>> WELCOME TO THE ANNUAL BIRCWH MEETING FOR 2022. MY NAME IS LISA BEGG AND I'M THE PROGRAM OFFICIAL FOR THE BIRCWH PROGRAM. IT'S MY HONOR AND PLEASURE TO OPEN THE MEETING TODAY. AS YOU CAN SEE, WE ARE VIRTUAL THIS YEAR. YOU MAY JOINING VIA THE NIH VIDEO CAST OR THROUGH OUR VIRTUAL PLATFORM. AS YOU CAN SEE HERE, FOR THOSE OF YOU THAT ARE ALREADY REGISTERED, I'D LIKE TO BRING YOUR ATTENTION TO THE NAVIGATION GUIDE HIGHLIGHTED IN THE CENTER. FOR THOSE OF YOU THAT WOULD LIKE TO JOIN, THERE ARE ADVANTAGES TO THAT. CAN YOU STILL REGISTER BY GOING TO BIRCWH2022. VFAIRS.COM AND IT IS ALSO ON THE ORWH WEBSITE. IF YOU REGISTERED, YOU WILL BE PART OF THE VIRTUAL PLATFORM FOR THE ENTIRE DAY. YOU CAN POSE QUESTIONS THROUGH THE Q&A TAB AND COMMUNICATE WITH OTHER ATTEND'S VIA THE CHATBOX AND ALSO PARTICIPATE IN THE AFTERNOON'S POSTER SESSION WITH OUR BIRCWH SCHOLARS WHICH WE INVITE TO YOU DO THAT. IT'S 51 POSTERS THAT HAVE BEEN ACCEPTED. THE VIRTUAL PLATFORM WILL RUN IN THE 4:00 P.M. TODAY. OUR FIRST SPEAKER WILL BE OUR DIRECTOR Dr. JANINE AUSTIN CLAYTON, WHO WILL GIVE OPENING REMARKS AND INTRODUCE THE RUTH L. KIRSCHSTEIN AWARD FOR 2022. Dr. CLAYTON CELEBRATED HER TENTH ANNIVERSARY AS OUR DIRECTOR AND SHE'S A PHYSICIAN SCIENTIST WHO WAS CONDUCTED RESEARCH IN HER OWN RIGHT OVER THE YEARS AT NIH AND SHE HAS SPEARHEADED A MAJOR POLICY CHANGE FOR NIH WITH SEX AS A BIOLOGICAL POLICY IMPLEMENTED AND ADVANCING THE STUDY OF SEX AND GENDER DIFFERENCES. PLEASE WELCOME Dr. CLAYTON. >> THANK YOU SO MUCH, Dr. BEGG FOR THAT KIND INTRODUCTION. SO, IT'S SO EXCITING TO WELCOME YOU HERE TO OUR ANNUAL BIRCWH MEETINGS. THINGS HAVE BEEN CHANGING IN THE WORLD, AS ALL OF US KNOW. I WANT TO SET STAGE, AS I AGAIN, TALKING ABOUT HOW WOMEN ARE FARING IN THE LABOR FORCE. WE'VE TALKED ABOUT WOMEN IN THE LABOR FORCE IN SCIENCE AND LABOR FORCE GENERALLY HAVE EXPERIENCED CAREER SET BACKS AND IT'S BEEN HARD. AFTER ALL THE WORK ALL OF US HAVE DONE, MANY OF YOU HERE, LEADERS, SCHOLARS AND NIH AND BEYOND TO ADVANCE WOMEN'S CAREERS IN SCIENCE IT'S BEEN PAINFUL TO SEE SOME OF THE DATA AND STATISTICS AND HEAR IT CALLED NOT A RECESSION BUT A SHE-SESSION. FORTUNATELY, THE GOOD NEWS IS, DATA FROM THE BUREAU OF LABOR STATISTICS ARE STARTING TO SHOW THAT WOMEN ARE COMING BACK STRONG AND IN FACT, WOMEN'S EMPLOYMENT GAINS HAVE OUT PLACED MEN FOR THE PAST SIX OF THE LAST EIGHT MONTHS AND WE'RE ALSO SEEING IMPROVEMENTS ACROSS THE BOARD. EVEN THOUGH WE'RE HERE TODAY, TO CELEBRATE THE SUCCESS OF WOMEN AND RESEARCH, WE WANT TO JUST KEEP IN MIND THE LARGER CONTEXT AND I WANTED TO FRAME THOSE REMARKS AT THE BEGINNING HERE TO ENCOURAGE US ALL TO UP LIFT ALL WOMEN, CONTINUE TO HELP THOSE IN YOUR LABS AND IN YOUR CLINICS, ESPECIALLY THOSE ON THE FRONT LINES AND THOSE AT THE EARLY STAGES OF THEIR CAREERS, WHO HAVE BEEN MOST AFFECTED BY THE PAST TWO AND A HALF YEARS. SOME OF THE CHANGES IN THE PAST TWO AND A HALF YEARS MAY BE BRINGING TO THE FLOOR THE WAY THAT WE EVALUATE SCIENTIST AND APPLICANTS. I WAS REALLY INTERESTED TO SEE THIS PIECE IN "NATURE" WHERE A GROUP IS PROPOSING A CHANGE TO HOW SCIENTISTS AND APPLICANTS ARE EVALUATED BOTH FOR GRANTS AND FOR HIRING AND THEY'RE PROPOSING A SYSTEM THAT WOULD DEEMPHASIS IMPACT FACTORS AND AGE AND THE INSTITUTIONS FROM WHICH A SCIENTIST OR CANDIDATE COMES BECAUSE OF THESE FACTORS AND HOW THEY CONTRIBUTE TO BUY AS. MAYBE ONE OF THE CHALLENGES TO THE WORKFORCE THAT COMES FROM THE CHANGES WILL RESULT IN A MORE HOLISTIC ASSESSMENT OF CANDIDATES. LATER TODAY, YOU ARE HEAR FROM Dr. JUDITH JAMES AS OUR LEGACY OF LEADERSHIP LECTURER AND I WANT TO OFFER HER MY HEARTFELT CONGRATULATIONS IN HER RECENT ELECTION INTO THE NATIONAL ACADEMY OF MEDICINE. Dr. JAMES IS A FIFTH GENERATION OKLAHOMAN A PIONEER IN THE FIELD OF SYSTEMIC AUTOIMMUNELY AND ADVANCED HOW AUTO MANY UNION DISEASES START AND HOW IMMUNE RESPONSES EVOLVE. FROM HAVING TREATED PATIENTS WITH SYSTEMIC LUPUS AND DISEASES LIKE SHOW GRIN SYNDROME, THESE DISEASES ARE PARTICULARLY CHALLENGING AND HAVE, IN THE PAST, BEEN TRULY LIFE-THREATENING. Dr. JAMES' LEADERSHIP AND DEDICATION TO THE FIELD OF AUTOIMMUNITY HAS CHANGED LIVES AREN'T THE WORLD AND THAT IS WHAT THE PRESIDENT OF OMRF SAID, HE SAID SHE'S DEVOTED HER LIFE AND THE DIFFICULT TO TREAT DISEASES IT RECOGNIZES THE IMPACT SHE'S HAD BOTH IN THE LAB AND FOR PATIENTS. SHE IS ALSO BEEN DEVOTED TO IMPROVING THE HEALTH OF NATIVE AMERICANS. CONGRATULATIONS AND WE LOOK FORWARD TO YOUR PRESENTATION LATER TODAY. THE TITLE OF HER PRESENTATION IS "THE WINDING ROAD OF RESEARCH AND LESSON ALONG THE WAY." SO I'M ALSO REALLY EXCITE TODAY SHARE WITH YOU SOME OF THE DATA FROM THIS YEAR'S BIRCWH SCHOLARS AND WE HAVE 82 CURRENT SCHOLARS FROM 19 ACTIVE PROGRAMS AND WE HAVE 51 POSTERS WE'RE HIGHLIGHTING ACROSS DISCIPLINES AND SCIENTIFIC TOPICS AND WE HAVE UNDER REPRESENTED IN MEDICINE SCHOLARS IN EVERY PROGRAM SO WE'RE THRILLED TO SEE THE REACH AND BREADTH OF THIS YEAR'S BIRCWH SCHOLARS AND I AM DOUBLY EXCITED TO SHARE THE DIVERSITY IN THE BIRCWH PROGRAM. NINE OF OUR PROGRAMS ARE COLLABORATING WITH HBC YOU OR MINORITY-SERVING INSTITUTIONS, OVER 10 OF THEM, AND WE'RE DELIGHTED TO SEE THIS REACH AND BREADTH AND DIVERSITY THAT EXPAND THEXEXPANDS THE STRENGTH OF THE BIRCWH PROGRAM. RECENTLY, A NICE PUBLICATION, LED BY ESTHER CHEW, WITH Dr. HEART MAN, OUR LECTURER AS A CO-AUTHOR, TALKED ABOUT WHAT CONTRIBUTES TO BUY SCHOLAR SUCCESS. WE KNOW THESE FACULTY TRAINING AWARDS ARE ADVANCING EARLY CAREER FACULTY AND RESEARCH AND HAVE BEEN INSTRUMENTAL IN EXPANDING THE WOMEN'S HEALTH RESEARCH CAD RAY ACROSS COUNTRY. AND THIS PUBLICATION FOCUSED ON THE BIRCWH ASK IT HIGHLIGHTED THESE FACTORS THAT WERE CRITICAL AND IN THE MENTOR, PERSISTENCE, RESILIENCE. THE CAPACITY TO DEVELOP COMMUNITY AND TO HAVE NETWORKS. AND THE PROGRAM DIRECTOR'S TALKED ABOUT HOW IMPORTANT IT WAS TO HAVE STRONG, ACTIVELY ENGAGE MENTORS WHO BOTH SUPPORT THE SCHOLARS' CAREER AND CULTIVATE THE SCHOLARS RESEARCH FOCUS. THEY TALKED ABOUT THE IMPORTANCE OF DEVELOPING A PERSONAL RESEARCH VISION SO THE SCHOLAR CAN ENSURE ALIGNMENT WITH THE ACTIVITIES WITH A WELL-ESTABLISHED VISION AND HIGHLIGHTED THAT SOME GROUPS ARE MORE VULNERABLE THAN OTHERS IN THE RESEARCH WORKFORCE INCLUDING CLINICIANS, WOMEN AND PARENTS AND UNDER REPRESENTED GROUPS. CLINICIAN SCHOLARS AND PARENTS WERE ALSO THE MOST VULNERABLE FORAFOR ATTRITION FROM A RESEARCH CAREER AND THERE'S COMPETITION FOR THE LIMITED TIME THAT ALL OF US HAVE AVAILABLE BETWEEN FAMILY OR CLINICAL DUTIES AND RESEARCH. THEY HIGHLIGHTED THE IMPORTANCE OF, IN THE CONTEXT OF ATTRITION, MENTORS AND P.I.s FRAMED THE OBSERVE IN TERMS OF A INDIVIDUAL RESPONSIBILITY OR INSTITUTIONAL RESPONSIBILITY AND THOSE THAT HIGHLIGHTED THE RESPONSIBILITY OF THE INSTITUTION AND IN SUPPORTING THE MENTOR WERE ABLE TO FRAME SUCH ATTRITION IN A POSITIVE AND CONSTRUCTIVE WAY. PROMOTING SCHOLAR SUCCESS INCLUDING THE CRITICALITY OF A PLAN FOR TRANSITIONING TO OTHER FUNDING, THE IMPORTANCE OF DEVELOPING A TIMELINE FOR PUBLICATIONS AND GRANTS SUBMISSIONS, AND AS WELL AS DEVELOPING A BACK-UP PLAN OR PLAN B IF APPLICATIONS ARE UNSUCCESSFUL. AND HOW CRITICAL IT IS TO ENSURE AND ENCOURAGE SCHOLARS TO SOLIDIFY THEIR CLINICAL DUTIES AND TEACHING ROLES EARLY. HAVING THE SCHOLARS WORK WITH PROGRAM FACULTY TO SOLIDIFY A MULTI-STAGE TRANSITION PLAN WAS ALSO CITED AS IMPORTANT. AND OF COURSE, MENTORING IS AT THE HEART OF THE BIRCWH PROGRAM. THAT INCLUDES ALL OF THE MET FOR METAFOR I CAN SITUATIONS YOU CAN HAVE. WE TALK ABOUT HOW CRITICAL IT IS FOR WOMEN IN SCIENCE AND THE DEVELOPMENT OF WOMEN'S HEALTH RESEARCHERS. THIS THINGS CAN'T BE IMPARTED THROUGH A PRE-RECORDED ZOOM CLASS. THE IMPORTANCE OF HAVING SOMEONE THERE TO STAND WITH YOU, TO STAND FOR YOU, AND TO HELP YOU AND TO SUPPORT AS YOU GO THROUGH CHALLENGES. WE ALL NEED SOMEONE WHO HAS BEEN THERE AND I DO WANT TO HIGHLIGHT Dr. VIVIAN PEN WHO HAS BEEN THE INSPIRATION AND MOTIVATING FORCE HYPED THE BIRCWH PROGRAM AND IT'S BEEN A TIRELESS MENTOR TO SO MANY OF US AND CONTINUES TO WANT TO INSPIRE OTHERS TO MENTOR. THE ANNUAL BIRCWH KEYNOTE HONORS Dr. RUG L. KIRSCHSTEIN. SHE WAS THE LEADING SCENERY SEARCHER FOR POLIO, MEASLES AND RUBELLA SO IT WAS AT THE FOREFRONT OF HER MIND MANY, MANY YEARS AGO. SHE WAS THE FIRST INSTITUTE DIRECTOR FROM 1974 FOR ALMOST 20 YEARS TO 1993. SHE SERVED AS THE ACTING NIH DIRECTOR TWICE. AND SHE HELPED TO CHANGE THE DEMOGRAPHICS OF THE NIH. RECOGNIZING TALENT, AND ENCOURAGING THE HIRING AND PRE MOTION OF FEMALE AND UNDER REPRESENTED MINORITY RESEARCHERS INTO LEADERSHIP ROLES. Dr. KIRSCHSTEIN HAD MANY IMPACTS ACROSS NIH AND THIS IS JUST ONE WAY THAT WE HONOR HER AND WE ENSURE HER IMPACTS ARE REMEMBERED. THIS YEAR'S RUTH L. KIRSCHSTEIN MEMORIAL LECTURE WILL BE DELIVERED BY Dr. KATHERINE HARTMANN. SHE'S AN EPIDEMIOLOGIST WITH EXPERIENCE IN LARGE COHORTS, BEHAVIORAL INTERVENTIONS, CLINICAL TRIALS, ASSESSMENT OF MEDICAL TESTS AND TEACHING QUANTITIVE METHODS. MUCH OF HER PRIMARY RESEARCH FOCUSES ON GETTING ANSWERS THAT MATTER. AND ADVERSE PREGNANCY OUTCOMES, PELVIC FLOOR DISORDERS AND THYROID DISEASE. SHE ALSO SERVES IN CROSS-CUTTING ROLES IN POLICY-RELEVANT AREAS INCLUDING HEALTH SERVICE, HEALTH OUTCOMES, EVIDENCE-BASED PRACTICES, SYSTEMATIC REVIEWS, COST AN A LOAL SIS AND COMPARATIVE HE CAN TIVENESS AND YOU CAN SEE FROM HER TITLES HERE AS VICE PRESIDENT FOR RESEARCH INTEGRATION, ASSOCIATE DEAN FOR CLINICAL AND TRANSLATIONAL SCIENTIST DEVELOPMENT, PROFESSOR, OF OBSTETRICS AND GYNECOLOGY AND MEDICINE, AND THE LUCIUSE.BURCH CHAIR OF REPRODUCTIVE PHYSIOLOGY AND FAMILY PLANNING. SHOWS A TRAILBLAZER AND HAS MULTIPLE ROLES TO PLAY AND MULTIPLE HATS SHE WEARS ON ANY GIVEN DAY. SHE HAS A POPULAR ADVICE COLUMN, YOU COULD CALL IT, ON THE WEBSITE EDGE FOR SCHOLARS. SHE DISCUSSES TOPICS YOU WANT TO LEARN FROM A MENTOR. YOU CAN CATCH A GLIMPSE OF HER GREAT SENSE OF HUMOR THERE. IN DEED, SHE'S THE PERFECT CHOICE TO PRESENT THIS YEAR'S KIRSCHSTEIN MEMORIAL LECTURE. AS A FORMER BIRCH SCHOLAR AND P.I. WITH MANY OF HER MULTI P.I.s ON HER GRANT, BEING ALSO FORMER BIRCWH SCHOLARS, SHE HAS ALL OF THE CRITICAL CHARACTERISTICS THAT WE PUSH FORWARD IN THE BIRCWH PROGRAM. IT'S MY PRIVILEGE TO Dr. KATHERINE HARTMANN THE RUTH L. KIRSCHSTEIN. NO ONE TELLS YOU HOW TO DEAL WITH CATEGORY 6 RAPIDS IN LIFE. Dr. HARTMANN. >> THANK YOU, I'M EXCITED TO BE WITH YOU TODAY. AS YOU'VE HEARD, THIS CELEBRATES A REMARKABLE WOMAN, I FEEL I KNOW HER A BIT THROUGH HER FRIENDS WHO I KNOW. Dr. KIRSCHSTEIN WAS A PERSON WHO NAVIGATED SCIENTIFIC ACHIEVEMENT, REMARKABLE LEADERSHIP AND DEDICATION TO HER FAMILY WITH RARE SKILL. ON A PERSONAL LEVEL, SHE'S DESCRIBED AS A HEAD OF A TIME, KEEPING HER MAIDEN NAME AT A TIME WHEN THAT WASN'T DONE, MARRIED TO ANOTHER NIH POWER HOUSE, AND KNOWN FOR BRINGING HER CHILD TO WORK WITH HER AND TO CONFERENCES AND GIFTED AT ENJOYING LIFE AND INCLUDING DATE AND FAMILY NIGHTS SO I'M HONORED TO BE WITH YOU TO PRESENT. BIRCWH IS PART OF MY LIFE FOR MORE THAN 20 YEARS AND I WAS IN THE FIRST COHORT OF SCHOLARS AND MANY SCHOLARS WHO WEPT ON TO LEAD BIRCWH PROGRAMS. BIRCWH WERE MY MENTORS AND WERE MY COLLEAGUES AND LIFE-LONG SOUNDING BOARDS. OTHER SCHOLARS ALSO BECAME EXCEPTIONALLY VALUED PEERS, COLLEAGUES AND COLLABORATORS IN MY GRANT WORK. DESPITE OUR VIRTUAL FORMAT TODAY, I HOPE YOU WILL TAKE THE TIME TO MEET EACH OTHER, VIRTUALLY THROUGH E-MAIL OR OTHER MECHANISMS TO START CONVERSATIONS ABOUT SHARED INTEREST AND I LOOK FORWARD TO A YEAR WHEN WE'RE ALL BACK TOGETHER. I HAVE LED THE BIRCWH PROGRAM AT VANDERBILT FOR 15 YEARS AND I'M EXCITED, AS OF THIS ROUND OF FUNDING WE'RE A MULTI-P.I. AWARD WITH TWO EXCEPTIONAL ALUMNI AS OUR PROGRAM DIRECTORS AND CO P.I.s. THOSE ARE Dr. AMY MAJOR AND Dr. DIGNA EDWARDS AND WE MAY BE THE ONLY SITE IN THE COUNTRY THAT IS LED BY FORMER BIRCWH SCHOLARS. SO, WHY HAVE WE INVESTED SO MUCH IN BIRCWH? BIRCWH OPENED THE DOORS FOR US AND FOR A RESEARCH CAREER. THIS IS THE WEBSITE FOR THE RIGHT FROM THE START STUDY. MY TIME IN BIRCWH LAID THE GROUNDWORK THAT SPANNED NINE COMMUNITIES AND THREE STATES. FEEDBACK, CRITIQUE AND PRACTICAL WISDOM FROM EXPERIENCED RESEARCHERS RESULTED IN A STUDY STRUCTURE AND METHODS THAT HAVE BECOME A MODEL FOR LARGE-SCALE MULTI-STATE STUDY OF PREGNANCY OUTCOMES INCLUDING EVENTS LIKE MISCARRIAGE AND PRE TERM BIRTH. LAST YEAR, I HAD THE OPPORTUNITY TO SPEAK AT AN NIH STATE OF THE SCIENCE CONFERENCE AS A KEYNOTE ABOUT HOW WE ACCOMPLISHED IMPOSSIBLE THINGS LIKE RECRUITING PARTICIPANTS BEFORE PREGNANCY, AND UNIVERSAL USE OF RESEARCH ULTRASOUNDS THAT WERE NOT REPORTED BACK TO INDIVIDUALS' MEDICAL RECORDS THAT WERE DEEMED INFEASIBLE WHEN WE FIRST STARTED TRYING TO PLAN THE PERFECT STUDY. DURING BIRCWH, OUR RESEARCH TEAM SURVIVED THE INITIAL STUDY SECTION REVIEWS ASSERT ASKING THE APPROACH WASN'T FEASIBLE AND BY RESUBMITTING DATA WITH 900 WOMEN AND THREE DIFFERENT STATES AND WENT ON TO BE MORE THAN MORE THAN 9,000 WOMEN IN CONTACT WITH THE STUDY. I WOULD LIKE TO TALK ABOUT YOUR CAREER. ACROSS MY EDUCATION AND TRAINING, I LOOKED AT MENTORS AND OTHERS WHO I ADMIRED AND ANTICIPATED STARTING A NEW, EASIER AND MORE PREDICTABLE PHASE OF LIFE THAT WAS GOING TO LOOK SOMETHING LIKE THIS. DO ANY OF YOUR DAILY LIVES LOOK LIKE THIS? SMOOTH AND CALM WHERE STUDY PROGRESS AND BRIGHT SUNSHINE GREET YOU EVERY MORNING. IT WAS A REALLY NICE FANTASY. IN REALITY, IT'S MORE LIKE THIS ON A GOOD DAY. WE ALL KNOW THAT TURBULENCE IS ROUTINE AND AS SCHOLARS YOU ARE BLESSED TO HAVE MENTORS WHO HELP YOU PREPARE AND RESPOND TO NORMAL, ACADEMIC TURBULENCE LIKE GRANT AND MANUSCRIPT CRITIQUES AND FAILED EXPERIMENT AND ACADEMIC DISAPPOINTMENTS. ALL OF THESE ARE LEGITIMATE CHALLENGE THAT'S REQUIRE GUIDANCE TO DEMYSTIFY THEM AND TO NAVIGATE WELL IN YOUR FORTUNATE TO BE IN YOUR BIRCWH PROGRAMS. HOWEVER, THERE ARE FAR MORE DISRUPTIVE CATEGORY 6 RAPID, AND THINGS THAT CAN HAPPEN IN LIFE AND THIS STRETCH OF RIVER HEADS STRAIGHT FOR AN IMPRESSIVE WATERFALL. THESE REPRESENT THE CHALLENGE THAT'S WE DON'T DISCUSS. THAT'S THE WHITE WATER THAT HAPPENS IN OUR LIVES OUTSIDE OFF WORK. IN ACADEMIC PUBLICATIONS, WE MAY DOCUMENT THE RAPIDS, PRESENT IN OUR LIVES ENCLOUD CAREGIVING, DEMANDS, FAMILY AND PERSONAL HEALTH CRISIS AND OTHER LIFE CHANGING EVENTS AND WE PUBLISH ABOUT NOT ADDRESSING THESE BUT WE RARELY OFFER GUIDANCE FOR WAYS THAT INDIVIDUALS CAN DEVELOP SKILLS AND RESOURCES TO NAVIGATE CHALLENGE FORT BENEFIT OF THOSE WE LOVE AND FOR OUR CAREERS. AS PART OF THE GROUNDWORK FOR PROGRAM TO PROVIDE PRACTICAL SUPPORTS TO FACULTY, WE SOUGHT TO MAP THE RAPIDS AND DETERMINE THE PREVALENCE OF SPECIFIC LIFE CHALLENGES AND THE INCIDENTS OF STRESSFUL LIFE EVENTS. WE SURVEYED HUNDREDS OF EARLY CAREER FACULTY ASKING THEM, ABOUT THE PRIOR YEAR IN THEIR LIVES. EARL CAREER FOR THE PURPOSES OF THIS SURVEY, WHICH WAS ELECTRONIC, WAS TO INDIVIDUAL ON INDIVIDUALS ON K OR COMPARABLE AWARDS OR THOSE IN THE FIRST TWO YEARS OF THEIR FIRST RO1. SO THESE WERE THE PEOPLE WHO RESPONDED. THE AVERAGE AGE WAS COMPARABLE TO THE NATIONAL AVERAGE FOR EARLY CAREER SCHOLARS AT NEARLY 40 AND HALF WERE WOMEN, 63% WERE ASSISTANT PROFESSOR WITH THE MAJORITY OF THE OTHERS BEING AT LOWER RANK LIKE INSTRUCTORS, AND A FEW BEING AT ASSOCIATE PROFESSOR AND THOSE BEING THE PEOPLE WHO WERE THIS FIRST RO1. 70% HAD AN MD WITH OR WITHOUT OTHER GRADUATE DEGREES AND 30% WERE PH.D SCIENTISTS. MEN AND WOMEN WERE EQUALLY LIKELY TO BE MARRIED AND THEY ALSO WERE EQUALLY LIKELY TO HAVE CHILDREN. WHERE ARE THE CHALLENGES THAT THEY EXPERIENCED. 16% HAVE HAD A CHILD HAD SURGERY IN THE PRIOR YEAR AND 22% HAVE HAD AN ADULT MEMBER OF THEIR HOUSEHOLD WHO HAD BEEN HOSPITALIZED AND 28% SEPARATE FROM THOSE QUERIES ABOUT SURGERY HAD A CHILD HOSPITALIZED DURING THE PRIOR YEAR. WHEN WE ASKED ABOUT CARE COORDINATION, WHICH WE CONSIDERED TO BE PRIMARY RESPONSIBILITY FOR OVERSEEING THE SCHEDULING IMPLEMENTATION AND FOLLOW THROUGH OF CARE FOR HEALTH-RELATED CONDITIONS 4% REPORTED HAVING A CHILD WHO HAD A CHRONIC DEBILITATING CONDITION WHO NEEDED CONTINUOUS THERAPEUTIC INTERVENTION AND 21% WERE RESPONSIBLE FOR CARE COORDINATION FOR AN ADULT OUTSIDE OF THEIR HOME AND 5% FOR ELDER CARE THAT OFTEN INCLUDED RESIDENTIAL LIVING AND 1% WERE IN THE MIDST OF HELPING WITH HOSPICE CARE. WE CONSIDERED THE STRESSFUL LIFE ABOUT SCALE OF STRESS OR IN OUR LIVES AND YOU WILL SEE THAT 64% OF THE FACT YOU WILL TEE REPORTED AT LEAST ONE STRESSFUL LIFE SPENT AND AN AVERAGE CLOSER TO TWO. THIS INCLUDED 18% REPORTING MAJOR MONEY PROBLEMS, 9% HAVING A PARTNER WITH SERIOUS ILLNESS, AND 8% TOTAL SUFFERING SOME FORM OF ABUSE, 4% HAD AN EXPERIENCE OF DISASTER OR VIOLENCE AND 3% HAD DIVORCED IN THE PRIOR YEAR. WHEN WE ASKED FOR MORE DETAILS ABOUT WHAT HAPPENED, THESE WERE THE SORTS OF THINGS THAT PEOPLE REPORTED. AND I KNOW THAT YOU ARE FAMILIAR WITH THESE SORTS OF THINGS HAPPENING IN YOUR OWN FAMILY, AND AMONG YOUR PEERS. I WANT YOU TO CONSIDER WHAT PREPORTION OF THE FACULTY WHO HAS SUCH EVENTS, HAD REPORTED THIS OR SOUGHT TO PROBLEM-SOLVE WITH THEIR DIVISION CHIEFS, CHAIRS, OR MENTORS. NOT A SINGLE ONE HAD. WHY DO WE GO IT ALONE AND HIDE THE THINGS THAT WE'RE FACING. IN FOCUS GROUPS, THREE KEY THINGS EMERGED. THE FIRST WAS ABOUT COMMUNITY AND THERE WAS AN INDIVIDUAL ETHIC THAT WAS FAIRLY UNIFORM OF STRIVING AND SUCCEEDING AND A SENSE OF FAIRNESS AND THEY RECOGNIZED THAT IF THEY HAD A NEED FOR A CHANGE IN THE CALL SCHEDULE, HELPING THEIR LAB OR OTHER FORMS OF SUPPORT, IT MIGHT MAKE THINGS WORSE OR WOULD DEFINITELY MAKE THINGS WORSE FOR SOMEONE ELSE. SECOND WAS A SENSE THAT THINGS COULD GET WORSE AND THEY DIDN'T WANT TO CALL IN FAVORS TOO SOON IN CASE THEY DID GET WORSE AND THE THIRD WHICH WAS A ESPECIALLY STRONG AND FEAR OF THE IMPRESSIONS OF OTHERS AND MOST OF ALL, THEY DID NOT WANT OTHERS TO FEEL PITY FOR THEM OR STRESS THAT. THEY REPORTED EXPERIENCES OF SEEING OTHERS JUDGED FOR THE CIRCUMSTANCES THEY WERE IN AND OR FOR HOW THEY WERE HELPING THEM AND LAST THEY WORRIED ABOUT ROLES THEY COULD DO WELL BECAUSE JANE OR JOHN WAS IN THE MIDDLE OF CRISIS AND SO, FIRST LESSON IN HERE IS WHEN THINGS HAPPEN IT'S LIKELY THAT THINGS WILL HAPPEN AND WHEN YOU ARE READ TO GO DO THAT AND TO SAY A FEW MORE TIMES THAT EVERY RIVER HAS RAPIDS AND YOU DID NOT PUT THEM THERE. AND THESE ARE THINGS THAT ARE HELPFUL REGARDLESS OF WHETHER OR NOT IT GETS BUMPY AND THE FIRST ONE MAY BE SO AND THEN THERE MAY BE INTRODUCTIONS TO PEOPLE WHO LEASE CARS OR HAVE OTHER RESOURCE AND BEFORE YOU KNOW IT, YOU HAVE A WHOLE NEW LIFE AND BECAUSE OF DELAYED GRATIFICATION OF SO MANY YEARS OF TRAINING, BEFORE YOU LINE FAR YOU WILL TEE OR GET MORE SETTLED INTO A PERMANENT POSITION, IT'S EASY TO TAKE ON A DIFFERENT LIFESTYLE OVERNIGHT AND OFTEN THAT LIFESTYLE IS COMPLETELY WITHIN YOUR NEW MEANS AND THAT GETS TO POINT TO, IT REALLY CRUCIAL IN ORDER TO HAVE THE FLEXIBILITY TO ADDRESS CHALLENGES AND IN WAYS THAT MAKE IT EASIER TO GET OUT OF DEBT AND STAY OUT OF DEBT AND THE BEST WAY TO PROCEED WITH THAT IS TO START AN EMERGENCY FUND WHILE YOU ARE ALSO DOING THAT AND MAKE SURE THAT YOU ARE HONEST WITH YOURSELVES ABOUT WHAT IT TAKES TO HAVE THREE TO SIX MONTHS OF YOUR REAL EXPENSES INSURANCE PAYMENTS, GAS, FOOD, MORTGAGE, RENT, WHATEVER IT IS THAT MAKES UP YOUR MONTHLY BUDGET AND KNOW THAT AND BE HONEST WITH YOURSELVES ABOUT HAVING A SUBSTANTIAL JUNE ON AND WE WOULD ACTUALLY COVER A COUPLE OF MONTHS. SAFETY LIKE HELMETS AND FLOTATION DEVICES ARE NOT EXCITING BUT THIS ISN'T THE TIME OF YEAR WHEN WE ALL GET TO THINK ABOUT THAT TYPICALLY OPEN ENROLLMENT IN OCTOBER AND FOR US, AND WE'RE FORTUNATE THAT WE WORK AT THE KIND OF PLACE THAT'S OFFER SOLID HEALTH INSURANCE BUT YOU CAN BILL THAT WELL. ONE IS TO SET A RATIONAL DEDUCTIBLDEDUCTIBLE LEVEL. MAKE IT LOWER. IF YOU FOCUS ON THE PRIOR ISSUES OF GETTING AND STAYING OUT OF DEBT AND HAVING AN EMERGENCY FUND, MAKE SURE -- IF YOU HAVE THE OPTION OF PURCHASING ADVANCED MENTAL HEALTH COVERAGE, DO IT. THERE MAY BE MANY, MANY YEARS WHEN YOU DON'T NEED IT AND SHOULD YOU OR A MEMBER OF YOUR FAMILY NEED THAT COVERAGE, IT'S ABSOLUTELY WRENCHING TO HAVE A MINIMAL NUMBER OF SESSIONS COVERED AND THEN HAVE TO FIGURE OUT HOW TO COVER WEEKLY OR TWICE MONTHLY OR MONTHLY ENGAGEMENTS IN MENTAL HEALTH OVER THE LONG-TERM WITHOUT INSURANCE COVERAGE WHICH GETS TO WHY YOU WANT HEALTH SAVINGS ACCOUNT THE VERSIONS THAT ROLL OVER FROM YEAR TO YEAR AND YOU WANT BOTH LIFE INSURANCE AND DISABILITY INSURANCE AND IF YOU ARE YOUR INSTITUTION DOESN'T OFFER YOU BOTH, IT'S CRUCIAL TO MAKE SURE THAT YOU HAVE DISABILITY INSURANCE THAT WOULD REPLACE YOUR INCOME AND SINCE IT'S MORE LIKELY FOR HEALTH PROFESSIONALS AND OTHERS IN ACADEMIC MEDICAL CENTER SETTINGS TO EXPERIENCE DISABILITY THAN IT IS TO NEED THE LIFE INSURANCE BENEFIT ALTHOUGH BOTH IDEALLY YOU WOULD HAVE BUT MANY OF OUR INSTITUTIONS PROVIDE ONE AND NOT THE OTHER. LASTLY, EARLY, WHEN YOU TOTALLY NOT NEED IT OR WHEN YOU WANT TO UNDERSTAND IT FOR A FRIEND OR WHEN YOU THINKING ABOUT FUTURE OF EVENTS LIKE PLANNING A PREGNANCY, MAKE SURE YOU UNDERSTAND WHAT YOUR EMPLOYEE ASSISTANCE OR FACULTY ASSISTANCE PROGRAM THAT IS THE FAP ACRONYM IS ABLE TO PROVIDE OR DIRECT YOU TO. WHAT RESOURCES THEY HAVE AND. THEY'RE LIKELY TO BE MUCH MORE ROBUST THAN YOU EXPECT AND INCLUDE HOME HEALTH NURSING, SICK CHILDCARE AND WAYS TO ASSIST WITH THE CARE OF OLDER PARENTS OUT OF STATE AND NOT LOCAL. SO IT'S A GREAT IDEA TO UNDERSTAND WHAT IS AT YOUR FACULTY ASSISTANCE PROGRAM AND ALSO, TO GET FAMILIAR WITH THE FAMILY MEDICAL LEAVE ACT. MANY PEOPLE FEEL LIKE THAT'S THE ULTIMATE LAST STEP AND UNAWARE THERE ARE LEAVE FOR THINGS THAT OCCUR ON A PARTICULAR SCHEDULE. SO IF YOU GET FAMILIAR WITH THAT, YOU WILL BE MORE INFORMED FOR YOURSELVES AND FOR OTHERS WHO YOU ARE SUPPORTING AROUND YOU. MAYBE THE MOST IMPORTANT ADVICE IN ALL OF THIS IS TO MAKE SURE THAT YOU HAVE FELLOW TRAVELERS. ABOUT 80% OF PEOPLE WHO ARE FULL-TIME RESEARCHERS ARE INTROVERTS. WE'RE NOT NECESSARILY GOOD AT BEING IN COMMUNITY AND YOU ACTUALLY NEED TO WORK AT IT AND IT WILL PAYOFF IN MANY, MANY WAYS. WHETHER IT'S DEEPER ENGAGEMENT IN YOUR FAITH COMMUNITY, IN VOLUNTEER EFFORTS, OR EVEN WITH YOUR FRIENDS AND PEERS IN YOUR ACADEMIC COMMUNITY AND YOUR DIVISION AND YOUR DEPARTMENTS AND SOCIAL AND RELAXED WAYS SO THAT YOU REALLY KNOW EACH OTHER AND THE ABILITY TO DISCLOSE IF YOU NEED TO AND TO HELP EACH OTHER IS STRONG. KNOW YOUR NEIGHBORS. I LIVED IN BOTH CITIES UNTIL WE STARTED MOVING TO ACADEMIC UNIVERSITY SETTINGS IN CHAPEL HILL NORTH CAROLINA. THERE WAS A DIFFERENT SKILL SET. TO MEET AND GREAT PEOPLE AS THEY MOVED IN, TO HOST POTLUCK PARTIES AND KNOW EACH OTHER'S CHILDREN AND IN THE COURSE OF THAT, BE PROACTIVE ABOUT BRINGING UP, HOW CAN I HELP YOU IF SOMETHING COMES UP? DO YOU NEED AN ADDITIONAL EMERGENCY CONTACT. WOULD YOU FEEL COMFORTABLE HELPING ME IF SOMETHING HAPPENS? BECAUSE HAVING THAT CONTACT INFORMATION, AND HAVING FAMILIARITY WITH EACH OTHER AND YOUR WORK LIVES CAN BE TREMENDOUSLY HELPFUL. LIKEWISE, HAVE UP FRONT DISCUSSIONS ABOUT CRISIS MANAGEMENT WITH YOUR FAMILY MEMBERS AND I HAVE TWO SIBLINGS AND SINCE COLLEGE, WE'VE NEVER LIVED IN THE SAME STATE AND ONLY ONE OF MY SIBLINGS NEAR MY PARENTS. THAT REALLY CREATED EXTREME DIFFICULTIES ABOUT ASSUMPTIONS OF HOW WE WOULD MANAGE THINGS AND WHO WOULD BE THERE AND HOW WE WOULD ASSIST AND HOW LONG WE COULD BE AVAILABLE AND IN THE MIDDLE OF OUR FIRST CRISIS IN A SYSTEM THAT SAVED US MANY TIMES SINCE THAT INDICATES I NEED TO YOU COME HERE NOW, OR I NEED TO TALK TO YOU MORE OFTEN. I NEED SUPPORT IN THIS. TALKING ABOUT THE TYPES OF THINGS THAT ARE INEVITABLE AS FAMILY AGES OR WITH MEMBER OVERSEAS OR OTHER CHALLENGES, IT'S NOT ANYTHING ON FIRE IS TREE MACHINE DOESLY HELPFUL AND LASTLY HAVE ADAPTABLE SUPPORT IN YOUR LIFE. THAT FOR US HAS INCLUDED ULSRUD BEING INVOLVED WITH UNDERGRADUATE STUDENTS WHO NEEDED JOBS TO HAVE INCOME WHERE WE CAN PROVIDE FLEXIBLE THINGS THAT THEY CAN HELP WITH AND THAT WE NEEDED AS A FAMILY AND AGAIN, GET TO KNOW THEM OVER TIME THEY COULD HELP WITH FIXING A MEAL OR RUNNING YOU CAN SEE THE WHITE WATER LOOMING IS THE TIME TO ASK YOUR MENTORS AND OTHERS FOR INTRODUCTIONS. ASK FOR CONFIDENTIALITY IF YOU NEED IT. I NEED TO MEET PEOPLE WHO HAVE BEEN THROUGH THIS. ASK THEM TO SHARE THEIR EXPERIENCES. ASK THEM TO REFLECT ON WHAT THEY DID RIGHT AND WHAT THEY WISH THEY HAD DONE DIFFERENTLY AND AT THIS POINT, VISIT OR CALL AND HAVE A CONSULTATION WITH YOUR EMPLOYEE OR FACULTY ASSISTANCE PROGRAMS. THEY OFTEN ARE OFFER SHORT TERM COACHING OR COUNSELING SESSIONS TO HELP WITH THE NAVIGATION AND THEN WHEN YOU ARE COMFORTABLE, CONTACT ORGANIZATIONS ON YOUR CAMPUS, AND INCLUDING FOR INSTANCE, MANY UNIVERSITIES NOW HAVE THE DORIS DUKE FUND TO RETAIN CLINICIAN SCIENTISTS AND THEY HAVE FABULOUS RESOURCES TO ALSO GET SUPER PRACTICAL ABOUT HOW TO MAKE IT THROUGH PARTICULAR TYPES OF CHALLENGES. AND LASTLY I'D LIKE TO SAY THAT I THINK SENIOR FACULTY AND MENTORS HAVE A RESPONSIBILITY TO SHARE OUR STORIES AND WHAT WE'VE LEARNED. SO IF WE FOCUS ON FOR JUST A MINUTE, NOT ON EARLY CAREER FACULTY BUT ON MORE SENIOR PEOPLE, I WOULD LIKE TO TAKE A DETOUR TO SOME THOUGHTS FOR YOU AND THAT IT IS REALLY IMPORTANT THAT WE SHARE THE MAP. NORMATIVE DATA CAN CHANGE CULTURE. WHEN WE STARTED THE SURVEY, THE DATA I PRESENTED, I THOUGHT IT WOULD BE 9% OR 10% AND I HAVE NO SENSE THAT A QUARTER OF PEOPLE WOULD HAVE HOUSEHOLD MEMBERS HOSPITALIZED, SURGERIES, BE RESPONSIBLE FOR HOSPICE CARE AND EVEN LESS SENSE THAT LIFE EVENT SCALE WOULD ADD ANOTHER 20% OF THAT MEANING THAT PROBABLY 50% OF EARLY CAREER FACULTY ARE HAVING SOME SIGNIFICANT STRESSORS TO BALANCE WITH THEIR WORK LIFE DURING A NORMAL YEAR. THAT'S NOT HOW WE CONSIDERED AND IT'S NOT HOW WE ORGANIZED RESOURCES. WE HAVE TO PROVIDE THE RIGHT GEAR. WE HAVE TO PROMOTE THROUGH THE ROLES WE'RE IN AS MENTORS AND CAREER DEVELOPMENT PROGRAMS AND USE OF FACULTY INTRODUCING NEW PROGRAMS AND WE NEED TO DO IT IN PRACTICAL WAYS INCLUDING INFORMATION AND IN FACULTY ON BOARDING AND ORIENTATION AND HAVING INDIVIDUALS COME AND SPEAK AT SEMINAR SERIES AS PART OF NORMATIVE CHANGES TO OUR OCCUR ACTUAL AND WE HAVE TO COACH THE PROCESS AND NONE OF US HAVE BEEN IN ACADEMICS GOT THROUGH THIS WITH NO PRESSURES AND A SMOOTH SAILING CANOE ON A LAKE AND WE REAL VE TO TALK ABOUT HOW IT WENT AND WHAT WE WISH WE HAD DONE DIFFERENTLY AND WE NEED TO THINK ABOUT IF THERE ARE PRACTICAL WAYS THAT WE CAN INVEST IN THE JOURNEY WE'VE LEARNED THROUGH OUR PARTNERSHIP IN RETAINING EARLY CAREER FUNDING BY THE DORIS DUKE FOUNDATION AND THE FINANCIAL RESOURCES WE NEED TO PROVIDE ARE VERY, VERY MODEST AND THEY'RE FOR A PORTION OF THE YEAR OR HAVING THEM STEP OUT OF ACADEMIC LIFE AND SMALLMENTS OF FUNDS OR SUPPORT WITH PARTICULAR PERSONNEL INJECTED INTO THE WORK LIFE, BY HELPING IN THE LAB AND EVEN TO PROVIDE THINGS AND PULLING ALL MY COMMENTS TOGETHER, IT WILL REALLY BE POSSIBLE TO TAKE ON EVEN VERY DIFFICULT WHITE WATER. IT WILL GIVE YOU CONFIDENCE AND I SWEAR I'VE LEARNED THIS PERSONALLY, IT WILL GIVE YOU CONFIDENCE YOU WILL GET THROUGH THIS AND MAYBE HAVING IT IN PLACE IN ADVANCE OR HAVING MANY OF THESE THINGS IN PLACE IN ADVANCE AND IT'S A TREMENDOUS SAFETY NET. SO, BY WAY OF REASSURANCE THAT EARLIER THE MORE DETAILED WHAT HAPPENED WAS NOT OVER SHARING CONFIDENTIAL DETAILS. PEOPLE THAT I MEET. THESE ARE SOME OF THE THINGS THAT HAPPENED DURING MY CAREER. WHEN I STARTED MY FIRST JOB, MULTIPLE STATES AWAY I WAS THE ONLY MEDICAL PERSON IN MY FAMILY. MY FATHER HAD A HEART ATTACK, HAD BY PASS SURGERY AND STARTED HAVING NEW TIAs, THAT TH THAT'S NOT NEW. MOST OF US HAVE INDIVIDUALS IN OUR FAMILY WHO HAVE CARDIOVASCULAR CHARGES AND HE NEEDED MEDICAL INTERVENTION. ESPECIALLY IF YOU HAVE A MEDICAL BACKGROUND, YOU ARE LIKELY TO BE THE INDIVIDUAL IN YOUR FAMILY WHO IS LEANED ON TO BE THERE AND HELP INTERPRET. THEN WHEN I STARTED MY NEXT JOB, WITHIN A FEW MONTHS, MY CHILD LOST ALL NORMAL FUNCTION IN ORDER TO GET THE BEST POSSIBLE CARE, WE MOVED HER TO A HOSPITAL THAT HAD REHABILITATION FOR HER PARTICULAR DEFICITS WHERE SHE WAS HOSPITALIZED FOR MORE THAN SIX MONTHS. MY HUSBAND AND I OFTEN PASSED IN THE AIRPORT AS EACH OF US TOOK HALF OF A WEEK IN HOUSTON IN ORDER TO BE WITH HER. SEEING YOUR CHILD DEVASTATED, IT IS INCOMPARABLE AND IT IS THE THING, BECAUSE WE WERE IN A NEW JOB, WHERE WE OWNED TWO HOUSES IN TWO CITIES AND WE HAD BEEN IN A STATE JOB WITHOUT RAISES FOR QUITE SOME TIME, IT GOT US TALKING WITH BANKRUPTCY LAWYERS. BECAUSE WE WERE LIVING RIGHT AT THE EDGE OF OUR MEANS AND WE THOUGHT NEVER HAD THE OPPORTUNITY TO BUILD AN EMERGENCY FUND. ALL MY KIDS ARE ADULTS NOW. THIS CHILD IS A 32-YEAR-OLD WITH A FABULOUS CAREER WHO RECOVERED ALL FUNCTION COGNITIVE FUNCTION AND DID INCREDIBLY WELL BUT IT WAS A REALLY ROUGH GOING. WE COORDINATED MY FATHER IN LAW'S HOSPICE CARE IN A DIFFERENT STATE FOR 18 MONTHS AND TOOMONTHS.A NUMBER OF YEARS I WAS WITH MY BEST FRIEND'S HUSBAND WHEN HE WAS MURDERED IN HIS GYM AND DEVELOPED PRETTY FLOOR I HAD PTSD FROM THE TYPE OF VIOLENT TACK AND IT TOOK ALMOST TWO YEARS TO QUIT HAVING FLASH BACKS OF THAT EVENT ON A REGULAR BASIS. AND DUNG THE MIDST OF ALL OF THAT, MY PARENTS WITH RAPIDLY PROCESSING DEMENTIA WERE REFUSING RESIDENTIAL CARE AND DECIDED IT WOULD BE GOOD TO TAKE THEIR CHILDREN TO COURT TO BE ALLOWED TO STAY AT HOME, EVEN AFTER THERE WAS A KITCHEN FIRE AND MY FATHER GOING MISSING FOR ALMOST 20 HOURS. SO, THINGS HAPPEN, I PRAY THEY DON'T HAPPEN TO YOU, BUT YOU HAVE TO SHARE THESE STORIES AND I'M NOT SUPER HUMAN. MY FAMILY AND I LEARNED EVERY SINGLE ONE OF THE LESSONS I SUGGESTED TO YOU TODAY. WE FLAILED, WE CONSIDERED BANKRUPTCY, WE CRIED, GRIEVED AND WE CLUNG ONTO THE THINGS THAT MATTERED MOST. WITH OUR SIBLINGS, EXTENDED FAMILIES AND FRIENDS AND NEIGHBORS, BUT AGAINST THIS BACKDROP, LIFE WEPT ON. I HAVE A 36-YEAR MARRIAGE, FOUR AMAZING ADULT CHILDREN AND MY CAREER SURVIVED. OUR PAPERS HAVE BEEN CITED MORE THAN 10,000 TIMES AND I'VE ENJOYED MENTORING MORE THAN 100 SCIENTISTS INCLUDING GRADUATE STUDENTS, POSTDOCS, FACULTY, UNDER GRADS, THE GAM THE AND I HAVE RECEIVED AT LEAST AROUND $40 MILLION IN GRANTS AND CONTRACTS SERVED IN NATIONAL ROLES THAT I SOUGHT OUT AND THRIVED IN LEADERSHIP ROLES THAT I WAS ASKED TO TAKE ON. I LEARNED TO BE HOME FOR DINNER TO STRETCH MY INTROVERTED SELF INTO REAL RELATIONSHIPS THAT I BELIEVED PREVIOUSLY I DIDN'T HAVE THE TIME FOR. SO, IT TOOK ME MANY YEARS TO BE PREPARED FOR THE WHITE WATER BECAUSE MY GENERATION TREATED SUCH CHALLENGES AS PERSONAL ISSUES THAT ARE TOO (INAUDIBLE) TO DISCUSS THAT'S WHY I'M TRUSTING YOU TODAY, TO HEAR PIECES OF MY ACTUAL STORY. SO THINGS HAPPEN TO MOST OF US IN A TYPICAL YEAR. I PROMISE YOU, YOU WILL BE REWARDED IF YOU PLAN BY THINKING AHEAD AND DON'T PUT YOUR HEAD IN THE SAND. THINK THROUGH WHAT YOU MIGHT NEED. GET FAMILIAR WITH RESOURCES. KEEP YOUR FINANCES IN ORDER. BUILD A ROBUST EMERGENCY FUND. HAVE A PLAN FOR HELP AND TALK WITH PEOPLE AROUND YOU AND ABOUT HOW YOU CAN BE HELPING EACH OTHER NOW. EVEN IN DAILY LIFE. AND IF YOU NEED TO, ACCEPT HELP WHEN IT'S NEEDED YOU WILL MEET THESE CHALLENGES AND TAKE PRIDE HOW YOU HANDLE CHALLENGES IF YOU TAKE ON THAT PREPARATION. I HOPE IN FUTURE YEARS WHEN WE'RE BACK IN-PERSON THAT SOME OF YOU WILL FIND ME AND TELL ME THAT NOTHING HAS HAPPENED BUT YOU ARE IN GREAT SHAPE. OR WHAT DID HAPPEN AND HOW THINGS WENT FOR YOU AND WHAT YOU LEARNED. YOU KNOW YOU ARE HEARTY AND TOUCH YOU ARTOUGH.TAKE A SECOND TO THINK A BOUT WHAT IT REQUIRED OF YOU. SO I WANT TO ASK ONE MORE TIME, A WORD OF ENCOURAGEMENT, FOR YOU TO HONOR THE FACT THAT EVERY RIVER HAS RAPIDS, YOU DID NOT PUT THEM THERE, LIFE WILL HAPPEN. BOTH CHALLENGING THINGS AND REALLY GREAT THINGS AND EMBRACE THE CHALLENGE. >> Dr. HARTMANN. WE HAVE A QUESTION HERE FROM YOUR TALK AND FROM WORKING WITH YOU, YOU'VE BEEN PART OF THE OVER ALL BIRCWH PROGRAM FROM ITS EARLIEST DAYS AS A SCHOLAR AND THEN AS A LONG-TERM P.I. OVER THESE 20 PLUS YEARS, SCIENCE ASK CAREER DEVELOPMENT HAVE CHANGED GREATLY. DO YOU HAVE ANY SUMMARY GENERAL ADVICE YOU CAN GIVE THE SCHOLARS, THE MENTORS, THE NIH STAFF ON THIS VIRTUAL MEETING AS WELL AND WE WOULD APPRECIATE A LONGER TERM PERSPECTIVE SINCE YOU'VE BEEN PART OF THIS IMPORTANT PROGRAM. THANK YOU. >> THANK YOU. I THINK MY ADVICE FOR PEOPLE ADD STRAIGHTING CARES IS INCLUDED IN THE TALK. IT'S TO NOT JUST BE AWARE THAT THERE ARE CAREGIVING CHALLENGES OR OTHER ISSUES THAT SHOULD BE ADDRESSED TO PREVENT FACULTY BURNOUT OR PROGRAMS TO PROMOTE RESILIENCE, AND IT'S RATHER TO GET PRACTICAL ABOUT WHAT THINGS WE CAN PROVIDE AND WHAT THINGS WE CAN TEACH SKILLS OR ENCOURAGE AND TO BE MORE FLEXIBLE PERHAPS WITH CAREER DEVELOPMENT PROGRAM BUDGETS. SO, OUT OF A GENERAL FUND, I PROVIDE FUNDS FOR COACHING. WHEN LIFE IS REALLY TOUGH, WE SUPPORT ADDITIONAL SESSIONS THROUGH CONFIDENTIAL COUNSELING SERVICES AND WE OFTEN DO INVEST INTO SHORT TERM USE OF EXTRA EFFORT FROM A LAB MANAGER AND WHILE SOMEONE HAS THEIR PARTNER IN THE HOSPITAL FOR CANCER CARE. OR SHORT TERM USE OF AN EDITOR FOR A GRANT THAT CAN GO IN ON TIME WHILE SOMEONE THEMSELVES IS ILL SO I THINK THAT THINKING FLEXIBLY ABOUT WHAT OUR BADGE ET CATEGORIES FOR HOW WE CAN ASSIST IN THE WORKPLACE, AND BEING UP FRONT AND SOMETHING SOME IDEAS ABOUT THE THINGS WE CAN SUGGEST THAT INDIVIDUALS COULD REQUEST AND THAT WE CAN GROW TO SO, I WOULD HOPE THAT EVERY ONE OF OUR BIRCWH SCHOLARS FOR INSTANCE WOULD SAY I NEED TO STEP BACK AND I LOVE THE WEEKLY WORK IN PROGRESS SESSION AND I KNOW IT ONLY WORKS WHEN WE ALL CONTRIBUTE AND I WOULD LIKE TO PRESENT MY REPLY TO THE REVIEWERS AND NEXT WEEK AND TAKE A MONTH GAP WHILE THIS IS GOING ON AND I KNOW IN A HEARTBEAT, WE WOULD SAY YES. I KNOW BECAUSE OF THE FOCUS GROUPS AND SURVEYS AND NETWORKING WITH DOZENS AND DOZENS OF FACULTY IN THE MIDST OF CRISIS, THAT THEY OFTEN DON'T WANT TO WANT A FAVOR AND THEY OFTEN BELIEVE THEY HAVE TO REFEEL THAN THEY HAVE TO AND IN ORDER TOO GET SOME FLEXIBILITY AND IF WE CAN WE CAN MAKE IT SAFER TO ACKNOWLEDGE THAT LIFE HAPPENS. >> THANK YOU. >> SO, THANK YOU VERY MUCH FOR THAT VERY INSPIRING TALK THAW GAVE US AND MY NAME IS ANNIE AND I'M FROM CAREERS AT THE ORWH AND FOR ME THE SURVEY THAT YOU PRESENTED WAS VERY REVEALING AND YOU HAVE IDENTIFIED CHALLENGES THAT SCHOLARS AND ESIs FACE THAT YOU YOURSELF HAVE EXPERIENCED AND DESPITE THEM IT'S NOW A VERY ACCOMPLISHED SCIENTIST AND CAN YOU DISCUSS IF THESE CHALLENGES THAT YOU MENTIONED BASED ON YOUR EXPERIENCE IN THE BIRCWH PROGRAM HAVE INCREASED OR BECOME AGO VA RATE ISED DURING THE RECENT COVID PANDEMIC? >> ABSOLUTELY. ACTUALLY I THINK WE HAVE A PAPER THAT IS COMING OUT OF THE DOORS OF THE PROGRAM SITE THAT TALKS ABOUT HOW COVID EXACERBATED THIS AND WORE ALL COMPLETELY AWARE TOO THAT WE'RE LEFT IN THIS RIFT WHERE SOME OF THE PERSONAL INTERACTION AND SUPPORTIVE THINGS HAPPENING OVER CONVERSATIONS BEFORE OR AFTER SEMINARS OR LUNCH MEETINGS, AND VANISHED AND WE'RE HAVING TROUBLE COMING BACK AND ONE OF MY CHALLENGES OR REQUESTS FROM OUR GROUPS HAS BEEN, LET'S FIGURE OUT HOW TO RECONNECT AND LET'S FIGURE OUT HOW, AGAIN, IF YOU PERSONALLY HAVE ADDITIONAL RESOURCES THEY MAY HAVE BEEN DEPLETED DURING COVID FOR THINGS LIKE, TUTORING OR EXTRA ASSISTANCE IN THE HOME IN ORDER FOR YOU AND YOUR SPOUSE TO BE AT WORK WHILE CHILDREN NEEDED SCHOOLING AND AS SOME OF THOSE THINGS CLEARING IT'S A IMPORTANT THINK ABOUT REGROUPING AND PART OF THE WONDERFUL THING ABOUT BIRCWH IS RELATIONSHIPS AND THE CONFIDENCE THAT YOU HAVE AND IN TURNING TO APPEAR OR MENTOR AND SAY I FEEL STUPID UNDERSTANDING AND I FEEL LIKE MY PROJECTOR MY GRANT WILL BE BETTER, CAN YOU HELP ME GET CONNECTED TO SOMEONE WHO CAN FIGURE OUT A BETTER METHOD AND THAT IS SO MUCH HARDER, YOU CAN'T DO THAT ON THE MARGINS OF A GROUP ZOOM CALL WITH A DIRECTIVE TO REVIEW THIS PORTION OF A MANUSCRIPT THIS WEEK SO MY PERSONAL PASSION RIGHT NOW, FOR THINKING ABOUT HOW THINGS HAVE BEEN MORE CHALLENGING AND HOW WE CAN GET THEM BACK, IS TO GET THE HUMAN ELEMENT BACK AGAIN. I WOULD LOVE TO DO THE SURVEY WITH BIRCWH CITES SO PLEASE CONTACT ME AND SAY THAT WE'D LIKE TO BE CONSIDERED FOR REDO OF THE SURVEY AND THE SURVEY CAN BE REFLESHED AND MORE MEANING FIREFIGHTERS IT REFLECTED OUR SITES. THE LAS --MEANINGFUL. WE DIDN'T THINK THE NUMBERS WERE NEARLY GOING TO BE 25% OF PEOPLE WITH CRAZY STUFF GOING ON IN THEIR LIVES IN A YEAR THAT DIRECTLY INVOLVED MEDICAL AND HEALTH ISSUES. WE ALSO DIDN'T ANTICIPATE THE NUMBER OF SINGLE-FAMILY HOMES AND WE COMPLETELY DIDN'T ANTICIPATE THAT 5% OF OUR MALE FACULTY WERE SINGLE PARTICIPATING WITH SOLE CUSTODY AND THEY'RE ABSOLUTELY INVISIBLE AND ALL THE THINGS THAT HAVE PLY TO WOMEN PARENTING, SOLO OR IN FAMILIES AND HAVING RESPONSIBILITIES FOR A LOT OF DUTIES, APPLIED TO THAT GROUP AND YOU TALK ABOUT A SILENT, SMALL GROUP THEY'RE SILENT ABOUT THEIR NEEDS AND WE HAVE GOTTEN MORE PROACTIVE ABOUT FIGURE TAG OUT TOO. >> THANK YOU. >> I WORK WITH Dr. BEG IN SUPPORTING THE BIRCH PROGRAM SO THANK YOU FOR YOUR WONDERFUL TALK. YOU TALKED ABOUT THE IMPORTANCE OF COMMUNITY AND THE IMPACT OF YOUR FELLOW TRAVELERS. I JUST WANTED TO ASK IF CAN YOU SHARE YOUR THOUGHTS IN THE CONTEXT OF THE PIR PROGRAM AND PART ONE, HOW THIS CAN MAKE THE MOST OF THEIR TIME IN THE BIRCWH AND NUMBER TWO, HOW ORWH CAN SUPPORT BIRCWH SCHOLARS BETTER. >> FLEXIBILITY AND PEOPLE TO DO THINGS IN THEIR CAREER LIFE THROUGH THEIR WORK BUDGETS THAT SUPPORT. >> I MADE MY PLUG TWICE IN THE TALK AND WE'RE LET'S DO THIS IN-PERSON. I CAN'T IMAGINE IF I WAS THE SCHOLAR 20 SOME ODD YEARS AGO I WOULD HAVE MADE THE SAME CONDITIONS IF I DIDN'T HAVE A BOX LUNCH WITH PEOPLE AND TAKE AN EXTRA DAY TO STAY OVER TO TALK TO A PROGRAM OFFICER TO GET A CLEARER IDEA ABOUT HOW THINGS WORK AND I THINK THAT THAT IS PART OF THE PERSONAL ELEMENT AND THEN MAKING DECISIONS, ONE OF THE THINGS THAT I'VE SEEN THAT OTHER CAREER DEVELOPMENT PROGRAMS HAVE DONE IS HAVING GUEST LECTURE ACROSS SITES AND ALLOWING OUR SCHOLARS TO BE ON A ROSTER SHARING THEIR WORK AS ANOTHER WAY TO CROSS POLLENATE BECAUSE WE'RE NOT TOGETHER TO DO THAT. I'VE FOUND IT A LITTLE BIT CRAZY THAT OUR DEPARTMENT AND OUR DIVISION AND OUR ACADEMIC INSTITUTIONS ARE WARM AND FRIENDLY AND SUPPORTIVE PLACES, SOMETIMES THEY'RE NOT AND THEY'RE COMPETITIVE IN UGLY PLACES BUT IF YOU ARE FORTUNATE TO BE ONE THAT IS SUPPORTIVE, TO THINK ABOUT WHAT MAKES IT WORK AND TO SHARE THAT, AND BECAUSE WE OFTEN HAVE WAYS TO DEAL WITH A LEAVE FOR BEREAVEMENT OR WITH MATERNITY AND WE HAVE ABSOLUTELY NO PLANS FOR HOW TO DEAL WITH THESE OTHER MUCH MORE COMMON SORTS OF EFFORTS THAT WE IGNORE O HAVING SOMEONE MOW YOUR LAWN OR BRING A MEAL MIGHT BE MORE IMPORTANT WHEN A CHILD IS HOSPITALIZED OR A PARTNER THAT IS SICK OR YOU ARE REALLY SICK. THE ONLY WAY WE CAN DO THAT IS KNOWING EACH OTHER WELL ENOUGH TO FEEL COMFORTABLE BOTH WITHIN OUR ACADEMIC STRUCTURES AND OUR NEIGHBORHOODS AND TALKING ABOUT HOW CAN I HELP AND HOW CAN THAT FEEL NORMAL? >> Dr. HARTMANN, THIS IS HELL A WONG. THANK YOU FOR THE PRESENTATIONS. I LIKE IT AND I FEEL INSPIRED. I HAVE A QUESTION. OVER ALL PH.D AWARDEES IT'S ACROSS THE BOARD AND I TRUST THE BIRCWH PROGRAM WITH BIRCWH BEING A PHYSICIAN SCIENTIST AWARD PROGRAM, HOW CAN WE REACH OUT TO CLINICIANS SCIENTISTS FROM THE PROMOTING THE BIRCWH PROGRAM IMPROVING RESEARCH IN WOMEN'S HEALTH? >> ABSOLUTELY. I HOPE THAT WE'LL HAVE DATA SOON THAT THESE SMALL INVESTMENTS HELP WITH RETENTION AND KEEP BEATING THAT DIAGRAM THAT ASSISTANCE AND HELPFUL AND IT'S PROBLEM MORE OUR MDs WHO TAKE ADVANTAGE OF THAT AS WELL. WHEN THERE'S A TIME CRUNCH AND YOU ARE RIGHT, THE PRESSURES ON PHYSICIAN AND PHYSICIAN RESEARCHERS ARE DIFFERENT AND WE USUALLY DIFFERENTIATE TOWARDS THE RESEARCH TRACK PRETTY EARLY AND I THINK THE MORE DIFFICULT THING IS MECHANISMS TO PROVIDE TRAINING FOR INDIVIDUALS WHO ARE LATE BLOOMERS. WHO DISCOVERED A FELLOWSHIP PROJECT THAT THEY LOVE RESEARCH AND THEY DIDN'T HAVE FORMAL RESEARCH TRAINING. IN REVIEW SESSIONS I'VE NOTICED A TREND, NOT SO MUCH IN K12 REVIEW SECTIONS BUT INDIVIDUAL REVIEW AND WE ARE HARSH ON THESE LATENT TREMENDOUS PHYSICIANS. AND IF THEY HAVE AGAIN TO THE TROUBLE TO WORK WITH THEIR LEADERSHIP TO GET PERMISSION AND TO SATISFY THAT TIME TO SAY THAT THEY'RE MAYBE NOT READY YET BECAUSE THEY HAVEN'T DONE THE MASTERS OF SCIENCE AND CLINICAL INVESTIGATION OR THEY HAVEN'T DONE THE MPH AND THAT'S NOT SOMETHING THAT SHOULD BE COVERED AND I KNOW IT'S NOT THE NIH POSITION BUT REVIEWERS ARE SO USED TO SEEING SUPER SOPHISTICATED APPLICANTS THAT I FEEL LIKE OFTEN THE MDs ARE THE ONES THAT GET TRUMPED PREMATURELY BECAUSE THEY'RE SEEKING OPPORTUNITIES FOR ADDITIONAL TRAINING. I KNOW THAT'S NOT THE HEART OF WHAT YOU WERE ASKING, THERE'S BEEN A MULTI-DECADE CONCERN FOR WHY WE LOSE CLINICIAN RESEARCHERS AND IF T DEFINITELY DOUBLED DOWN DURING COVID AND WITH PEOPLE BEING REDEPLOYED IN CLINICAL WAYS THAT THEY HADN'T AND HAVING NEW DISTRACTION AND NEW REQUIREMENTS AND ALSO, LOTS OF NEW RESEARCH POTENTIAL TO TAKE ON THAT TALKING MORE CONCRETELY ABOUT WHAT DO YOU NEED AND HOW CAN WE MAKE THAT WORK FOR YOU IS HELPFUL. IT MAY BE HELPFUL TO HAVE CONVERSATIONS ABOUT IS IT POSSIBLE TO TAKE LEAD FOR A PERIOD OF TIME AND ONE OF THE REGULATORY ISSUES AROUND THAT, THEY ARE SUPER MURKY AND IT'S HARD TO KNOW WHAT TO TELL PEOPLE AND LATER ENTER TREE OF CLINICIAN SCIENCES, MODEST WAYS THAT WE CAN SUPPORT THEM AND THEN GIVING THEM A VOICE FOR ASKING FOR WHAT THEY NEED AND BEING ABLE TO CONSIDER THAT, ONE OF THE QUESTIONS DURING MY REHEARSAL OF THIS TALK WAS TO THE EFFECT OF, MY BOSS IS INCREDIBLY GET YOUR TOUGH TOGETHER AND PULL YOUR STUFF TOGETHER AND MOVE ON. I DON'T KNOW IF PEOPLE READ THAT ATTITUDE RIGHT BUT SOMETIMES WE'RE NOT PROACTIVE IN MENTORING PEOPLE FROM WHAT TO ASK FOR. OR WHAT TO ASSERT AS PART OF THEIR PLAN TO GET THAT PROTECTED TIME. YOU SHOULDN'T AND IT'S ONE OF MY JOBS AS ASSOCIATE DEAN AND VICE PRESIDENT IN OUR RESEARCH ENTERPRISE, YOU SHOULDN'T HAVE TO FIGHT FOR YOUR 75% PROTECTED TIME. SOMEONE SHOULD ENFORCE THAT FOR YOU AND SOMEONE SHOULD COACH YOU UP ABOUT WHAT IT MEANS CAN YOU PUT DOWN AND WHAT IT MEANS THAT YOU SHOULD ASK TO BE ALLOWED TO PUT DOWN SO YOU ARE FINANCE THAT PLACE OF TRYING TO WORK AROUND THE EFFORT AND WHEN YOU ARE GET WHAT IS YOU DESERVE AND TO LAUNCH YOUR CAREER AS A PHYSICIAN SCIENTIST HOW TO HAVE THE CONVERSATIONS I PLAN TO NOT DO THESE THINGS AND I WOULD LIKE PERMISSION TO NOT DO THESE OTHER THINGS OR DELAY DOING THESE THINGS AND WOULD IT BE POSSIBLE TO MAKE THESE CHANGES AND IT HAPPENS FOR CAREER DEVELOPMENT AWARDS AND WE NEED TO REINFORCE THAT AS MENTORS AND WE'RE THERE TO PROTECT PEOPLE TO MAKE SURE THEY IT WAS AMAZING IT PROTECTED THEIR CAREER AND HELPED THEM GROW FABULOUS AND NEW DURING THE TIME THAT THEY WERE ON THE VERGE VERGE. >> AT THE THANK YOU SO MUCH FOR GETTING THE 2022 RUTH L KIRSCHSTEIN MEMORIAL LECTURE. WE KNOW, SHE WAS AN ICON AND WELL RESPECTED AND THIS IS A VERY IMPORTANT LECTURE GIVEN ANNUALLY DURING THE BIRCWH MEETING AND WE APPRECIATE YOUR THOUGHTFUL AND CONSIDERATE LECTURE, THANK YOU. >> I'M ABSOLUTELY HONORED TO BE WITH YOU TODAY AND I APPRECIATE IT. >> THANK YOU SO MUCH. GREAT JOB. >> FOLLOWING Dr. HARTMANN'S TALK WE HAVE Dr. CLAYTON IN THE CAREER GROUP AND THEY HAVE ADDED A NEW SESSION FOR THIS ANNUAL MEETING AND BECAUSE THERE'S BEEN SO MANY POSITIVE, EXCITING DEVELOPMENTS WITH ORWH AND THESE THREE IMPACT THE BIRCH PROGRAMS SO FOR THE NEXT HOUR, THERE'S GOING TO BE THREE 20-MINUTE, THREE-15 MINUTE TALKS FOR FIVE MINUTES WITH Q&A AFTER EACH ONE SO YOU CAN GET CAUGHT UP ON THIS AND SO I'M GOING TO TURN IT OVER TO Dr. XENIA TIGNO FOR THE FIRST SESSION THAT SHE WILL HOST WITH Dr. HOLLY MOORE. Dr. TIGNO. >> THANK YOU Dr. BEGG. GOOD MORNING, EVERYBODY. MY NAME IS XENIA TIGNO AND AS THIS IS THE ASSOCIATE DIRECTOR FOR CAREER OF THE OFFICE OF RESEARCH IN WOMEN'S HEALTH AND ONE OF THE DELIGHTS OF BEING IN THIS POSITION IS LEADING THE EFFORTS OF THE NIH WIDE WORKING GROUP ON WOMEN IN MY MEDICAL CAREER. THIS YEAR, THE PARTNERSHIP'S COMMITTEE OF THE WORKING GROUP, HOSTED A SUMMIT THAT CHALLENGED THE CURRENT RESPECTIVE OF HOW WOMEN SCIENTIST CAREER TRAJECTORY SHOULD LIKE LIKE AND OTHER STEM SCIENTISTS AS WELL. IT GIVES ME GREAT PLEASURE TO INTRODUCE HOLLY MOORE FROM THE NATIONAL INSTITUTE OF DRUG ABUSE, WHO IN ADDITION TO CO CHAIRING THIS SUMMIT, ALSO CONTRIBUTES LEADERSHIP TO NUMEROUNUMEROUS TRANS NIH PROGRAMS. HOLLY IS TRAINED IN PSYCHOLOGY, CHEMISTRY AND NEUROSCIENCE AND WAS FACULTY AT THE COLOMBIA UNIVERSITY PRIOR TO JOINING THE NIH. MOST IMPORTANTLY, SHE IS AN EMPATHETIC AND INTENSE LEADER WHO EMPOWERS AND ELEVATES ALL PERSONS WITH WHOM SHE INTERACTS. SHE WILL BE SHARING WITH YOU SOME OF THE HIGHLIGHTS OF THAT SUMMIT. >> HELLO, I'M HOLLY MOORE ON DRUG ABUSE AND CO-CHAIR OF THE PARTNERSHIP GROUPS WITHIN NIH'S WORKING GROUP ON WOMEN IN BIOMEDICAL CAREERS. I'M HERE ON BEHALF OF MY CO-CHAIR AND CHAIR A AS WELL AS THE MEMBERS OF OUR GROUP SHOWN ON THIS SLIDE. OUR GROUP'S VISION IS A BIO MEDICAL SCIENCE TECHNOLOGY AND ENGINEERING MATH AND DATA FOR STEM WHERE DIVERSE AND INNOVATION SPECIFICS LENS AND WE'RE EVER PERSON MAY CHOSE A CAREER TO MAXIMIZE THEIR POTENTIAL AND OF ALL IDENTITIES FROM BACKGROUNDS OF ALL COMMUNITIES AND ALL CULTURES. WE HAVE A MULTI-SECTOR ECOSYSTEM AT PRESENT AND IT'S RELATIVELY SEGREGATED. THOSE OF US WHO PURSUE A CAREER TEND TO START IN ONE SECTOR AND STAY THERE AND GROW WITHIN THAT SECTOR TO THE EXTENT AND MANY OF US DON'T HAVE ACCESS TO OR ARE UNAWARE OF WAYS TO CROSS FROM ONE SECTOR TO ANOTHER ALTHOUGH THEY EXIST. OFTEN FOR WOMEN AND PEOPLE COMING FROM UNDER REPRESENTED COMMUNITIES, WE COME TO OUR CAREER WITH NON LINEAR OR UNTRADITIONAL PATHS AND IT'S ALSO THE CASE THAT LIFE EXPERIENCES WILL INTERRUPT OUR CAREER ACTIVITIES IN OUR GIVEN SECTOR AND ALL THOSE EXPERIENCES ACTUALLY DON'T LIMIT OUR OWN GROWTH, THEY LIMIT OUR OPPORTUNITIES AND IT'S THE CASE IF WE START AT ONE SECTOR AND FIND THAT WE ACTUALLY GROW MORE IF WE CAN CROSS OVER TO A DIFFERENT SECTOR TO TAKE ADVANTAGE OF AN OPPORTUNITY OR A JOB OPPORTUNITY AND IT'S THE CASE THAT THAT MAXIMIZES THEIR GROWTH. WE'VE STARTED THIS CONVERSATION AND WE DID THAT EARLIER THIS YEAR WITH THE SUMMIT. REIMAGINING WOMEN IN THE BIO ENGINEERING TECHNOLOGY AND DATA SCIENCE ECOSYSTEM. THE GOALS OF IS THE SUMMIT WERE TO GATHER TO SHARE IDEAS AND DATA AND THE CHARTER AND COMPONENTS OF A HEALTHY STEM ECOSYSTEM AND IN TURN PARTNERSHIP THAT'S BUILD THIS HEALTHY ECOSYSTEM WE FOCUSED ON MID CAREER WOMEN BECAUSE IT'S AN EXAMPLE RIGHT NOW OF AN OPPORTUNITY BOTTLENECK AND WE CAN CREATE IDEAS TO OPEN UP OPPORTUNITIES THERE, AT THAT BOTTLENECK WE HOPE TO EXPEND THOSE IDEAS TO OPEN UP THE OPPORTUNITIES THINGS ACROSS THE CAREER TRAJECTORY FOR ALL COMMUNITIES. WE HAVE FIVE EMPHASIS AREAS. WOMEN IN INVENTORS, EDUCATIONORS, PARTNERSHIPS, ALLY SHIP, MENTORSHIP AND SPONSORSHIP FOR WOMEN AND WEALTH AND OPPORTUNITY GAPS AND OUR THEMES WERE NEXTALITY, LEADERSHIP AND CARE OF OTHERS. WE HAD EXPERTISE IN DATA AND SCIENCE INFORMATION, NURSE, BIOMEDICAL SCIENCES AND BIO ENGINEERING AND THEY SHOW THE PIE CHART HERE TO THE RIGHT INCLUDING CHAIRS OF BIO ENGINEERING AND TECHNOLOGY DEPARTMENTS FROM RULES AND OTHER UNIVERSITIES. THEY ASKED OUR STEM LEADERS TO GIVE US A STATE ASSESSMENT OF THE ECOSYSTEM AND THE STEM ECOSYSTEM AS IT EXISTS TODAY AND TELL THEM WHAT IT'S LIKE FOR YOUR TRAINEE AND THEN WE ASKED THEM FOR IDEAS FOR THERE ARE A FEW BIG TAKEAWAYS. THE GENDER, RACIAL AND EQUITY AND CULTURAL DIVERSITY IS INDISPUTABLE. WE PERFORM ACROSS PRIVATE AND PUBLIC SECTOR AND WOMEN FROM PEOPLE UNDER REPRESENTED IDENTITIES AND COMMUNITIES PERFORM AT LEVELS THAT ARE EQUALLY TO OR SUPERIOR IN RELATIVE TO THEIR MAJORITY GROUP PEERS AND THERE'S DATA NOW TO SUPPORT THE IDEA THAT DIVERSITY AND EQUITY PROMOTE INNOVATION AND IMPACT AND WITHIN THE WORLD OF VENTURE CAPITAL, MINORITY FOUNDED COMPANIES PERFORMED ON BAR OR BETTER THAN THE PORTFOLIOS THAT VENTURE CAPITAL. IN SMALL AND LARGE BUSINESS INDUCE TREMENDOUS COMPANIES IN THE TOP FOR GENDER AND RACIAL AND ETHNIC DIVERSITY ARE MORE LIKELY TO HAVE RETURNS THAT ARE ABOVE THE INDUSTRY MAIN AND WHETHER IT'S AN ACADEMIA, FARM OR GOVERNMENT DIVERSE TEAMS HAVE MORE HIGH-IMPACT DELIVERABLES AND IT'S NOW BEEN SHOWN THAT THE MINORITY MEMBERS INDIVIDUAL CONTRIBUTIONS ON THOSE TEAMS ARE KEY TO THAT INCREASED INNOVATION. WE ALSO FACED BARRIERS EX CHALLENGE AND WE GET LESS CREDIT AND INVESTMENT DESPITE EQUAL OR SUPERIOR PERFORMANCE AND WITHIN THOSE HIGH PERFORMING I DO VERSE TEAMS THAT I JUST TALK ABOUT THE PREVIOUS SLIDE, PLENTY OF CREDIT GOES TO THE TEAM FOR BEING DIVERSE AND PRODUCING INNOVATION BUT WHEN IT COMES TO GIVING CREDIT, THAT GOES TO THE MAJORITY GROUP INDIVIDUALS ON THAT TEAM AND NOT THE DIVERSITY MEMBERS OF THE WE FACE WELCOMING ENVIRONMENTS IN BIAS AND STRUCTURES IN THE STEM WORKPLACE AND WE ALSO PAY AN OUTREACH TASK. WE TAKE ON THE BURDEN FOR OUR GROUP IN THE WORKPLACE AND WE'RE EFFECTED BY THE RICH GET RICHER EFFECT AND THAT LIMITS OUR BANDWIDTH AND OPPORTUNITIES AND WE ACTUALLY HAVE TO FACE GEOGRAPHIC AND PERSONAL RESOURCE AND WE'RE EFFECTED BY A SCARCE MENTALITY THAT IS HELD BY THE MAJORITY MEMBERS OF OUR WORKPLACE AND IN THAT THERE'S ONLY SO MUCH TO GO AROUND AND BE HAPPY WITH THE SLICE OF THE PIE THAT YOU HAVE AND SHARE IT WITH OTHERS IN YOUR GROUP. FINALLY, THERE ARE HIGH PERSONAL COSTS TO WOMEN IN PEOPLE FROM UNDER REPRESENTED COMMUNITIES TO CLIMB TO THE TOP WHERE WE WANT TO GET THERE. WE WANT TO MAKE A DIFFERENCE FROM THE TOP AND CHANGE FROM THE TOP BUT THE HIGH COST OF CLIMBING ARE RELATED TO THE POINTS ABOVE THAT I JUST TALKED ABOUT AND WHEN WE GET TO THE TOP, WE FIND LOWER DIVERSITY AND HIGHER BARRIERS TO DIVERSITY AND EQUITY AND MORE INERTIA WITH REGARDS TO CHANGING THINGS AND WE ALSO TALKED ABOUT WHAT WORKS. WE THRIVE IN MULTI-LEVEL MENTORING ALLY SHIP AND SPONSORSHIP. FOR EXAMPLE, WOMEN AND STEM CAREER WITH SPONSORS ARE MORE LIKELY TO BE SATISFIED WITH THEIR BIG PROMOTION AND ASK FOR A RAISE AND TO HAVE THEIR IDEAS ENDORSED, DEVELOPED AND MUCH MORE LIKELY TO HAVE THEIR IDEAS IMPLEMENTED. HERE ARE A FEW QUOTES THAT I'LL SHARE WITH YOU AND I'LL SHARE THESE SLIDES SO YOU CAN SEE THESE QUOTES IN THE SLIDES THAT IF YOU LIKE BUT I WANT TO POINT OUT FOR WOMEN AND OTHER PEOPLE AND FOR MANY PEOPLE IN STEM D AND IF THEY CHOSE TO STAY IN STEM D THEIR GROWTH IS NOT LINEAR. WE HAVE OUR CAREERS THAT WERE ALSO HAPPENING AND WE NEED WORK IN COLLABORATIVE SPACE AND HERE ARE A FEW OTHER QUOTES. NAMELY OR I'LL HIGHLIGHT THIS WHEN WE CAN'T CLOSE THE WEALTH GAP UNTIL WE HAVE MEN IN MAJORITY GROUPS AT THE TABLE WITH US AND WE NEED ACCOUNTABILITY AND TRANSPARENCY AND WE NEED THE THREE Rs, RELATIONSHIP, RESOURCE AND RECOGNITION AND A FEW MORE, THE BIG ONE I'LL HIGHLIGHT HERE AND THAT IT'S AMAZING HOW INNOVATIVE SCIENTIST AND ENGINEERS ARE AND BASICALLY RECORDING THE WHOLE COMMUNITY WITH THIS AND IT'S AMAZING HOW INNOVATIVE WE CAN BE WHEN IT COMES TO OUR OWN SCIENCE AND ENGINEERING AND HOW REAL INNOVATION WE CAN CONTRIBUTE OR ACTUALLY SPEND ON BUILDING THE ECOSYSTEM THAT SUPPORTS THE PEOPLE WHO DO THE WORK. WE NEED TO ACTUALLY INNOVATE WITH REGARD TO WHO WE'RE SUPPORTING AND HOW WE'RE DEVELOPING SCIENTISTS AND ENGINEERS. THE FINAL SET OF IDEAS FOR ACTION THAT ARE REALLY ABOUT THE NECESSARY ELEMENTS OF A HEALTHY MULTI SECTOR STEM TO ECOSYSTEM. YOU NEED A COMMITMENT TO DIVERSITY INCLUES AND AND NOT JUST REFLECT THE PRESENT AND WE NEED SUSTAINABLE EXPERIENCE AND MOBILITY ACROSS STEM DIS SCEPTERS AND NETWORKS THAT CONNECT PEOPLE ACROSS -- ALL PEOPLE IN ALL SECTORS OF STEM D AND WE NEED TO SUPPORT NON LINEAR CAREER GROWTH AND VOCATIONAL GROWTH WHICH MEANS WHEN SOMEONE HAS TO ACTUALLY EXIT TEMPORARILY, FROM THEIR CAREER PATH, DUE TO A LIFE EXPERIENCE, OR FOR OTHER RESPONSIBILITIES, WE NEED LOWER BARRIERS TO REENTRY. WE WANT AND NEED THE SYSTEM THAT IS A SET OF GROWTH VARIANCE GAINED FROM NON LINEAR PATHS AND LIFE EXPERIENCES AND WE NEED OPPORTUNITIES TO SHARE SUCCESS AND HELP OTHERS GROUP AND WE WANT TO REPLACEMENT OF A SYSTEM BASED ON PAST CREDIT WITH A GROWTH-FOCUSED VALUE SYSTEM AND WE NEED SYSTEMS THAT SUPPORT RISK TAKING AND AT THE LEVEL OF THE TEAM WITH THE INSTITUTION AND MITIGATING RISKS AT THE LEVEL OF INDIVIDUAL. WE WANT METRICS THAT REFLECT VALUES OF DIEA GROWTH AND OVATION THROUGH COLLABORATION AND WE WANT MILES FOR ALLY SHIP, MENTORSHIP AND SPENCE O ACROSS THE SPAN. NOW WE WANT ANOTHER PERSPECTIVE AND THAT'S YOURS. AND I'M GOING TO LEAVE YOU WITH Dr. XENIA TIGNO WHO WILL ASK OR ASK YOU TO THINK ABOUT THE FOLLOWING QUESTIONS, WE'RE CHALLENGING YOU TO IMAGINE YOUR CAREER PATH IN A HEALTHY STEM ECHO SYSTEM AND CONSIDER THE QUESTIONS ON THIS SLIDE AND DISCUSS TODAY AND OR CONTACT US AT THE BOTTOM AND THANK YOU. >> THANK YOU, Dr. MOORE. THE QUESTIONS AT THE END OF THE PRESENTATION OF Dr. MOORE ARE REALLY INTENDED TO PROVOKE YOUR MENTALLATION AND THE PARTNERSHIPS COMMITTEE WOULD LOVE TO HEAR YOUR THOUGHTS. THE E-MAIL LINK IS PROVIDED AND JUST IN CASE YOU NEED MORE TIME TO COMPOSE YOUR THOUGHTS, FEEL FREE TO SEND THEM TO THAT E-MAIL. JOINING ME IN THIS SESSION ARE TWO OF OUR DIS TINNISHED BIRCWH PV, SUSAN KORNSTEIN AND JUDITH REGENSTEINER OF THE UNIVERSITY OF COLORADO WHO WILL MODERATE THIS SESSION. >> THANK YOU. >> THANK YOU SO MUCH. I WILL START. I WAS ASKED TO MAKE COMMENTS ON HOLLY'S TALK SO I WANT TO POINT OUT THIS SUMMIT IS PART OF A BROADER EFFORT BY NIH AND THE NATIONAL ACADEMIES TO ADDRESS THE UNDER REPRESENTATION OF WOMEN IN THIS STEM D WORKFORCE AND TO SUPPOSE SORT THEIR FULL PARTICIPATION AND ADVANCEMENT AND ADVANCING DIVERSITY CAN EQUITY IN THE SCIENTIFIC WORKFORCE WAS A MAJOR FOCUS OF THE SUMMIT AND CREATING AN ECOSYSTEM IN WHICH ALL SCIENTISTS ONE THE MAIN TAKEAWAYS FOR ME IS COLLABORATION ACROSS SECTORS IN THE SCIENTIFIC RESEARCH ECOSYSTEM CAN BE TRANSFORMATIVE AND DISRUPTIVE AND THAT IT CAN GENERATE INNOVATION THAT WOULD NOT BE POSSIBLE IN ONE SECTOR ALONE. IT'S A SIMILAR ARGUMENT TO WHY WE PROMOTE AND AND THIS IS TAKING IT TO A BROADER LEVEL TO INCLUDE OTHER SECTORS BESIDES ACADEMIA. AND I CAN TELL YOU THAT AS A CLINICAL RESEARCHER, I HAVE ALWAYS FELT THAT PARTNERSHIP BETWEEN ACADEMIA AND INDUSTRY IS CRITICAL TO ADVANCING SCIENCE AND I'VE COLLABORATED WITH SEVERAL PHARMACEUTICAL COMPANIES OVER THE COURSE OF MY CAREER TO DESIGN AND CONDUCT CLINICAL TRIALS. AND THERE WERE TIMES THAT I EVEN TOYED WITH THE IDEA OF TAKING A POSITION IN INDUSTRY AND I ALWAYS FOUND IT TO BE MUCH MORE FULFILLING FOR ME TO STAY IN ACADEMIA AND SOME OF THE RESEARCH THAT I WAS PART OF WITH THESE INDUSTRY COLLABORATIONS WAS REALLY IMPORTANT AND SOME OF OUR STUDIES WERE PUBLISHED IN "THE NEW ENGLAND JOURNAL" OF MEDICINE AND JAMA AND THE BEST EXTOL I KNOW IS BARBRA BOY AN MY CO PI ON MY BIRCWH GRANT. SHE'S . MEDICAL ENGINEER AND SHE'S AN INTERNATIONALLY RECOGNIZED WOMEN'S HEALTH RESEARCHER AND SHE'S IN THE NATIONAL ACADEMY OF ENGINEERING AND THE NATIONAL ACADEMY OF INVENTORS AND SHE WAS DEAN OF OUR COLLEGE OF ENGINEERING AND CURRENTLY DIRECTS OUR INSTITUTE FOR ENGINEERING AND MEDICINE. BARBRA HAS COLLABORATED EXTENSIVELY WITH MANY DIFFERENT SECTORS AND THE ECOSYSTEM THROUGH OUT HER CAREER AND SHE HAS CO FOUNDED FOUR COMPANIES, SHE HAS 24 PATENTS, AND SHE SITS ON THE BOARD OF SEVERAL COMPANIES, ALL WHILE STAYING IN ACADEMIA. SHE'S DEMONSTRATED WHAT THE SUMMIT IS ABOUT AND SHE'S LIVED IT AND SHE'S ALSO MEN FORWARD TO LOTS AND LOTS OF WOMENNEN GUINEARS AND SCIENTISTS ALL ALONG THE WAY. SO HOLLY PRESENTED TO US SOME OF THE RECOMMENDATIONS FROM THE THOUGHT LEADERS WHO ATTENDED THE SUMMIT BUT WHAT THE GROUP IS LOOKING FOR NOW TO GET FEEDBACK FROM THE STAKEHOLDERS. SO THEY WANTED TO HEAR FROM BIRCWH SCHOLARS AND MENTORS WHO ARE WORKING IN THIS SPACE, HOW CAN WE, AS BIRCWH PROGRAMS, PARTICIPATE IN THAT INNOVATION. SO I WILL LEAVE YOU WITH THAT TO THINK ABOUT AND I WILL TURN IT OVER TO JUDY TO MAKE HER REMARKS. >> THANK YOU, SUSAN. GREAT THOUGHTS WHICH I WOULD ECHO AT OUR INSTITUTION. WE HAVE A NEW DEPARTMENT OF HEALTH ARTIFICIAL INTELLIGENCE AND A BIG FOCUS TO THAT AREA WHICH YEARS AGO WASN'T EVEN A THOUGHT SO THERE'S A LOT OF OPPORTUNITY ARISING IN THE AREAS OF DATA SCIENCE AND ENGINEERING AND SOME OF OUR TOP SCIENTISTS AT THE CENTER ARE BIO ENGINEERS NOW SO IT'S EXCITING GROWTH AND DEVELOPMENT WITH ROOM FOR TRADITIONAL FORMS OF SCIENCE AND NEW FORMS OR TYPES OF SCIENCE AND SO WE WANT TO ASK YOU, WE WANT TO HAVE THIS BE AN INTERACTIVE SESSION WHERE YOU WERE ABLE TO PLACE QUESTIONS IN THE CHAT. WE WISH WE WERE IN-PERSON TALKING TO YOU BUT WE'RE NOT. SO ANYWAY, PLEASE ASK YOUR QUESTIONS. THE FIRST QUESTION WE WOULD LIKE TO POSE TO YOU AND THE WHOLE LIST OF QUESTIONS WAS ON THE SLIDE IN THE PRESENTATION WHICH YOU CAN LOOK AT AND ADDRESS AND FOR THIS DISCUSSION, HOW COULD THE SCIENTIFIC RESEARCH AND DATA SCIENCE AND ENGINEER BETTER SUPPORT YOU TO BE THE EDUCATOR AND SCIENTIST, AND ENGINEER, AND ADMINISTRATOR THAT YOU WANT TO BE. SO HOW CAN THE ECOSYSTEM SUPPORT YOU? I HAVE ONE YOUNG SCIENTIST/BIO ENGINEER AND SHE WENT TO INDUSTRY AND SHE REALIZED IT WAS NOT FOR HER AND SHE'S BACK AT UNIVERSITY AND AN ACADEMIC WRITING GRANTS AND GETTING PATENTS AND INVENTING AND HAPPY IN THAT ENVIRONMENT SO THERE'S A LOT OF OPPORTUNITIES. THE OTHER QUESTION WE HAVE IS WHAT WOULD MAKE IT MORE LIKELY FOR YOU TO TRANSLATE AND COMMERCIALIZE YOUR WORK WHICH IS POSSIBLE FOR MANY FORMS OF SCIENCE AND PARTNER WITH STEM FOLKS OUTSIDE YOUR SECTOR. WE WANT TO MAKE THIS AREA MORE TRANSLATABLE TO YOUR LIVES. I HAD ONE SCIENTIST WHO HAD AN INVENTION IDEA BUT SHE COULDN'T FIND ANYONE TO TALK TO HER AND WE WERE ABLE TO CONDUCT HER TO THE INNOVATIONS OFFICE WHICH MOST UNIVERSITIES HAVE THESE DAYS AND SHE WAS ABLE TO GO AFTER A PATENT SO, LOTS OF OPPORTUNITIES SO WHAT ARE YOUR QUESTIONS ABOUT THIS BIRCWH SCHOLARS? DO WE HAVE ANY BIO ENGINEERS IN THE AUDIENCE? I BET WE DO THAT MIGHT WANT TO COMMENT ON THEIR EXPERIENCE. I'M CURIOUS, DO WE KNOW HOW MANY BIRCWH SCHOLARS ARE BIO ENGINEERS OR DATA SIGNIST XENIA OR LISA, I'M JUST CURIOUS, NOT PUTTING YOU ON THE SPOT? >> LISA, WOULD YOU HAVE ANY IDEA? >> HI, THIS IS LISA. SO WE HAVE, WE PROBABLY HAVE FIVE AND THERE'S ALWAYS A FEW. THEY'RE USUALLY INDIVIDUAL BIO ENGINEERS OF INDIVIDUAL PROGRAMS. WE HAVE AT LEAST FIVE ACTIVE WITHIN THE LAST COUPLE OF YEARS. >> SO TELL US YOUR EXPERIENCE YOU FIVE, WE WITH LOVE TO HEAR. HOPEFULLY WE'RE PROVOKING THOUGHT SO EVEN IF PEOPLE AREN'T PARTICIPATING RIGHT NOW, I HOPE YOU WILL THINK ABOUT IT AND GIVE US YOUR THOUGHTS. >> I WANT TO REINFORCE AGAIN TO THE AUDIENCE, BECAUSE WE WILL NOT BE ABLE TO HAVE A THOROUGH DISCUSSION OF THESE IMPORTANT QUESTIONS IS WE INVITE YOU AND ENCOURAGE YOU TO E-MAIL US AND SO THAT WE CAN SET UP A DIALOGUE AND THERE'S ALSO THE LINK FOR THE FULL EXECUTIVE SUMMARY. SHE HAD A CAREER WITH IT'S INDULGENT OF HER NEED TO SEE BASIC SIGNS AND FINDINGS BE CONVERTED INTO PRODUCTS THAT HELP PEOPLE IN THE POST COVID WORLD, HOW CAN NIH AND BIRCWH SUPPORT THE GROWTH OF OUR FACULTY FOCUS ON WOMEN'S HEALTH AND SEE THE EFFORTS GO FORWARD SO AND THOUGHT PROVOKING QUESTIONS AND THEN WE HAVE A BIRCWH SCHOLAR SAYING SHE'S IDENTIFYING HERSELF AND I HOPE I DIDN'T BUTCHER YOUR NAME AND MAY I ASK YOU, WHICH ARE YOU? >> CAN I ADD TOO THAT EVEN THOUGH THIS WAS A SUMMIT FOCUSING ON DATA SCIENCE AND BIO ENGINEERING THIS CROSS SECTORAL APPROACH IS APPLICABLE TO ZOO SCIENTISTS, NOT THOSE WHO ARE IN THE DATA SCIENCE. OR BIO ENGINEERING. >> ABSOLUTELY. BASIC SCIENTIST MIGHT COME UP WITH A MOLECULE THAT MIGHT TURN INTO A MEDICINE THAT HAS HAPPENED AND IS VERY PALPABLE. >> WELL, IT LOOKS LIKE WE'RE NOT GETTING MUCH FEEDBACK SO ANY FURTHER THOUGHTS, Dr. KORNSTEIN. >> I THINK WE'RE OUT OF TIME? I THINK. >> YES. >> TWO MORE MINUTES I THINK. >> OK, NOW I THINK THAT POINT WAS VERY WELL TAKEN THAT THIS DOES NOT APPLY TO ENGINEER AND I THINK THAT THE IDEA OF CROSS SECTOR COLLABORATION IS ALL SCIENTISTS AND ALL AREAS AND I THINK THAT EVERYONE SHOULD BE THINKING ABOUT HOW THEY CAN PARTNER WITH INDUCE TREMENDOUS AND THE GOVERNMENT AND NON PROFITS AND ALL THESE OTHER SUCK TOURS THASECTORS.>> MEANWHILE, SHE'S A BY OWE MEDICAL ENGINEER AND A DATA SCIENTIST AND SHE IS VERY LUCKY WITH HER MENTORS WHO ARE SUPPORTIVE SO THAT'S GOOD TO HEAR. AND NOT SURPRISING AT A BIRCWH MEETING WHERE MENTORSHIP HAS SENT IT TO ALL OF US. THANK YOU, EVERYBODY. AND HOPEFULLY WE WERE THOUGHT-PROVOKING AND YOU WILL RESPOND, BIRCWH SCHOLARS YOU CAN RESPOND IN WRITING AND NIH IS CERTAINLY INTERESTED IN GATHERING YOUR THOUGHTS AND FEEDBACK BECAUSE IT HELPS US IN OUR DEVELOPMENT OF PROGRAMS. >> THANK YOU, VERY MUCH, Dr. KORNSTEEN AND Dr. REGENSTINER FOR JOINING US. >> IF WE COULD MOVE ONTO THE NEXT SLIDE. I'D LIKE TO INTRODUCE OUR SECOND SPEAKER, Dr. KATHLEEN BRADY IS LITERALLY THE DISTINGUISHED PROFESSOR OF PSYCHIATRY AND HOLDS A M D AND PH.D AND SHE'S HAD A LONG HISTORY OF SUCCESSFUL RESEARCH SUPPORTED BY NIH AND IN SUBSTANCE USE DISORDERS AND TRANSLATIONAL RESEARCH AND SPECTRUM ACROSS THE U.S. AND SHE FOCUSES ALONG ON NEW THERAPIES FOR THESE CONDITIONS AND SHE CURRENTLY I TURN IT OVER TO Dr. BRADY. >> THANK YOU, VERY MUCH. AND I'M HERE TODAY TO TALK ABOUT A NEW PROGRAM AND IT'S AN ADMINISTRATIVE SUPPLEMENT TO THE MUSC SCORE GRANT BUT IT IS TO OFFER SOME EXTRA EDUCATIONAL RESOURCES TO THE CURRENT BIRCWH SCHOLARS AND WE'RE CALLING IT THE BIRCWH SCHOLAR INNOVATION PROGRAM. AS I SAID, IT'S AN ADMINISTRATIVE SUPPLEMENT TO OUR CURRENT SCORE AS YOU GUYS KNOW, SPECIALIZED CENTER FOCUSED ON GENDER STUDIES, OURS IS IN THE AREA OF STRESS AND SUBSTANCE USE DISORDERS AND THE PURPOSE OF THIS ADMINISTRATIVE SUPPLEMENT IS TO PROVIDE TRAINING AND MENTORSHIP IN THE CRITICAL AREAS OF SUBSTANCE USE DISORDERS AND MENTAL HEALTH DISORDERS, PARTICULARLY THOSE THAT CO OCCUR COMMONLY WITH SUBSTANCE ABUSE AND THE AREA OF WOMEN'S HEALTH AND THAT INTERSECTION THERE. WE'RE GOING TO BE TARGETING BIRCWH SCHOLARS BUT ALSO OPENING IT UP AND THE SCORE ALSO HAS A CAREER ENHANCEMENT CORE AND WE ARE GOING TO IN TWO OR THREE SCORE SCHOLARS ARE SELECTED EVERY YEAR FOR THAT SO WE WILL, THOSE SCORE CEC SCHOLARS INTERESTED WILL ALSO BE INVITED TO PARTICIPATE. SO, THERE ARE REALLY THREE AIMS AND THE FIRST IS TO DEVELOP BY DIDACTIC SERIES AND AN ON-LINE TRAINING EXPERIENCE FOR A SYNCHRONOUS LEARNING THAT IS FOCUSED ON GENDER DIFFERENCES AND SUBSTANCE USE DISORDERS AND MENTAL HEALTH ISSUES RELATED TO SUBSTANCE USE DISORDERS THROUGHOUT THE LIFESPAN. WE WILL HAVE A FOCUS ON UNDER REPRESENTATIVE AND UNDERSERVED POPULATIONS AND DIVERSITY IN SUBSTANCE USE DISORDER RESEARCH AND AIM TWO, IS A CONSULTATIVE AND MENTORING SYSTEM TO ALLOW BIRCWH SCHOLARS TO WORK WITH MUSC SCORE INVESTIGATORS AND INCLUDING VISITS TO MUSC OR WILL SUPPORT TRAVEL TO NATIONAL MEETINGS WHERE NETWORKING AND COLLABORATIONS MIGHT BE ESTABLISHED. AND THEN AIM THREE, WE WILL OFFER GRANT REVIEW AND MOCK STUDY SECTIONS FOR BIRCWH SCHOLARS WHO ARE SUBMITTING GRANTS FOCUSED IN THIS SPECIFIC SEX GENDER DIFFERENCES AND MENTAL HEALTH SUBSTANCE USE DISORDERS SO WORE GOING TO HAVE A DIDACTIC SERIES AND MENTORING SYSTEM AND SKILL DEVELOPMENT. SO, PHASE 1 AND YOU CAN EXPECT OUR WEBSITE TO BE UP IN JANUARY OF 2023. WE'RE GOING TO BEGIN WITH THIS MONTHLY DIDACTIC SERIES WITH LEADING EXPERTS AND WE'LL BASE IT ON THE ECHO MODEL WHICH I'LL DESCRIBE IN A MINUTE. THIS SURVEY WILL GO OUT IN THE NEXT WEEK OR TWO AND WE'LL ASSESS THE NEEDS OF THE TRAININGS AND WHAT DO THEY WANT TO LEARN ABOUT AND WHERE SHOULD WE FOCUS THESE INITIAL TRAININGS AND BASICALLY, THEY'LL ADDRESS SUBSTANCE USE AND MISUSE AND SUBSTANCE USE DISORDERS AND WOMEN AND AGAIN PROMOTE DIVERSITY IN SUBSTANCE USE RESEARCH AND WITH THIS ON-LINE SYSTEM LEVERAGING EXISTING TRAINING RESOURCES IN THE SUBSTANCE ABUSE MENTAL HEALTH AREA FOR FOR A ASYNCHRONOUS LEARNING. I JUST WANTED TO DESCRIBE WHAT ECHO IS AND HOW WE'RE ADAPTING IT. EXTENSION FOR COMMUNITY HEALTHCARE OUTCOMES FOUNDED AT THE UNIVERSITY OF NEW MEXICO, IT WAS STARTED AS A WAY TO TREAT HEPATITIS C PATIENTS WHO WERE RURAL AREAS WHERE THERE WERE NO HEPATOLOGISTS OR EXPERTS AND SO INSTEAD OF TRYING TO DEVELOP EXPERTISE IN EVERY SITE THEY USED TELEHEALTH THAT WAS CENTRALLY LOCATE LOCATED TO SUPPORT PRIMARY CARE PROVIDERS IN RURAL AREAS WHO WERE TREATING HELP C AND THEY DO THIS THROUGH REGULAR MEETINGS. IT STARTS WITH I DO DAKA DIE DAKAL TICKS D IDACTICS AND IN OUR CASE, WE'RE GOING TO DO IS START BY HAVING A DIDACTIC SESSION AND WE'LL HAVE MORE THAN ONE EXPERTS THERE AND WE'LL ASK A SCHOLAR TO HAVE A QUESTION AND THERE'S SOME SPECIFIC AREA AND WHAT IS THE BEST FOR XY AND Z AND WE'LL HAVE DISCUSSION BY OTHER EXPERTS AND THE TRAINEES THAT ARE INVOLVED. ONE OF THE THINGS WE LIKE ABOUT WHICH WILL BE SO DRY AND SO EASY FOR SORT OF LOSE ATTENTION SO WE FIND THAT THE ECHO MODEL IS ACTUALLY VERY HELPFUL FOR VIRTUAL LEARNING AND IF I HAVE THE NEXT SLIDE. WHEN I TALKED ABOUT DEVELOP THE WEBSITE I WANTED TO SHOW WE'VE GOT A NUMBER, WE HAVE 40 FACULTY THAT ARE FUNDED RESEARCHERS IN THE SUBSTANCE USE AREA AND MANY HAVE BEEN VERY INVOLVED IN A NUMBER OF TRAINING THEY ARE LISTED HERE WINDOW SO THERE'S A, WE HAVE A LECTURE SERIES AND WE DEVELOPED FOR ANOTHER PROGRAM THAT IS FOCUSED AND SUBSTANCE USE RESEARCH AND AMY McCRAE CLARK HAS BEEN INVOLVED IN DEVELOPING LECTURES ON RESEARCH WITH VULNERABLE POPULATIONS AND WE'RE REALLY LUCKY TO HAVE CONNIE GILL THE HEAD OF OUR MATERNAL HEALTH AND BEHAVIORAL HEALTH AND SHE'S THE AUTHOR OF A NUMBER OF ON-LINE SERIES ABOUT PERINATAL SUBSTANCE DISORDER SO THESE ARE THE RESOURCES THAT WE HAVE THROUGH OUR FACULTY THAT WILL MAKE AVAILABLE IN THE ON-LINE TRAINING AND IF IT'S LECTURES, WE'LL PROVIDE LINKS FOR THAT AS APPROPRIATE. PHASE 2, WILL BE BEGIN IN OCTOBER TO NOVEMBER OF 2012 AND THAT WILL BE CONSULTATIONS, MENTORSHIP, NETWORKING AND THEN AVAILABILITY OF OUR WOMEN'S INTEREST GROUPS SO LET ME JUST START BY SAYING, WE'LL BUILD A WEBSITE THAT WILL BE UP IN JANUARY AND IT WILL HAVE ON IT, THE PROFILES OF ALL OF OUR, AS I SAID, WE HAVE 40 OR SO FUNDED RESEARCHERS IN THIS AREA AND WHAT THEIR AREAS OF EXPERTISE IS. IF INDIVIDUALS WANT A ONE-TIME CONSULTATION, AGAIN, THEY CAN ARRANGE IT THROUGH THE WEBSITE IF THAT ONE TIME CONSULTATION TURNS INTO SOMETHING THAT'S A LITTLE BIT MORE LONG-TERM MENTORSHIP THAT'S FINE TOO AND AS I SAID, WE WOULD SUPPORT VISITS AND EITHER TO AND WE HAVE THIS THEY RANGE FROM MOLECULAR BIOLOGY TO POPULATION HEALTH AND WE'LL MAKE THE PROFILES AVAILABLE ON THE WEBSITE. NEXT SLIDE. PHASE 3 WILL BE FOCUSED ON SKILLS DEVELOPMENT. WE WILL PROVIDE A GRANT REVIEW SYSTEM AND MOCK STUDY SECTIONS AND THEN ON-LINE GRANT RESOURCES. THERE'S A COUPLE OF REALLY GOOD COURSES THAT ARE OFFERED AT DIFFERENT MEETINGS AND A COUPLE OF BOOKS, WORK BOOKS THAT PEOPLE GO THROUGH SO WE'LL MAKE IT AVAILABLE AND IF I COULD HAVE THE NEXT SLIDE AND I DIDN'T KNOW, YEAH, SO WOVE WITHIN DOING THESE GRANT REVIEWS AND THE MOCK STUDY SECTIONS FOR QUITE A WHILE FOR SECTOR AND CTSA AND SCHOLARS WILL PRESS THROUGH THE PROGRAM WEBSITE AND THEY'LL SUBMIT INITIALLY AN ABSTRACT JUST SO WE CAN SEE IF IT LOOKS LIKE THIS IS APPROPRIATE FOR OUR EXPERTS TO REVIEW AND IF THEY ARE LOOKING FOR AN EXTERNAL GRANT REVIEW THEY WILL SUBMIT A FULL DRAFT OF THE GRANT AND WE'LL SEND IT OUT TO REVIEWERS PAYING INSIDE AND OUTSIDE OF MUSC AND TWO TO THREE REVIEWERS PER GRANT AND THE INDIVIDUAL WILL RECEIVE WRITTEN FEEDBACK WITHIN ONE MONTH. IF SOMEONE REQUIRES SOMETHING A LITTLE MORE INTENSIVE, A MOCK STUDY SECTION THEY CAN SUBMIT A FULL DRAFT OF THE GRANT EIGHT WEEKS BEFORE THE DUE DATE AND WE'LL ASSEMBLE A PANEL OF EXPERTS THAT WILL ENCLOUD THE MENTEE, IT WILL BE VIRTUAL BUT WE'LL HAVE THAT MEETING ONE MONTH AFTER THE SUBMISSION TO REVIEW THE GRANT AND THE SCHOLAR WILL SIT IN ON THE REVIEW SO THEY'LL LEARN FROM IT AS WELL. IF I COULD HAVE THE NEXT SLIDE. THIS IS OUR STEER' COMMITTEE AND WE HAD THE AND ALSO RUNS THE 9-12 AND JAKE' McKINZIE AND PEOPLE THAT ARE CONNIE GILL IS THE BEHAVIORAL HEALTH DIVISION AND THEN JENNA MCCAULEY WHO IS AN EXPERT IN WEBSITE AND REMOTE LEARNING WILL GEAR ALL THAT UP SO I THINK WITH THAT, IF I COULD HAVE THE NEXT SLIDE, I AM DONE AND I'M HAPPY TO ANSWER ANY QUESTIONS. >> SO WE HAVE ONE QUESTION AND IN THE COMMENT IS, I KNOW THIS IS A NEW RESOURCE BUT I'M NOT A DRUG ABUSE RESEARCHER AND OVER THE NEXT SIX TO NINE MONTHS, WHAT SHOULD I BE LOOKING FOR AS RESOURCE OZ FOR MY CAREER DEVELOPMENT. >> SO, YOU KNOW, AGAIN, I THINK THEY'LL BE SOME MORE GENERIC MATERIALS AVAILABLE ON THE WELCOME BACK SIGHT ABOUT WHAT ARE GOOD GRANT WRITING SOURCES AND WHAT ARE RESOURCES THAT ONE MIGHT USE. EVEN IF YOU ARE NOT IN THE DRUG ABUSE AREA, SOME THINGS ABOUT PERINATAL HEALTH AND PERINATAL RESEARCH PEOPLE IN THE PERINATAL PERIOD COULD BE OF INTEREST BUT BASICALLY THIS IS FUNDED BY THE NATIONAL INSTITUTE ON DRUG ABUSE SO IT'S FOCUSED FOR A -- WE UNDERSTAND THAT NOT ALL BIRCWH SCHOLARS WILL BE ABLE TO FULLY UTILIZE ALL THE RESOURCES BECAUSE THE RESEARCHES ARE WORKING AT THAT INTERSECTION OF SEX AND GENDER DIFFERENCES AND SUBSTANCE USE DISORDERS AND MENTAL HEALTH AND PROBLEMS THAT SO WE'LL WORK AT THAT INTER PACE. >> THANK YOU, AND IT'S JUST MY OBSERVATION, HAVING BEEN INVOLVED THAT THIS WAS BEING CREATED IS THAT THERE ARE GENERIC COMPONENTS THAT WILL BE HELPFUL SO CLEARLY THEY WANT TO SPEAK FOR Dr. CLAYTON BUT WE'RE EXCITED FOR THIS OPPORTUNITY BECAUSE OF THE GREAT GROUP YOU PULLED TELLING. >> YES. >> THERE WILL BE SOME GENERIC OPPONENTS AND WE'LL TRY TO UPDATE YOU GUYS IN AN ONGOING MANNER AS WE STAND THINGS UP ON THE WEBSITE AND I THINK THE GRAND WRITING RESOURCES ARE THOSE I'M THINKING OF MOSTLY THAT WILL BE VERY GENERIC BUT THERE'S ON-LINE TRAININGS AND STUFF THAT WOULD BE USEFUL. >> GOOD. >> AND THAT LEADS INTO THE SECOND QUESTION FROM THIS PART, THEY'RE WONDERING IN TERMS OF REMOTE LEARNING, ZOOM, ZOOM CALLS, SO WOULD SOMETHING LIKE A GRANT REVIEW, WOULD YOU PLAN ON CONDUCTING IT OF VIA ZOOM OR NOT BE IN-PERSON? >> CAN YOU HAVE A WRITTEN GRANT REVIEW OR MOCK STUDY SECTION. THE WRITTEN GRANT WILL BE COMPLETELY IN WRITING AND SOMEONE WILL SEND THE GRANT IN AND THEY WILL GET WRITTEN COMMENTS BACK. THE MOCK STUDY SECTION WE WILL CONDUCT IT OVER ZOOM AND IT WILL BE A VIRTUAL MOCK STUDY SECTION. >> ONE OF THE ONLY GOOD THINGS ABOUT COVID IS IT HAS TAUGHT US DIFFERENT WAYS OF INTERACTING AND SO THE NEXT QUESTION S. THE 40 FACULTY THEY'RE MAINLY IN THE SUBSTANCE ABUSE AREA AND YOU INDICATED THAT IF SOMEONE DID WANT TO GRANT REVIEW, AND IT WASN'T IN SUBSTANCE ABUSE, WOULD YOU BE ABLE TOLL ACCOMMODATE THEM OR NO? >> NO, WE'RE NOT, YOU KNOW, WE REALLY AREN'T ABLE TO FIGHT -- YOU KNOW, AS YOU CAN IMAGINE, YOU KNOW THE EXPERTS IN YOUR OWN FIELD AND I DON'T REALLY KNOW THE EXPERTS SO I WOULDN'T BE THE BEST PERSON TO HELP YOU IF THAT WAS YOUR AREA. I WOULDN'T BE THE BEST PERSON TO HELP YOU FIND A REVIEWER BUT IF YOU HAVE A GRANT IN SUBSTANCE USE AND OR ANY MENTAL HEALTH ISSUES RELATED TO SUBSTANCE USE, PTSD, THAT SORT OF THING, WE HAVE A CAD RAY OF PEOPLE THAT CAN REVIEW IT THEMSELVES OR WE'LL KNOW THE BEST REVIEWERS SO, IF IT'S OUTSIDE OUR AREA IT'S BEYOND THE SCOPE. >> I THINK THOSE ARE THE QUESTIONS AND I DID WANT TO JUST CLARIFY FOR THE AUDIENCE AND THAT I WOULD BE HAPPY TO SERVE AS A LIAISON WITHIN THE PROGRAM TO YOU AND YOUR COLLEAGUES SO THAT YOU ARE NOT INUNDATED AND WE CAN ARRANGE ONCE WE GET PASTING MEETING HOW TO ROLL THIS OUT IN TERMS OF COMMUNICATIONS. WORKING WITH THE PIs. SO I WANTED TO THANK YOU VERY MUCH FOR YOUR LEADERSHIP AND YOUR DEDICATION AND YOU ARE A BIRCWH P.I. SO YOU KNOW THE PROGRAM WELL AND WE APPRECIATE ALL YOUR EFFORTS IN TERMS OF RESEARCH. THANK YOU SO MUCH. >> THANK YOU, I APPRECIATE IT AND I REALLY HOPE WE CAN GET SOME ENTHUSIASM FOR THIS PROGRAM AND I HOPE YOU WILL ENCOURAGE LOOK AT THE WEBSITE AND ENCOURAGE YOUR THE PROGRAM WILL ONLY BE AS SUCCESSFUL AS THE INENTHUSIASM OF THE PARTICIPANTS SO, WE'RE LOOKING FORWARD TO IT. >> ABSOLUTELY AND ONE LAST NOTE, YOU YOURSELF ARE THE ROLE MODEL AND I MEAN WHEN I WAS DOING THIS THE PREP TO INTRODUCE YOU TO HAVE THREE INSTITUTES FUNDING LARGE AWARDS TO YOU IS JUST AMAZING SO, I MEAN, YOU ARE CLEARLY A ROLE MODEL FOR ALL OF US SO THANK YOU AGAIN. >> THANK YOU, VERY MUCH. IT WOULD BE NICE TO BE WORKING WITH YOU AGAIN. >> TAKE CARE. >> ALL RIGHT, BYE-BYE. >> SO, OUR THIRD SESSION IS BACK TO OUR DIRECTOR Dr. CLAYTON AND ALL OF US ARE SO EXCITED ABOUT THIS AND SO I WILL TURN IT OVER TO JANINE TO BRIEF EVERYONE ON THIS BRAND NEW TRANSFORMATIONAL PROJECT. >> THANK YOU SO MUCH. LET ME GET MY SCREEN UP. >> I AM EXCITE TODAY SHARE INFORMATION WITH YOU ABOUT A NEW PROGRAM. A COLLABORATION WITH THE NATIONAL INSTITUTE OF ARTHRITIS, MUSCULAR SKELETAL AND SKIN DES SEIZES AND WE'RE TALKING ABOUT THIS AS A TEAM LEADING A NEW TEAM PROGRAM. THE NAME OF THE PROGRAM IS TEAM SCIENCE LEADERSHIP TO ADVANCE WOMEN'S HEALTH WITH A FOCUS ON AUTOIMMUNITY AND IMMUNE MEDIATED DISEASES AND ITSEN INTENDED TO TRAIN SCIENTIST TO LEAD LARGE PROJECTS, MULTI-PRONGED PROJECTS WITH MULTIPLE COMPONENTS IT'S DESIGNED TO BE ANNIE PERCENTING AND COLLABORATIVE AND HOW IMPORTANT IT IS TO GET MORE SCIENCE TO ENABLE THESE WOMEN SCIENCE LEADERS AND WOMEN TO BECOME LARGE CON OR SLUM TEAM LEADERS AND AS CONSORTIUM LEADERSAND IT WA S DELIGHTFUL FOR US TO HAVE THE NEW DIRECTOR OF NAIMS SPEAK AT OUR RESENT ADVISORY COMMITTEE FOR RESEARCH ON WOMEN'S HEALTH AND SHE INVITED ME TO SPEAK AT THE NAIMS COUNCIL ABOUT THIS PROGRAM WHERE WE LAUNCHED IT TOGETHER. WE HAVE LONGSTANDING COLLABORATIONS WITH ORWH AND NAIMS BECAUSE SO MANY OF THE GROUPS THAT NAIMS WAS FOCUSED ON NOW WITH Dr. CRISWELL SO WE'RE THRILLED TO EXPAND OUR PARTNERSHIP WITH NAIMS FOR THIS NEW PROGRAM. THIS PROGRAM WILL BE LEVERAGING A LARGE PUBLIC-PRIVATE PARTNERSHIP CALLED ACCELERATING MEDICINE PARTNERSHIP. AND THE ACCELERATING MENNANCES PIP WAS LAUNCHED IN 2014 IT'S A PUBLIC-PRIVATE PARTNERSHIP BETWEEN NIH, THE FOOD AND DRUG ADMINISTRATION AND LIFE SCIENCE COMPANIES AND NON PROFITS, AND OTHER ORGANIZATIONS. AND IT'S THROUGH THE FOUNDATION FOR NIH OR FNIH. THE PARTNERSHIP HAS MULTIPLE COMPONENTS AND SOME OF THEM ARE LISTED HERE WITH THESE MULTI-COLORED ROW HOUSES HERE AND IT HAS LARGE EFFORTS. THE ALZHEIMER'S DISEASE EFFORTS, ONE COMMON METABOLIC DISEASE AND SCHIZOPHRENIA AND AUTOIMMUNE AND IMMUNE MEDIATED DISEASES. THE COMMON GOAL OF INCREASING DIAGNOSTICS AND THERAPEUTICS FOR PATIENTS AND REDUCING THE TIME AND COST OF DEVELOPING THEM. A COMMON GOAL IS TO IMPROVE UNDERSTANDING OF THERAPEUTICALLY RELEVANT BIOLOGIC PATHWAYS AND VALIDATE INFORMATION THAT CAN BE RELEVANT FOR MULTIPLE THERAPEUTICS. AND JUST TO GIVE A SENSE OF THE SCALE OF THIS PROGRAM, TO DATE SINCE 2014, OVER $768 MILLION HAVE BEEN INVESTED IN THIS PROGRAM THAT HAS AN INTEGRATED GOVERNANCE STRUCTURE THAT ENABLES THE BEST CONTRIBUTION TO SCIENCE FROM ALL PARTICIPANTS. SO LET'S DIG DEEPER INTO THE AUTOIMMUNE AND IMMUNE MEDIATED DISEASE AMP OR AMP AIM PARTNERSHIP WITH IS ONE COMPONENT THAT WE'RE LEVERAGING. THEY HAVE STRENGTH IN TEAM SCIENCE AND COLLABORATION THAT HAVE BEEN WELL DOCUMENTED OVER THE YEARS AND THAT'S CRITICALLY IMPORTANT TO HELP US LEADERS AND DEVELOP LEADERS TO DEAL EFFECTIVELY WITH THE COMPLEXITY OF BIG TEAM SCIENCE-BASED PROJECTS. THE BIRCWH IS ONE EXAMPLE OF OUR STRENGTH AT ORWH IN CULTIVATING LEADERSHIP FOR WOMEN HEALTH RESEARCHERS INCLUDING WOMEN SCIENTISTS IN PARTICULAR SUPPORTING EARLY AND MID CAREER WHERE THERE'S SO MUCH POTENTIAL FOR US TO BREAK OUT OF THE BOX AND DO NEW THINGS. SO TOGETHER, WE'RE SEEKING TO TRAIN THE NEW KIND OF LEADER, ONE WITH WIDER EXPERIENCE AND UNDERSTANDS THE INTER RELATIONSHIPS OF ALL THE PLAYERS IN THE RESEARCH, HEALTH RESEARCH ECOSYSTEM. AND WE WANT TO CREATE A CROSS SECTORAL COLLABORATIVE EXPERIENCE AND IT WILL ENABLE LEADERS TO BE LARGE CONSORTIUM TEAM LEADERS SO THAT'S WHY WE'RE PLEASED TO ANNOUNCE A NEW AND EXCITING PROGRAM DESIGNED TO CREATE A MORE ROBUST KADRI OF RESEARCHERS DEDICATED TO WOMEN'S WOMEN'S HEALTH RESEARCH. THE GOALS OF THE PROGRAM THE OVER ALL GOAL IS TO EXPAND THIS KADRI OF WOMEN'S HEALTH SCIENCE WHO'S CAN LEAD COMPLEX HIGH-IMPACT RESEARCH PROGRAMS AND ACADEMIA, EASTBOUND INDUSTRY AND THE PUBLIC-HEALTH SECTORS. FIRST, GOAL, IMPROVE WOMEN'S HEALTH BY SUPPORTING RESEARCH AND DEVELOPMENT OF THESE WOMEN HEALTH SCHOLARS WHO SPECIALIZE IN AREAS RELATED TO AUTOIMMUNITY AND IMMUNE RELATED DISEASES WHICH IS SO IMPORTANT FOR WOMEN'S HEALTH AND RELATED SCIENTIFIC AND CLINICAL TOPICS. WE WANT TO PROVIDE THIS PROGRAM TO DEVELOP THEIR SKILLS SETS IN TEAM SCIENCE THROUGH THIS COLLABORATIVE EXPERIENCE AND WE WANT TO ENHANCE THIS SCHOLARS LEADERSHIP AND MENTORSHIP EXPERIENCES BY EXPANDING THEIR NETWORKS OUTSIDE OF THEIR CURRENT PLACE OF EMPLOYMENT AND IN THEIR CURRENT SECTOR SO THEY CAN SERVE IN TERMS AS FUTURE EFFECTIVE MENTORS FOR GENERATIONS OF TEAM SCIENTISTS, FOCUSED ON IMPROVING WOMEN'S HEALTH. WE WANT TO INTEGRATE THESE NEW EMERGING LEADERS WITH UNIQUE SCIENTIFIC QUESTIONS ESPECIALLY THOSE RELEVANT TO WOMEN'S HEALTH AND SEX DIFFERENCES AND APPROACHES INCLUDING NEW FIELDS LIKE DATA SCIENCE ANALYSIS, THAT CAN LEVERAGE THE AMP AIM INFRASTRUCTURE AND LEVERAGE THE SAMPLES THAT EXIST AND THE COHORTS AND THE ON GOING STUDIES AND DATA AVAILABLE TO ADVANCE AND IMPROVE OUTCOMES FOR AUTOIMMUNE IMMUNE DISEASE AND OTHER RELEVANT SCIENTIFIC TOPICS. WE WANT TO INTEGRATE AND SYNERGIES THE SCHOLARS' WORK WITH THE AMP AIM NETWORK SCIENTIFIC GOALS. AND THE PROJECTS' DUTY TO ADDRESS SCIENTIFIC QUESTIONS THAT ENHANCE THE REACH AND IMPACT OF AMP-AIM AND WILL BENEFIT FROM THE INFRASTRUCTURE, CLINICAL INFORMATION SAMPLE, SCIENTIFIC EXPERTISE AS WELL AS AMP-AIM AND BRING A NEW OPPORTUNITY TO THE AMP-AIM NETWORK WHICH IS NOT YET COVERED AND I TALKED ABOUT THIS PROGRAM AND A BLOG POST EARLIER THIS YEAR AND WHERE A HIGHLIGHTED THE FACT THAT MENTORING IS A CRITICAL COMMUNICATION CHALLENGE AND THROUGH WHICH WE AS . MEDICAL RESEARCH COMMUNITY CAN BOTH GAIN AND UNDERSTANDING OF THE CHALLENGES FACED BY WOMEN IN SCIENCE AND -- DESPITE GREAT PROGRAMS LIKE THE BIRCWH AND OTHERS, A BIOMEDICAL AND THE RESEARCH ECOSYSTEM ITSELF, WE SEE THAT A STUBBORN PROBLEM PERSISTS, NAMELY WOMEN ENTER THE ACADEMIC CAREER LADDER AND DESPITE THEM ENTERING IN ONE CASE FOR BIOLOGICAL LIFE SCIENCES AT OVER PARITY BY THE TIME YOU GET TO LEADERSHIP POSITIONS WE SEE FOR ALL OF THESE CAREERS, WHETHER IT'S CHEMISTRY, MATHEMATICS OR COMPUTER SCIENCE, THE NUMBERS OF WOMEN BELOW PARITY AND AT EVERY LEVEL BEYOND THE DOCTORATE AND THIS IS A SITUATION THAT EXISTED FOR MANY YEARS AND IT'S NOT SIMPLY A PIPELINE ISSUE, AND WE SEE WHAT IS HAPPENING IN MEDICAL SCHOOLS NOW OVER HALF OF THE MEDICAL STUDENTS ARE WOMEN AND THEY'VE BEEN THERE 40% FOR DECADES AT THE HOSPITAL C.E.O. LEVEL WE SEE LOWER RATES AND SO WE WILL WORK TO DO AND WE WANT TO GET WOMEN INTO LEADERSHIP IN EARLIER STAGES AND WE WANT THEM TO BE PREPARED FOR THE LEADERSHIP THAT IS NEEDED FOR SCIENCE TODAY. WE KNOW THAT WOMEN AND ACADEMIC MEDICINE CAN CONTINUE TO FACE SIGNIFICANT SYSTEMIC INEQUITY AND DO NOT RECEIVE PROMOTIONS OR ADVANCE TO LEADERSHIP ROLES AT THE SAME RATE AS MEN. GENDER DIS PE DISPARITIES AND WOMEN RECEIVE LOWER SALARY OFFERS AND LESS INSTITUTIONAL RESEARCH FUNDING IN SOME CASE AND WE'VE TALKED ABOUT WORK LIFE BEING PROGRESSIVE THROUGH OUT MEDICINE AND SCIENCE GENERALLY AND WOMEN PHYSICIANS SAFE SIGMA THAN MEN DO AND GIVING RESPONSIBILITIES AND THE FACT THAT WE SEE CONTINUING CHALLENGES WITH SEXUAL HARASSMENT AND HOS PILL TEE AND DISCRIMINATION IN THE WORKFORCE AND ALL THE WAY TO THE INSTRUCTOR LEVEL AND I'VE BLOWN THAT UP FOR YOU HERE ON THE RIGHT IN TERMS OF WOMEN DEPARTMENT AND YOU CAN SEE WOMEN OF COLOR REPRESENT A SMALLER PREPORTION THAN DO OTHERS AND WE WANT TO BE ABLE TO ADVANCE ALL WOMEN IN SCIENCE AND WE HAVE ARTICULATED IN THE PLAN A VISION WHERE ALL WOMEN REACH THIS SO WE STILL HAVE WORK TO DO HERE, WE HOPE TO BALANCE THE SCALES IN KEY AREAS WHERE WOMEN IN SCIENCE CAN CONTINUE TO BE UNDER REPRESENTED AND ESPECIALLY AT MID CAREER AND EVEN FOR FIELDS LIKE COMPUTER SCIENCE AND WHERE COMPUTER SCIENCE MAJORS AT THE UNDERGRADUATE LEVEL HAD BEEN INCREASING FOR MANY YEARS AND THEY ARE NOW DECREASEING AND WE DO HAVE WORK TO DO. IN TERMS OF DATA WITH GENDER AND RO1 EQUIVALENT GRANTS AND SUCCESS RATES, AND YOU CAN SEE WOMEN AND MEN HAVE SIMILAR SUCCESS RATES. TYPE 2, THERE ARE DIFFERENCES OVER THE YEARS WITH WOMEN BEING LESS SUCCESSFUL FOR TYPE 2s AND IN THE RECENT YEARS, WOMEN AND MEN ARE SIMILARLY SUCCESSFUL WHEN THEY APPLY. IF YOU LOCK AT THIS DATA, WOMEN, HELP, THESE ARE COMPETING APPLICATIONS HERE AND HERE ARE THE NUMBERS OF APPLICATIONS FOR WOMEN AND FOR THE LAST TWO YEARS AND HERE ARE THE NUMBERS OF APPLICATIONS FOR MEN. BECAUSE THERE ARE FEWER WOMEN IN THE POOL, THAT'S ONE PIECE OF IT. ALTHOUGH BOTH WOMEN AND MEN HAVE A 20% SUCCESS RATE IN COMPETING RPGs, THIS IS A CHALLENGE FOR US. BUT WHAT ABOUT THE PRECURSOR TO MANY RPGs. OVER THE PAST YEARS, THIS DATA IS FROM OUR BY ANNUAL REPORT THE REPORT OF THE ADVISORY COMMITTEE ON RESEARCH OF WOMEN'S HEALTH AND THE FY19-20 REPORT INCLUDES VERY DETAILED DISAGGREGATED DATA BY SEX GENERATION AND ETHNICITY AND FOR NIH AND ALSO OUR NIH EMPLOYEES WHO ARE SCIENTISTS AND YOU CAN SEE FOR AWARDS FROM 2016 TO 2020, WE SEE THAT THIS IS THE PERCENTAGE OF WOMEN AND IT IS OVER 50% OR 50% NEARLY 50% FOR ALL OF THESE LEVELS AND SO WOMEN ARE COMPETING SUCCESSFULLY AND GETTING K AWARDS AND WE'RE NOT SEEING THAT TRANSLATING INTO FURTHER DOWN THE PIPELINE. SO THAT PIPELINE ANALOGY THAT YOU'VE HEARD SO OFTEN, REALLY DOES NOT APPLY TO WHAT WE SEE IN SCIENCE TODAY. EARLIER THIS YEAR, AT THE VIVIAN PIN SYMPOSIUM WE TALKED ABOUT THE FACT THAT THE CAREER LANDSCAPE HAS CHANGED PROFOUNDLY AND WE INTRODUCED A NEW METAPHOR AND THAT'S A BRAIDED RIVER AS A NEW METAPHOR FOR CAREER PATHS. WE RECOGNIZED THAT INDIVIDUALS MOVE IN AND OUT OF ROLES IN SCIENCE AND POSITIONS AND STEM AND THEY HAVE FULL THEY HAVE FULL TIME CAREGIVING RESPONSIBILITIES THAT REPRESENT THE CATEGORY 6 RAPIDS THAT Dr. HARTMANN TALKED ABOUT AND THEY EXPERIENCE ILLNESSES THEMSELVES AND THEY'RE CARRYING FOR MANY OTHERS IN THEIR FAMILIES AND WE SAW THAT DURING COVID AND THAT THAT ISSUE JUST RAMPED UP. THESE EXPERIENCES, WHERE WOMEN AND MEN MOVE IN AND OUT OF PATHS TRIBUTARIES AND CREEKS, AND CAN ENTER THE CAREER SPACE FROM A VARIETY OF VENUES IS A MORE APPROPRIATE META FOR TO BE TODAY'S SCIENTISTS. WE KNOW THAT BENEATH THIS BRAIDED RIVER, A FOUNDATION OF MENTORSHIP AND HOLISTIC SUPPORT IS NEEDED FOR ALL TO SUCCEED AND WE KNOW THAT IN OTHER DISCIPLINES CAN STRENGTHEN US, WE CAN SEE THESE CLOUDS HERE, I'M GOING TO HAVE TO ADD SOME RAPIDS TO OUR PICTURE HERE AND HONOR Dr. HARTMANN'S AMAZING PRESENTATION, AND WE ALSO KNOW THAT THOSE WHO EXPERIENCE RAPIDS AND Dr. HARTMANN, TALKED ABOUT US ALL RECOGNIZING THAT WE CAN ROADWAYS TO THESE CHALLENGES AND THAT DOES DOES PROMOTE RESILIENCE AND I DID HAVE A BLOG AS A MU NET A FOR FORAY CAREER PATH AND WHAT WE NEED TO DO TO SUPPORT SCIENTISTS WITHOUT THAT BRAIDED RIVER AND TO PROMOTE EQUITY SO THIS NEW LEADERSHIP SCHOLAR AS A AMP AIM AND TO CREATE AND TO SUPPORT THE DEVELOPMENT OF SCIENTIST AND LEADERS LIKE THOSE FEATURED HERE AND YOU HEARD OUR LEGACY FOR LEADERSHIP SPEAKER TODAY AND YOU MAY NOT KNOW ABOUT Dr. COURTNEY SILVERTHORNE, SHE'S THE DIRECTOR OF AIM PROGRAM THAT I OUTLINED FOR YOU. SO SHE'S ASSOCIATE V.P. FOR RESEARCH PARTNERSHIPS AT FNIH AND PARTNERSHIPS AT NIST AND Dr. LITA PROCTOR FROM THE MICROBIOME PROJECT FROM NSF AND A MARINE, DIRECTOR OF THE MARINE MICROBIOLOGY WITH THE GORDON AND BETTY MORE FOUNDATION AND THESE ARE LARGE INITIATIVES THAT WE ARE EXAMPLES OF THE KINDS OF ACTIVITIES THAT ARE REQUIRED FOR LEADERS OF TODAY AND SO THESE ARE THE TYPES OF LEADERS THAT WE SEEK TO SUPPORT AND GROW. WITH THIS PENULTIMATE SLIDE, I'M HIGHLIGHTING DATA AND INFORMATION FROM A RECENT PUBLICATION THAT I HAD THE PRIVILEGE OF CO-AUTHORING AND WITH Dr. MARINE BERNARD, THE CHIEF OFFICER FOR SCIENTIFIC WORKFORCE DIVERSITY AT NIH AND THE NIH ACTING CHIEF-OF-STAFF AND IS NOW AT OSDP IN THE WHITE HOUSE AND Dr. KELLY TENHAGGEN A LEAD FRESH THE SPACE FROM THE A -- IT HIGHLIGHTS THE IMPORTANCE OF COORDINATED EFFORTS AMONG FIVE DIFFERENT DOMAINS TO ADVANCE WOMEN AND BIO MEDICAL CAREERS AND WE TALKED ABOUT THE IMPORTANCE OF ENHANCED FLEXIBILITY OPTIONS. AND ONE EXAMPLE BEING OUR REINTEGRATION PROGRAMS AND ANOTHER CONTINUITY SUPPLEMENTS A PROGRAM THEY HELPED TO SPEAR THROUGH THE NIH WORKING GROUP ON WOMEN AND BIOMEDICAL CAREER WHICH I CO-CHAIR WITH THE DIRECTOR AND THESE CONTINUITIES SUPPLEMENTS HAVE FUNDING FORAY WARDIES AND FIRST TIME RPG RECIPIENTS EXPERIENCING QUALIFYING THE LIFE EVENT LICK A CRITICAL ILLNESS OF A CHILD, LIKE A CRITICAL ILLNESS OF A PARTNER, AND THEY PROVIDE FUNDING TO SUPPORT THE RESEARCH TO CONTINUE DURING THAT EXPERIENCE SO IF YOU DON'T KNOW ABOUT THOSE, I ENCOURAGE YOU TO TAKE A LOOK AT THOSE NEW SUPPLEMENT THAT'S HAVE BEEN MADE AVAILABLE IN THE LAST FEW YEARS. CULTURAL OF INCLUSION IS EQUALLY IMPORTANT. AND SO, UNITE IS NIH'S EFFORT TO ADDRESS THE CONSEQUENCES OF STRUCTURAL RACISM AND ON THE BIOMEDICAL WORKFORCE AND THE PRIVILEGE OF SERVING ON THE END MIGHTN'T OF THE UNITE EFFORTS SO A WIDE ARRAY OF INFORMATION ARE AVAILABLE ON STEPS NIH IS TAKING INTERNALLY AND TO SUPPORT ADDITIONAL HEALTH DISPARITIES RESEARCH TO ADVANCE HEALTH EQUITY. DEMONSTRABLE LEADERSHIP IS CRITICAL AND WHEN FRANCIS COLLINS ANNOUNCED HE WOULD NOT BE WILLING TO SPEAK ON HIM POSE YUM THAT WAS A SIGNAL THAT HE CHALLENGED OTHERS TO DO THE SAME. IT'S THE WAY CULTER CHANGE HAS SHIFTED SO HERE ARE THE EXAMPLES OF THE STEPS WE'VE TAKEN IN TERMS OF HOW REQUIRING CODES OF CONDUCT FOR NIH SPONSORED CONFERENCE THAT'S TALK ABOUT THE IMPORTANCE OF A SAFE ENVIRONMENT AND WHAT NEEDS TO HAPPEN IF AN ENVIRONMENT IS NOT SAFE. STANDARDS FOR SAFE WORK ENVIRONMENTS BEG PART OF NIH AWARDS AND EXPLICIT CONDITIONS OF NIH AWARDS AND NEW REQUIREMENTS FOR REPORTING HARASSMENT AND WE NEED THE DATA. WE NEED TO STUDY INTERVENTIONS SO WE KNOW WHAT WORKS AND WITH THE SAME RIGOR WE STUDY ANY RESEARCH QUESTION AND WE NEED TO MAKE THAT INFORMATION AVAILABLE SO THEY'RE LEASHED IN BEST PRACTICES CAN BE APPLIED AS APPROPRIATE AND THE RFA THAT RESULTED FROM THE WORKING GROUP GENERATED A LARGE AMOUNT OF INFORMATION AND EVIDENCE THAT IS NOW BEING PUT INTO PLACE AND RECENTLY OUR CHALLENGE ON GENDER ADVANCING INCLUSIVE EXCELLENCE AND HIGHLIGHTED INSTITUTIONS WHO WERE DOING WELL. SO IF YOU HAVEN'T SEEN THIS, I COMMAND YOU TO TAKE A LOOK AT THE PAPER AND THIS IS MY LAST SLIDE. WE'RE COMMIT TODAY ACHIEVING EQUITY AND INCLUSION, CONTINUED EFFORTS ARE NEEDED TO ACHIEVE EQUITY AND INCLUSION AND ESPECIALLY GIVEN THE PANDEMIC'S IMPACT ON WOMEN AND INCLUSIVE RESEARCH ENVIRONMENT IS JUST AS IMPORTANT AS HAVING THE NECESSITY EQUIPMENT TO DO YOUR RESEARCH. AND WE AT NIH ARE COMMITTED TO ACHIEVING GENDER EQUITY ACROSS THE RESEARCH ENTERPRISE AND WE KNOW A DIVERSE WORKFORCE PRODUCES BETTER SCIENCE AND INNOVATION BUT WE CANNOT DO IT LOAN, THIS REQUIRES SYSTEM WIDE AND INSTITUTIONAL WIDE SOLUTIONS AND CREATIVITY AND ACCOUNTABILITY. AND WE LOOK FORWARD TO INFLUENCING THE WHOLE HEALTH ECOSYSTEM AND PARTNERING WITH WHAT MAY BE CALLED NONTRADITIONAL SECTORS TO STRENGTHEN AND ROW GENERATE THE WHOLE ECOSYSTEM FOR WHAT WE NEED TODAY. THANK YOU SO MUCH. BACK TO YOU, Dr. BEGG. >> Dr. CLAYTON. THANK YOU, WE'RE A FEW MINUTES OVER SO WE HAVE A COUPLE QUICK QUESTIONS. IS THE TEAM LEADERSHIP PROGRAM OVER TO PHDs AND MDs? >> SO Dr. BEGG I BELIEVE THAT ANSWER IS YES. >> IT IS YES. >> AND THEN ANOTHER QUESTION IS THIS IS FROM A PHYSICIAN, I'M NOT AN IMMUNOLOGIST BUT CAN I STILL APPLY? >> AND I BELIEVE THE ANSWER IS YES. THE ISSUE IS NOT THE NECESSARILY THE FIELD THAT THE PERSON IS COMING FROM THAT THE RESEARCH QUESTION CAN BE ANSWERED AND USING THE AMP-AIM NETWORK AS A PLATFORM AND THAT IT MEETS THE OTHER STANDARDS AND CRITERIA FOR THE PROGRAM. >> YES AND THERE'S ALSO BROAD AREAS SUCH AS PAIN AND FATIGUE AND OTHER THINGS THAT ACTUALLY ARE ALSO PART OF THE AMP-AIM AND OUR LAST QUESTION IS, SEX DIFFERENCES PLAY A ROLE IN HOW CELLS AND TISSUES INTERACT BIO MATERIALS USED IN TECHNOLOGIES THAT ARE TYPICAL OF MUSS CUE CALORIE SEARCH. IT RO1, PO1, ET CETERA, TYPE GRANTS OR ONLY FOR K AWARDS? AMP-AIM IS PART OF AMP SO IT'S TOTALLY DISTINCT FROM RO1s AND POs 1 AND IT TAKES ADVANTAGE OF OUR ABILITY TO PARTNER BREDLY ACROSS SECTORS THROUGH FMIH WITH PHARMA AND NON PROFITS SO IT'S A COMPLIMENT AND IT'S A TEAM-SCIENCE ENVIRONMENT. EVERYTHING IN AMP IS DONE THROUGH A SHARED GOVERNANCE STRUCTURE, WITH A TEAM SCIENCE APPROACH. AND SO I WOULD ENCOURAGE YOU TO TAKE A LOOK AT THE WEBSITE AND WE CAN SHARE THAT INFORMATION WITH YOU LATER TO GIVE A LITTLE BIT OF A WINDOW INTO SOME OF THE AMAZING SCIENCE THAT HAS BEEN SUPPORTED THROUGH THE AMP PROGRAM. I'M JUST ADD THAT DATA SCIENCE, DATA SCIENTISTS, COMPUTATIONAL BIOLOGISTS ARE REALLY ENCOURAGED TO APPLY AND WE REALLY WANT TO SEE MORE WOMEN IN THOSE FIELDS AND THIS IS AN OPPORTUNITY AND WE'RE ACTUALLY GETTING MORE PARTNERSHIPS, THE OFFICE OF DATA SCIENCE CENTRAL GEE IS NOW JOINED US IN PARTNERSHIP FOR THOUGH PROGRAM WITH NAIMS. >> I'M WILLING TO BE THE LIAISON FOR ANYONE IN THE AUDIENCE IF YOU HAVE FURTHER QUESTIONS AND FEEL FREE TO E-MAIL ME BECAUSE I'M WORKING WITH IS NOT AND WITH THAT WE'LL CLOSE OUT AND WE HAVE LAST SLIDE TO TAKE US TO LUNCH AND IT HAS TO BE A QUICK LUNCH, BECAUSE WE ARE ASKING YOU TO RETURN 12:30 AND THERE WILL BE A FIVE MINUTE ALERT AT 12:25 AND SO PLEASE, REJOIN US IN 20 MINUTES AND FOR THE REMAINDER OF THE PROGRAM. GOOD AFTERNOON, EVERYONE, THIS IS LISA BEGG, WE'RE STARTING OUR POST LUNCH BREAK SESSION AND WITH THE PODIUM SESSION FOR THOSE OF YOU THAT MAY NOT BE FAMILIAR, THE SCHOLARS THAT SUBMIT ABSTRACTS COMPETE FOR APPROVAL TO BE INCLUDED AND THEY'RE ALSO THE ONES THAT ARE ACCEPTED ALSO INCLUDED IN THE JOURNAL OF WOMEN'S HEALTH AND A SPECIAL ISSUE IN THE FALL SO THAT IS AVAILABLE, THE LINK VIRTUALLY IS AVAILABLE IT WOULD BE BETTER TO HAVE ALL THREE BIRCWH PODIUM SPEAKERS TAPED TOGETHER AND THEY'RE INTRODUCED BY THE P.I. OF THEIR PROGRAM SO YOU HAVE A LITTLE BACKGROUND ON THEM AND SO IT WILL BE 45 MINUTES AND THEN, WE COME BACK AT THAT TIME FOR A GENERAL Q&A SO WE ENCOURAGE YOU TO SUBMIT ANY QUESTIONS THAT YOU HAVE INTO THE Q&A TAB ON THE VIRTUAL PLATFORM AND SO THAT WE CAN HAVE SOME DIALOGUE SO WITH THAT I WILL ASK FOR THE TAPE TO BEGIN FOR THE THREE PODIUM SPEAKERS. >> HI, MY NAME Dr. ABBEY BERENSON. IT'S MY GREAT PLEASURE TODAY TO INTRODUCE DR. PHI Dr. CANTU. HE RECEIVED A MASTER'S DEGREE AND DOCTORAL DEGREE AT THE UNIVERSITY OF TEXAS IN AUSTIN. FOLLOWING THIS, HE WAS RECRUITED TO UTMB AND RESEARCH DIRECTOR OF TWO DIFFERENT PROGRAMS AND THE HISPANIC ESTABLISHED POPULATION FOR THE EPIDEMIOLOGIC STUDY OF THE HE WAS PROMOTED TO ASSISTANT PROFESSOR IN THE DEPARTMENT OF INTERNAL MEDICINE DIVISION OF GERIATRICS. Dr. CANTU'S RESEARCH FOCUSES ON CAREGIVING AND SOCIAL RELATIONSHIPS OF OLDER MEXICAN AMERICANS. AS A BIRCWH SCHOLAR, HE WILL EXAMINE GENDER DIFFERENCES IN THE CARE OF OLDER ADULTS WITH DEMENTIA AND EXPLORE PROXY MEASUREMENTS OF COGNITIVE DECLINE. PLEASE JOIN ME IN WELCOMING Dr. CANTU. >> THANK YOU FOR JOINING ME TODAY. I WILL SHARE WORK ON GENDER DIFFERENCES AND CARE NETWORKS OF OLDER ADULTS WITH DEMENTIA. HERE IS AN OUTLINE TO HELP YOU KEEP TRACK OF WHERE WORE GOING IN THIS PRESENTATION. FIRST, I'M GOING TO SHOW YOU THE RESEARCH QUESTIONS THAT GUIDE THIS ANALYSIS AND THEN I'M GOING TO DESCRIBE THE DATA WE USED AND SAMPLE CHARACTERISTICS AND THEN I'M GOING TO DESCRIBE OUR MEASURES OF CARE AND CARE NETWORKS FOR OLDER ADULT S WITH DEMENTIA AND THEN SHOW YOU RESULTS PREDICTING THE HOURS OF INFORMAL CARE THAT PEOPLE WITH DEMENTIA RECEIVE. THIS ANALYSIS IS GUIDED BY THREE RESEARCH QUESTIONS. FIRST, WE WANT TO KNOW IF THERE ARE DIFFERENCE THIS IS THE COMPOSITION OF CARE NETWORKS BY FENDER WITH PEOPLE WITH DEMENTIA. WHO DOES THE CARING AND ARE THEY BEING PAID? SECOND, WE WANT TOE KNOW HOW DO THE COST OF INFORMAL CARE DIFFER BY GENDER AND NOT JUST IN TERMS OF DOLLAR AMOUNT BUT HOURS OF CARE THAT INFORMAL CAREGIVERS ARE GIVING AND THE AVAILABLE ABILITY OF FAMILY CAREGIVERS, SPOUSES AND CHILDREN, EXPLAIN THE DIFFERENCES IN HOURS OF INFORMAL CARE. AND TO ANSWER THESE QUESTIONS, WE'RE GOING TO IDENTIFY CASES OF DEMENTIA IN A NATIONALLY REPRESENTATIVE DATASET AND WE WILL CATEGORIZE THE CARE OF CAREGIVING NETWORKS OF PEOPLE WITH DEMENTIA AND STRAT GUY THE HOURS OF CARE BY GENDER AND THEN WE USE REGRESSION MODELS TO IDENTIFY GENDER PATTERNS AND INFORMAL CARE HOURS. THE DATA WE USE FOR THIS STUDY COMES FROM THE HEALTH AND RETIREMENT SURVEY. AND NATIONALLY REPRESENTATIVE SAMPLE OF U.S. ADULTS OVER AGE 50 COLLECTED BY ANNUALLY AND WE USED DATA FROM 2002 TO 2018 AND WE USED THE CORE INTE INTERNET -- IT IDENTIFIES DEMENTIA AS A FUNCTION OF AGE, EDUCATION, GENDER, DISABILITY, CURRENT AND PREVIOUS COGNITIVE FUNCTION. AND IT DOES NOT HAVE A DIAGNOSIS OF DEMENTIA INSTEAD, THERE ARE A BATTERY OF COGNITIVE TESTS TO IDENTIFY THE PROBABILITY OF DEMENTIA AND RANGE INTERESTING 0.01 TO .99. ANYBODY WHO HAS IDENTIFIED AS HAVING A PROBABILITY ABOVE .51 IS PUT INTO OUR SAMPLE AS PROBABLE DEMENTIA. AND WE ASKED QUESTIONS ABOUT CAREGIVING NETWORKS AND THEY COLLECT A WIDE RANGE OF DEMOGRAPHIC FAMILY, SOCIOECONOMIC AND HEALTH CHARACTERISTICS INCLUDING, DEPENDGENDER, RACE, NON HISPANIC WHITE, BLACK AND HISPANIC. FAMILY CHARACTERISTICS INCLUDED WHETHER OR NOT SOMEONE IS MARRIED, THE NUMBER OF LIVING CHILDREN AND ROW CODE LIVING CHILDREN INTO THREE MEANINGFUL CATEGORIES. THOSE WERE NO CHILDREN, THOSE WHO HAVE 1-3 CHILDREN AND THOSE WHO HAVE FOUR OR MORE CHILDREN. SOCIOECONOMIC STATUS IS MEASURED BY EDUCATION, COMPARING THOSE WITH LESS THAN HIGH SCHOOL EDUCATION, TO THOSE WITH HIGH SCHOOL EDUCATION OR MORE. HEALTH IS OPERATIONALIZED INTO TWO BROAD DOMAINS, DISABILITY, MEASURED WITH INSTRUMENTAL ACTIVITIES OF DAILY LIVING AND ACTIVITIES OF DAILY LIVING DISABILITY AS A COUNT OF DISABLING CONDITIONS FROM ZERO TO 11 AND CHRONIC CONDITIONS INCLUDE, DIABETES, HYPERTENSION, STROKE, HEART ATTACK, ARTHRITIS, CANCER, LUNG DISEASE AND DEPRESSION. YOU CAN SEE ACROSS ALMOST EVERY SAMPLE CHARACTERISTICS THERE ARE SIGNIFICANT DIFFERENCES BETWEEN MEN AND WOMEN WITH DEMENTIA. WOMEN WERE OLDER, THEY WERE DISPROPORTIONATELY MINORITIES, THEY WERE LESS LIKELY TO BE MARRIED, AND THEY HAD MORE DISABILITIES, AND THEY HAD FEWER LIVING CHILDREN COMPARED TO MEN WITH DEMENTIA. ACTIVITIES DAILY LIVING DISABILITIES ARE DISABLING RELATED TO SELF-CARE SO THINGS YOU NEED TO DO TO MAINTAIN INDEPENDENCE SUCH AGO WALKING, DRESSING, BATHING, EATING, GETTING IN AND OUT OF BED AND USING THE TOILET. INSTRUMENTAL DAILY ARE RELATED TO MAINTAINING A INDEPENDENT HOUSEHOLD SO THINGS YOU NEED TO DO AND IN ORDER TO LIVE BY YOURSELF SUCH AS CLEANING, PREPARING MEALS, BUYING GROCERIES, USING A PHONE, TAKING MEDICATIONS AND MANAGING MONEY SO THEY DETERMINE IF AN OLDER ADULT IS EXPERIENCING THESE DISABLING CONDITIONS AND THEY ASK WHO IS MOST RESPONSIBLE FOR HELPING WITH THESE CONDITIONS. UP TO EIGHT HELPERS COULD BE NAMED AND WE CATEGORIZED THOSE HELPERS INTO TWO BROAD CATEGORIES, INFORMAL CAREGIVERS, THOSE UNPAID, AND PAID FORMAL CAREGIVERS AND INFORMAL CAREGIVERS ARE FURTHER SUBDIVIDED INTO SPOUSES, CHILDREN AND OTHER UNPAID FAMILY AND NON FAMILY MEMBERS. FORMAL CAREGIVERS, ARE FURTHER SUBDIVIDED INTO THOSE WHO ARE PAID NON FAMILY MEMBERS, THOSE WHO ARE PAID FAMILY MEMBERS, AND CAREGIVERS WHO ARE PAID BY INSURANCE. HERE WE SEE THERE ARE BIG DIFFERENCES IN THE COMPOSITION OF CAREGIVING NETWORKS FOR PEOPLE WITH DEMENTIA BY GENDER. WOMEN WITH DEMENTIA WERE MORE LIKELY TO RECEIVE CARE AND WOMEN'S CARE CAME FROM THEIR CHILDREN AND OLDER MEN'S CARE CAME MOSTLY FROM THEIR SPOUSES. I THINK IT'S IMPORTANT TO NOTE THAT WOMEN RECEIVE MORE CARE FROM EVERY SOURCE EXCEPT FOR SPOUSES. WE WERE ALSO INTERESTED IN WHAT WERE THE COST OF CAREGIVING AND IN TERMS OF HOURS OF CARE DELIVERED BY EACH SOURCE OF CARE AND EACH COURSE WAS ASKED ON AVERAGE, HOW MANY HOURS OF CARE THEY DELIVERED ON AN AVERAGE DAY. AND HERE WE SEE THERE ARE BIG GENDER DIFFERENCES IN THE ESTIMATED COST OF INFORMAL CARE FOR PEOPLE WITH DEMENTIA AND WOMEN RECEIVED ON AVERAGE, 10% CARE HOURS THAN MEN AND THOSE HOURS OF CARE WERE FROM THEIR CHILDREN. AND WHILE FOR MEN, MOST OF THEIR HOURS OF CARE WERE COMING FROM THEIR SPOUSES. USING THE REPLACEMENT COST APPROACH THE NEARLY 20 HOURS OF CARE EACH WEEK THAT WOMEN RECEIVE REFLECTED A COST OF NEARLY $25,000 COMPARED TO $21,000 A YEAR FOR MEN AND HOWEVER, IT'S IMPORTANT TO NOTE THAT IF YOU WERE TO GO OUT AND ACTUALLY TRY TO PURCHASE CARE THAT WOULD BE COMPARABLE IN TERMS OF IN-HOME CARE FOR OLDER ADULT S WITH DEMENTIA IT COULD BE MUCH MORE THAN THE $24 PER HOUR THAT WE ESTIMATED. AND WOULD DID THIS USING A TWO-PART REGRESSION MODEL. WE MODELED THE TOTAL HOURS OF INFORMAL CARE AS OUR DEPENDENT VARIABLE IN THIS TWO PART REGRESSION. BECAUSE SO MANY PEOPLE WEREN'T RECEIVING CARE AT ALL, WE FIRST USED LOGISTIC PROGRESSION TO PREDICT THE ODDS OF RECEIVING CARE AND WE USED A GENERALIZED LINEAR MODEL WITH A LOG LINK DISTRIBUTION TO PREDICT TOTAL HOURS OF INFORMAL CARE DEPENDING ON RECEIVING CARE. WE CONTROL FOR THOSE INDIVIDUALS WHO DO NOT RECEIVE CARE IN OUR MODEL. IN THE FIRST PART OF OUR TWO-PART REGRESSION THE ODDS OF RECEIVING INFORMAL CARE AND AS YOU CAN SEE HERE, WOMEN WERE MORE LIKELY TO RECEIVE CARE THAN MEN AND WHEN WE STRATIFIED THE MODELS BY GENDER, THEY DON'T APPEAR TO BE DIFFERENCES IN THE RELATIONSHIP BETWEEN THE CO VAR VARIANTS THAT WERE PREDICTING THE ODDS OF INFORMAL CARE. THE PREDICTORS OF INFORMAL CARE WERE THE SAME FOR MEN AND WOMEN AND WOMEN WERE JUST MORE LIKELY TO RECEIVE INFORMAL CARE THAN MEN. LOOKING AT THE HOURS OF INFORMAL CARE THERE WERE NO DIFFERENCES IN THE PREDICTORS OF INFORMAL CARE BY GENDER. AND WOMEN RECEIVED MORE WHOA PREDICTED HOURS OF INFORMAL CARE AND UNMARRIED AND WHILE WOMEN RECEIVED MORE CARE THAN MEN, BETWEEN HOURS OF CARE AND BY GENDER AND MARITAL STATUS. IT DID NOT DIFFER BY GENDER AND WHILE ALL PEOPLE WITH FEWER CHILDREN RECEIVED FEWER HOURS OF INFORMAL CARE, THERE WASN'T A DIFFERENCE BETWEEN WE KNOW AND WE SEE NON HISPANIC BLACK WOMEN RECEIVED THE GREATEST NUMBER OF INFORMAL CARE HOURS. THERE ARE IN DEED DIFFERENCES IN CARE NETWORKS, COMPOSITION BY GENDER. WOMEN RECEIVED MORE OF THEIR CARE FROM THEIR ADULT CHILDREN WHILE MEN RECEIVED MORE OF THEIR CARE FROM THEIR SPOUSES AND THAT'S LARGELY A FUNCTION OF THE FACT THAT WOMEN ARE MUCH MORE LIKELY TO BE WIDOWED IN LATE LIFE THAN MEN ARE TO BE WIDOWERS AND SECOND, INFORMAL CARE NETWORKS ARE RESPONSIBLE FOR MORE HOURS OF CARE FOR WOMEN THAN FOR MEN AND WOMEN RECEIVED ABOUT 10% MORE INFORMAL HOURS OF CARE PER WEEK THAN MEN AND THE GENDER DIFFERENCE THIS IS HOURS OF CARE CANNOT BE EXPLAINED BY HEALTH OR AVAILABILITY OF FAMILY MEMBERS. AND THESE RESULTS SUGGEST THAT DEMENTIA MAY CAUSE GREATER NEED FOR CARE IN WOMEN AND THAN IN MEN. SO, THANK YOU SO MUCH FOR YOUR ATTENTION AND I WANT TO THANK MY MENTORS AT UTMB, AS WELL AS MY CO-AUTHORS AND IF YOU HAVE ANY QUESTIONS, FILL FREE TO' MEL ME THANK YOU SO MUCH FOR YOUR TIME. >> IT'S A DISTINCT HONOR TO INTRODUCE THE ALL OF US AND IT'S A CLINICAL RESEARCHER, HE FOCUSED ON SOURCES OF PREGNANCY IN AS I CLINICIAN TAKING CARE OF PREGNANT WOMEN SHE'S POSITIONED TO DEFINE THIS COURSE IN TAKING FINDINGS TO IMPROVE DIAGNOSIS AND EX THEN SHE MOVED TO PITTSBURG IN MATERNAL MEDICINE AT THE UNIVERSITY OF PITTSBURGH HOSPITAL. SHE IS NOW EXPANDING HER STUDIES BEYOND THE NINE MONTHS PREGNANCY TO BETTER UNDERSTANDING OF THE POSTPARTUM CARE AND RECOVERY AFTER HYPERTENSIVE DISORDERS DURING PREGNANCY. PLEASE JOIN ME IN WELCOMING HER TO PRESENT HER DAUGHTER. >> >> THANK YOU FOR ALLOWING ME TO PRESENT OUR WORK AND INITIATION OF ANTI HYPERTENSIVE MEDICATIONS AND FOLLOWING HOSPITAL DISCHARGE AND AMONG INDIVIDUALS WITH HYPERTENSIVE DISORDERS OF PREGNANCY. HYPERTENSIVE DISORDERS OF PREGNANCY INCLUDE PREGNANCY-ASSOCIATED HYPERTENSION AS WELL AS CHRONIC HYPERTENSION WHICH IS PRESENT BEFORE PREGNANCY. THE PREVALENCE OF HYPERTENSIVE DISORDERS OF PREGNANCIES, AMONG DELIVERY HOSPITALIZATIONS, IS INCREASING AS SHOWN IN THE FIGURE HERE. THE MOST RECENT DATA FROM THE CDC ESTIMATES THAT HYPERTENSION COMPLICATES 1/7 DELIVER RE HOSPITALIZATIONS. HYPERTENSIVE DISORDERS OF PREGNANCY ARE COMMON AND CAN CAUSE SEVERE COMPLICATIONS FOR PREGNANT PEOPLE AND THERE ARE LEADING CAUSE OF PREGNANCY RELATED DEATH IN THE UNITED STATES AND THEY'RE ALSO THE MOST COMMON REASON FOR POSTPARTUM HOSPITAL READMISSION. DESPITE THIS, THERE ARE LIMITED RECOMMENDATIONS FOR POSTPARTUM ANTI HYPERTENSIVE MANAGEMENT FOLLOWING A HYPERTENSIVE DISORDER OF PREGNANCY. THE AMERICAN COLLEGE OF GYNECOLOGISTS OR ACOG SUGGESTS THAT TREATMENT SHOULD BE INITIATED FOR PERSISTENT, POSTPARTUM BLOOD PRESSURE GREATING THAN 150/100. BUT THESE RECOMMENDATIONS DO NOT ADDRESS THE EXPECTED BLOOD PRESSURE TRAJECTORIES AFTER HOSPITAL DISCHARGE. WHICH IS ONE OF THE LARGEST CONTRIBUTORS TO HOSPITAL ROW ADMISSION. DATA FROM HOME BLOOD PRESSURE MONITORING PROGRAMS, SUGGEST THERE'S AN EX EXACERBATION AND YOU SEE HERE IN THE FIGURE, HOME BLOOD PRESSURE IN THE FIRST TWO WEEKS POSTPARTUM, ALONG THE X AXIS WITH BLOOD PRESSURE ON THE LEFT AND BLOOD PRESSURE ON THE RIGHT. THERE'S AN EX ASKER EVACUATION OAN EXACERBATION WHENMOST INDIVIDUALS HAVE BEEN DISCHARGED FROM THE HOSPITAL. WE KNOW THAT THESE HIGHER BLOOD PRESSURES INCREASE THE RISK OF SIGMA TERNAL MORBID TEASE SUCH AS STROKE, SEE SEIZURE AND OTHER EVENTS. BECAUSE OF THIS, ACOG RECOMMEND BLOOD PRESSURE ASSESSMENT THREE TO 10 DAYS AFTER DELIVERY AND AGAIN AT THE TIME OF THE COMPREHENSIVE POSTPARTUM VISIT. THE PRIOR STUDIES HAVE DEMONSTRATED POOR ADHERENCE TO SCHEDULED VISITS DURING THIS TIME PERIOD. WHICH IS LIMITED OUR ABILITY TO UNDERSTAND BLOOD PRESSURE PATTERNS AFTER HOSPITAL DISCHARGE. REMOTE MONITORING AND MANAGEMENT PROGRAMS HAVE BEEN SHOWN TO BE FEASIBLE AND IMPROVE ADHERENCE TO HYPERTENSIVE CARE IN THIS PERIOD. THESE PROGRAMS HAVE GIVEN US THE ABILITY TO BETTER UNDERSTAND BLOOD PRESSURE PATTERNS AND RISK FACTORS FOR POSTPARTUM MORBIDITY AFTER HOSPITAL DISCHARGE. THUS IN THIS STUDY, OUR OBJECTIVES WERE TO FIRST IDENTIFY RISK FACTORS FOR INITIATION OF ANTI HYPERTENSIVE MEDICATION AND FOLLOWING HOSPITAL DISCHARGE POSTPARTUM AND CHARACTERIZE ASSOCIATED OUTCOMES, AND SECOND, TO INTERROGATE THE INPATIENT PERFORMANCE OF ACOG GUIDELINES FOR IDENTIFYING INDIVIDUALS WITH HYPERTENSIVE MEDICATIONS AND WE UTILIZED DATA FROM A REMOTE BLOOD PRESSURE MONITORING PROGRAM AS PART OF A QUALITY IMPROVEMENT PROJECT THAT REPLACES THE THREE TO 10 DAY IN OFFICE VISIT. INDIVIDUALS ARE ENROLLED IN THE NURSING CALL CENTER DRIVEN BLOOD PRESSURE MANAGEMENT PROGRAM BY THEIR PRIMARY OBSTETRIC PROVIDER DURING THEIR HOSPITALIZATION AND THEY'RE PROMPTED TO TAKE AND REPORT BLOOD PRESSURE BY TEXT MESSAGE AFTER HOSPITAL DISCHARGE AND ALLOWING FOR MEDICATION AND INITIATION IN REAL-TIME FOLLOWING STANDARDIZED PROTOCOLS. TO BE INCLUDED IN THE PROGRAM, INDIVIDUALS HAD TO BE ENGLISH SPEAKING AND HAVE A PHONE THAT ACCEPT TEXT MESSAGES. FOR THIS ANALYSIS, WE INCLUDED DELIVERIES BETWEEN SEPTEMBER 2019 AND JUNE OF 2021 WITH A DIAGNOSED HYPERTENSIVE DISORDER DURING THE DELIVERY ADMISSION. WE EXCLUDED INDIVIDUALS WHO REPORTED LESS THAN TWO BLOOD PRESSURES THROUGH THE PROGRAM AND OR WHO HAD A KNOWN DIAGNOSIS OF PRE PREGNANCY HYPERTENSION AS THEIR BLOOD PRESSURE MANAGEMENT AND GOALS MAY HAVE BEEN DIFFERENT POSTPARTUM. WE COMPARED DEMOGRAPHICS AND CLINIC OUTCOMES AS DEPICTED HERE. SHOWN IN THE MIDDLE, INDIVIDUALS WHO ARE INITIATED ON ANTI HYPERTENSIVE MEDICATIONS, THROUGH OUR REMOTE MONITORING PROGRAM, AFTER DISCHARGE FROM THE DELIVERY HOSPITALIZATION, INDIVIDUALS WHO NEVER REQUIRED ANTI HYPERTENSIVE MEDICATIONS, AND THIRD, THOSE WHO WERE STARTED ON ANTI HYPERTENSIVE MEDICATIONS DURING THEIR DELIVERY HYPERTENSION. WE MODEL ODDS OF EMERGENCY ROOM VISITS AND POSTPARTUM READMISSION AND TO COMPARE BLOOD PRESSURE TRAJECTORIES IN THE PERIOD WE FIT MIXED EFFECTS LYNN YEAR REGRESSION MODEL WITH RE PETEED BLOOD PRESSURE MEASURES. WE TESTED THE DIFFERENCES BETWEEN GROUPS USING LIKELIHOOD RATIO TESTS AND FINALLY REINTEG GATED THE ABILITY OF THE ACOG GUIDELINES WITH PERSISTENT HYPERTENSION AS GREATER THAN FOUR HOURS APART HAVING A BLOOD PRESSURE OF MORE THAN 150 OVER 100 AND WHEN A PLIED IN PATIENT TO IDENTIFY INDIVIDUALS WHO ULTIMATELY REQUIRED ANTI HYPERTENSIVE AGENTS. OVER ALL, THERE WERE 2,705 INDIVIDUALS ENROLLED IN THE PROGRAM OVER OUR TARGET TIME PERIOD. WITH 54% NEVER REQUIRING MEDS AND 46% REQUIRING ANTI HYPERTENSIVE MEDICATIONS AND AMONG THOSE REQUIRING ANTI HYPERTENSIVE MEDICATIONS, HALF WERE STARTED ON ORAL MEDICATIONS DURING THE DELIVER ROW HOSPITALIZATION SHOWN HERE IN RED AND ABOUT HALF WERE STARTED ON MEDICATIONS AFTER HOSPITAL DISCHARGE. SHOWN HERE IN ORANGE. WHEN WE COMPARED DEMOGRAPHIC CHARACTERISTICS, BETWEEN THOSE EVENTUALLY NEEDING AGENTS AND TO THOSE WHO NEVER NEEDED AN HIGH HYPERTENSIVE MEDICATIONS, WE SEE THAT INDIVIDUALS WHO REQUIRED MEDICATIONS WERE HOLDER, HAD A HIGHER BODY MASS INDEX AND IDENTIFY AS BLACK RACE. WHEN WE CAM PAIRED THEM TO THE GROUP DURING THE DELIVER ROW HOSPITALIZATION, WE SEE THAT THEY ACTUALLY LOOK SIMILAR FROM THE DEMOGRAPHIC STANDPOINT WITH THE EXCEPTION OF A SLIGHTLY HIGHER BMI. WHEN WE LOOK AT CLINICAL CHARACTERISTICS OF THE GROUP WE SEE THOSE REQUIRING ANTI HYPERTENSIVE AFTER DISCHARGE, LOOK VERY SIMILAR TO THOSE WHO NEVER REQUIRED MEDICATIONS. HAVING A SIMILAR POSTPARTUM LENGTH OF STAY. I HAVE EXPECTED, INDIVIDUALS WHO ARE TREATED WITH MEDICATIONS OR STARTED ON MEDICATIONS INPATIENTS DURING THE DELIVERY HOSPITALIZATIONS, CLINICALLY APPEARED TO HAVE THE MOST SEVERE DISEASE. A HIGHER PREPORTION HAVE A DIAGNOSIS OF PRE-ECLAMPSIA, PRE TERM BIRTH, AND RECEIVED MAGNESIUM. THEY ALSO HAD A LONGER POSTPARTUM HOSPITAL LENGTH OF STAY COMPARED TO THOSE ON HOSPITAL MEDICATIONS AFTER DISCHARGE. ALSO NOT SURPRISINGLY, WHEN WE LOOK AT IN PATIENT POSTPARTUM BLOOD PRESSURES WHICH ARE SHOWN HERE BY GROUP WITH SYSTEM I CAN ON THE LEFT AND THE RIGHT WE SEE THAT INDIVIDUALS WHO ARE STARTING ON MEDICATIONS IN PATIENT, HAD THE HIGHEST MEAN AND MAXIMUM SYSTEM I CAN AND DIE STOLL I CAN BLOOD PRESSURE DURING THEIR POSTPARTUM HOSPITALIZATION. SO IN A DIFFERENT WAY, WHEN WE LOOK AT THE TRAJECTORY OF SIS STOLL I CAN AND DIASTOLIC BLOOD PRESSURE WE SEE THAT THE GROUP IS STARTED ON MEDICATIONS, THAT OCCURS BETWEEN DAYS FOUR AND SEVEN POSTPARTUM. WE THEN LOOKED AT CARE UTILIZATION AMONG EACH OF THESE GROUPS. AGAIN, WE SEE THAT INDIVIDUALS STARTED ON ANTI HYPERTENSIVE AGENTS AFTER DISCHARGE, HAD THE HIGHEST RATE OF EMERGENCY ROOM VISITS, AND HOSPITAL READMISSIONS POSTPARTUM. WHEN COMPARED TO THOSE WERE STARTED ON MEDICATIONS DURING THEIR INPATIENT DELIVERY HOSPITALIZATIONS, WHO AGAIN CLINICALLY SEEMED TO HAVE THE MOST SEVERE DISEASE, THEY HAD A 1.7 FOLD INCREASED ODDS OF EMERGENCY ROOM VISITS AND A 3.3 FOLD INCREASE ODDS OF HOSPITAL READMISSION. AND WHILE CARE UTILIZATION IS INCREASED IN THIS GROUP, WHAT WE'RE PARTICULARLY INTERESTED IN IS MATERNAL MORBIDITY AND THE SURROGATE FOR THAT WE LOOKED AT PREVALENCE OF SEVERE HYPERTENSION IN THE POSTPARTUM PER IDEA ON HOME BLOOD PRESSURE MONITORING, WHICH SEVERE HYPERTENSION GREATER THAN OR EQUAL TO 160/110 HAS BEEN SHOWN TO INCREASE HEART FAILURE, SEIZURES AND STROKE AND MULTI ORGAN FAILURE SUCH AS RENAL FAILURE AND WE SEE THAT A THIRD OF THOSE WHO ARE STARTED ON MEDICATIONS AFTER DISCHARGE, HAD SEVERE HYPERTENSION AND THEY HAD A 1.6 FOLD INCREASE ODDS OF SEVERE HYPERTENSION AND WHEN COMPARED TO THOSE STARTED ON MEDICATIONS WHILE IN PATIENT AND FINALLY WE ASKED THE QUESTION, IS IT THAT THE 150 OVER 100 CUT OFF FOR INITIATION OF MEDICATIONS, IS MISSING THESE INDIVIDUALS WHO HAD ULTIMATELY NEEDED MEDICATIONS AND OR WERE THEY JUST INAPPROPRIATELY TREATED DURING THEIR DELIVER ROW HOSPITALIZATIONS AND SO TO DO THAT, WE LOOKED AT THE PREPORTION OF INDIVIDUALS WITHIN EACH GROUP WHO METED 150 OVER 100 CUT OFF WHILE INPAY SHA. WE FOUND THAT 25% OF THOSE WHO NEVER NEEDED MEDICATIONS MET THE CRY TER WHY AND COMPARED TO 37% OF THOSE WHO ARE INITIATED ON MEDICATIONS POST HOSPITAL DISCHARGE AND 75% OF THOSE WHO STARTED ON MEDICATIONS IN THE HOSPITAL SUGGESTING THAT THE MAJORITY OF INDIVIDUALS WHO NEEDED INITIATIONS OF MEDICATIONS, AFTER HOSPITAL DISCHARGE, WERE NOT ACTUALLY IDENTIFIED BY THE 150/100 CRITERIA WHEN APPLIED INPAY SHA. SO BASED ON THOSE FINDINGS, WE ASKED HOW WOULD A LOWER THRESHOLD CHANGE THE PREPORTION OF INDIVIDUALS TREATED WITH ANTI-HYPERTENSIVE ACTS. 25% OF THOSE NEVER NEEDING MEDICATIONS, MET THE 150/100 CUT OFF IN THE HOSPITAL AND 56% OF THOSE WHO REQUIRE MEDICATIONS, WERE IDENTIFIED BY THE 150/100. IF WE USED A LOWER CUT OFF LIKE 140/90, WHICH IS USED FOR INITIATION OF ANTI HYPERTENSIVE AND NON OBSTETRIC POPULATION WE SEE WE WOULD CORRECTLY IDENTIFY 84% OF INDIVIDUALS NEEDING MEDICATIONS DURING THE DELIVERY HOSPITALIZATIONS AND WE WOULD POTENTIALLY END UP OVER TREATING MORE THAN 60% OF THOSE WHO NEVER ACTUALLY REQUIRED MEDICATION. WHICH COULD INCREASE THE RISK OF ADVERSE EFFECTS RELATED TO AN HIGH HYPERTENSIVE MEDICATIONS. REINFORCING THAT SIMPLY LOWERING THE THRESHOLD FOR MEDICATION INITIATIONS WITHOUT UTILIZATION OF HOME BLOOD PRESSURE MONITORING, AND DEVELOPMENT OF FURTHER TOOLS FOR RISK STRATIFICATION, WOULD BE PREMATURE. THIS IS THE LARGE PROSPECTIVE COHORT WITH REAL-TIME BLOOD PRESSURE MEASURES THAT UTILIZE THE STANDARDIZED MANAGEMENT PROTOCOLS. LIKE ANY STUDY, OUR STUDY HAS A NUMBER OF LIMITATIONS AND THE SINGLE SITE AS WELL AS IN PATIENT PROVIDING PRACTICE DIFFERENCES AND LIMIT THE GENERALIZABILITY AND HOSPITAL READMISSION IN RELATION TO MEDICATION INITIATION. IN CONCLUSION, OVER 20% OF INDIVIDUALS IN OUR COHORT REQUIRED INITIATION OF ANTI HYPERTENSIVE AFTER HOSPITAL DISCHARGE AND THESE INDIVIDUALS HAVE THE HIGHEST HOME BLOOD PRESSURES AND THE GREATEST ODDS OF POSTPARTUM HOSPITAL READMISSION AND CURRENT GUIDELINES FAILED TO IDENTIFY THE POSTPARTUM INDIVIDUALS WHO REQUIRE AN HIGH HYPERTENSIVE MEDICATION AFTER HOSPITAL DISCHARGE. THESE DATA SUPPORT THE CRITICAL ROLE OF REMOTE BLOOD PRESSURE MONITORING PROGRAMS AND HIGHLIGHT THE NEED FOR IMPROVED TOOLS FOR RISK STRATIFICATION AND LIBERALIZATION OF THRESHOLDS FOR MEDICATION INITIATION POSTPARTUM. I WANT TO THANK MY CO-AUTHORS AND MENTORS AND THANK THE BIRCWH PROGRAM FOR SUPPORTING MY CAREER AND THIS WORK. THANK YOU FOR THE OPPORTUNITY TO PRESENT OUR WORK TODAY. >> THE BIRCWH SCHOLAR PRESENTATIONS ARE ALWAYS A HIGHLIGHT OF THE ANNUAL BIRCWH MEETING AND PROVIDE A GLIMPSE OF THE OUTSTANDING WORK THAT'S BEING CONDUCTED BY BIRCWH SCHOLARS NATIONWIDE. I'M TONETTE KROUSEL-WOOD AND TODAY, I AM DELIGHTED TO INTRODUCE ONE OF OUR EXCELLENT SCHOLARS Dr. YILIY YOSHIDA. SHE RECEIVED HER BACHELOR DEGREES FROM ALTERNATIVE MEDICINE FROM CHINESE MEDICINE AND GLOBAL COMMUNITY HEALTH SCIENCES FROM THE TULANE UNIVERSITY SCHOOL OF PUBLIC-HEALTH AND TROPICAL MEDICINE AND A PH.D IN COMMUNITY AND BEHAVIORAL SCIENCES FROM THE LOUISIANA STATE UNIVERSITY. AFTER COMPLETING A TWO YEAR POSTDOCTORAL FELLOWSHIP AT THE UNIVERSITY OF MISSISSIPPI WITH THE FOCUS ON CHRONIC DISEASE EPIDEMIOLOGY, SHE JOINED HER FIRST FACULTY RANK AT THE UNIVERSITY OF MISSOURI AT COLOMBIA AS A RESEARCH ASSISTANT PROFESSOR. IN 2019, WE REPLACED A WELCOME HER TO TULANE UNIVERSITY AS AN ASSISTANT PROFESSOR IN THE DEPARTMENT OF MEDICINE AND SCHOOL OF MEDICINE. HER CURRENT RESEARCH IS AND DELINEATING MECHANISMS SHE WAS ALREADY PUBLISHED 25 PEER REVIEW JOURNALS INCLUDING 21 AS FIRST AND SENIOR AUTHORS AND SHE'S PUBLISHED IN LAST YEAR, SHE RECEIVED THE YOUNG INVESTIGATORS AWARD THEY HAVE RECEIVED PILOT GRANT AWARDS FROM THE LOUISIANA CENTER FOR CLINICAL AND TRANSLATIONAL RESEARCH AND THE MELINDA AND BILL GATES FOUNDATION. SHE SERVICE THROUGH SPECIALTY SEW SIGHS TEASE AS WELL AS CONDUCTS PEER REVIEW ORWH OVER 20 SCIENTIFIC JOURNALS. SHE'S PROVEN TO BE AN OUTSTANDING ACADEMIC CITIZEN, COL EQUAL, COLLABORATE OR AND SCIENTIST. SHE'S EMBRACED THE BIRCWH MISSION AND HAS CONTRIBUTED SUBSTANTIALLY TO OUR UNDERSTANDING OF AND COVID-19. TODAY SHE WILL PRESENT HER RESEARCH ENTITLED "PRE DIABETES AND UNDIAGNOSED AS -- MANY THANKS TO THE NATIONAL INSTITUTES OF HEALTH, THE OFFICE OF RESEARCH AND WOMEN'S HEALTH AND THE BIRCWH PROGRAM FOR THIS OPPORTUNITY TO SHOWCASE AND EXCELLENT WORK AND HER COMMITMENT TO ADVANCING WOMEN'S HEALTH. THANK YOU. >> HELLO, EVERYONE, I'M A SCHOLAR AT TULANE UNIVERSITY AND A IS THE ANT PROFESSOTHANK YOU TO THE NIH OFFICE OF RESEARCH AND WOMEN'S HEALTH GIVING THIS GREAT OPPORTUNITY TO PRESENT THE RESEARCH ON SEX DIFFERENCES IN DIABETES ASK CARD YE VASCULAR DISEASE. I WILL SPECIFICALLY DISCUSS MY LATEST FINDINGS ON THE ASSOCIATION BETWEEN PRE DIABETES AND CARDIOVASCULAR RACE. I KNOW HOW CONFLICT OF INTEREST TO DISCLOSE AND THESE OBJECTIVES OF MY PRESENTATIONS AND FIRST I WILL BE PROVIDING YOU AN OVERVIEW OF THE EPIDEMIOLOGY OF DIABETES WITH A SEX SPECIFIC PERSPECTIVE AND I WILL SPEND MORE TIME PROVIDING YOU SOME MECHANISMS FOR THE SEX DISPARITIES AND SUCH AS IMPLICATIONS OF SEX HOR MONTHS AND MORE SEVERE METABOLIC PHENOTYPE FOR WOMEN AND MEN AND PARTICULARLY I WILL COVER THE ROLE OF PRE DIABETES AND UNDIAGNOSED DIABETES IN SEX DISPARITIES. I WILL ALSO COVER OTHER BIOLOGICAL RISK FACTORS THAT POTENTIALLY FURTHER EXPLAIN THIS SEX DISPARITY. SO GLOBALLY, THERE ARE MORE MEN DIAGNOSED WITH DIABETES. DIABETES PROBLEMS RISES WITH ADVANCING AGES IN BOTH SEXES. REACHING THE HIGHEST RATES IN A VERY OLD WOMAN. THERE ARE MORE WOMEN DIAGNOSED WITH PRE DIABETES THAN MEN AFTER THE GLOBAL SCALE. IN THE U.S. HE CAN SEE VARIED BY RACE AND ETHNICITY. THE PREVALENCE OF DIABETES IS HIGHER IN WOMEN THAN MEN IN ALASKA NATIVES AND HISPANICS AND MEN IN ASIAN AND WHITE GROUPS. IN NON HISPANIC BLACKS, THE DIABETES RATE IS ALMOST EQUIVALENT IN MEN AND WOMEN. DIABETES IS ASSOCIATED WITH COMPLICATIONS AND THE MORTALITY IN DIABETES IS NOT CAUSED BY DIABETES PER SE BUT RATHER IT'S DUE TO DIABETIC COMPLICATIONS AND THE MOST COMMON CAUSE OF THAT IN THOSE TYPE 1 AND TYPE-2 DIABETES IS CBD. IT ACCOUNTED FOR HALF IN THE DIABETES AND NOTABLY, THERE IS A SEX DISPARITY THAT IS FEMALE PATIENTS FACE A HIGHER RACE OF BOTH FATAL AND NON FATAL SEVERITY COMPARED TO MALE PATIENTS. AND THESE ARE THE PROVEN ANALYSIS FROM 60 COHORTS AROUND THE WORLD BY THE YEAR OF 2014. THEY'RE RACE SHOWS THAT DIABETES CONFERS A 44% GREATER RISK FOR CHRONIC HEART DISEASE CHD IN 27% HIGHER RISK OF STROKE IN WOMEN COMPARED TO MEN AND SO WHAT IS THE REASONS FOR THIS SEX DISPARITY IN DIABETICS, THE MECHANISMS ARE NOT FULLY RISKS. SOME MAY BE THE RESULT OF WOMEN'S POOR MANAGEMENT AND TREATMENT OF RISK FACTORS. HOWEVER, MANAGEMENT AND TREATMENT ALONE DO NOT FULLY EXPLAIN WOMEN'S DISADVANTAGE. MORE EVIDENCE SUGGESTS THAT BIOLOGICAL DIFFERENCES BETWEEN MEN AND WOMEN UNDER PAYING THE HIGH-RISK OF DIABETES RELATED CART YO VASCULAR COMPLICATIONS. AND FOR EXAMPLE, THE IMPLICATION OF MENOPAUSE TRANSITION, THE USE OF SEX OR MONTHS AND IN OUR PREVIOUSLY ANALYSIS BASED ON OBSERVATIONAL COHORTS, WE FOUND THAT MENOPAUSE REPRESENTING THE EARLY LOSS OF ESTROGEN SIGNIFICANTLY AUGMENT CARDIOVASCULAR RATES IN WOMEN WITH PREEXISTING DIABETES. THEY WE FOUND THE USE OF HORMONE REPLACEMENT THERAPY, ESPECIALLY EARLY USE OF THE THERAPY IS ASSOCIATED WITH THE RISK REDUCTION OF SEVERITY AND WOMEN WITH PRE DIABETES AND OR TYPE-2 DIABETES. MANY ALSO SPECULATE THAT WOMEN EXPERIENCE A GREATER DETERIORATION IN RISK FACTORS COMPARED TO MEN IN THE TRANSITION FROM NORMAL GLYCEMIA TO DIABETES AND THIS GRAPH SHOWS YOU THAT WOMEN NEED TO PUT ON MORE WEIGHT ESPECIALLY IN THE ABDOMINAL AREA OR A MORE LIKELY TO HAVE A DIAGNOSIS OF DIABETES. AS OPPOSED TO MEN WHO CAN BE DIAGNOSED WITH DIABETES AS A LOWER RATE AND NORMAL FAT DISTRIBUTION. WOMEN HAVE A STRONGER ASSOCIATION OF ABDOMINAL FAT. TO VERIFY IF WOMEN HAVE A SEVERE METABOLIC RISK PHENOTYPE BEFORE DIABETES, WE DID A COHORT ANALYSIS BASED ON THE RISK IN COMMUNITIES STUDY AND THE ERIC STUDY AND WE EXAMINED A CONTINUOUS BIOMARKER, THE METABOLIC SYNDROME AND WAYS TO AND BLOOD PRESSURE, HDL AND THE GLUCOSE. THE Y AXIS REPRESENTS THE CHANGE OR THE DETERIORATION RATE OF METABOLIC SYNDROME SEVERITY AND THE HIGHER THE NUMBER, THE GREATER THE DETERIORATION. LOOK AT GREEN BARS, ESPECIALLY THE FIRST TWO AND GENERALLY THE PRE DIABETES FACE WILL MAKE EXPERIENCE A SIGNIFICANT GREATER DETERIORATION IN SEVERITY COMPARED TO MEN. WHAT ALSO STRIKES IS THAT EVEN IN THE NORMAL TEST IN THIS NEW LIFE COHORT AND THESE ORANGE BARS, THE CHANGE OF THE RISK OR IS STILL GREATER IN MORE THAN COMPARED TO MEN SO OUR FINDINGS SUGGEST THAT IT'S PRE DIABETES, HAVE ADVERSE METABOLIC RISK PROFILE WHICH POTENTIALLY PUTS THEM AT A HIGH-RISK OF SEVERITY LATER IN LIFE. SO WE FOUND PRE DIABETES IS A ASSOCIATE WITH THE WORSE METABOLIC RISK PROVIDER COMPARED TO MEN AND WE WONDERED TO WHAT EXTENT PRE DIABETES HAS THE RISK OF SEVERITY AND HOW THE MAPPINGS OF THIS ASSOCIATION VARIES BY SEX AND SO WOMEN HAVE A HIGHER PREVALENCE OF UNDIAGNOSED DIABETES WE WANT THE FACTS OF DELAYED DIAGNOSIS AND AND THIS PROLONGED TIME AND ALSO SERVE AS EXPLANATION AND HIGH-RISK SA SEVERITY AND TO UNDER THIS QUESTION WE HAVE ANALYSIS BASED ON THREE COMMUNE BASED COHORTS AND THE STUDY AND STUDY AND THE JACKSON HEART STUDY AND PRE DIABETES AND UNDIAGNOSED DIABETES IS ASSOCIATED WITH GREATER MAGNITUDE OF IN WOMEN THAN IN MEN AND WE HAVE THREE SETS OF OUTCOMES INCLUDING HEART DISEASE, COMPOSED BY MIO CARDIO INFECTIONS, AND PROCEDURES AND WE ALSO INCLUDE TWO MAJOR TYPES OF STROKES AND A COMPOSITE OUTCOME INCLUDING ANY CONDITION INVOLVED. WE DEFINE OUR EXPOSURE PRE DIABETES BASED ON THE AMERICAN DIABETES ASSOCIATION CRITERIA AND THAT IS FASTING GLUCOSE 100 TO 125 AND 5.7 TO 6.4. WE DEFINE UNDIAGNOSED DIABETES BY FASTING GLUCOSE LEVEL OVER 126 OR OVER 6.5 WITHOUT A PREVIOUSLY DIAGNOSIS OF DIABETES FOR MEDICATION USE AND WE PERFORMED PROPORTIONAL HAZARD MODELS ADJUSTED CAREERS LISTED HERE AND THIS IS OUR EXAMPLES SELECTION PROCESS. AFTER EXCLUDING THOSE PROBLEMS, SEVERE CASES AND THOSE WITH PREVIOUS DIAGNOSIS OF DIABETES, THOSE WITH MEETING THE OUTCOMES WE HAVE A SAMPLE OF OVER 80,000 INDIVIDUALS IN OUR ANALYSIS AND FROM HERE, I PRESENT YOU THE ANALYSIS CELLS AND THIS IS SHOWING YOU THAT PRE DIABETES IS A SIGNIFICANTLY ASSOCIATED WITH WAYS OF CHRONIC HEART DISEASE AND STROKE AND COMPOSED OUTCOME IN WOMEN. BUT NOT IN MEN. IT'S STRONGER IN WOMEN THAN IN MEN. WE FURTHER STRATIFIED RACIAL GROUPS. SIMILAR FINDINGS PRESENT HERE IN WHITE AND THAT IS THERE IS A SIGNIFICANT ASSOCIATION BETWEEN PRE-DIABETES AND WE'RE SEVERE OUTCOMES IN WHITE WOMEN BUT NOT IN WHITE MEN AND NON HISPANIC BLACKS, THE ASSOCIATION DID NOT REACH STATISTICAL BLACKS AND INDICATING BLACK WOMEN HAVE A HIGHER RISK OF SEVERITY WITH PRE-DIABETES. NEXT, WE EXAMINED THE ASSOCIATION OF UNDIAGNOSED DIABETES AND EVEN MORE STRIKING SEX DIFFERENCES APPEARED, SOME ATTITUDES OF CARDIOVASCULAR RACE ASSOCIATED WITH UNDIAGNOSED DIABETES IS STRONGER IN WOMEN COMPARED TO MEN. SIMILAR FINDINGS APPEARED IN RACIAL STRATIFIED ANALYSIS AND ESPECIALLY NON HISPANIC WHITES. THESE INCLUDE WOMEN SPECIFIC CONDITIONS OR RISK FACTORS AND THE POLICY CYSTIC OVARY SYNDROME, PCOS, GESTATIONAL DIABETES, REPRESENT INTER PLAY OF SEX, HOR MONTHS AND MASS KULAR DYSFUNCTION AND INSULIN RESISTANCE. AND SOME RESEARCH ALSO SUGGESTS THAT WOMEN HAVE A HIGHER SUSCEPTIBLE TO PSYCHO SOCIAL STRESS AND THERE ARE SEX DIFFERENCES IN NONTRADITIONAL RISK FACTORS AND SUCH AS BIOMARKERS IN INFLAMMATION, FUNCTION, AND THERE ARE ALSO GENETIC INFLUENCERS AND SO NEW ASSOCIATION STUDIES AND THEY FOUND SPECIFIC IN INVOLVED IN THE REGULATORY FUNCTIONS OF ADD A POSE AND INSULIN BIOLOGY AND I WAS MORE AND MORE STUDIES, THESE SEX SPECIFIC IS A CAUSEWAY OF DIABETES CAN BE FURTHER EXPLAINED. TO SUMMARIZE, THE HIGHER CARDIOVASCULAR RACE ASSOCIATED WITH DIABETES IN WOMEN IS DUE TO POOR MANAGEMENT AND TREATMENT AND MORE SO DUE TO BIOLOGICAL DIFFERENCES BETWEEN SEXES. WOMEN HAVE A GREATER DOUGH TIERATION IN RISK FACTORS BEFORE DIABETES AND PRE-DIABETES AND UNDIAGNOSED DIABETES HAVE A STRONGER ADVERSE IMPACTS ON CARDIOVASCULAR RATES IN WOMEN COMPARED TO WOMEN SUCH AS THE IMPORTANCE OF DIABETES SCREENING AND EARLY INTERVENTION TO PREVENT OR DELAY THE ONSET OF DIABETES AND PARTICULARLY IN WOMEN. THERE ARE DEFINITELY MOR WORK TO GO DOWN TO EXPLAIN AND REDUCE THIS SEX DISPARITY. THIS INCLUDES IDENTIFYING SEX SPECIFIC RISK FACTORS FOR DIABETES DIAGNOSIS AND PROGNOSIS. WITH MORE EMPIRICAL EVIDENCE, RESEARCHERS CAN DESIGN AND IMPLEMENT SEX AND EDUCATION AND SUPPOSE SORT PROGRAMS AND FOR PEOPLE WITH HIGH-RISK OF DIABETES AND SEVERITY. I WANT TO THANK AGAIN FOR THE SUPPORT FROM THE NIH OFFICE OF RESEARCH AND WOMEN'S HEALTH AND ALSO OUR PROGRAMS. THAT SUPPORTS AND FOUND MY RESEARCH IN SEX DIFFERENCES OF DIABETES AND CARDIOVASCULAR COMPLICATIONS AND I'M VERY GRATEFUL FOR THE SUPPORT FROM ALL THE BIRCWH ASSOCIATES AT TULANE. ALSO I THANK MY COLLABORATORS AND OTHER FUNDING SOURCES THAT SUPPORTED MY RESEARCH PROGRAM. AND ALSO, THANK YOU FOR YOUR ATTENTION AND BEING HERE FOR MY PRESENTATION AND WELCOME ALL THE COMMENTS AND QUESTIONS. >> THANK YOU SO MUCH. LISA BEGG HERE, IF I CAN ASK THE THREE PODIUM SPEAKERS TO PUT THEIR CAMERAS ON AND IT WILL BE JUST I THINK THE FOUR OF US ON THIS SCREEN AND WE HAVE ONE QUESTION THAT IS COMING IN BUT I JUST WANT TO STATE, THAT WE'RE HEARING FROM SOME OF YOU THAT I GUESS THERE'S A Q&A TAB OR A SECTION THAT YOU ARE PUTTING QUESTIONS IN AND SOMEHOW WE, MEANING THE NIH FOLKS IN OUR CONTRACTORS, DON'T SEE SO THEY'RE DOING SOME TROUBLESHOOTING AND WE HOPE TO GET THAT REINVOLVED. IF WE DON'T, WE'LL ASK THE VIRTUAL FOLKS IS THAT THEY CAPTURE THE QUESTIONS AND WE'LL GET BACK TO YOU. THIS IS A MYSTERY TO US. THERE'S ONE QUESTION THAT CAME IN AND SO FASCINATING FINDINGS ON THE HIGHER CO MORBID RISK IN PREGNANT WOMEN STARTED ON MEDS POST DISCHARGE. BY ANY CHANCE, DID YOU LOOK AT FACTORS SUCH AS SEX IS THE BABY, SINGLETON VERSUS NON SINGLETON BIRTH, FIRST OR PRIOR PREGNANCY ACROSS COHORTS. >> YEAH, THANK YOU SO MUCH FOR THAT QUESTION. SO, WE DID LOCK AT SOME OF THE FACTORS AND I APOLOGIZE -- I DIDN'T SHOW THAT DATA BUT IT WASN'T DIFFERENT SO LOOKING AT FEMALE VERSUS MALE SEX. WE HAVE NOT LOOKED AT SINGLETON'S VERSUS MULTIPLES WHICH I THINK IS A REALLY INTERESTING QUESTION AND IT'S OBVIOUSLY GOING TO BE A RELATIVELY SMALL NUMBER ARE YOU ALSO LOOKING AT OTHER METRICS LIKE CAREGIVING INTENSITY, WHICH THEY'RE DEFINING AS CARE, THE NUMBER OF CAREGIVING TASK PERFORMED. DO YOU HAVE ANY COMMENTS ON THAT? >> YEAH, IT'S A REALLY GOOD QUESTION AND UNFORTUNATELY THE HRS DOESN'T REALLY ALLOW US TO DISAGGREGATE WHICH TASK PEOPLE ARE HELPING WITH AND WE DO HAVE INFORMATION ON WHICH SPECIFIC DISABILITIES PEOPLE ARE HELPING WITH AND SO WE CAN GET A LITTLE BIT AT THAT BUY LOOKING THE THE NUMBER OF DISABLING CONDITIONS THAT OLDER ADULTS ARE EXPERIENCING AND COMPARE THAT TO THE NUMBER OF HOURS THAT CAREGIVERS ARE REPORTING. YOU KNOW, I'VE TRIED TO LOOK AT CAREGIVING INTENSITY AND SOME OTHER RESEARCH AND WHAT WE'RE FINDING IS THAT IT'S, YOU KNOW, THERE ARE SPECIFIC DISABILITIES ASSOCIATED WITH GREATER CAREGIVING INTENSITY AND SPECIFICALLY THOSE HELPING WITH BATHROOM AND TILE ETING TASKS AND INDIVIDUALS TO NEED HELP EATING AND THOSE TWO SEEM TO STICK OUT AS VERY, VERY IMPORTANT IN TASKS THAT MIGHT REPLAYER, A EXAMINATION SO WE DON'T HAVE SPECIFIC INFORMATION ON WHICH ADO DISABILITIES ARE PEEPING ARE HELPING WITH, PEOPLE ARE EXPERIENCES PARTICULAR DISABILITIES. >> GOOD, THANK YOU. I HOPE THAT ANSWERS THE QUESTION. A QUESTION ABOUT THE SEVERE MEDICINMETABOLIC PHENOTYPES AND IF IT'S CORRECT, THE METABOLIC SYNDROME SEVERITY DO YOU WANT TO IMPLEMENT THAT A LITTLE BIT. >> YES, SO THIS IS A QUESTION I THINK MANY PEOPLE ARE SPECULATING FOR ALMOST 10 YEARS IN THE LITERATURE. THAT S. YOU KNOW, WHEN THEY FOUND THAT THERE'S A SEX DISPARITY THAT WOMEN TEND TO HAVE A HIGHER RATE OF CHD AFTER THEY DYING KNOWS WITH DIABETES AND THEN PEOPLE ARE SPECULATING THAT SO BEFORE, AT THE TIME OF DIAGNOSIS, DO WOMEN ALREADY HAVE A WORSE METABOLIC RISK PROFILE COMPARED TO MEN THAT THEY ALREADY SITTING ON THE WORSE SHAPE AND WHICH YOU KNOW, THE PRO DISPOSED THEM TO A HIGHER RISK OF CBD SO OUR ANALYSIS USING THE DATA COHORT IS REALLY TRYING TO VERIFY THIS HYPOTHESIS AND WE DID FIND THAT YOU KNOW, USING THIS COMPOSITE INCLUDING ALL THOSE TRANSITIONAL RISK MARKERS WE FIND THAT WOMEN'S METABOLIC SEVERITY THEY DETERIORATED IN A FASTER RATE COMPARED TO MEN IN THE PRE-DIABETES STATE. SO THIS IS, I THINK THIS IS NOT OUR ORIGINAL HYPOTHESIS BUT WE DID USE A VERY GOOD COHORT DATA. >> GOOD, THANK YOU. VERY COMPLICATED SITUATION TO TRY TO ANNA TO AN ANALYZE, WE HAVE ANOTHER Q DO YOU WANT ME TO READ IT TO YOU? >> I THINK I SEE IT. >> IF THE FREQUENCY OF MEDICATION ADMINISTRATION OR PERCEIVED BURDEN WAS ASSESSED FOR THOSE ON MEDICATIONS POST DISCHARGE AND YES, YOU KNOW, MOST OF THE APPROVED MEDICATIONS ARE NOT EXTENDED WHICH COULD REQUIRE MULTIPLE PILLS MULTIPLE TIMES A DAY THAT IS VERY TRUE AND WE CERTAINLY NEED BETTER PHARMACOLOGIC AGENTS THAT HAVE GOOD SAFETY DATA FOR USE IN PREGNANCY AND IN BREASTFEEDING AND SO WE ASSESSED BURDEN OF -- WE DIDN'T SPECIFICALLY SEPARATE MEDICATIONS FROM BURDEN OF PARTICIPATION IN THE PROGRAM, BUT WE ASSESSED BURDEN OF PARTICIPATE IN THE PROGRAM WHICH INCLUDES TAKING MEDICATIONS, MEASURING BLOOD PRESSURE, AND WE HAVE VERY FAVORABLE DATA FROM THAT IN TERMS OF PARTICIPANTS RECORDING THE HIGH SATISFACTION WITH PARTICIPATION AND I WILL SAY IN TERMS OF KIND OF OUR PRACTICE, THE MAJORITY OF PEOPLE WHO ARE STARTING ON MEDICATIONS POST HOSPITAL DISCHARGE WE TRY TO USE EXTENDED RELEASE MEDICATION AND SO THAT TWO-THIRDS OF PEOPLE WHO ARE STARTING ON MEDICATIONS, AFTER HOSPITAL DISCHARGE WERE STARTED ON THAT BECAUSE OF THE INCREASE CLEARANCE IN THE POSTPARTUM STATES IT HAS TO BE TWICE A DAY CLOSINCLOSE DOSING BUT IT'S MORE COMMON DATA BLOCKERS WHICH MIGHT BE THREE TIMES A DAY WHICH IS A SIGNIFICANT BURDEN FOR INDIVIDUALS THAT MAY ALSO BE CARRYING FOR A NEWBORN OR HAVE A BABY IN THE NICU SO IT'S A GREAT POINT AND IT HIGHLIGHTS THE FACT THAT THIS IS A REALLY VERY UNDER STUDIED AREA AND IN REGARDS TO MEDICATION AND SAFETY AND IT ENDS UP INCREASING BURDEN ON PREGNANT AND POSTPARTUM INDIVIDUALS. >> THANK YOU FOR THAT AND JUST HIGH COMMENTARY AND I HOPE YOU WILL CONTINUE TO STUDY THIS BECAUSE IT SEEMS THERE SHOULD BE SOME POLICY CHANGES SO IT'S REALLY A PUBLIC-HEALTH ISSUE AS WELL IS THE MEDICAL MANAGEMENT ISSUE, DO YOU WANT TO COMMENT ON THAT? >> I THINK I AM AT AN INSTITUTION THAT HAS THIS KIND OF ROBUST HOME BLOOD PRESSURE MONITORING PROGRAM AND WHO HAS REALLY INVESTED BEING ABLE TO DO THIS FOR OUR PATIENTS BUT I THINK THAT IS NOT THE CASE EVERYWHERE AND THERE'S A LOT OF AREAS IN THE COUNTRY THAT DON'T HAVE ACCESS TO BLOOD PRESSURE COX THAT MAY NOT HAVE BROADBAND ACCESS TO SEND IN BLOOD PRESSURE TO THEIR CARE TEAM. MOST IN 99% OF HEALTH INSURANCE WON'T COVER HOME MONITORING OR BLOOD PRESSURE MANAGEMENT WHEN IT'S DONE REMOTELY AND NOT DONE IN A PHYSICAL OFFICES AND SO THERE'S CERTAINLY MAJOR POLICY IMPLICATIONS THAT REALLY LIMIT THE ABILITY OF A LOT OF THE POPULATION TO BE ABLE TO ACCESS THIS TYPE OF CARE AND MANAGEMENT THAT I THINK OUR DATA SUGGESTS THAT IS PROBABLY REALLY CRITICAL AND ACTUALLY STARTING TO REDUCE HYPERTENSION RELATED MORBIDITY IN THE POSTPARTUM PERIOD. >> ONE FINAL PLUG FOR ORWH, WE HAVE A CENTRAL WEBSITE ON OUR HOME PAGE AND Dr. CLAYTON HAS WORKED ACROSS NIH IN ACTUALLY ACROSS THE FEDERAL GOVERNMENT SO THIS IS AN AREA IN GENERAL, MATERNAL MORBIDITY AND MORTALITY THAT OUR OFFICE TAKES SERIOUSLY SO THANK YOU FOR THAT. Dr. CANTU, I THINK IT'S A COMMENT FROM Dr. MACKIE. THANK YOU FOR YOUR WORK IN THIS AREA AND IT FILLS AN IMPORTANT GAPS. THE OTHER WORK, DAUGHTERS PROVIDE MORE CARE THAN SONS SO BURDEN THERE AND WOMEN IS HIGHER. DO YOU WANT TO COMMENT ON THAT. >> I THINK IT'S AN IMPORTANT POINT AND I THINK IT'S ONE OF THE THINGS MISS INTERESTING THIS CURRENT ALANAL SIS IS WE AREN'T LOOKING CAREGIVERS BEYOND CATEGORIZING THEM AS SPOUSES, CHILDREN, NON FAMILY MEMBERS, OTHER FAMILY MEMBERS BUT I THINK THERE'S IMPORTANT WORK TO BE DONE THERE AND LOOKING AT THE GENDER OF THE ACTUAL CAREGIVERS THEMSELVES AND ANY SENSE IS THAT THE VAST MAJORITY OF THE CARE THAT'S BEING DELIVERED IN THIS POPULATION IS COMING FROM DAUGHTERS AND WIVES SO YOU KNOW, I THINK THAT ONE OF THE SORT OF OUTSTANDING QUESTIONS THAT I'M LEFT FROM THIS RESEARCH IS SO, WE GET THIS SENSE THAT WOMEN ARE DELIVERING MORE CARE AND WOMEN ARE NEEDING MORE CARE BUT WHAT I REALLY WANT TO KNOW AND WHAT RESEARCH HAS KIND OF NOT GOT TO IS WHAT IS THE NET EFFECT OF THESE CAREGIVING RELATIONSHIPS AND OF THIS CARE SO IS THIS CARE LEADING TO BETTER OUTCOMES? SOME RESEARCH LOOKING AT INFORMAL CARE HAS SHOWN THERE'S NOT REALLY A RELATIONSHIP WITH REDUCING MEDICARE COSTS BUT IT DOESN'T GET AT THE OUTCOME. THAT I MENTIONED. HOW DOES IT EFFECT PEOPLE'S WELLBEING AND WHILE THEY'RE EXPERIENCING HEALTH PROBLEMS? HOW DOES IT EFFECT PEOPLE'S WELLBEING SORT OF LONG-TERM AND I THINK THAT THE HRS MIGHT BE ONE AVENUE WE CAN GET THOSE QUESTIONS. >> ANOTHER IMMENSE PROBLEM FOR RESEARCH AND PUBLIC-HEALTH IMPLICATIONS SO THANK YOU FOR THAT. WE HAVE TIME FOR ONE MORE QUESTION SO I'M GOING TO GO TO YOU. YOU MENTIONED SOMETHING ABOUT POOR MANAGEMENT AND TREATMENT AND DO YOU COMMENT ON THAT. WAS IT JUST ANECDOTAL OR -- >> YES, YES, ABSOLUTELY. SO, WE KNOW THERE'S A HISTORICAL GAP THAT WOMEN RECEIVES LESS AGGRESSIVE TREATMENTS ON THE RISK FACTORS. SO, I'M NOT AN EXPERT IN THIS FIELD BECAUSE I FOCUS ON BIOLOGICAL RISK FACTORS BUT I THINK YOU KNOW, EVEN IN THE PAST 20 YEARS WE'VE SEEN THIS GAP IS GETTING SMALLER AND STILL, I THINK WOMEN STAND IN A DISADVANTAGE IN TERMS OF MANAGEMENT AND TREATMENTS AND SO THIS IS IMPLICATED IN COVID-19. PART OF MY RESEARCH IS SEEING THE SEX DIFFERENCES IN CHRONIC DISEASE MANAGEMENT DURING COVID-19 AND WE SEE THAT YOU KNOW, THESE CHRONIC CONDITIONS ARE POORLY MAN NOTED IN WOMEN COMPARED TO MEN WHICH LEAD TO MORE SEVERE OUTCOME IN WOMEN SO I THINK MAYBE IF IT'S GOING TO BE DELIBERATED IN MY DIABETES RESEARCH A LITTLE BIT. >> GOOD AND WE'LL BE HAPPY TO HELP FACILITATE WITH ALL OUR SCHOLARS THE INTERACTIONS WITH OUR IC PARTNERS SO FEEL FREE TO LET US KNOW AND WORK WITH YOUR PIs AND SO FOURTH. I WANT TO THANK ALL THREE OF YOU FOR A WONDERFUL SESSION. AND WE APPRECIATE IT VERY MUCH. AND I AM GOING TO TURN IT OVER INFORM Dr. TIGNO FOR OUR LEGACY OF LEADERSHIP. >> THANK YOU, LISA AND HELLO AGAIN, EVERYONE. IN 2020, ON THE 30th ANNIVERSARY OF THE ORWH AND THE 20th ANNIVERSARY OF THE BIRCWH PROGRAM, Dr. JANINE CLAYTON CREATED THE LEGACY OF LEADERSHIP LECTURE TO HONOR WOMEN RESEARCH, RESEARCH ADMINISTRATION AND ADVOCACY. EACH YEAR SINK THE ORWH INVITES A DISTINGUISHED FEMALE SCIENTIST WHO NOT ONLY EXEMPLIFIES WHAT WE AS PAIR FOR AS SCIENTISTS BUT ALSO EMBODIES REMARKABLE LEADERSHIP SKILLS THAT INSPIRE AWFUL US TO CREATE AND CONTRIBUTE TO A BETTER AND HEALTHIER FUTURE. IN THE PAST, WE WERE HONORED TO HAVE Dr. CLAIRE STICK STIKR AND CREDIT -- THIS YEAR IT'S MY PRIVILEGE TO INTRODUCE Dr. JUDITH A. JAMES, VICEROYS OF CLINICAAT THEOKLAHOMA MEDICAL RESEARCH FOUNDATION OR OMRF. SHE'S ALSO THE ASSOCIATE VICE PROVOST FOR CLINICAL INFORMATIONAL SCIENCE AND PROFESSOR OF MEDICINE IN PATHOLOGY AT THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER. Dr. JAMES GRADUATED FROM THE OKLAHOMA BAPTIST UNIVERSITY AND THE FIRST GRADUATE OF THE UNIVERSITY OF OKLAHOMA PROGRAM AND SHE COMPLETED HER INTERNAL RESIDENCY AND HUM Dr. JAMES RESEARCH IS FOCUSED ON DISEASES THAT ARE IN WOMEN. A PRACTICE BEING RHUMATOLOGIST, SHE SEEKS TO UNDERSTAND THE IDEOLOGY AND PATHOGENESIS OF LUPUS, MECHANISMS OF AUTO ANTIBODIES IN SYSTEMIC DISEASE AND THE INTER PLAY OF GENETIC RISK AND ENVIRONMENTAL RESPONSES IN SYSTEMIC AUTOIMMUNITY AND THE UNIQUE DRIVERS OF DISEASE SEVERITY IN NATIVE AMERICAN AUTOIMMUNE RHEUMATIC DISEASE PATIENTS. SHE HAS MADE CONTRIBUTIONS TO UNDERSTANDING ALL AUTOIMMUNE DISEASES START AND THE CONCEPT OF EPITOPE SPREADING AND EARLIER IN HER CAREER, AND A YEAR AFTER MEDICINE SCHOOL, SHE RECEIVED THE PRESTIGIOUS PRESIDENTIAL EARLY CAREER AWARD FOR SCIENTISTS AND ENGINEERS. Dr. JAMES HAS RECEIVED WHAT MANY OF US DO NOT EVEN DARE TO DREAM OF, A MILE-LONG LIST OF NIH FUNDED GRANTS FROM MULTIPLE INSTITUTES OF THE NIH AND NOT JUST THE AREs BUT Us AND Ps WHICH ARE CURRENT, PEND ORGANIZE COMPLETED. SHE HOLDS A DOZEN PATENTS OR MORE AND IN ADDITION TO HAVING PUBLISHED OVER 330 SCIENTIFIC ARTICLES. Dr. JAMES' CV IS 90 PAGES LONG AND SHE'S THE BRING PEL PRINCIPLE FOR SEVE RAL GRANTS TO INCLUDED AMONG THEM ARE THE U54 OKLAHOMA SHARED CLINICAL AND TRANSLATIONAL RESOURCES, GRANT FROM NIH EMS AND THE AUTOIMMUNITY CENTER OF EXCELLENCE FROM NIAID WHERE SHE IS THE NATIONAL CLINICAL CO-CHAIR AND THE UC HE CAN SELL RATING MEDICINE PARTNERSHIP IN AUTOIMMUNE MITIGATE DISEASES OR THE AMP-AIM, WHICH IS FUNDED FROM THE FOUNDATION FOR NIH AS WELL AS IN COLLABORATION WITH SEVERAL NIH CENTERS AND PARTICULARLY THE NAIMS AND WHERE SHE SERVESES A THE NATIONAL CHAIR AND THE RHEUMATIC DISEASE RESEARCH COURSE FROM NAIMS. OF NOTE, Dr. JAMES ALSO IS INVOLVED IN STRENGTHENING THE BIOMEDICAL RESEARCH CAPACITY AND TRAINING OF ETHNIC MINORITIES IN THIS CASE, MOSTLY NATIVE AMERICANS FROM SUPPORT FROM A SUPPLEMENT GRANT FROM NIGMS. Dr. JAMES CONTINUES TO REAP MULTIPLE NATIONAL AND INTERNATIONAL AWARDS AND INCLUDING THE LECTOR SHIP FROM THE AMERICAN COLLEGE OF RUM A TOLL GOUGH AND THE EVELYN HESS A WORD FOR LUPUS RESEARCH AND THE STANLEY COURSEMIRE AWARD FROM THE AMERICAN SOCIETY OF CLINICAL INVESTIGATIONS. SHE WAS A MEMBER OF THE NAIMS COUNCIL AND SERVED AS THE ELECTED SECRETARY, TREASURER OF THE AMERICAN SOCIETY OF CLINICAL INVESTIGATION. AND AS Dr. CLAYTON MENTIONED EARLIER, SHE WAS ELECTED TO THE NATIONAL ACADEMY OF MEDICINE AND ALSO TO THE ASSOCIATION OF AMERICAN PHYSICIANS. LADIES AND GENTLEMEN, Dr. JUDITH JAMES. >> HELLO THANK YOU FOR JOINING US TODAY AND I'M VERY EXCITED AND ACTUALLY VERY HONORED TO BE ASKED TO GIVE THIS LECTURE. SO, I'M GOING TO TALK JUST BRIEFLY ABOUT KIND OF THE WINDING ROAD TO RESEARCH AND SOME LESSONS THAT I'VE LEARNED ALONG THE WAY. SO I HAD TO HAVE A LITTLE BIT OF SCIENCE BECAUSE YOU CAN'T GIVE A SCIENTIST POWERPOINT SLIDES AND NOT LET US SHOW SCIENCE BUT ALL OF THE RELATE BACK TO SOME OF THESE LESSONS. AND SO, ONE OF THE FIRST LESSONS THAT I'D LIKE TO TALK ABOUT IS THERE ARE MANY, MANY DIFFERENT PATHS. IN RESEARCH AND YOU JUST HAVE TO FIND YOUR OWN WAY. ALL OF THIS WILL HAVE DIFFERENCES. I GREW UP A FARM OUTSIDE OF A TOWN LESS THAN 1,000 PEOPLE AND I WAS SO I FEW FROM A YOUNG AGE BECAUSE I HAD SEVERE ASTHMA I WANTED TO BE A PHYSICIAN. I TOLD MY PHYSICIAN THIS AND I TOLD ME IF I WOULD BE A NURSE HE WOULD BE HAPPY TO HIRE ME IN A COUPLE DECADES BUT I NEVER SWAYED FROM THAT PATH OF WANT TO GO DO WHAT I THOUGHT WAS MEDICINE BUT THE FIRST I ROUNDED WITH A PHYSICIAN THEY SAID I ASKED TOO MANY QUESTIONS TO WANT TO PRACTICE FOR ALL MY LIFE SO THEY ENCOURAGED ME TO FIND A RESEARCH OPPORTUNITY AND SO FOR THOSE OF YOU THAT MAY NOT HAVE SUCCEEDED THE VERY FIRST TIME THAT YOU A EMPLOYED TO SOMETHING, I ACTUAL LOW HAD TO A PLOY THROW TIMES TO BE SELECTED FOR SOME UNDERGRADUATE RESEARCH PROGRAM AND IT WAS BECAUSE I CAME FROM A BACKGROUND WHERE I DIDN'T HAVE EXPOSURE FOR SCIENCE EXCEPT FOR HAVING A PHENOMENAL HIGH SCHOOL SCIENCE TEACHER. I WAS DROPPED INTO AN NIH FUNDED RESEARCH LAB AND I WANTED TO WORK ON ALLERGY AND ACE MA BUT THERE WAS NO ASTHMA RESEARCH HAPPENING IN OKLAHOMA AND THAT LED ME TO MY SECOND LESSON I'D LIKE TO TALK ABOUT AND IT'S ABOUT THE FACT THAT THE RESEARCH ROAD IS MUCH EASIER WHEN YOU REALLY FIND YOUR PASSION. AND WHAT YOU ARE EXCITED ABOUT. AND THAT SUMMER, I FOUND MY PASSION. THAT WAS AUTOIMMUNE DISEASES AND SO AUTOIMMUNE DISEASES ARE WHEN YOUR HUMAN IMMUNE SYSTEM ATTACKS YOURSELF AND IT'S VERY, VERY COMMON AND THIS ONE SAYS 1/5 IT'S PROBABLY 1/8 AMERICANS AND OVER 75% OF THOSE HAPPEN TO WOMEN IN WOMEN OF CHILD BEARING AGE SO WE SEE SIGNIFICANT ENRICHMENT IN COMMUNITIES OF COLOR AND SO AFRICAN AMERICAN, NATIVE AMERICAN AND LATINO PATIENTS AND SO THERE ARE MANY, MANY DIFFERENT AUTOIMMUNE DISEASES, PROBABLY OVER 80 AND I'VE BEEN VERY INTERESTED IN THIS SYSTEMIC AUTOIMMUNE DISEASES AND HOW, EVEN WITH THIS SAME GENETIC PREDICTION POSITION, THAT SOME PATIENTS MAY END UP WITH ONE AUTOIMMUNE DISEASE WHILE OTHERS END UP WITH ANOTHER AUTOIMMUNE DISEASE AND SO I FOLLOWED AS A PATIENT UNTIL SHE PASSED AWAY TWO YEARS AGO AND THE OTHER DIED THAT SUMMER. AND SO, THAT REALLY SPARKED MY INTEREST IN HOW CONDITIONS IT'S THE SAME DISEASE COULD EFFECT TWO PATIENTS SO DIFFERENTLY AND BOTH OF THOSE PATIENTS HAD AN AUTOIMMUNE DISEASE CALLED SYSTEMIC LUPUS AND SO LUPUS IS A CLINICALLY AND BIOLOGICALLY VERY DIVERSE AUTOIMMUNE DISEASE WITH THIS COMPLEX PATHOGENESIS AND IT EFFECT EVERY ORGAN SYSTEM IN THE BODY THAT HAS THIS BEAUTIFYING FEATURE OF AUTO ANTIBODY AND PRODUCTION AND MOST PEOPLE DON'T REALIZE THAT LUPUS ACTUALLY STILL REMAINS EVEN THOUGH WE'VE MADE LOTS OF ADVANCES IN THE LAST 60 YEARS AND IT STILL REMAINS A TOP 10 MEDICAL CAUSE OF DEATH IN YOUNG WOMEN AND ESPECIALLY IN YOUNG WOMEN BETWEEN 15 AND 45 YEARS OF AGE. AND YOU CAN SEE HERE THAT IN 15 TO 25-YEARS-OLD, IT'S ONE OF THE TOP 10 IN ALL FEMALES BUT IT'S THE FIFTH HIGHEST CAUSE OF DEATH IN BLACK FEMALES AND LATINA PATIENTS AND SO THIS IS REALLY SPURRED BY INTEREST AND LED ME INTO A CAREER PATH WHERE I FOCUS ON AUTOIMMUNE DISEASES AND I WAS FORTUNATE TO BE THE FIRST PH.D STUDENT AT THE UNIVERSITY OF OKLAHOMA HEALTH SCIENCES CENTER. WHILE I WAS DOING THAT, WE DIDN'T HAVE A MSDP PROGRAM SO I WAS ENCOURAGED TO WRITE A GRANT AND WROTE A F31 THAT WAS FUNDED IN THE SECOND YEAR OF MY PROGRAM. I WAS ABLE, EVEN WHILE DOING SOME OF MY CLINICAL TRAINING, TO RECEIVE LOCAL LUPUS FOUNDATION AWARDS AND STATE AWARD AND THEN THAT LED TO THE PRELIMINARY DATA TO APPLY AND RECEIVE MY KO8 AND THEN RO3 FOR KO8 RECIPIENTS AND WHAT USED TO BE THE FIRST AWARD WHICH IS AN R29 AND IT'S NOW EVOLVED INTO THAT EARLY STAGE INVESTIGATOR RO1 AND SO IN MANY WAYS I WAS REALLY FORTUNATE TO BE ABLE TO FOLLOW THIS KIND OF THE NIH PATH TO BECOME AN INVESTIGATORS AND SO THAT LED TO RO1s AND MY FIRST INTERACTION WITH THE OFFICE O OFFICE OF RESEARCH AND WOMEN'S HEALTH AND IT LED ME TO THIS NEXT LESSON I'D LIKE TO TALK ABOUT WHICH IS THE RESEARCH ROAD IS SELDOM STRAIGHT AND GOOD THINGS CAN HAPPEN WHEN YOU FOLLOW THE SCIENCE, HOPEFULLY MANY OF YOU ALREADY LEARNED THIS DURING YOUR TRAINING PROGRAMS AND YOUR EARLY CAREER STAGES BUT, I THINK THIS IS BEEN ONE OF THE MOST EXCITING AREAS OF RESEARCH IS NOW I KNOW THAT THINGS WILL GO DIFFERENT DIRECTIONS BUT EARLY IN MY CAREER, I ALWAYS FELT LIKE WHEN THINGS DIDN'T QUOTE-UNQUOTE WORK OR WHEN WE DISPROVED THE HYPOTHESIS AND INSTEAD OF PROVING THE HYPOTHESIS, THAT THAT WAS A STUMBLING BLOCK AND NOW I UNDERSTAND THAT ALMOST ALL OF THOSE LEADS TO OTHER SCIENTIFIC OPPORTUNITIES SOMETIMES THAT ARE EVEN BIGGER THAN WHERE YOU REEL PLANNED ON GOING YOURSELF. SO WHEN I STARTED, WE WERE EXCITED LEARNING WHERE OUR ANTIBODIES WERE TARGETING SO PART OF THE PROTEIN, MY BACKGROUND WAS IN CHEMISTRY AND SO WE BUILT TENS OF THOUSANDS OF SOLID PHASED PEPTIDES WHERE WE MAPPED WHERE THE ANTIBODIES WERE FINDINGS SO IF THEY WERE BINDINGS YOU WOULBINDINGS AND WE WOULD IDE NTIFY THE COMMON TARGETS FOR OVER 20 DIFFERENT AUTO ANTIGENS BUT THIS ALSO GAVE US AN OPPORTUNITY BASED ON HAVING SERIAL SAMPLES FROM PATIENTS OVER TIME TO BE ABLE TO SEE HOW THEIR AUTOIMMUNE REPERTOIRE CHANGED OVER TIME AND AS THEY WERE ILL AND SO IN THIS PATIENT, BEFORE SHE HAD ANY SYMPTOMS, BEFORE WE MADE THIS AUTO ANTIBODY SHE WAS THE SISTER OF A LUPUS PATIENT AND SHE DID NOT HAVE A BINDINGS TO THESE PEPTIDES AND THIS PROTEIN WHICH IS PART OF THE COMPLEX AND THEN WHEN SHE FIRST STARTED DEVELOPING SYMPTOMS AND HAD ANTI SM, SHE MADE ANTIBODIES THAT REALLY STRONGLY BOUND TO THESE PEPTIDES AND THAT ACTUALLY WAS A REPEATED MOTIF THAT HAD RICH AND OR PDPGMRP AND THEY MADE ANTIBODIES THAT TARGETED THIS PROTEIN UNTIL SHE HAD A DIVERSE RESPONSE WHEN SHE WAS IN THE ICU AND WE'VE GONE AHEAD AND THIS IS NOW BEEN DECADES AGO AND LOOKED AT OTHER ANTIGENS AND IN AUTOIMMUNE DISEASES WE FOUND THAT WE HAD THIS SIMILAR KIND OF EPITOPE SPREADING WHERE WE WENT FROM HAVING NO ANTIBODIES TO BINDING KIND OF A LIMITED PART OF THE PROTEIN SO HAVING DIVERSE RESPONSES AND IT WAS VERY INTERESTED IN WHAT TRIGGERS THESE VERY EARLY RESPONSES AND SO THIS WAS A PEPTIDE THAT IS AMINO ACIDS STARTED WITH THEM SO THIS IS A 60KD ROW AND WE AFFINITY PURIFIED THIS ANTIBODY AND SHOWED IT CROSS REACTED WITH AN EPSTEIN BAR VIRUS AND WE COULD IMMUNE ICE RABBITS AND MOUSE STRINGS AND DEVELOP NOT ONLY ANTIBODIES TO THE PEP SIDE THAT WE WERE VACCINATING WITH BUT ALSO THAT IN CERTAIN STRINGS OF MICE AND IN RABBITS, THIS WOULD DIVERSIFY AND BIND TO OTHER PARTS OF THE PROTEIN AND ALSO TO THESE CROSS REACTIVE AUTO ANTIGENS AND SO THIS LED TO THIS MOLECULAR HYPOTHESIS THAT WE'VE BEEN ABLE TO DEMONSTRATE FOR SEVERAL DIFFERENT ANTIGENS BUT BEING ABLE TO GO BACK IN TIME, AND REALLY THINK ABOUT WHAT ARE THE FIRST THINGS GOING WRONG, HAS REALLY BEEN A FOCUS OF OUR RESEARCH AND THIS LED TO A PARTNERSHIP WITH THE DEPARTMENT OF DEFENSE AND THE DEFENDANT OF DEFENSE HAS SAMPLES WHEN YOU ENLIST INTO THE MILITARY AND THEY HAVE ABOUT EVERY TWO YEARS AFTERWARDS AND WE PARTNERED WITH DEPARTMENT OF DEFENSE RHUMATOLOGISTS AND WE FOUND PATIENTS WHO LISTED INTO THE MILITARY HEALTHY BUT LATER BECAME LUPUS PATIENTS WE COULD GET SERIAL SAMPL SAMPLES BEFORE DYING KNOW SIS SO WE HAD SAMPLES BEFORE DIAGNOSIS AND SOME AFTER DIAGNOSIS AND WE NOW HAVE BEEN ABLE TO LOOK AT 205 UNIQUE INDIVIDUALS WHO DEVELOPED LUPUS WHILE IN THE MILITARY AND WOVE BEEN ABLE TO TRACK WHAT IS HAPPENING IN THIS PRECLINICAL TIME PERIOD AND SO SOME OF THESE WERE VERY PRESENT IN 70% OF PATIENTS FIVE YEARS BEFORE THEY WERE A LUPUS PATIENT SO YOU CAN SEE THEY'RE THAT EVEN FOR ANTI-ROW AND ANTI LAW THAT 70% OF THESE PATIENTS HAD THESE ANTIBODIES FOR YEARS BEFORE THEY WERE CLINICALLY SICK AND WE HAD OTHER ANTIBODIES LIKE NTSM THAT OCCUR CLOSE TO THE TIME OF DIAGNOSIS AND THESE A AUTO ANTI-ED BO HE'S HAVE UP TO THE TIME OF DIAGNOSIS AND THEN THEY START TO PLATEAU USUALLY WITH THERAPY. AND SO, WE'VE GONE ON TO CHARACTERIZE WHAT OTHER ASPECTS OF THE IMMUNE SYSTEM IS CHANGING BEFORE PATIENTS CLINICALLY ILL AND WE SEE INCREASES IN CHANGES IN THE INNATE IMMUNE SYSTEM AS WELL AS IN DIFFERENT ASPECTS OF THE ADAPTIVE T CELLS AND CYTOKINES AS WELL AS TNF RELATED MOLECULES AND WE SEE THIS LOSS OF SOME ASPECTS OF IMMUNE REGULATION. THIS ALLOWED US TO PUT TOGETHER PREDICTIVE MODELS FOR THE TRANSITION TO LUPUS WHERE WE CAN MERGE AUTO ANTIBODIES WITH THESE DIFFERENT IMMUNE DIS-REGULATED MOLECULES WITH THE MEDIATORS AND DEVELOP BEYOND JUST WHAT WE NORMALLY USE IN CLINICAL PRACTICE WHICH IS JUST AUTO ANTIBODIES TO GET TO WHERE WE HAVE REALLY NICE SPECIFICITY AND POSITIVE PREDICTIVE VALUE WHEN WE ADD SOLO ABLE MEDIATORS TO THESE AUTO ANTIBODIES SO WE'VE GONE TO LOOK AT OTHER GROUPS OF INDIVIDUALS WHO ARE AT HIGH-RISK FOR LUPUS FOR INDIVIDUALS WHO HAVE SYSTEMIC LOOP US AND THAT LED TO THE CREE ACE OF LUPUS FAMILY REGISTRY AN REPOSITORY WHO LED PEOPLE FROM THE UNITED STATES AND OTHER PLACES IN THE GLOBE AND ALSO, THEY'RE UNEFFECTED FAMILY MEMBERS AND SO AFTER SIX YEARS WE WANTED TO RECONTACT THE FAMILY MEMBERS AND SEE IF WE HAD ANY AS WELL AS OTHER SPECIMENS AND SEE HOW MANY OF THEM CAN TRANSITION AND SO, WE FOLLOWED THEM UP ABOUT SIX AND A HALF YEARS LATER TO SEE WHO TRANSITIONS AND THEY DIDN'T TRANSITION AND WE CAN'T HERE AS A POSITIVE RELATIVES THE BLOOD RELATIVES AND THEN MATCH THOSE AGAIN TO A AND A NEGATIVE TO AUTO ANTIBODY NEGATIVE FAMILIES MEMBERS AND THEY WERE MATCHED BASED ON AGE, RACE, GENDER AND THE THINGS YOU WOULD EXPECT AND WHAT WE FOUND WERE THAT WE HAD A NUMBER OF MOLECULES LIKE FOR EXAMPLE, B STIMULATING FACTOR WHICH WAS HIGHER SECURED BEFORE AND THAT VICTIMS WHO TRANSITIONS AND WHO DID NOT AND THE NEGATIVE INDIVIDUALS, AND THIS WAS TRUE FOR OTHER MOLECULES THAT ARE NOT AS WELL STUDIED LIKE STEM CELL FACT OR WHICH OTHER NAME IS LAG INWHERE THIS INCREASES IN THE STAIR STEP WAY AND WE ALSO STRIKINGLY AWE THA -- THEY ARE MUCH HIGHER IN THE AUTO ANTIBODY NEGATIVE FAMILY MEMBERS COMPARED TO THE AUTO ANTIBODY POSITIVE MEMBERS AND THEY ARE STILL HIGHER THAT WHAT WE SEE IN THE PATIENTS WHO TRANSITION. AND THIS SUGGESTS OR SUPPORTS AND THEY ARE TRANSITION TO LUPUS PATIENTS AND THEY ARE ABLE TO COMPENSATE AND DECROWS SO WE HAVE THIS DISREGULATION THAT LEADS TO AUTOIMMUNITY SO THE THINGS THAT COME INTO THIS MODEL THAT MAKE THE BEST PREDICTION IS A ELEVATION OF STEM CELL FACT OR AND DECREASE THE TGF BETA SO THIS IS LEFT US WITH THIS MODEL WHERE YOU HAVE INDIVIDUALS WHO HAVE GENETIC RISK WHO HAVE SOME ENVIROMENTAL TRIGGERS AND AUTO ANTIBODY PRODUCTION, PATHOGENIC AUTOIMMUNITY AND CLINICAL FEATURES OF DISEASE AND SO, THE EXCITING PART OF THIS FOR ME AS A CLINICIAN SCIENTIST THIS IS BEEN ABLE TO HELP US IDENTIFY HIGHER RISK INDIVIDUALS THAT WE CAN ENROLL INTO A PREVENTION STUDY AND SO THIS WAS THE FIRST LUPUS PREVENTION STUDY THAT HAPPENED AND FUNDED BY THE NIH AND IT'S FOCUSED ON ENROLLING INDIVIDUALS WHO HAVE ANTIBODIES PLUS ONE OTHER CLINICAL FACTOR AND WE'RE ENROLLING 240 INDIVIDUALS AND YOUR RANDOMIZED TO RECEIVE HYDROXYCHLOROQUINE OR BE CAREFULLY MONITORED FOR INDIVIDUALS WHO TRANSITION AND SO WE'RE TESTING THIS HIGH-RISK SOL YOU ABLE MEET AIDER TO SEE IF WE CAN IDENTIFY THESE AND THIS PROVIDING US WITH AMAZING SAMPLES TO BE ABLE TO STUDY DIFFERENT HYPOTHESIS AND SO THIS IS THE FOUNDATIONAL WORK WE DO IN OUR LAB AND WE STILL DO A LOT OF WORK FOCUSING ON EARLY ASPECTS OF AUTOIMMUNITY AND ENVIRONMENTAL TRYINGORS AND MECHANISMS OF DISEASE FLARE AND IMPROVING DISEASE OUTCOMES IN THOSE PATIENTS AND DISEASE QUALITY AND OF COURSE THE PINNACLE WOULD BE FOR US IN WORKING ON WAYS TO PREVENT AUTOIMMUNE DISEASES AND SO, IN ADDITION TO KIND OF DOING MY OWN INDIVIDUAL RESEARCH WHICH OF COURSE IS NEVER INDIVIDUAL RESEARCH I'VE HAD WONDERFUL PEOPLE WHO WORKED WITH ME OVER THE YEARS IN THESE DIFFERENT PROJECTS AND I ALSO HAVE BEEN ABLE TO MO MORPH INTO DOING TEAM SCIENCE AND SO THAT IS THROUGH DIFFERENT TIMES OF U WARDS AND LEADING OKLAHOMA EXCELLENCE AND IT'S A U19 SO WE HAVE A CONSORTIUM OF 10 DIFFERENT% U19s ACROSS THE NATION AND THAT IS LED US TO PARTICIPATE IN TEAM SCIENCE AND TEAM SCIENCE IS BROUGHT NEW TECHNOLOGIES THAT ALLOW US TO BASICALLY GO DOWN PATHS THAT I NEVER WOULD HAVE EXPECTED AND I THINK THE BIGGEST LESSON THAT I'VE LEARNED HERE IS IN WORKING WITH ACCELERATING MEDICINES PARTNERSHIP AND SO THIS EXPOSED US TO THE NEW SINGLE CELL TECHNOLOGIES THAT STARTED COMING OUT SEVERAL YEARS AGO NOW AND THAT WE'VE BEEN ABLE TO APPLY TO OUR QUESTIONS WHICH FOCUS ON OF COURSE, LUPUS PATIENTS AND AUTO ANTIBODY POSITIVE VERSUS NEGATIVE AND IN THE INTEREST OF TIME, I'M GOING TO FLY THROUGH THIS DATA BUT I'M HAPPY TO ANSWER QUESTIONS OR IF YOU ARE EXCITED ABOUT THIS AREA, AS YOU CAN TELL I AM, DROP ME AN E-MAIL AND WE CAN TALK ABOUT IT OFF LINE SO WE'VE DONE A LOT OF DIFFERENT TYPES OF DETAILED IMMUNO MONITORING IN THIS INDIVIDUALS TO SEE IF WE CAN IDENTIFY WHAT IS IS UNIQUE ABOUT THESE INDIVIDUALS. THIS IS THINKING ABOUT SO FOR THE IMMUNOLOGIST IN THE GROUP, YOU HAVE HERE IN THE MIDDLE WHERE WE'RE REALLY THINKING ABOUT T CELLS AND YOU CAN SEE THAT THE KIND OF INNATE CELLS ARE OVER HERE ON THIS LEFT SIDE AND THEN B CELLS ON THIS OTHER SIDE AND JUST KIND OF IF YOU LOOK AT THESE YOU CAN SEE WE SEE A FEW DIFFERENCES BETWEEN A AND A NEGATIVE AND A AND A POSITIVE HEALTHY INDIVIDUALS WHICH THESE WOULD USUALLY BE LUMPED TOGETHER AND A DIFFERENCE IN THE B CELLS IN LUPUS PATIENTS COMPARED TO THE UNEFFECTED CONTROLS AND THE OTHER THING TO POINT OUT IS THESE TOP ONES ARE EUROPEAN AMERICANS COMPARED TO THE AFRICAN AMERICANS BELOW AND THERE'S A DRAMATIC DIFFERENCES BETWEEN THE TWO GROUPS AND THIS IS ALLOWED US BY LOOKING AT THESE POSITIVE HEALTHY INDIVIDUALS AND TO START TRYING TO ARE MORE ACCEPTABLE TO DEVELOP LUPUS AND AND MANY OF YOU ARE DOING AND YOU ARE SEEING THESE KINDS OF ALL THE TIME NOW AND THEY'RE NOT ON THE LEFT AND T CELLS ARE ON THE RIGHT AND WE HAVE THE LUPUS PATIENTS WHO ARE IN GREEN COMPARED TO THE A AND A POSITIVE WHO ARE IN BLUE AND THE WHO ARE IN RED SO YOU CAN SEE THAT THERE'S SOME PLACES WHERE THINGS LOOK LIKE THEY MAY BE ENRICHED AND IT GETS EASIER TO SEE HERE THAT OF COURSE, WE SEE MORE PLASMA CELLS, MORE MEMORY B CELLS IN OUR LUPUS PATIENTS AND THEN WE ALSO HAVE SOME AREAS WHERE WE SEE EXPANSION OF CERTAIN T-CELL SUBSETS AND LET'S DEFINED IMMUNE CELLS IN THESE AUTO ANTIBODY POSITIVE INDIVIDUALS AND IF YOU LOOK, THE TOP ONE IS LUPUS PATIENTS ASK IN POSITIVE A AND A NEGATIVE THERE ARE OFFICER THINGS HIGHER IN OUR LUPUS PATIENTS BUT WE ALSO HAVE THINGS THAT ARE REALLY STRIKINGLY ELEVATED IN THESE A AND A POSITIVE AND AGAIN, THIS IS POINTING TOWARDS THOSE REGULATORY PATHWAYS AND SO, THEY HAVE NOW MORPHED INTO A NEW COMPETITION FOR ACCELERATED MEDICINES PARTNERSHIP INTO AUTOIMMUNE AND IMMUNE RELATED DISEASES AND I'M EXCITED ABOUT THIS AND THIS REALLY FOCUSING ON GOING BEYOND SINGLE CELL TECHNOLOGIES AND LOOKING AT SPACIAL AND USING SPACIAL PLATFORMS TO ALL OF THE DISEASE WE'RE STUDYING HAVE A FEMALE PREDOMINANCE AND SO LUPUS IS THE MOST STRIKING AT 9-1 AND CHOW GRINS WHICH HAS A 7-1 AND NER A LITTLE MORE EVENLY DISBURSED BUT CLOSE TO TWO TO THROW TIMES MORE LIKELY TO THE CURRENT LUPUS IN I'M VERY FORTUNATE TO SERVE AS THE DIRECTOR OF CONSORTIUM RIGHT NOW AND WE HAVE TECHNOLOGY SCORES WE SERVE AS THE LEADERSHIP MANAGEMENT AND TISSUE RESEARCH CORE AND WE HAVE SYSTEMS BIOLOGY GROUPS SO THIS BRINGS TOGETHER A LOT OF DIFFERENT TYPES OF SCIENTISTS AND ALL WITH THE COMMON PASSION OF UNDERSTANDING JUST FROM A COUPLE OF SMALL REGIONS OF INTEREST AND I THINK THIS IS GOING TO BE REALLY EXCITING AS WE MOVE FORWARD. THE OTHER THING I'D LIKE TO POINT OUT, JUST BRIEFLY, IS AN AMAZING PARTNERSHIP THAT IS REALLY BEING LED BY THE OFFICE OF RESEARCH IN WOMEN'S HEALTH AND THIS IS THE NEW TEAM SCIENCE LEADERSHIP SCHOLAR PROGRAM AND THIS IS FROM MID LEVEL INVESTIGATORS AND SCHOLARS WILL LEAD PROJECTS THAT ARE SYNERGISTIC OR BUILD ON THE INFRASTRUCTURE THAT WE HAVE DEVELOPED AND ARE DEVELOPING IN AMP-AIM AND THIS PROVIDES OPPORTUNITIES FOR WOMEN LEADERS TO DEVELOP SKILLS AND TEAM SCIENCE AND LEADERSHIP AND MENTORING AND TO INTERACT WITH ALL THESE DIVERSE INVESTIGATORS NA ARE PART OF AMP-AIM THROUGH THE GRANTS I SHOWED YOU AND THE INDUSTRY PARTNERS AND THE PRIVATE RESEARCH ORGANIZATIONSAL S WITHAL WITH A DIVERSE NUMBER OF NIH SCIENTISTS AND INSTITUTES AND AND THE OFFICE OF RESEARCH AND WOMEN'S HEALTH AND SO IN THIS PROGRAM IT WILL BE A NATURAL SEARCH AND MAYBE A COUPLE INSTITUTIONS THAT ARE ALREADY INVOLVED UNTIL THE CAMPAIGN AND WE'RE ALSO LOOKING FOR CANDIDATES OUTSIDE AND THEY NEED TO BE INDIVIDUALS WHO ARE BEYOND THOSE K YEARS AND REALLY OUR ASSOCIATE PROFESSOR TO FULL PROFESSOR AND THEY HAVE PROJECTS OR QUESTIONS THAT CAN BE REALLY INFORMATIVE WHEN WE'RE THINKING ABOUT THESE OPPORTUNITIES LOOKING ACROSS CORE DISEASES OR LOOKING AT FEATURES THAT MIGHT BE IMPORTANT ACROSS THE FOUR DISEASES, FOR EXAMPLE,. >> TO TAKE ON INSTITUTIONAL LEADERSHIP OPPORTUNITIES. AND SO, I WAS FORTUNATE TO BE A TENURES PROFESSOR IN FIVE AND BECOME A FULL RECOMMEND MEMBER AT THE RESEARCH FOUNDATION IN 2006 AND SO I HAVE A FULL DUEL APPOINTMENT IN THAT I WILL ALWAYS BEEN ON FACULTY AT OUR MEDICAL SCHOOL AND PLUS MY RESEARCH LABS AND MY PRIMARY APPOINTMENT IS A NON-PROFIT RESEARCH FOUNDATION THAT IS ACROSS THE STREET FROM OUR MEDICAL SCHOOLS AND A OUR MEDICAL CENTER AND IT'S CALLED THE OKLAHOMA MEDICAL RESEARCH FOUNDATION AND I KNEW THAT I WANTED DO ADDITIONAL LEADERSHIP AND SO I WENT AND TALKED TO OUR ORGANIZATIONAL PRESIDENT AND BECAME A DEPARTMENT CHAIR AND CREATED A NEW DEPARTMENT IN 2009 STARTING WITH TWO P.I.s AND 45 PEOPLE AND I HAD A FEW RECREWMENT LINES BUT ONE OF THESE CURVES THAT CAN HAPPEN IN YOUR RESEARCH PATH, WE HAD A LARGE PROGRAM THAT THE DEPARTMENT CHAIR LEFT QUICKLY AND SO THAT, MY OLD DEPARTMENT MERGED WITH THE NEW DEPARTMENT AND WE WENT FROM HAVING TWO P.I.s TO 12P.I. COMES 45 AND 45 PEOPLE TO 145 OVERNIGHT. THERE WAS A LOT OF OPPORTUNITY SERVING AS THE DEPARTMENT CHAIR AND I AM VERY EXCITED TO STILL BE SERVING AS THE DEPARTMENT CHAIR FOR THE ARTHRITIS CLINICAL IMMUNOLOGY RESEARCH PROGRAM WHICH SPANS FROM BASIC IMMUNOLOGY RESEARCH TO CLINICAL INVESTIGATORS DOING CLINICAL TRIALS OUTCOMES, RESEARCH AND KIND OF EVERYTHING IN BETWEEN. WE HAVE 18 FEDERALLY FUNDED PRINCIPLE INVESTIGATORS AND WE INCLUDE TWO DIFFERENT CLINICAL CENTERS FOCUSED ON AUTOIMMUNE DISEASES AND HAVE OVER 200 INDIVIDUALS CLOSE TO 210 WE FOLLOW OVER 4,000 PATIENTS BOTH IN RHEUMATOLOGY CENTER OF EXPENSE WHERE I'M HOUSED AS WELL AS IN A MULTIPLE SCLEROSIS CENTER OF EXCELLENCE AND LONGITUDINAL COHORTS WITH PATIENT SAMPLES THAT ARE USED ALL OF OUR BASIC INVESTIGATORS AND AND THEN, I WAS FOR CLINICAL TRANSLATION AT SCIENCE AT THE UNIVERSITY OF OKLAHOMA AND WE HAD HAD A GCRC PREVIOUSLY AND I WAS PART OF THE GCRC AS A USER NOT A LEADER AND THEN WE WERE HAVING DIFFICULTY AND THEY ASKED IF I WOULD WRITE THE CLINICAL AND TRANSLATION AT RESEARCH AWARD AND I CAN EXPLAIN THAT OFF LINE IS ANYONE IS INTERESTED AND IT PROVIDES A CLINICAL AND TRANSLATIONAL RESEARCH SUPPORT TO GROW THE CTR INFRASTRUCTURE AND AS WELL AS TO PROVIDE SUPPORT FOR PILOT PROGRAMS AND TO MAKE OUTREACH SO WE BROUGHT TOGETHER 29 DIFFERENT ENTRIES WHO ALL FOCUSED ON THIS PASSION TO IMPROVE THE HEALTH, ESPECIALLY OF RURAL AND TRIBAL ORGANIZATIONS AND WE HAVE A NUMBER OF DIFFERENT TRIBAL PARTNERS AND THIS IS BEEN REALLY EXCITING AND THEN I WAS THE VICE PRESIDENT OF CLINICAL AFFAIRS HERE IN 2019 SO I'D LIKE TO LEAVE YOU WITH THE LESSON THAT'S PROBABLY THE MOST IMPORTANT AND IT'S THAT THE PEOPLE YOU MEET ALONG THE WAY THAT WILL MAKE YOUR PATH WORTH WHILE AND SO I HAVE BEEN VERY FORTUNATE TO HAVE A NUMBER OF REALLY OUTSTANDING MENTORS AND AS WELL AS INSTITUTIONAL LEADERSHIP. I'VE NEVER HAD AN OFFICIAL MENTOR OR INSTITUTIONAL LEADER WHO LOOKED EXACTLY LIKE ME I HAVE MORE HAIR THAN MOST OF THEM BUT I WANTED TO ENCOURAGE YOU TO SERVE IN THIS ROLE TO BE MENTORS, TO BE INSTITUTIONAL LEADERS AND SO THAT WE CAN EXPAND WOMEN'S HEALTH AND WOMEN'S HEALTH RESEARCH AT OUR INSTITUTIONAL LEFT AND DEVELOPING THE NEXT GENERATION. I'VE BEEN PASSIONATE ABOUT HELPING OTHER TRAINEES SO I'VE HAD OVER 130 STUDENTS AND TRAINEES MAINLY UNDERGRADUATES COME THROUGH MY LAB WHO MANY ARE PHYSICIANS OR PH.D SCIENTIST TO DO GRAD WORK PORK AND THEY HAVE ALL COMPLETED ONE OF THOSE ARE IN TRAINING AND THEY'RE THROUGHOUT THE STATE OF OKLAHOMA AND WE ONLY HAVE TWO COUNTRIES THAT COUNT AS BEING URBAN COUNTIES AND THEN WE HAVE UNFORTUNATELY, A NUMBER OF CHALLENGES IN OKLAHOMA INCLUDING WE HAVE HIGH RATES OF POVERTY AND WE HAVE MOST OF OUR STATE ALMOST ALL OF OUR STATE EVERYTHING THAT IS NOT READ HERE IS CONSIDERED A HEALTH PROFESSION SHORTAGE AREA AND SO YOU CAN SEE THAT THESE COUNTIES ARE THE ONES IN THIS COLOR BLUE ARE THOSE THAT HAVE ALMOST NO PHYSICIANS PROVIDE IS EVERYTHING ADVISES IPROVIDING SERVICESAND THIS IS MY HOMETOWN AND MANY OF MY TRAINEES HAVE GONE ON AND DONE GREAT THINGS. THEY'RE GREAT STUDENTS WHO HAVE GONE ON TO HAVE FANTASTIC INDIVIDUAL CAREERS. I'VE HAD MANY DIFFERENT NATIVE AMERICAN TRAINEES AND THEY'VE GONE ON TO BE PH.Ds OR MDs AND MANY OF THE MD-PH.D STUDENTS WHO HAVE GONE ON TO FACULTY POSITIONS AND PLACES FROM HARVARD AND YALE TO UCSF SO I'D LIKE TO END WITH JUST A FEW LESSON THAT WE'VE TALKED ABOUT ALONG THE WAY SO YOU HAVE A LOT OF OPTION AND THERE ARE MANY WAYS TO HAVE A VERY SUCCESSFUL RESEARCH. MY PATH IS MY PATH AND IT'S DIFFERENT THAN MOST OF YOURS BUT YOU WILL FIND YOUR WAY AND IT'S IMPORTANT TO TALK TO OTHERS ABOUT HOW YOU CAN FIND YOUR WAY AND TO MAKE THOSE COURSE CORRECTIONS AS YOU NEED TO AS YOU TAKE THIS JOURNEY. FOLLOW YOUR PASSION THAT'S FUNDABLE AND IT'S REALLY IMPORTANT TO FIND THE TYPE OF SCIENCE YOU ARE REALLY PASSIONATE ABOUT BECAUSE IT HELPS YOU AND NO MATTER WHAT YOU DID YOU SEE ARE WE HAVE A LOT OF SCIENCE THAT NEEDS TO HAPPEN INFORM THINK ABOUT NEW APPROACHES AND THAT IS EASIEST TO SEE THOSE IF YOU ENGAGE IN TEAM SCIENCE WHERE YOU BRING TOGETHER DIFFERENT TYPES OF PEOPLE WHO HAVE HAD DIFFERENT TYPES OF TRAINING THAT COME AT THE QUESTION FROM DIFFERENT DIRECTIONS SO WE MAKE THOSE TRANSFORMATIVE ADVANCE AND OF COURSE TO TAKE PEOPLE ALONG THE JOURNEY. SO HERE ARE A FEW PEOPLE WHO HAVE BEEN REALLY PIVOTAL IN HELPING WITH THE DIFFERENCE RESEARCH THAT I'VE TALKED ABOUT REALLY BRIEFLY TODAY AND THEN OF COURSE, THE FUNDING AGENCIES OF WHICH NONE OF THIS WOULD BE POSSIBLE WITHOUT THEY SIP OR THE A RO1 AND TWO THE AND WHICH SUPPORTED MY FIRST KO8 AND IT'S BEEN SUPPORTIVE OF ME ALL ALONG AND TWO OF MY SCIENTIFIC OFFICERS AND I WILL BE HAPPY TO ANSWER ANY QUESTIONS. >> THANK YOU, VERY MUCH, Dr. JAMES AND SOMEHOW I CANNOT SEEM TO TURN ON MY CAMERA. THANK YOU, Dr. JAMES THAT LECTURE WAS REALLY PIVOTING AND EXCITING AND AND YOUR EXPERIENCES AS A SCIENTIST IS TRULY REMARKABLE BUT EVEN MORE EXCITING WAS YOUR CAREER IS PATH AND YOUR PASSION FOR YOUR WORK IS ALSO VERY PALPABLE. I HAVE THE ROLE OF MODERATING THE Q&A AND SO FAR THEY HAVE BEEN NON POSTED AND I'M SURE THE AUDIENCE IS TRYING TO COMPOST THEIR THOUGHTS AT THIS TIME AND WHILE WE'RE WAITING TO HEAR FROM THEM AND HOPEFULLY THIS TIME WE GET BOTH CHATBOXES WHERE THEY ARE POSITIONED, WE HAVE BEEN ABLE TO SEE ONE OF THEM LAST SESSION AND IT APPEARS THERE'S ANOTHER ONE THAT WE DID NOT HAVE ACCESS TO. SO, Dr. JAMES, YOU WERE IN LOCATE LA HOME A YOU SAY FIFTH GENERATION AND GREW UP IN A FARM BUT ENDED UP BEING A TOP-NOTCH SCIENTIST AND PHYSICIAN. IT APPEARS THAT YOU KNOW, YOU WENT THROUGH THE DIFFERENT CAREER DEVELOPMENTS MECHANISMS AT NIH INCLUDING THE K AWARD AND UP TO THE TIME YOU WERE A TENURE PROFESSOR AND NOW YOU HAVE MULTIPLE AWARDS AND STARTING WITH THE R AND ENDING UP WITH THIS VERY HUGE MULTI-DISCIPLINARY, MULTI-SECTORAL AND MULTI INSTITUTIONAL BECAUSE IT IS NOT JUST FOR INSTANCE FOR THE AMP-AIM IT'S NOT JUST NAIMS OR AWARD THE AGES. NAIMS AND NIAID, ET CETERA, NETS. AT THE SAME TIME, YOU SAID THERE ARE MANY RIGHT PATHS, WOULD YOU SAY THAT BECAUSE IT SEEMS LIKE YOU ARE A VERY GOOD POSTER CHILD FOR THE NIH CAREER DEVELOPMENT PATHWAY, WOULD YOU SAY THAT THIS IS PROBABLY THE RIGHT PATH FOR YOU? >> OH, WITHOUT A DOUBT THIS WAS THE RIGHT PATH FOR ME. I THINK IT WAS PARTIALLY BECAUSE I CAME FROM A BACKGROUND WHERE NO ONE HAD THOUGHT ABOUT SCIENCES AS A CAREER, RIGHT. THE GREAT THING FOR ME THROUGH MY F31 I SAW THE NIH HAD THESE DIFFERENT STEPS AND HAD INFORMATION ABOUT HOW TO TRANSITION AT DIFFERENT CAREER POINTS AND DIFFERENT TYPES OF AWARDS AND SO I THINK THAT BETWEEN THAT AND THEN TALK TO GO MY PROGRAM OFFICERS THAT WERE VERY TUNED INTO THOSE THINGS AND HELPED ME FIND THAT CAREER PATH AND I THINK WE DO HAVE ONE QUESTION THAT I SEE IN THE CHAT AND IT MAY BE THAT WE SEE DIFFERENT CHATS AND IS ABOUT THE FACT THAT SOMEONE NOTICED THAT ALL OF MY MENTORS AND INSTITUTIONAL LEADERS WERE ALL WHITE MEN, ENGAGE MORE MALE MENTORS AND LEADERS TO DEVELOP NEXT GENERATION FEMALE SCIENTISTS MENTORS AND LEADERS AND THIS IS A GOOD QUESTION AND SO I'VE ALWAYS BEEN IN OKLAHOMA AND OKLAHOMA, EVEN KNOW, THE NUMBER OF TEEN YOU'RED PROFESSORS THAT WE HAVE THAT ARE FULL FEMALE PROFESSOR IN THE COLLEGE OF MEDICINE, UNFORTUNATELY, IT'S STILL A LITTLE BIT BELOW 20% WHICH IS DRAMATICALLY LOWER THAN THE NUMBER OF ASSISTANT PROFESSOR WHO ARE ABOUT 55% WOMEN SO THERE'S JUST NOT ENOUGH SENIOR FEMALE MENTORS TO MENTOR THE NEXT GENERATION AND SO, I POINT DON CAPRA AND HE WAS AN OUT STANDING MENTOR TO FEMALE SCIENTISTS AND IN WHO ARE NOW RA CROSS THE UNITED STATES AND DOING GREAT SCIENCE AND I THINK THAT HE CONTRIBUTED THIS TOO. HE WAS MARRIED TO ANOTHER Dr. CAPRA, HIS WIFE, WHO WAS A FEMALE SCIENTIST WHO WAS A NURSE SCIENTIST AND THE FACT THAT HE REALLY WORKED VERY HARD TO MAKE SURE THAT HE HE WAS PROVIDING THE SAME OPPORTUNITIES, THE SAME OPTIONS TO ALL OF HIS FACULTY WHETHER THEY WERE MALE OR FEMALE, WHETHER THEY WERE HISTORICALLY FROM UNDERSERVED BACKGROUNDS OR FROM PEOPLE WHO CAME WITH THE PEDESTRIAN A GROW OF FIVPEDIGREE OFSCIENTISTS, RIGHT SO I TH INK THAT THAT WAS A GREAT ROLE MODEL FOR ME TO HAVE AND I THINK THAT TOO MANY OTHER MALE AND FEMALE SCIENTISTS THAT HE HAS LEARNED HE HAS PASSED THAT ON EAT LEAST THROUGHOUT THE IMMUNOLOGY COMMUNITY SO A LOT OF THAT CAN HAPPEN AND I THINK THAT THERE ARE MORE TOOLS NOW THAT ARE AVAILABLE TO HELP INSTITUTIONS TO HELP THAT HAPPEN. I WAS JUST ACTUALLY, FOR SOMETHING ELSE, READING THE NATIONAL ACADEMY REPORT ON BEST PRACTICES TO HELP FORWARD WOMEN SCIENTISTS AND SCIENTISTS FROM UNDER REPRESENTED AK GROUNDS AND THERE ARE A LOT OF DIFFERENT OPTIONS IN THERE AND I THINK THAT HE ACTUALLY PROBABLY THOUGHT OF SOME OF THOSE THINGS BEFORE PEOPLE WERE STARTING TO ACTUALLY DO RESEARCH AND LINE THIS OUT. >> THANK YOU. AND THANK YOU ALSO FOR EMPHASIZING MENTORSHIP AND SPONSORSHIP AND MAY ALSO SAY ALLY SHIP AND IT ECHOS THE THOUGHTS THAT WERE DISCUSSED DURING THE SUMMIT MEETING THAT WE HAD THIS SPRING AND WHICH ACTUALLY WAS SORT OF A WITH THE AIM PROGRAM WHERE TEAM SCIENCE AND DISCIPLINARY APPROACHES AS WELL AS EMERSION AND COLLABORATION ACROSS SECTORS WHICH IS AN ABILITY FOR THE AMP-AIM PROGRAM TO IMPLEMENT BECAUSE OF THIS STRUCTURE AND AGAIN I CAN'T EMPHASIZE HOW LUCKY WE ARE THA THAT YOU WILL LEAD THAT PROJECT. >> WE'RE JUST SO EXCITED TO HAVE THAT OPPORTUNITY AND IT'S SUCH AN INCREDIBLE OPPORTUNITY FOR US TO BRING IN FEMALE SCIENTIST WHO'S ARE THINKING ABOUT COMMON COMMON THEMES ACROSS DISEASE, PAIN, FATIGUE, MENTAL FOG, THOSE AFFECT MANY PATIENTS ACROSS OUR DIFFERENT AUTO IMMUNE DISEASES AND BECAUSE THE WAY AMP-AIM WAS SET UP WE HAVE TEAMS THAT THINK ABOUT THE DISEASE ENTITIES INDIVIDUALLY AND SO WE WERE REALLY HOPEFUL THAT WE WILL GET SCIENTISTS THINKING ABOUT COMPUTATIONAL METHODS LIKE ACROSS ALL FOUR OR OTHER PATIENT REPORTED OUTCOMES ACROSS ALL FOUR DISEASES SO I'M HOPING THERE ARE GREAT CANDIDATES LISTENING TO THIS LECTURE TODAY. >> THANK YOU. WHILE THAT WAS FOCUSED ON MID CAREER SCIENTISTS WHAT WE'RE TRYING TO DO IS ACTUALLY DO A PILOT WITH AMP-AIM AND EXPAND IT IF THE OUTCOMES ARE VERY PROMISING EVEN EARLIER OR LATER THAN THAT IN THEIR CAREER STAGES. DO WE HAVE ANY OTHER QUESTIONS ON THE CHAT? I DON'T SEE ANY HERE. THAT WERE FORWARDED TO ME. AGAIN, I WOULD LIKE TO THANK YOU VERY MUCH. THIS IS BEEN AN ENLIGHTENING TALK AND I WOULD LIKE TO GIVE THE FLOOR BACK TO Dr. LISA BEGG. TO CLOSE OUR SESSIONS. >> THANK YOU, Dr. TIGNO. A PROFOUND THANK YOU TO Dr. JAMES FOR A SUPER TALK AND I LISTENED TO YOUR TALK BEFORE THE MEETING AND THEN OF COURSE, THIS TIME AND IT'S EVEN MORE POWERFUL SO I ENCOURAGE EVERYONE TO KEEP THIS BOOK MARKED AND IT WILL BE ON THE NIH VIDEO CAST ARCHIVE AND A FEW DAYS AND IT WILL ALSO THE LINK WILL BE PLACED ON OUR WEBSITE AND AS IT WILL FOR THE RUTH L. KIRSCHSTEIN MEMORIAL LECTURE SHIP IN THE GENERAL LINK FOR THE MEETING AS WELL. THANK YOU SO MUCH Dr. JAMES, FOR YOUR LEADERSHIP AND YOUR SUPERB ROLE MODEL FOR ALL OF US. IT'S MUCH APPRECIATED. >> THANK YOU. >> AS WE COME TO THE END OF THE PLENARY SELLING SESSION, IF I HAVE THE SLIDE AND Dr. MAY TON MAY WANT TO MAKE COMMENTS TOO SO JUST ONE SORT OF APPARENTLY WE HAVE SOME SORT OF A BUG IN SOME OF THESE BEING ABLE TO POSE QUESTIONS SO, IF THERE WERE ANY QUESTIONS FROM THE MORNING OR EVEN UP UNTIL NOW, AND YOU HAVE NOT BEEN ABLE TO GET THROUGH, E-MAIL ME AND I WILL SEE WHAT I CAN DO IN TERMS OF GETTING YOU AN ANSWER. I WOULD BE HAPPY TO DO THAT AND WE'LL FIGURE THAT OUT. A LITTLE PLUG FOR THE POSTER SESSION, WHICH I'M GO TO GO INTO THAT ALL THREE OF THEM WILL BE PRESENT FOR THE POSTER SESSION ICH BEGINS AT 2:30 AND GOES TO 4:00 AND IS VIEWABLE FOR THE NEXT THREE MONTHS ON THE VIRTUAL PLATFORM SO FOR THOSE OF YOU THAT WANT TO GO, YOU SEE THE LITTLE POSTER HOLE, THE RED BAR AROUND IT AND IF YOU HIT THAT THEN YOU COME INTO THE 51 ABSTRACTS AND THEY'RE GROUPED SO YOU CAN PULL DOWN THE INDEX THERE AND YOU WILL SEE WHICH ARE CLINICAL, NEUROSCIENCE, SEX AND GENDER AND SO ON AND SO FOURTH. SO YOU CAN THEN GO IN AND THE SEARCH BAR AND FIND THE SPECIFIC ABSTRACT YOU WANT AND CONTACT BETWEEN 2:30 AND 4:00 TODAY THE LEAD AUTHOR FOR THE POSTER, THE BIRCWH SCHOLAR. SO WITH THAT, I TURN IT OVER TO Dr. CLAYTON FOR ANY FINAL, FINAL COMMENTS BUT AGAIN, THANK YOU SO MUCH FOR YOUR INTEREST IN OUR PROGRAM. WE'RE PLEASED THAT WE HAVE HAD ANOTHER SUCCESSFUL MEETING. >> THANK YOU, Dr. BEGG. I WANT TO ADD MY THANKS TO EVERYONE, ALL OUR SPEAKERS, SCHOLARS, P.I.s, CO P.I.s, EVERYONE ATTENDING AND EVERYONE THANK YOU VERY, VERY MUCH AND I WANT TO END BY THANKING THE AMAZING BIRCWH TEAM AND THAT WOULD BE Dr. BEGG, Dr. TIGNO, Dr. HUANG, Dr. JOHNS, AND I THINK I GOT EVERYONE? AND EVERYONE ON THE CAREER SECTION. THANK YOU TO OUR CONTRACTORS AND OUR COMMUNICATION STAFF WHO DID A LOT OF WORK BEHIND THE SCENES TO MAKE THE MEETING GO SMOOTHLY AND WE'LL SEE YOU IN THE POSTER HALL, THANK YOU, EVERYONE.