Farrah Mateen of Massachusetts General Hospital in the U.S. will measure the thickness of the retina in children from Zimbabwe over the first five years of life using a handheld optical coherence tomography device to determine whether they can identify abnormal brain development in low-income settings. Optical coherence tomography is noninvasive and should be easy for community health workers to use. They will recruit 300 children and correlate retinal layer thicknesses with parameters including weight, height, and gestational age at birth, as well as HIV status. In parallel, the correlation between retinal thickness and cortical volume will be measured using volumetric MRI and optical coherence tomography on 25 children from the U.S.

Sean Deoni of Brown University in the U.S. will evaluate whether mapping myelination in the infant brain can predict their subsequent levels of cognitive ability such as language and motor functioning, which emerge later in childhood. Myelin is a lipid that is deposited around neuronal axons during development. Twenty-four infants between four and six months old will be recruited to a controlled pilot study. At six and 12 months the children will be evaluated for brain myelin content, using magnetic resonance imaging and neurocognitive functions, to link specific myelination levels with cognitive ability. In the future, this approach could also be used to measure the impact of the environment, such as diet, on brain development.

Don Sharkey of the University of Nottingham in the United Kingdom will develop a software-based analysis tool to automatically calculate gestational age from simple videos of newborn faces and feet. Knowing the gestational age, particularly for babies born preterm, is critical for ensuring their healthy development. However, current dating procedures are expensive and/or require trained personnel, and as such are often unavailable in low-middle income countries. They will create a face and foot video database of newborns with known gestational ages of between 23 and 42 weeks, and use automated methods to extract specific features and generate a gestational algorithm. This algorithm will then be validated in a separate group of newborns.

Vasily Yarnykh from the University of Washington in the U.S. will test whether measuring myelin content in the brain using a low-cost magnetic resonance imaging method can act as a reliable biomarker for brain maturation. They will build on a method involving the measurement of the macromolecular proton fraction by magnetic resonance. This method will be converted to a non-image-based and non-localized method that can be more easily and inexpensively used to measure myelin content in developing countries. The new method will be tested for accuracy compared to the standard method, and used on children of a range of ages to see if it can differentiate brain maturation level.

George Wehby and colleagues at the University of Iowa in the U.S. will evaluate newborn metabolic biomarkers for their ability to predict gestational age, and identify associations between them and long-term academic achievement. They will analyze existing newborn metabolic profiles and academic tests from almost one million children in Iowa born between 1980 and 2006 to identify the most predictive biomarkers. In the future they will expand their method to developing countries to help estimate gestational age and identify newborns at risk of neurodevelopmental defects. Being able to accurately determine gestational age is critical in preterm birth, which is the leading cause of child death worldwide. And knowing which regions have the highest incidence of preterm births would help better target prevention strategies. In Phase I, they identified candidate biomarkers that can be detected by tandem mass spectrometry using existing dried blood spot samples and based on around 150,000 children born between 1980 and 2006 in Iowa, they developed a predictive model for gestational age. In Phase II, through a grant awarded to Kelli Ryckman, their model will be tested using around 2,000 cord blood samples from newborns in Bangladesh, Pakistan and Tanzania, and refine it to improve accuracy by measuring additional biomarkers such as hemoglobin.

Alice Cepeda from the University of Southern California in the U.S. will project short 3-D messages given by crack users on selected walls and buildings to illustrate the dangers of crack use on HIV risk, and to promote healthy behavior and testing in local communities. Mexico has seen a recent increase in crack cocaine consumption, which is associated with an increased risk of HIV. They will focus on a vulnerable community in Mexico City, and select message content and ideal sites and times to project the messages. During the projections, they will provide trained individuals to offer additional health advice and on-site HIV testing. The effects will be evaluated on the behavior of 50 local crack users.

Yuval Gielchinsky of Hadassah Medical Center in Israel will develop a non-invasive approach for determining gestational age by analyzing DNA methylation profiles in cells from umbilical cord blood. Accurate gestational age is critical for monitoring and promoting the healthy development of newborns. Current gestational age dating approaches require expensive equipment and trained users, or are relatively inaccurate. Previous work has linked gestational age with epigenetic states such as the patterns of methylation along DNA. They will use two different approaches to measure DNA methylation in 40 newborns, and test which one can most accurately determine gestational age.

Marilyn Nations from the University of Fortaleza in Brazil will evaluate a program established in 1990 at a public hospital in Fortaleza that was designed to increase bonding between fathers and their newborns and thereby improve overall health, as well as reducing crime rates. Fortaleza has a high crime rate mostly linked to low socioeconomic class males. Given fathers had been traditionally excluded from pregnancy and birth-related events, the hypothesis was that encouraging father-baby bonding could establish a 'life-valuing' ethos that would have a knock-on effect on a variety of health and social factors. They will now formally assess this program using questionnaires and in-depth interviews to measure its effect on factors such as violent behavior and employment status after five years. Evidence that the approach is successful will be used to promote its application in other hospitals in Brazil and beyond.

John Spencer of the University of East Anglia in the United Kingdom along with Sean Deoni of the University of Colorado in the U.S. are assessing the trajectory of brain development during the first two years of age using a range of imaging, physiological and behavioral assessment tools to understand how development is affected by environmental factors such as nutrition, stress, and parent-child interaction. In their Phase I project, Spencer and colleagues (while at the University of Iowa in the U.S.) used a neuroimaging technology – functional near-infrared spectroscopy (fNIRS) – to localize brain activity during a preferential looking task as a representation of visual working memory in children between four months and four years of age. They used this data to create a developmental trajectory for this visual working memory task and the underlying functional brain network. Sean Deoni and colleagues in their Phase I project (while at Brown University in the U.S.) used MRI to characterize developmental trajectories of myelination in healthy infants and young children to understand the relationship between myelination and cognitive ability. In Phase II, these two research groups will partner together along with an organization in the state of Uttar Pradesh in India, and use the same methods to assess functional brain development over the first two years of age in two cohorts from different socioeconomic-educational settings starting at six and nine months of age. They will also analyze the effects of various factors such as sleep and nutrition on brain development. In addition, they will develop and test a new tablet-based application for larger-scale studies by untrained assessors in the field, and identify tailored approaches for parents to help them promote healthy cognitive development in their children.

Ann Don Bosco of Good Business in the United Kingdom will run a prevention campaign to reduce the transmission of tuberculosis by making coughing without covering your mouth socially unacceptable. Tuberculosis is a major problem in developing countries, particularly in South Africa, and is primarily spread by coughing. Previous cough prevention campaigns have focused on changing the behavior of the infected person. However, healthy individuals should be more willing to promote preventative behavior in order to avoid becoming infected. Therefore, their campaign will involve promoting the use of a simple, humorous catchphrase by uninfected individuals to express displeasure when someone coughs in their presence without covering their mouths. They will utilize radio, billboards, and mobile phones to spread the message, and analyze the impact on behavior.

Catherine Poulsen of Electrical Geodesics, Inc. in the U.S. will develop a protocol based on electroencephalography for the automated measurement of functional connectivity networks in the infant brain in order to predict the development of neurological defects. Functional connectivity networks such as emotion, memory, and language begin developing during gestation, and defects are linked with disorders including ADHD and depression. However, measuring functional networks requires magnetic resonance imaging, which is expensive and problematic for use on infants. They will develop a new protocol that would enable a low-cost, portable and infant-friendly neuroimaging tool. They will test it on a small sample of infants at 6 and 12 months of age to identify changes in functional networks over time.