 Nurses we wear many hats. There's many roles and you just slide into that role whatever is needed at that time. The hybrid nurse I think just elevates it a little bit more because now we're mixing standard care and research. Historically many institutions the nursing department and the research department are two separate departments in any institution. We want research and nursing to be more connected if you're at City of Hope. The idea of the hybrid nurse is a nurse who can do everything. Research as well as you know standard of care, procedures, transplants. We are part of this whole extraordinary team working with the principal investigators working with the positions, the clinical nurse research nurses, the coordinators. You know we all work together for the patient. It's all a team effort. We read up on you know the disease itself, the studies to make sure that we're prepared and make sure that you know whatever the patient needs like you know we're ready. Nurses we spend quite a bit of time with the patients. We develop relationships with them and we can provide one-on-one teaching and it helps support patients to continue coming for their study, follow-up visits, reinforcing why you know this research is being done when it gets difficult coming to that appointment. As a patient I would expect you know when I'm when I need care I want the best care and that involves an organization that's very good at doing established care that's safe as well as the new innovative research therapies that are coming along. That's the concept of the hybrid nurse. Nursing has evolved over these years you know what we're able to do, what we're able to get trained on. For many nurses there are two worlds that just kind of ran parallel and I think we're seeing it intersect now a little bit more and it's just really exciting to be in that to be involved in the beginning of that. This paper we've written is just all the things we've done accelerating therapies for patients with unmet needs from HIV, sickle cell, hemiphilia, glioblastoma. I don't envision it's limited to these diseases you know the future is every disease that's out there.