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GROW: Adapting and Enhancing Group-based Prenatal Care to Support Healthy Gestational Weight Gain for HIV-affected Women

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FIC - John E. Fogarty International Center for Advanced Study in the Health Sciences

ABSTRACT: Suboptimal gestational weight gain (GWG) is a modifiable risk factor for adverse pregnancy outcomes, postpartum weight retention and obesity, and subsequently, the long-term development of non-communicable diseases (NCD) among women and children. In South Africa, 45% of women exceed the Institute of Medicine’s (IOM) recommended weight gain in pregnancy, and 38% gain too little weight, putting them at risk for poor perinatal and postpartum NCD outcomes. Women in low- and middle-income countries (LMICs) with a high burden of HIV and NCDs, such as South Africa, are at particularly high risk of suboptimal weight gain due to poor diet quality, limited physical activity, high levels of psychosocial stressors, and, for women with HIV (WHIV), possible antiretroviral-associated weight gain. By supporting healthy GWG, there is strong potential to reduce postpartum NCD risk and improve perinatal outcomes for women with and without HIV. However, few GWG interventions are available for delivery in LMICs, and none have been adapted to address excessive and inadequate GWG or enhanced to meet the unique needs of women with and without HIV. To address this gap, our team previously developed an innovative, theoretically driven group prenatal care (GPNC) intervention and adapted it to reduce GWG and NCD (GPNC-NCD) risk in resource-constrained settings. GPNC-NCD is an evidence-based intervention, based on social cognitive theory, that builds health literacy, self-efficacy, social support, and satisfaction with care, leading to improved perinatal, GWG, NCD, and perinatal outcomes. The goal of this proposal is to adapt the GPNC-NCD intervention for use in South Africa to support healthy GWG (not too much or too little), enhance it to address the needs of WHIV and without HIV, and evaluate the feasibility, acceptability, and preliminary efficacy of the intervention to improve GWG, NCD, perinatal, and HIV care and prevention outcomes in a pilot randomized trial. Our specific aims are: 1) to adapt the GPNC-NCD intervention for use in South Africa to support healthy GWG and enhance it to address HIV status as a driver of GWG, and 2) to determine the feasibility, acceptability, and preliminary efficacy of the adapted and enhanced GPNC intervention. In a pilot trial, 80 women will be individually randomized by HIV status at ≤14 weeks gestation to GPNC (n=20 WHIV, n=20 HIV-) versus usual care (n=20 WHIV, n=20 HIV-). We hypothesize that adapted GPNC will be feasible, acceptable and show preliminary efficacy to improve GWG, NCD (blood pressure, breastfeeding, diet, physical activity), HIV care/prevention (ART adherence, viral suppression, or PreP uptake), and perinatal (birthweight, large-for-gestational age, cesarean delivery) outcomes. This proposal addresses the goals of PAR-23-191 by leveraging the evidence-based GPNC intervention to support healthy GWG, addresses HIV-NCD disparities, and builds capacity for HIV/NCD research in LMICs. If successful, our adapted GPNC intervention has strong potential to serve as a model for how to integrate NCD and HIV care and prevention support into routine prenatal care in LMICs to improve perinatal, HIV, and NCD outcomes.

Up to $81K
2028-03-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

Harnessing Androgen-Driven Immune Modulation to Enhance Immunotherapy for Endocrine Cancers

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NCI - National Cancer Institute

PROJECT SUMMARY Immunotherapy has transformed cancer treatment, yet patients with endocrine tumors, including adrenal and ovarian cancers, rarely benefit due to poor immune infiltration and activation in steroid-rich environments. Androgens, traditionally viewed as cancer-promoting, may enhance anti-tumor immunity. High androgen receptor expression correlates with improved outcomes in adrenal, ovarian, and select breast cancers; however, the mechanisms underlying these effects remain poorly understood. Using a mouse model of adrenal cancer, my work revealed a sex bias in tumor incidence, with males exhibiting lower tumor burden, which was associated with androgen-driven immune activation. Androgen-secreting adrenal tumors in the clinic show better prognosis and greater immune infiltration, while androgen deprivation in our mouse model reduces intratumoral myeloid and lymphoid cells. Androgen supplementation increases circulating inflammatory monocytes, suggesting a tumor-protective role via immune activation. Similar androgen-driven immune responses occur in the ovary, paralleling clinical data linking androgens to reduced ovarian cancer risk. These findings support a translational potential for androgen-mediated immunity across endocrine malignancies. In the K99 phase, I will investigate how androgens enhance myeloid and lymphoid immune responses to improve ICB efficacy in ACC. Aim 1 will assess how androgens modulate myeloid cell function and recruit the adaptive immune response to promote anti-tumor immunity. I will use a syngeneic ACC mouse model with immune cell depletion and ICB, real-time ultrasound tumor tracking, and Xenium transcriptomics to dissect androgen-driven immune mechanisms. Findings will be validated in androgen-secreting ACC patient tumors. In the R00 phase, I will extend this work to ovarian cancer, a leading cause of gynecologic cancer mortality. Aim 2 will examine how androgen signaling enhances immune infiltration in the ovary and whether this can improve ICB efficacy in ovarian cancer. I will use AR-deficient myeloid mouse models, syngeneic ovarian tumor injections, and Xenium transcriptomics to define androgen-mediated immune effects. This will establish a potential rationale for androgen-based immunotherapeutics in ovarian cancer. My career development plan includes training in tumor immunology, Xenium transcriptomics, and ovarian cancer biology, supported by mentorship from leaders in the field. The research environment at Huntsman Cancer Institute offers state-of-the-art resources and collaborative opportunities to achieve these goals. The K99/R00 award will enable me to establish my independent research lab, where I aim to advance our understanding of how hormones impact the tumor immune environment and ultimately use this to improve therapeutic strategies.

Up to $127K
2028-04-30
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

Harnessing Metabolic Machinery of Gut Bacteria for Metabolic Dysfunction-Associated Steatohepatitis

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NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases

Project Summary/Abstract Metabolic dysfunction-associated steatohepatitis (MASH) is a growing public health concern in industrialized nations, with an estimated cost of $1.66 trillion in the U.S. by 2039. Despite its prevalence, therapeutic strategies remain limited due to an incomplete understanding of its pathogenesis. Emerging evidence suggests that the gut microbiota plays a critical role in modulating metabolic and inflammatory processes in MASH through the production of microbiota-dependent metabolites (MDMs). Therefore, a promising approach is to augment therapeutic MDMs in the gut by reintroducing their producers. However, current microbiome-based interventions, such as fecal microbiota transplantation (FMT), have been largely ineffective in ameliorating MASH due to critical gaps in identifying potent MDM-producing bacterial strains and elucidating the mechanisms that enable their durable engraftment in the gut. My long-term goal is to develop rationally designed microbiome therapeutics for MASH and other metabolic diseases by leading a multidisciplinary research program. This proposal aims to establish a foundational strategy to combat liver inflammation in MASH by leveraging bacterial strains with high MDM-producing capacity, focusing on Clostridia isolated from the Hadza hunter-gatherers. The Hadza harbor a highly distinct gut microbiome enriched with bacterial strains that efficiently utilize dietary polysaccharides and synthesize health-promoting MDMs, presenting promising therapeutic potential. Aim 1 will identify Hadza-derived Clostridia that produce anti-inflammatory MDMs. Aim 2 will investigate the mechanisms enabling their stable MDM production in the gut, with a focus on their polysaccharide-utilizing machinery that facilitates engraftment. Aim 3 will determine their immune and therapeutic effects in diet-induced MASH models. The successful completion of this study will enhance our understanding of gut bacterial metabolism in MASH and establish a rational framework for developing targeted microbiome therapeutics beyond current FMT approaches. Additionally, this K99/R00 award will provide essential training in both scientific and career development, facilitating my transition to becoming an interdisciplinary independent researcher. My training will be supported by a distinguished mentoring team with expertise in microbiome science (Dr. Justin Sonnenburg, primary mentor), liver biology (Dr. Natalie Torok, co-mentor), metabolomics (Dr. Michael Fischbach, advisor), gut ecology (Dr. Kerwyn Casey Huang, advisor), and immune profiling (Dr. Holden Maecker, advisor). Stanford University, a renowned institution in biomedical research, provides extensive resources, state-of-the-art equipment, and unparalleled opportunities to support my training. In summary, this K99/R00 proposal will equip me with the necessary skills to launch an independent research program in microbiome therapeutics for MASH and other metabolic diseases. The research findings will provide key insights into the role of microbiota in MASH and establish the groundwork for translational strategies aimed at improving metabolic and liver health.

Up to $92K
2028-01-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

Harnessing Technology to Develop a Just-in-Time Adaptive Intervention to Promote Physical Activity in Adolescents with Type 2 Diabetes

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NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases

PROJECT SUMMARY/ABSTRACT The incidence of youth-onset type 2 diabetes (T2D) is on the rise, with a 95% escalation rate since 2001, and a staggering 77% increase during the COVID-19 pandemic. Regular physical activity is a cornerstone of T2D treatment. Yet, physical activity engagement is alarmingly low among youth with T2D, and effective interventions are lacking. Dr. Gutierrez-Colina’s long-term career objective is to improve health outcomes for youth with T2D by developing state-of-the-art mobile health (mHealth) interventions that provide personalized support for T2D self-management. The goal of this K23 proposal is to develop a novel just-in-time adaptive intervention (JITAI) that integrates dissemination and implementation science with real-time assessments of physical activity barriers and facilitators to deliver tailored strategies for promoting physical activity in adolescents with T2D. In Aim 1, a sequential exploratory design will be used to identify time-varying factors (e.g., motivation, fatigue, self- regulation) that influence physical activity engagement in adolescents with T2D. Qualitative interviews with N=18 T2D stakeholders will be conducted to gather in-depth feedback about physical activity barriers and facilitators. Qualitative findings will be integrated into the development of a 2-week ecological momentary assessment protocol designed to examine daily temporal associations between real-world barriers/facilitators and physical activity in the daily lives of N=25 adolescents with T2D. In Aim 2, the intervention components of a physical activity JITAI (e.g., personalized text messages, tailoring variables) will be co-developed with an advisory board of adolescents and caregivers. Intervention development will draw from dissemination and implementation science frameworks, as well as the “Capability, Opportunity, and Motivation (COM-B) Model,” a well-established theory of health behavior change. The JITAI will target activity barriers/facilitators related to Capability, Opportunity, and Motivation and deliver tailored support at the right time, in the right dose, and only when needed. In Aim 3, a sequential factorial experimental design will be used to pilot a 28-day micro-randomized trial of the physical activity JITAI with N=30 adolescents. Study feasibility and acceptability will be evaluated through usability surveys and post-intervention end-user interviews. Findings will generate critical data to inform an R01 application focused on a full-scale micro-randomized trial to optimize the physical activity JITAI. The proposed K23 research and career development plan will be supported by an outstanding mentorship team and a rich research environment at Colorado State University and the University of Colorado/Children's Hospital Colorado. Completion of the K23 training goals in (1) qualitative/mixed methods, (2) JITAI intervention development with an emphasis on dissemination and implementation science, and (3) the design and evaluation of micro- randomized clinical trials will equip Dr. Gutierrez-Colina with essential expertise in digital interventions and the rigorous methods involved in their evaluation. This training will directly support her successful transition to an independent research career focused on advancing personalized digital interventions for youth with T2D.

Up to $184K
2031-03-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

High End Laser Scanning Confocal Microscope for the University of Chicago Integrated Light Microscopy Facility

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NIGMS - National Institute of General Medical Sciences

Project Summary / Abstract The University of Chicago Integrated Light Microscopy Facility (ILMF) requests funds to purchase a high-end laser scanning confocal microscope. The ILMF currently serves 420 users in 80 labs from across the University. Sixty-seven of those labs use laser scanning confocal microscopy, and 78% of those labs have NIH funding. Usage hours have increased as the ILMF’s microscope capacity has decreased. Two of our confocal microscopes, both Leica SP5 models, are over 14 years old. Leica has designated them end-of-life, meaning they are no longer manufacturing parts for these systems and replacements are not guaranteed. We have already experienced failure of the 488nm Argon and 592nm depletion lasers on one, and failure of the Mai Tai multiphoton excitation laser on the other, with no possibility of replacing any of these components. We expect to decommission at least one SP5 within the next year, making users hesitant to start new projects on those systems. This has stressed our two newer laser scanning confocal systems (purchased with institutional funds in 2016 and 2020), pushing them to use levels averaging 91% of AUT, defined as 3640 hours per year. The system proposed here is the Evident (formerly Olympus) Fluoview 4000 (FV4000), released in 2024. The system will increase the capacity and functionality of laser scanning confocal microscopes in the ILMF, allowing users to collect high-quality data more readily. Several features of the FV4000 will be new to the ILMF, and satisfy a number of outstanding investigator needs. Features include: state-of-the-art, patented, fast signal processing silicon photomultiplier (SiPM, Evident SilVIRTM) detectors, to significantly improve signal-to-noise levels, enhancing detection of Golgi cisternae and other organelle sub-structures; four high magnification, long working distance silicone immersion objectives for detailed, multi-color, 3-dimentional imaging of organoids, thick tissues and tumor samples; and three near-infrared wavelength lasers for excitation of fluorophores beyond the current imaging spectrum, allowing for investigation of a larger number of molecules of interest in a single sample. The FV4000 will also feature full environmental control, allowing users to take advantage of faster imaging speeds to image live samples. This will make it possible to image longer sessions at higher frame rates with less photodamage, resulting in more robust and reliable data from live samples than currently possible. Finally, the FV4000 base is modular in design, allowing for field upgrades with Evident or third-party resources (e.g. a single molecule localization module) as users’ experimental needs grow. In summary, adding an Evident FV4000 laser scanning confocal microscope to the ILMF will make it possible for users to gather information from samples that are currently challenging but valuable research models.

Up to $726K
2027-05-31
health research

Free to search & build · $99 one-time to unlock the application pack · No subscription

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