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Low-Income Suburban Residents in the San Francisco Bay Area Face Significant Housing and Transportation Issues
Get PDFGrowing poverty in America’s suburbs challenges their image as single-family residential communities for middle class, predominantly white families. Research shows that suburban areas now have the largest share of households under the poverty line. Since these areas have lower density development and lower levels of public transit service compared to urban areas, living in the suburbs may pose accessibility challenges for low-income households, particularly those without a personal vehicle. To explore housing and transportation issues associated with the suburbanization of poverty, we combined U.S. Census data from Contra Costa County, which has the highest rates of suburban poverty in the San Francisco Bay Area, and online and in-person surveys with individuals who earn less than 80% of the Area Median Income (AMI), around $75,000. This research identifies demographic and external factors that lead low- and moderate-income households to move to suburban areas, accessibility barriers faced by low- and moderate-income suburban households, and how transportation use and transportation and housing costs differ between urban and suburban low-income residents in the Bay Area
Assessing the synergies of flexibly-operated carbon capture power plants with variable renewable energy in large-scale power systems
Get PDFOn O-Constructions in Jarawara
Get PDFThe language Jarawara (Arauan, spoken in Brazil) exhibits a puzzling set of passive-like properties in its “O-Construction” (Dixon 2000, 2004). We argue that O-Constructions have a type of passive voice in some person combinations but not in others, and that they are unified in that they always have topic agreement on C with the internal argument. We relate this approach to recent research on Algonquian inverse systems (especially Oxford 2023a,b, 2024) which have also been argued to involve a passive-like voice-based alternation for specific person combinations. Our analysis captures facts about case, word order, divergences between C and T agreement, and the distribution of the passive-like prefix hi- (among other properties). Our findings provide support for the approach to person restrictions embodied in Oxford’s work and also demonstrate how topic agreement and the A system can interact. More generally, this work shows how a nuanced approach to passive constructions, and a willingness to separate agreement from voice, can lead to a cross-linguistically grounded analysis of what seems prima facie like an “unusual” construction
An Integrated Framework for Infectious Disease Control Using Mathematical Modeling and Deep Learning.
Get PDFInfectious diseases are a major global public health concern. Precise modeling and prediction methods are essential to develop effective strategies for disease control. However, data imbalance and the presence of noise and intensity inhomogeneity make disease detection more challenging. Goal: In this article, a novel infectious disease pattern prediction system is proposed by integrating deterministic and stochastic model benefits with the benefits of the deep learning model. Results: The combined benefits yield improvement in the performance of solution prediction. Moreover, the objective is also to investigate the influence of time delay on infection rates and rates associated with vaccination. Conclusions: In this proposed framework, at first, the global stability at disease free equilibrium is effectively analysed using Routh-Haurwitz criteria and Lyapunov method, and the endemic equilibrium is analysed using non-linear Volterra integral equations in the infectious disease model. Unlike the existing model, emphasis is given to suggesting a model that is capable of investigating stability while considering the effect of vaccination and migration rate. Next, the influence of vaccination on the rate of infection is effectively predicted using an efficient deep learning model by employing the long-term dependencies in sequential data. Thus making the prediction more accurate
Defining and Validating Criteria to Identify Populations Who May Benefit From Home-Based Primary Care.
Get PDFBACKGROUND: Home-based primary care (HBPC) is an important care delivery model for high-need older adults. Currently, target patient populations vary across HBPC programs, hindering expansion and large-scale evaluation. OBJECTIVES: Develop and validate criteria that identify appropriate HBPC target populations. RESEARCH DESIGN: A modified Delphi process was used to achieve expert consensus on criteria for identifying HBPC target populations. All criteria were defined and validated using linked data from Medicare claims and the National Health and Aging Trends Study (NHATS) (cohort n=21,727). Construct validation involved assessing demographics and health outcomes/expenditures for selected criteria. SUBJECTS: Delphi panelists (n=29) represented diverse professional perspectives. Criteria were validated on community-dwelling Medicare beneficiaries (age ≥70) enrolled in NHATS. MEASURES: Criteria were selected via Delphi questionnaires. For construct validation, sociodemographic characteristics of Medicare beneficiaries were self-reported in NHATS, and annual health care expenditures and mortality were obtained via linked Medicare claims. RESULTS: Panelists proposed an algorithm of criteria for HBPC target populations that included indicators for serious illness, functional impairment, and social isolation. The algorithms Delphi-selected criteria applied to 16.8% of Medicare beneficiaries. These HBPC target populations had higher annual health care costs [Med (IQR): 2830 (913, 9574)] and higher 12-month mortality [15% (95% CI: 14, 17) vs. 5% (95% CI: 4, 5)] compared with the total validation cohort. CONCLUSIONS: We developed and validated an algorithm to define target populations for HBPC, which suggests a need for increased HBPC availability. By enabling objective identification of unmet demands for HBPC access or resources, this algorithm can foster robust evaluation and equitable expansion of HBPC
Efficacy and safety of lemborexant in subjects with insomnia disorder receiving medications for depression or anxiety symptoms.
Get PDFAIM: Individuals with insomnia frequently have comorbid depression or anxiety. This study sought to provide a preliminary indication of the effects of lemborexant (LEM) in subjects treated for mild depression/anxiety symptoms. METHODS: E2006-G000-303 (NCT02952820; EudraCT 2015-001463-39; SUNRISE-2) was a 12-month, phase 3, randomized, placebo-controlled, double-blind study where subjects with insomnia disorder were randomized (1:1:1) to placebo, LEM 5 mg (LEM5), or LEM 10 mg (LEM10) for 6 months. During the second 6 months (not reported), placebo-treated subjects were re-randomized to LEM5 or LEM10. In this post hoc analysis, changes from baseline (CFB) in subject-reported (subjective) sleep onset latency (sSOL), sleep efficiency (sSE), wake after sleep onset (sWASO), total sleep time (sTST), Fatigue Severity Scale, and Insomnia Severity Index were evaluated in subjects treated with medications for symptoms of depression/anxiety (subpopulation). RESULTS: Of 949 randomized subjects, 61 treated with medications for symptoms of depression/anxiety were included. In the subpopulation, CFB comparing LEM with placebo were generally smaller than the overall population due to a larger placebo response in the subpopulation. However, the magnitudes of CFB within the active treatment groups for sSOL, sWASO, sTST, and sSE were similar between the subpopulation and the overall population. No new safety signals were observed in the subpopulation. CONCLUSION: LEM treatment benefited subjects with insomnia treated with medications for depression/anxiety symptoms, with no new safety signals. A greater placebo response in the subpopulation than in the overall population decreased the drug versus placebo effect size for LEM, as has been reported for other insomnia medications
Preclinical Development of Tuspetinib for the Treatment of Acute Myeloid Leukemia.
Get PDFThis article reports preclinical development of TUS, an oral kinase inhibitor currently in clinical development for treatment of AML. The article covers the studies of TUS activities on cellular targets and the nonclinical studies that supported the advancement of TUS to a phase I/II trial of TUS/VEN in refractory AML and a phase I/II trial of TUS/VEN/5-azacytidine in newly diagnosed patients with AML (NCT03850574)
MIBiG 4.0: advancing biosynthetic gene cluster curation through global collaboration
Get PDFSpecialized or secondary metabolites are small molecules of biological origin, often showing potent biological activities with applications in agriculture, engineering and medicine. Usually, the biosynthesis of these natural products is governed by sets of co-regulated and physically clustered genes known as biosynthetic gene clusters (BGCs). To share information about BGCs in a standardized and machine-readable way, the Minimum Information about a Biosynthetic Gene cluster (MIBiG) data standard and repository was initiated in 2015. Since its conception, MIBiG has been regularly updated to expand data coverage and remain up to date with innovations in natural product research. Here, we describe MIBiG version 4.0, an extensive update to the data repository and the underlying data standard. In a massive community annotation effort, 267 contributors performed 8304 edits, creating 557 new entries and modifying 590 existing entries, resulting in a new total of 3059 curated entries in MIBiG. Particular attention was paid to ensuring high data quality, with automated data validation using a newly developed custom submission portal prototype, paired with a novel peer-reviewing model. MIBiG 4.0 also takes steps towards a rolling release model and a broader involvement of the scientific community. MIBiG 4.0 is accessible online at https://mibig.secondarymetabolites.org/
Post-intervention control in HIV immunotherapy trials
Get PDFPurpose of reviewWhile post-treatment control following interruption of standard-of-care antiretroviral therapy (ART) is well described, post-intervention control following immunotherapy in HIV cure-related clinical trials is less well understood. We provide an overview of recent studies that have identified post-intervention controllers and review the mechanisms that may drive this biologically important phenotype.Recent findingsPost-intervention controllers have been identified in recent immunotherapy trials testing broadly neutralizing antibodies, immune modulators, modified T cells, checkpoint inhibitors, and gene therapy administered individually or in combination. Currently, there is substantial variability in how each trial defines post-intervention control, as well as in how the mechanisms underlying such control are evaluated. Such mechanisms include ongoing activity of both exogenous and autologous antibodies, as well as changes in HIV-specific T cell function.SummaryWhile no therapeutic strategy to date has succeeded in definitively inducing HIV control, many studies have identified at least a small number of post-intervention controllers. The field would benefit from a standardized approach to defining and reporting this phenotype, as well as standardization in the approach to assessment of how it is achieved. Such efforts would allow for comparisons across clinical trials and could help accelerate efforts toward an HIV cure
Syphilis reactivity among blood donors in Brazil: associated factors and implications for public health monitoring.
Get PDFBACKGROUND: Increasing syphilis infection rates are a concerning issue worldwide. Blood donation screening is an opportunity to monitor the burden of asymptomatic infections, providing information on contemporary factors associated with infection and public health insights into transmission. METHODS: Blood donations collected at five Brazilian blood centers between January 2020 and February 2022 were screened with treponemal or non-treponemal assays according to local protocols, followed by alternate Enzyme-Linked Immunosorbent Assay (ELISA); samples with reactive or indeterminate results in the alternate ELISA were further tested with the rapid plasma reagin (RPR), and categorized as RPR-positive or RPR-negative. RPR-positive donations were also grouped according to RPR titers (< 1:8 or ≥ 1:8). We report the prevalence of syphilis in first-time donors (FTD) and repeat donors (RD), as well as incidence in RD. Multivariable models were used to assess factors associated with RPR-positive syphilis. Additionally, we explored the relationship between syphilis positivity in FTD and syphilis cases registered by the Brazilian public health surveillance system from 2012 to 2022. FINDINGS: Of 862,146 donations, 10,771 (1.3%) were reactive or indeterminate on screening; 7,541 available samples underwent additional testing. Of those, 5,876 (77.9%) tested positive or indeterminate on the alternate ELISA; 907 (12.0%) were RPR-negative, 2,980 (39.5%) were RPR-positive < 1:8, and 1,989 (26.4%) were RPR-positive with titers ≥ 1:8. The prevalence of syphilis including RPR-positive and RPR-negative cases was 2.5% among FTD and 0.6% among RD. The incidence of syphilis in RD was 90/105 person-years (95% CI 86-95), with younger age, male gender, Black and Mixed race (relative to White) and lower education associated with incident syphilis in RD. Blood donors had lower rates of syphilis compared to the general population, with correspondence between numbers in blood donors and congenital syphilis rates registered by the Brazilian surveillance system between 2012 and 2022. CONCLUSION: The prevalence of syphilis was < 3% among FTD and < 1% among RD. We found wide variability according to donor characteristics, with gender, age, race, and schooling significantly associated with prevalent and incident RPR-positive syphilis in multivariable models. Syphilis occurrence among blood donors can be used to assess disease patterns in low-risk populations