TLC Year in Review

With contributions by Matthew Schehl, Shona Dunn, Ali Rodgers, Betsy Wallace, Miriam Bergue Alves, Michael Guerrero, Aileen B. Houston, Cheryldee Huddleston, Leo Blanken and Cecilia Panella, and a forward by Scott Bischoff, Dennis Lester, and Tom Rosko

Goal setting in diabetes self-management: Taking the baby steps to success

To evaluate the usefulness of a diabetes self-management guide and a brief counseling intervention in helping patients set and achieve their behavioral goals

Literacy-appropriate educational materials and brief counseling improve diabetes self-management

In this pilot study, we evaluated the impact of providing patients with a literacy-appropriate diabetes education guide accompanied by brief counseling designed for use in primary care

A Randomized Trial to Assess Anti-HIV Activity in Female Genital Tract Secretions and Soluble Mucosal Immunity Following Application of 1% Tenofovir Gel

Preclinical and early phase clinical microbicide studies have not consistently predicted the outcome of efficacy trials. To address this gap, candidate biomarkers of microbicide pharmacodynamics and safety were evaluated in a double-blind, placebo-controlled trial of tenofovir gel, the first microbicide to demonstrate significant protection against HIV acquisition.30 women were randomized to apply a single daily dose of tenofovir or placebo gel for 14 consecutive days. Anti-HIV activity was measured in cervicovaginal lavage (CVL) on Days 0, 3, 7, 14 and 21 by luciferase assay as a surrogate marker of pharmacodynamics. Endogenous activity against E. coli and HSV-2 and concentrations of immune mediators were quantified in CVL as candidate biomarkers of safety. Tenofovir levels were measured in CVL and blood.A significant increase in anti-HIV activity was detected in CVL from women who applied tenofovir gel compared to their endogenous anti-HIV activity in genital tract secretions on Day 0 and compared to activity in CVL from women in the placebo group. The activity correlated significantly with CVL concentration of tenofovir (r = 0.6, p<0.001) and fit a sigmoid E(max) pharmacodynamic model. Anti-HIV activity in CVL from women who applied tenofovir persisted when virus was introduced in semen, whereas endogenous anti-HIV activity decreased. Tenofovir did not trigger an inflammatory response or induce sustained loss in endogenous antimicrobial activity or immune mediators.Tenofovir gel had no deleterious impact on soluble mucosal immunity. The increased anti-HIV activity in CVL, which persisted in the presence of semen and correlated with tenofovir concentration, is consistent with the efficacy observed in a recent clinical trial. These results promote quantified CVL anti-HIV activity as a surrogate of tissue pharmacodynamics and as a potential biomarker of adherence to product. This simple, feasible and inexpensive bioassay may promote the development of models more predictive of microbicide efficacy.ClinicalTrials.gov NCT00594373

The US Program in Ground-Based Gravitational Wave Science: Contribution from the LIGO Laboratory

Recent gravitational-wave observations from the LIGO and Virgo observatories have brought a sense of great excitement to scientists and citizens the world over. Since September 2015,10 binary black hole coalescences and one binary neutron star coalescence have been observed. They have provided remarkable, revolutionary insight into the "gravitational Universe" and have greatly extended the field of multi-messenger astronomy. At present, Advanced LIGO can see binary black hole coalescences out to redshift 0.6 and binary neutron star coalescences to redshift 0.05. This probes only a very small fraction of the volume of the observable Universe. However, current technologies can be extended to construct "3rd Generation" (3G) gravitational-wave observatories that would extend our reach to the very edge of the observable Universe. The event rates over such a large volume would be in the hundreds of thousands per year (i.e. tens per hour). Such 3G detectors would have a 10-fold improvement in strain sensitivity over the current generation of instruments, yielding signal-to-noise ratios of 1000 for events like those already seen. Several concepts are being studied for which engineering studies and reliable cost estimates will be developed in the next 5 years

Temperament Moderates Novel Word Learning at 15 Months

Researchers have been reporting temperament-language correlations in infants for 10 years. However, in order to identify directions of effects between temperament and language, methodologies besides correlations need to be developed. The “competition attention paradigm” is an effort to sidestep some of the direction-of-effect issues by asking infants to learn novel words in the context of environmental distractions designed to tap into children’s temperaments. The purpose of the present study was to explore whether environmental distracters would differentially impact 15-month-olds’ novel wordlearning as a function of children’s temperamental profiles. Twenty-eight 15-month-olds were asked to learn 4 novel words. Novel word learning consisted of initially familiarizing children with two novel objects, and then mapping a novel label to only one of the novel objects five times. Novel word comprehension was tested by asking children to select the newly-labeled object from the pair of novel objects across 4 test trials. A remotely-controlled mechanical spider competed for children’s attention during object familiarization on two of the words. Half the children were distracted on the first two words, half were distracted on the last two. Temperament was assessed via parental reporting using the Early Child Behavior Questionnaire. The environmental distractions did not impact children’s word-learning directly. However, order of distraction presentation did [F(1, 23) = 7.16, p = .014], such that children who were distracted on the first two words performed higher overall than children who were distracted on the last two. Results involving temperament were complex, yielding many significant interaction effects with factors impacting children’s word-learning. For example, children high in fear demonstrated better word-learning in the absence of the spider than in its presence, whereas the spider had no effect on low-fear children, but only when learning the first word in the pair [F(1, 23) = 5.20, p = .032]. Other temperament factors found to impact novel word-learning included attentional focus, cuddliness, impulsivity, frustration, and high intensity pleasure. The results of the present investigation contribute to a growing body of research linking temperament to word learning. The competition attention paradigm suggest ways through which word learning may be impacted by dimensions of temperament. Although not presentable here due to space limitations, the pattern of results also points to attentional focus as playing a central moderating role over other dimensions of temperament. Finally, the present results are the first to link temperament to language acquisition at 15 months

Public health impact of the U.S. Scenario Modeling Hub

Beginning in December 2020, the COVID-19 Scenario Modeling Hub has provided quantitative scenario-based projections for cases, hospitalizations, and deaths, aggregated across up to nine modeling groups. Projections spanned multiple months into the future and provided timely information on potential impacts of epidemiological uncertainties and interventions. Projections results were shared with the public, public health partners, and the Centers for Disease Control COVID-19 Response Team. The projections provided insights on situational awareness and informed decision-making to mitigate COVID-19 disease burden (e.g., vaccination strategies). By aggregating projections from multiple modeling teams, the Scenario Modeling Hub provided rapidly synthesized information in times of great uncertainty and conveyed possible trajectories in the presence of emerging variants. Here we detail several use cases of these projections in public health practice and communication, including assessments of whether modeling results directly or indirectly informed public health communication or guidance. These include multiple examples where comparisons of projected COVID-19 disease outcomes under different vaccination scenarios were used to inform Advisory Committee for Immunization Practices recommendations. We also describe challenges and lessons learned during this highly beneficial collaboration