Toward Equity in Guided Pathways Reforms: Lessons from Californias Career Advancement Academies

Community colleges across California are now investigating and planning Guided Pathways reforms with the goals of improving equity on their campuses and increasing the number of students completing degrees, certificates, and transfers. Some especially helpful lessons for improving equity as part of this reform effort may come from more than 30 California colleges that implemented Career Advancement Academies (CAAs).The CAAs, which were funded by the California Community Colleges Chancellor's Office from 2007 to 2017, aimed to reach and serve students who are traditionally underrepresented in higher education. They were shown to improve persistence in college and completion of system-recognized certificates and degrees among underrepresented students. This brief distills insights from that experience, aligns them with the Guided Pathways reform framework, and highlights CAA approaches that practitioners can incorporate into their reforms

Normal Values for CD4 and CD8 Lymphocyte Subsets in Healthy Chinese Adults from Shanghai

The aim of this study was to establish reference ranges for lymphocyte subsets in Chinese adults. Venous blood specimens were obtained from 614 healthy, human immunodeficiency virus (HIV)-seronegative adults in Shanghai. Flow cytometry was used to determine percentages and absolute numbers of CD4 and CD8 T lymphocytes. Mean values for CD4 and CD8 lymphocytes were 727 and 540 cells/μl, respectively, yielding a CD4/CD8 ratio of 1.49. While CD8 lymphocyte values varied with age and gender, no significant differences in CD4 lymphocyte values were observed. Shanghai adults had approximately 100 fewer CD4 lymphocytes/μl on average than Caucasians, suggesting that lower CD4 lymphocyte cutoffs for classifying and monitoring HIV infection may be needed in China

HIV-1 Genetic Diversity and Its Impact on Baseline CD4+T Cells and Viral Loads among Recently Infected Men Who Have Sex with Men in Shanghai, China.

The HIV-1 epidemic among men who have sex with men (MSM) has been spreading throughout China. Shanghai, a central gathering place for MSM, is facing a continuously increasing incidence of HIV-1 infection. In order to better understand the dynamics of HIV-1 diversity and its influence on patient's immune status at baseline on diagnosis, 1265 newly HIV-1-infected MSM collected from January 2009 to December 2013 in Shanghai were retrospectively analyzed for genetic subtyping, CD4+T cell counts, and viral loads. HIV-1 phylogenetic analysis revealed a broad viral diversity including CRF01_AE (62.13%), CRF07_BC (24.51%), subtype B (8.06%), CRF55_01B (3.24%), CER67_01B (0.95%), CRF68_01B (0.4%), CRF08_BC (0.08%) and CRF59_01B (0.08%). Twenty-four unique recombination forms (URFs) (1.98%) were identified as well. Bayesian inference analysis indicated that the introduction of CRF01_AE strain (1997) was earlier than CRF07_BC strain (2001) into MSM population in Shanghai based on the time of the most recent common ancestor (tMRCA). Three epidemic clusters and five sub-clusters were found in CRF01_AE. Significantly lower CD4+T cell count was found in individuals infected with CRF01_AE than in those infected with CRF07_BC infection (P45 years of age were found to have lower CD4+T cell counts and higher viral loads than the patients with <25 years of age (P<0.05). This study reveals the presence of HIV-1 subtype diversity in Shanghai and its remarkable influence on clinical outcome. A real-time surveillance of HIV-1 viral diversity and phylodynamics of epidemic cluster, patient's baseline CD4+T cell count and viral load would be of great value to monitoring of disease progression, intervention for transmission, improvement of antiretroviral therapy strategy and design of vaccines

Maximum clade credibility (MCC) trees representing the rooted genealogy of CRF01_AE and CRF07_BC among MSM in Shanghai.

<p>2A: the MCC tree for CRF01_AE strain. HIV-1 A1 sequences from Uganda(UG), Rwanda(RW), Australia(AU) and HIV-1 CRF01_AE sequences from Thailand (TH) were used as the references, including UG.92.AB253429, AU.03.DQ676872, RW.92.AB253421, TH.93.051, TH.90.U54771, TH.96.02138, TH.97.1695, TH.98.1251, TH.99.4460, and TH.01.2570. Blue lines represent A1 from UG, RW, AU and red lines represent CRF01_AE from TH. I, II, and III represent three clusters belonging to CRF01_AE strain. 2B: the MCC tree for CRF07_BC strain. HIV-1 subtype C sequence from Indian (IN), Ethiopia (ET), South Africa (ZA), and CRF07_BC sequence from Xinjiang, China (CNEF) were used as the reference, including IN.95.21068, ET.86.368370, ZA.04.AY772699, CNEF.05.368370, CNEF.05.368372. Blue lines represent subtype C from IN, ET, ZA and red lines represent CRF07_BC from CNEF. The branch lengths in the MCC tress reflect time and corresponding time-scale is shown at the bottom of the trees. Both the posterior probabilities and the tMRCA for the key nodes are indicated.</p

Comparisons of median baseline CD4+T cell counts and viral loads between three different subtypes.

<p>Median baseline CD4+T cell was lower in CRF01_AE infection than in CRF07_BC infection (P<0.05) while median baseline viral load was higher in CRF01_AE infection than in CRF07_BC infection (P = 0.001).</p

Association of three different subtype strains circulating among HIV-1-infected MSM from 2009 to 2013 with baseline CD4+T cell counts.

<p>*: P<0.05 when comparing CRF01_AE with CRF07_BC; **: P<0.01 when comparing CRF01_AE with CRF07_BC.</p

Phylogenetic tree analysis based on HIV-1 <i>pol</i> region among MSM who were newly infected from 2009 to 2013 in Shanghai.

<p>The phylogenetic trees were constructed using the Neighbor-Joining method. The bootstrap values of 1000 replicates above 70% are marked on the cluster nodes. CRF01_AE sequence cluster is shown as a triangle in red, CRF07_BC cluster in blue, subtype B cluster in green, and CRF55_01B cluster in pink. U, ambiguous/unidentified subtypes or recombinants and is marked as a solid circle in black. The reference sequences obtained from the Los Alamos HIV database are marked as a solid triangle in black. Trees were rooted by group O. The pie figures presented the proportion of analyzed subtypes represented in the corresponding phylogenetic trees.</p

Demographics and Clinical Characteristics Based on Co-receptor Tropism.

<p>*Algorithm I: Geno2pheno (FPR = 10%) and webPSSM in combination;</p><p>**Algorithm II: Geno2pheno (FPR = 5%) and webPSSM in combination.</p

Socio-demographic Characteristics of Studied Subjects Based on Subtypes.

<p>*The year when blood samples were collected.</p><p>**Place of birth. North: Beijing, Hebei, Shanxi and Inner Mongolia; Northeast: Liaoning, Jilin, and Heilongjiang; East: Fujian, Shandong, Zhejiang, Anhui, JiangXi, and Jiangsu; South Central: Guangxi, Henan, Hubei, Hunan, Guangdong and Hainan; Southwest: Sichuan, Chongqing, Guizhou and Ynunan; Northwest: Shannxi, Gansu, Ningxia, Qinghai and Xinjiang.</p