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Advancing Cardiovascular Health Among Adolescents with Intellectual Disabilities: Co-Development of Technology Interventions to Enhance Physical Activity

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NINR - National Institute of Nursing Research

Adolescents with intellectual disabilities (ID) face significant health issues, particularly in managing chronic conditions such as cardiovascular (CV) health risks. These issues are exacerbated by limited physical activity (PA), health literacy challenges, and a lack of evidence-based health interventions. This project aims to address these gaps by engaging adolescents with ID and their stakeholders supporting ID as co-researchers to design, adapt, and pilot-test a virtual reality (VR)-based PA intervention tailored to their needs. The long-term goal is to dismantle factors to improve health outcomes for adolescents with ID through innovative, collaborative research that enhances health literacy, increases PA, and lowers CV health risks. With this goal in mind, the proposed K Mentored Research Scientist Development Award will direct Dr. Patricia West toward an established innovative independent research program. Guidance for her transition to independence will be provided in a strong institutional research environment at Michigan State University with dedicated interprofessional expert scientists and collaborative resources both internal and external to the University. The objectives of this application will address three specific aims: 1) adapt and validate research instruments by collaborating with adolescents with ID and their ID stakeholders to incorporate common language in measures for assessing health outcomes; 2) evaluate and select VR-based PA programs by engaging co-researchers in identifying effective VR exergame interventions for improving health outcomes through PA; and 3) pilot-test the VR PA intervention, which incorporates peer support. We will assess feasibility, acceptability, and preliminary efficacy of our 16-week VR exergame PA intervention using co-adapted measures and biologic CV risk measures. A quasi-experimental mixed-methods approach will be used, guided by our Logic Model. Preliminary evidence highlights the potential of interactive, technology-driven PA to address CV risks while fostering peer engagement and optimal self-efficacy to manage health. The expected outcomes are: 1) validated measures through greater health literacy, and 2) a co-designed intervention to reduce CV risks that helps adolescents with ID to take an active role in their health. By addressing critical gaps in health literacy, self-efficacy, and PA, this work advances healthcare practices and supports long-term improvements in public health.

Up to $169K
2029-01-31
health research
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Advancing HIV Vaccine Development with a Lipid Nanodisc Platform

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NIAID - National Institute of Allergy and Infectious Diseases

Project Summary The envelope (Env) glycoprotein of HIV is the only viral protein on the surface of virions, making it the sole target of B cell-based HIV vaccines. While Env is natively a transmembrane protein, most vaccine development relies on soluble versions of the trimer. These versions lack the membrane-proximal external region (MPER) epitope, the native bilayer environment, and the transmembrane (TM) and C- terminal (CT) domains. Broadly neutralizing antibodies (bnAbs) targeting MPER have remarkable breadth, reaching near-complete coverage of all circulating HIV strains, thus making MPER an attractive target for vaccine development. Recent progress in MPER-targeted vaccine development has been notable on two fronts. First, in the HVTN133 clinical trial, MPER peptide presented in a liposome formulation induced a B cell lineage for bnAbs and their precursors and reached 15 % neutralization breadth of a global tier 2 panel. Second, two studies described the development of a germline targeting immunogen for 10E8-class MPER bnAb, and affinity maturation process of the primed antibodies in pre-clinical mouse models. Characterization of new and improved MPER- targeting immunogen candidates and responses they elicit will require biophysical and structural analysis. Challenges in handling Env as a recombinant transmembrane protein therefore persist. This project incorporates engineered transmembrane Env vaccine candidates into stable lipid nanodiscs using membrane scaffold proteins and a selection of lipid molecules. This solution enables scalable and reproducible in vitro characterization and optimization of engineered transmembrane Env-based immunogens and evaluation of in vivo responses from MPER-targeting immunizations. Env nanodiscs allow using transmembrane Envs under identical conditions that have been established for soluble Envs in commonly used iterative vaccine development methods. In the first specific aim of this proposal, Env nanodisc structures are solved in complex with MPER-targeting antibodies to give guideposts for vaccine development. In the second, nanodiscs are assembled with controlled lipid compositions to elucidate the contribution of the bilayer surface to MPER antibody binding. Lastly, the third specific aim establishes conditions for utilizing Env nanodiscs in electron microscopy- based polyclonal epitope mapping (EMPEM). All aims will collectively contribute to improved nanodisc assembly pipeline that can be scaled to serve multiple HIV MPER targeting vaccine development projects. This pipeline can also serve the development of any transmembrane Env immunogen that targets other epitopes. Ultimately, the tools will be made available for other virus glycoprotein vaccine development projects beyond HIV.

Up to $512K
2031-01-31
Health
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Advancing neurodevelopmental outcome prediction in children exposed to HIV using clinical features and placental imaging

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NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development

PROJECT SUMMARY More than one million children who are HIV-exposed but uninfected (CHEU) are born to pregnant people with HIV (PPHIV) every year. CHEU have a higher risk of adverse early-life outcomes than HIV-unexposed peers, including neurodevelopmental deficits and a >2-fold risk of growth stunting. The pathophysiology of adverse CHEU outcomes is incompletely understood, but mounting evidence suggests that placental abnormalities play a key role. A better understanding of the causes and mechanisms of poor developmental outcomes in CHEU is essential to improve the care of PPHIV and their offspring. Our overarching goal is to determine which 1) clinical, 2) placental histological, and 3) placental stereologic features predict adverse CHEU neurodevelopmental and growth outcomes. Leveraging our ongoing multi-country (Uganda, South Africa) birth cohort (n=1,200) and linked placental biobank, we will perform state-of-the-art 3D placental stereology and build artificial intelligence (AI) classifier models to predict CHEU child health outcomes, employing causal inference and instrumental variable analysis to account for confounding. We will also perform mediation analysis to determine whether placental features mediate the relationship between clinical and laboratory features and child outcomes. Innovation: Distinct advantages of our proposed research include 1) simultaneous collection and comparison of CHEU and HIV/antiretroviral-unexposed placentas and children, 2) use of rich clinical data and complementary methods [3D stereologic imaging and histopathology] to evaluate associations between placental abnormalities and adverse CHEU neurodevelopmental and growth outcomes, and 3) use of causal inference and mediation analysis methods to identify key and modifiable features. Investigators: Our interdisciplinary team with expertise in placental collection and birth cohorts (Bebell, Gray), placental pathology and AI (Goldstein), bioinformatics, AI, and mediation analysis (Dreyfuss, Kawuma), placental ARV effects (Serghides), developmental psychology (Malcolm-Smith), and pediatric neurodevelopment (Donald) is well-poised to complete this work. Approach: We will leverage biobanked placental samples and extend follow-up of enrolled mother-child dyads in Dr. Bebell’s (R01HD11232) and Dr. Gray’s (R01HD102050) birth cohorts; Dr. Serghides’ laboratory infrastructure, Dr. Goldstein’s AI algorithms, and Dr. Dreyfuss’ mediation analysis and causal inference methods to elucidate the effects of HIV and specific ARV exposure on the placenta and child neurodevelopment and growth through age 5 years via these Specific Aims: 1a) Identify clinical and laboratory features that predict neurodevelopmental and growth outcomes in CHEU, 1b) Determine whether placental histologic diagnoses advance neurodevelopmental and growth outcome prediction, and 2) Incorporate placental stereology features into prediction models for neurodevelopmental and growth outcomes. Identifying HIV- and specific ARV-related placental abnormalities and associations with adverse CHEU outcomes has great potential to improve child health by informing ARV selection in pregnancy and early identification and intervention for at-risk children.

Up to $553K
2031-01-31
Health