Culture-specific neurodevelopmental assessment of HIV-affected children: Home-Based Evaluation through Cloud-Readiness Enhancement

In R01HD098027 we have rolled out our Africa Brain Powered Games (BPG) tablet-based games app for use with HIV-affected children at our Kampala Uganda and Blantyre Malawi study clinic sites. BPG is a package of cognitive training games originally clinically tested (with NIH support) with HIV+ school children in Uganda.

As a child plays, BPG gathers game data for neurocognitive assessment. During the lockdowns in 2020-2021 associated with COVID-19 outbreak in Uganda, we shifted BPG sessions from the clinic to the participant’s homes. Developing a cloud architecture would allow us to deliver content and receive data faster given the

distributed nature of the cloud structure. If we could manage neurocognitive training app requests using the cloud-based integrated network of many servers, local mobile network bandwidth constraints in Africa could be circumvented. Real-time data requests could be scaled up to meet demand and therefore, not overwhelm

a single local server. This is the overarching goal of making our computer-based assessment/rehabilitative apps with at-risk African children “cloud-ready” with the support of this supplemental grant. In Study Aim 1 we will evaluate concurrent and predictive validity of BPG and a newly developed prosocial game of

reasoning and planning called Village Builder (VB) to other proven computer-based and testing battery indicators of brain/behavior integrity of neurocognitive function. Supplemental Development Activity for Study Aim 1. The software development activities most relevant to our 1st study aim is re-factoring software

to scale efficiently to the cloud. Cloud-readiness consulting experts will work with R01 co-investigator and BPG and VB apps developer Professor Brian Winn to move the apps developed in his “serious games for entertainment and learning” (GEL) lab from the LAMP (Linux, Apache, MySQL, PHP) web stack to AWS or

other cloud providers. We will then move our current PHP API used for internet-based data gathering to a REST API componentized application. Supplemental Development Activity for Study Aim 2 involves provisioning of standard source code structure, documentation, version management, build and test support

in codebases that promotes community open-source enhancement. We will do so with such provisioning tools as Git/GitHub, that we have use for other software adaptations to the cloud. Prof. Winn’s GEL lab programmers will utilize JSON (JavaScript Object Notation). Most of the REST APIs and any native cloud

services are going to utilize JSON as our R01 training/assessment apps (BPG and VB) are transitioned for cloud readiness in this supplemental software development initiative. Supplemental Development Activity for Study Aim 3 will pilot test the usability, interoperability and scalability of BPG under increasing internet

real-time bandwidth at both sites (Uganda and Malawi). These include making use of enhanced hardware and clustering technology. Conclusion. This administrative supplement allows us to effectively interfacing the cloud to mobile-based internet real-time BPG and VB app management in the child’s home environment.