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Here are the seeds
\"This sweet picture book follows two young children as they grow their garden from seeds ... and encounter a few missteps along the way! Planting a garden is not as easy as it seems -- OH NO! -- there is the hot sun that cracks the earth! And the rain that floods the garden! And those worms that are eating all the plants! But could all of these elements help their garden grow?\"-- Provided by publisher.
Book
AI-Guided Computing Insights into a Thermostat Monitoring Neonatal Intensive Care Unit (NICU)
In any healthcare setting, it is important to monitor and control airflow and ventilation with a thermostat. Computational fluid dynamics (CFD) simulations can be carried out to investigate the airflow and heat transfer taking place inside a neonatal intensive care unit (NICU). In this present study, the NICU is modeled based on the realistic dimensions of a single-patient room in compliance with the appropriate square footage allocated per incubator. The physics of flow in NICU is predicted based on the Navier–Stokes conservation equations for an incompressible flow, according to suitable thermophysical characteristics of the climate. The results show sensible flow structures and heat transfer as expected from any indoor climate with this configuration. Furthermore, machine learning (ML) in an artificial intelligence (AI) model has been adopted to take the important geometric parameter values as input from our CFD settings. The model provides accurate predictions of the thermal performance (i.e., temperature evaluation) associated with that design in real time. Besides the geometric parameters, there are three thermophysical variables of interest: the mass flow rate (i.e., inlet velocity), the heat flux of the radiator (i.e., heat source), and the temperature gradient caused by the convection. These thermophysical variables have significantly recovered the physics of convective flows and enhanced the heat transfer throughout the incubator. Importantly, the AI model is not only trained to improve the turbulence modeling but also to capture the large temperature gradient occurring between the infant and surrounding air. These physics-informed (Pi) computing insights make the AI model more general by reproducing the flow of fluid and heat transfer with high levels of numerical accuracy. It can be concluded that AI can aid in dealing with large datasets such as those produced in NICU, and in turn, ML can identify patterns in data and help with the sensor readings in health care.
Journal Article
Three limited interaction approaches to understanding the epidemiology of HIV among YMSM in the US
Background
Using a theoretically-grounded approach to the epidemiological study of HIV incidence among a national, diverse sample of sexual and gender minority (SGM) men (age 17 -29 years), as well as examining HIV incidence through an innovative geospatial lens, is of considerable public health significance. Our overarching objectives are to assemble a U.S.-based national cohort of diverse SGM men: (1) to estimate HIV incidence in SGM men followed every 6 months for up to 24 months, (2) to assess the association of individual and geospatial factors associated with HIV incidence and (3) to determine the relative efficiency and acceptability of three different, discrete study enrollment approaches (including completion of remote HIV testing). The purpose of this manuscript is to describe the study protocol.
Methods
The cohort is composed of English- and/or Spanish-speaking SGM men at risk for HIV, age 17–29 years and living in the United States and its territories. We used multiple methods to recruit our sample including social networking apps like GrindrTM. If a participant was eligible for the study, they completed an address intake form so an HIV test could be mailed to their home or chosen address. We assembled three cohorts using different enrollment approaches. Cohort 1 used Zoom video calls with study staff observing participants use of OraQuick test with oral swabs at the baseline visit. Cohort 2 used No Zoom and OraSure oral fluid tests that participants mailed to an external lab. Cohort 3 used No Zoom/self-administration of OraQuick tests and participants uploading test results to an online portal (REDCap).
Discussion
This study will provide important data on multilevel determinants of HIV incidence among SGM men at the national level, allowing us to examine important differences by local jurisdiction, region and state and to better understand the impact of individual, social and geospatial factors on HIV incidence to help inform future prevention strategies.
Journal Article
A community health worker and mobile health app intervention to improve adherence to HIV medication among persons with HIV: the CHAMPS study protocol
Background
Persons with HIV (PWH) can now achieve a near-normal life expectancy due to antiretroviral therapy (ART). Despite widespread availability of ART in the United States (US), many of the country’s approximate 1.1 million PWH are not achieving viral suppression due to poor ART adherence. Viral suppression rates are particularly low in Alabama (AL, 62%) and New York City (NYC, 67%). There is mixed evidence on the efficacy of community health workers (CHW) and mHealth interventions for improving ART adherence and viral suppression in PWH thus, we sought to combine these interventions and test the efficacy for improving health outcomes in PWH.
Methods
The CHAMPS study is a two-arm randomized controlled trial among 300 PWH with suboptimal primary care appointment adherence (
n
= 150 in AL and 150 in NYC) over the course of 12 months. Participants are randomly assigned to CHAMPS (intervention) or a standard-of-care (control) arm. Participants in the intervention arm are given a CleverCap pill bottle that syncs to the WiseApp to track medication adherence, reminds users to take their medication at a set time, and enables communication with CHW. All participants complete baseline, 6-month, and 12-month follow-up visits where surveys are administered and, CD4 and HIV-1 viral load are obtained through blood draw.
Discussion
Maintaining ART adherence has significant implications in HIV management and transmission. mHealth technologies have been shown to optimize the provision of health services, produce positive changes in health behavior, and significantly improve health outcomes. CHW interventions also provide personal support to PWH. The combination of these strategies may provide the necessary intensity to increase ART adherence and clinic attendance among PWH at highest risk for low engagement. Delivering care remotely enables CHW to contact, assess, and support numerous participants throughout the day, reducing burden on CHW and potentially improving intervention durability for PWH. The adoption of the WiseApp coupled with community health worker sessions in the CHAMPS study has the potential to improve HIV health outcomes, and will add to the growing knowledge of mHealth and CHW efforts to improve PWH medication adherence and viral suppression.
Trial registration
This trial was registered with Clinicaltrials.gov (NCT04562649) on 9/24/20.
Journal Article
Innovative strategies for providing menstruation-supportive water, sanitation and hygiene (WASH) facilities: learning from refugee camps in Cox’s bazar, Bangladesh
Background
There is growing attention to addressing the menstrual hygiene management (MHM) needs of the over 21 million displaced adolescent girls and women globally. Current approaches to MHM-related humanitarian programming often prioritize the provision of menstrual materials and information. However, a critical component of an MHM response includes the construction and maintenance of water, sanitation and hygiene (WASH) facilities, including more female-friendly toilets. This enables spaces for menstruating girls and women to change, dispose, wash and dry menstrual materials; all of which are integral tasks required for MHM. A global assessment identified a number of innovations focused on designing and implementing menstruation-supportive WASH facilities in the Rohingya refugee camps located in Cox’s Bazar (CXB), Bangladesh. These pilot efforts strove to include the use of more participatory methodologies in the process of developing the new MHM-supportive WASH approaches. This study aimed to capture new approaches and practical insights on innovating menstrual disposal, waste management and laundering in emergency contexts through the conduct of a qualitative assessment in CXB.
Methods
The qualitative assessment was conducted in the Rohingya refugee camps in CXB in September of 2019 to capture new approaches and practical insights on innovating for menstrual disposal, waste management and laundering. This included Key Informant Interviews with 19 humanitarian response staff from the WASH and Protection sectors of a range of non-governmental organizations and UN agencies; Focus Group Discussions with 47 Rohingya adolescent girls and women; and direct observations of 8 WASH facilities (toilets, bathing, and laundering spaces).
Results
Key findings included: one, the identification of new female-driven consultation methods aimed at improving female beneficiary involvement and buy-in during the design and construction phases; two, the design of new multi-purpose WASH facilities to increase female beneficiary usage; three, new menstrual waste disposal innovations being piloted in communal and institutional settings, with female users indicating at least initial acceptability; and four, novel strategies for engaging male beneficiaries in the design of female WASH facilities, including promoting dialogue to generate buy-in regarding the importance of these facilities and debate about their placement.
Conclusions
Although the identified innovative participatory methodologies and design approaches are promising, the long term viability of the facilities, including plans to expand them, may be dependent on the continued engagement of girls and women, and the availability of resources.
Journal Article
Social Marketing Perspective on Participant Recruitment in Informatics-Based Intervention Studies
Effective recruitment strategies are pivotal for informatics-based intervention trials success, particularly for people living with HIV (PLWH), where engagement can be challenging. Although informatics interventions are recognized for improving health outcomes, the effectiveness of their recruitment strategies remains unclear. We investigated the application of a social marketing framework in navigating the nuances of recruitment for informatics-based intervention trials for PLWH by examining participant experiences and perceptions. We used qualitative descriptive methodology to conduct semi-structured interviews with 90 research participants from four informatics-based intervention trials. Directed inductive and deductive content analyses were guided by Howcutt et al.’s social marketing framework on applying the decision-making process to research recruitment. The majority were male (86.7%), living in the Northeast United States (56%), and identified as Black (32%) or White (32%). Most participants (60%) completed the interview remotely. Sixteen subthemes emerged from five themes: motivation, perception, attitude formation, integration, and learning. Findings from our interview data suggest that concepts from Howcutt et al.’s framework informed participants’ decisions to participate in an informatics-based intervention trial. We found that the participants’ perceptions of trust in the research process were integral to the participants across the four trials. However, the recruitment approach and communication medium preferences varied between older and younger age groups. Social marketing framework can provide insight into improving the research recruitment process. Future work should delve into the complex interplay between the type of informatics-based interventions, trust in the research process, and communication preferences, and how these factors collectively influence participants’ willingness to engage.
Journal Article
A randomized controlled trial of an mHealth intervention for increasing access to HIV testing and care among young cisgender men and transgender women: the mLab App study protocol
Background
The number of youth living with HIV in the United States (US) continues to rise, and racial, ethnic, and sexual minority youth including young men who have sex with men (YMSM) and young transgender women (YTGW) bear a disproportionate burden of the HIV epidemic. Due to social and healthcare system factors, many YMSM and YTGW do not seek HIV testing services and are therefore less likely to be aware that they are infected. Mobile health technology (mHealth) has the ability to increase uptake of HIV testing among these populations. Thus, the mLab App—which combines HIV prevention information with a mobile phone imaging feature for interpreting at-home HIV test results—was developed to improve testing rates and linkage to care among Black, Latino, and other YMSM and YTGW living in New York City and Chicago and their surrounding areas.
Methods
This study is a three-arm randomized controlled trial among YMSM and YTGW aged 18–29 years. Participants are randomized to either the mLab App intervention including HIV home test kits and standard of preventive care, standard of preventive care only, or HIV home test kits and standard of preventive care only.
Discussion
mHealth technology used for HIV prevention is capable of delivering interventions in real-time, which creates an opportunity to remotely reach users across the country to strengthen their HIV care continuum engagement and treatment outcomes. Specifically during the COVID-19 pandemic, mHealth technology combined with at-home testing may prove to be essential in increasing HIV testing rates, especially among populations at high-risk or without regular access to HIV testing.
Trial registration
This trial was registered with
Clinicaltrials.gov
(
NCT03803683
) on January 14, 2019.
Journal Article
Different Classes of HIV-Preventive Behavioral Intention Among Youths Vulnerable to HIV Acquisition
The HIV incidence rate continues to increase among youth, especially among young men who have sex with men (YMSM) and young transgender women (YTW). To date, behavioral intention has often been viewed as the likelihood of engaging in prevention behaviors and emphasized as a key antecedent for condom use, disclosure of serostatus, and PrEP use among people living with HIV. In addition, individuals with different sociodemographic factors may have varying degrees of HIV prevention intention, which is a critical knowledge needed to identify facilitators and barriers to HIV prevention intention. This is a secondary data analysis of baseline data from a randomized controlled trial (RCT) (
N
= 488). This study aimed to identify distinct, latent classes of HIV prevention intention among youth vulnerable to HIV acquisition and to understand the sociodemographic and contextual factors associated with each latent class. Latent class analysis was conducted to identify meaningful latent classes of youths based on HIV prevention intention. Class 1: “High condomless sex, low serosorting, low PrEP intention,” Class 2: “High condomless sex, high serosorting, low PrEP intention,” Class 3: “Moderate condom use, serosorting, low PrEP intention,” and Class 4: “Moderate condom use, high serosorting, moderate PrEP intention” were identified. Significant differences were found in age, sexual orientation, level of education, current employment status, annual household income, housing/living arrangement, and relationship status. Overall, YMSM and YTW without a recent history of HIV testing or PrEP use may have particularly low intentions for HIV prevention, and therefore may be at higher risk for HIV infection.
Journal Article
Disrupting the DREAM complex enables proliferation of adult human pancreatic β cells
Resistance to regeneration of insulin-producing pancreatic β cells is a fundamental challenge for type 1 and type 2 diabetes. Recently, small molecule inhibitors of the kinase DYRK1A have proven effective in inducing adult human β cells to proliferate, but their detailed mechanism of action is incompletely understood. We interrogated our human insulinoma and β cell transcriptomic databases seeking to understand why β cells in insulinomas proliferate, while normal β cells do not. This search reveals the DREAM complex as a central regulator of quiescence in human β cells. The DREAM complex consists of a module of transcriptionally repressive proteins that assemble in response to DYRK1A kinase activity, thereby inducing and maintaining cellular quiescence. In the absence of DYRK1A, DREAM subunits reassemble into the pro-proliferative MMB complex. Here, we demonstrate that small molecule DYRK1A inhibitors induce human β cells to replicate by converting the repressive DREAM complex to its pro-proliferative MMB conformation.
Journal Article