 Thank you. Great. So my name is Megan Town. As Ingrid said, I'm a genetic counselor and one of the project managers for the Baby Seek project. And today I just wanted to talk to you about some of the family experiences that we've had so far. We've been enrolling for about six months. So now we're just starting to see some of the outcomes of what our family is doing with this information. Is it starting to be helpful for them? And so I'm going to present about two specific babies, both of which we've made up fake names for. The names that I'll be using are not their real names. So baby number one is baby Maya. And we enrolled her when she was 10 days old. She was in our neonatal intensive care unit because she was diagnosed with a rare and complex heart condition prenatally called Tetralogy of Phyllo. And after this was diagnosed on prenatal ultrasound, the family was approached about a research study to actually look at different imaging during the prenatal period to see how babies with this type of heart condition develop over time. And so as part of this study, mom had a fetal MRI, and on that MRI they actually saw that baby Maya also had something called a duodenal atresia, which is a problem in the small intestine that actually causes the intestine to not be connected completely. So it's a blockage. And so even though baby Maya's heart needed to be repaired eventually, this duodenal atresia actually ended up being a much more immediate surgery that was needed. So this is baby Maya while she was in the NICU right after she had the surgery to correct the duodenal atresia in her first week of life. So we like to assess parents' motivations for enrolling. What are they hoping to learn? What are they hoping to get out of this? And for Maya's family, they were very grateful that they were able to be diagnosed with this duodenal atresia through their participation in the original research study. So it really allowed them to be more prepared after birth for this not to be a surprise, which is oftentimes when most of duodenal atresias are diagnosed or just by chance after birth when the baby's having problems with feeding. So they were able to schedule this surgery to have less surprises and actually to just cope better overall with it. And because of that positive experience and research, they really felt that research and or participation in other research where they can get more information could only be helpful. So baby Maya was in the genomic sequencing arm, so she did get genetic sequencing. And even though we looked very closely at genes that we know can be associated with tetralogy of phyllo and duodenal atresia, we weren't able to find a genetic cause that fully explained the birth defects that she was born with. She was found to be a carrier for two rare genetic variants, which again we would not assume would affect her health, but gave her parents more information about possibly testing themselves for carrier status to see if a future baby they might have could be at risk for one of these two rare conditions. By happenstance, the day after the disclosure with our study team, baby Maya's family was actually scheduled to see a clinical geneticist for follow up. So right after she was born, she was seen by a geneticist while she was in the NICU and she was just going back to hear more about what other testing options or information might be able to be provided. So we sent the genomic sequencing report to the clinician so that he would have that ahead of time before seeing Maya in clinic and have that additional information. And there was actually a conversation between that geneticist and myself and one of our lab scientists to talk about what was looked at, the specific genes that had been looked at more closely, and the different limitations in testing. And the clinician's response was this is excellent timing. We're seeing the baby in 30 minutes and this is very helpful. So we talked quite a bit about what additional testing might want to be ordered. Exome testing isn't very good at finding small deletions and duplications within the gene, and so he was going to look more closely into ordering that specific test now that he had this information. And it probably cut out a lot of tests that he maybe would have ordered in the meantime and before that. And this is baby Maya now, absolutely adorable, doing very well. And she's got the repair for her heart surgery coming up later this month. The second baby I wanted to talk to you about is baby Emma. And we enrolled her also from the NICU, so she was 18 days old when we enrolled her. And she was admitted to the NICU after some birthing complications where they thought she was having some health problems related to oxygen shortly being cut off during birth. She also had a six finger on one of her hands, which is actually something we see fairly commonly in the population, and that was removed without any incidents. Later on she was found to fail her newborn hearing screen, which again isn't too abnormal to fail the initial hearing screen, but further work up later on actually diagnosed her with bilateral moderate to severe hearing loss. And we do know that hearing loss is one type of condition that can have a lot of genetic causes to it. So in terms of motivations to enroll, both parents had a scientific background. They both worked on various types of research studies. And they just said they were interested in participating in research, and in general were what we call information seeking parents, people who want to know more information up front. Baby Maya was randomized to the control arm though, so she did not receive any genomic sequencing. On the day of the results disclosure, Baby Emma's autolaryngologist, who was following her for the hearing loss, had contacted our study team to see if, because she knew that Baby Emma was in the study, if they had done genomic sequencing, if any hearing loss genes had been found, mutations in hearing loss genes had been found on our report. Unfortunately because Emma was in the control arm, we didn't have any genomic information to share with her, but because we had collected DNA as part of our research study, and because the testing that we're doing is all done under clinical standards, we still had that DNA available for that autolaryngologist to order additional clinical testing on. So we at least saved Baby Emma another blood draw. And there, I believe, planning on ordering the hearing loss panel at their next clinic appointment. Some other reasons why we're finding families are enrolling our study. If one parent was adopted and therefore maybe didn't have a lot of information about their own biological family and maybe what health concerns run in their family, we're finding people are more motivated to try to learn about the genetics of their child. Also we're finding quite a few people who have used an anonymous sperm or egg donor for various reasons are more interested in learning about the genetics of their child. If there's a specific history of a genetic condition in the family, we're finding people are interested in enrolling, as well as parents who are just curious, are interested in genetics and research and want to know more, you know, based of their just interest on genetics itself. So in conclusion, genomic sequencing reports from the BabySeq project can help clinicians think about a patient's diagnosis. So in the case of Baby Maya, I really think that it helped that clinician figure out what testing he didn't need to order and more quickly jumped to the testing that could be more specific for her. Genetic results have been requested for some of the babies in our control arm, and so we're finding that had they been in that genomic sequencing arm, perhaps a diagnosis could be found a little bit faster for them if that information was available. We're also finding that genomic sequencing is identifying carrier status in families. Nearly all of our genomic reports so far have identified at least one carrier status in the babies, and we have not yet identified a risk factor or something that would actually diagnose the child, so so far what we're finding mostly is carrier status only. And then, whoops, that didn't need to be so dramatic, but families have very different motivations for enrolling, so we're finding kind of a wide variety of reasons why families want this information. We have a very large project team at Brigham and Women's, Boston Children's, and Baylor College of Medicine, and I've got everyone listed here, and thank you. So thank you everyone for listening in today for our 2015 update on the Insight projects. We hope that the presentations today have been informative, and if you do have any further questions or comments about the presentations, please feel free to reach out to the media contacts that are listed on the website, where there will also be a recording of these presentations and the slides available for your further perusal. Thank you very much.