 I want to thank the organizers for the invitation. Those in the room who know me know that I'm very passionate about this issue of genomic medicine or precision medicine, and particularly the promise of precision medicine in diverse and underserved populations. And so I see this Ignite program as an opportunity for some serious sort of engagement and work that could facilitate and bring to bear the promise of precision medicine. So we are all familiar with this curve as it relates to the disease process, and with these genomic tools we are trying to intervene earlier in this process. Of course, there's obviously been some barriers, be it reimbursement or actual scientific knowledge, research and access issues, but as you guys are well aware, the implementation has started. And so we're in this era now of precision medicine, and I think probably one of the more successful has been in cardiovascular sort of and cancer realm with these genetic tests being quite informative and actionable, right? But as many of us know, precision medicine may actually increase health disparities, and there are many reasons for that. Actually one of the most important ones is that still today, the bulk of the information that's used is based on populations of European ancestry. And so when we talk about implementation, we sort of wonder at times what the, if those benefits are equitable across all populations. And I like to show this cartoon, this is sort of a take-home point. Now I just wanted to just focus on a couple of points. I really wanted us to have a really good discussion, so I'm not going to be long or belabor this point, because most of you know where I'm coming from. When we think about the gaps, and this is something that really has started to concern me and others, in particular, we talk about precision oncology. We talk about these, be it from BRCA, or BRCA testing, or even sequencing of tumors. And we come up with these variants of unknown significance in populations like Hispanic or African American populations. What do we do with that information? And so there are many now trying to see if we can start sharing these databases across institutions. Now that I'm at the University of Arizona, I see sort of the impact of these variants of unknown significance in these genetic tests that we're doing in the Kansas Center. The bulk of our patient population being of Mexican heritage. And so the bulk of their gene pool coming from Native American populations. And we know, if we look through the literature, very, very little bits of information on these variants. Then of course, just this past couple of weeks, there was a lot of discussion on the misclassification of pathogenic variants and inadequate patient samples and the lack of diversity in these trials, which then go to implementation. And then of course, one way I think that we can actually start appreciating and leveraging these diverse populations in this work is by leveraging genetic ancestry because it will allow us to focus in on potential actionable markers. I'll give you some examples shortly. But there have been many throughout the literature, many examples of insights from studies conducted in diverse racial ethnic groups. And I think even within Ignite, there are some examples of these studies. When we think about sort of the impact of genomic medicine on disease and health, especially when we're trying to focus in on disparities, we have this social component and this genetic component that might actually interact. And so one way in which we determine the role of genetics in that is by trying to understand genetic ancestry as a proxy for a genetic background as opposed to self-reported race. I like to give this example. This is a study that we did where there was a clinical trial looking at naltrexone. And you know naltrexone has been used for alcohol dependency and smoking sensation. But there are some big differences in terms of response between those who self-reported as white and those that self-reported as African-American. What we did in this study was we went in and looked at the African-American samples and saw that the response or the quit rates for the mixed group of African-Americans really wasn't different between the individuals naltrexone versus placebo. But when we stratified the African-American population based on West African genetic ancestry, we saw the effect among those African-Americans that had lower West African genetic ancestry. Similar to what we saw in those that self-reported as European, those that had higher West African ancestors, we didn't see an effect there. And so that made us really want to go in then and focus in on what was this information a proxy for. And in fact, it was some variance in the mu opioid receptor that varied significantly between these West African and European populations that actually are potentially functional, impactful in terms of response and naltrexone response. So this is a situation where looking at ancestry allowed us to dig deeper. We didn't stop there. Of course, we shouldn't stop at self-reported race. We shouldn't stop at genetic ancestry. This is, we're trying to take this at the individual level, but this is one way to get there and leverage diverse populations. Since my work is focused mainly in cancer-cancer genetics, I find it interesting when we look at this sort of the impact of rare variants in cancer. This was a study where they actually did resequencing in many of the GWAS hits found across multiple GWAS studies. And of course, not surprising, the number of rare variants found in African descent populations significantly higher than the other worldwide populations. But what's even more surprising is that the heritability attributable to those rare variants being much more higher in the African descent population. So this is something that actually could be something that needs to be understood and leveraged and hopefully programs like Ignite could explore that. As I mentioned earlier, this issue of genetic misdiagnosis and its potential impact in health disparities. When we look through the literature and look through the databases, we find that, yes, there are studies where there are a couple of African-Americans or Hispanic patients in these studies, but the numbers of patients and controls are very limited. And that has led to, in many cases, misclassification of some of these potential actionable variants. And so there is a need, obviously, to really go back and say, well, are we doing these populations a mis-service, a disservice? And actually, you know, is it ethically right for insurance companies to pay for some of these tests when, in fact, the information given back to some of these populations is very limited? I mean, that's something that I wonder at times. So anyway, I'm going to end here. As I said, attention must be paid to increasing diversity in genomic medicine implementation. And of course, folks here in Ignite could help identify these barriers and develop more aggressive strategies. If anybody is sort of in the foxhole, let's say, that could be impactful as it relates to genomic medicine and having an impact in disparities, it is folks like this who are in programs like Ignite who have started this genomic medicine implementation. And I always end with this issue of equitable benefits, depending on overcoming barriers of education, accessibility, regulation, and reimbursement, obviously. The biggest thing, I was happy to hear about this workshop where the payers were engaged because, you know, there has to be this back and forth dialogue as things move forward in order to really get broad implementation. But most importantly, obviously, diversity in the genetic studies. Thank you. Thank you, Rick. Next, we have Carol Horowitz from Mount Sinai.