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The Vets First podcast is a research-based podcast that focuses on the VA healthcare system and its patients. Instead of being just another research podcast, the Vets First podcast was created with a primary focus on the Veterans and their stories. The hosts, Levi Sowers PhD, and Brandon Rea work to bridge the gap between the state-of-the-art research being performed at Veterans Affairs and the Veterans themselves in an easy-to-understand manner. Importantly, Levi and Brandon want to assist researchers around the country to better understand the needs of Veterans. In this podcast you will hear interviews from Veterans with specific conditions and then hear from VA funded researchers who are studying those very topics as well as other highlighted services the VA provides.
The Department of Veterans Affairs does not endorse or officially sanction any entities that may be discussed in this podcast, nor any media, products or services they may provide.
Announcer: Welcome to the Vets First Podcast, a research-based conversation centered around the VA health care system, its services, and patients. From Iowa city, Iowa, here's your hosts: Dr. Levi Sowers and Brandon Rea.
Levi Sowers: Welcome back to the Vets First podcast. As always, I have Brandon Rae.
Brandon Rea: Hello, everyone.
Levi Sowers: Today, we have Dr. Lina Kubli, the Scientific Program Manager for the Office of Research and Development. Her focus is sensory systems and communication disorders. And we're really lucky to have you here. Dr. Kubli, welcome to the Vets First Podcast.
Lina Kubli: Thank you. Hello, everyone.
Levi Sowers: You know, I think my first question that we typically ask people and I like to ask is where do you come from? How did you end up as a scientific program officer for the VA?
Lina Kubli: So like some people, I didn't have a direct path to audiology and to becoming a scientific program manager at the VA. I knew that I wanted to work with people. I had thought about medical school but really didn't think that I had wanted to spend the time going through that kind of training. Little did I know, and then B, I honestly didn't even know that I could do it. I was beginning to doubt whether I had what it took to go through that long of training. And looking back, it was kind of silly that I didn't pursue it. My dad really wanted me to go to medical school, but I knew that I wanted to do something with patient care in something in science, and I was really intrigued by not the things that were known and and applying them, but more about the questions that were unanswered.
Levi Sowers: Yeah, sure. And so where did you grow up and where did you go to high school?
Lina Kubli: Oh, when I got to high school, I went to Wootton High School in Maryland.
Levi Sowers: So you grew up on the East Coast?
Lina Kubli: I grew up on the East Coast. Never really left the area. Yeah, but I did- I was born in India and I spent the first seven years of my life in India.
Levi Sowers: Oh, wow. Very cool. Cool. Yeah. So where did you go to college?
Lina Kubli: I went to University of Maryland first, and it started out in biochemistry. And then at some point, I decided I was an absolute disaster in the labs and it was not really setting. I completely was just not a lab person. And I knew that I had to do something where I was interacting with people. And so I switched majors and I ended up in hearing and speech as an undergrad just towards the last year and a half of finishing a degree and decided I liked it, but I didn't really want to do clinical, just clinical work. I knew that I would if I did something that would be related to research.
Levi Sowers: Mm hmm. And so for your PhD, did you also state Maryland?
Lina Kubli: I did. I did. Well, at that. At that point, I had a family. I had- I went back to get my master's degree. And once I finished my master's, I was actually working at Walter Reed Army Medical Center at the time. And I was recruited to working on a fantastic research project, which, by the way, was funded by the VA. So it was a DOD VA funded project and all of the service members that were tested that were returning from deployment were tested at Walter Reed Army Medical Center. So this was around 2007, 2008. And at that time I was considering going back for a Ph.D., but I didn't want to quit my job because it was such a fantastic project that I was really enthusiastic about. So the director of the clinic said to me, Why do you have to quit? Can't you find a program that can accommodate your schedule? You know? And I thought, How am I going to do this? I have two kids at the time, and I, I found two options. One was University of Maryland. I didn't want to move away because I like the jobs in. And then the second option was working at Gallaudet University. And that kind of intrigued me because I'd never worked with a completely deaf popular nation. I didn't know what that environment was like, and I thought that would be good exposure. Plus, Gallaudet was really willing to be flexible. University of Maryland would have wanted me to quit my job to be full time committed not only in the program, but also to help out in the labs. Yeah, I knew that I couldn't afford to do that, so I ended up taking the opportunity to study at Gallaudet, which was really interesting, and I worked my job and then I would leave to go to classes in the evening. So for a couple of years it was kind of crazy because I was working for kids with two kids right?
Levi Sowers: Which are like three like three full time jobs.
Lina Kubli: Really? Yes, you're right.
Levi Sowers: That's impressive. Yeah, that's crazy. I know. I have one child and I feel overwhelmed by that. So I can't imagine going to school and having a child and working. That's crazy.
Lina Kubli: You know what? I think if you have a supportive family and my daughter was great. She was really at one point I said to her, do you- you know, I could quit because all these neighbors and friends, they were mostly stay at home moms. And she said to me, that would be embarrassing, mom. And I said, That would be embarrassing to you. And she goes, Yeah, because you work with service members. I'm proud of what you do.
Levi Sowers: Oh, absolutely.
Lina Kubli: Yeah. So it's really she was my biggest super girlfriend. Yeah. Yeah.
Levi Sowers: That's awesome. Good words of encouragement from your tiny human. Yeah, I get those once in a while, and it's nice to have.
Lina Kubli: Oh, that's fantastic. That's really good.
Levi Sowers: You know. You know, So I think the first question is, what is a scientific program manager? Um, you know, the VA has this office of Research and Development, which is split into four main branches, I believe. And there's those four main pillars of research, at least for now. You're in part of one called Rehabilitation Research and Development, and it is split up into a little bit further groups. And you're one of the people that sort of filter, I believe, filter grants that come in to the VA or award calls for funding, if you will. That's what we call them in our world. And so can you tell me a little bit about what you do and what your role is at the VA?
Lina Kubli: Sure. So as a scientific program manager, I oversee the program within Rehabilitation Research and Development Service. As you mentioned, the applications that come in a broad range of topics that include vision, hearing, vestibular research, and they could be speech and communication sciences. So people that we have stroke and need rehabilitation or projects that are related to traumatic brain injury and multiple sensory issues that can occur afterwards. And so it's a scientific program manager and I evaluate the letters of intent that come in from different investigators throughout the VA and see if it's appropriate because we have four services that fund research. So some projects are a little more basic. The VA funds research anything from basic to health services where we're really looking at health care delivery types of questions. And so my job is to look to see if the applications are appropriate and then oversee. Even though I don't really interfere with the meetings, try to I will recruit all the scientific panel members that are needed to evaluate the applications because they have to have an expertise in a particular area. So if an application comes in glaucoma related and they might be looking at A.I., for example, it would be finding those reviewers that have knowledge of those areas and then putting together a panel of experts that can evaluate the applications. And then once they come in, then listening to that and then based on the scores that the applications may get, making recommendations for what is needed for veteran care and what is ready to move forward.
Levi Sowers: When you get someone to review an award application or a grant application, I think they're technically called awards at the VA because they're internal awards. Do you recruit only scientists or people, experts really in the field from within the VA, or do you look outside the VA too?
Lina Kubli: That's a great question. I look for people, they have to be either wanting to work at the VA so they would have a letter, and that's a requirement because it's an intramural funding resource. Congress appropriates this for people within the VA, but they could be at universities as long as they have an agreement with the VA office that they want to work at, that they can submit that proposal. Then if it should be funded, they can then be part of the VA and work on that project. So it really requires the person who's interested to go to their local VA medical center and make that arrangement. But I also do recruit people in areas where we have gaps. So, for example, low vision research in the vision area, we don't have a lot of submissions in that. And so I've actually gone out and talked to different people and gotten them to submit applications. Or Coogler implants is another area where I do a lot of recruiting and getting people interested in applying to the VA. And we do have a lot of new investigators that have never submitted to the VA before because they have an expertise and we are lacking in that expertise.
Levi Sowers: And how many applicants do you get in a typical cycle?
Lina Kubli: Our panel is pretty small, probably about 20 applications, 16 to 20. So it's really not that many. And again, it depends on what stage the application is in. So if they're asking a lot of mechanistic questions, meaning they're really looking at work, basic science related questions, they would go to another, another service that can fund it. So some applications are turned away because they don't really meet the criteria for habilitation research.
Levi Sowers: I see when a grant does come in, it is reviewed by usually three people, right?
Lina Kubli: Yes.
Levi Sowers: You talked about that a little bit earlier. So when you put those people together, are those people within the VA too, or are they really researchers? Are they also from outside the VA?
Lina Kubli: And most of the panel members are outside the VA are- we are required for our faculty members, which is the Federal Advisory Committee members, 70% to 80% of them should be outside of the VA. So we try most of them are affiliated with universities. There are many that have never applied to the VA and don't- may have niche funding or funding from other federal agencies. So really we try to get a mixture. We don't want all VA, but we certainly want some input from V.A. because they would understand some of the complexities of, you know, navigating issues that may occur when you are trying to implement a project in the VA.
Levi Sowers: Yeah, that's some good insight there about sort of the process of how a VA investigator like me would submit a grant or an award application and it gets reviewed by a panel and you usually get three tries at that, right? As an investigator.
Lina Kubli: It depends on the kind of application submitted. So it's- we've got many different types of awards. We have what NIH, what is similar to an NIH award, it's called the merit application. We also have small projects in rehabilitation research. So different services may offer different types of awards for the merit award. You do get three submissions. I'm sorry, I'm not sure why, but sometimes that's okay.
Levi Sowers: We've gotten so used to dogs barking. Oh yeah, we've had children screaming and it's crazy. We've done a few of these. It's a candid experience, that's for certain. Yeah. Let's think about it. So you're talking about certain areas of research that you're kind of recruiting for, like asking for applications. Can you highlight that again or highlight more on that? Like which areas are you most excited to kind of expand upon in terms of research?
Lina Kubli: If I think there are a lot of projects that have been put forth that I'm really excited about, it's it's a diagnostic piece trying to evaluate injury when there is no diagnosis currently or trying to evaluate the injury before it becomes something like a vision loss or hearing loss. So the diagnostic piece really is exciting or use of artificial intelligence to try to figure out through many different algorithms, you know, how we can best diagnose different types of issues that can happen without using without taking too long and trying to, you know, use telemedicine as much as possible for those patients that may have long commutes. So some of those areas are really exciting. So the diagnosis piece, I know with the hearing program that that is an important element in the same thing with the Vision program, then of course the treatment part is really important, trying to move things from animal studies to eventually where it can make an impact on veteran care. I think that is so important because as we evaluate research, there are times when things are funded for over 20 years, but they may or may not make an impact. And so it's really the impactful research. And VA has a good track record of lots of projects like tinnitus research that's been very impactful and has made a big difference in veteran health care and not only in veteran health. Health care, but it's also the tinnitus. The progressive tinnitus management program that was developed at the VA is also used in the civilian sector. It's used on the DOD side and so those kinds of projects that translate to patient care are the ones that are the most exciting. But I know that there are different stages of research. Not everything can be immediately ready for that type of transformation.
Levi Sowers: Yeah, I think what you're really highlighting is for at least I refer to, is translational research. So things that can be impactful and 5 to 10 years in a veteran, right? So you know I study animals but the work that we do can directly influence the way clinicians think about disease, in this case, diagnostics for treatment. Right. And so I think that the VA has really made a huge focus on translational research and how can we directly benefit to veterans in a shorter time period to improve their lives and outcomes of their lives, comorbidities and things like that, I think is sort of the focus that I've come to fruition in the past decade or so that I've been here. So it's pretty cool to see. I think the VA, a lot of people don't understand that VA research has had some really groundbreaking discoveries in the past, and I think moving towards that again is is something that they're really focusing on, which is kind of neat to see. So another question I want to ask is, you know, this is a season that we've done on blind veterans. What are some of the biggest research focus areas you think are important for vision, loss and veterans?
Lina Kubli: I think that what chronic for chronic related conditions that can happen with veterans trying to find therapeutics or rehabilitation approaches that can make an impact on their daily life and, you know, functional ability. So it's really about looking at the person overall and some of the challenges that they may face. And it's not just vision loss. Many veterans have hearing loss. So when you talk about dual sensory issues is very hard to address. I understand that it's not easy, but having seen servicemen on the Walter Reed Army side and then also Walter Reed National Military Medical Center, I can tell you from the people that I've evaluated, they are very complex. It's not so easy. And many of them have similarities in the kinds of symptoms that they report in the visual domain as they do in the auditory domain. And so I often wonder if it's a sensory issue in general or how or perhaps multiple areas are affected because of the kind of combat exposures that veterans have. And it's really looking at whole health again. And that's hard to do for investigator or we're focused in a specific area. But it is very important because they can go to one provider and talk about vision kinds of issues and they may get an evaluation and told they're fine and then they come to another provider and now they're having to report their case history again and they may talk about the same things in the hearing domain. But if there's a multidisciplinary team approach, then it's really difficult to address all of the needs of veterans.
Levi Sowers: Now, of course, you know, I think that the whole idea that, you know, one of the big focuses is the season is going to be on TBI related vision problems and what that looks like. Well, the reality is that it looks like a whole gamut of things. There's all these problems that come along with TBI. There's some letters, some that are from the onset, some of that develop over time and, you know, long term pain, headaches, vision loss, you know, the idea that that you have overall sensory abnormalities is something that I'm really taking a liking to in my research, that it's it's these distinct dysregulation of sensory input on multiple fronts because that's how we perceive our world, right? And when that goes haywire, it can be really bad for some people. And that's become a big focus of what we work on, not just migraine per se, but sensory processing.
Lina Kubli: And sensory integration. So one of my first jobs actually a long time ago that led me to be really interested in this area, was working with a group of children who had speech and language as their main issues level for classroom. This was when I was- had just finished my undergraduate degree and was trying to figure out what to do in terms of graduate school, and I was interested in speech pathology, but had worked with this- in this classroom with kids who had traumatic brain injury. Some of them had mothers who were cocaine addicts. Some of the kids in the classroom had undiagnosed related issues, but they all had a common element. They had difficulty with both auditory and visual processing, which was interesting. They had severely delayed language and lots of neurological issues, so they had difficulty with motor coordination and the school was really focused on a multi disciplinary approach of doing petty o.t, all kinds of services. But it was really intriguing for me to see how much progress they made in the few months that I was there. I took on another job, but while I was there, it was- it was fascinating to me how much of a brain is affected in one domain, how much another part can take over. And I know that it's hard to cite examples, but we had a child who was born with a cocaine addiction, and these are toddlers. I'm talking about three years old. And she would have these withdrawal efforts even after three years of being born with an addiction and had a real disconnect with people. And so to see that kind of progress over time leading to what happens with service members. So getting back to adults, the same kind of thing was true with service members that we saw at Walter Reed that had multiple issues that kind of vision, loss, hearing loss and even motor loss. And through repeated therapy that sometimes you go as a provider, is this really going to work? It was amazing to see that after six or eight months they can regain their use of hand function where they had lost it completely. And so it's those types of those types of strides that they can only make through that- a multi-disciplinary approach. And I go off on a tangent on you.
Levi Sowers: No, that was- that was great. That was a really great answer. I think we're getting to be towards our limited time, but we have time for a couple more questions, I think. Is there anything you want to talk about that you think is important to talk about today?
Lina Kubli: Well, I wanted to just highlight that the VA is focused on making improvements in veteran care, and that's the ultimate goal for the research. It's very unique from other funding agencies. Not to say that the other funding agencies, they have concerns about patient care detail is really invested in three goals. One is to make sure that the innovations that we come up with make an impact on health care. The second piece is to train VA clinician scientists and researchers to take on some of those tasks. So it's the career development piece that's really important. And the third is really to make sure that whatever we do ultimately is veterans centric. And so we want our veterans to get the best care. And I think the message would be even for veterans who are out there and feeling kind of lost, whether it be clinical care or research, know that there are opportunities, that there's always someone available to reach out to. And I can say this from the service members that I've seen at Walter Reed, sometimes it feels like you could be lost in a big system, but trust me, there are providers who are there with the VA because they are so concerned about veteran care and because they feel that this is their duty to help the VA. And so if you find that you're running into a roadblock in one domain, please go back and talk to somebody else, because there's always someone there that is willing to invest the time to help guide you.
Levi Sowers: Of course. Yeah, I think that's a good message and that sort of plays into what we've seen this season, which is reaching out to these veterans who go from fully, fully functional vision to no vision, right, Brandon? These people, well, they really highlighted how I mean, initially you kind of feel alone and what where do you go from now? And like, I think a common theme we're hearing is how they make these connections, how they realize they're not alone, how there's a community of other veterans have experienced similar things that they have and how that's improved their lives. And that's why that's through the VA. Yeah, we've had a lot of good feedback about that and reaching out for help. And the blind rehabilitation centers have been a really big deal for them as well. So there's a lot of stuff out there for people who lose their sight, especially veterans. And I think that that is just a phone call away oftentimes for veterans who need help with hearing loss or vision loss-
Lina Kubli: Or even other issues. There are times when all of it can be a lot to deal with. So there are, you know, lack of sleep. There are post-traumatic stress disorder. It can be a multitude of symptoms. And I think it's just a matter of reaching out to providers and making sure that that communication avenue is kept open. And really, we're very appreciative of veterans who come in, who volunteer their time for all of these research studies. I can say at Walter Reed National Military Medical Center and Walter Reed Army Medical Center, we were seeing people that were severe. They had serious bodily injuries. I mean, I'm talking about people who are going through women mutations and all kinds of surgeries, and yet they were volunteering for research studies. And it just I mean, it speaks so much to the kind of dedication that veterans have and servicemembers have. And we appreciate that. I think all of us appreciate that so much as we are looking very hard to find those solutions that can really benefit health care for them in the long run.
Levi Sowers: Awesome. Awesome. That's a really good point. Now we get to the more fun. Not that that wasn't fun.
[laughter]
Levi Sowers: First off, is this your first podcast?
Lina Kubli: It is!
Levi Sowers: Oh, well, that's exciting. So everybody I mean, I've.
Lina Kubli: Well, I’ve done other interviews on like XM Radio, but that was a long time.
Levi Sowers: Oh, that's cool!
Brandon Rea: And now you have just got two guys on a Zoom call!
[laughter]
Levi Sowers: Yeah, we’re not XM radio.
Lina Kubli: Great, I like these two guys on the Zoom Call.
[laughter]
Levi Sowers: You know, one thing I always ask people is what do you like to do for fun outside of work? So I had one the other day that was like, “Work.” And I'm like, no, you have to have something other than that!
Brandon Rea: No cop outs!
Lina Kubli: They took my answer!
Levi Sowers: What do you like to do outside of work for fun?
Lina Kubli: Oh, I love to. Let's see, what do I like to do? I love to travel. I have not been able to travel the last couple of years, but I love to travel. I love to go to other parts of the world- and this country there's a lot of the U.S. and I haven't seen yet! I've got a list of places that I'd like to go to.
Levi Sowers: I’m sure Iowa’s on there, it’s a hotspot!
[laughter]
Brandon Rea: Oh, of course.
Lina Kubli: Actually, Iowa is really interesting. I went to Iowa once and I really liked it. It's really low key and people are very friendly and I was warned that it would be super cold. And honestly, I think because I braced myself for the cold, I loved it.
[laughter]
Levi Sowers: Getting my face frozen- the whole bit.
Brandon Rea: Oh, you were here during the winter. I remember that. Yeah, that was pretty good. Yeah.
Lina Kubli: And I like working out. So I enjoy physical activity, lots of different types of challenges. I get really bored if I'm doing the same kind of thing for too long, but I like weightlifting, running. I don't love running, but I run - and swimming, yoga. So I think that it really brings about the mind and body connection. And so that's why I enjoy it.
Levi Sowers: I'm allergic to running, so I-
Brandon Rea: I like running!
[laughter]
Lina Kubli: I was too, when I started. I mean, honestly, it's like one of the hardest things anyone can do.
Levi Sowers: I was like running when I was like, in a sport, like I'm running to, like, tackle somebody or I'm running like an anticipation for, like a, like wrestling meet or something. When I'm running just for the sake of running, I don't know. I just get kind of bored, especially on a treadmill.
Lina Kubli: It's so true. I mean, my first run was down this road called Pikes Peak, and it wasn't Colorado or anything that adventurous. It was just a straight run. And I remember it was a 90 year old man who was speed walking faster than you could run.
Brandon Rea: Yes.
Lina Kubli: And my goal at the end of the race was to beat that guy. And I did, but only barely.
[laughter]
Levi Sowers: That's amazing. Well, you know, I think it's- it's interesting to talk to you about today because, you know, as a researcher, we put all the program officers on like I call you a program master program managers, in this case on a pedestal. Right. You're sort of these people who are like overlords for us - and I know you shake your head “No.”, but that's, like, how it looks like or feels like. So, you know, it's interesting to sit here and talk to you and get to know you a little more. And, you know, there's so many different ways to serve our country and you're doing that well. So awesome. Thank you for that.
Lina Kubli: Thank you!
Levi Sowers: And I’d love to have you on again. So that's another thing is, like, finding all this information to put into a podcast is difficult. So having you on again someday would be really cool. Yeah. So yeah, no.
Lina Kubli: I'm happy to do that. I just want it to be useful for your audience. That's what it really is.
Brandon Rea: Yes!
Lina Kubli: I think there's so many interesting things from Walter Reed, meaning that so I could go on about this, but I just I actually hope that I highlighted and I'll tell you this, that people there are times when people can run into the most difficult of circumstances, and I've seen this with servicemembers and that's night and they are people that they run into be they may not even realize it makes a difference, but it can make a big difference in terms of even suicide prevention.
Levi Sowers: Oh yeah. You know, it's interesting you say that we, you know, in a few of our interviews that we've done, Doug Lanphier in the first season-
Brandon Rea: Yeah, it was- Doug was not in a good place and he was calling in to cancel the dentist appointment that he had and the person on the other end line concerns and could tell that something was off and Doug attributes his life to that person on the other end of the phone helping him out.
Levi Sowers: That random receptionist that you never met?
Lina Kubli: Yeah. Because he was having thoughts of suicide at the time.
Lina Kubli: Yeah. And I can relate to that. I had somebody volunteer for a research study and I happened to call at the end of the day and I thought, I will - this, this person had just stopped in to the clinic and came to me and I called her and she's like, No, I'm not interested. But there's something about her voice that triggered Let me talk to her. Well, how are your services? You know, and I started speaking to her more, and the more I talked to her, I realized she said, look, I have a bag of pills and I'm just going to take them right now and I'm going, okay, can't get her. And I was using my cell phone. Well, I'm using my landline in my office phone to keep her going and try to identify where she was at and what unit could respond. And even on our website that we didn't have the suicide information readily available. So I'm calling. I called the police on the Walter Reed base and they found four units and eventually but I kept her talking for an hour and they got to work on time. So it's like you, but it doesn't always happen, you know?
Levi Sowers: No, of course…
Lina Kubli: So it's really important, I think, when people feel that desperate, that's they, no matter who you reach out to, it can make a big difference.
Levi Sowers: I guess one question I didn't ask that I want to ask now is like, what do you think the importance of research is within a system like the VA? The VA is a health care organization for veterans, and it's the largest health care organization in the United States. What role does research play in that?
Lina Kubli: Well, I think research plays a big role in the interactions that we have with our veterans, with the clinical partners in driving, what areas need researching. So, for example, in COVID 19 pandemic occurred, we were listening to clinical partners and there were different divisions within Office of Research and Development that immediately started evaluating the health care system, how it could respond, what were some of the concerns? How would you make the hospital safe when patients come in? And these are things that we were ahead of the game when it came to being able to respond to those kinds of questions because we had a concerted effort and were really concerned about veterans. So the other area was telemedicine, trying to figure out, okay, all of these veterans may not be able to come in for care, but they definitely need monitoring. So how do we go about doing this? And the VA has always been ahead in terms of telemedicine services that it provides for vision care. Also, thanks to the efforts of lots of people, including Dr. Martin Atlanta and just a whole host of people that have implemented being able to diagnose through telemedicine. And so looking at the value of that now, moving forward and looking at what are some of the barriers that people may encounter when they're getting care, What are some things how comfortable are they with that type of care? And so there are so many questions that are relevant for veterans. And it's such a big health care facility, as you mentioned, that it's important that they are very, Badran said, centric issues that are complicated that I don't think other funding agencies can address. DOD's the closest, but they're looking at more acute battle forward types of issues that can occur. What do we do to mitigate the type of loss that can happen on the battlefield? And how do we diagnose on the battlefield? But then the chronic related issues are something that only the VA can take care of, of diagnosing it, making sure that they're well taken care of. And the interventions that we come up with, our investigators come up with something that can be implemented, of course, to help our veterans.
Levi Sowers: Absolutely.
Lina Kubli: Did I answer your question?
Levi Sowers: That was a great answer. Yeah, I think that's about it for this episode. We're really excited to have you on the podcast today and we really want to thank you for coming on. So thank you!
Lina Kubli: Thank you for the opportunity!
Announcer: This concludes today's Vets First Podcast. For questions or comments relating to the program, please direct email correspondence to vetsfirstpodcast@gmail.com. Thanks for listening!