 All right. So I was tasked with kind of reviewing the things that we've been doing in these meetings and at NHGRI in genomic medicine for the past year and a half, two years or so, just to kind of give a context for where we are and where we're going. So we'll do that. And just to mention that at our May meeting, one of the topics that came up was, what do we really mean by genomic medicine? And so we've come up with a definition that has been vetted throughout the institute and also with our council and publicly. And so what we defined it as was an emerging medical discipline involves genomic information about an individual as part of their clinical care, such as for diagnostic or therapeutic decision making and the other implications of that clinical use. We recognize that this is a narrow definition and we made it narrow purposefully so that we could work with it within the institute. We recognize that there are departments and divisions and institutes of genomic medicine that are much broader than this, but we're really sort of focusing on the use in individual patients' care. We also wanted to sort of emphasize what we meant by genomic in our institute but recognizing that there are much broader definitions. So direct information about DNA and RNA, but as we get to sort of more downstream products, there are a little bit outside of our institute's immediate purview recognizing that we're a small group. So we'll kind of stay with sequence and the further we get from that, the less involved we're likely to be. We also recognize that the dominant proportion of our portfolio will continue to support the basic research on the structure of the genome and how it functions, but we recognize we need to then stretch into these other areas. And particularly if Eric described our strategic plan to you previously and a little bit touched on it yesterday. We have five main areas. The last two are the science of medicine and increasing the access to genomically informed health care. And those would be the two that would fit most under this umbrella recognizing that the area just before that, which is the biology of disease, is probably, it is, our biggest area of investment within the institute and as well is critical in forming the underpinnings of this area. Then we sort of view the genomic medicine implementation or application in clinical care as a key destination for the basic research that the institute will continue to support in our mission of improving health through genomics research. So that was sort of one output that came out of our directly from our main meeting that we wanted to share with you. We also just kind of wanted to remind you that we do have a working group of our advisory council that focuses on this and that has been the planning group for these meetings. And so that's been one of their main functions. But more importantly, we use the meetings as a tool for helping them and others to provide guidance to us in areas of genomic medicine implementation such as, you know, what are the needs for infrastructure to make this happen, what are related efforts that might be related to future collaborations such as we're doing today. And in general, kind of reviewing progress in implementation and identifying next steps. This is the group and almost all of them are here today. Jim Evans couldn't be with us. Dan Rodin actually we sent to a meeting in Brussels to represent the group at a European Science Foundation meeting that was about implementing genomic medicine and Jeff may touch on that a little bit in what he'll be talking about. We also established a social networking site kind of as an experiment following our main meeting. There seemed to be some interest in doing this, although we didn't have it up and running by May because it came out of that meeting. And so I'm not sure that it's as well known. And we thought it might be a nice place for people have questions to each other among the various institutes or centers that are doing this kind of work, you know, how do you deal with an incidental finding of a BRCA, one variant of unknown significance or, you know, something along those lines to be able to share those and kind of bat them back and forth. And this was an experiment for us. There's not a lot on it now, but we would encourage you to go to it and see and give us advice on how we can make it more useful. This is something, this siteable is actually a service provided by nature and it's free and very easy to use, so we thought we would try it. We also held a workshop in September about implicating sequence variants that several of you were involved in. And the goal was to develop guidelines for assessing or at least guidance for assessing the evidence implicating sequence variants or genes as being causal in a specific disease. This was the issue. Very often you'll see publications saying, oh, this is it, this is the variant or the gene that causes X disease and then, you know, months or years later you'll see subsequent publications disproving that. And so this was kind of the area of confusion that we were trying to address. And there is a manuscript in preparation from that we hope to have out very soon. Everything that we've been doing is collecting recent advances, you know, publications and other announcements that seem to us to be sort of hallmarks of what this field can do for medicine and the public in general. Obviously, we find this very useful for explaining to the public and Congress and to others, you know, why we're doing what we're doing. And we suspect it's probably, it would be a useful thing for others of you when people say, well, you know, what in this has made a difference in patient care. And so some that we have identified include this whole genome sequencing in a fetus, which is done through maternal serum rather than through amniocentesis and now is largely replacing amniocentesis in most cases than followed up by a confirmatory amnio when necessary. This was an episode or several episodes actually at the NIH Clinical Center trying to determine how this Klebsiella that came to us from a patient from New York actually continued to spread even though every possible effort was made to eradicate the organism and to sterilize the staff. And it ended up, I think it was growing in the drain pipe of one of the sinks or something. And using sequencing enabled folks to be able to trace this and how it was transmitted from patient to patient. This was another advance using whole genome sequencing and neonatal intensive care units for newborns with severe disorders. And this very recent one in Newland Journal looking at this, the PIC3CA mutation in relation to aspirin use and colon cancer survival. So these are just examples of things that we're trying to collect. And if you have an example of something that's really pretty close to ready for implementation, this one may be a little bit further, but maybe not. Or that demonstrates an example of implementation, it would be very helpful if you would send those to us. Ian Mopuri is the person that's collecting them or you can send them to me. And we'll try to get them up on our website and that's down here, these numbers, but at least the Genoic Medicine website of NHGRI. Mention was made of the first meeting that we held in June 2011. We finally have a paper out on that, it took longer than I would have liked and my apologies for that, but at any rate. And the purpose there was to kind of collect what the ongoing projects were and the challenges that they had encountered, identify some common infrastructural research needs and then outline an implementation framework for other groups that might want to apply this kind of work. So that's now available through in Genomics Medicine. And this just briefly summarizes what we've done, defining the landscape and identifying commonalities and then developing the roadmap in the first meeting. We didn't call it GM1, just as they didn't call the First World War, World War I because there hadn't been a World War II, but at any rate. So that was the colloquium and then we followed it with GM2 in December where we were looking at potential collaborative projects and developing some working groups around those. And then we also spent some time with institutional leaders actually asking them, what does it take at your institution to make this a reality? And got some very interesting insights from them that I won't review here because we've reviewed them at previous meetings. But that meeting is on our web, we've videotaped or videocast and taped and archived these meetings since the first one. And then the third one in Chicago looked at the pilot project working groups and spent a fair amount of time with payers and other stakeholders looking at what some of the barriers were. And that then led to the payers meeting last time, in October which Derek has described to you. And then of course our meeting here really focusing on professional societies. So that's kind of the landscape here, the way Rex has summarized it is, the first meeting we said there's significant action in genomic medicine, the second we recognize that healthcare providers care about genomic medicine, the third that those who pay for healthcare care about it and the professional organisms and physicians care about it. So we're moving along which we're very excited about. We were a little concerned when we started these meetings that we'd get into Meeting Hell. I'm a big Gary Larson fan and here you see this guy getting coffee. Oh man the coffee's cold, they thought of everything. And hopefully we have at least avoided that small problem if not others but we feel it is worth it to get this group together not only because of what goes on in the main session but also what goes on in the breaks and the side meetings and that. Another important thing we feel that has come out of this are a variety of funding opportunities that we've developed based on the input that we've gotten from this community and the needs for research. And so I'll talk about each of these. There's the pilot demonstration projects, RFA, the clinical relevant variance resource that Erin described yesterday, a newborn sequencing effort that we're doing with NICHD. And just to focus on the pilot demonstration projects we have two RFAs out for this for a coordinating center and for clinical sites. The purpose is to demonstrate the feasibility of and develop methods for incorporating patients' genomic findings into their clinical care, particularly expanding efforts and developing new projects and methods in diverse clinical settings as well as diverse populations. So not just at tertiary care centers but in a variety of places. Contributing to the evidence base to the degree that's possible and defining and disseminating the processes of this implementation in diverse settings. Applications were received in July, the review has already occurred. My colleagues Ebony and Heather are here and unfortunately they can't answer much in the way of questions on this. Another Gary Larson, yes I believe there's a question here in the back. So they can tell you sort of what's publicly obvious but beyond that they really can't comment much and that's our apologies but stay tuned. We hope to be able to announce those awards fairly soon. The clinically relevant variance resource that Erin described. I won't belabor this but these were the purposes of it developing a resource that could provide information for professional societies like yours to base their guideline development process on. And also try to build on some of the existing programs in this area. And those applications were received in October, the review is coming up. Erin you've heard from and again she can't say much more than yes it's a cow so stay tuned to that. The clinical sequencing exploratory research was two RFAs that were actually a repeat issuance of an RFA that was issued back in 2010 I believe that began the clinical sequencing exploratory research or CSER consortium. There was a fair amount of demand and need at that point to expand that consortium and so we're making an effort to do that through this. The purpose is to investigate challenges to applying actual sequence data in the care of patients and the goals would be to generate genomic sequence data that can be used in a clinical care and that would be relevant to an individual patient then translate these data for the physician and communicate them to the patient and examine the ethical and psychosocial implications of doing that. So a fairly ambitious agenda for that program applications received in the summer the review was partially carried out in October was interrupted by Hurricane Sandy and so was continued in January. Lucia and Brad are both here and again you'll need to stay tuned on that. And then the genomic sequencing and newborn screening disorders RFA is something that we're doing in collaboration with the Child Health and Human Development Institute. The goals were to explore possible uses of genome sequence information in the newborn period and these are the goals here. Acquiring these data sets in the newborn period try to understand specific disorders that might be identifiable using sequence data through newborn screening and examine the LC implications of doing that. And applications have just been received the review is coming up and a station was unable to be here and she will be having more information on that in the future. So we also as I believe is an outcome of the second meeting or maybe even the first developed a fairly concerted effort in pharmacogenomics that I'm not going to describe now because Josh Denney actually is going to describe it in a moment but just to point out that we are working with the Pharmacogenomics Research Network in Emerge and I won't go through this but do have a nice graphic here that describes using this as sort of the basic foundational research where they're sort of taking a state of the art array and then passing it down to Emerge which is kind of the implementation arm which has less pharmacogenomic focused labs, a large patient base and electronic phenotyping and can address some of the privacy concerns and find out how effective and practical this is in clinical care. So I think I'll stop at this point and be happy to answer any questions. Thanks. My goodness. Obviously it was perfectly clear. Stunned into silence. It was a cow. It was a cow. Say what? It was a cow. That's right. Yeah exactly. Okay. All right. Great. Thank you very much and if you have questions feel free to attack Terry at the break. All right. I think we have now report outs from a couple of the different work groups. So first will be periodontal microbiome.