Patient Oriented Research Program in ALI/ARF

急性肺损伤（ALI）是一种严重的肺损伤，在美国每年影响20万人。急性呼吸衰竭（ARF）是一种更为常见的肺功能障碍类型，其特征是氧合和通气的严重改变。虽然这些危重患者的护理已经取得了进展，但进一步培养对ALI/ARF感兴趣的以患者为导向的研究人员将是必要的，以显着改善这些患者的结局。指导是迄今为止最重要的和充实的组成部分，我目前的学术地位。我完全致力于指导，天生喜欢与我的学员共同发展成功的愿景，并感谢有机会改变他们的生活和职业生涯。在我目前的K24的支持下，我已经担任了16名初级或中级研究人员的主要导师或共同导师，他们进行了以ALI/ARF患者为导向的研究。其中88%（14/16）的学生继续留在医学院校。在不到四年的时间里，这些受训人员获得了4笔超过500万美元的新赠款，另有4笔国家卫生研究院赠款正在审查或准备重新提交。他们还撰写了24篇研究文章，9篇评论文章/社论，5篇目前正在提交的研究文章，以及29篇ATS摘要，我是资深作者或合著者。尽管我们的生产力，几个新的计划提出了在这个竞争性的更新，将进一步加强我的职业发展和培训，我们所有的现在和未来的学员。随着我们全市研究网络的建立，我们有能力进行比较有效性研究（CER）研究。为了正确领导这些工作，我需要提高我在CER研究方面的技能。我们越来越多的中级调查员将需要在指导和领导技能方面进行高级培训，以便为他们成为下一代ALI/ARF导师做好准备。此外，我将为我们较初级的调查人员创造新的培训机会，并努力吸引来自其他多学科领域的受训人员。在这次更新中，我们还提出了两项研究，这将导致我们的ALI/ARF患者的护理改善。第一项研究将建立在我们对ALI/ARF患者外周神经肌肉功能障碍的现有兴趣的基础上，并确定简单床边技术在诊断吞咽功能障碍中的实用性，吞咽功能障碍在我们的患者中很常见且使人衰弱。在第二个翻译研究中，我们将继续探索酒精改变发展ALI的易感性的机制，并确定酒精滥用是否通过氧化剂依赖性RhoA激活改变ALI消退期凋亡炎症细胞的清除。在这次竞争性续约的支持下，我将能够继续发展我们的研究计划，并最终成为美国首屈一指的ALI/ARF研究小组之一。

Acute lung injury (ALI) is a severe form of pulmonary impairment affecting 200,000 people annually in the United States. Acute respiratory failure (ARF) is an even more common type of pulmonary dysfunction characterized by profound alterations in oxygenation and ventilation. Though advances in the care of these critically ill patients have occurred, further cultivation of patient-oriented investigators with an interest in ALI/ARF will be necessary to generate significant improvements in the outcomes of these patients. Mentoring is by far the most important and fulfilling component of my current academic position. I am completely committed to mentoring, inherently enjoy developing mutual visions of success with my trainees, and appreciate the opportunity to make a difference in their lives and careers. With the support of my present K24, I have already served as the primary mentor or co-mentor for 16 junior or mid-level investigators performing ALI/ARF patient-oriented research. A total of 88% (14/16) of them remain in academic medicine. In less than four years, these trainees have received 4 new grants in excess of $5,000,000 and have 4 more NIH grants under review or ready for resubmission. They have also authored 24 research articles, 9 review articles/editorials, 5 research articles presently under submission, and 29 ATS abstracts on which I am the senior or a co-author. Despite our productivity, several new programs are proposed in this competitive renewal that will further enhance my career development and the training for all of our present and future trainees. With the creation of our city-wide research network, we are well positioned to perform comparative effectiveness research (CER) studies. In order to properly lead these efforts, I will need to boost my skills in CER research. Our increasing number of mid-level investigators will require advanced training in mentoring and leadership skills in order to prepare them to become the next generation of ALI/ARF mentors. In addition, I will create new training opportunities for our more junior investigators and work to attract trainees from other multidisciplinary fields. In this renewal, we also propose two research studies that will lead to improvements in the care of our ALI/ARF patients. The first study will build upon our existing interest in peripheral neuromuscular dysfunction in ALI/ARF patients and determine the utility of simple bedside techniques for the diagnosis of swallowing dysfunction that is common and debilitating in our patients. In the second translational study, we will continue to explore the mechanisms by which alcohol alters the susceptibility to develop ALI and determine whether alcohol abuse alters the clearance of apoptotic inflammatory cells during the resolution phase of ALI through oxidant-dependent RhoA activation. With the support of this competitive renewal, I will be able to continue to develop our research program and ultimately establish ourselves as one of the premier ALI/ARF research groups in the United States.