NIH

Rock Talk, a National Institutes of Health (NIH) blog on extramural research policy, debuted two years ago as a way to enhance transparency about how the federal agency develops policies and present data that influence such decisions.

In a commentary published yesterday in Nature, Sally Rockey, PhD, deputy director for extramural research at the NIH, discusses her motivation for launching the blog and how it has increased dialogue with constituents about science policy. She writes:

We learned a lot about our constituents’ interests and needs through the blog, and we have been able to highlight behind-the-scenes data, actively engage the community in policy-making and provide insight into our decisions. Without public input, effective and impactful policy cannot be created. My blogging experience has convinced me that using social-media platforms is one effective way for science-funding agencies to successfully support research.

The blog is not the official vehicle for communicating policy changes. We have the NIH Guide for Grants and Contracts for that. And we have official channels for soliciting public feedback — through requests for information in the NIH Guide, for example. But the blog allows me to extend that conversation to people worldwide, many of whom I would not be able to reach in other ways. People are sometimes concerned that offering a dissenting opinion to NIH officials might affect their chances of getting funding. Although that is absolutely not the case, one advantage the blog does have over some other channels is that it allows people to remain anonymous if they wish.

In addition to fostering conversations on policy, Rockey offers examples of how the blog has allowed her team to provide real-time updates during national emergencies, such as Hurricane Sandy, and debunk urban myths about NIH-supported research.

Previously: Veteran blogger offers tips for starting a science blog

This kaleidoscope-esque video depicts the immune response in the lymph node of a mouse. Titled “Sensing Danger,” the clip won first place in this year’s Small World in Motion Photomicrography Competition by Nikon Instruments. It was produced in the Laboratory of Immunoregulation at the National Institute of Allergy and Infectious Disease.

From the Nikon release:

This video is representative of efficient innate immune reaction in the lymph node, which typically has been studied for the development of adaptive immune response.

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The inguinal lymph node was imaged using a two-photon microscope equipped with an L25.0 x 0.95 water immersion objective. Together, this allowed for the visualization of actual events occurring in challenged lymphatic tissue.

Second place was awarded to a video capturing sperm from two males competing within reproductive tract of a female fruit fly. Footage of a metanephric kidney, cultured in vitro and imaged over four days took third place.

Previously: Video of killer T cell of the immune system battling a cancer cell and Tiny wonders: Small World in Motion competition winners bring microscopic activity to life
Via Medgadget

Many of us, myself included, turn to yoga, meditation, tai chi or other mind body practices to reduce stress and relieve anxiety. While past studies provide insights into how these approaches can put us at ease, researchers are still working to understand exactly how such psychosocial interventions can lessen the adverse effects stress on our physical and mental health.

Tomorrow, the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health is hosting a Twitter chat on managing holiday stress and what recent research says about the safety and effectiveness of mind body practices for de-stressing. The chat will be held at 12:30 PM Pacific Time. To join participate in the discussion, use the hashtag #nccamchat or follow @NCCAM. Joining the conversation will be NCCAM program officer John Glowa, PhD, who oversees the center’s behavioral health research portfolio, and Daniel Pine, MD, from the  National Institute of Mental Health.

On a related note, the latest Ask Stanford Med Q&A features David Spiegel, MD, director of the Stanford Center for Stress and Health and medical director of the Stanford Center for Integrative Medicine, responding to questions about managing seasonal stress and depression. In the piece, Spiegel discusses the scientific evidence relating to the use of natural remedies, including fish oil and St. John’s wort, in treating holiday stress and depression.

Previously: Ask Stanford Med: David Spiegel answers your questions on holiday stress and depression, Report highlights how integrative medicine is used in the U.S., More hospitals offering complementary medicine and Meditate and call me in the morning: Study looks at doctors’ referrals for mind-body therapies
Photo by Toby Gray

Stanford researcher John Ioannidis, MD, DSci, who is well-known for his critiques of much current scientific methodology, has now turned his sights on the National Institutes of Health. He and a colleague, Joshua Nicholson from Virginia Tech, have published an analysis (subscription required)  in today’s Nature questioning the way the organization funds research proposals.

Ionannidis and Nicholson argue that the peer-review process, in which groups called study sections review and rank research applications submitted by their colleagues, is inherently flawed and encourages “conformity, if not mediocrity.”

The result? Only 40 percent of scientists with highly cited papers are listed as the principal investigators on NIH grants. That is, those scientists whose peers value their insights and research most highly in their field are often not receiving federal support for that work.

The article is a pretty rousing condemnation of the status quo. Ioannidis, who is the chief of the Stanford Prevention Research Center, elaborated to me:

Our analysis shows with large-scale evidence that the system is totally broken. The majority of the US authors of the most influential papers in medicine and life sciences in the last decade do not have NIH funding; their funding rate may even be less than the rate of the average applicant. Conversely, study section members are almost always funded (a corollary of their selection process by NIH), but their citation impact is typically modest, nothing exceptional. High-impact innovators and funded study section members are almost completely mutually exclusive groups.

Ioannidis went on to note that the average age of a researcher receiving his or her first independent funding award from the NIH is 44 years (47 for MDs):

An out-of-the-box innovator who waits patiently and complies with orthodoxy until age 47 before becoming independent represents an oxymoron. A truly innovative idea cannot be judged by peers: if it is truly innovative, no peer has any clue about it; if peers already know about it, it is not innovative.

Although the NIH has tried to address concerns about a lack of support for new ideas with specific award categories such as the Pioneer and New Innovator Awards, Ioannidis called the outcome of such efforts “a drop in the bucket:”

We believe that NIH should fund some exceptional scientists based on the objectively measurable citation impact of their previous work. Peer review is the way it is applied now encourages conformity and mediocrity and favors people who know how to network and play the petty games of academia, not those who have brilliant ideas.

Previously: Research shows small studies may overestimate the effects of many medical interventions, Animal studies: necessary, but often flawed, says Stanford’s Ioannidis and Outing bias in scientific research
Photo by videocrab

Updated 11-28-12: As Nature’s Meredith Wadman writes today, the NIH has decided not to change its resubmission policy.

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10-16-12: In case you didn’t see it yesterday, Nature News Blog is reporting on a possible NIH policy change involving how many times rejected grant applicants can re-submit proposals. Meredith Wadman writes:

Senior leaders at the $31 billion biomedical agency in Bethesda, Maryland will decide in the next several weeks whether to abandon a “two strikes and you’re out” policy that was instituted in January 2009 as part of an extensive overhaul of peer review at the agency. Before then, grant-seekers had been allowed a third try after a proposal twice failed to pass muster with peer reviewers.

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The NIH’s rationale for the 2009 change was that the three-strikes-and-you’re out rule was causing peer reviewers, either consciously or sub-consciously, to favor second and third submissions over first-time proposals, creating, in effect, a queue similar to airplanes circling an airport waiting for a free runway to allow them to land. “Support for meritorious science may be delayed if initial submissions are placed at the end of the queue,” the expert group that reviewed peer review for NIH concluded in a draft report in 2008 that showed the success rates for first-time applications falling from over 60% in 1998 to 30% in 2007. (See page 33 of the report for the graph plotting these numbers.)

However, the change generated tremendous pushback from scientists, who have complained of it nearly incessantly to NIH’s Office of Extramural Research…

Approximately one in ten adults in the United States experience some symptoms of depression, according to the latest data from the Centers for Disease Control and Prevention. Over the years, complementary interventions have been gaining in popularity among Americans, and a report published earlier this year showed that depression was among the top health conditions for which such treatments appeared to be most effective.

On Friday, the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health will host a Twitter chat to discuss the safety and effectiveness of these and other complementary health treatments for depression. The chat will be held at 10 AM Pacific time. To join the conversation, use the hashtag #nccamchat or follow @NCCAM.

Participants will be able to ask questions about the use and potential negative effects of various medicines and practices, as well as general questions about depression and its treatment. Joining the conversation will be NCCAM expert Wendy J. Weber, PhD, and Matthew Rudorfer, MD, from the National Institute of Mental Health.

As a friendly reminder, David Spiegel, MD, director of the Stanford Center for Stress and Health and medical director of the Stanford Center for Integrative Medicine, is currently taking questions about managing holiday stress and depression as part of our Ask Stanford Med series. Questions can be submitted to Spiegel by either sending a tweet that includes the hashtag #AskSUMed or posting a question in the comments section of this entry.

Previously: Report highlights how integrative medicine is used in the U.S., More hospitals offering complementary medicine and Meditate and call me in the morning: Study looks at doctors’ referrals for mind-body therapies

Here’s a little motivation to not skip your fitness routine today: New research shows that people who regularly exercise, even in modest amounts, live longer regardless of whether they’re overweight.

In the study, researchers examined how leisure-time physical activities in adulthood contributed to increased life expectancy. The analysis included six population-based studies involving 650,000 people age 40 or older. According to a release from the National Institutes of Health:

After accounting for other factors that could affect life expectancy, the researchers found that life expectancy was 3.4 years longer for people who reported they got the recommend level of physical activity. People who reported leisure-time physical activity at twice the recommended level gained 4.2 years of life. In general, more physical activity corresponded to longer life expectancy.

The researchers even saw benefit at low levels of activity. For example, people who said they got half of the recommended amount of physical activity still added 1.8 years to their life.

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The researchers also examined how life expectancy changed with the combination of both activity and obesity. Obesity was associated with a shorter life expectancy, but physical activity helped to mitigate some of the harm. People who were obese and inactive had a life expectancy that was between five to seven years shorter (depending on their level of obesity) than people who were normal weight and moderately active.

Previously: Examining exercise and cancer survivorship, Exercise may boost heart failure patients’ mental and physical health, Study shows short, daily jogs boost longevity and How physical activity influences health
Photo by Don DeBold

Today, the National Institutes of Health released four new videos spotlighting noteworthy research that demonstrates behavior’s role in personal health. Topics of the short films include mindless eating, risk-taking, diabetes management and the evolution of skin pigmentation.

In the above video, Carl Lejuez, PhD, director for the Center for Addictions, Personality, and Emotion Research at the University of Maryland, discusses how a person’s impulsive tendencies, toleration of stress and willnessness to take risks are key to understanding substance use and developing successful treatments.

Previously: To reduce use, educate teens on the risks of marijuana and prescription drugs, Examining how addiction in the U.S. has changed over the last decade, A discussion of the history and effectiveness of Alcoholics Anonymous and Better than the real thing: How drugs hot wire our brains’ reward circuitry

Drug-induced liver injury is the leading cause of acute liver failure in the United States, accounting for at least half of cases. The National Institutes of Health (NIH) recently launched a new online resource to advance health-care professionals and researchers’ understanding of how prescription and over-the-counter medications can harm the liver and spur development of new methods for reducing rates of drug-induced liver injury.

The database, called LiverTox, is a searchable catalog of roughly 700 medications available by prescription or over the counter in the United States. The NIH plans to add another 300 medications during the next few years. According to an NIH release, database features include:

• An overview of drug-induced liver injury, including diagnostic criteria, the role of liver biopsy, descriptions of different clinical patterns and standard definitions
• A detailed report of each drug, including background, case study, product package insert, chemical makeup and structure, dose recommendations and references with links
• An interactive section, allowing users to report cases of drug-induced liver injury to the LiverTox website. Reports will be automatically forwarded to the Food and Drug Administration’s (FDA) MedWatch program. MedWatch allows the public and health care professionals to report adverse events, product defects, or product use errors. The FDA uses the information to monitor product safety.

LiverTox creators hope the resource will help physicians better diagnose drug-induced liver injury and boost research on the topic. Jay Hoofnagle, MD, director of the Liver Disease Research Branch at NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, commented in the release:

Because drug-induced liver disease is not a single, common disease, it is very difficult to diagnose, with each drug causing a somewhat different pattern of liver damage … Doctors have to rule out all other causes of liver disease before saying that a patient has drug-induced injury liver … By integrating data that tends to be scattered across the published literature into a single, readily accessible place, we hope to bring greater focus and interest to the study of drug-induced liver injury, and to guide doctors involved with patient care and ultimately, reduce liver injury and improve the health of people.

Previously: The importance of including risk information in ads for over-the-counter medications, Report shows over 60 percent of Americans don’t follow doctors’ orders in taking prescription meds and Older adults increasingly turning to complementary medicine
Photo by Michelle Tribe

An estimated 12 percent of children use some form of complementary medicine, such as herbs and dietary supplements, massage or acupuncture, according to the latest data from the National Center for Complementary and Alternative Medicine (NCCAM). But few large studies have been completed on the safety of such therapies in children, leaving some people with questions about the potential benefits or harm of the practices.

In an effort to provide answers to the questions of parents, practitioners and others, NCCAM is hosting a Twitter chat tomorrow at 10 a.m. Pacific time. To join the conversation, use the hashtag #nccamchat or follow @NCCAM.

During the chat, Twitter users will have an opportunity to ask questions about the use and safety of complementary health approaches in children. Lawrence Rosen, MD, a founding member and chair of the American Academy of Pediatrics Section on Integrative Medicine, and NCCAM expert Wendy J. Weber, PhD, will participate in the conversation.

Previously: Study shows meditation may lower teens’ risk of developing heart disease, New NIH series offers consumer-friendly tips on complementary health practices and Report highlights how integrative medicine is used in the U.S.
Photo by Wellcome Trust