G2P Director Robert C. Green, MD, MPH, is selected for the Brigham and Women’s Hospital Kenneth L. Baughman Faculty Mentoring Award.


G2P Director Robert C. Green, MD, MPH, is selected for the Brigham and Women's Hospital Kenneth L. Baughman Faculty Mentoring Award. 


The award – to be presented during Medical Grand Rounds at BWH on Jan. 20 – recognizes a faculty member who demonstrates effective mentoring through guiding and encouraging the career development of fellow faculty in the department.

Established in 2010, the award is named in memory of Kenneth L. Baughman, MD, who exemplified dedication to the career development of faculty. Baughman was director of the Advanced Heart Disease Section of BWH's Division of Cardiovascular Medicine from 2002 to 2009. 

Green, a medical geneticist and physician-scientist, directs the G2P Research Program – a program within BWH, the Broad Institute and Harvard Medical School focused on studying translational genomics and health outcomes. He leads and co-leads the first randomized trials to explore the implementation of medical sequencing in adults (MedSeq Project) and newborns (BabySeq Project), respectively, as well as several other projects.

Green also serves as associate director for Research at Partners HealthCare Personalized Medicine and is a member of the Executive Committee for the Partners BioBank.


Read more here

G2P celebrates our 16th PGen Publication!

Despite being on the market for nearly a decade, direct-to-consumer (DTC) genetic testing continues to be controversial among experts and raises concerns among health care providers and regulatory agencies. The NIH-funded “Impact of Personal Genomics (PGen) Study” addresses these concerns by empirically measuring the perceptions and tracking the behaviors of individuals who have received DTC genetic testing from two separate companies. Research from this large-scale prospective study has already generated numerous new scientific reports.

These findings shed light on who seeks testing and why, and how they respond to the results that they receive.


The latest results from the PGen Study were published on December 12 in the Journal of Clinical Oncology. This was an analysis of how customers respond to common cancer risk information (not Mendelian cancer risks like BRCA1/2), and was led by Stacy W. Gray, MD, City of Hope National Medical Center with senior author Robert C. Green, MD, MPH of Brigham and Women’s Hospital, Broad Institute and Harvard Medical School. In this analysis, Gray and colleagues specifically looked at personal genomic testing for cancer risk, and found that 12-24% of individuals received “elevated” cancer risk estimates for prostate, breast and colon cancer. Despite learning they were at increased risk for these common cancers, most

customers did not report changing their diet, exercise, supplement use, advanced care planning or cancer screening in comparison to the customers who learned they were at average or lower risk. The one exception is men who received elevated prostate cancer risk estimates as some of these men changed their vitamin and supplement use more than those at average or reduced risk. This counter-intuitive finding may have resulted because the increased cancer risks reported to the customers were very modest, and because the kind of individual who purchases DTC genetic testing may already have been very proactive about their health and using other available screening tests for cancer.


“These results suggest that people are not over-reacting to very modest cancer risks in DTC genetic testing” said Green, director of the Genomes2People Research Program, “and is consistent with some of our other findings showing that early adopters of DTC genetic testing


understand the limited predictive impact of DTC results and do not over-react either emotionally or in terms of generating additional and unnecessary medical expenses.”


The advent in 2007 of DTC personal genomic testing, in which consumers could purchase genetic testing services directly from private companies, raised expectations for a new era of consumer genomics. This raised concerns about patients understanding the implications of their results and the response from doctors if asked to interpret these results. The PGen Study cohort is a group of more than 1,600 consumers who purchased personal genomic tests prior to the imposition of FDA restrictions in 2013 from 23andMe and Pathway Genomics (Pathway has since changed their business model and no longer provides DTC testing). In addition to sharing their actual test results with investigators, participants completed surveys before receiving their results and again two weeks and six months after receiving their results. The surveys also presented mock results to determine if consumers could accurately interpret them.


“There has been a tremendous amount of interest and opinion expressed about the potential benefits, harms and costs associated with personal genomic testing, and most of it has been speculative” said Green, “the PGen Study provided us with a goldmine of data on consumer expectations, how consumers interpret, recall and experience their results, how their results impact their state of mind, what actions they take after testing, and how all of these factors change over time.”


“As far as many of the speculated risks and harms around direct-to-consumer genomic testing, we have not uncovered evidence that they are either common or severe,” added Scott Roberts, PhD, of the University of Michigan's School of Public Health, and joint principal investigator of the PGen Study with Green. “Although we have found some areas where informed consent for testing and communication of results could be improved, our data suggest most consumers find their results as potentially useful in informing future health decisions and advance planning.”


Here we provide a link to a complete list of scientific reports from the PGen Study. Some selected papers, along with their key findings from the PGen Study include:


  • Ostergren et al. (2015) in Public Health Genomics: This study investigated how well consumers understood and could apply the information contained in their DTC genetic testing reports. Most consumers accurately interpreted sample test reports, but with some variation depending on consumer demographics (e.g., education level) and the type of results. For example, comprehension was lowest for carrier screening results, suggesting that companies could perhaps communicate these results more


  • Meisel et al. (2015) in Genome Medicine: While the debates around DTC genetic testing have focused on its ability to predict future disease, this study demonstrated that consumers are particularly interested in genetic test results that explain conditions they already have, not just risks for diseases they may develop in future. This was found to be particularly true for conditions without an established
  • Baptista et al. (2016) in Genetics in Medicine: This study showed that adopted persons who did not have access to their family histories valued DTC genetic testing even more than non-adopted



  • Kreiger et al. (2016) in Nature Biotechnology: Before-and-after surveys revealed that participants adjusted their assessment of their health risks by about twice as much when their results included good news rather than bad news. The study also found that consumers who were surprised by something in their results were the most likely to follow up by scheduling a doctor's


  • Carere et al. (2016) in Genetics in Medicine: Comparison of consumers' real-world prescription medication changes with their personal genomic test results. The study found that while 5.6% of participants changed medications as a result of their genomic test results, only nine out of 961 participants - less than 1% - did so without first consulting a health care


  • Van der Wouden et al. (2016) in Annals of Internal Medicine: Six months after receiving their personal genomic test results, approximately 35% of participants had shared their results with their primary care physician or another health care provider. This was the first study to report consumer perspectives on those doctors' visits, with some interesting findings; for example, 22% of patients reported that their primary care physicians were dismissive of the genomic test


  • Olfson et al. (2016) in Nicotine and Tobacco Research: DTC customers who were smokers show a high level of interest in genetic risks of smoking-related illnesses. The experience of receiving direct-to-consumer genomic health risks did not lead to “false reassurance” around their efforts to quit


This research was supported by the National Institutes of Health (NIH) National Human Genome Research Institute (Grant No. R01-HG005092); National Human Genome Research Institute (Grant No. U01HG006492); the American Cancer Society Grant No. 120529-MRSG-11-006-01- CPPB; a Canadian Institutes of Health Research Doctoral Foreign Study Award; and these NIH grants K07CA131103, U01-HG006500, U19-HD077671, U01-HG008685, and U41-HG006834.



Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits and nearly 46,000 inpatient stays, is the largest birthing center in Massachusetts and employs nearly 16,000 people. The Brigham’s medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to

research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 3,000 researchers, including physician-investigators and renowned biomedical scientists and faculty supported by nearly $666 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study


Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH’s online newsroom.

Careers of the Future: Promising Professions in Research and Patient Care

From genomic-directed clinical trials and gene editing to personalized medicine and more, recent innovations in science and medicine are helping patients live longer, healthier and fuller lives. "Careers of the Future", a BWH blog series, explores the experts behind these medical advances, and how their roles in healthcare are pushing thier fields forward in service to patients.

Genetic Counselors: Making results meaningful to clinicians, patients and study participants

From left: Genomes2People genetic counselors Sheila Sutti and Carrie Blout

In the past decade, the number of certified genetic counselors in the U.S. rose by 88 percent, according to a 2016 National Society of Genetic Counselors (NSGC) Professional Status Survey. That number is likely to keep rising, with the U.S. Bureau of Labor Statistics projecting a growth rate of 29 percent for genetic counseling positions from 2014 to 2024.

Genetic counseling is the process of helping people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease. It is a unique blend of care coordination, interpretation and, of course, counseling. Genetic counselors are trained to take complex genetic information and explain it in ways patients, providers and consumers can understand. The field has been around since the early 1970s, when genetic counselors first began working alongside clinical geneticists, primarily seeing families of patients with pediatric disorders.

“I chose to become a genetic counselor because it combines my love for genetics with the ability to work with and help people. I also hope our research will impact U.S. health care policy in the future,” said Carrie Blout, MS, CGC, a senior genetic counselor and project manager for Genomes2People (G2P) at BWH. G2P is a translational research program led by medical geneticist and physician-scientist Robert Green, MD, MPH, that integrates genomic research and sequencing into clinical practice.

Today, the clinical specialty areas in which genetic counselors practice have expanded to include prenatal settings, oncology, cardiology, neurology, ophthalmology, metabolic disease and others. Blout says that genetic counseling in a clinical setting involves collecting extensive family and medical histories, analyzing inheritance patterns and explaining genetic testing options and test results in the context of a patient’s medical and family history, as well as providing support and advocating for patients.

Genetic counselors also have the option to explore the field’s unanswered questions as research genetic counselors, project managers and research coordinators. Some work in clinical academic laboratories while others work in industry settings including diagnostic laboratories, biotech or pharma companies. Others work in education or marketing roles to disseminate information about genetics to a variety of patient, provider, media, student and consumer audiences.

At BWH, genetic counselors on the G2P team are working to explore the medical, behavioral and economic implications of genomic sequencing. They are also seeking to better understand Alzheimer’s disease and its implications. Other counselors at BWH see adult patients in a variety of specialty clinics, including cardiology, endocrinology, pulmonology and prenatal settings.

No matter the area, genetic counselor and G2P team member Sheila Sutti, MS, CGC, says that clear communication still remains at the heart of the profession.

“We need to help patients understand the risks and benefits of the information we are providing them, some of which is extremely delicate,” said Sutti, the G2P project manager of REVEAL-SCAN: Risk Evaluation and Education of Alzheimer’s Disease: The Study of Communicating Amyloid Neuroimaging. “It is our responsibility to safely communicate these results because once people learn certain information, they can’t unlearn it.”

Blout says that she and her colleagues make sure patients understand what the presence of a genetic variant means in the context of their own history.

“We’re looking at family history and medical information combined to make the results meaningful for the patient,” she said. “In some cases, we explain that just because he or she has a genetic variant doesn’t mean they will develop a disorder.”

Genetic counselors also see patients who do not yet have an established diagnosis and have sometimes undergone years of testing and consults to try to find an answer to their diagnostic odyssey. At BWH, genetic counselors try to help these patients discover the cause of their medical condition not only in the clinic, but also in their research roles as part of Harvard’s Undiagnosed Diseases Network, which is funded by the National Institutes of Health.

Additionally, healthy people’s interest in undergoing genome sequencing is growing. As part of G2P’s MedSeq Project, a randomized clinical trial of whole genome sequencing, Blout and Green enroll seemingly healthy individuals, as well as those with a diagnosis of cardiomyopathy.

In BWH’s Adult Genetics Clinic, Sutti and Green evaluate and counsel a unique cohort of self-referred healthy individuals without any clinical indication of disease. These individuals are interested in obtaining whole genome sequencing to find out conditions to which they may be predisposed.

“Genomic sequencing is a new frontier being explored now,” said Blout. “Some patients come in with no real indications, and others have a family history that might predispose them to have a genetic condition even if they don’t have symptoms. Sequencing in healthy individuals is still a very new field.”

Blout says she hopes the role of genetic counselors will continue to expand into all aspects of medicine. She also hopes, and expects, that research and industry opportunities will continue to grow.

“Exploring these topics on the cutting edge is so rewarding, though a lot of what we do is a bit controversial, even in the genetics world,” Blout said. “We’re sequencing healthy babies and adults and providing Alzheimer’s information to patients at risk, but we’re doing it in careful and meaningful ways to explore the true impact of providing this information and how it affects patients, their families and the larger health care system.”


See original article here.

Researchers Assess Impact of Exome Sequencing on Newborns and their Families Findings Reported at ASHG 2016 Annual Meeting

BETHESDA, MD – Early results from the BabySeq Project, a Boston-based study exploring the impact of whole-exome sequencing (WES) on newborn infants and their families, suggest some utility in genetically sequencing these infants and offer new insights into parental attitudes toward the procedure and results. Findings were presented at the American Society of Human Genetics (ASHG) 2016 Annual Meeting in Vancouver, B.C.

Robert C. Green, MD, MPH (photo credit: GretchenErtl)

Led by Robert C. Green, MD, MPH, of Brigham and Women’s Hospital, Harvard Medical School, and the Broad Institute; and Alan H. Beggs, PhD, of the Manton Center for Orphan Disease Research at Boston Children’s Hospital and Harvard Medical School; the project has recruited more than 100 families to date. Infants are enrolled from the neonatal intensive care units at Boston Children’s Hospital and Brigham and Women’s Hospital as well as the well-baby nursery at Brigham and Women’s Hospital. Half of each group is randomized to receive WES – genetic sequencing of all protein-coding genes, with analysis of about 1,800 genes implicated in childhood health – and follow-up counseling. Data are collected from participating families at enrollment, when receiving their sequencing results, three months after sequencing, and ten months after sequencing.


“This is the first randomized trial to sequence healthy infants with interpretation and return of the information,” Dr. Green said. “We faced enormous early challenges in creating processes for informed consent, accurate sequencing and interpretation, choosing which genes to report, clearly reporting results to families and their providers, and measuring potential benefits and harms.”


“Having created these processes, we are now collecting data from medical record reviews and parental surveys, in order to measure medical benefits, harms, and costs, as well as parents’ understanding of genetic sequencing, their attitudes and anxieties about it, and any actions they may have taken based on the results,” said Shawn Fayer, MSc, MS, Project Manager of the BabySeq Project. 


So far, the researchers have identified potentially harmful variants in two healthy infants who were sequenced – variants that would not have been detected otherwise – suggesting some value in sequencing infants with no family history of genetic disease. It is not yet known how this knowledge will affect the families’ medical actions or the infants’ eventual health outcomes.


In some cases, challenges during the recruitment process led to unexpected insights. Before enrolling, parents had the opportunity to meet with a genetic counselor to discuss the study. Those who declined to participate after learning about the study expressed concerns about receiving unfavorable or uncertain results, insurance discrimination, and confidentiality and privacy. These findings reflect current societal attitudes about genetic testing, which are likely to affect its clinical implementation.

In the coming months, the researchers hope to enroll several hundred additional infants and families. In addition to measuring parental attitudes about sequencing newborns, they plan to assess the usefulness of WES information over time, including how it is used in later medical decisionmaking.  

“This is the first rigorously designed study to examine the often-cited vision that humans will benefit from having genomic information from the very first days of life,” said Dr. Green. “While it will take many years of follow-up to determine the ultimate benefits and harms, we are already learning a tremendous amount about creating the process for returning genomic information in newborns, parental hopes and concerns, and the kinds of results that are emerging.”

The BabySeq Project is funded by the National Institute of Child Health and Development and the National Human Genome Research Institute, both part of the National Institutes of Health.  

Presentation: Dr. Green will present his research on Wednesday, October 19, 2016, from 9:45-10:00 a.m., in Room 109 of the Vancouver Convention Centre.

Press Availability: Dr. Green will be available to discuss this research with interested media on Wednesday, October 19, 2016, from 11:00-11:45 a.m. in the ASHG 2016 Press Office (Room 111).

Reference: Green RC et al. (2016 Oct 19). Abstract: The BabySeq Project: Preliminary findings from a randomized trial of exome sequencing in newborns. Presented at the American Society of Human Genetics 2016 Annual Meeting. Vancouver, B.C., Canada.

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 About the American Society of Human Genetics (ASHG)

Founded in 1948, the American Society of Human Genetics is the primary professional membership organization for human genetics specialists worldwide. Its nearly 8,000 members include researchers, academicians, clinicians, laboratory practice professionals, genetic counselors, nurses, and others with an interest in human genetics. The Society serves scientists, health professionals, and the public by providing forums to: (1) share research results through the ASHG Annual Meeting and in The American Journal of Human Genetics; (2) advance genetic research by advocating for research support; (3) educate current and future genetics professionals, health care providers, advocates, policymakers, educators, students, and the public about all aspects of human genetics; and (4) promote genetic services and support responsible social and scientific policies. For more information, visit: http://www.ashg.org.


9650 Rockville Pike | Bethesda, MD 20814 | 301.634.7300 | society@ashg.org | www.ashg.org

Connect with ASHG on Twitter (@GeneticsSociety) | Facebook | LinkedIn

G2P at ASHG 2016

We are thrilled to have given several platform and poster presentations at this year’s ASHG meeting in Vancouver where we had the opportunity to share new Genomes2People research data! Please see below for information about our speakers and follow us @Genomes2People; for more on the conference, visit: https://www.ashg.org/2016meeting/

Click here for ASHG's press release on our BabySeq project.

Platform Presentations

RCG photoRobert Green, MD, MPH (Platform presenter)

Title: The BabySeq Project: Preliminary Findings from a Randomized Trial of Exome Sequencing in Newborns

Wednesday, Oct. 19, 9:45am Room 109, West Building

Session #9: Early Detection: New Approaches to Pre- and Perinatal Analyses

Co-Authors: I.A. Holm, H.L. Rehm, A.L. McGuire, P.B. Agrawal, R.B. Parad, M.H. Helm, C.A. Genetti, A.H. Beggs


Jason VassyJason Vassy, MD, MPH, SM (Platform presenter)

Title: Healthcare Outcomes and Costs after genome Sequencing Among Healthy Adults: Results of a Randomized Controlled Trial

Friday, Oct. 21, 9:30am Room 302, West Building

Session #56: Genomes in the Clinic and Research: Patient-family-participant Perspectives

Co-Authors: K.D. Christenson, E.F. Schonman, D. Dukhovny, P.M. Diamond, C.L. Blout, J. Oliver Robinson, J.B. Krier, M.F. Murray, A.L.                                   McGuire, R.C. Green


Ian Richardson (Platform presenter)

Title: Risk, Recommendation, and Rationale: How Primary Care Providers Interpret and Manage Genome Sequencing Results

Session #74: The Clinical Impact of WES and WGS

Saturday, Oct. 22, 9:45am Room 109, West Building

Co-Authors: J.K. Davis, C. Kirby, R.C. Green, P.A. Ubel, J.L. Vassy


Poster Presentations

Jason VassyJason Vassy, MD, MPH, SM (Poster presenter)

Title: Do Primary Care Physicians Manage Genome Sequencing Results Appropriately?: Results of an Expert Panel Evaluation

Poster #: 3065T; Genetic Counseling, ELSI, Education and Health Services Research

Thursday, Oct. 20 2-3pm Convention Centre, Exhibit Hall B, West Building

Co-Authors: E. Schonman, M.F. Murray, J.B. Krier, C.L. Blout, D.W. Bates, R.C. Green


Wylie Burke, MD, PhD (Poster presenter)

Title: Negotiating the research-clinical interface in genomic medicine: analysis from the CSER Consortium

Poster #: 3128T; Genetic Counseling, ELSI, Education, and Health Services Research

Thursday, Oct. 20, 3-4pm Convention Centre, Exhibit Hall B, West Building

Co-Authors: S.M. Wolf, R.C. Green


Hayley Peoples (Poster presenter)

Title: Benefits, Risks, and Perceived Utility of Newborn Genomic Sequencing: Comparing Parents’ and Physicians’ Baseline Attitudes in the BabySeq Project

Poster #: 3068T; Genetic Counseling, ELSI Education and Health Services Research

  Thursday, Oct. 20, 3-4pm Convention Centre, Exhibit Hall B, West Building

  Co-Authors: A.M. Gutierrez, S. Pereira, J.O. Robinson, L. Frankel, M.               Towne, M. Helm, C.A. Genetti, I.A. Holm, A.H. Beggs, R.C. Green, A.L.         McGuire


Kurt ChristensenKurt Christensen, PhD (Poster presenter)

Title: Cardiologists’ Responses to Whole Genome Sequencing: Preliminary Findings from the MedSeq Project

Poster #: 3012F; Genetic Counseling, ELSI, Education, and Health Services Research

Friday, Oct 21, 3-4pm Convention Centre, Exhibit Hall B, West Building

Co-Authors: J.L. Vassy, A.L. Cirino, M.F. Murray, A.L McGuire


Jill Robinson, MA (Poster presenter)

Title: Patient’s perceived utility after receiving whole genome sequencing

Poster #: 3126F; Genetic Counseling, ELSI Education and Health Services Research

Friday, Oct. 21, 3-4pm Convention Centre, Exhibit Hall B, West Building

Co-Authors: K.D. Christensen, P.M. Diamond, L. Jamal, K. Lee, H.                                                        Peoples, C. Blout, J.L. Vassy, R.C. Green, A.L. McGuire


person-ed-esplin-thumbEdward Esplin, MD, PhD (Poster presenter)

Title: Attitudes regarding personal genome sequencing among healthy early adopters: Findings from the PeopleSeq Consortium

Poster #: 3108F; Genetic Counseling, ELSI, Education, and Health Services

Friday, Oct. 21, 3-4pm Convention Centre, Exhibit Hall B, West Building

Co-Authors: E. Haverfield, D.E. Nielsen, E.F. Schonman, E. Ramos, M. McGinniss, S. Tucker, D.G.B. Leonard, R.C. Green


Stephen Miller, PhD (Poster Presenter)

Title: The I-PICC Study: Protocol for a point-of-care randomized controlled trial of statin pharmacogenetics in a learning healthcare system

Poster #: 666F; Cardiovascular Phenotypes

Friday, Oct. 21, 3-4pm Convention Centre, Exhibit Hall B, West Building

Co-Authors: R.E. Ferguson, J.M. Gaziano, R.C. Green, J.L. Vassy


Calendar of Events:

Wednesday, October 19, 2016 

9:45am: Robert Green (Platform presentation)- The BabySeq Project: Preliminary Findings from a Randomized Trial of Exome Sequencing in Newborns

Thursday, October 20, 2016

2-3pm: Jason Vassy (Poster presentation)- Do Primary Care Physicians Manage Genome Sequencing Results Appropriately?: Results of an Expert Panel Evaluation 

3-4 pm: Wylie Burke (Poster presentation)- Negotiating the research-clinical interface in genomic medicine: analysis from the CSER Consortium

3-4pm: Hayley Peoples (Poster presentation)- Benefits, Risks, and Perceived Utility of Newborn Genomic Sequencing: Comparing Parents’ and Physicians’ Baseline Attitudes in the BabySeq Project

Friday, October 21, 2016

9:30am: Jason Vassy (Platform presentation)- Healthcare Outcomes and Costs after genome Sequencing Among Healthy Adults: Results of a Randomized Controlled Trial

3-4 pm: Kurt Christensen (Poster presentation)- Cardiologists’ Responses to Whole Genome Sequencing: Preliminary Findings from the MedSeq Project

3-4 pm: Jill Robinson (Poster presentation)- Patient’s perceived utility after receiving whole genome sequencing

3-4 pm: Edward Esplin (Poster presentation)- Attitudes regarding personal genome sequencing among healthy early adopters: Findings from the PeopleSeq Consortium

3-4 pm: Stephen Miller (Poster presentation)- The I-PICC Study: Protocol for a point-of-care randomized controlled trial of statin pharmacogenetics in a learning healthcare system

Saturday, October 22, 2016

9:45am: Ian Richardson (Platform presentation)- Risk, Recommendation, and Rationale: How Primary Care Providers Interpret and Manage Genome Sequencing Results

Sheila Sutti Runs 2016 Boston Marathon for G2P

mile_26_for_g2p_________On April 18, 2016, G2P Project Manager Sheila Sutti ran the 2016 Boston Marathon to raise money for G2P's research, as part of the Brigham & Women's Hospital Boston Marathon Team. Sheila successfully raised over $17,000 to support our projects in translational genomics and Alzheimer's research.

You can still donate to Sheila's campaign and our work here!