School of Medicine

The Pulse

Your Neck of the Woods

Internal Medicine

Dr. Erwin Aguilar (Nephrology) recently spoke via Zoom at the School of Public Health of the University of Santiago, Chile. Dr. Aguilar’s talk, "The environment and CKD," was part of a larger conference entitled "The Environment and Chronic Renal Insufficiency: A Public Health Problem." 

Dr. Jameel Ahmed (Cardiology) was selected to serve on the ABIM Cardiovascular Board representing electrophysiology. His three-year term began in July.

Dr. Ashaur Azhar (Infectious Diseases) recently presented “Prosthetic Joint Infections Management - From an Infectious Diseases Physician Perspective” at the Joint Replacement Didactic Sessions for LSUHSC orthopaedic residents in New Orleans.

Dr. Allison Augustus-Wallace has been elected to serve as a board member and the Diversity Committee Chair for the Research Society on Alcohol for the 2024-25 term. and as Chairperson-Emerita for 2025-2026. 

Dr. Augustus-Wallace recently spoke at an AAMC IDEAS Learning Series on the "Voters’ Education Initiative: Engagement and Empowerment" during which speakers discussed voting as a social determinate of health and the use of this legal, non-partisan initiative to increase awareness of current issues relevant to academic medicine.

Advocacy DayDr. Catherine Hudson (Gastroenterology) recently attended an advocacy day through the American College of Gastroenterology and met with state lawmakers including Senator Bill Cassidy (also a gastroenterologist) and Congressman Troy Carter from New Orleans to discuss bills focused on lessening the burden of prior authorizations and step therapy as well as changing some of the language for the fiscal year 2025 appropriations bill to reduce cost sharing for patients who have had polyps in the past and need a follow up colonoscopy. Dr. Hudson also was able to talk with Senator Cassidy about the Treat and Reduce Obesity Act (TROA) which is aimed at providing comprehensive care for the treatment of obesity.

 

Advocacy Day

 

Dr. Hudson also recently delivered a keynote lecture at the Alumni Scientific Session lecture to more than 60 attendees.

 

 

 

Dr. Sanjay Kamboj (Pulmonary/Critical Care & Allergy/Immunology) was interviewed by Fox8Live about a rare bacterial illness that can lead to meningitis and death.

Dr. Rebecca Lillis (Infectious Diseases) was invited to present at the World Health Organization’s Integrated Global Action Plan (I-GAP) on Drug Resistance for HIV, Viral Hepatitis and Sexually Transmitted Infections (STIs): STI Stakeholder Consultation, in Geneva, Switzerland.

Dr. Nisha Loganantharaj (Gastroenterology) was recently selected to serve on the 2024–2028 Crohn's & Colitis Foundation and Rising Educators, Academics, and Clinicians Helping Inflammatory Bowel Disease (REACH-IBD) Committee. She has also been invited to be part of the REACH-IBD Career Development Leadership Program Workgroup.

Dr. Miranda Mitchell (Baton Rouge) was featured in an interview for the June edition of the ACP Impact, a monthly newsletter published online for medical students interested in internal medicine. The newsletter helps students explore IM career opportunities and access helpful information and resources.

Dr. Murphey poster presentationDr. Casey Murphy (PM&R) and several PM&R Pain fellows recently attended the American Society of Interventional Pain Physicians (ASIPP) Conference in Dallas, Texas, where the LSU Health team presented two posters.

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Dr. Mihran Naljayan (Nephrology) recently published an article on overcoming equity barriers to home dialysis in Helio News.

Dr. Lauren Richey (Infectious Diseases) recently presented at the International Association of Providers of AIDS Care (IAPAC) CONTINUUM 2024 Conference in Puerto Rico. Dr. Richey presented "Corrective Strategies and Adaptive Benefits to Address Maladaptive Thoughts and Reduce Internal HIV Stigma in Individuals with Trauma Histories" and "Best Practices Learned from PEPFAR HRSA SkillsSharing Program in Jamaica."

Dr. Hope Oddo-Moise (Hospital Medicine) also presented her CQI project: "Rapid Re-Entry into Care" at the IAPAC CONTINUUM.

Dr. Brooks Robey (Nephrology) was recently appointed by the Board of Directors to serve as the Chair of the Medical Advisory Board of the National Kidney Foundation of Louisiana.

Dr. Ben Springgate (Community and Population Medicine) chaired a mini-plenary discussion at the CMS Quality Conference in Baltimore, MD entitled "Care for Complex Patients: Clinical Approaches to Quality Improvement at the Intersection Substance Use Disorder, Mental Illness, and Chronic Pain". The presentation highlighted expert clinicians’ and system leaders’ approaches to healthcare delivery and quality improvement for community members with comorbid substance use disorder, mental illness, and chronic pain.

Dr. Springgate also spoke with Tommy Tucket on WWL Radio in May about cannabis and potential changes in federal cannabis regulation moving it from a Schedule I to Schedule III controlled substance.  

Dr. Springgate was recently a discussant for CMS Grand Rounds “Leveraging Research and Data to Inform Overdose Prevention and Response Activities and Drive Improvements in Access, Quality, and Equity.” He also was invited to serve as a discussant for a CMS Behavioral Health Coordinating Committee meeting. 

Dr. Gala True (Community and Population Medicine) is PI on a study entitled “Promoting Secure Firearm Storage Behaviors among Louisiana Veterans.” This study is a subaward through the Louisiana Department of Health through a Centers for Disease Control and Prevention (5 NU50CE002597-02-00). This study recruits firearm owners at local gun shows and Veterans Service Organization events.

The department was well-represented at the recent international annual meeting of the American College of Physicians in Boston, MA. LSU faculty members presenting at the meeting included Dr. Cynthia Brown (ACP Rapid Board Review 2024), Dr. Victoria Burke (Meet the Professor -- Common Outpatient Bacterial Infections and Update in Infectious Diseases), Dr. Taniya De Silva (ACP Rapid Board Review 2024), Dr. Neeraj Jain (ACP Rapid Board Review 2024), Dr. Stephen Kantrow (ACP Rapid Board Review 2024), Dr. Rebecca Lillis (Meet the Professor -- Sexually Transmitted Infections in Primary Care), Dr. Fred Lopez (ACP Rapid Board Review 2024 and Update in Infectious Diseases), and Dr. Daniel Raines (ACP Rapid Board Review 2024).

The NTM-Bronchiectasis Team commemorated the World Bronchiectasis Day 2024 and participated in the International Congress 2024. Dr. Shelby MacRae (Pulmonary/Critical Care) presented a poster at the congress and the other team members arranged a news item appearance, two national and international webinars and a booth at UMC on this subject.

 

Neuroscience Center of Excellence

Dr. Nicolas Bazan, Director of the Neuroscience Center of Excellence, together with department heads Dr. Frank Culicchia (Neurosurgery) and Dr. Lucio Miele (Genetics), voiced support in a letter to the editor in the Times Picayune/Advocate for Dr. Steve Nelson’s recent appointment as the permanent chancellor of LSU Health New Orleans.

 

Office of Graduate Medical Education

The 24-25 AY GME Coordinator Advisory Group has been announced. The peer nominated and selected members are tasked with improving the Residency and Fellowship Program Coordinator roles. Those serving are:

  • Sherilyn Munoz- Dermatology Residency Coordinator
  • Dana Brian- Radiology Residency/Fellowship Coordinator
  • Marcy Navarre- Emergency Medicine, Baton Rouge, Residency Coordinator
  • Krystal Fisher- Geriatrics/Hematology & Oncology Fellowship Coordinator
  • Katherine Dickens- Psychiatry Residency Coordinator.

 

Office of Alumni Affairs

Alumni from as far back as 1964 came together for a lively reunion over a recent weekend in June. The classes met at various locations throughout the city to reconnect and celebrate their shared history.

 

Office of Medical Education

The Isidore Cohn Learning Center and Russell Klein Center for Advanced Practice were recently reaccredited through June 30, 2029, by the American College of Surgeons. The space, located on the 5th and 6th floors of the Lions Building, is considered an American College of Surgeons-Accredited Education Institute (ACS-AEI). The ACS-AEIs undergo a rigorous application and evaluation process to ensure standards for all phases of learning. After the survey and secondary review by the Accreditation Review Committee, all criteria were found to be compliant with the standards. Several strengths and best practices were identified, and LSU was commended for its outstanding work and dedication to educating in simulation. Dr. John Paige and the Office of Medical Education thanked the faculty and staff who contributed to the success of the site visit as well as the ongoing support of simulation activities within their individual curricula.

LSU DayThe Office of Medical Education recently participated in LSU Day at the Capitol. All LSU campuses were invited to showcase the unique components of their campus at this annual event. The office showed off the simulators.

 

 

Office of Medical EducationThe Otolaryngology Department held their Annual Anatomy Course in the Center for Advanced Practice recently. Eighteen ENT residents had the opportunity to dissect out the facial and neck anatomy on a fresh cadaver specimen with the guidance of LSUHSC expert faculty and anatomists. The ENT Anatomy course is led by Co-Course Directors Drs. Alyssa Oviatt and Vilija Vaitaitis. Participating LSU ENT faculty included Dr. Laura Hetzler, Dr. Moises Arriaga, Dr. Laura Pelaez, Dr. Katie Melder, Dr. Lisa Morris, and Dr. Graham Boyce. Anatomy faculty Drs. Jay Mussell and Sonya Van Nuland are noted for promoting the education of LSU SOM learners.

 

The Center for Advanced Practice in partnership with ENT and Anatomy faculty hosted a Temporal Bone Anatomy and Surgical Dissection Course delivered to an interdisciplinary audience, including LSU ENT resident physicians as well as audiology doctoral students from LSUHSC New Orleans Allied Health Professions.

Ortho departmentThe Department of Orthopaedic Surgery hosted a monthly skills training lab for orthopedic residents and medical students with the support of Optimotion Implants. The lab focused on an approach to minimally invasive lateral subvastus total knee arthroplasty. This first-time course featured guest Professor Steve Nguyen, MD and also had instruction from Eric Bonenberger, MD. More than 20 students, residents and faculty participated.

 

 

 

 

Surgical boot camp

PGY-1 LSUHSC Surgery residents attended Surgery Boot Camp for three days in July, hosted by Dr. John Morrison (General Surgery). The boot camp receives support from industry partners, including Medtronic, Ethicon, Boston Scientific, Baxter, Fuji Ultrasound and Steris Endoscopy, and serves as an introduction of surgery faculty and the facilities to new interns. Fuji ultrasound machines were used throughout the training activity and a special thanks to Steris Endoscopy for providing porcine tissue for suture practice.

 

Otolaryngology – Head & Neck Surgery

Dr. Stephen Hernandez has accepted the role as the Residency Program Director for the department, effective July 1, 2024.

Dr Lisa Morris is a course director for the American Academy of Facial Plastic and Recontructive Surgery (AAFRPS) annual meeting in October 2024.

Dr. Laura Hetzler is on three panels and Dr. Alyssa Ovaitt is on a panel at AAFPRS in October 2024. 

Dr. Lisa Morris and Dr. Laura Hetzler are both presenting at the Cleft and VPD Conference in November 2024 in Charleston.

Melda Kunduk, PhD, served as the session chair for Voice Disorders III at the 13th International Conference on Voice Physiology and Biomechanics in Erlangen, Germany. Other oral presentations and posters included:

  • Ikuma T, McWhorter AJ, Kunduk M. Evaluation of machine-learning pitch estimation algorithms. Oral presentation.
  • Ikuma T, McWhorter AJ, Samlan RA, Schraut T, Döllinger M, Kunduk M. Vocal transient analysis using piecewise linear approximation. Poster presentation.
  • Kunduk M, Ikuma T, McWhorter AJ, Schraut T, Döllinger M, Samlan RA. Voice onset and offset oscillatory patterns based on place, manner and voiced/voiceless consonant environment. Oral presentation.

Faculty also had a presence at the 53rd Voice Foundation Annual Symposium in Philadelphia, PA in June:

  • Ikuma T, McWhorter AJ, Kunduk M. Automatic detection of subharmonics in acoustic voice signal. Poster presentation.
  • Ikuma T, McWhorter AJ, Kunduk M. Subharmonics in normal voice: an acoustic database study. Oral presentation.
  • Ikuma T, McWhorter AJ, Kunduk M, Story BH. Synthesis of subharmonic voice with kinematic vocal fold model. Poster presentation.

Several faculty collaborated on a recent grant submission to the Basic and Advanced Clinical Science Research Collaboration in Action Program (CAP) 2024 Our Lady of the Lake Health & LSU. The grant, Understanding “Cancer Voice”: Towards low-cost early detection of laryngeal cancer, includes Melda Kunduk, PhD (Dept. Communications Sci. & Disorders, LSU PD/PI); Takeshi Ikuma, PhD (Dept. Otolaryngology–Head & Neck Surgery, LSUHSC MPI); Gerald Knapp, PhD (Dept. Mechanical and Industrial Engineering, LSU Co-investigator); Andrew McWhorter, MD (Dept. Otolaryngology–Head & Neck Surgery, LSUHSC Our Lady of the Lake Voice Center); Lacey Adkins, MD (Dept. Otolaryngology–Head & Neck Surgery, LSUHSC Our Lady of the Lake Voice Center); and Daniel Nuss, MD (Dept. Otolaryngology–Head & Neck Surgery, LSUHSC Our Lady of the Lake Head and Neck Center).

 

Pathology

Rachna Jetly, MD, recently assumed the additional role of Vice Chair for the department.

Ellen Connor, MD, PhD, recently assumed the additional role of Pathology Clinical Content Co-Director.

The department hosts an educational webpage, “Case of the Month,” that highlights complex, rare and unusual clinical presentation pathology cases encountered in the department’s practice. Every month, a faculty and resident present a case with the associated pertinent clinical and pathology findings, followed by a discussion on the diagnosis and its differential diagnoses. A few multiple-choice questions are provided, allowing learners to assess their understanding of the topic and identify areas needing improvement. The diagnostic dilemmas encountered in the cases and discussions on the topic are intended to serve as an educational resource for medical trainees and for pathologists for work-up of similar cases. The website currently contains 10 cases. Drs. Rachna Jetly and Grace Athas spearheaded the endeavor.

 

Pediatrics

The department recently held Pediatric Research Day. Frankie Robertson gave the keynote address, How Research Shapes What We Do Differently. Scott Macicek provided opening remarks and Andrew Abreo moderated the oral presentation session. The Planning Committee was made up of Julie Gallois, Tamara Bradford, Stuart Chalew, Meghan Howell, John Schieffelin and Kelly Allerton. Andrew Abreo, Tamara Bradford, Rebecca Buckley, Julie Gallois, Stephen Hales, Sunyoung Kim, Thomas Kimball, Michelle Knecht, Jay Kolls, Shannon Palombo, John Schieffelin, Tina Simpson, Luke Wall, Rohan Walvekar and Benjamin Watkins served as judges. Rebecca Calix, Kegan Reid, Hanh Rimmer, Taylor Rogge, Emma Simon and Ashley Walker assisted with event setup and organization. For those who missed Pediatric Research Day, you can view the program and abstract booklet here. You can view pictures here.

The division of neonatology recently hosted a Vermont Oxford Network Subgroup Meeting at Children's Hospital. The Vermont Oxford Network is an international collaboration of NICUs dedicated to improving the quality, safety, and value of care for newborn infants and their families through a coordinated program of data-driven quality improvement, education, and research. Children's Hospital and each of the other LCMC birthing hospitals are part of the network. Drs. Julie Gallois, Michelle Knecht, Christy Mumphrey, and Brian Barkemeyer organized the meeting, which was attended by more than 60 participants representing seven different institutions. Presentations included topics such as perinatal care of the complex fetus, neonatal transport, perioperative transitions of care, disaster preparedness, and trauma informed care.  

The department was actively involved throughout the School’s recent QI & PS Forum. Dr. Amanda Dumas, Ambulatory Division of Pediatrics, served as keynote speaker. Drs. Shannon Palombo, Julie Gallois and Leslie Reilly served as forum moderators. Department representatives were responsible for five of the seven oral presentations and six of the 42 posters.

Dr. Maria Velez (Hematology/Oncology) was featured in a recent Children's Oncology Group's Foundation newsletter about efforts related to diversity and addressing health disparities.

Drs. David Rayburn and Katie Hodgdon have accepted new leadership roles for the Pediatrics-Emergency Medicine Residency Program. Dr. Rayburn will serve as Program Director and Dr. Hodgdon as the Associate Program Director. Dr. Anna McFarlin served as program director for the past nine years. By developing the program from the ground up, she has made a profound impact on children who present to the emergency room. 

Dr. McDonough in Washington, DCDr. Elizabeth McDonough (Gastroenterology) recently traveled to Washington, DC with other members of the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) to meet with staff members for Rep. Steve Scalise and Sen. Bill Cassidy to support the Medical Nutrition Equity Act, Safe Step Act for biologics and the ban on water beads. Dr. McDonough in Washington DC

 

 

 

 

 

 

 

Stuart Chalew’s and Ricardo Gomez’ (Endocrinology) study will be featured in the official Press Program for the American Diabetes Association’s 84th Scientific Sessions. The study, "Mean Blood Glucose-Independent Racial Disparity in HbA1c and Higher Risk for Severe Hypoglycemia Is Evident Among Participants in the Diabetes Control and Complications Trial", was selected based on its overall excellence in furthering the research and treatment for people with diabetes, as well as its potential appeal to the medical and general news media.

Dr. Amy Creel and Dr. Amanda Messer organized Visiting Professor Dr. Hayley Gans' time with the department. Dr. Gans is Professor of Pediatrics at Stanford University and shared her expertise as Director of Fellowships and met with several groups including department educational leaders, fellowship program directors, and subspecialty fellows. Her Grand Rounds presentation, "The State of Pediatric Subspecialties and the Academic Mission," reached nearly 200 people.

Peter Joslyn (Neonatology) has been selected as the co-editor of the SOAP Notes Blog, an offering from the AAP’s Section on Early Career Physicians (SOECP). The SOAP Notes Blog allows Section members to share information on various topics related to pediatrics, including clinical work, advocacy, career experiences, and wellness. Each month, the Section publishes up to two articles on the blog. Visit the SOAP Notes Blog at https://collaborate.aap.org/SOECP/blog/default.aspx.

Dr. Callie Roth (Hospital Medicine Division) has been named Pediatric Clerkship Director. She replaces Dr. Amy Prudhomme who served as Clerkship Director since 2017. Dr. Prudhomme will support the transition in the role of Assistant Clerkship Director for the third-year students. Dr. Leslie Reilly continues to serve as Assistant Clerkship Director for the fourth-year medical students, and Dr. Jessica Patrick-Esteve is transitioning from Assistant Clerkship Director for third-years to a more active role with the medical school in the Undergraduate Medical Education office.

Dr. Kimiyo Harris-Williams has been appointed as Medical Director of the LSUHSC School Based Health Center located on the campus of New Orleans Charter Science and Mathematics High School. Dr. Harris-Williams and her team deliver quality, adolescent-centered healthcare services on-site in a safe and confidential environment.

Dr. Harris-Williams was also selected as a Pediatric Champion for the NIH All of Us Research Program and is serving on the NIH All of Us Research Program Steering Committee and the Program's Executive Committee as well.

Dr. Zambrano with posterGenetics faculty Dr. Regina Zambrano presented her poster "Malignant Peripheral Nerve Sheath Tumors, a Malignant Transformation from a Plexiform Neurofibroma in a Pediatric Patient: A Case Report" at the 2024 Global Neurofibromatosis Conference in Brussels, Belgium. Dr. Zambrano in Belgium  

 

 

 

 

 

 

 

 

Physiology

Magazine CoverDr. Patricia Molina was featured on the cover of The Physiologist.

 

 

 

 

 

 

 

The NIH/NIAAA T35 Medical Student Alcohol Research Internship program began in June with seven new T35 Fellows. Technical seminars were provided by Eden Gallegos, Dr. Sydney Vita, Dr. Patrick McTernan, Nicholas Harris, Taylor Fitzpatrick-Schmidt, and Stephanie Lee, and research seminars were provided by Dr. Stefany Primeaux, Dr. Janos Paloczi, Dr. Liz Simon, and Dr. Michael Salling.

Lauri Byerley presented an abstract “Protein’s Effect on the Gut Microbiota and Its Metabolites: Our Virtual/Remote Recruitment Efforts” at the American Society of Nutrition meeting in Chicago, IL, June 29- July 2nd.

Scott Edwards presented the talk "The Importance of Interprofessional Education in Developing Collaboration-Ready Biomedical Scientists for Translational Research" at the American Physiological Society Summit in Long Beach, CA.

Edwards also presented two talks at the 2024 Research Society on Alcohol meeting in Minneapolis, MN: "Preclinical Research on Pain & Alcohol Interactions and Pain and Negative Affect in Relation to Alcohol Use Disorder Risk in People with HIV".

Edwards presented a talk, "Intersection of Pain and Alcohol Use Disorder Risk" at the University of Virginia Brain Symposium in Charlottesville, VA.

Robert Siggins presented a talk “Alcohol's Unseen Harm: Fueling Immunosenescence & SASP in HIV+ Individuals" at the Research Society on Alcohol meeting in Minneapolis, MN.

Liz Simon chaired the symposium "Mitochondrial adaptations: basic mechanism in alcohol-associated end organ injury" and gave a talk “Alcohol-mediated mitochondrial adaptations in the skeletal muscle” at the Research Society on Alcohol meeting in Minneapolis, MN.

Sydney Vita presented a talk titled "Neurodegenerative consequences of blood-brain barrier injury" in the Spring 2024 Physiology Seminar Series.

The department has had several recent poster presentations:

  • Gallegos EM, Simon L, Molina P. "Chronic binge alcohol alters hepatic expression of metabolic genes in SIV-infected female rhesus macaques". Annual Meeting of the Research Society of Alcoholism, Minneapolis, MN. June 2024.
  • Gallegos EM, Molina P, Simon L. "Ethanol increases cholesterol and decreases ATP in HepaRG spheroids". Annual Meeting of the Research Society of Alcoholism, Minneapolis, MN. June 2024.
  • PM McTernan, RW Siggins, H-Y Lin, PE Molina and DA Welsh. "High Alcohol Use Increases Caspase 1 Activation in Senescent CD8+ T Cells in People With HIV". Annual Meeting of the Research Society of Alcoholism, Minneapolis, MN. June 2024.

 

Psychiatry

Dr. Kim Kent (Psychology) was a guest lecturer at the UCLA Neuroimaging and Bioformatics Core, G. Oppenheimer Center for Neurobiology of Stress and Resilience, David Geffen School of Medicine. The topic was "Treating Gastroenterology Patients: An Integrated Psychotherapy Approach for Complex Trauma and Historically Unstable Attachment Co-morbidities.”

Dr. Michelle Moore (Psychology) and Dr. Bob Zura (Orthopaedic Surgery) presented with a colleague from University of Arkansas for Medical Sciences at AAMC Group on Faculty Affairs Professional Development Conference in June on ”Holistic Faculty Development Framework Conceptualized Through Wellness.”

Dr. Sebastian Del Corral-Winder (Psychology) and Dr. Megan Maher (child psychiatrist) brought school supplies to a clinic for primarily Spanish speaking families. Dr. Del Corral-Winder gave a presentation in Spanish for parents regarding barriers and needs of children seeking Special Education. 

Dr. Shane Bierma (Psychology) was awarded the Cookie Medallion by the Section of Psychology by baking the best tasting cookies at the section’s 3rd Annual Cookie Challenge. She has won the coveted baking award three years in a row for her delicious chocolate chip cookies!

The Psychology Section was well represented at the Louisiana Psychological Association Annual Convention:

  • Dr. Nathan Brown moderated a discussion for a "Health Psychology Panel" that featured Dr. Lindsey Poe, Dr. Sandy Hyatt and Brad Landry​.
  • Dr. Shane Bierma presented during the Science Cafe about her research on "Diagnostic and Treatment Considerations in Individuals with Low Cognitive Capacity.“​
  • Dr. Hannah Walsh presented on "The Mitigating and Aggravating Factors of Mental Illness on Case Law Related to Capital Punishment in the United States." 

 

Radiology

Dr. Douglas Casey presented “Tiny Tech, Big Smiles: Toy MRI Scanner Transforms the Pediatric Experience” at the American Roentgen Ray Society (ARRS) annual meeting in Boston, MA. This exhibit was a collaboration between Dr. Casey, Dr. Mark Rocco, Dr. Mae Igi, Dr. Neel Gupta, Dr. Jagan Gupta, and Dr. H. Dimmit.

Dr. David Smith presented “ILD: The Big Four” at the Southern Radiological Conference in Point Clear, AL.

 

Surgery

The department held its Second Annual Research Symposium earlier this year. Herbert Chen, MD, Chair of the UAB Hospital and Health System’s Department of Surgery, provided the keynote address.