York City Area Research Articles

Lifestyle and vascular risk effects on MRI-based biomarkers of Alzheimer’s disease: a cross-sectional study of middle-aged adults from the broader New York City area

ObjectiveTo investigate the effects of lifestyle and vascular-related risk factors for Alzheimer’s disease (AD) on in vivo MRI-based brain atrophy in asymptomatic young to middle-aged adults.DesignCross-sectional, observational.SettingBroader New York City...

The impact of HIV diagnosis on length of hospital stay in New York City, NY, USA

ABSTRACTWhile hospitalizations among people living with human immunodeficiency virus (PLWH) have been elevated in the past compared to their uninfected counterparts, the introduction of antiretroviral therapy (ART) has resulted in great strides in controlling symptomatic infection. However, research largely overlooks important differences among HIV-infected individuals, primarily PLWH who are symptomatic versus those who are asymptomatic. We conducted a retrospective study assessing the length of hospital stay among 717,237 admissions from three hospitals in the New York City area. Using zero-truncated negative binomial regression we documented trends in length of hospital stay among individuals who are HIV positive (with symptoms versus those without symptoms) compared to HIV-negative patients over nine consecutive years, from 2006 to 2014. Approximately 0.85% of the admissions were infected with asymptomatic HIV (n = 6,131), while 1.43% of admissions were infected with symptomatic HIV (n = 10,271). The length of stay (LOS) among symptomatic HIV-infected admissions was 32.0% (95% CI: 29.7%–34.2%) longer than LOS in the general admissions. The mean LOS dropped about 1.5% (95% CI: 1.5%–1.6%) per year in the study sample. The LOS in inpatients with asymptomatic HIV had the same LOS as the general inpatient population. Our findings highlight the need for comprehensive strategies to reduce length of hospitalization among HIV-infected individuals.

Desire for Patient-Centered HIV Care Among Inconsistently Engaged Racial and Ethnic Minority People Living With HIV

Many low-income people of color living with HIV are not virally suppressed. More research is needed to understand how socially marginalized, disengaged, or inconsistently engaged people living with HIV (PLWH) contend with antiretroviral therapy (ART)-related challenges, particularly in the context of interactions with HIV care providers. Twenty-seven semi-structured interviews were conducted with low-income Black and Hispanic PLWH in the New York City area who were currently, or recently, disengaged from outpatient HIV health care at the time of the interview. Participants valued patient-centered health care in which they felt genuinely heard and cared for by their HIV clinicians. This desire was particularly pronounced in the context of wanting to change one's ART regimen. Participant emphasis on wanting to manage ART-related challenges with their providers suggests that HIV providers have an instrumental role in helping their patients feel able to manage their HIV.

Wildfire smoke transport and impact on air quality observed by a mullti-wavelength elastic-raman lidar and ceilometer in New York city

The intense wildfires from the western Canada in May 2016 injected large amount of smoke into the atmosphere. This paper presents integrated observation of the event by a lidar, ceilometer, and satellite together with models and an assessment of smoke plume impacts on local air quality in New York City (NYC) area. A dense aloft plume on May 20 and a boundary layer plume on May 25 are analyzed. The smoke mixing into planetary-boundary-layer (PBL) and strong diurnal variation of PBL-top are shown. For the 2ndcase, the ground PM2.5 measurements show a significant increase in both the urban and upwind non-urban areas of NYC. The smoke sources and transport paths are further verified by the satellite observations and HYSPLIT model data.

Delays in the New York City metroplex

Aviation delays impose significant external costs on society. This paper represents one of the first attempts to use a count regression model to study delays at the three New York city area airports – Liberty (Newark), John F. Kennedy and LaGuardia. Explanatory variables are drawn from an extensive literature survey and reflect a range of environmental and operational causal factors. Adverse weather has the largest impact on expected delay, followed by congestion during the metroplex peak. Airport operations peaks matter if they occur at times when the metroplex is busy. Other significant causal factors include surface congestion and arrivals from congested domestic hubs. The impact of the latter appears to be driven by the proportion of domestic traffic. The complex causal factors of delays suggest that regardless of the empirical approach, airport specificities are important in reducing delays.

Natural disasters and their policy implications for business schools

PurposeThe purpose of this paper is to analyze the impact of Hurricane Sandy and a series of snowstorms that affects two universities in the northeast.Design/methodology/approachA survey instrument was used to assess the educational impact that these storms had on the college students at two AACSB business schools located in the New York City area. Utilizing 519 observations from Hurricane Sandy in 2012 and 441 observations from the snowstorms in the Spring of 2015, the paper is able to document the impact these natural disasters had on the college students in a few selected areas. The paper conducts univariate t-statistics for mean differences, principal component analysis determining eigenvalues, and a multivariate logit model using log likelihood functions.FindingsThe empirical results illustrate that the two different events had different impacts upon the students. In addition, the events in certain circumstances had different impacts upon the student responses between the two universities. Students perceived an increase in preparation by the faculty more significantly when make-up classes were conducted in classrooms as opposed to additional online work. Dorm residents at the suburban university felt greater financial hardship than their counterpart dorm residents at the urban university. Commuter students overall felt an increase in concerns related to their overall education.Originality/valueThe empirical results are robust to multiple specifications, and the authors are able to identify the predominate factors that affected the students during the two natural disasters. The unique survey based nature of the data set provides valuable insights into the students’ behavior that has not previously been documented.

Association between housing, personal capacity factors and community participation among persons with psychiatric disabilities

There is a need to understand which housing and personal capacity factors facilitate and hinder maximum community participation among people with psychiatric disabilities. The present study examined housing and personal capacity factors associated with community participation in a large sample of persons with psychiatric disabilities living in the same neighborhoods (defined by specified zip codes). Three hundred and forty-three persons with psychiatric disabilities were recruited from congregate and independent scatter-site housing programs in 3 New York City-area neighborhoods with high concentrations of housing for persons with psychiatric disabilities. Participants completed measures of community participation, psychiatric symptoms, substance use, independent living-skill, self-efficacy, and coping style. Community participation measures grouped into 3 factors: social community participation, physical community participation, and vocational involvement. Social community participation was associated with negative symptoms and active coping, but not by housing. Independent living-skill moderated the relationship between independent scatter-site housing and social community participation. Physical community participation was associated with negative symptoms, active coping, independent living-skill, and residence in independent scatter-site housing. Vocational involvement was only associated with negative symptoms. Findings suggest that a complex array of personal capacity and housing factors are associated with community participation among persons with psychiatric disabilities.

Modeling pathogens for oceanic contact recreation advisories in the New York City area using total event simulations

A simulation of transport and fate of pathogen indicators for the New York City open waters was completed using a coupled numerical model. Modeled concentrations for Enterococci in receiving waters were extracted from the model and compared with NYC beach observations and NYC Harbor Surveys to validate and bias-correct the result. Results, both before and after bias-correction, were then used to calculate model-based contact recreation advisories and compare to existing advisories: NYC DEP advisory guidance for waterbodies, and NYC DOHMH advisory guidance for NYC beaches. The model was able to simulate the transport and fate of Enterococci. Receiving water Enterococci concentrations grew responsively to rainfall, and decreased notably after rainfall. The model showed the ability to take complexity of natural effects into account, and was conservative in most cases after bias-correction. Based on an exceedance criterion of 110cfu/100mL, simulated Enterococci concentrations exceeded that criterion 54% (109%) of the total advisory days that existing NYC DOHMH guidance would suggest throughout all NYC beaches, on average, before (after) bias-correction. The model exceeded that criterion 217% (246%) of the total advisory days that existing NYC DEP guidance would suggest throughout all NYC waterbodies, on average, before (after) bias-correction. Simulation results were provided to NYC DEP and NYC DOHMH for the refinement of existing advisories.

The Impact of Customer Loyalty and Restaurant Sanitation Grades on Revisit Intention and the Importance of Narrative Information: The Case of New York Restaurant Sanitation Grading System

New York City launched a restaurant sanitation letter grade system in 2010. We evaluate the impact of customer loyalty on restaurant revisit intentions after exposure to a sanitation grade alone, and after exposure to a sanitation grade plus narrative information about sanitation violations (e.g., presence of rats). We use a 2 (loyalty: high or low) × 4 (sanitation grade: A, B, C, or pending) between-subjects full factorial design to test the hypotheses using data from 547 participants recruited from Amazon MTurk who reside in the New York City area. Our study yields three findings. First, loyal customers exhibit higher intentions to revisit restaurants than non-loyal customers, regardless of sanitation letter grades. Second, the difference in revisit intentions between loyal and non-loyal customers is higher when sanitation grades are poorer. Finally, loyal customers are less sensitive to narrative information about sanitation violations.

New York City area could soon see massive floods every 5 years

New York City area could soon see massive floods every 5 years

2093

OBJECTIVES/SPECIFIC AIMS: We aim to examine the epidemiological characteristics of prosopagnosia by querying and analyzing a large deidentified clinical data set from 12 New York City-based hospitals and Federally Qualified Health Centers (FQHCs). The PCORI-funded New York City Clinical Data Research Network (NYC-CDRN) contains ~4.5 million deidentified ICD-coded electronic health records (EHRs) with comprehensive longitudinal information on demographics, patient visits, clinical conditions/diagnoses, laboratory and radiology results, medications, and clinical procedures. The NYC-CDRN will be expanded to include other data sources, including insurance claims, social determinant of health, patient reported outcomes, and patient generated data. The central hypothesis was that systematic mining of this database would reveal new epidemiological information about prosopagnosia. We developed a computable phenotype for prosopagnosia, using the International Classification of Diseases version 9 (ICD-9). The computable phenotype consisted of the diagnostic code for the condition under study, prosopagnosia (ICD-9 code 368.16), as well as the codes for known surrogate diagnoses. We expected to identify cases of acquired prosopagnosia, where the condition occurs only after brain damage, due to stroke, trauma, or meningitis for example, and cases of developmental prosopagnosia, where the condition is present from an early age, with no history of brain damage. The goals of this project were to provide new information about the condition’s prevalence rate in the New York City area, which could be furthermore translated into wider geographical areas and to yield novel details about its antecedents and comorbid conditions. METHODS/STUDY POPULATION: To determine the presence of the diagnosis of interest, prosopagnosia, and common co-occurring conditions among a New York City-based study population, we investigated a large database in collaboration with the NYC-CDRN. At the time the large database was mined it contained ~4 million ICD-9 coded EHRs. We first created a search paradigm; applicable for screening the database that consists of ICD-9 coded EHRs. We generated a list of ICD-9 codes indicative for the patients’ difficulties with the perception of faces (368.16), which indicates the presence of the condition as part of the psychophysical visual disturbances complex, and this code identified 871 patients. Furthermore, we collected codes that indicate the presence of conditions that are known to be surrogate diagnoses of prosopagnosia. ICD-9 codes for surrogate diagnoses included for example, 854.* (coding for personal history of traumatic brain injury, n=1,409), 434.01, 434.11, and 434.91 (coding for cerebral thrombosis, embolus and artery occlusion unspecified with cerebral infarction, n=19,409), and 191.2 (coding for malignant neoplasm of the temporal lobe, n=566). In October 2015, coding was changed to the new ICD-10 coding system. No additional patients were revealed from the data set when the cohort was searched for the presence of corresponding ICD-10 codes, as institutions are currently in transition from ICD-9 to ICD-10. Using this search query with the large database, we extracted novel information about the epidemiological and demographical distribution of prosopagnosia and furthermore, gained new knowledge about commonly associated diseases. The fact that it must be presumed that the majority of diagnoses of prosopagnosia have been made on the basis of patients’ self-reports and clinicians’ judgments represents a limiting factor in this study. We are currently exploring machine-learning strategies to identify potential false-negative cases among the patients with surrogate diagnoses. RESULTS/ANTICIPATED RESULTS: Investigations and application of our search query revealed a total number of n=129,549 patients carrying either the diagnosis code for prosopagnosia or the codes for the known surrogate diagnoses. There were 871 patients who carried the ICD-9 code 368.16, indicating the potential presence of prosopagnosia among other visual disturbances. Remaining patients (n=128,678) carried codes for known surrogate diagnoses, contained in the search query. Statistical analyses revealed elevated odds ratios for men (OR=1.55, 95% CI: 1.36, 1.77, p<0.0001), and for Black/African Americans Versus White individuals (OR=2.09, 95% CI: 1.74, 2.51, p<0.0001). DISCUSSION/SIGNIFICANCE OF IMPACT: Currently, the prevalence of prosopagnosia remains unknown. Face blind individuals are struggling to recognize their social contacts by their face only in every day life and are therefore prone to experience reduced quality of life. We searched the large NYC-based clinical database, containing more than 4.5 million deidentified ICD-coded health records, for cases of prosopagnosia to shed light into its prevalence and epidemiological characteristics. We furthermore, mined the database for cases carrying known surrogate diagnoses to explore the magnitude and characteristics of individuals potentially under increased risk. Our efforts address a great healthcare need, as they revealed new epidemiological knowledge of a vulnerable and understudied population. The results of this project reveal new insights into the epidemiological characteristics of prosopagnosia and its surrogate diagnoses, and demonstrate the feasibility of mining large clinical databases to identify rare clinical populations. Our results suggest the need for a more targeted diagnostic assessment of face perception abilities in populations under increased risk.

“Shopping while Black”: Black consumers’ management of racial stigma and racial profiling in retail settings

This article draws on qualitative interview data collected from 55 African Americans residing in the New York City area to examine African Americans’ experiences of consumer racial profiling or “Shopping While Black.” I find that racial discrimination alters African Americans’ experiences as consumers. Racial stigma in retail settings impacts the consumptive process for Blacks in two central ways. First, retail settings are often sites where anti-Black bias is made evident, requiring Black shoppers to navigate racial hierarchies while procuring goods. Second, discrimination alters the experience of shopping, arguably raising the costs and reducing the rewards derived from consumption. When a store’s sales staff is hesitant to serve Black shoppers or suspects that they are prospective shoplifters, shopping no longer becomes a form of leisure. A qualitative assessment of Blacks’ reports of racial stigma and discrimination in retail settings reveals that race can change the meaning and status attached to goods, when they are sought out or owned by racial minorities. By examining Blacks’ experiences of retail racism and the cultural strategies they adopt in responding to occasions when they are treated discriminatorily, this research brings to light Blacks’ experiences of discrimination on the ground, while also examining how racism impacts the quality of Black consumers’ experiences.

A novel surveillance approach for disaster mental health.

BackgroundDisasters have substantial consequences for population mental health. Social media data present an opportunity for mental health surveillance after disasters to help identify areas of mental health needs. We aimed to 1) identify specific basic emotions from Twitter for the greater New York City area during Hurricane Sandy, which made landfall on October 29, 2012, and to 2) detect and map spatial temporal clusters representing excess risk of these emotions.MethodsWe applied an advanced sentiment analysis on 344,957 Twitter tweets in the study area over eleven days, from October 22 to November 1, 2012, to extract basic emotions, a space-time scan statistic (SaTScan) and a geographic information system (QGIS) to detect and map excess risk of these emotions.ResultsSadness and disgust were among the most prominent emotions identified. Furthermore, we noted 24 spatial clusters of excess risk of basic emotions over time: Four for anger, one for confusion, three for disgust, five for fear, five for sadness, and six for surprise. Of these, anger, confusion, disgust and fear clusters appeared pre disaster, a cluster of surprise was found peri disaster, and a cluster of sadness emerged post disaster.ConclusionsWe proposed a novel syndromic surveillance approach for mental health based on social media data that may support conventional approaches by providing useful additional information in the context of disaster. We showed that excess risk of multiple basic emotions could be mapped in space and time as a step towards anticipating acute stress in the population and identifying community mental health need rapidly and efficiently in the aftermath of disaster. More studies are needed to better control for bias, identify associations with reliable and valid instruments measuring mental health, and to explore computational methods for continued model-fitting, causal relationships, and ongoing evaluation. Our study may be a starting point also for more fully elaborated models that can either prospectively detect mental health risk using real-time social media data or detect excess risk of emotional reactions in areas that lack efficient infrastructure during and after disasters. As such, social media data may be used for mental health surveillance after large scale disasters to help identify areas of mental health needs and to guide us in our knowledge where we may most effectively intervene to reduce the mental health consequences of disasters.

Comparative LCA of concrete with natural and recycled coarse aggregate in the New York City area

The purpose of the present study is to compare the environmental impacts of using coarse natural aggregate (NA) and coarse recycled concrete aggregate (RCA) to produce concrete in the New York City area, by means of a unique LCA framework that incorporates comprehensive regional data. A comparative environmental impact assessment study was performed on the critical processes of the life cycles of NA and RCA concretes. For this purpose, concrete ready-mix plants, construction and demolition waste (CDW) recycling plants, NA quarries, and other producers and distributers of concrete raw materials, in addition to CDW landfills in the New York City area, were located. NA and RCA concrete mix proportions that result in the same compressive strength of concrete were used. Also, the environmental impact that would be caused if CDW was landfilled rather than processed into RCA was measured. In the New York City area, replacing NA with RCA as a concrete aggregate does not affect the environmental impact of concrete production significantly. However, if CDW is recycled only for the purpose of producing concrete aggregate, the avoided landfilling of the CDW will be a result of producing RCA concrete. When avoided landfilling is accounted for, the magnitude of some of the environmental impact indicators for RCA concrete is significantly lower than those of NA concrete (16 and 17% for acidification and smog formation, respectively). In addition, it was found that the impact from transporting RCA to ready-mix plants is on average 37% less than that caused by transporting NA to the plants. Sensitivity analyses and normalization of the results revealed that the environmental impact of changing the type of concrete aggregate from NA to RCA is negligible compared to the total environmental burden of New York City. If RCA concrete is used for all types of construction projects in the NYC area, achieving a significant reduction in the environmental impacts is unlikely. Future work is needed to study specific projects in the region that are categorized based on demand for transportation and cement (the largest environmental stressors of concrete production) to determine for which type of project the use of RCA concrete has the highest environmental benefits.

Primary care physicians' attitudes and beliefs about cancer clinical trials.

Cancer clinical trials give patients access to state-of-the-art treatments and facilitate the translation of findings into mainstream clinical care. However, patients from racial and ethnic minority groups remain underrepresented in clinical trials. Primary care physicians are a trusted source of information for patients, yet their role in decision-making about cancer treatment and referrals to trial participation has received little attention. The aim of this study was to determine physicians' knowledge, attitudes, and beliefs about cancer clinical trials, their experience with trials, and their interest in appropriate training about trials. A total of 613 physicians in the New York City area primarily serving patients from ethnic and racial minority groups were invited via email to participate in a 20-min online survey. Physicians were asked about their patient population, trial knowledge and attitudes, interest in training, and personal demographics. Using calculated scale variables, we used descriptive statistical analyses to better understand physicians' knowledge, attitudes, and beliefs about trials. A total of 127 physicians completed the survey. Overall, they had low knowledge about and little experience with trials. However, they generally had positive attitudes toward trials, with 41.4% indicating a strong interest in learning more about their role in trials, and 35.7% indicating that they might be interested. Results suggest that Black and Latino physicians and those with more positive attitudes and beliefs were more likely to be interested in future training opportunities. Primary care physicians may be an important group to target in trying to improve cancer clinical trial participation among minority patients. Future work should explore methods of educational intervention for such interested providers.

Airport, airline and departure time choice and substitution patterns: An empirical analysis

This paper uses the random-coefficients logit methodology that controls for potential endogeneity of prices and allows for general substitution patterns to estimate various demand systems. The estimation takes advantage of an original ticket-level revealed preference data set on travels from the New York City area to Toronto that contains prices and characteristics of not only flight choices but also of all non-booked alternative flights. Consistent with having higher valuations, our results show that travelers buying closer to departure have a higher utility of flying. Moreover, consumers’ heterogeneity decreases as the flight date nears. At the carrier level, we identify which carriers have more price-sensitive consumers and which carriers face greater competition. In addition, the results suggest that our multi-airport metropolitan area can be considered as a single market and that JFK and Newark are relatively closer substitutes. Overall, consumers are more willing to switch to alternative carriers than between airports or departure times.

The Role of Religiousness/Spirituality and Social Networks in Predicting Depressive Symptoms among Older Korean Americans.

This study (1) examined the effects of religiousness/spirituality and social networks as predictors of depressive symptoms in older Korean Americans and (2) compared the best predictors of depressive symptoms. A cross-sectional survey was conducted with 200 older Korean Americans residing in the New York City area in 2009. Best-subsets regression analyses were used to evaluate the best predictors of depressive symptoms. Nearly 30% of older Korean participants reported mild or severe depressive symptoms. The best model fit for depressive symptoms involved four predictors: physical health status, religious/spiritual coping skills, social networks, and annual household income. Social networks and religious/spiritual coping skills contributed significantly to the variance of depressive symptoms. Adding additional variables to the model did not enhance predictive and descriptive power. Religiousness/spirituality and social networks are important for coping with life stress and may be useful in developing effective health care strategies in the management of depression among older Korean Americans. Health education and intervention could be framed in ways that strengthen such coping resources for this population. Future research is needed to best guide prevention and intervention strategies.

Duration of commute travel changes in the aftermath of Hurricane Sandy using accelerated failure time modeling

This paper used survey data from 397 commuters in the New York City area to determine the transportation-related disruptions and socio-demographic characteristics associated with the duration of home to work commute travel changes after Hurricane Sandy in 2012. The durations examined included those associated with working schedule/location alterations, home-to-work trip delays, telecommuting time, and the alteration of commuting patterns. Accelerated failure time fully parametric duration models, based on the Weibull distribution were used. The models’ significant variables differed. Commuters with higher income or who were highly educated were more likely to prolong the time to return to normal working schedules and increase telecommuting duration. Longer commutes under normal circumstances (based on trip time) prolonged trip delays and the number of days that the commute was changed. Prolonged service recovery periods increased the duration of commute changes and delays, emphasizing the importance of timely transit service restoration. Policies like gas purchase restrictions were found to have trade-offs, since they can prolong the duration of commute changes and create queues at gas stations. Telecommuting can allow commuters to keep their productivity levels high during post-disaster periods.

“Nobody Sees It, Nobody Gets Mad”: Social Media, Privacy, and Personal Responsibility Among Low-SES Youth

While few studies examine the online privacy practices or attitudes of young people of low socio-economic status (SES), they are often at the most risk of and most susceptible to privacy violations. This participatory, collaborative study of 28 low-SES young adults in the New York City area investigates how they view online information sharing. Like most Americans, our participants viewed online privacy as an individual responsibility. We make two primary contributions. First, participants revealed extensive awareness of the risks of sharing information online, and many avoided social media, self-censored, or obfuscated their contributions as a result. Second, many participants had extensive experience with policing and physical surveillance and were aware they could not avoid such encounters through their own efforts. This window into structural discrimination provides an alternate frame to that of “individual responsibility” that educators and researchers can use to conceptualize how privacy is violated online. Framing online privacy violations as inevitable and widespread may not only help foster activist anger and strategic resistance but also avoid the victim-blaming narratives of some media literacy efforts. By examining the experiences of these young people, who are often left out of mainstream discussions about privacy, we hope to show how approaches to managing the interplay of on- and offline information flows are related to marginalized social and economic positions.

Can parked cars and carbon taxes create a profit? The economics of vehicle-to-grid energy storage for peak reduction

This article discusses a five-year, hourly economic model of vehicle-to-grid energy storage for peak reduction. Several scenarios are modeled for a participant using a 60kW-h capacity battery electric vehicle, such as the Tesla Model S or Chevrolet Bolt, in the New York City area using pricing data for the years 2010 through 2014. Sensitivity analysis identifies that variables such as one-way power efficiency and battery lifetime are the major factors influencing the economics of selling electricity back to the grid. Although it is shown that vehicle-to-grid electricity sales can create positive economic benefits, the magnitudes are small due to the cost of added degradation to the vehicle's battery and are not likely to entice the average electric vehicle owner to participate. However, over the five-year period, the potential economic benefits of this technology have shown a promising trend. A carbon dioxide tax is examined as a potential policy measure to encourage vehicle-to-grid adoption. The implementation of a carbon dioxide tax is shown to create additional opportunities for economic gain but, these benefits are dependent on the grid's electricity generation portfolio. Added benefits from the tax are also small in magnitude considering current international carbon prices.