REDUCING THE IMPACT OF HOUSING COST BURDEN ON LOW-INCOME HOUSEHOLDS IN SOUTHEAST CENTRAL DURHAM

The health outcomes of low-income households in Southeast Central Durham are impacted in numerous ways by their neighborhood and built environment. At the core of these issues, we find that the cost burden of housing plays a major role on health outcomes. We have created a policy and program that will allow our target population to gain affordable housing while also increasing access to healthy food. Using analysis of our target population along with analysis of our stakeholders, we created a policy and program along with an engagement and accountability plan. Intertwining housing and access to healthy food has given us a foundation for addressing a cumulative burden. Implementing affordable loans with minority owned brokers as well as providing education lends to the sustainability of the program; along the same lines, working with local farmers to implement community-supported agriculture subsidies has a win-win impact.Master of Public Healt

REDUCING THE IMPACT OF HOUSING COST BURDEN ON LOW-INCOME HOUSEHOLDS IN SOUTHEAST CENTRAL DURHAM

The health outcomes of low-income households in Southeast Central Durham are impacted in numerous ways by their neighborhood and built environment. At the core of these issues, we find that the cost burden of housing plays a major role on health outcomes. We have created a policy and program that will allow our target population to gain affordable housing while also increasing access to healthy food. Using analysis of our target population along with analysis of our stakeholders, we created a policy and program along with an engagement and accountability plan. Intertwining housing and access to healthy food has given us a foundation for addressing a cumulative burden. Implementing affordable loans with minority owned brokers as well as providing education lends to the sustainability of the program; along the same lines, working with local farmers to implement community-supported agriculture subsidies has a win-win impact.Master of Public Healt

REDUCING THE IMPACT OF HOUSING COST BURDEN ON LOW-INCOME HOUSEHOLDS IN SOUTHEAST CENTRAL DURHAM

The health outcomes of low-income households in Southeast Central Durham are impacted in numerous ways by their neighborhood and built environment. At the core of these issues, we find that the cost burden of housing plays a major role on health outcomes. We have created a policy and program that will allow our target population to gain affordable housing while also increasing access to healthy food. Using analysis of our target population along with analysis of our stakeholders, we created a policy and program along with an engagement and accountability plan. Intertwining housing and access to healthy food has given us a foundation for addressing a cumulative burden. Implementing affordable loans with minority owned brokers as well as providing education lends to the sustainability of the program; along the same lines, working with local farmers to implement community-supported agriculture subsidies has a win-win impact.Master of Public Healt

150,000-year palaeoclimate record from northern Ethiopia supports early, multiple dispersals of modern humans from Africa

Climatic change is widely acknowledged to have played a role in the dispersal of modern humans out of Africa, but the timing is contentious. Dispersal is often linked to climatic change at ~60,000 years ago, despite increasing evidence for earlier presence of modern humans in Asia. Here we report a deep seismic and near-continuous core record of the last 150,000 years from Lake Tana in the Ethiopian highlands, close to the earliest modern human fossil sites and to postulated dispersal routes. The record shows varied climate at the end of the penultimate glacial, followed by an abrupt change to relatively stable moist climate during the last interglacial. These conditions would have favored population growth and range expansion, supporting models of early, multiple dispersals of modern humans from AfricapublishersversionPeer reviewe

Author Correction: 150,000-year palaeoclimate record from northern Ethiopia supports early, multiple dispersals of modern humans from Africa

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper

An Observational Cohort Comparison of Facilitators of Retention in Care and Adherence to Anti-Eetroviral Therapy at an HIV Treatment Center in Kenya

BACKGROUND: Most HIV treatment programs in resource-limited settings utilize multiple facilitators of adherence and retention in care but there is little data on the efficacy of these methods. We performed an observational cohort analysis of a treatment program in Kenya to assess which program components promote adherence and retention in HIV care in East Africa. METHODS: Patients initiating ART at A.I.C. Kijabe Hospital were prospectively enrolled in an observational study. Kijabe has an intensive program to promote adherence and retention in care during the first 6 months of ART that incorporates the following facilitators: home visits by community health workers, community based support groups, pharmacy counseling, and unannounced pill counts by clinicians. The primary endpoint was time to treatment failure, defined as a detectable HIV-1 viral load; discontinuation of ART; death; or loss to follow-up. Time to treatment failure for each facilitator was calculated using Kaplan-Meier analysis. The relative effects of the facilitators were determined by the Cox Proportional Hazards Model. RESULTS: 301 patients were enrolled. Time to treatment failure was longer in patients participating in support groups (448 days vs. 337 days, P<0.001), pharmacy counseling (480 days vs. 386 days, P = 0.002), pill counts (482 days vs. 189 days, P<0.001) and home visits (485 days vs. 426 days, P = 0.024). Better adherence was seen with support groups (89% vs. 82%, P = 0.05) and pill counts (89% vs. 75%, P = 0.02). Multivariate analysis using the Cox Model found significant reductions in risk of treatment failure associated with pill counts (HR = 0.19, P<0.001) and support groups (HR = 0.43, P = 0.003). CONCLUSION: Unannounced pill counts by the clinician and community based support groups were associated with better long term treatment success and with better adherence

A study exploring learners' informal learning space behaviors, attitudes, and preferences

What makes a successful informal learning space is a topic in need of further research. The body of discourse on informal space design is drawn from learning theory, placemaking and architecture, with a need for understanding of the synergy between the three. Findings from a longitudinal, quantitative and qualitative study at Sheffield Hallam University, explore learners' behaviours, attitudes and preferences towards informal learning spaces in higher education, within and outside of the context of the academic library. The learning spaces study contributes to the discourse on informal learning spaces design by producing a typology of nine learning space preference attributes which address aspects of learning theory, placemaking and architecture. The typology can be used to evaluate existing spaces and inform redevelopment of informal learning spaces in higher education institutions. Implementing the typology will be subject to localised conditions, but at Sheffield Hallam University the key conclusions have included developing a portfolio of discrete, interrelated learning environments, offering spaces with a clear identity and encouraging students to translate their learning preferences into space selection

The Aminopeptidase CD13 Induces Homotypic Aggregation in Neutrophils and Impairs Collagen Invasion.

Aminopeptidase N (CD13) is a widely expressed cell surface metallopeptidase involved in the migration of cancer and endothelial cells. Apart from our demonstration that CD13 modulates the efficacy of tumor necrosis factor-α-induced apoptosis in neutrophils, no other function for CD13 has been ascribed in this cell. We hypothesized that CD13 may be involved in neutrophil migration and/or homotypic aggregation. Using purified human blood neutrophils we confirmed the expression of CD13 on neutrophils and its up-regulation by pro-inflammatory agonists. However, using the anti-CD13 monoclonal antibody WM-15 and the aminopeptidase enzymatic inhibitor bestatin we were unable to demonstrate any direct involvement of CD13 in neutrophil polarisation or chemotaxis. In contrast, IL-8-mediated neutrophil migration in type I collagen gels was significantly impaired by the anti-CD13 monoclonal antibodies WM-15 and MY7. Notably, these antibodies also induced significant homotypic aggregation of neutrophils, which was dependent on CD13 cross-linking and was attenuated by phosphoinositide 3-kinase and extracellular signal-related kinase 1/2 inhibition. Live imaging demonstrated that in WM-15-treated neutrophils, where homotypic aggregation was evident, the number of cells entering IL-8 impregnated collagen I gels was significantly reduced. These data reveal a novel role for CD13 in inducing homotypic aggregation in neutrophils, which results in a transmigration deficiency; this mechanism may be relevant to neutrophil micro-aggregation in vivo.This work was funded by a Medical Research Council Research Training Fellowship to CAF (G0900329), Addenbrooke’s Charitable Trust (ACT), CUHNHSFT, Papworth Hospital NHS Foundation Trust and the NIHR Cambridge Biomedical Research Centre. CAF received a Raymond and Beverly Sackler Studentship.This is the final version of the article. It first appeared from the Public Library of Science via http://dx.doi.org/10.1371/journal.pone.016010

HRDetect is a predictor of BRCA1 and BRCA2 deficiency based on mutational signatures.

Approximately 1-5% of breast cancers are attributed to inherited mutations in BRCA1 or BRCA2 and are selectively sensitive to poly(ADP-ribose) polymerase (PARP) inhibitors. In other cancer types, germline and/or somatic mutations in BRCA1 and/or BRCA2 (BRCA1/BRCA2) also confer selective sensitivity to PARP inhibitors. Thus, assays to detect BRCA1/BRCA2-deficient tumors have been sought. Recently, somatic substitution, insertion/deletion and rearrangement patterns, or 'mutational signatures', were associated with BRCA1/BRCA2 dysfunction. Herein we used a lasso logistic regression model to identify six distinguishing mutational signatures predictive of BRCA1/BRCA2 deficiency. A weighted model called HRDetect was developed to accurately detect BRCA1/BRCA2-deficient samples. HRDetect identifies BRCA1/BRCA2-deficient tumors with 98.7% sensitivity (area under the curve (AUC) = 0.98). Application of this model in a cohort of 560 individuals with breast cancer, of whom 22 were known to carry a germline BRCA1 or BRCA2 mutation, allowed us to identify an additional 22 tumors with somatic loss of BRCA1 or BRCA2 and 47 tumors with functional BRCA1/BRCA2 deficiency where no mutation was detected. We validated HRDetect on independent cohorts of breast, ovarian and pancreatic cancers and demonstrated its efficacy in alternative sequencing strategies. Integrating all of the classes of mutational signatures thus reveals a larger proportion of individuals with breast cancer harboring BRCA1/BRCA2 deficiency (up to 22%) than hitherto appreciated (∼1-5%) who could have selective therapeutic sensitivity to PARP inhibition