The earliest events following mucosal HIV-1 infection, prior to measurable viremia, remain poorly understood. Here, by detailed necropsy studies, we show that the virus can rapidly disseminate following mucosal SIV infection of rhesus monkeys and trigger components of the inflammasome, both at the site of inoculation and at early sites of distal virus spread. By 24 hr following inoculation, a proinflammatory signature that lacked antiviral restriction factors was observed in viral RNA-positive tissues. The early innate response included expression of NLRX1, which inhibits antiviral responses, and activation of the TGF-beta pathway, which negatively regulates adaptive immune responses. These data suggest a model in which the virus triggers specific host mechanisms that suppress the generation of antiviral innate and adaptive immune responses in the first few days of infection, thus facilitating its own replication. These findings have important implications for the development of vaccines and other strategies to prevent infection.

Background: Understanding racial inequities in emergency medical care for traumatic injuries is important to policy considerations. Methods: We analyzed data on the first emergency department (ED) visit for trauma treatment among patients in the Massachusetts (MA) Statewide Trauma Registry. This Registry collects information on all trauma patients who die in the ED, or are dead on arrival, or who are transferred between hospitals in MA. This analysis included ED visits among MA residents aged 15 years and older from 2008 through 2010. Those who died on arrival were excluded. Patients were grouped as non-Hispanic white, non-Hispanic black, Hispanic, Asian, and other or unknown races. We compared injury severity, departure status and ED mortality among the 5 groups while adjusting for severity, sex and age. Results: The 27,453 patients averaged 57.3 years of age, and included 44.9% women, 83.4% whites, 5.4% blacks, 6.8% Hispanics, 1.3% Asians, and 3.1% other or unknown races. In total, 534 (1.95%) died in ED. There was no clinically significant difference in injury severity among race groups. Compared to whites, blacks and other race group had higher mortality (OR=1.62, p=0.006 and OR=2.30, p Conclusions: Substantial racial disparities in ED mortality and departure status were observed among MA trauma patients. Determinants of the disparities are under investigation in an ongoing study funded by the National Institute on Minority Health and Health Disparities.

INTRODUCTION. The availability of healthy options in food stores is important to healthy eating and obesity prevention. The Health Statistics and Geography Lab at UMass Medical School is conducting longitudinal surveys to determine the availability of healthy food in food stores throughout the state of Massachusetts as part the Community Transformation Grant and Mass in Motion initiatives. Providing feedback to store proprietors and managers as well as community workers is an important component to support community environmental interventions. METHODS. The Community Nutrition Environment Evaluation Data System (C-NEEDS) was developed for food environment surveillance. C-NEEDS takes into account seasonal and geographic variations in food supplies, cultural relevance, and USDA dietary recommendations. Since May 2012, nearly 1300 food stores throughout Massachusetts have been surveyed and analyzed. Healthy Food Availability Index (HFAI) is calculated for each store (range: 0 to 56), with a higher score indicating greater availability of healthy items. REPORTS. Store-level reports are provided to proprietors and managers of individual food stores in conjunction with community workers. The reports provide HFAI scores for the store for the current year, previous year(s), if available, comparing to the average scores of similar stores within the same community. Community workers and proprietors of food stores can use the store-level reports to determine areas of need and appropriate intervention methodology. Community-level feedback reports provide information on average scores, by store type, for their community as well as for communities of similar size and socio-demographic status. They can be used to compare community HFAI to comparable communities as well as track change in scores over time. DISCUSSION. Providing feedback to community workers and food store owners is an essential aspect of community enviornment interventions. The information contained in the C-NEEDS feedback reports provides benchmarks for both store owners and communities to achieve.

Background The Cox proportional hazards (PH) regression model is the most common method to estimate underlying survival or failure probabilities and to estimate the effects of covariates on survival times. In Cox PH models, the regression coefficients are assumed constant over time. However, if covariate effects vary over time, alternative models which do not necessarily assume proportionality are needed. Method We proposed the Gray’s time-varying coefficient (TVC) method based on pseudo-observation. By using pseudo-observations, pseudo-residuals were calculated and plotted against the estimated survival rates at each of the nine selected time points, then were used to evaluate the goodness-of-fit of the Gray’s model. We applied this method to assess the fit for a model that predicts post-transplant survival probability among children who were under the age of 12 years, had end-stage liver disease, and underwent liver transplantation between January 2005 and June 2010. Result For Gray’s TVC model, through the first time point and the sixth time point, pseudo residual plots are around zero, while pseudo residual plots show slight departure at small values of estimated survival rate through the seventh time point and the ninth time point. Since the pseudo residual plots stay around zero at each time point without any significant departure or tendency, we can conclude that Gray’s model shows a good fit in estimating survival function at each time point. The results from this real liver transplantation data demonstrate that the final Gray’s model shows a good fit in estimating post-transplant survival. Conclusion When data violate the PH assumption, the Gray TVC model or an alternative should be used to obtain unbiased estimates on survival function and give correct inference on the relationship between potential covariates and survival. The proposed goodness-of-fit test offers a tool to investigate how well the model fits the data.