# data[].attributes.title
NCI PATTERNS OF CARE STUDY-DIAGNOSIS YEAR 2021 (PROSTATE CANCER AND OVARIAN CANCER)

# data[].attributes.abstract
The National Cancer Institute (NCI) Patterns of Care (POC) studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. POC Studies are conducted periodically, typically annually, to satisfy a congressional directive (under Public Law 100-607, Sec. 413 (a)(2)(C) adopted on November 4, 1988) to the NCI to “assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports…”. To satisfy the directive and to update and enhance the utility of the POC Studies, a working group including representatives from the NCI’s Divisions of Cancer Control and Population Sciences and Cancer Treatment and Diagnosis and a representative from the American Cancer Society was developed to review knowledge gaps in cancer therapy dissemination and to develop priority areas for study. The group reached a consensus that a gap remains regarding factors associated with guideline use of biomarker tests and targeted therapy. Furthermore, the group determined there is limited information about the effects of the COVID-19 pandemic on cancer screening, diagnosis, treatment, and receipt of supportive/palliative care among individuals diagnosed with cancer. For feasibility reasons, the group also recommended that this POC Study be focused specifically on the patterns of care for patients newly diagnosed with prostate or ovarian cancer. This POC Study will also collect data on documentation of palliative care and patient financial impacts of the COVID-19 pandemic. Relevant information on cancer diagnosis, cancer recurrence and metastasis, patterns of care (e.g., utilization of biomarker testing, specific cancer treatments, supportive/palliative care), and patient financial stability shall be abstracted from medical records among patients aged 20 years of older who were diagnosed with prostate or ovarian cancer in 2021.

# data[].attributes.title
NCI PATTERNS OF CARE STUDY - DIAGNOSIS YEAR 2021 (PROSTATE CANCER AND OVARIAN CANCER)

# data[].attributes.abstract
The National Cancer Institute (NCI) Patterns of Care (POC) studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. POC Studies are conducted periodically, typically annually, to satisfy a congressional directive (under Public Law 100-607, Sec. 413 (a)(2)(C) adopted on November 4, 1988) to the NCI to “assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports…”. To satisfy the directive and to update and enhance the utility of the POC Studies, a working group including representatives from the NCI’s Divisions of Cancer Control and Population Sciences and Cancer Treatment and Diagnosis and a representative from the American Cancer Society was developed to review knowledge gaps in cancer therapy dissemination and to develop priority areas for study. The group reached a consensus that a gap remains regarding factors associated with guideline use of biomarker tests and targeted therapy. Furthermore, the group determined there is limited information about the effects of the COVID-19 pandemic on cancer screening, diagnosis, treatment, and receipt of supportive/palliative care among individuals diagnosed with cancer. For feasibility reasons, the group also recommended that this POC Study be focused specifically on the patterns of care for patients newly diagnosed with prostate or ovarian cancer. This POC Study will also collect data on documentation of palliative care and patient financial impacts of the COVID-19 pandemic. Relevant information on cancer diagnosis, cancer recurrence and metastasis, patterns of care (e.g., utilization of biomarker testing, specific cancer treatments, supportive/palliative care), and patient financial stability shall be abstracted from medical records among patients aged 20 years of older who were diagnosed with prostate or ovarian cancer in 2021.

# data[].attributes.title
NCI PATTERNS OF CARE (POC) STUDY: DIAGNOSIS YEAR 2021 (PROSTATE CANCER AND OVARIAN CANCER)

# data[].attributes.awardee_organization.name
UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR

# data[].attributes.abstract
The National Cancer Institute (NCI) Patterns of Care (POC) studies describe, characterize, and compare practice patterns and treatments provided for cancer in different geographic areas of the United States. POC Studies are conducted periodically, typically annually, to satisfy a congressional directive (under Public Law 100-607, Sec. 413 (a)(2)(C) adopted on November 4, 1988) to the NCI to “assess the incorporation of state-of-the-art cancer treatments into clinical practice and the extent to which cancer patients receive such treatments and include the results of such assessment in the biennial reports…”. To satisfy the directive and to update and enhance the utility of the POC Studies, a working group including representatives from the NCI’s Divisions of Cancer Control and Population Sciences and Cancer Treatment and Diagnosis and a representative from the American Cancer Society was developed to review knowledge gaps in cancer therapy dissemination and to develop priority areas for study. The group reached a consensus that a gap remains regarding factors associated with guideline use of biomarker tests and targeted therapy. Furthermore, the group determined there is limited information about the effects of the COVID-19 pandemic on cancer screening, diagnosis, treatment, and receipt of supportive/palliative care among individuals diagnosed with cancer. For feasibility reasons, the group also recommended that this POC Study be focused specifically on the patterns of care for patients newly diagnosed with prostate or ovarian cancer. This POC Study will also collect data on documentation of palliative care and patient financial impacts of the COVID-19 pandemic. Relevant information on cancer diagnosis, cancer recurrence and metastasis, patterns of care (e.g., utilization of biomarker testing, specific cancer treatments, supportive/palliative care), and patient financial stability shall be abstracted from medical records among patients aged 20 years or older who were diagnosed with prostate or ovarian cancer in 2021.

# data[].attributes.title
COVID-19: NIAID Regulatory Support Center

# data[].attributes.funder_divisions[]
National Institute of Allergy and Infectious Diseases (NIAID)

# data[].attributes.title
LINKAGE HONEST BROKER SERVICES FOR THE N3C DATA ENCLAVE

# data[].attributes.funder_divisions[]
National Center for Advancing Translational Sciences (NCATS)

# data[].attributes.abstract
National COVID-19 Cohort Collaborative (N3C): The N3C Data Enclave is a secure platform storing harmonized clinical data provided by more than 50 contributing members. The Enclave hosts over 651 million clinical observations on over 6.5 million persons, including over 2.1 million COVID cases, amounting to more than 7.3 billion rows of data. Harmonization, anonymity, and security is accomplished through the N3C privacy-preserving record linkage (PPRL). The PPRL uses a de-identified, software-generated token applied by a data contributor to each patient record. A linkage honest broker holds the de-identified tokens and provides a service matching token generated across disparate data sets without knowledge of the identity of the patients. The de-identified tokens are held separately from data residing within the data enclave. As an illustration of the PPRL process, Regenstrief generates a series of de-identified tokens using software provided by Datavant, Inc. The tokens are provided to a data provider, such as Hospital Network Alpha (HNA). HNA strips identifying PII from its clinical records and replaces the PII with the tokens. HNA then uploads the de-identified clinical records to N3C. If researchers require additional information about those records, they provide the token to Regenstrief, who passes it on to HNA without any knowledge of the underlying clinical data. HNA then provides the appropriate response. The linkage honest broker function is critical to the PPRL, which in turn is critical to continued use of the N3C Data Enclave by researchers. The salient characteristic of this requirement is the vendor?s ability to provide uninterrupted linkage honest broker support (harmonization, anonymity, and security) for the N3C Data Enclave.

# data[].attributes.title
Evaluation of Post-Acute Care Access and Outcomes: Influence of Social Determinants of Health on Urban and Rural Rehabilitation Service Areas Before and After COVID-19

# data[].attributes.funder_divisions[]
Agency for Healthcare Research and Quality (AHRQ)

# data[].attributes.abstract
This project is instrumental in evaluating predictors of access and outcomes of post-acute care (PAC) and how Social Determinants of Health (SDH) across rural and urban Rehabilitation Service Areas (RSA) influence access and outcomes pre- and post-COVID pandemic. SDH are critically understudied drivers of access and outcomes of PAC. The proposed project leverages the AHRQ SDH dataset coupled with multiple years of Medicare claims data for beneficiaries receiving post-acute care to study access and outcomes of rehabilitation services in the context of SDH. Our specific research aims are to:  1. Evaluate RSA level PAC access for inpatient rehabilitation, skilled nursing, and home health related to  acute hospital discharges for stroke, hip fracture, and joint replacement and: a) how the association is  moderated by urban and rural areas; b) how the association is moderated by racial and ethnic minority  resident density; c) how the association is moderated by COVID.  2. Characterize SDH based on area social, economic, education, physical, and healthcare context variables  and evaluate a) the association between SDH and access to PAC settings across RSAs for those with  stroke, hip fracture, and joint replacement; b) how this association is modified by Covid; c) how this  association is modified by urban rural context.  3. Evaluate the association between SDH variables and successful community discharge and readmission  among those with stroke, hip fracture, and joint replacement and: a) how the associations are moderated  by urban and rural areas; b) how the associations are moderated by racial and ethnic minority resident  density; c) how the associations are moderated by COVID. Impact and Need: This project has potential to impact both policies related to post-acute care delivery and the day-to-day operations of post-acute care management. Equity in care has been at the forefront of healthcare discussions over the past several years highlighted by noted disparity issues with the COVID pandemic. Disparities continue to disproportionately affect racial minorities across all aspects of rehabilitation, supporting the need for more research examining both individual and community factors to address care and outcome inequities. The project takes a broad look at SDH for older adults’ access and outcomes for PAC in urban and rural areas pre and post the COVID pandemic and will inform future use of individual and ecological SDH variables for examining PAC access and outcomes. Findings will inform policy makers about the influence of ecological social determinants of health have on post-acute care. With this information, policy makers can adjust reimbursement formulae, reduce barriers by creating incentives to improve availability and accessibility of post-acute care in areas where PAC utilization is positively and negatively influenced by social determinants of health, and set policies aimed at addressing the root causes behind inequities due to SDH.

# data[].attributes.title
State Telehealth Policies and Mental Care for Children in Underserved Areas

# data[].attributes.funder_divisions[]
National Institute of Mental Health (NIMH)

# data[].attributes.abstract
Unmet need for child mental health services is a persistent and pressing public health problem in the US. One of the key drivers of the unmet need is health workforce shortage, which has been exacerbated during the COVID-19 pandemic. This exacerbation has occurred against the backdrop of rising mental disorders among children, leading to the national emergency in child mental health declared by multiple specialty organizations.  At the same time, the pandemic has also stimulated innovations, including the widespread adoption of telehealth, which has been promoted by recent government policies. Although telehealth has long been advocated for improving health care access for vulnerable populations, such as children living in mental health professional shortage areas (MHPSAs), no study to date has examined how the recent dramatic growth of telehealth affects mental health care availability and utilization for children in MHPSAs. Furthermore, amid the rapid transition to telehealth during the pandemic, some experts have been concerned with disparities in telehealth access and utilization and called for further research on the equitable development of telehealth.  In response to that call, this proposed project aims to draw lessons about telehealth adoption during the pandemic to inform future telehealth policies. As a comprehensive evaluation of state telehealth policies on licensure, insurance coverage, and reimbursement, the proposed project has three aims: (1) mental health treatment facility (MHTF) level analyses to assess how changes in state telehealth policies affect disparities in mental health service availability for children from before to during the pandemic, (2) child level analyses to evaluate how changes in state telehealth policies affect disparities in mental care access, utilization, and spending among children from before to during the pandemic, and (3) qualitative interviews with medical directors at MHTFs to understand their experiences using telehealth to serve children as well as facilitators and barriers that they have identified for expanding telehealth in MHPSAs.  For each aim, we will analyze two types of disparities—by area of residence (e.g., MHPSAs vs. non- shortage areas), and by child socio-demographic characteristic (e.g., race/ethnicity). Examining these disparities is crucial given the concern about digital health equity during the pandemic.  To examine the aims, we will analyze quantitative data from both primary and secondary sources, including our unique longitudinal survey of nearly all MHTFs in the US. We will also collect complementary qualitative data through interviews with medical directors at MHTFs.  The proposed study is both timely and important, as state policymakers are considering actions to revise their telehealth policies. The study findings will help them identify policies that have (or haven’t) been successful in expanding telehealth services for children with mental disorders—especially those who live in MHPSAs—to inform subsequent policy decisions.

# data[].attributes.title
SECURE PLATFORMS SUPPORT FOR THE N3C DATA ENCLAVE

# data[].attributes.funder_divisions[]
National Center for Advancing Translational Sciences (NCATS)

# data[].attributes.abstract
National COVID-19 Cohort Collaborative (N3C): The National COVID-19 Cohort Collaborative (N3C) sponsors the NIH COVID-19 Data Enclave, one of the largest data enclaves in the world supporting COVID-19 research. N3C is a partnership among the NCATS-supported Clinical and Translational Science Awards (CTSA) Program hubs and the NIGMS-supported Institutional Development Award Networks for Clinical and Translational Research (IDeA-CTR), with overall stewardship by NCATS. The N3C Data Enclave is a secure platform storing harmonized clinical data provided by more than 60 contributing members. The Enclave hosts over 670 million clinical observations on over 6.8 million persons, including over 2.2 million COVID cases, amounting to more than 7.8 billion rows of data. To protect privacy, this data consists only of limited data sets, de-identified data sets, and synthetic data sets; there is no personally identifiable information kept in the Enclave. The Enclave resides in the NCATS Secure Scientific Platforms Environment. The Environment is a specialized cloud-based data aggregation and analytics enclave that can integrate, manage, secure, and analyze any kind of scientific data, and provide secure, controlled access to internal and external collaborators. Within the Environment, multiple NIH ICs, Federal agencies, and Federal task forces integrate, manage, secure, and analyze all types of scientific data using dedicated platforms, and, equally importantly, make that data available in specific and controlled collaborations with each other and with external collaborators.

# data[].attributes.title
Compressed sequential infection regimen to model immune responses to systemic and mucosal vaccination

# data[].attributes.funder_divisions[]
National Institute of Allergy and Infectious Diseases (NIAID)

# data[].attributes.abstract
Laboratory mice exhibit underdeveloped immune systems which fail to accurately predict human responses to challenges such as vaccination. Intentional exposure of these mice to environmental microbes (creating “dirty” mice) through various approaches has been shown to confer effective maturation of the immune system, but generally requires specialized facilities which are not widely available to the research community. Rapid sequential infection with six murine viral pathogens, beginning in early life to mimic human viral exposures, is sufficient to drive immune maturation and yields mice available for subsequent challenge at 10 weeks of age. Viral pathogens selected include those frequently identified in and transferred from other “dirty” mouse models. This rapid sequential infection regimen dramatically alters circulating immune cells as well as total serum antibody and cytokine levels, and critically, also diminishes specific serum antibody responses to both intramuscular and intranasal SARS-CoV-2 vaccination. Intriguingly, the regimen also stimulates robust changes in the endogenous bacterial microbiota. Thus, this sequential infection model mimics phenotypes observed in other microbially-experienced mice and in human adults, and it can be readily implemented in standard animal facilities without special containment protocols.  In the studies proposed here, this sequential infection regimen will be further refined and simplified, and the role of microbiota changes in immune maturation in this model will be explored. In Aim 1, the sufficiency and necessity of combinations of and individual viral exposures to stimulate immune maturation will be defined. Antibody responses to systemic and mucosal SARS-CoV-2 vaccination, as well as robust immunophenotypes observed in the sequential infection model, will serve as key assays. In Aim 2, the effects of sequential infections on the bacterial, viral and fungal microbiome will be defined, and the functional contributions of the endogenous microbiota to immune maturation will be tested. Microbiome profiling, germ-free mice, and antibiotic treatment with fecal transplants will be used to elucidate microbiota contributions. These studies will use established approaches supported by extensive published and preliminary data to reveal the contributions of individual viral pathogen exposures as well as endogenous microbial communities to immune maturation following the rapid sequential infection regimen.  Completion of this proposal will yield a simplified “dirty” mouse model that is tractable and affordable for the majority of investigators studying infectious diseases, vaccine responses, or immune outcomes. Additionally, the proposed experiments will address an important open question about the relative importance of the endogenous microbiota versus specific viral pathogen exposures in immune maturation of “dirty” mice. Finally, they will serve to provide novel insights into immune responses directed against mucosal vaccines, which may have predictive value as this vaccination approach is increasingly implemented in humans.

# data[].attributes.title
Maturation of Social and Non-Social Reward Processing in the Adolescent Amygdala and Orbitofrontal Cortex

# data[].attributes.funder_divisions[]
National Institute of Mental Health (NIMH)

# data[].attributes.abstract
Adolescence is a time of substantial development attributed to the maturation of brain circuits that underlie the acquisition of new cognitive, emotional, and social skills. It is also a time of maximum vulnerability for mental disorders. In the past decade, the incidence of anxiety, depression, and suicide increased by ~60% in adolescents, remarkably more in females than in males. The social isolation during the COVID-19 pandemic added to the severity of the national and international statistics. To fully address the current youth mental health crisis, we need to understand how and why the dramatic reorganization of the adolescent brain contributes to the increased vulnerability to mental disorders. The studies proposed here rest on the assumption that the remodeling of the reward circuits of the brain creates the shared foundation of cognitive, affective, and social maturation during adolescence. Our multifaceted project addresses foundational gaps in our knowledge on how reward-driven motivational states inform adolescent behaviors such as risk-taking, pleasure-seeking, impulsivity, and a range of emotional responses to challenges of the social environment. We designed a within-subject, longitudinal study that spans the 2.5 - 3-year duration of adolescence in non-human primates. During this period, we will obtain repeated samplings of neurophysiological data recorded from the amygdala and orbitofrontal cortex in the context of the same behavioral tasks. In parallel, we will longitudinally monitor morphometric and microstructural changes in the gray and white matter of the brain through serial MRI scans, complemented by physical and hormonal measures of pubertal maturation. The three specific aims address the neural basis of three different aspects of reward processing in the subcircuit of the amygdala and orbitofrontal cortex. First, we will use a delay discounting task to determine the cellular and circuit level changes that underlie the increasing tolerance (or lack thereof) for delayed rewards. Second, we use a social reward-allocation task to test the neural underpinning of social reward processing in a self-oriented and an other-oriented social frame of reference. Finally, we will determine where and how social status is processed in the adolescent brain. Understanding social status relies on the ability to form abstract representations and is also a prerequisite for the successful integration of the individual into a hierarchical adult social group. The team, with combined expertise in human and non-human primate social behavior, neurophysiology, neuroimaging, and endocrinology, will apply conceptually and technically innovative approaches to generate unique and translational data, at both cellular and circuit levels, that account for the emerging cognitive, affective, and social skills acquired during adolescence.

# data[].attributes.keywords[]
United States National Institutes of Health