This is a multi-part message in MIME format. --Boundary_[ID_8WhGV28W4n4amqAiIC24OA] Content-type: text/plain; charset=iso-8859-1 Content-transfer-encoding: QUOTED-PRINTABLE I've attached an RFA that contains instructions for modular budgets; = its=20 RFA HL 96 001, Sickle Cell Disease Therapy gopher://gopher.nih.gov:70/00/res/nih-guide/rfa-files/RFA-HL-96-001 --=20 =FFWPCB=04 --Boundary_[ID_8WhGV28W4n4amqAiIC24OA] Content-type: text/plain; charset=us-ascii; NAME=RFA-HL-96-001 Content-disposition: inline; filename=RFA-HL-96-001 Content-transfer-encoding: QUOTED-PRINTABLE Full Text HL-96-001 SICKLE CELL DISEASE THERAPY NIH GUIDE, Volume 24, Number 40, November 24, 1995 RFA: HL-96-001 National Heart, Lung, and Blood Institute P.T. 34 Keywords:=20 Blood Diseases=20 Biology, Cellular=20 Biology, Molecular=20 Chemotherapeutic Agents=20 Letter of Intent Receipt Date: December 22, 1995 Application Receipt Date: January 23, 1996 THIS RFA USES "MODULAR GRANT" AND "JUST-IN-TIME" CONCEPTS. THIS RFA INCLUDES DETAILED MODIFICATIONS TO STANDARD APPLICATION INSTRUCTIONS THAT MUST BE USED TO PREPARE AN APPLICATION IN RESPONSE TO THIS RFA. PURPOSE The Division of Blood Diseases and Resources (DBDR) of the National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health (NIH), invites research grant applications for the support of research leading to the development of effective therapeutic approaches for the treatment of sickle cell disease. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000", a PHS-led national activity for setting priority areas. This Request for Applications (RFA), Sickle Cell Disease Therapy, is related to the priority areas of chronic disabling conditions, and maternal and infant health. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0 or Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (telephone 202-512-1800). ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic and foreign for-profit and non-profit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of state and local governments, and eligible agencies of the Federal government. Awards in response to this RFA will be made to foreign institutions only for research of unusual merit, need, and promise, and in accordance with PHS policy governing such awards. Applications from minority individuals and women are encouraged. MECHANISM OF SUPPORT This RFA will use the NIH individual research project grant (R01) mechanism of support. However, specific application instructions have been modified to reflect "MODULAR GRANT" and "JUST-IN-TIME" streamlining efforts being examined by the NIH. The modular grant concept establishes specific modules (increments) in which direct costs may be requested as well as a maximum level for requested budgets. Only limited budgetary information is required under this approach. The just-in-time concept allows applicants to submit certain information only when there is a possibility for an award. It is anticipated that these changes will reduce the administrative burden for the applicants, reviewers, and NHLBI staff. For this RFA, funds must be requested in $25,000 direct cost modules and a maximum of eight modules ($200,000 direct costs) per year may be requested. A feature of the modular grant concept is that not escalation is provided for future years, and all anticipated expenses for all years of the project must be included within the number of modules being requested. Only limited budget information will be required and any budget adjustments recommended by the Initial Review Group will be in modules of $25,000. Instructions for completing the Biographical Sketch have also been modified. In addition, Other Support information and the application Checklist page are not required as part of the initial application. If there is a possibility for an award, necessary budget, Other Support, and Checklist information will be requested by NHLBI staff following the initial review. The APPLICATION PROCEDURES section of this RFA provides specific details of modifications to standard PHS 398 application kit instructions. Applicants are requested to furnish estimates of the time required to achieve the objectives of the proposed research project. Up to four years of support may be requested. At the end of the official award period, renewal applications may be submitted for peer review and competition for support through the regular grant program of the NHLBI. It is anticipated that awards resulting from RFA HL-96-001 will begin August 1, 1996. Administrative adjustments in project period or amount of support may be required at the time of the award. Since a variety of approaches would represent valid responses to this RFA, it is anticipated that there will be a range of costs among the grants awarded. All current policies and requirements that govern the research grant programs of the NIH will apply to grants awarded in connection with this RFA. FUNDS AVAILABLE It is anticipated that for fiscal year 1996, $1.2 million total costs will be available for the first year of support for this initiative. Award of grants pursuant to this RFA is contingent upon receipt of such funds for this purpose. It is anticipated that approximately four new grants will be awarded under this program. The specific number to be funded will, however, depend on the merit and scope of the applications received and on the availability of funds. Direct costs will be awarded in modules of $25,000, less any overlap or other necessary administrative adjustments. Indirect costs will be awarded based on the negotiated rates. Collaborative arrangements involving subcontracts with other institutions should be discussed with Ms. Jane R. Davis at the address listed under INQUIRIES. RESEARCH OBJECTIVES Background Effective therapy remains a primary goal of the Sickle Cell Disease Program. Research in recent years has provided significant advances in the state of knowledge of the pathophysiology, genetic characteristics, molecular and cellular biology, natural history, and clinical aspects of the sickling disorders. Despite this progress, there is still no universally effective therapeutic agent for this disease. The recent results of the Multicenter Study of Hydroxyurea have shown that hydroxyurea is effective at reducing the complications associated with severe sickle cell disease in some individuals. However, it is clear from these studies that not all patients with sickle cell disease respond to hydroxyurea. In addition, the long term side effects of this drug are not known, and the safety and efficacy of this drug for pediatric patients are not known. Thus, other approaches to sickle cell disease therapy that have the potential to be less toxic and more universally applicable are needed. Furthermore, approaches that would enhance the therapeutic effects of hydroxyurea would also be extremely beneficial. Research in recent years has led to an increased understanding of the extraordinarily complex pathophysiological consequences of sickle cell disease. The central event involves the deoxygenation-induced accumulation of hemoglobin S polymers, leading to an increased intracellular viscosity and the generation of deformed sickled red cells. However, this does not fully explain sickle disease pathophysiology, and even the sickling process itself is governed by various factors. It is clear that diverse mechanisms contribute to catastrophic interruptions of microcirculatory flow and consequent vaso-occlusive manifestations. Contributory factors include red cell sickling, red cell adherence to vascular endothelial cells, abnormalities of the red cell membrane causing cellular dehydration and poor deformability, and possibly abnormalities of coagulation and vascular tone. Likewise, the characteristic hemolytic anemia of sickle cell disease derives from diverse mechanisms, including red cell fragility, sequestration, opsonization with immunoglobulin, and interaction with phagocytic macrophages. The capacity of some sickle red cells to adhere to the endothelium or interact with other cell types leading to the increased production of various cytokines, peptides or other vaso-active substances may also impact on the pathology of this disease. Therapeutic Opportunities The multifactorial aspect of sickle disease pathophysiology provides a number of potential opportunities for therapeutic intervention. Several approaches could be utilized to inhibit the basic sickling process. Emphasis in the past was on the identification of molecules capable of increasing the affinity of hemoglobin S for oxygen, agents that inhibit polymerization, or molecules that alter the critical contact points involved in polymer formation (an approach that may deserve further study). The detailed data now available regarding the development and structure of the hemoglobin S polymer may provide a basis for rational design of inhibitors based on specific binding to defined regions of the hemoglobin S molecule. Alternatively, since sickling depends so strikingly on hemoglobin S concentration, this process could be inhibited by agents that lower this concentration, either by direct effects on hemoglobin synthesis or by increasing cell water content, i.e., correcting cellular dehydration. Pharmacologic or genetic manipulation can be used to increase cellular content of fetal hemoglobin, which inhibits the polymerization process. The abnormal adherence of sickle red cells to endothelial cells can delay microvascular transit times and thereby promote sickling, and adhesion may even directly initiate vaso-occlusion. Various therapeutic approaches could be relevant since adherence derives from several different mechanisms and involves the endothelial cell itself plus abnormalities of both the red cell membrane and plasma proteins. Agents that specifically inhibit one or another of the identified adherence mechanisms warrant further investigation. Since red cell subpopulations exhibit differences in adhesiveness, therapeutic benefit also theoretically could be derived from agents that alter subpopulation size or composition. Several approaches could be valuable for dealing with the various defects of the sickle membrane that lead to abnormal cellular dehydration, which promotes sickling and has an adverse effect on deformability. The calcium-mediated direct loss of cations and water during red cell sickling could be prevented by specific Gardos channel inhibitors. Also of possible value would be agents that selectively interfere with the K:CL cotransport pathway that is abnormally active in sickle reticulocytes and that can dehydrate even oxygenated sickle erythrocytes. Since rapid development of red cell dehydration tends to be a characteristic of those cells having low hemoglobin F levels, successful manipulation of cell fetal hemoglobin content might prove beneficial. Additionally, it would be reasonable to examine inhibitors of the deformation-activated potassium leak pathway that is exaggerated for cells that have minimal amounts of oxidized membrane lipid, as is the case for sickle red cells. The disparate abnormalities of sickle red cells suggest other approaches of potential therapeutic value that include, but are not limited to, the following: (1) benefit might derive from agents that stabilize the sickle membrane or otherwise inhibit the vesiculation process that contributes procoagulant material to sickle plasma, (2) vasoactive substances possibly could be utilized to manipulate vascular tone and flow dynamics, (3) agents that modify or inhibit formation of the sickle membrane's abnormal stiffness would likely be useful, and (4) approaches that lessen membrane fragility or prevent accumulation of opsonizing immunoglobulin on the cell surface might be of value in diminishing the severity of anemia. There is also continued interest in cell-cycle specific agents, such as 5-azacytidine and hydroxyurea that turn on the expression of the fetal hemoglobin gene. These compounds have demonstrated the capability of generating increased synthesis of Hb F in red cells of animals and patients, but serious concerns exist regarding the toxicity of 5-azacytidine. Hydroxyurea, which is much safer, has now been used in a small number of patients with reports of significant elevations of HbF, and a clinical trial has recently revealed that recurrent painful episodes can be reduced by 50 percent in patients with severe sickle cell disease. More recently erythropoietin and sodium butyrate have been added to the list. By themselves or in combination with hydroxyurea, they also increase the synthesis of Hb F in red cells. More information about the molecular, genetic, and cellular basis of action of these agents is needed. Allogenic bone marrow transplantation has recently begun to be used for therapy of this genetic disease but has not yet been widely accepted. Other approaches that involve replacing genes in autologous bone marrow cells using DNA-mediated gene transfer using viral vectors are underway with the idea of treating genetic diseases, including sickle cell anemia. Additional efforts could also be focused on a general understanding of stem cell biology and erythroid cell differentiation, with the goal of using targeted peripheral stem- cells as alternatives or adjuncts to bone marrow transplantation. Of equal importance, recent advances in molecular genetics, including identification of cis-acting DNA sequences and trans-acting proteins, have clarified the genetic mechanisms controlling the expression of hemoglobin genes and, in particular, the switches from embryonic and fetal to adult hemoglobins. Methods of isolating and growing stem cells in culture from bone marrow or peripheral blood should also prove useful in developing genetic approaches to sickle cell disease treatment. These studies promise to clarify the mechanisms of action of drugs like hydroxyurea, butyrate, and erythropoietin which affect expression of Hb F, and are also relevant to the long term development of gene therapy by attempts to transfer genes for normal hemoglobin or under ideal circumstances to use targeting to replace the defective sickle gene in stem cells. Judicious Timing The extraordinary complexity of sickle disease makes it unlikely that a complete solution to its pathophysiology will be forthcoming in the immediate future. On the other hand, the greater understanding of this pathophysiology stemming from research over the last decade identifies a number of areas that might be profitably exploited in terms of effective therapeutic intervention. The preceding discussions do not represent an all-inclusive listing of these opportunities, but merely indicate the great variety of possibilities that could be considered given the current state of knowledge and understanding. In addition, certain recent developments make this a particularly opportune moment for considering intervention strategies. The creation of transgenic sickle mice provides the opportunity for animal testing of certain strategies that are best evaluated in vivo. The establishment of flow models utilizing in situ vascular beds or endothelialized flow chambers now allows instructive evaluation of sickle cell adhesiveness under physiologic conditions. Further development of micropipette technology and other analytical systems has allowed more revealing analysis of red cell membrane properties and recent years have provided a general advancement of knowledge in areas relevant to sickle disease. Examples include the biology of adhesive molecules and their receptors, computer assisted molecular design, vascular biology/physiology, and the biophysical properties of membrane proteins and lipids. In virtually all cases, such advances have been used primarily to extend our knowledge of the pathophysiology of sickle cell disease. While the development of therapeutic strategies cannot and should not be separated from this enhanced understanding, it is clear that the attainment of our therapeutic goal will be greatly facilitated by targeting basic and applied research to the specific problem of identifying mechanisms that will lead to effective therapies. In this regard, the impressive results of the hydroxyurea clinical trial does not obviate the need for further studies. There are clearly nonresponders and others for whom this chemotherapeutic drug is not a satisfactory therapy, and the long term side effects of this drug are currently unknown. Moreover, since early studies suggest that the beneficial effects of hydroxyurea may derive from diminution of RBC adhesiveness and/or improvement of cellular hydration rather than =66rom effects on hemoglobin F level alone, it is possible that equivalent benefit could be derived from alterative approaches. This approach is worth considering, particularly for sickle children who may not be candidates for cytotoxic agents. Clearly, the continued development of rational therapeutic strategies is needed. With respect to methodology, it may be noted that the classic cell sickling assays have been complemented and in some ways supplanted by assays of the thermodynamics and kinetics of deoxyhemoglobin S gelation in solution, the intracellular polymerization of deoxyhemoglobin S, and the oxygen affinity of concentrated solutions of Hb S and sickle erythrocytes. These advances in assay techniques increase the opportunity to conduct more basic research in the area of the development of therapeutic approaches and have begun to allow the development of a quantitative approach to evaluating disease severity. Recent advances in genetics, cell biology, biophysics, and biochemistry broaden the search for therapeutic approaches to include pharmacological manipulation of hemoglobin switching and gene therapy, as well as strategies designed to develop inhibitors of polymerization, effectors of red cell volume, and a variety of physiological and cellular approaches. This initiative is not intended to support clinical trials. Rather, it is intended to support laboratory testing of defined potential therapeutic approaches based upon our current understanding of sickle cell disease pathophysiology. The multifactorial aspect of sickle disease pathophysiology provides a number of potential approaches for therapeutic intervention. These approaches include, but are not limited to: (1) identification of molecules that are capable of inhibiting sickle polymer formation, (2) decreasing the intracellular concentration of Hb S either by a direct effect on hemoglobin synthesis or by increasing the water content of the cell, (3) pharmacologic or genetic manipulation to increase the synthesis of fetal hemoglobin, (4) development of mechanisms that would e red cell adherence to vascular endothelium, (5) development of agents that stabilize the membranes of sickle red blood cells, (6) development of vasoactive substances to manipulate vascular tone and flow characteristics, or (7) development of agents that modify or inhibit formation of the sickle membrane's abnormal stiffness. These suggested approaches are intended as examples only. Investigators are encouraged to consider other innovative approaches. SPECIAL REQUIREMENTS Upon initiation of the program, the NHLBI will sponsor annual meetings to encourage the exchange of information among investigators who participate in this program. In the budget section of the grant application, applicants must include one meeting each year to be held in Bethesda, Maryland. Applicants should also include a statement in the application indicating their willingness to participate in such meetings. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of research. This new policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43) and supersedes and strengthens the previous policies (Concerning the Inclusion of Women in Study Populations, and Concerning the Inclusion of Minorities in Study Populations) which have been in effect since 1990. The new policy contains some new provisions that are substantially different from the 1990 policies. All investigators proposing research involving human subjects should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research", which have been published in the Federal Register of March 28, 1994 (FR 59 14508-14513), and reprinted in the NIH GUIDE FOR GRANTS AND CONTRACTS of March 18, 1994, Volume 23, Number 11. Investigators may obtain copies from these sources or from the program staff or contact person listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. LETTER OF INTENT Prospective applicants are asked to submit, by December 22, 1995, a letter of intent that includes a descriptive title of the proposed research and identification of any other participating institutions. Such letters are requested only for the purpose of providing an indication of the number and scope of applications to be received; therefore, their receipt is usually not acknowledged. A letter of intent is not binding, and it will not enter into the review of any application subsequently submitted, nor is it necessary to have sent a letter of intent to submit an application. The letter of intent is to be sent to: Chief, Review Branch Division of Extramural Affairs National Heart, Lung, and Blood Institute 6701 Rockledge Drive, MSC 7924 Bethesda, MD 20892-7924 Telephone: (301) 435-0266 FAX: (301) 480-3541 APPLICATION PROCEDURES Applications are to be submitted on the research grant application form PHS 398 (rev. 5/95). This form is available in an applicant institution's office of sponsored research and from the Office of Grants Information, Division of Research Grants, National Institutes of Health, 6701 Rockledge Drive, Room 3034 - MSC 7762, Bethesda, MD 20892-7762 telephone (301) 435-0714, email: xxxxxx@drgpo.drg.nih.gov. This RFA uses the "Just-in-Time" concept. The following modifications must be made to the standard PHS 398 application instructions: Applications not conforming to these guidelines will be considered unresponsive to this RFA and will be returned without further review. o INITIAL BUDGET PERIOD - Only the names of personnel and level of effort must be itemized in the Personnel section of the "Detailed Budget for the Initial Budget Period" (Form Page 4). In addition, list consultants, equipment, supplies, travel, patient care activities, alterations and renovations, and other needs, as appropriate. Costs are not to be indicated for these individual items or categories. If subcontracts are involved, state the name(s) of collaborating institutions in the "Consortium/Contractual Costs" section and provide individual budgets as detailed in the "SUBCONTRACTS" section below. The "Total Direct Costs" line at the bottom of the page must be completed based on the number of $25,000 modules being requested. Applicants may not request a change in the amount of each module. A maximum of eight modules ($200,000 direct costs) per year may be requested. Any large one-time purchases, such as large equipment requests, must be accommodated within these limits. o FUTURE BUDGET PERIODS - It is anticipated that direct cost budgets will remain the same for each year of the period of award (i.e., the same number of modules requested for each and every budget period). Any necessary escalation must be considered when determining the number of modules to be requested. However, in the event that the number of modules requested must change in any future year, appropriate justification must be provided. The "Budget for Entire Proposed Project Period" (top section of Form Page 5) must include Total Direct Costs requested for each year and the Total Direct Costs for the Entire Proposed Project Period. The Justification section must be completed based on instructions provided on Form Page 5. o SUBCONTRACTS - If collaborations or subcontracts are involved that require transfer of funds from the grantee to other institutions, it is necessary to establish formal subcontract agreements with each collaborating institution. A letter of agreement from each collaborating institution must be submitted with the application. Initial and future year budgets for subcontracts must be prepared using the same guidelines as for the main grant except that total subcontract costs need not be in $25,000 modules. Requested amounts must be based on individual needs of the subcontract and must reflect both direct and indirect costs. The subcontract costs are included in the total budget request, which must conform with the number of $25,000 modules requested. o BIOGRAPHICAL SKETCH - In addition to the standard information requested on Form Page 6, the applicant has the option of providing the title and source of any sponsored support relevant to the proposed research. o OTHER SUPPORT - No other support information is required on "Other Support" pages (Form Page 7). Selected other support information relevant to the proposed research may be included in the Biographical Sketch as indicated above. Complete other support information will be requested by NHLBI staff if there is a possibility for an award. o CHECKLIST - No "Checklist" page is required as part of the initial application. A completed Checklist will be requested by NHLBI staff if there is a possibility for an award. o The applicant must provide the name and phone number of the individual to contact concerning fiscal and administrative issues if additional information is necessary following the initial review. Applicants from institutions that have a General Clinical Research Center (GCRC) funded by the NIH National Center for Research Resources may wish to identify the GCRC as a resource for conducting the proposed research. If so, a letter of agreement from either the GCRC program director or principal investigator could be included with the application. To identify the application as a response to this RFA, check "YES" on Item 2 of page 1 of the application and enter the title and RFA number. SICKLE CELL DISEASE THERAPY: NHLBI RFA HL-96-001 The RFA label available in the PHS 398 application kit must be affixed to the bottom of the face page of the original copy of the application. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. Send or deliver the completed application and three signed, exact photocopies to: DIVISION OF RESEARCH GRANTS NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710 BETHESDA, MD 20892-7710 BETHESDA, MD 20817 (for courier/overnight service) Send an additional two copies of the application to the Chief, Review Branch at the address listed under LETTER OF INTENT. It is important to send these two copies at the same time as the original and three copies are sent to the Division of Research Grants. Otherwise the NHLBI cannot guarantee that the application will be reviewed in competition for this RFA. Applications must be received by January 23, 1996. If an application is received after that date, it will be returned to the applicant without review. The Division of Research Grants (DRG) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The DRG will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of substantial revisions of applications already reviewed, but such applications must include an introduction addressing the previous critique. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by the DRG and responsiveness by the NHLBI. Incomplete applications will be returned to the applicant without further consideration. If NHLBI staff determine that the application is not responsive to the RFA, it will be returned to the applicant without further consideration. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by the NHLBI in accordance with the review criteria stated below. Applications that are complete and responsive to the program announcement will be evaluated for scientific and technical merit by an appropriate peer review group convened in accordance with the standard NIH peer review procedures. As part of the initial merit review, all applications will receive a written critique and undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of applications under review, will be discussed, assigned a priority score, and receive a second level review by the appropriate national advisory council or board. Applications should be prepared so that they can be reviewed without the necessity of interaction between the applicants and the reviewers, since no site visit or reverse site visit will be part of the technical review. The personnel category will be reviewed for appropriate staffing based on the requested percent effort and any changes requested in future years. The total budget request will be reviewed for consistency with the proposed methods and specific aims. The duration of support will be reviewed to determine if it is appropriate to ensure successful completion of the recommended scope of the project. Review Criteria o scientific, technical, or medical significance and originality of proposed research; o appropriateness and adequacy of the experimental approach and methodology proposed to carry out the research; o qualifications and research experience of the Principal Investigator and staff, particularly, but not exclusively, in the area of the proposed research; o availability of the resources necessary to perform the research; o appropriateness of the budget and duration in relation to the proposed research; o adequacy of plans to include both genders and minorities and their subgroups as appropriate for the scientific goals of the research. Plans for the recruitment and retention of subjects will also be evaluated. The initial review group will also examine the provisions for the protection of human and animal subjects and the safety of the research environment. AWARD CRITERIA The anticipated date of award is August 1, 1996. Funding decisions will be made on the basis of scientific and technical merit as determined by peer review, program needs and balance, and the availability of funds. Awards in response to this RFA will be made to foreign institutions only for research of unusual merit, need, and promise, and in accordance with PHS policy governing such awards. INQUIRIES Inquiries concerning this RFA are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues to: Dr. Junius G. Adams, III Division of Blood Diseases and Resources National Heart, Lung, and Blood Institute 6701 Rockledge Drive, MSC 7950 Bethesda, MD 20892-7950 Telephone: (301) 435-0055 FAX: (301) 480-0868 Email: xxxxxx@nih.gov Inquiries regarding fiscal matters or collaborative arrangements involving subcontracts with other institutions may be directed to: Ms. Jane R. Davis Blood Division Grants Management Section National Heart, Lung, and Blood Institute 6701 Rockledge Drive, MSC 7926 Bethesda, MD 20892-7926 Telephone: (301) 435-0166 AUTHORITY AND REGULATIONS The programs of the Division of Blood Diseases and Resources, NHLBI, are described in the Catalog of Federal Domestic Assistance No. 93.839. Awards will be made under the authority of the Public Health Service Act, Section 301 (42 USC 241) and administered under PHS grant policies and Federal regulations, most specifically 42 CFR Part 52 and 45 CFR Part 74. This program is not subject to the intergovernmental review requirements of Executive Order 12372, or to Health Systems Agency Review. =2E --Boundary_[ID_8WhGV28W4n4amqAiIC24OA]--