Research Grant Funding Research Articles

Three years of quality assurance data assessing the performance of over 4000 grant peer review contributions to the Canadian Institutes of Health Research Project Grant Competition

The Canadian Institutes of Health Research (CIHR) commenced a Quality Assurance Program in 2019 to monitor the quality of peer review in its Project Grant Competition Peer Review Committees. Our primary aim was to describe the performance of CIHR grant peer reviewers, based on the assessments made by CIHR peer review leaders during the first 3 years of the Research Quality Assurance Program. All Peer Review Committee Chairs and (or) Scientific Officers who led peer review for CIHR in 2019, 2020, and 2021 completed Reviewer Quality Feedback forms immediately following Peer Review Committee meetings. The form assessed Performance, Future potential, Review quality, Participation, and Responsiveness. We summarised and descriptively synthesised data from assessments conducted after each of the four grant competitions. The performance of peer reviewers on 4438 occasions was rated by Chairs and Scientific Officers. Approximately one in three peer reviewers submitted outstanding reviews or discussed additional applications and one in 10 demonstrated potential as a future Peer Review Committee leader. At most, one in 20 peer reviewers was considered to have not performed adequately with respect to review quality, participation, or responsiveness. There is a need for more research on the processes involved in allocating research grant funding.

Gendered research grant conditions and their effect on women’s application (dis)engagement

Men continue to outperform women in obtaining funding through research grants globally, in both science, technology, engineering and mathematics (STEM) and social science, in multidisciplinary and transdisciplinary fields. This article focuses on the role of research grant funding conditions in women’s lack of research grant funding. Grant conditions are the rules of participation and funding use set out by grant funders. This study aimed to answer the question: how do grant conditions limit women’s propensity to engage with research grant applications? Research grants from the Open 4 Research database were analysed. Research careers with a reproductive life-cycle perspective and four feminist concepts were deliberately gendered. These resulted in a theoretical framework. A content analysis on n = 270 multidisciplinary early career grants for those who already have a PhD was conducted. Grants were selected from both the social science and STEM disciplines. The findings suggest that, overwhelmingly, grant conditions are gender-neutral, assuming no differences between women and men. A comparison between STEM and social science grant conditions also show very little difference. The article provides a framework to guide multidisciplinary and transdisciplinary grant funders in crafting deliberately gendered grant conditions.Transdisciplinary contribution: A pre-application phase to the research grant application process by problematising gender neutrality in early-career researcher grant conditions is introduced. It is posited that grants’ gender neutrality is discouraging women to consider applying, resulting in self-exclusion early in the pre-application phase.

Search for hidden-charm tetraquark with strangeness in * *Supported in part by National Key R&D Program of China (Grant Nos. 2020YFA0406400, 2020YFA0406300); National Natural Science Foundation of China (NSFC) (Grant Nos. 11635010, 11735014, 11805086, 11835012, 11935015, 11935016, 11935018, 11961141012, 12022510, 12025502, 12035009, 12035013, 12192260, 12192261, 12192262, 12192263, 12192264, 12192265); the Chinese Academy of Sciences (CAS) Large-Scale Scientific Facility Program; Joint

We report a search for a heavier partner of the recently observed state, denoted as , in the process , based on collision data collected at the center-of-mass energies of , 4.682 and 4.699 GeV with the BESIII detector. The is of interest as it is expected to be a candidate for a hidden-charm and open-strange tetraquark. A partial-reconstruction technique is used to isolate recoil-mass spectra, which are probed for a potential contribution from (). We find an excess of () candidates with a significance of , after considering systematic uncertainties, at a mass of . As the data set is limited in size, the upper limits are evaluated at the 90% confidence level on the product of the Born cross sections () and the branching fraction () of , under different assumptions of the mass from 4.120 to 4.140 MeV and of the width from 10 to 50 MeV at the three center-of-mass energies. The upper limits of are found to be at the level of pb at each energy. Larger data samples are needed to confirm the state and clarify its nature in the coming years.

Liquidity Windfalls and Reallocation: Evidence from Farming and Fracking

Financing frictions may create a misallocation of assets in a market, thus depressing output, productivity, and asset values. This paper empirically explores how liquidity shocks generate a reallocation that diminishes this misallocation. Using a unique data set of agricultural outcomes, I explore how farmers respond to a relaxation of financial constraints through a liquidity shock unrelated to farming fundamentals, namely exogenous cash inflows caused by an expansion of hydraulic fracturing (fracking) leases. Farmers experiencing positive cash flow shocks increase their land purchases, which results in a reallocation effect. Examining purchases across areas, I find that farmers in high-productivity areas who receive cash flow shocks buy farmland in low-productivity areas, but farmers in low-productivity areas receiving positive cash flow shocks do not. Moreover, farmers increase their purchases of vacant (undeveloped) land. Average output, productivity, equipment investment, and profits all increase significantly following these positive cash flow shocks. Farmland prices also rise significantly, consistent with a cash-in-the-market pricing effect. These effects are consistent with an efficient reallocation of land toward more productive users. This paper was accepted by Tyler Shumway, finance. Funding: This work was supported by the Kritzman and Gorman Research Fund Grant. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2022.4602 .

Getting funded in a highly fluctuating environment: Shifting from excellence to luck and timing.

Recent data highlights the presence of luck in research grant allocations, where most vulnerable are early-career researchers. The national research funding contributes typically the greatest share of total research funding in a given country, fulfilling simultaneously the roles of promoting excellence in science, and most importantly, development of the careers of young generation of scientists. Yet, there is limited supply of studies that have investigated how do early-career researchers stand compared to advanced-career level researchers in case of a national research grant system. We analyzed the Estonian national highly competitive research grant funding across different fields of research for a ten-year-period between 2013-2022, including all the awarded grants for this period (845 grants, 658 individual principal investigators, PI). The analysis was conducted separately for early-career and advanced-career researchers. We aimed to investigate how the age, scientific productivity and the previous grant success of the PI vary across a national research system, by comparing early- and advanced-career researchers. The annual grant success rates varied between 14% and 28%, and within the discipline the success rate fluctuated across years even between 0-67%. The year-to-year fluctuations in grant success were stronger for early-career researchers. The study highlights how the seniority does not automatically deliver better research performance, at some fields, younger PIs outperform older cohorts. Also, as the size of the available annual grants fluctuates remarkably, early-career researchers are most vulnerable as they can apply for the starting grant only within a limited "time window".

Harnessing the nursing and midwifery workforce to boost Australia's clinical research impact.

Harnessing the nursing and midwifery workforce to boost Australia's clinical research impact.

Symposium review: Development of a funding program to support research on enteric methane mitigation from ruminants.

Enteric methane is a major source of greenhouse gas emissions from milk production systems. Two organizations based in the United States, the Foundation for Food and Agriculture Research and the Dairy Research Institute, have developed a collaborative program to align resources and fund projects to identify, develop, and validate new and existing mitigation options for enteric methane emissions from dairy and beef cattle. This collaborative program is called the Greener Cattle Initiative. The program will develop requests for proposals and award grants on projects that address challenges within, but not limited, to the following research areas: dairy and beef cattle nutrition, rumen microbiome, dairy and beef cattle genetics, sensing and data technology for enteric methane measurement and prediction, and socioeconomic analysis of enteric methane mitigation practices. The program is structured as a consortium with closed participation and a flat governance collaboration model. The Greener Cattle Initiative program will continue incorporating participants from the food and agriculture industry, commodity groups, and nonprofit organizations who share common objectives and contribute in-kind and matching funds to the program, up to a total of 10 organizations. Research findings will be communicated broadly, after a waiting period for exclusive access to program participants, to create shared knowledge on enteric methane mitigation. The Greener Cattle Initiative is expected to award up to $5 million in research grant funding in a 5-year period, which will contribute to advancing the voluntary greenhouse gas reduction goals established by both the United States and global dairy sectors.

Introduction to this special issue.

Introduction to this special issue.

Dynamically defined subsets of generic self-affine sets* *BB acknowledges support from Grants OTKA K123782 and OTKA FK134251. ST acknowledges support from Austrian Research Fund (FWF) Grant M-2813. Both authors acknowledge support from Aktion Österreich-Ungarn 103öu6. The authors also thank the anonymous referees for their valuable comments and suggestions.

In dynamical systems, shrinking target sets and pointwise recurrent sets are two important classes of dynamically defined subsets. In this article we introduce a mild condition on the linear parts of the affine mappings that allow us to bound the Hausdorff dimension of cylindrical shrinking target and recurrence sets. For generic self-affine sets in the sense of Falconer, that is by randomising the translation part of the affine maps, we prove that these bounds are sharp. These mild assumptions mean that our results significantly extend and complement the existing literature for recurrence on self-affine sets.

Research and academic output evaluation for career initiation or progression: Critical issues for Health Professionals

In current times, much stress is being laid on the evaluation of research productivity of researchers or faculty in addition to the academic qualifications and experience for the purposes of recruitment, promotion, and research grant funding. Over the years, several quantitative indices have been devised for this purpose. Some of these indices such as h-index, impact factor and e-index are being extensively used by research organizations, universities, accreditation bodies and funding agencies for basic scientists as well as health professionals. In the absence of any formal training, these parameters or their advantages and shortcomings may not be well understood by the health professionals, especially in the early stages of their careers and sometimes, even by the evaluators. A big unanswered question is the validity of the same criteria for health professionals as are applicable for the basic science researchers. Since health professional undertaking research assignments are neither adequately trained in basic research nor can they comprehend these indices well, the same yardstick to evaluate these two widely different groups of researchers often places the health professionals at a disadvantage. This paper aims to highlight certain vital issues related to the application of research productivity indicators for recruitment and career progression of health care professionals.

Viewpoint on Milestones for Fellowship Training in Movement Disorders.

Viewpoint on Milestones for Fellowship Training in Movement Disorders.

Scholarly productivity and growth of academic hospital medicine full professors.

Scholarship remains the principal currency for faculty promotion in academic medicine. Reference pointsfor scholarly growth and productivity at academic medical centers (AMCs) are lacking. We identified hospital medicine full professors (HMFPs) at AMCs ranked in research by US News & World Report. Scopus was used to identify each HMFP's publications, citations, and Hirsch-index (H-index). Publications; citations; and first, middle, and senior author papers were measured in 3-year intervals postresidency. Scholarly productivity was analyzed by quintile based on publications, AMC research ranking, years postresidency, and grant funding. Data were extracted for 128 HMFPs from 54 AMCs. HMFPs were a mean of 20.5 (SD: 5.4) years postresidency. The median H-index was 7.0 (interquartile range [IQR]: 2.0-16.0); the median number of publications was 15.0 (IQR: 4.0-51.0). Top quintile HMFPs had a median of 175.5 (IQR: 101.5-248.0) publications, whereas fifth quintile HMFPs had a median of 0.0(IQR: 0.0-1.0) (p < .001). HMFPs on faculty at the top 20 AMCs had a median of 35.5 (IQR: 11.0-108.0) publications, whereas HMFPs in AMCs ranked 81-122 had a median of 3.0 (IQR: 1.0-9.0) (p < .001). Grant-funded HMFPs had a median of 177.0 (IQR: 71.0-278.0) publications, while nongrant-funded HMFPs had a median of 11.0 (IQR: 3.0-25.0) (p < .001). At 3, 6, and 9 years postresidency, HMFPs had a median of 0.0 (IQR:0.0-1.0), 1.5 (IQR: 0.0-5.0), and 3.5 (IQR:0.0-11.0) publications. Fellowship training, additional degrees, and top 25 residency programs correlated with the top half of scholarly productivity. Scholarly productivity amongHMFPs varies considerably. At 3, 6, and 9 years postresidency, it is minimal to modest. Grant funding and AMC research rank may establish separate frames of reference for scholarly growth.

Abstract 5647: PTEN loss is associated with elevation of cell cycle signature in human glioblastoma transcriptome

Abstract Glioblastoma is the most lethal type of brain cancer with universally poor prognosis. Despite advanced treatment, the cancer recurs frequently. Phosphatase and tensin homolog (PTEN) is a tumor suppressor gene whose mutations have been found to be one of the most frequent events in GBM. PTEN acts as a negative regulator of the phosphoinositide 3-kinase (PI3K) pathway. GBM transcriptome data from The Cancer Genome Atlas (TCGA) revealed a positive enrichment of cell cycle and PI3K pathway. Moreover, weighted gene co-expression network analysis (WGCNA) on TCGA GBMLGG cohort revealed a cell cycle-related module (‘cell-cycle’ module), which was shown to be positively correlated with PTEN mutation status. This ‘cell-cycle’ module also showed a positive correlation with glioma aggressiveness.We then utilized a nestin-cre;Pten-fl/fl mouse model to investigate the consequences of PTEN loss that may be involved in GBM. Based on our preliminary data, transcriptomic profiling of primary astrocytes derived from Pten knockout mice revealed an overlapping enrichment of cell cycle related pathways with human GBM. Four cell cycle genes, RCC1, RCC2, NEK2, and CHK2, were validated to be significantly upregulated in Pten-null astrocytes by qRT-PCR. Regulator of chromatin condensation 1 (RCC1) and Regulator of chromatin condensation 2 (RCC2) both belong to the RCC1 family. Accumulating evidence demonstrated that both RCC1 and RCC2 are involved in tumorigenesis of multiple cancers and cell cycle progression. By siRNA inhibition, we demonstrated that silencing of either RCC1 or RCC2 in glioblastoma cell lines suppresses GBM cell growth. Moreover, we found that RCC2 is essential for both G1-S and G2-M transition. Additionally, RCC2 silencing and a PI3K inhibitor LY294002 inhibit glioblastoma cell viability in a synergistic manner. In summary, PTEN deficiency leads to the alteration of cell cycle progression, which may promote tumorigenesis of glioblastoma. RCC1 and RCC2 have been demonstrated to be potential targets regulated by PTEN and affects cell viability. RCC2 was shown to be a key regulator of cell cycle progression. To further explore the RCC1 and RCC2 roles, we will find the potential downstream target of RCC1 and RCC2 and its potential therapeutic effect in vivo. Funding: This work is supported by a General Research Fund grant (#14113519) from the University Grants Committee of Hong Kong. Citation Format: Tian Liu, Penelope Mei-Yu Or, Chi-Wai Wong, Stanley Kwok-Kuen Cheung, Yubing Wang, Yiwei Wang, Wayne Lut-Heng Ho, Andrew M. Chan. PTEN loss is associated with elevation of cell cycle signature in human glioblastoma transcriptome [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5647.

The Effectiveness of the IFA Supplementation in Reducing the Prevalence of Anemia During Pregnancy Among Women in Eastern Maharashtra, India

ObjectivesMaternal anemia is a critical public health problem, especially in Low- and Middle-Income Countries (LMIC) like India. Anemia during pregnancy increases the risk of poor fetal outcomes, such as low birth weight. The Indian national Iron + Initiative includes iron & folic acid (IFA) supplementation for pregnant & lactating women. We sought out to assess the effectiveness of the IFA program in Nagpur, India.MethodsWe conducted a prospective cohort study of 200 pregnant women from four clusters in Nagpur (Eastern Maharashtra), India. Maternal hemoglobin was assessed using Hemocue and the finger prick method. Anemia was defined as hemoglobin < 110g/L. IFA receipt and consumption was assessed via questionnaire during the 1st and 3rd trimester of pregnancy.ResultsHemocue/capillary assessment revealed prevalence of anemia in the third trimester of 69.52% (N = 187), as compared to 50.0% (N = 200) in the first trimester. In the first trimester, 44.5% of women reported consuming IFA the previous day, while 84.8% reported consuming it the previous day by the 3rd trimester. In the first trimester, 61% (n = 122) of women reported receiving IFA: 43% for free from a public health facility, 14% purchased it from a store/pharmacy, and 4% from other locations. By the 3rd trimester, 99.5% of women had received IFA: 75.4% for free from a facility, 11.8% from a pharmacy/store and 8.02% from other locations.ConclusionsWe noted a markedly high prevalence of anemia in pregnancy that increased from the first to third trimester, characteristic of physiologic amenia, despite an increase IFA coverage and consumption. Other nutritional and non-nutritional interventions to reduce anemia in pregnancy need to be explored to prevent maternal anemia in Nagpur, India and possibly other LMIC contexts.Funding SourcesThis study was funded by the Thrasher Research Fund grant.

Anemia and Micronutrient Deficiencies in the First Trimester of Pregnancy Among Women in Eastern Maharashtra, India

ObjectivesMaternal anemia during pregnancy increases the risk of a myriad of negative birth outcomes, including maternal mortality, neonatal mortality, and low birth weight. In Eastern Maharashtra, India, the prevalence of anemia among pregnant women has been reported to be > 80%. While the most common cause of anemia is iron deficiency, its relative contribution is often unknown, as are rates of other key micronutrient deficiencies including B12 and folic acid. The primary objectives of this study are 1) to determine the prevalence of micronutrient deficiencies (iron, folic acid, and B12) and 2) to quantify the contribution of these micronutrient deficiencies to anemia among pregnant women in Nagpur (Eastern Maharashtra, India).MethodsWe conducted a cross-sectional study of 200 women from four clusters in Nagpur. In the first trimester of pregnancy, trained nurses collected venous blood samples and we used Hemocue on blood samples collected with a finger prick. Anemia was defined as hemoglobin < 110 g/L, iron deficiency as serum ferritin < 15 µg/mL (adjusted for inflammation), folic acid deficiency as serum folic acid < 3 ng/mL, and B12 deficiency as < 203 pg/mL.ResultsAmong women in our sample, 37.5% were anemic, 40.0% were iron deficient, 30.0% were vitamin B12 deficient, and none were folic acid deficient. Hemocue assessment of capillary blood yielded a prevalence of anemia of 50.0%. Approximately half (53.0%) of women diagnosed with anemia via Hemocue were iron deficient and 31.0% were vitamin B12 deficient. We did not find any folate deficiency in this population.ConclusionsWe found the prevalence of anemia in Eastern Maharashtra to be lower compared to previous studies collecting capillary blood, though still unacceptably high. Furthermore, as only half of anemia cases were associated with iron deficiency, iron and folic acid (IFA) supplementation programs may only partially ameliorate the high prevalence of anemia.Funding SourcesThis study was funded by the Thrasher Research Fund grant.

906-P: Lost Workdays from Treating Type 2 Diabetes–Related Complications in Hong Kong: A Population-Based Cohort Study

To estimate the lost workdays associated with type 2 diabetes and related complications in Hong Kong in 2017 and inform productivity loss and indirect costs. Using population-representative data of 540,370 people with type 2 diabetes managed in the public sector, we fitted a negative binomial regression model to investigate the association of diabetes complications on length of stay. Model fit was assessed by Akaike information criterion. A total of 4.28 million workdays (mean 7.93, 95% CI 7.88-7.97) was lost in 2017. Table 1 shows the regression coefficients: interpreted as the expected log (length of stay) increase for each one-unit increase in the corresponding variable. For example, the adjusted length of stay for 60-year male without any complication is 6.82 days (95% CI 5.52-8.43) . Hemodialysis contributed to the longest length of stay, followed by renal failure, skin ulcer, amputation, heart failure, cerebrovascular disease, atrial fibrillation, neuropathy, peripheral vascular disease, cataract, myocardial infarction, retinopathy, and ischemic heart disease. Enrolment in the multidisciplinary Risk Assessment and Management Programme was associated with reduced length of stay. This lost workday analysis helps to inform the indirect costs of diabetes in terms of lost productivity, and is essential for estimating the total economic loss from diabetes. Disclosure H.Kwok: None. C.Ng: None. J.Quan: None. Funding Research Grants Council of the Hong Kong SAR, China [27112518].

1274-P: Prevalence and Clinical Characteristics of Monogenic Diabetes in Chinese Population

Background: Prognosis of monogenic diabetes in Chinese is not well reported. We identified pathogenic mutations in monogenic diabetes genes in a prospective cohort of Chinese with young-onset diabetes, and compared the clinical characteristics and outcome between patients with and those without mutations. Methods: From patients enrolled in the Hong Kong Diabetes Register between 1995-2012, DNA samples of 1021 Chinese with non-type 1 diabetes diagnosed ≤40 years old were sequenced. The custom targeted panel included 34 genes related to neonatal diabetes, maturity-onset diabetes of the young, syndromes associated with diabetes and severe insulin resistance. Variants were interpreted according to standard guidelines by ACMG. Patients were followed for incident complications until 2019. Results: Pathogenic or likely pathogenic mutations in monogenic diabetes genes were detected in 33 (3.2%) patients. Mutations were more common in HNF1A (n=7) , GCK (n=6) and ABCC8 (n=5) genes. Mutation carriers had a higher female ratio (72.7 vs. 54.6%, p=0.05) and lower age at enrollment (37.9±10.6 vs. 41.5±10.4 years, p=0.05) but were similar age at diagnosis (31.5±7.3 vs. 33.1±6.0 years, p=0.13) and in diabetes duration (5.0[1.0-11.0] vs. 6.0[1.0-13.0] years, p=0.29) at baseline compared to non-carriers. Mutation carriers had lower BMI (23.6±3.5 vs. 26.0±4.8 kg/m2, p&amp;lt;0.01) , systolic blood pressure (119.4±14.9 vs. 125.6±17.4 mmHg, p=0.05) , HbA1c (7.3±1.3 vs. 7.9±2.0%, p=0.01) and triglyceride level (1.01[0.66-1.53] vs. 1.38[0.90-2.17] mmol/L, p=0.01) . Over a median follow-up of 17.1 years, (30.3%) patients with mutation vs. 369 (37.3%) without mutations developed cardiovascular disease, chronic or end-stage kidney disease and/or died (p=0.47) . Conclusion: Around 3% of Chinese with young-onset non-type 1 diabetes had mutation in monogenic diabetes genes. Despite a more favorable metabolic profile, patients with mutation had similar incidence of diabetes complications to those without mutations. Disclosure S.Tsoi: None. C.K.Lim: None. R.C.Ma: Other Relationship; Bayer AG, Boehringer Ingelheim International GmbH, Research Support; AstraZeneca, Bayer AG, Novo Nordisk A/S, Pfizer Inc., Tricida, Inc. E.S.Lau: None. B.Fan: None. E.Chow: Research Support; Hua Medicine, Medtronic, Powder Pharmaceuticals Inc., Speaker's Bureau; Novartis AG, Sanofi. A.P.Kong: Advisory Panel; Abbott, Kyowa Kirin Co., Ltd., Other Relationship; AstraZeneca, Novo Nordisk, Research Support; Boehringer Ingelheim, Speaker's Bureau; AstraZeneca, Bayer, Eli Lilly and Company, Sanofi, Stock/Shareholder; Aptorum Group Limited. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer AG, Boehringer Ingelheim International GmbH, Celltrion, Merck Sharp &amp; Dohme Corp., Roche Diabetes Care, Viatris Inc., Research Support; Applied Therapeutics, AstraZeneca, Eli Lilly and Company, Hua Medicine, Servier Laboratories, Stock/Shareholder; GemVCare Ltd. A.Luk: None. Funding Research Grants Council of Hong Kong (14114918) ; Research Impact Fund (R4012-18)

Association of stress-related disorders with subsequent risk of all-cause and cause-specific mortality: A population-based and sibling-controlled cohort study.

SummaryBackgroundPrior research provides suggestive evidence on an association between stress-related disorders and mortality. No previous study has however addressed the role of familial confounding on such association.MethodsWe conducted a nationwide cohort study of 189,757 individuals with a first-onset stress-related disorder between January 1, 1981 and December 31, 2016 in Sweden (i.e., exposed patients), 1,896,352 matched unexposed individuals, and 207,479 unaffected full siblings of the exposed patients. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause and cause-specific mortality.FindingsDuring a mean follow-up of 9.42 years, an elevated risk of all-cause mortality was observed during the entire follow-up among patients with stress-related disorders, compared with either unexposed individuals or their unaffected full siblings. Such excess risk was most pronounced within the first year after diagnosis of stress-related disorders (HR, 3.19 [95% CI, 2.87-3.54] in population-based comparison; HR, 3.21 [95% CI, 2.56-4.02] in sibling-based comparison). The excess risk decreased but remained statistically significant thereafter (HR, 1.64 [95% CI, 1.60-1.67] in population-based comparison; HR, 1.61 [95% CI, 1.54-1.68] in sibling-based comparison). An increased risk was observed for almost all cause-specific mortality, with greater risk increase for deaths from unnatural causes, especially suicide, and potentially avoidable causes.InterpretationStress-related disorders were associated with an increased risk of all-cause mortality and multiple cause-specific mortality, and the risk elevation was independent of familial confounding. The excess mortality attributable to unnatural causes and potentially avoidable causes highlights the importance of clinical surveillance of major health hazards among patients with stress-related disorders.FundingEU Horizon 2020 Research and Innovation Action Grant, 1.3.5 Project for Disciplines of Excellence at West China Hospital of Sichuan University, National Natural Science Foundation of China, Icelandic Research Fund (Grant of Excellence), ERC Consolidator Grant, and Swedish Research Council.

The Impact of Resistance Exercise on Muscle Mass in Glioblastoma in Survivors (RESIST): Protocol for a Randomized Controlled Trial.

BackgroundGlioblastoma is the most common primary brain malignancy in adults, accounting for approximately 48% of all brain tumors. Standard treatment includes radiation and temozolomide chemotherapy. Glioblastomas are highly vascular and can cause vasogenic brain edema and mass effect, which can worsen the neurologic symptoms associated with the disease. The steroid dexamethasone (DEX) is the treatment of choice to reduce vasogenic edema and intracranial pressure associated with glioblastoma. However high-dose DEX or long-term use can result in muscle myopathy in 10%-60% of glioblastoma patients, significantly reducing functional fitness and quality of life (QOL). There is a wealth of evidence to support the use of exercise as an adjuvant therapy to improve functional ability as well as help manage treatment-related symptoms. Specifically, resistance training has been shown to increase muscle mass, strength, and functional fitness in aging adults and several cancer populations. Although studies are limited, research has shown that exercise is safe and feasible in glioblastoma populations. However, it is not clear whether resistance training can be successfully used in glioblastoma to prevent or mitigate steroid-induced muscle myopathy and associated loss of function.ObjectiveThe primary purpose of this study is to establish whether an individualized circuit-based program will reduce steroid-induced muscle myopathy, as indicated by maintained or improved functional fitness for patients on active treatment and receiving steroids.MethodsThis is a 2-armed, randomized controlled trial with repeated measures. We will recruit 38 adult (≥18 years) patients diagnosed with either primary or secondary glioblastoma who are scheduled to receive standard radiation and concurrent and adjuvant temozolomide chemotherapy postsurgical debulking and received any dose of DEX through the neurooncology clinic and the Nova Scotia Health Cancer Center. Patients will be randomly allocated to a standard of care waitlist control group or standard of care + circuit-based resistance training exercise group. The exercise group will receive a 12-week individualized, group and home-based exercise program. The control group will be advised to maintain an active lifestyle. The primary outcome, muscle myopathy (functional fitness), will be assessed using the Short Physical Performance Battery and hand grip strength. Secondary outcome measures will include body composition, cardiorespiratory fitness, physical activity, QOL, fatigue, and cognitive function. All measures will be assessed pre- and postintervention. Participant accrual, exercise adherence, and safety will be assessed throughout the study.ResultsThis study has been funded by the Canadian Cancer Society Atlantic Cancer Research Grant and the J.D. Irving Limited–Excellence in Cancer Research Fund (grant number 707182). The protocol was approved by the Nova Scotia Health and Acadia University’s Research Ethics Boards. Enrollment is anticipated to begin in March 2022.ConclusionsThis study will inform how individualized circuit-based resistance training may improve functional independence and overall QOL of glioblastoma patients.Trial RegistrationClinicalTrails.gov NCT05116137; https://www.clinicaltrials.gov/ct2/show/NCT05116137International Registered Report Identifier (IRRID)DERR1-10.2196/37709

Development and Assessment of Early Utilization of the Standardized Letter of Recommendation for Use in the Radiology Residency Match

Letters of recommendation are essential for residency applications. Traditionally, narrative letters have been used. Standardized letters of recommendation (SLOR) have been developed and have benefits to the writer and reader. The goal was to develop an informative, meaningful, and efficient SLOR for the radiology residency Match and to assess its early use. An Association of University Radiologists (AUR) Research and Education Venture Fund Grant was awarded for the development of a SLOR for use in the radiology residency Match. Grant recipients developed the letter and modifications were based on feedback from the Alliance of Medical Student Educators in Radiology (AMSER) SLOR task force and a larger task force including additional AUR and Association of Program Directors in Radiology (APDR) members. AUR and APDR members were surveyed in 2020 to assess the radiology SLOR. The radiology SLOR became available for use in September 2018. It highlights the top six traits or abilities deemed most valued in a resident candidate and guides the writer to develop a concrete narrative. Top perceived benefits of the Radiology SLOR are ease of reading and interpretation. Top perceived drawbacks are an impersonal format and concerns regarding program directors' perceptions of the new SLOR. SLOR utilization increased in the second year of availability. The radiology SLOR was developed and first used in 2018. Its use increased over two years and will likely continue to increase given the perceived benefits and increasing awareness of the SLOR.