGANIZE THIS, SO HOPEFULLY IT'S SOMETHING -- IT'S BIG ADVANCE. COUPLE OF THINGS COMING DOWN THE ROAD. FRANCESCA AND JIM KOENIG AND OTHERS IN OUR GROUP HELD THE TRANSLATION HAL STROKE WORKSHOP. AS PEOPLE MAY RECALL IN THE '90s THERE WAS ACTIVITY TRYING TO DEVELOP NEUROPROTECTIVE AGENTS FOR PEOPLE WITH STROKE. AND THOSE ALL FAILED AND COMPANIES DISAPPEARED FROM THE LANDSCAPE. THERE'S REALLY GOOD SCIENCE GOING ON SO WE'RE TRYING TO FIGURE OUT NOW HOW TO DO I HAVE GET OUT OF THE DOLL DRUMS AND MOVE THE SCIENCE FORWARD AGAIN. IF THERE ARE SOME REAL MAJOR OPPORTUNITIES WE HAVE NOW TO DO THIS THAT WE DIDN'T HAVE BEFORE. PRIMARILY IT'S COMMON PLACE TO PUT CATHETERS IN AND REMOVE CLOTS FROM PEOPLE WHO ARE HAVING MAJOR STROKES AND THAT GIVES YOU ACCESS TO THE BRAIN YOU NEVER HAD BEFORE AND ALSO GIVES YOU THE ABILITY TO ASSESS THE BRAIN AT THE TIME OF THE REPRO FUSION WHICH YOU NEVER KNEW BEFORE, IT WAS A COMMISSION OF LOTS OF PEOPLE WHO REPROFUSE TOO LATE, NOW WE HAVE A DIFFERENT SITUATION TO TEST THINGS IN PEOPLE. WE HAVE TO PICK THINGS THAT ARE RIGHT, NOT JUST WHAT'S IN THE FAD. THAT'S WHAT THE GROUP IS DOING, WE'LL COME UP WITH A PLAN HOW WE MIGHT GET TO THAT. THE THINGS THAT I HAVE SEEN THE LAST YEAR, MARK TENDS TO WOW US, IT'S SOCIETY FOR NEUROSCIENCE, MARK IS HERE WITH SATELLITE WORKSHOPS. SUE RESOLUTION MICROSCOPY. THIS YEAR WAS ON CNS ORGANOIDS. AMAZING AMOUNT OF WORK GOING ON DEVELOPING REAL BRAIN REGIONS THAT LOOK LIKE REAL BRAIN REGIONS IN A DISH WITH THESE IPS CELLS AND ENGINEERING TECHNOLOGIES GETTING VASCULATURE INTO THEM, AND WAYS TO STUDY DEVELOPMENT IN THE CORTEX OR OTHER BRAIN AREAS YOU NEVER REALLY HAD BEFORE. SO LOOKING FORWARD TO THE AREA OF SCIENCE HELPING US AS WE GO FORWARD. COUPLE OF ADVANCES, THIS IS ONE WHICH IS REALLY NICE STORY. CARSON DONOVAN IS A RESEARCHER HERE, PEDIATRIC NEUROLOGIST INTERESTED IN RARE PEDIATRIC NEUROLOGIC DISORDERS. HE WAS SEEING THESE KIDS WHO HAD BASICALLY LOSS OF APPROPRIATE RECEPTIONS SO THEY DIDN'T KNOW JOINT IN KIND THEY HAD SEVERE ATAXIA,. HE WAS FOUND A COUPLE OF KIDS, TWO OF THEM, AND THEN HE WAS SITTING IN A ROOM ACROSS FROM THE OTHER BUILDING AND THERE WAS AN INVESTIGATOR WHO STUDIES THE PIZO CHANNEL IN THE MECHANICAL TRANSDUCTIONS, HE WAS LISTENING TO -- HE HAD THE IDEA MAYBE THE PROBLEM IS THESE KIDS HAVE A PROBLEM. SO THEY STUDY THE KIDS AND THEY DID HAVE MUTATIONS IN THIS PIZO 2 MECHANICAL SENSATION TRANSDUCER SO AN INTERESTING STORY. KAREN WANTS TO SAY ANYTHING ABOUT THIS, BUT I BROUGHT IT UP LAST TIME. THIS IS SOMETHING HOPEFULLY A REALLY BIG WIN. THIS IS NEW THERAPY THAT'S OUT OF ANTI-SENSE THERAPY FOR CHILDREN WITH SPINAL MUSCULAR ATROPHY. SO THIS IS A TIME LINE THAT PAUL SCOTT'S GROUP PUT TOGETHER IN TERMS OF WHERE THE DISCOVERIES WERE MADE, WHICH WERE WITHER WERE DONE BY NINDS AND COMPANIES COMING IN, THE OTHER THING TO KNOW IS NINDS WITH JERRY FISH BACK STARTED A PROGRAM TO FIND A DRUG WITH SM 2 PROTEIN WHICH SAVES THESE KIDS, CNS MUTATION IS A TERRIBLE ONE BUT YOU CAN INCREASE THE SMN 2 PROTEIN TO GET A MUCH MILDER PHENOTYPE SO HOW DO YOU DO THAT, SEEMS LIKE THEY MAY HAVE SUCCEEDED, KAREN DO YOU WANT TO SAY ANYTHING? WHAT YOU THINK IS GOING TO HAPPEN NOW? >> OBVIOUSLY IT WAS VERY GREAT MILESTONE IN SMA FIELD. BUT I HAVE TO ALSO POINT TO MODEL FOR INTERACTION TO NIH FUNDING ACADEMIC INVESTIGATORS AS YOU MENTION NINDS HAS ITS OWN SMA DRUG DEVELOPMENT PROGRAM INDUSTRY OBVIOUSLY. AND FOUNDATIONS. SO I THINK THIS IS THE FIRST TIME I HAVE SEEN COMPANIES ACKNOWLEDGE PARTNERS IN ACADEMIA AS WELL AS FOUNDATIONS IN MILESTONE EVENT. SO I HOPE IT SERVES AS AN EXAMPLE FOR OTHER RARE DISEASES WHERE COMPANIES MAYBE HESITANT TO MAKE THE FIRST MOVE. AND THAT NIH AND FOUNDATIONS CAN HELP THEM TAKE THAT FIRST STEP WHICH WILL ULTIMATELY HOPEFULLY LEAD TO ANOTHER DRUG. >> THANKS. >> CAN I ADD SOMETHING >> THIS IS TERRIFIC TO SORT OUT THE COMPLEX OF SMA SPLICING LEADING TO THIS NOVEL CREATIVE TREATMENT. GOOD ARCMENT FOR SUPPORTING BASIC SCIENCE OF RNA METABOLISM AND NEURONS. >> IT IS A GREAT EXAMPLE OF UNDERSTANDING ALL THE PIECES AS AND THE DISEASE SO IT CAN BE PRETTY CONFIDENT IF YOU CAN ACHIEVE WHAT YOUR GOAL IS, IS GOING TO WORK. REALLY DID TIE EVERYTHING TOGETHER. SO -- >> IT'S A GREAT STORY. >> SO JUST GOING TO ADD NOW A COUPLE OF INTRAMURAL AWARDS THAT CAME THROUGH. TINA -- MACAQUE IS A TENURE TRACK INVESTIGATOR FOR TENURE NOW WHO HAS BEEN -- A NUMBER OF BASIC AWARDS. DANNY WRIGHT AWARD FROM THE MS SOCIETY, STILL CAN'T TAKE THE MONEY AS FAR AS I KNOW. MARK HA WILL,LET A NUMBER OF AWARDS AND ZU HANG SHANE, ELECTED TO AAAS. WE HAD TWO RESIDENTIAL CAREER AWARDS FOR SCIENTISTS AND ENGINEERING. MARIA LATINAN FROM CHILDRENs AND DAN O'CONNER FROM HOPKINS GOT THIS AWARD. THIS IS AN UNUSUAL THING, 2014 AWARDEE IF I UNDERSTAND CORRECTLY. I DON'T KNOW WHAT -- THE GOVERNMENT TO TACK THREE YEARS TO GIVE AN WARED. THEY DO GREAT WORK, WE'RE PROUD OF THEM. FINALLY I WANT TO END UP JUST THAT GIVING ALAN A CHANCE TO SAY SOMETHING AS WE TALKED ABOUT ALAN HAHN AN AMAZING INTEGRAL PART OF NINDS FOR A LONG PERIOD OF TIME, HE BRINGS JOY TO PEOPLE THAT WORK HERE. THIS WAS CAN'T READ THIS BUT THIS WAS THE AWARD WITH VANNA WHITE AWARD. IF I REMEMBER RIGHT. FOR THE LOVELY SIDE KICK AT THE RETREAT. AND ALWAYS GOT -- POINTING SOMETHING OUT THAT'S GOOD TO KNOW. HE SAYS I LOVE PUBLIC SERVICE BECAUSE I GET TO WORK WITH AMAZING DEDICATED PEOPLE. AND I THINK WE'RE AMAZINGLY DEDICATED A LOT OF TIME BECAUSE OF ALAN, THANKS SO MUCH ALAN, WANT TO SAY A COUPLE OF WORDS IN PARTING. BE NICE. [APPLAUSE] >> I WILL CREATE SOME IMAGES HOWEVER. SO FIRST I WOULD LIKE TO ACKNOWLEDGE AND THANK THE AMAZING PEOPLE THAT I HAVE GOTTEN TO WORK WITH OVER THESE 19 YEARS. WE HAVE HAD WONDERFUL DIRECTORS AT NINDS. SO WHEN I WAS HIRED ZACK HALL WAS THE DIRECTOR. BY THE TIME I GOT HERE, HE HAD ACTUALLY MOVED ON. SO AUDREY PENN WAS DIRECTOR AND JERRY FISHBACH THEN AUDREY PENN STORY LANDIS, WALTER AND EVERY ONE OF THESE WAS GREAT IN TERMS OF GIVING ME OPPORTUNITIES TO ENGAGE IN A NUMBER OF ACTIVITIES AND WORK WITH DIFFERENT PEOPLE ON THE THE EXTRAMURAL SIDE, TWO WONDERFUL BOSSES, CONNIE ATWELL AND BOB AND EACH OF THEM WAS INCREDIBLY GENEROUS IN ALLOWING ME TO PARTICIPATE IN MANY DIFFERENT TRANS-NIH AND OUTSIDE NIH ACTIVITIES. IT WAS INTERESTING AS I THOUGHT ABOUT THE LEADERSHIP WHEN I GOT HERE, THERE WAS AT ONE POINT WHEN THE CHAIN OF COMMAND BETWEEN ME AND THE PRESIDENT WERE ALL WOMEN. SO GOING FROM LILLIAN PUPILS WHO WAS CHIEF REVIEW TO CONNIE ATWELL, HEAD OF EXTRAMURAL, TO AUDREY PENN, ACTK NIH DIRECTOR TO RUTH KIRSCHSTEIN, DONNA SHALAYLA DEPUTY SECRETARY OF HHS. THAT WAS COOL TO NOTE. TO TAKE A SENATE SHOP AND GET AN IMAGE -- SNAP SHOT AND SEE WHERE WE AVE BEEN GONE, I THOUGHT IT INTERESTING TO GO BACK AND LOOK AT THE MINUTES OF THE FIRST COUNCIL MEETING I ATTENDED, IN MARCH -- I MEAN MAY OF 1998. AND AMAZINGLY ENOUGH KELLY BAKER HAS RECORDS OF ALL OF OUR MINUTES. I THINK GOING BACK TO DAY ZERO. FUNNY YOU MENTION THAT. AS I LOOK AT THE TECHNOLOGICAL CHANGES THAT HAPPENED IN THE TIME I HAVE BEEN HERE, I KNOW THAT THE PRESENTATION THAT THAT COUNCIL WE'RE ALL DONE WITH 35-MILLIMETER SLIDES, EVERYTHING WAS PAPER, THE THING THAT STRUCK ME WHEN I STARTED AT NINDS WAS THERE WAS PAPER EVERY WHERE, BOXES AND BOXES. THOSE ON STUDY SECTIONS IN THE '80s AN '90s YOU HAVE SHIPMENTS OF THREE BIG BOXES OF DOUBLE SIDED COPIES, ALL APPLICATIONS, THERE WAS NO TRIAGE. SO YOU DISCUSSED EVERYTHING, THE BAD BAD AND THE UGLY. AND SO THAT WAS WHEN MEETINGS WENT ON FOR THREE DAYS. THAT WAS INTERESTING. TECHNOLOGICALLY AT THE OLD SUMMARY STATEMENTS IS INTERESTING. I REMEMBER IT WAS ALMOST LIKE ENTERING THE LOTTERY AFTER COMPLETED REVIEW AND SUMMARY STATEMENT THROUGH TWO SEPARATE PIECES OF MAINFRAME COMPUTER ONE WITH THE FACE PAGE, PI AND THE BUDGET INFORMATION AND THE OTHER THAT HAVE THE TEXT. YOU MAY REMEMBER THERE WAS NO FORMATTING. JUST ASKING KEY CHARACTERS AND THERE WAS THIS TEXT BASED STUFF. SO WELL BEFORE WINDOWS. THOSE ARE THINGS THAT I GENUINELY DON'T MISS. THE OTHER THINGS THAT WAS INTERESTING TO THINK ABOUT IS HOW WE ACTUALLY WENT ABOUT DOING SEARCHES, WALTER REFERRED TO GOOGLING. WE DIDN'T HAVE GOOGLE IN THOSE DAYS, I TRY TO REMEMBER SOME OF THE ONES WERE AL TA SRI TA AND ASK JEFES. YAHOO WAS AROUND BUT IT WAS A PRETTY DIFFERENT TIME. THAT WAS A VERY GOOD MEMORY OF WHEN I WALK DOWN THE HALL TO TALK TO A COLLEAGUE WHO SAID I FOUND THIS SEARCH GENERAL WITH A FUNNY -- ENGINE, IT'S TWO STUDENTS AT STANFORD THAT STARTED IT AND SHOWED ME THIS GOOGLE THING, AND I GO THAT'S KIND OF INTERESTING. THAT REALLY TOOK OFF SO THAT WAS INTERESTING TO SEE. SO CLEARLY WE HAVE MADE A LOT OF TECHNOLOGICAL ADVANCES SINCE THEN. JUST LOOKING NO PILES OF PAPER HERE. THAT IS DEFINITELY A PROGRESS AND BREATHING EASIER EVERYWHERE. ALSO INTERESTING TO LOOK AT ISSUES COUNCIL WAS DISCUSSING AT THAT MEETING. AND SOME OF THEM ACTUALLY ARE RELEVANT TO DISCUSSIONS WE'RE GOING TO HAVE TODAY. SO THE FIRST TOPIC THAT WAS CONSIDERED AT THAT MEETING, WAS QUESTION OF WHETHER OR NOT TO RAISE THE BUDGET CAP ON PROGRAM PROJECTS AND CENTERS. AT THAT TIME IT WAS $750,000, IT'S BEEN 750 BUT DISCUSSION WAS TO RAISE IT TO A MILLION. THERE WERE A LOT OF PROS AND CONS, INTERESTING TO SEE SOME OF THE COMMENTS FROM COUNCIL MEMBERS WHO SEVERAL COUNCIL MEMBERS FAVORITE DROPPING THE CAP BECAUSE IT CREATES INTERACTIONS BEFORE THEY BEGIN. THE INITIAL REVIEW GROUP CAN RECOMMEND THE DELETION OF SUBPROJECTS OR OTHER BUDGET CUTS IF NECESSARY. BUT PROGRAM PROJECTS ARE CRUCIAL FUNDING MECHANISMS FOR THE TRANSLATIONAL RESEARCH THAT IS NOW SO IMPORTANT. ANOTHER THING THAT WAS INTERESTING IS THIS WAS THE START OF THE PLANNING PROCESS, FOR WHAT WAS THE NEUROSCIENCE OF THE NEW MILLENNIUM. SO THERE WAS PRESENTATIONS AND DISCUSSIONS HOW COUNCIL WOULD BE INVOLVED IN HELPING NINDS PLAN FOR THE 21st CENTURY. AND THE COUNCIL RECOMMENDED A NUMBER OF SMALL WORKING GROUPS AND A NUMBER ENDED UP BEING THE WORKING GROUPS THAT ULTIMATELY LED TO WHAT BECAME THE CLUSTERS SEVERAL YEARS LATE SORE INTERESTING TO SEE THE SEEDS OF THIS IN THIS 1998 MEETING. IT WAS ALSO INTERESTING TO SEE COUNSEL THOUGHT ONE OF THE MOST IMPORTANT WORKING GROUPS WOULD BE ONE ON TRANSLATIONAL RESEARCH BECAUSE QUOTE, OF THE INADEQUACY OF THE IDENTIFICATION OF ADVANCES IN BASIC RESEARCH, THAT COULD NOW BE TRANSLATED INTO PATIENT CARE, NINDS PLAYS A VALUABLE ROLE PROVIDING A FORUM FOR COMMUNICATION AMONG RELEVANT AREAS OF BASIC RESEARCH, CLINICAL RESEARCH AND CLINICAL PRACTICE. IT WAS ALSO A STRONG SUGGESTION NINDS NEEDED TO BE MORE PROACTIVE HOW THOUGHT ABOUT CLINICAL TRIALS. SO YOU CAN SEE THE SEEDS HOW WE COME TO THE DIVISIONS THAT THEY NOW LEAD. WE HAVE TAKEN EXCELLENT OPPORTUNITIES TO HIRE WONDERFUL PEOPLE TO COME IN AND HELP US. THERE WAS QUITE A BIT OF DISCUSSION ABOUT TRAINING AND THIS IS ONE THAT WILL PERK UP STEVE CORN'S EARS WHERE ONE COUNCIL MEMBER RAIDED TOPIC OF RESEARCH TRAINING DURING AND AFTER RESIDENCY TRAINING. THIS WAS CRITICAL ISSUE FOR THE CLINICAL SPECIALTIES BECAUSE WORK FOR SUCH TRAINING IS NEEDED TO DEVELOP A GREATER NUMBER OF HIGHLY SKILLED CLINICAL RESEARCHERS. SO 1998. WE WERE ON IT. WE MADE PRETTY GOOD PROGRESS. THE LAST THING THAT I NOTICED THAT WAS PRETTY INTERESTING WAS A REPORT FROM A GENETICS WORKING GROUP TALKING ABOUT A NUMBER OF TRANS-NIH ACTIVITIES THAT WERE REALLY THE FORERUNNERS OF WHAT WE NOW SEE IN THE COMMON FUND AND NEUROSCIENCE BLUEPRINT. SO THEY WERE TALKING BRAIN MOLECULAR ANATOMY PROJECT. THE BRAIN TUMOR GENOME ANATOMY PROJECT. CENTER FOR INHERITED DISEASE RESEARCH. AN INITIATIVE FOR GENOMIC RESOURCES FOR THE ZEBRAFISH. METHODS FOR DISCOVERING ARE AND SCORING SNPS, QUANTITATIVE METHOD TO MAP GENES FOR COMPLEX DISEASES. SO LOTS OF FORWARD-LOOKING THINGS, ALL WHICH HAVE HAPPENED SINCE THAT TIME. SO LOOKING AT THAT, YOU SEE THERE WAS A LOT OF VERY INTERESTING COLLABORATIVE RESEARCH THAT WAS COMING OUT OF IT AND THAT HAPPENED. SO JUST TO GO BACK TO THAT PARTICULAR SNAP SHOT IN TIME, AT LEAST VERY INSPIRING TO SEE HOW MUCH HAS HAPPENED IN THAT TIME. SO LOOKING FORWARD, ONE THING I HAVE ENJOYED MOST HAVE BEEN INCREDIBLE PEOPLE. SO IN THE 19 YEARS WE HAVE HAD 100% TURN OVER IN THE EXTRAMURAL SIDE OF NINDS. ONLY TWO PEOPLE OUT OF 150 WHEN I GOTTER HUE. BRENDA CAN BE LEER AND DENISE CHAPMAN, THE GRANTS MANAGEMENT BRANCH. THE REST I CAN REMEMBER WHEN YOU WERE HIRED AND WHEN YOU CAME HERE, THAT'S INSPIRING TO ME AS WELL. ONE THING I NOTED EARLY ON IN MY TIME AT NINDS AND NIH WAS THAT NOBODY STARTS SCIENTIFIC CAREER INTENDING TO BE A GOVERNMENT ADMINISTRATOR. ALL OF US CAME HERE FROM SOMEWHERE ELSE. EVERYONE HAS A STORY, EVERYONE HAS AN INTERESTING STORY, JUST REMARKABLE AND I THINK THAT'S WHAT MAKES IT SO MUCH FUN AND HAS MADE SO MANY THINGS SUCCESSFUL. IT'S JUST WHEN YOU TAKE THE TIME TO GET TO KNOW PEOPLE YOU FIND OUT THAT THEY DID REALLY INTERESTING THINGS AND BRING AN INCREDIBLE RICHNESS OF EXPERIENCE. YOU HAVE SOME SAMPLE AS BOB ZIPPED THROUGH THE INTRODUCTIONS OF OUR LATEST NEW EMPLOYEES. AND THEY'RE PRETTY AMAZING PEOPLE, I WISH I WAS GOING TO HAVE THE OPPORTUNITY TO WORK WITH THEM LONGER. I KNOW THOSE WHO ARE STILL HERE HAVE GREAT COLLABORATIONS AHEAD SO THERE ARE PHENOMENAL OPPORTUNITIES, THAT'S THE THING I ENCOURAGE MY DELETIONS TO TAKE ADVANTAGE OF -- COLLEAGUES TO TAKE ADVANTAGE OF IS THE WISDOM AND EXPERTISE OF THE COLLEAGUES. THROUGHOUT MY CAREER I HAVE BEEN INCREDIBLY FORTUNATE TO WORK WITH INSPIRING PEOPLE WHO HAVE GREAT EXPERIENCE, GREAT KNOWLEDGE, WISDOM, THAT'S BEEN BOTH SOME OF THE MOST ELITE INSTITUTIONS IN THE COUNTRY AND ALSO SOME VERY EVERY DAY INSTITUTIONS, PEOPLE HAVE ENCOUNTERED AND DINERS IN KANSAS, THINGS LIKE THAT. IF YOU TAKE THE TIME TO TALK ABOUT WHAT'S GOING ON, YOU CAN REALLY LEARN A LOT. ONE OF THE THINGS I HAVE ALWAYS ENJOYED DOING, I LOOK FORWARD TO DOING MORE AS I GO OFF TO MY VARIOUS RETIREMENT ACTIVITIES IS TO CONTINUING TO SPREAD THE WORD HOW EXCITING NEUROSCIENCE IS. I FELT NORTH GNAT THAT UNIVERSITY OF NORTH CAROLINA THAT I HAD WHAT WAS PROBABLY THE BEST TEACHING ASSIGNMENT POSSIBLE WHICH WAS TEACHING INTRODUCTORY NEUROSCIENCE TO FIRST YEAR MEDICAL STUDENTS. IF YOU CAN'T HAVE FUN TEACHING THE HUMAN BRAIN TO PEOPLE THEN YOU SHOULDN'T BE A TEACHER. THAT WAS JUST -- IT WAS GREAT. WE HAD -- WE JUST HAD SUCH A GOOD TIME WITH THAT. EVEN YEARS LATER PEOPLE COME UP TO ME SAYING HOW MUCH THEY ENJOYED THAT COURSE. THAT WAS A GREAT TEAM I GOT TO WORK WITH. I FIND EVEN WHEN NIGHING ON PLANES OR -- FLYING ON PLANES OR TALKING WITH PEOPLE, SITTING IN A DINER IN SOME REMOTE PLACE WHEN I'M OUT ON A BIRD WATCHING OR BACKPACKING TRIP, I DON'T MISS THE OPPORTUNITY TO TELL THEM ABOUT NEUROSCIENCE, AND WHAT'S GOING ON AND PEOPLE WHO ARE DOING IT. EVERYONE IS INTERESTED. WHETHER TALKING ABOUT THIS AMAZING GUY NAMED DAVID JULIUS WHO IS STUDYING HOW YOU CAN FUEL COAL AND HEAT AND WAY TO DETECT SPICY PEPPERS OR INTERESTING THINGS THIS GUY LARRY DOES WHERE HE STUDIES THE TINY FRUIT FLIES AN EVEN THE BRAIN OF FRUIT FLY IN THREE OR FOUR ATTEMPTS CAN LEARN WHICH IS THE BAD SIDE OF A TEST TUBE. YOU CAN START TO UNDERSTAND THE CIRCUIT AND FIND INDIVIDUAL MUTATIONS THAT WILL INFLUENCE A LITTLE FLY ABILITY TO LEARN FAIRLY COMPLICATED BEHAVIOR. SO THERE'S LOTS OF INTERESTING WAYS TO SPEND -- SPREAD THE MESSAGE ABOUT HOW INTERESTING NEUROSCIENCE IS. AND I THINK THAT'S REALLY IMPORTANT. I THINK THAT'S THE WAY THAT YOU BUILD SUPPORT FOR THINGS. WE CAN DO BIG TARGETED OUTREACH BUT I THINK ONE ON ONE IS REALLY VALUABLE SO I WOULD LIKE TO ENCOURAGE YOU TO TAKE THAT OPPORTUNITY. I IT'S FUN, PEOPLE ENJOY IT. SO LOTS OF OPINING HERE. SO LET ME CONCLUDE BY -- I HAD TO BRING SOME HUMOR IN HERE AND I'M VERY GRATEFUL TO BOB FOR HAVING POINTED TOUT ME AN INTERESTING ORGANIZATION THAT HAD NEVER HEARD OF BEFORE. IT'S APPLIED THERAPEUTIC HUMOR, IT'S GROUP THAT LOOKS AT IT. I'M GOING TO CLOSE BY GIVING YOU THEIR MOTTO. WHICH IS LAUGHTER IS THE BEST MEDICINE, UNLESS YOU HAVE DIARRHEA. [APPLAUSE] >> I'M NOT GOING TO SAY ANYTHING BECAUSE I'LL GET CHOKED UP IF I DO. BUT NICE AND SUPER SMART DON'T ALWAYS GO TOGETHER AND YOU ARE IT. I CAN'T IMAGINE THIS PLACE WITHOUT YOU. OKAY. SO FOR A GOOD REASON WE'RE WAY BEHIND SCHEDULE NOW. SO I GUESS IF THERE'S MAYBE ONE OR TWO URGENT QUESTIONS ABOUT WALTER'S TALK, WE CAN DO THAT. NOW SO I THINK SO WE'RE MOVING TO THIS CEREBRAL PALSY THING, I THINK THAT JIM KOENIG WHO WILL TALK, WHO IS A PROGRAM DIRECTOR IN ONE OF OUR CLUSTERS, THIS IS SELF-EXPLANATORY SO UNLESS YOU WANT TO SAY SOMETHING WALTER WHY DON'T YOU JUST -- >> GOOD MORNING. SO AS BOB SAID I'M JIM KOENIG FROM THE NEURAL ENVIRONMENT CLUSTER. I WILL PRESENT THE DRAFT STRATEGIC PLAN FOR CEREBRAL PALSY RESEARCH TO YOU FOR YOUR INFORMATION AND FOR YOUR COMMENT. SO THE PLAN THAT I'M GOING TO TALK WITH YOU ABOUT THIS MORNING HAS ACTUALLY BEEN A VERY COLLABORATIVE TEAM EFFORT AND THESE ARE THE -- ALL THE PEOPLE AT NINDS AND NICHD THAT CONTRIBUTED TO PUTTING THIS PLAN TOGETHER. IT'S TAKEN A COUPLE OF YEARS TO PULL TOGETHER ALL THE INFORMATION NECESSARY TO COME UP WITH A COHERENT PLAN. AND HOPEFULLY I'LL PRESENT IT IN A WAY THAT IS EQUALLY AS COHERENT AND ALLOWS YOU TO SEE SOME OF THE MAJOR THINGS THAT WE FEEL ARE AREAS TO EXPLORE IN THE FUTURE. SO JUST A COUPLE OF WORDS ABOUT CEREBRAL PALSY AND WHAT IT IS IN CASE SOME AREN'T FAMILIAR WITH IT. >> JUST TO FOLKS THAT THE PLAN IS ACTUALLY IN YOUR BOOK IN THE FOLDER THERE. >> SO JUST A COUPLE OF WORDS ABOUT CP, IT IS A HETEROGENEOUS GROUP OF NEURAL DEVELOPMENTAL DISORDERS THAT AFFECT MUSCLE TONE MOVEMENT POSTURE AND IN SOME CASES SPEECH AND COGNITION. IT IS CAUSED PREDOMINANTLY BY DAMAGE TO THE BRAIN THAT OCCURS AS A RESULT OF PERINATAL HYPOXIA ISCHEMIA, GESTATIONAL INFECTIONS, LOW BIRTH WEIGHT PREMATURE BIRTH OR EARLY CHILDHOOD TRAUMA. CEREBRAL PALSY IS ONE OF THE MOST COMMON CHILDHOOD NEUROLOGICAL DISORDERS AND AFFECTS APPROXIMATELY -- EXCUSE ME. AFFECTS PREDOMINANTLY TWO TO FOUR INDIVIDUALS PER 1,000 CHILDREN. HOWEVER IF YOU LOOK IN THE POPULATIONS LOW BIRTH WEIGHT OR PREMATURE BIRTH, INCIDENCE OF CEREBRAL PALSY GOES UP BY TENFOLD, THERE IT BECOMES A PROMINENT PROBLEM. SO THERE ARE MAJOR CHALLENGES THAT FACE INVESTIGATORS AND CLINICIANS WHEN TEALING WITH THE -- DEALING WITH CEREBRAL PALSY RESEARCH AND CLINICALLY. THE FIRST OF WHICH IS THAT THE INJURY THAT LEADS TO CEREBRAL PALSY USUALLY OCCURS DURING THE PRE-OR PERINATAL -- PERIPARTUM PERIOD AND CHILDREN ARE NOT OFTEN DIAGNOSED WITH IT UNTIL THEY'RE AROUND AGE 2. AND AS A CONSEQUENCE THIS PRESENTS MAYOR CHALLENGES IN TRYING TO TREAT THESE CHILDREN BECAUSE THE INJURY IS ALREADY HAPPENED AND HOW DO YOU INTERVENE IN A TIME WHEN THERE'S NO ACTIVE INJURY PROCESS ONGOING. THERE ARE FEW IN ANY BRAIN TARGETED TREATMENTS THAT EXIST THAT PRODUCE STRONG CONSISTENT FUNCTIONAL IMPROVEMENT IN CHILDREN WITH CEREBRAL PALSY. THE NEUROPROTECTIVE -- NEUROPROTECTIVE TREATMENTS WE HAVE FOR CEREBRAL PALSY FOR DEVELOP MENTAL BRAIN DISORDERS SUCH AS HYPERTHERMIA, FOR EXAMPLE MAY ONLY PREINVENTORY OR OR ATTENUATE CP IN CERTAIN POPULATIONS OF AT RISK CHILDREN. SO AS A CONSEQUENCE, BETTER TREATMENTS ARE NEEDED. UNDERLYING SUBSTRATES FOR CP CONTINUE TO BE AMBIGUOUS AND NEED TO BE IDENTIFIED IN A CLEARER WAY. AND ALSO THERE IS RECENT EVIDENCE THAT SUGGESTS THAT GENETICS PLAYS A PROMINENT ROLE IN CEREBRAL PALSY BUT THE EXACT ROLE THAT GENETICS PLAY IS UNCLEAR, THIS IS A BURGEONING AREA OF O INVESTIGATION AND ONE THAT NEEDS DRAMATICALLY GREATER RESOURCES PUT INTO IT. SO THE MOTIVATION FOR PRODUCING THIS STRATEGIC PLAN, FOR CEREBRAL PALSY STARTED WITH SOME LANGUAGE IN THE SENATE APPROPRIATION SUBCOMMITTEE REPORT FOR FISCAL YEAR 2016. IN THAT REPORT SUBCOMMITTEE RECOMMENDED OR URGED NIH TO WORK WITH SCIENTIST AND STAKEHOLDERS TO DEVELOP FIVE YEAR STRATEGIC PLAN FOR CEREBRAL PALSY PREVENTION TREATMENT CURE FOR THE LIFE SPAN WITH THE GOAL OF REDUCING THE NUMBER OF PEOPLE IMPACTED BY CP OTHERALL. IMPROVE OPPORTUNITY FOR RECOVERY IN THOSE ALREADY DIAGNOSED. THE -- THIS LANGUAGE DIDN'T MAKE IT INTO THE FINAL SENATE REPORT. OR THE SUBCOMMITTEE REPORT. BUT SIGNAL TO NIH THAT CONGRESS IS INTERESTED AND WATCHING WHAT NIH WAS DOING AROUND CEREBRAL PALSY RESEARCH. WE TOOK THE MESSAGE THE HEART AND BEGAN AT THAT POINT IN TIME TO UNDERTAKE PLANNING TO DEVELOP THE STRATEGIC PLAN. TO GATHER INFORMATION FOR THE STRATEGIC PLAN, NINDS AND NICHD WORKED TOGETHER TO HOLD TWO WORKSHOPS. FIRST WORKSHOP WAS IN 2014 IN NOVEMBER OF 2014. IT WAS FOCUSED ON CLINICAL SCIENCE, AROUND CEREBRAL PALSY AND TREATMENT DECISIONS FOR CP. THE SECOND WORKSHOP OCCURRED ABOUT A YEAR AGO AND FOCUSED ON BASIC AND TRANSLATIONAL RESEARCH IN CEREBRAL PALSY. NINDS AND NICHD PARTNERED WITH AMERICAN ACADEMY OF CEREBRAL PALSY AND DEVELOPMENTAL MEDICINE, THE CP FOUNDATION IN ETCH RADIOING FOR THE STARS, IN ORGANIZING AND SPONSORING THESE WORKSHOPS. IT'S INTERESTING TO NOTE FIRST WORKSHOP IN 2014 IS ONE THAT WAS PLANNED WHEN THE SENATE REPORT LANGUAGE WAS MADE PUBLIC SO WE DECIDED TO LEVERAGE THE OUTCOMES OF THAT PARTICULAR WORKSHOP TOEN FORM STRATEGIC PLAN. THERE ARE THREE PRIORITY AREAS IDENTIFIED DURING THE COURSE OF INFORMATION GATHERING PROCESS. THE FIRST PRIORITY AREA WAS BASIC AND TRANSLATIONAL RESEARCH. THERE WERE FOUR GLOBAL TYPES OF RECOMMENDATIONS THAT WERE PUT FORWARD FROM THIS AROUND THIS PARTICULAR PRIORITY AREA. THE FIRST GLOBAL AREA THAT WAS FELT TO BE NEEDING ATTENTION WAS TO ENHANCE UNDERSTANDING OF THE FUNDAMENTAL MECHANISMS OF THE DEVELOPING BRAIN, SPINE, MUSCLE AXIS. WITHIN THIS PARTICULAR CONTEXT, SOME SPECIFIC RECOMMENDATIONS WERE TO CREATE AND EVALUATE ANIMAL MODELS. TO STUDY THE COMPLEX DYNAMIC CREATED WHEN ENVIRONMENTAL PERTURBATIONS IMPINGE ON THE DEVELOPING NERVOUS SYSTEM. AND TO FURTHER ELUCIDATE THE CELLULAR MOLECULAR PATHWAYS OF INJURY AND REPAIR. IT WAS ALSO FELT THERE WAS INTEREST IN CELL BASED SORTS OF THERAPIES, BUT STUDIES BEING DONE WERE NOT DONE IN A RIGOROUS WAY AND ONE OF THE RECOMMENDATIONS WAS TO ACTUALLY IMPROVE THE RIGOR AND UNDERSTAND MORE ABOUT THE MECHANISMS CELL BASED THERAPIES WERE HAVING IN MODELS FOR CEREBRAL PALSY AND DEVELOPMENTAL DISORDER. AND FINALLY, THERE NEEDED TO BE INCREASED EMPHASIS ON MATERNAL FACTORS ESPECIALLY PLACENTAL FUNCTION HOW THAT MIGHT BE ASSOCIATED WITH CEREBRAL PALSY AND IMPACT THE DEVELOPMENT OF CP. THE NEXT MAJOR OVERARCHING THEME FROM THE WORKING GROUPS AND THE WORKSHOPS WERE TO INTEGRATE STATE-OF-THE-ART IMAGING THROUGHOUT THE STUDY OF CEREBRAL PALSY. IN THIS PARTICULAR INSTANCE THERE WERE THREE SPECIFIC RECOMMENDATIONS MADE. ONE WAS TO BROADEN THE APPLICATION, OF IMAGING TECHNIQUES TO STUDY AT RISK FETUSES, INFANTS AND AFFECTED CHILDREN, THE SECOND WAS TO DEVELOP NEW TECHNOLOGIES TO IMAGE THE FETAL BRAIN IN UTERO AS WELL AS THE PERINATAL BRAIN. AND TO USE THAT INFORMATION TO PERHAPS REALLY DIAGNOSE CHILDREN THAT MIGHT BE AFFECTED WITH CP EARLIER. TO IMAGE IF POSSIBLE PLACENTAL FUNCTION. THIS IS AN AREA THAT HAZEN BEEN INVESTIGATED OR WORKED IN A LOT LATELY. THEN ENCORP RATE IMAGING BASIC AND CLINICAL SORTS OF STUDIES. WHICH REALLY HASN'T BEEN DONE A LOT. THE FOURTH -- SORRY, THE THIRD MAJOR THEME FROM IN THIS PARTICULAR PRIORITY AREA WAS TO CLARIFY MECHANISMS AND ESTABLISH BIOMARKERS FOR CEREBRAL PALSY. IT WAS FELT THERE NEEDED TO BE ADDITIONAL INVESTIGATIONS INTO THE MECHANISTIC BASIS OF GENETIC STRUCTURAL AND FUNCTIONAL FACTORS THAT DRIVE BOTH IMPAIRMENT AND RECOVERY FROM CP. TO UNDERSTAND HOW INJURIES UNDERLYING CP LED TO HYDROCEPHALUS AND DEVELOP BIOMARKER WITH CAPABILITY TO IMPROVE DIAGNOSIS EXPLAIN HETEROGENEITY AN IMPROVE TREATMENT OUTCOMES. THE HETEROGENEITY IN CEREBRAL PALSY IS PROMINENT AND HAS A WAY OF INSIDIOUSLY AFFECTING CLINICAL TRIALS. IF WE DON'T HAVE A GOOD WAY TO ASSESS THAT HETEROGENEITY, WE'RE NOT GOING TO BE ABLE TO HAVE ADEQUATE CLINICAL TRIALS AROUND CP TREATMENTS. FINALLY THERE WAS A NEED TO UNDERSTAND AND UTILIZE NEUROPLASTICITY IN CP IN A MORE EFFICIENT AND INFORMED WAY. SPECIFICALLY AT CRITICAL PERIODS FOR BRAIN AND MANY FOR SYSTEM AND HOW THAT TRANSLATES INTO CLINICAL APPLICATIONS AND PULL NEURAL PLASTICITY PROMOTING INTERVENTIONS FROM OTHER FIELDS INTO THE CEREBRAL PALSY FIELD AND ALSO TO UNDERSTAND MORE ABOUT THE BIOLOGY OF THE RESILIENT PHENOTYPE OR NCP. THE SECOND PRIORITY AREA WHICH AROSE OUT OF THE THE CLINICAL RESEARCH AND TREATMENT WORKSHOP WAS AROUND CLINICAL RESEARCHERS MIGHT BE EXPECTED. IN THE FIRST OVERARCHING THEME THAT WAS PROMINENTLY MENTIONED WAS THAT WE NEEDED TO CONSIDER THE ENTIRE LIFE SPAN WHEN TALKING ABOUT CEREBRAL PALSY. IT WAS THOUGHT THAT THERE WAS A LOT OF ATTENTION BEING PLACED EARLY IN UNDERSTANDING THE ONSET AND DEVELOPMENT OF CEREBRAL PALSY. BUT THERE WASN'T ENOUGH CONSIDERATION GIVEN TO ADULTS WITH CEREBRAL PALSY SO YOU CAN SEE SPECIFIC RECOMMENDATIONS HERE AND I WANT TO PARTICULARLY HIGHLIGHT THE THIRD BULLET AROUND DEVELOPING REHABILITATIVE STRATEGIES THAT ENHANCE BENEFICIAL NEUROPLASTITY. THIS IS SOMETHING MANY IN THE FIELD BELIEVE HAS ENORMOUS POTENTIAL FOR HELPING PEOPLE WITH CEREBRAL PALSY AND SOMETHING THAT WE NEED TO EMPHASIZE GOING FORWARD. THE SECOND MAJOR THEME WAS AROUND ENHANCING TREATMENT OPTIONS, AND RIGHT NOW EVERYBODY IS LOOKING AT TREATMENTS FOR CP IN SORT OF SINGLE MODALITY TYPES OF STRATEGIES AND SOME INVESTIGATORS FEEL THAT WE NEED TO COMBINE THERAPEUTAE THERAPIES AN TARGET PATHWAYS IN A MORE INTEGRATED DYNAMIC WAY. THERE ALSO NEEDS TO BE AN ACCELERATION OF BENCH TO BEDSIDE TRANSITION AND THERE NEEDS TO BE WAYS TO INCENTIVIZE SPECIFICALLY IN THE CONTEXT OF SBIR TYPE APPLICATIONS. SO BUSINESSES WERE ENGAGED WITH PRODUCTS FORWARD, MORE MORE RAPIDLY. THE THIRD THEME WAS TO TAKE A CLOSER LOOK AT THE STUDY DESIGNS FOR CLINICAL TRIALS IN THE FIELD OR CEREBRAL PALSY AND HERE SPECIFICALLY IT WAS TALKED ABOUT INTEGRATING INNOVATIVE STUDY DESIGNS TO COMPLIMENT RANDOMIZED CLINICAL TRIALS IN COMPARATIVE EFFECTIVENESS RESEARCH. THIS WAS A MAJOR THEME AND ONE THAT MANY INFORMED STRATEGIC PLANNING PROCESS FELT WAS CRITICALLY IMPORTANT. THERE ALSO WAS FEEDBACK THAT SUGGESTED WE NEEDED TO MAXIMIZE THE POTENTIAL FOR EXISTING DATABASES AND REGISTRIES, THESE WERE FELT TO BE UNDERUTILIZED. BUT PART OF THAT UNDERUTILIZATION WAS DUE TO THE FACT THAT PATIENT REGISTRIES AND DATABASE WERE BROKEN UP, IF THERE WAS CONSOLIDATION OF THAT INFORMATION, THE IMPACT MIGHT BE BENEFICIAL TO THE RESEARCH COMMUNITY. FINALLY IT WAS MENTIONED THERE NEEDED TO BE BETTER DATA METRICS DEVELOPED WITH CEREBRAL PALSY, THE DEVELOPMENT OF COMMON DATA ELEMENTS AND TO INCREASE QUALITY AND AVAILABILITY WITH PATIENT REPORTED OUTCOMES. THIRD AREA WAS WORK FORCE DEVELOPMENT, A THEME YOU HEARD A LITTLE BIT BEFORE. AND THAT THERE NEEDS TO BE ENHANCED TRAINING OF NEXT GENERATION INVESTIGATORS. WE NEED TO FIND WAYS TO ATTRACT NEW INVESTIGATORS TO THE FIELD OF CEREBRAL FALLACY RESEARCH AND CLINICAL CARE AND WE NEED TO LEVERAGE EXPERTISE ACROSS SPECIALTIES. SO BRING IN BIOENGINEER, BRING IN COMPUTATIONAL SCIENTIST, TO INFORM THE CEREBRAL PALSY FIELD OF NEW WAYS TO THINK ABOUT TREATMENTS IN RESEARCH IN THIS PARTICULAR AREA. NOW, THE FIELD OF CEREBRAL PALSY HAS ADVANCED SINCE THE FIRST WORKSHOP AND A NUMBER OF ACCOMPLISHMENTS HAVE OCCURRED SINCE THE FIRST CEREBRAL PALSY WORKSHOP. THIS SLIDE HIGHLIGHTS THREE OF THOSE THINGS. THE FIRST OF WHICH WAS THE ESTABLISHMENT OF THE CEREBRAL PALSY RESEARCH NETWORK. WHICH WAS WHICH ADDRESS THE NEED OF MAXIMIZING POTENTIAL DATABASES AND REGISTRIES. THIS IS HEADED BY PAUL GROSS, FORMER NINDS COUNSELOR WHO IS IN THE AUDIENCE TODAY. AND THIS IS AN ACTIVITY THAT PAUL IS TAKEN TO HEART AND GOTTEN OFF THE GROUND IN A GREAT WAY. NINDS IS WORKED WITH THE AMERICAN ACADEMY OF CEREBRAL PALSY AND DEVELOP MENTAL MEDICINE TO DEVELOP AND PUBLISH CP COMMON DATA ELEMENTS AND YOU CAN FIND THOSE ON THE NINDS WEBSITE. TO ADDRESS THE NEEDS OF FAMILIES WITH NEWLY DIAGNOSED CP INDIVIDUALS WITH CP, CP TOOL KIT HAS BEEN DEVELOPED BY THE CP NOW FOUNDATION TO GUIDE PEOPLE TO RESOURCES WHERE THEY CAN GAIN A BETTER UNDERSTANDING OF WHAT CP IS AND HOW THEIR CHILD IS GOING TO BE AFFECTED BY CP. SO WHAT IS OUR STRATEGY AND PLAN FOR MOVING FORWARD WITH THIS STRATEGIC PLAN? SO WE'RE GOING TO GET ADDITIONAL INPUT FROM THE SPONSORS OF THE WORKSHOP AND ORGANIZE RECOGNIZERS AND -- ORGANIZE RECOGNIZERS. WE'RE GOING -- ORGANIZEERS. AND INVITE PUBLIC COMMENT FROM THE -- WHERE EVERY INCLUDING PARTICIPANTS TO REVISE AND FINALIZE THE PLAN AND SHARE THAT WITH STAKEHOLDERS. WE'LL DEVELOP RESEARCH INITIATIVES TO FILL KNOWLEDGE GAPS AROUND CP RESEARCH IN CLINICAL CARE. AND WILL BRING FINALIZED PLAN BACK TO COUNCIL ALONG WITH PROPOSAL FOR INITIATIVES FOR YOUR APPROVAL SOMEWHERE DOWN THE ROAD AT A FUTURE MEETING. SO I WILL THROW IT OPEN FOR DISCUSSION. OFFER A COUPLE OF TANTALIZING SUGGESTIONS FOR THAT DISCUSSION THAT WOULD BE INFORMATIVE TO US. THOSE INCLUDE DOES THE DRAFT STRATEGIC PLAN ACTUALLY ADDRESS RESEARCH OPPORTUNITIES THAT REFLECT THE CRITICAL NEEDS OF UNDERSTANDING CP AND IMPROVING CLINICAL CARE? ARE WE FOCUSED ON THE RIGHT AREAS OR DO NEW THINGS NEED TO BE BROUGHT IN TO THE STRATEGIC PLAN THAT WE HAVEN'T THOUGHT ABOUT? AND DO YOU HAVE ANY RECOMMENDATIONS FOR AREAS TO PRIORITIZE AROUND CP RESEARCH AND CLINICAL CARE? SO THANK YOU FOR YOUR ATTENTION. I'M HAPPY TO TAKE ANY QUESTIONS IF THERE ARE ANY. I LOOK FORWARD TO THE DISCUSSION. THANK YOU. >> SO I WAS INTERESTED IN YOUR COMMENT AROUND REHABILITATIVE STRATEGIES PARTICULARLY AS IT RELATES TO COGNITIVE MANAGEMENT. IS THERE A VISION IN THE PLAN TO CONNECT WITH OTHER DISEASE INDICATIONS WHERE THERE'S A LOT OF -- THERE'S EMERGING -- OTHER AREAS THAT ARE OPPORTUNITIES FOR CROSS SECTOR COLLABORATION? I WAS WONDERING IF THAT'S A VISION WITHIN THIS? >> I THINK THAT'S SOMETHING THAT WE NEED TO EXPLORE IN A GREATER WAY THAT WE HAVEN'T DONE UP TO THIS PARTICULAR POINT IN TIME. I THINK OUR COLLEAGUE AT NICHD AND US ARE AWARE OF THOSE ACTIVITIES, WE HAVEN'T REALLY BROUGHT THEM TO BARE ON THE STRATEGIC PLAN YET AND THAT'S SOMETHING WE CAN CERTAINLY DO IN THE FUTURE. THAT IS A GOOD RECOMMENDATION. >> IS THERE SOMETHING SPECIFIC THAT WE SHOULD HAVE ON THE RADAR SCREEN IN >> >> THE WORK JOHN IS DOING AT KESSLER AND GROUPS IN EUROPE ARE FOCUSING ON THAT IN AN INTENSIVE WAY, THERE MAYBE LEARNINGS, OBVIOUSLY IT'S NOT TOTAL POPULATION BUT THERE MAYBE LEARNINGS THAT CAN BE BROUGHT OVER AND THEY'RE SPENDING TIME TRAINING PEOPLE. SO I THINK THAT YOU COULD HAVE A NUCLEUS OF PEOPLE TO REALLY DRAW ON SOME EXPERIENCE. >> I'M HAPPY TO CONNECT YOU IF YOU WOULD LIKE. >> GREAT. >> >> JIM, I WANTED TO ASK A LITTLE BIT HOW YOU GO ABOUT COORDINATING THE STRATEGIC PLAN AMONG DIFFERENT INSTITUTES THAT REALLY HAVE AN INTEREST IN STAKEHOLDERS IN THIS DISEASE SPECIFICALLY NOW THAT YOU ARE DEFINING IT MORE BROADLY OR PATENTING IT MORE BROADLY, NOT JUST AT THE DEVELOPMENT AND NEUROSCIENCE ASPECT. BUT THE HOLISTIC APPROACH. HOW DO YOU BRING THOSE DIFFERENT INSTITUTES TOGETHER IN TO THE STRATEGIC PLAN? >> SO WHAT WE HAVE DONE UP TO THIS PARTICULAR POINT IN TIME SYSTEM USED OUR IS USED LOCAL CONTACTS TO REACH TO OTHER INSTITUTES THAT MIGHT BE INTERESTED. WE ALSO LOOK AT WHO IS FUNDING THE PREDOCUMENT INNOCENCE OF RESEARCH AND CLINICAL CARE IN THIS PARTICULAR AREA AND BRING THEM ON BOARD AND ESTABLISH A WORKING GROUP SO THEY'RE AT THE TABLE AS WE GO FORWARD AND IT'S SOMETHING WE WILL CONTINUE TO DO AS WE FINALIZE THE STRATEGIC PLAN AND PROCESS AND PUT SOME INITIATIVES IN PLACE AROUND THIS EFFORT. SO WE'LL LOOK AT FOR EXAMPLE, HEART LUNG AND BLOOD HASN'T BEEN PART OF THIS PROCESS YET BUT THEY HAVE A PERINATAL STROKE INITIATIVE OUT THERE AND MAYBE THERE'S SOMEBODY WE NEED TO BRING TO THE TABLE AT THIS PARTICULAR POINT, THAT'S CERTAINLY SOMETHING WE WILL DO GOING FORWARD. >> NICHD CHILD HEALTH HAS THE NATIONAL CENTER FOR MEDICAL REHAB RESEARCH. SO THEY ARE ACTUALLY NOT JUST CHILD DEVELOPMENT BUT ALSO THE REHAB. >> JUST TO FOLLOW-UP ON THESE QUESTIONS, THIS IS AN ISSUE FOR ALL THESE TRANS-NIH INITIATIVES WHETHER NEUROFIBROMATOSIS OR GENES SPREAD AMONG INSTITUTES. SO AS JIM SAID, USUALLY AFTER WE GET THE RECOMMENDATIONS AND USUALLY BEFORE, TRANS-NIH WORKING GROUP, INITIATIVES, WORKSHOPS THINK WHAT INSTITUTE MIGHT FUND WHAT. SO THERE COULD BE ISOLATED INITIATIVES FROM ONE INSTITUTE, THERE COULD BE ONE WHICH DIFFERENT INSTITUTES HAVE DIFFERENT THINGS, THERE COULD BE NO INITIATIVE AT ALL AND MORE FOLLOW-UP DISCUSSION. SO IT'S A GOOD QUESTION WE FACE FOR ANY DISEASE THAT AFFECTS MULTIPLE INSTITUTES. >> ALONG THE SAME LINES, ANOTHER OPPORTUNITY FOR PARTNERING WOULD SEEM TO BE WITH THE BRAIN INITIATIVE ACTIVITIES PARTICULARLY RELATED TO IMAGING AND I THINK IMAGING IS THE KEY BIOMARKER OBVIOUSLY AND BOTH CURRENT AND POTENTIALLY INNOVATIVE TECHNIQUES THAT MAKE OUT OF BRAIN INITIATIVE COULD BE USEFUL HERE TO TRY TO STRATIFY THE POPULATION AS WELL AS TO LOOK FOR BIOMARKERS. >> I THINK THAT'S SOMETHING WE HAVE TALKED ABOUT ALREADY. AND THAT IS THE TIP OF THE ICEBERG. THERE'S THE HUMAN PLACENTA -- SORRY, THE HUMAN PLACENTA PROJECT BEING FUNDED OUT OF NICHD, WILL HOPEFULLY PULL INVESTIGATORS FROM THAT INTO OUR STRATEGIC THINKING AND PLANNING PROCESS. AND ALSO THERE'S THE HUMAN CONNECTOME PROJECT AND SO IF WE CAN ATTRACT SOME INDIVIDUALS FROM THAT GROUP INTO THE CP PLANNING PROCESS, THAT WOULD LEVERAGE SOME OF THEIR EXPERTISE AND BRING IT TO BEAR HERE AS WELL. SO WE HAVE THOUGHT ABOUT SOME OF THESE TRANS-NIH ACTIVITIES THAT ARE ONGOING AND HOW WE CAN MAKE USE OF THEM AS WELL. BUT IT'S GOOD POINT. >> MEMBER EMERITUS, PAUL GROSS. >> IS THIS WORK SOMETHING DOESN'T SOUND LIKE IT IS. >> BOB GOV ME EMERITUS PERMISSION SO I'LL LAKE MAKE A COMMENT, I STARTED TO MAKE THIS COMMENT TO YOU IN MAIL JIM BUT IT'S WORTHWHILE. SO FIRST I THINK THIS IS GREAT, I'M GLAD TO SEE THE ENERGY AROUND IT. AND THE CONCLUSIONS DRAWN. I THINK A WORKING GROUP IS A GREAT START. ONE THING I OBSERVED AND TALKED TO PEOPLE FROM THE DOWN'S SYNDROME SPACE IS THEY ALSO MADE A PUBLIC PRIVATE CONSORTIUM. I WOULD REALLY RECOMMEND THAT AS A WAY TREMENDOUS ENERGY AFTER THE FIRST CLINICAL MEETING AND THERE WAS A LOT OF THE WORK THAT YOU POINTED TO THAT HAPPENED AS AN OUTCOME OF THAT. I THINK THE FIELD NEEDS MORE HELP IN BRIDGING FOR THAT TRANSLATIONAL AND THAT ACCELERATION WITH THE BASIC TRANSLATIONAL WORK THAT YOU EAR RECOMMENDING. SO I WOULD ENCOURAGE YOU TO LOOK AT WAYS TO PULL THE FIELD TOGETHER BECAUSE AROUND WHAT'S HAPPENING IN AUSTRALIA, THAT DOES THAT IS VERY GOOD AND IT CAN BE EFFECTIVE HERE AND WE CAN REALLY INCREASE THE PACE OF THINGS. >> THANKS, PAUL. >> I WAS GOING TO SAY INASMUCH AS EARLY IDENTIFICATION AS POTENTIAL TO IMPROVE CLINICAL OUTCOMES IN THIS AN CERTAINLY PRIMARY CARE DOCS THAT'S REALLY BIG ISSUE JUST IDENTIFICATION, MOST NOT BEING IDENTIFIED BEFORE AGE TWO, IN THESE STRATEGIC TYPE PLANS, OBVIOUSLY A PLAN TO TRANSLATE KNOWLEDGE AS IT ACCRUES IS ALSO A BIG PART IN MY VIEW. >> I'M A RESEARCHER HERE AT NIH AND INTRAMURAL, I HAVE BEEN DONE CPV RESEARCH FOR 25ERS I DON'T RECOLLECT WAS INVOLVED WITH -- VERY INVOLVED IN DESIGNING THESE MEETINGS. WE HAD INCREDIBLE MEETINGS. BUT JUST TO PUT A MORE EMOTIONAL FACE OR MORE EXCITING FACE OF WHAT'S HAPPENED, WHEN I WAS DOING CEREBRAL RESEARCH EARLY ON WE WERE FUNDED BY NCMRR BECAUSE WE COULDN'T -- WE HAD TO USE CHILDREN WITH THE BRAIN LESION AND HAD TO TRY TO MAKE THEIR LIVES BEAR. -- BETTER. THINGS CHANGED TREMENDOUSLY. IT WENT TO WHEN I WAS EXTRAMURAL WORLD, IT STARTED COMING IN TO NINDS BECAUSE THINKING DEVELOPMENTAL NEUROSCIENCE, THE BRAIN INITIATIVE, THIS IS WHAT WE NEED NOW. WHAT IS REALLY HAPPENED IN CP IS TREMENDOUS, WE NOW HAVE THINGS LIKE COOLING AND MAGNESIUM SUM FATE TO REDUCE THE MORTALITY MORBIDITY OF THIS PROBLEM AND MAKE IT LESS SEVERE. WE HAVE LEARNED A LOT ABOUT PERINATAL BRAIN INJURY, THERE IS BEAUTIFUL WORK BY JACK MARTIN AND OTHERS WHERE WHAT WE KNOW NOW WE'RE TRYING TO FIND CRITICAL PERIODS FOR DEVELOPMENT OF MOTOR PROBLEMS, IF YOU DON'T GET IN THERE BEFORE THREE TO SIX MONTHS AND GET SPINAL INNER NEURONS YOU DON'T HAVE A CHANCE FOR RECOVERY BUT IF YOU DO, IN KITTEN MODELS YOU CAN RECOVER BRAIN INJURY, THESE ARE TREMENDOUS FINDINGS. WHAT WE NEED INSTEAD OF CLINICAL RESEARCHERS WE NEED THE START PARTNERING WITH THE NEUROSCIENTISTS. AND SO THIS IS WHAT THE TRANSLATIONAL WORKSHOP WAS TRYING TO DO. I MEAN, I REALLY THINK THIS IS A HUGE ROLE FOR NINDS. YEARS AGO WHEN I WAS PRESIDENT OF THE AMERICAN ACADEMY OF CP, I WAS THE ONE THAT GATHERED GROUP ADVOCACY GROUPS TOGETHER. WE WERE THE ONES THAT YOU ARE THE STAYED GOING TO CONGRESS AND SAYING AUTISM IS GETTING ALL THIS MONEY, WE -- CEREBRAL PALSY IS -- IT STARTS AT BIRTH AND AFFECTS PEOPLE, THEY HAVE NORMAL LIFE SPANS, IT'S FOR DECADES, WE REALLY NEED TO LOOK AT THIS AND DEVELOP MORE NEUROSCIENCE ACTUALLY PRETTY SEXY, PEOPLE WERE INTERESTED IN IT AND IF WE CAN GET THOSE PEOPLE TOGETHER TALKING WITH CP, I THINK IT WOULD BE TREMENDOUS. SO I REALLY WANT TO ENCOURAGE NINDS TO REALLY JUMP ON THIS AND WITH A LOT OF ENTHUSIASM BECAUSE I THINK IT COULD MAKE A HUGE IMPACT. >> OKAY. WE'LL TAKE A BREAK IT'S A PLEASURE TO INTRODUCE PATTY BRENNON, DIRECTOR NATIONAL LIBRARY OF MEDICINE. SO I TALKED TO HER GROUP LAST NIGHT. NIGHT BEFORE. SO NOW I WILL GET BACK AT HER FOR INTRODUCING ME. SO PATTY IS DIRECTOR OF THE NLM, THE WORLD'S LARGEST BIOMEDICAL LIBRARY AND PRODUCER OF DIGITAL INFORMATION SERVICES. WE ALL LIVE BY THOSE SERVICES EVERY DAY. I DON'T KNOW HOW WE CAN MANAGE WITHOUT THEM. PEOPLE WHO ARE OLD ENOUGH TO REMEMBER INDEX MEDICUS GOING INTO DEPTHS OF LIBRARIES, IF YOU'RE ALLERGIC TO DUST THAT WAS A BIG PROBLEM. SO -- IN JANUARY OF 2017 WITH TRANSITION OF THE NIH SCIENCE INITIATIVES AND NLM, DR. BRENNAN ASSUMED THE ROLE OF THE NIH INTERIM ASSOCIATE DIRECTOR FOR DATA SCIENCE. SO YOU CAN SEE DATA SCIENCE NATIONAL LIBRARY OF MEDICINE AND FOR PEOPLE WHO ARE ATTUNE TO THE ISSUES OF HOW DATA IS CHANGING OUR LIVES IN SCIENCE CAN UNDERSTAND WHAT A GREAT ROLE SHE'S GOING TO PLAY AND HOW NIH DEALS WITH THIS MAKING THE MOST OF THE DATA THAT THE GOVERNMENT FUNDS RESEARCHERS TO ACQUIRE. SO DR. BRENNAN CAME TO NIH FROM UNIVERSITY OF WISCONSIN MADISON WHERE SHE WAS PROFESSOR AT THE SCHOOL OF NURSING AND COLLEGE OF ENGINEERING. SHE LED THE LIVING ENVIRONMENTS LABORATORY AT THE WISCONSIN INSTITUTE OR DISCOVERY. DEVELOPED NEW WAYS TO EFFECTIVELY VISUALIZE HIGH DIMENSIONAL DATA. WORK SPAN APPLICATION OF GAME THEORY TO THE DEVELOPMENT OF HEALTH INFORMATION EXCHANGES. THE ALIGNMENT OF CLINICAL INFORMATION SYSTEMS WE MER GENT AND EXTANT PROFESSIONAL PRACTICE MODELS AND THE EVOLUTION OF SPECIAL'SED COMPUTER TOOLS TO SUPPORT SELF-MANAGEMENT AND SELF-CARE IN THE HOME. SPECIALIZED COMPUTER SELF-MANAGEMENT IN THE HOME. EDUCATIONAL HISTORY, MASTER OF SCIENCE IN NURSING FROM U PENN AND Ph.D. IN INDUSTRIAL ENGINEERING FROM THE UNIVERSITY OF WISCONSIN MADISON. FOLLOWING SEVEN YEARS OF CLINICAL PRACTICE AND CRITICAL CARE NURSING PSYCHIATRIC NURSING, SHE WENT ON TO SEVERAL ACADEMIC POSITIONS IN THE BIOINFORMATICS SPACE IN MARKET, MILWAUKEE, CASE WESTERN, CLEVELAND AND UNIVERSITY OF WISCONSIN MADISON. SHE'S PAST PRESIDENT OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION, SHE'S ELECTED TO INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES, IN 2001. SHE'S A FOLLOW OF THE AMERICAN ACADEMY OF NURSING, THE AMERICAN COLLEGE OF MEDICAL INFORMATICS AND NEW YORK ACADEMY OF MEDICINE. PATTY, WE'RE WAITING WITH BAITED BREATH TO HEAR FROM THE NATIONAL LIBRARY OF MEDICINE IS GOING THE NEXT CENTURY. >> THANKS SO MUCH, WALLER. GOOD MORNING, THANK YOU FOR THE OPPORTUNITY TO SPEAK TO THIS GROUP. DATA SCIENCE AT NIH IS A MOVING TARGET, I'M GOING TO SPEAK TO YOU TODAY ABOUT WHAT I UNDERSTAND TODAY. IT MAYBE DIFFERENT IN 30 HOURS. BUT WE THINK THE SUBSTRATE IS GOING FORWARD AND WE'RE OPTIMISTIC ABOUT THIS. IT'S NO SECRET DATA ARE THE SUBSTRATE OF KNOWLEDGE. AND THE PURPOSE OF THE TALK IS TO INTRODUCE YOU TO NATIONAL LIBRARY OF MEDICINE AS FUTURE BEACON IN DRIVING THE DATA SCIENCE INITIATIVES HERE AT NIH. IS THE REASON WE OTHER DOING THIS AND TAKING A LOOK AT THESE OPPORTUNITIES, LOOKING AT CHALLENGING OF ENORMOUS DATA SETS AND TRYING TO CHART DIRECTION IS WE WANT TO ACCELERATE DISCOVERY. THIS IS A BIT OF A GAMBLE. WE HAVE BEEN KNOWN HOW TO ACCELERATE DISCOVERY IN MORE TRADITIONAL MEANS NOW WE'RE MOVING TO A NEW AREA. THE BIG DATA TO KNOWLEDGE BD 2K INITIATIVE ACTIVE HERE AT NIH FOR FIVE YEARS REMAINS VIBRANT AS EXTRAMURAL PROGRAM, WE HAVE 12 CENTERS IN THE COUNTRY, WE HAVE A NEW FOA RELEASING FUNDING THIS WEEK FOR CURE RATION INITIATIVES AND WE HAVE TRAINING PROGRAMS GOING ON. YET AT THE SAME TIME WE ARE IN THE PROCESS OF PIVOTING TOWARDS THE FUTURE. YOU WILL BE HEARING ME REFLECT AND GET YOUR GUIDANCE HOW AT THE GNASH LIBRARY OF MEDICINE HELP LEVERAGE WHAT WE LEARNED FROM BD 2K AND MOVE ACTIVITY FORWARD. INWANT TO SPEAK FOR 20 MINUTES AS I HEAR YOUR THOUGHTS AS I MOVEN TO THIS AREA OF MY WORK, THE INTERIM ADS FOR ABOUT A MONTH AND I HAVE BEEN AT NIH FOR ABOUT FIVE MONTH SO I'M FAIRLY NEW TO THE WHOLE PROCESS HERE. I'M NOT NEW TO THE PROCESS OF DISCOEVER I. SO I WANT YOU TO THINK WITH ME A FEW MINUTES WHERE DISCOVERIES ORIGINATE FROM. WHAT LEADS TO SCIENTIFIC DISCOVERY AND PARTICULARLY DISCOVERY IN THE SERVICE OF BIOMEDICINE AND PATIENT CARE. EARLY ON DISCOVERIES EMERGE FROM THE EXPERIENCE OF SKILLED CLINICIANS WHO TOUCH A PATIENT, SEE A PERSON'S RESPONSE TO A PARTICULAR MEDICATION, WATCH HOW AN INDIVIDUAL SPOKE OR TALK AND USE THAT AS A WAY TO UNDERSTAND THE PHENOMENON AND MAKE INTUITIVE BUT EDUCATED GUESSES EXPERIENCE GUESSES WHAT TO DO ABOUT THAT INDIVIDUAL, WHAT TO DO FOR THE CARE AND BEGIN TO GROW A BODY OF KNOWLEDGE, IF YOU HAVE THE OPPORTUNITY I INVITE YOU TO VISIT OUR NATIONAL LIBRARY OF MEDICINE HISTORICAL COLLECTION, WE HOLD PRECIOUS MANUSCRIPTS FROM 10TH, 11th CENTURY ARABIC SCHOLARS WHO TALKED MEDICINE AS LEARNED THROUGH EXPERIENCE BUT OVER TIME WE BEGIN TO VALUE EXPERIMENTATION AS A WAY OF DISCOVERY, EXPERIMENTATION BROUGHT WITH IT THE IDEA THAT WE COULD BE MORE PRECISE, WE NEEDED TO LABEL OBJECTS AND IDEAS IN A MORE SPECIFIC FASHION AND WE CAN CONTROL THE CONTEXT OF LEARNING SO THAT WE CAN LEARN FROM EXPERIMENTING. IN THE LATE 40s TO EARLY '60s WE SAW A RISE OF EXPERIMENTATION BY COMPUTATION, MASSIVE COMPUTERS NOT DESIGNED TO ASSIST AND DISCOVER BUT MOVE SPREADSHEETS AND TABLES BECAME FUNDAMENTAL PATHWAY FOR DISCOVERY, DR. NEURON BERG'S VALIDATION OF THE ORIGINAL DNA SEQUENCE. COMPUTATION IS A FORCE FOR DISCOVERY IS NOT NEW. WHAT IS NEW IS THE MASSIVE AMOUNT OF DATA EMERGING THROUGH COMPUTATION. THE MASSIVE AMOUNTS OF UNDERSTANDING OF THE ENVIRONMENT WE'RE SITTING IN RIGHT NOW OF WHERE YOU HAD YOUR COFFEE THIS MORNING, DIFFERENT MUSCLES THAT GET ACTIVATED A Z YOU SHIFT IN YOUR CHAIR, THE GENES RUNNING THROUGH YOUR BODY, THE DATA DRIVEN DISCOVERIES UPON US ARE LEADING US TO A BRAND NEW ERA BUT STILL ERA OF DISCOVERY AND STILL FOR THE PURPOSES OF NIH DRIVEN FOR THE DISCOVERY AND SERVICE OF HUMAN HEALTH. I WANT TO TAKE YOU BACK TO YOUR CLINICAL THINKING THOSE WHO ARE CLINICIANS, TO A FAMILIAR PROBLEM TO THOSE TO THINK ABOUT THE CLINICAL PROBLEM OF ALZHEIMER'S DISEASE. THE CRITICAL PROBLEM WAS A TARGET OF MY EARLY WORK IN THE '80s WHERE WE TRIED TO USE EMERGING COMPUTER NETWORKS TO SUPPORT THE CAREGIVERS AT ALZHEIMERS DISEASE, THE PART TO SPEAK WITH YOU ABOUT TODAY IS FUNDAMENTAL PATHOLOGY OF ALZHEIMER'S DISEASE, NOTED IN PATIENTS BY DR. ALZHEIMER'S BUT BEFORE THAT DEMENTIA OR THE IDEA OF ELDERS FORGETTING SOMETIME YOUNG ELDERS FORGETTING OR NOT REMEMBERING WHAT THE PURPOSE OF FAMILIAR OBJECTS WERE OR WHO AN INDIVIDUAL WAS, WAS OBSERVED AND NOTED. EXPERIENCE REVEALED THIS DIMENSION MIGHT BE A CONSEQUENCE RELATED TO SOME KIND OF BRAIN ATROPHY. EXPERIMENTAL STUDIES BEGIN TO THE APO GENE IN THE PROCESS OF COMPUTATIONAL STUDIES REVEAL ABOUT NORMAL FORM OF THOSE GENES HAD CLINICAL SIGNIFICANCE. NOW WE'RE TO 1960s IN ERA OF DISCOVERY, WE COULD HAVE DONE THIS 50 YEARS AGO AND NOT THOUGHT ABOUT BD 2K OR DATA SCIENCE. THINK ABOUT HOW DATA SCIENCE STRATEGIES AND INFORMATION SUBSTRATE DRIVEN BY DATA NOT BY TEXT WILL LEAD TO ACCELERATE DISCOVERY FOR VERY IMPORTANT COMPLEX CLINICAL PROBLEMS, AND WE HOPE THEY VERY IMPORTANT CONFLICTS, STATES OF HEALTH. SO DATA SCIENCE APPROACHES TO ACCELERATE DISCOVERY WITH THE CARE WITH ALZHEIMER'S DISEASE IS A PHENOMENON. MACHINE LEARNING STRATEGIES HIGHLIGHTED THE ROLE OF WHITE MATTER HYPERINTENSITIES AND LONG TERM DEVELOPMENT OF SYMPTOMATOLOGY RELATED TO ALZHEIMER'S. AND DATA DISCOVERY LOCATE DATA SETS THAT LET INVESTIGATORS EXPLORE VISUAL OR CLINICAL FINDINGS THAT INDICATE NEW AREAS OF EXPLORATION. DATA WRANGLING WHICH IS EXACTLY AS IT SOUNDS, PROCESS OF GRABBING TOGETHER LOTS OF DATA NOW LETS US LOOK AT NOT ONLY THE PHYSIOLOGICAL OR ANATOMICAL STRUCTURES THAT LEAD TO ALZHEIMER'S DISEASE BUT THE IMPACT OF LIFESTYLE DIET ACTIVITY AND BEGINNING TO SEW SOME RELATIONSHIPS THAT LIFETIME PHYSICAL ACTIVITIES BEGINNING TO SHOW EVIDENCE THAT IT MITIGATE CHANGES IN WHITE MATTER HYPERINTENSITY THAT MAYBE WAY OF PREVENTING ALWAYS ALZHEIMER'S DISEASE. IF YOU KNEW 30s WOULD PREVENT ALZHEIMERS IN '70s WE CHANGE DEVELOPMENTAL STRATEGIES. HOWEVER MONITORING THAT, MASSIVE STRUCTURES IN THE BRAIN AND PICKING WHICH VOXELS MONITORED AT BUT POINT AND HOW OFTEN IS ITSELF A DATA SCIENCE CHALLENGE AND THE IDEA OF SELECTING ANY SINGLE SPACE AND PROJECTING HOW IT MIGHT CONTRIBUTE TO FUTURE REMAINS DAUNTING BUT INFORMED BY COMPUTATION. STOCHASTIC MODELS RELATED TO BUT NOT THE SAME AS BASIC BIOSTATISTICS AND STATISTICAL MODELS CAN HELP US SELECT THE MOST LIKELY TRAJECTORY OF DISEASE PROCESS FOR THE THOUSANDS OF TRAJECTORIES THAT OCCUR. THE PROCESS OF DATA SCIENCE ADDRESSING AN IMPORTANT SOCIAL AND MEDICAL PROBLEM IN OUR ERA REMAINS OUT OF REACH BUT SEEING HOW TO POSSIBLY GET THERE. THAT'S WHERE THE NATIONAL LIBRARY OF MEDICINE WILL BE PLAYING A SIGNIFICANT ROLE. FUNDAMENTALLY DATA BY ITSELF IS NOT USEFUL BUT DATA THAT IS GOING TO BE THE SUBSTRATE OF DISCOVERY MUST BE FOUND AND FINDABLE SO WE HAVE FOUR PRINCIPLES THAT WE USE WHEN WE THINK ABOUT DATA SCIENCE, DATA SUBSET FOR DISCOVERY, IT MUST BE FINDABLE, ACCESSIBLE, ENTEROPERABLE AND IT MUST BE REUSABLE. THESE ARE THE FAIR PRINCIPLES MAYBE FAMILIAR TO SOME AND NEW TO OTHERS. FINDABLE DATA SET HAS PERSISTENT IDENTIFIER AND RELEVANT METADATA WITH IT. THAT'S SYSTEMATIC CURE RATION BY HUMANS TO MAKE SURE THE DATA ARE WELL DISCOVERED AND INDEX IN A WAY CATALOGED. TO THIS POINT IN TIME WE MADE PROGRESS ON MAKING DATA FINDABLE AS LONG AS THE DATA SET IS STABLE AND UNCHANGING BUT WHEN WE LOOK AT THE DATA SETS IMPORTANT TO HUMAN HEALTH THEY MUST BE AUGMENTED AS A PERSON GROWS THROUGH MATURATION OR MUST BE ATTITUDE BY OTHER SAMPLES. WE THINK HOW TO MOVE THE FINDIBILITY STRUCTURES INTO NOT JUST STABLE DATA SETS BUT SOURCES ON THE FLY. TO BE ACCESSIBLE DATA MUST BE FIRST AND FOREMOST SECURE, IN A PATHWAY TO PROTECT AND PRESERVE SO IT CAN BE REVIEWED. AUTHORIZATION STRATEGIES HAVE TO BE PUT IN PLACE THAT ALLOW FOR THE ONLY ACCESS BY THOSE INDIVIDUALS WHO HAVE RIGHTS TO REVIEW. EVEN IF THE DATA ITSELF DISAPPEARS SO THE REPRODUCIBILITY OF ANY RESEARCH PROCESS CAN BE ENHANCED BY IDENTIFYING WHICH DATA WAS USED FOR THAT STUDY. IMPORTANTLY, ACCESSIBILITY IS NOT GOING TO BE SOLVED SOLELY BY NIH, ACCESSIBILITY IS A INDUSTRY CHALLENGE, ACCESSIBILITY IS A CHALLENGE TO OUR COLLEAGUES, ASTRONOMICAL SCIENCE, PHYSICAL SCIENCE, SO WE'RE LOOKING TO A FUTURE WHERE PUBLIC PRIVATE SOLUTIONS BECOME PART OF OUR EVERY DAY REALITY. INTERON PROGRAM MEANS DATA NAMED IN ONE COMMUNITY ARE UNDERSTANDABLE BY ANOTHER COMMUNITY. POTATO IS POETY TOE AND NOT POTATO BUT BECOMES COMPLEX WHEN TALKING VOXELS. WHERE THE DATA SET ITSELF IS A POINT AND IT HAS NO DIRECT MAPPING TO A PHYSICAL REPRESENTATION SO INTEROPERABILITY REPRESENTS A CHALLENGE WHEN WE GET INTO IMAGE BASE DATA BUT FUNDAMENTALLY A CHALLENGE IN THE GENOMICS AREA. IN OUR MODEL ORGANS DATABASES WE HAVE 17 WAYS OF LABELING THE SAME PHENOMENON SO FINDING A WAY TO HARMONIZE THESE IS A CHALLENGE. AND IT MUST FOLLOW FAIR PRINCIPLES ACCESSIBLE AND FINDABLE. BUT FUNDAMENTALLY WE WANT TO THINK ABOUT DATA SCIENCE IN THE FUTURE AS A PLATFORM FOR DISCOVERY BECAUSE IT'S THE DATA ITSELF BECOME REUSABLE. JUST LIKE THOSE THOUSANDS OF PICTURES YOU HAVE OF YOUR CHILDREN. YOU WANT TO BE ABLE TO LOOK AT THEM OVER TIME OR MAYBE YOU LOOK AT SOME OF THEM OVER TIME, DATA IS REUSABLE, OCCASIONALLY PULL THEM OUT OF THE BASEMENT TO LOOK AT THEM. WE NEED TO FIND WAY HOW WE USE DATA, FIND WAYS TO DEVELOP PROVIDENCE, MAINTENANCE OF UNDERSTANDING WHAT'S HAPPENED TO THAT DATA OVER TIME. THE DATA AND STRUCTURE NEEDS TO BE SUSTAINABLE OVER MANY GENERATIONS INCLUDING TECHNICAL GENERATIONS. WE NEED TO MOVE INQUIRY COMMUNITY, MOVE STUDY SECTIONS RESEARCH TO CONCEPT OF DISCOVERY THROUGH DATA, NOT DISCOVERY THROUGH EXPERIMENTATION. THAT MAY PROVE DAUNTING OF CHALLENGINGS. DATA ALONE WE HAVE TO LOOK TO COMPUTATIONAL RESOURCES SO LET ME PRESENT THREE DIFFERENT AREAS OF COMPUTATIONAL DEVELOPMENT ESSENTIAL TO MAKE GOOD USE OF ANY TYPE OF DATA THAT WILL BE WANT TO REUSE FOR INQUIRY IN THE FUTURE. WE NEED ANALYTICS AN BIOSTATISTICS AND STATISTICAL ANALYTICS ARE MOST FAMILIAR TO US. WE ARE NOW MOVING TO ERA OF DISTRIBUTED DATA SETS WHICH REQUIRE DISTRIBUTED ANALYTICS. NO LONGER ARE OUR DATA SETS SMALL ENOUGH TO GATHER THEM AT ONE PLACE AN OPERATE UPON THEM, WE NEED TO GATHER DISTRIBUTE ANALYSES AND RECONNECT THE INTERPRETATION. MACHINE LEARNING STRATEGY OPTIMIZATION ARE SHOWING GREAT PROMISE BUT I BELIEVE THERE'S ENORMOUS NEED FOR INVESTMENT IN LARGE SCALE METHODOLOGICAL DEVELOPMENT. THIS I BELIEVE IS AN OPPORTUNITY FOR THE NATIONAL LIBRARY OF MEDICINE, PARTNERSHIP WITH SISTER ICs AROUND THE NIH. GIVE US TWO TOOLS. ONE IS VISUAL ANALYTICS. BEFORE WE INTERPRET, LET'S ANALYZE AND USE THE ABILITY NOT HUMAN VISION BUT MACHINE VISION. IDENTIFY PATTERNS TO IDENTIFY ABOUT NORMALITIES AN UNDERSTANDINGS AND THEN ALSO THE NEED TO DEPICT RESULTS. THE LEAST INTERESTING ONE BUT PERHAPS MOST IMPORTANT ARE COMPUTATIONAL TOOLS FOR MANAGEMENT, BUSINESS PROCESSES, PRESERVING THE PROVIDENCE OF ANALYTICAL STRATEGIES SO ONE REMEMBERS NOT ONLY WHICH DATA BUT WHICH VERSION OF WHICH MODEL APPLIED AT THIS POINT IN TIME, THIS IS CHALLENGE AND MAINTAINING VERSION CONTROL WE HAVE TWO ISSUES OF VERSION CONTROL, ONE IS A DATA SET THAT'S MODIFIED OR MASSAGE OVER TIME, PERHAPS ERRORS FIXED IN HIT OR MAYBE HAD A REALIGNMENT OF INFORMATION BUT WE ALSO HAVE TO CONSIDER THE DATA SET THAT HAS NEW INFORMATION ADDED ON TOP. PERHAPS NEW INFORMATION THAT IS SLIGHTLY DIFFERENT SET OF TERMS OR SLIGHTLY DIFFERENT NUMBER OF CASES. SO OUR MANAGEMENT TOOLS ARE CRITICAL. NOT INTERESTING BUT TERRIBLY IMPORTANT AND NOT INTERESTING TO THE DOMAIN SCIENTISTS, THEY ARE INTERESTING TO THE MEDICAL INFORMATICS COMMUNITY. SO WE HAVE A PARTNERSHIP READY TO GO. WE ALSO NEED INFRASTRUCTURE FOR THIS DATA AND I BRING TO YOU AN IMAGE FROM LAUREN -- PHIL BORN HAS BEEN BRINGING THIS IMAGE SEVERAL TIMES AND THIS IS A DATA COMMONS, ON THE LEFT HAHN SIDE YOU SEE FEATURES ON THE RIGHT HAND SIDE, A CONCEPTUAL STRUCTURE THAT BEGINS WITH TA COMPUTE PLATFORM, CLOUD PLATFORMS, MOVES ALL THE WAY THROUGH SOFTWARE TOOLS CONTAINERS, APIs THAT ALLOW INTERACTION AND DISCOVERABILITY. THE COMMONS FRAMEWORK DESCRIBES CONCEPTUAL ORGANIZATION OF DATA AS WELL AS PHYSICAL ORGANIZATION OF DATA THAT COMMON FRAMEWORK MANAGED SUCH THINGS AS IDENTITY MANAGEMENT AUTHENTICATION PLANNING AND FORECASTING TOOLS HOW LONG IS THAT DATA SET VALUABLE. MAYBE ONLY USED BY ONE PERSON EVERY TEN YEARS BUT THAT'S CRITICAL, MAYBE BY A THOUSAND TEAMS A YEAR FOR FIVE YEARS AND THEN PLANNING FORECASTING FOR STORAGE AND SUPPORT IS NECESSARY AS WELL AS BUSINESS ANALYTICS. ARE WE ABLE THE DO WHAT WE SAID WE WOULD DO, ENTERACT THE COMMUNITY. I SUBMIT TO YOU AS NIH DATA SCIENCE AT THE NIH MIGRATES TO NATIONAL LIBRARY OF MEDICINE WE ARE READY AND POISED TO TAKE ON CERTAIN CHALLENGES. IT MIGHT BE SURPRISING TO YOU, WHO ONLY KNOW NATIONAL LIBRARY OF MEDICINE THROUGH PUBMED OR MED LINE IS TAKE A MINUTE AND WATCH A SHORT VIDEO THAT SHOWS YOU TALENTED RESOURCES. >> NATIONAL LIE PRAYER OF MEDICINE (INAUDIBLE) 1838, IN MEDICAL ARMY SUR JOHN IT'S TENT. WE NOW ALMOST FACING OUR THIRD CENTURY HAVE MIGRATED IN A NUMBER OF WAYS, WE'RE WORLDWIDE, OUR RESOURCES ARE USED BY OVER 4 MILLION PEOPLE A DAY, WE HAVE OUR DB GAP HAS 150,000 ENGAGE.S EVERY DAY. FROM 1838 TO 1960, THE FOCUS WAS ON INDEXING CATALOGING CURE RATING WHAT'S IN A MEDICAL LIBRARY. WE NOW HAVE 26 MILLION CITATIONS, AND COUNTLESS NUMBER OF SERIALS IN OUR BUILDING. FROM 1970 TO 1983 ROUGHLY WE WERE WORKING ON DIGITIZING THE COLLECTION, GETTING RID OF THE BIG RED INDEX AND COULD BE REVIEW, COULD BE SEARCHED BUT ONLY BY SPECIALIZED LIBRARIANS. 1984 TO 2015 PUSHED THE INTERNET, DEMOCRATIZE ACCESS TO THE LITERATURE, ACCESS TO 70,000 IMAGING, WE HAVE DEVELOPED RESOURCES THAT ALLOW YOU TO SEARCH BY IMAGE INSTEAD OF SEARCHING BY TEXT. NOW WE'RE MOVING TO ERA OF DATA. SO I WANT TO CONCLUDE BY TALKING WHAT I BELIEVE IS NECESSARY IN THE PART VISION THAT I HAVE THAT WILL BE BALANCE RESPONSE NATIONAL LIBRARY OF MEDICINE, NATIONAL INSTITUTES OF HEALTH INSTITUTES AND CENTERS AND INDUSTRY AND SCIENTISTS AROUND THE WORLD. FIRST WE MUST DETERMINE WHAT ARE THE HIGH VALUE DATA SETS, OUR HIGH VALUE SETS MIGHT BE HIGH VALUE BECAUSE THEY WERE HARD TO COLLECT AND NEVER BE COLLECTED AGAIN OR USED BY INDIVIDUALS, THIS IS A SCHOLARLY DISCUSSION, IT IS NOT A TECHNICAL DISCUSSION BUT COMING UP UP WITH CRITERIA HIGH VALUE IS IMPORTANT FIRST AND ONGOING STEP, THIS WILL CHANGE OVER TIME, WE WON'T GET IT RIGHT THE FIRST TIME. WE MAY LOSE A DATA SET. BUT WE NEED TO MOVE TO PROBABILISTIC THINK OTHERWISE DAA SETS WILL LOCK LIKE PICTURES OF CHILDREN IN YOUR BASE., HUNDREDS OF THEN AND YOU CAN'T FIND THE ONE YOU WANT. SECONDLY WE HAVE TO PRESERVE THE PURPOSE. THAT'S LINKED TO HIGH VALUE DATA SET. WE HAVE TO TEACH SCHOLARS INVESTIGATORS WE HAVE TO TEACH OUR IC DIRECTORS TO ENVICES WHERE DO YOU WANT TO BE IN 15 YEARS WITH THIS DATA SET? HOW MUCH ARE YOU WILLING TO SPEND TO GET THERE? WHAT I NOW HEAR FROM IC DIRECTORS IS PAIN POINT I'M SPENDING TOO MUCH TODAY AND NOT SURE I SPEND IT IN THE RIGHT WAY. WE CAN HELP WITH THE SECOND. NOT SURE WE CAN FIX THE FIRST ONE, IT MIGHT BE MORE MORE EXPENSIVE THAN WE THINK OR SWITCH PURPOSE OR CHANGE DECISIONS. NEXT WE NEED TO THINK ABOUT HOW WE PREPARE FOR THIS WHAT WE ALREADY KNOW HOW TO DO. NATIONAL LIBRARY OF MEDICINE WE HAVE IN PLACE A COUPLE OF E FEATURES GIVING EXPERIENCE. PUBMED CENTRAL IS A FULL TEXT DATABASE AS OF OCTOBER THIS YEAR WILL ACCEPT DATA SETS ATTACHED TO INDIVIDUAL STUDIES. SO THAT A REPORT OF A STUDY CAN HAVE ITS DATA SET ACCESSIBLE AT THE POINT OF ENGAGEMENT. SECONDLY TRUST.GOV HAS BEEN WORKING ON TRIALS RESULTS REPORTING. AS OF JANUARY THIS YEAR FDA CHARLES MUST PUT RESULTS ON PRIMARY OUTCOMES INTO DATABASE AND FULLY ACCESSIBLE. THE CURRENT NEED FROM IC DIRECTORS AND OTHER MEMBERS AROUND THE COMMUNITY HERE ARE WE NEED TO IMPROVE THE SAFETY AND ACCESSIBILITY OF HIGH VALUE DATA SET THE SAFETY, PHYSICAL SAFETY AS WELL AS AVOW DANCE OF INTRUSION, AVOIDANCE OF APPROPRIATE USE AND ACCELERATE USE OF CLINICAL TRIALS, THIS IS A SOCIOLOGICAL SHIFT IN SCIENCE TO LEARN FROM DATA OR DISTINGUISH WHAT WE SHOULD LEARN FROM DATA VERSUS EXPERIMENTS AND THAT'S GOING TO TAKE -- PATHWAY IN EVERY SCIENTIFIC COMMUNITY. FUTURE DEMAND IS FOR ROBUST SUSTAINABLE AND SCALABLE STORAGE SOLUTIONS, SCALABLE UP AND DOWN. I DON'T BELIEVE THEY WILL GO DOWN. I CAN'T IMAGINE SHRINKING DATA SETS BUT WE MIGHT. AND NEW IN EMERGING MATHEMATICS. REQUIRING CLOSE ENGAGEMENT WITH COLLEAGUES IN MATHEMATICS AND SCIENCE. NIH -- NLM HAS SECRET SAUCE TO BRING TO THIS PROCESS, WE HAVE YEARS OF EXPERIENCE WITH PROMOTING STANDARDS FOR CLINICAL RECORD SYSTEMS AND BEGINNING TO MOVE INTO THOSE STANDARD TERMINOLOGIES FOR OTHER SERVICES INCLUDING NINDS KEY STANDARDS, MUCH MORE FAMILIAR WITH THE HUMAN ENGAGEMENT IN CLINICAL CARE, THEY WILL BE EMERGING IN THE DATA SCIENCE UNDERNEATH. WE NEED TO ACCELERATE THE DESIGN OF TOOLS FOR DISCOVERY ANALYSIS, THIS WILL HAPPEN IN PART WITHIN EACH IC BUT INCREASINGLY WE NEED TO HAVE METHODOLOGICAL CENTER. A RESOURCE IF YOU WILL, A TALENT POOL NIH AND SCIENTIFIC COMMUNITY DRAW FROM. WE MUST PROMOTE TRAINING UNIVERSITY BASED PRE-AND POST-DOCTORAL TRAINING, HOW TO GET MID CAREER SCIENTISTS AND CLINICIANS TO UNDERSTAND HOW DATA SCIENCE DRIVEN INVESTIGATION. WE NEED TO ENGAGE WITH OTHERS BECAUSE SOLUTION TO DATA SCIENCE CHALLENGES ARE NOT GOING TO BE SOLVED LOAN BY NIH BY NLM, FOR EVERYBODY TO DUTCH THEIR DATE SETS, AND IT COULD BE WASTEFUL, THIS PARTNERSHIP WITH COMPUTER SCIENCE WITH OTHER GOVERNMENT ENTITIES SUCH AS NOAAA CRITICAL FOR OUR FUTURE. WE ALSO HAVE TO KEEP IN TOUCH WITH THE CONSUMERS OF OUR DATA, THE SCIENTISTS, THE PATIENTS AND CLINICIANS T WE NEED TO WALK THEM ALONG WITH US TO BRING THAT CHANGE ALONG. HERE AT NIH WE'RE IN THE PROCESS OF DIFFERENT STRATEGIC PLANNING ACTIVITIES. WE JUST COMPLETED THE NIH STRATEGIC PLAN LAST YEAR NOW AT THE NATIONAL LIBRARY OF MEDICINE WORKING ON ONE FOR OUR INSTITUTE. BUT WE'RE ALSO WORKIN ON HALF A DOZEN IC DIRECTORS BLUEPRINTS FOR THE NEXT PHASE OF DATA SCIENCE AT NIH. AND THAT BLUEPRINT INTEGRATE WITH FINDINGS LESSONS WE HAVE LEARNED FROM BD 2K MUST THAT INVESTMENT WAS CRITICAL. AND SHOULD LEAD TO NIH WIDE SOLUTIONS AS WELL AS SOLUTIONS THAT ARE SPECIFIC TO THE NATIONAL LIBRARY OF MEDICINE, WE'RE JUST ACROSS THE STREET NATCHER. THE LOW BUILDING LOOK LIKE THE FLYING NONE. AS AN ASIDE, IT WAS BUILT WITH NUCLEAR -- SO IT COLLAPSES IN TO PRESERVE BOOKS AND STAFF TOO, I GUESS, I DON'T KNOW. WHAT'S IMPORTANT WHEN YOU LOOK AT THIS COMPLEX NIH AND THE COMPLEX WORLD AROUND US AND COMPLEXITIES OF DATA SCIENCES WE NEED A STRUCTURE TO ORGANIZE, WE HAD A STRUCTURE FOR A WHILE THAT WAS THE ADS OFFICE AND ICs INVOLVED IN DIFFERENT WAYS WE'RE NOW MOVING TO A NEW STRUCTURE AND I NEAT THOUGHTS HOW THAT STRUCTURE SHOULD SERVE NINDS. HERE IS WHAT I THINK WE SHOULD BE FINDING WITHIN A RELATIVELY SHORT TIME FRAME. MAYBE FIVE YEARS. WE HAVE TO HAVE MECHANISMS THAT DETERMINE HIGH VALUE DATA SETS IN A SYSTEMATIC WAY, LOCATE AND FORECAST THEIR COST AND UTILIZATION. ECONOMETRIC MODELS ARE USEFUL HERE. WE NEED TO IMPLEMENT EFFICIENCY CURE PRESERVATION STRATEGIES, THAT FACILITATE ACCESS AND REUSE, WE'RE NOT PRESERVING TO SAVE, PRESERVING TO ENABLE. THIRD WE NEED TO REENGAGE AND STIMULATE THE INTRAMURAL AND EXTRAMURAL EFFORTS AND STANDARDS OF THE BD 2K PROGRAM COMMUNITY BASED STANDARDS, THE BALKANIZATION HAS LED US TO SOMETHING THAT'S NOT USABLE AND WE NEED TO ACCELERATE INS THIS AREA, IT'S A DIFFICULT AREA AND IT'S DIFFICULT TO ENGAGE BECAUSE IT DOESN'T LOOK LIKE ANYTHING, IT'S WORDS ANALYSTS OF THINGS BUT IT'S CRITICAL FOR OUR INFRASTRUCTURE. DEVELOP NEW METHODS FOR DATA MANAGEMENT AND FOR DATA DRIVEN DISCOVERY AND THE METHODOLOGIES WILL RANGE FROM BUSINESS PRACTICES TO AN LITTIC. WE NEED TO GROW A TALENTND WORK FORCE ON CAMPUS AS WELL AS INTERNATIONALLY AND WE NEED TO ENGAGE WITH GOVERNMENT AND INTERNATIONAL AND GLOBAL COLLABORATIVES INCLUDING THOSE THAT HAVE INDUSTRY AS KEY PARTNERS. OUR BELIEF IS DATA SCIENCE FUTURE IS FOUNDATION FOR OPEN SCIENCE. FOUNDATION FOR ENSURING DATA GENERATING MANY TIMES IN SAFE AND SECURE WAYS FOR INQUIRY WE MAY NOT HAVE ANTICIPATED AHEAD OF TIME. KEEPING A FRAME OF OPEN SCIENCE NOT BECAUSE IT'S THE GOOD THING TO DO BUT IT'S ESSENTIAL FOR DISCOVERY IS KEY TO OUR SOLUTIONS. AND FINALLY WE MUST ENSURE THE INTEGRATION LEARNED FROM THE BD 2K PROGRAM, SOMETHING REFERRED TO NOW IS THE CLOUD PILOT. FIRST ATTEMPT TO INTEGRATE HIGH VALUE DATA SETS INTO PUBLIC SERVICES. LET ME CLOSE WITH A BRIEF VIDEO WE WILL SHOW YOU THE DATA FUTURE THAT I HOPE TO SEE. * >> THE MOST IMPORTANT THING CLINICAL RESEARCHERS OF BASIC BIOMEDICAL RESEARCHERS AND PATIENTS BRING TO PROCESS IS THE ABILITY TO DREAM ON A DATA DISCOVERY ENVIRONMENT. WE PROVIDE THE TOOLS, THEY PROVIDE THE DIRECTIONS. THANK YOU VERY MUCH FOR YOUR TIME. HERE IS HOW YOU CAN REACH ME, HAPPY TO BE HERE FOR MORE CONVERSATION. [APPLAUSE] >> THANKS, PATTY. FOLKS HAVE QUESTIONS? LARRY. >> LOOK TO THE DAY WHEN WE RELY ON MACHINE LEARNING SEARCHES OF HUGE AMOUNT OF DATA, HUGE AMOUNTS OF LITERATURE, A QUESTION THIS COME UP TODAY IS RELIABILITY. SO I WONDER IF YOU WORK TOGETHER ON DEVELOPING RELIABILITY METRICS BE PUT INTO THOSE SEARCHES, SO WE HAVE A FEELING THAT THAT'S BEEN FACTORED IN TO AS SOME KIND OF MACHINE LEARNING SUMMARY OF VAST DATA SET. I'M NOT A DATA SCIENTIST OR MACHINE LEARNING SPECIALIST SO I HAVE TO REFER TO PEOPLE WHO HAVE A TECHNICAL ASPECT. LET ME ASK YOU TO EXPAND BEYOND RELIABILITY TO UNDERSTAND WHAT IS IMPORTANT. IS IT IMPORTANT TO KNOW THE PROCESS THAT WE WENT THROUGH TO DECIDE THIS SET OF VOXELS NOT THAT OR THIS PATTERN WAS EVIDENT IN THE LITERATURE AND NOT THAT. THAT TRACEABILITY OF REASONS IS BECOMING MORE DIFFICULT TO DO. BECAUSE MANY MACHINE LEARNING STRATEGIES THAT ARE USED ARE NON-SEMANTIC, THEY LOOK FOR PATTERNS INFORMATION AND SEMANTICS GET APPLIED LATER. FROM IT'S POSSIBLE TO REPRODUCE THE NON-SEMANTIC SOLUTION. WE HAVE A TRADITION IN THE EXPERIMENTAL MODELS REPRODUCIBILITY REPEATING THE SAME FINDING, AFFIRMING THE FINDING IS EVIDENCE THE EVIDENCE IS STRONG AND GOOD. I CAUTION YOU ABOUT USING THAT BECAUSE I'M TRAINED IN BASIC FUNDAMENTALS OF MEASUREMENT MATHEMATICS AND THAT REQUIRES US TO THINK MEASUREMENT NOT AS A FEATURE OF A SCALE THAT'S DEVELOPED BUT PROPERTIES OF UNDERLYING SUBSTRATE. LOOKING REPRODUCIBILITY CONSIDER WHAT DOES THE SUBSTRATE LEAD US TO EXPECT AND HOW DOES NEW MODEL SHOW THAT? A LITTLE BIT OF DIFFERENCE BETWEEN USING ELECTRIC SCALE AND USING OTHER MODELS WITH PHENOMENON. THERE CERTAINLY IS ESPECIALLY WHEN WE START TO LOOK AT INTERPRETING THE TRUST THAT ONE PLACE IN RESULTS OF MACHINE LEARNING ALGORITHM, THERE ARE FEATURES PARTICULARLY GROWING OUT OF MAKING NATURAL LANGUAGE PROCESSING AND MACHINE LEARNING THAT ALLOW REDUNDANCY AND THEY TRUST BUILT IN AS THE POINT OF THE PROCESS. TO SHIFT DATA SCIENCE INVESTIGATION IS EXPERIMENTAL SCIENCE, WE BUILT CONTROLS IN FROM THE BEGINNING. WE IDENTIFIED PRECISE AREAS, CARRIED OUT METHODOLOGIES ACCORDING TO VERY SEMANTIC PROCESS, IN DATA SCIENCE STRATEGY, WE BUILT CONTROL AT THE END. SOMETIMES DATA ARELY OCCURRING SO MACHINE LEARNING ALGORITHM ON TOP OF DATA IS NOT COVERED WITH PRECISION TO SAY LITERATURE IS SELECTED SO EXPAND CONCEPT OF RELIABILITY TO CHARACTERIZE DATA SETS AND THE PROCESS OF ANALYSIS AND TO CHARACTERIZE INTERPRETATION RECOGNIZING THAT ALIGNMENT OF DISCOVERY WITH SOMETHING THAT WAS PRIOR KNOWN THROUGH AN EXPERIMENT MAYBE ONLY ONE STRATEGY, WE MAY NEED TO THINK OF NEW WAYS TO POST DISCOVERY VALIDATION. IF THAT ANSWERS YOUR QUESTION. >> THANK YOU FOR THE PRESENTATION. IT'S CLEAR NLM IS A GREAT RESOURCE FOR INTELLECTUAL CAPITAL FOR SCIENTISTS. COULD A BETTER RESOURCE AND SOCIAL CAPITAL FOR SCIENTISTS, AMONG SCIENTISTS, TRYING TO CONNECT SCIENTISTS EVEN MORE, TRYING TO ALERT THEM OR PROMPT THEM TO DATA SETS OR PUBLICATIONS OR GROUNDS ESPECIALLY PERTINENT TO THEM. IN EARLIES THE OF TIMELINESS, TRYING TO COLLECT THOSE SO THE ANECDOTE WALTER GAVE ABOUT TWO PEOPLE WHO SENT IT TO MEET EACH OTHER AND LED TO PUBLICATION HOW CAN NLM BE PART IN TERMS OF CONNECTING PEOPLE? ON THAT LEVEL? >> CERTAINLY IT'S CHALLENGE WE HAVE NOT DONE AS WELL WITH IT, WE DON'T THINK ABOUT SCIENTISTS FROM A SENIOR PERSPECTIVE. SO WE EVEN THE WAY OUR SEARCH STRUCTURES ARE SET OUT, THEY'RE SET OUT WITH TRYING TO ALLOW AN INDIVIDUAL TO PURSUE A STRATEGY, WHICH IS FLYING IN THE FACE OF TEAM SCIENCE, ONE STRATEGY IS LOOKING AT NEW KINDS OF SEARCH STRATEGIES AND GOING BACK TO MACHINE LEARNING QUESTION, NEW WAYS ORGANIZING THE INFORMATION. PART OF THE REASON I TOOK THIS POSITION IS THAT I WANTED TO BE SURE IN THIS VAST LIBRARY OF KNOWLEDGE THE DEFINITION OF HEALTH AND INDEED THE DETERMINATION OF PHENOTYPE WAS INFORMED BY SOCIAL BEHAVIORAL DOMAINS AS MUCH AS BIOLOGICAL DOMAINS SO THE STRUCTURING OF THE LITERATURE IS IMPORTANT. IN OUR VIDEO YOU MIGHT HAVE SEEN THE PUBMED COMMONS. THE PUBMED COMMONS SERVINGS MUCH THE WAY THAT COMMENTARY AND PRE-PRINT ARTICLES SERVE SO AN INDIVIDUAL PLACE HAS AN ARTICLE IN PUBMED, CENTRAL WHICH IS OUR FULL TEXT DATABASE, OTHERS READ AND COMMENT, SO WE HAVE IF YOU WILL A NEXUS FOR INDIVIDUALS TO TO LEARN ABOUT BUT'S ORGANIZED AT THE LEVEL OF AN ARTICLE. WITHIN OUR NCBI RESOURCES YOU'RE ABLE TO CREATE YOUR LOCKER AND IN THE LOCKER YOU CAN SAVE SEARCHES DATA SETS YOU ARE LOOKING AT, FROM THAT WE CAN INFER OTHER THINGS THAT MIGHT BE OF INTEREST AS A PERSON. WHAT WE HAVEN'T DONE IS FIGURE HOW TO ENSURE YOU AND WOMAN NEXT TO YOU IS LOOKING AT THE SAME ARTICLE. THERE'S INTERESTING SOCIOLOGICAL CHALLENGES WITH THIS. WHEN AMAZON SAID DID YOU KNOW BOUGHT THAT GO LIKE, THEY'RE NOT TELLING YOU WHO BOUGHT IT JUST SAYING OTHER PEOPLE. AS LIBRARY SCIENCE TRADITION WE DON'T MONITOR WHAT PEOPLE READ AND WE BELIEVE THIS IS CRITICALLY IMPORTANT. IFIF I MAY SEGUE INTO ISSUE OF SECURITY, ONE WE HAVE TO DEAL WITH LOOKING AT DATA SCIENCE IS THE TENSION BETWEEN DISCLOSING WHO IS OPERATING ON THIS DATA SET SO YOU CAN FIND A COLLABORATOR AND ALLOWING PEOPLE NOT TO BE DISCLOSED AS THEY LOOK AT THAT DATA SET, MAYBE THEY HAVE AN IDEA FOR A MACHINE OR DRUG IN MIND. THEY DON'T WANT YOU TO KNOW THEY'RE POKING AROUND IN THE DATA SO THESE CONVERSATIONS ARE IMPORTANT TO HAVE. BUT I APPRECIATE THE QUESTION WITHIN THE BD 2K INITIATIVE, THERE IS A PLAN FOR WHAT'S REFERRED TO AS THE LC STUDIES ETHICAL LEGAL SOCIAL STUDIES INFORMATION AND DATA SCIENCE WITHIN THEM ONE IS SOCIOLOGY OF SCIENCE AS IT GROWS IN THIS NEW WAY. I'M EXCITED BUT I DON'T HAVE ALL THE ANSWERS YET. >> I THINK THIS IS TERRIFIC, THANK YOU FOR SHARING THIS INFORMATION. WE NEED TO GET THE WORD OUT TO ALL OF OUR CONSTITUENTS ABOUT THE AMOUNT OF BIG DATA OUT THERE. SO I APPLAUD YOUR ENTHUSIASM AS WELL AS THESE VIDEOS THAT ARE UPLIFTING. THE THING HE WANT TO EMPHASIZE AND -- THAT I WANT TO EMPHASIZE AND THEY HAVE WE HAVE TO THINK ABOUT IS ACCESSIBILITY AND HOW TO USE THE DATA. THAT'S WHERE TRAINEES, STUDENTS, FELLOWS, RESIDENT, OTHER PEOPLE IN TRAINING, WE NEED TO GIVE THEM THE RIGHT TOOLS SO THEY CAN ACCESS THIS IN AN EASY FRIENDLY WAY. SO IF YOU CAN EXPAND A LITTLE BIT FOR US WHAT ARE THE PROGRAMS OUT THERE, WEBINARS, TRAINING PROGRAMS, OTHER KINDS OF FELLOWSHIPS THAT WE CAN GET PEOPLE SO THEY CAN USE SOME OF THE TOOLS AVAILABLE TO ACCESS THE DATA AND MAKE IT -- >> YOUR QUESTION IS TELLING ME YOU'RE IN THE AWARE, WE'RE NOT MAKING GOOD PUBLIC RELATIONS ABOUT WHAT'S ALREADY THERE. SO WITHIN THE BD 2K INITIATIVE, THERE IS A TRAINING SITE CALLED AREA INDICT THAT HAS EVERYTHING FROM ONE HOUR TO MULTI-SESSION COURSES BUT THE TRAINING IS SITTING THERE, PEOPLE AREN'T GETTING TO IT, IT'S NOT GOING TO WORK. WE NEED TO INCENTIVIZE IT. >> HOW DO WE INTEGRATE INTO OUR ACADEMIC INSTITUTIONS, IT MAYBE OUT THERE BUT WE NEED BETTER CONNECTIONS WITH THE ACADEMIC INSTITUTIONS TO GET THAT INTO CURRICULUM FOR TRAINEES. >> LET ME SPEAK ABOUT TWO ISSUES. ONE IS WE NEED TO HAVE THE DATA INFORMED CLINICIAN AND DATA INFORMED SCIENTISTS. THESE ARE TWO INDIVIDUALS WHO NEED TO KNOW WHAT'S AVAILABLE, THAT SOMEONE ELSE CAN HELP WITH IT. WE NEED THE BUILDING OF THE DATA SCIENTIST WORK FORCE. THE DATA INFORMED CLINICIAN AND THE DATA INFORMED CLINICAL SCIENTISTS OR BIOMEDICAL SCIENTISTS ARE TRAINED THROUGH OUR ICs. SO WITH THEM WE HAVE PARTNERSHIPS WHERE WE CAN ADD INFORMATACISTS TO A TRAINING GROUND, WE NEED TO WORK WITH THE CREATION OF THE T-32 PROGRAM TO MAKE SURE THE ICs ARE BUILDING THE KIND OF DATA SCIENTISTS THEY NEED. BUT WE WILL ALWAYS NEED BASIC DATA SCIENTISTS. THAT'S PEOPLE WHO ARE NEW. BUT US OLD PEOPLE WE HAVE TO CATCH THIS ON A DIFFERENT WAY. SO THERE ARE A COUPLE OF THINGS, WE BELIEVE THE MECHANISM MID CAREER K MECHANISM IS AN IMPORTANT PATHWAY. WE'RE ALSO CONSIDERING AN OPTION CALLED AN F-38. THAT'S A TRAINING OPTION WE HAVE NOT ACTIVATED AT THE NATIONAL LIBRARY OF MEDICINE IN A LONG TIME. AND IT ALLOWS FOR A SHORT TERM MID CAREER TRAINING SO PERSON HAS A Ph.D., THEY SPEND THREE MONTHS IN AN INTENSIVE TRAINING WHICH WILL LIKELY HAVE TO BE REMOTE OR SOME WAY DISTRIBUTED, NOT DELIVERED ON STONE BUT LET ME TAKE YOU TO THE TWO OTHER AREAS TO THINK ABOUT TRAINING. DATA LIBRARIAN, OUR LIBRARY SCIENCE WORK FORCE AROUND THE COUNTRY, NATIONAL NETWORK OF LIBRARIES OF MEDICINE, OUR ACADEMIC HEALTH SCIENCE LIBRARIES ARE AN IMPORTANT LOCAL RESOURCE, SO WE ARE WORKING RIGHT NOW WITH MEDICAL LIBRARY ASSOCIATION TO THINK ABOUT FIRST WHAT IS THE CORE CONTENT EVERY LIBRARIAN NEEDS TO KNOW ABOUT DATA SCIENCE AND WHAT ARE THE ONE OR TWO COURSES TO ADD IN FOR THE DATA INTENSIVE LIBRARIAN. SO WE HAVE SOME PROGRESS COMING, IF I COULD COME UP WITH A PILL YOU CAN SWALLOW AND GET, THAT WOULD BE BETTER OFF BUT THAT'S CLINICAL DIVISION TO HANDLE. >> ABSOLUTELY FASCINATING. THE MODEL YOU WERE TALKING ABOUT IS WHERE THE INDIVIDUAL COMES ON, LEARNS THE TOOLS, GATHERS THE DATA SET, COLLABORATES. THAT'S CLEARLY A WONDERFUL PART OF THE EQUATION. IN THE DATA SETS, WE CREATE ALGORITHMS. TAKING CHUNKS OF DATA, AND THEN TAKE >> SIZE, SCALABILITY. >> LOTS OF THESE. ANYWAY, I WANT TO HEAR YOUR THOUGHTS ABOUT THE CONSIDERATIONS TOWARDS DOING THAT AND THINGS THAT PERHAPS I HADN'T THOUGHT ABOUT THAT MAY IMPACT. >> I THINK ONE OF THE POINTS YOU BRING TO ME THAT NO ONE HAS BROUGHT BEFORE IS WHAT ARE WE GOING TO DO ABOUT TRAP. TRANSPORT. WE KNOW MANY DATA SETS THAT EXIST NOW ARE TOO BIG TO MOVE. AND TOO BIG TO ANALYZE A SINGLE MACHINE SO WE NEED SUPER COMPUTERS, CLUSTERS THINGS LIKE THAT. BUT WE HAVEN'T -- WE -- I MAY SAY WE ROYALLY -- THE PEOPLE DISCUSSING DATA SCIENCE IN THE CAMPUS HAVE BEEN WE'RE GOING TO BEAT Y'ALL TO SUBMISSION TO MAKE YOU COMPUTE IF THE CLOUD BUT WHAT YOU SAY IS WE WANT TO BE ABLE TO EXTRACT AND DO SOME OF THAT. SO THIS IS WHERE THE PROVIDENCE MECHANISMS HAVE TO BE IN PLACE WHAT'S WHERE DATA COME FROM, HOW IS IT CHANGED ONCE THERE, HOW REFLECT AND SITE THE DATA SET AND SITE THE MODIFICATIONS TO IT. THE OTHER PART YOU SUGGEST IS A COOPERATIVE SOLUTION WITH INDUSTRY IS TRANSPORT. WHEN PROPERTY TO TRANSPORT THE DATA HOW TO DO IT IN A SAFE SECURE WAY. INFORM THE OTHER NIGHT AT DINNER , I THINK AT UCSC TO MOVE A DEATH SET FROM THE SUPER COMPUTER BACK TO THE LAB WAS FAST IF THEY LOADED THEIR HARD DRIVES ON TO A TRUCK AND JUST PUSHED IT ON OVER. IT COULDN'T GO FAST ENOUGH EVEN AT T-1 LINE. HAPPY TO TELL YOU ANDREA NORRIS, OUR C I CANO FOR THE NIH HAS -- CIO FOR THE NIH PULLED TOGETHER BASICALLY RESOURCE PEOPLE, NOT ALL IC DIRECTORS BUT TALENTED CIOs TO TALK ABOUT HOW THE NIH WILL SUPPORT AND ACCELERATE INTERNET 2 DEVELOPMENTS BECAUSE TRANSPORT ON COMMODITY INTERNET WON'T WORK. LAST TO THINK ABOUT IS HOW WE ADDRESS ISSUES OF RIGHTS TO DATA JOINTLY DEVELOPED BUT THEN LAB LEVEL EXTRACTED AND MANIPULATED. THERE'S A POINT WHERE WE'LL GET INTO AN IP CONVERSATION, I'M SURE OF IT. >> SO NEED FOR STABILITY AND RELIABILITY IN ALGORITHMS, WE RELY ON PARSIMONY IN ARMY STARS AND THINGS ALONG THOSE LINES. YOU TALK A 15 YEAR TIME FRAME, THE PARSIMONY THAT I NEED FOR INSTANCE TO PUT SUICIDE ON TO A CLINICAL EHR IN VA OR SUICIDE RISK NOW I NEED TO USE PARSIMONY IN MY DATA I WON'T NEED 15 YEARS FROM NOW, WHAT DOES THAT PLANNING LOOK LIKE? >> IT'S A VERY IMPORTANT QUESTION AND IT'S ANOTHER AREA I GET TO BEING A LITTLE BIT MOW THE NATIONAL LIBRARY OF MEDICINE IS SHINING. YOU'RE TALKING INTERFACE BETWEEN WHAT WE LEARN FROM A RESEARCH PERSPECTIVE ON DATA SCIENCE AND WHAT'S EXTENT IN ELECTRONIC HEALTH RECORDS. THAT PARTICULARLY ARE VENDOR DRIVEN THOUGH I KNOW DOD IS IN THE PROCESS OF RELEASING A NEW -- IS IT THIS WEEK A NEW ELECTRONIC HEALTH RECORD? SO Y'ALL ARE INFLUX AT THE FRONT END. THE RECORDS WE HAVE ARE DRIVEN FROM A FRAMEWORK, CODE AT TIME OF COLLECTION, MINIMUM NUMBER OF UNITS POSSIBLE AND BY GOD DON'T BOTHER THE CLINICIAN TOO MUCH. AND THEN IN THE OPPORTUNITY TO GATHER IN THE FUTURE WHICH I DON'T THINK IS WILL TOTALLY TAKE 15 YEARS BUT WILL TAKE TIME, WHAT YOU CAN PUT ANYTIME MAKE IT MEANINGFUL AND USEFUL AT POINT CARE AND HOW THE INDIVIDUALS LIFE LONG HEALTH INFRASTRUCTURE AND WHY THE NLM IS THE RIGHT PLAY TO BE THINKING ABOUT THIS IS OUR LISTER HEALTH CENTER HAS A SIGNIFICANT RESEARCH AGENDA IN USE OF ELECTRONIC HEALTH RECORD AND CLAIMS DATA. FLIP SIDE EXTRAMURAL PROGRAMS HAVE BEEN LOOKING AT HIGHLY DISTRIBUTED CLINICAL INFORMATION SYSTEMS INCLUDING WHAT DOES PATIENT CARRY AROUND. WE HAVE VENDOR LOCK 3 TO 5 YEARS ON THE STRUCTURE OF ELECTRONIC HEALTH RECORDS BUT INCREASINGLY AS WE ACCEPT NEW MODELS LIKE STRUCTURAL MODEL WITH LATENT VARIABLES AND WE CAN EXTRACT AS OPPOSED TO DATA STRUCTURES AT POINT OF CARE IS MORE USEFUL TO THE CLINICIAN. >> TWO QUESTIONS. ONE RELATES TO THIS GROWING INFRASTRUCTURE IN THE WORK AT HARVARD I'M DOING TESTING HOW YOU ENVISION THAT BEAR BURGEONING MOVEMENT. >> WE HOST A CLINICALTRIALS.GOV. WHICH IS NOT REQUIRED FOUNDATION FOR THE HARVARD PROJECT. THEY'RE DEVELOPING A DIFFERENT MODEL. ALSO LOOKING TO SHARE CLINICAL TRIALS, SHARE IN A COMPUTABLE WAY THAT PROCEDURES, WE CERTAINLY ARE INVOLVED WITH FUNDING PART OF THAT EFFORT, WORK CLOSE WHETHER I WITH HIM, ZACK COHANE IS WORKING WITH OUR STRATEGIC PLAN HOW TO CREATE THE LIBRARIES THAT WILL SUPPORT THAT. I BELIEVE WE NEED TO THINK TWO OTHER ASPECTS. ONE IS OFTEN THOUGHT CLINICAL TRIALS ACCOUNTABILITY WAS FREE AND WE NEVER REALLY BUILT INTO OUR EXTRAMURAL PROJECTS. IT'S NOT FREE. 'S NOT SOMETHING THIRD YEAR GRADUATE STUDENT CAN HELP WITH ALL TIME. SOMETIMES WE NEED A SOPHISTICATED SET OF TRIALISTS AS WELL AS DATA MANAGERS. SO I THINK WE NEED TO BEGIN TO SEE HOW TO BUILD THE RIGHT INFRASTRUCTURE WHETHER CORE FACILITY AT UNIVERSITY STUDENTS CTSA OR CORE FACILITY AT NIH TO MANAGE SOME OF THE CLINICAL TRIALS. WE KNOW HOW TO REPORT AND INDECK ARTICLES, WE'RE IN THE BEGINNING OF THE CLINICAL TRIALS PROCESS. THE SECOND PIECE IS WE HAVE TO LOOK AT ACCOUNTABILITY. JOURNAL EDITORS ARE TELLING US WHEN THEY ALLOW TRIALISTS TO SUBMIT THEIR PROCEDURES ONLINE AS AN SUPPLEMENT TO THE ARTICLES THEY'RE HARDLY EVER USED. SO IF WE'RE GOING TO MAKE THEM USEFUL, WHETHER BECAUSE WE WANT TO MAKE SURE WE DON'T DUPLICATE OR WE CAN COMPARE TWO PROCEDURES, WE HAVE TO FIND SOCIOLOGY TO MARKET THEM. >> THAT TIES INTO MY SECOND QUESTION RELATED TO THIS, SO THERE'S A LOT OF EMPHASIS ON REGULATOR SCIENTISTS USING THIS BUT I'M INTERESTED IN NLM THINKING AROUND ENGAGEMENT OF CITIZEN SCIENTISTS. >> ABSOLUTELY. >> PATIENT DRIVEN INTEREST. SO INTERESTED IN WHERE YOU'RE HEADED. >> THIS VERY DAY WE RELEASED F,A FOR DATA DRIVEN DISCOVERY, THIS IS DESIGNED TO BUILD ANOTHER APP FOR PATIENT TO USE BUT TO FIND WHAT KIND OF TOOLS IN BASIC INFORMATICS SEARCH AND WHAT TOOLS ARE NEEDED FOR VISUALIZATION FOR ANALYSIS. THE QUESTION POSED EARLIER HOW MUCH WE HAVE TO DISCLOSE ABOUT THE LOGIC THAT GOT YOU TO THE RECOMMENDATION THAT YOU SHOULDN'T HAVE THAT SECOND GLASS OF WINE, THAT MAYBE VERY IMPORTANT BUT WE MAY NEED TO FIGURE HOW TO DO THAT. SECOND ONE IS OKAY. THIRD. >> I'M SO GLAD TO HEAR THAT, YOU'RE THE PEOPLE I WORRY ABOUT TELLING ME I CAN'T HAVE THE SECOND ONE. IF WE CAN HAVE THE THIRD. I'M FINE. WE HAVEN'T BEEN EXPERIMENTING WITH CITIZEN SCIENCE IN NUMBER OF WAYS, LAST YEAR WE RAN THE IDENTIFIER PROJECT WHERE 7,000 IMAGES OF PILLS RELATED TO RX NORM AND THE PHARMACEUTICAL DATABASE WILL BE MADE OPEN TO PUBLIC, WE HAD A CHALLENGE, CAN YOU TAKE A PICTURE WITH A CELL PHONE, NOT HIGHLY PRECISE ROLE BUT A PICTURE WITH A CELL PHONE AND FIGURE WHAT KIND OF DRUG THIS IS. THE WINNING TEAM CAME FROM MICHIGAN STATE, 40% ARE WIPE WHITE AND ROUND AND NOT MARKED SO IT'S A CHALLENGING TO GET -- THEY CAME UP WITH ABOUT 80% ACCURACY OF THE PILL CLASS, CITIZEN SCIENCE CROWD SOURCING HAS A VALUE HERE. PHIL BORN THE ORIGINAL ASSOCIATE DIRECTOR OF DATA SCIENCE FOR NIH WAS BRILLIANT IN MANY WAYS AND ONE WAS ADVANCING THE CITIZEN -- THE OPEN SCIENCE MODEL THERE WAS A WORLDWIDE COMPETITION THE LAST YEAR IN COLLABORATION WITH A WELCOME TRUST FOR AN OPEN SCIENCE, IT WAS A BROAD QUESTION, WAS IT RESTRICTED LAY PEOPLE COULD HAVE ADVANCE SCIENTIST IN IT BUT BROAD QUESTION ABOUT PUBLIC DATA SET AND DEMONSTRATING ITS USEFULNESS. THE TOP SIX WERE PICKED IN MAY LAST YEAR AND WINNER IS PICKED THIS WEEK AND ANNOUNCE WELCOME TRUST IN TWOS WE'RE. WHEN THE REORGANIZATION OF THE DATA SCIENCE IS NIH HAPPENED AND WE MOVED SOME OF THE RESOURCES AROUND WE BROUGHT ELIZABETH INTO NLM HER RESPONSIBILITY IS OPEN SCIENCE AND PARTICULARLY -- OPEN SCIENCE BROADLY. WE ARE WITH YOU. >> PERHAPS LAST QUESTION. >> THIS WAS WONDERFUL, ONE QUESTION DID NOT COME UP HAS TO DO WITH DATA QUALITY. >> YES. >> AND QUALITY CONTROL. IN THE SENSE THAT THE POST TALK ANALYSIS OF POOLED DATA LOSES TRACK OF WHAT WAS THE SOURCE QUALITY OF THE -- IS THERE ANY WAY AT ALL, ONSET TO BUILD IN A MEASURE OF HOMOGENEITY MEASURE OF RIGOR. PICTURES OF YOUR CHILDREN FROM SECOND GRADE, THERE IS A GOOD ONE IN THERE, I PROMISE YOU. NO. SORRY REASON I SAY NO IS THIS, TWO THINGS. ONE IS IF DIFFERENT PHILOSOPHICAL PERSPECTIVE, EMPIRICIST LOGICAL PERSPECTIVE SAYS BUILD THE INFRASTRUCTURE FROM THE BEGINNING. THE DATA SCIENCE POST POSITIVE PEOPLE SAY WE TAKE EVERYTHING IN THE CRAP AND FIND MODELS THAT EXTRACT THE GOOD SO SIGNAL DETECTION THEORY, MODELS FROM TRANSPORT THERE ARE AND ENGINEERING, MODELS FROM STOCHASTIC OPTIMIZATION, THAT ALLOW FOR THE FACT SOME DATA EVEN IF LOOKS RIGHT COULD BE WRONG, EVEN IF IT LOOKS INCORRECT MIGHT BE AN OUTLIAR THAT'S IMPORTANT SO IT'S A DIFFERENT FRAMING. BACK TO THE COMMENT THAT WAS ASKED EARLIER ABOUT DATA, THE INTERPRETABILITY OF THE RESULTS, WE NEED THE TEACH SCIENTISTS TO UNDERSTAND THIS ISN'T JUST A BIGGER DATA SET THAT YOU PUT THROUGH A BIGGER COMPUTER, THIS IS A DIFFERENT KIND OF DATA ANALYSIS. SO INTERPRETATIONS HAVE TO BE MORE PROBABLYISTIC, YOU THINK OF ALL THE PEOPLE IN THE WORLD WHO THINK WITH UNCERTAINTY, SCIENTISTS AND CLINICIANS, THEY'RE THE ONES PERHAPS BECAUSE OF PRESSURE, WE NEED TO REACTIVATE THAT. >> THANK YOU VERY MUCH FOR THE TIMING TO HAVE THIS DISCUSSION FO THE NEW IDEAS. [APPLAUSE] >> WE'RE MOVING INTO THE LAST AGENDA ITEM BEFORE LUNCH WHICH IS CONCEPT CLEARANCE FOR PROPOSED INITIATIVES. SO IF WE'RE GOING TO DO AN INITIATIVE THAT INVOLVES MONEY WE USE OUR COUNCIL FOR QUOTE UNQUOTE FORMAL CONCEPT CLEARANCE, WE DON'T HAVE TO DO THAT, WE CHOOSE TO DO THAT. IN THE INTEREST OF TRANSPARENCY, LYN JAKEMAN AND PAT BELLGOWAN WILL PRESENT TWO THINGS. YOU'RE ALL SET. LYN IS PROGRAM DIRECTOR IN REPAIR PLASTICITY, RESPONSIBLE FOR SPINAL CORD INJURY STUFF. >> SO THE FIRST INITIATIVE WE WANT TO BRING FORWARD TO CONSIDER AND COMMENT ON AND EVENTUALLY DECIDE WHETHER OR NOT WE SHOULD MOVE FORWARD WITH IS A COLLABORATION BETWEEN MYSELF, I MANAGE THE SPINAL CORD INJURY PORTFOLIO AND PATRICK BELLGOWAN YOU SEE IN A MINUTE WHO MANAGES BRAIN INJURY PORTFOLIO. THIS IS ACTUALLY CONFLUENCE OF COINCIDENCE OF AN OPPORTUNITY, A VERY RARE AND FOR THE GNAT OPPORTUNITY, AS WELL AS NEED, DIRE NEED IN THE NEUROTRAUMA RESEARCH COMMUNITY, SO IN JUST FEW MINUTES BECAUSE I WANT TO SAVE TIME FOR QUESTIONS, I WANT TO TALK ABOUT THE OPPORTUNITY AND THEN A LITTLE BIT ABOUT THE GAP THAT HAS ARISEN IN THE FIELD AND WHY IT WOULD BE SOMEWHAT UNIQUE IN NEUROTRAUMA THOUGH THERE ARE SIMILARITIES WITH OTHER DISEASE AREAS. AND THEN FINALLY THE STRUCTURE THAT WE'RE LOOKING AT TO PROPOSE A FUNDING ANNOUNCEMENT. SO THE OPPORTUNITY WAS A ONE TIME DONATION FROM THE VIVIAN L. SMITH FOUNDATION, THIS WAS A FOUNDATION THAT WAS SUPPORTING NEUROTRAUMA RESEARCH THIS WAS THE LANGUAGE FOR NEW RESEARCH INITIATIVE OF NINDS CHOOSING, PURSUANT TO A SELECTION PROCESS CONSISTENT WITH OUR POLICIES AND PROCEDURES. THAT WAS THE CHARGE, THERE WAS ALSO REQUEST THIS FOCUS IN BASIC RATHER THIS THAN CLINICAL RESEARCH AND THAT EFFORT BE DONE IN MANNER THAT PERHAPS SPURS RESEARCH IN AN AREA THAT MIGHT OTHERWISE BE FUNDED. WITH THAT IN MIND AT THE SAME TIME BOTH PATRICK AND I WHO ARE ACTIVE MEMBER OF NEUROTRAUMA COMMUNITY HAD BEEN FEELING SENSING AND HEARING ABOUT THE CHALLENGES ACROSS NINDS ARE CHALLENGES OF TRANSLATION BUT THERE'S UNIQUE CHARACTERISTICS OF TRANSLATION IN NEUROTRAUMA. THAT LED US TO A GAP THAT GOES WAY BACK TO BASIC END OF THE SPECTRUM. SO NEUROTRAUMA WE KNOW ESSENTIALLY WHAT EXTERNAL CAUSE OF DISEASE IS, GENETICS MAY PLAY A ROLE IN RISKY LIFESTYLE, MAY PLAY A ROLE IN PROGRESSION OF VARY YOU POLICIES BUT BEGINS WITH A MITT TO THE HEAD OR AN IMPACT TO THE SPINAL CORD. WE NOS KNOW THE TIME THIS BEGINS NEUROLOGICAL DISORDERS WE KNOW TIMES ZERO IS TIME OF ALSO OF CONSCIOUSNESS, PARALYSIS, AND MOVES FORWARD. WHERE WE HAVE A REAL HETEROGENEITY THAT EXCEEDS MANY NEUROLOGICAL CONDITIONS IS HOW THIS PLAYS OUT IN INDIVIDUALS BASED ON MECHANISM OF PATHOLOGY AS WELL AS LOCATION IN CNS PATHOLOGY HAS BEEN OCCURRED MAYBE OCCURRING AT IS REALLY VERY MUCH UNKNOWN. SO A LOT OF THINGS HAVE BEEN DONE IN THE TRANSLATIONAL SPECTRUM BASED ON THE FACT THAT CLINICAL TRIALS IN TRAUMATIC BRAIN INJURY HAVE COME UP FAILED TO IDENTIFY NEW THERAPIES, CLINICAL TRIALS IN SPINAL CORD INJURY FIELD HAVE REALLY FAIL TO GET OFF THE GROUND IN RECENT YEARS IN PART BECAUSE WE DON'T REALLY UNDERSTAND BASIC END OF IT. SO THE GAPS -- THE THINGS GOING ON IN THE FIELD PROMOTING STANDARDIZATION OF MODELS, PROMOTING TRAINING IN RESEARCH ON HOW TO DO THE MODELS, WORK ON IDENTIFYING THE PATHWAY TO TRANSLATION, WORK ON SCREENING SOME POTENTIALLY EFFICACIOUS COMPOUNDS THROUGH VARIOUS MODELS FOR EFFICACY. AND ACTUALLY LAYING OUT A PATH TO BETTER CLINICAL TRIALS SO THEY CAN BE DESIGNED BETTER. BUT WHAT IS LACKING IS IMPACT OF REVERSE TRANSLATION. TAKING THE CLINICAL KNOWLEDGE AND BETTER UNDERSTANDING OUR ANIMAL MODELS AND HOW THEY REFLECT THAT. SO THE GAP WE ARE LOOKING TO FILL HERE IS TO DEVELOP OUTCOME MEASURES IN ANIMAL MODEL, WE HAVE CONTUSION, PROGRESSION, COME PREGNANT, YOU WILL SORT OF ANIMAL MODELS THAT REFLECT WHAT'S HAPPENING IN THE BRAIN AN SPINAL CORD BUT DONE UNDERSTAND THE -- OUTCOME MEASURES, WE HAVE LOCOMOTIVE RATINGS SCALES WE HAVE SWING SCALES ALONG THOSE LINES BUT NOT OUTCOME MEASURES THAT REFLECT UNDERLYING PATHOLOGY SO THIS IS SOMETHING YOU SHOULD BE FA I WILL MANY YARR WITH SO THAT SETS UP WHAT WE HAVE DECIDED TO DO. >> SO THIS IS A WAY TOO LONG SINGLE SENTENCE BUT WHAT WE WANT TO DO IS TO PROMOTE AN INITIATIVE DEVELOP AND VALIDATE YOUR REPRODUCIBLE BATTERY OF PRE-CLINICAL FUNCTIONAL OUTCOMES THAT ADDRESS THE HETEROGENEITY ALIGNED WITH FEASIBLE SENSITIVE CLINICAL ASSESSMENT SO WHAT WE'RE LOOKING FOR ARE A BATTERY OF OUTCOME MEASURES THAT GET BACK TO THE MECHANISMS OF THE SECONDARY PROCESS, LOOKING FOR MULTI-DISCIPLINARY APPROACHES, LOOKING FOR AND REQUIRE SOME SORT OF CLINICAL COLLABORATION SO THIS IS TRUE REVERSE TRANSLATION AND WE ARE LOOKING FOR OUTCOME MEASURES THAT WILL PROVIDE DIAGNOSTIC AND/OR PREDICTIVE SPECIFICITY. SO THE MECHANISM THAT WE HAVE SOME ACROSS TO DO THIS, WHERE WE WOULD LIKE AS MUCH INPUT AS POSSIBLE, IS TO USE A PHASED INNOVATION, ONE SOMETIME RFA FOR A PHASE T INNOVATION AWARD, THAT BEGINS WITH A UH 2 PREPARATORY PHASE WHERE INVESTIGATORS COME IN AND THEY WILL PROPOSE WHAT THEY SUSPECT WOULD BE A NICE BATTERY OF OUTCOMES THAT THEY CAN PUT TOGETHER IN AT LEAST TWO INJURY MODELS TO DISTINGUISH SPECIFICITY AS WELL AS SENSITIVITY. THEN AT THE END OF THE TWO YEAR PERIOD OR ALONG THE TWO YEAR PERIOD WE WORK CLOSELY WITH THEM AND WHAT WE HOPE TO DO IS TO IN THE SECOND PHASE HAVE THEM TEST AND DISSEMINATE ACROSS SITES. THESE OUTCOME MEASURE BATTERIES ALSO INCORPORATE A COMPONENT OF DATA SHARING SO WE HOPE TO SET ASIDE A PORTION OF THIS ONE TIME GIFT TO SET UP DATA SHARING CAPACITY, AND THE IDEA IS THAT AS OUR INVESTIGATORS COME UP WITH OUTCOMES BATTERIES WE CAPTURE THEIR DATA IN A WAY THAT FUTURE TRAINEES AND FUTURE PEOPLE MOVING INTO THE FIELD WILL HAVE A PLACE TO LOOK AT WHAT INJURY PATHOLOGY OR DATA LOOKS LIKE, I THINK IT WILL HELP WITH TRAINING, TRANSPARENCY AND HOPEFULLY HELP WITH REPRODUCIBILITY. ONE OF THE CHALLENGES OF REPRODUCIBILITY IS IF YOUR OUTCOME MEASURE IS DISTINCT FROM YOUR PATHOLOGY THAT A SMALL CHANGE IN SOMETHING YOU CANNOT CONTROL LEADS TO A BIG CHANGE IN THE OUTCOME MEASURE. THAT'S WHAT WE'RE PROPOSING AND I'M OPEN FOR QUESTIONS. >> IT MIGHT HELP IF YOU THINK OF KIND OF EXAMPLES THINGS YOU MIGHT THINK COME OUT OF THIS? >> SURE. >> IN GENERAL. >> I WANT TO REMOON YOU OUR INITIATIVE PROPOSAL IS IN YOU ARE YOU FOLDER AND I DON'T WANT TO BE PREPPY AT THIS SHUTS BUT IT MIGHT BE A COMBINATION OF ELECTROPHYSIOLOGY WITH IMAGING PARAMETER. A COMBINATION OF CSF BIOMARKER WITH A PARTICULAR WHITE MATTER INDICATOR. THINGS THAT WILL IDENTIFY AND LEAD TO SPECIFIC OUTCOMES. >> SO YOU HAVE 9 MILLION SO TRANSLATE BACK INTO DIRECT COSTS YOU HAVE 11.2 MILLION PER YEAR, IF IT'S A FIVE YEAR PROJECT. ROUGHLY HOW MANY PROJECTS WOULD YOU BE FUNDING. I DON'T KNOW IF -- WHAT FRACTION WOULD GO UH-2 TO 3 BUT WE HAVE 1.2 MILLION A AREA. WHAT DO YOU THINK THE COST OF THE PROJECT WOULD BE? >> WE'RE LOOKING FOR MULTI-DISCIPLINARY, AN APPROACH THAT WILL HAVE AT LEAST TWO DIFFERENT PARAMETERS, TWO DISCIPLINES BROUGHT IN. WHAT WE WERE THINKING AFTER WE SET ASIDE SOME FOR DATA SHARING AND CONVENING PURPOSES, THAT WE COULD FUND TWO TO THREE OF THESE PROBABLY RO1 SIZED INITIATION PHASE 1s. THEN THAT WOULD FUND EITHER ONE OR TWO DEPENDING HOW THE SCIENCE BEARS OUT OF THESE PROTOCOL TESTING AND DISSEMINATION, THINGS WHICH WOULD BE PROBABLY ABOUT THE SIZE OF TWO RO1s. >> ANY OTHER QUESTIONS? >> FOR COLLARTY, YOU MOVE TO UH-3 STAGE THEN YOU HAVE IT'S THE SAME GROUP FROM ABOVE AND NOW THEY'RE WORKING TOGETHER SO THE FOLKS IN PROJECT ONE AND TWO ARE NOW CROSS FERTILIZING. >> THAT'S -- THE APPLICANTS WILL PROPOSE BOTH PHASES HOW THEY DO UH-2 PHASE AND HOW WE DO THE UH 3 PHASE PUT INTO COOPERATIVE AGREEMENT MECHANISM WE CAN WORK WITH THEM TO DEVELOP MORE A CONSORTIUM. >> THAT'S 'STRENGTH. >> COORDINATION WITH TDI PROGRAM. >> ABSOLUTELY. THIS IS PATRICK AND I WORKING TOGETHER. AND WE HOPE TO BE ABLE TO ROLL THIS OUT TO THE NATIONAL NEUROTRAUMA MEETING THIS SUMMER. >> THANKS VERY MUCH, GREAT WORK ON THIS, JUST INTERESTING STORY BEHIND THE DONATION, CONDITIONAL GIFT FUND THAT CAME TO NIH FOR THIS PURPOSE, COMES FROM A FOUNDATION IN TEXAS WORKING TO TRY TO ENCOURAGE RESEARCH IN BRAIN INJURY AND THE PERSON WHO IS CLOSEST BETWEEN THE FOUNDATION AND NIH WAS A NEUROSURGEON CLIFTON, GUY SPENT HIS CAREER WORKING ON PEDIATRIC HEAD INJURY AND NOW RETIRED FROM THAT. WAS THE PI FROM MULTIPLE NIH GRANTS WHICH ALL FAILED TO SHOW BENEFIT OF HYPERTHERMIA IN PEDIATRIC HEAD TRAUMA. SO I THIS I THE REALIZATION HE HAD WHICH THE FOUNDATION ADOPTED IS A SENSE THAT REALLY NEED TO GO BACK AND TRY TO UNDERSTAND THE BASIC MECHANISMS BECAUSE JUMPING THE GUN THOUGH HYPERTHERMIA WAS SO ATTRACTIVE, JUST DIDN'T WORK. SO IT'S JUST AN INTERESTING STORY AND WE'RE GRATEFUL TO THE FOUNDATION FOR GUY FOR DOING -- GIVING US THIS OPPORTUNITY. THANKS. >> WE DON'T REALLY ACTUALLY HAVE TO FORMALLY VOTE HERE BUT WE MIGHT AS WELL. QUESTION, IS THERE A MOTION FOR THIS TO GO FORWARD OR NOT GO FORWARD? IN TERMS OF BEING FLESHED OUT FURTHER AND DEVELOPED BY -- MOVE FORWARD A SECOND, ALL IN FAVOR? ANY -- ALL OPPOSED? ABSTENTIONS? WHY DONE WE MOVE -- >> WHAT DID YOU SAY, LARRY? >> I'M IN FAVOR ALSO. >> STEVE, ARE YOU STILL ON THE PHONE? >> I AM ALSO IN FAVOR. >> THANKS. NOW PAT BELLGOWAN OUR TBI PROGRAM DIRECTOR FROM THE SAME REPAIR AND PLASTICITY GROUP WILL TALK ABOUT OTHER. >> SO THANKS. THIS CONCEPT PROPOSAL IS ABOUT -- IS TRYING TO ADDRESS AN IMPORTANT PROBLEM THAT IS BOTH A KNOWLEDGE GAP AND ALSO A PRACTICE GAP THAT HAS A LOT OF ATTENTION IN THE MEDIA, AND REALLY COMES FROM THE IDEA I THINK THE BASIC IDEA COMES FROM TE PROBLEM THAT PARENTS HAVE BECAUSE WE DON'T KNOW ONE, WHAT A CONCUSSION IS, TWO, THERE'S A LOT OF IDEAS HOW YOU TREAT A CONCUSSION AND HOW LONG THAT CONCUSSION LASTS. SO THIS PROPOSAL IS REALLY ABOUT DEVELOPING BIOLOGICAL MEASURES SO ONTIVE BIOLOGICAL MEASURES FOR A PEDIATRIC CONCUSSION THAT HELP PREDICT WHICH KIDS HAVE PERSISTENT SYMPTOMS. SO NOT ALL HAVE PERSISTENT SYMPTOMS BUT ONES THAT DO HAS A NEGATIVE AFFECT ON THEIR LIFE. THE OTHER HOPE THAT WE HAVE FOR THESE BIOLOGICAL MEASURES IS IT WILL PROVIDE SOMETHING FOR US TO MONITOR THE RECOVERY. BECAUSE RIGHT NOW THERE'S ALSO NO BIOLOGICAL BASIS FOR DECIDING WHEN A KID IS RECOVERED. THERE'S GUIDELINES WAIT TWO DAYS, YOU FEEL BETTER, THERE'S NO BIOLOGICAL OBJECTIVE MEASURE FOR THAT. THIS IS JUST AN ISSUE OF HOW BIG THE PROBLEM IS, SO EACH YEAR THERE'S 750,000 U.S. EMERGENCY ROOM VISITS, THAT ARE ACCOUNTED FOR BY YOUTH THAT PRESENT WITH SYMPTOMS OF CONCUSSION. AND THE RECENT STUDY OUT OF CANADA WITH THREE THOUSAND ER VISITS SHOW 33% OF THOSE HAVE PERSISTENT SYMPTOMS GREATER THAN 28 DAYS. 28 DAYS OF HEADACHE AND VERTIGO AND IT'S A WHOLE BREATH OF SYMPTOMS THAT WE'RE LOOKING AT. THE KEY TO THIS TO KNOWING THIS STATISTIC SEEMS BAD IS THAT CHOP THIS YEAR PUBLISHED A STUDY THAT SHOWED THAT IF YOU LOOK AT FOUR TO 14-YEAR-OLD KIDS, ONLY A QUARTER PRESENT AT THE ER. THREE QUARTERS PRESENT, PRIMARY CARE PHYSICIAN OR SPECIALIST. THIS SIGNIFICANTLY UNDERSTOOD ESTIMATES THE PROBLEM. WHAT IS OUR GOAL? TO FACILITATE DISCOVERY AND IMPROVED CARE PEDIATRIC CONCUSSION. I'LL GET TO THE MECHANISM IN A MINUTE BUT IT CAME OUT OF IT WASN'T JUST COME OUT OF MY HEAD, IT CAME OUT OF WORKSHOP THAT WAS HELD AND CHAIRED BY DR. MINK. THE GOAL OF THE WORKSHOP IS REALLY TO GET THE COMMUNITY TO TELL US WHAT IS THE STATE OF THE SCIENCE AND WHAT DO THEY THINK ARE THE MOST IMPORTANT FACTORS. AT THIS TIME, I WOULD LIKE DR. MINK GIVE A PERSPECTIVE HOW WE THOUGHT THE WORKSHOP WENT. >> JUST A COUPLE OF MINUTE, THANKS PAT, DIDN'T COME OUT OF HIS HEAD BUT HE DID HARD WORK, IT WAS A REALLY IMPORTANT USEFUL TWO DAY WORKSHOP THAT INCLUDED A WIDE VARIETY OF E PARTS DOING EPITEAM LOGICAL WORK TO THOSE DOING BIOMECHANICAL WORK SURGERY, PEDIATRICS, DEVELOP MENTAL NEUROPSYCHOLOGY, THE WHOLE GAMUT. AND HIGHLIGHT AD COUPLE OF THINGS WE KNOW GOING INTO IT, MOST FOCUS ON CONCUSSION TRAUMATIC BRAIN INJURY HAS BEEN IN THE SPORTS VENUE, OLDER ADOLESCENTS AND I WANT TO POINT OUT IT'S THE YOUNGER KIDS WHO HAVE A HIGH INCIDENCE OF IN AND WE DON'T KNOW WHAT TO DO. TIME FRAME, TIME OF DEVELOPMENT WHERE THERE ARE A LOT OF THINGS THAT ARE CHANGING THAT PROBABLY HAVE MAJOR IMPACT ON BOTH UNDERSTANDING THE BIOLOGY AND HOW TO ASSESS THE IMPACT, THIS IS A TIME WE'RE GOING FROM PERIOD OF RAPID PROLIFERATION OF CORTICAL SYNAPSES TO BEGINNING OF PRUNING. SYNAPSES AND WHEN THAT DEVELOP MENTAL PROCESS INJURY HAPPENS MAYBE VERY -- THE IMPACT MIGHT BE QUITE DIFFERENT. THE BIOMECHANICS ARE CHANGING WITH OOH MYELINATED AXONS HAVING STIFFNESS AND COMPLIANCE THAN UNMYELINATED. AND THE CHANGES IN THE BIOPHYSICAL PROPERTIES OF THE BRAIN MAY CHANGE THE RESPONSE TO INJURY. GENDER AND SEX DIFFERENCE, COUPLE OF THINGS I LEARNED THAT I HAD NO IDEA FOR EQUIVALENT SPORTS FOR EXAMPLE, BASEBALL VERSUS SOFTBALL BASKETBALL, COMPARING MALES AND FEMALES, MECHANISM OF INJURY IS DIFFERENT. BOYS TEND TO HIT THEIR HEAD AGAINST OTHER BOYS AND GIRLS MORE LIKELY IMPACT WITH EQUIPMENT OR THE GROUND. PHYSICS OF THE INJURY MAYBE DIFFERENT BASED ON SEX OR GENDER DIFFERENCES THAT MAY NOT RELATE SPECIFICALLY TO BIOLOGY BUT CHANGING HORMONAL ENVIRONMENT TO AND CLEARLY THERE ARE EMERGING TO IMPACT OF CLOSED HEAD INJURY DEPENDS ON ESTROGEN LEVELS. THAT'S BOTH PRE-VERSUS POST GLOBAL WHERE IN THE MENSTRUAL CYCLE THE HEAD INJURY OCCURS WITH RELATION TO AGAIN CHANGING LEVELS OF HORMONE SO WHAT THAT MEANS IS THE BYE-BYOLOGY, BIOLOGICAL IMPACT CONSEQUENCES MAY DEPEND ON MANY THINGS THAT ARE CHANGING DURING THIS PERIOD OF DEVELOPMENT THAT WE DON'T CAPTURE, WE DON'T REALLY UNDERSTAND IN WHAT IS CURRENTLY USED FOR GUIDING OUTCOMES RESEARCH AT HEAD INJURY. SO I THOUGHT IT WAS A VERY USEFUL WORKSHOP AND REALLY LED TO THIS PROPOSAL WHICH I THINK IS A VERY IMPORTANT ONE. >> THANK YOU, JONATHAN. YOU THINK THERE'S AN EXECUTIVE SUMMARY OF THE MEETING SESSIONS AND THE PRIOR -- THEY PRIORITIZE RESEARCH AREAS, AND WHAT WE SHOULD DO AND OF COURSE, SO BEFORE I SHOW YOU THE CONCEPT YOU SHOULD KNOW THEY CAME UP WITH A 20 YEAR LONG STUDY THEY MEASURE ACROSS THE AGES SO THIS IS CHEAPER. SO WHAT WE CAME UP WITH WAS TO FUND A SINGLE UO-1 COOPERATIVE AGREEMENT, THE ADVANTAGE OF THE UO-1 MECHANISM IS THAT IT ALLOWS US TO PUT IN MILESTONES, I REALLY HAVE TWO GOALS FOR THIS COOPERATIVE AGREEMENT, ONE IS TO IDENTIFY BUY ALMOSTCAL MEASURES OF CONCUSSION AND RECOVERY. BUT TWO IS TO DEVELOP A DATA REPOSITORY TO DEVELOP RESOURCE FOR INVESTIGATORS TO ADVANCE ACCELERATE RESEARCH IN THIS AREA, MORE QUICKLY PROVIDE US WITH THESE ANSWERS. SO WHAT WE'RE ASKING THEM TO DO IS COLLECT DATA IN PEDIATRIC COHORT WITH AGE 9 TO 14, 9 TO 14 BECAUSE IT WAS A RECOMMENDATION BUT ALSO BECAUSE IT MATCHES WITH NIH ABCD STUDY WHICH IS A $30 MILLION A YEAR STUDY FOLLOWING A 10,000 KIDS ACROSS TEN YEARS, THEY STARTED WITH AGE 9 THIS WILL ALLOW US THE USE THAT DATA SET AS CONTROL AND COMPARED TO DATA SET. AND AT A MINIMUM WHAT WE WANT THEM TO DO IS LOOK AT ACUTE INJURY SO THEY CAN GET BIOLOGICAL MEASURES ACUTELY AND BRING IN A GROUP OF KIDS WITH PERSISTENT SYMPTOMS AN WORKED BACKWARDS. SO WHAT ABOUT THESE KIDS CAN WE LEARN SO WE CAN PREDICT WHAT HAPPENS TO THEM AND WHAT TREATMENTS MIGHT BE EFFECTIVE WITH THEM. THE OTHER THING COOPERATIVE AGREEMENT ALLOWS US TO DO IS ENFORCE THE DATA SHARING COMPONENT OF THIS. SO THERE IS A WRITE UP OF SOME OF THE OTHER THINGS THAT HAVE DRIVEN THIS INCLUDING CONGRESSIONAL INTEREST. WITHNA I'LL OPEN UP TO QUESTIONS. >> TRICKY WHEN OUTCOME IS TO FUND ONE THING. HOW MANY GROUPS WOULD YOU ESTIMATE WOULD BE INTERESTED IN APPLY. >> MY ESTIMATE IS ABOUT PROBABLY SIX. I CAN THINK OF THREE OR FOUR OFF THE TOP OF MY HEAD. AND I'M SURE THERE ARE A COUPLE OF OTHERS THAT I'M UNAWARE OF. THE OTHER KEY JONATHAN MENTIONED IS WE WANT TO MACK SURE THIS IS NOT JUST ABOUT SPORTS INJURY. THIS IS CONCUSSION AND KIDS BECAUSE MOST CONCUSSIONS ARE NOT FROM SPORTS. >> QUICK QUESTION, FOR THE COHORT WITH THE PERSISTENT SYMPTOMS, ARE YOU GOING TO ASSUME THAT THERE IS DATA AVAILABLE AROUND THE TIME OF THEIR ACUTE INJURY SO THAT YOU CAN EXTRAPOLATE BACK TO WHAT HAPPENED TO THEM AT THE TIME OF THE ACUTE INJURY AND POTENTIALLY IDENTIFY MARKERS OF OUTCOMES BASED ON THAT? >> THAT WOULD BE NICE. ULTIMATELY THAT'S WHAT YOU WANT, BUT DATA PROBABLY AREN'T NECESSARILY THERE. THERE WILL BE CLINICAL RECORDS, PROBLEM SOMETIMES WITH PERSISTENT SYMPTOMS THEY DON'T COME IN FOR A WEEK. THEY HAD THIS HEADACHE FOR A WEEK AND A HALF MOM SAYS OKAY WE'RE GOING TO SEE THE DOCTOR BUT WE ALSO WANT TO -- THAT'S -- WE WANT THAT GROUP ENROLLED BECAUSE THAT GROUP MAY HAVE -- THERE MAYBE BIOLOGICAL MARKERS THAT IDENTIFY WHY THAT KID HAVING THOSE SYMPTOMS VERSUS ANOTHER KID WHO IS NOT HAVING SYMPTOMS. THAT MIGHT NOT BE RELATED TO INJURY MECHANISM. >> THROW IN -- >> HARD TO EXTRACT IN ABSENCE OF KNOWLEDGE ABOUT ACUTE INJURY. >> SO YOU CAN DO RETROSPECTIVE INTERVIEW, THERE'S LOTS OF RETROSPECTIVE INTERVIEW AND CURRENTLY SO OUT OF THAT CANADIAN STUDY CAME ROGER Z EMIC CREATED A JAMA PEDIATRICS PAPER THAT WAS INFLUENTIAL. I FORGET HUNDREDS OF MEASURES OF QUESTIONNAIRES OF SYMPTOM REPORTS AND GOT DOWN TO 12 QUESTIONS. SO SYMPTOM REPORTING AND MECHANISM WE HAVE A GOOD IDEA THAT GIVES US LIMITED PREDICTABILITY OF WHO IS GOING TO HAVE PROBLEMS. HIS CONCLUSION FROM THAT PAPER IS THE ROC CURVE WAS .7, 70% ACCURACY PERSISTENT SYMPTOMS. WHAT WE DON'T KNOW IS WITH BIOLOGICAL -- SOME HAVE HEADACHES ANXIETY, SOME SOME HAVE CONCENTRATION ISSUE, THERE'S COMBINATION OF THOSE SO HAVING PERSISTENT SYMPTOM GROUP ALLOW US TO SHOW DIVERSITY. AND REALLY START THE GET RECOVERY, I THINK WE CAN GET RECOVERY ISSUE THE MONITORING WHAT I CALL WAS A MONITORING BIOMARKER. BUT THAT'S TO ME THAT'S ALMOST AS IMPORTANT PREDICTING WHICH KIDS HAVE IT BECAUSE IF WE HAD MONITORING BIOMARKER YOU CAN DECIDE WHEN THEY'RE BETTER RESUME ACTIVITIES. THAT PERSISTENT SYMPTOM GROUP IS IMPORTANT FOR THAT. >> ECONOMICS ALSO START WITH PEOPLE WHO HAVE THESE SYMPTOMS TRYING TO UNDERSTAND THE BIOLOGY THERE, OPPOSED TO GOING INTO A COHORT WHERE ONLY A THIRD OF THE PEOPLE HAVE SYMPTOMS. I THINK EVENTUALLY THAT'S KIND OF WHERE YOU WANT TO GO BACK. THE OTHER ONE IS THE IDEA OF REPETITIVE CONCUSSION ISSUE, THAT'S WHAT GET PEOPLE INTO TROUBLE. NOT THE SECOND ONE BUT SECOND AND THIRD ONE. WHAT'S THE BIOLOGY GOING ON THERE? >> THE OTHER POINT IS PERSISTENT CONCUSSIVE GROUP MAY NOT HAVE HAD A DIAGNOSED CONCUSSION. SO THE FIELD TALKED ABOUT AND JONATHAN CONFIRMED THAT JUST ACCUMULATION OF HEAD IMPACTS BRING ON THESE SYMPTOMS, THAT'S ALSO OF INTEREST. >> ONE QUESTION TO FOLLOW-UP ON WHAT WAS ALREADY WHEN TALKING BIOLOGICAL MEASURES. THE LACK OF CONTROL IS A LITTLE BIT OF A PROBLEM TO DEFINE WHEN YOU DEFINE THE PERSON AS THE KID WHO STILL HAS PERSISTENT, HOW DO WE KNOW THOSE MARKERS DON'T EXIST IN THE ONE WHO HAVE CONCUSSION WITHOUT THE SYSTEM -- >> I'M NOT LIMITING IT TO THOSE TWO GROUPS BUT I'M LIMITED TO A MINIMUM OF THOSE GROUPS. I THINK YOU DEFINE WHICH -- THE CONTROL SEEM REALLY EASY IN THESE STUDIES BUT IF YOU LOOK AT THE NCAA DOD STUDY AN TRACK TBI THEY'RE SPINNING AROUND. DO I LOOK AT ORTHOPEDICS, DO I LOOK AT HEALTHY CONTROL? I HAVE TEENAGERS SO I KNOW KIDS ARE MOODY. SO THAT TO ME I THINK THAT'S PART OF THE REVIEW PROCESS. AND THEY NEED TO HAVE CONTROLS BUT THEY NEED TO DEFINE -- THEY ARE BETTER AT DEFINING WHICH CONTROLS THEY WANT. I'M DEFINING AT LEAST GIVE INJURY GROUPS. THESE PEOPLE WITH SYMPTOM. >> IF THERE'S NO OTHER QUESTIONS, WE NEED O MOTION FOR THIS TO MOVE FORWARD. SECOND. ALL IN FAVOR. OPPOSED? ABSTENTIONS? PEOPLE ON THE PHONE? LARRY, IN FAVOR. >> IN FAVOR. >> THANKS A LOT. SO WE'RE DONE A LITTLE -- WHICH IS INCREDIBLE. WE'RE GOING TO BREAK FOR LUNCH BUT I WOULD LIKE YOU TO GET BACK BY FIVE OF ONE, SO WE WILL TALKING EXTREMELY IMPORTANT AND INTERESTING TOPIC HOW NIH PARTICULARLY NINDS SHOULD SPEND ITS MONEY. SO OUR SPEAKERS HAVE ONLY A LIMITED AMOUNT OF TIME HERE, JOHN LORSCH AND MIKE LAUER, BUT IF YOU CAN GET BACK FROM LUNCH AT 5:OF 1:00. -- 5 OF 1:00. >> IF I'M GOING TO READ THAT BEFORE WE DO SPECIAL -- SO ONE QUICK SLIDE -- I CAN JUST READ IT. I DO HAVE IT HERE. WALTER IS ABOUT TO TALK ABOUT IN 2012, NIH WAS MANDATED TO USE THIS PROCESS CALLED SPECIAL COUNCIL REVIEW. SO WHENEVER SOMEBODY COMES TO US, YOU WILL SEE IN CLOSED SESSION WHO HAS PA MILLION DOLLARS IN DIRECT COSTS OF NIH SUPPORT, COUNCIL HAS TO LOOK AT THE NEXT, THEY WANT FUNDED. THESE ARE THE CRITERIA THEY'RE SUPPOSED TO APPLY. SO THE SECOND BULLET. >> JUST TO PREFACE THIS, THE REASON WE'REBLYING TO YOUR ATTENTION IS WE HAVE A LITTLE TIME. THE SECOND OF ALL, WE'LL HAVE A DISCUSSION ABOUT THE PROS AND CONS OF DELIVERING FUNDING TO FOLKS WHO HAVE LOTS OF FUNDING. THAT'S GOING TO BE VERY INTERESTING DISCUSSION. I HAVE SEEN THE DATA. WE HAD TALKS ABOUT THIS, SO IT'S GOING TO INSIGHT A LOT OF I WOULD SAY HIGH VALENCE. >> INSIGHT GOES WITH VIOLENCE. >> VALENCE. VALENCE. AFTER THAT, WE'RE GOING TO REVIEW THE GRANTS OF PEOPLE WHO HAVE A MILLION DOLLARS IN GRANT FUNDING. IN THE CLOSED SESSION. IS TO WHEN I WANT TO EMPHASIZE NOW THAT WE HAVE THE TIME, IS THAT WHEN WE GO INTO THE CLOSED SESSION TO LOOK AT THOSE THIS IS THE POLICY AS IT STANDS NOW, WE MAY WANT TO CHANGE THE POLICY, BUT WE DON'T WANT TO DO IS TO AFFECT DISCUSSION TODAY WITHOUT A CHANGE IN THE POLICY, SO THIS IS THE POLICY WE'RE RUNNING UNDER. ALL THE NIH INSTITUTES ALL ARE INSTRUCTED TO LOOK AT ALL -- ANY GRANTS FROM PIs WHO HAVE MORE THAN A $1 MILLION IN DIRECT COSTS, FROM ACTIVE RPG. THAT'S WHAT WE'RE INSTRUCTED TO DO, GUIDELINES ARE THAT WE SHOULD BE FOCUS ON WHETHER OR NOT FUNDING THE GRANTS GIVES SPECIAL OPPORTUNITIES FORWARDED TO THE INVESTIGATOR, DIRECTIONS HIGHLY PROMISING AND DISTINCT FROM HIS OR HER FUNDED PROJECT. SO HIGHLY DISTINCT NOT OVERLAPPING. SO THAT'S CRITERIA NUMBER ONE. THE RENEWAL APPLICATION, IN LOOKING AT RENEWAL APPLICATION CAN ALSO CONSIDER THE VALUE OF CONTINUING WHAT WAS PRODUCTIVE PRODUCT. SO IF YOU LOOK AT NEW APPLICATION THAT PUTS SOMEBODY OVER A MILLION. AND THE OTHER CONSIDERATIONS WE ALSO BE GIVEN TO DIFFERENT TYPES OF RESEARCH CLINICAL TRIALS TRANSLATION, SOMETHING DIFFERENT THAN DONE BEFORE REQUIRES A LARGER AWARD THAN ANOTHER FIELD REQUIRES JUST BECAUSE THE EXPENSE OF DOING THAT TYPE RESEARCH. GOAL IS TO ENSURE RESPONSIBLE STEWARDSHIP OF PUBLIC FUNDS. THAT'S THE POLICY THAT WE'RE OPERATING UNDER SO FAR, BUT WE'RE GOING TO TALK ABOUT IN THE OPEN SESSION THIS AFTERNOON IS WHAT -- IS THIS POLICY REALLY DOING US RIGHT BY OUR INVESTMENT BUT THEN THAT WOULD REQUIRE IF WE CHANGE IT A NEW POLICY SO WE WANTED TO KIND OF BRING THAT OUT IN THE OPEN, THIS IS WHAT WE'LL WORK UNDER TODAY. >> QUESTIONS IF YOU'RE CONFUSED WE'LL TALK ABOUT THIS IN MORE DETAIL. >> ANYBODY HAVE ANY QUESTIONS? >> I HAVE A QUESTION. >> YEAH LARRY. >> I WANTED TO WHEN YOU TALK ABOUT -- SOUNDS LIKE LIMIT IS OF NIH FUNDING, NOT TOTAL FUNDING. >> THAT'S CORRECT. SO FAR WHAT NIH HAS BEEN DOING. >> OKAY. THE LINES TEND TO BE VERY LONG IN THIS CAFETERIA UPSTAIRS. >> AMY. >> I CAN ASK IT LATER IF WE'RE GOING -- >> >> WHAT IS IT >> IT'S MORE A CLARIFICATION. BECAUSE WE DO -- WE HAVE HAD THIS DISCUSSION AT MULTIPLE COUNCIL SESSIONS I HAVE BEEN ON NOW. AND ALMOST BY DEFINITION, THE HIGHLY SCORING GRANT IS GOING TO HAVE MET MANY OF THOSE THINGS. THOSE CRITERIA. IT OFTEN FEELS RATHER PERFUNCTORY AND I GUESS THE QUESTION IS, IS THE BAR REALLY HIGHER IF OVER A MILLION DOLLAR OR IS THE ROLE TO GO THROUGH AND SEE IF THEY MEET THESE CRITERIA, CLOSE TO MANY OF THE CRITERIA THAT STUDY SECTIONS TAKE INTO CONSIDERATION WHEN SCORING. SO I DON'T THINK I HAVE SEEN US TURN DOWN FUNDING. >> LET ME GO THERE, BOB. THAT'S EXACTLY THE QUESTION WE'RE GOING TO BE DISCUSSING WHEN WE COME BACK TO OPEN SESSION. PUBLIC DISCUSSION, WE MAY DEFINE POLICY BUT THE TRUTH OF THE MATTER IS, THIS IS COME -- THIS QUESTION YOU ASKED ABOUT THE BAR COME OUT TRANS-NIH WIDES, IT'S EXCEEDINGLY RARE IF NOT -- NEVER HAPPENED AT ANY INSTITUTE IS ACTUALLY DONE THIS. WITH THE EXCEPTION OF NIGMS WHO YOU WILL BE HEARING FROM. >> BY THE WAY, IT'S NOT EXACTLY TRUE THAT THIS IS ADDRESSED IN PEER REVIEW, COMPLETELY, BECAUSE FOR EXAMPLE, THE FIRST GUIDELINE IS THAT THE NEW PROJECT UNDER CONSIDERATION BE SIGNIFICANTLY DIFFERENT FROM THE INVESTIGATORS OTHER PROJECTS. WHICH MAY OR MAY NOT BE DISCUSSED IN PEER REVIEW. SOMETIMES IT IS, SOMETIMES IT ISN'T. BUT YOU'RE RIGHT THIS IS PER FUNCTIONTORY. >> THIS ISSUE COMES UP POST TALK, IS THAT RIGHT? NOBODY IS ASKED IF YOU APPLY FOR THIS GRANT AND YOU KNOW IT'S GOING TO PUT YOU OVER THE LINE, PLEASE DESCRIBE. >> THIS POLICY IS PUBLISHED. >> WE DON'T ALERT INVESTIGATORS BUT BY THE WAY YOU ARE SCRUTINIZED BUT THIS IS A PUBLIC POLICY. >> THE PATTERNS WELL FUNDED PEOPLE SUBMIT GRANTS WOULD INDICATE THEY ARE QUITE WELL AWARE OF THIS POLICY, SOME THINGS COME OUT AS OTHERS EXPIRE. >> MANY PIs YOU WILL SEE THIS IN CLOSED SESSION, THEY'RE PROPOSING TO PUT 8% EFFORT ON THE RO1 OR 10%, THIS IS COMMON. >> THIS IS GOING TO COME UP BUT WALTER'S POINT IS CRITICAL, WHEN WE LOOK AT THIS IN THE CLOSED SESSION UNTIL WE PUBLISH A NEW POLICY IF WE CHOOSE TO DO SO WE CAN WING IT. >> GREAT. ANY OTHER QUESTIONS? 5 OF 1:00, IF YOU BACK HERE THAT WOULD BE GREAT. THE NEXT ISSUE ON THE AGENDA IS A MAJOR POLICY ISSUE FOR NIH. AND ALSO FOR OUR INSTITUTE. THE INTENSE DISCUSSIONS ACROSS NIH AND WITHIN THE COMMUNITY ABOUT THIS TOPIC WHICH TO SAY IT IN GENERAL TERMS IS HOW WE -- CAN E WE SPEND OUR MONEY MOST WISELY TO CREATE A DIVERSE SUSTAINABLE BIOMEDICAL WORK FORCE. SO WE HAVE INVITED JOHN LORSCH AND MIKE LAUER. JOHN IS DOWN THERE. WHO SPEARHEADED THIS DISCUSSION AT NIH. THEY CHAIRED A WORKING GROUP THAT CAME UP WITH IDEAS ABOUT IT. MIKE IS DEPUTY DIRECTOR FOR EXTRAMURAL RESEARCH AT NIH. WHICH IS A VERY IMPORTANT POSITION JOHN IS DIRECTOR OF NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES I DON'T HAVE TIME TO LIST THERE'S MANY HONORARY -- HOPEFULLY YOU HAVE GOTTEN MANY -- YOU WON'T BE GETTING HONORARIUM FOR THIS. BUT THEY ARE BOTH GREAT. I'M SUMMARIZE IN TERMS OF THAT. AFTER MIKE PRESENCE, HE WILL GIVE THE FIRST TALK, UNLESS THERE'S PRESSING QUESTIONS THAT CAN'T WAIT 20 MINUTES THEY WILL TALK ABOUT THE TRANS-NIH, THE NIH WIDE DATA ON THIS PARTICULAR TOPIC. THEN ANNA TAYLOR, THE POINT PERSON IN MY OFFICE FOR ANALYSIS WILL GIVE A SHORTER TALK WHICH IS ESSENTIALLY EXTRAPOLATION FOR WHAT MIKE WILL TALK SPECIFIC TO NINDS, DISSECTING THE NINDS DATA FROM THE NIH DATA. THEN WE'LL OPEN FOR BROAD DISCUSSION. WALTER, ANYTHING ELSE YOU WANT TO SAY WITH THIS? MIKE. THANKS A LOT TO BOTH OF YOU FOR COMING. >> GOOD AFTERNOON, JOHN AND I ARE REALLY PLEASED TO BE HEREMENT I WANT TO POINT OUT THIS STEMS FROM THE WORK OF A LOT OF PEOPLE, JOHN CHAIRS A WORKING GROUP CALLED THE EXTRAMURAL ACTIVITIES WORKING GROUP AND AS PART OF THAT, HE SET UP A WORKING GROUP ON EFFICIENCY AND SUSTAINABILITY AND FUNDING AND WHAT KIND OF POLICIES WE CAN SET UP FOR THAT. THAT LED TO THIS PARTICULAR WORK. HOW MANY HAVE SEEN THIS PAPER? THIS WAS A PAPER THAT CAME OUT A FEW YEARS AGO, THOSE WHO HAVEN'T SEEN IT, I WOULD STRONGLY RECOMMEND YOU TAKE A LOOK AT IT. THIS PAPER APPEARED IN PNAS AND TALKED ABOUT THE SYSTEMIC FLAWS IN OUR SYSTEM OF BIOMEDICAL RESEARCH. WHAT THESE DISTINGUISHED AUTHORS POINTED OUT IS THAT AN ERRONEOUS ASSUMPTION OF NEVER ENDING GROWTH LED TO SUSTAINABLE HYPEREXEAT TV SYSTEM. WHAT THIS IS DOING IS MAKING IT VERY DIFFICULT FOR NEW OUTSTANDING PEOPLE TO ENTER INTO OUR PROFESSION AND IT'S ALSO MAKING A DIFFICULT FOR PEOPLE WHO ARE ESTABLISHED INVESTIGATORS TO STAY IN. WITHOUT SOME KIND OF FUNDAMENTAL READDRESSING HOW OUR SYSTEM IS SET UP IS A RECIPE FOR LONG TERM DECLINE. AT THE SAME TIME THIS PARTICULAR PAPER CAME OUT, ANOTHER PAPER CAME OUT IN E LIFE WHICH WAS LED BY JUDITH KIMABLE. SHE LED A SERIES OF WORKSHOPS AT THE UNIVERSITY OF WISCONSIN, SHE BROUGHT PEOPLE FROM ALL OVER THE COUNTRY TO LOOK AT VARIOUS PROBLEMS, IN THE U.S. BIOMEDAL RESEARCH SYSTEM, THEY IDENTIFIED WHAT THEY CALL TWO CORE PROBLEMS. THEY SAY THAT THESE TWO CORE PROBLEMS ESSENTIALLY EXPLAIN EVERYTHING ELSE, ALL THE OTHER PROBLEMS WE HAVE SUCH AS OVERBURDENED PEER REVIEW SYSTEM ARE SYMPTOMS OF THESE TWO CORE PROBLEMS. SO ONE IS THERE ARE TOO MANY SCIENTISTS VYING OUT TOO FEW DOLLARS, SECOND IS THERE'S POST-DOCS VYING AFTER TOO FEW FACULTY POSITIONS. THIS GETS AT -- WE THINK TOO MANY SCIENTISTS, TOO MANY POST-DOCS, GETS AT YOU MIGHT SAY SIMPLEST BUT VERY IMPORTANT MEASURE OR METRIC OF OUR RESEARCH SYSTEM WHICH IS HOW MANY SCIENTISTS DO WE HAVE. THIS IS AN ARTICLE JOHN WROTE YEAR AND A HALF AGO IN WHICH HE SUGGESTED THAT INSTEAD OF FOCUSING ONLY ON GRANTS OR ON DOLLARS, AS A METRIC OF OUR RESEARCH FUNDING SYSTEM, WE SHOULD LOOK AT SOMETHING WHICH SEEMINGLY MAYBE TRIVIAL BUT NONETHELESS IS ARGUABLY VERY IMPORTANT. THAT IS THE NUMBER OF UNIQUE INVESTIGATORS WHOM WE SUPPORT. YOU'RE POSTPRANDIAL. HERE IS ONE, AMONG ALL OUR RPGs, RESEARCH PROGRAM GRANTS, HOW MANY UNIQUE PIs DOES NIH SUPPORT? HOW MANY PEOPLE ARE THERE IN THIS COUNTRY WHO CAN RAISE THEIR HAND AND SAY I AM THE PROUD PI OF AT LEAST ONE NIH RPG. NOBODY HAS ANY IDEA. THIS IS LIKE AN AUCTION. SOMEBODY HAS TO PUT OUT THE FIRST BID. 8,000. 9,000. 10,000. 80,000. LOWER. THIS PLOT ON THE X AXIS, 2003 TO 2015, THE Y AXIS IS A NUMBER. THE RED LINE REFERS TO NUMBER OF O UNIQUE AWARDEES WHO HAVE ONE RPG. BACK IN 2003 IT WAS ABOUT 25 1/2 THOUSAND, IN 2015, IT WAS A LITTLE UNDER 28,000, THAT'S WHAT IT IS ABOUT RIGHT NOW. SINCE 2011 THROUGH NOW IT HAS NOT CHANGED VERY MUCH. IN ANY GIVEN YEAR YOU CAN ASK THE QUESTION HOW MANY WANTED TO BE FUNDED THAT AREA. LAST YEAR 2016. HOW MANY WOULD HAVE WANTED TO HAVE BEEN FUNDED IN TO 16. SOME WHO WEREN'T FUNDED AND APPLIED FOR A GRANT IN 2016 BUT SOME MAY APPLY IN 2015, 2014, 2013 BECAUSE GLANCE ARE MULTI-YEAR MECHANISM. SO WHAT WE DID IS LOOKED OVER A MULTI-YEAR WINDOW AND THEN FOR EACH YEAR IDENTIFIED HOW MANY UNIQUE PEOPLE WANTED TO BE FUNDED IN ANY GIVEN YEAR. THIS IS NOT SUBTLE SO BACK IN 2003 WAS ABOUT 60,000 UNIQUE PEOPLE WHO WANTED TO BE FUND AND 2003 BE AND BY 2015 THAT INCREASED TO 90,000. THIS IS WHAT TYPE OF COMPETITION LOOKS LIKE. WE HAVE MORE PEOPLE WHO ARE VYING FOR ROUGHLY EQUIVALENT OR IF ANYTHING DECLINING AMOUNT OF MONEY. SO ONE WAY WE CAN THINK ABOUT THE RESEARCH WORK FORCE IS THE NUMBER OF INVESTIGATORS WHO WE SUPPORT AND WHAT WE'RE SEEING IS THE NUMBER OF INVESTIGATORS WE'RE SUPPORTING HAS REMAINED RELATIVELY STAGE OR MAYBE INCREASED A TINY BIT WHILE NUMBER WHO WANT TO BE INCREASED DRAMATICALLY, THAT'S THE SHAPE OF COMPETITION. WE KNOW THE DEMOGRAPHIC OF THE BIOMEDICAL WORK FORCE IS CHANGING, HOW MANY HAVE SEEN THIS? SO THIS AMALGAM OF PLOTS SOME PRODUCED BY AAMC, SOME BY NIH, THE X AXIS SHOWS RO1 FUNDED INVESTIGATORS AND THE Y IS PERCENT. SO YOU SEE IN THE LIGHT BLUE THAT'S WHAT THE DISTRIBUTION WAS BACK IN 1980. THE MODE WAS AROUND 38, 39. YOU CAN SEE THE DARK BLUE WHAT IT LOOKED LIKE IN 2013. SO THE WHOLE AGE DISTRIBUTION SHIFTED TO THE RIGHT. RED LINES REFER TO AAMC FACULTY, YOU SEE A VERY SIMILAR KIND OF PATTERN. THERE'S MORE TO IT GOING ON THAN THIS T. RESEARCHER CAN BE AN EARLY STAGE OF THEIR CAREER, MIDDLE STAGE OF THEIR CAREER, AND LATER STAGE CAREER, WE SEE DIFFERENT THINGS HAPPENING. THIS IS SHOWN HERE. X AXIS IS FISCAL YEAR, THIS GOES FROM 1990 TO 2015, AND Y AXIS IS A PERCENT. WHAT PERCENT OF FUNDED RESEARCHERS IN ANY GIVEN YEAR ARE IN EARLY STAGE CAREER WHICH WE DEFINE HERE AS AGE OF LESS THAN 45 IN A MID STAGE CAREER WE DEFINE AGE 45 TO 60 OR LATER STAGE OF CAREER WHICH WE DEFINE AS 60 OR HIGHER. BACK IN 1990, LITTLE OVER HALF WERE EARLY STAGE INVESTIGATORS, ABOUT 40% MID CAREER INVESTIGATORS AND ONLY A SMALL NUMBER WERE LATE CAREER INVESTIGATORS. IF YOU LOOK AT THE RED LINE, IT SHOWS THAT THE NUMBER OF YOUNGER EARLY STAGE INVESTIGATORS, THAT'S GONE DOWN AND HAS GONE WAY DOWN FROM 55% DOWN TO 30% AND FLATTENS OUT AROUND 2007, THAT'S WHEN NIH INSTITUTED SOME MORE AGGRESSIVE NEW INVESTIGATOR POLICIES. BLUE LINE ARE LATER STAGE INVESTIGATORS. WHAT WE SEE IS BEGINNING AROUND TIME DOUBLING WE SEE A STEADY INCREASE, NOW THAT'S OVER 20% OF OUR FUNDED INVESTIGATORS. THAT COINCIDES WITH NIH DOUBLING AS WELL AS DOUBLING AT END OF MANDATORY RETIREMENT. THE GREEN LINE REPRESENTS MID CAREER INVESTIGATORS. THE DIRECTION OF THE CURVE IS ACTUALLY SHIFTED SO FEWER MID CAREER INVESTIGATORS WE'RE FUNDING. THE FACT THAT EARLY CAREER INVESTIGATORS AND MID CAREER INVESTIGATORS ARE HAVING A HARD TIME SOMETHING WHICH IS WIDELY RECOGNIZED, THIS IS A PIECE THAT APPEARED IN NATURE TWO, THREE MONTHS AGO. ED FROM TVS A SPECIAL ISSUE ON YOUNGER SCIENTISTS, UNITED STATES FUNDING SUCCESS RATES FOR ALL AGE BRACKETS ARE LESS THAN HALF WHAT THEY WERE BACK IN THE 1980, SO RESEARCHERS ARE SPENDING MORE TIME SEEKING FUNDING BURDEN FALL HEAVILY ON YOUNG OR NEW FACULTY MEMBERS. RESEARCHERS HAVE LITTLE TIME FOR DOING ANYTHING OTHER THAN GOING AFTER FUNDING AND THAT MAKES THEM CONSERVATIVE RATHER THAN AMBITIOUS. AND THERE'S SURVEYS DONE, IT'S IN THE APPENDIX OF THE SLIDES HERE, BUT THERE'S LARGE SCALE SURVEYS DONE THAT THE BIGGEST SOURCE OF STRESS FOR NEW AND MID CAREER INVESTIGATORS IS THE WORRY ABOUT WHERE THEIR MONEY IS GOING TO COME FROM. THAT IS PROBLEM NUMBER 1, WE HAVE A SYSTEM WHICH IS POTENTIALLY INHERENTLY UNSTABLE AND BESET BY EXTREME HYPERCOMPETITIO. THIS EXTREME HYPERTENSION MAYBE HURTING YOUNG ERICA REAR INVESTIGATORS. HERE IS ITEM 2. THE SAME ARTICLE IN PNAS ABOUT THE SYSTEMIC FLAWS IN THE BIOMEDICAL RESEARCH SYSTEM. AUTHORS SAY AGENCIES SHOULD BE SENSITIVE TO TOTAL NUMBER OF DOLLARS GIVEN TO AN INDIVIDUAL LABORATORIES. THOUGH DIFFERENT RESEARCH ACTIVITIES AND DIFFERENT COSTS AT SOME POINT RETURNS PER DOLLAR DIMINISH. THEY CONGRATULATE THE NIH FOR POLICY THAT REQUIRES SOMETHING YOU MAY WELL BE DOING TODAY, YOU HAVE TO LOOK AT LABORATORIES THAT ARE GETTING MORE THAN A MILLION DOLLARS PER YEAR. WE BOLDED THREE ITEMS HERE, SHOULD BE SENSITIVE TO TOTAL NUMBER OF DOLLARS THAT A LABORATORY RECEIVE, SO WE'LL TAKE A LOOK AT THAT. DIFFERENT RESEARCH ACTIVITIES HAVE DIFFERENT COST, SO THIS IS AN IMPORTANT PROBLEM. CLINICAL TRIALS ARE MORE EXPENSIVE THAN OTHER KINDS OF RESEARCH. LARGE ANIMAL STUDIES OR STUDIES INVOLVING NON-HUMAN PRIMATES ARE MORE EXPENSIVE THAN OTHER KINDS OF RESEARCH. SO YOU HAVE TO BE CAREFUL IF WE FOCUS SOLELY ON DOLLARS ALONE. SO WE WILL TALK ABOUT HOW WE GET TO THAT AND RETURNS PER DOLLAR DIMINISHED. WE WILL LOOK AT DATA TO GET A SENSE WHAT THAT MEANS. SO IF WE LOOK AT HOW MONEY IS DISTRIBUTED THESE ARE OVER 2015, IT DOESN'T CHANGE VERY MUCH. THIS IS WHAT WE CALL A PARADEO PLOT. A PARADEO PLOT IS A RANGING PLOT. WE TAKE EACH INVESTIGATOR AND SEE HOW MUCH MONEY THEY. -- THEY HAVE AND RANK THEM ONE ON TOP OF THE OTHER WHERE THE PERSON AT THE TOP IS EAST AMOUNT OF MONEY, THE SECOND LEAST AMOUNT OF MONEY, THEN THE THIRD LEAST AND PERSON ON THE BOTTOM HAS THE MOST AMOUNT OF MONEY AND CUT IT INTO TEN EQUAL PIECES SO WE HAVE DECILES ACCORDING TO FUNDING AND WE LOOK WITHIN EACH DECILE WHAT IS A TOTAL AMOUNT OF MONEY THEY GET. SO THESE ARE THE FOLKS WITH THE LEASTMENT OF FUNDING AND THESE GET THE MOST AMOUNT OF FUNDING, TURNS OUT 10% OF THE NIH INVESTIGATORS ARE GETTING 40% OF THE MONEY. THAT IS AN IMPORTANT POINT HERE SO UNEVEN DISTRIBUTION HOW MONEY IS BEING GIVEN OUT. WHY IS THAT A PROBLEM? ONE REASON IT MAYBE A PROBLEM IS BECAUSE OF THE PHENOMENON AUTHORS REFER TOTI MY NICHING RETURNS. SO THIS IS FROM NIGMS WEBSITE, IN THIS CASE YOU'RE LOOKING AT A PUBLICATION OUTPUT T THIS IS OPPORTUNITY FOR LOTS OF OUTPUTS. I WILL SHOW YOU MORE DATA LATER. BOTTOM LINE IF YOU GIVE LABORATORY MORE MONEY THEY BECOME PRODUCTIVE BUT TO A LESSER DEGREE. THIS IS A PHENOMENON OF DIMINISHING RETURNS. ONE OF MY TEACHERS ONCE TAUGHT THIS WAS THAT FIRST SCOOP OF ICE CREAM IS WONDERFUL, THE SECOND SCOOP IS REALLY GOOD. THE THIRD SCOOP OF ICE CREAM IS OKAY AND THE FOURTH SCOOP OF ICE CREAM I COULD DO WITHOUT. SO IT'S SIMILAR -- NOT TO TRIVIALIZE THIS BUT THE IDEA IS THAT AS ONE GIVES A UNIT MORE MONEY INCREMENTAL INCREASE IN PRODUCTIVITY WILL DECREASE. THESE ARE REFERENCES THERE'S QUITE A WIT OF WORK NIH AND ELSEWHERE LOOKING AT THIS. HOW ARE WE GOING TO THINK ABOUT THIS? WE'RE THINKING ABOUT INPUT WE PUT IN A LABORATORY AND WE HAVE TO THINK WHAT IS THE OUTPUT, WHAT WE'RE GETTING FOR IT. SO FOR INPUT ONE WAY YOU CAN THINK INPUT IS DOLLARS. TOTAL AMOUNT OF MONEY THAT A LABORATORY GETS? THE PROBLEM WITH THAT IS EXACTLY WHAT THE AUTHOR SAID. THAT'S WORRISOME. ANOTHER WAY WE CAN THINK IS PERCENT EFFORT. WE CAN COUNT UP WITH INVESTIGATORS. IT'S A DIFFICULT MEASURE SO USE IN PRACTICALITY BECAUSE IT GETS REPORTED OUT IN DIFFERENT WAYS. A THIRD WAY WE CAN LOOK IS SIMPLY COUNT GRANTS. WE CAN SAY WELL, SOME INVESTIGATORS HAVE ONE GRANT, SOME TWO, SOME THREE. AND THERE'S A PROBLEM WITH THAT. NOT ALL GRANTS ARE THE SAME. BACK IN THE 1990s THERE WAS BASICALLY ONE TIME GRANT. 1980s, RO1. THERE WERE A FEW PEOPLE WHO HAD OTHER GRANTS BUT MOST PART THAT WAS IT. NOW WE HAVE OTHER KINDS OF GRANTS. SO I WILL SEW YOU HOW WE ATTEMPTED TO GET AROUND THIS. THEN WE'LL TALK ABOUT POTENTIAL OUTPUT MEASURES SO THAT WE CAN LOOK AT THE RELATIONSHIP OF OUTPUT TO INPUT. WE CAN'T JUST LOOK AT NUMBER OF GRANTS, RO1 IS NOT SAME AS RO 3 OR R 2 #, IT'S NOT THE SAME AS A P 50. THEY IMPLY SOMETHING VERY DIFFERENT TERMS OF THE KIND OF INTELLECTUAL EFFORT THAT AN INVESTIGATOR IS GOING TO PUT IN. SO WE HAVE COME UP WITH THIS CONSTRUCT WHICH WE CALL A RESEARCH COMMITMENT INDEX. IT'S A WAY OF MEASURING A PI BANDWIDTH. WE CAN SAY WE'LL BENCHMARK TO RO1, WE'LL SAY RO1 REPRESENTS A RESEARCH COMMITMENT INDEX OF SEVEN. DOESN'T MATTER WHAT THE RO1 IS, DOESN'T MATTER WHETHER BASIC PROJECT OR EPIDEMIOLOGY PROJECT, WE'LL GIVE IT A VALUE OF SEVEN. THAN SAY RO 3 AND R 21 IS LESS THAN THAT. P-54 IS MORE THAN THAT. IF YOU ARE A PI ON THE SUBPROJECT, MIGHT BE LESS THAN THAT. SO WE HAD A WHOLE GROUP OF PEOPLE AT NIH GET TOGETHER BRAIN STORM SO WE CAME UP WITH THIS SCHEME AND IT'S IN DETAIL IN APPENDIX OF YOUR SLIDES. EFFECTIVELY WHAT THIS IS, IT'S A KIND OF MODIFIED GRANT, WE DON'T COUNT EACH GRANT THE SAME BECAUSE GRANTS COME IN DIFFERENT FLAVORS. SO THIS IS A HISTOGRAM THAT SHOWS THE DISTRIBUTION RESEARCH COMMITMENT INDEX, FY 15 DATA. SO ON THE X AXIS WE HAVE TOTAL NUMBER RESEARCH COMMITMENT INDEX POINTS. A SEVEN IS ONE RO 1, 14 WOULD BE TWO RO1s. SO HERE IS THE MODE HERE, THAT WOULD BE A SEVEN, ONE RO1. YOU CAN SEE THERE'S A PEAK THERE. THAT'S THE MEDIAN VALUE. HERE, THIS WOULD BE THOSE PEOPLE WHO HAVE TWO RO1s OR EQUIVALENT. HERE WE GET UP TO THREE. NOTICE THIS FOLLOWS A SKEWED DISTRIBUTIONFUL. WE HAVE SMALL RAYTORS WHO HAVE EXTREMELY HIGH RESEARCH INDEXES. SO GETTING A LOT OF GRANTS. THESE PEOPLE HERE, THESE ARE THE MOST INVESTIGATORS. THE WAY YOU CAN THINK IS, THESE ARE THE FOLKS WHO ARE ONE GRANT AWAY FROM LOSING ALL FUNDING. AND SO MAYBE THIS IS A GROUP OF PEOPLE WHOM WE NEED TO BE PARTICULARLY CONCERNED ABOUT. IN FACT IT TURNS OUT THAT THIS GROUP COINCIDES WITH MID CAREER INVESTIGATORS. HERE IS ANOTHER WAY OF LOOKING AT THE SAME DATA, THIS IS A BOX PLOT, HOW MANY ARE FAMILIAR WITH BOX PLOTS? THAT'S GOOD SINCE NATURE SAYS THAT'S WHAT WE'RE SUPPOSED TO BE USING. THIS IS A BOX PLOT SHOWING THE SAME DATA, DISTRIBUTION OF RESEARCH COMMITMENT INDEX. THE -- THAT'S NOW ON THE Y AXIS SO HERE IS THE MEDIAN, SEVEN, THIS IS THE 25th PERCENTILE BOTTOM OF THE BOX, THE 75TH PERCENTILE IS TOP OF THE BOX. THOSE ARE THE OUTLIARS. THIS BIG DOT IS THE MEAN. THE MEAN IS SUBSTANTIALLY HIGHER THAN THE MEDIAN WITH REFLECTS THE SKEWED DISTRIBUTION OF THIS RESEARCH COMMITMENT INDECK. THESE ARE -- THIS BOX PLOT SHOWS WHAT 2015 LOOKS LIKE. WE SHOW YOU WHAT'S HAPPENING OVER THE LAST QUARTER CENTURY. SO 1990, LIFE WAS SIMPLE. THE VAST MAJORITY OF PEOPLE HAD ONE RO1. THERE WERE A FEW WHO HAD MORE. BUT IT WAS A FAIRLY STEREO TYPE KIND OF PATTERN. THEN WE SEE BEGINNING IN IF '96, '97, '98 WHEN THE NIH BUDGET REALLY STARTED TO GO UP, WE SAW THE MEAN CREEPING FROM THE MEDIAN, AND THAT'S WHERE DEGREE OF SKEWNESS INCREASES. THERE IS SOMETHING ELSE INTERESTING GOING ON AS WELL. WHAT WE LOOK AT HERE, IS THE AGE OF THE INVESTIGATOR AND HOW MANY GRANT SUPPORT THEY'RE GETTING. SO THE X AXIS IS AGE, THIS IS 40, 50, 60, 70. AND THE Y AXIS IS WHAT THEIR RESEARCH COMMITMENT INDEX IS, WHICH AGAIN IS THIS WEIGHTED GRANT COUNT MEASURE OF GRANT SUPPORT. BACK IN 1990 WHICH IS THE RED LINE, MOST OF RESEARCHERS CAREER, FROM SAY EARLY 40s ON, THE PATTERN IS STABLE, IT'S A LITTLE OVER SEVEN, BASICALLY PEOPLE WOULD HAVE ONE GRANT AND GO FROM ONE GRANT TO THE NEXT GRANT TO THE NEXT GRANT. BY 2015 WE'RE SEEING A VERY DIFFERENT KIND OF PATTERN WHICH IS THAT AS AMONG THOSE INVESTIGATORS WHO ARE STAYING IN THE SYSTEM, AS THEY GET OLDER, THE AMOUNT OF GRANT SUPPORT INCREASES. SO THAT'S OUR MEASURE OF RESEARCH COMMITMENT INDEX. IT IS IN ATTEMPT TO MEASURE THE AMOUNT OF GRANT SUPPORT A PERSON GETS WITHOUT PENALIZING THEM FOR DOING MORE EXPENSIVE RESEARCH LIKE CLINICAL TRIALS OR LARGE ANIMAL STUDIES. AND GOING BEYOND VERY SIMPLISTIC GRANT COUNT. WHAT WE'RE GOING TO DO NOW SHIFT GEARS AND THINK ABOUT HOW WE MEASURE OUTPUT. YES. FROM >> CAN YOU EXTRACT INFORMATION ON GENDER AN ETHNICITY AND HOW IT CHANGED OVER THE COURSE OF THOSE TWO TIME PERIODS? >> YES. WE HAVE DONE THAT. SO FOR GENDER, THE PATTERN IS FAIRLY SIMILAR THOUGH WOMEN GET LESS SUPPORT OVER TIME THAN MEN BUT CHANGE IN THE SHAPE OF THE CURVE STAYED THE SAME. WE HAVE A LITTLE DATA, NOT TIME COURSE BUT RESEARCH SUPPORT DEMOGRAPHIC. ET CETERA. >> SO THE ISSUE HOW ONE MEASURES RESEARCH OUTPUT IS A GIGANTIC ISSUE IN AND OF ITSELF THERE'S A HUGE AMOUNT WRITTEN ON IT, LOTS OF REPORTS, LOTS OF SUGGESTIONS, I WILL SHOW YOU WHAT WE'RE DOING POINTING OUT THAT THIS IS A MEASURE, TWO MEASURES NOT AT ALL ATTEMPTING TO BE COMPREHENSIVE, BUT NONETHELESS, HELPS US THINK THROUGH THIS. THIS IS CALLED THE RELATIVE CITATION RATIO. IT WAS DEVELOPED BY OUR COLLEAGUE GEORGE SANTANGELO AND HIS COLLEAGUES IN OFFICE OF PORTFOLIO ANALYSIS. HOW MANY OF YOU HAVE SEEN THIS? SEW A FEW. THIS IS A TOOL AVAILABLE TO YOU. IT IS AVAILABLE TO YOU FOR FREE. PLEASE PUT IN YOUR OWN PAPERS AND SEE HOW WELL YOU'RE DOING. THIS IS HOW IT WORKS. THAT RED DOT, THAT'S YOUR PAPER. IN YOUR PAPER YOU SITE OTHER PEOPLE. THOSE ARE THESE PAPERS DOWN HERE. YOU PUBLISH YOUR PAPER, YOU HOPE OTHER PEOPLE NOTICE YOUR PAPER. AND YOU HOPE THAT THEY WILL NOTICE IT ENOUGH THEY WILL SITE IT. SO THOSE ARE THE PAPERS ON THE TOP, THEY SITE YOUR PAPER. BUT THEY DON'T ONLY SITE YOUR PAPER, THEY SITE OTHER PAPERS AS WELL. YOU CAN THINK OF THESE AS SIBLINGS, CAN YOU COUSIN, GEORGE CALLS THIS A CO-CITATION NETWORK. AND THESE ARE PAPERS THAT ARE LIKELY TO BE SIMILAR TO YOURS. THEY'RE SIMILAR, MAYBE SIMILAR IN TERMS OF TOPIC, MAYBE SIMILAR IN TERMS OF TIME, THEY YOU CAN PUBLISH SAME TIME WHEN YOUR PAPER BUZZ PUBLISHED. THIS IS AN ATTEMPT TO MEASURE CITATION, GETTING AROUND THE PROBLEM THAT PAPERS SITE DIFFERENT RATES DIFFERENT FIELDS. SAY HEAVEN FORKED BY YOUR PAPER NEVER EVER EVER GETS CITED. THE RATE OF BY YOUR PAPER GETS CITED COMPARED TO THE COUSINS, THE CO-PAPERS AND CO-CITATION NETWORK WILL BE ZERO BECAUSE YOUR PAPER WAS NEVER CITED. IN THE ACADEMIC LITERATURE, 40% PAPERS NEVER GET CITED EVEN BY THE AUTHORS WHO WROTE THEM. IN T BIOMEDICAL LITERATURE, IT'S 20%, OF ALL PAPERS IN PUBMED ARE NEVER CITED. GEORGE SET THIS SCALE UP TO BENCH MARKET AGAINST NIH PAPERS. SO IF THE RATIO OF THE RATE YOUR PAPER IS CITED COMPARED TO OTHERS IS ABOUT THE SAME, AS STANDARD NIH PAPERS, YOU WILL HAVE A RELATIVE CITATION RATIO OF ONE. IF YOUR PAPER CITED A LOT MORE OFTEN THAN WOULD BE EXPECTED YOU WOULD HAVE A RELATIVE CITATION RATIO OF TWO. AND THAT'S HIGHLY CITED PAPER AND MORE THAN 20 IS VERY HIGH LIE CITED PAPER OR BLOCKBUSTER PAPER. BEFORE WE GO FURTHER IS THIS COUNTING NUMBERS OR IS THERE SOMETHING TO THIS? IN GEORGE'S PAPER PUBLISHED IN PLUS BIOLOGY SEPTEMBER, HE PRESENTED THREE STUDIES, HE HAD A GROUP OF PEOPLE E EXPERTS PEER REVIEWERS LOOK AT PAPER AND RATE ACCORDING TO VARIOUS SCALES. THEN HE LOOKED WHAT THE RATERS OF THOSE PAPERS SAID AND COMPARED THAT TO THE RELATIVE CITATION RATIO. FOR ALL THREE OF THESE STUDIES HE FINDS THERE IS AN ASSOCIATION, WHICH IS REASONABLY STRONG, THAT AS PEER REVIEWERS THOUGHT THE PAPERS WERE BETTER, THE RELATIVE CITATION RATIO WERE HIGHER. THIS IS A STATISTICAL ASSOCIATION. THERE ARE PAPERS THAT GOT HIGHLY CITED THAT TURNED OUT WRONG OR THAT WERE JUNK. OTHER PAPERS DIDN'T GET CITED OR DIDN'T GET CITED FOR MANY YEARS AND TURNED OUT TO BE VERY IMPORTANT, GOT CITED LATER. THOSE ARE CALLED SLEEPING BEAUTIES. THAT'S THE TERM WE USE FOR THOSE. WE HAVE IT CAN CAREFUL, YES, THERE'S CASES LIKE THAT. THIS IS A STATISTICAL ASSOCIATION LOOKING OVER LARGE NUMBERS AND THAT'S WHERE IT MAYBE POTENTIALLY USEFUL WITH APPROPRIATE THOUGHTFULNESS AND CAVEATS. OKAY. SO WHAT WE DID, WE LOOK AT LARGE GROUP OF INVESTIGATORS, # 0,000 INVESTIGATORS FUNDED BY NIH, BETWEEN 1995 AND 2014. WE LOOKED AT THE PAPERS THAT CAME OUT OF THEIR GRANTS, RPG GRANTS, RESEARCH GRANTS, AND WE LOOK AT HOW MUCH GRANTS SUPPORT THEY GOT OVER THAT PERIOD OF TIME. AND THEN WE LOOK AT THEIR PRODUCTIVITY. THE WAY WE LOOK AT PRODUCTIVITY WAS EACH PAPER COUNTED DOORING TO WHAT ITS RELATIVE CITATION RATIO WAS. SO SAY A PAPER GETS PUBLISHED AND IS NEVER CITED, SO IT HAS A RELATIVE CITATION RATIO OF 0, IT COUNTS AS ZERO. RELATIVE CITATION RATIO OF ONE THEN IT ACCOUNTS FOR ONE. IF EACH PAPER WAS SOLIDLY AVERAGE THAT GRANT WOULD HAVE A WEIGHTED RELATIVE CITATION RATIO OR OUTPUT OF FIVE. SAY FOUR PAPERS HAD A VALUE OF ONE BUT ONE HAD A VALUE OF A HUNDRED, IT WAS A SUPER BLOCKBUSTER PAPER, THAT GRANT WOULD HAVE PRODUCED WEIGHTED RELATIVE CITATION RATIO OF 104. SO HERE WE SHOW WHAT THEIR RESEARCH COMMITMENT INDEX WAS, AMOUNT OF GRANT SUPPORT THEY RECEIVE PER YEAR. SO WE TAKE TOTAL AMOUNT OF GRANT SUPPORT OVER THAT PERIOD AND DIVIDE BY NUMBER OF YEARS THEY RECEIVED ANY FUNDING. AND ON THE Y AXIS, WE SHOW THE WEIGHTED RELATIVE CITATION RATIO THEIR GRANTS PRODUCE PER YEAR, DIVIDED BY NUMBER OF YEARS THEY RECEIVE FUNDING. SO WHAT ONE SEES, THIS IS SEVEN, SO SEVEN AGAIN IS ONE RO1, 14 WOULD BE TWO. 21 WOULD BE 3. AS INVESTIGATORS RECEIVE FUNDING THE PRODUCTIVITY GOES UP BUT LESSER AND LESSER INCREMENTS SO AS YOU GO FROM SAY ALMOST NOTHING TO 7 THERE'S A MARKED INCREASE FROM 7 TO 14, THERE'S STILL INCREASE BUT NOT QUITE AS MUCH. AND 14 TO 21, THE INCREMENT IS LESS. SO THIS IS DIMINISHING RETURNS. THIS IS WHAT DIMINISHING RETURNS LOOKS LIKE. SO BEEN ASKED ME WELL, YES, BUT WHAT ABOUT NINDS? SO WE RAN THE DATA FOR NINDS INVESTIGATORS, THERE WERE 7,000 PLUS INVESTIGATORS WHO RECEIVED AT LEAST ONE NINDS RPG DURING THAT PERIOD AND (INAUDIBLE). JOHN AND I SHOWED THIS TO ANOTHER AUDIENCE, ONE QUESTION WE WERE ASKED IS WHAT ABOUT YOUR I WANT TO GIVE PARTICULAR CREDIT TO BRIAN HOGGIN AND SIDNEY DANIELSON WHO SCRAPED THE WEBSITE, WE IDENTIFIED EVERYBODY WITH HHMI SUPPORT WHEN THEY RECEIVE SUPPORT AND CROSS MATCHED THAT AGAINST OUR DATABASE. THIS IS THE PLOT I SHOWED YOU BEFORE BUT WE SPLIT OUT THOSE INVESTIGATORS WHO DID RECEIVE HHMI SUPPORT DURING THAT TIME AND THOSE WHO DID NOT AND WHAT WE'RE LOOKING ON HERE IS THE PRODUCTIVITY OF THEIR NIH SUPPORTED WORK. SO GREEN LINE FOLKS ARE NOT SUPPORTED BY HHMI, THE RED LINE WERE SUPPORTED BY HHMI, NOT SURPRISINGLY FOR ANY GIVEN AMOUNT OF NIH GRANT SUPPORT THE HHMI INVESTIGATORS WERE MORE PRODUCTIVE. I DON'T THINK THAT SHOULD BE PARTICULARLY SURPRISING. THIS PATTERN OF DIMINISHING RETURNS IS THE SAME. EXACTLY THE SAME. YES. (OFF MIC) >> THESE ARE FOR EXAMPLE RO 3s, R21s, THESE ARE RO -- THESE ARE GRANTS LESS THAN RO1. ALSO THE OTHER THING -- IT'S ALSO AVERAGE OVER THE YEAR. SO IF YOU'RE FUNDED OVER A PERIOD OF EIGHT YEARS AND SOME YOU GET RO1, SOME YOU GET RO 3 YOUR ARCH OVER THAT PERIOD OF TIME IS LESS THAN RO1. (OFF MIC) >> THAT'S A LIMITATION OF THIS WORK, WE KNOW HOW MUCH MONEY WE GAVE THE INVESTIGATORS, WE DON'T KNOW HOW MUCH MONEY THEY GET ELSEWHERE. HERE WITH HHMI WE HAVE SOME SENSE, ALSO GOING TO BE LOOKING AT NSF FUNDING BECAUSE WE HAVE SOME RESEARCHERS FUNDED BY NIH AND NSF. AND WE CAN LOOK AT THAT. I'M SORRY? (OFF MIC) CONTINUITY OF SUPPORT. IS SOMEBODY GETTING SUPPORT EVERY YEAR OR ARE THERE INTERRUPTIONS? WHEN THEY'RE NOT GETTING ANY SUPPORT? THEY MAYBE SUPPORTED FROM 1996 TO 2000 AND THEN GO TWO YEARS NO FUNDING AND THEN 2000 START GETTING FUNDING AGAIN. I THINK THAT'S A SLIDE IN THE APPENDIX BUT ESSENTIALLY WHAT WE FOUND WAS THE GREATER DEGREE OF DISCONTINUITY THE LOWER THE PRODUCTIVITY. NOT THAT THAT SHOULD BE PARTICULARLY SURPRISING. BUT IT'S VERY MARKED, SO AS YOU GO FROM 100%, IN OTHER WORDS SUPPORTED EVERY YEAR DURING THE YEARS YOU'RE FUNDED TO 85% MEANING THAT FOR 15% OF THE TIME FROM'S MARKED FLAW IN DISCONTINUITY. THERE'S A PROBLEM, NO QUESTION ABOUT THAT. (OFF MIC) >> SO THERE'S SEVERAL LOOKS AT THAT. WE LOOK AT BUDGET, INSTEAD OF LOOKING AT THIS RESEARCH COMMITMENT AND PUT DOLLARS ON THE X AXIS, AND YOU GET THE SAME THING, THERE'S A GROUP IN ENGLAND THAT JOHN AND I HAVE CORRESPONDED WITH LOOKING AT 400 LABORATORY, DETAILED INFORMATION FROM LABORATORIES ON HOW MANY PERSONNEL THEY HAVE AND WHAT KIND OF PERSONNEL THEY HAD. LOOK AT SIZE OF LABORATORY, AND COMPOSITION AND WHAT THEIR PRODUCTIVITY WAS BY VARIETY OF MEASURES. THEY FOUND INTERESTING THINGS, ONE IS THE LARGEsEST PREDICTORS OF PRODUCTIVITY WERE POST DOCS, SURPRISING. THE SECOND IS THEY FOUND SAME P TERM OF DIMINISHING RETURNS. VERY STRONG. A GROUP IN CANADIAN TA HAS DONE SOMETHING SIMILAR AND COME UP WITH THE SAGE RESULTS. ONE QUESTION WE ASK IS MENTORSHIP FUNDED INVESTIGATORS MAYBE MENTORING PEOPLE WHO GO ON TO SUBMIT THEIR OWN GRANT APPLICATIONS. GEORGE SANTANGELO DID A STUDY FOR US THAT WE ASKED THEM TO DO WHERE HE LOOKED AT BIOSKETCH EARLY STAGE INVESTIGATORS AND HE PULLED OUT THE REFERENCES IN THE BIOSKETCHES TO IDENTIFY WHO THEIR MENTORS WERE. THEN LOOKED TO SEE HOW WELL FUNDED THE MENTORS WERE SO IN THIS WAYS HE WAS ABLE TO LOOK AT HOW WELL FUNDED MENTORS ARE AND LINK HOW MANY EARLY STAGE INVESTIGATORS COME TO LABORATORY AND SUBMITTING APPLICATIONS AGAIN AWARDS. THIS IS THE NUMBER OF AWARDEES. SO ON THE X AXIS HERE IS THE DIRECT COST THAT A MENTOR IS RECEIVING, Y SHOWS THE NUMBER OF AWARDEES PER MENTOR. THIS IS FY 16 DATA, PARTICULARLY STRONG RELATIONSHIP. HE LOOKED AT THIS FOR NINDS. THESE ARE NINDS DATA SHOWS THE RELATIONSHIP BETWEEN HOW WELL FUNDED A MENTOR WAS AND HOW MANY APPLICANTS WERE COMING OUT OF THEIR GROUP. ALSO THIS IS THE NUMBER OF AWARDEES. THE NUMBERS ARE SMALL THAT'S WHY IT'S ALL OVER THE MAP. FOR ALL HIPPOWE HAD MORE ROBUST PATTERN O TO LOOK AT. SO PUTTING TOGETHER THE FOCUS IS NOT ONLY ON GRANTS BUT ALSO ON INVESTIGATORS. IN PARTICULAR THERE'S CONCERNS ABOUT NEW AND MID CAREER INVESTIGATORS. WE PUT MID CAREER INVESTIGATORS IN IN BOLD BECAUSE FOLKS HAVEN'T HAD AS MUCH ATTENTION AS THEY SHOULD HAVE. WE THOUGHT ABOUT OTHER TOOLS TO LOOK AT INPUT NOT JUST DOLLARS BUT RESEARCH COMMITMENT INDEX WHICH GETS BEYOND INTRINSIC COSTS OF DIFFERENT RESEARCH. WE NOTE THERE ARE DIMINISHING RETURNS, AS WELL DOCUMENTED IN THE LITERATURE AND THE IMPORTANCE OF THIS IS IT SUGGESTS THAT EVEN WITH THE CONSTRAINED AND LIMITED RESOURCES WE HAVE, IT MAY BE POSSIBLE TO FUND MORE INVESTIGATORS. WE STARTED WITH A HYPERCOMPETITIVE SYSTEM. WE HAVE MORE PEOPLE TRYING TO GET FUNDING, THE PEOPLE GETTING SQUEEZED ARE THE YOUNGER INVESTIGATORS AND SO IT ORGANIZEBLY MAYBE POSSIBLE TO INCREASE THE INVESTIGATORS WHO WE ARE SUPPORTING WITH THE AMOUNT OF MONEY WE HAVE WITHOUT ADVERSELY AFFECTING THE OVERALL PRODUCTIVITY OF THE SYSTEM. SOME MIGHT ARGUE YOU COULD SLIGHTLY INCREASE PRODUCTIVITY OF THE SYSTEM. BUT NOT HARM IT. SO BACK WE FOUND DECREASED PROPORTION OF INVESTIGATORS ARE EARLY STATEMENT PEOPLE THOUGH THAT TREND HAS ATTENUATED WITH A NEW INVESTIGATOR POLICIES. WE'RE SEEING A VERY WORRISOME DECREASE IN PROPORTION OF INVESTIGATOR WHOSE ARE MID CAREER, MIGHT IT BE POSSIBLE TO USE SOME POLICY LEVERS TO TURN THESE CURVES? SO IN CLOSING WE HAVE A SYSTEM WHICH OTHERS HAVE POINTED OUT IS INHERENTLY UNSTABLE. LARGELY BECAUSE OF THE HYPERCOMPETITION WE'RE IN. THIS IS PARTICULARLY HURTING EARLY AND MID CAREER INVESTIGATORS. THE SYSTEM IS ARGUABLY NOT OPTIMAL HI EFFICIENT. IN PART RELATED TO PHENOMENON OF DIMINISHING RETURNS. IT MIGHT BE POSSIBLE TO FUND MORE INVESTIGATORS IN PARTICULAR YOUNGER INVESTIGATORS, MID CAREER INVESTIGATORS, AND IF WE PRESENT IT TO YOU WITH A LITTLE BIT ABOUT THE TOOLS WE'RE USING THE HELP US THINK THREE THIS TOM COMPLICATED PROBLEM. >> I WILL ASK YOU UNLESS YOU HAVE AN UNBELIEVABLY BURNING QUESTION THAT YOU CAN'T WAY FOR 15 MORE MINUTES, WE'RE GOING TO SEGUE INTO ANNA'S TALK WHICH IS AS I SAID, DISECONDING OUT THE NINDS TRENDS AND THEN WE'LL OPEN IT UP FOR DISCUSSION. >> THANK YOU. SO I'M GOING TO CONTINUE ON SOME OF THE THEMES THAT MIKE RAISED AND TALK ABOUT A LITTLE BIT OF DATA THAT RELATE SPECIFICALLY TO NINDS INVESTIGATORS WHEN CONSIDERING THE AMOUNT OF MINUTE ARE NIH SUPPORT THEY HAD. AS MIKE MENTIONED THERE'S A NUMBER OF WAYS TO CONSIDER THAT. THAT HAVE BEEN ANALYZED OVER THE YEARS, YOU CAN LOOK AT THE NUMBER OF PRINTS SOMEBODY HAS, AMOUNT OF MONEY THEY HAVE, AMOUNT OF EFFORT ON THE GRANT AND AS MIKE DESCRIBED USING THE RESEARCH COMMITMENT INDEX. THESE LOOK AT DIFFERENT THINGS BUT THEY HAVE CAVEATS TO ALL, AS WE DISCUSSED, I DON'T CAPTURE NON-NIH SUPPORT. IT IS DIFFICULT TO HE CAN TABLY ACCOUNT FOR MULTI-PI GRANTS WHICH ARE BECOMING LARGER FRACTION GRANTS AT NIH. THEY ALSO INCLUDE SUPPORT THAT GOES TO A LAB FROM FELLOWSHIPS AND TRAINING GRANTS. SO I WILL TALK TO YOU ABOUT ANALYSES WE DID LOOKING AT THESE MEASURES, ONE BY ONE BUT OVERALL STRATEGY FOR DOING THIS WAS TO TAKE THE NINDS COHORT OF PEOPLE THAT HAD A RESEARCH GRANT IN 2016, TO DETERMINE UNIVERSE OF GRANTS THEY HAD ACROSS NIH IN THE SAME YEAR. WE LOOK AT NUMBER OF RO1 EQUIVALENTS WE HAD, AS MIKE MENTIONED NOT ALL GRANTS ARE CREATED EQUALLY, SO WE WANTED TO CONTAIN THAT UNIVERSE TO THE RO1 BENCH MARK, THE AMOUNT OF FUNDING AND DIRECT COSTS THAT PEOPLE HAVE AND NUMBER OF RCI POINTS. AS PREVIOUSLY MENTIONED PERCENT EFFORT IS PROBLEMATIC FOR A NUMBER OF REASONS. SO WE DIDN'T MAKE ATTEMPTS TO COME UP WITH ANYTHING FOR THAT. FIRST THING THAT I WILL SHOW YOU IS DATA ON NINDS INVESTIGATORS AND NIH SUPPORT THEY HAVE IN TERMS OF NUMBER OF RO1s THEY HAVE. THESE ARE RO1 EQUIVALENTS, WHAT YOU CAN SEE HERE IS ON THE X AXIS IS NUMBER OF GRANTS AND ON THE Y AXIS IS NUMBER OF INVESTIGATORS. SO WHAT THIS GRAPH SHOWS YOU IS A FEW MORE THAN 1100 PEOPLE HAVE ONE RO1. IN FACT, 95% NINDS INVESTIGATORS HAVE RO1 EQUIVALENTS. U LOOK WHAT THIS EQUATES TO IN TERMS OF MONEY YOU CAN PLOT ON TOP OF THE DATA, THE AVERAGE AMOUNT OF SUPPORT THAT ANYONE -- ONE INVESTIGATOR HAS AT -- IN ANY WIN ONE OF THESE BINS. FOR EXAMPLE, ON AVERAGE AN INVESTIGATOR HAS 3 HUB THOUSAND DOLLARS IN DIRECT COSTS SOMEBODY WITH 2 RO 1s HAS $500,000, ET CETERA. NOTICE HAS YOU GO FURTHER OUT TO RIGHT ON THIS CURVE, THE DATA BECOME A LITTLE LESS RELIABLE, LARGELY BEING DUE TO THE SMALL END ON THAT SIDE OF THE CURVE. NEXT I WILL SHOW YOU SOME DATA STARTING THE AMOUNT OF FUNDING THAT PEOPLE HAVE. AS WE PREVIOUSLY DOES CUSSED, THERE'S SOME -- DISCUSSED THERE'S SOME SCIENCE INHERENTLY MORE EXPENSIVE THAN OTHERS WHICH IS MAJOR CAVEAT FOR LOOKING AT THESE TYPES OF DATA. BUT WHAT YOU SEE HERE IS THE DISTRIBUTION OF NINDS INVESTIGATORS AND THEIR NIH SUPPORT. SO ON THE X AXIS RESEARCH FUNDING DIRECT COSTS IN $250,000 INCREMENTS. THEN AGAIN ON THE Y AXIS IS NUMBER OF INVESTIGATORS. SO WHAT YOU SEE IS THE VAST MAJORITY OF PEOPLE HAVE $250,000 OR LESS. YOU HAVE ABOUT 1100 PEOPLE THAT HAVE $250,000 OR LESS WHICH CORRELATES NICELY WITH THE SAME 1100 PEOPLE WITH ONE RO1. WHAT YOU SEE IN FACT IS ALMOST 90% OF OUR INVESTIGATORS HAVE $750,000 OR LESS. SO IF YOU ZOOM IN ON THE PEOPLE THAT HAVE MORE THAN $750,000 WHAT YOU SEE IS A PEAK BETWEEN $750,000 AND A MILLION DOLLARS. WE HAVE 150 PEOPLE THAT FALL INTO THAT BUCKET AND REDUCE PEOPLE THAT FALL INTO THESE HIGHER BIN CATEGORIES. SO WE PREVIOUSLY DISCUSSED THAT CERTAIN TYPES OF RESEARCH ARE MORE EXPENSIVE THAN OTHERS, THE EXAMPLE BEING CLINICAL TRIALS, SO THOUGH THERE ARE MANY OTHERS BUT IF YOU TAKE CLINICAL TRIALS OUT OF THIS POOL, I SHOULD HAVE MENTIONED THIS, REPRESENTS 334 INVESTIGATORS, AND $429 MILLION. SO TAKE CLINICAL TRIALS OUT OF THIS POOL WHAT YOU SEE IS THAT IT REALLY ACCOUNTS FOR FAIRLY SMALL PORTION OF THIS FUNDING. AND AS YOU MOVE FURTHER TO THE RIGHT OF THE CURVE THE NUMBER OF INVESTIGATORS THAT HAVE LARGER AMOUNTS OF MONEY MORE LIKELY TO BE DOING CLINICAL TRIALS. IF YOU EXCLUDE CLINICAL TRIALS FROM THE PREVIOUS NUMBER THAT I SHOWED YOU WHAT WE HAVE IS ABOUT 270 PEOPLE WITH $319 MILLION IN SUPPORT. SO WE KIND OF COVERED THIS IN TERMS OF LOOKING AT PERCENT EFFORT. SO I'LL MOVE ON LOOKING AT THE NINDS COMMITMENT INDEX. ADS MIKE DESCRIBED, THIS ME SURE NORMALIZED FOR THIS DIFFERENT TIME COMMITMENTS THAT ARE REQUIRED TO DO DIFFERENT GRANT ACTIVITIES. BUT IT'S WORTH NOTING THE DOLLARS IN THE RCI ARE HIGHLY VARIABLE SO FOR EXAMPLE RO 3 FOR $50,000 IS $12,000 PER POINT. VERSUS AN NINDS R 35 THAT GETS THE FULL BUDGET OF $750,000. THAT'S EQUIVALENT TO $100,000. SO SOMETHING TO GET IN MIND. THESE DATA LOOK SIMILAR TO THOSE MIKE SHOWED. THESE ARE THE DATA HIPPOINVESTIGATORS AND NUMBER OF POINTS THAT THEY HAVE. AGAIN YOU SEE LARGE PEAK -- SEVEN POINTS REPRESENTING ONE RO1 AND ANOTHER SIGNIFICANTLY SMALLER PEAK AT TWO POINT, OR EXCUSE ME 14 POINTS WHICH REPRESENTS TWO RO1s. IF YOU LOOK AT INVESTIGATORS PAST 20 POINTS WHICH AROUND NIH HAS BEEN DISCUSSED AS A THEORETICAL THRESHOLD. WHAT YOU SEE IS 250 PEOPLE MOST WHOM OR MANY FIT INTO THE 21.3 RO1 CATEGORY. WITH A SMALLER NUMBER FOLLOWENING THE TRAIL. SO JUST -- SHOW YOU SOME DATA ABOUT THE DEMOGRAPHICS OF PEOPLE AND THE RCI POINTS THEY HAVE SINCE THAT'S SORT OF WHAT WE'RE DISCUSSING TODAY. SIMILAR TO WHAT MIKE SHOWED IN RECENT YEARS THE RCI FOR NINDS INVESTIGATORS REMAINED RELATIVELY STABLE WITH THE MEAN HOVERING AROUND 10. THANK YOU TO MIKE FOR EXPLAINING BOX PLOTS SO I DON'T HAVE TO. THE MEDIAN IS AROUND SEVEN -- LOOK AT INVESTIGATORS -- INVESTIGATOR DEMOGRAPHICS, WHAT WE HAVE DONE IS TAKEN TWO LARGE PEAKS AT 7 AND 14 POINTS AND IN THIS PARTICULAR SLIDE LOOKED AT DEGREES THEY HAVE. WHAT YOU SEE IS NOT SURPRISINGLY IN ALL THREE BINS THE VAST PA MAJORITY OF PEOPLE HAVE Ph.D.s BUT AS YOU SEE OVER 20 RCI POINTS BEEN THIS NUMBER IS DECREASED IN WHILE NUMBER OF M.D. Ph.D.s INCREASES. CAREER STAGE, SOMEWHAT DIFFERENCE WAY THAN MIKE ADDRESSED, LOOK AT THE YEAR IN WHICH AN INVESTIATOR TERMINAL DEGREE IN DECADES WHAT YOU SEE IS PEOPLE WITH SEVEN OR 14 RCI POINTS ARE MORE LIKELY TO BE JUNIOR, WHEREAS PEOPLE WITH GREATER THAN 20 RCI POINTS MORE LIKELY TO HAVE GOTTEN TERMINAL DEGREE EARLIER. SO FOR EXAMPLE IF YOU FOLLOW THE ORANGE BAR YOU SEE THAT 35%, 37% OF INVESTIGATORS IN THE 7 RCI POINT BIN GOT THEIR DEGREE IN THE 2000s, AND THAT SORT OF DECREASES AS YOU MOVE OUT TO SOME OF THE BINS WITH MORE NIH FUNDING. YOU CAN SEE SIMILAR TRENDS LOOKING AT THE YEAR, INVESTIGATORS GOT THEIR FIRST RESEARCH GRANT FOR EXAMPLE, IF YOU FOLLOW THE GREEN BARS WHICH IS SOMEBODY THAT GOT THEIR FIRST GRANT BETWEEN TEN AND 19 YEARS AGO YOU SEE THEY ARE INCREASINGLY REPRESENTED THE HIGH FLYERS PEOPLE THAT HAVE MORE THAN 20 RCI POINTS. NOT SURPRISINGLY NIECES CLUSTER OF PEOPLE WITH SEVEN RCI POINTS, THESE ARE PEOPLE THAT WITHIN THE LAST FOUR YEARS GOT FIRST RESEARCH GRANT. SO WE TOOK A LOOKED OTHER MISCELLANEOUS DEMOGRAPHIC INFORMATION, WE HAD A QUESTION EARLIER ABOUT GENDER. THESE ARE COHORTS OF PEOPLE WITH SEVEN RCI POINTS, 14 OR MORE THAN 20. SO LOOK AT THE SEVEN AND 14 RCI POINTS, WHAT YOU SEE IS ON AVERAGE 27% OF THESE PEOPLE ARE WOMEN, WHICH TRACKS WHAT WE KNOW ABOUT THE NIH RO1 INVESTIGATOR PULL. LOOK AT THE FRACTION OF WOMEN IN THE GREATER THAN 20 RCI POINT BUCKET, THAT NUMBER DECLINES SIGNIFICANTLY AND WILL BECOME MUCH MORE UNDER-REPRESENTED. IF YOU LOOK IN TERMS OF TOP 20 INSTITUTIONS, THESE ARE TOP 20 IN TERMS OF THE AMOUNT OF FUNDING THEY RECEIVE FROM NIH, YOU SEE A THIRD OF THEM HAVE SEVEN RCI POINTS OR EQUIVALENT OF ONE RO1. ABOUT 40% HAVE BETWEEN -- EITHER 14 OR MORE THAN 20 RCI POINTS. LASTLY, JUST POINT OUT A LITTLE HUMOR HERE. IF YOU LOOK AT PERCENTAGE OF PEOPLE IN EACH OF THESE BUCKETS THAT HAVE EVER SERVED ON NIH COUNCIL OR BIC, 40% HAVE MORE THAN 20 RCI POINTS COMPARED TO THE SMALLER BINS. >> SO YOU'RE ALL FORMALLY IN CONFLICT WITH THIS DISCUSSION. WE TALKED ABOUT THREE DIFFERENT MEASURES OF LOOKING AT AN INVESTIGATOR SUPPORT. AND WE HAVE TALKED ABOUT THREE THEORETICAL THRESHOLDS FOR LIMITING THAT SUPPORT. SO LOOK AT THE COHORT OF INVESTIGATORS THAT HAS GREATER THAN $750,000 MORE THAN THREE RO1 EQUIVALENTS OR MORE THAN 20 RCI POINTS. THERE ARE 410 NINDS INVESTIGATORS THAT ONE OR MORE BUCKETS. BUT WHAT'S SURPRISING IS THAT THERE'S A FAIRLY LARGE DEGREE OF NON-OVERLAPPING INTERSECTION BETWEEN THESE, ONLY 88 OF 410 PEOPLE FIT INTO THESE BUCKETS. WHICH SUGGEST IF YOU'RE TALKING ABOUT SETTING LIMBS YOU MIGHT WANT TO CONSIDER MULTIPLE METRICS IN YOUR DECISION MAKING. YES. >> SO WOULDN'T YOU WANT TO LIMIT THOSE PEOPLE HAVE A LOT OF MONEY AND RO1s THAT ARE NEVER CITED? >> I'M JUST HERE FOR THE DATA. I SEE WHAT YOU'RE SAYING. YEAH. SO THE LAST THING I WILL LEAVE YOU WITH THE THEORETICAL IMPACT OF SETTING LIMITS. SO AS WE TALKED ABOUT THE POSSIBILITY OF REDISTRIBUTING FUNDS TO TRY TO BRING PEOPLE IN EARLIER OR TO SORT OF BEND THE CURVES AT THE EARLY AND MIDDLE STAGE CAREER. INVESTIGATORS. IF YOU USE THE LIMITS DESCRIBED AND LIMIT SOMEBODY TO THREE HOUR YOU CAN SUPPORT 150 ADDITIONAL RO1s. IF YOU LIMIT TO $750,000 EXCLUDING CLINICAL TRIALS YOU CAN SUPPORT 269 ADDITIONAL RO1s, IT WOULD BE WORTH NOTING THERE'S OTHER THINGS TO THINK ABOUT. TAKING OUT OF THIS POOL OF MONEY, AS ANY ONE GRANT CAN BE $750,000. IF YOU LIMIT 20 RCI POINTS YOU HAVE FUNDS TO SUPPORT 28 MORE RO1s. THERE'S A NUMBER OF CAVEATS WE DON'T KNOW WHAT THE SOCIAL DYNAMICS OF PEOPLE AND NEW MONEY WILL BE BUT WE CAN'T PREDICT WHETHER THIS IS NEW PEOPLE IN THE SYSTEM OR WHETHER IT WILL CAUSE SOMEBODY TO GO FROM HAVING ONE RO1 TO HAVING TWO RO1s OR WHETHER IT RESULTS IN PEOPLE WRITING LARGER GRANTS. BUT THIS ISN'T A THEORETICAL CONSTRUCT FRAME DISCUSSION THAT WE WANT TO HAVE. THAT'S ALL I HAVE IN TERMS OF DATA, BUT I WANT TO ACKNOWLEDGE PEOPLE'S CONTRIBUTIONS TO. THIS SO I WOULD LIKE TO THANK ALISSA SHAVER WHO DID ANALYSIS TO THIS, I HAVE DRIVEN CRAZY FOR THE LAST TWO MONTHS. AS ALWAYS CHRISTINE, BOB AND PAUL SCOTT HAVE PROVIDED A NUMBER OF CONTRIBUTIONS BOTH PHILOSOPHICALLY AND IN TERMS OF THINKING ABOUT DATA AND ANALYSIS AND LASTLY I WOULD LIKE TO THANK DAVID OWENS FOR HIS CONTRIBUTION AND THINKING HOW TO EFFECT TESTIFILY PRESENT THIS DATA. BEFORE I TURN IT BACK OVER I JUST LEAVE THIS HERE FOR DISCUSSION. >> I ADDED THIS SLIDE AS A SEGUE, THANKS A LOT, ANGELA, THAT WAS GREAT. AS SEGUE TO OUR DISCUSSION THE QUESTION BEING THE ONE IN THE TOP, I DELIBERATELY INSERTED THE SLIDE FOCUSING VERGE PRODUCTIVITY, BUT IN TERMS OF COMING UP WITH AN OPTIMAL FUNDING STRATEGY, THERE'S OTHER THINGS TO THINK ABOUT. FOR EXAMPLE, ENSURING A HIGH QUALITY TRAINING ENVIRONMENT, IF SOMEONE HAS 8 ON RO1, IS THAT GOOD OR BAD THING? PROMOTING SCIENTIFIC RIGOR, BRUCE ALBERTS IN THE LAB, OR PARTICULAR PROJECT, WHAT DOES THAT MEAN FOR THE QUALITY OF DATA PRODUCED. AND ALSO THIS ISSUE THAT WE HAVE TOUCHED ON, WE DON'T HAVE MUCH DATA ABOUT INCREASING PI DIVERSITY. THIS ISSUE WOMEN ARE UNDER-REPRESENTED AT HIGHER SUPPORT LEVELS. SO THAT LAST THING IS WE TRUE TRYING TO GET THOUGHTS HOW TO DO THIS BUT OTHER THINGS WE NEED THE THINK ABOUT THIS QUESTION. >> I THINK WE SHOULD REALLY LUCKY TV JOHN AND MIC HERE WHO HAVE BEEN THINKING THIS THROUGH FOR AT LEAST TWO YEARS, IF NOT LONGER. THAT WOULD BE GREAT CHANCE TO PICK THEIR BRAINS, THE ONE THING I SAY IS WE'RE INTERESTED FROM DO YOU UNDERSTAND, THIS IS AN NIH CENTRIC VIEW OF THE WORLD. SO NOW THE QUESTION IS, FROM THE OUTSIDE WORLD, WHAT DO YOU THINK THE EFFECTS WOULD BE OF TRYING TO MAKE A MOVE IN DIRECTIONS YOU HEARD. >> DAVID. DEERA THEN DAVID THEN LARRY. >> SO I HAVE DONE THAT AT NINDS AND IT'S TRICKY BOARD OF SCIENTIFIC COUNCIL IS ON THE GROUP, A LOT OF RESOURCES THAT PEOPLE GET HERE ARE PAID CENTRALLY. SO THEY HAVE -- DON'T PAY FOR MOUSE CAGES, DON'T PAY FOR MRI TIME, THEIR SALARY IS PAID, YOU THROW SALARY TENURE TRACKS ABOUT $750,000 A YEAR AND TENURED PEOPLE ARE GETTING OVER A MILLION A YEAR. >> THE OUTSIDE PEOPLE ARE ALSO GETTING ADDITIONAL MONEY FROM FELLOWSHIPS N. PEOPLE FROM LAB AND OTHER SOURCES OF THE LAB. WHO IS NEXT? >> I'M REALLY INTERESTED IN BOTH ILLUSTRATION OF THE DIMINISHING RETURNS AND ALSO THE RELATIONSHIP TO MENTORSHIP. AND IN PARTICULAR I HAVE ALWAYS BEEN INTERESTED IN THE MENTORSHIP IN THE VERY LARGE LABS. WHICH ARE PAYING A LOT OF PERSONNEL WHICH PROBABLY FIT INTO SOME OF THOSE VERY HIGHLY FUNDED GROUPS. THE METRIC I HAVE ALWAYS BEEN INTERESTED IN IS WHETHER THERE'S SOME WAY OF QUANTIFYING NUMBER OF PUBLICATIONS WITH DISTINCT FIRST AUTHORS OUT OF NUMBER OF TRAINEES AND THE LABORATORIES. SO SOMETHING THAT GIVES YOU A SENSE OF WHETHER THE INDIVIDUALS IN THE LABORATORY ARE ACTUALLY GETTING THE TRAINING NECESSARY TO BE INDIVIDUALLY SUCCESSFUL AND THE CLOSEST I COULD GET TO IS NUMBER OF PUBLICATIONS WITH DISTINCT FIRST AUTHORS OUT OF TOTAL NUMBER OF PEOPLE IN THE LAB. SO I'M INTERESTED IN COMMENTS ON THAT, OR THOUGHTS ON THAT. IN THE RELATED ISSUE WAY WE TALK COLLABORATIONS WITH A CERTAIN DEGREE OF INVENTORY RATION THESE DAYS, WONDER WHETHER THAT DOESN'T IN SOME WAYS GIVE LIFE THE ALL ASPECT OF THAT INVENTORY RATION BECAUSE I THINK THOSE PROBABLY REPRESENT LARGE IN PARTS WHERE YOU HAVE MANY PEOPLE CONTRIBUTING TO A SINGLE PAPER. THAT RELATES TO QUESTIONS OF RIGOR, THE ABILITY OF ANYONE INDIVIDUAL TAKING RESPONSIBILITY FOR THAT WORK. I WONDER HOW ALL THOSE IDEAS PUT TOGETHER AND TO WHAT EXTENT YOU HAVE GIVEN THOUGHTS TO THAT. NOT AS COMMON IN THE LAST PIECE FIRST ABOUT COLLABORATION WHICH NO ONE DISPUTES IS EXTREMELY IMPORTANT. IN THE SCIENCE. BUT I THINK, BOB MAY WANT TO COMMENT, HE AND I DISCUSSED THIS, THE NIH OVER THE LAST 20 YEARS HAS SPENT TIME TRYING TO INCENTIVIZE COLLABORATION. I WONDER HOW PRODUCTIVE THAT HAS BEEN. >> ONE THING WE SEE AT NIGMS WHEN WE LOOK AT OUR VERY WELL FUNDED INVESTIGATORS, HOW DO THEY GET SO MUCH MONEY, CERTAIN AMOUNT OF IT IS BY PICKING UP PIECES HERE AND THERE. EVERY TIME THEY WANT TO START COLLABORATION THE EXPECTATION NOW IS MORE -- 100,000, $150,000 MORE. IT'S GONE COUNTER PRODUCTIVE IN MY VIEW BECAUSE WE HEAR FREQUENTLY WHY SHOULD I COLLABORATE IF YOU'RE NOT GOING TO GIVE MY MORE MONEY, SO MY POINT IS COLLABORATE BECAUSE OF PURE SCIENCE, NOT BECAUSE WE'RE GIVING MORE MONEY. THAT'S WHAT I WOULD SAY. YOUR FIRST POINT IS EXCELLENT. MIKE'S DATA ABOUT THE NUMBER OF FUNDING BEGINS TO SPEAK BUT STUDIES SUGGEST WOULD BE EXTREMELY INTERESTING, I DON'T KNOW THAT IT'S BEEN DONE. >> THAT WOULD BE A GOOD PLACE. >> ALONG THOSE LINE, THE WAY WE ATTACK THIS AND THIS IS NOT ANYWHERE AS ROBUST AS WHAT YOU'RE PROPOSING, WE LOOKED FOR AN APPLICATION COMING IN FROM ESR, WE LOOK AT FIRST AUTHORED PAPERS THAT THEY IDENTIFIED IN THEIR BIOSKETCH WITH FIRST AUTHOR AND LAST AUTHOR AS A WAY TO IDENTIFY WHO THE MENTORS WERE AS WELL AS OTHER DATA AS WELL. WE'RE IN A POSITION TO DISSECT OUT, WE KNOW WHO THE AUTHORS WERE VARIOUS PAPERS WHERE IT GETS TRICKY IS DISAMBIGUATING NAMES, IN THIS CASE IT'S EASY BECAUSE WE KNEW WHO THE APPLICANT WAS, WE KNEW WE COULD MAKE A SAFE ASSUMPTION APPLICANT SITES OWN PAPER IN A BIOSKETCH. WHEN LOOKING LARGER SCALE IT'S A CHALLENGING EXERCISE. >> ONE THING THAT DOESN'T SEEM TO BE INCLUDE THOUGH THERE'S VALUE IN THEM, THE PEOPLE WHO ARE IN A LABORATORY IN BEING PAID IN A LABORATORY BUT NOT ACTUALLY PRODUCING ANYTHING. OR AT LEAST -- NOT EVERY PERSON HAS TO BE THERE, TECHNICAL SUPPORT MIGHT BE APPROPRIATE BUT SOMETHING HELPS FIGURE OUT WHAT'S HAPPENING IN CASE THAT EVERYONE RECOGNIZES IN HUGE LAB, THREE ARE SUCCESSFUL AND VERY SUCCESSFUL AND THERE ARE 18 WHO ARE LANGUISHING IN THE -- >> THE SLIDES DATA YOU SHOWED SHOWS KNOW WITH THE AMOUNT OF MONEY SO THE EXPECTATION IS PEOPLE WITH A LOT OF MONEY HAVE A LOT MORE PEOPLE. SO IF YOU HAD THE PERCENT THAT BECOME ESIs, IT WOULD BE A DRASTIC JUMP DOWN. >> MAY NOT BE EVERY SINGLE ONE OF THEM WILL GO ON TO BE AN EARLY STAGE INVESTIGATOR BECAUSE PEOPLE MAY GO INTO MEANINGFUL SCIENTIFIC PROFESSIONS THAT DEVIATE SLIGHTLY. I REALIZE THAT DOESN'T CONTRIBUTE TO THE WORK FORCE BUT IN THE MOST NARROW DEFINITION OF THE WORK FORCE, BUT LOOKING WHILE TRAINEES MAYBE VALUABLE. >> I WONDER WHAT YOU LOOKED AT AND FOUND OUT ABOUT NON-NIH FUNDING. A QUESTION THAT ARISES, IF THE HIGH ROLLERS ARE CUT OFF HOW SUCCESSFUL MIGHT THEY BE IN REPLACING THAT MONEY WITH NON-NIH FUNDING. >> THE BEST WE HAVE LOOKED AT THIS AND THAT REALLY ISN'T VERY FAR IS LOOKING AT THE HHMI FUNDING. THAT DOESN'T TOTALLY GET TO WHAT YOU HAVE. PIERRE, MANY YEARS AGO DID A STUDY IN WHICH WE LOOKED AT PEOPLE WHO RECEIVED NIH FUNDING AND PEOPLE WHO APPLY FOR NIH FUNDING BUT DIDN'T GET IT BUT HAD VERY SIMILAR SCORES. SO EFFECTIVELY I NATURALLY EXPERIMENT YOU LOOK AT PEOPLE JUST BELOW THE PAY LINE, PEOPLE WHO ARE JUST ABOVE THE PAY LINE, THOSE ABOVE NOT GETTING FUNDED AND THEN FOLLOWING PRODUCT TIE OVER TIME. WHAT HE FOUND WAS FORTUNATELY GETTING AN NIH GRANT IS ASSOCIATED WITH HIGHER LEVEL PRODUCTIVITY BUT NOT BY THAT MUCH. SO SUGGESTED THAT PERHAPS PART OF THE REASON WHY THE DEGREE OF INCREASE PRODUCTIVITY WITH GETTING INCREASED FUNDING WAS NOT AS MUCH AS YOU MIGHT EXPECT BECAUSE OF EXACTLY THAT. SOMEHOW THEY'RE GETTING MONEY ELSEWHERE. SO ONCE THOUGHT WE HAVE HAD IS TO REPEAT THAT SAME STUDY, THAT WAS DONE TEN YEARS AGO. SO THE IDEA WOULD BE TO REPEAT THE SAME STUDY NOW IN TIME OF TIGHTER FUNDING AND SEE WHETHER OR NOT THAT GRADIENT CHANGED. ARGUABLY THAT MIGHT BE GREATER NOW BECAUSE JUST AS NIH FUNDING IS GETTING MORE DIFFICULT TO GET SO IS OTHER KINDS OF FUNDING MAYBE. >> DAVID. THEN AMY. >> BEING SCIENTISTS WE'RE SUPPOSED TO BE DATA DRIVEN SO IF I'M INTERPRETING THE DATA YOU PRESENTED CORRECTLY, LIMITING THE AMOUNT OF FUNDING COULD INCREASE TOTAL NUMBER OF INVESTIGATORS THAT WE FUND WHICH IS A GOAL EVERYBODY CAN AGREE ON, INCREASE DIVERSITY, POTENTIALLY INCREASE NUMBER OF YOUNG INVESTIGATORS WHO ARE BEING FUNDED, INCREASE RESEARCH PRODUCTIVITY. THE ONLY THING I HEARD AGAINST IT WAS BRUISING EGOS OF CURRENT AND FORMER COUNCIL MEMBERS. WHAT AM I MISTING? IT MAY IMPROVE MENTORING AND IT MAY IMPROVE SCIENTIFIC RIGOR WORKING WITH MORE THAN SAY 8% WHICH IS WHAT A LOT OF PEOPLE WE SEE WITH THESE MULTIPLE GRANTS HAVE ON THEIR RO1. AM I MISSING THE DOWN SIDE? OR IS THE DATA POINTENING ONE DIRECTION? >> YOU HAVE TO UNDERSTAND THAT NIGMS THE INSTITUTE JOHN IS DIRECTOR ALREADY DOES THIS. SO THEY HAVE A CAP OF 750,000 DIRECT COSTS. JUMP IN IF I'M SAYING IT WRONG. IF YOU WANT TO GO ABOVE THAT THEY SCRUTINIZE AND DISCUSS WITH COUNCIL, IS THAT ACCURATE? >> THAT'S ACCURATE. WE'RE INVOLVING IN THE DIRECTION YOU'RE TALKING ABOUT, WE'RE NOT THERE YET. THE MIRROR PROGRAM IS ACTUALLY ONE OF THE GOALS IS TO PUT CONSTRAINTS ON FUNDINGIBILITY IN THE MERE PROGRAM THERE IS A LIMIT. >> A CRITICAL POINT YOU MAKE IS THAT IN MAKING FUNDING DECISION, WE DO NEED TO SPECIFICALLY THINK ABOUT THE WORK FORCE. IT'S NOTS JUST THE GRANTS. THE PONT YOU MAKE IS SPOT ON. >> SUPPORT LIMITING FUNDING. >> I THINK TWO THINGS JUST TEMPER A LITTLE BIT THEWS YAM IN THIS DIRECTION THAT I WANT TO PUT ON THE TABLE. THEWS ENTHUSIASM. NEVER REALLY PROVES CAUSATION IN THE SENSE THAT IF YOU WERE TO IMPLEMENT POLICY OF ONERO 1, WHAT IS THE IMPLICATION IN ABILITY CONTINUITY, IMPLICATION ON TYPE OF SCIENCE THAT HAPPENS IN SOME OF THOSE LABS. SOME MAY BE SOME MAY NOT BE, ONE HAS TO BE CAREFUL. I WANT TO SEGUE TO THE AREA OF RESEARCH THAT THAT IS AT THE EDGE BETWEEN THE CLINICAL SCIENCE AND LABORATORY MANY OF THE LABS THAT ACTUALLY HAVE -- ALREADY TALK MULTIPLE PIs BUT THAT IS ANOTHER BIGGER COMPONENT OF IT WHERE WE HAVE A LOT OF SUBCONTRACTS EVEN RO1s. WHAT APPEARS TO BE $500,000 GRANT IS 150 TO THIS LAB AND 160, SUPPORTING OTHER THINGS. DO TYPES OF SCIENCE THAT DOESN'T GET DONE WITH THE REGULAR SINGLE RO 1. , SO MY ONLY CONCERN IS ABOUT THE STIFLED SCIENCE THAT HAPPENS WITH THE CRITICAL MASS, I KNOW CERTAIN LABS THAT I JUST KNOW THE FACT THAT IF THEY WERE -- DID NOT HAVE TWO GRANTS RISK SHUTTING DOWN SOME OF THEM. THEY ARE BRIDGE FUND BUG THEY'RE NOT RELIABLE. SUCCESSFUL MODEL IS THE TWO MODEL ONE READY TO SUN SET THIS IS HOW YOU GET KICKING AND I WONDER IF YOU'RE -- (LOST AUDIO) >> NO TALKING LIMITING PEOPLE TO SICKLE RO1. PROPOSAL THAT ANNA WAS SHOWING, WHICH IS JUST A STRAW MAN, WE'RE NOT ABOUT TO DO ANYTHING YET. WAS ACTUALLY THREE MODULAR RO1s. >> I UNDERSTAND. BUT I THINK WHEN YOU START SHOWING THE BIG DIFFERENTIATION GOING AFTER ONE RO1 BETWEEN ACTIVITY AND DIMINISHING RETURN, I WANT TO BE VERY CAREFUL THAT DOESN'T GET TAKEN TO ITS EXTREME. NOT TAKEN TO EXTREME, THE QUESTION IS WHETHER IT >> TAKEN AT ALL. >> THAT'S FINE. >> I VERY MUCH LIKE THE IDEA, THE VIEW NOT EXPRESSED HERE THE VIEW OF THE DEANS YOU HAVE THESE VERY -- THEY HAVE A LOT OF TIME DEVOTED TO CALCULATING INDIRECT COSTS RECOVERY RATES AND EVALUATING FACULTY AND DEPARTMENTS BASED ON THOSE THINGS. THIS TYPE OF POLICY WOULD AT MINIMUM REQUIRE THEM TO RETHINK HOW THEY VIEW THE FUNDING OF SCIENTIFIC RESEARCH AT THE INSTITUTIONAL LEVEL. BUT ALSO CHANGE THE WAY INSTITUTIONS REWARD THEIR RESEARCHES. A DIFFERENT POTENTIAL IMPACT. >> SO I'M PROBABLY AN OUTLIER HERE, I'M SKEPTICAL. I'M STILL TRYING TO GET WHAT IS THE PROBLEM WE'RE TRYING TO SOLVE OTHER THAN BEING FAIR? THAT'S SORT OF AS A PATIENT ADVOCATE, THAT'S WHAT I'M HEARING. WE NEED TO BE FAIR. >> IT'S NOT CLEAR TO ME. >> THE MAIN PROBLEM WE'RE TRYING TO -- >> ONE OF THE PROBLEMS WE ARE EAR TRYING TO SOLVE IS THE SYSTEM IS INHERENTLY UNSTABLE, INCREASINGLY HYPE COMPETITIVE, SO HYPE COMPETITIVE IT THREATENS THE INTEGRITY OF SCIENCE, THE ABILITY TO DO INNOVATIVE WORK. IT IS PARTICULARLY THE WAY THE SYSTEM IS CURRENTLY SET UP, SQUEEZING OUT PROMISING MID CAREER INVESTIGATORS. THINK OF YOURSELF AS THE DEAN YOU HAVE INVESTED IN A NEW FACULTY MEMBER, THAT NEW FACULTY MEMBER IS DOING GOOD WORK, PERHAPS START TO GAIN DEGREE OF INDEPENDENCE BUT BECAUSE THE SYSTEM IS THE WAY IT IS, DESPITE THE FACT HE OR SHE DOING GREAT WORK IS GOING TO GET SQUEEZED OUT. >> KEEP GOING. >> I THINK TIM HAS A DIFFERENT ANGLE. >> LET ME -- >> LET TIM FINISH. SO THAT'S ONE PROBLEM. ONE PROBLEM IS THAT WE HAVE INCREASINGLY HYPERCOMPETITIVE SYSTEM MORE AND MORE PEOPLE TRY TO GET FUNDED, MORE PEOPLE BEING SQUEEZED OUT OF THE SYSTEM. >> HE CARES ABOUT -- >> I HAVE TO SAY I FIND THE -- THE TERMINOLOGY TROUBLING. INSTABILITY AND INSURANCE MARKETS WHERE PEOPLE ARE LOSING INSURANCE IS ONE THING, THESE ARE DECLARATIVE TERMS, SOME PEOPLE LOSE THEIR JOBS. I THINK I WOULD PERSONALLY PREFER DIALING DOWN THE RHETORIC. BIOMEDICAL RESEARCH INFRASTRUCTURE IS NOT GOING TO COLLAPSE. WHEN YOU USE TERMINOLOGY LIKE THIS, WE'RE ON THE PREP PUS OF COLLAPSE OF INVESTIGATORS DON'T GET A MILLION DOLLARS A YEAR. I'M REALLY CONCERNED IT'S HYPERBOLLIC. UNUSUALLY STRIDENT FOR ME BUT IT IS TROUBLING WE'RE USING TERMS THAT ARE JUST SEEM A BIT EXTREME. IN MY MIND. >> LET ME PUT IT IN DIFFERENT CONTEXT. SO THE WAY I LOOK AT IT IS THIS DISCUSSION IS GETTING THE BEST QUALITY SCIENCE FOR THE TAXPAYERS' MONEY. AN INVESTMENT STRATEGY. JUST LIKE PUTTING MONEY INTO START UP COMPANIES OR STOCKS, THAT WE WANT TO MAXIMIZE THE AMOUNT OF SCIENCE THAT GETS DONE FOR THE AMOUNT OF MONEY TAXPAYERS PUT IN AND ALSO THE QUALITY OF IT. WHICH IS DIRECTLY RELATED TO WHAT YOUR OBJECTIVE IS. RIGHT? WHICH IS DISCOVERING IMPORTANT THINGS THAT WILL LEAD TO CURS FOR DISEASES. IF YOU HOE WHAT THE DATA SYES IF WE LIMIT -- OR AGGREGATE MONEY IN A SMALL NUMBER OF RESEARCHERS, WE ACTUALLY GET LESS SCIENCE DONE TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST TEST SOME OF THE DATA SUGGESTS WE HAVE TO DO THAT BUT THE OTHER ISSUE IS STILL ACKNOWLEDGE WE NEED FUNDING FOR MAKING DISCOVERIES FOR OUR PATIENTS A REALITY. >> I THAT WE ALL ACKNOWLEDGE. >> I WAS GOING TO ADDRESS TIM'S COMMENTS. BEING FROM A DISEASE FOUND OUR GOAL IS TO FIGURE OUT THE BEST WAY TO MOVE FORWARD. SO OUR FOCUS IS MORE NARROW THAN SUPPORTING SCIENCE GENERALLY AS NIH MANDATE IS TO DO. AND SO THAT IS WHERE FOUNDATIONS AND OTHER SOURCES OF MONEY CAN HAVE A MORE FOCUSED APPROACH SO WE CAN FUND PEOPLE LIKE ADRIENNE BECAUSE THEY HAVE A MORE I GUESS DISEASE-FOCUSED THERAPEUTIC DRIVEN MISSION. AND I GUESS THE OTHER THING IS LOOKING AT ASO THEY'RE NOT EXACTLY THAT POPULAR IN THE SMA FEEL COMPARED TO DEVELOPING SMALL MOLECULES AND OTHER THINGS. AND SO IN A WAY IT'S GREAT THAT NIH DID FUND HIM, AND AGAIN, NOT TO BELABOR SPECIFIC EXAMPLE IF IT WAS CONCENTRATING MONEY IN SAY THE BIG SMA LABS, THEN HE MIGHT NEVER HAVE BEEN FUNDED TO PURSUE THE WORK HE DID THAT LED TO A DRUG. SO I CAN SEE THE ARGUMENT BOTH WAYS, SO DON'T MEAN TO ARGUE TIM, BUT I THINK THERE E AN ALTERNATIVE APPROACH TO HELP WHAT YOUR THOUGHTS ARE. >> I DON'T THINK IT'S AN ARGUMENT, I THINK FROM A POLICY POINT OF VIEW, IT'S REALLY TRYING TO -- WE'RE SPECULATING AND TRYING TO MAKE A SIGNIFICANT WHAT I CONSIDER A VERY SIGNIFICANT CHANGE WITH WITHOUT A GOOD LINE OF SITE, YOU START PULLING THE LEVER NOW YOU WON'T SEE IMPACT FOR A LONG TIME. THAT'S THE CONCERN I HAVE IS IT'S SORT OF LIKE SHOT IN THE DARK. >> ILENE. >> TO ECHO, I THINK THERE IS AN UNINTENDED CONSEQUENCE NOW THE WAY THE SYSTEM WORKS OF CONCENTRATING LARGE AMOUNTS OF MONEY THAT DO FOCUS ON MORE READILY FUNDED DISEASES. SO ACTUALLY IN FAVOR OF WHAT YOU'RE DESCRIBING BECAUSE IT'S FOR AN INSTITUTE LIKE NINDS THAT HAS 450 SOME ODD DISEASES WHEN YOU OPEN THIS UP TO OTHER DISEASES AND OTHER INTERESTS AND YOU HAVE MORE DIVERSITY, THE LIKELIHOOD OF SOME OF THOSE RARE DISEASES THAT RARELY GET FUNDING IS MORE LIKELY >> GOURD. OTHER HANDS? GOURD. WHO IS WAITING? >> I THINK THE FOCUS ON INDIVIDUAL WHOSE HAVE A LARGE AM OF MONEY IS THE WRONG FOCUS. THE POINT I WOULD MAKE, JONATHAN MENTIONED THIS, WHERE IS THAT DRIVE COMING FROM? I HAVE BEEN AT MEDICAL SCHOOL FOR A AWFULLY LONG TIME AND I HAVE SEEN THEM GET HUNDREDS OF MILLIONS OF DOLLARS. DO THEY PUT IT IN POCKETS OF RESEARCHERS? THEY BUILD NEW BUILDINGS TO INCENTIVIZE PEOPLE TO HAVE DOLLAR DENSITIES. THAT'S THE TERM, DOLLAR DENSITIES. IF YOU MAD SLIDING SCALE OF INDIRECT COST, WHICH IS JUSTIFIED, IF I HAVE A LAB OF 20 PEOPLE, THERE IS ECONOMY OF SCALE OVER FIVE PEOPLE. ONE OF THE THINGS I HAVEN'T HEARD YET MENTIONED IS IF YOU CHANGE THE INDIRECT COSTS TOVINGS WHO HAD LARGE GRANTS YOU SAVE MONEY, JUSTIFY IT AND GET WHAT I THINK IS A REAL CULPRIT WHICH ARE MEDDLE DA SCHOOLS, WHO ARE PUSHING TOWARD DOLLAR DENSITIES TO REDIRECT MONEY PEOPLE WHO ARE SUCCESSFUL GETTING MONEY WHO ARE OFTEN REALLY -- PEOPLE, INSTEAD OF BUILDING MORE LABS SO THEY CAN STUFF IT IN. >> DO YOU WANT THE ADDRESS THE INDIRECT COST ISSUE? I DON'T WANT TO TOUCH THAT. >> FIRST ISSUE, WE DON'T CONTROL IT SO IT'S OUT OF OUR JURISDICTION. SALLY ROCKEY DID APPROXIMATE EXTENSIVE ANALYSIS OF INDIRECT COSTS. NIH SPENDS $5 BILLION A YEAR IN DIRECT COSTS AND THAT'S REMAINED FAIRLY STABLE OVER TIME. WHEN I FIRST CAME HERE ABOUT TEN YEARS AGO AND I ASKED THAT QUESTION TO BETSY NAGLE WHO WAS DIRECTOR OF NHLBI COULDN'T WE CUT DOWN ON INDIRECT COST AND THAT WAY WE CAN FUNDS MORE SCIENTISTS? SHE SMILE AND SAY WE CAN'T TOUCH THAT. POINT IS WELL TAKEN BUT REALITY, WE DON'T HAVE DIRECT CONTROL OVER THAT. >> ONE SOLUTION YOU POINT OUT THAT IS NOT PRACTICAL. THE POINT I WOULD MAKE IS A LOT OF THE DRIVING FORCE FOR THIS IS BEHAVIOR OF HOSPITALS. MAYBE THAT'S IN THE THE RIGHT SOLUTION BUT SOMETHING THE CHANGE THEIR BEHAVIOR, IT DRIVES ME CRAZY, THEY GET BIG DONATIONS TO A HOSPITAL, BUILD BRICK AND MORTAR, THEY DON'T SUPPORT THEIR OWN PEOPLE. >> THE ISSUE WE'RE CONCERNED ABOUT, SALARY SUPPORT, AAMC, SOFT MONEY SALARY WHICH IS CERTAINLY TAKING MONEY OUT OF THE ACTUAL RESEARCH AND PUTTING IT TO SUPPORTING FACULTY INSTEAD OF UNIVERSITIES AND MEDICAL SCHOOLS, ACCORDING TO FACULTY. THAT ANECDOTALLY SEEMS TO BE GETTING WORSE BECAUSE NOW ARTS AND SIGNS SCHOOLS THAT USED TO PROKED -- SCIENCES SCHOOLS ARE STARTING TO SHIFT TO SOFT MONEY LEVELS SO WE'RE CONCERNED ABOUT THE DIRECTION THAT'S HEADING AND THAT'S A SIGNIFICANT -- >> BRUCE. >> JOHN JUST ON THAT POINT. AS HEAD OF NIGMS, ONE OTHER CONCERN WE CAME UP WITH YESTERDAY IS THAT THIS COULD PREFERENTIALLY PENALIZE BASIC SCIENCE FOLKS BECAUSE CLINICAL SCIENCE THESE FOLKS HAVE MANY OTHER OPTIONS TO GET MONEY, BASIC SCIENCE FOLKS DON'T. WHAT HAS BEEN YOUR EXPERIENCE SO FAR? HOW IS IT PLAYING OUT? >> I HEARD DEANS SAY THAT. IT IS A CONCERN BUT YEAR-END I DON'T THINK IT'S A JUSTIFICATION OF MAKING RECOVERING 80, 90, 100% COSTS FROM TAXPAYERS. WE NEED TO COME UP WITH A DIFFERENT SOLUTION. >> BRUCE, THEN SHANNON. >> I HEAR TWO THINGS BY FUNDING MORE INVESTIGATORS IT WILL BE HIGHER ROI WHICH MAKES SENSE, THE OTHER ISSUE IS ABOUT HYPERCOMPETITION. THAT'S WHERE I HAVE A QUESTION. DO YOU HAVE A SENSE OF THE -- BECAUSE WHEN YOU PRESENTED THIS SLIDE YOU SPOKE ABOUT THE AWARDEES AND THE TRENDS OVER TIME AND YOU SPOKE ABOUT THE APPLICANTS AND THE TRENDS OVER TIME. DO YOU HAVE A SENSE OF THE WOULD BE APPLICANTS OVER TIME? THAT -- THE MAIN DENOMINATOR, THIS IS AKIN TO NATIONAL UNEMPLOYMENT. IF IT'S LOW, IT COULD MEAN THAT PEOPLE TRYING TO FIND WORK HAVE FOUND IT BUT IT COULD ALSO MEAN PEOPLE HAVE GIVEN UP TRYING TO FIND WORK. AT THE END OF THE DAY IF YOU DO THIS IS THIS A RISK OF HYPERCOMPETITION BECAUSE PEOPLE ARE ENCOURAGED TO GO IN AGAIN AND PEOPLE LIKELY IN ARE THE EARLY AND MIDDLE CAREER PEOPLE. >> REALLY GOOD POINT. IF I UNDERSTAND WHAT U YOU'RE SAYING RIGHT WE MAYBE HUNDRED DOLLARS ESTIMATING THE SEVERITY OF THE PROBLEM BECAUSE PEOPLE ARE GIVING UP AND BY VIRTUE OF THE FACT THEY'RE GIVING UP THEY'RE ABSOLUTELY E IT'S A BIGGER DENOMINATOR THAN WE THINK AND LOW SUCCESS RATES WE HAVE SHOULD BE EVEN LOWER. I THINK THAT'S ONE THING YOU'RE SAYING. ISN'T ONE OF THE POINTS OF THE MIRROR IS TO PROVIDE PEOPLE WITH MORE STABLE SUPPORT OVER TIME? >> ABSOLUTELY. ANOTHER CONSIDERATION, INSTABILITY OF FUNDING IS PERCEIVED TO INCREASE CONSERVATISM. SO IF YOU WANT TO DO SOMETHING AMBITIOUS THAT MAY LEAD TO CURE OF DISEASE, A SYSTEM YOU'RE WORRIED TO LOOSE YOUR FUNDING NEXT MONTH IS NOT PROBABLY THE BEST WAY TO GET PEOPLE TO REALLY TAKE THE SHOTS. SO IF WE CAN INCREASE VISIBILITY, -- YOUR POINT EARLY STAGE INVESTIGATORS, THIS IS ALSO AN POINT IMPORTANT POINT. IF WE ARE DRIVING POTENTIAL SCIENTISTS OUT OF COMING INTO THE SYSTEM, IT WILL HAVE LONG TERM NEGATIVE CONSEQUENCES FOR FUTURE DISCOVERIES, NOR THE MOMENT MAYBE COVERED BY THE SENIOR INVESTIGATORS WHO ARE WELL FUNDED BUT WHEN THEY DO RETIRE AND POTENTIALLY THEY WILL, THERE COULD BE A HUGE DEFICIT. THAT HAPPENED I BELIEVE IN A UK IN CHEMISTRY, THEY DECIDE THERE WERE TOO MANY CHEMISTS AND STOPPED PUTTING THEM IN. 20 YEARS DOWN THE ROAD THEY HAD A DEFICIT. WE NEED TO HAVE ENOUGH PEOPLE COMING TO THE SYSTEM 20 YEARS DOWN THE ROAD OR WON'T HAVE DISCOVERIES THAT LEAD THE CURES FOR DISEASES. >> I APPRECIATE THE EFFORT TO MAKE SURE THE TAXPAYER DOLLARS ARE MAXIMIZED. I JUST THINK THAT WE NEED TO LOOK AT THE ENTIRE FINANCIAL PICTURE SO TO THE EXTENT WE CAN WE NEED TO LOOK AT PRIVATE DOLLARS WITH ALL OF THESE INVESTIGATORS, ESPECIALLY EARLY IN MID STAGE BECAUSE THAT'S GOING TO HELP US REALLY SEE THE FULL PICTURE BEFORE WE SAY ONE GRANT LEAVING SCIENCE. >> IN OUR $750,000 POLICY THAT WAS MENTIONED WE DO LOOK AT ALL THEIR FUNDING. SO WE GET THERE JUST IN TIME INFORMATION AND THAT 750 IS NOT JUST NIH, IT'S EVERYTHING THEY'RE GETTING. WE EVALUATE THAT WHOLE PORTFOLIO FUNDING. >> WE'RE ON THE CUSP OF HAVING IS WE DON'T HAVE ACCESS TO DATA ON NIH GRANTS BUT ALSO HAVE ACCESS TO DATA ON GRANTS FROM MANY OTHER FUNDING BODIES. BOTH PRIVATE AND PUBLIC THIS IS A DIFFICULT THING TO DO BUT WE'RE TRYING TO GET TO A POINT MORE HOLISTIC LOOK AND NOT SOLELY STEVE THEN TIM. >> GOOD IF YOU COULD BRIEFLY SAY WHERE WE'RE FROM. FOR OUR GUESTS. WITH TUMOR SCLEROSIS, NON-PROFIT PATIENT ADVOCACY GROUP. YOU TOUCHED ON SEXUAL SOURCE OF MONEY WHICH -- I DON'T DISPUTE DIMINISHING RETURNS BUT THERE IS A GOOD POINT ABOUT STARTUP FUNDS THAT MADE ME THINK OTHER SOURCES OF MONEY, SHOWED ME OTHER SOURCES LIKE HHMI SHOWED A PEAK, FOUNDATION FUNDING OR YOU MENTION INVESTIGATORS WHO MAY HAVE SALARY SUPPORT FROM AN INSTITUTION TO DO MORE WITH A SMALLER GRANT. SO IT'S NOT SO MUCH I WORRY -- YOUR DATA IS NOT GOING TO CHANGE MUCH ON THE FAR SIDE. MIGHT IN THE LOOK LIKE SUCH A DIMINISHING RETURN BECAUSE FOLKS WHO ARE AT THE LOW END OF THE NIH FUNDING MAY HAVE OTHER THINGS THAT ARE HELPING THEM GENERATE PRODUCTIVITY SO NOT SURE THE SLOPE WILL CHANGE AS DRASTICALLY. >> THERE ARE SOME AT LEAST IN MY PORTFOLIO NIGMS. WE GET EVERYONE'S INFORMATION MAKING FUNDING DECISIONS. MOST OF THE PEOPLE HAVE ONE GRANT HAVE ONE NIH GRANT. THAT'S REALITY OF THE SYSTEM. THERE ARE PEOPLE OUT THERE RUNNING THEIR LABS IN SINGLE RO1 WITHOUT ANYTHING ELSE, HERE AND THERE THEY GET SMALL FOUNDATION GRANTS FOR A COUPLE OF YEARS. ON THE EDGES COULD BE SOMETHING BUT WHAT WE SEE IN OUR PORTFOLIO IS THAT'S WHAT THEY HAVE GOT. >> AND THE OTHER THOUGHT >> WE HAVE SEEN A SHIFT IN THE AGES OF THE YOUNG INVESTIGATORS ALONG THE BLUE LINE, AGE WHERE FOLKS AT 70 HAVE LOTS OF MONEY THAT DIDN'T EXIST BEFORE. YOU HAVE SEEN THE SHIFT TO RIGHT SO WE NEED TO ENCOURAGE THAT YOUNG GENERATION OF FOLKS REALLY GOING TO TRY SOMETHING NEW BUT I HAVE A DISCONNECT WITH LIMITING PEOPLE AT THE TOP WHO ARE ALSO HAVE A MILLION DOLLAR WORTH OF FUNDING BUT SUBMITTING APPLICATIONS THAT SCORE EXTREMELY HIGH ON INNOVATION AND POTENTIAL IMPACT. LIKE ARTIFICIALLY SAY WE CAN ADDRESS IT BY TAKING MONEY FROM THE TOP AND REALLOCATING IT BUT IF THE PROBLEM IS HERE SOMETHING ELSE WE CAN DO RATHER THAN ART IF I RECOLLECTLY LIMIT THE TOP. >> ONE WAY TO THINK ABOUT IT IS LET'S FOR SAKE OF THE THOUGHT EXERCISE MAKE IT MORE EXTREME. SO WE HAVE TWO INVESTIGATORS WHO SUBMITTED TWO GRANTS, EACH SUBMITTED A GRANT, BOTH GOT GREAT SCORES. BOTH TERRIFIC INVESTMENTS. INVESTIGATOR 1 AS $2 MILLION FUNDING. INVESTIGATOR 2 HAS ONE GRANT. AND THAT GRANT IS ABOUT TO END IN A YEAR OR SO. SO IN OTHER WORDS IF HE DOESN'T GET THIS GRANT THEN THERE'S A VERY GOOD POSSIBILITY HIS LABORATORY WILL SHUT DOWN OR AT THE VERY LEAST IS GOING TO EXPERIENCE A MAJOR DISRUPTION. NOW THE QUESTION IS FOR THE AGENCY, WHO DO WE GIVE THAT MONEY TOO? WE'RE NOT SAYING TAKE MONEY FROM THIS PERSON AND GIVE IT TO THAT PERSON, THE QUESTION IS WHAT'S THE MARGINAL DECISION? DO WE GIVE THE -- DO WE SUPPORT THAT SECOND INVESTIGATOR WHO IS VERY PROMISING, AND SUBMIT AD TERRIFIC PROPOSAL AND ENABLE HIM TO KEEP GOING FOR ANOTHER FOUR TO FIVE YEARS. OR DO WE NOT GIVE -- NOT TAKE THE FIRST INVESTIGATOR AND MOVE FROM 2 TO $2.5 MILLION. THAT MIGHT BE A WAY OF THINKING ABOUT IT. >> TO MAKE AN OBSERVATION, I DON'T THINK THAT'S THE COMPARISON WE'RE MAKING. BECAUSE WHAT WE'RE TALKING ABOUT HERE IS AN INVESTIGATOR IS -- HAS SUBMITTED SOMETHING SAY HE'S FUNDED OVER A MILLION DOLLARS HE SUBMIT SOMETHING THAT SCORES IN THE 10TH PERCENTILE. NOT COMPARING TO ANOTHER PERCENTILE GRANT WHICH IS ALREADY GETTING FUNDED TOO OF INVESTIGATOR ONLY ADS ONE RO1, WHAT WE'RE COMPARING TO IS THE MARGINAL SIDE OF THINGS AND WITH NINDS WE'RE ALREADY ADDING TEN PERCENTAGE POINTS TO EARLY STAGE INVESTIGATORS, YOU ARE COMPARING NOW THIS WELL FUNDED INVESTIGATOR TO THIS OTHER INVESTIGATOR BUT THE GRANT SCORED 20 OR HIGHER. SO IT'S NOT REALLY SAME QUALITY OF RESEARCH, YOU'RE SAYING WE CAN FUND REALLY GOOD RESEARCH IN A LAB OR GOOD RESEARCH SO IN A LOWER FUNDED LAND. I WOULD CAUTION MIKE HAS,TESTIMONYSIVE DATA SAYING PEER REVIEW CAN'T HAVE THAT LEVEL RESOLUTION. WE DID ANALYSIS LOOKING AT NEW GRANTS FOR ESTABLISHED INVESTIGATORS AND EARLY STAGE INVESTIGATORS. AND WE FOUND THAT THE EARLY STAGE INVESTIGATORS WHO WE REACHED FOR, SO FARTHER OUT THAN NORMALLY WOULD HAVE FUNDED APPLICATIONS SCORED, DID BETTER THAN THE ESTABLISHED INVESTIGATORS ON AVERAGE WHO ARE MORE INTO THE FUNDING RANGE. WE FOUND A VERY FASCINATING AND SLIGHTLY TROUBLING THING, A LARGE FRACTION OF THE ESTABLISHED INVESTIGATORS, WHO GET A NEW GRANT NEVER PUT IN FOR RENEWAL. IF YOU LOOK AT THE PRODUCTIVITY OF THOSE GRANTS, THEY WERE LIMITED. SO THAT SPEAKS TO THIS IDEA BEING CAREFUL ABOUT MACKING ARGUMENTS ABOUT A WELL SCORING INVESTIGATOR, BECAUSE THERE ARE BIASES IN THE SYSTEM THAT FAVOR ESTABLISHED INVESTIGATORS IN TERMS OF REVIEW AND OTHER THINGS. >> IN THE SYSTEM AS WE LOOK AT IT FORMALLY WE HAVE THIS IDEA THAT EVERY TIME SOMEONE HAS A NEW IDEA, YOU CAN'T EXECUTE IT UNTIL THEY WRITE AND RECEIVE A NEW GRANT FOR IT. IN MY EXPERIENCE, IF I HAD A REALLY GREAT IDEA AND I DIDN'T HAVE A GRANT THAT WAS WRITTEN ON THAT TO DO IT, I'M GOING TO DO THE DAM IDEA, I WILL TRY IT. A LOT OF TIMES IT DOESN'T TAKE A WHOLE GRANT TO FIGURE OUT IF THERE'S SOMETHING INTERESTING, OTHER TIMES I LOOK T A PEOPLE'S FUNDING LOOKING AT GRANTS AND I THINK DO THEY REALLY NEED ANOTHER GRANT TO DO THIS? THIS IS SIMILAR TO THE THREE OTHER GRANTS THEY HAVE. I CAN DO THAT AND SEE IF IT WOULD FLY WITH $50,000. SO I THINK THERE'S A LITTLE DISCONNECT BETWEEN FITTING ALL THESE THINGS AND SAYING THIS BIG LAB WON'T BE ABLE TO DO THAT UNLESS THEY GET THEIR RO1. CHANCES ARE THEY CAN MAKE A PRETTY GOOD CASE TO DO THAT WITH TH MONEY THEY HAVE, IF THEY CAN'T ANOTHER GRANT (INAUDIBLE). >> EXCELLENT POINTS. >> CLOSING COMMENT FROM AMY? >> SO I WOULD COMMENT THAT'S EXACTLY RIGHT, IF YOU DO HAVE A COUPLE RO1s, NOT IF YOU'RE LIVING OFF ONE RO1 OR YOUR JUNIOR INVESTIGATOR YET TO GET THEIR FIRST RO1. ONE THING THAT I LIKED WAS DISCUSSION OF NOT JUST THE QUOTE UNQUOTE EARLY STAGE INVESTIGATOR WHOM WE DO GIVE NINDS A VERY NICE BUMP TO BUT THOSE INVESTIGATORS THAT ARE TRYING TO RENEW THEIR FIRST RO1 WHICH WE KNOW IS HUGELY PROBLEMATIC AND HIGH RISK TIME FOR INVESTIGATORS AND MID CAREER INVESTIGATORS DOING OUTSTANDING WORK, MAYBE DOING IT ON ONE RO1 IN A FOUNDATION GRANT. THAT'S -- THAT -- NOT ALL THIS IS JUST GOING TO GO TO THE PEOPLE WE'RE ALREADY GIVING VANNINGS TO, THE IDEA IS TO HELP THAT GROUP, I THINK WHO IS VERY MUCH AT RISK WHOM WE ARE LOSING FURTHER INTO THE PROCESS. >> I FORGET, ANYBODY ON THE PHONE WHO WANTS TO SAY ANYTHING? >> THIS IS LARRY. IT'S BEEN A FASCINATING DISCUSSION. AND COMPLICATED ONE, WE DO HAVE A PROBLEM IN THE COUNTRY WE HAVE TO ADDRESS, I WAS STRUCK BY DAVID'S COMMENT A MOMENT AGO BECAUSE I DO THINK THAT FOR A WELL FUNDED LAB TO GO AFTER NEW IDEA YOU FIND THE FUND. I THINK YOU MADE AN EXCELLENT POINT. SO I NO DON'T KNOW HOW WE IMPLEMENT THIS SORT OF SYSTEM BUT I THINK WE HAVE TO BE COGNITIVE OF THE FACT WE'RE LOSEING A GROUP OF SCIENTISTS MANY OF WHOM HAVE WELL TRAIN AND CREATIVE, WE'RE LOSING THAT AND WE HAVE TO THINK HOW TO SHIFT. HOW DO WE DO THAT, THE MECHANISM FOR DOING IT IS COMPLICATED BUT A WAY TO REVIEW THOSE GETTING -- WE HAVE THAT LINE AT 750 OR A MILLION. WE NEED TO HAVE A WAY OF MORE SERIOUSLY EVALUATING THOSE WHO ARE GETTING ADDITIONAL FUND. AS A HUGE INVESTIGATOR IT'S IMPORTANT THE TAKE INTO ACCOUNT TOTAL FUNDING. >> THIS IS A TERRIFIC DISCUSSION AND I WANT TO THANK BEYOND AND MIKE FOR COMING HERE AND SPENDING AN HOUR AND A HALF WITH US. [APPLAUSE] >> YOU HAVE NOT SEEN THE END OF THIS DISCUSSION. >> WE'RE TAKING A 15 MINUTE BREAK THEN CLOSED SESSION