Submitting a successful National Institutes of Health career development award for the vascular surgeon scientist.

Obtaining a career development award from the National Institutes of Health (K award) is often an important step in establishing a career as a vascular surgeon scientist. The application and review process is competitive, involves many steps, and may be confusing to the prospective applicant. Further, there are requirements involving mentors and the applicant's institution. This article, authored completely by vascular surgeons with active K awards, is intended for potential applicants and personnel at their institution and reviews relevant information including strategies for a successful application.

A Scholarly Dialog on Recent Trends in National Institutes of Health's Funding for the Thyroid Field.

Background: The National Institutes of Health (NIH) is the major funding agency for biomedical research in the United States. To initiate a scholarly dialog about research and career development in the thyroid field, here we reviewed recent trends in NIH funding for this area. We used the Research Portfolio Online Reporting Tool database to estimate the level of NIH extramural support during 2013-2022 (number of active grants/year and $amount/year weighed by the total number of active grants/year and $amount/year), provided by the NIH to the thyroid field. We determined that in 2013, the NIH supported ∼140 grants/year, totaling almost $50 million/year, the majority in the form of R01 grants. Within the thyroid field, support was evenly split between thyroid cancer and thyroid hormone metabolism and action subareas. In the subsequent years (2014-2022), the total number of active grants peaked at 150/year ($55 million) in 2014 but progressively decreased to about 100 active grants/year ($30 million) in 2022. This trend occurred while the NIH budget increased from $29 to $46 billion/year. Globally, the number of thyroid-related publications increased by ∼70% during the study period, and the fractional contribution of several countries remained relatively stable, except for China which increased by ∼600%. Remarkably, the fraction of thyroid-related publications in the United States sponsored by the NIH decreased from 5.5% to 3.1% of the global number. Conclusion: These results constitute a very concerning scenario for research and education in the thyroid field. We appeal to the NIH, the professional societies in endocrinology and thyroidology, and all other relevant stakeholders such as thyroid-related professionals and thyroid patients to engage in further discussions to identify the root causes of this trend and implement an action plan to stabilize and eventually reverse this situation.

The nonlinear impact of financial flexibility on corporate sustainability: Empirical evidence from the Chinese manufacturing industry.

In the face of challenges ushered in by globalization and technological advancements, financial flexibility has emerged as a pivotal strategy for attaining sustainable development in China's manufacturing sector. Financial flexibility allows firms to manage internal cash flows, alleviate external financing constraints, and augment their capability to absorb risks. Using the framework of Financial Flexibility Theory and Institutional Theory, this study examines data from A-share listed manufacturing firms on the Shanghai and Shenzhen Stock Exchanges from 2011 to 2021. The research aims to investigate the nexus between financial flexibility and sustainable performance, while also probing the moderating roles of environmental uncertainty and governmental grants. The key findings of the study unveil an inverted U-shaped relationship between financial flexibility and sustainable performance. Moreover, environmental uncertainty exerts a significant negative influence on sustainable performance. When both environmental uncertainty and governmental grants are substantial, the inverted U-shaped correlation between financial flexibility and sustainable performance intensifies. The innovation of this study lies in revealing the optimal zone of financial flexibility for enterprises under the influence of environmental uncertainty and government grants. Amidst an increasingly intricate macro-environment, this research furnishes pragmatic insights for optimizing sustainable performance in manufacturing enterprises and offers a series of empirically grounded suggestions for enterprise managers, government departments, and investors, guiding them to enhance sustainable performance through judicious calibration of financial flexibility levels.

Analysis of National Institutes of Health Funding for the COVID-19 Pandemic.

Background: Evaluating the National Institute's Health's (NIH's) response to the coronavirus disease 2019 (COVID-19) pandemic via grants and clinical trials is crucial to determining the impact they had on aiding US citizens. We determined how the NIH's funding for COVID-19 research was disbursed and used by various institutions across the United States. Methods: We queried NIH RePORTER and isolated COVID-19-related grants from January 2020 to December 2021. We analyzed grant type, geographical location, and awardee institution. Manuscripts published from these grants were quantitatively analyzed. COVID-19 clinical trials were mapped and distances from counties to clinical trial sites were calculated using ArcGis. Results: A total of 2401 COVID-19 NIH grants resulted in 14 654 manuscripts from $4.2 billion and generated more than 150 000 citations. R01s make up 32% of grants (763/2401) and 8% of funding ($329 million). UM1 grants account for the majority of funding (30.8%; $1.3 Billion). Five states received 50.6% of funding: North Carolina, Washington, New York, California, and Massachusetts. Finally, of the 1806 clinical trials across 1266 sites in the United States, the majority were in metropolitan areas in close proximity to areas of high COVID-19 disease burden. Conclusions and Relevance: Evaluating the outcome of the NIH's response to the COVID-19 pandemic is of interest to the general public. The present study finds that the NIH disbursed more than $4 billion in funding to large consortiums and clinical trials to develop diagnostics, therapeutics, and vaccines. Approximately 8% of funding was used for R01 grants. Clinical trial sites were generally located in areas of high COVID-19 burden.

Evaluation of the National Cancer Institute (NCI) Pathway to Independence Award (K99/R00) Program.

The National Cancer Institute (NCI) K99/R00 award is intended to help postdoctoral scholars transition in a timely manner to research independence and to foster their development of an impactful cancer research program that is competitive for subsequent independent funding. Here we analyzed factors that impact peer review outcomes and evaluated whether NCI K99/R00 awardees have achieved the goals of the K99/R00 funding mechanism. Our analysis of the K99/R00 review criterion scores demonstrates that while all review criterion scores are positively correlated with the overall impact score, the Research Plan criterion is the strongest predictor of the overall impact score and funding outcomes. In addition, our analysis shows the NCI K99/R00 award facilitated the successful transition of postdoctoral scholars to research independence and enhanced the likelihood of K99/R00 awardees to secure subsequent R01-equivalent NIH grant support although not in an accelerated fashion as originally intended. An NCI K99/R00 award was not determined to be a prerequisite to obtain a faculty position, but for some awardees, it was an asset in that transition. Our results suggest that the NCI K99/R00 award is an important component for training and retention of the next generation of independent cancer researchers and to increasing the percentage of women and promoting the diversity of the cancer research workforce.

Grant funding among underrepresented minority and women urologists at academic institutions.

INTRODUCTION: Grant funding to Urology has decreased over the last decade. Documented lack of gender and race diversity at the faculty level raises concerns for funding disparities. This study sought to characterize disparities based upon race and gender in National Institutes of Health (NIH) funding data to Urologic faculty. METHODS AND MATERIALS: Data from 145 ACGME accredited Urology residency programs incorporating faculty gender and underrepresented in medicine (URiM) status was utilized. The NIH Research Portfolio Online Report Tool was queried between 1985 and 2023 for grants related to current Urology faculty. URiM status, gender, years of practice, academic rank, and Doximity residency program rank were factors in multivariable analysis. RESULTS: A total of 2,131 faculty were included. Three hundred one Urologists received 793 urologic grants for a total of $993,919,052 in funding. By race, grants were awarded to: White 72.9%, Asian 21.8%, Hispanic 3.0%, Black 2.1%. Men received 708 grants (89.3%) worth $917,083,475 total. Women received 85 grants (10.7%) worth $76,835,577 total. Likelihood of being awarded a grant was significantly associated with non-URiM status (p < 0.001) and men (p < 0.0001). On multivariable analysis, Doximity rank (p < 0.001) and academic rank (p < 0.001) were significant predictors of receiving a grant; male gender, URiM status, and years of practice were not. Academic rank was also a significant predictor of number of grants received (p = 0.04) and total funding (p = 0.04); years of practice, Doximity rank, URiM status, and gender were not. CONCLUSIONS: NIH grants were more likely awarded to higher ranked faculty from higher Doximity ranked institutions with no differences based on URiM status or gender.

Grants and Funding in Podiatric Science.

Evidence-based research is essential to improving podiatric medicine and surgery; however, there are many barriers to conducting research, with a major limitation being lack of research funding. There are various grants and funding sources available to podiatric surgeon scientists, but navigating through the resources can be daunting. In this article, we provide a framework for grant writing and funding opportunities for podiatric surgeons to consider.

Orthopedic surgeon-scientist representation is low among National Institutes of Health grants for rotator cuff research.

Background: The purpose of this study is to characterize National Institutes of Health (NIH) funding for rotator cuff research and evaluate the impact of orthopedic surgeons on this portfolio. Methods: The NIH's Research Portfolio Online Reporting Tools Expenditures and Results database was queried for "rotator cuff repair" or "rotator cuff tear" from the 2011 to 2021 fiscal years. Compound annual growth rates were calculated and grants were categorized by basic, clinical, or translational research. Funding totals were compared by Principal Investigator (PI) and grant characteristics. Results: A total of 52 grants were awarded to 38 PIs between 2011 and 2021, totaling $40,156,859. Annual NIH funding for rotator cuff tear and rotator cuff repair increased by a Compound annual growth rate of 11.0% from 2011 to 2021, compared to 3.4% for the total NIH budget. Orthopedic surgeon-scientists received $9,208,212 (22.9%), most commonly through R01 (80.5%) and K08 (7.1%) mechanisms. No significant difference in funding was found by PI sex (P = .332), degree (P = .460), academic rank (P = .118), or researcher type (P = .227). Professors had a higher h-index than associate and assistant professors (P = .001). Orthopedic surgeon-scientists had a higher h-index (mean 36.3 ± 9.4) compared to clinician-scientists (mean 8.0 ± 1.4) and research-scientists (35.5 ± 40.7) (P = .044). Clinical topics receiving the highest funding were rehabilitation (23.9%), diagnosis, (22.3%) and surgical technique (14.8%). Orthopedic surgeon-scientists acquired funding for diagnosis (57.1%), rehabilitation (17.0%), and surgical technique (14.5%). Discussion: While NIH funding for rotator cuff research is growing, orthopedic surgeon representation is low. Future studies should evaluate barriers to obtaining funding for orthopedic surgeon-scientists.

Analysis of NIH K99/R00 awards and the career progression of awardees.

Many postdoctoral fellows and scholars who hope to secure tenure-track faculty positions in the United States apply to the National Institutes of Health (NIH) for a Pathway to Independence Award. This award has two phases (K99 and R00) and provides funding for up to 5 years. Using NIH data for the period 2006-2022, we report that ~230 K99 awards were made every year, representing up to ~$250 million annual investment. About 40% of K99 awardees were women and ~89% of K99 awardees went on to receive an R00 award annually. Institutions with the most NIH funding produced the most recipients of K99 awards and recruited the most recipients of R00 awards. The time between a researcher starting an R00 award and receiving a major NIH award (such as an R01) ranged between 4.6 and 7.4 years, and was significantly longer for women, for those who remained at their home institution, and for those hired by an institution that was not one of the 25 institutions with the most NIH funding. Shockingly, there has yet to be a K99 awardee at a historically Black college or university. We go on to show how K99 awardees flow to faculty positions, and to identify various factors that influence the future success of individual researchers and, therefore, also influence the composition of biomedical faculty at universities in the United States.

The status of women in academic ophthalmology: Authorship of papers, presentations, and academic promotions.

As the field of ophthalmology has evolved in the last several decades, so has the gender distribution of ophthalmologists. We conducted a narrative review to further characterise the status of women in the realm of publication, presentations, editorial positions, grants, academic promotion, and financial compensation. While the proportion of women publishing, presenting, and filling academic and editorial roles has increased over time, it still does not match that of men. Women are more likely to be first authors instead of senior authors, have lower average h-indices, and are awarded fewer grants. The magnitude of some of these differences is smaller when adjusted for women's shorter career duration on average. Despite increased representation of women in ophthalmology, women continue to receive less compensation for the same work. This review highlights that more can be done to improve gender parity in ophthalmology.

Chemistry in Ukraine.

In this special issue, we highlight recent advances in chemical research by scientists in Ukraine, as well as by their compatriots and collaborators outside the country. Besides spotlighting their contributions, we see our task in fostering global partnerships and multi-, inter-, and trans-disciplinary collaborations, including much-needed co-funded projects and initiatives. The three decades of the renewed Ukraine independence have seen rather limited integration of Ukrainian (chemical) science into global research communities.[1] At the same time, the recent surge of collaborative science initiatives between European Union (EU) and Ukraine echoes the unfolding steps towards Ukraine's full research participation to the Horizon Europe Program. This recently implemented step opens enormous possibilities for Ukrainian researchers to apply for diverse EU research grants. Moreover, a number of journal special issues and collections were launched to highlight Ukrainian chemistry (i. e., by Chemistry of Heterocyclic Compounds[2] and ChemistrySelect[3] ). Other scientific initiatives include 'European Chemistry School for Ukrainians'[4] and 'Kharkiv Chemical Seminar'[5] as voluntary projects aimed at engaging Ukrainian scientists into European and international chemical research.

Innovation to Impact: Introduction to the Special Issue on Evidence from the Teen Pregnancy Prevention Program Experiment with Innovation.

Congress has provided funding for the federal Teen Pregnancy Prevention (TPP) Program since 2009 for spending beginning in Fiscal Year 2010. Designated TPP programs develop, test, and evaluate innovations for reducing teen pregnancy, teen pregnancy disparities, and associated risk factors and for promoting positive youth development. Since its inception, the TPP Program has experimented with multiple uniquely structured cohorts of innovation and demonstration projects, producing critical insights into equitable and effective public health innovation while also serving as a highly productive contributor of evidence-based, TPP innovations for scale. This article briefly documents the innovation history of the TPP Program and its iterations in response to the shifting needs of the field. We then synthesize findings from the fifteen TPP innovators published in this special edition. We highlight emergent priorities of the TPP Program informed by this federal experiment in rigorous adolescent sexual health innovation development, testing, evaluation, and scaling and conclude by discussing how the TPP program adapted and refined its approach for fostering dynamic innovation-to-scale projects over time.

National Institutes of Health R-series Grants portfolio of racism and healthcare, 2017-2022.

BACKGROUND: Any form of racism in healthcare is an unacceptable barrier to receiving equitable and quality care, further contributing to health disparities among populations. For these reasons, it is critical to have a better understanding on the amount of research and scientific advances of funded projects aimed at racism in healthcare. An examination of the distribution of R-series funded research by the National Institutes of Health (NIH) on racism in healthcare during a 5-year fiscal year (FY) period (2017-2022) was conducted by the study team. METHODS: This cross-sectional study used publicly available data from the NIH RePORTER (Research Portfolio Online Reporting Tools: Expenditures and Results) for research project grants awarded on racism and healthcare during the FYs of 2017 to 2022. The number of R-series NIH funded projects on racism in healthcare were examined, including the abstract and public health relevance statement, number of publications, spending category, fiscal start and end dates, total amount of funding each year, funding agency/center(s), and type of funding opportunity announcements. Descriptive statistics were performed on the data by the research team. RESULTS: There were a total of 93 R-series grants funded during the FYs of 2017 to 2022. Most of the grants were R01s (77.4%); focused primarily on racism at the system-wide level (68.8%), and on patients (64.5%); the largest racial and ethnic minority group reported were African/American/Black (20.4%); and close to 40% did not report race or ethnicity. None of the grants focused in internalized racism, which is at the individual -level. From the FYs of 2017 to 2022, 0.07% of all NIH research funding was awarded to racism in healthcare. CONCLUSION: The findings of this study showed the need for continued funding and of the need of more research on racism in healthcare, that potentially can reduce health disparities and inequities.

A pilot study on our non-traditional, varied writing accountability group for historically excluded and underrepresented persons in STEMM.

Underrepresented faculty have higher burnout rates and lower grant attainment rates when compared with their non-minority counterparts. Many in science, technology, engineering, mathematics, and medicine (STEMM) disciplines, including underrepresented individuals, often have difficulty dedicating time to the writing process, with trainees often being relegated to laboratory tasks in their training years, resulting in a lack of practice in academic writing. Notably, past studies have shown that grant attainment rates of underrepresented individuals are lower than their majority counterparts. Here, we sought to consider a mechanism targeted to underrepresented individuals, although applicable to everyone, to help overcome traditional barriers to writing in STEMM. The authors have hosted a writing accountability group (WAG) that uniquely provides a format focused on physical activity and different forms of writing to strengthen both career development and award/funding attainment. Our objectives were to evaluate this unique format, thus creating a resource for individuals and institutions to learn about WAGs and expand upon the framework to formulate their own WAG. To do this, we performed a small pilot study (n = 21) to investigate attitudes towards the WAG. We present the results of a survey conducted among underrepresented WAG participants, which spanned different career stages and was highly diverse demographically. Our results show that following attendance of our WAG, individuals did not note a significant change in scales pertaining to John Henryism (high-effort coping), resilience, sense of belonging, or grit. However, significant increases were noted in the self-perceived ability to handle stress, confidence in applying for awards, appreciation for mentoring, and satisfaction of WAGs. Taken together, the results of this study suggest that our unique WAG format can have some positive results as a career and writing development opportunity and may be able to support underrepresented individuals in attaining funding at higher education institutions.

Vosoritide, a miracle drug, covering unmet need in achondroplasia: A regulatory update.

Dwarfism is a rare condition characterized by small stature. Achondroplasia is predominantly considered the leading cause of dwarfism. Although the condition is not life-threatening, it dramatically impacts the social life of the patient. The United States Food and Drug Administration (US FDA) first approved the drug Voxzogo (vosoritide) for achondroplasia. The drug also received approval from the European Medicines Agency (EMA) via the centralized procedure. The drug is associated with a decrease in blood pressure, a severe adverse event. However, this adverse event/risk has been overcome by benefits, i.e. fulfilling of unmet medical need. In the United States, the drug received accelerated approval as it satisfied the criteria of rare pediatric disease. This review includes a detailed orphan drug approval process with particular reference to vosoritide, which is considered a milestone for the treatment of achondroplasia.

NIH-supported implementation science and nutrition research: a portfolio review of the past decade.

Objective: This portfolio analysis aims to describe the scope of NIH-funded extramural research grants at the intersection of nutrition research and implementation science (IS) from 2011 to 2022 and to offer insights into future research opportunities relevant to the Strategic Plan for NIH Nutrition Research 2020-2030. Methods: A portfolio analysis of funded grants using NIH reporting systems was conducted to identify nutrition research and IS awarded between fiscal years 2011 and 2022. The authors screened the titles and abstracts for inclusion criteria: research and career development awards involved a nutrition and/or dietary intervention and measured a stated implementation outcome or used an IS theory, model, or framework. Results: In total, 33 NIH-funded awards met the inclusion criteria. Almost half of the awards (48.5%) were investigator-initiated research projects compared to research career awards and cooperative agreements. While studies were predominantly conducted in the United States, 15.2% were conducted in low- and middle-income countries in Africa, Latin America, and Asia. Adults aged 19-64 years and children aged 2-11 years represented most of the study populations (45.5 and 15.2%, respectively). Studies provided nutrition/dietary guidelines and created culturally tailored interventions, which were then adapted in collaboration with community partners in schools, hospitals, and religious settings. The most cited IS outcomes were feasibility, costs, adoption, and acceptability. Sixteen awards (48.5%) used an IS theory, model, or framework to guide their work. Discussion: The findings show the breadth of NIH-funded nutrition and implementation research and highlight potential research opportunities.

State Priorities and Needs: The Role of Block Grants.

OBJECTIVES: Block grant funding provides federal financial support to states, with increased flexibility as to how those funds can be allocated at the community level. At the state level, block grant amounts and distributions are often based on outdated formulas that consider population measures and funding environments at the time of their creation. We describe variation in state-level funding allocations for 5 federal block grant programs and the extent to which funding aligns with the current needs of state populations. METHODS: We conducted an analysis in 2022 of state block grant allocations as a function of state-level characteristics for 2015-2019 for all 50 states. We provide descriptive statistics of state block grant allocations and multivariate regression models for each program. Models include base characteristics relevant across programs plus supplemental characteristics based on program-specific goals and state population needs. RESULTS: Mean state block grant allocations per 1000 population by program ranged from $618 to $21 528 during 2015-2019. Characteristics associated with state allocations varied across block grants. For example, for every 1-percentage-point increase in the percentage of the population living in nonmetropolitan areas, Preventive Health and Health Services Block Grant funding was approximately $7 per 1000 population higher and Community Services Block Grant funding was approximately $40 per 1000 population higher. Few supplemental characteristics were associated with allocations. CONCLUSIONS: Current block grant funding does not align with state characteristics and needs. Future research should consider how funds are used at the state level or allocated to local agencies or organizations and compare state block grant allocations with other types of funding mechanisms, such as categorical funding.

Champions for School Health-An NASN Initiative to Increase Vaccine Confidence, Equity, and Uptake in COVID-19 and School-Required Vaccinations: Part 2.

NASN, with generous funding from Kaiser Permanente (KP) and partnered with the Institute for Educational Leadership, developed and implemented the Champions for School Health (CSH) grant initiative. The CSH initiative awarded 54 Implementation Grants in two funding cycles in 2022, funding school districts and community-based organizations (CBOs) to increase access to the pediatric COVID-19 vaccine as well as school-required immunizations and to increase vaccine confidence among underserved populations in KP's footprint: California, Colorado, Georgia, Hawaii, Maryland, Oregon, Virginia, Washington, and the District of Columbia. These grantees administered a total of 17,630 COVID-19 vaccines to individuals ages 5 or older and 34,025 routine immunizations, of which 8,233 school-required vaccinations went to children of ages 5-11 years. Over 851,000 people were reached by vaccine education events in all nine KP markets. A notable takeaway from the project's results was the new partnerships created and the continuation of existing partnerships by the grantees. NASN's implementation of the CSH initiative and results provides a model and a source of critical data on how school health services and community-based organizations can partner to provide hyper-local responses to community/public health crises. This Part 2 article provides an overview of the key results of the project.

Cultivating participatory approaches in health promotion planning, delivery, and evaluation: A case study of an academic-health service partnership in rural Victoria.

ISSUE ADDRESSED: Community participation in planning, delivery, and evaluation of health promotion (HP) programs is a poorly explored topic. However, this approach has the potential to improve health outcomes and reduce health inequities, particularly for residents of rural and remote areas. METHODS: This case study describes the outputs of an academic-health service partnership in rural Victoria. The collaboration has led to the implementation and ongoing evaluation of a microgrant program for HP which integrates community participation principles in the foundations of the program and its evaluation. RESULTS: To date, 10 funded projects have been brought to completion, with COVID-19 having disturbed both grant distribution and funded activity implementation. Semi-structured interviews with health service officers served to clarify conceptualisation and operationalization of HP principles. Focus groups with health service management and officers contributed to building an overarching evaluation framework for the HP team's activities. Finally, the specific methodological evaluation framework for the microgrant program was developed through a collaborative workshop with the HP team and grantees. CONCLUSIONS: Fostering community participation in HP planning, delivery, and evaluation, especially in rural areas, is feasible as evidenced by the experience described in this case study. The forthcoming evaluation results will help clarify the impact of community participation on health-related outcomes. SO WHAT?: Documentation and dissemination of processes used to increase community participation in HP programs is essential to grow the knowledge base around what works and what doesn't, and for whom.

Toward an Effective Innovation Framework for Federal Grant-Making: an Exploration into OPA's Teen Pregnancy Prevention Program.

States, local, tribal, and territorial governments received almost 20% of all federal spending in fiscal year 2022, about $1.2 trillion dollars (US Office of Management and Budget, 2023a). For a strong, well-functioning democracy, the federal government must be able to disperse grant funds efficiently and effectively. Rates of teen pregnancy in the USA, while decreasing in recent years, are still consistently higher than that of other western industrialized nations (Centers for Disease Control and Prevention, 2023). The Office of Population Affairs' (OPA) Teen Pregnancy Prevention program combines cutting edge research with innovative grant distribution to creatively tackle this issue. In this commentary, we explore some of the strengths of OPA's grant distribution program in the hope that others may emulate best practices from this program. Specifically, the special issue highlights how OPA's grant program took a customer-centered focus by prioritizing work with end users and community. This evidence-based focus enabled the testing of ideas, which in turn could be iterated and scaled up. Through grantee innovation networks, they created space for external expertise, creative thinking, and diversity of thought. Other programs, policymakers, and their partners may learn from OPA's success, which arises from three core characteristics: (1) their funding stature allows long-term and flexible allocation of funding toward innovation; (2) OPA focuses on creating and supporting local communities and networks of innovation; (3) OPA emphasizes evidence-based decision-making and rigorous evaluation throughout the grant process. With a fifth of the federal budget being dispersed through grant-making and teen pregnancy still at high rates, OPA offers an exciting avenue for innovation and success in both of these areas. This commentary concludes with some recommendations for future practice.