Grant List
Represents Grant table in the DB
GET /v1/grants?page%5Bnumber%5D=1384&sort=-award_amount
{ "links": { "first": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1&sort=-award_amount", "last": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1392&sort=-award_amount", "next": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1385&sort=-award_amount", "prev": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=1383&sort=-award_amount" }, "data": [ { "type": "Grant", "id": "8384", "attributes": { "award_id": "1I01BX005475-01", "title": "COVID19: SARS-CoV-2 and ACE2 interaction in hypertension", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-06-01", "end_date": "2023-05-31", "award_amount": null, "principal_investigator": { "id": 24159, "first_name": "ERIC D", "last_name": "LAZARTIGUES", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1705, "ror": "", "name": "SOUTHEAST LOUISIANA VETERANS HEALTH CARE", "address": "", "city": "", "state": "LA", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1705, "ror": "", "name": "SOUTHEAST LOUISIANA VETERANS HEALTH CARE", "address": "", "city": "", "state": "LA", "zip": "", "country": "United States", "approved": true }, "abstract": "The current COVID-19 pandemic is one of the most disruptive events in human history, caused by the SARS- CoV-2 virus, member of the coronavirus family that uses angiotensin converting enzyme 2 (ACE2), a transmembrane carboxypeptidase identified as a member of the renin-angiotensin system (RAS) as an entry point to the cells. Clinical reports suggest that pre-existing conditions such as hypertension, diabetes and obesity predispose to COVID-19 mortality. Considering that these co-morbidities are highly prevalent in Veterans and active duty personnel, these populations are at high risk of infection by SARS-CoV-2. The role of the brain RAS in the maintenance of normal blood pressure (BP) and in the neuro-cardiovascular dysregulation leading to hypertension has been firmly established. In addition, anosmia (loss of smell) is an early symptom of COVID-19 suggesting the brain is a primary target for SARS-CoV-2 infection. For the treatment of hypertension, two of the most popular drug choices are ACE inhibitors (ACEI) and angiotensin-II (Ang-II) type 1 receptor (AT1R) blockers (ARB). None of these classes of drugs have a direct effect on ACE2 activity, but there is evidence indicating that they may alter long-term ACE2 expression levels and subcellular localization, suggesting that patients taking these medications may be subject to more severe infections with SARS-CoV-2. Thus, clear data on the relationship between ACE2 plasma membrane levels, SARS-CoV-2 and co-expression of other RAS members are required to promptly adapt the therapy in this subset of patients. Beyond establishing ACE2 as a critical player in the prevention of neurogenic hypertension, our group was the first to report that Ang-II mediates ACE2 internalization and degradation via AT1R activation. Thus, the hypothesis of this proposal is that ACE2-AT1R complexes enhance SARS-CoV-2 infection in hypertensive Veterans while RAS blockers prevent ACE2 internalization and coronavirus infection. Taking advantage of unique resources, including a humanized transgenic mouse expressing human ACE2 constitutively, we will determine whether AT1R contribute to SARS- CoV-2 infection and whether ACEI and ARB reduce the incidence of COVID-19.", "keywords": [ "2019-nCoV", "ACE2", "Address", "Adult", "Affect", "Age", "Aldosterone", "American", "Angiotensin II Receptor", "Angiotensin-Converting Enzyme Inhibitors", "Angiotensins", "Anosmia", "Blood Pressure", "Brain", "Brain hemorrhage", "COVID-19", "COVID-19 mortality", "COVID-19 pandemic", "COVID-19 susceptibility", "Carboxypeptidase", "Cardiovascular system", "Cell Culture Techniques", "Cell membrane", "Cells", "Cleaved cell", "Clinical", "Clinical Trials", "Complex", "Coronary heart disease", "Coronavirus", "Coronavirus Infections", "Coronavirus spike protein", "Data", "Diabetes Mellitus", "Down-Regulation", "Enzymes", "Epithelial Cells", "Event", "Experimental Models", "Exposure to", "Family", "Human", "Human Resources", "Hypertension", "In Vitro", "Incidence", "Individual", "Infection", "Inflammation", "Ischemia", "Knock-in Mouse", "Life Style", "Light", "Losartan", "Lung", "Lysosomes", "Maintenance", "Mediating", "Medical", "Molecular", "Mus", "Neurons", "Obesity", "Patients", "Peptides", "Peptidyl-Dipeptidase A", "Pharmaceutical Preparations", "Pharmacology", "Population", "Predisposition", "Prevention", "Public Health", "Receptor Activation", "Receptor Angiotensin Type 1", "Recording of previous events", "Renin-Angiotensin System", "Reporting", "Resources", "Risk Factors", "Role", "SARS-CoV-2 infection", "Sodium Chloride", "Symptoms", "System", "Telemetry", "Testing", "Therapeutic", "Time", "Transgenic Mice", "Ubiquitination", "Up-Regulation", "Vasodilator Agents", "Vasopressins", "Veterans", "Viral", "Virus", "Virus Diseases", "Water", "active duty", "angiotensin I (1-7)", "base", "comorbidity", "diabetic patient", "high risk", "hypertension treatment", "improved", "in vivo", "infection rate", "inhibitor/antagonist", "member", "mouse model", "neurogenic hypertension", "novel therapeutic intervention", "obese patients", "overexpression", "patient subsets", "preservation", "prevent", "receptor", "therapeutic evaluation", "tool", "vascular bed", "vasoconstriction" ], "approved": true } }, { "type": "Grant", "id": "8425", "attributes": { "award_id": "1I01HX003221-01A1", "title": "Addressing insufficient positive airway pressure use among older Veterans with obstructive sleep apnea", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-07-01", "end_date": "2025-06-30", "award_amount": null, "principal_investigator": { "id": 24186, "first_name": "Cathy A", "last_name": "Alessi", "orcid": null, "emails": "[email protected]", "private_emails": null, "keywords": "[]", "approved": true, "websites": "[]", "desired_collaboration": "", "comments": "", "affiliations": [ { "id": 1708, "ror": "https://ror.org/05xcarb80", "name": "VA Greater Los Angeles Healthcare System", "address": "", "city": "", "state": "CA", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1708, "ror": "https://ror.org/05xcarb80", "name": "VA Greater Los Angeles Healthcare System", "address": "", "city": "", "state": "CA", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: The most frequently diagnosed sleep disorder among older Veterans is obstructive sleep apnea (OSA), which is associated with serious adverse effects on health, quality of life and survival. Positive airway pressure (PAP) is recommended as first-line treatment (particularly for moderate to severe OSA), but sustained use is difficult to achieve, including among older Veterans, and nearly half of patients with OSA who begin PAP therapy discontinue use within a year. Significance/Impact: Although OSA is a chronic condition, research to date has primarily focused on increasing initial PAP use in patients with newly diagnosed OSA. In addition, most research has not addressed PAP use in older adults, which is unfortunate given the high prevalence and important adverse effects of OSA on their health and well-being. Prior work suggests that behavioral interventions are effective in improving initial PAP use, but little is known of how to address insufficient use over time. Innovation: To address this problem, we developed and pilot-tested a structured, manual-based approach to address insufficient PAP use among older adults with previously diagnosed OSA. The intervention (5 sessions over 8 weeks, then monthly contact for up to 6 months) is designed so it can be provided by individuals (“sleep coaches”) from various disciplines (supervised remotely by a psychologist) in a variety of settings for maximal implementation. Core components of the intervention include: 1) educational and behavioral approaches to improve PAP use, 2) individualized self-management and troubleshooting techniques to address factors contributing to insufficient PAP use, and 3) ongoing review of objective PAP use (via remote monitoring). Specific Aims: Primary Aim 1 will test the efficacy of this intervention for improving PAP usage among older Veterans with previously diagnosed OSA who have insufficient PAP use. Our hypotheses are that the intervention will increase objectively measured PAP use at 6-months follow-up, with effects sustained at 12 months. Secondary Aim 2 will test for effects on sleep quality, daytime sleepiness and sleep-related function; and Exploratory Aim 3 will test for effects on health-related quality of life. Our hypotheses are that these outcomes will also improve at 6 months, and effects will be sustained at 12 months. Methodology: We propose a randomized, controlled trial to test this new intervention in older Veterans (aged > 65 years, N=90) with previously diagnosed OSA (moderate to severe) who were prescribed PAP 1-5 years in the past, but have insufficient PAP use (defined as no PAP use over the prior 30 days). Given prior growing interest in telehealth and remote monitoring approaches to optimize PAP use, and the ongoing COVID-19 pandemic, all aspects of the study will be performed virtually in keeping with the latest VA COVID-era guidance for the remote testing and treatment of OSA. Participants will be randomized to the intervention or a control program that mirrors “optimal usual care” for OSA plus general sleep education (attention control). Structured assessments at baseline, post-treatment (after session 5) and 6- and 12-months follow-up include objectively measured PAP use (via remote telemonitoring), sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness Scale), sleep-related function (Functional Outcomes of Sleep-10) and health- related quality of life (PROMIS-29 v2.1 Physical and Mental Health Summary Scores). We will collect participant experiences and attitudes related to the intervention, and implementation outcome measures (acceptability, appropriateness, fidelity and staff time as an estimate of cost) to inform future implementation. Implementation/Next Steps: The long-term goal of this work is to effectively address insufficient PAP use among older Veterans with OSA to improve their health and quality of life. If successful, we will implement the intervention at our institution, and develop and disseminate an implementation package with actual tools needed to promote wider implementation of this model of care into clinical practice.", "keywords": [ "Address", "Adverse effects", "Aftercare", "Area", "Attitude", "Behavior Therapy", "Behavioral", "COVID-19 pandemic", "Cardiovascular Diseases", "Caring", "Chronic", "Clinical", "Data", "Diabetes Mellitus", "Diagnosis", "Discipline", "Disease", "Drowsiness", "Education", "Elderly", "Equipment", "Future", "Goals", "Health", "Healthcare Systems", "High Prevalence", "Hour", "Hypertension", "Hypoxia", "Impaired cognition", "Individual", "Information Systems", "Institution", "Intervention", "Left", "Manuals", "Measurement", "Measures", "Mental Depression", "Mental Health", "Methodology", "Modeling", "Newly Diagnosed", "Obstructive Sleep Apnea", "Outcome", "Outcome Measure", "Participant", "Patient Outcomes Assessments", "Patients", "Personal Satisfaction", "Pittsburgh Sleep Quality Index", "Prevalence", "Provider", "Psychologist", "Quality of life", "Randomized", "Randomized Controlled Trials", "Reporting", "Research", "Risk", "Self Management", "Services", "Sleep", "Sleep Apnea Syndromes", "Sleep Disorders", "Structure", "Supervision", "Techniques", "Telephone", "Testing", "Time", "Treatment Efficacy", "Veterans", "Work", "adverse outcome", "aged", "airway obstruction", "attentional control", "base", "clinical practice", "coronavirus disease", "cost estimate", "design", "effective intervention", "efficacy testing", "experience", "follow-up", "functional outcomes", "health related quality of life", "implementation outcomes", "improved", "innovation", "interest", "novel", "novel strategies", "outreach", "physical conditioning", "pressure", "primary outcome", "programs", "remote health care", "remote monitoring", "sleep quality", "stroke recovery", "telehealth", "telemonitoring", "tool", "treatment as usual", "virtual" ], "approved": true } }, { "type": "Grant", "id": "8524", "attributes": { "award_id": "1I01BX005507-01", "title": "COVID19: Respiratory SARS-CoV-2 seroprevalence and the association of humoral immune responses with clinical outcomes in veterans and employees in the Cleveland VA Medical Center", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-07-01", "end_date": "2023-06-30", "award_amount": null, "principal_investigator": { "id": 24292, "first_name": "Carey", "last_name": "Shive", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1483, "ror": "https://ror.org/01vrybr67", "name": "Louis Stokes Cleveland VA Medical Center", "address": "", "city": "", "state": "OH", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1483, "ror": "https://ror.org/01vrybr67", "name": "Louis Stokes Cleveland VA Medical Center", "address": "", "city": "", "state": "OH", "zip": "", "country": "United States", "approved": true }, "abstract": "The global pandemic of SARS-CoV-2 is placing urgent demands on health care workers and researchers. Between April 3rd and May 1st global cases of COVID19 nearly tripled from approximately 1 million to over 3 million. With the possibility of a reemergence of SARS-CoV-2 in the fall, rapid specific antibody assays are essential. This application proposes to investigate the humoral immune responses to SARS-CoV-2 in veterans and employees at the Cleveland VA Medical Center. The proposal has three aims. Aim 1) To develop rapid, high throughput assays to measure total and functional antibodies to SARS-CoV-2 proteins in COVID19 infected individuals. In aim 1, we will establish a magnet bead-based assay that can detect antibody (Ab) responses to up to 50 different epitopes of SARS-CoV-2 in one serum sample. This assay will also be able to detect Abs that interfere with the binding of the receptor binding domain (RBD) of the spike protein of SARS- CoV-2 to its receptor, ACE2. Antibodies that can block binding between the RBD and ACE2 on lung epithelial cells will prevent viral entry and will likely be neutralizing. Aim 2) To determine if robust humoral immunity and higher neutralizing Ab titers protect VA health care employees from clinical COVID19 compared to their colleagues with low or no SAR2-CoV-2 specific antibodies. In aim 2 we will use a rapid antibody test to screen Cleveland VA health care employees at high-risk for infection with COVID19 (first responders, emergency department staff, intensive care unit staff, COVID19 ward staff). We will ask for a serum sample from those that are Ab positive for COVID19 to examine the SARS-CoV-2 Ab response in more depth. We will examine general Ab titers, neutralizing Ab titers, and antibody isotypes. If there is a resurgence of COVID19 in the fall, we will determine if those health care employees with a robust humoral response are better protected from re- infection than those employees who had a weak or no Ab response. Aim 3) To examine the association of COVID19-induced lymphopenia with the ability to generate a humoral immune response. Older age, SARS- CoV-1 and SARS-COV-2 infection are all associated with a decrease of white blood cells or lymphopenia. In aim 3 we will examine the effect of lymphopenia on the development of the humoral Ab response to COVID19. We expect that those individuals with severe lymphopenia will have few T follicular helper cells in their lymph nodes and this will lead to poor Ab affinity maturation, isotype switching, and B cell memory development. In summary, results from this project will provide a rapid SARS-CoV-2 specific serum assay able to detect neutralizing Ab that can be used to screen VA healthcare workers for exposure to SARS-CoV-2. We will investigate the humoral antibody responses of high-risk health care employees that were infected with COVID19 and try to determine what constitutes protection from re-infection if there is a resurgence of COVID19 in the fall. Lastly, we will gain an understanding of the B cell affinity maturation, isotype switching and generation of B cell memory and neutralizing Ab titers and determine how lymphopenia may play a role in the dysfunction of humoral immunity to COVID19. This knowledge will aid in development of better treatment and future vaccines.", "keywords": [ "2019-nCoV", "ACE2", "Accident and Emergency department", "Address", "Affect", "Affinity", "Age", "Antibodies", "Antibody Affinity", "Antibody Response", "Antibody titer measurement", "Antigens", "Avidity", "B-Lymphocyte Subsets", "B-Lymphocytes", "Binding", "Biological Assay", "Blood specimen", "COVID-19", "COVID-19 morbidity", "COVID-19 mortality", "COVID-19 pandemic", "Cells", "Characteristics", "Clinic", "Clinical", "Common Cold", "Coronavirus", "Development", "Disease Progression", "Elderly", "Employee", "Enrollment", "Enzyme-Linked Immunosorbent Assay", "Epithelial Cells", "Epitopes", "Exposure to", "Flow Cytometry", "Foundations", "Frequencies", "Functional disorder", "Future", "Generations", "Health Personnel", "Healthcare", "Helper-Inducer T-Lymphocyte", "Hospitals", "Humoral Immunities", "Immune response", "Immunoglobulin Class Switching", "Immunoglobulin Somatic Hypermutation", "Immunologics", "Individual", "Infection", "Inpatients", "Intensive Care Units", "KAI1 gene", "Knowledge", "Length", "Leukocytes", "Lung", "Lymphopenia", "Measures", "Mediating", "Medical center", "Memory B-Lymphocyte", "Ohio", "Outcome", "Outpatients", "Patients", "Play", "Proteins", "Recombinants", "Research Personnel", "Risk", "Role", "SARS coronavirus", "SARS-CoV-2 antibody", "SARS-CoV-2 exposure", "SARS-CoV-2 immunity", "SARS-CoV-2 infection", "SARS-CoV-2 positive", "SARS-CoV-2 spike protein", "Sampling", "Seroprevalences", "Serum", "Severity of illness", "T-Lymphocyte", "Testing", "Vaccines", "Veterans", "Viral", "Virus", "antibody detection", "antibody test", "antigen detection", "base", "falls", "first responder", "high risk", "high throughput screening", "infection risk", "lymph nodes", "neutralizing antibody", "novel therapeutics", "pandemic disease", "prevent", "receptor", "receptor binding", "respiratory", "response", "symptomatic COVID-19", "therapeutic development", "therapy development", "vaccine development", "ward" ], "approved": true } }, { "type": "Grant", "id": "8527", "attributes": { "award_id": "1I01BX005459-01", "title": "COVID-19: HDL's Role in Innate Immunity and Cardiovascular Protection with COVID-19", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-07-01", "end_date": "2023-06-30", "award_amount": null, "principal_investigator": { "id": 24296, "first_name": "John Michael", "last_name": "Stafford", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1477, "ror": "https://ror.org/05eq41471", "name": "Veterans Health Administration", "address": "", "city": "", "state": "MI", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1477, "ror": "https://ror.org/05eq41471", "name": "Veterans Health Administration", "address": "", "city": "", "state": "MI", "zip": "", "country": "United States", "approved": true }, "abstract": "COVID19: HDL’s Role in Innate Immunity and Cardiovascular Protection with COVID-19 The novel coronavirus (SARS-CoV-2) causes a disease called COVID-19. For many people, COVID-19 has almost no symptoms, yet for others, COVID-19 is particularly dangerous and has high morbidity and mortality rates. People with pre-existing type-2 diabetes and atherosclerotic cardiovascular disease (ASCVD) have twice the risk of SARS-CoV-2 infection and are more likely to have poor outcomes. 70% of patients with ASCVD and elevated troponin die of COVID. We don’t know what intrinsic factors contribute to these disparate outcomes. High Density Lipoprotein (HDL) particles play a critical role in the innate immune system and are protective against viral and bacterial infections. HDL particles best are known for their roles protecting from atherosclerotic cardiovascular disease (ASCVD). The cardiovascular protection conferred by HDL is largely mediated by HDL’s associated proteins, which comprise about half of HDL’s mass. Mechanisms for HDL’s protection from ASCVD are shared with mechanisms for HDL’s protection from viral infections. These protective properties center around the HDL-associated proteins that mediate its anti-inflammatory and antioxidative functions. The goal of this project is to define how HDL may protect from Sars-CoV-2 infection and limit the inflammatory response to COVID-19 illness. Obesity and type-2 diabetes (DM2) lead to hypertriglyceridemia and metabolic changes that impair HDL’s anti-inflammatory and antioxidative functions. We will define if DM2 leads to HDL dysfunction and contributes to severe COVID-19 outcomes. Our overarching hypothesis is that HDL’s antiviral properties can limit SARS-CoV-2 infection and that HDL’s anti-inflammatory and antioxidative capacity limit the systemic inflammatory response to COVID-19. We have initiated a collaboration with Dr. Malall, an immunology expert running a large trial with COVID-19 patients whose de-identified samples are paired with de-identified EMR outcomes data. In AIM1 we will test the hypothesis that SARS-CoV-2 infection impairs HDL’s antioxidative and anti-inflammatory capacities, and that these changes can be predicted by proteomic signatures of HDL. We also have collaboration with Dr. Denison, an expert in coronavirus biology. In AIM2 we will test the hypothesis that HDL can reduce SARS-CoV-2 infectivity of lung epithelial cells, but that COVID-19 impairs HDL’s antiviral capacity, which can be improved with Remdesavir treatment. In AIM3 we will test the hypothesis that type-2 diabetes alters the HDL-associated protein networks that limit systemic inflammation with COVID-19 and protect against SARS-CoV-2 infection. Diabetes and cardiovascular disease are among the most prevalent problems among United States Veterans, making Veterans more likely to have poor COVID-19 outcomes. An asset to this project is that we can relate our HDL function and antiviral assays with clinical outcomes. Our studies will define proteomic signatures from HDL that are important for its antiviral effects. We ultimately aim to use HDL-directed therapies like recombinant Apo-A1 peptides to improve COVID outcomes.", "keywords": [ "2019-nCoV", "Acute-Phase Reaction", "Adult Respiratory Distress Syndrome", "Age", "Anti-Bacterial Agents", "Anti-Inflammatory Agents", "Antiviral Agents", "Apolipoprotein A-I", "Apolipoprotein E", "Atherosclerosis", "Bacterial Infections", "Basic Science", "Biological Assay", "Biology", "COVID-19", "COVID-19 assay", "COVID-19 mortality", "COVID-19 patient", "Cardiovascular Diseases", "Cardiovascular system", "Cause of Death", "Cessation of life", "Cholesterol", "Clinical", "Clinical Trials", "Collaborations", "Coronavirus", "Dangerousness", "Data", "Development", "Diabetes Mellitus", "Disease", "Epithelial Cells", "Functional disorder", "Goals", "HIV", "HIV Infections", "Heart Diseases", "Hepatic", "High Density Lipoprotein Cholesterol", "High Density Lipoproteins", "Hypertriglyceridemia", "Immunology", "Impairment", "Infection", "Inflammation", "Inflammatory", "Inflammatory Response", "Influenza", "Innate Immune System", "Interferon-beta", "Intrinsic factor", "Knowledge", "Lead", "Lipids", "Lipoproteins", "Lung", "Mediating", "Membrane Fusion", "Metabolic", "Morbidity - disease rate", "Natural Immunity", "Non-Insulin-Dependent Diabetes Mellitus", "Obesity", "Outcome", "Pathway interactions", "Patients", "Peptides", "Play", "Production", "Property", "Proteins", "Proteomics", "Recombinants", "Risk", "Role", "Running", "SARS-CoV-2 infection", "Sampling", "Scaffolding Protein", "Sepsis", "Symptoms", "Testing", "Therapeutic", "Troponin", "United States", "Veterans", "Viral", "Virus Diseases", "Virus Replication", "coronavirus disease", "cytokine", "high risk", "improved", "innovation", "lipidomics", "macrophage", "mortality", "novel coronavirus", "particle", "peptidomimetics", "protein expression", "proteomic signature", "response", "severe COVID-19", "symptomatic COVID-19", "systemic inflammatory response", "targeted treatment" ], "approved": true } }, { "type": "Grant", "id": "8549", "attributes": { "award_id": "1I21RX003731-01", "title": "Feasibility of a tele-game-based exercise (Tele-exergame) program to prevent deconditioning in hospitalized COVID-19 patients", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-07-01", "end_date": "2023-06-30", "award_amount": null, "principal_investigator": { "id": 24319, "first_name": "Sarvari", "last_name": "Yellapragada", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1685, "ror": "", "name": "MICHAEL E DEBAKEY VA MEDICAL CENTER", "address": "", "city": "", "state": "TX", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1685, "ror": "", "name": "MICHAEL E DEBAKEY VA MEDICAL CENTER", "address": "", "city": "", "state": "TX", "zip": "", "country": "United States", "approved": true }, "abstract": "Conventional face-to-face in-hospital mobility program (MP) is impractical for COVID-19 patients because of its associated risk of infection to hospital staff as well as other hospitalized patients. To address the gap, we propose a novel game-based virtually supervised (contactless) foot and ankle exercise, called Tele-Exergame, as an alternative and practical option. The primary goal of this SPiRE application is to test feasibility, acceptability, and proof of concept effectiveness of Exergame in COVID-19 patients as an alternative to conventional in-hospital MP to reduce the loss of mobility during hospitalization and decline in mental health. Exergames are digital or web-based games that use body movement to promote physical activity and generally involve strength, balance, and flexibility exercises. The tele-exergame MP, developed by our team, uses a remotely supervised and game-based approach, which helps to increase patient motivation and engagement in a cognitively demanding exercise program. For example, the Tele-Exergame MP includes foot and ankle exercise tasks with explicit augmented visual feedback (i.e., the patient's movement controls an object on the screen, thus providing real-time visual and audio feedback that is critical for motor learning). Monitoring and feedback are achieved by using wearable sensors worn on feet. Our game-based exercise includes a wide range of safe non-weight bearing exercise tasks, suitable for bedbound patients, and is inspired by an evidence-based exercise program. A popular game (flight shooter game) that could be played either while sitting or lying in bed by rapid, alternating ankle dorsiflexion and plantarflexion will be used. The motion of foot is translated into the movement of an avatar to play the game; for example, to “shoot” targets on a screen. The sensor on the foot can quantify motor and cognitive performance (e.g., slowness, weakness, exhaustion, and working memory), defined as cognitive frailty, using a validated algorithm developed by our team. Exercises are demonstrated remotely using a tele-medicine tablet, and the movement of subjects is monitored in real-time by research staff. To demonstrate the feasibility of Tele-Exergame MP, COVID-19 or PUI (persons under investigation) participants admitted to the MEDVAMC (n=60), with an anticipated length of stay at least 3 days will be recruited. Participants will be randomized (n=1:1) to either intervention (IG) or control (CG) groups. Both groups will receive standard of care. IG will additionally receive Tele-Exergame MP therapy. Tele-Exergame sessions will range from 3-10 minutes based on patient ability and completed twice daily. Primary outcomes include acceptability, deconditioning (cognitive-frailty), and mental health (e.g., depression and anxiety) assessed at baseline, at discharge, and at 1-month post-discharge. Secondary outcomes include adverse events (e.g., venous thromboembolism (VTE), falls, etc), instrumental activities of daily living, and community mobility, which will be assessed at baseline and at one-month post-hospital discharge. Our main hypotheses are H1) Tele-Exergame in hospital setting is feasible with less than 15% drop out and over 70% compliance; H2) The perceived ease of use, acceptability, and benefit is high as assessed using a validated technology acceptance model survey; H3) IG has less deconditioning and better mental health outcomes compared to CG at the time of discharge; H3) At 4 weeks post-discharge, the self-reported activity of daily living (ADL) and life space (LSA) would be higher in IG compared to CG. Impact: There is no existing contact-less in-hospital MP that is available for hospitalized COVID-19 population. If the feasibility and effectiveness of the proposed tele-exergame MP is demonstrated, it will address the current challenges for implementing in-hospital MP for COVID-19 patients and also open new avenues to deliver personalized exercise for non-COVID-19 patients with limited mobility including bedbound and hospitalized patients.", "keywords": [ "Activities of Daily Living", "Address", "Adherence", "Adverse event", "Aging", "Algorithms", "Ankle", "Anxiety", "Beds", "Blood Vessels", "COVID-19", "COVID-19 patient", "Cessation of life", "Cognitive", "Communities", "Complex", "Dropout", "Drops", "Effectiveness", "Elderly", "Equilibrium", "Equipment", "Exercise", "Feedback", "Fright", "Goals", "Health", "Home", "Hospitalization", "Hospitals", "Image", "Infection", "Inpatients", "Intervention", "Investigation", "Lead", "Leg", "Length of Stay", "Life", "Lower Extremity", "Medical center", "Mental Depression", "Mental Health", "Modeling", "Monitor", "Motion", "Motivation", "Motor", "Movement", "Online Systems", "Outcome", "Participant", "Patient Self-Report", "Patients", "Perception", "Persons", "Physical activity", "Pilot Projects", "Play", "Population", "Protocols documentation", "Questionnaires", "Randomized", "Recovery", "Research", "Research Support", "Risk", "Series", "Severity of illness", "Short-Term Memory", "Supervision", "Surveys", "Tablet Computer", "Tablets", "Technology", "Telemedicine", "Telephone", "Texas", "Time", "Translating", "Veterans", "Visual", "Work", "acceptability and feasibility", "base", "cognitive performance", "comorbidity", "deconditioning", "design", "digital", "disability", "eligible participant", "evidence base", "exercise intensity", "exercise program", "exergame", "exhaustion", "falls", "feasibility testing", "flexibility", "foot", "frailty", "functional decline", "improved", "improved mobility", "infection risk", "innovation", "instrumental activity of daily living", "meter", "motor learning", "novel", "patient population", "prevent", "primary outcome", "programs", "psychologic", "recruit", "secondary outcome", "sensor", "standard of care", "venous thromboembolism", "virtual", "visual feedback", "wearable sensor technology" ], "approved": true } }, { "type": "Grant", "id": "8560", "attributes": { "award_id": "1I21HX003373-01A1", "title": "Optimizing Patient-Centered Routine Care at a Distance for Veterans with Chronic Conditions", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-08-01", "end_date": "2023-01-31", "award_amount": null, "principal_investigator": { "id": 24329, "first_name": "Abigail", "last_name": "Baim-Lance", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1533, "ror": "", "name": "JAMES J PETERS VA MEDICAL CENTER", "address": "", "city": "", "state": "NY", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1533, "ror": "", "name": "JAMES J PETERS VA MEDICAL CENTER", "address": "", "city": "", "state": "NY", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: As a result of COVID-19, the VA has undergone a sizable transition to Care at a Distance in order to ensure the safe delivery of services. Components encompass expanded telehealth, distancing measures at routine face to face visits, and other practice changes. How Veterans with chronic conditions who regularly use VA healthcare experience these changes is unknown. This 18-month pilot study assesses a mixed methods approach to describe Care at a Distance for older, chronically ill Veterans, how service changes are experienced by Veterans, and how the experiences affect health management and outcomes. Significance/Impact: The unprecedented impact of COVID-19 provides an opportunity to advance novel Veteran-centered mixed methods to understand the pandemic’s effects on Veteran healthcare. Investigations can identify and test out Veteran-centered system improvements that support preparedness for future emergencies. This study aligns with VA’s strategic goals and objectives for FY2018-2024 to promote ‘customer service,’ and HSR&D’s scientific priorities to improve telehealth’s effectiveness, and to use primary care to optimize complex chronic disease management. It also aligns with ongoing activities in the Veterans Experience Office using journey mapping to understand Veteran experiences of VA care. Innovation: The proposed mixed methods pilot study is interdisciplinary, using novel methods in VA studies. By drawing upon theories and methods of medical anthropology and health services research, the pilot study is positioned to produce deep and actionable knowledge about COVID-19’s impact on Veterans and their care. Specific Aims: Aim 1: Describe components of Care at a Distance, to inform adapting an experience-based journey mapping template, which will describe how Care at a Distance affects the healthcare experiences of older Veterans with comorbidities, and their health outcomes. Aim 2: Test the feasibility and acceptability, and conduct an analysis, of embedding experienced-based journey mapping within in-depth qualitative interviews to describe Care at a Distance for older Veterans with comorbidities, and their routine care providers. Aim 3: Assess the utility of the mixed methods techniques to examine relationships among service changes, Veteran experiences, and health outcomes, incorporating chart review as a comparative and triangulating data source. Methods: The study uses a sequential design carried out at the James J. Peters VA in Bronx, NY and VA Hudson Valley Health Care in upstate, New York. In Aim 1, a documents analysis of VA Care at a Distance changes will be conducted to refine an inventory of components, key features, and their implementation. The inventory will inform an adapted experience-based journey map template and interview topic guide, and a medical chart analysis. In Aim 2, 40 Veterans will be recruited who are 65+ years old with two or more comorbidities (one being HIV or diabetes) and eligible for enrollment in the GeriPact, or HIV clinic. Interviews will use the experience-based survey mapping template to document service encounters and experiences before COVID- 19 (prior to March 2020), in the initial phase (March-May 2020), and during the Moving Forward period (June 2020-time of study). A follow-up interview will discuss feasibility and acceptability of mapping. 12 provider interviews will be conducted about implementation and Veteran experiences of Care at a Distance, and the feasibility of journey mapping. We will analyze for feasibility and acceptability, and conduct a qualitative thematic and process analysis. In Aim 3, a chart review will be performed to examine the record of health use and outcomes, and a comparative analysis will be performed between charts and the maps. Implementation/ Next Steps: Findings will be used to develop an IIR research proposal to: 1) describe Care at a Distance impact across VA facilities; and 2) test out and evaluate interventions to improve care for Veterans, particularly those aging with chronic health conditions. The VA Veteran Experience Office will partner on this study, and continuous Veteran input will be sought.", "keywords": [ "Affect", "Aging", "Anthropology", "COVID-19", "Caring", "Chronic", "Chronic Disease", "Chronically Ill", "Clinic", "Complex", "Consult", "Data", "Data Sources", "Development", "Diabetes Mellitus", "Disease Management", "Effectiveness", "Eligibility Determination", "Emergency Situation", "Enrollment", "Ensure", "Environment", "Equipment and supply inventories", "Evaluation", "Frequencies", "Future", "Goals", "Guidelines", "HIV", "Health", "Health Services Research", "Healthcare", "Intervention", "Interview", "Investigation", "Knowledge", "Maps", "Measures", "Medical", "Medical center", "Methods", "New York", "Outcome", "Outpatients", "Patient-Centered Care", "Persons", "Phase", "Pilot Projects", "Positioning Attribute", "Primary Health Care", "Process", "Provider", "Quality of Care", "Readiness", "Research Proposals", "Services", "Surveys", "System", "Techniques", "Telephone", "Testing", "Time Study", "To specify", "Veterans", "Veterans Health Administration", "Visit", "acceptability and feasibility", "base", "care delivery", "care providers", "comorbidity", "comparative", "coronavirus disease", "design", "experience", "feasibility testing", "follow-up", "health care availability", "health management", "health record", "human old age (65+)", "improved", "innovation", "medical appointment", "medical specialties", "novel", "pandemic disease", "patient oriented", "primary care services", "recruit", "routine care", "service delivery", "social", "stem", "telehealth", "telemonitoring", "theories", "virtual" ], "approved": true } }, { "type": "Grant", "id": "8954", "attributes": { "award_id": "1IK6HX003395-01", "title": "HSR&D Senior Research Career Scientist Award", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-10-01", "end_date": "2028-09-30", "award_amount": null, "principal_investigator": { "id": 24789, "first_name": "Denise M.", "last_name": "Hynes", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1518, "ror": "https://ror.org/02v3txv81", "name": "Portland VA Medical Center", "address": "", "city": "", "state": "OR", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1518, "ror": "https://ror.org/02v3txv81", "name": "Portland VA Medical Center", "address": "", "city": "", "state": "OR", "zip": "", "country": "United States", "approved": true }, "abstract": "As a VA Core Investigator at the HSR&D Center to Improve Veteran Involvement in Care and the Evidence Synthesis Program Coordinating Center based at the Portland VA Healthcare System, my current research activities include Scholarly Research, Training emerging scientists, and leading and participating in Service to VA research and clinical programs. My current work is innovative and highly relevant for one of the most dynamic and transformative periods for healthcare systems broadly, and for VA healthcare especially. The overarching goal of my Scholarly Research activities is to understand and identify ways to improve chronic disease management, including access, quality, and economic outcomes. I direct research on the potential for care coordination models to improve chronic disease management for high risk/high need Veterans and to offset any adverse effects of multi-system health care use across the VA and non-VA health systems. My past research focused on Veterans with chronic kidney disease and cancer led to my current focus on high risk/high need Veterans, including ongoing research on Veterans recovering from COVID-19 illness. Our HSR&D grant pending “Care Coordination and Outcomes for High Risk Patients: Building the Evidence for Implementation”, seeks to identify the current care coordination processes and data resources necessary to conduct a VA implementation study aimed at improving patient and provider experience and health outcomes across VA and non-VA settings. The project also includes partnership with the VA Offices of Community Care, Nursing, and Social Work and other VA offices. Proactive dissemination of my research findings is done through briefings at stakeholder meetings and professional society meetings. I will continue to produce peer reviewed publications of my own research and seek a new opportunity to edit a journal supplement on care coordination as more evidence on implementation science grows and yields results. My research Training activities aim to develop the next generation of VA health services researchers with focus on skill development in methods, measurement, and applying health data resources. I am currently mentoring four VA early career clinician scientists and one PhD postdoctoral fellow. As a graduate program director in Health Management and Policy in my university role, I am and will continue to mentor MPH and PhD candidates and make them aware of the opportunities the VA offers in HSR&D research careers. Further, with faculty roles in Oregon State University (OSU) College of Public Health and Human Sciences, the OSU Center for Genome Research and Biocomputing, and Oregon Health and Science University, together with a new HSR&D Senior Research Career Scientist award, I will be uniquely positioned to develop a new training program that draws on these multi-institutional relationships. My vision is to develop a new training program in Data Science for Better Health, including data science to support care coordination process and outcome measurement and analytics. The goals of my research Service activities are to share my research expertise to inform clinical policy and practice and to contribute to the VA research programs. I will continue involvement in the national VA efforts to inform implementation of care coordination practice alongside our research. My contributions to research programs will include continued support of our Veteran engagement efforts, and participation in peer review activities and on advisory boards for critical VA research programs. An award as a Senior Research Career Scientist would provide me with the opportunity to continue and enrich these important research activities in conducting scholarly and impactful research, training the next generation of scientists, and enhancing the visibility of VA research through leadership and service, and ultimately benefiting the Veterans served by VA health systems.", "keywords": [ "Address", "Adverse effects", "Anemia", "Appointment", "Award", "Awareness", "COVID-19", "Caring", "Case Management", "Chronic", "Chronic Disease", "Chronic Kidney Failure", "Clinical", "Clinical Practice Guideline", "Communities", "Cost Savings", "Data", "Data Analyses", "Data Science", "Depression screen", "Dialysis procedure", "Discipline of Nursing", "Disease Management", "Doctor of Philosophy", "Dose", "Erythropoietin", "Evaluation", "Faculty", "Family", "Fellowship", "Funding", "General Population", "Genome", "Geography", "Goals", "Grant", "Health", "Health Policy", "Health Sciences", "Health Services", "Health Services Accessibility", "Health system", "Healthcare", "Healthcare Systems", "Hearing", "Hemodialysis", "Human", "Information Resources", "Information Systems", "Intervention", "Joints", "Journals", "Kidney", "Kidney Diseases", "Knowledge", "Lead", "Leadership", "Link", "Measurement", "Medical", "Medicare", "Medicare/Medicaid", "Medication Management", "Medicine", "Mentors", "Methods", "Modeling", "Nurses", "Oregon", "Outcome", "Patients", "Peer Review", "Policies", "Positioning Attribute", "Postdoctoral Fellow", "Primary Health Care", "Private Sector", "Process", "Professional Organizations", "Provider", "Public Health", "Public Health Informatics", "Publications", "Quality of Care", "Quality of life", "Renal carcinoma", "Research", "Research Activity", "Research Personnel", "Research Training", "Resources", "Role", "Saran", "Savings", "Scholarship", "School Nursing", "Science", "Scientist", "Seminal", "Services", "Social Work", "Speed", "System", "Technical Expertise", "Training", "Training Activity", "Training Programs", "Translations", "Universities", "Veterans", "Vision", "Work", "base", "biocomputing", "care coordination", "care costs", "care outcomes", "career", "clinical practice", "college", "community based care", "cost", "data resource", "economic outcome", "experience", "health data", "health management", "high risk", "implementation efforts", "implementation research", "implementation science", "implementation study", "improved", "innovation", "meetings", "military veteran", "next generation", "payment", "post-doctoral training", "professor", "programs", "routine practice", "service engagement", "skill acquisition", "socioeconomics", "subcutaneous", "symposium", "working group" ], "approved": true } }, { "type": "Grant", "id": "8955", "attributes": { "award_id": "1IS1BX005567-01", "title": "ShEEP request for Andor Dragonfly High Speed Confocal Platform", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-10-01", "end_date": "2022-09-30", "award_amount": null, "principal_investigator": { "id": 24790, "first_name": "Nicole Faron", "last_name": "Liachko", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1512, "ror": "", "name": "VA PUGET SOUND HEALTHCARE SYSTEM", "address": "", "city": "", "state": "WA", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1512, "ror": "", "name": "VA PUGET SOUND HEALTHCARE SYSTEM", "address": "", "city": "", "state": "WA", "zip": "", "country": "United States", "approved": true }, "abstract": "Request for an Andor Dragonfly High Speed Confocal Platform. We are requesting the purchase of an Andor Dragonfly spinning disk confocal microscope (aka Dragonfly) for high- speed and high-resolution imaging of microscopic cellular features. This instrument incorporates high-speed fully scalable state-of-the-art confocal imaging capable of resolving sub-cellular protein targets at the cell membrane using total internal reflectance (TIRF), or deeper in the cell with SRRF-Stream and dSTORM super-resolution techniques. The Dragonfly uses Imaris for real-time graphics processing unit (GPU)-based image processing providing seamless integration with downstream image processing workflows and data analysis, platform interoperability, improved data integrity, audit compliance, and user productivity. The Dragonfly uses a proprietary multi-point confocal for high-speed and high- sensitivity imaging that is at least 10 times faster than conventional confocal technology. The unique illumination method enables even signal intensity across the field of view. The Dragonfly is the optimal solution to meet a broad array of rigorous live cell imaging needs that encompass analysis of behaving brain cells in ex vivo experiments examining calcium dynamics or neuroimmune cell function, cellular transport, synaptic vesicle trafficking, immune cell mobility and infiltration assays among others. As such, it will advance research into Aging, Dementia, Traumatic brain injury, and other emergent health concerns including COVID-19. The instrument will be placed in VA Puget Sound Health Care System (VA PSHCS) GRECC research space (Building 1 7th floor) and operated by trained staff. Primary users are BLR&D Merit review funded GRECC core staff: Drs. David Cook, Nicole Liachko, Brian Kraemer, Jose Garcia, and Chang-en Yu. Secondary users are MIRECC Investigators Jeffery Iliff, Dianne Lattemann, and James Meabon as well as GRECC core staff Erik Carlson and CDA2 recipient Rebecca Kow. Purchase of the Dragonfly is expected to increase the competitiveness of the overall VA PSHCS research program, significantly increase effectiveness and efficiency of confocal microscope imaging, and further the GRECC and MIRECC research missions by providing instrumentation necessary for robust cell and tissue based investigations into the molecular mechanisms of disease and aging.", "keywords": [ "Acute Disease", "Aging", "American", "Amyotrophic Lateral Sclerosis", "Area", "Basic Science", "Biological Assay", "COVID-19", "Calcium", "Cell Mobility", "Cell membrane", "Cell physiology", "Cells", "Cellular Structures", "Chronic Disease", "Clinical Research", "Color", "Confocal Microscopy", "Data", "Data Analyses", "Dementia", "Disease", "Effectiveness", "Elderly", "Floor", "Funding", "Health", "Healthcare Systems", "Image", "Immune", "In Vitro", "Infiltration", "Informatics", "Infrastructure", "Institution", "Investigation", "Lighting", "Mental disorders", "Metabolic Diseases", "Methods", "Microscope", "Microscopy", "Mission", "Molecular", "Neuroimmune", "Output", "Performance", "Photobleaching", "Phototoxicity", "Process", "Productivity", "Property", "Protein Dynamics", "Proteins", "Research", "Research Personnel", "Research Priority", "Research Support", "Resolution", "Sheep", "Signal Transduction", "Speed", "Stream", "Synaptic Vesicles", "System", "Techniques", "Technology", "Testing", "Time", "Tissues", "Training", "Traumatic Brain Injury", "Veterans", "archive data", "base", "brain cell", "clinical center", "confocal imaging", "cooking", "cost", "data archive", "data integrity", "data sharing", "digital", "education research", "experimental study", "high resolution imaging", "image processing", "imaging capabilities", "improved", "in vivo", "instrument", "instrumentation", "interoperability", "live cell imaging", "microscopic imaging", "molecular imaging", "programs", "protein protein interaction", "rehabilitation research", "repository", "research and development", "research study", "single molecule", "sound", "systems research", "trafficking" ], "approved": true } }, { "type": "Grant", "id": "8956", "attributes": { "award_id": "1I01HX003304-01A1", "title": "Optimizing Veteran Recovery from Sepsis (OVeR-Sepsis)", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-10-01", "end_date": "2025-09-30", "award_amount": null, "principal_investigator": { "id": 24791, "first_name": "Hallie Christine", "last_name": "Prescott", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1477, "ror": "https://ror.org/05eq41471", "name": "Veterans Health Administration", "address": "", "city": "", "state": "MI", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [ { "id": 24792, "first_name": "Jeremy Broder", "last_name": "Sussman", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] } ], "awardee_organization": { "id": 1477, "ror": "https://ror.org/05eq41471", "name": "Veterans Health Administration", "address": "", "city": "", "state": "MI", "zip": "", "country": "United States", "approved": true }, "abstract": "Background. Sepsis—life-threatening organ dysfunction triggered by infection—hospitalizes more than 25,000 Veterans each year, making it the 2nd most common reason for hospitalization in the VA. While most Veterans survive the acute episode, many suffer poor longer term outcomes. Approximately 1 in 3 survivors die in the year following sepsis, 1 in 5 have a potentially preventable rehospitalization, and 1 in 6 experience severe persistent physical or cognitive impairments. The dramatic increase in sepsis from COVID-19 brings new urgency to optimizing sepsis survivorship, but also new opportunity to learn from hospitals implementing recovery-focused practices to address the needs of Veterans surviving viral sepsis from SARS-CoV-2. Significance. Despite the prevalence of long-term morbidity after sepsis, there are no treatment guidelines focused on enhancing recovery from sepsis. OVeR-Sepsis will meet an urgent clinical need in VA, enhancing the recovery of the thousands of Veterans who survive sepsis each year (including viral sepsis from COVID). OVeR-Sepsis will validate best practices for enhancing recovery from sepsis that are responsive to Veteran and caregiver perspectives and identify feasible strategies for implementation. We will make these tools freely available, easy to use, and promote them nationally to encourage their use. Innovation and Impact. OVeR-Sepsis is innovative by studying sepsis survivorship systematically and broadly. We will study survivorship from both COVID and non-COVID sepsis, and consider how innovation in COVID sepsis survivorship practices can inform practice for non-COVID sepsis survivors. Our sequential explanatory mixed methods approach, with video site visits for 4-6 top- and 4-6 bottom- performing sites for sepsis survivorship, will allow us to study of clinical practices and implementation strategies that differentiate top-performing sites. We will then incorporate qualitative findings from our site visits into the evidence synthesis informing a modified Delphi panel to assess best practices for sepsis recovery. Specific Aims. (A1) Identify top- and bottom-performing VA hospitals for 90-day survival and quality of life after sepsis. (A2) Define practices that differentiate top-performing hospitals through electronic health record analysis, surveys, and video site visits. (A3) Prioritize best practices for sepsis recovery based on validity, improvement opportunity, and feasibility. Methodology. We will measure risk-standardized 90-day survival from sepsis across VA hospitals using hierarchical regression models and 2017-2020 CDW data. We will then empanel a cohort of N=600 Veterans from (25 Veterans per hospital, from 12 higher- and 12-lower survival hospitals) to measure quality of life and disability using telephone survey instruments with proxy respondent options. From those, we will select 4-6 top-performing (higher survival, high quality of life) and 4-6 bottom- performing hospitals for 360-degree video site visits. Through quantitative analyses of select practices, survey of current practices, and semi-structured interviews with a diverse set of 12-15 informants (clinicians, administrators, Veterans, caregivers), we will identify “best practices” for sepsis recovery and associated implementation strategies. Using a modified Delphi panel of experts, we will assess the validity, improvement opportunity, and feasibility of these best practices. Next Steps/Implementation. Upon successful completion of this research, we will work with our operational partners—who we have included even in the design stage of this IIR—to implement these best practices.", "keywords": [ "2019-nCoV", "Acute", "Address", "Administrator", "Adopted", "Awareness", "COVID-19", "COVID-19 pandemic", "Caregivers", "Caring", "Censuses", "Characteristics", "Chronic", "Clinical", "Clinics and Hospitals", "Cognitive", "Creativeness", "Critical Care", "Data", "Diffusion", "Disasters", "Electronic Health Record", "Epidemiology", "Family", "Functional disorder", "Future", "Goals", "Guidelines", "Health system", "Hospitalization", "Hospitals", "Impaired cognition", "Incidence", "Infection", "Intervention", "Interview", "Learning", "Life", "Measures", "Medical", "Methodology", "Methods", "Modeling", "Morbidity - disease rate", "Nursing Research", "Organ", "Outcome", "Patients", "Pharmaceutical Preparations", "Prevalence", "Primary Health Care", "Professional Organizations", "Proxy", "Public Health", "Qualitative Research", "Quality of life", "Recommendation", "Recovery", "Research", "Resolution", "Respondent", "Review Literature", "Risk", "Sepsis", "Sepsis Syndrome", "Series", "Site", "Site Visit", "Standardization", "Structure", "Surveys", "Survivors", "Telephone", "Veterans", "Viremia", "Work", "World Health Organization", "World Health Organization Disability Assessment Schedule", "base", "clinical epidemiology", "clinical implementation", "clinical practice", "cohort", "coronavirus disease", "design", "disability", "epidemiology study", "experience", "hospital readmission", "implementation strategy", "improved", "informant", "innovation", "multidisciplinary", "pandemic disease", "primary caregiver", "survivorship", "tool", "treatment guidelines", "treatment research", "virtual" ], "approved": true } }, { "type": "Grant", "id": "8957", "attributes": { "award_id": "1I50HX003230-01A1", "title": "Combating Antimicrobial Resistance through Rapid Implementation of Available Guidelines and Evidence (CARRIAGE)", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-10-01", "end_date": "2025-09-30", "award_amount": null, "principal_investigator": { "id": 23816, "first_name": "CHARLESNIKA T", "last_name": "EVANS", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1483, "ror": "https://ror.org/01vrybr67", "name": "Louis Stokes Cleveland VA Medical Center", "address": "", "city": "", "state": "OH", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [ { "id": 24169, "first_name": "MICHAEL A.", "last_name": "RUBIN", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 202, "ror": "https://ror.org/03r0ha626", "name": "University of Utah", "address": "", "city": "", "state": "UT", "zip": "", "country": "United States", "approved": true } ] }, { "id": 24793, "first_name": "Makoto", "last_name": "Jones", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, { "id": 24794, "first_name": "Eli N", "last_name": "Perencevich", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] } ], "awardee_organization": { "id": 1781, "ror": "https://ror.org/007fyq698", "name": "VA Salt Lake City Healthcare System", "address": "", "city": "", "state": "UT", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Under-investments in antimicrobial discovery, antimicrobial stewardship, and infection control have reached crisis proportions. While these under-investments have been laid bare by SARS-CoV-2, antimi- crobial-resistant infections—a more silent killer—are accelerating with three million illnesses, 48,000 deaths and $35 billion in excess costs annually in the US, secondary to treatment failure and associated higher morbidity and mortality. The ongoing pandemic of COVID-19, the disease caused by SARS-CoV-2, has also revealed much about the limits of our public health infrastructure and the need to rapidly engage partners, dis- seminate best practices, and adapt to changing conditions during times of widespread uncertainty. Our national, integrated healthcare system for Veterans offers unique opportunities to significantly alter the course of events and improve the outlook for our future through novel implementation and quality improvement efforts. Objectives: The goal of this QUERI program is to continue the successes of its predecessor by addressing the growing concern of antimicrobial resistance and other emerging infectious threats through strategies that train, communicate, and coordinate front-line staff, operational leaders, and field experts. In doing so, we will address the priority goals of our VA operational partners, increase the impact of VA research findings through bi-directional partnerships and rigorous evaluation, and promote VA as a high reliability organization through innovative implementation science. Three projects designed to implement key evidence-based practices in the areas of infection prevention, biosurveillance, and antimicrobial stewardship will target the behaviors and processes that facilitate the spread of antibiotic-resistant and other emerging pathogens, including (1) improv- ing patient safety through overcoming barriers to Ultraviolet-C (UVC) no-touch room disinfection; (2) improving implementation of strategies to prevent the spread of carbapenem-resistant organisms (CROs); and (3) estimating the impact of two different electronic audit and feedback strategies on antimicrobial prescribing practices. These efforts will be supplemented with time-sensitive rapid response projects guided by our operational partners to assist their work with front-line providers across the country. We will also train a new generation of VA implementation scientists through our mentoring core, led by investigators committed to developing junior implementation researchers committed to careers improving the quality, safety, and value of Veteran health care. Methods: The program will employ complementary implementation strategies and theories guided by an Implementation Core consisting of a team of notable VA implementation scientists with proven track records in designing and executing programs to control antimicrobial resistance and prevent the spread of pathogens. We will follow the principles of High Reliability Organizations to deliver reliable performance, consistent safety, and exceptional quality, using approaches that are aligned with the three phases of the QUERI Implementation Roadmap (pre-implementation, implementation, and sustainment). Specific implementation strategies will include blended (internal and external) facilitation, audit and feedback, and provider and staff education and activation. Work system barriers and facilitators will be assessed using the Systems Engineering Initiative for Patient Safety (SEIPS) model, which will help identify factors that influence the processes of care and inform data collection methods that will include the use of national VA datasets, direct observation, and primary data (i.e., surveys, interviews, and focus groups). Finally, our Mentoring Core will utilize the Matrix Mentoring Model as a framework to provide each trainee with a team of mentors, each contributing unique expertise. 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