NIH Funded Special Supplements

NIH and NIGMS offer Administrative Supplements that provide additional funding to a currently funded grant within the scope of another project area. Currently DE-INBRE has four active administrative supplements.

Learn more about these supplements here or click on their project number to see the NIH Reporter Listing:

Feasibility and Acceptance of Early Ambulatory Blood Pressure Monitoring (ABPM) for Enhanced Pediatric Hypertension Diagnosis within a High Deprivation Community

Investigator(s): Carissa Baker-Smith, MD MPH FAHA FACC FAAP and Erica Sood, PhD
Project Number: 3P20GM103446-23S1

Summary: This proposal investigates a novel approach to hypertension (HTN) diagnosis in youth. We investigate the feasibility of ambulatory blood pressure monitoring (ABPM) device placement at an initial outpatient pediatrician visit for expediated diagnosis of HTN in youth living within socially and economically deprived communities. We assess the feasibility of ABPM device placement and provider, parent, and patient acceptance of ABPM at this initial visit. We will use 20 INBRE already purchased ABPM devices. ABPM device placement will occur within a single pediatric practice. The pediatric practice is located within a high socially and economically deprived community in Wilmington, Delaware. The ABPM will be offered at an initial outpatient pediatric visit in youth 10 to 18 years of age, when initial manual BP measured is above threshold (e.g., systolic blood pressure > 130mmHg and/or diastolic blood pressure > 80mmHg). Currently, HTN diagnosis in youth is fraught with the challenges of underdiagnosis, compounded by time-consuming algorithms that require multiple visits. We address a significant clinical need encompassing timely diagnosis and prompt clinical intervention for adolescents with HTN. The supplement also employs a mixed-methods approach and applies qualitative interview to assess provider, patient and parent response to this modified diagnostic strategy. The proposal is a supplement to 1 actively funded INBRE proposal and 1 actively funded COBRE. In accordance with the goals of this supplement, an undergraduate student will be trained in research design, ABPM placement and reporting, guideline recommendations for HTN diagnosis in youth, responsible conduct of research, data entry, qualitative interview, data analysis and presentation of findings. The supplement is the joint effort of 2 experienced INBRE and COBRE funded investigators, Dr. Carissa Baker-Smith (pediatric cardiologist, director of Pediatric Preventive Cardiology) and Dr. Erica Sood (psychologist). This project will lay the groundwork for future dissemination and implementation of a clinical decision support tool combined with earlier placement of ABPM device to improve HTN diagnosis. Earlier introduction of hypertensive disease attenuating intervention strategies in youth is possible if diagnosis is made earlier.

Acquisition of a CytoFLEX LX Flow Cytometer to characterize extracellular vesicle (EV)
formation and multiparametric flow cytometry assays

Investigator(s): Arit Ghosh, University of Delaware
Project Number: 3P20GM103446-23S2

Summary: The aim of this project is to acquire a Beckman CytoFLEX LX flow cytometer for small particle and multicolor flow cytometry. The University of Delaware Flow Cytometry Core has two fluorescence-activated cell sorters (BD FACS Aria Fusions), but does not have a dedicated, modern analytical flow cytometer for multicolor flow cytometry panels and small particle (~80 nm) analyses. The existing BD FACS Aria Fusion can resolve only up to ~300-1000 nm particles, a range that does not achieve the lower limits of small particle and EV biology. Acquiring an instrument with FSC detectors specializing in small particle detection will make it possible to use flow cytometry to study the rapidly growing field of research on extracellular vesicles (EV) and exosomes. It will open up new avenues of research for UDEL investigators studying EV release in human and mouse bone marrow cells, pancreatic cancer cells, bacteria, fungi as well as other small particles, such as virus-like particles and nanoparticles for drug delivery. With a complement of 4 active lasers (and detectors) similar to the current Aria Fusions at the core labs, existing users can efficiently transition to the CytoFLEX LX for dedicated analysis purposes. Additionally, new and existing users will also benefit from the CytoFLEX LX’s highly sensitive avalanche photodiode (APDs) technology which provide a greater sensitivity and better resolution of signal-to- noise ratios compared to existing PMT technology inherent to other flow cytometers. Furthermore, it will greatly expand the UD flow cytometry core’s capabilities to conduct multiparametric single cell analyses with multicolor flow cytometry panels to reveal clinical and translationally relevant findings.

Detecting Epigenetic Signatures to Prevent Avoidable Racial Inequities in TNBC (DESPARIT)

Investigator(s): Scott Siegel, PhD, MHCDS and Jennifer Sims-Mourtada PhD
Project Number: 3P20GM103446-23S3

Summary: Breast cancer is the most common cancer and second leading cause of cancer mortality for women overall. Black women experience 40% higher breast cancer mortality rates than White women despite similar incidence rates. More than half of this racial disparity is attributable to triple negative breast cancer (TNBC), an aggressive subtype of invasive breast cancer that is twice as prevalent among Black vs. White women. TNBC is also more common among young women, often presenting before screening mammography is first recommended There is therefore a critical need to identify young women at risk for TNBC for earlier referral to screening and other prevention interventions. Several TNBC risk factors have been identified (e.g., limited breastfeeding, obesity, alcohol use), which are more prevalent in Black relative to White women and help to explain racial disparities in TNBC incidence. However, prior attempts to develop risk prediction models based on these risk factors have not succeeded. Thus, novel approaches for the identification of young women at risk for TNBC are necessary to close racial disparities in breast cancer mortality. Promising new evidence suggests that epigenetic biomarkers can overcome the limitations of traditional risk factor approaches and be used to personalize breast cancer prevention. Epigenetic-mediated changes in inflammatory processes as a result exposure to TNBC risk factors may contribute to TNBC pathogenesis. The identification of an epigenetic-based susceptibility/risk biomarker could be utilized in primary care settings to inform the recommendation to initiate screening mammography earlier and target modifiable risk factors among women at elevated risk for TNBC. To capitalize on this opportunity, the overall objective of this proposal is to develop the infrastructure to conduct this type of biomedical research in Delaware, an IDeA state that leads the US in both TNBC and alcohol-attributable breast cancer. We aim to develop a new prospective cohort to conduct comprehensive assessments of exposures for established and emerging TNBC risk factors in tandem with epigenetic immune patterns from a representative sample of breast cancer patients. We hypothesize that the cumulative exposure to reproductive, metabolic, alcohol, and environmental risk factors induces a distinct epigenetic immune signature. The long-term impact of this research includes reducing the burden of breast cancer for all women and closing racial disparities in breast cancer mortality.

Effects of child, family, and community-level factors on health behaviors and developmental outcomes of children with neurodevelopmental disabilities

Investigator(s): Anjana Bhat, PT, PhD, Carissa Baker-Smith, MD MPH FAHA FACC FAAP, Shannon Robson, PhD, Freda Patterson PhD, and Zugui Zhang, PhD
Project Number: 3P20GM103446-23S4

Summary: Abstract Children with neurodevelopmental disabilities (NDD) face many individual (diagnosis-specific, demographic), parent/family-related, and community-level barriers that affect their ability to optimize their health behaviors (being physically active, eating healthy, sleeping appropriately) and developmental outcomes (motor/participation, social, behavioral, cognitive/academic performance). Children with NDD are at a greater risk for poor developmental outcomes, physical inactivity, and reduced school and community-based recreational participation compared to their neurotypical (NT) peers. These challenges faced by children with NDD lead to higher rates of overweight/obesity and social isolation and in turn affect their long-term physical health (cardiovascular disease, diabetes, shorter life expectancy), psychological health (i.e., anxiety, depression, behavioral problems), and future development. Identifying and addressing the various complex, multi-level factors affecting health behaviors and developmental outcomes of children with NDD will eventually improve their overall physical/mental well-being, quality of life, as well as life expectancy. To ask these complex questions, we propose a multi/inter-disciplinary team including a physical therapist (Bhat, PL), dietitian (Robson, Co-PL), epidemiologist (Patterson, Co-PL), cardiologist (Baker-Smith, Co-PL), and data scientists (Zhang, Brewer, Co- Is) who will work together to examine the National Survey of Children’s Health (NSCH), a large national, open- source database. We will compare cross-sectional data collected across 6 timepoints from years 2016-2021 to understand differences in children’s health and development before versus during the pandemic. We will also pool data across all timepoints (N=50K-90K per year, ~94K total sample in 2021) to report patterns of children’s health behaviors, development, and factors influencing them. NSCH tracks parent-reported behaviors of neurotypical children (~70% sample, N~67,000 in 2021) along with children with various neurodevelopmental disabilities (NDD, ~30% sample, N~27,000 in 2021) such as Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorders (ADHD), Anxiety, Learning Disability (LD), Speech Delay (SD), Intellectual Disability (ID), Down Syndrome (DS), Developmental Delay (DD), Seizures, and Behavioral/Mood Problems (BP). The majority of the current literature is focused on the 2016-2017 NSCH sample. So far, no one has compared the changing trends in health and development in children with NDD using the NSCH dataset. Few studies have used a holistic perspective including complex, multi-level factors to evaluate health and developmental outcomes. We will use statistical / data science approaches (e.g., machine learning) to characterize subgroups based on various factors and identify the key and proximal factors to make recommendations for generalized and tailored interventions targeting the needs of children with NDD. In the future, we will build on this work through a RM1 / multi-PI R01 team science application to conduct a more in-depth study using objective measures obtained from large-scale cohorts to inform holistic interventions (lifestyle changes, community resources, etc.) for children with NDD.