ABSTRACT
Purpose: COVID-19 has caused a shift toward consumer-facing technology such as mobile health (mHealth) applications. However, most mHealth apps do not use accessible language. Standardized terminologies have potential to solve this problem but have not been simplified for consumer use. Methods: We used a standardized health terminology, the Omaha System, as the framework to develop the Simplified Omaha System Terms (SOST) for use within a mHealth application, MyStrengths + MyHealth. Plain language principles informed the SOST development in three phases, a community-validation focus group enabled feedback from diverse end-users, a readability assessment provide validation to the desired goal readability level. Results: The community-validation members (n = 19) ages ranged from 22 to 74;51% male, 84% people of color, and 21% college educated. The reading level of the final SOST averaged 3.86 on the Coleman–Liau Index (fourth grade). A case study showed meaningful whole-person health data were generated in a community-led study during COVID-19. Conclusions: Community validation and readability assessment demonstrated accessible language for a clinical terminology. The SOST was deployed successfully in MyStrengths + My Health and in a community-led study. The Omaha System as a framework for the SOST may enable the data to be integrated with clinical datasets. Future research should focus on validation of SOST in additional languages and integration within electronic health platforms. © 2022 The Authors.
ABSTRACT
Human adenovirus serotype 26 (Ad26) is used as a gene-based vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and HIV-1. However, its primary receptor portfolio remains controversial, potentially including sialic acid, coxsackie and adenovirus receptor (CAR), integrins, and CD46. We and others have shown that Ad26 can use CD46, but these observations were questioned on the basis of the inability to cocrystallize Ad26 fiber with CD46. Recent work demonstrated that Ad26 binds CD46 with its hexon protein rather than its fiber. We examined the functional consequences of Ad26 for infection in vitro and in vivo. Ectopic expression of human CD46 on Chinese hamster ovary cells increased Ad26 infection significantly. Deletion of the complement control protein domain CCP1 or CCP2 or the serine-threonine-proline (STP) region of CD46 reduced infection. Comparing wild-type and sialic acid-deficient CHO cells, we show that the usage of CD46 is independent of its sialylation status. Ad26 transduction was increased in CD46 transgenic mice after intramuscular (i.m.) injection but not after intranasal (i.n.) administration. Ad26 transduction was 10-fold lower than Ad5 transduction after intratumoral (i.t.) injection of CD46expressing tumors. Ad26 transduction of liver was 1,000-fold lower than that ofAd5 after intravenous (i.v.) injection. These data demonstrate the use of CD46 by Ad26 in certain situations but also show that the receptor has little consequence by other routes of administration. Finally, i.v. injection of high doses of Ad26 into CD46 mice induced release of liver enzymes into the bloodstream and reduced white blood cell counts but did not induce thrombocytopenia. This suggests that Ad26 virions do not induce direct clotting side effects seen during coronavirus disease 2019 (COVID-19) vaccination with this serotype of adenovirus. IMPORTANCE The human species D Ad26 is being investigated as a low-seroprevalence vector for oncolytic virotherapy and gene-based vaccination against HIV-1 and SARS-CoV-2. However, there is debate in the literature about its tropism and receptor utilization, which directly influence its efficiency for certain applications. This work was aimed at determining which receptor(s) this virus uses for infection and its role in virus biology, vaccine efficacy, and, importantly, vaccine safety.