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A.ABSTRACTProject BackgroundSocial determinants of health (SDoH), such as financial resource strain and housing instability, account for between 30-55% of people’s health outcomes. While many studies have identified strong associations among specific SDoH and health outcomes, most people experience multiple SDoH in their daily lives. Analysis of this complexity requires the integration of personal, clinical, social, and environmental information from a large cohort of individuals that have been traditionally underrepresented in research, which is only recently being made available through theAll of Usresearch program. However, little is known about the range and response of SDoH inAll of Us, and how they co-occur to form subtypes, which are critical for designing precision medicine interventions.Research Questions(1) What is the range and response to survey questions related to SDoH? (2) How do SDoH co-occur to form subtypes, and what are their risk for adverse health outcomes?MethodsFor Question-1, we analyzed the range of SDoH questions across the surveys with respect to the 5 domains inHealthy People 2030(HP-30), and analyzed their responses across the fullAll of Uscohort (n=372,397, V6). For Question-2, we used the following steps: (1) due to the missingness across the surveys, selected all participants with valid and complete SDoH data, and used inverse probability weighting to adjust their imbalance in demographics, compared to the full cohort; (2) asked three domain experts to group the SDoH questions into SDoH subdomains, for enabling a more consistent granularity; (3) used bipartite modularity maximization to identify SDoH biclusters, their significance, and their replicability; (4) measured the association of each bicluster to three outcomes (depression, delayed medical care, emergency room visits in the last year) using multiple data types (surveys, electronic health records, and zip codes mapped to Medicaid expansion states); and (5) asked three domain experts to infer the subtype labels, in addition to the potential mechanisms that precipitate their adverse health outcomes and interventions to prevent them.ResultsFor Question-1, we identified 110 SDoH questions across 4 surveys, which were categorized into 18 SDoH subdomains, and covered all 5 domains in HP-30. However, the results also revealed a large degree of missingness in survey responses (1.76%-84.56%), with later surveys having significantly fewer responses compared to earlier ones, and significant differences in race, ethnicity, and age of participants when compared to the full cohort. For Question-2, the subtype analysis (n=12,913, d=18) identified 4 biclusters with significant biclusteredness (Q=0.13, random-Q=0.11, z=7.5,PP<.001). Furthermore, there were significant associations between specific subtypes and the outcomes and with Medicaid expansion, each with meaningful interpretations and potential precision interventions. For example, the subtypeSocioeconomic Barriersincluded the SDoH subdomainsemployment, food security, housing, income, literacy, andeducation attainment, and had a significantly higher odds ratio (OR=4.2, CI=3.5-5.1,P-corrSociocultural Barriers. Individuals that match this subtype profile could be screened early for depression and referred to social services for addressing combinations of SDoH such as housing and income. Finally, the identified subtypes spanned one or more HP-30 domains revealing the difference between the current knowledge-based SDoH domains and the data-driven subtypes. These results reflect the complexity of how SDoH co-occur in the real world, and their potential use in the design of models to predict adverse health outcomes, and the design of interventions.Community ImpactWhile several SDoH models including the Dahlgren-Whitehead conceptual model have identified SDoH domains, they have emphasized that real-world SDoH span multiple domains with complex interactions and feedback loops. However, this phenomenon has been difficult to analyze given the lack of large cohorts of individuals that have been traditionally underrepresented in biomedical research, and characterized by a wide range of SDoH and datatypes. The results from analyzing SDoH using theAll of Uscohort provided direct evidence for this real-world phenomenon by showing that data-driven SDoH subtypes span one or more of the SDoH domains defined by HP-30. This result provides testable hypotheses for future studies that SDoH models based on data-driven subtypes will be more accurate and interpretable for predicting adverse health outcomes, when compared to models that do not use those subtypes. Furthermore, the characterization of the range and response to SDoH across the entireAll of Uscohort using over one hundred SDoH, should enable researchers to use the approach for characterizing other cohorts to identify and address missingness. Finally, our workbench which focuses on subtyping SDoH, provides generalizable and scalable machine learning methods that can be used to periodically rerun the analysis as theAll of Uscohort continues to evolve.

This article presents a miniature magnetic swimmer and a control apparatus able to perform both 3-D path following and blood clot removal. The robots are 2.5 mm in diameter, 6 mm in length, contain an internal permanent magnet, and have cutting tips coated in diamond powder. The robots are magnetically propelled by an external magnetic system using three coil pairs arranged orthogonally. A range of robot tip designs were tested for abrading human blood clots in vitro . The best design removed a blood clot at a maximum rate of 20.13 mm $^3$ /min. A controller for 3-D navigation is presented and tested. The best prototype was used in an experiment that combined both 3-D path following and blood clot removal.

Phosphate addition is commonly applied as an effective method to remediate lead contaminated sites via formation of low solubility lead phosphate solids. However, subsequent transport of the lead phosphate particles may impact the effectiveness of this remediation strategy. Hence, this study investigates the mechanisms involved in the aggregation of lead phosphate particles and their deposition in sand columns as a function of typical water chemistry parameters. Clean bed filtration theory was evaluated to predict the particle deposition behavior, using Derjaguin-Landau-Verwey-Overbeek (DLVO) theory to estimate particle-substrate interactions. The observed particle deposition was not predictable from the primary energy barrier in clean bed filtration models, even in simple monovalent background electrolyte (NaNO

Academic research, no matter how innovative, will never make a difference in the lives of people unless it is disseminated in an appropriate and timely manner to providers and organizations serving the public. Yet many researchers are not trained, rewarded, or supported to disseminate research findings. The Community Advisory Board (CAB) of the University of California, San Francisco, Center for AIDS Prevention Studies (CAPS) developed a set guidelines to support researchers' intentions to disseminate their findings through nontraditional venues. These guidelines are unique because community members, many of whom have struggled with accessing research in a timely way, generated them. In addition to developing the guidelines, the CAB also conceived and implemented a dissemination strategy for the guidelines. The purpose of this article is to present specific guidelines for disseminating research developed by the CAPS CAB.

Despite increasing need for HIV prevention research and intervention programs, the voices and stories of Asian and Pacific Islander men who have sex with men (API MSM) have remained absent from HIV prevention literature. Five focus groups with API MSM (N = 38) were conducted to identify psychological, social, and cultural factors related to HIV risk and protection. Six themes were identified based on focus group discussion: (a) dual-identity status, (b) coming out and disclosure issues, (c) relationships and dating, (d) substance use, (e) sexual risk reduction strategies, and (f) health and social services. Narrative data indicate that multilevel HIV prevention intervention strategies are necessary for addressing the unique psychosocial and behavioral HIV risk factors among API MSM, such as dual stigma stemming from homophobia and racism, discomfort with sexuality, power dynamics and stereotypes in relationships with White men, substance use, and low utilization of health and social services.

The author discusses Argentinean construction of homosexuality from 1900 to 1950 in the context of the raging debate of the essentialists versus social constructionists. The history of sexual inverts is discussed with reference to early sexologists. After a broad exploration of sexual inversion, the author turns to the Argentinean doctors who distinguish between acquired and congenital inverts. There was much resistance to the medical and legal establishments as there were autobiographies written by inverts, who subverted the medical views of the day. Finally, Bao concludes that there was, indeed, an Argentine construction of homosexuality, and that there were similarities between Buenos Aires and other large European cities. It is also noted that at the beginning of the twentieth century, there was a developed Argentine subculture of inverts who had meeting places, fashion, sexual tastes, and customs.

We describe lessons learned from a national HIV prevention research program grounded in community-based participatory research, the Men of Asia Testing for HIV (MATH) Study, which targeted self-identified Asian/Pacific Islander men in the United States who have sex with men. We discuss the genesis of and impetus for the study and then describe its various facets, including accomplishments, challenges, and unanticipated consequences. We conclude with a discussion about the real-world practice of community-based participatory research with respect to the MATH Study in particular and similar research in general.