The mosquito Aedes aegypti is the principal vector for arboviruses including dengue/yellow fever, chikungunya, and Zika virus, infecting hundreds of millions of people annually. Unfortunately, traditional control methodologies are insufficient, so innovative control methods are needed. To complement existing measures, here we develop a molecular genetic control system termed precision-guided sterile insect technique (pgSIT) in Aedes aegypti. PgSIT uses a simple CRISPR-based approach to generate flightless females and sterile males that are deployable at any life stage. Supported by mathematical models, we empirically demonstrate that released pgSIT males can compete, suppress, and even eliminate mosquito populations. This platform technology could be used in the field, and adapted to many vectors, for controlling wild populations to curtail disease in a safe, confinable, and reversible manner.

Background In the United States, African Americans and whites differ in access to the deceased donor renal transplant waitlist. The extent to which racial disparities in waitlisting differ between United Network for Organ Sharing (UNOS) regions is understudied. Methods The US Renal Data System (USRDS) was linked with US census data to examine time from dialysis initiation to waitlisting for whites (n = 188 410) and African Americans (n = 144 335) using Cox proportional hazards across 11 UNOS regions, adjusting for potentially confounding individual, neighborhood, and state characteristics. Results Likelihood of waitlisting varies significantly by UNOS region, overall and by race. Additionally, African Americans face significantly lower likelihood of waitlisting compared to whites in all but two regions (1 and 6). Overall, 39% of African Americans with ESRD reside in Regions 3 and 4 – regions with a large racial disparity and where African Americans comprise a large proportion of the ESRD population. In these regions, the African American–white disparity is an important contributor to their overall regional disparity. Conclusions Race remains an important factor in time to transplant waitlist in the United States. Race contributes to overall regional disparities; however, the importance of race varies by UNOS region.

Late life living environments are important contexts for aging. Aging-in-Place interventions should address subjective interpretations of place to reduce future risks of cognitive decline.

Background For patients receiving hemodialysis, distance to their dialysis facility may be particularly important due to the need for thrice weekly dialysis. We sought to determine whether African-Americans and Whites differ in proximity and access to high quality dialysis facilities. Methods We analyzed urban, Whites and African-Americans aged 18-65 receiving in-center hemodialysis linked to data on neighborhood and dialysis facility quality measures. In multivariable analyses, we examined the association between individual and neighborhood characteristics, and our outcomes: distance from home zip code to nearest dialysis facility, their current facility and the nearest high quality facility, as well as likelihood of receiving dialysis in a high quality facility. Results African-Americans lived a half mile closer to a dialysis facility (B=-0.52) but traveled the same distance to their own dialysis facility compared to Whites. In initial analysis, African-Americans are 14% less likely than their White counterparts to attend a high quality dialysis facility (OR 0.86); and those disparities persist, though are reduced, even after adjusting for region, neighborhood poverty and percent African-American. In predominately African-American neighborhoods, individuals lived closer to high quality facilities (B=--5.92), but were 53% less likely to receive dialysis there (OR 0.47, highest group versus lowest, p<0.05). Living in a predominately African-American neighborhood explains 24% of racial disparity in attending a high quality facility. Conclusions African-Americans' proximity to high quality facilities does not lead to receiving care there. Institutional and social barriers may also play an important role in where people receive dialysis.