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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.

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Longitudinal Trajectories in Brain Function in Infancy

Silvia RigatoUniversity of EssexColchester, United Kingdom
Grand Challenges Explorations
Brain Function/Gestational Age
22 Oct 2014

Silvia Rigato and Karla Holmboe of the University of Essex in the United Kingdom will track the development of attention and social skills in infants over time to enable the early identification of children with impairments. They will recruit 60 infants and analyze attention skills such as alertness monitored by heart rate, and social skills such as face perception monitored by eye tracking, from the last trimester of pregnancy through to 10 months old. In the future, these developmental trajectories will be used to help identify infants at risk of poor intellectual and social abilities.

Go Baby Go!

Nana ColemanWorld VisionFederal Way, Washington, United States
Grand Challenges Explorations
Brain Function/Gestational Age
22 Oct 2014

Nana Coleman of World Vision in the U.S. will teach positive parenting skills such as hugging, reading, and playing to parents in Armenia to promote healthy childhood development. They will exploit their existing network of health care providers and parent support groups to teach better parenting behavior, and integrate it with another program they have been running to improve child and maternal health. They will test whether this holistic strategy is more effective at changing parental behavior and improving childhood nutrition and development than the individual approaches.

Handheld Retinal Measurements to Assess Early Brain Growth

Farrah MateenGeneral Hospital CorporationBoston, Massachusetts, United States
Grand Challenges Explorations
Brain Function/Gestational Age
21 Oct 2014

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.

Full-use of Guinea Worm Eradication Plans to Address NTDs

James RansomAfrican Field Epidemiology NetworkAbuja, Nigeria
Grand Challenges Explorations
Community-Based Interventions
21 Oct 2014

James Ransom of IFETP in the U.S. will promote detection and treatment of five neglected tropical diseases in South Sudan by exploiting and further developing an existing health infrastructure that has successfully reduced the incidence of guinea worm disease. They will target two regions with particularly high incidences of the targeted diseases, and train the local health surveillance officers on preventative methods and to provide comprehensive care and treatment. They will also work to educate the public and media about these diseases.

Imaging Healthy Infant Brain Myelination

Sean DeoniBrown UniversityProvidence, Rhode Island, United States
Grand Challenges Explorations
Brain Function/Gestational Age
21 Oct 2014

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.

Voices that Count

Steff DeprezVredeseilandenLeuven, Belgium
Grand Challenges Explorations
Agricultural Programs
21 Oct 2014

Steff Deprez of Vredeseilanden in Belgium will develop an approach utilizing pattern detection software (SenseMaker) to translate feedback from smallholder farmers directly into quantitative data that can be easily queried by agricultural development program managers and evaluators. They will test their approach on rice, passion fruit and coffee smallholder farmers in sub-Saharan African to evaluate whether they should be included in modern markets. A so-called signification framework will be developed that comprises specific questions for the farmers in a format that allows them to supplement their feedback with additional narrative to facilitate conversion into statistical data. Participatory feedback sessions will also be organized. The entire approach will be cost-effective and designed for up to 3000 participants.

Newborn Face and Foot Analysis to Determine Gestational Age

Don SharkeyUniversity of NottinghamLoughborough, United Kingdom
Grand Challenges Explorations
Brain Function/Gestational Age
20 Oct 2014

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.

Gestational Dating at Birth by Metabolic Profile

Laura Jelliffe-PawlowskiUniversity of California San FranciscoSan Francisco, California, United States
Grand Challenges Explorations
Brain Function/Gestational Age
16 Oct 2014

Laura Jelliffe-Pawlowski of the University of California, San Francisco in the U.S. is developing an algorithm to measure gestational age from metabolic markers taken during routine newborn screening. Measuring accurate gestational age is important for assessing infant health such as brain development, but it is challenging in developing countries without specialized equipment and expertise. In Phase I, they developed a statistical model using data on 51 metabolic markers from around 730,000 newborns in the U.S. that predicted gestational age at birth within around an average of one week margin of error. In Phase II, they will further adapt and test their algorithm for use in Malawi and Uganda by using existing data from 500 pregnancies in Malawi and 1000 in Uganda, and also determine its value for identifying newborns at risk of neonatal death or complications.

Low-cost Quantitative Assessment of Brain Maturation

Vasily YarnykhUniversity of WashingtonSeattle, Washington, United States
Grand Challenges Explorations
Brain Function/Gestational Age
16 Oct 2014

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.

Using Eye Movements To Assess Functional Brain Development in Infants

Shannon Ross-SheehyEast Tennessee State UniversityJohnson City, Tennessee, United States
Grand Challenges Explorations
Brain Function/Gestational Age
16 Oct 2014

Shannon Ross-Sheehy of East Tennessee State University in the U.S. will study whether simply monitoring eye movements in infants can be used to measure their neural development. During the first year of life, infant's brains are highly plastic and thus potentially more amenable to the correction of any developmental defects. However, these defects are often only detected in childhood, which may be too late. They will study the changes in eye movement patterns in infants over time at ages four, seven and ten months, and in parallel measure cognitive development to identify links between the two. This method would be relatively inexpensive and quick to perform, and therefore be suitable for use also in developing countries.

Gestational Age, Metabolic Markers, and Academic Achievement

George WehbyUniversity of IowaIowa City, Iowa, United States
Grand Challenges Explorations
Brain Function/Gestational Age
16 Oct 2014

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.

Childhood Malnutrition and Enteric Infections

Linda SaifOhio State UniversityColumbus, Ohio, United States
Grand Challenges Explorations
Enteric Disease Models
15 Oct 2014

Linda Saif from Ohio State University in the U.S. will develop a pig model to recapitulate the vicious cycle of malnutrition and repeated enteric infections seen in young children in developing countries in order to study the underlying biology and identify effective treatments. Childhood malnutrition is rife in impoverished regions, and causes substantial mortality and disabilities. It impairs gut function and immunity, and leads to increased enteric infection rates. They will explore the relationship between malnutrition and enteric infections using piglet models of malnutrition and multiple pathogen-associated enteropathy, and analyze the effects on the cellular and microbial composition of the gut, and the immune response. They will also test whether specific diets and supplements such as tryptophan can restore healthy gut function.

HIV Projection Mapping with Crack Users in Mexico City

Alice CepedaUniversity of Southern CaliforniaLos Angeles, California, United States
Grand Challenges Explorations
Behavior Change
15 Oct 2014

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.

Using Mobile Phone for Transparent School Feeding Tendering

Lesley DrakeImperial College LondonLondon, United Kingdom
Grand Challenges Explorations
Agricultural Programs
15 Oct 2014

Lesley Drake of Imperial College London in the United Kingdom will develop a mobile phone-based platform to increase the participation of smallholder farmers in the Kenyan government's homegrown school meals program. The technology will enable schools to report their food requirements, and the Ministry to advertise tenders to registered sellers including smallholder farmers, all via mobile phone. This approach will lower the cost of making school feeding contracts and make the process transparent, as well as providing a new market for local farmers. They will develop and pilot test the platform with 48 schools in two counties in Kenya.

Determining Gestational Age Using Genome Methylation Profile

Yuval GielchinskyHadassah Medical OrganizationJerusalem, Israel
Grand Challenges Explorations
Brain Function/Gestational Age
14 Oct 2014

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.

Veggie Lite Conjunction of Agriculture, Nutrition, and Health for Inclusive Development of Women

Suvankar MishraEKutir Rural Management Services Private LimitedBhubaneshwar, , India
Grand Challenges India
Agriculture and Nutrition
14 Oct 2014

This project, run in collaboration with international partners Daisa Enterprises (formerly Wholesome Wave) and the McGill University Centre for the Convergence of Health and Economics, aims to pilot an innovative entrepreneurial approach to provide economic benefits and increase agricultural production, nutritional intake, and overall health to women in resource-poor rural and urban communities.

Father-Baby Bonding for Infant Health and Family Nonviolence

Marilyn NationsUniversidade de FortalezaFortaleza, Ceará, Brazil
Grand Challenges Explorations
Behavior Change
13 Oct 2014

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.

Enhance Integrated Delivery of NTD and WASH programs

Mwelecele MalecelaNational Institute for Medical ResearchDar es Salaam, Tanzania
Grand Challenges Explorations
Community-Based Interventions
13 Oct 2014

Mwelecele Malecela of the National Institute for Medical Research in the United Republic of Tanzania will integrate the treatment of neglected tropical diseases with water, hygiene and sanitation programs to lower costs and maximize the use of resources. They will extend and develop local health infrastructures by generating income for community health workers, and involve people at all community levels in the project. In this way, they aim to provide a unified platform for managing and executing diverse projects related to the treatment of diseases to increase their long-term success.

Measuring Changes in Functional Brain Activity with fNIRS

John SpencerUniversity of IowaIowa City, Iowa, United States
Grand Challenges Explorations
Brain Function/Gestational Age
13 Oct 2014

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.

Farm Buddy: Mobile Linkage to Farmers and Organizations

Adam AbramsonFoundations for FarmingHarare, Zimbabwe
Grand Challenges Explorations
Agricultural Programs
13 Oct 2014

Adam Abramson from Foundations for Farming in Zimbabwe will develop a low-cost mobile phone platform to encourage local farmers to directly engage with each other and with local organizations to share their experiences and provide feedback. The platform is installed on feature phones and allows the formation of 'buddy' chat groups. They will further develop the software, and evaluate its ability to promote the adoption of a novel farming technique by conducting a randomized controlled trial in 72 sites across Zimbabwe. They plan to provide the technology as an SMS interface delivered on the user's SIM card for a low-cost monthly access fee, and organizations will be able to collect and analyze mobile data.

Nudging TB Sufferers to Cover Mouths Through Social Pressure

Ann Don BoscoGood BusinessLondon, United Kingdom
Grand Challenges Explorations
Behavior Change
10 Oct 2014

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.

Smartphone Ophthalmoscope Image Analysis for Gestational Age

Jennifer GriffinResearch Triangle InstituteResearch Triangle Park, North Carolina, United States
Grand Challenges Explorations
Brain Function/Gestational Age
10 Oct 2014

Jennifer Griffin of RTI International in the U.S. will test whether the gestational age of infants born prematurely can be determined by combining simple physical measurements with an automated analysis of the blood vessels in the retina using the camera on a mobile phone. As the fetus develops in the womb, blood vessels in the anterior lens gradually disappear, which closely correlates with gestational age at delivery. An automated approach increases accuracy and reproducibility, and their new method is also lower cost and requires less skill than traditional ultrasound-based methods of gestational age dating, and therefore should be useful also in low-middle income settings. In Phase I, they developed methods for acquiring quality images of the eye using an ophthalmoscope and smartphone. In Phase II, they will perform a multisite cross-sectional study to generate retinal images and biophysical parameter datasets from preterm neonates for developing the image analysis software and producing an algorithm to identify the best predictors of gestational age. They will evaluate their approach by comparing it to the gold standard of ultrasound.

Functional Connectivity Assessment of Brain Development

Catherine PoulsenElectrical Geodesics, Inc.Eugene, Oregon, United States
Grand Challenges Explorations
Brain Function/Gestational Age
10 Oct 2014

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.

Fostering TB Medication Adherence via Innovative Packaging

Andrew CrossKarma HealthcareUdaipur, , India
Grand Challenges Explorations
Behavior Change
9 Oct 2014

Andrew Cross of Microsoft Research India in India will try to improve adherence to tuberculosis medication in India by evaluating an inexpensive approach combining personalized pill packaging with mobile phones to report when medication has been taken and to receive reminders. Less than half of people with chronic diseases take their medication correctly. And for diseases like tuberculosis this can lead to drug-resistance, which is a serious problem. Solutions such as the electronic pillbox have been successful, but are expensive. They will conduct a randomized controlled trial of their pill blister packet, which exposes a unique number when a pill is taken and prompts the user to make a free mobile phone call to report it. Frequent reminders to take medication will be sent by SMS, and if medication is missed, individuals will be contacted directly by health care workers.

Pollen-Based Assays of Intestinal Mucus Water Content and Rheology

Carson MeredithGeorgia Institute of TechnologyAtlanta, Georgia, United States
Grand Challenges Explorations
Enteric Disease Models
9 Oct 2014

Carson Meredith from Georgia Tech in the U.S. will determine whether pollen can measure gut function by assessing mucus qualities, which vary along the gastrointestinal tract particularly in children with enteric diseases. Gastrointestinal mucus prevents pathogens entering the body and promotes the absorption of nutrients and medicines. Therefore, its physical properties are relevant for gut health and the development of effective treatments. Pollen particles vary widely in size and shape, and can survive the harsh environment of the gastrointestinal tract. He will test the ability of a selection of pollen to probe properties such as water content and viscosity of synthetic and porcine intestinal mucus using an established technique known as particle tracking microrheology to track pollen motion.

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