Unless we fix and increase the R01 funding rate, which most basic scientists depend upon, we will continue to lose outstanding scientists of all ages and not have the next generation of scientists or the numbers of currently outstanding scientists to answer any of these compelling questions and critical challenges. Related to this, much has been written about the significant failure rate of clinical trials in part due... more »

How can we provide better support for junior investigators who are transitioning from K Award to R Award funding?

A comprehensive research strategy and plan is needed to determine the most efficient, safe, cost-effective and widely applicable strategy to decrease circulating levels of lipoprotein(a) and to determine whether lowering circulating lipoprotein(a) levels will reduce the risk of developing cardiovascular disease such as a heart attack or a stroke as well as the progression of atherosclerosis or aortic stenosis.

Data indicate the association between short sleep and circadian disruption on a number of adverse outcomes such as cardiovascular disease, metabolic disorders, hypertension, etc. There is a need to move beyond association to interventions that can be shown to improve sleep duration and circadian disruption.

Funding opportunities explicitly for studies of exercise have not been a major NIH priority. The NHLBI has been an exception to this, but the non-existence of a true exercise study section still makes funding a challenge for individuals in the field of Exercise Science. Exercise, along with sleep and diet, is one of the pillars of health and has been shown to be highly beneficial for a number of medical conditions. However,... more »

How might the NHLBI effectively encourage and support its investigators to collaborate with strategic partners to pursue the early translation of their HLBS discoveries into new diagnostics and therapeutics?

The critical challenges to effective early translation of discovery science experienced by the investigator community include:

1. The need for translational skills development, training and guidance

2. Need for... more »

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 »

We need to understand sleep and circadian disorders at a more mechanistic level. This applies to both the pathogenesis of these disorders and to their impact on health. New neurobiological and molecular tools facilitate this research. The focus needs to be not only in brain but also the impact of these disorders on future of peripheral organs. The elucidation of the fundamental functions of sleep and the impact of... more »

There is an urgent need to develop quantifiable biomarkers for acute sleep loss, chronic sleep insufficiency, circadian disruption and sleep disorders such as obstructive sleep apnea. These problems are highly prevalent but currently we do not have biomarkers to use for case identification, prognosis, or assessing response to therapy. There are currently small studies that indicate the feasibility. A recent workshop... more »

There are developing data from clinical studies that sleep deficiency and circadian disruption have multiple adverse consequences for health. The clinical data provide the base for mechanistic studies. Studies in animal models indicate that both circadian disruption and insufficient sleep later gene expression in peripheral tissues. Moreover, the effect of sleep loss in molecular changes in brain changes with age.... more »

There is developing evidence of major individual differences in pathways to different common sleep disorders such as obstructive sleep apnea. Moreover, there is evidence of different clinical presentations of disease and different outcomes. For example, some subjects with obstructive sleep apnea who get excessive sleepiness while others do not. The latter are still at risk for other consequences of the disorder such... more »

Can new advances in allogeneic blood or marrow transplantation (BMT) make the procedure a safe and universally available therapeutic strategy for treating non-malignant blood and immune disorders such as sickle cell anemia, thalassemia, aplastic anemia, and severe combined immune deficiency?

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.

There is developing evidence that sleep disorders, in particular obstructive sleep apnea and inadequate sleep, can influence the course of other chronic diseases. Observational studies show that CPAP treatment of patients with pre-diabetes who have OSA reduces the incidence of future diabetes. Moreover, animal and human data indicate that insufficient sleep and sleep apnea can affect the rate of progression of neurodegenerative... more »

Studies in different subjects have shown that there are major individual differences in response to sleep loss and circadian disruption. Twin studies have shown that this is heritable. There needs to be an intensive effort to assess basis of these individual differences. This could include in-depth phenotyping studies, e.g., neuroimaging, genetic studies, “-omic” studies, epigenetic changes, etc.