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BackgroundCardiac rehabilitation participants are encouraged to meet physical activity guidelines to reduce the risk of repeat cardiac events. However, previous studies have found that physical activity levels are low and sedentary behavior is high, both during and after cardiac rehabilitation. There is potential for smartphone apps to be effective in reducing sedentary behavior, although among the few studies that have investigated smartphone apps in cardiac rehabilitation, none targeted sedentary behavior. ObjectiveThis study aims to evaluate the feasibility of a behavioral smartphone app (Vire) and a web-based behavior change program (ToDo-CR) to decrease sedentary behavior in cardiac rehabilitation participants. MethodsUsing a single-center, pre-post design, participants were recruited by nursing staff on admission to cardiac rehabilitation. All eligible participants installed the Vire app, were given a Fitbit Flex, and received the 6-week ToDo-CR program while attending cardiac rehabilitation. The ToDo-CR program uses personalized analytics to interpret important behavioral aspects (physical activity, variety, and social opportunity) and real-time information for generating and suggesting context-specific actionable microbehavioral alternatives (Do’s). Do’s were delivered via the app, with participants receiving 14 to 19 Do’s during the 6-week intervention period. Outcome measures were collected at 0, 6, and 16 weeks. The assessors were not blinded. Feasibility outcomes included recruitment and follow-up rates, resource requirements, app usability (Unified Theory of Acceptance and Use of Technology 2 [UTAUT2] questionnaire), and objectively measured daily minutes of sedentary behavior (ActiGraph) for sample size estimation. Secondary outcomes included functional aerobic capacity (6-min walk test), quality of life (MacNew Heart Disease Health-Related Quality of Life Questionnaire), anxiety and depression (Hospital Anxiety and Depression Scale questionnaire), BMI, waist circumference, waist-to-hip ratio, and blood pressure. ResultsBetween January and May 2019, 20 participants were recruited consecutively. One-third of people who commenced cardiac rehabilitation were eligible to participate. Other than declining to take part in the study (15/40, 38%), not having a smartphone was a major reason for exclusion (11/40, 28%). Those excluded without a smartphone were significantly older than participants with a smartphone (mean difference 20 [SD 5] years; P

Nationally, there are low rates of high school-age youth receiving health care transition (HCT) preparation from health care providers. This pilot study implemented and assessed the use of a structured HCT process, the Six Core Elements of HCT, in two school-based health centers (SBHCs) in Washington, DC. The pilot study examined the feasibility of incorporating the Six Core Elements into routine care and identified self-care skill gaps among students. Quality improvement methods were used to customize, implement, and measure the Six Core Elements and HCT supports. After the pilot, both SBHCs demonstrated improvement in their implementation of the structured HCT process. More than half of the pilot participants reported not knowing how to find their doctor's phone number and not knowing what a referral is. These findings indicate the need for incorporating HCT supports into SBHCs to help students build self-care skills necessary for adulthood.

IntroductionA key barrier to translation of biomedical research discoveries is a lack of understanding among scientists regarding the complexity and process of implementation. To address this challenge, the National Science Foundation's Innovation Corps™ (I-Corps™) program trains researchers in entrepreneurship. We report results from the implementation of an I-Corps™ training program aimed at biomedical scientists from institutions funded by the National Center for Advancing Translational Sciences (NCATS).MethodsNational/regional instructors delivered 5-week I-Corps@NCATS short courses to 62 teams (150 individuals) across six institutions. Content included customer discovery, value proposition, and validating needs. Teams interviewed real-life customers and presented the value of innovations for specific end-users weekly, culminating in a "Finale" featuring their refined business thesis and business model canvas. Methodology was developed to evaluate the newly adapted program. National mixed-methods evaluation assessed program implementation, reach, effectiveness using observations of training delivery and surveys at Finale (n = 55 teams), and 3-12 months post-training (n = 34 teams).ResultsInnovations related to medical devices (33%), drugs/biologics (20%), software applications (16%), and diagnostics (8%). An average of 24 interviews was conducted. Teams reported increased readiness for commercialization over time (83%, 9 months; 14%, 3 months). Thirty-nine percent met with institutional technology transfer to pursue licensing/patents and 24% pursued venture capital/investor funding following the short courses.ConclusionsI-Corps@NCATS training provided the NCATS teams a rigorous and repeatable process to aid development of a business model based on customer needs. Outcomes of this pilot program support the expansion of I-Corps™ training to biomedical scientists for accelerating research translation.

To support conservation practices, societal demand for understanding fundamental coastal ocean ecosystem mechanisms has grown in recent decades. Globally, these regions are among the world’s most productive, but they are highly vulnerable to extractive and non-extractive stresses. In 1999, we established the Partnership for Interdisciplinary Studies of Coastal Oceans (PISCO) to perform basic and use-inspired, long-term ecological research at local to large marine ecosystem (LME) scales. Coordinated investigations of ecosystem patterns and dynamics focused on nearshore coastal waters and hard-bottom habitats (rocky intertidal and kelp forests) in the California Current Large Marine Ecosystem. Communicating relevant scientific discoveries to inform decision-making was an integral component, as was commitment to training new generations of interdisciplinary marine scientists, thereby building scientific capacity and expertise in marine conservation science and policy. Issues of climate change and ocean acidification, wildlife disease outbreaks, oil spills, and conservation strategies such as marine protected areas have spotlighted the immense value of long-term monitoring and research at the LME scale. Here, we reflect on PISCO’s approach and progress in linking science, conservation, management, and policy using 20 years of experience in the formation and operation of this research network.

BackgroundThis study measured serial plasma human immunodeficiency virus (HIV)-1-specific antibody (Ab) levels in children who initiated antiretroviral therapy (ART) prior to 2 years of age, and evaluated their relationship to peripheral blood HIV-1 RNA and DNA levels.MethodsWe studied 46 HIV-1-infected children, stratified by age at ART initiation (3 mo-2 years, late therapy [LT]) and by virologic response (R) or non-response (NR), before and up to 4 years following ART. We studied 20 HIV-1-uninfected children born to HIV-1-infected mothers (seroreverters [SR]) as controls. Plasma immunoglobulin G (IgG) Ab levels directed against HIV-1 envelope (gp160, gp41), gag (capsid, p24; matrix, p17), reverse transcriptase (p66/51), and integrase (p31) were serially measured using quantitative enzyme-linked immunosorbent assays. HIV-1 Ab rates of decline were estimated over the first 15 months of the study.ResultsThe HIV-1 Ab rates of decline in the ET-R group were similar to those in the SR group for all Ab specificities, except for p17 (P = .01). Ab decline rates in the LT-R group and the NR group were significantly slower than in the SR group for all tested Ab specificities. After 1 year of age, Ab levels to p31 and p17 were significantly associated with HIV-1 RNA levels (P < .001); Ab levels to gp160 (P < .001) and gp41 (P < .001) were significantly associated with cell-associated HIV-1 DNA levels.ConclusionsQuantitative HIV-1-specific Ab levels may be useful for screening children on ART for viral suppression or for residual, cell-associated HIV-1 DNA levels.Clinical trials registrationNCT00000872.

Islands in oligotrophic oceans act as local sources of nutrients. These nutrients originate from land and from deep oceanic nutrients introduced to the photic zone by tides, currents, and internal waves interacting with island bathymetry. These processes create the island mass effect (IME), in which increased chlorophyll a (Chl a) is found near islands compared to oceanic waters. The IME has been described via satellite observations, but the effects on phytoplankton community structure are not well documented. From 2013 to 2020, chlorophyll, nutrient, and picoplankton samples were collected from multiple depths on quarterly cruises at two sites south of O'ahu, Hawai'i. Prochlorococcus, Synechococcus, picoeukaryotes, and heterotrophic bacteria were enumerated using flow cytometry. We compared nearshore results to Sta. ALOHA, 100 km from O'ahu. Consistent with the expected IME, Chl a concentrations were significantly enhanced at both nearshore sites compared to Sta. ALOHA. Prochlorococcus concentrations increased with greater distance from shore, particularly below 50 m; mixed layer concentrations of Synechococcus and picoeukaryotes significantly decreased with greater distance from shore, as did concentrations of nitrate and phosphate below the mixed layer. Heterotrophic bacteria concentrations did not show a spatial trend. Carbon‐based biomass estimates of the picoplankton population indicated that the IME‐associated Chl a increases near the island are likely driven by larger phytoplankton classes. This study describes the IME‐associated shift in the picophytoplankton community distribution, which has implications for nutrient cycling, food web dynamics and fisheries in oligotrophic island ecosystems, and adds to the understanding of spatial heterogeneity in carbon fixation in the ocean. [ABSTRACT FROM AUTHOR]

BackgroundEarly initiation of combination antiretroviral therapy (cART) to human immunodeficiency virus type 1 (HIV-1)-infected infants controls HIV-1 replication and reduces mortality.MethodsPlasma viremia (lower limit of detection,

Nuʻupia Ponds, a traditional Hawaiian fishpond system, are located at Marine Corps Base Hawaiʻi (MCBH) and part of the Nuʻupia Ponds Wildlife Management Area, a wetland refuge for native, endangered, and protected birds and Hawaiian green sea turtles, as well as many native fish species. Currently, there is uncertainty regarding the ecological status and condition of the fishponds following prior modification of wetland habitats in and around the ponds. This study examines circulation dynamics and characterizes water exchange, pond volume, and residence time across the full tidal spectrum at the Nuʻupia fishponds. Our results indicate a general west to east gradient in current flow; with higher flushing rates and lower residence times of fishponds in the western ponds of the Nuʻupia system compared to the eastern ponds. We further found low flushing rates at several sites causing limited water exchange with Kāneʻohe Bay, as well as within the Nuʻupia Pond system. Sufficient water circulation plays a fundamental role in maintaining a healthy balance of fishpond flora and fauna and preserving ecosystem health. The results from this study provide a baseline for current physical water circulation dynamics and implications for ecosystem health, as well as informing science-based conservation and management strategies moving forward. [ABSTRACT FROM AUTHOR]

Our original research, to design and develop an Intelligent Collaborative Learning System (ICLS), yielded the creation of a Group Leader Tutor software system which utilizes a Collaborative Skills Network to monitor students working collaboratively in a networked environment. The Collaborative Skills Network was a conceptualization of collaborative skills and subskills associated with particular sentence openers. The Group Leader (GL) Tutor taught students effective use of collaboration skills while they worked in Jigsaw Teams on a Local Area Network (LAN). In their discussions, students selected sentence openers associated with particular collaborative skills defined in the Collaborative Skills Network, completing them with free-form sentence closers. Subsequent researchers leveraged this system in various ways including incorporating intelligent agents, expanding the Collaborative Skills Network, and matching sentence openers with appropriate sentence closers. The universal use of the Internet, responsive user interfaces, and learning management systems (LMS) have since provided additional research opportunities using more powerful technology. The ICLS research continues to hold promise for future applications and extensions of our model to new domains. Addressing the needs of both traditional students as well as adult learners in e-learning environments, even MOOCs, may extend the reach of our research into the future. Additionally, enhanced assessment of students' learning outcomes may help improve their collaborative skills.

The coastal ocean environment displays variability across a wide array of time scales. This environmental variability confounds many coastal environmental concerns, e.g., water quality, fisheries, community ecology, and conservation. There is a need for long-term high-quality data over a network of sites.We propose to establish such a coastal environment observation network, with sites at seven of the UC campuses. At each site long-term, high-resolution data would be collected, with a common system of quality control, analysis and interpretation. Physical, chemical, and biological data would be obtained concurrently. The multiple sites will allow for resolution of spatial pattern in coastal environment variability, while links with other observation programs will allow for resolution of offshore and land influences. The data will be web-reported in real time and data analyses and interpretations will be reported at regular intervals. The underlying concept of this system is that data collection would continue indefinitely and with minimal operational costs. The goal is to provide a simple but high-quality record for the next century.In the first year, each site will be instrumented with sensors for temperature, salinity, sea level, chlorophyll fluorescence, turbidity, and PAR. These sensors will be wired for real-time transmission to local data loggers as well as to a centralized data quality control node at UCSC. In the second year, each site will be instrumented with sensors for dissolved nitrate concentration and meteorology and we will seek to integrate other automated coastal observation sites into our UC protocols. Further, analysis and data quality checks of historical data will proceed in parallel with this program (supported by separate funds). The 7 investigators will form a management team, ensuring a common level of operation at all sites and providing adequate channels for consultation with researchers and students at each campus.