Director’s Report to the National Advisory Mental Health Council - May 23, 2008
- NIH-Wide Update
- NIMH Updates
- New NIMH Initiatives
- Research Conferences and Workshops
- Staff Changes
I am pleased to welcome members of the National Advisory Mental Health Council (NAMHC) and other participants and guests to our 218th Council meeting. Since our last meeting in January, we have made progress on several fronts, which I share with you in this report.
NIH Roadmap—Selected Updates
The NIH Roadmap is a trans-NIH effort to support innovative science, stimulate interdisciplinary research, and reshape clinical research to accelerate medical discovery and improve public health. Currently, workgroups co-chaired by the Directors of NIH Institutes and Centers (ICs) and populated by nominees from interested Institutes are developing initiatives for “Roadmap 1.5.” The Roadmap Web site contains a full summary of Roadmap activities, including an update on Roadmap 1.5.
Patient Reported Outcomes Measurement Information System (PROMIS)
This initiative recently released resources and services for use by clinical researchers interested in performing studies to test whether PROMIS measures provide valid and reliable assessments and correlate with other measurement tools and clinical diagnoses. The resources comprise network item banks on depression, anxiety, anger, social role participation, physical functioning, pain, and fatigue. The PROMIS Assessment Center is a web-based program designed to provide clinical researchers with computerized adaptive testing administration of the PROMIS item banks as well as researcher-defined measures. The PROMIS Assessment Center and all related documentation can be found online .
In April, the NIH Center for Scientific Review (CSR) completed the peer review of 18 applications received in response to the Request for Applications (RFA) “Molecular Libraries Probe Production Centers Network (MLPCN) ”. Applicants were limited to invitees who received favorable reviews on their pre-applications for this project.
This RFA will establish a network of screening and probe generation centers that will use high-throughput screening and chemistry to discover small molecules that can be used as new molecular tools to aid the investigation of protein function, signaling pathways and cellular processes that are important to the maintenance of human health and to accelerate the development of new therapeutics.
A funding plan that includes three types of screening and chemical probe generation centers with complementary capabilities to comprise a research network will be developed by the MLPCN Project Team in May-June 2008. It is anticipated that up to 2-4 Comprehensive Centers, 2-3 Specialized Screening Centers, and 2-3 Specialized Chemistry Centers will be awarded in July-August 2008. The total funds available from the NIH Common Fund for the new awards are approximately $70 million per year for the four-year production phase.
Planning for FY 2011
On April 22, 2008, NIH released a Request for Information (RFI) inviting ideas from the scientific community, health professionals, patient advocates, and the general public on ways to:
- Address specific barriers to basic, translational, or clinical research through development of novel tools, technologies, services, etc.
- Fill specific knowledge gaps that impede research across a broad spectrum of health science.
Collecting these ideas is an initial step to identify a new cohort of Common Fund/Roadmap programs for Fiscal Year (FY) 2011. NIH expects to spend $30–50 million per year from within the currently projected Roadmap budget for new five-year initiatives.
NIH Blueprint for Neuroscience Research
The Neuroscience Blueprint is a framework to enhance cooperation among the 15 NIH ICs that support research on the nervous system as well as NIH’s Office of Behavioral and Social Sciences Research. Created in 2004, the Blueprint now has more than 20 project teams steering a variety of initiatives that provide tools, resources, and training to the neuroscience research community in ways that cut across boundaries of individual ICs. The Blueprint will focus on neural development in 2008 and neural plasticity in 2009, with plans to continue the Blueprint initiative beyond FY 2009. Since January, several activities under the Blueprint have moved forward, including:
Neurodevelopment Workshop Team
Team leaders: Beth-Anne Sieber, National Institute on Neurological Disorders and Stroke (NINDS); Robert Riddle, NINDS
In November 2006, the Neurodevelopment Workshop Team hosted a workshop to request input from the extramural community on neurodevelopment initiative topics for FY08. The following three initiatives were the result of this process.
- Blueprint Resource Antibodies Initiative for Neurodevelopment (BRAINdev)
Team leaders: Robert Riddle, NINDS; Randy Stewart, NINDS
This initiative supports the targeted creation and distribution of a large number of high quality monoclonal antibodies for neurodevelopment research. More information is online at http://www.neuromab.org/.
- Center for Evaluation of Neurodevelopmental Antibodies (CENA)
Team leaders: Robert Riddle, NINDS; Randy Stewart, NINDS
An RFA was issued to solicit U24 applications to create center(s) to evaluate immunoreactivity of monoclonal antibodies generated by BRAINdev (see above) in the developing central and peripheral nervous systems of multiple model organisms. The applications were reviewed on May 15, 2008.
- Tools and Techniques for Elucidating and Manipulating Neural Circuit Development
Team leaders: Michelle Freund, NIMH; Beth Anne Sieber, NINDS
An RFA was issued to solicit applications proposing to develop new technologies and methods to better and more precisely understand circuit formation and development in the nervous system. Applications will be brought to May 2008 Council.
Primate Gene Expression Team
Team leaders: Kathy Anderson, NIMH; Michelle Freund, NIMH
Two Requests for Proposals (RFPs) were issued to solicit contracts that will provide knowledge of detailed localization of gene expression in the developing primate nervous system as a means to better inform understanding of human brain development. This initiative intends to support contracts that will study specified brain regions at specified developmental time points, demonstrate the expression of specified genes in those samples, and provide this information to the community through a digital brain atlas with associated informatics tools for searching and analyzing the data.
Proposals for the RFP, “Preparation of Developing Brain Tissue from Rhesus macaque for Gene Expression Analysis ” are due on May 23, 2008; applicants for “High-throughput Collection of Gene Expression Data in Developing Rhesus Macaque Brain ” have until June 4, 2008 to submit proposals. Both contracts are expected to be awarded in September.
FY 2009 Initiatives
Neuroplasticity Tools Team
Team Leaders: Michelle Freund, NIMH; Ned Talley, NINDS; John Satterlee, National Institute on Drug Abuse (NIDA)
This new project team was formed to develop an initiative based on the concept document approved by the NIH Blueprint IC Directors. The recently issued announcement, “Probes and Instrumentation for Monitoring and Manipulating Nervous System Plasticity ” focuses on the development of tools or techniques that will significantly advance the current state of the art in neuroplasticity research but will not be restricted to a particular type of technology. A parallel Small Business Innovation Research (SBIR) program announcement was also issued.
May 1,2008 • Science Update
NIMH recently awarded Sophia Vinogradov, M.D., of the University of California, San Francisco (UCSF), a grant to study whether an intensive, computerized training program can help prevent youth at high risk for developing schizophrenia from having a first psychotic episode and improve adaptive functioning.
April 4, 2008 • Science Update
A new grant funded by NIMH will support research by Melanie Bennett, Ph.D., of the University of Maryland, Baltimore, to develop an intervention designed to help people with serious mental illness (SMI) quit smoking. The addiction is very common among people with SMI, and contributes significantly to deteriorating health and higher costs for care. But it is difficult to treat among people with SMI because they require a tailored approach that is incorporated into their existing mental health treatment.
April 1, 2008 • Press Release
NIH announced on March 24, 2008, the latest recipients of the Autism Centers of Excellence (ACE) program. These grants will support studies covering a broad range of autism research areas, including early brain development and functioning, social interactions in infants, rare genetic variants and mutations, associations between autism-related genes and physical traits, possible environmental risk factors and biomarkers, and a potential new medication treatment. The FY 2008 ACE award recipients are:
- Ami Klin, Ph.D., Yale University
- Diane Chugani, Ph.D., Wayne State University
- Daniel Geschwind, M.D., Ph.D., University of California Los Angeles
- Craig Newschaffer, Ph.D., Drexel University.
January 4, 2008 • Science Update
Two new NIMH grants awarded to Phillip Harvey, Ph.D., of Emory University, and Thomas Patterson, Ph.D., of the University of California, San Diego, are aimed at determining the most accurate methods of measuring how community-dwelling people with schizophrenia are faring. Results of the project are meant to provide scientists who conduct future research on the effectiveness of treatments with tools that reflect the truest possible picture of daily-life outcomes.
Clinical Trials for Services and Intervention Research
The NIMH Division of Services and Intervention Research (DSIR) has announced two new multi-site clinical trials in bipolar disorder and depression that have just begun recruiting and are expected to be completed in the next three years.
- The Lithium Use for Bipolar Disorder (LiTMUS) trial will study the use of moderate-dose lithium for the treatment of bipolar disorder in 264 participants. LiTMUS is being conducted by the Bipolar Trials Network, comprising investigators with previous experience from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) trial.
- The Depression Trials Network, consisting of experts who previously conducted the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, is seeking participants for the Combining Medications to Enhance Depression Outcomes (CO-MED) trial. This study will examine, for the first time, the use of combination drug therapy as initial treatment for depression in 660 participants.
The protocols for each of these projects were evaluated by the NAMHC Workgroup on a New Generation of NIMH Network Trials that continues to help prioritize research to be conducted on NIMH networks. Both of these effectiveness studies address timely and critical research questions of public health importance in the management of bipolar disorder and depression, and will help inform the optimization and personalization of treatment in the future.
New NIMH Initiatives
- Use of Pooled State Administrative Data for Policy Relevant Mental Health Services Research
In response to key recommendations from the NIMH Advisory Council’s “The Road Ahead: Research Partnership to Transform Services,” the NIMH Services Research and Clinical Epidemiology Branch (srcEB) issued this funding opportunity announcement (FOA) to support studies on the impact of state policy changes on access to and cost, quality and outcomes of care provided to people with mental disorders.
Release/Posted Date: May 9, 2008; Expiration Date: August 20, 2008
Use of Pooled State Administrative Data for Policy Relevant Mental Health Services Research (R01)
Scientific Program Director: David A. Chambers, Ph.D., DSIR, NIMH
- Network(s) for Developing PTSD Risk Assessment Tools
NIMH and the Department of Veterans Affairs Clinical Science Research & Development Service are inviting applications or teams of investigators to conduct exploratory studies combining, weighting, and sequencing measures of post-traumatic stress disorder (PTSD) risk with the goal of differentiating trauma survivors who will recover naturally from those who will develop enduring symptoms and PTSD. Applicants are encouraged to propose developing and testing risk assessment tools using existing data (past trials and epidemiological studies) and/or in the context on-going PTSD studies. The expected outcomes of such teams will be preliminary data on risk assessment tools that are sensitive to and balance statistical and clinical significance for future prediction and pre-emption studies and research to develop clinical decision tools.
Release/Posted Date: April 7, 2008; Expiration Date: September 1, 2008
Network(s) for Developing PTSD Risk Assessment Tools (R21)
Scientific Program Director: Farris Tuma, Sc.D., Division of Adult Translational Research and Treatment Development (DATR), NIMH
- Innovative Approaches to Personalizing the Treatment of Depression
This NIMH FOA, issued using the R01 and R34 grant mechanisms, aims to advance research on individualizing the treatment of depression by developing models and testing new approaches that, by accounting for patient characteristics, aim to be more specific and thus potentially leading to more effective and efficient treatment interventions. Intended to support relatively small projects or preliminary investigations, this FOA is an initial step toward advancing research on personalization of care in mental health.
Release/Posted Date: March 7, 2008; Expiration Date: June 21, 2008
Innovative Approaches to Personalizing the Treatment of Depression (R01)
Innovative Approaches to Personalizing the Treatment of Depression (R34)
Scientific Program Director: Benedetto Vitiello, M.D., DSIR, NIMH
- Novel Interventions for Neurodevelopmental Disorders
NIMH seeks applications to develop novel interventions that will improve functioning in domains commonly affected by neurodevelopmental disorders. This FOA is intended to encourage a broad scope of new treatment approaches with potential for widespread, cost-effective application across a variety of neurodevelopmental disorders based on the targeted domain(s) of functioning. This FOA has been issued using the R34 and R21/R33 mechanisms.
Release/Posted Date: March 7, 2008; Expiration Date: June 18, 2008
Novel Interventions for Neurodevelopmental Disorders (R34)
Novel Interventions for Neurodevelopmental Disorders (R21/R33)
Scientific Program Director: Judy Rumsey, Ph.D., Division of Developmental Translational Research (DDTR), NIMH
Selected Collaborative RFAs
- Methods for Prevention Packages Program
The National Institute on Allergy and Infectious Diseases (NIAID) and NIMH invite applications for multidisciplinary research programs that (1) devise optimal HIV prevention packages (combination interventions) for specific populations, (2) design clinical studies to rigorously examine the safety and efficacy of these “packages” in the target population, and (3) perform pilot studies to demonstrate that the proposed prevention package is acceptable to the target population and the study design is appropriate and feasible. This FOA is intended to encourage collaborations between behavioral and biomedical clinical scientists, epidemiologists, mathematical modelers, and clinical trial design specialists.
Release/Posted Date: April 24, 2008; Expiration Date: August 26, 2008
Methods for Prevention Packages Program (MP3) (R01)
Scientific Program Director: David Burns, M.D., M.P.H., Division of AIDS, NIAID
- Microbicide Innovation Program (MIP IV)
NIAID, NIMH, and the NIH Office of Research in Women’s Health are soliciting Research Project Grant (R21/R33) applications in the field of topical microbicides to advance (1) the development of new microbicide approaches and additional rational targets through preclinical and basic research; (2) discovery and characterization of microbicides (singly or in combinations) directed against HIV or STIs (sexually transmitted infections) that are linked to HIV acquisition; (3) emerging technologies or models that contribute to the development of new and/or more efficient ways of assessing microbicide safety, efficacy and acceptability; and (4) the design of complex prevention strategies that incorporate applied microbicides in the context of mucosally active vaccines.
Release/Posted Date: April 16, 2008; Expiration Date: July 26, 2008
Methods for Prevention Packages Program (MP3) (R01)
Scientific Program Director: Jim A. Turpin, Ph.D., Division of AIDS, NIAID
- Gender, Youth and HIV Risk
The Eunice Kennedy Shriver National Institute on Child Health and Human Development (NICHD) and NIMH invite research on understanding the behaviors and developing strategies to mitigate the exposure to HIV in young people in populations and areas of the world where HIV prevalence is high. Responsive applications will focus on a specific aspect of HIV risk, in a specific cultural or geographic setting, while integrating understanding of the processes of human development in that population and of the social environment. The social environment includes, in addition to structural aspects of the world of youth, the local understandings of issues related to individuals’ behaviors. This FOA has been issued using the Exploratory/Developmental (R21) mechanism.
Release/Posted Date: March 31, 2008; Expiration Date: July 30, 2008
Gender, Youth and HIV Risk (R21)
Scientific Program Director: Susan F. Newcomer Ph.D., Demographic and Behavioral Sciences Branch, NICHD
Science of Note
All press releases and science updates listed below can be read in full in the Science News section of the NIMH Web site. These items can also be sorted by date or subject.
May 7, 2008 • Press Release
Major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to an NIMH-funded study. The results were drawn from data from the 2002 National Comorbidity Survey Replication (NCS-R).
Kessler RC, Heeringa S, Lakoma MD, Petukhova M, Rupp AE, Schoenbaum M, Wang PS, Zaslavsky AM. Individual and Societal Effects of Mental Disorders on Earnings in the United States: Results From the National Comorbidity Survey Replication. Am J Psychiatry. 2008 May 7. [Epub ahead of print]
January 24, 2008 • Science Update
More residents affected by Hurricane Katrina are enduring mental disorders than was initially determined a few months after the storm.
Kessler RC, Galea S, Gruber MJ, Sampson NA, Ursano RJ, Wessely S. Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry. 2008 Apr;13(4):374-84. PMID: 18180768
February 25, 2008 • Science Update
People with major depression accompanied by high levels of anxiety are significantly less likely to benefit from antidepressant medication than those without anxiety, according to a study based on data from the NIMH-funded STAR*D study.
Fava M, Rush AJ, Alpert JE, Balasubramani GK, Wisniewski SR, Carmin CN, Biggs MM, Zisook S, Leuchter A, Howland R, Warden D, Trivedi MH. Difference in treatment outcome in outpatients with anxious versus nonanxious depression: a STAR*D report. Am J Psychiatry. 2008 Mar;165(3):342-51.
April 2, 2008 • Science Update
New cost-sharing policies may prevent some older adults diagnosed with depression from filling new antidepressant prescriptions.
Wang PS, Patrick AR, Dormuth CR, Avorn J, Maclure M, Canning CF, Schneeweiss S. The impact of cost sharing on antidepressant use among older adults in British Columbia. Psychiatr Serv. 2008 Apr;59(4):377-83.
March 14, 2008 • Science Update
After the U.S. Food and Drug Administration (FDA) issued a “black box” warning on antidepressant medications, Nebraskan doctors began prescribing fewer antidepressant medications to children and teens and referring more patients to specialists, according to a state survey.
Bhatia SK, Rezac AJ, Vitiello B, Sitorius MA, Buehler BA, Kratochvil CJ. Antidepressant prescribing practices for the treatment of children and adolescents. J Child Adolesc Psychopharmacol. 2008 Feb;18(1):70-80.
February 26, 2008 • Press Release
Teens with difficult-to-treat depression who do not respond to a first antidepressant medication are more likely to get well if they switch to another antidepressant medication and add psychotherapy rather than just switching to another antidepressant.
Brent D, Emslie G, Clarke G, Wagner KD, Asarnow JR, Keller M, Vitiello B, Ritz L, Iyengar S, Abebe K, Birmaher B, Ryan N, Kennard B, Hughes C, DeBar L,McCracken J, Strober M, Suddath R, Spirito A, Leonard H, Melhem N, Porta G, Onorato M, Zelazny J. Switching to another SSRI or to venlafaxine with or without cognitive behavioral therapy for adolescents with SSRI-resistant depression: the TORDIA randomized controlled trial. JAMA. 2008 Feb 27;299(8):901-13.
February 20, 2008 • Science Update
Variations in a gene known as TREK1 may explain some forms of treatment-resistant major depression, according to a new study analyzing genetic data.
Perlis RH, Moorjani P, Fagerness J, Purcell S, Trivedi MH, Fava M, Rush AJ, Smoller JW. Pharmacogenetic Analysis of Genes Implicated in Rodent Models of Antidepressant Response: Association of TREK1 and Treatment Resistance in the STAR(*)D Study. Neuropsychopharmacology. 2008 Feb 20. [Epub ahead of print]
February 14, 2008 • Science Update
Even when serotonin levels stayed low, scientists were able to correct abnormal, mental-illness-like behaviors in mice by blocking an enzyme called GSK3ß. The finding adds evidence that molecular targets other than serotonin may lead to better and faster medications for some mental illnesses.
Beaulieu JM, Zhang X, Rodriguiz RM, Sotnikova TD, Cools MJ, Wetsel WC, Gainetdinov RR, Caron MG. Role of GSK3 beta in behavioral abnormalities induced by serotonin deficiency. Proc Natl Acad Sci U S A. 2008 Jan 29;105(4):1333-8.
January 23, 2008 • Science Update
Scientists may be able to develop faster-acting medications for the manic phase of bipolar disorder, new research shows.
Du J, Creson TK, Wu LJ, Ren M, Gray NA, Falke C, Wei Y, Wang Y, Blumenthal R, Machado-Vieira R, Yuan P, Chen G, Zhuo M, Manji HK. The role of hippocampal GluR1 and GluR2 receptors in manic-like behavior. J Neurosci. 2008 Jan 2;28(1):68-79.
March 4, 2008 • Science Update
Youngsters with pediatric bipolar disorder and healthy peers who have first-degree relatives with bipolar disorder share the same difficulty labeling facial emotions, NIMH researchers have discovered.
Brotman MA, Guyer AE, Lawson ES, Horsey SE, Rich BA, Dickstein DP, Pine DS, Leibenluft E. Facial Emotion Labeling Deficits in Children and Adolescents at Risk for Bipolar Disorder. Am J Psychiatry. 2008 Mar;165(3):385-9.
Rich BA, Fromm SJ, Berghorst LH, Dickstein DP, Brotman MA, Pine DS, Leibenluft E. Neural connectivity in children with bipolar disorder: impairment in the face emotion processing circuit. J Child Psychol Psychiatry. 2008 Jan;49(1):88-96.
March 18, 2008 • Press Release
A traumatic event is much more likely to result in posttraumatic stress disorder (PTSD) in adults who experienced trauma in childhood—but certain gene variations raise the risk considerably if the childhood trauma involved physical or sexual abuse.
Binder EB, Bradley RG, Liu W, Epstein MP, Deveau TC, Mercer KB, Tang Y,Gillespie CF, Heim CM, Nemeroff CB, Schwartz AC, Cubells JF, Ressler KJ. Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults. JAMA. 2008 Mar 19;299(11):1291-305.
January 7, 2008 • Press Release
Youth who are going to develop psychosis can be identified before their illness becomes full-blown 35 percent of the time if they meet widely accepted criteria for risk, but that figure rises to 65 to 80 percent if they have certain combinations of risk factors, the largest study of its kind has shown.
Cannon TD, Cadenhead K, Cornblatt B, Woods SW, Addington J, Walker E, Seidman LJ, Perkins D, Tsuang M, McGlashan T, Heinssen R. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch Gen Psychiatry. 2008 Jan;65(1):28-37.
March 27, 2008 • Press Release
People with schizophrenia have high rates of rare genetic deletions and duplications that likely disrupt the developing brain, according to studies funded in part by NIH.
Walsh T, McClellan JM, McCarthy SE, Addington AM, Pierce SB, Cooper GM, Nord AS, Kusenda M, Malhotra D, Bhandari A, Stray SM, Rippey CF, Roccanova P, Makarov V, Lakshmi B, Findling RL, Sikich L, Stromberg T, Merriman B, Gogtay N, Butler P, Eckstrand K, Noory L, Gochman P, Long R, Chen Z, Davis S, Baker C, Eichler EE,Meltzer PS, Nelson SF, Singleton AB, Lee MK, Rapoport JL, King MC, Sebat J. Rare structural variants disrupt multiple genes in neurodevelopmental pathways inschizophrenia. Science. 2008 Apr 25;320(5875):539-43.
March 19, 2008 • Science Update
Four teams of scientists, using resources supported in part by NIMH, have pinpointed two different sites in the genome, each conferring a different type of genetic risk for autism. At one site, risk genes appear to be inherited. At the other, risk stems from spontaneous mutations, not seen in the genetics of the parents. In both examples, evidence suggests the suspect genes are critical for development of brain circuits impaired in autism.
Eichler EE, Zimmerman AW. A Hot Spot of Genetic Instability in Autism. N Engl J Med. 2008 Feb 14;358(7):737-9.
- Weiss LA, Shen Y, Korn JM, Arking DE, Miller DT, Fossdal R, Saemundsen E, Stefansson H, Ferreira MA, Green T, Platt OS, Ruderfer DM, Walsh CA, Altshuler D, Chakravarti A, Tanzi RE, Stefansson K, Santangelo SL, Gusella JF, Sklar P, Wu BL, Daly MJ; the Autism Consortium. Association between Microdeletion and Microduplication at 16p11.2 and Autism. N Engl J Med. 2008 Feb 14;358(7):667-75. PMID: 18184952
Stephan DA. Unraveling autism. Am J Hum Genet. 2008 Jan;82(1):7-9.
Alarcón M, Abrahams BS, Stone JL, Duvall JA, Perederiy JV, Bomar JM, Sebat J, Wigler M, Martin CL, Ledbetter DH, Nelson SF, Cantor RM, Geschwind DH. Linkage, Association, and Gene-Expression Analyses Identify CNTNAP2 as an Autism-Susceptibility Gene. Am J Hum Genet. 2008 Jan 10;82(1):150-159.
Arking DE, Cutler DJ, Brune CW, Teslovich TM, West K, Ikeda M, Rea A, Guy M, Lin S, Cook EH Jr, Chakravarti A. A Common Genetic Variant in the Neurexin Superfamily Member CNTNAP2 Increases Familial Risk of Autism. Am J Hum Genet. 2008 Jan;82(1):160-4.
Bakkaloglu B, O'Roak BJ, Louvi A, Gupta AR, Abelson JF, Morgan TM, Chawarska K, Klin A, Ercan-Sencicek AG, Stillman AA, Tanriover G, Abrahams BS, Duvall JA, Robbins EM, Geschwind DH, Biederer T, Gunel M, Lifton RP, State MW. Molecular Cytogenetic Analysis and Resequencing of Contactin Associated Protein-Like 2 in Autism Spectrum Disorders. Am J Hum Genet. 2008 Jan 10;82(1):165-173.
May 1, 2008 • Science Update
A medication that enhances learning, taken just before an exposure therapy session, may aid cognitive behavior therapy (CBT) for anxiety disorders, say NIMH-funded researchers, who adapted the technique from studies on fear extinction in rats.
Rothbaum BO. Critical parameters for d-cycloserine enhancement of cognitive-behaviorial therapy for obsessive-compulsive disorder. Am J Psychiatry. 2008 Mar;165(3):293-6.
April 7, 2008 • Science Update
Several variations within the same gene act together to raise the risk of obsessive-compulsive disorder (OCD), new NIMH research suggests.
Wendland JR, Moya PR, Kruse MR, Ren-Patterson RF, Jensen CL, Timpano KR,Murphy DL. A novel, putative gain-of-function haplotype at SLC6A4 associates withobsessive-compulsive disorder. Hum Mol Genet. 2008 Mar 1;17(5):717-23.
April 23, 2008 • Press Release
Human imaging studies have for the first time identified brain circuitry associated with social status, according to NIMH researchers.
Zink CF, Tong Y, Chen Q, Bassett DS, Stein JL, Meyer-Lindenberg A. Know your place: neural processing of social hierarchy in humans. Neuron. 2008 Apr 24;58(2):273-83.
February 20, 2008 • Science Update
An NIMH study using an emerging imaging technology has discovered faulty wiring in the brains of people with Williams Syndrome, a rare genetic disorder that affects some aspects of thinking.
Marenco S, Siuta MA, Kippenhan JS, Grodofsky S, Chang WL, Kohn P, Mervis CB, Morris CA, Weinberger DR, Meyer-Lindenberg A, Pierpaoli C, Berman KF. Proc Natl Acad Sci U S A. 2007 Sep 18;104(38):15117-22.
February 21, 2008 • Press Release
A better understanding of how memory works is emerging from a newfound ability to link a learning experience in a mouse to consequent changes in the inner workings of its neurons. Researchers, supported in part by NIMH, developed a way to pinpoint specific cellular components that sustain a specific memory in genetically-engineered mice.
Matsuo N, Reijmers L, Mayford M. Spine-type-specific recruitment of newly synthesized AMPA receptors with learning. Science. 2008 Feb 22;319(5866):1104-7.
Research Conferences and Workshops
All meeting summaries listed below can be read in full in the Research and Funding section of the NIMH Web site. These items can also be sorted by date or subject.
February 18-19, 2008
The purpose of this workshop was to discuss empirical evidence for sources of heterogeneity in child and adolescent depression, evaluate the significance of known heterogeneity, and identify promising research directions in this area.
January 24-25, 2008
This workshop provided a forum for reviewing accomplishments and challenges in conducting effectiveness research in practice and other community settings and served as an opportunity for informally discussing promising approaches to further research. The focus of the meeting was on testing the effectiveness of treatment interventions for children and adolescents when delivered in clinical practice and other community settings, such as schools.
January 22-23, 2008
NIMH joined the Department of Veterans Affairs, Office of Research and Development, and the Department of Defense, Health Affairs, in organizing a two day working group to review, in the context of the recent Institute of Medicine report, generally agreed upon standards for clinical trials in biomedical and behavioral research; discuss some of the clinical and research challenges associated with clinical trials for PTSD; and develop expert advice for surmounting these challenges in future intervention trials for PTSD.
NIMH Outreach Meetings
Outreach Partnership Program 9th Annual Meeting
The NIMH Outreach Partnership Program held its annual meeting in Portland, Maine on March 31–April 2, 2008. The Outreach Partnership Program is a national program that enlists one partner from each of the 50 states (two in California, Texas and New York) and the District of Columbia in conducting outreach and education to help bridge the gap between mental health research and clinical practice. The meeting provided the opportunity for participants to hear scientific updates from NIMH and NIH staff, guest speakers, as well as to present their own activities, and to network with one another. This year the conference highlighted co-occurring conditions, violence and stigma, and building effective collaborations between researchers and communities. For more information please contact Al Golden.
Brain Awareness Week
NIMH was one of five NIH Institutes to participate in the annual Brain Awareness Week (BAW) health and science information fair held at the National Museum of Health and Medicine on the campus of the Walter Reed Army Medical Center in Washington, DC. BAW is an international effort that takes place for one week in March. The program is sponsored by the Dana Alliance for Brain Initiatives, a nonprofit organization dedicated to increasing public awareness about brain research, and is designed to teach middle school students about neuroscience and brain health. The National Institute on Aging (NIA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIDA, and NINDS also participated in the event. For more information, please contact Phyllis Quartey.
NIMH Professional Coalition for Research Progress Annual Meeting
The NIMH Office of Constituency Relations and Public Liaison (OCRPL) convened the fourth annual Professional Coalition for Research Progress Meeting in Washington, DC in April. The Coalition consists of representatives from professional organizations having an interest in NIMH research. The meeting was an opportunity for NIMH to share information about research advances, current and new directions for NIMH, and possible future strategies. Representatives also shared their views on NIMH research. Attendees heard presentations on PTSD, autism, and prodromal schizophrenia. For more information, please contact Alison Bennett.
NIMH Alliance for Research Progress—Winter Meeting
In February, OCRPL convened the Winter Science Meeting of the NIMH Alliance for Research Progress in Bethesda, Maryland. The Alliance is a group of representatives from patient and family-related advocacy organizations directly concerned with mental illnesses. The meeting serves as an opportunity for Alliance members to interact directly with NIMH leadership and provide crucial input and feedback, learn about exciting and new mental health research, discuss important information on changes in the field, and network with colleagues. Speakers presented information on the NAMHC Neurodevelopment Workgroup Report, new mental health treatments, the NIMH strategic plan, and the Research, Condition, and Disease Categorization (RCDC) Project. The meeting summary is posted online. For more information, please contact Alison Bennett.
National Business Group on Health: Business Health Agenda 2008
In March, DSIR and OCRPL held a pre-conference session at the National Business Group on Health’s (NBGH) Business Health Agenda 2008 meeting. The session afforded NBGH members the opportunity to hear about research focused on improving mental health in workplace settings. NIMH staff could also communicate directly with health care payers and organization leaders with an interest in mental health. Richard Nakamura, Acting Scientific Director of the NIMH Intramural Research Program (IRP), discussed NIMH’s commitment to research, and Philip Wang, Director of DSIR, discussed recent research findings on care management for depressed workers. For more information, please contact Alison Bennett.
FY 2008 President’s Budget Request:
On December 26, 2007, the FY 2008 Omnibus appropriations bill was signed. The NIH program level is $29.465 billion, about $328 million more than the FY 2007 Actual. The FY 2008 bill included a 1.7% across-the-board rescission. Non-competing Research Project Grant (RPG) awards will receive a 1.0% inflationary increase in lieu of the full committed level of 3% for all grants and average cost for competing RPGs increases is allowed to 1.0% over FY 2007.
For NIH, an additional $16 million is being invested in the “Pathways to Independence” new investigator program (K99/R00), the same as the FY 2008 President’s Budget. This is in the Research Careers mechanism; NIMH is supporting 10 awards. Within the Research Centers, Other Research, R&D Contracts, non-competing grants receive inflationary increases of 1%, not full committed levels. The FY 2008 Omnibus bill provides $1 million, or $983 thousand post-rescission, for the Interagency Autism Coordinating Committee, which will be managed for NIH by NIMH. The Omnibus appropriations bill provided an NIMH program level of $1,405 million for an increase of $1.906 million or +0.1% over the FY 2007 Actual.
FY 2009 President’s Budget Request:
The FY 2009 NIMH President’s Budget Request became public on February 4, 2008. It can be viewed online (PDF file, 28 pages).
This request would provide a total NIH program level of $29,465 million, which is equal to the FY 2008 enacted appropriation. The FY 2009 request of $1,407 million for NIMH is an increase of $1,365 thousand or + 0.1% over the FY 2008 Omnibus. NIMH actual expenditures by budget mechanism for FY 2007, estimates for FY 2008 Omnibus, and the FY 2009 President’s Budget are displayed on Attachment 1.
The NIH total FY 2009 President’s Budget Request can be viewed online . Components of the overall budget of interest to NIMH include:
- NIH Research Project Grants (RPGs)
The FY 2009 President’s Budget would support an estimated 9,757 competing Research Project Grants (RPGs) at NIH. NIH has made the difficult decision to again eliminate inflationary increases for RPGs. While no inflationary increases are provided for direct, recurring costs in noncompeting RPGs in the FY 2009 President’s Budget, wherever NIH has committed to a programmatic increase in an award, such increases will be provided. The average cost of competing RPGs will remain at the FY 2008 level.
- NIH Support for New Investigators
In FY 2009, the Pathways to Independence program will support approximately 500 awardees at a total of $71 million. In FY 2009, NIH will also support approximately 25 New Innovator Awards, for a total of $56 million in the NIH Common Fund.
- NIH Director’s Bridge Award
The FY 2009 Request level includes $91.2 million to continue the NIH Director’s Bridge Award program, to protect NIH’s investment in well established and meritorious investigators with little of no other significant support.
- NIH Intramural Research Program (IRP)
Funding for the NIH IRP will be increased by $49.992 million or +1.6% from the FY 2008 Enacted Budget.
- Research Management and Support (RMS)
RMS funds support the Headquarters and extramural program support activities of each NIH Institute. Funding for the NIH RMS in FY 2008 will receive an increase of $20.322 million or 1.5% over the FY 2008 Enacted Budget.
- NIH Roadmap for Medical Research
In FY 2009, NIH will direct $534 million towards NIH Roadmap initiatives. This is an increase of $38.269 million or 7.7% over the FY 2008 Enacted Budget.
More direct implications of the FY 2008 for NIMH include:
- At the FY 2009 President’s Budget level, NIMH would support an estimated 2,149 total RPGs compared to an estimated 2,230 total RPGs in FY 2008. Approximately 497 of the 2,149 grants to be funded in FY 2009 will be competing awards, either new or renewal. This compares to an estimated 526 in FY 2008 and 620 in FY 2007.
- The NIMH success rate for RPGs in FY 2008 would be about 16% compared to an NIH average of about 18%.
The NIH House hearing was held March 5, 2008. Testimony for Dr. Elias Zerhouni, NIH Director, is available on-line (PDF file, 14 pages). The NIH Senate hearing scheduled for April 23, 2008 was cancelled and has not yet been rescheduled.
Major Awards for NIMH Grantees
In April 2008, the National Academy of Sciences, a private, non-governmental organization of scientists and engineers, elected to membership the following NIMH grantees:
- Thomas D. Albright, Ph.D.; professor and director, vision center laboratory, Salk Institute for Biological Studies, San Diego
- Steve A. Kay, Ph.D.; Dean and Richard C. Atkinson Chair, division of biological sciences, University of California, San Diego, La Jolla
- Ronald C. Kessler, Ph.D.; professor, department of health care policy, Harvard Medical School, Boston
- Michael B. Oldstone, M.D.; professor and head, viral-immunobiology laboratory, department of immunology and microbial science, Scripps Research Institute, La Jolla
Randy D. Blakely, Ph.D., Allan D. Bass Professor of Pharmacology, Vanderbilt University School of Medicine, was honored twice at the Annual Meeting of the American Society for Pharmacology and Experimental Therapeutics (ASPET) Experimental Biology 2008 Meeting, held on April 5, 2008, in San Diego, California. At the meeting, Dr. Blakely received the ASPET-Astellas Award in Translational Pharmacology in recognition of his discoveries impacting pharmacology and neuroscience, new techniques and approaches he introduced to the field of transporter biology, and his contributions to the knowledge base on regulatory mechanisms that dictate synaptic function and drug action. Dr. Blakely also received the ASPET Julius Axelrod Award in Pharmacology, which recognizes outstanding scientific contributions in research and mentoring. The Julius Axelrod Award in Pharmacology was established to honor the memory of the former NIMH researcher and Nobel Laureate who shaped the fields of neuroscience, drug metabolism and biochemistry. Dr. Blakely has mentored numerous young pharmacologists and neuroscientists throughout his career and has served as Director of both graduate and postdoctoral training programs at Vanderbilt.
Michael Davis, Ph.D., Robert W. Woodruff Professor of Psychiatry and Behavioral Sciences at Emory University School of Medicine, was awarded the Edward M. Scolnick Prize in Neuroscience in February 2008. The award was presented by the McGovern Institute for Brain Research at MIT, which gives the award annually to recognize those individuals who have made outstanding advances in the field of neuroscience. Dr. Davis has made pivotal discoveries on receptors that control learning and extinction of fear in amygdala and on the effects of drug D-cycloserine that have been clinically tested and applied in psychiatric research on fear and anxiety disorders.
Sean Joe, Ph.D., Assistant Professor of Social Work, University of Michigan, received the 2008 Society for Social Work and Research (SSWR) Deborah K. Padgett Early Career Achievement Award. The award recognizes his innovative scholarship, rigorous approach to social work research, and work that exhibits an emerging influence in the field. The award was presented at the Presidential Awards Ceremony in January at the 2008 SSWR conference in Washington, DC.
Beatriz Luna, Ph.D., Associate Professor of Psychiatry and Psychology, Laboratory of Neurocognitive Development, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center was invited in March by NIH Director Dr. Elias Zerhouni to apply to be a candidate in the NIH Director’s Advisory Council.
Major NIMH Staff Awards
Lisa Catapano, M.D., Ph.D., Clinical Fellow, NIMH Mood and Anxiety Disorders Program (MAP), participated in the American Psychiatric Association (APA) Research Colloquium for Junior Investigators at their annual meeting in May. Candidates whose applications are accepted for the colloquium receive guidance and mentorship on their research interests and
Husseini K. Manji, M.D., Chief of the NIMH Laboratory of Molecular Pathophysiology and director of the NIMH MAP, recently received a number of awards and honors, including
- appointment to President, Society of Biological Psychiatry
- Thomas O’Donohue Memorial Lectureship in Neuropharmacology
- Depression and Bipolar Support Alliance Gerald L. Klerman Senior Investigator Award
- appointment to Councilor, American College of Neuropsychopharmacology
Keri Martinowich, Ph.D., Post-Doctoral Fellow in the NIMH Laboratory of Molecular Pathophysiology/MAP was among the 220 recent recipients of NARSAD’s Young Investigator Award in 2008. With these awards, NARSAD—the largest donor-supported organization in the world that supports research on brain and behavior disorders—recognizes promising young scientists conducting neurobiological research.
Daniel Pine, M.D., Chief, Section on Development and Affective Neuroscience and Chief of Emotion and Development Branch in the NIMH MAP, received the Gerald L. Klerman Young Investigator Award. This award is presented annually to honor the young investigator who has made the most important and innovative contributions to improve the lives of people living with mood disorders. Dr. Pine received the award in May at the APA annual meeting, on behalf of the Depression and Bipolar Support Alliance.
Joe Carey joined the Office Science Policy, Planning and Communications (OSPPC) Science Writing, Press and Dissemination Branch as a contractor in January. Before coming to NIMH, he served as the Senior Director of Communications and Public Affairs at the Society for Neuroscience. He has extensive experience in science journalism, communications and public affairs. Mr. Carey has been a writer and editor for several national publications. As a member of OSPPC, he has been involved in numerous activities, including developing eight NIMH research track press events for the May 2008 American Psychiatric Association meeting, helping to create a “brain basics” section on the NIMH Web site, and advising on the development of video clips about various mental health disorders.
Al Golden accepted the position as Director of the Outreach Partnership Program, OCRPL, in January. Prior to coming to NIMH, Mr. Golden served as Public Health Advisor with NIH’s National Heart, Lung, and Blood Institute (NHLBI), where he coordinated the NIH Sleep Disorders Research Advisory Board, managed a portion of the NHLBI sleep research grant portfolio, and represented the Institute on several working groups and committees. Mr. Golden earned his bachelor’s degree from the University of Michigan and a master’s degree in Public Health Policy and Administration from the University of Michigan School of Public Health. He has also worked in leadership positions with local two local health departments, the University of Michigan Alzheimer’s Disease Research Center and the American Public Health Association.
Stephen Lalekos joined the NIMH Budget Office as a Budget Analyst in March 2008. His primary responsibility is the Research Management & Support mechanism in addition to managing gift fund activities. Mr. Lalekos previously held a position at NICHD, and also has prior budget experience with the National Center on Minority Health and Health Disparities and the NIH Office of Financial Management, Government Accounting Branch.
Bettina Osborn, Ph.D., recently joined the extramural program staff in the NIMH Division of Neuroscience and Basic Behavioral Science (DNBBS) as program officer for the “Substrates of Memory and Learning” Program within the Behavioral Science and Integrative Neuroscience Research Branch. Dr. Osborn most recently held a position in the NIMH Division of Extramural Activities (DEA) where she has been a scientific review officer since the summer of 2004. Prior to that, she was a postdoc in Steve Wise’s lab in the NIMH IRP. Dr. Osborn received her doctoral degree from Brown University, where she did her dissertation work with John Donoghue.
Michele Pearson joined the Molecular, Cellular, and Genomic Neuroscience Research Branch, DNBBS, as a contract Program Analyst. She earned her Bachelor of Arts degree with honors from Salisbury University and was the recipient of an Intramural Research Training Award through NIA. Among other duties, Ms. Pearson will be assisting with the administration of model organism and resource sharing efforts supported through the NIH Neuroscience Blueprint and Roadmap efforts.
Stephanne Player accepted her appointment as an Administrative Officer for DEA in April. Ms. Player previously held a position at the National Cancer Institute, Clinical Administrative Resource Center.
Fabrice Simeon, Ph.D., joined the Molecular Imaging Branch in the NIMH MAP in January. Dr. Simeon previously held a position as a Visiting Fellow with the same group since 2003. Before joining NIMH, he was with the Department of Life Sciences of the French Energy Atomic Commission (Cyceron, Caen) as a postdoctoral Chemist Engineer. He received his Bachelor of Science in Organic Chemistry in 1993 and doctoral degree in Synthetic Organic Chemistry in 1998, both from the University of Caen, France.
Janine Simmons, M.D., Ph.D., recently joined DNBBS as program officer for the “Affect, Social Behavior and Social Cognition” Program within the Behavioral Science and Integrative Neuroscience Research Branch. Dr. Simmons is on a detail from the NIMH IRP, where she is a Senior Research Fellow working with Barry Richmond in the Section on Neural Computation and Coding. Janine has an M.D./Ph.D. from UCLA, where she did her dissertation work with Charles Gallistel.
Yong Yao, Ph.D., recently accepted a leadership position in DNBBS over the “High Throughput Screening (HTS) Assay” Roadmap Program that NIMH coordinates on behalf of NIH. Dr. Yao previously worked within NIMH DEA, where he has been a scientific review officer since June 2004, reviewing NIH Molecular Libraries Roadmap and NIMH applications. Prior to that, he was a research faculty in Roger Tsien’s lab at UCSD, and an associate director in a biotechnology company, BD Atto Bioscience. Dr. Yao received his Ph.D. in neuroscience at the University of Bern, Switzerland.
Susan Cahill accepted a position with the FDA in April, after serving in the OSPPC Science Writing, Press and Dissemination Branch for two years.
Editha Nottelmann, Ph.D., Chief of the Affective and Regulatory Disorders Branch in the Division of Developmental Translational Research (DDTR), retired in April after almost 28 years of service to NIMH. Dr. Nottelmann began her NIMH career in the IRP in 1979, conducting longitudinal research on pubertal development, children of depressed mothers, and children’s adjustment to school transitions. She joined the Extramural Research Program in 1991 and has been in charge of the NIMH research portfolio on affective disorders in children and adolescents in one capacity or another since that time. A major contribution has been her leadership and mentoring, specifically in the development of the NIMH research portfolio on bipolar disorder in children and adolescents. A valued colleague to many at NIMH and the field, Dr. Nottelmann received both NIH and NIMH Mentoring Awards in 2006. Shelli Avenevoli, Ph.D., currently Chief of the Emotion, Mood and Depressive Disorders Program and the Mood Regulation and Bipolar Disorder Program within the Branch, has assumed the role of Acting Chief of the Affective and Regulatory Disorders Branch, DDTR.
Transfers and Other NIMH Staff Changes:
Eve Moscicki, Sc.D., M.P.H. accepted appointment as the new NIMH Associate Director for Prevention in April. A member of NIMH staff since 1984, Dr. Moscicki has served the Institute in a variety of positions, most recently as the Acting Chief of the Psychosocial Stress and Related Disorders Branch in DDTR. Her affiliation with NIH began in 1981 when she joined the Public Health Service Epidemiology Program as a post doctoral fellow and also served as a scientist in NINDS. She brings a wealth of experience and expertise to the Associate Director position, serving as Chief of the former Prevention Branch and past Co-Chair for the NIMH Prevention Research Consortium.
Judy Rumsey, Ph.D., transferred in May from DDTR to the Division of Adult Translational Research and Treatment Development (DATR), where she serves as the Associate Director for Translational Research. In her new position, Dr. Rumsey oversees, supports and manages trans-NIMH and trans-NIH activities and initiatives involving translational applications of human/clinicalneuroimaging and will serve as a liaison to other divisions and Institutes. While in DDTR, Dr. Rumsey served as chief of the Executive Function and ADHD (attention deficit hyperactivity disorder) program and the Neurodevelopment and Neuroimaging Program. Her accomplishments include establishing the NIH Pediatric MRI (magnetic resonance imaging) Data Repository, a freely-shared resource of longitudinal MRI, magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), and correlated clinical/behavioral data from healthy children from newborn to young adult.
Rob Willcoxon has agreed to serve on detail as the NIMH’s Deputy Executive Officer (DEO), until the position is filled on a permanent basis. He joined NIMH in 2001 as a Management Analyst, and during the past seven years has taken the lead for the Institute in a variety of critical areas, such as A-76 competitions and the implementation of the Performance Management Appraisal Program (PMAP). During Mr. Willcoxon’s time as DEO, Ms. Dominica Roth will serve asActing Chief, Management Analysis and Services Branch.
National Institutes of Health
FY 2009 President's Budget
(Dollars in Thousands)
Attachment 1 - Table 1 of 3
|FY 2007 Actual (Budget Authority)|
|Coop. Clin. Res||0||500||5||5,728||5||6,228|
|Res. Mgmt. & Supp||223||58,414||15||7,611||238||66,025|
|% Over Prior Year||0.4%||-2.2%||0.0%|
Attachment 1 - Table 2 of 3
|FY 2008 Estimate|
|Coop. Clin. Res||0||490||5||3,920||5||4,410|
|Res. Mgmt. & Supp||223||60,273||1/||15||7,725||238||67,998|
|% Over Prior Year||0.1%||0.3%||0.1%|
1/ Includes $983 for Interagency Autism Coordinating Committee.
Attachment 1 - Table 3 of 3
|FY 2009 President's Budget|
|Coop. Clin. Res||0||490||5||3,920||5||4,410|
|Res. Mgmt. & Supp||227||61,177||15||7,841||242||69,018|
|% Over Prior Year||0.1%||0.0%||0.1%|
National Institutes of Health
FY 2009 President's Budget Request
(Dollars in Thousands)
Attachment 2 - Table 1 of 2
1/ 2/ 3/ 4/ 5/
|Type 1 Diabetes||(150,000)||(150,000)||(150,000)|
Total, NIH Discr. BA
|Type 1 Diabetes 7/||150,000||150,000||150,000|
Total, NIH B.A.
|NLM Prog. Eval||8,200||8,200||8,200|
1/ Includes funds to be transferred to the Global Fund for HIV/AIDS, Malaria, & Tuberculosis (FY 2007 - $99,000,000; FY 2008 - $294,759,000; and FY 2009 - $300,000,000).
2/ Comparable for ASAMH and ASPA transfer - $62,000.
3/ Comparable for DBEPS program transfer to NIBIB (FY 2007 $1,528,000).
4/ Comparable for CIO transfer to OD (FY 2007 $669,000).
5/ Comparable for K-30 transfer NCRR ($10,613,000).
6/ Includes funds for Type 1 Diabeties Initiative supported with mandatory funds.
7/ Comparable for transfer of Advanced Development Fund to ASsPR (-$49,500,000).
8/ Comparable for transfer to DHHS for PHS Historian ($480,000).
9/ OD comparable (-49,500,000) to ASPR for Advanded Development Fund.
10/ Includes recession of $520,929,000.
11/ Includes IC transfer to NIDDK from NHLBI ($816,000) and from NLM to NIDCR from NLM ($455,000).
12/ Transfer from DHHS of $983,000.
Source: NIH CJ overview
Attachment 2 - Table 2 of 2
|FY 2009 > FY2008|
|$ Incr.||% Incr.|
|Type 1 Diabetes||0||0.0%|
Total, NIH Discr. BA
|Type 1 Diabetes 7/||0||0.0%|
Total, NIH B.A.
|NLM Prog. Eval||0||0.0%|