So can you tell us a little bit about the piano registry? How did this work up and what came out so far and what are the plans for the future?

Yeah, absolutely.

So as part of my career development award, one of the things I looked at was I used the Kaiser database, which in the United States is the closest thing we have to a population-based cohort.

And from that, then again, the Crohn's Colitis Foundation in the United States started the Clinical Research Alliance and Bill Sanborn was one of the people who started this.

And they were looking for proposals and we put out this pregnancy registry as something that the alliance could do together so we had 33 sites in the alliance and we said okay we're going to start this pregnancy registry and the alliance is a foundation you don't get a lot of money for research but you get something and so the 33 sites did this because they were interested, not because they were being paid well.

And so it started all the way back in 2007.

And we initially, the question was, are there birth defects with thiopurines, which was of concern, as you mentioned? And then what about this new medicine, infliximab and adalimumab? So back in 2007, people were stopping these drugs.

Could you comment on this a little bit?

Mandavan, do you wanna start?

I think it all, uh, for me, fell from things that I was very interested in doing.

So for example, the pregnancy research, it became patient advocacy.

It became education of physician and pr- physicians and providers.

Next year will be 20 years of the PIANO Registry, amazingly.

And so we had the benefit of many, many mothers with IBD who contributed, many universities who participated in the study, though they don't make a lot of money from it.

And so I think the impact really came from, in this case, doing something I really loved.

But Dr. Rothbaum, is there anything that you are really excited about? Or if you were a fellow right now, maybe something that you would be excited about?