Goal 1: Promote Human Health

Enhancing Understanding of Determinants of Health in Rural Areas & Developing Solutions

What are the biological, environmental, social and economic determinants of health in rural areas related to COPD and other lung disease.

Submitted by (@gacdk0)

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

Details on the impact of addressing this CQ or CC :

There are extreme disparities in the impact of COPD in rural areas, especially in rural Appalachia. These areas experience much larger prevalence rates and higher rates of hospitalization, readmissions and other health indicators that contribute to increased cost and decreased quality of life. These are also areas with the least ability to make improvements. Research that can inform both the causes of these disparities and identify proven methods for systematically confronting these issues has the potential to dramatically improve overall health status in rural America

Name of idea submitter and other team members who worked on this idea : Grace Anne Dorney Koppel

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Goal 1: Promote Human Health

Interaction of blood cells with their environment

It is beginning to be known that malignant cells interact with neighboring cells and the course of their malignancy is directed by those cells. It is also known that transplanted stem cells interact with nearby cells and acquire direction of maturation and cell type from those cells. In my experience in unpublished work, the nature of the materials that leukocytes and monocytes have encountered during their apheresis ...more »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 :

Research project: To identify a sensitive method of determining functionality of lymphocytes or/and monocytes. And to use such a method to characterize cells reaction to exposure to foreign surfaces.

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

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47 up votes
8 down votes
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Goal 1: Promote Human Health

ROLE OF HEALTH DISPARITIES IN SLEEP AND CIRCADIAN HEALTH—ENVIRONMENT

Self-report data indicate that insufficient sleep is more common in minority populations. This seems to be related to socioeconomic status. There is a need to move this beyond self-report and obtain objective measures in the relevant populations. Moreover, the basis of this difference needs to be established. What aspect of the environment leads to these differences, e.g., noise, stress related to sense of vulnerability, ...more »

Submitted by (@jnoel0)

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

Details on the impact of addressing this CQ or CC :

Self-report indicates that sleep duration is lower in minority populations. This seems to be related to socioeconomic groups. To address this issue requires understanding the basis of this and developing appropriate interventions.

 

The impact of this is as follows:

 

a. Implementing new technology based on mobile approaches to assess sleep duration in subjects in different socioeconomic groups.

b. Developing a comprehensive approach to understanding and evaluating environmental influences in sleep and circadian rhythm.

c. Designing and testing intervention to increase sleep duration in disadvantaged populations.

d. Improving the sleep health of minority populations.

Feasibility and challenges of addressing this CQ or CC :

There is rapidly developing new mobile technology to assess sleep duration and other phenotypes in individuals living in their normal lives. There are a number of studies currently being conducted that could be leveraged to address this question. There are also developing approaches to assess environmental influences on sleep and circadian rhythm such as noise, light exposure, etc. Thus, this question could be addressed in the near future.

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

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122 net votes
173 up votes
51 down votes
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Goal 2: Reduce Human Disease

What are the Determinants of Short Term Prediction of Heart Attacks?

In spite of many years of research, we still cannot predict the short term risk of a heart attack or sudden CHD death. Most CHD deaths occur outside of the hospital. In spite of improvement of out-of-hospital emergency care, most “sudden death events” are still not successfully resuscitated.

Submitted by (@kullerl)

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

Details on the impact of addressing this CQ or CC :

There is strong evidence of interrelationship between inflammation, thrombogenesis, especially activation of tissue factor and platelets, and risk of a heart attack or sudden death. This is especially true in individuals who have pneumonia, influenza, etc. but also perhaps in relationship to environmental factors such as air pollution. Development of early identification and treatment approaches could substantially reduce CHD mortality.

Feasibility and challenges of addressing this CQ or CC :

The NHLBI has certainly had a major commitment in studying the interrelationship between inflammation and CHD. However, there is a need to go into the field and evaluation the interrelationship between inflammation, especially infection, drug therapies and short term acute precipitation of heart attacks. For example, there is suggestive evidence that older individuals on aspirin who have pneumonia may have reduced risk of a heart attack and sudden CHD death. Further studies linking work at the National Institute of Allergy and Infectious Diseases and the Heart and Lung Institute should attempt to further understand the interrelationships between infection, inflammation, and activation of tissue factor and platelets, and risk of thrombosis and heart attack and whether specific drug therapies, especially in high risk older individuals or even among individuals who have had previous CVD or high atherosclerotic burden, whether newer drugs could substantially reduce the risk of a heart attack.

Name of idea submitter and other team members who worked on this idea : Lewis H. Kuller, MD, DrPH

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19 down votes
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Goal 2: Reduce Human Disease

Lung cell stimuli responses

What alterations in respiratory epithelia in response to environmental / external insults are irreversible and lead to disease onset or progression?

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
7 up votes
9 down votes
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Goal 2: Reduce Human Disease

Predictive biomarkers

What biomarkers of acute environmental exposure are predictive of disease onset or progression?

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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27 up votes
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Goal 1: Promote Human Health

What is the role of the environment in HLB disease etiology

It is clear that genetic sequence variation does not account for a substantial portion of disease burden. It is likely that the broad environment contributes to HLB disease via epigenomic alterations and interaction with genetic variants. There is an urgent need to understand the environmental contribution to disease as most exposures are modifiable and are targets for prevention interventions.

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 :

Environmental exposures are clear involved in the pathogenesis of asthma, copd, CVD, and stroke. Understanding the environmental contribution may be critical for reducing disease burden for these common diseases.

Feasibility and challenges of addressing this CQ or CC :

Interventions to reduce disease burden are highly feasible in the next 5-10 years

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

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11 up votes
7 down votes
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Goal 2: Reduce Human Disease

Making It Real: Affordable Physiologically Relevant In Vitro Environments

We have done the best we can to mimic the human internal environment in vitro for the discovery, testing, and validation of therapeutics, but there is a critical need to do better. The use of more complex cell-based in vitro models is the result of the recognition of how little predictive power there is in current experimental conditions, even with animal models. With an in vitro environment that goes beyond temperature ...more »

Submitted by (@ahenn0)

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

Details on the impact of addressing this CQ or CC :

Physiologically relevant in vitro environments could potentially impact research on every tissue type, disease, and intervention, including transfusion-based treatments. Basic research, drug-testing, and translational medicine would all be fundamentally altered. Individualized medicine, cellular therapies, and regenerative medicine could all benefit from in vitro conditions that best support the care of the patient's cells and guide those cells in the direction needed for effective treatment.

Feasibility and challenges of addressing this CQ or CC :

Research and Industry are in the early stages of developing the techniques and know-how needed to address the technical challenges in establishing human-relevant in vitro environments. We already have the technology to control in vitro oxygen and other critical gas components. Mimicking cell-cell interactions and variable cell states such as states of differentiation or stress are areas under active research. Computational and analytical techniques are being developed that can gain insight from large data sets. More of a challenge may be assessing distant effects like metabolism of drugs by the liver or potential drug and cellular interactions with the external environment. However, making a human-predictive in vitro environment affordable is the challenge that could define success or failure of any particular approach. It is feasible within the next ten years to have truly predictive in vitro environments for drug cellular therapy development.

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14 down votes
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