The National Institutes of Health’s (NIH) K99/R00 Pathway to Independence Award offers promising postdoctoral researchers and clinician-scientists an opportunity to receive research support at both the mentored and the independent levels with the goal of facilitating a timely transition to a tenure-track faculty position. This transitional program has been generally successful, with most K99/R00 awardees successfully securing R01-equivalent funding by the end of the R00 period. However, often highly promising proposals fail because of poor grantsmanship. This overview provides guidance from the perspective of long-standing members of the National Heart, Lung, and Blood Institute’s Mentored Transition to Independence study section for the purpose of helping mentors and trainees regarding how best to assemble competitive K99/R00 applications.

Biospecimen repositories play a vital role in enabling investigation of biologic mechanisms, identification of disease-related biomarkers, advances in diagnostic assays, recognition of microbial evolution, and characterization of new therapeutic targets for intervention. They rely on the complex integration of scientific need, regulatory oversight, quality control in collection, processing and tracking, and linkage to robust phenotype information. The COVID-19 pandemic amplified many of these considerations and illuminated new challenges, all while academic health centers were trying to adapt to unprecedented clinical demands and heightened research constraints not witnessed in over 100 years. The outbreak demanded rapid understanding of SARS-CoV-2 to develop diagnostics and therapeutics, prompting the immediate need for access to high quality, well-characterized COVID-19-associated biospecimens. We surveyed 60 Clinical and Translational Science Award (CTSA) hubs to better understand the strategies and barriers encountered in biobanking before and in response to the COVID-19 pandemic. Feedback revealed a major shift in biorepository model, specimen-acquisition and consent process from a combination of investigator-initiated and institutional protocols to an enterprise-serving strategy. CTSA hubs were well equipped to leverage established capacities and expertise to quickly respond to the scientific needs of this crisis through support of institutional approaches in biorepository management.

With the many changes occurring in today's healthcare organizations, patients are increasingly equipped with a vast quantity of health care data and being more included in the healthcare decision-making process. The new approach we propose incorporates a new patient-organization framework that examines relevant historical, legal and ethical elements within the doctrine of informed consent in addition to examining the role of new healthcare organizations' obligations to include data to support addressing issues such as population health, health outcomes and health disparities within the informed consent. There is a growing consensus among healthcare professionals that using an evidencebased organizational informed consent framework to improve the informed consent process can lead to better comprehension, health outcomes, transparency and improved patient trust and retention overall.

The Tarija Formation of southern Bolivia, which is well known for its classic vertebrate faunas, is of prime importance in understanding of the chronology of the Ensenadan Land Mammal Age. This formation consists of well-exposed and relatively fossiliferous sections of clays, clayey silts, sands, gravels, and tuffs which were deposited in a predominately fluviatile regime in a Pleistocene structural basin. Four stratigraphic sections, each measuring 110 m or less, were studied to establish a magnetic polarity stratigraphy. Paleomagnetic samples were collected from the finer-grained sediments at 100 sites spaced at stratigraphic intervals of 5 m or less. All paleomagnetic specimens were demagnetized in alternating fields of least 250 oersteds (oe). Some specimens were also thermally demagnetized at 200°C or more. Of the 100 sites, 77 were ultimately used to determine the magnetic polarity zonation. Based on the four sections sampled, the Tarija Formation spans a time interval from about 1 my to about 0.7 my B.P. or perhaps younger. The lower half of the composite section is of reversed polarity punctuated by a short normal event. This sequence probably represents the late Matuyama chron with the Jaramillo subchron. The upper part of the section is of normal polarity and represents early Brunhes time. A tuffaceous unit 43 m above the Brunhes-Matuyama boundary yielded a fission track (zircon) age of 0.7 ± 0.2 by B.P. These data indicate that the classic Tarija fauna is middle Pleistocene Ensendan in age.

A thick blanket of Holocene alluvium lies over southwestern lowland Amazonia, and may possibly occur throughout much of the Amazon Basin. These deposits resulted from massive, seasonal flooding from about 11,000 to about 5000 yr B.P. that was followed by two cycles of erosion and deposition. Interpretations based on these geologic data suggest that southwestern lowland Amazonia is ecologically an “island” in a state of supersaturated disequilibrium as a result of colonization from Pleistocene refugia on its perimeter, and that habitats of highest diversity may be the most recent in origin. Conservation efforts and studies of Amazonian biogeography, soils, and paleoethnography should be reevaluated in light of the geologic data.

Two new, extinct taxa of peccaries from upper Miocene deposits of the western Amazon Basin provide the first data documenting the presence of these North American mammals in South America in the Miocene. One, Sylvochoerus woodburnei n. gen. n. sp., is allied morphologically to Tayassu pecari, whereas the second, Waldochoerus bassleri n. gen. n. sp., is more similar to Pecari tajacu. Both new taxa reflect an intermediate position between middle Miocene peccaries and modern Tayassu and Pecari. The specimens reported here were unstudied, but when collected they were referred to living species of Tayassu and Pecari based on their general similarity to species of those two living genera, and they were dated to the Pleistocene, presumably based on a long–standing model of the Great American Faunal Interchange. The presence of peccaries in South America at approximately the same time that South American ground sloths began appearing in upper Miocene deposits of North America, and soon after the appearance of gomphotheres in South America, indicates that dispersal between the Americas was earlier and involved more taxa than previously interpreted. Molecular divergence data are consistent, in part, with a late Miocene dispersal of peccaries to South America.

A new dromomerycine palaeomerycid artiodactyl, Surameryx acrensis new genus new species, from upper Miocene deposits of the Amazon Basin documents the first and only known occurrence of this Northern Hemisphere group in South America. Osteological characters place the new taxon among the earliest known dromomerycine artiodactyls, most similar to Barbouromeryx trigonocorneus, which lived in North America during the early to middle Miocene, 20–16 Ma. Although it has long been assumed that the Great American Biotic Interchange (GABI) began with the closure of the Isthmus of Panama in the late Pliocene, or ca. 3.0–2.5 Ma, the presence of this North American immigrant in Amazonia is further evidence that terrestrial connections between North America and South America through Panama existed as early as the early late Miocene, or ca. 9.5 Ma. This early interchange date was previously indicated by approximately coeval specimens of proboscideans, peccaries, and tapirs in South America and ground sloths in North America. Although palaeomerycids apparently never flourished in South America, proboscideans thrived there until the end of the Pleistocene, and peccaries and tapirs diversified and still live there today.

The effects of infant suckling patterns on the post-partum resumption of ovulation and on birth-spacing are investigated among the Gainj of highland New Guinea. Based on hormonal evidence, the median duration of lactational anovulation is 20·4 months, accounting for about 75% of the median interval between live birth and next successful conception (i.e. resulting in live birth). Throughout lactation, suckling episodes are short and frequent, the interval changing slowly over time, from 24 minutes in newborns to 80 minutes in 3-year olds. Maternal serum prolactin concentrations decline in parallel with the changes in suckling patterns, approaching the level observed in non-nursing women by about 24 months post-partum. A path analysis indicates that the interval between suckling episodes is the principal determinant of maternal prolactin concentration, with time since parturition affecting prolactin secretion only in so far as it affects suckling frequency. The extremely prolonged contraceptive effect of breast-feeding in this population thus appears to be due to (i) a slow decline in suckling frequency with time since parturition and (ii) absence of a decline over time in hypothalamic–pituitary responsiveness to the suckling stimulus.

More than 60% of newborns with severe congenital cardiac disease develop perioperative brain injuries. Known risk factors include: pre-operative hypoxemia, cardiopulmonary bypass characteristics, and post-operative hypotension. Infection is an established risk factor for white matter injury in premature newborns. In this study, we examined term infants with congenital cardiac disease requiring surgical repair to determine whether infection is associated with white matter injury. Acquired infection was specified by site – bloodstream, pneumonia, or surgical site infection – according to strict definitions. Infection was present in 23 of 127 infants. Pre- and post-operative imaging was evaluated for acquired injury by a paediatric neuroradiologist. Overall, there was no difference in newly acquired post-operative white matter injury in infants with infection (30%), compared to those without (31%). When stratified by anatomy, infants with transposition of the great arteries, and bloodstream infection had an estimated doubling of risk of white matter injury that was not significant, whereas those with single ventricle anatomy had no apparent added risk. When considering only infants without stroke, the estimated association was higher, and became significant after adjusting for duration of inotrope therapy. In this study, nosocomial infection was not associated with white matter injury. Nonetheless, when controlling for risk factors, there was an association between bloodstream infection and white matter injury in selected sub-populations. Infection prevention may have the potential to mitigate long-term neurologic impairment as a consequence of white matter injury, which underscores the importance of attention to infection control for these patients.