Universal Health Services

UNACOMMPANIED ALIEN CHILDREN PROGRAMS

A NOVEL NANOCHANNEL SYSTEM FOR SUSTAINED DELIVERY OF TENOFOVIR ALAFENAMIDE FUMARATE AND EMTRICITABINE FOR HIV PRE-EXPOSURE PROPHYLAXIS

INTERVENTION OF IMMUNE TOLERANCE BY SMALL MOLECULES TO ENHANCE IMMUNE THERAPY

INTEGRATIVE MOLECULAR AND IMAGING APPROACHES FOR RISK OF SUBTYPE SPECIFIC BREAST

MOLECULAR REGULATION OF LONG-TERM IMMUNE MEMORY

PSYCHIATRIC RESIDENTIAL TREATMENT SERVICES FOR UNACCOMPANIED ALIEN CHILDREN

TARGETING ADIPOCYTE-SECRETED CHEMERIN FOR CHEMOTHERAPY RESISTANCE IN MYELOMA

TUMOR VASCULATURE-TARGETED NANOTHERAPEUTICS FOR DNA DAMAGE RESPONSE

A NOVEL T-CELL SUBSET ABLE TO KILL RELAPSED CANCERS

ETIOLOGICAL LINKAGE OF DNA DAMAGE/REPAIR DEFICIENCY IN NEURODEGENERATIVE DISEASES

NY-ESO-1-SPECIFIC TCR-ENGINEERED T CELL IMMUNOTHERAPY FOR TRIPLE NEGATIVE BREAST CANCER

SUPRASPINAL TARGETS IN NEUROGENIC VOIDING DYSFUNCTION

DETERMINANTS OF STREPTOCOCCUS PYOGENES VIRULENCE IN THE PRIMATE OROPHARYNX: A GENOME-WIDE ANALYSIS

DETERMINANTS OF STREPTOCOCCUS PYOGENES FITNESS IN THE FEMALE PRIMATE GENITAL TRACT: A GENOME-WIDE ANALYSIS

THE ROLE OF THE GUT MICROBIOME IN THE NEUROPATHOLOGY OF TRAUMATIC BRAIN INJURY

TELEMEDICINE GRANT

TELEMEDICINE GRANT

DLT GRANTS - SUBSTANCE USE DISORDER - MEDICAL

EVALUATION OF IMMUNE RESPONSES TO CD44-TARGETED NANOVECTORS FOR DESIGNING A NOVEL ANTI-TUBERCULOSIS HOST-DIRECTED THERAPY

COLLABORATIVE RESEARCH: FW-HTF-RL: COLLABORATIVE REMOTE PHYSICAL EXAMINATION: TRANSFORMING MEDICAL AND NURSING PRACTICE -SINCE THE FDA LIFTED RESTRICTIONS ON TELEMEDICINE DURING AND AFTER THE COVID-19 PANDEMIC, REMOTE TELE-HEALTH VISITS HAVE GROWN TO ACCOUNT FOR ONE OF EVERY FIVE PATIENT-PHYSICIAN CONSULTATIONS. SUCH TELEMEDICINE CONSULTATION HAS BROUGHT CONVENIENCE AND ACCESS, ESPECIALLY FOR THE ELDERLY AND RURAL COMMUNITIES THAT ARE IN THE GREATEST NEED. TELEMEDICINE CONSULTATIONS, HOWEVER, ARE TYPICALLY LIMITED TO VIDEO AND VOICE EXCHANGES, OFTEN THROUGH THE CONSTRAINED INTERFACE OF A SMARTPHONE. PHYSICAL EXAMINATIONS, CRITICAL TO EARLY DETECTION AND DIAGNOSIS OF SERIOUS HEALTH CONCERNS, ARE REDUCED TO THE PHYSICIAN ASKING THE PATIENT TO DO A SELF-EXAMINATION. THE PROJECT WILL INVESTIGATE TECHNOLOGIES AND PRACTICES THAT ENABLE REMOTE PHYSICIANS TO COLLABORATE WITH NURSES AT LOCAL SITES TO PERFORM MEDICAL PHYSICAL EXAMINATIONS. THE NURSE WEARS TOUCH SENSING GLOVES TO DO THE EXAMINATION. THE PHYSICIAN EXPERIENCES WHAT THE NURSE FEELS THROUGH A TOUCH-ENABLED MEDICAL COCKPIT AT WHICH PHYSICIAN ALSO SEES THE EXAMINATION FROM THE NURSE?S PERSPECTIVE. CLINICAL PHYSICIAN AND NURSING RESEARCHERS; MECHANICAL, INDUSTRIAL, AND COMPUTER ENGINEERS; AND PSYCHOLOGISTS WILL COLLABORATE ON THIS RESEARCH TO DEVELOP THE TOUCH SENSING AND DISPLAY TECHNOLOGIES, THE INTERACTION METHODOLOGIES AND DESIGNS, AND THE MEDICAL/NURSING PRACTICES AND TRAINING NEEDED FOR SUCH REMOTE PHYSICAL EXAMINATIONS. THE TEAM WILL STUDY THE EFFECTIVENESS OF THE TECHNOLOGY AND PRACTICES, AND THE DEGREE TO WHICH PHYSICIANS, NURSES, AND PATIENTS WILL ACCEPT SUCH EXAMINATIONS. THE TEAM WILL ALSO INVESTIGATE HOW THIS TECHNOLOGY MAY BE DEPLOYED IN REMOTE AND RURAL SETTINGS WHERE PATIENTS MAY NOT OTHERWISE HAVE ACCESS TO MEDICAL EXAMINATIONS, ESPECIALLY IF A SPECIALIST IS REQUIRED. HENCE, THIS RESEARCH AIMS AT REALIZING BROADER IMPACTS ON SOCIETY, ESPECIALLY FOR UNDERSERVED COMMUNITIES, AND DURING INFECTIOUS DISEASE OUTBREAKS WHEN PHYSICAL VISITS TO CENTRALIZED MEDICAL FACILITIES CARRY RISKS. THE PROJECT SEEKS TO TRANSFORM THE ALLIED WORK CONTEXTS OF PHYSICIANS AND NURSES WHILE ADDRESSING THE SOCIETAL NEED OF PROVIDING INCLUSIVE ACCESS TO HEALTHCARE THROUGH TELEMEDICINE. THE RESEARCH EFFORTS FRAME REMOTE PHYSICAL EXAMINATION AS A COOPERATIVE PRACTICE BETWEEN A NURSE/CAREGIVER WEARING TACTILE SENSING GLOVES PROXIMAL TO THE PATIENT WITH A DISTAL PHYSICIAN AT A MULTIMODAL INTERACTIVE COCKPIT. CRITICAL CHALLENGES TO THIS FRAMING ARE THAT TACTILE PERCEPTION IS ACTIVE (MEANING THAT IT IS DIFFICULT TO INTERPRET TACTILE PATTERNS IF ONE IS NOT IN DIRECT CONTROL OF THE MOVEMENT OF ONE?S FINGERS), THE PAUCITY IN HAPTIC SENSING AND DISPLAY TECHNOLOGIES, AND THE LACK OF UNDERSTANDING OF SUCH INTERACTION DESIGNS AND THEIR IMPACTS ON THE MEMBERS OF THE EXAMINATION TRIAD: THE PHYSICIAN, NURSE, AND PATIENT. THESE CHALLENGES MOTIVATE THREE RESEARCH THRUSTS IN THE CONTEXT OF EAR, NOSE, AND THROAT EXAMINATIONS: 1. THE INTERACTION DYNAMICS AND DESIGN OF EXAMINATION COCKPITS AND METHODOLOGIES; 2. TOUCH TECHNOLOGY INNOVATIONS FOR HAPTIC SENSING AND DISPLAY/ACTUATION; AND 3. UNDERSTANDING THE IMPACTS OF THE APPROACH FROM THE STAND-POINTS OF PERCEPTUAL AND SOCIAL UNDERSTANDING, COGNITIVE LOAD, TECHNOLOGY ACCEPTANCE, AND MEDICAL/NURSING PRACTICE AND TRAINING. ALL THRUSTS INVOLVE INTERDISCIPLINARY COLLABORATION AMONG ENGINEERS, SOCIAL/HUMANITIES SCIENTISTS, AND CLINICAL/NURSING RESEARCHERS. THE RESEARCH WILL TAKE AN ITERATIVE DESIGN-BUILD-TEST-OBSERVE/REFLECT APPROACH. THRUST 1 WILL INVESTIGATE INTERACTIVE AND TESTBED CONFIGURATION ISSUES AND DEVELOP/MAINTAIN A RESEARCH TESTBED. THRUST 2 WILL DEVELOP TECHNOLOGIES THAT WILL BE EVALUATED SEPARATELY AND INTEGRATED IN THE TESTBED. THRUST 3 WILL EVALUATE THE ITERATIVE DESIGNS AND TECHNOLOGIES AND DEVELOP NEW WORKFLOWS AND TRAINING FOR MEDICAL PROFESSIONALS. CLINICAL PHYSICIAN AND NURSING RESEARCHERS WILL PARTICIPATE IN ALL DESIGN AND EVALUATION PHASES TO GROUND THE RESEARCH, MOTIVATE DESIGN TRAJECTORIES, AND FORMULATE NEW PRACTICE AND TRAINING APPROACHES FOR DOCTORS AND NURSES. THESE METHODS WILL, IN TURN, BE TESTED IN CONJUNCTION WITH THE TECHNOLOGY AND TESTBEDS. AN ADVISORY TEAM WILL GUIDE THE RESEARCH AND INFORM INVESTIGATION OF FEASIBILITY OF THE TECHNOLOGY IN RURAL AND REMOTE COMMUNITIES. THIS AWARD REFLECTS NSF'S STATUTORY MISSION AND HAS BEEN DEEMED WORTHY OF SUPPORT THROUGH EVALUATION USING THE FOUNDATION'S INTELLECTUAL MERIT AND BROADER IMPACTS REVIEW CRITERIA.- SUBAWARDS ARE NOT PLANNED FOR THIS AWARD.

DLT OPIOID GRANTS

RURAL COMMUNITIES OPIOID RESPONSE (PLANNING)

COLLABORATIVE RESEARCH [FW-HTF-RM]: THE FUTURE OF NURSE TRAINING: ROBOTIC TEACHING ASSISTANT SYSTEMS FOR NURSING INSTRUCTORS -AS THE LARGEST HOSPITAL WORKFORCE, REGISTERED NURSES ARE ESSENTIAL TO THE OVERALL STABILITY OF HOSPITALS AND PLAY A VITAL ROLE IN DELIVERING QUALITY PATIENT CARE. NURSING INSTRUCTORS ARE RESPONSIBLE FOR TRAINING AND ASSESSMENTS OF THIS WORKFORCE. THE U.S. IS EXPERIENCING A DIRE SHORTAGE OF NURSES, LEADING TO SIGNIFICANT TURNOVER OF NURSING STAFF AND AN EVER-GROWING NEED TO TRAIN MORE NURSES. AS A RESULT, THE SUPPLY FOR NURSING INSTRUCTORS TOO HAS OUTSTRIPPED DEMAND. MEETING THE NURSE WORKFORCE TRAINING NEEDS IS A SIGNIFICANT CHALLENGE AND MOTIVATES DEVELOPMENT OF TRANSFORMATIVE MECHANISMS FOR HUMAN-TECHNOLOGY PARTNERSHIP IN NURSE WORKFORCE TRAINING. TO ADDRESS THIS CHALLENGE, THE PROJECT'S OVERALL GOAL IS TO HELP NURSE INSTRUCTORS IMPROVE TRAINING OUTCOMES WHILE FREEING UP THEIR TIME FOR PERSONALIZED INSTRUCTION AND ENHANCE EFFICIENCY OF NURSING WORKFORCE TRAINING PROGRAMS. TO ACHIEVE THIS GOAL THE PROJECT WILL DESIGN, DEVELOP, AND EVALUATE THE IMPACTS OF ROBOTIC INTELLIGENT TEACHING ASSISTANT SYSTEMS (RITAS) ON THE FUTURE OF NURSE WORKFORCE TRAINING. THROUGH A SYMBIOSIS OF VIRTUAL AND EMBODIED INTELLIGENCE COMPONENTS, THE TEACHING ASSISTANCE SYSTEM WILL ASSIST NURSING INSTRUCTORS IN TRAINING OF ROUTINE NURSING PROCEDURES BY ASSESSING TRAINEES' SKILLS, REPORTING THE ASSESSMENT SUMMARIES TO INSTRUCTORS, AND DELIVERING INSTRUCTOR-GUIDED TUTORING TO TRAINEES. THROUGH MECHANISMS FOR PARTICIPATORY DESIGN, NURSING INSTRUCTORS AND NURSES OF VARYING BACKGROUNDS WILL BE INVOLVED IN THE TECHNOLOGY DESIGN FROM THE VERY BEGINNING, SHAPING THE USE OF SUCH TOOLS AND INFORMING FUTURE EFFORTS ON THE USE OF ARTIFICIAL INTELLIGENCE AND ROBOTICS IN NURSING CURRICULUM AND MORE BROADLY HEALTHCARE. THE CORE TEAM BRINGS TOGETHER EXPERTISE IN NURSING, NURSING EDUCATION, BEHAVIORAL SCIENCE, ROBOTICS, ARTIFICIAL INTELLIGENCE, INTELLIGENT TUTORING, AND HUMAN-CENTERED COMPUTING TO ACHIEVE THE OVERARCHING GOALS. PROJECT ADVISORS WILL CONTRIBUTE TECHNOLOGY, NURSING, ORGANIZATIONAL BEHAVIOR AND MANAGEMENT, AND LEARNING SCIENCES EXPERTISE. THE PROJECT INCLUDES THREE CONCURRENT AND INTEGRATED TRACKS TO REALIZE NOVEL MECHANISMS FOR HUMAN-TECHNOLOGY PARTNERSHIP IN NURSE WORKFORCE TRAINING. THE FIRST TWO TRACKS FOCUS ON DESIGN AND DEVELOPMENT OF THE VIRTUAL AND EMBODIED COMPONENTS OF THE FUTURE TECHNOLOGY, RESPECTIVELY, THROUGH ALGORITHMIC INNOVATIONS IN INTELLIGENT TUTORING AND ROBOTICS. THROUGH THESE INNOVATIONS, THE PROJECT WILL BRING A TRANSFORMATIVE LEAP IN INTELLIGENT TUTORING ROBOTS: INSTEAD OF RELYING SOLELY ON CONVERSATIONAL INTERACTION, RITAS WILL UTILIZE ITS SENSORS AND EMBODIMENT TO VERIFY AND IMPROVE TRAINEES' PHYSICAL SKILL EXECUTION. TOGETHER, THE TWO COMPONENTS WILL ASSIST WITH ASSESSMENT AND TRAINING OF NURSING PROCEDURES. ASSESSMENT SUMMARIES AND TUTORING WILL BE DELIVERED USING BOTH VERBAL AND NON-VERBAL MECHANISMS FOR HUMAN-ROBOT COMMUNICATION. THE THIRD TRACK WILL MEASURE TRAINING, PRODUCTIVITY, AND BEHAVIORAL METRICS THAT ARE RELEVANT TO DEPLOYMENT AND ADOPTION OF THE FUTURE TECHNOLOGY, SUCH AS THE IMPACT OF ROBOTIC TEACHING ASSISTANCE ON NURSING INSTRUCTORS' WORKLOAD AND NURSE TRAINEES' LEARNING OUTCOMES. THESE MEASUREMENTS WILL BE DERIVED THROUGH EXTENSIVE HUMAN SUBJECT EXPERIMENTS CONDUCTED WITHIN ONGOING NURSE WORKFORCE TRAINING ACTIVITIES AT A LARGE HOSPITAL, WHICH ONBOARDS OVER THOUSAND NURSES PER YEAR, AND DISTILLED INTO A CONCISE NURSING THEORY GUIDING TECHNOLOGY ADOPTION IN NURSING EDUCATION. THE PROJECT WILL ALSO DEVELOP SPATIALLY-GROUNDED MODELS OF NURSING PROCEDURES AND TRAINING ENVIRONMENTS. THROUGH THESE WORKER-CENTERED ASSESSMENTS, THEORIES, AND MODELS, THE PROJECT WILL INFORM THE WORK DESIGN OF FUTURE NURSING INSTRUCTORS AT THE HUMAN-TECHNOLOGY FRONTIER. THIS PROJECT IS SUPPORTED BY THE FUTURE OF WORK AT THE HUMAN-TECHNOLOGY FRONTIER PROGRAM WHICH SUPPORTS MULTI-DISCIPLINARY RESEARCH TO SUSTAIN ECONOMIC COMPETITIVENESS, PROMOTE WORKER WELL-BEING, LIFELONG AND PERVASIVE LEARNING, AND QUALITY OF LIFE, AND ILLUMINATE THE EMERGING SOCIAL AND ECONOMIC CONTEXT AND DRIVERS OF INNOVATIONS THAT ARE SHAPING THE FUTURE OF JOBS AND WORK. THIS AWARD REFLECTS NSF'S STATUTORY MISSION AND HAS BEEN DEEMED WORTHY OF SUPPORT THROUGH EVALUATION USING THE FOUNDATION'S INTELLECTUAL MERIT AND BROADER IMPACTS REVIEW CRITERIA.- SUBAWARDS ARE NOT PLANNED FOR THIS AWARD.

TELEMEDICINE GRANT

DLT GRANTS - SUBSTANCE USE DISORDER - MEDICAL

DLT GRANTS - SUBSTANCE USE DISORDER - MEDICAL

DLT GRANTS - SUBSTANCE USE DISORDER - MEDICAL

DLT GRANTS - SUBSTANCE USE DISORDER - MEDICAL

DLT GRANTS - SUBSTANCE USE DISORDER - MEDICAL

DLT OPIOID GRANTS

NOVEL DETERMINANTS OF STREPTOCOCCUS PYOGENES VIRULENCE AND PROTECTIVE IMMUNITY IN THE PRIMATE OROPHARYNX: A GENOME-WIDE STRATEGY - PROJECT SUMMARY THE HUMAN BACTERIAL PATHOGEN STREPTOCOCCUS PYOGENES (GROUP A STREPTOCOCCUS, GAS) CAUSES MORE THAN 600 MILLION CASES OF PHARYNGITIS ANNUALLY WORLDWIDE. DESPITE 100 YEARS OF EFFORT, THIS ORGANISM HAS SUCCESSFULLY DEFIED ATTEMPTS TO CREATE A VACCINE THAT PROTECTS HUMANS FROM PHARYNGITIS AND INVASIVE INFECTIONS. WE BELIEVE A NEW STRATEGY IS WARRANTED AND NECESSARY. THE PROPOSED RESEARCH SEEKS TO DISCOVER, ON A GENOME-WIDE SCALE USING A STRATEGY NOT PREVIOUSLY APPLIED TO GAS VACCINOLOGY, NOVEL GAS GENES CONTRIBUTING TO PHARYNGITIS, AND EXPLOIT THIS INFORMATION FOR VACCINE RESEARCH EFFORTS. IT IS OUR THESIS THAT THIS KNOWLEDGE GAP HAS SEVERELY LIMITED THE ABILITY TO FULLY UNDERSTAND THE VIRULENCE DETERMINANTS AT WORK IN THE UPPER RESPIRATORY TRACT (URT) AND CREATE A PROTECTIVE GAS VACCINE. WE WILL ADDRESS THESE ISSUES BY COMBINING OUR RECENT SUCCESSES APPLYING TRANSPOSON- DIRECTED INSERTION SITE SEQUENCING (TRADIS) TECHNOLOGY TO GAS IN SEVERAL SETTINGS, TOGETHER WITH OUR 19 YEARS OF PRODUCTIVELY USING A CYNOMOLGUS MACAQUE (NONHUMAN PRIMATE, NHP) MODEL OF PHARYNGITIS, IN VACCINOLOGY RESEARCH. WE WILL FIRST USE TRADIS TO CONDUCT IN VIVO GENOME-WIDE SCREENS TO SYSTEMATICALLY IDENTIFY SEROTYPE M89 GAS GENES REQUIRED FOR COLONIZATION, CLINICAL DISEASE, AND PERSISTENCE IN THE URT OF NHPS. THESE DATA WILL COMPLEMENT AND ENRICH ANALOGOUS INFORMATION WE HAVE ALREADY GENERATED FOR SEROTYPE M1 AND M28 GAS. OUR CENTRAL HYPOTHESIS IS THAT DEFINING THE GAS GENES THAT CONTRIBUTE TO FITNESS IN THE NHP URT WILL SIGNIFICANTLY IMPROVE OUR UNDERSTANDING OF THE MOLECULAR PROCESSES OCCURRING IN THIS NICHE, THEREBY FILLING A MASSIVE KNOWLEDGE GAP AND LEADING TO NEW STRATEGIES FOR CREATING A VACCINE THAT PROTECTS AGAINST GAS PHARYNGITIS. WE PROPOSE THE FOLLOWING THREE SPECIFIC AIMS: SPECIFIC AIM 1: EXPLOIT TRADIS FOR GENOME- WIDE IDENTIFICATION OF SEROTYPE M89 GAS GENES REQUIRED FOR COLONIZATION, ACUTE CLINICAL DISEASE, AND PERSISTENCE (I.E., FITNESS) IN THE URT OF NHPS. SPECIFIC AIM 2: USE OUR COMBINED M1, M28, AND M89 TRADIS URT SCREEN DATA TO GENERATE ISOGENIC GENE-DELETION MUTANT STRAINS AND VALIDATE THE IMPORTANCE OF ADDITIONAL SELECTED CANDIDATE GENES IN CAUSING GAS PHARYNGITIS IN NHPS. SPECIFIC AIM 3: DETERMINE IF VACCINATION OF NHPS WITH PROTEINS ENCODED BY GENES IDENTIFIED IN SPECIFIC AIMS 1 AND 2 CONFERS PROTECTIVE IMMUNITY AGAINST EXPERIMENTAL PHARYNGITIS CAUSED BY HOMOLOGOUS (SEROTYPE M1) AND HETEROLOGOUS (SEROTYPE M28) M PROTEIN SEROTYPES OF GAS. THE PROPOSED LINE OF RESEARCH WILL EXPLOIT AND SIGNIFICANTLY EXPAND STUDIES FUNDED BY AN R21 GRANT, AND OUR INNOVATIVE AND SUCCESSFUL APPLICATION OF TRADIS TO GAS, OUR LONG HISTORY OF GAS PHARYNGITIS AND VACCINOLOGY STUDIES USING NHPS, OUR ANALYSES OF HUMAN SPECIMENS, AND OUR CONTRIBUTIONS TO UNDERSTANDING THE BASIC BIOLOGY OF GAS MOLECULAR PATHOGENESIS AND GENOMICS. IN ESSENCE, THIS RESEARCH REPRESENTS A NEW WAY FORWARD FOR GAS VACCINE EFFORTS. IMPORTANT TO NOTE, AN ANALOGOUS STRATEGY HAS BEEN USED TO IDENTIFY FOUR PROTEINS PRESENT IN A NEW VACCINE THAT PROTECTS HORSES AGAINST “STRANGLES,” A SEVERE URT DISEASE CAUSED BY THE CLOSELY RELATED PATHOGEN, STREPTOCOCCUS EQUI.

DLT OPIOID GRANTS