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«Table of Contents National Cancer Institute 1 National Heart, Lung, and Blood Institute 13 National Institute of Dental and Craniofacial Research 23 ...»

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FY 2012 Senate Appropriations Committee Report


FY 2012 Conference Committee Report

Table of Contents

National Cancer Institute 1

National Heart, Lung, and Blood Institute 13

National Institute of Dental and Craniofacial Research 23

National Institute of Diabetes and Digestive and Kidney Diseases 27

National Institute of Neurological Disorders and Stroke 39 National Institute of Allergy and Infectious Diseases 45 National Institute of General Medical Sciences 55 National Institute of Child Health and Human Developement 59 National Eye Institute 71 National Institute of Environmental Health Sciences 75 National Institute on Aging 79 National Institute of Arthritis and Musculoskeletal and Skin Diseases 85 National Institute on Deafness and Other Communication Disorders 89 National Institute of Mental Health 105 National Institute on Drug Abuse 109 National Institute on Alcohol Abuse and Alcoholism 117 National Institute of Nursing Research 119 National Institute on Minority Health and Health Disparities 121 National Center for Complimentary and Alternative Medicine 127 National Center for Advancing Translational Sciences 129 Office of the Director 135 A Accelerating Commercialization of Therapies to Patients.

Access to Natural Product Collections.

Adverse Pregnancy Outcomes.

Age-Related Bone Loss.

Age-Related Macular Degeneration [AMD].


Anti-Malarial Medicines.



B Basic Behavioral Research.

Behavioral Interventions.

Behavioral Research.

Black Scientists.

Blending Initiative.

Bone Research.

Breast Cancer.

C Cardiovascular Disease.

Chemical Risk Assessment.


Chromosome Abnormalities.

Chronic Fatigue Syndrome [CFS].

Chronic Obstructive Pulmonary Disease [COPD]

Chronic Pelvic Pain.

Class B Animal Dealers.

Clinical and Translational Science Awards [CTSAs]

Cystic Fibrosis [CF].

D Demographic and Economic Research.

Depression and Diabetes.

Diabetic Eye Disease.


Diabetes Prevention Program.

Discretionary Fund.

Drug Repurposing.


Dystonia Coalition.

i E Early Detection, Diagnosis and Intervention.


Eosinophil-Associated Disorders.


Extramural Research.

F Food Allergies

Fragile X.

Functional Gastrointestinal Disorders and Gulf War Syndrome.

G Genetic Basis of Eye Disease.

Gestational Diabetes.

Global Rare Diseases Patient Registry and Data Repository.

Glomerular Diseases.

H Hair Cell Regeneration.

Health Decisionmaking

Health Services Research

Hearing Aids and Cochlear Implants.

Hearing Impairment Among Children and Young Adults

Hearing Loss.

Hepatitis B Virus [HBV].

Hereditary Angioedema [HAE].

Hereditary Hearing Loss.

Hereditary Hemorrhagic Telangiectasia [HHT].

HIV / AIDS Behavioral Research.

Human Tissue Supply.

I Immunotherapy.

Inflammatory Bowel Disease [IBD].

Interdisciplinary Research Consortia and the NeuroTherapeutics Research Institute................ 150 Institutional Development Awards [IDeA]

–  –  –

ii Lessons Learned.

Life Course Perspectives.

Liver Cancer.

Lung Cancer.

Lymphatic Research and Lymphatic Disease.

M Marfan Syndrome.

Marfan Syndrome and Thoracic Aortic Aneurysms.

Maternal Morbidity.

Medications Development.


Metabolic Bone Disease.

Metastasis to Bone.


Military Personnel, Veterans, and Their Families.

Mitochondrial Disease.

Mobile Technology.

Mucopolysaccharidoses [MPS].

Multidisciplinary Research.

Muscular Dystrophy.

N Network of Excellence in Neuroscience Clinical Trials.


Neurofibromatosis [NF].

New and Competing Research Project Grants [RPGs]

Noise-Induced Hearing Loss.


P Pain.

Pancreatic Cancer.

Pediatric Cancer.

Pediatric Functional Gastrointestinal Disorders [FGIDs]

Pediatric Kidney Disease.

Pediatric Low-Grade Astrocytoma [PLGA].


Polycystic Kidney Disease [PKD].

Premature Mortality.

iii Presbycusis

Prescription Drug Abuse.

Preterm Birth

Primate Research.

Product Development Partnerships.

Prosthetics Research.

Psychotropic Drugs and Children.

Public Health Hazards.

Pulmonary Hypertension [PH]

RRehabilitation Research.

S Science-Driven Practice.


Sleep Disorders.

Slow-Growing Children's Brain Tumors.

SMA Newborn Screening.

Social Support.

Spina Bifida.


Substance Abuse by Teenagers

Synapse Function.

Systemic Bone Active Therapeutics.

T Temporomandibular Joint [TMJ] Disorders.


Translational Research.

Tuberculosis [TB].

Tuberous Sclerosis Complex [TSC].

UUnderage Drinking Initiatives.

V Vitamin D Deficiency and Chronic Kidney Disease.

Vestibular Research.


–  –  –

Item Breast Cancer. - The Committee notes that triple-negative breast cancer is poorly understood and has a disproportionate prevalence among African American women. The Committee encourages NCI to increase research and awareness of this disease, and to advance prevention, detection, diagnosis, care, and treatment. The Institute is urged to collaborate with ORWH, NIMHD, the Office of Minority Health, and the Office of Women's Health in these efforts. (p.

86) Action taken or to be taken Triple-negative breast cancer lacks three "receptors" known to fuel most breast cancers, estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2). NCI is supporting research to provide greater insights into the biological basis underlying triplenegative breast cancer among high-risk, racially/ethnically diverse, and underserved populations.

One project focuses on epigenetic factors, i.e., environmental factors such as diet or exposure to carcinogens or hormones that may alter genomic function. The research will focus on pregnancyassociated post-partum breast cancers (often triple negative) compared with non-pregnancyassociated breast cancers in Hispanic women. Findings may also serve as a foundation for the development of biomarkers and targeted therapies. Another study is exploring the interplay between mammary fat tissue and breast cancer health disparities, which may lead to new insights into prevention strategies and/or therapeutic alternatives for overweight/obese women, especially among African Americans and Latinas. A third study is testing an immunotherapeutic strategy with potential to improve cancer treatment for patients who are resistant to other, more conventional therapies.

NCI is also supporting research on triple-negative breast cancer through proceeds from sales of the Stamp for Breast Cancer Research. One effort aims to identify distinct subtypes of triplenegative breast cancers and potential therapeutic targets. Another uses genomic technology to examine triple-negative breast cancers from Caucasians, Hispanics, and African Americans to explore the differences across ethnic groups and to examine connections to differences in tumors across populations. A third project will explore a gene-silencing protein called EZH2 that is elevated in triple-negative breast cancers and assess it as a possible prognostic tool. Finally, the NCI’s Early Detection Research Network is undertaking a project to identify blood markers for triple-negative breast cancer to identify women age 40 and older who may be at high risk for the disease.

Other related research includes two prevention trials in women with a history of hormonereceptor negative breast cancer. One study is testing a method to reduce the level of a protein called poly-adenosine-ribose polymerase (PARP) by using an inhibitor called ABT-888. PARP inhibitors have been identified as agents that could further disrupt DNA repair in breast cancer cells, rendering them particularly vulnerable to certain chemotherapy treatments. The other study is exploring ways to reduce the level of a protein called Ki67 that is associated with cancer cell growth by using increasing doses of a green tea component called Polyphenone E.

1 NCI works with trans-NIH groups to disseminate and coordinate information about health disparities research, pursue collaborative research efforts, and co-fund investigators studying health disparities and cancer, as well as participating in HHS-wide efforts to address minority and women’s health concerns. NIMHD Centers of Excellence Program conducts research, training, and community outreach around issues of minority health and health disparities. The Center of Excellence in Eliminating Disparities at the University of Illinois-Chicago is evaluating the effectiveness of a hospital-based patient navigation intervention strategy on the adequacy of diagnostic and treatment services for breast cancer care among underserved women.

The primary research outcome will be treatment adequacy and adherence to follow-up care in women with abnormal mammograms. In addition, in FY2011, NIMHD funded an NCI intramural scientist to investigate triple-negative breast cancer that is prevalent in younger African American women. Findings from these studies will inform strategies for early screening and treatments for these women.

Item Health Decisionmaking. - The Committee commends NCI for its efforts to understand how the ability to comprehend and use numerical information affects health decisionmaking, as low numerical skills may not only distort perception of risks and impair risk communication, but may also impede treatment. (p. 86) Action taken or to be taken Advances in cancer prevention, screening, treatment and end-of-life care, coupled with advances in bioinformatics, have created a wide array of health care options and sources of medical information. NCI funds research that examines, among other factors, cognitive and affective processes underlying decision making; basic decision-making processes involved in the initiation and long-term maintenance of healthy lifestyle behaviors; and health-related numeracy—how people use, process, and attach meaning to health-related numeric information.

To better understand health behaviors and their underlying processes, NCI experts and external scientists work together to examine cognitive, affective, and social processes involved in health communication and risk perception. This effort enables cancer-related information such as risk assessments to be presented to patients, providers, and the public in a user-friendly, easily processed, and informative manner. For example, the Health Information National Trends Survey (HINTS) (http://hints.cancer.gov/) is an NCI project that collects data on the American public's need for, access to, and use of cancer information, with special emphasis on ethnic minority populations. It provides a unique set of data that enables investigators to examine the relationship between health communication and cancer-related knowledge, attitudes, and behaviors.

NCI supports centers that conduct transdisciplinary cancer communication research aimed at directly contributing to improved health outcomes and quality of life for individuals. The centers facilitate rapid advances in knowledge about cancer communications, develop effective interventions, translate theory and programs into practice, and train health communication scientists.

2 NCI also works closely with NIH to lead the trans-NIH Basic Behavioral and Social Science Opportunity Network (OppNet). OppNet supports research including analyses of theoretical issues of numeracy, risk taking and risk perception, and cognitive mechanisms that link the framing of choices to decision outcomes in general.

Item Health Services Research. - The Committee commends NCI for its efforts to determine how well state-of-the-art cancer care is actually delivered. Ongoing health services data collection and surveillance programs represent an important contribution to cancer surveillance and the efforts to understand and improve clinical and community practices. NCI is strongly urged to maintain support for ongoing activities that advance cancer prevention and early detection research, including data collection infrastructure that can contribute to measuring the delivery and outcome of services, and comparative effectiveness research. (p. 86) Action taken or to be taken NCI recognizes the importance of health services research to understand and improve cancer prevention, early detection, cancer care delivery, and health outcomes. Through a number of initiatives involving networks and consortia and infrastructure support, NCI research is making vital contributions to measuring health services and patient-centered outcomes research (PCOR).

PCOR includes research that helps people to make informed health care decisions, allows their voice to be heard in assessing the value of health care options, and answers patient-focused questions.

The NCI Surveillance, Epidemiology, and End Results (SEER)-Medicare database combines two large population-based sources of data that provide detailed information about Medicare beneficiaries with cancer. The SEER-Medicare database is a unique population-based source of information that can be used for an array of epidemiological and health services research, including patterns of care, utilization of cancer tests, and efficacy of cancer treatment.

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