Accessing adequate healthcare, particularly essential services like physical therapy, presents a significant challenge for individuals with Down syndrome. This demographic often encounters obstacles such as limited accessibility, scarce resources, and a lack of tailored solutions that specifically address their unique needs. The resulting disparity leads to inconsistent care and suboptimal healthcare experiences. Recognizing the importance of eliminating these barriers is crucial to create a more inclusive healthcare environment for individuals with Down syndrome. Rainbow Monster Madness serves as a multifaceted solution to the social determinants of health that significantly impact individuals with Down syndrome. The game's design directly tackles several of these determinants by offering accessible, engaging, and family-centered therapy. In terms of healthcare access and quality, the game empowers parents to actively participate in their child's therapy, ensuring the correct administration of exercises and the consistent provision of quality care. The game's design addresses neighborly and built environment determinants by providing an accessible and inclusive therapy option that can be implemented within the comfort of one's home. This approach fosters a sense of safety and familiarity for children undergoing therapy, promoting a more relaxed and conducive environment. Additionally, Rainbow Monster Madness encourages social community engagement by fostering a collaborative atmosphere between parents and children during therapy sessions. This collaborative approach creates a supportive and engaging environment, positively impacting the overall therapeutic experience. Adhering to the principles of Self-Determination Theory, the game cultivates intrinsic motivation and psychological well-being among children with Down syndrome. This approach enables active engagement in therapy and contributes to their overall health and well-being. The exercises included in Rainbow Monster Madness are carefully selected to cater to the unique needs of individuals with Down syndrome. This regimen combines muscle-strengthening, cardio, and balance exercises, tailored to this specific population. The modification of exercises and thematic design ensures that children remain enthusiastic about their therapy, ultimately promoting better adherence and more effective results. In summary, Rainbow Monster Madness represents a comprehensive solution to the multitude of challenges faced by individuals with Down syndrome in accessing healthcare. Simultaneously, it addresses the broader social determinants of health, thereby fostering a healthier and more inclusive future for this deserving population.

The lack of affordable pharmaceutical access in rural communities is a nationwide crisis for up to 14% of American homes. Pharm to Farm believes that individuals in rural areas deserve the treatment and accessibility that urban and suburban areas receive. Through our approach, we help to bridge this accessibility gap by empowering those marginalized homes to affordably access pharmaceutical health resources. Pharm to Farm achieves this with our business model that allows individuals to get their medications delivered at a cost of only $35 per month.

Agassiz’s desert tortoise (Gopherus agassizii) is a long-lived species native to the Mojave Desert and is listed as threatened under the US Endangered Species Act. To aid conservation efforts for preserving the genetic diversity of this species, we generated a whole genome reference sequence with an annotation based on deep transcriptome sequences of adult skeletal muscle, lung, brain, and blood. The draft genome assembly for G. agassizii has a scaffold N50 length of 252 kbp and a total length of 2.4 Gbp. Genome annotation reveals 20,172 protein-coding genes in the G. agassizii assembly, and that gene structure is more similar to chicken than other turtles. We provide a series of comparative analyses demonstrating (1) that turtles are among the slowest-evolving genome-enabled reptiles, (2) amino acid changes in genes controlling desert tortoise traits such as shell development, longevity and osmoregulation, and (3) fixed variants across the Gopherus species complex in genes related to desert adaptations, including circadian rhythm and innate immune response. This G. agassizii genome reference and annotation is the first such resource for any tortoise, and will serve as a foundation for future analysis of the genetic basis of adaptations to the desert environment, allow for investigation into genomic factors affecting tortoise health, disease and longevity, and serve as a valuable resource for additional studies in this species complex.

Data Availability: All genomic and transcriptomic sequence files are available from the NIH-NCBI BioProject database (accession numbers PRJNA352725, PRJNA352726, and PRJNA281763). All genome assembly, transcriptome assembly, predicted protein, transcript, genome annotation, repeatmasker, phylogenetic trees, .vcf and GO enrichment files are available on Harvard Dataverse (doi:10.7910/DVN/EH2S9K).