National Institutes Of Health Awards Research Articles

Spatio-temporal hybrid neural networks reduce erroneous human "judgement calls" in the diagnosis of Takotsubo syndrome.

BackgroundWe investigate whether deep learning (DL) neural networks can reduce erroneous human “judgment calls” on bedside echocardiograms and help distinguish Takotsubo syndrome (TTS) from anterior wall ST segment elevation myocardial infarction (STEMI).MethodsWe developed a single-channel (DCNN[2D SCI]), a multi-channel (DCNN[2D MCI]), and a 3-dimensional (DCNN[2D+t]) deep convolution neural network, and a recurrent neural network (RNN) based on 17,280 still-frame images and 540 videos from 2-dimensional echocardiograms in 10 years (1 January 2008 to 1 January 2018) retrospective cohort in University of Iowa (UI) and eight other medical centers. Echocardiograms from 450 UI patients were randomly divided into training and testing sets for internal training, testing, and model construction. Echocardiograms of 90 patients from the other medical centers were used for external validation to evaluate the model generalizability. A total of 49 board-certified human readers performed human-side classification on the same echocardiography dataset to compare the diagnostic performance and help data visualization.FindingsThe DCNN (2D SCI), DCNN (2D MCI), DCNN(2D+t), and RNN models established based on UI dataset for TTS versus STEMI prediction showed mean diagnostic accuracy 73%, 75%, 80%, and 75% respectively, and mean diagnostic accuracy of 74%, 74%, 77%, and 73%, respectively, on the external validation. DCNN(2D+t) (area under the curve [AUC] 0·787 vs. 0·699, P = 0·015) and RNN models (AUC 0·774 vs. 0·699, P = 0·033) outperformed human readers in differentiating TTS and STEMI by reducing human erroneous judgement calls on TTS.InterpretationSpatio-temporal hybrid DL neural networks reduce erroneous human “judgement calls” in distinguishing TTS from anterior wall STEMI based on bedside echocardiographic videos.FundingUniversity of Iowa Obermann Center for Advanced Studies Interdisciplinary Research Grant, and Institute for Clinical and Translational Science Grant. National Institutes of Health Award (1R01EB025018–01).

Gender gaps in National Institutes of Health dermatology grant recipients.

BackgroundUnderstanding the demographics and scholarly merit among National Institutes of Health (NIH) award recipients can help guide future applicants in the field of dermatology.ObjectiveHerein, we aimed to explore gender gaps in NIH award recipient demographics and scholarly merits for dermatology-related projects.MethodsProjects funded by the National Institutes of Arthritis and Musculoskeletal and Skin Diseases between 2015 and 2019 related to dermatology were extracted using the NIH Research Portfolio Online Reporting Tools database. The number of publications and h-index of each award recipient were collected using the Scopus database. The 2019 Blue Ridge Institute for Medical Research report was used to determine the top 20 NIH-funded dermatology departments/divisions.ResultsBetween 2015 and 2019, there were 35.1% more unique male than unique female recipients. Award recipients had an average of 116.7 total publications and an average h-index of 37.1. However, men also had more than half as many publications and a >37% higher average h-index. Gender gaps in research merit, as well as number and type of awards, are reduced among recipients affiliated with a top 20 NIH-funded institution.ConclusionA higher number of awards were granted to male recipients. Men had a higher mean publication number and h-index compared with their female counterparts. Increased support, resources, and mentorship opportunities to women in research may help mitigate these gaps.

Axial MRI biomarkers of spinal cord damage to predict future walking and motor function: a retrospective study

Study designRetrospective.ObjectivesPrimary: to assess if axial damage ratios are predictors of future walking after spinal cord injury (SCI), and if they add any predictive value if initial neurological impairment grades are available. Secondary: to determine if lateral spinal cord regions are predictors of future lower extremity motor scores (LEMS).SettingUniversity/hospital.MethodsAxial T2-weighted MRIs were used. Axial damage ratios and non-damaged lateral cord volumes were calculated. Each participant answered at 1 year after SCI, “Are you able to walk for 150 feet? (45.72 meters)” For the secondary aim, right and left LEMS were used.ResultsIn total, 145 participants were selected. Individuals that could walk had smaller ratios than those that were unable. Walking and axial damage ratios were negatively correlated. A 0.374 ratio cut-off showed optimal sensitivity/specificity. When initial neurological grades were used, axial damage ratios did not add predictive value. Forty-two participants had LEMS available and were included for the secondary aim. Right cord regions and right LEMS were positively correlated and left regions and left LEMS, but these variables were also correlated with each other.ConclusionsAxial damage ratios were significant predictors of walking ability 1 year after SCI. However, this measure did not add predictive value over initial neurological grades. Lateral cord regions correlated with same-side LEMS, but the opposite was also found, calling this biomarker’s specificity into question. Axial damage ratios may be useful in predicting walking after SCI if initial neurological grades are unavailable.SponsorshipThis research was funded by a National Institutes of Health award, National Institute of Child Health and Development—NIH R03HD094577.

National Institutes of Health Dermatology Funding Trends 2015–2019

National Institutes of Health Dermatology Funding Trends 2015–2019

Transdisciplinary Research in Energetics and Cancer early career investigator training program: first year results.

Energy imbalance increases cancer burden by increasing cancer risk and mortality. Training early career investigators on conducting impactful energy balance and cancer research is needed. We developed a Transdisciplinary Research in Energetics and Cancer (TREC) Training Program for early career investigators. This analysis examined program satisfaction, knowledge gained, publications, and awards among Year 1 participants (i.e., fellows). The program consists of an in-person course, followed by 1 year of mentorship. Faculty and fellows completed precourse and postcourse surveys. Following the mentorship period, we surveyed fellows for TREC-related research productivity, including publications and grant funding attributed to the program. Twenty fellows were accepted into the program: 3 basic, 7 clinical, and 10 population scientists. Sixteen fellows were junior faculty and four were postdoctoral fellows. The course included ~50 lectures, small group sessions, and faculty-fellow sessions. 96.7% of attendees rated the course in the highest categories of "good/very good." Knowledge significantly improved in 37 of 39 research competencies (94.8%). In the 18 months following the course, fellows published 25 manuscripts, with 3 published in journals with impact factor ≥10. Nineteen grants were funded to TREC fellows (i.e., 7 National Institutes of Health awards, 2 American Cancer Society [ACS] awards, and 10 foundation/pilot awards), and 7 fellows received career promotions. The program's impact will be defined by the degree to which TREC fellows produce discoveries that could improve the health of populations at risk for and/or surviving cancer. Upon the conclusion of our fifth year in 2021, we will publicly disseminate the program material.

Trends in Academic Dentistry and Oral Health Research Funding by Gender.

Dental and oral health researchers compose a small share of the research workforce, and within this group female researchers form a much smaller share than male researchers. Additionally, a majority of full-time faculty appointments at dental schools are held by men, with women making up only 39% of full-time appointments. These factors suggest that there could be disparities between men and women in obtaining research funding. The focus of our study was to determine whether there are gender differences in award funding obtained from the National Institute of Dental and Craniofacial Research or the National Institutes of Health (NIH). NIH administrative data were analyzed by focusing on Research Project Grants (RPGs), the primary and most commonly used mechanism to support investigator-initiated research projects. Analyses involved 1 or 2 of the following variables: number of unique applicants or awardees, fiscal years 2007 to 2016, average age of unique applicants, awardee's degrees, awardee's age at first R01, and award rates. About two-thirds of RPG applicants and awardees were men. Although there were significantly more male applicants and awardees, there was no significant difference in award rate by gender, and there was no significant award rate variation through time or by degrees. The average ages of RPG applicants were similar for genders for all degrees, except that male dentists and PhD-dentists applying to the National Institute of Dental and Craniofacial Research were older and male MDs and PhD-dentists from dental schools applying to the NIH were older. This study demonstrated that men in the dental/oral health workforce submit more applications and receive more NIH awards than do women; however, there was no difference in award rates between women and men and no difference in ages by gender at which the first R01 awards are received. Analyses of the implications of this study by the academic dentistry and oral health community could lead to establishing opportunities to expand the representation of women in dental and oral health research. Increasing the number of applications submitted by women may help achieve an equitable balance of grantees in the workforce.

The Impact of Individual Mentored Career Development (K) Awards on the Research Trajectories of Early-Career Scientists.

This analysis examined the role of a National Institutes of Health (NIH) individual Mentored Career Development Award (K01, K08, K23) on launching and sustaining independent research careers for early-career scientists, and investigated the effects of these awards during and after the doubling of the NIH budget. The authors used grants data from the NIH covering the period 1990 through 2016, and compared success in receipt of R01 equivalent awards (R01 Eq.) and Research Project Grants (RPGs) for K awardees and K applicants who did not receive funding. The analysis combined regression discontinuity design with coarsened exact matching, and regression. Overall, receipt of K award was associated with a 24.1% increase in likelihood of first independent NIH award (P < .01), and a larger number of R01 Eq. and RPG awards. After accounting for first major independent awards, K awards were uncorrelated with receiving second major independent research awards. Comparing different funding periods, K01 awards were predictive of subsequent R01 Eq. and RPG awards after but not during the NIH doubling, K08 awards were predictive only during the NIH doubling, and K23 awards were predictive during both periods. Receipt of Mentored Career Development Awards was linked to increased likelihood that early-career scientists successfully transitioned to an independent research career. These findings indicate that extending funding to additional K award applicants with meritorious scores could significantly strengthen the pipeline of biomedical researchers. In addition, enhancing K awards may be relevant to sustaining research careers for clinician scientists.

Cultivating Global Surgery Initiatives Abroad and at Home.

Cultivating Global Surgery Initiatives Abroad and at Home.

Cross‐talk Between MAPK Inhibitors and TGF‐β Signaling Results in Variable Activation of Human Dermal Fibroblasts

Differentiation of fibroblasts into myofibroblasts, a process known as fibroblast activation, is a key step in the wound healing process, but persistence of myofibroblasts through the resolution of wound remodeling can lead to fibroproliferative, pathophysiological disease states. Fibroblasts are activated by myriad extracellular cues including a multitude of growth factors which relay information from the extracellular environment and are integrated into a cellular differentiation response, but the rough contributions of particular signaling pathways, and the ways in which these pathways interact with each other, are not entirely understood. Here we demonstrate that small molecule‐mediated inhibition of the mitogen activated protein kinases ERK and JNK is sufficient to promote fibroblast activation, and that inhibition of p38 MAPK is sufficient to inhibit fibroblast activation, as determined by the expression of canonical myofibroblast markers assessed by qRT‐PCR, Western blot, immunofluorescence, and flow cytometry. The promotion of fibroblast activation by ERK and JNK inhibition and the antagonism of fibroblast activation by p38 MAPK inhibition results in expected changes in expression of extracellular matrix‐associated genes including those encoding type I collagen, type III collagen, matrix metalloproteinase 1, lysyl oxidase, myocardin, connective tissue growth factor, and the ED‐A isoform of fibronectin. Co‐treatment of human dermal fibroblasts with exogenous recombinant TGF‐β1 and ERK or JNK inhibitor leads to cooperative induction of fibroblast activation, and a higher degree of activation than that imparted by treatment of either of these factors individually. Conversely, treatment with p38 inhibitor attenuates ERK inhibitor‐mediated or JNK inhibitor‐mediated fibroblast activation, suggesting antagonism between these pathways. Treatment with ERK or JNK inhibitor results in relatively rapid activation of canonical TGF‐βR/SMAD signaling, likely contributing at least in part to the activation witnessed in these fibroblasts. Fibroblast activation as a result of JNK inhibition, but not of ERK inhibition, is partially attenuated by small molecule‐mediated inhibition of TGF‐βRI, suggesting variable mechanisms of induction of fibroblast activation by inhibition of these two pathways. These data demonstrate that multiple growth factor and MAPK signals are integrated to determine the extent of fibroblast activation, and they demonstrate evidence regarding the mechanisms of fibroblast activation induced by MAPK inhibition, providing valuable information for further development of much‐needed antifibrotic therapies.Support or Funding InformationThis research was supported by a National Institutes of Health award to Tanja Dominko (grant # R01GM85456) and a National Science Foundation Integrative Graduate Education and Research Traineeship (grant number DGE 1144804) awarded to David Dolivo.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Artesunate Antagonizes Myofibroblast Markers and Fibrosis‐Associated Extracellular Matrix Protein Expression in Human Dermal Fibroblasts

Artemisia annua, a plant species native to eastern Asia, is the source of a compound known as artemenisin that has been shown to have numerous medicinal effects. Artesunate, artemether and other chemical analogs of artemisinin, initially studied as antimalarial compounds, have also demonstrated cytostatic and cytotoxic effects in bacterial and cancer cells. Recently, artemisinin‐derivative compounds have also been demonstrated to attenuate fibrotic pathologies in various preclinical animal models, including those of hepatic and pulmonary fibrosis, but the mechanisms by which this inhibition of fibrosis occurs is not well‐understood. Given the ability of artemisinin derivatives, artesunate in particular, to antagonize various fibrotic pathologies, we decided to investigate the effects of artesunate on a process common to all fibrotic pathologies: the emergence of the highly secretory, contractile myofibroblast. We demonstrated by Western blot analysis that treatment of human dermal fibroblasts with artesunate results in a dose‐dependent decrease in expression of alpha smooth muscle actin (ɑ‐SMA), the de facto marker of fibroblast activation. Treatment of human dermal fibroblasts with artesunate also inhibited activation of fibroblasts mediated by the profibrotic cytokine TGF‐β1, which is largely responsible for differentiation of fibroblasts into myofibroblasts in vivo, and this antagonistic effect of artesunate towards fibroblast activation was consistent among multiple lines of primary human dermal fibroblasts. Further, immunofluorescent analysis for collagen I and collagen III demonstrated a marked reduction of both basal and TGF‐β1‐induced expression of extracellular matrix‐associated proteins. Understanding that fibrosis is the result of excessive differentiation of fibroblasts to myofibroblasts and accumulation of extracellular matrix proteins secreted by myofibroblasts, our data suggest that the antifibrotic mechanisms of artesunate in vivo may be mediated by their antagonistic effects towards myofibroblast phenotypes. We next plan to determine the direct mechanisms underlying the antagonism of artesunate towards fibroblast activation, paying particular attention to the hypotheses regarding the induction of myofibroblast apoptosis or cell cycle arrest, and the dependence of these phenotypes on the generation and activity of peroxide. With mechanistic data underpinning the effects of artesunate as an antagonist to profibrotic fibroblast activation, we hope that our work will enable progression towards the use of artesunate and other artemenisin‐derived compounds as therapies for fibrotic pathologies.Support or Funding InformationThis research was supported by a National Institutes of Health award to Tanja Dominko (grant # R01GM85456) and a National Science Foundation Integrative Graduate Education and Research Traineeship (grant number DGE 1144804) awarded to David Dolivo.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Cdt1 Variants Offer Novel Insights Into Cdt1‐MCM Interactions and an Unexpected Mechanism for Cyclin A to Block DNA Re‐Replication

The correct execution of DNA replication is critical for normal cell proliferation. The earliest step in DNA replication is known as origin licensing. Origins are licensed by the loading of MCM complexes, an event that is restricted to G1 phase. The Cdt1 protein is essential for MCM loading, yet the molecular mechanisms of its activity are still remarkably mysterious. Here, we examined a collection of rare Cdt1 variants associated with a specific form of human primordial dwarfism (Meier‐Gorlin syndrome), plus one hypomorphic conserved Drosophila allele, to shed light on Cdt1 function. Our results indicate that two dwarfism variants (Cdt1‐R462Q, Cdt1‐E468K) are expressed normally, but load less MCM than WT Cdt1. We found the lower origin licensing activity of these variants correlates with impaired MCM binding. Likewise, the hypomorphic Drosophila allele (Cdt1‐R210C) consistently induces less MCM loading, and this deficiency also correlates with impaired MCM binding. Interestingly, this variant impacts a previously uncharacterized MCM binding domain in Cdt1. To visualize these molecular interactions, we generated human Cdt1‐MCM structural homology models based on recent yeast cryo‐EM structures. Our models position the hypomorphic mutations at direct contact points in the interface between human Cdt1 and human MCM complex. These results suggest human Cdt1 uses two domains to make multiple contacts with the MCM hexamer rather than the previously‐described single Cdt1‐MCM interaction site. Furthermore, this newly‐discovered MCM binding domain can explain how the Cdt1 inhibitor protein, geminin, blocks Cdt1‐MCM interaction.Surprisingly, one dwarfism allele (Cdt1‐A66T) is more rather than less active than WT Cdt1, reproducibly inducing four‐fold more DNA re‐replication when overexpressed to the same degree. A66 is located next to the S phase CDK binding motif, and its mutational alteration inhibits Cyclin A binding and subsequent recognition by the E3 ubiquitin ligase, SCFSkp2. This variant is not more stable however and has identical degradation and accumulation kinetics to WT Cdt1, presumably because the CRL4Cdt2 E3 ubiquitin ligase interaction is intact. We postulate that Cyclin A acts as a direct inhibitor of Cdt1‐MCM binding, suggesting a novel Cyclin‐dependent mechanism of Cdt1 inhibition at the end of S phase and prior to cell division. Together, these findings reveal additional roles of Cyclin/Cdk regulation of Cdt1, as well as newly described Cdt1‐MCM molecular interactions. Overall, our study identifies two new aspects of Cdt1 interactions that ensure efficient but once‐and‐only once genome duplication and normal cell proliferation.Support or Funding InformationThis work was supported by the National Institutes of Health award to J.G.C. R01GM102413 and R01GM102413‐S1 and to the University of North Carolina Flow Cytometry Core Facility award P30CA016086. P.N.P. is supported by the National Institutes of Health F31GM121073.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Trends in sinusitis research: a systematic review of extramural funding.

Innovation represents a core value of the American Rhinologic Society (ARS), with multiple efforts to promote research in the advancement rhinologic care. We therefore sought to identify trends in extramural sinusitis funding and underutilized sources of support to facilitate future efforts. A systematic review of the National Institutes of Health (NIH) Research Portfolio Online Tools (RePORTER) database (fiscal year 1993 to 2017) was completed with the search strategy: ("chronic sinusitis" OR rhinosinusitis). All identified studies were accepted for review, with comparison to ARS membership rolls to identify studies supported by ARS investigators. Foundation awards were surveyed to identify and characterize additional sources of support. The systematic review identified 958 projects receiving NIH funding, of which 120 remain active. The percentage of sinusitis-related awards and total funding relative to all NIH awards increased over the past 10 years (2006 to 2016) from 0.06% (8 / 9128) and 0.09% ($2,151,152 / $3,358,338,602) to 0.87% (86 / 9540) and 0.90% ($37,201,095 / $4,300,145,614). Among active studies, 9 investigators maintain membership in the ARS and serve as principal investigator or project leader in 12 (10%) studies. ARS investigators received the greatest number of awards from the National Institute on Deafness and Other Communication Disrders (n = 8,66.7%), while only receiving 2.2% of awarded funding from the National Institute of Allergy and Infectious Diseases ($607,500/$26,873,022), the largest source of awards for sinusitis research. Support for sinusitis research is significantly growing, with the largest source of active funding not being fully utilized by members of the ARS. Further efforts to promote funding priorities among extramural sources is necessary to facilitate increased funding for ARS member initiatives.

Patterns of Recent National Institutes of Health (NIH) Funding to Diagnostic Radiology Departments: Analysis Using the NIH RePORTER System

This study aimed to characterize recent National Institutes of Health (NIH) funding for diagnostic radiology departments at US medical schools. This retrospective study did not use private identifiable information and thus did not constitute human subjects research. The public NIH Research Portfolio Online Reporting Tools Expenditure and Results system was used to extract information regarding 887 NIH awards in 2015 to departments of "Radiation-Diagnostic/Oncology." Internet searches were conducted to identify each primary investigator (PI)'s university web page, which was used to identify the PI's departmental affiliation, gender, degree, and academic rank. A total of 649 awards to diagnostic radiology departments, based on these web searches, were included; awards to radiation oncology departments were excluded. Characteristics were summarized descriptively. A total of 61 unique institutions received awards. The top five funded institutions represented 33.6% of all funding. The most common institutes administering these awards were the National Cancer Institute (29.0%) and the National Institute of Biomedical Imaging and Bioengineering (21.6%). Women received 15.9% of awards and 13.3% of funding, with average funding per award of $353,512 compared to $434,572 for men. PhDs received 77.7% of all awards, with average funding per award of $457,413 compared to $505,516 for MDs. Full professors received 51.2% of awards (average funding per award of $532,668), compared to assistant professors who received 18.4% of awards ($260,177). Average funding was $499,859 for multiple-PI awards vs. $397,932 for single-PI awards. Common spending categories included "neurosciences," "cancer," "prevention," and "aging." NIH funding for diagnostic radiology departments has largely been awarded to senior-ranking male PhD investigators, commonly at large major academic medical centers. Initiatives are warranted to address such disparities and promote greater diversity in NIH funding among diagnostic radiology investigators.

Measuring Success in Global Health Training: Data From 14 Years of a Postdoctoral Fellowship in Infectious Diseases and Tropical Medicine

In modern academic medicine, especially in the fields of infectious diseases and global health, aspiring physician-scientists often wait years before achieving independence as basic, translational, and clinical investigators. This study employed mixed methods to evaluate the success of the Burroughs Wellcome Fund/American Society for Tropical Medicine and Hygiene (BWF/ASTMH) global health postdoctoral fellowship in promoting scientific independence. We examined quantitative data obtained from the National Institutes of Health (NIH) and qualitative data provided by the ASTMH and program participants to assess BWF/ASTMH trainees' success in earning NIH grants, publishing manuscripts, and gaining faculty positions. We also calculated the return on investment (ROI) associated with the training program by dividing direct costs of NIH research grants awarded to trainees by the direct costs invested by the BWF/ASTMH fellowship. Forty-one trainees received fellowships between 2001 and 2015. Within 3 years of completing their fellowships, 21 of 35 (60%) had received career development awards, and within 5 years, 12 of 26 (46%) had received independent research awards. Overall, 22 of 35 (63%) received 1 or more research awards. BWF/ASTMH recipients with at least 3 years of follow-up data had coauthored a mean of 36 publications (range, 2-151) and 29 of 35 (82%) held academic positions. The return on investment was 11.9 overall and 31.8 for fellowships awarded between 2001 and 2004. Between 2001 and 2015, the BWF/ASTMH postdoctoral training program successfully facilitated progress to scientific independence. This program model underscores the importance of custom-designed postdoctoral training as a bridge to NIH awards and professional autonomy.

Sex Differences in Faculty Rank Among Academic Cardiologists in the United States.

Studies demonstrate that women physicians are less likely than men to be full professors. Comprehensive evidence examining whether sex differences in faculty rank exist in academic cardiology, adjusting for experience and research productivity, is lacking. Therefore, we evaluated for sex differences in faculty rank among a comprehensive, contemporary cohort of US cardiologists after adjustment for several factors that impact academic advancement, including measures of clinical experience and research productivity. We identified all US cardiologists with medical school faculty appointments in 2014 by using the American Association of Medical Colleges faculty roster and linked this list to a comprehensive physician database from Doximity, a professional networking website for doctors. Data on physician age, sex, years since residency, cardiology subspecialty, publications, National Institutes of Health grants, and registered clinical trials were available for all academic cardiologists. We estimated sex differences in full professorship, adjusting for these factors and medical school-specific fixed effects in a multivariable regression model. Among 3810 cardiologists with faculty appointments in 2014 (13.3% of all US cardiologists), 630 (16.5%) were women. Women faculty were younger than men (mean age, 48.3 years versus 53.5 years, P<0.001), had fewer total publications (mean number: 16.5 publications versus 25.2 publications; P<0.001), were similarly likely to have National Institutes of Health funding (proportion with at least 1 National Institutes of Health award, 10.8% versus 10.4%; P=0.77), and were less likely to have a registered clinical trial (percentage with at least 1 clinical trial, 8.9% versus 11.1%; P=0.10). Among 3180 men, 973 (30.6%) were full professors in comparison with 100 (15.9%) of 630 women. In adjusted analyses, women were less likely to be full professors than men (adjusted odds ratio, 0.63; 95% confidence interval, 0.43-0.94; P=0.02; adjusted proportions, 22.7% versus 26.7%; absolute difference, -4.0%; 95% confidence interval, -7.5% to -0.7%). Among cardiology faculty at US medical schools, women were less likely than men to be full professors after accounting for several factors known to influence faculty rank.

Surgery investigators funded through the National Institutes of Health: A rebirth

Funding toward surgical research through the National Institutes of Health has decreased relative to other medical specialties. This study was initiated to characterize features of academically successful surgeon-scientists and departments of surgery. We hypothesized that there may be decreases in young investigators obtaining independent National Institutes of Health awards and that successful academic departments of surgery may be depending increasingly on PhD faculty. The National Institutes of Health RePORTER database was queried for grants awarded to departments of surgery during fiscal years 2003 and 2013. Grant summaries were categorized by research methodology. Training of the principal investigator and academic position were determined through the RePORTER database and publicly available academic biographies. Institutions were ranked by number of grants funded. Between 2003 and 2013, total surgery grants awarded decreased by 19%. The number of National Institutes of Health-funded, clinically active surgeons (MDs) decreased 11%, while funded PhDs increased 9%; however, clinically active junior faculty have comprised an increasing proportion of funded MDs (from 20-38%). Shifts in research topics include an increasing proportion of investigators engaged in outcomes research. Among institutions ranking in the top 20 for surgical research in both 2003 and 2013 (N=15), the ratio of MDs to PhDs was 2:1 in both fiscal years. Among institutions falling out of the top 20, this ratio was less than 1:1. There has been an expansion of outcomes-based surgical research. The most consistently successful institutions are those that actively cultivate MD researchers. Encouragingly, the number of young, independently funded surgeon-scientists in America appears to be increasing.

Recent Trends in Oral Cavity Cancer Research Support in the United States

The objectives were to characterize oral cavity cancer (OCC) funding from the National Institutes of Health (NIH) with a secondary aim of comparing NIH support provided to OCC and other malignancies. NIH awards supporting OCC inquiry from 2000 to 2014 were accessed from the NIH RePORTER database. These data were used to evaluate temporal trends and the role of human papilloma virus and to determine the academic training and professional profiles of the principal investigators. Comparison of 2014 funding levels with other malignancies was also performed, controlling for incidence. Overall funding totals decreased considerably after 2009. Funding administered through the National Institute of Dental and Craniofacial Research (NIDCR) was 6.5 times greater than dollars awarded by the National Cancer Institute in 2000. During the period evaluated, NIDCR support decreased in most years, while National Cancer Institute support increased and approached NIDCR funding levels. Funding for human papilloma virus–related projects gradually rose, from 3.4% of dollars in 2000 to 2004 to 6.2% from 2010 to 2014 (P < 0.05). A majority of principal investigators had a PhD omnia solus (57%), and 13% possessed dual PhD/clinical degrees. Among clinicians with specialty training, otolaryngologists and oral/maxillofacial pathologists garnered the most funding. OCC had a 2014 funding:incidence ratio of $785, much lower than for other malignancies. There has been increased volatility in funding support in recent years possibly due to budget cuts and sequestration. The National Cancer Institute has played an increasingly important role in supporting OCC research, concomitant with decreasing NIDCR support. Our findings suggest that OCC is underfunded relative to other non–oral cavity malignancies, indicating a need to increase the focus on rectifying the disparity.

Biostatistics Faculty and NIH Awards at U.S. Medical Schools

Statistical principles and methods are critical to the success of biomedical and translational research. However, it is difficult to track and evaluate the monetary value of a biostatistician to a medical school (SoM). Limited published data on this topic are available, especially comparing across SoMs. Using National Institutes of Health (NIH) awards and American Association of Medical Colleges (AAMC) faculty counts data (2010–2013), together with online information on biostatistics faculty from 119 institutions across the country, we demonstrated that the number of biostatistics faculty was significantly positively associated with the amount of NIH awards, both as a school total and on a per faculty basis, across various sizes of U.S. SoMs. Biostatisticians, as a profession, should be proactive in communicating and advocating the value of their work and their unique contribution to the long-term success of a biomedical research enterprise. Supplementary materials for this article are available online.

Do AAO-HNSF CORE Grants Predict Future NIH Funding Success?

To determine (1) whether academic otolaryngologists who have received an American Academy of Otolaryngology- Head and Neck Surgery Foundation (AAO-HNSF) Centralized Otolaryngology Research Efforts (CORE) grant are more likely to procure future National Institutes of Health (NIH) funding; (2) whether CORE grants or NIH Career Development (K) awards have a stronger association with scholarly impact. Historical cohort. Scholarly impact, as measured by the h-index, publication experience, and prior grant history, were determined for CORE-funded and non-CORE-funded academic otolaryngologists. All individuals were assessed for NIH funding history. Of 192 academic otolaryngologists with a CORE funding history, 39.6% had active or prior NIH awards versus 15.1% of 1002 non-CORE-funded faculty (P < .0001). Higher proportions of CORE-funded otolaryngologists have received K-series and R-series grants from the NIH (P-values < .05). K-grant recipients had higher h-indices than CORE recipients (12.6 vs 7.1, P < .01). Upon controlling for rank and experience, this difference remained significant among junior faculty. A higher proportion of academic otolaryngologists with prior AAO-HNSF CORE funding have received NIH funding relative to their non-CORE-funded peers, suggesting that the CORE program may be successful in its stated goals of preparing individuals for the NIH peer review process, although further prospective study is needed to evaluate a "cause and effect" relationship. Individuals with current or prior NIH K-grants had greater research productivity than those with CORE funding history. Both cohorts had higher scholarly impact values than previously published figures among academic otolaryngologists, highlighting that both CORE grants and NIH K-grants awards are effective career development resources.

Sources of Federal Funding in Plastic and Reconstructive Surgery Research

In the last several years, federal funding has become increasingly difficult to obtain. The purpose of this project was to define the level of federal funding among plastic surgeons in the modern era. The authors evaluated members of the Plastic Surgery Research Council because of their expected invested interested in research. The authors collected information from 1998 to 2012 on funding using curricula vitae and publically available online tools. Data on Plastic Surgery Foundation funding was also collected to determine its role in supporting federally funded investigators. Of 256 individuals, the authors found 41 to be primary investigators on federally funded grants, with the majority receiving one to two awards. Common subtypes of awards included National Institutes of Health R01 (n = 15), K08 (n = 9), and R21 (n = 6). Limited funding from the National Science Foundation and the Department of Defense was identified. Despite a steady number of available National Institutes of Health awards, plastic surgery recipients have grown in number over the past 15 years. In a review of 20 years of Plastic Surgery Foundation awards, 113 Plastic Surgery Research Council members (44.1 percent) were awardees, averaging 1.8 awards per person. Twenty-nine Plastic Surgery Foundation awardees were also recipients of federal funding; 12 individuals received federal funding without prior Plastic Surgery Foundation funding. A search of plastic surgeons indicates a limited but increasing number of individuals receive federal funding. Plastic Surgery Foundation awards appear to be helpful in supporting investigators as they move to larger federal awards.