Precision medicine will provide unprecedented opportunities to tailor health care based on knowledge of personal patterns of genetic variations. These variations usually impact protein or RNA sequences, resulting in altered properties. These alterations can result in increased susceptibility to a particular disease or intolerance to common therapeutics. To take full advantage of knowing a patient’s set of gene variations,... more »

Much of the hopes for precision medicine (as outlined Dr. Dr. Collins) are based on deriving large amounts of genomic, proteomic, epigenomic and metabolomic data on large cohorts of patients. It will take decades to build these cohorts and even more time to analyze them and derive specific conclusions on how these will help individualize treatments. However, there is a pressing need for how to individualize contemporary... more »

Assess better screening measures (phsyiological tests, biomarkers or novel technology) for diagnosis of microvascular angina in emergency department patients with chest pain.

The prevalence of cardiometabolic disorders of pregnancy are increasing rapidly in women in the United States, particularly in black women. These disorders have a significant impact on the development of CVD in women as they age and on their offspring. The science to answer these questions are both mechanistic(understanding underlying mecanism of disease, esp preeclampsia) and behavioral. New methods of gathering... more »

Heart Failure (HF) remains a major public health burden. A working group was convened by NHLBI and ODS in June, 2013 to address the role of diet and nutrition in management of HF. A review of existing evidence produced no clear rationale for appropriate dietary interventions. On the contrary, the group developed recommendations for conducting additional research specifically on the role of sodium, fluid, nutrients, and... more »

Precision medicine will be invested in across NIH, as per the President's "Precision Medicine Initiative". It is critical that the population base be reflective of the US population, including 50% women. Gender, especially as it relates to exposures, must be a dominant consideration, as these factors are critical to the development of human disease and therefore will be important to prevention.

As patients who suffer a hemostatic complication (hemorrhage or thrombosis) while on extracorporeal membrane oxygenation (ECMO) have worse outcomes, how do optimize anticoagulation in this population to minimize complications and improve outcomes?

How do patients learn? What is the educational model to promote disease self‐management?

NHLBI directed research should be abandoned and switched to investigator initiated research. I respectfully suggest read the following assay by Brown and Goldstein, Science 2012; 338: 1033-1034 The best way to run the science sponsored by the NIH (or NHLBI) is not to guide it (analogy to running science from ivory tower) but let the investigators decide what is worth pursuing. Get rid of NHLBI-directed research initiative... more »

Many biological models developed to date are based on studies using heterogeneous cell populations. For example, ChIP-Seq studies have shown that RNA Pol II is frequently paused near promotes and that in stem cells, developmentally poised genes are controlled by bivalent enhancers. These studies are largely based on statistical analyses of average ChIP-Seq reads from millions of cells. Earlier biochemical analysis of... more »

Condom designed to protect a males pubic areas and scrotum, fingers and hands from coming in contact with infectious fluids. The adoption of a shield to reduce the occurrence of HPV and other STI infections. This is the first and only condom in the world that uses a latex shield which is designed to protect a promiscuous males fingers and hands from HPV and other infectious human secretions that may be in fluids,. We... more »

Can we develop model systems for the high throughput screening of new and existing agents as possible therapies for rare diseases?

There is a need for a large, simple, hard outcome trial of dietary advice to measure the effects of lowering simple carbohydrates versus lowering unhealthy fats. The main challenge will be to overcome bias favoring the more conventional dietary approach.

What are the primary molecules and cellular signals associated with prolonged hypertensive stress that cause adverse myocardial tissue remodeling, and what strategies that prevent or reverse adverse remodeling can be developed and tested?

What are the determinants of persistent respiratory failure in children? Are obese children at greater risk for prolonged mechanical ventilation than non-obese children? Does BMI affect the time to recovery of lung function in obese children with ARDS? What is the pathogenesis and molecular contributors of obesity on respiratory failure in critical illness?