 Good morning. I'm here to orient you a little bit to the CSER program, and in particular I was asked to talk about the top five consortium-wide products, but before I do that I'm going to give you a couple announcements. One is that when we break at 11.25 for the first set of breakout rooms, neither of those is in this room, and you have to take your stuff out of this room because they're resetting this room. So a lot of times we leave our stuff behind but not this time. And then at the second session group of breakouts, LC and genomics will be switching rooms because of the size of the rooms. So just be aware there'll be people to direct you, but LC and genomics are switching rooms. All right. So CSER, as most of you know, is just winding down its first project years, and it has had this mission of getting the genome to the clinic fundamentally. And it is different than a lot of NIH programs in that it has a very high clinical involvement over 200 clinicians of all types involved. And we have had a really interesting time, and hopefully CSER and Emerge can share lessons. As I talk about the top five projects, I'm not going to talk about these two because I hope everyone knows about them. These are the two joint CSER, Emerge, two papers that were published a couple years ago. It will start with this paper, which was an Actionability and Return of Results Work Group paper. And all the products I'm talking about today were network-wide products. This paper is one in which we took 6,500 and three people from the exome variant server and decided to not only estimate the rate of actionable incidental findings in those persons, but also get classifications to be submitted to ClinVar for those. And the idea was that these would be variants we'd probably come up with again. And if we were concerned that they were pathogenic or misclassified, this would be a way to get ahead of those variants. And so this is one of the tables from the paper. It summarizes that we found several percent variants in European, and it depends on how you want to count the likely pathogenics, since some people don't return those, and a lesser number in African ancestry people. And this has been a highly cited paper, and I was actually participating in a bioethics symposium about six months ago, and a speaker who was from Continental Africa showed a version of this slide from this work to talk about the challenges in African ancestry populations and health care disparities in that population, and he noticed me smiling in the front row, and he said, oh, Gail's smiling, but he didn't realize it was my slide. But I was really pleased it had made all the way to Africa, so that was good. The next paper that was also an actionability return of results workgroup paper, we called the variant bake-off, and we worked on it for a long time. And what we did here is take 99 variants and classify them, each one in at least three different of the nine CSER clinical laboratories, CLIA-certified laboratories, and look for concordance across those variants. And what we found, and we found this whether we were using our own lab classification status or what were relatively the new ACMG classification categories at the time, was only about 34% concordance. And so we moved forward and spent a lot of time trying to figure out where we were discordant and why. And this led to discussion and rule clarification of the ACMG rules in ways that sites were interpreting the same rule differently. We could come up with a consensus interpretation for that ruling. And to be honest, sometimes that consensus interpretation was pretty clearly in the original ACMG paper, but not read the same way by everyone. And we were helped by having people who were involved in that paper on our committee. And we were able to get the consensus up to 71%, but still not achieve perfect consensus, although most of the disagreement was by one category. This led to several spin-off papers. The pathogenicity calculator. So one of the things we found is that some of our discordance were because one site or another had misadded all those classification criteria that you use under ACMG to come up with a final classification and put it in the wrong class even though they had characterized the classifications the same way. And so one of the groups developed a calculator where you just put those classification codes in and it will tell you the correct pathogenicity classification, and that's been very useful to avoid simple errors. Another was the general lack of consensus around what qualified as co-segregation evidence. And so that was a follow-up paper on proposed co-segregation criteria to standardize that. And then the last, which I'll talk about in a little bit more detail, was a survey of the current practices for genomic sequencing across, I think it was 21 labs, yes, 21 labs looking for best practices. And they came up with some recommendations that are listed here, things that should be in the reports, lists of genes, minimum thresholds for coverage, and making sure people understand when a target has below the expected coverage. And in particular, if there's no pathogenic variation in regions with below expected or desirable coverage, the idea that having a diverse group of people in case review, especially having clinicians in case review, was useful. The orthogonal validation of some variants as necessary and analysis guidelines and then questions about reanalysis are all addressed in this paper. And I think it's a very useful paper for clinical labs. The third topic I wanted to cover today, also a consortium-wide product, was to look at informed consent for genomic sequencing. And what was done by this group was evaluation of all the nine U01 CSER consent forms, interviews with the genetic counselors and coordinators who were obtaining consent. And then they tried to summarize what were the questions that came up in these conversations, what misconceptions did the participants have, and what content did the people who were doing the consenting feel was most important to cover. And I'm not going to go through this table here, but some of these things are things to think about a little bit more. Of course, patients often ask us about privacy, the impact on insurance. But it's really important to also cover some things that they may not ask about, such as their misconception that a negative result means that they're completely genetically normal or that no future changes will be seen. Or sometimes people believe that their genome will change over time. While it's true that our interpretation can change over time, it's not usually the case that the genome does. So this is a very helpful paper in preparing to consent people who are having genomic results, both in the research and in the clinical setting. The next thing I wanted to highlight was a product of the pediatrics work group. And that was a discussion of sequencing results for the pediatric population. And of course, they followed very standard ethical guidelines of what's in the best interest of the child. How do we work with parents as surrogates for their children? And when do you need to obtain pediatric assent? And I can't go into the many details of this paper, but for those working in pediatric populations I highly encourage you to look at it more closely. The fifth thing that I wanted to highlight today is a product from the practitioner education work group, not the physician education work group, but the practitioner education work group because it's a much more general targeted audience. And the idea was to provide healthcare providers just in time information on how to understand genetic lab report tests. And this was a very collaborative, cross-site product, and we were trying to target short, you know, things that can capture practitioners, you know, busy practitioners' attention with visuals and get to the message as quickly as possible, not have it be related to any particular lab but useful for anyone reading a genetic test. And now this has just as of yesterday gone live in a collaboration with the American Society of Human Genetics on their website, and this is just a screenshot below, but there's the link above. But if you go to ashg.org and follow the education and practitioner tabs, you will find this toolkit and you can work your way through it. And so the next step with this will be to, you know, beta test it a little because it just went live yesterday but then to do some marketing to make people aware that this tool exists. So this may be a very good tool as emerge sites are starting to release results to their practitioners who are not specialists to be aware of. And we'll hear more about it today at the physician education breakout this afternoon for those of you attending that. Of course, in this short amount of time I couldn't summarize all of the important work. Robert Green headlined a summary paper which we call a marker paper of consortium products a little while ago and I recommend that paper and then this is us all dressed up and looking fine. So with that I'll turn it over to Rex who's going to tell you about emerge.