NINDS Advisory Council Meeting Minutes, February 14-15, 2019

NINDS Advisory Council Meeting Minutes, February 14-15, 2019

Department of Health and Human Services
Public Health Service
National Institutes of Health
National Advisory Neurological Disorders and Stroke Council

Summary of Meeting1
February 14-15, 2019

The National Advisory Neurological Disorders and Stroke (NANDS) Council was convened for its 204th meeting on February 14-15, 2019, in the John Edward Porter Neuroscience Research Center Building, Building 35, Conference Room 620/630/640, in Bethesda, Maryland. Dr. Walter Koroshetz, Director of the National Institute of Neurological Disorders and Stroke (NINDS), served as Chairperson.

In accordance with Public Law 92-463, the meeting was:

Open:    February 14, 2019: 12:30 p.m. to 6:00 p.m. for the review and discussion of program development, needs, and policy; and

Closed:  February 15, 2019: 8:30 a.m. to 1:00 p.m. for the consideration of individual grant applications.

Council members present:
Dr. Laurence Abbott
Dr. Issam Awad
Dr. S. Thomas Carmichael
Dr. Hollis Cline
Ms. Susan Dickinson
Dr. Nita Farahany
Dr. Gordon Fishell
Dr. Margorie Frazier
Dr. Aaron Gitler
Dr. David Gutmann
Dr. David Hackney
Ms. Janet Hieshetter
Dr. Karen Johnston
Dr. Arnold Kriegstein
Dr. Bruce Ovbiagele
Dr. Steve Perrin
Dr. Indira Raman (via telephone)
Dr. Steve Roberds

Ex officio member present:
Colonel Sidney Hinds, M.D., II, Department of Defense (via telephone)
Christopher Bever, Jr., M.D., Department of Veteran Affairs

Council Roster (Attachment 1)

Members of the public present for portions of the open meeting included:

Philip Goglas II, Dystonia Medical Research Foundation
Tzvi Oshinsky, Citizen

Federal attendees are listed at the end of these minutes.

I.  Call to Order and Opening Remarks

Dr. Koroshetz welcomed Council members, visitors, and staff to the 204th meeting of the National Advisory Neurological Disorders and Stroke Council.

II.  Report of the Director, Division of Extramural Activities, NINDS

Approval of Council Minutes—Dr. Finkelstein requested, and the Council voted approval of the September 12-13, 2018, Council meeting minutes.

The following future Council meeting dates were confirmed:

                                                Thursday & Friday, May 23-24, 2019
                                                Wednesday & Thursday, September 4-5, 2019
                                                Wednesday & Thursday, February 5-6, 2020
                                                Wednesday & Thursday, May 27-28, 2020
                                                Wednesday & Thursday, September 9-10, 2020

Approval of Council Operating Procedures – Dr. Finkelstein requested, and the Council voted approval of the 2019 Council operating procedures.

Expedited Review Process – Each Council round, a subset of Council members approves applications in advance of the meeting with scores within the payline. This expedited review process focuses on applications for which there are no unresolved issues. Dr. Finkelstein thanked Council members Issam Awad, Holly Cline, and Steve Roberds for handling this responsibility for this meeting and the fiscal year. For the current Council round, 208 applications were eligible to be expedited. Thirty-five (35) of these awards already have been issued, and the others will be issued shortly after Council.

Extramural Announcements

Dr. Finkelstein introduced Hawa Sesay from the Division of Extramural Activities Office of the Director, Marguerite Matthews, Ph.D., from the Office of Programs to Enhance Neuroscience Workforce Diversity, and Joonil Seog, Ph.D., from the Scientific Review Branch.

Dr. Lyn Jakeman introduced Ben Churn, Ph.D., Karen David, Ph.D., and Miriam Leenders, Ph.D., from the Division of Neuroscience. Dr. Jakeman also announced Dr. Margaret Sutherland’s departure.

Dr. Clinton Wright introduced Carlos Faraco, Ph.D., and Barbara Karp, Ph.D., from the Division of Clinical Research.

Dr. Amir Tamiz introduced Andrew Moore and Nick Langhals, Ph.D., from the Division of Translational Research.

Dr. Koroshetz introduced Jackie Ward, Ph.D., from the Office of the Director and announced the departure of Meghan Mott, Ph.D.

Dr. Nina Schor introduced Liza Litvina, Ph.D., from the Office of the Director.

Dr. Linda Porter introduced Laura Wandner, Ph.D., from the Office of Pain Policy.

Dr. Paul Scott announced the departures of Heather Rieff, Ph.D., and Katie Pahigiannis, Ph.D., from the Office of Science Policy and Planning.

III.  Report of the Director, NINDS

Dr. Walter Koroshetz, Director, NINDS

NIH and NINDS Budget—Dr. Koroshetz provided an overview of the appropriation history for the National Institutes of Health (NIH) and National Institute of Neurological Disorders and Stroke (NINDS). The Fiscal Year (FY) 2019 budget represents increases of 5.4 percent to the NIH budget and 3.9 percent to the NINDS budget. NINDS received a $250 million increase for pain research as part of the Helping to End Addiction Long-term (HEAL) Initiative and $57.5 million in 21st Century Cures Act funding for the Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative. In FY 2019, NINDS expects to co-manage approximately $100 million of the Alzheimer’s Disease (AD)/AD Related Dementia (ADRD) funds received by the National Institute on Aging (NIA).

The majority of NINDS funding supports basic, translational and clinical research, as well as training and career development.

NIH Leadership Changes—Dr. Koroshetz memorialized Dr. Stephen I. Katz, Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) who died from a stroke in December 2018; he had served at NIH since 1974. Dr. Robert H. Carter has been named Acting Director of NIAMS.

New NIH leadership includes Dr. Helene M. Langevin, Director of the National Center for Complementary and Integrative Health (NCCIH); Dr. Bruce J. Tromberg, Director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB); and Dr. Noni Byrnes, Director of the Center for Scientific Review (CSR). Searches are ongoing for Directors of the National Institute on Deafness and Other Communication Disorders (NIDCD) and the National Institute on Nursing Research (NINR).

Dr. Lorna Role has joined NINDS as Scientific Director and Dr. Lyn Jakeman as Director of the Division of Neuroscience.

Trans-NIH Programs—Dr. Koroshetz highlighted HEAL Initiative efforts to address opioid misuse and addiction and to advance the field of pain management. To achieve this, programs such as the Early Phase Pain Investigation Clinical (EPPIC) Network, Back Pain Research Consortium, Hemodialysis Pain Management, Pain Effectiveness Research Network, and Pragmatic and Implementation Studies for Management of Pain have been launched under the HEAL initiative. HEAL is governed by an executive committee co-chaired by Dr. Koroshetz and Dr. Nora Volkow, Director, National Institute on Drug Abuse (NIDA), with oversight from NIH Director, Dr. Francis Collins.

Special Council Review—Dr. Koroshetz summarized the new NINDS Special Council Review policy implemented as of the 201901 Council review cycle. The policy requires review of applications submitted to NINDS by researchers whose current and pending NIH research support exceeds $1 million in direct costs. If the investigator exceeds the $1M threshold, then the payline for the pending application will be one-half of the NINDS payline. Awards for training, conferences, core facilities, research resources, and Small Business Innovation Research/Small Business Technology Transfer (SBIR/STTR) are excluded from the investigator’s funding level and are not part of SCR. Additionally, consideration is given to exceptions for inherently expensive research such as clinical trials (CTs), non-human primate projects and therapy development projects, and exempting applications involving congressionally directed funds (e.g., BRAIN, HEAL, ADRD, and CounterACT).

INCLUDE—The INvestigation of Co-occurring conditions across the Lifespan to Understand Down syndromE project was launched in June 2018 in response to a $22.2 million Congressional Directive to focus on critical health and quality-of-life needs for individuals with Down Syndrome. INCLUDE funding targets high-risk, high-reward basic science studies, a cohort study, and a clinical trial network. Dr. Nina Shor is leading the INCLUDE effort at NINDS.

NINDS P30 Program—NINDS-funded P30 Centers offer services and expertise that would be difficult or impractical to support in individual labs, capitalizing on economies of scale by sharing resources and fostering collaborative environments among neuroscientists at host institutions. In 2016, the NANDS decided to pause the P30 program to analyze the impact of NINDS’ funding and determine the most appropriate use of the funds to support resources for neuroscience.  Following further deliberations, NINDS will sunset its P30 program and consider alternative ways to support resource infrastructure to have the greatest impact.

Strategic Planning—Dr. Koroshetz noted that NINDS is presenting an overview of the Institute’s major Divisions and high-priority topics areas to Council so members can understand how these efforts integrate across the Institute’s portfolio. The goal of these presentations is to help guide the Institute’s strategic planning efforts.

NINDS Workshops—Recent NINDS workshops have included: “A Visionary Resource for Instilling Fundamental Principles of Rigorous Neuroscience Research,” “Bridging the Translational Gap in Stroke Recovery & Rehabilitation Research,” “Discovery and Validation of Biomarkers to Develop Non-Addictive Therapeutics for Pain,” “A Critical Evaluation of Animal Pain Models,” and “SCI 2020: Launching a Decade for Disruption in Spinal Cord Injury Research.”

NINDS Advances—Dr. Koroshetz summarized a recent scientific advance published by NINDS supported investigators. The Systolic Blood Pressure Intervention Trial-Memory and Cognition in Decreased Hypertension (SPRINT MIND) trial indicated that improved vascular health can decrease risk of dementia; although the trial closed early, sufficient data had been collected to show a significant effect on reduction of cognitive impairment in the intensive blood pressure lowering group.

IV.  Discussion of the Director's Report

Council members discussed implementation of NINDS’ strategic planning efforts.

V.  Report from the Society for Neuroscience

Dr. Diane Lipscombe
President, Society for Neuroscience
Professor of Neuroscience and Director of the Brown Institute for Brain Science
Brown University

Dr. Lipscombe presented an overview of the mission and activities of the Society for Neuroscience (SfN). The mission of the SfN is to advance discovery in neuroscience and accelerate discovery for treatment. About 40 percent of its 57,000 members are from outside the United States, contributing to the Society’s global reach. Society activities include professional development and training as well as information dissemination via SfN’s two scientific publications, educational resources, and conferences (in-person and virtual). The SfN aims to improve recruitment and retention of individuals to the profession from diverse disciplines as well as underrepresented minorities and women. The Society’s reviewer/mentor program is designed to help young scientists understand the manuscript review process and review criteria. In addition, the Society awards travel support for its annual meeting.

VI.  Overview of the Office of Training & Workforce Development Activities

Dr. Stephen Korn
Office of Training & Workforce Development

Dr. Korn presented an overview of NINDS-funded training programs.

NINDS Institutional Research Training Grants (T32) enable institutions to recruit individuals selected by the program for advanced research training of predoctoral students and postdoctoral fellows. Program goals include formal training in experimental design and statistical principles. Awardee institutions are expected to incorporate a statistician into the training and bring in outside experts. Council suggested measuring the T32 program’s impact on training by evaluating concept application in the laboratory, reviewing content of papers produced by trainees, and assessing career trajectory.

NINDS’ Postdoctoral NRSA Fellowships (F32) can support a postdoctoral fellow up to the first three years in the laboratory. Applicants are eligible to apply within approximately one year prior to joining a postdoctoral laboratory to within the first 12 months of starting in that laboratory. To encourage earlier submissions, the inclusion of preliminary data is discouraged. The application review process focuses on originality and rigor of the research and training plan. Data from the first five rounds of the new NINDS F32 indicate that awards are going to those who apply earlier in their postdoctoral training; those with mid-career mentors (i.e., 11–20 years since their terminal degrees); and those working in small to mid-sized labs. Council members discussed ways to evaluate the projects developed by F32 recipients. Later it was mentioned that a K01 mechanism is available to fund later stages of post doc training for projects that have high likelihood of continuation in an independent research career.

NIH Pathway to Independence Awards are designed to support both an initial mentored research experience (K99) followed by independent research (R00) for highly qualified, postdoctoral researchers, to secure an independent research position. Award recipients are expected to compete successfully for independent R01 support during the R00 phase. NINDS has awarded 165 K99s since 2007, with 80 percent of recipients having transitioned to tenure-track or equivalent positions. Notably, 85 percent of those who were awarded an R00 went on to receive an R01 or an NIH Director's New Innovator Award (DP2).

NINDS’ support of clinician-scientists includes institutional R25 awards for residents and fellows housed in neurology, neurosurgery, or neuropathology; K08 and K23 awards; and K12s for neurosurgeons and pediatric neurologists. R25 recipients have a success rate for obtaining a K08 or K23 that is nearly double that of applicants without prior R25 or K12 support, and time to award is shorter for those with an R25 than for applicants without a prior R25.

The Neurosurgeon Research Career Development Program (NRCDP) is an institutional K12 program designed to address challenges neurosurgeon researchers face—developing research skills, maintaining momentum in residency, and requiring protected time and department support for research once they become faculty. The NRCDP K12 requires that department chairs commit to five years of 50 percent protected time for the applicant to conduct research.

VII. Overview of the Division of Clinical Research Activities

Dr. Clinton Wright
Division of Clinical Research

Dr. Wright summarized NINDS’ Division of Clinical Research (DCR) program activities and the Division’s role in providing oversight for clinical trials to test safety and efficacy of innovative treatments; providing expertise in statistics and clinical trial design; and ensuring appropriate patient safety monitoring and compliance with human subjects research policy. DCR’s pipeline starts with clinical trial readiness and extends through dissemination and implementation of comparative effectiveness research (CER). NINDS recently issued a Funding Opportunity Announcement (FOA), CER in Clinical Neurosciences to support pragmatic study designs using cost-effective means of prospectively collecting observational data important to current clinical practice. For this FOA, applicants are encouraged to engage patient advocate groups in their proposed studies.

The NINDS’ clinical trials program aims to provide funding opportunities and CT infrastructure, support training in CT research methods, and promote data sharing and reporting. Clinical trial networks such as the Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT), StrokeNet, and Strategies to Innovate EmeRgENcy Care Clinical Trials Network (SIREN) were designed to increase trial quality, and build stable, trial-ready shared infrastructure. Furthermore, DCR also supports training to build research capacity among clinical trialists.

Council members commented on a perceived gap between effectiveness and efficacy trials and the need for real-world evidence of efficacy. Other needs identified include: evidence for return on investment in clinical trials, opportunities for improved data sharing around best practices, applications in artificial intelligence and machine learning, and disparities research that goes beyond documenting disparities to solving problems.

VIII. Initiatives Requiring Concept Clearance:

  1. Renewal of the Senator Paul D. Wellstone Muscular Dystrophy Specialized Research Centers (P50) Program

    Dr. Paul Scott
    Office of Science Policy and Planning

    Dr. Scott summarized recommendations from an evaluation of the Wellstone Muscular Dystrophy (MD) Research Centers Program (pdf, 143 kb) designed to identify best practices for achieving the Wellstone Program’s goals. Recommendations included expanding the program scope to encompass muscle diseases with related mechanisms and similar clinical manifestations and encourage interdisciplinary collaboration with a particular focus on community engagement. Centers are encouraged to increase transparency around researcher access to Center resources and strengthen bidirectional communication with the patient community.

    Dr. Glen Nuckolls
    Division of Neuroscience

    Dr. Nuckolls presented a proposal to renew the Wellstone P50 program to continue support for Centers that conduct multidisciplinary research on different muscular dystrophies; promote sharing of clinical data and research resources; and promote training and career development for the next generation of MD clinical and translational researchers.

    Council voted to approve renewal of the Wellstone Program.
     
  2. NINDS DNA and Cell Line Repository

    Dr. Ran Zhang
    Division of Neuroscience

    The goal of the NINDS Human Genetics Resource Center is to accelerate discovery of genetics causes and risk factors for neurological disorders by sharing samples & standardized, de-identified clinical data. The repository was established in 2002 and samples are collected for stroke, epilepsy, Tourette’s Syndrome, dystonia and other neurological diseases. Almost 100,000 samples have been distributed and over 400 publications make an attribution to the NINDS repository. NINDS is putting out a call for proposals to recompete the contract for (1) the collection of whole blood samples for DNA extraction and preparation of cryopreserved lymphocytes and clinical data and (2) storage and distribution services for the existing repository collection.

    Council voted to approve continuation of the repository’s activities.
     
  3. Reevaluation of the NINDS P30 (Research Core) Mechanism

    Dr. Timothy LaVaute
    Division of Neuroscience

    NINDS is considering the best way to provide core resources to neuroscientists at research institutions that have limited NIH funding. Dr. LaVaute outlined a proposal to direct funding of neurotechnology infrastructure toward emerging programs; that is, small to mid-sized institutions that are committed to building their neuroscience programs.

    Council members discussed pros and cons of the proposal and agreed that further exploration of a comprehensive solution is needed.

IX.  IC Reports Monitoring Adherence to the NIH Policy on the Inclusion of Women and Minorities in Clinical Research

Dr. Carolina Mendoza-Puccini
Division of Clinical Research

Dr. Mendoza-Puccini reported on NINDS’ inclusion of women and minorities in clinical research and across the lifespan. For the period 2016 through 2018, NINDS clinical research (CR) and phase III trials were stable for participants in all monitored groups: non-white participants (CR, 33 percent; phase III, 29%), women (CR, 53 percent; phase III, 39 percent), African Americans/blacks (CR, 15 percent; phase III, 19 percent), and Hispanics (CR, 9 percent; phase III, 15 percent). NINDS strategies to improve compliance with NIH inclusion policy include provision of inclusion guidelines to peer reviewers, program and grants management oversight, training on policy, the NINDS Recruitment Planning and Monitoring System, and NINDS support for network and individual trial efforts to identify and overcome barriers.

Council voted to accept the report as presented.


X.  Council Consideration of Pending Applications

This portion of the meeting, involving specific grant review, was closed to the public. The Council gave special attention to applications from foreign institutions and other applications requiring specific discussion. Prior to discussion of the grants, Dr. Finkelstein reminded Council members regarding conflict of interest and confidentiality.

Conflict of Interest—Regulations concerning conflict of interest were reviewed. Council members were reminded that materials furnished for review purposes and discussion during the closed portions of the meeting are considered privileged information. All Council members present signed a statement certifying that they had not been involved in any conflict-of-interest situations during the review of grant applications.

Confidentiality—During the closed session, any information that is discussed and the outcome of any recommendation are considered privileged information. They may not be discussed outside of the closed session. If an applicant requests support for his or her application from a Council member, the Council member must respond that he/she is not permitted to discuss the application. Any inquiry should be referred to Dr. Robert Finkelstein, NINDS Advisory Council Executive Secretary, who then will refer the question to the appropriate staff member for response.

Research Training and Career Development Programs—The Council reviewed a total of 223 research career development and institutional training grant applications with primary assignment to NINDS, and 134 of them (60 percent) were scored in the amount of $19.1 million first-year direct costs. It is anticipated that, of the research career development and institutional training grant applications competing at this Council, NINDS will be able to pay first-year direct costs of approximately $7.73 million (59 grants). Research Project and Center Awards – The Council reviewed a total of 1,617 research project and center applications with primary assignment to NINDS, and 897 of them (55.5 percent) were scored/percentiled in the amount of $316.2 million first-year direct costs. It is anticipated that, of the research grants competing at this Council, NINDS will be able to pay first-year direct costs of approximately $84.9 million (273 grants).

Research Project and Center Awards—The Council reviewed a total of 1,617 research project and center applications with primary assignment to NINDS, and 897 of them (55.5 percent) were scored/percentiled in the amount of $316.2 million first-year direct costs. It is anticipated that, of the research grants competing at this Council, NINDS will be able to pay first-year direct costs of approximately $84.9 million (273 grants).

Senator Jacob Javits Neuroscience Investigator Awards—The Senator Jacob Javits Neuroscience Investigator Awards are made to distinguished investigators who have a record of scientific excellence and productivity, who are actively pursuing an area of research of strategic importance, and who can be expected to continue to be highly productive for a seven-year period. Candidates are nominated and selected at each Council meeting. Council approved four Javits nominations at this meeting: Jin-Moo Lee, M.D. (Washington University); Cheryl Louise Stucky, Ph.D. (Medical College of Wisconsin); Karen S. Wilcox, Ph.D. (University of Utah); and Yimin Zou, Ph.D. (University of California, San Diego).

Small Business Innovation Research and Small Business Technology Transfer Award Programs—The Council reviewed a total of 134 Small Business Innovation Research (SBIR) and Small Technology Transfer Award (STTR) grant applications with primary assignment to NINDS, and 76 of them (56.3 percent) were scored in the amount of $27.5 million first-year direct costs. It is anticipated that, of the SBIR and STTR applications competing at this Council, NINDS will be able to pay first-year direct costs of approximately $8.37 million (22 grants).

XI.  Adjournment

The meeting was adjourned at 12:40 p.m. on Friday, February 15, 2019.

NINDS employees present for portions of the meeting included:

Dr. Amy Adams
Dr. Deborah Babcock
Ms. Kelly Baker
Dr. Pat Bellgowan
Dr. William Benzing
Dr. Moria Bittman
Dr. Francesca Bosetti
Dr. Chris Boshoff
Dr. Andrew Breeden
Dr. Jeremy Brown
Mr. Roger Campbell
Dr. Emily Carifi
Ms. Stacey Chambers
Dr. Daofen Chen
Dr. Ben Churn
Dr. Robin Conwit
Ms. Janice Cordell
Dr. Devon Crawford
Dr. Diana Cummings
Dr. Charles Cywin
Dr. Will Daley
Dr. Karen David
Dr. Tia Decoster
Dr. Carlos Faraco
Ms. Stephanie Fertig
Dr. Robert Finkelstein
Dr. Jane Fountain
Mr. Peter Gilbert
Ms. Marie Gill
Mr. Paul Girolami
Dr. Jordan Gladman
Dr. Jim Gnadt
Dr. Maureen Gormley
Dr. Amelie Gubitz
Dr. Mohamed Hachicha
Ms. Preeti Hans
Dr. Adam Hartman
Mr. Brandon Hartsell
Dr. Janet He
Dr. Andrew Hooper
Dr. Nina Hsu
Dr. Lyn Jakeman
Dr. Scott Janis
Dr. Michelle Jones-London
Dr. John Kehne
Dr. Brian Klein
Dr. Jim Koenig
Dr. Steve Korn
Dr. Doe Kumsa
Dr. Walter Koroshetz
Dr. Pascal Laeng
Ms. Christine Lam
Dr. Nick Langhals
Dr. Tim LaVaute
Dr. Miriam Leenders
Dr. Codrin Lungu
Ms. Quynh Ly
Dr. Ernie Lyons
Dr. Laura Mamounas
Dr. Linda McGavern
Ms. Barbara McMakin
Dr. Carolina Mendoza-Puccini
Dr. Daniel Miller
Dr. Marilyn Moore-Hoon
Dr. Jill Morris
Dr. Claudia Moy
Dr. Glen Nuckolls
Dr. Ana Olariu
Ms. Oreisa O’Neil
Dr. Michael Oshinsky
Dr. David Owens
Dr. Katie Pahigiannis
Dr. Mary Ann Pelleymounter
Dr. Leah Pogorzala
Dr. Shanta Rajaram
Dr. Robert Riddle
Dr. Becky Roof
Dr. Jonathan Sabbagh
Dr. Cristina Saugar-Lanchas
Dr. Alisa Schaefer
Dr. Paul Scott
Dr. Joonil Seog
Ms. Hawa Sesay
Ms. Shalini Sharma
Dr. Beth-Anne Sieber
Dr. Shai Silberberg
Dr. Shardell Spriggs
Dr. Natalia Strunnikova
Dr. Marg Sutherland
Dr. Christine Swanson-Fischer
Dr. Ned Talley
Dr. Amir Tamiz
Dr. Anna Taylor
Dr. Carol Taylor-Burds
Dr. Christine Torborg
Dr. Lauren Ullrich
Dr. Ursula Utz
Dr. Joanna Vivalda
Dr. Laura Wandner
Dr. Samantha White
Dr. Vicky Whittemore
Dr. Ling Wong
Dr. May Wong
Dr. Robert Zalutsky
Dr. Ran Zhang

Other federal employees present for portions of the meeting included:

Dr. Aurea De Sousa, CSR


We certify that, to the best of our knowledge, the foregoing minutes and attachments are accurate and complete.

 

______
Date

_____________________________
Robert Finkelstein, Ph.D.
Executive Secretary
National Advisory Neurological Disorders
and Stroke Council

Director, Division of Extramural Research
National Institute of Neurological Disorders
and Stroke

______
Date
_____________________________
Walter Koroshetz, M.D.
Chairperson
National Advisory Neurological Disorders
and Stroke Council

Director
National Institute of Neurological Disorders
and Stroke

These minutes will be formally considered by the Council at its next meeting.  Corrections or notations will be incorporated in the minutes of that meeting.


1For the record, it is noted that members absent themselves from the meeting when the Council is discussing applications (a) from their respective institutions or (b) in which a real or apparent conflict of interest might occur.