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Monika Haack, Ph.D.

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University of Trier, Tier, GermanyM.A.05/1995Biological Psychology
Max Planck Institute of Psychiatry, Munich, GermanyPh.D.12/2001Sleep, Immunology, Psychiatry
Beth Israel Deaconess Medical Center, Boston, MA, USAPostdoc11/2004Sleep, Immunology, Pain
German Research Foundation Fellowship
Travel Award
Trainee Research Merit Award
Trainee Travel Award
Participant & Clinical Interactions Resources (PCIR) Junior Investigator Laboratory Support
Harvard Medical School Excellence in Tutoring Award
SRS Biomarker Trainee Travel Award
SRS Participation Award ‘Precision Sleep Medicine'

My research goals are directed at discovering the mechanisms involved in the relationship between sleep deficiency and disease risk, in particular chronic pain, with a focus on central pain processing and inflammatory networks as promising mechanistic candidates. Over the years, I have developed an interdisciplinary research program linking sleep physiology, inflammatory and endocrine stress systems, and pain processing.
I have developed and implemented complex and lengthy experimental models of sleep deficiency that mimic sleep patterns that are highly common in society, such as the repeated exposure to restricting sleep on weekdays and catching-up on sleep over the weekend, or patterns of recurrent sleep disturbances. I am also investigating the sleep-pain relationships using real-life models, such as insomnia disorder. Based on these laboratory and non-laboratory models, findings repeatedly suggested that women and may respond differently to sleep deficiency. Given that such response differences may contribute to sex-differential disease susceptibility, my future work will incorporate the investigation of sex differences.

1999 – present German Sleep Society (DGSM)
2003 – present Sleep Research Society (SRS)
2012 – present American Pain Society (APS)
2015 – present Psychoneuroimmunology Research Society (PNIRS)

Subjective and biological response reactivity to a pain challenge in the course of repeated patterns of sleep restriction and recovery – a pilot study
Summer, 06/17/13 - 08/16/13
Actigraphy-Based Sleep Characteristics as Predictors of Inflammatory, Autonomic, and Stress Systems Activation in Individuals Suffering From Primary Insomnia
Summer, 06/01/12 - 09/01/12

The research activities and funding listed below are automatically derived from NIH ExPORTER and other sources, which might result in incorrect or missing items. Faculty can login to make corrections and additions.
  1. R01HL136310 (HAACK, MONIKA) Apr 15, 2018 - Feb 28, 2023
    Patterns of Sleep Restriction and Recovery: The Inflammatory Resolution Pathways
    Role: Principal Investigator
  2. R01NS091177 (HAACK, MONIKA) Apr 1, 2015 - Mar 31, 2020
    Pain Sensitization and Habituation in a Model of Experimentally-Induced Insomnia Symptoms
    Role: Principal Investigator
  3. R01HL105544 (HAACK, MONIKA) Jun 7, 2011 - Mar 31, 2016
    Repeating patterns of sleep restriction and recovery - do we get used to it?
    Role: Principal Investigator
  4. M01RR001032 (SUKHATME, VIKAS P) Dec 1, 1977 - Mar 31, 2010
    General Clinical Research Center
    Role: Co-Principal Investigator

Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
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PMC Citations indicate the number of times the publication was cited by articles in PubMed Central, and the Altmetric score represents citations in news articles and social media. (Note that publications are often cited in additional ways that are not shown here.) Fields are based on how the National Library of Medicine (NLM) classifies the publication's journal and might not represent the specific topic of the publication. Translation tags are based on the publication type and the MeSH terms NLM assigns to the publication. Some publications (especially newer ones and publications not in PubMed) might not yet be assigned Field or Translation tags.) Click a Field or Translation tag to filter the publications.
  1. Besedovsky L, Dang R, Engert LC, Goldstein MR, Devine JK, Bertisch SM, Mullington JM, Simpson N, Haack M. Differential effects of an experimental model of prolonged sleep disturbance on inflammation in healthy females and males. PNAS Nexus. 2022 Mar; 1(1). PMID: 36380854; PMCID: PMC9648610.
  2. Mullington JM, Cunningham TJ, Haack M, Yang H. Causes and Consequences of Chronic Sleep Deficiency and the Role of Orexin. Front Neurol Neurosci. 2021; 45:128-138. PMID: 34052807.
    Citations:    Fields:    Translation:HumansAnimals
  3. Yang H, Baltzis D, Bhatt V, Haack M, Meier-Ewert HK, Gautam S, Veves A, Mullington JM. Macro- and microvascular reactivity during repetitive exposure to shortened sleep: sex differences. Sleep. 2021 05 14; 44(5). PMID: 33249482.
    Citations: 1     Fields:    Translation:Humans
  4. Haspel JA, Anafi R, Brown MK, Cermakian N, Depner C, Desplats P, Gelman AE, Haack M, Jelic S, Kim BS, Laposky AD, Lee YC, Mongodin E, Prather AA, Prendergast BJ, Reardon C, Shaw AC, Sengupta S, Szentirmai É, Thakkar M, Walker WE, Solt LA. Perfect timing: circadian rhythms, sleep, and immunity - an NIH workshop summary. JCI Insight. 2020 01 16; 5(1). PMID: 31941836; PMCID: PMC7030790.
    Citations: 43     Fields:    Translation:HumansAnimalsCells
  5. Lazaridou A, Koulouris A, Devine JK, Haack M, Jamison RN, Edwards RR, Schreiber KL. Impact of daily yoga-based exercise on pain, catastrophizing, and sleep amongst individuals with fibromyalgia. J Pain Res. 2019; 12:2915-2923. PMID: 31802932; PMCID: PMC6802732.
    Citations: 9     
  6. Besedovsky L, Lange T, Haack M. The Sleep-Immune Crosstalk in Health and Disease. Physiol Rev. 2019 07 01; 99(3):1325-1380. PMID: 30920354; PMCID: PMC6689741.
    Citations: 176     Fields:    Translation:HumansAnimals
  7. Haack M, Simpson N, Sethna N, Kaur S, Mullington J. Sleep deficiency and chronic pain: potential underlying mechanisms and clinical implications. Neuropsychopharmacology. 2020 01; 45(1):205-216. PMID: 31207606.
    Citations: 54     Fields:    Translation:HumansAnimals
  8. Yang H, Haack M, Dang R, Gautam S, Simpson NS, Mullington JM. Heart rate variability rebound following exposure to persistent and repetitive sleep restriction. Sleep. 2019 02 01; 42(2). PMID: 30476269; PMCID: PMC6369727.
    Citations: 7     Fields:    Translation:Humans
  9. Alkozei A, Haack M, Skalamera J, Smith R, Satterfield BC, Raikes AC, Killgore WD. Chronic sleep restriction affects the association between implicit bias and explicit social decision making. Sleep Health. 2018 10; 4(5):456-462. PMID: 30241661.
    Citations: 2     Fields:    Translation:Humans
  10. Devine JK, Bertisch SM, Yang H, Scott-Sutherland J, Wilkins A, Molina V, Henrikson K, Haack M. Glucocorticoid and inflammatory reactivity to a repeated physiological stressor in insomnia disorder. Neurobiol Sleep Circadian Rhythms. 2019 Jan; 6:77-84. PMID: 31236523; PMCID: PMC6586925.
    Citations: 2     
  11. Simpson NS, Scott-Sutherland J, Gautam S, Sethna N, Haack M. Chronic exposure to insufficient sleep alters processes of pain habituation and sensitization. Pain. 2018 01; 159(1):33-40. PMID: 28891869; PMCID: PMC5832516.
    Citations: 21     Fields:    Translation:Humans
  12. Alkozei A, Killgore WDS, Smith R, Dailey NS, Bajaj S, Raikes AC, Haack M. Chronic sleep restriction differentially affects implicit biases toward food among men and women: preliminary evidence. J Sleep Res. 2018 08; 27(4):e12629. PMID: 29094414.
    Citations: 2     Fields:    Translation:Humans
  13. Alkozei A, Killgore WDS, Smith R, Dailey NS, Bajaj S, Haack M. Chronic Sleep Restriction Increases Negative Implicit Attitudes Toward Arab Muslims. Sci Rep. 2017 06 27; 7(1):4285. PMID: 28655901; PMCID: PMC5487318.
    Citations: 4     Fields:    Translation:Humans
  14. Yang H, Haack M, Gautam S, Meier-Ewert HK, Mullington JM. Repetitive exposure to shortened sleep leads to blunted sleep-associated blood pressure dipping. J Hypertens. 2017 06; 35(6):1187-1194. PMID: 28169885; PMCID: PMC6052859.
    Citations: 23     Fields:    Translation:Humans
  15. Simpson NS, Diolombi M, Scott-Sutherland J, Yang H, Bhatt V, Gautam S, Mullington J, Haack M. Repeating patterns of sleep restriction and recovery: Do we get used to it? Brain Behav Immun. 2016 Nov; 58:142-151. PMID: 27263430; PMCID: PMC5067189.
    Citations: 20     Fields:    Translation:HumansCells
  16. Mullington JM, Abbott SM, Carroll JE, Davis CJ, Dijk DJ, Dinges DF, Gehrman PR, Ginsburg GS, Gozal D, Haack M, Lim DC, Macrea M, Pack AI, Plante DT, Teske JA, Zee PC. Developing Biomarker Arrays Predicting Sleep and Circadian-Coupled Risks to Health. Sleep. 2016 Apr 01; 39(4):727-36. PMID: 26951388.
    Citations: 36     Fields:    
  17. Floam S, Simpson N, Nemeth E, Scott-Sutherland J, Gautam S, Haack M. Sleep characteristics as predictor variables of stress systems markers in insomnia disorder. J Sleep Res. 2015 Jun; 24(3):296-304. PMID: 25524529.
    Citations: 30     Fields:    Translation:HumansCells
  18. Haack M, Serrador J, Cohen D, Simpson N, Meier-Ewert H, Mullington JM. Increasing sleep duration to lower beat-to-beat blood pressure: a pilot study. J Sleep Res. 2013 Jun; 22(3):295-304. PMID: 23171375.
    Citations: 49     Fields:    Translation:Humans
  19. Haack M, Scott-Sutherland J, Santangelo G, Simpson NS, Sethna N, Mullington JM. Pain sensitivity and modulation in primary insomnia. Eur J Pain. 2012 Apr; 16(4):522-33. PMID: 22396081.
    Citations: 45     Fields:    Translation:Humans
  20. Mullington JM, Simpson NS, Meier-Ewert HK, Haack M. Sleep loss and inflammation. Best Pract Res Clin Endocrinol Metab. 2010 Oct; 24(5):775-84. PMID: 21112025.
    Citations: 158     Fields:    Translation:HumansAnimalsCells
  21. Haack M, Lee E, Cohen DA, Mullington JM. Activation of the prostaglandin system in response to sleep loss in healthy humans: potential mediator of increased spontaneous pain. Pain. 2009 Sep; 145(1-2):136-41. PMID: 19560866.
    Citations: 51     Fields:    Translation:Humans
  22. Mullington JM, Haack M, Toth M, Serrador JM, Meier-Ewert HK. Cardiovascular, inflammatory, and metabolic consequences of sleep deprivation. Prog Cardiovasc Dis. 2009 Jan-Feb; 51(4):294-302. PMID: 19110131; PMCID: PMC3403737.
    Citations: 253     Fields:    Translation:Humans
  23. Haack M, Sanchez E, Mullington JM. Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Sleep. 2007 Sep; 30(9):1145-52. PMID: 17910386.
    Citations: 192     Fields:    Translation:Humans
  24. Schuld A, Birkmann S., Beitinger P., Haack M., Kraus T., Dalal M.A., Holsboer F., Pollmächer T. Low doses of dexamethasone affect immune parameters in the absence of immunological stimulation. Experimental and Clinical Endocrinology and Diabetes. 2006; 114(6):322-28.
  25. Haack M, Mullington, JM. Shorter habitual sleep duration is associated with higher increase in subjective estimation of pain in response to a total sleep deprivation (TSD) challenge. Sleep. 2006; 129:A133.
  26. Meier-Ewert HK, Seo JY, Haack,M, Hyppolite G, Gervino E, Mullington JM. Habitual sleep duration predicts heart rate recovery following exercise in men. Sleep. 2006; 29:A149-150.
  27. Haack M, Mullington JM. Sustained sleep restriction reduces emotional and physical well-being. Pain. 2005 Dec 15; 119(1-3):56-64. PMID: 16297554.
    Citations: 98     Fields:    Translation:Humans
  28. Mullington JM, Haack M, Rifai A. Diurnal rhythms of endothelial markers: Nadirs are not correlated with those of cortisol or body temperature. Sleep. 2005; 28:A70.
  29. Haack M, Mullington JM. Subjective estimations of pain increase in both total sleep deprivation (TSD) and partial sleep deprivation (PSD). Sleep. 2005; 28:A145.
  30. Schuld A, Haack M, Hinze-Selch D, Mullington J, Pollmächer T. [Experimental studies on the interaction between sleep and the immune system in humans]. Psychother Psychosom Med Psychol. 2005 Jan; 55(1):29-35. PMID: 15647993.
    Citations: 5     Fields:    Translation:Humans
  31. Himmerich H, Schuld A, Haack M, Kaufmann C, Pollmächer T. Early prediction of changes in weight during six weeks of treatment with antidepressants. J Psychiatr Res. 2004 Sep-Oct; 38(5):485-9. PMID: 15380398.
    Citations: 7     Fields:    Translation:Humans
  32. Haack M, Pollmächer T, Mullington JM. Diurnal and sleep-wake dependent variations of soluble TNF- and IL-2 receptors in healthy volunteers. Brain Behav Immun. 2004 Jul; 18(4):361-7. PMID: 15157953.
    Citations: 30     Fields:    Translation:HumansCTClinical Trials
  33. Haack M, Sanchez E, Broussard J, Regan M, Mullington JM. Sleep restriction increases IL-6 levels and pain-related symptoms in healthy volunteers. Sleep. 2004; 27:A137-A138.
  34. Broussard J, Haack M, Serrador J, Mullington J. Effects of sleep restriction on blood pressure. Sleep. 2004; 27:A171.
  35. Schuld A, Schmid DA, Haack M, Holsboer F, Friess E, Pollmächer T. Hypothalamo-pituitary-adrenal function in patients with depressive disorders is correlated with baseline cytokine levels, but not with cytokine responses to hydrocortisone. J Psychiatr Res. 2003 Nov-Dec; 37(6):463-70. PMID: 14563377.
    Citations: 9     Fields:    Translation:Humans
  36. Schuld A, Hinze-Selch D, Haack M, Dalal MA, Himmerich H, Lancel M, Pollmächer T. Sleep changes following chlorpromazine, clozapine, olanzapine or thalidomide in healthy subjects - First results from a double-blind, placebo-controlled study. Pharmacopsychiatry. 2003; 36(5):263-264.
  37. Schuld A, Haack M, Birkmann S, Friess E, Pollmächer T. Immune-neuroendocrine interactions and their influence on the immune function in patients with depressive disorders. Pharmacopsychiatry. 2003; 36(5):263.
  38. Himmerich H, Schuld A, Haack M, Kaufmann C, Pollmächer T. Early prediction of changes in weight during six weeks of treatment with antidepressants. Pharmacopsychiatry. 2003; 36(5):235.
  39. Broussard J, Haack M, Kan R, Mullington J. Early morning awakening is stressful. Sleep. 2003; 26:A205.
  40. Haack M, Broussard J, Repp A, Regan M, Connolly C, Mullington J. Increased headache frequency during chronic sleep restriction in healthy human subjects. Sleep. 2003; 26:A206.
  41. Hyppolite G, Haack M, Regan M, Kan R, Mullington J. A diurnal rhythm exists in circulating levels of lipopolysaccaride binding protein (LBP) in healthy young volunteers. Sleep. 2003; 26:A113.
  42. Straub RH, Schuld A, Mullington J, Haack M, Schölmerich J, Pollmächer T. The endotoxin-induced increase of cytokines is followed by an increase of cortisol relative to dehydroepiandrosterone (DHEA) in healthy male subjects. J Endocrinol. 2002 Nov; 175(2):467-74. PMID: 12429044.
    Citations: 11     Fields:    Translation:Humans
  43. Haack M, Kraus T, Schuld A, Dalal M, Koethe D, Pollmächer T. Diurnal variations of interleukin-6 plasma levels are confounded by blood drawing procedures. Psychoneuroendocrinology. 2002 Nov; 27(8):921-31. PMID: 12383453.
    Citations: 43     Fields:    Translation:HumansCTClinical Trials
  44. Reichenberg A, Kraus T, Haack M, Schuld A, Pollmächer T, Yirmiya R. Endotoxin-induced changes in food consumption in healthy volunteers are associated with TNF-alpha and IL-6 secretion. Psychoneuroendocrinology. 2002 Nov; 27(8):945-56. PMID: 12383455.
    Citations: 19     Fields:    Translation:Humans
  45. Kraus T, Haack M, Schuld A, Hinze-Selch D, Koethe D, Pollmächer T. Body weight, the tumor necrosis factor system, and leptin production during treatment with mirtazapine or venlafaxine. Pharmacopsychiatry. 2002 Nov; 35(6):220-5. PMID: 12518269.
    Citations: 40     Fields:    Translation:HumansCTClinical Trials
  46. Pollmächer T, Haack M, Schuld A, Reichenberg A, Yirmiya R. Low levels of circulating inflammatory cytokines--do they affect human brain functions? Brain Behav Immun. 2002 Oct; 16(5):525-32. PMID: 12401466.
    Citations: 61     Fields:    Translation:Humans
  47. Haack M, Schuld A, Pollmächer T. Immunstimulation: Wirkung auf Stimmung und Gedächtnis. Psychotherapie in Psychiatrie, Psychotherapeutischer Medizin und Klinischer Psychologie. 2002; 7(2):210-218.
  48. Haack M. Interactions between the endotoxin-induced human host response and sleep, mood, and cognitive performance. 2001.
  49. Pollmächer T, Schuld A, Kraus T, Haack M, Hinze-Selch D. [On the clinical relevance of clozapine-triggered release of cytokines and soluble cytokine-receptors]. Fortschr Neurol Psychiatr. 2001 Sep; 69 Suppl 2:S65-74. PMID: 11533853.
    Citations: 5     Fields:    Translation:Humans
  50. Haack M, Schuld A, Kraus T, Pollmächer T. Effects of sleep on endotoxin-induced host responses in healthy men. Psychosom Med. 2001 Jul-Aug; 63(4):568-78. PMID: 11485110.
    Citations: 9     Fields:    Translation:HumansCellsCTClinical Trials
  51. Dalal MA, Schuld A, Haack M, Uhr M, Geisler P, Eisensehr I, Noachtar S, Pollmächer T. Normal plasma levels of orexin A (hypocretin-1) in narcoleptic patients. Neurology. 2001 Jun 26; 56(12):1749-51. PMID: 11425946.
    Citations: 22     Fields:    Translation:Humans
  52. Kraus T, Schuld A, Haack M, Dalal E, Pollmächer T. Leptin and Psychopharmacology. Sperner-Unterweger B, Fleischhacker WW, Kaschka WP. Psychoneuroimmunology.Hypotheses and Current Research. Adv Biol Psychiatry. 2001; 20:20-29.
  53. Reichenberg A, Yirmiya R, Schuld A, Kraus T, Haack M, Morag A, Pollmächer T. Cytokine-associated emotional and cognitive disturbances in humans. Arch Gen Psychiatry. 2001 May; 58(5):445-52. PMID: 11343523.
    Citations: 426     Fields:    Translation:HumansCTClinical Trials
  54. Kraus T, Haack M, Schuld A, Hinze-Selch D, Pollmächer T. Low leptin levels but normal body mass indices in patients with depression or schizophrenia. Neuroendocrinology. 2001 Apr; 73(4):243-7. PMID: 11340338.
    Citations: 54     Fields:    Translation:HumansCTClinical Trials
  55. Kraus T, Zimmermann U, Schuld A, Haack M, Hinze-Selch D, Pollmächer T. [The physiopathology of weight regulation during treatment with psychotropic drugs]. Fortschr Neurol Psychiatr. 2001 Mar; 69(3):116-37. PMID: 11305122.
    Citations:    Fields:    Translation:HumansAnimals
  56. Schuld A, Kraus T, Haack M, Hinze-Selch D, Zobel AW, Holsboer F, Pollmächer T. Effects of dexamethasone on cytokine plasma levels and white blood cell counts in depressed patients. Psychoneuroendocrinology. 2001 Jan; 26(1):65-76. PMID: 11070335.
    Citations: 6     Fields:    Translation:Humans
  57. Pollmächer T, Haack M, Schuld A, Kraus T, Hinze-Selch D. Effects of antipsychotic drugs on cytokine networks. J Psychiatr Res. 2000 Nov-Dec; 34(6):369-82. PMID: 11165304.
    Citations: 41     Fields:    Translation:Humans
  58. Schuld A, Blum WF, Uhr M, Haack M, Kraus T, Holsboer F, Pollmächer T. Reduced leptin levels in human narcolepsy. Neuroendocrinology. 2000 Oct; 72(4):195-8. PMID: 11070422.
    Citations: 11     Fields:    Translation:Humans
  59. Schuld A, Kraus T, Hinze-Selch D, Haack M, Pollmächer T. Granulocyte colony-stimulating factor plasma levels during clozapine- and olanzapine-induced granulocytopenia. Acta Psychiatr Scand. 2000 Aug; 102(2):153-5. PMID: 10937789.
    Citations: 4     Fields:    Translation:HumansCells
  60. Hinze-Selch D, Schuld A, Kraus T, Kühn M, Uhr M, Haack M, Pollmächer T. Effects of antidepressants on weight and on the plasma levels of leptin, TNF-alpha and soluble TNF receptors: A longitudinal study in patients treated with amitriptyline or paroxetine. Neuropsychopharmacology. 2000 Jul; 23(1):13-9. PMID: 10869882.
    Citations: 29     Fields:    Translation:Humans
  61. Schuld A, Kraus T, Haack M, Hinze-Selch D, Kühn M, Pollmächer T. Plasma levels of cytokines and soluble cytokine receptors during treatment with olanzapine. Schizophr Res. 2000 Jun 16; 43(2-3):164-6. PMID: 11001592.
    Citations: 6     Fields:    Translation:Humans
  62. Haack M, Reichenberg A, Kraus T, Schuld A, Yirmiya R, Pollmächer T. Effects of an intravenous catheter on the local production of cytokines and soluble cytokine receptors in healthy men. Cytokine. 2000 Jun; 12(6):694-8. PMID: 10843747.
    Citations: 13     Fields:    Translation:HumansCTClinical Trials
  63. Schuld A, Kühn M, Haack M, Kraus T, Hinze-Selch D, Lechner C, Pollmächer T. A comparison of the effects of clozapine and olanzapine on the EEG in patients with schizophrenia. Pharmacopsychiatry. 2000 May; 33(3):109-11. PMID: 10855462.
    Citations: 12     Fields:    Translation:HumansCTClinical Trials
  64. Pollmächer T, Schuld A, Kraus T, Haack M, Hinze-Selch D, Mullington J. Experimental immunomodulation, sleep, and sleepiness in humans. Ann N Y Acad Sci. 2000; 917:488-99. PMID: 11268376.
    Citations: 15     Fields:    Translation:Humans
  65. Schuld A, Kraus T, Haack M, Hinze-Selch D, Pollmächer T. Obstructive sleep apnea syndrome induced by clonazepam in a narcoleptic patient with REM-sleep-behavior disorder. J Sleep Res. 1999 Dec; 8(4):321-2. PMID: 10646174.
    Citations: 8     Fields:    Translation:Humans
  66. Haack M, Hinze-Selch D, Fenzel T, Kraus T, Kühn M, Schuld A, Pollmächer T. Plasma levels of cytokines and soluble cytokine receptors in psychiatric patients upon hospital admission: effects of confounding factors and diagnosis. J Psychiatr Res. 1999 Sep-Oct; 33(5):407-18. PMID: 10504009.
    Citations: 74     Fields:    Translation:Humans
  67. Pollmächer T, Kraus T, Haack M, Uhr M, Mullington J. Salmonella abortus equi endotoxin does not affect leptin plasma levels in healthy humans. J Infect Dis. 1999 Apr; 179(4):1047-8. PMID: 10068609.
    Citations: 1     Fields:    Translation:HumansCells
  68. Kraus T, Haack M, Schuld A, Hinze-Selch D, Kühn M, Uhr M, Pollmächer T. Body weight and leptin plasma levels during treatment with antipsychotic drugs. Am J Psychiatry. 1999 Feb; 156(2):312-4. PMID: 9989571.
    Citations: 39     Fields:    Translation:Humans
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Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.