AID Atlanta

This protocol describes a hybrid type 2 effectiveness-implementation trial to examine the effectiveness, maintenance, and reach of an mHealth-mediated intervention to promote HIV and psychological health among Black same gender loving men. The intervention was developed by and for Black same gender loving men and seeks to reduce social isolation, increase access to culturally affirming healthcare, and decrease barriers to stable housing and economic empowerment due to interpersonal, institutional, and structural stigma. It does so through promoting individual-level health education and motivation, social support among Black same gender loving men, access to culturally-affirming healthcare, and pathways to stable housing and economic empowerment. This study will be implemented in the Ending the HIV Epidemic in the U.S. jurisdictions in and around Atlanta, GA through a collaboration between NAESM, a Black same gender loving men-led community-based organization in Atlanta, GA, Positive Impact Health Centers, an Atlanta-based comprehensive HIV service organization, and Rutgers School of Public Health in New Jersey. This study will test the latest iteration of the intervention called NPOWER365. We will conduct a 6-month randomized controlled trial to assess the effectiveness of NPOWER365 on HIV-related and psychological health, its moderating effect on intersectional stigma, and its intervention maintenance and reach. We will randomize 350 Black same gender loving men living with HIV to intervention (n = 175) or wait-list control (n = 175) groups and assess daily and longer-lag HIV care (i.e., anti-retroviral treatment adherence) and psychological health (e.g., depressive symptoms, anxiety symptoms) outcomes through baseline and 6-month daily diary studies and 1-, 2-, 4-, and 6-month longer-lag assessments. We will analyze intervention effectiveness, stigma moderation, and implementation outcome data through dynamic structural equation modelling and latent growth curve models. Thus, this study will establish the effectiveness of NPOWER365, a community-led mHealth intervention, for improving HIV behavioral and psychological health for Black same gender loving men living with HIV in four of the Ending the HIV Epidemic jurisdictions with the highest HIV burden. NPOWER365 was designed for implementation and is poised to offer a model for effective HIV and psychological support among Black SGLM in high-stigma, low-resource areas of the U.S. South and beyond. This trial is registered on ClinicalTrials.gov (NCT06315218).

BackgroundLong-acting cabotegravir and rilpivirine (LA CAB/RPV) was approved in 2021 for treatment of HIV-1 to replace current antiretroviral therapy (ART) in those who are virologically suppressed with a viral load (VL) < 50 copies/mL. Challenges with patient access led to development of a standardized office-based LA CAB/RPV program in a network of Infectious Disease offices in the US. We reported initial success and patient adherence in 2024, and this study evaluates the long-term effectiveness of the LA CAB/RPV program.Table 1.Baseline Demographics and Treatment CharacteristicsFigure 1.Virologic Outcomes at Baseline and Follow-UpMethodsThe LA CAB/RPV program was initiated in July 2023 and the first 100 patients were followed through April 2025. Data collection included demographics, prior therapy, baseline and follow-up VL, adherence to schedule, adverse events, and reasons for discontinuation. Adherence was defined as LA CAB/RPV received within 7 days of target date.Table 2.Reasons for discontinuationResults100 pts from 20 sites were included. Patient and treatment characteristics are in Table 1. Median age was 49 years (IQR 39-59) with 81% male. Median BMI was 29.2 kg/m2 (IQR 27.1-31.9), with 38% ≥30 kg/m2. The majority (98%) received 2-month injections. The duration of therapy with LA CAB/RPV was 13 months (median, IQR 11-15), with 753 injections administered to date. Injections were administered on schedule in 94.8% of all doses. Virologic outcomes are noted in Figure 1. The baseline VL was 29 c/mL (median, IQR 20-54) and 94% were virologically suppressed at initiation of LA CAB/RPV. After a median of 8 doses (IQR 7-9) and for those with follow-up VL, 91 remained suppressed with a VL non-detectable (IQR 0-0). One had a VL of 84 copies/mL. Overall, 21 discontinued therapy, with reasons noted in Table 1. One third discontinued due to financial or payor issues. Non-serious adverse events occurred in 6%, with 4 resulting in discontinuation.ConclusionAn ID physician office based LA CAB/RPV program demonstrated durability in maintenance of virologic suppression with high injection adherence. These results suggest that LA CAB/RPV administered through a standardized ID office-based program is effective in managing HIV-1.DisclosuresNikhil K. Bhayani, MD, FIDSA, Cumberland Pharmaceuticals: Advisor/Consultant|Melinta: Advisor/Consultant|Paratek Pharmaceuticals: Advisor/Consultant Brian S. Metzger, MD, MPH, Abbvie: Advisor/Consultant|Cumberland Pharmaceuticals: Advisor/Consultant|Ferring Pharmaceuticals: Advisor/Consultant Richard L. Hengel, MD, FIDSA, Gilead: Grant/Research Support Lucinda J. Van Anglen, PharmD, FIDSA, Cumberland Pharmaceuticals: Grant/Research Support|Ferring Pharmaceuticals: Grant/Research Support|Melinta Therapeutics: Grant/Research Support|Novartis: Grant/Research Support|Takeda Pharmaceuticals: Grant/Research Support

Abstract Background The intersection of foreign-born (FB) status and HIV among transgender women (TW) presents public health challenges, especially unmet healthcare needs (UHN). FBTW often encounter barriers like immigration status, language difficulties, and institutional distrust, which may be compounded for those living with HIV. Understanding how FB status and HIV intersect with UHN can guide health equity policies tailored to FBTW.Prevalence of unmet healthcare needs among US-born and foreign-born transgender women by HIV status in 7 U.S. Cities from June 2019 – February 2020Notes: aPR – adjusted prevalence ratios; CI – confidence intervals; * - significant at p&amp;lt;0.05, Models were adjusted for respondent-driven sampling design and confounding factors, including age and racial categories stratified by Hispanic/Latina ethnicity Methods TW in 7 US cities were recruited via respondent-driven sampling, consented, interviewed, and offered HIV testing. Data from people who were ≥18 years, assigned male/intersex at birth, self-identified as women or TW, spoke English/Spanish, and who had valid responses to variables of interest were included. Participants were grouped by FB status: US-born vs. FB. Log-linked Poisson regression models estimated the association between FB status and past-year UHN due to cost. HIV test results and FB status were assessed for effect modification. Models generated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). Results Among 1561 TW, 1152 (74%) were US-born and 409 (26%) were FB. 520 (42%) US-born TW and 139 (34%) FBTW tested HIV-positive. Overall, FBTW reported higher prevalence of UHN compared to US-born TW (22.2% vs 19.4%; aPR 1.15, 95%CI 1.01-1.46). There was a significant interaction between HIV test result and FB status (p&amp;lt; 0.05) (Figure). Among those HIV-negative, FBTW reported higher prevalence of UHN compared to US-born (29.3% vs 21.4%; aPR 1.34, 95%CI 1.06-1.69); whereas among those HIV-positive, FBTW reported lower prevalence of UHN’s compared to US-born (8.6%; vs 16.9% vs 8.6%; aPR 0.54, 95%CI 0.32-0.89). Conclusion This finding challenge assumptions that HIV-positive FBTW, often at greater risk of comorbidities and requiring more medical care, would face more barriers to healthcare. Instead, HIV-negative FBTW having higher UHN’s may suggest lack of access to HIV prevention. This raises critical questions on underlying factors contributing to these UHN’s and suggests a complex interaction between HIV status and gender identity and its implications on healthcare access. Status-neutral, comprehensive care approaches must be prioritized for FBTW. Disclosures All Authors: No reported disclosures

Understanding customer preferences across communication channels is critical for optimizing marketing strategies in the automotive industry. This paper introduces a machine learning framework that predicts customer engagement rates for various channels, including email, SMS, and social media. By linking historical engagement data with future behaviors using observation and performance windows, the framework enables precise channel assignment based on predictive scores. Applications in vehicle purchase campaigns and after-sales promotions highlight the framework's potential to improve marketing efficiency and customer satisfaction. Challenges like data sparsity and interpretability are discussed, along with proposed mitigation strategies.

Abstract This editorial is the first in a series of editorials exploring the future of engineering design from the perspective of thought-leaders within the engineering design community. Five early- and mid-career researchers were invited to present their perspectives at a meeting of the Design Society in March 2025 on the campus of the Georgia Institute of Technology. Jessica Menold focused on teaming and collaboration in the context of artificial intelligence (AI); Kosa Goucher-Lambert on design cognition; Astrid Layton on sustainable and resilient design; Mohsen Moghaddam on virtual reality (VR)/augmented reality (AR)/extended reality (XR) in engineering design; and Zhenghui Sha on the design of complex sociotechnical systems. Each presentation was followed by roundtable discussions of the challenges and opportunities posed by the speaker. The presentations and audience discussions are summarized in this editorial, along with a brief overview of some of the opportunities for further work. The goal of this editorial series is to inform the broader community of the progress, challenges, and opportunities associated with important themes within our research community and to offer a starting point for those who seek to investigate these topics and continue to advance the state-of-the-art in our field.

Ensuring the integrity of firmware running on embedded systems—such as automotive Electronic Control Units (ECUs)—is critical to system reliability and security. This paper presents a lightweight, non-intrusive method for detecting firmware flashing events using electromagnetic (EM) sidechannel emissions collected via low-cost software-defined radios (SDRs). By focusing on short, deterministic update phases (e.g., bootloader-based flashing), we avoid the overhead of continuous monitoring. We propose a kernel-based pattern matching framework that identifies flashing operations by comparing short-time spectral signatures to a reference. We validate this approach on SAMV71 development boards and show that appropriate frequency band selection is key to signal clarity. Cross-board experiments reveal challenges related to hardware variability, including missing components. These results highlight the feasibility of EM-based firmware inspection in real-world, resource-constrained environments.

Background: Modern software increasingly relies on Developer Prompts (Dev Prompts)-snippets of natural language embedded directly in source code-to leverage the capabilities of Large Language Models (LLMs) for tasks like classification, summarization, and content generation. Yet, despite the rapid adoption of LLMs and Dev Prompts, it remains unclear to what extent these prompts unintentionally encode biases, invite injection attacks, or underperform due to sub-optimal phrasing. Aims: To address this gap, we present a large-scale empirical analysis of Dev Prompts found in real open-source software projects to assess the prevalence of bias, security vulnerabilities, and performance issues. Then, we propose and validate approaches to mitigate these issues, and demonstrate the practical feasibility of addressing them. Method: We systematically sampled 2,320 Dev Prompts from a set of 40,573 found in open-source software projects, to identify the prevalence of the aforementioned issues. We also implemented a lightweight tool that automatically rewrites flawed prompts. Results: We find evidence of easy-to-fix issues across multiple dimensions: 3.46% of prompts contain language likely to lead to biased model responses, while over 10.75% are vulnerable to straightforward injection attacks, and we posit that many more are amenable to performance improvement through minor adjustments. Our prototype successfully mitigated bias in 68.29% of cases, prevented injection vulnerabilities in 41.81%, and improved performance in 37.1% of tested prompts. Conclusions: Our findings highlight an urgent need for future research and dedicated tool-support to help software developers write safer, fairer, and more effective prompts. To facilitate ongoing work in this emerging area, we share our data and analysis infrastructure publicly. We encourage the community to further explore the implications of Dev Prompts in modern software.

Background/Objectives: Low back pain (LBP) remains one of the leading causes of disability globally and contributes significantly to healthcare expenditures. Discogenic LBP, a subtype stemming from intervertebral disc degeneration, often provesrefractory to conventional treatment modalities. Regenerative orthobiologic therapies, including platelet-rich plasma (PRP), platelet lysate (PL), and mesenchymal stem cells (MSCs), have emerged as promising alternatives, though long-term outcomes and safety profiles are not yet well understood. Methods: This case series reports 13 patients treated between 2015 and 2016 at an outpatient interventional pain center who received intradiscal culture-expanded MSC injections with or without additional injections to other surrounding vertebral structures. There was no control group. Inclusion required patients to have discogenic LBP with or without radiculopathy and at least six years of completed follow-up data. Outcomes were assessed using Numeric Rating Scale (NRS), Functional Rating Index (FRI), and modified Single Assessment Numeric Evaluation (SANE) scores at multiple time points up to 10 years post treatment. Results: Thirteen patients met the inclusion criteria. Significant reductions in NRS and FRI scores were observed at 6 months, 3 years, and 6 years (p < 0.01). At 6 years, the average NRS score decreased by 2.50 points, FRI by 24.14 points, and SANE showed a 60% improvement. At 10 years, among the seven patients who responded, average SANE improvement was 78.1%. No adverse events were reported. Conclusions: This study presents the longest known follow-up data for intradiscal MSC therapy for discogenic LBP, demonstrating sustained improvements in pain and function. These findings support further investigation into combination orthobiologic therapies as a viable long-term treatment option for chronic LBP.

Structural biology plays a key role in therapeutic drug discovery by revealing mechanisms of drug leads against their macromolecular targets and allowing for the optimization of their structures to enhance their therapeutic properties. One way that structural biology has been widely performed is by crystallography, which encompasses protein expression, crystallization, diffraction data collection, and model building and refinement. While experiments employing these techniques often are hard for students to perform on their own, since they require steep expertise, equipment, and funding barriers, the crystallographic and adjacent experiences can offer students unique opportunities to learn valuable research skills that they can use for projects they may want to pursue in the future in an engaging, captivating manner.The Structural Nucleic Acid Anticancer Research Society (STARS) is a student-led nonprofit organization that aims to provide these educational opportunities in relatable and engaging ways to students by creating robust infrastructure needed to support K-8th educators, 9th-12th graders, and undergraduate students to implement inorganic crystal-growing and macromolecular crystallography club projects and outreach programs to provide valuable experiences and skills, such as micro pipetting solutions for experimental setups, analyzing molecular interactions in protein complexes, or practice diffracting crystals, to elevate students’ understanding and learning of crystal-growing and crystallography along with key scientific skills, such as observation, notetaking, and analysis skills, so that students may use these experiences for their own projects in the future.Our strategy is to provide club branch projects, which can have therapeutic significance, that (1) provide valuable scientific experiences to students; (2) are applicable to students’ research interests; (3) are thematically accessible and easily understandable in nature; and (4) are rendered much more feasible to perform through clear and concise handouts provided by STARS and through branch fundraising with clear budgets. In starting new STARS branches in K-12th and in undergraduate student populations, we aim to not only equip students with important scientific skills and experiences through club branch activities, such as crystal-growing or crystallography projects, and outreach programs, such as crystallography workshops and crystal-growing competitions, but also aim to build up student leaders in science by providing students the opportunity to advocate for their STARS branch mission and purpose, share their outreach and research message through presentations, and network with industry and academia leaders at, for example, the American Crystallographic Association conference.So far, STARS already has two STARS branches, where student leaders bring STARS programming and outreach to life. These two branches have together organized over 12 events and programs, such as crystal-growing competitions, crystallography workshops, and lecture series sessions over the past four years with 380+ participants cumulatively. However, to truly provide all students in the United States the crystal- growing and crystallography opportunities to learn valuable scientific skills and be inspired in research for the treatment of diseases, STARS aims to (1) fully streamline its club programming and outreach activities with clear guidance and handouts, which can enable our STARS programs to scale up; (2) foster inter-STARS branch communications and collaborations to form a network of research-focused students through our annual STARS meetings; (3) enable students more accessible opportunities to give presentations at the American Crystallographic Association (ACA) conference through the STARS Travel Grant; and (4) engage more K-12th and undergraduate students in not only inorganic crystal growing, but also protein crystallography through national crystallography competitions of proteins (such as with lysozyme, the chicken egg white protein).Crystallography is a unique research field that not only is very important for structural biology and therapeutic drug discovery research but also can easily captivate students with its beautiful inorganic and macromolecular crystals and structures. The Structural Nucleic Acid Anticancer Research Society (STARS) aims to capitalize on these inherent qualities to engage and empower students in crystal-growing, crystallography, and therapeutic research through our streamlined programs and club activities.