1 00:00:05,720 --> 00:00:08,760 >>THANKS, EVERYONE, FOR COMING 2 00:00:08,760 --> 00:00:11,600 BOTH HERE IN LIPSETT AS WELL AS 3 00:00:11,600 --> 00:00:12,720 THE NIH VIDEOCAST. 4 00:00:12,720 --> 00:00:15,480 MY NAME IS CAITLYN SATLER, I'M A 5 00:00:15,480 --> 00:00:16,680 MEMBER OF THE ORGANIZING 6 00:00:16,680 --> 00:00:17,640 COMMITTEE AND HAPPY TO HOST YOU 7 00:00:17,640 --> 00:00:19,040 ALL TODAY. 8 00:00:19,040 --> 00:00:20,280 JUST A FEW INSTRUCTIONS BEFORE 9 00:00:20,280 --> 00:00:22,800 WE BEGIN FOR THOSE OF YOU 10 00:00:22,800 --> 00:00:24,440 JOINING US VIA VIDEOCAST. 11 00:00:24,440 --> 00:00:25,640 IF YOU HAVE ANY QUESTIONS, 12 00:00:25,640 --> 00:00:27,280 PLEASE DIRECT THEM VIA THE LIVE 13 00:00:27,280 --> 00:00:30,120 FEEDBACK BUTTON BELOW THE SCREEN 14 00:00:30,120 --> 00:00:31,480 IN THE VIDEOCAST DESCRIPTION. 15 00:00:31,480 --> 00:00:32,680 IF YOU NEED CLOSED CAPTIONS, 16 00:00:32,680 --> 00:00:33,840 THOSE ARE AVAILABLE AS WELL. 17 00:00:33,840 --> 00:00:35,520 THE QUESTIONS WILL BE ASKED AT 18 00:00:35,520 --> 00:00:39,080 THE END OF EACH SPEAKER'S 19 00:00:39,080 --> 00:00:40,400 PRESENTATION. 20 00:00:40,400 --> 00:00:42,360 AND FOR THOSE OF YOU WITH US IN 21 00:00:42,360 --> 00:00:43,240 LIPSETT, PLEASE ASK YOUR 22 00:00:43,240 --> 00:00:44,560 QUESTIONS AT THE MICROPHONES 23 00:00:44,560 --> 00:00:46,160 LOCATED ON EITHER SIDE OF THE 24 00:00:46,160 --> 00:00:46,440 HALL HERE. 25 00:00:46,440 --> 00:00:47,720 WITH THAT, WITHOUT FURTHER ADO, 26 00:00:47,720 --> 00:00:50,720 I'M VERY EXCITED TO BE ABLE TO 27 00:00:50,720 --> 00:00:53,080 INTRODUCE OUR SPECIAL GUEST FOR 28 00:00:53,080 --> 00:00:56,240 THIS MORNING, WHO IS DR. CAROL 29 00:00:56,240 --> 00:00:57,880 FEELEY OF NCI. 30 00:00:57,880 --> 00:01:00,000 SHE IS A PIONEER HERE AT THE NIH 31 00:01:00,000 --> 00:01:04,480 BOTH IN SCIENCE AND IN EQUITY 32 00:01:04,480 --> 00:01:05,080 FOR WOMEN, AND WITHOUT FURTHER 33 00:01:05,080 --> 00:01:06,960 ADO, CAROL. 34 00:01:06,960 --> 00:01:07,440 >>THANK YOU. 35 00:01:07,440 --> 00:01:09,080 I FEEL VERY HONORED TO BE 36 00:01:09,080 --> 00:01:11,520 INVITED TO SPEAK HERE TODAY. 37 00:01:11,520 --> 00:01:14,360 I WANTED TO START A LITTLE BIT 38 00:01:14,360 --> 00:01:15,360 HISTORICALLY, WHEN I CAME TO THE 39 00:01:15,360 --> 00:01:18,680 NIH IN 1981, IT WAS QUITE A 40 00:01:18,680 --> 00:01:21,040 DIFFERENT PLACE. 41 00:01:21,040 --> 00:01:23,560 CLEARLY IT WAS AN AMAZING 42 00:01:23,560 --> 00:01:24,600 BIOMEDICAL ENTERPRISE, MUCH AS 43 00:01:24,600 --> 00:01:27,720 IT IS TODAY. 44 00:01:27,720 --> 00:01:29,040 BUT IT WAS WITHIN THE STRUCTURE 45 00:01:29,040 --> 00:01:34,760 OF A QUASI MILITARY INSTITUTION 46 00:01:34,760 --> 00:01:37,000 OR FACILITY THAT WAS REFERRED TO 47 00:01:37,000 --> 00:01:38,560 AS "THE RESERVATION." 48 00:01:38,560 --> 00:01:41,440 I CAME ON A CANCER RESEARCH 49 00:01:41,440 --> 00:01:44,880 INSTITUTE AND LATER A DAMON 50 00:01:44,880 --> 00:01:45,920 RUNION FELLOWSHIP BECAUSE THERE 51 00:01:45,920 --> 00:01:48,200 WAS NOT REALLY A FORMAL TRAINING 52 00:01:48,200 --> 00:01:51,800 PATHWAY FOR AMERICAN PH.D. 53 00:01:51,800 --> 00:01:53,000 POSTDOCTORAL SCHOLARS AT THAT 54 00:01:53,000 --> 00:01:54,960 TIME. 55 00:01:54,960 --> 00:01:59,800 NO ERTAs OR SERTAs. 56 00:01:59,800 --> 00:02:00,960 I WAS RAISED IN SORT OF THE 57 00:02:00,960 --> 00:02:02,840 SOCIAL FORCES OF THE 70s AND 58 00:02:02,840 --> 00:02:04,960 80s, WHERE WE PROTESTED THE 59 00:02:04,960 --> 00:02:08,200 WAR, AND THEN WE LATER LOBBIED 60 00:02:08,200 --> 00:02:12,040 FOR INCREASED VISIBILITY OF 61 00:02:12,040 --> 00:02:15,360 WOMEN IN ALL ASPECTS OF LIFE, 62 00:02:15,360 --> 00:02:18,280 AND ESPECIALLY THE JOB ARENA. 63 00:02:18,280 --> 00:02:23,320 AND I THINK THE INSTITUTE ALSO 64 00:02:23,320 --> 00:02:27,040 WAS INFLUENCED BY THIS. 65 00:02:27,040 --> 00:02:30,240 CONGRESS AS WELL AS DHHS IN 1983 66 00:02:30,240 --> 00:02:32,400 STARTED THE PHS TASK FORCE ON 67 00:02:32,400 --> 00:02:37,000 THE STATUS OF WOMEN ISSUES. 68 00:02:37,000 --> 00:02:40,200 AND THEN THIS LED TO THE ONLY 69 00:02:40,200 --> 00:02:41,400 INSTITUTE DIRECTOR, FEMALE 70 00:02:41,400 --> 00:02:45,440 INSTITUTE DIRECTOR, RUTH 71 00:02:45,440 --> 00:02:46,280 KIRSCHSTEIN, BEGINNING TO 72 00:02:46,280 --> 00:02:47,160 ORGANIZE THE OFFICE OF RESEARCH 73 00:02:47,160 --> 00:02:49,240 ON WOMEN'S HEALTH, WHICH LATER 74 00:02:49,240 --> 00:02:51,160 WAS TAKEN OVER BY THE FIRST 75 00:02:51,160 --> 00:02:53,200 DIRECTOR, VIVIAN PINN. 76 00:02:53,200 --> 00:02:55,640 AND THIS WAS REALLY A 77 00:02:55,640 --> 00:02:57,280 GALVANIZING EVENT IN BIOMEDICAL 78 00:02:57,280 --> 00:02:58,360 RESEARCH, BECAUSE AT THAT TIME, 79 00:02:58,360 --> 00:03:01,240 WOMEN WERE NOT INCLUDED IN 80 00:03:01,240 --> 00:03:04,720 BIOMEDICAL RESEARCH, AND THEY 81 00:03:04,720 --> 00:03:08,360 WERE JUST CONSIDERED MEN WITH 82 00:03:08,360 --> 00:03:10,120 HORMONES AND THEN THEY ALSO 83 00:03:10,120 --> 00:03:12,600 DEPARTMENT WANT TO PUT THEM ON 84 00:03:12,600 --> 00:03:13,960 HORMONES -- I MEAN ON STUDIES 85 00:03:13,960 --> 00:03:16,880 BECAUSE OF THE HORMONAL 86 00:03:16,880 --> 00:03:18,760 FLUCTUATIONS. 87 00:03:18,760 --> 00:03:20,040 AND POST-MENOPAUSAL WOMEN WERE 88 00:03:20,040 --> 00:03:23,440 NOT EVEN CONSIDERED AS WELL. 89 00:03:23,440 --> 00:03:24,880 AND SO IT WAS IN THIS 90 00:03:24,880 --> 00:03:28,920 ENVIRONMENT THAT REALLY, I THINK 91 00:03:28,920 --> 00:03:31,680 IN 1991, GEORGE BUSH APPOINTED 92 00:03:31,680 --> 00:03:34,680 BERNADINE HEALY TO BE THE FIRST 93 00:03:34,680 --> 00:03:38,880 DIRECTOR OF THE NIH. 94 00:03:38,880 --> 00:03:40,600 AND HER SHORT TENURE, I THINK, 95 00:03:40,600 --> 00:03:43,760 WAS QUITE TRANSFORMATIVE. 96 00:03:43,760 --> 00:03:47,200 TWO MAJOR ASPECTS THAT SHE DID 97 00:03:47,200 --> 00:03:51,680 WAS TO EARMARK $150 MILLION FOR 98 00:03:51,680 --> 00:03:53,640 THE WOMEN'S HEALTH INITIATIVE, 99 00:03:53,640 --> 00:03:55,160 AND FOR THOSE OF YOU WHO KNOW, 100 00:03:55,160 --> 00:03:57,360 MONEY IS REALLY WHAT POWERS THE 101 00:03:57,360 --> 00:04:00,520 ABILITY OF AN INSTITUTE TO 102 00:04:00,520 --> 00:04:02,480 EFFECT CHANGE, AND I THINK THIS 103 00:04:02,480 --> 00:04:05,040 REALLY LED TO THE STRENGTHENING 104 00:04:05,040 --> 00:04:07,000 OF WOMEN'S HEALTH ISSUES. 105 00:04:07,000 --> 00:04:08,720 THE OTHER IMPORTANT THING THAT 106 00:04:08,720 --> 00:04:11,480 SHE DID WAS TO START THE NIH 107 00:04:11,480 --> 00:04:15,400 TASK FORCE ON THE STATUS OF 108 00:04:15,400 --> 00:04:17,360 WOMEN, AND THIS, AS YOU HEARD 109 00:04:17,360 --> 00:04:22,840 EARLIER, WAS LED BY THE CHAIR, 110 00:04:22,840 --> 00:04:24,960 WAS HINDA KLEINMAN AND A NUMBER 111 00:04:24,960 --> 00:04:26,600 OF WOMEN SCIENTISTS, AND I'VE 112 00:04:26,600 --> 00:04:28,080 TAKEN THIS FROM AN OLD COPY THAT 113 00:04:28,080 --> 00:04:34,040 I ACTUALLY RESURRECTED OF THAT 114 00:04:34,040 --> 00:04:36,640 GROUP, AND HYNDA WAS THE CHAIR 115 00:04:36,640 --> 00:04:37,400 OF THE TASK FORCE. 116 00:04:37,400 --> 00:04:40,040 SHE WAS AN AMAZING SCIENTIST IN 117 00:04:40,040 --> 00:04:44,240 THE DENTAL RESEARCH INSTITUTE. 118 00:04:44,240 --> 00:04:45,360 SHARP-WITTED AND VERY 119 00:04:45,360 --> 00:04:46,160 INSIGHTFUL. 120 00:04:46,160 --> 00:04:51,240 KREE ATER OF MATRIGEL AND AS ANY 121 00:04:51,240 --> 00:04:52,800 CANCER BIOLOGIST KNOWS, A REALLY 122 00:04:52,800 --> 00:04:53,800 IMPORTANT COMPONENT OF THEIR 123 00:04:53,800 --> 00:04:55,000 STUDIES. 124 00:04:55,000 --> 00:05:01,080 AND SO HYNDA AND THE TASK FORCE 125 00:05:01,080 --> 00:05:02,440 DELVED INTO THE STATUS OF WOMEN 126 00:05:02,440 --> 00:05:04,400 AT NIH AND THEIR FINDINGS WERE 127 00:05:04,400 --> 00:05:06,480 PRESENTED TO THE NIH IN AN 128 00:05:06,480 --> 00:05:07,440 AMAZING DOCUMENT ALMOST 30 YEARS 129 00:05:07,440 --> 00:05:11,280 AGO TO THE DAY. 130 00:05:11,280 --> 00:05:14,360 SO THE MAJOR FINDINGS FROM THIS 131 00:05:14,360 --> 00:05:16,640 WAS THE ESTABLISHMENT OF THE 132 00:05:16,640 --> 00:05:17,960 WOMEN SCIENTIST ADVISORS. 133 00:05:17,960 --> 00:05:19,880 AMONG THE FIRST ARE LISTED ON 134 00:05:19,880 --> 00:05:22,800 THE SIDE HERE. 135 00:05:22,800 --> 00:05:24,200 AND THE ISSUES THAT THEY RAISED 136 00:05:24,200 --> 00:05:25,760 AS BEING IMPORTANT WERE PAY 137 00:05:25,760 --> 00:05:29,600 EQUITY, VISIBILITY, LEADERSHIP, 138 00:05:29,600 --> 00:05:33,240 WORK AND FAMILY ISSUES. 139 00:05:33,240 --> 00:05:35,120 SUSAN BATES AND I WERE ASKED -- 140 00:05:35,120 --> 00:05:37,720 I WAS A NEWLY TENURED 141 00:05:37,720 --> 00:05:40,120 INVESTIGATOR, AND WAS SOMEWHAT 142 00:05:40,120 --> 00:05:43,080 SURPRISED AFTER A SEMINAR WHEN 143 00:05:43,080 --> 00:05:45,520 BRUCE CHABNER, HEAD OF ONE OF 144 00:05:45,520 --> 00:05:46,880 THE LARGEST INTRAMURAL DIVISIONS 145 00:05:46,880 --> 00:05:48,200 OF THE CANCER INSTITUTE, CAME UP 146 00:05:48,200 --> 00:05:51,160 TO ME AND ASKED ME TO BE THE 147 00:05:51,160 --> 00:05:52,480 WOMEN SCIENTIST ADVISOR. 148 00:05:52,480 --> 00:05:56,120 I KNEW THEY WERE SUPPOSE SUPPOSE 149 00:05:56,120 --> 00:05:57,760 ELECTED AND HE SAID, WELL, YOU 150 00:05:57,760 --> 00:05:59,440 AND SUSAN ARE THE ONLY TWO 151 00:05:59,440 --> 00:06:00,320 TENURED INVESTIGATORS IN OUR 152 00:06:00,320 --> 00:06:00,720 DIVISION. 153 00:06:00,720 --> 00:06:03,440 SO THAT'S HOW I BEGAN TO 154 00:06:03,440 --> 00:06:06,640 PARTICIPATE IN THIS EFFORT. 155 00:06:06,640 --> 00:06:08,040 I'VE HIGHLIGHTED HERE JOAN 156 00:06:08,040 --> 00:06:09,160 SCHWARTZ BECAUSE I THINK SHE 157 00:06:09,160 --> 00:06:12,200 REALLY PLAYED A KEY ROLE IN 158 00:06:12,200 --> 00:06:14,600 REALLY TRANSFORMING THE 159 00:06:14,600 --> 00:06:19,720 AWARENESS OF THESE ISSUES AT NIH 160 00:06:19,720 --> 00:06:23,800 INTO A REALITY, AND THAT CAME 161 00:06:23,800 --> 00:06:25,680 ABOUT LATER ON WHEN MIGHT 162 00:06:25,680 --> 00:06:26,840 GOTTESMAN WAS APPOINTED BY 163 00:06:26,840 --> 00:06:28,520 HAROLD VARMUS TO BE THE 164 00:06:28,520 --> 00:06:31,160 INTRAMURAL DIRECTOR OF NIH. 165 00:06:31,160 --> 00:06:35,040 AND JOAN, ALONG WITH THE WSAs, 166 00:06:35,040 --> 00:06:37,240 REALLY BEGAN TO TACKLE THESE 167 00:06:37,240 --> 00:06:40,640 ISSUES ONE BY ONE. 168 00:06:40,640 --> 00:06:43,920 JOAN REALLY WAS AN IMPORTANT 169 00:06:43,920 --> 00:06:46,320 MENTOR TO ME THROUGHOUT MY 170 00:06:46,320 --> 00:06:47,000 ENTIRE CAREER. 171 00:06:47,000 --> 00:06:49,840 MY GO-TO PERSON FOR ANY 172 00:06:49,840 --> 00:06:50,880 UNDERSTANDING OF HOW THE 173 00:06:50,880 --> 00:06:52,920 INSTITUTION WORKED. 174 00:06:52,920 --> 00:06:56,840 AND YOU KNOW, JOAN AND HER GROUP 175 00:06:56,840 --> 00:07:01,760 ACTUALLY ENABLE US TO FIND A 176 00:07:01,760 --> 00:07:04,600 PATH TO PAY EQUITY THROUGH A 177 00:07:04,600 --> 00:07:07,800 NO-FAULT EEO MEMORANDUM OF 178 00:07:07,800 --> 00:07:10,520 UNDERSTANDING. 179 00:07:10,520 --> 00:07:11,640 AND THIS WAS QUITE AMAZING 180 00:07:11,640 --> 00:07:12,640 BECAUSE WE WERE ABLE TO CHANGE 181 00:07:12,640 --> 00:07:15,240 THE PAYS OF THE TRAINEES, BUT 182 00:07:15,240 --> 00:07:19,280 EVEN MORE IMPORTANTLY, FOR THE 183 00:07:19,280 --> 00:07:21,280 GOVERNMENT SCIENTISTS, THE 184 00:07:21,280 --> 00:07:22,160 GS-RATED GOVERNMENT SCIENTISTS. 185 00:07:22,160 --> 00:07:26,560 SO THIS WAS REALLY A FASCINA 186 00:07:26,560 --> 00:07:27,200 FASCINATING -- TO ME IT WAS 187 00:07:27,200 --> 00:07:29,040 LIKE, OH, YOU CAN IF YOU ARE 188 00:07:29,040 --> 00:07:32,480 ACTIVE MAKE A CHANGE. 189 00:07:32,480 --> 00:07:36,040 THEY LATER THEN WERE JOINED BY 190 00:07:36,040 --> 00:07:41,920 ARLENE AND ROLAND, WHO THEN 191 00:07:41,920 --> 00:07:43,600 BEGAN TO EFFECT ALL THE OTHER 192 00:07:43,600 --> 00:07:44,920 ISSUES TO REALLY TRANSFORM THE 193 00:07:44,920 --> 00:07:48,320 NIH FROM THIS QUASI MILITARY 194 00:07:48,320 --> 00:07:52,480 STRUCTURE INTO A MORE ACADEMIC 195 00:07:52,480 --> 00:07:54,480 ORGANIZATION WITH PROGRAMS LIKE 196 00:07:54,480 --> 00:08:00,160 HOW TO BE A SUCCESSFUL P.I., HOW 197 00:08:00,160 --> 00:08:03,320 TO DEVELOP MORE OF THE TRAINING 198 00:08:03,320 --> 00:08:06,320 PATHWAYS, THE SERTA AND ERTA 199 00:08:06,320 --> 00:08:08,040 PROGRAMS AND INTO THE OITE, AS 200 00:08:08,040 --> 00:08:10,640 WELL AS REALLY TAKING TO THE 201 00:08:10,640 --> 00:08:14,400 FORE AND KEEPING IN THE FORE THE 202 00:08:14,400 --> 00:08:16,240 WORK/LIFE ISSUES FOR SCIENTISTS. 203 00:08:16,240 --> 00:08:17,640 AND THESE ISSUES ALTHOUGH THEY 204 00:08:17,640 --> 00:08:19,960 STARTED AT WOMEN'S ISSUES ARE 205 00:08:19,960 --> 00:08:20,720 REALLY TRANSFORMATIVE FOR BOTH 206 00:08:20,720 --> 00:08:22,160 MEN AND WOMEN, SO FOR ALL 207 00:08:22,160 --> 00:08:22,480 PEOPLES. 208 00:08:22,480 --> 00:08:25,480 AND I THINK THAT WE CAN BE 209 00:08:25,480 --> 00:08:27,400 EXCITED THAT THE INSTITUTE NOW 210 00:08:27,400 --> 00:08:31,680 IS BEING LED BY DR. NINA SCHOR. 211 00:08:31,680 --> 00:08:33,000 I KNOW HER, SHE IS A 212 00:08:33,000 --> 00:08:34,000 PEDIATRICIAN AND PEDIATRICIANS 213 00:08:34,000 --> 00:08:36,920 ARE VERY SPECIAL PEOPLE. 214 00:08:36,920 --> 00:08:39,760 SO I'M SURE THAT THE ACTIVITIES 215 00:08:39,760 --> 00:08:44,800 OF THE DDIR WILL BE AS STRONG AS 216 00:08:44,800 --> 00:08:45,080 EVER. 217 00:08:45,080 --> 00:08:48,840 AND I WANTED TO LEAVE YOU WITH A 218 00:08:48,840 --> 00:08:50,280 SAYING THAT I LEARNED FROM 219 00:08:50,280 --> 00:08:52,360 BERNADINE HEALY. 220 00:08:52,360 --> 00:08:54,040 SHE SAID SHORT SENTENCES BUT 221 00:08:54,040 --> 00:08:54,800 STRONG VERBS. 222 00:08:54,800 --> 00:08:56,640 AND I THINK THIS IS AN IMPORTANT 223 00:08:56,640 --> 00:08:59,360 ASPECT TO CONSIDER, AND I'LL ADD 224 00:08:59,360 --> 00:09:02,480 MY OWN MANTRA THAT HAS KEPT ME 225 00:09:02,480 --> 00:09:03,880 MOVING FORWARD: ALWAYS DO WHAT 226 00:09:03,880 --> 00:09:05,520 YOU'RE AFRAID TO DO, AND 227 00:09:05,520 --> 00:09:06,040 ACTIONS, NOT WORDS. 228 00:09:06,040 --> 00:09:07,080 THANK YOU VERY MUCH. 229 00:09:07,080 --> 00:09:14,960 [APPLAUSE] 230 00:09:14,960 --> 00:09:17,400 >>THANKS SO MUCH FOR THAT 231 00:09:17,400 --> 00:09:17,880 FANTASTIC PERSPECTIVE. 232 00:09:17,880 --> 00:09:20,400 AND IT IS MY HONOR TO BE ABLE TO 233 00:09:20,400 --> 00:09:22,440 LEAD INTO OUR SCIENTIFIC 234 00:09:22,440 --> 00:09:24,400 PROGRAMMING FOR TODAY WITH OUR 235 00:09:24,400 --> 00:09:25,520 TWO SPEAKERS. 236 00:09:25,520 --> 00:09:27,840 OUR FIRST SPEAKER OF THE DAY IS 237 00:09:27,840 --> 00:09:34,920 DR. SEGRE, A SENIOR INVESTIGATOR 238 00:09:34,920 --> 00:09:35,480 IN NHGRI. 239 00:09:35,480 --> 00:09:37,880 SHE HAS BEEN ELECTED TO BOTH NIS 240 00:09:37,880 --> 00:09:41,400 AND NAM AS A FELLOW OF BOTH AAAS 241 00:09:41,400 --> 00:09:44,680 AND AAM. 242 00:09:44,680 --> 00:09:45,960 DR. SEGRE IN 2013 RECEIVED THE 243 00:09:45,960 --> 00:09:47,680 SERVICE TO AMERICA MEDAL FOR 244 00:09:47,680 --> 00:09:50,560 LAUNCHING A REALTIME GENOMIC 245 00:09:50,560 --> 00:09:52,640 STUDIES DURING MULTIDRUG 246 00:09:52,640 --> 00:09:53,400 RESISTANT BACTERIA OUTBREAK AT 247 00:09:53,400 --> 00:09:55,160 THE NIH CLINICAL CENTER. 248 00:09:55,160 --> 00:09:59,120 WITH THAT, DR. SEGRE, WE'RE 249 00:09:59,120 --> 00:09:59,920 LOOKING FORWARD TO YOUR TALK. 250 00:09:59,920 --> 00:10:05,800 [APPLAUSE] 251 00:10:05,800 --> 00:10:06,680 >>THANKS VERY MUCH. 252 00:10:06,680 --> 00:10:07,880 AND IT IS REALLY A PLEASURE TO 253 00:10:07,880 --> 00:10:10,480 BE HERE AND TO JOIN YOU ALL IN 254 00:10:10,480 --> 00:10:12,680 PERSON, AND THANK YOU FOR THAT 255 00:10:12,680 --> 00:10:13,720 NICE INTRODUCTION. 256 00:10:13,720 --> 00:10:15,840 SO I'M GOING TO TALK ABOUT THE 257 00:10:15,840 --> 00:10:16,480 RESEARCH PROGRAM THAT I 258 00:10:16,480 --> 00:10:20,040 DEVELOPED HERE AT THE NIH ON THE 259 00:10:20,040 --> 00:10:21,520 HUMAN SKIN MICROBIOME. 260 00:10:21,520 --> 00:10:23,360 SO FIRST OF ALL, WHAT DO I MEAN 261 00:10:23,360 --> 00:10:26,560 BY THE HUMAN MICROBIOME? 262 00:10:26,560 --> 00:10:28,400 FOR ME, THE MICROBIOME IS THE 263 00:10:28,400 --> 00:10:29,720 COLLECTION OF ALL THE 264 00:10:29,720 --> 00:10:30,600 MICROORGANISMS AND THEIR DNA 265 00:10:30,600 --> 00:10:31,880 LIVING IN ASSOCIATION WITH THE 266 00:10:31,880 --> 00:10:32,400 HUMAN BODY. 267 00:10:32,400 --> 00:10:36,520 SO THAT'S THE BACTERIA, THE 268 00:10:36,520 --> 00:10:38,680 EUKARYOTES OR FUNGI, VIRUSES, 269 00:10:38,680 --> 00:10:40,480 AND IN SOME CIRCUMSTANCES 270 00:10:40,480 --> 00:10:41,680 ALTHOUGH NOT ACTUALLY FOUND ON 271 00:10:41,680 --> 00:10:44,520 THE SKIN, THE ARCHAEA. 272 00:10:44,520 --> 00:10:46,680 SO THE BASIC UNDERSTANDING IS 273 00:10:46,680 --> 00:10:47,920 THAT AS SOMEONE WHO CAME FROM 274 00:10:47,920 --> 00:10:53,800 THE HUMAN GENOME PROJECT, I 275 00:10:53,800 --> 00:10:55,240 ORIGINALLY THOUGHT OF HUMANS AS 276 00:10:55,240 --> 00:10:57,120 BEING THE GENETIC MATERIAL OF 277 00:10:57,120 --> 00:10:58,520 THESE 23 CHROMOSOMES, BUT IN 278 00:10:58,520 --> 00:11:03,240 FACT, HUMANS ARE SUPERORGANISMS. 279 00:11:03,240 --> 00:11:05,440 AND OUR DNA IS ACTUALLY MADE UP 280 00:11:05,440 --> 00:11:08,240 OF THE HUMAN GENOME, AS WELL AS 281 00:11:08,240 --> 00:11:10,680 ALL OF THE MICROBES THAT LIVE IN 282 00:11:10,680 --> 00:11:11,320 AND ON US. 283 00:11:11,320 --> 00:11:14,920 AND THIS IS IMPORTANT AND CAN BE 284 00:11:14,920 --> 00:11:17,880 IMPORTANT FOR DISEASE STATES 285 00:11:17,880 --> 00:11:21,840 BECAUSE THESE BACTERIAL GENOMES 286 00:11:21,840 --> 00:11:25,160 ARE MUCH SMALLER THAN A HUMAN 287 00:11:25,160 --> 00:11:27,880 GENOME, BUT WITH THEIR CODING 288 00:11:27,880 --> 00:11:29,280 POTENTIAL, THE DNA OF THE HUMAN 289 00:11:29,280 --> 00:11:31,680 GENOME IS THE SAME IN EVERY 290 00:11:31,680 --> 00:11:33,120 CELL, WE MIGHT HAVE 291 00:11:33,120 --> 00:11:34,200 TRANSCRIPTIONAL DIFFERENCES, BUT 292 00:11:34,200 --> 00:11:35,720 THE DNA OF THE BACTERIA OR THE 293 00:11:35,720 --> 00:11:36,760 FUNGI CAN ACTUALLY BE QUITE 294 00:11:36,760 --> 00:11:37,040 DIFFERENT. 295 00:11:37,040 --> 00:11:38,800 SO YOU'VE GOT THIS OTHER GENOME 296 00:11:38,800 --> 00:11:41,640 THAT'S LIVING SIMULTANEOUSLY 297 00:11:41,640 --> 00:11:44,480 WITH YOU, AND THAT CAN CHANGE IN 298 00:11:44,480 --> 00:11:46,120 THE CONTEXT BOTH OF DISEASE 299 00:11:46,120 --> 00:11:48,760 STATES BUT ALSO HOW WE MIGHT TRY 300 00:11:48,760 --> 00:11:50,720 TO AMELIORATE DISEASE. 301 00:11:50,720 --> 00:11:52,800 SO IN THAT CONTEXT, THE SORT OF 302 00:11:52,800 --> 00:11:55,720 THEMES THAT I WANT TO TALK ABOUT 303 00:11:55,720 --> 00:11:57,200 THAT WE'RE INTERESTED IN IS SORT 304 00:11:57,200 --> 00:12:01,000 OF HOW DOES THE HUMAN MICROBIOME 305 00:12:01,000 --> 00:12:02,240 FUNCTION AS AN ORGAN SYSTEM OF 306 00:12:02,240 --> 00:12:03,640 THE HUMAN BODY TO TUNE THE 307 00:12:03,640 --> 00:12:05,400 IMMUNE SYSTEM, TO AID IN 308 00:12:05,400 --> 00:12:07,120 DIGESTION, AND TO PROVIDE 309 00:12:07,120 --> 00:12:12,000 PROTECTION FROM PATHOGENS. 310 00:12:12,000 --> 00:12:14,240 SO AWESOME NEW FIELD, BUT HOW DO 311 00:12:14,240 --> 00:12:17,120 WE ACTUALLY CHARACTERIZE THE 312 00:12:17,120 --> 00:12:17,800 MICROBIOME? 313 00:12:17,800 --> 00:12:19,080 SO WE'RE ALL NOW VERY 314 00:12:19,080 --> 00:12:20,560 COMFORTABLE WITH THIS IDEA OF 315 00:12:20,560 --> 00:12:22,280 STICKING SWABS UP OUR NOSE, BUT 316 00:12:22,280 --> 00:12:25,440 HOW DO YOU ACTUALLY CHARACTERIZE 317 00:12:25,440 --> 00:12:27,920 THE MICROBIOME BECAUSE THE 318 00:12:27,920 --> 00:12:29,960 TRADITIONAL WAY WAS TO PUT THESE 319 00:12:29,960 --> 00:12:32,800 ON TO AUGER PLATES AND SEE WHAT 320 00:12:32,800 --> 00:12:34,840 GREW. 321 00:12:34,840 --> 00:12:37,160 BUT THE ISSUE IS THAT MANY 322 00:12:37,160 --> 00:12:40,000 BACTERIA ARE FASTIDIOUS OR THE 323 00:12:40,000 --> 00:12:43,680 VIRUSES ARE IMPOSSIBLE AND THE 324 00:12:43,680 --> 00:12:44,880 FUNGI ARE ALSO HARD. 325 00:12:44,880 --> 00:12:46,760 SO MY SCIENTIFIC UPBRINGING WAS 326 00:12:46,760 --> 00:12:47,960 WITHIN THE HUMAN GENOME PROJECT, 327 00:12:47,960 --> 00:12:50,320 WHERE WE TALKED ABOUT THIS 328 00:12:50,320 --> 00:12:51,360 3 BILLION BASE PAIRS AND WE 329 00:12:51,360 --> 00:12:53,040 TALKED ABOUT IT IN TERMS OF 330 00:12:53,040 --> 00:12:54,320 BOOKS AND CHAPTERS, BUT REALLY 331 00:12:54,320 --> 00:12:56,920 WE WERE DEVELOPING THIS 332 00:12:56,920 --> 00:13:01,200 TECHNOLOGY OF GENETIC MAPS AND 333 00:13:01,200 --> 00:13:02,720 PHYSICAL MABS AND CONSTRUCTING 334 00:13:02,720 --> 00:13:03,720 THESE SEQUENCE READS THAT WE 335 00:13:03,720 --> 00:13:05,160 THEN REASSEMBLED. 336 00:13:05,160 --> 00:13:09,760 BUT ALONG WITH THESE TECHNOL 337 00:13:09,760 --> 00:13:11,280 TECHNOLOGIES, ALONG WITH THIS 338 00:13:11,280 --> 00:13:12,240 INTELLECTUAL CONSTRUCT OF THE 339 00:13:12,240 --> 00:13:13,480 HUMAN GENOME PROJECT, WE WERE 340 00:13:13,480 --> 00:13:15,320 ALSO DEVELOPING THESE 341 00:13:15,320 --> 00:13:18,080 TECHNOLOGIES OF MOVING FROM 342 00:13:18,080 --> 00:13:21,240 SEQUENCING ON SANGER INSTRUMENTS 343 00:13:21,240 --> 00:13:22,800 INTO THESE HIGH THROUGHPUT 344 00:13:22,800 --> 00:13:25,680 SEQUENCING CENTERS, AND ALSO THE 345 00:13:25,680 --> 00:13:26,640 COMPUTE POWER THAT GOES ALONG 346 00:13:26,640 --> 00:13:29,080 WITH THAT. 347 00:13:29,080 --> 00:13:31,240 AND SO WITH THAT AS A FRAMEWORK, 348 00:13:31,240 --> 00:13:33,520 I REALLY AS AN INDEPENDENT 349 00:13:33,520 --> 00:13:35,840 INVESTIGATOR HERE AT THE NIH 350 00:13:35,840 --> 00:13:37,360 STARTED TO THINK ABOUT 351 00:13:37,360 --> 00:13:38,680 SEQUENCING AS A NEW LENS TO 352 00:13:38,680 --> 00:13:41,600 OBSERVE BIOLOGY. 353 00:13:41,600 --> 00:13:42,720 AND WE MAY THINK ABOUT 354 00:13:42,720 --> 00:13:44,240 SEQUENCING AS A WAY TO OBSERVE 355 00:13:44,240 --> 00:13:45,680 THE STATE OF HUMAN CELLS IN 356 00:13:45,680 --> 00:13:48,840 TERMS OF CHROMATIN STATE OR THE 357 00:13:48,840 --> 00:13:49,960 TRANSCRIPTIONAL EXPRESSION, BUT 358 00:13:49,960 --> 00:13:51,920 I ALSO WAS THINKING ABOUT IT IN 359 00:13:51,920 --> 00:13:54,640 THE CONTEXT OF THE WORLD AROUND 360 00:13:54,640 --> 00:13:55,080 US. 361 00:13:55,080 --> 00:13:56,400 THAT IN THE PAST, WE'VE THOUGHT 362 00:13:56,400 --> 00:13:57,760 ABOUT MICROBES AND OBSERVING 363 00:13:57,760 --> 00:14:00,360 THEM USING THE LENS OF A 364 00:14:00,360 --> 00:14:00,880 MICROSCOPE. 365 00:14:00,880 --> 00:14:02,960 BUT WHAT NOW ABOUT USING THE 366 00:14:02,960 --> 00:14:05,520 LENS OF SEQUENCING TO EXPLORE 367 00:14:05,520 --> 00:14:11,840 WHAT IS THE MICROBIAL COMMUNITY. 368 00:14:11,840 --> 00:14:14,920 SO WE DEVELOPED METHODS TO 369 00:14:14,920 --> 00:14:17,720 SAMPLE THE HUMAN SKIN, AND THEN 370 00:14:17,720 --> 00:14:18,800 CHARACTERIZED THE COMPONENTS OF 371 00:14:18,800 --> 00:14:19,760 THE SKIN. 372 00:14:19,760 --> 00:14:22,280 AND WE STARTED WITH SIGNATURE 373 00:14:22,280 --> 00:14:23,680 MARKER GENES OF THE BACTERIA AND 374 00:14:23,680 --> 00:14:26,880 THE FUNGI SO THAT WE COULD AT 375 00:14:26,880 --> 00:14:27,640 LEAST CHARACTERIZE WHAT WAS 376 00:14:27,640 --> 00:14:29,480 THERE, AND THEN MOVED THE ENTIRE 377 00:14:29,480 --> 00:14:32,480 PIPELINE INTO A MUCH MORE 378 00:14:32,480 --> 00:14:34,240 COMPLEX SYSTEM, WHERE WE'RE 379 00:14:34,240 --> 00:14:36,760 DOING SHOTGUN METAGENOMIC 380 00:14:36,760 --> 00:14:37,720 SEQUENCING OF TAKING THAT SAMPLE 381 00:14:37,720 --> 00:14:38,840 AND DIRECTLY SEQUENCING 382 00:14:38,840 --> 00:14:40,320 EVERYTHING THAT'S THERE AND THEN 383 00:14:40,320 --> 00:14:43,160 PULLING THE GENOMES BACK OUT. 384 00:14:43,160 --> 00:14:46,280 AND OUR INITIAL FINDING TOGETHER 385 00:14:46,280 --> 00:14:50,400 WITH MY LONG-TIME COLLABORATOR 386 00:14:50,400 --> 00:14:53,560 DR. HEIDI KONG, THEN IN NCI, NOW 387 00:14:53,560 --> 00:14:56,080 IN NIAMS, AND A VERY TALENTED 388 00:14:56,080 --> 00:14:59,800 POSTDOC WHO ELIZABETH GRIES 389 00:14:59,800 --> 00:15:03,440 WHO'S NOW AT PENN, WE SET UP THE 390 00:15:03,440 --> 00:15:04,480 FIRST EXPERIMENT ON THE SKIN. 391 00:15:04,480 --> 00:15:05,920 THIS WILL BE KIND OF A MODEL 392 00:15:05,920 --> 00:15:08,120 THAT WE USE WHERE WE 393 00:15:08,120 --> 00:15:09,200 CHARACTERIZE 18 DIFFERENT BODY 394 00:15:09,200 --> 00:15:10,720 SITES OF HEALTHY VOLUNTEERS AND 395 00:15:10,720 --> 00:15:13,720 THEN OF PATIENTS. 396 00:15:13,720 --> 00:15:15,720 AND WHAT WE FOUND HERE WITH THE 397 00:15:15,720 --> 00:15:17,680 INSIGHTS BORROWED FROM DR. MARIA 398 00:15:17,680 --> 00:15:24,280 TURNER, WHO WAS OUR SCIENTIFIC 399 00:15:24,280 --> 00:15:27,360 GURU AT THAT POINT WAS THIS IDEA 400 00:15:27,360 --> 00:15:28,560 THAT DERMATOLOGIC DISORDERS 401 00:15:28,560 --> 00:15:29,960 MANIFEST AT STEREOTYPICAL SITES. 402 00:15:29,960 --> 00:15:32,040 SO YOU'RE GOING TO SEE PSORIASIS 403 00:15:32,040 --> 00:15:33,440 ON THE OUTSIDE OF THE ELBOW, 404 00:15:33,440 --> 00:15:35,640 ECZEMA ON THE INSIDE OF THE 405 00:15:35,640 --> 00:15:37,040 ELBOW, AND THAT MAYBE THERE IS 406 00:15:37,040 --> 00:15:38,280 SOMETHING BIOLOGICAL ABOUT THOSE 407 00:15:38,280 --> 00:15:38,840 MICROBES. 408 00:15:38,840 --> 00:15:42,080 AND SO WHEN WE CHARACTERIZE THE 409 00:15:42,080 --> 00:15:43,440 SCIENCE, WHAT WE FOUND WAS A 410 00:15:43,440 --> 00:15:45,080 GREAT DISTINCTION BETWEEN THE 411 00:15:45,080 --> 00:15:48,760 KNOW KROABS --BETWEEN THE MICROE 412 00:15:48,760 --> 00:15:53,000 ON OILY SITES ENRICHED INTO THE 413 00:15:53,000 --> 00:15:55,000 BACTERIUM, THE MOIST SITES THAT 414 00:15:55,000 --> 00:15:57,560 WERE MORE DIVERSE, AND HAD A 415 00:15:57,560 --> 00:16:00,000 GREATER AMOUNT OF PROTEOBACTERIA 416 00:16:00,000 --> 00:16:01,080 AND STAPHYLOCOCCUS, AND THE DRY 417 00:16:01,080 --> 00:16:02,640 SITES THAT WERE EXTREMELY 418 00:16:02,640 --> 00:16:03,640 DIVERSE. 419 00:16:03,640 --> 00:16:05,080 AND WE STARTED TO THING ABOUT 420 00:16:05,080 --> 00:16:07,080 THIS THEN THAT HUMANS ARE THESE 421 00:16:07,080 --> 00:16:09,120 ECOSYSTEMS FOR THE RESIDENT 422 00:16:09,120 --> 00:16:10,640 BACTERIA, AND THAT THE MICROBES 423 00:16:10,640 --> 00:16:12,520 ARE TUNING THEMSELVES TO LIVING 424 00:16:12,520 --> 00:16:14,960 ON THE HUMAN BODY, SEEING THE 425 00:16:14,960 --> 00:16:17,080 HUMAN SKIN AS A NUTRIENT FIELD. 426 00:16:17,080 --> 00:16:19,320 AND THAT WE ARE THEIR HOMES BUT 427 00:16:19,320 --> 00:16:20,720 THEY ARE THEN PROVIDING BENEFIT 428 00:16:20,720 --> 00:16:25,560 TO US. 429 00:16:25,560 --> 00:16:27,480 SO UNDERSTANDING THIS, WE HAD 430 00:16:27,480 --> 00:16:29,720 ONE ISSUE AS WE MOVED SORT OF 431 00:16:29,720 --> 00:16:31,280 FROM THE SIMPLICITY OF 432 00:16:31,280 --> 00:16:32,280 CHARACTERIZING THE BACTERIAL AND 433 00:16:32,280 --> 00:16:34,360 THE FUNGAL COMMUNITIES TO TRYING 434 00:16:34,360 --> 00:16:36,200 TO UNDERSTAND THE FULL 435 00:16:36,200 --> 00:16:37,800 COMPLEXITY OF THE HUMAN 436 00:16:37,800 --> 00:16:39,160 MICROBIOME. 437 00:16:39,160 --> 00:16:40,160 AND THE PROBLEM WAS THAT WE 438 00:16:40,160 --> 00:16:41,960 STILL ONLY WERE SEEING THE 439 00:16:41,960 --> 00:16:45,160 MICROBES THAT MATCHED A 440 00:16:45,160 --> 00:16:48,120 REFERENCE. 441 00:16:48,120 --> 00:16:49,320 & THE ISSUE WAS THAT THE 442 00:16:49,320 --> 00:16:52,400 DATABASES WERE FILLED WITH 443 00:16:52,400 --> 00:16:52,680 PATHOGENS. 444 00:16:52,680 --> 00:16:55,720 SO WE HAD A TON OF SEQUENCES 445 00:16:55,720 --> 00:16:57,040 FROM STAPH AUREUS THAT HAD 446 00:16:57,040 --> 00:16:58,240 CAUSED AN INFECTION, BUT WE 447 00:16:58,240 --> 00:16:59,560 STILL REALLY DIDN'T HAVE VERY 448 00:16:59,560 --> 00:17:01,840 MANY SEQUENCES FROM THE 449 00:17:01,840 --> 00:17:05,720 COMMENSAL MICROBES. 450 00:17:05,720 --> 00:17:13,680 SO SARAH KASHA AL TOOK ON THIS 451 00:17:13,680 --> 00:17:17,200 ISSUE. 452 00:17:17,200 --> 00:17:19,480 THE ANALOGY YOU WANT YOU TO 453 00:17:19,480 --> 00:17:20,480 ENVISION IS THAT YOU HAD THE 454 00:17:20,480 --> 00:17:21,600 PUZZLE, RIGHT, AND YOU'VE THROWN 455 00:17:21,600 --> 00:17:23,320 ALL THESE PUZZLE PIECES INTO A 456 00:17:23,320 --> 00:17:25,280 BOX, AND WHAT WE SHOWED WITH THE 457 00:17:25,280 --> 00:17:26,400 HUMAN GENOME IS THAT YOU CAN 458 00:17:26,400 --> 00:17:28,360 TAKE THOSE PIECES, THOSE 459 00:17:28,360 --> 00:17:29,720 SEQUENCES, AND YOU CAN 460 00:17:29,720 --> 00:17:30,720 RECONSTRUCT THE HUMAN GENOME AS 461 00:17:30,720 --> 00:17:33,320 A PUZZLE. 462 00:17:33,320 --> 00:17:35,720 BUT FROM META GENOMICS, WHAT WE 463 00:17:35,720 --> 00:17:38,480 HAVE IS THAT SOMEONE THREW 10 464 00:17:38,480 --> 00:17:39,320 PUZZLES INTO THE SAME BOX AND 465 00:17:39,320 --> 00:17:40,400 YOU ARE NOW TRYING TO 466 00:17:40,400 --> 00:17:41,320 RECONSTRUCT THAT BUT YOU HAVE A 467 00:17:41,320 --> 00:17:42,960 LOT OF LANDMARKS BECAUSE SOME 468 00:17:42,960 --> 00:17:44,160 PUZZLES HAVE SMALLER PIECES AND 469 00:17:44,160 --> 00:17:47,360 SOME HAVE BIGGER PIECES AND THEY 470 00:17:47,360 --> 00:17:51,920 HAVE DIFFERENT SCENERIES ON 471 00:17:51,920 --> 00:17:52,800 THEM. 472 00:17:52,800 --> 00:17:55,000 SO SARA WAS TAKING THIS TO 473 00:17:55,000 --> 00:17:55,880 SEQUENCING, TAKING THE SEQUENCE 474 00:17:55,880 --> 00:17:58,720 READS AND ASSEMBLING THEM 475 00:17:58,720 --> 00:18:00,240 BECAUSE THEY OVERLAPPED AND THEN 476 00:18:00,240 --> 00:18:01,960 BINNING THEM BASED ON THE 477 00:18:01,960 --> 00:18:04,080 QUALITIES OF TETRANUCLEOTIDE 478 00:18:04,080 --> 00:18:07,760 FREQUENCY AND OTHER ASPECTS OF 479 00:18:07,760 --> 00:18:10,840 THOSE AND BUILDING MAGS FROM 480 00:18:10,840 --> 00:18:11,160 THIS. 481 00:18:11,160 --> 00:18:14,120 FROM THIS, SARA WAS ABLE TO 482 00:18:14,120 --> 00:18:15,320 IDENTIFY 213 NOVEL BACTERIAL 483 00:18:15,320 --> 00:18:17,280 SPECIES LIVING ON THE SKIN, 484 00:18:17,280 --> 00:18:19,400 WHICH INCLUDED 14 NOVEL 485 00:18:19,400 --> 00:18:21,800 BACTERIAL GENERA, SOME OF WHICH 486 00:18:21,800 --> 00:18:24,520 WERE ACTUALLY AS COMMON IN 487 00:18:24,520 --> 00:18:26,160 RELATIVE ABUNDANCE AS MICROBES 488 00:18:26,160 --> 00:18:29,880 THAT WE KNOW A LOT ABOUT LIKE 489 00:18:29,880 --> 00:18:32,080 STAPHYLOCOCCUS. 490 00:18:32,080 --> 00:18:33,920 TWO NOVEL SPECIES AND THOUSANDS 491 00:18:33,920 --> 00:18:36,680 OF NOVEL VIRUSES INCLUDING JUMBO 492 00:18:36,680 --> 00:18:37,120 PHAGE. 493 00:18:37,120 --> 00:18:38,640 SO ENOUGH ABOUT OUR FRIENDS. 494 00:18:38,640 --> 00:18:42,400 WHAT WILL ABOUT THESE FOES THAT 495 00:18:42,400 --> 00:18:44,560 WE'RE SO CONCERNED ABOUT? 496 00:18:44,560 --> 00:18:47,160 THIS IS WHERE BEING AT THE NIH 497 00:18:47,160 --> 00:18:49,800 CLINICAL CENTER HAS REALLY BEEN 498 00:18:49,800 --> 00:18:50,200 TRANSFORMATIVE. 499 00:18:50,200 --> 00:18:52,760 I SHOW YOU A PICTURE HERE OF THE 500 00:18:52,760 --> 00:18:54,520 FAMOUS OUTBREAK DETECTION BY 501 00:18:54,520 --> 00:18:56,440 JOHN SNOW, WHERE HE'S TRYING TO 502 00:18:56,440 --> 00:18:57,440 FIND AND THEY STILL HAVE 503 00:18:57,440 --> 00:18:59,640 PRESERVED IN LONDON THE WATER 504 00:18:59,640 --> 00:19:01,400 PUMP WHERE THEY'RE TRYING TO 505 00:19:01,400 --> 00:19:04,280 FIND WHAT WAS THE SOURCE OF AN 506 00:19:04,280 --> 00:19:05,480 OUTBREAK. 507 00:19:05,480 --> 00:19:07,120 SO WITH THAT AS A MODEL, AND 508 00:19:07,120 --> 00:19:09,400 THINKING NOW AGAIN ABOUT 509 00:19:09,400 --> 00:19:13,200 SEQUENCING AS A NEW LENS, 510 00:19:13,200 --> 00:19:16,880 TOGETHER WITH MY COLLEAGUE, TEAR 511 00:19:16,880 --> 00:19:20,680 A POLMORE AND ANOTHER EXTREMELY 512 00:19:20,680 --> 00:19:23,960 TALENTED POSTDOC EVAN SNICKEN IN 513 00:19:23,960 --> 00:19:26,240 THE LAB, WE HAD BEEN SEQUENCING 514 00:19:26,240 --> 00:19:30,240 HISTORIC SAMPLES THAT HAD COME 515 00:19:30,240 --> 00:19:31,440 TO THE CLINICAL CENTER AND 516 00:19:31,440 --> 00:19:34,040 CAUSED A CLUSTER OF INFECTIONS, 517 00:19:34,040 --> 00:19:35,680 AND SITTING IN THE OFFICE WITH 518 00:19:35,680 --> 00:19:37,480 THE THEN DIRECTOR OF THE 519 00:19:37,480 --> 00:19:40,880 CLINICAL MICRO LAB, PATRICK 520 00:19:40,880 --> 00:19:45,800 MURRAY, WE WERE AWARE THAT THE 521 00:19:45,800 --> 00:19:48,760 FIRST PATIENT WITH CARBAPENEM 522 00:19:48,760 --> 00:19:51,080 RESISTANT KLEBSIELLA PNEUMONIAE 523 00:19:51,080 --> 00:19:53,880 WAS BEING ADMITTED TO THE 524 00:19:53,880 --> 00:19:54,560 CLINICAL CENTER. 525 00:19:54,560 --> 00:19:57,960 AND SHE WAS ADMITTED IN JUNE OF 526 00:19:57,960 --> 00:20:01,120 2011, AND DISCHARGED FROM THE 527 00:20:01,120 --> 00:20:03,440 CLINICAL CENTER, STILL DOING 528 00:20:03,440 --> 00:20:05,520 WELL. 529 00:20:05,520 --> 00:20:10,000 AND ABOUT TWO MONTHS LATER, 530 00:20:10,000 --> 00:20:11,480 PATIENT -- THEY IDENTIFIED AS 531 00:20:11,480 --> 00:20:15,040 SECOND PATIENT WITH A CLINICAL 532 00:20:15,040 --> 00:20:16,480 CULTURE WHO HAD AN INFECTION 533 00:20:16,480 --> 00:20:18,320 WITH KLEBSIELLA PNEUMONIA AND 534 00:20:18,320 --> 00:20:19,760 THEN A PATIENT A WEEK AFTER THAT 535 00:20:19,760 --> 00:20:21,160 ON EITHER SURVEILLANCE OR 536 00:20:21,160 --> 00:20:24,360 CLINICAL CULTURES. 537 00:20:24,360 --> 00:20:28,560 SO HERE'S THE QUESTION. 538 00:20:28,560 --> 00:20:30,600 CARBAPENEM RESISTANT -- ARE ONE 539 00:20:30,600 --> 00:20:31,600 OF THE MOST URGENT THREATS 540 00:20:31,600 --> 00:20:34,040 BECAUSE WE HAVE SO FEW DRUGS 541 00:20:34,040 --> 00:20:35,000 LEFT TO TREAT THEM. 542 00:20:35,000 --> 00:20:38,480 THAT MAKES HOSPITAL INFECTION 543 00:20:38,480 --> 00:20:39,360 CONTROL REALLY CRITICAL. 544 00:20:39,360 --> 00:20:43,680 SO THE QUESTION WAS, DOES THE 545 00:20:43,680 --> 00:20:45,160 ISOLATE FROM PATIENT 1 MATCH 546 00:20:45,160 --> 00:20:47,040 PATIENTS 2, 3, 4 AND 5? 547 00:20:47,040 --> 00:20:48,440 AND THE REASON THIS IS IMPORTANT 548 00:20:48,440 --> 00:20:53,840 IS IF THERE IS MATCH, THEN WE 549 00:20:53,840 --> 00:20:55,800 HAD POSSIBLE KNOW SEW COMB YAL 550 00:20:55,800 --> 00:20:56,520 TRANSMISSIONS IN THE HOSPITAL 551 00:20:56,520 --> 00:20:57,360 AND THAT WOULD MEAN THAT THE 552 00:20:57,360 --> 00:20:59,560 CONTACT ISOLATION WAS 553 00:20:59,560 --> 00:21:00,400 INSUFFICIENT AND THE SCREENING 554 00:21:00,400 --> 00:21:01,800 OF PATIENTS WAS INSUFFICIENT, 555 00:21:01,800 --> 00:21:04,680 AND WE SHOULD -- AND TEAR A 556 00:21:04,680 --> 00:21:05,800 SHOULD CHANGE HOSPITAL PRACTICE. 557 00:21:05,800 --> 00:21:08,840 IF THERE'S NO MATCH, AND THIS IS 558 00:21:08,840 --> 00:21:10,160 A SEPARATE INTRODUCTION, THEN 559 00:21:10,160 --> 00:21:11,600 THE CONTACT ISOLATION WAS 560 00:21:11,600 --> 00:21:12,360 SUFFICIENT, THE SCREENING OF 561 00:21:12,360 --> 00:21:15,280 PATIENTS WAS SUFFICIENT AND STAY 562 00:21:15,280 --> 00:21:17,480 THE COURSE ALTHOUGH ADDRESS WHAT 563 00:21:17,480 --> 00:21:20,560 HAPPENS BETWEEN PATIENTS 2, 3, 564 00:21:20,560 --> 00:21:25,840 4, 5. 565 00:21:25,840 --> 00:21:27,360 AT THAT POINT THE DATA WE HAD 566 00:21:27,360 --> 00:21:32,400 WAS RUNNING SEQUENCE TYPE 258. 567 00:21:32,400 --> 00:21:33,480 THAT DOESN'T GIVE YOU THE 568 00:21:33,480 --> 00:21:36,880 RESOLUTION BECAUSE 70% OF 569 00:21:36,880 --> 00:21:37,840 HEALTHCARE-ASSOCIATED ARE 570 00:21:37,840 --> 00:21:45,360 SEQUENCE TYPE 258. 571 00:21:45,360 --> 00:21:47,760 SO WE STARTED RAPIDLY SEQUENCING 572 00:21:47,760 --> 00:21:50,040 THE ISOLETTES FROM THESE 573 00:21:50,040 --> 00:21:50,280 PATIENTS. 574 00:21:50,280 --> 00:21:52,120 WE HAD MULTIPLE ISOLATES FROM 575 00:21:52,120 --> 00:21:53,440 PATIENT 1 WHO HAD BEEN ADMITTED 576 00:21:53,440 --> 00:21:56,120 TO THE CLINICAL CENTER FOR 577 00:21:56,120 --> 00:21:58,720 ACTUALLY A WHILE AND SHE CAME 578 00:21:58,720 --> 00:22:00,160 ALREADY COLONIZED SO SHE HAD 579 00:22:00,160 --> 00:22:03,600 BEEN COLONIZED ALREADY FOR, WE 580 00:22:03,600 --> 00:22:05,320 SUSPECT, ABOUT SIX MONTHS. 581 00:22:05,320 --> 00:22:07,280 WE HAD ISOLETTES FROM THE 582 00:22:07,280 --> 00:22:09,600 URINARY TRACT THAT WE SEQUENCED, 583 00:22:09,600 --> 00:22:13,280 THE THROAT, THE GROIN AND ACTUAL 584 00:22:13,280 --> 00:22:15,360 BRONCHIAL ALVEOLAR LAVAGE. 585 00:22:15,360 --> 00:22:16,680 AND WHEN WE SEQUENCED THESE 586 00:22:16,680 --> 00:22:17,760 ISOLETTES FROM PATIENT 1, WE 587 00:22:17,760 --> 00:22:19,280 COULD SEE THAT ACTUALLY THE 588 00:22:19,280 --> 00:22:21,480 KLEBSIELLA PNEUMONIA HAD 589 00:22:21,480 --> 00:22:22,360 DIVERSIFIED ALREADY ON THIS 590 00:22:22,360 --> 00:22:24,440 PATIENT, SO THE URINARY TRACT IS 591 00:22:24,440 --> 00:22:26,640 THE ANCESTRAL STRAIN THAT 592 00:22:26,640 --> 00:22:29,160 MATCHES OTHER THINGS IN THE 593 00:22:29,160 --> 00:22:34,520 DATABASE, BUT THERE WERE THREE 594 00:22:34,520 --> 00:22:36,160 SNPs THAT WE FOUND IN THE 595 00:22:36,160 --> 00:22:37,680 THROAT THAT HAD DIVERGED FROM 596 00:22:37,680 --> 00:22:38,880 THE URINARY TRACT, SUGGESTING 597 00:22:38,880 --> 00:22:40,600 THAT THOSE DIVERGED ON THE 598 00:22:40,600 --> 00:22:42,560 PATIENT AND THEN ACTUALLY WERE, 599 00:22:42,560 --> 00:22:45,240 YOU KNOW, DIVERSIFIED ON THE 600 00:22:45,240 --> 00:22:46,440 BODY SITES. 601 00:22:46,440 --> 00:22:50,040 WE FOUND THREE DIFFERENT SNPs 602 00:22:50,040 --> 00:22:52,800 WHEN WE LOOKED AT THE GROIN 603 00:22:52,800 --> 00:22:53,240 ISOLETTES. 604 00:22:53,240 --> 00:22:55,880 SO WE WOULD SAY THAT THESE 605 00:22:55,880 --> 00:22:57,920 SNPs EVOLVED IN THAT PATIENT 606 00:22:57,920 --> 00:23:03,280 ON OUR SIGNATURE OF HER GENETIC 607 00:23:03,280 --> 00:23:03,640 STATE. 608 00:23:03,640 --> 00:23:04,920 THEN WE ISOLATED PATIENTS THAT 609 00:23:04,920 --> 00:23:06,920 WE DID THE SEQUENCING ANALYSES 610 00:23:06,920 --> 00:23:11,800 FOR PATIENTS 3 AND PATIENTS 2, U 611 00:23:11,800 --> 00:23:12,280 3 AND 2. 612 00:23:12,280 --> 00:23:14,800 AND WHAT WE SAW WAS THAT PATIENT 613 00:23:14,800 --> 00:23:17,600 3'S THROAT ISOLATE WAS EXACTLY 614 00:23:17,600 --> 00:23:18,800 IDENTICAL TO PATIENT 1 AND 615 00:23:18,800 --> 00:23:22,760 CARRIED THOSE THREE SNPs THAT 616 00:23:22,760 --> 00:23:24,640 WE BELIEVE EVOLVED ON PATIENT 617 00:23:24,640 --> 00:23:25,960 1 AND WERE SIGNATURE FOR HER 618 00:23:25,960 --> 00:23:26,800 ISOLATES. 619 00:23:26,800 --> 00:23:28,920 PATIENT 2 HAD ONE ADDITIONAL SNP 620 00:23:28,920 --> 00:23:31,080 SO WITH THE GENETIC MAPPING, WE 621 00:23:31,080 --> 00:23:34,360 WOULD SAY THAT THE MOST 622 00:23:34,360 --> 00:23:36,680 PARSIMONIOUS EXPLANATION IS THAT 623 00:23:36,680 --> 00:23:37,720 PATIENT 1 TRANSMITTED TO PATIENT 624 00:23:37,720 --> 00:23:39,400 3, WHO THEN TRANSMITTED TO 625 00:23:39,400 --> 00:23:43,000 PATIENT 2. 626 00:23:43,000 --> 00:23:43,920 AND IN THE CONVERSATION WE HAD 627 00:23:43,920 --> 00:23:46,520 THE NEXT MORNING WITH 628 00:23:46,520 --> 00:23:47,320 DR. PALMORE, SHE SAID, YES, 629 00:23:47,320 --> 00:23:50,560 THAT'S EXACTLY WHAT OUR 630 00:23:50,560 --> 00:23:52,440 EPIDEMIOLOGIC DATA WOULD 631 00:23:52,440 --> 00:23:52,960 SUGGEST. 632 00:23:52,960 --> 00:23:54,640 PATIENT 1 AND 3 OVERLAPPED IN 633 00:23:54,640 --> 00:23:56,440 THE ICU AND THEN PATIENT 2 AND 634 00:23:56,440 --> 00:23:58,320 PATIENT 3 OVERLAPPED IN THE ICU 635 00:23:58,320 --> 00:24:01,280 AFTER PATIENT 1 WAS ALREADY 636 00:24:01,280 --> 00:24:01,840 DISCHARGED. 637 00:24:01,840 --> 00:24:03,480 SO FOR THE FIRST TIME WHAT WE 638 00:24:03,480 --> 00:24:05,880 HAD WAS GENETIC AND 639 00:24:05,880 --> 00:24:07,720 EPIDEMIOLOGIC DATA THAT WERE 640 00:24:07,720 --> 00:24:10,120 BOTH CONSISTENT WITH A 641 00:24:10,120 --> 00:24:11,760 TRANSMISSION AND A REALTIME 642 00:24:11,760 --> 00:24:16,800 ASSESSMENT OF HOW WE NEEDED TO 643 00:24:16,800 --> 00:24:20,000 CONSIDER HOSPITAL PRACTICE IN 644 00:24:20,000 --> 00:24:24,480 THAT THIS WOULD SUGGEST THAT THE 645 00:24:24,480 --> 00:24:25,160 TRANSMISSIONS -- THAT THE 646 00:24:25,160 --> 00:24:27,440 SCREENING WAS INSUFFICIENT AND 647 00:24:27,440 --> 00:24:30,280 THAT PROBABLY SUBJECT 3 WAS 648 00:24:30,280 --> 00:24:31,760 COLONIZED FOR A LONGER PERIOD OF 649 00:24:31,760 --> 00:24:35,000 TIME THAN WAS DETECTED. 650 00:24:35,000 --> 00:24:38,160 OVER THE NEXT SIX MONTHS, 651 00:24:38,160 --> 00:24:40,920 SCREENING CONTINUED AND 652 00:24:40,920 --> 00:24:44,080 COLONIZATION WAS DETECTED IN AN 653 00:24:44,080 --> 00:24:49,000 ADDITIONAL TOTAL OF 18 PATIENTS, 654 00:24:49,000 --> 00:24:51,840 AND AS DR. PALMORE SORT OF 655 00:24:51,840 --> 00:24:53,040 RUSHED THROUGH TRYING TO WORK TO 656 00:24:53,040 --> 00:24:54,040 UNDERSTAND WHAT WERE THE 657 00:24:54,040 --> 00:24:55,680 TRANSMISSIONS THAT WERE 658 00:24:55,680 --> 00:24:57,280 OCCURRING, WE CONTINUED TO BUILD 659 00:24:57,280 --> 00:24:59,600 THIS GENETIC MAP BECAUSE IF YOU 660 00:24:59,600 --> 00:25:02,040 LOOK AT IT JUST WITH 661 00:25:02,040 --> 00:25:02,880 EPIDEMIOLOGIC DATA, WHICH IS 662 00:25:02,880 --> 00:25:05,000 WHAT YOU'D HAVE ON THE LEFT, YOU 663 00:25:05,000 --> 00:25:07,480 SEE THE SORT OF PLATE OF 664 00:25:07,480 --> 00:25:08,480 SPAGHETTI, AND WE KEPT HAVING 665 00:25:08,480 --> 00:25:09,680 THESE QUESTIONS OF, YOU KNOW, 666 00:25:09,680 --> 00:25:13,920 HOW DID PATIENT 15 BECOME -- HOW 667 00:25:13,920 --> 00:25:16,840 DID PATIENT 15 BECOME INFECTED 668 00:25:16,840 --> 00:25:20,200 AND WAS IT FROM THIS PERSON OR 669 00:25:20,200 --> 00:25:21,680 THAT PERSON, AND THERE WERE A 670 00:25:21,680 --> 00:25:24,760 LOT OF FALSE LEADS THAT WE WERE 671 00:25:24,760 --> 00:25:27,600 ABLE TO -- THAT WAS ACTUALLY 672 00:25:27,600 --> 00:25:28,960 ABLE TO DISCOUNT LIKE THERE 673 00:25:28,960 --> 00:25:29,800 WOULD BE SOMETHING WHERE THERE 674 00:25:29,800 --> 00:25:31,360 WOULD BE THE SAME BURN CART 675 00:25:31,360 --> 00:25:32,560 BEING USED ON DIFFERENT SUBJECTS 676 00:25:32,560 --> 00:25:34,520 AND WE COULD SAY NO, IT WASN'T 677 00:25:34,520 --> 00:25:36,840 THAT PATIENT 17 TRANSMITTED TO 678 00:25:36,840 --> 00:25:37,200 PATIENT 18. 679 00:25:37,200 --> 00:25:39,600 WE SEE THAT THEY ARE GENETICALLY 680 00:25:39,600 --> 00:25:40,880 DISTINCT, YOU KNOW, PUT YOUR 681 00:25:40,880 --> 00:25:41,680 RESOURCES TO LOOK SOMEWHERE 682 00:25:41,680 --> 00:25:43,960 ELSE. 683 00:25:43,960 --> 00:25:45,280 SO THAT'S THE BEGINNING OF HOW 684 00:25:45,280 --> 00:25:47,720 WE STARTED USING GENOMIC 685 00:25:47,720 --> 00:25:48,360 INFORMATION TO TRACK 686 00:25:48,360 --> 00:25:49,520 TRANSMISSION. 687 00:25:49,520 --> 00:25:50,760 AND NOW I JUST WANT TO TALK 688 00:25:50,760 --> 00:25:53,160 ABOUT SOME OF THE WORK WE'RE 689 00:25:53,160 --> 00:26:00,520 DOING NOW, LOOKING AT CANDIDA 690 00:26:00,520 --> 00:26:00,760 AURUS. 691 00:26:00,760 --> 00:26:03,360 IT WAS FIRST DETECTED IN 2008, 692 00:26:03,360 --> 00:26:07,040 AND EMERGED SIMULTANEOUSLY ON 693 00:26:07,040 --> 00:26:08,920 DIFFERENT CONTINENTS, BUT BY 694 00:26:08,920 --> 00:26:11,320 NOW, THERE ARE OUTBREAKS OF 695 00:26:11,320 --> 00:26:22,040 CANDYCANDIDA AURIS, IT IS THE FT 696 00:26:22,040 --> 00:26:24,480 FUNGUS TO BE RATED AS AN URGENT 697 00:26:24,480 --> 00:26:25,320 THREAT. 698 00:26:25,320 --> 00:26:30,040 BY THE CDC AND THE WORLD HEALTH 699 00:26:30,040 --> 00:26:32,120 ORGANIZATION, BECAUSE OF ITS 700 00:26:32,120 --> 00:26:33,880 EXTREMELY HIGH LEVEL OF 701 00:26:33,880 --> 00:26:34,840 ANTIMICROBIAL RESISTANCE, WHICH 702 00:26:34,840 --> 00:26:36,200 CAUSES DIFFICULT TO TREAT 703 00:26:36,200 --> 00:26:37,480 BLOODSTREAM INFECTIONS AND THE 704 00:26:37,480 --> 00:26:39,440 ISSUE IS THAT PATIENTS ARE 705 00:26:39,440 --> 00:26:43,600 COLONIZED ON THEIR SKIN SO 706 00:26:43,600 --> 00:26:44,600 THEY'RE INFECTED IN THE 707 00:26:44,600 --> 00:26:45,840 BLOODSTREAM BUT THEY REMAIN 708 00:26:45,840 --> 00:26:47,080 COLONIZED ON THE SKIN AND FROM 709 00:26:47,080 --> 00:26:51,160 THE SKIN, YOU SHED INTO THE 710 00:26:51,160 --> 00:26:52,360 ENVIRONMENT ABOUT A MILLION 711 00:26:52,360 --> 00:26:53,360 MICROBES AN HOUR, SO YOU'RE 712 00:26:53,360 --> 00:26:55,520 SHEDDING INTO THE ENVIRONMENT, 713 00:26:55,520 --> 00:26:56,960 AND THAT'S REALLY DIFFICULT IF 714 00:26:56,960 --> 00:27:00,800 YOU'RE IN THESE NURSING HOMES 715 00:27:00,800 --> 00:27:03,360 WHERE PEOPLE LIVE FOR PROLONGED 716 00:27:03,360 --> 00:27:07,640 PERIODS. 717 00:27:07,640 --> 00:27:10,720 SO WORKING WITH DR. MARY HAYDEN 718 00:27:10,720 --> 00:27:12,280 IN THE CHICAGO DEPARTMENT OF 719 00:27:12,280 --> 00:27:15,760 HEALTH, WE ASKED WHY ARE THESE 720 00:27:15,760 --> 00:27:16,520 SO INTRACTABLE. 721 00:27:16,520 --> 00:27:18,360 AT THIS .1 OF THE ISSUES IS 722 00:27:18,360 --> 00:27:19,360 AGAIN COMING BACK TO WHAT SITE 723 00:27:19,360 --> 00:27:21,880 DO YOU DO SURVEILLANCE ON. 724 00:27:21,880 --> 00:27:26,040 THE TRADITIONAL SURVEILLANCE IS 725 00:27:26,040 --> 00:27:26,680 AXILLA GROIN. 726 00:27:26,680 --> 00:27:28,960 WHAT WE FOUND IN THIS DOING 727 00:27:28,960 --> 00:27:30,440 SURVEILLANCE OF MULTIPLE BODY 728 00:27:30,440 --> 00:27:31,720 SITES OF THE 57 SUBJECTS LIVING 729 00:27:31,720 --> 00:27:34,960 IN THIS NURSING HOME IS THAT 730 00:27:34,960 --> 00:27:36,320 ACTUALLY THE SITE OF HIGHEST 731 00:27:36,320 --> 00:27:38,360 COLONIZATION IS THE NARES, BUT 732 00:27:38,360 --> 00:27:39,920 UNFORTUNATELY WHAT WE FOUND WAS 733 00:27:39,920 --> 00:27:43,400 THAT WE WOULD HAVE TO DO 734 00:27:43,400 --> 00:27:44,480 SURVEILLANCE ON SIX BODY SITES 735 00:27:44,480 --> 00:27:45,800 IN ORDER TO IDENTIFY EVERY 736 00:27:45,800 --> 00:27:46,840 PATIENT WHO WAS COLONIZED ON 737 00:27:46,840 --> 00:27:49,000 THEIR SKIN. 738 00:27:49,000 --> 00:27:50,200 SO THAT MAKES IT REALLY 739 00:27:50,200 --> 00:27:51,840 DIFFICULT TO FIND EVERY PATIENT 740 00:27:51,840 --> 00:27:53,840 AND THEN PUT THEM INTO CONTACT 741 00:27:53,840 --> 00:27:56,000 ISOLATION. 742 00:27:56,000 --> 00:27:58,480 AND TO DO THAT FOR EVERY PATIENT 743 00:27:58,480 --> 00:27:59,720 WHO'S BEING ADMITTED INTO THE 744 00:27:59,720 --> 00:28:02,800 NURSING HOME. 745 00:28:02,800 --> 00:28:06,760 AND SO NOW WE'RE FACED WITH THIS 746 00:28:06,760 --> 00:28:08,920 DIFFICULT SITUATION WHERE THE 747 00:28:08,920 --> 00:28:15,120 OCCULT COLONIZATION MAY UNDERLIE 748 00:28:15,120 --> 00:28:16,680 THIS ENDEMIC, INTRACTABLE 749 00:28:16,680 --> 00:28:17,000 OUTBREAK. 750 00:28:17,000 --> 00:28:19,760 WE'RE USING THIS DATA TO TRY TO 751 00:28:19,760 --> 00:28:25,360 THINK ABOUT WHY -- WHAT IS THE 752 00:28:25,360 --> 00:28:27,520 PREDISPOSITION TO BECOMING 753 00:28:27,520 --> 00:28:30,360 COLONIZED WITH CANDIDA AURIS IN 754 00:28:30,360 --> 00:28:31,480 TERMS OF IS THERE SOMETHING 755 00:28:31,480 --> 00:28:32,760 PROTECTIVE IN THE SKIN 756 00:28:32,760 --> 00:28:33,640 MICROBIOME THAT WE COULD 757 00:28:33,640 --> 00:28:33,920 LEVERAGE. 758 00:28:33,920 --> 00:28:38,920 SO THE DOMINANT FUNGI IS 759 00:28:38,920 --> 00:28:39,760 MALESSEZIA FOR THE SKIN 760 00:28:39,760 --> 00:28:40,760 COMMUNITIES BUT WHAT WE OBSERVED 761 00:28:40,760 --> 00:28:42,400 IN THIS NURSING HOME IS THAT 762 00:28:42,400 --> 00:28:43,920 THERE ARE THE BLUE DOTS, WHICH 763 00:28:43,920 --> 00:28:48,760 ARE THE MALASSEZIA DOMINATED 764 00:28:48,760 --> 00:28:50,040 POPULATIONS BUT EACH DOT 765 00:28:50,040 --> 00:28:51,600 REPRESENTS THE BODY SITE OF A 766 00:28:51,600 --> 00:28:52,000 SUBJECT. 767 00:28:52,000 --> 00:28:56,040 THERE ALSO IS A CANDIDA DIVERSE 768 00:28:56,040 --> 00:28:57,200 COMMUNITY ON THESE INDIVIDUALS. 769 00:28:57,200 --> 00:28:59,120 AND WHEN WE LOOKED AT THE 770 00:28:59,120 --> 00:29:00,680 MONTHLY SURVEYS, ON THE 771 00:29:00,680 --> 00:29:05,840 RIGHT-HAND SIDE, WHAT WE COULD 772 00:29:05,840 --> 00:29:10,240 SEE, THERE IS AN 80% CHANCE. 773 00:29:10,240 --> 00:29:14,560 IF YOU'RE MALASSEZIA DIVERSE, A 774 00:29:14,560 --> 00:29:16,560 MONTH LATER YOU WILL STILL BE AT 775 00:29:16,560 --> 00:29:17,240 THAT BODY SITE. 776 00:29:17,240 --> 00:29:19,200 BUT THERE IS A 9% CHANCE YOU 777 00:29:19,200 --> 00:29:21,200 WOULD GO TO BEING CANDIDA 778 00:29:21,200 --> 00:29:21,760 DIVERSE. 779 00:29:21,760 --> 00:29:23,040 ONCE YOU'RE CANDIDA DIVERSE, 780 00:29:23,040 --> 00:29:25,680 THEN THERE'S AN EQUAL CLANS THAE 781 00:29:25,680 --> 00:29:28,680 THAT YOU WOULD STAY CANDIDA 782 00:29:28,680 --> 00:29:29,840 DIVERSE AS THAT YOU WOULD GULF 783 00:29:29,840 --> 00:29:32,240 COAST COLONIZED WITH CANDIDA 784 00:29:32,240 --> 00:29:32,680 AURIS. 785 00:29:32,680 --> 00:29:33,520 AND IF YOU ARE, THERE'S A 786 00:29:33,520 --> 00:29:35,400 GREATER THAN 50% CHANCE THAT YOU 787 00:29:35,400 --> 00:29:37,360 WILL REMAIN COLONIZED WITH 788 00:29:37,360 --> 00:29:37,920 CANDIDA AURIS. 789 00:29:37,920 --> 00:29:39,520 SO THIS TAKES US BACK AT LEAST 790 00:29:39,520 --> 00:29:44,040 ONE STEP WHERE WE CAN THINK 791 00:29:44,040 --> 00:29:46,680 ABOUT TRYING TO INTERVENE AT THE 792 00:29:46,680 --> 00:29:49,960 POINT WHERE THERE IS A CANDIDA 793 00:29:49,960 --> 00:29:51,720 DIVERSE COMMUNITY. 794 00:29:51,720 --> 00:29:57,480 IN CONCLUSION, UNDERSTANDING THE 795 00:29:57,480 --> 00:29:58,720 MICROBIOME WILL REVOLUTIONIZE 796 00:29:58,720 --> 00:29:59,800 WHAT IT MEANS TO BE HUMAN, WHAT 797 00:29:59,800 --> 00:30:01,120 IT MEANS TO BE HEALTHY, AND 798 00:30:01,120 --> 00:30:02,640 PROVIDE NEW INSIGHTS TO FIGHT 799 00:30:02,640 --> 00:30:04,920 FOR MICROBIAL FOES AND CULTIVATE 800 00:30:04,920 --> 00:30:05,840 OUR MICROBIAL FRIENDS. 801 00:30:05,840 --> 00:30:11,080 AND I'LL JUST SAY THAT THE 802 00:30:11,080 --> 00:30:12,040 RESEARCH WORK HAS BEEN PART OF 803 00:30:12,040 --> 00:30:14,240 THE U.S. GOVERNMENT AND BEING AT 804 00:30:14,240 --> 00:30:16,080 NIH HAS ENABLED ME THESE GREAT 805 00:30:16,080 --> 00:30:18,920 OPPORTUNITIES TO WORK ACROSS THE 806 00:30:18,920 --> 00:30:19,960 U.S. GOVERNMENT INCLUDING 807 00:30:19,960 --> 00:30:25,000 WORKING ON PCAST, NATIONAL 808 00:30:25,000 --> 00:30:25,880 ACADEMIES REPORTS AND WORKING ON 809 00:30:25,880 --> 00:30:27,440 THE NCAA DEFENSE STRATEGY. 810 00:30:27,440 --> 00:30:29,400 I'LL CLOSE QUICKLY BY 811 00:30:29,400 --> 00:30:30,720 ACKNOWLEDGING THE AMAZING PEOPLE 812 00:30:30,720 --> 00:30:32,240 THAT I'VE HAD THE CHANCE TO WORK 813 00:30:32,240 --> 00:30:33,120 WITH. 814 00:30:33,120 --> 00:30:36,320 IN PARTICULAR, TEAM SCIENCE HAS 815 00:30:36,320 --> 00:30:37,200 REALLY BEEN AT THE FOREFRONT OF 816 00:30:37,200 --> 00:30:39,280 ALL OF THIS WORK, WORKING WITH 817 00:30:39,280 --> 00:30:44,480 DR. CONGRESS, DR. PALMORE, 818 00:30:44,480 --> 00:30:46,960 DR. BELKAID AND MY FABULOUS LAB, 819 00:30:46,960 --> 00:30:47,840 THE 2011 GROUP WHO STARTED ALL 820 00:30:47,840 --> 00:30:49,240 OF THIS WORK AND THE CHERRY 821 00:30:49,240 --> 00:30:52,760 BLOSSOMS IN 2023, AND MY 822 00:30:52,760 --> 00:30:53,360 ADVISORS AND FAMILY. 823 00:30:53,360 --> 00:30:53,760 THANK YOU. 824 00:30:53,760 --> 00:31:03,920 [APPLAUSE] 825 00:31:05,840 --> 00:31:07,960 >>IF WE VL ANY QUESTIONS FROM 826 00:31:07,960 --> 00:31:09,480 OUR AUDIENCE HERE IN LIPSETT, 827 00:31:09,480 --> 00:31:11,040 WE'LL START THERE. 828 00:31:11,040 --> 00:31:11,880 >>BEAUTIFUL TALK. 829 00:31:11,880 --> 00:31:13,040 IS THIS ON? 830 00:31:13,040 --> 00:31:14,000 OKAY. 831 00:31:14,000 --> 00:31:16,720 CAN YOU COMMENT ON SOME OF THE 832 00:31:16,720 --> 00:31:18,800 THINGS THAT YOU THINK HELPED TO 833 00:31:18,800 --> 00:31:20,360 MAINTAIN THE STABILITY OF THE 834 00:31:20,360 --> 00:31:22,120 MICROBIOME, LIKE LOCAL RESIDENT 835 00:31:22,120 --> 00:31:24,200 IMMUNE CELLS AND HOW THAT MIGHT 836 00:31:24,200 --> 00:31:26,720 CHANGE IN CONDITIONS OF 837 00:31:26,720 --> 00:31:27,840 AUTOIMMUNITY AND THE FEEDBACK 838 00:31:27,840 --> 00:31:29,040 BETWEEN THOSE TWO THINGS? 839 00:31:29,040 --> 00:31:30,640 >>YEAH. 840 00:31:30,640 --> 00:31:33,920 THANKS, KELLY. 841 00:31:33,920 --> 00:31:35,040 SO THE STABILITY OF THE SKIN 842 00:31:35,040 --> 00:31:35,880 MICROBIOME IS SOMETHING WE 843 00:31:35,880 --> 00:31:37,840 LOOKED AT A LOT IN COMMENSALS, 844 00:31:37,840 --> 00:31:39,640 BECAUSE THAT HELPS US POWER OUR 845 00:31:39,640 --> 00:31:41,440 CLINICAL STUDIES WHERE WE LOOK 846 00:31:41,440 --> 00:31:42,920 AT -- THERE'S A FAIR AMOUNT OF 847 00:31:42,920 --> 00:31:45,520 VARIATION BETWEEN INDIVIDUALS, 848 00:31:45,520 --> 00:31:47,280 BUT WE NOW POWER OUR CLINICAL 849 00:31:47,280 --> 00:31:48,480 STUDIES BY USING SOMEONE AS 850 00:31:48,480 --> 00:31:49,560 THEIR OWN CONTROL. 851 00:31:49,560 --> 00:31:52,280 SO IT'S IMPORTANT FOR US TO 852 00:31:52,280 --> 00:31:53,960 UNDERSTAND ON A WEEKLY, MONTHLY 853 00:31:53,960 --> 00:31:54,880 BASIS, WHAT KIND OF STABILITY 854 00:31:54,880 --> 00:31:55,280 THERE IS. 855 00:31:55,280 --> 00:31:57,680 AND WE SEE THE STABILITY AT THE 856 00:31:57,680 --> 00:31:59,440 MICROBIAL COMMUNITY LEVEL AND AT 857 00:31:59,440 --> 00:32:00,200 THE STRAIN LEVEL. 858 00:32:00,200 --> 00:32:01,960 AND WE ATTRIBUTE THAT TO THE 859 00:32:01,960 --> 00:32:03,360 FACT THAT THE MICROBES AREN'T 860 00:32:03,360 --> 00:32:05,000 JUST LIVING ON THE SURFACE OF 861 00:32:05,000 --> 00:32:05,440 YOUR SKIN. 862 00:32:05,440 --> 00:32:07,000 THEY'RE ACTUALLY LIVING MUCH 863 00:32:07,000 --> 00:32:09,720 DEEPER IN YOUR SKIN, SO THEY'RE 864 00:32:09,720 --> 00:32:11,240 LIVING INSIDE THE HAIR FOLLICLES 865 00:32:11,240 --> 00:32:13,120 AND THE SEBACEOUS GLANDS, AND 866 00:32:13,120 --> 00:32:14,200 THAT MEANS THAT WHEN YOU WASH 867 00:32:14,200 --> 00:32:17,440 YOUR SKIN, YOU'RE NOT ACTUAL 868 00:32:17,440 --> 00:32:19,040 ACTUALLY -- YOU'RE REMOVING THE 869 00:32:19,040 --> 00:32:20,320 RESIDENT MICROBES BUT YOU 870 00:32:20,320 --> 00:32:22,960 ACTUALLY HAVE AN UNDERLYING 871 00:32:22,960 --> 00:32:25,560 POPULATION THAT CAN MAINTAIN 872 00:32:25,560 --> 00:32:26,720 THAT COMMUNITY AT THE STRAIN 873 00:32:26,720 --> 00:32:28,120 LEVEL. 874 00:32:28,120 --> 00:32:30,920 AND I'M SURE THERE ARE ALSO 875 00:32:30,920 --> 00:32:33,360 THINGS, WE'RE LOOKING AT 876 00:32:33,360 --> 00:32:35,000 TRANSMISSIONS WITHIN FAMILIES 877 00:32:35,000 --> 00:32:36,640 AND THINKING ABOUT THE 878 00:32:36,640 --> 00:32:37,600 INHERITANCE OF THE MICROBIAL 879 00:32:37,600 --> 00:32:37,880 COMMUNITY. 880 00:32:37,880 --> 00:32:40,800 YEAH. 881 00:32:40,800 --> 00:32:41,880 >>JULIE, THANK YOU. 882 00:32:41,880 --> 00:32:42,360 THAT WAS GREAT. 883 00:32:42,360 --> 00:32:44,080 I HAVE A QUESTION ABOUT THE 884 00:32:44,080 --> 00:32:44,640 CANDIDA EXPERIMENTS. 885 00:32:44,640 --> 00:32:47,800 SO YOU SAID THAT SOME PEOPLE ARE 886 00:32:47,800 --> 00:32:49,040 COLONIZED WITH MALASSEZIA, AND 887 00:32:49,040 --> 00:32:50,960 THEN THERE'S A CONVERSION RATE 888 00:32:50,960 --> 00:32:54,480 TO CANDIDA, DIVERSE CANDIDA 889 00:32:54,480 --> 00:32:56,040 SPECIES. 890 00:32:56,040 --> 00:32:57,480 DOES ONE PRECLUDE THE OTHER? 891 00:32:57,480 --> 00:32:59,080 IN OTHIN OTHER WORDS, COULD YOU 892 00:32:59,080 --> 00:32:59,920 COLONIZE PEOPLE WITH MALASSEZIA 893 00:32:59,920 --> 00:33:02,280 TO PREVENT THEM FROM BEING 894 00:33:02,280 --> 00:33:04,560 COLONIZED WITH CANDIDA? 895 00:33:04,560 --> 00:33:09,800 YEAH, UM, SO WITH A LOT OF THESE 896 00:33:09,800 --> 00:33:10,800 EXPERIMENTS AND THE SORT OF 897 00:33:10,800 --> 00:33:17,720 CONCEPT OF MICROBIAL THERAPIES, 898 00:33:17,720 --> 00:33:19,440 YOU COULD IMAGINE USING 899 00:33:19,440 --> 00:33:24,200 BENEFICIAL MICROBES. 900 00:33:24,200 --> 00:33:26,480 AND BUT I WOULD SAY THAT I HAVE 901 00:33:26,480 --> 00:33:28,640 THOUGHT MORE ABOUT IT IN THE 902 00:33:28,640 --> 00:33:32,120 CONCEPT OF THE PREBIOTIC, 903 00:33:32,120 --> 00:33:33,320 PROBIOTIC, SYMBIOTIC, THAT 904 00:33:33,320 --> 00:33:37,600 PERHAPS WHAT WE WANT TO DO IS TO 905 00:33:37,600 --> 00:33:39,240 CULTIVATE THE HEALTHY MICROBES 906 00:33:39,240 --> 00:33:43,400 AND USE SKINCARE PRODUCTS THAT 907 00:33:43,400 --> 00:33:45,160 WILL HELP PROMOTE THE GROWTH OF 908 00:33:45,160 --> 00:33:50,200 THE BENEFICIAL MICROBES, THE 909 00:33:50,200 --> 00:33:53,160 MALASSEZIA, BECAUSE ADDING AN 910 00:33:53,160 --> 00:33:55,440 EXOGENOUS MICROBE HAS OTHER 911 00:33:55,440 --> 00:34:01,840 ISSUES. 912 00:34:01,840 --> 00:34:03,560 SO, YES, WE PROBABLY DO WANT TO 913 00:34:03,560 --> 00:34:07,080 USE OUR BENEFICIAL MICROBES 914 00:34:07,080 --> 00:34:08,800 TO -- YOU KNOW, TO -- AND IT 915 00:34:08,800 --> 00:34:10,760 COULD BE ACTUALLY BACTERIA. 916 00:34:10,760 --> 00:34:12,520 THERE'S A LOT OF BACTERIAL 917 00:34:12,520 --> 00:34:13,760 FUNGAL INTERACTION, SO WE COULD 918 00:34:13,760 --> 00:34:15,400 ALSO FIND BACTERIA THAT HELP TO 919 00:34:15,400 --> 00:34:17,280 PREVENT THE COLONIZATION WITH 920 00:34:17,280 --> 00:34:20,960 CANDIDA AURIS. 921 00:34:20,960 --> 00:34:22,440 I KNOW OF STUDIES LIKE THAT. 922 00:34:22,440 --> 00:34:25,320 BUT SOMETIMES YOU ALSO HAVE THIS 923 00:34:25,320 --> 00:34:27,000 CONCEPT WHICH IS TRUE DURING 924 00:34:27,000 --> 00:34:28,280 TRANSPLANT, IS TRUE FOR NURSING 925 00:34:28,280 --> 00:34:30,080 HOME PATIENTS, YOU'RE TRYING TO 926 00:34:30,080 --> 00:34:32,200 ALSO REDUCE THE MICROBIAL 927 00:34:32,200 --> 00:34:32,600 BURDEN. 928 00:34:32,600 --> 00:34:33,880 SO I THINK THAT MIGHT BE ANOTHER 929 00:34:33,880 --> 00:34:35,200 CASE WHERE YOU DON'T WANT TO 930 00:34:35,200 --> 00:34:38,800 JUST ADD ON LOTS OF MICROBES 931 00:34:38,800 --> 00:34:41,160 BECAUSE WE HAVE THIS CONCEPT OF 932 00:34:41,160 --> 00:34:43,320 SORT OF, YOU KNOW, COMMENSALS 933 00:34:43,320 --> 00:34:45,840 CAN BECOME PATHOGENS. 934 00:34:45,840 --> 00:34:49,000 >>OKAY, THANKS. 935 00:34:49,000 --> 00:34:55,000 [APPLAUSE] 936 00:34:55,000 --> 00:34:55,360 >>WONDERFUL. 937 00:34:55,360 --> 00:34:57,360 >>THANKS AGAIN, DR. SEGRE, FOR 938 00:34:57,360 --> 00:35:00,000 YOUR TALK. 939 00:35:00,000 --> 00:35:01,120 AND LOOKING AROUND, THERE ARE 940 00:35:01,120 --> 00:35:03,280 SOME AMAZING WOMEN HERE AT THE 941 00:35:03,280 --> 00:35:05,160 NIH THAT HAVE NOT ONLY DONE 942 00:35:05,160 --> 00:35:08,760 AMAZING RESEARCH, BUT HAVE ALSO 943 00:35:08,760 --> 00:35:10,440 DONE AMAZING WORK FOR EQUITY, 944 00:35:10,440 --> 00:35:11,480 BOTH FOR THEMSELVES AND THE 945 00:35:11,480 --> 00:35:14,040 WOMEN THAT COME AFTER THEM. 946 00:35:14,040 --> 00:35:16,640 AS MENTIONED, I AM A TENURE 947 00:35:16,640 --> 00:35:18,600 TRACK INVESTIGATOR AND ALONG 948 00:35:18,600 --> 00:35:20,040 WITH DR. PAULIE JOSEPH WHO WILL 949 00:35:20,040 --> 00:35:22,000 BE PRESENTING AT THE NEXT 950 00:35:22,000 --> 00:35:23,200 SESSION, THE JUNIOR 951 00:35:23,200 --> 00:35:24,400 REPRESENTATIVES FOR THE 952 00:35:24,400 --> 00:35:25,080 ORGANIZING COMMITTEE. 953 00:35:25,080 --> 00:35:26,160 AS MENTIONED AT THE BEGINNING OF 954 00:35:26,160 --> 00:35:28,240 THIS SESSION, WSA WAS 955 00:35:28,240 --> 00:35:31,000 ESTABLISHED IN 1993, ABOUT 30 956 00:35:31,000 --> 00:35:32,520 YEARS AGO. 957 00:35:32,520 --> 00:35:35,160 AND FROM THE JUNIOR WOMEN OF 958 00:35:35,160 --> 00:35:36,160 NIH, THANK YOU TO THOSE THAT 959 00:35:36,160 --> 00:35:38,040 CAME BEFORE US TO START THIS 960 00:35:38,040 --> 00:35:39,120 LONG JOURNEY. 961 00:35:39,120 --> 00:35:40,800 IT IS REALLY, REALLY 962 00:35:40,800 --> 00:35:41,600 APPRECIATED. 963 00:35:41,600 --> 00:35:43,080 IT MIGHT NOT SEEM TOO LONG AGO 964 00:35:43,080 --> 00:35:44,280 FOR THOSE WHO HAVE BEEN AT THE 965 00:35:44,280 --> 00:35:48,120 NIH FOR A WHILE, BUT FOR JUST A 966 00:35:48,120 --> 00:35:50,200 BIT OF CONTEXT FOR HOW LONG AND 967 00:35:50,200 --> 00:35:51,120 HARD THESE WOMEN HAVE BEEN 968 00:35:51,120 --> 00:35:53,720 WORKING FOR EQUITY, IN 1993, 969 00:35:53,720 --> 00:35:55,680 THIS IS WHAT I LOOKED LIKE. 970 00:35:55,680 --> 00:35:58,600 [LAUGHTER] 971 00:35:58,600 --> 00:36:01,040 I WAS 3 YEARS OLD. 972 00:36:01,040 --> 00:36:03,040 I AM THE VISIBLE REPRESENTATION 973 00:36:03,040 --> 00:36:04,120 OF THE TIME THAT THESE WOMEN 974 00:36:04,120 --> 00:36:05,520 HAVE TAKEN NOT ONLY TO DO 975 00:36:05,520 --> 00:36:07,720 AMAZING RESEARCH, BUT ALSO BRING 976 00:36:07,720 --> 00:36:10,240 WOMEN CLOSER TO EQUITY. 977 00:36:10,240 --> 00:36:11,480 NOW THAT LITTLE GIRL IS STARTING 978 00:36:11,480 --> 00:36:13,200 TO GET SOME GREY HAIRS, AND IN 979 00:36:13,200 --> 00:36:15,920 2019, I BECAME THE FIRST FEMALE 980 00:36:15,920 --> 00:36:18,360 P.I. AT NIBIB AND IN 2021, I 981 00:36:18,360 --> 00:36:20,320 BECAME THE FIRST WSA 982 00:36:20,320 --> 00:36:21,080 REPRESENTATIVE FOR OUR 983 00:36:21,080 --> 00:36:22,160 INSTITUTE. 984 00:36:22,160 --> 00:36:24,520 SO WE'VE COME VERY FAR SINCE 985 00:36:24,520 --> 00:36:26,120 1993, BUT THERE ARE STILL 986 00:36:26,120 --> 00:36:28,400 BARRIERS THAT WOMEN FACE. 987 00:36:28,400 --> 00:36:30,280 SO JUNIOR WOMEN AS WE COME IN TO 988 00:36:30,280 --> 00:36:30,960 DIFFERENT ENVIRONMENTS, THIS IS 989 00:36:30,960 --> 00:36:33,440 TRUE FOR A NUMBER OF 990 00:36:33,440 --> 00:36:35,400 INSTITUTIONS, WE DO LOOK TO 991 00:36:35,400 --> 00:36:36,640 LEADERSHIP AND WE DO NOTICE WHEN 992 00:36:36,640 --> 00:36:39,680 WOMEN ARE ABSENT. 993 00:36:39,680 --> 00:36:40,800 WOMEN -- WE CAN SEE WHEN WOMEN 994 00:36:40,800 --> 00:36:42,200 ARE IN LEADERSHIP ROLES THAT 995 00:36:42,200 --> 00:36:44,280 INVOLVE A LOT OF RESPONSIBILITY, 996 00:36:44,280 --> 00:36:45,480 BUT NOT NECESSARILY A LOT OF 997 00:36:45,480 --> 00:36:47,440 AUTHORITY. 998 00:36:47,440 --> 00:36:52,400 AND OF COURSE THERE ARE INFORMAL 999 00:36:52,400 --> 00:36:56,440 GROUPS -- STILL PRESENT ACROSS 1000 00:36:56,440 --> 00:36:57,320 MANY INSTITUTES. 1001 00:36:57,320 --> 00:36:58,720 WOMEN IN GENERAL CAN RECEIVE 1002 00:36:58,720 --> 00:36:59,920 LESS CREDIT IN SCIENCE AND 1003 00:36:59,920 --> 00:37:01,920 THEY'RE A LARGER BURDEN OF 1004 00:37:01,920 --> 00:37:02,560 NON-PROMOTABLE TASK. 1005 00:37:02,560 --> 00:37:04,640 THIS IS A NON-PROMOTABLE TASK. 1006 00:37:04,640 --> 00:37:05,800 [LAUGHTER] 1007 00:37:05,800 --> 00:37:07,080 AND WHEN WOMEN DO RECEIVE 1008 00:37:07,080 --> 00:37:09,160 CREDIT, IT'S SEEN BY SOME AS NOT 1009 00:37:09,160 --> 00:37:11,560 RIGHTFULLY EARNED. 1010 00:37:11,560 --> 00:37:14,400 SO RECENTLY THERE WAS AN 1011 00:37:14,400 --> 00:37:16,160 INTERVIEW BY THE OUTGOING PRIME 1012 00:37:16,160 --> 00:37:17,920 MINISTER OF NEW ZEALAND AND SHE 1013 00:37:17,920 --> 00:37:18,800 MENTIONED THAT ONE DAY ALL THAT 1014 00:37:18,800 --> 00:37:20,880 WILL BE LEFT OF HER IS A PHOTO 1015 00:37:20,880 --> 00:37:22,640 IN PARLIAMENT, AND HOW SHE MADE 1016 00:37:22,640 --> 00:37:23,680 PEOPLE FEEL. 1017 00:37:23,680 --> 00:37:26,920 THE REPORTER THEN ASKED HER, HOW 1018 00:37:26,920 --> 00:37:28,280 DID YOU MAKE YOURSELF FEEL? 1019 00:37:28,280 --> 00:37:32,520 AND SHE SAID, TIRED. 1020 00:37:32,520 --> 00:37:34,720 SO IT'S NOT JUST THE WSA AND 1021 00:37:34,720 --> 00:37:35,600 THESE SENIOR WOMEN THAT HAVE 1022 00:37:35,600 --> 00:37:37,720 BEEN PUSHING FOR YEARS THAT CAN 1023 00:37:37,720 --> 00:37:39,880 SUPPORT NEW WOMEN AT THE NIH. 1024 00:37:39,880 --> 00:37:43,160 OF COURSE WE HAVE WSA BUT ALSO 1025 00:37:43,160 --> 00:37:44,640 SUPERVISORS OF WOMEN SCIENTISTS, 1026 00:37:44,640 --> 00:37:47,760 I'M VERY THANKFUL TO HAVE A 1027 00:37:47,760 --> 00:37:49,320 SUPPORTIVE MENTOR HERE AT THE 1028 00:37:49,320 --> 00:37:52,040 NIH, OUR SCIENTIFIC DIRECTOR, 1029 00:37:52,040 --> 00:37:54,560 DR. RICHARD LEETMAN, VERY 1030 00:37:54,560 --> 00:37:55,640 THANKFUL FOR HIM. 1031 00:37:55,640 --> 00:37:57,080 OUR MALE COLLEAGUES, IF YOU SEE 1032 00:37:57,080 --> 00:37:58,200 SOMETHING, SAY SOMETHING, SPEAK 1033 00:37:58,200 --> 00:38:00,400 OUT AGAINST SOMETHING IF IT 1034 00:38:00,400 --> 00:38:02,680 LOOKS LIKE IT'S WRONG, STAND UP 1035 00:38:02,680 --> 00:38:04,120 FOR PEOPLE WHO MIGHT NOT BE ABLE 1036 00:38:04,120 --> 00:38:05,240 TO STAND UP FOR THEMSELVES. 1037 00:38:05,240 --> 00:38:06,640 AND OF COURSE OTHER WOMEN 1038 00:38:06,640 --> 00:38:07,760 SUPPORTING OUR INTERSECTIONAL 1039 00:38:07,760 --> 00:38:08,080 COLLEAGUES. 1040 00:38:08,080 --> 00:38:09,360 WOMEN OF COLOR, DISABLED WOMEN 1041 00:38:09,360 --> 00:38:11,680 IN SCIENCE, AND THE LGBTQ 1042 00:38:11,680 --> 00:38:12,160 COMMUNITY. 1043 00:38:12,160 --> 00:38:12,960 WE HAVE TO MAKE SURE THAT WE'RE 1044 00:38:12,960 --> 00:38:14,560 THERE FOR EACH OTHER. 1045 00:38:14,560 --> 00:38:17,840 AND OF COURSE, WE KNOW THAT 1046 00:38:17,840 --> 00:38:19,000 DIVERSE LABS COME WITH DIFFERENT 1047 00:38:19,000 --> 00:38:20,800 IDEAS AND ARE MORE INNOVATIVE. 1048 00:38:20,800 --> 00:38:22,960 THEY HELP AVOID GROUP THINK AND 1049 00:38:22,960 --> 00:38:24,880 THAT IS SOMETHING THAT CAN HAVE 1050 00:38:24,880 --> 00:38:25,840 SEVERE CONSEQUENCES. 1051 00:38:25,840 --> 00:38:28,160 AND HOW SEVERE? 1052 00:38:28,160 --> 00:38:30,040 THE NIGHT BEFORE LAUNCH, A GROUP 1053 00:38:30,040 --> 00:38:32,080 OF INDIVIDUALS FLAGGED A PROBLEM 1054 00:38:32,080 --> 00:38:34,480 WITH O-RINGS IN THE SPACE 1055 00:38:34,480 --> 00:38:36,480 SHUTTLE CHAL ENJER. 1056 00:38:36,480 --> 00:38:37,480 THEY DECIDED IT WAS OKAY. 1057 00:38:37,480 --> 00:38:39,320 THE FOLLOWING DAY, 74 SECONDS 1058 00:38:39,320 --> 00:38:40,760 AFTER LIFTOFF, SEVEN LIVES WERE 1059 00:38:40,760 --> 00:38:41,280 LOST. 1060 00:38:41,280 --> 00:38:42,880 AND NOW OUR DAY TO DAY MIGHT NOT 1061 00:38:42,880 --> 00:38:44,840 INVOLVE LAUNCHING PEOPLE ON 1062 00:38:44,840 --> 00:38:46,040 ROCKETS INTO SPACE, BUT THINK OF 1063 00:38:46,040 --> 00:38:48,720 THE DISCOVERIES OR THE DIFFERENT 1064 00:38:48,720 --> 00:38:50,120 IDEAS THAT MAY BE QUASHED 1065 00:38:50,120 --> 00:38:51,520 BECAUSE A ROOM DOES NOT INCLUDE 1066 00:38:51,520 --> 00:38:53,960 A DIVERSE SET OF MINDS. 1067 00:38:53,960 --> 00:38:55,800 GOOD WITH DISAGREEING WITH EACH 1068 00:38:55,800 --> 00:38:57,680 OTHER, FINDING HOLES IN OUR 1069 00:38:57,680 --> 00:38:58,800 ASSUMPTIONS, AND TO REALLY PUSH 1070 00:38:58,800 --> 00:39:00,120 FORWARD AND BREAK SCIENTIFIC 1071 00:39:00,120 --> 00:39:01,240 PARADIGMS. 1072 00:39:01,240 --> 00:39:02,640 AND SO HOW DO WE DO THAT? 1073 00:39:02,640 --> 00:39:04,040 HOW DO WE AVOID THIS GROUP 1074 00:39:04,040 --> 00:39:04,640 THINK? 1075 00:39:04,640 --> 00:39:06,880 WE LISTEN TO PEOPLE THAT ARE 1076 00:39:06,880 --> 00:39:07,880 UNDERREPRESENTED AND WE LISTEN 1077 00:39:07,880 --> 00:39:09,680 TO NEW EMERGING LEADERS W THAT 1078 00:39:09,680 --> 00:39:11,320 THOUGHT, I'M VERY HAPPY TO 1079 00:39:11,320 --> 00:39:12,840 INTRODUCE OUR NEXT SPEAKER 1080 00:39:12,840 --> 00:39:14,840 TODAY, DR. EMILY RICOTTA. 1081 00:39:14,840 --> 00:39:16,360 DR. RICOTTA IS AN INDEPENDENT 1082 00:39:16,360 --> 00:39:18,000 RESEARCH SCHOLAR AND CHIEF OF 1083 00:39:18,000 --> 00:39:19,640 THE EPIDEMIOLOGY AND DATA 1084 00:39:19,640 --> 00:39:21,640 MANAGEMENT UNIT IN NIAID. 1085 00:39:21,640 --> 00:39:24,480 IN 2019, SHE WAS ELECTED AS AN 1086 00:39:24,480 --> 00:39:26,120 EMERGING LEADER IN BIOSECURITY 1087 00:39:26,120 --> 00:39:27,320 INITIATIVE FELLOWSHIP PROGRAM. 1088 00:39:27,320 --> 00:39:29,720 AND WAS RECENTLY AWARDED A GRANT 1089 00:39:29,720 --> 00:39:30,840 TO ANALYZE DATA MANAGEMENT IN 1090 00:39:30,840 --> 00:39:32,360 REGIONS AT HIGH RISK FOR 1091 00:39:32,360 --> 00:39:33,360 INFECTIOUS DISEASE SPILLOVER. 1092 00:39:33,360 --> 00:39:35,320 WITH THAT, EMILY, PODIUM IS 1093 00:39:35,320 --> 00:39:36,000 YOURS. 1094 00:39:36,000 --> 00:39:43,640 [APPLAUSE] 1095 00:39:43,640 --> 00:39:45,160 >>THANK YOU SO MUCH TO THE 1096 00:39:45,160 --> 00:39:45,800 ORGANIZING COMMITTEE FOR 1097 00:39:45,800 --> 00:39:48,800 INVITING ME TO SPEAK TODAY, TO 1098 00:39:48,800 --> 00:39:50,880 DR. SAIDLER FOR THAT 1099 00:39:50,880 --> 00:39:52,960 INTRODUCTION, AND THANKS TO 1100 00:39:52,960 --> 00:39:54,720 DR. SEGRE FORGIVE AGO WONDERFUL 1101 00:39:54,720 --> 00:39:55,360 TALK BEFORE ME. 1102 00:39:55,360 --> 00:39:56,800 ONE OF THE THINGS I LOVE MOST 1103 00:39:56,800 --> 00:39:58,000 ABOUT WORKING AT NIH IS THE 1104 00:39:58,000 --> 00:39:59,000 COMMUNITY WE HAVE AND WE GET TO 1105 00:39:59,000 --> 00:40:00,760 WORK WITH AND FIGURING OUT HOW 1106 00:40:00,760 --> 00:40:03,160 WE GET TO COME TOGETHER AND WORK 1107 00:40:03,160 --> 00:40:04,560 ACROSS DIFFERENT DOMAINS AND 1108 00:40:04,560 --> 00:40:07,520 DIFFERENT FIELDS, FOR EXAMPLE, 1109 00:40:07,520 --> 00:40:08,800 DR. SEGRE STUDIES THE MICROBIOME 1110 00:40:08,800 --> 00:40:09,920 AND ALL THE DIFFERENT ORGANISMS 1111 00:40:09,920 --> 00:40:12,240 THAT ARE FOUND ALL OVER PEOPLE'S 1112 00:40:12,240 --> 00:40:13,520 BODIES AND CAROL IS SITTING HERE 1113 00:40:13,520 --> 00:40:16,480 BEING A LITTLE GROSSED OUT AND 1114 00:40:16,480 --> 00:40:20,280 IT'S MY JOB AS AN EPIDEMIOLOGIST 1115 00:40:20,280 --> 00:40:21,360 TO STUDY THE GROUPS OF PEOPLE 1116 00:40:21,360 --> 00:40:23,040 THAT ARE COVERED IN THOSE 1117 00:40:23,040 --> 00:40:24,240 MICROBES THAT RIN FECTED WITH 1118 00:40:24,240 --> 00:40:25,800 THEM OR HAVE THEM STUFFED ALL 1119 00:40:25,800 --> 00:40:26,880 OVER THEIR BODIES. 1120 00:40:26,880 --> 00:40:28,280 AND SO THERE'S ALWAYS A WAY TO 1121 00:40:28,280 --> 00:40:29,960 FIND THAT CROSS COMMUNICATION 1122 00:40:29,960 --> 00:40:31,560 AND IT'S A REALLY EXCELLENT 1123 00:40:31,560 --> 00:40:34,720 OPPORTUNITY TO GET TO DO THAT. 1124 00:40:34,720 --> 00:40:35,680 SO TODAY I'M GOING TO TALK TO 1125 00:40:35,680 --> 00:40:38,440 YOU ABOUT HOW WE TURN DATA INTO 1126 00:40:38,440 --> 00:40:38,720 SCIENCE. 1127 00:40:38,720 --> 00:40:40,400 I WANT TO START WITH POINTING 1128 00:40:40,400 --> 00:40:43,120 OUT SO I AM AN INDEPENDENT 1129 00:40:43,120 --> 00:40:44,040 RESEARCH SCHOLAR. 1130 00:40:44,040 --> 00:40:46,080 THIS IS A PROGRAM THAT HAS 1131 00:40:46,080 --> 00:40:47,640 CROSSED NIH AND IT IS WITH THE 1132 00:40:47,640 --> 00:40:51,360 GOAL OF IMPROVING WORKFORCE 1133 00:40:51,360 --> 00:40:53,040 DIVERSITY, TO BUILD A DIVERSE 1134 00:40:53,040 --> 00:40:54,680 INTRAMURAL RESEARCH PROGRAM. 1135 00:40:54,680 --> 00:40:57,520 SO INDIVIDUALS WHO ARE REALLY 1136 00:40:57,520 --> 00:40:59,040 DEDICATED TO HIRING A DIVERSE 1137 00:40:59,040 --> 00:41:03,560 WORKFORCE, TRAINING A DIVERSE 1138 00:41:03,560 --> 00:41:04,560 WORKFORCE SCHOLARS ARE 1139 00:41:04,560 --> 00:41:06,440 INDEPENDENT, WE ARE PRETENURE 1140 00:41:06,440 --> 00:41:07,560 TRACK, HOPEFULLY WE'LL BECOME 1141 00:41:07,560 --> 00:41:08,400 TENURE TRACK WHEN WE'RE DONE 1142 00:41:08,400 --> 00:41:09,960 WITH THE PROGRAM AND WE ARE 1143 00:41:09,960 --> 00:41:10,840 SCIENTIFICALLY INDEPENDENT OF 1144 00:41:10,840 --> 00:41:12,040 OUR PREVIOUS MENTORS. 1145 00:41:12,040 --> 00:41:13,800 IT'S A THREE-YEAR PERIOD, AND SO 1146 00:41:13,800 --> 00:41:15,320 IT GIVES US THE OPPORTUNITY TO 1147 00:41:15,320 --> 00:41:16,640 REALLY TRANSITION FROM THAT 1148 00:41:16,640 --> 00:41:17,520 POSTDOCTORAL WORK THROUGH TO 1149 00:41:17,520 --> 00:41:19,160 BEING AN INDEPENDENT 1150 00:41:19,160 --> 00:41:20,080 INVESTIGATOR, WHILE STILL 1151 00:41:20,080 --> 00:41:21,680 MAINTAINING THE MENTORSHIP OF 1152 00:41:21,680 --> 00:41:22,800 ALL THE WONDERFUL INVESTIGATORS 1153 00:41:22,800 --> 00:41:25,680 WE HAVE AT NIH. 1154 00:41:25,680 --> 00:41:29,600 SO BECAUSE OF THAT, MY LAB IS 1155 00:41:29,600 --> 00:41:29,920 VERY NEW. 1156 00:41:29,920 --> 00:41:32,360 WE ARE IN NIAID'S DIVISION OF 1157 00:41:32,360 --> 00:41:33,000 INTRAMURAL RESEARCH IN THE 1158 00:41:33,000 --> 00:41:34,200 LABORATORY OF CLINICAL 1159 00:41:34,200 --> 00:41:35,960 IMMUNOLOGY AND MICROBIOLOGY. 1160 00:41:35,960 --> 00:41:38,800 PHYSICALLY, WE ARE LOCATED IN 1161 00:41:38,800 --> 00:41:39,840 29B, WHICH MOST PEOPLE DON'T 1162 00:41:39,840 --> 00:41:43,320 KNOW WHERE IT IS, BUT FUN FACT, 1163 00:41:43,320 --> 00:41:45,960 IT FORMERLY HAS THE FDA CENTER 1164 00:41:45,960 --> 00:41:47,240 FOR BIOLOGICS AND RESEARCH AND 1165 00:41:47,240 --> 00:41:48,360 WE ARE STILL THERE. 1166 00:41:48,360 --> 00:41:50,320 I'M VERY PROUD OF OUR NEW OFFICE 1167 00:41:50,320 --> 00:41:52,880 AS WE JUST GOT IT A MONTH AGO, 1168 00:41:52,880 --> 00:41:53,600 SO STOP BY! 1169 00:41:53,600 --> 00:41:55,080 AND I JUST WANT TO GIVE A QUICK 1170 00:41:55,080 --> 00:41:56,680 SHOUT OUT TO MY WONDERFUL, 1171 00:41:56,680 --> 00:41:58,520 WONDERFUL UNIT. 1172 00:41:58,520 --> 00:42:01,960 WE HAVE EPIDEMIOLOGISTS, NURSE 1173 00:42:01,960 --> 00:42:02,920 PRACTITIONERS, CLINICAL STUDY 1174 00:42:02,920 --> 00:42:04,280 COORDINATORS AND WE ALSO LOVE 1175 00:42:04,280 --> 00:42:06,240 HAVING TRAINEES. 1176 00:42:06,240 --> 00:42:08,120 WE CURRENTLY HAVE A POSTBAC 1177 00:42:08,120 --> 00:42:09,840 TRAINEE IN THE UNIT, AND WE ALSO 1178 00:42:09,840 --> 00:42:12,200 WORK WITH DATA SCIENCE FELLOWS, 1179 00:42:12,200 --> 00:42:14,000 PRESIDENTIAL MANAGEMENT FELLOWS, 1180 00:42:14,000 --> 00:42:14,440 ALL VARIETIES. 1181 00:42:14,440 --> 00:42:15,840 SO WE'RE REALLY BIG ON TRAINING 1182 00:42:15,840 --> 00:42:20,840 IN THE UNIT IN THAT GROUP. 1183 00:42:20,840 --> 00:42:22,880 SO WHAT EXACTLY IS EPIDEMIOLOGY? 1184 00:42:22,880 --> 00:42:23,920 DR. SEGRE GAVE A BIT OF AN 1185 00:42:23,920 --> 00:42:24,840 INTRODUCTION TO THAT, BUT IT IS 1186 00:42:24,840 --> 00:42:26,480 THE STUDY OF THE DISTRIBUTION 1187 00:42:26,480 --> 00:42:29,440 AND DETERMINANTS OF DISEASE, AND 1188 00:42:29,440 --> 00:42:30,720 HEALTH-RELATED STATES IN 1189 00:42:30,720 --> 00:42:31,320 SPECIFIC POPULATIONS. 1190 00:42:31,320 --> 00:42:33,160 IT ALSO IS THE APPLICATION OF 1191 00:42:33,160 --> 00:42:34,360 THIS STUDY TO THE CONTROL OF 1192 00:42:34,360 --> 00:42:38,120 HEALTH PROBLEMS. 1193 00:42:38,120 --> 00:42:41,160 WHAT IS EPIDEMIOLOGY NOT? 1194 00:42:41,160 --> 00:42:43,480 REAL FAST, WE'RE NOT 1195 00:42:43,480 --> 00:42:44,400 BIOSTATISTICIANS. 1196 00:42:44,400 --> 00:42:45,160 THERE'S A DIFFERENCE. 1197 00:42:45,160 --> 00:42:46,560 SO IF YOU HAVE QUESTIONS, I'LL 1198 00:42:46,560 --> 00:42:47,640 TAKE THEM LATER. 1199 00:42:47,640 --> 00:42:48,080 [LAUGHTER] 1200 00:42:48,080 --> 00:42:50,280 YOU KNOW, EPIDEMIOLOGIST, WE DO 1201 00:42:50,280 --> 00:42:52,360 OUR OWN RESEARCH STUDIES, WE 1202 00:42:52,360 --> 00:42:53,400 DESIGN POPULATION LEVEL STUDIES 1203 00:42:53,400 --> 00:42:55,440 THAT ARE MEANT TO UNDERSTAND 1204 00:42:55,440 --> 00:42:56,760 DISEASE I PHENOMENON. 1205 00:42:56,760 --> 00:42:58,200 THESE INCLUDE NON-EXPERIMENTAL 1206 00:42:58,200 --> 00:42:59,960 STUDIES, THINGS THAT ARE JUST 1207 00:42:59,960 --> 00:43:00,600 DESCRIPTIVE, WE'RE JUST TRYING 1208 00:43:00,600 --> 00:43:01,600 TO UNDERSTAND THE OCCURRENCE OF 1209 00:43:01,600 --> 00:43:03,080 A DISEASE OR WHAT A POPULATION 1210 00:43:03,080 --> 00:43:04,360 WITH A CERTAIN ILLNESS MIGHT 1211 00:43:04,360 --> 00:43:05,680 LOOK LIKE. 1212 00:43:05,680 --> 00:43:07,680 WE DO ANALYTIC STUDIES, 1213 00:43:07,680 --> 00:43:08,880 OBSERVATIONAL STUDIES WHERE THE 1214 00:43:08,880 --> 00:43:11,080 INVESTIGATORS ARE NOT IN CONTROL 1215 00:43:11,080 --> 00:43:12,160 OF THE INTERVENTION OR THE 1216 00:43:12,160 --> 00:43:14,040 TREATMENT OR THINGS THAT ARE 1217 00:43:14,040 --> 00:43:15,560 IMPACTING THE OUTCOME. 1218 00:43:15,560 --> 00:43:17,120 AND WE ALSO DO EXPERIMENTAL 1219 00:43:17,120 --> 00:43:18,200 STUDIES. 1220 00:43:18,200 --> 00:43:20,720 WE CAN RUN OUR CTs IN CLINICAL 1221 00:43:20,720 --> 00:43:22,160 TRIALS, WE CAN GIVE A GROUP OF 1222 00:43:22,160 --> 00:43:24,680 PEOPLE A TREATMENT, 1223 00:43:24,680 --> 00:43:25,440 EPIDEMIOLOGISTS WILL STUDY WHAT 1224 00:43:25,440 --> 00:43:26,440 HAPPENS IF WE GIVE A GROUP OF 1225 00:43:26,440 --> 00:43:27,240 PEOPLE AN INTERVENTION. 1226 00:43:27,240 --> 00:43:29,120 SO THERE'S A LOT THAT WE DO AS 1227 00:43:29,120 --> 00:43:30,880 EEPIDEMIOLOGISTS TO REALLY DO OR 1228 00:43:30,880 --> 00:43:33,600 OWN RESEARCH AND CONDUCT 1229 00:43:33,600 --> 00:43:34,040 RESEARCH, AS WELL AS 1230 00:43:34,040 --> 00:43:36,680 COLLABORATING WITH OTHER PEOPLE. 1231 00:43:36,680 --> 00:43:38,000 WE ALSO GET DATA FROM A LOT OF 1232 00:43:38,000 --> 00:43:39,400 DIFFERENT PLACES. 1233 00:43:39,400 --> 00:43:41,280 SO LIKE I SAID, WE'VE GOTTEN ON 1234 00:43:41,280 --> 00:43:44,000 RANDOMIZED STUDIES, WE'LL DO 1235 00:43:44,000 --> 00:43:45,360 SURVEYS AND GET OPINIONS FROM 1236 00:43:45,360 --> 00:43:47,960 PEOPLE THAT WAY. 1237 00:43:47,960 --> 00:43:50,080 WE USE GEOGRAPHIC INFORMATION 1238 00:43:50,080 --> 00:43:51,480 SERVICES, SATELLITE DATA, TO 1239 00:43:51,480 --> 00:43:53,120 STUDY HOW DISEASE AND THE 1240 00:43:53,120 --> 00:43:55,400 ENVIRONMENTS ARE ASSOCIATED. 1241 00:43:55,400 --> 00:43:57,200 WE USE OMICS DATA OF ALL 1242 00:43:57,200 --> 00:43:59,040 DIFFERENT VARIETIES TO STUDY 1243 00:43:59,040 --> 00:44:00,640 LIKE DR. SEGRE GAVE THAT GREAT 1244 00:44:00,640 --> 00:44:03,040 EXAMPLE, YOU KNOW, TO STUDY HOW 1245 00:44:03,040 --> 00:44:04,360 THE GENOMICS MIGHT BE HELPFUL IN 1246 00:44:04,360 --> 00:44:05,240 UNDERSTANDING DISEASE IN A 1247 00:44:05,240 --> 00:44:07,200 POPULATION. 1248 00:44:07,200 --> 00:44:08,080 RECENTLY WE'VE BEEN USING A LOT 1249 00:44:08,080 --> 00:44:10,600 OF SOCIAL MEDIA TO UNDERSTAND 1250 00:44:10,600 --> 00:44:12,920 WHO HAS DISEASE TO SEE WHAT 1251 00:44:12,920 --> 00:44:15,240 PEOPLE ARE INTERESTED IN, HOW 1252 00:44:15,240 --> 00:44:16,520 THEY RESPOND TO DIFFERENT PUBLIC 1253 00:44:16,520 --> 00:44:17,400 HEALTH MEASURES, THINGS LIKE 1254 00:44:17,400 --> 00:44:18,080 THAT. 1255 00:44:18,080 --> 00:44:19,520 WE USE GOOGLE SEARCH TRENDS. 1256 00:44:19,520 --> 00:44:20,960 WHO IS INTERESTED IN THESE 1257 00:44:20,960 --> 00:44:21,840 DIFFERENT OUTCOMES? 1258 00:44:21,840 --> 00:44:22,760 WHO'S INTERESTED IN DIFFERENT 1259 00:44:22,760 --> 00:44:24,680 HEALTH PROBLEMS? 1260 00:44:24,680 --> 00:44:26,360 AND WE USE ELECTRONIC HEALTH 1261 00:44:26,360 --> 00:44:27,880 RECORDS A LOT TO REALLY GET AT 1262 00:44:27,880 --> 00:44:29,000 THESE LARGE POPULATIONS OF 1263 00:44:29,000 --> 00:44:30,080 PEOPLE ACROSS THE UNITED STATES 1264 00:44:30,080 --> 00:44:31,840 WHO HAVE ILLNESSES THAT WE MAY 1265 00:44:31,840 --> 00:44:33,240 NOT BE ABLE TO OBSERVE IN 1266 00:44:33,240 --> 00:44:33,880 REALTIME. 1267 00:44:33,880 --> 00:44:34,560 AND THE GREAT THING IS THAT WE 1268 00:44:34,560 --> 00:44:35,920 CAN ACTUALLY LINK THIS DATA 1269 00:44:35,920 --> 00:44:38,000 TOGETHER IN CERTAIN INSTANCES TO 1270 00:44:38,000 --> 00:44:39,560 BUILD UNIQUE DATASETS TO ANSWER 1271 00:44:39,560 --> 00:44:41,080 QUESTIONS WE MAY NOT BE ABLE TO 1272 00:44:41,080 --> 00:44:44,560 GET AT, USING JUST ONE DATASET 1273 00:44:44,560 --> 00:44:48,640 OR JUST ONE STUDY ALONE. 1274 00:44:48,640 --> 00:44:50,080 BUT ALL OF THIS CREATES A LOT OF 1275 00:44:50,080 --> 00:44:50,440 DATA. 1276 00:44:50,440 --> 00:44:52,280 WE HAVE A LOT OF DATA. 1277 00:44:52,280 --> 00:44:53,600 AND IT NEEDS TO BE MANAGED. 1278 00:44:53,600 --> 00:44:54,720 AND WHAT DOES THAT ACTUALLY 1279 00:44:54,720 --> 00:44:55,160 MEAN? 1280 00:44:55,160 --> 00:44:56,760 EVERYONE HEARS DATA MANAGEMENT, 1281 00:44:56,760 --> 00:44:58,800 ESPECIALLY NOW WITH THE DATA 1282 00:44:58,800 --> 00:45:00,640 MANAGEMENT AND SHARING PLANS AND 1283 00:45:00,640 --> 00:45:01,080 GOES -- I KNOW. 1284 00:45:01,080 --> 00:45:02,480 IT'S NOT THE MOST FLASHY OF 1285 00:45:02,480 --> 00:45:02,840 TOPICS. 1286 00:45:02,840 --> 00:45:04,840 BUT IT'S REALLY IMPORTANT. 1287 00:45:04,840 --> 00:45:06,400 SO DATA MANAGEMENT IS ACTUALLY 1288 00:45:06,400 --> 00:45:08,920 THE PROCESS OF MOVING DATA FROM 1289 00:45:08,920 --> 00:45:10,480 COLLECTION ALL THE WAY THROUGH 1290 00:45:10,480 --> 00:45:11,600 TO PUBLICATION AND SHARING. 1291 00:45:11,600 --> 00:45:15,080 IT IS THE ENTIRE PROCESS OF DATA 1292 00:45:15,080 --> 00:45:16,400 ACQUISITION, CLEANING, QUALITY 1293 00:45:16,400 --> 00:45:18,280 ASSURANCE, STORAGE, AND DATA 1294 00:45:18,280 --> 00:45:20,080 SHARING, AND ITS MAINTENANCE 1295 00:45:20,080 --> 00:45:21,040 OVER TIME. 1296 00:45:21,040 --> 00:45:23,440 NOTICE I DID NOT SAY THAT DATA 1297 00:45:23,440 --> 00:45:24,560 ANALYSIS WAS PART OF THE DATA 1298 00:45:24,560 --> 00:45:25,600 MANAGEMENT PATHWAY. 1299 00:45:25,600 --> 00:45:26,760 DATA ANALYSIS REALLY REQUIRES 1300 00:45:26,760 --> 00:45:28,800 ITS OWN TOOLS AND SKILLS AND 1301 00:45:28,800 --> 00:45:30,920 IT'S MORE BEFORE ANSWERING THE 1302 00:45:30,920 --> 00:45:32,360 SCIENTIFIC QUESTIONS WHEREAS 1303 00:45:32,360 --> 00:45:33,200 DATA MANAGEMENT IS ABOUT THE 1304 00:45:33,200 --> 00:45:37,040 DATA ITSELF. 1305 00:45:37,040 --> 00:45:38,120 THIS FIGURE HERE REALLY 1306 00:45:38,120 --> 00:45:38,720 REPRESENTS THE FACT THAT DATA 1307 00:45:38,720 --> 00:45:39,920 MANAGEMENT OCCURS THROUGHOUT THE 1308 00:45:39,920 --> 00:45:41,440 ENTIRE LIFETIME OF A STUDY. 1309 00:45:41,440 --> 00:45:43,280 FROM STUDY DESIGN ALL THE WAY 1310 00:45:43,280 --> 00:45:46,080 THROUGH UNTIL THE END OF STUDY 1311 00:45:46,080 --> 00:45:48,480 COLLECTION, DATA COLLECTION AND 1312 00:45:48,480 --> 00:45:49,880 PUBLICATION. 1313 00:45:49,880 --> 00:45:51,320 SO WHY DID I TALK ABOUT ALL THIS 1314 00:45:51,320 --> 00:45:52,680 IF I'M A RESEARCH UNIT, RIGHT? 1315 00:45:52,680 --> 00:45:53,680 WE'RE INTERESTED IN THE RESEARCH 1316 00:45:53,680 --> 00:45:54,200 THAT GOES ON. 1317 00:45:54,200 --> 00:45:56,720 SO NOW I'M GOING TO TALK A BUILT 1318 00:45:56,720 --> 00:46:00,920 ABOUT MY UNIT'S MISSIONS AND 1319 00:46:00,920 --> 00:46:01,320 GOALS. 1320 00:46:01,320 --> 00:46:02,640 THE FIRST IS TO IDENTIFY AREAS 1321 00:46:02,640 --> 00:46:04,080 FOR IMPROVEMENT FOR INFECTIOUS 1322 00:46:04,080 --> 00:46:05,800 DISEASE STUDY DESIGN AND DATA 1323 00:46:05,800 --> 00:46:06,280 MANAGEMENT. 1324 00:46:06,280 --> 00:46:10,440 WE'RE SPECIFICALLY INTERESTED IN 1325 00:46:10,440 --> 00:46:11,560 NON-RANDOMIZED STUDIES. 1326 00:46:11,560 --> 00:46:12,560 WE'RE ALSO INTERESTED IN 1327 00:46:12,560 --> 00:46:14,000 DEVELOPING STANDARDIZED TOOLS 1328 00:46:14,000 --> 00:46:15,840 THAT ENHANCE EFFICIENCY AND 1329 00:46:15,840 --> 00:46:17,400 REPRODUCIBILITY OF INFECTIOUS 1330 00:46:17,400 --> 00:46:17,960 DISEASE RESEARCH. 1331 00:46:17,960 --> 00:46:19,600 AND YOU MAY ASK WHY. 1332 00:46:19,600 --> 00:46:21,240 WHY ARE WE INTERESTED IN LOOKING 1333 00:46:21,240 --> 00:46:24,440 AT NON-RANDOMIZED STUDIES. 1334 00:46:24,440 --> 00:46:27,160 AREN'T RANDOMIZED STUDIES THE 1335 00:46:27,160 --> 00:46:27,720 GOLD STANDARD? 1336 00:46:27,720 --> 00:46:29,360 THEY HAVE THEIR PLACE BUT 1337 00:46:29,360 --> 00:46:30,480 NON-RANDOMIZED STUDIES ARE ALSO 1338 00:46:30,480 --> 00:46:31,040 REALLY IMPORTANT. 1339 00:46:31,040 --> 00:46:33,240 THEY'RE GREAT FOR QUI QUICKLY 1340 00:46:33,240 --> 00:46:35,120 EVALUATING HEALTH OUTCOMES AFTER 1341 00:46:35,120 --> 00:46:35,760 EXPOSURES OF INTEREST. 1342 00:46:35,760 --> 00:46:37,640 WE'RE IN AN EPIDEMIC SETTING. 1343 00:46:37,640 --> 00:46:38,840 WE DON'T NECESSARILY HAVE THE 1344 00:46:38,840 --> 00:46:40,360 TIME TO SET UP A RANDOMIZED 1345 00:46:40,360 --> 00:46:41,800 CONTROL TRIAL, YET WE NEED TO 1346 00:46:41,800 --> 00:46:44,600 FIND OUT INFORMATION ABOUT HOW A 1347 00:46:44,600 --> 00:46:45,560 DISEASE GETS TRANSMITTED, WHAT 1348 00:46:45,560 --> 00:46:48,440 IS THE DISEASE, WHAT'S CAUSING 1349 00:46:48,440 --> 00:46:49,520 IT, WHAT DO THE SYMPTOMS LOOK 1350 00:46:49,520 --> 00:46:50,720 LIKE, WHO'S GOING TO GET THIS 1351 00:46:50,720 --> 00:46:50,960 DISEASE? 1352 00:46:50,960 --> 00:46:52,360 AND YOU CAN'T ALWAYS DO THAT 1353 00:46:52,360 --> 00:46:54,680 THROUGH A RANDOMIZED CONTROL 1354 00:46:54,680 --> 00:46:55,280 TRIAL. 1355 00:46:55,280 --> 00:46:56,640 YOU NEED OBSERVATIONAL STUDIES, 1356 00:46:56,640 --> 00:46:57,760 AND YOU NEED TO BE ABLE TO DO 1357 00:46:57,760 --> 00:46:59,640 THEM WELL. 1358 00:46:59,640 --> 00:47:00,960 WHY ELSE? 1359 00:47:00,960 --> 00:47:02,720 WELL, WELL DESIGNED AND WELL 1360 00:47:02,720 --> 00:47:04,480 EXECUTED, NON-RANDOMIZED STUDIES 1361 00:47:04,480 --> 00:47:05,520 CAN ACTUALLY BE MORE 1362 00:47:05,520 --> 00:47:07,960 REPRESENTATIVE OF THE POPULATION 1363 00:47:07,960 --> 00:47:09,440 THAN POPULATION INVOLVED IN AN 1364 00:47:09,440 --> 00:47:10,560 RCT. 1365 00:47:10,560 --> 00:47:12,880 WE HAVE VERY STRINGENT INCLUSION 1366 00:47:12,880 --> 00:47:13,960 AND EXCLUSION CRITERIA FOR 1367 00:47:13,960 --> 00:47:15,000 CLINICAL TRIALS, WITH GOOD 1368 00:47:15,000 --> 00:47:15,200 REASON. 1369 00:47:15,200 --> 00:47:16,520 WE WANT TO BE ABLE TO MAKE SURE 1370 00:47:16,520 --> 00:47:18,840 THAT THE CONCLUSIONS WE'RE 1371 00:47:18,840 --> 00:47:22,560 DRAWING ARE ACCURATE, BUT THAT 1372 00:47:22,560 --> 00:47:23,840 CAN EXCLUDE A WHOLE LOT OF THE 1373 00:47:23,840 --> 00:47:24,840 POPULATION. 1374 00:47:24,840 --> 00:47:25,880 AS WAS SAID EARLIER, WOMEN WERE 1375 00:47:25,880 --> 00:47:27,080 NOT INCLUDED IN CLINICAL STUDIES 1376 00:47:27,080 --> 00:47:30,600 FOR A LONG TIME. 1377 00:47:30,600 --> 00:47:32,200 WE'RE STILL FIGHTING TO GET 1378 00:47:32,200 --> 00:47:33,160 PREGNANT WOMEN INCLUDED IN MANY 1379 00:47:33,160 --> 00:47:33,520 STUDIES. 1380 00:47:33,520 --> 00:47:35,000 SO BY DOING OBSERVATIONAL 1381 00:47:35,000 --> 00:47:36,040 STUDIES OUT IN THE COMMUNITY, WE 1382 00:47:36,040 --> 00:47:37,680 CAN TEND TO GET A MORE 1383 00:47:37,680 --> 00:47:38,760 REPRESENTATIVE IDEA OF WHAT'S 1384 00:47:38,760 --> 00:47:40,400 HAPPENING IN TERMS OF A DISEASE 1385 00:47:40,400 --> 00:47:45,400 PROCESS OR AN INTERVENTION. 1386 00:47:45,400 --> 00:47:46,520 NON-RANDOMIZED STUDIES ARE ALSO 1387 00:47:46,520 --> 00:47:47,880 GREAT FOR MULTISITE DATA 1388 00:47:47,880 --> 00:47:48,760 COLLECTION AND DATA POOLING. 1389 00:47:48,760 --> 00:47:50,280 SO IF YOU HAVE SOMETHING, SAY, A 1390 00:47:50,280 --> 00:47:52,360 PANDEMIC THAT'S HAPPENING ACROSS 1391 00:47:52,360 --> 00:47:57,240 MULTIPLE GEOGRAPHIC REGIONS OR A 1392 00:47:57,240 --> 00:47:58,760 DIFFERENT TIME POINTS OR 1393 00:47:58,760 --> 00:48:00,200 COMMUNITIES, HAVE A WELL 1394 00:48:00,200 --> 00:48:02,200 STANDARDIZED AND WELL RUN 1395 00:48:02,200 --> 00:48:02,960 NON-RANDOMIZED STUDY CAN 1396 00:48:02,960 --> 00:48:04,360 ACTUALLY HELP YOU GET A LOT OF 1397 00:48:04,360 --> 00:48:05,280 INFORMATION FROM A LOT OF 1398 00:48:05,280 --> 00:48:07,920 DIFFERENT PLACES VERY QUICKLY. 1399 00:48:07,920 --> 00:48:10,120 AND FINALLY, HAVING BAD DATA 1400 00:48:10,120 --> 00:48:11,520 MANAGEMENT AND POORLY RUN 1401 00:48:11,520 --> 00:48:12,560 STUDIES CAN ACTUALLY CONTRIBUTE 1402 00:48:12,560 --> 00:48:14,200 TO INCREASED DISEASE 1403 00:48:14,200 --> 00:48:15,400 TRANSMISSION OR WORSE DISEASE 1404 00:48:15,400 --> 00:48:15,760 OUTCOMES. 1405 00:48:15,760 --> 00:48:18,800 IF YOU DON'T KNOW WHERE A 1406 00:48:18,800 --> 00:48:20,360 DISEASE MAY BE EMERGING, HOW ARE 1407 00:48:20,360 --> 00:48:21,920 YOU GOING TO RESPOND TO IT? 1408 00:48:21,920 --> 00:48:23,800 IF YOU DON'T HAVE GOOD DATA AND 1409 00:48:23,800 --> 00:48:25,440 YOU CAN'T UNDERSTAND WHERE 1410 00:48:25,440 --> 00:48:26,880 DISEASES MIGHT ARISE, HOW DO YOU 1411 00:48:26,880 --> 00:48:29,400 PREPARE FOR IT? 1412 00:48:29,400 --> 00:48:30,920 AND IF YOU HAVE BAD DATA THAT 1413 00:48:30,920 --> 00:48:32,840 COMES FROM POORLY DONE CLINICAL 1414 00:48:32,840 --> 00:48:35,600 STUDIES, YOU END UP WITH THINGS 1415 00:48:35,600 --> 00:48:36,680 LIKE HYDROXYCHLOROQUINE TAKING 1416 00:48:36,680 --> 00:48:38,040 OVER THE MEDIA AS THE TREATMENT 1417 00:48:38,040 --> 00:48:40,000 OF CHOICE FOR COVID-19, ONLY TO 1418 00:48:40,000 --> 00:48:41,720 FIND OUT, OOPS, THIS ISN'T 1419 00:48:41,720 --> 00:48:45,640 ACTUALLY WORKING. 1420 00:48:45,640 --> 00:48:46,840 SO THIS IS WHY WE WANT TO 1421 00:48:46,840 --> 00:48:51,800 UNDERSTAND HOW TO IMPRO IMPROVE 1422 00:48:51,800 --> 00:48:52,360 NON-RANDOMIZED STUDIES. 1423 00:48:52,360 --> 00:48:53,680 WE'RE GOING TO START BY STUDYING 1424 00:48:53,680 --> 00:48:54,200 THE FIELD. 1425 00:48:54,200 --> 00:48:55,200 WE'RE GOING TO TRY TO UNDERSTAND 1426 00:48:55,200 --> 00:48:56,400 THE CURRENT STATE OF 1427 00:48:56,400 --> 00:48:57,640 OBSERVATIONAL DATA COLLECTION, 1428 00:48:57,640 --> 00:48:59,640 DATA MANAGEMENT METHODS, SEE 1429 00:48:59,640 --> 00:49:00,720 WHAT DATA AVAILABILITY LOOKS 1430 00:49:00,720 --> 00:49:02,360 LIKE, TO SEE WHAT THE 1431 00:49:02,360 --> 00:49:03,360 LIMITATIONS FOR DOING RESEARCH 1432 00:49:03,360 --> 00:49:04,240 ARE. 1433 00:49:04,240 --> 00:49:06,480 DURING MY IRS PERIOD, I'M 1434 00:49:06,480 --> 00:49:07,120 FOCUSING SPECIFICALLY ON LOOKING 1435 00:49:07,120 --> 00:49:09,520 AT THIS IN EPIDEMIC SETTINGS, 1436 00:49:09,520 --> 00:49:10,640 BECAUSE AS MUCH AS I WOULD LIKE 1437 00:49:10,640 --> 00:49:13,320 TO CHANGE THE WORLD AND MAKE ALL 1438 00:49:13,320 --> 00:49:14,920 OBSERVATIONAL STUDIES BETTER 1439 00:49:14,920 --> 00:49:16,360 FOREVER, I SADLY ONLY HAVE A 1440 00:49:16,360 --> 00:49:17,520 CONFINED TIME PERIOD TO DO SO. 1441 00:49:17,520 --> 00:49:19,040 SO WE'RE CONCENTRATING ON 1442 00:49:19,040 --> 00:49:20,160 EPIDEMICS, BUT KNOW THAT THIS IS 1443 00:49:20,160 --> 00:49:21,600 ALL APPLICABLE TO NATURAL 1444 00:49:21,600 --> 00:49:24,320 HISTORY STUDIES, LONGITUDAL 1445 00:49:24,320 --> 00:49:26,000 COHORT STUDIES, THINGS LIKE 1446 00:49:26,000 --> 00:49:26,320 THAT. 1447 00:49:26,320 --> 00:49:27,400 SO HOW ARE WE ACTUALLY GOING TO 1448 00:49:27,400 --> 00:49:28,120 DO THIS? 1449 00:49:28,120 --> 00:49:29,400 WE'RE GOING TO CONDUCT -- WE'RE 1450 00:49:29,400 --> 00:49:31,000 STARTING WITH A SCOPING REVIEW 1451 00:49:31,000 --> 00:49:32,720 OF HISTORIC OUTBREAKS TO 1452 00:49:32,720 --> 00:49:33,840 UNDERSTAND OBSERVATIONAL DATA 1453 00:49:33,840 --> 00:49:35,120 COLLECTION METHODS, 1454 00:49:35,120 --> 00:49:37,160 AVAILABILITY, AND LIMITATIONS. 1455 00:49:37,160 --> 00:49:38,120 TAKE FOR EXAMPLE EBOLA. 1456 00:49:38,120 --> 00:49:39,320 WHAT DID THE LITERATURE LOOK 1457 00:49:39,320 --> 00:49:41,080 LIKE EARLY ON DURING THE EBOLA 1458 00:49:41,080 --> 00:49:41,880 OUTBREAK? 1459 00:49:41,880 --> 00:49:44,440 HOW THRO LONG DID IT TAKE FOR 1460 00:49:44,440 --> 00:49:45,320 OBSERVATIONAL STUDIES TO GET 1461 00:49:45,320 --> 00:49:45,720 REPORTED? 1462 00:49:45,720 --> 00:49:47,680 HOW LONG DID THAT DELAY CLINICAL 1463 00:49:47,680 --> 00:49:48,640 TRIALS BEING ABLE TO GO TO 1464 00:49:48,640 --> 00:49:50,480 FIELD? 1465 00:49:50,480 --> 00:49:52,000 NEXT WE'RE GOING TO EVALUATE 1466 00:49:52,000 --> 00:49:53,600 DATA MANAGEMENT CAPACITY IN 1467 00:49:53,600 --> 00:49:55,160 REGIONS WITH HIGH PREDICTED 1468 00:49:55,160 --> 00:49:55,760 OUTBREAK POTENTIAL. 1469 00:49:55,760 --> 00:49:57,800 THIS IS THE TOPIC OF MY 1470 00:49:57,800 --> 00:49:59,200 INTRAMURAL TARGETED CLIMATE 1471 00:49:59,200 --> 00:50:00,280 CHANGE AND HEALTH GRANT THAT I 1472 00:50:00,280 --> 00:50:02,160 RECENTLY RECEIVED FROM NIEHS. 1473 00:50:02,160 --> 00:50:03,760 SO WE'RE GOING TO BE TRYING TO 1474 00:50:03,760 --> 00:50:05,040 ACTUALLY EXPLICITLY DEFINE DATA 1475 00:50:05,040 --> 00:50:06,560 MANAGEMENT CAPACITY AS AN 1476 00:50:06,560 --> 00:50:07,640 INDICATOR FOR INFECTIOUS 1477 00:50:07,640 --> 00:50:09,680 DISEASES. 1478 00:50:09,680 --> 00:50:11,080 THERE ARE MANY OTHER INDICATORS 1479 00:50:11,080 --> 00:50:12,880 THAT ARE OUT THERE, BUT NONE OF 1480 00:50:12,880 --> 00:50:14,280 THEM EXPLICITLY ADDRESS DATA 1481 00:50:14,280 --> 00:50:15,720 MANAGEMENT TO CAPACITY. 1482 00:50:15,720 --> 00:50:17,800 AND WE WANT TO QUANTIFY THOSE 1483 00:50:17,800 --> 00:50:19,720 GAPS AND SEE WHAT MAY BE THE 1484 00:50:19,720 --> 00:50:22,320 IDENTIFYING CAUSES ARE CAUSING 1485 00:50:22,320 --> 00:50:23,920 THIS LACK OF DATA MANAGEMENT 1486 00:50:23,920 --> 00:50:24,320 CAPACITY. 1487 00:50:24,320 --> 00:50:25,560 IS IT THAT THERE'S JUST NO 1488 00:50:25,560 --> 00:50:26,280 INFRASTRUCTURE, NO TRAINING, OR 1489 00:50:26,280 --> 00:50:27,360 IS THERE MAYBE A POLITICAL 1490 00:50:27,360 --> 00:50:28,400 PROBLEM IN A CERTAIN COUNTRY 1491 00:50:28,400 --> 00:50:29,960 THAT DOESN'T WANT TO SHARE THEIR 1492 00:50:29,960 --> 00:50:30,960 DATA BECAUSE THEY'RE WORRIED 1493 00:50:30,960 --> 00:50:34,000 ABOUT FINANCIAL IMPLICATIONS? 1494 00:50:34,000 --> 00:50:35,520 WE ALSO THEN ARE GOING TO 1495 00:50:35,520 --> 00:50:36,240 ACTUALLY MODEL THIS, WE'RE ABLE 1496 00:50:36,240 --> 00:50:38,560 TO USE THIS AS AN INDICATOR 1497 00:50:38,560 --> 00:50:40,760 VARIABLE THAT WE INCLUDE INTO 1498 00:50:40,760 --> 00:50:42,440 MODELS TO UNDERSTAND AND 1499 00:50:42,440 --> 00:50:43,640 QUANTIFY HOW MUCH DATA 1500 00:50:43,640 --> 00:50:45,600 MANAGEMENT CAPACITY CAN ACTUALLY 1501 00:50:45,600 --> 00:50:47,080 IMPACT PREDICTED HOT SPOTS OF 1502 00:50:47,080 --> 00:50:48,280 DISEASE AND PREDICTED RISK OF 1503 00:50:48,280 --> 00:50:51,480 SPILLOVER. 1504 00:50:51,480 --> 00:50:53,320 FINALLY, WE'RE GOING TO BE 1505 00:50:53,320 --> 00:50:54,640 CONDUCTING A PARTICIPATORY 1506 00:50:54,640 --> 00:50:55,320 ASSESSMENT OF GLOBAL DATA 1507 00:50:55,320 --> 00:50:56,520 MANAGEMENT CAPACITY BY RUNNING 1508 00:50:56,520 --> 00:50:57,960 AN INTERACTIVE PANDEMIC SCENARIO 1509 00:50:57,960 --> 00:50:59,080 WITH DATA END USERS. 1510 00:50:59,080 --> 00:51:00,760 SO THE PLAN IS TO BRING DATA END 1511 00:51:00,760 --> 00:51:02,040 USERS FROM AROUND THE WORLD, 1512 00:51:02,040 --> 00:51:03,080 FOLKS WHO ARE ACTUALLY IN 1513 00:51:03,080 --> 00:51:04,720 COUNTRY WHO DEAL WITH PANDEMICS 1514 00:51:04,720 --> 00:51:06,680 AND OUTBREAKS ON A REGULAR 1515 00:51:06,680 --> 00:51:08,280 BASIS, BRING THEM IN, AND GIVE 1516 00:51:08,280 --> 00:51:09,800 THEM DIFFERENT SCENARIOS TO SAY 1517 00:51:09,800 --> 00:51:11,240 HERE'S WHAT YOUR DATA MANAGEMENT 1518 00:51:11,240 --> 00:51:12,320 LOOKS LIKE IN COUNTRY. 1519 00:51:12,320 --> 00:51:13,640 LET'S SEE HOW YOU DO. 1520 00:51:13,640 --> 00:51:14,640 AND THEN WE'LL CHANGE IT AND 1521 00:51:14,640 --> 00:51:16,280 WE'LL SAY, YOU HAVE A PERFECT 1522 00:51:16,280 --> 00:51:16,840 SYSTEM. 1523 00:51:16,840 --> 00:51:17,880 YOU HAVE THIS WONDERFUL DATA 1524 00:51:17,880 --> 00:51:18,440 MANAGEMENT SYSTEM. 1525 00:51:18,440 --> 00:51:19,640 WHAT DO YOU DO NOW? 1526 00:51:19,640 --> 00:51:21,680 AND LOOK TO SEE HOW THEIR 1527 00:51:21,680 --> 00:51:22,560 RESPONSES ARE GOING TO CHANGE 1528 00:51:22,560 --> 00:51:24,040 AND HOW THEIR FEELINGS ABOUT 1529 00:51:24,040 --> 00:51:25,800 THAT ARE GOING TO CHANGE GIVEN 1530 00:51:25,800 --> 00:51:27,200 BETTER ACCESS TO BETTER DATA 1531 00:51:27,200 --> 00:51:30,440 MANAGEMENT CAPACITY. 1532 00:51:30,440 --> 00:51:32,320 THE SECOND RESEARCH GOAL IS TO 1533 00:51:32,320 --> 00:51:33,600 REALLY IDENTIFY OPPORTUNITIES 1534 00:51:33,600 --> 00:51:34,840 FOR IMPROVEMENT AND SPECIFICALLY 1535 00:51:34,840 --> 00:51:36,960 WE WANT TO IDENTIFY AND DEVELOP 1536 00:51:36,960 --> 00:51:38,720 METHODS FOR STANDARDIZING AND 1537 00:51:38,720 --> 00:51:42,080 IMPROVING DATA MANAGEMENT. 1538 00:51:42,080 --> 00:51:43,200 FIRST, WE'RE GOING TO START BY 1539 00:51:43,200 --> 00:51:44,880 HOLDING A STAKEHOLDER ENGAGEMENT 1540 00:51:44,880 --> 00:51:45,320 WORKSHOP. 1541 00:51:45,320 --> 00:51:47,160 THIS IS SCHEDULED FOR SEPTEMBER 1542 00:51:47,160 --> 00:51:47,920 OF THIS YEAR. 1543 00:51:47,920 --> 00:51:50,000 WE HAVE SOME REALLY EXCELLENT 1544 00:51:50,000 --> 00:51:52,280 PEOPLE COMING FROM ALL OVER TO 1545 00:51:52,280 --> 00:51:53,360 COME AND SPEAK. 1546 00:51:53,360 --> 00:51:55,440 AND TELL US WHAT THEY BELIEVE 1547 00:51:55,440 --> 00:51:57,520 THE GAPS IN DATA MANAGEMENT AND 1548 00:51:57,520 --> 00:51:59,240 DATA COLLECTION DURING EPIDEMICS 1549 00:51:59,240 --> 00:52:00,520 ARE AND HOW THOSE CAN BE 1550 00:52:00,520 --> 00:52:01,080 IMPROVED. 1551 00:52:01,080 --> 00:52:04,120 WITH THE GOAL OF DEVELOPING 1552 00:52:04,120 --> 00:52:04,960 CONSENSUS RECOMMENDATIONS FOR 1553 00:52:04,960 --> 00:52:07,160 HOW THE FIELD SHOULD MOVE 1554 00:52:07,160 --> 00:52:09,320 FORWARD. 1555 00:52:09,320 --> 00:52:11,080 WE ARE GOING TO BE CONDUCTING AN 1556 00:52:11,080 --> 00:52:12,320 ENVIRONMENTAL SCAN TO IDENTIFY 1557 00:52:12,320 --> 00:52:13,400 EXISTING METHODS FOR 1558 00:52:13,400 --> 00:52:14,000 STANDARDIZATION. 1559 00:52:14,000 --> 00:52:15,040 I DON'T WANT TO REINVENT THE 1560 00:52:15,040 --> 00:52:15,520 WHEEL. 1561 00:52:15,520 --> 00:52:16,840 THE MORE STANDARD WE CAN BE, THE 1562 00:52:16,840 --> 00:52:17,840 BETTER OFF WE'RE ALL GOING TO 1563 00:52:17,840 --> 00:52:18,280 BE. 1564 00:52:18,280 --> 00:52:19,600 AND SO WE WANT TO LOOK AND SEE, 1565 00:52:19,600 --> 00:52:21,160 YOU KNOW, WHAT LESSONS HAVE BEEN 1566 00:52:21,160 --> 00:52:23,040 LEARNED FROM STANDARDIZING 1567 00:52:23,040 --> 00:52:23,920 RANDOMIZED CONTROL TRIALS? 1568 00:52:23,920 --> 00:52:26,280 WHAT LESSONS CAN WE LEARN FROM 1569 00:52:26,280 --> 00:52:27,240 SURVEILLANCE DATA THAT MAYBE 1570 00:52:27,240 --> 00:52:28,480 DOESN'T GET USE FORD RESEARCH, 1571 00:52:28,480 --> 00:52:30,440 BUT WE HAVE THESE GREAT 1572 00:52:30,440 --> 00:52:31,120 SURVEILLANCE SYSTEMS. 1573 00:52:31,120 --> 00:52:32,320 HOW CAN WE LEVERAGE THEM MAYBE 1574 00:52:32,320 --> 00:52:33,680 HOW DO WE IMPROVE THAT? 1575 00:52:33,680 --> 00:52:35,520 WE CAN ALSO LEARN FROM THE 1576 00:52:35,520 --> 00:52:36,680 DISASTER RESPONSE DOMAIN. 1577 00:52:36,680 --> 00:52:38,000 THESE PEOPLE GO AND THEY RESPOND 1578 00:52:38,000 --> 00:52:42,840 AND DO RESEARCH DURING -- AFTER 1579 00:52:42,840 --> 00:52:45,520 HURRICANE KATRINA AND AFTER 1580 00:52:45,520 --> 00:52:46,400 TSUNAMIS AROUND THE GLOBE. 1581 00:52:46,400 --> 00:52:48,040 HOW DO THEY DO THAT, HOW DO THEY 1582 00:52:48,040 --> 00:52:49,160 STANDARDIZE THAT RESEARCH AND 1583 00:52:49,160 --> 00:52:50,800 HOW CAN WE ADOPT THAT AS 1584 00:52:50,800 --> 00:52:52,600 INFECTIOUS DISEASE 1585 00:52:52,600 --> 00:52:53,120 PRACTITIONERS. 1586 00:52:53,120 --> 00:52:54,240 FINALLY WE'RE GOING TO EVALUATE 1587 00:52:54,240 --> 00:52:55,920 ANY TOOLS WE FIND AND, IF 1588 00:52:55,920 --> 00:52:56,880 NECESSARY, DEVELOP NEW TOOLS 1589 00:52:56,880 --> 00:52:59,720 WITH THE GLOBAL RESEARCH 1590 00:52:59,720 --> 00:53:00,160 COMMUNITY. 1591 00:53:00,160 --> 00:53:01,440 AND TRYING TO REALLY CREATE 1592 00:53:01,440 --> 00:53:02,760 RESOURCES FOR PEOPLE TO USE. 1593 00:53:02,760 --> 00:53:05,840 SO IF ANYONE -- IF WE RESPOND AT 1594 00:53:05,840 --> 00:53:08,600 NIH TO A GLOBAL OUTBREAK, AS WE 1595 00:53:08,600 --> 00:53:09,800 DO, YOU'LL HAVE TOOLS THAT YOU 1596 00:53:09,800 --> 00:53:11,240 CAN TAKE WITH YOU SO YOU DON'T 1597 00:53:11,240 --> 00:53:13,560 HAVE TO TRY TO DESIGN AN 1598 00:53:13,560 --> 00:53:14,400 OBSERVATIONAL STUDY FROM 1599 00:53:14,400 --> 00:53:14,640 SCRATCH. 1600 00:53:14,640 --> 00:53:16,440 YOU DON'T HAVE TO QUICKLY 1601 00:53:16,440 --> 00:53:18,360 UNDERSTAND WHO'S GOING TO HELP 1602 00:53:18,360 --> 00:53:19,480 WHAT VARIABLES ARE WE GOING TO 1603 00:53:19,480 --> 00:53:19,680 CHECK. 1604 00:53:19,680 --> 00:53:20,640 WE'LL HAVE THOSE TOOLS THAT CAN 1605 00:53:20,640 --> 00:53:21,640 HELP YOU AND WE'LL HAVE 1606 00:53:21,640 --> 00:53:24,360 RESOURCES TO HELP YOU USE THAT. 1607 00:53:24,360 --> 00:53:25,560 SO BECAUSE EVERYBODY LOVES 1608 00:53:25,560 --> 00:53:27,200 SEEING DATA, I'M GOING TO CLOSE 1609 00:53:27,200 --> 00:53:29,560 WITH SOME EXAMPLES OF WHY MAYBE 1610 00:53:29,560 --> 00:53:30,640 AN EPIDEMIOLOGIST WOULD BE 1611 00:53:30,640 --> 00:53:31,840 INVOLVED IN SOME OF THESE 1612 00:53:31,840 --> 00:53:33,400 STUDIES. 1613 00:53:33,400 --> 00:53:35,720 SO THE FIRST STUDY WE DID WAS 1614 00:53:35,720 --> 00:53:37,480 EARLY, EARLY IN THE PANDEMIC, WE 1615 00:53:37,480 --> 00:53:39,160 PUBLISHED THIS IN JANUARY OF 1616 00:53:39,160 --> 00:53:39,520 2021. 1617 00:53:39,520 --> 00:53:41,320 IT WAS A RETROSPECTIVE COHORT 1618 00:53:41,320 --> 00:53:41,920 STUDY. 1619 00:53:41,920 --> 00:53:44,840 WE ENROLLED -- WE HAD 1620 00:53:44,840 --> 00:53:45,800 175 PATIENTS WHO WERE 1621 00:53:45,800 --> 00:53:47,280 HOSPITALIZED WITH COVID-19 1622 00:53:47,280 --> 00:53:48,200 BETWEEN APRIL -- EXCUSE ME -- 1623 00:53:48,200 --> 00:53:50,920 END OF FEBRUARY, END OF 1624 00:53:50,920 --> 00:53:52,240 MAY 2020, BUT WHAT WE DID WAS, 1625 00:53:52,240 --> 00:53:54,040 THESE FOLKS WERE HOSPITALIZED 1626 00:53:54,040 --> 00:53:56,000 AND THEY HAD BLOOD DRAWN FOR 1627 00:53:56,000 --> 00:53:57,560 CLINICAL PAIR AND THEN WE 1628 00:53:57,560 --> 00:53:58,680 RANDOMLY OBTAINED WHATEVER 1629 00:53:58,680 --> 00:54:00,440 SAMPLES THAT WE COULD FROM 1630 00:54:00,440 --> 00:54:01,560 DISCARDED BLOOD, AND WE SAID 1631 00:54:01,560 --> 00:54:03,440 OKAY, WE'RE GOING TO TEST THOSE. 1632 00:54:03,440 --> 00:54:04,680 THE QUESTIONS THAT WE WERE 1633 00:54:04,680 --> 00:54:06,440 TRYING TO ANSWER WERE, IS THERE 1634 00:54:06,440 --> 00:54:07,720 AN ASSOCIATION BETWEEN 1635 00:54:07,720 --> 00:54:09,840 BIOMARKERS AND SEVERITY OF 1636 00:54:09,840 --> 00:54:12,320 ILLNESS AND DEATH, AND CAN THESE 1637 00:54:12,320 --> 00:54:13,520 BIOMARKERS BE PREDICTIVE? 1638 00:54:13,520 --> 00:54:15,520 AND WHAT WE DID WAS, WE LINED UP 1639 00:54:15,520 --> 00:54:17,720 SAMPLES FROM THE TIME SINCE 1640 00:54:17,720 --> 00:54:18,600 ADMISSION, AND THEN LOOKED 1641 00:54:18,600 --> 00:54:20,000 FORWARD OVER TIME. 1642 00:54:20,000 --> 00:54:21,280 NOW, IDEALLY, WE WOULD HAVE 1643 00:54:21,280 --> 00:54:22,920 LOOKED AT TIME FROM SYMPTOM 1644 00:54:22,920 --> 00:54:24,000 ONSET, BECAUSE WE'RE LOOKING AT 1645 00:54:24,000 --> 00:54:25,800 A BIOLOGICAL PHENOMENON, RIGHT? 1646 00:54:25,800 --> 00:54:28,000 IF WE'RE INTERESTED IN SEEING 1647 00:54:28,000 --> 00:54:31,200 HOW IL2 CHANGES OVER TIME AND 1648 00:54:31,200 --> 00:54:34,760 MIGHT BE RELATED TO AN ILLNESS, 1649 00:54:34,760 --> 00:54:36,040 ADMISSION DOES NOT TELL YOU A 1650 00:54:36,040 --> 00:54:37,240 WHOLE LOT BECAUSE THAT'S NOT 1651 00:54:37,240 --> 00:54:38,160 WHEN PEOPLE STARTED GETTING 1652 00:54:38,160 --> 00:54:39,080 SICK. 1653 00:54:39,080 --> 00:54:40,840 WHAT YOU CAN SEE IN THIS FIGURE 1654 00:54:40,840 --> 00:54:42,120 IS WE LOOKED THROUGH A WHOLE 1655 00:54:42,120 --> 00:54:44,600 SLEW OF BIOMARKERS AND THEY VARY 1656 00:54:44,600 --> 00:54:46,040 FROM TIME OVER COURSE OF A 1657 00:54:46,040 --> 00:54:47,040 PERSON'S ADMISSION, WHETHER THEY 1658 00:54:47,040 --> 00:54:48,320 WERE SURVIVORS OR WHETHER THEY 1659 00:54:48,320 --> 00:54:48,840 DIED. 1660 00:54:48,840 --> 00:54:50,800 SO WE DIDN'T KNOW WHAT THE 1661 00:54:50,800 --> 00:54:53,440 EXPOSURE PATTERN LOOKED LIKE, WE 1662 00:54:53,440 --> 00:54:54,760 DIDN'T KNOW WHAT OR WHEN OR HOW 1663 00:54:54,760 --> 00:54:56,560 MUCH TO BE MEASURING. 1664 00:54:56,560 --> 00:54:58,360 DO WE LOOK AT TOTAL EXPOSURE TO 1665 00:54:58,360 --> 00:54:59,200 A BIOMARKER? 1666 00:54:59,200 --> 00:55:01,200 DO WE LOOK AT HOW HIGH IT GOES? 1667 00:55:01,200 --> 00:55:02,640 DO WE LOOK AT WHAT IT IS THE DAY 1668 00:55:02,640 --> 00:55:03,200 BEFORE YOU DIED? 1669 00:55:03,200 --> 00:55:04,480 WE DON'T KNOW. 1670 00:55:04,480 --> 00:55:06,320 AND THIS REALLY HIGHLIGHTS THE 1671 00:55:06,320 --> 00:55:07,840 NEED FOR APPROPRIATE SAMPLE 1672 00:55:07,840 --> 00:55:09,840 TIMING AND SAMPLE NUMBER, AND 1673 00:55:09,840 --> 00:55:12,040 THIS REQUIRES VERY THOUGHTFUL 1674 00:55:12,040 --> 00:55:15,120 STUDY DESIGN UP FRONT. 1675 00:55:15,120 --> 00:55:18,360 MY SECOND EXAMPLE IS AN ONGOING 1676 00:55:18,360 --> 00:55:19,560 PROSPECTIVE OBSERVATIONAL COHORT 1677 00:55:19,560 --> 00:55:19,880 STUDY. 1678 00:55:19,880 --> 00:55:21,520 THIS IS MY UNIT STUDY, THE 1679 00:55:21,520 --> 00:55:24,200 PERSIST STUDY, WITH WHERE WE ARE 1680 00:55:24,200 --> 00:55:26,400 EVALUATING THE IMMUNE RESPONSE 1681 00:55:26,400 --> 00:55:27,720 TO COVID VACCINES IN PEOPLE WITH 1682 00:55:27,720 --> 00:55:28,200 IMMUNE DISORDERS. 1683 00:55:28,200 --> 00:55:30,000 WE HAVE ENROLLED 300 1684 00:55:30,000 --> 00:55:31,200 PARTICIPANTS SINCE APRIL OF 1685 00:55:31,200 --> 00:55:31,920 2021. 1686 00:55:31,920 --> 00:55:33,440 WE JUST CLOSED ENROLLMENT AT THE 1687 00:55:33,440 --> 00:55:35,240 END OF LAST YEAR, AND WE'VE BEEN 1688 00:55:35,240 --> 00:55:37,360 OBTAINING SAMPLES FOLLOWING THIS 1689 00:55:37,360 --> 00:55:39,840 VERY SPECIFIC SCHEDULE. 1690 00:55:39,840 --> 00:55:41,200 WE ARE INTERESTED IN LOOKING AT 1691 00:55:41,200 --> 00:55:42,840 THE POST VACCINE IGG RESPONSE IN 1692 00:55:42,840 --> 00:55:44,000 PEOPLE WITH IMMUNE DISORDERS AS 1693 00:55:44,000 --> 00:55:45,680 WELL AS WHAT THE RATE OF 1694 00:55:45,680 --> 00:55:48,240 BREAKTHROUGH INFECTIONS MIGHT 1695 00:55:48,240 --> 00:55:49,120 BE. 1696 00:55:49,120 --> 00:55:49,840 AND THIS 1697 00:55:49,840 --> 00:55:54,320 Q.JUST AN EXA 1698 00:55:54,320 --> 00:55:56,280 WE HAVE THESE SAMPLE WINDOWS 1699 00:55:56,280 --> 00:55:59,760 CHOSEN FOR RELEVANCY, ONE MONTH, 1700 00:55:59,760 --> 00:56:01,000 SIX MONTHS, 12 MONTHS AFTER 1701 00:56:01,000 --> 00:56:01,960 VACCINATION TO SEE WHAT THAT 1702 00:56:01,960 --> 00:56:04,160 RESPONSE LOOKS LIKE AND HOW IT 1703 00:56:04,160 --> 00:56:06,000 WANES TO INSTRUCT ONGOING 1704 00:56:06,000 --> 00:56:06,600 VACCINATION ADVICE AND 1705 00:56:06,600 --> 00:56:07,400 RECOMMENDATION IN THIS 1706 00:56:07,400 --> 00:56:08,760 POPULATION. 1707 00:56:08,760 --> 00:56:10,800 AND HAVING THESE BIOLOGICAL 1708 00:56:10,800 --> 00:56:12,640 WINDOWS REDUCES VARIATION IN 1709 00:56:12,640 --> 00:56:13,480 OUTCOME MEASURES DUAL TO TIME, 1710 00:56:13,480 --> 00:56:15,800 WHICH WAS A PROBLEM WE HAD IN 1711 00:56:15,800 --> 00:56:16,400 THAT FIRST STUDY. 1712 00:56:16,400 --> 00:56:19,160 WITH THIS STUDY, WE HAVE THESE 1713 00:56:19,160 --> 00:56:20,640 WINDOWS AND WE'RE ABLE TO REALLY 1714 00:56:20,640 --> 00:56:21,680 SAY HERE'S WHAT THIS LOOKS LIKE 1715 00:56:21,680 --> 00:56:23,480 AT THE ONE MONTH TIME POINT, AT 1716 00:56:23,480 --> 00:56:25,480 THE SIX MONTH TIME POINT. 1717 00:56:25,480 --> 00:56:28,040 BUT AS WITH ALL OBSERVATIONAL 1718 00:56:28,040 --> 00:56:28,920 DATA, LIFE WILL FIND A WAY, 1719 00:56:28,920 --> 00:56:30,560 WHICH IS WHY WE SEE THIS 1720 00:56:30,560 --> 00:56:32,640 VARIATION AROUND THOSE LINES. 1721 00:56:32,640 --> 00:56:33,480 UNFORTUNATELY IT'S NEVER 1722 00:56:33,480 --> 00:56:35,440 PERFECT, NO MATTER WHAT YOU DO. 1723 00:56:35,440 --> 00:56:36,560 BECAUSE EVERYBODY LOVES SEEING 1724 00:56:36,560 --> 00:56:39,000 DATA, I'M SHARING MY VERY 1725 00:56:39,000 --> 00:56:40,360 FAVORITE PLOT, WE CALL IT THE 1726 00:56:40,360 --> 00:56:42,280 CONFETTI PLOT, BUT HAVING THIS 1727 00:56:42,280 --> 00:56:44,400 RIGID DATA COLLECTION STRUCTURE 1728 00:56:44,400 --> 00:56:45,760 HAS ALLOWED US TO REALLY MAKE 1729 00:56:45,760 --> 00:56:48,360 THESE GREAT COMPARISONS LOOKING 1730 00:56:48,360 --> 00:56:51,440 AT ANTI-S IGG OVER TIME, THESE 1731 00:56:51,440 --> 00:56:52,360 DIFFERENT TIME POINTS, COMPARING 1732 00:56:52,360 --> 00:56:53,160 BETWEEN DIFFERENT IMMUNE 1733 00:56:53,160 --> 00:56:53,600 SUBGROUPS. 1734 00:56:53,600 --> 00:56:56,200 WE WERE ALSO ABLE TO LOOK AT 1735 00:56:56,200 --> 00:56:58,720 VIRUS NEUTRALIZATION TITERS AND 1736 00:56:58,720 --> 00:56:59,920 SEE WHAT THAT CORRELATION MIGHT 1737 00:56:59,920 --> 00:57:03,680 HAVE BEEN OVER TIME AND BY 1738 00:57:03,680 --> 00:57:04,840 DIFFERENT COVID VARIANTS SO WE 1739 00:57:04,840 --> 00:57:06,400 COULD SAY JUST LOOKING AT YOUR 1740 00:57:06,400 --> 00:57:08,760 ANTIBODY TITERS IN THIS COHORT 1741 00:57:08,760 --> 00:57:09,680 ISN'T NECESSARILY GOING TO TELL 1742 00:57:09,680 --> 00:57:11,600 YOU HOW WELL YOU CAN NEUTRALIZE 1743 00:57:11,600 --> 00:57:11,800 VIRUS. 1744 00:57:11,800 --> 00:57:12,960 WITHOUT HAVING THAT PARTICULAR 1745 00:57:12,960 --> 00:57:14,400 DATA SAMPLING TIME FRAME, WE 1746 00:57:14,400 --> 00:57:15,400 WOULDN'T HAVE BEEN ABLE TO LOOK 1747 00:57:15,400 --> 00:57:17,520 AT SOMETHING LIKE THIS TO 1748 00:57:17,520 --> 00:57:21,040 THE DEGREE THAT WE WERE ABLE. 1749 00:57:21,040 --> 00:57:22,560 SO OBVIOUSLY WE CAN'T DO THESE 1750 00:57:22,560 --> 00:57:23,440 STUDIES IN ISOLATION. 1751 00:57:23,440 --> 00:57:24,680 MY UNIT WORKS IN VERY CLOSE 1752 00:57:24,680 --> 00:57:25,560 COORDINATION WITH A WHOLE LOT OF 1753 00:57:25,560 --> 00:57:25,880 PEOPLE. 1754 00:57:25,880 --> 00:57:28,040 WE WORK A LOT WITHIN NIAID, THE 1755 00:57:28,040 --> 00:57:29,600 DIVISION OF CLINICAL RESEARCH, 1756 00:57:29,600 --> 00:57:30,680 ROCKY MOUNTAIN LABS. 1757 00:57:30,680 --> 00:57:32,200 WE WORK WITH FOLKS IN THE 1758 00:57:32,200 --> 00:57:32,560 CLINICAL CENTER. 1759 00:57:32,560 --> 00:57:34,120 WE HAVE A GOOD RELATIONSHIP WITH 1760 00:57:34,120 --> 00:57:35,520 THE BIOETHICS OFFICE, THE 1761 00:57:35,520 --> 00:57:37,120 DIVISION OF LABORATORY MEDICINE, 1762 00:57:37,120 --> 00:57:39,120 CRITICAL CARE MEDICINE, BOTH 1763 00:57:39,120 --> 00:57:40,200 THEY HELP US WITH OUR RESEARCH, 1764 00:57:40,200 --> 00:57:42,760 WE HELP THEM WITH THEIR RESEA 1765 00:57:42,760 --> 00:57:43,960 RESEARCH. 1766 00:57:43,960 --> 00:57:46,280 DR. SADLER AND DR. KAYLISH FROM 1767 00:57:46,280 --> 00:57:47,800 THE NIBIB HAVE REALLY DONE ALL 1768 00:57:47,800 --> 00:57:49,120 OF OUR LAB WORK FOR US. 1769 00:57:49,120 --> 00:57:50,480 WE WOULD NEVER HAVE BEEN ABLE TO 1770 00:57:50,480 --> 00:57:52,040 DO THIS STUDY WITHOUT THEM AND 1771 00:57:52,040 --> 00:57:53,040 THEIR GREAT ASSISTANCE. 1772 00:57:53,040 --> 00:57:57,440 I HAVE MY ICH TEAM, THAT'S A 1773 00:57:57,440 --> 00:58:00,840 HORRIBLE NAME, NOT MY AK NISM, , 1774 00:58:00,840 --> 00:58:02,280 BUT WE'RE WORKING WITH FOLKS 1775 00:58:02,280 --> 00:58:03,000 FROM GEORGETOWN UNIVERSITY IN 1776 00:58:03,000 --> 00:58:04,960 THE COUNCIL ON STRATEGIC RISKS 1777 00:58:04,960 --> 00:58:06,800 AS WELL TO HIGHLIGHT HOW CLIMATE 1778 00:58:06,800 --> 00:58:07,960 CHANGE IMPACTS INFECTIOUS 1779 00:58:07,960 --> 00:58:09,280 DISEASES AND HOW THAT IS A 1780 00:58:09,280 --> 00:58:10,480 BIOLOGICAL AND HEALTH SECURITY 1781 00:58:10,480 --> 00:58:11,800 AND SAFETY RISK. 1782 00:58:11,800 --> 00:58:14,280 AND FINALLY, I'VE GOT A BUNCH OF 1783 00:58:14,280 --> 00:58:14,960 EXTRAMURAL COLLABORATORS. 1784 00:58:14,960 --> 00:58:16,680 I WOULD LIKE TO POINT OUT WE ARE 1785 00:58:16,680 --> 00:58:18,480 WORKING WITH THE CLINICAL DATA 1786 00:58:18,480 --> 00:58:20,240 INTERCHANGE STANDARDS 1787 00:58:20,240 --> 00:58:21,200 CONSORTIUM, AN INTERNATIONAL 1788 00:58:21,200 --> 00:58:25,200 ORGANIZATION TRYING TO AIM TO 1789 00:58:25,200 --> 00:58:25,960 MAKE CLINICAL STANDARDS THAT CAN 1790 00:58:25,960 --> 00:58:27,440 BE USED AND ADOPTED BY ANYONE IN 1791 00:58:27,440 --> 00:58:27,800 THE COMMUNITY. 1792 00:58:27,800 --> 00:58:30,800 AS WELL AS THE COMPUTATIONAL 1793 00:58:30,800 --> 00:58:32,080 EPIDEMIOLOGY DISTRIBUTED 1794 00:58:32,080 --> 00:58:33,080 VOLUNTEER NETWORK, WHICH IS A 1795 00:58:33,080 --> 00:58:34,040 REALLY INTERESTING GROUP OF 1796 00:58:34,040 --> 00:58:35,720 VOLUNTEERS FROM AROUND THE WORLD 1797 00:58:35,720 --> 00:58:36,840 DOING VERY COOL RESEARCH LOOKING 1798 00:58:36,840 --> 00:58:39,360 AT GOOGLE SEARCH TRENDS, SOCIAL 1799 00:58:39,360 --> 00:58:41,280 MEDIA, AND OTHER THINGS AND HOW 1800 00:58:41,280 --> 00:58:42,840 THAT IMPACTS EPIDEMIOLOGY 1801 00:58:42,840 --> 00:58:43,120 STUDIES. 1802 00:58:43,120 --> 00:58:51,000 SO WITH THAT, I'M HAPPY TO TAKE 1803 00:58:51,000 --> 00:58:51,440 ANY QUESTIONS. 1804 00:58:51,440 --> 00:59:01,520 [APPLAUSE] 1805 00:59:01,520 --> 00:59:01,960 >>THANK YOU. 1806 00:59:01,960 --> 00:59:03,720 THIS WAS REALLY FUN FOR ME TO 1807 00:59:03,720 --> 00:59:04,680 THINK ABOUT SOMETHING I DON'T 1808 00:59:04,680 --> 00:59:06,520 USUALLY THINK ABOUT. 1809 00:59:06,520 --> 00:59:11,000 I WONDER HOW MUCH THE FACTOR OF 1810 00:59:11,000 --> 00:59:14,160 THE COST OF MAINTAINING THE 1811 00:59:14,160 --> 00:59:16,720 DATA, ACCESSING THE DATA, 1812 00:59:16,720 --> 00:59:19,040 FACTORS INTO YOUR MODELS. 1813 00:59:19,040 --> 00:59:22,120 ESPECIALLY SORT OF FOR WORLDWIDE 1814 00:59:22,120 --> 00:59:22,360 PANDEMICS. 1815 00:59:22,360 --> 00:59:23,240 >>YEAH, ABSOLUTELY. 1816 00:59:23,240 --> 00:59:25,480 YOU KNOW, COST IS DEFINITELY A 1817 00:59:25,480 --> 00:59:27,920 BIG THING TO THINK ABOUT. 1818 00:59:27,920 --> 00:59:29,360 BUT INVESTING IN -- THIS IS 1819 00:59:29,360 --> 00:59:30,600 WHERE WE GET THAT SAYING, AN 1820 00:59:30,600 --> 00:59:32,040 OUNCE OF PREVENTION IS WORTH A 1821 00:59:32,040 --> 00:59:32,840 POUND OF CURE. 1822 00:59:32,840 --> 00:59:35,000 IT APPLIES TO HAVING DATA TOO. 1823 00:59:35,000 --> 00:59:36,920 SO WE ACTUALLY INVEST IN DATA 1824 00:59:36,920 --> 00:59:38,240 SYSTEMS AND HAVING ACCESS TO 1825 00:59:38,240 --> 00:59:40,480 GOOD DATA, THEN THAT'S GOING TO 1826 00:59:40,480 --> 00:59:42,040 PAY OFF WHEN WE DON'T HAVE A 1827 00:59:42,040 --> 00:59:43,760 HUGE GLOBAL PANDEMIC THAT BREAKS 1828 00:59:43,760 --> 00:59:45,760 OUT AND CRASHES THE ECONOMY, 1829 00:59:45,760 --> 00:59:46,920 RIGHT? 1830 00:59:46,920 --> 00:59:48,320 SO WHILE YES, IT IS ABSOLUTELY 1831 00:59:48,320 --> 00:59:50,600 EXPENSIVE AND IT'S A BIG 1832 00:59:50,600 --> 00:59:51,840 INVESTMENT UP FRONT TO DO, IT 1833 00:59:51,840 --> 00:59:54,320 SHOULD SAVE MONEY OVER THE LONG 1834 00:59:54,320 --> 00:59:56,560 TERM BY GIVING US ACCESS TO DATA 1835 00:59:56,560 --> 00:59:57,760 TO HELP ANSWER THESE QUESTIONS 1836 00:59:57,760 --> 00:59:59,640 AHEAD OF TIME, HELP PREPARE FOR, 1837 00:59:59,640 --> 01:00:01,360 YOU KNOW, OUTBREAKS THAT WE MAY 1838 01:00:01,360 --> 01:00:02,200 HAVE, THINGS LIKE THAT. 1839 01:00:02,200 --> 01:00:05,760 >>SO I GUESS ANOTHER TWIST TO 1840 01:00:05,760 --> 01:00:06,720 THAT IS THEN YOU'RE ALSO HAVING 1841 01:00:06,720 --> 01:00:07,800 TO DEAL WITH POLITICAL 1842 01:00:07,800 --> 01:00:10,440 SITUATIONS AND POLITICAL WILL 1843 01:00:10,440 --> 01:00:12,800 AND SORT OF, I GUESS, THE HOPE 1844 01:00:12,800 --> 01:00:15,640 IS BY PRESENTING DATA, THEN YOU 1845 01:00:15,640 --> 01:00:17,640 CAN CONVINCE PEOPLE. 1846 01:00:17,640 --> 01:00:21,440 >>AGAIN, YES. 1847 01:00:21,440 --> 01:00:22,920 SO IDEALLY WE WOULD HAVE DATA 1848 01:00:22,920 --> 01:00:25,480 AHEAD OF TIME TO SAY LOOK, ISN'T 1849 01:00:25,480 --> 01:00:27,040 PREVENTING A PANDEMIC A GREAT 1850 01:00:27,040 --> 01:00:29,160 IDEA, EVERYBODY? 1851 01:00:29,160 --> 01:00:30,240 BUT THIS IS THE PROBLEM THAT WE 1852 01:00:30,240 --> 01:00:32,640 HAVE WITH VACCINES. 1853 01:00:32,640 --> 01:00:33,560 VACCINE-PREVENTABLE ILLNESSES 1854 01:00:33,560 --> 01:00:34,840 HAVE ALL BUT DISAPPEARED IN THE 1855 01:00:34,840 --> 01:00:36,960 UNITED STATES, AND SO FOLKS SAY 1856 01:00:36,960 --> 01:00:38,360 WELL, WHY DO I NEED TO VACCINATE 1857 01:00:38,360 --> 01:00:38,840 MY KIDS? 1858 01:00:38,840 --> 01:00:40,640 NOW WE'RE SEEING A RE-EMERGENCE 1859 01:00:40,640 --> 01:00:42,640 OF MEASLES, OF POLIO, LIKE, WHY 1860 01:00:42,640 --> 01:00:43,680 ARE WE SEEING THIS COME BACK 1861 01:00:43,680 --> 01:00:45,040 INTO THE U.S.? 1862 01:00:45,040 --> 01:00:46,360 WE HAVE VACCINES TO PREVENT 1863 01:00:46,360 --> 01:00:46,680 THESE. 1864 01:00:46,680 --> 01:00:49,360 AND IT'S THE SAME THING WITH 1865 01:00:49,360 --> 01:00:51,240 PREVENTION OF INFECTIOUS DISEASE 1866 01:00:51,240 --> 01:00:51,680 OUTBREAKS. 1867 01:00:51,680 --> 01:00:53,640 IT IS SOMETHING THAT WE ALL KNOW 1868 01:00:53,640 --> 01:00:55,800 LOGICALLY WE SHOULD DO. 1869 01:00:55,800 --> 01:00:57,440 BUT TRYING TO MOTIVATE PEOPLE TO 1870 01:00:57,440 --> 01:00:59,080 SPEND THEIR MONEY AND TO PUT 1871 01:00:59,080 --> 01:01:01,920 TIME AND INVESTMENT INTO THAT, 1872 01:01:01,920 --> 01:01:03,760 WHEN IT -- IF IT WORKS, YOU SEE 1873 01:01:03,760 --> 01:01:04,800 NOTHING, YOU SEE NO RESULTS. 1874 01:01:04,800 --> 01:01:08,680 IT IS REALLY HARD. 1875 01:01:08,680 --> 01:01:10,040 >>I'M JUST WONDERING IF YOU CAN 1876 01:01:10,040 --> 01:01:13,360 SPEAK TO SOME OF THE CHALLENGES 1877 01:01:13,360 --> 01:01:15,120 OF DATA COLLECTION AND 1878 01:01:15,120 --> 01:01:17,120 MANAGEMENT IN CASES WHERE THERE 1879 01:01:17,120 --> 01:01:19,440 IS LIKE A HUGE DISASTER 1880 01:01:19,440 --> 01:01:21,840 RESPONSE, PARTICULARLY IN MAYBE 1881 01:01:21,840 --> 01:01:23,360 ANOTHER COUNTRY WHERE THAT IS, 1882 01:01:23,360 --> 01:01:24,840 YOU KNOW, MAYBE DOESN'T HAVE THE 1883 01:01:24,840 --> 01:01:25,600 RESOURCES THAT WE DO. 1884 01:01:25,600 --> 01:01:28,480 WHAT ARE SOME OF THE MAJOR 1885 01:01:28,480 --> 01:01:29,880 PROBLEMS IN TERMS OF DEALING 1886 01:01:29,880 --> 01:01:32,840 WITH BOTH THE WHOLE DISASTER 1887 01:01:32,840 --> 01:01:34,000 SITUATION AND STILL MAINTAINING 1888 01:01:34,000 --> 01:01:36,080 YOUR ABILITY TO COLLECT DATA? 1889 01:01:36,080 --> 01:01:37,960 >>GREAT QUESTION. 1890 01:01:37,960 --> 01:01:39,240 SO THERE ARE A COUPLE FACTORS 1891 01:01:39,240 --> 01:01:40,440 THAT PLAY INTO THAT. 1892 01:01:40,440 --> 01:01:44,200 SO THE FIRST IS THAT IF THERE'S 1893 01:01:44,200 --> 01:01:45,560 NO INFRASTRUCTURE TO COLLECT 1894 01:01:45,560 --> 01:01:47,040 DATA, ESPECIALLY IN COUNTRY, 1895 01:01:47,040 --> 01:01:48,280 THEN IT'S GOING TO BE REALLY 1896 01:01:48,280 --> 01:01:49,840 HARD TO START DOING THAT DURING 1897 01:01:49,840 --> 01:01:51,680 THE MIDDLE OF A DISASTER. 1898 01:01:51,680 --> 01:01:53,760 IF YOU HAVE INFRASTRUCTURE THERE 1899 01:01:53,760 --> 01:01:54,880 BEFOREHAND, THEN IT'S NOT QUITE 1900 01:01:54,880 --> 01:01:56,840 AS DIFFICULT TO COME IN, YOU 1901 01:01:56,840 --> 01:01:57,240 HAVE PEOPLE. 1902 01:01:57,240 --> 01:01:58,320 WE CAN SEND IN PEOPLE FROM 1903 01:01:58,320 --> 01:01:59,640 AROUND THE WORLD TO GO AND 1904 01:01:59,640 --> 01:02:02,520 COLLECT DATA, BUT THEN WE HAVE 1905 01:02:02,520 --> 01:02:03,640 PROBLEMS WITH, YOU KNOW, THE 1906 01:02:03,640 --> 01:02:05,760 ETHICS OF DOING THAT, OF SENDING 1907 01:02:05,760 --> 01:02:07,400 IN PEOPLE FROM, YOU KNOW, SAY 1908 01:02:07,400 --> 01:02:08,320 THE GLOBAL NORTH INTO THE GLOBAL 1909 01:02:08,320 --> 01:02:09,560 SOUTH AND COLLECTING DATA AND 1910 01:02:09,560 --> 01:02:11,720 NOT SHARING THAT WITH THE FOLKS 1911 01:02:11,720 --> 01:02:13,800 IN THAT COMMUNITY, NOT RETURNING 1912 01:02:13,800 --> 01:02:15,080 ANYTHING THAT WE LEARN ABOUT 1913 01:02:15,080 --> 01:02:16,160 THAT DATA. 1914 01:02:16,160 --> 01:02:18,000 WE ALSO HAVE TROUBLE, AND THIS 1915 01:02:18,000 --> 01:02:19,960 IS WHY I'M WORKING WITH 1916 01:02:19,960 --> 01:02:21,640 ETHICISTS AND LAWYERS, IS WHEN 1917 01:02:21,640 --> 01:02:23,560 WE GO INTO A COUNTRY THAT'S 1918 01:02:23,560 --> 01:02:25,080 HAVING, LET'S SAY, AN OUTBREAK 1919 01:02:25,080 --> 01:02:26,680 AND WE WANT TO COLLECT DATA 1920 01:02:26,680 --> 01:02:27,880 QUICKLY, WE HAVE TO -- IN ORDER 1921 01:02:27,880 --> 01:02:29,240 TO DO RESEARCH, WE HAVE TO WORK 1922 01:02:29,240 --> 01:02:30,920 WITHIN THE CONFINES OF THE 1923 01:02:30,920 --> 01:02:32,320 INSTITUTIONAL REVIEW BOARD OF 1924 01:02:32,320 --> 01:02:34,680 THE NIH, OF THAT COUNTRY. 1925 01:02:34,680 --> 01:02:36,520 AND THAT IS NEVER A QUICK 1926 01:02:36,520 --> 01:02:37,520 PROCESS, RIGHT? 1927 01:02:37,520 --> 01:02:39,760 YOU KNOW, IRB CAN TAKE ITS TIME. 1928 01:02:39,760 --> 01:02:40,880 AND THAT'S NOT GREAT IF YOU'RE 1929 01:02:40,880 --> 01:02:42,280 TRYING TO RESPOND TO AN 1930 01:02:42,280 --> 01:02:43,040 EMERGENCY SITUATION. 1931 01:02:43,040 --> 01:02:44,800 AND SO THE WAY WE GET AROUND 1932 01:02:44,800 --> 01:02:46,120 THAT IS BY SAYING WELL, WE'RE 1933 01:02:46,120 --> 01:02:49,000 DOING THIS IN -- UNDER THE GUISE 1934 01:02:49,000 --> 01:02:49,880 OF PUBLIC HEALTH RESPONSE. 1935 01:02:49,880 --> 01:02:50,880 BUT THERE ARE STIP LAYINGS IN 1936 01:02:50,880 --> 01:02:52,160 THAT YOU WILL NOT BE USING THAT 1937 01:02:52,160 --> 01:02:53,560 DATA FOR RESEARCH PURPOSES. 1938 01:02:53,560 --> 01:02:56,080 SO HOW DO WE GET AROUND THAT? 1939 01:02:56,080 --> 01:02:56,760 DON'T KNOW YET. 1940 01:02:56,760 --> 01:02:57,840 THAT'S WHAT WE'RE TRYING TO BE 1941 01:02:57,840 --> 01:02:58,280 WORKING ON. 1942 01:02:58,280 --> 01:03:00,040 AND THIS IS WHY WE'RE BRINGING 1943 01:03:00,040 --> 01:03:01,400 IN, YOU KNOW, THESE OTHER 1944 01:03:01,400 --> 01:03:02,080 PEOPLE, THESE LAWYERS AND 1945 01:03:02,080 --> 01:03:03,800 EXPERTS AND FOLKS FROM IN 1946 01:03:03,800 --> 01:03:05,480 COUNTRY TO REALLY SAY, HOW DO WE 1947 01:03:05,480 --> 01:03:06,920 MAKE THIS WORK SO THAT WE CAN 1948 01:03:06,920 --> 01:03:08,360 STILL GET GOOD QUALITY DATA THAT 1949 01:03:08,360 --> 01:03:09,480 WE KNOW WE'RE GOING TO USE FOR 1950 01:03:09,480 --> 01:03:12,520 RESEARCH LATER ON, WITHOUT MAYBE 1951 01:03:12,520 --> 01:03:13,360 HAVING TO DEAL WITH THE TIME 1952 01:03:13,360 --> 01:03:15,160 REQUIRED TO GO THROUGH A FULL 1953 01:03:15,160 --> 01:03:16,760 IRB. 1954 01:03:16,760 --> 01:03:18,160 AND SO YEAH, IT'S TRICKY. 1955 01:03:18,160 --> 01:03:19,600 AND AGAIN, THERE'S THE MONEY AND 1956 01:03:19,600 --> 01:03:21,200 THE POLITICAL WILL, TRYING TO 1957 01:03:21,200 --> 01:03:23,160 GET INTO A COUNTRY AND COLLECT 1958 01:03:23,160 --> 01:03:24,000 DATA DURING AN EMERGENCY 1959 01:03:24,000 --> 01:03:26,000 SITUATION, TRYING TO REROUTE 1960 01:03:26,000 --> 01:03:26,320 FUNDS. 1961 01:03:26,320 --> 01:03:28,080 IT CAN BE REALLY HARD TO DO. 1962 01:03:28,080 --> 01:03:30,160 AND THAT'S WHAT COMPOUNDS THESE 1963 01:03:30,160 --> 01:03:31,880 PROBLEMS, ESPECIALLY IN OUTBREAK 1964 01:03:31,880 --> 01:03:32,600 SETTINGS. 1965 01:03:32,600 --> 01:03:33,920 YOU KNOW, IS THAT YOU'RE NOT 1966 01:03:33,920 --> 01:03:35,040 GETTING THE DATA THAT YOU NEED, 1967 01:03:35,040 --> 01:03:37,440 AND THEN IT JUST -- IT COMPOUNDS 1968 01:03:37,440 --> 01:03:38,760 AND IT MAKES THINGS WORSE AND SO 1969 01:03:38,760 --> 01:03:40,080 IF WE COULD PREVENT THAT FROM 1970 01:03:40,080 --> 01:03:41,480 HAPPENING IN THE FIRST PLACE, OR 1971 01:03:41,480 --> 01:03:44,200 AT LEAST HAVE THAT 1972 01:03:44,200 --> 01:03:45,960 INFRASTRUCTURE IN PLACE SO THAT 1973 01:03:45,960 --> 01:03:47,880 WHEN SOMETHING DOES OCCUR, WE'D 1974 01:03:47,880 --> 01:03:49,640 BE ABLE TO RESPOND A LOT MORE 1975 01:03:49,640 --> 01:03:50,880 AGILELY TO THAT, AND I THINK IT 1976 01:03:50,880 --> 01:03:52,600 WOULD BE -- YOU KNOW, IT COULD 1977 01:03:52,600 --> 01:04:01,880 PAY DIVIDENDS. 1978 01:04:01,880 --> 01:04:03,520 GOT TO GET A WORKOUT TO GET YOUR 1979 01:04:03,520 --> 01:04:04,440 QUESTIONS IN. 1980 01:04:04,440 --> 01:04:04,960 >>REALLY. 1981 01:04:04,960 --> 01:04:06,360 SO I WAS WONDERING IF YOU COULD 1982 01:04:06,360 --> 01:04:11,400 SPEAK TO WHETHER DATA COLLECTION 1983 01:04:11,400 --> 01:04:14,120 IN COUNTRIES THAT HAVE A WELL 1984 01:04:14,120 --> 01:04:16,880 CONTROLLED HEALTHCARE SYSTEM IS 1985 01:04:16,880 --> 01:04:21,680 EASIER THAN THOSE THAT HAVE KIND 1986 01:04:21,680 --> 01:04:22,680 OF -- LIKE THE UNITED STATES, 1987 01:04:22,680 --> 01:04:22,960 YOU KNOW. 1988 01:04:22,960 --> 01:04:26,160 >>YEAH, ACTUALLY, I AM VERY 1989 01:04:26,160 --> 01:04:28,440 JEALOUS OF A LOT OF 1990 01:04:28,440 --> 01:04:29,320 EPIDEMIOLOGISTS WHO GET TO WORK 1991 01:04:29,320 --> 01:04:30,600 WITH A LOT OF EUROPEAN DATA. 1992 01:04:30,600 --> 01:04:33,120 YOU KNOW, THE UK IS A GOOD 1993 01:04:33,120 --> 01:04:34,720 EXAMPLE, BUT EVEN BETTER IS LIKE 1994 01:04:34,720 --> 01:04:36,920 THE NETHERLANDS AND DENMARK, 1995 01:04:36,920 --> 01:04:38,560 THEY HAVE CENTRALIZED HEALTHCARE 1996 01:04:38,560 --> 01:04:39,760 SYSTEMS SO ALL OF THEIR DATA IS 1997 01:04:39,760 --> 01:04:41,280 THERE AND IT JUST THIS 1998 01:04:41,280 --> 01:04:42,880 BEAUTIFULLY ROBUST DATA SYSTEM, 1999 01:04:42,880 --> 01:04:45,880 WHEREAS IN THE UNITED STATES, 2000 01:04:45,880 --> 01:04:46,880 THINGS ARE FRACTURED, SO 2001 01:04:46,880 --> 01:04:48,360 EVERYTHING IS RUN AT THE STATE 2002 01:04:48,360 --> 01:04:51,880 LEVEL, OR YOU HAVE PEOPLE WHO 2003 01:04:51,880 --> 01:04:54,040 BUY INTO COMMERCIAL ELECTRONIC 2004 01:04:54,040 --> 01:04:56,200 HEALTHCARE RECORDS, LIKE EPIC, 2005 01:04:56,200 --> 01:04:57,600 AND EPIC DOESN'T ACTUALLY SELL 2006 01:04:57,600 --> 01:04:59,040 THEIR DATA FOR RESEARCH 2007 01:04:59,040 --> 01:04:59,480 PURPOSES. 2008 01:04:59,480 --> 01:05:02,880 YOU CAN GET DATA FROM OTHER 2009 01:05:02,880 --> 01:05:05,400 COMPANIES AND IT COSTS A TON OF 2010 01:05:05,400 --> 01:05:05,640 MONEY. 2011 01:05:05,640 --> 01:05:07,680 AND THEN IT'S NOT NECESSARILY 2012 01:05:07,680 --> 01:05:08,440 REPRESENTATIVE OF THE WHOLE 2013 01:05:08,440 --> 01:05:09,320 COUNTRY BECAUSE NOT EVERYBODY IS 2014 01:05:09,320 --> 01:05:10,280 USING THAT SYSTEM. 2015 01:05:10,280 --> 01:05:10,640 >>RIGHT. 2016 01:05:10,640 --> 01:05:15,760 >>AND SO, YEAH, IT MAKES IT 2017 01:05:15,760 --> 01:05:17,200 VERY CHALLENGING, AND WE DID, WE 2018 01:05:17,200 --> 01:05:18,480 SAW THAT DURING THE COVID 2019 01:05:18,480 --> 01:05:18,800 PANDEMIC. 2020 01:05:18,800 --> 01:05:21,640 WE SAW THAT THIS FRAGMENTATION 2021 01:05:21,640 --> 01:05:23,720 REALLY DIDN'T PERMIT US TO GET 2022 01:05:23,720 --> 01:05:25,160 THE INFORMATION WE NEEDED OP 2023 01:05:25,160 --> 01:05:27,000 WHERE OUTBREAKS WERE OCCURRING, 2024 01:05:27,000 --> 01:05:29,720 WHO WAS GETTING INFECTED, TRYING 2025 01:05:29,720 --> 01:05:32,000 TO GET ANY DATA ON TREATMENTS. 2026 01:05:32,000 --> 01:05:34,000 USUALLY IF YOU PURCHASE AN 2027 01:05:34,000 --> 01:05:35,200 ELECTRONIC HEALTH RECORD DATA 2028 01:05:35,200 --> 01:05:37,000 SYSTEM, YOU DON'T GET ANY OF THE 2029 01:05:37,000 --> 01:05:38,640 PHARMACY RECORDS. 2030 01:05:38,640 --> 01:05:43,120 LIKE GET MY PRESCRIPTIONS FILLD 2031 01:05:43,120 --> 01:05:44,640 AT CVS AND NONE OF THAT IS IN 2032 01:05:44,640 --> 01:05:45,320 THOSE SYSTEMS. 2033 01:05:45,320 --> 01:05:46,880 SO HOW DO YOU ACCURATELY ASSESS 2034 01:05:46,880 --> 01:05:47,680 TREATMENT FOR A PERSON? 2035 01:05:47,680 --> 01:05:48,920 IT'S A MAJOR PROBLEM. 2036 01:05:48,920 --> 01:05:52,040 AND ACTUALLY IN THE NATIONAL 2037 01:05:52,040 --> 01:05:54,000 BIODEFENSE PLAN, IT DOES TALK 2038 01:05:54,000 --> 01:05:55,520 ABOUT DATA WITHIN THE UNITED 2039 01:05:55,520 --> 01:05:56,960 STATES AND TRYING TO -- THE NEED 2040 01:05:56,960 --> 01:05:59,960 TO BUILD BETTER DATA 2041 01:05:59,960 --> 01:06:00,880 INFRASTRUCTURE FOR RESPONDING TO 2042 01:06:00,880 --> 01:06:01,360 HEALTH PROBLEMS. 2043 01:06:01,360 --> 01:06:03,320 BUT HOW WE'RE GOING TO TACKLE 2044 01:06:03,320 --> 01:06:04,560 THAT IS -- I'LL BE INTERESTED TO 2045 01:06:04,560 --> 01:06:05,560 SEE HOW THAT GOES. 2046 01:06:05,560 --> 01:06:06,080 >>YEAH. 2047 01:06:06,080 --> 01:06:06,320 THANKS. 2048 01:06:06,320 --> 01:06:09,800 >>GREAT QUESTION. 2049 01:06:09,800 --> 01:06:10,560 >>OKAY. 2050 01:06:10,560 --> 01:06:11,960 I THINK WE'VE GOT QUESTIONS FROM 2051 01:06:11,960 --> 01:06:13,360 THE VIDEOCAST SO WE'RE GOING TO 2052 01:06:13,360 --> 01:06:16,960 GO AHEAD AND BUMP TO MARY 2053 01:06:16,960 --> 01:06:18,240 KEARNEY, THE CHAIR OF WSA, TO 2054 01:06:18,240 --> 01:06:18,600 FIELD THOSE. 2055 01:06:18,600 --> 01:06:19,000 >>HI. 2056 01:06:19,000 --> 01:06:21,280 CAN YOU SEE ME? 2057 01:06:21,280 --> 01:06:24,120 SO ACTUALLY THE QUESTIONS ARE 2058 01:06:24,120 --> 01:06:25,720 RIGHT IN LINE WITH WHAT CAROL 2059 01:06:25,720 --> 01:06:28,880 JUST ASKED ACTUALLY, SO -- BUT 2060 01:06:28,880 --> 01:06:29,960 CAN YOU HEAR ME? 2061 01:06:29,960 --> 01:06:30,560 >>YES. 2062 01:06:30,560 --> 01:06:32,120 >>OKAY. 2063 01:06:32,120 --> 01:06:32,960 BECAUSE I'M HAVING TROUBLE 2064 01:06:32,960 --> 01:06:34,480 HEARING YOU. 2065 01:06:34,480 --> 01:06:37,440 BUT SO ONE OF THE QUESTIONS IS 2066 01:06:37,440 --> 01:06:39,600 ABOUT -- WHICH I THINK YOU JUST 2067 01:06:39,600 --> 01:06:41,360 ADDRESSED IN THE LAST QUESTION, 2068 01:06:41,360 --> 01:06:44,960 BUT -- SO THE WHO HAS, IN MANY 2069 01:06:44,960 --> 01:06:46,160 COUNTRIES, SET UP LOCAL AND 2070 01:06:46,160 --> 01:06:47,360 REGIONAL AND NATIONAL LABS SO 2071 01:06:47,360 --> 01:06:49,840 THAT THEY CAN MEASURE INCIDENCE 2072 01:06:49,840 --> 01:06:52,280 RATES AND DO GENETIC 2073 01:06:52,280 --> 01:06:53,360 SURVEILLANCE. 2074 01:06:53,360 --> 01:06:55,040 AND CDCs WITHIN MANY COUNTRIES 2075 01:06:55,040 --> 01:06:56,480 DO THE SAME, SET UP LOCAL AND 2076 01:06:56,480 --> 01:06:57,880 REGIONAL LABS AND ALL THE DATA 2077 01:06:57,880 --> 01:07:01,280 GET SENT TO THE CDC AND THAT 2078 01:07:01,280 --> 01:07:02,600 REALLY OBVIOUSLY HELPS WITH LIKE 2079 01:07:02,600 --> 01:07:04,480 YOU JUST MENTIONED, IT'S CLEAR 2080 01:07:04,480 --> 01:07:06,120 THAT IN THE UNITED STATES, WE 2081 01:07:06,120 --> 01:07:07,840 HAVE VERY POOR SURVEILLANCE IN 2082 01:07:07,840 --> 01:07:09,480 THE COVID PANDEMIC, AND THIS IS 2083 01:07:09,480 --> 01:07:10,680 TRUE, OF COURSE, WITH OTHER 2084 01:07:10,680 --> 01:07:13,200 VIRUSES LIKE HIV. 2085 01:07:13,200 --> 01:07:15,280 AND SO WHAT CAN WE DO AS 2086 01:07:15,280 --> 01:07:16,800 CITIZENS, NOT JUST AS SCIENTISTS 2087 01:07:16,800 --> 01:07:17,600 BECAUSE THE SCIENTISTS, OF 2088 01:07:17,600 --> 01:07:19,160 COURSE, WE CAN ENROLL IN 2089 01:07:19,160 --> 01:07:20,640 CLINICAL TRIALS AND 2090 01:07:20,640 --> 01:07:21,880 EPIDEMIOLOGISTS LIKE YOU CAN DO 2091 01:07:21,880 --> 01:07:23,960 THE BEST YOU CAN TO COLLECT DATA 2092 01:07:23,960 --> 01:07:26,040 AND DO ANALYSIS IN THE UNITED 2093 01:07:26,040 --> 01:07:27,760 STATES THAT WOULD BE THE 2094 01:07:27,760 --> 01:07:29,240 EQUIVALENT TO WHAT'S DONE IN 2095 01:07:29,240 --> 01:07:30,080 MANY OTHER COUNTRIES. 2096 01:07:30,080 --> 01:07:32,080 BUT AS CITIZENS, WHAT CAN BE 2097 01:07:32,080 --> 01:07:33,920 DONE TO -- I DON'T KNOW -- PUT 2098 01:07:33,920 --> 01:07:35,440 PRESSURE ON CONGRESS OR TO MAKE 2099 01:07:35,440 --> 01:07:38,600 SOME KIND OF CHANGES WHERE THE 2100 01:07:38,600 --> 01:07:39,720 CDC WOULD HAVE SOME KIND OF 2101 01:07:39,720 --> 01:07:41,760 POWER TO HAVE LOCAL AND REGIONAL 2102 01:07:41,760 --> 01:07:44,280 LABS SET UP TO MEASURE INCIDENCE 2103 01:07:44,280 --> 01:07:47,880 RATES AND GENETIC DIVERSITY OF 2104 01:07:47,880 --> 01:07:48,800 DIFFERENT PATHOGENS. 2105 01:07:48,800 --> 01:07:50,200 >>YEAH, GREAT QUESTION. 2106 01:07:50,200 --> 01:07:52,240 SO THE CDC ACTUALLY DOES IN THE 2107 01:07:52,240 --> 01:07:56,880 UNITED STATES HAVE SENTINEL 2108 01:07:56,880 --> 01:07:57,760 SURVEILLANCE PROGRAMS, AND WE 2109 01:07:57,760 --> 01:07:58,960 HAVE MANDATORY REPORTING OF 2110 01:07:58,960 --> 01:08:03,120 CERTAIN PATHOGENS THAT STATES 2111 01:08:03,120 --> 01:08:04,840 HAVE TO DO, SO IF WE HAVE 2112 01:08:04,840 --> 01:08:07,760 INCIDENCE OF, SAY, EXTREMELY 2113 01:08:07,760 --> 01:08:09,680 DRUG RESISTANCE TO TUBERCULOSIS, 2114 01:08:09,680 --> 01:08:11,360 THAT HAS TO GET REPORTED TO THE 2115 01:08:11,360 --> 01:08:11,520 CDC. 2116 01:08:11,520 --> 01:08:14,240 I USED TO WORK FOR THE 2117 01:08:14,240 --> 01:08:15,720 FOOD-BORNE DISEASE NETWORK WHEN 2118 01:08:15,720 --> 01:08:17,240 I WORKED AT THE MARYLAND STATE 2119 01:08:17,240 --> 01:08:20,160 HEALTH DEPARTMENT, WHICH WAS 2120 01:08:20,160 --> 01:08:22,120 HILARIOUS WITH THE LAST NAME 2121 01:08:22,120 --> 01:08:23,200 RICOTTA, HA HA. 2122 01:08:23,200 --> 01:08:25,640 BUT FOR THAT, IN MARYLAND, IN 2123 01:08:25,640 --> 01:08:26,600 THE STATE OF MARYLAND, IF THERE 2124 01:08:26,600 --> 01:08:28,880 WAS A CASE OF SALMONELLA OR CAM 2125 01:08:28,880 --> 01:08:30,520 FLOW BACTER THAT GOT REPORTED, 2126 01:08:30,520 --> 01:08:32,280 SHOWED UP TO THE CLINIC AND THEN 2127 01:08:32,280 --> 01:08:34,240 THOSE SAMPLES WOULD GET SENT TO 2128 01:08:34,240 --> 01:08:35,680 THE STATE LAB, WE'D REPORT THAT 2129 01:08:35,680 --> 01:08:37,280 TO THE CDC, BUT THAT WAS JUST 2130 01:08:37,280 --> 01:08:38,480 FOR MARYLAND AND THAT WAS JUST 2131 01:08:38,480 --> 01:08:42,920 IF PEOPLE WENT TO THE CLINIC. 2132 01:08:42,920 --> 01:08:44,400 SO HOW CAN REGULAR EVERYDAY 2133 01:08:44,400 --> 01:08:45,120 PEOPLE HELP? 2134 01:08:45,120 --> 01:08:48,280 WELL, THEY CAN, YOU KNOW, IF 2135 01:08:48,280 --> 01:08:50,440 YOU'RE SICK, YOU CAN GO TO YOUR 2136 01:08:50,440 --> 01:08:51,360 DOCTOR, CALL YOUR DOCTOR. 2137 01:08:51,360 --> 01:08:53,080 THE CDC DOES HAVE SOME PROGRAMS 2138 01:08:53,080 --> 01:08:56,600 WHERE YOU CAN REPORT YOUR 2139 01:08:56,600 --> 01:09:00,280 VACCINE AND ANY ADVERSE EVENTS. 2140 01:09:00,280 --> 01:09:02,040 CDC HAS VSAFE FOR THE COVID 2141 01:09:02,040 --> 01:09:02,640 VACCINES. 2142 01:09:02,640 --> 01:09:04,160 CHECK OUT WHAT PROGRAMS YOUR 2143 01:09:04,160 --> 01:09:04,840 LOCAL PUBLIC HEALTH DEPARTMENTS 2144 01:09:04,840 --> 01:09:05,320 MAY HAVE. 2145 01:09:05,320 --> 01:09:07,840 THEY MAY HAVE OPTIONS FOR THE 2146 01:09:07,840 --> 01:09:08,800 COMMUNITY TO HELP. 2147 01:09:08,800 --> 01:09:10,280 THE OTHER THING IS ABSOLUTELY 2148 01:09:10,280 --> 01:09:12,920 TALKING TO YOUR CONGRESSPEOPLE 2149 01:09:12,920 --> 01:09:13,800 AND SAYING, THIS IS SOMETHING 2150 01:09:13,800 --> 01:09:15,280 THAT WE WANT OUR MONEY DEDICATED 2151 01:09:15,280 --> 01:09:15,560 TO. 2152 01:09:15,560 --> 01:09:17,920 I WOULD LOVE TO KNOW WHERE COVID 2153 01:09:17,920 --> 01:09:19,000 OUTBREAKS ARE SO I DON'T GET 2154 01:09:19,000 --> 01:09:19,200 COVID. 2155 01:09:19,200 --> 01:09:21,600 I MEAN, I'M FINE, LIKE, PUT SOME 2156 01:09:21,600 --> 01:09:22,720 MONEY TOWARDS THAT, AND MAYBE 2157 01:09:22,720 --> 01:09:23,640 FIX THIS ROAD WHILE YOU'RE AT 2158 01:09:23,640 --> 01:09:24,040 IT. 2159 01:09:24,040 --> 01:09:24,640 BUT WHATEVER. 2160 01:09:24,640 --> 01:09:26,160 SO YEAH, IT'S -- YOU KNOW, JUST 2161 01:09:26,160 --> 01:09:28,440 MAKING SURE THAT THE GOVERNMENT 2162 01:09:28,440 --> 01:09:29,800 KNOWS THIS IS SOMETHING THAT WE 2163 01:09:29,800 --> 01:09:33,160 WANT TO HAVE OUR MONEY SPENT ON, 2164 01:09:33,160 --> 01:09:36,240 BECAUSE IT IS FOR THE GOOD OF 2165 01:09:36,240 --> 01:09:37,440 EVERYONE IS DEFINITELY SO, SO 2166 01:09:37,440 --> 01:09:41,600 VERY IMPORTANT. 2167 01:09:41,600 --> 01:09:45,200 >>THANK YOU. 2168 01:09:45,200 --> 01:09:46,120 >>THANK YOU SO MUCH. 2169 01:09:46,120 --> 01:09:52,200 [APPLAUSE] 2170 01:09:52,200 --> 01:09:55,480 >>THANK YOU SO MUCH, 2171 01:09:55,480 --> 01:10:00,200 DR. RICOTTA, DR. SEGRE, 2172 01:10:00,200 --> 01:10:00,960 DR. THIELE, FOR YOUR 2173 01:10:00,960 --> 01:10:02,480 PARTICIPATION TODAY AND A HUGE 2174 01:10:02,480 --> 01:10:04,000 THANKS TO THE OTHER MEMBERS OF 2175 01:10:04,000 --> 01:10:06,000 THE ORGANIZING COMMITTEE, AS 2176 01:10:06,000 --> 01:10:07,640 WELL AS THOSE IN EVENTS 2177 01:10:07,640 --> 01:10:08,840 MANAGEMENT AND I.T. THAT HELPED 2178 01:10:08,840 --> 01:10:10,320 PUT THIS ON TODAY. 2179 01:10:10,320 --> 01:10:11,640 JUST A QUICK ANNOUNCEMENT BEFORE 2180 01:10:11,640 --> 01:10:13,480 WE LET YOU ALL GO. 2181 01:10:13,480 --> 01:10:15,600 WE HAVE ANOTHER EVENT COMING UP 2182 01:10:15,600 --> 01:10:18,480 ON MAY 12TH AT 11:00 A.M. AGAIN 2183 01:10:18,480 --> 01:10:20,840 HERE IN LIPSETT FEATURING DRS. 2184 01:10:20,840 --> 01:10:23,480 CANDACE TANNER AND PAULI JOSEPH 2185 01:10:23,480 --> 01:10:24,640 ON THEIR RESEARCH, AND THERE 2186 01:10:24,640 --> 01:10:26,840 WILL ALSO BE A NETWORKING EVENT 2187 01:10:26,840 --> 01:10:28,720 DIRECTLY AFTERWARD THAT'S 2188 01:10:28,720 --> 01:10:30,240 SPONSORED BY FAES, SO IF YOU'D 2189 01:10:30,240 --> 01:10:32,800 LIKE TO MEET MORE WOMEN HERE AND 2190 01:10:32,800 --> 01:10:34,000 OTHER PEOPLE THAT SUPPORT WOMEN 2191 01:10:34,000 --> 01:10:35,840 IN SCIENCE, PLEASE DO COME, SO 2192 01:10:35,840 --> 01:10:38,320 WE HOPE TO SEE YOU IN MAY, AND 2193 01:10:38,320 --> 01:10:39,520 THANKS, EVERYBODY, FOR JOINING 2194 01:10:39,520 --> 01:10:42,040 US ON VIDEOCAST, AND WITH THAT, 2195 01:10:42,040 --> 01:10:43,560 OUR SESSION TODAY IS CONCLUDED. 2196 01:10:43,560 --> 01:10:44,680 SO THANK YOU VERY MUCH. 2197 01:10:44,680 --> 01:10:54,880 [APPLAUSE]