Seniors Seeking Housing, Health, and Climate Justice, An Oral History of Hurricane Recovery in the Gulf Coast

On the Gulf Coast of Texas, a large disparity exists between the number of homes still in need of repair after Hurricane Harvey and the number of homes actually repaired by the City of Houston, Housing and Community Development, 6 years after the storm. This research was conducted through the lens of environmental justice, with attention to climate change impacts and the vulnerability of previously segregated neighborhoods over extended periods of time. The most vulnerable, seniors, were interviewed to collect their personal experiences post Hurricane Harvey to determine the true extent of home damage, how they recovered from the storm, and what impact that recovery period post-storm had on their health and displacement from the home. In the context of a just planning model and through the lens of environmental justice, their ecological knowledge and participation should be used to improve housing recovery. Oral histories allow others an alternative perspective to their own and offer policy makers insight into complex nuances, actors, and events that have transpired post-disaster

Enhancing Timeliness of Drug Overdose Mortality Surveillance: A Machine Learning Approach

BACKGROUND: Timely data is key to effective public health responses to epidemics. Drug overdose deaths are identified in surveillance systems through ICD-10 codes present on death certificates. ICD-10 coding takes time, but free-text information is available on death certificates prior to ICD-10 coding. The objective of this study was to develop a machine learning method to classify free-text death certificates as drug overdoses to provide faster drug overdose mortality surveillance. METHODS: Using 2017–2018 Kentucky death certificate data, free-text fields were tokenized and features were created from these tokens using natural language processing (NLP). Word, bigram, and trigram features were created as well as features indicating the part-of-speech of each word. These features were then used to train machine learning classifiers on 2017 data. The resulting models were tested on 2018 Kentucky data and compared to a simple rule-based classification approach. Documented code for this method is available for reuse and extensions: https://github.com/pjward5656/dcnlp. RESULTS: The top scoring machine learning model achieved 0.96 positive predictive value (PPV) and 0.98 sensitivity for an F-score of 0.97 in identification of fatal drug overdoses on test data. This machine learning model achieved significantly higher performance for sensitivity (p \u3c 0.001) than the rule-based approach. Additional feature engineering may improve the model’s prediction. This model can be deployed on death certificates as soon as the free-text is available, eliminating the time needed to code the death certificates. CONCLUSION: Machine learning using natural language processing is a relatively new approach in the context of surveillance of health conditions. This method presents an accessible application of machine learning that improves the timeliness of drug overdose mortality surveillance. As such, it can be employed to inform public health responses to the drug overdose epidemic in near-real time as opposed to several weeks following events

Spatial Distribution of Partner-Seeking Men Who Have Sex With Men Using Geosocial Networking Apps: Epidemiologic Study

Background: Geosocial networking apps have made sexual partner-seeking easier for men who have sex with men, raising both challenges and opportunities for human immunodeficiency virus and sexually transmitted infection prevention and research. Most studies on men who have sex with men geosocial networking app use have been conducted in large urban areas, despite research indicating similar patterns of online- and app-based sex-seeking among men who have sex with men in rural and midsize cities. Objective: The goal of our research was to examine the spatial distribution of geosocial networking app usage and characterize areas with increasing numbers of partner-seeking men who have sex with men in a midsize city in the South. Methods: Data collection points (n=62) were spaced in 2-mile increments along 9 routes (112 miles) covering the county encompassing the city. At each point, staff logged into 3 different geosocial networking apps to record the number of geosocial networking app users within a 1-mile radius. Data were collected separately during weekday daytime (9:00 AM to 4:00 PM) and weekend nighttime (8:00 PM to 12:00 AM) hours. Empirical Bayesian kriging was used to create a raster estimating the number of app users throughout the county. Raster values were summarized for each of the county\u27s 208 Census block groups and used as the outcome measure (ie, geosocial networking app usage). Negative binomial regression and Wilcoxon signed rank sum tests were used to examine Census block group variables (eg, median income, median age) associated with geosocial networking app usage and temporal differences in app usage, respectively. Results: The number of geosocial networking app users within a 1-mile radius of the data collection points ranged from 0 to 36 during weekday daytime hours and 0 to 39 during weekend nighttime hours. In adjusted analyses, Census block group median income and percent Hispanic ethnicity were negatively associated with geosocial networking app usage for all 3 geosocial networking apps during weekday daytime and weekend nighttime hours. Population density and the presence of businesses were positively associated with geosocial networking app usage for all 3 geosocial networking apps during both times. Conclusions: In this midsize city, geosocial networking app usage was highest in areas that were more population-dense, were lower income, and had more businesses. This research is an example of how geosocial networking apps\u27 geospatial capabilities can be used to better understand patterns of virtual partner-seeking among men who have sex with men

The continuing story of the future as a liminal ethical space for the present.​

Ethical concern has a futures orientation AND anticipation is inherently ethical ​ The establishment of Futures Studies addressed an imperative of responsibility – to save humanity from itself​ Ethics and responsibility in FS are dominated by western worldviews (e.g. agency, freedom, exceptionalism, “techne”…)​ Norms and values change over time and are contested​ In anticipatory processes ethics and responsibility have presence, but likely to be implicit in actions​ The concept of “Future generations” gives substance to future obligations​ Does reframing Anticipation as ‘life itself’ (Rosen) offer a transitionary critical life change for epistemology.

Radiation protection of the gastrointestinal tract and growth inhibition of prostate cancer xenografts by a single compound.

Normal tissue toxicity markedly reduces the therapeutic index of genotoxic anticancer agents, including ionizing radiation. Countermeasures against tissue damage caused by radiation are limited by their potential to also protect malignant cells and tissues. Here, we tested a panel of signal transduction modifiers for selective radioprotection of normal but not tumor tissues. These included three inhibitors of GSK3 (LiCl, SB216763, and SB415286) and two inhibitors of NF-κB (ethyl pyruvate and RTA 408). Among these, the thiol-reactive triterpenoid RTA 408 emerged as a robust and effective protector of multiple organ systems (gastrointestinal, skin, and hemopoietic) against lethal doses of radiation. RTA 408 preserved survival and proliferation of intestinal crypt cells in lethally irradiated mice while reducing apoptosis incidence in crypts and villi. In contrast, RTA 408 uniformly inhibited growth of established CWR22Rv1, LNCaP/C4-2B, PC3, and DU145 xenografts either alone or combined with radiation. Antitumor effects in vivo were associated with reduced proliferation and intratumoral apoptosis and with inhibition of NF-κB-dependent transcription in PC3 cells. Selective protection of normal tissue compartments by RTA 408 critically depended on tissue context and could not be replicated in vitro. Collectively, these data highlight the potential of RTA 408 as a cytoprotective agent that may be safely used in chemoradiation approaches

Readability And Its Effects On Standardized Assessment Outcomes

Readability And Its Effects On Standardized Assessment Outcomes. April Ward; Mara Charles; Amanda Barlow; Crystal Randolph,Corine Myers-Jennings, Ruth Renee Hanniba

How to prioritize species recovery after a megafire

Due to climate change, megafires are increasingly common and have sudden, extensive impacts on many species over vast areas, leaving decision makers uncertain about how best to prioritize recovery. We devised a decision-support framework to prioritize conservation actions to improve species outcomes immediately after a megafire. Complementary locations are selected to extend recovery actions across all fire-affected species' habitats. We applied our method to areas burned in the 2019-2020 Australian megafires and assessed its conservation advantages by comparing our results with outcomes of a site-richness approach (i.e., identifying areas that cost-effectively recover the most species in any one location). We found that 290 threatened species were likely severely affected and will require immediate conservation action to prevent population declines and possible extirpation. We identified 179 subregions, mostly in southeastern Australia, that are key locations to extend actions that benefit multiple species. Cost savings were over AU$300 million to reduce 95% of threats across all species. Our complementarity-based prioritization also spread postfire management actions across a wider proportion of the study area compared with the site-richness method (43% vs. 37% of the landscape managed, respectively) and put more of each species' range under management (average 90% vs. 79% of every species' habitat managed). In addition to wildfire response, our framework can be used to prioritize conservation actions that will best mitigate threats affecting species following other extreme environmental events (e.g., floods and drought)

Restoring habitat for fire-impacted species' across degraded Australian landscapes

In the summer of 2019-2020, southern Australia experienced the largest fires on record, detrimentally impacting the habitat of native species, many of which were already threatened by past and current anthropogenic land use. A large-scale restoration effort to improve degraded species habitat would provide fire-affected species with the chance to recover and persist in burnt and unburnt habitat. To facilitate this, decision-makers require information on priority species needs for restoration intervention, the suite of potential restoration interventions, and the priority locations for applying these interventions. We prioritize actions in areas where restoration would most likely provide cost-effective benefits to priority species (defined by each species proportion of habitat burned, threat status, and vulnerability to fires), by integrating current and future species habitat suitability maps with spatially modelled costs of restoration interventions such as replanting, removing invasive species, and implementing ecologically appropriate fire management. We show that restoring the top similar to 69% (112 million hectares) of the study region (current and future distributions of priority species) accounts for, on average, 95% of current and future habitat for every priority species and costs similar to AUD$73 billion yr(-1) (AUD$650 hectare(-1) yr(-1)) annualized over 30 years. This effort would include restoration actions over 6 million hectares of fire-impacted habitat, costing similar to AUD$8.8 billion/year. Large scale restoration efforts are often costly but can have significant societal co-benefits beyond biodiversity conservation. We also show that up to 291 MtCO2 (similar to 150 Mt DM) of carbon could be sequestered by restoration efforts, resulting in approximately AUD$253 million yr(-1) in carbon market revenue if all carbon was remunerated. Our approach highlights the scale, costs, and benefits of targeted restoration activities both inside and outside of the immediate bushfire footprint over vast areas of different land tenures

Ovarian Cancer Epidemiology, Healthcare Access and Disparities (ORCHiD): Methodology for a Population-Based Study of Black, Hispanic and White Patients with Ovarian Cancer

INTRODUCTION: Less than 40% of patients with ovarian cancer (OC) in the USA receive stage-appropriate guideline-adherent surgery and chemotherapy. Black patients with cancer report greater depression, pain and fatigue than white patients. Lack of access to healthcare likely contributes to low treatment rates and racial differences in outcomes. The Ovarian Cancer Epidemiology, Healthcare Access and Disparities study aims to characterise healthcare access (HCA) across five specific dimensions-Availability, Affordability, Accessibility, Accommodation and Acceptability-among black, Hispanic and white patients with OC, evaluate the impact of HCA on quality of treatment, supportive care and survival, and explore biological mechanisms that may contribute to OC disparities. METHODS AND ANALYSIS: We will use the Surveillance Epidemiology and Ends Results dataset linked with Medicare claims data from 9744 patients with OC ages 65 years and older. We will recruit 1641 patients with OC (413 black, 299 Hispanic and 929 white) from cancer registries in nine US states. We will examine HCA dimensions in relation to three main outcomes: (1) receipt of quality, guideline adherent initial treatment and supportive care, (2) quality of life based on patient-reported outcomes and (3) survival. We will obtain saliva and vaginal microbiome samples to examine prognostic biomarkers. We will use hierarchical regression models to estimate the impact of HCA dimensions across patient, neighbourhood, provider and hospital levels, with random effects to account for clustering. Multilevel structural equation models will estimate the total, direct and indirect effects of race on treatment mediated through HCA dimensions. ETHICS AND DISSEMINATION: Result dissemination will occur through presentations at national meetings and in collaboration with collaborators, community partners and colleagues across othercancer centres. We will disclose findings to key stakeholders, including scientists, providers and community members. This study has been approved by the Duke Institutional Review Board (Pro00101872). Safety considerations include protection of patient privacy. All disseminated data will be deidentified and summarised

Incarceration history and risk of HIV and hepatitis C virus acquisition among people who inject drugs: a systematic review and meta-analysis

Background People who inject drugs (PWID) experience a high prevalence of incarceration and might be at high risk of HIV and hepatitis C virus (HCV) infection during or after incarceration. We aimed to assess whether incarceration history elevates HIV or HCV acquisition risk among PWID. Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, and PsycINFO databases for studies in any language published from Jan 1, 2000 until June 13, 2017 assessing HIV or HCV incidence among PWID. We included studies that measured HIV or HCV incidence among community-recruited PWID. We included only studies reporting original results and excluded studies that evaluated incident infections by self-report. We contacted authors of cohort studies that met the inclusion or exclusion criteria, but that did not report on the outcomes of interest, to request data. We extracted and pooled data from the included studies using random-effects meta-analyses to quantify the associations between recent (past 3, 6, or 12 months or since last follow-up) or past incarceration and HIV or HCV acquisition (primary infection or reinfection) risk among PWID. We assessed the risk of bias of included studies using the Newcastle-Ottawa Scale. Between-study heterogeneity was evaluated using the I2 statistic and the P-value for heterogeneity. Findings We included published results from 20 studies and unpublished results from 21 studies. These studies originated from Australasia, western and eastern Europe, North and Latin America, and east and southeast Asia. Recent incarceration was associated with an 81% (relative risk [RR] 1·81, 95% CI 1·40–2·34) increase in HIV acquisition risk, with moderate heterogeneity between studies (I2=63·5%; p=0·001), and a 62% (RR 1·62, 95% CI 1·28–2·05) increase in HCV acquisition risk, also with moderate heterogeneity between studies (I2=57·3%; p=0·002). Past incarceration was associated with a 25% increase in HIV (RR 1·25, 95% CI 0·94–1·65) and a 21% increase in HCV (1·21, 1·02–1·43) acquisition risk. Interpretation Incarceration is associated with substantial short-term increases in HIV and HCV acquisition risk among PWID and could be a significant driver of HCV and HIV transmission among PWID. These findings support the need for developing novel interventions to minimise the risk of HCV and HIV acquisition, including addressing structural risks associated with drug laws and excessive incarceration of PWID