Goal 3: Advance Translational Research

To facilitate innovation and accelerate research translation, knowledge dissemination, and implementation science that enhances public health.

Goal 3: Advance Translational Research

Access to healthcare for treatment/management of asthma and allergies, and funding of research on asthma and allergies

It is essential that people with asthma and allergies have access to affordable, quality healthcare for the treatment and management of asthma and allergies, and that research is funded to address prevention, screening, and lifestyle interventions to reduce the incidence and adverse effects of asthma and allergies. These conditions impose significant costs on the overall health care system and on patients and their families. ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Currently, more people than ever are struggling to live normal and healthy lives in the face of the daily limits that asthma and allergic diseases create. More than 25 million Americans have asthma, 15 million have food allergies, and 50 million have other allergic conditions. AAFA urges the National Institutes of Health (NIH) to continue to focus and accelerate research on asthma and allergies, which are life threatening chronic conditions for which there are no cures.

 

While asthma affects all populations, the burden of asthma falls disproportionately on the black and Hispanic/Latino—largely Puerto Rican—populations, and especially on minority children. Asthma is the third leading cause of hospitalization among children under the age of 15 and is a leading cause of school absences from chronic disease – accounting for over 10.5 million lost school days in 2008. Asthma costs our healthcare system over $50.1 billion annually and indirect costs from lost productivity add another $5.9 billion. Asthma claimed the lives of more than 3,400 Americans in 2010. According to the American College of Allergy, Asthma & Immunology, allergic diseases, which include asthma, are the fifth most prevalent chronic diseases in all ages, and the third most common in children.

Name of idea submitter and other team members who worked on this idea : Asthma and Allergy Foundation of America (AAFA)

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Goal 3: Advance Translational Research

facilitate journal submissions by creating a common submission template

To increase the efficiency of getting timely findings published and to decrease the administrative busywork of learning formatting requirements of each journal for each new submission and of reformatting manuscripts for submission to a new journal. Although this may only take a day or 2 to do, multiplied by thousands of investigators and by all their publications each year this administrative time adds up and takes away ...more »

Submitted by (@lindapeterson)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Formatting and especially reformatting journal submissions to fit different journal specifications (if a manuscript (MS) isn't accepted at the first journal) takes time, which decreases the efficiency of getting new translational (and all) scientific findings published. If the NHLBI could partner with e.g., cardiology journals to develop a common app. at least for the first submission, this would decrease the amount of administrative busywork needed to reformat MSs and improve efficiency of publication. This would be akin to the "Common Application" used by many colleges, which has increased ease and competitiveness of the applications and decreased formatting time. After acceptance a MS could be formatted according to the journal specs.

Feasibility and challenges of addressing this CQ or CC :

Challenge would be to have the journals agree on a common application format.

Name of idea submitter and other team members who worked on this idea : Peterson

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Goal 3: Advance Translational Research

To expand the NHLBI emphasis on lymphatic research

The critical challenge is to acknowledge the central circulatory role of the lymphatic system and its requisite ability to provide integration of the circulation with the immune system. The NHLBI is challenged to provide programs, resources and education to stimulate and encourage increasing research into the function and the dysfunction of the lymphatics in human health and disease

Submitted by (@rockson)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

The poorly understood, yet vital lymphatic component of the cardiovascular system ensures the internal environment for cellular function. Dysfunction of this system can create regional disturbances (lymphedema, lymphatic vascular malformation, lymphangiectasia), lead to genetic presentations of complex disease, and also contributes to the pathogenesis of coronary disease, congestive heart failure, chronic venous disease, dyslipidemia, cancer metastasis, infection, inflammation, autoimmune disease, diabetes, gastrointestinal malfunction and many other pathologies. Improved and intensified research approaches will help to solve these compelling problems in human health and disease.

Feasibility and challenges of addressing this CQ or CC :

This CC is eminently feasible, inasmuch as compelling research questions have already been identified and the tools and technologies are available to address them. The missing ingredient is funding and sufficient motivation of the investigative community by the NHLBI to step forward and address the problems.

Name of idea submitter and other team members who worked on this idea : Stanley G. Rockson MD

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Goal 3: Advance Translational Research

The "Metagenome"

How could we best understand the interplay within the metagenome (the nuclear (nDNA), mitochondrial (mtDNA), and microbiome DNA), and between the metagenome and environment as a cause for individual variability, including susceptibility to disease and therapeutics? Could the genomic “chimerism” possibly be related to reported sex differences in HLBS diseases? • Most factors needed for mitochondria are encoded by nDNA. ...more »

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Would allow understanding the basis for complex individual variations beyond the current focus on the nuclear genome

Feasibility and challenges of addressing this CQ or CC :

Feasible in 10 years.

For example, the issue of “chimerism” between mtDNA and nDNA is intriguing: every cell, male or female, contains mtDNA and mitochondria of female (maternal) origin. Mitochondria are cell’s main energy engine, essential in all cells with high energy expenditure, such as myocytes, but mitochondria are also emerging as a major source of pathogenic reactive oxygen species in connection with a variety of heart, lung, blood, sleep diseases.

 

 

High complexity requires researchers working across discipline boundaries, big data science, modeling

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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Goal 3: Advance Translational Research

T4 Translation Research Informing Early Stage Translational Research

There is a need to utilize insights gained from T4 translation research and implementation science to inform the design and execution of early-stage translational research and clinical trials.

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

• Assure that early stage translation research will be suitable for implementation in real world setting

• Aligns the research interventions from T1-T3 research to those appropriate to T4 research

• Potential to focus early stage research in key high burden areas

• Provides research community an understanding of the connections from early stage to late stage translation research which will potentially refine research strategies and directions at all levels

Feasibility and challenges of addressing this CQ or CC :

• Promote the importance of translation to population of heart, lung, blood, and sleep researcher to broader research community

• Potential for more T4 research contributions for guiding investment into translation research from T1-T3

• Provide avenues for T1-T3 investigators to translate their ideas into positive outcomes for population health

• Successful T4 research will stimulate feedback loop and identify opportunities for early translation research

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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Goal 3: Advance Translational Research

Improve patient compliance through community health workers

What are effective strategies for community-based participatory dissemination and implementation research initiatives in rural settings? • Limited number of studies that adapt evidence- or practice-based interventions to rural settings • Needs innovative approaches to engaging the rural community • New intervention approaches needs testing in rural communities • Building a team would have to involve of local community ...more »

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Nearly 60 million Americans living in rural communities face additional barriers to receiving effective prevention and treatment services.

• Rural residents often enter care later in the course of their illness than their urban peers, enter care with more serious symptoms, and require more intensive and expensive treatment.

• The rural communities in the US are closely connected and can be leveraged to disseminate heart, lung, blood, and sleep relevant preventive and/or treatment options within those communities.

• Enhance understanding of community resilience factors, cultural, and individual factors that may enhance the provision and utilization of prevention and treatment services in these communities.

• Generate knowledge to improve the organization, efficiency, effectiveness, quality, and services for rural and frontier populations.

• Support movement of evidence-based effective health care and prevention and the public health knowledge base in rural communities in the US.

• Stimulate implementation science in rural and frontier communities

• High return on investment.

Feasibility and challenges of addressing this CQ or CC :

• NHLBI investigators could initiate controlled trials that would maximize the opportunities available in rural communities.

• Documented sustainable interventions and scientific research could serve to reduce morbidity and mortality in high-risk rural populations.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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Goal 3: Advance Translational Research

NHLBI Cohort Populations for T4 Implementation Research

How best can NHLBI observational cohorts be utilized to study observational T4 Implementation Research among both general and vulnerable US populations?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

• Would help identify key factor associated with successful implementation that could be studied in interventional T4 implementation research

• Result would refine implementation strategies and health and social policy aimed to reduce heart, lung, blood, sleep diseases and conditions

• Builds on excellent established platform of research with high quality outcomes in well characterized study populations over long term follow-up.

Feasibility and challenges of addressing this CQ or CC :

• Big data is developing methods to link large data sets from national, state, and community level surveys – surveys that can define exposures to various policies and interventions in place, time, and population.

• A family of high quality cohorts are available for ancillary observation studies

• Collection of community level and more broad policy level exposures is feasible through data already collected and through potentially new data collection.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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Goal 3: Advance Translational Research

Non-invasive vs Invasive Positive Pressure Ventilation in Managing Acute Respiratory Failure

What is the comparative effectiveness of a Non-invasive vs. Invasive Positive Pressure

 

Ventilation Protocol for managing acute respiratory failure due to acute exacerbations of COPD

Submitted by (@joem00)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

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Goal 3: Advance Translational Research

Finding Why Apolipoprotein L1 Gene Variants Increase the Risk for Kidney Failure in African Americans

We plan to find the role of APOL1 in increasing the risk of kidney failure in African Americans and translate this knowledge into preventing end-stage kidney disease and the need for kidney replacement therapy, dialysis or kidney transplantation.

Submitted by (@careygreen)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Increase the quality of life for millions by preventing end-stage kidney disease and thus saving billions of dollars.

Name of idea submitter and other team members who worked on this idea : Carey Green MD, Dollie Green MD

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Goal 3: Advance Translational Research

New funding mechanism for major diseases

According to the National Bioeconomy Blueprint" published in 2012 by the White House Office of Science and Technology Policy, “Flexibility in the use of new and existing funding mechanisms in and across agencies will be vital to stimulating the discovery of new bioinventions with potential to grow the bioeconomy” (p. 24). It is known that the most effective research program in American history was the Manhattan Project. ...more »

Submitted by (@soldatovn.humgenex)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

In accordance with its mission, NIH should practically test this idea by creating, e.g., in NCATS or NHLBI, a highly segmented experimental group work setting that is specifically tailored to the NIH mission-critical directions, such as hypertension, atherosclerosis or autism, and recruit both IRP and extramural researchers on a limited time and one-off bases. The success of such a program is defined by the mission-oriented organizational structure applied to the scientific community. Such structure facilitates the management of the involved scientists for better performance while preserving their natural desire to have autonomy at work. It helps to orchestrate group decisions, harness good intent and enable organizational boundary-spanning. This will enable NIH to work-out the most desirable knowledge-oriented organizational culture for modern research that can be characterized in Rosabeth Kanter’s words as the Five ‘F’s attributes: fast, flexible, focused, friendly, and fun. The key is to keep high-achieving scientists independent of the academic establishment’s censorship as well as happy and productive by removing barriers and fading the bureaucracy to the minimally required level. Implementation of the mission-oriented Manhattan Project type programs will facilitate the concept clearance process, reduce administrative burden for NIH and thus will be responsive to the public demand to reduce the size of the Federal Government.

Feasibility and challenges of addressing this CQ or CC :

In response to the NIH public announcement, a self-assembling group of experts at an open meeting selects its acting chair and a research team, proposes the program, course of actions and budget cuts (within the allocated gross budget) according to the ultimate task to be resolved, e.g., treatment of hypertension. The team is composed of the specialists needed for the success of the study, other relevant NIH, public and business organizations. The appointed NIH Science Administrator sets semiannual working meetings accessible to all interested in the program including the potential competitors for a piece of it. The participants present evidence of their productive research that is critically discussed and either approved for continuation or discontinued and replaced according to suggestions of the attendees. The mechanism of trans-NIH Common Fund initiatives may be applied, but the functions of strategic plans development, program management, reviewing plans and progress of award recipients should be the prerogative of the semiannual meetings, while future funding strategies should be based on actual results delivered in the form of regular meeting reports. Successful participation should be treated as a highly prestigious achievement and be subject to awards, honorary titles, and other signs of public appreciation. Urgent need in such Manhattan Project type programs is obvious, because it should better prepare our country to major challenges associated with health issues.

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Goal 3: Advance Translational Research

Lipid and lipoprotein metabolism in the CNS

The analysis of lipoprotein metabolism has traditionally been restricted to the easily accessible circulation and peripheral tissues. Very little work has been done behind the blood brain barrier, where many of the lipid carrying or metabolizing genes are also expressed. Yet we know very little about their functions there, although for instance ApoE4 is THE primary risk factor for late-onset Alzheimer's disease. Conventional ...more »

Submitted by (@joachim.herz)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Alzheimer's disease currently affects ~6 million Americans and costs upwards of 200 billion $ per year. Lipoprotein components, specifically containing ApoE and ApoJ, are the predominant risk factors for late-onset AD. The neuroscience community lacks the expertise in lipoprotein biology that is necessary to solve this enormous socioeconomic problem.

The NHLBI is ideally positioned to assume a leadership role to address this major challenge, which transcends traditional institute boundaries.

Feasibility and challenges of addressing this CQ or CC :

This is perfectly feasible, I am addressing this problem for years, there are clear rational approaches for it, but far too few investigators have picked up the challenge.

 

I would be most interested in discussing strategies and solutions to this pressing challenge in detail with the NHLBI!

Name of idea submitter and other team members who worked on this idea : Joachim Herz

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Goal 3: Advance Translational Research

Lifestyle Interventions for Weight Control

What is the comparative effectiveness in comparison to usual care of scalable alternatives for delivery of evidence-based, comprehensive, lifestyle interventions for weight control that physicians can prescribe to patients either within the primary care setting or by referral within the community? What kinds of infrastructure changes are needed within the primary care setting to increase the effectiveness of these interventions? ...more »

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

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