Goal 1: Promote Human Health

To expand knowledge of the molecular and physiological mechanisms governing the normal function of heart, lung, blood, and sleep systems as essential elements for sustaining human health.

Goal 1: Promote Human Health

Preventing hypotensive reactions and injury after blood donation

How can blood centers prevent hypotensive reactions after blood donation?

Submitted by (@anne.eder)

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

Details on the impact of addressing this CQ or CC :

Blood donation is generally safe and well tolerated by most individuals, but some people will experience syncopal reactions after donating blood, such as dizziness, lightheadedness, or loss of consciousness. Injuries which occur as a result of loss of consciousness after blood donation can rarely cause significant morbidity or disability. Although uncommon, such donation-related injuries are likely underreported because they often occur after the donor leaves the blood center. Published studies on interventions that reduce the risk of reactions have not shown an effect on preventing injuries, although some incidents might still be preventable. Physiologists have successfully treated syncope in patients with dysautonomia, in trained athletes, in astronauts, in pilots and others, using physical maneuvers with muscle tensing, to almost instantly increase venous return, cardiac output and cerebral perfusion. But studies on the use of physical maneuvers during blood donation have yielded conflicting results. Further efforts are needed to design, implement and monitor strategies to reduce injuries after blood donation and optimize donor health.

Feasibility and challenges of addressing this CQ or CC :

Injuries are most commonly associated with syncopal reactions which occur after the blood donor leaves the collection site and resumes normal daily activities. Reducing injuries will require identifying susceptible donors, providing them with postdonation instructions, and improving their ability to recognize prodromal symptoms and respond to orthostatic changes in blood pressure. Technology for personalized medicine platforms, such as mobile phone apps, could be developed to capture information about post-donation reactions and facilitate real-time interactions with blood donors. Such a system would also enable blood centers to design and deliver intervention and continuously monitor the effectiveness of the approach to prevent postdonation injuries.

Name of idea submitter and other team members who worked on this idea : Anne Eder MD PhD and Dana Devine PhD for the 2015 NHLBI State of the Science in Transfusion Medicine

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-1 net votes
19 up votes
20 down votes
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Goal 1: Promote Human Health

Missing upper teeth & sleep apnea treatment: Problems?

I am a 73 year old female with Hypersensitivity Pneumonitis, Complex Sleep Neap, using oxygen @ 4-5 L/min 24/7 who just had my upper teeth extracted. I notice this has a negative effect, or appears to, on the effectiveness of apnea treatment. I wake several times during the night with lips flapping! This did not happen before the extraction. Because there are still some lower teeth, I am unable to close my mouth tightly ...more »

Submitted by (@lesliesmyth)

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

Details on the impact of addressing this CQ or CC :

If this question has an answer, it would help an unknown number of persons by once again providing effective treatment for sleep apnea. I find fatigue is building again, as it did before I was diagnosed and treated.

 

It may be simply a matter of a different style of mask, but it appears ideas on what kind are a bit sparse on the ground.

Feasibility and challenges of addressing this CQ or CC :

One would need a sampling of persons with lower teeth (some, or all) who also have sleep apnea. One would have to determine whether indeed, there is a deterioration in quality of treatment, and if the number of lower teeth are a factor. Does the form of apnea make a difference? Does age or body weight play a part?

 

This is not exactly couched in academic, medical terms, but it is still a valid question. Its solution, or if a solution already exists, it's distribution among sleep physicians, would help those who experience this combination of circumstances.

Name of idea submitter and other team members who worked on this idea : Leslie H. Smyth

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-42 net votes
5 up votes
47 down votes
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Goal 1: Promote Human Health

Bypass the CSR and concurrently act to help reform it

A key aspect of making any strategic plan focused upon glycoscience funding effective is the mechanisms by which grants are chosen. The problem is not the IC and making prioritized decisions; the problem is the study section ignorance and bias. Proposals that are reviewed poorly in study section out of flippancy towards glycobiology or simple lack of a critical mass of appropriate expertise never see the light of day ...more »

Submitted by (@nhlbiforumadministrator)

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

Feasibility and challenges of addressing this CQ or CC :

In order to truly promote glycobiology at the NHLBI, I would suggest two action items: 1) Heavily rely upon the RFA mechanisms in which the scientific review process is internal to the NHLBI or

special emphasis panel to ensure proper representation of glycobiologists on the panel. The success of this approach can be seen in the NHLBI-funded Programs of Excellence in Glycoscience (PEG), and I would predict similar success with the nascent NIH Common Fund Initiative in Glycosciences.

2) As much as possible, place significant pressure on the CSR to integrate far more glycobiology expertise into all standing study sections. As far as I can tell, any pressure placed on the CSR from the research community has fell upon deaf ears. One glycobiologist on a panel is inadequate.

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

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1 net vote
1 up votes
0 down votes
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Goal 1: Promote Human Health

Combinatorial intervention of immune dynamics to combat cariovascular disease

Human health and disease are modulated by complex and inter-connected dynamic processes. With particular significance, a well-balanced immune environment may play a key role in maintaining health and preventing the pathogenesis of cardiovascular disease. Defining the dynamic programming and balance of immune environment will be the key for combinatorial therapies to reset homeostasis.

Submitted by (@lwli00)

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

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

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8 net votes
10 up votes
2 down votes
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Goal 1: Promote Human Health

Re-examining Antigenicity of Rare Blood Disease Proteins

What specific roles do protein glycosylation and protein complex formation on stable and activated cellular membranes play in inherent immunogenicity and antibody formation to life-saving therapies for rare blood disorders?

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 :

Inhibitory alloantibody formation to critical life-saving therapies impedes effective replacement therapy in up to 30-40% of children and adults with congenital blood diseases, thereby significantly increasing the complications of the underlying disease. For children with hemophilia A, this treatment complication has significantly limited the impact of the last 20 years of therapeutic advances in product efficacy and safety. Discovery science in this area has focused on the relationship between the immune response and treatment circumstances, and the epitope specificity of the targeted immune response. However, this scientific pathway to discovery has not yielded the critical mechanistic data required to inform effective prevention strategies. Recent advances in our understanding of the co-factors for immunogenicity, the biochemistry of coagulation factor complex formation on cellular membranes, glycobiology and gene transfer must now converge to create a potential platform for exploring new paradigms of immunogenicity, and thus leading to new strategies for inducing tolerance to future new therapeutics in hemophilia.

Feasibility and challenges of addressing this CQ or CC :

A recent workshop sponsored by the National Hemophilia Foundation highlighted the threat to novel therapies for hemophilia as well as curative gene therapy from the unsolved problem of replacement protein or gene product antigenicity. However recent advances in our understanding of the co-factors for immunogenicity, the biochemistry of coagulation factor complex formation on cellular membranes, glycobiology and gene transfer, can now converge to create a potential platform for exploring new paradigms of immunogenicity, and thus leading to new strategies for inducing tolerance to future new therapeutic. NHLBI leadership and collaboration with NIAID is needed to bring this combined expertise to bear on the understanding and prevention of this most significant complication of hemophilia therapy.

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

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-20 net votes
6 up votes
26 down votes
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Goal 1: Promote Human Health

Hand Held Device to treat PTSD and Traumatic Brain Injury

Undo Obesity, Now! Hand Held Electronic Device to Treat Obesity Undo PTSD/TBI Hand held vagus nerve stimulator for PTSD and traumatic brain injury PTSD may be similar to depression and epilepsy. Traumatic brain injury may relate to nerve injury and nerve inflammation Vagus nerve stimulation causes nerve function regeneration. Vagus nerve stimulation stops inflammation. Vagus nerve stimulation treats depression. Vagus ...more »

Submitted by (@chrislahr22)

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

Details on the impact of addressing this CQ or CC :

This could revolutionize the treatment of PTSD and traumatic brain injury. No drugs, no surgery.

Feasibility and challenges of addressing this CQ or CC :

App is in development.

Power source and electrical wave generator produced by Apple

Stimulator cord produced by Apple.

Ear Stimulator in production by General Motors Global Research and Development.

Name of idea submitter and other team members who worked on this idea : Chris Lahr, Nitin Gupta,Derek Lahr, Christian R. Gomez, Ingrid Espinoza, Ryan Marshall, Thomas Abell, Omer H. Yilmaz

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2 net votes
2 up votes
0 down votes
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Goal 1: Promote Human Health

Engineering Healthy Lungs

What tools and knowledge are required to engineer healthy lungs? Can we engineer lungs and/or successfully modify cadaveric donor lungs using our understanding of matrix biology and lung development to provide a durable effective organ replacement therapy for patients with advanced lung disease?

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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2 net votes
8 up votes
6 down votes
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Goal 1: Promote Human Health

Role of the lymphatic system in heart, lung, blood, sleep health and diseases

What is the role of lymphatic system in normal function of the heart? Do dysfunctional lymphatics contribute to heart failure? Do lymphatics have a role in recovery after MI? It has been reported that lymphatic vasculature transport HDL during reverse cholesterol transfer. Do lymphatics have a role in atherosclerosis? What is the contribution of lymphatic system to asthma or COPD? Does the lymphatic system contribute ...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 :

Understanding how lymphatic system contributes to normal physiology of heart, lung, blood, sleep systems will help also lead to new approaches for treatment of heart, lung, blood, sleep diseases.

Feasibility and challenges of addressing this CQ or CC :

Basic understanding of the development and hemodynamics of the lymphatic system and reagents to study the lymphatic function are available.

Lymphatic vasculature is essential for fluid hemostasis in the body, collects and returns the protein- and lipid-rich interstitial fluid to blood circulation, and also involved in immune cell trafficking and inflammation. Given these important physiological roles, function of the lymphatic system is expected to contribute to normal physiology of organs and its dysfunction to major diseases. There is very little or no information how the lymphatic system contribute to health and diseases of the cardiovascular, pulmonary and blood systems, and there are many unanswered questions. Answers to these questions may lead to new approaches for treatment of major HLB diseases. Main challenge is to get heart, lung, blood, sleep investigators interested in studying the contribution of the lymphatic system to heart, lung, blood, sleep health and diseases.

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

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50 net votes
77 up votes
27 down votes
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Goal 1: Promote Human Health

Genetic, epigenetic, and environmental influences on lung development.

Understanding the genetic, epigenetic, and environmental influences on lung development.

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 :

While we are fully supportive of the recent emphasis on patient‐centered outcomes and implementation science, we are also reminded of the critical importance of investigating underlying mechanisms of pulmonary, critical care and sleep disorders. Recent discoveries have created exciting progress in the areas of cystic fibrosis, pulmonary hypertension, pulmonary fibrosis, and biological therapies in asthma. Only through further efforts to elucidate underlying mechanisms are new therapeutic approaches likely to emerge. Promoting further academic‐industry interactions are likely to yield benefits, which will ultimately lead to improvements in the health of our nation.

Name of idea submitter and other team members who worked on this idea : Research Advocacy Committee, American Thoracic Society

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3 net votes
3 up votes
0 down votes
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Goal 1: Promote Human Health

Endoglin Regulates biolgy and signal transduction in vascular smooth muscle cells

Why loss of endoglin causes HHT is not known. Endoglin is expressed by vascular smooth muscle cells and endothelial cells.

What is the role of endogin on vascular smooth muscle cells and why its loss contributes to HHT and other vascular malformations

Submitted by (@mariannes.clancy)

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

Details on the impact of addressing this CQ or CC :

Vascular smooth muscle cells wrap around arteries and control their diameter.

Name of idea submitter and other team members who worked on this idea : Marianne Clancy MPA, Chris Hughes PhD

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1 net vote
1 up votes
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Goal 1: Promote Human Health

ORAL HEALTH AND HEART TREATMENT

Compelling Question:

It is very well established now that oral health, particularly gingavitis, play a significant role in cardiac health.

Why this reality is not considered as integral part of Cardiac care?

Submitted by (@abasit88)

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

Details on the impact of addressing this CQ or CC :

It is expected that incorporating Oral Bacterial ailments such as Gingivitis for cardiac care will more than pay for itself. It will significantly improve the cardiac event prognoses and CUT THE COST OF CARDIAC CARE.

Feasibility and challenges of addressing this CQ or CC :

It is quite feasible and practically possible to incorporate Gingivitis or other serious bacterial oral health problems as integral part of the work of a Cardiologist.

CHALLENGES: Researching the contribution of Oral bacterial issues such as Gingivitis as compared to smoking, obesity and cholesterol levels.

My hypothesis is that Chronoc Oral Bactrial diseases are significant contributors to cardiac problems.

Name of idea submitter and other team members who worked on this idea : Abdul Basit, Ph. D.

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7 net votes
14 up votes
7 down votes
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Goal 1: Promote Human Health

Transformative Impact of Proteomics

The proteomics field has dramatically progressed over the past 20 years, with advancements and improvements in experimental designs and sample preparation protocols, as well as mass spectrometry equipment, approaches, and analysis. This has resulted in substantial forward progress towards a proteomic pipeline to establish cause and effect mechanisms of cardiovascular disease. There is a need for CV proteomics that resolve ...more »

Submitted by (@mllindsey)

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 necessary tools have been assembled, and managing implementation will reduce the time required for completion of larger scale projects.

Feasibility and challenges of addressing this CQ or CC :

high feasibility; the challenge will be managing communication across groups to maximize impact

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

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196 net votes
234 up votes
38 down votes
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