Products like SensePlace2, Twitter-based event detection and analysis system, DataSift, Gnip, SABESS, and others, enable those interested in crime or emergency detection to gather and aggregate publicly-available, geo-located, time-stamped information in real time about where and when an incident may have occurred, who was involved and how serious it was. Because these data are publicly available, issues that other forms of remote sensing bring up in terms of the invasion of privacy are avoided. Further, because reports are on the ground and produced by humans, they may offer information on the context of crimes and their perpetrators and an interpretation of the events that took place rather than leaving this work up to far-removed remote sensing analysts. While connectivity in rural areas is more limited than in urban spaces, the Pew Research Group has found that as of January 2014, 88% of rural Americans have a cellphone and 43% of rural Americans have smartphones, making such data gathering feasible in these areas. Landscape-scale ecological data: Remote sensing of large-scale cannabis production can be validated using landscape-scale ecological data, as well. Down-stream water quality is one way remote sensing of these grow sites can be validated, for example. Large-scale outdoor cannabis grow indoor production can threaten water quality through water diversion, erosion and sediment deposition due to grading, terracing, road construction, deforestation and clearing; as well as the inputs of harmful chemicals or other pollutants, such as rodenticides, fungicides, herbicides, fertilizers, trash, human waste, gasoline, oil and insecticides, into local water sources.

Using stream water quality analysis that picks up the chemical signatures of such pollutants may be one way to affirm that remote sensing analysts were correct in their characterization of given drug production sites. Though no studies using this approach to detect upstream drug growth exist to date, similar methods have been used in the early detection of sudden oak death. Stream monitoring efforts are able to detect Phytophthora ramorum even before signs of infection are even visible from over-flights. Surveys of local populations: The U.S. Bureau of Justice Statistics has conducted a National Crime Victimization Survey since 1973. This survey asks a representative sample of the national population about the frequency, characteristics and consequences of crimes they have experienced. This survey allows the Bureau to estimate the likelihood of victimization for certain subsets of the population in given areas. Because only 90,000 households spread across the United States are surveyed each year,these statistics are too dispersed be used for targeted accuracy assessments of remotely sensed crimes. The techniques used by the Bureau of Justice Statistics may be helpful for this purpose, however. This survey uses in-person or phone interviews that are strictly confidential about the nature of victimizations, where they occurred, the victim’s thoughts as to why these crimes happened and where they happened. Using structured phone interviews in the regions surrounding the remotely sensed sites of crime might be another manner in which analysts could assess the accuracy of their analyses. Conducting such interviews would, of course, require serious attention to maintaining the security and confidentiality of respondents, as well as the security of interviewers themselves. As we pointed out in the Introduction, different crimes occur over different spatial and temporal scales.For example, crimes taking place over larger geographical areas and longer periods of time will be easier to validate.

The second order validation methods we propose here together would be most useful in validating crimes occurring over longer periods of time and larger geographical areas. LBSN can, and has been, used in detecting crimes that happen rapidly and over smaller geographical areas, however. Because this is one of the first efforts in a hopefully fruitful conversation of the topic, we hope that future explorations will explore techniques that are scale specific.Although disparities in life expectancy among PWH continue to persist, there is an increasing prevalence of PWH 50 years of age and older.In addition, a proportion of incident HIV infections is occurring in older adults.As a result, some estimates indicate that over 70% of PWH will be 50 years of age or older by 2030.Compared to people aging without HIV, people aging with HIV experience a greater burden of aging-related conditions, including neurocognitive impairment, kidney disease, liver disease, osteoporosis, cardiovascular disease, and frailty.Understanding the interaction between HIV infection and aging is a high priority to best manage care and treatment for older PWH.In 2009, the annual International Workshop on HIV and Aging began as an effort to address the needs of aging PWH and as a unique opportunity to engage in scientific dialog about the clinical care of, and research with, people aging with HIV. The workshop has three goals: to stimulate and guide research that will enable better treatment methods and strategies for older PWH, to encourage young investigators to engage in research and clinical care of older PWH, and to foster collaborations among investigators, clinicians, advocates, and PWH. For the past decade, the workshop has brought together experts in pertinent cross-disciplinary fields, including basic mechanisms of aging, HIV biology and pathogenesis, clinical geriatrics, endocrinology, pharmacology, neurology, psychology, and social work. The 10th annual International Workshop on HIV and Aging was held on October 10 and 11, 2019, in New York, NY. In this study, we present a summary of the key oral presentations from the workshop, beginning with the current HIV epidemic both in high-income countries and in SubSaharan Africa, and then reviewing advances in understanding phenotypes that overlap between aging and HIV, such as frailty. We also summarize presentations related to factors that contribute to these aging phenotypes, including pathogenesis such as increased coagulation and social factors such as loneliness.

Current morbidity for PWH can be categorized into physical health morbidity , mental health morbidity , co-infections , and syndromes .Prevalence estimates of these morbidities in PWH vary. For example, globally, COPD prevalence is estimated to be 10.5%, 3% of PWH were co-infected with tuberculosis in 2017, 7% of PWH are co-infected with hepatitis B virus, and 6% of PWH are co-infected with hepatitis C virus.A systems biology approach over the life course will consider how factors earlier in life affect future burden of HIV associated comorbidities, co-infections, and complications.In addition, a ‘‘geroprotectors approach’’ to devise interventions that target common mechanisms of aging and delay the onset of more than one age-related disease at the same time may be especially relevant for PWH.With effective test and treat interventions now stimulated by Ending the HIV Epidemic in cities and countries worldwide, the risk profiles for comorbidities among PWH will likely shift.Overall, PWH will continue to age, but simulation models suggest that risk profiles and burden of outcomes will differ for sub-populations of PWH .Changing exposures to duration of uncontrolled viremia before ART initiation, antiretroviral drugs, and early- and mid-life intervention opportunities may also affect future morbidity. Those who have been infected more recently and have benefited from test and treat initiatives in the Treat All era, initiating ART immediately after HIV diagnosis with less toxic ART, may have a reduced burden of comorbidities as they age, compared to those with prior exposure to more toxic ART and longer durations of pretreatment viremia. In addition, there may be more opportunity for early- and mid-life interventions to reduce the prevalence of traditional risk factors for age-related comorbidities through HIV clinical care.Following the initiation of HIV treatment, long-term viral suppression, longer-term effects of current antiviral drugs , and changes in lifestyle behaviors, including substance, use will also influence the future burden of morbidity in PWH.In conclusion, interventions to address HIV-associated comorbidities, co-infections, and complications remain essential to reduce future morbidity for PWH and improve quality of life, even as efforts progress toward ending HIV epidemics around the world32,41; it will be important to consider how these interventions may need to be tailored for different sub-populations of PWH.As ART roll out continues to expand in low- and middle income countries, the aging of the HIV epidemic will be mirrored in sub-Saharan Africa,vertical farming supplies which is home to 70% of the world’s HIV epidemic. The associated increased life expectancy of PWH in this setting will lead to increases in HIV prevalence among older adults.Indeed, modeling by Hontelez et al. using South African data suggests that HIV prevalence among people older than 50 years will nearly double in the next 30 years, and the absolute number of similarly aged PWH will triple in the same period.To sustain the benefits of global investments in HIV care in Africa, there is a need for increased research on determinants of health and quality of life for older PWH in sub-Saharan Africa. To date, most studies of aging with HIV in the region have been cross-sectional, have focused on single comorbidity domains , and lack insight about local preferences for quality of life . In addition, available evidence suggests that some determinants of HIV-associated comorbidities among older PWH in Africa differ from those in the United States and Europe.For example, increased exposure to biomass cooking fuel commonly used in sub-Saharan Africa has been found to be associated with higher odds of metabolic syndrome among PWH in the Eastern Democratic Republic of the Congo.Host genetic predictors of kynurenine pathway of tryptophan metabolism and increase in K/T ratio also have been associated with an increased risk of atherosclerosis, depression, AIDS-related cancer, and all-cause mortality in Ugandan PWH.Elucidating these determinants and their relative contributions to comorbidities among older PWH in sub-Saharan Africa is essential to developing effective interventions to optimize health for a growing population of older PWH in this region.This will require investment in training and research infrastructure for HIV and aging in subSaharan Africa.

Understanding the evolution of frailty can help researchers identify the implications of and interventions for frailty in the context of HIV and aging. In the 1980s, frailty and disability were often considered synonymous, which caused problems in geriatric care and research due to the lack of specificity.The following decade saw an effort by researchers and clinicians to differentiate aging from disease, and further distinguish multi-morbidity, disability, and frailty, which were thought to be different from aging itself. Furthermore, frailty began to emerge as distinct from all of these. Over the last two decades, researchers have identified frailty not only as a unique medical syndrome linked to a particular underlying pathobiology that is aging related but also likely accelerated by catabolic disease.More recently, through the efforts of the National Institute on Aging leadership in geroscience, there is an emerging central thesis of shared biologic pathways that are aging associated and aging driven, which emerge in the presentation of a frailty syndrome and in disease development.The frailty phenotype,the theory for which was operationalized in the Cardiovascular Health Study and later validated in U.S. community-dwelling cohorts,includes five primary characteristics: shrinking, weakness, slowness, poor endurance, and low activity. Individuals with none of the five characteristics were classified as non-frail, those with one or two characteristics as prefrail, and those with three or more as frail. This identification of a constellation of symptoms and signs as diagnostic is consistent with the definition of a clinical syndrome. In subsequent studies, frail individuals had the highest risk of adverse health outcomes when compared to those who were nonfrail or prefrail, independent of disease.When examined together, studies from 1998 to 2008 show that frailty is clinically observable; is not synonymous with multi-morbidity, disability, or extreme old age; increases with age and varies by race and gender; behaves as a clinical syndrome; predicts disability and mortality independent of disease; and is associated with inflammation, and dysregulation of each of the core physiologic systems that regulate stress response and maintain homeostasis.It has a natural progression, with those who are prefrail at the highest risk for becoming frail and those who are frail at highest risk of dying within the next 6–36 months, depending on severity of frailty.Energy is a key factor in frailty, including energy homeostasis, energy production and utilization, and energy dysregulation. Energy is a driver at every level of the syndrome, cellular, physiologic, and phenotypic. When the individual is stressed, such as in challenge studies , frail, prefrail, and nonfrail can be clearly differentiated by the degree of response and rapidity in return to baseline, with the response to stressors in frail delayed and exaggerated, compared to the nonfrail.