 Okay, we're going to resume open session. There are four working groups of counsel, and one of the requirements is that the working groups have to give a report to the full counsel at least one time per year. So Terry Minoglio is going to give the report from the Genomic Medicine Working Group. Great. Thank you. So on behalf of the Genomic Medicine Working Group, I'm happy to give you an annual update. This is the group, and you can see them here. I believe it. I trust I can be heard. And I would just note that our current counsel member and member of the Genomic Medicine Working Group is Pat DeVerca, and I'll ask her to comment when I finish. We do have a new member since we presented to you last in that scale, Jarvik, from the University of Washington. Reminding you of the charge, they assist you actually in advising NHGRI on research needed to evaluate and implement genomic medicine, particularly looking at current progress and identifying research gaps, identifying and publicizing key advances, planning the series of genomic medicine meetings were up to number 13. We were thinking we might skip that one, but we'll go ahead and do it on timely themes facilitating collaborations and then exploring models for long-term infrastructure for implementation. Once a month, we meet by conference call, and one of the significant portions of our meetings is to review a series of papers that are pulled out by our program analyst Cecilia Tamburo, and what we do is try and determine are these things that should be then posted on the Genomic Medicine Working Group website. So, and you can see here what we pull out just as a couple of examples, disease-based findings in November, we had rare genetic variants associated with sudden cardiac death, and there's a link to the PubMed entry for that. And then the earlier we had genomic risk prediction of coronary artery disease, again, links provided to those. We do this for disease-based finds. We kind of divide these things up, pharmacogenomics, clinical implementation, sequencing, oncology, professional guidelines and policy. And we met last week, and we're talking about maybe a little bit of reorientation of some of these categories, but that's the way they're currently posted, and we welcome people who are looking for timely papers in the field to go there and pull them out. I think Eric also mentioned Pat Deverka's idea about a year ago. She said, want to be cool if we actually pulled out some of these and kind of picked our top 10 for the year. So, we did that in the American Journal of Human Genetics is very generous in being willing to publish this, and there she is again. We used criteria of involving the use of patients' individual genetic variant information in clinical decision-making, a demonstrating impact of direct clinical implementation that are likely to be generalizable and have implications for health care systems or practice guidelines, and then also a sufficient size to be robust and broadly representative of the field. We wanted to be sure we weren't focusing just on the U.S. or just on NHGRI programs. And we did a little characterization or categorization of the papers that had been published just in the past year just to show you where they seem to be falling, and you can see that most of them are in clinical implementation. These in blue here indicate the 10 that were pulled out for the kind of top 10, and then you can see the others. So, if you think you have a paper, either your work or someone else's that you think should be considered for notable accomplishments, it's always very helpful for us to have this called out. So, please send us a nomination, gmwgatnih.gov. We also published a series on genomic medicine in the Lancet. This came out in August, and you can see a series of them here. We are, of course, dwarfed by the 10 or so that came out from Columbia and many more that are coming. So hats off to you, but we did our own little effort in this. And we've told you before about the genomic medicine meetings that the group organizes. We started off with about one meeting every six months and have since scaled that back a little bit as progress has continued and staff have gotten exhausted to move to about once per year. Our most recent one was the GM12, Ongenomics and Risk Prediction. And just to comment a bit on some of the outgrowths of these meetings, so the very first was held very shortly after our strategic plan was published, saying that we actually were going to go from base pairs to bedside. And from that, we had a meeting, the ClinAction meeting, which was actually sort of the germinal center of the ClinGen consortium. So it came out from that. The Genome Connect registry is a way for patients to actually provide their own DNA sequencing results with full consent, et cetera, for public use. And recently that was recognized by the FDA as part of its precision FDA database. So we consider that a very positive effort as well as the pharmacogenetic component of a merge was added back in 2011 directly coming out of this meeting. Our second meeting was focused on collaborations, and it led to the IGNITE program that you heard about multiple times. We had a third meeting focused on payers. Initially, we ran into a bit of a brick wall there. We think we're seeing a little bit more daylight with them, and we'll talk a little bit about that not only with UnitedHealthcare, which has really stepped up to show an end in this area, but also with employers. Our fourth meeting was on education, and we formed a coordinating committee of professional societies interested in education of practitioners at all levels. Our fifth meeting was on federal strategies, and we developed some partnerships with Centers for Medicaid and Medicare Services. Sixth meeting on global implementation, and identified a number of really very exciting implementation projects going on around the world in smaller and nimbler health care systems. And from that, built the Global Genomic Medicine Collaborative, which is now an international effort to bring those implementation efforts together, working with the GA4GH. From that, we had a follow-on meeting on Stevens-Johnson syndrome, toxic epidermal necrolysis, SJS-10, which was a highlight of the sixth meeting, because we learned that there were very effective programs in Southeast Asia to reduce the incidence of this based on genetic testing, and we wanted to see how we could explore that in other parts of the world. And from that, we then developed a program announcement on serious adverse drug reactions. We also developed a summit of large-scale cohorts, including the All of Us Research Program, the UK Biobank, Million Veterans Program, and a number of other large cohort studies around the world. And that has now become a collaboration of 100,000-plus cohorts. So our seventh meeting was on genomic clinical decision support, and we partnered with the National Academy of Sciences in their Digitized Consortium. Our eighth meeting looked at an overview of all of our programs. But one thing that came out was the very active effort from Health Education England as part of Genomics England in developing educational materials. And so we've developed a partnership with them on that. The ninth meeting was to bring back together basic scientists and clinicians and try to take things from the bedside back to the bench. And that led to our successful variant function and disease program here. Our tenth meeting was in pharmacogenomics. We invited somebody from Optum to participate, who was very active and got others at Optum and United Health Care, their parent group, involved. And we now have a very active ongoing dialogue, and hopefully plans for some collaboration built around the Undiadose Disease Network, as well as sequencing and critically ill newborns working with United Health Care. And one thing that they did, they developed a collaboration with the genetic testing registry to actually use GTR test codes as a more precise way of identifying and billing for genetic tests, as opposed to the 200-some CPT codes that are currently available. They've piloted this, and they'll be publishing their results soon. Our eleventh meeting was focused on implementation, but led directly to, as part of that meeting, the suggestion for a panel that Pat led on how employers are looking at genetic testing. We then followed that up with an interaction and a meeting with a group of employers who are more in the health care setting than not, but there are some that also are the Kentucky teachers retirement system and others that are beginning to use genetics in their wellness programs. And we're pursuing that in a follow-on program that Pat is leading. And our twelfth program I mentioned was focused on risk. And we've also been lucky enough to be able to publish some of the output of those meetings, as you can see here. From our first meeting, our second, this was the fourth, I believe, the sixth and the ninth and 10th. So it's really been quite an, I think, an effective working group. And we're just delighted that the people that are on it are willing to put as much work into it in time as they do. I would mention, as I have before, that these meetings are all webcast and live-streamed. And they are available on our website first one, because we didn't know that at the time that the first one was going to sort of become a thing. But since then, our very good communications group is now involved in webcasting all of these. You can see a list of them here. If you click on them on any one meeting, you'll find the executive summary, meeting summary prepared by our program analysts. And then the video and slides are all available. So all of those materials are available for you. Our twelfth meeting had the objectives of reviewing the state of science with polygenic risk scores and how to improve it, looking for other information sources that should be integrated with genomic risk information in genomic variant information and predicting risk. And then, as always, identifying research directions in the development, in this case, and implementation of genomic risk prediction. There were a number of recommendations from that meeting, and those are listed in the executive summary and the main meeting summary, including research that should be done, how to accelerate adoption of evidence-based risk prediction, looking at how to communicate risk not only to patients but to clinicians, prioritizing validating existing PRS in diverse populations because so little work has been done in those populations, recognizing the differences among them, finding ways to incorporate them into existing risk estimation tools so that they might be more rapidly and readily adopted by professional societies, guidelines, and measuring process outcomes in intermediate phenotypes, recognizing that sometimes it's gonna take a little bit too long for the clinical outcomes to occur, but we can still learn some useful things from that. We believe that most of these recommendations will, at least in part, be addressed by the Emerge program that you'll hear more about tomorrow, which is designed to use electronic medical records to develop, evaluate, and disseminate genomic risk assessments, so sort of right up that alley. Further recommendations included investigating methods, and we heard this when we discussed genomic risk assessment in the council back a year or so ago, investigating, or actually in September, for integrating other omic data, prioritizing investigation of diseases with existing data, investigating how PRS can further stratify risk of developing disease in patients with monogenic diseases, something that hasn't been done quite so much, although it's beginning to be, and then developing risk scores for specific disease subtypes as opposed to kind of a one-size-fits-all. And we believe that the notice on development of statistical population genetics and computational methods related to polygenic prediction of health and disease in diverse populations, or the notice that went out earlier this year, encourages investigation into these aspects, and really will be addressing many of these recommendations. We also held a panel on how one goes about doing studies, either observational or clinical trials of polygenic risk prediction, and we were strongly urged, probably because we're the Omic Institute, we were strongly urged to capture a breadth of diseases, not to focus on a single one or a single type, and so look at a wide range of disease incidents of risk variants, risk magnitudes across different ancestries, different ages of onset, potentially optimal ages for intervention, strengths of the environmental component will vary across genetic conditions, the genetic architecture, there are just a few genes or very many, the burden and invasiveness of the intervention, implementation models that might be used, and availability of hard endpoints, so those are all things that we would like to consider as we do work in this area, and particularly, if one takes a whole genome approach to this, we would hope to be able to cover a broad range of conditions. We will go forward with a 13th meeting, and that will be in June, genomics and public health, we thought it might be timely to, at least to ask the question, what research needs to be done in order to move this into public health, and maybe it shouldn't be moved, but there are some, there's already some movement in that direction, so at least let's sort of find out from a bunch of smart people things like, what's the landscape of genomic medicines being applied to population and public health in the US? There is some that's going on, largely supported by either the CDC or the Health Resource Services Administration, HRSA, and public health models that might be informative, and then looking at the barriers, particularly in reaching out to underserved communities and how to get them on an equal footing and defining a research agenda to build on these efforts. So that will be this June, and again, it will be webcast and livestreamed. And then lastly, I'd just like to review for you briefly our portfolio. You've heard about many of these programs. I would note the end site program actually ended, the funding for it ended in 2018. They were a very enthusiastic group of investigators, and so they continued and actually finished up last September or so. And from that, we learned very useful lessons in terms of the use of sequencing in the newborn period and the neonatal intensive care unit and in other settings. The CSER program you heard earlier will be ending in fiscal 2020, so that's its current phase is, so winding up, we may extend it by a year just to be sure that they're able to have an orderly closeout. And the reason for that is that sequencing really has gotten into the clinical realm, and so there isn't as much of a need for a consortium, a top-down driven approach to sort of get it there, but there's still a host of questions to be asked and answered, and we feel that will be more suitably addressed in individual R01 type research. And then the UDN, which is a common fund supported program, although we manage it, it will be sunsetting in fiscal 22, so it has another two years to run. And I should mention, as well, the N-Site program was split 50-50 with our NICHD colleagues, and we're continuing that collaboration with the DGTEX program that you heard about. The Emerge, Ignite, and ClinGen programs you've heard mentioned multiple times, and we'll hear a little bit more about Emerge tomorrow, but I would note as well that with the concept that you heard on investigator initiated awards, we really are trying to reach out to get people to come into this field, particularly new folks, folks who haven't been involved in it previously in any of our large consortia, but everyone will be welcome to apply to that. And then our training efforts, we do want to expand those and bring, again, more investigators into this field. So I think that I'll stop and ask Pat if you'd like to make any other comments about the working group. Could you use your microphone? I just wanted to first point out that it's a very productive working group, and that's really due to Terry's great leadership and our fantastic staff. So she mentioned Cecilia Tamburo and Rob Raleigh, and we really couldn't do it without them, it's really your leadership, Terry. And then I think the only other thing is just to emphasize that implementation we're really focused requires partnerships. And so it's not just about the academic partnerships or even the international partnerships, but partnerships with groups that are based in industry. So she mentioned Optum, I'm doing a project with employers, and just really hearing how they view genomics from their perspective, is very, very different than the kinds of conversations that we're having here. And so I think it's, I kind of see us as like being bilingual. We can speak genomics, but we can speak plain language. And I think that's really important for people to understand sort of what is the opportunity for genomics, for example, to have an impact in employee wellness programs. Is this the right time? So, and also being very externally facing tracking developments like the FDA's position on pharmacogenomics, very important in terms of thinking how we're gonna implement. And then finally, just the importance of raising awareness of what we're doing. And I think the year in review, but the website, we really do encourage all of you to send articles in, we're taking that process very seriously. And I think the more we can do to have Eric have it on his social media account or any other links is really critically important because we really are, I think, in an inflection point where we can tangibly demonstrate the impact that genomics is having on clinical care. So it's an exciting time. Great, thank you, Pat. Other comments or questions? Okay, thank you very much, Terry.