Vitamin D deficiency and the severity of bronchiolitis

描述（由申请人提供）：候选人：Jonathan Mansbach，医学博士，哈佛医学院波士顿儿童医院（CHB）儿科讲师。他监督儿科住院服务，并与他的导师Carlos A. Camargo， MD， DrPH一起进行细支气管炎研究。作为联合pi，他们最近完成了两项以急诊科（ED）为基础的细支气管炎研究：1)一项37点队列研究，收集了2,847名儿童的数据；2)一项14点病毒学研究，收集了277名儿童的数据。他还发表了关于细支气管炎的卫生服务研究。最后，他是U01 AI67693 （Camargo， PI）的共同研究者，这是一项对2250名年龄<2岁的毛细支气管炎住院患者进行的15点研究。这个K23应用程序将直接构建在这个U01项目上。培训：为了实现他的职业目标：1)成为全国毛细支气管炎研究的领导者；2)了解维生素D缺乏与细支严重程度之间的关系；3)成为一名独立的以病人为中心的研究者，曼斯巴赫博士需要在流行病学、生物统计学、维生素D /营养学和传染病方面接受更多的培训。因此，他建议在哈佛大学公共卫生学院学习所有这些领域的硕士课程。他还将参加领导力发展和研究伦理行为方面的课程。科学：我们的研究表明，维生素D缺乏与出生后3个月内呼吸道感染的增加和儿童喘息的风险增加有关。本K23应用的科学部分侧重于婴儿期维生素D缺乏与毛细支气管炎严重程度之间的关系。Mansbach博士建议对表现为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——从急诊科送回家、病房入住或重症监护病房入住；2)呼吸道合胞病毒载量；3)咳嗽持续时间和住院时间。使用U01的75名住院患者和K23项目的150名新入组的ED患者，我们将有80%的能力为每个假设检测合理的优势比、效应大小和风险比。总结：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Mansbach博士实现这个K23应用程序的个人和科学目标。该提案的科学部分的结果可能会提供数据，将改变儿童的照顾，并直接导致R01应用。

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.