Goal 3: Advance Translational Research

Screening for SDB and Sleep Disorders in School-Aged Chidren by School Nurses

Can school nurses effectively screen for SDB and Sleep Disorders in school aged children? Who else in the school setting could provide such screening? Should such screening be limited to "at risk" children who display identified markers, or be open to all children? What is the role of teachers to "identify" children in need of such screening?

What role will such screening serve to mitigate learning, behavioral, developmental... more »

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

Details on the impact of addressing this CQ or CC

The impact of screening at risk children for sleep disorders and sleep disordered breathing, including subsequent referrals and professional treatment, may serve to mitigate future health, learning, developmental and behavioral risks/issues for children by addressing these issues in early childhood. Research based protocols will be accessed and used for screening.

Feasibility and challenges of addressing this CQ or CC

Additional considerations:
Does the nurse refer an at risk child to the Pediatrician? Dentist? ENT?
What questionnaires or other identifiers would be used for screening? Is there a bio test to assess risk for a SD or SDB?
What should the target age level be for children undergoing proposed screening?

How can sleep education and training be integrated with this screening process to promote good sleeping habits/hygiene at home, for all children, parents and caretakers, as well as teachers. Who creates and provides the educational material? Who does the teaching?

Parental involvement- KEY!

Name of idea submitter and other team members who worked on this idea Nancy Rothstein

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Goal 3: Advance Translational Research

Screening the work force for genetic arrhythmias

Is anyone in your family at risk for a potentially lethal genetic arrhythmia? 4000 young people die each year because they bear a genetic mutation that makes them susceptible to a sudden fatal arrhythmia. The symptoms are easy to identify and awareness of these symptoms would help unsuspecting families.

 

It is estimated that one of these syndromes (LQTS) is 3 times more common in the US than childhood leukemia.

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 are 3 simple warning signs for families bearing dominant mutations that could lead to arrhythmia and sudden death. These are unexplained fainting or seizure during exercise or startle, an unexplained sudden death of a young family member, chest pain and/or shortness of breath during exercise. A simple questionnaire of all families with children entering school or any athlete signing up for a sport, or any adult entering the work force would help identify potential family members at risk for these genetic arrythmias.

Feasibility and challenges of addressing this CQ or CC

A simple questionnaire of all families with children entering school or any athlete signing up for a sport, or any adult entering the work force would help identify potential family members at risk for these genetic arrythmias. Such potential patients could then be further screening by a EKG and a consult with a cardiologist.

Name of idea submitter and other team members who worked on this idea Andy Golden

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Goal 3: Advance Translational Research

Why are CHD Mortality Rates Much Higher in United States Than in Japan or Mediterranean Countries?

There remain very substantial unexplained international geographic variations in the incidence of CHD. Japan, for example, and some of the Mediterranean countries have CHD incidence rates for both men and women that are 1/3-1/4 of those in the United States.

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

Details on the impact of addressing this CQ or CC

Migrants from these countries have substantial increase in their CHD rates within a very short time after emigration to the United States or to other countries, strongly suggesting that fundamental genetic differences do not account for these variations in the rates. Reduction of the CHD rates in the United States to those in low risk countries will have the most profound effect on CHD and CVD incidence and mortality.

Feasibility and challenges of addressing this CQ or CC

Research to further evaluate the probable dietary determinants of these extremely low rates and their implications to the United States should be a high priority. This includes careful study of fatty acids, especially polyunsaturated fatty acids, soy proteins, etc., interrelationships with markers of inflammation and inflammatory diseases. Japan, for example, not only has low CHD rates but also low rates of rheumatoid arthritis (RA), chronic obstructive pulmonary disease even in the presence of high levels of cigarette smoking, multiple sclerosis, all of which would suggest that inflammation may be contributing to these variations in risk of disease. Furthermore, there is growing evidence that omega-3 fatty acids and perhaps other fatty acids may play an important role in T cell function and the development of CVD.

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

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Goal 3: Advance Translational Research

Apps for asthma and allergy management

Integrate real time data acquired from or through mobile health care applications (apps) and devices into asthma and allergy management.

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 Asthma and Allergy Foundation of America (AAFA)

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Goal 3: Advance Translational Research

What program elements are most effective in improving patient outcomes?

Which programs or program elements are most critical (the “active ingredients”) in improving quality of life, reducing hospitalizations, reducing emergency department visits, and increasing survival?

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

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Goal 3: Advance Translational Research

Translating cardiac development/genetics knowledge into therapy

What is needed to translate our knowledge of cardiac development and congenital heart disease genetics into novel diagnostic and/or therapeutic strategies for congenital or acquired heart disease?

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

Details on the impact of addressing this CQ or CC

Develop new therapies for congenital or acquired heart disease.

Feasibility and challenges of addressing this CQ or CC

We are poised to take advantage of the incredible advances in our understanding of cardiac development and genetics which have resulted from the development of high throughput technologies.

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

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Goal 3: Advance Translational Research

Core funding for successful PBRNSs

Practiced-Based Research Networks (PBRNs) are critical for the conduct of pragmatic real world studies. Most PBRNs struggle to support their infrastructure. Funding is needed to support core administration and IT, i.e. electronic interfaces and data extraction, transfer and loading from multiple EHRs and PBRN registries. Continuous if not core funding is needed whether though Center (P) awards, through through NHLBI... more »

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

Details on the impact of addressing this CQ or CC

Pragmatic research designed to answer real world questions is best conducted in the real world of office-based practices. This type of research is critical to informing health care innovations. Dynamic registries are needed to answer questions quickly. Once these community laboratories are lost, they are expensive to replace or revive.

Feasibility and challenges of addressing this CQ or CC

Competing priorities during an era of flat funding

Name of idea submitter and other team members who worked on this idea Kevin Fiscella, MD, MPH

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Goal 3: Advance Translational Research

Non-invasive vs Invasive Positive Pressure Ventilation in Managing Acute Respiratory Failure

What is the comparative effectiveness of a Non-invasive vs. Invasive Positive Pressure

 

Ventilation Protocol for managing acute respiratory failure due to acute exacerbations of COPD

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

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Goal 3: Advance Translational Research

Community Trials for Cardiovascular Health Enhancement

There is a need to initiate innovative community trials that are: theory-based; are integrated multi-component, multi-setting, and multi-level (i.e., they target individual, family, community, and built environment); engage community stakeholders; and use community-participatory research principles to enhance cardiovascular health (CVH) in vulnerable and diverse populations.

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

Details on the impact of addressing this CQ or CC

Global impact on cardiovascular health.

Feasibility and challenges of addressing this CQ or CC

There are smaller scale community interventions but none in the literature that focuses on larger-scale multi-level trials as proposed here. This CQ would target vulnerable and diverse populations to reduce health disparities.
NHLBI supported the stroke belt initiative, and the exemplars in community CV health research: (e.g., the Stanford 5 City Project, The Minnesota Heart Health Program, The Pawtucket Heart Health). The next generation of community CVH research should harness the lessons from these studies, findings for the 8 Americas (Chris Murray), and numerous results from NHLBI cohort studies to implement large-scale community trials for cardiovascular health enhancement.
Resources for a large scale study could be a challenge. Ability to motivate a whole community, to prevent contamination, and to sustain interventions would be a challenge.

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

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Goal 3: Advance Translational Research

Develop relevant large animal models for various disease conditions

What is the possibility of investing funds primarily in clinically-relevant models where the findings could be translated in to human diseases?

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

Details on the impact of addressing this CQ or CC

Strong emphasis on the use of a clinically-relevant large animal model would hopefully be more productive in developing better therapeutic approaches and management of patients.

Feasibility and challenges of addressing this CQ or CC

In view of the lack of facility at many institutions and the cost involved, and the rules and regulations by the USDA and other regularity bodies, special emphasis will be required to build the animal facility at an institution. Where will the funds come from? Similar to many other core facilities set up by the NIH at various institutions, what is the possibility of developing specialized centers for testing a new idea in a clinically-relevant large animal facility?

Name of idea submitter and other team members who worked on this idea Devendra K. Agrawal, PhD

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Goal 3: Advance Translational Research

Biomarkers of asthma

Need to develop and integrate biomarkers of asthma into phenotype/endotype-driven asthma management algorithms

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 Asthma and Allergy Foundation of America (AAFA)

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Goal 3: Advance Translational Research

Personalized Medicine thru CV bioinformation/tissue repository

There is a need to establish virtual CV biologic tissues and a bioinformational repository for specific CV diseases, including congenital cardiovascular malformations, genetic or other unique cardiomyopathies, such as stress cardiomyopathy and giant cell myocarditis.

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

Details on the impact of addressing this CQ or CC

Personalized medicine promises patient-tailored management enhancing patient care and decreasing overall treatment costs by focusing on genetics/omics data obtained from patient biospecimens and electronic medical records (EMR) to guide therapy that generate optimal clinical outcomes. The approach relies on diagnostic and prognostic use of novel biomarkers discovered through combinations of tissue banking, bioinformatics, and electronic medical records. The analytical power of bioinformatic platforms combined with patient clinical data from EMRs can reveal potential biomarkers and clinical phenotypes that allow researchers to develop experimental strategies using selected patient biospecimens stored in tissue banks.

Feasibility and challenges of addressing this CQ or CC

the repository would utilize high quality biospecimens in concert with reliable EMR collected at diagnosis and through various treatment stages to provide crucial resources help identify a new risk factors and to facilitate development of novel therapies. The data obtained would also require cross-disciplinary collaborations to translate experimental results into clinical practice and diagnostic and prognostic use in personalized medicine. The repository focus would be on the discovery of predictive, diagnostic, and prognostic biomarkers that will allow proper diagnosis of specific CV diseases, increase information about a particular disease, and indicate the direction treatment should take.

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

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Goal 3: Advance Translational Research

Greating grant mechanism for fostering collaboration with industrial partners

There is a disconnect between the cardiovascular devices industry and the basic research that is conducted in the field by biomedical engineering researchers. Technological solutions that the industry is converging to are not well informed by the advances in basic translational research. A distinct funding mechanism should be created for fostering such collaborations. To motivate for profit cardiovascular device manufacturers... more »

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 Danny Bluestein, Ph.D.

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Goal 3: Advance Translational Research

Developing Methods and Metrics for T4 Outcomes and Impact

How can methods and metrics capable of conducting high quality T4 research be developed to accurately capture outcomes and the overall impact new T4 knowledge has on population health for heart, lung, blood, sleep diseases and disorders?

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

Details on the impact of addressing this CQ or CC

High quality T4 research methods and metrics are needed to move the field of T4 translation research forward while linking large data sets from different sources.

Feasibility and challenges of addressing this CQ or CC

Demand for high quality methods, metric and evaluation of T4 translation research interest is growing and needs to be addressed immediately to move the field forward.
Recent IOM/NRC studies recommended that the NIH and other research funding agencies support the development of more refined analytic methods and study designs for cross-national health research. These methods should include innovative study designs, creative uses of existing data, and novel analytical approaches to better elucidate the complex causal pathways. The T4 field has some specific metrics including acceptability, reach, adoption, appropriateness, feasibility, fidelity, cost, penetration, and sustainability, each with its standard measurement approach. In addition to a rigorous study design, including these metrics along with population level impact direct measures (e.g., morbidity, mortality) and intermediate measures (e.g. blood pressure reduction) will be critical to assess what has been accomplished and to define success. Finally, measuring the overall impact of new knowledge generated from T4 research is challenging because publication bibliometrics of high impact scholarly journals may not fully capture it.

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

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