The aging of biomedical research in the United States

Trajectories of biomedical research leading to Nobel Prize-winning discoveries

Significant advancements in public health come from scientific discoveries, but more are needed to meet the ever-growing societal needs. Examining the best practices of outstanding scientists may help develop future researchers and lead to more discoveries. This study compared the comprehensive work of 49 Nobel laureates in Physiology or Medicine from 2000 to 2019 to a matched control of National Institutes of Health (NIH)-funded biomedical investigators. Our unique data set, comprising 11,737 publications, 571 US patents, and 1693 NIH research awards produced by pre-Nobel laureates, was compared to a similar data set of control researchers. Compared to control researchers, pre-Nobel laureates produce significantly more publications annually (median = 5.66; interquartile range [IQR] = 5.16); significantly fewer coauthors per publication (median = 3.32; IQR = 1.95); consistently higher Journal Impact Factor publications (median = 12.04; IQR = 6.83); and substantially more patents per researcher (median = 5; IQR = 14). Such differences arose from nearly identical cumulative NIH award budgets of pre-Nobel laureates (median $25.3 M) and control researchers. Nobel laureates are neither hyper-prolific (>72 papers per year) nor hyper-funded (>$100 M cumulative). An academic age-specific trajectory graph allows aspiring researchers to compare their productivity and collaboration patterns to those of pre-Nobel laureates.

Recovery of cardiac electrophysiological alterations by heart rate complexity based on multiscale entropy following liver transplantation

Autonomic nervous dysfunction is a known cardiac sequalae in patients with end-stage liver disease and is associated with a poor prognosis. Heart rate analysis using nonlinear models such as multiscale entropy (MSE) or complexity may identify marked changes in these patients where conventional heart rate variability (HRV) measurements do not. To investigate the application of heart rate complexity (HRC) based on MSE in liver transplantation settings. Thirty adult recipients of elective living donor liver transplantation were enrolled. HRV parameters using conventional HRV analysis and HRC analysis were obtained at the following time points: (1) 1 day before surgery, (2) postoperative day (POD) 7, (3) POD 14, (4) POD 90, and (5) POD 180. Preoperatively, patients with MELD score ≥ 25 had significantly lower HRC compared to patients with lower MELD scores. This difference in HRC disappeared by POD 7 following liver transplantation and subsequent analyses at POD 90 and 180 continued to show no significant difference. Our results indicated a significant negative correlation between HRC based on MSE analysis and liver disease severity preoperatively, which may be more sensitive than conventional linear HRV analysis. HRC in patients with MELD score ≧ 25 improved over time and became comparable to those with MELD < 25 as early as in 7 days.

An evaluation of programs to support new investigators at the National Institute of Allergy and Infectious Diseases: Striking a balance with funding for established investigators

As the largest funder of basic biomedical research in the US, the National Institutes of Health (NIH) has an interest in maintaining a sustainable, productive workforce of investigators. Over the years, NIH has implemented several programs to attract early-stage investigators and other applicants without prior NIH support. The latest of these is the Next Generation Researchers Initiative. These programs have been shown to be successful in meeting NIH-wide goals but their success for any particular NIH institute or center (IC), and in any particular year, is determined by a variety of factors, some extrinsic to an IC's funding decision process. Each IC must balance support for new investigators with funding for productive ongoing programs of research. We examine historical trends in support of new investigators at the National Institute of Allergy and Infectious Diseases (NIAID) over a 22-year period, as well as trends in some major extrinsic influences on that support. The results indicate that NIH's new investigator programs have succeeded in maintaining a balance between the support for new NIAID investigators while also continuing to support an expanded pool of established investigators. The programs have been particularly effective in providing support to early-stage investigators.

Changes in the National Cancer Institute's R01 workforce: growth, aging, retention, and policy implications

Scientific progress and discovery of preventions and cures for life-threatening diseases depend on the vitality of the biomedical research workforce. We analyzed the workforce of cancer researchers applying for and receiving R01 awards from the National Cancer Institute (NCI) from fiscal years 1990 to 2016, the last year prior to implementation of the Next Generation Researchers Initiative. Here we report that the NCI R01 Principal Investigator (PI) workforce expanded 1.4-fold and aged over this time frame. We tracked 9 age groups and found that the number of PIs in the 3 oldest groups increased dramatically, in contrast with the younger groups. Sustained increases in the number of funded older PIs stemmed from increases in the number of older PIs submitting applications, rather than higher funding rates for older PIs. The decline in the number of funded younger PIs was driven in part by (a) a marked increase in time from PhD degree to first R01 application and award, as well as (b) a decrease in retention of PIs in the funded R01 workforce beyond their first R01 award. The NCI is using these and other analyses to inform strategies and policies for attracting, supporting, and retaining meritorious early-career researchers.

Burn injury induces elevated inflammatory traffic: the role of NF-κB

A burn insult generally sustains a hypovolemic shock due to a significant loss of plasma from the vessels. The burn injury triggers the release of various mediators, such as reactive oxygen species (ROS), cytokines, and inflammatory mediators. Damage-associated molecular patterns (DAMPs) and pathogen-associated molecular patterns (PAMPs), stemming from foreign microbial discharge and damaged tissue or necrotic cells from the burn-injured site, enter the systemic circulation, activate toll-like receptors (TLRs), and trigger the excessive secretion of cytokines and inflammatory mediators. Inflammation plays a vital role in remodeling an injured tissue, detoxifying toxins, and helps in the healing process. A transcription factor, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), contributes to a variety of physiological and pathological conditions, including immune response, cell death, cell survival, and inflammatory processes. During the pathogenesis of a burn wound, upregulation of various cytokines and growth factors lead to undesirable tissue inflammation. Thus, NF-κB, a dominant moderator of inflammation, needs to be altered to prove beneficial to the treatment of burns or other inflammation-associated diseases. This review addresses the relationship between NF-κB and elevated inflammation in a burn condition that could potentially be altered to induce an early wound-healing mechanism of burn wounds.

Cross-Center Virtual Education Fellowship Program for Early-Career Researchers in Atrial Fibrillation

BACKGROUND

It is estimated that over 46 million individuals have atrial fibrillation (AF) worldwide, and the incidence and prevalence of AF are increasing globally. There is an urgent need to accelerate the academic development of scientists possessing the skills to conduct innovative, collaborative AF research.

METHODS

We designed and implemented a virtual AF Strategically Focused Research Network Cross-Center Fellowship program to enhance the competencies of early-stage AF basic, clinical, and population health researchers through experiential education and mentorship. The pedagogical model involves significant cross-center collaboration to produce a curriculum focused on enhancing AF scientific competencies, fostering career/professional development, and cultivating grant writing skills. Outcomes for success involve clear expectations for fellows to produce manuscripts, presentations, and-for those at the appropriate career stage-grant applications. We evaluated the effectiveness of the fellowship model via mixed methods formative and summative surveys.

RESULTS

In 2 years of the fellowship, fellows generally achieved the productivity metrics sought by our pedagogical model, with outcomes for the 12 fellows including 50 AF-related manuscripts, 7 publications, 28 presentations, and 3 grant awards applications. Participant evaluations reported that the fellowship effectively met its educational objectives. All fellows reported medium to high satisfaction with the overall fellowship, webinar content and facilitation, staff communication and support, and program organization.

CONCLUSIONS

The fellowship model represents an innovative educational strategy by providing a virtual AF training and mentoring curriculum for early-career basic, clinical, and population health scientists working across multiple institutions, which is particularly valuable in the pandemic era.

The Impact of Individual Mentored Career Development (K) Awards on the Research Trajectories of Early-Career Scientists

PURPOSE

This analysis examined the role of a National Institutes of Health (NIH) individual Mentored Career Development Award (K01, K08, K23) on launching and sustaining independent research careers for early-career scientists, and investigated the effects of these awards during and after the doubling of the NIH budget.

METHOD

The authors used grants data from the NIH covering the period 1990 through 2016, and compared success in receipt of R01 equivalent awards (R01 Eq.) and Research Project Grants (RPGs) for K awardees and K applicants who did not receive funding. The analysis combined regression discontinuity design with coarsened exact matching, and regression.

RESULTS

Overall, receipt of K award was associated with a 24.1% increase in likelihood of first independent NIH award (P < .01), and a larger number of R01 Eq. and RPG awards. After accounting for first major independent awards, K awards were uncorrelated with receiving second major independent research awards. Comparing different funding periods, K01 awards were predictive of subsequent R01 Eq. and RPG awards after but not during the NIH doubling, K08 awards were predictive only during the NIH doubling, and K23 awards were predictive during both periods.

CONCLUSIONS

Receipt of Mentored Career Development Awards was linked to increased likelihood that early-career scientists successfully transitioned to an independent research career. These findings indicate that extending funding to additional K award applicants with meritorious scores could significantly strengthen the pipeline of biomedical researchers. In addition, enhancing K awards may be relevant to sustaining research careers for clinician scientists.

An evaluation of the National Institutes of Health Early Stage Investigator policy: Using existing data to evaluate federal policy

To assist new scientists in the transition to independent research careers, the National Institutes of Health (NIH) implemented an Early Stage Investigator (ESI) policy beginning with applications submitted in 2009. During the review process, the ESI designation segregates applications submitted by investigators who are within 10 years of completing their terminal degree or medical residency from applications submitted by more experienced investigators. Institutes/centers can then give special consideration to ESI applications when making funding decisions. One goal of this policy is to increase the probability of newly emergent investigators receiving research support. Using optimal matching to generate comparable groups pre- and post-policy implementation, generalized linear models were used to evaluate the ESI policy. Due to a lack of control group, existing data from 2004 to 2008 were leveraged to infer causality of the ESI policy effects on the probability of funding applications from 2011 to 2015. This article addresses the statistical necessities of public policy evaluation, finding administrative data can serve as a control group when proper steps are taken to match the samples. Not only did the ESI policy stabilize the proportion of NIH funded newly emergent investigators but also, in the absence of the ESI policy, 54% of newly emergent investigators would not have received funding. This manuscript is important to Research Evaluation as a demonstration of ways in which existing data can be modeled to evaluate new policy, in the absence of a control group, forming a quasi-experimental design to infer causality when evaluating federal policy.

Navigating the path to a biomedical science career

The number of biomedical PhD scientists undergoing training and graduating far exceeds the number of academic faculty positions and academic research jobs. This trend compels biomedical PhD scientists to increasingly seek career paths outside of academia. Prior studies have used quantitative methodology to determine trends and outcomes of single factors contributing to this shift, but there is a literature gap in studies considering multiple factors and in qualitative work focusing on biomedical PhD scientists’ experiences and their processes of career navigation. This paper draws on a social cognitive career theory (SCCT) framework and incorporates case study data from a southeastern Tier 1 research university to explore a nexus of factors influencing PhD scientists’ employment sector preferences and job search processes. It simultaneously concludes that relationships with faculty, particularly the mentor advisor, are essential to the opportunities available to these professionals and to the career paths they choose.

Examining trends in the diversity of the U.S. National Institutes of Health participating and funded workforce

Here, we use recent U.S. National Institutes of Health (NIH) data to document trends in the NIH-funded workforce over time. Consistent with previous studies that were initiated by NIH, we find that the number of scientists funded on competing R01-equivalent (R01 Eq.) and research project grants (RPGs) increased 2-5% per year between 2009 and 2016. Primary beneficiaries of this growth were experienced investigators (Exp), whereas the share of funding awarded to early-stage investigators (ESIs) and new investigators (NIs) declined. The decline occurred even after NIH instituted the New and Early-Stage Investigator policy in 2009. When we evaluate the investigator pool, we find that women and racial and ethnic minorities represent a higher percentage of NIs and ESIs relative to Exp. Thus, trends of diminishing support for NIs and ESIs may negatively impact the diversity of the current and future biomedical research workforce. We find some recent gains among women and Hispanics as part of the applicant and awardee pool for both R01 Eq. and RPGs, but significant, large gaps persist among nationally underrepresented racial minorities. Our findings suggest a need to prioritize investments and support of ESIs and NIs, groups in which women and racial and ethnic minorities represent a larger proportion of the applicant pool, to enhance diversity in the NIH-funded workforce.-Nikaj, S., Roychowdhury, D., Lund, P. K., Matthews, M., Pearson, K. Examining trends in the diversity of the U.S. National Institutes of Health participating and funded workforce.

Future of fundamental discovery in US biomedical research

Young researchers are crucially important for basic science as they make unexpected, fundamental discoveries. Since 1982, we find a steady drop in the number of grant-eligible basic-science faculty [principal investigators (PIs)] younger than 46. This fall occurred over a 32-y period when inflation-corrected congressional funds for NIH almost tripled. During this time, the PI success ratio (fraction of basic-science PIs who are R01 grantees) dropped for younger PIs (below 46) and increased for older PIs (above 55). This age-related bias seems to have caused the steady drop in the number of young basic-science PIs and could reduce future US discoveries in fundamental biomedical science. The NIH recognized this bias in its 2008 early-stage investigator (ESI) policy to fund young PIs at higher rates. We show this policy is working and recommend that it be enhanced by using better data. Together with the National Institute of General Medical Sciences (NIGMS) Maximizing Investigators' Research Award (MIRA) program to reward senior PIs with research time in exchange for less funding, this may reverse a decades-long trend of more money going to older PIs. To prepare young scientists for increased demand, additional resources should be devoted to transitional postdoctoral fellowships already offered by NIH.

The academic-industrial complex: navigating the translational and cultural divide

In general, the fruits of academic discoveries can only be realized through joint efforts with industry. However, the poor reproducibility of much academic research has damaged credibility and jeopardized translational efforts that could benefit patients. Meanwhile, journals are rife with articles bemoaning the limited productivity and increasing costs of the biopharmaceutical industry and its resultant predilection for mergers and reorganizations while decreasing internal research efforts. The ensuing disarray and uncertainty has created tremendous opportunities for academia and industry to form even closer ties, and to embrace new operational and financial models to their joint benefit. This review article offers a personal perspective on the opportunities, models and approaches that harness the increased interface and growing interdependency between biomedical research institutes, the biopharmaceutical industry and the technological world.

Performance curves of medical researchers during their career: analysis of scientific production from a retrospective cohort

OBJECTIVES

To establish the pattern of change in individual scientific production over the career of medical researchers.

DESIGN

Retrospective cohort based on prospectively collected data in a hospital information system.

SETTING

Multicentre university hospital in France.

PARTICIPANTS

Two distinct populations of 1835 researchers (full professors vs non-academic physicians) having produced 44 723 publications between 1995 and 2014.

MAIN OUTCOME MEASURES

Annual number of publications referenced in Medline/PubMed with a sensitivity analysis based on publications as first/last author and in high impact journals. The individual volume of publications was modelled by age using generalised estimating equations adjusted for birth cohort, biomedical discipline and academic position of researchers.

RESULTS

Averaged over the whole career, the annual number of publications was 5.28 (95% CI 4.90 to 5.69) among professors compared to 0.82 (95% CI 0.76 to 0.89) among non-academic physicians (p<0.0001). The performance curve of professors evolved in three successive phases, including an initiation phase with a sharp increase in scientific production between 25 and 35 years (adjusted incidence rate ratio 102.20, 95% CI 60.99 to 171.30), a maturation phase with a slower increase from 35 to 50 years (2.10, 95% CI 1.75 to 2.51) until a stabilisation phase with constant production followed by a potential decline at the end of career (0.90, 95% CI 0.77 to 1.06). The non-academic physicians experienced a slower pace of learning curve at the beginning of their careers (42.38, 95% CI 25.37 to 70.81) followed by a smaller increase in the annual number of publications (1.29, 95% CI 1.11 to 1.51).

CONCLUSIONS

Compared to full professors, non-academic physicians had a poor capacity to publish, indicating a low productivity when medical doctors have limited time or little interest in undertaking research. This finding highlights the potential for rethinking the missions of medical doctors towards an enlargement of scientific prerogatives in favour of progress in global knowledge.

A new model for catalyzing translational science: the early stage investigator mentored research scholar program in HIV vaccines

Engagement of early stage investigators (ESIs) in the search for a safe and effective vaccine is critical to the success of this highly challenging endeavor. In the wake of disappointing results from a large-scale efficacy trial, the HIV Vaccine Trials Network (HVTN) and Center for HIV/AIDS Vaccine Immunology (CHAVI) developed a novel mentored research program focused on the translation of findings from nonhuman primate studies to human trials of experimental vaccines. From 2008 to 2011, 14 ESI Scholars were selected from 42 complete applications. Post program surveys and tracked outcomes suggest that the combination of flexible funding, transdisciplinary mentorship, and structured training and networking promoted the scientific contributions and career development of promising ESIs. Embedding a multicomponent research program within collaborative clinical trial networks and research consortia is a promising strategy to attract and retain early career investigators and catalyze important translational science.

Evaluating how we evaluate

Evaluation of scientific work underlies the process of career advancement in academic science, with publications being a fundamental metric. Many aspects of the evaluation process for grants and promotions are deeply ingrained in institutions and funding agencies and have been altered very little in the past several decades, despite substantial changes that have taken place in the scientific work force, the funding landscape, and the way that science is being conducted. This article examines how scientific productivity is being evaluated, what it is rewarding, where it falls short, and why richer information than a standard curriculum vitae/biosketch might provide a more accurate picture of scientific and educational contributions. The article also explores how the evaluation process exerts a profound influence on many aspects of the scientific enterprise, including the training of new scientists, the way in which grant resources are distributed, the manner in which new knowledge is published, and the culture of science itself.

Health research funding in Mexico: the need for a long-term agenda

Background

The legal framework and funding mechanisms of the national health research system were recently reformed in Mexico. A study of the resource allocation for health research is still missing. We identified the health research areas funded by the National Council on Science and Technology (CONACYT) and examined whether research funding has been aligned to national health problems.

Methods and Findings

We collected the information to create a database of research grant projects supported through the three main Sectoral Funds managed by CONACYT between 2003 and 2010. The health-related projects were identified and classified according to their methodological approach and research objective. A correlation analysis was carried out to evaluate the association between disease-specific funding and two indicators of disease burden. From 2003 to 2010, research grant funding increased by 32% at a compound annual growth rate of 3.5%. By research objective, the budget fluctuated annually resulting in modest increments or even decrements during the period under analysis. The basic science category received the largest share of funding (29%) while the less funded category was violence and accidents (1.4%). The number of deaths (ρ = 0.51; P<0.001) and disability-adjusted life years (DALYs; ρ = 0.33; P = 0.004) were weakly correlated with the funding for health research. Considering the two indicators, poisonings and infectious and parasitic diseases were among the most overfunded conditions. In contrast, congenital anomalies, road traffic accidents, cerebrovascular disease, and chronic obstructive pulmonary disease were the most underfunded conditions.

Conclusions

Although the health research funding has grown since the creation of CONACYT sectoral funds, the financial effort is still low in comparison to other Latin American countries with similar development. Furthermore, the great diversity of the funded topics compromises the efficacy of the investment. Better mechanisms of research priority-setting are required to adjust the research portfolio to the new health panorama of Mexican population.

Commentary: a ray of hope for medical school research funding

Academic health centers are traditionally dependent on extramural agencies like the National Institutes of Health to fund medical research. The still-struggling U.S. economy has kept federal paylines stagnant in recent years even as research costs climb. Academic health center leaders need to find new funding sources to ensure that critical medical research continues. Myers and colleagues, in their report in this issue of Academic Medicine, found that scientific research funding by philanthropic nonprofit organizations rose 26% from 2006 to 2008. Even though the time frame for their study precedes the recent economic recession, their findings provide hope and guidance to academic health centers. Stable research portfolios should include a variety of sources, and Myers and colleagues suggest that partnership opportunities exist between federal and not-for-profit funding sources to focus on key disease areas. Seeking broader research funding may benefit at-risk groups like junior investigators, as the average age of a first-time NIH grant recipient in 2008 was 42 years old. To foster the new discoveries and ideas that come from young scientists, academic health centers need to diversify their research funding sources.It is encouraging that high-visibility philanthropic organizations enhanced funding by 26% from 2006 to 2008. However, between 2008 and 2010, overall grant support from foundations declined 2.3%. Should federal and private funding continue to fall, there is an eminent threat of losing a generation of investigators. Thus, creative solutions and partnerships are needed to fund more high-priority research to cure disease and create the future of medicine.

Science PhD career preferences: levels, changes, and advisor encouragement

Even though academic research is often viewed as the preferred career path for PhD trained scientists, most U.S. graduates enter careers in industry, government, or “alternative careers.” There has been a growing concern that these career patterns reflect fundamental imbalances between the supply of scientists seeking academic positions and the availability of such positions. However, while government statistics provide insights into realized career transitions, there is little systematic data on scientists' career preferences and thus on the degree to which there is a mismatch between observed career paths and scientists' preferences. Moreover, we lack systematic evidence whether career preferences adjust over the course of the PhD training and to what extent advisors exacerbate imbalances by encouraging their students to pursue academic positions. Based on a national survey of PhD students at tier-one U.S. institutions, we provide insights into the career preferences of junior scientists across the life sciences, physics, and chemistry. We also show that the attractiveness of academic careers decreases significantly over the course of the PhD program, despite the fact that advisors strongly encourage academic careers over non-academic careers. Our data provide an empirical basis for common concerns regarding labor market imbalances. Our results also suggest the need for mechanisms that provide PhD applicants with information that allows them to carefully weigh the costs and benefits of pursuing a PhD, as well as for mechanisms that complement the job market advice advisors give to their current students.