Baby Monitor, a mobile interactive voice response system, will bring clinical assessment and referrals directly to mothers and their infants in resource-poor settings who are unlikely to access routine care. To date, mobile applications largely have been used to send patient reminders and health information or to collect patient information through intermediaries such as community health workers. Patients in developing countries have not been end-users of mobile diagnostic tools and medical record systems. If successful, this innovation could save lives, improve health outcomes, and optimize the use of extension workers in rural and remote regions where access to health systems is limited and clinical assessment often occurs too late or not at all. Baby Monitor will help mothers to assess the signs and symptoms of newborn and maternal ill-health in the weeks before and after birth. The system will assess responses to verbal screening questions, provide mothers with health information, and, when necessary, make referrals, alert healthcare providers, and dispatch appropriate healthcare workers.

The specific aim of the proposed study is to test the safety and feasibility of a new low-cost device (Odon Device: http://www.youtube.com/watch?v=OGLLXFzULd4) to deliver the fetus during the second stage of labor. This device may be potentially safer and easier to apply than forceps/vacuum extractor for assisted deliveries, and a safe alternative to some Caesarean sections in settings with limited surgical capacity and human resource constraints. It has potential for wide application in resource poor settings even by mid-level providers. If proven safe and effective, the Odon Device will be the first innovation in operative vaginal delivery since the development of forceps centuries ago and vacuum extractor decades ago.

An HIV+ mother will often be reluctant to travel to a clinic the day or two after delivering her baby. She may feel too weak to travel to a clinic miles away or fear stigmatization after explaining why she must go to a clinic after delivering a healthy baby. This leaves millions of children at risk of becoming HIV+ during the birthing process. We have developed and tested in the laboratory a foilized, polyethylene pouch - something like a fast-food ketchup pouch - that can store the medication for months. If the mother is unable to make it to the hospital to deliver, she can tear open the pouch and provide the drugs to the infant, preventing her newborn from becoming HIV+.

Grameen Foundation, in partnership with Ghana Health Service, aims to expand the successfully piloted MOTECH (Mobile Technology for Community Health) initiative to two new districts in a transition plan towards national scale-up. The program will reach approximately 14,000 pregnant women and 46,000 children under five over the two-year implementation, increasing access to accurate health information, generating increased demand for antenatal, postnatal and neonatal care, and providing detailed data on health service delivery and outcomes to Ghana Health Service. MOTECH has two interrelated mobile applications which focus on improving the health of pregnant women and infants in poor rural areas: Mobile Midwife sends targeted, time-specific, evidence-based voice messages containing important health information to pregnant women and new parents in their local language and the Nurse Application allows community health nurses to electronically record care given to patients so they can easily identify clients in their area due for critical care. If a patient misses scheduled antenatal care, the Mobile Midwife service sends a message to remind the woman to go to the clinic. If she fails to attend, her nurse is alerted via text message enabling the nurse to follow up quickly.

This project confronts the barriers to maternal and neo-natal health constructed and maintained by some community and religious leaders (CRLs) in six states of Nigeria. CRLs provide the ideology, messages and personal life examples which counter the myriad maternal and neonatal health interventions in this region. Previous interventions avoided resistant CRLs, engaging only liberal scholars in one-off events such as workshops. This has failed to bring down the barriers and the death rates persist. This project targets 180 of the most conservative CRLs in 3 states in zone with the highest rates. Using an innovative multi-stage leadership development model, we will train CRLs, support them to attend a study tour in Egypt, facilitate a process by which they use internet and GSM technologies to host community dialogues with Egyptian scholars participating via video link to reinforce correct messages, and convene step-down trainings for lower level CRLs.

Haim Breitbart of Bar-Ilan University in Israel will design and test antisense molecules that will inactivate specific genes within sperm that are essential to the fertilization process. If successful, these antisense molecules can be used to develop a reversible oral male contraceptive.

Gary Foutch and AJ Johannes of Oklahoma State University in the U.S. propose to develop a small-scale device in which an auger forces feces and other solid wastes device through a die that results in high temperatures and pressure that dewaters the waste and destroys microorganisms. The device could reduce odor, insects, surface and ground water contamination, and the associated spread of diseases. In Phase I, they designed a laboratory-scale extruder, which is a fixed shell containing a rotating inner core driven by a motor, and an air-driven plunger to push in the material and generate pressure. They tested its performance using different operating conditions. Preliminary results revealed that their method could destroy 99 percent of parasitic worm eggs in baboon feces. In Phase II, Foutch, AJ Johannes and colleagues will develop and field test a next-generation stand-alone extruder that can effectively sanitize different types of solid sludge in the field, and is also capable of water recovery via evaporation. They will also design a sanitation module from their extruder that can be incorporated into the Omni-Ingestor technology, which is a modular system that combines sanitation with waste removal and transportation.

Mark Illian of Nature Healing Nature in the U.S. will work with villagers in rural Africa to design a pour-flush latrine utilizing readily available urine instead of scarce water for flushing, and drops of used cooking oil for odor control. Achieving a successful design of these latrines could stimulate more latrine building to reduce open defecation and resulting diarrheal diseases.

David Robbins of RTI International in the U.S. will test a septic tank biofilter made from cocopeat, which is a readily available byproduct of coconut processing, for its ability to decompose human waste and produce effluent that can be used for crop fertilization and irrigation. If successful, the cocopeat biofilter could be produced locally and aid in solid waste treatment and water conservation efforts.

Elmer Sayre of the WAND Foundation in the Philippines will explore how to close the loop between sanitation, health and food consumption by testing low-cost dry toilets appropriate for most conditions and using the human waste in small-scale agriculture efforts. Results and best practices will then be shared for future scale-up of the project.

Marcos Fioravanti and Chris Canaday of Fundación In Terris in Ecuador will develop an easy-to-use urine-diverting dry toilet that uses a pedal to "flush" feces into a pipe and mix the waste with dry material for faster composting. Following toilet use, pushing the pedal turns an auger in the pipe, withdrawing the waste to eliminate odors and to enable safe sanitation, after which it can be used as fertilizer. In Phase I, they designed, built and laboratory-tested three prototypes with varying designs. The two best designs, one for home use and one for public use, were field tested in Ecuador to evaluate performance and usability. In Phase II, Fioravanti, now working with co-investigator Chuck Henry, will further refine the design through feedback from the field, and test modified prototypes with a view to conduct large-scale local demonstrations across different continents to promote user acceptance. They will also look to scale-up manufacturing to low-cost mass production.

Virginia Gardiner of Loowatt Ltd. in the United Kingdom will develop a waterless toilet that uses biodegradable film to safely separate and seal waste into a portable cartridge for local anaerobic digestion. The digester will produce fuel (biogas) and fertilizer, creating local waste treatment economies. In Phase I Gardiner performed market research in Madagascar to adapt the basic toilet system to local contexts and to develop a business model. She further developed the toilet, digester, and post-treatment system, and built a pilot system that was tested using human waste in the laboratory. In Phase II, Loowatt looks to scale-up their technology and tools for the global market by further developing the anaerobic digester, readying toilet components for mass production and local manufacture and supply, and exploring local manufacturing possibilities for the biodegradable film.

Peter Dreher of Livvon LLC in the U.S. is developing a simple, low-cost toilet for resource-poor settings that uses a hand crank to remove the water from infected feces and urine, and converts the feces into dry, harmless, odorless pellets in a sealed bag that can be used for fertilizer or fuel. The air-tight system will also control odor and keep out flies and vermin, and requires no water, chemicals, or electricity. The system will help to contain human pathogens such as strains of Escherichia coli that cause many diseases and are particularly deadly to small children. In Phase I, they built the toilet and tested it on cow feces, which has similar water and bacteria content to humans. They found that it killed all the pathogens, sealed in odor, and the urine collector made nitrogen fertilizer. In Phase II, they will adapt the design for mass production, and develop a sustainable business model that generates revenue from the fertilizer and from electricity, which will be produced by a feces-fueled generator, to cover the cost of the toilet and collection service. They will also develop a reward system for using the toilets. They will produce several thousand toilets to test their business model in Africa or Haiti, and evaluate the profit or loss.

Joao Goncalves of ADEIM - Faculdade de Farmacia Lisboa in Portugal proposes to develop molecular sensor strategies using nanoparticles to target memory T cells to deliver a toxin that will be expressed when zinc-finger proteins detect HIV-1 sequences.

Jerome Zack of the University of California, Los Angeles in the U.S. will test nanoparticles for their ability to specifically activate HIV from latently infected cells. Once the latent cells express viral proteins, host immune responses and targeted therapies can be used to kill the cell. If successful, this project could provide an effective approach to eliminate an important viral reservoir from HIV infected individuals.

Hajime Mori of Kyoto Institute of Technology in Japan will develop protein chips that encapsulate poliovirus-like particles (PLP) for use as a safe and effective polio vaccine. When the PLP-protein chips are orally administered, they pass through the stomach without degradation and then are gradually released into the gut to induce a strong immunity against poliovirus infection.

Allen Wilcox of Village Reach in the U.S., working with the University of Washington's Computer Science & Engineering Department, will refine and field test a mobile scanning application to transform paper data into a scalable digital system. The solution would lower time and cost for data capture, improve data quality from the point of care, and provide access to the same information for all levels in the healthcare delivery system.

Fabio Romerio of the University of Maryland, Baltimore in the U.S. seeks to identify surface biomarkers of HIV latently infected cells by comparing membrane proteomes of latently infected and uninfected cells. Unique biomarkers allow selective killing of latently infected cells with specific ligands, or targeted delivery of chemotherapeutic agents.

Marc-Andre Langlois of the University of Ottawa in Canada will develop small molecules that combine together to form a toxic compound only when they enter an HIV-infected cell. Because the molecules are non-toxic for healthy cells, they could constitute promising candidates for a vaccine-based delivery system aimed at specifically eliminating HIV-infected cells.

Andreas G. Koestler and Andrew Larsen of the Fontes Foundation in Norway will design and conduct a small field test in Haiti of a new toilet block system that can be erected as a kit in high-density, difficult to serve communities such as refugee camps. The system will feature urine diverting toilet pans as well as enlarged ventilation areas to help eliminate odors and desiccate feces, and will utilize used billboard fabric as waterproof walls, ceilings, and bladders to store excreta and contain pathogens that can foul water supplies.

Clair Null and Silantoi Kisoso with Innovations for Poverty Action in the U.S., along with Michael Kremer of Harvard University, are designing a children's latrine training mat made from easy-to-clean plastic that fits over an existing latrine hole. The sturdy but easy-to-move platform has a child-sized hole that eliminates the fear and risk of falling into the latrine, promoting good sanitation practices and fostering a life-long habit of latrine use.

Lawino Kagumba of ZanaAfrica in Kenya will develop and test sanitary pads that use a locally available agricultural by-product as an alternative low-cost absorbent material. This would enable low-income women and girls to have access to affordable feminine hygiene products, improving their productivity and menstrual health. In Phase I, Lawino Kagumbe and Megan White Mukuria of American Friends of ZanaAfrica Group in the U.S., working with collaborators in Kenya, developed a pulping process that could inexpensively and efficiently process readily available materials into an absorbent pulp suitable for sanitary pads. They also estimated costs of large-scale processing. In Phase II, Kagumba, now working directly for ZanaAfrica in Kenya, will further optimize the manufacturing process, design a plant for large-scale production, and produce low-cost sanitary pads for evaluation by end users in Kenya.

Mike Barrett, Jon Cooper and Lisa Ranford-Cartwright of the University of Glasgow in the United Kingdom will test the ability of a key component in mobile phones to separate out red blood cells infected with malaria parasites in a blood sample. If successful, such devices could be mass produced for rapid and accurate malaria diagnosis.

Robert Garfield of St. Joseph's Hospital in Phoenix, Arizona in the U.S. will develop a compact, battery-powered device to electrically stimulate uterine contraction and prevent profuse bleeding following childbirth. The instrument could be used by any individual to reduce life-threatening postpartum hemorrhage in hospitals and in remote areas where prompt action is necessary.

Leonard Tender of the Naval Research Laboratory in the U.S. proposes to develop a low-cost wastewater treatment system comprised of an anaerobic digester that generates organically rich acids to power a microbial fuel cell. If successful, the technology could reduce the burden of waterborne diseases in the developing world while providing useful energy.

Erez Lieberman-Aiden and his team at Harvard University in the U.S. propose to develop a low-cost microbial fuel cell (MFC) to power cell phones in Africa. Certain naturally occurring soil microbes produce free electrons during the course of their ordinary metabolic processes, and MFCs will recharge themselves using power derived from these soil microbes. These fuel cells do not require any sophisticated materials to build, and can be easily assembled using locally available materials.

Marco Sgarbanti at the Istituto Superiore di Sanità in Italy proposes to develop a new class of small molecules designed to mimic Tat gene products found in HIV that stimulate and accelerate the transcription of HIV RNA. These Tat-mimicking compounds could activate the latent virus, creating an opportunity to expose it to effective antiretroviral therapies.

Ian Gates and Michael Kallos of the University of Calgary in Canada propose to combine two well-established technologies - anaerobic micro-digesters and micro combined heat/power thermoelectric generation units – into a single portable unit that can consume human excreta to generate electricity, heat, methane, fertilizer and water. Each device will be designed to serve a single extended family.

Ian Jones of the University of Reading in the United Kingdom will investigate new methods to produce empty poliovirus capsids. These are virus-like particles that stimulate the same immunity as poliovirus itself but are completely non-infectious. A successful technology could offer cost and safety benefits leading to the replacement of traditional polio vaccines. In Phase I, he provided proof-of-concept for efficient assembly of empty viral capsids in vitro by testing different approaches to reduce the activity of the 3C enzyme, which has been associated with toxicity. In Phase II, he will scale-up viral capsid production, provide a complete biochemical and biophysical analysis of the capsids, and evaluate factors to promote stability, which is required for a usable vaccine. He will also test the ability of their empty viral capsids to initiate a protective immune response by immunizing small animal models.

Iain Buxton of the University of Nevada School of Medicine will test the theory that the uterine muscle is regulated by a unique potassium channel that allows it to remain relaxed while a growing fetus continues to exert increasing pressure. Studying the dysfunction of this channel could lead to a therapeutic target to treat preterm delivery.

John Herr of the University of Virginia in the U.S. will research the egg-specific membrane enzyme metalloprotease as a target for a non-hormonal female contraceptive. After determining the nature of the enzyme's catalytic pocket, a family of peptidomimetic compounds will be tested for their ability to bind to the enzyme and block its key role in egg fertilization.

Christof von Kalle of Deutsches Krebsforschungszentrum/NCT in Germany will study the genomic location and clonal structure of HIV integration sites in host cells. Finding and eliminating these cells could make antiretroviral therapies more effective and increase the survival of infected individuals.

Kristen DeStigter and Brian Garra of Imaging the World in the U.S. will test a newly developed ultrasound imaging and diagnosis system that can be used in rural areas without trained personnel or electricity to help detect critical maternal conditions that increase maternal and infant mortality.

Gorica Rakleova of Sofia University in Bulgaria proposes to identify and create a library of HIV-1 integrase variants that are capable of removing virus sequences from infected cell genomes. If successful, these variants could be used as new HIV therapies.

Simon Carding of the University of East Anglia in the United Kingdom will test the feasibility of a new technology using live commensal gut bacteria for the controlled delivery of poliovirus antigens to the intestinal mucosa to generate protective viral immunity.

Larry Rand and colleagues at the University of California, San Francisco in the U.S. will develop a vaginal diaphragm to detect changes in cervical collagen and wirelessly alert health providers before preterm labor begins. This device would identify a new pre-labor "window" during which intervention could reduce mortality and disability resulting from preterm birth among at-risk pregnant women. In Phase I, they designed an easy to use and low-cost device incorporating electrical impedance detection circuitry and fiber optic cable to accurately measure collagen concentration in the cervix of pregnant women over time. Prototypes were built for clinical tests to evaluate the capacity for identifying pregnant women at risk of preterm birth, as well as comfort and acceptability. In Phase II they will optimize the device to make it more robust and user-friendly and expand clinical testing to rural settings in South Africa. They will also develop phone-to-cloud technology for wirelessly collecting the measurements from the device through a mobile phone to a server (cloud) for analysis, and to enable return of the prognosis.

Zhenan Bao of Stanford University in the U.S. will develop a low-cost sensing strip with a diagnostic reader to diagnose pre-eclampsia. The diagnosis is based upon the fact that there is an electrical current change when pre-eclampsia is present. If successful, this diagnostic tool could be used for the early detection and monitoring of this condition to avoid late-stage pregnancy complications.

Eva Wiberg-Itzel of the Karolinska Institute in Sweden proposes to develop an easy and informative test which measures the concentration of lactate in the amniotic fluid of laboring women to help obstetricians and midwifes predict labor outcomes. Measuring lactate levels can give care providers an early indication of whether interventions are needed to reduce maternal and infant mortality in developing countries.

Peter Wright of Dartmouth Medical School in the U.S. will determine if preexisting gut immunity predicts shedding of poliovirus vaccine. The study builds on specimens from two previous trials conducted by the WHO. Understanding how inactivated and live poliovirus vaccines protect against shedding of poliovirus is central to strategies for polio eradication.

Ralph Tripp at the University of Georgia in the U.S. will identify genes that, when inhibited, enhance viral replication in the host cell lines used in the manufacture of vaccines in order to reduce the cost of vaccine production. In Phase I, he performed RNA interference screens to identify 21 host genes that, when inhibited, could enhance poliovirus replication and thereby vaccine production. In Phase II, Tripp will broaden his approach to vaccine production against rotaviruses, which cause substantial childhood mortality particularly in developing countries. He will perform a high-throughput RNA interference screen to identify genes that significantly influence viral replication. These will be used to generate a stable gene knockout cell line to test for increased rotavirus production.

Xin Wang and colleagues from Brigham and Women's Hospital and Boston Medical Center in the U.S., along with collaborators from Weifang Medical University in China and Christian Medical College in India, will identify new treatments and associated diagnostic biomarkers for hypoxic-ischemic brain injury in newborns, which is a significant cause of morbidity and mortality. In Phase I they discovered that agonists of the melatonin receptor, alone or in combination with hypothermia, could prevent newborn hypoxic-ischemic brain injury in a mouse model. In Phase II, they will study the mechanism of action of these agonists, and evaluate their potential as diagnostic or prognostic biomarkers in newborn mice and humans with hypoxic-ischemic brain injury to help rapid detection and the optimization of treatment strategies.

Gero Hütter of Red Cross Germany proposes to use stem cells transplants to cure HIV. He is planning to develop a program that generates a registry of stem cells that lack the CCR5 protein, which is used by HIV to enter into a cell. If successful these adult stem cells could be transplanted into a HIV patient and effectively “cure” HIV.

Karsten Gjefle of Sustainable Sanitation Design in Norway will design and test a low cost system to rapidly turn human excreta into pathogen-free compost for use as fertilizer for farmers. Gjefle and his team hope to create a viable financial market that will remove untreated sewage from urban areas and also provide farmers with recycled, safe and natural soil improvements.

John Wyatt of Power-free Education and Technology in South Africa will develop a durable, low-cost pulse oximetry probe for use with a “wind-up” pulse oximeter to monitor oxygen saturation levels in the blood of newborns, sick children and mothers undergoing cesarean section in low resource settings.

Josiane Nzouonta and Renita Machado of Cayoll LLC in the U.S. will develop and test a cell phone application, eMosquitoNet, which plays music that includes sound waves at resonant frequencies of female Aedes aegypti mosquitoes, which transmit yellow fever and dengue fever. These sound waves cause uncontrollable vibrations and failure of the mosquito's navigation system, preventing them from feeding and spreading disease.

Kenneth Puzey of QuantaSpec in the U.S. will develop the Spectraphone to provide automated, rapid, reagent-less diagnosis of malaria and other infectious diseases using an infrared spectrometer embedded in a cell phone.

Noune Sarvazyan and a team at Artann Laboratories in the U.S. will develop a hand-held ultrasonic device for noninvasive measurement of soft tissue water content to assess dehydration in newborns. Dehydration is one of the leading causes of infant morbidity and mortality.

Mark Hauswald, Nancy Kerr, and David Wachter of Global Health Partnerships and the University of New Mexico in the U.S. will work with care providers in Nepal to evaluate their use and acceptance of inexpensive devices constructed of local materials that decrease blood flow to the pelvic organs for treating post-partum hemorrhage, a major cause of maternal morbidity and mortality in the developing world.

Natalie Cookson and colleagues at Quantitative BioSciences in the U.S. are developing an algae-based waste treatment system targeted for third-world applications. Cyanobacteria will treat a community's waste and produce two forms of renewable energy: nutrient-rich fertilizer to enhance agriculture and biomethane to power the facility and neighboring community.