Vitamin D deficiency and the severity of bronchiolitis

求职者：乔纳森·曼斯巴赫，医学博士，波士顿儿童医院哈佛医学院儿科讲师。他监督一家住院儿科服务机构，并与他的导师卡洛斯·A·卡马戈医学博士合作进行毛细支气管炎研究。作为协作者，他们最近完成了两项以急诊科(ED)为基础的毛细支气管炎研究：1)37个地点的队列研究，收集了2847名儿童的数据；2)14个地点的病毒学研究，收集了277名儿童的数据。他还发表了关于毛细支气管炎的卫生服务研究。最后，他是U01 AI67693(卡马戈，PI)的联合调查员，这是一项对2,250名2岁毛细支气管炎住院患者进行的15个地点的研究。此K23应用程序将直接基于此U01项目构建。培训：为了实现他的职业目标：1)成为毛细支气管炎研究的全国领导者；2)了解维生素D缺乏与毛细支气管炎严重程度之间的联系；3)成为一名独立的以患者为中心的研究人员，Mansbach博士需要更多的流行病学、生物统计学、维生素D/营养和传染病方面的培训。因此，他建议在哈佛公共卫生学院攻读所有这些领域的硕士课程。他还将参加领导力发展和研究道德行为方面的课程。科学：我们的研究表明，维生素D缺乏与出生后前三个月呼吸道感染增加和儿童喘息风险增加有关。这项K23应用的科学部分侧重于婴儿维生素D缺乏与毛细支气管炎严重程度之间的联系。Mansbach博士建议对出现在CHB的毛细支气管炎儿童进行一项研究，以检查维生素D缺乏是否与以下因素有关：1)儿童需要的护理水平--急诊室送回家、病房入院或重症监护病房入院；2)呼吸道合胞病毒的病毒载量；以及3)咳嗽持续时间和住院时间。使用来自U01的75名住院患者和150名新登记的ED患者参加这个K23项目，我们将有80%的能力来检测每个假设的合理优势比、效果大小和风险比。摘要：一个由经验丰富的导师和顾问组成的多学科团队致力于帮助曼斯巴赫博士实现这项K23申请的个人和科学目标。这项提案的科学部分的结果可能会提供数据，将改变儿童的护理并直接导致R01申请。

DESCRIPTION (provided by applicant): Candidate: Jonathan Mansbach, MD is an Instructor in Pediatrics at Harvard Medical School at Children's Hospital Boston (CHB). He supervises an inpatient pediatric service and works with his mentor, Carlos A. Camargo, MD, DrPH, conducting bronchiolitis research. As Co-PIs, they recently completed two Emergency Department (ED)-based bronchiolitis studies: 1) a 37-site cohort study with data collection on 2,847 children, and 2) a 14-site virology study with data collection on 277 children. He also has published health services research on bronchiolitis. Finally, he is a Co-Investigator on U01 AI67693 (Camargo, PI), a 15-site study of 2,250 inpatients age <2 years with bronchiolitis. This K23 application will build directly on this U01 project. Training: In order to meet his career goals of: 1) becoming a national leader of bronchiolitis research; 2) understanding the association between vitamin D deficiency and severity of bronchiolits; and 3) becoming an independent patient-oriented investigator, Dr Mansbach requires more training in epidemiology, biostatistics, vitamin D /nutrition, and infectious disease. Therefore, he proposes to take masters-level courses at the Harvard School of Public Health in all of these areas. He also will take classes in leadership development and the ethical conduct of research. Science: Our research has shown that vitamin D deficiency is associated with increased respiratory infections in the first 3 months of life and increased risk of childhood wheezing. The scientific portion of this K23 application focuses on the association between vitamin D deficiency in infancy and the severity of bronchiolitis. Dr Mansbach proposes to conduct a study of children with bronchiolitis presenting to CHB to examine if vitamin D deficiency is associated with: 1) the level of care a child requires - sent home from the ED, ward admission, or intensive care unit admission; 2) the viral load of respiratory syncytial virus; and 3) the duration of cough and hospital length of stay. Using 75 hospitalized patients from the U01, and 150 newly-enrolled ED patients for this K23 project, we will have 80% power to detect reasonable odds ratios, effect sizes, and hazard ratios for each of the hypotheses. Summary: A multidisciplinary team of experienced mentors and consultants have committed to help Dr Mansbach fulfill the personal and scientific goals of this K23 application. The results from the scientific portion of this proposal may provide data that will change the care of children and directly lead to R01 applications.