Successful strategies for the private development of workforce housing in New York City

Thesis (S.M. in Real Estate Development)--Massachusetts Institute of Technology, Program in Real Estate Development in Conjunction with the Center for Real Estate, 2011.Cataloged from PDF version of thesis.Includes bibliographical references (p. 52-53).A lack of quality housing affordable to the average worker near employment centers has long been an issue in American cities where the private production of housing for middle income families is restricted by market forces, zoning or physical boundaries. There are approximately 2.3 million middle income households in New York who earn between 80% and 150% of the Median Family Income who are priced out of market rate housing. These households are forced to relocate elsewhere or spend a daunting percentage of their time and income on housing and/or transportation. The high cost of land, labor and materials are further exacerbated by zoning regulations and entitlement review processes to result in a prohibitively high cost of housing production. Governments across the US and in New York have developed various types of policy strategies aimed at subsidizing development and increasing the affordability of housing. This thesis provides a summary discussion and perspective on the factors that increase the cost of housing production. It then reviews the different strategies utilized in reducing these costs, both nationally and locally in New York. Next it tests each strategy's effectiveness using a case study of a proposed development project in Brooklyn, NY. Finally it discusses the effectiveness of these strategies and proposes additional ideas that could also be effective in reducing the overall cost of housing, aiding in the effort to make housing more affordable to the average worker.by Samuel R. Moore.S.M.in Real Estate Developmen

AIDS-defining illnesses at initial diagnosis of HIV in a large Guatemalan cohort

AbstractBackgroundAnecdotal evidence suggests that a high proportion of patients diagnosed with HIV in Guatemala present with AIDS. There remain limited data on the epidemiology of AIDS-defining illnesses (ADIs) in Central America.MethodsWe conducted a retrospective cohort study of all patients living with HIV at the largest HIV clinic in Guatemala. Charts were analyzed for clinical and demographic data. Presence of an ADI was assessed by US Centers for Disease Control definitions; patients who presented with an ADI were compared with those without ADI using descriptive statistics.ResultsOf 3686 patients living with HIV, 931 (25.3%) had an ADI at HIV diagnosis, 748 (80.3%) of whom had CD4 counts lower than 200 cells/mm3. Those with ADIs were more likely to be male (67.5% vs 54.6%; P &amp;lt; .0001) and heterosexual (89.4% vs 85.0%; P = .005). The most common ADIs were Mycobacterium tuberculosis (55.0%), Pneumocystis jirovecii pneumonia (13.7%), esophageal candidiasis (13.4%), and histoplasmosis (11.4%). Histoplasmosis and HIV wasting syndrome were both more common among rural patients.ConclusionsIn this large Guatemalan cohort of patients currently living with HIV, a significant portion presented with an ADI. These data inform the most common ADIs diagnosed among survivors, show that histoplasmosis is more commonly diagnosed in rural patients, and suggest that HIV wasting syndrome may reflect missed histoplasmosis diagnoses.</jats:sec

Prevalence of established and emerging biomarkers of immune checkpoint inhibitor response in advanced hepatocellular carcinoma.

The clinical deployment of immune checkpoint inhibitors (ICIs) has created a tandem drive for the identification of biomarkers linked to benefit. Comprehensive genomic profiling was performed to evaluate the frequency of genomic biomarkers of ICI response in 755 patients with advanced hepatocellular carcinoma (HCC). Median age was 62 years' old, 73% were male, 46% had extrahepatic disease, 107 had documented hepatitis C, 96 had hepatitis B and 4 patients were coinfected. Median tumor mutation burden (TMB) was 4 mutations/Mb and only 6 tumors (0.8%) were TMB-high. Out of 542 cases assessed for microsatellite instability (MSI), one (0.2%) was MSI-high and TMB-high. Twenty-seven (4%) patients had POLE/D alterations. One patient had a pathogenic POLE R762W mutation but TMB was 4 mutations/Mb. Forty percent had DNA damage response gene alterations. In a small case series (N=17) exploring the relationship between biomarkers and ICI response, one patient (TMB 15 mutations/Mb, MSI-low) had a sustained complete response to nivolumab lasting &gt; 2 years. Otherwise there were no significant genomic or TMB differences between responders, progressors, and those with stable disease. Overall, markers of genomic instability were infrequent in this cohort. Larger clinically annotated datasets are needed to explore genomic and non-genomic determinants of ICI response in HCC