What translational bioinformatics tools could be used in pulmonary medicine to allow multidimensional, multi-scale modeling of clinical and biomolecular data to assist clinical decision-making?

There is a need to leverage ongoing research on active materials (e.g., self-regenerating body armor, insulin-releasing polymers that respond to glucose, etc.) to stimulate the invention of new materials and constructs that are electrically, chemically and mechanically active to enable self-adjusting bioengineered implants.

Congenital heart defects (CHDs) continue to be the leading cause of death among all infants with birth defects. It is reported that approximately 10% of cardiac congenital anomalies have a genetic basis. An equal percentage, or ~10%, is due to environmental factors. For ~60% the etiology is unknown and considered to have a multifactorial basis, eg, environmental agents having a role against a specific genetic background,... more »

Identification of new genetic/genomic variants and risk genes often opens a new window to explore the fundamental molecular mechanisms underlying a disease and to develop new methods and strategies for diagnosis and treatment. Existing genomic variants and/or mutations explain only 10% to 20% heritability of common heart diseases. Much remains to be done in this important area. However, most genetic projects are discovery-driven... more »

There is evidence of a higher prevalence of sleep and circadian disorders in different ethnic groups. This is true for both adult and pediatric subjects. There is also evidence that minority populations in lower socioeconomic groups do not seek evaluation for sleep disorders as frequently as other segments of our population. There is also evidence that they are less adherent to treatments such as nasal CPAP for obstructive... more »

How does inflammation and cell injury induce the immune system during transplant rejection? How do we control immune responses to enable cell- and tissue-regenerative strategies?
• How does inflammation and cell injury induce the immune system during transplant rejection?
• How do we control immune responses to enable cell and tissue regenerative strategies?
• How do we use iPS cell based and gene editing based therapies... more »

Venous pressure, being very low, distends (deforms) the ventricle - but due to elastic or viscous law of deformation? Elastic deformation depends on stress (pressure) only and the viscous one - on stress and time. When pressures are low you can't get large distention due to stress only (time-independent) unlike the case when you apply low stress and long time interval. If we want to use venous pressure as one of regulators... more »

Why does a cross-reference gap occur when prescriptions are filled through a patient's one and only pharmacy. How can a pharmacist double check a physician's work when the physician prescribes a medication that should NOT be taken if the patient has a diagnosis the pharmacist has no documented evidence to REJECT the prescription and NOT dispense the dangerous drug-interaction, drug vs. medical condition information? Since... more »

What HIV/AIDS-related clinical research can NHLBI support in the next 5-10 years on the prevention, diagnosis, and treatment of HIV-related heart, lung, and/or blood (HLB) diseases in adults and children to improve heart, lung, and blood health outcomes in HIV infections?

Several inhibitors of PCSK9 are in phase 3 development and show considerable promise for improving the lipid profile; they will be especially appropriate for patients with Familial Hypercholesterolemia and those with statin intolerance. The sponsoring pharmaceutical companies need to complete CVD endpoint trials with full safety testing. However, there may well be more than one drug approved for marketing. The sponsors... more »

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.

1. NHLBI investments over the last decade in terms of genomic approaches have yielded many research findings.
2. Rapid analyses of early data identified the "low hanging" fruit (and perhaps some/many important results were missed); this limited the scope of translation (partly because of relatively limited discovery?)
3. Important data are being generated at much greater rate than the data are processed/analyzed thoughtfully.... more »

There is a need to encourage the development and growth of integrated and multi-disciplinary biomedical research skills needed to utilize emerging technology, infrastructure, and paradigms, including the development of competitive research training strategies that embrace the role of multi-institutional and professional scientific organization research collaboration.

Pulmonary function generally remains stable in Duchenne until loss of ambulation. What is the trigger that occurs at loss of ambulation that initiates the cascade of pulmonary dysfunction?

Clinical trials are at a crossroads. They are too expensive, take too long, and often can't recruit adequately. A critical challenge is to develop tools that can change the cost, time, and recruiting practices for clinical trials.