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International Mentoring Program Mentee Application Overview The International Mentoring Program focuses on reaching out to Early Career members who reside outside the United States. The objectives of this program are: 1) to help young physicians, clinicians and scientists develop their professional careers; 2) to promote the highest possible quality of science and practice in cardiovascular and cerebral vascular disease throughout the world by enriching the scientific base of junior scientists, clinicians, and physicians; 3) to increase international collaboration in basic and clinical research in cardiovascular and cerebral vascular disease; and 4) to increase the involvement of physicians, clinicians and scientists from other countries in the American Heart Association. Mentor/Mentee Matching 1) Each mentor will be assigned only one mentee at a time. 2) The term of mentorship of an individual mentee will be limited to a maximum of three years. Participation Requirements: 1) Participants must be active members of the American Heart Association (AHA) at the Early Career level. To become a member of the AHA please visit the AHA Professional Membership web page. 2) Participants must permanently reside outside the United States. 3) The program requires the mentor and mentee to meet regularly via telephone, email or other electronic means to discuss issues and strategies for career development. 4) When feasible, face-to-face individual mentoring at the AHA Scientific Session or specialty meeting each year. 5) Mentee and mentor must complete a survey 4-months after the match to help AHA determine how success of the match. 6) Mentee and mentor must complete and submit an annual report on their mentoring experience. Applications must include the following: 1) Completed application form 2) Up-to-date curriculum vitae including publications 3) Photograph (jpeg or tiff format) 4) Email application and required documents to [email protected]. International Mentoring Program Mentee Application Form Thank you for your interest in participating in the International Mentoring Program. Please complete the application form in full, attach a copy of your up-to-date curriculum vitae including publications, a head and shoulder photograph, and submit to [email protected]. Demographic Information First Name: MI: Last Name: Degree(s): Current Position/Title: How long at the above position (number of years): Institution: Mailing Address: City: State/Province: Phone: Postal Code: Country: Fax: Email: AHA Affiliation AHA Membership ID: Council Affiliation: Arteriosclerosis, Thrombosis & Vascular Biology Basic Cardiovascular Sciences Cardiopulmonary, Critical Care, Perioperative & Resuscitation CV Disease in the Young CV Nursing CV Radiology & Intervention CV Surgery and Anesthesia Clinical Cardiology Epidemiology & Prevention Functional Genomics & Translational Biology High Blood Pressure Research Kidney in CV Disease Nutrition, Physical Activity& Metabolism Peripheral Vascular Disease Quality Care & Outcomes Research Stroke Please describe your clinical experience: Please describe your research experience: Research Funding: Personal Statement about your career goals, and what you hope to accomplish by participating in this program: Science Interests To help us match you with an appropriate mentor, please select the areas of your science interests: ATVB Angiogenesis and Arteriogenesis Aortic aneurysm disease Apolipoproteins - structure and function Blood coagulation and fibrinolysis Carotid and peripheral artery disease Cellular lipid metabolism Clinical aspects of diabetes, obesity and insulin resistance Clinical lipidology - diagnostics and therapeutics Diabetes, obesity and metabolic disorders Endothelium, Vascular Tone and Nitric Oxide Hemostasis, Thrombosis and Fibrinolysis Immunity and inflammation in vascular biology and atherosclerosis Inflammation and Adhesion Molecules Lipid and Lipoprotein Metabolism: Clinical Lipids, Lipid Mediators and Lipoprotein Lipoprotein metabolism and therapeutic targets Mechanisms of Atherosclerosis Mechanisms of atherosclerosis Metabolism: Cellular and Animal Microcirculation and Cerebral/Coronary/ Peripheral Circulation Molecular and cellular biology of the vessel wall Platelet production, signaling, and function Proliferation, Remodeling, Extracellular Matrix Redox Signaling and Oxidative Stress Stem/Progenitor Cells Vascular cells, inflammation, and thrombosis Vascular Development, Differentiation, and Regeneration Vascular development, differentiation, regeneration and angiogenesis BCVS Apoptosis and Necrosis Arrhythmias in Experimental Models Autonomic, Reflex, and Neurohumoral Control of Circulation Autophagy, Mitochondria, and Protein Homeostasis Cardiac Development Cardiac Failure and Remodeling Cardiac Regeneration/Cellular Therapy Experimental Cellular Electrophysiology and Excitationcontraction coupling Experimental Myocardial Infarction Gene Expression/Molecular Biology Growth Factors, Cytokines, Signal Transduction Ion Channels and membrane Transporters Molecular Basis of Hypertrophy Myocardial Energetics/Intermediary Metabolism Myocardial Structure and Pathology Protection of Ischemic Myocardium Ventricular Function/Mechanics Cardiac Regeneration, Stem Cells and Tissue Engineering Cardiac Reprogramming and iPS Cells Cell Death Mechanisms, Apoptosis, Necrosis and Autophagy Clinical/Translational Research Contractility and Calcium-Handling Genetics and Genomics of Cardiovascular Disease Growth and Development Heart Failure Biology Hypertrophic Signaling Pathways Mechanisms of Cardiac Aging Mitochondria and Metabolism Myocardial Ischemia and Cardioprotection Myofilament Proteins Systems Approach to Cardiovascular Biology Transcriptional and Epigenetic Regulation of Gene Expression 3CPR Resuscitation, CPR, Emergency Cardiac Care, Critical Care, AED and Trauma Pulmonary Hypertension CVDY Adult Congenital Heart Disease Cardiac Development Pediatric Cardiac Surgery Pediatric Congenital and Acquired Heart Disease Pediatric Electrophysiology Pediatric Pediatric Pediatric Pediatric Epidemiology and Prevention Heart Failure Imaging Interventional Catheterization CVN Physiologic Aspects of Acute and Chronic Care Prevention, Education, and Disease Management Psychosocial and Behavioral Aspects CVRI Computed Tomography (CT): Coronary Artery Computed Tomography (CT): Heart (NonCoronary) Congenital Heart Disease (CT/MRI) Hybrid Imaging (Heart): SPECT-CT/PET-CT/MRPET) Magnetic Resonance Imaging (MRI): Heart Molecular Imaging (Heart/Vasculature) Nuclear Cardiology (SPECT/PET) Computed Tomography (CT): Heart (NonCoronary) Non-Coronary Vascular Imaging (CT/MRI/Other) Peripheral Vascular Disease: Non-Invasive Imaging (CT/MRI/Other) Peripheral Vascular Disease: Intervention Plaque Imaging (CT/MRI/Other) Pulmonary Hypertension (CT/MRI/Other) Whole Body Imaging: Vascular (CT/MRI/Other) CVSA Cell, Tissue Engineering, and Gene Based Therapies Thoracic Aortic Disease Surgical Revascularization for Ischemic Heart Disease Myocardial Protection, Intraoperative Management, and Postoperative Critical Care Surgical Therapy for Valvular Heart Disease Surgical Treatment of Heart Failure, Transplantation, and Arrhythmias CLCD Arrhythmia: Clinical Electrophysiology, Diagnosis and Risk Stratification Catheter-Based Coronary Imaging and Hemodynamics Catheter-Based Coronary Interventions: Experimental & New Technology Catheter-Based Coronary Interventions: Stents – Clinical Use Chronic Ischemic Heart Disease Echocardiography in CAD: Stress and Contrast Echocardiography in Clinical Syndromes: Valve disease, Stroke and Arrhythmias Echocardiography: Emerging Technologies Echocardiography: Evaluation of Diastolic Function Echocardiography: Evaluation of Systolic Function Heart Failure: Disease Management, Quality of Care, and Clinical Outcomes Heart Failure: Pacing and Other Therapeutic Devices Heart Failure: Pathophysiology & Diagnosis Heart Failure: Pharmacologic Therapy Medical Aspects End Stage Heart Failure: Transplantation and Device Therapies Myocardial (including Hypertrophy)/Pericardial Disease Nuclear Cardiology: Isotope Imaging and PET Percutaneous Non-Coronary Cardiac Intervention (including Percutaneous Valves) Pharmacology for ACS and PCI Stress Testing Exercise and Pharmacologic Treatment of Arrhythmias: Ablation Treatment of Arrhythmias: ICD/Pacemaker – excluding CRT Treatment of Arrhythmias: Pharmacologic Unstable Angina, NSTEMI and STEMI: Diagnosis and Pathophysiology Unstable Angina, NSTEMI and STEMI: Prognosis and Pharmacologic Therapy Valvular Heart Disease: Diagnosis, Pathophysiology and Medical Management Ventricular Function/Hemodynamics and Biomarkers EPI/PREV Aging Arrhythmia Behavior Biomarkers Childhood Cigarette Smoking Clinical and Hospital-Based Observational Studies Clinical Trials Diabetes/Metabolic Syndrome Environmental Agents Epidemiology: Population Studies, Risk Factors, Biomarkers Ethnic Health Disparities Genetic Epidemiology, Genomics and Pharmacogenomics of Cardiovascular Disease Genetics Global Health Health Services/Outcomes Heart Failure Hypertension Infection/HIV Lifecourse Lifestyle Interventions Lipids & Lipoproteins Metabolism Methodology Molecular epidemiology Nutrition Obesity Peripheral Artery Disease Pharmacoepidemiology Physical Activity/Fitness Pregnancy Preventive Cardiology Preventive Interventions: Population and Clinical Trials Preventive Interventions: Population and Clinical Trials Psychosocial Quality of Life Reaching the AHA 2020 Goals: Strategies for Success Renal Disease Sleep Stroke Subclinical Disease Sudden Death Surveillance Technology to Promote/ Measure Health Behaviors Translational Research Venous Thrombosis FGTB Functional Genomics, Transcriptomics, Proteomics and Metabolomics of Cardiovascular Disease Genetic Epidemiology, Genomics and Pharmacogenomics of Cardiovascular Disease HBPR Aging Aldosterone and Adrenal Mechanisms Angiotensin Converting Enzymes Blood Pressure Monitoring Brain Mechanisms Cardiac Hypertrophy and Dysfunction Cardiovascular-Renal Interactions Cerebrovascular Disease and Stroke Chronic Kidney Disease Clinical Studies and Trials Diabetes Endothelial Function Epidemiology Experimental Models Gender Differences Genetics, Gene Therapy and Proteomics Hormones & Natriuretic Factors Hypertension: Clinical Hypertension: Experimental KCVD Inflammation, Immunity and Cytokines Novel Therapeutic Approaches Nutrition and Hypertension Obesity and Metabolic Syndrome Oxidative Stress Peripheral Neural Mechanisms Pregnancy and Preeclampsia Prorenin and (Pro)renin Receptor Receptors and Signal Transduction Renal Hemodynamics & Renovascular Hypertension Renal Tubular Transport Renin-Angiotensin System Resistant Hypertension Salt and Hypertension Vascular Biology Vascular Remodeling and Dysfunction Vascular Stiffness Cardiorenal Physiology/Pathophysiology Receptor Pharmacology LIFESTYLE AND CARDIOMETABOLIC HEALTH Arrhythmia/Sudden Death Behavior/Lifestyle Biomarkers Biomarkers/Environmental Agents Clinical Epidemiology/Outcomes Diabetes Mellitus and CVD: Prevention and Management Drug Safety Ethnic Health Disparaties Exercise, Physical Activity and Rehabilitation Genetics Heart Failure Hypertension Lifecourse Lipids Lipids and lipoproteins Metabolmics Nutrition Nutrition in CVD Risk and Prevention Obesity Obesity in CVD Risk and Prevention Peripheral Arterial Disease Physical Activity/Fitness Prevention Psychosocial Renal Disease Risk Factors Stroke Venous Thrombosis PVD Endovascular Therapy Vascular Medicine (non-coronary): Clinical Science QCOR Acute and Chronic Coronary Artery Disease: Quality Care and Outcomes Adherence Appropriateness/Efficiency of Care Behaviorial/Psychosocial Factors Cardiac Arrest/CPR Cardiovascular Registries Clinical Trials – Main Results and Substudies Cost Effectiveness Analysis/Economic Assessment Disparities in Care Innovations of Care/Health IT/Technology Assessment International Research (Studies Outside the US) Late-Breaking Clinical Trials Methodology of Outcomes Research Patient Safety Pattern of Care Description Quality Improvement Initiatives – Local Level Quality Improvement Initiatives – Regional/National Level Quality of Care Assessment Quality of Care, Outcomes Research and Health Policy Quality of Life/Functional Status Assessment Risk Factor Assessment and Treatment Risk Stratification and Prognosis Women and Cardiovascular Disease STROKE Acute Endovascular Treatment Acute Neuroimaging Acute Nonendovascular Treatment Aneurysm Basic and Translational Neuroscience of Stroke Recovery Cerebrovascular Disease/Stroke (Basic) Cerebrovascular Disease/Stroke (Clinical) Cerebrovascular Occlusive Disease Community/Risk Factors Diagnosis Emergency Care/Systems Experimental Mechanisms and Models In-Hospital Treatment Intracerebral Hemorrhage Multidisciplinary Clinical Rehabilitation Need Stroke conf categories Nursing Outcomes, Quality and Health Services Research Pediatric Stroke Preventive Strategies SAH and Other Neurocritical Management Vascular Biology in Health and Disease Vascular Cognitive Impairment Vascular Malformations