Represents Grant table in the DB

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            "type": "Grant",
            "id": "15952",
            "attributes": {
                "award_id": "1K25AI196259-01",
                "title": "Modeling SARS-CoV-2 variant emergence from immunocompromised hosts",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
                    "approved": true
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                    "National Institute of Allergy and Infectious Diseases (NIAID)"
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                    {
                        "id": 32891,
                        "first_name": "MARY KATHERINE BRADFORD",
                        "last_name": "PLIMACK",
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                "start_date": "2026-04-02",
                "end_date": "2031-03-31",
                "award_amount": 161946,
                "principal_investigator": {
                    "id": 44397,
                    "first_name": "Katherine",
                    "last_name": "Owens",
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                    "id": 3410,
                    "ror": "",
                    "name": "FRED HUTCHINSON CANCER CENTER",
                    "address": "",
                    "city": "",
                    "state": "WA",
                    "zip": "",
                    "country": "United States",
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                "abstract": "This proposal describes a five-year research training program that will facilitate my ongoing transition from an applied mathematician to an independent, quantitative, multidisciplinary biomedical researcher. I will work closely with clinicians, mathematical modelers, bioinformaticians, evolutionary biologists, virologists and immunologists to develop a suite of mathematical models which will be validated against viral, immune, phylogenetic and epidemiolocal datasets. The goals of my proposal will be to: 1) understand the mechanisms facilitating generation of SARS-CoV-2 variants of concern (VOC) during prolonged infections in immunocompromised (IC) individuals, and 2) identify key bottle necks that limit the number of VOCs that predominate in the general population. SARS-CoV-2 is the appropriate virus for which to develop this modeling framework due to the availability of data, and ongoing incidence, but the approach will be widely applicable to other pathogens.  The training program includes an outstanding group of mentors and collaborators. My scientific advisory committee consists of experts in modeling infectious diseases (Dr Josh Schiffer and Dr Dan Reeves), clinical care for IC individuals (Dr Josh Schiffer and Dr. Alpana Wahgmare), epidemiology (Dr Cheryl Cohen and Dr Dobromir Dimitrov), viral evolution (Dr JT McCrone and Dr Mahan Ghafari), and biostatistics and machine learning (Dr Ollivier Hyrien). This group is dedicated to ensuring the success of my project, and my career development as an independent researcher. The specific learning goals required for my successful transition to biomedical research will be accomplished through didactic coursework in virology, immunology, epidemiology and phylogenetics as well as conferences and professional training in the skills of a successful mentor and group leader.  The research plan addresses a critically important clinical and public health issue. Prolonged SARS-CoV- 2 infections in IC individuals are the most likely source of most novel VOC, which have extended and strongly exacerbated the impact of the pandemic. Though these infections have had an outsized public health impact, clear guidance regarding clinical management and safety measures is lacking. Understanding the within-host evolution of SARS-CoV-2 is paramount to addressing these issues. Through accomplishing the aims of this proposal, Dr Owens will address critical gaps in our knowledge of SARS-CoV-2 evolution and create an in silico framework to study SARS-CoV-2 interventions at both individual and population level. Ultimately, this proposal will allow Dr Owens to influence the future of pandemic response research as well as build a self-sustaining program at the interface of mathematical modeling, immunology, viral dynamics, and viral evolution.",
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        {
            "type": "Grant",
            "id": "15957",
            "attributes": {
                "award_id": "1R01AI196011-01",
                "title": "Protective mRNA Vaccines Against Tuberculosis",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
                    "approved": true
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                    "National Institute of Allergy and Infectious Diseases (NIAID)"
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                        "id": 44404,
                        "first_name": "KATRIN",
                        "last_name": "EICHELBERG",
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                ],
                "start_date": "2026-04-06",
                "end_date": "2031-03-31",
                "award_amount": 717003,
                "principal_investigator": {
                    "id": 27480,
                    "first_name": "ADEL M",
                    "last_name": "TALAAT",
                    "orcid": null,
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                    "id": 799,
                    "ror": "",
                    "name": "UNIVERSITY OF WISCONSIN-MADISON",
                    "address": "",
                    "city": "",
                    "state": "WI",
                    "zip": "",
                    "country": "United States",
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                "abstract": "Protective mRNA Vaccines Against Tuberculosis. Summary. Tuberculosis (TB), caused by Mycobacterium tuberculosis (M. tb), remains a significant global health challenge, affecting approximately one-third of the world’s population and resulting in nearly 1.4 million deaths annually. The existing vaccine, M. bovis BCG (BCG), offers variable protection, with efficacy ranging from 0% to 80%. Our previous research has identified several innovative platform technologies aimed at enhancing vaccine development for major infections impacting both human and animal health. Notably, we have developed unique nano-adjuvant systems (NAS) that have demonstrated effectiveness against respiratory infections, including coronavirus and M. avium. In this project, we will utilize our expertise in tuberculosis vaccine development and nanoparticle vaccine platforms to assess the protective efficacy of a novel combination vaccine against TB. Our approach incorporates cutting-edge mRNA vaccine technology delivered via QuilA-DOTAP (QTAP), a novel lipid nanoparticle delivery adjuvant that ensures stable mRNA transcript delivery at various temperatures suitable for use in TB- endemic regions. Preliminary analyses of QTAP-adjuvanted combination mRNA vaccine encoding three mycobacterial antigens (Ag85B, Hsp70, and EsxH), referred to as QRNA, have shown robust protective immunity in mouse models challenged with both low and high doses of the virulent M. tb Erdman strain. In this project, we plan to First; examine the safety and immunogenicity of QRNA vaccines in variable murine models using both immune-compromised (Rag1-/-) and immune-competent (C3HeB/FeJ) murine models. Second; analyze the protective role of QRNA vaccine as a homologous or heterologous vaccine primed with BCG against challenge with M. tb Erdman (lineage 4, laboratory strain) or HN878 (lineage 2, hypervirulent clinical strain). Finally, we will assess protective immunity of QRNA vaccines in guinea pigs to identify vaccine-induced immune correlates of protection elicited by the mRNA vaccine candidates in guinea pigs, a TB model that mimic human infection. Once achieved, results from those aims will enhance our understanding of RNA-based immunization against TB. Future projects will further dissect the generated immunity in non-human primates, a more relevant model for human TB.",
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        {
            "type": "Grant",
            "id": "15955",
            "attributes": {
                "award_id": "1R01AI195543-01",
                "title": "Discovery and Optimization of Broadly Protective Merbecovirus Neutralizing Antibodies",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
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                    "National Institute of Allergy and Infectious Diseases (NIAID)"
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                    {
                        "id": 32536,
                        "first_name": "DIPANWITA",
                        "last_name": "BASU",
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                "start_date": "2026-04-01",
                "end_date": "2031-03-31",
                "award_amount": 829735,
                "principal_investigator": {
                    "id": 44402,
                    "first_name": "KEVIN O",
                    "last_name": "SAUNDERS",
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                    "id": 3412,
                    "ror": "",
                    "name": "DUKE UNIVERSITY",
                    "address": "",
                    "city": "",
                    "state": "NC",
                    "zip": "",
                    "country": "United States",
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                "abstract": "Middle East respiratory syndrome coronavirus (MERS-CoV) infection has the highest mortality rate (36%) of any of the known human-pathogenic Betacoronaviruses. MERS-CoV continues to circulate in the Middle East, and due to global travel has spread to 27 other countries making it a global health priority. A number of viruses related to MERS-CoV have been identified in mammals worldwide, and several have been found to utilize human DPP4- or ACE2-receptors for cell entry. Therefore, the MERS-related betacoronaviruses (Merbecoviruses, MERBs) have considerable zoonotic potential. While many medical countermeasures like vaccines and antibody therapeutics were developed to fight SARS-CoV-2, these countermeasures do not prevent disease caused by MERBs. The long-term goal of this proposal is to generate such MERB broadly neutralizing antibody (bnAb) therapeutics. The significance of this project includes the identification of broadly protective antibodies (Abs) and their epitopes, enabling rational design of antibody-based therapeutics and vaccines against a deadly virus. While previous research has focused on identifying potent neutralizing antibodies against MERS-CoV, no antibodies have been shown to be cross- protective against MERS-CoV and other MERBs. In preliminary studies in vaccinated rhesus macaques (RMs), we elicited robust cross-binding and cross-neutralizing plasma Abs against multiple MERBs. Post- vaccination RM B cells bound both MERS-CoV receptor binding domain (RBD) and bat MERS-CoV-related virus NL140422 RBD. Individual Abs from these RMs bound to as many as 7 different MERS-CoV-related RBDs and MERS-CoV. The objectives of this study are to 1) determine the neutralization breadth of monoclonal nAbs from these vaccinated RMs, 2) determine the critical features of the binding interface between cross-reactive nAb and virus spike RBD, and 3) determine the cross-protective efficacy of the mAbs. The innovations of this project include human, bat, and pangolin live-virus MERB models (MERS-CoV, PDF2180, NL140422 (MERS 422), MjHKU4r, HKU-5), 13 genetically diverse MERB spike and RBD antigens, MERS-CoV and MjHKU4 mouse challenge models, and the use of a machine-learning Ab optimization to improve natural Abs. The impact of this project includes the demonstration that vaccination can elicit broad MERB nAbs against multiple conserved epitopes, the development of trispecific immunotherapies, and the definition of bnAb epitopes that inform rational design of immunogens targeting cross-protective B cells. Our Abs will be potential tools to combat MERS-CoV outbreaks and prepare for future outbreaks from pre- emergent MERBs.",
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        {
            "type": "Grant",
            "id": "15956",
            "attributes": {
                "award_id": "1R01AI189721-01A1",
                "title": "Decoding cellular networks governing respiratory mucosal IgA immunity",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
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                "start_date": "2026-04-01",
                "end_date": "2031-03-31",
                "award_amount": 773388,
                "principal_investigator": {
                    "id": 20818,
                    "first_name": "Jie",
                    "last_name": "Sun",
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                            "id": 1426,
                            "ror": "",
                            "name": "MAYO CLINIC ROCHESTER",
                            "address": "",
                            "city": "",
                            "state": "MN",
                            "zip": "",
                            "country": "United States",
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                    "id": 3413,
                    "ror": "",
                    "name": "UNIVERSITY OF VIRGINIA",
                    "address": "",
                    "city": "",
                    "state": "VA",
                    "zip": "",
                    "country": "United States",
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                "abstract": "Abstract/summary The factors and mechanisms driving robust respiratory mucosal immunity, particularly respiratory IgA responses, post-infection or vaccination are largely unknown. This represents a significant gap in our understanding necessary for designing future vaccination strategies aimed at providing enhanced mucosal protection against respiratory viral infections including new SARS-CoV-2 variants. This RO1 grant proposal aims to address this critical knowledge gap. Our central hypothesis is that the generation of mucosal IgA and respiratory protective immunity is contingent upon the localized interactions among pulmonary macrophages, CD4 T cells, and B cells within the respiratory tract. Three specific aims (SA) are proposed. Aim 1: Identify the associated mechanisms by which respiratory CD4+ T cells promote IgA production in situ. Aim 2: Elucidate TGFβ-dependent macrophages and B cell interactions in mucosal IgA production. Aim 3: Define the molecular and functional signatures of mucosal cross-reactive IgA-producing B cells. We believe that the insights obtained will be crucial in developing next-generation mucosal vaccines designed to effectively counter SARS-CoV-2 variants and other respiratory pathogens, significantly enhancing public health prevention strategies against respiratory infections. .",
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        },
        {
            "type": "Grant",
            "id": "15960",
            "attributes": {
                "award_id": "2R25NS117281-06",
                "title": "Training in Advanced Statistical Methods in Neuroimaging and Genetics",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
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                        "first_name": "LETITIA ALEXIS",
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                "start_date": "2026-04-01",
                "end_date": "2031-03-31",
                "award_amount": 261311,
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                    "id": 44408,
                    "first_name": "ROBERT C.",
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                    "name": "UNIVERSITY OF CALIFORNIA LOS ANGELES",
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                    "country": "United States",
                    "approved": true
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                "abstract": "This education project is a continuation of our current, national class, Training in Advanced Statistical Methods in Neuroimaging and Genetics. Over the past 15 year the National Institutes of Health has greatly increased funding of grants that utilized advanced neuroimaging methods, genetic methods, and advanced statistical methods. While introductory courses are offered, ours is the only advanced course offered in the United States that provides an intensive, hands-on (“doing”) learning opportunity to better prepare biomedical and clinical researchers in advanced statistical methods. In one decade the combined budgets that utilize these advanced analysis techniques from the National Institute of Neurological Disorders and Stroke, National Institute of Mental Health, National Institute on Aging, National Institute on Drug Abuse, and National Institute of Biomedical Imaging and Bioengineering grew 5-fold, and there continues to be a great need to provide an educational opportunity to ensure the workforce is well positioned to carry out important work that has been identified by these and other institutes. Our program will continue to meet this need. We bring together a group of diverse world-class scientists and educators in a two-week intensive format to provide theoretical lectures paired with hands-on computer tutorials. Our course has served 103 students (55 total in 2021-2022 via Zoom due to COVID-19), and in 2023 (our 1st year of in-person) we taught 20 students, and 28 students in 2024 (in-person). We will enroll 26-30 students in April 2025 session. In our competitive renewal we will continue to enroll 26-30 students per year. With this being an advanced course, we ensure that the students accepted are a good education-level match for the content. We also implement mechanisms to maximize diverse perspective in our students and our teaching faculty. These students are accepted from across the United States, with attention to attracting a diverse student cohort. This education program will continue to distribute Tuition Awards based on financial need. We have evolved our course based on feedback from our current course alumni. In our class, over two weeks, students learn and put into practice methods such as: hierarchical statistical models, Bayesian statistics, network science, functional and structural connectomics, disease driven degeneration of the brain, and methods for analysis of genetics data such as polygenic risk scoring and structural equation modeling. The course concludes with lectures and labs on multi-modal analysis (imaging and imaging-genetics), and classification methods for biomarker development. Our course now includes 5 guest lecturers and team building activities outside of the classroom. To ensure students apply the acquired knowledge and skills to their independent research projects back at their home institutes, we supplement the course with our innovative continuing education: zoom-based sessions with the faculty for 8-months post formal course and students having near-real-time access regarding technical implementation questions through the Slack. This continued education portion greatly increases success utilizing their new practical skills in their own research.",
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        {
            "type": "Grant",
            "id": "15968",
            "attributes": {
                "award_id": "1R01AG092489-01A1",
                "title": "Effect of paid family care (vs aides) on Medicaid waiver participants w/ IDD across the lifespan",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
                    "approved": true
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                "funder_divisions": [
                    "National Institute on Aging (NIA)"
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                    {
                        "id": 44276,
                        "first_name": "PRISCILLA JOY",
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                "start_date": "2026-03-01",
                "end_date": "2031-02-28",
                "award_amount": 678231,
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                    "id": 44421,
                    "first_name": "Courtney Harold",
                    "last_name": "Van Houtven",
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                    "name": "DUKE UNIVERSITY",
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                    "state": "NC",
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                "abstract": "Home and community-based services are the most common support for people with Intellectual and/or Developmental Disability (I/DD) who otherwise would require facility-level care. Many state Medicaid waivers allow participants to choose to hire family as direct support personnel to meet their care needs at home and in the community rather than a professional aide. Ability to hire family increased during the Covid-19 pandemic through state policy changes, and yet we do not know how involving paid family affects the ability for people with I/DD to remain at home. The objectives of this study are to use North Carolina (NC) as a case to elucidate the experiences of waiver participants with I/DD (Innovations Waiver participants). With no national data fields systematically identifying self-direction status or who is paid for personal care, foundational state-level work is required to understand people with I/DD’s experiences with self-direction. First, we will describe prevalence and dynamics of paid family care using Medicaid administrative data over the past 9+ years, including patterns by self-direction or not, by individual and geographic factors and by era (pre-post Covid-19 (Aim 1). Second, qualitative approaches will center the voices of people with I/DD and their families to obtain their perspectives on what is gained and what is lost from self-directed care including paid family care (Aim 2). Specifically, photo elicitation, case study, and focus group interviews will examine the lived experience of accessing and receiving care through the Innovations Waiver according to 1) individuals with I/DD, 2) their parent/partner/guardian/unpaid family caregiver, 3) their paid family caregivers, 4) their paid aide, and 5) Innovations Waiver experts. Third, we will estimate the comparative effectiveness of paid family care versus paid aide care only on person-centered outcomes (e.g., home time, preventive care) and on potential harms (potentially harmful medications, injurious falls, mistreatment) (Aim 3). We hypothesize that waiver participants with paid family care will have better person-centered outcomes and no increase in harms compared to those with paid aides alone. Effects of self- direction will also be explored. By using a convergent parallel mixed-methods process we will integrate results to paint a full picture of the comparative effectiveness of paid family care and self-direction from childhood to older adulthood, including identification of any harms. The results of this 5-year R01 study will be immediately applicable to state Medicaid office benefit design and inform strategies to optimize quality of care and life for people living with I/DD from childhood throughout the lifespan. Results from the North Carolina case will also position us to pursue a national study, given knowledge gained along with emerging efforts to identify “self- direction” in national CMS data sets. Examining paid family care and self-direction’s effects across the lifespan aligns with NIA’s strategic goal to improve the health, well-being, and independence of adults as they age.",
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            "attributes": {
                "award_id": "1R35HL171346-01",
                "title": "Transcriptional and epigenetic mechanisms of alveologenesis and re-alveologenesis",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
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                        "first_name": "Sara",
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                "start_date": "2024-03-15",
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                    "first_name": "Jichao",
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                    "state": "OH",
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                "abstract": "Lung diseases impacting the gas exchange alveoli, including COVID-19, are becoming the leading cause of death. A multi-lineage, transcriptional, and epigenetic understanding of alveologenesis and re- alveologenesis upon injury is a timely response to the disease burden and leverages latest single-cell technology. My lab’s track record in studying the lung epithelial, endothelial, and mesenchymal lineages lays the foundation for pursuing a poorly understood process of cellular maturation (Theme 1), a recently identified capillary cell type (Theme 2), and a novel signaling regulation of distinct mesenchymal cell populations (Theme 3). The anticipated knowledge will tackle fundamental questions of cell fate, plasticity, and signaling; shed light on bronchopulmonary dysplasia, pulmonary hypertension, acute lung injury, as well as non-coding variants from genome-wide association studies; and opens the door to single-cell functional genomics applicable to any organ.",
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        {
            "type": "Grant",
            "id": "15965",
            "attributes": {
                "award_id": "1P50DC022549-01A1",
                "title": "Sensory and molecular studies of human taste dysfunction",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
                    "approved": true
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                "funder_divisions": [
                    "National Institute on Deafness and Other Communication Disorders (NIDCD)"
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                "start_date": "2026-03-01",
                "end_date": "2031-02-28",
                "award_amount": 786679,
                "principal_investigator": {
                    "id": 44417,
                    "first_name": "PeiHua",
                    "last_name": "Jiang",
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                    "name": "MONELL CHEMICAL SENSES CENTER",
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                "abstract": "Project 3. Sensory and molecular studies of human taste dysfunction Taste dysfunction is a cardinal feature of COVID. Project 3 of this P50 Clinical Research Center (CRC) proposal focuses on (1) molecular description of taste tissue from people with sustained COVID-19-associated taste dysfunction, compared to people with no current taste problems (regardless of infection history) (Aim 3.1), and (2) mechanistic interrogation of COVID-associated taste dysfunction using taste organoids (Aim 3.2). We will test the hypothesis that people with COVID taste dysfunction have fewer taste receptor cells, reduced expression of taste-relevant genes, and immune cell infiltration due to sustained inflammation. In Aim 3.1, we will sample taste tissue from people with and without sustained COVID-19-associated taste dysfunction to measure taste receptor cell number and gene expression of inflammatory (e.g., cytokines and chemokines) and other molecules with single-cell RNA sequencing (scRNA-seq) methods. In Aim 3.2, we will use taste organoids derived from wild-type mice, humanized-ACE2 mice, and humans to examine SARS-CoV-2 tropism in taste tissue to determine if taste tissue homeostasis is altered by (a) SARS-CoV-2 infection or (b) inflammatory molecules identified in Aim 3.1 and/or known to be elevated in COVID. Project 3 of this CRC proposal is supported by Project 1 and the Chemosensory Clinical Services Core, which will perform and support remote and in-house sensory screening of all participants in this research program. The investigators here are experts in their fields, particularly in single-cell biology, genetics, and stem cell biology of taste tissue. We have engaged consultants who are inflammation, infection, and immunology experts. Several types of pilot data support this application, including scRNA-seq data from human fungiform tissue and taste organoid data after treatment with inflammatory molecules. Institutional support for this project is outlined in a Letter of Support from administrative officials, and the Monell Chemical Senses Center is well suited to complete this project because of its cross-disciplinary focus on chemosensory biology and its connection with an experienced coronavirus expert at the nearby University of Pennsylvania. This project is part of a larger program to understand and treat people with communication disorders of taste and smell dysfunction due to COVID. We anticipate our data will answer key unsolved questions regarding taste dysfunction and point to potential avenues of treatment for this debilitating condition.",
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            "type": "Grant",
            "id": "15966",
            "attributes": {
                "award_id": "1R35GM161764-01",
                "title": "Elucidating kinetics and thermodynamics of RNA-ligand interactions using single molecule approaches",
                "funder": {
                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
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                "funder_divisions": [
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                    {
                        "id": 22244,
                        "first_name": "MICHAEL",
                        "last_name": "SAKALIAN",
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                "start_date": "2026-03-01",
                "end_date": "2031-02-28",
                "award_amount": 425100,
                "principal_investigator": {
                    "id": 44418,
                    "first_name": "Maria",
                    "last_name": "Kamenetska",
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                    "id": 3420,
                    "ror": "",
                    "name": "BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)",
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                    "state": "MA",
                    "zip": "",
                    "country": "United States",
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                "abstract": "Project summary/abstract: Current understanding of and predictive models for folded RNA structures lag far behind our advances in protein folding. Yet recent work reveals the central role of RNA folds in diseases like viral infection, cancer and neurodegeneration. The potential to develop drugs against RNA targets causing illness is impeded by critical knowledge gaps in our understanding of the sequence-structure-function relationships of RNA polymers. Beyond structure, the role of fast fluctuations between the various conformations of RNA is being recognized as playing a bigger role in RNA than in amino acid function. Quantifying both shape and kinetics of RNA requires single molecule tools that can achieve millisecond time and nanometer distance resolution. Through this Maximizing Investigator Research Award (MIRA), the Kamenetska Lab will be supported in their continued efforts to develop such single molecule biophysical tools combined with machine learning approaches in order to expand our knowledge and understanding of the structural and kinetic properties of RNA. These optical tweezer force spectroscopy tools are uniquely suited to quantifying the full energy landscape profile of RNA structures that governs the dynamics of these molecules. Here I propose to use these methods, based on published results from my laboratory, to fill three critical knowledge gaps. First, I will investigate the effects on RNA mechanics and dynamics of non-specific interactions between nucleic acids, including RNA, with small molecules and ions present in mammalian cells. Second, I will build on our work on synthetic and modified RNA structures to systematically quantify the relationship between structure and folding energetics, generating data for training predictive models of RNA folding not currently available. Finally, I will build analytic methods and pursue structural and kinetic characterization of complex RNA tertiary structures with multiple conformations. My targets include SARS-CoV-2 viral genomic RNA implicated in viral gene regulation, telomeric and 5’ untranslated regions (5’ UTR) structures associated with cancer phenotypes.",
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            "type": "Grant",
            "id": "15954",
            "attributes": {
                "award_id": "1R01AG092810-01A1",
                "title": "The Impact of Changes in Primary Care Clinicians' Work Effort on the Health of Older Adults",
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                    "id": 4,
                    "ror": "https://ror.org/01cwqze88",
                    "name": "National Institutes of Health",
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                    "National Institute on Aging (NIA)"
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                        "id": 44399,
                        "first_name": "MARCEL",
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                "start_date": "2026-04-01",
                "end_date": "2031-01-31",
                "award_amount": 680086,
                "principal_investigator": {
                    "id": 44400,
                    "first_name": "Bruce E.",
                    "last_name": "Landon",
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                        "id": 44401,
                        "first_name": "Lisa",
                        "last_name": "Rotenstein",
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                "awardee_organization": {
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                    "name": "UNIVERSITY OF CALIFORNIA, SAN FRANCISCO",
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                    "country": "United States",
                    "approved": true
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                "abstract": "There are demonstrated benefits of comprehensive, continuous, and coordinated primary care for older adults, ranging from higher rates of appropriate preventive care receipt to lower rates of hospitalization and mortality. However, the benefits of strong primary care are threatened by an impending primary care workforce crisis, exacerbated by prevalent trends of primary care physician (PCP) workforce attrition and clinical effort reduction. Partly in response to these trends, there is increasing representation of NPs and PAs, collectively referred to as advanced practice clinicians (APCs), in the primary care workforce. However, burnout, intent to leave, and intent to reduce clinical effort are also prevalent among primary care APCs. These trends across primary care clinicians (PCCs; comprising physicians, NPs, and PAs) may significantly threaten quality of and access to care for older adults. At present, there is limited evidence to inform healthcare leaders and policy makers about how primary care workforce disruptions impact access to and quality of primary care received by older adults. There is additionally insufficient information on the actionable factors associated with PCC turnover and PCC reductions in clinical effort. In this grant, we will leverage data from Medicare fee-for-service and Medicare Advantage, which together provide coverage for 93% of older adults, in order to: 1) quantify the number of Medicare patients impacted by PCC turnover and sustained reductions in billed clinical effort and identify factors associated with these work effort changes; 2) assess the impact of PCC turnover and PCCs’ sustained reductions in billed clinical effort on patterns of primary care receipt and non-primary care utilization, including emergency department visits and hospitalizations; and 3) assess the impact of PCC turnover and sustained reductions in billed clinical effort on quality of care for older adults. All analyses will be conducted for the overall population of older adults as well as for subgroups of more vulnerable older adults, including those with dementia, multiple chronic conditions, and from underserved groups (e.g., dually eligible for Medicaid). Additionally, analyses will be conducted for physicians and APCs separately, and for the overall study period and comparing the pre- and post-COVID periods. The results from this study will elucidate how changes in PCCs’ work patterns influence the care of the growing US population of older adults. They will provide actionable insights for leaders seeking to design clinical systems and policies that enhance primary care for older adults. Overall, this proposal will enhance the ability of clinical, operational, and policy leaders to maintain the effort of the primary care workforce and optimize care for older adults.",
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