Grant List
Represents Grant table in the DB
GET /v1/grants?page%5Bnumber%5D=4&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=1397&sort=award_amount", "next": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=5&sort=award_amount", "prev": "https://cic-apps.datascience.columbia.edu/v1/grants?page%5Bnumber%5D=3&sort=award_amount" }, "data": [ { "type": "Grant", "id": "8217", "attributes": { "award_id": "1IK6BX005692-01", "title": "BLRD Research Career Scientist Award Application", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-04-01", "end_date": "2026-03-31", "award_amount": null, "principal_investigator": { "id": 24051, "first_name": "Robert", "last_name": "Raffai", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1522, "ror": "", "name": "VETERANS AFFAIRS MED CTR SAN FRANCISCO", "address": "", "city": "", "state": "CA", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1522, "ror": "", "name": "VETERANS AFFAIRS MED CTR SAN FRANCISCO", "address": "", "city": "", "state": "CA", "zip": "", "country": "United States", "approved": true }, "abstract": "The overall goal of this Research Career Scientist award is to foster the nominee’s ongoing research program that is focused on the study of extracellular vesicles (EVs) and their extracellular RNA (exRNA) cargo as biomarkers and effectors of human health and disease including among Veterans. Through participation in a national NIH-funded consortium research program, the nominee is working to develop novel methods to study EVs and other carriers of exRNA for biomarker development projects. The nominee also recently reported the first evidence of intercellular signaling between macrophage EVs and hematopoietic progenitor cells to control the process of systemic and vascular inflammation and atherosclerosis cardiovascular disease. Ongoing funding from a VA Merit grant is supporting the nominee’s goal of exploring the role of circulating EVs isolated from Veterans treated for advanced vascular disease as biomarkers and contributors to disease progression including via microRNA cargo. Experiments in the lab will also test if EVs produced from anti- inflammatory macrophages can serve to control inflammation and atherosclerosis in diabetic rodent models. Furthermore, funding from a VA Invention-based Supplement Award will support pre-clinical studies testing such anti-inflammatory EVs as therapeutics to control cardiac inflammation and heart failure in a rodent model system developed and patented for the VA by the nominee. Findings from these studies could provide much needed new therapeutics in the form of EV-biologics to treat inflammatory diseases including in the cardiovascular system that is a major healthcare need among the Veteran patient population. The nominee’s internationally recognized program on EV biology has led to new collaborative research projects with VA clinician investigators at the local and offsite stations. This includes a collaborative project to test EVs produced by cultured stem cells as therapeutic mediators of skeletal muscle regeneration. Such studies have been proposed in a VA Merit grant proposal with the nominee serving as co-Investigator, which is being revised for a resubmission. The nominee is also engaged in collaborative studies with VA clinician investigators to develop biomarkers of adverse outcomes of surgical procedures used to treat advanced vascular disease among Veterans. Finally, projects proposed by the nominee through grants pending at the Department of VA and the NIH make use of EV technology and expertise developed by the nominee to address the COVID19 disease crisis. This includes by making use of new methods of EV detection in biofluids to develop biomarkers for clinical outcomes of COVID19 disease. It also includes developing new forms of engineered EVs designed to serve in improving host immune response against SARS-CoV-2 viral infection as well as to control lung inflammation. Together, the award will serve to sustain the nominee’s momentum to developing a first-in-class research program centered on the study of EVs as biomarkers and biologics to control tissue inflammation and remodeling including in the cardiovascular system. It will also allow to expand the nominees network of collaborators with clinician and basic scientists within the VA intramural research program, as well as at local, national and international sites to widely disseminate and implement expertise in the study of EVs as biologics to improve the diagnosis and treatment of diseases in priority areas to the VA. Furthermore, it will allow the nominee to increase professional service to local and national committees including within the VA and maintain teaching and mentoring to next generation research investigators and clinician scientists within the VA research program.", "keywords": [ "2019-nCoV", "Achievement", "Address", "Alzheimer&apos", "s disease model", "Anti-Inflammatory Agents", "Apolipoprotein E", "Applications Grants", "Area", "Atherosclerosis", "Award", "Biological", "Biological Markers", "Biological Models", "Biology", "Blood Circulation", "Blood Vessels", "COVID-19", "Cardiovascular Diseases", "Cardiovascular system", "Cells", "Clinical", "Collaborations", "Communication", "Coronary Arteriosclerosis", "Country", "Detection", "Diagnosis", "Diet", "Disclosure", "Disease", "Disease Progression", "Educational process of instructing", "Engineering", "Faculty", "Fostering", "Foundations", "Funding", "Goals", "Grant", "Growth", "Health", "Healthcare", "Healthcare Systems", "Heart failure", "Hematopoietic stem cells", "Host Defense", "Human", "Immune", "Immune response", "Immunologic Tests", "Inflammation", "Inflammatory", "Institution", "Intellectual Property", "International", "Intramural Research Program", "Journals", "Laboratories", "Lead", "Legal patent", "Los Angeles", "Lung Inflammation", "Mediator of activation protein", "Medical Research", "Medical Students", "Medical center", "Mentors", "Methods", "MicroRNAs", "Mission", "Molecular", "Myocarditis", "Operative Surgical Procedures", "Outcome", "Pathogenesis", "Peripheral", "Postdoctoral Fellow", "Principal Investigator", "Process", "Professional Organizations", "Property Rights", "Proteins", "Publications", "Publishing", "RNA", "Reporting", "Research", "Research Personnel", "Research Project Grants", "Resources", "Rodent Model", "Role", "Scientist", "Services", "Signal Transduction", "Site", "Skeletal Muscle", "Technology", "Testing", "Therapeutic", "Tissues", "Translations", "United States National Institutes of Health", "Vascular Diseases", "Ventricular Remodeling", "Veterans", "Virus", "Virus Diseases", "adverse outcome", "base", "biomarker development", "career", "design", "diabetic", "experimental study", "extracellular", "extracellular vesicles", "fighting", "graduate student", "health care delivery", "improved", "insight", "invention", "macrophage", "muscle regeneration", "neuroinflammation", "next generation", "novel", "novel therapeutics", "patient population", "preclinical study", "programs", "recruit", "research and development", "stem cells", "systemic inflammatory response", "therapeutic evaluation", "therapy development", "tissue repair", "vascular inflammation" ], "approved": true } }, { "type": "Grant", "id": "11550", "attributes": { "award_id": "5I01HX003412-02", "title": "Role of Non-pharmacological Pain Treatments in Safe and Effective Opioid Tapering in Chronic Pain", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-05-01", "end_date": "2026-04-30", "award_amount": null, "principal_investigator": { "id": 22420, "first_name": "WILLIAM C", "last_name": "BECKER", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1492, "ror": "https://ror.org/000rgm762", "name": "VA Connecticut Healthcare System", "address": "", "city": "", "state": "CT", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [ { "id": 22421, "first_name": "Anne C.", "last_name": "Black", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] } ], "awardee_organization": { "id": 1492, "ror": "https://ror.org/000rgm762", "name": "VA Connecticut Healthcare System", "address": "", "city": "", "state": "CT", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Evidence of risks for serious adverse outcomes and limited benefit of long-term opioid therapy (LTOT) have driven VA recommendations for LTOT tapering or discontinuation when benefits no longer outweigh harms. However, LTOT tapering may also pose risks of harm. Significance: The study addresses a critical need for clear demonstration of LTOT tapering risks and a specific VA call for evaluation of nonpharmacological pain treatments including complementary and integrative health services (NPM/CIH). The goals of this project are to assess the role of NPM/CIH use in effecting safe and clinically meaningful reductions in LTOT regimens for Veterans with chronic pain. Changes in outcomes associated with two major periods -- the implementation of the Whole Health System of care (WHS) and COVID-19 – will be assessed. Innovation and Impact: In ongoing partnership with the Office of Patient-Centered Care and Cultural Transformation (OPCC&CT), the study will broaden the scope of ongoing NPM/CIH evaluation to include outcomes related to substance dependence and addiction. Partnering with Pharmacy Benefits Management Services’ VA Center for Medication Safety (MedSAFE), informed by new pilot data, our team will be one of the first to apply a novel method to optimize determination of LTOT tapering to improve analyses of tapering- related outcomes. The study will inform clinical guidelines addressing multimodal approaches to tapering. Specific Aims are to (1) Characterize NPM/CIH access and utilization among Veterans with LTOT, considering the impact of implementation of the VHA Whole Health System of Care and COVID-19; (2) Compare the effectiveness and safety of opioid tapering for Veterans with LTOT with and without NPM/CIH; (3) Assess the moderating effect of buprenorphine on NPM/CIH effects on outcomes. We hypothesize that use of NPM/CIH will be associated with higher rates of effectiveness and safety, and that use of buprenorphine will be associated with more positive effects of NPM/CIH on these outcomes. Methodology: The project will identify a retrospective cohort between 2016-2020 of approximately 200,000 Veterans receiving LTOT at ≥ 30 mg morphine equivalent daily dose (MEDD) across 54 VA facilities. Leveraging Veterans Health Administration (VHA) electronic health record data, Veterans’ utilization of NPM/CIH within VHA and in the community will be assessed. Applying a novel method developed by VA MedSAFE using VHA electronic pharmacy data within the Corporate Data Warehouse, we will develop models of opioid tapering within the target period. Using quasi-experimental methods, Veterans will be “assigned” to NPM/CIH treatment or no treatment based on their observed service utilization. Propensity score matching will balance baseline differences due to nonrandom assignment. In multilevel models, opioid tapering outcomes will be modeled as a function of NPM/CIH use. The primary tapering effectiveness outcome will be the proportion of Veterans achieving a reduction in prescribed opioid dose of ≥50% of baseline mg MEDD, maintained over six months in the absence of worsened pain intensity. Tapering safety will be measured as the proportion of Veterans experiencing any serious adverse event (SAE), allowing tapering to take all values, including no taper and dose increases. SAE will include hospitalization, emergency department visit, opioid overdose, new mental health disorder, new opioid or other substance use disorder, suicide attempt, and all- cause mortality. Models will assess moderation of NPM/CIH effects by buprenorphine treatment for opioid tapering and for chronic pain. Secondary models will assess the effect of NPM/CIH on LTOT-related side effects and differences in NPM/CIH effect by age, race/ethnicity and gender. Next Steps/Implementation: Operational partners and a Veteran engagement panel will guide interpretation of results and promote dissemination and translation to practice. Results will inform an implementation study to support the scale-up and sustainment of effective practices for pain management and facilitating safe and effective opioid reduction.", "keywords": [ "Address", "Adverse event", "American", "Articulation", "Benefits and Risks", "Buprenorphine", "COVID-19", "COVID-19 impact", "Caring", "Centers for Disease Control and Prevention (U.S.)", "Cessation of life", "Characteristics", "Clinical", "Combined Modality Therapy", "Communities", "Complementary Health", "Data", "Deimplementation", "Dose", "Dropout", "Effectiveness", "Electronic Health Record", "Electronics", "Emergency department visit", "Equilibrium", "Ethnic Origin", "Evaluation", "Evaluation Reports", "Event", "Exercise", "Face", "Feeling suicidal", "Formulation", "Funding", "Gender", "Goals", "Guidelines", "Health Services", "Health Services Accessibility", "Health Services Research", "Healthcare Systems", "Hospitalization", "Institution", "Integrative Medicine", "Measures", "Mental Health", "Mental disorders", "Methodology", "Methods", "Modality", "Modeling", "Opiate Addiction", "Opioid", "Outcome", "Overdose", "Pain", "Pain intensity", "Pain management", "Patient-Centered Care", "Patients", "Pattern", "Perception", "Personal Satisfaction", "Pharmacy facility", "Physiological", "Practice Management", "Prevention Guidelines", "Quasi-experiment", "Race", "Randomized Controlled Trials", "Recommendation", "Recovery", "Regimen", "Research", "Research Design", "Retrospective cohort", "Retrospective cohort study", "Risk", "Role", "Safety", "Sampling", "Serious Adverse Event", "Services", "Site", "Substance Addiction", "Substance Use Disorder", "Suicide attempt", "Testing", "Translations", "United States Department of Veterans Affairs", "Veterans", "Veterans Health Administration", "Withdrawal Symptom", "Work", "Yoga", "addiction", "adverse outcome", "age effect", "buprenorphine treatment", "chiropracty", "chronic pain", "chronic pain management", "cohort", "comorbidity", "compare effectiveness", "data warehouse", "design", "effective therapy", "effectiveness outcome", "evidence base", "experience", "health service use", "implementation study", "improved", "innovation", "medication safety", "milligram", "morphine equivalent", "mortality", "multidisciplinary", "multilevel analysis", "multimodality", "novel", "opioid mortality", "opioid overdose", "opioid tapering", "opioid therapy", "opioid use", "opioid use disorder", "pharmacy benefit", "physical conditioning", "prescription opioid", "scale up", "secondary analysis", "service uptake", "service utilization", "side" ], "approved": true } }, { "type": "Grant", "id": "6696", "attributes": { "award_id": "1I01HX003412-01A1", "title": "Role of Non-pharmacological Pain Treatments in Safe and Effective Opioid Tapering in Chronic Pain", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-05-01", "end_date": "2026-04-30", "award_amount": null, "principal_investigator": { "id": 22420, "first_name": "WILLIAM C", "last_name": "BECKER", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1492, "ror": "https://ror.org/000rgm762", "name": "VA Connecticut Healthcare System", "address": "", "city": "", "state": "CT", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [ { "id": 22421, "first_name": "Anne C.", "last_name": "Black", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] } ], "awardee_organization": { "id": 1492, "ror": "https://ror.org/000rgm762", "name": "VA Connecticut Healthcare System", "address": "", "city": "", "state": "CT", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Evidence of risks for serious adverse outcomes and limited benefit of long-term opioid therapy (LTOT) have driven VA recommendations for LTOT tapering or discontinuation when benefits no longer outweigh harms. However, LTOT tapering may also pose risks of harm. Significance: The study addresses a critical need for clear demonstration of LTOT tapering risks and a specific VA call for evaluation of nonpharmacological pain treatments including complementary and integrative health services (NPM/CIH). The goals of this project are to assess the role of NPM/CIH use in effecting safe and clinically meaningful reductions in LTOT regimens for Veterans with chronic pain. Changes in outcomes associated with two major periods -- the implementation of the Whole Health System of care (WHS) and COVID-19 – will be assessed. Innovation and Impact: In ongoing partnership with the Office of Patient-Centered Care and Cultural Transformation (OPCC&CT), the study will broaden the scope of ongoing NPM/CIH evaluation to include outcomes related to substance dependence and addiction. Partnering with Pharmacy Benefits Management Services’ VA Center for Medication Safety (MedSAFE), informed by new pilot data, our team will be one of the first to apply a novel method to optimize determination of LTOT tapering to improve analyses of tapering- related outcomes. The study will inform clinical guidelines addressing multimodal approaches to tapering. Specific Aims are to (1) Characterize NPM/CIH access and utilization among Veterans with LTOT, considering the impact of implementation of the VHA Whole Health System of Care and COVID-19; (2) Compare the effectiveness and safety of opioid tapering for Veterans with LTOT with and without NPM/CIH; (3) Assess the moderating effect of buprenorphine on NPM/CIH effects on outcomes. We hypothesize that use of NPM/CIH will be associated with higher rates of effectiveness and safety, and that use of buprenorphine will be associated with more positive effects of NPM/CIH on these outcomes. Methodology: The project will identify a retrospective cohort between 2016-2020 of approximately 200,000 Veterans receiving LTOT at ≥ 30 mg morphine equivalent daily dose (MEDD) across 54 VA facilities. Leveraging Veterans Health Administration (VHA) electronic health record data, Veterans’ utilization of NPM/CIH within VHA and in the community will be assessed. Applying a novel method developed by VA MedSAFE using VHA electronic pharmacy data within the Corporate Data Warehouse, we will develop models of opioid tapering within the target period. Using quasi-experimental methods, Veterans will be “assigned” to NPM/CIH treatment or no treatment based on their observed service utilization. Propensity score matching will balance baseline differences due to nonrandom assignment. In multilevel models, opioid tapering outcomes will be modeled as a function of NPM/CIH use. The primary tapering effectiveness outcome will be the proportion of Veterans achieving a reduction in prescribed opioid dose of ≥50% of baseline mg MEDD, maintained over six months in the absence of worsened pain intensity. Tapering safety will be measured as the proportion of Veterans experiencing any serious adverse event (SAE), allowing tapering to take all values, including no taper and dose increases. SAE will include hospitalization, emergency department visit, opioid overdose, new mental health disorder, new opioid or other substance use disorder, suicide attempt, and all- cause mortality. Models will assess moderation of NPM/CIH effects by buprenorphine treatment for opioid tapering and for chronic pain. Secondary models will assess the effect of NPM/CIH on LTOT-related side effects and differences in NPM/CIH effect by age, race/ethnicity and gender. Next Steps/Implementation: Operational partners and a Veteran engagement panel will guide interpretation of results and promote dissemination and translation to practice. Results will inform an implementation study to support the scale-up and sustainment of effective practices for pain management and facilitating safe and effective opioid reduction.", "keywords": [ "Address", "Adverse event", "American", "Benefits and Risks", "Buprenorphine", "COVID-19", "Caring", "Centers for Disease Control and Prevention (U.S.)", "Characteristics", "Clinical", "Communities", "Complementary Health", "Data", "Deimplementation", "Dose", "Dropout", "Effectiveness", "Electronic Health Record", "Emergency department visit", "Equilibrium", "Ethnic Origin", "Evaluation", "Evaluation Reports", "Event", "Exercise", "Face", "Feeling suicidal", "Formulation", "Funding", "Gender", "Goals", "Guidelines", "Health", "Health Services", "Health Services Accessibility", "Health Services Research", "Healthcare Systems", "Hospitalization", "Institution", "Integrative Medicine", "Lead", "Measures", "Mental Health", "Mental disorders", "Methodology", "Methods", "Modality", "Modeling", "Opiate Addiction", "Opioid", "Outcome", "Overdose", "Pain", "Pain intensity", "Pain management", "Patient-Centered Care", "Patients", "Pattern", "Perception", "Personal Satisfaction", "Pharmacy facility", "Physiological", "Practice Management", "Prevention Guidelines", "Quasi-experiment", "Race", "Randomized Controlled Trials", "Recommendation", "Recovery", "Regimen", "Research", "Research Design", "Retrospective cohort", "Retrospective cohort study", "Risk", "Role", "Safety", "Sampling", "Serious Adverse Event", "Services", "Site", "Substance Addiction", "Substance Use Disorder", "Suicide attempt", "Testing", "Translations", "United States Department of Veterans Affairs", "Veterans", "Veterans Health Administration", "Withdrawal Symptom", "Work", "Yoga", "addiction", "adverse outcome", "age effect", "base", "buprenorphine treatment", "chiropracty", "chronic pain", "chronic pain patient", "cohort", "comorbidity", "compare effectiveness", "data warehouse", "design", "effective therapy", "effectiveness outcome", "evidence base", "experience", "health service use", "implementation study", "improved", "innovation", "medication safety", "milligram", "morphine equivalent", "mortality", "multidisciplinary", "multilevel analysis", "multimodality", "novel", "opioid mortality", "opioid overdose", "opioid tapering", "opioid therapy", "opioid use", "opioid use disorder", "pharmacy benefit", "physical conditioning", "prescription opioid", "scale up", "secondary analysis", "service uptake", "service utilization", "side effect", "sociodemographics", "substance use", "symposium", "treatment effect", "treat" ], "approved": true } }, { "type": "Grant", "id": "8200", "attributes": { "award_id": "5I01BX005490-02", "title": "COVID-19: SARS-CoV-2 Neutralizing Agents", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-04-01", "end_date": "2023-03-31", "award_amount": null, "principal_investigator": { "id": 24037, "first_name": "SUBHRA", "last_name": "MOHAPATRA", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1638, "ror": "", "name": "JAMES A. HALEY VA MEDICAL CENTER", "address": "", "city": "", "state": "FL", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [ { "id": 23775, "first_name": "Shyam S", "last_name": "Mohapatra", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1638, "ror": "", "name": "JAMES A. HALEY VA MEDICAL CENTER", "address": "", "city": "", "state": "FL", "zip": "", "country": "United States", "approved": true } ] } ], "awardee_organization": { "id": 1638, "ror": "", "name": "JAMES A. HALEY VA MEDICAL CENTER", "address": "", "city": "", "state": "FL", "zip": "", "country": "United States", "approved": true }, "abstract": "COVID-19 super pandemic is still suffering from the lack of a vaccine or infection control measures and the lack of any treatments against this new virus. One of the unique features of SARS-CoV-2 is that it has an R0=2.2 (the ability of an infected patient to spread the disease) vs R0=1 for SARS-CoV and R0=0.3 for Influenza. Due to this, individuals infected with SARS-CoV-2 remain asymptomatic and yet pass on the virus to family, friends and colleagues at work, thus expanding the COVID-19 cases. Given the impending second wave of the pandemic and the potential of SARS-CoV-2 being a seasonal virus, there is a dire urgent need to develop prophylactic vaccines and/or therapy (PV/T), which can treat the viral infection during the virus expansion in the lung and during oxygen therapy. This proposal addresses the COVID-19 pandemic by developing a PV/T, which will be a unique approach that has not been tested before. This project is inspired by discovery of a special agent, i.e., a nanoscale 10 kDa chitosan, derived using proprietary methods from chitosan used as a common diet supplement [‘generally regarded as safe’ (GRAS) by FDA] , referred to as nanoscale chitosan derivative (NCD). NCD1 and other chemical derivatives were synthesized and tested for their anti-viral activity by neutralizing RNA of viruses, such as HIV, respiratory syncytial virus (RSV) and Coxsackie virus. Thus, in preliminary studies, 5 out of 9 examined showed significant anti-viral (80-90%) effects. Further, molecular docking studies showed that NCD1 can dock to the Spike protein of SARS-CoV-2 virus. Finally, we have developed lung targeted nanomedicine methods to combine NCD1 with remdesivir for improving treatment efficacy and expanding its use for prevention. Based on data at hand, it is hypothesized that NCDs by themselves or in combination with remdesivir will provide an excellent PV/T against COVID-19. To test this hypothesis, it is planned to examine in both prophylactic and therapeutic settings: the antiviral effectiveness of NCDs in vitro lung epithelial cell cultures (aim #1), the effectiveness of select top two NCDs with or without remdesivir in EpiAlveolar 3D co-culture model (MatTek) of the air-blood barrier (aim #2), and efficacy of select NCD with or without remdesivir in in vivo mouse models (aim #3). The results will provide us in identifying one or two NCDs as a single agent or in combination with remdesivir as COVID-19 PV/T regimen(s), which will inhibit SARS-CoV-2 infection. The results of these studies will uniquely contribute to the repertoire of COVID-19 prophylactics and therapeutics and allow us to move towards regulatory approval and future clinical trials. The team is uniquely poised to conduct these studies and has appropriate expertise. The successful completion of the proposed research is expected to lead to obtaining regulatory approval for a clinical trial.", "keywords": [ "2019-nCoV", "3-Dimensional", "ACE2", "Acute Respiratory Distress Syndrome", "Address", "Affect", "Antiviral Agents", "Biological", "Biological Assay", "Blood-Air Barrier", "COVID-19", "COVID-19 pandemic", "COVID-19 patient", "COVID-19 treatment", "Cell Culture Techniques", "Cell model", "Cells", "Cessation of life", "Chemicals", "Chitosan", "Clinical Trials", "Coculture Techniques", "Combined Modality Therapy", "Country", "Coxsackie Viruses", "Data", "Diagnosis", "Disease", "Docking", "Effectiveness", "Endothelial Cells", "Enzyme-Linked Immunosorbent Assay", "Epithelial Cells", "Evolution", "FDA approved", "Family", "Fibroblasts", "Friends", "Future", "HIV", "Hand", "Human", "In Vitro", "Individual", "Infection", "Infection Control", "Influenza", "Lead", "Lung", "Measures", "Methods", "Modeling", "Molecular", "Oxygen", "Oxygen Therapy Care", "Patients", "Pharmaceutical Preparations", "Prevention", "Preventive vaccine", "Prophylactic treatment", "RNA Viruses", "Regimen", "Research", "Respiratory syncytial virus", "SARS coronavirus", "SARS-CoV-2 infection", "SARS-CoV-2 inhibitor", "SARS-CoV-2 spike protein", "Testing", "Therapeutic", "Toxic effect", "Treatment Efficacy", "Vaccines", "Viral", "Viral Load result", "Viral Physiology", "Virus", "Virus Diseases", "Work", "alveolar epithelium", "base", "crosslink", "dietary supplements", "efficacy evaluation", "efficacy testing", "immunocytochemistry", "improved", "in vivo", "innovation", "mouse model", "nanomedicine", "nanoscale", "novel coronavirus", "novel virus", "overexpression", "pandemic disease", "particle", "prophylactic", "remdesivir", "response", "tripolyphosphate" ], "approved": true } }, { "type": "Grant", "id": "14594", "attributes": { "award_id": "1I21HX003799-01A1", "title": "Systems Analysis of Healthcare-Associated Infection Prevention during the COVID-19 Pandemic", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2024-05-01", "end_date": "2025-10-31", "award_amount": null, "principal_investigator": { "id": 31260, "first_name": "Julie A", "last_name": "Keating", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "other_investigators": [], "awardee_organization": { "id": 2247, "ror": "", "name": "WM S. MIDDLETON MEMORIAL VETERANS HOSP", "address": "", "city": "", "state": "WI", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: Effective healthcare-associated infection (HAI) prevention requires multiple complex interventions (e.g., hand hygiene, environmental cleaning, personal protective equipment use, and evidence-based patient procedure protocols such as central line maintenance). The COVID-19 pandemic’s effects on healthcare (e.g., staffing shortages, supply chain disruptions, modified protocols to reduce exposure) also impacted HAI prevention. Retrospective analyses have found differential impacts on HAI rates during the pandemic, with some HAIs increasing and others decreasing. However, there has not yet been an assessment of how the COVID-19 pandemic specifically impacted guideline-concordant HAI prevention practices. Significance: This pilot project directly addresses HSR&D’s research priority to enhance the Quality and Safety of Health Care by gathering critical information regarding the implementation of HAI prevention practices during the COVID-19 pandemic. Information gathered here will inform the effective implementation of HAI prevention activities, including resuming guideline-concordant HAI prevention practices, to reduce HAIs across VA and increase the quality and safety of the healthcare received by Veterans. Innovation and Impact: We will conduct a work systems analysis using the Systems Engineering Initiative for Patient Safety (SEIPS) framework, which allows for the assessment of barriers and facilitators within and between each individual work system element (people, tools and technology, task, organization, and environment). This granular analysis allows for identifying and addressing specific barriers to implementation, which can be difficult to identify in complex work systems like those in HAI prevention. By addressing these barriers, we can develop implementation strategies to support the resuming of guideline-concordant HAI prevention practices in work systems that were or are continuing to be affected by COVID-19-related impacts. Specific Aims: In this pilot project, we aim to: 1. Conduct a work systems analysis of HAI prevention during the COVID-19 pandemic among acute inpatient care facilities in VISN12 to identify specific impacts of the pandemic on HAI prevention and HCW-reported needs for improved HAI prevention during the pandemic. 2. Identify barriers and facilitators to resuming IPC best practices in the COVID endemic era. Methodology: We will conduct semi-structured interviews with 1) 1-2 HAI prevention stakeholders and 2) up to 5 frontline nursing personnel at each of the 8 VA medical centers in VISN12. We will use interview guides structured around the CDC’s multidrug-resistant organism prevention strategies and the SEIPS framework to probe pandemic-related changes to HAI prevention practices as well as reasons behind these changes and barriers to resuming practices. We will use a rapid qualitative inquiry approach to analyze interview data, ultimately producing 1) a specific list of HAI prevention practices that were substantially modified during the COVID-19 pandemic and require additional implementation support to resuming practices; 2) work system element barriers and facilitators to conducting these practices during the pandemic; and 3) a logic model guiding the development of a larger research project on priority HAI prevention practices. Next Steps/Implementation: This pilot project will identify specific HAI prevention practices requiring additional implementation support, leading directly to a larger research project to gather VA-wide data on the implementation of these practices. We will also then develop and test implementation strategies to maximize effectiveness of the practice in reducing HAIs while minimizing burden on healthcare workers. This work will thus improve VA’s ability to respond to major disruptions to resources and processes (as COVID-19 was) while maintaining the safety and quality of care for Veterans.", "keywords": [ "Acute", "Address", "Area", "Bathing", "COVID-19", "COVID-19 impact", "COVID-19 pandemic", "COVID-19 pandemic effects", "Catalogs", "Clostridium difficile", "Complex", "Data", "Development", "Devices", "Disease Outbreaks", "Effectiveness", "Elements", "Engineering", "Environment", "Equipment", "Event", "Future", "Goals", "Guidelines", "Hand", "Health Personnel", "Health Priorities", "Health care facility", "Healthcare", "Healthcare Systems", "Hospitals", "Hygiene", "Individual", "Infection", "Infection Control", "Infection prevention", "Inpatients", "Interruption", "Intervention", "Interview", "Logic", "Maintenance", "Measures", "Medical center", "Mental Health", "Methodology", "Modeling", "Nursing Staff", "Oral", "Outcome", "Patient Care", "Patients", "Patterns of Care", "Persons", "Phase", "Pilot Projects", "Prevention strategy", "Procedures", "Process", "Protocols documentation", "Provider", "Quality of Care", "Reporting", "Research Priority", "Research Project Grants", "Resource-limited setting", "Resources", "Risk Reduction", "Route", "Safety", "Sepsis", "Shock", "Structure", "System", "Systems Analysis", "Technology", "Testing", "Training", "United States Department of Veterans Affairs", "Ventilator", "Veterans", "Work", "acute care", "burnout", "evidence base", "healthcare-associated infections", "implementation barriers", "implementation evaluation", "implementation strategy", "implementation study", "improved", "infection rate", "information gathering", "innovation", "inpatient service", "multi-drug resistant pathogen", "pandemic disease", "pandemic impact", "pathogen", "patient safety", "personal protective equipment", "pre-pandemic", "prevent", "prevention practice", "response", "supply chain", "tool", "transmission process", "trend" ], "approved": true } }, { "type": "Grant", "id": "6682", "attributes": { "award_id": "5I01BX005411-02", "title": "COVID-19: Understanding The Role of Corona Virus InducedDisruption Of Alveolar Type 2 Cell Function And SurfactantHomeostasis In The Pathogenesis Of COVID-19 AcuteRespiratory Distress Syndrome", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-01-01", "end_date": "2022-12-31", "award_amount": null, "principal_investigator": { "id": 22384, "first_name": "MICHAEL FRANCIS", "last_name": "BEERS", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1488, "ror": "https://ror.org/03j05zz84", "name": "Philadelphia VA Medical Center", "address": "", "city": "", "state": "PA", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [], "awardee_organization": { "id": 1488, "ror": "https://ror.org/03j05zz84", "name": "Philadelphia VA Medical Center", "address": "", "city": "", "state": "PA", "zip": "", "country": "United States", "approved": true }, "abstract": "The Severe Acute Respiratory Syndrome (SARS)-associated coronavirus 2 (SCoV2) is the cause of COVID-19 syndrome which is marked by a refractory acute lung injury that results in dramatic hypoxic respiratory failure and high mortality. Despite the recurrent health and economic devastation produced by novel coronaviruses (nCoV) over the past 20 years including SCoV2 as well as its predecessors SCoV1, and MERS-CoV, there remains a significant unmet need both for a clearer understanding of virus-host cell interactions as well as identification of new therapeutic targets. To address these issues with the ultimate goal of improving the health and outcomes of veterans with COVID-19, we have assembled a team of internationally recognized scientists with expertise in coronavirus virology and in lung biology coupled with a strong foundation of our own prior work on surfactant biology, lung injury, and fibrotic repair funded, in part, by the VA Merit Review program. Utilizing this expertise, this proposal is directed at filling in large knowledge gaps that exist in the pathogenesis of nCoV induced respiratory failure. The motivation for this investigation has been fueled by the recent recognition that the alveolar type 2 (AT2) epithelial cell of the distal lung has emerged as an important portal of entry for SCoV- 2. The central hypothesis of this application is that AT2 cells infected with nCoV acquire defects in surfactant biosynthesis/metabolism, activate cellular stress pathways, and develop alterations in progenitor cell function all of which promote hypoxic respiratory failure, persistent lung inflammation and injury, and impact recovery through effects on epithelial repair capacity. To test this, we will leverage an established murine model of CoV infection (MHV-1) with a pulmonary phenotype combined with reductionist studies supported by ex vivo infection of primary human AT2 cells obtained from a robust human lung pipeline with an already in hand SARS-CoV-2 isolate. Our experimental approach will interrogate these preclinical models using tools and reagents available in our program, to map the effect of CoV infection on distal lung cell populations with a focus on identifying and translating molecular mechanisms linking the disrupted AT2 function with altered surfactant biology and proinflammatory/profibrotic cell cross talk in the alveoilar niche. In Specific Aim 1, we will first define temporal changes in distal lung epithelial endophenotypes focusing on the ontogeny of the disruption of AT2 homeostasis by viral infection using a well characterized mouse model of MHV-1 lung infection. Using both unbiased approaches such as transcriptomic profiling as well as classical cell biology and biochemistry this aim will investigate CoV induced changes in surfactant metabolism/biophysical activity, AT2 cell stress (i.e. ER stress, proteasome dysfunction, autophagy malfunction, changes in mitochondrial dynamics/ / bioenergetics) and AT2 progenitor cell function. In Specific Aim 2, armed with this “functional map” of the mouse CoV-lung and aberrant AT2 behaviors, we will translate the identified lead targets and mechanisms to human AT2 cells utilizing both primary AT2 cultures as well as precision cut lung slices (PCLS) infected with SARS-CoV-2. The research design involves the analysis of virus-dependent AT2 surfactant protein and lipid metabolism, interrogation of AT2 cell quality control pathways, and functional evaluation of AT2 progenitor function phenotypes in the SCoV-2 infected human epithelial cells. By understanding the path to epithelial injury / dysfunction from nCoV, the mechanisms and affected lung cell populations identified using these models will improve the understanding of sCOV2/COVID- 19 syndrome, promote identification of new target pathways, and can be cross-purposed to test emerging therapies for both the current and future nCoV pandemics.", "keywords": [ "2019-nCoV", "ACE2", "Acute Lung Injury", "Acute Respiratory Distress Syndrome", "Address", "Affect", "Alveolar", "Anabolism", "Apoptosis", "Autophagocytosis", "Behavior", "Berlin", "Big Data", "Biochemistry", "Bioenergetics", "Biology", "Biophysics", "COVID-19", "COVID-19 pandemic", "COVID-19 pathogenesis", "Caring", "Catalogs", "Cell Communication", "Cell Ontogeny", "Cell model", "Cell physiology", "Cells", "Cellular Stress", "Cellular biology", "Characteristics", "Clinical", "Coronavirus", "Coronavirus Infections", "Coupled", "Data", "Defect", "Development", "Disease", "Dissociation", "Distal", "Distress", "Epidemic", "Epithelial", "Epithelial Cells", "Evaluation", "Foundations", "Functional disorder", "Funding", "Future", "Genetic", "Goals", "Gold", "Growth", "Hand", "Health", "Homeostasis", "Human", "Hypoxemia", "Hypoxemic Respiratory Failure", "Impairment", "In Vitro", "Infection", "Inflammatory", "Innate Immune Response", "International", "Investigation", "Knowledge", "Lead", "Link", "Lung", "Lung Capacity", "Lung infections", "Maintenance", "Maps", "Mediating", "Metabolism", "Middle East Respiratory Syndrome Coronavirus", "Mitochondria", "Modeling", "Molecular", "Molecular Target", "Morbidity - disease rate", "Motivation", "Mus", "Natural Immunity", "Organoids", "Outcome", "Pathogenesis", "Pathway interactions", "Peripheral", "Pharmacology", "Phenotype", "Physiological", "Population", "Positioning Attribute", "Pre-Clinical Model", "Primary Infection", "Program Reviews", "Proteins", "Pulmonary Inflammation", "Pulmonary Surfactants", "Quality Control", "Radiology Specialty", "Reagent", "Recovery", "Recurrence", "Refractory", "Reporting", "Research Design", "Residual state", "Respiratory Disease", "Respiratory Failure", "Role", "SARS coronavirus", "Scientist", "Severities", "Signal Pathway", "Slice", "Survivors", "Syndrome", "System", "Techniques", "Technology", "Testing", "Therapeutic", "Time", "Translating", "Ubiquitin", "Veterans", "Viral", "Virus", "Virus Diseases", "Work", "alveolar epithelium", "arm", "base", "biological adaptation to stress", "cytokine", "effective therapy", "endophenotype", "endoplasmic reticulum stress", "epithelial injury", "epithelial repair", "experience", "fibrotic lung", "health economics", "immunopathology", "improved", "in vivo", "induced pluripotent stem cell", "lipid metabolism", "lung injury", "lung repair", "mortality", "mouse model", "multicatalytic endopeptidase complex", "new ther" ], "approved": true } }, { "type": "Grant", "id": "12073", "attributes": { "award_id": "1I21HX003503-01A1", "title": "Understanding and Improving Video-Based Primary Care Delivery to Veterans", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2023-09-01", "end_date": "2025-02-28", "award_amount": null, "principal_investigator": { "id": 27925, "first_name": "Claudia", "last_name": "Der-Martirosian", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, "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: [With the onset of the COVID-19 pandemic, VA primary care (PC) experienced a substantial increase in video-based encounters, nationwide. This rapid uptake of video-based care in PC clinics, however, varied by site. Given that the VA is committed to continue expanding VA Video Connect (VVC), which is the main videoconferencing platform at the VA, more research is needed to comprehensively examine why and how VVC was successfully adopted at some sites and understand why VVC expansion was limited at other sites.] Significance/Impact: [Barriers and facilitators to video-based care are many and multifaceted. This study will examine patient, provider, and site-level characteristics of VVC use in PC at high and low VVC sites, and identify patient-centered, provider-recommended, and leadership supported VVC guidelines that are context-specific for PC clinics. This study will contribute more generally to our understanding of what is needed to achieve acceptance of video technology. Such knowledge will be helpful for VA, as well as the delivery of healthcare in general. In-depth understanding about challenges and successes of VVC use will inform future improvements of VVC policies, processes, and procedures for all Veterans, across all VA facilities.] Innovation: This study will examine Veterans’ perspectives about how VVC in PC can be improved to better meet their needs when using video-based care. This is an understudied topic. Furthermore, by learning about the providers’ and leadership’s perspectives on how VVC can be implemented more effectively, we will better understand the full context of VA video care. [This 18-month pilot study will create context-specific VVC playbook for high and low VVC using sites that will be patient-centered, provider-recommended, and leadership supported. This will help improve delivery of video-based primary care and patient outcomes at the VA.] Specific Aims: This pilot study’s overall objective is to identify strategies to improve VVC use for all Veterans. 1) Identify PC clinic sites in the top 5% and bottom 5% of VVC use nationally by examining patient, provider, and site-level variations in VVC use since the onset of COVID-19 (March 2020-March 2024, aka study period). 2) Characterize patient-, provider-, site-specific factors associated with VVC use in PC, nationwide, during the study period. 3) Evaluate barriers and facilitators to using VVC in PC from patients, providers, and leadership (VISN/VAMC/CBOC) perspectives at 3 high and 3 low VVC using sites in PC (identified in Aims 1 & 2). Methodology: [The non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework will be used for all aspects of the proposed study (data collection, analyses, synthesis of quantitative and qualitative findings). Two sequential, mixed methods approaches will be used, where quantitative analyses (Aims 1 & 2) will first inform the sampling and data collection for the qualitative interviews (Aim 3, n=60) at 3 high and 3 low VVC sites with patients, providers, and leadership. Using the explanatory mixed methods, the qualitative data will then help explain quantitative findings. In addition to in-depth interviews, the qualitative research will include document reviews on video-based care and VVC use for all 6 study sites After completing all analyses, quantitative and qualitative study findings will be mapped into the NASSS framework, which will help inform the development of patient-centered, provider-recommended, leadership-supported, and context-specific VVC playbook for PC clinics. The playbook will include strategies on how to improve VVC for high and low VVC sites. In close collaboration with all study operation partners (OCC, OPC, VEO), study Co-Investigators, and Veteran Engagement Groups (VEG), the playbook will be assessed for feasibility and usability.] Next Steps/Implementation: [To assess the effectiveness of the VVC playbook, future studies can pilot test the playbook at PC clinics at multiple VA sites. Pilot testing the playbook will provide the opportunity to receive feedback from different sites on how best to make the playbook suitable for all sites at the VA, nationally.]", "keywords": [ "Adopted", "Ambulatory Care", "COVID-19", "COVID-19 pandemic", "Caregivers", "Caring", "Characteristics", "Clinical", "Collaborations", "Data", "Data Collection", "Development", "Effectiveness", "Equipment", "Familiarity", "Feedback", "Future", "Guidelines", "Health", "Health Personnel", "Health Services Accessibility", "Home", "Individual", "Interruption", "Intervention", "Interview", "Knowledge", "Leadership", "Learning", "Literature", "Logistics", "Maps", "Methodology", "Methods", "Modality", "Patient-Focused Outcomes", "Patients", "Persons", "Pilot Projects", "Policies", "Primary Care", "Procedures", "Process", "Provider", "Qualitative Research", "Recommendation", "Regression Analysis", "Research", "Research Personnel", "Schedule", "Site", "Structure", "Technology", "Telephone", "Time", "Time Series Analysis", "Training and Education", "Update", "Variant", "Veterans", "Videoconferencing", "Visit", "Work", "care delivery", "care outcomes", "effectiveness evaluation", "experience", "health care delivery", "improved", "innovation", "operation", "pandemic disease", "patient oriented", "pilot test", "preference", "primary care clinic", "primary care patient", "sample collection", "scale up", "success", "sustainability framework", "telehealth", "uptake", "usability", "video delivery", "virtual", "willingness" ], "approved": true } }, { "type": "Grant", "id": "8229", "attributes": { "award_id": "5I01BX005442-02", "title": "COVID-19: Multi-Omics Approach to Identify Molecular Mechanisms Responsible for Risk and Resilience to Adverse Outcomes", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-04-01", "end_date": "2023-03-31", "award_amount": null, "principal_investigator": { "id": 24057, "first_name": "CHARLES D", "last_name": "SEARLES", "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": "Objective: Emerging data from the COVID-19 pandemic indicate that men and African Americans have higher mortality, and cardiometabolic risk factors, including obesity, diabetes, and hypertension, cluster in patients who develop adverse outcomes to SARS-CoV-2 infection. The Veteran population is particularly vulnerable to COVID-19 because of the very high prevalence of cardiometabolic risk factors. However, not all Veterans with COVID-19 experience severe disease, and there is an urgent need to identify novel molecular pathways underlying risk and resilience to COVID-19. Previous work and preliminary studies from our team have demonstrated that targeted proteomics, metabolomics, and miRNA-omics can identify novel biomarkers and molecular pathways associated with cardiovascular health and disease. In this project, we will use a multi-omics to elucidate novel biomarkers and pathways associated with risk and resilience to severe COVID-19. Research Plan: In Aim 1, we will compare expression of pathway-specific biomarkers in hospitalized patients with severe COVID-19 with expression of these biomarkers in patients who do not develop severe COVID-19. Pathway-specific biomarkers reflecting activation of the renin-angiotensin-aldosterone system, systemic inflammation, oxidative stress, immune activation, thrombogenesis, and myocardial injury and stretch will be assessed. The primary endpoints for severe disease will be pathologic elevation of IL-6 levels or troponin I levels. Secondary endpoints will be requirement for mechanical ventilation, congestive heart failure, change in SOFA score, and death. In Aim 2, we will assess the extracellular miRNA and metabolomic profiles of the same two groups of hospitalized COVID-19 patients and determine miRNAs and metabolites differentially expressed between the two groups. Subsequently, we will examine connectivity between miRNA-metabolome networks and clinical endpoints in COVID-19 patients by performing an integrative analysis of differentially expressed miRNAs and metabolites, which will identify metabolic pathways associated with severe infection. Methods: The proposed studies will analyze de-identified blood samples and clinical data from COVID-19 patients hospitalized at the Atlanta VAMC and Emory University Hospital. The samples will be obtained from a bio repository that is currently banking residual plasma and serum from routine laboratory testing of COVID-19 patients. In Aim 1, we will measure levels of aminothiol (oxidative stress), suPAR (thrombogenesis/immune dysregulation), hsCRP (inflammation), hsTnI (myocardial injury), BNP (myocardial stretch), D-dimers (thrombogenesis), angiotensin II, angiotensin-(1-7) and plasma renin activity. Logistic regression modeling will be performed to identify biomarkers predictive of clinical endpoints. In Aim 2, we will use next generation sequencing, RT-qPCR, and high-throughput metabolomics profiling to assess expression of extracellular miRNAs and metabolites. A metabolome wide association study (MWAS) and ensemble feature selection (EFS) will be used to identify robust biomarkers and develop predictive models for severe COVID-19. Data from EFS analysis will input to the program xMWAS, which will determine connectivity between miRNA-metabolome networks and clinical outcomes. Clinical Relevance: Veterans with cardiovascular conditions are at higher risk for SARS-CoV-2 infection and severe disease progression. Our team has the infrastructure and methods in place to conduct in-depth, multi- omics studies to address predictors of adverse outcomes in Veterans with COVID-19 and identify epigenetic and cardiometabolic pathways that determine susceptibility to adverse outcomes. Furthermore, because 50% of the Veteran population at the Atlanta VA Medical Center Veteran is African American, we are in a unique position to address the role of race in susceptibility to severe COVID-19. Discovery of novel biomarkers and pathways associated with severe COVID-19 has broad implications for screening, therapeutics, and implementation of earlier personalized interventional strategies for attenuating adverse outcomes.", "keywords": [ "2019-nCoV", "Address", "African American", "Age", "Angiotensin II", "Arrhythmia", "Attenuated", "Biochemical Pathway", "Biological", "Biological Markers", "Blood", "Blood Banks", "Blood specimen", "Brain natriuretic peptide", "C-reactive protein", "COVID-19", "COVID-19 mortality", "COVID-19 pandemic", "COVID-19 patient", "COVID-19 test", "COVID-19 testing", "Cardiovascular Diseases", "Cardiovascular system", "Centers for Disease Control and Prevention (U.S.)", "Cessation of life", "Characteristics", "China", "Clinical", "Clinical Data", "Congestive Heart Failure", "Coronary Arteriosclerosis", "Data", "Databases", "Development", "Diabetes Mellitus", "Disease", "Disease Outcome", "Disease Progression", "Electronic Health Record", "Enrollment", "Epidemic", "Epigenetic Process", "Ethnic Origin", "Europe", "Fibrin fragment D", "Fibrin split products", "Health", "High Prevalence", "Hypertension", "Immune", "Immune response", "Immunologic Markers", "Infarction", "Infection", "Inflammation", "Infrastructure", "Interleukin-6", "International", "Intervention", "Laboratories", "Lead", "Left", "Logistic Regressions", "Measurement", "Measures", "Mechanical ventilation", "Medical center", "Metabolic", "Metabolic Pathway", "Methods", "MicroRNAs", "Modeling", "Molecular", "Molecular Profiling", "Myocardial", "Myocarditis", "Obesity", "Outcome", "Oxidative Stress", "Participant", "Pathologic", "Pathway interactions", "Patients", "Pilot Projects", "Plasma", "Play", "Positioning Attribute", "Predisposition", "Proteomics", "Protocols documentation", "Race", "Renin", "Renin-Angiotensin-Aldosterone System", "Research", "Residual state", "Risk", "Risk Factors", "Role", "SARS-CoV-2 infection", "Sampling", "Severity of illness", "Stretching", "Testing", "Therapeutic", "Therapeutic Intervention", "Troponin I", "University Hospitals", "Urokinase Plasminogen Activator Receptor", "Veterans", "Virus Diseases", "Work", "acute infection", "adverse outcome", "airway epithelium", "aminothiol", "angiotensin I (1-7)", "biobank", "cardiometabolic risk", "cardiometabolism", "cardiovascular health", "cardiovascular risk factor", "cell injury", "clinical predictors", "clinically relevant", "cohort", "differential expression", "experience", "extracellular", "feature selection", "heart circulation", "hemodynamics", "high risk", "immune activation", "indicated prevention", "inflammatory marker", "lung in" ], "approved": true } }, { "type": "Grant", "id": "8973", "attributes": { "award_id": "1I21RX003888-01", "title": "Auditory Rehabilitation Needs in COVID-19 Survivors", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2021-12-01", "end_date": "2023-11-30", "award_amount": null, "principal_investigator": { "id": 24810, "first_name": "Kelly M.", "last_name": "Reavis", "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": "Project Background/Rationale: The purpose of this proposal is to quantitatively examine and qualitatively understand the impact of COVID-19 on Veterans' auditory function. Since the pandemic began, over 230,000 Veterans in the VA health care system have tested or been presumed positive for COVID-19. It has been hypothesized that COVID-19 may have adverse effects on the auditory system, although the extent is unknown. Viral induced hearing loss is not a new phenomenon and several case studies and case series have reported new onset and progression of hearing loss and tinnitus, sudden hearing loss (sudden occurrence of acute hearing loss), ear pain, noise sensitivity and otitis media with respect to COVID-19. Moreover, we are lacking an understanding of the auditory rehabilitation needs of COVID-19 survivors. This evidence is required to successfully restore and return Veterans' auditory function to improve their quality of life. Project Aims: There is a need to understand the short- and long-term consequences of COVID-19 on the auditory system, especially among Veterans who are already at risk for underlying auditory complications, and to conceptualize these within a rehabilitation framework. The specific aims of this research proposal are to (1) Quantify the burden and impact of COVID- 19 on Veterans' auditory function; and (2) Describe Veterans' experiences with auditory complications following COVID-19 with respect to timing, onset, clinical course, rehabilitation needs, and quality of life. Project Methods: This 2-year pilot project will be accomplished through a mixed-methods approach with a sequential quantitative-qualitative design. Quantitative data regarding COVID- 19 auditory sequelae will be gathered via patient surveys and review of the electronic medical record (n=1,566). Qualitative data will be gathered via semi-structured interviews with COVID- 19 patients (n=40). By focusing on the personal and lived experiences among Veterans with COVID-19, the qualitative aim will explore emerging issues and contextual nuances otherwise unmeasurable using survey methods. Data will be stratified by hospitalization history so that unique needs of Veterans with more severe disease can be examined. Anticipated Impact: Completion of the proposed study will provide evidence for the impacts of COVID-19 on the auditory system. It is our goal to immediately provide clinicians with a better understanding of this complex patient population, functional limitations, and perceived rehabilitation needs. Observed hearing loss and tinnitus may very well become chronic, so the audiological impact of the pandemic may substantially outlast the current phase. Results of this study will lead to a VA Rehabilitation Research & Development, Merit Award application exploring the longitudinal effects of COVID-19 on the ear, hearing, and tinnitus using more robust and audiometric test measures not feasible in this pilot study.", "keywords": [ "2019-nCoV", "ACE2", "Acute", "Adverse effects", "Affect", "Auditory", "Auditory system", "Award", "Bacterial Pneumonia", "Biological", "Brain", "COVID-19", "COVID-19 patient", "COVID-19 survivors", "COVID-19 treatment", "Cadaver", "Caring", "Case Series", "Case Study", "Cells", "Chronic", "Clinical", "Coagulation Process", "Cochlea", "Communicable Diseases", "Complex", "Computerized Medical Record", "Consequentialism", "Cytomegalovirus", "Data", "Disease", "Ear", "Earache", "Endothelium", "Epithelial Cells", "Functional disorder", "Future", "Goals", "Health", "Healthcare Systems", "Hearing", "Hearing Tests", "Hearing problem", "Hospitalization", "Hyperacusis", "Immune system", "Infection", "Inflammation", "Inflammatory", "Interview", "Ischemia", "Life", "Life Experience", "Literature", "Mastoid process", "Measles", "Measures", "Meningitis", "Methods", "Morbidity - disease rate", "Multiple Organ Failure", "Mumps", "Nervous system structure", "Otitis Media", "Pathway interactions", "Patients", "Phase", "Pilot Projects", "Prevalence", "Quality of life", "Receptor Cell", "Recording of previous events", "Rehabilitation therapy", "Reporting", "Research Proposals", "Respiratory Signs and Symptoms", "Respiratory System", "Respiratory distress", "Risk", "Rubella", "SARS-CoV-2 infection", "SARS-CoV-2 positive", "Structure", "Sudden Hearing Loss", "Survey Methodology", "Surveys", "Survivors", "Systemic infection", "Temporal Lobe", "Testing", "Therapeutic", "Time", "Tinnitus", "Vascular Smooth Muscle", "Veterans", "Viral", "Virus", "Work", "adverse outcome", "auditory pathway", "auditory rehabilitation", "base", "comorbidity", "cytokine", "cytokine release syndrome", "design", "experience", "hearing impairment", "improved", "interest", "long term consequences of COVID-19", "male", "middle ear", "military veteran", "mortality", "novel coronavirus", "ototoxicity", "pandemic disease", "patient population", "rehabilitation research", "rehabilitation service", "rehabilitative care", "research and development", "sepsis induced ARDS" ], "approved": true } }, { "type": "Grant", "id": "7971", "attributes": { "award_id": "1I01HX003277-01A1", "title": "Hospital In Home: Evaluating Need and Readiness for Implementation (HENRI)", "funder": { "id": 4, "ror": "https://ror.org/01cwqze88", "name": "National Institutes of Health", "approved": true }, "funder_divisions": [], "program_reference_codes": [], "program_officials": [], "start_date": "2022-06-01", "end_date": "2026-05-31", "award_amount": null, "principal_investigator": { "id": 23857, "first_name": "William W.,MPH, MD", "last_name": "Hung", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [ { "id": 1653, "ror": "", "name": "VETERANS AFFAIRS, UNITED STATES DEPARTMENT OF", "address": "", "city": "", "state": "NY", "zip": "", "country": "United States", "approved": true } ] }, "other_investigators": [ { "id": 23858, "first_name": "ORNA K.", "last_name": "INTRATOR", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] }, { "id": 23859, "first_name": "Jennifer L", "last_name": "Sullivan", "orcid": null, "emails": "", "private_emails": "", "keywords": null, "approved": true, "websites": null, "desired_collaboration": null, "comments": null, "affiliations": [] } ], "awardee_organization": { "id": 1653, "ror": "", "name": "VETERANS AFFAIRS, UNITED STATES DEPARTMENT OF", "address": "", "city": "", "state": "NY", "zip": "", "country": "United States", "approved": true }, "abstract": "Background: The Department of Veterans Affairs (VA's) Hospital In Home (HIH) program, designed from experiences of the Hospital At Home community program, is a model of care that delivers patient-centered, acute-level hospital care at home which has demonstrated safety, effectiveness and patient satisfaction beyond those observed in hospitals. Since 2010, the VHA Office of Geriatrics & Extended Care (GEC), through its transformational programs and mentored partnerships has spurred the development of [12] HIH program sites nationally, which have all been sustained by their parent station. Significance/Impact: [Hospital In Home is a mix of interventions and levels of implementations; understanding how to weave these successfully is the overarching aim of this project.] Continued spread of HIH across the VA requires evidence be established regarding the need for HIH and about the implementation of existing HIH programs. Understanding barriers and facilitators and processes of implementation of HIH programs will allow more facile adoption of HIH programs allowing for substantial cost savings of about $3,000 per inpatient event. Especially in the era of the Mission Act, having HIH available may incentivize Veterans to choose VA. [With the recent Covid-19 pandemic, HIH has been identified as a potential contributor to addressing the disease and sequelae.] Innovation: This project will generate generalizable knowledge regarding implementation of HIH models and will advance implementation science from its application of implementation science frameworks, Re-Aim- PRISM and novel methods such as Implementation Mapping. The project will curate knowledge garnered from the existing programs and develop tools to disseminate it. It will develop and conduct readiness for implementation surveys. Finally, it will “dry-run” implementations in sites with greater readiness for implementation. The results of the “dry runs” will provide feedback to the implementation planning thus increasing their probability of successful adoption of HIH and its sustainment and growth. Specific Aims: 1. Establish evidence regarding the implementation of the existing HIH sites using a mixed methods approach. Deliverables: An evaluation framework and report summarizing the experiences of the existing sites. 2. Develop operational implementation tools and a readiness for implementation survey to be conducted. Deliverables: A survey of readiness for implementation and prioritization of sites ready to implement; implementation tools. 3. Select ten new sites with the greatest evidence of readiness for implementation to conduct “dry-runs” and create blueprints for implementation; identify causal loop diagram(s); catalog the evidence. Deliverables: Report summarizing common and site specific implementation themes; Site-specific Implementation logic models; Searchable catalog of HIH implementation strategies. Methodology: This mixed-methods project will conduct quantitative analyses, interviews, focus groups and “dry runs” applying implementation science frameworks and methods (RE-AIM-PRISM, implementation mapping) and system science to understand the existing HIH programs and to create implementation tools, evaluation framework, readiness survey, causal loop diagrams and a searchable catalog of HIH implementation evidence. Implementation/Next Steps: Future work will develop simulation studies and conduct evaluations of newly implemented sites as well as a hybrid II implementation trial of the effectiveness and safety of the HIH model.", "keywords": [ "Accident and Emergency department", "Acute", "Address", "Admission activity", "Adoption", "Beds", "Benchmarking", "COVID-19 pandemic", "Caring", "Catalogs", "Client satisfaction", "Communities", "Complex", "Contracts", "Cost Savings", "Development", "Disease", "Effectiveness", "Evaluation", "Evaluation Reports", "Event", "Feedback", "Focus Groups", "Future", "Geriatrics", "Growth", "Health Services Accessibility", "Home", "Hospital safety", "Hospitals", "Hybrids", "Implementation readiness", "Incentives", "Inpatients", "Intervention", "Interview", "Knowledge", "Learning", "Logic", "Long-Term Care", "Mentors", "Methodology", "Methods", "Mission", "Modeling", "Parents", "Patient-Focused Outcomes", "Probability", "Process", "Quality of Care", "Quantitative Evaluations", "Reach Effectiveness Adoption Implementation and Maintenance", "Readiness", "Reporting", "Resources", "Running", "Safety", "Science", "Series", "Site", "Standardization", "Surveys", "System", "Techniques", "United States Department of Veterans Affairs", "Variant", "Veterans", "Work", "base", "design", "effectiveness implementation trial", "experience", "experimental study", "guidebooks", "implementation barriers", "implementation evaluation", "implementation framework", "implementation science", "implementation strategy", "implementation tool", "informant", "innovation", "interest", "novel", "patient oriented", "preference", "programs", "simulation", "stem", "tool" ], "approved": true } } ], "meta": { "pagination": { "page": 4, "pages": 1397, "count": 13961 } } }