Gays in the neighborhood: How neighborhood and context impact HIV and substance use risks and resiliencies of gay, bisexual and other men who have sex with men in New York City

Thirty years into the HIV pandemic gay, bisexual, and other men who have sex with men (MSM) are still disproportionately impacted by HIV/AIDS, accounting for two-thirds of the U.S epidemic. There is increasing evidence that context is an important driver of HIV risk. This dissertation was designed to summarize the literature on the influences of neighborhoods on MSM health and to explore three contextual moments of heightened HIV risk using data from the NYCM2M study (N=1493). Migration: There is a well-established history of gay migration to NYC. These data support that migration is an important moment of heightened HIV risk for MSM. More recent migrants to NYC had increased risk for condomless sex and heavy drinking compared to men in NYC for longer. Compared to White MSM, Black and Latino MSM had a greater proportional hazard of seroconverting within the first ten years of migration. Community Viral Load (CVL): Where MSM live and have sex is not random, but constructed by socio-historical factors. These findings suggest that differences may be an important determinant in the social epidemiology of HIV. Compared to White MSM, Black MSM had greater odds of living in and having sex in higher CVL neighborhoods, Latino MSM had greater odds of a higher CVL sex neighborhood. Both Black MSM and bisexuals had greater odds of migrating to higher CVL spaces (than White gay men). White MSM who migrated had greater odds for condomless sex than those who did not. Substance Use: Elevated substance use has been documented among MSM, particularly those in cities. These findings show significant between neighborhood differences in any drug use and hazardous drinking (home and social) and heavy drinking (social) suggesting that neighborhood factors uniquely influence substance use behaviors among MSM. Without substantial changes to the implementation of HIV treatment/prevention, we will continue to fall short of our potential impact. Although context/place has considerable promise as a location for HIV prevention efforts, it has been underemphasized. This dissertation is a step towards addressing this gap, suggesting contextual opportunities for multi-level public health HIV interventions to reduce HIV among MSM

The impact of believing you have had COVID-19 on self-reported behaviour: Cross-sectional survey.

OBJECTIVES: To investigate whether people who think they have had COVID-19 are less likely to report engaging with lockdown measures compared with those who think they have not had COVID-19. DESIGN: On-line cross-sectional survey. SETTING: Data were collected between 20th and 22nd April 2020. PARTICIPANTS: 6149 participants living in the UK aged 18 years or over. MAIN OUTCOME MEASURES: Perceived immunity to COVID-19, self-reported adherence to social distancing measures (going out for essential shopping, nonessential shopping, and meeting up with friends/family; total out-of-home activity), worry about COVID-19 and perceived risk of COVID-19 to oneself and people in the UK. Knowledge that cough and high temperature / fever are the main symptoms of COVID-19. We used logistic regression analyses and one-way ANOVAs to investigate associations between believing you had had COVID-19 and binary and continuous outcomes respectively. RESULTS: In this sample, 1493 people (24.3%) thought they had had COVID-19 but only 245 (4.0%) reported having received a positive test result. Reported test results were often incongruent with participants' belief that they had had COVID-19. People who believed that they had had COVID-19 were: more likely to agree that they had some immunity to COVID-19; less likely to report adhering to lockdown measures; less worried about COVID-19; and less likely to know that cough and high temperature / fever are two of the most common symptoms of COVID-19. CONCLUSIONS: At the time of data collection, the percentage of people in the UK who thought they had already had COVID-19 was about twice the estimated infection rate. Those who believed they had had COVID-19 were more likely to report leaving home. This may contribute to transmission of the virus. Clear communications to this growing group are needed to explain why protective measures continue to be important and to encourage sustained adherence

Equivalence classes of functions of finite Markov chains

A matrical representation of a Markov chain consists of the initial vector and transition matrix of the chain, along with matrices that specify which observable response occurs for each state. The likelihood function based on a Markov model can be stated in a general way using the components of the model's matrical representation. It follows directly from that statement that two models are equivalent in likelihood if they are related through matrix operations that constitute a change of basis of the matrical representation. Two necessary properties of a change matrix associating two Markov models that are members of the same equivalence class with respect to likelihood are derived. Examples are provided, involving use of the results in analyzing identifiability of Markov models, including a useful application of diagonalization that provides a connection between the problem of identifiability and the eigenvalue problem.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/22239/1/0000675.pd

District-led School Turnaround: Aiming for Ambitious and Equitable Instruction in Shelby County’s iZone

The Shelby County iZone is a district-led effort to dramatically improve, or “turn around,” 23 of the lowest performing schools in Tennessee in the 15th largest district in the country. Despite circumstances that have derailed many past reforms, iZone schools have made statistically significant and educationally meaningful gains in mathematics and English language arts (ELA) (Zimmer, Henry, Kho, & Viano, 2015). This report presents the findings of a multi-year research project that examined the evolution of the iZone as it shifted its strategy from school-level autonomy to one that featured a common curriculum, shared pedagogy, and collegial learning. The analysis delves into the challenges that iZone leaders, principals, and teachers confronted in coping with the needs of a student population mired in intergeneration poverty, rigorous performance standards, and a stringent accountability system. The results illuminate the importance of multi-level system re-design, continuous improvement, and compromise and negotiation among key stakeholder groups

SOFIA/FORCAST and Spitzer/IRAC Imaging of the Ultra Compact H II Region W3(OH) and Associated Protostars in W3

We present infrared observations of the ultra-compact H II region W3(OH) made by the FORCAST instrument aboard SOFIA and by Spitzer/IRAC. We contribute new wavelength data to the spectral energy distribution, which constrains the optical depth, grain size distribution, and temperature gradient of the dusty shell surrounding the H II region. We model the dust component as a spherical shell containing an inner cavity with radius ~ 600 AU, irradiated by a central star of type O9 and temperature ~ 31,000 K. The total luminosity of this system is 71,000 L_solar. An observed excess of 2.2 - 4.5 microns emission in the SED can be explained by our viewing a cavity opening or clumpiness in the shell structure whereby radiation from the warm interior of the shell can escape. We claim to detect the nearby water maser source W3 (H2O) at 31.4 and 37.1 microns using beam deconvolution of the FORCAST images. We constrain the flux densities of this object at 19.7 - 37.1 microns. Additionally, we present in situ observations of four young stellar and protostellar objects in the SOFIA field, presumably associated with the W3 molecular cloud. Results from the model SED fitting tool of Robitaille et al. (2006, 2007} suggest that two objects (2MASS J02270352+6152357 and 2MASS J02270824+6152281) are intermediate-luminosity (~ 236 - 432 L_solar) protostars; one object (2MASS J02270887+6152344) is either a high-mass protostar with luminosity 3000 L_solar or a less massive young star with a substantial circumstellar disk but depleted envelope; and one object (2MASS J02270743+6152281) is an intermediate-luminosity (~ 768 L_solar) protostar nearing the end of its envelope accretion phase or a young star surrounded by a circumstellar disk with no appreciable circumstellar envelope.Comment: 12 pages, 8 figures, 2 tables, accepted by Ap

IRX-2, a Novel Immunotherapeutic, Enhances Functions of Human Dendritic Cells

Background: In a recent phase II clinical trial for HNSCC patients, IRX-2, a cell-derived biologic, promoted T-cell infiltration into the tumor and prolonged overall survival. Mechanisms responsible for these IRX-2-mediated effects are unknown. We hypothesized that IRX-2 enhanced tumor antigen-(TA)-specific immunity by up-regulating functions of dendritic cells (DC). Methodology/Principal Findings: Monocyte-derived DC obtained from 18 HNSCC patients and 12 healthy donors were matured using IRX-2 or a mix of TNF-α, IL-1β and IL-6 ("conv. mix"). Multicolor flow cytometry was used to study the DC phenotype and antigen processing machinery (APM) component expression. ELISPOT and cytotoxicity assays were used to evaluate tumor-reactive cytotoxic T lymphocytes (CTL). IL-12p70 and IL-10 production by DC was measured by Luminex® and DC migration toward CCL21 was tested in transwell migration assays. IRX-2-matured DC functions were compared with those of conv. mix-matured DC. IRX-2-matured DC expressed higher levels (p<0.05) of CD11c, CD40, CCR7 as well as LMP2, TAP1, TAP2 and tapasin than conv. mix-matured DC. IRX-2-matured DC migrated significantly better towards CCL21, produced more IL-12p70 and had a higher IL12p70/IL-10 ratio than conv. mix-matured DC (p<0.05 for all). IRX-2-matured DC carried a higher density of tumor antigen-derived peptides, and CTL primed with these DC mediated higher cytotoxicity against tumor targets (p<0.05) compared to the conv. mix-matured DC. Conclusion: Excellent ability of IRX-2 to induce ex vivo DC maturation in HNSCC patients explains, in part, its clinical benefits and emphasizes its utility in ex vivo maturation of DC generated for therapy. © 2013 Schilling et al