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

smoking cessation in rural and special populations

We are concerned about access to smoking cessation programs in populations that are hard to reach (rural) and who have other challenges (underserved/marginalized populations including people with serious mental illness). What kind of computer-based or mobile health technologies can assist these groups?

Submitted by (@anna.adachimejia)

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 : Anna Adachi-Mejia for colleagues at Dartmouth

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

Hypothermia and hemostasis after severe trauma

There is a need to employ new molecular tools to delineate the difference between beneficial and uncontrolled shock-induced hypothermia, because data on hypothermia and hemostasis are incomplete or lacking, especially on the duration, depth and type of hypothermia.

 

availability of targeted resource grant funding

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 :

improvement of survival with life threatening traumatic injuries with new metabolically modulating strategies, including "simple hypothermia", improved understanding of the relationship between ischemia and reperfusion, the role of inflammatory and metabolic pathways, definition and identification of appropriate targets for therapy, the role for mechanical devices, and relationship between timely application of hypothermia and rewarming.

Feasibility and challenges of addressing this CQ or CC :

the tools and animal models are available to study hemostatic and metabolic modulation/hypothermia in traumatic injury

Trauma is the major cause of death in young individuals in the US, and globally, with uncontrolled hemorrhage representing the major cause of preventable deaths. Hypothermia, used in life threatening cardiovascular states, also holds enormous promise for application in traumatic injuries. Early deployment (pre-hospital) of novel protective metabolically modulating strategies to attenuate cellular injury from shock and reperfusion, such as hypothermia could be beneficial. However, the relationship between hypothermia in traumatic setting is complex, with data suggesting detrimental outcomes if it occurred spontaneously. In contrast, hypothermia induced in a controlled manner can protect tissues from ischemic injury.

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

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-8 net votes
7 up votes
15 down votes
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Goal 1: Promote Human Health

What administrative changes might facilitate team science? Update peer-review and budget mechanisms for team science.

NIH peer-review methods were developed at a time when biomedical science was generally conducted by individual investigators. Approaches to defining conflict of interest in peer review that worked well for individual investigators may not be fit for the review of large-scale collaborative projects. Similarly, the subcontract mechanisms are often slow and cumbersome at a time when projects need to be nimble and timely. ...more »

Submitted by (@psaty0)

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

Details on the impact of addressing this CQ or CC :

Promote team science.

Feasibility and challenges of addressing this CQ or CC :

Some of the policies are NIH or government wide, but the problems of peer review and subcontracting mechanisms need to be addressed

Name of idea submitter and other team members who worked on this idea : Psaty & Tracy

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54 net votes
74 up votes
20 down votes
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Goal 1: Promote Human Health

ESTABLISH NORMATIVE AGE- AND GENDER-SPECIFIC DATA FOR SLEEP DISRUPTION, SLEEP QUALITY AND CIRCADIAN TIMING

There is growing evidence that sleep durations are progressively declining in the United States. Moreover, sleep durations are different at different ages and in different ethnic groups. Currently definitions of normal are based on consensus since there is a lack of key data. Defining normal as with FEV1 is a critical step.

Submitted by (@jnoel0)

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

Details on the impact of addressing this CQ or CC :

There is a developing evidence from both basic research and clinical research on the role of insufficient sleep in different co-morbidities. These include cardiovascular disease, hypertension and metabolic disorders. The Centers for Disease Control (CDC) has appreciated the importance of this that adequate sleep is one of the pillars of health. As part of the CDC-supported program on sleep health, a consensus statement has been issued on normal sleep duration. The group doing this on behalf of the American Academic of Sleep Medicine and Sleep Research Society realized that our evidence base is inadequate at this time. Thus, there is a need to focus on this critical challenge. Sleep duration varies across the lifespan and there is some evidence that it is different in different ethnic groups. Thus, there is a need for comprehensive efforts to address this question and to obtain normative data for sleep duration that is age-, gender-specific and with respect to different ethnic groups.

Feasibility and challenges of addressing this CQ or CC :

There are now recent cohorts at NIH assessing sleep duration using not only self-report but also actigraphy. These could be used as an initial approach to address this question. This will require some degree of coordination between NIH Institutes. In the future a cohort that is specific to addressing questions about sleep duration and other sleep problems would be optimal. There are major prevalent public health issues. This would be facilitated by development of new mobile approaches to assessing these behaviors in an objective way.

Name of idea submitter and other team members who worked on this idea : Sleep Research Society

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157 net votes
214 up votes
57 down votes
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Goal 1: Promote Human Health

Mechanisms of Vascular Stiffness

Increased vascular stiffness has been identified as an important cardiovascular event that accompanies aging and cardiovascular disease. Although multiple vascular changes have been identified and suggested to cause increased vascular stiffness, our understanding of the underlying mechanisms needs to be refined in order to develop useful therapeutic strategies to prevent or reverse these changes. An example of critical ...more »

Submitted by (@meiningerg)

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

Details on the impact of addressing this CQ or CC :

Ultimately, addressing this CQ would impact treatment of CV disease, reduce incidence of significant and life threatening CV events and improve quality of life. This area of investigation is relevant to therapeutics and potentially lifestyle changes that will improve CV health and slow CV age related changes linked to disease.

Feasibility and challenges of addressing this CQ or CC :

Current advances in our technologies make it very feasible to address new questions to improve our knowledge of the mechanisms underlying vascular stiffness. Challenges will include developing multi-scale and cross disciplinary strategies that will, by design, facilitate an integrated understanding of the process leading to altered vascular stiffness.

Name of idea submitter and other team members who worked on this idea : Gerald A. Meininger

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55 net votes
88 up votes
33 down votes
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Goal 1: Promote Human Health

What is the potential effect of the burden of COPD on the US workforce?

COPD currently affects approximately 25 million individuals in the US alone, many of whom are of working age, according to the most recent BFRSS data. Many of those people are encouraged by their doctors or families to apply for disability and receive it, even though there are still jobs they could do. This is going to have an impact on business and industry as these people who are at the peak of their careers leave. ...more »

Submitted by (@jmrommes)

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

Details on the impact of addressing this CQ or CC :

I think if this question were answered and that industry understood the impact of COPD on the potential workforce going forward, there would be significant interest from business and industry to do several things:

prevent COPD; develop accommodations that would allow people with COPD to continue to work; reduce the burden to both industry and individuals with COPD by allowing them to continue to work and produce until planned retirement.

Feasibility and challenges of addressing this CQ or CC :

This would not be a difficult question to answer. More difficult would be the education of both individuals and business and industry in how to accommodate people with COPD so they can continue to work until their planned retirement. Techniques and strategies could be developed, however, benefiting both business and the individual.

Name of idea submitter and other team members who worked on this idea : Jean M. Rommes

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8 net votes
15 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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Goal 1: Promote Human Health

Updating level C evidence in Clinical Guidelines

Clinical Guidelines depends on good science. Despite this, only 11% of guidelines that reported level of evidence in 2009, had level of evidence A while 48% had level C. Studies have shown that recommendations based on Level of Evidence C (or their equivalence) are significantly less reliable and may be downgraded, reversed or omitted when better evidence is available. I propose a comprehensive review of ACC/AHA ...more »

Submitted by (@glancast)

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

Details on the impact of addressing this CQ or CC :

Upgrading the level of evidence that recommendations are based on in clinical guidelines, will potentially improve outcomes, reduce unnecessary risk and reduce cost of all aspects of cardiovascular care.

Feasibility and challenges of addressing this CQ or CC :

There are three phases:

1) Review the current published clinical guidelines (and Appropriate Use Criteria) for recommendations relying on level of evidence of C- Very feasible.

2) Ranking impact of clinical recommendations that only have level of evidence C- Quite feasible, but will need to set up a protocol and review committee.

3) Designing and funding high priority studies: Feasible- especially if done under the umbrella of the NHLBI. The challenges will be to set up good studies that supply enough data to be useful in making recommendations based on Level of evidence A in the Guidelines.

Name of idea submitter and other team members who worked on this idea : Gilead Lancaster, MD, Associate Clinical Professor of Medicine, Yale University School of Medicine

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

The CRISPER-Cas challenge: Need to re-phenotype KO animals?

Because traditional knock out models and CRISP/Cas models often show different phenotypes for the same gene deletion, do we need to re-phenotype hundreds/thousands of knock out animal models and revisit the conclusions of many studies based on using these animal models? This research may not appear very innovative but may be very important for drawing correct conclusions about gene functions and interactions - should ...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 :

Discovering differences in phenotypes may change many conclusions reported previously regarding gene functions and interactions.

Feasibility and challenges of addressing this CQ or CC :

New methodologies for genetic editing are available

I recently saw at least of couple of presentations showing compelling evidence that KO mice generated with CRISPR (clustered regularly interspaced short palindromic repeat) and Cas (CRISPR-associated) had different phenotypes from the corresponding existing - and widely used - KO (same gene had been knocked-out) using previous methods. This was attributed to the non-specific modification introduced by previously used constructs/methods compared to the most recent precise genetic editing methods using with CRISPER-Cas.

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

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-16 net votes
10 up votes
26 down votes
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Goal 1: Promote Human Health

Patient- and Family-Centered Care in the ICU

Many medical centers have incorporated the concept of patient- and family-centered care into their mission statements and are now introducing policies that address topics such as open visiting hours in the ICU and family presence at resuscitation. These changes are often being made in the absence of robust evidence to support their introduction. There must be a commitment to rigorous study of these issues so that we can ...more »

Submitted by (@along11)

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 : acl

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-1 net votes
8 up votes
9 down votes
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Goal 1: Promote Human Health

Critical Windows in Early Development to Maximize Lung Health

Is there a critical window of growth and development for maximizing lung function?

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 :

Low lung function during childhood tracks to early adulthood and contributes to early onset disease. Lung health promotion is needed, but we know little about what can enhance and protect human health during rapid phases of lung development in utero and growth postnatally to adulthood.

Feasibility and challenges of addressing this CQ or CC :

Researchers could turn their attention on healthy and “maximally” health populations (human and model organisms) to understand genetic and environmental exposures that influence lung function at upper ends of the spectrum (>2 SD from the mean).

Recent findings suggest that there is an urban-rural continuum of lung function in specific ethnic groups; and interventions with maternal dietary supplements can enhance lung function in offspring. These set the stage for further study on developing knowledge of early life events that can inform lung health promotion.

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5 net votes
17 up votes
12 down votes
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